AC. 4365 The Parish of Hackeny. REPORT ON THE SANITARY CONDITION OP THE HACKNEY DISTRICTS FOB THE YEAR 1895 BY J. KING WARRY, M.D. (Lond.), Diplomate in Public Health; Licentiate of the Society of Apotliccarics.; 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; Foreign Associate Member of the Society of Hygiene of France; Medical Officer of Health for the District. London: A. T. Bobbrts, Son & Co., Printers, 5, Hackney Boad, N.E. 1896 INDEX. page Bakehouses 37 Birth Rate g Canal Boats Act 38 Constitutional Diseases 27 Cow Sheds, List of 71 Death Rateiphtheria 11 Dusting Account 60 East London Water Co 43 Estimated Population 4 Factory and Workshop's Act 35 Do. do. (amended) 35 Pood Poisoning at Homerton (Special Report) 24 Health Condition of Hackney Wick (Special Report) 49 Infant Mortality 6 Marriage Rate 5 Meteorology 61 Mortuary 61 Notifiable Diseases 11 Non-Notifiable Diseases 23 Prosecutions under Public Health Act (London) 64 Prosecutions under Food and Drugs Acts 68 Public Health Act (London) 27 Do. do. Bye-Laws 29 Register of Sanitary Work 63 River Lea 40 Removal of House Refuse 55 Spread of Small-Pox 39 Specific Causes of Death 7 Slaughter-Houses, List of 70 Tables— Population, Area and Density in Sub-Districts of Hackney. 5 Births in Sub-Districts 5 Infant Mortality 7 Deaths 8—10 Death Statistics, according to Diseases, Ages and Localities 18—19 Population, Births, and New Cases of Infectious Sickness 20 Notifiable Diseases distributed in Months 22 Influenza 23 Dusting Account 60 Deaths from Diarrhoea 23 Inquests 62 Suicides and Accidental Deaths 62 Zymotic Diseases 17 The parish of hackney. MEDICAL OFFICER'S REPORT FOR THE YEAR 1895, SANITARY DEPARTMENT, Town Hall, Hackney, N.E. To the Members of the Hackney Vestry. Gentlemen, I have the honour to present to you my report upon the health of the District of Hackney, for the year 1895. Several features have rendered the year a most remarkable one. The beginning; of the year was noted for an almost arctic severity of cold, the temperature falling many degrees below freezing point. This was succeeded by a summer of unusual heat and dryness; and these conditions were aggravated by a failure in the supply of the East London Water Company. The combined effects of the above circumstances, as I have remarked, render the year unique from a health point of view; and it is not surprising that the general death-rate was higher than that for some years past, and that the infant mortality rate was much above the average; and on this point it is a singular thing, that while only 160 children, under one year, died during the first 4 quarter, 356 died during the third quarter—the winter was not so fatal as the summer, with its accompanying circumstances. Infectious disease was also more prevalent during the year, as evidenced by a higher death-rate than in the preceding year. A feature in the sanitary administration of the district, was a more systematic distribution of the sanitary work of the district, by dividing the parish into nine areas, and appointing one inspector to each area. These areas are identical with the wards, with the exception of the Homerton Ward, which was divided into two parts, and an inspector appointed to each part. The work done by these inspectors is set out in a table at the end of this report. A re-organisation of the method of collecting the bouse dust has been undergoing trial during the year, with encouraging results. The Sanitary Authority, during the year, adopted the model set of bye-laws of the Local Government Board as to houses let in lodgings; and by this action increased largely the work and usefulness of the sanitary department. The passing by the Legislature of the Factory and Workshops' Act, 1895, has added another beneficial measure to the sanitary laws, and has to a large extent increased the work of the department. On the whole the work of the sanitary department has been characterised by greater thoroughness and a high standard of efficiency, which, if further encouraged and assisted by the Vestry, will ultimately result in an improved standard of public health of thee parish. Population and Density.—Estimating the population of Hackney up to June, 1895, on the rate of increase during the decade ending 1891, I find it to number 215,620. This is an estimated increase of 3,173 persons over that for the previous year. The natural increase, i.e., the increase due to the excess of births over deaths registered during the year, equalled 2,318. The density calculated from the above estimate of population equalled 65.3 persons per acre. The following tables show these facts, also worked out for the various registration sub-districts. 5 Table I.—Showing estimated Population, Area and Density of Registration Sub-Districts in Hackney. Stamford Hill. West Hackney Hackney South Hackney Totals for Hackney. Estimated Population 23,238 44,602 105,497 42,283 215,620 Area in square acres 613 467 1,749 470 3,299 Density=persons per acre 37.9 95.5 60.3 89.9 65.3 Girths.—The births registered during the year 1895 were 6,141; of which 3,191 were males, and 2,947 were females. Compared with 1894 the total shows an increase of 203 births. Calculated as a rate per 1,000 living persons, this is equivalent to an annual birth-rate of 28.4, which is almost identical with that for 1894. The birth-rate for all London for the year 1895 was 30.4 per 1,000. The subjoined table shows the number of births and rates per 1,000 living persons in each sub-district. Table II.—Births. Registration District, of Hackney. Registration Sub-Districts. All London. Stamford Hill. West Hackney- Hackney. South Hackney. No. of Births 6,141 357 1,226 3,181 1,377 325 133,915 Rate per 1000 28.4 15.3 27.4 30.1 30.1 Marriages.—The total number of marriages solemnised in Hackney during the year 1895 was 1,540, which is equivalent to a marriage rate of 14.2 per 1,000. 6 Deaths.—The year 1895 was noted for a large increase in the number of deaths in the Hackney parish. After making the usual corrections, of excluding deaths of persons belonging to other parishes, but dying in Hackney, and including the deaths of Hackney parishioners dying in outside institutions, the total number of deaths amounted to 3,823, of which 1889 were male, and 1934 were female. The above table shows an increase of 524 deaths over the number for the year 1891. The recorded death rate, then, for the Hackney Parish for the year was 17.7 per 1,000 living persons, and multiplying this by 1.05047, the factor for correction for age and sex distribution, the result gives the corrected death-rate; that is, 18.6 per 1,000, showing a difference of 2.3 per 1,000 over 1894. The very severe weather at the beginning of the year is accountable for some of the increase; but the greater part of it, I believe to be due to the high atmospheric temperature, and to the scarcity of water during the months of July and August. Infant Mortality.—The total deaths under one year during 1895, amongst the Hackney population, was 976, of which 356 occurred during the third quarter. The above total is an increase of 174 over that for the year 1894. The infant mortality for the year calculated as a rate per 1,000 births equalled 159 per 1,000. Thus is an abnormally high rate for Hackney. The high temperature, and the lack of sufficient water for domestic and sanitary purposes, during the third quarter, are responsible no doubt for this increase. The rate for all London for 1895 was 165 per 1,000 births. The table below gives the chief causes of death under one year distributed in the four quarters of the year. 7 Table III.—Eleven 'principal causes of Infant Mortality. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. TOTALS. Measles 3 5 9 7 24 Scarlatina 0 1 2 0 3 Whooping Cough 10 6 3 10 29 Teething 7 6 7 3 23 Diarrhœa 5 6 117 13 141 Convulsions 25 21 27 31 104 Lung Diseases 54 36 15 49 154 Tubercular Diseases 8 7 8 8 31 Atrophy and Debility 29 21 49 26 125 Premature Birth 16 23 26 34 99 Accidents & Violence 8 11 9 6 34 Total 165 143 272 187 767 Other Causes 40 38 84 47 209 Totals 205 181 356 234 Grand Total. 976 SPECIFIC CAUSES OF DEATH. Class I. Specific Febrile or Zymotic Diseases.—The deaths from Zymotic diseases during the year number 706, equalling a death-rate of 3.3 per 1,000 persons. This is an increase of .5 per 1,000 upon the rate for 1894. The rate for all London for 1895 was 3.3 per 1,000. 8 TABLE OF DEATHS Of Inhabitants of the Hackney District between 1st Jan. and 31st Dee., 1895. 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 .. .. .. .. .. .. .. .. .. 2 Membranous Croup .. 5 1 .. .. .. .. .. .. .. .. 6 Smallpox. Vaccinated 1 .. .. .. .. .. .. .. .. .. .. 1 Unvaccinat'd .. .. .. .. .. .. .. .. .. .. .. .. Vaccn doubtfl .. .. .. .. .. .. .. .. .. .. .. Measles 24 80 4 .. .. .. .. .. .. .. 108 Scarlet Fever 3 27 11 .. .. .. .. .. .. .. .. 41 Typhus Fever .. .. .. 1 1 .. .. .. .. .. .. 2 oping Cough 29 30 3 .. .. .. .. .. .. .. .. 62 Diphtheria 7 44 18 2 .. .. .. .. .. .. ,, 71 Simple Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 1 3 13 11 8 4 2 1 1 .. .. .. Other Miasmatic .. .. .. .. .. .. .. .. .. .. .. .. English Cholera 2 1 .. .. .. .. .. .. .. .. .. 3 Diarrhoea, Dysentery 141 30 3 .. 3 .. .. 3 5 6 191 Ague, Remittent Fever Hydrophobia Syphilis, &c. 14 1 1 1 17 Erysipelas 2 1 1 1 1 4 10 Pyæmia 2 2 3 1 2 2 3 1 16 Puerperal Fever .. .. 2 5 .. .. .. .. .. .. 7 TlrushVege Parasites 1 .. .. .. .. 1 .. .. .. .. .. 2 Worms, Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism .. .. .. .. 1 5 2 3 .. .. .. 11 Influenza 4 9 1 5 6 16 11 20 31 19 2 124 232 232 46 27 28 33 19 32 42 26 2 - 719 Constitutional Diseases. Rheumatic Fever .. .. 2 1 1 1 1 .. .. .. .. 6 Rheumatism .. .. .. 1 1 .. .. 1 2 1 .. 6 Gout .. .. .. .. .. .. .. 1 1 1 .. 3 Rickets 5 6 .. .. .. .. .. .. .. .. .. 11 Cancer .. 1 1 4 2 .. 37 38 33 9 6 153 Tabes Mesenterica 40 21 1 .. .. .. .. .. .. .. .. 62 Tubercular Meningitis 15 24 3 1 .. .. .. .. .. .. .. 43 Phthisis 1 6 13 45 68 60 65 28 5 1 .. 292 Scrofula, Tuberculosis 15 10 7 11 0 4 2 1 .. .. .. 62 Purpura Hæmorrhagica .. .. .. .. .. .. 1 .. .. .. .. 1 Anaemia, Leucocytha 1 1 .. .. 1 1 .. 1 1 .. .. 6 Diabetes .. .. .. 2 .. 3 1 1 4 1 .. 12 Other Constitutional Diseases 1 1 1 .. .. .. .. 2 .. .. .. 5 - 662 78 76 28 65 79 91 107 73 46 13 6 Developmental Premature Birth 99 .. .. .. .. .. .. .. .. .. .. 99 Malformations 21 1 .. .. .. .. .. .. .. .. .. 22 Old Age .. .. .. .. .. .. .. 1 30 89 63 183 120 1 .. .. .. .. .. 1 30 89 63 - 304 9 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. 05 to 75. 75 to 85. 85 and upwards Totals Nervous Diseases. Inflammation of Brain or Membranes 24 17 8 1 4 3 4 9 5 1 76 Apoplexy, Hemiplegia .. .. .. .. 4 8 17 29 42 24 6 130 Insanity, General Paralysis .. .. .. 4 5 4 9 12 13 18 2 67 Epilepsy .. .. 2 2 .. .. 5 .. .. .. 13 Convulsions 104 18 1 .. .. .. 2 .. .. .. .. 125 Laryngismus Stidulus 2 2 .. .. .. .. .. .. .. .. .. 4 Diseases of Spinal cord •• 0 .... rapl..egia .. .. .. .. .. .. .. .. .. .. 0 Other Nervousdiseases 7 4 3 2 5 2 4 2 7 4 4o 137 41 14 9 20 17 36 57 69 47 8 - 455 Diseases of Circulating Orsans. Peri & Endo-Carditis .. 2 3 1 3 9 Valvular Disease of Heart 3 1.. 7.. 11 15 20 31 41 28 20 5 182 Other diseases of heart .. .. .. 1 .. 3 7 4 3 1 .. 19 Aneurism .. .. .. 1 1 .. .. 3 2 .. ..7 3 1 9 13 19 24 41 48 33 21 5 - 217 Respiratory Organs. Laryngitis 1 3 5 .. .. 1 .. .. .. .. .. 10 Croup 3 8 1 .. .. .. .. .. .. .. .. 12 Asthma .. 1 .. .. .. 1 5 4 3 14 Bronchitis 92 53 5 1 9 8 24 55 91 72 11 421 Pneumonia 55 112 13 5 9 19 16 26 29 8 4 296 Pleurisy 2 1 .. .. 1 2 1 .. 2 .. .. 9 Other Respiratory Dis 1 .. 1 .. .. 1 .. .. 2 1 .. 6 154 178 25 6 19 32 46 85 127 81 15 - 768 Diseases Digestive System. Dentition 23 19 .. .. .. .. .. .. .. .. .. 42 Quinsy, Sore Throat 2 1 .. .. .. 3 Disease of Stomach 4 .. .. .. 2 2 2 2 4 2 .. 18 „ Bowels .. .. .. .. .. .. .. .. .. .. .. 0 Enteritis 50 11 1 2 2 .. 1 1 2 1 71 Obstruction of Intestines 1 .. 1 9, 3 1 1 5 4 2 2 22 Peritonitis 3 3 4 3 11 6 5 3 3 .. .. 41 Spleen .. .. .. .. .. .. .. .. .. .. .. 0 Jaundice, Liver Dis 4 .. 1 3 4 6 12 15 10 2 1 58 85 35 8 10 22 15 21 26 23 7 3 - 255 10 TABLE OF DEATHS—Continued. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards Totals Diseases of Urinary System. Kidney Diseases .. 1 1 .. 1 3 2 5 7 1 .. 21 Nephritis 1 1 4 .. .. 2 3 3 3 1 .. 18 Bright's Disease .. .. .. .. 5 8 8 13 11 1 .. 46 Other Kidney Diseases .. .. .. .. .. .. .. .. .. .. .. 0 Bladder and Prostate .. .. .. .. .. .. .. 1 1 .. 1 3 1 2 5 .. 6 13 13 22 22 3 1 - 88 Diseases of Utercs &c Disease of Uterus .. .. .. .. 1 1 2 .. 1 .. .. 5 Abortion, Flooding .. .. .. .. 2 3 .. .. .. .. .. 5 Puerperal Convulsion .. .. .. .. 1 .. .. .. .. .. .. 1 Ovarian Dropsy .. .. .. .. .. 1 .. 1 .. .. .. 2 .. .. .. .. 4 0 2 1 1 .. .. - 13 Bones and Joints, Ac. Caries, Necrosis .. 1 1 2 1 3 .. .. .. 1 .. 9 Arthritis, Ostitis .. 2 1 .. .. .. 1 .. .. .. .. 4 Carbuncle, Phlegmon .. .. .. .. .. 2 .. .. 1 .. .. 3 Other Skin Diseases 4 .. .. .. .. .. .. .. .. .. .. 4 4 3 2 2 1 5 1 .. 1 1 .. - 20 Violence. Accidents & Violence 34 15 11 6 3 8 5 7 4 7 2 102 Homicide .. .. .. .. 1 .. 1 .. .. .. .. 2 Suicide .. .. .. 1 2 .. 7 1 .. .. .. 12 34 15 11 7 6 8 13 8 5 7 2 - 116 Ill-Defined Causes. Dropsy .. .. 1 .. .. 2 .. 5 2 2 .. 12 Debility and Atrophy 125 8 .. 1 .. .. .. .. 2 1 .. 137 Mortification .. .. .. .. .. .. 1 2 4 2 2 11 Tumour .. .. .. .. 1 2 .. 2 2 .. 1 8 Abscess .. 1 1 4 .. .. 1 .. 1 .. .. 8 Haemorrhage .. .. .. .. .. .. .. 1 .. 1 .. 2 Sudden Deaths (doubtful) 1 .. .. 1 .. .. 3 8 6 4 1 24 Causes not Specified 2 .. .. .. 1 .. .. 1 .. .. .. 4 128 9 2 6 2 4 5 19 17 10 4 - 206 Totals 976 593 150 145 200 247 304 372 416 305 109 3823 11 NOTIFIABLE DISEASES. Small Pox.—During the year 14 cases were notified as small pox, but one ultimately was discovered to be chicken pox. Of the 13 cases, 11 were vaccinated in infancy, but of the remaining two cases one had not been vaccinated, and the other was doubtful. This last case was the only death from this disease during the year. The attack rate was .06 per 1,000 of the population. From inquiries made at the time of notification it appears that three of the above contracted the disease in other districts. Scarlet Fever.—The notifications for this disease for the year under consideration numbered 1,044, of which 41 died. This is a slight increase of notifications upon the number for 1894. Of the total cases 316 were under five years, and 728 above five years old. The total gives an attack rate of 4.8 per 1,000, and a mortality rate of .19 per 1,000 living persons in the Parish. Diphtheria and Membranous Croup.—There was a further decline during the year 1895 in the number of cases of this disease notified, the total number being 494, compared with 522 in 1894. The deaths numbered 77. So that the attack rate for the year was 2.2 per 1,000 the death-rate .35 per 1,000 living persons. The following account of a localised outbreak of diphtheria and sore throat disease in a public institution in Hackney has some features which are, from a public health point of view, worth recording. The outbreak of sore-throat disease and diphtheria, above referred to, occurred amongst the inmates of the King Edward's Industrial School, Andrew's Road. This institution is supported partly by public and partly by private contributions, and affords accommodation for 120 girls. At the period of this illness there were 119 girls in the school, whose ages varied from eight to sixteen years. My attention was first drawn to the cases by the. medical attendant, Dr. Greenwood, who informed me on the 8th November that there were several girls belonging to the institution suffering 12 from sore-throat of a suspiciously diphtheritic type, but some others with sore throat of a simple nature, and a few with slight fever and malaise, but no sore throat, and asked my co-operation to prevent the spread of what was apparently an infectious disease. On seeing the sick girls, I arrived at the same conclusions as Dr. Greenwood—the worst cases taken alone would, perhaps, have justified their being notified as cases of Diphtheria; but the milder cases appeared clinically to deserve only the name of sore throat. I suggested to Dr. Greenwood the advisab.lity of making a bacteriological examination of the exudation on the throats of the worst cases. This was done by Dr. Potts, assistant medical officer to the Homerton Fever Hospital, who wrote me on the following day, that he had found diphtheritic bacilli in large quantities in the cultivation from the throat of one of the patients, and a few from the cultivations of two others. In the first case the bacilli were in sufficient quantity to establish a positive diagnosis. Taking the clinical symptoms of the worst cases with the bacteriological test, I felt convinced I had to deal with a localised outburst of Diphtheria. As there was not sufficient accommodation in the institution for the isolation and treatment of all the cases, I suggested the removal of the worst to the Asylum Board's Hospital, and that convalescing cases should be kept in quarantine— a large dormitory was available for this purpose—and that fresh cases of sore-throat should be immediately isolated. These preventive measures were put into operation immediately. Fresh cases continued to develop until the 18th of the month, when the last was notified. Subsequently, on making inquiry of Dr. Goodall, medical superintendent of the Homerton Fever Hospital, to which the worst cases had been removed, as to their progress, he wrote me, "My own opinion is that these girls suffered from a very mild form of Diphtheria." On inquiry, I learned that there had been a succession of cases of sore throat disease in the school since the 7th of 13 September. The following table, furnished by Miss Gussel, the matron of the institution, shows the order in which the cases arose, etc. Table IV. Date. Name. Age. remarks. 1895 Sept. 7 M. A. M 15 Accompanied by febrile symptoms; remained in bed 3 days, was downstairs again on 11th October. „ 19 F. H 14 Cold and sore threat; raised temperature, headache. „ 25 F. S 13 Similar symptons. „ 25 F. F 11 „ „ „ 26 B. L 12 „ „ throat spotty, down 1st October. „ 26 R. J 15 „ „ but milder. .. 27 E B 13 „ „ throat spotty. .. 27 A. T 15 „ „ milder, down 1st Oct. 27 L. B 12 „ „ „ „ „ 30 E. W 15 „ „ mild. Oct. 1 F. S 9 „ „ „ 1 —F 13 ,; „ very mild, down 5th Oct. „ 3 F. M. A 14 „ „ „ „ „ 3 N. R 9 „ „ „ „ „ 3 —M 14 „ „ „ „ „ 5 — H 14 „ „ very slight, down 7th Oct. „ 6 S. B 10 „ „ „ 6 — L 14 „ „ All above girls on coming d own we re in needle-room for a day or so before going fully among girls. „ 7 E. R 14 Very bad throats; these four cases were removed to the Eastern Hospital on the 9th October. „ 7 V. B 14 „ 7 H. L 14 „ 7 C. G 13 Sore throat, no spots as in former cases, improving after the 3rd day; from this date extreme isolation was put in force, these girls ware not allowed in the School-room until the 18th; were sent into the playground with other convalescents from Infirmary on 15th and following days during absence of the School. All girls (invalids and healthy) gargled with Condy three times daily, tonic was given to all convalescents, and special extra nourishment. „ 8 — H 15 8 E. T 14 ,, 8 S. R 11 „ 8 E. F 14 „ 10 A. P 13 Shivering, headache, considerable weakness. ., 10 E. W 12 Throat spotty. „ 11 R. W 15 „ „ 11 M. N 12 Rather more feverish, throat spotty. „ 12 E. I 15 Throat much ulcerated. „ 13 E. W 15 Mild case. „ 14 M. A 14 Throat painful, but not spotted. „ 17 G. R 12 A mild case. „ 17 —C 14 Very spotted. „ 18 —G 13 Mild case. 14 In inquiring into the cause of this epidemic, I carefully inspected the sanitary arrangements of the institution, but found they were in perfect order, and quite up to date; in fact, the drainage had been entirely re-modelled and re-constructed under the supervision of an eminent sanitary engineer only two years ago. Suspicion as to the milk supply being the cause is entirely removed, by the fact that the milk is always boiled before being used by the children. The water used for drinking is drawn directly from the mains of the East London Water Company, and there is no reason to credit this with causing the disease. The only animal kept on the premises was a oat, which was free from all disease. I also made inquiries as to whether there had been any throat illness amongst the attendants or teachers, but could not hear of any; but on examining the Medical Register of the institution, I found a record of cases of Tonsillitis, Pharyngitis, and Febricula, treated at intervals so far back as 1892, thus— Table V. 1895—June 25th E. N. aged 14 Pharyngitis May 14th L. H. „ 10 Febricula April 4th S. F. „ 13 Tonsillitis 1894—July 7th R. B. „ 13 Febricula June 26th R. B. „ 13 Tonsillitis (ulceration on both tonsils) „ 22nd M.A.F „ 14 Febricula 1893—Dec. 15th E. N. „ 15 Pharyngitis Nov. 13t A. T. „ 13 Tonsillitis (temp. 100°, both tonsils ulcerated) „ 7th E, R. „ 15 Pharyngitis Oct. 24th . E. B. „ 15 Tonsillitis „ 10th A. S. „ 15 Tonsillitis And again in July, 1892, there is a note in the register by the medical attendant: "There seems to have been a slight outbreak of sore throats, but as yet showing no specific characters." This refers to a series of cases numbering sixteen, which occurred during that month in the institution 15 These facts must be considered in connection with a consideration of the physical condition of the girls admitted into the school. The girls admitted are almost all of a low physical type, with a great tendency to catching colds, enlargement of glands, and relaxed throats, with poor circulations, etc., in a word their disposition of body is strumous. Such a condition of body needs only a slight departure from what may be termed its normal condition of health—a condition which may be called one of unstable equilibrium—to exhibit such symptoms as those above recorded as prevalent during the years 1892 to 1895, and needs only the introduction of a specific material, to confer upon a hitherto non-infectious and comparatively harmless affection a specific infectious and harmful character. I do not believe that the cases of 1892-1894 were of a diphtheritic character, but they are a proof that the soil was ready for the reception of the specific germ of Diphtheria, which being introduced by some means in September, 1895, gave to the outbreak in question its specific qualities. The alternative is open for one to suppose that the cases of 1892-94 were diphtheritic, although of an exceedingly mild type, and that they were connected in the way of cause with the cases of last year, the latter exhibiting, owing to some obscure cause, qualities more characteristic of Diphtheria than the former. Inquiry as to the means by which the disease could be introduced was without any certain result. Suspicion fell upon the relatives and friends of the children who are allowed to visit the institution four times a year, but no proof that they introduced the disease was established. The last visiting day before the outbreak was in June. Although the means by which the disease was introduced into the school could not be ascertained, it is very evident from a study of the table supplied by the matron that it spread by the associating of the sick girls with others, before they were 16 entirely free from the disease, this, of course following from a belief in the benign nature of the disease. This epidemic deserves being recorded, because it illustrates in the first place one of the modes in which. Diphtheria is spread, that is, amongst school children at school ages. Secondly, it is an instance of definite cases of Diphtheria being preceded by a series of sore throats or tonsillitis, not presenting any specific characters, and having a duration of three or four days only, an apparent instance of what has been aptly described as "a progressive development of the property of infectiveness." Thirdly, it shows the value of the preventive measures adopted, isolation, quarantine, etc., in checking the spread of the disease, for fresh cases ceased to develop at the end of about a week after their adoption. Fourthly, it is of interest as being the first instance in which the help of bacteriology has been sought by the local authority of Hackney, in order to establish a diagnosis to prepare the way for the adoption of preventive measures. From the experience of this epidemic, I am disposed to regard every case of sore-throat or tonsillitis, occurring in an institution of young people, with grave suspicion. That it may be the forerunner of a series of cases ending in Diphtheria is at least possible, and the only logical deduction is to regard all sore throats in such institutions as infectious, and to recommend their isolation. I think if this were rigidly carried out in schools and similar places, a considerable diminution in the prevalence of Diphtheria would result. Enteric or Typhoid Fever.—The notifications for this disease during 1895 show a large increase upon those for 1894, no less than 256 cases being reported. These are equivalent to an attack rate of nearly 1.2 per 1,000 living persons. The deaths numbered 45, giving a death rate of .21 per 1,000. The death rate for all London for the year was .14 per 1,000. 17 Typhus Fever.—One case of this disease was notified which was fatal. The disease occurred in a religious institution, but owing to prompt preventive interference the disease was confined to that one case. Continued Fever.—Under this name six cases of fever were notified, all of which recovered. Erysipelas.—This disease was very prevalent during the year, no less than 278 cases being notified in Hackney, of which 10 proved fatal. The attack rate was 1.3 per 1,000, and the mortality rate .04 per 1,000 living persons. Cholera.—No case of true Asiatic Cholera occurred in the district during the year, but several fatal cases of English Cholera, or summer diarrhoea were registered, but these are included under the head of Diarrhœa. Puerperal Fever.—Twelve cases of this disease were notified during the twelve months, seven of these being fatal. Efforts were made in each ease to ascertain whether the disease was associated with any previous case of the same disease, but without success; but in several of the cases serious sanitary defects were found in the dwellings where the disease occurred. The mortality rate amounts to 583 per 1,000 persons attacked. 18 19 Table A. 18 TABLE OF DEATHS during the year 1895 in the Hackney Metropolitan 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. 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 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa and 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. Contiuued Relapsing Puerperal (a) (b) (c) (d) (e) (f) (g) (h) (i) Hackney 1444 456 250 48 38 373 279 Under 5 .. 1 13 3 .. 1 .. .. .. 3 2 44 35 84 .. .. 14 133 .. 19 354 706 5 upwds. .. 2 5 .. 2 6 .. .. 3 .. 2 .. 1 4 3 .. 109 151 62 22 366 738 Infirmary 431 23 34 10 27 184 153 Under 5 .. 1 .. .. .. .. .. .. .. .. .. 4 .. 3 .. .. 4 15 .. 3 27 57 5 upwds. .. .. .. .. .. .. .. .. .. .. 2 .. .. 5 2 .. 63 53 35 7 207 374 Workhouse 11 .. .. .. .. 4 7 Under .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 3 1 .. 4 11 City of London Union 2 .. .. .. .. .. 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Barracks 2 .. .. .. .. 2 .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 2 Metropolitan Asylums Fever Hospital 58 3 32 12 4 7 0 Under 5 .. 19 13 .. .. .. . .. .. .. .. 1 .. .. .. .. .. 2 .. .. .. 35 5 upwds. .. 5 5 .. .. 6 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 5 23 German Hospital 21 1 2 1 2 12 3 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 3 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 3 8 6 18 South Hackney 670 235 133 22 16 138 126 Under 5 .. 1 10 1 .. 1 .. .. .. .. 1 30 10 50 .. .. 7 77 2 11 167 368 5 upwds. .. .. 3 .. .. 6 .. .. 2 .. 1 .. 1 3 .. .. 38 70 29 7 142 302 French Hospital 3 .. .. .. .. 1 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 3 Jewish Home and Hospital 1 .. .. .. .. 1 .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 West Hackney 654 178 88 16 18 193 161 Under 5 .. .. 7 1 .. .. .. .. .. .. .. 21 11 31 .. .. 8 55 1 8 123 266 5 upwds. .. .. 3 1 .. 10 .. .. 1 .. .. 3 1 3 .. .. 45 92 43 4 182 388 M. Fever Hospital 45 5 7 3 5 22 3 Under 5 .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 .. 1 4 12 5 upwds. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 9 1 1 2 19 33 Stamford Hill 211 51 22 10 10 64 54 Under 5 .. .. 1 .. .. .. .. .. .. .. .. 3 3 2 .. .. 4 20 .. 3 37 73 5 upwds. .. .. 3 .. .. 3 .. .. 1 .. .. .. .. 1 1 .. 16 22 12 5 74 138 Totals 3553 952 568 122 120 1001 790 Under 5 .. 22 46 5 .. 2 .. .. .. 3 3 103 59 170 .. .. 37 307 3 47 713 1520 5 upwards .. 7 19 1 2 31 .. .. 7 .. 6 4 3 17 6 .. 283 394 187 55 1011 2033 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 there to 270 24 25 28 25 128 40 Under 5 1 8 5 .. .. .. .. .. .. .. .. 1 .. 1 .. .. 1 8 1 2 21 49 5 up wds .. 4 1 .. .. 12 .. .. .. .. 1 .. .. 3 .. .. 33 17 19 12 119 221 Deaths occurring within the district among persons not belonging thereto 507 32 208 102 38 103 24 Under 5 .. 66 107 .. .. .. .. .. .. .. .. 12 .. 5 .. .. 5 15 .. 7 23 240 5 upwds .. 26 58 .. 1 25 .. .. .. .. .. .. .. .. .. .. 42 15 12 19 69 267 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 1895, in the Hackney Metropolitan Sanitary District; classified according to Diseases, Ages and Localities. Names of Localities adopted (or 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 of Sickness in eac??? 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 1895. 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 6 6 7 8 9 10 11 12 13 Smallpox. Scarlatina Diphtheria Membranous Croup. fever 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) Stamford Hill 23,238 357 Under 5 .. 30 8 .. .. .. .. .. .. .. 1 .. 10 3 .. .. .. .. .. .. .. .. 5 upwds. 1 66 25 .. .. 20 2 .. 2 .. 11 .. 19 5 .. .. 4 .. .. .. .. .. West Hackney 44,602 1,226 Under 5 1 55 41 1 .. 1 .. .. .. .. 2 1 19 20 .. .. .. .. .. .. .. .. 5 upwds. 5 137 56 1 .. 48 .. .. 1 .. 32 5 51 18 .. .. 12 .. .. .. .. .. Metropolitan Hospital Under 5 .. 1 1 .. .. .. .. . .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 5 upwds. .. 2 1 .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. Hackney (H) 105497 3,181 Under 5 .. 148 68 7 .. 9 .. .. .. .. 11 .. 55 19 1 .. 2 .. .. .. .. .. 5 upwds. 2 367 146 2 1 113 1 .. 6 .. 138 2 169 36 1 .. 36 .. .. .. .. .. Workhouse Under 5 .. 9 .. .. .. .. .. .. .. .. .. .. 9 .. .. .. .. .. .. .. .. .. 5 upwds. 1 8 .. .. .. 1 .. .. .. .. 10 1 8 .. .. .. 1 .. .. .. .. .. Hackney Union Infirmary Under 5 .. 3 .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. 5 upwds. .. 6 .. .. .. .. .. .. .. .. 3 .. 6 .. .. .. .. .. .. .. .. .. M.A.B. Eastern Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 4 7 .. .. 2 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. German Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Salvation Army Maternity Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Truant School Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. South Hackney 42,283 1,377 Under 5 1 70 38 1 .. 3 .. .. .. .. 12 1 31 15 .. .. .. .. .. .. .. .. 5 upwds. 3 138 71 1 .. 58 3 .. 3 1 57 3 59 18 1 .. 30 1 .. .. .. .. Bethnal Green Overflow Workhouse Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. King Edward Industrial Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. 19 .. .. 1 .. .. .. .. .. .. .. 5 .. .. .. .. .. .. .. .. Totals 215620 6,141 Under 5 2 316 156 9 .. 13 .. .. .. .. 26 2 127 58 1 .. 2 .. .. .. .. .. 5 upwds. 12 728 325 4 1 243 6 .. 12 1 252 11 314 82 2 .. 84 1 .. .. .. .. 22 Table showing the number of cases in Hackney of Notifiable Diseases distributed in each month of the year 1895. Month. Smallpox. Scarlet Fever. Diphtheria Typhus. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Cholera. Membranous Croup. Totals. January .. 37 32 .. 22 1 14 4 .. 1 111 February • • 28 24 .. 5 .. 28 .. .. .. 85 March .. 37 23 .. 4 .. 16 .. .. .. 80 April • • 43 21 .. 8 1 13 .. .. 3 89 May 1 55 35 .. 9 .. 13 1 .. 1 115 June .. 79 25 .. 3 .. 22 .. .. 2 131 July 5 90 31 .. 19 .. 21 .. .. .. 166 August 4 90 29 .. 12 .. 16 3 .. .. 146 September 4 100 61 .. 43 .. 29 .. .. 1 239 October •• 156 78 .. 45 1 36 2 .. 1 319 November .. 191 66 .. 59 3 39 1 .. 1 360 December .. 138 65 .. 27 .. 31 1 .. 3 265 14 1044 481 1 256 6 278 12 1 13 2106 28 NON-NOTIFIABLE DISEASES. Influenza.—This disease caused 124 deaths in Hackney during 1895. the large number of 91 occurring in the month of March. The table below will show the distribution of deaths for several years, in the different months of the year. The mortality rate for this disease for the year is .5 per 1,000, for London .41 per 1,000 persons. Table VI. Deaths from Influenza in each month during the years 1891—1895. Year. Jan. Feb. Mar. Apr. May. June. July. Aug. Sep. Oct. Nov. Dec. 189 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 1895 2 6 91 9 3 1 0 0 2 2 3 5 This table shows a peculiar periodicity in the recurrence of this disease, the quiescent periods being alternately about six and twelve months. Diarrhoea.—The year 1895 was remarkable for the large number cf deaths from this cause, no less than 191 being registered in Hackney; and of these 153 occurred during the third quarter. Of the total 141 occurred amongst children under one year old, and 171 amongst children under five years old. The annual mortality from this cause is, therefore, .88 per 1,000. I have consulted the vital statistics of the district from 1888, but in none of these years can I find so large a number of deaths from this cause as in 1895. I am of opinion that the high temperature and scarcity of water in the third quarter of the year were instrumental in causing this high death rate. Table VII. Deaths from Diarrhœa— 1892. 1893. 1894. 1895. First Quarter 8 5 5 8 Second Quarter 12 29 6 11 Third Quarter 88 102 57 153 Fourth Quarter 5 9 7 19 24 The following report presented to the Vestry during the year on a case of food poisoning, the symptoms of which were diarrhoeal, may fitly come in here. SPECIAL REPORT ON A CASE OF FOOD POISONING AT HOMERTON. I have to report that on June 26th my attention was called to a paragraph in an evening paper, where it was stated that on the preceding Monday a family of nine persons were attacked with symptoms of acute poisoning, some few hours after partaking of a meat pie. Upon this information I made enquiries into the circumstances and ascertained the following facts:— Mr. and Mrs. D., with a family of seven children, lived in a six-roomed house in Homer Road, Homerton, occupying the ground floor, consisting of two rooms and a kitchen, and two bedrooms on the first floor, the remaining room being occupied by a married couple and three children. On Saturday evening, June 22nd, Mrs. D. purchased some meat at a neighbouring butcher's, which she made into a meat pie for the Sunday's dinner. This was cooked on that day, and the whole of the family dined upon it, half only being consumed then. The only other special articles taken by the family on Sunday were some currants and strawberries, some of the children taking the former and others the latter. No bad symptoms were experienced by any member of the family during that day or night. On Monday at mid-day, the remaining half of the meat pie was warmed, and partaken of by the whole family. Up to this time no evil symptoms had manifested themselves; but about half-past two o'clock the baby, aged 1½ years, was taken with vomiting and diarrhoea, and speedily became much collapsed; at the same time a daughter, aged 15, fell ill with the same symptoms; and about three o'clock five other children and the father and mother were seized in the same manner. Dr. Fisher was called in, but subsequently in the evening, the symptoms increasing in severity, the seven children were admitted to the infirmary, the father and mother whose symptoms had not been so severe, remaining at home. Both Dr. Fisher and Dr. Oliver, Assistant Medical Officer to the infirmary, informed me that the symptoms exhibited by the patients, the most prominent of which were vomiting, diarrhoea, and collapse, were typical of food poisoning of some sort. 25 I may here add, that after two days' treatment, the whole of the patients were pronounced out of danger, although on admittance to the infirmary, the condition of the whole family was serious, and that of one boy very critical, but the last improved after the second day also, and at the time of writing all the patients have regained their former health. In enquiring as to the cause of the illness, I ascertained that the milk taken by this family was purchased from the same vendor supplyne other households in the street but these customers were not injuriously affected in any way. The water supplied to this house was drawn from the main supplying the whole street, so that both water and milk must be abandoned as probable causes of the illness. The cause was certainly something taken internally and confined to /the members of the affected family, and taken in the morning on Monday, and great suspicion is attached to the mid-day meal. As stated above, the remaining half of the pie made on Sunday was then consumed. This had been stored in the interval in the living-room, on a shelf above the doorway, and close to the ceiling. The outdoor temperature of Sunday and Monday was very high, reaching respectively 83.3 and 76.8 Fahr. I also learned that the drains of this house, were entirely choked on the Sunday, and that Mr. D. made an attempt to release them on that day, and that the choked drains at the same time gave out a very foul smell which pervaded the room where the food was kept. The walls of this room, together with the other rooms of the house, were very dirty and dilapidated. In addition the washhouse walls were damp, the w.c. apparatus defective, and the bust-bin dilapidated. In a word the house was in a very insanitary state. After careful consideration of the foregoing facts, I am of opinion that the cause of the illness of the family, was the half of pie eaten on the Monday. My reasons for believing so are these. I was assured by Mrs. D. that the meat purchased on the Saturday evening was fresh, of good colour and free from any ,bad odour. Had it been tainted the high temperature of Sunday's baking would have effectually destroyed any organisms present. But the half eaten on Monday was only warmed, and its composition has been materially changed since Sunday. The operation of baking had led to the formation of a certain amount of gelatine, which is a most suitable nutrient medium for the growth of organisms. The foul odours from the choked drain on the Sunday were probably laden with 26 harmful organisms, which obtaining access to the pie, rapidly multiplied, ,at the high temperature of the room, producing a poison, alkaloidal or otherwise, which taken on the Monday with the meat pie produced the symptoms complained of. I was unable to obtain any of the pie, for the jwhole of it was consumed on the Monday; so have no proof from bacteriological analysis to offer in support of the above opinion. Thus. I believe that choked drains evolving foul smells, together with the general insanitary condition of the place, assisted by the high temperature, are responsible for the illness of this family. The symptoms of poisoning coming on so soon after the dinner on Monday, i.e., within two hours, induces me to think that a considerable amount of the poison had been produced in the pie, prior to its being eaten. Had the micro-organisms alone been present, the symptoms would in all probability have been delayed much longer. This case of food poisoning resembles in its history, certain cases which have occurred at different times in various parts of the country, the most notable of which were at (1) Bishop Stortford it. 1882; (2) Whitchurch in 1878; (3) Whitchurch in 1882; (4) Retford in 1887. In the first case the poisonous food was beef; in the second, brawn; in the third, pork; in the last, pork pie. In the whole of the cases there was this similarity, that some of the food was eaten soon after cooking, but no ill effects followed, but that later, the period varying in each case, the food became very poisonous, and produced disastrous results in those eating it. The Homerton case emphasises again the need for removing all sources of effluvia where food is stored, especially during the summer months. Note.—Of course, immediately on the discovery of the defective condition of the drains, etc., at 24, Homer Road, notices .were served on the owner to put the house into a sanitary state. I remain, Gentlemen, yours obediently, J. KING-WARRY, M.D., D.P.H., July 10th, 1895. Medical Officer of Health. 27 Measles.—This disease was not so fatal during 1895 as the previous year, only 108 deaths being due to this cause. These will be equal to an annual death rate of .50 per 1,000 living persons. Whooping Cough.—The deaths registered in Hackney during the year from this cause were 62 against 65 in 1894. The annual death rate was .28 per 1,000. CONSTITUTIONAL DISEASES. Class II. From these diseases 662 persons died during the year, the targe number of 459 being due to tuberculous diseases, and 153 to cancer. The annual mortality rate for this class of disease is, therefore, 3.0 per 1,000. Class III. Developmental.—The deaths from this class numbered 304, and give an annual death rate of 1.4 per 1,000. Class IV. Local Diseases.—From these diseases 1,816 deaths occurred during the year, giving an annual death-rate of 8.4 per 1,000. Class V. Violent Deaths.—From this cause 116 deaths took place during the year. Violence gives an annual death-rate, therefore, of .5 per 1,000. Class VI. Ill-defined Causes.—Under this head 206 deaths were registered uring the twelve months. The death-rate for this class is, therefore, .9 per 1,000. PUBLIC HEALTH (LONDON) ACT, 1891. During the year, 3,521 nuisances were removed under the provisions of this Act. Most of these were abated within a reasonable time, upon the attention of the owner being called to the matter, by means of a preliminary notice or intimation; but in other cases statutory notices had to be served, and in 138 cases legal proceedings had to 28 be resorted to, before the abatement of the nuisance could be assured. In 18 cases where summonses had been applied for, they were withdrawn, as the nuisance was abated at the time of hearing. In five cases the summonses were dismissed, in one instance to amend the summons; but in the instance of the dismissed summonses against the owner of 109, Southgate Road, the Sanitary Committee resolved to appeal to a higher court, as the dismissal involved the principle, as to whether the magistrate or the Sanitary Authority was to be the sole judge, of what constituted proper and sufficient w.c. accommodation. The cases of infectious disease notified by medical practitioners numbered 2,790. This is an increase of 702 over those of 1894, and to this extent the work of the Sanitary department was increased ; for in all cases of infectious disease, except where certified by the medical attendant, the rooms occupied by the patients are fumigated, and in some cases the walls stripped and cleaned and the patients' clothes, bedding, etc., disinfected by high-pressure steam. Hie houses where these cases occurred were inspected, and any nuisance found abated. In accordance with Sec. 60 (4), accommodation was provided for those persons who were compelled to leave their homes during their disinfection. This was necessary in c ne case only. Cowsheds and Slaughterhouses.—All of those cowsheds, where licences had been granted by the London County Council, were inspected and visited by the Sanitary View Committee. The total number visited was 46, which were found in a very satisfactory condition, with one exception. In this instance, the committee resolved to inform the owner that if certain works were not done within a specified time, they would oppose the grant of the licence at the next hearing of applications for licences before the London County Council. The work was not done within the time allowed, and the Council v as accordingly informed of the Sanitary Authority's objection to 29 the licence. After one or two adjournments the tenant has engaged to do all that is required. The slaughter-houses, 37 in number, were all, with few exceptions, found in excellent condition. Bake Houses.—The whole of these were re-inspected during the year, the total number being 108, and notices were served to abate any nuisance present and for periodical cleansing. All required work was done within a reasonable time. This year, 1895, saw the passing of an Act by the Legislature for the amendment of the Factory and Workshops' Acts, embodied in which were several sections, which materially affect the law relating to bake-houses. Smoke Nuisances.—Not less than 290 observations, each lasting on an average from 15 to 20 minutes were made by the inspector during the year, and eleven notices were served to abate this class of nuisance. These notices secured the abatement without recourse to further proceedings. The following bye-laws as to houses let in lodgings, framed under the provisions of the Public Health Act, 1891, were adopted by the Vestry, and received the consent of the Local Government Board during the year: — PUBLIC HEALTH (LONDON) ACT, 1891. BYE-LAWS. Made by the Hackney Vestry, being the Sanitary Authority for the Parish of Hackney, with respect to Houses let in Lodgings, or occupied by Members of more than one Family. Interpretation of Term's. 1. In these bye-laws, unless the context otherwise requires, the following words and expressions have the meanings hereinafter respectively assigned to them; that is to say: — "Sanitary Authority" means the Hackney Vestry; " Lodging-house" means a house or part of a house 30 which is let in lodgings or occupied by members of more than one family. " Landlord," in relation to a house or part of a house which is let in lodgings or occupied by members of more than one family, means the person (whatever may be the nature or extent of his interest in the premises) by whom or on whose behalf such house or part of a house is let in lodgings or for occupation by members of more than one family, or who for the time being receives, or is entitled to receive the profits arising from such letting. "Lodger" in relation to a house or part of a house which is let in lodgings or occupied by members of more than one family, means a person to whom any room or rooms in such house or part of a house may have been let as a lodging or for his use and occupation. Exempted Houses. 2. In either of the following cases a lodging house shall be exempt from the operation of these bye-laws; that is to say : (a) Where the rent or charge payable by each lodger, and exclusive of any charge for the use by such lodger of any furniture, is at a rate of six shillings per week or upwards. (b) Where the rent or charge payable by each lodger, and inclusive of any charge for the use by such lodger of any furniture is at a rate of eight shillings per week or upwards. (a) For fixing the number of persons who may occupy a house or part of a house which is let in lodgings or occupied by members of more than one family. (b) For the registration of houses so let or occupied. (c) For the inspection of such houses. (d) For enforcing drainage for such houses, and for promoting cleanliness and ventilation in such houses. (e) For the cleansing and lime-washing at stated times of the premises. 31 (f) For the taking of precautions in case of any infectious disease. 3. The landlord of a lodging-house, or a lodger therein shall not knowingly cause or suffer a greater number of persons than will admit of the provision of three hundred cubic feet of free air space for each person of an age exceeding ten years, and of one hundred and fifty cubic feet of free air space for each person of an age not exceeding ten years to occupy, at anv one time, as a sleeping apartment, a room which is used exclusively for that purpose, and which is under the control of such landlord, or which has been let to such lodger respectively, as the case may be. 4. The landlord of a lodging-house, or a lodger therein, shall not knowingly cause or suffer a greater number of persons than will admit of the provision of four hundred cubic feet of free air space for each person of an age exceeding ten years, and of two hundred cubic feet of free air space for each person of an age not exceeding ten years to occupy, at any one time, as a sleeping apartment, a room which is not used exclusively for that purpose, and which is under the control of such landlord, or which has been let to such lodger respectively, as the case may be. 5. The landlord of a lodging-house, within a period of fourteen days after he shall have been required by a notice in writing, signed by the Clerk to the Sanitary Authority, and dulv served upon or delivered to such landlord, to supply the information necessary for the registration of such house by the Sanitary Authority, shall , himself or by his agent, duly authorised in that behalf, sign and furnish to the Sanitary Authority a true statement of the following particulars with respect to such house, that is to say: — (a) The total number of rooms in the house. (b) The total number of rooms let in lodgings or occupied by members of more than one family. (c) The manner of use of each room. (d) The number, age, and sex of the occupants of each room used for sleeping. (e) The Christian name and surname of the lessee of each room; and 32 (f) The amount of rent or charge per week payable by each lessee. 6. In any case where the landlord of a lodging-house occupies or resides in any part of the premises, or retains a general possession or control of the premises, such landlord, and in any case where the landlord of a lodging-house does not occupy or reside in any part of the premises, or retain a general possession or control of the premises, every lodger who is entitled to have or to exercise the control of the outer door of the premises shall, at all times when required by the Medical Officer of Health, the Sanitary inspector, or any other officer specially appointed or authorised by the Sanitary Authority in that behalf, afford any such officer free access to the interior of the premises for the purpose of inspection. 7. Every lodger in a lodging-house shall, at all times when required by the Medical Officer of Health, the Sanitary Inspector, or any other officer specially appointed or authorised bv the Sanitary Authority in that behalf, afford any such officer free access for the purpose of inspection to the interior of anv room or rooms which may have, been let to such lodger. 8. Where the Medical Officer of Health, the Sanitary Inspector, or any other officer specially appointed or authorised bv the Sanitary Authority in that behalf, has, for the purpose of inspection, obtained access to the interior of a lodginghouse or to the interior of any room or rooms in such house, a person shall not wilfully obstruct any such officer in the inspection of any part of the premises, or, without reasonable excuse, neglect or refuse, when required by any such officer, to render him such assistance as may be reasonably necessary for the purpose of such inspection. 9. In any case where a lodger in a lodging-house is entitled to the exclusive use of any court, court-yard, area, or other open space within the curtilage of the premises, such lodger, and in any case where two or more lodgers in a lodging-house are entitled to the use in common of any court, court-yard, area, or other open space within the curtilage of the premises, the landlord shall cause such court, court-yard, area, or other open space to be thoroughly cleansed from time to time as often as may be requisite, for the purpose of keeping the same in a cleanly condition, 33 10. The landlord of a lodging-house shall cause every drain or means of drainage with which any water-closet belonging to such house may communicate to be maintained at all times in good order and efficient action. He shall also cause all such means of ventilation as may be nrovided in or in connexion therewith to be maintained at all times in good order. 11. Every lodger in a lodging-house shall cause all solid or liquid filth or refuse to be removed once at least in every day from every room which has been let to him, and shall once at least in every day cause every vessel, utensil, or other receptacle for such filth or refuse to be thoroughly cleansed. 12. In every case where a lodger in a lodging-house is entitled to the exclusive use of any staircase, landing, or passaee in such house, such lodger shall cause every part of such staircase, landing, or passage, to be thoroughly cleansed from time to time as often as may be requisite. 13. A lodger in a lodging-house shall not cause or suffer anv animal to be kept in any room which has been let to such lodger or elsewhere upon the premises in such a manner as to render the condition of such room or premises filthy. 14. The landlord of a lodging-house shall cause every common passage or staircase in such house to be thoroughly cleansed from time to time as often as may be requisite. 15. The landlord of a lodging-house shall, in the first week of the month of April in every year, cause every part of the premises to be cleansed. He shall, at the same time, except in such cases as are hereinafter specified, cause every area, the interior surface of everv ceiling and wall of every water closet belonging to the premises, and the interior surface of every ceiling and wall of everv room staircase, and passage in the house to be thoroughly lime-washed. Provided that the foregoing requirement with respect tc the lime washing of the internal surface of the walls of rooms, staircases, and passages, shall not apply in any case where the internal surface of any such wall is painted, or where 34 the material of or with which such surface is constructed or covered is such as to render the limewashing thereof unsuitable or inexpedient, and where such surface is thoroughly cleansed, and the paint or other covering is renewed, if the renewal thereof be necessary for the purpose of keeping the premises in a cleanly and wholesome condition. 16. The landlord of a lodging-house shall provide adequate means of ventilation in or in connexion with every common passage or staircase in such house, and shall cause such means of ventilation to be maintained at all times in good order. 17. The landlord of a lodging-house shall cause all such means of ventilation as may be provided in or in connection with any room in such house to be maintained at all times in good order. 18. In every case where in pursuance of any statutory provision in that behalf, an order of a justice has been obtained for the removal from a lodging-house to a hospital of a person who is suffering from any dangerous infectious disease and is without proper lodging or accommodation, the landlord of such house, and the lodger to whom any room whereof such person may be an occupant has been let shall, on being informed of such order forthwith take all such steps as may be requisite on the part of such landlord and of such lodger, respectively, to secure the safe and prompt removal of such person in compliance with such order, and shall in and about such removal, adopt all such precautions as, in accordance with any instructions which such landlord and such lodger, respectively mav receive from the Medical Officer of Health of the Sanitary Authority, may be most suitable for the circumstances of the case. Penalties. 19. Every person who shall offend against any of the foregoing bye-laws shall be liable for every such offence to a penalty of five pounds, and in the case of a continuing offence to a further penalty of forty shillings for each day after written notice of the offence from the Sanitary Authority. Provided, nevertheless, that the justices or court before whom any complaint may be made or any proceedings may be taken in respect of any such offence may, if they think fit, 35 adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. Repeal of Regulations. From and after the date of the confirmation of these byelaws the regulations relating to houses let in lodgings which were confirmed on the 14th day of February in the year One Thousand Eight Hundred and Eighty Five by the Local Government Board shall be repealed. The Seal of the Hackney Vestry was hereunto affixed on the thirteenth day of November, 1895. C. BUTTON, Chairman of the Hackney Vestry. HENRY HULLAND, CHARLES MATE, Members. GEORGE GROCOTT, Vestry Clerk Allowed bv the Local Government Board this twenty-fifth day of November, 1895. HENRY CHAPLIN. President. HUGH OWEN, Secretary. FACTORY AND WORKSHOPS' ACTS, 1878-1895. The total number of workshops inspected during 1895 was 170. Out of these, 96 were found in which some nuisance existed requiring abatement; that is, over 56 per cent, of the inspected workshops were found to be in an insanitary condition. The remainder were in a satisfactory condition. At the end of the year the nuisances were abated in 79 of the workshops, and the necessary works for the abatement of the remaining nuisances were in progress. AMENDED ACT RELATING TO FACTORIES AND WORKSHOPS, 1895. The following are the principal sections relating to the Sanitary Authority. 36 Section 1. (1) Fixes the minimum cubic feet of space allowed to each person in a factory or workshop at 250 cubic feet, or, during overtime, 400 cubic feet. (2) Provides that the Secretary of State may by order modify these figures for any period during which artificial light, other than electric light, is used, or as regards any particular manufacturing process or handicraft, substitute higher figures than 250 and 400 respectively. (3) Provides that a notice shall be affixed in each room of factory or workshop, specifying the number of persons who may be employed therein. Section 2. (1) A court of summary jurisdiction may, on complaint by an inspector, prohibit any place being used as a factory or workshop on being satisfied that any manufacturing process carried on there is dangerous to health, life, or limb, until works have been executed which, in the opinion of the Court, would remove the danger. (2) But where proceedings might be taken by or at the mstance of any Sanitary Authority under the provision of the law relating to Public Health, proceedings shall not be taken under (his section, unless the inspector is authorised to take proceedings in pursuance of Sec. 1 or 2 of the Act of 1891. (2) Contravention of any order under this section will render the occupier of the place liable to a fine not exceeding 40 shillings a day during such contravention. Section 3 (1) Provides that where a notice of any act, neglect, or default has been given by the factory inspector to the local authority, it shall be the duty of the Sanitary Authority to inform the inspector of the proceedings taken in consequence of the notice. (2) Substitute for the words "within a reasonable time," in Section 2 of the principal Act, the words "within one month." Section ft (1) This provides that if any occupier of a factory or workshop or contractor employed by him gives out work to be done in any place after the expiration of one month from the receipt of a notice from a factory inspector, that such place is dangerous or injurious to the health of the persons employed therein, and the 37 place is found by the Court having cognizance of the case to be so injurious or dangerous, he shall be liable on summary conviction to a fine not exceeding ten pounds. Section 6 Renders any occupier of a factory or workshop or laundry or contractor employed by such occupier liable to a fine of £5, if he knowingly causes or allows any wearing apparel to be made, cleaned, or repaired in any dwelling house or building occupied therewith, whilst any inmate of the dwelling house is suffering from scarlet fever or small pox. LAUNDRIES. Section 22 (i) (iv) As regards sanitary provision, safety, etc., in the case of laundries this paragraph enacts that the Factory Acts shall have effect as if every laundry in which steam, water, or other mechanical power is used in aid of the laundry process were a factory, and every other laundry were a workshop; and as if every occupier of a laundry were the occupier of a factory or a workshop. (3) Provides that nothing in this Section 22 shall apply to any laundry in which the only persons employed are (c) Members of the same family dwelling there, or in which not more than two persons dwelling elsewhere are employed. BAKEHOUSES. Section 27 (1) applies Section 34 and 35 of the principal Act to all bakehouses, and repeals the limitation of those sections to cities, towns, and places having a population of more than five thousand persons, (2) Repeals the words, "which was not so let or occupied before the first day of June, 1883," in Section 15 of the Factory and Workshop Act, 1883. (3) Prohibits the use of any underground place as a bakehouse, unless it was so used at the commencement of this Act. Section 29 (1) provides that every medical practitioner attending on or called in to visit a patient suffering from lead, phosphorus, 38 or arsenical poisoning or anthrax, contracted in any factory or workshop, shall notify the same to the Chief Inspector of Factories at the Home Office, London, with the name and full postal address of the patient, and the disease from which patient is suffering, for which he will receive the sum of two shillings and sixpense. (2) If a medical practitioner fails to send a notice as required by above, he will be liable to a fine not exceeding forty shillings. Section 41 provides that every person in occupation of a workshop at the commencement of this Act shall, before the expiration of twelve months from its commencement, unless he has already done so, serve on the inspector of the district, a written notice containing the name of the workshop, the place where it is situate, the address to which he desires his letters to be addressed, the nature of the work, and the name of the person or firm under which the business of the workshop is carried on, and in default shall be liable to a fine not exceeding five pounds. Any notice so served shall bo forthwith forwarded to the Sanitary Authority of the district in which the workshop is situate. CANAL BOATS ACTS. At the beginning of 1895 a new arrangement was made for the inspection of canal boats passing through the Hackney District. The arrangement was the appointment of one of the Sanitary Inspectors to devote one whole day per week to this duty. The year's work shows that 82 boats were inspected and re-inspected, that 70 of these were found to conform to the acts and regulations, and 12 were found not to be in accordance with them. The owners of three were prosecuted for not being provided with a certificate of registration, and a fourth owner for not having the boat registered in accordance with the Acts. 39 ON THE SPREAD OF SMALL POX. During the year the following letter on the means to be adopted to prevent the spread of small pox was received by the Hackney Sanitary Authority from the Local Government Board:— Local Government Hoard, Whitehall, S.W., August 2nd, 1895. Sir,—I am directed by the Local Government Board to bring under the attention of the Vestries and District. Boards in the inetropolis the fact that small-pox has recently undergone pome considerable increase in London, and that its extension tends to involve a number of metropolitan sanitary districts. The circumstance is more noteworthy, since at this season of the year small-pox in London is as a rule at its lowest ebb. The Board attach very great importance to the most energetic measures being taken in connection with the cases which are occurring with the view of preventing the spread of infection, and they will be obliged to the authority if they will specially instruct their Medical Officer of Health in every case which may be notified to him, or which may come to his knowledge, immediately to visit the house where the disease has broken out, and at the earliest possible moment to take such measures as may be necessary to secure, as far as practicable, the isolation of the patient, the vaccintion of any persons who may have been exposed to infection, and the disinfection of the premises, and any further action which the circumstances will admit of for the purpose of checking the extension of the disease. The Board deem it desirable that the authority hould as regards each case be informed precisely of the measures which have been taken by the Medical Officer of Health, and they will be glad to be furnished with copies of the reports which are made by him on the subject. I am, Sir, your obedient servant, HUGH .OWEN, Secretary. This letter was considered by the Sanitary Committee on October 3rd, and I was instructed in all future cases of small-pox 40 notified to me, to carry out the wishes of the Local Government Board as expressed in the above letter, and to inform the Board of the measures adopted in each case. Since receiving these instructions, I have not received any notification for this disease. 1 may add, that it has always been my practice to visit the homes of such cases on their notification, in order to be certain that proper measures were adopted to prevent the spread of the disease. RIVER LEA. As regards the quality of the water of this river as it passes through Hackney it remains in much the same condition as during the previous year. It needs great amendment. This is shown by the following report of the Public Analyst on a sample of water taken from the river near the London County Council bathing pool, or. November 1st of last year:— Report on a sample of water received from the Hackney Vestry marked Lea Water, taken near new bathing lake, Hackney Marshes at 2.45 p.m., November 1st, 1895. Received November 2nd, 1895. Total solid residue 40.7 grains per gallon. Organic and volatile matter 9.7 ,, ,, Mineral Residue 31.0 ,, ,, Dissolved solids 37.6 „ „ Suspended matter 3.1 ,, „ Saline ammonia 728 ,, „ Organic ammonia .063 „ ,, Oxygen required to oxidise the organic matter 241 ,, „ Chlorine 4.3 „ „ Nitrates and Nitrites very slight traces. Phosphoric Acid very slight traces. The sample was free from Sulphuretted Hydrogen, and possessed a faint earthy smell; when viewed in a white basin one inch deep it was slightly yellow in tint. The above figures indicate considerable pollution. LEO. TAYLOR, F.I.C., Public Analyst. 41 It is also a matter of common knowledge, that during the hot months of the year, when the flow of the river is at its lowest, the water is at times very offensive, especially in the shallow branches of the river to persons walking near the banks. During the month of April of last year, a letter, of which the following is a copy, was received by the Vestry:— London County Council, Parks and Open Spaces Sub-Department, Spring Gardens, S.W., 24th April, 1895. To the Parks, Ac., N.E. District Sub-Committee. Hackney Marsh. I have to report that I have noticed frequently that the effluent water which is discharged into the River Lea, at a point close to the bathing pool, and which flows, I believe, from the Walthamstow Sewage Farm, is of an offensive character, the smell being very objectionable at times. As it is clearly most objectionable that this state of things should exist in connection with a recreation ground and bathing place, I would suggest that the matter be referred to the Vestry of Hackney, who have, I believe, a power of taking action in such matters. (Signed) JNO. J. SEXBY, Chief Officer. The Sanitary Committee, in reporting to the Vestry on this letter, recapitulated what had been done by the late District Board of Works, and subsequently by the Vestry, to cause an abatement of this nuisance, and further stated— Your Committee are advised that the Hackney Sanitary Authority have not the jurisdiction to take proceedings against the offending district such as that conferred upon the Lea Conservancy Board by the Rivers Pollution Act, 1876., Sec. 9, which provides:— "The Conservancy Board constituted under the Lea Conservancy Act, 1868, shall, within the area of their jurisdiction, have, to the exclusion of any other sanitary authority, the powers for enforcing the provisions of this Act, which sanitary authorities have under this Act.'' 42 It appears therefore to your Committee that the proper authority to take active steps to abate this nuisance is the Lea Conservancy Board, and they therefore recommend, having regard to the difficulties experienced in the past by the late Hackney District Board in their endeavours to prevent the pollution of the River Lea, that the London County Council be asked to bring pressure to bear upon the Lea Conservancy Board with a view to compelling that body to immediately put into force the powers they possess to have this nuisance permanently abated, and that a copy of this report be forwarded to the London County Council in reply to their communication. All of which your Committee respectfully submit. HENRY HULLAND, Chairman. JOSIAH D. DENHAM. WALTER. E. ROWE. As a result of this report some action was taken, I believe by the Lea Conservancy Board, but at present with little result. As the banks of the river are being raised by the London County Council to form walks, I think it is very essential that something further should be done to improve the quality of the water. Since the effluents from the Leyton and Walthamstow sewage farms are no doubt responsible to a large extent for the present unsatisfactory state, the diversion of the effluents from the river into the Metropolitan Drainage System would altogether change the character of the water. Nothing less than this will, in my opinion, effectually remove this nuisance. NEW RIVER WATER COMPANY (CONSTANT SUPPLY). On this subject I have to report that on making inquiries of the London County Council, as to what progress had been made in furnishing that part of Hackney supplied by this Company with a constant supply, I was informed "That the whole of the district in the Parish of Hackney supplied by the New River Company, and 43 now under intermittent supply will be brought under constant supply on the 1st of September next (1896) pursuant to notice given by the Council to the Company in November last." EAST LONDON WATER COMPANY. The most important event during the year from a Public Health point of view was undoubtedly the failure of the East London Water Company to supply the East London Parishes with the necessary water for domestic and sanitary purposes during the autumn. During the year 1894 the supply was curtailed in Hackney during the summer months, but not to the extent or with the results as in 1895. The trouble began towards the end of June, when a letter was received by the Vestry from the Company's Secretary, stating, amongst other things," that in consequence of the unprecedented drought, coupled with the excessive consumption of water, which now amounts to 45 gallons per head per day, they consider it necessary to husband their recources by shutting off the water from the service mains during a portion of the night, until the constant supply can be safely resumed. The whole of the District Mains will be kept continuously charged for fire purposes as usual." To this communication the Sanitary Committee replied that they regretted the Company had considered such a course necessary, but trusted, however, the directors would, especially in the interest of the people residing in the poorer quarters of the Parish, increase the hours of supply to 4 a.m. to 10 p.m., and also asked the Directors to seriously consider the question of resuming the constant service at the earliest possible opportunity. 42 It appears therefore to your Committee that the proper authority to take active steps to abate this nuisance is the Lea Conservancy Board, and they therefore recommend, having regard to the difficulties experienced in the past by the late Hackney District Board in their endeavours to prevent the pollution of the River Lea, that the London County Council be asked to bring pressure to bear upon the Lea Conservancy Board with a view to compelling that body to immediately put into force the powers they possess to have this nuisance permanently abated, and that a copy of this report be forwarded to the London County Council in reply to their communication. All of which your Committee respectfully submit. HENRY HULLAND, Chairman. JOSIAH D. DENHAM. WALTER. E. ROWE. As a result of this report some action was taken, I believe by the Lea Conservancy Board, but at present with little result. Ah the banks of the river are being raised by the London County Council to form walks, I think it is very essential that something further should be done to improve the quality of the water. Since the effluents from the Leyton and Walthamstow sewage farms are no doubt responsible to a large extent for the present unsatisfactory state, the diversion of the effluents from the river into the Metropolitan Drainage System would altogether change the character of the water. Nothing less than this will, in my opinion, effectually remove this nuisance. NEW RIVER WATER COMPANY (CONSTANT SUPPLY). On this subject I have to report that on making inquiries of the London County Council, as to what progress had been made in furnishing that part of Hackney supplied by this Company with a constant supply, I was informed "That the whole of the district in the Parish of Hackney supplied by the New River Company, and 43 now under intermittent supply will be brought under constant supply on the 1st of September next (1896) pursuant to notice given by the Council to the Company in November last." EAST LONDON WATER COMPANY. The most important event during the year from a Public Health point of view was undoubtedly the failure of the East London Water Company to supply the East London Parishes with the necessary water for domestic and sanitary purposes during the autumn. During the year 1894 the supply was curtailed in Hackney during the summer months, but not to the extent or with the results as in 1895. The trouble began towards the end of June, when a letter was received by the Vestry from the Company's Secretary, stating, amongst other things," that in consequence of the unprecedented drought, coupled with the excessive consumption of water, which now amounts to 45 gallons per head per day, they consider it necessary to husband their recources by shutting off the water from the service mains during a portion of the night, until the constant supply can be safely resumed. The whole of the District Mains will be kept continuously charged for fire purposes as usual." To this communication the Sanitary Committee replied that they regretted the Company had considered such a course necessary, but trusted, however, the directors would, especially in the interest of the people residing in the poorer quarters of the Parish, increase the hours of supply to 4 a.m. to 10 p.m., and also asked the Directors to seriously consider the question of resuming the constant service at the earliest possible opportunity. 44 On the 12th July the following notice was issued by the Company:— NOTICE. In consequence of the unprecedented and continuous drought, the hours of supply of water must be materially curtailed. Consumers are requested therefore to store a reserve while the water is on and to abstain from using it for any purpose whatever other than domestic necessities. The watering of gardens by sprinklers and hose is strictly prohibited for the time being. By order, J. A. CROOKENDEN, Secretary. St Helen's Place, E.C., July 12tn, 1895. Up to this time the water had been supplied during the day, but on the 13th it was reduced to three hours during the twentyfour, and for the next two or three weeks, serious complaints were heard on all sides of want of water, insufficient pressure while the supply was on, in addition to complaints of choked drains, waterclosets, etc., and foul emanations from such insanitary conveniences. The number of written complaints received by the Sanitary Department during this period, did not much exceed the usual number at this time of the year, but the reason for this was not that such results did not occur in consequence of the scarcity of water, but that the public early recognised the fact that the Sanitary Authority were as helpless as themselves, and that it was useless to apply to them for a remedy against the action of the Company. Complaints were also general that the sewer ventilators and road gullies were very offensive at this time. And this is what might be expected; for the curtailment of the domestic supply means curtailment of the volume of water passing through the sewers. This state of things continued until the 28th July when the supply was increased to about five or six hours daily. This extension continued until the 17th August, when the supply was further increased to about eleven hours a day, and on the 8th September, the constant service was resumed. 45 Owing to the inconvenience experienced by the inhabitants of the affected parishes, and the danger and injury to health to which they had been exposed, representations were made to the Local Government Board for an inquiry into the causes and consequences of the failure of the Company to continue its constant service. As a result of these representations, the following letter, dated 3rd September, 1895, was received from the Local Government Board:— "I am directed by the President of the Local Government Board to state that having considered the representations which were submitted by the deputation which attended here on the 30th ultimo, he has given directions for the holding of an inquiry as to the circumstances which occasioned a deficiency of the water supply in the Metropolitan area, comprised in the district of the East London Water Works Company, the effects of the deficient water supply, as regards the public health, and the means which should be adopted with a view to preventing a recurrence of such deficiency." Accordingly, on the 1st October, 1895, the inquiry was opened by two inspectors appointed by the Local Government Board, Colonel Ducat, R.E., and F. W. Barry, Esq., M.D., and extended over five days. In. my evidence before the Inspectors, I presented the following tables of increased general death-rate in Hackney over that for Registration London, and increased death-rate from Diarrhoea and enteritis over remainder of Registration London during the five weeks of lowest water supply. I may explain that I included gastroenteritis and enteritis in my calculations, because deaths from Diarrhœa are often registered under these names and vice-versa, and it is to diseases of a diarrhœal nature we should look for evidence of the effects of a scarcity of water, like that experienced last year. 46 Table 1.—Death rates of Hackney Parish and Registration London for the five weeks ending 17th August, 1895. DISTRICT. Population (1891) Deaths. Death Rate per 1000. Parish of Hackney 198,606 448 23.3 Registration London 4,211,734 8,802 21.7 Table 2.—Deaths from Diarrhœa and Enteritis in that portion of Hackney supplied by the East London Water Company, compared with the same in the remainder of London for the five weeks ending 17th August, 1895:— DISTRICT. Population (1891) Deaths from Diarrhœa an Enteritis. DeathRate per 1000. That portion of Hackney Parish supplied by the East London Waterworks Co. 144,131 104 75 The remaining portion of Registration London 4,067,612 1,897 4.8 Table 3.—Deaths from Diarrhœa and Enteritis in that portion of the Parish of Hackney supplied by the East London Water Company, compared with the same in the remainder of London for the year, 1893:— DISTRICT. Population (1891) Deaths from Diarrhoea and Enteritis. Death Rate per 1000.  That portion of Hackney Parish supplied by the East London Waterworks Co. 144,131 146 101 The remaining portion of Registration London 4,067,612 4,392 107 If in Table 2 the death-rate from Diarrhoea and Enteritis for the remaining portion of London be taken as 100, that for the part of Hackney supplied by the East London Water Company is 47 represented by the figure 166, or the ratio between the two deathrates is as 100 to 166. Adopting the same method in Table 3 the ratio is as 100:99, and these latter figures represent the ratio that generally exists between the death-rate of London and Hackney. Upon the effects of the scarcity, I must remark, in the first place, that an insufficient supply of pure water may be of such a degree as to amount only to an inconvenience; on the other hand it may be so great as to become a positive injury to the public health. The extent of such injury involves the question of adequate and proper storage upon the premises; and to a certain extent the provision of what is deemed proper storage, would modify the results of an intermittent supply, but not wholly, for there are dangers attaching to the storage of drinking water upon the premises. Therefore, where no provision for such storage has been made we might expect to see the evil results of an insufficient supply of water in their fullest extent. And there are districts in Hackney where such a provision is altogether absent. There is another point which ought to be mentioned. At the beginning the water supply was cut off at night only, then the day's supply was shortened to three hours. This continued for rather more than two weeks, after which it was again increased, and finally restored. The whole period between the first reduction of the constant service, and its restoration was about two and a half months, but the period during which the results would naturally be most apparent would be the two or three weeks of scantiest supply. Again, a paucity of water may affect a community in several ways. Firstly, it might result in a resort to impure sources to make up for the deficiency and so injuriously affect the health. For instance, if those dwelling near the river Lea used that water for drinking, or if recourse were made to the water of shallow wells, of which there are several in Hackney, the health of the sufferers would very probably suffer. Secondly, a constant and plenteous supply of 48 water is necessary to keep the water carriage system of sewage in a sanitary condition. This is especially necessary during the hot summer months. At this time of the year, all the factors for rapid decomposition of organic matter are present, and any deficiency in water will lead to delay in the removal of offensive organic matter, both from the premises and house drains, and to the evolution of foul odours which would injure the health of those exposed to them. Thirdly, a lack of water will lead to a laxity in personal and domestic cleanliness, and this is especially the case in the poorer districts where their importance and value are not estimated so highly as in other classes and districts; in the case of sick persons to the spread of certain diseases. And at this point the opinion of the Inspectors whose report has just been issued is worth quoting. Commenting on the use of cisterns for storage, the Inspectors go on to say, "Under the best arrangements" (and in certain parts of Hackney the worst arrangements obtained) "there must be times when short periods of interruption of a constant service will occur, and at such times the want of water for domestic purposes, for flushing water closets, sealing water traps, etc., is calculated to lead to conditions injurious to health, which should not be allowed to exist, and which a proper use of really efficient cisterns would guard against." There is no doubt that such "a period of interruption of a constant service," did occur last year, and that there was a "want of water for domestic purposes," and that this did "lead to conditions injurious to health," and as there was a total absence of "really efficient cisterns," to guard againsts such consequences, the inference is obvious, apart from statistics, that such consequences did follow. Further, it can hardly be expected that the results of a scarcity such as that experienced in Hackney, which was brought on gradually, and was of a comparatively short duration, should manifest 49 itself in a large increase in the death-rate, bat that the death-rate did increase during that period above the normal is undoubted. But health-injuring agencies in the vast majority of cases stop far short of being fatal in their effects, and this is recognised in the various Acts of Parliament relating to the public health; otherwise, if we had to prove that every nuisance, which was injuring health, had proved fatal to some individual, very few magisterial orders to abate such nuisances would be made, and very little progress would be made in the Public Health. But while deaths are registered, cases of sickness, with the exception of certain infectious diseases, are not recorded, so the lesser effects of the scarcity of water are not to be estimated, although health injuring; those killed may be numbered, but the injured will never be known. And it was a matter of common knowledge and observation that such minor effects were produced. And making every allowance for fallacies connected with statistics over a short period, and for exaggeration of incidents at a period of mental excitement, I am of opinion for the reasons advanced, that the health of Hackney did suffer seriously during, and in consequence of, the scarcity of water last year. THE HEALTH CONDITIONS OF HACKNEY WICK. The following report, as a result of special instructions, was presented during the year:— Gentlemen,—In accordance with your instructions, I beg to present to you a report upon the Health conditions of that part of Hacknev. known as Hackney Wick. The circumstances, which led you to instruct me to report thereon, were these: On the 27th of July a letter was received by the Vestry from the Medical Officer of Health to the London County Council, stating that a complaint had been made to the Council, that during the four weeks ending July 1st, the death rate had been abnormally high in certain streets of Hackney Wick, and that under the circumstances, the Public Health Committee considered it desirable, that your Medical Officer 50 should report to the Vestry upon the health of this area, and that a copy of such report should be sent on to the Council. The streets named in the Council's communication were Plover Street, Gainsborough Road, Gainsborough Cottages, Gainsborough Square, Windsor Road, Windsor Terrace, Prince Edward Road, Osborn Road, Mallard Street, Bower Road, Daintry Street, Homfray Street, Percy Terace, Victoria Road, Montague Road, Montague Terrace, Felstead Street, Chapman Road, White Post Lane, and Suther Street. These streets represent almost the whole of Hackney Wick, and correspond very closely with the Registrar General's enumeration Districts, Nos. 18, 19, 20 of South Hackney, the population of which was about 7,000 at the last census (1891). Site.—Hackney Wick is built over what was, a quarter of a century ago, a continuation of the present marsh land. The soil, at that time, consisted of a layer of brick earth and alluvium, overlaying the London clay. The brick earth was, in course of time, excavated and used up in the manufacture of bricks, the excavations being ultimately filled in with rubbish, mostly house refuse, the whole area being raised to its present height with the same material, which material varies in depth from 2 ft. to about 7 or 8 feet. The soil of the adjoining marsh consists of alluvium, covering the London clay. The surface levels of Hackney Wick varies from 16 feet above ordnance datum at Windsor and Prince Edward Roads to 20 feet above datum at Gainsborough Road; the level of the marsh adjoining is about 14 feet, above datum. Population.—This, as stated above, was about 7,000 at the last census, mainly of persons of the labouring classes, with a few tradespeople. In the neighbourhood are a few large factories, giving employment to some hundreds of young adults. From a consideration of the death returns and local inquiries I am of opinion) that the population of Hackney Wick consists mainly of young adults, with a large proportion of infants, and very few aged persons. Sewerage and Drainage.—Most of the sewers of this area are formed of 12 in. glazed earthenware pipes; but the size of the Gainsborough Road sewer is 15 in., and a part of Windsor Road has a 5 ft. 6 in. brick-barrel sewer. A very remarkable feature of these sewers is the difference in their gradients. For instance, the 51 following streets have 12 in. sewers, but their gradients vary; for Prince Edward Road and Windsor Terrace the gradient is 1 in 2,000; part of Daintry Street 1 in 756, and the remainder of Daintry Street, 1 in 280; Chapman Road, 1 in 300; in Victoria Road the gradient varies from 1 in 176 to 1 in 416; the 5 ft. 6 in. barrel sewer of Windsor Road has a fall of about 1 in 2,500 and the Gainsborough Road 15 in. sewer has a fall of 1 in 600. The houses are drained mostly on the combined system, in blocks of from five to fifteen, into 9 in. drains, passing into back areas and connected with the road sewers. The gradient of these house drains is very small, an average being about 1 in 120. The whole of the drainage of Hackney Wick is carried into the Council's Hackney Wick branch of the Low Level sewer in Windsor Road, which also receives the Tottenham sewage, and the gradients of the Vestry's sewers is entirely dependent upon the depth of the Council's sewer. I am informed that the level of the sewage in the Council's sewer is generally above the outlet of the Vestry's sewers, so that there is always sewage standing in some of the latter sewers, for some distance from the outlets, and in times of floods this sewage is dammed back into the yards of houses and roads. Statistics.—With respect to the complaint that the deaths were abnormally high during the four weeks ending July 1st, I have to state that on consulting the death returns I find there were 17 deaths only in Hackney Wick, 5 under one year and 12 above. Of those under one year 2 deaths occurred from diarrhoea, and 3 from diseases other than zymotic; of the 12 above one year, 4 died from scarlet fever, and four from diarrhœa, the remaining from other diseases. These 17 deaths give an annual general death rate of 31.7 per 1,000; an infant mortality of 265 per 1,000 births and a zymotic death rate of 18.6 per 1,000. These are much higher than the same rates for the whole of Hackney or; all London for the same period; but any deduction from these figures as to the healthiness of Hackney Wick would be entirely misleading, for it is a fundamental principle in statistics that the accuracy of any deductions increases with the number of observation and vice versa. Briefly, the period to which these rates apply is too short to be any guide to the true rates for Hackney Wick. I have therefore calculated from the returns the general death-rate, infantile death-rate, and zymotic death-rate for Hackney Wick and the whole of Hackney for the years 1891 to 52 1894 inclusive and contrasted them in the following table, from which it appears that the general death-rate does not differ much from that of Hackney, except that it is lower in certain years; but the infant mortality is very much higher than the Hackney rate; the same is true of the zymotic death-rate. Comparative Table showing Death, Infant Mortality, and Zymotic Rates in the Parish of Hackney and Sub-District of Hackney Wick during the following years:— YEARS. HACKNEY. HACKNEY WICK. General Death Rate per 1 000 living. Infant Mortality Rate per 1,000 births. Zymotic Rate per 1,000 living. General Death Rate per 1 000 living. Infant Mortality Rate per 1000 births Zymotic Rate per 1,000 living. 1891 18.45 137 2.0 19.28 222 4.1 1892 18.27 138 2.7 16.71 195 3.5 1893 2615 155 3.2 18.71 252 3.5 1894 17.03 135 2.5 14.14 159 3.3 4 weeks ending July 1st, 1895 13.1 122 3.2 31.7 263 18.6 Population (Census 1891). Total Deaths 1891. Hackney 198,606 3,665 Hackney Wick 7,000 135 This apparent contradiction is not at all difficult to explain. In an earlier part of this Report I stated that the population of Hackney Wick consisted mainly of young adults with a large proportion of infants—this latter is proved by the high birth-rate. The death-rate amongst young adults is always low compared with the general rate; so the result of the above age distribution in Hackney Wick is a general death-rate not above the average for the whole of Hackney—the low death-rate of the adults balancing the high rate of infants. There is in this area an abnormal infantile death-rate and zymotic death-rate—the latter naturally following from the former because symotic diseases find their victims chiefly amongst infants. 53 What is the cause of these high rates amongst the infants of Hackney Wick? In the first place the conditions under which this class of people live, and their habits contribute somewhat towards it. Poverty, unfortunately, is always amongst them; overcrowding with its attendant evils is more or less present; and the necessary attendance of young mothers at workshop, stall, or factory, together with want of experience in the management of the young, increases the danger to infant life. A second cause may be found in the soil upon which the houses are built. I mentioned above that this was formed of house refuse, supported on a bed of clay. The impermeable stratum below retains the moisture in the superficial layers of soil, and as this latter contains a large quantity of organic matter, the ground air becomes damp and charged with organic and deleterious vapours, the products of decomposition. As most of the houses in this area stand immediately over the made soil, with only a few inches of air space intervening between it and the wooder ground floor—a concreted ground floor in this locality is a rarity—the atmosphere of the dwellings, especially at night, is vitiated, and produces a lowering effect upon the health of the inmates. Further, any defective drains or sewers allowing sewage to percolate into the soil in the vicinity of houses will add further to the impurity of the ground air, and possibly for this means specific germs may be conveyed into the dwellings. A third factor which must injuriously affect the public health in Hackney Wick is the unsatisfactory state of the sewers and drains with respect to fall. Even at ordinary times, i.e., during dry weather, the sewage is standing in some of the Vestry's sewers at a varying distance from the outlets, the distance depending upon the rise and fall of the sewage in the Council's sewer in Windsor Road, and this level is kept up by the Tottenham Sewage in addition to the local sewage. This condition of things is much exaggerated during storms. Then the local outlets are entirely covered, the contents dammed back under great pressure, even to the house drains. As a result the soil becomes saturated with sewage, where any defect in drain or sewer exists; and any floors below the road level are liable to flooding. This has recently occurred in the case of the houses of Windsor Road, in consequence of the surcharging of the Council's sewer 54 As to how much each of these conditions contributes towards the increased infantile death-rate in Hackney Wick, it is impossible for me to state; but we do know that wherever the first condition of things exist, i.e., a labouring population amongst whom poverty is rife, with overcrowding and other consequences, there the infantile death rate will be found high. This is well known and exemplified in all manufacturing 'districts. Further!, populations living on made soils have been proved to suffer from a higher infant death-rate than those living on other soils. This was notably the case with certain parts of Liverpool. Indeed the harmfulness of such soils for building sites needs no proof at the present day. It is recognised in the following bye-law made by the London County Council, under the Building Acts: FOUNDATIONS AND SITES OF BUILDINGS. No house, building, or other erection shall be erected upon any site or portion of any site which shall have been filled up or covered with any material impregnated or mixed with any fœcal, animal or vegetable matter, or which shall have been filled up or covered with dust, or slop, or other refuse, or in or upon which any such matter or refuse shall have been deposited, unless and until such matter or refuse shall have been properly removed, by excavation or otherwise from such site. Any holes caused by such excavation, must, if not used for a basement or cellar, bo filled in with hard brick or dry rubbish, or concrete, or other suitable material to be approved by the District Surveyor. The site of every house or building shall be covered with a layer of good concrete, at least six inches thick and smoothed on the upper surface. Lastlv, that sewers laid with an insufficient gradient and subject to overflowing and other effects noted above, are injurious to the health of persons in their neighbourhood, I have ample proof. At this point the question rightly comes in: Is there any practical remedy for the evils existing at Hackney Wick? Those arising from the social condition of the Wick people can only be removed by the diminution of poverty and the spread of education. 55 A remedy against the evils of made soils has been already provided by the Building Act and the Public Health Act, London; the first prohibiting the erectcion of dwellings over such sites, the second prohibiting the deposition of house refuse anywhere near dwellings in London. But these remedies are not retrospective, and in order to benefit Hackney Wick the law as to covering the w hole site of any house with an impermeable concrete floor should be extended to all existing dwellings. I believe the health of the Hackney Wick people would be greatly 'improved by such an alteration. Whether and how a better fall can be obtained for the Vestry's sewers and for the prevention of the overflowing of the London County Council's sewer, it will be for the Engineer to that body to determine. Such improvements, together with perhaps some land drainage to reduce the dampness of the soil, would constitute another remedial work of great value. The Vestry will readily see from the above Report how complex the health injuring agencies are in this locality; but, however complex, their remedy lies in the above recommendations. I remain, gentlemen, yours obediently, J. KING WARRY, M.D., D.P.H., Medical Officer of Health. November 22nd, 1895. REMOVAL OF HOUSE REFUSE. During the year 1895 a total of 43,658 loads (two cubic yards) of house refuse was removed and disposed of by the Vestry s con tractors, at a total cost of £11,046 8s. 7d. The number of loads removed during 1894 was 37,404, at a cost of £8,221 18s.; so that during the year 1895, the loads increased by 6,254, and the total cost by £2,824 10s. 7d. The actual amount paid per load varied during the year. At the beginning of the year the contractors were 56 paid at the rate of 3s. 9d. per load for the North Division, and 5s. 3d. per load for the South Division; but on the 25th of March fresh contracts were made by the Vestry, at rates of 5s. 4d. for the North Division, and 5s. 3d. per load for the South Division, for the remainder of the year; the average price per load for the whole year being 5s. 0¾d. The average price during the year 1894 was 4s. 4¾d. per load, so that the price for the year 1895 increased 8d. per load on that for 1894. This increase in the rate, together with the increase in the loads removed, accounts for the greatly increased total cost for the past year. But in addition to the above cost the sum of £1,934 Os. 8d. was paid to the Vestry's dustmen as wages. This brings the total cost to £12,980 9s. 3d. In my last year's report, I stated that the Hackney Sanitary Authority had resolved to put into operation the following bye-law of the London County Council: — Bye-law sec. 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." This has been strictly followed during the year 1895 with very good results. In the first place, the weekly house-to-house visit led to the detection and removal of large accumulations of house refuse. This may be seen on reference to the tabulated statement below which shows that the greatest number of loads in any month was removed, during the month of January—the first month during which the new system was working. Secondly, it led to a great diminution in the number of written requests to remove the house dust. Comparing the nine months ending December, 1894, with the same month, 1895, we have the following results : — 57 List of Requests for the Removal of Dust received during the Years 1894-95. MONTHS April. May. June. July. August. September. October. November. December. TOTALS. No. of Requests to remove dust during the following months of the year, 1894 98 55 73 64 58 59 73 92 49 621 No. of Bequests to remove dust during the following months of the year, 1895, after deducting refusals 39 36 21 7 10 21 11 15 9 169 Thus during the last nine months of 1894, the large number of 621 requests were received by letter to remove the dust, during the same period in 1895 the number declined to 361, but during the whole of 1895 the weekly house visitation was made by the dustmen, and in a very great number of instances the tenants, for various reasons, mostly connected with convenience, refused to allow the dustmen to remove the refuse. At the beginning of the year no record was kept of these refusals, but at the beginning of April, the du3tmen were instructed to furnish a return every week of all such refusals. The number of refusals at houses, where subsequent complaint of non-removal of dust was made during the last nine months of 1895, was 192; so that the 361 requests noted above must be diminished by 192, which leaves only 169 bona-fide instances of complaint. The experience of the year shows, that on an average, one-fourth of the householders in the parish weekly refuse to allow the dustmen to remove the house refuse. The subjoined table shows the number of refusals for the month of December of last year, but I have reason to believe that householders are becoming 58 more alive to the necessity, from a health point of view, of haying this material speedily and regularly removed from the premises, and I am hoping that it will not be necessary to put into operation the penalty section of the bye-laws. A list of the number of houses where the dustmen were refused admission, to remove the dust during the month ending December 31st, 1895: — Week ending December 7 th 11,640 „ „ 14th 10,937 „ 21st 10,77-5 „ „ 28th 7,942 „ 31st 3,012 Total 44,306 In my last annual report I commented upon the annual increasing cost to the Parish for the removal and disposal of its house refuse, and expressed the opinion that the Vestry ought to undertake the entire removal and destruction by fire of the house refuse of the parish On the 25th of September, 1895, the following report on this subject was submitted by the Sanitary Committee to the Vestry. HE COLLECTION AND DISPOSAL OF HOUSE REFUSE. Adverting to reference from the Vestry of the 9th January last: "That it be an instruction to the Sanitary Committee, to consider the advisability of the Vestry itself undertaking the removal of house refuse, etc., at the expiration of the nresent contract, and to bring up a report, at the earliest possible date." Your Committee have to state that they advised the Vestry at that time of the impracticability of carrying out the reference at the expiration of the existing contract, there not being sufficient time to make the necessary enquiries and arrangements in an important matter of this kind, but that the question was still being considered and would be reported upon in due course. The contract system was 59 accordingly continued for another twelve months, which expires on 25th March next. Your Committee have since given the subject the fullest consideration. and are of opinion that the best method for disposing of the house refuse is by means of a Dust Destructor; firstly, on the ground of public health; secondly on account of the increasing difficulty of obtaining land suitable for depositing upon; thirdly, the refusal of other sanitary authorities to allow the refuse to be deposited upon land within their district, and fourthly, the increasing cost of the contract system. Seeing, however, that the realisation of a combined scheme of Dust Destructors and Electric Lighting may be extended over a considerable period, your Committee think that the time has now arrived when the Vestry should express its approval or otherwise to the principle of doing its own collection and disposal of house refuse, so that an attempt could be made, after a scheme has been presented to the Vestry, to commence the work at an early date without the intervention of a contractor. Your Committee therefore recommend— (a) That the Vestry do undertake the work of collection and disposal of house refuse in the parish. (b) That the system of disposal of the house refuse by Dust Destructor be adopted. (c) If recommendations (a) and (b) be adopted, that the Sanitary Committee be instructed to submit to the Vestry a scheme for the collection and disposal of house refuse. All of which your Committee respectfully submit. HENRY HULLAND, Chairman. JOSIAH D. DENHAM. CHARLES MATE. J. W. ANDERSON J. R. R. ELLIOTT. J. SPENCER; W. L. BEURLE. G. COOK. T. B. TTJGWELL 25th September, 1895 The consideration of this report was adjourned until December 18th, when the Vestry adopted the Committee's recommendations, (a) and (b) but resolved that (c) should be considered at a later 60 date in conjunction with a report of the Electric Lighting Committee, on a combined scheme of electric lighting and dust destruction. Sanitary Labour.— During the year a sum of £689 13s. lOd. was expended on the cleansing and disinfection of rooms and the disinfection of bedding, clothing, and other articles after exposure to infectious disease. DUSTING ACCOUNT, January to December, 1895. MONTH. Northern Division Southern Division Totals. Loads. Cost. Loads. Cost. Loads. Cost. £ 8. d. £ s. d. £ s. d. January 1868 326 18 0 2502 656 15 6 4370 983 13 6 February 1729 302 11 6 2196 576 9 0 3925 879 0 6 March 1802 315 7 0 2376 623 14 0 4178 939 1 0 April 1641 437 12 0 2207 579 6 9 3848 1017 0 9 May 1674 446 8 0 2144 562 16 0 3818 1009 4 0 June 1551 413 12 0 1924 505 1 0 3475 918 13 0 July 1492 397 17 4 1839 482 14 9 3331 880 ii 1 August 1399 373 1 4 1652 433 13 0 3051 806 14 4 September 1501 400 5 4 1690 443 12 6 3191 843 17 10 October .. 1493 398 2 8 1774 465 13 6 3267 863 15 2 November 1623 432 16 0 1901 499 0 3 3524 931 16 3 December 1706 454 18 8 1974 518 3 6 3680 973 1 2 Totals 19479 4699 9 10 24179 6346 19 9 43658 11046 8 7 Dustmen's Wages £1,934 0 8 Sanitary Labour 689 13 10 61 METEOROLOGY. The following table, for which I am indebted to the Secretary of the Royal Meteorological Society, gives an abstract of the Meteorology for the district for the year 1895 : — ABSTRACT OP CLIHATOLOGICAL OBSERVATIONS, St. Luke's, Old Street, E.C. 1895. Temperature. Relative Humidity. Amount of Cloud. Rain. Means. Extremes. Amnt. No. of Days. 9 a.m. Min. Max. Range. Mean. Min. Max. ○ ○ ○ ○ ○ ○ ○ % in. January 34.4 31.0 38.4 7.4 34.7 22.0 51.5 88 8.6 2.03 17 February 29.4 25.4 36.0 10.6 30.7 13.0 44.9 75 8.8 .16 3 March 42.4 37.9 50.0 12.1 44.0 25.4 63.7 83 8.9 1.49 18 April 48.7 42.8 56.6 13.8 49.7 34.0 65.2 79 8.4 1.41 14 May 57.1 47.8 66.4 18.6 57.1 39.2 83.1 69 6.2 .51 6 June 61.5 52.5 71.3 18.8 61.9 44.0 82.1 69 6.3 .15 3 July 63.6 56.0 70.6 14.6 63.3 .. 80.1 71 7.7 3.38 13 August 62.7 55.5 70.2 14.7 62.8 47.8 79.3 75 7.1 2.95 18 September 61.9 53.8 72.7 18.9 63.3 44.0 84.7 78 4.8 1.44 6 October 47.5 43.0 53.2 10.2 48.1 29.6 73.2 84 8.5 3.26 15 November 48.0 44.0 53.1 9.1 48.5 36.2 63.4 89 8.9 2.96 17 December 40.8 37.2 45.3 8.1 41.3 27.8 56.6 88 9.1 2.23 19 Year 49.8 43.9 57.0 13.1 50.5 13.0 84.7 79 7.8 21.97 149 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 1895:— (52 Number of bodies deposited in Mortuary 322 (a). To await inquests 318 (b). Upon request of relatives, to await burial 4 Number of Post-mortems performed 142 INQUESTS. Verdicts. Sex. Male. Female. Natural causes 109 113 Accidental Death 50 18 14 2 0 1 Open Verdict 6 3 Manslaughter ... 1 1 Totals 180 138 Table showing nature of above Suicidal and Accidental Deaths in the Hackney District during the Year ended 1895. SUICIDES. ACCIDENTAL DEATHS. nature ok kuici1jk. No. nature ok accidental death. No. Poisoning 8 Crushed Abdomen 1 Cut Throat 3 Blood Poisoning 1 Drowning 3 Fall 17 Hanging 2 Shock after operation 1 Shock from burns 11 Kick 1 Drowning 8 Run over 9 Shock from scalds 5 Pierced Ear 1 Fracture of Skull 8 „ Thigh 2 Injury to Spine 1 Strangulated 1 Knocked down by Train 1 Total 16 Total 68 68 REGISTER OP SANITARY WORK, 1895. Sanitary Department. SANITARY DISTRICTS. Mr. (lough, Stamford Hill Mr. Harvey, West Hackney Mr. Legg, Hackney Mr. Kemp, Clapton Mr. High, Mare Street, Mr. Bellringer, Kin-island Mr. Punter, South Hackney Mr. Wood. Homerton, N. Mr. Mansell, Homerton. E. Total. Inspections— Made on Complaint 121 339 251 460 416 237 421 453 628 3626 Workshops 3 9 21 14 52 18 39 8 17 181 House to House 34 102 28 20 120 37 27 100 468 Houses after Infectious Disease 185 206 128 255 264 249 187 231 195 1900 Premises re-inspected 1611 2479 2458 2230 2003 2150 1033 3312 3050 20326 Fishmongers'& Poulterers' Yards 10 4 .. 3 3 . . .. 3 10 33 Slaughterhouses 37 .. .. .. .. .. .. .. .. 37 Cow houses (Premises) 37 .. .. .. .. .. .. .. 4 41 „ (Sheds) 46 .. .. .. .. .. .. .. 12 58 Miscellaneous Inspections 3 22 27 10 25 23 .. 33 20 163 Greengrocers' Yards 6 1 .. 1 2 .. .. 3 6 19 Schools 2 .. .. 1 .. .. 1 1 4 9 Bakehouses 7 22 9 11 12 17 2 15 13 108 Urinals 11 25 18 28 16 26 4 24 9 161 Canal Boats 82 .. .. .. .. .. .. .. .. 82 Animals improperly kept .. 3 .. 6 8 .. .. 5 11 33 Statutory Notices served 67 82 22 5 17 17 20 30 14 274 Intimation Notices served 338 477 250 488 460 371 385 568 565 3902 Peremptory or Final Notices served .. 46 .. 29 40 37 53 70 13 288 Proceedings taken before Magistrate under the Sanitary Acts 21 25 46 4 11 5 5 5 13 138 Nuisances abated 320 409 198 421 456 163 529 530 495 3521 Seized and Condemned as Unfit foe Human Food Pish 12 •• .. .. •• •• .. .. .. 12 cwt. cwt. Fruit and Vegetables 2 tons .. .. .. .. .. .. .. 1 cwt. of plums. Tomatoes 2 tons 1 cwt. Meat 28 2 .. 420 .. ¼ .. ¼ 1 2 tons lbs. cwt lbs. cwt cwt. cwt. 19½cwt Other Articles .. 1 .. 100 .. ..• . . .. .. 3 cwt. lb. lbs. 17 lbs. Open Spaces cleared 3 1 2 4 3 .. .. 2 3 18 Food Adulteration— .. .. .. Samples eollec'd for Analysis .. .. .. .. .. .. 200 .. .. 200 Proceeding taken before Magistrates .. .. .. .. .. .. 45 .. .. 45 64 Record of Prosecutions under the Public Health (London) Act, 1891, during ths. year 1895. Address. Complaint. Magistkatk's Decision. 5, 7, 9, Saudringham road Choked and defective drains Order to do work iu 7 days, and pay 2/- costs 11. " " " " " 175, Richmond road Soil pipe unventilated, sink connected to drain " " " 3, Sheperds lane Defective drains Order to do work in 14 days and pay 2/- costs 28, Valentine road.. " " Order to do work in 1 month, and pay 2/- costs 29, " " " " " " " 30, " " " " " " " 31," " " " " " 65, Downs road Insufficient w.c. accommodation Order to do work in 14 days, and pay 2/- costs 171, Brook road No ventilating shaft Order to do work in 1 month 60, Shacklewell lane Smells from defective soil pipe Order to do work in 14 days 119, Almack road Defective drains Order to do work in 14 days, and pay 6/- costs 2, Gore road " " Withdrawn 15, Wellington street " " Order to do work in 14 days, and pay 2/- costs 13, St. Mark's villas " " Order to do work in 7 days, and pay 2/- costs la, Hacknoy Church yard " " Order to do work in 14 days, and pay 2/- costs 30, Colvestone crescent " " " " " Birkbeck works .... Water closet choked Order to do work in 21 days, and pay 2/- costs 5, St. Mark's villas Defective drains Order to do work in 14 days, and pay 6/- costs 8, .. ., " " " " " 11, Saudringham road N o n-c ompliance with justice's order Dismissed (fresh summons to be applied for) 13, St. Mark's villas " " " Withdrawn, owner to pay costs 52, Cricketfield road No water supply to house, to Order to do work in 14 days, and pay 2/- costs 12, Speldhurst road Defective drains Order to do work in 7 days, and pay 6/- costs 109. Southgate road No closet accommodation.. Dismissed 20, Dodd street Uncovered dust cart in Victoria park road Fined 10/-, and 2/ costs 29, Clapton square.. Drains not connected to sewer Withdrawn, work done 30, " " " " " " 33, " " " " " " 34. " " " " " " 8 65 Address. Complaint. Magistrates' Decision. ll.Sandringhain road Drains improperly laid, &c. Order to do work in 7 days 50, Thisttewaite road Inspector refused admissioi. W ithdrawn Waste land, Clarence road Carpet beating Order to do work in 14 days 1, Abbot street Foul,defective and impropei pan in w.c., &c. " " " 45, Colvestone crescent Defoctive and exposed drains, &c " " " 84, High street, Hornerton General insanitary condition Withdrawn 168, Well street Removing fish offal during prohibited hours Pined 10/- 144, Amliurst road Defective drains, &c Withdrawn 6, Half Nichol street Shoreditch Uncovered dust cart in Victoria Park road Pined 10/- 109, Southgate road No w.c. accommodation .. Dismissed 1 la, Clarence road.. Defective drains Order to do work in 14 days 9a, ,, ,, ii ii " " " 77, Richmond road Soil pipe inside house unventilated " " " 81, " " " " " " " " " 9, Millington street Defective drains „ „ 28 days 13, „ " " " " " 11 " " " " " l1 " " " " " " ' " 14, " " " " " " " 285 Mare street. House dirty " " " 13, Clarence road Defective drains " " " 105, Well street General insanitary condition " " " 132, High street, Homerton Soil pipe unventilated " " " 65, Percy road No water supply to house No Order 68, Stamford hill Insufficient paving and drainage, &c. Order to do work in 28 days, and pay 6/- costs 70 , " " " " " " " " " 72, „ " " " " " " 74, „ " " " " " " 76, „ „ " " " " " " 78, „ " " " Order to do work in 28 days, and pay 4/- costs 80, " " " " " Order to do work in 28 days, and pay 4/- costs 82, „ " " " Order to do work in 28 days, and pay 6 - costs 84, " " " " " " " " Cottage, rear of 51, Old Hill street " " " Order to do work in 28 days, and pay 4/- costs Rear of 69, Old Hill street " " " Order to do work in 14 days, and pay 4/- costs " 39, " " " " Withdrawn, notice to be affixed to house " 49, " " " " Order to do work in 28 days, and pay 4/- costs 47, " " " ii ii ii 66 Address. Complaint. Magistrates' Decision. 20, Crozier terrace.. House dirty, &c Order to do work in 14 days 21, " " " " " " " 22, " " " " " 98, Shrubland grove Yard insufficiently paved.. Dismissed 39, Stockmar road.. General insanitary condition Order to do work in 1 month, and pay 1/- costs Pike's Boot Factory, Lyme grove Insufficient w.c. accommodation " " " 42, Crozier terrace.. No ventilation to ground floor, &c. ii ii 21 days 41," " " " " " " " 35, Lavender grove Yard insufficiently paved.. Order to do work in 14 days, and pay 1/- costs 44, Malvern road No ventilating shaft " " " 48, Clarence road General insanitary condition " " " 58, Well street Walls of house damp, &c " " " 28, ., House dirty " " " 125, Evering road General insanitary condition Order to do work in 14 days, and pay 6/- costs 260, Amhurst road " " " Dismissed 65, Bayston road " " " Order to do work in 14 days, and pay 6/- costs 3, High road, Claptor Defective drains Withdrawn 4, " " " " " " ,, 5," " " " " " 11 90, Haggerston road Walls damp, &c Order to do work in 14 days, and pay 1/- costs 79, Evering road Defective drains Order to do work in 7 days, and pay 1/- costs 44, Malvern road .. N o n-c o m p 1 i a n c e with justice's order Penalty Order, 2/- per day, 1'2 days 48, Clarence road .. " " " Penalty Order, 2/- per day, 10 days 12, Marian street .. General insanitary condition Order to do the work in 14 days, and pay 1/- costs 14, " " " " " " " " 65, Bayston road Non-compliance with magistrate's order Withdrawn 69, Clapton common " " " Withdrawn, 2/- costs 39, „" " Mews in an insanitary condition Order to do work in 14 daya, and pay 6/- costs 1, Abbott street N o n-c o m p 1 i a n c e with justice's order Withdrawn, 1/- costs )) a 11 110, Clarence road.. General insanitary condition 9, Millington street N o n-c o m p 11 a n c e with justice's order 11 II II 105, Well street " " " Penalty ordor 1/- per day, 120 days, £6 20, Crozier terrace.. " " " Penalty order 2/- per day 5 days 10/- 21, " " " " " " " " 22, " " " " " " " " 14, Marian street . " " " Penalty order 1/- per day 21 days £1 1. 67 Address. Complaint. Magistrates' Decision. 12, Marian street Non-eompliance with justice's order Penalty order 1/- per day 21 days £1 Is 79, Evering road " " " Penalty order 2/- per day 28 days £2 16s. 68, Jenner road Soil pipe defective, &c. Order to do work in 7 days and pay 1/- costs. 10, Suther street General insanitary condition Order to do work in 1 month and pay 6/- costs. 10,Wallis road " " " " " " 11, " " " " " " " " 12, " " " " " " " " 13, " " " " " " " " 14, " " " " " " " " REGISTER OF SANITARY WORK, 1895. Sanitary Department.— continued. Letters, etc., sent out 2568 Circulars, Notices, etc 7740 Committee Notices sent out 1110 Copies of Summonses and Orders made out 534 Houses from which bedding,etc., was removed to be disinfected by the Board's apparatus. 813 Articles disinfected by the Board's apparatus— Beds 709 Mattresses 340 Palliasses 14 Bolsters 578 Pillows 1403 Blankets 988 Sheets 111 Carpets, Bugs, etc 389 Quilts 310 Other Articles 783 Rooms fumigated 1429 Houses cleansed after Infectious Diseases 540 Disinfectants supplied to the poor (bottles) 1318 Do. do. (bags) 6311 Infectious Patients removed to Hospital 684 Cautionary Notices to Schools re Infectious Sickness 1619 Certificates of Disinfection issued to Schools, etc 1391 Accumulations of Dust specially removed 508 Articles destroyed by request- Beds 20 Mattresses 8 Bolsters 2 Pillows 5 Palliasses 13 Cushions 8 Articles of Clothing 11 Miscellaneous 7 68 Table of Prosecutions under the Food and Drugs Acts and Margarine Acts. No. of Sample. Article. Adulteration or Offence. Result of Legal Proceeding*. Remarks. 138 Milk 10% added water Wrong name and ad dress given, summons not served by the police 139 Milk 12%deficient of cream Fined 20/- & 12/6 costs 148 149 Margarine Margarine Exposed for sale tinlabelled " " „ 20/-,,12/6 „ „ 20/-,,12/6 „ 149 Margarine Served in plain wrapper >t 20/- ,, 2/- ,1 152 Milk 10%deficient of cream 5/- „ I/- „ 153 Milk 35% " " „ 6/-„ 1/- „ 153 Milk 10% added water .. „ s/-„ 1/- „ 157 Milk 15%deficiont of cream Summons dismissed, warranty proved 171 Margarine Exposed for sale unlabeled Fined JE5 & 1/- costs 183 Milk 30% added water „ 10/- „ 11/6 „ 186 Milk 7% " " „ 5/. „ 11/6 „ 187 Milk 8% „ „ Summons dismissed, with £3 3/- & 10,6 costs against the Vestry 194 Margarine Exposed for sale unlabeled Fined 1/- & 12/6 costs 199 Milk 10% added water 10/-„ 7,6 „ 199 Milk 20% cream abstracted 10/- „ 7/- „ 215 Margarine Exposed for sale unlabeled „ 10/6,, 21- „ 215 Batter 90% margarine „ 10/- 226 Milk 27% added water „ 10/- „ 11/6 „ 228 Milk 5% " Dismissed, change of proprietors 241 Milk 6% " Fined 1/- & 12/6 costs 242 Milk 8% " „ 1/-,. 12/6 „ 239 Milk 6% " „ 10/- „ 12/6 „ 69 Table of Prosecutions under the Food and Drugs Acts and Margarine Acts.— continued. No. of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Remarks. 245 Milk 5% added water Dismissed, warranty proved 246 Milk 8% " Fined £5 & 12/6 costs 246 Milk ⅓ of fat abstracted .. „ 1 2/- „ 254 Milk 9% added water . „ 10/- „ 12/6 „ 262 Milk 6% " 12/6 costs 264 Milk 20% " Pined 40/- & 12/6 costs 277 Margarine Exposed for sale unlabelled „ 21- „ 12/6 „ 279 Milk 8% added water „ 5/- „ 12/6 „ 281 Milk 6% " „ 1/- „ 12/6 „ 289 Cocoa 55% starch and sugar 2/- costs 290 Milk 10% added water Fined 10/6 & 2/- costs 293 Milk 8% " Dismissed because of outstanding fine not recovered 296 Milk 17% " Fined 10/6 & 2/- costs 297 Milk 27% „ 5/- „ 2/- „ 305 Milk 34% " „ £3 „ 12/6 „ 307 Milk 10% " 12/6 costs 308 Milk 11% " 12/6 „ 319 Milk 10% " Fined 40/- & 12/6 costs 324 Butter 67% foreign fat Dismissed, sample served in wrapper marked margarine, therefore not to the prejudice of the purchaser 334 Milk 6% added water 12/6 costs 335 Milk 6% " 12/6 „ 336 Milk 16% " 12/6 „ 70 LIST OF LICENSED SLAUGHTER-HOUSES in the Hackney Disteict, October, 1895. Name. Address. Friday, E. 235, Amhurst Road Raymond, E. 186, Cassland Road Hussey, A. J. 37, Church Road, Homerton Shaman, 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., jun. 32, Morning Lane Golding, Geo. 200, Queen's Road, Dalston Miall, E. D 211, Queen's Road, Daistoo Stephenson, Jonathan ... 103, Rendlesham Road Chalkley, F. G. 53, Southgate Road Ebbells, E 94, Southgate Road Row, R. 130, High St., Stoke ATewingten May, A. A. 220, Stoke Newington Road Stoneman, P. 3, Terrace Road Clark, Chas Upper Clapton 71 Tyler, W. Hill, George F. Butcher, F. Friday, R. Wildsmith, S. Browning, John 92, Well Street 169, Well Street 216, Well Street 51, Wilton Road 258, Wick Road West Side, London Fields LIST OF LICENSED COW-SHEDS in the Hackney District, October, 1895. 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. 5. Bridge Street, Homerton 1 Jones, J. 46, Brooksby's Walk, Homerton 1 Jenkins, J. 2, Buckingham Road, Kingsland 2 Thomas ,M. (late French) 72, Church Road, Homerton 1 Lloyd, E. 84, G'lifderi Road, Clapton Park 2 Jenkins 67, Downham Road, Kingsland 1 James, Mrs. 11, Downham Road, Kingsland 1 Davies, Daniel 3, Elsdale Street, Hackney 1 Coxall, T 41, High Street, Homerton 1 Motts, E. 6, Florefield Road, Hackney 1 Larter, George William, trading as J. T. Larter 2, Gloucester Road, South Hackney 1 2 Snewin, W. H. 3, Hill Street, Upper Clapton 1 Rum ball, 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 Dear, A. S. Lea Bridge Road, Ivy Cottage 1 Wingrove, J. T 11, London Lane, Hackney 1 Low, Walter Manor Farm, Hackney Wick 1 72 Warner, J. C. 23, Mare Street 1 Bush, J. Marsh Gdtc, Homerton 1 Low, Edwin Marsh Hill, Homerton 1 Lewis, J. 6, Palace Road, Hackney 1 Harper, Sophia 257, Queen's Road, Dalston 1 Camp, Thomas 79, Shacklewell Lane, Hackney 1 Tasker, J. Sigdon Road, Hackney 1 Williams, W. 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 Total Cow Sheds 1 53 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. I remain, Gentlemen, Yours obediently, J. KING WARRY, M.D., D.P.H., Medical Officer of Health for Hackney. Report of Medical Officer of Health received, and ordered to be printed and circulated in the usual manner. llf/i March, 1896. GEO. CHAMBERS, Chairman of the Vestry.