HAC 5 The Parish of Hackney REPORT ON THE SANITARY CONDITION OF THE HACKNEY DISTRICT, FOR THE YEAR 1897, BY J. KING WARRY, M.D., LOND., M.R.C.P., Diplomate in Public Health; Licentiate of the Society of Apothecaries; Fellow of the Society of Medical Officers of Health; Fellow of the Royal 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. Roberts, Son & Co., Printers, 5, Hackney Road, N.E. 1898. INDEX. PAGE Bakehouses 30 Birth Rate 6 Byelaws (Houses let in Lodgings) 35 Canal Boats Act 31 Constitutional Diseases 27 Cow Sheds, List of 29-94 Customs and Inland Revenue Act 34 Death Rate 6 Diphtheria 14 Dusting Account 61 Enteric Fever 13 Estimated Population 5 Factory and Workshops' Act 30 Flooding of House Basements in Clapton Park 52 Floods at Lea Bridge 48 Hackney Wick 36 Illegitimacy 6 Infant Mortality 8 Infectious Fevers and Drain Effluvia 44 Marriage Rate 6 Measles 24 Meteorology 73 Mortuary 72 Notifiable Diseases 12 Non-Notifiable Diseases 16 Population and Density 4 Prosecutions under Food and Drugs Act 70 Prosecutions under Public Health Act (London) 67 Public Health Act (London) 1891 28 Register of Sanitary Work 66 Removal of House Refuse 58 Report of Conference on Pollution of River Lea 75 River Lea 36 Scarlatina 12 Slaughter-Houses, List of 93 Small-pox 12 Smoke Nuisances 30 Specific Causes of Death 8 Storm Floodings 46 Zymotic Diseases 8 Tables— Analysis of Lea Water 37 Bakehouses 96 Deaths 7-9 Deaths from Diarrhœa 24 Death Statistics, according to Diseases, Ages and Localities 18-21 Dusting Account 61 Infant Mortality Influenza 16 Inquests 72 Population, Area and Density in Sub-Districts of Hackney 1 Population, Births, and New Cases of Infectious Sickness 22 Sewers in Clapton Park 53-56 Requests for Removal of Dust 64 Suicides and Accidental Deaths 72 Vaccination 59 The Parish of Hackney MEDICAL OFFICER'S REPORT. FOR THE YEAR 1897. SANITARY DEPARTMENT, Town Hall, Hackney, N.E. To the Members of the Hackney Vestry. Gentlemen, I beg to present my Report upon the Health of the district of Hackney for the year 1897; and 'in doing so, to congratulate the Vestry upon the fact that in spite of increasing population and density with its attendant risks, the district continues to occupy a prominent place amongst the healthy London districts. The deathrate, although a little higher than that for the year 1896, was lower than the rate for all London. Infectious disease was very prevalent during the year, the nonnotifiable diseases of measles and summer diarrhoea being conspicuous in their fatality. 4 The work of the Department in the abatement of nuisances continues to increase; and much work of a valuable and permanent character has been executed by the Sanitary Inspectors during the year. It would much assist the Department in securing uniformity through the district in drainage matters, if the much delayed regulations of the London County Council on drainage were available for the district. I am pleased to state that the sanitary condition generally of the district has much improved during the last few years, and it may now be said to be in the front rank amongst the London districts in its regard for sanitary matters and the Public Health. I am glad to put on record that the Sanitary Inspectors and staff generally have worked well and to my satisfaction during the past year. Population and Density.—Assuming that the increase of population in the Hackney district has been at the same rate as that during the preceding quinquennium, I estimate the population at the middle of the year 1897 to be 216,651 persons. This, with an acreage of 3299, gives a density of 65 persons per acre. At the beginning of the third quarter of the year, the boundaries and names of the four registration sub-districts of the Parish were altered by order of the Registrar General. The following are the new subdistricts and their boundaries:— 1. All that part of Hackney Parish lying North of a line commencing at Arcola street, Stoke Newington road, on the Western Boundary of the Parish, and passing along the centre of Arcola street, Shacklewell lane, Rectory road, Downs road, Lower Clapton road, Millfields road, and the East London Water Works Company's Canal, until it reaches the Northern Boundary of the Parish at the filter Beds of the said Company, to constitute North Hackney Sub-District. 5 2. All that part of Hackney Parish lying South and East of Hackney North Sub-District, and North of a line commencing at the junction of Arcola street and Shacklewell lane, and passing along the centre of Shacklewell lane, Downs Park road, Norfolk road, Dalston lane, the line of the North London Railway, Bridge street, High street (Homerton), Marsh Hill, Homerton road, and ending at Temple Mills Bridge on the Eastern boundary of the Parish to constitute Central Hackney Sub-District. 3. All that part of Hackney Parish lying South and West of a line commencing at Arcola street, Stoke Newington road, on the Western boundary of the Parish, and passing along the centre of Areola street, Shacklewell lane, Downs Park road, Norfolk road, Dalston lane, the line of the North London Railway, Mare street, and Cambridge road, and ending at the Southern boundary of the Parish, to constitute South-west Hackney Sub-District. 4. All that part of Hackney Parish lying East and South of a line commencing at Cambridge road, at the Southern boundary of the Parish, and passing along the centre of Cambridge road, Mare street, the line of the North London Railway, Bridge street, High street, (Homerton), Marsh Hill, Homerton road, and ending at Temple Mills Bridge on the Eastern boundary of the Parish, to constitute South-east Hackney Sub-District. The following table gives the population and density calculated for the new sub-districts. Table I. Showing estimated Population, Area, and Density of Registration SubDistricts in Hackney, at middle of 1897. North. Central. South West. South East. Total for Hackney Total for London. Estimated Population 48,874 47,042 62,432 58,303 216,651 4 463,169 Area in square acres 1,113 815 601 770 3,299 74,672 Density=persons per acre 43.9 57.7 103.8 75-7 65.6 59.8 6 *Marriages.—The marriages solemnized in Hackney during the year 1897 numbered 1788, an increase of 94 upon the number for 1896. This figure gives a marriage rate for the year of 16.9 per 1,000 living persons. The rate for all London for the same period is 18.5 per 1,000. Births.—The births registered in the district during the year totalled 6,312, which is equivalent to a birth-rate of 29 per 1,000 living. The annual rate for all London for the same period is 30 per 1,000. "Illegitimacy.—The number of illegitimate births registered in Hackney during 1897 was 460; this is an increase of 185 on the previous year, and is equivalent to an illegitimate birth-rate of 72.8 per 1,000 births. From the above total births it is necessary to subtract those brought into Hackney from outlying districts by the Salvation Army Rescue Workers, in order to obtain the true illegitimate birth-rate for Hackney. The number which should be credited to districts outside Hackney is 121, which reduces the total illegitimate births for Hackney to 339, and the illegitimate birth-rate to 53.7 per 1,000 births. Deaths.—The number of deaths registered in Hackney during 1897 was 3,838, of which 1,941 were males, and 1897 were females; but of this total 438 were persons not belonging to the district. In addition, there were 303 deaths of Hackney parishioners in outside districts and institutions. Making these corrections, the total number of deaths to be credited to Hackney is 3,703. This gives an annual mortality rate of 17.0 per 1,000 living persons. Making a further correction for age and sex distribution by means of the factor 1.04645, the true rate for the whole district of Hackney for the year 1897 becomes 17.8 per 1,000 living. This is an increase of .7 per 1,000 on the rate for 1896. The death-rate for all London for the year 1897 is 18.2 per 1,000. The deaths and rates in the old and new registration subdistricts I have worked out in the following tables. In both the rates are annual. •I have here to acknowledge my indebtedness to Mr. Tom Hosgood, Superintendent Registrar, who has kindly abstracted for me the number of marriages and illegitimate births for the year 1897. 7 Table II. Showing the corrected number of deaths in Hackney during the first three quarters of the year distributed in the Registration Sub-Districts, with the annual rate per 1,000 living persons. Hackney. South Hackney. West Hackney. Stamford Hill. All Hackney. Total Deaths registered in the four sub-districts. 1,597 449 526 149 2,721 Deaths occurring in the sub-districts amongst persons not belonging thereto. 236 14 62 2 314 Deaths occurring outside the subdistricts amongst persons belonging thereto 125 45 39 13 222 Corrected No. of Deaths 1,486 480 503 160 2629 Rates per 1,000 living 18.5 14.2 15.3 10.1 16.1 Table III. Showing the corrected number of deaths in Hachney during the fourth quarter of the year distributed in the Registration Sub-Districts, with the annual rates per 1,000 living persons. Central Hackney. South-East Hackney. South-West Hackney. North Hackney. All Hackney. Total Deaths registered in the four sub-districts 300 365 301 151 1117 Deaths occurring in the sub-districts amongst persons not belonging thereto. 81 9 34 124 Deaths occurring outside the subdistricts amongst persons belonging thereto 12 34 23 12 81 Corrected No. of Deaths 231 390 290 163 1074 Rates per 1,000 living 19.6 26.7 121 133 19.8 8 Infant Mortality.—The deaths under one year during 1897 numbered 979, showing a decrease of 31 on the total for 1896. The infant death-rate is therefore equivalent to 137 per 1,000 births. This is a decline of 20 per 1,000 on the rate for the previous year. The largest number of deaths occurred in the third quarter, 137 being due to diarrhoea. The following table gives the eleven chief causes of death under one year in the four quarters of 1897. Table IV.—Eleven principal causes of Infant Mortality. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Totals. Measles 1 5 9 17 32 Scarlatina 1 1 2 3 7 Whooping Cough 7 14 2 13 36 Teething 4 1 5 1 11 Diarrhœa 3 7 139 2 151 Convulsions 15 16 23 18 72 Lung Diseases 34 19 15 74 142 Tubercular Diseases 11 13 21 10 55 Atrophy and Debility 34 24 44 29 131 Premature Birth 30 35 26 27 118 Accidents & Violence 6 6 3 11 26 Total 146 141 289 205 781 Other Causes 40 33 95 30 198 Total 186 174 384 235 979 The infantile death-rate for all London for the same period is 177 per 1,000 births. Senile Mortality.—The deaths over 65 years of age numbered 740, being equivalent to a death-rate of 3.4 per 1000 living. Of the total, 371 were between the ages of 65 and 75 years; 302 between the ages of 75 and 85 years; and 67 above 85 years of age. SPECIFIC CAUSES OF DEATH. Class I. Specific Febrile or Zymotic Diseases.—The deaths from these diseases during the year numbered 912, being an increase of 81 over those of the previous year. The chief of these causes were diphtheria, diarrhoea, measles, whooping cough, and scarlet fever. The death rate for Hackney is 4.2 per 1000, that for all London being 2.5 per 1000. 9 TABLE OF DEATHS Of Inhabitants of the Hackney District between 1st Jan. and 31st Dec., 1897. 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 2 .. .. .. .. .. .. .. .. .. .. 2 Membranous Croup 3 8 .. .. .. .. .. .. .. .. .. 11 Smallpox. Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. Unvaccinat'd .. .. .. .. .. .. .. .. .. .. .. .. Vaccn doubtt .. .. .. .. .. .. .. .. .. .. .. .. Measles 32 96 5 2 .. .. .. .. .. .. .. 135 Scarlet Fever 7 50 18 4 .. .. .. .. .. .. .. 79 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough. 36 57 1 .. .. .. .. .. .. .. .. 94 Diphtheria 17 151 92 2 .. 2 .. 1 .. .. .. 265 Simple Fever .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. 1 9 12 7 5 2 1 .. .. .. 37 Other Miasmatic .. .. .. .. .. .. .. .. .. .. .. .. English Cholera .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea. Dysentery 151 27 1 1 1 1 .. 2 4 5 2 195 Ague, Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Syphilis, &c 22 .. .. .. 2 .. .. .. .. .. .. 24 Erysipelas 4 .. .. 2 1 1 1 .. 3 .. .. 12 Pyaemia 3 1 2 2 4 1 1 1 1 .. .. 16 Puerperal Fever .. .. .. 2 2 1 .. .. .. .. .. 5 Thrush Vege Parasites 2 .. .. .. .. .. .. .. .. .. .. 2 Worms, Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism .. .. .. .. 1 5 2 5 1 .. .. 14 Influenza 2 2 1 1 2 3 5 6 5 9 1 37 281 393 129 28 20 19 11 16 14 14 3 - 928 Constitutional Diseases. Eheumatic Fever .. 1 .. 1 3 1 1 .. 1 .. .. 8 Rheumatism .. 1 2 3 2 .. 1 .. 2 3 .. 14 Gont .. .. .. .. .. .. .. 1 .. 1 .. 2 Rickets 3 2 .. .. .. .. .. .. .. .. .. 5 Cancer .. 1 1 2 8 15 44 47 32 14 .. 164 Tabes Mesenterica 27 6 1 .. .. .. .. .. .. .. .. 34 TubercularMeningitis 11 19 7 4 .. .. .. .. .. .. .. 41 Phthisis 5 7 5 41 84 69 57 20 8 3 .. 299 Scrofula, Tuberculosis 12 14 12 6 8 6 4 1 .. .. .. 63 Purpura Hæmorrhagica. .. .. .. .. .. .. .. .. .. .. .. .. Anæmia, Leucocytha .. .. 1 1 .. .. 1 .. 1 .. .. 4 Diabetes .. .. .. 1 1 2 3 8 2 1 .. 18 Other Constitutional Diseases .. .. .. .. 1 .. 1 .. .. .. .. 2 58 51 29 59 107 93 112 77 46 22 .. - 654 Developmental Premature Birth 118 .. .. .. .. .. .. .. .. .. .. 118 Malformations 17 .. .. .. .. .. .. .. .. .. 17 Old Age .. .. .. .. .. .. .. 1 34 91 39 165 135 .. .. .. .. .. .. 1 34 91 39 300 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 Nervous Diseases. Inflammation of Brain or Membranes 19 23 5 4 1 .. 2 .. .. .. .. 54 Apoplexy, Hemiplegia .. .. 1 1 5 11 20 33 40 32 4 147 Insanity, General Paralysis .. 1 .. .. .. .. 2 1 4 2 1 11 Epilepsy .. 1 1 1 2 2 .. 1 .. .. .. 8 Convulsions 72 19 4 .. .. .. .. .. .. .. 96 LaryngismusStridulus 5 l .. .. .. .. .. .. .. .. .. 6 Diseases of Spinal cord .. .. .. .. 1 .. 2 1 .. .. .. 4 Paraplegia .. .. .. .. .. .. .. .. .. .. .. .. OtherNervousdiseases 5 5 2 2 3 6 11 13 12 11 .. 70 101 50 13 8 12 19 38 49 56 45 5 - 396 Diseases of Circulating Organs. Peri & Endo-Carditis 1 1 2 5 1 2 3 3 .. .. .. 18 Valvular Disease of Heart 3 .. 10 13 8 18 31 48 43 19 .. 193 Other diseases of heart .. .. .. .. .. .. 1 2 4 .. .. 7 Aneurism .. .. .. .. 1 1 3 l .. 1 .. 7 4 1 12 18 10 21 38 54 47 20 .. - 225 Respiratory Organs. Laryngitis .. 2 1 .. .. .. .. .. .. .. .. 3 Croup .. 5 .. .. .. .. .. .. .. .. .. 5 Asthma .. .. .. .. .. 1 3 4 3 1 .. 12 Bronchitis 76 38 4 1 5 10 16 39 82 51 14 336 Pneumonia 65 78 10 18 13 21 23 15 19 13 .. 275 Pleuris .. 1 1 .. 1 2 .. 1 .. 1 .. 7 Other RespiratoryDis. 1 .. 1 .. 2 .. .. 2 3 .. .. 9 142 124 17 19 21 34 42 61 107 66 14 - 647 Diseases Digestive System. Dentition 11 7 .. .. .. .. .. .. .. .. .. 18 Quinsy, Sore Throat .. 2 2 .. .. .. .. 1 1 .. .. 6 Disease of Stomach 5 2 1 .. .. .. 1 1 4 1 .. 15 „ Bowels 1 .. 2 .. 1 1 .. 1 .. .. .. 6 Enteritis 61 16 2 .. 4 1 1 1 1 4 .. 91 Obstruction of Intestines 2 .. 2 1 .. 1 2 2 4 4 .. 18 Peritonitis 1 1 3 7 6 6 4 .. 2 1 1 32 Spleen .. .. .. .. .. .. .. .. .. .. .. .. Jaundice, Liver Dis. 7 1 .. 1 1 13 17 14 11 3 .. 68 88 29 12 9 12 22 25 20 23 13 1 - 254 11 TABLE OF DEATHS—Continued. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards Totals Diseases of Urinary System. Kidney Diseases .. .. 1 .. 2 1 3 3 2 2 .. 14 Nephritis .. 5 2 2 5 4 6 7 1 2 .. 34 Bright's Disease .. .. 1 .. 2 5 3 5 11 2 1 30 Other Kidney Diseases .. .. .. .. .. .. .. .. .. 1 .. 1 Bladder and Prostate .. .. .. .. 1 .. .. 2 8 5 .. 16 0 5 4 2 10 10 12 17 22 12 1 - 95 Diseases of Uterus &c Disease of Uterus .. .. .. .. 2 1 .. 2 .. .. .. 5 Abortion, Flooding .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsion .. .. .. 1 1 .. .. .. .. .. .. 2 Ovarian Dropsy .. .. .. .. .. 1 .. .. 1 .. .. 2 .. .. .. 1 3 2 .. 2 1 .. .. - 9 Bones and Joints, &c. Caries, Necrosis .. 1 .. .. .. 1 1 1 .. .. .. 4 Arthritis, Ostitis .. .. .. .. .. .. .. .. .. .. .. .. Carbuncle, Phlegmon .. .. .. .. .. .. .. 1 .. .. .. 1 Other Skin Diseases .. 1 .. .. 1 .. 1 .. 2 .. .. 6 1 2 .. .. 1 1 2 2 2 .. .. - 11 Violence. Accidents & Violence 25 10 9 4 7 10 6 4 7 9 2 93 Homicide 1 .. .. .. .. .. .. .. .. .. .. 1 Suicide .. .. .. 1 4 6 6 4 2 .. .. 23 26 10 9 5 11 16 12 8 9 9 2 117 Ill-Defined Causes. Dropsy .. .. .. .. .. 1 .. 2 .. 2 .. 5 Debility and Atrophy 131 6 .. .. .. 1 .. .. .. 1 1 140 Mortification 1 .. .. .. .. .. 1 2 .. 1 1 6 Tumour .. .. .. .. .. .. .. 1 1 .. .. 2 Abscess 1 .. .. 1 .. 2 .. 1 2 .. .. 7 Hæmorrhage 1 .. 1 .. 1 .. 1 1 .. 2 .. 7 SuddenDeaths (doubtful) 2 2 .. 1 2 1 6 7 4 .. 25 Causes not Specified 7 .. .. .. .. 2 1 .. .. .. 10 143 6 3 1 2 6 5 14 10 10 2 - 202 Totals 979 671 228 150 209 243 297 321 171 302 67 3838 12 NOTIFIABLE DISEASE. Small Pox.—Four cases of this disease were notified during the year, but three of these, on investigation, turned out to be cases of chicken-pox. The following are the circumstances of the fourth case:— A. M. Female, age 21. State of vaccination, unknown. Source of disease, unknown. The necessary disinfection, both of residence and clothing, &c., was done in this case. Scarlatina.—This disease was very prevalent in the district during the year, no less than 1386 cases being notified. This is, however, a less number than during 1896. The accompanying table (page 22) shows the distribution of the disease in the different subdistricts of the Parish. The deaths during the year numbered 79. The attack-rate is therefore 6.8, and the death-rate .31 per 1000 living persons in the Parish. The fluctuations of the disease are represented on the following chart. It will be seen that the disease was above the average during the first four months of the year, then the number of cases declined and remained low with one or two fluctuations until the beginning of August, when a continuous rise set in which attained its maximum during the third week in October. This was succeeded by a sudden fall in the number of cases, which fall was maintained until the end of the year. With respect to the removal of patients suffering from this disease to the Asylums Board's Hospitals, we did not have so much difficulty during 1897 as during the previous year. I give here a table showing the number of applications made for the removal of each case of Scarlatina and Diphtheria during the period when these diseases were most prevalent in the district. The table shows that the removals were not so prompt as the necessities of the cases required; probably with the increased hospital accommodation now provided, these delays will be avoided in the future. No of Applications 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Scarlet Fever 64 21 12 20 3 8 2 2 3 3 2 1 1 1 2 Diphtheria 14 2 1 1 Chart, Showing the rise and fall weekly in cases of Scarlet Fever, Diptheria, and Typhoid Fever, reported during 1897. 13 Enteric Fever.—The total cases of this disease notified in the district during the year numbered 203, with 87 deaths. These give an attack-rate of .94, and a death-rate of .17 per 1,000 living. Of the 203 cases, no less than 14 appear to have been contracted outside the district, and only one case seemed to be associated with oystereating; but this latter may have been a coincidence only. The connection of enteric fever with defective house drainage is important, and I have referred to this in a subsequent part of this report. The secondary cases of this disease, I have every reason to believe, have arisen from personal infection from primary cases; but the source of most of the primary cases has defied our efforts to discover. During the last two years very important investigations have been made by Dr. Sidney Martin for the Local Government Board, into the connection of enteric fever with different kinds of soil. The investigations which are still proceeding, took the direction of ascertaining whether the bacillus of enteric fever survived for any appreciable time in the soil, and the character of the soil which favoured most the growth of the organism. Dr. Martin arrived at the following results: That in organically polluted soil, the bacillus of enteric fever, "increased speedily and spread abroad, whereas in the virgin soil under like conditions of temperature and moisture, it languished and quickly died out." The practical importance of these facts lies in the indications they afford of the measures to be applied in order to prevent the spread of enteric fever, due to the growth of this micro-organism in the soil about dwellings. The indications are such as will prevent the fouling of the soil about dwellings. These are: 1.—The speedy removal of all filth of an organic nature, from all dwellings and their neighbourhood. 2.—The paving of yards; and what I consider of most importance, the concreting of the whole site of the house to prevent the entrance of the ground air. 3.—The provision of proper surface drainage. 4.—The construction of all sewers and house drains in such a manner as to prevent fouling of the soil. 5.—The abolition of all dust shoots, and the substitution of cremation of all the filth for the present means of disposal. 14 Diphtheria and Membranous Croup.—This disease was very prevalent during the year, 738 cases of diphtheria and 25 of membranous croup being notified. This is an increase of 191 over the number for 1896. The attack-rate for the year is 3.5 per 1,000. The number of deaths was 265, giving a mortality rate of 1.1 per 1,000 persons living in the Parish, against .50 per 1,000 for all London. The chart shows the disease to have been present during the whole year, with a marked increase during the latter half of the year. This increase I was unable to associate with any particular agency. It was not confined to any particular part of the district, although the attack-rate has varied in the different wards. Schools have not appeared to be conspicuous in causing a spread of this disease, neither has milk been an agency to call for comment. There seems the best grounds for belief that the disease has been spread by personal infection, and in many of the secondary cases we have been able, fairly well, to localise the source of infection; but the majority of the primary cases appear to baffle our efforts to trace them to their source. The connection of this disease with defective house drainage I have dealt with in another part of this report. Diphtheria and Anti-toxin Treatment.—The serum treatment of diphtheria has now been on trial at the Metropolitan Asylums Board's Hospitals during three years, and the general results have been reported upon for the years 1895-1896. The conclusions arrived at from the experience of those two years by the Board were:— 1. A great reduction in the mortality of cases brought under treatment on the first three days of illness. 2. The lowering of the combined general mortality to a point below that of any former year. 3. The still more remarkable reduction in the mortality of the laryngeal cases. 4. The uniform improvement in the results of tracheotomy at each separate hospital. 15 5. The beneficial effect produced on the clinical course of the disease. With such an opinion from those most competent to judge, there can be no doubt that in anti-diphtheritic serum we have a remedy of great potency in the treatment of diphtheria. During the past year it was represented to me by Dr. Frederick Wallace, of Upper Clapton, that it would probably be for the benefit of the public health if the serum could be obtained locally, thereby avoiding the delay involved—in some instances probably 24 hours—in obtaining it from the manufacturers. Such a saving of time in the administration of the remedy might result in the saving of the patient's life. Influenced by these considerations, I reported these circumstances to the Public Health Committee, and recommended that I should keep a small stock of the serum at the Town Hall, to be supplied to medical practitioners who desired it at cost price. This was agreed to, and I was instructed to obtain the serum I required, and to inform the medical practitioners of the district of the arrangement made. Prom the number of applications made for serum up to the end of the year, I am convinced the action of the Committee was wise in the interest of public health. The spread of Diphtheria in this country, and London in particular, is so serious that no step, however small, which promises either to lessen the mortality or spread of the disease, should be neglected by the Local Authority. Towards the end of the year, I received a communication from the Clerk to the Asylums Board asking whether, in the event of pressure upon the Board's accommodation, necessitating the temporary refusal of diphtheria cases, I should be willing to receive and distribute serum to medical practitioners for the use of those eases refused admission to hospital; I, of course, replied in the affirmative, as I believe by this arrangement there will be very little delay in the delivery of the serum to the medical attendants. 16 Typhus.—No case of this disease was notified in Hackney during 1897. Continued Fever.—Five cases were notified under this name during the year, none of which were fatal. Although there was considerable uncertainty as to the nature of these cases, I considered it advisable to adopt all precautions of isolation and disinfection applicable to the other infectious diseases. Puerperal Fever.—Ten cases of this disease were notified in the district, five of which were fatal. The death rate is -02 per 1,000 living for the year. Cholera.—No case of this disease occurred in Hackney during 1897. Erysipelas.—A rather less number of cases of this disease was notified during 1897, the number being 270—ten less than the previous year. The deaths were 12. The attack-rate is therefore 1.2, and the mortality nearly .06 per 1,000 living persons. NON-NOTIFIABLE DISEASES. Influenza.—The deaths from this disease rose again during 1897, the total numbering 37 against 22 in 1896. The death-rate is therefore .17 per 1,000 living persons—that for London being .15 per 1,000. Table Y. Deaths from Influenza during the years 1891 to 1897. Year. Jan. Feb. Mar. Apl. May June July Aug. Sep. Oct. Nov. Dec 1891 0 0 0 2 86 39 6 3 2 1 1 1 1892 77 29 6 3 1 1 1 0 0 0 0 1 1893 3 4 11 10 4 4 3 1 1 1 7 37 1894 18 5 2 4 1 3 0 0 1 1 1 3 1895 2 6 91 9 3 1 0 0 2 2 3 5 1896 1 4 2 3 2 1 0 1 0 1 3 4 1897 1 1 6 5 9 3 0 0 1 2 2 7 It appears from the above table of deaths in Hackney from Influenza during the last seven years, that the disease has been most prevalent during the months of December to June, but not constant to an)' particular months of this period, and not prevalent at all during the months of July to November. If we can interpret these facts into an indication that the prevalence of the disease is affected by season, 17 the seasonal prevalence may be shown by the following diagram. This represents the comparative average monthly deaths for the last seven years from Influenza. Diarrhœa.—The deaths from this disease in Hackney during the year numbered 195, rather less than the total for the year 1896, but those in the third quarter numbered 177 against 175 for the previous year, so that the death-rate, compared with the previous year, is much the same. The total number of deaths from this cause in London far exceeded many previous years, no less than 3507 occurring during the third quarter, giving a death-rate of 3.1 per 1,000. The average temperature for London during that period was higher than it had been since 1891, and the rain-fall was low. From a consideration of the following table, I am confirmed in my opinion, expressed in my annual reports for 1895 and 1896, as to the malign influence of the water famines on the diarrhœa death-rate during those years. It will be seen that the close correspondence in the death-rates of Hackney and London, which had existed during the third quarters of the years 1892, 1898, and B 18 19 Table A. 18 19 TABLE OF DEATHS during the 1st, 2nd and 3rd quarters of the year 1891 «* the Hackney Metropolitan 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. (Columns for Population and Births are in Table B.) Mortality from all causes, 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 ander 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 16 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Mombranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis. Pneumonia, and Pleurisy. Heart Disease. Injuries. All Other Diseases. Total. Typhus. Entericion Typhoid. Continued Relapsing Puerperal (a) (b) (c) (d) (e) (f) (g) (h) Haokney 973 351 129 37 35 247 174 Under 5 .. 3 10 2 .. .. .. .. .. .. 2 29 18 82 .. 4 59 2 .. 12 257 480 5 upwds. .. .. 10 •• •• 2 .. .. 2 .. 4 2 .. 4 2 71 79 45 .. 22 250 433 Infirmary 318 25 17 8 15 143 110 Under 5 .. .. .. .. .. .. .. .. .. .. .. 4 .. 4 .. .. 6 .. .. 1 27 42 5 upwds. .. .. .. .. .. .. .. .. .. .. 2 .. .. 3 .. 53 47 34 .. 6 131 276 Fever Hospital 207 17 144 54 13 9 .. Under 5 .. 38 81 .. .. .. .. .. .. .. .. 3 1 .. .. 1 2 .. .. 1 4 131 5 upwds. .. 14 34 .. .. 11 .. .. 1 .. .. .. .. .. 1 1 3 .. .. .. 11 76 German Hospital 90 5 4 5 9 61 6 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 2 5 9 5 upwds .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 21 3 10 .. 5 41 81 City of London Workhouse 4 .. .. .. .. .. 4 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 3 4 Workhouse 5 1 .. .. .. 3 1 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 3 4 West Haokney 425 138 41 17 12 120 97 Under 5 .. .. 8 1 .. .. .. .. .. .. .. 3 9 35 .. 2 15 1 .. 1 104 179 5 upwds. .. 1 7 .. .. 2 .. .. .. .. .. .. .. 6 1 28 41 32 .. 8 120 246 Metropolitan Hospital 101 30 13 12 11 32 3 Under 5 .. .. 3 .. .. .. .. .. .. .. 1 1 .. 9 .. .. 5 .. .. 3 21 43 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 5 6 .. 10 34 58 South Hackney 445 149 64 20 12 117 83 Under 5 .. 1 4 3 .. 1 .. .. .. .. .. 7 8 40 .. 2 32 .. .. 4 111 213 5 upwds. .. 1 5 .. .. 4 .. .. .. .. .. 1 .. 1 .. 3 42 26 .. 10 109 232 French Hospital 4 .. .. .. .. .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 4 Stamford Hill 149 28 17 1 7 55 41 Under 5 .. 2 2 .. .. .. .. .. .. .. .. 1 14 .. .. .. 4 .. .. 1 21 45 5 upwds. .. .. 1 .. .. 2 .. .. 1 .. .. .. .. .. .. 10 13 13 .. 3 61 104 Totals 2721 744 399 154 114 787 523 Under 5 .. 44 108 6 .. 1 .. .. .. 3 48 45 175 .. 10 124 3 .. 25 551 1143 5 upwards .. 16 57 .. .. 21 .. .. 4 .. 7 3 .. 15 4 219 234 167 .. 64 767 1578 The subjoined number, have also to be taken .account judqinq of the above of mortality. Deaths occurring outside the district among persons belonging thereto 222 27 22 20 17 104 32 Under 5 .. 3 3 .. .. .. .. .. .. .. 1 .. 1 8 .. .. 3 .. .. 1 29 49 5 upwds. •• 1 7 .. .. 2 .. .. .. .. .. .. .. .. .. 12 10 27 .. 12 102 173 Deaths occurring within the district among persons not belonging thereto 314 31 113 47 18 79 26 Under 5 .. 31 71 .. .. .. .. .. .. .. .. 4 1 6 .. 1 8 .. .. 5 17 144 5 upwds. .. 9 23 .. .. 6 .. .. .. .. 1 .. .. .. .. 19 8 16 •• 18 70 170 20 21 Table A. 20 21 TABLE OF DEATHS during 4th quarter of the year 1897, in the Hackney Metropolitan 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. (Columns for Population and Births are in Table B.) Mortality from all causes, at subjoined ages. 65 and upwards Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age, 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 1 2 3 At all Ages. Under 1 year. 1 and under 5. 6 and under 15. 15 and under 25. 25 and under 65. Smallpox Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa & Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued. Relapsing Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) North Hackney 151 27 18 3 1 51 51 Under 5 .. .. .. .. .. .. .. .. .. .. .. 4 1 .. .. .. 16 .. .. 2 21 45 5 upwds. .. .. 0 •• .. 2 .. .. .. .. .. 1 0 .. .. 9 25 10 •• 2 57 106 S.E. Hackney 239 71 74 4 4 53 33 Under 5 .. 3 2 1 .. .. .. .. .. .. .. 32 17 2 .. 1 40 .. .. 4 43 145 5 upwds. .. 1 1 0 .. 2 .. .. .. .. .. .. .. .. .. 13 26 8 .. .. 43 94 Infirmary 124 9 11 4 6 51 43 Under 5 .. .. .. .. .. .. .. .. .. .. .. 5 .. .. .. .. 6 1 .. 1 7 20 5 upwds. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 16 22 8 .. 3 53 104 Workhouse 2 •• .. .. .. .. 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 2 S.W. Hackney 245 59 61 8 6 68 43 Under 5 .. 3 3 2 .. .. .. .. .. .. .. 22 17 .. .. .. 34 .. .. 1 88 120 5 upwds. .. 0 2 .. .. 2 .. .. 1 .. 1 2 .. .. 1 16 28 15 .. 4 53 125 Metropolitan Hospital 34 5 10 4 1 12 2 Under 5 .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. 2 .. 2 .. .. .. 8 16 5 upwds. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 2 .. 2 11 19 German Hospital 22 •• 1 2 3 14 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 3 •• 3 12 21 Central Hackney 184 58 35 12 9 38 37 Under 5 .. .. 2 2 .. .. .. .. .. .. 1 11 13 .. .. 1 84 .. .. 2 27 93 5 upwds. .. .. 3 .. .. 2 .. .. .. .. .. .. .. .. 1 10 23 6 .. 3 43 91 Metropolitan Fever Hospital 114 6 61 38 6 3 •• Under 5 .. 7 51 .. .. .. .. .. .. .. .. 5 .. 1 .. .. 2 .. .. 1 .. 67 5 upwds. .. 5 33 .. .. 5 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 2 47 City of London Union 2 .. .. .. .. .. 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 2 Totals 1117 235 271 75 36 285 215 Under 5 .. 13 60 5 .. .. .. .. .. .. 1 80 49 3 2 2 134 1 .. 11 145 506 5 upwards .. 6 40 .. .. 15 .. .. 1 .. 1 4 .. 2 2 68 126 54 •• 17 275 611 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 81 7 11 7 4 1 39 13 Under 5 .. 2 2 .. .. .. .. .. .. .. .. .. .. .. .. .. 3 1 .. .. 10 18 5 upwds .. .. 2 .. .. 6 .. .. .. .. .. .. .. .. .. 9 1 5 .. 4 36 63 Deaths occurring within the district among persons not belonging thereto 124 12 49 29 9 15 10 Under 5 .. 6 35 .. .. .. .. .. .. .. .. 5 .. 1 .. .. 4 .. .. 1 9 61 5 upwds .. 3 24 .. .. 4 .. .. .. .. .. .. .. 1 1 2 4 5 .. 1 18 63 22 23 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 1st, 2nd and 3rd quarters of the year 1897, in the Hackney Metropolitan 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 each Knowledge of the Locality, coming to the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1896. Estimated to middle of 1897. 1 2 8 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 Smallpox. Scarlatina Diphtheria Membranous Croup. Fevers. Cholera. Erysipelas Smallpox. Scarlatina Diphtheria Membranous Croup. Cholera. Erysipelas Typhus. Enteric or Typhoid. Continued Relapsing Puerperal Typhus. Enteric or Typhoid. Continued Relapsing Puerperal (a) (b) (c) (d) (e) Hackney (H) Under 5 .. 133 66 7 .. 3 .. .. .. .. 9 .. 69 22 1 .. 1 .. .. .. .. .. 5 upwds. .. 293 176 1 .. 53 1 .. 2 .. 90 .. 182 59 .. .. 21 .. .. .. .. 11 Stamford Hill Under 5 .. 21 10 .. .. .. .. .. .. .. 1 .. 9 1 .. .. .. .. .. .. .. .. 5 upwds. .. 35 23 .. .. 8 .. .. 2 .. 17 1 17 6 .. .. .. .. .. .. .. .. South Hackney Under 5 .. 76 44 4 .. 1 .. .. .. .. .. .. 43 21 .. .. .. .. .. .. .. .. 5 upwds. .. 156 77 1 .. 28 .. .. 1 .. 46 .. 91 36 .. .. 6 .. .. .. .. 1 West Hackney Under 5 .. 75 29 3 .. 2 .. .. .. .. 4 .. 50 12 .. .. 2 .. .. .. .. .. 5 upwds. .. 126 62 .. .. 24 2 .. 1 .. 23 .. 75 33 .. .. 10 .. .. .. .. 1 Eastern Hospital Under 5 .. 2 4 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 14 18 .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Hackney Workhouse Under 5 .. .. 3 .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. 5 upwds. .. 1 2 .. .. .. .. .. .. .. 7 .. 1 2 .. .. .. .. .. .. .. 7 Hackney Infirmary Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds .. 1 .. .. .. 2 .. .. .. .. 4 .. .. .. .. .. 2 .. .. .. .. .. Metropolitan Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. German Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. Totals Under 5 307 156 14 .. 6 .. .. .. .. 14 .. 171 59 1 .. 3 .. .. .. .. 5 upwds. 4 627 358 2 .. 117 3 .. 7 .. 188 1 367 136 .. •• 39 .. .. .. .. 20 During the 4th quarter of the year 1897. North Under 5 .. 14 5 .. .. .. .. .. .. .. .. .. 5 1 .. .. .. .. .. .. .. .. 5 upwds. .. 41 11 .. .. 14 .. .. .. .. 9 .. 22 4 .. .. 3 .. .. .. .. 1 Central Under 5 .. 26 26 .. .. 1 .. .. .. .. .. .. 11 15 .. .. .. .. .. .. .. .. 5upwds. .. 56 46 3 .. 16 .. .. .. .. 14 .. 22 23 .. .. 8 .. .. .. .. 1 South West Under 5 33 32 2 .. 1 .. .. .. .. 2 .. 14 20 .. .. .. .. .. .. .. .. 5 upwds. .. 60 51 .. .. 29 2 .. 2 .. 21 .. 28 22 .. .. 19 .. .. 1 .. 3 South East Under 5 .. 80 9 4 .. 2 .. .. .. .. 2 .. 29 6 .. .. 1 .. .. .. .. .. 5 upwds. .. 142 44 .. .. 17 .. .. 1 .. 20 .. 69 26 .. .. 10 .. .. .. .. 2 Totals Under 5 .. 153 72 6 .. 4 .. .. .. .. 4 59 42 .. .. 1 .. .. .. .. .. 5 upwds. •• 299 152 3 .. 76 2 .. 3 .. 64 141 75 .. .. 40 .. .. 1 .. 7 24 1894, was disturbed, the rate of Hackney rising considerably above the London rate in 1895, and excessively so in 1896, but during the third quarter of last year the old relationship of 1892 to 1894 between the death-rates of Hackney and London was restored. Table VI. Number of Deaths from Diarrhcea during the third Quarter of the years 1892-1897 in Hackney and London, and the corresponding mortality rates per 1,000 living persons. Year. No.of deaths from Diarrhœa in 3rd quarter in Hackney. Mortality rate per 1.000 living. No.of deaths from Diarrhcea in 3rd quarter in London. Mortality rate per 1,000 living in London. Average atmospheric temperature for the quarter. Rain fall in inches during the quarter. 1802 84 1.6 1747 1.6 59 .2 6.6 1893 98 1.8 2177 2.0 61.9 5.9 1894 57 1.1 1212 1.1 58.6 7.5 1895 153 2.9 2647 2.4 62.3 6.5 1896 175 3.2 2624 2.3 60.4 8.7 1897 177 3.2 3507 3.1 6.4 6 .6 To produce such an alteration in the relative death-rates, some local cause must have been at work in Hackney during 1895 and 1896 which was not operating over the whole of London. The only local factor in existence during the above periods was the water famine. How this could produce an increase in diarrhoea I have pointed out in my former reports. Whooping Cough.—This disease was not so prevalent during 1897 as the previous year, the number of deaths being 94 against 146 in 1896. The death-rate for the year is therefore .43 per 1,000, against .41 per 1,000 for all London. Measles.—This disease was very prevalent in Hackney during the year; how prevalent cannot be exactly stated, owing to the absence of notification, but that the number of cases was considerable may be inferred from the fact that 135 deaths were due to this cause. The death-rate is therefore .62 per 1,000 living persons in Hackney. The disease was most prevalent during the fourth quarter of the year, no less than 85 of the total deaths being registered during that 25 period. The part of the district which appeared to suffer most was South-East Hackney, and it is in this locality that the scholars of one of the London Board Schools were very much affected. On this subject I received a letter from the Medical Officer of the Lodon School Board on November 10th, stating that his attention had been drawn to a prevalence of measles in connection with the Gainsborough Road Board School, chiefly in the Infants' Department, and from information received from the Head Mistress of that department, it appears at that time that there were 120 children away suffering from measles, and 36 absent because of the disease being in their homes; the Medical Officer at the same time suggested the closure of the Infants' Department for 14 days. This letter was the first intimation I had received that the disease was prevalent amongst the scholars of that school, but I immediately, with the above figures before me, coincided in the views of the Medical Officer of the School Board in the temporary closure of the Infants' Department of the above named school. That department did not open again until the 29th of November— the period of closure being 18 days. On enquiry at the School on that date, I found 96 of the 120 children who were ill with the disease on the closure of the School were still absent, and of the 36 absentees owing to measles in their homes, only 13 had not returned to school. These figures indicate a beneficial influence on the spread of the disease by temporary closure of one department. From enquiries made of the Head Mistress of the School, I learn that at the beginning of the above epidemic amongst her scholars, the disease was confined to the pupils of the youngest class in the school for nearly three weeks. Then it appeared to spread gradually through the other classes of the School. From this experience, it appears to me that the principle of closure might usefully be applied to classes in the Infants' Department at a much earlier stage of an epidemic of infectious disease. 26 But in order that I might advise such limited closure, it would be necessary that I should receive prompt notice from the Head Mistress of absentees either suffering from the disease or from disease being in their homes, with, of course, the class attended by the scholar; with such information systematically classified one might see at a glance which measure would be most appropriate to prevent the spread of the disease. By Article 148, Sec. (ii) of the Code of Regulations and Instructions issued by the School Board for London for the guidance of their teachers, it is provided : "(ii) Any Child showing symptoms of an infectious disease, or any child coming from a house where an infectious disease exists, must be sent home at once, and the Superintendent of Visitors must be immediately informed of the case, in order that enquiries may at once be made with a view to proper steps being taken to prevent the children living in the same house or tenement from attending school. The Medical Officer of Health for the District must also at the same time be informed of the child's exclusion, and furnished with the name and address of the child and the reason for its exclusion on a form with which the teachers will be supplied at the Head Office." It will be seen from this Article that the Board have given instruction that the Medical Officer of Health should be informed of all children absent from their schools from infectious disease, but at present this is almost entirely ignored by the Head Teachers of Schools. In order to set at rest any doubt I might have, that the Board required this information sent to the Medical Officer of Health, I communicated with the Clerk to the Board on the subject and received the following reply:— 27 SCHOOL BOARD FOR LONDON. Victoria Embankment, W.C. 21st December, 1897. Sir, In reply to your letter of the 20th inst., I have to state that the instruction in the Board's Code which you quote in your letter, applies to all infectious diseases. It will interest you to know that the Board have, this week, in their Official "Gazette " issued the following notice to their teachers : "The Board desire to call the attention of Teachers generally, and of the Plumstead Teachers in particular, to the requirement that all cases of exclusion on account of infection, either in the children themselves or in the home or tenement from which they come, shall be notified to the Local Medical Officer of Health, and to state that this instruction applies to all infectious ailments and not only those which are notifiable under the Public Health (London) Act." In reply to your further enquiry, I am to say that it is the intention of the Board that the teachers shall notify measles and Whooping-Cough to the Medical Officer of Health." It follows from this letter that if the Board desire the cooperation of the Medical Officer of Health in preventing the spread of the non-notifiable infectious diseases amongst their scholars, it is their duty to see that their instruction as to notifying the same is carried out. I have no doubt if this were done, the local authorities would do their part in giving their Medical Officers of Health the means to secure isolation of infected pupils and the disinfection of their homes. Class II. Constitutional Diseases. Under this head 654 deaths were recorded which gives a death-rate of 3.0 per 1,000 living persons. The diseases which furnished the largest number of deaths were Cancer and Phthisis, the former being responsible for 164 and the latter 265. Class III. Developmental. The deaths in this class numbered 300 which is equivalent to a death rate of 1.3 per 1,000. 28 Class IV. Local Diseases. The diseases of this class were responsible for 1,637 deaths during the year, no less than 647 being due to diseases of the respiratory organs, 396 to nervous diseases, and 254 to diseases of the digestive organs. The mortality rate for the whole class is 7.5 per 1,000 living persons. Class V. Violence. The large number of 117 deaths were due, during the year, to this cause, giving a death-rate of .5 per 1,000 living persons. Class VI. Ill-Defined Causes. The deaths under this head numbered 202, and are equivalent to a death-rate of .9 per 1,000 living persons. PUBLIC HEALTH (LONDON) ACT, 1891. Under this Act 4,074 Nuisances were abated during 1897. Intimation notices alone secured the abatement of 3,550; over 400 were abated after service of statutory notices; and legal proceedings had to be instituted in 95 cases. The results of these are set out in full on page 67 of this report. Amongst the summonses heard at the North London Police Court, there is only one calling for comment; this was a summons for conveying spent gas lime, commonly known as "blue billy," in a barge uncovered and during prohibited hours, along the river Lea in contravention of the London County Council's bye-laws. The case turned on the point whether this material was offensive. I gave evidence that it was not only offensive, but very dangerous to health. The defendant produced no medical evidence to prove either its inoffensive or innocuous character; but was fortunate in having as witnesses the Clerk and the Analyst to the Lea Conservancy Board. The Magistrate decided to visit the Gas Works and see a sample of spent lime. After his visit he gave as his opinion that spent gas lime was neither offensive nor dangerous to health and mulct the Vestry in heavy costs. 29 As a comment upon this decision I give the following account, taken from the Daily Mail, of January 17th, 1898, of the death of two persons suffocated in a barge by the gases arising from spent lime with which the barge was laden. "A tragedy of an extraordinary nature was discovered at Hanwell on Saturday. "Early in the morning the dead bodies of a man and woman were found in the cabin of the barge 'Azalea,' which had been moored all night in the canal near Hanwell. The body of the man was subsequently identified as that of John Sumpter, aged 33, and the women as Jane Merritt, aged 36, both of no fixed abode. "The barge was laden with gas lime, and was deserted at night by all the bargemen working it. It is supposed that Sumpter got into the barge with the woman the previous evening unperceived. "Dr. Hope, who examined the bodies, gave it as his opinion that death was due to suffocation by the fumes of the gas lime." Cases of infectious disease were notified in 2,169 houses. These were disinfected, cleansed, and the house drains tested, and notice served to abate any insanitary condition found. The rooms cleansed numbered 757 and the number of families for whom accommodation has been provided, under sec. 60 (4), while their homes were being disinfected, was 9. Articles seized unfit for Food.—Five-and-a-half hundred weight of fish, 15¾ cwt. of fruit and vegetables, 13½ cwt. of meat, 9 cwt. of margarine, and 5 cases of eggs were seized by the sanitary inspectors and brought before a magistrate, who condemned and ordered their destruction. We are still in great need of a furnace for destroying condemned food and other offensive articles. I have either to rely upon the kindness of neighbouring districts to get rid of bad food or dead animals, or to bury the same in land away from human habitation. Cow-sheds and Slaughter-houses.—All of these in the district were inspected and visited by the Public Health Committee during the year. Few defects were found on inspection, several of 30 them required some cleansing. The committee were satisfied with the result of their inspection, and decided not to oppose the applications for the renewal of the licenses. Bake-houses.—These were all visited by the Public Health Committee during the year, and were found to be, with few exceptions, in a good condition. Exception was taken in several to the growth of cobwebs. Notices were served to remedy any insanitary condition found. The notices were carried out in each case. Smoke Nuisances.—Complaints under this head numbered 27 during the year. All of these were abated, with one exception, by service of a notice only. In the exceptional case, legal proceedings were instituted, and, on the defendant giving an undertaking to the magistrate to adopt proper means to prevent a recurrence of the nuisance, the summons was adjourned sine die. FACTORY AND WORKSHOPS ACTS, 1878-1895. The number of workshops registered during 1897 was 153. This is an increase of 50 on the number for the previous year. Notices were received from the Factory Inspector to the number of 35, and those inspected on my instruction were 27. The defects found, we had no difficulty in getting remedied on serving the usual notices. The following table gives the number registered and inspected and the result of inspection :— No. of workshops registered during the year 1897 153 „ „ inspected on notice by Factory Inspector 35 „ „ „ by instruction of Medical Officer of Health 27 Result of inspections (a) Workshops overcrowded 10 (b) Improper W.C. accommodation 1 (c) No w.c. accommodation 6 (d) No separate W.C. accommodation for the sexes 2 (e) Other nuisances 241 During the discussion by the Vestry on the subject of appointing two additional Inspectors for house to house inspection and the 31 registration of houses let in lodgings, it was suggested that a female Sanitary Inspector should be appointed for the purpose of inspecting workshops where females were employed, and the homes of female out-workers. The Vestry adopted this suggestion and subsequently the Local Government Board signified their assent to this proposal. With this extra assistance considerable progress should be made during 1898 in the inspection of the above class of work-shops. CANAL BOATS ACTS, 1877-1884. Owing to the resignation of the Inspector appointed for the inspection of canal boats in the month of July, 1897, and delay in appointing his successor, the total inspections for the year declined upon the number for 1896. The total inspected and re-inspected was 43, of these 38 were found to conform with the Acts and Regulation and in five instances infringements were found. Notices were served by the Inspector in these five cases, attention being immediately given in three cases and legal proceedings had to be resorted to in two instances with the following results : Legal Proceedings. Boat. Owner. Contravention. Result. "Gracie " Lewis Brace Not proper certificate 4/- costs " Moses " Hailey Brick Co. Not registered Summons dismissed (boat changed owners) VEHICLES FOR THE CONVEYANCE OF INFECTED AND DISINFECTED ARTICLES. At a meeting of the Sanitary Committee held on the 7th of January, 1897, I reported that the vehicles used in the conveyance of infected and disinfected articles in the District were too small for the work to be done and, being only hand carts, much time was lost in both collection and distribution of the articles disinfected; the articles ought, in my opinion, to be returned to their owners on the same day they were taken from the infected home ; and suggested that two light vans and horses, &c., should be purchased, and accomodation for the same be provided. 32 The Committee reported in these terms to the Vestry, who adopted the report and authorised the committee to purchase the necessary vehicles, horses, &c., and to take steps to provide new sheds for the vans and stable, &c., for the horses. The vans have been purchased at a cost of £108 17s. 6d.; and the Committee are now considering the question of the site for tbe shed and stables. TEMPORARY SHELTER—PUBLIC HEALTH (LONDON) ACT, 1891, Sec. 60 (4). In the month of October I reported to the Public Health Committee that the system, which had been in operation in Hackney for some time, of payingfor lodging accommodation for persons during the disinfection of their homes after infectious disease therein, was unsatisfactory. The sum paid had been at the rate of 2s. 6d. per night, the choice of the accommodation being left with the person requiring it. During August and September last 19 instances of fever had occurred in one-roomed tenancies, where this temporary accommodation was needed, and of this number only six made application to the Town Hall, the remainder being lodged at their own expense and in their own way. The weakness of this system is apparent, and I have reason to believe that it led to the infection of a person in a house accommodating a necessitous family. In consequence of this danger, I recommended the Committee to provide a furnished shelter, with attendants, in accordance with Sec. 60 (4) of the above Act. After consideration, the Committee agreed to the recommendation, and reported the same to the Vestry—the latter approving of the report, and authorising the necessary expenditure for this purpose. The question of site and arrangement of the building is now under consideration. 33 CLEANSING OP PERSONS ACT, 1897. This is an Act to permit Local Authorities to provide apparatus for cleansing and disinfection for persons infested with vermin. The essential part of the Act is section 1, which reads as follows:— 1.—" On and after the passing of this Act any Local Authority shall have the power, when in their discretion they shall see fit, to permit any person who shall apply to the said Authority, on the ground that he is infested with vermin, to have the use, free of charge, of the apparatus (if any) which the Authority possess, for cleansing the person and his clothing from vermin. The use of such apparatus shall not be considered to be parochial relief or charitable allowance to the person using the same, or to the parent of such person, and no such parent or person shall by reason thereof be deprived of any right or privilege or be subject to any disqualification or disability. " " Local Authorities may expend any reasonable sum on buildings, appliances, and attendants that may be required for the carrying out of this Act, and any expenses for these purposes may be defrayed out of any rate or fund applicable by the Authority for general sanitary purposes or for the relief of the poor." This Act was considered by the Public Health Committee, but while sympathising with the object of the Act, they could not see their way to make any recommendation at present on the subject, and adjourned its further consideration sine die. I am of the opinion that in the interests of the Public Health, the Local Authority should adopt the Act, and make provisions in accordance with the above quoted section. It must be remembered, that in providing means to cleanse persons from vermin the Local Authority are doing the public generally a service; for these infested persons travelling in public vehicles are very likely to affect cleanly persons; and any good done to these unfortunate people is a service rendered to Public Health. C 34 In one of the London parishes where the Local Authority, as an experiment, provided a single bath for the purposes of this Act, no less than 148 persons within the space of one month attended to cleanse their person and have their clothes disinfected. This result has been so gratifying to the Local Authority that they have resolved to provide additional bathing accommodation and disinfecting apparatus. CUSTOMS AND INLAND REVENUE ACTS, 1890. Under the provisions of the above Act, I inspected 316 tenement houses on fifteen applications made to me for certificates for exemption from inhabited house duty. I found in a large number of cases that the dwellings were not in such a condition as to justify me in giving the necessary certificate unless considerable repairs were done. These in all cases were completed, according to notice, and the certificate furnished to the owner. I find that it is the rule of those who impose the inhabited house duty, to accept the certificate of the Medical Officer of Health for the whole period during which the assessment is made, and this is usually for a period of five years. Now, I do not believe that it was the intention of the Legislature that one certificate of the Medical Officer of Health should last five years. Anyone having experience of tenement property knows well that at the end of twelve months from the granting of the certificate much of the property is not in a state to "afford suitable accommodation for each of the families or persons dwelling therein, and that due provision is made for their sanitary requirements." I believe this relief of exemption from inhabited house duty was intended to encourage the provision of a class of tenements for the working classes, which shall be thoroughly sanitary and shall be kept in such a state; but the acceptance by the Inland Revenue Authorities of one certificate for five years is calculated to defeat this object. The owners of this class of property should be required to produce a certificate every year before obtaining the exemption from inhabited house duty. 35 BYE-LAWS AS TO HOUSES LET IN LODGINGS. My anticipations with regard to the number of houses which would be registered and under inspection at the end of 1897 under the above bye-laws have not been realised. Several sudden and exceptional demands were made during the year upon the sanitary staff, and this work in consequence suffered ; so that without some special increase in the staff of inspectors any substantial progress in the application of these bye-laws could not be expected. In consequence of complaints as to the insanitary condition of certain localities in Hackney, the Public Health Committee, after enquiry, resolved to ask the Vestry to appoint two more inspectors, to give their whole time to house-to-house inspections. I at the same time pointed out to the Committee the necessity for some help in the registration of houses let in lodgings. The Committee accordingly reported to the Vestry in the following terms :— ADDITIONAL SANITARY INSPECTORS. Your Committee have to report that the question of a more systematic house-to-house inspection in the Parish, especially in the Hackney Wick and Homerton Districts, has had their serious consideration, with a view of securing a much more frequent visitation of such houses. Your Oommittee have interrogated the Inspectors of the Hackney Wick and Homerton Districts, and they are satisfied that assistance is urgently needed if the inspection of houses and any real progress is to be made in the carrying out of the necessary sanitary works in those Districts. There are about 2,000 houses in the Hackney Wick District, and about 2,500 in the Homerton District. Quite 1,000 of these are in a very bad condition, each house being occupied by three or four families, and to keep them in anything like a sanitary state they require to be thoroughly inspected at least once in every six months. Moreover, the Medical Officer of Health strongly recommends that these houses should be inspected and registered as houses let in lodgings, and the bye-laws properly carried out, which under existing conditions cannot be done. Your Committee went very fully into the question of the time occupied by the Inspectors of the Districts in question in carrying out the duties, and they find that it is quite impossible for them to make the number of houseto-house inspections which it is essential should be made. 36 Your Committee are of opinion that it is advisable to appoint two additional sanitary inspectors to make a house-to-house inspection of the 1,000 houses referred to, and that the rooms of some be properly measured up and registered as houses let in lodgings, and the bye-laws enforced ; also . when these houses have been put into a proper sanitary condition, the services of the inspectors proposed to be appointed should be transferred to other sanitary districts where similar circumstances exist and the same course adopted there. Your Committee recommend that two additional sanitary inspectors be appointed, and if approved, that your Committee be empowered to submit the usual proposal for such appointments to the Local Government Board, and if allowed by that Board, that they be also empowered to advertise for candidates and bring up six for selection by the Vestry. All which is respectfully submitted. HENRY HULLAND, Chairman. The Vestry agreed to the appointment of two additional inspectors, and I have no doubt that during 1898 great progress will be made in the registration and control of this class of dwellings. HACKNEY WICK. This part of the district has received particular attention during the year, and much progress has been made in remedying the dampness and general insanitary condition of the houses in this locality. The promised relief to the sewers is much needed. During the summer certain parts of the district were flooded on two occasions, doing damage to the property and inconveniencing the tenants greatly. Moreover, the danger to tenants from sewage flooding was not inconsiderable. POLLUTION OF THE RIVER LEA. The condition of this river as it passes through Hackney continues to give rise to complaints, and to cause anxiety to those responsible for the public health. Efforts have been made by the Walthamstow and Leyton Authorities to improve the effluents which enter the Lea in this district, but with doubtful success so far as the pollution of the river is concerned. The state of the river may be said to be much the same as last year; and this may be seen by 37 Table VII.—Analyses of River Lea Water, made during the year 1897, by Mr. Leo Taylor, F.I.C., Public Analyst. Date. Where Taken. Total solid residue. Saline ammonia. Organic Ammonia. Oxygen requir'd to oxidise the organic matter Chr'line Nitra??? e and Nitrites remarks. June 11th, River Lea opposite "Jolly Anglers." 38.5 .033 .025 .157 1.4 Distinct traces There was a considerable amount of suspended matter in this water composed partly of decomposing vegetable matter, and to this was due the slight odour given off by the sample. The sample when viewed in a white basin one inch deep, was slightly yellow in tint. The details of the analysis point to organic contamination from decayed vegetable matter. June 11th, River Lea, bottom of of Spring Hill. 39.2 .041 .029 .159 1.5 Distinct Same as above, although the figures in this sample are slightly higher. June 24th, River Lea, near "White Hart." 39.2 1.510 .042 .794 3.1 Traces Odour very foul; considerable suspended matter. Possesses all the characteristics of dilute sewage. June 24th, River Lea, near "White House." 31.64 .007 .026 .192 1.8 Slight traces The organic matter in this water is higher than it should be; a small quantity of sewage matter is evidently finding its way into the stream above this point. 38 comparing the following analyses of the water made during the year with those during 1896. In consequence of the above complaints the Public Health Committee after much consideration presented the following report to the Vestry :— POLLUTION OF THE RIVER LEA. Gentlemen,—Your Committee have to report that the question of the continued pollution of the River Lea and its tributaries, has had their serious consideration for some time past. Samples of the river water have been taken and analysed from time to time, and the result of these analyses which have been submitted to the Vestry, show conclusively, that sewage contamination of the river is going on from some source or another. Copies of these analytical reports have been forwarded to the Local Government Board, the London County Council, and Lea Conservancy Board; but beyond a formal acknowledgement, your Committee are unaware of any action having been taken to remedy the existing state of things. This subject has engaged the attention of the Vestry in the past, and its action thereon has been productive of very good results, but it has again become necessary that active steps should be taken for dealing with this growing evil. With this object, your Committee held a meeting in July last to consider the subject, when delegates were present from the Limehouse and Poplar Board of Works; these bodies are both willing to join with Hackney in the matter. It was then felt that a more representative Conference might be arranged ; and it was decided to adjourn until Wednesday, 13th October next, for this purpose. In the meantime, the following have been invited to attend :— Members of Parliament and London County Councillors for Hackney, Limehouse, Poplar, and Mile End Old Town. Three delegates each from the Essex County Council, Leyton Urban District Council, Walthamstow Urban District Council, Poplar and Limehouse Boards of Works and the Vestry of Mile End Old Town. In asking the Vestry's approval to the steps already taken in this matter, your Committee beg to say that every effort will be made at the forthcoming Conference towards devising some scheme for dealing effectually with this long standing nuisance. All of which is respectfully submitted. HENRY HULLAND, Chairman. 22nd September, 1897. 39 In accordance with the terms of this report, a Conference of representatives from the districts named was held on the 13th of October, at the Town Hall, Hackney, and it was resolved to approach Mr. Chaplin, Secretary to the Local Government Board by deputation, to ask him to obtain the re-appointment of the Select Committee which enquired into the pollution of the River Lea, in 1886, but which failed to report fully on the subject owing to the dissolution of Parliament. The reasons for desiring the reappointment of the Select Committee may now be briefly summarised. So far as Hackney is concerned the part of the river which is the subject of representation forms the eastern boundary of the parish, and borders the large recreation space known as the Hackney Marshes. Into this part of the river, the combined effluents from the Walthamstow sewage farm and the Leyton Sewage Works are poured, rendering the river highly polluted and offensive, the degree of offensiveness varying with the atmospheric temperature and being more offensive during the summer than the winter. I have reported that this condition of the river close to a much frequented open space is a danger to the public health. The full extent of the pollution may be estimated when I state that the population of Walthamstow is 46,346 and that of Leyton 63,056, and the river receives the sewage effluents from these districts. But besides the nuisance, the water of the river is too foul for recreation purposes, including bathing. The London County Council, two years ago, proposed to construct a bathing pool in this part of the river, but owing to the foul condition of the water the scheme was given up. The above is the condition of the river which the local authority of Hackney complain of. Although other parts of the river, such as the Navigation Cut, are not absolutely free from pollution, yet the nuisance is not apparent, so that if the effluents from the above-named places were diverted from the river and so from the district of Hackney, this would be satisfactory locally; but the question must be considered 40 from a broader standpoint than that of local wants. So far back as the year 1886, the question of the pollution of the Lea occupied the attention of a Select Committee of the House of Commons. From the evidence then laid before the Committee it appeared that the river was subject to pollutions from sewage and sewage effluents from most of the districts adjoining. Briefly, it was found that from some places crude sewage, from others sewage effluents after precipitation of the solids, and from others again the effluents after precipitation and land filtration, were passed into the river. In other instances sewage was turned on to land from which no effluent appeared, the water, &c., disappearing in the under-lying strata, possibly gaining the river at a lower point or the waters stored up in the chalk, from which we derive our drinking water. Those witnesses examined, who were competent to express an opinion, were unanimous in the view that whether the river were used as a source for our domestic supply or only for recreation purposes, it should be freed from all sewage whatever the treatment it was previously submitted to, and the view was expressed that whatever the treatment, whether by land or chemical or any combination, it " was unsatisfactory which left an effluent to come into the river," and that there was a considerable danger attaching to those effluents which were allowed to disappear in the underlying strata, especially in the chalk. So much did this evidence influence the Committee that in presenting their report they stated : " Without desiring to prejudge the fuller consideration of the question of the purification of the Biver Lea as a whole, your Committee desire to point to the mode in which the sewage which formerly polluted the Biver Thames in its passa ge through London was dealt with by the Metropolitan Board of Works, as affording a precedent which ought to be considered in connection with the Biver Lea, and which, if followed, might be expected to remedy the more flagrant evils complained of, at the earliest practicable date." 41 On comparing the evidence of the above report of 1886 with some recent evidence obtained by the London County Council of the methods adopted for the disposal of sewage in the Lea Valley, it will be seen that the present state, although slightly improved upon that of 1886, remains practically the same—any improvements in methods being more than counteracted by the great increase of population which has taken place since that date; so that, coming back to Hackney, we may say that practically the circumstances of the river in Hackney represent a condition applicable to nearly the whole river. Such being the case, it is desirable that in seeking for a remedy we should choose one which, relieving Hackney, would at the same time afford relief to any other districts in the Lea Valley suffering from the same evils. This remedy is to be found in a main drainage scheme for the Lea Valley—a scheme outlined in the report of the Select Committee of 1886. If necessary then, how much more so now ? It is with the object of bringing about such a remedy that the Hackney Local Authority invited representatives from districts affected by the condition of the Lea to the above Conference, whose deliberations resulted in the resolution quoted before. It is evident that if the Committee of 1886 could be re-appointed in 1898, the evidence of the former would be much strengthened by evidence now available, and the main recommendation of 1886 of a Lea Valley drainage scheme would be put forward with so much more force as to overcome all opposition against it. The proceedings of this Conference I give in an appendix. STABLE REFUSE. By an order of the Vestry, it is provided that stable refuse shall be removed from all stables in the district at least twice a week; and much has been done to enforce this order. But there are certain difficulties in the way of providing an efficient remedy against nuisance from stable refuse. It is not often that much nuisance is caused by a small accumulation of ordinary stable manure; but if the accumulation is a large 42 one and it has been kept on the premises in dung-pits, the nuisance although small while the dung is at rest, gets almost unbearable while the pit is being cleared. This nuisance is bad when ordinary stable (straw) litter is used; but of late years in large stables, straw has given place to peat-moss as a litter. The reason for the substitution is, I understand, one of economy. Moss litter, I am told, is cheaper and more absorbent than straw and this is where it gives rise to more nuisance than straw. Peat-moss is used until it is thoroughly saturated with urine, then deposited in the pit, and after remaining there a sufficient time to setup decomposition of the urea, is disturbed during the course of removal, to the great annoyance of the neighbourhood. This has been a source of much thought to me during the last two or three years, and I have arrived at the conclusion that, except for very small accumulations, stable dung-pits are a source of nuisance for the reasons above stated. The remedy is a simple one. For the dung-pit which is never cleaned out, I would substitute a van or portable dung pit into which the stable refuse direct from the stable is placed, and when full have it removed without any further disturbance of the manure, into the country or to the railway depot, the van at the same time being thoroughly cleaned ; in fact, convert the fixed into a portable dung receptacle. I have tried this in a few places, where complaint had been made of the nuisance arising during the removal of stable manure, with complete success, and I have suggested it to the North Metropolitan Tramways Co., for their stables at Stamford Hill; but they prefer to employ a staff of men continually going through the double process of loading the dung-pits, transferring their contents to vans, and during this process annoying the residents in the neighbourhood, to the simple operation of loading a reserve van direct from the stables and removing it when full from the premises. I believe the above is the only effective remedy for nuisance arising from large stables. ALTERATION OF TITLE OF COMMITTEE. Luring the year it was considered desirable to change the names of the Sanitary Committee and Department to that of Public Health 43 Committee and Department. The reasons for such an alteration are set out in the following report, which was adopted by the Vestry :— Your Committee have given this subject their careful consideration, and would like, in the first place, to remind the Vestry that the first Sanitary Committee were appointed by the following resolution of the late Board of Works, on the 27th of July, 1866:— Resolved—That the Clerk direct circular letters of request to the various Medical Officers of the district, as directed by the Order of Council, and that the Committee appointed on the 19th day of July instant, be appointed by this Board to act as a Committee, under the 5th section of the Nuisance Removal Act, to consolidate and amend the Nuisance Removal and Diseases Prevention Acts, 1848 and 1849, and to put in force the several orders in Council as occasion or circumstance may require. The duties of the Committee at this time were confined to dealing with the removal of nuisances and the execution of any order of the Privy Council relating to epidemic disease. From this date the duties of your Committee have gradually increased under various Acts of Parliament passed by the Legislature, of which the following are a few:— An Act to amend the Removal of Nuisances, and the Prevention of Diseases Acts, 1860. The Sanitary Act, 1866. The Sanitary Act, 1868. The Sanitary Law Amendment Act, 1874. The Infectious Disease Notification Act, 1889. The Infectious Disease Prevention Act, 1889. But in the year 1891, the Public Health Act was passed, and your Sanitary Committee were reappointed to execute all the duties which fall upon the Vestry under its provisions. It is almost unnecessary to state that the functions of the Committee under the new legislation were very much enlarged, and their character altered. While in 1866 the work of the Committee might rightly be described as sanitary work, in 1897 their duties include much that it would be incorrect to describe under this term, instances of which are the Notification of Disease and the Adulteration of Food and Drugs. 44 Your Committee do not think that its present title of Sanitary Committee, which has become associated in the popular mind with the removal of nuisances, is sufficiently wide to adequately convey the idea of the important duties entrusted to them, and consider that it is an anomaly that they should retain a name derived from Acts of Parliament which have been repealed, and which is misleading, inasmuch as it does not properly describe their duties. They therefore recommend that the titles of Sanitary Committee and Sanitary Department be changed respectively to Public Health Committee and Public Health Department, as being more descriptive of the work of your Committee in safeguarding the public health in your district. All of which is respectfully submitted. HENRY HULLAND, Chairman INFECTIOUS FEVEES AND DRAIN EFFLUVIA. The connection of infectious disease with defects in house drainage is a subject upon which the popular mind has very pronounced views. Such defects are competent, it is thought, to produce any infectious disease; at one time enteric fever, at another measles, scarlatina or diphtheria without rhyme or reason ; but to those engaged in practical sanitation the connection of the two has not been so obvious. The difficulties of arriving at any certain or probable conclusion on the subject are many— the most serious being the want of data upon which to found any conclusion. In order to arrive at an accurate conclusion, it is necessary to know, firstly, what proportion of house drains is defective to use as a standard of comparison for houses where infectious disease exists, and where the drains are defective. By this means we would learn whether the incidence of infectious disease was greater upon houses with defective drains than upon houses without defective drains. This is to say, whether the infectious disease rose or fell pari passu, with the number of defective drains. I mean by the term defective drains such a condition of the drain as led to the escape of drain air into the dwelling; but as I have not been able to obtain the above information, I am thrown back upon the less satisfactory method of comparing the houses where infectious cases have occurred with one another, as in the table below. 45 That a certain number of cases of infectious disease occurs in houses where a defective condition of house drain is found is quite true; but the sequence is by no means invariable. During the year 1897, the house drains of every dwelling house where a case of either of the diseases given below occurred in this district were tested, and the results are set out in the following table. I have, of course, taken only primary cases into consideration. Table VIII. showing condition of drains of houses in which primary cases of infectious disease occurred during the year, 1897. disease. Houses in which drains were defective. Houses in which drains were not defective Total No. of houses in which primany cases occurred. Percentage of houses with defective drains. 1. Enteric Fever 37 89 126 29.3 2. Diphtheria 154 400 554 27.8 3. Scarlatina 171 740 911 18.7 4. Erysipelas 31 140 171 18.1 From this table it appears that enteric fever and diphtheria occur more frequently in houses with defective drains than scarlatina and erysipelas, and that the former two diseases occur with almost the same frequency as each other, the latter two behave in a similar manner. But if any relationship exists beween defective drains and the above diseases, it is closer, from the above table, in enteric fever and diphtheria than in scarlatina and erysipelas. With regard to enteric fever we are aware that this disease may be spread by means of defective drains receiving the evacuations of patients suffering from this disease ; but in the case of diphtheria the effect of drain air would be, I imagine, to cause sore throat, rendering this part of the body more vulnerable to the bacillus of diphtheria, and may be thus considered a predisposing cause. The connection of scarlatina and erysipelas does not appear to be so close as in the former two diseases. I believe that if the whole 46 district were inspected and the drains of each house tested, the percentage of defective drains would not be much less than in the houses where scarlatina and erysipelas occurred during 1897 ; so that from this table — which I admit is not conclusive, but rather suggestive—there is not much evidence that defective drainage acts either as a predisposing or exciting cause of these latter diseases. STORM FLOODINGS. On the 21st July, 1897, a very severe storm broke over the North and North-Eastern parts of London, being specially severe in Hackney, and resulting in great damage to property and danger to health. It is stated that during the storm 1½ inches of rain fell in the short space of time of half-an-hour. From the known capacity of the sewers in the district, it is clear that floodings must result, and, indeed, a large number of houses in the district—chiefly houses with basements—were flooded with sewage. It is unnecessary to say that the health of the inmates of these houses was endangered. Having reported these circumstances to the Public Health Committee, it was resolved : " That the Medical Officer of Health have full authority to deal with these cases of floodings as he considers necessary, and report thereon." The measures I thought necessary were the removal of the foul deposit left by the flood, the cleansing and disinfection of the floors, and removal of the polluted soil beneath. These measures were promptly carried out under the supervision of the Sanitary Inspectors. The following table shows the houses and parts of the district chiefly affected, with an account of the work done and its cost. This storm showed the inadequacy of the sewers to carry off an excess of storm waters, but the parts of Hackney which appeared to suffer most were situated in the eastern part of the district. Hackney Wick was much flooded, and would have suffered more had not the Marsh sewer burst—thus leading to the flooding of a large part of the Marsh, and so relieving Hackney Wick. I have in 47 HACKNEY VESTRY. Table X.—Work done by the Public Health Department in houses flooded by the Storm on 21st July, 1897, in the Parish of Hackney. name of road. nos. of houses. work done. Rendleshain Road 1, 3, 7, 9, 10, 11, 12, 16, 17, 25, 27, 36, 38, 40, 42, and 46. The floors were taken up in basement, and the accumulation of sewage, mud, etc., removed; the surface under the floors was covered with lime and disinfecting powder; the floors were then relaid with old materials where possible, new boards having to be used in some cases where the old boards and joists were too rotten to be used again. Dalston Lane 246 and 248. Aspland Grove 2, 3, 4, and 10. McLaren Street 1, 3, 7, 9, 11, 13, 15, 17, 19, 21, 25a, 27, 27a, 29a, 31a, 6, 8, 10, 12, 14 and 16. Oswald Street 11, 13, 15, 17, 19, 21, 23, 27, 31, and 16. Graham Road 166, 168, 170, 172, 174, 176, 178, 180, 182, 129, 131, 133, and 102. Total number of houses dealt with; 120. Prince Edward Road 58 to 82. Amount expended on Labour:£66 17 10. Old Windsor Road 15 to 30. Carbolic Powder used: 10 cwt. Peroy Terrace 25 to 32. Wick Road 224. Sanitas Powderused: 3 tons. Marian Street 22 to 32, and 17 to 25. Lime used : 6 cubic yards. Mare Street Old Town Hall. The mud, etc. cleared away,and the floors cleansed. Brooksby's Walk 42 and 44. Dalston Lane 254 and 256. 48 former reports referred to the small amount of fall in the sewers of this part of the district, and the need of relief; and I am informed that the scheme formulated by the London County Council is making progress—not of a very rapid character, it is true, but with a reasonable amount of certainty that the scheme will be carried out shortly. Another part of the district which was badly affected by the storm was the most Eastern part of Clapton Park, and it would have suffered much more if the Marsh sewer had not burst, as referred to above ; but the subject of floods in Clapton Park and their causes and remedy I am dealing with separately below. FLOODS AT LEA BRIDGE. Early in the year my attention was called to the overflow of the River Lea between the East London Waterworks Company's Offices at Lea Bridge and Spring Field. It appears there had been a rather excessive amount of rain at the beginning of the month of February, and on the night of the 5th of that month, the water of the river rose and overflowed its banks, flooding the cottages on the western side of the river and the Millfields. The water rose in the houses to a height of about 18 inches, subsiding the next day about noon, but rose again the next night finally subsiding the night after. The area flooded reached from Lea Bridge Road to the foot of Spring Field. The water overflowed both sides of the river; but the greatest damage was done on the western side, as the houses are on this side of the river. The following is a list of the houses flooded. List of houses in the Stamford Hill district flooded by the overflow of the River Lea on the 5th, 6th and 7th February, 1897 :— Hammond's Cottages Nos. 1 to 10 inclusive. Green's Cottages „ 1 „ 12 „ Lower Docks ,, 1 „ 9 „ Upper Docks „ 1 „ 12 „ Laburnham Villas „ 1 „ 7 ,, Willow Cottages „ 1 ,, 7 „ Hammond's Cottages „ 1 and 2 King's Head P.H. 49 On inspecting the houses, I found that the water had risen about 18 inches above the ground floor' Most of them showed the height the water rose, by the dampness of the walls. It appeared on enquiry that the houses were flooded in a similar manner a few years before; but the more recent flood appeared to be out of all proportion to the amount of rain-fall preceding. The importance of this flood depends on the fact, whether it was an accidental event, due to an extraordinary fall of water in the Lea Valley, or whether any change had taken place on the banks of the river, by which flood waters are more confined to the course of the stream, or that their exit by the natural channel is restricted. I am indebted to Mr. W. B. Bryan, Chief Engineer to the East London Water Company, for the following letter giving details as to the gaugings taken at Field's Weir on the 6th and 7th February last. East, London Waterworks Company, Engineer's Office, Lea Bridge, Clapton, N.E. March 10th, 1897. FLOODS IN THE LEA VALLEY. Dear Sir,—I find, on investigation, that far greater volumes have passed over Field's Weir in years gone by, on many occasions, than on the 6th February last. The quantity gauged on that day was 945 million gallons. In November, 1894, 1114 millions passed, but the November, 1894, floods were very much smaller at Lea Bridge than the floods of the 6th and 7th February, 1897. It must be noted, however, that the volume of water at Lea Bridge is very much in excess of that at Field's Weir. I must, however, point out that for the four days preceding 6th Fobruary the daily flow was 810 million gallons, while in November, 1894, the flow only reached about 645 million gallons daily on the two preceding days. Consequently the whole of the valley had a greater accumulation of water in February last than in November, 1894, although a much greater quantity passed on one day in 1894 than in 1897. The normal level of the water in the River Lea at Lea Bridge is 20 80 above Ordnance Datum. In 1894 the flood only caused a rise in the river at Lea Bridge of from 7 to 8 inches, but in February last the rise was 1 foot 9 inches. In each case the whole of the sluices in the waste weir were raised, giving full vent to the flood waters, and the level of the water below the weir was seven inches lower than at Lea Bridge, and at the boundary of the Company's property, some hundreds of yards lower down, D 50 the level of the water was only 1 foot 8 inches below the level at the bridge, thus showing the slope of the surface of the water to be almost uniform, and proving that the weir caused scarcely any perceptible obstruction. The water in the North Mill Field rose to 23.43. and in the marshes north of the Lea Bridge Road it was 23.72. The Lea Bridge Road was under water between the Company's entrance gates and just west of the bridge over the Company's canal. In 1894 no water covered the road, and I believe none of the houses were flooded. The Hackney Marshes have been embanked, and no water can spread over them or reach the various branches of the river at lower levels. All the marshes on the Essex side were under water. Should these be banked eventually the backing up of the river to even higher extent than on the 6th and 7th February, must ensue in times of great floods. Yours truly, WILLIAM B. BRYAN. Dr. J. King Warry, 39, Filey Avenue, Clapton, N.E. The opinion expressed by many persons, and here shared by Mr. Bryan, as to the cause of the flood, is that the Hackney Marshes have hitherto acted as a reservoir or a channel for the diversion of any extra flood waters should the river rise above a certain height, and that the embanking of the Marsh has cut off this relief, hence the flooding of some other part. While this is no doubt a reasonable explanation, I do not think it goes far enough. I understand that the Hackney Marshes are not the only lands which have been embanked to prevent flooding from the river. The immense reservoir recently completed was constructed on a site contiguous to the river, and which I have every reason to believe used to receive storm waters on the same occasions as the Hackney Marshes. Moreover, certain works have been carried out under the Lea Valley Drainage Act, 1892, for the prevention of flooding of lands adjacent to the river. The net result of these works has been to allow storm waters to get into the lower parts of the river without causing any floods ; but it is obvious that unless the outlet for storm waters from the lower part of the river is increased in the same proportion, the river must get overcharged and overflow its banks. 51 Considering the whole of these circumstances it is probable that the embanking of the Hackney Marshes by the London County Council was instrumental, to some extent, in bringing about the flooding of the houses on the west bank of the river referred to above, but, I am of opinion that the other works referred to, and carried out by the East London Water Company and the Lea Valley Drainage Commissioners were also to a similar extent responsible. It is obvious that the waters of a river, which during heavy rains is accustomed to overflow its banks, and flood low lying lands, will, if the banks are raised, rise considerably during such times and probably overflow other parts, if the water cannot get away fast enough by the natural channel of the river. Endeavours are being made to reclaim from the river such of the low lying lands as are capable of being utilised. This is especially the case in our district. We may then confidently anticipate that the flooding of the houses named above which hitherto has been a rare event, will become more frequent; and the object of recording this event is to consider what, if any, remedy can be applied to prevent the recurrence of floods to the detriment of inhabited houses in this district. It is clear that the reclaiming of low lying land near the river, and its utilisation cannot be stopped ; so the problem to be solved is how to allow storm waters to pass rapidly enough away to prevent the flooding of inhabited houses on the river banks. The first suggestion is to raise that part of the river bank adjacent to the dwellings ; or, if this is not practicable, to construct some channel of relief to be used during the times of flood; but the remedy is really an engineering work, and properly, should be proposed by such an expert. As to who should undertake this work, I would suggest that the Lea Drainage Commissioners, who have already done similar work in other parts of the Lea, and apparently with good results, should be re-appointed, under a new Act of Parliament, if necessary, to carry out the work of preventing floods from the Lea in this district. 52 FLOODING OF HOUSE BASEMENTS IN CLAPTON PARK. During the period I have been Medical Officer of Health for Hackney, my attention has frequently been called to the flooding of the basements of houses with sewage, in different parts of the district during unusual rain falls; but while in some parts the incident is fortuitous and apparently unpreventable, there is one district where flooding occurs with so marked a constancy after rainfall as to cause me to believe there is some local condition favouring such an event. The area in question is situated at the most eastern part of Clapton Park, stretching from Glyn Road on the west to the Hackney Cut on the east, and from Millfields Road on the north to Blinco Road and Redwald Road on the south. I do not mean to state that the whole of the houses in this area are subject to floods during heavy rainfall; but where basements are present in the house, there, with few exceptions, flooding takes place ; and if more houses in this area had been provided with basements, more would be subject to floods from overcharged sewers. As I remarked above, the recurrence of floods in the area caused me to make enquiries as to its cause; and I have been much assisted in this enquiry by Mr. Lawrenson, the Surveyor of Sewers, who has, with the permission of Mr. Lovegrove, your Chief Surveyor, kindly supplied me with information as to the character of gradients, depth, etc., of the sewers in this locality—so far as his knowledge extends. The following table which I have compiled from the information thus afforded shows:— 1.—That the whole of the sewage of the above district is carried off by the Marsh Sewer, which receives also the sewage from Tottenham; and that now its dry weather flow is about 18 inches. This leads to the result that a considerable length of the main sewers conveying the sewage from the eastern section of Clapton Park is charged with backed up sewage. 2.—The gradients of many of the branch sewers are too small for the effectual conveyance away of the sewage. 3.—That owing to the presence of basements in certain streets, the gradients are still further reduced ; the consequence being that the house drains are almost flat. 53 Table of Sewers draining Eastern part of Clapton Park, with size, gradients, and depths, &c. Name of Sewer. Area drained. Course of Sewer. Size and Material. Gradient. Average depth. REMARKS. Marsh Sewer. Clapton Park, portion of Upper Clapton and Tottenham Parale1 with the Hackney Cut. 4ft. 9in by 3ft.9in. brick. About 1 in 3,000. 7ft. Gin. Constructed in 1875. Since that date the drainage received has gradually increased ; the consequence being that now the dry weather flow is about 18 inches in depth; in storms it becomes overcharged, and the whole of the sewers in the immediate neighbourhood become blocked up, and numerous basements are flooded. Blinco Road. Daubeney Road Ashenden Road, Durrington Road, Roding Road, part of Glyn Road, Chelmer Road, Coopersale Road. 3ft. by 2ft.brick. 1 in 610 No basements in Blinco Road; the house drains have fair gradients. Rushmore Road. 3ft.6in.by 2ft. 4in. brick. 1 in 473 Between Overbury Street and the main sewer there are numerous basements in this Road, which are flooded in times of heavy flood. MillfieldsRoad. 3ft. 6in by 2ft.4in. brick. At its lower end about 1 in 250. In addition to taking the sewage of a portion of the District of Clapton Park, this sewer also receives a large volume from the new streets laid out in recent years at the western end of Millfields Road. In times of storm this sewer is over charged. With regard to the three abovementioned sewers, of late years it has been found impracticable to clean out their lower ends during the day time, because of the large quantity of sewage held back owing to the great depth of flow in the main sewer, and the work has had to be done at night. 61 Table of Sewers draining Eastern part of Clapton Park, with size, gradients, and depths, &c.—continued. Name of Sewer. Area drained. Course of Sewer. Size and Material. Gradient. Average depth. remarks. Oilpin Road. 15in. pipe 1 in 350. 7ft 2in. There are no basements to the houses in this street, but even in dry weather some eight or nine inches of sewage backs up the pipes from the main sewer. Carlton Road. 12in. pipe. 1 in 240 No basements, and the sewer is in fairly good condition. Mandeville Street. Between Blinco Road and Gilpin Road. 12in. pipe 1 in 223. No basements in this portion of Mandeville Street. Ditto. Between Millfields Road and Rushmore Road. 12in pipe. Gradient irregular about 1 in 400. Greatest depth 7ft Gin , least depth 3ft. 9in. A few half basements in thiB street. Oswald Street. (1) Between Millfields Road and Rushmore Road, part falling into Rushmore Road. l'iin pipe. 1 in 370. This sewer is in two sections. The section falling into Rushmore Road sewer was relaid with cement joints to a uniform gradient in ' May, 1895. There are several basements in Ditto. (2) Part falling northwards into Millfields Road. 12in. pipe 1 in 218. this street which are flooded in times of heavy rainfall. Pedro Street. Between Rush more Road and Rodwald Road. 15in. pipe. 1 in 380. There are basements to all the houses in this portion of the street, and in times of heavy rain they are flooded. 55 Pedro Street. Between Millfields Road and Rushmore Road. Secti o n falling into Rushmore Road. Section flowing northwards into Millfields Road. 12in. pipe. 15in. and 12in. pipes very irregular. 1 in 350. 1 in 135. Greatest depth 6ft. 3in., least depth 3ft. 6in. Greatest depth 5ft. 10in.,least depth 3ft. 6in. - House drains are very flat. Preaburg Street. 12in. pipe. 1 in 300. 4ft. 6in. House drains very flat. Overbury Street. Between Rushmore Road and Presburg Street. Section falling n'thward; into Presburg Street. I2in. pipe. 1 in 290. 1 (1) Section falling s'th wards into Rushmore Road. 12in.pipe. 1 in 320. Least depth 4ft. 9in. Numerous basements, the whole of whicl r are flooded in heavy rains. 56 Table of Sewers draining Eastern part of Clapton Park, with size, gradients, and depths, &c.—continued. Name of Sewer. Area drained. Course of Sewer. Size and Material. Gradient. Average depth. REMARKS. Overbury Street (2) Between Rushmore Road and Redwald Road. 12in. pipe. 1 in 200. Basements to all of the houses in this road, but a few only at lower end are ever flooded. Glyn Road. (1) Between Millfields Road and Elderfield Road 15in pipe. The 15in. pipes are nearly level. Impossible to raise the upper end of sewer owing to the depth of basements. Ditto (2) From Elderfield Road, southwards 12in. and 9in. pipe 1 in 200. In heavy rainfall all the basements between Millfields Road and Elderfield Road are flooded. Redwald Road 12in. pipe. varying gradients. This sewer turns down Pedro Street, and near its Junction with Pedro Street the sewer is almost level, and the basements at this point are flooded in time of heavy rain. As Redwald Road rises somewhat rapidly from Pedro Street, the upper section of the street is not affected by floods Maclaren Street, 12in. pipe. 1 in 410. In times of storm the houses here suffer considerably, the majority having basements. In some houses the basement floor is only about 2 feet above the invert of the sewer in front In these, of course, the house drains are very flat 57 4.—That most of the basemented houses of this locality are flooded with backed up sewage during periods of storms. Such is the condition of this part of Clapton Park ; and the above is only a bare statement of things as they exist. The occurrence of the storms during last summer, producing so much misery and danger to health, has forced me to draw attention to the conditions described above, in the hope that some remedy might be applied to prevent these disastrous floods. If some remedy for the above described state of things is not soon applied, I have great fear that the population of this area, which is a growing one and contains a large proportion of young people, will suffer in health. The danger to health from sewage flooded houses is apparent. I am not prepared to say that the imperfect sewage arrangements are responsible for the infectious disease; which is above the average of the whole district in this area ; but I am of opinion that repeated floods of the kind described above, have a detrimental effect upon the health of its inhabitants by leading to fouling of the soil beneath and around the dwellings, which fouling, the latest researches indicate as being an active agent in the spread of disease ; moreover, we do know that the foul smells from drains and sewers produce a lowering of the system of persons exposed to these smells, and predispose to the reception of the active agents in infectious disease, so that for health considerations it is desirable that some remedy should be soon forthcoming. In addition, the discomfort and expense caused by these floods, would be a sufficient reason for removing their cause, if possible, without the more important and serious reason of danger to public health. The remedy, of course, is an engineering one which can only be applied by the London County Council. The time is opportune for drawing their attention to this matter because they are considering a scheme for the relief of Hackney Wick; and some modification of this scheme to relieve Clapton Park might now be made more easily than at a later period; and I would most strongly urge that their attention should be called to this area, and be asked to improve, if possible, its sewage arrangements to prevent the recurrence of similar floods to that noted above. 58 VACCINATION. The following table is a summary of the returns rendered by the vaccination officers for the year 1897, respecting the vaccination of children in the Hackney district. It will be seen that out of a total of 6,332 births, no less than 3,808 were unaccounted for—a percentage of 61-7. The following are the percentages of cat-es unvaccinated in the four registration sub-districts: Stamford Hill, 37%; West Hackney, 46-2%; Hackney, 65'5 %; South Hackney, 66-5 %. The percentage of unvaccinated children has been gradually increasing during the last few years, and for practical purposes, vaccination may be said to be almost at a stand-still in Hackney. The Bill which is now before Parliament will, it is hoped, stimulate public interest in a branch of preventive medicine which, by every test applied to it, has been proved to lessen the prevalence of small-pox and greatly reduces its mortality. REMOVAL OF HOUSE REFUSE. During 1897 the number of loads of house refuse removed from the district was 50,788 at a cost of £11,655 15s., being an increase of 6,126 loads and £1,387 19s. 3d. on the previous year. The prices paid per load and the number of loads removed during the several months of the year are given in the table below. The above increase in loads and cost is a large one, but is partly due to an increased number of occupied houses in the district, and to greater vigilance being exercised by the dustmen in securing the removal of all refuse from the houses they are allowed to enter. I may here add, the more general adoption of portable dustbins in place of the old offensive and insanitary dustbins is a great assistance to dustmen in the removal of refuse. In addition to the above cost, the sum of £2,152 3s. 7d. was expended in wages to the Vestry's dustmen, bringing up the total cost of removal of house refuse in Hackney for the year 1897 to £15,195 7s. Id. In my last year's report I gave a list of the number of requests received for the removal of house refuse for the years 1894-5 and 6. This year I give the number received during 1897. It will be seen Return respecting the Vaccination of children whose births were registered in the Hackney Union during the year 1897. REGISTRATION SUB. DISTRICTS. No. of births Registered from 1st January to 31 December, 1897. Number of these births daily entered by 31st January, 1898, in cols. 10, 11, 13 of the Vaccination Register (Birth List Sheets) viz:— No. of these births which on 31st January, 1898, remained unentered in the Vaccination Register on account (as shown by Report Book) of No. of these births remaining on 31st January, 1898, respectively, neither duly entered in the Vaccination Register (cols. 3, 4 and 6 of this return), nor temporarily accounted for in the Report Book columns 8, 9 and 10 of this return. Col. 10. Successfully Vaccinated Col. 11 Insusceptible of Vaccination Col. 13. '* Dead." Unvaccinated. Postponement by Medical Certificate. Removal to Districts, the Vaccination Officer of which has been apprized. Removal to places unknown, or which cannot be reached, and cases not having been found. 1 2 3 4 6 9 10 11 Hackney 3254 698 4 247 — 8 166 2131 South Hackney 1437 245 — 139 — — 97 956 West Hackney 1210 431 1 121 7 3 86 561 Stamford Hill 431 205 — 33 7 1 25 160 Totals 6332 1579 5 540 14 12 374 3808 59 60 that the number has decreased to an almost insignificant figure. This satisfactory result has followed from the introduction of the system of calling weekly at each house in the district. This periodical house-call was begun at the beginning of the year 1895, and since that time there has been a steady decline in the number of complaints or requests. While this gradual diminution of the complaints of non-removal of dust is satisfactory, there is not so much satisfaction derived from the consideration of the attitude of householders towards the dustmen when they make their weekly calls. A list of the refusals during the year is appended. On comparison with that for the year 1896, it will be seen that the average number of refusals for 1897 is much the same as in 1896. It appears that during 1897 an independent enquiry was made by the London County Council as to the mode of collection of house refuse carried on in Hackney, with the results recorded in the following copy of a letter sent to the Vestry by the clerk to the Council. London County Council, Spring Gardens, S.W., 17th December, 1897. Sir,—With reference to previous correspondence on the subject of the collection of house refuse in the Parish of Hackney I am directed to inform you that the result of inquiry made by the Council's inspector at 10,119 houses is to show that: — (а) It is the practice of the dust collectors to call at every house once a week. (б) It is the fault of the inhabitants when weekly collection is not made. (c) There were accumulations of refuse due to non-removal for periods of two or more weeks in 2,834 out of the 10,119 houses visited. In the case of Borrow v. Howland it was decided in the Queen's Bench Division of the High Court of Justice on 15th May, 1896, that refusing to allow scavengers of the Sanitary Authority to enter premises for the purpose of removing house refuse constituted " obstruction " within the meaning of Section 116 of the Public Health (London) Act, 1891 ; and I am to suggest to the Vestry that the institution of proceedings against a few inhabitants, and the publication of the results on handbills left at each house, would probably suffice to overcome the difficulty which the Vestry now encounters in its endeavour to secure the weekly removal of house refuse. I am also to call the Vestry's attention to the fact that the dust receptacles at 2,693 houses were found by the inspector to be in a dilapidated condition. I am, Sir, Your obedient servant, T. BELL, For the Clerk of the Counoil. The Clerk of the Vestry of Hackney. 61 With respect to paragraphs (a) and (b), these confirm the reports I have made on these subjects for the years 1895 and 1896 ; and as to (c) it will be seen that in nearly one quarter of the houses visited there were accumulations of refuse, due to non-removal for periods of two or more weeks. This proportion corresponds almost exactly with the proportion of weekly refusals. It is obvious that if the entry of the dustman is denied, these accumulations will exist, and exactly in proportion to the refusals. MONTH. Northern Division Southern Division Totals. Loads. Cost. Loads. Cost. Loads. Cost. 1897 £ 8. d. £ s. d. £ 8. d. January 1817 476 19 3 2244 579 14 0 4061 1056 13 3 February 2059 540 9 9 2408 622 1 4 4467 1162 11 1 March 1814 476 3 6 2236 577 12 8 4050 1053 16 2 April 1916 494 19 4 2282 580 0 2 4198 1074 19 6 May 2061 532 8 6 2466 626 15 6 4527 1159 4 0 June 1936 500 2 8 2346 596 6 6 4282 1096 8 2 July 1838 474 16 4 2212 562 4 4 ! 405(1 1037 0 8 August 1834 473 15 8 2330 592 4 2 4164 1065 19 10 September 1795 463 14 2 2266 575 18 10 4061 1039 13 0 October 1806 466 11 0 2278 578 19 10 4084 1045 10 10 November 1969 508 13 2 2518 639 19 10 1487 1148 13 0 December 1921 496 5 2 2386 606 8 10 4307 1102 14 0 Totals 22766 £5904 18 6 27972 £7138 5 0 50738 £13043 3 6 Dustmen's Wages £2 152 3 7 Sanitary Labour £974 14 6 trices per load—To March, 1897 N. 5s. 3d. S. 5s. 2d. „ March to December, 1897 N, 5s, 2d. S. 5s. Id 62 In order to reduce the number of refusals, I suggested to the Public Health Committee that a notice should be served on each householder, pointing out that it is the duty of the local authority to cause the removal of house refuse from each house in the district once a week, and the penalty incurred by obstruction The following notice was accordingly issued, a copy being left at each occupied house in the district, with what success may be seen from the above table of refusals. Hackney Vestry Public Health (London) Act, 1891. REMOVAL OF HOUSE REFUSE. To the Occupier, Notice is hereby given, that under the provisions of the Public Health (London) Act, 1891, and By-Laws made in accordance therewith, it is the duty of the Sanitary Authority to secure the due removal of House Refuse from every house in the Parish at least once in every week. The Dustmen in the employ of the Vestry will therefore call, as far as practicable, at every house in the District at least once a week ; and anyone obstructing the Officers of the Vestry in the execution of their duty, by refusing to allow the House Refuse to be removed, will render himself liable, under the clauses of the above-named Act, to a penalty not exceeding £5 [Five Pounds] for each offence. By order of the Public Health Committee, (Signed) J. KING WARRY M.D., D.P.H., Medical Officer of Health. Public Health Department, Town Hall, Hackney, N.E. 26th July, 1897. 63 I am afraid the only proceedure left to the local authority now to diminish the refusals, is to adopt the suggestion of the London County Council and prosecute. It may be well here to give a brief description of the system of removing the house refuse practised in this district. For the purposes of dust removal, the whole district is sub-divided into sub-districts, to each of which one of the Vestry's dustmen is appointed with two vans, horses and carmen, supplied by the contractors. It is the dustman's duty to call at every occupied house in his sub-district, and, if possible, remove the dust at least once a week. In order to learn where the dustmen are refused admission, or where no replies to their calls are made, each dustman is supplied with a sheet, on which he marks the number of the house under its appropriate heading of " refusal " or " no answer." These sheets are handed into the Public Health Office every morning and tabulated. If a complaint of non-removal of dust is made, we can, by turning to the sheets, see whether it is the fault of the householder or dustman. The fulness of the loads is checked by men appointed by the Vestry, before delivery of the refuse at the shoot or place of deposit. It would, in my opinion, be more satisfactory if each van-load were weighed, and payment made at per ton. Most of the Hackney refuse is deposited on a "shoot" in the neighbourhood of Hackney Wick. Although I am unable to trace any disease in the district to this cause, I regard the presence of this large accumulation of filth as a menace to this and neighbouring districts ; and I should be glad to see the " shoot " closed, and all the Hackney refuse burned in a well-designed destructor. This is the only sanitary mode of dealing with offensive refuse of any kind. 64 Table XI. A List of the requests for the removal of Dust, received during the four years, ending December 31st, 1896, viz., 1894, 1895, 1896 and 1897. 1894 1895 1896 1897 January 136 89 37 21 February 48 41 17 20 March 85 53 30 15 April 97 66 46 8 May 55 73 22 11 June 72 46 39 12 July 63 31 18 17 August 56 23 12 9 September 58 38 24 6 October 73 27 21 8 November 94 39 14 9 December 46 26 17 7 Totals 893 552 297 143 Table XII. A list of refusals in the collection of Dust during the year 1897- Week ending Refusals. Week ending Refusals. No answers. January 2nd 1,537 July 3rd 9,768 „ 9th 7.350 „ 10th 9,854 „ 16th 8,121 „ 17th 9,153 „ 23rd 9,484 „ 24th 9,317 „ 30th 8,632 „ 31st 8,948 February 6th 10,127 August 7th 10,869 „ 13th 8,958 „ 14th 9,653 „ 20th 9,822 „ 21st 10,887 „ 27th 9,513 „ 28th 9,950 March 6th 10,465 Sept. 4th 9,876 1,243 „ 13th 8,760 „ 11th 9,798 1,168 „ 20th 10,456 „ 18th 8.645 1,350 „ 27th 9,524 „ 25th 9,211 1,436 April 3rd 8,958 October 2nd 9,061 1,127 „ 10th 9,763 „ 9th 8,759 1,213 „ 17th 10,485 „ 16th 9,515 1,343 „ 24th 13,347 „ 23rd 8,642 1,195 May 1st 10,056 „ 30th 9,844 1,368 „ 8th 11,421 Nov. 6th 9,219 1,214 „ 15th 10,913 „ 13th 8,682 1,350 „ 22nd 10,040 „ 20th 8,971 1,246 „ 29th 9,873 „ 27th 8,729 1,349 June 5th 9,446 Dec. 4th 8,531 1,470 „ 12th 10,381 „ 11th 9,288 1,169 „ 19th 10,793 „ 18th 7,683 1,028 „ 26th 9,567 „ 25th 7,842 1,109 „ „ 31st 4,026 571 65 REGISTER OF SANITARY WORK. 1897. Public Health Department.—continued. Letters, etc., sent out 2640 Circulars, Notices, etc 13440 Committee Notices sent out 1584 Copies of Summonses and Orders made out 566 Houses from which Bedding, etc., were removed to be disinfected by the Vestry's apparatus 1350 Articles disinfected by the Vestry's apparatus— Heds 1050 Mattresses 462 Palliasses 12 Bolsters 741 Pillows 2004 Blankets 1055 Sheets 151 Carpets, Rugs, etc. 577 Quilts 345 Other Article 743 Rooms fumigated 2003 Houses cleansed after Infectious Diseases 757 Disinfectants supplied to the poor (bottles) 1410 Do. do. (bags) 5645 Infectious Patients removed to Hospital 1260 Cautionary Notices to Schools re Infectious Sickness 2018 Certificates of Disinfection issued to Schools, etc 1869 Accumulations of Dust specially removed 11 Articles destroyed by request— Beds 38 Mattresses 21 Bolsters 3 Pillows 6 Palliasses 8 Cushions 14 Articles of Clothing 30 Miscellaneous 8 Blankets 1 E 66 REGISTER OF SANITARY WORK, 1897. sanitary districts. Mr.Gough & Wood Stamford Hill Mr. Harvey, West Hackney Mr. Legg, Hackney Mr. Morley, Clapton Mr. Wood & Booy. Kingsland. Mare Street and South Hackney. Mr. Bobbitt, Hornerton E. Mr. Mansell, Homerton,N. Mr. Ellis, Homerton, S. Totals. Mr. High, Mr. Kemp Mr. Punter, No.l No.2 No.3 No.4 No.5 No.6 No.7 No.8 No. 9 No.10 Noll Inspections— Made on Complaint 438 355 249 288 281 321 324 225 226 341 166 3219 Workshops 14 11 23 22 11 12 47 28 14 62 4 248 House to House 89 85 113 8 93 138 109 135 117 66 175 1128 House after Infections Diseases 179 177 130 281 253 255 311 202 252 275 174 2469 Premises re-inspected 1957 3055 3037 2686 3583 2789 2630 1611 3245 4000 3155 31748 Fishmongers'& Poulterers' Yards 1 4 2 2 5 3 2 .. 7 15 6 47 Slaughterhouses .. 9 .. 1 17 .. .. 24 .. 6 1 58 Cow houses (Premises) .. 8 .. .. 1 .. .. .. .. .. 1 10 „ (Sheds) .. .. .. .. 14 .. .. .. .. 4 .. 18 Miscellaneous Inspections 25 7 5 .. 20 84 9 .. 96 86 150 482 Greengrocers' Yards 3 1 .. .. 2 .. 2 1 .. 10 3 22 Schools .. 1 .. 1 1 .. .. .. 1 4 .. 8 Bakehouses 23 2 .. 13 5 21 35 38 15 20 19 184 Urinals 6 3 21 7 4 31 40 12 3 44 2 173 Canal Boats .. .. .. .. .. .. .. .. .. .. .. .. Animals improperly kept .. 8 .. .. 4 .. 19 8 3 6 7 55 Statutory Notices served 19 114 84 35 31 16 20 4 84 10 94 511 Intimation Notices served 185 431 320 388 380 416 508 325 296 369 426 4044 Peremptory. or Pinal Notices served 25 64 38 .. 80 40 75 74 42 50 70 558 Proceedings taken before Magistrate under the Sanitary Acts 14 17 5 4 17 4 4 2 20 3 5 95 Nuisances abated 240 431 213 395 387 450 478 342 372 370 396 4074 Seized and Condemned as Unfit for Human Food— Fish .. 1 cwt. .. .. .. ½ cwt. 4 cwt. 2¼ cwt. .. 3 cwt. .. 10¾ cwt. Fruit and Vegetables .. .. .. .. 20 lbs. 20 lbs. ½ cwt. .. .. .. .. 96 lbs. Meat .. .. .. .. ½ cwt. ½ cwt .. .. .. .. ½ cwt. 1½ cwt. Other Articles .. .. .. .. .. .. .. .. .. .. .. .. Open Spaces cleared .. 1 2 15 .. 1 2 .. 1 13 6 41 Special Reports to Medical Officer of Health .. .. .. .. 3 .. 10 .. 2 4 4 23 Food Adulteration— Samples collec'd for Analysis .. .. .. .. .. .. .. 250 .. .. .. 250 Proceedings taken before Magistrates .. .. .. .. .. .. .. 37 .. .. .. 37 67 Table XIII. Record of Prosecutions under the Public Health (London) Act, 1891, during the year 1897. Address Complaint. Magistrate's Decision. 17, Rosina Cottages No dustbin Withdrawn, dustbin supplied Taylor's Buildings ,, ,, ,, ,, 3, Dunn Street Insanitary condition Order to do the work in 28 days, and pay 6/- costs 5, ,, ,, ,, ,, ,, ,, ,, 7, ,, ,, ,, ,, ,, ,, ,, 9, ,, ,, ,, ,, ,, ,, ,, 8, Hindle Street ,, ,, ,, ,, ,, 12, ,, ,, ,, ,, ,, ,, ,, 15a, St. Mark's Road ,, ,, ,, ,, ,, Barge "Priscillia" Carrying offensive refuse during prohibited hours uncovored Fined 1/- 22, Shacklewell lane Iusanitary condition . Withdrawn,work completed 49, Crozier Terrace House dirty Order to do the work in 14 days and pay 6/- costs 40, Castlewood Road insanitary condition Withdrawn, work completed 30, Dunn Street Choked drains Order to do the work in 14 days, and pay 6/- costs Dust Cart Uncovered Fined 15/- and 1/- costs Barge "Moses" (owner) Carrying offensive refuse during prohibited hours Withdrawn „ ,, (captain) ,, ,, ,, ,, Barge "William and Mary" (owner) ,, ,, ,, Dismissed, £2 2s. costs against the Vestry „ „ (captain; ,, ,, ,, ,, ,, ,, 91, Greenwood Road Defective drains Withdrawn,work completed Barge "William and Mary" (owner) Carrying offensive refuse uncovered Dismissed, £2 2s. costs against the Vestry ,, ,, (captain) ,, ,, ,, ,, ,, ,, 9, Landfield Street Defective drains Withdrawn,work completed 11, ,, ,, ,, ,, ,, ,, ,, 18, Cowdry Street Insanitary condition ,, ,, ,, 194a, Mare Street ,, ,, ,, ,, ,, 26, Victoria Road. Damp Walls Order to do the work in 1 month, and pay 6/- costs 28, „ „ ,, ,, ,, ,, ,, 30, „ ,, ,, ,, ,, ,, ,, 28, Greenwood Road Insanitary condition Withdrawn,work completed Middleton's Workshop, Winchester place ,, ,, Adjourned sine die 317, Victoria Park Road Soil-pipe unventilated Order to do the work in 7 days and pay 6/- costs 206, Morning Lane Insanitary condition Dismissed 84, High Street, Homerton Defective rain-water pipes Withdrawn,work completed 1, Bones Cottages Insanitary condition Order to do the work in 7 days and pay 1 /- costs 68 Address. Complaint. Magistrate's Decision. 2, Bones Cottages Insanitary condition Order to do the work in 7 days and pav 1/- costs 14, Gainsboro' Cottages ,, ,, Withdrawn,work completed 19, Crozier Terrace Defective drains Order to do the work in 7 days, and pay 6/- costs 113, Clarence Road Insanitary condition Order to do the work in 14 days, and pay 6/- costs 58, Dunsmure Koad Defective drains and insanitary condition Withdrawn, work completed Dung Wharf, Homerton Bridge Accumulation of manure on wharf Dismissed, £1 1s. costs against the Vestry 66, Brooke Road Defective drains and water closet Withdrawn, work completed Osment's Steam Joinery, Northwold Road Smoke nuisance Adjourned sine die 109, Southgate Road Penalty summons Dismissed Bricklock Cottages Piggery Penalty 40/- and 2/- cost 175, Clarence Road Insanitary condition Order to do the work in 14 days, and pay 1/- costs 39, High Street, Homerton No dustbin Withdrawn, dustbin supplied 59, „ „ ,, ,, ,, ,, ,, 25, Sandford Terrace Defective drains, &c Withdrawn,work completed 116, Culford Road Defective drains Dismissed, 10/- costs against the Vestry 118, ,, ,, ,, ,, ,, ,, ,, 121, ,, ,, ,, ,, ,, ,, ,, 122, ,, ,, ,, ,, ,, ,, ,, 124, ,, ,, ,, ,, ,, ,, ,, 126, ,, ,, ,, ,, ,, ,, ,, 128, ,, ,, ,, ,, ,, ,, ,, 130, „ „ ,, ,, ,, ,, ,, 132, ,, ,, ,, ,, ,, ,, ,, 134, ,, ,, ,, ,, ,, ,, ,, 136, „ „ ,, ,, Dismissed 138, ,, ,, ,, ,, ,, 135, ,, ,, ,, ,, Order to do the work in 14 days, and pay 28/- costs 53, DeBeauvoir road ,, ,, Withdrawn,work completed 55, Dalston lane ,, ,, Order to do the work in 14 days and pay 3/- costs 50, Foulden road ,, ,, ,, ,, 1/- „ 65, Downs Park road Insanitary condition Withdrawn,work completed 41, Brooke road ,, ,, ,, ,, ,, 7a, Rectory road Defective drains ,, ,, ,, 19, Prout road Defective drains and dirty water closet ,, ,, ,, 21, ,, ,, Roof leaky, yard paving defective, &c ,, ,, ,, 23, ,, ,, Gutters defective, house dirty, &c ,, ,, ,, 25, ,, ,, Roof leaky, house dirty, &c. ,, ,, ,, 69 address. Complaint. Magistrate's Decision. 108,DeBeauvoir road Unventilated soilpipe Order to do the work in 14 days and pay 3/- costs 110, De Beauvoir Road Unventilated soilpipe Order to do the work in 14 days, and pay 3/- costs Rear of 17, Church road Accumulation of manure. Order to remove the accumulation forthwith, and pay 1/- costs 8, Bones cottages Broken air bricks in front wall Order to no the work in 7 days, and pay Is. costs 4. Burton terrace No w.s. to water closet, house dirty, &c Withdrawn 30, Crozier terrace Sink waste pipe and gutters defective Withdrawn,work completed 17, Link street Insanitary condition ,, ,, ,, 19, „ ,, ,, ,, ,, ,, ,, ,, 21, „ ,, ,, ,, ,, ,, ,, ,, 23, „ ,, ,, ,, ,, ,, ,, ,, 25, ,, „ ,, ,, ,, ,, ,, ,, 27, ,, ,, ,, ,, ,, ,, ,, ,, 7, „ ,, ,, ,, ,, ,, ,, ,, 7, lima terrace Bath and sink waste-pipe defective Order to do the work in 14 days and pay 1/- costs 20, Somerford Grove Defective water closet apparatus ,, ,, ,, Rear of 85, Lower Clapton road Passage unpaved and undrained Withdrawn, work completed „ 87, „ ,, ,, ,, ,, ,, ,, ,, 89, „ ,, ,, ,, ,, ,, ,, ,, 91, ,, ,, ,, ,, ,, ,, ,, ,, 93 ,, ,, ,, ,, ,, ,, ,, 144, Amhurst road Defective rain-water pipe Order to do the work in 14 days and pay 1/- costs 212, Mare street No water supply to house Order to close the house in 14 days and pay 1/- costs 39, Hassett road No light and ventilation to water closet Order to provide light and ventilation to w.c. in 14 2, Fulham place Defective drains davs and pay 1/- costs Withdrawn, work to be done by Vestry 4, „ „ ,, ,, ,, ,, ,, 70 Table XIV. Prosecutions under the Food and Drugs Acts and Margarine Acts during the year 1897. No. of Sample. Article. Adulteration or Offence. Result of T.epal Proceedings. Remarks. 552 Milk 9% added water .... Fined 5/- & 12/6 costs 555 Milk 10% 12/6 costs 556 Milk 27% fat abstracted.. Fined 40/- & 12/6 costs 557 Milk 8% „ „ 5 - , 12/6 „ 578 Milk 21% added water.... „ 40/- „ 12/6 ., 581 Milk 8% 12/6 costs 582 Milk 7% Dismissed ; £3 3s. Od. costs against the Vestry 584 Milk 12% 11 Fined 5/- & 12/6 costs 564 Butter 71% foreign fat „ 2/-,, 10/6 „ 601 Milk 18% added water „ 1/- ,, 12/6 „ 603 Milk 7% ,, „ 10/- „ 12/6 „ 604 Milk 6% ,, Dismissed ; £7 7s. 0d. costs against the Vestry 605 Milk 19% ,, Fined 3/- & 12/6 costs 607 Milk 10% ,, „ 1/- „ 12/6 „ 628 Milk 12% ,, „ 10/-,,12/6 631 Milk 13% ,, „ 10/- ,,12/6 „ 632 Milk 18% ,, „ 5/- ,, 12/6 „ 636 Cocoa 73% foreign starch and sugar „ 10/-,, 2/- „ 640 Cocoa 78% „ „ Summons not served 646 Milk 7% added water Dismissed; £2 12s. 6d. costs against the Vestry 648 Milk 9% ,, Fined 10/6 & 2/- costs 71 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. 658 Cocoa 60% foreign starch and sugar Fined 40/- & 12/6 costs 669 Cocoa 85% ,, ,, „ 10/- ,, 12/6 „ 660 Cocoa 45% ,, ,, „ 5/- ,, 12/6 „ 671 Rum 7.6% added water Withdrawn by order of the Public Health Committee 686 Milk 8% Dismissed, warranty proved 690 Milk 12% Dismissed ; £1 1s. 0d. costs against the Vestry 695 Milk 10% 12/6 costs 697 Butter 78-5% foreign fat .. Fined 40/- & 12/6 costs 709 Milk 20% added water .. „ 7/- „ 12/6 „ 710 Milk 18% ,, ,, 2/- „ 12/6 „ 711 Milk 13% ,, Withdrawn 715 Milk 21% ,, Fined £8 & 12/6 costs 720 Margarine Exposed for sale unlabelled 2/- costs 721 Margarine ,, ,, 2/- costs 737 Spirits of Nitre 60% deficient of Ethyl Nitrite 12/6 costs 781 Milk 12% added water Fined 10/- & 12/0 costs 72 THE MORTUARY. The following tables give the number of bodies deposited in the mortuary during the year; also the number of inquests held there, with the causes of deaths, &c. Number of bodies deposited in Mortuary 382 (a). To await inquests 356 (b). Upon request of relatives, to await burial 26 Number of Postmortems performed 158 INQUESTS Verdicts. Sex. Male. Female. Natural causes 144 119 Accidental Death 49 22 Suicide 13 4 Open Verdict 4 0 Manslaughter 1 0 Totals 211 145 Table showing nature of above Suicidal and Accidental Deaths in the Hackney District during the Year ended 1897. SUICIDES. ACCIDENTAL DEATHS. NATURE OF SUICIDE. No. NATUltE OF ACCIDENTAL DEATH. No. Poisoning 4 Shock from Broken Thigh 1 Cut Throat 1 Concussion of Brain 1 Drowning 6 Poisoning Hanging 3 Fall 3 Shooting 3 Suffocated 14 Shock from burns 12 Dog Bite 1 Drowning 19 Run over 2 Shock from scalds 1 Crushed by Truck 1 Fracture of Skull 9 Crushed by Crowd 1 Fracture of Spine 1 Suffocated in Bed 1 Not stated 2 Total 17 Total 71 73 METEOROLOGY. The following table, for which I am indebted to the Secretary of the Royal Meteorological Society, is an abstract of the Climatological Observations made at St. Luke's, Old Street, E.C., for the year 1897:— ABSTRACT OF CLIMATOLOGICAL OBSERVATIONS. 1897. Temperature. Relative Humidity Amount of Cloud. Rain. Means. Extremes Amnt No. of Days 9a.m Min. Max Range Mean Min Max 0 0 0 0 0 0 0 % in. January 36.4 33.6 40.1 6.5 36.9 26.0 47.2 90 9.6 2.00 16 February 43.8 41.0 48.6 7.6 44.8 33.4 58.2 86 8.9 2.62 14 March 45.8 41.3 51.7 10.4 46.5 33.6 60.9 79 8.2 3.44 22 April 46.8 42.0 53.6 11.6 47.8 33.0 65.2 78 8.6 1.66 17 May 53.6 45.5 62.0 16.5 53.7 36.6 77.1 66 5.8 1.07 9 June 61.8 55.6 69.6 14.0 62.6 46.6 85.1 77 8.3 1.74 14 July 64.6 58.1 73.5 15.4 65.8 51.8 80.6 71 5.9 .65 6 August 63.7 57.7 71.4 13.7 64.6 52.2 86.1 77 6.3 3.06 17 September 55.9 51.3 62.5 11.2 56.9 41.6 69.2 80 8.2 2.89 13 October 51.6 47.3 58.4 11.1 52.8 39.4 66.2 79 7.6 .61 10 November 46.7 42.6 52.0 9.4 47.3 33.8 59.2 87 8.9 1.12 11 December 42.4 38.9 47.2 8.3 43.1 28.0 56.4 85 8.1 2.32 17 Year 51.1 46.2 57.5 11.8 51.9 26.0 86.1 80 7.9 23.18 166 I remain, Gentlemen, Yours obediently, J. KING WAEEY, M.D., Etc., Medical Officer of Health. Report of the Medical Officer of Health received, and ordered to be printed and circulated in the usual manner. GEO. CHAMBERS, 11th May, 1898. Chairman of the Vestry. APPENDIX A. Report of Proceedings of CONFERENCE OF DELEGATES upon the subject of the Prevention of the Pollution of the River Lea, held at THE TOWN HALL, HACKNEY, ON WEDNESDAY, 13th OCTOBER, 1897. Chairman : HENRY HULLAND, Esq. 76 POLLUTION OF THE RIVER LEA. REPORT OP THE PROCEEDINGS of a CONFERENCE of Members of Parliament, Members of the London and Essex County Councils, and of public bodies of districts along the banks of the River Lea, convened by the Public Health Committee of the Hackey Vestry to consider the steps to be taken to remedy the pollution of the said river, and held at Hackney Town Hall, on October 13th, 1897. Present : Scoble, Sir Andrew, q.c., m.p. HacKney. FoRMAN, E. B., m.d., M.R.c.P., l.c.c. „ Pearce, W., l.c.c. Limehouse Board of Works. Dixon, W. H „ Whittingham, W. B., alderman ... Essex County Council. Thresh, J. C., d.sc., m.d., d.p.h. (medical officer of health) „ Mcsguave, C. G. Leyton Urban District Council. Trumble, J „ Chapman, M ,, Anderson, J., j.p Walthamstow Urban District Council. Geary, C. J. ,, Gowen, E. S. (clerk) Holmes, E. W. (engineer and surveyor) „ McSheedy, J ,, 77 Malins, A. Poplar Board of Works. Alexander, F. W., l.r.c.p., m.r.c.s., d.p.h. (medical officer of health) ,, Bassett R. Hackney Yestry. Feesey, R „ Forsaith, J. S. „ Hulland, H. „ Holmes, G. B., j.p. „ Kyffin, J. B. „ Spencer, J. „ Whittaker, T. E. ,, wlmhurst, T. ,, Warry, J. King, m.d., m.r.c.p d.p.h. (medical officer of health) „ Taylor, Leo, f.c.i. (public analyst) „ and others. Mr. Henry Hulland, Chairman of the Public Health Committee of the Hackney Yestry, presided, and in opening the Conference said:—In the first place I must apologise to you for not having a better room in which to receive you, and in the next place Mr. Chambers, the Chairman of the Hackney Vestry, has desired me to apologise for his absence to-night. Mr. Chambers has to control the Vestry which is now sitting, and I hope you will accept my expression of his regret at not being able to attend here to-night. The question that we have asked you to meet and consider is a question which we, in Hackney, consider a very serious one, and you will agree that any question which affects the health of a million of people is of the greatest importance. What we really wish to do is this, to try and bring about such a condition of things as will render the Eiver Lea. as far as it affects Hackney and in its lower courses, more pure and far more sanitary. We have had submitted to us from time to time, as the Hackney Sanitary Authority, reports of our analyst, which show that the river is not in the condition that it ought to be. We are quite prepared to enter heartily and fully into the consideration of any and every project and any and every plan which would prove 78 a solution of the difficulty. We wish to work in conjunction with all the Parishes, and we hope we may be able to do something on similar lines to what was done ten or twelve years ago. At that time Hackney suffered very much from the pollution of the River Lea, and it was only by Sir Charles Russell taking up the matter that the main river was brought into such a condition that it is not a disgrace to the Parish. I hope that one result of our deliberations to-night will be to formulate some such plan as was carried out some ten years ago which brought about such a good end for the Northern part of the Parish. We have one or two resolutions, but before putting them I should like to call upon two experts here, Dr. Warry, Medical Officer of Health for Hackney, and Dr. Alexander, Medical Officer of Health for Poplar, to give you the result of their visits to the River Lea. Dr. Warry, Medical Officer of Health for Hackney, said: On Saturday we visited that portion of the River Lea which forms the eastern boundary of Hackney, at the point where the effluent from the Walthamstow sewage farm and Leyton sewage works enter; and I did not find very much difference in the quality of the water from what it was last year. It was in such a condition as to be dangerous to the health of persons frequenting the Marshes for the purpose of recreation, and dangerous to the health of persons residing in the immediate neighbourhood. That was the condition in which we found the River Lea. In regard to its physical appearance it was very turbid. The banks were lined with sewage fungus and we could see bubbles of gas arising, due to decomposition. In summer time the smell is very offensive and a danger to the health of the people. We are desirous of getting this altered by almost any means. Dr. Alexander, Medical Officer of Health for Poplar, said : I went with Dr. Warry, and members of the Poplar Board of Works and of the Hackney Vestry, on Wednesday. It was high water then, but since Wednesday I have watched the River Lea at different times of the day so as to get the low water tide, and I have reported on more than one occasion to my Board the condition of the River Lea from Bromley Mills, which affect the Poplar district, to the Bow Creek 79 That part of the river is not in the condition which it should be. I notice that the banks of the River Thames are clean, and that shows that the County Council at their works at Barking and Crossness are taking away the sludge. They are taking away about two millions tons of sludge every year, so that the mud cannot come from the Thames. If you will trace the River Lea round, you will come to an old Board School, and the river there is nothing else than simply mud. I have reported that there is a very offensive smell from that mud. In Bow Creek the whole of the river banks at low tide are covered with mud, a settlement of sewage. Next you come to the outfall of the West Ham District. On Wednesday we went up at high water, and we just caught the West Ham people turning their sewage out. It was turned out in a very crude state. We noticed that excrement was floating on the top of the water. There were other sources of pollution which were minor compared to West Ham. Then we come to Bromley Mills, and that is where the Bow Creek and the Channelsea River come in. We saw there simply mud. The condition of the Waterworks River is simply a ditch with a horrible smell. The Hackney Cut and the Navigation Cut are in a fairly good condition, and sources of pollution were noticed from the Old Ford Lock to the Bromley Mills, but it is the back rivers which we noticed were polluted most. I must think that the condition of the River Lea, from the Bromley Mills to the mouth at the Thames, is in a disgraceful and horrible state. They would be horrified to see the river at low water. The men working in the gasworks opposite the West Ham outfall complain that when the wind blows westward the smell is very bad. The Chairman : We have one other expert here, Mr. Leo Taylor, the public analyst for Hackney. I shall ask him to state candidly to you what is his opinion of certain samples of water from the river submitted to him. Mr. Leo. Taylor said: I can only speak generally that I have had samples submitted to me of Lea water and water from the tributaries, and the analyses that I have made have been published and circulated. They are all of a similar character. The water is 80 undoubtedly badly polluted. It is hardly necessary now to go into details, but they all tend to show that the water of the River Lea is in a very bad state organically speaking, and needs your very serious attention. A member : Where were the samples taken ? Mr. Taylor : The samples have been taken from various parts, from the back of the " White Hart" and from the main stream itself. A member : Will the experts tell us to what they attribute the causes of pollution ? Dr. Warry : So far as our district is concerned I consider the effluents from the Walthamstow sewage farm and Leyton sewage works are the cause of the bad condition of the water. Of course there are pollutions higher up the river, in Tottenham up as far as the intake of the Water Company, and beyond that. But of course I cannot personally speak of these. As far as our district is concerned, I repeat that the cause of the bad condition of the water, the great cause, is the bad condition of the effluents from the sewage farm. Higher up the river there are sources of pollution which contribute towards it: I refer to the River Moselle in Tottenham. Above that point there are several others, and we have on record a report by a Medical Officer about five years ago, who reported that above the intakes of the East London Water Company there were pollutions, and he roughly put it that the sewage from 100,000 persons entered the river above that point, and eight or nine million gallons of malt liquor. Although this liquor might not cause disease it forms a pabulum to microbes in the water. What we complain of are the two effluents I have named. A member : Where are these sewage farms? Dr. Warry : Leyton and Walthamstow; the one from Leyton joins the one from Walthamstow and then enters the river. 81 A member: Do you say that the greater pollution is above those effluents? Dr. Wakky: I don't say that, but there are pollutions above. Do you consider the Walthamstow sewage farm a source of pollution ? I do. But there are others which enter it besides the Walthamstow? Yes. Have you sampled the water from the Walthamstow sewage farm ? No, I have not. Then how can you say it is polluted ? By my senses. I cannot allot the amount of pollution to each district. That is my point. I want to know whether you have sampled the water from the Walthamstow farm before it enters Leyton ? The Chairman : Will you allow me to say this : We only take samples in our own district. We have no control of that part of the Lea into which the Walthamstow sewage farm drains. We have control of the river ;ust after it has passed Leyton effluent. I have gone down there on many occasions and I consider the condition of that stream could not be properly described other than by the word disgraceful. That would be the least word to be applied to that portion of the river between the "White House" and the " White Hart," and that of course is after the river has received the effluent from the Leyton sewage works combined with the effluent from the Walthamstow sewage farm. A member: You cannot apportion it ? The Chairman: I should not attempt to do it. We are not going to attempt to apportion how much blame is due to F 82 Walthamstow and how much to Leyton, but if we have ordinary senses we can see that after the effluent passes both of these works it is anything but satisfactory to the people of Hackney. We are not meeting to apportion blame, the only spirit we are meeting in is to bring about a more satisfactory state of affairs. I may point out to you that when we raised this question ten years ago the people of Tottenham proved conclusively that they had nothing to do with the pollution of the river, but since the remedy was found for Tottenham we found a much cleaner river, so we must think that they bad something to do with the pollution of the river. However, what we want is to find a solution of the matter. Mr. J. Spencer, a member of the Public Health Committee of the Hackney Vestry: How long have we been taking samples ? Dr. Warey : Two or three years. The Chairman : Mr. Idris describes one of the rivers which run into the River Lea above the intake of the Water Company as a dirty stinking ditch. If you will go up there you will see that pollution is going into it which ought not to go in. Dr. Alexander, who was asked to repeat his statement, said : I visited the old River Lea one day this week. The banks were dark and discoloured from dirt. On Saturday I saw the effluent from the waterworks and there was sewage coming in. The next pollution that we get in our District is the outfall from the London County Council sewers. That is only during storm times. We get it from the high and middle sewers and from the Hackney Wick, but of course we get a large amount of water, so that it is not so bad as simply sewage. The next place is opposite the Iceland wharf; the water there is bad, but where they turn their sewage in I do not know, the water was bubbling with gas shewing that decomposition was taking place. Then there are Messrs. Cook's works which have a right to discharge their sewage into the River Lea. Opposite to that there is another overflow from the sewers. The water from the Bow Bridge to Bromley Mills was in a better condition. When we come to Bow level the water from the Channelsea river comes in. 83 That Channelsea river is in a beastly state. At the Abbey Mills there is a lock, and 1 walked along the Channelsea road and saw the condition of that which was nothing else than a sewage settling tank, and when the lock is open it comes down to our river. We next noticed some overflow water from the gas works. I have seen the manager, and he told me that was exhaust water, and not much harm. Opposite the Commercial Gas Works we saw the West Ham sewage overflow, and that was simply sewage with excrement floating on the top. We have redrained several portions of our district, and have spent about £3,000 in taking our sewage out of the River Lea, therefore, so far as the Poplar Board of Works is concerned there is very little to complain of. Mr. W. Pearce, one of the members of the London County Council for Limehouse, said : I can speak as to the condition of the Limehouse Cut. The condition of the river is now continually under my notice, and I am on the Main Drainage Committee of the County Council, and am now chairman of it. No doubt the largest portion of the pollution of the Biver Lea is from West Ham. Eight million gallons per day of sewage are discharged from that district into the river. This must be remedied in the future by Parliament, and before very long this sewage must find its way into the County Council sewers. The effect of that will be great indeed. I can bear out what Dr. Alexander says as to the state of the river. The County Council are also to some extent offenders, but in our case it has been inevitable. The sewers have a certain capacity, and sometimes that is exceeded, and then they overflow. There are three discharges into the river. We are trying to remedy this, and we have already a scheme in preparation. The plans are nearly finished, and in a little time I hope the scheme will be carried. If it is there will be a new 7-ft. 6-in. sewer provided from Hackney Wick down to West Ham. That will close two of the overflows, and largely mitigate the evil. So that I hope that in the future this second pollution will be mitigated. Now we come to Leyton and Walthamstow. I should like to assure you, gentlemen, how almost impossible it is to produce an effluent from large districts like that 84 fit to be discharged into the river. If we at Barking and Crossness had no larger an effluent than that, it would not be fit to go into the river. This effluent ought to be removed from the river. One way would be to take it into the County Council sewers, and the other way would be for the districts themselves to take it into the Thames and treat it themselves. I believe the sewage question will have to be treated in this way. I think it would be better for these districts in Essex to have a separate system from the County Council. My own personal opinion is that it would be better if the matter were fairly faced and considered, and a large scheme embracing the whole of these districts undertaken. When that is done the third large pollution of the River Lea will be removed, and I don't think you will have occasion to go any further in the matter. The Chaihman: I should like to make an explanation. We in Hackney have felt the grievance of this river, and have approached the London County Council. The Rivers Committee of the Council considered the matter, and recommended that the Government should be urged to reappoint the Select Committee. I may frankly say that we want to urge the County Council not only to pass this resolution, but to urge them to go forward and make this one of the chief items of their work in the year in the east of London. For this purpose we have drawn up a resolution as a basis on which we can arrive at some conclusion. I hope everything will be done in an amicable spirit, because we are strong enough now to urge upon the County Council to take action in the matter. I think by a strong pull we may be able to get 'this Commission reappointed, and then possibly some of us may be able to give such evidence as will make Parliament consider the matter. Dr. E. B. Forman, Chairman of the Public Health Committee of the London County Council said: Most of what I was going to say has been already said. I was going to speak upon the pollution of the River Lea, and I hold in my hands some papers on the subject; but Dr. Alexander has treated the subject so exhaustively that I need 85 not say anything more upon it. They cannot deny that Walthamstow and Leyton are very great sinners, and they must not mind me saying so because the County Council are great sinners also. The Chairman thinks that this great body can do everything. Now it does do a very great deal, and I think London ought to be very much obliged to it for what it does do, but it cannot do everything, and I don't think it should do all that Mr. Pearce has suggested. It will be seen at once that as representing the County of London we have very little power except in regard to the parishes on this side of the river, but as most of the pollution comes from the other side it is the duty of the County Council of Essex to take the work upon its own shoulders. The Conservators of the Eiver Lea have a duty in the matter placed upon them. I have been looking through their Act and I find that by one section they are compelled to keep a certain depth of river, and to pass a certain number of cubic feet of water down the River daily, and they are liable at the instance of the sanitary body for prosecution for pollution of the river. It has been held that the word " premises " used in the Public Health Act includes a river such as the Lea, and therefore they might be attacked on that clause that their river is a danger to public health. But, notwithstanding all that, I have also in my hand an opinion by an eminent solicitor who says that he doubts very much whether the London County Council could successfully prosecute the conservators of the River Lea. Though most things have been said to-night as to the bad state of the Lea there is one thing that everybody has omitted, and that is that not sufficient water is sent down the stream and too much is taken out. The London County Council in their opposition to the Water Company's Bill last year succeeded in arriving at a compromise by which the Company are not allowed to take more out of the river than previously. It was then said that if more water were passed down the river it would burst through the lock gates into the Limehouse Cut. It does seem to me that more stringent laws ought to be applied, and if they don't exist we must get Sir Andrew Scoble to assist us. We were told that if they passed more water down the Limehouse Cut the sides would fall in and the warehouses on each side might collapse. I join with every word that has been said as to the frightful state of the river, and Mr. Pearce has said properly that a more thorough drainage on both sides of the river is necessary Mr. Whittingham, Chairman of the Sanitary Committee of the Essex County Council, said : We are all more or less sinners, and I am glad you suggested that we should be in conference harmoniously. I agree with what has been said about the stream in West Ham, but at the same time the intake of water for drinking purposes requires an extra amount of watchfulness over the condition of the river above it. I believe, sir, the Lea Conservancy has been fairly tolerant of the effluents of the districts named, and if it had not been so some action would have been taken by my committee. I hope the result of this evening's conference will be as you suggested. The districts on the River Lea in Essex have looked with longing eyes to the London County Council, because they know that they have the power to take the sewage of these districts along their sewers. Walthamstow has its sewage farm, and Leyton its sewage works for consuming the sludge, but still it would be better if the sewage could be taken away into the London main sewer as it has been suggested. Mr. McSheedy, a member of the Walthamstow Urban District Council, said: We admit that we are sinners, and we trust that having admitted that you will help us to carry our sewage away. We have only about 180 acres of sewage farm, but as we have a population of 71,000 in Walthamstow, increasing at six or seven thousand yearly, that is quite inadequate. We have to deal with about two million gallons daily, and it has been a source of great anxiety to us all to know what to do. It is not our fault; it is not the fault of our officials that we have not that effluent as well as it might be. We have done all we can, and we are surrounded on all sides by people looking askance at us. We are under the cloud of a prosecution, and the court has allowed us till July in order to make our effluent better. W hen we applied to the Local Government Board to sanction the borrowing of money for a large scheme, what was the reply? Their answer was, "We will not allow you to borrow this money to carry out this scheme until you have used 87 every effort to induce the London County Council to take the sewage." We have tried every legal means. We have admitted we are sinners, and will do all we can to associate ourselves with Leyton, but I would point out that while we are willing to do all we can to take our sewage out of the river, we shall be doing a great benefit for Hackney. The sale of the 180 acres would be sufficient tocover our contribution towards the joint scheme, and the remainder we would throw open for a playground. It will be a source of great advantage to Hackney to have such a space open. I urge this conference to receive this scheme as soon as possible. I was pleased to hear the gentleman of the London County Council hold out to us some hope of being able to take our sewage into their system. We got a letter from the County Council last Friday declaring that they could not possibly entertain our wishes, and holding out no hope at all that they would ever give us a chance of taking our sewage into their sewers. I am glad that there is now some hope. Mr. Pearce: Oh, no! I said the districts themselves must do the work. Mr. McSheedy: It is impossible for us to do anything. The Local Government Board refuses to allow us to borrow money, and the London County Council won't help us. I do hope the conference to-night will hold out some hope of inducing the County Council to help us. I look to the County Council as our saviour in this respect. We admit our guilt, and ask them to do what they can to relieve us of this responsibility. Mr. Pearce: I hope I have not been misunderstood. The London County Council sewer is barely sufficient for the duty it has to perform for the County of London, and therefore, it is very unfortunate if any remarks have come from me which have been taken in the sense mentioned by the last speaker. It is impossible for us to entertain anything of the kind. These istricts outside London must have a separate scheme. Mr. Whittingham: This is a good time for us to join with others in making the London County Council sewer bigger. 88 Mr. Musgrave, Chairman of the Leyton Urban District Council, said: Although Walthamstow may confess that they are sinners, I deny that we are. We have a sewage works and not a farm as they have. Our sewage works are the best known of. I have sometimes drunk the water coming from our works, and, therefore, I am not prepared to admit for one moment that because the Lea is polluted where it enters Hackney that that comes from Leyton. I deny that any pollution comes from Leyton at all. 1 will not admit for one moment that it is caused by the effluent from the Leyton Sewage Works though we shall be happy to join in any scheme. The only idea that we have in our sequestration order against Walthamstow is to get them to make the effluent better, I believe Walthamstow are doing their best and when they sent to us a request to join in the application to the London County Council to take their sewage, Leyton did so, though I am bound to say that it was by no means so pressing to them as to Walthamstow. Therefore, I have no objection to any inquiry by Parliament, or the County Council, or anybody else. Where the stream is polluted should be known, and must be of public benefit to everybody, but as far as Leyton is concerned we emphatically deny that there is any pollution from our district. Mr. Trumble, Chairman of the Sanitary Committee of the Leyton District Council, said: We all agree that the River Lea is polluted ana that the backwaters are disgraceful, but I can confirm what the last speaker has said as far as our own works are concerned. We distinctly deny that we are the offenders, and without going into the question as to our mode of the treatment of sewage, I must say that I would like to throw out an invitation to Mr. Pearce to come and see our works, and see if they are not vastly superior to those at Barking. Mr. Anderson, Chairman of the Walthamstow Urban District Council, said: In the case of Walthamstow we have done everything possible, but we cannot lose sight of the fact that the London County Council could help us. It is well known that we have a large sewage farm, and not only that, but we have sewage works upon which we 89 have been spending money, and are providing a large sum for the ensuing half-year. We not only use the same process as Leyton. but we pass our effluent over 170 acres afterwards. I am not so sure that the Leyton effluent is so pure as to be fit to drink. We are open to do anything in our power. We have not stinted for money, and the scheme that we prepared, and for which we asked the Local Government Board to sanction the borrowing of £16,000 but were refused, would have remedied the evil. They said the County Council was the proper body to take our sewage. What we think is this—our districts are taking the residents from London. The County Council say that we are asking them to take something which we ought not to, but still we are taking the people who clear out of London. They come down to us in enormous numbers, month by month. I notice again that the County Council are very anxious to take the water from Essex, but refuse to do anything else. They require all the sweets, but won't have any of the sours. These two districts should be helped by the County Council, and I urge that there should be only one authority to deal with this sewage question. Every effort should be put forward by every district represented there to urge the County Council, if they have not a sewer big enough, to build a new one, and ask the bodies concerned to help to pay for it. Dr. Thresh, Medical Officer of Health for Essex, said: With reference to Leyton, there are few better works in the country, and the effluent has been exceedingly clear. I don't know any works turning out water purer. But they would have to admit that at some future time a scheme for taking the sewage all away would have to be brought forward. I think there should be a joint scheme, and Leyton should join, because they will have trouble by-and-bye. If it were found possible for the London County Council to make a fresh sewer, that would do away with the difficulty. If this conference is the means of bringing about anything it will be a great service. Mr. Geary: We want to know the best way to deal with this and I must certainly say we are wasting a great deal of time. We 90 want to get to work and see what can be done. . It is a work that must be done and if we are to lay out hundreds of pounds it must be done. We must pass the resolution I am about to move and then either force the County Council or get the Government to help us. We can all combine so as to get over this difficulty. I shall propose " that this conference is of opinion that a full enquiry into the condition of the whole of the River Lea as to its source of impurities should be undertaken by the Government in continuation of the report of the Select Committee of 1886." The Chairman : We want to get all we can from the Government and we are very glad to hear that they are going to be approached on the question of the pollution of the river. Mr. J. B. Kyffin, a member of the Public Health Committee of the Hackney Vestry, said: We all know the dreadful condition of the backwaters. If ever you saw a black polluted stream you can see it here. A speedy remedy should be found for the disgraceful condition of the backwaters. Not very many months ago the river was most offensive, and I think it is time something was done. We know the scare at Maidstone, and though I don't want to raise a scare in London we must guard against it. We on the Hackney Vestry have worked at this question for a number of years. We know the London County Council is a very powerful body, and 1 think they may do something. There is the remedy of suing the Lea Conservancy. At one time we pointed out to them the disgusting condition of the river, and their answer was that they must float their barges. We actually saw them pumping water back into a lock in order to float their barges. They only care about floating their barges, and not the health of the district. Sir Andrew Scoble, q.c., m.p., said: Fortunately, I don't live on the banks of the River Lea, and therefore I cannot express any personal opinion of its condition, but I have heard enough to satisfy me that the state of the river is a disgrace to civilization. It is offensive and dangerous, and a long standing nuisance. We are here to discuss not who is responsible. We are all agreed upon 91 two things—first, that it is in an unsatisfactory state; and second, that steps ought to be taken to remedy it. Surely that is enough. We are not to apportion the responsibility for it, or to point out the causes. We have come here, as I understand, for a practical purpose, and as the London County Council is unable do everything that is necessary, you must go to Parliament. It is thought that Parliament should continue the enquiry of 1886, and surely that is a proper course to take. I agree with the motion that has been brought forward. Mr. Pearce : I also agree with the motion. I don't think the London County Council are prepared to take any action for approaching the Government. There is another point we have not dealt with—the condition of the upper river, and 1 could say a good deal about that. The motion is far reaching, and will include all these points. Mr. Musgrave : And if you apportion the blame, the Government will not think it necessary to hold an enquiry. I will second the motion. The resolution was then put to the meeting, and carried unanimously. The Chairman : I hope we shall be able to pull together so unanimously that good results may be attained. Sir Andrew Scoble : I would suggest that everybody interested in this matter will press upon their members to join in a deputation to the Local Government Board. I think if we get a strong deputation, Mr. Chaplin cannot possibly refuse to reappoint the committee. Mr. McSheedy suggested that the Conference should form themselves into a deputation. Mr. G. B. Holmes, j p., a member of the Hackney Vestry, said : I do think we ought to do something more. I have taken some interest in this matter for years past, and I do think we ought to «.»2 follow this matter up. We have got the experience of Sir Andrew Scoble in respect to the way to influence Parliament, and if we can secure the sympathy of Mr. Chaplin in this matter we have done a great deal. It is all very well to write letters to our Members, but we have to move Parliament itself, and I will suggest that we do form ourselves into a deputation, and call upon our respective Members of Parliament, and urge this matter upon them. The Chairman : It is moved that we form ourselves into a deputation and try and seek an interview with Mr. Chaplin, to press upon him the necessity of the work being taken in hand, and that we ask the local Members of Parliament to assist us. This was agreed to. Mr. Holmes : Will Sir Andrew Scoble introduce us. Sir Andrew Scoble : I shall be very happy to do so. The Chairman : We will ask our Medical Officer to keep you well informed as to the date and will also make all other arrangements. Mr. Anderson : 1 shall move a vote of thanks to the Chairman for presiding and to the Hackney Vestry for calling this Conference. Dr. Forman seconded the motion, which was carried. The Chairman : I hope we shall be able to work in harmony, and that we shall not look at the blame, but at the cause. The Conference then terminated. 93 APPENDIX E5 . LIST OF LICENSED SLAUGHTER-HOUSES in the Hackney District, October, 1897. Name. Address. Friday, E. 235, Amnurst Road Raymond, E. 186, Cassland Road Hussey, A. J. 37, Church Road, Homerton Sharman, J. 90, Frampton Park Road Tucker, Robert 5, High Street, Homerton Wragg, W. J. 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. Lea Bridge Corner, Clapton Witherden, C. A. Lower Road, Clapton Tyler, A. 80, Mare Street Maples, Richard W. 142, Mare Street Beaver, W. P. 177, Mare Street Palmer, A. J. 266, Mare Street Harris, Samuel 296, Mare Street Capon, J., jun. 32, Morning Lane Lockie, J J. 200, Queen's Road, Dalston Miall, E. D. 211, Queen's Road, Dalston Hammer, William 103. Rendlesham Road Chalkley, F. G. 53, Southgate Road Ebbells, E. 94, Southgate Road 94 Row, R. 130, High St., Stoke Newingtcn Young, J. C. 220, Stoke Newington Road Stoneman, P. 3, Terrace Road Clark, Chas. Upper Clapton Tyler, W. 92, Well Street Hill, George F. 169, Well Street Wagstaff, H. J. 216, Well Street Friday, R. 51, Wilton Road Baker, W. J. 258, Wick Road Browning, John West Side, London Fields LIST OF LICENSED COW-SHEDS in the Hackney District, October, 1897. Name. Address. No. of Sheds Jones, L. J. 3, Ardleigh Road, De Beauvoir Town 1 Jones, Mary 46, Brooksby's Road. Homerton 1 Jenkins, J. 2, Buckingham Road, Kingsland 2 Evans, D. M. 72, Church Road, Homerton 1 Lloyd, E. 84, Clifden Road, Clapton Park 2 Jenkins Downham Road, Kingsland 1 James, Mrs. 11, Downham Road, Kingsland 1 Motts, E. 6, Floreiield Road, Hackney 1 Larter, George William, trading as J. T. Larter 2, Gloucester Road, South Hackney 2 Snewin, W. H. 3, Hill Street, Upper Clapton I Rumball, T. E. High Road, Upper Clapton 4 Bates, T. and W. 46a, Leswin Street, Hackney 1 Cashford, W. G. Jerusalem Square, Mare Street, Hackney 1 Reynolds, Edwin Landfield Street, Hackney I Wingrove, J. T. 11, London Lane, Hackney 1 Low, Walter Manor Farm, Hackney Wick I Warner, J. C. 23, Mare Street 1 Bush. J. Marsh Gate, Homerton 1 95 Low, Edwin Marsh Hill, Homerton 1 Lewis. J. 6, Palace Road, Hackney 1 Outram and Faulkner 257, Queen's Road, Dalston 1 Camp, Arthur 79, Shacklewell Lane, Hackney 1 Tasker, J. Sigdon Road, Hackney 1 Spring Hill, Clapton 2 Stapleton. A. Stoke Newington Common 5 Briggs, J. 180, Victoria Park Road 1 Thomas, David 3, Warburton Road, Hackney 1 Brace, E. A. 133, Well Street 1 Jones, John 271, Wick Road 2 Roper, R. 37, Wilton Road 1 Total Cow Sheds 45 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. 96 APPENDIX C. LIST OF BAKE-HOUSES, 1897. Name. Address No. 1 District. Pettit 17, Caroline Street Shutz, Jacob 62, Winslade Road Budden, James 26, Northwold Road Vincent, A. 74, Hill Street Vincent Clapton Common Reis, W. E. 8, Cazenove Road Gibson, R. T. 9, Northwold Road No. 2 District. Cullen, W. 216, High Street, Stoke Newington. James & Sons 176, ,, „ Stanmore, K. 24, Sanford Lane Pile, W. 114, High Street, Stoke Newington. Curran, H. K. 33, Rectory Poad Allardyce, J. W. 62, Evering Road Burch, L 9, Maury Road Willomer, Chas. 8, Stellman Street Guscott, J, 128, Stoke Newington Road Bunch, F. 73, Shacklewell Lane No. 3 District. Mason, P. 3, Kenninghall Road Hull, W. E. 50, London Road Brion, A. 26, Downs Road Hall, J. 8, High Road, Clapton Parish, W. 117, Lower Clapton Road Prestage, T. H. 71, Tanner, J. 5 Reeves, T 9, Clarence Road Nevill & Co. 393, Mare Street Hall, J. 370, „ 97 Thrift, A 38, Amhurst Road Seward, R. 240, Dalston Lane No. 4 District. Carpenter, A 13, Median Road Rest, O. 2, Beeeholme Road Paul, Jas 11, Lea Bridge Road „ 3a, Glyn Road Lankin, J.40, Mandeville Street Saur, H 198, Rushmore Road Manketz, L. 182, Chatsworth Road Mack, L 138, Remnant, J. E. 136, „ Lunken, H. 71, ,, Maloney, J. 36, ,, Woods, E. 19, Noa. 5 & 6 Districts. Waters, R. J 121,-Richmond Road Berry, H. 47, ,, Ibell, H 81, Wilton Road Goodwin, J. 178, Dalston Lane Withers, R. 83, „ Taylor & Co. 72, ,, Aerated Bread Co., LimiteJ 28a, „ Shedden, Mrs 64. Richmond Road Goodwin, J , 20 & 22, Forest Road Shedden, Mrs. S. F. 11, Holly Street Howse, T. 207, Queen's Road Way, J. 63, Lansdowne Road Birkett, T 8, Field View No. 7 District. Pavne, A. 54, Broadway, London Fields Busliell, F. 10, „ „ Lloyd, Mrs. F. 52, Sheep Lane White, Jas. 26, West Street Rehn, M. C. 139, Mare Street Reihs, J 6, Well Street Reitz, C. 183, Mare Street Tanner, J. 205, „ Harvey, A. 231, ,, Hudson, T. 297, ,, Lunken, H. 27, Morning Lane G 98 No. 8 District. Krauss, John 13, Loddiges Road Skeer, Philip 76, Well Street Kurtz, W. 105, Ransom, John 127, „ Heard, C 142, Mustard, Mrs. E. C. 79, Lauriston Road Holzapfel, C. , . 142, Victoria Park Road Hatherill, John 105, Lauriston Road No. 9 District Grimwood, Thos. 39, High Street, Homerton „ „ 59 „ „ „ „ 17, Bridge Street Hollis, G. 95, High Street, Homerton Gibbons, Geo. 131, ,, „ Bradford,G. 162, „ „ Jessup, Hy. ,. 167, „ „ Wells, Jos. 18, Brooksby's Walk Hertz, John 14, The Grove, Homerton Dillaway. N 3, Churchill Road No. 10 District Mager, Geo. 220, Wick Road Conrad, F. 184, Cassland Road Maul, Edw. 16, Gloucester Road Beck, Geo. 92, Wick Road Gunner, Geo. 34, Church Road, Homerton Edwards, Robert 12, Berger Road Eller, C. H 154, Well Street Weber, G. 50, Kenton Road Klengel, Geo. 186, „ Ashby, J 127, Morse, G. 25, Elsdale Street Carton, Hy. 144, Morning Lane No. 11 District. Schaumloffel, Selzer H. 89, Sidney Road Raynes, H. 276, Wick Road Dance, Mrs. 315, „ Weston, W. 2, Victoria Road, E. Anspach, Wm. 3, Montague Buildings Reissler, F. 41, Osborne Road Terpahs, J.J. 13, Gainsborough Road Davis, W 71, Felstead Street