REPORT ON THE SANITARY CONDITION OF THE LIMEHOUSE DISTRICT (Comprising the Parishes of Limehouse, Shadwell, and Wapping, and the Hamlet of Ratcliff) For the Year 1897. BY DANIEL LEWIS THOMAS, Medical Officer of Health and Public Analyst; Diplomate in Public Health, London; Licentiate of the Royal College of Physicians of London; Member of the Royal College of Surgeons of England; Licentiate of the Society of Apothecaries; Fellow of the Royal Institute of Public Health; Member of the Sanitary Institute. TO THE BOARD OF WORKS FOR THE LIMEHOUSE DISTRICT. Gentlemen, In presenting to you my first Annual Report, I may remind you that my appointment dates from the 1st of October, For three months Dr. Stedman acted as substitute for Dr. Rogers, your highly esteemed and respected late Medical Officer of Health. With the exception therefore of the last three months of the year, the facts on which this Report is based did not come under my personal notice. The population estimated to the middle of 1897 was 58,508. Births.—The births registered during the year numbered 1997, of which:— 1197 were registered in Limehouse. 471 „ „ Ratcliff. 267 „ „ Shadwell. 62 „ „ Wapping. This corresponds to a birth rate of 34.1 per 1,000 for the year, or exactly the same as the average for the last 10 years. The birth rate is 4.1 per 1,000 more than that of London as a whole. 4 Marriages.—The marriages during the year numbered 459. This is the highest number recorded in any year since 1883. The average number for the last 10 years was 404, so that during the year the number of marriages was 12 per cent in excess of the average for 10 years. This increased number is of importance, because the number of marriages that takes place is recognised to correspond to the prosperity of a district. In that case the past year was the most prosperous one for the district for the last 14 years. The proportion of persons married was 15 per 1,000 of the population. The marriage rate for the whole of London was 18.5 per 1,000—the highest rate recorded since 1878. Deaths.—The registered deaths exclusive of those of nonresidents which occurred in the Public Institutions situated in the District, but inclusive of those of residents which occurred in outlying Institutions numbered 1462. This corresponds to a death rate of 25.1 per 1,000. The death rate for the whole of London was 18.2 per 1,000. These deaths were distributed over the District as follows:— Limehouse 536 Ratclifif 244 Shad well and Wapping 169 East London Children's Hospital 342 Drowning Cases 10 1301 Deaths occurring outside the District among persons belonging thereto 446 1747 Deduct deaths occurring within the District among persons not belonging thereto 285 1462 This number is 77 more than that registered in 1896. 5 Compared with 1896 the causes of death were as follows:— 1896 1897 Increase Decrease Scarlet Fever 14 12 - 2 Diphtheria 35 26 - 9 Membranous Croup 2 3 1 - Enteric Fever 2 4 2 - Puerperal Fever 1 1 - - Erysipelas 1 8 63 7 - Measles 49 14 - Whooping Cough 52 37 - 15 Diarrhoea & Dysentry 40 61 21 - Cholera Infantum - 1 1 - Rheumatic Fever 3 4 1 - Phthisis 167 149 - 18 Bronchitis, Pneumonia and Pleurisy 251 260 9 - Heart Disease 101 125 24 - Influenza 5 5 - - Injuries 96 86 - 10 All other Diseases 566 617 51 - 1385 1462 131 54 The excess of births over deaths in 1897 was 535. In 1896 the excess of births over deaths was 627 1895 „ „ „ 475 1894 „ „ „ 515 1893 „ „ „ 357 The following is a list of the outlying Institutions and other places where residents of the Limehouse District died during the year:— 3, Alma Cottages, Harrow Road 1 66, Albany Street, Regents Park 1 Brook Fever Hospital 5 Bolingbroke Hospital 1 Brampton Hospital 2 Banstead Asylum 4 Bethlem Asylum 1 Cane Hill Asylum 4 Claybury Asylum 1 6 Clapham Maternity 1 Charles Street, Mile End 1 Colney Hatch Asylum 0 City of London Chest Hospital 5 Darenth Asylum 8 East India Dock Road 1 German Hospital 2 Homerton Fever Hospital 8 Hanwell Asylum 2 Hospital for Women, Soho 1 Hackney Infirmary 1 Homœpathic Hospital 1 Ilford Asylum 10 King's College Hospital 1 London Hospital 68 Leavesden Asylum Limehouse Cut Limehouse Pier 1 Limehouse Cut (Bromley) 1 Licensed Victuallers' Asylum 1 Middlesex Hospital 1 Millwall Docks 2 Mother's Home, Commercial Road 1 Mile End Infirmary 3 45, Morning Lane, Hackney 1 North Eastern Fever Hospital 1 Poplar Hospital 4 River Thames (Bermondsey) 1 River Thames (Poplar) 1 River Thames (Greenwich) 1 Regent's Canal 1 Regent's Canal, Mile End 1 Regent's Canal, Kingsland Road 1 Royal Chest Hospital 1 South Eastern Fever Hospital 7 St. Peter's Home, Kilburn 1 Sick Asylum (Bromley) 200 Stepney Workhouse 69 St. George's Infirmary 4 St. Bartholomew's Hospital 3 Stepney Union 1 Westminster Hospital 1 Whitechapel Infirmary 1 446 7 Small Pox.—No case of Small Pox has been notified during the year, although 101 occurred in London with 16 deaths. Scarlet Fever.—The corrected number of deaths was 12; the annual average for the last 10 years being 22.7. 420 cases were reported during the year, of which 289 were removed to Hospital. Two Hundred and Thirty-one occurred in Limehouse, 118 in Ratcliff, 71 in Shadwell and Wapping. This is an increase of 75 over the number reported in 1896, although the number of deaths is less by 2. The death rate was 21 per 1,000 of the population. The death rate for the whole of London from Scarlet Fever, was .17per 1,000 of the population. The mortality was 2 8 per cent. of the seizures. The average mortality for the last 10 years was 116 per cent. of the seizures. This increase in the number of notifications is partly due to the fact that the disease was of a mild type, and in several instances the children were kept at home without Medical attendance, and no attempt made at isolation. In October I received a communication from the Head Mistress, in the Infants' Department of Collingwood Street Board School, informing me that she had sent home one of the pupils because her hands were peeling. When the child had been questioned by the governess it seemed that she denied that she had been ill, but that the peeling was due to a very bad scald she had some time before. She attended school with her hands in this condition for several days. I immediately visited the child's home. The child as well as the father and mother were out, and the shop was in charge of of three other children. When I was in the shop, at least six children came in and were served with ice cream and sweets. I noticed that one of the three children had a discharge from her ears. As a discharge from the ears is a frequent complication of Scarlet Fever, I became suspicious, and examined her hands and feet. I found that she was desquamating. I then examined the other two, and found that they were also suffering from Scarlet Fever. I left Mr. Pavitt, the Inspector for the No. 2 district (who was with me at the time) in the shop, to prevent the children selling any more sweets. I then went to look for the mother and father and found her with two of the other children, one of them being the child that had been sent home from School. I examined them and found both suffering from Scarlet Fever. There was another child who was out playing. I sent 8 a neighbour's child (after making certain that she was not susceptible to Scarlet Fever) to look for him and to bring him home. He was also suffering from Scarlet Fever. I had the six removed to the Fever Hospital as soon as possible. The goods in the shop were destroyed. The parents slept at the shelter for two nights, during which time the house was thoroughly disinfected. The girl that had attended school for some days whilst suffering from Scarlet Fever had acted as monitor; one of her duties was to hand round the books to 40 other children. I had the books removed at once to the disinfecting station, and after receiving the consent of the School Board, they were destroyed. I wrote to the Head Mistress of the school, telling her that she would greatly oblige me by instructing the teachers to examine the children's hands every morning for a few days, and in the event of desquamation being discovered, to send the children home and to notify me immediately of the fact. These instructions were carried out and several other cases of Scarlet Fever were discovered. Diphtheria.—The corrected number of deaths from Diphtheria was 26, the annual average number for the last 10 years being 32.2. One hundred and eighty cases were notified, and 118 were removed to Hospital. This is a decrease of 79 in the number of notifications. The decrease occurred chiefly in Limehouse. Eighty-four occurred in Limehouse, 52 in Ratcliff, and 50 in Shadwell and Wapping. The mortality was 13.4 per cent, of those attacked. The average mortality for the last 10 years was 30 8 per cent. of those attacked. This decrease is no doubt due to the use of Antidiphtheritic serum which has been used very extensively during the last 2 or 3 years. The deaths were equal to a rate of 44 per 1,000, that for the whole of London being 50 per 1,000 of the population. membranous Croup.—Three cases were notified during the year, and the three proved fatal. One occurred in Limehouse, 1 in Ratcliff, and 1 in Shadwell. Typhus Fever.—No case was reported during the year. 9 Erysipelas.—The corrected number of deaths was 8. Ninety cases were notified during the year, and 21 were removed to different Infirmaries and Hospitals. Forty-nine occurred in Limehouse, 29 in Ratcliff, and 12 in Shadwell and Wapping. Puerperal Fever.—There were 4 cases reported during the year, and one proved fatal. Three occurred in Limehouse and 1 in Ratcliff. Enteric Fever.—The corrected number of deaths was 4. The average annual number for the last 10 years was 8 3. Fifty-one eases were notified, and 41 were removed to Hospital. Twenty occurred in Limehouse, 19 in Ratcliff, and 12 in Shadwell and Wapping. The mortality was 7.8 per cent. of those attacked. The annual average for the last 10 years was 17.7 per cent. of the seizures. The death rate was 07 per 1,000, that for the whole of London being 13 per 1,000 of the population. In one instance I was able to trace the disease to Maidstone. A girl, who had spent the greater part of August and September at that place, was taken ill soon after she came home, about the last week in September. She was removed to the Hospital. Whooping Cough.—The corrected number of deaths was 37. The average number for the last 10 years was 50 5 a year. The death rate was 63 per 1,000 of the population. The death rate for London as a whole, was 41 per 1,000. Diarriicea.—The corrected number of deaths was 61. The annual average number for the last 10 years was 43. The epidemic followed the hot weather in July and August. This form of Diarrhoea differs from the ordinary form, which occurs at all seasons, and is due to various causes. The epidemic summer Diarrhcea, is associated with high temperatures. It is considered to be due to a form of micro-organism, which resides in the superficial layers of the earth that contains food suitable for it, that is, soil polluted with decomposing organic matter. The micro-organism has the power of leaving the soil to be carried by the air; by this means it gains access to food, and is introduced into the human body. According to Dr. Ballard's report to the Local Government Board, from "food the micro-organism can manufacture a substance which is a virulent chemical poison, and 10 this chemical substance is in the human body the material cause of the epidemic summer Diarrhœa." The development and multiplication of the micro-organism depends on a high temperature not in the air itself, but in the superficial layers of the soil. The rise in the Diarrhoea death rate does not begin till the average weekly temperature of the thermometer(suspcnded in an iron tube 4 feet deep in the earth) has reached 56° F. This takes place about a week later than that in the air. Taking this into consideration and that death occurs only after a longer or shorter period of disease, the following table giving the number of deaths from Diarrhoea in the district, side by side with the average temperature of the air for the same week, shows the relationship existing between high temperatures of the soil, and epidemic summer Diarrhœa. Week ending. No. of Cases. Mean Temperature of the Air. Week ending. No. of Cases. Mean Temperature of the Air. January 9 - 39.6 July 17 3 65.5 16 - 37.8 24 4 66.9 23 - 81.1 31 10 64.6 30 - 331 August 7 4 68.1 February 6 - 37.8 14 9 63.6 13 - 41.4 21 8 62.0 20 - 43.6 28 9 59.6 27 1 48.1 September 4 3 56.8 March 6 - 40.6 11 3 54.2 13 - 41.0 18 - 54.6 20 - 46.5 25 - 55.4 27 - 51.9 October 2 1 56.5 April 3 10 - 42.2 9 - 48.4 1 42.4 16 1 51.9 17 - 47.4 23 - 53.7 24 - 46.4 30 - 49.8 May 1 - 51.2 November 6 1 45.7 8 - 49.7 13 2 48.0 15 - 47.3 20 - 47.5 22 - 57.3 27 - 48.4 29 - 53.5 December 4 - 390 Jue 5 - 59.3 11 - 41.7 12 - 58.6 18 - 46.0 19 - 59.8 25 - 35.8 26 - 64.0 1898 July 3 - 64.4 January 1 - 45.1 10 1 61.5 11 There are several factors associated with the high Diarrhoea mortalities that are not under the direct influence of the Sanitary Authority, such as poverty, improper feeding (it is always higher among children artificially fed than those that are breast-fed), density of population, and want of cleanliness, but organic pollution of the soil by leakage from drains or otherwise, is a most potent factor, which may be remedied. Measles.—The corrected number of deaths was 63. The annual average number for the last 10 years was 55. These deaths were equal to a rate of 108 per 1,000 of the population, the rate for London as a whole was .43 per 1,000 of the population. The deaths from Zymotic Diseases numbered 206, and correspond to a death rate of 3 54 per 1,000. The Zymotic death rate for the whole of London was 2 56 per 1,000 of the population. Such deaths include Small Pox, Measles, Scarlet Fever, Diphtheria, Membranous Croup, Whooping Cough, Puerperal, Enteric and Simple Continued Fevers, and Diarrhoea. The deaths from Pulmonary Diseases numbered 260, and correspond to a death rate of 4 5 per 1,000 of the population. Fifty deaths were due to Senile Decay. This number corresponds to a death rate of .85 per 1,000 of the population. The number of deaths of infants under 1 year of age was 386. This number corresponds to an infantile mortality of 194 for every 1,000 births. The infantile mortality for London as a whole, was 158 per 1,000 births. During the year 754 notifications were received, of which 420 referred to Scarlet Fever, 186 to Diphtheria, 3 to Membranous Croup, 90 to Erysipelas, 4 to Puerperal Fever, and 51 to Enteric Fever; of these, 289 cases of Scarlet Fever, 118 cases of Diphtheria, 21 cases of Erysipelas, and 41 cases of Enteric Fever were removed to Hospital. For detailed information as regards ages, localities affected etc., I beg to refer you to the tables at the end of the report 12 HOUSING OF THE WORKING CLASSES ACT. King John's Court.—The Board has had under consideration for several years what is called the King John's Court Scheme. The area was surveyed several times by the Sanitary Committee. In July 1894, the Board passed a resolution that the closeness, narrowness and bad condition of the buildings and the want of light, air, proper conveniences and other sanitary defects in the buildings, rendered the area dangerous to the health of the inhabitants. That the demolition and re-arrangement of the buildings were necessary to remedy the evils, and that the site was too small to be dealt with as an unhealthy area under Part I. The Board directed a scheme to be carried out under Part II of the Act. The Local Government Board was petitioned for an order sanctioning the scheme, and after the legal formalities had been observed and the necessary notices served, an inquiry was held by a Local Government Board Inspector in October, but the decision has not yet been announced. chusan Place Area.—After inspecting this area with the Chairmen of the different Committees, I made an official representation to the Board that 1, 2, 3 and 4, Chusan Place, 1 to 8, Marchants Row and 2, 4, and 13, St. Anne's Row were in a state so dangerous to health as to be unfit for human habitation. An order was obtained from the magistrate to have them closed. The houses in Marchants Row have been demolished; 1 to 4, Chusan Place are also to be demolished, but I beleive that 2, 4 and 13, St. Anne's Row are being repaired with a view of making them fit for human habitation. DISINFECTION. The disinfector used is one of Washington Lyon's improved high pressure steam disinfectors. The temperature of the steam applied to the infected articles is 260° F. in the interior, and 2750 F. in the jacket. The goods are retained in the apparatus for 30 13 to 45 minutes, they are then taken out on the non-infected side of the building. Six men are employed in the disinfecting station. Two men draw the truck containing the infected articles; two men are employed to return the goods in a noninfected truck; one man is employed to strip the paper from rooms that have been fumigated; one man—the foreman disinfector—attends to the apparatus. The foreman (who is a fitter by trade) is able to take the apparatus to pieces when necessary, and refit it. He did this when the Inspector from the Insurance Company was sent down to inspect it. When the number of premises to be disinfected is below the average, the Inspectors find occupation for the men in testing drains, etc. They thus assist the Inspectors to make more progress with their houseto-house inspection. Sulphur has been in use to fumigate rooms for several years. Towards the latter part of the year I recommended the Board to use Formalin in some cases. There are two conditions in which Formalin seems to have an advantage over sulphur. (1). In rooms containing brass bedsteads, gilded panels and sewing machines, as these articles are tarnished by the sulphur. (2). In rare cases, where it is found impossible to spread out the clothing in such a manner that all its surface is exposed to the action of the gas, Formalin is more penetrating and under such circumstances, will probably be found more effectual than sulphur. With these exceptions sulphur is still used. The following articles were burnt in the Incinerator during the year: 15 beds, 45 mattresses, 10 pillows, 394 sundries, 250 sacks of paper stripped from walls of infected rooms, 347 cases of eggs, 6-lbs of bacon. 14 LIST OF ARTICLES DISINFECTED IN THE APPARATUS. Articles. January. February. March. April. May. June. July. August. September. October. November. December. Total. Beds 36 37 28 32 36 41 56 51 57 81 75 51 581 Sheets 98 37 48 40 37 32 46 39 41 78 66 50 602 Blankets 129 56 50 62 73 66 82 60 59 90 86 70 883 Bolsters 19 24 20 18 22 30 24 31 34 50 44 31 347 Pillows 106 50 56 62 88 70 86 72 84 96 88 74 932 Quilts 50 49 34 42 52 60 65 67 74 88 79 61 721 Mattresses 56 32 30 28 24 30 28 34 40 56 44 41 443 Sundries 629 300 116 246 142 186 297 264 220 286 210 196 3092 Total 1123 585 377 530 474 515 684 618 609 820 692 574 7601 15 The Shelter.—Sixteen families were received in the shelter during the year, whilst their homes were disinfected. These families consisted of 39 children and 29 adults. MORTUARY. The number of bodies deposited in the Mortuary during the year was 179; 122 were removed to the Mortuary by the Coroner's orders, 17 by the Medical Officer of Health's orders, 6 by the Relieving Officer's orders, 33 by the Police, and 1 was taken by a friend for the sake of convenience. Nine bodies were deposited in that part of the Mortuary set apart for infectious cases, 6 of the deaths were due to Diphtheria, 1 to Scarlet Fever, 1 to Typhoid Fever and 1 to Membranous Croup. In 148 of the cases inquests were held, and in 33 cases postmorten examinations were made. Instruments are provided free of charge for the use of Medical men to conduct these operations. The deaths of the above were due to the following causes:— Zymotic Diseases 9 Violence, accident, &c. 29 Suicide 7 Drowning 23 Diseases of the heart 31 Respiratory Diseases 16 Nervous Diseases 11 Convulsions and improper feeding 22 Constitutional Diseases 14 Other causes 15 Still-born 1 One child was found in the Thames but whether he had a separate existence or not there was not sufficient evidence. 16 THE SALE OF FOOD AND DRUGS' ACT. The total number of articles analysed during the year was 135; of which 129 were submitted by the Inspectors, and 9 by residents and others. This number consisted of 57 milks, 24 butters, 7 coffees, 1 mixed pickles, 7 mustards, 6 whiskies, 2 gins, 2 rums, 1 limewater, 7 peppers, 9 flours, 9 breads, 3 oatmeals. Of these 43 milks, 6 coffees, the mixed pickles, 19 butters, 7 mustards, 6 whiskies, 2 grins, 7 peppers, a flours, 9 breads. 3 oatmeals and 1 rum were genuine. Articles. Extent of Adulteration. Result. Milk Adulterated with 17 per cent. of water Fined 30s., and 23s. costs. Milk Adulterated with 17 per cent. of water Fined 30s., and 23s. costs. Coffee Adulterated with 50 per cent. of Chicory Fined 30s., and 23s. costs. Limewater Deficient in lime to the extent of 24.4 per cent.. Cautioned. Milk Adulterated with 5 per cent. of water Cautioned by the Magistrate. Milk Adulterated with 5 per cent. of water Cautioned by Magistrate, but had to pay cost of summons. Butter Contained 82 per cent. of foreign fat Proceedings not taken on account of death of Public Analyst. Milk Adulterated with 9 per cent. of water Ditto. Milk Adulterated with 11 per cent. of water Fined 30s. Milk Adulterated with 13 per cent. of water Fined 20s. Milk Adulterated with 13 per cent. of water Fined 10s. Milk Adulterated with 9 per cent. of water Summons dismissed, sold under a warranty. Butter Contained 99 per cent. of foreign fat Fined 20s., and 23s. costs. Butter Contained 80 per cent. of foreign fat Fined 20s., and 23s. costs. 17 Articles. Extent of Adulteration. Result. Butter Contained 80 per cent. of foreign fat Fined 40s., and 23s. costs. Milk Adulterated with 4.7 per cent. of water Cautioned. Milk Adulterated with 4 per cent. of water Cautioned. Rum 29.4° under proof Informality of purchase. Milk Adulterated with 4 per cent. of water Cautioned. Milk Adulterated with 4 per cent. of water Cautioned. Articles Submitted by Ratepayers and Others. Milk Adulterated with 6 per cent. of water Informality of purchase. Butter Contained 60 per cent. of foreign fat Fined £12, and £2 costs. Total of Penalties and Costs, £32 8s. The Inspectors have performed their duties to my satisfaction, and I have to express my thanks to them for the manner in which they have assisted me in carrying out the duties of my office. I have the honour to remain, Gentlemen, Your most obedient Servant, D. L. THOMAS, Medical Officer of Health and Public Analyst. Board's Offices:— White Horse Street. May 4th, 1898. 18 TABLE I. Table shewing the Population, Inhabited Houses, Marriages, Births, and Deaths for the Year 1897, and 10 years preceding. The Year. Estimated Population. Marriages. Registered Births. Corrected No. of Deaths. Deaths in Public Institutions. Total All Ages. Under One Year. Under Five Years. 1897 58,508 459 1997 1462 386 715 342 189G 58,300 419 2012 1385 368 663 262 1895 57,600 378 2050 1575 456 736 255 1894 ... 382 1911 1396 327 616 ... 1893 ... 402 1954 1597 394 640 ... 1892 ... 417 1940 1468 366 674 ... 1891 ... 387 1998 1500 349 564 ... 1890 ... 411 1851 1609 387 785 ... 1889 ... 411 2109 1363 336 5S2 ... 1888 ... 420 2084 1441 431 712 ... 1887 ... 420 2064 1450 363 626 ... Avrge. of 10 yrs 1887-96. ... 404 1997 1478 377 659 ... 19 TABLE II. Table shewing the Annual Birth and Death Rates, Death Rates of Children in a Thousand Deaths for the Year 1897, and 10 Years preceding. In the Year. Birth Rate per 1,000 of the Population. Corrected Death Rate per 1,000 of the Population. Deaths of Children under 1 year; per 1,000 of Registered Births. Deaths of Children under 1 year; per 1,000 of Total Deaths. Deaths of Children under 5 years ; per 1,000 of Total Deaths. 1897 34.1 25.1 193 264 420.5 1896 34.6 23.7 182 265 478 1895 35.3 27.3 222 289 466 1894 33.1 24.2 161 234 441 1893 33.9 27.7 201 247 400 1892 33.6 25.5 188 249 459 1891 34.6 26.0 174 232 376 1890 30.8 26.8 209 240 445 1889 35.0 22.7 159 246 427 1888 35.5 24.6 207 299 494 1887 35.0 24.7 176 250 431 Average of 10 years, 1887-96. 34.1 25.3 187 255 441 20 TABLE III. Shewing the Number of Deaths at all ages in 1897, from certain groups of Diseases, and proportions to 1000 of Population, and to 1000 Deaths from all causes; also the Number of Deaths of Infants under one year of age from other groups of Diseases, and proportions to 1000 Births and to 1000 Deaths from all causes under one year. DIVISION I. (ADULTS). Total Deaths. Deaths per 1000 of population at all ages. Deaths per 1000 of total deaths at all ages. 1. Principal Zymotic Diseases 206 3.54 140.9 2. Pulmonary Diseases 260 4.5 181.9 3. Principal Tubercular Diseases 192 3.2 131.3 DIVISION II. (Infants under One Year). Total Deaths. Deaths per 1000 of Births. Deaths per 1000 of total deaths under one year. 4. Wasting Diseases 122 2 83 5. Convulsive Diseases 74 1.2 50 NOTICE. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Membranous Croup, Whooping Cough, Influenza, Typhus, Puerperal, Enteric (or Typhoid), and Simple Continued Fevers, and Diarrhoea ; 37 of the deaths occurred in Hospitals situated beyond the limits of the District. 3. Includes Phthisis, Scrofula, Tuberculosis, Rickets, and Tabes. 4. Includes Marasmus, Atrophy, Debility, Want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. 21 TABLE IV. Table shewing the Number of Deaths from the principal Zymotic Diseases, in the 10 years, 1887 to 1806, and in the year 1897. Disease. 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 Annual Average of 10 years, 1887—1896. Total Deaths in 1897. Proportion of Deaths to 1000 Deaths in 1897. Small Pox - - - - - - 7 1 1 - 9 - - Measles 58 88 20 92 14 63 16 72 81 49 55.3 63 43.4 Scarlet Fever 27 23 27 15 5 27 31 41 17 14 22.7 12 8.4 Diphtheria 10 23 41 25 15 28 62 42 41 35 32.2 26 17.7 Membranous Croup - - - - - - - - - 2 2 3 2 Whooping Cough 65 58 23 70 59 59 49 28 42 52 50.5 37 25.3 Influenza - - - - - - - - - 5 . 5 3.4 Fever Typhus - - 1 - - - 1 - - - .2 - - Enteric 6 9 13 14 6 - 16 6 10 3 8.8 4 2.7 Simple contn'd 1 9 1 - - 6 - - - - 1.7 - - Puerprl. — — - — — — — — — 1 . 1 .6 Diarrhœ 67 27 47 52 49 27 56 22 49 40 43.6 61 41.7 Totals 234 237 173 268 148 210 238 212 241 201 2162 212 145.2 22 SPECIAL RETURNS REQUIRED BY THE LOCAL GOVERNMENT BOARD 27 TABLE V.—TABLE OF DEATHS during the Year 1897, in the Metropolitan Sanitary District of Limehouse, classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Mortality from All Causes, at subjoined ages. Mortality from subjoined Causes, distinguishing Deaths of Children under Five Years of Age. A tall ages. Under 1 Year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 (Columns for Population and Births are in Table B.) Small Fox Scarlatina Diphtheria MembranousCroup Fevers. Cholera Erysipelas Measles Whooping Cough Diarrhoea and Dysentery Rheumatic Fever Phthisis Bronchitis Pneumonia and Pleurisy Heart Disease Influenza Injraies All Other Diseases Total Typhus Enteric or Typhoid Continued Relapsing Puerperal (a) (6) (e) (d) (e) (f) (g) (h) (i) Limehouse 536 204 95 15 17 131 74 Under 5 - 1 2 1 - - - - - 1 4 25 28 36 - 1 43 5 1 4 136 288 5 upwds. - - 1 - - 1 — — 1 — — — — — 2 36 46 37 1 22 101 248 Ratcliff 244 73 52 16 11 67 25 Under 5 - 2 5 2 - - - - - - - 9 1 14 - 1 23 1 - 3 65 126 5 upwds. - - - - - - - - - - - - - - 1 17 20 19 - 10 49 118 Shadwell and Wapping 169 43 49 3 5 51 18 Under 5 - - - - - - - - - - - 18 4 10 - 4 16 1 - 4 29 89 5 upwds. - - - - - - - - - - - - - - - 20 16 9 1 6 25 77 East London Children's Hospital 342 178 134 23 - 5 2 Under 5 - - 5 - - - - - - - - 1 1 2 - 18 74 7 - 5 199 312 5 upwds. - - - - - 1 - - 1 - 1 - - - - 6 1 6 - 3 11 30 Totals 1291 498 330 57 33 254 119 Under 5 - 3 18 3 - - - - - 1 4 53 34 62 - 2 156 14 1 16 429 815 5 upwds. - 1 1 - - 2 - - 2 - 1 2 - - 3 79 83 71 2 41 186 473 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 446 66 33 18 32 201 96 Under 5 - 7 9 - - - - - - - 1 8 - - - 4 12 - 1 4 51 99 5 upwds. - 1 3 — — 3 - — — — 3 1 - 1 1 66 49 51 1 23 144 347 Deaths occurring within the district among persons not belonging thereto 269 137 99 17 1 13 2 Under 5 - - 4 - - - - - - - 1 - 1 5 - 13 60 7 - 2 143 236 5 upwds. — — - - — - - - - - - - - - - 5 - 6 - 11 10 33 32 TABLE VI.—TABLE OF POPULATION, BIRTHS, and of NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1897, in the Limehouse District; classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5 New Cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Last Census. Estimated to middle of 1897. Small Pox Scarlatina Diphtheria Membranuus Croup Fevers. Cholera Erysipelas Small Pox Scarlatina Diphtheria Membranous Croup. Fevers. Puerperal Cholera Erysipelas Typhus Enteric or Typhoid Continued Relapsing Puerperal Typhus Enteric or Typhoid Continued Relapsing (a) (b) (c) (d) (e) Limehouse 32917 1197 Under 5 — 68 31 1 — 3 - - - - 5 - 44 23 - - 3 - - - - - 5 upwds. - 163 53 - - 17 - - 3 - 44 - 112 33 - - 14 - - - - 10 Ratcliff 14954 471 Under 5 - 37 16 1 - 1 - - 1 - 1 - 19 5 - - 1 - - - - - 5 upwds. - 81 36 - - 18 - - - - 28 - 57 21 - - 12 - - - - 6 Shadwell and Wapping 10434 329 Under 5 - 30 16 1 - - - - - - - - 23 11 - - - - - - - - 5 upwds. - 41 34 - - 12 - - - - 12 - 34 25 - - 11 - - - - 5 Totals 58305 58508 1997 Under 5 - 135 63 3 - 4 - - 1 - 6 - 86 39 - - - - - - - - 5 upwds. - 285 123 - - 47 - - 3 - 84 - 203 79 - - - - - - - 21 88 Board of Works for the Limehouse District, Sanitary Department. To Dr. D. L. Thomas, Medical Officer of Health and Public Analyst. Sir, We have much pleasure in submitting our tabulated statement showing the amount of work performed by us during the past year, the details of which came under the notice and supervision of Drs. G. A. Rogers, S. B. Stedman, and yourself. Although an increase in the general work of the District has occurred, we have been able to give attention to the inspection of Houses let in Lodgings, and to Workshops. Diligent attention has been given throughout the year to the Meat, Fish, Fruit and Vegetables exposed for sale in the shops and thoroughfares in the District. The cases of Infectious Disease have had our immediate attention and constant vigilance day and night, and occasionally on Sundays. We are, Yours obediently, JOHN WILLIAM JOHNSON, GEORGE OSBORNE PAVITT, EDWIN THOMAS CROOK. 34 TABLE VII. INSPECTORS' REPORT OF THE SANITARY WORK, &c. Completed in the year ending December 31st, 1897. Sanitary Work, &c. No. 1 District. No. 2 District. No. 3 District. Total. Houses, Premises, &c., inspected 1351 1220 1290 *3861 Orders issued for amendments 3467 2335 2382 8184 Houses cleansed and whitewashed 125 147 275 547 Rooms disinfected, stripped and cleansed 156 170 114 440 Drains repaired, cleansed and trapped 689 396 440 1525 Drains new and reconstructed 168 97 155 420 Yards paved, and paving repaired 266 217 330 813 Water Closets cleansed and repaired 442 256 345 1043 Closets and urinals supplied with water 88 190 90 368 New Closets supplied 38 6 13 57 Water supply laid on 77 90 30 197 Cisterns cleansed and covered, and defective water fittings 374 123 240 737 Waste and stack pipes disconnected from drains 101 62 45 208 Dust-pails supplied 416 345 271 1032 Dust removal complaints attended to 9 12 15 36 Removal of accumulations, &c. 5 4 18 27 Dead bodies removed to Mortuary - 7 7 14 Canal Boats inspected 30 - - 30 Flooring, stairs, window sashes and eaves gutters provided, and roofs repaired 708 367 350 1425 Overcrowding abated 2 4 2 8 Notices to Schools 374 424 220 1018 Factory inspections 49 5 140 194 35 Factory nuisances abated 9 3 16 28 Bake-houses inspected 40 28 20 88 Licensed Slaughter-houses inspected 2 1 - 3 Legal proceedings, i.e.,Summonses 13 11 2 26 Houses closed, unfit for habitation 2 - - 2 Houses demolished - 10 6 16 Notices given to London County Council of dangerous and dilapidated premises 31 40 12 83 Drain test used 861 850 318 2029 Improved ventilation in houses 180 117 17 314 Basements discontinued to be used as dwellings 1 - 3 4 Drinking water supplies separate from the w.c.s 18 - 5 23 Animals removed 1 14 - 15 Cesspools abolished 1 1 2 4 Free Shelters inspected - 24 - 24 New dung pits provided 3 3 3 9 Water closets discharging into the River Thames - - 4 4 Notices to provide crossings, area gratings, flaps and trap doors in footways 4 22 30 56 Samples taken under Sale of Food and Drugs' Act 53 36 40 129 Dust-bins defective - 4 2 6 Licensed Cow-sheds inspected 6 3 12 21 Smoke nuisances abated 9 2 12 23 *This does not include re-inspection to premises to ascertain works in progress; such, if added would probably treble the number. In addition to this, we have had destroyed, as unfit for human food, during the year the following articles, viz:—3 Barrels of Roker, a quantity of Pineapples, Oranges and Bacon, 397 Cases of Eggs, 120 Cases of Oranges, 50 Sacks of Potatoes, and 1 Case of Onions. JOHN WILLIAM JOHNSON GEORGE OSBORNE PAVITT. EDWIN THOMAS CROOK. 36 TABLE VIII. Shewing the Localities in which certain Diseases of a Zymotic character occurred during the year 1897. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total. Acland-street ... 1 1 2 ... ... 4 Albert-square • • • ... 1 5 ... ... 6 Ann-street 1 ... 1 4 2 ... 8 Anchor-street .. ... ... 3 ... ... 3 Aston-street 1 ... 2 6 1 ... 10 Albert-street Bdgs. ... ... ... 1 ... ... 1 Barnes-street ... ... ... 4 1 ... 5 Belgrave-street 7 ... ... 6 1 ... 14 Bromley-street 7 ... 1 4 1 ... 13 Brenton-street ... ... 2 5 ... ... 7 Burdett-road 1 ... 2 6 ... ... 9 Burgess-street 3 ... 1 10 ... ... 14 Bower-street 3 ... ... 5 2 ... 10 Brook-street ... ... 2 13 2 ... 17 Blount-street 1 ... 1 8 ... ... 10 Beachcrof t-bdgs ... ... ... 1 ... ... 1 Broad-street ... ... ... 1 ... ... 1 Ben Jonson-road 1 ... ... 2 ... ... 3 Bere-street ... ... ... 1 ... ... 1 Burn-street ... ... ... ... 1 ... 1 Balls-buildings ... ... ... 2 ... ... 2 Bewley-buildings 2 ... .... 1 1 ... 4 Batson-street 1 ... ... ... ... ... 2 Black Bull-court 1 ... 1 1 ... ... 3 Butcher-row 1 ... ... ... ... ... 1 Beccles-street 1 ... l ... ... ... 2 Brunswick-place ... ... ... 1 ... ... 1 Commercial -road 1 ... 4 8 1 ... 14 Caroline-street 2 ... 1 1 ... ... 4 Cable-street 5 ... 4 10 1 ... 20 Clemence-street 3 ... ... 8 ... ... 11 37 TABLE VIII. (Continued). Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total. Coleman-street ... ... ... 3 ... ... 3 Chaseley-street ... ... 1 4 ... ... 5 Church-row ... ... 1 3 ... 1 5 Cosh's-buildings 1 ... ... ... ... ... 1 Conder-street ... ... ... 5 ... ... 7 Cayley-street 1 ... 1 1 ... ... 3 Carr-street ... ... ... 3 2 ... 8 Copenhagen-place ... ... 1 6 ... ... 8 Church-court ... 1 ... 1 1 ... 3 Chambers-square 1 ... ... ... ... ... 1 Collingwood-street 1 ... ... 1 ... ... 2 Devonport-street ... ... ... 2 ... ... 2 Dunstan -place ... ... 2 4 ... ... 6 Dod-street ... ... ... 2 ... ... 2 Drew's buildings 1 ... ... 5 ... ... 6 Dora-street 1 ... ... 1 ... ... 2 Dixon-street 1 ... ... 6 ... ... 7 Durham-row 2 ... 1 ... ... ... 3 Dalgleish-street 2 ... ... ... ... ... 2 Dellow-street 2 ... 1 3 ... ... 6 Dupont-street 1 ... ... 2 1 ... 4 Duke Shore-alley ... ... ... 1 ... ... 1 Dr. Barnardo's-hme 6 ... 2 17 ... ... 25 Elizabeth-place East London 1 ... ... ... ... ... 1 Hospital 1 ... ... 1 1 ... 3 Eastfield-street 6 ... 5 5 ... ... 16 Elsa-street 4 ... 4 5 3 ... 16 Elbow-lane-bldgs. ... ... ... 1 ... ... 1 Ebenezer-place ... ... ... 2 ... 2 East India Dockroad 1 ... ... 3 1 ... 5 Elm-row ... ... ... 3 ... ... 3 38 TABLE VIII. (Continued). Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total. Farrance-street ... ... 2 2 ... ... 4 Gait-street ... ... 1 1 ... ... 2 Gun-lane ... ... ... 1 ... ... 1 Green-bank 1 ... ... ... ... ... 1 George-street • •• ... 1 1 ... ... 2 Globe-alley 3 ... ... 2 ... ... 5 Gun-square ... ... 1 ... ... ... 1 Glasshouse-fields 1 ... 1 ... ... ... 2 Gill-street ... ... ... 2 ... ... 2 Glamis-road 1 ... 1 6 ... ... 8 Gill-place ... ... 1 1 ... ... 2 Grocers-court 1 ... ... 1 ... ... 2 High-st., Stepney ... ... 1 1 1 ... 3 High-st., Shadwell 6 ... ... 6 2 ... 14 High-st., Wapping ... ... ... 2 1 ... 3 Harding-street 1 ... ... ... ... ... 1 Havering-street ... ... ... 2 ... ... 2 Halley-street ... ... ... 7 ... ... 7 Hilton-street ... ... 1 ... ... ... 1 Juniper-street 10 ... 1 9 2 ... 22 James-place ... ... 1 ... 1 ... 2 Jamaica-passage ... ... 1 ... ... ... 1 Kirks-place 3 ... 1 ... ... ... 4 Lee-street ... ... ... 2 1 ... 3 London-street ... ... 1 1 ... ... 2 Locksley-street 1 ... ... 9 .... ... 10 Limehouse Causeway 2 ... 1 ... ... ... 3 39 TABLE VIII. (Continued). Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total. Lance-street 2 ... ... 3 ... ... 5 Love-lane 1 ... ... 1 ... ... 2 Lockside 1 ... ... ... ... ... 1 Lydbrook-street ... ... ... 1 ... ... 1 Lowell-street ... ... ... 1 ... ... 1 Monza-street ... ... ... 2 ... ... 2 Maroon-street 8 ... 2 19 1 ... 30 Mercer-street 2 ... ... 8 ... ... 5 Manning-street ... ... ... 2 1 ... 3 Medland-street 2 ... ... 4 ... ... 6 Market-hill 1 ... 1 ... ... ... 2 Milk-yard ... ... 1 ... ... ... 1 Notgrove-street ... ... 1 ... ... ... 1 Nortliey-street ... ... 4 4 .. 1 13 New Gravel-lane ... ... ... 1 1 ... 2 Narrow-street 4 ... ... 1 ... ... 5 New Alley-square ... ... .. 2 ... ... 2 Newtons-rents 1 ... ... ... ... ... 1 Neptune-street ... ... ... 1 ... ... 1 Nightingale-lane ... ... ... 1 ... ... 1 Orchard, The 1 ... ... ... ... ... 1 Periwinkle-street ... ... 2 3 ... ... 5 Peabody-buildings 1 ... ... 5 1 ... 7 Pigott-street ... ... ... 2 ... ... 2 Parnham-street ... ... ... 1 ... ... 1 Portland-street ... ... ... 3 4 ... 7 Ratcliff-workhouse 1 ... 3 1 ... ... 5 Rhodeswell-road 7 ... ... 5 ... ... 12 4o TABLE VIII. (Continued). Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total. Ropemakers-fields 1 ... ... 1 ... ... 2 Red Lion-street 3 ... ... 1 ... ... 4 Ratcliff-square ... ... ... 1 ... ... 1 Rose-lane 1 ... ... 1 ... 1 3 Repton-street ... ... 1 10 ... ... 11 Rich-street ... ... 1 1 1 ... 3 Rugg-street ... ... ... ... 1 ... 1 Ronald-street 2 ... ... 4 ... ... 6 Salter-street ... ... 1 ... ... ... 1 Salmon-lane 2 ... 1 3 ... ... 6 Samuel-street 1 ... ... 2 ... ... 3 Streatfield-street ... ... ... ... ... ... 3 Selsev-street ... ... ... 1 ... ... 1 Stainsby-road 3 ... ... ... ... ... 5 Sarah-street 2 ... 1 1 ... ... 4 Stepney-causeway 1 ... ... ... 1 ... 3 Sage-street ... ... ... 1 1 ... 2 School-house-lane 1 1 2 ... ... ... 4 Spenlow-street ... ... ... ... 1 ... 1 Spencer-street ... ... ... 1 ... ... 1 Thomas-street, Ratcliff 3 ... ... 3 ... ... 6 Tower-buildings 1 ... 1 ... ... ... 2 Turners-road ... ... ... 6 ... ... 6 Three Colt-street 2 ... ... 3 ... ... 5 Twine-court 1 ... ... ... ... ... 1 Tower-bldgs (old) 1 ... ... ... ... ... 1 Taylor's-place ... ... ... 1 .. ... 1 Thomas-street Limehouse 2 ... 2 13 1 ... 18 Tenbury-place ... ... ... 1 ... ... 1 Troon-street 2 ... ... 3 ... ... 5 41 TABLE VIII. (Continued). Locality. Diphtheria. Membranous Croup. Erysip elas. Scarlatina. Enteric Fever. Puerperal Fever. Total. Upper-well-alley ... ... ... 1 ... ... 1 West-pier 1 ... ... ... ... ... 1 White Horse-street ... ... 2 4 1 ... 7 Walker street 1 ... .. 4 ... ... 5 West India Dock Road ... ... 1 4 1 ... 6 Walter-street ... ... ... ... 1 ... 1 Wapping-wall ... ... ... 1 ... ... 2 West Garden-bldgs. 2 ... 1 ... ... ... 3 West-gardens ... ... ... 1 ... ... 1 Waterloo-street ... ... ... 2 ... ... 2 White Hall-place ... ... ... 1 ... ... 1 York-buildings 3 ... 1 2 3 ... 9 York-street 2 ... ... 3 ... ... 5 York-road • • • ... 1 ... ... ... 1 York-square ... ... ... 1 ... ... 1 42 1897. BAKEHOUSES. LIMEHOUSE. NAMES. Mr. J. Rickert, „ C. Baldwin, Miss Bulgin (not used), Mr. J. Draude, „ M. Donaldson, „ Schwarz, (empty) „ W. Living, „ P. Fiehl, „ H. Fuchs, „ J. Few, „ W. Pearce, „ H. Bretz, „ J. Faber, „ Miller, „ C. Smeith, „ W, Wagner, „ H. Haust, „ W. Stevens, „ J. W. Domm, (not used) „ W. H. Pearce, „ T. Slawson, „ J. A. Siebert, „ H. Marks, (not used) ADDRESSES. 22, Gill-street 821, Commercial-road 341, Burdett-road 31, Repton-street 3, Repton-street 137, Eastfield-street 21, Halley-street 12, Parnham-street 45, Thomns-street 84, Locksley-street 132, Rhodeswell-road 131, Salmon-lane 145, Salmon-lane 181, Salmon-lane 209, Salmon-lane 71, Salmon-lane 7, Limehouse-causeway 40, Limehouse-causeway 68, Limehouse-causeway 146, White Horse-street 51, Three Colt-street 77, Three Colt-street 87, Three Colt-street 93, Three Colt-street 36, Three Colt-street 56. Three Colt-street RATCLIFF. Mr. Prummer, „ A. S. Harding, „ Bader, Mrs. Lee, 105, White Horse-street 42, White Horse-street 147, White Horse-street 631, Commercial-road 43 Bakehouses—Continued. RATCLIFF. NAMES. Mr. Weimer, „ J. W. Newman, „ G. Siebert, (empty) „ Schwenk, (empty) „ Schneider, (empty) (empty) „ W. Herbert, „ Cattung, ADDRESSES, 119, Broad-street 27, Hardinge-street 415, Cable-street 59, Brook-street 91, Brook-street 139, Brook-street 85, Brook-street 28, White Horse-street 43G, Commercial-road 508, Commercial-road 13, Devonport-street SHADWELL. Mr. W. Atkinson, Miss Green, Mr. Westrick, „ Menzler, „ Grender, 84, High-street 161, High-street 47, High-street 5, King David-lane 278, Cable-street 44 Licensed Cow Houses—Continued. RATCL1FF. NAMES. Mr. Charles Warman, „ Charles Toms, „ James Allcock, Messrs. J. & W. Morris, ADDRESSES. Railway Arch, Drewton-street G3, Brook-street 12, Hilton-street 87, White Horse-street SHADWELL. Mr. Thomas Williams, „ Charles Warman, Sage-street Lower Shadwell SLAUGHTER HOUSES. LIMEHOUSE. Mr. W. H. Phillips, „ A. Brown, 160, White Horse-street 22, Three Colt-street