HAN 8 QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY OF Saint George, Hanober Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOR THE FIRST QUARTER OF THE YEAR 1858. Presented to the Vestry 27th April, 1858. LONDON. LONDON: PRINTED BY GEORGE PHIPPS, RANELAGH STREET, EATON SQUARE. to the Desty of St. George, Hanoder Square. My Lords and Gentlemen, I. We will begin by speaking of the mortality of the Parish during the first quarter of 1858. We regret to say that it has been high, by comparison, both with the average of the last ten years, and with that of the year 1857. For during the first thirteen weeks of 1858 no fewer than 528 deaths have been registered, including the deaths of 62 non-parishioners in St. George's Hospital, and of 11 inmates of the Little Chelsea Workhouse. The average mortality for the corresponding quarter of the 10 years previous, was 416. So that, in round numbers, 100 deaths have occurred in this quarter, in excess of that average. The deaths during the corresponding period of 1857 were 436; so that, in round numbers, and making 4 ances for St. George's Hospital, there have been 80 deaths this year in excess of last year. Nevertheless, there are not so many by about 38, as there were in the corresponding period of 1855. This increased mortality has been spread as nearly as possible equally over each sub-district of the parish; we may say, over the whole of the western part of London. Moreover, it has fallen almost equally upon every age, except that there is a slightly greater increase of deaths under 20. But, when we cast our eye over the quarterly table, dated March 27, 1858, and compare it with that dated March 28, 1857, we see the increase readily accounted for by one or two significant items. Every malady affecting the organs of breathing has been more fatal this year. Measles this year have destroyed 32 against 5 last year; and lung diseases 141 against 87. Hooping-cough has destroyed 15, typhus 12, scarlatina, with diphtherite and quinsy (maladies which spend their virulence on the throat) 18. The diphtherite is a new name for an old disease, heretofore called ulcerated, or putrid sore throat; and sometimes mistaken for croup, or quinsy. Two deaths from these maladies happened in one house in Weaver's Court, and two (of a mother and child) in Shepherd's Place. Scrofulous maladies, together with inflammation of the brain in children, convulsions, and teething carried off 90. Two deaths only have been given registered from bowel disorder. Amongst the miscellaneous causes, we may notice 12 deaths of prematurely born children (including two separate twins in the Hanover Sub-district) ; five children of single women starved for want of breast milk; one male infant exhausted from insufficient nourishment; 5 one of four months suffocated whilst in bed with its parents ; and four suicidal drownings of women in the Serpentine. II. The sickness has likewise been great. In the Hanover and May Fair Sub-districts 929 persons have received medical relief from the parochial surgeons, and from the Mount Street Branch of the St. George's and St. James's Dispensary; of whom 50 were entered as suffering from measles, 8 from scarlet fever, 34 from common fever, and 256 from bronchitis and catarrh. Of diarrhoea there were 19 cases. In the Belgrave Sub-district 6074 cases of disease were treated by the parochial surgeons, at the St. George's Hospital, the Royal Pimlico Dispensary, and the St. Paul and Barnabas' Dispensary; and at the Workhouse, Little Chelsea. Of these cases 3376 were treated at St. George's Hospital, leaving 2655; amongst whom, the proportion of parishioners and non-parishioners is not known. The proportion which diseases bare to each other is shown by the fact, that out of the 2655 were 60 cases of diarrhoea, 37 of measles, 17 of typhus, 18 of rheumatic fever, 14 of hooping-cough, 10 of erysipelas, 2 of diphtherite, and 229 of bronchitis. The small-pox appeared in Gilbert Street, and in Hart Street, in the middle of March. In each case the patient was a child already vaccinated imperfectly; the former died. The family of the patient in Hart Street occupied a front room; behind this is a closet 9 feet square, in which four children of another family sleep, and which derives all its light and air from the front room. 6 III. In the next place we will speak of various details, which have been brought before the Sanitary Committee respectively, and of works recommended and executed, since the last report. Carrington Street. — Nos. 6 and 8 have been newly drained. The former drainage apparatus of No. 8 consisted of pipes broken and disjointed; the earth under the house was saturated with leakage, and the stench during the work, such as to cause illness to the inmates. The earth was sweetened with quicklime, under the inspection of Mr. Grant. Hertford Place.—The agent for this property having been convinced of the defective state of the drains, has caused new pipes to be laid down from the front of every house. Thus it may be hoped that, at last, these premises are put into a sound condition. No. 1, Weaver's Place, North Row.—Two deaths from scarlet fever occurred here in January. An untrapped sink, which admitted effluvia from the drains, has been set to rights by the owner; and the occupier was enabled, by means of a notice, to insist on the removal and cleansing of the clothes which had been worn by the deceased children. No. 1, Shepherd's Place, Upper Brook Street.—Here a mother and son died of diphtherite. Defects in the drains and ashpit were removed. No. 9, Blenheim Street. —Attention was directed to this house, in consequence of a death from scarlet fever, more especially as two deaths from measles had occurred at No. 10, in 1856. The owners were induced to make a thorough investigation of the drainage, with the result of discovering that the whole of the sewage of No. 9 drained into a cesspool under No. 10, the earth under which house was saturated 7 with it. No. 11 also drains partly into No. 10, and partly into No. 12. No. 10 had been offensive for years; but not through the fault of the occupier, who had " had the drains up five times in five years,"—the fact being that pipes had been laid down which carried off the sewage of this house, but not that of the houses on either side, of which this house was the receptacle. This is one instance amongst many, of long continued annoyance and danger, arising from old and unsuspected cesspools. In this case, new pipes were laid down, perfect drainage effected, and the contaminated earth mixed with quicklime. Davies Street.—Nos. 65, 67, 68, and 70, and No. 13.— These were instances of houses made unwholesome, by defects in the water closet arrangements, or by the carelessness of the inmates. No. 29, Upper Brook Street.—A servant from this house was registered as having died of fever in St. George's Hospital, and, as in all similar cases, an inspection of the premises was made; inasmuch as servants are often exposed to causes of illness, of which the masters know nothing. Some trifling defects were pointed out, but it did not appear that the deceased had contracted his illness in the house. No. 8, Reeve's Mews.—Many cases of fever. The house cleansed on application to the owner. Mount Row, Nos. 1 and 2 ; Davies Street, No. 27 ; Carpenter Street, Nos. 5 and 6.—A block of buildings communicating with each other, and all annoyed by cesspools and imperfect drainage. No. 15, Mill Street.—Here was a leakage of most offensive sewage, from a house in the adjoining parish of St. James. 8 No. 52, South Molton Street.—Rendered damp by leakage from a cesspool in the yard of 19, Woodstock Street. Nos. 280 and 282, Oxford Street.—Obstructed drainage; No. 42, Clarges Street—Insufficient means of preventing the entry of gas from the sewer; No. 18, Grosvenor Street— Old and dilapidated drainage. No. 6, Little Stanhope Street; the Public Baths and Wash-houses in Davies Street,; No. 1, Swallow Place; No. 94, Park Street; No. 5, Berkeley Street, Berkeley Square; Three Kings' Yard, Piccadilly; No. 23, Cock Yard; Nos. 5 and 6, Robert Street; Nos. 3 and 4, Ducking Pond Mews ; are premises where various causes of unhealthiness, chiefly old, dilapidated, or ill-constructed drains, have been investigated and removed, under the superintendence of the Medical Officers of Health, or Inspector of Nuisances. In some cases complaint was made by the occupiers; in others, the investigation was set on foot by the Medical Officers, in consequence of the presence of illness; amongst the latter was— No. 5, Seamore Place.—A house let furnished, at a high rent, in which the butler was seized with the acutest possible symptoms of cholera, caused without doubt by the vapours from the decayed drains, which poisoned the place in which the servants slept. One other inmate had severe diarrhoea. No. 3, Upper Belgrave Terrace, and No. 18, Little Chester Street, a defective water supply to the closets. A notice was served upon the owners in both instances and the work was finished satisfactorily in the former. Nos. 8 to 14, New Street Cottages, Hindon Street, were without ashpits. The notice required a covered ashpit to be erected for the use of each house, which was supplied. At No. 31, Queen Street, the back yard and kitchen 9 were completely saturated with sewage, and the area contained a large quantity of the same offensive matter. Such a state of things became a serious nuisance to the numerous customers who frequented the house, and probably would have occasioned disease but for its speedy removal. No. 12, Upper Belgrave Place.—Drainage stopped up and smell offensive. Work finished. No. 31, Upper Eaton Street.—An offensive smell caused by a cesspool, no cover to ash-pit, and gully in the washhouse untrapped. It was recommended that the cesspool be emptied and filled up; the privy be panned and trapped; water laid on properly; the drainage to be connected with the sewer, and the gully trapped. Work finished. No. 18, Burton Street.—This place is a stable yard ; the stabling for 15 horses; there is a dwelling above, no water to the closet. The stables are badly drained, and apparently five or six houses drain into the same drain. Notice made out to the owner. No. 40, Kinnerton Street.—Family not sufficiently supplied with water owing to the cistern being locked up. This was a hard case. A poor patient under the care of Dr. Aldis at the St. Paul and St. Barnabas' Dispensary, residing over a stable, complained to him of a deficient supply of water for domestic purposes. The landlord had agreed to allow her the use of water laid on in the stables, when she first took the lodging, and at some future time to extend the supply to her room ; but recently he had taken away the key of the door through which she was obliged to pass in order to obtain water, so that, whenever the family needed water she was compelled to apply to him for the key. One 10 morning herself and family had not breakfasted in consequence of being unable to obtain it. The facts having been enquired into, the landlord excused his breach of promise, by stating that he wished to protect his fowls ; and not only refused to extend the water supply to the tenant's room, but even to return the key; and in addition, was giving him notice to quit the premises, because his wife complained to the Medical Officer of Health who could only regret that the local authority had not power to enforce a supply of water in such cases. Nos. 1 to 10, inclusive, Upper Grillingham Street.—All the tenants complain of bad smells in their kitchens, no covers to ashpits, common privies and drainage in a defective state, only one drain for two houses. After sanitary inspection and recommendations, closets have been constructed, with a proper supply of water, and a separate drain for each house; and the ash-pits have been covered, which will add materially to the comfort of the inmates. No. 13, Upper Belgrave Place.—Drainage in a defective state, and a most offensive smell in the front kitchen. A new pipe drain was laid down, which has remedied the evil. Many similar obstructions in the drains have occurred in this place, because there was only one outlet for the drainage from several houses. Hence the removal of such a nuisance from one house has created another in the adjoining one. This has happened from No. 7 to No. 13 inclusive. The fact that the sewer in the front of these houses was private, no doubt deterred many of the inhabitants from draining into it separately in consequence of the expense, until the impediments became so serious as to render additional channels necessary. 11 No. 2, Albert Street, Victoria Square.— The water supplied smells and tastes offensively. The cistern was very dirty and required to be properly cleansed; when this was effected the water was found to be good, showing the necessity of attention to the state of the water receptacles. No. 27, Caroline Street.—Offensive smell in the house, coming from the adjoining premises No. 28, where there was a cesspool. Caroline Mews, Caroline Street. — Drainage obstructed and overflowing. Passage behind Nos. 97 and 98, Westbourne Street.— Drainage stopped up, paving out of repair, a quantity of stagnant water, smell offensive, and no water supply to the closet at No. 97. Yard behind the Chapel in Charlotte Street.—A large quantity of dung in three places. It was taken away, and a notice served for a daily removal. No. 39, Queen Street.—A cesspool, and no ash-pit. No. 40, Queen Street.—Drains choked up, and no cover to ash-pit. It was mentioned in the last quarterly report, that a portion of Ebury Mews, in Belgravia, had no sewer; but since that time a 12-inch pipe has been very properly laid down by the landlord and vestry, extending from No. 4, to the sewer in Elizabeth Street, a distance of 140 feet. No wonder the stable smelt most offensively, for three loads of night soil have been taken from the cesspool, the gully of which had no trap; and as there was a common privy and no drainage for the horses, it is still less surprising that fever existed in such a hotbed for creating pestilence. The Medical Officers of Health have frequently alluded 12 to the neglect of vaccination among the poorer classes, who also entertain a similar prejudice against another operation, that is, lancing the gums of their children during dentition, accompanied by threatening symptons of some dangerous complaint. No doubt infantile mortality is increased through dread of this remedial measure. A complaint was made by a family residing in Westbourne Place of the bad state of the water used by them for drinking, when it was found to be strongly impregnated with gas, and to have been drawn from the pump in Sloane Square. The Medical Officer of Health for Chelsea was written to upon the subject, and the pump has very properly been closed by authority of the vestry of that parish. On December 29, 1857, the water from the Chelsea Company contained of Grs. Total impurity 19.96 Organic „ .68 On Jan. 5, 1858, „ „ 1.08 Inorganic „ 20.48 An analysis of the water supplied by the Chelsea Company, and taken February 16, 1858, from the main in Chapel Street, Belgrave Square, produced Grs. Total impurity 20.00 Organic „ 52 which was unusually good. C. J. B. ALDIS, M.D. R. Druitt. TABLE OF MORTALITY. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 27th of March, 1858. Average, 40.6 DISEASES. Ages at Death. Sub-Districts and Population. Sexes. Under 1. 1 and under 5. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave.—40,034. Mount-street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 31,930. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. I. Zymotic. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mumps .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 4 23 32 .. .. .. .. 8 4 18 .. 2 .. .. 11 21 32 Scarlatina & Diphtherite. 1 8 15 3 .. .. .. 7 2 7 .. .. .. 2 13 5 18 Hooping Cough 4 10 15 .. .. .. .. 2 .. 13 .. .. .. .. 5 10 15 Croup .. 5 6 .. .. .. .. 3 .. 2 .. .. .. .. 2 4 6 Thrush 2 .. 2 .. .. .. .. .. .. 2 .. .. .. .. 2 .. 2 Diarrhœa 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Dysentery .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Influenza .. .. .. .. 2 2 .. 1 .. 3 .. .. .. .. 1 3 4 Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Remittent Fever .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Infantile Fever .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Typhus Fever .. 3 7 2 2 1 .. 1 1 9 .. .. 1 .. 4 8 12 Child-bed Fever .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 1 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas and Pyemia .. .. .. 2 1 .. .. .. .. 1 .. .. .. 2 2 1 3 Syphilis 2 .. 2 .. .. .. .. .. .. 2 .. .. .. .. 1 1 2 Canker .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. II. Cancer, Dropsy. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hæmorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dropsy .. .. .. 3 6 3 .. 2 .. 3 .. .. 2 5 7 5 12 Abscess 1 .. 1 .. .. 1 .. .. 1 1 .. .. .. .. .. 2 2 Ulcer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 .. 1 Cancer .. .. .. 2 5 3 .. 1 1 3 .. .. .. 5 1 9 10 Gout .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 III. Scrofula. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scrofula .. .. 2 1 1 .. .. .. .. 1 .. .. 2 1 4 .. 4 Mesenteric Disease 1 4 5 .. .. .. .. 1 .. 4 .. .. .. .. 3 2 5 Consumption .. .. 4 34 16 .. .. 14 6 2/ .. 2 .. 5 27 27 54 Water in the Head 2 5 7 .. .. .. .. 3 .. 4 .. .. .. .. 7 .. 7 IV. Nervous System. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Brain .. 1 3 2 1 1 .. 1 .. 3 1 .. .. 2 4 3 7 Apoplexy .. .. .. 2 4 3 1 3 1 6 .. .. .. .. 6 4 10 Paralysis .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 Delirium Tremens .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epilepsy .. .. 1 1 3 2 .. 1 2 3 .. .. 1 .. 3 4 7 Tetanus .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 Insanity & Mental Shock. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Convulsions 8 8 16 .. .. .. .. 3 .. 12 .. 1 .. .. 11 5 16 Disease of Brain, &c. 2 1 4 3 1 2 1 6 .. 2 1 .. .. 2 5 6 11 V. Heart, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pericarditis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Heart, &c. .. .. 2 1 13 7 .. 4 2 14 .. .. 2 1 10 13 23 VI. Lungs, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Laryngitis .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 Bronchitis 17 10 29 1 23 36 2 20 9 38 9 2 2 11 41 50 91 Pleurisy and Empyema .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Pneumonia 12 5 19 3 7 5 .. 5 .. 21 3 .. 2 3 22 12 34 Asthma .. .. .. .. .. 3 .. .. .. 3 .. .. .. .. .. 3 3 Disease of Lungs, &c. 1 2 4 5 l 1 .. 1 3 4 .. .. 1 2 6 5 11 BIRTHS registered during 13 weeks.—Hanover Square, M. 71, F. 61; May Fair, M. 25, F. 35; Belgrave, M. 209, F. 203. Total . . 604. Average . . 46.46 DISEASES. Ages at Death. Sub-districts & population Sexes. Under 1. 1 and under 5. Total under 20. 20 and under 40. 40 and under 60. 60 and under SO. 80 and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave.—40,034. Mount-street Work.—268. | Little Chelsea Work.—350. St. George's Hospital. -216. Males, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. VII. Of Stomach, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Teething 4 3 7 .. .. .. .. 1 .. 6 .. .. .. .. 4 3 7 Quinsy .. 2 2 .. .. .. .. 2 .. .. .... .. .. .. 1 1 2 Inflammation of Stomach .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Bowels 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Inflammation of Peritoneum .. 1 1 .. 1 1 .. .. .. 3 .. .. .. .. 2 1 3 Dropsy of Belly .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 Ulcer of Bowels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rupture .. .. .. .. 1 1 .. .. .. .. .. .. 2 .. .. 2 2 Heus, Hæmatemesis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intussusception .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stricture of Bowels .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Disease of Stomach .. .. .. 1 3 1 1 3 1 1 1 .. .. .. 3 3 6 Disease of Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Jaundice 1 1 2 .. 1 1 .. 2 .. 2 .. .. .. .. 1 3 4 Disease of Liver .. .. .. 1 2 3 .. 2 .. 3 .. .. .. 1 3 3 6 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Urinary, &c, .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Kidney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bright's Dosease .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 1 Ischuria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Bladder .. .. .. 1 1 1 .. 1 1 .. .. .. .. 1 2 1 3 Stricture of Urethra .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Disease of Kidneys, &c. .. .. .. 3 4 1 1 2 2 1 .. .. .. 4 7 2 9 IX. Womb, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paramenia .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Ovarian Dropsy .. .. .. .. 2 .. .. 1 .. .. .. .. .. 1 .. 2 2 Child-birth .. .. .. 2 .. .. .. .. .. 2 .. .. .. .. .. 2 2 Disease of Uteruns, &c. .. .. .. .. 3 .. .. .. 1 1 .. .. .. 1 .. 3 3 X. Joints ,&c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. .. .. 1 .. .. .. .. 1 .. ...... .. .. .. 1 1 Disease of Joints, &c .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 XI. Skin, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carbuncle .. .. 1 1 .. .. .. .. .. 1 .. .. .. 1 2 .. 2 Plegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Skin, &c 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 XII. Malformations. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Blue Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Malformations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XIII. Debility: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 12 .. 12 .. .. .. .. 4 .. 6 2 .. .. .. 9 3 12 XIY. Atrophy: 3 .. 4 .. 1 5 2 1 2 7 .. 2 .. .. 4 8 12 XV. Age: .. .. .. .. .. 5 1 2 .. 1 3 .. .. .. 3 3 6 XVI. Sudden: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVII. Violent Death: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intermperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk 5 .. 5 .. .. .. .. 2 .. .. 1 2 .. .. 2 3 5 Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Poison (Amylene) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 Hanging .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suffocation 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Drowning .. .. .. 4 1 1 .. 4 .. 2 .. .. .. .. 2 4 6 Fractures .. 1 3 1 4 .. 1 1 .. .. .. .. 1 7 7 2 9 Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Violence .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. All Violence .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVIII. Not Specified. .. .. 1 1 1 .. .. 1 .. 2 .. .. .. .. 2 1 3 TOTAL: 86 95 224 84 114 95 11 120 43 254 21 11 17 62 265 983 528 DEATHS registered during corresponding weeks of ten years (average), 416. Weekly average, 32. C. B. ALDIS, M.D. R. DRUITT. HAN 8 QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY OF Saint George, Hanober Square, AND OP THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOB THE QUARTER ENDING MIDSUMMER 1858. LONDON. london; printed by george phipps, ranelagh street, eaton square. TO THE Destry of St. George, Hanober Square. My Lords and Gentlemen, I. The deaths of the parish during the second quarter of 1858, were 479, including the deaths of 81 non-parishioners in St. George's Hospital, and of six inmates of the Little Chelsea Workhouse. The average mortality for the corresponding weeks of the 10 years previous amounted to 391, so that 88 deaths have occurred in this quarter in excess of that average; hut allowance must be made for an increase of population. The deaths during the corresponding period of 1857 were 374, showing an increase of 105 deaths in this quarter above that of last year. But allowing for the deaths of nonparishioners in St. George's Hospital, an excess of 85 deaths would remain. On comparing the quarterly table, dated June 26th, 1858, with that dated June 27th, 1857, we find a heavy increase of zymotic diseases in the former, especially in regard to measles, which has destroyed 16 against 1 of last year; 4 latina and diphtheria 17 against 4; whooping-cough 27 against 11; and small-pox 2. Lung diseases destroyed 122, of which bronchitis numbered 31, pneumonia 18, and consumption 67. Various diseases carried off 85 children under five years of age. Only one death occurred from diarrhoea. Premature birth destroyed 10 children, want of breast milk 1, and 4 under one year were suffocated. II. The new cases of existing disease were as follow:— The sickness in the Hanover and May Fair sub-districts, amongst the class who are attended by the Parochial Surgeons, and at the Mount Street Branch of the St. George's and St. James's Dispensary, produced 1030 applications, including 119 cases of catarrh and bronchitis, 24 of diarrhoea, and 50 of fever. Small-Pox. — In consequence of the appearance of this malady in Gilbert Street and Hart Street, referred to in the last Quarterly Summary, every charitable school in the Inwards has been visited, and a knowledge of the danger spread amongst the classes who are most likely to neglect vaccination. The number of children at these schools is about 2000; and at five out of the seven schools enquiry is made (and at the other two it ought by the rules to be made) as to whether children, newly admitted, have been vaccinated. In the Belgrave sub-district 6283 cases of disease were treated by the Parochial Surgeons, at St. George's Hospital, the Royal Pimlico Dispensary, and the St. Paul and St. Barnabas' Dispensary; and at the Workhouse, Little Chelsea. Of these cases 3551 were patients at St. George's Hospital, leaving a remainder of 2732. 5 It has already been stated that the mortality from zymotic diseases was heavy, which would naturally result from an increase of sickness produced by these complaints; and accordingly, we find that out of the 2732, 87 were cases of measles, 7 of chicken-pox, 6 of scarlatina, 47 of whooping-cough, 4 of croup, 164 of diarrhoea, 30 of continued fever, 34 of rheumatic fever, 11 of erysipelas, and 4 of diphtheria. There were also 303 cases of bronchitis, and 18 of pneumonia. Oases of small-pox have occurred in Newland Street, Shaftesbury Terrace, and Victoria Mews. One proved fatal, in May, at 26, Shaftesbury Terrace, in a child aged five months, who was not vaccinated, although a caution had been left at the house by the Medical Officer of Health in April for all the children living there to be vaccinated, in consequence of the complaint having then appeared in a female. The father of the child helped at the Royal Mews, where fortunately the disease did not appear ; but he consented to be revaccinated. IH. We now present an account of certain sanitary matters brought before the Committee authorized to carry out the " Nuisances Removal and Diseases Prevention Act." Cesspool in Bell Yard, Mount Street. — Complaints were made almost simultaneously of a leakage of water into the kitchens of Nos. 58 and of 60, Mount Street, premises which abut upon Bell Yard. The drainage of Bell Yard was therefore explored by the Surveyor, when it was found that a large cesspool existed there, 10 or 12 feet deep, and 3 or 4 in breadth; and that this cesspool received the drainage of the seven stables in Bell Yard, and part of the drainage of 57, Mount 6 Street. The outlet, a small square drain, was entirely choked up, so that all, or nearly all, of the water which entered this pit, must have soaked into the gravel. It is worth notice that a very popular pump is situated close to this cesspool, and that the efficacy of London gravel as a filter, in depriving sewage of its offensive properties, has seldom been more clearly shown. The cesspool has been abolished, and pipe drainage into the sewer provided, at the joint expense of the parties whose premises are drained thereby. No. 4, Ducking Pond Mews.—Here there were apartments over a dirty undrained stable, occupied by a man with his wife and two children; and there was no water closet, so that all the house slops were emptied into the mews—a low sunless place. At the next house a whole family was destroyed by cholera in 1849. The occupiers paid a heavy rent, and complained of the indecency of these arrangements; and many were the visits and letters of entreaty to the owners, who disregarded the notices served on them; at last, however, a summons was taken out at Marlborough Street, but before it came to the trial, they paid the costs and did the work required. No. 69, Brook Street, Hanover Square.—Here was an instance of a kind of nuisance not very uncommon, and always perilous. A sink in the nursery led into a rainwater-pipe, which had been made foul by emptying slops into the gutter, and, besides, ended in an untrapped drain; hence, in certain states of wind, a current of foul air was brought into the sleeping apartments of the children. A servant and one child 7 were seriously ill with choleraic diarrhoea, on the 17th April, and on the 19th three other children with the same malady. The advice of the Medical Officer of Health was asked, and he pointed out the above, and some other sanitary defects in the house, which amply accounted for the attack of illness. John's Court, Farm Street.—This is a place so viciously constituted, that the occurrence of sickness and death are quite in accordance with the laws of physiology. It is a space about 117 feet long, and 20 broad; out of the breadth the houses take 15 feet, leaving 5 feet for a passage from one end to the other. It is bounded on each side by a large livery stable, the emanations from which lessen the purity of the air ; the entrance is by a narrow passage, the air entering which must pass by a dust heap and urinal; and at the other end is a day school frequented by 160 children, the urinals and closets for whom are (or were) insufficient and scarcely decent. In addition to the want of free air, and to the sources of impurity without, each house is constructed with an unventilated water closet under the staircase on the ground floor, the fumes from which annoy the Residents. If we say that there is no sufficient aperture at the top of the houses for ventilation, or for escape from fire, and that if there is a trap-door there is no ladder, we speak of a thing quite common, but which, nevertheless, is sure some day to lead to loss of life. The court contains five houses, in which 58 persons lived at the census of 1851, and 84 were ascertained to live there in May 1858. Sickness has been prevalent on the ground floors of the houses. The proprietor of Nos. 2 and 3 had often been appealed to, 8 and had more than once rectified the drainage of those houses ; but, at the desire of the Committee, a statement respecting the court was drawn up by the Medical Officer of Health, and forwarded to the patrons of the school, and to the proprietor of the houses. It was recommended that the number of inhabitants in the court be reduced, and the water closet accommodation made more ample and less conspicuous; and in their hands the matter is left. Thomas Street and its neighbourhood.—This street is very densely peopled, for it contained 600 inhabitants at the census of 1851, and there is no reason to believe that the number has since decreased. As there were many cases of fever there, an examination was instituted, with the following results:— No. 2. Staircase and some of the rooms very dirty, roof leaky, house ill ventilated. Nos. 3,4,5,7, and 8, in a similar condition, with untrapped gullies, and uncovered ash-pits. No. 9, clean, but exposed to the effluvia from the dust-bin of No. 9, Robert Street, round the corner. These houses, which contain on an average at least 30 inhabitants in each, were evidently built with the view of economizing every square inch of space, and without an adequate staircase window or skylight for giving air to the body of the house. Moreover, each room is inhabited by a separate family, and the door, window, fireplace, and bed, are placed in the least favourable situations for ventilation. But as it is evident that in a population so crowded, any little defect in the mode of carrying off animal exhalations may lead to disease, the authority of the Committee was exercised to induce the 9 proprietors to ventilate the rooms by means of a square aperture filled with perforated zinc, which has been done. No. 9, Robert Street, a continuation of the houses in Thomas Street, contains 11 families, has a central staircase, and a skylight at the top which cannot be used for ventilation or fire escape. No. 32, Thomas Street, a respectably occupied house, but with vaults behind filled with stinking refuse, quite sufficient to create fever. No. 30. A very dirty and dilapidated house, which, about this time, came under the notice of the police, and was pulled down as a dangerous structure. No. 37. A very dirty house occupied by a marine store dealer. No. 38. An ill-ventilated and overcrowded house, with no skylight, a central staircase, and with every staircase window blocked up to erect little sleeping closets for the inmates. Here the proprietor has been induced to abolish one of these closets, so as to throw more air and light into the house. No. 42. The basement dirty. Tom's Court.—No. 2. Ill ventilated. No. 6. Very dirty. These are notes of some evils observed in the course of a very complete and laborious inspection of this neighbourhood, most of which have been rectified to a certain degree. Every day's observation furnishes proof, that large numbers of people living in close proximity, can only escape disease by taking greater pains to keep their persons, clothes, beds, and apart- a 10 ments clean, to admit air and light, and get rid of all refuse, than most of these poor people seem to think necessary. Street's Buildings, Nos. 1 and 2, are often, and Grosvenor Market, Nos. 21 & 22, are always, under notice, for some defect in cleanliness. No. 5,George Street, Grosvenor Square; an inhabited stable adjoining Trafalgar Yard, Mount Street; No. 29, Grosvenor Street; No. 90, Mount Street; Nos. 31a and 75, Grosvenor Mews; No. 3, Maddox Street; No. 8, Little Stanhope Street; No. 5, Curzon Street; No. 6, Down Street; and Black Horse Yard, New Bond Street, are places where various nuisances have been investigated and removed. Dung-pit Nuisances.—Dung-pits enclosed with brick walls, and sunk in the earth, are much to be discouraged, inasmuch as they are seldom completely emptied, the bottom becomes extremely offensive, and when disturbed the smell affects the whole neighbourhood; moreover, water is liable to accumulate in them and to soak into neighbouring walls. Such nuisances have been investigated at No. 12 a, Park Lane, and in Swan Passage. A representation was made to the Committee respecting the want of a gas lamp in Chapel Yard, Robert Street, which, if placed there, would prevent many nuisances injurious to the health of the inhabitants, for the place is made a regular laystall at night. Removal of Refuse from Tradesmen's Houses.—This year in May, as in the two preceding years, we were besieged by tradesmen complaining of the difficulty of getting trade refuse taken away; the consequence being, that the houses of fishmongers and greengrocers were filled for two of the hottest days with effluvia 11 of a sort which no one can imagine of without personal experience. To have measures for the prompt removal of such matters is of the very highest consequence to the public health. The Metropolis Local Management Act throws on the Local Authority the onus of providing the means of removing trade refuse, for which the tradesman must pay a reasonable sum; and in this case, as the contract of the Vestry with their scavengers was quite in accordance with the Act, the difficulty was soon surmounted. The Pumps have furnished occasion for some degree of watching. That in Hanover Square yielded turbid water on the 14th of June, and a pump in South Audley Street, which yielded good water two years ago, has yielded undiluted sewage this quarter. It is obvious that vast quantities of water pass from the sewers and cesspools into the earth, and that the gravel has a remarkable power of rendering it clear and bright; but an accidental failure of its purifying power might lead to great mischief. No. 22, Robert Street, Commercial Road Soidh.—No cover to the ash-pit. A hole made in the back yard containing water for ducks to swim in, which causes dampness in the kitchen and back yard of No. 1, Robert Street, the adjoining premises. The hole has been filled up. This street has produced much sickness, and therefore requires careful watching as to its sanitary condition, but it is expected that the houses will soon be taken down. Nos. 1, 2, 3, 4, 5, 6, 7, 8, and 9, Robert Street, south side ditto.—No ash-pits and no covers to the water butts. Ash-pits erected and the water-butts covered. 12 Nos. 1 and 2, Robert's Court, Robert Street, Commercial Road South.—No ash-pits and no covers to water-butts. Ashpits erected and water-butts covered. Neivson's Yard, ditto.—Overcharged cesspool, draining through the wall into the back yard of No. 5, Robert Street. The cesspool has been emptied and nuisance abated. No. 1, Flash Row, Ebury Square.—Bad smell from the drains, caused by several rat holes opening into the cellar. The drains have been cleansed and repaired to the sewer. Denbigh Mews, Denbigh Street.—Bad smell from the dungpits. A notice was served on each of the occupiers, seven in number, and the dung removed. No. 4, Commercial Road South.—Bad smell in the kitchen from the drains, and the waste pipe from the cistern over the closet untrapped. The family have complained of diarrhoea, which they attributed to the foul state of the water, occasioned by gases passing through the waste pipe from the drain. The drains in the kitchen were cleansed and repaired, and the waste pipe trapped. Nos. 1,2,3, and 4, Nell Gwynne Cottages.—Drainage from the closets obstructed and smell offensive. New drains were constructed and properly connected with the sewer. Mr. Smith's Building Yard, Hindon Street.—Complaint of bad smell from the furnace of the engine used for sawing wood. The premises were carefully examined by the Medical Officer of Health and Inspector, who could not detect any reason for the complaint. 13 No. 28, Queen Street.—Drainage choked up and smell offensive. Drain properly cleansed and repaired. Nos. 1, 2, 3, 4, and 5, Rogers'1 Court, Eaton Lane North.— Houses dirty and no water supply to the closets. Houses cleansed throughout, and water supplied to the closets. Nos. 6, 7, 8, 9, 10, 11, 12, and 13, Eaton Court, Eaton Lane North.—Dwellings dirty, and no water supply to the closets. Houses cleansed from top to bottom, and water laid on to the closets. No. 40, G-rosvenor Row. — Overcharged cesspool in the back yard, and smell offensive. The cesspool was emptied and filled up, and the premises drained with a 6-inch pipe drain into the sewer. School Rooms, Little Charlotte Street.—Common privy in the front area, drain open, and the basement dirty. The privy requires to be panned and trapped, and water supplied; the drains to be repaired; and basement cleansed. The schools were not used at the time the complaint was made, but the requisite alterations are now in progress. Nos. 14, and 16, St. Leonard Street.—Common privy, and smell offensive. Pans with traps have been supplied and water laid on. No. 10, Park Side, Knightsbridge.—Drainage obstructed and smell offensive. This was a very serious nuisance, and required prompt attention. It appeared that a 9-inch drain in good repair passed behind No. 10, and entered another about 2 feet wide, and 3 feet 6 inches in depth, at the back of No. 11, which extended to the Ranelagh sewer, near the French 14 bassador's, and was extremely dilapidated. The sink in the kitchen at No. 11 was overflowing, and the walls damp, producing such a smell as to prevent the servants from eating their meals below stairs. There was also a cesspool behind the Queen's Head public house. The drain had fallen in in some places, and was obstructed by an accumulation of crockery, broken bottles,'saucepans, pieces of wood, and stones, which had, no doubt, been thrown down the open privies at Nos. 15, 15a, 16, and the public house above mentioned. Some of the leases terminate in twelve years, when it is expected the houses will be taken down. The evils were remedied by the parish authorities at the expense of £1 8s. 9d. per house. No. 12, Park Side, Knightsbridge. — Common privy, gully untrapped, and no ash-pit. A new closet has been erected and connected with the sewer, gully trapped, and ash-pit provided. Nos. 15 and 15a, Park Side, Knightsbridge.—Common . privies and gullies untrapped. Work in progress. No. 16, Park Side, Knightsbridge.—Common privy, sink choked and smell offensive. Work in progress. No. 20, Park Side, Knightsbridge.—Queen's Head. Two common privies in the back yard, and a large cesspool, smell offensive. The cesspool has been done away with, one new water closet ha3 been erected, with a water supply, and the drainage connected with the sewer. No. 2, Park Side, Knightsbridge.—A large cesspool in the kitchen, and the water closet in a defective state. Work under consideration. No. 29, Upper JEbvry Street.—Drainage from the water 15 closet stopped, and smell offensive. The drain has been properly cleansed. No. 32, St. George's Place, Knightsbridge.—Leakage from the closet in back yard into the complainant's kitchen, smell offensive. A new 9-inch pipe drain has been connected with the sewer in front, the old drain has been filled up, and the nuisance abated satisfactorily. The " Youthful Queen " Beer Shop, Princess Row, Victoria Street.—Common privy, cesspool, no cover to ash-pit, gully untrapped. Work in progress. No. 3, Motcomb Street.—Bad smell and leakage of water into the bakehouse from No. 4. The steps and wall have been cemented, and nuisance abated. Upper Denbigh Mews, Denbigh Street, Pimlico. Disgusting state of the stables; the refuse is allowed to remain until it becomes offensive. Dung removed satisfactorily until June 4, 1858. The occupier not having kept his promise, a notice was served, June 10, 1858. This place is frequently visited. No. 5, Bridge Row, Pimlico.—Drainage of the house in a very defective state, and the nuisance arising from the closets is injurious to health; the floor of the shop was taken up, and several rat holes were found communicating with a drain, which has been cleansed and repaired. Eaton Lane South. — Dust and dung-pits very offensive. They were cleansed, and the question of a nuisance connected with them was referred to a Committee. No. 13, Eccleston Place.—Dung-pit very offensive, from the dung being in a decomposed state, and mixed with vegetable 16 matter. Dung removed, and the owner cautioned against allowing it to remain so long for the future. No. 12, Queen's Row.—Dung-pit full of dung, mixed with vegetable and animal matter. Dung removed and owner cautioned against mixing animal matter with it. No. 2, Lupus Street.—A quantity of decomposed cabbages in the front area, and in the dust-pit. Refuse removed and nuisance abated. Nos. 35 and 36, Eccleston Place.—Bad smells. Nuisance abated by the removal of the dust. Jones's Gottages, Eccleston Street East.—Defective drainage. A new pipe drain has been laid down, and connected with the drain from the closet of the cottages. Whilmarsh's Stable, adjoining Clough's Cottages. — Very dirty, offensive, and a pig kept there. Pig removed and stable cleansed. No. 24, Ranelagh Street.—Leakage of water into the back kitchen from No. 23. The drains have been repaired. No. 19, Queen's Row, Pimlico.—An offensive accumulation of vegetable matter, which has been removed. Nos. 1 and 4, Little Charlotte Street. — No water supply to the closets. A notice has been served. No. 6, Little Charlotte Street. — No water supply to the closet, gully untrapped, and no dust-pit. Work in progress. No. 13, Brewer Street, Pimlico.—This was a very dangerous nuisance, four rooms being occupied by three families, numbering 20 inmates, without water closet accommodation. The slops and offensive matter were emptied into the gutter on the roof 17 of a room occupied by a man, bis wife, and eight children. The moisture penetrated the roof and ceiling, which had fallen in some places with the other filth on the floor, thereby rendered damp and very offensive. Diarrhoea had occurred, and some of the children were sick on waking in the morning. Immediate steps were taken, and proceedings were threatened, unless the work was commenced by the next day. This was effectual; and the whole of the rooms have been lime-whited and cleansed, the roof of the house repaired, and a new water closet erected. No. 12, St. George's Place.—Three tubs containing hog's wash and a quantity of cabbage leaves in a foul state. The wash has been removed, and the occupier cautioned against offending in future. "Marquis of Grranby" Public House, Kemp's Row, Pimlico.— Smell very offensive, supposed to arise from an old drain under the footpath. The drain was examined, and several rat holes found, which were stopped, and the sides of the drain repaired. Two complaints having been made connected with smoke nuisances in Belgravia, the Medical Officer communicated with the proper authorities on the subject, with a view to their abatement, although it did not come within the sphere of his official duties. The Rev. G. C. White wished Dr. Aldis to attend at St. Barnabas' Church, in order to examine the crypt with him, as the clergy were desirous of appropriating a portion of it for the 18 construction of a mortuary house, which caused several visits and some correspondence. After full consideration, Dr. Aldis wrote to the effect, that although a place for the purpose of preventing the corpses of persons from being retained in the crowded dwellings of the poor, longer than is safe to the living, would be most desirable, nevertheless, several reasons were mentioned that might be considered fatal to the plan in this instance. He also consulted Dr. Druitt, who visited the crypt, and Mr. Grainger, the Government Inspector of burial grounds, who both concurred in this opinion. . The Hon. and Rev. R. Liddell subsequently expressed a wish that Mr. Grainger might be invited to inspect the spot, to see whether he could change his views. Dr. Aldis replied to the Rev. Mr. Liddell, that his request should be complied with; and at the same time stated, that in addition to the objections already urged, " in certain cases, as dropsy for instance, oozings might take place, only to be prevented by leaden coffins, which would not be provided for the poor ; and as three or four coffins might be placed there at the same time, the evil would be concentrated. Any escape from the coffins would cause a great nuisance, especially as the entrance to St. Barnabas' must be at least 100 feet from the crypt. He therefore strongly advised Mr. Liddell against the project." Mr. Grainger, having examined the crypt, was opposed to the principle of allowing dead bodies to be placed under churches, and saw no reason to alter his previous opinion. 19 It was thought necessary to call a special meeting of the Nuisances Removal Committee, in reference to Hatt's cow-yard, behind Ebury Street, in consequence of his having infringed the magistrate's order, which limited him to keeping 90 cows, and to ask the Committee to sanction an application for a penalty for a contravention of the order of abatement, in accordance with the 14th section of the Nuisances Removal Act. The owner has been repeatedly cautioned to keep within bounds by the Medical Officer and Inspector of Nuisances, Mr. Grant, and every leniency exercised towards him before taking further proceedings. A short history of the case was then related, but as it is recorded in the Annual Report, there will be no necessity for repeating it here. A return also of existing disease from the Pimlico Dispensary, for the week ending June 19th, showed that 29 cases of diarrhoea had occurred there, being an increase of 20 above that of the previous week. Hatt's cow-yard is situated in the district of this Dispensary, and on the Medical Officer applying at that establishment a few days before the meeting, it was ascertained that patients suffering from diarrhoea were constantly coming from the immediate vicinity of the cow-yard. An analysis of the water supplied by the Chelsea Company, and taken March 11, 1858, from the main in Chapel Street, Belgrave Square, produced Grs. Total Impurity 20.52 Organic ditto 1.96 20 April 17, 1858. Total Impurity 19.00 Organic ditto 1.8 May 25, 1858. Total Impurity 18.20 Organic ditto 1.68 We have the honour to be Your obedient Servants, C. J. B. Aldis, M.D. R. DRuitt. TABLE OF MORTALITY. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 26th of June, 1858. Average, 36.8 DISEASES. Ages at Death. Sub-Districts and Population. Sexes. Under 1. 1 and under 5. | Total under 20. 20 nnd under 40. 1 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave.—40,034. Mount-street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 31,930. | Females, 41,310. Total, 73,230. Parishioners. NonParishioners. I. zymotic. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. mumps .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox 1 1 2 .. .. .. .. 1 .. 1 .. .. .. .. 1 1 2 Measles 2 12 15 1 .. .. .. 1 1 14 .. .. .. .. 7 9 16 Scarlatina & Diphtheria 1 7 15 .. 2 .. .. 2 4 11 .. .. .. .. 8 9 17 Hooping cough 14 11 27 .. .. .. .. 3 1 22 .. .. 1 .. 15 12 27 croup .. 6 6 .. .. .. .. 1 1 2 .. .. .. 2 3 3 6 Thrush .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Diarrhoea .. 1 1 1 1 .. .. .. .. 1 .. 1 .. 1 2 1 3 Dysentery .. .. .. .. . .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. . .. .. .. .. .. .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ague .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Infantile Fever .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Typhus Fever .. 1 4 2 2 1 .. 1 1 6 .. .. 1 .. 1 8 9 Child-bed Fever .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas and Pyaemia . 1 .. 1 .. 1 1 .. .. .. 1 .. .. .. 2 1 2 3 Syphilis 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. Canker .. . .. ... .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. II.Cancer, Dropsy. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hæmorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dropsy .. 1 1 1 10 6 1 1 3 9 .. .. 1 5 11 8 19 Abscess .. 1 1 2 1 .. .. .. .. 1 .. .. .. 3 2 2 4 Ulcer .. .. 1 .. 1 .. .. .. .. 2 .. .. .. .. 1 1 2 Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mortification .. .. 1 .. 2 .. 1 .. .. 2 .. 1 1 2 2 4 Cancer .. .. .. 1 9 1 .. 1 1 8 .. .. .. 1 2 9 11 Gout .. .. .. .. 1 .. 1 .. .. 2 .. .. .. .. 2 .. 2 III.Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scrofula .. .. 2 .. .. .. .. .. .. .. .. .. .. 2 1 1 2 Mesenteric Disease 1 2 4 1 .. .. .. 1 .. 3 1 .. .. .. 4 1 5 Consumption 1 6 19 31 16 1 .. 12 3 36 3 .. .. 13 42 25 67 Water in the Head 1 5 9 .. .. .. .. 2 1 5 .. .. .. 1 5 4 9 IV.Nervous system .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Brain 3 1 6 2 2 1 .. 3 3 3 1 .. .. 1 8 3 11 Apoplexy .. .. .. .. 4 2 1 4 .. 3 .. .. .. .. 3 .. 7 Paralysis .. .. .. 1 3 5 1 4 1 4 1 .. .. .. .. .. .. Delirium Tremens .. .. .. 2 1 .. .. .. .. .. .. .. 2 1 3 .. 3 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epilepsy .. .. .. .. 3 1 .. 1 1 1 .. .. .. 1 2 .. 4 Tetanus .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Insanity & Mental Shock. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 Convulsions 17 9 27 .. 1 .. .. 2 3 23 .. .. .. .. 11 17 28 Disease of Brain, &c .. 1 2 3 4 1 .. 3 1 3 .. .. .. 3 3 7 10 V. Heart, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pericarditis .. .. 1 .. 2 .. .. 1 .. .. 1 .. .. 1 .. 1 3 Aneurism .. .. .. 1 1 .. .. .. 1 .. .. .. .. 1 2 .. 2 Disease of Heart, &c .. .. 2 4 2 7 .. .. 2 6 .. 1 1 5 7 8 15 VI. Lungs, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Laryngitis .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Bronchitis 6 9 16 1 5 8 1 13 4 12 .. .. .. 2 .. 17 .. Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Pneumonia 7 4 12 2 2 1 .. 3 5 7 1 1 .. 1 .. 7 18 Asthma .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Disease of Lungs, &c .. 1 1 .. 2 .. .. .. 1 1 .. .. .. 1 2 1 3 BIRTHS registered during 13 weeks.—Hanover Square, M. 62, F. 63; May Fair, M. 31, F. 26; Belgrave, M. 201, F. 175. Total . . 558. Average . . 42.9 DISEASES. Ages at Death. Sub-districts & population Sexes. Under 1. | 1 and under 5. Total under 20. | 20 and under 40. 40 and under 60. | 60 and under 80. | 80 and above. Hanover Square.—20,216. | May Fair.—12,980. Belgrave.—40,034. Mount-street Work.—268.1 Little Chelsea Work.—350. St. George's Hospital. —216. | Males, 31,930. j Females, 41,310. | Total, 73,230. Parishioners. NonParishioners. | VII. Of Stomach, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Teething 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Stomach .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. inflammation of Bowels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Peritoneum .. .. 2 2 2 .. .. 2 1 2 .. .. .. 1 2 4 6 Dropsy of Belly .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ulcer of Bowels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rupture .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. 1 Ileus,Hæmatemesis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intussusception 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Stricture of Bowels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Stomach .. .. .. .. 1 1 .. .. .. 1 .. .. .. 1 2 .. 2 Disease of Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Jaundice 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Disease of Liver .. .. 1 .. 2 .. .. 1 .. .. .. .. .. 2 2 1 3 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Urinary, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. inflammation of Kidney .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. 1 Bright's Disease .. .. 1 2 3 .. .. 1 .. 1 .. .. 2 2 3 3 6 Ischuria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Bladder .. .. .. .. 1 2 .. .. .. .. .. 1 2 .. 2 1 3 Stricture of Urethra .. .. .. .. .. 2 .. .. .. .. .. .. .. 2 2 .. 2 Disease of Kidneys, &c .. .. .. .. 4 1 .. .. .. 1 .. .. .. 6 4 4 8 IX. Womb, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. 1 .. 1 .. .. .. 1 .. .. .. 1 .. 2 2 Child-birth .. .. .. .. .. .. .. .. 1 2 .. .. .. .. .. 3 3 Disease of Uterus, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. X.Joints, &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 Disease of Joints &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XI. Skin, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Skin, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XII. Malformations. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Blue Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Spina Bifida 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Other Malformations 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 XIII. DEbility : 2 .. 2 .. 1 2 .. 2 1 2 .. .. .. .. 2 3 5 Premature Birth 10 .. 10 .. .. .. .. 1 .. 9 .. .. .. .. 2 8 10 XIV. Atrophy : 2 1 3 .. .. 3 .. 1 1 2 .. .. .. .. 2 4 6 XV. Age : .. .. .. .. .. 10 7 4 2 6 5 .. .. .. 9 8 17 XVI. Sudden: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVII. Violent Death: .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Intemperance .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. 1 Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. 2 5 2 2 .. 1 .. .. .. .. .. 1 9 1 9 10 Hanging (Suicide) .. .. .. .. 2 .. .. 1 .. 1 .. .. .. .. 1 1 2 Suffocation .. .. 4 .. 1 .. .. 3 .. 2 .. .. .. .. 1 4 5 Drowning .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Fractures .. .. .. 2 3 4 .. .. .. .. .. .. 2 .. 7 2 9 Wounds .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. 1 Other Violence (Concussion) .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 All Violence .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVIII. Not Specified. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 TOTAL: 82 85 218 74 102 69 16 81 45 233 16 6 17 81 241 238 479 DEATHS registered during corresponding weeks of ten years (average) 30.0. C. J. B. ALDIS, M.D. R. DRUITT. No. IV.] HAN 8 QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY OF Saint George, Hanover Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OP HEALTH, FOR THE QUARTER ENDING MICHAELMAS 1858. LONDON. TO THE Vestry of St. George, Hanover Square. My Lords and Gentlemen, I. During the first quarter of the present year 528 deaths were registered in the parish; during the second quarter 479; and now, during the third quarter, comprising 13 weeks, ending 25th September, 1858, 412 deaths have been registered in the parish. This number gives a weekly average of 31.6, which is very slightly in excess of the average of the last 10 years. The 412 deaths, include those of 49 non-parishioners in St. George's Hospital, and of 7 inmates of Little Chelsea Workhouse; so that the net mortality of the parish was 356 ; against which may be set the 528 births that occurred during the same 13 weeks. If we analyze the causes of death, we find, by comparison with the corresponding quarter of 1857, that we have lost fewer children this year by diarrhœa; 23 this year, against 50 last year; and that the entire number of deaths at all ages from diarrhoea, dysentery, and cholera, is less this quarter than it was last year, viz., 35 against 64. Of the 35 deaths from diarrhoea, 24 occurred in Belgravia. One death from small-pox occurred in Ebury Street; that of a child of three months, unvaccinated, who was brought 4 from Gosport on the 18th June, sickened on the 24th, and died on the 4th of July. Scarlatina with diphtherite, quinsey, and putrid or malignant sore throat, (diseases which are closely allied, but not identical,) destroyed 24 lives this quarter, against 17 last year. Diphtherite is scattered over the parish, as it is over the rest of the metropolis; the attacks are wide apart, but often fatal where they fall. Deaths from this disease occurred at 16, Brick Street; 19, Hay's Mews; 1, King Street, Park Street; 17, Shaftesbury Terrace; 19, Caroline Street; 14, Eaton Lane North; 12, Wilton Mews; and at 7 and 38, Gillingham Street. Fevers of the kind called remittent and continued, or typhoid, destroyed 23 lives. Altogether, 118 of our fellow parishioners lost their lives this quarter from zymotic diseases; many of which depend on specific poisons, and some of which may be guarded against by cleanliness. But when we speak of cleanliness, we could wish that some definite and practical details on the subject were taught to every child in the kingdom, instead of vague admonitions to cleanliness in general. Many persons, especially amongst the poor, scarcely know what it means. But we would have every child taught that to be clean— 1st. The skin and hair must be clean. 2nd. The wearing apparel must be clean. 3rd. Fixed articles of clothing, such as beds, blankets, carpets, curtains, and the like, ought to be systematically purified. 4th. The walls and ceilings of inhabited rooms ought to be purified by lime-whiting, or by a coating of distemper of some cheerful colour, which should be renewed once a year at the least. The cheap papers which are much used, 5 soon become damp in rooms where a whole family lives, and where cooking and washing go on; and they separate from the walls, and become a harbour for vermin. 5th. The drainage ought to be perfect; the closets cleaned out and deodorized once a week; and no accumulation of animal or vegetable refuse be permitted in the ash-pits, nor in gutters and roadways. If cleanliness of person, clothes, and houses, were systematically taught and practised, we should then be qualified to judge of the mode of propagation and fatality of infectious diseases; but it will be far easier to effect the main drainage of London, than to change the habits and ideas of the owners and occupiers of the homes of the poor. A second set of diseases, more or less preventable, are those which depend on a degeneration of the human constitution, and which carry off those who are feebly organized from the first, or become so from want of food, air, and light. Such are scrofula, consumption, teething, and water of the head, and convulsions of children; from which causes combined, we lost 55 children, and 50 adults during the quarter. A .third set, consists of deaths by violence or accident, arising usually from want of care, or want of knowledge, or from breach of the moral law. Amongst these is the common, but, when duly considered, most painful case of infants condemned to death by slow starvation, either through the poverty and feebleness of the mothers, or through some moral complication. One infant died of " inanition," in Little Chelsea Workhouse, and another of " want of breast milk." Four others died in the parish of the latter cause; besides that in six of the cases of diarrhoea, the significant addition " dry-nursed," or " daughter of a maid of all work," or " son of a housemaid," shews too plainly what the real state of the case is. 6 Amongst the accidental deaths, those by burning and scalding show how essential it is, that every nursemaid in the kingdom should be taught the danger of losing sight of children for an instant, if fire or boiling water are at hand. One child, in Thomas Street, was killed by drinking hot tea out of a teapot: a child, in Belgravia, was killed by pulling a jug of hot water over himself: a child, two years old, fell backwards into a bason of scalding water: another child was burned in its cradle; another died, because, as the verdict states, " the clothes ignited, but there is no evidence how." Two persons were drowned in the Thames, and one in the Serpentine, by accident ; and one by suicide. One infant was found in the Serpentine, another in the Grosvenor canal; results of the " social evil." But these cases concern the other districts which surround Hyde Park, as much as they do St. George, Hanover Square. II. From the mortality we pass to the sickness, and find that 951 persons in the Hanover and May Fair sub-districts were patients of the Parochial Medical Officers, or of the Branch Dispensary in Mount Street. Amongst these were 133 cases of diarrhoea; 3 of small-pox, at 6, Shepherd's Court, at 12, Robert Street, and in Steel's Court; 35 of continued fever; and only 1 of scarlet fever. The deaths from this malady occurred amongst persons who do not habitually resort to gratuitous medical advice. As some illustration of an idea, published by one of us that lesser epidemics, usually accompany greater ones of an analogous kind, just as diarrhoea attends cholera, it may be mentioned, that an unusual number of cases of sore throats were treated during this quarter; arising probably from some modification of the scarlatina poison. It may be of interest to mention the parts of the parish, 7 whose inhabitants are provided with medical advice at the expense of their richer neighbours. Accordingly, we here give a list of some of the poorer streets, with the population of those streets at the Census of 1851, or (in the case of those marked with an asterisk) with the population ascertained by enumeration since. The other figures give the number of cases of fever and diarrhoea, and the total number of cases of illness attended during the quarter, by the Parochial and Dispensary Medical Officers; and the total deaths of children and adults during the same period. Population. Fever. Diarrhoea. Total of Parish patients. Deaths children Deaths adults *From the Model Lodgings 130 1 l 12 0 0 *Bloomfield Buildings 130 1 3 23 2 0 Brick Street 296 0 0 9 2 0 *Brown Street 200 2 6 37 1 1 Carrington Street 280 0 0 17 1 0 George St., Grosvenor Sq. 540 3 1 42 1 2 Grosvenor Market 211 2 2 19 3 0 Grosvenor Mews 944 8 1 57 1 2 *Hertford Place 200 1 1 22 0 0 *John's Court, Farm Street 80 2 0 19 1 1 May's Buildings 122 0 1 18 3 0 Mount Row and Place 133 2 1 11 0 1* North Bruton Mews 154 2 1 15 0 0 Street's Buildings 79 1 2 19 1 1 Queen Street 316 4 6 27 1 0 Robert St., Grosvenor Sq. 543 1 1 28 6 2 Thomas Street 600 2 3 42 1 0 * Adult died in workhouse. No. 17, Little Grosvenor Street, yielded 8 patients; No. 3, John's Court, (which court, we regret to say, remains as it was,) yielded 9 ; 7 patients came from No. 10, Grosvenor Mews; 6 out of the 23 patients from Bloomfield Place 8 came from No. 26; 8 from 24, George Street; 9 from 18, North Bruton Mews; and 15 from the contiguous building, No. 30, Grosvenor Mews, a building which holds nearly 100 inhabitants, and furnishes a model of what lodgings ought not to be. The mortality of Robert Street, Grosvenor Square, where six children and two adults died, will not fail to be noticed. These houses, like some in Thomas Street, are clean and respectably tenanted, but are built without due regard to the amount of air required for a house when every room is occupied by a family. If not offensive they are stuffy; the staircase, whence the main supply of air comes at night, is small and not provided with sufficient windows. During the night the air comes in from the basement, where it has been filtered over the dust-bin, and possibly over an untrapped gully. But landlords cannot be got to see, that if many human beings are crowded into small space, the apparatus for ventilation and drainage, must be looked after with the utmost nicety. In the Belgrave sub-district 5664 cases were treated by the Parochial Surgeons, at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul and St. Barnabas Dispensary, and at the Workhouse, Little Chelsea. Of these cases 3157 were patients at St. George's Hospital, leaving a remainder of 2507. We find that out of the 2507, 5 were cases of chicken pox, 65 of measles, 34 of scarlatina, 43 of whooping cough, 484 of Diarrhoea, 7 of dysentery, 4 of cholera, 58 of continued fever, 44 of rheumatic fever, 9 of erysipelas, and 5 of diphtheria. There were also 187 cases of bronchitis, and 11 of pneumonia. A case of choleraic diarrhoea occurred at No. 6, Skinner Street on June 6th, when a complaint having been made of 9 an offensive smell occasioned by the pigs in Union Place, Chelsea; the Medical Officer of Health for that parish was made acquainted with the circumstance. In our Annual Report it is stated, " On the supposition that Belgravia now contains 47,435 inhabitants, the number of deaths in the district (815), added to those of the inhabitants who died in St. George's Hospital (42), and to the deaths in Little Chelsea Workhouse (41), which are added, by way of compensation, together, make 898, which is at the rate of 19.6 per thousand." We therefore inferred, that the death-rate in Belgravia was higher than it is in the older parts of the parish. III. In the next place we will give some details respecting the poor and their habitations, which will show, at a glance, what their most pressing want is, and in what way the charity of the rich can best be directed for their relief. On the present occasion, allusion is made solely to the Hanover and May Fair, or In Wards, for they are smaller and more compact than Belgravia, lying as it were within a ring fence; and the character of their poorer population is different from that of Belgravia. Out of the 33,000 inhabitants of the older part of St. George, Hanover Square, about 20,000 live in first and second class streets, and 13,000 in third class streets and stables. It is fair to assume, that the number of the poor (that is, of those who require medical attendance when sick, and other aid at the hands of the rich) is 13,000, exclusive of the inmates of the workhouse. As we stated in our Annual Report, the mortality of the dwellers in the better, and in the worse parts of the parish, is very different. During the two years, ending Lady-day, 1858, there died at home in the houses of the 20,000 better class, 425 persons, being at the rate of nearly 11 per 10 1000 per annum of the population, as estimated in 1851. During the same two years, there died in the homes of the 13,000 poor, 544 persons, being at the rate of nearly 21 per 1000 per annum of the persons who occupied these houses in 1851. In this statement all deaths in the workhouse, hospital, streets, and Serpentine are left out, although they belong chiefly to the poor. But without them, the difference of the mortality in the two classes of residences is palpable enough. In the next place, taking 29 places called Mews, with a population of 2,928 persons in 1851, the mortality in those Mews was, during those two years, at the rate of 16 per 1000 per annum, whereas the mortality of the remaining 10,072 of the poorer classes, who live in the lodging-houses in poor streets, was at the rate of 22.3 per 1000 per annum. Thus the stables, some of which are even luxurious, although others are still ill-ventilated and rank enough, are, as a whole, wholesomer than the lodging-houses. According to a Report presented by Dr. Druitt in April, 1857, there were living in Brown Street 93 families, 47 of which, at the least, were provided with medical attendance and medicine by charity. Of the 93 families, 3 had three or more rooms ; 26 had two rooms; 64 had one room each. In 61 of the rooms there lived 162 persons. The average size of these rooms from actual measurement, was 10 feet square, and 8 feet high, giving a cubic capacity of 800 feet; and the average rent 3s. 5d. weekly. Of course there are great varieties in the details. A kitchen measuring 1,145 feet, lets for 2s. 9d.; a second floor front of the same dimensions for 4s.; a first floor front of 1,440 feet, for 4s. 9d.; a first floor front of 864 feet, for 4s. 6d.; a front parlour only 864 feet, inhabited by a shoemaker, also 4s. 6d. The number of inmates varies from 1 to 8. 11 Taking 75 families, living in the other poorer districts, (Hertford Place, May's Buildings, Carrington Street,, Thomas Street, Grosvenor Market, &c.,) it was found that 61 live in single rooms ; that these rooms, if measured, give an average cubic capacity of 982 feet; that the average number of inmates is 3.7, and the average rent 3s. 4d. In the Model Lodgings in Grosvenor Mews, one set of rooms, 1,568 cubic feet,brings a rental of 3s. 6d. per week; another 1,480 feet, let for 4s.; and a third 2,160 cubic feet (that is a space 8 feet high, 27 long, and 10 broad), is let for 5s. All the lodgings in the model house, and in Bloomfield Buildings, which are built on the same plan, are subdivided into two apartments. Now, as we said before, if fevers and diseases of that class are to be kept under, it can only be by such cleanliness as shall destroy the germs, and freely lay open all lurking places to the light and air. Of the five points of cleanliness which we enumerated above, three, viz.: cleanliness of person, of wearing apparel, and of bedding, must be practised by the tenants; but ought to be encouraged and enforced by the landlords. The remaining two, viz.: cleanliness of walls and ceilings, and of drains and refuse, are the duty of the landlords alone. Yet our experience has shown, that of owners of house property there are three classes: the conscientious and intelligent, who are many; the feeble and poor, (such as old women who have invested their savings in the purchase of the lease of a lodging-house, and who are defrauded by their dirty and disorderly tenants, and who, as we have known, when willing to repair their houses, have been cruelly cheated by people employed); lastly, there are the utterly reckless, whose only care it is to get what they can, and who never trouble themselves about decency, health, and morality. 12 The first class, too often, cannot be got to see the use of cleanliness: the second class cannot enforce it: the third will not. But all should be made responsible for the cleansing of all dwelling-rooms once a year, and for the emptying of dust-bins, and purifying of water-closets once a week with a very little chloride of lime. If these two specific practical points were attended to, there would be fewer cases of diarrhoea, fever, and debility, amongst the inhabitants. Under these circumstances, it is a subject of congratulation that the " Parochial Association for Improving the Dwellings of the Poor,'' propose to carry out their original plan of taking the lease of any suitable premises, improving them, and sub-letting them in apartments for the poor. Their model lodgings in Grosvenor Mews are the healthiest dwellings in the parish. The occupants are encouraged in personal and domestic cleanliness, and good conduct; and the managers take good care cf our fourth and fifth items of cleanliness. The rooms are cleansed and coloured periodically, and those great chronic sources of disease, the effluvia of foul water-closets and dust-bins cannot enter the apartments. We cannot, then, too strongly express our. opinion of the public benefit to health and morals that will result from the extended operations of this Association. Must not the feelings of self-respect and decency be promoted by clean and airy apartments, more than by walls covered with a dirty and verminous paper, and a ceiling black with smoke and exhalations ? Will the poor be likely to go to church when their landlord, a low tradesman from Peckham, appoints Sunday morning as his weekly time for coming to collect his rents ? Will they scrub their floors if they are so decayed and spongy that they will not become dry ? Must they not go to market on Sundays, if they have no place to put a bit of meat into on Saturday night ? Will not the husband be 13 less likely to frequent the public house, if the children sleep in a separate apartment, so that he can have a quiet chat with a friend by his own fireside ? These and a thousand similar ideas will suggest themselves, of the benefits likely to result, if a resident body of gentlemen, whose interest it is to keep down the poor rates, were to take the place of some of the ignorant, or needy, or utterly reckless lessees of houses. Of all methods of helping the poor, too, none is so likely to put them into the way of helping themselves, as the providing them with clean and wholesome houses. Instead of coals and blankets, give them warmer and dryer habitations. A guinea is better spent in averting consumption, by letting in the sun, and keeping out the damp from a poor man's house, than in a subscription to the Consumption Hospital, when the mischief ia done. Instead, then, of giving alms in the shape of money, which will go into the pockets of their landlords, give them, what too often they cannot get for money,* a wholesome home. Charge a fair price, and insist on being paid. Fever hospitals, and hospitals for children, are very well as stop-gaps; but we do insist, that the most economical way of spending money is, to go at once to the root of the evil, and provide homes that shall be free from putrid effluvia; and prohibit the attempt to rear children in kitchens and cellars, where they become early victims to scrofula, if they escape fever. IV. The following are some of the details of cases * During this quarter, a girl died of purpura (a kind of scurvy arising from impoverished blood), at 3, George Yard, Brown Street; and the medical attendant added to his certificate, a memorandum on the unwholesomeness of the room in which the family resides. The only thing to be said is, that so many others are as bad or worse, that it is impossible to condemn one without condemning all. 14 which have been investigated, and brought before the Local Authority during the quarter :— Davies Street. The inhabitants of 39, 40, and 41, were greatly annoyed by the effluvia from a sunken dung-pit in a stable-yard behind, which the owners, on being applied to, promptly and liberally caused to be abolished, and entirely paved the yard afresh. Robert Street, No. 5, a house, which, like others in the vicinity, was provided, when built, with an unsubstantial brick drain for rain water, which was afterwards made to act as water-closet drain, and has long since been decayed and no better than a cesspool. In such cases, the Inspector collects evidence from time to time; and when the owner is clearly convinced that legal proceedings could be maintained if begun, he tardily consents, as in the present case, to lay down pipes, and make the drainage thoroughly good. New Bond, Street, No. 41, is a house in which a like nuisance existed, which has been remedied in like manner. Old Chesterfield Arms Public House, Shepherd's Market. An old and unsuspected public sewer running under this house fell in from natural decay. It was ordered by the Committee of Works to be filled in and abolished ; and the house to be drained into the sewer in Shepherd Street. Shepherd's Market, Nos. 14 and 15. The premises of two marine store-dealers have been compelled to be emptied of filth, and lime-whited. Hart Street, No. 19. A house damp and dilapidated, has been referred to the Police Surveyor. Brook's Mews, has been thoroughly investigated from house to house. At No. 13, an offensive dung-pit has been cleansed. No. 14. The sleeping apartments ill ventilated. An application was made as usual to the owner, on the ground that 15 the occupants of such places, if ill, are discharged, and usually become recipients of parochial or hospital medical relief. No. 15. Wonderfully dirty, dilapidated, and ill-drained. Cesspools have been abolished, and pipe drainage introduced, to the great comfort of the poor servants who occupied the sleeping apartments. No. 25. A large undrained livery stable. A notice has been served. No. 47. The same. No. 49. The sleeping apartments have been better ventilated, at our suggestion. Farm Street, No. 17. An offensive dung-pit cleansed. Dover Yard. The same. Providence Court. The two cow-sheds lime-whited. Shepherd's Court, No. 1, was offensive and dirty. No. 7. Offensive from keeping fowls and rabbits. Floors dangerous from dilapidation. No. 9. Back premises dirty. Smoke nuisance. No. 19, and the adjoining houses in Old Bond Street, much annoyed by fumes from a chimney opposite, belonging to 12, Albemarle Street. As the chimneys were dilapidated and dangerous, the case was referred to the District Surveyor. Albemarle and Stafford Streets. Two huge overflowing cesspools were discovered in the vaults of No. 5, Stafford Street, saturating all the earth around, and overflowing into the vaults of a wine merchant adjoining. The wine merchant's men were made sick on entering the cellars in the morning, and their eyes smarted with the ammonia given off. The cesspools have been filled up, and new sewerage provided in Stafford Street. Dover Street, Nos. 17 and 18. Here was a leakage through the kitchen walls of most offensive matter, from a 16 cesspool in the yard of No. 37, Albemarle Street, close behind. This cesspool, 13 feet deep, 6 long, and 4 broad, has been abolished. It was distant a very few feet from a favourite pump well. An immense number of cesspools probably remain in the better parts of the parish ; in the poorer, we hope they are almost eradicated. The fatal mistake was made when waterclosets were first introduced, of not providing at once a system of pipe drainage, which should convey the stream of manure down to land under cultivation. Instead of which, the old cesspools were made receptacles for immense quantities of water, whence it flows and contaminates the earth and springs; and the old rain-water drains were made to carry off the surplus. Hence the pollution of house-drains, of street-sewers, and of the Thames. In addition to three of these receptacles abolished in Stafford Street, and one at 37, Albemarle Street, one dry and disused, but not filled up, remains at No. 38. Seven were abolished at the London Hotel, Nos. 43 and 44, in 1849; five were abolished at 45, Albemarle Street, in 1853; and one that continued undiscovered, in 1858; eleven were abolished at Nos. 18, 35, and 40, during the last ten years; and one at 32, Dover Street. Lee's Mews. A rain-water pipe from the Globe Public House, which was both an encroachment and a cause of serious nuisance, has been abolished. Hay's Mews, No. 21, where occurred a death from diphtherite, was cleansed in obedience to a Notice. King Street, No. 1. A death from the same malady occurred here; and a cleansing and new drainage were ordered and executed. White-Horse Yard Stables. Cesspools have been abolished, and pipe drainage substituted. 17 Much of the Inspector's time was consumed in investigating nuisances at 3, John's Court, 16, Conduit Street, and 14, Davies' Mews, consisting of obstructed drainage ; and an alleged nuisance from gas at 31, Charles Street, and from dung-heaps in Berkeley Street. No. 3, Lancashire Court. A house crowded and badly looked after; offensive in its drainage. Here two grown women and four children were sleeping in a room (7 ft. 6 in. high, 10 ft. 6 in. long, by 8 ft. broad, 630 cubic feet); and the children, one of whom was ill with mesenteric disease, passed their days in a most damp and frowsy kitchen. The owner was appealed to, and reminded of the Common Lodging House Act, and tardily put a stop to the occupation of the kitchen. No. 21, Grosvenor Market. The owner of this scandalous Irish rookery was summoned to Marlborough Street, on account of a nuisance from defective drainage arrangements, which he allowed to go on from week to week, spite of entreaty and notice. An attorney, who appeared, made a statement regarding the ownership (not upon oath), which caused the magistrate to direct a summons to be taken out against another of the lessees; but before this was done, the owner thought fit to abate the nuisance. No. 3, Little Grosvenor Street. Here a kitchen, unfit and illegal, was occupied by an aged female; but the occupation has ceased. Stable drainage. The whole block between Down Street and Park Lane is now completely drained, by the completion of extensive works on the premises of Mr. Mason and Mr. Tollit. Lambeth Mews. A stable, occupied by Mr. Simms, has been newly drained, and cesspools abolished. No. 1, Ducking Pond Mews. The same. £ 18 Chapel Street, Park Street. A leakage of water from a street gulley. Park Lane, 12a. The same from a stable adjoining; both remedied. " Red Lion " Public House, Union Street, Berkeley Square. An offensive cesspool abolished, and pipe drainage inserted. Shepherd's Market, No. 30. The same. No. 2, Union Street, Bond Street. Here a complaint was made of water leaking through the roof; but the whole house was so unsafe, that it was referred to the police. No. 23, South Molton Street. A dilapidated, unhealthy lodging house, with obstructed drains, which have been remedied. No. 40, Old Bond Street. A house, through which passed the drainage of some livery stables behind. The work required has been done by the parties interested. No. 18, Brown Street. A house which had been completely drained, but continued offensive, till it was discovered that it was the receptacle of drainage from a stable behind. This has been cut off, and turned into the sewer in George Yard. Chemical Laboratory, 22, Conduit Street. Complaint was made of effluvia, arising from the manufacture of certain preparations of phosphorus and valerian. The fact was admitted by the proprietors, who had evidently used all precaution, and promised to have such operations for the future carried on out of town. No. 8, Mill Street. A cesspool on these premises leaked through a wall into adjoining premises in Conduit Street. This has been abolished. Mill Street is very badly drained. No. 8, Hart Street. This is one of those unhealthy abodes built against Thrupp's coach factory, with no thorough 19 draught, and very imperfect drainage. Slops thrown into the roof-gutters at the back, out of the attic windows, by the dirty inhabitants, passed through a kind of wooden gutter at No. 8, and occasionally overflowed. The house was a picture of damp, dirt, and decay, from this fetid inundation, which the owner neglected to remedy, till compelled by the threat of legal proceedings on the part of the local authority. Urinal at the " William IV." Public House, Caledonia Street, Pimlico. It is situated under the parlour window of No. 2 in the same street, which caused the occupiers to complain of the smell. The landlord kept the place very clean, and was willing to have it removed should the local authority deem it expedient. Referred to a committee. The Parish Shoot, Commercial Road South. Stagnant and foul water. Several nuisances of a similar kind have been at various times removed from the same locality, but a system of sifting road grit having been kept up, much fetid water still remained. The nuisance was observed by several persons, more especially since the opening of the new bridge. Mere passers-by would probably derive no injury from this offensive accumulation of stinking mud and water, but children who frequently played about the spot were likely to be infected by disease. It may be mentioned, that infantile remittent fever, formerly very common at this extremity of the Commercial Road, has considerably diminished since the improvements made in the shoot. The stagnant water has been drained into the sewer. No. 9, Ranelagh Mews, Ranelagh Street. Drainage from the stable, and water closet obstructed, with an offensive smell. A new 12-inch pipe sewer has been laid down from Ranelagh Street along Ranelagh Mews. Mr. Charles Hatt's Cowyard behind Ebury Street. The Medical Officer and Inspector visited the premises on June 20 22nd last, and counted 108 cows, being 18 more than allowed by the magistrate's order dated March 7th, 1857. Mr. Hatt then received a letter acquainting him that, unless the cows were reduced to the number allowed by the magistrate, a special meeting of the Nuisances Removal Committee would be called. The meeting took place, and Dr. Aldis was instructed to apply for a summons at the Westminster police court. The case was subsequently heard by Mr. Arnold and Mr. Paynter, who fined him for each cow beyond the magistrate's order, with costs. Mr. Paynter, in a communication to Dr. Aldis, said that he had visited the premises, which were much improved, and that Mr. Hatt might be allowed to keep six more cows, in winter only; but this arrangement would be left entirely to the local authority and the Medical Officer of Health. He had already fined him and intended to be very severe in any further transgression. No. 27, Stockbridge Terrace. An offensive gully opposite to this house was cleaned out. Mr. Bull's Cowyard, Commercial Road South. Bad smell from an accumulation of dung, which was removed and the nuisance abated. No. 7, Ebury Place, Ebury Square. Drains from the closet obstructed, paving out of repair in the back yard, and smell offensive. The drains have been cleansed, paving repaired, and nuisance abated. Stable in the Yard behind Moreton Terrace. Cows kept, and smell most offensive. The cows were removed, stable cleansed, and the whole of the dung taken away. Stable behind 5, Moreton Terrace. A large quantity of horse dung, which was removed. Waiting's Yard, Little Charlotte Street, Pimlico. The attention of the Medical Officer was directed to this place 21 by a gentleman in attendance upon a patient who suffered from fever, and resided in Cutmore's Buildings. A very great nuisance was alleged to have arisen from the grunting of pigs, and a bad smell. The Medical Officer and Inspector of Nuisances at once visited the premises, and found them clean. The pigs are brought to be slaughtered, and are sometimes kept for a night and day before being killed, but none are retained on the premises for any other purpose. The yard is swept every day, the slaughter-house kept clean, and inspected three or four times every week. Back Entrance to No. 39, Chapel Street. A quantity of vegetable refuse causing an offensive smell. The nuisance was abated, and occupier promised to remove the leaves daily in future. No. 40, Hindon Street. Bad smell from the front room on the first floor, where three dogs were kept night and day. The dogs have been removed. Gullies in Warwick Street, opposite the Princess Royal Public House, smell very offensive. The nuisance has been remedied. Nos. 1, 2, 3,4, Ebury Gardens. Water butts very dirty and without covers, two gullies untrapped and no water to the closets. A new cistern has been erected, the gullies trapped, and water laid on to the closets. No. 8, King Street, Pimlico. No water to the closet, no cover to the water-butt, no dust-pit, and the gully untrapped. A new ash-pit has been erected, water-butt covered, and water supplied to the closet. Eaton Yard, Westbourne Street. Bad smell from the cowsheds and slaughter-house at the rear of 10 and 11, Westbourne Place. The whole of this yard was drained by 9-inch pipes into the sewer during the summer, 1856. The only thing complained of was the recent introduction of four small ventilators, which have been removed. 22 Francis Yard, Ranelagh Cottages, Commercial Road South. Bad smell from two very offensive dung heaps. One extends nearly to the open windows of a ragged school. The heaps were removed, and the yard is frequently visited, in order to prevent similar accumulations. Stables, No. 18, Burton Street. Mr. Grant, the Inspector of Nuisances, having reported to Dr. Aldis that, although a notice had been served for the drainage of the above premises, the work had not been done, they examined the place and found the sewer-water overflowing into the stalls, which caused a very strong smell of ammonia. No less than nine horses had been attacked with severe sore throat, which caused abscesses in the neck, and left marks. It was the opinion of the Veterinary Surgeon, that the " Influenza" was produced by vitiated air in consequence of defective drainage. The horses were valued at £50 each, and the complainant's business was nearly stopped in consequence of the injury done to his stud. Under these circumstances it became necessary to write to the owner requiring the necessary works to be done forthwith, otherwise proceedings would be commenced to enforce the same. This plan proved effectual, and the stables have been properly drained. No. 27, Gloucester Terrace, Pimlico. The following is a very lamentable case. Five deaths occurred from diphtheria in the family of a clergyman. Three children died and were buried on June 24th ; the mother became a victim to the complaint on the 25 th ; and another child, that had been visiting at Sydenham, in consequence of the outbreak of the disease at home, became ill, was taken to St. George's Hospital and died on the following day. The last case was recorded as " Sloughing Throat," at St. George's Hospital, no false membrane having been detected during the post mortem examination, but ulcers, and appearances of strong inflammation 23 were detected. A membrane, however, which is considered pathognomonic of the disease, was taken from the mouth of the housemaid, who recovered in the same institution. The mother of the deceased lady, and a nurse, were attacked with the same complaint and recovered. The Medical Officer ascertained that a closet in the back yard had been obstructed for a week, and that offensive matter had been removed from it and buried in the ground where the children had been digging. The drainage also was thoroughly examined in consequence of several rat holes, but it was found to be in good order. A complaint having been made of the foul condition of the outlet of the Ranelagh sewer, the Medical Officer did not succeed in finding any nuisance. Milk of lime has been used for the purpose of deodorizing the Ranelagh and King's Scholars' Pond sewers, and experiments have been made on a small scale in the latter, with gases produced from a mixture of sulphuric acid and the coke of boghead coal. No. 3, Passmore Street. The drains in the area were choked up and caused an offensive smell. They have been properly cleansed into the sewer. No. 12, Little Ebury Street. A common privy with cesspool, and no cover to the dust-pit. The cesspool has been filled up, a water-closet erected, and the ash-pit covered. No. 11. A common privy, no cover to the water-butt, and no ash-pit. The cesspool has been emptied and a new water-closet constructed, two gullies have been trapped, the water-butt covered, and a new covered ash-pit erected. No. 8. This house is occupied by a marine store dealer, and was very dirty throughout. There was a common privy and cesspool, no ash-pit, and the yard dirty. A summons was taken out and complaint made to the magistrate at the 24 Westminster police court, after which the house was cleansed, the cesspool emptied, and a water-closet erected, with a covered ash-pit. No. 3, Robert Street, South-side, Commercial Road South. The cellars were damp and contained a quantity of rubbish with human excrement. The filth and rubbish have been removed and the cellars lime-whited. No. 12, Brewer Street. Obstructed drainage, which has been remedied. No. 10, Wallace's Yard. A quantity of garbage mixed with the dung. The mass was covered with lime and taken away the following morning. No. 10, Grosvenor Street West. Leakage of sewage into the bake-house from No. 9 and 11, adjoining premises. The nuisance has been abated. The Equitable Gas Works, Thames Bank. A large heap of ashes, commonly called " breeze," extending about 8 feet above the parting wall in the yard, behind some adjoining houses, the occupiers of which could not open their windows or doors lest particles of coke should be blown inside. The whole mound has teen removed, and a promise made that the cause of complaint shall not occur again. No. 12, Gillingham Street. The closet, which had been obstructed, was cleansed. St. Barnabas' College. Bad smell in the dust-holes from decomposed vegetable matter and house refuse. One of the boys' water-closets obstructed. The rubbish and obstruction in the closet have been removed, and the walls of the dust-hole ordered to be lime-whited. No. 45, St. Georges's Road. Drainage choked up, and the basement flooded with stagnant water. This obstruction was caused by the syphon in the front area being filled with shavings, thrown down by workmen before the house was 25 occupied. The whole of the drains have been taken up and relaid throughout the house, and the saturated earth removed. No. 62, Upper Ebury Street. A very offensive common privy and cesspool, with no cover to the ash-pit. The cesspool has been emptied and filled up, a new watercloset erected, dust-pit covered, and inlets to the drains trapped. The following statement is connected with the above premises. In the Registrar General's weekly return, ending July 26th, the death of a woman is recorded, " as having been caused by fever, which was directly attributed to the inhaling of the stench of the river during a short excursion between Pimlico and London Bridge." The person having died in Belgravia, Dr. Aldis was induced to ascertain with precision the particulars of the case, which was one of sanitary as well as scientific interest. Although the patient's dwelling was supposed to be free from any nuisance by one or two of the occupiers, nevertheless he found a very offensive common privy, with a cesspool in the back yard, and the smell extending from it into the passage of the house. The ash-pit had no cover, and a complaint was made of an occasional smell from the drain under the front kitchen. The deceased was forty years of age, her mode of life said to be steady, and the previous state of health very good. The day of her excursion on the river was Thursday, June 24th. Before and after arriving at home, she complained of the dreadful smell from the Thames, " that it had got into her throat," and soon afterwards experienced faintness, nausea, vomiting, with shivering at night, followed by heat. Having been in bed some days with these symptoms, she applied for medical relief, July 1st, suffering from low fever. She had been delivered on May 26th, in the back room of 26 the first floor, but no untoward symptom presented itself during her confinement. While suffering from fever, she complained of " that horrible river " during her paroxysms of delirium. There was neither diarrhoea nor eruption. It was the only fatal case of fever returned for the week, in question from the same district, nor was the Medical Officer aware of any similar cases in the immediate neighbourhood. No other case of fever occurred in the same house, but the child has since died, probably from want of breast milk. No. 63, Upper Ebury Street. A very offensive common privy, no cover to ash-pit, and the gullies untrapped. A new water-closet has been erected with a cistern over it, inlets to the drain have been trapped, and the dust-pit covered. No. 8, King Street, Pimlico. The order for carrying out certain sanitary measures not having been complied with, the owner was written to by the Medical Officer of Health, that, unless the evils were remedied, the case would be taken before a magistrate, which had the desired effect. No. 54, Eaton Mews West. While drainage was being provided for the houses, it was suggested to the agent by the Medical Officer of Health, that it might be a good opportunity, and save additional expense, if at the same time a water-closet with a drain to the sewer were constructed, as the coachman and helpers were not allowed to use the one appropriated to the other servants of the house. But the agent, although favourable to sanitary measures, thought it an interference with the " rights of property," and declined, whereupon the Nuisances Removal Committee issued an order for a water-closet to be made, and properly connected with the sewer. This case has occasioned much trouble. Unless persons in a high station of life render their premises 27 commonly decent, and set a good example, how can the labouring classes be expected to improve their sanitary condition ? Nos. 1 and 2, Little Charlotte Street are under inspection, in consequence of the closets not having a water supply. " Youthful Queen " Public House, Princes How. Dr. Aldis gave evidence in this case before Mr. Paynter at the Westminster police court, on August 18th, when it appeared that an enormous cesspool existed in the yard, and that five loads of offensive matter had been recently removed from it. The ash-pit had no cover, and the yard was in a dirty condition. The magistrate ordered the cesspool to be filled up, and a water-closet to be constructed communicating with the sewer, and the ash-pit to be covered. The work has been completed. No. 24, Ranelagh Street, Pimlico. Leakage of water into the back kitchen, supposed to come from No. 5, the adjoining premises. The place has been properly drained by 6-inch pipes into the sewer. No. 11, Eaton Lane North. Drainage stopped up and the occupier placing the dirty water out of the drain into the gully in the lane; smell offensive. The drains have been cleansed and the nuisance abated. No. 4, Little Ebury Street. No cover to ash-pit, and fowls kept under the kitchen staircase; smell offensive. The fowls have been removed. No. 3, Wilton Street, Grosvenor Place. The following complaint was originally made by letter to the Central Board of Works, namely, the leakage of water into the front cellar, supposed to arise from the sewer. The nuisance having been caused by an escape of gas and water, information was given to the Gas and Water Companies. The gas pipes were repaired ; 28 but, as the Medical Officer of Health found a very offensive smell from house refuse in the cellar, the walls of which were dirty and covered with bunches of earth worms, he ordered the refuse to be removed, and the walls to be cleansed and lime-whited. No. 62, Lupus Street, Pimlico. Water-closet in the back yard damp, dirty, and very offensive. The supply pipe has been repaired, closet cleansed, and nuisance abated. The smell arising from this closet is supposed to have caused the illness of a gentleman residing next door. No. 16, Brewer Street, Pimlico. The occupier was detected in slaughtering four sheep without a licence. He regretted that he had committed himself and promised not to offend again. He was made to understand that, if the offence was repeated, he would be summoned. Plot of Waste Ground between Charlwood Street West and Denbigh Place. While some workmen were engaged in digging up the earth, they perceived a putrid smell, which caused great annoyance to the inhabitants. It was found to proceed from a quantity of Crimean stores in canisters, 58 in number, which had been buried there. It is supposed that nails were driven into the canisters in packing, which allowed air to enter, and caused putrefaction. It may be mentioned as a coincidence, that the occupier of the adjoining house, and the men exposed to the foul emanations, were attacked with sore throat. The whole of the canisters were removed before six o'clock the next morning, in consequence of a threat that immediate steps would be taken unless the nuisance was abated. No. 24, Coleshill Street, Pimlico. A most offensive smell at the lower part of the house, supposed to arise from the drains. The executrices of the property called upon the Medical Officer and promised to remedy the nuisance as soon 29 as possible. A new water-closet has been constructed, and the premises drained by a six-inch pipe drain into the sewer. Shed behind No. 9, New Grosvenor Place. Six pigs are kept here in a very small wooden building, the drainage of which was very defective. Upon the Medical Officer telling the owner that the shed was not adapted for the purpose of keeping pigs, and that the neighbours were greatly annoyed by the stench, he caused them to be removed. No. 3, Clough's Cottages, Elizabeth Street South. This house being out of repair, information was given of it to the District Surveyor. No. 8, Little Ebury Street. Proceedings were taken in this care by the Medical Officer and the Inspector, but it was adjourned in consequence of the owner having commenced the required alterations, which have been completed. A child having died from falling through the iron palisades on the New Thames Embankment into the river, the Medical Officer saw Mr. Keeble, and inquired whether some method could not be contrived to prevent similar accidents in future. He replied that the Commissioners of Woods and Forests had been made acquainted with the circumstance, and that five plans to protect the place were under consideration. On September 8th, the Medical Officer of Health and Inspector visited all the slaughter-houses in Belgravia, 28 in number, and found them, with one exception, much improved since the last inspection. Drinking Fountains. We take the liberty of reminding the Vestry, that in consequence of the disuse of the public surface wells, the poor have no chance of getting a draught of cold water in the streets, and that if thirsty they are thus driven to the public house. All over England the subject is under discussion, and it would be worth 30 ing, whether a combination of the western parishes in London might not erect conduits in the great thoroughfares, supplied either from an artesian well, or with Thames water cooled and aerated. An analysis of the water of the Chelsea Company, taken from the main in Chapel Street, Belgrave Square, June 10th, 1858, produced of Grs. Total Impurity 19.24 Organic ditto 2.16 July 10, 1858. Total Impurity 16.52 Organic ditto 1.40 Aug. 3, 1858. Total Impurity 15.88 Organic ditto 0.92 Sep. 21, 1858. Total Impurity 16.92 Organic ditto 1.56 We have the honour to be Your faithful Servants, C. J. B. ALDIS, M.D. R. Druitt. September 25th, 1858. 31 APPENDIX. On the Gas supplied by the Chartered and London Companies. In conclusion, we have to report upon the quality and illuminating power of the Cannel coal gas, supplied by the Chartered and London Gas Companies. Dr. Aldis is responsible for the experiments made on the gas supplied by the London Company, and Dr. Druitt for those on the gas from the Chartered Company. They have been supplied with similar apparatus, and care is taken that the tests in each case shall be equal. I. The room in Mount Street, where the gas from the Chartered Company is tested, was not completed until July 26th. So far as the gas had then been examined, it was free from sulphuretted hydrogen and ammonia. The room in West Basin Road, where the gas from the London Company is tested, was finished on May 21, since when a series of experiments has been made, the result of which, with a batswing burner, gives a mean equal to 11.19 sperm candles, burning 120 grains per hour. A Cannel batswing burner was used, consuming 2½ cubic feet per hour. The gas was entirely free from sulphuretted hydrogen, and presented only a trace of ammonia.— August 3, 1858. II. The gas submitted to examination, at the 32 house in Mount Street, at sundry times during the month of August 1858, was uniformly free from sulphuretted hydrogen, but contained traces of ammonia. Its illuminating power was such, that a batswing burner, consuming 2½ cubic feet per hour, gave a light equal on the average to that of 13¼ sperm candles, burning at the rate of 120 grains per hour. The Cannel Gas supplied by the London Gas Light Company was also entirely free from sulphuretted hydrogen, but contained slight traces of ammonia and carbonic acid. A course of experiments, from May 21st, on the illuminating power, with a batswing burner, consuming 2½ cubic feet per hour, gave an average light equal to 10.9 sperm candles, burning at the rate of 120 grains per hour.— September 7th, 1858. III. The result of observations, continued during the month of September and up to 19th October, shows that the Cannel Gas, supplied by the Chartered Company, was absolutely free from sulphuretted hydrogen, and that a batswing burner, consuming 2½ cubic feet per hour, gave a light equal on the average to that of 15 7/10 sperm candles, burning 120 grains per hour. The Cannel Gas supplied by the London Company, from September 8th to October 15th, was also perfectly free from sulphuretted hydrogen, and a batswing burner, consuming 2½ cubic feet per hour, gave an average light of 10.3 sperm candles, burning 120 grains per hour. TABLE OF MORTALITY. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 25th of September, 1858. Average, 31.6 DISEASES. Ages at Death. Sub-Districts and Population. Sexes. Under 1. 1 and under ft. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave.—40,034. Mount-street Work.—268 Little Chelsea Work.—350. St. George's Hospital. —216. Males, 31,920. Females, 41,310. Total, 73,230. Parishioners. Non- Parishioners. I. Zymotic. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 0 1 Measles 2 8 11 .. .. .. .. .. .. 11 .. .. .. .. 9 2 11 Scarlatina .. 5 11 .. .. .. .. 1 1 6 .. 2 .. 1 4 7 11 Diphthérite .. 6 9 2 .. .. .. .. 2 6 .. .. 1 2 2 9 11 Hooping Cough 4 15 19 .. .. .. .. 5 .. 13 .. .. 1 .. 9 10 19 Croup .. 3 6 .. .. .. .. 2 .. 2 .. .. 1 1 2 4 6 Putrid Sore Throat .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. 1 1 Diarrhœa 20 3 23 .. .. 3 2 6 1 20 .. 1 .. .. 15 13 28 Dysentery 1 1 2 1 .. .. .. .. .. 2 1 .. .. .. 1 2 3 Cholera 3 .. 3 .. .. 1 .. 1 1 2 .. .. .. .. 1 3 4 Influenza .. 1 1 .. .. .. .. .. .. 2 .. .. .. .. 1 1 2 Purpura and Scurvy .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Mumps .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 0 1 Remittent Fever .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Infantile Fever .. l 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Continued Fever .. 2 4 8 5 2 .. 2 3 7 1 .. 5 l 8 11 19 Rheumatic Fever .. .. .. 1 .. 1 .. .. 1 1 .. .. .. .. 1 1 2 Erysipelas .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 1 0 1 Canker .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pyæmia .. .. .. 1 1 .. .. .. .. .. .. .. .. 2 2 0 2 II. Cancer, Dropsy. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hæmorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dropsy .. .. .. 1 i 6 .. 1 1 2 .. .. 1 2 1 6 7 Abscess .. .. 2 .. .. .. .. .. .. .. .. .. 1 2 2 1 3 Ulcer .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 0 1 Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lupus .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 0 1 Cancer .. .. 1 .. 3 3 1 1 1 4 2 .. .. .. 3 5 8 Gout .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. III. Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mesenteric Disease .. 3 3 1 .. .. .. 1 1 2 .. .. .. .. 2 2 4 Consumption .. 1 3 27 19 1 .. 10 3 29 5 .. .. 4 21 30 51 Water in the Head 3 6 9 .. .. .. .. 2 3 4 .. .. .. .. 5 4 9 IV. Nervous System. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Brain .. .. .. 2 .. .. .. .. .. .. 1 .. .. 1 2 0 2 Apoplexy .. .. .. .. 3 4 .. .. 1 6 .. .. .. .. 4 3 7 Paralysis .. .. .. 1 3 3 .. 2 2 2 .. .. .. 1 4 3 7 Delirium Tremens .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 0 1 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epilepsy .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. 1 1 Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Spine .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 0 l Convulsions 7 3 10 1 .. .. .. 3 1 7 .. .. .. .. 6 5 11 Disease of Brain, &c. .. 3 5 .. 1 2 .. .. .. 5 1 .. .. 2 2 6 8 V. Heart, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pericarditis .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Aneurism .. .. .. .. 2 .. .. .. .. 1 .. .. .. 1 2 .. 2 Disease of Heart, &c. .. .. .. 7 8 5 1 2 2 11 .. 1 .. 5 13 8 21 VI. Lungs, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bronchitis 1 2 3 3 1 8 .. 3 .. 13 .. .. 1 1 8 10 18 Pleurisy .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 1 1 Pneumonia 1 .. 3 4 1 .. .. 1 1 3 2 .. .. 1 6 2 8 Asthma .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Lungs, &c. 1 1 2 1 .. .. .. .. .. 2 .. .. .. 1 2 1 3 Abscess of Diaphragm . .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 1 BIRTHS registered during 13 weeks.—Hanover Square, M. 56, F. 39; May Fair, M. 26, F. 35; Belgrave, M. 174, F. 198. Total 528. Average 40.6 DISEASES. f Ages at Death. Sub-districts & population Sexes. Under 1. 1 and under 5. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave .—40,034. Mount-street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. VII. Of Stomach, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Teething 6 1 7 .. .. .. .. 3 .. 4 .. .. .. .. 6 1 7 Quinsy .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Inflammation of Stomach .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Bowels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Peritonaeum .. 1 1 .. 3 1 .. 1 .. 1 .. .. 1 2 2 3 5 Dropsy of Belly .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 .. 1 Ulcer of Bowels .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. 1 Rupture .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ileus, Hæmatemesis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intussusception 1 .. 1 .. .. 1 .. .. 1 1 .. .. .. .. 1 1 2 Stricture of Bowels .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 1 Disease of Stomach .. .. .. 1 3 1 .. 2 1 2 .. .. .. .. 4 1 5 Disease of Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Liver .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 1 Jaundice .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Liver .. .. .. .. 2 1 .. 1 .. 2 .. .. .. .. 2 1 3 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Urinary, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Kidney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bright's Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Bladder .. .. .. .. .. 2 1 1 1 .. .. .. .. 1 3 .. 3 Stricture of Urethra .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Kidneys, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. IX. Womb, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Child-birth .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 Disease of Uterus, &c .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 X. Joints, &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 Disease of Joints, &c .. .. 1 .. .. 1 .. 1 .. .. .. .. 1 .. 1 1 2 XI. Skin, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carbuncle .. .. .. .. .. 3 .. .. .. 3 .. .. .. .. 1 2 3 Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Skin, &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XII. Malformations. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Blue Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Spina Bifida 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Other Malformations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XIII. Debility: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 9 .. 9 .. .. .. .. 2 .. 7 .. .. .. .. 7 2 9 XIV. Atrophy: 10 3 13 .. 1 1 .. 2 2 11 .. .. .. .. 7 8 15 XV. Age: .. .. .. .. .. 5 5 4 2 4 .. .. .. .. 2 8 10 XVI. Sudden: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVII. Violent Death: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Starvation 1 .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 Want of Breast Milk 5 .. 5 .. .. .. .. 1 1 2 .. 1 .. .. 2 3 5 Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. 5 5 3 .. .. .. 1 .. 1 .. .. 1 5 6 2 8 Hanging (Suicide) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suffocation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. 2 1 1 .. .. 2 .. 2 .. .. .. .. 3 1 4 Fractures .. .. 1 7 4 2 .. 3 .. .. .. .. 3 8 14 .. 14 Wounds .. .. .. 1 1 .. .. 1 .. 1 .. .. .. .. 2 .. 2 Other Violence (Concussion) 2 .. 2 .. .. .. .. 1 .. 1 .. .. .. .. 1 1 2 All Violence .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVIII. Not Specified. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 .. 1 TOTAL: 77 77 187 80 71 61 13 76 35 214 14 7 17 49 213 199 412 DEATHS registered during corresponding weeks of ten years (average) 379.2. Weekly average 29.1. C.J.B. ALDIS. M.D. R. DRUITT. london: printed by george phipps, ranelagh street, eaton square. HAN 8 No. V.] QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY OF Saint George, Hanover Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOR THE QUARTER ENDING CHRISTMAS 1858. LONDON. TO THE Vestry of St. George, Hanover Square. My Lords and Gentlemen, I. During the first quarter of the present year, 528 deaths were registered in the parish; during the second quarter, 479; during the third quarter, 412; and now, during the fourth quarter, comprising 14 weeks, ending 1st January, 1859, 490 deaths have been recorded in the parish. This number gives a weekly average of 35, whereas the weekly average (for 10 years) was 29.75, but allowance must be made for increase of population. The 490 deaths, include those of 60 non-parishioners in St. George's Hospital, and of 12 inmates of the Workhouse at Little Chelsea; so that the net mortality of the parish was 419 ; against which may be set the 595 births during the same 14 weeks. Scarlatina with diphtheria, quinsy, and pharingitis, destroyed 32 lives this quarter, against 33 in the corresponding quarter of last year. Deaths from diphtheria occurred at 5, Victoria Square; 1, Lower Belgrave Place; 3, Erin Place; 9, Wallis' Yard; 41, Moreton Place, and at Swan Passage; 6, North Row, and 2 at 299 Oxford Street. The disease at 1, Lower Belgrave Place was imported there; the patient died after having nursed three nephews, 4 who fell victims to the same complaint at Esher and Blackheath. Infantile fever and continued or typhoid fevers destroyed, 17 lives, so that with others 88 deaths happened from zymotic disease. Lung diseases, as bronchitis, pneumonia, and asthma, have destroyed 94 persons during a period in which great variations of temperature occurred. Among the violent deaths, nine were produced by burns and scalds; five from want of breast milk; one from suffocation ; and two persons committed suicide by drowning themselves when insane. II. Passing on to the sickness, we find that 856 persons in the Hanover and May Fair sub-districts, during the quarter, availed themselves of gratuitous medical attendance from the Medical Officers of the parish, and of the Dispensary. This number gives a very inadequate representation of the whole amount of sickness amongst the humbler classes, and of the amount of medical attendance provided by public and private charity; but it represents the sickness of one section of the people pretty uniformly. Amongst these cases were two of small pox; one in an adult; one very mild in a vaccinated infant, eight months old, who brought the disease from Norwich, where she had contracted it from a very severe case amongst children whose parents would not allow them to be vaccinated. Of measles, only one case appears. Of scarlatina, eight. Of diphtherite, only three cases appear; one at 28, Brook's Mews ; one at 18, North Bruton Mews; and one at 5, Adam's Mews. A large number of cases of other throat affections, under the titles, quinsy, tonsillitis, &c. Of whooping cough five cases only; and four of pneumonia appear. 118 cases, or a seventh of the whole amount of illness, was due to bronchitis; and there were 33 cases of 5 diarrhœa; and 39 of fever, mostly of a very slight degree of severity. Altogether, making allowances for the prevalence of instances of severity here and there, the quarter was anything but an unhealthy one for the inhabitants of the Hanover and May Fair sub-districts. In the previous quarter the number of cases was 956. The following table, which may be compared with one at page 7 of our last Report, will show the relative amount of sickness in the most densely populated parts of the parish, and the deaths :— Population. Total Parish patients Deaths of children Deaths of adults. From the Model Lodgings 130 24 0 2 Bloomfield Buildings 130 20 0 0 Brick Street 296 8 2 0 Brown Street 200 34 0 3 Carrington Street 280 13 l 2 George Street, Grosvenor Square 540 28 2 0 Grosvenor Market 211 19 0 0 Grosvenor Mews 944 68 2 2 Hertford Place 200 12 0 1 John's Court, Farm Street 80 21 0 0 May's Buildings 122 10 0 0 Mount Row and Place 133 17 1 0 North Bruton Mews 154 21 0 0 Street's Buildings 79 11 0 1 Queen Street 316 22 3 1 Robert Street, Grosvenor Square 543 24 1 2 Thomas Street 600 40 0 3 Amongst individual instances, we may refer to the Model Lodging House, which has not quite kept up its character this quarter; 10, Grosvenor Mews, which was the subject of legal proceedings, as we shall presently relate; John's Court is 6 still in statu quo; 3, 8, and 9, Lancashire Court, have been sickly; No. 5, Brown Street has furnished nine patients; No. 8, Carrington Street has yielded 4; and No. 10, six patients. Respecting Grosvenor Market, of which No. 21 yielded six; Nos. 22 and 23, yielded two patients each; it is most gratifying to state that the "Parochial Association for improving the Dwellings of the Labouring Classes," has taken Nos. 21 and 22, and is going to cleanse and make them wholesome, and to admit a proper number of tenants. Everyone who knows the locality will admit that this is a most substantially good move for the benefit of the rate-payers. In the Belgrave sub-district, 6487 cases were treated by the Parochial Surgeons, at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul and St. Barnabas Dispensary, and at the Workhouse, Little Chelsea. Of these eases 3318 were patients at St. George's Hospital, leaving a remainder of 3169. Among the zymotic diseases, 8 were cases of small-pox, 21 of chicken-pox, 10 of measles, 25 of scarlatina, 31 of whooping cough, 1 of croup, 124 of diarrhœa, 3 of dysentery, 2 of ague, 42 of continued fever, 52 of rheumatic fever, 15 of erysipelas, and 4 of diphtherite. There were also 636 cases of bronchitis, and 22 of pneumonia. It will be seen in the context that active means were taken to prevent the extension of small-pox. III. The following are some of the details of matters which have been brought before the local authority during the quarter. Before giving them we would remark, that they are the result of two collateral but totally distinct lines of enquiry. In the first place there is the investigation of nuisances, which is instituted in consequence of the 7 plaints of persons aggrieved, or in consequence of observations made whilst inspecting various localities. In the next place there are the enquiries made because the Medical Officers of Health, from learning the existence of sickness, are led to infer the existence likewise of some conditions which make that sickness more intense than it would be otherwise. Grosvenor Mews, No. 10. This is a house, which, from its crowded state and the imperfect nature of its drainage, requires constant observation. A population of 12 families, comprising between 50 and 60 persons in one house, cannot be maintained in health without scrupulous care; and on the outbreak of epidemic disease, such a house is liable to furnish one or more victims. Besides, there is scarcely a family inhabiting a single room in the parish that does not occasionally take in a servant out of place as a lodger; hence, infection may be carried into the families of the richer classes. Moreover, common sense and experience alike show, that if three or four people live night and day, and wash and cook in a single room, that their bedding, as well as the walls and ceilings, become impregnated with effluvia, and that fever once introduced will remain till it has affected every person susceptible of it. In the case before us, the peculiar form of infectious disease which we had to deal with, was scarlet fever, and few persons who have not had practical experience can form an idea of the number of mischiefs that may ensue from this one cause. The patients actually attacked have their lives endangered; and even when they recover from the fever they are liable to dropsy and other diseases which follow in its train, and perhaps may have their whole blood poisoned and suffer from glandular swellings and scrofula. Besides, persons who do not suffer from the fever in its fully developed form, are liable to all kinds of feverish attacks and sore throats. 8 On all of these grounds, there is no disease, the existence of which, more imperatively demands a visit from the Inspector than this; and it must be manifest that cleansing of bedding, walls and ceilings, and of the drains and closets, and other lurking places, together with a thorough airing of the infected apartments is the best; and is in fact an almost certain mode of checking the disease. Considering then that two deaths from scarlet fever occurred in this house in October, and that cases occurred of "febricula" "sore throat," and "dropsy after scarlet fever," in the same house, 17 cases of illness altogether; and that the rooms in which the scarlet fever patients died, had not been emptied or cleansed (as was alleged by the occupiers) for two years at the least, it became a clear matter of duty to call upon the owner to cleanse these rooms at the least; and on his peremptory refusal, the Local Authority ordered him to be summoned to Marlborough Street. He accordingly appeared before the Magistrate on the 19th of November, to answer to the complaint of having premises in such a state as to be a nuisance and injurious to health;—and tried to set aside the proceedings-on technical grounds. The Magistrate, however, without listening to his objections, advised him to comply with the wish of the Local Authority, and adjourned the case for a fortnight to give him the opportunity of so doing. During this fortnight the work was done. The case is valuable as a precedent. Mount Row, No. 8. This house had become thoroughly dirty, dilapidated, and offensive; the water closets out oforder, and pavement of yard broken. The Committee ordered it to be cleansed, and directed legal proceedings if necessary. Mount Street, No. 3. Here a leakage through the wall, from an ill-constructed water closet apparatus at No. 2, has been rectified. 9 No. 82. A house complained of by the lodgers on account of offensive drains and a closet without water. A notice was served, and the nuisance abated. Hertford Arms Public House, Little Q-rosvenor Street. This house was examined by the Medical Officer of Health and Inspector, in consequence of a complaint of dampness in the basement. It was found that the cellar was inundated at times by land springs; and that the drainage of the house, although good enough for its special purpose, was not at a sufficiently low level to carry off this spring water. The case was referred to the Surveyor. Half-Moon Street, No. 32. This is a house, the occupier of which has been an incessant complainant, and has considerably taxed the time and ingenuity of the Medical Officer of Health and of the Inspector. The house has been enlarged by the erection of a back wing, or set of apartments in the yard; a plan which gives internal space, but usually at the sacrifice of light, air, and dryness. This part of the house was infested with smells which made it almost uninhabitable, and which were attributed at first to a neighbouring slaughter-house, then to a large disused branch of the King's Scholars' Pond Sewer, which was discovered to run under this house and through White-Horse Yard at the back. When it was shewn that neither the slaughter-house nor sewer could be the cause of the nuisance; a further search was made, when it was found that Nos. 33 and 34 adjoining, had cesspools in their back yards, the overflow of which passed by old brick drains into the basement of No. 32, and thence into the old sewer just mentioned. Hereupon, the owners of Nos. 33 and 34 were induced to drain their premises by a new pipe drainage into the sewer in front, and all connection with the old sewer was cut off. The York Minster Public House, North Audley Street. 10 Here was a complaint of defective drainage creating a nuisance in the adjoining house, which was remedied on application. North Audley Street, No. 20. Here the lady who occupies the upper part of the house, as a milliner and lodgingkeeper, complained of the nuisance occasioned by the conversion of part of the back premises, opening into North Row, into a stable. The Committee, however, determined that it was a case in which the aggrieved party should proceed by civil action, and not one for the interference of the Local Authority. George Yard, No. 1. This is a stable originally attached to No. 18, Brown Street, which house, after years of neglect, has lately been entirely newly drained by pipes, and purified by the abolition of four cesspools. Still the house remained unwholesome, and it was found at last that the drainage of the stable in George Yard passed into the basement of it, where it had no outlet, but soaked into the earth. This is one of the instances that come under notice almost every week, shewing the expediency of thoroughly digging out and examining the basement of a house whilst it is under repair; for however perfect any man's drainage may be, he never can be sure otherwise, that his basement may not be the receptacle of filth from his neighbours ; owing to the lamentable fact which we deplore now that it is too late, that when water closets were introduced, no sufficient means were provided for carrying off the foul water, but any drain which might be used harmlessly for rain-water was made the receptacle for it. Providence Court, Nos. 1 and 2. These houses afford an illustration of the remark just made: for their drain passed under the adjoining house, No. 19, George Street, Grosvenor Square; and, never having been adapted for sewage, had 11 come thoroughly rotten and dilapidated, and a great nuisancc to the owner of No. 19, who had put his own drains into good condition. The Committee were of opinion that the houses in Providence Court should be drained directly into the sewer in that court, which the owner willingly agreed to. George Street, No. 24. Here a dirty and offensive kitchen has been cleansed. Mount Street, 10a. The back parlour of this house, inhabited by a medical gentleman, had for years been most unwholesome, owing, as was discovered after a most tedious and laborious investigation, to a cesspool, and to an old brick short in the wall, conveying sewage from a water-closet in the adjoining house. The evil is now remedied. Robert Street, No. 6. The kitchen, inhabited by a poor family, rendered offensive by the dilapidated state of the drains, which have been repaired. No. 14. A clean respectable house, but the basement and workshop in the back yard very offensive from some fault in the drains. No. 15, also is very offensive from the same cause. No. 16, has been allowed to become dangerously dirty, through long occupation of every room by a family, without a wholesome whitewashing. Legal proceedings were authorized in this case, if required. Market Street, No. 3. A small ruinous house, rendered damp and offensive by an escape of water under the floor. Houses at the corner of Maddox and Regent Streets. Here is one of those complicated and vicious arrangements of drainage which we have before referred to. The Occupier of 223a, Regent Street, has long complained of unwholesome smells in his house: he has been ill: one shopman has had sore throat; another, carbuncles: his jewellery is speedily tarnished; and his customers grumble at the smell when they 12 enter the shop. These unpleasant circumstances lead him to examine his drain, which he finds to be old and dilapidated, so as in fact to be not a drain at all, but a receptacle for the sewage of his own house, and of his neighbours': for the next house, 223, Regent Street, 2, Maddox Street, and probably also 20, Hanover Street, discharge their sewage into his drain. This case was investigated with a great deal of trouble, and each of the parties concerned, except one, agreed to execute new and separate works for himself. The Committee therefore gave instructions and authority for an application to the Magistrate (if necessary) to examine the drains, and to require the respective premises to be properly drained. Union Street, Berkeley Square, No. 3. This was another case of the same sort. This house was damp and offensive: its basement was taken up, when it was found that the soil underneath was a putrid swamp: the drains were entirely decayed: No. 4, next door, drained into No. 3; and No. 3 drained into No. 2, the outlet of which last-named house into Red Lion Yard adjoining was choked up. Thus, for an indefinite period, the drains of these houses have been mere cesspools, from which the liquid sewage has been absorbed by the earth, whilst the solid matter has remained. This case gave a very great deal of trouble: first, in finding out the real facts; and, secondly, in inducing the different parties interested to arrange on a common plan for their united drainage. George Street, Hanover Square, No. 3. A first-class house, most respectably occupied, in which the Inspector found a cesspool, 10 feet deep in the back area; from which a drain, thoroughly dilapidated and broken down, ran through the house. There was a grating in the course of this drain which prevented the passage of anything but 13 quid; so that the solid sewage matter had accumulated during the 25 years which had elapsed since the drainage was examined. Oxford Street, No. 299. Two children died in this house of diphtherite, in November, when the house was visited, and the occupier instructed as to the necessary measures for improving the drainage and cleansing the premises. Hertford, Street, No. 49. A small house in which every room was poisoned by emanations from the drains of the adjoining house in Carrington Mews, ascending through a decayed wall. This case has been but partially remedied. Ourzon Street, No. 34, was in like manner poisoned by emanations from old imperfect drainage arrangements at No. 33, which have been rectified. Other nuisances, more or less dangerous to the health of the parties concerned, have been investigated and removed: viz., at, Shepherd Street, No. 1. An obstruction of drainage. Thomas Street, No. 32. The same. No. 36. A marine store dealer's—has been cleansed. Davies Mews, No. 9. An offensive closet without water —a great nuisance to houses in Brook street, &c. Shepherd's Court, Upper Brook Street, No. 5. Here a great dampness in the wall, which had existed for years, and been accused of producing illness amongst the inmates, was ascertained by the Inspector to be caused by a defective cistern at the Castle public house adjoining. Charles Street, Berkeley Square, No. 35. Annoyed by a dung-heap in Lambeth Mews. Brook Street, No. 52. The proprietor of the livery stables here made a complaint of the ventilation of his private apartments, which was investigated, but it was found that the evil could not be remedied without an encroachment on the property of his neighbours. 14 Warwick Street, Pimlico, No. 136. A lady having complained of a nuisance in the yard behind this house, it was visited by the Medical Officer of Health and the Inspector of Nuisances, who found the place very dirty and offensive from the keeping of ducks and fowls;—the former have been removed and the yard kept clean. G-rosvenor Mow, No. 47. A most offensive gully opposite has been cleansed and trapped. Westbourne Street, No. 55. Offensive smells from the drain in the kitchen. A notice has been served. Upper Ebury Street, No. 86. Common privy and drains in a defective state, dust-hole dirty, and the water closet in the basement is out of repair,—smell very offensive. Diarrhœa, which has been extremely less prevalent this autumn than usual, attacked nearly all the inmates, consisting of several families; and the medical attendant assigned the bad state of the drains as a reason for its occurrence. A notice was served on September 21st; since when the house has been drained by a 6-inch pipe drain, the lower part lime-whited, the inlets to the drains trapped, and a new closet erected in the area. Eccleston Place, No. 17. The gully opposite stopped up, and complaint of smell from the ventilator communicating with sewer. The gully has been cleansed and a small box containing charcoal was recommended to be placed in the course of the draught of the ventilator. Wood and peat charcoal are the most effective in absorbing gases within the pores, so that when it is exposed to an atmosphere containing the putrid vapours of decomposition it absorbs them and causes decomposition from their uniting with the atmospheric oxygen. Lupus Street, No. 66. Bad smell and dampness in the back kitchen from the cistern in the yard of No. 68, 15 joining premises. The dust has been removed and repairs necessary to abate the nuisance completed. Cottage Road, Nos. 11 and 12. Two most offensive gullies opposite have been cleansed. Allingham Street, No. 8. Paving in the back yard out of repair, and the drains under the house in a defective state. The drains have been cleansed and repaired, the paving made complete, and the gully trapped. Queen Street, Pimlico, No. 35. Drainage in a defective state. The drains have been cleansed and repaired into the sewer in Queen Street, and the inlets trapped. Princes Row, No. 11. Offensive state of the drains, which communicated with an old sewer between the above place and Queen Street. It became necessary to open the sewer, which was completely filled. This case was referred to the Surveyor. Gillingham Street, No. 12. Defective drainage. Drains cleansed and repaired into the sewer, and dust-pit covered. Mr. Bull's Cow-yard and Private House, Commercial Road South. Both these places, as well as Stone-house, with the adjoining houses, were flooded with sewage water. The premises have been liable to similar inundations for several years, owing to the basements being below the level of the backwater in the Commercial Road sewer. This water gained admission into the basements of the houses whenever anything prevented the flap from being closed. The Surveyor has introduced an additional flap to intercept any back-current, in case one should not act properly, and the result at present is satisfactory. Ranelagh Grove, Nos. 17 and 18. Bad smell from the drains, which are in defective state; common privies in the yards, and the dust-pits uncovered. New water-closets have been erected with cisterns over them, and the ash-pits covered. 16 Gillingham Street, Pimlico, No. 1. Bad smells in the bake-house, supposed to arise from a cesspool in the backyard of No. 2, adjoining premises. The cesspool has been emptied and filled up, an old brick drain broken up and a new 6-inch pipe drain laid down. St. George's Road, Pimlico, No. 40. Bad smell from the drains, said to be caused by rats. The kitchen floors were taken up and the drains inspected, which were found to consist of 9-inch pipes in good condition. Upper Eaton Street, No. 9. Four pigs kept in a washhouse in the back yard, which is dirty and offensive. The pigs have been removed and the yard limewhited. The Equitable Gras Works, Thames Bank. An inhabitant complained that the smell was so bad as to prevent his windows from being opened. The premises were thoroughly examined, and fully reported upon, when it appeared that no smell was detected beyond their boundary. It is due to Mr. Jones, the engineer, to state, that he is perfectly willing to adopt any suggestion that science can devise, but he thinks no further improvements could be contrived. Ranelagh Road, Thames Bank, No. 5. House dirty and yard choked up with dust and house refuse: no ash-pit. Dr. Aldis visited this house on November 9th, when he found it in the state already described, and containing four cases of small-pox. A girl aged 14 was lying ill with smallpox in the back kitchen, the window of which and the bed were close to the offensive accumulation. The front room on the first floor contained three children suffering from the same complaint, all of whom were unvaccinated. The disease commenced in the latter, a circumstance generally noticed whenever an epidemic small-pox commences. Two more cases occurred in the same house, one was that of a child unvaccinated. The complaint spread to Nos. 4 and 6, adjoining 17 houses, and to No. 8, Johnson's Place, situate near the spot where it first appeared. He also visited two cases on December 9th, with Mr. Love, at 87, Upper Ebury Street, where the disease seemed to have been imported from Fore Street, City, by the daughter, who infected her mother and brother. The malady had appeared in other parts of London, and fatal cases were recorded by the Registrar-General. Under these circumstances it was thought desirable to order notices to be printed and circulated for the purpose of calling attention to the circumstance that small-pox had appeared, and of urgently recommending parents to cause all their children, not yet vaccinated, to be vaccinated, as early as possible, either by their own qualified medical attendant, or by the district vaccinator. It was also advised to have the ceilings, walls, and bedding cleansed, and house refuse quickly removed. The Nuisances Removal Committee instructed the Medical Officers of Health to take proceedings in all cases of wilful neglect of vaccination, and notice has already been given to several persons who are opposed to the operation. Commercial Road South, Nos. 24 and 25. Common privies and cesspools: no ash-pit at 24; and at 25 the ashpit is without a cover. After a notice had been served, the cesspools were filled up, covered dust-pits erected at each house, and the inlets to the drains trapped. At No. 24, a boy cut one of his knees slightly, which was followed by a tedious and dangerous form of erysipelas. The medical attendant thought the disease was aggravated by the unwholesome condition of the house. Upper Ebury Street, No. 67. Bad smell from the drains, caused by the want of a trap. The pipe leading to the drain was trapped, and the nuisance abated. St. Gabriel's Church, Pimlico. On Friday, November 19th, the Rev. Brymer Belcher complained of a most B 18 sive smell in the vaults of his church, which was immediately visited and inspected. On entering the building a bad smell was perceived, especially in that part of the church where the hot-water pipes penetrated the floor. On descending the stairs leading to the stove room and to the vaults below, a noxious odour was emitted. Dr. Aldis inspected the vaults and found stagnant water extending nearly the whole length of the church, and emitting a most offensive effluvium. The water was 6 feet wide in some parts, and a yard wide in others, and 3 inches deep. At the west end of the vaults, where it was welling up, the nuisance became so intense that the gases caused a sense of suffocation, rendering it necessary for any one near to escape from them as speedily as possible. The ground was black and smelt strongly of ammonia, from its being thoroughly saturated with the offensive water. Boards had been placed over the ventilating openings on the outside of the church. Hence the vaults became converted into a kind of blind sewer, the pestilential gases escaping only through the aperture for the hot-water pipes into the interior of the building, so that a person standing near the communion table suffered from nausea. It appeared that the nuisance arose from obstructed drainage in the following manner. 6-inch surface drain pipes, laid down "dry," extended from the western to the eastern extremity of the church, and communicated with the water closet, from whence a pipe entered the shaft, connected by a drain with the sewer, from which the water escaped into the vaults, and could not return owing to the obstruction. The church was immediately closed from the public by the churchwardens at the wish of the Medical Officer of Health, and men were engaged to throw down lime, and to remove the obstruction, so as to allow the water to flow away. The surface drain pipes were then taken away to cut off all communication with the closet, and to prevent a recurrence of the nuisance. The 19 saturated earth was ordered to be taken away and replaced by brick rubbish, to be covered with charcoal. Two additional ventilators were made, one at either end of the church, and the walls of the vaults were twice limewhited. Hindon Street, No. 8. Bad smell caused by a leakage of water from the supply pipe to the cistern in the adjoining house. The pipe was repaired, and the nuisance abated. Stockbridge Terrace, Pimlico, No. 10. The closet choked up, arising from defective drainage, and causing a most offensive smell. The closet has been cleansed. Eaton Court, Eaton Lane North, Nos. 16 and 17. Drainage stopped, no traps to the closets, the yards flooded with sewage, and the smell most offensive. New closets have been made, and connected with the sewer by 9-inch pipe drains. Slaughter House behind No. 31, St. George's Place, Knightsbridge. Walls very dirty, which have been limewhited according to order. Slaughter House behind No. 29, Ditto. Walls very dirty, which have been limewhited. Slaughter House behind No. 23, Westboume Street. Walls very dirty, which have also been limewhited. Slaughter House behind No. 2, Queen Street, Pimlico. The walls are very dirty. The slaughter house has been limewhited. The last four cases of neglect in cleanliness occurred during the illness of the Inspector, and show the necessity of constant sanitary supervision. Victoria Road, Nos. 21 and 22. Both houses drain into a large cesspool under the pavement, which gave way on account of the rotten state of the wood covering the cesspool. It has been emptied and filled up, and the drainage of both houses properly connected with the sewer. Churton Street, No. 62. A most offensive smell, arising 20 from the gullies opposite to this house, which is frequently experienced in the street. Information was given to Mr. Richman, the Surveyor. Eaton Mews West, No. 32. No water supply, nor water closet accommodation, for the use of five inmates. Slops kept in a pail and thrown down the gullies in the Mews at night, which causes them to be offensive. The stable has been closed, and is not to be used as a dwelling. Coleshill Street, No. 62. Common privy and cesspool in the back kitchen, Bad smell from the drains, and two gullies untrapped. A notice was served on December 11th, 1858. IV. The slaughter houses in the parish, of which there are 15 in Hanover and Mayfair, and 24 in the Belgrave districts, are frequently visited by the Inspector, and once a year at the least are formally examined by ourselves, preparatory to the Petty Sessions, at which applications for licences are entertained by the magistrates, and at which we attend. The question of the entire abolition of slaughter houses from towns, and in particular from London, is one which we have carefully examined into: and as every circumstance connected with the supply and price of an article of prime necessity, like butchers' meat, is of importance to the whole community, we will venture to make a few remarks thereon. On abstract grounds, both of health and economy, no perishable matters ought to be brought into a town which will have to be carried out again as refuse, and be likely to be offensive or dangerous to health in the meanwhile. For thus the consumer has to pay double carriage, and is liable to nuisances into the bargain. As a rule, whatever is to be consumed should be brought into town, and all offal, even to pea shells, be left behind. 21 Vegetable refuse, as we know to our cost, creates trouble enough. Still more then does it seem unreasonable to bring a whole live animal into the heart of a town from a long distance, whereas only six-eighths of the animal are used as food, and the residue is a source of disgust and annoyance till it is carted away. Undoubtedly the consummation to be aimed at is, that animals should be killed in the country, fresh from pure air and wholesome food, without the loss of weight and fevered blood, caused by driving, thirst, and ill treatment on their way to a town slaughter house. The eatable parts should be sent, and the offal be left behind. But, on investigating the matter practically, we find that, under present arrangements, there is liable to be so much loss of country killed meat from putrefaction in hot weather, and consequently such uncertainty in the supply, and such an increase of price, that we are compelled for the present to acquiesce in the expediency of maintaining some slaughter houses in town. The question of the supply of meat is, as we have said, of such immense consequence in a social and political point of view, that we make no apology for introducing some of the scientific details involved therein; for it is only by public discussion that a better system can be brought about. After the death of an animal, whilst the body is cooling, there comes on the well known state of stiffness, technically called rigor mortis. This state consists in a partial solidification of matters in the flesh which were previously fluid, and is of the greatest value in hindering putrefaction, by preventing the admixture of the blood, which is alkaline, with the juice of the flesh, which is acid. This state is promoted by keeping the dead animal at perfect rest, and allowing it to become quite cold; and, so long as it lasts, putrefaction is absent. 22 But, unfortunately, meat killed in the country in summer is packed whilst warm (and the natural heat is just that degree which is most conducive to putrefaction), and is kept in constant movement till it reaches the shop of the retail butcher. Hence it cannot set, and is often tainted before unpacked, or becomes so soon afterwards. Besides, there are many details in the killing and preparation of meat which ought to be attended to; for instance, if the animal be not entirely and quickly drained of blood; if it be allowed to rest on its side so that the blood may stagnate; if there be any defect in cleanliness; or even if the ripe, full-fed, juicy meat be too roughly handled, decomposition is apt to begin very early and suddenly: so that a parcel of meat which arrives fresh in appearance may become tainted in a few hours. Considering then what losses the town butchers would be exposed to from the careless manufacture of meat in the country, considering moreover that all the risk of loss from putrefaction at present belongs to the retail butcher, who purchases in the wholesale market, it cannot be wondered that the town butchers should desire to keep the management of the slaughtering in their own hands; and we believe that the summary abolition of town slaughter houses might be attended with a most unpleasant rise in the price of meat. The real point to aim at, in order to procure the removal of these places from towns, is the introduction of a more careful system of killing, cooling, packing, and conveying meat from the country; and a proviso that, if the meat putrefies within a certain time after delivery in town, the loss shall fall on the vendor. At the Petty Sessions which were holden at Mount Street on the 22nd October, 1858, 36 licences were renewed, and new licences were granted to three places. The number refused was three, because they were underground, or otherwise unfit for the purpose. 23 V. Clnirch Vaults. Mr. P. H. Holland, Medical Inspector of Burial Grounds, visited the vaults beneath the churches in this parish after which Dr. Aldis reported the following result to the Vestry on December 7th, 1858, and to the Nuisances Removal Committee, December 21st, 1858 : St. Peter's Church, Eaton Square. The vaults underneath this church contain about 350 coffins, of which about 50 are uncovered; the rest are already enclosed by brickwork. It would be a prudent course to enclose all in the same manner, but Mr. Holland does not like trusting to brickwork alone, because it is difficult to get underground work done perfectly in every part, and a very small opening would allow poisonous gas to escape should a coffin burst. It would be a safer plan to embed the coffins in soil covered with charcoal, for the gas could not escape without being decomposed in passing through the porous material. Grosvenor Chapel, South Audley Street. The vault extending about half way under this chapel is so completely filled with coffins that it was quite impossible to ascertain their condition. The entrance is by an open gate, which could not prevent the escape of foul air. Should any of the coffins burst, it would be almost impossible, from the close manner in which they are packed, to ascertain which had given way. The enclosed catacombs contain a great many coffins, and are situated near to the passages leading into the school. St. Mark's Church. The Rev. Mr. Eyre was present during this inspection. These vaults, which contain about 160 coffins, most of which are uncovered on the ground, but some are enclosed in cells. The Incumbent wishes to have all these coffins properly covered, for, about six years ago, one of them burst, and occasioned a very offensive smell, not only in the vault, but in the churchyard, from the ventilating openings. He thinks the coffins might be buried in the 24 ground beneath the vault floor, without danger to the building, but, if not, they might be entombed by masonry or concrete. The Vaults at Bayswater Road, Burial Grround, contain 1121 coffins piled up in tiers of six or seven. A slight unpleasant smell was not only perceptible, but also a peculiar smarting in the throat was felt; and Mr. Holland has suffered from indisposition since visiting this place. The ventilation is good, which would allow any foul gases when generated to be diffused in the surrounding air. A great number of coffins are hidden from sight, so that we were unable to see their condition. Hanover Chapel, Regent Street. The Rev, Mr. James was present during the inspection cf the vaults beneath it. They contain only 24 coffins, all but two of which are entirely uncovered. There has been no complaint; but they could easily be buried or entombed. The Medical Officers of Health agree with Mr. Holland, that it would be very desirable to enclose securely these numerous coffins, especially where their condition cannot be ascertained. Such a proceeding would afford additional security to the Public health, and protect the remains from the chance of desecration. It is also most desirable to prevent the removal of the coffins, which can be effected by either burying them, or entombing them with substantial brick-work. VI. An analysis of the water of the Chelsea Company, taken from the main in Chapel Street, Belgrave Square, October 19th, 1858, produced of: Grs. Total Impurity 17.52 Organic ditto 1.76 Nov. 3, 1858. Total Impurity 17.72 Organic ditto 1.72 25 Dcc. 15,1858. Total Impurity 18.24 Organic ditto 1.12 * We have the honour to be Your faithful Servants, C. J. B. Aldis, M.D. R. Druitt. January 1st, 1859. 26 APPENDIX. On the Gas supplied by the Chartered and London Companies. The result of experiments made between the 21st October and the 31st December, 1858, on the gas supplied by the Chartered Company, to the Work House in Mount Street is, that a batswing burner, consuming 2.5 feet per hour, gave a light equal, on the average, to that of 14 sperm candles, burning 120 grains per hour; and that no sulphuretted hydrogen was detected in the gas. The result of experiments made between the 27th of October, 1858, and the 4th of January, 1859, on the gas supplied by the London Company to the room in West Basin Road, Belgravia, is, that a batswing burner, consuming 2.5 feet per hour, gave a light equal, on the average, to that of 11.1 sperm candles, burning 120 grains per hour; and that no sulphuretted hydrogen was detected in the gas. TABLE OF M0RTALITY. DEATHS registered in the Parish of St. George, Hanover Square, in the 14 Weeks ending 1st of January, 1859. Average, 35. DISEASES. Ages at Death. Sub-Districts and Population. Sexes. Under 1. 1 and under 6. Total under 20. 20 and under 40 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave.—40,034. Mount-street Work.—268 Little Chelsea Work.—350. St. George's Hospital. —216. Males, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. I. Zymotic. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. 2 2 1 .. .. .. .. .. 3 .. .. .. .. .. 3 3 Scarlatina 2 16 20 .. 1 .. .. 5 1 15 .. .. .. .. 11 10 21 Diphtherite 2 4 7 2 .. .. .. 4 .. 5 .. .. .. .. 2 7 9 Whooping Cough 4 12 17 .. .. .. .. 2 2 13 .. .. .. .. 5 12 17 Croup .. 2 4 .. .. .. .. .. 2 2 .. .. .. .. 3 1 4 Thrush 1 1 2 .. .. .. .. 1 .. 1 .. .. .. .. 1 1 2 Diarrhœa 2 .. 2 .. .. 1 .. .. .. 3 .. .. .. .. 2 1 3 Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera 1 .. 1 1 .. .. .. .. .. 2 .. .. .. .. 1 1 2 Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Purpura and Scurvy .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Infantile Fever .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Typhus Fever 1 1 8 2 4 2 .. 2 .. 10 .. 1 2 1 5 11 16 Child bed Fever .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ervsipclas 1 .. 1 .. 1 1 .. .. .. 1 2 .. .. .. 2 1 3 Syphilis 1 1 2 .. .. .. .. .. .. 2 .. .. .. .. 1 l 2 Pycemia .. .. 1 1 1 .. .. .. 1 .. .. .. .. 2 3 .. 3 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. II. Cancer, Dropsy. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hæmorrhage 1 .. 1 2 .. .. .. 1 1 .. .. .. 1 .. 2 l 3 Dropsy .. .. .. 1 7 7 .. 3 2 6 I .. .. 3 9 6 15 Abscess .. .. 1 1 1 .. .. .. .. .. .. 1 .. 2 2 l 3 Ulcer .. .. .. .. 1 2 .. .. .. 2 .. .. .. 1 3 .. 3 Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mortilication .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Cancer .. .. 2 .. 5 6 .. 2 .. 7 1 .. .. 3 2 11 13 Gout .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. III. Scrofula. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scrofula 2 .. 3 3 .. 1 1 1 .. 2 .. .. 3 2 1 7 8 Mesenteric Disease 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Consumption 1 .. 5 21 25 1 1 10 6 28 1 3 .. 5 31 22 53 Water in the Head 1 7 10 .. .. .. .. 4 .. 6 .. .. .. .. 8 2 10 IV. Nervous System. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Brain .. 2 3 1 1 .. .. .. .. 3 .. .. .. 2 4 1 5 Apoplexy .. .. .. 3 4 5 1 3 1 4 1 2 .. 2 7 6 13 Paralysis .. .. .. 1 2 3 .. 1 .. 3 2 .. .. .. 1 5 6 Delirium Tremens .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chorea .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 Epilepsy .. .. .. 2 2 1 .. .. .. 1 2 .. .. 2 5 .. 5 Tetanus Disease of Spine .. 1 1 .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Insanity .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Convulsions 21 9 30 .. .. .. .. 3 2 25 .. .. .. .. 14 16 30 Disease of Brain, &c. .. .. 1 1 1 .. .. .. .. .. .. .. .. 3 1 2 3 V. Heart, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pericarditis 1 .. 1 .. 1 .. .. .. .. 1 1 .. .. .. 1 1 2 Aneurism .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 .. 1 Disease of Heart, &c. .. .. 3 3 5 4 .. 2 2 11 .. .. .. .. 7 8 15 VI. Lungs, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bronchitis 8 8 17 2 13 16 3 10 7 24 4 1 .. 5 19 32 51 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia 13 7 22 6 4 4 .. 3 3 24 2 .. 1 3 22 14 36 Asthma .. .. .. 2 1 3 1 2 1 4 .. .. .. .. 4 3 7 Disease of Lungs, &c. .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 BIRTHS registered during 14 weeks.—Hanover Square, M. 59, F. 64; May Fair, M. 39, F. 24; Belgrave, M. 227, F. 182. Total 595. Average 42.5 DISEASES. Ages at Death. Sub-districts population) Sexes. Under 1. 1 and under 5. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave.—40,034. Mouut-street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. VII. Of Stomach, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Teething 1 1 2 .. .. .. .. .. 1 1 .. .. .. .. 1 1 2 Quinsy .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Phalangitis .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Inflammation of Stomach .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 Inflammation of Bowels 1 .. 2 1 .. 1 .. 1 1 1 .. .. .. 1 .. 4 4 Inflammation of Peritonaeum .. .. .. 2 .. .. .. .. .. .. .. .. 2 .. 2 .. 2 Dropsy of Belly .. .. .. 2 .. 1 .. .. .. 2 .. .. 1 .. 2 1 3 Ulcer of Bowels .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 1 Rupture .. .. .. .. 1 1 .. 1 .. .. 1 .. .. .. 1 1 2 Ileus, Hæmatemesls .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. 1 1 Intussusception .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stricture of Bowels .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 1 Disease of Stomach .. .. .. 1 .. 1 .. 1 .. .. .. 1 .. .. .. 2 2 Disease of Umbilicus 1 .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. 1 1 Inflammation of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Jaundice .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Disease of Liver .. .. .. 1 1 2 .. .. .. 4 .. .. .. .. 2 2 4 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Ukinary, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Kidney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bright's Disease .. .. .. .. 2 1 .. .. 1 1 .. .. .. 1 2 1 3 Ischuria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Bladder .. .. .. .. 1 .. 1 .. .. .. .. .. .. 2 2 .. 2 Stricture of Urethra .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Kidneys, &c. .. .. .. .. 3 1 .. .. .. 2 .. .. 1 1 1 3 4 IX. Womb, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. 1 1 .. .. 1 .. .. .. .. .. 1 .. 2 2 Child-birth .. .. .. 2 .. .. .. 1 .. 1 .. .. .. .. .. 2 2 Disease of Uterus, &c. 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 X. Joints, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 1 Disease of Joints, &c. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 XI. Skin, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phlegmon .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. 1 Disease of Skin, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XII. Malformations. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Blue Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Malformations 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 XIII. Debility: 5 .. 5 .. l 1 .. .. 1 5 .. .. .. 1 3 4 7 Premature Birth 7 .. 7 .. .. .. .. 1 .. 6 .. .. .. .. 6 1 7 XIV. Atropuy: 5 4 9 .. .. .. .. 2 1 6 .. .. .. .. 6 3 9 XV. Age: .. .. .. .. .. 13 6 3 3 7 3 3 .. .. 5 14 19 XVI. Sudden: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVII. Violent Death: .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk 5 .. 5 .. .. .. .. .. .. 5 .. .. .. .. 2 3 5 Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. 8 8 .. 1 .. .. 2 1 .. .. .. 2 4 5 4 9 Hanging (Suicide) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suffocation 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Drowning .. .. .. .. l 1 .. 1 .. 1 .. .. .. .. .. 2 2 Fractures .. 1 1 5 2 .. .. .. .. .. .. .. 1 7 6 2 8 Wounds .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Other Violence (Concussion) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. All Violence .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVIII. Not Specified. 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 TOTAL: 93 91 218 75 100 83 14 73 41 266 23 12 15 60 239 9ri1 490 DEATHS registered during corresponding weeks of ten years (average) 416.6. Weekly average 29.75. C.J. B. ALDIS, M.D. R. DRUITT. LONDON: PRINTED BY GEORGE PIJIPP8, RANELAGH STREET, EATON square.