No. VI.] 10 HAN 9 QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY OF Saint George, Hanober Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOB THE QUARTER ENDING APRIL 2nd 1859. LONDON. TO THE Vestrg of St. George, Hanober Square. My Lords and Gentlemen, I. The number of deaths in the parish during the present quarter has been 457. In the corresponding quarter of 1858, it was 528; so that our present mortality is much lower than it was last year, and very slightly in advance of that of the preceding 10 years. From the 457 deaths, we deduct 61 of strangers, who have died in St. George's Hospital, and 8 of inmates of the Little Chelsea Workhouse; so that the net mortality is 388; whilst the births have been 607. In analyzing the causes of death, we cannot fail to remark the absence of measles, from which 32 children died in the first quarter of last year, and not one this year; and the reduction of the deaths from lung disease from 141 to 88, in consequence of the more equable temperature. Diseases affecting the throat, which at present excite a great deal of alarm in the public mind, destroyed 35 lives, of which 18 were ascribed to diphtherite, 14 to scarlet fever, and 3 to "putrid sore throat." The average number of deaths from these maladies conjointly, during the preceding five quarters, is 25. 4 Deaths from diphtherite occurred in the following houses: 16, Half-Moon Street, a girl set. 6, no cause to be traced;— 46,Green Street, a girl aged 4,who came ill from Suffolk;—16, Grosvenor Mews, a boy of 3, no cause to be traced;—299, Oxford Street, a girl æt. 4, who died on the 8th January, having been ill since her brother and sister died of the same malady in the same house in November. In this case there is no reasonable doubt that the disease was originally caused, and was kept up in the last surviving child during her six weeks' illness, by the intensely dirty and unwholesome state of the whole house, and by the entire absence of drainage. The air of the house was nauseous in the extreme ; all the workmen who were employed in emptying the cesspools, and excavating the putrid sludge which the house stood upon, were made ill, and all were affected with sore throat. In the last autumn, the Inspector, whilst superintending similar operations at No. 10, Grosvenor Mews, a house infected with scarlet fever, was suddenly smitten, as it were, by the effluvium of a cesspool, and went home, and took to his bed directly, for scarlet fever in a very severe form had seized him then and there. These are amongst the accumulating instances which show that sewer gases may be vehicles not only of typhoid fever and diarrhoea, but of scarlet fever also. In this case, at 299, Oxford Street, the house of a first-class tradesman, not of the poor and ignorant, the owner, as stated at p. 13 of our last Report, was instructed in the measures necessary for the safety of his inmates, so soon as the two children died in November; yet nothing was done, till, on the death of the third child, the Local Authority interfered for the protection of the public; and the Inspector never found a house in so unwholesome a state. If it be true, as is sometimes said, that diphtherite is more 5 fatal amongst persons of affluence than amongst the destitute (which is doubtful), it must be admitted likewise that some of the houses of persons above the reach of want, are in a state which, we are glad to say, no poor lodging house in this parish would be allowed to remain in for a single week. In the Belgrave sub-district, the houses in which diphtherite was fatal, were 13, Upper Tachbrook Street, boy of 2, son of a policeman; 6, Little Chester Street, boy of 1¼, son of a farrier; 28, Hugh Street West, girl set. 3, daughter of a carpenter; la, Hugh Street West, daughter of a baker, set. 4, and another daughter set. 7; 32, Hindon Street, daughter of a carpenter, set. 3; St. George's Hospital, daughter of an Inspector of Chelsea Water Works, set. 8, from Sloane Street; 13, West Street, daughter of a musician, set. 4; 62, Westbourne Street, daughter of a messenger to Board of Trade, set. 4; 22, Shaftesbury Crescent, a female, no occupation, set. 32; 22, Hindon Place, daughter of a journeyman carpenter, set. 2; 22, Graham Street, son of a clerk, set. 2; also the wife set. 35 ; 62, Warwick Street, daughter of a gentleman, set. 4. One of the cases was fatal in 24 hours; another, as we have before said, lingered for six weeks. We have given these details at length, in order to show exactly the places, the ages, and the condition in life, of the victims, and to correct any exaggerated fears that may prevail. The 18 lives which this new form of disease has taken from us, demand that all possible enquiry should be made into causes, and every care taken in prevention; and the fact that more than one case occurs at the same time in one house, points evidently to local causes as inviting or bringing the malady. But the disease is by no means generally diffused; and no case of it has been yet entered 6 on the books of the Branch dispensary, 48, Mount Street, at •which two-thirds of the poor in the In-wards apply for medical relief. Sore throats there have been in abundance; but not one case that could fairly be called diphtherite. Fever, in its varieties, infantile and typhoid, destroyed 9 persons; one a healthy child at 23, Grosvenor Market. This house was constructed in the way most favourable for generating disease, but now will be remodelled entirely. Small-pox destroyed one child at a month old. This is under the age at which vaccination is usually performed; but the case shows, that in quarters where the disease prevails, the operation should not be postponed. Diseases of Degeneration, including scrofula, consumption, teething, water in the head, and children's fits, destroyed 98 lives; besides that, 22 more were lost in consequence of premature births, atrophy, and malformation. Tetanus or Lock Jaw was fatal in three cases. One, of a poor boy in the Hanover sub-district, who injured his foot: and two cases of gentlemen in the Belgrave subdistrict, after operations for the removal of tumors. In the last division, we find three victims of misfortune or carelessness, in the case of three infants smothered in bed; and three victims of something worse: one infant found in Hyde Park, one in Grosvenor Place, and one in a cupboard in Mount Street. H. The number of cases of sickness amongst the classes who avail themselves of the medical charities in the InWards, was 964 this quarter, against 856 in the last. Of these, 173, or rather less than one-sixth of the whole, were cases of bronchitis; 24 of diarrhoea; 27 of sore throat; 1 7 of diphtherite; 37 of fever, including some very mild cases; 3 of measles; and 7 of scarlatina. The illness for the most part was not severe, and the excess over the last quarter chiefly due to the increase of bronchitis and catarrh. Continuing the plan adopted in previous Reports, we present the number of cases which were furnished by each of the following thickly peopled quarters. Deaths of children Deaths of adults Population. Total parish patients Model Lodgings 130 10 0 0 Bloomfield Buildings 130 21 0 0 Brick Street 296 9 0 0 Brown Street 200 46 0 2 Carrington Street 280 21 2 0 George Street, Grosvenor Square 540 42 1 0 Grosvenor Market 211 7 11 Grosvenor Mews 944 57 1 2 Hertford Place 200 23 1 0 John's Court, Farm Street 80 25 0 0 May's Buildings 122 12 0 0 Mount Row and Place 133 17 1 0 North Bruton Mews 154 18 0 1 Street's Buildings 79 2 0 0 Queen Street 316 10 1 1 Robert Street, Grosvenor Square 543 35 3 1 Thomas Street 600 62 4.0 In the Belgrave sub-district, 5,988 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, 3,441 were patients at St. George's Hospital, leaving a remainder of 2,547. Among the zymotic diseases, 3 were cases of small-pox, 11 of chicken-pox, 3 of measles, 22 of scarlatina, 31 of whooping cough, 93 of diarrhoea, 2 of dysentery, 5 of ague, 8 47 of continued fever, 48 of rheumatic fever, 13 of erysipelas, and 8 of diphtherite. There were also 483 cases of bronchitis, and 19 of pneumonia. Small-pox. — This complaint has occurred in several houses from some of which sanitary evils have been removed. It happened in a mild form, and mostly among unvaccinated persons. A threat of taking proceedings in cases of neglected vaccination, has had a salutary effect upon the parents, who have immediately had the operation performed upon their other children. It is gratifying to notice the sanitary improvements which are now being made at St. George's Hospital. It appears that there are 48 nurses to be accommodated, viz., 17 head nurses, 19 assistant nurses, 11 night nurses, and the superintendent of the night nurses, who is now obliged to live elsewhere, for want of room in the hospital. This number sleep in 21 rooms; these rooms vary from 6 feet to 7 feet 8 inches in height, giving an average height of only 7 feet 1 inch. The cubic space for each nurse averages 657 feet only, viz., from 487 feet to 915 feet. Of these rooms 8 only have chimneys; 3 have chimneys, but not grates; and 13 have no chimneys at all. Two rooms, in which 8 nurses sleep, situate in the centre of the hospital, have no fire places or external windows, the only access for light and air being two openings into a staircase; consequently, these 8 women are constantly sleeping in an hospital atmosphere, and are themselves tainting this atmosphere. Some of the rooms are only lighted by skylights or borrowed lights, and through some of them, small and ill-ventilated as they are, the pipes containing hot water for warming the hospital pass. The water-closets were badly placed, having no communication with the exterior of the building. All these evils are now being remedied. 9 III. In the next place, we give the details of the various cases in which the Local Authority has been called upon to interfere, either by ourselves, or in consequence of the complaints of any of the ratepayers. Upper Brook Street, No. 56. During the repair of the sewer in this street, the bottom of which has been made new, and during the removal of the sediment, the water in the pump of this house became turbid, and was offensive. This is one instance more of the unsafeness of the surface wells. Shepherd's Court, Upper Brook Street, No. 1, was reported as very dirty and dilapidated; the kitchen occupied by four persons, and the old house drain broken in, and yielding a stream of offensive effluvia just outside the window. After very troublesome correspondence and visits to the agents and attornies in the city, nothing was done, till a summons was taken out, to which the solicitor to the owner appeared on 1st February, 1859, at Marlborough Street, and gave an undertaking to execute the necessary works, which have since been completed satisfactorily. Berkeley Street, Piccadilly, No. 5. This is an instance of the misery that may be occasioned to the occupants of even first-class houses, from slovenly and unworkman-like drainage arrangements on the part of their neighbours, and from that strange ignorance or indifference as to the poisonous properties of sewer gases, which allows people to fancy that they may cause their fellow-creatures to breathe these offensive compounds day after day, and yet do them no real injury. When some stables were built and new water-closets constructed in Dover Yard a few years since, the water-closet drainage, instead of being conveyed into the public sewer by proper pipes, was turned into ah old, jointed, cast-iron rainwater pipe, which ran down in a chase or groove within 10 the back wall of No. 5, Berkeley Street, and thence into a common brick rain-water channel, in close contiguity with the walls of No. 5 and No. 7. After a time the joints of the iron pipe became defective, and effluvia escaped from them through the thin cracked old wall into the apartments of No. 5. Moreover, the old brick drain became saturated with sewage matter, which penetrated the wall of No. 7, causing intense annoyance and severe illness. Complaint was made to the Local Authority, and much time was expended in ascertaining the real facts of the case, and in endeavouring to persuade the owner of the stable to remove the offending pipe; but at last it became evident that no good would be done by private remonstrance, for the owners of the stable alleged, either that there was no nuisance, or that, if there was a nuisance, it was probably caused by something wrong on the premises of the complainant himself; or thirdly, that whether this were the case or no, the wall containing the pipe was their own property, and they had a right to do as they liked with it. Then the Local Authority gave directions that the case should be brought before the magistrate at Marlborough Street. It was accordingly heard on the 18th February; when, after a hard fight, the magistrate persuaded the defendant to submit to his decision, after he should have viewed the premises. Mr. Bingham accordingly inspected them on the 21st of February, and the result was an order, confirming altogether the decision of the Local Authority, and requiring that the pipe and drain complained of should be absolutely removed, and that a new drainage should be provided. Mr. Bingham very justly remarked on the benefits of the new law, whereby any person aggrieved in the manner in which the complainants in this case were, may be saved the expense of an action in one of the Superior Courts, 11 and the trouble of bringing an array of witnesses, and the defendant be saved heavy expenses also, by the intervention of the Local Authority; who, having satisfied themselves that there are just grounds of complaint, appear as prosecutors, and obtain a decision from the magistrate, which is quite as likely to be satisfactory to all parties as the verdict of a jury would be. . G-rosvenor Marlcet, No. 24. Here a horse was kept in the back parlour, to the great annoyance of the inmates of No. 23. It was not the case of human beings living in or near a stable, but of a horse being brought into a human habitation, which was never intended for such an inmate. Therefore the Local Authority caused a notice to be served, requiring the animal to be removed, which has been attended to. Gilbert Street, No. 35. Here there occurred a case of diphtherite, which was not fatal; but inasmuch as the house contained nine families and 42 persons, it appeared desirable to take every precaution against the spread of the disease. This was effected by cleansing and limewhiting; moreover, it was found that the drains of the house were not perfect; and there were crevices in the wall close to the sleeping place of the sick child, which allowed effluvia to enter from the dust-bin of the adjoining premises in Robert Street. Dover Yard, No. 9. A stable in which cases of scarlet fever occurred ; and some defects in drainage and cleanliness rectified. North Bruton Mews, No. 18. Here the apartments, in which one or two mild cases of diptherite occurred, were limewhited, and some improvements in ventilation effected. This house is so large, old, densely peopled, and sickly, that it requires inspection regularly. 12 Hart Street, No. 17. Cases of scarlet fever. The rooms emptied and cleansed. Thomas Street, Nos. 36, 37, & 38. Here there were cases of scarlet fever and malignant sore throat, in consequence of which the owners were called on to cleanse the apartments. North Row, No. 4. Scarlet fever. The apartments cleansed. . Hertford Place, No. 4. A child from this house died in St. George's Hospital of scarlet fever; and the owner was called on to cleanse the apartments. Davies Mews, No. 9a. A case of fever occurred in this very badly ventilated and offensive house, inhabited by Irish people. The owner has been obliged to cleanse it, and lay on a supply of water. North Bruton Mews, No. 23a. A nuisance from obstructed drainage. George Street, Oxford Street, No. 19. The same from a leakage of water. King Street, Park Street, No. 17. The same. Grosvenor Mews, No. 30a. The same. Oxford Street, No. 309a. The same. Reeve's Mews, No. 38. A stable undrained, with a large cesspool, which leaked into No. 26, Park Street, adjoining. Hayes' Mews, No. 27a. An undrained stable, with cesspools, which were emptied into the mews, to the great annoyance of the neighbours. Davies Street, No. 13. Mear's Livery Stables. A nuisance caused by misconduct on the part of the inhabitants of a public house adjoining. Albemarle Street, No. 38. A nuisance arising from leakage of water. 13 Weaver's Place, North Row, No. 2. A decayed and offensive state of the drains. Norfolk Street, No. 17. A nuisance occasioned by leakage from the drains of the next house. Cowley's Yard, White Horse Street. Leakage of water caused by the carelessness of neighbours. In each of the foregoing twelve cases, various nuisances detrimental to the health and comfort of the complainants, have been speedily and effectually remedied by the intervention of the Local Authority and agency of the Inspector, without legal proceedings and expense. Grosvenor Street, Nos. 64 and 65, and Little Grosvenor Street, No 12. In this case too, a most complicated cause of nuisance has been rectified by the same means. Under the party wall, separating No. 64 from No. 65, was an old well, which in bygone times supplied the neighbouring houses with water, but which had long been disused for that purpose. When the wall was built, the well was not filled up, but arched over, and left to itself. In process of time, the drains of No. 64 (which also conveyed the drainage of a house behind it, No. 12, Little Grosvenor Street,) became dilapidated, and the sewage water filled up the old well. Then, forasmuch as the basement of No. 65 had been excavated to a lower level than that of its neighbours, it became wet with the overflow of the well. A great deal of time was expended in ascertaining all these facts; and in bringing the several parties concerned to an arrangement for filling up the old well, and putting a new pipe drainage to No. 64 and to 12, Little Grosvenor Street. Stafford Street, No. 5. This house, formerly without any outlet for its sewage, except the earth, and the adjoining wine-cellars, is now thoroughly drained; and the saturated earth has been sweetened with quicklime. 14 Effluvia from the Ranelagh Sewer. In the beginning of March, the inhabitants of that part of our parish which is situated in the Uxbridge Road, were very much annoyed by most disgusting effluvia from the Ranelagh sewer. Some of the neighbouring streets were annoyed in the same manner. The smell was excessively bad, and resembled that of the Thames last summer. Whether it were owing to a current of. air blowing up from the Thames, or to the disturbance of deposit by flushing, in some of the branches of this sewer, is uncertain; but it is to be regretted that certain doubtful legal and technical questions rendered it impossible for the Vestry of St. George, Hanover Square, to interfere. North Bruton Mews, No. 2. This house was becoming unhealthy again; but the owner was persuaded to cleanse it partially. The wooden sheds round the yard, over the wash-house and dust-bin, are really not fit for human habitation. Lancashire Court, No. 3. This house is dark, dilapidated, and ill-smelling, and crowded with Irish inhabitants, who almost defy the efforts of the owner to preserve anything like cleanliness. The number of inhabitants has been somewhat reduced, and part of the house cleansed; but it is a place in which it is impossible for human beings to be reared healthily. Ranelagh Place, No. 12. There was a complaint of no ash-pit, with decomposing house refuse, which caused an offensive smell, and has been removed. Factory, Newman's Yard, Brewer Street, Pimlico. Leakage of water into the above place from Mr. Hatt's cow-yard, adjoining premises. The parting wall has been cemented, and nuisance abated. Berwick Street, No. 28. Bad smell from the defective state of the drains, and no water supply to the closet. The drain has been trapped and water supplied. 15 St. George's Row, No. 7. Drain from the sink stopped up. A notice was served on January 12th, and the drains have been cleansed. Upper Denbigh Mews, Denbigh Street. No water-closet accommodation for the use of four persons. The offensive matter is thrown on the dung-heap and down the gulley in the mews. A notice was served on December 31st; new water-closets have been erected, and the whole of the stable drains properly cleansed. Gloucester Street, Pimlico, No. 9. A most offensive smell in the lower part of the house, caused by the defective state of the bell traps, which were attended to. Gloucester Terrace, St. George's Road, Pimlico, No. 32. The drains from the closet in the back kitchen are choked up, and sewage escapes through the gully underneath the sink. It appeared, on examination, that only water had passed underneath the trap, which was placed so low as not to allow the passage of any solid matter. No solid sewage had passed into the sewer since the house had been occupied. The drains were cleansed and trap altered. Hindon Place, Hindon Street, No. 9. A nuisance existed here from the defective state of the drains in No. 2, situate at the rear of No. 9. No. 2 has been cleansed, limewhited, and drained by a 6-inch pipe drain into the sewer. Hindon Street, Pimlico, No. 13. Dampness in the kitchen, caused by the defective state of the drains. The premises have been drained by 9-inch pipe drains into the sewer. Eccleston Place, Pimlico, No. 35. The closet and drains are choked up. The drains have been cleansed. 16 Upper Eaton Street, No. 30. The drains are obstructed, and the offensive matter is oozing up through the gully in the yard, and the smell is offensive. The drains have been cleansed into the sewer, and the nuisance abated. Eaton Lane North, Nos. 20 and 21. The drains are obstructed, and the offensive matter is rising up through the gully in the back yard. The work is finished. Waste Ground, Belgrave Road, between Charlwood Street and Moreton Street, behind Tachbrook Street. A quantity of decomposing refuse thrown over the walls from the houses in Tachbrook Street. The refuse has been removed. Upper Ebury Street, Nos. 37 and 38. No covers to the ash-pits. Notices were served on January 12th, and the dust-pits have been covered. Minera Street, No. 1. Here there was no cover to the ash-pit, and no water to the closet, which caused an offensive smell. The water has been supplied to the closet, and the ash-pit covered. Berwick Street, Pimlico, Nos. 1, 2, 3, 4, 5, 6, 7, and 8. The occupiers complained of bad smells, arising from common privies and cesspools which belong to each house. The cesspools were required to be emptied and filled up privies panned, trapped, and water laid on properly; the old brick drains through each house to be cleansed and repaired, or broken up, and new 6-inch pipe drains laid down, and the inlets trapped. A notice was served on January 22nd, and the work is in progress. The drains were choked, and a large cesspool was found in the front area, into which offensive matter oozed through the gully. An old brick drain was broken up, a large cesspool in the 17 front area emptied and filled up, and the premises were properly drained by a 6-inch pipe drain into the sewer, and the inlets trapped. Flask Lane, No. 5. The front kitchen very dirty, and contained the body of a child which had died from scarlatina, and two others were sickening. The kitchen was 12 feet in length, 11 feet wide, and 7 feet high. The cubic capacity was diminished by a mangle and large bedstead ; and the rent of this miserable hole was 2s. 6d. weekly. The kitchen is obviously too small to accommodate a family, and should never be let off to more than a man and his wife. On applying to the landlord, he permitted the family to remove to the back parlour, while the kitchen was being cleansed and limewhited. The father and one of the children in the front parlour were attacked with diphtheria, shortly after the mother had been confined. The front room, on the first floor, although small, was used as a school, and sometimes contained as many as 30 or 40 children. Dr. Aldis directed the school to be closed for the present. Eaton Row, No. 7. This stable was drained only into the dung-pit, and required to be drained into the sewer. There was a case of fever, and two children had already died within three weeks. Seven in family slept there, and the rooms not being suitable for a dwelling, the occupiers have been requested by the master to quit the premises. A notice was served, and the stable has been properly drained by a 6-inch pipe drain into the sewer in Eaton Row. b 18 Charlwood Street, No. 70. The drains were obstructed, and the offensive matter escaped through the gullies into the area and kitchens, causing a most offensive smell. A notice was served on February 2nd, and the drains have since been properly cleansed into the sewer. The stoppage occurred in the syphon trap. Trellick Terrace, Vauxhall Road, No. 2. A nuisance arising from dampness, which was remedied. A notice was served; the work has been completed. Ebury Street, No. 61. The drains are choked, and the soil is oozing up through the gullies. This nuisance has been remedied. Caledonia Street, Grosvenor Road, Nos. 3, 4, and 5. The drains are choked up and the soil is oozing through the gullies, and the areas are flooded with sewage. The sewer has been cleansed throughout. Flash Lane, No. 6. The front kitchen of this house was overcrowded, from its being occupied by a man, his wife, and six children, while the dimensions were only 12 feet long, 11 feet wide, and 7 feet high. A notice was sent on February 16th, under the 29th section of the Nuisance Removal Act, since when the family has been removed. The power given to any Medical Officer of Health to prevent overcrowding in such a case as the present, and particularly in that previously mentioned, is of the utmost importance for nipping disease in the bud, and thus preventing its extension. For fever and overcrowding were festering together, which, by prompt interference, have been suppressed. Such places are the feeders of our hospitals and workhouses. Westbourne Street, Pimlico, Nos. 32, 33, and 34. The 19 drainage is in a defective state, and the smell most offensive in No. 33, from the drainage of the other two houses passing through it. The drain is constructed of brick, and infested with rats. New pipe drains have been laid down. Cambridge Street, Pimlico, No. 21. The drains were choked throughout the house, and offensive matter oozed ' through the gullies. A notice was served on February 17th, since when the drains have been properly cleansed into the sewer, and the nuisance abated. Chesliam Place, No. 24. A bad smell from the drawing room, supposed to come from the drains, which were tested, and proved to be in perfect order. The distemper on the walls was also suspected to have caused the nuisance ; ventilators were recommended to be fixed to allow the admission of air under the floor. St. George's Row, No. 30. The drains were choked up, the pan of the closet broken, no dust-pit, no cover to the water-butt, smell most offensive. A notice was served on March 18th. A new watercloset has been erected, also a dust-pit, and the gully has been trapped. Princes Row, Pimlico, No. 9. Bad smell, caused by the defective state of the drains, which are constructed of bricks, and full of rat holes. A notice was served on March 17th, since when the drains have deen cleansed and repaired, and the nuisance abated. Upper Belgrave Terrace, No. 10. Two large cesspools, one in the front area, the other in the back yard, and the house without drainage. The cesspools have been emptied and filled up, and the premises drained by 6-inch pipe drains into the sewer. Bloomfield Place, Pimlico, Nos. 7 and 8. These premises 20 are used for Orphan Schools. Scarlet fever having occurred in them at different times, the rooms were measured by the Inspector at the wish of the Medical Officer, who recommended a reduction of the number of children sleeping in certain bed chambers, and Arnott's ventilators to be introduced in the flues. The rooms have been limewhited, and the ventilators will be introduced; the infected children were removed to St. George's Hospital. Flask Lane, No. 8. Drains choked up, no cover to the dust-pit, gully untrapped, and no water to the closet. A notice was served on March 18th. The drains have been cleansed, and water laid on to the closet. Mr. Hatt's Cow-yard, Ebury Street. A complaint was made of manure being carted on to his premises; the manure was removed. Wilton Road, No. 3. This place was a perfect den. The water-closet situate under the staircase, and close to the street door, smelt most offensively, and was in too disgusting a state to be described. The room above, occupied by a man, his wife, and two children, measured only 6 feet in width, and, although sufficiently long, still its cubic capacity was much diminished by the presence of a mangle. It was very dirty, smelt offensively, and the ceiling in a very dilapidated state, allowing the rain to enter. The house was shut up, and not allowed to be used as a dwelling. Mr. Watling's Yard, Charlotte Street, Pimlico. A quantity of dung and garbage mixed with it. The nuisance has been removed. Grosvenor Cottages, Eaton Terrace, No. 2. No drainage to the house. Common privy, with a large cesspool under it, and the smell most offensive. A notice was served on March 21 25 th. The cesspool was filled up, and the premises properlydrained. Ebury Street, Nos. 8 and 9. Drainage in a defective state, a cesspool in the area of No. 8, and a most offensive smell in No. 9. The work is finished. Chapel Street, Belgrave Square, No. 10. Drainage in a defective state, and the drain of No. 9 passes into that of No. 10, which is objected to. The drain of No. 10 is in a very dilapidated condition, and that leading from No. 9 is very defective. Each house has been properly drained by 6-inch pipe drains into the sewer. Hugh Street, Pimlico, Nos. 38 and 39. Common privies, and no covers to the ash-pits. A notice was served on April 5th. Middleton,s Cottages, Ranelagh Road. Bad smell from the closets, caused by the neglected state of the pans, three in number, and two gullies out of repair. The Inspector saw the landlord, who said he would do anything that was required. General London Omnibus Yard, Eccleston Place. A complaint having been made of a bad smell from this yard, it was visited by the Inspector and myself; but we found the place clean, and well ventilated. Bridge Row, Pimlico, No. 1. Rooms in the third floor dirty, staircase dark and badly ventilated, and no trap to the gully-hole. Notice served, and work finished. Brewer Street, No. 22. A female afflicted with small-pox in the second floor; bad smell from the drains, no trap to the gully in the back yard, no cover to the dust-pit. Notice served. Small-pox also appeared at No. 9, Allington Street, and 3, Wilton Terrace, which were visited, but sanitary measures were required only in the former. 22 Chilly opposite to No. 9, Robert Street, Commercial Road, Pimlico. Smell offensive; information given to the Clerk of the Works. Little Chester Street, Belgrave Square, Nos. 15, 16, and 17. Drains full of offensive matter, and only one outlet for the three houses. It was recommended that the drains be cleansed, and pipes laid down, to which the owners consented. A new closet has been constructed, and pipe drains laid down. The Old Chelsea Water Works Public House, Upper Belgrave Terrace. The cellar is flooded with sewage, in consequence of a piece of wood in the outlet preventing the action of the trap. The wood was removed, and the trap put in working condition. Upper Belgrave Terrace, Pimlico, No. 1. A most offensive smell in the corner part of the house, from the neglected state of the closet in the yard, an untrapped gully, and the imperfect mode of cementing the joints of the drain pipes. The staircase is badly ventilated, and requires a skylight that can open and shut. A notice has been served. The drains have been taken up and relaid. Queen Street, Pimlico, No. 46. Bad smell in the basement, and offensive matter oozing up through the gully from a cesspool, about 8 feet deep, and 4 feet wide, completely filled. A notice was served on February 19th; and the cesspool has been emptied, and filled up, and the kitchen sink drained into the sewer. Westbourne Street, No. 54. No water to the closets, nor trap to the gully in the front area, nor cover to ash-pit. The owner has promised to do all that might be requisite. Queen Street, No. 40. Bad smell from the closet in the 23 yard. This house was properly drained by 6-inch pipe drains into the sewer, a new water-closet was properly erected, trapped, and cistern put over the closet, almost nine months ago. The smell complained of is caused by the neglected state of the closet and the back yard. The back yard and lower part of the house have been limewhited. Pembroke Place, Vauxhall Bridge Road, Nos. 22 and 23. The basements are flooded with stagnant water, 6 inches in depth, and smell offensively. A notice was served on March 4th, and the drains have been cleansed. Warwick Street, Pimlico, No. 15. The drainage through the house is choked up, which is caused by the defective state of the drains at No. 14, adjoining premises, the drains of the two houses being connected. No. 15 has been drained, and the drains of No. 14 cleansed. Sadler's Yard, Ranelagh Road. This place was visited on Friday, February 4th, in consequence of a complaint of a nuisance arising from dust. The open space was filled with an immense quantity of house refuse, containing vegetable matter, which men were engaged in sifting. In fact, the spot was converted into a large lay stall, containing all the house refuse brought from the houses in South Belgravia, but the yard has only been lately used for such a purpose. A notice was served, and several hundred loads of refuse have been removed. An analysis of the Chelsea water taken from the main in Chapel Street, Belgrave Square, January 19th, 1859, produced of: Grs. Total Impurity 20.42 Organic ditto 1.6 24 Ditto from the main at 43, Lower Belgrave Place, February 8th, 1859: Grs. Total Impurity 17.20 Organic ditto 1.80 March 10,1859. Total Residue 18.64 Organic Matter 1.12 We have the honour to be Your faithful Servants, C. J. B. Aldis, M.D. R. Druitt. 25 Annual Report of Births, Deaths, Vaccinations, and Sanitary Improvements, from March 27th, 1858, to April 2nd, 1859. (Fifty-three weeks.) Births. The number of births in the whole parish was 2,288, or 43.1 per week. In the preceding year, 2,165, or 41.6 per week. In the Hanover and May Fair Sub-districts 705 births against 660 last year; in the Belgrave 1,583 against 1,505. Deaths. Gross number of deaths 1,838, (in 53 weeks,) or 34.7 per week; against 1,768 or 34 per week last year. District Mortality. The deaths of non-parishioners in St. George's Hospital were 251 against 255 last year; of parishioners 63 against 56. In Mount Street Workhouse, 75 against 88; in Little Chelsea, 33 against 41; in the Serpentine and Hyde Park, 8 against 15. In the Hanover and May Fair Sub-districts the gross total of deaths during the last three years respectively has been 560, 605, and 543; the weekly averages being 10.76, 11.63, and 10.26. In the aristocratic and first-class business streets of these Sub-districts, whose population in 1851 was, in round numbers, 20,000, the deaths in these three years were 216, 209, and 192; or at the rate of 10.8, 1045, and 9.4 per 1,000 per annum (due correction being made for the odd number of weeks). * This is artificially low, in consequence of servants and apprentices being sent home or to hospitals when very ill; and of families going to the country. 26 In the third-class and poor streets and mews, whose population in 1857 was, in round numbers, 13,000, the deaths in the last three years were 251, 293, and 269; or at the rate of 19.3, 22.4, 20.3 per 1,000 per annum; exclusive of deaths in hospitals and workhouses. If we take the purely aristocratic streets, Berkeley Square, Grosvenor Square, Upper Brook Street, Upper Grosvenor Street, Park Lane, Hill Street, and Norfolk Street, with a population of 2,600, the deaths in the three years were 45, and of these 3 of persons under 20. Take another cluster of streets, including New and Old Bond Street, Oxford Street, (south side of, from Park Lane to Regent Circus,) Maddox Street, and North Audley Street, with a population of 3,158, the deaths were 119, of which 31 were of persons under 20. Take another cluster, including Brick Street, Brown Street, Gilbert Street, George Street, Oxford Street, Hart Street, Robert Street, South Molton Street, Thomas Street, Union Street, and Woodstock Street, with a population of 4,413, the deaths in three years were 298, of which 151 were of persons under 20. In the Belgrave Sub-district the deaths at home were 948, weekly average 17.8, against 813, weekly average 15.3 last year. We do not know the exact population of this Subdistrict, but assume that it has increased from 40,034 in 1851, to 48,383. If then we take the deaths at home, 948, those in the hospital 53, and in the Little Chelsea Workhouse 33, making 1,034, the mortality is at the rate of 20.9 per 1,000 per year of 52 weeks; whereas, if we calculate the mortality of the older Sub-districts in the most unfavorable manner, giving them the entire mortality of the 27 workhouse in Mount Street, and supposing the population quite stationary, (which it is not,) the deaths amount to only 16.6 per 1,000 per annum. We thus see that Belgravia, as a whole, has a death rate equal to that of the poorer parts of the Hanover and May Fair Districts, as a whole. This we explain, not so much by the lower level, the contiguity of the Thames, and the daily obstruction of the sewers for three hours at high water, as by the existence of numerous poor streets, swarming with children, in which the mortality is equal to that of the very worst parts of the Hanover and May Fair districts: such as Robert Street, Grosvenor Square, where the mortality is 30 per 1,000. As we proceed in getting rid of causes of disease, the mortality will decrease in Belgravia, as it has in the older parts already. Causes of Death. There have been 845 deaths from zymotic disease this year, against 343 last year; 54 from scarlatina, 47 from diphtherite, and 8 from quinsy, altogether 109, from these throat diseases, against 75 last year; 57 from fevers, against 59 last year; 48 from diarrhoea, dysentery, and cholera, against 76 last year; and 395 from diseases of degeneration, including teething, convulsions, consumption, and the scrofulous class, against 346 last year. Vaccinations. There were 4 deaths from small-pox, none last year ; and 1,025 children vaccinated by Mr. Jay and Mr. Jorden, the district vaccinators, against 782 last year. Be it remembered, that the Vaccination Act is a dead letter, so far as regards the registration of every vaccinated child. Our greatest trouble in this matter is the immigration of persons, who bring unvaccinated children, and the small-pox with them. 28 Sanitary Improvement. Mr. Grant, the Inspector, has reported 425 cases of nuisance, on most of which we have reported specially, and the whole of which have been remedied, with the exception of 26 now in progress. Notices served, 114. Summonses before magistrates, 8. Our quarterly Report will show our supervision of different trades: cowhouses, slaughter-houses, marine store dealers, and the like. \ 29 APPENDIX. An examination of the Gas supplied to the Workhouse in Mount Street, at sundry times during the first quarter of 1859, showed its illuminating power to be such that, burned with a batswing burner, at the rate of 2.5 feet per hour, it yielded a light equal to that of 13.8 sperm candles, burning at the rate of 120 grains per hour. No sulphuretted hydrogen was detected during the quarter. The result of experiments made between January 14th, 1859, and March 31st, 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 11.89 sperm candles burning 120 grains per hour; and that no sulphuretted hydrogen was detected in the Gas. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 2nd of April, 1859. Average, 35.1. 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. ftO and above. Hanover Square.—20,216. May Fair.—12,980. Belgrave.—40,034. j Mount-street Work.—268 J Little Chelsea Work.—350. St. George's Hospital. —216. Males, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. I. Zymotic. Small-pox 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlatina 1 13 14 .. .. .. .. 5 .. 8 .. .. 1 .. 5 9 14 Diphtherite 1 13 16 2 .. .. .. 3 1 13 .. .. .. 1 6 12 18 Putrid Sore Throat .. 1 3 .. .. .. .. 2 .. 1 .. .. .. .. .. 3 3 Whooping Cough 5 13 18 .. .. .. .. 2 .. 16 .. ...... .. .. 9 9 18 Croup .. 4 4 .. .. .. .. .. 1 2 .. .. .. 1 3 1 4 Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Dysentery .. .. .. 1 1 1 .. 2 .. 1 .. .. .. .. 3 .. 3 Cholera .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Infantile Fever .. 2 2 .. .. .. .. .. 1 1 .. .. .. .. .. 2 2 Typhus Fever .. 1 6 .. 1 .. .. 1 .. 4 .. .. 1 1 4 136 7 Child-bed Fever .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 1 Rheumatic Fever .. .. .. 2 2 .. .. .. .. 3 .. .. .. 1 2 2 4 Erysipelas .. .. 1 .. 3 1 1 .. 1 1 .. .. 1 3 4 2 6 Syphilis 2 .. 2 .. .. .. .. 1 .. 1 .. .. .. .. 2 .. 2 Canker .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. II. Cancer, Dropsy. Hæmorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dropsy .. 1 1 .. 3 .. .. 2 .. 1 .. .. 1 2 2 4 Abscess .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ulcer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mortification .. .. .. .. 2 .. .. .. .. .. .. .. .. 2 1 1 2 Cancer .. .. .. 1 1 2 .. 1 1 1 .. .. .. 1 .. 4 4 Gout .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 III. Scrofula. Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mesenteric Disease 4 4 8 .. .. 2 .. 3 .. 3 2 2 .. .. 8 2 10 Consumption 1 1 5 27 17 3 .. 11 3 26 4 .. .. 8 34 18 52 Water in the Head 2 8 10 .. .. .. .. 1 2 7 .. .. .. .. 5 5 10 IV. Nervous System. Inflammation of Brain . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Apoplexy .. .. .. 1 4 1 .. .. 1 4 .. .. 1 .. 2 4 6 Paralysis .. 1 1 .. 2 8 .. .. 2 9 .. .. .. .. 7 4 11 Delirium Tremens .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 .. 1 Chorea .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 Epilepsy .. .. 1 1 2 .. .. .. 1 1 1 .. .. 1 4 .. 4 Tetanus .. .. 1 1 1 .. .. .. .. 2 1 .. .. .. 3 .. 3 Disease of Spine .. .. .. .. 2 .. .. .. .. 1 .. .. .. 1 1 1 2 Convulsions 11 4 15 1 .. .. .. 3 2 9 2 .. .. .. 9 7 16 Disease of Brain, &c. 1 .. 3 2 2 2 .. 1 1 4 1 .. l 1 3 6 9 V. Heart, &c. Pericarditis .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 Aneurism .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 1 .. 1 Disease of Heart, &c. .. .. 4 3 4 7 .. 3 2 8 .. 1 1 3 7 11 18 VI. Lungs, &c. Laryngitis 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Bronchitis 10 8 19 1 14 26 3 10 6 36 6 3 1 1 31 32 63 Pleurisy .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 Pnemonia 7 3 10 4 3 3 .. 1 1 14 1 .. 1 2 7 13 20 Asthma .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Lungs, &c. 2 1 3 .. .. .. .. .. 1 2 .. .. .. .. 2 1 3 BIRTHS registered during 13 weeks.—Hanover Square, M. 56, F. 56; May Fair, M. 33, F. 36; Belgrave, M. 212, F. 214. Total 607 Average . . 46.6 DISEASES. Ages at Death. Sub-districts & population Sexes. 1 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 4 6 10 .. .. .. .. .. .. 10 .. .. .. .. 7 3 10 Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pharingitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Stomach .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 .. 1 Inflammation of Bowels .. .. 1 .. 1 .. .. 1 .. 1 .. .. .. .. l 1 2 Inflammation of Peritonaeum .. .. .. 1 1 1 .. .. 1 .. .. .. .. 2 1 2 3 Dropsy of Belly .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ulcer of Bowels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rupture .. .. .. .. 1 1 .. 1 .. .. .. .. .. 1 1 1 2 Ileus, Hæmatemesis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intussusception .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stricture of Bowels .. .. .. .. .. 2 .. .. .. 1 .. .. 1 .. 1 1 2 Disease of Stomach .. .. .. 3 2 1 .. 3 1 1 .. .. .. 1 1 5 6 Disease of Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Jaundice .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 1 Disease of Liver .. .. .. 1 5 2 .. 1 1 2 .. .. 2 2 3 5 8 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Urinary, &c. Inflammation of Kidney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bright'8 Disease .. .. .. 3 2 1 .. .. 2 1 .. .. .. 3 3 3 6 Ischuria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stone .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 Inflammation of Bladder .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. 2 1 .. .. .. 1 .. .. .. 2 3 .. 3 Disease of Kidneys, &c. .. .. .. .. .. 2 .. .. .. .. .. .. .. 2 1 1 2 IX. Womb, &c. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 1 Child-birth .. .. .. 3 .. .. .. 1 .. 2 .. .. .. .. .. 3 3 Disease of Uterus, &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. X. Joints, &c. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Joints, &c .. .. .. 1 1 .. .. .. .. .. .. .. .. .. 2 .. 2 XI. Skin, &c. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Skin, &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XII. Malformations. Blue Disease 2 .. 2 .. .. .. .. 1 .. 1 .. .. .. .. 2 .. 2 Spina Bifida 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Other Malformations 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 XIII. Debility: Premature Birth 15 .. 15 .. .. .. .. 1 1 12 .. .. 1 .. 8 7 15 XIV. Atrophy : 3 2 6 1 .. .. .. 3 .. 4 .. .. .. .. 4 3 7 XV. Age: .. .. .. .. .. 11 9 5 1 9 3 2 .. .. 3 17 20 XVI. Sudden: XVII. Violent Death: Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. 2 6 .. .. .. .. .. .. 1 1 .. .. 4 3 3 6 Hanging .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suffocation 3 .. 3 .. .. .. .. 2 1 .. .. .. .. .. 3 .. 3 Drowning .. .. 1 .. l 1 .. 1 .. 2 .. .. .. .. 3 .. 3 Fractures .. 1 1 2 l .. .. .. .. .. .. .. .. 4 4 .. 4 Wounds .. .. .. 1 l 1 .. .. .. .. .. .. 1 2 2 1 3 Other Violence .. .. .. 2 2 .. 1 1 .. 1 .. .. .. 3 1 1 5 XVIII. Not Specified. 4 .. 4 .. .. 1 .. 3 .. 2 .. .. .. .. 3 2 5 TOTAL: 82 89 203 67 87 86 14 78 38 235 23 8 14 61 237 220 457 DEATHS registered during corresponding weeks of ten years (average) 425.6 Weekly average 32.7 C.J.B. ALDIS, M.D. R. DRUITT. LONDON: PRINTED BY GEORGE PHIPPS, RANELAGN STREET, EATON SQUARE. No. VII.] HAN 9 QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY OF Saint George, Banober Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOR THE QUARTER ENDING JULY 2nd, 1859. TO THE Vestry of St. George, Banober Square. My Lords and Gentlemen, I. The deaths for the quarter ending July 2nd, 1859, amounted to 421, including the deaths of 65 non-parishioners in St. George's Hospital, and of 6 inmates of the Little Chelsea Workhouse, so that the actual mortality is 350, whilst the births have been 547. The deaths during the corresponding period of 1858 were 479, so that the present mortality is less by 58 than that of the previous Midsummer Quarter. On examining the table of mortality, we see at once that the deaths from measles in the two quarters compared were as 16 to 4, and from whooping-cough as 27 to 9 ; but the deaths from scarlet fever, diphtheria, and sorethroat, are as 28 to 17. Of these last named maladies 11 are recorded as due to diphtheria; 3 in the Hanover, 6 in the Belgrave subdistrict, and 2 non-parishioners in St. George's Hospital. The houses in which the deaths from diphtheria occurred were No. 18, Union Street, Bond Street, a girl of 1 year, living over livery stable ; a boy of 10 months, No. 18, Lancashire Court; and a girl of 5 years, No. 17, Hanover Place, close to the house 299, Oxford Street, mentioned 4 in our last report; an adult at No. 18, Chesham Place; a boy set. 6 and a female adult at No. 24 Wilton Crescent; a female child set. 4, at 5, Grosvenor Row. Altogether, the decrease in the mortality this quarter Is explained by the fewer deaths of children under 5 in Belgravia. Five deaths from scarlatina occurred in one house, No. 15, Woodstock Street, at the beginning of April, and at the same time the mistress of the house died of consumption. All the deaths from scarlet fever occurred at the back of the house : four children, the whole offspring of a respectable tradesman, in the first floor back; and one child in the room above; whilst a woman was ill with the same malady in the attic over. On carefully scrutinizing the premises, the house, although nearly 150 years old, was evidently large, lofty, and airy in its staircase, although the apartments, inhabited as they were by highly respectable persons, were close and uncleansed, and sickly smelling. The water-closet in the middle of the house had lately been offensive: there was a most offensive current of sewer air from an untrapped sink in the kitchen; and, from want of traps, the basement was often so offensive, that the mother of the deceased children often forbade their going there. Whether or not the poison was introduced by contagion or by the sewer gases, we do not pretend to say ; but in support of the latter hypothesis, may point to the cases in the neighbourhood, No. 17, Hanover Place, and No. 299, Oxford Street. Amongst the other zymotic diseases, scarlatina destroyed 16, diphtheria 11, whooping-cougli 9, diarrhoea 9, measles 4, and typhus fever 12 ; lung diseases destroyed 119, of which bronchitis numbered 31, pneumonia 22, and consumption 55. 5 II. Sickness. — The number of cases of sickness relieved by the usual public institutions in the Hanover and May Fair sub-districts has been 833, against 964 in the preceding quarter of this year, and 1,030 in the corresponding quarter of last year. Amongst these were 107 cases, being about an eighth of the whole, of catarrh and bronchitis, or what is popularly called cold, 27 of diarrhoea, 22 of fever or febricula, 2 of small-pox, 10 of measles, 1 of diphtheria, 5 of scarlatina, and 22 of sore-throat of various kinds, some cases being dependent on the scarlatina poison. Concerning the places where sickness prevailed, we present, as before, the following table of the most thickly peopled districts. Population. Total Parish patients. Deaths of children. Deaths of adults. Moder Lodgings 130 23 1 1 Blomfield Buildings 130 18 0 0 Brick Street 206 4 1 1 Brown Street 200 34 1 1 Carrington Street 280 12 1 1 GeorgeStreet,Grosvenor Square, and George Yard | 540 47 2 2 Grosvenor Market 211 6 0 1 Grosvenor Mews 944 42 3 2 Hertford Place 200 24 0 0 John's Court, Farm Street 80 11 0 0 May's Buildings 122 8 0 1 Mount Row and Place 133 18 0 2 North Bruton Mews 154 0 1 0 Street's Buildings 79 4 0 0 Queen Street, Oxford Street 316 17 0 4 Robert Street, Grosvenor Square 543 23 0 0 Thomas Street 600 52 2 0 Lancashire Court 270 37 3 0 6 In the Belgrave sub-district 5596 cases 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 3323 were patients at St. George's Hospital, leaving a remainder of 2273. During the preceding quarter 5,988 cases were treated at the same institutions, and 6283 in the corresponding quarter of last year. Included in the above were 63 of measles, 15 of chickenpox, 19 of scarlatina, 25 of whooping-cough, 207 of diarrhoea, 35 of continued fever, 53 of rheumatic fever, 15 of erysipelas, and 4 of diphtheria. There were also 315 cases of bronchitis, and 9 of pneumonia. » Small-pox and Vaccination.—It will be observed in the sequel that this complaint occurred in a house, the sanitary condition of which was faulty, and that the threatening of taking proceedings in some instances of neglected vaccination had a good effect. The small-pox appeared in a crowded lodging-house, No. 27, Thomas Street, about the 25tli April, in a lodger, and in two young persons of the family. All had been vaccinated, and the disease was mild. About the same time a child, not a resident, was said to be affected with it, at No. 1, South Molton Lane; but the disease was afterwards pronounced not to be small-pox. This being the time of year at which the malady generally makes its appearance, and the locality being precisely one of those in which the medical gentlemen who have charge of the poor state that it commonly commences, it appeared necessary, after taking measures to extinguish the contagion in its birth-place, to set on foot 7 a regular revival of vaccination, so as to diminish the number of persons capable of taking the disease and propagating it. Accordingly, the different parochial schools were visited; with the result of finding two unvaccinated children in the Curzon Schools; a few at St. Mark's, and many at the Roman Catholic School in Davies Mews. The next point was to beat up the parents and gain their consent; and in the case of the poor Irish children in the school in Davies Mews, this was materially facilitated by the authority of their clergyman; and then Mr. Jay, the District Vaccinator, was good enough to attend at the school with Dr. Druitt, and operated on 15 children at St. Mark's, of whom 4 had not been vaccinated before: and on 21 in Davies Mews, of whom 10 had not been vaccinated. It is intended to repeat this visitation periodically, and by so doing the number of unvaccinated, or illvaccinated children will be kept under; at the same time it is bare justice to say, that every case in which the operation had been neglected, was one in which the people had migrated into, and were not regular denizens of, this parish. Lancashire Court is at present garrisoned by the Irish, who are much at home in that dark and dilapidated sepulchre for the living. III. In the next place we give some details of cases dealt with during the quarter. New Bond Street, No. 161. These premises, consisting of the residence and cellars of an eminent winemerchant, are situated just in the angle formed by New Bond Street and the north side of Grafton Street, and behind both. The cellars were incessantly wet, the 8 ground underneath a quagmire, and the owner obliged to have a small well sunk and the water baled out. This arose, doubtless, in part, from the natural wetness of the soil, for which no system of sub-soil drainage is provided, and which, therefore, cannot be helped ; but in part from one of those instances of perversity in the management of the drainage of the neighbouring houses, which brought it under our cognizance. After a long process of correspondence, visits, and examinations, it was made out by the Inspector, that No. 13, Grafton Street used to drain through No. 14, and both through No. 15, into the sewer in Bond Street; but that alterations had been made some years since, which raised the level of the outfall: hence the drainage of No. 13 was impeded; part of the refuse water, indeed, was conveyed by a raised pipe, but for the remainder there was no outlet whatever. In fact, the drain by which it once passed into No. 14 was bricked up; and it was turned into an old well in the middle of the kitchen, which was once probably the pump-well. Hence, part of the percolation into the wine-merchant's cellar. To have caused these houses to be properly and statutably drained, would have been a work of immense expense and litigation; therefore, under Mr. Grant's direction, a means was devised of removing all the refuse water by the existing channel, except the rain water which falls in the back area, for which no outfall could be found; and which therefore is received into a small well, and got rid of by pumping from time to time. Brook Street, No. 34, the house of an eminent physician, would require a volume to describe all the suffering it has inflicted on the unhappy residents, through a 9 combination of almost every conceivable mode by which a house can be polluted with sewer air. After the owner had exhausted himself in his efforts to remove sources of contamination within the house, he applied for the assistance of the local authority to deliver him from the evils arising from the stable of a nobleman which adjoined his house. The party-wall was old, cracked, and tunnelled by mice, which brought oats from the stable into the space under the floors of the house; and through these apertures, not only the common stable smell, but gusts of air from the stable sewers, and from the house sewers beyond, used to be wafted into the house. Fortunately we had a nobleman to deal with, who, at great expense, caused the drainage of the stable to be renewed, and efficiently trapped, and the whole wall to be faced with cement, so as to shut out effluvia absolutely, and render the physician's house less unwholesome. Half-Moon Street, Nos. 32 and 33. The occupant of the former of these houses has been a frequent complainant ; first against a cow-shed and slaughter-house, White Horse Yard, at the back of her house; then, in consequence of her complaints, the discovery was made of an old disused sewer running under her house, as detailed in former reports; in consequence of fresh complaints, her neighbours were invaded, and cesspools obliged to be abolished, and new drainage effected at Nos. 33 and 34; and now again fresh complaints are made against the slaughter-house. But these were soon found to be utterly unfounded. About the same time the occupier of No. 33 complained of nuisance arising from No. 32 ; but after a long investigation, Mr. Grant found a rain water-pipe, previously unnoticed, which passed down the 10 back of the house into the old sewer, and was the channel for foul gases. This was secured by a trap. Lancashire Court has been thoroughly explored. Nos. 1, 2, 5, 6, 9, 12, 15, and 17, have been cleansed; a kitchen at No. 8, in which a family of father, mother, and eight children slept (including two boys of 16 and 18), has been thinned of its inhabitants; and No. 12 has been reported to the police as dangerous, and has undergone an amount of repair which will tend to sweeten it. Hanover Street, Hanover Square, No. 18. The owner complained of the amount of illness which infested his family; his assistant was last year laid up for three months with typhoid fever, and this year obliged to leave in consequence of sore-throat; his predecessor in the business always ill; his servants always ill; and every man in his employ laid up at some time or other, with fever, sorethroat, or rheumatism. Having directed Mr. Grant to inspect these and the adjoining premises, I learn that at complainant's own house is a common privy and cesspool, dust-pit uncovered, and no drainage to the yard; at No. 17, a common privy and lot of stinking rubbish; and at No. 6, Maddox Street, in the rear, the same state of things. All these nuisances are now abolished. Nos. 16 and 18 were till lately as bad, but are now well drained. Drainage of Little Grosvenor Street. Nos. 3, 4, 5, and 6, in this street, drained down the hill behind them, through a stable and other premises belonging to Mrs. Sparrow. That drain had become dilapidated and choked, and Mrs. Sparrow desired that the owners of these houses should make new drains separately to the front. It was shown, however, that their drain backwards had existed before her stables were built over it; moreover, that a combined back drainage was the best in itself. The 11 local authority, therefore, decided that this drain should be restored. Pitt's Head Mews, No. 11. Here a cross complaint was brought for the "local authority to settle. The occupiers of this inhabited stable complained that it was made unwholesome by ovens and cooking apparatus at No. 11, Little Stanhope Place, the occupier of which latter house complained (with more reason) of nuisance from the stables. King's Mews, South Street, No. 21. Complaint was made that a dead body had been kept here too long. The complaint was ill-founded, but the stable was dirty and ordered to be cleansed. Robert Street, No. 3. A back kitchen, inhabited by a man, wife, and two children, with no ventilation, except through an area covered in and used as a washhouse. The lessee of this very dirty house, doubtless, could not afford, as she said, to keep it in good condition and live by it too; neither could she control dirty and disorderly tenants. The house, however, has been cleansed, and the kitchen disused. SteePs Court, Lee's Mews. This is one of the first places visited by the cholera in 1849, and no wonder, for the offensive water-closets were close to the windows. Nos. 2, 3, and 4, have been cleansed, and the closets repaired. Wood's Mews, No. 28. This stable was like many other premises, supposed to be drained, till the pump brought up sewage instead of drinking water, and then a large cesspool was discovered, which has since been abolished. Not to take up too much time with details, when no principle is involved, we may classify the following cases, thus:— 12 Nine cases in which cesspools or old drains were abolished, and pipes substituted, viz.:— Mount Row, No. 47. Green Street, No. 26. John Street, Berkeley Square, No. 13. Castle Public House, Shepherd's Court, Brook Street. Green Street, No. 33. Mount Street, Nos. 49 and 50. Maddox Street, Nos. 3 and 5. Six cases of leakage through walls, viz.:— Piccadilly, No. 127. Griffin's Court, No. 6. North Audley Street, No. 38. The Baths, Davies Street. Duke Street, No. 14. Hertford Street, No. 37. Be it observed that this, slight as it may seem, is a most insidious and mischievous nuisance. There can be no worse neighbour than a pipe or cistern, or other means of holding or conveying water, close to the wall of your house. The cistern decays, or a joint in the pipe leaks, or perhaps the water-pipe permits an overflow, or the ball-cock may be unable to shut off the water, or there may be a fissure in the supply-pipe, from which a spray of water no bigger than a hair issues every time the water comes in. Then the old proverb comes into force—-gutta cavat lapidem, &c. No noise is made, and there is nothing to attract attention till a portion of wall is rendered hopelessly damp, even if it does not become rotten and unsafe. We have had cases of rheumatism, and other illness, from this cause. Seventeen other cases of miscellaneous nuisance which have been rectified by the Inspector, viz:— 13 Oxford Street, No. 314. Effluvia from College of Chemistry. Carrington Mews, No. 1. North Bruton Mews, No. 18. Roman Catholic School, Davies Mews. Curzon Street, No. 34. North Audley Street, No. 39. A poor family put in to take care of the house when empty, made ill, as is often the case, by want of ventilation. Mount Street, No. 87. Bad ventilation, neglect of cleanliness, and accumulation of rubbish. Dolphin Court. Houses badly ventilated. Chapel Street, May Fair, No. 8. Badly-drained and ventilated. Providence Court, No. 2. Leakage of sewage. Upper Grosvenor Street, No. 8. Leakage from stables behind. Grosvenor Street, No. 24. An overfull dust-heap. Arlington Street, No. 14. Ill-trapped drains. Piccadilly, No. 71. Accumulation of rubbish in vaults. Clarges Street, No. 26. Damp and dirty. Hertford Stables, Brick Street, and Evans's, Brook Street. Dung-pit nuisances. The Piccadilly Flood. On Friday, the 20th May, a heavy storm fell, and in consequence some of the houses in the lower part of Piccadilly, and in Hertford Place, were invaded by an overflow from the adjoining sewer, but to no serious extent. On Sunday, the 12th June, between twelve and one at noon, another more heavy storm occurred, which produced an amount of misery and destruction not to be imagined but by those who witnessed it. Every house in Piccadilly from No. 98 to No. 115 inclusive, all the ten 14 houses in the poor district called Hertford Place, and No. 1, Brick Street, were suddenly invaded by a flood of black stinking water. It came roaring up through every sink, and every water-closet in the basement, and blew up many of the drains; and in the unfinished mansion, Hertford House, at the corner of Engine Street, it lifted the whole of a compact wooden floor in a large room in the basement. At 102, Piccadilly, a large hole was burst up in the kitchen passage, and the water rose in an incredibly short space of time to the height of 5 feet 3 inches, so that it is quite certain that had the flood happened in the night, the numerous domestics, who slept in the basement of this and the adjoining houses, could not have escaped drowning. As it was, they had to rush for their lives; and the master of the house was knocked down and lost his cash-box. Immense quantities of valuable property were destroyed in the basements of these houses— servants' bedding and wearing apparel; wine cellars destroyed, and coals spoiled; and when the water subsided, which it did in two hours, many things were washed away. Then the floors were left covered with a thick black, slippery mud of nauseous odour, which of course penetrated under floors and skirting boards, and into the drawers and cupboards; and every house was left in free communication with the main sewer, out of which the water had burst. Many details might be ridiculous, such as the putting out of kitchen fires, and the spoiling of eatables and of wearing apparel, on a day when they could not be replaced: but that which might be a trifle to the mansions of Piccadilly, was serious enough to the poor people in Hertford Place. At No. 9, the lowest in level, a large hole was blown up in the floor, and had it been by night, a whole family must have perished. As it was, they lost .15 every earthly thing they possessed, including their tools, and the food for their Sunday's dinner. The other houses suffered each a little less in proportion to its higher level. It is gratifying to say that the poor people were taken in by their neighbours, and refused the accommodation of the workhouse, which was offered them as a temporary refuge. The immediate source from which the water came was a large disused branch (formerly the main channel) of the King's Scholars' Pond Sewer, which appears to run from the top of Half-Moon Street to the lowest part of Piccadilly, under No. 102. This sewer seems not to have been cleansed since it was disused as a main trunk, and was full of an unusual excess of filth.. Then, immediately below the spot where it joins the main stream, a dam or weir is said to have been erected, for the purpose of gauging the water-flow, and to have been left there, in spite of the clearest remonstrance of Mr. Richman, after the flood of the 20th May; and by its obstruction, it appears to have occasioned the overflow above. Be this as it may, the Metropolitan Board of Works promptly set to work to repair the damage and compensate the sufferers. Floors were taken up, all slush was carted away, and the earth was sweetened and dried by quicklime; and in token of the necessity and success of these operations, that part of Piccadilly stunk intolerably for many days. Some of the inmates complained, as was natural, of weakness and loss of appetite. To the poor people in Hertford Place, after making allowance for the misery and privation of the first day or two, the affair was quite a blessing. The old floors and skirtings, rotten for generations past, were taken up, the earth dried by lime, new sound pipe drainage, a thing we had long earnestly desired, laid down in workmanlike order, new 16 floors laid, and altogether the place made better than it ever has been, and as little unhealthy as such a swampy residence can ever be expected to be. The moral of the story, as regards the public health and the influence of sewers thereupon, is not unimportant. If, as was the case here, a sewer can be in such a state of accumulated filth, that the heaviest deluge of waters does but stir without cleansing it, and so that many men need be employed for many days afterwards in removing the said accumulated filth, as they were in that sewer under No. 102, Piccadilly, we naturally ask, where do the gases of this decomposing matter escape to ? What effect have they on the people who live over them in ignorance? And supposing the Main Drainage scheme to be successful in purifying the Thames, shall we be delivered from these and the like evils existing under houses ? * Graham Street, Pimlico, No. 35. An offensive gully opposite. The gully has been trapped. Spring Garden Place, No. 4. The closet was choked up. A notice was served on May 5,1859, since when the closet and drains have been cleansed, and the nuisance abated. Eaton Square, No. 104. Fetid gases, causing illness in the house, which a nobleman had recently taken furnished. They emanated from a perforation in the trap of the closet on the drawing-room floor, and a quantity of matter in the brick drains, which were penetrated with rat-holes. A similar nuisance had existed here last year, when.it was attributed to the Thames. The servants' closet in the front area offensive, damp, and badly ventilated. A notice was served on March 26. The drains have been properly cleansed and * See page 22 for an account of the flood at Knightsbridge and Commercial Road South. 17 repaired throughout the house. The closet on the drawing-room floor has been removed, and the nuisance abated. Shop and Parlour in Allington Street, behind No. 4, Brewer Street. This den, consisting of a shop opening into a bed-room, was occupied by a costermonger and his wife. The place was damp, dirty, and most offensive from fish and decayed vegetable matter. The roof of the shop consisted of boards, through which the rain passed, and the ceiling of the bed-room was dilapidated. These premises were connected with the house adjoining, and should any infectious disease have occurred in them, it might have spread extensively. The refuse was removed, and the shop with the parlour closed, as the Medical Officer thought them unfit for human habitation. Warwick Street, Pimlico, No. 21. A quantity of house refuse, which it was alleged the scavengers had refused to take away; the house was infected with fever. The rubbish has been removed. Allington Street, Pimlico, No. 9. Two cases of smallpox have occurred in this house, where the drainage was in a defective state. As two other children had not been vaccinated, the Medical Officer gave notice to the mother, that unless the operation were soon performed, proceedings would be taken. The house and drains have been cleansed, and the children vaccinated. Buckingham Place, Pimlico, No. 3. Defective state of the drains under the kitchen, no cover to the dust-pit, no bell to the trap in the yard, and the ceiling of the kitchen is very dirty. A notice was served on April 30, and the work is finished. Waste Ground in front of Nell Gwynne Cottages, Grosvenor Row, Pimlico. A large quantity of putrid fish, which was immediately removed. b 18 Stafford Row, No. 19. A defective state of the rain water-pipe. A new pipe has been erected. Eccleston Place, No. 46. Obstructed drains, which have been cleansed after a notice served on May 2, Elizabeth Street South, No. 25. A complaint was made of the kitchen not being habitable within the meaning of the Act. It appeared, however, that the same was let or occupied as a dwelling before the passing of the Act, and that it possessed the requisites required by the said Act, and, therefore, may continue to be let or occupied. Burton Street, Pimlico, No. 12. Cow kept in a stable behind the house. Several inspections have been made here by the Medical Officer and Inspector, and the place has always been found very clean. Victoria Road, No. 18a. The drains were in a defective state. A new water-closet has been erected at Nos. 18 and 19, and both have been jointly drained by a nine-inch pipe. Victoria Street, No. 3. About 70 dead cats without their skins were found in the vaults under the footway of Yauxhall Bridge Boad. The animals were in a state of decomposition. It appeared that a man had been in the habit of catching cats, and skinning them alive, for which he was taken before the magistrate, and sentenced to three months' imprisonment. The cats were buried, lime thrown down, and the vaults cleansed. When we see the barbarous use that is likely to be made of such places, it is to be regretted that they are allowed to remain open. Ranelagh Place, Pimlico, No. 9- A most offensive nuisance in the yard, caused by a large and overflowing cesspool without drainage. No sewer came within 172 feet; but there was drainage from all the other houses, which constituted one property. The case having been 19 referred to a special committee, who authorized proceedings to be taken, Dr. Aldis applied for an order from Mr. Paynter, at the Westminster Police Court, to be given for cleansing and filling up the cesspool, and fixing a six-inch pipe drain in the closet, to be connected with the drainage in front of No. 10. The affair occupied considerable time in consequence of several interviews with correspondence on the subject; but upon the owner sending in workmen, it ended satisfactorily without recourse to litigation. Hindon Street, Pimlico, No. 46. The yard flooded with stagnant water from the drains of Nos. 21 and 22, Gray's Inn Place, adjoining premises. A notice was served on May 12th, since when the drains have been properly cleansed and repaired. Eaton Court, Eaton Lane North, No. 4. The drains were choked up. A large quantity of dust mixed with decomposed vegetable matter. The obstruction is remedied, and the refuse has been removed. Wilton Road, No. 6. House infected with small-pox. The yard and kitchen were damp, the closet offensive, and out of repair. A large quantity of dust mixed with vegetable matter. The yard has been limewhited, the closet cleansed and repaired, and the dust removed. Gray's Inn Place, Hindon Street, Nos. 21 and 22. The drains were obstructed, and in a dilapidated condition. They have been cleansed and repaired. Upper Denbigh Meivs, Denbigh Street. A large quantity of dung, which has been removed. St. Leonard's Street, Pimlico, No. 9a. A complaint of offensive water, which has been taken away. Grosvenor Canal and Basin. When the water had been let out, the mud became very offensive. The Medical 20 Officer and Inspector frequently examined the spot, and caused large quantities of lime to be thrown down to prevent the nuisance as much as possible. Eccleston Square, No. 9. A nuisance supposed to come from the stables behind the house, St. George's Mews, Hugh Street. Two common privies have been converted into water-closets, and two gullies at the end of Hugh Street trapped. Cow-yards. Another instance has occurred in Belgravia, showing the great advantage of the sanitary controul which can now be exercised with regard to these places. The details of the case are mentioned below. For several years prior to the appointment of Medical Officers of Health in this parish, complaints have been urged against the yard in question. Mr. Perry and Dr. Aldis were consulted upon the subject before the present owner held the premises, and gave a joint certificate that they were prejudicial to the health of the inhabitants. But whenever the late Trustees visited the yard they found it so clean that they did not think it necessary to interfere. Illness occurred, families left the houses, and the property became deteriorated. At length such improvements have been effected through the Local Authority and its Officers as to render the spot comparatively wholesome without litigation. Chester Square, No. 87. A bad smell entering the windows from the cow-yard behind No. 39, Elizabeth Street, Eaton Square. This yard has been frequently visited by the sanitary officers; but it was always found to be clean. It is to be remembered that the houses in the vicinity were brought to the nuisance, and not the nuisance to the houses. The servants at No. 37, Chester Square, 21 complained of nausea and vomiting arising from the effluvium of the cow-yard. Thirteen cows were found in the yard. One shed containing twelve cows, six in a row, was 24 feet long, and 17 wide, and 8 feet high, whereas the magistrate, Mr. Paynter, in the case of Hatt's cowyard, recommended the width of the shed to be 25 feet, where there are two rows of cows. Dr. Aldis reported the ventilation as insufficient, the shed too small for the number of cows, and recommended that they should be reduced. The occupier then submitted a plan of alterations to the Nuisances Removal Committee, and the result is, that the shed has been reconstructed, and is 24 feet wide. The number of cows has been reduced to eight, the shed has been newly paved, better ventilated, properly drained and trapped, and 7 feet 4 inches allowed for each pair of cows. The dung-pit has also been newly drained and cemented. Upper Tachbrook Street, No. 15. A large quantity of offensive rubbish, which has been removed. Kanelagli Street, No. 34. A common privy, cesspool, and an old rotten brick-drain. The cesspool has been cleansed and filled up, new water-closet erected, yard limewhited, and the drains have been cleansed and repaired. Stochbridge Terrace, Pimlico, No. 11. A smoke nuisance, which was referred to the police. Victoria Road, Pimlico, No. 19. The drainage in a defective state, and passing through No. 18a, adjoining premises, and no water to the closet. The two houses have been drained jointly, by nine-inch pipe drains, and a new water-closet has been erected to each house. St. Peter's Chapel, Charlotte Street, Pimlico. An offensive dung-pit in the adjoining yard. Dung-pit cleansed and removed to another part of the yard. 22 Lupus Street, Pimlico, No. 66. Nuisance and dampness in the back kitchen, from a dust-pit in the yard of No. 68, adjoining premises. The wall has been cemented, and the nuisance abated. Belgrave Road. Two offensive gullies opposite to Hugh Street have been trapped. St. George's Terrace. A large quantity of dust and decomposing vegetable matter was removed from the dust-pits. Chester Terrace, Chester Square, A most offensive gully was rectified. Tachbrook Street, Pimlico, Nos. 1 to 7. A large quantity of dung against the wall, between the mews and the houses in Upper Tachbrook Street. That portion of the mews next to the wall is not paved, and the whole of the pavement is so much out of repair, as to allow a quantity of stagnant water to accumulate and saturate the earth, causing dampness and effluvia in the washhouses and yard adjoining. The dung has been removed, and the paving referred to the Committee of Works. Queen's Head and White Hart Public Houses, and Nos. 15, 21, and 22, Park Side, Knightsbridge. The basements and cellars flooded with sewage on June 13. In the cellars of the two public houses, the depth of the water was about 2 feet, with 3 inches of mud. The basements of the other houses presented a similar appearance. The water came up from the sewer through the sinks, and the same thing had occurred before, in consequence of the flaps not acting properly. One of the houses contained valuable property, which was seriously damaged. Had the water risen only a few feet higher, property to the amount of several thousand pounds would have been 23 destroyed. The whole of the mud has been removed, and the basements cleansed. At the same time, great inconvenience and some loss were felt by several poor persons residing at the lower end of Commercial Road South, owing to the flood of water during the heavy rains, for which there were no outlets at Ranelagh Cottages. A pool* was also formed at the back of some of the houses, and became so offensive, that it was supposed to have occasioned sickness. The medical officer of Chelsea was informed of the nuisance, as it was situated in that district. An analysis of the water supplied by the Chelsea Company, and taken April 12th, 1859, from the main at 43, Lower Belgrave Place, produced Grs. Total Impurity 18.24 Organic ditto 1.44 May 10th, 1859, Total Impurity 18.08 Organic ditto 1.28 June 7th, 1859, Total Residue in a gallon 14.92 Organic Matter .80 We have the honour to be Your faithful Servants, C. J. B. Aldis, M.D. R. Druitt. (*) The Medical Officer received a memorial numerously signed, in reference to the stagnant water in Green's Fields. 24 APPENDIX. The illuminating power of the Gas supplied to the Workhouse in Mount Street, during the second quarter of 1859, when burned in a batswing burner, at the rate of 2.5 feet per hour, was equal to that of 15.5 sperm candles, burning at the rate of 120 grains per hour. No sulphuretted hydrogen was detected during the quarter. The illuminating power of the Gas supplied to the room in West Basin Road during the same period, when burned in a batswing burner, gave an average result equal to that of 10.8 sperm candles, burning at the above rate; and no sulphuretted hydrogen was discovered. TABLE OF MORTALITY. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 2nd of July, 1859. Average, 32.3. 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, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. I i. Zymotic. Measles 1 3 4 .. .. .. .. 2 .. 2 .. .. .. .. 2 2 4 Scarlatina .. 5 15 1 .. .. .. 8 1 4 .. .. 2 1 9 7 16 Diphtheria 1 4 9 .. 2 .. .. 3 .. 6 .. .. .. 2 3 8 11 Whooping Cough 3 6 9 .. .. .. .. 1 .. 8 .. .. .. .. .. 4 .. Croup .. 1 2 .. .. .. .. .. 1 .. .. .. .. 1 1 1 2 Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 6 1 7 .. 2 .. .. .. 1 8 .. .. .. .. 5 4 9 Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 Cholera .. ...... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 1 Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Putrid Sore Throat .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Remittent Fever .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Infantile Fever Typhus Fever 1 4 6 3 3 .. .. 2 .. 10 .. .. .. .. 7 5 12 Child-bed Fever. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 1 Rheumatic Fever .. .. .. 2 .. .. .. .. .. 1 .. .. .. 1 .. 2 2 Erysipelas 1 .. 1 .. 1 3 .. 1 .. 2 1 .. .. 1 2 3 5 Pyæmia .. .. .. 2 .. .. .. .. .. .. .. .. .. 2 2 .. 2 Syphilis 1 .. 1 1 .. .. .. 1 .. .. .. .. .. 1 1 1 2 Canker .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. II. Cancer, Dropsy. Haemorrhage 1 3 2 1 .. .. 3 .. 1 .. .. .. 2 4 2 6 Dropsy .. .. 2 1 4 .. .. 2 .. 1 1 1 1 1 1 6 7 Abscess .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. 1 Ulcer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. Mortification .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 1 Cancer .. .. .. 1 4 1 .. 3 1 2 .. .. .. .. 2 4 6 Gout .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 III. Scrofula. Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mesenteric Disease 3 1 4 .. .. .. .. 1 .. 3 .. .. .. .. 2 2 4 Consumption 2 2 9 22 19 5 .. 10 1 28 3 .. 1 12 33 22 55 Water in the Head 1 4 7 .. .. .. .. 4 1 2 .. .. .. .. 4 3 7 IV. Nervous System. Inflammation of Brain .. .. 2 1 1 .. .. 1 .. 2 .. .. 1 .. 1 3 4 Apoplexy .. .. .. 1 7 3 .. 2 2 4 1 .. .. 2 8 3 11 Paralysis .. .. .. 2 5 .. .. 1 6 .. .. .. .. 2 5 7 Delirium Tremens .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. 1 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epilepsy .. .. .. .. 3 .. .. 1 .. 1 1 .. .. .. 1 2 3 Tetanus .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. 1 Insanity .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Convulsions 13 5 17 1 .. .. .. 6 2 10 .. .. .. .. 11 7 18 Disease of Brain, &c. 1 1 5 1 3 1 1 2 4 .. .. 1 2 4 6 10 V. Heart, &c. Pericarditis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Aneurism .. .. .. 4 .. .. .. .. .. 1 .. .. 1 2 3 1 4 Disease of Heart, &c. .. 1 5 5 3 8 .. 6 2 6 .. .. 3 4 10 11 21 VI. Lungs, &c. Laryngitis .. 2 3 .. .. 1 .. 1 1 2 .. .. .. .. 3 1 4 Bronchitis 4 4 8 2 6 12 3 8 6 10 3 1 2 1 16 15 31 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 Hydrothorax .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Pneumonia 7 5 13 2 1 1 2 3 5 10 4 .. .. .. 14 8 22 Asthma .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 2 Disease of Lungs, &c. .. 1 1 1 1 .. .. .. .. 3 .. .. .. .. 2 1 3 BIRTHS registered during 13 weeks.—Hanover Square, M. 69, F. 53; May Fair, M. 28, F. 23; Belgrave, M. 175, F. 199. Total 547 Average 42.7 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. 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 3 1 4 .. .. .. .. 1 1 2 .. .. .. .. 3 1 4 Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. Inflammation of Peritoneum .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 • • 1 Inflammation of Bowels 1 1 3 .. 1 .. .. 1 .. 2 .. .. 1 .. 1 3 4 Disease of Bowels .. .. .. .. 2 .. .. .. .. .. .. .. .. 2 1 1 2 Ulcer of Bowels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Constipation .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 Dropsy of Belly .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rupture .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Intussusception .. .. 1 .. .. .. .. .. .. I .. .. .. .. .. 1 1 Stricture of Bowels .. .. .. .. 2 .. .. .. .. 2 .. .. .. .. 1 .. 2 Disease of Stomach .. .. .. .. 3 3 1 1 5 1 .. .. .. .. 6 1 7 Disease of Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Liver .. .. .. .. .. 2 .. 1 .. 1 .. .. .. .. 2 .. 2 Jaundice 1 1 2 .. 1 1 .. .. .. 4 .. .. .. .. 2 2 4 Disease of Liver .. .. .. 1 1 1 .. 2 .. 1 .. .. .. .. 3 .. 3 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Urinary, &c. Inflammation of Kidney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bright's Disease .. .. .. 2 .. 1 .. 1 .. .. .. .. .. 2 2 1 3 Ischuria .. .. .. 1 l .. .. .. .. .. .. .. .. 2 2 .. 2 Diabetes .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 Stone .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Bladder .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Kidneys, &c. .. .. 1 1 2 1 .. .. .. 1 .. .. .. 4 3 2 5 IX. Womb, &c. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Child-birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Uterus, &c. .. .. .. .. 2 .. .. .. .. 1 .. .. .. 1 .. 2 2 X. Joints, &c. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Joints, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XI. Skin, &c. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phlegmon .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 Disease of Skin, Ac 1 .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 XII. Malformations. Blue Disease 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Spina Bifida 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Other Malformations l .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 XIII. Debility: 10 .. 10 .. .. .. .. 1 .. 9 .. .. .. .. 5 5 10 Premature Birth 2 .. 2 .. .. .. .. .. 1 1 .. .. .. .. .. 2 2 XIV. Atrophy: 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 XV. Age: .. .. .. .. .. 6 10 2 .. 7 .. 2 .. .. 5 11 16 XVI. Sudden: 1 .. 1 .. 1 .. .. 1 .. .. .. .. .. 1 2 .. 2 XVII. Violent Death: .. .. .. .. 2 1 .. .. .. 1 .. .. 1 1 3 .. 3 Intemperance .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 1 .. 1 Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. 2 3 .. .. .. .. .. .. .. .. .. 1 2 .. 3 3 Hanging .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suffocation 1 .. 2 .. .. .. .. .. .. 1 .. .. .. 1 2 .. 2 Drowning .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Fractures .. .. .. 1 6 .. .. 1 .. 1 .. .. .. 5 6 1 7 Wounds .. 1 I .. 4 1 .. .. .. 1 .. .. 3 2 3 3 6 Other Violence .. .. 2 .. .. .. .. .. .. .. .. .. 1 1 9 .. 9 XVIII. Not Specified. 1 .. 1 .. 1 .. .. .. 1 1 .. .. .. .. 2 2 TOTAL: 71 58 179 64 94 66 18 85 44 185 15 6 21 65 228 193 421 DEATHS registered during corresponding weeks of ten years (average) 389.3 Weekly average 29.9 C.J. B. ALDIS, M.D. R. DRUITT. london: printed by george phipps, ranelagh street raton square. HAN 9 No. VIII.] QUARTERLY SUMMARY ' OF THE SICKNESS AND MORTALITY OF Saint George, Banober Square, AND OP THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOB THE QUARTER ENDING OCTOBER 1st, 1859. \ LONDON. to the Vestry of St. George, Hanover Square. My Lords and Gentlemen, I.—During the thirteen weeks ending 1st October, 1859, 440 deaths have occurred in the Parish, including those of 5 inflates of the Workhouse at Little Chelsea, and of 48 non-parishioners in St. George's Hospital. The weekly average 33.8, is slightly above that of the preceding ten years, which is about 32. On looking at the death table practically, with an eye to causes and prevention, we are struck with the two items of infant mortality, and mortality from bowel complaints ; which two items, however, are connected by the fact, that the greater part of the deaths from bowel disorders are those of infants. For example, in the third or corresponding quarter of 1857, there were 63 deaths of parishioners from diarrhoea, dysentery, and cholera; in the same quarter of 1858 there were 35; and in the same quarter of the present year 62. And in each of these years, seven-ninths of these deaths from bowel disorder have been of infants under 1 year; one-ninth of children between 1 and 5 4 years; and the remaining ninth, of persons advanced in life. So again, looking at the amount of infant mortality this quarter, we see that against the 528 births, 112 infants have died, that is nearly one child in four. Out of this wholesale infant destruction, 48 deaths are due to diarrhoea; 35 to scrofula, convulsions, debility, atrophy, and premature birth; 11 to want of breast milk. When we add that one babe was suffocated in bed with its parents in Swan Passage, another found strangled in Hyde Park, and another in Bolton Yard, we leave only about a dozen infants' deaths to be accounted for. It must be said, moreover, that besides 11 infants, whose deaths are directly attributed to want of breast milk, there are 30 others in the Belgrave sub-district alone, who died of diarrhoea, atrophy, and the like, and who are reported as having been dry-nursed. Looking at the affair in a practical light, we see in the first place that some infants die, because their mothers, when they took upon themselves the responsibility of giving existence to an infant, did not secure for it the necessary protection of a married home. They perhaps take situations as wet-nurses, the babes are put out to nurse, or put out of the way. Hence, increase of morality will prevent the deaths of some children. In the next place, we are met with the fact, that in all ranks of life, many women are too feeble to be good mothers. Hence, the offspring is feeble too, and if it does not die outright, the mothers are unable to nourish it naturally. Then comes a struggle; for the rearing a feeble child by hand is more laborious, more trying to temper, requiring more watchfulness, and more skill, and good-will to the task, than any other human occupation. 5 Infant mortality may therefore be diminished when expectant mothers more deliberately train themselves, both in body and mind, for the very serious task they have engaged in. The promotion of practical knowledge in these matters is much to be desired. The special reasons for increase of infant mortality by diarrhoea in hot weather are palpable. The heat is directly exhausting in itself, and some cases of diarrhoea, in infants and the aged, arise from pure exhaustion. Heat renders a better supply of air necessary; and it gives intensity to putrid emanations. Further, it increases the difficulty of preparing and preserving food. Hence, infant mortality will be decreased by the supply of sweet and airy dwellings. Scarlatina, diphtheria, and putrid sore-throat conjointly destroyed 15 parishioners. In the preceding quarters, the number of parishioners destroyed by these diseases was 20, 30, 34, and 25. The decrease is gratifying. Scarlatina was very prevalent in Brook's Mews, Davies Street, where a young married woman and two children died of it. The case of putrid sore-throat (a girl of 13), occurred at No. 2, Hertford Street, May Fair, a house, the proprietor of which successfully refused two years ago to pay the expense to which the local authority had been put in abating a dangerous nuisance. For some time before the poor girl's illness, a putrid taint had pervaded the house, and doubtless there are some remaining sources of impurity which are not thoroughly explored. The patient died a month after the attack. One death from diphtheria occurred at No. 263, Oxford Street, in a delicate boy of 6. He too died exhausted after six weeks. 6 Another more sudden death from the same cause occurred at No. 30, North Audley Street, in a healthy boy of 4, who came ill from Union Street, Borough, and died on the seventh day. Amongst other note-worthy cases of death, are that of a young woman of 28, at No. 6, Robert Street, who died in consequence of an alarm of fire in a neighbouring house, after her confinement; two suicides of young women, and one of an old man in the Serpentine; and that of a woman at No. 96, New Bond Street, on whom an inquest was held, with the verdict that her death was accelerated by the impure air of the apartment in which she lived. See p. 12. II.—The Sickness. The number of cases attended gratuitously this quarter, in the Hanover and May Fair sub-districts, was 1,031, against 951 last year. Of these 249 were cases of diarrhoea; and fully a third of these were casual applications for relief, at the St. George's and St. James's Dispensary; and it must be added, as a matter of fact, that the largest number of applications from adults came on Mondays, from the misuse, possibly, of the foregoing holy-day. Of cases of continued fever and febricula there were 26; of scarlatina only 3; showing that the persons affected were supplied with medicine elsewhere. Disorders of the breathing organs sink into insignificance at this season; thus there were only 40 cases of bronchitis. And though there were 50 of measles, (which number represents but a fraction of the prevalence of the disease,) there were no more than 4 deaths from it in these sub-districts. In the Belgrave sub-district, 6,243 cases of disease were treated by the parochial surgeons, at St. George's Hospital, the Royal Pimlico Dispensary, and the St. Paul 7 and St. Barnabas' Dispensary, and at the Workhouse, Little Chelsea. Of these cases 3,363 were patients at St. George's Hospital, leaving a remainder of 2,883. We find that the above included 119 of measles, 5 of chicken-pox, 7 of scarlatina, 6 of small-pox, 22 of whooping-cough, 38 of rheumatic fever, 35 of continued fever, 3 of cholera, 809 of diarrhoea, 15 of erysipelas, and 6 of diphtheria. There were also 173 of bronchitis, and 13 of pneumonia. From the warm state of the weather, there occurred a larger proportion of bilious disorders, and a smaller number of catarrhal affections. Although there were merely 3 cases of cholera, 1 of which was Asiatic, still we observe 809 cases of diarrhœa recorded during the present quarter, whereas in the corresponding period of last year, there were only 164. Again we remark, only 173 cases of bronchitis, against 303 in the previous Michaelmas quarter. Measles prevailed to a greater extent during this season, when 119 cases happened against 87. Small-pox. Every house is immediately visited when there is reason for supposing that it is infected with this dreadful malady, and sanitary measures, if requisite, are at once applied.' We regret to state, that numerous children are constantly exposed to the liability of an attack, owing to the ignorant prejudices of parents against vaccination; but we endeavour to counteract them by persuasion or threats, in order to obtain as much security as possible for their children, and the public generally. Concerning the places where sickness prevailed, the following is a list of the worst districts:— Concerning the places where sickness prevailed, the following is a list of the worst districts:— 8  Population. Total Parish patients. Deaths of children. Deaths of adults Model Lodgings 130 4 0 0 Blomfield Buildings 130 20 0 0 Brick Street 296 4 0 1 Brown Street 200 57 1 2 Carrington Street 280 18 1 1 George Street, Grosvenor Square, and George Yard 1540 47 3 1 Grosvenor Market 211 10 0 0 Grosvenor Mews 944 58 1 0 Hertford Place 200 26 2 1 John's Court, Farm Street 80 18 0 0 Lancashire Court 270 37 0 0 May's Buildings 122 10 0 0 Mount Row and Place 133 9 0 0 North Bruton Mews 154 24 1 0 Hart Street 265 18 1 3 Queen Street, Oxford Street 316 11 1 0 Robert Street, Grosvenor Square 543 39 1 1 Thomas Street 600 65 6 0 Thomas Street has been particularly sickly; three children died at No. 4, of convulsions, spinal irritation, and diarrhoea; one at No. 5, of brain disease; one at No. 28, of scarlet fever; and one prematurely born at No. 32. In George Street, two children died of diarrhoea at No. 8; and like Hart Street, and the other crowded streets between Grosvenor Square and Oxford Street, it was very sickly. No. 17, Little Grosvenor Street contributed sixteen cases; 30 and 30a, Grosvenor Mews, fifteen patients; Lancashire Court contributed its quota. Of No. 30, Thomas Street, Mr. Bloxam, the very able and experienced parochial surgeon, says, that for the last 25 years it has been the haunt of zymotic disease; and 9 that (although it is a small house) he had attended 24 persons in it during the year ending 6th July, 1859. Now follows this grave question. This hot summer has tested our sanitary state pretty severely. We have seen the prevalence of the three classes of malady which revel in houses tainted with sewer poison—the diarrhoea class, the fever class, and the scarlet-fever and throat class. Are we, judging from the results of this summer, in such a state as to face an epidemic with confidence— supposing, for example, that the cholera were to come over from Belgium? We fear not. At the same time, we affirm that we have prevented much sickness and saved many lives; and we can point out what we know to require remedy, and are eager to carry our ideas into action when we can. In particular, we observe : 1. That there are some houses, which stand upon ground so honeycombed with old drains and cesspools, that after a good pipe drainage has been laid down, other unknown channels of sewer vapour exist. Some of these houses are so old, ricketty, and ill-constructed, that they ought to be pulled down. No. 30, Thomas Street is one of these. It was condemned by the police surveyor at our instigation, and the front wall obliged to be built anew; notices have been served, and fairly enough obeyed, as to cleansing and draining; still the house is as unhealthy as ever. No. 16, Brown Street is another instance of incurable defects in drainage. 2. Other houses, having numerous inhabitants, have their latrines in such narrow ill-ventilated places, that the air is unavoidably tainted. The remedies are, to diminish the population, which we do where possible, and to induce the owner to have the places dosed with a little chloride of lime once a week. 10 3. In all classes of houses the dust-heaps are dangerously neglected, by the fault of the inhabitants in nine cases out of ten. 4. We notice, with regret, a kind of apathy and indisposition to help themselves on the part of the poor. In the case of an accumulation of stinking water at No. 30, Thomas Street, not one would take the trouble to remove the nuisance, or even to complain of it. Nothing, however, is to be despaired of. , Continued exertion will tell in time. Meanwhile, any nobleman or moneyed person, who would invest a few hundreds in poor men's houses, and put them into the hands of an agent who would follow our instructions, would not only reap interest from the capital invested, but do infinitely more good than if he gave the same sum as a free gift to an hospital.* III. "We will now give such of the details of various cases brought before us as deserve notice. Unwholesome Bread. On the 3rd August, the Resident Medical Officer at the Dispensary, No. 48, Mount Street, called on Dr. Druitt, bringing with him a specimen of bread, by eating which, as he believed, a family named Aylett, at No. 7, Little Grosvenor Street, had been made ill. On investigating the case, it was found that Mrs. Aylett and two children were ill; that their illness was likely to be caused or aggravated by bad bread; and that the bread in question was as bad as possible—very dark and moist, and not merely sour but *The society for improving the dwellings of the labouring classes has just opened its new houses, Nos. 21 and 22, Grosvenor Market, and would furnish the means of managing the property which any benevolent person, might get possession of. 11 putrid. A visit was made to the shop of the baker, at No. 1, Medway Street, Westminster, to caution him; and a loaf was bought and left at the office of the Westminster Board of Works, in order that the local authority of that district might protect the public. Burial of the . Dead. A man died in St. George's Hospital, on Thursday, the 14th July, and late in the evening of the 15th was brought home to his own lodging in Blomfield Place. Then a representation was made by the neighbours, and the undertaker, Mr. Simmonds, to the Medical Officer of Health, of the extreme rigour of the regulations of the parochial cemetery at Hanwell, by which, if notice is not given to the sexton by noon on Friday, no corpse can be interred till the following Tuesday. Notice evidently could not be given in this case; and the body was not buried till Tuesday, the 19th: although luckily no nuisance was created, for Mr. Newson caused it to be put into an empty warehouse. Offences against health and decency are unavoidable when interments are delayed in hot weather, unless such substance as the disinfecting powder of Macdougal or of Falconer, be used copiously, which the undertakers seldom choose to do. An undertaker averred, that a body removed for burial from Davies Street, on Sunday, the 14th August, 1859, was so decomposed, that he was obliged to take out of the coffin a quantity of sawdust saturated with putrilage, and put it into the dust-hole; and that the coffin still leaked, in spite of his filling it up with fresh sawdust. The regulations should be suspended at discretion, to prevent even the chance of occurrences like this, too disgusting to commit to writing. Death accelerated by impure air. On 20th July, a complaint was brought to Dr. Druitt, concerning the 12 unwholesomeness of the servants' apartments at a tailor's at No. 96, New Bond Street, which, it was alleged, had caused the death of a female servant. On investigation, it was evident that all the yard or open space behind the house in question, had been built over, to make a show-room behind the shop; and thus that the whole of an extensive basement was most insufficiently supplied with air. In the middle of this basement were some apartments, one within the other, with borrowed light, and air at second hand; certain apertures which had been made for air were stopped up; and close by were two water-closets and a urinal, and a stove for heating the irons of the tailor's men. In an inner apartment so situated, and squalidly dirty, was seen, by the aid of a candle, the body of an elderly woman. The weather was most intensely hot, and the atmosphere of the place stifling; the woman was described as of intemperate habits, and having some disease of the heart. She had evidently fallen asleep on the edge of the bed the preceding night, and had never awaked. Dr. Druitt gave it as his opinion at the inquest, that such an atmosphere in such weather was dangerous; and the jury found the verdict, that the deceased died from natural causes, but that her death was hastened by the impure air of her apartments. The occupier of the house promised to discontinue the use of the place as a sleeping apartment. His attention was called to the ventilation of a narrow gallery around the upper part of the show-room, used as a work-room for his journeymen. Tailors who work in such places must expect consumption. Unwholesome Workshops. The Committee of Vestry 13 for carrying out the Nuisances Removal Act, 1855, deservedly attach great importance to the healthiness of workshops, and have desired that such places be from time to time examined. They are generally very squalid and neglected, sometimes quite offensive. Oxford Street, No. 256. This place was formerly a livery stable; now, the passage leading from the street is, or was, occupied by a shop for the sale of penny ices and other cheap luxuries, whilst the premises behind were converted partly into a trunk-maker's factory, and partly into sleeping apartments. The place was brought under the notice of the local authority, in consequence of the owner of these premises complaining of offence from the drains of his neighbour, a stationer. On inquiry, however, the Inspector caused the tables to be turned, inasmuch as the mischief arose from the dirty and illdrained state of complainant's own premises. They formed a most unwholesome factory ; but it would not be easy to describe the filthiness of the sleeping apartments, in which some of the cheap confectionery was manufactured. Harrison's Yard, No. 1. This was an inhabited stable with no water-closet accommodation. Hence, nuisances were committed in the yard. Notice was served, and some correspondence passed with Norris and Son, of No. 2, Bedford Row, attorneys for the owner, who denied their liability to do the work, on the plea, that although they had a lease of 41 years, they were not the real owners. A summons was therefore taken out, which came on for hearing at Marlborough Street on the 1st of July, when the magistrate, Mr. Beadon, granted an order, requiring proper water-closet accommodation to be provided, according to sect, xiii, of the Nuisances Removal Act. 14 The time allowed expired on the 22nd, and on the 28th, as nothing had been done, another summons was taken out, requiring the owners to show cause why they should not pay the fine of 10s. per day for the six days during which the magistrate's order had been disobeyed. This was heard on the 4th of August, when the defendant again disputed his liability. It was then adjourned to the 6th, when the defendant gave in his submission, and promised that the work should be executed forthwith; on which condition, and payment of costs, we agreed not to press for the penalty. The work is now done. It must be understood, that the owner had the option of ceasing to use the premises as a human habitation. Diarrhoea Localities. The places where this disease was most prevalent during the hot weather, were frequently visited, and every pains taken to remove any cause of disease, to encourage the inhabitants to bestir and protect themselves. Of such places the following were about the worst:— North Row, No. 34, a rag and bottle dealer's. Thomas Street, Nos. 4, 5, and 30. Robert Street, Nos. 18 and 23. George Street, Nos. 6, 7, 8, 10, 23, and 24. North Bruton Mews, No. 18. Diphtheria Localities. Union Street,Bond Street, No. 18. A livery stable yard, where a girl died. The apartments were ordered to be cleansed, the dung removed more frequently, and the drainage of the yard and stables made new. They were very offensive. This work is not yet complete. Hanover Place, No. 17. This and No. 16 were ordered to be cleansed, and the water-closets constructed afresh. 15 Scarlet Fever. In consequence of this disease, notices have been served requiring the cleansing of Thomas Street, No. 28. Robert Street, No. 28. Brook's Mews, Nos. 21 and 49. The following premises, which formerly drained into each other, or into cesspools, have had new pipe drainage under the Inspector's superintendence:— Mount Row, Nos. 8 and 9. Oliver's Mount Public House. In the following cases, leakages of water have been attended to by the Inspector:— George Street, No. 19, from a tank at 20. Providence Court, No. 8, from a stable behind. King Street, No. 7, from the water company's pipes. Blenheim Street, No. 8, from a street gully. Inhabited stables, the owners of which have been called on to provide water-closets:— Farm Street Mews, Nos. 40 and 41. Red Lion Yard, No. 3. Stables in which new drainage has been constructed:— Shenton's Livery Stables, North Roto. Farm Street Mews, No. 38. Hay's Mews, No. 47. Dung-heap nuisances have been attended to by the Inspector at Horse Shoe Yard; 3, Berkeley Square; and 297, Oxford Street. The following miscellaneous cases of nuisance:— South Molton Street, No. 23. A house crowded, dirty, and ill-drained. Twelve deaths had occurred in it and the three adjoining houses, in three years. 16 Oxford Street, No. 253. Poisoned by escape of sewer gases from a pipe at No. 253a. George Street, No. 5. A cesspool in blacksmith's factory. Chapel Mews, Robert Street, No. 6. The same. Old Bond Street, No. 3. No closets for 120 workmen. Grafton Street, No. 20. Little Stanhope Street, No. 8. Clarges Street, No. 8. White Bear, Park Street. Hamilton Place, Piccadilly, No. 7. Chapel Street, Grosvenor Square, No. 10. Houses rendered unwholesome by defects in drainage, and rectified by the Inspector. Hart Street, No. 12. Very dirty. Three persons died of various diseases in this house in one week. Shepherd's Market, Nos. 2, 3, 4. Annoyed by street gully. Ditto, No. 17. A butcher accused of keeping putrid meat. In reality, a cesspool within his unventilable house. So much for cases in the Hanover and May Fair districts. Now follow those in Belgravia. In the Belgrave Sub-district, several complaints were brought against Marine store dealers, whose premises require constant supervision. Slaughter-houses and butchers' premises, owing to the state of the weather, and the rapidity with which decomposition took place in meat, contributed so much to annoy several persons, as to cause more inspections than usual. One of the former required frequent visits, in consequence of its being a public slaughter-house. Besides the owner, who killed a great number of pigs, four or five butchers also destroyed 17 sheep; and another pork butcher, from the in-wards, killed 40 or 50 pigs weekly. Besides the evils, in a sanitary point of view, from this excess of business, the noise occasioned by the animals was something terrific. Hitherto it has been usual for the magistrates to grant licenses unconditionally, but in consequence of the preceding case, Dr. Aldis brought the subject before the magistrates, Mr. Thrupp and Colonel Bagot, at the recent Petty Sessions, when the former told two of the butchers that their licenses were to be used only for private slaughtering. Pump-water. It will be seen in the sequel (page 25), that Dr. Aldis has condemned the water of two pumps at Grosvenor Cottages, Eaton Terrace, as totally unfit for drinking. This might form a plea, if needed, in favor of the establishment of drinking fountains. There can be no doubt that persons run considerable risk, especially at certain seasons of the year, in swallowing water from the London superficial wells. The owner of one of those now alluded to, in order, no doubt, to avoid paying water rates, caused a well to be dug in his garden, quite close to a common privy with a cesspool, near to which an underground tank for rain-water was placed. Altogether, the cottage, the garden, &c., might have been considered a snug arrangement. The mulberry-tree flourished over the cesspool, and produced fruit abundantly; and the more the adjoining well was contaminated, the more luxuriant the tree became. Sanitary measures, however, were introduced in the form of cleansing and filling up the cesspool, and draining the premises. Old associations, no doubt, were disturbed by such an innovation, more especially when the mulberries ceased to appear, and it became requisite to take care of health by condemning the pumpwater, and introducing that from the Chelsea Company. B 18 Green's Cottages, Eccleston Street East, No. 2. A nuisance from cesspools which have been abolished from the adjoining premises. Belgrave Street South, No. 2. Water has been supplied to the closet. Flask Lane, No. 10. A nuisance from dogs and cats, which have been removed. Roberts' Buildings, Nos. 9 and 10. Two common privies with cesspools, no dust-pits, and gullies in the yards untrapped, and a large quantity of rubbish. The cesspools have been cleansed and filled up, new waterclosets erected, and the houses drained jointly by pipe drains into the sewer. Spring Gardens, No. 3. Some rooms, with the staircase, have been limewashed and cleansed. Brewer Street, Pimlico, No. 10. Obstructed drains, which rendered the yard filthy, have been cleansed. Trellick Terrace, Vauxhall Road, No. 1. Sewage leaking into the vault at the rear of the house, from No. 2, adjoining premises. The drains have been repaired. Robert Street, Commercial Road South, Nos. 1 to 22. A large quantity of dust and decomposed vegetable matter has been removed from each house. Grosvenor Row, Pimlico, No. 18. Dampness abated in the parlour, where a person was ill with rheumatism. House Refuse. The following is the substance of a •letter which appeared in the Times on this subject from Dr. Aldis, on November 9th, 1858. It was written in consequence of the numerous complaints, some of which are now repeated, regarding the manner in which it was allowed to accumulate:— "The irregular manner in which the dust is at present removed, especially from the houses of the poorer classes, 19 and the constant complaint of nuisance therefrom, render it necessary that some systematic plan should be adopted in the metropolis. " It is well known, that dust being loaded with animal and vegetable refuse in a decomposing state, soon becomes offensive and injurious to the public health. In a report published by the Medical Officers of Health, it appears that 'the mortality of infants under 5 years is nearly four times as great in the neighbourhood of the canal- basin, around which the lay-stalls are situated, as in other parts of the parish.' This paragraph refers to Paddington, and is quoted with a view to prove my previous assertion, relative to the noxious quality of dust on account of the putrid emanations which are disengaged. "The object, however, of this letter is intended to encourage the daily removal of dust from every dwelling, in order to prevent its accumulation. " The plan is effectually carried out at Brussels, Amsterdam, Paris, Cardiff, Dover, and the City of London: and I see no reason why it could not be applied to the whole of the metropolis. "I have already communicated with Dr. Milroy, who is well versed in sanitary matters, with Messrs. Tomkins, lleddin, and Boakes, contractors, with Mr. Rees, surveyor, Dover, Mr. Newlands, Liverpool, and Mr. Paine, Medical Officer of Health, Cardiff,—all of whom speak favourably of the daily removal of ashes and house refuse. "In some towns, the dust is placed at the door of the premises in a light box, easily lifted, and emptied into a cart; but the form and size of the vessel could be soon determined upon." Since this letter was written, Dr. Aldis has visited Edinburgh, and ascertained that carts are sent out twice 20 daily, at eight in the morning and about nine in the evening, for the removal of refuse which has been deposited in the streets. The inhabitants approve highly of the plan. Some persons in England might consider it a nuisance; but however that may be, the Medical Officers think that a more systematic arrangement is absolutely required, as far, at least, as the health of the poor is concerned, and strongly recommend the consideration of it to the notice of the Vestry. The poor allege that if they do not pay for its removal, the scavengers allow it to accumulate, and are abusive; and even those who are in better circumstances are anxious for some alteration. A physician residing in the in-wards told Dr. Aldis that he could not get his dust removed when necessary, although he paid 1s. 6d. It is true that a complaint may be made; but this often involves much waste of time. St. George's Row, Nos. 2 to 32. A large quantity of dust and decomposed vegetable matter taken from each house. St. George's Place. A similar nuisance was remedied in 16 houses. Watling's Yard, Charlotte Street. A large quantity of dung under the chapel windows. It has been removed. Eaton Lane North, No. 7. A marine store dealer's. The shop and lower part of the house have been cleansed and limewhited. Ditto, No. 11. A marine store dealer's. The house has been cleansed throughout. Eaton Lane South, No. 8. A marine store dealer's. The shop and the whole of the house very dirty; a quantity of stinking bones lying on the floor in the back kitchens. A notice was served on July 12th. The house has been 21 limewhited and cleansed throughout, and sacks prepared for the bones. Messrs. Cowell and Son's Slaughter-house, Kinnerton Street, opposite to the complainant's house. Blood cart standing for two hours. The owners were cautioned against allowing the cart to remain longer than was required. Vacant Ground North of St. GabrieVs Church. A quantity of refuse deposited, which has been removed. • Grosvenor Row, No. 38. About half a cart-load of decomposed vegetables in the back yard. The nuisance has been abated. O' Connor's Yard, West Street, Pimlico. A large quantity of dung and pigs' wash. They have been removed. Mr. Bull's Cow-yard, Commercial Road South. A large accumulation of dung, which has been removed. New Street, No. 7. The house refuse has been removed, and the bad state of the paving referred to the surveyor. Upper St. Leonard Street, No. 7. Common privy in the yard. It has been trapped and panned, and the water laid on. Commercial Road South, No. 14. Two offensive gullies opposite to this house have been cleansed. Shoot at the end of Commercial Road South. A quantity of stagnant water, which has been remedied by Mr. Richman, the surveyor. Belgrave Arms, Upper Ebury Street. A nuisance was experienced from a large quantity of house refuse in the back yard of the marine store dealer's adjoining, and from the dung in the omnibus yard. The refuse and dung have been taken away, and the yard of the former limewhited. 22 Grosvenor Place, No. 2. Nuisance complained of here as proceeding from the St. George's School of Medicine. But on inspecting No. 2, before the School of Medicine was examined, a large cesspool close to the back parlour window was detected. On further inquiry at the school, by Dr. Aldis, it appeared that sulphuretted hydrogen was frequently made, but, in most instances, it was either passed through some decomposing alkali, as ammonia, by which a sulphide of ammonium was formed, or the gas was made for the purpose of saturating water, so that very little free sulphuretted hydrogen escaped into the place. Some money had been expended in taking precaution against any nuisance, and great willingness was evinced to adopt any other means that could be suggested. The cesspool at No. 2 has been cleansed and filled up, and a new water-closet erected. Upper Ehury Street, No. 3. A marine store dealer's. The shop, lower part of house, and back premises, have been limewhited and cleansed. Offensive gullies opposite to the Baths and Wash Houses in Lower Belgrave Place, and No. 24, Chesham Place, have been put into proper order. Wat ling's Slaughter-house, Charlotte Street. Several butchers had been slaughtering sheep on the Saturday night and the following Sunday, but neither washed the slaughter-house, nor removed the offal, which caused a very great nuisance. The slaughter-house has been properly limewhited, cleansed, and shut up, by the owners. It is to be used in future for private slaughtering, which takes place only during a few months in the winter season. Victoria Road, Pimlico, No. 12. A defective state of the drains, and an untrapped gully remedied. 23 Tachbrook Street, Pimlico, No. 1. An offensive gully opposite to this house has been trapped. Waste piece of ground adjoining Bedford Place, Vauxhall Bridge Road. Several dead cats in a state of decomposition were removed, and the nuisance abated. Two dung-pits at the corner of Eaton Lane South, belonging to Nos. 1 and 2, Lower Eaton Street. That at No. 1, has been filled up and paved over, and the other at No. 2, has been cleansed. Kemp's Row, Pimlico, No. 1. Nuisance arising from a marine store dealer's, No. 14, Avery Farm Row, adjoining premises. The shop has been cleansed, the vaults limewhited, and the bones in the cellar ordered to be placed in sacks for the future. Upper Denbigh Mews. A large quantity of dung has been removed from the premises. Victoria Street, Pimlico, No. 19. Offensive effluvia entering the windows from the butcher's adjoining premises. A similar nuisance, which caused a second complaint, was abated. May's Yard, Wilton Road, Pimlico. A large quantity of dung has been removed. Offensive gullies opposite to No. 33a, Charlwood Street, and 3 and 4, Gloucester Terrace, Pimlico, have been remedied. Ebury Place, Ebury Square, No. 6. An offensive closet has been removed. Upper Ranelagh Street, No. 3. A cesspool has been cleansed and filled up, a new water-closet erected, and the premises properly drained by six-inch pipe drains into the sewer, and the inlets trapped. Infants' Nursery, Ranelagh Cottages, Lower Ranelagh 24 Grove, Pimlico. The dead body of an infant was left here, the mother having gone to travel with a family. The body has been taken away. Another death occurred in the same place shortly afterwards. Belgrave Terrace, No. 17. No water supply for three months. The complainant takes care of the house, which is not let. The water company had cut off the supply owing to the non-payment of the rates; when these are paid, the water will be properly laid on by the company. Stalle-yard behind No. 13, Bloomfield Place. A large quantity of dung, which was removed; and the owner promised to have it taken away daily during the summer months. Distillery, Thames Bank. A large reservoir, containing a quantity of mud partly covered by water, situate behind Lupus Street. Illness occurred in one of the houses here, and a great nuisance was experienced from the above receptacle, in consequence of the mud being frequently disturbed with a view to flushing it into the drains. The Medical Officer received a complaint, which caused him and the Inspector to examine both premises, and recommend the mud to be covered with water, and not disturbed during the warm weather. Omnibus Yard, Elizabeth Street South. A large quantity of dung. A notice was served for its daily removal before 9 a.m. Robert Street, No. 4, (left-hand side,) Commercial Road South. The Medical Officer attended a case of fever in this house, and found it dirty throughout. A child had also died from diarrhoea in the same place, which has since been limewhited and cleansed throughout. Ditto, No. 8, (right-hand side,) Commercial Road 25 South. Diarrhœa in the house, which has been cleansed and limewhited. St. George's Place, Pimlico. The drains have been cleansed and repaired, gully trapped, and water supplied to the closet. G-reyhound Public House, Cambridge Street, Pimlico. The sewer has been flushed to abate a nuisance here. Mr. Hatt's Cow-yard, between Eccleston Street East, and Ebury Street, Bad effluvia, and ten cows more than the number allowed by the magistrate's order. The dung-pit has been properly cleansed, and the cows reduced according to the order. Mr. Henry Wise's Cow-yard, Elizabeth Street South. A large quantity of dung mixed with decomposed vegetable matter, pools of stagnant water, yard very dirty and offensive. The dung has been removed, and the yard cleansed. Park-side, Knightsbridge, No. 6. Leakage of water through the roof, from the defective state of a watercloset at No. 7. The closet and pipe have been repaired. Victoria Road, Pimlico, No. 15. A gully opposite to this house has been cleansed. Upper Ranelagh Street, Pimlico, No. 2. A common privy and cesspool in the yard, with defective drainage in the house. A notice was served on August 16. Grosvenor Cottages, Eaton Terrace, No. 7. The following is the result of an analysis of an imperial gallon of water taken from the pump behind these premises, on July 26:— Grains. Total Residue 91.20 Organic Matter 11.95 26 It also contained more nitric acid than was considered fit for drinking purposes. The handle of the pump has been chained up, and the water is used only for cleansing. GrosvenorCottages,Eaton Terrace, No. 1. An analysis of the pump-water behind these premises produced, August 6, Grains. Total Residue 82.40 Organic Impurity 8 Nitric acid was present. As there was no proper water supply to the closet, and the pump-water was unfit to drink, a notice has been served. A proper supply of water has been laid on from the Chelsea Company's main, and a new water-closet erected with a cistern over it. An analysis of the water supplied by the Chelsea Company, and taken July 8th, 1859, from the main at 43, Lower Belgrave Place, produced Grains per Gallon. Total Impurity 15.48 Organic ditto.92 Aug. 4th, 1859, Total Residue 17.20 Organic Impurity 1.52 Sept. 8th, 1859, Total Impurity 14.96 Organic ditto 1.00 We have the honour to be Your faithful Servants, C. J. B. Aldis, M.D. R. Druitt. 27 APPENDIX. The illuminating power of the Gas supplied to the Workhouse at Mount Street, according to observations made during August and September 1859, was such, that 2*5 feet burned in a batswing burner, gave a light equal to that of 13'9 sperm candles, burning 120 grains per hour. No sulphuretted hydrogen was detected. During July the apparatus was dismantled, that the meter might be examined and tested. The illuminating power of the Gas* supplied to the room in West Basin Road during the same period, when burned in a batswing burner, gave an average result equal to that of 9.9 sperm candles, burning at the above rate ; and no sulphuretted hydrogen was discovered. * In consequence of a strike among the workmen, there was a considerable diminution of illuminating power for several nights early in August, and on Tuesday night, September 20, the out-wards were almost in total darkness, arising, as alleged, from an obstruction in the hydraulic main, where one bed of pipes was supplying cannel gas. TABLE OF MORTALITY. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending Is/ of October, 1859. Average, 33*84. 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, 31,920. Females, 41,310. Total, 73,230. Parishioners. Nonl'arishioners. I. Zymotic. Small-pox .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Measles 2 9 13 .. .. .. .. 2 2 9 .. .. .. .. 2 11 13 Scarlatina. 1 6 7 1 .. .. .. 5 .. 2 .. .. .. 1 4 4 8 Diphtheria .. 4 8 .. .. .. .. 2 .. 5 .. .. .. 1 1 1 8 Whooping Cough 5 1 7 .. .. .. .. .. .. 7 .. .. .. .. 5 2 7 Putrid Sore Throat .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 Diarrhœa 48 7 55 .. 2 4 1 13 4 44 1 .. .. .. 30 32 62 Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Remittent Fever .. .. 1 1 .. .. .. .. 2 .. .. .. .. .. 1 1 2 Infantile Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever Child-ved Fever .. .. 2 2 2 2 .. 3 .. 5 .. .. .. .. .. 4 4 8 Rheumatic Fever .. .. .. 2 1 .. .. .. 1 2 .. .. .. .. 1 2 3 Erysipelas .. .. 1 1 1 .. .. .. .. .. 1 .. .. 2 2 1 3 Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Canker .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. II. Cancer, Dropsy. Hæmorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dropsy .. .. 1 .. .. .. 1 .. .. 2 .. .. .. .. 1 1 2 Abscess .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Ulcer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Cancer .. .. .. .. 7 1 .. .. 1 5 .. .. .. 2 2 6 8 Gout .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 III. Scrofula. Scrofula .. .. .. .. .. .. .. .. .. 1 1 .. .. .. 1 1 2 Mesenteric Disease 2 6 9 1 .. .. .. .. 4 4 .. .. .. 2 6 4 10 Consumption .. 1 6 36 11 .. .. 4 4 34 6 .. 2 3 32 21 53 Water in the Head. 5 4 10 .. .. .. .. 2 2 6 .. .. .. .. 6 4 10 IV. Nervous System. Inflammation of Brain .. 1 1 1 .. .. .. .. 1 .. .. .. 1 .. 2 .. 2 Apoplexy .. .. .. .. 3 3 .. 1 1 .. 1 .. 1 2 3 3 6 Paralysis .. 1 1 .. .. 2 1 2 .. .. 1 1 .. .. 1 3 4 Delirium Tremens .. .. .. .. 2 .. .. .. .. .. .. .. 1 1 2 .. 2 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epilepsy .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Convulsions 6 6 12 .. .. .. .. 4 1 7 .. .. .. .. 4 8 12 Disoaseof Brain,Spine, &c. 1 .. 1 2 6 2 1 1 2 7 .. .. .. 2 7 5 12 V. Heart, &c. Pericarditis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Aneurism .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. 1 Disease of Heart, &c .. 1 1 3 7 7 .. 3 .. 6 1 .. .. 5 8 10 18 VI. Lungs, &c. Laryngitis .. 1 1 .. 1 .. .. .. .. 1 .. .. 1 .. 1 1 2 Bronchitis .. 2 4 .. 3 7 1 5 .. 5 2 .. 1 1 8 7 15 Pleurisy .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Pheumonia 2 3 5 1 .. 2 .. 2 .. 3 1 .. 1 .. 5 3 8 Asthma .. .. .. .. 1 2 1 .. .. 4 .. .. .. .. 1 3 4 Disease of Lungs, &c 1 .. 1 1 1 2 .. 1 1 1 .. 1 .. 1 1 4 5 BIRTHS registered during 13 weeks.—Hanover Square, M. 58, F. 53; May Fair, M, 28, F. 17: Belgravc, M. 191, F. 191, Total. . .538 Average . , 41*3 DISEASES. Ages at Death. Sub-districts & population Sexes. | Under 1. | 1 and under 5. j 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. Belgravc.—40,034. | Mount-street Work.—268. | Little Chelsea Work.—350. St. George's Hospital. —210. | Males, 31,920. | Females, 41,310. | Total, 73,230. Parishioners. !Non1 Parishioners. VII. Op Stomach, &c. Teething .. 5 5 .. .. .. .. .. .. 5 .. .. .. .. 2 3 5 Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Stomach 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Inflammation of Bowels .. .. 2 .. .. .. .. .. .. 1 .. .. .. .. 1 1 2 Inflammation of Peritoneum .. .. .. 3 .. .. .. .. .. 1 .. .. .. 1 2 1 3 Dropsy of Belly .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ulcer of Bowels 1 .. 1 .. 1 .. .. .. .. 1 .. .. .. 1 2 2 Rupture .. .. .. 1 1 .. .. .. .. 1 .. .. .. 1 .. 2 2 Heus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intussuseption .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stricture of Bowels .. .. 1 .. .. 1 .. .. .. 1 .. .. .. .. 1 1 2 Disease of Stomach .. .. .. .. .. 3 .. 1 .. 4 .. .. .. .. .. 5 5 Disease of Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Jaundice .. .. .. l 1 .. .. .. .. 2 .. .. .. .. 1 1 2 Disease of Liver .. .. .. l 2 4 .. .. 2 4 .. .. .. 1 3 4 7 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Ukinary, &c. Inflammation of Kidney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bright's Disease .. .. 1 2 2 .. .. .. .. 1 .. .. 1 2 2 3 5 Ischuria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. 1 1 .. .. .. .. .. .. .. 2 2 .. 2 Stricture of Urethra .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. 1 Disease of Kidneys, &c .. 1 2 2 5 1 .. 1 .. 5 .. .. .. 4 5 5 10 IX. Womb, &c. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. 1 1 .. .. 1 .. .. .. .. .. 1 .. 2 2 Child-birth .. .. .. 2 .. .. .. 1 .. 1 .. .. .. .. .. 2 2 Disease of Uterus, &c .. .. .. 1 4 .. .. .. .. 3 .. .. .. 2 .. 5 5 X. Joints, &c. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Joints, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XI. Skin, &c. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. . .. .. .. .. Disease of Skin, &c .. .. .. 1 .. .. .. 1 .. .. .. .. ... .. .. 1 1 XII. Malformations. 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Blue Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Spina Bifida 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Other Malformations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XIII. Debility: 8 .. 8 .. .. 2 .. 2 2 3 .. 3 .. .. 5 5 10 Premature Birth 6 .. 6 .. .. .. .. 1 1 3 1 .. .. .. 5 1 6 XIV. Atrophy: 6 .. 6 .. 1 .. 1 1 .. 7 .. .. .. .. 3 5 8 XV. Age .. .. .. .. .. 12 8 3 2 10 5 .. .. .. 9 11 20 XVI. Sudden: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVII. Violent Death: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk 11 .. 11 .. .. .. .. 2 .. 9 .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sun Stroke .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. Poison .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. Burns and Scalds .. 1 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Hanging .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. Suffocation ..1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Drowning .. .. 1 2 1 .. .. 3 .. 1 .. .. .. .. 9 9 4 Fractures .. .. .. 2 1 2 .. 1 .. .. .. .. 3 1 2 3 5 Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Violence 2 . 3 1 2 .. .. .. 1 1 .. .. 1 3 5 1 6 Surgical Operations .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 XVIII. Not Specified. 1 1 2 1 1 1 .. 2 1 1 .. .. .. 1 3 2 5 TOTAL: 112 61 203 84 73 65 15 76 42 233 21 5 15 48 219 221 440 DEATHS registered during corresponding weeks of ten years (average) 380 Weekly average 29.1 C. J. B. ALDIS, M.D. R. DRUITT, LONDON : PRINTED BY GEOBGE PHIPPS, RANELAGH STREET, RATON SQUARE. HAN 9 13 No. IX.] QUAETEKLY SUMIAIJY OF THE SICKNESS AND MORTALITY OF Saint George, Hanorber Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICEBS OP HEALTH, FOR THE \ QUARTER ENDING DECEMBER 31ST, 1859. LONDON. to the Vestry of St. Geogre, Honober Square. My Lords and Gentlemen, I.—During the thirteen weeks ending December 31st, 1859, 429 deaths occurred, including those of 8 inmates at Little Chelsea, and of 58 non-parishioners in St. George's Hospital. The weekly average 33, exceeds that of the preceding ten years by 3 ; but we are happy to state that the total deaths during the Quarter, when compared with those which occurred in the corresponding periods of 1857 and 1858, are less by 74, although the population has increased. Diseases of the respiratory organs, including 56 from consumption, destroyed 133 persons. Amongst the deaths which deserve a passing notice, we find that of a foreign nobleman, set 54, on the 1st December, 1859, at the Clarendon Hotel, of confluent small-pox. This death was one of the first palpable signs of that almost universal outbreak, which it will soon be our duty to chronicle. There is no reason for supposing that the disease was contracted in the hotel; on the contrary, as it requires a space of at least eight days from 4 the reception of contagion to develop itself, and as the deceased had just returned from a visit into Norfolk, it seems that he must have taken it whilst travelling. The attack itself, as we learn from Mr. Young, the medical attendant, was of the most virulent nature conceivable. Yet the deceased had been well vaccinated when a child; in fact, as we are informed, he was the child first vaccinated in Florence, in 1810, when Jenner's discovery was first promulgated in Italy. It is worth recording, that a young man of 19, son of the undertaker, became infected whilst superintending the last offices to the body of the deceased; yet this young man, as we learn from Mr. Young, was well vaccinated when an infant; notwithstanding which, he had small-pox at the age of one year and nine months, and now again, spite of the double protection he may be supposed to enjoy, he takes the small-pox a second time in its most virulent shape, and just escapes with his life, marked from head to foot, and with one eye almost lost. It is worthy of remark, that the woman who removed the rings from the body, incautiously infected one eye, and nearly lost the sight of it through the violent suppuration which ensued. Without anticipating what we shall have to say hereafter, we may remark here, that if vaccination be not a perfect preservative, so neither is the small-pox itself, against a second attack; and that the liability of every one to second attacks of this class of diseases, is becoming daily a better established fact; hence, that the task of hunting out and exterminating the fever poisons, must be pursued with double energy. Three deaths occurred from the same disease in the Belgrave Sub-district. A man cook, who came from Paris on September 27th, fell decidedly ill on the 28th, 5 and died on October 3rd. There is evidence of his having been attacked with shivering on the way to London, when he was affected by incipient symptoms of the malady, which he clearly brought from Paris. The ceiling of this room was lime-whited, and the room newly papered and cleansed. An infant, aet 11 days, unvaccinated, died from smallpox in Churton Place on November 2nd. The mother was confined on October 23rd, small-pox appeared in her case on October 25th, the infant sickened and died on November 2nd. Mr. Cooke, the medical attendant, could not account in any way for the mother having the disease. Another child, unvaccinated, in the same house, was vaccinated forthwith. A child died from natural small-pox in Westmoreland Street on November 23rd. It appeared that the father, prejudiced against vaccination, had lately brought his family to London. It was alleged that one of the boys, aged 12, had sat near other children in St. Michael's Schools, who had just recovered from small-pox, and that he subsequently became infected. When convalescent he visited his brother in the Westminster Hospital, who had been admitted there for hip-disease. The latter was attacked with the malady as well as the mother, and a boy aged nine. In consequence of the allegation that one of the above children had been affected with the disease at St. Michael's Schools, Dr. Aldis visited them, and found the statement to be untrue, for no other pupil had lately suffered from small-pox. He then took an opportunity of examining the arms of 403 children, and ascertained that no less than 37 were without traces of vaccination, and 3 in whom they were doubtful. Twenty-three of the children 6 were soon afterwards vaccinated in the presence of the Medical Officer by Mr. Jorden, and the operation has since been performed upon others. The rules of these schools required all children to be vaccinated before admission, but as the arms of the children had not been examined, many were entered without any evidence of vaccination having been performed. Hence it became desirable to recommend the clergymen, and others, who have the charge of schools, to send them either to the public vaccinator or the Medical Officers of Health for examination, before their admission into the schools. One death from scarlatina occurred in Brooks' Mews, where the prevalence of the disease was entered in our last Report. No fewer than six deaths occurred in the adjoining Avery Row, during the Quarter. One death from scarlatina maligna at No. 1, John's Place, Grosvenor Mews, and one at No. 84, Mount Street. Other deaths from the same complaint occurred: 1 at No. 18, Eccleston Place, 2 at No. 114, Eccleston Mews, and 3 at No. 100, Stanley Street. Diphtheria destroyed four persons, who respectively resided at No. 3, Cornwall Terrace, No. 2, Grosvenor Row, No. 12, Charlwood Street, and No. 1, Lower Belgrave Street. The death of a Capt., R.N., set 36, from China fever, is returned at No. 31, Park Street. A child, aet 1, ill of dysentery, residing at No. 30a, Grosvenor Mews, died in its mother's lap at the dispensary, on 11th October, 1859. It is unsafe to move patients when very exhausted. A maid-of-all-work, ast 24, died of fever on 28th November, 1859, in the workhouse, to which she had been removed from a tradesman's family in South Audley 7 Street. A "clerk in holy orders," set 30, was returned as having died of the same disease on October 9th, at an hotel in Brook Street. As this was the second death from alleged zymotic disease, reported to have occurred in that house within a short time, it was thought proper to ascertain the facts of the case, which were, that both patients had come to town ill, and that the arrangements of the hotel were quite healthy. Enquiries of this nature are a great protection to the public. They are not always needless in the case of the rich, who go to expensive lodgings ; but still less are they superfluous in the case of poor friendless " maids-of-all-work," who are compelled to sleep in the kitchen, the part of the house the most liable to dampness and drain smells, and their consequences— fever and rheumatism. Among the deaths arising from mental suffering we observe, that there were 3 cases of suicide: one, a male, strangled himself by means of a scarf; another from drowning, when insane, in the Serpentine; and the third, a female, who threw herself from a window. There were also 4 deaths from want of breast-milk, and 1 in a child aged three months from suffocation. Fractures proved fatal to eight persons, four of whom were non-parishioners. II. The Sickness. The number of cases attended gratuitously this quarter, in the Hanover and May Fair sub-districts, by the physicians and surgeons of the parish, and of the branch dispensary, 48, Mount Street, was 781, against 856 attended in the corresponding quarter of last year. There may be some disturbing causes which render these figures not entirely exact 8 measures of the amount of sickness; yet we believe they are to be relied on in the main, and that they exhibit fairly the sickness of that portion of the poor who habitually seek medical attendance gratuitously. In the winter quarters of the last four years, these numbers have been 787, 1126, 856, and 781. Amongst these were 2 cases of small-pox, 1 of chickenpox, 13 of measles, 3 of scarlatina, 3 of whooping cough, 16 of diarrhoea, 14 of continued fever, 155 of bronchitis and catarrh, 11 of sore-throat in various forms, besides 2 of diphtheria. The small-pox appeared in this district first, so far as we know, at 11, Carrington Mews, May-Fair, about the 17th of October, in a girl aet 17, a pupil teacher of the Curzon Schools. She was well vaccinated, and the attack was slight. The second was in the daughter of a milliner in South Molton Street, who had recently come from Soho; the disease was very slight, and they denied the existence of it. These were the 2 cases attended by public charity, and noticed above. Next we heard of the fatal case at the Clarendon, and of cases at No. 26, Grosvenor Market, and No. 6, Carrington Street, at the end of December. Other cases there doubtless were; but they occurred in families who naturally prefer to keep such disagreeable things quiet. The cases of diphtheria were not fatal; one at No. 8, Carrington Street, and the other at No. 1, John's Place, in which house a child died of malignant scarlatina, and most of the inmates had sore-throats in some form. Sore-throat is the most variable of maladies in some respects, for it may be utterly insignificant, or may destroy life in a few hours ; but we have learned, by experience, that it often accompanies zymotic disease, and where we hear of one or 9 more cases, we think that the house deserves inspection. This rule was well exemplified by a house in South Street. The cases of fever were, for the most part, very mild, and distributed equally amongst the houses in the least healthy districts. Here we present the usual table showing the amount of public patients contributed by the places referred to. Population. Cases of illness attended by Charity. Deaths of children. Deaths of adults. Model Lodgings 130 2 0 0 Blomfield Buildings 130 17 1 0 Brick Street 296 5 1 2 Brown Street 200 42 3 2 Carrington Street 280 18 1 1 George Street, Grosvenor Square 540 43 2 3 Grosvenor Market 211 12 0 0 Grosvenor Market 944 63 3 0 Grosvenor Mews 265 21 2 3 Hart Street 200 19 1 1 John's Court, Farm Street. 80 18 0 0 Lancashire Court 270 24 1 2 May's Buildings 122 11 0 0 Mount Row and Place 133 13 0 0 North Bruton Mews 154 26 1 1 Queen Street 316 12 1 0 Robert Street 543 28 0 1 Thomas Street 600 36 1 1 The Curzon Schools, and the Roman Catholic School in Davies Mews, were visited and examined by Mr. Jay, the District Vaccinator, and many of the elder children in each re-vaccinated, and a few of the younger ones vaccinated for the first time. The periodic inspection of schools secures the vaccination of the native children, especially in combination with careful examination of the 10 register, and personal enquiry after such children as are not brought within the usual time. But it is difficult to be safe from the immigration of unprotected persons from other districts. In the Belgrave Sub-district, 5,093 cases were treated by the Parochial Surgeons, at St. George's Hospital, the Royal Pimlico Dispensary, and the St. Paul's and St. Barnabas' Dispensary, and at the Workhouse, Little Chelsea, whereas in the corresponding winter quarters of 1857 and 1858, the numbers were respectively 5,335 and 6,487. Of the 5,093 cases, 3,087 were patients at St. George's Hospital, leaving a remainder of 2,006. We find that the above included 6 of small-pox, 7 of chicken-pox, 48 of measles, 11 of scarlatina, 36 of whooping cough, 3 of croup, 96 of diarrhoea, 3 of cholera, 37 of continued fever, 59 of rheumatic fever, 14 of erysipelas, 1 of diphtheria, and 5 of ague, 3 of which occurred among non-parishioners. There were also 493 cases of bronchitis, 10 of pleurisy, and 15 of pneumonia. III. Ventilation of Sewers. It is well known, that the present mode of ventilating sewers, in many instances, causes a great annoyance to the inhabitants, and, in some, is highly prejudicial to health. For example, one end of Eccleston Place in the Belgrave Sub-district, forms a cul de sac, and a ventilator is placed over the sewer towards the closed extremity. The result is, that frequent complaints have arisen from the inhabitants of the houses on either side, in consequence of the effluvium which escapes from the opening, particularly during warm weather. Medical men have also expressed a strong opinion, that it has produced numerous cases of sickness. But loud complaints 11 have been made against the present ventilators, even when placed in more open situations than that just mentioned. It is not necessary to prove that the emanations from sewers are highly dangerous to animal life, for experience seems to have decided this question. Indeed, a very conclusive proof of their fatal tendency occurred near to our own dwellings, when the Kennilworth Sewer was opened at Pimlico in October 1849, when five men were as suddenly poisoned by the sewer gases as if they had swallowed prussic acid. Many other similar instances have occurred in the metropolis since that period, one in June 1857, at the Green Bank Sewer at Wapping Wall, and another in August following in a branch sewer at Whitechapel. We have also met with cases likely to prove very dangerous, owing to leakage from pipes connected with water closets. The walls of the rooms become damp, and noxious exhalations escape; but should they be used for sleeping apartments, the danger to health and life is increased. Neither is it requisite to enter fully into the merits of antiseptics, or anti-putrescents, deodorizers, and disinfectants, although they may be very useful under certain circumstances. The two first have been considered to be inexpedient for the present purpose, unless they could be applied before sewage matter had become decomposed, which is impracticable. With regard to the two latter, some are difficult of application, others would be dangerous to the workmen, and most would be too expensive, when it is remembered that there are about thirty miles of sewage to deal with in this parish. Some, however, of the disinfectants are extremely valuable, by bringing the putrid matters into contact with the atmospheric oxygen. Of these, charcoal is esteemed the most useful to fulfil the 12 present object; the atmospheric oxygen acting upon the putrid vapours generated in the sewers, decomposes the sulphuretted hydrogen, and water is formed during a process of slow combustion. It has been objected, that this mode of ventilation might impede the free egress of the sewer air; such, at one time, was the opinion of Mr. William Haywood, Engineer to the Commissioners of Sewers of the City of London; and Mr. Richman, your surveyor, entertains a similar notion. But, in the third report of the Board of Works for the Fulham district for March 1859, it is stated, " That the mechanical obstruction offered by the charcoal, does not prevent the free and easy egress of the sewer air." The ventilator used there is a modification of those first tried in the City; and one has been constructed for the purpose of being placed over the sewer in Eccleston Place. A model of the apparatus was exhibited by Dr. Aldis to the Sanitary Committee who recommended it to be adopted. IV. Over-Crowding. Some notices have been issued to prevent the evils arising from this cause in the Belgrave Sub-district.* Assuming the quantity of air which passes through the lungs of a man of ordinary size in 24 hours to be 267 cubic feet, a space of at least 300 cubic feet should be allowed for each individual, but a much larger space is afforded in prisons and workhouses. It is bad enough for persons who are in health to be huddled together; but, in the course of time, when fever is engendered, the consequences become extremely dangerous. The state of depression induced by over-crowding frequently tends to habits of intemperance, which increases the tavern as well * See pp. 27, 28, and 29. 13 as the fever bill; and much of the immorality among the labouring classes may be attributed to a similar source. A process of mutual poisoning is going on in rooms occupied by too many persons, during which carbonic acid gas is thrown off from the skin and lungs of each person ; and when we consider that one or two per cent, of this agent, if breathed for several hours continuously, has produced alarming effects, it becomes imperative on the Medical Officers of Health to counteract the evils of air so vitiated. Besides, we must not overlook the organic particles exhaled from the lungs of each person, which, floating in the atmosphere, probably occasion disease and death to the greatest extent in the more densely populated districts. V. Under-Ground Dwellings. A few examples of some of these, situated in the Belgrave Sub-district, are now given. Avery Farm Row, No. 13. Staircase in a very dangerous state. The room exceedingly dirty, and the floor covered with the debris of rotten harness. Ditto, No. 6. The front kitchen dark and unwholesome. Two infants are received here to be nursed during the day. Flask Lane, No. 3. A small kitchen occupied by a man, his wife, and five children, and only 6 feet 3 inches high. Ditto, No. 2. A man, his wife, and three children occupy the front kitchen, which is only 6 feet 9 inches high. Upon this state of things being represented to the sanitary committee, it was referred to the Vestry, who directed the district surveyors to report upon the underground dwellings. YI. Cow Houses. The Metropolitan Association of 14 Medical Officers of Health have issued the following letter, dated October 29th, 1859, to each chairman of the metropolitan vestries:— "Sir,—At a meeting of the above Association, held at Richmond Terrace, Whitehall, on Wednesday, October 19th, it was resolved,—' That a letter, signed by the chairman, be addressed to each vestry and district board in the metropolis, urging them to procure insertion, in the proposed bill for Amending the Metropolis Local Management Act, a clause relating to an annual licensing of cow houses.' "In conformity with the above resolution, I most respectfully and urgently request that your board will, at its earliest convenience, represent to those who have charge of the proposed Amendment Bill, the desirability of placing all cowhouses on a similar footing to slaughter-houses, as regards the necessity of their being annually licensed. "The Association of Medical Officers of Health are thoroughly convinced that cow houses, as at present conducted in London, are nuisances, and injurious to health, both directly by giving rise to noxious effluvia, and indirectly by impairing the health of the cows, which thus supply unwholesome milk." VII. Visit of Inspection. It should be recorded, that pursuant to a resolution passed at a meeting of the Committee, on the 20th December, the following gentlemen assembled on the' 23rd at noon, and proceeded to inspect the worst parts of the May Fair and Hanover Sub-districts; viz., Messrs. Pocock, Walton, Sydney Howell, and Englefield. They visited May's Buildings, Brick Street, Hertford Place, Ducking Pond Mews, No. 18, Grosvenor Mews, Blomfield Place, Lancashire Court, No. 17, Avery 15 Row, Grosvenor Market, Robert Street, and Hart Street. It is a significant fact, that one gentleman left the Committee in the middle of their labours, complaining that the air of these houses gave him a sore-throat. The Petty Sessions for Licensing Slaughter-houses was holden at Mount Street, in October, 1859. There are now fourteen of these places in the Hanover and May Fair Sub-districts, and nineteen in the Belgrave. VIII. We now proceed to the details of various cases brought before the Committee of Vestry for carrying out the Nuisances' Removal and Disease Prevention Acts, at their monthly meetings. Unwholesome Bread. It is right to put on record, that Dr. Druitt informed the Committee, on the 18th October, that he had received letters from a solicitor, claiming compensation and apology, for his proceedings in reference to some unwholesome bread sold to inhabitants of Grosvenor Mews, by a baker at Westminster. (See Report VIII., p. 10). The committee desired him to reply, by asking whether the solicitor wished the case to be brought before the Vestry of St. George, Hanover Square, since which nothing more has been heard of thecase. Analysis of Bread. In the course of the discussion which took place relative to this matter, Dr. Druitt informed the Committee, that in December 1856 he had caused an analysis to be made of the bread used in the parish, including one home-made loaf, one loaf from the workhouse, and fourteen other loaves purchased at various shops, in such a way as to include the greatest possible variety of price and quality; for the price varied from 7½d. to lOrf. per 4-lb. loaf. It may stated: first, that a very experienced 16 cal chemist, operating in the most approved manner, did not find reliable specimens of alum in any one of the samples. The quantity of combined water was estimated, in consequence of the assertion sometimes hazarded, that cheap bread contains more water than the best bread, and that slack baking and alum are used in order to add to the retentiveness of water, and that hungry stomachs are thus cheated, by giving them bulk without value. On the contrary, it was found that the loaf which contained the smallest per centage of water, was a cheap one; which at 1%d. per 4-lb., contained 1*26 lbs. of water, or 31*62 per cent.; whereas a better loaf at 8^<f. contained 1*89 lbs. of water, or 47*37 per cent. A homemade loaf, which was taken as a model of good bread, contained 34*8 per cent.; and a loaf from Bond Street, at 9%d., also a model, contained 35*77; one loaf at 10rf. 36*49 per cent. In the next place, respecting the gluten, or nitrogenized constituents, which are important flesh-making ingredients: a loaf, from a first-rate baker in Bond Street, contained 11*6; that of a cheap baker in Grosvenor Mews, 13*; home-made bread, 14*37; and a best loaf from Oxford Street, 19*18 per cent., estimated in each case from bread thoroughly dried. Later researches of Lawes and Gilbert shew that a high rate of gluten is by no means, as was once thought, a characteristic of the best wheat. The ash, supposed to be the bone-making ingredient, varied from 1.5 to 3. per cent. But when the outward qualities were compared, there is no doubt that any person of common sense would immediately have declared, that the best was the most 17 agreeable to the taste and smell, and therefore, presumably, the wholesomest; and there was no doubt also that the only loaf which was unpleasant to taste and smell, was one of the cheapest, although it is not pretended, that it would have been prejudicial to a sound stomach. These chemical determinations, and other examinations, which the writer had made before and since, have convinced him that the bread sold in the parish is substantially good; and that in judging of bread as well as of meat, milk, butter, and beer, the common senses not only are quite adequate tests for all ordinary purposes, but that they reveal conditions of quality which the microscope and test tube cannot take cognizance of. Blomfield Buildings. This, which is a model house, has never been so healthy as the other model house in Grosvenor Mews. The position is worse, the ventilation less, it is exposed to noxious fumes from a never-thoroughly-emptied dung-pit of Sadler's; and through some defect in the water apparatus, the inmates were always deprived of water on Sundays, and the drainage arrangements became offensive in consequence. After some correspondence with the Grand Junction Company, who shewed that the quantity supplied was ample under better management, the owner of these buildings was induced by the Medical Officer of Health to put new closets, taps, &c., by which waste has been mitigated, and a comfortable and wholesome supply of water maintained, even on Sundays. Whitehorse Yard. The pavement which had become dilapidated, permitting pools of water to stagnate, has been repaired; and a better supply of water obtained for the cottages and stables in the yard. Brown Street, No. 16. This is a house which has b 18 been incessantly attempted to be improved; but the kitchen continued so offensive, that the Committee authorized a requisition to the owner to close it as unfit for human habitation, and the whole house to be cleansed, which was done. Ditto, No. 14. Again dirty throughout. Has been cleansed. George Street, Grosvenor Square, No. 24. The area and basement of this crowded house were so offensive, as to annoy passers-by in the street, owing to want of traps, which have been provided. Ditto, No. 23. Attics dirty; roof leaky; inhabited kitchens offensive. Ditto, No. 22. Inhabited kitchen dirty; gullies untrapped; no water to closet. A shoemaker, wife, and seven children occupied, day and night, a room under 1008 cubic feet in capacity. The kitchen has been cleansed, the gullies trapped, a new water-closet erected, and the over-crowding diminished. The family have taken another sleeping room. George Yard, Brown Street, No. 6. This, like some other out-of-the-way places, had escaped observation, and was mistaken for a stable or workshop; nevertheless it was inhabited by a man, wife, and three children; very dirty, a cesspool underneath, and no water supply. The cesspool has been abolished, but the owner has preferred shutting it up to making it fit for human habitation. Swan Passage, Mount Street. The three cottages in this yard had become dirty, the water supply inadequate, and the old brick drain decayed and leaking into the cellars of the White Swan public house adjoining. The place has been cleansed, the tenants changed, the old 19 brick drain removed, a new pipe drain laid down, and the urinal in the passage abolished. Red Lion Yard, Union Street, No. 4. Here an untrapped pipe, which brought dirty water into the yard, and conveyed effluvia into the living rooms, has been trapped. Park Street, No. 87. This case offers one instance more of the recklessness of the workmen formerly employed about house drains, and the expediency of employing competent persons to overlook them. Nos. 87 and 88, formerly drained through one outlet. The owner of No. 87 laid down a new pipe drain some time since, and cut off the drainage from the front area of No. 88. Hence, after a time, the drains of No. 88 became surcharged, and oozed up. The proper outlet has been restored. North Row, No. 36. Ten families of forty persons live here over a coach factory. The roof was partially leaky, and some of the rooms damp and dirty. They have been cleansed and limewhited. Dolphin Court, Oxford Street. A narrow court, containing a population of about fifty persons in six houses; drains through Nos. 5 and 6, Princes Street, Hanover Square, into the sewer in Princes Street. One drain was choked up, and several inlets untrapped, which have been attended to properly by the Inspector. Hill Street Stables, Nos. 20a and 20b. These stables, inhabited by coachmen and their families, being without water-closet accommodation, have been provided with the requisite apparatus and pipe drainage on the requisition of the local authorities. (See precedent in No. VIII.,p. 13.) Carrington Mews, No. 45. This was a stable, within 20 the original hay-loft of which apartments had been constructed and occupied by a married couple and five children. The woman and children had lived here six years; say they have never been well since, with debility and scrofulous complaints; and that at whatever hospital or dispensary they applied for relief, were always told that want of pure air was probably the cause of their complaints. As is usual, the hay-loft had been converted into a dwelling, not by using the whole space, and having free external apertures, but by erecting within it a closed lath-and-plaster box, of about 853 feet cubic capacity, which was used as the dormitory for the seven inmates. The owner has done somewhat to mitigate the evil, by inserting a skylight which opens. It is a pity that the classes interested do not bestir themselves, instead of leaving all to public authority. South Street, No. 14. Lodgers applied at dispensary for diarrhoea and sore-throat. This led to inquiry whether the house.was wholesome; roof was leaky, attics dirty, no water to closet, and an untrapped gully in the basement. All these things have been attended to as required. Thomas Street, No. 4. A young woman complains of "debility." It is found that she, with her sister, æt 21 and 23, and their brother, æt 14, sleep in a small back kitchen (cubic capacity 504 feet). Underneath it an old disused drain, which had not been broken up and removed as it ought to have been, and which served still to bring an offensive current of air. Even whilst this old drain was open and being removed, these persons slept in the room; in fact, they had no other place to sleep in. Robert Street, No. 3. House dirty throughout: has been cleansed. 21 Park Lane, No. 14. This first-class house affords an instance, that no one is safe from the recklessness and mismanagement of workmen. It is contiguous behind with a stable, No. 22a, Brick Street, and is on a lower level, for the ground had been excavated when the house was built, so as to give a fictitious height to the basement storey; a thing often done by architects, and always repented of by occupiers. (See case of No. 65, Grosvenor Street, Report No. VI., p. 13.) Under the floor of the stable, but on a higher level than the floor of No. 14, and in contiguity with it, ran a drain, which received the water-closet drainage of the stable, and that of a sink at No. 15, Park Lane, on the other side of Brick Street. This drain had been bricked up. Hence the water having no vent, oozed, or rather trickled or streamed through the wall into the wine cellar and butler's pantry of No. 14. When the floors were taken up, the stagnant offensive water was lying there; and as the house lies on a bed of clay, which we have before alluded to, the water could not soak away very fast. The occupiers noticed a close sour smell when the house was closed, and never enjoyed thorough health nor appetite. Under the directions of Mr. Grant, the offending drain was restored and cleansed; and the occupier of No. 14, with great good sense, took up the floors of the basement, and caused all the offensive mud underneath to be excavated, and the ground to be made good with clean dry rubbish. But it was some time before the house could be pronounced sweet and habitable. Brick Street, No. 19. Had become dirty, and the roof out of repair. The owner has done the requisite work. Ditto, No. 21. The same. Davies Street, No. 46. Had been damaged by leakage 22 from the pipes and cisterns of No. 45, an empty house. These have been repaired. Mount Street, No. 60. The occupier complained of a leakage of water into his wine cellars, which being satisfactorily shewn to proceed from a dung-pit in his own yard, was left to himself to remedy. South Molton Street, No. 55, Hanover Schools. Here a leakage of water into the boys' schoolroom has been ascertained by the Inspector to proceed from a dilapidated water-closet at No. 54, and been rectified. Robert Street, No. 11. Roof somewhat leaky; gully untrapped in the basement. Ditto, No. 9. A case of fever. Basement cleansed; refuse removed. Grosvenor Street, No.—Complaint made by a lodger of unwholesome smells. Several visits made by the Inspector, without discovering any just cause of complaint. Duke Street, Grosvenor Square, No. 16. Here a child died of typhoid fever; nothing amiss discovered in the house. New Bond Street, No. 161. In consequence of a repetition of complaint from the occupier, of the soakage of water into his wine cellar (the case is described at p. 7, Report, No. VII.). The premises in question, and No. 13, Grafton Street, were visited on the 18th November, by Mr. Evans, Chairman of the preceding Committee, accompanied by Mr. Richman, and by the Medical Officer of Health, and the Inspector. The Chairman having deliberately examined into the facts, and heard all the statements made, was of opinion that it was a case in which the local authorities could scarcely interfere, with benefit to the complainant, inasmuch as it seemed almost certain that the grievance now existing was due to the 23 natural wetness of the earth; and he recommended a private arrangement if possible. Grosvenor Gate, No. 6. The owner complained of a leakage of water into his premises, from the King's Head public house, in King's Street Mews, adjoining. It was ascertained by Mr. Grant, to be caused by a defective state of water-butts and water-closet, which have been repaired, and the wall cemented. St. George's Terrace, Uxbridge Road, No. 5. A similar case; a leakage from a sink at No. 5, remedied by the construction of a new drain. Union Street, South Street, No. 10. A leakage of water into the parlour, from a defective pipe in the George public house adjoining. Lancashire Court, No. 15. Here a case of overcrowding has been put a stop to by the Inspector. A tailor (Irish) with his wife and three children occupied the first floor front, in which another tailor worked with them by day. Besides, they took in a young woman and child as lodgers. Stable behind No. 14, South Audley Street. Here the Inspector discovered an offensive cesspool, but it was removed spontaneously by the occupier. North Row, No. 11. Here was a case of fever. Such rooms as were dirty, and the basement, have been limewhited. Eaton Place, North Row, No. 4. Another case of mild fever. Rooms cleansed. Hertford Place, No. 9. The front area rendered damp and unwholesome, by a rain-water pipe from the roof of Mr. Quartermain's stables adjoining. Albemarle Street, No. 17. Here the complaint was of leakage ; and the Inspector ascertained that it proceeded 24 from a huge cesspool on the adjoining premises, 171, New Bond Street, close to the party wall. This has been abolished, a proper apparatus substituted, and the place disinfected. Providence Court, No. 7. Here was a leakage of water from the drains of No. 6. New pipes have been laid down under the Inspector's supervision. Park Street, Grosvenor Square, No. 26. This house has been entirely drained under the Inspector's advice; the old drains abolished, cesspools emptied, new pipes laid down, proper traps, &c. Tenterden Street, No. 5. Here the complaint was against a leakage of sewage water from Laurie and Warner's coach factory, which, if it existed, has been removed: meanwhile, a thoroughly ill-smelling back kitchen underground, in which two female servants slept, has been ventilated, a fire place put in, and the window made to open and shut. Lee's Mews, Park Street, No. 2. Visited in consequence of the death of a child from diarrhoea; attic 618 feet cubic capacity, i. e. 9 feet by 11 feet, and 6 feet 3 inches high, let furnished at 4s. per week; much wants cleansing, and roof repairing, which has been done. Robert Street, No. 29. One child destroyed, another blinded by scarlet fever. Apartments cleansed. Queen Street, Oxford Street, No. 15. A case of fever. The roof leaky; people shifting their beds in the night to escape the wet; the closet out of repair and offensive; and house partially dirty. These things have been remedied. Ditto, No. 14. Here was a case of fever, removed to St. George's Hospital; the child slept in a kind of wooden loft in the yard over the water-closet. The occupier 25 cleansed the yard and basement, and promised to discontinue the use of the loft as a sleeping apartment. All over the parish, the pressure for space induces many persons to occupy similar sheds over similar places, which the Committee authorise us to discourage as much as possible, Hertford Place, No. 9, is another example. The room has been shut up, and there is a promise that it shall not be again occupied. Little Grosvenor Street, No. 17. The yard and several rooms very dirty. Cleansed. Ditto, No. 7. Scarlet fever here: lower part of house cleansed and lime-whited, offensive closet trapped, and water supplied. Avery Row, No. 13a. Scarlet fever here: the apartments cleansed; but the whole premises require repairs and ventilation, which have not yet been effected, and must be noticed again. Ditto, No. 17. This place, which adjoins the premises last mentioned, consisted of a yard, extremely filthy with chickens, a stable, and a residence over, no sufficient light, ventilation, or water-closet accommodation. The most distressing thing is, that the rooms are inhabited by a respectable man, with three idiot children, aged respectively 14, 15, and 18, utterly helpless and imbecile. All the desired improvements are not yet effected. Dung-pit Nuisances. Attended to by the Inspector. One in Adam's Mews, opposite Charles Street, Grosvenor Square. One in Horse Shoe Yard, Brook Street. Offensive Street Gullies. Trapped and cleansed. Two opposite 20b, Hill Street, Berkeley Square. Stable Drained. Bell Yard, Mount Street, No. 4. 26 Ducking Pond Mews, May Fair, No. 3. Properly drained by 6 inch pipes. Hertford Street, May Fair, No. 2. Effluvium said to enter the first floor window, alleged to be caused by a ventilating cowl over the slaughter-house behind. It is but fair to state that the slaughter-house had been incessantly visited by the Inspector, and always found sweet and clean. Yet to avoid even a nominal cause of offence the cowl has been removed, and a shaft carried above the parapet of the house. Analysis of Milk and Bread. Dr. Aldis informed the Sanitary Committee that he had caused an analysis of these articles of food to be made in 1857, and the following table shows the result: JULY 21, 1857. Number. Specific Gravity. Ashes. Insoluble Salt. Soluble. Chlorine. Specific Gravity of Serum. 1 Workhouse (Lit. Chelsea) 1.017.5 4.08 26.4 1.44 .43 1.015 2 Hatt's (from the Cow) . 1.024 7.28 4.17 3.11 1.04 1.025 3 Prett's 1.030.5 7.34 4.49 2.88 .82 1.023.5 4 Keightley's 1.028 6.33 3.94 2.39 .66 1.025 5 Wise's (Elizabeth Street South) 1.028.5 6.53 3.80 2.73 .69 1.025 6 Glover's 1.028.5 6.90 4.28 2.62 .81 1.026 7 Workhouse (Little Chelsea), 28 July, 1857 1.016 3.80 2.56 1.27 .42 1.0145 From the above analysis it is evident that the milk supplied to the workhouse (Little Chelsea) was of very inferior quality, owing probably to the addition of nearly onehalf water, while the other specimens may be considered as good. The bread used at the same place was reported upon favourably, and it contained no alum. When we reflect upon the number of children 27 tained at this establishment, it became very essential that the milk should be of proper quality. The house committee therefore subsequently resolved, that the person who had hitherto supplied the milk should not be permitted to do so any longer. On July 16th, 1857, the writer saw some samples of bread tested, which were purchased at Messrs. Jones's, Eccleston Street, and Price's, Ebury Street, and found to be genuine, while that purchased at another baker's in determined 5.12 grains of alum in the pound. The last person, on being cautioned against selling such bread in future, did not deny the adulteration, but thought that the alum was sold to him mixed with the flour. Two gullies opposite to No. 1, Grosvenor Place, have been trapped. Roberts Buildings, Ebury Square, No. 1. This house presented a most filthy appearance. It was dirty throughout, the drains obstructed, and there was no dust pit. It is a small six-roomed house, which contained a family in each room,—altogether 28 inmates—so that it was overcrowded. The paper of the rooms was tattered and loaded with vermin. The walls of the wash-house were so dangerous, that they vibrated readily with slight pressure of the hand. The house has been cleansed and repaired throughout, and the number of inmates reduced. West Street, Commercial Road, No. 10. The attention of Dr. Aldis was directed to the nuisance here through having visited three children, suffering from measles, one of which was in a typhoid state. The effluvium was caused by an untrapped gully in the yard, and the drain round the rain-water pipe being in a defective state. The drain has been repaired, and the gully trapped. Moreton Street, the Globe Coffee House, No. 23. The drains have been cleansed and repaired. 28 Eaton Lane North, No. 15. This house has been lime-whited and cleansed throughout, and the drain in the back-yard repaired. Pembroke Mews, No. 4. A number of rabbits kept in the washhouse underneath, and causing a most offensive effluvium, have been removed. Corner of Denbigh Street. Two offensive gullies, which have been attended to. Rogers' Court, Eaton Lane North, No. 2. This house, which is unfit for human habitation, is to be pulled down. Bloomfield Place, Pimlico, No. 10. A nuisance arising from the defective state of a soil pipe in the back kitchen, and an untrapped gully, which have been repaired. Two children were suffering from fever. New Grosvenor Place. The house refuse was removed from 26 houses. St. George's Place. The dust was removed from 15 houses. Bloomfield. Terrace, No. 12. A gully was cleansed opposite to this house. Union Public House, Queen Street, Pimlico. Two gullies were also cleansed opposite to this place. Mr. Bull's Cow-yard, Commercial Road South. A large quantity of dung about the yard, and several new stables built without drainage. The work has been finished. Greyhound Public House, Hugh Street West, Pimlico. Drains choked, and sewage rising up through the sink in the back kitchen. The drains have been cleansed. Robert Street (right-hand side), Commercial Road South, No 3. A room, very dirty, has been lime-washed and cleansed. Ditto, No. 4. The front bed-room, occupied by a labourer, his wife, and five children; two sons were, respectively, aged 22 and 14, and a daughter 18; the two remaining children 10 and 8 years. The dimensions of the 29 room gave a cubic capacity of 163 cubic feet for each person. The family have been removed, and the room cleansed. Ditto, No. 5. The back bed-room was occupied by a man, his wife, and four children, aged respectively, 11,9, and 1 years, and gave a cubic capacity of 110 cubic feet for each person. The family have been removed. Ditto, No. 5. The front room was occupied by a labourer, his wife, and four children, two daughters, aged respectively 24 and 18, and two sons, 21 and 15 years old. The cubic capacity gave only 190 cubic feet for each person. Two of the family were removed. Ditto, No. 6. Two bed-rooms have been cleansed. Ditto, Nos. 1 to 12 have been either partially or entirely cleansed. Graham Street, Pimlico, No. 32. A cesspool in the back yard, and the drains throughout, in a defective state. The cesspool has been cleansed and filled up, a new watercloset erected, and the premises properly drained by a 6-inch pipe drain into the sewer. Grosvenor Row, Pimlico, Nos. 3 and 4. An old drain under Nell Gwynn Cottages has been cleansed and broken up, and two water-closets erected, with cisterns and pipe drains laid down. Chester Square, No. 62. A gully opposite to this house has been cleansed. Queen Street, Pimlico, Nos. 37 and 38, have been drained into Princes Row. Robert Street (right-hand side), Nos. 3 and 9. No water supply to the closets, or covers to the dust bins. The whole of the water butts required to be repaired, cleansed, pitched, and newly covered. The work is finished. Eaton Lane North, No. 22a. The drains have been 30 cleansed and repaired, a new water closet erected, and house lime-washed and cleansed. Ditto, No. 22. The whole of the house has been limewashed and cleansed throughout, with the exception of the shop and back parlour. Kemp's Row, No. 6. A child had died from diphtheria here, and the father had a severe attack of the same complaint. Two most offensive gullies opposite to the house have been inspected and cleansed. All the slaughter-houses in the out-wards, 19 in number, were visited by the Inspector of Nuisances and Medical Officer of Health on September 21, 1859, and a report has since been made of them by the former to the Vestry. Belgrave Buildings, Nos. 1, 2, 3 and 4, and Eccleston Street East, No. 17. Each house dirty throughout, roofs out of repair, closets and drains defective, water butts dirty, out of repair, and without covers. The work is finished. A gully opposite to No. 48, Wilton Crescent has been cleansed. Westbourne Street, No. 62. An old brick drain has been destroyed, new pipes laid down, and the inlets trapped. Hatt's Cow-yard, Eccleston Street East, contained 109 cows on October 6th, being 13 more than is allowed by the magistrate's order. The extra number were immediately removed. Hugh Street, Pimlico, No. 39. Illness occurred here in consequence, as alleged, of the effluvia from the adjoining premises, where a large quantity of dung was found, which has since been removed. Spring Gardens, No. 4. The house has been limewashed and cleansed throughout, and the roofs and ceilings repaired. 31 Omnibus Yard, Elizabeth Street South. An accumulation of dung, which has been removed. Ellis's Slaughter House, corner of Newland Street. Stale meat has been removed. Moreton Mews, Nos. 1, 3, 5, and 7, behind Moreton Terrace. The refuse has been removed, and a new pipe drain laid down throughout this place, which has been partly paved. Windsor Terrace, Vauxliall Bridge Road, No. 4. "Water has been supplied to the closets, and the pipe and traps repaired. Moreton Terrace Mews, Nos. 1, 2, 3, 4 and 5. This spot has been partly paved, and an arrangement made for the removal of the dung three times a-week. St. George's Bow, No. 12. Obstructed drains, no water to closet, no trap to the drain in the yard, the roof is out of repair, and the whole of the house is dirty, excepting the back rooms on the second and ground floors. A notice was served on October 17th, and the work is finished. Upper Belgrave Terrace, Nos. 2 and 3. Both houses have been jointly drained. Flask Lane, Pimlico, Nos. 1 to 6. The kitchens are unfit to be used as separate dwellings. At No. 1 the dust was removed; at No. 6 the parlour and kitchen were cleansed. Deferred until the District Surveyor had sent in his report to the Vestry. The New Dock near Effingham Street, Thames Bank. A large quantity of offensive mud, which has been removed. Grosvenor Canal. The water foul, owing to an accumulation of mud. A letter was written by the Medical Officer of Health to the Marquis of Westminster, who caused the mud to be removed. 32 Clifford's Row, Nos. 3, 4 and 5. No water to the closets, in consequence of a portion of pipe having been stolen. Ranelagh Mews, No. 9. A large quantity of cow dung, which has been removed. Westbourne Street, No. 77. Defective drainage throughout. The old drain has been broken up, and a new 6-inch pipe drain laid down and the inlets trapped. Smith's Cow-yard, Whitaker Street, Pimlico. Walls dirty. Burton Street, Eaton Square, No. 12. A complaint of a cow-shed and piggery behind these premises, preventing the owner of No. 13 from letting her house. The cowshed contained three cows, and was clean, but no pigs could be found. The complainant will refer the case to her solicitor, the shed having been erected without her consent. Berwick Street, Pimlico. An offensive gully near here, which has been trapped. Iron Works, Eccleston Street East. No water-closet accommodation for between 50 and 60 workmen. Remedied. Lupus Street, Pimlico, Patent Firewood Manufactory. Three new water-closets have been erected. Upper Ebury Street, No. 56. A large quantity of dust and decomposed vegetable matter, no ash-pit, and closet dirty. Remedied. Avery Farm Row, Nos. 4, 6, 7, 8, 9, 10, 11, and 13. The kitchens are unfit for separate dwellings. Deferred for the District Surveyor's report. Moreton Terrace, Pimlico, Nos. 6 and 8. A new water-closet has been erected at each house. Stable-yard, Ranelagh Cottages, Commercial Road South. A large accumulation of dung has been removed. Ranelagh Cottages. The road is very damp after 33 rain, for which there is no escape. Information was given to the Surveyor. Ranelagh Street, Pimlico, No. 35. A dampness and effluvia in the back yard abated, and the sink trapped. Ditto, No. 34. Obstructed drains remedied, and water supplied to the closet. Mr. Green's Cow-yard, Eaton Row. Drains cleansed and repaired. Dung has been removed from the following places:— Mr. Henry Wise's Cow-yard, Elizabeth Street South; Mr. Bull's, Commercial Road South; and the stable-yard adjoining Middleton's Cottages, Ranelagh Road. Ranelagh Place, No. 14. Obstructed drains and no water-closet. The owner's address is not known at present. Brewer Street, Pimlico, No. 14. Dampness in one of the bed rooms, caused by leakage from the water-butt on the roof. A notice was served on December 10th, 1859, Brewer Place, Brewer Street, Pimlico, No. 1. Leakage of offensive water through the wall into the parlour and the yard, from Mr. Hatt's cow-yard, adjoining premises. The wall has been cemented. Stable Yard, Bloomfield Place. A large quantity of dung has been removed. Upper Ebury Street, No. 73. This house was infected with measles, scarlet fever, and whooping cough. The ceilings of the front attics where the families were living, admitted rain, and one of the rooms was very dirty. No trap to the sink, and no bell to the trap in the back yard. A notice was served on November 26th, and the work has been finished. Skinner's Cottages, Nos. 1 and 2. The water does not enter the closet, because the supply pipe has been wilfully stopped up. One large cistern supplies three closets. Obstruction removed. C 34 Skinner Place. New water butts have been erected for three cottages in Skinner Place. Westbourne Street, Nos. 71 and 72. A notice was served on November 26th, since when the cesspools have been cleansed and filled up, new water-closets erected, and each house properly drained. Wrights Cottages, Eccleston Place, No. 4. The house is infected with small-pox, of which two cases occurred in young men who had been vaccinated. Closets have been limewashed and cleansed, and a large quanty of dung removed. Westmoreland Street, No. 65. The house is infected with small-pox; the inhabitants of this street throw vegetable matter into the lane behind. A communication has been made to Mr. Smith, surveyor to Messrs. Cubitt, respecting the removal of all refuse from the lane. Ebury Street, No. 42. Drains offensive, and dampness in the back cellar supposed to come from the next house. Stockbridge Terrace, No. 25. The house is infected with small-pox, although the patient had been vaccinated; the only nuisance complained of, is that arising from a trapped gully opposite to No. 27. Upper Tachbrooh Street, Pimlico, No. 16. Leakage of foul water from No. 17 adjoining premises into the area, caused by a rain-water pipe, which has now been connected with the drain of the house. The nuisance is abated. Upper Ranelagh Street, No. 4. No water laid on to the closet. A notice was served on December 10th, and the water has been supplied. Ditto, No. 8. A notice was served on December 10th, and a new water-closet has been erected. 35 Ditto, No. 9. A notice was served on December 10th, and a new water-butt erected, and drains cleansed and repaired. Ditto, No. 10. A notice was served on December 10th, and a new water-closet erected. Ditto, Nos. 13 and 14. Cesspools cleansed and filled up, and new water-closets erected with proper drainage. Eaton Lane South, No. 1. Cesspool cleansed and filled up, and a new water-closet erected with proper drainage. © Eaton Cottages, Westbourne Street, Nos. 2 to 9. The drainage is obstructed. The drains have been cleansed, and a new syphon trap put into each closet. Whitaker Street, No. 14. The closet and wash-house are very dirty. The inmates complain of effluvia from Smith's cow-yard in adjoining premises. The places complained of, including the cow-shed, have been limewashed. An analysis of the water supplied by the Chelsea Company, and taken October 15th, 1859, from the main at Chapel Street, Belgrave Square, produced Grains per Gallon. Total Impurity 18.56 Organic ditto 2.08 Nov. 1st, 1859. Total Impurity 18.44 Organic ditto 1.72 Dec. 13th, 1859, Total Impurity 17.44 Organic ditto 1.44 We have the honour to be Your faithful Servants, C. J. B. Aldis, M.D. R. Druitt. APPENDIX. During the fourth quarter of 1859, 2.5 feet of the gas supplied to the Workhouse, Mount Street, burned per hour in a batswing burner, gave a light equal to that of 13.1 sperm candles, burning 120 grains per hour. The average during October and November was 13.73; whilst that in December was only 11.9. During December, the supply was very feeble, insomuch that in a room in the writer's house, two burners could not yield the light given by one the preceding winter. Complaint was made to the engineer at Horseferry Road, and it is believed that satisfactory efforts were made to remove all cause of complaint on this head. Another and more serious matter is this: on the 27th and 28th November, the gas, whether of the Cannel or ordinary sort, produced, when burned, the most pungent and unpleasant fumes, causing headache and oppression to a degree quite intolerable. On an interview with the engineer, he admitted the thing frankly, and said that, owing to an accident, some very impure gas had been mixed with that which wa8 purified ready for delivery. On December 7th, at Mount Street, Dr. Druitt burned carefully, during five hours, 1.15 feet of Cannel gas, and collected the products, to which the fumes of ammonia had been added during combustion, after the plan of the late Alexander Wright, in order to promote the oxidation of the sulphureous fumes, and to combine with the sulphuric acid. The liquid which distilled over, being tested in the usual way, yielded a quantity of sulphuric acid equal to .1415 grain of sulphur. Hence every 100 feet of this gas contained 12.38 grs. of sulphur. Be it observed 37 that no sulphuretted hydrogen has been detected, but that the sulphur exists in some other combination, the imperfectly burned fumes of which yield an unpleasant smell, and if collected with ammonia, or condensed in solid bodies, yield sulphuric acid. Any one who chooses may convince himself of this by washing out a bell glass which has been suspended for some days over a gas flame, and applying the requisite test. That the hot watery vapour produced by burning gas, and so impregnated, is injurious to health and destructive of metallic and other household articles, there can be no doubt. The manufacturer must therefore be urged to tax his ingenuity to get rid of sulphur; although, considering the composition of coal, the wonder is that the gas contains so little. On the other hand, the consumer should put his lamps outside his premises, whenever possible, and use thorough ventilation indoors; for without this, whether he use gas or anything else, it will be impossible to obtain an equal quantity of light without offence. The writer has collected and examined the products of the combustion of the Colza oil used in moderator lamps, of Price's patent candles, and of the common tallow candle. They contained no sulphur, and so far, are superior to gas ; but the quantity of half-oxydized offensive liquor which they yield is surprising when it is collected and made visible; and supposing any one foolish enough to try to get the same quantity of light as he now gets from gas, in the same space, and with the same ventilation, by using an equivalent quantity of tallow dips, he would scarcely be able to breathe the effluvia without sick headache. During the same quarter, the gas supplied to the room in Ebury Mews, burned in a bats wing burner, gave a light equal to that of 10.41 sperm candles, consuming 120 grains per hour, and presented no traces of sulphuretted hydrogen. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 31st of December, 1859. Average, 33. 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, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. I. Zymotic. small-pox 1 1 2 .. 2 .. .. .. 1 3 .. .. .. .. 3 1 4 Measles 3 9 13 .. .. .. .. 3 .. 10 .. .. .. .. 7 6 13 Scarlatina .. 3 9 2 .. .. .. 1 1 8 .. .. 1 .. 6 5 11 Diphtheria 1 1 4 .. .. .. .. .. .. 4 .. .. .. .. 1 3 4 Whooping Cough 6 8 14 .. .. .. .. 4 1 9 .. .. .. .. 7 7 14 Croup 1 1 2 .. .. .. .. .. .. l .. .. .. 1 1 1 2 Ulcerated Sore Throat .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 1 Diarrhœa 1 1 3 .. .. .. .. 1 .. 2 .. .. .. .. 2 1 3 Dysentery .. 1 1 1 1 .. .. 2 .. 1 .. .. .. .. 1 2 3 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Infantile Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever .. .. 1 6 3 .. .. 2 .. 4 1 .. 1 2 6 4 10 Child-bed Fever .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pyæmia .. .. .. 1 1 1 .. .. .. .. .. .. .. 3 3 .. 3 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. II. Cancer, Dropsy. Hæmorrhage .. .. .. .. 2 .. .. .. .. 1 .. .. .. 1 1 1 2 Dropsy .. .. .. 1 1 2 .. 1 .. 3 .. .. .. .. .. 4 4 Abscess 1 .. 1 2 1 1 .. .. 1 2 .. .. .. 2 4 1 5 Ulcer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Mortification 1 .. 1 .. 1 .. 1 .. .. 2 .. .. .. 1 2 1 3 Cancer .. .. .. 1 5 1 .. .. 3 3 1 .. .. .. 2 5 7 Gout .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. III. Scrofula. Scrofula .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 Mesenteric Disease 1 1 2 1 .. .. .. 2 .. 1 .. .. .. .. 2 1 3 Consumption .. 2 6 25 21 4 .. 8 9 31 .. 1 2 5 33 23 56 Water in the Head 5 7 14 .. .. .. .. 5 l 8 .. .. .. .. 9 5 14 IV. Nervous System. Inflammation of Brain . 1 1 5 .. 2 .. .. 2 1 3 .. .. .. 1 5 2 7 Apoplexy .. .. .. .. 5 6 .. 4 .. 7 .. .. .. .. 7 4 11 Paralysis .. .. .. .. 5 8 .. 3 1 5 .. 3 .. 1 4 9 13 Delirium Tremens .. .. .. .. 1 .. .. .. I .. .. .. .. .. 1 .. 1 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epilepsy .. .. .. .. 2 2 .. 1 I 1 1 .. .. .. 2 2 4 Tetanus .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 Insanity .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Convulsions 3 1 4 .. .. .. .. 1 .. 3 .. .. .. .. 3 1 4 Diseaseof Brain,Spine, &c. 2 1 6 1 3 3 .. 2 .. 5 2 1 1 2 10 3 13 V. Heart, &c. Pericarditis 1 .. 1 1 .. 1 .. 1 .. 1 .. .. .. 1 2 1 3 Aneurism .. .. .. 1 3 1 .. 1 1 .. 2 .. .. 1 4 1 5 Disease of Heart, &c. .. .. 4 3 b 8 1 4 1 10 1 .. 1 4 13 8 21 VI. Lungs, &c. Laryngitis 1 .. 1 1 .. .. .. .. .. l .. .. l .. 1 1 2 Bronchitis 6 5 12 1 14 20 1 5 3 27 8 .. 1 4 27 21 48 Pleurisy .. .. 2 .. .. .. l .. 1 .. 1 .. .. 1 .. 3 3 Pneumonia 3 3 6 6 2 1 .. 3 1 7 1 .. 1 2 8 7 15 Asthma .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Lungs, &c. 3 3 6 .. 3 .. .. .. .. 9 .. .. .. .. 5 4 9 BIRTHS registered during 13 weeks.—Hanover Square, M. 54, F. 60; May Fair, M. 27, F. 28; Belgrave, M. 217, F. 185. Total 571 Average 43.0 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. Be1grave .—40,034. Mount-street Work.—268. Little Chelsea Work.—350. St. Georgo's Hospital. —216. Males, 31,920. Females, 41,310. Total, 73,230. Parishioners. NonParishioners. VII. Of Stomach, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Qunisy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malignant Disease .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 Inflammation of Bowels .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 1 Inflammation of Peritoneum 2 .. 2 5 1 1 .. .. 1 3 .. .. .. 5 5 4 9 Dropsy of Belly .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. 1 1 Ulcer of Bowels .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 1 Rupture .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ileus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intussusception .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 1 Stricture of Bowels .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Disease of Stomach .. .. .. .. 1 1 .. .. .. 1 .. .. .. 1 2 .. 2 Disease of Pancreas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Inflammation of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Jaundice .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Disease of Liver .. .. .. .. 5 l .. 1 .. 4 .. .. .. 1 3 3 6 Disease of Spleen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII. Urinary, &c.. Inflammation of Kidney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bright s Disease .. .. 1 1 3 .. .. .. 1 .. .. .. .. 4 4 1 5 Ischuria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diabetes .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Stone .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. 1 1 .. .. 1 .. .. .. .. 1 2 .. 2 Stricture of Urethra .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .... 1 Disease of Kidneys, &c. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 2 1 1 IX. Womb, &c. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. 1 1 .. .. 1 .. .. .. .. .. 1 .. 2 2 Child-birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Uterus, &c. .. .. .. 2 1 .. .. .. 1 1 .. .. .. 1 .. 3 3 X. Joints, &c. Arthritis .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Rheumatism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Joints, &c .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 XI. Skin, &c. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Eczema 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 Herpes Phlyctrenodes, &c. 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 XII. Malformations. Blue Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Oilier Malformations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XIII. Debility: Premature Birth 8 5 .. .. 8 5 l 1 6 5 1 1 6 3 9 XIV. Atrophy: .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 .. 1 XV. Age: .. .. .. .. .. 6 11 5 2 8 2 .. .. .. 7 10 17 XVI. Sudden: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVII. Violent Death: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Intemperance .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. 1 1 Injury at Birth 2 .. 2 .. .. .. .. .. 2 .. .. .. .. .. 2 .. 2 Want of Breast Milk 4 .. 4 .. .. .. .. .. .. 4 .. .. .. .. 2 2 4 Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds .. 1 2 .. 1 .. .. .. .. 1 .. .. 1 1 1 2 3 Hanging (Suicide) .. .. .. 3 .. .. .. 2 .. .. .. .. 1 .. 2 1 3 Suflocation 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fractures .. .. 1 3 3 .. 1 .. .. 2 .. .. 2 4 8 .. 8 Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Violence .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 Surgical Operations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. XVIII. Not Specified. 3 .. 3 .. .. 2 .. 1 .. 2 .. 2 .. .. 1 4 5 TOTAL: 68 50 153 76 107 77 16 70 38 220 22 8 13 58 237 192 429 DEATHS registered during corresponding weeks of ten years (average) 390 5 Weekly average 30 C. J. B. ALDIS, M.D. R. DRU1TT. LONDON: PRINTED BY GEORGE PHIPPS, RANELAGH STREET, EATON SQUARE.