HAN 14 No. XXV.] QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY IN THE PARISH OF Saint George, Hanober Square THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOR THE QUARTER ENDED JANUARY 2nd, 1864. London: PRINTED BY GEORGE PHIPPS UPPER RANELAGH STREET, PIMLICO, S.W. to the Vestrg of St. George, Hanober Square. My Lords and Gentlemen, During the quarter, consisting of fourteen weeks, and ending on the 2nd January, 1864, the number of deaths registered in the parish was 482, including those of 68 nonparishioners in St. George's Hospital, and 13 of our parishioners in the Workhouse at Little Chelsea. The deaths registered in the parish during the corresponding quarters of foregoing ten years, gave a weekly average 32.4. Hence the mortality for this quarter (if we deduct the deaths in the Little Chelsea Workhouse, which do not enter into the weekly average just cited,) has been on the average 33.5 per week. During the corresponding quarter of Total Deaths. Weekly Average. Deaths from Zymotic disease. Deaths from Lung disease. 1857 442 34 82 86 1858 490 35 85 95 1859 429 33 70 77 1860 399 30.69 57 69 1861 535 41 144 71 1862 469 36 99 84 During the ten years 1851—1861, the population increased from 73,230 to 87,747, and is now, probably, 91,500. 4 The deaths from small-pox happened in the following places: one of a girl, aged 17, at the Workhouse, Mountstreet, a second of an infant, aged 10 months, unvaccinated, in Ranelagh-road, and the third of a woman, aged 29, vaccinated, in Rutland-street; she had been engaged during the day at a wholesale draper's in Lisson-grove, and only slept in this district. Besides small-pox, premature labour and hœmorrhage were registered among the causes of her death. The 13 deaths from measles took place in George-yard, Duke-street; Thomas-street, Grosvenor-square; Conduitstreet; Gilbert-street; Upper Brook-street; Davies-street, Berkeley-square; Providence-court, North Audley-street; Little Grosvenor-street; Carpenter-street, Mount-street; Glasgow-terrace, Belgravia; Cambridge-terrace; and Sutherland-terrace. Scarlet fever proved fatal to 2 children at 16, Brownstreet, who came ill from Marylebone into a clean house; to a mother and child at 2, Chapel-mews, Robert-street; and to a lad of 16 at 23, George-street, where was necessity for some urgency to get old bedding removed and the apartments cleansed. It also proved fatal in Eccleston-square-mews, Rutlandstreet, Cornwall-street, Glasgow-terrace, Westmoreland-place, Upper Ranelagh-street, Hugh-street West, St. George'shospital, West-street, and Princes-row West. Diphtheria proved fatal to 2 non-parishioners at St. George's-hospital; to a girl of 2 in Hart-street; a boy of 2 in White-horse-yard; a boy of 1 in New Grosvenor-place; and a girl of 4 in Stanley-street. A death from ulcerated sore throat occurred in Warwickmews, and another from quinsy in Ebury-square. Of the deaths from fever in the Hanover and May-fair sub-districts, some scarcely belong to this parish; as for 5 example, that of a well-known and illustrious person, aged 91, in George-street, Hanover-square, for the fever was contracted elsewhere; nor that of a young lady who died of typhoid at an hotel in Piccadilly, and was brought there ill from Essex; nor of a girl who died in Carrington-street, who contracted her illness elsewhere. One lamentable case was that of Mr. C., a tradesman, at No. —, Avery-row, who came to the house in October 1862, and died of typhoid on November 22nd, 1863. The widow says that their health had never been good during the year; the back of the house is dark and airless, and there were constant foul smells in the area and cellar. The inspector's report of the neglected state of the drains and traps, fully explains the whole case, and the only thing to be lamented is, that the unfortunate sufferers should have ignorantly or carelessly allowed it to continue without complaint. A child of 8 died in an ill-drained and ill-ventilated stable, 49, Mount-row, and one of 7, at No. —, Brick-street, where no cause is discoverable. Fever proved fatal in the following streets in the OutWards, namely, Pulford-street, Lupus-street, Howick-terrace, Princes-row East—where the patient, a man-servant, had been brought from an hotel in Brook-street, having come with his mistress from a house in Rutlandshire, in which other servants were ill with fever—Charlwood-place, Cambridge-street, Eatonlane North, Chapel-street, Gloucester-street, Hindon-street. Lung diseases have destroyed 77 persons. In our Summary, No. XXI., we inserted a table, showing the number of deaths in the parish from the same causes, during the fourth quarter of the preceding four years. Consumption, scrofula, convulsions, teething, and other diseases of degeneration and ill-development, destroyed 113 patients, including, from premature birth, 3; from atrophy and debility 14; from malformations 1; water in the head 57; 6 scrofula 3; tabes mesenterica 4; convulsions 11; teething 1; and consumption 57. A non-parishioner died from the effects of intemperance in St. George's-hospital. Nine persons died from fractures in the same institution; 8 being non-parishioners. Four deaths from drowning took place; one of a man, aged 41, a bath attendant, in the Public Baths, Davies-street; another of a sheriff's officer, aged 47, in the Serpentine; a third of a man, aged 50, also in the Serpentine; and the last of a man, aged 34, a boiler maker, in the River Thames, New Chelsea Bridge. Two infants were suffocated; one was found in Hyde-park, and the other, a boy of 1 year, was choked while feeding. Three persons committed suicide when insane; one, a non-parishioner, who cut his throat, and died in the hospital; the other, a solicitor, aged 26; and a female servant, aged 23, who hung herself in Park-street, by a cord looped on a cupboard door. Among the deaths from causes not specified or ill-defined, were those of 2 infants; one, aged 3 months, found dead in bed with its mother, and the other, a boy of 5 years. sickness in the hanover and mayfair sub-districts. During the fourth quarter of 1863, the number of persons who obtained medical relief from the Parochial Surgeons, and at the Dispensary, Mount-street, and in the Sick Wards of the Workhouse, Mount-street, was 1086. Amongst them were 4 cases of small-pox, 2 of chickenpox, 82 of measles, 24 of scarlet fever, 6 of whooping cough, 25 of diarrhoea, 30 of continued fever, 1 of rheumatic fever, 2 of erysipelas, 179 of bronchitis and catarrh, 7 2 of diphtheria, 22 of sore throat of various kinds, 2 of pneumonia, and 2 of carbuncle. Epidemic diseases never showed a more threatening appearance than they did this quarter; and they showed also that capriciousness as we call it, which is really due to our entire ignorance of the causes which regulate their rise and fall. With regard to measles, in July there were amongst the public patients in the Hanover and Mayfair Sub-districts 9 cases, in August 4, in September 8, in October 16, in November 40, in December 25; but in the middle of December there was a sudden pause, and but two cases have occurred since. Out of the ten deaths from measles in the Hanover Sub-district, two only can be identified with any of the 82 patients who were attended gratuitously as above. Of scarlatina there was 1 case in July, 9 in August, 8 in September, 18 in October, 6 in November; and then this disease disappeared. The cases of sore throat hung about the rear of the other diseases. Of the thirty cases of "continued fever," one was that of a maidservant admitted to the sick wards, Mount-street, on 24th October, from a milliner's establishment in Conduitstreet. The house was, as is the rule, inspected by Mr. Grant, and an untrapped sink found in the kitchen, and an old disused closet without water in the front area, which yielded sewer gases enough to poison the whole family. One, that of a woman, æt. 24, from Hyde Park, and a man from Eaton-lane, admitted to the Workhouse. The remainder were scattered uniformly over the poorer parts of the two sub-districts, and not one of them appears on the list of 5 deaths. 8 sickness in the belgrave sub-district. In the Belgrave Sub-District 8,382 persons were treated by the Parochial Surgeons, and at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul and St. Barnabas' Dispensary, and at the Workhouse, Little Chelsea. Of these, 4,645 were patients at St. George's Hospital, leaving a remainder of 3,737. The total figures include 1 of small-pox, 12 of chickenpox, 29 of measles, 37 of scarlet fever, 51 of whooping-cough, 127 of diarrhoea, 7 of dysentery, 69 of continued fever, 74 of rheumatic fever, 21 of erysipelas, 11 of diphtheria, and 5 of carbuncle. There were 515 cases of bronchitis, 18 of pleurisy, and 45 of pneumonia. the small-pox. Continuing the history of this disease in the Hanover and Mayfair Sub-districts, we find that four patients were received into the wards at Mount-street; of whom one died; viz.:- Oct. 7. Richard Haines, set. 16, 65, Davies-street; one of four brothers mentioned in our last report, not vaccinated. Nov. 5. Mary Ann T., set. 17 ; niece to a respectable tradesman in Hart-street; twice vaccinated. Died 28th November. Nov. 28. John H., set. 32, No. 18, North Bruton-mews; vaccinated. Dec. 7. Claude T., set. 25; a Frenchman, waiter at an hotel in Dover-street, where he had been only a week before he was seized with the small-pox. There were sent to the Small-pox Hospital, Oct. 24, Maria E., set. 21, servant at No. - Conduit-street. 9 Dec. 2. Rachel C., set. 17, from No. — Mount-street, a house in which there had been a private case of small-pox, six months before. One case was sent from the Belgrave Sub-district, 8th September, Henry T., set. 19, from No. — Churton-street. There was one case during November in a private house in New Bond-street; a lady, set. 30, who had been vaccinated but was much marked. With these seven, the total number of cases known to have happened in the Hanover and Mayfair Sub-districts, since December 1862, is 118; of which 16 were fatal. vaccination. Dr. Seaton, the Government Inspector of vaccination, was appointed Nov. 21st, 1863, to inspect some of the schools in Belgravia with Dr. Aldis. They accordingly visited several of the infant schools in Belgravia, and the following is the result of their examination. Number out of Number having no those with no School. Total number of vaccination mark, children examined. or only doubtful mark, or doubtful mark. mark, of tion, who are marked with small-pox. St. Peter's, Infant 111 6 8 St. Michael's, Infant 142 8 2 St. Barnabas', Infant 119 3 1 372 17 6 So that out of the 372 children examined, there were but 11 found unprotected, 6 out of the 17, who had not a vaccination mark, having marks of small-pox. Nearly, if not quite all these, were recent admissions. This, while it shows how completely the schools had been examined 10 viously, shows also the necessity for periodical examinations of this kind. Dr. Aldis, having been told that three children, residing in Belgravia, aged seven, six, and four respectively, had never been vaccinated, called upon the parents, and tried to persuade them to have the operation performed; but they obstinately refused. It was useless to tell them that they were liable to penalties under the Vaccination Act, and that their children might be dismissed from the school (St. Paul's). He then determined to take proceedings, but it appeared upon further inquiry, that the births of two of the children had never been registered, and with regard to the other, whose birth had been duly registered, no evidence could be adduced as to whether a notice for vaccination had been given or not, so that he was powerless. It is true that the children have been dismissed from the school, but they may be the means of spreading a loathsome disease, which the Medical Officers of Health are striving hard to eradicate. Why should not a notice from the Medical Officers of Health, under an amended Act, be sufficient ? * It would be very desirable that the registration of births should be made compulsory. typhus fever. Typhus fever was very prevalent in London; we, therefore, made particular inquiry about it, and took every precaution to prevent its extending. The table shows that 22 deaths, 3 of which were those of non-parishioners, occurred in the parish from that disease. In the * See the Times, Dec. 9, 1863. 11 sponding period of last year, we reported 10 deaths, one being that of a non-parishioner, from the same cause. But it should be remembered that cases of "infantile fever" are classed with those of typhoid, relapsing, and other continued fevers, under one name "typhus," which coincides with the Registrar General's mode of registration. In the Belgrave Sub-district, however, your Medical Officer saw only one case of true typhus, or that form of fever with which the Fever Hospital was filled at the same time. The patient, Emma A., aged 26, had just come from the Field Lane Refuge into Commercial-road South, and soon showed symptoms of fever, accompanied by the characteristic measly or mulberry rash all over the body, upon which she was removed into St. George's Hospital, where she recovered. The fever did not spread, although many persons were in the same house, it being a public institution. We have reason to be thankful that the visitation of true typhus in this parish was slight, in comparison with that of other parishes in London. visitation op bakehouses. We may remind the Vestry, that in the year 1860 (see Quarterly Summary, No. XI.), we made a general visitation of the bakers, that led to the enquiries which resulted in the passing of the Bakehouses Regulation Act, 1863. During the month of October, we again visited and inspected, in company with Mr. Grant, all the premises occupied and used as bakehouses, whether by bakers or confectioners, in every part of the parish, to see whether or not they were in conformity with the provisions of that Act. A table was presented to the Vestry at their meeting in November, containing the name and address of every baker 12 and confectioner, with remarks showing how far the chief provisions of the Act were complied with, or not. The total number is 95, of whom nine are confectioners purely. The first question to which we directed our attention was, as to cleanliness ; and the answer we record is that 49 were clean, and 46 required limewashing; but it must be remembered that this in most cases was accidental. In eight cases the floor was noticed to be much out of repair; a thing somewhat hostile to cleanliness. The second point was the ventilation, which we noted to be good in 87 and bad in 8. When we say "good," we do not mean theoretically perfect, but simply as good as it can be made under the circumstances, or as testifying to the fact that pains have been taken to make it good. Of those marked bad, six seemed capable of improvement; the best term for the other two would be "impossible." The third point was, are there any drains, sinks, &c., &c., from which there could be an escape of sewer air into the bakehouse ? There were eleven cases in which sinks without traps were found in the bakehouses; there were two cases in which nuisances were created by untidy and disgusting habits of the men: in all the other cases, provided common care and cleanliness were used, there was no reason why the bakehouse should be contaminated with sewer air. Advantage was taken by Mr. Grant of his visit to inspect the whole premises, and in seven cases he detected various nuisances; in one case a most tremendous and abominable old cesspool on a baker's premises, but not in strict connection with the bakehouse, and therefore coming under the general provisions of the Nuisances Removal Act, and not of the Bakehouses Act. The next question is, whether boys under 18 were employed in nightwork, i.e., between 9 p.m., and 5 a.m.? On 13 this point, we accepted the assurances of the bakers, that no such boys work by night. We heard of 14 boys who worked by day; but we were careful not to ask questions which we had no right to ask; hence we give no statistics as to nightwork, number of men employed, &c., &c. We were received courteously, and felt it our duty to confine ourselves to such things as we had a right to ask. The last enquiry was, are there any places on the same level with the bakehouse", and forming parts of the same building, used as sleeping places? and, if so, are they effectually separated by a partition extending from the floor to the ceiling, and having an external glazed window of at least 9 superficial feet, of which at least 4½ superficial feet can be opened for ventilation ? We were informed in 73 cases that no men sleep on the premises. In 16 cases there was sleeping accommodation for men on the same level with the bakehouse; in two of which 16 cases, the men slept in the bakehouse, the others in places adjoining, but partitioned off as the Act directs. Of these, 8 were noted as ill-ventilated ; 2 had no windows to open, but 1 of these is said not to be used. In three cases, sleeping places over the bakehouse, or elsewhere on the premises, are noted as ill-ventilated. When we speak of "sleeping places," we mean bed rooms with beds. In many bakehouses the men lie down in their clothes, and sleep for a portion of the night on the boards, whilst waiting for the fermentation of the bread. But however undesirable, this practice is not contrary to law. We were, as we have said, most courteously received by the bakers, most of whom, we were astonished to find quite ignorant of the provisions, and almost of the existence of an Act that concerns them so closely. The Vestry, since our Report, has caused a copy of the Act to be distributed to each of them; and in the weeks that have since passed, all 14 those premises where nuisances existed, or where there was want of lime-wash, have been visited again, and, with very few exceptions, the Act was found to have been obeyed, and things promise to work well for the future. The carrying out of the Act has been entrusted by the Vestry to the Sanitary Committee, who will see to the periodic cleansing, and the general other measures contemplated by the Act. slaughter-houses and cow-houses. The greatly improved condition of these places affords strong evidence of the advantage to be derived from constant sanitary supervision. We made a systematic inspection of every one of the 37 slaughter-houses and 20 cow-houses, in the month of September, accompanied by the Inspector of Nuisances, and were gratified to observe the attention paid to the cleanliness, ventilation, water-supply, and condition of the pavement. The proprietors have all been licensed, and this is the first year that the cow-keepers have received licenses under the amended Metropolis Local Management Act. It is true that a great many complaints appear against the cowkeepers in the Nuisances Complaint Book, with regard to the non-removal of dung before 9 o'clock a.m.; but as it was quite impossible for them to carry this order into effect, the magistrates have allowed them to extend the time until 12 o'clock to get it removed. special cases. An unusual amount of cases have to be reported this quarter in which it was necessary to apply to the magistrate. First amongst these may be mentioned the case of No. 3, Steele's-court, Lee'-i-mews ; in which the powers of the 15 Sanitary Committee of the Vestry were set at nought by a peculiar combination of circumstances. The history of this case begins so far back as April 13, when a complaint was entered in the inspector's book of a stoppage of the drainage. On May 2, a second complaint was entered in the inspector's book, to the effect that there was offensive rubbish in the yard; first floor dirty; no water to the closet. A notice was served May 21. As nothing was done, a summons was ordered by the Sanitary Committee at their meeting on June 16; and heard at Marlboro'-street on July 8, when a person appeared, representing the owner ; and as he promised to do what was required, the magistrate, as usual, adjourned the case for ten days, to give opportunity for his fulfilling the promise. But nothing was done, and no one appeared to represent the defendant when the adjourned summons was heard on 18th July; so the magistrate granted a written order that the work should be done forthwith ; viz., " within ten days from the service of a true copy of the order to whitewash and cleanse the premises, limewhite the yard, and repair the supply pipe to the water closet." A copy of the order was served on the 24th, on a person said to be son of the owner,—the same that appeared on July 8th. Still nothing was done, and the Committee at their meeting, on August 18th, directed a summons to be taken out, calling on the defendant to show cause why he should not suffer the penalties provided by the 14th Section of the Nuisances Removal Act; which says, that "any person not obeying such order for abatement, shall, if he fail to satisfy the justices that he has used all due diligence to carry out such order, be liable for every such offence to a penalty of not more than ten shillings per day during his default." This summons was taken out, and came on for hearing on the 1st September. The owner did not appear; but as the constable who served the summons was 16 not present, the case could not he gone into. So a fresh summons was forthwith taken out, to be heard on Monday, September 7th. Meanwhile a special meeting of the Sanitary Committee was held, on September 3rd, to consider the matter, at which it was ordered that the opinion and assistance of Mr. Capron, the solicitor, be had. We may remind the Vestry that the ordinary course of proceeding is as follows: A nuisance is believed or ascertained to exist; notice of it is given to the "Local Authority," i.e., to the Sanitary Committee; the facts are formally verified by the officers of the Local Authority, who have power of entry, under the 11th Section of the Nuisances Removal Act;—the Local Authority serves a notice on the "owner" of the property where the nuisance exists, requiring him to abate said nuisance;—if he refuses, a summons is taken out; and if the case be proved to the satisfaction of the magistrate, he may make an order requiring the person on -whom it is made to do various things to abate the nuisance; and if the nuisance be such as to render the house unfit for human habitation, he may prohibit the using thereof for that purpose. (Sect. 13.) Or, he may order the Local Authority to do the work, and recover the costs from the owner, (Sect. 14 and 17.) Moreover, it is provided (Sect. 35) that it shall be quite sufficient to designate the " owner" of any given premises as " owner," without name or further description; consequently, all our proceedings are impersonal, so to say; -we leave a notice on premises, directed to the " owner," and never mention any name. Thus much enables us clearly to state the various complications which followed. For instance, when we appeared before the magistrate on September 1, we begged him, as the defendant disobeyed his order, to grant another order, under the 13th Section of the 17 Act, declaring the house unfit for human habitation, and shutting it up. But he said, no; he had made one order on the defendant, requiring him to whitewash, &c., and he could not go back now and make a different order because the first had been disobeyed. If we had wanted the house shut up, we should have asked that at first. He said the alternative was, either to inflict a penalty on the defendant, or to order the Local Authority themselves to go in and do the work, and recover the costs from the defendant. But the Sanitary Committee, at their special meeting of the 3rd September, thought that to accept the latter alternative would be a bad precedent, and encourage other owners of property to resist them; it would be easy to go in and cleanse a house, repair drains, &c., but often impossible to recover costs; as was exemplified by a case that once occurred; so they ordered the penalties to be sued for, with Mr. Capron's assistance. Accordingly Mr. Capron appeared at Marlboro'-street, on the 7 th September, when the magistrate imposed on the "owner" of No. 3, Steele's-court, a penalty of 2s. 6d. per day and costs, for disobedience to the order served on him on the 24th July; reckoning 26 days from the 24th July to the 20th August, when the summons for penalty was taken out. And now came to the surface a curious point. This " order for payment of costs, expenses, and penalties" (Sect. 20, Form I., Nuisances Removal Act,) authorizes seizure of goods of the defendant, or in default of sufficient distress, adjudges him to be imprisoned for some term not exceeding three calendar months. It is therefore a very serious penal kind of instrument. But whereas the Act says it is sufficient to designate the owner of any premises as " the owner," without mentioning his name, it so happens that the order (Form I.) requires a name. It begins, " To—[name the person on whom the order b 18 is made]n—and in three several places says "[naming the person against whom the complaint is made']." Whereupon the magistrate's clerk sent a polite message by a constable to the Medical Officer of Health, asking him to name the "owner," or if not this, at any rate to go and point out the owner to the constable who was to serve the order, or to authorize some one else to point him out; for, as he reasonably enough said, it would not do for the officers of the court to incur risk of actions and damages for serving on the wrong person an order that might end in seizure of goods or imprisonment. He said that it might be very well to use the word "owner" only, if the proceedings were to end in levying a distress on the premises concerned; but when it came to fines, or to seizing the goods of a person who lived a long way off, and still more to imprisonment, it was very necessary to have the exact person specified and no other. It needs scarcely be said, that the Medical Officer of Health also declined to run this risk, and so the proceedings dropped, with Mr. Capron's sanction, who said they had come to a dead lock; for, as it happened, nobody knew who was the real owner. The supposed owner was insolvent, and the property seemed to be in the hands of persons for whom three legal firms were concerned, each of whom had some fruitless correspondence with us about this vexatious case. But now, the insolvency of the owner brought us a remedy. The woman who was supposed to be owner used to collect rents from the poor people who still clung to this dirty house, but she paid nobody. So that at last the water was cut off on Oct. 19th. Then we took out a new summons for declaring the place unfit for human habitation; but before it was served, some one had taken possession of the property, and turned all the tenants out; since which it has been repaired, and seems to be in good hands. 19 This is a narrative of a ease in which the powers, usually tolerably efficient, of the Local Authority, were set at nought. It is as well to remark, that throughout this business a man was employed by us to go from time to time and abate the worst nuisance, so that the poor tenants might not die of fever, whilst the Local Authority was fruitlessly trying its powers against an insolvent owner. No. 11a, Farm-street. This is a stable, and it appeared from the books of the Dispensary, Mount-street, for the week ending August 22,1863, that three children, aged 9, 4, and 3, were there ill of scarlet fever. One of them was entered as suffering from "debility after fever," in the week ending September 5th. One of them had been entered for "gastric fever," in the week ending June 20th. A visit was paid, the place found in an extremely dirty state, such as would breed or keep any fever; and, as it belonged to a respectable physician, a recommendation was given that it should be cleansed. As nothing was done, a notice was served on 24th October, followed by a summons, taken out on December 2, and heard on the 9th. Then as it appeared that it had been served by the constable at the wrong house—(the officers of the Marlboro'-street Police Court complain against the system of serving summonses on "owners," and not on persons duly designated)—it was withdrawn, and another taken out, to be heard on the 16th. Then nobody authorized to represent the "owner" appeared; so the magistrate adjourned the case till the 23rd, then again to the 4th January, and then to the 18th, when the rooms were reported to be cleansed, and the costs paid. Proceedings repeatedly adjourned like this are more comfortable to the defendants than to the complainants. Nos. 5, 7, and 8, Thomas-street. In our last Report we spoke of the illness at No. 4, and of the risks of the spread 20 of illness in these very large and densely-peopled houses. At No. 5 there was a case of fever in a room crowded by persons not well off; patient sent to St. George's Hospital. A notice was served, on October 24, requiring it to be cleansed in ten days. At No. 7 some of the rooms were also required to be cleansed. At No. 8, on the first floor front, lived a man, wife, grown-up daughter, and 4 other children; two of them had been sent to St. George's Hospital with fever. In the second floor of the same house cases of small-pox had occurred last quarter. A notice was served, requiring such parts of the house as had not been done lately to be cleansed; this was disregarded: a summons was taken out, heard December 9th ; defendant did not appear. A fresh summons was taken out for the 11th; defendant then appeared, and on her promise to do what was wanted, the magistrate adjourned it till the 18th, when the work was reported finished, and costs paid. Nos. 2 and 3, Avery-terrace, Brook-street. There was complaint of grievous nuisance affecting an underground room at No. 3, used as the day residence of six or seven sickly children of a tailor. Nuisance reported on by Mr. Grant, who believes it to arise from the next house, No. 2. Here there lives an insolvent tradesman, whose goods have been seized for rent, and the water cut off for non-payment of rates. It was really a spectacle to see the miserable bundles used as bedding by his respectable looking wife and children. The " owner," i.e., the occupier of No. 2, was summoned because his house was not fit for human habitation, there being no water supply to an internal closet. Summons heard December 23; adjourned till January 4th, 1864, again to 18th, when water was reported by Mr. Grant to have been laid on, and costs paid. A very large amount of business was done by the 21 tor during this quarter. Part of it consisted in exploring and getting rid of the most dangerous nuisances, most of them amongst the better classes; for instance, two houses in Green-street, each filled with sewer vapour, through the rotten state of a soil pipe passing perpendicularly down in a groove in the party wall. This is a common, often unsuspected, and most effectual way of keeping two adjoining houses filled with the most abominable odours. In the same street, another house, whose own drains had been set to rights, was flooded with sewage from an old drain passing under an archway adjoining. In Upper Brook-street, one house was quite poisoned by its old rotten drains, from which by means of rats, ill vapours were conveyed into the next house also. Another case deserves mention from its singularity. No. 6, Adam's-mews, is a house having also a cottage in its yard, often visited for illness, and which had in our eyes the reputation of anything but a healthy house; nevertheless, the rooms had been cleansed, and the drains were said to be efficient. At all events, there was no evidence that would have justified us in ordering them to be dug up. At last, however, Mr. Grant found out that the drainage from this house, containing families and people, consisting of all their sewage and slops, was not carried away, nor yet even received in a cesspool, but was permitted to soak away into the earth underneath the cottage in the yard. This state of things had existed ever since the house was built. The soil is of course porous; and there is a pump in the next yard, the water of which was used for washing carriages, and was noticed to be often offensive. A very large cesspool was abolished from under an inhabited stable in Derby-street. Much other work fell on the inspector, in visiting houses in which illness was prevalent. 22 No. 37, Queen-street, Pimlico, was found to be infected with scarlet fever and overcrowded, the front kitchen being occupied by a man, his wife, and four children, and the front attic by a family of seven in number, with other lodgers in the house. The evil was remedied. Overcrowding was also abated at No. 7, Bridge-row, and at No. 6, Little Ebury-street, in both of which small-pox and other diseases had existed. No. 47, St. George's-place, Pimlico.—This was a case of combined drainage. The main drain in the back area became obstructed at No. 48. A brick drain passes from No. 45, behind Nos. 46, 47, 48, 49, 50, 51, and 52, into the sewer in William-street, and was completely full in the back areas of Nos. 47 and 48, where it has been opened. It appeared that only three houses, namely, Nos. 45, 47, and 48, had an outlet into this old drain, and that Nos. 46, 49, 50, 51, and 52, drain out by pipe-drains into the sewer in Knightsbridge. Nos. 47 and 48 have been properly drained by pipe-drains throughout into the sewer in front, and the old drain behind the premises has been broken up, and the drains of No. 45 have been connected with those of No. 46, and with the sewer. No. 12, Commercial-road, South.—This was another case of combined drainage with that of No. 11, an obstruction in which caused a very great nuisance; it was remedied. Nos. 20 and 21, Pembroke-place, Vauxhall-bridge-road.— This also was a case of combined drainage, and two full cesspools were in the yard of No. 20, one of which was fourteen feet deep and six wide. The old brick drains have been broken up, the cesspools filled up, and a new six-inch pipedrain laid down. The law permits the use of combined drainage, which is obviously the source of frequent and dangerous nuisances 23 arising from the most trifling circumstances, as carelessness in throwing brushes, clothes, or dolls, down water-closets. Servants and children should be strictly cautioned against such negligence, either as regards combined or single housedrains. the women admitted to the workhouse from hyde park. There are circumstances which make it worth while to introduce a note of the facts relating to the unfortunate women who are in the habit of haunting Hyde Park, and who are brought by the police to the Mount-street Workhouse from time to time, when their state of disease and filth becomes unbearable. It may be noted, in the first place, that these women, if outcast and homeless, are so by their own act and choice, and not because they are refused admission into our Workhouse. One morning in October we went round Hyde Park with one of the officers of the Workhouse, and with one of the park-keepers, and hunted out and spoke to every destitute person whom we found there. On that occasion we found nine women, most of them under 20, respectably born ; they were educated, and had been at school (this we tested by asking them to spell, such words as " Michael," " Norwich," &c.); they were in all degrees of tidiness, one or two apparently neat, some crouching under trees, like animals, in the very extremest state of dirt; they all seemed well fed, even if tattered in their clothes ; some had been in the park only a few days, others for 5 or 6 months; some were well known at Mount-street, where they had been inmates: all were entreated by us to come in and be taken care of, and all refused. 24 The police, however, from time to time cleared them out, and brought them to Mount-street Workhouse. For instance, in January 1863 was brouhgt one aged 16; in February one aged 19; in April, one aged 19 ; in May, four, aged 19,20, 21, and 22 ; in June, three, aged one 17 and two 19; in July, twelve, two aged 17, two aged 18, four aged 19, one 22, one 26, and two 30; in August, two aged 17, and one 19; in September, nineteen; in October, thirteen; in November, two; in December, two, including a woman, set. 24, ill of fever. Sixty altogether. One of these unfortunate creatures, aged 17 (the register of death says 15), died at Mount-street on the 10th November of syphilis and gangrene. We were able to obtain admission for another into the Refuge, Stone House, Commercial Road South, Pimlico, where she is going on favourably. The thing to aim at, by the due execution of existing laws, or by framing new ones if necessary, is not to allow any young girl under age to lead a life of notorious, open, undisguised vice combined with vagrancy. If elder women choose such a course, there may be no help for it; but all experience shows that the very youngest are the worst of these unfortunates, and the most prone to maladies which are only too easily propagated. C. J. B. ALDIS, M.D. R. DRUITT. 25 APPENDIX. No. I. water. An analysis of the Chelsea Water supplied by the Chelsea Company, and taken from the main at Chapel-street, Belgrave-square— Total Impurity 1863. in grains J>er gallon. Organic ditto. October 17 ... . 16*44 2,80 November 17 . . . 22-04 2-56 December 17 . . . 17*48 2-36 C. J. B. A. APPENDIX. No. H. The following table refers to cases dealt with by the Nuisances Removal Committee, during the quarter ending January 2nd, 1864. Houses reported by Medical Officers of Health in consequence of illness or nuisance . . 89 Of these there were reported for scarlet fever 30 „ „ diphtheria ... 9 „ „ typhus fever . . 19 „ „ measles .... 2 „ „ diarrhoea ... 5 » »» croup 1 „ „ small-pox ... 9 Houses and other premises reported by Inspector 40 Ditto by inhabitants 45 26 nature op nuisance complained of. Drains obstructed 5 Ditto defective 19 Houses without drains 1 Cesspools 3 Yard dirty 1 Offensive water 1 Leakage of water 12 Cistern dirty 1 Defective state of boiler 1 Offensive effluvia 18 Ditto from gas-main 1 Ditto from gas-pipe 1 Stables dirty 3 Ditto without drainage 1 Ditto inhabited with defective drainage 1 Dung-heaps complained of 3 Houses dirty 16 No dust-pits 2 No traps 1 No water supply 2 Water-closets out of order 8 Slops emptied down rain-water pipe 2 Overcrowding 2 Defective ventilation 1 Urinal 1 Premises dangerous 2 work done. Infected or dirty rooms cleansed 27 Ditto newly drained by pipes in lieu of old brick drains 17 27 Ditto shut up 2 Water-closets and soil-pipes repaired 19 Leaky roof repaired 1 Traps supplied 1 Urinal removed 1 Dung nuisance abated 3 Drains cleansed 11 Effluvia from gas abated 3 New dust-pits 2 Yard cleansed and limewhited 1 Ventilation 3 Leakage remedied 4 Houses shut-up 2 Cesspools abolished 6 Horse removed 1 Inhabited stables newly drained by pipes 8 Defective boiler repaired 1 Ditto pipe repaired 1 Overcrowding abated; families removed 2 Slaughter-houses limewashed 2 Number of Notices served 34 Legal proceedings 3 APPENDIX. No. III. gas. Seventy-two observations were made during the quarter, upon the six gases supplied by the Chartered, London, and Equitable Companies, in Horseferry-road, 73, Bessboroughstreet, and 78, Cambridge-street, respectively. The gases were burned in accordance with the Metropolis Gas Act, 1860, and the illuminating power continued above 28 the standard light required by the Act. With respect to purity, all the gases were free from sulphuretted hydrogen, and so far free from ammonia, that they did not discolour the turmeric paper, except on November the 15th, when both the gases supplied by the Chartered Company discoloured the turmeric, paper in consequence of an excess of ammonia. I immediately wrote to the engineer of the Company complaining of the impurity of the gases, which was subsequently remedied. The following Table gives the average light in sperm candles of all the gases— Chartered. London. Equitable. Cannel 23.85 23.81 24.73 Common 14.29 14.2 15.04 A Table and Summary were sent with each Monthly Report on the gas to the Vestry, containing the number of examinations, with the dates, and the maximum and minimum light, with the weekly and monthly average illuminating power. C. J. B. Aldis, M.D., Gras Examiner. r r r > ■** r ■ t \ .IJfXrt- Til : 10.- • TABLE OF MORTALITY. DEATHS registered in the Parish of St. George, Hanover Square, in the 14 Weeks ending 2nd of January, 1864. Average, 34. DISEASES. Ages at Death. Sub-Districts & Population. Sexes. Under 1. 1 and under 6. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—19,770. May Fair.—12,648. Belgrave.—55,099. Mount street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 37,511. Females, 50,236. Total, 87,747. Parishioners. NonParishioners. 1. Small-pox 1 .. 2 1 .. .. .. .. .. 2 1 .. .. .. .. 3 3 2. Measles 1 10 13 .. .. .. .. 10 .. 3 .. .. .. .. 6 7 13 3. Scarlatina .. 7 18 1 .. .. .. 7 .. 10 .. .. 1 1 14 5 19 4. Diphtheria .. 3 5 1 .. .. .. 1 1 2 .. .. .. 2 3 3 6 5. Quinsy .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 1 6. Croup 1 2 3 .. .. .. .. 1 .. 2 .. .. .. .. 3 .. 3 7. Sore Throat .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 8. Whooping Cough 4 3 7 .. .. .. .. .. .. 7 .. .. .. .. 2 5 7 9. Typhus(and infantile fever) .. 1 9 7 1 4 1 3 4 12 .. .. .. 3 11 11 28 10. Erysipelas 2 1 3 1 1 .. .. 1 .. 4 .. .. .. .. 3 2 5 11. Metria .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 12. Pyaemia .. .. .. 1 3 .. .. 1 .. .. .. .. 2 1 2 2 4 13. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 14. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15. Dysentery .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 16. Diarrhæa 6 .. 6 .. 1 1 .. 3 2 2 .. 1 .. .. 3 5 8 17. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 18. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 19. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 20. Rheumatism Order 2. .. .. 3 .. 1 1 .. 3 1 .. .. .. .. 1 1 4 5 1. Syphilis 3 .. 4 .. .. .. .. .. .. 2 2 .. .. .. 2 2 4 2. Stricture of Urethra Order 3. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1. Privation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. a Del. Tremens .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 4. Alcoholism b Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 4. 1. Thrush II. Order 1. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1. Gout .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Dropsy .. .. 3 1 5 5 1 2 1 6 1 1 .. 4 10 5 15 3. Cancer .. .. .. .. 1 3 .. 1 1 1 .. 1 .. .. .. 4 4 4. Mortification .. .. .. 3 .. 3 .. .. 1 2 .. .. 1 2 3 3 6 5. Abscess .. .. .. 3 2 .. .. .. .. 2 .. .. .. 3 4 1 5 6. Hoemorrhage Order 2. 1 .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1. Scrofula .. .. .. .. 1 1 .. .. 1 1 1 .. .. .. 2 1 3 2. Tabes Mesenterica 3 .. 4 .. .. .. .. .. 1 3 .. .. .. .. 1 3 .. 3. Phthisis 1 4 9 29 16 3 .. 11 2 32 4 1 1 6 35 22 57 4. Hæmoptjsis .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 5. Hydrocephalus 9 8 18 1 .. .. .. 2 1 16 .. .. .. .. 12 7 19 III. Order 1. 1. Cephalitis .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 2. Apoplexy .. .. 1 2 5 3 1 1 4 4 1 .. 1 1 9 3 12 3. Paralysis .. .. .. 1 1 1 2 1 5 .. .. .. .. 3 5 8 4. Epilepsy .. .. .. .. .. 1 .. .. .. 1 .. 1 .. .. .. 2 2 5. Convulsions 6 5 11 .. .. .. .. 1 1 9 .. .. .. .. 7 4 11 6. Brain Disease, Spine, &c. Order 2. 2 1 6 1 2 4 .. 4 1 6 •• .. 1 1 8 5 13 1. Pericarditis .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 2. Aneurism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Heart Disease, &c. Order 3. 2 .. 4 4 10 13 1 2 3 15 2 1 2 7 15 17 32 1. Laryngitis .. 1 1 .. l .. .. .. 1 .. 1 .. .. .. 1 1 2 2. Bronchitis 9 7 16 .. 3 20 5 5 3 31 1 2 .. 2 24 20 44 3. Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 4. Pneumonia 3 7 12 3 2 1 1 1 2 10 1 1 2 2 9 10 19 BIRTHS registered during 14 weeks.—Hanover Square, M. 50, F. 56 ; May Fair, M. 31, F 33 Belgrave, M. 243, F. 209. Total . . 622. Average . . 44. 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.—19,770. May Fair.—12,648. Belgrave.—55,099 Mount-street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 37,511. Females, 50,236. Total, 87,747. Parishioners NonParishioners. 5. Asthma .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. 2 2 6. Lung Disease, &c .. .. 3 1 2 2 .. 2 .. 5 .. .. .. 1 4 4 8 Order 4. Enteritis .. .. 1 1 .. .. .. 1 1 .. .. .. .. .. .. 2 2 2. Peritonitis .. .. 1 2 2 .. .. 2 .. 1 .. .. .. 2 4 1 5 3. Ascites .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Hernia .. .. .. .. 1 .. 1 .. .. 1 .. .. 1 .. 2 .. 2 5. Ileus and Intussusception .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7. Stomach Disease, &c. 2 .. 3 1 2 5 .. 2 .. 8 .. .. 1 6 5 11 8. Hepatitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9. Jaundice .. .. .. .. 1 1 .. .. .. 1 .. .. .. 1 2 .. 2 10. Liver Disease, &c. Order 5. .. .. .. 3 3 1 .. 1 2 2 .. .. .. 1 3 4 7 1. Nephria .. .. .. 1 1 .. .. .. .. 2 .. .. .. .. 1 1 2 2. Diabetes. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Kidney Disease,&c. .. .. .. 3 .. 2 2 .. .. 1 .. 1 2 5 5 5 10 4. Diseased Bladder Order 6. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 1. Ovarian Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Uterus Disease, &c. .. .. .. 2 3 .. .. 2 .. .. .. .. .. 3 .. 5 5 3. Extra uterine Fætation order 7. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1. Arthritis. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Joint Disease, &c. Order 8. .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 1. Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Ulcer .. .. .. .. 2 1 .. .. .. 1 .. .. .. 1 1 2 3 IV. Order 1. 1 1 1 1 1. Premature Birth 3 .. 3 .. .. .. .. 1 .. 2 .. .. .. .. 2 1 3 2. Cyanosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Other Malformations .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 5. Teething .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 2. 1. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Child-birth (see Metria) 1 .. 1 1 1 .. .. .. .. 3 .. .. .. .. .. .. 3 Order 3. 1. Old Age .. .. .. .. .. 7 1 1 2 3 2 .. .. .. 3 5 8 Order 4. 1. Atrophy and Debility 8 2 11 .. .. 1 2 4 1 6 .. 3 .. .. 9 5 14 2. Exhaustion .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. V. Order 1. (Accident or Negligence.) 1. Fractures and Contusions .. .. .. 1 4 3 1 .. .. .. .. .. 1 8 5 4 9 2. Gunshot .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 4. Burns and Scalds .. 1 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 5. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Drowning .. .. .. 1 3 .. .. .. .. 3 .. 1 .. .. 4 .. 4 7. Suffocation 1 1 2 .. .. .. .. .. .. 1 .. 1 .. .. 1 1 2 8. Other Injuries .. l 1 1 .. .. .. .. .. 1 .. .. .. 1 1 1 2 Order 3. 1. Murder and Manslaughter. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 4. (Suicide.) 1. Cut, Stab, Shot, . .. .. .. 1 1 .. .. .. .. 1 .. .. .. 1 2 .. 2 2. Poison .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. 1 3. Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Hanging .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Deaths (Cause unascertained) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Causes not specified or ill-defined 2 .. 2 .. .. .. .. .. .. 2 .. .. .. .. 2 .. 2 TOTAL: 72 69 193 85 92 93 19 85 40 243 17 13 16 63 263 219 482 DEATHS registered during corresponding weeks of ten years (average) 454-3. Weekly Average 32.4. LONDON : PRINTED BY GEORGE PHIPPS, RANELAGH STREET, EATON SQUARE. HAN 14 No. XXVI.] QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY IN THE PARISH OF Saint George, Hanober Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OP HEALTH, FOR THE QUARTER ENDED APRIL 2nd, 1864, WITH REPORT OF THE YEAR. London: PRINTED BY GEORGE PHIPPS, UPPER RANELAGH STREET, PIMLICO, S.W. TO THE Vestry of St. George, Hanober Square. My Lords and Gentlemen, In the thirteen weeks ended 2nd April, 1864, the deaths of 604 persons have been registered in our parish, if we include in that number the deaths of 9 inmates of the Little Chelsea Workhouse, and of 72 non-parishioners in St. George's Hospital. The average number for the same quarter in the foregoing ten years (not including those in Little Chelsea Workhouse) is 502, and is thus exceeded by 93. The following memorandum shows some of the details:— First Quarter of Total Deaths in whole Parish. Hanorer and Mayfair. Mount Street Workhouse. Belgrave. Zymotic. Long and Phthsis. Under 5. Over 60. 1857 436 137 14 206 74 151 142 115 1858 528 163 21 254 110 195 181 106 1859 457 116 23 235 85 140 171 100 1860 547 140 14 288 80 199 202 118 1861 540 133 31 273 74 201 160 146 1862 609 129 25 358 116 183 239 123 1863 553 140 23 298 136 140 220 110 1864 604 169 38 300 75 214 167 178 From this it is clear, that the mortality this quarter did not, as it usually does, fall most heavily upon children; for the number of their deaths was less than in 5 of the 7 4 going years; neither did it arise from zymotic disease, which was at as low a level as ever it has been; but we see that the deaths of adults, especially of persons advanced in life, were unusually numerous, so that the deaths over 60 were more than those under 5, whereas they usually range from one-half to two-thirds, whilst diseases of the lungs, with consumption, were also very high. In the Hanover and Mayfair Sub-Districts, the character of the mortality was well marked;—few deaths of children, many of the aged, and only 12 of any kind of zymotic disease. Of the 3 deaths from small-pox we speak elsewhere. Two deaths from measles, and 14 from whooping-cough, occurred amongst the poor children of the Belgrave SubDistrict. One death from diphtheria occurred at No. 1, George-street, Oxford-street, one at Princes-row East, and one at Spring-gardens, Belgravia. One death from scarlet fever occurred in South Audley-street, one in Oxford-street, one in a girl of 5 at St. George's Hospital from a house in Wiltonroad; an infant died in the same house; two in one house in Churton-street; the others in Lupus-street, Colchester-street (two houses), Moreton-street West (two houses), Ebury-street, Queen-street, and Berwick-street. Of the deaths from fever, one occurred in Park-street, one of a man of 73 in Mount-street Workhouse, others at Cutmore's-buildings, Robert's-buildings, Eaton-place, Park-side, Burton-street, and Hanoverstreet, besides 6 non-parishioners in St. George's Hospital. The deaths from pyæmia, which may be otherwise called puerperal fever, may be added to the 5 registered under the head childbirth; one was a patient removed from Queen Charlotte's Lying-in Hospital to St. George's. The 8 deaths from diarrhæa, were chiefly of young children, from cold, and difficulty of feeding them. 5 The deaths from scrofula, consumption, and other diseases of degeneration and debility, water in the head, &c., were heavy, and so were those under the head of accident and negligence. A carman died of a fractured thigh from being thrown out of a cart; a labourer through falling from a scaffold at the International Exhibition, and another in Warwick-square; a man fractured his skull by falling down stairs at Chelsea, a lady of 83 died through fracture of the thigh, and a potman, set. 27, of delirium tremens, after breaking his leg. A jobmaster, of 60, also died of delirium tremens. A child of 3 months lost its life through the bleeding which followed cutting it for "tongue-tie." A barmaid, aged 50; died through pricking her thumb with holly on New Year's Day. Three children died of burns: one, a girl of 8, whose apron caught fire at a grate, two other children whose clothes caught fire, "no evidence how." A seamstress, of 24, was found drowned in the Thames. Three infants were found suffocated in bed in the arms of their mothers. A woman, æt. 37, wife of a journeyman, a man, æt. 45, and an infant of 4 months, were registered with the unsatisfactory account, that the cause of death was unknown, and that there was no medical attendant: a thing extraordinary at a time when gratuitous medical services are not only offered freely, but almost forced upon the poor. Lastly, five infants were found, in Hyde Park, or in boxes, or on door steps, which were pronounced by the coroner's jury to have been stillborn. As a matter of public economy, it were better for the parish to offer to bury all such bodies gratuitously, (which would cost about 5s. each,) than to have the expense of coroner's inquests, post-mortem examinations, &c., which cost £2 9s. 6d. apiece besides the coroner's salary. 6 the sickness in the hanover and mayfair sub-districts. During the first quarter of 1864, the number of persons who obtained medical relief from the Parochial Surgeons, and at the Dispensary, Mount-street, and in the Sick Wards of the Workhouse, Mount-street, was 1139. Amongst them were 5 cases of small-pox, 2 of chickenpox, 3 of measles, 3 of scarlet fever, 5 of whoopingcough, 19 of diarrhæa, 1 of ague, 15 of continued fever, (or feverish maladies of various grades, some very slight,) 4 of erysipelas, 331 of bronchitis and catarrh, 5 of pneumonia, and one of carbuncle. Since the chief use and purport of our office is to check the epidemic class of diseases, it is our great anxiety to learn all the facts attainable respecting them, so as, if possible, to deduce the laws. But we are baffled. We can explain their spread by infection or contagion; but why they should come as they do, flourish for a time with great virulence, and then vanish, is as yet an impenetrable mystery. As we stated at p. 7 of the foregoing Report, No. XXV., measles and scarlatina, which had been prevalent during the Summer and Autumn, disappeared from the Hanover and Mayfair Sub-Districts in December, and have scarcely shown themselves since amongst the poor in these Sub-Districts. It is true that we may claim something for the active cleansings instituted in houses where these diseases are ascertained to exist; but we must not claim too much on this score, because we found last Autumn that scarlet fever sometimes appeared in houses just after they had been cleansed for small-pox. Be this as it may, the fact remains, that the high mortality of these Sub-Districts during this quarter, was of an unusual sort, inasmuch as it fell upon adults, and was caused 7 by "cold," and did not fall upon children, and was not caused by zymotic disease. Of the 15 cases of "fever," 6 were admitted into the Mount-street Workhouse. Of these, 5 were tramps. One of them was an inmate of one of the model lodging houses in Grosvenor-market, admitted for remittent fever. We must not conceal the fact, that no fewer than 16 persons were ill in the two model lodging houses in Grosvenor-market, in January and February, a quantity of sickness altogether unusual. sickness during the quarter. In the Belgrave Sub-District 8,989 persons were treated by the parochial surgeons, and at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul and St. Barnabas' Dispensary, and at the Workhouse, Little Chelsea. Of these 4,533 were patients of St. George's Hospital, leaving a remainder of 4,456. The total figures include 11 of small-pox, 12 of chickenpox, 25 of measles, 28 of scarlet fever, 91 of whoopingcough, 3 of croup, 148 of diarrhæa, 9 of dysentery, 43 of continued fever, 88 of rheumatic fever, 18 of erysipelas, 6 of diphtheria, and 5 of carbuncle. There were 880 cases of bronchitis, 19 of pleurisy, and 62 of pneumonia. the small-pox. In the Hanover and Mayfair Sub-Districts, the number of persons known to have had small-pox during this quarter was 6, five of whom applied for aid to the parish, viz.: January 8th, EmmaH.,æt. 15, vaccinated, 5, Lancashirecourt, sent to the small-pox hospital. 8 January 26th, Wm. M., æt. 7, vaccinated, 18, North Bruton-mews. March 7th, C., a boy, set. 3, at 9, Shepherd's-court, Upper Brook-street, died of confluent small-pox, after 14 days' illness. March 12th, Gertrude C., æt. 7, sister of the foregoing, sent to the hospital. These two children had been vaccinated in the country, but the vaccination had taken very imperfectly, and there was one faint spot on each child. March 23rd, Emily H., æt. 20, apprentice to a milliner in Duke-street, sent to the hospital. March 24th, W. F., æt, 40, servant in Brook-street, sent to the hospital. With the above, the number of cases known to have occurred in the Hanover and Mayfair Sub-Districts, since December, 1862, is 124 +6 inmates of the Workhouse =130; viz. 68 treated in the Workhouse, 14 at home, 16 at the Small-Pox Hospital, and 32 private cases, besides 84 persons from Belgravia, treated at Mount-street, of which 17 were mortal within the parish. Six cases were sent to the Small-Pox Hospital, from the Belgrave Sub-District during the quarter. the following cases occurred in the belgrave sub-dibtrict:— No. 101, Lupus-street, a boy, aged 1 year, unvaccinated: died. No. 135, Lupus-street, a girl, aged 4 years, vaccinated: died. [Besides this case, a man aged 21, a boy of 9, and 3 girls aged 15,19, and 20 respectively, and vaccinated, had the disease in this house.] 9 No. 11, Sutherland-place, Elizabeth L., 24, vaccinated when a child: had been to Greenwich for a holiday, just before the disease occurred. She was sent to the SmallPox Hospital, 5 January, 1864. No. 2, Brewer's-yard, Brewer-street, a girl who had been vaccinated. No. 12, Gray's-inn-place, Hindon-street, Mary Ann M., aged 8, not vaccinated: removed to the Small-Pox Hospital, March 14; her sister, Eliza M., also not vaccinated, on 1st April. No. 11 ib., a girl of 11, three boys of 10, 7, and 4 years of age, and a boy of 17 months, had the disease very slightly. No. 10, Bloomfield-place, a man aged 28, who worked in the Borough Market, and a child of 10 months, both unvaccinated: the latter was removed to the Small-Pox Hospital, March 4, 1864. No. 6, Johnsons-place, Lupus-street, George M., aged 27, vaccinated: came with the disease from Galashiels, and was sent to the Small-Pox Hospital on the 30th of March. No. 59, Hanover-street, W. Hunt, sent to the Small-Pox Hospital, March 2. special cases. Nos. 9 to 31, St. George's-row, and Nos. 3, 4, 7, and 9, St. Georges-place.—These houses are old, dirty, and dilapidated, the sinks without traps, the water-butts dirty and uncovered, yards dirty, water-closets very much out of repair, and some of them without water. A notice was served on December the 26th, and subsequently power was given by the Nuisances Removal Committee to take proceedings; but it was not required, as the roofs of the houses 10 in St. George's-row had been repaired and white-washed, the drains of some of them cleansed and repaired, and the waterbutts cleansed. Twelve of the houses in St. George's-place were shut up, and will not be let again. Bakehouses in Grillingham-street, Upper Tachbrook-street, and Hindon-street.—Two were lime-whited, and one was ventilated, the owners not having complied with the requirements of the Bakehouses Regulation Act of 1863. They stated that in future it would be more convenient to limewhite and cleanse them in the months of January and August, because they are then less engaged, and they have not so many sacks of flour on the premises. No. 5, Graham-street-west.—Over-crowding was abated here. The father of the family had been bedridden for several years through incurable paralysis, and had suffered from small-pox with the children. No. 17½, Burton-street, Eaton-square.—A great nuisance in the yard from a percolation of sewage matter from the drains of Nos. 16 and 17, adjoining premises, caused by the complainant sinking a dung-pit against the yard wall of Nos. 16 and 17, Burton-street, and breaking into the drain, which he removed, and wanted the owner of the two houses to make a new drain. The complainant has, at his own expense, put down a six-inch pipe drain, instead of the brick drain removed by his workmen. Nos. 26 and 27, Wilton-road.—Effluvia from an obstructed drain, which passes through No. 4, Shaftesburyterrace. It is a nine-inch brick drain, full of sewage matter, and communicates with that of No. 3, Shaftesburyterrace. The kitchens at No. 4 were occupied by a man, his wife, and four children. The wife was found by Dr. Aldis to be dangerously ill in bed with sore throat, in the back kitchen, which was close to an open drain. He gave a 11 certificate for her immediate removal into the Infirmary, Mount-street, and Mr. Grant took care that the drains belonging to the four houses were properly cleansed into the sewer, and repaired, and that the offensive matter was removed. Nos. 2, 3, 4, 5, and 6, Flask-row, and Nos. 1, 2, and 3, Susannah-place.—The drains obstructed, and the yards of Nos. 3 and 5 flooded with offensive water. A notice was served at each house on February 2nd, and the drains at the back of Nos. 2, 3, 4, 5, and 6, Flask-row have been cleansed and repaired. legal proceedings for neglect of vaccination. In the large premises, No. 18, North Bruton-mews, where one case of small-pox occurred during the quarter, were found twin children, 9 months' old, and unvaccinated. The parents at first set us at defiance, and positively refused to allow of the operation, alleging that it had been injurious to one of their elder children. After delay enough to allow of change of mind, a summons was taken out. Then the mother who appeared, pleaded that she was willing to have the operation done, but that the children were too weakly. As there was some truth in this, we procured them chicken broth and other things to feed up the children till they were fit to be vaccinated, and were vaccinated accordingly. If we had pushed the legal proceedings we might have failed, through a difficulty in proving the delivery of that "notice" respecting vaccination, which ought to be given to the parent or guardian when a child's birth is registered. 12 APPENDIX. No. I. WATER. The Water supplied by the Chelsea Company, and taken from the main at Chapel-street, Belgrave-square— Total Impurity 1864. in grains per gallon. Organic ditto. January 17 21.84 2.64 February 17 19.80 1.56 March 17 20.40 3.04 C. J. B. A. APPENDIX. No. II. The following table refers to cases dealt with by the Nuisances Removal Committee, during the quarter ending April 2nd, 1864. Houses reported by Medical Officers of Health in consequence of illness or nuisance 40 Viz. for scarlet fever 16 diphtheria 2 typhus fever 1 measles 1 diarrhæa 1 small-pox 13 Houses and other premises reported by Inspector 80 Ditto by inhabitants 45 Total 165 13 nature of nuisance complained of. Drains obstructed or defective 45 Cesspools 3 Ditto in stables 1 Yard dirty 1 Leakage of offensive water 2 Leakage of water 9 Ditto of soil-pipe 1 Offensive effluvia 9 Ditto from gas-pipe 1 Stables dirty 1 Dung-heaps complained of 3 Houses dirty and dilapidated 38 Ditto inspected and no just cause of complaint found 2 No dust-pits 2 No traps 1 No water supply 1 Water-closets out of order 4 Offensive gully 1 Dampness 3 Cow house 1 work done. Houses cleansed and repaired 36 Ditto shut up 12 Water-closets and soil-pipes repaired or erected 6 Old rotten brick drains replaced by pipes 9 Water laid on 1 Gully cleansed 1 Traps supplied 1 14 Dung nuisance abated 1 Drains cleansed, repaired, &c 34 Leakage remedied 6 Cesspools abolished 4 Inhabited stables newly drained by pipes 2 Slaughter-houses limewashed 1 Rubbish removed 1 Number of Notices served 25 APPENDIX. No. III. gas. Seventy-two observations were made during the quarter, upon the six gases supplied by the Chartered, London, and Equitable Companies, in Horseferry-road, 73, Bessboroughstreet, and 78, Cambridge-street, respectively. The gases were burned in accordance with the Metropoli Gas Act, 1860, and the illuminating power continued above the standard light required by the Act. With respect to purity, all the gases were free from sulphuretted hydrogen, and so far free from ammonia, that they did not discolour the turmeric paper. The following Table gives the average light in sperm candles of all the gases— Chartered. London. Equitable. Cannel 25.64 24.92 24.95 Common 15.84 14.56 15.08 In compliance with the resolution of the Vestry, passed on Jan. 14, that my attention be called to the subject of the gas supplied in this parish, both as regards pressure and illuminating power, I have since kept a record of the 15 ferent pressures on the mains and the burners, which has been inserted in my Reports to the Vestry. Although the illuminating power of some of the gases has been unusually good during my examinations, yet the pressure was sometimes low, which may be seen by referring to the Report, dated March 3rd, 1864. This can be easily explained; for example—the common gas supplied by the Chartered Company, on Feb. 10th, gave a light equal to nearly 17 instead of 12 sperm candles, when the pressure on the main was only 6/10ths of an inch; but the day being foggy, and the storage for gas at the works being inadequate to the public demand, the gas was enriched in order that the pressure might be diminished. The Company, however, are now erecting a very large new gas-holder, to contain one million six hundred thousand cubic feet. A Table and Summary were sent with each Monthly Report on the gas to the Vestry, containing the number of examinations and the pressures, with the dates, and the weekly and monthly average illuminating power. C. J. B. Aldis, M.D., Gas Examiner. 16 ANNUAL REPORT. Short Annual Report of Births, Deaths, Vaccinations, Sanitary Statistics., and Improvements, for One Year of 53 weeks, from March 26th, 1863, April 2nd, 1864. Births. The number in the whole parish was 2412. In the years ending March 31st 1858 1859 I860 1861 1862 1863 The numbers were 2165 2288 2300 2119 2498 2411 In the Hanover and Mayfair Sub-Districts, the births this year were 694, in the years 1858 1859 1860 1861 1862 1863 The numbers were 660 705 710 656 735 661 In the Belgrave SubDistrict this year there were 1718 1505 1583 1590 1463 1763 1750 Deaths. The gross number in the whole parish has been 2054, whereas in the foregoing 6 years they were 1768 1838 1837 1769 1965 1882 Gross Death-rate. Estimating the population of the whole parish as 91,500 the gross death-rate was 22.4 per 1000 living; last year it was 20.9, with an estimated population of 90,000; the year before 22.2 with an estimated population of 88,500. Excess of Births over Deaths, 358 in the whole parish 397 450 463 350 533 529 Estimated Population. This we believe to have been 91,500 at the end of 1863. The five wards in the Hanover and Mayfair Sub-Districts are virtually stationary; but the two Belgrave wards increase at the rate of at least 1500 per annum. They increased 15,000 in the ten years 1851-61, and although the Knightsbridge 17 Ward is now stationary, having 2489 ratings in 1862 and 2497 in 1863, the number of premises rated to the relief of the poor has, during the last few years, increased at an uniform rate, owing to the steady increase of building in the Out-ward, or South Belgravia The increase, however, cannot last much longer, because all the ground will be occupied. The ratings were 6458 in 1860, 6659 in 1861, 6802 in 1862, and 6956 in 1863. The assumed increase of inhabitants in Belgravia is, we think, thus warranted. The ratings in Hanover and Mayfair were 3649 in 1862 and 3641 in 1863. 1858 1859 1860 1861 1863 1863 Deaths in St. George's Hospital for the year ended 2nd April, 1864, 321 311 314 316 330 308 317 Non-Parishioners who died there, 260 255 251 243 263 243 253 Parishioners who died there, 61 . 56 63 73 67 65 64 From the Hanover and Mayfair Sub-Districts, 17 - - 24 27 22 19 From the Belgrave, 44 — — 49 40 43 45 Deaths in Mount-street Workhouse, 104 88 75 72 96 69 100 Deaths in Little Chelsea Workhouse, 36 41 33 28 25 27 26 In the Hanover and Mayfair Sub-Districts the gross mortality in the year ended 2nd April, 1864, has been 630, including the deaths of 104 in the workhouse, the newly-born child whose body was found in the streets, 4 adults in the Serpentine, and 8 children in Hydepark. The numbers for the preceding seven years in succession are, 563, 605, 543, 567, 534, 570, and 577. This gives a gross death rate of 19.6 per 1000 for this year, estimating the population as stationary at 32,500. Thus during the last seven years the mortality in this part of the parish has fluctuated between 16, 17, 18, and 19 per 1000 per annum. We now proceed, as in former reports, to divide the Hanover and Mayfair Sub-Districts into two classes of streets. First, the aristocratic and first-class business streets and squares,—such as Albemarle and Arlington streets, North and South Audley streets, Grosvenor and Berkeley squares, Old and New Bond streets, Bolton, Brook, and Bruton streets, &c„ &c. We obtained an exact record of the population of these streets at the census of 1851, and we believe there has been no material fluctuation since: the population of these streets was then 20,000. The deaths in them last year were 240, or at the rate of 12 per 1000 of the population. The deaths for the foregoing seven years have been 216,209, 192, 201, 187, 187, 201. Out of the 240 deaths, 39, or one-sixth, were of children under 5. The number of children's deaths was 41 last year, 43 the year before. Now if we take the remaining streets, that is the second and third class business streets, the mews, and the streets occupied by the artizan and servant classes,—such as Adam's-mews, Averyrow, Barlow-mews, Bell-yard, &c., &c.—the population of these B 18 is 12,500, say 13,000. The total number of persons who died at home in these streets last year, excluding all that died in the workhouse or in the hospital, and all that were found in the park or streets, is 273, of whom 123 were children under 5, or nearly onehalf The rate of persons who died at home is 21 per 1000. The number of deaths under 5 was 121 last year and 154 the year before. But we need scarcely say, that people of this class do not all die at home. And if we add together the deaths of our 61 fellow-parishioners, who died in St. George's Hospital, and the 140 in the two workhouses, = 201, and compare this with the gross mortality 2054, we shall see that this year, as heretofore, one in every ten of our parishioners who died in this parish, died in a bed provided by public or private charity. The gross number of deaths in the Belgrave Sub-District is 1368. If we estimate the population at the close of the year 1862 as 59,500, the gross rate of mortality was very nearly 23 per 1000 living. If we exclude the 321 deaths in St. George's Hospital, and take no account of those which occurred in the workhouses, the deaths at home were 1047, or at the rate of 17.5 per 1000 living. One infant was found in Belgrave-square, 1 in Eaton-square, and 1 in Hyde-park. The deaths under 5, in the Belgrave Sub-District, were 475, or nearly half of the total deaths at home. Last year the deaths under 5 in this Sub-District were 489. In the year before 580. So that in this year, and the foregoing, there has been a saving of nearly 100 children's lives. We have not the exact record of the population in the streets of the Belgrave Sub-District as we have of the Hanover and Mayfair; but just as we have shown the contrast between the rich streets and poor streets in the one, so we can in the other District. For an example, in 5 squares inhabited by the rich and 7 streets inhabited by the poor, the deaths under and over 5 during the last three years were as follows:— MORTALITY IN FIVE SQUARES. To April,— 1862. 1863. 1864. Deaths under 5. Deaths over 5. Deaths under 5. Deaths over 5. Deaths under 5. Deaths over 5. Belgrave-square 1 2 0 2 0 2 Eaton-square 0 5 0 8 l 6 Chester-square 1 4 0 3 0 4 Eccleston-square 0 4 0 2 1 2 Warwick-square 0 2 0 1 l 1 2 17 0 16 3 15 19 MORTALITY IN SEVEN STREETS. Year ending April,— 1862. 1863. 1864. Deaths under 5. Deaths over 5. Deaths under 5. Deaths over 5. Deaths under 5. Deaths over 5. Upper Ebury-street 17 9 10 12 9 14 Pulford-street 17 7 9 7 13 5 New Grosvenor-place 8 5 1 0 6 6 Brewer-street 6 4 3 2 6 6 Glasgow terrace 15 3 0 0 8 6 Robert-street 11 3 12 2 4 4 Eaton-court 8 2 2 3 6 4 82 33 37 26 66 44 We now proceed to sum up the deaths from preventible or partially preventible causes in the whole parish. CAUSES OF DEATH. In the year ending March,— 1860. 1861. 1862. 1863. 1864. The deaths from zymotic disease 346 291 448 395 393 „ small-pox 6 8 1 13 41 „ scarlatina, diphtheria, croup, and other forms of fever with throat disease 82 53 82 117 102 „ fever 44 39 63 68 68 „ diarrhoea, dysentery, and cholera 48 83 53 41 52 „ teething, convulsions, consumption, water in the head, mesenteric disease, and scrofula 395 353 387 342 385 THE SICKNESS. The total number of cases treated in the Hanover and Mayfair Sub-Districts during the year, by the Parochial Medical Officers, and at the Dispensary, Mount-street, and in the SickWards of the Mount-street Workhouse, has been 4,450. Last year 3,901, the year before 3,803. Amongst which were 58 cases of small-pox from the Hanover and Mayfair Sub-Districts admitted to the Sick-Wards, Mountstreet; 6 inmates of the workhouse; 61 cases admitted from Belgravia; 9 treated at home; and 12 sent to the small pox hospital during the year--146 altogether—besides 25 private cases; 20 of chicken-pox, 117 of measles, 58 of scarlatina, 8 of diphtheria, 50 of whooping-cough, 122 of diarrhœa, 93 of fever, 11 of erysipelas; 753 of bronchitis and catarrh, pneumonia 7, carbuncle 3. In the Belgrave Sub-District 34,340 persons were treated by the Parochial Surgeons, and at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul and St. Barnabas' Dispensary, and the Workhouse, Little Chelsea ; of these 18,799 were patients 20 at St. George's Hospital. The whole number includes 129 cases of small-pox, 73 of chicken-pox, 122 of measles, 98 of scarlet fever, 274 of whooping-cough, 6 of croup, 945 of diarrhoea, 32 of dysentery, 209 of continued fever, 245 of rheumatic fever, 77 of erysipelas, 24 of diphtheria, 17 of carbuncle. There were also 2,174 cases of bronchitis, 00 of pleurisy, and 179 of pneumonia. VACCINATION. Mr. Jorden reports as follows for the year:— Successful. Unsuccessful. 1st Qr.— 1st Qr.— Primary 405 Primary 11 Secondary 707 Secondary 170 2nd Qr.— 2nd Qr.— Primary 169 Primary 1 Secondary 25 Secondary 4 3rd Qr.— 3rd Qr.— Primary 156 Primary 4 Secondary 3 4th Qr.— 4th Qr.— Primary 173 Primary 2 Secondary 1 Total successful 1,639 Total unsuccessful 192 Mr. Jay makes the following statement of the number of persons (including children) vaccinated during the year ending 2nd April, 1864. Successful. Unsuccessful. 1st Quarter vaccinated 670 586 84 2nd Quarter „ 46 46 0 3rd Quarter „ 40 43* 0 4th Quarter „ 88 78 10 844 753 94 Of the 884 cases, 318 were primary, and 526 secondary. ST. GEORGE 8, HANOVER SQUARE, SCHOOLS. Boys. Girls. Infants. Total. South-street 250 216 168 634 Hanover Schools, South Molton-street 130 145 154 429 St. Mark's Schools, North Audley-street 126 117 164 407 Grosvenor School — 100 120 220 Curzon Schools 90 75 140 305 Farm-street School, Mixed 26 24 26 76 Catholic School, Davies-mews, Mixed School — — — 75 (Seventeen of these children come from St. Marylebone). 2,146 *This discrepancy is owing to the last week of the quarter being included in successful of next. 21  Boys. Girls. Infants . Total. St. Peter's School 230 180 152 662 St Michael's School 263 232 254 740 St. Michael's Free School — — — 250 St. Gabriel's Schools* — — — — St. Paul's School 135 122 100 357 St. Barnabas' School 116 87 160 363 St. Barnabas' Schools, Mixed — — — 88 Eaton Chapel Schools 56 63 — 109 Catholic Schools, Belgravia — — — 100 2,578 The law for enforcing vaccination is very difficult to enforce, because we cannot proceed against a parent for neglecting to have a child vaccinated, simply but only against such parents, &c., as neglect to have a child vaccinated after receipt of a notice, which the Registrar is bound to give within seven days after registration of the birth. Consequently, we cannot inflict a penalty on the parent, unless we can first prove that he has had the above notice. The Vaccination Act is a dead letter, so far as regards the registry of certificates of vaccination. Mr. Jay only received five certificates last year. We are thus deprived of a very important means of knowing how far the vaccination of infants is kept up. In order to ascertain the existence of unvaccinated children, we procure from the Registrars lists of births, in the poorer Districts, and send round a messenger to inquire into the vaccination. It is a singular fact, that, within six months, at least a fourth of the people will be found to have removed after the birth of a child. Another evidence of the fluctuation of a portion of the poorer population is the fact, that 75 at least per cent of the infants in the various schools, are shifted during the year. For example, in the St. Mark's School, out of 164 infants, 162 had been admitted within the year ; in the Curzon School, 70 out of 120. The examination of the children in the various schools, is one of the most effective means of insuring general vaccination It is of no use to take the word of parents, for they may deceive; certificates are never forthcoming; the only proceeding necessary, is that the candidate for admission should show the vaccination marks on his arm, to the schoolmaster or mistress, and that a little note should be made of the fact in the School Register. As it is, we are sure to find 2 or 3 per cent, of unvaccinated children in any school where this is not enforced. We have before given utterance to our sentiments, as to the dirty and diseased state of some children's skins; but we believe that the masters and mistresses do all they can to enforce cleanliness, short of expelling the children, which would be punishing them for the neglect of their parents. Last year, 48 unvaccinated (including some doubtful cases, failures, &c.) were found amongst 1,748 school-children in the Hanover and Mayfair Sub-Districts. *New Schools—no information as to numbers. 22 SANITARY WORK. The nutnber of complaints entered in the Inspector's Report Book, between March 30th, 1863, and April 2nd, 1864, is 717, of which 298 relate to premises in the Hanover and Mayfair, and 424 to the Belgrave Sub-Districts. The number of notices served has been 141. The number of premises to which they refer is 536 in the Belgrave and 337 in the Hanover and Mayfair Districts. The number of summonses taken out has been 5, besides 1 for vaccination. Mr. Grant reports that there are 37 slaughter-houses, 20 bowyards, 40 marine store dealers, and 96 bake-houses in the parish. The Sanitary Improvements in the Parish, between March 30th, 1863, and April 2nd, 1864, inclusive, are shown in the following Table, compiled from the Nuisances' Complaint Book, kept by Mr. Grant:— Dwelling House1. No. of oaies. Dilapidated and shut up as unfit for human habitation 2 Repaired, whitewashed, and cleansed 275 Extra supply of water laid on 4 Overcrowding abated 1 Ash-pits erected 7 Ash-pits repaired or covered 2 Water-butts or cisterns cleansed, covered, or repaired 4 New water receptacles erected 7 Leakage from water-pipes or cisterns of adjoining premises 24 Leakage from drains of adjoining premises, gullies in streets, or sewers 8 Houses without drainage, but since drained by pipes 1 Cesspools abolished 13 Old brick-drains broken up and pipe-drains laid down 47 Drains and water-closets cleansed and repaired 103 Extra water-closets erected 8 Common privies abolished and new water-closets constructed 9 Drains and sinks trapped 29 Dwellings extra ventilated 12 Old public sewers repaired under dwellings Stables. 1 Cleansed and repaired with rooms over 4 Cesspools abolished 13 Yards paved, &c 4 Old brick-drains broken up and pipe-drains laid down 8 Without water-closets, but drained water-closets since erected 5 Without water-closets or drainage, since drained by pipe-drains and water-closets erected 2 Inlets to drains trapped 4 Drained by pipe-drains, water-closets not required 4 Extra ventilated 1 Drains cleansed and repaired 10 23 Cow Yards. Complaints of non-removal of dung during proper hours 19 Dung removed 3 Offensive grains removed 1 Slaughter Houses. Drains cleansed and repaired 1 Limewashed and cleansed 2 Garbage and blood removed 7 Various Nuisances. Dung removed from pits and heaps when offensive 21 Rubbish offensive in yards or on waste ground 4 Slops thrown from windows and on to roofs of adjoining premises, down gullies in streets and on to carriage-ways. 1 Urinals abolished 1 Gas escapes into dwellings from Company's mains 3 Complaint as to dissection of dead horses 1 A cab stand dirty and offensive 1 Gullies offensive in streets cleansed or trapped 9 Offensive privies abolished 1 Horses removed from a skittle ground 1 Dogs, goats, and donkey removed 3 Dangerous houses reported to police 1 Chimney stacks ditto ditto 2 WHAT ABE THE RESULTS OF SANITARY WORK? Our efforts are directed against "preventible diseases,'' which we refer to certain causes, admitting of accurate classification, although we generally find two or more of these causes at work together in most cases. They are, !, the sewer poisons, which we believe to cause typhoid fever, diarrhoea, and dysentery; and to be main vehicles for the spread of the next class. 2. The true injections fevers, as scarlatina, &c., which come upon us we know not whence, and abate after a while, and which spread during their season of prevalence by means of the exhalations and excretions of the sick. 3. The diseases occasioned by cold, damp, and malaria, rheumatism, S.c. 4. The diseases of degeneration, due to town air, and want of light, exercise, ventilation, cleanliness, &c., as scrofula, consumption, &c. 5. Diseases due to indulgence of base appetites, as syphilis and delirium tremens. 6. Accidents and the effects of want of care and prudence, of which the deaths of children whose clothes " ignite, no evidence how." are examples. " 1. Now respecting sewer poisons, there can be no doubt that we are not yet nearly free from them. In the houses of the poor, where, perhaps, 20 or 30 persons resort to one closet within the house, they are scarcely ever free from these vapours. We have done almost all that the law permits, in structural improvement, the erection of new closets, the laying down drains, and so forth. Now 24 we want what no law will give: care and cleanliness on the part of the people. The Table shows that the Local Authority has been appealed to this year in about 200 instances, where houses were subjected to some form of sewer nuisance. In the poorer houses, tliese arose, for the most part, from negleot, obstructed drains, want of water, wilful damage to the water apparatus, &c. But it would be a gr at mistake to suppose that it is in the houses of the poor only, that sewer nuisances are found. In each of the following first-rate streets, the Inspector has been called in to detect and remove such nuisances during the year. Albemarle-street, 2 houses; Arlington-street, 2; Audley. square, 1; South Audley-street, 2; New Bond-street, 3; Brook-street, 3; Bruton-street, 1; Charles-street, Grosvenor-square, 1; Chapelstreet, 1; Clarges-street, 1; Conduit street, 1 ; Davies-street, 1 ; Dover-street, 3; Duke-street, 3; Green-street, 3; Grosvenorstreet, 1; Half-moon-street, 1; Maddox-street, 1; Mount-street, 2; Park-street, 4; Piccadilly, 1; South-street, 2; Stratton-street, 1; Chapel-street, Belgrave-square, 1; Eccleston-place, 3; Eccleston-squire, 1; Chester-street, 1; Lower Belgrave-place, 2; Cambridge street, 1; St. George's-place, 1. The nuisances in some of these houses were slight, though still sufficient to induce the occupiers to get the benefit of the Inspector's skill; but in others they were of the worst possible kind. When we read in the Inspector's Book a record of such work as this,—"Cesspool abolished, old rotten brick drains broken up, saturated earth carted away, the excavation sweetened with quicklime, and filled in with dry brick rubbish, new pipe drains laid down, and all the inlets trapped," we may be certain that such a house, before the work, stood over a putrid swamp. Yet houses in this state are every month, one by one, explored and purified, in the best parts of the parish. We know what the results are sure to be at some time or other. For instance, there is a house in New Bond-street. The medical attendant of the family applied to the Medical Officer of Health, saying that the family had had small-pox, measles, sore throat, boils, and other eruptions since they had come to the house, though quite healthy before. Through a stupid arrangement of some pipes, they were all inhaling putrid sewer air, especially at night, and this they felt to be the cause of their illness. When, then, we look at the list, for 1863, of 13 cesspools abolished (some from beneath noblemen's houses), at 47 cases of old brick drains replaced by pipes, and the rest of the 200 cases, we feel certain that the (say 2,000) inhabitants of those houses are relieved from a possible source of most dangerous illness. The only wonder at present is, that they have suffered so little. There is another possible vehicle of sewer poison, the drinking water. We repeat analyses, time after time, of the water delivered by the public companies, with the variation of from halfa-grain to two or three grains of "organic matter" per gallon. What this organic matter is, we know not; all we know is, that when the residue of the water after evaporation is exposed to a red heat, it blackens, then becomes winter; and after it has cooled, shows a certain loss of weight which is considered 25 ganic matter." It may be the germs of infusoria and confervas, or may be urinous matter; may be innocent, or may contain the poison of cholera. But we have no chemical test beyond the test of mere quantity. We have tried many other forms of testing without good result; yet, suffice it to say that the inhabitants of London should watch the character of the drainage of the Upper Thames Valley, most carefully. As to pump water, cool and sparkling as it is, every day's experience shows from what foul sources it may be derived. Whoever drinks water from the pumps in Mount-street, should think of the awkward fact, that one house in Adam's-mews, of 20 or 30 inhabitants, never had any outlet for its drainage till this year, but that all the house sewage had been allowed to soak into the gravel. Moreover, the sewer in Bell-yard had given way, and soaked into neighbouring cellars, and, unless the laws of nature were reversed, it would find its way into the pump well in that yard. 2. Respecting the infectious fevers, as the fever poison, being a material substance, must exist somewhere, we may point to the 275 houses cleansed, as, at all events, some contribution to the public safety. So much of the infectious poison as adheres to walls and ceilings, or lies in sinks and closets, must be destroyed by the limewash, which has been employed so profusely. 3. No one can form a notion of the wretchedness caused in some houses by the leakage of water from rainwater pipes, or from the water company's supply pipes. Kitchens are flooded, and walls made damp permanently, and the servants and others who live in the basement made subject to rheumatism. We may point to the 32 cases in which leakages have been remedied, and may say that some of them were most puzzling, and took much time to explore. We will not go through the other heads, but content ourselves with one practical remark about the maladies which cut off such frightful numbers of elderly people in January and March. Cold is the great agent, and one to be combated by fires, clothing, and food. But cold is not all. People "catch cold" who are never exposed to it. There is a malaria in addition to a low temperature, and in all probability a more liberal use of quinine would render the other remedies employed more efficacious. Our thanks are due to Mr. Jay and Mr. Jorden, the registrars and vaccinators; to Mr. Hughes, registrar: to Drs. Bloxam, W. Bloxam, and Symes, Messrs. W. Griffith, E. Davis, F. Goodrich, sen., and W. Fain, of the Royal Pimlico Dispensary, and to Mr. Connock of the Mount-street Dispensary, for much valuable information and many facilities in the discharge of our duties. With regard to the Small-pox Wards at Mount-street, we will only say, that some remarkably serious cases were treated with astonishing success; and that the ventilation and other arrangements for the benefit of the sick, and for the safety of the other inmates of the house, were most ably and successfully carried out. C. J. B. Aldis, M.D. R. Druitt. c DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 2nd of April, 1864. Average, 46'6 DISEASES. Ages at Death. Sub-Districts & Population. Sexes. Under 1. 1 and under 5. Total undfr 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above. Hanover Square.—19 770. May Fair.—12,648. Iielgrave.—55,< 9'.». Mount-street Work.—268. Little Chelsea Work.—350 St. George's Hospital. —216. Males, 35,511. Females, 50,236. Total, 87,747 in 1861. Parishioners. NonParishioners. I. ORDER 1. 1. Small-pox .. 3 3 .. .. .. .. 1 .. 2 .. .. .. .. 2 1 3 2. Measles .. 2 2 .. .. .. .. .. .. 2 .. .. .. .. 2 .. 2 3. Scarlatina 1 9 16 .. .. .. .. 2 .. 11 .. .. 1 2 8 8 16 4. Diphtheria .. 2 2 1 .. .. .. 1 .. 2 .. .. .. .. 1 2 3 5. Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Croup 1 3 4 .. .. .. .. 1 .. 2 .. 1 .. .. 3 1 4 7. Sore Throat .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Whooping Cough 6 7 14 .. .. .. .. .. .. 14 .. .. .. .. 11 3 14 9. Typhus (and infantile fever) .. 2 7 2 2 2 .. 1 .. 5 1 .. .. 6 6 7 13 10. Erysipelas 2 1 3 .. 1 2 .. .. .. 5 1 .. .. .. 2 4 6 11. Metria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12. Pyaemia .. .. .. 1 1 .. .. .. 1 .. .. .. .. 1 .. .. 2 13. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 16. Diarrhœa 4 1 5 .. 1 2 .. 1 1 4 1 .. .. 1 3 5 8 17. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 18. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 19. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 20. Rheumatism .. .. 1 1 2 .. .. .. .. 2 1 .. .. 1 1 3 4 Order 2. 1 Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Stricture of Urethra .. .. .. .. 1 1 1 .. 1 1 .. .. .. 1 3 .. 3 Order 3. 1. Privation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Alcoholism a Del. Tremens .. .. .. 1 1 .. .. 1 .. .. .. .. .. 1 2 .. 2 b Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 4. 1. Thrush .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 II. Order 1. 1. Gout .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 1 2. Dropsy .. .. 1 2 2 .. .. .. .. 3 .. .. .. 2 3 2 5 3. Cancer .. .. .. .. 10 1 .. 2 1 6 .. .. .. 2 1 10 11 4. Morti6cation .. .. 1 .. .. 1 .. .. .. 2 .. .. .. .. 2 .. 2 5. Abscess .. .. 1 1 .. 1 .. 1 .. 2 .. .. .. .. 2 1 3 6. Haemorrhage .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Order 2. 1. Scrofula .. 1 2 .. .. 1 .. .. .. 2 1 .. .. .. 2 1 3 2. Tabes Mesenterica 3 2 6 .. .. .. .. 5 .. 1 .. .. .. .. 2 4 6 3. Phthisis .. .. 4 31 15 2 .. 9 7 19 7 .. 4 6 31 21 52 4. Haemoptysis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Hydrocephalus 7 6 13 .. .. .. .. 1 2 10 .. .. .. .. 5 8 13 III. Order 1. 1. Cephalitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Apoplexy .. .. .. 1 9 9 1 1 2 14 .. 1 .. 2 8 12 20 3. Paralysis .. .. .. 2 1 4 1 .. 1 5 1 .. .. 1 3 5 8 4. Epilepsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Convulsions 9 6 16 .. .. .. .. 3 3 8 1 1 .. .. 10 6 16 6. Brain Disease, Spine, Ac. 1 1 3 1 2 3 .. .. 1 5 .. .. .. 3 2 7 9 Order 2. 1. Pericarditis .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 2. Aneurism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Heart Disease, &c. .. .. 4 7 11 12 1 9 7 12 1 1 1 5 22 14! 36 Order 3. 1. Laryngitis .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 2. Bronchitis 8 8 18 7 28 52 5 25 15 46 13 .. 3 8 52 58 110 3. Pleurisy .. .. .. .. 1 1 .. .. .. 3 .. .. .. .. 1 2 3 4. Pneumonia 8 7 17 4 5 3 .. 7 1 17 .. 1 .. 3 16 13 29 BIRTHS registered during 13 weeks.—Hanover Square, M. 56, F. 53; May Fair, M. 39, F, 37; Belgrave, M. 170, F. 198. Total 553. Average 42 5 DISEASES. Ages at Death. Sub-districts & population Sexes. Under 1. 1 and under 5. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. SO and above. Hanover Square.—19,770. May Fair.—12,648. Belgrave.—55,099. Mount-street Work.—268. Little Chelsea Work.—350 St. George's Hospital. —216. Males, 35,511. Females, 50,236. Total, 87,747 in 1861. Parishioners. NonParishioners. 5. Asthma .. .. .. .. 6 2 .. 2 .. 6 .. .. .. .. 5 3 8 6. Lung Disease, &c 1 1 2 2 3 4 .. 1 2 6 1 .. .. 1 7 4 11 Order 4. 1. Enteritis 1 .. 1 1 .. .. .. .. 1 1 .. .. .. .. 1 1 2 2. Peritonitis .. 1 3 1 1 1 .. 1 1 1 1 .. .. 2 3 3 6 3. Ascites .. .. .. .. 2 .. .. .. .. 2 .. .. .. .. 1 1 2 4. Hernia .. .. .. .. 1 1 .. .. .. .. .. .. 1 1 .. 2 2 5. Ileus and Intussusception .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 6. Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7. Stomach Disease, &c .. .. .. 1 1 3 .. .. .. 2 1 .. 1 1 2 3 5 8. Hepatitis .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 9. Jaundice .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. 1 1 10. Liver Disease, &c 1 .. 1 2 7 3 .. 5 1 5 .. .. 1 1 6 7 13 Order 5. 1. Nephria .. .. .. .. .. 5 .. 3 1 1 .. .. .. .. .. 5 5 2. Diabetes .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 3. Kidney Disease, &c .. .. .. 4 4 5 .. 3 2 2 .. .. .. 6 9 4 13 4. Diseased Bladder .. .. 1 1 1 2 .. 1 1 1 .. .. 1 1 4 1 5 Order 6. 1. Ovarian Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Uterus Disease, &c .. .. .. .. 4 .. .. 2 .. .. 1 .. .. 1 .. 4 4 8. Extra Uterine Foetation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 7. 1. Arthritis. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Joint Disease, &c .. .. 1 1 1 1 .. .. .. .. .. .. 1 3 3 1 4 Order 8. 1. Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Ulcer .. .. .. .. 1 1 .. .. .. 1 1 .. .. .. .. 2 2 IV. Order 1. 1. Premature Birth 9 .. 9 .. .. .. .. 1 2 6 .. .. .. .. 7 2 9 2. Cyanosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Other Malformations 1 .. 1 .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 5. leething 5 5 10 .. .. .. .. 1 .. 9 .. .. .. .. 6 4 10 Order 2. 1. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Child-birth (see Metria) .. .. 1 2 2 .. .. .. .. 3 .. .. 1 1 .. 5 5 Order 3. 1. Old Age .. .. .. .. .. 19 18 8 3 20 3 3 .. .. 13 24 37 Order 4. 1. Atrophy and Debility 16 3 19 .. 2 1 .. 3 3 15 1 .. .. .. 16 6 22 2. Exhaustion .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. V. Order 1. (Accident or Negligence.) 1. Fractures and Contusions .. .. .. .. 2 1 1 .. .. 1 .. .. 1 4 5 1 6 2. Gunshot .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Burns and Scalds. • • 1 3 .. .. .. .. .. .. .. .. .. .. 3 1 2 3 5. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Drowning .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 7. Suffocation 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 H. Other Injuries .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 1 Order 3. 1. Murder and Manslaughter .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 4. (Suicide.) 1. Cut, Stab, Shot, .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Hanging .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Deaths (Cause unascertained) .. .. .. .. .. 2 .. 1 .. .. .. 1 .. .. 1 1 2 Causes not specified or ill-defined 7 .. 7 I 1 .. .. 2 2 5 .. .. .. .. 3 6 9 TOTAL: 94 73 207 86 133 150 28 107 62 300 38 9 16 72 305 299 604 DEATHS registered during corresponding weeks of ten years (average) 502.3. Weekly Average . 38.6. LONDON: PRINTED BY GEORGE PHIPPS, RANELAGH STREET, EATON SQUARE. HAN 14 14 No. XXVII.] QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY IN THE PARISH OF Saint George, Hanober Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOR THE QUARTER ENDED JULY 2nd, 1864. London : PRINTED BY GEORGE PHIPPS, UPPER RANELAGH STREET, PIMLICO, S.W. TO THE Destry of St. George, Hanober Square. My Lords and Gentlemen, As usual, we commence by analyzing the deathstatistics. The Table tells us that during the thirteen weeks, ended July 2nd, 1864, 466 deaths occurred, including those of 63 non-parishioners in St. George'shospital, and of 10 inmates at Little Chelsea Workhouse. But during the corresponding period of last year the number of deaths amounted to 550, or 84 in excess of the present quarter. The weekly average, 35.8, though less than for the corresponding quarter of last year, is greater than that for the corresponding period of the ten foregoing years, which was 32.5. Zymotic disease destroyed 81 persons, whereas in the corresponding weeks of 1863, 134 deaths happened from the same cause. Amongst the deaths were 3 from measles, which occurred in Green's-cottages, Pimlico, Bloomfield-place, and Pulfordstreet. There were 12 deaths from scarlet fever; one in Union-street, Bond-street, another in Shepherd's-market, and a third at St. George's-hospital, from Clarges-street. Eight died in the following streets in the Out-wards, namely, 2 in Moreton-terrace, Gillingham-street, Stromboli-cottages, Moreton-place, Wilton-terrace, Cambridge-terrace, and Hindon-street. A non-parishioner died at St. George's-hospital. 4 Five deaths from diphtheria took place respectively in Sussex-street, Robert's-buildings, Queen's Royal-mews, Westmoreland-street, and Ranelagh-grove. Croup proved fatal to a child, aged 2, in Moreton-street, West, and whooping-cough to 19. Twenty-two persons appear in the Register as having died of fever, viz., 2 in the Hanover Sub-District—a young tradesman, set. 21, of the typhoid kind, which is believed to be caused by sewer vapour, on 13th June, at No. 1, Providencecourt, and a healthy girl of 10, at No. 2, Weaver's-place, North-row, after a very short illness. Two tramps in the workhouse of the typhus variety; 14 in the Belgrave SubDistrict, viz., in Eccleston-street East, Upper Belgrave-place, Kinnerton-street, Pulford-street, Sutherland-terrace, Little Ebury-street, Warwick-street, Warwick-row, Passmore-street, Upper Tachbrook-street, Denbigh-street, Belgrave-street South, Coleshill-street, Stanley-street;—one parishioner from Eaton-mews West, and 3 non-parishioners in St. George's-hospital. Erysipelas killed 7 persons, of whom 4 were nonparishioners, at St. George's-hospital. There was also a death from pyaemia in the same institution. There were 3 deaths from diarrhoea, one of which was registered as choleraic, proving fatal in 12 hours, to a woman, aged 41, who resided in St. George's-terrace. Diseases of degeneration and ill-development destroyed 114 patients, including, from premature birth, 2; teething, 8; atrophy and debility, 12; water in the head, 8; tabes mesenterica, 5; convulsions, 6; and consumption, 73. Lung diseases proved fatal to 73 persons. We find among the accidental deaths at St. George's Hospital, 6 from fractures and contusions and 1 from burns, and all of non-parishioners. 5 A non-parishioner, aged 18, was drowned accidentally because the boat he was rowing came into contact with a steam vessel near Cadogan Pier. Two men, aged respectively 21 and 24, were also drowned while bathing in the Serpentine. One suicide was registered, namely, a servant, aged 30, who threw herself from a window, in Wilton-terrace, while insane. One that might be called suicide was that of a. veterinary surgeon, aged 29, from delirium apotu. Among the deaths from causes not specified or ill-defined were those of 3 infants, 1 of which was found in an area in Aylesford-street, another in Queen-street, and the third in the Serpentine. THE sickness. In the Hanover and Mayfair Sub-Districts, the number of persons treated by the Parochial and Dispensary Medical Officers, Mount-street, and in the Sick-Wards of the Workhouse, was 985. Amongst them were 3 cases of small-pox, 2 of chickenpox, 2 of measles, 9 of scarlatina, 2 of whooping-cough, 18 of diarrhoea, 25 of continued fever, 4 of erysipelas, 177 of bronchitis and catarrh, 4 of pleurisy, and 5 of pneumonia. Chicken-pox, like whooping-cough, measles, and scar- latina, sometimes attacks children so mildly, that the parents do not think it worth while to seek medical advice. The nine cases of scarlatina formed a petty epidemic in two or three houses in Shepherd's-market in the early part of June; but even allowing due weight to these, the In-Wards have been very free from these infectious fevers during this year. The most serious item on the list, are the 25 cases marked as "fever," amongst which were the two fatal cases mentioned as having occurred in the Hanover Sub-District. Twelve cases were treated in the Sick-Wards at the Workhouse, and of these 6 10 were tramps, of whom 3 died; one a man from Flask-row, who was at first supposed to have small-pox; and one a girl from No. 7, Thomas-street. It will be seen that three deaths occurred in the Workhouse during the quarter, though only two were registered. The remaining ten cases were scattered about amongst the poor, chiefly in the Hanover Sub-District, and comprised cases of many shades of severity—some very slight. There were sent to the Fever Hospital during the quarter, one tramp, two inhabitants of the In-Wards, and one of Belgravia. the small-pox. During this quarter, six cases of small-pox were heard of:— May 21. Thomas Brooks, set. 5, 2, Shepherd's-court. June 2. Jane Brunkall 22, 10, Brown-street; both vaccinated; disease very slight, and treated at home. June 18. G. Ashton 19, 3, John's-court, sent to the Small-pox Hospital. Besides these, there were sent to the Small-pox Hospital:— April 27. Sarah Crawford 37, 33, Grosvenor-mews. June 27. Emily Godfrey, servant at 24, Grosyenor-square. July 2. W. Clark, 7, Farm-street-mews. These make 136 cases heard of in the Hanover and Mayfair Sub-Districts, since December 1862. sickness during the quarter. In the Belgrave Sub-District 8,650 persons were treated by the Parochial Surgeons, and at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul's and St. Barnabas' Dispensary, and at the Workhouse, Little Chelsea. Of these 5,152 were patients at St. George's Hospital, leaving a remainder of 5,408. The total figures include 15 of small-pox, 26 of chickenpox, 24 of measles, 25 of scarlet fever, 40 of whooping- 7 cough, 2 of croup, 129 of diarrhoea, 9 of dysentery, 28 of continued fever, 46 of rheumatic fever, 25 of erysipelas, 8 of diphtheria, 1 of carbuncle, and 4 of ague, all of which were non-parishioners at St. George's Hospital. There were 492 cases of bronchitis, 22 of pleurisy, and 36 of pneumonia. The following cases of small-pox occurred in the Belgrave Sub-District:— No. 56, Hindon-street. A boy, aged 3 years ; vaccinated. No. 18, Hindon-street. A boy, aged 3 years; vaccinated. Ditto. A boy, aged 5 months; unvaccinated. No. 11, Little Ebury-street. A girl, aged 21; vaccinated. No. 3,Gray's-inn-place. A girl, aged 2 years; unvaccinated. No. 13, ditto. A girl, aged 4; vaccinated. No. 13, ditto. A boy, aged 10; removed to the Smallpox Hospital. 12 April. No. 21, ditto. A child, aged 12; unvaccinated; and a girl, aged 14 ; vaccinated. No. 16, Spring-gardens. A child, aged 2; vaccinated. No. 6a,Boyd's-gardens. Agirl,aged 6 months; vaccinated. special cases. London, Chatham, and Dover Railway Company. Stableyard, Wilton-road.—The stables hold about 40 horses, and the complaint was of effluvia from about 40 loads of dung. A notice was served on March 22nd, and on April 3rd the dung was removed and the yard cleansed. The nuisances from accumulations of this kind are much less numerous than they used to be, owing to the careful inspection of the mews ; but here is produced a strong instance of the extent to which neglect may be carried, and of the advantage of having the means of getting rid of such a nuisance in a summary manner, which formerly did not exist. 8 Nos. 11,12,13,14, 15, and 16, JEcckston-street, East.— This is an example of combined drainage, there being only one drain for all the houses, which runs behind, and drains from No. 16 to No. 11. There was a cesspool in the yard of No. 11, which has been emptied and filled up. The old brick drain has been broken up, and a new nine-inch pipe drain laid down in the yards of Nos. 11,12, and 13, and a six-inch pipe drain in those of Nos. 14, 15, and 16. No. 20, Shaftesbury-crescent.—Dr. Aldis having received a memorial signed by several inhabitants of this place, complaining of the cow-yard behind, inspected the yard, and found it to be clean and well drained. But the successor to the late occupier, who was permitted to keep only 40 cows, was constructing new stalls with the view of increasing the number of cows to 60. Moreover, he had erected a workshop over the sheds, and had inserted windows overlooking the yards at the back of Shaftesbury-crescent. The Nuisances Removal Committee recommended the windows to be abolished, and a copy of a letter, written by Mr. Thrupp, the magistrate, who had kindly visited the premises, was sent to the occupier. It intimated that he incurred the risk of losing his license if the number of cows were increased. The cows have since been removed by the owner. No. 11, Princes-row West, Pimlico.—This was a melancholy instance of the way in which some persons reduce themselves to the lowest depth of degradation through drinking. Dr. Aldis was requested to see a patient here of the St. Paul and St. Barnabas' Dispensary. On his arrival he found a woman lying on some rags on the floor in a state of delirium tremens. Her chest was covered with bruises, which arose from a fall through intoxication one night, while returning from Chelsea after receiving some money for nursing. It appeared that she slept in this den with a man and his wife. She was taken to the Workhouse, Mount-street, where she 9 died. The man soon afterwards became ill with fever, wag seen by Mr. Davis the Parochial Surgeon, and died. Another woman, at No. 5, who laid him out, was also seized with typhoid fever, but is recovering under the treatment from the same Dispensary. No. 19, St. George's-row.—This house was in so horrible a condition, that it is most surprising some disease did not break out. The drains were left uncovered, the closet had no water supply, and the house was dirty and dilapidated. The windows had been removed, and the parlours were overcrowded. A summons was taken out against the owner, to be heard on July 9th, but before then the occupiers set to work cleansing and whitewashing the rooms, and the drains were covered. This house will shortly be taken down to make room for a new railway on the Chatham and Dover line. No. 6, Griffin's-court.—A summons was taken out against the owner of this house, for allowing the kitchen to be used as a dwelling, the same not having the area, &c., required by the 103 Sect. of the Metropolis Local Management Act. He pleaded guilty, the lodgers were removed, and the costs paid. He had already taken proceedings to eject the lodgers, who paid him no rent, and set him at defiance. Slaughter-house in White-horse-yard.—The owner was summoned, by direction of the Nuisances Removal Committee, at their meeting of the 21st June, for neglect of proper caution and cleanliness, whereby a tub of blood, which was being removed at an hour contrary to the regulations proposed by the Vestry, and sanctioned by the Magistrates, and agreed to by the Butchers, was burst, and a horrible effluvium created in the neighbourhood. The case was proved by the evidence of two of the inhabitants who were subpoenaed, and after an adjournment, the defendant was fined 16s., and 6s. costs. 10 APPENDIX. No. I. WATER. The Water supplied by the Chelsea Company, and taken from the main at Chapel-street, Belgrave-square— 1864. Total Impurity in grains per gallon. Organic ditto. April 17 20.08 1.36 May 17 19.04 1.68 June 17 17.02 1.13 PUMP WATER. An analysis has been made of the water yielded by five pumps:— Total Impurity in grains per gallon. Organio ditto. Inorgamc, Earthy, Ac. Nitric Acid. 1. Pump in Bell-yard 49.33 8.10 41.23 Slight trace. 2. Do. Robson's.yard, Chapel.st. 44.47 8.25 30.22 Ditto. 3. Do. Adam's.mews 92.83 31.08 00.85 More. 4. Do. Swan-passage 111.44 24.30 81.13 Ditto. 5. Do. Private House, Park-lane, near Hamilton-place 48.97 7.50 41.41 None. These analyses, especially if compared with those contained in a former Report, show some interesting facts. The pump in Bell-yard, in Robson's-yard, Chapel-street, and in the House in Park-lane, yielded water pretty uniform in quality, and containing about 8 grains of "organic matter" per gallon, i.e., about six times as much as is contained in the water yielded by the water companies. But the water from the pump in Adam's-mews, and that in Swan-passage, contained an enormous quantity, and may fairly be called " filtered sewage." It is perfectly certain that a sewer in Bell-yard was lately broken in, and that the sewage leaked into the adjoining cellar. It is diflicult to conceive that some of it did not leak into the Bell-yard well; but if that escaped, the well in Swan-passage may have been enriched by some of it. As for the pump-well in Adam's-mews, at the rear of the 11 Trafalgar stables, there was no mistake about it during the month of May, for it then yielded undiluted yellow sewage, too offensive for washing carriages; and about this time an obstructed sewer was discovered, leading from Nos. 5 and 6, Adam's-mews, which was replaced by a pipe at the Parish expense. The well was then pumped dry, and the water is now clear; but the enormous quantity of 31. grains of organic matter per gallon, shows that, even if cool and bright, it must be a very suspicious kind of drink. We have cautioned some of the neighbours, but there seems to be a kind of rooted conviction that all water which comes out of a pump must be good. APPENDIX. No. II. The following table refers to cases dealt with by the Nuisances Removal Committee, during the quarter ending April 2nd, 1864. Houses reported by Medical Officers of Health in consequence of illness or nuisance 57 Viz. for scarlet fever 15 diphtheria 4 typhus fever 15 measles 1 diarrhoea 1 small-pox 14 Houses and other premises reported by Inspector 65 Ditto by inhabitants 71 Total 193 NATURE OF NUISANCE COMPLAINED OF. Drains obstructed or defective 52 Leakage of offensive water 7 Leakage of water 2 12 Offensive effluvia 8 Houses dirty and dilapidated 7 No dust-pits 1 No water supply 1 Water-closets out of order 6 Inhabited stable without water-closet 1 Dampness 1 Dampness from defective boiler 1 Overcrowding 2 Stables dirty 3 Dung-heaps complained of 13 Escape from gas-main 1 Offensive urinal 1 Ventilator of sewer complained of 1 Rubbish, dust, dead dogs, and stinking fish 10 Slaughter-houses dirty 3 Offensive gullies 10 Cow-houses offensive 2 Offensive rabbits 1 Smoke 1 WORK DONE. Houses cleansed and repaired 18 Ditto newly drained by pipes 6 Water-closets and soil-pipes repaired or cleansed 4 Old rotten brick drains replaced by pipes 7 Sewer repaired 1 Gullies cleansed 9 Traps supplied 1 Stables cleansed 3 Ditto newly drained by pipes 1 Dampness from foundation without remedy 1 Cow-house cleansed 1 Escape from gas-main remedied 2 Overcrowding 2 Cistern repaired 1 Dust-pits covered 2 13 New sewer constructed 1 Dung nuisance abated 12 Drains cleansed, repaired, &c 27 Leakage remedied 10 Cesspools abolished 5 Inhabited stable provided with water-closet accommodation 1 Slaughter-houses limewashed 3 Rubbish removed 11 Groundless 3 Number of Notices served 28 APPENDIX. No. III. GAS. Seventy-two observations were made during the quarter, upon the six gases supplied by the Chartered, London, and Equitable Companies, in the Horseferry-road,73,Bessboroughstreet, and 78, Cambridge-street, respectively. The gases were burned in accordance with the Metropolis Gas Act, 1860, and the illuminating power continued above the standard light required by the Act, except on May 11th, when the common gas of the Chartered Company gave a light equal to that of 11.65 instead of 12 sperm candles, but as the flame was only 2 inches high instead of 3½, and the light was comparatively good for so short a flame, it was evident that a leakage must be taking place from the meter, which proved to be so on the plug, and in the inlet to the governor. After these were stopped, the gas gave a light equal to that of 14.40 sperm candles. With respect to purity, all the gases were free from sulphuretted hydrogen, and so far free from ammonia, that they did not discolour the turmeric paper, except on April the 21st and the 26th, when the cannel gas of the Equitable Company presented traces of ammonia, which were attributed by the engineer to the trial of a new kind of coal. On June the 23rd, 14 the cannel gas of the Chartered Company also presented a trace of ammonia. The following Table gives the average light in sperm candles of all the gases— Chartered. London. Equitable. Cannel 24.38 23.88 26.07 Common 14.31 14.31 14.58 On May the 26th, I made some experiments on the common gas, at the testing room of the Equitable Gas Company, between the "Birmingham " burner, No. 1; Sugg's burner, No. 2, used by the Gas Companies; and the old iron burner, No. 3, employed by the public. The average light of No. 1 equalled that of 13.07 sperm candles No. 2 „ „ 14.21 „ No. 3 „ „ 12.36 „ the difference therefore between No. 1 and No. 3 equalled .71 sperm candles, and between No. 2 and No. 3 „ 1.85 „ or 14.96 per cent. in favour of the burner used by the Companies as against that used by the public. I was requested to make these experiments in consequence of the recent opposition to the Birmingham and Staffordshire Gas Bill in the House of Commons, which ended in a compromise with the following results: 1. No notice of examination of the gas was to be given to the Company. 2. The adoption of the system of meter for public lights. 3. The burner, used by the Company, to be posited. A Table and Summary were sent with each Monthly Report on the gas to the Vestry, containing the number of examinations and the pressures, with the dates, and the weekly and monthly average illuminating power. C. J. B. ALDIS, M.D., Gas Examiner. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 2nd of July, 1864. Average, 35.8. 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.—19,770. | May Fair.—12,648. Belgrave.—55,099. Mount-street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 37,511. Females, 50,236. Total, 87,747. Parishioners. NonParishioners. I. Order 1. 1. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Measles .. .. 3 .. .. .. .. .. .. 3 .. .. .. .. 1 2 3 3. Scarlatina .. 7 11 .. 1 .. .. 1 1 8 .. .. 1 1 7 5 12 4. Diphtheria 1 4 5 .. .. .. .. .. .. 5 .. .. .. .. 1 4 5 5. Quiney .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Croup .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 7. Sore Throat .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Whooping Cough 4 14 19 .. .. .. .. 2 .. 14 .. 3 .. .. 9 10 19 9. Typhus (and infantile fever) .. 3 8 4 4 6 .. 2 .. 14 2 .. 1 3 13 9 22 10. Erysipelas 1 .. 1 2 2 2 .. .. .. 2 .. .. 1 4 4 3 7 11. Metria .. .. .. 2 .. .. .. 1 .. 1 .. .. .. .. .. 2 2 12. Pvæmia .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 .. 1 13. Carbuncle .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 14. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15. Dysentery .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 16. Diarrhœa 1 1 2 .. 1 .. .. .. .. 3 .. .. .. .. 1 2 3 17. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 18. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 19. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 20. Rheumatism .. .. 1 1 1 1 .. .. .. 2 1 .. .. 1 2 2 4 Order 2. 1. Syphilis 2 1 3 .. .. .. .. 2 .. 1 .. .. .. .. 2 1 3 2. Stricture of Urethra .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 3. 1. Privation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Want of Breast Milk 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 3. Purpura and scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Alcoholism a Del. Tremens .. .. .. 2 .. .. .. .. 1 .. .. .. 1 .. 2 .. 2 b Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 4. 1. Thrush 1 .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 II. Order 1. 1. Gout .. .. .. .. 1 1 .. 1 1 .. .. .. .. .. 2 .. 2 2. Dropsy .. .. .. .. 5 1 1 2 2 3 .. .. .. .. 2 5 7 3. Cancer .. .. .. .. 7 2 .. 3 1 4 1 .. .. .. 1 8 9 4. Mortification .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 5. Abscess .. .. 1 .. 1 2 .. .. .. .. .. 1 .. 3 2 2 4 6. Hemorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 2. 1. Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Tabes Mesenterica 2 3 5 .. .. .. .. .. .. 5 .. .. .. .. 3 2 5 3. Phthisis 4 8 19 26 25 3 .. 13 5 42 7 1 .. .. 43 30 73 4. Haemoptysis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Hydrocephalus 4 4 8 .. .. .. .. 2 1 5 .. .. .. .. 6 2 8 III. Order 1. 1. Cephalitis .. 2 4 1 .. .. .. 1 .. 2 1 1 .. .. 3 1 4 2. Apoplexy 1 1 2 .. 4 6 .. 2 1 7 .. .. .. 2 5 7 12 3. Paralysis .. .. .. 1 1 6 1 1 .. 5 1 2 .. .. 4 5 9 4. Epilepsy .. .. .. 2 .. 1 .. 1 1 1 .. .. .. .. 2 1 3 5. Convulsions 3 3 6 .. .. .. .. 1 .. 5 .. .. .. .. 3 3 6 6. Brain Disease, &c 2 6 9 .. 2 2 .. 2 .. 7 .. 1 2 1 8 6 14 Order 2. 1. Pericarditis .. .. .. .. .. 2 .. .. .. 2 .. .. .. .. .. 2 2 2. Aneurism 1 .. 1 .. 1 .. .. .. .. 1 .. .. .. 1 2 .. 2 3. Heart Disease, &c 4 .. 10 10 13 5 .. 2 2 18 .. .. 4 12 26 12 38 Order 3. 1. Laryngitis .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 2. Bronchitis 9 3 13 5 9 8 7 5 7 22 2 .. 2 4 19 23 42 3. Pleurisy .. 1 1 1 1 .. .. 1 .. 1 .. .. 1 .. 1 2 3 4. Pneumonia 2 3 6 5 4 4 1 5 1 10 .. .. 3 1 10 10 20 BIRTHS registered during 13 weeks.—Hanover Square, M. 65, F. 49 ; May Fair, M. 36. F, 20; Belgrave, M. 223, F. 196. Total 595. Average 53. 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.—19,770. May Fair.—12,648. Belgrave.—55,099. Mount-Btreet Work.—268 Little Chelsea Work.—350 St. George's Hospital. —216. Males, 37,511. Females, 50,236. Total, 87,747. Parishioners. NonParishioners. 5.Asthma .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 1 1 6.Lung Disease,&c. .. 1 1 1 2 1 .. 1 2 1 1 .. .. .. 1 4 5 Order 4. 1.Enteritis .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 2.Peritonitis .. 1 1 2 .. 1 .. .. 1 2 .. .. .. 1 .. 4 4 3.Ascites .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4.Hernia 1 .. 1 .. 1 .. .. .. .. 1 .. .. .. 1 .. 1 2 5.Ileus and Intussusception .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6.Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7.Stomach Disease,&c. 2 .. 4 5 4 4 .. 2 2 9 1 .. 1 2 6 11 17 8.Hepatitis .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 9.jaundice .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 10. Liver Disease, &c. .. .. .. 1 3 3 .. 2 .. .. 1 .. 1 3 4 3 7 Order 5. .. .. .. 1 1 2 .. 1 1 .. .. .. .. .. 1 3 4 1.Nephria .. .. .. .. .. 2 .. 2 .. .. .. .. .. 2 3 1 4 2.Diabetes .. .. .. 1 5 1 .. 1 .. 1 .. .. 1 4 5 2 7 3.kidney Disease,&c. .. .. .. .. 3 .. .. .. .. 2 .. .. 1 .. 2 1 3 Order 6. 1. Ovarian Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.Uterus Dropsy .. .. .. 1 2 .. .. .. 1 1 1 .. .. .. .. 3 3 3. Extra Uterine Fœtation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 7. 1. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.Joint Disease, &c. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 1 Order 8. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1.Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Ulcer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. IV. Order 1. 1.Premature Births 2 .. 2 .. .. .. .. .. 1 1 .. .. .. .. .. 2 2 2.Cyanosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3.Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4.Other Malfomkations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5.Teeting 5 3 8 .. .. .. .. 2 .. 6 .. .. .. .. 5 3 8 Order 2. 1.Premania .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.Child-Birth (see Metria) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 3. 1. Old Age .. .. .. .. 1 7 3 1 2 5 3 .. .. .. 6 5 11 Order 4. 1.Atrophy and Debility 8 2 10 2 2 7 1 1 .. 1 9 3 12 2.Exhaustion .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. V. Order 1. (Accident or Negligence.) 1. Fractures and Contusions .. .. .. 4 3 .. .. 1 .. .. .. .. 1 6 7 .. 7 2.Gunshot .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3.Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Burns and Scalds .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 1 5.Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6.Drowing .. .. 1 2 .. .. .. 2 .. 1 .. .. .. 1 3 .. 3 7.Soffocation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Other Injuries .. .. 1 .. 1 .. .. .. .. 1 .. .. .. 1 2 .. 2 Order 3. 1.Murder and Manslaughter .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 4. (Suicide.) 1.Cut,Stab, Shot .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3.Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Fall .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. 1 1 Sudden Deaths (Cause tained) 1 .. 1 .. 1 1 .. 2 .. .. .. .. .. .. 3 .. 3 Causes not specified or ill-defined 3 .. 3 .. .. .. .. 1 .. 2 .. .. .. .. 2 1 3 TOTAL 65 76 176 84 115 77 14 73 35 240 24 10 21 63 248 218 466 DEATHS registered during corresponding weeks of ten years (average) 423.1. Weekly Average 32.5. HAN 14 No. XXVIII.] QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY IN THE PARISH OF Saint George, Hanober Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH, FOR THE QUARTER ENDED 1st OCTOBER, 1864. London: PRINTED BY GEORGE PHIPPS, UPPER RANELAGH STREET, PIMLICO, S.W. TO THE Destry of St. George, Hanober Square. My Lords and Gentlemen, The Table annexed to this Summary shows the deaths of 452 persons in the Parish during the summer quarter of 1864, including the deaths of 69 non-parishioners in St. George's Hospital, and of 1 inmate of the Workhouse, at Little Chelsea. We are sorry to say that this mortality is above the average of the corresponding quarter in preceding years, and that the excess is due to a general increase of zymotic disease, of which one palpable evidence is excess of deaths of children from bowel disorder, diarrhoea, dysentery, and cholera. Thus in the third quarter of— Total Deaths, St. George, Hanover Square. Ditto, under 1 year. Deaths in Hanover and May-fair. Ditto, from Bowel Disorder. Deaths in Belgravia. Ditto, from Bowel Disorder. 1857 424 130 106 19 212 43 1858 412 77 111 9 214 24 1859 440 112 118 17 233 44 1860 380 84 81 7 190 10 1861 410 107 109 8 215 27 1862 407 75 101 4 193 14 1863 418 104 93 5 231 26 1864 452 98 87 11 252 40 This memorandum purposely includes deaths at koine only, and omits all deaths in Workhouse and Hospital. It 4 therefore omits the few cases of death from bowel disorder which occurred at the Workhouses and Hospital, and which bring up the entire number this year to 54. But it will be seen that the total mortality from diarrhoea at home, in both the great divisions of the Parish, has a certain ratio to the total mortality of this quarter of the year, and to the mortality of infants under 1 year. In fact, in every year, seven-eights or more of the deaths from diarrhoea, are those of young children. This year, 36 died of it under 1 year, and 9 more under 5, so that 47 of the 54 deaths were those of very young children. We advert to this subject year after year, because it is one in which great good might be effected, if parents did but use the means at their disposal. The machinery of which Medical Officers of Health are a part, can do something towards providing purer air and purer water, but cannot enforce the use of them. Great heat is exhausting to young infants as to all other delicate persons, and tends both directly and indirectly to induce diarrhoea; yet a great deal may be done to counteract its effects by liberal ablution with cold water, and by free ventilation. All children's food is liable to turn sour, but an intelligent mother might get milk from the nearest cow, instead of buying skim milk casually hawked about the streets. Having made special enquiry for causes after these infants' deaths from diarrhoea, we can testify to the apathy displayed by some mothers, who " never thought of getting different milk" from that on which they fed their baby till it died. We believe many of these deaths to come truly under the head "preventible." The note is made that 27 of the children in the Belgrave Sub-District were dry-nursed, besides that 2 died from want of breast milk. Of the 27, 14 died of diarrhoea; the remainder were entered under the heads "wasting," 5 anition," "atrophy," "defective ventilation," and other terms which really mean "starvation," with or without the additional torment of disease of skin, lungs, or bowels. Here is a field for the philanthropist!—for a "society for preventing cruelty" to children. Twins, 6 weeks old, died in one day in Westbourne-street; such a case involves peculiar difficulty. Four deaths, out of 54, appear under the ominous head, cholera. One of them was that of a man, set. 37, a servant out of place, who died at 2, Mount-row, on July 13th, but the medical gentleman who attended him expressed doubts whether it might not be rather ulceration of the bowels. One was of a child, set. 2, at 10, Robert-street; 1 a woman of 60, at 6, Hart's-buildings; and 1 of 76, in the Mountstreet Workhouse. There was 1 death from small-pox, 3 from measles, and 4 from whooping-cough; but scarlet fever, with the kindred diphtheria, sore throat, and croup, destroyed no less than 38 persons, of whom 27 lived in the Belgrave Sub-District, and 5 were non-parishioners in the Hospital. Thirty-three were under 20 years of age. Two children died in one house, in Lupus-street; 2 in one house in Chichester-street; 3 in Pulford-street, 2 in one house; other cases occurred in St. George's-road, Tachbrook-street, Hindon-street, "Winchesterstreet, Cornwall-street, Brewer-street, Worcester-street, Westmoreland-street, Minera-street, Wilton-road, and Bedfordplace ; George-street, Hanover-square, and Albemarle-street. The fatal cases of diphtheria occurred in Grosvenorstreet, Carrington-street, Eccleston-place, Upper Belgraveplace, Ranelagh-grove, Allington-street, Commercial-road, and Grosvenor-terrace; in which last place the victim was an M.D., aged 29, who suffered tracheotomy in the vain hope of saving his life. The various forms of fever were also unusually fatal, and caused 21 deaths, of which three-fourths (15) were of 6 sons advanced in life, contrary to the rule which holds good with scarlet fever. Two of these were in the Hanover SubDistrict, a tradesman's wife in Oxford-street, and an eminent surgeon in Grosvenor-street; 9 in the Belgrave Sub-District, viz., a lady, aet. 24, in Stanley-street; a girl of 5, and 1 of 3, in one house, in Boyd's-gardens; 1 of 6, in Cambridgestreet ; a woman, aet. 54, in Belgrave-mews South; a lady of 64, at Wilton-terrace; a child of 6, in Warwick-street; a girl of 17, at 5, Chapel-place; and a gentleman of 74, in Eccleston-square. Three deaths from fever occurred in the Mount-street Workhouse, viz., a male tramp, aet. 57, on 16th June (his death, registered in the 1st week of July, comes into this quarter); a man, Gill, aged 62, who acted as nurse, 26th July; and a groom, set. 28, on the 2nd August. In St. George's Hospital there died of fever, a journeyman saddler, aet. 21, from Grosvenor-cottages, Pimlico, and 6 non-parishioners. Altogether, it is a mortifying fact, that we have to record 128 deaths from zymotic disease : a larger number than we ever had before in this quarter of the year. Other causes of death which indicate general conditions of debility were rife this quarter. Thus 2 children died from want of breast milk, 13 from premature birth or malformation, 14 from atrophy and debility, and no fewer than 85 from scrofula, consumption, water in the head, and convulsions. The 34 deaths from accident and negligence also form a heavy item, although 19 were those of non-parishioners. It is an interesting and not unprofitable study to analyse these, and see how ready mutilation or death is to follow every act of negligence. Fifteen persons died from falls; a workman from a scaffold at the Chelsea barracks; an engineer from a railway engine; a builder's boy and a painter from roofs 7 of houses; a labourer fell through a skylight; a bricklayer fell from a ladder; another from a wall at the International Exhibition; a bargeman fell into the hold of a barge; and a woman, aged 37, fell into the street whilst cleaning a window; all these were engaged in labours more or less hazardous. But some risk attends recreation and the quietest occupations. A gentleman fell from his horse; a schoolmistress in Trellick-terrace, and a carpenter, fell down stairs ; a boy of 4 fell from a loft in which he was playing; a strong man fell whilst wrestling, and a feeble woman of 78, when walking in the street; and all these died from broken bones. Conversely, 7 persons of all ages;— children of 2 and 5, men in the prime of life, and old men—died from being knocked down by saddle horses, broughams, or drays: I man was killed by a cart which fell on him at the South Kensington Museum, and a boy of 2 from an injury inflicted no one knows how. Four children were burned or scalded to death; 1 from a bonfire; 1 from a common grate; 1 by upsetting a washintub; and 1, lamentably enough, from a dangerous toy, a little model steamboat worked by a spirit lamp. Two children were drowned in the Grosvenor Canal; 1 suffocated in bed with its parents; a girl of 21 suffocated after a fit of epilepsy; 1 newly born found in Hyde-park, and supposed to have been murdered. Four persons attempted suicide when insane, and died sooner or later from the act; 2 women by jumping into the Serpentine; 1 by throwing herself from a window; and a man by hanging. displacement of population in belgravia. Displacements of a population are of course most necessary to be considered in all estimates of mortality. Hence 8 we must take notice of the fact, that large numbers of houses have been pulled down in the Belgrave Sub-District; 33 houses in Upper Eaton-street are swept away, all, in fact, except 1 house, No. 17; 10 houses in Grosvenor-street West; 3 in Upper Ranelagh-street; 16 premises in Ranelaghplace; 22 in Ranelagh-street; 6 in Ranelagh-mews; 11 in Lower Grosvenor-place; 1 in Arabella-row; 13 in Eatonlane, North; 15 (at least) in Lower Eaton-street; 2 in Victoria-road. This, which is but an instalment of further change, has removed 132 houses inhabited by 1,135 persons. We have delayed this Report considerably, in order to get these figures, which we are at last enabled to do by the special favour of the Registrar-General; we shall give some further particulars in the Annual Summary at the end of the winter quarter. This diminution of population gives greater emphasis to an increase of the death figures. Of the superior class of inhabitants, many have got residences elsewhere in the Parish; as to the lower class it is most difficult to trace them. Their nearest neighbours either do not know, or refuse to tell where they have removed to. sickness in the hanover and may-fair sub-districts. The number of persons treated by the Parochial Surgeons at the Dispensary, and in the Sick-Wards of the Mountstreet Workhouse, during the quarter, was 957; in the corresponding quarters of 4 preceding years, the numbers were 693, 999, 983, and 1047. Amongst them were 2 cases of small-pox, 1 chicken-pox, 3 measles, 2 scarlatina, 6 diphtheria, 15 whooping-cough, 78 diarrhoea, 1 cholera, 23 fever, 2 erysipelas, and 85 bronchitis. The figures thus summed up, do not show very badly for that part of the population which depends on public aid for medical treatment; but there were fluctuations and periods 9 of great anxiety. Thus though measles and scarlatina were virtually absent, yet the presence of diphtheria and fever was threatening enough at the beginning of August. In the week ending 13th, there were 3 cases of fever at 35 Gilbert-street, and 1 in Lancashire-court; and 3 of diphtheria in Griffin-court, besides others in a private house in Mountstreet, which was exposed to the emanations of a street gully. Cases of diphtheria appeared soon after, at 18, North Bruton-mews, and 4, Hertford-place. Diarrhoea was very prevalent in the weeks ending 13th and 20th August. Of the 23 cases of fever, 1 occurred in Thomas-street; 1 in Tom's-court; 1 in Davies-mews; 1 in Brook's-mews; 2 at 8, Lancashire-court; 2 in Brown-street; 2 at 35, Gilbert-street; 2 in Hanover-place; 1 in Robert-street; 1 in Mount-street; 1 in Shepherd-street; and 1 in Little Grosvenor-street. the small pox. In the Hanover and May-fair Sub-Districts, the number of cases of small pox ascertained was 3; of which one was under the care of public charity as above. September 26th, Emily H, 18, 14, Union-street, vaccinated. Sent to the Small Pox Hospital. The other two were— July 23rd, Mr. C, 1, Chapel-place. Refused to go to the hospital. August 9th, John M, get. 40, 4, Audiey-square. Sent to the Small Pox Hospital. These bring up the number of cases in the Hanover and May-fair Sub-Districts since December 1862 to 139. fever. Seven cases of fever were treated in the sick wards at Mount-street during the quarter. 10 July 16th, Robert Gill, 62, inmate, died 26th July. „ 19th, Patrick Walsh, 16, from 10, Princes-row West. Aug. 6th, William, 9, ib. „ 2nd, Geo. Fisher, 26, tramp. „ John Haddon, 28, died August 2nd. Sept. 26th, Samuel East, 64. „ 29th, Sarah Johnson, 18,24, New Grosvenor-place. Five were sent to the Fever Hospital. July 20th, Emma May, 19,4, Little Ebury-street, S. W. Sept. 1st, Ann M. Welsh, 10, 10, Princes-row West. „ 17th, Mary Rollemore, 37, Queen-street, Pimlico. „ 22nd, Sarah Allen, 50, 3, Passmore-street. „ 29th, James Rollemore, 37, Queen-street, died. sickness during the quarter in the belgrave sub-district. In the Belgrave Sub-District 9,298 persons were treated by the parochial surgeons, and at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul's and St. Barnabas' Dispensary, and at the Workhouse, Little Chelsea. Of these 5,437 were patients at St. George's Hospital, leaving a remainder of 3,861. The total figures include 13 cases of small pox, 17 of chicken pox, 13 of measles, 29 of scarlet fever, 35 of whooping cough, 1 of croup, 656 of diarrhoea, 3 of dysentery, 79 of continued fever, 14 of rheumatic fever, 18 of erysipelas, 8 of diphtheria, 14 of cholera, 3 of carbuncle, and 1 of ague. There were 656 cases of bronchitis, 14 of pleurisy, and 35 of pneumonia. The following are the particulars of the 13 cases of small pox, namely:— 11 July 4th, Sam. Locke, set. 9, unvaccinated, No. 4, Weststreet ; removed to the Small Pox Hospital. A boy, set. 3, vaccinated,No. 3,Robert's-buildings. Two girls, set. 6 and 2 years, vaccinated, No. 56, Hindon-street. „ 15th, Jessie N, set. 15, vaccinated, No. 5, Cornwall-street, removed to the Small Pox Hospital. — Hunt, set. 4, unvaccinated, No. 10, Robertstreet. Aug. 1st, Isaac Woodley, set. 88, No. 87, Ranelagh-grove; removed to the Small Pox Hospital. Sept. 7th, Anne Copping, set. 20, unvaccinated, No. 8, Robert-street; removed to the Small Pox Hospital. Margaret Campbell, set. 8 months, unvaccinated, No. 11, Robert-street, died. Mary Overton, set. 4, unvaccinated, No. 4, Robert-street. William Weaver, set. 30, vaccinated, No. 8, Robert-street. Grace Noxon, set. 10, vaccinated, No. 2, Brewer's-yard, Brewer-street. Maria Davis, set. 15, St. George's Hospital, from No. 19, Wellington-street, Oakley-square. Besides these there were others, of which we obtained information, at the following houses:— Sept. 7th, No. 1, Robert-street, Alfred Smee, set. 16, sent to the Small Pox Hospital. No. 10, Robert-street, a girl, set. 2, vaccinated. C. J. B. Aldis, M.D. R. Druitx. 12 APPENDIX. No. I. WATER. Contamination with lead is an accident not liable to happen to the London water, except under occasional circumstances, such as the erecting new leaden cisterns, or laying down new leaden supply pipes. It were to be wished that cast iron or slate took the place of lead for cisterns. A sample of Grand Junction water, taken from a lately erected cistern in the house of a physician in Dover-street, yielded, in September 1864,— Total solid contents Organic per gallon. ditto. Inorganic. 14.76 1.08 13.68 Distinct traces of lead. A sample of water taken next day from the service pipe before it entered the cistern, also contained traces of lead. In order to trace the thing to its source, we applied at the office of the Grand Junction Company, and requested the engineer to favour us with a sample of the water taken from the engine well at the Kew works, after filtration, and before pumped into the mains. This was done on September 28th, and yielded,— Total solid contents. Organic do. Inorganic. 15.66 0.54 15.12 No trace of lead. The Water supplied by the Chelsea Company, and taken from the main at Chapel-street, Belgrave-square,— 1864. Total Impurity in grains per gallon. Organic ditto. August 17 16.8 .56 September 17 16.24 .80 13 APPENDIX. No. n. The following table refers to cases dealt with by the Nuisances Removal Committee, during the quarter ending October 1st, 1864. Premises reported by Medical Officers of Health in consequence of illness or nuisance 118 Of these there were reported for scarlet fever 20 „ „ diphtheria 6 „ ,, fever 31 „ „ measles 1 „ „ diarrhoea 34 „ „ cholera 6 „ „ small-pox In-Wards 2 Belgrave 11 Houses and other premises reported by Inspector 29 Ditto by inhabitants 48 nature of ncisance complained of. Drains obstructed, defective, or offensive 21 Ditto in stable 1 Cesspools 2 Stables without drainage 1 Leakage from a cistern 7 Ditto from sewer 1 Effluvia offensive 5 Water-closets out of order, &c 4 Milliner's factory ill ventilated 1 No dust-pit 1 Ditto, offensive 1 Deficient water supply 1 Gullies offensive 7 Public nuisances 2 Dung-heaps complained of 9 14 Offensive slops 4 Rubbish and dust 6 Houses and rooms dirty and dilapidated 10 Smoke 2 Cow-houses, dung not removed 2 Trade nuisances—marine store dealer's 1 Dogs 2 Figs 2 Dead body 1 work done. Houses cleansed and repaired 26 Water-closets and soil-pipes repaired or cleansed 9 Old rotten brick drains replaced by pipes 2 Sewer repaired 1 Gullies cleansed and repaired 8 Traps supplied 2 Marine stores cleansed 1 Offensive gutters cleaned 4 Pigs and dogs removed 3 Water laid on 1 Ventilation improved 1 Smoke nuisance abated 1 Dung nuisance abated 8 Leakage remedied 4 Cesspools abolished 2 Stable drained 1 Drains of stable repaired 1 Slaughter-houses limewashed 1 Rubbish removed—dead dogs, dust, &c 4 Dead body removed 1 Groundless 9 Use of offensive small coal discontinued 1 Number of Notices served 17 16 APPENDIX No. III. special cases, and notes on the foregoing tables. 1. The cases of cesspools were in first-class houses; four, with a whole set of rotten brick drains, were extirpated from a house in Berkeley-square; another from South-street. 2. Seven bull-dogs removed from 11, Lancashire-court; pigs from 14, Ebury-square. Pigs are complained of in Chelsea parish adjoining Belgravia. 3. One of the smoke nuisances was caused by burning offensive breeze from a gas factory, in the furnace of a dyer's factory in Davies-street. 4. In one house that was cleansed, and that needed it badly enough, no fewer than 10 old coatings of paper were stripped off the walls of some rooms. In every case we have the greatest difficulty in persuading house-owners to get rid of old paper, mischievous as it is in harbouring vermin and effluvia. 5. Messrs. Jay's Factory, in Verey's-yard, Princes-street. A complaint was forwarded through a physician of the unwholesome state of this factory, and it was visited. It is a large building about 32 feet broad, 70 long, and the walls 18 feet high, with an open roof above. It is warmed by an iron stove ; and has, at one end, certain parts partitioned off, for store rooms, water-closets, &c. The largest number of young women who work in this place is 84, so that there is no deficiency of space or ventilation; but there were complaints of drain effluvia, which were traced to defective water-closets and drains, and short supply of water. These evils were remedied by the proprietors, after reiterated visits and expostulations, followed by threat of legal proceedings. 6. Chemist's Laboratory,Old Barrack Yard.—A memorial, dated June 28th, 1864, was forwarded to the Medical Officer of Health, complaining of the effluvia and smoke arising 16 from these premises. He consequently visited them, and examined the memorialists as to the nature of the complaint. Some stated that the smell from the chimney of the laboratory was nauseating, while others found fault with the smoke alone. When the Medical Officer inspected it, the only process going on was that of distilling water, with the view of utilizing the steam for heating purposes. There was nothing offensive during his or the Inspector's visit, and the laboratory was quite clean. It did not appear that chemicals were made, although the room was elaborately fitted up, but only pharmaceutical preparations. A new laboratory, however, was taken, at a greater distance from the houses in St. George's-place than the one now reported, where the manager said chemicals would be prepared. The Medical Officer has received no complaint of nuisance since the removal. APPENDIX No. IV. the bakehouses. The half-yearly visitation of the bakehouses was made in this quarter, when there were visited 86 in the Hanover and May-fair Sub-Districts and 57 in the Belgrave. Seventeen in the Hanover and May-fair Sub-Districts, and 53 in the Belgrave, required limewashing, in order to comply with the Act; but one only was noted as decidedly dirty, and there was a general aspect of improved cleanliness and care about certain of them which had been a little behindhand in that respect. Enquiry was made into the other particulars which the Act directs attention to, such as the sleeping places of the men, the existence of sewer nuisances, and the employment of boys at night; and the results were satisfactory. In one or two instances we were able to suggest some little improvements in the ventilation of sleeping places, beyond what the letter of the Act requires. 17 APPENDIX. No. V. GAS. Seventy-two observations were made during the quarter, upon the six gases supplied by the Chartered, London, and Equitable Companies,in the Horseferry-road,73,Bessboroughstreet, and 78, Cambridge-street, respectively. The gases were burned in accordance with the Metropolis Gas Act, 1860, and the illuminating power continued above the standard required by the Act. With respect to purity, all the gases were free from sulphuretted hydrogen, and so far free from ammonia, that they did not discolour the turmeric paper, except on August 12th, when both the gases supplied by the Chartered Company presented traces of ammonia, which were attributed by the late engineer to the foul state of the meters, caused by the passing through them of impure gas, made from wood the day before while making experiments. The following Table gives the average light in sperm candles of all the gases— Chartered. London. Equitable. Cannel 24.53 22.93 25.62 Common 15.15 14.09 14.82 A Table and Summary were sent with each Monthly Report on the gas to the Vestry, containing the number of examinations and the pressures, with the dates, and the weekly and monthly average illuminating power. C. J. B. ALDIS, M.D., Gas Examiner. DEATHS registered in the Parish of St. George, Hanover Square, in the 13 Weeks ending 1st of October, 1864. Average, 34. 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.—19,770. May Fair.—12,648. Belgrave.—55,099. Mount-street Work.—268. Little Chelsea Work.—350. St. George's Hospital. —216. Males, 37,511. Females, 50,236. Total, 87,747. Parishioners. NonParishioners. I. Order 1. 1. Small-pox 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 2. Measles .. 2 3 .. .. .. .. 1 .. 2 .. .. .. .. 1 2 3 3.Scarlatina .. 10 22 1 1 .. .. 1 1 18 .. .. .. 4 12 12 24 4. Diphtheria .. 2 3 3 .. .. .. 1 .. 4 .. .. .. 1 3 3 6 5.Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6.Croup .. 5 5 .. .. .. .. 2 1 2 .. .. .. .. 3 2 5 7.Sore Throat .. 2 3 .. .. .. .. .. .. 3 .. .. .. .. 2 1 3 8.Whooping Cough .. 4 4 .. .. .. .. 2 .. 2 .. .. .. .. 2 2 4 9.Typhus(and infantile fever) .. 1 5 5 6 4 .. 2 .. 8 3 .. 1 6 12 8 20 10.Erysipelas 1 .. 1 1 2 .. .. .. .. 3 .. .. .. 1 2 2 4 11.Metria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12. Pyaemia .. .. .. 1 1 .. .. .. 1 1 .. .. .. .. 1 1 2 13.Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14.Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15.Dysentery 1 .. 1 .. 1 .. .. .. .. 1 1 .. .. .. .. 2 2 16.Diarrhœa 35 8 45 .. 1 2 .. 8 1 38 1 .. .. .. 22 26 48 17. Cholera .. 1 1 1 .. 2 .. 2 .. 1 1 .. .. .. 3 1 4 18.Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 19.Remittent Fever .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 20. Rheumatism .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 Order 2. 1. Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.Stricture of Urethra .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 3. 1. Privation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Want of Breast Milk 2 2 .. .. .. .. 1 .. 1 .. .. .. .. .. 2 2 3. Purpura and Scurvy 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 4. Alcoholism a Del. Tremens .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. b Intemperance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 4. 1. Thrush 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 II. Order 1. 1.Gout .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 2. Dropsy .. .. 1 .. 1 4 .. .. 1 3 1 .. .. 1 1 5 6 3. Cancer .. .. .. .. 5 5 .. .. 1 7 .. .. .. 2 3 7 10 4. Mortification .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 .. 1 5. Abscess .. .. 1 1 .. .. .. .. .. 1 1 1 1 2 6. Haemorrhage 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Order 2. 1. Scrofula .. 1 1 .. 1 .. .. 1 .. .. 1 .. .. .. 1 1 2 2. Tabes Mesenterica .. 4 5 .. .. 2 .. .. .. 4 1 .. 1 1 4 3 7 3.Phthisis 4 2 16 15 15 6 .. 7 3 27 6 .. 1 8 37 15 52 4. Haemoptysis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5.Hydrocephalus 7 4 14 1 .. .. 5 1 8 .. .. 1 .. 6 9 15 III. Order 1. 1. Cephalitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Apoplexy .. .. .. .. 4 5 1 l 3 6 .. .. .. .. 5 5 10 3. Paralysis .. .. 1 1 4 1 1 3 .. 1 1 1 1 1 3 5 8 4. Epilepsy .. .. .. 1 1 1 .. 1 .. 2 .. .. .. .. 1 2 3 5. Convulsions 5 4 9 .. .. .. .. 2 .. 7 .. .. .. .. 5 4 9 6.Brain Disease,&c. .. 1 3 4 4 5 .. 2 2 8 .. .. 1 3 10 6 16 Order 2. 1. Pericarditis .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 2. Aneurism .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 3. Heart Disease, &c. 1 .. 3 3 5 5 .. 2 .. 8 .. .. .. 6 9 7 16 Order 3. 1. Laryngitis .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. 1 2. Bronchitis 4 1 5 2 4 2 1 1 9 2 .. .. .. 6 7 13 3. Pleurisy .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 4. Pneumonia 2 4 6 4 .. 2 .. 1 .. 7 1 .. 1 2 6 6 12 BIRTHS registered during 13 weeks.—Hanover Square, M. 46, F. 57; May Fair, M. 31, F, 30; Belgrave, M, 223, F. 206. Total 593. Average 45.5. diseases. Ages at Death. II 3ub-districta & population Sexes. Under 1. 1 and under 5. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. so mid above. Hanover Square.—19,770. May Fair.—12.648. Bclgrave.—55,099. Mount-street Work.—268. Little Chelsea Work.—350 St. George's Hospital. —216. Males, 37,511. Females, 50,236. Total. 87,747. Parishioners. NonParishioners. 5.Asthma .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 6. Lung Disease, &c. .. .. 1 .. 1 1 .. 1 .. 2 .. .. .. .. .. 3 3 Order 4. 1. Enteritis 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 2. Peritonitis .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 3.Ascites .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Hernia .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. 1 5. Ileus and Intussusception .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 6.Fistula .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7. Stomach Disease, &c. .. .. .. .. 4 3 .. 2 2 2 .. .. .. 1 .. 4 7 8.Hepatitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9.Jaundice .. .. .. .. 1 1 .. .. .. 2 .. .. .. .. 1 1 2 10. Liver Disease, &c. .. .. .. .. 1 4 .. 1 1 2 .. .. .. 1 .. 2 5 order 5. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1.Nephria .. .. .. 1 3 2 .. .. .. 4 .. .. .. 2 4 2 6 2.Diabetes .. .. .. .. 1 1 .. .. .. 1 .. .. .. 1 1 1 2 3.Kidney Disease,&c. .. .. .. 1 2 .. .. .. .. 1 .. .. 1 1 1 2 3 4. Diseased Bladder .. .. .. .. 1 2 1 1 1 1 .. .. .. 1 .. .. 4 Order 6. 1.Ovarian Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Uterus Disease, &c. .. .. .. 1 4 1 .. .. 2 2 .. .. 1 1 6 6 Order 7. 1. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Joint Disease, &c. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 Order 8. 1. Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Ulcer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Skin Disease, &c. 1 .. 1 .. .. 2 .. .. 1 2 .. .. .. .. .. 3 3 IV. Order 1. 1. Premature Birth 9 .. 9 .. .. .. .. 1 1 1 2 .. .. .. 4 5 9 2. Cyanosis 2 .. 2 .. .. .. .. .. .. 2 .. .. .. .. 1 1 2 3. Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Other Malformations 2 .. 2 .. .. .. .. .. .. 2 .. .. .. .. .. 2 2 5.Teething 2 3 5 .. .. .. .. .. .. 5 .. .. .. .. 4 1 5 order 2. 1. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Child-birth (see Metria) .. .. .. 2 .. .. .. l .. 1 .. .. .. .. .. 2 2 Order 3. 1. Old Age .. .. .. .. .. 9 7 3 3 6 4 .. .. .. 6 10 16 Order 4. 1. Atrophy and Debility 13 .. 13 1 1 .. .. 1 1 13 .. .. .. .. 8 7 15 2. Exhaustion .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. V. Ordbr 1. (Accident or Negligence.) 1. Fractures and Contusions .. 1 3 6 1 2 .. .. .. .. .. .. 4 8 10 2 12 2. Gunshot .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. W ounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Burns and Scalds .. 1 3 .. 1 .. .. .. .. 1 .. .. .. 3 2 2 4 5. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Drowning .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 1 1 2 7. Suffocation 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 8. Other Injuries .. 2 3 1 2 2 .. .. .. 2 .. .. 1 7 8 2 10 Order 3. 1. Murder and Manslaughter 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Order 4. (Suicide.) 1. Cut, Stab, Precipitation, &c. .. .. .. l .. .. .. .. .. .. .. .. 1 .. .. 1 1 2. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 2 4. Hanging .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 Sudden Deaths (Cause unascertained) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Causes not specified or ill-defined .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. TOTAL 98 63 212 65 81 82 12 59 28 252 27 1 16 69 235 217 452 Weekly Average of DEATHS registered during corresponding weeks of ten years (average) 31.7. LONDON: PRINTED BY GEORGE PHIPPS, RANELAGH STREET, EATON SQUARE. 16 HAN 14 No. XXIX.] QUARTERLY SUMMARY OF THE SICKNESS AND MORTALITY IN THE PARISH OF Saint George, Hanober Square, AND OF THE PROCEEDINGS OF THE MEDICAL OFFICERS OF HEALTH. FOR THE QUARTER ENDED 31st DECEMBER, 1864. London: PRINTED BY GEORGE PHIPPS, UPPER RANELAGH STREET, PIMLIOO, S.W. TO THE Destry of st. George, Hanober Square. My Lords and Gentlemen, During the quarter ended on the 31st December, 1864, the number of deaths registered in the Parish was 490, including those of 61 non-parishioners in St. George's Hospital, and 7 inmates of the Workhouse at Little Chelsea. The deaths registered in the Parish during the corresponding quarters of the preceding ten years, gave a weekly average 32, but the mortality for this quarter has been on the average 37 per week. The 8 deaths from small-pox happened in the following places:—One of a girl, aged 20, unvaccinated, in Sutherlandterrace; a second, of an infant, aged 1 year, unvaccinated, in Robert-street, S. W.; the third, of a man, aged 27,unvaccinated, in Pulford-street; the fourth, of a girl, aged 12, in Westmoreland-street; the fifth arid sixth, of a woman, aged 36, vaccinated, and her infant, aged 18 days, in Westbourne-street; the seventh, of an infant, aged 2 months, unvaccinated, in Victoria-mews; and the eighth, of an infant, aged 7 weeks, in Nell Gwynne-cottages. The 3 deaths from measles took place in Grosvenormarket, Shepherd-street, and Winchester-street. Last year there were 13 in the corresponding quarter. Scarlet fever proved fatal to an infant in Steele's-court, Lee's-mews (see Appendix IV.); to a boy in Park-street, 4 Grosvenor-square; and to a parishioner in St. George's Hospital, who came from Bolton-yard, May-fair. It also proved fatal in Pulford-street, York-place, Lupusstreet, Rutland-street, St. Michael's-terrace, Whitaker-street, Westmoreland-street, Winchester-street, and Bun-house-yard. Diphtheria proved fatal to an infant, aged 8 months, in Tachbrook-street, and to 2 girls, aged 8 and 9 years, in Warwick-street and Union-street respectively. Of the 32 deaths from fever, 12 were those of nonparishioners in the Hospital, reducing the number to 20. Of these, four parishioners died in St. George's Hospital, and came from Spring-garden-place, Wilton-place, Gilbert-street, and Hanover-street. Five persons died in the Workhouse, Mount-street, 4 in the following streets in the In-Wards, namely, Ham-yard, Maddox-street, Charlesstreet Grosvenor-square, and Curzon-street, and 7 in the following streets in the Out-Wards, namely, in Grosvenorcottages, Upper Belgrave-place, Cambridge-terrace, Sussexstreet, Hart's-buildings, Passmore-street, and Ecclestonplace. A death from erysipelas occurred to a woman, aged 50, in Davies-street, Berkeley-square, and 1 from pyaemia after jaundice, to a woman, aged 59, in Claverton-street. We notice that pyaemia also destroyed 3 non-parishioners at St. George's Hospital. Lung diseases have destroyed 108 persons. Consumption, scrofula, convulsions, teething, and other diseases of degeneration and ill development destroyed 99, including from premature birth 3, from atrophy and debility 20, water in the head 7, scrofula 1, tabes mesenterica 2, convulsions 8, teething 1, and consumption 50. Four persons died from the effects of intemperance in the Hanover District. Eight persons died from fractures in St. George's Hospital, 5 5 being non-parishioners. The 3 following patients died in the same institution:—an infant from a bum on body and limbs, his clothes igniting from a fire in a grate in Hughstreet; a tinman from the effects of lead poisoning; and a woman from injuries received while driving in the park. A man, aged 24, was suffocated by meat in the larynx at Brown's-place, North-row. A newly born infant was found in Hyde-park strangled by a ligature round the neck. A woman, aged 32, committed suicide when insane, by throwing herself into the Serpentine. Among the deaths from causes not specified or ill defined were those of 4 infants; 2 found dead in Hyde-park, another which died in Grosvenor-mews, Berkeley-square, and the fourth of a colonel in Chester-square. sickness in the hanover and may-fair sub-districts. The number of patients who were entered on the books of the Medical Officers of the Parish, and of the Dispensary Mount Street, and of the sick wards of the Workhouse Mount Street, during the quarter, was 804. This number i3 less than usual, because the Dispensary was closed during a month for repairs. Amongst them were 2 cases of small-pox, 3 of chicken pox, 5 of measles, 11 of scarlatina, 11 of whooping-cough, 8 of diarrhoea, 21 of continued fever, 184 of bronchitis, and 3 of diphtheria. The 11 cases of scarlet fever, and 3 of diphtheria, were distributed over Brown-street, Lancashire-court, Grosvenormews, Barlow-mews ; not one of these cases was fatal. 6 THE SMALL POX. The 2 cases of small-pox were, a child, set. 4, unvaccinated, at 19, Brick-street, and A. S., aged 18, a servant out of place, at 6, Hart-street. The child was not vaccinated, because the operation was delayed on the plea of bad health. The patient, after recovering from the small-pox, died of whooping-cough. There was also sent to the Small-pox Hospital Frances C., set. 16, from 61, Mount-street. These make up the number known to have occurred in the Hanover and May-Fair Sub-districts to 142. FEVEK. Of the 21 cases of fever included in this summary, 9 were imported, viz., 2 tramps, and 7 persons from the Irish quarter of Belgravia, who were treated in the Sick-Wards, Mount-street. Two were inmates of the Workhouse. One man from Brick-street was also treated in the Workhouse. One woman, set. 35, from South-street, was sent to the Fever Hospital, and received into the Sick-Wards afterwards. A girl of 19, from 35, Gilbert-street, was sent to St. George's Hospital, and died there. Seven others, not one of them fatal, were dispersed over Hanover-place, Brown-street, Lancashirecourt, 21, Grosvenor-market, Grosvenor-mews, and North Bruton-mews. Admitted to the Sick-Wards, Mount-street— Oct. 31st, George Quaif, 9, Passmore-street, died 2nd Nov., dying when admitted. ,, 25th, Robt. Pryer, 61, 48, Upper Ebury-street, died 7th Nov. „ 18th, Mary Luckhurst, 76 7 Nov. 5 th, Joseph Towsey, 10, 19, Eccleston-place. „ 3rd, William Chumn, 30, from 3, Brick-street. Mary Roe, 38, tramp, died 27th Nov. Dec. 16th, Ann Smith, 68, died 16th Dec., 6, Princes-row West. „ 10th, Margaret Rycroft, 69. Richard Colingham, 15, died 29 Dec., tramp. Oct. 18th, Sarah Wrighting, 18, 7, Flask-lane. Dec. 6th, W. Meredith, 16, 11, Boyd's-gardens. „ 9th, Caroline Towsey, 44. There were sent to the Fever Hospital— Oct. 11th, Thos. Mc Manus, Grosvenor-row. „ 18th, Jane Taylor, 62, Upper Ebury-street Nov. 21st, Elizt. Seaman, 35, " The Carved Lion," Southstreet. Dec. 2nd, Emily Clary, 1, Denbigh-street. sickness in the belgrave sub-district. In theBelgrave Sub-District 8,763 persons were treated by the Parochial Surgeons, and at St. George's Hospital, the Royal Pimlico Dispensary, the St. Paul and St. Barnabas Dispensary, and at the Workhouse, Little Chelsea. Of these 4,946 were patients at St. George's Hospital, leaving a remainder of 6,817. The total figures include 29 of small-pox, 24 of chickenpox, 5 of measles, 58 of scarlet fever, 40 of whoopingcough, 90 of diarrhoea, 15 of dysentery, 79 of continued fever, 48 of rheumatic fever, 38 of erysipelas, 16 of diphtheria, 3 of carbuncle, and 1 of ague. There were 628 cases of bronchitis, 28 of pleurisy, and 88 of pneumonia. 8 THE SMALL-POX. — Veiling, set. 12, unvaccinated ' Emma Taylor, set. 7, vaccinated Elizabeth Taylor, set. 2, un vaccinated j — Taylor, set. 30, vaccinated J 8, Robert-street. Martha Moscow, set. 12, 2, Brewer's-yard. George Lambe, set. 26, vaccinated, 6, Ranelagh-grove; removed to the Small-pox Hospital. Rachel Carver, set. 21 months, vaccinated Jane Carver, set. 7, unvaccinated 73, Upper Ebury-street. Ditto, set. 4, unvaccinated Jane Lloyd, set. 13, vaccinated, 32, Westbourne-street. R. Moncrieff, set. 35, vaccinated, 9, Hanover-street; removed to the Small-pox Hospital. Catherine Wheeler, set. 30, vaccinated, 2, Flask-row; removed to the Small-pox Hospital. H. Jarvis, set. 12, vaccinated, 13, Little Grosvenor-place. Isabella Wilde, set. 21, vaccinated, 13, Gray's-inn-place; removed to the Small-pox Hospital. S. Jerfield, set. 15, vaccinated, 50, Grosvenor-row. Emily Jarvis, set. 5 months, unvaccinated, 13, New Grosvenor-place. Mary Dawson, set. 7, Sarah Dawson, set. 32, vaccinated Alice Dawson, set. 2, 4, Pulford-terrace. Rebecca Harding, set. 8, vaccinated, 16, New Grosvenorplace. Mary Stone, set. 3 months, unvaccinated, 13, New Grosvenor-place. An infant, set. 6 weeks, unvaccinated A woman, set. 25. vaccinated 4, Nell Gwynnecottages. W. Edwards, set. 4, vaccinated, 5, Ranelagh-grove. 9 Anne Welsh, aet. 10, vaccinated, 10, Princes'-row. W. Wright, aet. 42, vaccinated Eliza Wright, set. 40, vaccinated W. Wright, aet. 20, vaccinated 3, Bridge-row. Emma Taylor, set. 26, vaccinated, 13, Little Grosvenorplace. In addition to these, the following cases occurred:— Oct. 4th, W. Saunders, aet. 18, 21, Eccleston-place; removed to the Small-pox Hospital. „ 5th, G. Barrett, set. 19, 21, Rutland-street; removed to the Small-pox Hospital. A girl, set. 10, vaccinated, 24, Cominercial-road, South.' Nov. 1st, James Cook, set. 17, 2£, Ebury-square; sent to the Hospital. „ 11th, — Atkinson, 4, Victoria-mews, Wilton-road. C. J. B. Aldis, M.D. R. Druitt. 10 APPENDIX. No. I. WATER. The Water supplied by the Chelsea Company, and taken from the main at Chapel-street, Belgrave-square,— 1864. Total Impurity in grains per gallon. Organic ditto. October 17 16.40 .80 November 17 18.72 1.28 December 22 20.2 1.17 APPENDIX. No. II. The following table refers to cases dealt with by the Nuisances Removal Committee, during the quarter ending December 31st, 1864. Houses reported by Medical Officers of Health in consequence of illness or nuisance Viz. for scarlet fever 24 diphtheria 5 typhus fever 18 diarrhoea 8 small-pox 23 Houses and other premises reported by Inspector Ditto by inhabitants 82 51 33 11 NATURE OF NUISANCE COMPLAINED OF. Drains obstructed Ditto defective Cesspools Houses dirty No traps ; traps and sinks defective Water-closets out of order, soil-pipes defective, no water Overcrowding Yard dirty, ill-paved, stagnant water, &c Leakage of water, damp foundation Defective state of boiler Offensive effluvia Dung-heaps complained of Urinal Premises unfit for occupation Stables undrained, with cesspools, &c. Offensive rubbish Cases of pigs kept Smoke nuisance Complaints not substantiated Gullies stopped Slops emptied into yard, street, roof, &c. Premises dangerous Pavement dangerous Horse in a shed WORK DONE. Dirty rooms cleansed Houses newly drained by pipes in lieu of old brick drains 15 6 4 2 2 8 2 2 7 1 4 4 1 2 1 2 3 1 2 2 1 2 1 1 46 3 12 Drains cleansed and repaired Houses shut up Cesspools abolished Water-closets and soil-pipes repaired Water-closets erected Water laid on to closet Traps and sinks remedied Dung nuisance abated Yard cleansed, paved, &c Leakage remedied Overcrowding abated ; families removed Offensive rubbish removed Pigs removed from yard Smoke nuisance abated Dung-pit removed Gullies cleansed Unwholesome sleeping apartment discontinued Dangerous premises reported to the police Horse removed from an undrained shed Number of Notices served 21 1 4 2 4 2 1 1 2 2 2 2 3 1 1 2 1 2 1 16 APPENDIX No. HI. SPECIAL CASKS. 1. No. 3,SteeVs-court, Lee's-mews.—When a house,or set of houses, continues unhealthy spite of white-washing, cleansing, and the removal of whatever nuisances are apparent, further search at some future time is sure to explain the mystery. In the case of this court, the main drain leading from it had 13 been inefficient for years, and 27 yards of it, with very imperfect fall, were choked with night-soil. So that these houses, instead of effective drains, had nothing but an elongated cesspool, which disposed of the sewage put into it, as so many other imperfect drains do. That is to say, the liquid part was let soak into the earth for the benefit of the nearest pump: the solid remained in the drain, and the foetid gases escaped into the dwelling, particularly at night. Strange to say, a respectable man who knew of this state of the main drain, and who lost a child from diphtheria soon after coming into the house, never made any complaint of it to us, although such an inquiry was in this case, and always is in others, made personally after death from the like cause.* 2. Old drains kept when new ones are laid down.—This is a matter of the most vital importance to all persons who re-build houses on old sites, or who lay down new pipe-drains. The old rotten drains and their connection with the sewer, and all the earth around them, must be dug out and utterly abolished; otherwise the new state of things will be worse than the old. In the case of two houses in Green-street, Park-lane, newly drained by pipes, one old brick drain full of rat-holes was left. Of course this served as a channel for sewer vapour, and till it was removed the houses continued offensive. 3. The London, Chatham and Dover Railway Company's Stable Yard, Wilton-road, Pimlico.—This was a nuisance of a very dangerous character, owing to the non-removal of the dung from the stable, which contained about 40 horses, and to several water-closets draining into cesspools. There was no proper drainage, and eight saw-pits filled with stagnant water emitted a most offensive smell. The water in these * See Quarterly Summary, No. XXV., page 15, for an account of former proceedings with reference to this house. 14 pits was deodorised at first. They were then emptied and filled up with dry brick rubbish and lime. Two large cesspools were also emptied and filled up, three new water-closets erected with a good water supply; three other water-closets were repaired, and the whole of the premises properly drained on the south side of the yard by a 12-inch, and on the north side, by a 9-inch pipe-drain, with connections from the stable drains. One of the ostlers, a fine strong man, nearly lost his life from a severe choleraic attack. APPENDIX No. IV. THE SLAUGHTER-HOUSES AND COW-SHEDS. These places are systematically and formally inspected by ourselves every August, in company with the Inspector, and a note made of their condition. They are constantly visited by the Inspector during all the other months, and by ourselves from time to time. The number of applications for licenses for slaughterhouses was 36, and for cow-sheds 18. A careful report containing the result of our inspection, was drawn up and sent to the Vestry for the information of the Magistrates, who met in Petty Sessions at the Board Room, Mount-street, on October 14 th, for the purpose of granting licenses. Amongst the slaughter-houses, thatof Mr. Hurryin Whitehorse-yard, was refused a license. The evidence of occasional carelessness of management, afforded by the great nuisance which occurred in June, for which the applicant was fined at the Marlborough-street Police Court; and the palpable fact that a slaughter-house could only exist in such close proximity with dwelling-houses on condition of the greatest care, and 15 the unfavourable nature of the place for any establishment of the sort, were grounds on which the Magistrate declined to renew the license. Amongst the cow-sheds, that of Mr. Cowley, also situated in White-horse-yard, opposite the slaughter-house aforesaid, was refused a license. There was not only no evidence of want of care and cleanliness, but the fullest evidence that every precaution had been taken (compatible with keeping cows at all in such a locality) to avoid nuisance to the neighbours. Plenty of water, the use of disinfectants, and regular removal of the dung were practised ; and the place was constantly visited by the Inspector and by ourselves; and on one occasion all the Members of the Committee of the Vestry, appointed to carry out the Nuisances Removal and Diseases Preventive Acts, adjourned thither, without notice, to inspect it, and found nothing objectionable. Nevertheless, the license was refused, on the ground of the intrinsic unfitness of the place, and that the applicant had had time to obtain premises elsewhere, and that it was the intention of the legislature gradually to abolish all such establishments in towns. It is worth mentioning, that four of the slaughter-houses in the Hanover and May-fair Sub-Districts, though licensed, are virtually disused. APPENDIX. No. V. GAS. Seventy-two observations were made during the quarter, upon the six gases supplied by the Chartered, London, and Equitable Companies, in the Horseferry-road,73, Bessboroughstreet, and 78, Cambridge-street, respectively. 16 The gases were burned in accordance with the Metropolis Gas Act, 1860, and the illuminating power continued above the standard light required by the Act, except on November 29 th, when the common gas of the London Company gave a light equal to 8 instead of 12 sperm candles. In reference to this very defective illuminating power of the gas, the engineer alleged that it was occasioned by putting the exhauster in action before the retorts were charged, thus air, and probably carbonic oxide, were forced into the gas holder, which would in a short time diminish the illuminating power so much, that many hours would be required for its restoration to the proper standard. On the 7th December last, I was requested to attend the Committee of Works, and was examined at some length respecting the complaint of the London Gas Company's supply —the Resolutions of the Committee were as follows:— " That they report to the Vestry that there was a defi" ciency in the quality of the common gas on the night of " the 29th ult., but that the Committee are of opinion, that " it would not be advisable to institute proceeding s against " the Company." " That in the opinion of the Committee, it is desirable " that, upon complaints of gas being made to, or any want " of illuminating power in it, being discovered by Dr. Aldis, " he should not put himself in communication with any Gas " Company, but report the same direct to the Vestry." The latter resolution was not adopted by the Vestry. With respect to purity, all the gases were free from sulphuretted hydrogen, and so far free from ammonia, that they did not discolour the turmeric paper, except on November 24th, when the common gas supplied by the London Company presented a slight trace of ammonia. The following Table gives the average light in sperm candles of all the gases— 17  Chartered. London. able. Cannel 23.46 24.34 25.09 Common 15.12 14.03 14.74 A Table and Summary were sent with each Monthly Report on the gas to the Vestry, containing the number of examinations and the pressures, with the dates, and the weekly and monthly average illuminating power. C. J. B. ALDIS, M.D., Gas Examiner. 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.—19,770. j May Fair.—12,648. Belgrave.—55,C99. Mount-street Work.—268. Little Chelsea Work.—350.1 St. George's Hospital. —216. Males, 37,611. Females, 50,236. Total, 87,747. Parishioners. NonParishioners. I. Order 1. Small-pox 3 1 5 3 .. .. .. .. .. 8 .. .. .. .. 4 4 8 2. Measles .. 3 3 .. .. .. .. 1 1 1 .. .. .. .. 2 1 3 3. Scarlatina 2 6 15 .. .. .. .. 2 .. 10 .. .. 1 2 6 9 15 4. Diphtheria 1 .. 3 .. .. .. .. .. 1 2 .. .. .. .. 1 2 3 5. Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Croup .. 4 4 .. .. .. .. .. .. 3 .. .. 1 .. 2 2 4 7. Sore Throat .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Whooping Cough 2 8 10 .. .. .. .. 8 l 1 .. .. .. .. 7 3 10 9. Typhus (and infantile fever) . .. 4 11 8 7 6 .. 4 .. 7 5 .. 4 12 16 16 32 10. Erysipelas .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 11. Metria .. .. 1 2 .. .. .. .. .. 2 1 .. .. .. .. 3 3 12. Pyaemia .. .. 1 2 1 .. .. .. .. 1 .. .. .. 3 .. 4 4 13. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15. Dysentery .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. 1 3 3 .. 1 .. .. .. 2 .. 4 .. .. .. .. .. .. 6 17- Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 18. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 19. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 20. Rheumatism .. .. 1 1 .. .. .. 1 I .. .. .. .. .. 1 1 2 Order 2. 1. Syphilis 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 2. Stricture of Urethra .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1. Privation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Want of Breast Milk 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 3. Purpura and Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Alcoholism a Del. Tremens .. .. .. .. 1 2 .. 3 .. .. .. .. .. .. 1 2 3 b Intemperance .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 1 .. 1 Urder 4. 1. Thrush 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 11. Order 1. 1. Gout .. .. .. .. 1 1 .. .. 1 1 .. .. .. .. 1 1 2 2. Dropsy 1 1 3 1 4 4 1 3 .. 5 1 .. .. 1 6 4 10 3. Cancer .. .. .. .. 3 2 .. .. 1 2 1 .. .. 1 1 4 5 4. Mortification .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 1 1 2 5. Abscess 1 1 3 1 2 .. .. 2 l 2 .. .. .. 1 3 3 6 6. Haemorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 2. 1. Scrofula .. 1 1 .. .. .... .. .. .. 1 .. .. .. .. .. 1 1 2. Tabes Mesenterica 2 .. 2 .. .. .. .. .. .. 2 .. .. .. .. 2 .. 2 3. Phthisis 1 1 9 24 12 5 .. 4 4 29 7 .. .. 6 29 21 50 4. Haemoptysis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Hydrocephalus .. 2 7 .. .. .. .. 1 .. 6 .. .. .. .. 3 4 7 III. Order 1. 1. Cephalitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Apoplexy 1 .. 3 .. 3 7 .. 4 .. 6 .. .. 1 2 9 4 13 3. Paralysis 1 .. 1 1 2 1 .. 2 .. 3 .. .. .. .. 2 3 5 4. Epilepsy .. .. .. .. 2 2 .. .. .. 1 1 1 .. 1 2 2 4 5. Convulsions 7 1 8 .. .. .. .. 1 1 6 .. .. .. .. 6 2 8 6. Brain Disease, &c 2 .. 4 .. 2 2 .. 1 2 3 1 .. .. 1 4 4 8 Order 2. 1. Pericarditis .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 1 2. Aneurism .. .. .. 1 1 .. .. 1 .. .. .. .. .. 1 .. .. 2? 3. Heart Disease, &c .. .. 1 8 8 4 .. 2 3 13 .. .. 1 2 8 13 21 Okder 3. 1. Laryngitis .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 2. Bronchitis 20 10 30 2 12 .. 4 15 4 45 1 .. .. 5 34 36 70 3 Pleurisy .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 4. Pneumonia 6 8 16 3 5 .. .. 5 .. 15 .. 1 .. 3 13 11 24 BIRTHS registered during 13 weeks.—Hanover Square, M. 39, F. 57; May Fair, M. 41, F 35; Belgrave, M. 223, F. 211. Total . . 606. Average . . 46. DISEASES. Ages at Death. Sub-districts & population Sexes. Under 1. 1 and under 5. Total under 20. 20 and under 40. 40 and under 60. 60 and under 80. SO and above. Hanover Square.—19,770. May Fair.—12,648. Belgrave.—55,099. Mount-street Work.—268. | Little Chelsea Work.— 350. St. George's Hospital. —216. Males, 37,511. Females, 50,236. Total. 87,747. Parishioners. Ts'onParishioners. 5. Asthma .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 6. Lung Disease, &c i 2 3 4 2 2 .. 1 6 1 1 .. 2 7 4 11 Order 4. 1. Enteritis 2 .. 2 1 1 .. .. 2 .. 2 .. .. .. .. 3 1 4 2. Peritonitis .. .. 4 5 2 .. .. 1 .. 6 .. 1 3 7 4 11 3.Ascites .. .. .. .. 2 1 .. .. .. 2 1 .. .. .. .. .. 3 4.Hernia .. .. .. .. 2 1 .. .. .. .. .. 1 2 2 1 3 5.Ileus and Intussusception .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6.Fistula .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. 1 7.Stomach Disease &c. 1 .. 3 3 3 3 .. .. 2 .. .. .. 3 5 7 12 8.Hepatitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9.Jaundice .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 10. Liver Disease, &c .. .. .. 1 7 3 3 1 4 .. .. 1 2 6 .. 11 Order 5. 1. Nephria .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 1 2 2.Diabetes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3.Kidney Disease, &c. .. 1 2 3 1 3 .. 2 .. 3 I .. 1 2 6 .. 9 4.Diseased Bladder .. .. .. 1 1 1 .. .. .. 2 .. .. .. 1 3 .. 3 Order 6. 1.Ovarian Dropsy .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 2.Uterus Disease, &c .. .. .. 1 3 .. .. 1 1 .. .. .. .. 1 .. 4 4 Order 7. 1.Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.Joint Disease, &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Order 8. 1.Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Uleer 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 3.Skin Disease, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. IV. Order 1. 1. Premature Birth 8 .. 8 .. .. .. .. .. .. 5 3 .. .. .. 2 6 8 2. Cyanosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Spina Bifida .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Other Malformations .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Teething 2 1 3 .. .. .. .. .. .. 3 .. .. .. .. 2 1 3 Order 2. 1. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Child-birth (see Metria) .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 1 Order 3 1. Old Age 1 .. 1 .. .. 10 9 .. 3 12 3 2 .. .. 8 12 20 Order 4. 1. Atrophy and Debility 16 .. 16 1 1 2 .. 2 1 13 2 2 .. .. 10 10 20 2. Exhaustion .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. V. Order 1. (Accident or Negligence.) 1. Fractures and Contusions .. .. 1 4 2 1 .. 1 .. .. .. .. 2 5 1 1 8 2.Gunshot .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4. Burns and Scalds. .. 1 1 .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 5. Poison .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 6. Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7.Suffocation .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 8. Other Injuries .. .. .. .. .. 1 .. 1 .. .. .. .. 1 .. 1 1 2 Order Injuries 1. Murder and Manslaughter 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Order 4. (Suicide.) 1. Cut, Stab, Precipitation, Ac. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Poison .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3. Drowning .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 1 4. Hanging Sudden Deaths (Cause unascertained) 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 Causes not specified or ill-defined 1 1 2 .. .. 1 .. 2 .. 1 .. .. .. .. 2 1 3 TOTAL 97 62 203 88 97 90 14 87 31 256 30 7 18 63 253 237 490' DEATHS registered during corresponding weeks of ten years (average) . 426.4 Weekly Average 32.7 LONDON : PRINTED BY GEORGE PHIPPS, RANELAGH STREET, EATON SQUARE.