ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. pace General Mortality in the Metropolis, &c. 1 The Birth-rate in St. Giles District 2 Analysis of ditto 3 Table of Birth-rate to population 4 The Death-rate in St. Giles District 4 Analysis of ditto 5 Table of Death-rate to population 6 Comparative Death-rate in St. Giles in 1874, and ten previous years 6 Causes of increased Mortality in St. Giles South 6 The Death-rate among Infants in St. Giles District 7 The Death-rate among Persons 60 years of age and upwards in ditto 7 The Death-rate among Persons at all ages in ditto 8 The Boys' Refuge in Great Queen Street 9 Table showing the annual rate of Mortality, Death rates among Children, &c. 10 Table showing the number of Deaths in ten years from seven principal Zymotic Diseases 11 Table showing the Mortality from certain classes of Diseases, and proportions to Population 12 Pulmonary Diseases and their Causes 12 The Influence of Flowering Plants in Purifying the Atmosphere 13 The Death-rate among the Zymotic Diseases 13 Small-Pox, Measles, Scarlet Fever, Diphtheria, Croup . 14 Whooping Cough, Fevers, Diarrhoea 15 Inquest Cases 15 Mortality in the Workhouse 16 Bloomsbury Dispensary 16 The British Lving-In Hospital 16 The Infant's Home and Necessity of Registration 17 The Sanitary Work of the year 17 Articles Disinfected 18 Provisions Condemned 19 Cowsheds, Slaughter Houses, Bakehouses, Rag and Bone Shops 19 Underground Rooms, Condemned Houses 19 APPENDIX. Table of Registered Deaths 20 Table of Registered Births 20 Table showing the Mortality in each Quarter, and in each Sub-District . Facing Table showing the Causes of Death in St. Giles District with the Ages at Death page 20 TO THE BOARD OF WORKS FOR THE ST. GILES DISTRICT. Gentlemen,— 1. In an interesting preface to his last "Annual Summary," the Registrar General sets forth many important facts bearing on the vital statistics of the Metropolis. I propose to refer to those only which afford materials for a comparison with the facts that constitute the subject-matter of my Report for this District. 2. With respect to the general health of the population of London, the Registrar General points out that there has been a marked reduction in the mortality. For the ten years 1840-49, the Death-rate was 25-2; for the thirty-five years 1840-74, it was 24.2; and for the last three years, 1872-74, it was 22*2. 3. With the view of showing the corresponding improvement in St. Giles District, the following facts may be cited : for the ten years 2 1861.70, the Death-rate was 28.4, and for the four years 1871-74, 24.73. The improvement has, therefore, been more decided in St. Giles than in the Metropolis at large, but this must he regarded as chiefly owing to the greater need and larger opportunity for improvement in this District than in the more extensive area of the Metropolis. 4. The Registrar General remarks that "the Bill now before Parliament to facilitate the abolition of rookeries in great cities, and to promote the erection of healthier dwellings, will carry the improvement further." Of the soundness of this opinion there cannot be a doubt. 5. The population of London, within the Registration division (estimated for the middle of the year), was 3,400,701; the Birth-rate was 35.7 per thousand, and the Death-rate 22.5. The estimated increase of the population was 44,544. The Birth-rate for St. Giles District, for 1874, was 29'23 (see Table, No. 2), and the Death-rate, 25.68 (see Table, No. 4). 6. We have had therefore a much lower Birth-rate, and a higher Death-rate than the Metropolis. Our Sub-District, which had the highest Birth-rate (31.82), viz.: St. Giles North, fell far below the Metropolis ; on the other hand, two of our Sub-Districts show a Death-rate less than the Metropolitan—one of them, Bloomsbury, very much less—and the comparison is carried against us only by the very high death rate of St. Giles South The causes of these differences in the mean rates would be a most interesting subject of investigation—more especially as regards the Birth-rate—for there can be no doubt that our population has many peculiarities that habitually tend to keep our Birth-rate at a low standard. The Birth-rate in St. Giles District. 7. The number of Registeked Births in St. Giles District, for the year 1874, was 1,725; of which 449 are attributed to the SubDistrict of St. George, Bloomsbury, 788 to St. Giles South, and 488 to St. Giles North.* 8. These numbers, however, do not accurately represent the Birth-rate, either in the whole District or in the Sub-Districts, and require correction in various ways. For example, there were 163 women confined in the British Lying-in Hospital, who gave birth to 167 children. Only 27 of the mothers belonged to the united parishes; there are, therefore, 140 births that must be deducted from the aggregate number, and also from the number for St. Giles South, in which Sub-District the Hospital stands. Again there were 134 births in the Workhouse, all of which are registered against the Sub-District of St. Giles South. I find that of this number 18 belonged to St. George Bloomsbury, by previous residence of the * The number of Registered Births here recorded is larger than stated in the Returns of the Registrar General, as this year, for the district of St. Giles, comprises 53 weeks—a correction that has to be made form time to time. 3 mothers, 55 to St. Giles South, 28 to St. Giles North, 20 to the Strand District, and there were 13 whose parishes could not he clearly ascertained. Three of the latter were undoubtedly outsiders, the other 10 were presumably belonging to one or other of the united parishes. I shall, therefore, enumerate them as our own, and distribute them proportionately among the three Sub-Districts, viz., 2 to St. George Bloomsbury, 5 to St. Giles South, and 3 to St. Giles North. After these deductions have been made, there will be only 60 of the births in the Workhouse that belong St. Giles South. The births deducted from St. Giles South must be added to the other Sub-Districts. To revert to the births in the British Lying-in Hospital; we noticed that there were 27 births in that Institution which belonged to this District, and of that number 5 must be appropriated to St. George Bloomsbury, 16 to St. Giles South (where they are already registered), and 6 to St. Giles North. The 5 and 6 must be added to the numbers for these Sub-Districts. 9. This analysis is necessarily tedious, because complex ; but the results show that the statement of births by the Registrar General does not accurately represent the actual facts of the birth-rate in our District and its Sub-Districts; and if exactness be desirable in this respect—as most unquestionably it is, for without it there cannot be a safe basis for further calculations—such a minute analysis as that now made is indispensable. I do not wish to be misunderstood as criticising captiously the Registrar General's returns. They are exact so far as they exhibit the actual registrations, and they are absolutely necessary to a more detailed investigation. 10. For the sake of clearness I will put these calculations in a tabular form. TABLE No. 1. Analysis of the Births in St. Giles District. St. Giles District. St. Giles South, Sub-District. Sf. Giles North, Sub-District. St. George Bloomsbury, Suit-District. Registered Births 1,725 Deduct Births in the British Lying-in Hospital . . 140 Deduct Strand and miscellaneous Births 23 163 Actual Births . 1,562 Registered Births 788 Deduct outsiders in Lying-in Hospital . . . 140 S t. George's (Workhouse) 20 St. George's (Hospital) . 5 — 25' St.GilesNorth (Workhouse) 31 St.GilesNorth (Hospital) . 6 — 37 Strand in Workhouse . 20 Miscellaneous in Workhouse 3 = 225 Actual Births . . 563 Registered Births 488 Add Births in Workhouse. 31 Add Bir hs in Hospital . . 6 — 37 Actual Births . . 525 Registered Births 449 Add Births in Workhouse . 20 Add Births in Hospital . . 5 — 25 (474 Actual Births . < 525 (563 Total Births . 1,562 b 4 As I pointed out last year these conclusions are more in accordance with the population of the several Sub.Districts than the numbers registered by the registrars. 11. I will now give the mean Birth.rate of St. Giles District and its Sub.Districts in the usual tabular form. TABLE No. 2. The Birth.rate to Population in St. Giles and its Sub.Districts in 1874. Sub.Districts. Population. Births. Ratio of Births to Population. Rate, per 1000. St. George Bloomsbury.. 17,843 474 1 in 37.64 26.56 St. Giles South 19,089 563 1 in 33. 9 29.49 St. Giles North 16,497 525 1 in 31.42 31.82 Whole District 53,429 1,562 1 in 34. 2 29.23 The mean annual Birth.rate for three years has been 30.3 per 1,000 ; the mean Birth.rate, therefore, for 1874 is a little below the average. The Death.Rate in St. Giles District. 12. The mean annual Death.rate must be ascertained by a similar method to that employed for determining the Birth.rate. The corrections are as complex as those in the case of the Birth.rate, but are more difficult to make. This difficulty is owing to the facts being derived from the Workhouse books, which, not being kept with any reference to vital statistics, do not always afford data sufficiently exact to work with. For example, there is no record in the books of the "previous residence" of the patients who died in the Highgate Infirmary; and inasmuch as the accuracy of these tables depends upon the essential fact of "previous residence," it is obvious that my corrections must be, to some extent, imperfect. The following statement will, however, give a tolerably accurate analysis of the deaths in the Workhouse. 13. The whole number of recorded deaths in the House, for the year 1874, is 187, viz., 24 for St. G.eorge Bloomsbury, 84 for St. Giles South, 35 for St. Giles North, 12 for the Strand, and 32 miscellaneous. Under the latter head I include persons who have lived more than 12 months in the House, and who may be fairly regarded as denizens of the House. 14. To these 187, must be added 29 deaths in Stockwell and 5 Homerton (viz., 1 Workhouse, 5 St. George Bloomsbury, 15 St. Giles South, and 18 St. Giles North), and 59 in the Highgate Infirmary. The additions make together 275 Workhouse deaths,— minus 18 referred to below (§16)=257 deaths in Workhouse. 15. Besides the foregoing, there were 87 deaths in the General Hospitals of persons belonging to our District, which must be added to our general registered mortality. The Hospitals from which these deaths were collected are the following:—Middlesex, 15; Charing Cross, 19; University College, 7; King's College, 32; St. Bartholomew's, 5; St. George's, 1; Westminster, 1; Childrens' Hospital, 3; London Fever, 4. I am much indebted to the authorities of these institutions for kindly permitting the inspection of their voluminous records. The aggregate additions to the registered deaths from all sources is therefore 175. 16. There are now certain deductions to be made of deaths of persons who did not belong to our District, which were registered within it. For example: there were 12 deaths in the Workhouse of Strand parishioners, and about 6 miscellaneous; these must be deducted from the 275 deaths in Workhouse, leaving 257. There was 1 in the British Lying-in Hospital, and 31 in the Infants' Home, Great Coram Street—altogether 50. Then, corrections must be made for the Sub-Districts, as well as for the whole Districts. The following Table shows the entire calculation at a glance:— TABLE No. 3. Analysis of the Deaths in St. Giles District. St. Giles District. St. Gil<*s South, Sub-District. St. Giles North, Sub-District. St. George Bloomsbury, Sub-District. Registered Deaths 1,247 Registered Deaths 588 Registered Deaths 334 Registered Deaths 325 Add Deaths in General Hospitals ... 87 Add Deaths in General Hospitals ... 46 Add Deaths in General Hospitals ... 18 Add Deaths in General Hospitals. ... 21 Add Deaths in Stockwell . . 29 Add Deaths in Stockwell . .16 Add Deaths in Stockwell . . 8 Add Deaths in Stockwell . . 5 Add Deaths in Highgate . . 59 64 26 26 175 652 Total, 360 351 1,422 Deduct Strand 12 Deduct Deduct Deaths in Infant8' Deduct Strand. 12 laneous ... 6 Home . . . - - 31 Deduct Miscellaneous ... 6 Deduct Lyingin Hospital . 1 Total, 320 Deduct Lying- 19 St. Giles North 360 in Hospital . 1 St Giles South 633 Deduct Infants' Total, 633 Home ... 31 1,313 50 Add Deaths in Highgate (Per- Total, 1,372 sonsResidences unknown) . . 59 Total, 1,372 17. I will now append the usual Table showing the mean annual Death-rate in the District and Sub-Districts. it 2 6 TABLE No. 4.—The Death.rate to Population in St. Giles and its Sub.Districts in 1874. Sub.Districts. Population. Deaths. Ratio of Deaths to Population. Rate per 1,000. St. George, Bloomsbury. 17,843 320 1 in 55.76 17.94 St. Giles South 19,089 633 1 in 31.73 3316 St. Giles North 16,497 360 1 in 45.82 21.82 Highgate Infirmary ... 59 ... ... Whole District 53,429 1,372 1 in 38.94 25.68 Our average Death.rate far ten years being 27.29, it is apparent that our Death.rate last year was I "61 below the average. 18. On comparing the Birth.rate with the Death.rate, we find that our Births last year exceeded our deaths by 190 only, which represents the natural increase of our population. Our population is, however, actually decreasing, owing to emigrations and conversion of dwelling houses into warehouses, &c. 19. The following Table shows the comparative Death.rate in St. Giles and its Sub.Distriets for a period of ten years, with the Death. rate for 1874. TABLE No. 5.—Death.rate per 1,000 in Sub.Districts. Districts. 1864. 1865. 1866. 1867. 1868. 1869. 1870. 1871. 1872. 1873. Average Death.rate of 10 years. 1874. &t. George, Bloomsbury 21.6 21.1 20.0 19.0 21.0 21.16 22.1 21.2 19.67 18. 0 20.48 17.94 St. Giles South 34.8 34.6 32.8 31.6 31.1 33.20 34.1 28.3 24.41 30. 2 3151 : 33.16 St. Giles North 29.2 26.6 29.8 26*6 25*3 29.47 27.5 23.4 21*15 20. 3 25.93 21.82 Whole District 311 29.6 29.0 26.9 26.8 27.94 28.19 25.6 23.77 23.90 27.29 25.68 Increased Mortality in St. Giles South. It is thus apparent that whilst St. George Bloomsbury and St. Giles North have had a mean Death.rate below the decennial average, that of St. Giles South has been above it, the general Death.rate for the District having been below the average as 25.68 is to 27.29. 20. The increased mortality in St. Giles South was caused by a continuance of the endemic of typhus fever (chiefly among the inhabitants of the Great Wild Street section), and by pulmonary affections. The latter are the constant scourge of this Sub.District, and as the Metropolis generally suffered more than usual from these maladies, owing to the remarkably low temperature of the latter months of the year, we cannot be surprised that the mortality in St. Giles South should exhibit a marked increase. I may observe that the temperature fell suddenly in the week ending the 28th November, from a mean of 44° 1" to a mean of 32° 8"; and in that and the following week 7 the mortality rapidly increased. The cold was most fatal to the old, the very young, the diseased, and the debilitated. The Registrar General has indicated a remarkable law, subject to which death from cold takes place. He says, in brief, "taking the increase of mortality by cold between 20—40 as one, then the mortality became 2, 4, 8, and so on, doubling every 9 years." Again, "the mortality from cold increased 8 per cent, for every year of age, or it doubled every 9 years from the age of 20, as it did in 1855." The Death-rate among Infants in St. Giles District. 21. In the year 1874 the number of deaths among Infants under 1 year of age was 286 (excluding the deaths in the Infants' Home and the British Lying-in Hospital). Of these 66 belonged to St. George Bloomsbury, 134 to St. Giles South, and 86 to St. Giles North. 22. The rate of mortality in each Sub-District was as follows:— Whole District 1 Death in every 5-46 Births = 18'4 per cent, of Births. St. George Bloomsbury 1 do. do. 7'18 do. = 13492 do. St. Giles South 1 do. do. 4'2 do. = 23'8 do. St. Giles North 1 do. do. 61 do. = 16'4 do. 23. The subjoined table shows the proportion of deaths of Infants to all deaths, which is the ordinary mode of comparison. Whole District 1 Death to every 4.8 of all Deaths St. George Bloomsbury 1 do. do. 4'85 do. St. Giles South 1 do. do. 4'72 do. St. Giles North 1 do. do. 4'19 da 24. There appears, on the surface, a remarkable discrepancy between these tables. According to the second table, St. George Bloomsbury (1 in 4-85), and St. Giles South (1 in 4'72), are nearly on a par as regards deaths of infants to total deaths, and a stranger to the district would conclude, unhesitatingly, that their sanitary condition must be similar. This conclusion would, however, be erroneous, and would be dissipated on an examination of the first table, when the deaths of infants, to births, in St. George Bloomsbury, is represented as 1 in 7.18, and in St. Giles South, as 1 in 4'2. The deaths in St. Giles South are clearly in great excess. 25. The reason why the Death-rate of infants, in relation to total deaths, is nearly as high in Bloomsbury as in St. Giles South, is because St. George Bloomsbury has a low Death-rate at all ages, which, of course, gives a relative preponderance to its infant deaths. This method of estimating the Death-rate is liable to fallacies, which are avoided by estimating it in relation to births. The Death-rate among Persons 60 years of Age and upwards. 26. The registered deaths among persons 60 years of age and upwards were 278 ; but various corrections have to be made, as I have already detailed (§ 12), with reference to the general Deathrate. After these corrections, the number is 287, of which 62 8 belonged to St. George Bloomsbury, 104 to St. Giles South, and 61 to St. Giles North. The rates in the Sub-Districts are as follows:- Whole District 1 death in every 4'93 of all deaths and in every 192 of pop. St. George Bloomsbury 1 do. do. 5'16 do. do. do. 287 do. St. Giles South 1 do. do. 3 86 do. do. do. 116 do. St. Giles North 1 do. do. 5'9 do. do. do. 270 do. The Deatti-rate among Persons at all Ages. (infants and persons 60 years of age and upwards being excluded.) 27. The number of deaths among persons at all ages was (after excluding the deaths in the Highgate Infirmary), 749. Although these deaths are excluded from the Sub-Districts, they are included in the Deaths for the whole District. The proportions to be distributed among the Sub-Districts are as follow:—192 to St. George Bloomsbury, 344 to St. Giles South and 213 to St. Giles North. 28. The ratios to the whole mortality, and to population, are thus expressed:— Whole District 1 Death in every 66 of pop. = 15'1 per 1,000 St. George Bloomsbury 1 do. do. 93 do. = 10 76 do. St. Giles South 1 do. do. 56 do. = 18- do. St. Giles North 1 do. do. 77 do. = 12-91 do. 29. Here we see that St. George Bloomsbury had a low Death-rate as compared with St. Giles South, but if we look at the following table, giving the ratios to total deaths, we find the conclusions reversed:— Whole District 1 in every 1-83 of all Deaths. St. George Bloomsbury 1 do. 1'66 do. St. Giles South 1 do. 1'84 do. St. Giles North 1 do. 1'69 do. 30. The apparently low Death-rate (1 in 1.84) in St. Giles South, as compared with Bloomsbury, is owing to its very high Death-rate among infants and old people, and it therefore illustrates the argument already stated (§ 24). 31. I have thought it right to dwell with some minuteness on this important branch of vital statistics, as there can be no doubt that erroneous opinions may be promulgated of the sanitary condition of a district, from an inaccurate method of calculating the Death-rates. 32. The District of St. Giles may be regarded as a typical one, it being constituted of the comparatively healthy parish of St. George Bloomsbury, the medium Sub-District of St. Giles North, and the destitute and unhealthy one of St. Giles South. All classes of the community in the Metropolis may be, therefore, said to be fairly represented by our District, which consequently affords peculiar opportunities for determining the influence of physical and social conditions upon mortality. This privilege of our position, in a scientific point of view, makes it the more necessary that our data should be accurately fixed. 9 The Boys' Refuge in Great Queen Street. 33. It is interesting to compare the results of training and occupation in the Boys' Refuge in Great Queen Street with the vital condition of boys at the same age among the community at large. The boys received into this Refuge are taken, as a rule, off the streets; some are sent by the magistrates, others are brought to the doors by the police; some are forwarded with a note or address by charitable persons, but all are either vagrants or destitute children. They thus come from the lowest classes of society, have been ill fed and ill cared for, and many with constitutions vitiated by disease. As soon as they enter the Refuge, however, suitable care is taken of them, and they are subjected to proper sanitary and educational discipline. Many are forwarded to the "Arethusa" and "Chichester" training ships to be turned into sailors, and others are provided for in various ways, as opportunities offer ; but up to the end of 1874 about 150 were retained in the house. These are taught trades, chiefly shoemaking, tailoring, firewood cutting, and the making of fruit punnets. About half of their time is spent in work and half in education. Their diet is simple, but evidently sufficient; they get soup, in which the vegetables are thoroughly incorporated by long boiling, bread as a staple, and four ounces of cooked meat for each boy three times a week. The rooms or halls in which they work and sleep are very large, but it may be doubted whether adequate superficial space is given to each boy in the sleeping apartment for ventilation. At any rate, there is no luxury here—everything is conducted on the most economical scale, and the good results to be witnessed are not due to extravagant liberality. The utmost attention is paid to cleanliness and to the good order of the necessary sanitary conveniences. The occupation of the boys provides healthy exercise for their minds and induces habits of attention and industry. Under these favourable circumstances we might expect the health of the children to improve rapidly, and such we find to be the case. There is little sickness among them, and the majority of them have fresh cheeks and a healthy look, in remarkable contrast to the puny, sickly, and cadaverous gutter children from among whom they are taken. 34. In the course of three years (1872-3-4) 1,356 children were received into the Home, which, with 150 in the Home at the commencement, gives an aggregate of 1,506 children under the charge of the superintendent during the period. Of this number only 440 were retained in the house to be taught trades and provided with elementary instruction. Among this number, during the three years, there has been but one death in the Institution. Three were sent to hospital as incurable, but the superintendent states that two of these eventually recovered. Assuming that the other boy died, this would give two deaths in three years in an annual population of 147 boys from ten to fifteen years of age, which is equivalent to a death rate of 4.5 per 1,000. Now, the mean rate of mortality among boys at the same ages 10 throughout England, for 35 years, is 4.8 per 1,000. This population includes all classes—the rich and well nourished as well as the destitute—and is therefore favourably constituted for a low mortality. Among the lowest and most impoverished class from which the boys are received into the Refuge, the mortality is far higher. We thus see how much the physical condition of children may be improved by the inculcation of regular habits, and how boys who are, many of them at least, afflicted with congenital disease, half starved and broken down in strength, may be brought up to a standard of health even better than the average of the country. 35. I will now append a Table summarising certain facts in relation, more particularly, to the deaths of children, which will facilitate comparison with similar facts in other districts. TABLE No. 6. Annual Rate of Mortality, Death.rates among Children, and Deaths in Public Institutions. Annual Bate of mortality per 1,000 living. Deaths of Children under one year ; percentage of total Deaths.* Percentage of Deaths of Children under one year to Births.† Deaths of Children under five years; percentage of total Deaths. Total number of Deaths among Parishioners in Public Hospitals outside the District. Total number of Deaths among Non. Parishioners in Public Institutions within the District. 1874 25.68 21.20 18.63 36.73 175 50 1873 23.9 24.59 19.5 40. 146 18 1872 23.77 25.02 20.08 40.61 136 25 1871 25.6 22.91 20.8 38.65 132 9 Average of 10 years 1864.1873. 27.29 36. The foregoing Table comprises a period of four years; and, on perusing it, it will be seen that whilst our general mortality has been slowly rising since 1872, and was, last year, nearly exactly what it was in 1871, yet that our deaths among infants under one year, and among children under five years, were less in proportion "last year than in any previous year of the series. 37. This difference is owing to two causes. First, to the small mortality from zymotic diseases in 1874, as shown in the subjoined Table, the proportion of deaths to 100 deaths having been, in that year, 159.61 to an average of 180.0 for ten years,—in fact, our number was never so low as last year; and, secondly, to a considerable mortality from pulmonary diseases. ‡ * The total Deaths exclude Non.Parishioners dying in public Institutions within the District, and include Parishioners dying in public Hospitals outside the District. †The Births exclude the Births of Non.Parishioners in the British Lying.in Hospital, and of Parishioners of the Strand District that occurred in the Workhouse. tin comparing the past year with previous years, the fact that 1874 includes an extra week must be fcorjie in mind. TABLE No. 7.—Showing the number of Deaths in the 10 Years, 1864 to 1873, from the seven principal Zymotic Diseases, and the number in 1874. Disease. 1864. 1865. 1866. 1867. 1868. 1869. 1870. 1871. 1872. 1873. Annual average of 10 years 1864 to 1873. Proportion of Deaths to 1,000 Deaths in 10 years 1864 to 1873. 1874. Proportion of Deaths to 1,000 Deaths in 1874. Small Pox 12 9 22 31 6 1 15 88 8 ... 19.2 13.14 ... ... Measles 38 12 47 20 23 19 29 15 37 27 26.7 18.28 31 22.59 Scarlet Fever 57 36 62 23 71 48 103 20 5 8 43.3 29.24 48 34.98 Diphtheria 10 8 9 6 6 5 4 7 5 2 6.2 4.66 ... ... Whooping Cough . 34 75 32 69 42 83 16 38 42 29 46.0 31.49 27 19.68 F ever 82 112 48 41 18 37 31 26 9 29 43.3 29.65 54 39.36 Diarrhoea 56 81 131 77 77 64 83 62 71 80 78.2 53.54 59 43.00 Total 289 333 351 267 243 257 281 256 177 175 262.9 180.00 219 159.61 London 16,029 14,272 14,761 11,660 14,925 17,413 16,476 19,455 12,699 11,376 14,906 196.17 11,230 146.59 England 1862 to 1872. 1862. 1863. No return published. 1862 to 71 1862 to 71 No return published. 73,270 98,490 96,279 92,030 82,692 72,587 97,352 91,380 100,497 103,801 91,743 90.838 186.36 12 TABLE No. 8. Showing the Mortality from Certain Classes op Diseases, and proportions to population, and to 1,000 deaths, 1874, viz.:. (Deaths in General Hospitals included.) Total Deaths. Deaths per 1,000 of Population. Proportion of Deaths to 1,000 Deaths 1. Seven Principal Zymotic diseases, 219 4.09 159.62 2. Pulmonary (other than Phthisis), 352 6.59 256.56 3. Tubercular 190 3.55 138.48 4. Wasting Diseases of Infants 95 1.78 69.24 5. Convulsive Diseases of Infants 79 1.48 57.50 1. Includes Small Pox, Measles, Scarlet Fever, Diptheria, Whooping Cough, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets and Tabes. 4. Includes Marasmus, Atrophy, Debility, Want of Breast milk and Premature Birth. 6. Includes Hydrocephalus, Infantile Meningitis, Convulsions and Teething, 38. Pulmonary Diseases and their Causes.—The foregoing Table exhibits the great preponderance of deaths from pulmonary diseases in our general mortality, more than one fourth of the whole number of deaths having been caused by this class of maladies. The chief of these is bronchitis. This fact should call more marked attention than it does to the causes that produce these maladies. The public are most concerned about the prevalence of fevers and the removal of certain conditions which are presumed to favour the propagation of these maladies, whilst they regard bronchitis, and lung diseases generally—other than phthisis—as among the inevitable consequences of our social state. It is, no doubt, true that the debilitating influences that pre.dispose to attacks of zymotic disease also prepare the way for fatal attacks of bronchitis, more especially in young children. But in much the same way that high temperature and foetor—plus a special poison—engender zymotic diseases, cold and draught induce pulmonary affections ; and it is of little consequence with which weapon death chooses to strike if the victims be knocked down and yield their annual tale. 39. I have no doubt that this heavy mortality from pulmonary affections is largely caused by the ill.constructed dwellings of the poor, and by the water.logged soil that constitutes their foundations. The windows, moreover, are constantly broken, the walls damp, and roofs leaky, letting in wind and rain upon the occupants. A large part of our sanitary work consists in the removal of these evils, but the mischief is apt to recur as soon as it. is corrected, owing to the recklessness and bad habits of the occupiers themselves, rather than to any systematic neglect of the owners. The intemperate habits of the poor, too, lay them open to attacks of bronchitis, for it is no uncommon thing for a man or woman to come home intoxicated and to lie down in wet clothes on the floor, either of the room or staircase. 13 They are thus exposed to the draughts that blow through the house, and waking up in the morning with a shiver, find that they have caught cold—in other words, have an attack of pneumonia or bronchitis. Accidents of this nature caunot be prevented by ordinary sanitary surveillance, but it may be hoped that, by the erection of dwellings for the poorer classes of a more suitable character, on a perfectly dry soil, concreted or otherwise, so that " damp " and foul exhalations may be arrested, and by a steady persistence in sanitary regulation, even the most ignorant people will be gradually taught the importance of obviating those causes that undermine their health, and bring about a premature destruction of life. The Influence of Flowering Plants in purifying the atmosphere. 40. The low death-rate of St. George, Bloomsbury, as exhibited in Tables 4 and 5, is mainly owing, as has been frequently pointed out, to the social condition of its inhabitants, and to the airy and spacious squares which occupy the site. There is a point of considerable importance in the planting and adornment of these squares which is not much thought of, but which, as Health Officer of the District, I think it right to urge. It is now well established that the atmosphere of large towns is deficient of ozone, which is nature's prime agent for purifying the air of deleterious organic poisons and preventing the spread of fevers. It is equally well proved that all odoriferous plants, the mints, for example, lavender, mignonette, wall-flower, and other old English flowers and herbs have a remarkable power of developing ozone, and therefore help materially in the destruction of miasmatic poisons. It is well to bear these facts in mind, and in laying out grounds to make the decoration of them subservient to purposes of health; and whilst gratifying the eye with beds of flowers of bright colours, to sow liberally such sweet scented flowering plants as are conducive to the purification of the atmosphere by the oxidation of the organic poisons that are constantly floating in it. Fevers may, in this way, be prevented, probably as effectually as by the use of the ordinary chemical disinfectants, whilst flowering plants have this advantage, that during the time they are in leaf and bloom their influence on the atmosphere is constant, whilst chemical re-agents exert only a transitory effect. The Death-rate among the Zymotic Diseases. 41. The aggregate number of Zymotic deaths during the year 1874 was 231 ; but only 205 of these were in the miasmatic order. In 1873 the deaths from miasmatic diseases were 217, and in 1872, 211, so that our mortality from these causes was lower last year than hitherto recorded. It must be always borne in mind that our records of mortality from these causes is increased by all the deaths that can be collected from public institutions outside the district. 14 42. Small Pox.—We had no death from this cause during the year. 43. Measles.—We sustained 31 deaths from measles, which were more numerous than last year (27), and also more than the average of 10 years (26.7) (vide Table No. 7). 44. Scarlatina.— 48 deaths occurred from this malady, our average number being 43'3. Our mortality last year was rather higher than the average, and shows a decided increase upon that of the three preceeding years, viz., 1873, 8; 1872, 5; 1871, 20; we may therefore look forward to the prevalence of this disease in an epidemic form next year. In 1870 we sustained 103 deaths from this cause (the largest number reported in recent times). Although there is no clear evidence (vide Table No. 7) that scarlatina appears epidemically at stated periods, yet its sudden leap in the past year is sufficient to raise grave apprehensions of a more formidable outbreak in the latter summer or autumn. The first case of this malady occurred at 63, New Compton Street, in St. Giles North. A woman had recently come into the parish from Westminster, but we could not get information of the disease existing in the house in which she had resided. The house in New Compton Street was moreover in want of sanitary improvements, and had been twice specially reported on in the previous year. It was without a yard, and all the domestic conveniences were in the basement. Other cases occurred in the same house, and the disease gradually extended over the District, but the Sub-District of St. Giles North continued to be the most heavily visited. The first deaths occurred in the week ending August 8th, when 2 were registered; there were 3 at the end of the month; in the month of of September there were 14, divided equally between St. Giles South and St. Giles North; in the month of October, 11, again divided equally between the two Sub-Districts, with 1 in hospital; in the month of November, 3, all in Bloomsbury; and in the month of December, 10, of which 3 were in Bloomsbury, 2 in St. Giles South, and 5 in St. Giles North. The remaining deaths occurred in hospital. Since the end of the year there has been a gradual reduction of the mortality, viz., 3, 1 and 2 deaths in the successive months of the Spring quarter, 1875. As the spread of scarlet fever is believed to depend very much upon temperature, it is interesting to know that the mean temperature of the month of July, immediately preceding the first death, was 63.2; of the month of August, 60.4; of the month of September, 58.3; of the month of October, 52.6; of the month of November, 41.8; and of the month of December, 33.9. Notwithstanding the low temperature of the last month, the coldest of the year, and, up to the present time, of the present year also, the death-rate continued excessive, showing that the range of temperature within which this disease is usually considered to prevail must be received with some qualification. 45. Diphtheria.—There has been no mortality from this disease. 46. Croup gave a tale of 8 deaths, of which 6 were females, and 2 males. 15 47. Whooping Cough.—Our deaths from whooping cough amounted to 27. There were 7 in Bloomsbury, 16 in St. Giles South, and 3 in St. Giles North. Our mortality from this affection was much below the average, our mean for ten years being 46. 48. Fevers, including typhus, enteric, and common continued fever, rendered 54 deaths; only 14 of these were registered within the District, the rest occurred either in Stockwell or the general hospitals. The number for the past year was rather in excess of our mean, which is 43.3. From the Report forwarded to us by the authorities of the Metropolitan Asylum District Board, I find that there were, in the course of the year 1874, 113 cases of fever of all kinds sent to Stockwell Hospital from this District, of which 37 were cases of typhus fever. Attention is drawn to the fact that, out of all the cases of fever, 27 came from the Great Wild Street Section, viz.: 11 from Lincoln Court; 2, Orange Court; 1, Wild Court; 4, Little Wild Street; 9, Great Wild Street; and of all the pure typhus cases (37) 15 came out of the Great Wild Street Section! The other groups of houses yielding the largest numbers of cases of fever, were King Street, Drury Lane, 9; and Little Coram Street, 9. There were 5 cases from 63, New Compton street, and 4 from 10, Charles Street. 49. It will be in the recollection of the Board that in my Report for 1873 I described the outbreak of typhus fever in the Great Wild Street Section of this district, an outbreak that originated in Lincoln Court; for two years, therefore, this endemic has haunted this quarter. Lincoln Court has long been notorious as the nestling place of fever, and your Board has, on numerous occasions, insisted upon large improvements being carried out there; but it has long been obvious that no partial measures can have any avail in destroying the seeds of pestilence in that locality. 50. I am glad to say that Little Coram Street and its surroundings, which have been equally conspicuous for disease and premature death, are likely soon to undergo a great change; the east side of that street, with Chapel Place, Marchmont Place, and the vacant sites of Coram Place and Russell Place, having recently been purchased by the Peabody Trustees. 51. Diarrhoea.—Our mortality from this disease was 59, our mean number for ten years being 78.2. We have, therefore, suffered from this cause a much lower mortality than usual, and it is to the diminished number of deaths from this disease and whooping cough, that our comparatively small mortality from zymotic diseases must be chiefly attributed. 52. Inquest Cases.—There were 108 inquests held during the year. In one instance the verdict was wilful murder, the occasion being an infant found dead on a door-step; there were 3 cases of suicide by hanging, 1 case of suicide by poisoning with cyanide of potassium, 1 by carbolic acid, 1 by throwing himself out of window, and 1 by cut throat. Two deaths occurred from fracture of skull, and 1 from fracture of ribs by a fall. There were also 2 deaths 16 attributed to shock; 1 after a fall, and another after burns. Many of the deaths were accelerated by intemperance, which is a common cause of deaths demanding investigation by a coroner's jury, and several deaths of infants were attributed to suffocation in bed. One death was occasioned by rupture of uterus after childbirth. There were only 4 registered deaths in which the cause was not specified. Mortality in the Workhouse and other Local Institutions. 53. The actual number of deaths in the Workhouse was 187, but this number requires to be corrected in various ways to obtain a true result. These corrections having already been made (§12) in treating of the general Death-rate, it is needless to repeat the process here. I have to acknowledge the personal kindness of all the officers of the Workhouse, in giving me the necessary assistance whilst consulting the various books in which the records of sickness and mortality are kept. The Bloomsbury Dispensary. 54. The medical officers of this Institution have favoured me with their usual return. There has been an increase in the number of patients treated at this Institution over those in the preceding year. The considerable number of sufferers attended by the medical officers of this charity proves its usefulness. There can be no doubt that many of the patients would have fallen upon the parish in their hour of trouble, but for the timely help afforded by this Institution. The following table shows the number of cases attended by the physicians and surgeons:— TABLE No. 8. New cases teeated at the Bloomsbury Dispensaey, 1874. Quarter ending- Physicians' Cases. Surgeons' Cases. Casualties about Total. Total No. under Treatmnt. Visited at home. Died. Total No. under Treatmnt. Visited at home. Died. Total No. under Treatmnt. Visited at home. Died. March 25th 689 293 20 457 42 4 342 1,146 335 24 June 24th 735 184 8 458 54 2 300 1,193 238 10 854 270 16 465 75 5 324 1,319 345 21 Dec. 25th 886 315 18 400 74 2 250 1,286 389 20 Whole Year 3,164 1,062 62 1,780 245 13 1,216 4,944 1,307 75 55. The British Lying-In Hospital.—The number of confinements in this charity during the year was 163. These gave 167 births, four being twin cases. There were 94 males and 73 females. There were 5 still births—4 males and 1 female, which are in- 17 eluded in the entire number. The Registrar-General reports 3 deaths of children in this Hospital during the year, viz.: 2 males and 1 female. The births in this Hospital belonging to St. Giles District were 27, of which number 5 were parishioners of St. George Bloomsbury; 16 belonged to the Sub-District of St. Giles South, and 6 to St. Giles North; the remainder (140) were parishioners of outside parishes. Allowance is made for these in the general summary of births. (Vide Tables I. and II.) 56. The Infants' Home.—I regret that I am unable to give such a report of the mortahty of this Institution as can be considered satisfactory in a scientific point of view, owing to the difficulty of fixing the mortahty occurring in the Home and outside of it, in relation to the whole number of children detained in the Home and passing through it. The number of infants usually in the house is, I am informed, about a dozen; and most of those who are received are, after a time, sent to the suburbs to be nursed. The deaths occuring in the Home in 1874 were 31, which is a much larger number than was reported to me last year. I find that, in every instance, the child that died was registered as the offspring of a domestic servant. The cause of death is returned in the large majority of cases as "debility" with "diarrhoea," and "tabes mesenterica": 5 as "syphilis." The age of the youngest child at death was 3 weeks, and of the eldest 1 year; and of the entire number 17 were registered at 3 months old or under. 57. This summary shows the importance of a proper registration and inspection of all institutions of this nature. Every woman, too, who takes in a child to nurse should be registered. This will appear the more important if we regard the class of women who make an especial use of this Institution. The conductors of this particular Home are desirous, I believe, of doing their best to improve the health, and increase the chances of life of the waifs and strays who are confided to their care; but it is nevertheless very obvious that any extension of this system might be attended with much evil that society would deprecate. The Sanitary Work of the Year. 58. The amount of work done during the year by the Inspectors is only partially shown in the following Table, owing to the dismissal of Inspector Harnack, and the failure of his return. A larger number of summonses was served this year than in previous years, and it is hoped that a salutary effect has been produced by the convictions that have been obtained against negligent owners. It is certain that less difficulty has been experienced of late in maintaining the regulations of your Board in those streets and courts where the owners were most frequently summoned in the earlier part of the year. In many other cases, too, where the orders of the Board used to be met with indifference or obstinate opposition, a more compliant temper has been evinced. 18 The chief difficulty, however, in keeping houses clean and habitable is found in the ignorance and apathy of the occupiers. House Improvements in St. Giles District effected under The Superintendence of Inspector J. McHugh between Lady-day, 1874, and 6th February, 1875. Improvements. Details. Inspector McHu&h. Improvements in Drainage. Number of houses improved 1,235 Drains constructed or repaired 126 Traps fixed 406 Cesspools abolished 28 Stables drained and horse-pools abolished 10 In. Water Closets. Pans, traps, and water provided 147 Water and apparatus only provided 411 Cleansed or repaired 643 Newly constructed or rebuil 28 In Dust Bins. Newly constructed 54 Repaired or covered 617 Paving. Re-laid or repaired 309 In General Water Supply. Receptacles provided 31 Receptacles repaired 242 In Cleanliness and Repair. Cleansed andlime-whited 952 Various accumulations removed from cellars,&c. 193 In Ventilation, &c. Ventilation improved 26 Overcrowding reduced 61 Kitchens disused, or made legally habitable 9 Proceedings taken. Request notices 313 Statutory notices 221 Summoned and fined 18 Reported to Police or District Surveyor 5 Total number of Improvements 4,850 Total number of Visits during the year 7,525 Disinfecting Chamber. List of Articles Disinfected in Hot Air Chamber during 1874-75. Articles. No. Articles. No. Articles. No. Beds 103 Quilts 53 Bags 3 Blankets 69 Coats 15 Jackets 3 Bolsters 56 Trowsers 9 Cushions 18 Pillows 147 Waistcoats 9 Petticoats 8 Cases 9 Skirts 13 Palliasses 8 Carpets 9 Table Covers 3 Scarfs 6 Counterpanes 22 Shawls 5 Hearth Rugs 5 Mattrasses 25 Frocks Drawers 2 Rugs 23 Flannels 5 Skirts 5 Sheets 103 Dresses 16 Sundries 45 Total Disinfections 85 Total Articles 801 TABLE No. III. Showing the Registered Mortality in each Quarter and in each Sub-District, 1874. Class. causes of death. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. St. George, Bloomsbury. St. Giles South. St. Giles North. St. George, Bloonrsbury. St. Giles South. St. Giles North. St. George, Bloomsbury. St. Giles South. St. Giles North. St. George, Bloomsbury. St. Giles 1 South. 8t. Giles Nonh. 1 Order 1. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. Measles 9 3 5 2 3 2 .. 3 4 .. • • .. Scarlet Fever .. 1 .. 1 .. .. .. 9 10 3 8 13 Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. Quinsey .. .. .. .. 1 .. .. .. .. .. .. .. Croup 1 1 .. .. 1 1 1 .. 1 1 1 .. Whooping Cough 1 9 2 1 3 1 2 4 .. 3 1 1 Fever 2 .. 1 1 1 1 2 1 2 1 1 l Erysipelas 1 .. 2 .. 1 .. 1 .. 1 .. 3 .. Metria .. 2 .. .. .. .. .. .. .. 1 .. .. Diarrhoea 1 3 1 1 3 2 15 11 15 l 2 2 Rheumatism .. .. .. 1 .. .. .. 2 .. .. .. 1 Other Miasmatic Diseases .. .. .. .. 1 .. .. .. 1 .. .. .. Order 2. Syphilis 2 4 .. 2 2 1 1 .. 1 5 2 1 Order 3. Want of Breast Milk .. 2 .. .. .. .. .. .. .. .. .. .. Delirium Tremens 1 .. .. .. .. .. .. .. .. .. 1 1 Order 4. Thrush .. .. .. .. .. .. .. .. .. .. .. .. 2 Order 1. Gout 1 .. .. .. .. .. .. .. .. .. .. .. Dropsy 1 .. .. .. 2 .. .. .. .. .. 1 .. Cancer 3 2 4 2 3 .. 1 1 .. 1 1 2 Mortification .. .. .. .. .. .. .. .. .. .. .. .. Order 2. Scrofula 2 .. 1 .. 1 .. l 1 .. .. .. 2 Tabes 2 3 1 4 2 1 3 2 1 4 2 1 Phthisis 10 20 8 9 12 5 10 16 11 15 17 11 Hydrocephalus 3 .. 2 .. 4 5 2 5 2 2 1 3 8 Order 1. Cephalitis .. .. 1 .. .. .. 1 .. .. .. .. 1 Apoplexy 3 8 1 1 4 3 8 5 .. 1 4 3 Paralysis 2 2 2 2 2 2 3 1 .. 4 .. 8 Epilepsy .. 4 .. 2 1 1 .. .. .. 1 .. .. Convulsions 2 6 1 3 2 2 2 5 2 2 9 3 Other Brain Diseases 2 1 1 3 5 .. 1 1 1 1 .. .. Order 2. Pericarditis .. .. .. .. 1 .. 1 .. .. .. .. 1 Aneurism .. .. 1 .. 2 .. .. 1 .. .. 2 .. Other Heart Disease 6 6 6 3 5 6 2 4 4 2 11 5 Order 3. Laryngitis .. .. .. .. .. .. .. .. 1 •• .. Bronchitis 17 51 28 4 25 12 7 11 4 17 63 20 Pleurisy .. .. .. .. .. 1 .. .. .. .. .. .. Pneumonia 1 11 6 3 9 4 .. 6 3 8 6 5 Asthma l .. .. .. 1 .. .. 1 .. .. .. 1 Other Lung Diseases 2 2 1 .. l .. .. .. .. 1 1 2 Order 4. Gastritis .. .. .. .. l .. .. .. .. .. .. .. Enteritis .. 1 2 .. l .. .. 1 .. 1 .. .. Peritonitis .. 1 1 .. l .. .. .. .. .. .. .. Ascitis .. 1 .. .. 2 .. .. .. .. 1 .. 1 Ulcer Intestines .. .. .. .. .. .. .. .. .. .. 1 .. Hernia .. .. .. .. .. 1 .. .. .. .. .. .. Ileus .. .. .. .. .. .. .. .. .. .. .. .. Intussusception .. .. 1 .. .. .. .. .. .. .. •• .. Stricture Intestines .. .. .. 1 1 .. .. .. .. 1 .. 1 Stomach Disease .. 1 .. 1 .. .. 2 .. .. .. .. .. Liver Disease 1 .. .. 4 .. 1 .. 2 1 .. 2 .. Order 5. Nephritis .. .. .. .. 1 .. .. .. .. .. 1 .. Nephria 1 3 1 .. 1 1 1 2 1 .. 2 .. Diabetes 1 .. .. .. .. .. .. 1 .. .. .. .. Cystisis l .. .. .. .. .. .. 1 .. .. .. .. Kidney Disease .. .. .. .. .. 1 1 1 .. .. .. .. Order 0. Ovarian Disease .. 1 l .. .. .. .. .. .. .. .. .. Order 7. Synovitis .. .. .. .. .. .. l .. .. .. .. .. Order 6. Phlegmon .. 2 .. .. .. .. .. .. .. .. .. 1 Ulcer .. .. .. .. .. .. .. .. .. .. .. .. Skin Disease .. .. .. .. .. .. .. .. .. .. .. .. 4 Order 1. Premature Birth .. 3 2 1 4 1 I 3 4 1 .. 6 Spina Bifida .. 3 .. .. .. .. .. 1 .. .. 1 .. Teething l 1 .. .. .. 1 l 2 .. .. 1 .. Other Malformations .. .. .. .. .. .. .. .. .. 1 .. .. Order 2 Childbirth .. 1 .. .. .. 2 .. .. 1 1 2 2 Order 3. Old Age l 4 2 3 5 .. .. 2 1 3 3 .. Order 4. Atrophy and Debility 9 6 4 .. 5 5 5 6 4 10 5 8 5 Order 1. Fractures, &c .. 2 .. .. 3 1 1 .. .. .. 1 .. Burns and Scalds .. .. .. .. .. .. .. .. .. .. 1 .. Suffocation 2 2 .. 2 3 .. .. 3 .. .. 1 .. Order 3. Homicide .. .. .. .. .. 1 .. .. .. .. .. .. Order 4. Wounds .. .. .. .. .. .. .. 1 .. .. .. .. Poison .. .. .. .. .. .. 1 .. .. .. 1 .. Hanging 3 .. .. .. .. .. .. .. .. .. .. .. Otherwise .. .. .. .. .. 1 .. .. .. .. .. .. Causes not specified .. 2 .. .. 1 .. .. 1 .. .. .. .. TABLE IV.—Causes of Death Registered in the St. Giles District in 1874, with the Ages at Death. Class* Causes op Death. At all Ages. Under 1 year. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Sub-Districts. Males. Pemales. Total. St. George, Bloomsbury. St. Giles South. St. Giles North. All causes 600 647 1247 318 209 72 157 213 245 33 325 588 334 Specified causes 598 645 1243 317 209 72 157 210 245 33 325 584 334 (Classes.) I. Zymotic Diseases 231 119 350 96 85 22 11 10 7 ... 64 91 76 II. Constitutional „ 233 116 349 30 34 19 70 58 21 1 78 95 60 III. Local „ 610 284 894 90 80 27 63 134 204 12 133 322 155 IV. Developmental „ 139 62 201 87 10 3 10 1 10 18 38 58 43 V. Violent Deaths 30 17 47 14 ... 1 3 7 4 1 9 18 3 (Orders.) L 1 Miasmatic Diseases 104 101 205 76 82 22 8 10 7 ... 53 80 72 2 Enthetic „ 12 9 21 18 3 ... ... ... ... .. 10 8 3 3 Dietic „ 3 2 5 2 ... ... 3 ... ... ... 1 3 1 4 Parasitic „ ... ... ... ... ... ... ... ... ... ... ... ... ... II. 1 Diathetic „ 9 16 25 ... 1 ... 4 7 12 1 9 10 6 2 Tubercular „ 107 101 208 30 33 19 66 51 9 ... 69 85 54 III. 1 Diseases of Nervous System 65 67 132 33 13 6 16 23 40 1 39 66 27 2 „ of Organs of Circulation 31 40 71 ... 1 8 10 20 30 2 14 33 24 3 „ of Inspiratory Organs 152 185 337 53 64 10 23 71 110 6 61 189 87 4 „ of Digestive Organs 20 22 42 2 ... 2 7 14 15 2 13 18 11 5 „ of Urinary Organs 14 8 22 ... 2 ... 7 5 7 1 5 13 4 6 „ of Organs of Generation ... 2 2 ... ... ... ... ... 2 ... ... 1 1 7 „ of Organs of Locomotion 1 ... 1 ... ... 1 ... ... ... ... 1 ... ... 8 „ of Integumentary System 1 2 3 2 ... ... ... 1 ... ... ... 2 1 IV. 1 Dev. Diseases of Children 18 21 39 34 5 ... ... ... ... ... 6 19 14 2 „ of Adults ... 9 9 ... ... ... 9 ... ... ... 1 3 5 3 „ of Old People 10 14 24 ... ... ... ... ... 7 17 7 14 3 4 Diseases of Nutrition 34 33 67 53 5 3 1 1 3 1 24 22 21 v. 1 Accident or Negligence 13 9 22 13 ... 1 1 4 3 ... 5 16 1 3 Homicide ... 1 1 1 ... ... ... ... ... ... ... ... 1 4 Suicide 4 3 7 ... ... ... 2 3 1 1 4 2 1 5 Execution ... ... ... ... ... ... ... ... ... ... ... ... ... Violent Deaths not classed ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Deaths, cause unascertained ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified or illdefined 2 2 4 1 ... ... ... 3 ... ... ... 4 ... TABLE IV.—Diseases in Orders—(Continued). Class. Causes of Death. At all Ages. Under 1 year. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Sub-Districts. Males. Females. Total. St. George, Bloomsbury. St. Giles South. St. Giles North. I. Order 1. 1 Small Pox ... ... ... ... . . • • • ... ... ... ... ... ... ... 2 Measles 13 18 31 8 23 • •• ... ... ... ... 11 9 11 3 Scarlatina 22 23 45 3 29 13 ... ... ... ... 4 18 23 4 Diphtheritis ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Quinsey 1 ... 1 ... 1 ... ... ... ... ... ... 1 ... 6 Croup 2 6 8 2 5 1 ... ... ... ... 3 3 2 7 Whooping Cough 10 16 26 10 16 ... ... ... ... ... 7 16 3 8 Continued Fevers, Typhus, &c 10 4 14 ... 2 6 3 1 2 ... 6 3 5 9 Erysipelas 7 2 9 1 ... ... ... 4 4 ... 2 4 3 10 Metria ... 3 3 ... ... ... 2 1 ... ... ... 2 1 11 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Dysentery 1 ... 1 ... ... ... • • • ... ... ... 1 ... ... 14 Diarrhoea 34 25 59 51 5 1 ... ... 1 ... 18 21 20 15 Cholera 1 1 2 1 1 ... ... ... ... ... ... ... 2 16 Ague ... ... ... ... ... .. . • • • ... ... ... ... ... ... 17 Remittent Fever ... ... • • • ... ... ... . . . ... ... ... ... ... ... 18 Rheumatism 3 1 4 ... ... 1 1 ... ... ... 1 2 1 19 Other Miasmatic Dis ... 2 2 ... ... ... 2 ... ... ... ... 1 1 Order 2. 1 Syphilis 12 9 21 18 3 ... ... ... ... ... 10 8 3 2 Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Glanders ... ... ... ... ... ... ... ... ... ... ... ... • • • Order 3. 1 Privation ... ... . . . ... ... ... ... ... ... ... ... ... ... 2 Want of Breast Milk 1 1 2 2 ... ... ... ... ... ... ... 2 ... 3 Purpura and Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Alcoholism:— a Delirium Tremens 2 ... 2 ... ... ... 2 ... ... ... ... 1 1 b Intemperance ... 1 1 ... ... ... 1 ... ... ... 1 ... ... Order 4. 1 Thrush ... ... ... ... ... ... ... ... ... ... ... • • • ... 2 Worms ... ... ... ... ... ... ... ... ... ... ... • •• • • • II. Order 1. 1 Gout 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... 2 Dropsy 2 2 4 ... 1 ... ... ... 1 1 1 3 ... 3 Cancer 6 14 20 ... ... ... 4 6 10 ... 7 7 6 4 Noma Canerum Ovis ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... Order 2. 1 Scrofula 6 2 8 3 2 3 ... ... ... ... 3 2 3 2 Tabes Mesenterica 12 14 26 17 8 1 ... ... ... ... 14 8 4 3 Phthisis 71 73 144 2 6 11 ... 51 9 ... 44 65 35 4 Hydrocephalus 18 12 30 8 18 4 ... ... ... ... 8 10 12 III. Order 1. 1 Cephalitis 2 1 3 ... 1 1 ... 1 ... ... 1 ... 2 2 Apoplexy 17 19 36 2 ... 1 9 7 17 ... 8 21 7 3 Paralysis 11 18 29 ... ... ... ... 9 19 1 11 11 7 4 Insanity ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Epilepsy 7 2 9 ... ... ... 6 1 2 ... 3 5 1 7 Convulsions&Laryngismus 19 20 39 29 9 1 ... ... ... ... 9 22 8 8 Other Brain Diseases 9 7 16 2 3 3 1 5 2 ... 7 7 2 Order 2. 1 Pericarditis 1 2 3 ... ... ... 2 1 ... ... 1 1 1 2 Aneurism 1 5 6 ... ... ... 1 4 1 ... ... 5 1 3 Heart Disease, See 29 33 62 ... 1 8 7 15 29 2 13 27 22 Order 3. 1 Laryngitis 1 ... 1 ... 1 ... ... ... ... ... ... ... 1 2 Bronchitis 109 151 260 42 45 6 9 56 97 5 45 151 64 3 Pleurisy ... 1 1 ... ... ... ... 1 ... ... ... ... 1 4 Pneumonia 37 24 61 10 18 3 10 11 9 ... 12 32 17 5 Asthma 1 3 4 ... ... ... ... 1 3 ... 1 2 1 6 Other Lung Diseases 4 6 10 1 ... 1 4 2 1 1 3 4 3 TABLE IV.—Diseases in Orders—(Continued). Class. Causes of Death. At all Ages. Under 1 year. 1 and under 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Sub-Districts. Males. Females. Total. St. George, BloomBbury. St. Giles South. St. Giles North. Order 4. 1 Gastritis 1 ... 1 ... ... ... ... ... 1 ... ... 1 ... 2 Enteritis 3 3 6 1 ... 1 1 ... 2 1 1 3 2 3 Peritonitis 2 1 3 ... ... ... 1 ... 2 ... ... 2 1 4 Ascites 2 3 5 ... ... ... 2 1 2 ... ... 4 1 5 Ulcer. Intest ... 1 1 ... ... ... ... 1 ... ... ... 1 ... 6 Hernia ... 1 1 ... ... ... ... ... ... 1 ... ... 1 7 Ileus ... ... ... ... ... ... ... ... ... ... ... ... ... 8 Intussusception 1 ... 1 1 ... ... ... ... ... ... ... ... 1 9 Strict. Intest 2 2 4 ... ... ... 1 1 2 ... 2 1 1 10 Fistula ... 1 1 ... ... ... 1 ... ... ... ... 1 ... 11 Stomach Disease, &c 4 ... 4 ... ... ... ... 2 2 ... 3 1 ... 12 Pancreas Disease ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Hepatitis 2 2 4 ... ... 1 1 1 1 ... 2 ... 2 14 Jaundice ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Liver Dis., &c 3 8 11 ... ... ... ... 8 3 ... 5 4 2 16 Spleen Disease, &c ... ... ... ... ... ... ... ... ... ... ... ... ... Order 5. 1 Nephritis 1 1 2 ... 1 ... ... ... 1 ... ... 2 ... 2 Ischuria 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... 3 Nephria 8 6 13 ... 1 ... 5 4 3 ... 2 8 3 4 Diabetes 1 1 2 ... ... ... 2 ... ... ... 1 1 ... 5 Stone ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Cystitis 2 ... 2 ... . . . ... ... ... 1 1 1 1 ... 7 Kidney Disease, &c 1 1 2 ... ... ... ... 1 1 ... ... 1 1 Order 6. 1 Ovarian Dropsy ... 2 2 ... ... ... ... ... 2 ... ... 1 1 2 Uterine Disease, &c ... ... ... ... ... ... ... ... ... ... ... ... ... Order 7. 1 Arthritis 1 ... 1 ... ... 1 ... ... ... ... 1 ... ... 2 Bone Disease, &c ... ... ... ... ... ... ... ... ... ... ... ... ... Order 8. 1 Phlegmon 1 2 3 2 ... ... ... 1 ... ... ... 2 1 2 Ulcer ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Skin Disease, &c ... ... ... ... ... ... ... ... ... ... ... ... ... IV. Order 1. 1 Premature Birth 12 14 26 26 ... ... ... ... ... ... 3 10 13 2 Cyanosis ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Spina Bifida 2 3 6 6 ... ... ... ... ... ... ... 5 ... 4 Other Malformations 1 ... 1 1 ... ... ... ... ... ... 1 ... ... 5 Teething 3 4 7 2 5 ... ... ... ... ... 2 4 1 Order 2. 1 Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Childbirth (see Metria) ... 9 9 ... ... ... 9 ... ... ... 1 3 5 Order 3. 1 Old Age 10 14 24 ... ... ... ... ... 7 17 7 14 3 Order 4. 1 Atrophy and Debility 34 33 67 53 5 3 1 1 3 1 24 22 21 V. Order 1. (Accident or Negligence):— 1 Fractures, &c 5 3 8 ... ... 1 1 4 2 ... 1 6 1 2-3 Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Burns, &c ... 1 1 ... ... ... ... ... 1 ... ... 1 ... 5 Poison ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Suffocation 8 6 13 13 ... ... ... ... ... ... 4 9 ... 8 Otherwis ... ... ... ... ... ... ... ... ... ... ... ... ... Order 3. Homicide ... 1 1 1 ... ... ... ... ... ... ... ... 1 Order 4. (Suicide):— 1 Wounds—Gunshot ... ... ... ... ... ... ... ... ... ... ... ... ... 2 „ Cut, Stab ... 1 1 ... ... ... ... ... 1 ... ... 1 ... 3 Poison 1 1 2 ... ... ... 2 ... ... ... 1 1 ... 4 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Hanging 2 1 3 ... ... ... ... 3 ... ... 3 ... ... 6 Otherwise 1 ... 1 ... ... ... ... ... ... 1 ... ... 1 Causes not specified 2 2 4 1 ... ... ... 3 ... ... ... 4 ... 1' ' —— ■ f ' — . - 19 Provisions Condemned and Destroyed from March, 1874, to March, 1875. Date. Articles. Weight. 31st March, 1874 One box of Mixed Fish 128 lbs 11th April, „ Beef, Mutton, Veal and Pork 112 lbs 24th April, „ One pad of Mixed Fish 85 lbs 27 th May, „ One pad Mackerel 96 lbs 30th June, „ A lot of Soles 40 lbs 15th June, „ One pad Mixed Fish 98 lbs 2nd July, „ A Carcase of Bee 4 cwt. 2 qrs, 16 lbs 59. Cow Sheds.—These have undergone the usual inspection during the year, and the whole of them have been improved in respect of ventilation, drainage, and other accessories. 60. Slaughter-houses.—The Slaughter-houses of the district have been kept fairly clean and regular. 61.—The Bakehouses have been kept in good condition, and the orders of the Board in respect of them have been carefully carried out. 62. Rag and Bone Shops.—The usual difficulties have been experienced in keeping these shops in a clean and wholesome condition. 63. Underground Rooms.—Inspector McHugh reports that very few cases of Underground Rooms illegally occupied have come under his notice during the year, and that whenever he had cause to interfere he found no difficulty in getting them vacated without having recourse to legal proceedings. Several underground water tanks have been abolished within the district, and new cisterns erected in the yards. 64. Such is the résuém of the last year's history of the sickness and mortality of our district. The year was, on the whole, a healthy one, although characterised by the severest winter experienced since 1855, and by epidemic disease in one of the sub-districts, which unduly raised its mortality. There is clear evidence, however, of a general improvement, and there is good reason to believe that, not only in St. Giles, but throughout the metropolis, the sanitary regulations that have been in operation for some years past are at length producing a decided effect in raising the standard of health, and diminishing the rate of mortality among all classes of the community. It is to be hoped that the "Artisans' and Labourers' Dwellings Improvement Bill," now passing through the Legislature, will largely enhance these beneficial results. I have the honour to be, Gentlemen, Your obedient servant, 1st May, 1875. GEORGE ROSS, M.D., Medical Officer of Health. APPENDIX. TABLE I. Registered Deaths in 53 Weeks of 1874. Sub-Districts of St. Giles, Sub-Districts. [Population, 1871.] First Quarter. 13 weeks. Second Quarter. 13 weeks. Third Quarter. 13 weeks. Fourth Quarter. 14 weeks. Whole Year, 1874. 53 weeks. m. f. m. f. m. f. m. f. m. f. Both Sexes. St. George, Bloomsbury. [17,843.] 53 45 27 32 37 36 50 45 167 158 325 St. Giles South. [19,089.] 78 92 68 60 55 60 85 90 286 302 588 St. Giles North. [16,497.] 39 45 32 36 48 30 37 67 156 178 334 Whole District. [53,429.] 170 182 127 128 140 126 172 202 609 638 1,247 TABLE II. Registered Births in 53 Weeks of 1874. Sub-Districts of St. Giles. Sub-Districts. First Quarter. 13 weeks. Second Quarter. 13 weeks. Third Quarter. 13 weeks. Fourth Quarter. 14 weeks. Whole Year, 1874. 53 weeks. m. F. m. f. m. F. m. F. m. f. Total Children. St. George,Bloomsbury 48 72 48 37 59 52 71 62 226 223 449 St. Giles South 125 125 98 74 76 67 114 109 413 375 788 St. Giles North 52 83 47 51 53 60 63 79 215 273 488 Whole District 225 280 193 162 188 179 248 250 854 871 1,725 1875. THE BOARD OF WORKS for the Saint Giles District. ANNUAL REPORT FOR THE YEAR ENDING 25th MARCH, 1875. Published pursuant to the Act 18 & 19 Vict., cap. 120. LONDON: KELLY & CO., PRINTERS, GATE STREET, LINCOLN'S INN FIELDS, W.C. THE BOARD OF WORKS For the St. Giles District. OFFICES, No. 199, HIGH HOLBORN, W.C. LIST OF THE MEMBERS OF THE BOARD, showing the year in which they go out of office. PARISH OF ST. GILES. Names. Addresses. Go out of office m ADLARD, Frederick 225, High Holborn 1876 BAKER, Charles 244, High Holborn 1877 BARRETT, Thomas 235, Tottenham Court Road ... 1877 BURDEN, Thomas 6, Store Street 1878 COOPER, Henry 20, Moor Street 1876 CORBEN, James Frederick... 30, Great Queen Street 1876 COWER, George Evelyn ... 1, Tavistock Street, Bedford Square 1878 CULL, Richard 13, Tavistock Street, Bedford Square 1876 DAVAGE, Frederick Byles,. 220, High Holborn 1878 DEED, Mark Hornsey 41 High Street 1877 GRIFFITH, Richard Clewin. 20, Gower Street 1878 HENDERSON, James 120, Great Russell Street 1877 HODGE, John 145, Drury Lane 1877 KERBY, Henry 545, New Oxford Street 1877 LAVERS, Nathaniel W 29, Endell Street 1877 LOVETT, Samuel Robert 13, Great Russell Street 1878 LOUGH, JosErH 70, Great Queen Street 1876 MAY, John 259, Holborn 1878 MOEDER, Frank 250, Tottenham Court Road 1877 PARSONS, Robert 6, Torrington Place 1877 PERRYMAN, Wm. Henry 232, Holborn 1878 PHILPOT, James 26, Endell Street 1876 SMITH, Joseph 28, Denmark Street 1878 SMITH, William 253, Tottenham Court Road 1876 SMITH, Gilbert 4, Gower Street 1878 WARNE, Thomas 33, Whetstone Park 1876 WILLSON, Thomas 68, Great Queen Street 1876 a 2 PARISH OF BLOOMSBURY. Names. Addresses. ADAMS, Borlase Hill 55, Torrington Square 1878 AMBLER, Matthew 122, High Holborn 1876 BARNETT, Edward 14, Woburn Square 1877 BENNETT, Benjamin 134, Southampton Row 1877 BELLAMY, Thomas 8, Charlotte Street 1876 BROUGH, John 144, Southampton Row 1876 CRAWFORD, Henry 118, Southampton Row 1877 CRONIN, Frederick Jambs 1, Vernon Place 1877 DOBREE, Robert John 15, Russell Square 1877 GOTTO, Henry Gaisford 13, Russell Square 1878 HEWITT, William Henry 23, Hart Street 1878 LATREILLE, Frederick 5, Bloomsbury Place 1877 PEACOCK, Joseph 15, Bloomsbury Square 1876 ROBARTS, Henry Pratt 43, Woburn Place 1876 RYDER, Francis B 16, Broad Street 1876 SIMMONS, Thomas 148, Southampton Row 1878 STATHAM, Hugh Worthington 50, Woburn Place 1878 THACKER, Samuel John 22, Montague Street 1878 TUCKETT, John 66, Great Russell Street 1876 TURNER, Charles Ernest 63, Great Russell Street 1877 WYATT, Matthew 8, Woburn Square 1878 REPRESENTATIVE AT THE METROPOLITAN BOARD OF WORKS. ADAMS, B. H., Esq., J.P., 55, Torrington Square. AUDITORS OF ACCOUNTS FOR THE PRESENT YEAR. EADE, Isaac, Mr., 130, High Holborn. HOLLEBONE, William Joshua, Mr., 19, Southampton Street. LEATHERS, Thomas, Mr., 40, Store Street. LIST OP THE OFFICERS OF THE BOARD. Names. Offices. Addresses. Salaries. JONES, John Henry Clerk to the Board 8, Hart Street, Bloomsbury £300 ROSS, George, M.D Medical Officer of Health 11, Hart Street, Bloomsbury £200 REDWOOD, Theophilus Analyst 17, Bloomsbury Square £100 WALLACE, George Surveyor 199, High Holborn £350 KERREY, Harry Accountant Clerk 199, High Holborn £120 DA VIES, Robert Surveyor's Clerk 199, High Holborn £100 FINNIS, Lewis Office Clerk 199, High Holborn £78 Hoyle, John Inspector of Nuisances, and under Adulteration of Food Act 199, High Holborn £120 HARTY James Sanitary Inspector High Holborn £78 SMITH, George Allen Sanitary Inspector 199, High Holborn £78 The Board of Works for the St. Giles District. ANNUAL REPORT, 1875. In compliance with the requirements of the Metropolis Management Act, the Board present to the Parishioners their Annual Report, comprising the Works commenced and completed, and those in progress; the proceedings for the Removal of Nuisances, the improvement of the Sanitary Condition of the District; the Reports of the Medical Officer of Health, and of the Analyst under the Adulteration of Food Acts, and abstracts and summaries of the Annual Accounts. The following meetings have been held during the year commencing June, 1874, and ending May, 1875:— Board Meetings 29 Finance Committee Meetings . 15 Works Committee „ 13 Sanitary Committee „ 15 Special Committees on various subjects 12 In all 84 Accounts. The Accounts of the Board are annexed to this Report. On perusal it will be seen that the largest item of the Board expenditure consists of the sum of £5,605 13s. 8d., paid to the Metropolitan Board of Works, for which precepts were made on this District, for the purposes following, viz.:— For the Consolidated Rate, including therein Main Drainage, Fire Brigade, Sinking Fund and General Expenses, the sum of . £5,551 6 5 For payment of the debts and liabilities of the late Commissioners of Sewers 54 7 3 Making together £5,605 13 8 8 The following table shows the several amounts paid by this District to the Metropolitan Board of Works for the last eight years:— Year. Amount. £ s. d. 1867-8 7,328 12 10 1868-9 6,297 8 5 1869-70 6,303 4 0 1870-1 6,648 13 10 1871-2 4,308 14 4 1872-3 3,244 0 10 1873-4 3,434 16 0 1874-5 5,605 13 8 The Board would call the attention of the Parishioners to the above items, which form a very large proportion of the rates, over which they have no control, and against which there is no appeal. The precept for the year 1875-6 amounts to £6,751 15s. 4d. nearly a sixth part of the annual expenditure of this Board. The amounts paid by this District to the London School since it was constituted are as follow:— Year. Amount. £ S. d. 1871 719 11 9 1872 1,208 8 10 1873 939 15 11 1874 2,348 5 1 In consequence of the extravagant and lavish expenditure in which the School Board have indulged, much dissatisfaction was expressed by the Ratepayers in all parts of the Metropolis, and the Board gladly co-operated with the Vestries of St. George Hanover Square, Kensington, St. Marylebone, St. Pancras, St. Martin-in-the-Fields, Mile End Old Town, Clerkenwell, and St. Luke's City Road, and the District Boards for Westminster, Holborn, Fulham and Whitechapel, in protesting against the heavy demand for the present year, amounting in this District to £3,875 19s. 3d., and at a meeting of the delegates on 27th April last, the following Resolution was passed unanimously:— "That this meeting, constituted of the Delegates of the several parishes of the Metropolis, deplores the course of action that has marked of late the conduct of the School Board, in changing the character for which the schools were originally intended, in establishing Board Schools in the very neighbourhoods where voluntary schools have existed and been found sufficient for their purposes; and also in the extravagant outlay which it has sanctioned, in the building of schools—making simplicity and economy give way before ornamental display and superfluous appliances. That this Meeting, powerfully impressed with the conviction that the burdens now imposed on the Ratepayers of London are most onerous, and, in fact most oppressive, protests against any further action on the part of the School Board that shall have a tendency to augment the present heavy rate. That a deputation be appointed to wait on Lord Sandon to point out to him the grievances of which the Ratepayers of London have such just cause of complaint, and praying that legislative means be employed to limitthe taxing powers of the Board." 9 A deputation subsequently waited on Lord Sandon, President of the Council of Education, and although no satisfactory result was immediately arrived at, the Board have reason to believe, from recent events, that the remonstrance will ultimately have a beneficial effect upon the policy and expenditure of the London School Board. This Board have no power of appeal against, or control over, the amounts imposed by the School Board. Watering the Streets. Under a contract for this purpose the District was efficiently watered, at a cost, for men, horses and carts, of . £897 10 0 And for water (4,648,000 gallons), meter hire and repairs to stand pipes 276 6 7 Total . . £1,173 16 7 Cleansing the Streets. A staff of Street Orderlies has been constantly employed for this purpose during the year, at a cost of £1,628 1 5 Removing the slop and dirt under contract . 1,735 2 0 Making the total expense £3,363 3 5 The speedy cleansing of the streets in bad weather is attended with much difficulty. The labour forms a considerable item of the expenditure. The Contractor experiences great difficulty in removing the slop and dirt. The Board have under consideration suggestions for improving the same, without increased cost, which is so much to be desired. Lighting the Streets. The moneys paid for this purpose were as follows:— The Imperial Gas Company £3,073 13 5 The London „ „ 1,622 4 8 The Chartered „ „ 70 17 8 Gas columns and alterations 99 6 9 £4,866 2 6 The great dissatisfaction felt last year by the inhabitants of the Metropolis at the large increase iu the price of Gas led to very active measures being taken by the Metropolitan Board of Works, the 10 trict Boards and Vestries, with the view of remedying, if not removing, the arbitrary and oppressive measures of the Companies. The result was a considerable reduction in the prices theretofore charged, the same being reduced, with some exceptions, to the former prices. The Metropolitan Board of Works, however, brought into Parliament Bills enabling them—1st. To purchase the existing Companies. 2nd. To establish independent Gas Works. 3rd. To amend the Metropolitan Gas Act of 1860, by giving them increased powers to deal with this important subject. These Bills are under the consideration of Parliament, and it is hoped that, by one or other of them, the public will be freed from the arbitrary powers of the Companies, and a fair and equitable charge for the supply of Gas in the Metropolis will be established. Dust and Ashes. The cost of removing the Dust and Ashes from the dwelling houses in the District during the year was £1,422 8s. Ad. Numerous complaints having been made to the Board of the neglect of the Contractor, an order for the better removal of the dust was issued, whereby the Contractor was required daily to send a sufficient number of carts and men into the District for the purpose of removal, and to go through the entire District once a week, calling in the several streets on fixed days. Notices of this order, and lists of the days and streets, were delivered at every house in the District. This arrangement has worked a great improvement, evidenced by the few complaints now received at the offices of the Board. Artizans' and Labourers' Dwellings Act, 1868. The Board have, under this Act, been endeavouring to improve the condition of the dwellings of the poorer classes in the District, and have made orders for the alteration and improvement of houses in Little Coram Street, Charles Street, Lloyd's Court and King's Arms Yard. They regret to state that the works ordered to be performed by one of the freeholders of the property on the south side of Church Lane have been neglected to be carried out. Those at the several houses on the north side of Church Lane have been performed to the satisfaction of the Board, and have much improved the sanitary condition of the same. Measures are being taken—so far as the law will allow—to prevent the occupation of the dwellings so neglected to be improved, and to cause the same to be entirely shut up, which the Board trust will have the effect of partially remedying the evils for which the Act was passed. Railways, etc., in the District. Prior to the commencement of the present Session of Parliament, this Board received Statutory Notices of applications by the London 11 and North Western and London Central Railways to take lands within the District of this Board. That by the first-named Company was to acquire by purchase, for offices and warehouses only, the buildings and premises theretofore used by them as such in New Oxford Street. The other application was to extend the time for acquisition of lands, &c., by the London Central Railway Company, for making an underground Railway from Charing Cross to join the Metropolitan Railway at Hampstead Road, by way of Tottenham Court Road; and also the formation of a new street from that road to St. Martin's Lane, to the cost of which new street the Metropolitan Board of Works were to be at liberty to contribute £200,000. It is much to be regretted that the Company failed to obtain the approval of the Committee of the House of Commons of their application, because the want of Railway communication in the Metropolis from North to South is a very great inconvenience, and daily becoming more serious, and the formation of the new street would have afforded a direct leading thoroughfare from the North to the South of the Metropolis, which does not at present exist. It would also have removed one of the most unhealthy and over-crowded spots in the Metropolis. Bury Street. During the year His Grace the Duke of Bedford has commenced to carry out a great and necessary improvement in the widening of this street, by taking down the houses on the east and west sides, from Hart Street as far as Little Russell Street and Pied Bull Yard, and appropriating a portion of the ground on which the same stood to the purpose of widening the street. It is believed that, as the leases of the remaining houses on the west side expire, the widening will be continued up to Great Russell Street, and that the class of houses to be erected thereon will greatly improve the character of the thoroughfare. Retirement of the Surveyor. It is with regret the Board announce the retirement of Mr. W. J. Trehearne, the Surveyor for upwards of nineteen years of this District, arising from entire loss of sight. The Board have, under such painful circumstances, exercised the power vested in them by the Statute, 29 Vic. cap. 31, and granted to Mr. Trehearne an annual allowance of £100. They have appointed Mr. George Wallace, late of the Engineers' Office, Guildhall, City, in the place of Mr. Trehearne, and they trust he will be found an able and active officer. His entire time is to be devoted to his duties, and he is debarred from private practice. Medical Officer of Health. The duties of this Officer (who was appointed in 1869) having enlarged, the Board have increased the stipend to £200 per annum. 12 Adulteration of Food Acts, Having regard to the dense and poor population of a large portion of this District, the Board have felt it was of the first importance that the Act should be actively enforced; and in this they have been ably assisted by the Analyst and other Officers. There have been 281 cases of analyses during the year. Proceedings were taken in 28 cases, and 24 convictions obtained. In three cases, there having been previous convictions, the magistrates, under a power given by the Act for that purpose, caused the names and addresses of the offenders and the convictions to be advertised in the newspapers. The fines and costs imposed in the several convictions amounted to £42 4s. 6d. The annual report of the analyst is annexed, and contains other information on this subject. The Board regret to find that the Acts have not been vigorously carried into effect in other Districts in the Metropolis. In some the District Boards or Vestries have, under pressure by the Local Government Board, appointed Analysts, but no further attempts (or, at best, very insignificant) have been made to remedy the extensive sale of adulterated articles of consumption in the Metropolis. Such a state of things is extremely discouraging and unsatisfactory, and ought not to exist. Sanitary Acts. There have been several cases of prosecutions and convictions under the Nuisance Removal Acts, particulars whereof will be found in the Report of the Medical Officer hereunto annexed. Offices of the Board 199, High Holborn, 30th June, 1876. THE SAINT GILES DISTRICT, PURPOSES, from 25th day of March, 1874, to 25th day of March, 1875. PAYMENTS. Folio in Ledger. £ s. d. To Balance overdrawn, 25th March, 1874 715 17 10 Salaries:— Salaries of Officers 47 1,684 19 9 Paving:— Wages of Workmen and Labourers 64 3,249 4 5 Granite and Footway Paving Stones 71 2,106 5 11 Gravel, Sand, Lime, &c 76 1,434 16 1 Smith's Work, Implements, &c 79 117 16 6 Wheelwrights' Work 81 32 7 0 Pauper Labour 87 5 1 3 Cleansing:— 6,945 11 2 Wages of Street Orderlies 96 1,486 8 2 Cartage of Slop 104 1,735 2 0 Miscellaneous Payments, Street Orderlies 107 141 13 3 Dusting:— 3,363 3 5 Removal of Dust 109 1,422 8 4 Lighting:— Lighting Public Lamps 120 4,766 15 9 Gas Columns, Lanterns, &c 114 99 6 9 Watering:— 4,866 2 6 Contract for 116 897 10 0 Repairs of Stand Posts 125 36 4 0 Water for Stand Pipes 126 240 2 7 Office Expenses:— 1,173 16 7 Stationery and Printing 128 95 1 10 Insurance of Offices, Taxes, &c 131 28 3 0 Advertisements and Stamps 133 26 1 10 Other Expenses:— 149 6 8 Carpenters' Work 135 21 12 2 Painting and Plumbers' Work 137 30 10 4 Miscellaneous Payments 143 312 3 6 Incidentals 145 5 19 1 370 5 1 Surveyor's Fees for Licenses 146 99 5 0 Balances of Deposits returned 148 50 13 0 Law Costs 149 4 17 0 London School Board, payment under precept for defraying expenses 185 2,348 5 1 Alterations at Offices and Premises of the Board 187 466 10 6 Vestry of St. Pancras:— Cleansing, &c., portion of the Carriage-way of Tottenham Court Road for one year, as per agreement 197 182 8 0 23,843 9 11 Balance at Bankers, 25th March, 1875 692 15 1 Amount due from Foundling Estate a/c, 25th March, 1875 240 15 5 933 10 6 £24,777 0 5 THE BOARD OF WORKS FOR Abstract of Receipts and Payments of the above Board, for GENERAL RECEIPTS. Ledger £ s. d. Amount due from Brunswick Square a/c, 25th March, 1874 27 0 0 From Joint Vestry of St. Giles and Bloomsbury, pursuant to precept of the 16th September, 1873, for the general purposes of the Board 8 2,400 0 0 Ditto, ditto, 10th March, 1874 ditto 9 15,000 0 0 Ditto, ditto, 15th Sept., 1874 ditto 9 5,600 0 0 From Gas and Water Companies, &c. 13 938 11 5 From Sewer Account : Superintending Expenses of Sewers 20 600 0 0 From the Vestry of St. Pancras for Cleansing, &c., portion of the Carriage-way of Tottenham Court Road for one year, as per agreement . 197 181 9 0 24,747 0 5 Amount due to Brunswick Square Garden Rate a/c, 25th March, 1875 30 0 0 £24,777 0 5 Summary of General Account, from the 25th day of March, 1874, to the 25th day of March, 1875. RECEIPTS. £ s. d. PAYMENTS. £ s. d. Amount due from Brunswick Square a/c 27 0 0 Balance overdrawn, 25th March, 1874 715 17 10 From Joint Vestry of St. Giles and Bloomsbury, pursuant to precepts of the Board 23,000 0 0 Salaries 1,684 19 9 Paving 6,945 11 2 From Gas and Water Companies, &c. 938 11 5 Cleansing 3,363 3 5 From Sewers Account, Superintending Expenses of Sewers 600 0 0 Dusting 1,422 8 4 Lighting 4,866 2 6 From Vestry of St. Pancras 181 9 0 Watering 1,173 16 7 Office Expenses 149 6 8 24,747 0 5 Other Expenses 370 5 1 Surveyor's Fees 99 5 0 Balance of Deposits returned 50 13 0 Law Costs 4 17 0 London School Board, pursuant to precept 2,348 5 1 Alterations at Offices and Premises of Board 466 10 6 Vestry of St. Pancras 182 8 0 23,843 9 11 £ s. d. Balance at Bankers, 25th March, 1875 692 15 1 Amount due from Foundling Estate Amount due to Brunswick Square a/c, 25th March, 1875 30 0 0 a/c, March 25th, 1875 . 240 15 5 933 10 6 £24,777 0 5 £24,777 0 5 Abstract of Receipts and Payments for SEWERS, from the 25th day of March, 1874, to the 25th day of March, 1875. RECEIPTS. Folio in Ledger £ s. d. PAYMENTS. Folio in Ledger. £ s. d. Balance at Bankers, 25th March, 1874 . 1,313 3 8 Superintending Expenses of Sewers 150 600 0 0 Amount received from the Joint Vestry of Saint Giles and Bloomsbury, pursuant to precept of the 18th March, 1873 24 350 0 0 Tradesmen's Accounts for Materials 161 535 12 1 Men's Wages 174 758 19 9 Metropolitan Board of Works, pursuant to precept of the 9th January, 1874 181 54 7 3 Ditto, 10th March, 1874 25 2,050 0 0 Entrances into Sewers, &c. 29 41 1 6 New Sewers, Contract for 183 1,987 10 11 3,754 5 2 To Balance overdrawn at Bankers, 25th March, 1875 182 4 10 £3,936 10 0 £3,936 10 0 Summary Sewers Account, from the 25th day of March, 1874, to the 25th day of March, 1875. RECEIPTS. £ s. d. PAYMENTS. £ s. d. Balance at Bankers, 25th March, 1874 . Amount received ...... 1,313 2,441 3 1 8 6 Payments . 3,936 10 0 3,754 5 2 Balance overdrawn at Bankers, 25th March, 1875 . 182 4 10 £3,936 10 0 £3,936 10 0 Abstract of Receipts and Payments on the FOUNDLING ESTATE ACCOUNT, from the 25th day of March, 1874, to the 25th day of Mareh, 1875. RECEIPTS. Folio in Ledger. £ s. d. PAYMENTS. Folio in Ledger £ s. d. Balance, 25th March, 1874 16 15 10 Interest to Bondholders of Foundling Estate Balance due to General Account, 25th March 187 240 15 5 190 257 11 3 £257 11 3 £257 11 3 Summary of Foundling Estate Account, from the 25th day of March, 1874, to the 25th day of March, 1875. RECEIPTS. £ s. d. PAYMENTS. £ s. d. Balance, 25th March, 1874 16 15 10 Interest to Bondholders 257 11 3 Balance due to General Account, 25th March, 1875 240 15 5 £257 11 3 £257 11 3 Brunswick Square Garden Rate Account. RECEIPTS. Folio in Ledger. £ s. d. PAYMENTS. Folio in Ledger. £ s. d. From Joint Vestry of St. Giles and Bloomsbury pursuant to precept of 18th March, 1873 37 27 0 0 Amount due to General a/c, 25th March, 1874 27 0 0 Amount due from General a/c, 25th March, 187 5 30 0 0 Ditto ditto 10th March, 1874 30 0 0 £57 0 0 £57 0 0 Summary of Brunswick Square Garden Rate Account. PAYMENTS. £. s. d. RECEIPTS. £ s. d. Amount due to General a/c, 25th March, 1874 . 27 0 0 Receipts 57 0 0 Ditto from General a/c 25th March 1875 30 0 0 £57 0 0 Metropolitan Consolidated Rate Account. RECEIPTS. Folio in Ledger £. s. d. PAYMENTS. Folio in Ledger. £. s. d. From Joint Vestry of St. Giles and Bloomsbury, pursuant to precept of 10th March, 1874 41 5,551 6 5 Metropolitan Board of Works 199 5,551 6 5 Summary of Metropolitan Consolidated Rate Account. RECEIPTS. £ s. d. PAYMENTS. £ s. d. Receipts 5,551 6 5 Payments 5,551 6 5 General Account. Moneys owing to the above Board, 25th March, 1875, and Stock Debts and Liabilities of the above Board, 25th March, 1875. in Hand. £ s. d. £ s. d. Balance at Bankers 692 15 1 Amount due to Brunswick Square a/c 30 0 0 Amount due from Foundling Estate a/c 240 15 5 Bills due to Tradesmen 916 17 1 Balance due from Joint Vestry on precept of Board of the 15th September, 1874 . 2,400 0 0 Balance due on deposits unclaimed up to the 25th March, 1875 524 16 3 Amount due from Joint Vestry on precept of Board of the 9th March, 1875 15,000 0 0 By Amount due to School Board for London under their precept 3,875 19 3 Impress money in hands of Clerk 100 0 0 By Amount due to Surveyor for License Fees, retained by the Board Amount due from Gas and Water Companies 302 2 2 81 7 6 Amount due from various persons for restoration of Paving 340 19 7 Amount due from Sewer a/c for Materials . 40 13 1¼ 5,429 0 1 Materials and Implements in Stock 669 7 0 Balance 14,357 13 1¼ £19,786 13 2¼ £19,786 13 2¼ Sewer Account. Moneys ouiing to the above Board, 25th March, 1875, and Stock Debts and Liabilities of the above Board, 2bth March, 1875. in Hand. £ s. d. £ s. d. Balance due from Joint Vestry on precept of the Board of 10th March, 1874 450 0 0 Balance overdrawn 182 4 10 Bills due to Tradesmen, &c. 110 1 11 Amount due from Joint Vestry on precept of the Board of 9th March, 1875 3,500 0 0 Balance due on deposits unclaimed 162 0 4 Amount due to General Account for Materials 40 13 11¼ Amount due from various persons for disturbed works 14 18 8 Materials and Implements in Stock 155 1 7 495 1 0¼ Balance 3,624 18 93/4 £4,119 19 10 £4,119 19 10 FOUNDLING ESTATE ACCOUNT. Proportion of Bond Debt on the Foundling Estate Account, transferred to this Board by order of the Metropolitan Board of Works, of the 1st day of August, 1856, £6,746. Moneys owing to the above Board, 2bth March, 1875. Debts and Liabilities of the above Board, 25th March, 1875. £ s. d. £ s. d. Amount due from Joint Vestry on precept of Board of the 10th March, 1874. Interest due to Bondholders to Christmas, 1875 19 8 11 263 6 2 Property tax ditto 2 10 8 Amount due do. 9th March, 1875 269 16 9 Interest due to Bondholders to Lady-day, 1875 67 9 2 Amount due to General a/c, 25th March, 1875 240 15 5 330 4 2 Balance 202 18 9 £533 2 11 £533 2 11 Metropolitan Consolidated Rate Account. Moneys owing to the above Board, 25th March, 1875. Debts and Liabilities of the above Board, 2bth March, 1875. £ s. d. £ s. d. Amount due from Joint Vestry, on precept of the Board of the 9th March, 1875 6,751 15 4 Precept of Metropolitan Board of Works of the 8th day of January, 1875 6,751 15 4 Brunswick Square Account. Moneys owing to the above Board, 2bth March, 1875. Debts and Liabilities of the above Board, 2bth March, 1875. £ S. d. £ s. d. Amount due from Joint Vestry, pursuant to precept of the Board of the 9th March, 1875 34 0 0 Amount due under the requisitions of the Garden Committee of Brunswick Square 64 0 0 Amount due from General a/c, 25th March, 1875 . 30 0 0 £64 0 0 £64 0 0 We, John Reynolds and Charles Jackson, two of the Auditors appointed by the Board of Works for the St. Giles District, to examine and audit the Accounts of the said Board up to the 25th day of March, 1875, having carefully investigated the Accounts of the said Board up to the period aforesaid, and the Vouchers in support of the same, and the Books, Papers and Writings in their custody or control, do hereby certify and declare that me have this day Audited the said Accounts of the Board, at their Offices, 199, Holborn, and that the same Accounts are true and correct in all particulars, and me do allow the same accordingly, and sign the same in token of such our allowance thereof. Given under our hands this Twenty-seventh day of May, One thousand eight hundred and seventy-five. JOHN REYNOLDS. CHARLES JACKSON. Summary Statement of all Contracts Entered into by the above Board, up to the 25th day of March, 1875. Messrs. A. & F. MANUELLE, Seeth- For the supply of Yorkshire Paving ing Lane, City. Stone, Aberdeen Granite, Granite Curb, and Guernsey Granite, for 12 months, from the 29th of September, 1874, at the several prices set out in the Contract. Mr. CHARLES KILLINGBACK, For the supply of Thames Sand, Upper James Street, Camden Town. Ballast, and Gravel, and the cartage of Old Materials, &c., for 12 months, from the 29th September, 1874, at the several prices set out in the Contract. Mr. THOMAS HOBBS, Paddington. For the removal of Slop swept up by the men employed by the Board, for 12 months, from the 29th September, 1874, for the sum of £1,300. Mr. THOMAS HOBBS, do. For the removal of Dust and Ashes from the houses of the inhabitants, for 12 months, from the 29th September, 1874, for the sum of £1,190. Mr. WILLIAM PERKINS, do. For watering the District during the season, 1875, for the sumof £1,100. Mr. CHARLES KILLINGBACK, For the supply of man, horse and Upper James Street, Camden Town. harness, and cart, for 12 months, for the sum of £130. Mr. C. KILLINGBACK,Upper James For the construction of new Sewers Street, Camden Town. in Bedford Place, Little White Lion Street, Church Passage (from Dudley Street to New Compton Street), Little Wild Street, and Chapel Place, Lincoln's Inn Fields, within the District of the Board, for the sum of £1,109. THE IMPERIAL GAS COMPANY.—The reduced cost for annual lighting of the District north of Holborn is £4 18s. 0d. for each Batswing burner lamp, and £3 6s. 0d. for each Cockspur burner lamp, including repairs, and painting the lamps and posts. THE LONDON GAS COMPANY.—The present cost for annual lighting the District south of Holborn is £5 Is. 4d. for each Batswing burner lamp, and £3 8s. 4d. for each Cockspur burner lamp, including repairs, and painting the lamps and posts. No reduction has been made by the Company. THE CHARTERED GAS COMPANY.—The reduced cost for annual lighting the portion of the District in Tottenham Court Road is £3 19s. 8d. for each lamp. The Board of Works for St. Biles District. SURVEYOR'S DEPARTMENT-REPORT. Gentlemen,— Appended is a summary of the Works commenced, completed, and in progress, under the superintendence of this Department, for the year ending 25th March, 1875. Maintenance of Streets. The cost of keeping in repair the undermentioned Macadamized Streets in the District during the year, namely, Bedford Square, Bedford Place, Bernard Street, Brunswick Square, Chenies Street, Hart Street, Montague Street, Russell Square, Torrington Place, Upper Bedford Place, &c., was as follows:— 892 yards of broken Granite £698 14 8 The cost of labour in repairing and spreading the materials on the streets for the year was 79 12 6 The cost of the steam roller in consolidating the Macadam was 50 7 6 Making together £828 14 8 Carriage-Ways. The Carriage-way Paving of the following Streets has been redressed and relayed on a bed of concrete 9 inches deep, at the following cost:— Russell Square 1,421 12 10 Southampton Row 600 6 7 South Keppel Mews 586 4 4 Short's Gardens 89 6 8 Brunswick Mews 277 12 4 Newton Street 188 8 1 Prince's Street, Drury Lane 184 14 2 Montague Mews 723 1 1 The following Street has been paved with new Aberdeen Granite Cubes:— Great Saint Andrew Street 553 14 1 Making together £4,625 0 2 26 Footway Paving. The following Streets have been relaid with new 3-inch Yorkshire Paving and Kerb:— Newton Street (at a cost of) £80 10 2 Princes Street, Drury Lane „ 52 17 9 £133 7 11 Sewers Works. New Sewers have been constructed in the following Streets:— Bedford Place, Little White Lion Street, Church Passage (from Dudley Street to New Compton Street), Little Wild Street, Chapel Place, Lincoln's Inn Fields, at a cost of £1,150 3s. 1d. The following Streets and Mews in the District are paved with Pebbles, and are to be repaired and paved with Guernsey Granite as circumstances permit, namely:— Alfred Mews Bedford Head Yard (Southampton Row) Bernard Mews Chapel Place (Duke Street, Lincoln's Inn Fields) Colonnade Mews Caroline Mews Chenies Mews Charlotte Mews George Yard (Little Queen Street) Gower Mews Hunter Mews Henrietta Mews King's Arms Yard (Silver Street) King's Arms Yard (Coal Yard) King's Arms Yard (Duke Street, Lincoln's Inn Fields) King's Head Yard (Duke Street, Bloomsbury) Little Britain Montague Mews (Upper) New Yard (Great Queen Street) Pied Bull Yard Queen's Head Yard (Great Queen Street) Red Lion Yard (Part) Russell Mews (Part) Torrington Mews East Torrington Mews (Part) Woburn Mews East Woburn Mews West W. J. TREHEARNE, Surveyor to the Board. 1874—5. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. PAGE General Mortality in the Metropolis, &c. 27 The Birth-rate in St. Giles District 28 Analysis of ditto 29 Table of Birth-rate to population 30 The Death-rate in St. Giles District 31 Analysis of ditto 32 Table of Death-rate to population 32 Comparative Death-rate in St. Giles in 1874, and ten previous years 32 Causes of increased Mortality in St. Giles South 32 The Death-rate among Infants in St. Giles District 33 The Death-rate among Persons 60 years of age and upwards in ditto 33 The Death-rate among Persons at all ages in ditto 34 The Boys' Refuge in Great Queen Street 35 Table showing the annual rate of Mortality, Death rates among Children,. &c. 36 Table showing the number of Deaths in ten years from seven principal Zymotic Diseases 37 Table showing the Mortality from certain classes of Diseases, and proportions to Population 38 Pulmonary Diseases and their Causes 38 The Influence of Flowering Plants in Purifying the Atmosphere 39 The Death-rate among the Zymotic Diseases 39 Small-Pox, Measles, Scarlet Fever, Diphtheria, Croup 40 Whooping Cough, Fevers, Diarrhoea 41 Inquest Cases. 41 Mortality in the Workhouse 42 Bloomsbury Dispensary 42 The British Lying-in Hospital 42 The Infant's Home and Necessity of Registration 43 The Sanitary Work of the year 43 Articles Disinfected 44 Provisions Condemned 45 Cowsheds, Slaughter Houses, Bakehouses, Rag and Bone Shops 45 Underground Rooms, Condemned Houses 45 APPENDIX. Table of Registered Deaths 46 Table of Registered Births 46 Table showing the Mortality in each Quarter, and in each Sub-District. Facing Table showing the Causes of Death in St. Giles District with the Ages at Death page 46 TO THE BOARD OF WORKS FOR THE ST. GILES DISTRICT. Gentlemen,— 1. In an interesting preface to his last "Annual Summary," the Registrar General sets forth many important facts bearing on the vital statistics of the Metropolis. I propose to refer to those only which afford materials for a comparison with the facts that constitute the subject-matter of my Report for this District. 2. With respect to the general health of the population of London, the Registrar General points out that there has been a marked reduction in the mortality. For the ten years 1840-49, the Death-rate was 25.2; for the thirty-five years 1840-74, it was 24.2; and for the last three years, 1872-74, it was 22.2. 3. With the view of showing the corresponding improvement in St. Giles District, the following facts may be cited: for the ten years 28 1861-70, the Death-rate was 28.4, and for the four years 1871-74, 24.73. The improvement has, therefore, been more decided in St. Giles than in the Metropolis at large, but this must be regarded as chiefly owing to the greater need and larger opportunity for improvement in this District than in the more extensive area of the Metropolis. 4. The Registrar General remarks that "the Bill now before Parliament to facilitate the abolition of rookeries in great cities, and to promote the erection of healthier dwellings, will carry the improvement further." Of the soundness of this opinion there cannot be a doubt. 5. The population of London, within the Registration division (estimated for the middle of the year), was 3,400,701; the Birth-rate was 35.7 per thousand, and the Death-rate 22.5. The estimated increase of the population was 44,544. The Birth-rate for St. Giles District, for 1874, was 29.23 (see Table, No. 2), and the Death-rate, 25.68 (see Table, No. 4). 6. We have had therefore a much lower Birth-rate, and a higher Death-rate than the Metropolis. Our Sub-District, which had the highest Birth-rate (31.82), viz.: St. Giles North, fell far below the Metropolis; on the other hand, two of our Sub-Districts show a Death-rate less than the Metropolitan—one of them, Bloomsbury, very much less—and the comparison is carried against us only by the very high death rate of St. Giles South The causes of these differences in the mean rates would be a most interesting subject of investigation—more especially as regards the Birth-rate—for there can be no doubt that our population has many peculiarities that habitually tend to keep our Birth-rate at a low standard. The Birth-rate in St. Giles District. 7. The number of Registered Births in St. Giles District, for the year 1874, was 1,725; of which 449 are attributed to the SubDistrict of St. George, Bloomsbury, 788 to St. Giles South, and 488 to St. Giles North.* 8. These numbers, however, do not accurately represent the Birth-rate, either in the whole District or in the Sub-Districts, and require correction in various ways. For example, there were 163 women confined in the British Lying-in Hospital, who gave birth to 167 children. Only 27 of the mothers belonged to the united parishes; there are, therefore, 140 births that must be deducted from the aggregate number, and also from the number for St. Giles South, in which Sub-District the Hospital stands. Again there were 134 births in the Workhouse, all of which are registered against the Sub-District of St. Giles South. I find that of this number 18 belonged to St. George Bloomsbury, by previous residence of the * The number of Registered Births here recorded is larger than stated in the Returns of the Registrar General, as this year, for the district of St. Giles, comprises 53 weeks—a correction that has to be made form time to time. 29 mothers, 55 to St. Giles South, 28 to St. Giles North, 20 to the Strand District, and there were 13 whose parishes could not be clearly ascertained. Three of the latter were undoubtedly outsiders, the other 10 were presumably belonging to one or other of the united parishes. I shall, therefore, enumerate them as our own, and distribute them proportionately among the three Sub-Districts, viz., 2 to St. George Bloomsbury, 5 to St. Giles South, and 3 to St. Giles North. After these deductions have been made, there will be only 60 of the births in the Workhouse that belong St. Giles South. The births deducted from St. Giles South must be added to the other Sub-Districts. To revert to the births in the British Lying-in Hospital; we noticed that there were 27 births in that Institution which belonged to this District, and of that number 5 must be appropriated to St. George Bloomsbury, 16 to St. Giles South (where they are already registered), and 6 to St. Giles North. The 5 and 6 must be added to the numbers for these Sub-Districts. 9. This analysis is necessarily tedious, because complex; but the results show that the statement of births by the Registrar General does not accurately represent the actual facts of the birth-rate in our District and its Sub-Districts; and if exactness be desirable in this respect—as most unquestionably it is, for without it there cannot be a safe basis for further calculations—such a minute analysis as that now made is indispensable. I do not wish to be misunderstood as criticising captiously the Registrar General's returns. They are exact so far as they exhibit the actual registrations, and they are absolutely necessary to a more detailed investigation. 10. For the sake of clearness I will put these calculations in a tabular form. TABLE No. 1. Analysts of the Births in St. Giles District. St. Giles District. St. Giles South, Sub-District. St. Giles North, Sub-District. St. George Bloomsbury, Sub-District. Registered Births 1,725 Registered Births 788 Registered Births 488 Registered Births 449 Deduct Births in the British Lying-in Hospital 140 Deduct outsiders in Lying-in Hospital 140 Add Births in Workhouse 31 Add Births in Workhouse 20 Add Bir hs in Hospital 6 Add Births in Hospital 5 Deduct Strand and miscellaneous Births 23 S t. George's (Workhouse) 20 37 25 Actual Births 525 Actual Births 474 St. George's (Hospital) 5 163 525 25 563 Actual Births 1,562 St.GilesNorth (Workhouse) 31 Total Births 1,562 St.GilesNorth (Hospital) 6 37 Strand in Workhouse 20 Miscellaneous in Workhouse 3 = 225 Actual Births 563 30 As I pointed out last year these conclusions are more in accordance with the population of the several Sub-Districts than the numbers registered by the registrars. 11. I will now give the mean Birth-rate of St. Giles District and its Sub-Districts in the usual tabular form. TABLE No. 2. The Birth-rate to Population in St. Giles and its Sub-Districts in 1874. Sub-Districts. Population. Births. Ratio of Births to Population. Rate, per 1000. St. George Bloomsbury.. 17,843 474 1 in 37.64 26.56 St. Giles South 19,089 563 1 in 33. 9 29.49 St. Giles North 16,497 525 1 in 31.42 31.82 Whole District 53,429 1,562 1 in 34.2 29.23 The mean annual Birth-rate for three years has been 30.3 per 1,000; the mean Birth-rate, therefore, for 1874 is a little below the average. The Death-Rate in St. Giles District. 12. The mean annual Death-rate must be ascertained by a similar method to that employed for determining the Birth-rate. The corrections are as complex as those in the case of the Birth-rate, but are more difficult to make. This difficulty is owing to the facts being derived from the Workhouse books, which, not being kept with any reference to vital statistics, do not always afford data sufficiently exact to work with. For example, there is no record in the books of the "previous residence" of the patients who died in the Highgate Infirmary; and inasmuch as the accuracy of these tables depends upon the essential fact of "previous residence," it is obvious that my corrections must be, to some extent, imperfect. The following statement will, however, give a tolerably accurate analysis of the deaths in the Workhouse. 13. The whole number of recorded deaths in the House, for the year 1874, is 187, viz., 24 for St. George Bloomsbury, 84 for St. Giles South, 35 for St. Giles North, 12 for the Strand, and 32 miscellaneous. Under the latter head I include persons who have lived more than 12 months in the House, and who may be fairly regarded as denizens of the House. 14. To these 187, must be added 29 deaths in Stockwell and 31 Homerton (viz., 1 Workhouse, 5 St. George Bloomsbury, 15 St. Giles South, and 18 St. Giles North), and 59 in the Highgate Infirmary. The additions make together 275 Workhouse deaths,— minus 18 referred to below (§16)=257 deaths in Workhouse. 15. Besides the foregoing, there were 87 deaths in the General Hospitals of persons belonging to our District, which must be added to our general registered mortality. The Hospitals from which these deaths were collected are the following:—Middlesex, 15; Charing Cross, 19; University College, 7; King's College, 32; St. Bartholomew's, 5; St. George's, 1; Westminster, 1; Childrens' Hospital, 3; London Fever, 4. I am much indebted to the authorities of these institutions for kindly permitting the inspection of their voluminous records. The aggregate additions to the registered deaths from all sources is therefore 175. 16. There are now certain deductions to be made of deaths of persons who did not belong to our District, which were registered within it. For example: there were 12 deaths in the Workhouse of Strand parishioners, and about 6 miscellaneous; these must be deducted from the 275 deaths in Workhouse, leaving 257. There was 1 in the British Lying-in Hospital, and 31 in the Infants' Home, Great Coram Street—altogether 50. Then, corrections must be made for the Sub-Districts, as well as for the whole Districts. The following Table shows the entire calculation at a glance:— TABLE No. 3. Analysis of the Deaths in St. Giles District. St. Giles District. St. Giles South, Sub-District. St. Giles North, Sub-District. St. George Bloomsbury, Sub-District. Registered Deaths 1,247 Registered Deaths 588 Registered Deaths 334 Registered Deaths 325 Add Deaths in General Hospitals 87 Add Deaths in General Hospitals 48 Add Deaths in General Hospitals 18 Add Deaths in General Hospitals 21 Add Deaths in Stockwell 29 Add Deaths in Stockwell 16 Add Deaths in Stockwell 8 Add Deaths in Stockwell 5 Add Deaths in Highgate 59 64 26 26 652 Total, 360 351 175 1,422 Deduct Strand 12 Deduct Deaths in Infants Home 31 Deduct Miscellaneous 6 Deduct Strand 12 Deduct Miscellaneous 6 Deduct Lyingin Hospital 1 Total, 320 Deduct Lyingin Hospital 1 19 St. Giles North 360 Total, 633 St Giles South 633 Deduct Infants Home 31 1,313 50 Add Deaths in Highgate(Persons Residences unknown) 59 Total, 1,372 Total, 1,372 17. I will now append the usual Table showing the mean annual Death-rate in the District and Sub-Districts. 32 TABLE No. 4.—The Death-rate to Population in St. Giles and its Sub-Districts in 1874. Sub-Districts. Population. Deaths. Ratio of Deaths to Population. Rate per 1,000. St. George, Bloomsbury. 17,843 320 1 in 55.76 17.94 St. Giles South 19,089 633 1 in 31.73 33.16 St. Giles North 16,497 360 1 in 45.82 21.82 Highgate Infirmary ... 59 ... ... Whole District 53,429 1,372 1 in 38.94 25.68 Our average Death-rate for ten years being 27.29, it is apparent that our Death-rate last year was 1.61 below the average. 18. On comparing the Birth-rate with the Death-rate, we find that our Births last year exceeded our deaths by 190 only, which represents the natural increase of our population. Our population is, however, actually decreasing, owing to emigrations and conversion of dwelling houses into warehouses, &c. 19. The following Table shows the comparative Death-rate in St. Giles and its Sub-Districts for a period of ten years, with the Deathrate for 1874. TABLE No. 5.—Death-rate per 1,000 in Sub-Districts. Districts. 1864. 1865. 1866. 1867. 1868. 1869. 1870. 1871. 1872. 1873. Average Death-rate of 10 years. 1874. St. George, Bloomsbury 21.6 2.1 20.0 19.0 21.0 21.16 22.1 21.2 19.67 18. 0 20.48 17.94 St. Giles South 34.8 34.6 32.8 31.6 31.1 33.20 34.1 28.3 24.41 30.2 31.51 33.16 St. Giles North 29.2 26.6 29.8 26.6 25.3 29.47 27.5 23.4 21.15 20. 3 25.93 21.82 Whole District 31.1 29.6 29.0 26.9 26.8 27.94 28.19 25.6 23.77 23.90 27.29 25-.68 Increased Mortality in St. Giles South. It is thus apparent that whilst St. George Bloomsbury and St. Giles North have had a mean Death-rate below the decennial average, that of St. Giles South has been above it, the general Death-rate for the District having been below the average as 25.68 is to 27.29. 20. The increased mortality in St. Giles South was caused by a continuance of the endemic of typhus fever (chiefly among the inhabitants of the Great Wild Street section), and by pulmonary affections. The latter are the constant scourge of this Sub-District, and as the Metropolis generally suffered more than usual from these maladies, owing to the remarkably low temperature of the latter months of the year, we cannot be surprised that the mortality in St. Giles South should exhibit a marked increase. I may observe that the temperature fell suddenly in the week ending the 28th November, from a mean of 44°1" to a mean of 32° 8"; and in that and the following week 33 the mortality rapidly increased. The cold was most fatal to the old, the very young, the diseased, and the debilitated. The Registrar General has indicated a remarkable law, subject to which death from cold takes place. He says, in brief, "taking the increase of mortality by cold between 20—40 as one, then the mortality became 2, 4, 8, and so on, doubling every 9 years." Again, "the mortality from cold increased 8 per cent. for every year of age, or it doubled every 9 years from the age of 20, as it did in 1855." The Death-rate among Infants in St. Giles District. 21. In the year 1874 the number of deaths among Infants under 1 year of age was 286 (excluding the deaths in the Infants' Home and the British Lying-in Hospital). Of these 66 belonged to St. George Bloomsbury, 134 to St. Giles South, and 86 to St. Giles North. 22. The rate of mortality in each Sub-District was as follows:— Whole District 1 Death in every 5.46 Births = 18.4 per cent. of Births. St. George Bloomsbury 1 do. do. 7.18 do. = 13.92 do. St. Giles South 1 do. do. 4.2 do. = 23.8 do. St. Giles North 1 do. do. 6.1 do. = 16.4 do. 23. The subjoined table shows the proportion of deaths of Infants to all deaths, which is the ordinary mode of comparison. Whole District 1 Death to every 4.8 of all Deaths St. George Bloomsbury 1 do. do. 4.85 do. St. Giles South 1 do. do. 4.72 do. St. Giles North 1 do. do. 4.19 do. 24. There appears, on the surface, a remarkable discrepancy between these tables. According to the second table, St. George Bloomsbury (1 in 4.85), and St. Giles South (1 in 4.72), are nearly on a par as regards deaths of infants to total deaths, and a stranger to the district would conclude, unhesitatingly, that their sanitary condition must be similar. This conclusion would, however, be erroneous, and would be dissipated on an examination of the first table, when the deaths of infants, to births, in St. George Bloomsbury, is represented as 1 in 7.18, and in St. Giles South, as 1 in 4.2. The deaths in St. Giles South are clearly in great excess. 25. The reason why the Death-rate of infants, in relation to total deaths, is nearly as high in Bloomsbury as in St. Giles South, is because St. George Bloomsbury has a low Death-rate at all ages, which, of course, gives a relative preponderance to its infant deaths. This method of estimating the Death-rate is liable to fallacies, which are avoided by estimating it in relation to births. The Death-rate among Persons 60 years of Age and upwards. 26. The registered deaths among persons 60 years of age and upwards were 278; but various corrections have to be made, as I have already detailed (§ 12), with reference to the general Deathrate. After these corrections, the number is 287, of which 62 c 34 belonged to St. George Bloomsbury, 164 to St. Giles South, and 61 to St. Giles North. The rates in the Sub-Districts are as follows Whole District 1 death in every 4.93 of all deaths and in every 192 of pop. St. George Bloomsbury 1 do. do. 5.16 do. do. do. 287 do. St. Giles South 1 do. do. 3.86 do. do. do. 116 do. St. Giles North 1 do. do. 6.9 do. do. do. 270 do. The Death-rate among Persons at all Ages. (INFANTS AND PERSONS 60 YEARS OF AGE AND UPWARDS BEING EXCLUDED.) 27. The number of deaths among persons at all ages was (after excluding the deaths in the Highgate Infirmary), 749. Although these deaths are excluded from the Sub-Districts, they are included in the Deaths for the whole District. The proportions to be distributed among the Sub-Districts are as follow:—192 to St. George Bloomsbury, 344 to St. Giles South and 213 to St. Giles North. 28. The ratios to the whole mortality, and to population, are thus expressed:— Whole District 1 Death in every 66 of pop. = 15.1 per 1,000 St. George Bloomsbury 1 do. do. 93 do. = 10.76 do. St. Giles South 1 do. do. 55 do. = 18. do. St. Giles North 1 do. do. 77 do. = 12.91 do. 29. Here we see that St. George Bloomsbury had a low Death-rate as compared with St. Giles South, but if we look at the following table, giving the ratios to total deaths, we find the conclusions reversed:— Whole District 1 in every 1.83 of all Deaths. St. George Bloomsbury 1 do. 1.66 do. St. Giles South 1 do. 1.84 do. St. Giles North 1 do. 1.69 do. 30. The apparently low Death-rate (1 in 1.84) in St. Giles South, as compared with Bloomsbury, is owing to its very high Death-rate among infants and old people, and it therefore illustrates the argument already stated (§ 24). 31. I have thought it right to dwell with some minuteness on this important branch of vital statistics, as there can be no doubt that erroneous opinions may be promulgated of the sanitary condition of a district, from an inaccurate method of calculating the Death-rates. 32. The District of St. Giles may be regarded as a typical one, it being constituted of the comparatively healthy parish of St. George Bloomsbury, the medium Sub-District of St. Giles North, and the destitute and unhealthy one of St. Giles South. All classes of the community in the Metropolis may be, therefore, said to be fairly represented by our District, which consequently affords peculiar opportunities for determining the influence of physical and social conditions upon mortality. This privilege of our position, in a scientific point of view, makes it the more necessary that our data should be accurately fixed. 35 The Boys' Refuge in Great Queen Street. 33. It is interesting to compare the results of training and occupation in the Boys' Refuge in Great Queen Street with the vital condition of boys at the same age among the community at large. The boys received into this Refuge are taken, as a rule, off the streets; some are sent by the magistrates, others are brought to the doors by the police; some are forwarded with a note or address by charitable persons, but all are either vagrants or destitute children. They thus come from the lowest classes of society, have been ill fed and ill cared for, and many with constitutions vitiated by disease. As soon as they enter the Refuge, however, suitable care is taken of them, and they are subjected to proper sanitary and educational discipline. Many are forwarded to the "Arethusa" and "Chichester" training ships to be turned into sailors, and others are provided for in various ways, as opportunities offer; but up to the end of 1874 about 150 were retained in the house. These are taught trades, chiefly shoemaking, tailoring, firewood cutting, and the making of fruit punnets. About half of their time is spent in work and half in education. Their diet is simple, but evidently sufficient; they get soup, in which the vegetables are thoroughly incorporated by long boiling, bread as a staple, and four ounces of cooked meat for each boy three times a week. The rooms or halls in which they work and sleep are very large, but it may be doubted whether adequate superficial space is given to each boy in the sleeping apartment for ventilation. At any rate, there is no luxury here—everything is conducted on the most economical scale, and the good results to be witnessed are not due to extravagant liberality. The utmost attention is paid to cleanliness and to the good order of the necessary sanitary conveniences. The occupation of the boys provides healthy exercise for their minds and induces habits of attention and industry. Under these favourable circumstances we might expect the health of the children to improve rapidly, and such we find to be the case. There is little sickness among them, and the majority of them have fresh cheeks and a healthy look, in remarkable contrast to the puny, sickly, and cadaverous gutter children from among whom they are taken. 34. In the course of three years (1872-3-4) 1,356 children were received into the Home, which, with 150 in the Home at the commencement, gives an aggregate of 1,506 children under the charge of the superintendent during the period. Of this number only 440 were retained in the house to be taught trades and provided with elementary instruction. Among this number, during the three years, there has been but one death in the Institution. Three were sent to hospital as incurable, but the superintendent states that two of these eventually recovered. Assuming that the other boy died, this would give two deaths in three years in an annual population of 147 boys from ten to fifteen years of age, which is equivalent to a death rate of 4.5 per 1,000. Now, the mean rate of mortality among boys at the same ages c 2 36 throughout England, for 35 years, is 4.8 per 1,000. This population includes all classes—the rich and well nourished as well as the destitute—and is therefore favourably constituted for a low mortality. Among the lowest and most impoverished class from which the boys are received into the Refuge, the mortality is far higher. We thus see how much the physical condition of children may be improved by the inculcation of regular habits, and how boys who are, many of them at least, afflicted with congenital disease, half starved and broken down in strength, may be brought up to a standard of health even better than the average of the country. 35. I will now append a Table summarising certain facts in relation, more particularly, to the deaths of children, which will facilitate comparison with similar facts in other districts. TABLE No. 6. Annual Rate or Mortality, Death-rates among Children, and Deaths in Public Institutions. Annual Rate of mortality per 1,000 living. Deaths of Children under one year ; percentage of total Deaths.* Percentage of Deaths of Children under one year to Births. † Deaths of Children under five years; percentage of total Deaths. Total number of Deaths among Parishioners in Public Hospitals outside the District. Total number of Deaths among NonParishioners in Public Institutions within the District. 1874 25.68 21.20 18.63 36.73 175 50 1873 23.9 24.59 19.5 40. 146 18 1872 23.77 25.02 20.08 40.61 136 25 1871 25.6 22.91 20.8 38.65 132 9 Average of 10 years 1864-1873. 27.29 36. The foregoing Table comprises a period of four years; and, on perusing it, it will be seen that whilst our general mortality has been slowly rising since 1872, and was, last year, nearly exactly what it was in 1871, yet that our deaths among infants under one year, and among children under five years, were less in proportion last year than in any previous year of the series. 37. This difference is owing to two causes. First, to the small mortality from zymotic diseases in 1874, as shown in the subjoined Table, the proportion of deaths to 100 deaths having been, in that year, 159.61 to an average of 180.0 for ten years,—in fact, our number was never so low as last year; and, secondly, to a considerable mortality from pulmonary diseases.‡ * The total Deaths exclude Non-Parishioners dying in public Institutions within the District, and include Parishioners dying in public Hospitals outside the District. †The Births exclude the Births of Non-Parishioners in the British Lying-in Hospital, and of Parishioners of the Strand District that occurred in the Workhouse. ‡ In comparing the past year with previous years, the fact that 1874 includes an extra week must be borne in mind. TABLE No. 7.—Showing the number of Deaths in the 10 Years, 1864 to 1873, from the seven principal Zymotic Diseases, and the number in 1874. Disease. 1864. 1865. 1866. 1867. 1868. 1869. 1870. 1871. 1872. 1873. Annual average of 10 years 1864 to 1873. Proportion of Deaths to 1,000 Deaths in 10 years 1864 to 1873. 1874. Proportion of Deaths to 1,000 Deaths in 1874. Small Pox 12 9 22 31 6 1 15 88 8 ... 19.2 13.14 ... ... Measles 38 12 47 20 23 19 29 15 37 27 26.7 18.28 31 22.59 Scarlet Fever 57 36 62 23 71 48 103 20 5 8 43.3 29.24 48 34.98 Diphtheria 10 8 9 6 6 5 4 7 5 2 6.2 4.66 ... ... Whooping Cough 34 75 32 69 42 83 16 38 42 29 46.0 31.49 27 19.68 Fever 82 112 48 41 18 37 31 26 9 29 43.3 29.65 54 39.36 Diarrhoea 56 81 131 77 77 64 83 62 71 80 78.2 53.54 59 43.00 Total 289 333 351 267 243 257 281 256 177 175 262.9 180.00 219 159.61 London 16,029 14,272 14,761 11,660 14,925 17,413 16,476 19,455 12,699 11,376 14,906 196.17 11,230 146.59 England 1862 to 1872. 1862. 1863. No return published. 1862 to 71 1862 to 71 No return published. 73,270 98,490 96,279 92,030 82,692 72,587 97,352 91,380 100,497 103,801 91,743 90-838 186-36 38 TABLE No. 8. Showing the Mortality from Certain Classes of Diseases, and proportions to Population, and to 1,000 Deaths, 1874, viz:- (Deaths in General Hospitals included.) Total Deaths. Deaths per 1,000 of Population. Proportion of Deaths to 1,000 Deaths 1. Seven Principal Zymotic diseases, 219 4.09 159.62 2. Pulmonary (other than Phthisis), 352 6.59 256.56 3. Tubercular 190 3.55 138.48 4. Wasting Diseases of Infants 95 1.78 69.24 5. Convulsive Diseases of Infants 79 1.48 57.50 1. Includes Small Pox, Measles, Scarlet Fever, Diptheria, Whooping Cough, Fever, and Diarrhoea. 3. Includes Phthisis, Scrofula, Rickets and Tabes. 4. Includes Marasmus, Atrophy, Debility, Want of Breast milk and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions and Teething, 38. Pulmonary Diseases and their Causes.—The foregoing Table exhibits the great preponderance of deaths from pulmonary diseases in our general mortality, more than one fourth of the whole number of deaths having been caused by this class of maladies. The chief of these is bronchitis. This fact should call more marked attention than it does to the causes that produce these maladies. The public are most concerned about the prevalence of fevers and the removal of certain conditions which are presumed to favour the propagation of these maladies, whilst they regard bronchitis, and lung diseases generally—other than phthisis—as among the inevitable consequences of our social state. It is, no doubt, true that the debilitating influences that pre-dispose to attacks of zymotic disease also prepare the way for fatal attacks of bronchitis, more especially in young children. But in much the same way that high temperature and fœtor—plus a special poison—engender zymotic diseases, cold and draught induce pulmonary affections; and it is of little consequence with which weapon death chooses to strike if the victims be knocked down and yield their annual tale. 39. I have no doubt that this heavy mortality from pulmonary affections is largely caused by the ill-constructed dwellings of the poor, and by the water-logged soil that constitutes their foundations. The windows, moreover, are constantly broken, the walls damp, and roofs leaky, letting in wind and rain upon the occupants. A large part of our sanitary work consists in the removal of these evils, but the mischief is apt to recur as soon as it is corrected, owing to the recklessness and bad habits of the occupiers themselves, rather than to any systematic neglect of the owners. The intemperate habits of the poor, too, lay them open to attacks of bronchitis, for it is no uncommon thing for a man or woman to come home intoxicated and to lie down in wet clothes on the floor, either of the room or staircase. 39 They are thus exposed to the draughts that blow through the house, and waking up in the morning with a shiver, find that they have caught cold—in other words, have an attack of pneumonia or bronchitis. Accidents of this nature cannot be prevented by ordinary sanitary surveillance, but it may be hoped that, by the erection of dwellings for the poorer classes of a more suitable character, on a perfectly dry soil, concreted or otherwise, so that "damp" and foul exhalations may be arrested, and by a steady persistence in sanitary regulation, even the most ignorant people will be gradually taught the importance of obviating those causes that undermine their health, and bring about a premature destruction of life. The Influence of Flowering Plants in purifying the atmosphere. 40. The low death-rate of St. George, Bloomsbury, as exhibited in Tables 4 and 5, is mainly owing, as has been frequently pointed out, to the social condition of its inhabitants, and to the airy and spacious squares which occupy the site. There is a point of considerable importance in the planting and adornment of these squares which is not much thought of, but which, as Health Officer of the District, I think it right to urge. It is now well established that the atmosphere of large towns is deficient of ozone, which is nature's prime agent for purifying the air of deleterious organic poisons and preventing the spread of fevers. It is equally well proved that all odoriferous plants, the mints, for example, lavender, mignonette, wall-flower, and other old English flowers and herbs have a remarkable power of developing ozone, and therefore help materially in the destruction of miasmatic poisons. It is well to bear these facts in mind, and in laying out grounds to make the decoration of them subservient to purposes of health; and whilst gratifying the eye with beds of flowers of bright colours, to sow liberally such sweet scented flowering plants as are conducive to the purification of the atmosphere by the oxidation of the organic poisons that are constantly floating in it. Fevers may, in this way, be prevented, probably as effectually as by the use of the ordinary chemical disinfectants, whilst flowering plants have this advantage, that during the time they are in leaf and bloom their influence on the atmosphere is constant, whilst chemical re-agents exert only a transitory effect. The Death-rate among the Zymotic Diseases. 41. The aggregate number of Zymotic deaths during the year 1874 was 231 ; but only 205 of these were in the miasmatic order. In 1873 the deaths from miasmatic diseases were 217, and in 1872, 211, so that our mortality from these causes was lower last year than hitherto recorded. It must be always borne in mind that our records of mortality from these causes is increased by all the deaths that can be collected from public institutions outside the district. 40 42. Small Pox.—We had no death from this cause during the year. 43. Measles.—We sustained 31 deaths from measles, which were more numerous than last year (27), and also more than the average of 10 years (26.7) (vide Table No. 7). 44. Scarlatina.—48 deaths occurred from this malady, our average number being 43.3. Our mortality last year was rather higher than the average, and shows a decided increase upon that of the three preceeding years, viz., 1873, 8; 1872, 5; 1871, 20; we may therefore look forward to the prevalence of this disease in an epidemic form next year. In 1870 we sustained 103 deaths from this cause (the largest number reported in recent times). Although there is no clear evidence (vide Table No. 7) that scarlatina appears epidemically at stated periods, yet its sudden leap in the past year is sufficient to raise grave apprehensions of a more formidable outbreak in the latter summer or autumn. The first case of this malady occurred at 63, New Compton Street, in St. Giles North. A woman had recently come into the parish from Westminster, but we could not get information of the disease existing in the house in which she had resided. The house in New Compton Street was moreover in want of sanitary improvements, and had been twice specially reported on in the previous year. It was without a yard, and all the domestic conveniences were in the basement. Other cases occurred in the same house, and the disease gradually extended over the District, but the Sub-District of St, Giles North continued to be the most heavily visited. The first deaths occurred in the week ending August 8th, when 2 were registered; there were 3 at the end of the month ; in the month of of September there were 14, divided equally between St. Giles South and St. Giles North ; in the month of October, 11, again divided equally between the two Sub-Districts, with 1 in hospital; in the month of November, 3, all in Bloomsbury; and in the month of December, 10, of which 3 were in Bloomsbury, 2 in St. Giles South, and 5 in St. Giles North. The remaining deaths occurred in hospital. Since the end of the year there has been a gradual reduction of the mortality, viz., 3, 1 and 2 deaths in the successive months of the Spring quarter, 1875. As the spread of scarlet fever is believed to depend very much upon temperature, it is interesting to know that the mean temperature of the month of July, immediately preceding the first death, was 63.2; of the month of August, 60.4; of the month of September, 58.3; of the month of October, 52.6; of the month of November, 41.8; and of the month of December, 33.9. Notwithstanding the low temperature of the last month, the coldest of the year, and, up to the present time, of the present year also, the death-rate continued excessive, showing that the range of temperature within which this disease is usually considered to prevail must be received with some qualification. 45. Diphtheria.—There has been no mortality from this disease. 46. Croup gave a tale of 8 deaths, of which 6 were females, and 2 males. 41 47. "Whooping Cough.—Our deaths from whooping cough amounted to 27. There were 7 in Bloomsbury, 16 in St. Giles South, and 3 in St. Giles North. Our mortality from this affection was much below the average, our mean for ten years being 46. 48. Fevers, including typhus, enteric, and common continued fever, rendered 54 deaths; only 14 of these were registered within the District, the rest occurred either in Stockwell or the general hospitals. The number for the past year was rather in excess of our mean, which is 43.3. From the Report forwarded to us by the authorities of the Metropolitan Asylum District Board, I find that there were, in the course of the year 1874, 113 cases of fever of all kinds sent to Stockwell Hospital from this District, of which 37 were cases of typhus fever. Attention is drawn to the fact that, out of all the cases of fever, 27 came from the Great "Wild Street Section, viz.: 11 from Lincoln Court; 2, Orange Court; 1, Wild Court; 4, Little Wild Street; 9, Great Wild Street; and of all the pure typhus cases (37) 15 came out of the Great Wild Street Section! The other groups of houses yielding the largest numbers of cases of fever, were King Street, Drury Lane, 9; and Little Coram Street, 9. There were 5 cases from 63, New Compton street, and 4 from 10, Charles Street. 49. It will be in the recollection of the Board that in my Report for 1873 I described the outbreak of typhus fever in the Great Wild Street Section of this district, an outbreak that originated in Lincoln Court; for two years, therefore, this endemic has haunted this quarter. Lincoln Court has long been notorious as the nestling place of fever, and your Board has, on numerous occasions, insisted upon large improvements being carried out there; but it has long been obvious that no partial measures can have any avail in destroying the seeds of pestilence in that locality. 50. I am glad to say that Little Coram Street and its surroundings, which have been equally conspicuous for disease and premature death, are likely soon to undergo a great change; the east side of that street, with Chapel Place, Marchmont Place, and the vacant sites of Coram Place and Russell Place, having recently been purchased by the Peabody Trustees. 51. Diarrhcea.—Our mortality from this disease was 59, our mean number for ten years being 78.2. We have, therefore, suffered from this cause a much lower mortality than usual, and it is to the diminished number of deaths from this disease and whooping cough, that our comparatively small mortality from zymotic diseases must be chiefly attributed. 52. Inquest Cases.—There were 108 inquests held during the year. In one instance the verdict was wilful murder, the occasion being an infant found dead on a door-step; there were 3 cases of suicide by hanging, 1 case of suicide by poisoning with cyanide of potassium, 1 by carbolic acid, 1 by throwing himself out of window, and 1 by cut throat. Two deaths occurred from fracture of skull, and 1 from fracture of ribs by a fall. There were also 2 deaths 42 attributed to shock; 1 after a fall, and another after burns. Many of the deaths were accelerated by intemperance, which is a common cause of deaths demanding investigation by a coroner's jury, and several deaths of infants were attributed to suffocation in bed. One death was occasioned by rupture of uterus after childbirth. There were only 4 registered deaths in which the cause was not specified. Mortality in the Workhouse and other Local Institutions. 53. The actual number of deaths in the Workhouse was 187, but this number requires to be corrected in various ways to obtain a true result. These corrections having already been made (§12) in treating of the general Death-rate, it is needless to repeat the process here. I have to acknowledge the personal kindness of all the officers of the Workhouse, in giving me the necessary assistance whilst consulting the various books in which the records of sickness and mortality are kept. The Bloomsbury Dispensary. 54. The medical officers of this Institution have favoured me with their usual return. There has been an increase in the number of patients treated at this Institution over those in the preceding year. The considerable number of sufferers attended by the medical officers of this charity proves its usefulness. There can be no doubt that many of the patients would have fallen upon the parish in their hour of trouble, but for the timely help afforded by this Institution. The following table shows the number of cases attended by the physicians and surgeons:— TABLE No. 8. New cases treated at the Bloomsbury Dispensary, 1874. Quarter ending— Physicians' Coses. Surgeons' Cases. Casualties about Total. Total No. under Treatment. Visited at home. Died. Total No. under Treatrant. Visited at home. Died. Total No. under Treatment. Visited at home. Died. March 25th 689 293 20 457 42 4 342 1,146 335 24 June 24th 735 184 8 458 54 2 300 1,193 238 10 Sept. 29th 854 270 16 465 75 5 324 1,319 345 21 Dec. 25th 886 315 18 400 74 2 250 1,286 389 20 Whole Year 3,164 1,062 62 1,780 245 13 1,216 4,944 1,307 75 55. The British Lying-In Hospital.—The number of confinements in this charity during the year was 163. These gave 167 births, four being twin cases. There were 94 males and 73 females. There were 5 still births—4 males and 1 female, which are in- 43 eluded in the entire number. The Registrar-General reports 3 deaths of children in this Hospital during the year, viz.: 2 males and 1 female. The births in this Hospital belonging to St. Giles District were 27, of which number 5 were parishioners of St. George Bloomsbury; 16 belonged to the Sub-District of St. Giles South, and 6 to St. Giles North; the remainder (140) were parishioners of outside parishes. Allowance is made for these in the general summary of births. (Vide Tables I. and II.) 56. The Infants' Home.—I regret that I am unable to give such a report of the mortality of this Institution as can be considered satisfactory in a scientific point of view, owing to the difficulty of fixing the mortality occurring in the Home and outside of it, in relation to the whole number of children detained in the Home and passing through it. The number of infants usually in the house is, I am informed, about a dozen; and most of those who are received are, after a time, sent to the suburbs to be nursed. The deaths occuring in the Home in 1874 were 31, which is a much larger number than was reported to me last year. I find that, in every instance, the child that died was registered as the offspring of a domestic servant. The cause of death is returned in the large majority of cases as "debility" with "diarrhoea," and "tabes mesenterica": 5 as "syphilis." The age of the youngest child at death was 3 weeks, and of the eldest 1 year; and of the entire number 17 were registered at 3 months old or under. 57. This summary shows the importance of a proper registration and inspection of all institutions of this nature. Every woman, too, who takes in a child to nurse should be registered. This will appear the more important if we regard the class of women who make an especial use of this Institution. The conductors of this particular Home are desirous, I believe, of doing their best to improve the health, and increase the chances of life of the waifs and strays who are confided to their care; but it is nevertheless very obvious that any extension of this system might be attended with much evil that society would deprecate. The Sanitary Work of the Year. 58. The amount of work done during the year by the Inspectors is only partially shown in the following Table, owing to the dismissal of Inspector Harnack, and the failure of his return. A larger number of summonses was served this year than in previous years, and it is hoped that a salutary effect has been produced by the convictions that have been obtained against negligent owners. It is certain that less difficulty has been experienced of late in maintaining the regulations of your Board in those streets and courts where the owners were most frequently summoned in the earlier part of the year. In many other cases, too, where the orders of the Board used to be met with indifference or obstinate opposition, a more compliant temper has been evinced. 44 The chief difficulty, however, in keeping houses clean and habitable is found in the ignorance and apathy of the occupiers. House Improvements in St. Giles District effected under the Superintendence of Inspector J. McHugh between Lady-day, 1874, and 6tii February, 1875. Improvements. Details. Inspector McHugh. Number of houses improved 1,235 Improvements in Drainage. Drains constructed or repaired 126 Traps fixed 406 ) Cesspools abolished 28 Stables drained and horse-pools abolished 10 In Water Closets. Pans, traps, and water provided 147 Water and apparatus only provided 411 Cleansed or repaired 643 Newly constructed or rebuilt 28 In Dust Bins. Newly constructed 54 Repaired or covered 617 Paving. Re-laid or repaired 309 In General Water Supply. Receptacles provided 31 Receptacles repaired 242 In Cleanliness and Repair. Cleansed and lime-whited 952 Various accumulations removed from cellars,&c. 193 In Ventilation, &C. Ventilation improved 26 Overcrowding reduced 61 Kitchens disused, or made legally habitable 9 Proceedings taken. Request notices 313 Statutory notices 221 Summoned and fined 18 Reported to Police or District Surveyor 5 Total number of Improvements 4,850 Total number of Visits during the year 7,525 Disinfecting Chamber. List of Articles Disinfected in Hot Air Chamber during 1874-75. Articles. No. Articles. No. Articles. No. Beds 103 Quilts 53 Bags 3 Blankets 69 Coats 15 Jackets 3 Bolsters 56 Trowsers 9 Cushions 18 Pillows 147 Waistcoats 9 Petticoats 8 Cases 9 Skirts 13 Palliasses 8 Carpets 9 Table Covers 3 Scarfs 6 Counterpanes 22 Shawls 5 Hearth Rugs 5 Mattrasses 25 Frocks 4 Drawers 2 Rugs 23 Flannels 5 Skirts 5 Sheets 103 Dresses 16 Sundries 45 Total Disinfections 85 Total Articles 801 45 Provisions Condemned and Destroyed from March, 1874, to March, 1875. Date. Articles. Weight. 31st March, 1874. One box of Mixed Fish 128 lbs 11th April, „ Beef, Mutton, Veal and Pork 112 lbs 24th April, „ One pad of Mixed Fish 85 lbs 27 th May, „ One pad Mackerel 96 lbs 30th June, „ A lot of Soles 40 lbs 15th June, „ One pad Mixed Fish 98 lbs 2nd July, „ A Carcase of Beef 4 cwt. 2 qrs. 16 lbs 59. Cow Sheds.—These have undergone the usual inspection during the year, and the whole of them have been improved in respect of ventilation, drainage, and other accessories. 60. Slaughter-houses.—The Slaughter-houses of the district have been kept fairly clean and regular. 61.—The Bakehouses have been kept in good condition, and the orders of the Board in respect of them have been carefully carried out. 62. Bag and Bone Shops.—The usual difficulties have been experienced in keeping these shops in a clean and wholesome condition. 63. Underground Rooms.—Inspector McHugh reports that very few cases of Underground Rooms illegally occupied have come under his notice during the year, and that whenever he had cause to interfere he found no difficulty in getting them vacated without having recourse to legal proceedings. Several underground water tanks have been abolished within the district, and new cisterns erected in the yards. 64. Such is the résumé of the last year's history of the sickness and mortality of our district. The year was, on the whole, a healthy one, although characterised by the severest winter experienced since 1855, and by epidemic disease in one of the sub-districts, which unduly raised its mortality. There is clear evidence, however, of a general improvement, and there is good reason to believe that, not only in St. Giles, but throughout the metropolis, the sanitary regulations that have been in operation for some years past are at length producing a decided effect in raising the standard of health, and diminishing the rate of mortality among all classes of the community. It is to be hoped that the "Artisans' and Labourers' Dwellings Improvement Bill," now passing through the Legislature, will largely enhance these beneficial results. I have the honour to be, Gentlemen, Your obedient servant, 1st May, 1875. GEORGE ROSS, M.D., Medical Officer of Health. APPENDIX. TABLE I. Registered Deaths in 53 Weeks of 1874. Sub-Districts of St. Giles. Sub-Districts. [Population, 18710 First Quarter. 13 weeks. Second Quarter. 13 weeks. Third Quarter. 13 weeks. Fourth Quarter. 14 weeks. Whole Year, 1874. 63 weeks. M. F. M. F. M. F. M. F. M. F. Both Sexes. St. George, Bloomsbury. [17,843.] 53 45 27 32 37 36 50 45 167 158 325 St. Giles South. [19,089.] 78 92 68 60 55 60 85 90 286 302 588 St. Giles North. [16,497.] 39 45 32 36 48 30 37 67 156 178 334 Whole District. [53,429.] 170 182 127 128 140 126 172 202 609 638 1,247 TABLE II. Registered Births in 53 Weeks of 1874. Sub-Districts of St. Giles. Sub Districts. First Quarter. 13 weeks. Second Quarter. 13 weeks. Third Quarter, 13 weeks. Fourth Quarter. 14 weeks. Whole Year, 1874. 53 weeks. M F. M. F. M. F. M. F. M F. Total Children. St. George, Bloomsbury 48 72 48 37 59 52 71 62 226 223 449 St. Giles South 125 125 98 74 76 67 114 109 413 375 788 St. Giles North 52 83 47 51 53 60 63 79 215 273 488 Whole District 225 280 193 162 188 179 248 250 854 871 1,725 TABLE No. III. Showing the Registered Mortality in each Quarter and in each Sub-District, 1874. Class. causes of death. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. St. George, Bloomsbury. St. Giles South. St. Giles North. St. George, Bloomsbury. St. Giles South. St. Giles North. 8t. George, Bloomsbury. St. Giles South. St. Giles North. St. George, Bloomsbury. St. Giles South. St. Giles North. I Order 1. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. Measles 9 3 5 2 3 2 .. 3 4 .. .. .. Scarlet Fever .. 1 .. 1 .. .. .. 9 10 3 8 13 Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. Quinsey .. .. .. .. 1 .. .. .. .. .. .. .. Croup 1 1 .. .. 1 1 1 .. 1 1 1 .. Whooping Cough 1 9 2 1 3 1 2 4 .. 3 1 1 Fever 2 .. 1 1 1 1 2 1 2 1 1 1 Erysipelas 1 .. 2 .. 1 .. 1 .. 1 .. 3 .. Metria .. 2 .. .. .. .. .. .. .. 1 .. .. Diarrhœa 1 3 1 1 3 2 15 11 15 l 2 9 Rheumatism .. .. .. 1 .. .. .. 2 .. .. .. 1 Other Miasmatic Diseases .. .. .. .. 1 .. .. .. 1 .. .. .. Order 2. Syphilis 2 4 .. 2 2 1 1 .. l 5 2 1 Order 3. Want of Breast Milk .. 2 .. .. .. .. .. .. .. .. .. .. Delirium Tremens 1 .. .. .. .. .. .. .. .. .. 1 1 Order 4. Thrush .. .. .. .. .. .. .. .. .. .. .. .. 2 Order 1. Gout 1 .. .. .. .. .. .. .. .. .. .. .. Dropsy 1 .. .. .. 2 .. .. .. .. .. 1 .. Cancer 3 2 4 2 3 .. 1 1 .. 1 1 2 Mortification .. .. .. .. .. .. .. .. .. .. .. .. Order 2. Scrofula 2 .. 1 .. 1 .. l l .. .. .. 2 Tabes 2 3 1 4 2 1 3 2 1 4 2 1 Phthisis 10 20 8 9 12 5 10 16 11 15 17 11 Hydrocephalus 3 .. 2 .. 4 5 2 5 2 2 1 3 3 Order 1. Cephalitis .. .. 1 .. .. .. 1 .. .. .. .. 1 Apoplexy 3 8 1 1 4 3 3 5 .. 1 4 3 Paralysis 2 2 2 2 2 2 3 1 .. 4 6 3 Epilepsy .. 4 .. 2 1 1 .. .. .. 1 .. .. Convulsions 2 6 1 3 2 2 2 5 2 2 9 3 Other Brain Diseases 2 1 1 3 5 .. 1 1 1 1 .. .. Order 2. Pericarditis .. .. .. .. 1 .. 1 .. .. .. .. 1 Aneurism .. .. 1 .. 2 .. .. 1 .. .. 2 .. Other Heart Disease 6 6 6 3 5 6 2 4 4 2 11 6 Order 3. Laryngitis .. .. .. .. .. .. .. .. 1 .. .. .. Bronchitis 17 51 28 4 25 12 7 11 4 17 63 20 Pleurisy .. .. .. .. .. 1 .. .. .. .. .. .. Pneumonia 1 11 5 3 9 4 .. 6 3 8 6 6 Asthma 1 .. .. .. 1 .. .. 1 .. .. .. 1 Other Lung Diseases 2 2 1 .. 1 .. .. .. .. 1 1 2 Order 4. Gastritis .. .. .. .. 1 .. .. .. .. .. .. .. Enteritis .. 1 2 .. 1 .. .. 1 .. 1 .. .. Peritonitis .. l 1 .. 1 .. .. .. .. .. .. .. Ascitis .. l .. .. 2 .. .. .. .. 1 .. 1 Ulcer Intestines .. .. .. .. .. .. .. .. .. .. 1 .. Hernia .. .. .. .. .. 1 .. .. .. .. .. .. Ileus .. .. .. .. .. .. .. .. .. .. .. .. Intussusception .. .. 1 .. .. .. .. .. .. .. .. .. Stricture Intestines .. .. .. 1 1 .. .. .. .. l .. 1 Stomach Disease .. 1 .. 1 .. .. 2 .. .. .. .. .. Liver Disease 1 .. .. 4 .. l .. 2 1 .. 2 .. Order 5. Nephritis .. .. .. .. 1 .. .. .. .. .. 1 .. Nephria 1 3 1 .. 1 1 1 2 1 .. 2 .. Diabetes 1 .. .. .. .. .. .. 1 .. .. .. .. Cystisis l .. .. .. .. .. .. 1 .. .. .. .. Kidney Disease .. .. .. .. .. l 1 1 .. .. .. .. Order 6. Ovarian Disease .. l 1 .. .. .. .. .. .. .. .. .. Order 7. Synovitis .. .. .. .. .. .. l .. .. .. .. .. Order 8. Phlegmon .. 2 .. .. .. .. .. .. .. .. .. 1 Ulcer .. .. .. .. .. .. .. .. .. .. .. .. Skin Disease .. .. .. .. .. .. .. .. .. .. .. .. 4 Order 1. Premature Birth .. 3 2 1 4 l l 3 4 l .. 6 Spina Bifida .. 3 .. .. .. .. .. 1 .. .. 1 .. Teething l 1 .. .. .. 1 l 2 .. .. 1 .. Other Malformations .. .. .. .. .. .. .. .. .. 1 .. .. Order 2 Childbirth .. 1 .. .. .. 2 .. .. 1 l 2 2 Order 3. Old Age l 4 2 3 5 .. .. 2 1 3 3 .. Order 4. Atrophy and Debility 9 6 4 .. 5 5 5 6 4 10 5 8 5 Order 1. Fractures, &c. .. 2 .. .. 8 1 1 .. .. .. 1 .. Burns and Scalds .. .. .. .. .. .. .. .. .. .. 1 .. Suffocation 2 2 .. 2 3 .. .. 3 .. .. 1 .. Order 3. Homicide .. .. .. .. 1 .. .. .. .. .. .. Order 4. Wounds .. .. .. .. .. .. .. 1 .. .. .. .. Poison .. .. .. .. .. .. 1 .. .. .. 1 .. Hanging 3 .. .. .. .. .. .. .. .. .. .. .. Otherwise .. .. .. .. .. 1 .. .. .. .. .. .. Causes not specified .. 2 .. .. 1 .. .. 1 .. .. .. .. TABLE IV.—Causes of Death Registered in the St. Giles District in 1874, with the Ages at Death. Class. Causes of Death. At all Ages. Under 1 year. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Sub-Districts. Males. Females. Total. St. George, Bloomsbury St. Giles South. St. Giles North. All causes 600 647 1247 318 209 72 157 213 245 33 325 588 334 Specified causes 598 645 1243 317 209 72 157 210 245 33 325 584 334 (Classes.) I. Zymotic Diseases 231 119 350 96 85 22 11 10 7 ... 64 91 76 II. Constitutional „ 233 116 349 30 34 19 70 58 21 1 78 95 60 III. Local „ 610 284 894 90 80 27 63 134 204 12 133 322 155 IV. Developmental „ 139 62 201 87 10 3 10 1 10 18 38 58 43 V. Violent Deaths 30 17 47 14 ... 1 3 7 4 1 9 18 3 Orders. I. 1 Miasmatic Diseases 104 101 205 76 82 22 8 10 7 ... 53 80 72 2 Enthetic „ 12 9 21 18 3 ... ... ... ... .. 10 8 3 3 Dietic „ 3 2 5 2 ... ... 3 ... ... ... 1 3 1 4 Parasitic „ ... ... ... ... ... ... ... ... ... ... ... ... ... II. 1 Diathetic 9 16 25 ... 1 ... 4 7 12 1 9 10 6 2 Tubercular „ 107 101 208 30 33 19 66 51 9 ... 69 85 54 III. 1 Diseases of Nervous System 65 67 132 33 13 6 16 23 40 1 39 66 27 2 „ of Organs of Circulation 31 40 71 ... 1 8 10 20 30 2 14 33 24 3 „ of Respiratory Organs 162 185 337 53 64 10 23 71 110 6 61 189 87 4 „ of Digestive Organs 20 22 42 2 ... 2 7 14 15 2 13 18 11 5 „ of Urinary Organs 14 8 22 ... 2 ... 7 5 7 1 5 13 4 6 „ of Organs of Generation ... 2 2 ... ... ... ... ... 2 ... ... 1 1 7 „ of Organs of Locomotion 1 ... 1 ... ... 1 ... ... ... ... 1 ... ... 8 „ of Integumentary System 1 2 3 2 ... ... ... 1 ... ... ... 2 1 IV. 1 Dev. Diseases of Children 18 21 39 34 5 ... ... ... ... ... 6 19 14 2 „ of Adults ... 9 9 ... ... ... 9 ... ... ... 1 3 5 3 „ of Old People 10 14 24 ... ... ... ... ... 7 17 7 14 3 4 Diseases of Nutrition 34 33 67 53 5 3 1 1 3 1 24 22 21 V. 1 Accident or Negligence 13 9 22 13 ... 1 1 4 3 ... 5 16 1 3 Homicide ... 1 1 1 ... ... ... ... ... ... ... ... 1 4 Suicide 4 3 7 ... ... ... 2 3 1 1 4 2 1 5 Execution ... ... ... ... ... ... ... ... ... ... ... ... ... Violent Deaths not classed ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Deaths, cause unascertained ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified or ill- 2 2 4 1 ... ... ... 3 ... ... ... 4 ... TABLE IV.—Diseases in Orders—(Continued). Class. Causes of Death. At all Ages. Under 1 year. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Sub-Districts. Males. Females. Total. St. George, Bloomsbury St. Giles South. St. Giles North. I. Order 1. 1 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Measles 13 18 31 8 23 ... ... ... ... ... 11 9 11 3 Scarlatina 22 23 45 3 29 13 ... ... ... ... 4 18 23 4 Diphtheritis ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Quinsey 1 ... 1 ... 1 ... ... ... ... ... ... 1 ... 6 Croup 2 6 8 2 5 1 ... ... ... ... 3 3 2 7 Whooping Cough 10 16 26 10 16 ... ... ... ... ... 7 16 3 8 Continued Fevers, Typhus, &c. 10 4 14 ... 2 6 3 1 2 ... 6 3 5 9 Erysipelas 7 2 9 1 ... ... ... 4 4 ... 2 4 3 10 Metria ... 3 3 ... ... ... 2 1 ... ... ... 2 1 11 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Dysentery 1 ... 1 ... ... ... ... ... ... ... 1 ... ... 14 Diarrhoea 34 25 59 51 5 1 ... ... 1 ... 18 21 20 15 Cholera 1 1 2 1 1 ... ... ... ... ... ... ... 2 16 Ague ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Remittent Fever ... ... ... ... ... ... ... ... ... ... ... ... ... 18 Rheumatism 3 1 4 ... ... 1 1 ... ... ... 1 2 1 19 Other Miasmatic Dis ... 2 2 ... ... ... 2 ... ... ... ... 1 1 Order 2. 1 Syphilis 12 9 21 18 3 ... ... ... ... ... 10 8 3 2 Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... Order 3. ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Privation ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Want of Breast Milk 1 1 2 2 ... ... ... ... ... ... ... 2 ... 3 Purpura and Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Alcoholism:— a Delirium Tremens 2 ... 2 ... ... ... 2 ... ... ... ... 1 1 b Intemperance ... 1 1 ... ... ... 1 ... ... ... 1 ... ... Order 4. 1 Thrush ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Worms ... ... ... ... ... ... ... ... ... ... ... ... ... II. Order 1. 1 Gout 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... 2 Dropsy 2 2 4 ... 1 ... ... ... 1 ... 1 3 ... 3 Cancer 6 14 20 ... ... ... 4 ... 10 ... 7 7 6 4 Noma Canerum Ovis ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... Order 2. 1 Scrofula 6 2 8 3 2 3 ... ... ... ... 3 2 3 2 Tabes Mesenterica 12 14 26 17 8 1 ... ... ... ... 14 8 4 3 Phthisis 71 73 144 2 5 11 66 51 9 ... 44 65 35 4 Hydrocephalus 18 12 30 8 18 4 ... ... ... ... 8 10 12 III. Order 1. 1 Cephalitis 2 1 3 ... 1 1 ... 1 ... ... 1 ... 2 2 Apoplexy 17 19 36 2 ... 1 9 7 17 ... 8 21 7 3 Paralysis 11 18 29 ... ... ... ... 9 19 ... 11 11 7 4 Insanity ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Epilepsy 7 2 9 ... ... ... 6 1 2 ... 3 5 1 7 Convulsions&Laryngismus 19 20 39 29 9 1 ... ... ... ... 9 22 8 8 Other Brain Diseases 9 7 16 2 3 3 1 5 2 ... 7 7 2 Order 2. 1 Pericarditis 1 2 3 ... ... ... 2 1 ... ... 1 1 1 2 Aneurism 1 5 6 ... ... ... 1 4 1 ... ... 5 1 3 Heart Disease, &c. 29 33 62 ... 1 8 7 15 29 2 13 27 22 Order 3. 1 Laryngitis 1 ... 1 ... 1 ... ... ... ... ... ... ... 1 2 Bronchitis 109 151 260 42 45 6 9 56 97 5 45 151 64 3 Pleurisy ... 1 1 ... ... ... ... 1 ... ... ... ... 1 4 Pneumonia 37 24 61 10 18 3 10 11 9 ... 12 32 17 5 Asthma 1 3 4 ... ... ... ... 1 3 ... 1 2 1 6 Other Lung Diseases 4 6 10 1 ... 1 4 2 1 1 3 4 3 TABLE IV—Diseases in Orders—(Continued). Class. Causes of Death. At all Ages. Under 1 year. 1 and under 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Sub-Districts. Males. Females. Total. St. George, Bloomsbury. St. Giles South. St. Giles North. Order 4. 1 Gastritis 1 ... 1 ... ... ... ... ... 1 ... ... 1 ... 2 Enteritis 3 3 6 ... ... ... 1 ... 2 1 1 3 2 3 Peritonitis 2 1 3 ... ... ... 1 ... 2 ... ... 2 1 4 Ascites 2 3 6 ... ... ... 2 1 2 ... ... 4 1 5 Ulcer. Intest ... 1 1 ... ... ... ... 1 ... ... ... 1 ... 6 Hernia ... 1 1 ... ... ... ... ... ... 1 ... ... 1 7 Ileus ... ... ... ... ... ... ... ... ... ... ... ... ... 8 Intussusception 1 ... 1 ... ... ... ... ... ... ... ... ... 1 9 Strict. Intest 2 2 4 ... ... ... 1 1 2 ... 2 1 1 10 Fistula ... 1 1 ... ... ... 1 ... ... ... ... 1 ... 11 Stomach Disease, &c. 4 ... 4 ... ... ... ... 2 2 ... 3 1 ... 12 Pancreas Disease ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Hepatitis 2 2 4 ... ... ... 1 1 1 ... 2 ... 2 14 Jaundice ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Liver Dis., &c. 3 8 11 ... ... ... ... 8 3 ... 5 4 2 16 Spleen Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... Order 5. 1 Nephritis 1 1 2 ... 1 ... ... ... 1 ... ... 2 ... 2 Ischuria 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... 3 Nephria 8 5 13 ... 1 ... 5 4 3 ... 2 8 3 4 Diabetes 1 1 2 ... ... ... 2 ... ... ... 1 1 ... 5 Stone ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Cystitis 2 ... 2 ... ... ... ... ... 1 1 1 1 ... 7 Kidney Disease, &c. Order 6. 1 1 2 ... ... ... ... 1 1 ... ... 1 1 1 Ovarian Dropsy ... 2 2 ... ... ... ... ... 2 ... ... 1 1 2 Uterine Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... Order 7. 1 Arthritis 1 ... 1 ... ... 1 ... ... ... ... 1 ... ... 2 Bone Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... Order 8. 1 Phlegmon 1 2 3 2 ... ... ... 1 ... ... ... 2 1 2 Ulcer ... . . . ... ... ... ... ... ... ... ... ... ... ... 3 Skin Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... IV. Order 1. 1 Premature Birth 12 14 26 26 ... ... ... ... ... ... 3 10 13 2 Cyanosis ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Spina Bifida 2 3 5 5 ... ... ... ... ... ... ... 5 ... 4 Other Malformations 1 ... 1 1 ... ... ... ... ... ... 1 ... ... 5 Teething 3 4 7 2 5 ... ... ... ... ... 2 4 1 Order 2. 1 Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Childbirth (see Metria) ... 9 9 ... ... ... 9 ... ... ... 1 3 5 Order 3. 1 Old Age 10 14 24 ... ... ... ... ... 7 17 7 14 3 Order 4. 1 Atrophy and Debility 34 33 67 53 5 3 1 1 3 1 24 22 21 V. Order 1. (Accident or Negligence) :— 1 Fractures, &c. 5 3 8 ... ... 1 1 4 2 ... 1 6 1 2-3 Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Burns, &c. ... 1 1 ... ... ... ... ... 1 ... ... 1 ... 5 Poison ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Suffocation 8 5 13 13 ... ... ... ... ... ... 4 9 ... 8 Otherwise ... ... ... ... ... ... . . . ... ... ... ... ... ... Order 3. Homicide ... 1 1 1 ... ... ... ... ... ... ... ... 1 Order 4. (Suicide):— 1 Wounds—Gunshot ... ... ... ... ... ... ... ... ... ... ... ... ... 2 „ Cut, Stab ... 1 1 ... ... ... ... ... 1 ... ... 1 ... 3 Poison 1 1 2 ... ... ... 2 ... ... ... 1 1 ... 4 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Hanging 2 1 3 ... ... ... ... 3 ... ... 3 ... ... 6 Otherwise 1 ... 1 ... ... ... ... ... ... 1 ... ... 1 Causes not specified 2 2 4 1 ... ... ... 3 ... ... ... 4 ... ANNUAL REPORT OF THE ANALYST Appointed under the Adulteration of Food, Drink, and Drugs Act. TO THE BOARD OF WORKS FOR THE ST. GILES DISTRICT. Gentlemen,— During the twelve months succeeding to the date up to which my last Annual Report was made, I received from your inspector 281 samples of various articles of food for analysis, consisting of milk, bread, flour, tea, coffee, mustard, vinegar, gin, pickles, pepper, cayenne pepper, preserved green peas, mushrooms, butter, beer, arrowroot, sweets, whisky, and ketchup. These have all been analysed and reported upon. 53 of the samples were found to be adulterated, comprising 38 samples of milk, 2 of tea, 1 of coffee, 6 of mustard, 4 of vinegar, and 3 of preserved green peas. The proportion of cases in which adulteration has been detected in the samples referred to in this Report, is considerably smaller than it was in those reported upon in the previous year: thus, of the samples analysed in 1873-4, thirty-three per cent., or one third of the whole, was found to be adulterated, while the proportion during the past year, 1874-5, has been less than nineteen per cent. There is also in the results obtained during the same two periods, a similar difference observable with reference to cases of milk, for while, in the former year, of the samples of milk analysed, thirty-five per cent. was adulterated, in the latter year the proportion has been only twenty-four per cent. In the early part of last year there was evidence of a considerable diminution in the extent to which milk was adulterated, and I concluded that we had to a great extent accomplished the object for which we had been devoting so much attention to that article. The inspector was therefore instructed to collect a larger proportion than he had previously done of other articles, and for some time only a few samples of milk were obtained, but during this period the dealers fell back into their former practice, so that cases of adulteration became again almost as frequent as ever. Latterly the inspector has made it a rule to collect samples of milk every week from some parts of his district, taking all parts in turn, and we have again succeeded in diminishing the proportion of cases of adulteration of this article. But even now, in relation to other articles of food, milk is that which is the most frequently adulterated, and it appears that the method usually resorted to of diluting it with water is so simple and easy, and at the same time so difficult of detection by the general public, that nothing short of the fear of the law, and the frequent visits of the inspector will keep it in check. With reference to many other articles of food, the improvement 48 which has been effected in preventing adulteration has been much more marked than it has been in the case of milk. Vinegar is no longer, as a rule, adulterated with sulphuric acid, nor mustard with flour, nor coffee with chicory, nor preserved green peas with copper. Another year will enable us to judge of the effect of the alterations which are now being made in the laws affecting the adulteration of food and drugs. The general tendency of these alterations seems to be in the direction of relieving the retail dealers of much of the responsibility that has hitherto rested upon them with reference to the sale of articles hitherto considered to be adulterated. I have the honour to be, Gentlemen, Your obedient servant, 17, Bloomsbury Square, T. REDWOOD. 22nd June, 1875.