1739 1864-5. SAINT JMES'S, WESTMINSTER. Account in Abstract OF RECEIPT AND EXPENDITURE FOR THE YEAR ENDING 25TH MARCH, 1865; AND SUMMARY STATEMENT OF CONTRACTS; TOGETHER WITH THE SURVEYOR'S REPORT OF THE PROCEEDINGS OF THE VESTRY IN THE EXECUTION OF THE ACT; TO WHICH ARE APPENDED, THE REPORTS OF THE MEDICAL OFFICER OF HEALTH, . ♦ AND THE SANITARY INSPECTOR. ' PRINTED BY THE VESTRY, IN COMPLIANCE WITH THE 198TH SECTION OF THE Metropolis Local Management Act By Order, GEORGE BUZZARD, Vestry Clerk. June 1865. St. James's, Westminster. We, the undersigned, being the Auditors appointed, by authority of the Metropolis Local Management Act, to audit ;he Accounts of the Vestry of the said Parish, having carefully examined the said Accounts from the 25th day of March, 1864, to the 25th day of March, 1865, and the Vouchers in support of the same, and the Books, Papers, and Writings, in the custody or control of the said Vestry relating thereto, Do hereby certify that the said Accounts are, to the best of our belief, true and correct, in token of which our examination we have signed the said Accounts, whereof an Abstract prepared and signed by us is annexed hereto, and we do make this our allowance of the said Accounts in conformity to the provisions of the said Act. As witness our hands this Seventeenth day of May, One thousand eight hundred and sixty-five. john clements, thomas jones, richard attenborough, evan ortner, Auditors. a 2 3 ST. JAMES'S, WESTMINSTER Account in Abstract shaving the Rcceipt and Expenditure under the Metropolis Local Management Act, from the 25th day of March, 1804, to the 25th day of March, 1865. RECEIPTS. EXPENDITURE. £. s. d. £. 8. d. Balance in Treasurer's hands at the close of the Accounts for 1863-64, 156 16 5 Contractors (Mowlem & Co.) for Paving, broken Guernsey, Lime, Sand, &c. 815 15 2 Sewers, Metropolis Main Drainage, and General Rates of the Year 1864, collected to the 25th March, 1865,. 23,023 15 1 H. Browse, for Roadway in Regent Street, . 2,625 0 0 H. Browse, for Reinstating Trenches made by Gas and Water Companies, 19 18 8 Cash for Works done for Gas and Water Companies, 194 15 10 Cash per Vestry Surveyor for grant of Scaffold Licences, and for Deposits on Account of Pavements disturbed for Building and Drainage purposes, 137 0 2 Stone Breakers' and Workmen's Wages, 713 0 5 Carting Slop, and Dust Removal, 1,102 10 0 Sweepers' Wages, 774 9 0 Cash by Trustees of Archbishop Tenison's Chapel, for one Years Nominal Rent of Ground and Porches in King Street, to Midsummer 1864, 0 3 0 Gas Lighting, 2,278 4 11 Street Watering, Carts, Men, &c. 564 4 0 Water Supply for ditto, 308 18 10 Cash, Income Tax Commissioners, for use of Vestry Hall, one vear to Michaelmas 1864, 5 5 0 Sewers Works and Wages, and Water for Flushing Sewers, and Urinals, 937 18 0 Metropolitan Board of Works, Expenses by Precept, for the Year 1864, 5,305 2 10 Metropolitan Board of Works, Main Drainage, Precept for 1864 5,393 15 0 Salaries, 1,023 6 8 Stationery, Books, and Printing, 102 3 3 Bricklayer, Carpenter, Painter, Smith, Gas Fitter, Pump Maker, Wheelwright, &c. 135 11 8 Horse, Harness, Hay, Corn, &c. 34 17 6 Collectors' Poundage, 152 17 8 Interest on overdrawn Account, to 25th March, 1865, 146 1 8 Third Instalment in Repayment of Loan of £.6,000, 300 0 0 Interest at £ 5 per cent. on portion of Loan of £.6,000 by London Life Association, Half a Year to 25th July, 1864, 255 14 4 Insurance of Vestry Hall and Furniture, 5 17 0 Coals, Gas, Fittings, &c. to Vestry Hall, 60 16 2 Law and other Disbursements, 42 3 6 Interest on Golden Square Debt, as paid to the Bondholders, 105 0 0 Messrs. Mayhew and Knight, Surveying and Making Plans of Premises at Argyll House, 2 2 0 Balance in Treasurer's Hands on 25th March, 1865, 312 7 3 £23,517 15 6 £.23,517 15 6 JOHN CLEMENTS, Auditors. THOMAS JONES, RICHARD ATTENBOROUGH, EVAN ORTNER, 4 5 ST. JAMES'S, WESTMINSTER. Account of Monies owing to, and Debts owing by, the Vestry, on the 25th day of March, 1865. ASSETS, DEBTS AND LIABILITIES. £. s. d. £. s. d. £. s. d. Remainder of Sewers, Metropolis Main Drainage, and General Rates of the year 1804, on 25th March, 1865, 2,372 19 0 H. Browse, Repairs, &c. Regent Street, Roadway, 875 0 0 H. Browse, Reinstating Trenches made by Gas and Water Companies, 7 3 4 Less probable deficiencies at close of Collection, 673 3 0 Contractors (Mowlem & Co.) for York Paving, Guernsey Lumps, 1,699 16 0 Sand, &c 199 12 4 Cash for Works done for Gas and Water Companies, 61 6 6 Stone Breakers' and Workmen's Wages, 170 0 0 Carting Slop and Dust Removal, 367 10 0 Cash for the Grant of Scaffold Licences, Paving Deposits, &c. 26 12 4 Watering, 21 8 0 Cash for Management of Regent Street, in St. George's Parish, for 1864-65, 125 0 0 Sweepers' Wages, 190 0 0 Gas Lighting, 764 9 7 Sewers' Works, Wages, &c. 236 1 1 Salaries, 245 10 0 Collectors' Poundage and Expenses, for Rates of 1864, 161 10 0 Stationery, Books, and Printing, 34 18 1 Bricklayer, Carpenter, Gas-fitter, and sundry other Tradesmen's Accounts, 69 9 6 St. George's Yestry, for New Bond Street Management for 1864-65, 72 18 5 St. Marylebone Yestry, for Oxford Street Management for 1864-65, 230 0 0 Interest on Debtor Balance, 30 11 5 £.1,912 14 10 £.3,676 1 9 * For further Liabilities vide page 8. JOHN CLEMENTS, Auditors. THOMAS JONES, RICHARD ATTENBOROUGH, EVAN ORTNER, 6 7 ST. JAMES'S, WESTMINSTER. An Account of all Contracts entered into or continued by the Vestry during the Year ending the 25th day of March, 1865. Date of Contract. Name of Company or Party with whom Contract was made. Nature of Work to be performed or Materials to be used or supplied. Amount, or Price. 30th June, 1862, EDWARD THIRST, General Works and Repairs to Sewers, At 15½ per cent. under the various prices affixed to the items in the Schedule to the Contracts. 25th March, 1863, MOWLEM & Co. Paviors' and Masons' Works, and for the supply of Granite and other Stone, and Materials for Re-laying and Repairing the Carriageways and Footway Pavings, At various Prices, as specified in the Contract. 25th March, 1863, THOMAS FERGUSON, Cleansing the Parish, excepting Regent Street, Regent Circus, and Waterloo Place,—Removing Dust from the whole of the Parish, At and after the Rate of £1,020 per Annum. 25th March, 1863, THOMAS FERGUSON, Street Watering, the Parish, excepting Regent Street, Regent Circus, and Waterloo Place, and St. James's and Golden Squares, . At 10.9. per day for each single Cart, Horse, and Man. 25th March, 1863, CHARLES GODDARD, Watering St. James's and Golden Squares, At 8.9. per day for each single Cart, Horse, and Man. 24th December,1860, WESTERN GAS LIGHT COMPANY, Lighting the Public Lamps in their Division of the Parish, At£.4 1s. per Lamp per Annum. 24th December,1860, CHARTERED GAS LIGHT COMPANY, Lighting the Public Lamps in their Division of the Parish, At £.4 1s. per Lamp per Annum. 1st May, 1861, HENRY BROWSE, Repairing, Cleansing, and Watering Regent Street, including the charge for Water, Not to exceed £.3,500 per Annum. 25th March, 1865. HENRY BROWSE, Repairing, Cleansing, Watering, and Maintaining Roadway in Piccadilly, and Coventry Street, (so much as lies in this Parish), At and after the Rate of £. 1,480 per Annum. JOHN CLEMENTS, Auditors. THOMAS JONES, RICHARD ATTENBOROUGH, EVAN ORTNER, 8 St. James's, Westminster. A Statement of the Debts and Liabilities owing by the Vestry on the 25th day of March, 1865. £. s. d. A Sum of £ 1504 14s. 2d. remaining due to the Trustees of the County Fire Office, with Interest thereon at 4 per cent. from the 14th January, 1856, in respect of a Deed of Assignment, executed by the late Board of Commissioners for Paving and Improving this Parish, on the 14th July, 1852, of the Rates under their jurisdiction, in consideration of a Loan of £.3,300 made then by the said Trustees to the said Commissioners, for the purposes of the Act 14 & 15 Vict. cap. 95,—vide Sections 18, 19, & 21. This sum of £.1504 14s. 2d. and Interest, is a charge upon and has to be specially raised from, the Occupiers of the Houses, &c. in Regent Street, situate as well within this Parish as within the Parish of St. George, Hanover Square, 1504 14 2 A Sum of £.5100 remaining due to the Trustees of the London Life Association, with Interest thereon at 5 per cent. per annum, in respect of a Mortgage of the Sewers and General Rates, made by the Vestry on the 25th day of July, 1861, in consideration of a Loan of £.6000, for the erection of the Vestry Hall, in Piccadilly 5100 0 0 A Sum of £.1400 borrowed by the Trustees of Golden Square upon Security of the Rates raised under their Local Act, with Interest at 5 per cent. paid by the Trustees to the Bondholders, from the 1st January, 1856, to the 16th July, 1863, and continued Interest to the Bondholders from the 16th December, 1864. The payment of such Debt and Interest being transferred to the Vestry by the 180th Section of the Metropolis Local Management Act, 1855, 1400 0 0 JOHN CLEMENTS, THOMAS JONES, RICHARD ATTENBOROUGH, EVAN ORTNER, Auditors. 4 General Report of Works EXECUTED BY THE VESTRY OF ST. JAMES'S, WESTMINSTER, IN THE YEAR 1864-05. 11 To the Chairman and Vestry of St. Jamess, Westminster. Vestry Hall, Piccadilly, June 1865. Reverend Sir, My Lords, and Gentlemen, In accordance with the requirements of the Act of Parliament and annual custom, I have again the honor of presenting a list of the various Works that have been executed by the Yestry in the department under my superintendence. A great part of this work, as I have often before stated, is of a routine character, and as far as Paving Works are concerned, is included under the heads of gas and water companies' trenches which have been made good, and places disturbed by private individuals for various purposes. As the cost of these works is re-imbursed to the Yestry, no corresponding figures will be found against the items. It must, however, be remembered that the making good these openings is a most important 12 work achieved, the real consequence of which can only be measured by the accidents and mischief that might arise were they in any way neglected ; and in the busy thoroughfares of St. James's Parish unquestionably such accidents would arise did any neglect or want of promptness exist. With the exceedingly small staff that is maintained for Paving purposes, the Yestry might be contented if they did all these small matters with dispatch and neatness; but, in addition to these constantly recurring openings, a multitude of small repairs have been executed; to attempt to give a list of these would not be actually impracticable, but would answer no useful purpose to print, as it would form a small volume of itself, and many of them come periodically before the Works Committee, and are also periodically reported to the Yestry. One small, though most useful and important work, has been the erection of a Refuge for Foot Passengers at the junction of Waterloo Place and Pall Mall. There is 110 doubt that this is a great public convenience and safeguard at this point, though being intended principally as a preventive to accidents, it is difficult to prove what accidents might have happened for the want of it; the immediate cause of its erection being, however, a fatal occurrence, proves that the necessity really existed for some such protection. The Sewers Works executed by the Yestry have been rather more extensive than they had been for 13 a year or two previously. Two new sewers have been constructed in the place of old and defective ones, viz. in portions of Warwick and Beak Streets, and Naylor's Yard, Silver Street. The actual necessity for the performance of these works was of course ascertained by the Works Committee before they were commenced. Both are a great improvement upon the old in every way, particularly as to depth and fall, and sooner or later must have been done. The majority of our sewers works are of a small but extremely troublesome nature, consisting chiefly of cleansings and repairs, involving a large amount of skill, anxiety, and care in their execution —much more than would be supposed—as every effort has to be made, and very properly, so that as little annoyance as possible shall be given to the persons whose premises we invade for the purpose, for it must be remembered that these " tributary" sewers are constructed almost entirely beneath the vaults, areas, and in some places kitchens, of private houses; they were the original drains continued from house to house as the houses were built, but only large houses had any such appliances originally at all, the smaller ones only had a cesspool; the consequence is that the various Sewers Commissions constructed proper sewers where none whatever existed, but left those streets untouched where there actually was sewerage, however defective, to be dealt with at some future time. The consequences of this 14 arrangement have now fallen upon the Vestry to put straight, for it is in the most important thoroughfares of the Parish, viz. Regent Street, Piccadilly, and the Haymarket, that our principal difficulties are experienced. It is needless to observe that these tributary sewers are very irregular, dilapidated, and small, so that is impossible for men to traverso them as they can a larger sewer, consequently that which would be immediately removed from a properly constructed sewer in a short time causes a complete stoppage in the small, the consequences of which, unless immediately relieved, would be most serious, as tlio least reflection on the work, a sewer is intended to do, will shew. Very little has been done in the matter of Public Urinals and Conveniences ; in fact, with the exception of clearing a drain or so when stopped, nothing has been attempted in this important matter. One has been removed from the North end of Pall Mall Place, at the request and expense of the Inhabitants. The Works Committee have given all the attention in their power to the subject, but the difficulties of selecting an appropriate and reasonably unobjectionable site, have hitherto been insurmountable. One additional Lamp has been erected, in the centre of the refuge for foot passengers, at the junction of Waterloo Place and Pall Mall. 15 The Lists annexed shew the most definite of these various works, but it is not, of course, only in the actual execution of works, that the time of the Yestry, the Works Committee, and the officers has been engaged ; a great portion of the time of the latter has been and is always occupied in regulating and controlling works done by other persons, and which cannot be included in the list, but should not therefore be altogether overlooked, as they rank with the others in importance. I have the honor to be, Rev. Sir, My Lords and Gentlemen, Your most obedient humble Servant, A. P. HOWELL, Vestry Surbegor. 17 GENERAL WORKS, &c. executed by the Vestnj of St. James's, Westminster, from 25th March, 1864, to 25th March, 1865. Situation. Description of Work. Cost. Total. Haymarket PAVING WORKS. Relaying Carriageway, including re- setting Kerb, regulating same, and making good portions of Footway, £. 345 s. 10 d. 0 £. 5. d. Gas and Water Companies' Trenches. 1750 Trenches made good for the Gas and Water Companies. The cost of doing which is re-imbursed to the Vestry by the Companies. Glasshouse Street Relaying Carriageway and Alterations to Footway and Kerb, 190 0 0 Private Works. Making good 87 Openings made for various purposes by private individuals. The cost of these works has been reimbursed to the Vestry. Waterloo Place, at junction of with Pall Mall Refuge for Foot Passengers erected 20 0 0 555 10 0 LAMPS. New Refuge, Pall Mall . One old Column and new Lamp fixed . 3 12 6 Savile Row, Glasshouse Street, New Burlington Street, and Clifford St. Alterations to various Lamps 17 16 2 21 8 8 URINALS. Pall Mall Place, North end Urinal removed. Expense borne by Inhabitants. Vine Street Clearing and making good Drain 3 15 3 Court in Haymarket Ditto ditto 1 10 0 5 5 3 NAMES TO STREETS. George Court, Rupert St. 3 Lables Painted 0 10 6 Pall Mall Place 2 ditto 0 7* 6 Bridle Lane Notice Board fixed 0 10 6 1 8 6 WATER CART. Repairs to Water Cart, new Hose, &c. 11 7 0 11 7 0 £594 19 5 18 SEWERS WORKS. Situation. Description of Work. Cost. Total. £. 8. d. £. s. d. 594 19 5 GULLIES CLEANSED. 131 Gullies Cleansed 66 0 0 66 0 0 GULLEY DRAINS REPAIRED. 52, Regent Street 2 0 0 10, Charles Street Ditto 1 0 0 69, Haymarket Ditto 1 14 0 133, Regent Street Ditto 1 2 0 201, ditto Ditto 1 12 0 202, ditto Ditto 1 12 0 208, ditto Ditto 1 12 0 158, ditto Ditto 1 16 0 66, ditto Ditto 1 9 0 203, ditto Ditto 1 9 0 15 6 0 GULLIES TRAPPED. Glasshouse Street Gulley Trapped 1 6 0 Wardour Street Ditto 0 12 6 1 18 6 NEW GULLIES BUILT. 69, Haymarket New Gulley Built 20 0 0 98, Regent Street Ditto 8 10 0 99, ditto Ditto 8 10 0 Feather's Yard, Oxford St. Ditto 12 0 0 49 0 0 VENTILATORS REPAIRED. Repairs to Ventilators and Side Entrances 5 10 0 5 10 0 FLUSHING SEWERS. Flushing 58 Pipe Sewers 55 0 0 55 0 0 Carried forward £. 787 13 11 19 SEWERS WORKS.—Continued. Situation. Description of Work. Cost. Total. £. s. d, £. s. d. Brought forward, 787 13 11 NEW SEWERS. Naylor's Yard Destroying old Sewer, constructing about 150 feet run of new Sewer, 4 feet by 2 feet, and connecting all V existing Drains 183 0 0 Warwick Street and Beak Street Destroying old Sewer, constructing new ditto, about 300 feet run, 3 feet 9 inches by 2 feet 6 inches, and connecting all existing Drains 325 0 0 -508 0 0 TRIBUTARY SEWERS CLEANSED. Regent Street, by 149 Tributary Sewer Cleansed 0 12 0 Ditto 99 to 103 Ditto ditto 10 0 0 Ditto 69 to 75 Ditto ditto 5 0 0 Ditto 270 . Ditto ditto 14 5 0 Ditto Argyll Place Ditto ditto 1 5 0 Haymarket,next Piccadilly Ditto ditto 4 17 0 Ditto from 40 to 49 Ditto ditto 47 10 0 Jermyn Street, nr.Church Yard Ditto ditto 24 0 0 Cleveland Yard, St. James's Ditto ditto 10 0 0 117 9 0 LOCAL SEWERS CLEANSED. Jermyn Street Removing accumulation of various Materials from the whole length of Sewer 163 0 0 Bridle Lane Cleansing Pipe Sewer 21 0 0 184 0 0 PRIVATE DRAINS. Connecting 27 House Drains with Sewers in various places. Cost re-imbursed to Vestry. £1597 2 11 Ninth Annual Report made to the VESTRY OF ST. JAMES'S, WESTMINSTER, FOB THE YEAR 18G4-65, by EDWIN LANEESTEE, M.D. E.E.S. F.L.S. member of the royal college of physicians ; medical officer of health and public analyst for 8t. james's, westminster. a TO THE VESTRY of The Parish of St. James's Westminster. Reverend Sir, My Lords, and Gentlemen, I have now to lay before you my Ninth Annual Report. It will embrace as heretofore an examination of the causes of death of the past year, and a survey of the work done under my superintendence, and of the various Reports I have laid before the Vestry during the year 1864. MORTALITY OF THE YEAR 1864. The following Table gives the Annual death rate of the Parish for the past nine years:— Year. Deaths. 1856 682 1857 712 1858 669 1859 764 1860 723 1861 758 1862 727 1863 757 1864 832 23 24 It will thus be seen, that the highest death rate for the last nine years is that of 1864. From this it would appear that all your sanitary arrangements have been in vain, and that, in spite of our sanitary activity, mortality is on the increase. It will be observed however, that this is not really the case, and that there has not been a regular increase of deaths for the last nine years. The year 1862 was not above the average, whilst the years 1863 and 1864 have undoubtedly been years of exceptional mortality. I have been at some pains to inquire into the cause of the increased death rate of the the two past years, especially the year 1864, and I now proceed to lay before you the result of my inquiries. ZYMOTIC DISEASES. In the first place I would call your attention to the fact that the great increase of mortality of 1864 over the two preceding years, has not depended upon these diseases belonging to the Zymotic Class, which are generally allowed to be diseases most under the control of sanitary activity. As 1862 may be regarded as an average year, it may be regarded as a standard year, and I shall therefore compare 1863 and 1864 with that year, for the purpose of ascertaining where the two last years show an increase of mortality on that year. I 25 I therefore present you with a Table of Zymotic Diseases for the three last years:— 1862. 1863. 1864. Diarrhoea, 13 20 15 Hooping Cough 33 22 29 Measles 9 24 29 Scarlet Fever and Diphtheria 66 31 13 Small Pox 1 21 , , Typhus and Typhoid 13 8 14 135 126 98 This table is interesting as shewing that the mortality of the last year has not been owing to the increase of these diseases which are regarded as most preventible by sanitary measures. The following gives the total mortality from all the foregoing Zymotic diseases for the last ten years:— Year. Total Cases of Diseases. 1855 130 1856 85* 1857 93* 1858 70* 1859 121 1860 80* 1861 111 1862 135 1863 126 1864 98 Thus it will be seen that there are but four years 1856,-57,-58,-60, with fewer deaths from Zymotic diseases than in 1864. It is clearly then not in the group of Zymotic diseases that we have to look for the cause of the increased mortality of 1864. 20 DISEASE IN DISTRICTS. I now proceed to inquire with regard to the mortality of 1864, whether it was more severe in one district than another, and I present the following table:— District of Parish. Deaths in 1864. 1863. 1862. St. James's Square 167 151 127 Golden Square 256 232 247 Berwick Street 272 214 218 Workhouse 139 159 135 834 756 727 It will be seen from this table that whilst there has been little or no difference in the mortality of the Workhouse between 1864 and 1862, that there has been a great increase of death in the Berwick Street Division of the Parish, less in the St. James's Square District, and least of all in the Golden Square District. It will be seen that the difference between the mortality of 1862 and 1864 is 107, whilst the excessive mortality of St. James's Square Division is 42, and that of Berwick Street is 74, making altogether 116, and thus giving the districts in which the excessive mortality occurred. 27 MORTALITY OF THE SEASON OF THE YEAR. Having ascertained the districts in which the mortality occurred, and then examined the tables of mortality, for the purpose of ascertaining whether the deaths had occurred in particular seasons, or all through the year, the following table presents the results:— Season of the Year. Deaths in 1864. 1863. 1862. First Quarter 284 214 183 Second ,, 163 202 158 Third ,, 180 184 188 Fourth ,, 207 156 198 834 756 727 From this it will be seen that the excess of death in the year is almost entirely accounted for by the death of the first quarter of the year 1864, which was 101 over the death in the first quarter 1862, and seventy over the death of the same quarter in 1863. NATURE OF FATAL DISEASES. In order to ascertain whether this mortality depended on any particular disease or class of diseases, I threw all the deaths into the following seven groups :— 28 Group I.— Zymotic diseases, including SmallPox, Measles, Hooping Cough, Scarlet Fever, Diphtheria, Diarrhoea, Typhus, Thrush, Croup, Erysipelas, Syphilis, &c. Group II.—General diseases as Dropsy, Mortification, Abscess, Cancer, Gout, &c. Group III.—Scrofulous diseases as Consumpstion, Tabes, Water on the Brain, and Scrofula. Group IV.—Diseases of the Brain. Group Y.—Diseases of the Chest including Lungs and Heart. Group VI.—Diseases of the Abdominal Viscera, including the Stomach, Liver, Kidnies, &c. Group VII.— Cases of death not embraced in the foregoing Groups. 1862. 1 2 3 4 5 6 7 Total. 1st Quarter, . 38 8 35 21 35 7 39 183 2nd Quarter,. 30 6 33 23 24 14 28 158 3rd Quarter, . 48 7 36 30 23 16 28 188 4th Quarter, . 43 8 31 14 56 6 40 198 159 29 135 88 138 43 135 727 1863 1 2 3 4 5 6 7 Total. 1st Quarter, . 42 4 36 30 48 13 41 214 2nd Quarter,. 38 12 47 25 43 10 27 202 3rd Quarter, . 53 11 24 17 37 11 31 184 4th Quarter, . 23 8 28 20 34 22 21 156 156 35 135 92 162 56 120 756 1864. 1 2 3 4 5 6 7 Total. 1st Quarter, . 32 7 41 35 115 12 42 284 2nd Quarter, 11 7 48 16 44 11 26 163 3rd Quarter, 37 10 30 30 30 17 26 180 4th Quarter, 38 7 35 24 64 11 28 207 118 31 154 105 253 51 122 834 29 From this table we arrive at the important result that whilst in all other groups the difference between 1862 and 1864 is in favour of 1862 by eight cases, the increase of disease in Group V. is 115 cases, thus showing most clearly that acute diseases of the chest were the real causes of the high mortality of 1864. AGE OF theSE WHO DIED. I was still anxious however to ascertain whether this mortality had fallen on children or adults, and accordingly I have drawn up the following comparative table of the ages of these who have died in the past year. I theught it would be sufficient for my purpose in this case, to divide the death of each year into two groups, the one of death under five years, the other of death above five years. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Under 5 Years. Above 5 Years. Under 5 Years. Above 5 Years. Under D Years. Above 5 Years. Under 5 Years. Above 5 Years. 1862 78 105 66 92 94 94 94 104 1863 91 123 82 20 85 99 65 91 1861 90 194 62 101 80 100 91 109 This table is very interesting, as shewing that the whole death of 1864 fell on the lives of persons above five years old, and that it was not infant mortality but adult mortality we had to contend. 30 This will be seen by comparing the excess of adult mortality over the infant mortality in each year. Thus in Infant Death. Adult Death. Excess of Adult Death. 1862 332 395 63 1863 323 433 110 1864 330 504 174 Supposing the excess of 63 in adult deaths in 1862 to represent the normal or average excess of adult death above infant death, the excess of the adult death in 1864 gives us 111, which is about the excess of death of 1864 over 1863, and we thus come to the conclusion that the excessive death of 1864 fell on the adult life of the population. In advance of this, I have made two other inquiries, one as to the real nature of the disease of the chest which took off this century of adults, and the next the nature of their occupations. SPECIAL NATURE OF DISEASE. Now, of the diseases of the chest, the only two that present constantly high numbers are bronchitis inflammation of the air passages, and pneumonia, inflammation of the air sacs of the lungs. The following table will shew the comparative prevalence of these two diseases, through the quarters of the years 1862-3 and 4:— 31 BRONCHITIS. Under 5 Years old. Above 5 Years old. 1862. 1863. 1864. 1862. 1863. 1864. First Quarter 5 4 18 16 13 55 Second ,, 2 38 5 9 10 13 Third „ 2 2 2 9 9 7 Fourth ,, 9 10 16 11 7 18 Total 18 54 41 38 39 93 PNEUMONIA. Under 5 Years old. Above 5 Years old. 1862. 1863. 1864. 1862. 1863. 1864. First Quarter 1 8 9 2 3 7 Second ,, 2 8 8 1 2 3 Third ,, 3 5 6 6 4 3 Fourth ,, 12 2 14 4 3 5 Total 18 23 35 13 12 18 It will be seen from these tables that bronchitis is to be credited with the largest amount of the excess of death, and pneumonia follows. The deaths from bronchitis in 1864 in excess of 1862 being 78, and the excess of pneumonia being 22. The excess from pneumonia, however, amongst adults, is only 5. In order, therefore, to substantiate 32 our previous position, that the whole excess of death in 1864 was in adult life, we have to turn to the remaining diseases of the chest, and here we find that an increase of the number of fatal cases ascribed to disease of the heart will make up for the deficiency thus produced. The diseases of the heart in the three years, were as follow:— 1862. 1863. 1864. 1st Quarter 7 13 16 2nd ,, 5 11 11 3rd „ 7 10 6 4th „ 3 7 7 22 41 40 There were 18 more cases of death from this cause in 1864 than in 1862. SEX AND OCCUPATION OF theSE WHO DIED IN EXCESS IN 1864. The next inquiry I have made was into the occupation of these who were attacked by this excess of mortality, and first I proceeded to get the sex of these who had died of diseases of the chest, and of the 157 persons who died at over five years of age, I found that 57 were males, and that 94 were females. It might have happened that this death was only that of old persons, between sixty 33 and eighty, and that consequently the loss to the community was not so great. I find, however, on looking at the ages, that of all the deaths in 1862-3-4, the death is not greater upon old life in 1864 than upon the whole adult life. Thus in of diseases of the chest. The excess of the death on persons above sixty is shewn to be only 21. We are thus driven to another conclusion by these calculations, that at least 80 of the 107 persons who died in excess, belonged to the most productive and the most valuable members of society. The occupation of persons whose deaths are recorded in the Registrar-General's returns are not sufficiently accurate to enable any one to come to correct conclusions, with regard to the death of so small a number as are involved in the group of diseases we have been considering. I find, however, of the deaths of 90 persons from diseases of the chest, that 23 may be regarded as pursuing active occupations, whilst the remaining 67 were engaged in sedentary occupations, as tailors, shoemakers, shopkeepers, &c. At first sight this would look as theugh persons pursuing sedentary occupations, must be most exposed to the excess of mortality of the year, but on turning to the Persons died above 60. 1862 27 1863 34 1864 48 34 classified list of occupations in our Parish, which I published in my last year's Report, you will find that the proportion of persons employed in in-door and sedentary occupations, is greater by more than three to one of these pursuing active occupations ; it will be seen that there is no reason to infer that this death especially affected these who pursued one particular kind of vocation, or one particular group of vocations. TEMPERATURE OF THE AIR. There is one great cause of death over which the Medical Officer of Health has comparatively little control, and that is diminished temperature or cold. It has been found on a much more enlarged scale than that which any single parish can afford, that after the age of thirty, cold exercises so baneful an influence, that its effects can be given by a kind of law. Thus, if the temperature falls low enough to produce one death at thirty years of age, it will produce two at thirty-nine years of age, and four at forty-eight years of age, and eight at fifty-seven years, and sixteen at sixty-six years, and so on. The question then for us now to answer is, whether the death of 1864 depended on a diminution of temperature in that year. 35 I now give a total of the average temperature of each quarter for the three years which we have already compared:- Average of Temperature. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. 1862 49'5° 40'6° 53'2° 58'7° 45'6° 1863 46'8° 42'5° 52'7° 59'2° 43'0° 1864 48'6° 38'2° 53'5° 59'4° 43'5° Now the most remarkable thing about this table is that the 1st Quarter of 1864, gives the lowest temperature of the 1st Quarters of the three years. It was in that Quarter the great excess of death occurred, and it is to that fall of temperature or rather that continuous low temperature to which we must attribute the excess of death of 1864. PREDISPOSING CAUSES OF DEATH FROM COLD. But there is another question of high interest to us, and that is how is it that certain persons die of cold, whilst certain other persons live on. Altheugh I have shewn that the great excess of death fell on persons between thirty and sixty years of age, yet after all only a few persons comparatively speaking, of that age died in the Parish. What then were the causes that predisposed to that death ? Occupation.—I have stated that the results of my examination of the cases of death, did not shew that any particular occupation predisposed to death. Overcrowding.—The fact that the largest amount of the excessive mortality fell upon the Berwick Street district, would seem to indicate that this has 36 been an active predisposing cause. Overcrowding produces impurity of the air which is breathed, and impure air constantly breathed, will at last undermine the strongest constitution. It does this in various ways, indigestion is first produced, then the blood is imperfectly constituted, every organ of the body then begins to suffer, the liver, the kidnies, the skin, all perform their functions defectively, the capillary vessels and the nervous filaments supplying them become imperfectly organised, and they are incapable of carrying on the functions of the lungs, especially witheut congestion. The consequence of all this is that exposure to cold produces fatal disease of the lungs. Use of Gas.—Overcrowding may explain the death in the Berwick Street division, but we found an excess of death in the St. James Square division, where overcrowding can hardly be said to exist. But it is in this division of the Parish that the perverseness of man has succeeded in producing results precisely similar from quite a different cause. The use of gas witheut sufficient ventilation renders the air as impure as if overcrowding were present. One gas light consumes as much Oxygen and gives out as much Carbonic acid as five human beings. The burning of gas gives rise to precisely the same consequences on the system, and I am convinced that a large amount of the mortality of persons above thirty, in London and our large manufacturing towns, is due to the utterly reckless way in which gas 37 is burned in shops, workshops, factories, sitting and bed rooms. Gas may be burned in rooms with impunity, and even made to assist in ventilating rooms, by arrangements being made for securing the exit of impure air and the entrance of fresh air. Such arrangements are not only not common, but they are the exceptions in the houses of our Parish, and such is the ignorance of the danger incurred by this process of slow poisoning, that it is with the greatest difficulty that even the most intelligent and wealthy of the inhabitants of the Parish, can be persuaded to adopt plans for preventing this poisoning of themselves and their families. One result of this poisoning of the blood by the impurity of the air is the extreme susceptibility of the system to cold. Hence persons have recourse to shutting up windows and doors, and enclosing rooms, and thus increasing tenfold their susceptibility to cold. Nothing is of greater importance to the health of the adult than the habit of breathing pure air in childhood and youth. This in fact explains the anomaly of so few persons living in London who are born there; the fact being that persons born in London get so badly nourished in their youth that they die off, or are obliged to go into the country, whilst the country people who have had the advantage of abundance of fresh air in their youth, are enabled more successfully to resist the destructive influences of London houses and habits. 88 Drinking Habits.— That drinking alcoholic beverages is a fertile source of disease there can be no doubt. The evidence on this head is abundant and conclusive. I have elsewhere* shewn, that an excessive use of alcohol produces the same results on the blood and tissues as aro produced by overcrowding, and gas poisoning. It is unfortunately the case that the very class of persons who are liable to diseaso from living in overcrowded or gaspoisoned apartments, are these who have recourse to the stimulus of alcohol, to relieve them of the depressing effects of an impure atmosphere. They thus add fuel to the fire that is consuming them. It is impossible to investigate each case of death from this point of view, but the well-established fact that the working classes of the community consume habitually large quantities of alcoholic beverages, is sufficient to account for the predisposition to these forms of chest diseases which we have seen carrying oft' so large numbers of our community. Alcoholic beverages are especially destructive of the health of these engaged in sedentary pursuits, and as it is that class of persons who have suffered most in our community, and as I have in vain sought for every proof that the consumption of alcoholic beverages is less in our population than others, I believe I am right in coming to the conclusion that the consumption of alcoholic beverages is one of the great * "Lectures on Food." Hardwicke, Piccadilly. 39 causes of death in our community, where the system is taxed for the purpose of affording resistance to the effects of an unusual depression of temperature. Overwork.—In prosperous and wealthy communities like that of the Parish of St. James's, and which may be regarded as the most wealthy and prosperous community in the world, there is the constant temptation to all classes of making money in proportion to the hours they can work. If we turn to the Census of occupations in St. James's, it will be seen that to the gains of the great mass of the population there are no limits but the necessity of sleep. If a tailor can work twenty hours whilst his neighbour can work only ten, there is the certainty of obtaining double gains, so with almost every other occupation that characterises the Parish. Here there is an enormous stimulus to work. A temptation to deprive the body of these hours of rest which are necessary for recruiting bodily strength. The want of sleep is a constant source of disease. It produces that exhaustion of the nervous system which speedily reacts upon the muscular system, and produces a variety of diseases. As the result of this ruinous practice no system suffers sooner than the respiratory system, and from an intimate knowledge of the habits of the working classes of our Parish I have no hesitation in saying that this system of over-work is a most fruitful cause of habitual disease, and especially exposes the system to the action of unusual 40 depression of temperature. It is not alone amongst the artisans and the lower classes as these who affect a better position in society call them, that these effects are seen. It is especially amongst our small tradesmen, our large tradesmen, our professional men, and the more studious of the upper classes, that this effect of overwork and under sleep is seen. The excessive death of our Parish has not been confined to these classes who are in a great measure dependent for their physical welfare upon the intelligence and sympathy of the wealthier classes, but the "grim tyrant" has remorselessly hewn down with the poor and the helpless, the wealthy and the powerful, wherever they have through ignorance or ambition, neglected the laws of Him who is as absolute in the government of the physical as the spiritual world. GENERAL WORK OF THE YEAR 1864. I now turn from the consideration of the causes of the high rate of death in 1864, to these questions of general interest in my department to which I have had occasion to refer in my reports to the Vestry from time to time. PAROCHIAL DEAD HOUSES. At the beginning of the year I drew the attention of the Vestry to the necessity of having a public 41 dead house independent of the Workhouse, for the purpose of depositing the bodies of these who died in houses where there was little or no accommodation for separating the dead from the living. I was induced to do this from having observed the great inconvenience and distress to which a large class of our Parishioners are put, when a death occurs in the household. I suggested that such a dead house should be situated independent of the Workhouse, as these of our Parishioners who most objected to sending their dead to the Workhouse were precisely these who with small incomes were successfully resisting any application for Parish relief, and who felt that to carry these whom they most loved to the Workhouse in death was a compromise with the principles they held most dear. The erection of a parish dead house, with convenient means for keeping the dead, and of making these examinations of the bodies by skilled anatomists, which is the most precious means of securing the health of the living, I felt was worthy of the ambition of the most wealthy and one of the most intelligent parish districts in London, and I hoped would have been acted on and been an example to the rest of the Metropolis. It was a great satisfaction to me to find that my representation to the Board of Guardians was so well received, and to find them recommending the subject to the serious consideration of the Vestry. 42 I subjoin an abstract from the letter of Mr. Buzzard, the clerk to the Poor Board, on the subject:— "The Governors of the Poor fully appreciate "the importance of a suggestion intended to "promote the health and comfort of these "numerous families who altheugh but little "removed from poverty yet struggle hard to main"tain themselves in honest independence of the "parish rates, and I am directed to suggest for "your consideration whether the proposition is not "of such a sanitary character, as you might very "properly bring under the notice of the Vestry, " with a view to the provision by the both of a " convenient receptacle for the purpose, and of " adequate arrangements for securing its prompt " use by application to an appointed officer of " Vestry quite distinct from the Workhouse or the " autherities thereof, the Governors of the Poor " feeling satisfied that such an association would " greatly tend to defeat the desired object." This question is still in abeyance. At the same time it cannot be too generally known, in order that legislative action may be secured, that at the present moment the Medical Officer of Health has no power of ordering the removal of a dead body from rooms where it may be producing upon the living the most disastrous results. This power is most desirable where bodies are obliged to be kept on account of the death being the subject of inquiry in the coroner's court. Here delay is often 43 necessary in order to secure the ends of justice, and it is in these cases that not only families but whole houses of families are grievously injured by the absence of any arrangement for the proper disposal of the dead. REGISTRATION OF DEATHS. I have often called your attention to the fact that many deaths appear on the register witheut any medical certificate, or the information that a coroner's inquest has been held. In many of these cases I believe that the coroner's information is returned after the death has been registered, but as this is a practice that must lead to incorrect results in estimating the death of the year, I allude to it as a source of error which ought to be corrected. At the same time I have the notes of cases in which certificates of registration of death have been granted, where certainly the coroner ought to have been informed of the death. The Government has given its sanction to the holding of inquests in all cases of persons found dead, or suddenly dying witheut medical assistance, or dying from accidental or personal violence or poison. In such cases it ought neither to be in the power of the registrar or coroner, or any other party, to prevent inquiry; but it is constantly the case that the registrar assumes to judge whether inquiry is necessary or not, and if he decides against the inquiry no inquest is held. I must protest against this power being placed in 44 the hands of registrars, who are not always persons capable of judging in these matters; and I am strongly of opinion, that the Legislature should definitely require, that in all cases where medical certificates cannot be procured, or where they are imperfect, or involve cases of sudden death, and deaths from violence, an inquiry should be conducted before a coroner's court. I know of no other system which can protect society from the possible risks of secret poisoning and other causes of violent death. The Medical Officers of Health in London have been impressed with the importance of this subject, and on the 17th of March, 1864, I laid before your Board the following correspondence:— METROPOLITAN ASSOCIATION OF MEDICAL OFFICERS OF HEALTH. 75, Gower Street, 9th March, 1864. Dear Sir, We arc directed by the Association to request that you will bring the annexed Memorial under the notice of your Vestry or District Board, with a view to their adopting it in your District. The grounds upon which an amendment is sought in the present laws relating to the Registration of Births and Deaths have been discussed fully at the Meetings of the Association. The registration returns of your own district, with your' own knowledge of the operation of the registration laws, will 45 probably furnish you with sufficient materials to justify the statements and prayer of the memorial; but if you desire further information upon the points raised therein, we shall be happy to furnish you with any facts that have been communicated to us by various of our fellow Officers of Health. We append a copy of a letter addressed by the RegistrarGeneral to a deputation of our Association that waited on him respecting an improved Registration of Births and Deaths. And we have the honour to be, Dear Sir, Yours faithfully, GEORGE BUCHANAN, Hon. secs. J. NORTHCOTE VINEN, To Dr. Lankester, Medical Officer of Health, St. James's, Westminster. General Register Office, Somerset House, 16th December, 1863. Sir, I will thank you to inform the Association of Medical Officers of Health that I will not fail to give my best consideration to the alterations in the Medical Certificate of Cause of Death, which were suggested by you and Dr. Buchanan when I lately had the pleasure of seeing you here. At that time you stated that there were four other points connected with this Department, in the opinion of the Metropolitan Association of Medical Officers of Health, susceptible of improvement:— 1st.—That the Registration of Births should, by statute, be made imperative and compulsory in England and Wales, as it now is in Scotland and Ireland. 46 2nd.—Tlmt the Births of Children stillborn should bo registered*. 8rd.—That no Death should bo registered except a written Medical Certificate of Cause of Death, from a legally qualified practitioner bo produced, or the record of the verdict of a Jury signed by the Coroner. 4th.—That no sudden death should bo registered until the decision of the Coroner bo made known to the Registrar whether ho will hold an inquest or not. I cannot say that I entirely concur in the opinion that you expressed that all these changes in the law should bo made; but I will not fail to bring them under the consideration of Her Majesty's Government, in order that a decision may bo arrived at, whether it is desirable for the sake of these proposed changes that in the next Session of Parliament another Bill should bo introduced amending the present Law of Civil Registration of Births and Deaths in England and Wales. I havo the honour to bo, Sir, Your faithful Servant, GEORGE GRAHAM, Registrar-General. Dr. Lankester, M.D. 8, Saville Row. * This was the suggestion in which the Registrar General was least disposed to concur with the opinions of the Deputation. For the present, therefore, it has appeared to the Association advisable not to press this suggestion in their Memorial to Government. But this particular point might, of course, be urged in any district where the Medical Officer of Health has very copious and unequivocal proofs of facilities being afforded to crime by the absence of provision for registering the stillborn. [G.B., J.N.V.] 47 The Memorial of the Vestry Board of Works for the Parish District of in the County of To the Right Hon. Sir George Grey, Bart. Her Majesty's Principal Secretary of State for the Home Department. Sheweth— That your memorialists have information, through their Medical Officer of Health, that a considerable number of Deaths are registered respecting which no sufficient evidence of the cause of death is produced, and that persons whose deaths are thus registered are interred upon Registrar's certificate witheut any inquiry being made into the manner in which they came by their death. That in other cases, where a medical certificate of the cause of death is produced to the Registrar, such certificate is given in a loose and unsatisfactory manner. That by these circumstances many deaths escape inquiry, about the cause of which there is reasonable ground for suspicion. That your memorialists further have reason to know that numbers of Births are not registered under the present provisions of the Registration laws for England, and that many fallacies and inconveniences arise from such omission. That in Scotland and Ireland the Registration laws provide for the registration, under penalty, of every birth. Your memorialists therefore pray— That Her Majesty's Government may be pleased to apply to Parliament for an amendment of the laws relating to the Registration of Births and Deaths in England, so as to provide— 1. For evidence in every case of death, as to the manner in which the deceased person came by his death. 2. For the complete registration of all births in 48 England, in the manner already provided for Scotland and Ireland. And your memorialists will ever pray. Signed on behalf of the Chairman. Clerk to the SMALL POX. The past year witnessed once more the freedom of the Parish from that most preventible of all diseases, small-pox. That this disease in the year 18G3 alone should have carried off in London above 2000 persons and have afflicted upwards of 12,000 more, is a fact that makes one stand aghast at the reckless indifference to human life that characterises our imperial and local governments. The remedy for preventing small-pox is Vaccination. To see that the whole population is vaccinated before it is six months old, is one of the easiest possible accomplishments to a government in earnest on the subject. It is done in many countries of Europe, and the consequence is small-pox is unknown amongst them. The real money cost of this amount of death and disease could not have been less than £.100,000. A tenth part of this sum spent in proper measures would have prevented the disease altogether. At my request the Sanitary Inspector was appointed by the Poor Board under my superinten- 49 dence to carry out the provisions of the Vaccination Act, and as far as possible to secure the vaccination of every child born in the Parish. I am sorry to say that this plan has failed. To bring up the arrears of neglected vaccination, and to keep up constant visits to those who were newly born, required the whole time of the Inspector, and I was reluctantly obliged to give up any further attempt at keeping up an Inspector for Vaccination. I hope however the failure of this attempt will not induce the Parish to abandon the plan I sketched out. The appointment of a separate Inspector for Vaccination would repay the community ten-fold, besides sparing life, which never ought to be regarded from a money point of view. During the time the Sanitary Inspector was engaged in his labours, above 100 children were discovered who were unvaccinated. At the same time a very large number who were born in the Parish had removed to other Parishes, and of course an equal number of children born in other Parishes had taken their place. This shews the necessity of united action in the Parishes of the Metropolis. It is vain for this and other sanitary purposes that one Parish should exert itself. United action is demanded, and it is I believe a question well worthy of consideration whether for sanitary purposes, it would not be wise to have a Board of Health for London alone, whose duty it would be to supervise and direct all sanitary measures that required unity of action. 50 At the present moment Parishes which are very much in earnest about sanitary action, are suffering from the inaction of their neighbours. BAKEHOUSES. During the year 1864 an Act came into force for the regulation of Bakehouses. Under the clauses of this Act the Vestry is constituted the proper authority to see to the execution of its requirements. Previous to the passing of this Act, the whole of the bakehouses in St. James's, Westminster, had been inspected, and I regarded them as in a satisfactory condition. Since the passing of the Act they have been put under a regular course of Inspection. On the 21st of July I reported that there were forty-five bakehouses in the Parish, forty-two of which were in the basement, and three in the rear of the shop. In these bakehouses there were employed, 109 men and 12 boys. Various suggestions have been made during the year for their sanitary improvement, and I have to report that in all cases there has been no hesitation on the part of the proprietors in complying with orders issued for their improvement. I may also add that one result of the desire on the part of the master bakers to improve the condition of their men, has been the formation in this Parish, of a Journeyman Bakers' Institute or Club, which serves the purpose of a House of Call, a Lodging House, and 51 Reading Boom, and I am glad to report that under the presidency of Mr. Bonthron of Regent Street, this Institution is likely to be a valuable agent in the improvement of the bodily and mental condition of journeymen bakers. WATER SUPPLY. It is now universally acknowledged that the health and life of large and populous communities is greatly affected by the nature of the water supply. Where water has been deficient and impure there disease has been rife and the bills of mortality high. Many towns in this country owe the diminution of their death rate from 28 or 30 in the thousand to 20, entirely to a new supply of pure water. Ten years ago the supply of Thames water to London was anything but what it ought to be. Through the watchfulness, however, of the Medical Officers, and especially of the publication of mortality reports by the late Dr. R. D. Thomson, Medical Officer of Health of St. Marylebone, in the Registrar General's weekly reports, the supply of Thames water has been greatly improved, and a supply is now afforded to London free from the injurious influence of organic contamination. It is to be regretted that this supply is still intermittent, and is stored in leaden cisterns and wooden butts, which when neglected to be cleansed, render the water impure. It cannot be too well known that 52 the water as supplied from the companies is perfectly free from injurious contaminations, and any impurity must arise from the impurity of pipes, cisterns, or other reservoirs in which it may be kept. The wells in this Parish are gradually being abandoned, as the longer they stand the more liable they are to impurities from the leakage of drains through rat-holes and the percolation of street gutters and cesspools. There are now but seven remaining in the whole parish, and these I constantly examine, for the purpose of preventing their use should any dangerous impurity arise. I have from time to time during the past year presented you with analyses of these waters. Some of them were carefully analysed by the late Dr. R. D. Thomson, in the laboratory of the Medical Officer of Health for St. Marylebone. The almost universal result of these examinations has been to shew that these waters present a greater amount of impurity than that supplied by the New River and Thames Water Companies. The few pumps remaining in London are almost entirely neglected for drinking purposes in favour of the fountains, which have been so generally erected in London by the Drinking Fountains Association. I would remind the Vestry that whilst the Parish of St. James's, Westminster, offers some of the finest sites for free drinking fountains in London, that there are fewer public fountains in its streets than in any parish in London. 53 CONCLUSION. Although the year 1864 was one of unusual sickness and mortality, I think I have succeeded in shewing that it has not arisen from the actual presence and progress of those causes of disease which are under the direct control of sanitary organisation. There remains undoubtedly much to do, and the fact, that indirectly even the excess of death of that year might have been limited by sanitary knowledge and appliances, gives hope for the future. Every year's experience shews more completely that man, by the application of his knowledge of the laws by which the Creator governs the world, can control the causes of disease and death. As these are the greatest disasters of our life, and the great antagonists of increasing wealth, it is the highest economy and the greatest practical wisdom to endeavour to conserve those vital powers of the community which are lost by death and disease. I am, Rev. Sir, My Lords, and Gentlemen, Your most obedient humble Servant, EDWIN LANKESTER. Vestry Hall, Piccadilly, June 1865. C APPENDIX, CONTAINING page 1. Tables of Causes of Death, 56 2. Report of Sanitary Inspector's Work, 60 3. A Summary of Work during the year, 63 4. Report on Vaccination for the year 1864, 64 5. Drains Reconstructed, Cleansed, Repaired, &c.) during the year 1864, 65 56 TABLE OF CAUSES OF DEATH. Deaths in Quarter ending March 26th, 1864. CAUSES OF DEATH. St. James's Square. Berwick | Street. Golden Square. Workhouse. Under 1 year of Age. Above 1 and under 5. Above 5 and under 20. Above 20 and under 40. Above 40 and under 60. Above 60 and under SO. Above 80 and upwards. At all Ages. Measles .. 4 .. .. 1 3 .. .. .. .. .. 4 Scarlatina 1 5 3 1 2 6 1 .. 1 .. .. 10 Hooping Cough .. 4 4 .. 2 6 .. .. .. .. .. 8 Diarrhoea 1 1 .. .. 2 .. .. .. .. .. .. 2 Typhus 1 3 1 l .. .. .. 4 .. .. .. 6 Erysipelas .. .. 1 .. 1 .. .. .. .. .. .. 1 Syphilis .. 1 .. .. 1 .. .. .. .. .. .. 1 Abscess .. .. 2 .. 2 .. .. .. .. .. .. 2 Mortification 1 .. .. .. .. .. .. .. .. .. .. 1 Cancer 1 2 .. .. .. .. .. 1 2 .. .. 3 Gout .. .. .. 1 .. .. .. .. 1 .. .. 1 Scrofula .. 1 .. .. .. 1 .. .. .. .. .. 1 Tabes Mesenterica 1 .. 1 1 1 1 1 .. .. .. .. 3 Phthisis 3 15 8 8 2 1 5 18 7 1 .. 34 Hydrocephalus 1 1 1 .. 2 1 .. .. .. .. .. 3 Apoplexy 3 3 3 1 .. .. 1 1 2 6 .. 10 Paralysis 2 .. 1 5 .. .. .. .. 2 5 .. 8 Delirium Tremens .. .. 1 .. .. .. .. 1 .. .. .. 1 Epilepsy .. .. .. 2 .. .. .. .. 1 1 .. 2 Convulsions 2 2 5 1 4 6 .. .. .. .. .. 10 Disease of Brain, &c. 1 1 1 1 1 1 1 .. .. 1 .. 4 Pericarditis .. 1 .. .. .. 1 .. .. .. .. .. 1 Disease of Heart, &c. 5 3 3 5 .. .. 2 2 7 5 .. 16 Laryngitis 1 .. .. .. .. 1 .. .. .. .. .. 1 Bronchitis 14 22 20 17 7 11 .. 4 22 26 3 73 Pneumonia 6 5 4 1 3 6 .. 4 1 2 .. 16 Asthma 2 1 2 .. .. .. .. 1 4 .. .. K Disease of Lungs, &c. .. 1 1 1 .. .. 1 .. 1 .. q Teething .. 1 1 .. .. .. .. .. .. 2 Peritonitis .. 2 .. .. .. .. 1 .. 1 .. .. 2 Ascites .. 1 .. .. .. .. .. .. 1 .. .. 1 Hernia .. .. 1 .. .. .. .. .. .. .. 1 Strict Intestinal Canal .. 1 .. .. .. .. .. .. .. .. 1 1 Disease of Stomach,&c .. 1 .. .. .. .. .. 1 .. .. .. 1 Disease of Liver .. 1 .. .. .. .. .. 1 1 .. 2 Cystitis 1 .. .. .. .. .. .. .. .. .. 1 1 Disease of Kidneys,&c .. .. 1 .. .. .. .. .. 1 .. .. 1 Childbirth .. .. 1 .. .. .. .. 1 .. .. .. 1 Rheumatism .. 1 .. .. .. 1 .. .. .. .. .. 1 Debility from Premature Birth, &c. 2 2 3 .. 6 1 .. .. .. .. .. 7 Atrophy 1 1 .. 1 2 .. .. .. .. 1 .. Age 1 3 3 14 .. .. .. .. .. 15 .. 21 Intemperance .. .. .. 1 .. .. .. .. 1 .. .. 1 Hanging, &c. .. 1 .. .. .. .. .. .. .. 1 .. 1 Fractures 1 .. 2 .. .. 1 .. 1 .. .. 1 3 Causes not specified. .. 2 1 1 1 .. .. .. 3 .. .. 4 52 98 75 64 41 49 14 40 59 67 14 284 57 Deaths in Quarter ending June 25th, 1864. CAUSES OF DEATH. St. James's Square. Berwick Street. Golden Square. Workhouse. Under 1 Year of Age. Above 1 and under 5. Above 5 and under 20. Above 20 and under 40. Above 40 and under 60. Above 60 and under 80. Above 80 and upwards. At all Ages. Scarlatina .. 1 1 .. .. .. 2 .. .. .. .. 2 Hooping Cough 1 .. .. .. .. 1 .. .. .. .. .. 1 Croup 1 2 .. .. .. 3 .. .. .. .. .. 3 Diarrhoea 1 .. .. .. 1 .. .. .. .. .. .. 1 Typhus 1 .. 1 .. .. 1 1 .. .. .. .. 2 Syphilis .. .. 1 1 2 .. .. .. .. .. .. 2 Dropsy 1 .. 1 .. .. .. .. .. 1 1 .. 2 Ulcer .. .. 1 .. .. .. .. .. .. 1 .. 1 Cancer .. .. .. 2 .. .. .. .. .. 2 .. 2 Gout .. .. .. 2 .. .. .. .. 1 1 .. 2 Scrofula .. .. 3 .. .. 3 .. .. .. .. .. 3 Tabes Mesenterica 1 2 3 .. 2 3 1 .. .. .. .. 6 Phthisis 6 9 10 9 .. .. 6 .. .. 3 .. 34 Hydrocephalus .. 3 2 .. 1 3 1 .. .. .. .. 5 Cephalitis .. .. 1 .. .. 1 .. .. .. .. .. 1 Apoplexy .. 1 1 .. .. .. .. .... 1 1 .. 2 Paralysis .. .. .. 2 .. .. .. .. .. 2 .. 2 Convulsions .. 2 4 1 5 2 .. .. .. .. .. 7 Disease of Brain, &c. 2 1 1 .. 1 1 2 .. .. .. .. 4 Aneurism .. .. 1 .. .. .. .. .. 1 .. .. 1 Disease of Heart, &c. 2 2 3 4 .. 1 3 .. 4 2 .. 11 Bronchitis 6 2 8 2 2 3 2 .. 6 4 .. 18 Pneumonia 4 4 2 1 4 4 2 .. 1 .. .. 11 Asthma .. .. .. 1 .. .. .. .. .. 1 .. 1 Disease of Lungs, &c. 1 .. .. 1 .. .. .. 1 1 .. .. 2 Teething 1 2 1 .. 2 2 .. .. .. .. .. 4 Gastritis .. 1 .. .. .. .. 1 .. .. .. .. 1 Enteritis .. .. 1 .. .. .. .. .. 1 .. .. 1 Intussusception .. .. 1 .. .. .. 1 .. .. .. .. 1 Disease of Liver .. .. .. 1 .. .. .. .. 1 .. .. 1 Nephritis .. .. 1 .. .. .. .. 1 .. .. .. 1 Nephria .. .. 2 .. .. .. .. .. 2 .. .. 2 Childbirth .. .. 1 .. .. .. .. .. 1 .. .. 1 Rheumatism .. .. 1 .. .. .. .. .. 1 .. .. 1 Malformations 2 .. .. .. 2 .. .. .. .. .. .. 2 Debility from Premature Birth, &c. 2 2 4 .. 8 .. .. .. .. .. .. 8 Atrophy 1 1 .. .. 1 .. .. .. .. 1 .. 2 Age 1 3 .. 4 .. .. .. .. .. 2 6 8 Burns and Scalds .. 1 .. .. 1 .. .. .. .. .. .. 1 Suffocation, &c. .. .. 1 .. 1 .. .. .. .. .. .. 1 Causes not specified .. 2 .. .. 1 .. .. .. .. .. 1 2 34 41 57 31 34 28 22 18 32 21 8 163 58 Deaths in Quarter ending October 1st, 1804. CAUSES OF DEATH. St. James's Square. Berwick Street. Golden Square. Workhouse. Under 1 year of Age. Above 1 and under 5. Above 5 and under 20. Above 20 and under 40. Above 40 and under 60. Above 60 and under 80. Above 80 and upwards. At all Ages. Measles 1 3 4 .. .. 5 3 .. .. .. .. 8 Scarlatina 1 .. .. .. .. .. .. 1 .. .. .. 1 Hooping Cough 1 2 6 .. 4 5 .. .. .. .. .. 9 Croup 1 .. .. .. .. 1 .. .. .. .. .. 1 Thrush 1 .. .. .. 1 • • .. .. .. .. .. 1 Diarrhoea 2 4 5 .. 7 3 .. .. .. .. .. 11 Remittent Fever .. .. 2 .. .. 1 .. .. .. .. .. 2 Typhus .. .. 2 .. .. 1 .. 1 .. .. .. 2 Erysipelas .. .. 1 .. .. .. .. .. .. 1 .. 1 Syphilis .. .. .. 1 .. .. .. .. .. l .. 1 Dropsy 1 1 .. .. .. .. .. 2 .. .. .. 2 Abscess 1 .. .. .. .. .. 1 .. .. .. .. 1 Fistula .. 1 .. .. .. .. .. .. 1 .. .. 1 Mortification 1 .. .. .. .. .. .. .. .. .. 1 1 Cancer l .. 4 .. .. .. .. 1 3 1 .. 5 Scrofula .. 3 3 1 2 4 1 .. .. .. .. 7 Tabes Mesenterica .. 1 .. 1 .. 2 .. .. .. .. .. 2 Phthisis 3 6 6 5 .. 1 10 .. 3 .. .. 20 Hydrocephalus .. .. 1 .. .. 1 .. .. .. .. .. 1 Apoplexy 1 2 .. 1 .. 2 .. .. 1 1 .. 4 Paralysis 1 .. 1 3 .. .. .. .. 1 4 .. 5 Delirium Tremens 1 1 .. .. .. .. .. .. 2 .. .. 2 Chorea .. 1 .. .. .. 1 .. .. .. .. .. 1 Convulsions 1 2 2 .. 3 1 .. .. .. 1 .. 5 Disease of Brain, &c. .. 1 1 .. 1 1 .. .. 1 .. .. 3 Pericarditis, 1 1 .. .. .. .. .. 1 1 .. .. 2 Disease of Heart, &c. 1 3 1 1 .. .. .. 2 3 1 .. 6 Laryngitis 1 .. .. .. .. 1 .. .. .. .. .. 1 Bronchitis 3 3 2 .. 2 .. .. .. 3 2 2 Pleurisy 1 .. .. .. .. .. .. .. 1 .. .. 1 Pneumonia .. 3 6 .. 2 4 1 2 .. .. .. Asthma .. .. 1 .. .. .. .. .. 1 .. .. 1 Disease of Lungs, &c. .. .. .. 1 .. .. .. .. .. 1 .. 1 Teething .. 2 2 .. 2 2 .. .. .. .. .. Gastritis .. 2 1 .. .. 2 1 .. .. .. .. Enteritis .. .. 1 .. 1 .. .. .. .. .. .. 1 Ulceration of Intestine .. .. 1 .. .. .. .. .. .. 1 .. 1 Strict. Intestinal Canal 1 .. .. .. 1 .. .. .. .. .. .. 1 Disease of Liver, l 1 1 1 .. .. .. .. 2 2 .. Stone l .. .. .. .. .. .. 1 .. .. .. 1 Cystitis 1 .. .. .. .. .. .. .. .. 1 .. 1 Disease of Kidneys,&c. .. .. .. 1 .. .. .. .. .. l .. 1 Ovarian Dropsy .. .. 1 .. .. .. .. 1 .. .. .. 1 Rheumatism 1 .. .. .. .. .. 1 .. .. .. .. 1 Carbuncle l .. .. .. .. .. .. .. .. .. 1 1 Disease of Skin, &c. .. .. 1 .. 1 .. .. .. .. .. .. 1 Poison .. 1 .. .. .. .. .. .. 1 .. .. 1 Drowning .. .. 1 .. .. .. .. .. 1 .. .. 1 Fractures .. .. .. 1 .. .. .. .. .. .. 1 1 Debility, Prem. Birth 2 .. l .. 3 .. .. .. .. .. .. 3 Atrophy 1 1 2 .. 2 .. .. .. .. .. .. 4 Age .. 4 3 3 .. .. .. .. .. 6 4 10 Causes not specified .. 1 1 .. 2 .. .. .. .. .. .. 2 34 50 64 22 34 40 19 18 25 24 10 170 59 Deaths in Quarter ending December 31st, 1864. CAUSES OF DEATH. St. James's Square. Berwick Street. Golden Square. Workhouse. Under 1 year of Age. Above 1 and under 5. Above 5 and under 20. Above 20 and under 40. Above 40 and under 60. Above 60 and under 80. Above 80 and upwards. At all Ages. Measles 3 6 6 .. 1 12 2 .. .. .. .. 15 Hooping Cough 2 3 6 .. 3 7 1 .. .. .. .. 11 Thrush 1 .. .. .. 1 .. .. .. .. .. .. 1 Diarrhoea .. 1 .. .. 1 .. .. .. .. .. .. 1 Typhus 1 .. 3 .. .. 1 .. 1 1 1 .. 4 Rheumatic Fever .. .. 2 .. .. .. 1 .. 1 .. .. 2 Erysipelas 1 1 .. .. .. .. .. .. 1 .. 1 2 Syphilis 1 .. .. .. 1 .. .. .. .. .. .. 1 Noma (or Canker) .. 1 .. .. .. .. .. .. .. .. .. 1 1 Dropsy .. 2 1 .. .. .. 1 1 .. 1 .. 3 Abscess 1 .. .. .. .. .. 1 .. .. .. .. 1 Cancer 1 1 .. .. .. .. .. .. 2 .. .. 2 Gout .. l .. .. .. .. .. 1 .. .. 1 Scrofula 1 .. 2 .. .. 2 1 .. .. .. .. 3 Tabes Mesenterica .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Phthisis 6 6 9 6 .. 1 3 8 12 3 .. 27 Hydrocephalus .. 1 3 .. 1 3 .. .. .. .. .. 4 Apoplexy 2 .. 1 .. .. 1 .. .. 2 .. .. 3 Paralysis .. .. .. 2 .. .. .. .. .. 2 .. 2 Delirium Tremens .. .. 2 .. .. .. .. .. .. 2 .. .. 2 Epilepsy .. 1 .. .. .. .. .. 1 .. .. .. 1 Insanity .. .. 1 .. .. .. 1 .. .. .. 1 Convulsions 1 8 3 1 7 5 .. .. 1 .. .. 13 Disease of Brain, &c.. .. 1 .. l .. .. .. 1 1 .. .. 2 Disease of Heart, &c. 2 1 2 2 .. .. .. .. 1 6 .. 7 Laryngitis .. .. 1 .. .. 1 .. .. .. .. .. 1 Bronchitis 3 16 13 2 9 7 3 .. 8 7 .. 34 Pneumonia 4 5 10 .. 8 5 1 1 2 2 .. 19 Asthma .. 2 .. .. .. 1 .. .. 1 .. .. 2 Disease of Lungs, &c. .. .. .. 1 .. .. .. .. 1 .. .. 1 Teething 2 1 .. .. 3 .. .. .. .. .. .. 3 Enteritis .. 1 .. .. .. .. .. 1 .. .. .. 1 Peritonitis .. .. 1 .. .. .. 1 .. .. .. .. 1 Intussusception .. 1 .. .. .. .. .. .. .. .. 1 1 Strict Intestinal Canal .. .. l .. 1 .. .. .. .. .. .. 1 Jaundice 2 .. .. .. .. .. .. .. 1 .. 1 2 Disease of Liver 1 .. .. .. .. .. .. .. 1 .. .. 1 Stricture of Urethra . .. .. 1 .. .. .. .. 1 .. .. .. 1 Rheumatism .. .. 2 1 .. 1 .. .. .. 1 1 3 Malformations .. 2 .. .. 2 .. .. .. .. .. .. 2 Debility from Pre-) mature Birth, &c. j .. 5 2 1 7 1 .. .. .. .. .. 8 Atrophy .. 2 2 .. 2 1 .. .. .. 1 .. 4 Age .._ .. 1 3 2 .. .. .. .. .. 4 2 6 Suffocation, &c. 1 .. .. .. 1 .. .. .. .. .. .. 1 Fractures 2 .. .. .. .. .. 1 .. .. 1 .. 2 Wounds 1 .. .. .. .. .. 1 .. .. .. .. 1 Causes not specified.. .. 1 .. .. 1 .. .. .. .. .. .. 1 40 73 75 19 49 49 18 16 39 29 7 207 60 St. James's, Westminster. REPORT OF SANITARY INSPECTOR'S WORK, FOR THE YEAR 1864. NUISANCES REMOVED OR ABATED. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. For the whole Year. Areas, front lime-whited, 1 4 2 1 8 „ back, „ 1 .. 2 1 4 „ front, paving of, repaired, .. 2 .. .. 2 „ back, „ „ 2 .. .. .. 2 „ cleansed, .. 3 .. .. 3 Animal matter removed, .. 1 .. .. 1 Abodes cleansed, 4 7 1 .. 12 Basements lime-whited, 2 10 .. 6 18 „ passages lime-whited, .. 5 1 5 11 „ stairs, „ 1 10 8 7 26 „ floors washed, .. 2 .. .. 2 Bedding foul, washed, 1 4 1 .. 6 Bones removed, .. .. 3 .. 3 Butts, cisterns, and other water receptacles cleansed, .. .. .. 1 1 „ „ „ „ repaired, 1 .. .. 1 2 „ „ „ „ covers added to, 1 .. 3 2 6 „ „ „ „ new ones furnished, .. .. 3 .. 3 Cesspools cleansed out and filled up, 2 1 .. 1 4 Corpse human, interred by request, .. 1 .. 2 3 Courts, walls of, lime-whited, .. 1 .. .. 1 Clothing washed, .. 2 .. .. 2 Drainage matter, stopped from entering Premises, 2 4 3 2 11 Drains re-constructed, with pipes, 3 2 5 .. 10 „repaired, 4 7 4 8 23 „unstopped and cleansed, 4 15 13 8 40 „connected with Main Sewer, 2 .. .. .. 2 „old ones not in use removed, .. .. 1 2 3 „ traps added to, 3 5 6 2 16 „ connections of, made good, .. 1 .. .. 1 Dust-bins cleansed, 4 16 10 11 41 „ new ones furnished, 3 .. .. .. 3 „ tops and covers added to, .. 1 3 .. 4 „ repaired, .. 6 3 .. 9 Dilapidations, exterior, made good, 2 1 1 .. 4 „ interior, „ 1 5 4 4 14 Damp prevented, 4 1 2 1 8 Dwellings, the ventilation of, improved, .. 1 .. .. 1 ,, overcrowded ones cleared, 2 .. .. .. 2 Carried forward, 50 118 79 65 312 61 REPORT OF SANITARY INSPECTOR'S WORK(continued.) NUISANCES REMOVED OR ABATED. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. For the whole Year. Brought forward, 50 118 79 65 312 Fowls removed, .. .. 1 .. 1 Fish baskets and boxes removed, .. .. 2 1 3 Foul smells prevented, 11 4 5 3 23 Gas stopped from House, &c. 1 1 1 2 5 Gullies cleansed, .. 1 .. 2 3 „ repaired, .. .. .. 1 1 Houses, to which a full supply of water added, .. 1 1 .. 2 „ painted and white-washed, 1 .. 5 1 7 „ improvements made in the ventilation, .. 1 .. .. 1 Kitchens, front, lime-whited or white-washed, l 1 2 1 5 „ back, „ „ 2 4 4 2 12 „ cleared of occupants, 10 3 .. 1 14 Lumber removed, .. 1 .. 2 3 Lead flats and gutters cleansed, 2 .. .. .. 2 Pigs removed, .. 1 .. .. 1 Passages, entrance, lime-whited or white-washed, 3 21 3 3 30 „ floors of, cleansed, 3 .. .. 1 4 Pipes, waste, repaired, .. .. 1 1 2 Paint-work washed and cleansed, .. .. 4 .. 4 Rain-water pipes unstopped and cleansed, .. .. 1 .. 1 Rooms white-washed, 17 38 19 9 83 „ dilapidations in, made good, 4 4 2 1 11 „ paint-work of, cleansed, .. .. 2 3 5 „ floors of, washed, 7 6 4 4 21 „ purified, 1 .. .. .. 1 „ overcrowded ones cleared, 1 1 .. .. 2 Rubbish removed from basements and vaults, 1 1 .. 3 5 Smoke, .. 2 .. .. 2 Sheds, or outbuildings, lime-whited, .. .. 1 .. 1 Stairs, main, white-washed, 1 26 4 2 33 „ basement, .. .. 4 .. 4 „ steps washed, 2 .. .. 1 3 Shops, walls and ceilings white-washed, 1 .. 1 .. 2 Slops, offensive, removed, .. .. .. 1 1 Urinals trapped, 1 .. .. .. 1 Vaults ventilated, 1 2 2 1 6 Carried forward, 121 237 148 111 617 62 REPORT OF SANITARY INSPECTORS WORK,—(continued.) NUISANCES REMOVED OR ABATED. First Quarter. Second Quarter. Third Quarter. Fourth Qvarter. For the whole Year. Brought forward, 121 237 148 111 617 Water stopped from entering Premises, 6 5 3 4 18 Water-closets, lime whited, 4 42 11 8 65 „ ventilation improved, .. 1 .. .. 1 „ furnished with a supply of water, 3 6 7 11 27 „ seats, new ones added, or repaired, .. 1 5 4 10 „ raisers, „ „ .. 1 4 1 6 „ pans, „ 2 2 5 1 10 „ traps, „ 1 3 4 2 10 „ soil pipes, „ or repaired, 2 1 .. 1 4 „ apparatus, new or repaired, .. 4 3 2 9 „ general dilapidations in, repaired, 1 7 1 2 11 „ pans of, cleared of soil, 8 5 6 9 28 „ floors, new or repaired, 3 1 4 .. 8 „ cleansed generally, .. 1 3 17 21 „ soil pipes unstopped and cleansed, 2 .. 1 2 5 „ Windows repaired, .. .. .. 2 2 „ top sashes of, made moveable, .. .. 22 1 23 Yards, walls of, lime-whited, .. 34 10 7 51 „ paving of, claansed, .. .. 4 .. 4 „ „ repaired, - - - - - .. 3 6 4 13 „ walls of, „ .. .. .. 1 1 SLAUGHTER HOUSES. Lime-whited, .. 5 .. 9 14 Yards of, lime-whited, .. .. .. 3 3 Paving, or floors of, cleansed, .. .. .. 4 4 STABLES. Drains of, re-constructed, .. .. 2 .. 2 „ traps added to, .. .. 1 .. 1 „ of yards unstopped, .. 1 .. .. 1 „ „ repaired, .. .. 1 .. 1 BAKE HOUSES. Walls, ceilings, and other parts of, lime-whited and cleansed, .. .. 8 1 9 Totals, 153 360 259 207 979 63 SUMMARY OF WORK DURING THE YEAR. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. For the whole Year. Number of Nuisances removed, 153 360 259 207 979 „ notices served, 12 18 21 21 72 „ „ attended to, 11 18 20 17 66 „ houses drained with 9-inch pipes, .. .. .. 1 1 „ „ „ 6-inch „ .. .. .. .. 16 „ cases of scarlatina visited, 5 2 4 9 20 „ „ typhus fever „ 7 10 8 7 32 „ „typhoid „ „ 4 .. 2 .. 6 „ „ continued „ „ 13 3 1 4 21 „ „ small-pox „ 2 2 .. .. 4 „ „ diphtheria „ 3 .. .. .. 3 „ „ diarrhœa „ .. .. 9 1 10 „ „ dysentery „ .. .. 1 .. 1 „ complaints received from the inhabitants of the Parish, - 46 37 53 23 159 „ visits made to cowsheds, - 69 10 .. .. 79 „ „ slaughter houses, .. 13 12 22 47 „ „ bake houses, .. 46 21 5 72 64 REPORT ON VACCINATION FOR THE YEAR 18G4. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. For the whole Year. Children found Vaccinated, 150 37 97 54 338 „ „ Unvaccinated, 39 58 24 19 140 „ „ Vaccinated by Order, 4 16 20 39 85 „ „ „ failed once, 8 2 2 5 17 „ „ „ „ twice, .. 1 .. 1 2 „ „ „ „ three times, .. 3 .. .. 3 „ „ „ „ four times, .. .. .. 1 1 „ „ Vaccination doubtful, 3 .. .. .. 3 „ „ taken out of the Parish, 66 30 18 8 122 „ „ removed, but not known to where, 9 27 41 25 102 „ „ deceased before Vaccinated, 28 19 7 7 61 „ „ Parents not known, as per address given on Register, 32 25 3 11 71 „ „ Certificates seen, 32 45 36 17 130 „ „ „ mislaid, .. .. 33 25 58 „ „ whose Parents, &c. had not received Certificates, .. .. 55 55 Number of Parents who refuses to satisfy the inquiries made, 2 .. .. .. 2 „ Children who had had small-pox, 1 .. .. .. 1 20th May, 1865. JAMES H. MORGAN, Sanitary Inspector. 65 St. James's Westminster. Drains reconstructed, cleansed, repaired, c&c. during the Year 1864 8, Archer Street. Main drain unstopped and cleansed. December 21st. 5, Anglesea yard. Main drain unstopped and cleansed. May 13th. 11, Argyll Place. Cesspool cleansed out and filled up, Privy in vault of front area abolished and drain repaired. February 8th. 15, Argyll Street. Branch drain in rear of House repaired. November 15 th. 58, Berwick Street. Main drain cleansed and repaired, branch drain in front area reconstructed with 4-inch pipes, old drain in front kitchen abolished. October 24th. 7, Blue Ball Yard. Stable drained direct into the main sewer with 6-inch pipes, and the branches of 4-inch pipes. July 17th. 1, Burlington Gardens. A new main drain laid down from the main sewer in Cork Street, up to the front area, and connected with water closet; main of 4-inch and branches of 6-inch pipes. July 27th. —Babmaes Mews. Stable and Coach House; main drain reconstructed with 6-inch pipes from Stable to main sewer. August 5th. 16, Broad Street. Main drain unstopped and cleansed. December 5th. 66 22, Carnaby Street. Main drain of House reconstructed with 6-inch pipes, and reconnected with the main of No. 2, Cross Court. November 16th. 27, Carnaby Street. Main drain unstopped and cleansed. March 21st. 2, Cross Court. House redrained with 6-inch pipes direct into the main sewer in Cross Court. October 25th. 8, Cambridge Street. Main drain unstopped and cleansed. November 16th. 3, Crown Court, Great. Main drain unstopped and cleansed. June 8th. 8, Crown Court, Great. Main drain let off, cleansed, and repaired with 6-inch pipes. July 20th. 24, Duke Street. House drained with 6-inch pipes into the main sewer. January 20th. 5, Dufours Place. Main drain unstopped and cleansed. July 19 th. 66, Haymarket. Main drain reconstructed with 6-inch pipes from branch sewer up to the yard. March 21st. Unstopped and cleansed on June 16th. 8, Heddon Street. Main drain let off and cleansed. November 16th. 18, Heddon Street. Main drain unstopped, cleansed, and repaired. January 26th. 11, Heddon Court. Main drain in yard repaired. April 19 th. 8, Husband Street. Main drain unstopped and cleansed. October 18th. 3, John Street, Upper. Main drain cleansed and repaired. May 9th. 67 34, King Street, Golden Square. Main drain unstopped, cleansed, and repaired. September 19th. 14, Marshall Street. Old branch drain in front area and vaults reconstructed with 4-inch pipes. January 10th. 48, Marshall Street. Main drain reconstructed from water closet to main sewer with 6-inch pipes. August 8th. 49, Marshall Street. Main drain reconstructed from water closet to main sewer with 6-inch pipes. August 8th. 50, Marshall Street. Main drain reconstructed from water closet to main sewer with 6-inch pipes. August 12th. 53, Marshall Street. Main drain reconstructed from main sewer to water closet in yard with 6-inch pipes. August 12th. 16, New Street. Main drain unstopped and repaired. May 26th. 24, Noel Street. Main drain let off, cleansed, and repaired. September 1 9th. 13, Park Place. The 6-inch pipe main drain reconstructed, and the brick sides of the old drain in which it was laid, removed with the soil. April 13th. 30, Piccadilly. House drained direct into the main sewer with 6-inch pipes. February 9th. 13, Portland Street. Branch drain from sink stone in front kitchen reconstructed with 4-inch pipes, and connected to main in front area. February 11th. 4, Portland Mews. Main drain let off and cleansed. January 9th. 2, Rupert Court Main drain let off and cleansed. September 30th. 22, Rupert Street. Drain from water closet in yard, to the main in back kitchen, reconstructed with 4-inch pipes. June 8th. 68 37, Rupert Street. Main drain unstopped, cleansed, and repaired. September 2nd. Smiths Court. Main drain unstopped, cleansed, and repaired. November 15th. 21, Sherwood Street. House and premises drained direct into main sewer; main drain of 6-inch and the branches of 4-inch pipes. December 20th. 41, Silver Street. Main drain unstopped and cleansed. June 11th. 4, Tylers Court, Berwick Street. Main drain repaired in yard and back kitchen. August 17th. I, Tichborne Street. Main drain reconstructed with 6-inch pipe from the water closet to the front area. October 25th. 16, Sackville Street. Cesspool cleansed out and filled up ; main drain from water closet in rear of House to vault of front area reconstructed with 6-inch pipe. January 14th. 20, Windmill Street, Little. Main drain unstopped, cleansed, and repaired. August llth. 11,West Street. Main drain unstopped and repaired. July 19th. 46, Warwick Street. Cesspool cleansed out and filled up, House drained into main sewer; main drain of 6-inch and branch of 4-inch pipes. June 10th. 11, William and Mary Yard. Main drain let off and cleansed. March 12th. White Bear Yard. The whole of the old brick main drain of yard removed, and the 12-inch pipe main continued to the top of the yard. July 6th. JAMES H. MORGAN, 20th May, 1865. Sanitary Inspector. printed by thomas brettell, rupert street, haymarket.