STMART 7 ST. MARTIN-IN THE FIELDS, WESTMINSTER THIRD ANNUAL REPOET OF THE Medical Officer of Health, FOR THE YEAR 1858. LONDON: john smith & co., printers, long acre, w.c. 1859. MEDICAL OFFICER'S REPORT, For the Year 1858. To the Vicar, Churchwardens, and Vestrymen of St. Martin-in-the-Fields. Gentlemen, Three years having elapsed since the Metropolis Local Management Act came into operation, the time has arrived when some general conclusions may be reached in relation to its influence on the public health. I have drawn un some tables, from which I think we may infer several conclusions of great importance. The Parish of St. Martin-in-the-Fields is not so healthy as from its position on a soil of gravel, its elevation above the bed of the river—affording great facilities for drainage, and other advantages—would have led us to expect. Our death rate for an average of years has been 24 in 1000. The number of our parishioners dying in all the Hospitals of London has been ascertained to be about 40 in the year; so that it will be fair to deduct this number from the total deaths in Charing Cross Hospital. The result will be that we had in the whole parish, in the year 1856, 561 deaths, in 1857, 606, and in 1858, 593, making the respective death rates of these years 22.8, 24.5, 22.3, the average for 3 years being 23.5 in 1000. I shall compare these numbers with the mortality of other districts, and then 4 consider what may be the causes which are in operation to account for the unnatural and unnecessary amount of death in our own parish. The computations of the Registrar General give 17 per 1000 as the average death-rate of healthy districts. Hampstead and St. George's, Hanover Square, give about 18 deaths for every 1000 persons living, while some of the worst districts of the metropolis reach 30 per 1000. The parish of St. Martin stands in a medium between these extremes; but if we take the worst parts of the parish—the old streets and courts, where the drainage is the same as it was when the houses were built—some as far back as the reign of Elizabeth, and many in that of Charles I., we find our deaths nearly as numerous as in the worst parts of London. The drainage in these old houses is very complicated, frequently passing under several houses before it reaches a sewer. All drains carried under houses from their neighbours' should be reconstructed, so that every house might have a direct and independent drainage into a sewer. Were this done, I have no doubt that our death rate would be diminished, and the health of our population increased. So long as the wretched old brick drains are allowed to remain, and to circulate under ranges of houses from one to another, so long shall we be sanctioning an unnatural excess of death to the amount of about 100 human beings, who, under proper conditions of ventilation and drainage, would live to aid in the increase of the wealth and prosperity of their country. While we allow people to live in such places as Prince's Court, Charles Court, York Place, Bedfordbury and its courts, not only do more of our people die than ought, but of those who escape death, a large proportion, from the feeble health engendered by living under such circumstances, are incapable of much exertion, and add considerably to the amount of the poor rates. 5 The principal cause which swells up our death rate is the disproportion of deaths in children under the age of 5 years, the number being, in 1857, 228, and in 1858, 191, or about one-third of the total number of deaths. That the gross mortality of the parish is greatly increased by the large amount of infant mortality, will be obvious by comparing the deaths in various localities. In 7 houses in Princes Court the total mortality was 6, 5 being children. In 47 houses in Bedfordbury the total mortality was 27, that of infants 14. In 52 houses in Drury Lane, 12 out of 19 deaths were children under 5. In 180 houses in the Strand, out of 12 deaths 3 only were children. In 38 houses in the Haymarket, in 7 deaths, 3 of children. In 46 houses in Craven Street only 1 death under 5 years to 8 adults. But it will be said that the children of the inhabitants of the Strand, &c., live away from London, and no very just comparison can be made. I have, therefore, selected some of our worst courts and some of our best, but all occupied by the working classes. In Bedfordbury and the courts branching out from it on each side there are 141 houses. In Duke's Court, Broad Court, Cross Court, Russell and Crown Courts, there are 144 houses. In the Bedfordbury districts there were, in 1858, 43 deaths, of which number 24 were children under 5. In Duke's Court, &c., there were 41 deaths, of which 16 were children under 5. I have given tables of the deaths in the two subdistricts into which the parish has been divided for registration purposes. The Charing Cross District, taking in all the parish west of Leicester Square, including part of Buckingham Palace, the Green Park, part of St. James's Park, St. James's Palace, Carlton Gardens, the Haymarket, Coventry Street, Spur Street, Orange Street, the south of Hemming's Row and Chandos Street, and then all south of the boundary of St. Paul, Covent Garden—the Long Acre district being 6 all the rest of the parish. The population of the two districts is so nearly equal, that a comparison of the number, ages, and causes of death will be instructive, especially as to the influences which give so large a preponderance of deaths to the Long Acre District ever that of Charing Cross. If we examine the two divisions, we shall see that in the Long Acre District there is a larger proportion of habitations for the poorer classes. By adding to the number of deaths in each district 20 deaths for parishioners dying in Charing Cross and other hospitals, and dividing the deaths in the workhouse equally between the two districts, we find the death rate of the Charing Cross division for 1857 and 1858 to be 20 per 1000 persons living in each year, while in the Long Acre Division it was 27 per 1000 in 1857, and 25 per 1000 in 1858. With the valuable assistance of our indefatigable Inspector, upwards of 200 nuisances, more or less injurious to health, have been brought under my notice ; the greater part of these have been remedied without the necessity of reporting them to the Vestry. Of the 67 which have been reported, 59 have been rectified by a notice to the landlord or his agent; in only 13 cases has it been necessary to call in the aid of the law. In relation to cesspools, by this time they should have been all filled up, and pipe drains carried through from every house into the sewers; but I am afraid many still escape discovery from their concealment by means of a pan and trap. Before the operation of the Metropolis Management Act, it was too common to convert a privy into a so-called water-closet by merely putting in a pan and trap with a supply of water, the old drainage into a cesspool remaining as before. One of these sham improvements occasionally turns up, and I fear there are still many. Unquestionably the drainage of our houses has improved, and is improving, but much yet remains 7 to be clone to make it what it ought to be. A very instructive case may here be mentioned. Mr.-, of 4, York Buildings, as soon as he moved his family into the house, found that the back rooms smelt offensively. After a short time, several of his children fell ill with low fever, one of them remaining for weeks in a very precarious state. At first we imputed the smells to the very probable cause of having a neighbour so dirty in his habits that the whole basement of his house was a general dust-hole—an accumulation of the rubbish and filth of many years. Here was sufficient cause for unhealthy exhalations; and in having these premises cleansed, we hoped the cause of disease would be removed. The fever, however, continued in Mr.-'s family. At lengh we found that the drainage of this block of houses passed under their yards, and close to the back rooms. The attention of Mr. Burstall being then directed to this strangely-placed sewer, an obstruction was found, by which the contents of the sewer were detained under Mr.-'s house, producing all the evils of a cesspool. As soon as the sewer was cleansed out and repaired, the fever disappeared. Innumerable cases similar to this might be adduced, to show the great danger of bad drainage, as well as the effluvia from any decaying matter. I knew an instance where fever lingered in a family a long time, until a hamper of decaying onions being found in a remote cellar, the disease ceased on their removal. If we would preserve the health of our families, we must investigate every smell, trace it to its cause, and remove that cause. This, I admit, is, in many cases, difficult. There are many such in our district where rooms, almost always at the lower part of a house, are untenantable at times from putrescent exhalations. I am inclined to impute most of these to the old brick drains, many of which are so nearly level as to be no better than elongated cesspools 8 The construction of drains and sewers was formerly very inconsiderate, and the inhabitants of many houses have now to pay the penalty in the unwholesomeness of their habitations. In many of the oldest parts of our parish, as the south part of the Strand and the back streets of the Haymarket, the drainage is very bad. We shall not have done all we ought to do in this matter until every house has a separate and distinct drain into a good sewer in front of each house. Nor will any house be well or healthily drained until all old brick drains are replaced by hard impermeable pipes. Brick drains are so liable to be out of order by age, by the destructive power of rats, &c., that there are few which do not leak into the adjoining soil, causing smells in the house, and engendering disease in its occupants, the diseases so engendered being often insidious, and of a character not commonly attributed to such causes. It would be good economy in all instances to remove brick drains and substitute earthenware pipes; the very complicated and tortuous drainage under the old system might then be reformed. But we cannot hope to make a neighbourhood healthy while the drainage of one house passes under another, and often a second and a third, before it reaches its proper destination—a common sewer. The death rate of the parish of St. Martin is 4 per 1000 higher than it ought to be; and to bad drainage much of this superfluous mortality may be attributed. The establishment of Drinking Fountains is very gratifying to all who are alive to the physical and moral improvement of mankind. No one thing will be more conducive to health and happiness than the substitution of good water for much of the beer with which all classes of the community lay the foundation of numerous diseases. I believe that beer-drinking in excess—and all beyond a pint a day is excess—does 9 more to engender disease among adults than overcrowding, or even dirty habits; it is upon the children that the latter are so fatal. In promoting the drinking of water it is of great importance to supply it good and palatable. Much has been done to improve the water of the New River and other London Companies. It is bright, and not very impure; but it is not palatable. In the bed of gravel underlying the greater part of London is an abundant supply of spring water, when uncontaminated, most agreeable to the palate and beneficial to health. It is probably in sufficient quantity for drinking purposes for our whole population; and it does seem lamentable that so much good water close to us should be permitted to remain unfit for use if anything can be done to render it as wholesome as it still is refreshing. I am willing to admit that many of our surface wells are deteriorated, and some rendered unfit for use by the admixture of extraneous and noxious matter with the water. But there are some still supplying wholesome water. I should like to see these preserved, and the others improved. Doubtless many of the wells are imperfect; the brick-work in a state of decay from time, rats, and other causes. Sometimes a drain or a sewer is in too close contact, and foul matter permeates into the well. But it is surely possible to remedy these and other defects; if it be impossible, and the evidence against the water of an individual well is conclusive, let it be closed; but do not let us condemn indiscriminately all our London pumps, and deny ourselves the use of the beautiful water which Nature has supplied in the gravel of the London basin. With regard to the possibility of any injury to the water of the London wells from rain percolating through the foul mass of earth under our paving stones, it is hardly necessary to say anything; turn up this gas-fed stinking matter where you will, it is 10 dry. The rain-fall of paved London passes at once into the sewers. The water that percolates under London comes from rain falling where the gravel is near the surface, as on Wimbledon Common, &c., filters through the loose soil, and finds its level in the gravel upon which London is built This water always contained a larger quantity of saline matter than river water; therefore we must not condemn it for this alone. Too much of it now contains organic matter, from the imperfect condition of the brick-work of the wells, their dirty and neglected condition, and their want of protection from the possibility of contamination. I hope the greater number of our London wells may still be preserved to us by proper means, and it is to be lamented that so large a supply of good drinking water should be sacrificed without an effort to preserve it. I find in the water from the pump in Covent Garden about 40 grains of solid matter per gallon, while the new river contains only 20; but I still prefer drinking the cool, fresh, and sparkling spring water to the mawkish fluid of the New River. There is no reason why water containing 40, or even 60, grains of some salts should be condemned. Our blood, also, contains a certain amount of salts, and who can say that it may not be better supplied with those essential ingredients for its healthy condition from the laboratory of Nature than from the laboratories of man? The minute subdivision and mixture of the saline matter contained in wholesome spring water may be necessary for health, and much of modern invalidism result from neglecting this natural mode of supplying our blood with some of its essential constituents. The boiled water used for tea, coffee, beer, &c., has, by the process of boiling, been deprived of many of its saline principles: and when we know how few ever take into their stomachs any other fluid than what is thus manufactured, I cannot think it a very improbable 11 conclusion that much bad health may be thus engendered. Assuredly drinkers of spring water as it comes from the earth are healthy people; and of wine drinkers, and even spirit drinkers, those best enjoy their health who merely mix the manufactured article with good spring water. If we go into the evidence against the use of London pump water, from the positive injury to health with which it may be not simply charged, but found guilty, the verdict must be in its favour. At the last outbreak of cholera there was good reason to believe that the disease was propagated by the use of the water, supplied by the pump in Broad Street, and it was discovered that a drain actually poured its contents into the well. Other similar cases are known. In an outbreak of cholera or diarrhoea all water must be suspected, whatever its source; and we may consider, as an established rule, that in all such diseases no water should be drank which has not been previously boiled; and, of course, on the same principle, all persons subject to bowel complaints should be very cautious about the water which they drink. I am not aware that beyond this class of diseases the London wells are chargeable with positive injury to health. Their condemnation is general, not specific. The water they supply is charged with containing an undue proportion of saline and an admixture of organic matter. With regard to the first charge, of holding in solution a large proportion of salts, most spring water does contain more than river water; and I presume it is the flavour thus given to spring water, together with the excess of carbonic acid holding these salts in solution, which constitutes that agreeable character which makes everybody prefer spring to river water; and if the water really contained nothing but the usual salts in solution, even if they amounted to 60, 80, or even 12 100 grains per gallon, from this fact alone, even if the water did disagree with a few individuals, that could be no just reason for its universal condemnation. We are all obliged individually to study what agrees and what disagrees with us ; but because one man cannot eat veal or pork can be no reason why those meats should be universally condemned. The only real charge against the London well water, therefore, is that it contains organic matter in some quantity. This arises from vegetable growths on the brick-work of the well; from vegetable or animal matter getting into the well; from percolation into the well of fluid from the too near position of a drain or sewer, or some other prevenlible cause of impurity. Nobody would put wine into dirty bottles, and we ought not to store our water in dirty wells. Who ever thinks of cleaning out a well ? A few of us do occasionally clean out our cisterns, and all ought to do this periodically. So our London wells should be periodically cleansed, and the brick-work rendered impermeable to contaminating causes, and even to the destructive power of rats. I cannot but believe at present that by proper means we might preserve the spring water contained in the superficial strata under London for the use of those who prefer it to river water.* It is a curious fact, that the deep well water obtained from the chalk is not relished by water drinkers so much as the superficial well water; and it is asserted that it is the very impurity of the latter which constitutes its popularity. I confess to have great faith in the common sense of mankind, and that multitudes would * Since the above was written, the well under the church supplying the pump in Duncannon Street, has been examined and cleaned. In taking up a pailful of the wet gravel it was found to be free from any slimy or greasy feel, although the well had not been cleansed for 20 years. The brickwork is quite sound, and the only fault to be found is that the depth of water is insufficient for the daily demand. 13 not continue to prefer London pump water if it was generally injurious to health. At times it may he, as during the prevalence of diarrhoea and cholera; let us at such times boil all the water used for drink; hut if we find that the majority of people at all other times do partake largely of London pump water, not only without injury to health, but positive advantage, let us not on theory condemn our pumps because their water ought to be unwholesome, when practically it is the reverse. At the same time it behoves our governing bodies to have all wells periodically cleansed; and where they are so situated as to be incurably subject to contamination, to have them closed altogether. But it also behoves the governing body of any parish or district when it is found necessary to close a well, to establish at least one other, so placed that it will not be subject to the contamination of sewerage. I conceive a superficial well in the centre of Lincoln's Inn Fields would be too far away from drains to be injured. In such spaces we might dig our wells, and conduct the water by impermeable piping wherever it is required, and there place our pump. There is one view of the case in relation to the state of our river which does not appear to me to have been sufficiently attended to. When we contemplate on the great scale of Nature, the modes she adopts for the destruction of putrescency and offensive fermentation, we find that all natural operations for this purpose are based on the principle of converting as rapidly as possible dead animal and vegetable remains into living organisms. I need not refer to the instances where, in hot climates, the putrefying remains of a large animal will be consumed by living vultures, adjutants, &c. Let us take the slower process in colder climates where dead animal and vegetable matter is consumed by innumerable insects and converted into living tissues. It is 14 thus in our rivers that dead organic matter becomes the food of animalculæ, insects, and fish. In a few hours or days the stinking mass is eaten up by these scavengers of nature, and thus it would be even in our own river if we had not destroyed all living beings in that river by the poisonous emanations of the debris our various factories cast into the drains, sewers, and rivers. It is a notorious fact that the number of fish in the river Thames has been gradually diminishing for many years, until they have in many places become extinct; and this fact probably is equally true of the smaller scavengers which live and thrive on animal exuvise, down to the very minute creatures only to be seen in the microscope. All this life has been poisoned—not by the increase of animal manure, but by the chemical and mineral poisons poured into our sewers, &c., as the waste of various factories—soap, gas, and others. Animal and vegetable decomposition would not poison these scavengers of nature, but, on the contrary, would feed and nourish them. Were it not for the poison poured into our sewers and rivers, the innumerable animalcula; which would otherwise people them would eat up any amount of organic exuviae committed to them: nay, it does not seem improbable that the increasing quantities of dead organised matter resulting from the increased population of cities would only increase the amount of life in animalculse, crustaceae, and fish, if the latter were permitted to increase as nature dictates. But the cleansing process, by which our offal should be again converted into living beings is frustrated by the mineral poisons which a manufacturing people necessarily create, but which need not of necessity be cast into our rivers. If there be any truth in these views, the present experiment of pouring lime into our sewers will do more harm than good, by still further destroying nature's scavengers in the form of crustaceans and animalculæ. 15 How far these minute creatures can consume the large amount of animal and vegetable matter which constitute the refuse of a large city, is a question I will not pretend to answer; but in the enormous problem which now demands our full attention—how to defecate our river— it appears to me that we should not entirely lose sight of that mode of purification which we see in nature, where nothing is wasted—where life as soon as extinguished by the death of one creature gives birth to others, these in their turn promoting the breed of fishes, which again administer to the wants of man. I do not think it too bold a speculation to conceive, that, if we did not poison the small fry of our rivers by mineral debris, our estuaries and seas might abound with fish almost sufficient to compensate for the waste of those animal exuviee which in a well-ordered state of things ought to be returned to the exhausted land. In the last century Brindley, the great engineer who constructed the Bridgwater and other canals, defined the use of rivers to be " feeders of navigable canals : " in the present day we might define them as receptacles for the contents of water closets. The present disgusting state of our river necessarily causes alarm; and, although hitherto it has not been so injurious to health as we should have expected, the probability is it may become so. We have, during the last three years, constructed so many water closets, and sent their contents into the river, that we must impute to this the increased stench of the two last summers. The intercepting drainage, when in operation, may carry the stench farther from us; but it is to be feared much will return by the tides; and if there be truth in the opinion, that the smell in a great measure results from the increasing quantity of sea water in the London portion of the Thames, there is reason to fear that this cause will be increased by deviating from the 16 river so large an amount of water, as will be done by the intercepting drains. The influence of sea water has been traced to Wandsworth ; if we take more water from the river it will be traced still higher. The question of purification of the Thames is a difficult problem, and can only be solved by intercepting in some way those pollutions which are now permitted to enter it. Many think we shall never succeed but, by putting an end to water closets, and returning, of course, with improvements and modifications, to the older contrivances. The introduction of water-closets necessitated the cesspools, the horrors of cesspools necessitated their destruction, and the deviation of the water-closets from them into the Thames, making it one immense cesspool, yet with all its evils, less injurious to health than cesspools under our dwellings. In addition to all this, we should consider what health-giving sources we sacrifice by the pollutions we daily cast into our River. We can no longer bathe in it, nor use its surface for exercise or recreation. So large an open space as the Thames forms in the centre of London is most important for ventilation ; while the facilities for locomotion by steamboats would form another source of health ; all lost to us until we have adopted means for the purification of the stream. There have been several projects for preserving what we now wastefully commit to our rivers, and restoring to the land the organic principles we have used up as food. I believe that one might be hit upon which would relieve our river, and save that worse than wasteful expense for intercepting sewers, which bids fair to be a gigantic failure. We have only a choice of evils; the great evil of the present state of the river, or a little evil, comparatively, to each householder. For example, why might there not be under our present waterclosets an iron tank, to receive nothing but exuviae? 17 In this tank might be an absorbing and deodorizing powder, to be increased from time to time, when required. When the tank is nearly full, an iron cover might be fixed so as to exclude any emanation, the tank removed and replaced by an empty one. Some such plan as this might be conceived, unattended with any nuisance. Inconvenience of some sort we must submit to in all human contrivances; but then, a scheme of this kind would at once purify the river, save the enormous expense of intercepting sewers, and restore to the land the element of fertility. It would be better to have recourse at once to some such expedient, than, after all our expenditure on main drainage, to be at last compelled to do so,as many who have deeply considered the question are of opinion we shall at last be compelled to do. In the formation of the accompany ing tables, my object has been to show clearly, that a large number of deaths in our parish are to be attributed to the evils necessarily resulting from families living in small, crowded rooms, in houses, old, ill-ventilated, and illdrained. Such as are most of those in Bedfordbury and its courts; and I would mention, in contrast with these miserable abodes, the houses in Crown Court, Duke's Court, Cross Court, Broad Court, &c., as decent and fit habitations for the families of working men. If any one will compare the proportion of deaths of young children in crowded and narrow courts, with those occurring in more open spaces, the reason will be apparent why the death rate of St. Martin's is so high : in plain English—why about a hundred human victims are annually sacrificed to the existing system of house accommodation for that portion of our working people who are obliged to live in London. From similar facts, to be gathered in every district of the metropolis, and of other great towns, is it not selfevident, that if the wealthier classes do not make a 18 determined effort to stay the degradation, the degeneration and the demoralisation of their wretched fellow creatures; uidess means are forthcoming to arrest the physical and moral plagues by which we are surrounded, that our civilization, our free institutions, our noble progress as an enlightened nation, enjoying more true liberty than any other people ever did enjoy; all must sink into the arms of some despotism, to hold together the discordant elements of the degraded poverty and physical misery of our lowest classes, and the absence of sound thought, of practical wisdom and feeling of duty which are too apparent in the masses of our monied classes. We do certainly see many noble examples of large wealth combined with that moral and religious sense, which teaches those of its possessors, that, to be entrusted with ample means, is to be entrusted also with the solemn duty of raising their fellow creatures from mere animals (for many human beings herd together with more beastliness than the beasts themselves) to percipient, reasonable, and religious beings. Doubtless, much is attempted for the improvement of the people; but practically, as yet, with too little success to enliven the hope that our country, if the degeneration of its people continues, will escape the fate of other nations, to be degraded to some species of despotism by the self-indulgence of its rich, and the base ignorance of its poor. We might say the base ignorance of its people as a whole, both rich and poor; for, can anything be more evident, than that it is the real duty, as well as the true source of happiness to the wealthy, to improve the condition of those classes who form the strength of a nation, and that, if these are allowed physically to degenerate, as in the wretched homes they occupy, and the degrading circumstances under which too many now live, not only in great cities but in many country districts, we are breeding up 19 amongst us the friends, rather than the opponents of despotism, spiritual and political, for both are the offspring of ignorance and corruption ? To permit such grievous evils as are to he seen in the worst localities of this great city, is a contradiction to the teaching of Christianity. No one in these days would limit the duties of religion to ceremonials and church services; no real religion can exist if duty is neglected; and surely duty is neglected, while such outrages on humanity as many of the abodes of the poor are permitted to remain. It is unholy, it is unchristian, that people should herd together in such dens; and, so long as such dwellings are allowed to be occupied, our assumed religion must be a pretence and a sham. I will enumerate the more important things to be done to improve the health of the parish. 1. The embankment of the river, and removal of the mud banks, which at low water are exposed to the extent of at least six times the space of Trafalgar Square: to how many pleasant and health-giving purposes this large amount of land might be applied ! 2. To make a survey of the drainage of all houses in the parish, to show how they drain into the sewers on a map, with a view to make each house independent of its neighbours, by each having a direct communication into a sewer. 3. To make a survey of the condition of all houses, especially those of the courts about Bedfordbury, and other crowded parts of the parish, with a view to their demolition or improvement. I know too well the difficulties which beset our attempts at such improvements. In the greater part of London, many years must elapse before any sensible change can be made; but the very bad parts of the 20 parish of St. Martin-in-thc-Fields are few, and the continuous efforts of a few years might make it what it ought to be, as the residence of royalty,—a model for the rest of the metropolis. I have honor to he, Gentlemen, Your obedient Servant, LIONEL J. BEALE, Medical Officer of Health. June, 1859. 21 BIRTHS AND DEATHS IN THE CHARING CROSS AND LONG ACRE DISTRICTS In the Year 1858. Districts Population Births Rate per 1000 Deaths Rate per 1000 Charing Cross 12,587 245 19,47 251 19.94 Long Acre 12,053 364 30.24 300 24.98 Deducting half the Deaths, occurring in Charing Cross Hospital as the average number of parishioners dying in this and other Hospitals, and distributing those deaths equally into the two districts, by giving half the deaths on the workhouse to the Long Acre District, although the probability is that much more than half the inmates if the workhouse come from that district. 22 TABLE OF THE CAUSES OF DEATH In the Parish of St. Martin-in-the-Fields, for the Year 1858 Under 5 Years From 5 to 20 From 20 to 40 From 40 to 60 From 60 to 80 80 and upwards Total Deaths at all ages Small Pox - - 1 - - - 1 Measles 10 - - - - - 10 Scarlet Fever 12 3 - - - - 15 Hooping Cough 14 - - - - - 14 Croup 3 - - - - - 3 Diarrhœa 8 3 4 2 1 - 18 Typhus Fever 5 6 2 1 4 - 18 Diphtheria - - 1 - - - 1 Rheumatic Fever - - 1 - - - 1 Erysipelas 2 - 2 1 3 - 8 Ague — - - - 1 - 1 Delirium Tremens — ' - 3 3 1 - 7 Carbuncle — - - 1 - - 1 Syphilis 2 - - - - - 2 Dropsy — - - 1 1 - 2 Cancer — 1 4 3 2 - 10 Mortification - - - - 1 - 1 Scrofula 2 - - - - - 3 Tabes Mesenterial 13 1 - - - - 14 Consumption 3 11 40 17 1 - 72 Hydrocephhalns 25 - - - - - 25 Apoplexy - - 2 7 5 3 17 Paralysis - - 2 3 6 1 12 Epilepsy 4 — 1 - 1 - 6 Convulsions 15 - — — - - 15 Brain Disease 7 - 5 1 1 - 14 Aneurism — - 1 1 1 - 3 Heart Disease 1 2 8 18 9 3 41 Bronchitis 12 - 3 13 26 1 55 Pneumonia 18 5 3 13 5 4 48 Asthma — - - 3 1 - 4 Lung Disease 1 - 2 3 - - 6 Peritonitis - - 1 1 1 - 3 Disease of Intestines - 1 3 6 2 - 12 Liver Disease — - 1 5 2 - 8 Kidney Disease - - 4 3 1 - 8 Uterus Disease - - - 2 1 - 3 Disease of Joints, &c — - - 3 1 - 4 Premature Birth 14 - - - - - 14 Teething 14 - - - - - 14 Childbirth - - 3 - - - 3 Old Age — - - - 26 16 42 Atrophy 2 - - 1 - - 3 Fractures - 1 5 3 3 - 12 Wounds - - 1 1 4 - 6 Burns 2 2 - - - - 4 Suicide - - 1 2 - - 3 Murder - - 1 - - - 1 Drowning — 4 1 - - - 5 Total 191 40 106 117 111 28 593 23 DEATHS IN THE CHARING CROSS DISTRICT In the Years 1857-8.—Population, 12,587. Total Deaths in 1857 Deaths in 1857 of Children under 5 Years Deaths in 1857 from Epidemic Diseases Total Deaths in 1858 Deaths of Children under 5 years, 1858. Deaths from Epidemic Diseases, 1858 - - - Adam Street 1 1 - 5 5 3 Adelphi cottages & wharf 1 — — — — — Adelphi terrace 2 — 1 2 2 1 Agar street 1 — — — — — Arundle place 2 — — 4 2 2 Bedford street — — — 8 5 3 Blue Cross street — — — 3 — — Buckingham street 2 — 1 4 2 2 Bullin court 1 — — — — — Burleigh street 1 — — — — — Carlton gardens 3 1 — — — — Catherine street (Little) 1 1 — 1 — — Cockspur street — — — 4 2 — Coventry street 1 1 — 1 — — Craig's court — — — 4 — 1 Craven street 4 1 — 1 — Charing Cross 3 2 2 1 1 — Charles court 5 3 3 1 1 1 Dorset place 1 — — 1 1 — Eagle court — — — — — — Exeter street 2 1 — — — — Fairfax court 3 3 - 3 2 2 George court 2 2 1 6 4 4 Harvey's buildings 3 — — 2 1 1 Haymarket 5 2 — 9 4 2 Hungerford st. and markt. 7 4 3 1 1 1 James street, Adelphi . 2 — — 1 1 1 James street, Haymarket 3 1 2 1 — — John street, Adelphi 3 — — 1 — — King William street 1 — — 1 1 — Leicester square 1 — — 3 1 — Long's court 1 1 — 2 — — Lowther arcade — — — 2 1 — Lumley court 4 1 — 3 — — Monmouth court 8 3 1 1 I — New Exchange court 2 2 — 2 — — New st., Spring gardens 1 — 1 2 1 — Northumberland street 2 — — 4 3 1 Oxendon street 4 1 - — — - Pall Mall, East 1 1 - 3 1 1 Panton street 3 2 - 2 1 1 Percy wharf — — - 6 5 1 Princes court 3 2 1 — — — Princes street 2 1 - 3 2 1 Salisbury st. and wharf 1 — — — — — St James's Palace 4 — - 11 4 3 St. Margin's street 11 4 2 9 3 1 Strand 15 3 3 1 — — Spring gardens 3 — — 1 1 — Spur street 2 1 — 1 — — Suffolk place and street . 2 — - — — — Trafalgar street 1 — - 8 2 4 Villiers street 7 4 2 1 — — Whitehall and place 3 1 - 9 7 3 Whitcomb street and ct. 17 7 - 3 1 1 York buildings 5 1 — 10 7 3 York place 11 2 1 24 DEATHS IN THE LONG ACRE DISTRICT In the Years 1857-8.—Population 12,053. Total Deaths in 1857 Deaths in Children under 5 years, 1857 Deaths from Epidemic Diseases, 1857 Total Deaths in 1853 Deaths in Children under 5 years 1858 Deaths from Epidemic Diseases, 1858 1 - - Alfred place 1 1 - — — — Hear street 2 — — 19 8 5 Bedfordbury 27 14 6 3 2 — Bow street — — — 2 2 — Brewer's court 2 1 — 8 3 3 Broad court 6 3 — 15 7 3 Castle street, Leicestersq. 19 11 8 11 7 4 Castle street, Long acre. 3 1 — 15 10 6 Cecil court 6 3 — 2 1 1 Chandos street 6 2 — — - - Chapel court 1 — — 2 1 — Charles street, Long acre 1 1 — 1 — — Chyniister's alley — — — 2 1 — Conduit court 3 2 1 2 2 - Cran bourn street 4 3 1 3 1 - Crown court 3 2 — 7 5 1 Cross court 6 3 — — — — Davey's buildings 1 — — 21 13 10 Drury lane 19 12 6 11 6 1 Duke's court 10 3 — — — — Goodwin's court 1 1 — 7 1 — Green street 8 4 4 1 1 - Hanover court 3 3 1 4 4 2 Hanover street 6 2 — 1 1 1 Hemming's row 4 2 — 1 — — Hop gardens 1 1 — 3 — — Hunt's court 1 - — 4 2 - James street, Long acre. 1 1 1 1 — — King street — - — 2 2 — Langley court — — — 2 1 — Leicester court 1 1 — 24 14 8 Long Acre 15 4 2 5 3 3 Maitlet court 4 2 2 1 — — Marquis court 2 1 — 9 4 1 May's buildings, great 3 2 3 3 2 1 May's buildings, little 2 1 — 7 4 3 Mercer street 5 3 2 — — — Newport street, great 1 — — — — — Peter's court 1 — 1 — — — Pipemakers' alley (no death since 1856) — — - 2 — — Red lion court 4 2 — 9 4 3 Russell court 7 3 1 2 1 — Russell street, little 3 1 - 6 3 2 Shelton court 3 2 3 4 — — St. Martin's court — - — 9 3 — St. Martin's lane 15 4 1 4 3 2 St. Martini's lane (upper) 1 1 1 7 3 3 Turner's court 6 2 — 5 3 1 Vinegar yard — — — 6 2 3 White hart street 5 3 3 — — — White hart court 3 1 — — — — Wilson street 1 1 —