STPAN 15 26 THIRD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. TO THE VESTRY OF ST. PANCRAS. Gentlemen, By the 132nd. section of the Metropolis Local Management Act, under which your Medical Officer of Health is appointed, it is prescribed that this officer shall " report periodically upon the sanitary condition of the parish, ascertain the existence of diseases, more especially epidemics increasing the rate of mortality, point out the existence of any nuisance or other local causes which are likely to originate and maintain such diseases, take cognizance of the fact of the existence of any contagious or epidemic diseases, and point out the most efficacious mode of checking or preventing the spread of such diseases." The periods chosen for these Reports, have been, in the first place, monthly, at which periods isolated facts relating to the sickness, mortality, and sanitary requirements of the District are brought before you; and in the second place, annual, so that these facts may be brought together, classified, analysed, and viewed in relation to former years, and made use of to suggest hints for the guidance of future conduct. The time is now come that I should present my Third Annual Report. MORTALITY AND DEATH RATE. For the information under this head, I am chiefly indebted to the kindness of the Registrar General, who forwards every week (free of expense) to each Officer of Health, a complete account of all the deaths which have occurred in the several districts, exactly in the form in which he obtains them from the District Registrars. Without this information, which it would cost the Parish about £50 to obtain directly from the Local Registrars, it would be impossible to 2 ascertain the localities and special forms of the prevalent diseases, as well as the sexes and ages of those who fall victims to them. Information on these facts is absolutely necessary in order to be in a position to comply with the Act of Parliament, or to make suggestions to improve the health of the District. The Treasury has recently adopted, as a measure of economy, a resolution to discontinue the gratuitous distribution of all documents printed by the Government; the Registrar General has, however, prevailed on their Lordships to make a special exception in favour of the Medical Officers of Health, who are again furnished gratuitously with copies of his weekly return. These also are very valuable, as they enable one to compare the mortality of one's own district with that of other districts of the Metropolis. Some of the information obtained from a careful analysis of these two sets of documents, I proceed now to lay before you. The deaths registered in St. Pancras, as occurring during the year 1858, numbered 4509, besides 140 deaths in the Strand Union Workhouse, which do not fairly belong to this parish. Under this number are included deaths in the University College and Royal Free Hospitals of persons who had recently come from other districts ; but those are excluded who left this parish to go to hospitals situated in other districts, where they died soon afterwards. I have found, however, from two previous years that these two numbers so nearly balance each other, that for all practical purposes there is no advantage to be gained by taking them into account so as to correct the total number. The death-rate, that is to say, the number who died in proportion to the number living during the period was, per hundred thousand, 2312, or a little above 23 persons for every thousand, or one person died out of 43 living. This rate is calculated on the assumption that the population of Saint Pancras in the middle of the year was 195,000, an estimate which is probably a little below the actual population. In 1857, the rate of mortality was only a little over 20 per thousand. In the whole Metropolis during 1858, the death-rate was 2356 per hundred thousand, a little higher than that of St. Pancras; in 1857 it was as much as 2 per thousand higher in London than in St. Pancras. The death-rate in the northern districts of the Metropolis, which include Marylebone, Hampstead, Islington, Hackney, and Pancras, was only 2248 in 1858, that is lower than the rate of this Parish ; whilst in 1857, St. Pancras mortality was lower than that of the districts by which it is surrounded. The deaths which occurred last year in the parish, above the rate of 17 per thousand (which is a rate we may fairly hope to attain to), numbered no fewer than eleven hundred and ninety; that is to say, nearly twelve hundred deaths were due to causes which may be prevented by sanitary improvements. This is a statement founded on remarks made by the Registrar General and deduced from his very extended experience concerning the mortality of different places under varying conditions. To every death we may safely assume that there are more than 30 cases of illness. This assumption will give 36,000 cases of preventible disease during the year: such disease has not only disabled for the time, and, in many cases, cut off the means of livelihood, but has frequently left shattered constitutions, and sown the seeds of future illness, and premature death. Of the causes of pauperism, none are so common as disease and death; so that by diminishing the latter, a decrease of the former must be effected. The death-rates in the different parts of the Parish have been different, a circumstance observed in my former Reports. In the several sub-districts, the estimated death-rate per ten thousand has been,—in Regent's Park 233, in 3 Tottenham Court 241, in Gray's Inn 249, in Somers Town 242, in Camden Town 224, and in Kentish Town 217. The method adopted to obtain these numbers is explained in the note to the table below. Area in Aores. Population in 1851. Estimated Population in 1858. Mortality in 1858, estimated as explained in Not**. Number of deaths to every 10000 living. Number of births to every 10000 living. Regent's Park 427 31918 34400 804 233 308† Tottenham Court 145 28433 29900 723 241 297† Gray's Inn Road 155 26522 28000 697 249 306† Somer's Town 184 35611 39600 958 242 335† Camden Town 171 21115 24100 540 224 313† Kentish Town 1634 23326 39000 846 217 338† Whole Parish 2716 166965 195000 4568 231 253 It appears then that Kentish Town stands first, Camden Town second, Regent's Park third, Tottenham Court and Somer's Town are nearly equal, and stand next, whilst Gray's Inn this year comes last, in the order of salubrity. The differences in the mortality of the different sub-districts are not so great this year as they were last, although they are still very large. To show more clearly the effect of external conditions on the rate of mortality, I have been at considerable pains to ascertain the numbers of deaths which have been registered during 1856, 1857, and 1858, in a few streets selected from each sub-district, as specimens of a class, and where I have been able to do so, have given an estimate of the populations of those streets, so as to be able to calculate the death-rate. In the Gray's Inn sub-district I have given the population of the streets as ascertained at the census of 1851, which I am enabled to do through the kindness of Mr. Worrell, District Registrar. The others are chiefly obtained from house to house visitation of the Inspectors. It will be seen by referring to the appended Table (Table A) that the death-rates in these streets have varied from 4 to 75 per thousand. This extreme difference cannot, in all cases, be taken as a fair representation of the ordinary relative mortality of the various places, because where the numbers we deal with are small, very slight accidental causes, unduly raise or depress the ratios; but in the more populous streets the results are sufficiently trustworthy; and here we have diversities which call for very serious attention. For instance, in Henry Street, Hampstead Road, we have 4 deaths in every 5 houses in one year, and a death-rate of 33 per thousand in 1858, and an average annual death-rate of 37 in 3 years. The insalubrity of this street is chiefly due to overcrowding and dirty habits. In Fitzroy Place and Upper Fitzroy Place, close by, there are death-rates of 27 and 40 per thousand respectively, and an average annual death-rate of 34. These places are crowded. In Holbrook Court and Place, which are very filthy, and not well drained, requiring constant inspection, the mortality has been very *In calculating this column, the deaths which occurred in the Strand Union are omitted; and the deaths in the University College Hospital, the Royal Free Hospital, and St. Pancras Workhouse, are distributed amongst the sub-districts in the proportion of their population. The deaths which occurred in hospitals out of the parish, of people belonging to Saint Pancras, aro not included, as they are nearly counterbalanced by the deaths in St. Pancrus Hospitals of persons belonging to other districts. † These numbers are a little below the actual birth-rate, because 174 have been deducted to allow for births in the Workhouse, as it is not known from what sub-districts women have come who have been delivered in the Workhouse. If the births which occurred in the Workhouse could be distributed in the due proportion to the several sub-districts, it is probable that the birthrate would be raised in Tottenham Court sub-district to about 312 per ten thousand, so as to be about on a par with that in Regent's Park, and in Gray's Inn Road it would be raised to about 318; whilst in Camden Town it would be about 327, and in Somers and Kentish Towns about 344. 4 high (50 per thousand). In Midford Place, where there is considerable crowding, and the sewer is not deep enough to drain the houses efficiently,* there have been as many deaths as there are houses (or at the rate of 32 per thousand) in 1858, and 41 as the average of 3 years. In Tottenham Place and Upper Tottenham Place, where there is overcrowding and much poverty, there have been 4 deaths to every 5 houses, and a death-rate of 33 per thousand. In Ashby Street, where there is no sewer, and consequently the drainage is bad, the mortality has been at the rate of 37 per thousand last year, and at an average rate of 44 in the 3 years. In the Gray's Inn sub-district, the following places exhibit very high rates of mortality, and it might be expected that they would do so from their conditions: Colonnade, Cromer Street, Poplar Place, Paradise Court, Melina Place, Wilson Place, Chad's Place, James Street, and "Wellington Square. In contrast with these high rates, varying from 31 to 75, we have at the Model Buildings, Bagnigge Wells Road, only 14 in 1858, and at Pancras Square only 18 in 1858; in Guilford Street only 5 in 1858, and 11 as an average death-rate of 3 years. Many other places might be mentioned, but these will suffice to show that it is not mere theory to maintain that bad drainage, overcrowding, and filth, are causes of death; in many instances rendering the mortality more than double what it would be under more favourable conditions. Then it must not be forgotten, that diseases originated and fostered in such places as those alluded to, does not confine its ravages to them, but is spread by means of the atmosphere, clothes, and in a variety of ways, to those who live in more wholesome circumstances. *A new sewer has now been put into this Court. April, 1859. 5 TABLE A. A Table showing the Mortality and Death-rate of, as well as other particulars relating to, certain Streets and Places selected as Specimens from each Sub-District. Names of Streets. No. of Houses. Estimated Population. No. of Deaths in 1858. Death-rate per 1000, in 1858. No. of Deaths in 1856-7. Average No. of' deaths in 3 years, 1856, 57, 58. Average Annual Death-rate per 1000, in 3 years. Main Peculiarities of the Places. Begent's Park Sub- District. Little Albany St. and ditto North 69 .. 16 .. 40 18⅔ . Near Stables — some badly drained. Eden Street Fitzroy PL, Euston 12 200 3 15 11 4⅔ 23 Chiefly occupied by Costermongers. Road 17 340 9 27 40 20 34 Many houses crowded, and occupied by dirty people. Upper ditto 12 240 10 40 Henry St., Hampstead Road 45 1100 36 33 87 41 37 Great crowding. Mary Street, ditto 70 1000 27 27 72 33 33 Drainage not good. Tottenham Court SubDistriet. Mary Place, ditto 19 260 7 27 17 8 31 A cul de sac—lying low— rather crowded. Draper's Place 32 600? 19 32? 43 20⅔ 34 Crowded—occupied cellars. Gresse Street 36 600 18 30 45 21 35 Bad drains—crowded. Holbrook Court and Place 10 100 5 50 10 5 50 Occupied by low Irish. Hertford Street 20 500? 19 38? 34 17⅔ 35? Poor—crowded. Midford Place 8 250 8 32 23 10⅓ 41 Badly drained and crowded. New Inn Yard 3 houses j 150 3 20 12 5 26 Occupied by Costermongers. 8 shops Tottenham Place & ditto Upper 40 1000 33 33 64 32⅓ 32 Poor and crowded. Somers Town Sub-District. Southampton Court • • • • 2 .. 9 3⅔ • • Only partially occupied of late. DrummondCrescent George St., Little. 56 700? 17 24? 29 15⅓ 22 Rather densely populated. Hampstead Road 50 600? 16 26? 45 20⅓ 34 Drainage not good. Hampton Court 11 150 5 33 16 7 46 Inhabitants poor and dirty. Pancras Square 110 450 8 18 28 12 26 Each family has 2 or 3 rooms with separate conveniences. Camden Town Sub-Distriot. Wellesley Street 36 • • 6 .. 25 10⅓ Ashby Street 28 355 13 37 34 151 44 No sewerage—people dirty. Charlton King's Rd. 30 .. 3 .. 5 2⅔ Kentish Town Sub-Distriot. Ferdinand Place 44 470 14 30 14 9⅔ 20 Ferdinand Street 53 540 16 29 23 13 24 Occupied chiefly by railway men. Haverstock Street 19 288? 3 11? 8 3⅔ 13? Street badly paved, and no surface drainage. Hethersett Street 15 260 9 34 11 6⅔ 26 Ditto ditto. Gray's Inn Sub-Distriot. Brighton Street 28 410 17 41 15 10⅔ 26 Britannia Street 63 690 19 28 38 19 28 Brunswick Buildings or Pearl Cottages 28 . . 9 .. 3 4 . These houses much improved during the period. Brunswick Grove 2 .. 3 .. 2 1⅔ Brunswick Square 40 190 2 .. 6 2⅔ 14 Gentlemen's houses. Burton Crescent, Nos. 1 to 26 26 155 7 45 2 3 19 Chads Row 29 323 10 30 19 9⅔ 30 Chads Place 13 90 3 33 7 3⅓ 34 Road unpaved. Charlotte Street 29 284 1 4 9 10 12 Ditto. Compton Street 35 355 12 33 17 9⅔ 27 Houses chiefly let out in tenements. Ditto Place Clarks PL, Bagnigge 24 370 8 22 21 9⅔ 26 Occupied by poor Irish— Houses in a bad condition. Wells Road 12 140 3 .. 5 2⅔ .. Lying rather low. 6 A Table showing the Mortality and Death-rate of, as well as other particulars relating to, certain Streets and Places selected as Specimens from each. Sub-District. Names of Streets. No. of Houses. Estimated Population. No. of Deaths in 1858. Death-rate per 1000, in 1858. No. of Deaths in 1856-7. Average No. of Deaths in 3 years, 1856, 57, 58. Average Annual Death-rate per 1000, in 3 years. Peculiarities of the Places Gray's Inn Sub-District continued. Colonnade 19 266 9 & 1 in Workhouse 38 17 9 37 Some houses crowded, some badly drained. Cooper's Buildings. 12 35 .. .. 2 ⅔ 19 Court lying low, with little circulation of air. Cromer Street Field PL, Bagnigge 120 1600 37 24 112 49⅔ 31 Crowded—Drainage of some part bad. Wells Road 5 63 1 16 2 1 16 Lvinag rather low. Ditto Street 14 240 4 16 16 6⅔ 27 Road unpaved. Ditto Terrace 17 220 3 13 13 5⅓ 24 Lying rather low. Fifteenfoot Lane .. 96 .. • • 3 1 • • Road unpaved—people dirty— drains defective. George St. Bagnigge Wells Road 52 700 13 16 40 17⅔ 25 Road unpaved. Greenland Grove 12 65? 4 61? 9 3 46? Guildford Street 100 673 3 5 19 7⅓ 11 Gentlemen's houses. Harrison Street 80 1020 20 20 29 I6⅓ 16 Crowded—houses let in separate tenements. Hastings Street 47 553 21 & 1 in Workhouse 39 20 14 25 Crowded—ditto. Henry Street 4 43 2 46 James St, Wellington Square 19 270 12 44 23 11⅔ 43 Drainage bad —some inhabited cellars. Judd Street 74 768 17 & l in Workhouse 23 25 141 19 Manchester Square 41 310 10 32 14 8 26 Mecklenburgh Sq 44 320 5 16 4 3 9 Gentlemen's houses. Melina Place 7 40 2 50 4 2 50 Closed Court, lying low— privies in the houses, not well constructed—occupied by Irish. Model Buildings 24 143 2 14 6 2⅔ 18 Each house well fitted up for two families. Paradise Court .. 24 1 40 1 ⅔ 27 Closed court, occupied by poor people. Paradise Street Pearl Crescent, 18 170 3 18 12 5 29 Road in a bad state. nigge Wells Road 16 120 2 16 8 3⅓ 28 Prospect Terrace 16 185 3 16 7 3⅓ 18 Houses let in tenements. Poplar Place 11 80 6 75 13 6⅓ 79 Very filthy—houses unfit for habitation. Riley Street 8 102? .. .. 4 l⅓ 13? Poor—houses in bad repair — population probably much less than in 1851, owing to empty rooms. Sandwich Street 46 797 25 31 31 18⅔ 23 Crowded. Sidmouth Street 40 360 9 25 18 9 25 Crowded. Speedy Place 23 160 1 7 1 ⅔ 6 A close court, with small well kept houses. Swinton Street 60 680 13 19 19 10⅔ 16 Wakefield Street 30 380 8 21 15 7⅔ 8⅔ 20 Wellington Square. 18 260 8 31 18 33 Drainage bad—neonle noor. Wilson Place 14 180 6 33 16 7⅓ 41 Very crowded. Wilson Street 16 220 2 9 11 4⅓ 19 Of the 44 deaths which occurred in Mews during 1858, 21 occurred in the Tottenham Court sub-district, 12 in the Eegent's Park, 3 in Gray's Inn, 6 in 7 Somer's Town, and 2 in the Kentish Town sub-district. Of the whole number in 1858, 17 were from Zymotic diseases, namely, 6 from Scarlet Fever, 3 from Typhoid Fever, 3 from Hooping Cough, 2 from Measles, 1 from Diphtherite, 1 from Diarrhoea, and 1 from Erysipelas; 14 were from Diseases of the Respiratory Organs, including Consumption, and 4 from the Nervous Diseases of Infancy. Of the 44, 24 were under 5 years of age. During the three years, 1856, 1857, and 1858, there were 127 deaths in the Mews, of which 59 were in Tottenham Court sub-district. Of these 127 deaths, 40 were from Zymotic diseases, namely,. 8 from Scarlet Fever, 6 from Typhoid Fever, 12 from Hooping Cough, 4 from Measles, 6 from Diarrhoea, 1 from Diphtherite, 2 from Erysipelas, and 1 from Puerperal Fever; 37 were from Diseases of the Respiratory Organs, besides the cases of Hooping Cough and Measles. There were 12 of the deaths from Hydrocephalus, Convulsions or Teething. More than half the number (65) were deaths under 5 years of age. I have, in a similar manner to that adopted with certain streets, tabulated the mortality in the various Mews of the Parish. It appears from this table (Table B) that the mortality of those living over stables is very high, greatly in excess of the average mortality in this parish. The population living over stables in the district may be estimated at about 1550. Last year the number of deaths mounted to 44, which gives a death-rate of more than 23 per thousand, whilst in the parish at large it was about 23. The average annual death in the three years, 1856, 1857, and 1858, was about 27 in the thousand; in the entire parish about 21. The causes of death which appear to be chiefly in excess are the Zymotic diseases, diseases of respiration, and nervous diseases of children, the three classes which are usually found to abound where bad sanitary arrangements exist. The mortality in the Mews of the Tottenham Court subdistrict is very excessive; during the last year, 21 deaths occurred out of a population of 500, giving a death-rate of 42 per thousand. The average annual death-rate in the last three' years was about 39 per thousand, or nearly 1 out of every 25 living. This is a mortality about twice as great as in the entire Parish, and is a circumstance which urgently demands investigation and improvement. The high rate of mortality is mainly dependent upon the constant inhalation of ammonia, carbonic acid, and the other gases given off by animal excreta. It was never intended that human beings should live in such a situation, as to breathe the air which has been first polluted by the lower animals; and if they occupy rooms over stables this is almost inevitably the case. The impurity of the air which is breathed in these lofts might, however, be greatly diminished by a few simple measures. If the stables were properly paved, drained, and ventilated, the air in them would be far less impure than at present. If all communication between the stable and the loft were shut off as far as practicable, and proper means adopted for the supply of pure air to the dwelling-rooms, the evils would be again immensely diminished. As things are now, the stables are, for the most part, badly paved, so that the flooring becomes saturated with organic matter in a state of putrefaction ; there is very imperfect provision for drainage; there is little or no means of ventilation for the stable, except the outer door and the passage from it to the dwelling rooms, so that nearly all the air supplied to the inmates comes through the stable ; the dwelling-rooms, too, have frequently but one window, opening out on to a badly-paved and badlydrained yard ; and, in many instances, they are not supplied with conveniences for disposing of the human excreta, which the inhabitants then deposit on the manure heaps either in the stable or in the yard just under their window. During the past year, you have, on my recommendation, adopted some regulations in reference to Mews and dwelling-rooms over stables. These have been, in a considerable number of instances, enforced; great benefit has resulted 8 therefrom, and it is the intention of your Sanitary Committee to proceed with the enforcement of them so soon as time will allow ; but owing to the pressure of other business, and the engagement of one of the Inspectors of Nuisances as temporary Coroner's Beadle, these works have lately been in great part suspended. TABLE B. MORTALITY IN MEWS. Names of Mews. No. of inhabited stables. |No. of Inhabitants No. of deaths in 1858. Death-rate in 1858 per 1000. Deaths in 1856, 1857, and 1858. Remarks on the condition of the Stables and Dwelling-rooms. Tottenham Court SubDistrict. Charlotte Mews .. .. 1 .. 3 Chenies Mews, Upper 22 85 3 35 8 Stables badly paved and drained; rooms badly ventilated. Cleveland Mews 6 27 .. .. .. Ventilation and drainage defective. Conway Mews 5 24 • • • • 2 Stables badly paved and drained; ventilation bad. Crescent Mews North . 7 26 1 . . 7 Arrangements bad. Ditto, South . . 120 8 64 15 Arrangements bad. Fitzroy or HertfordMews 3 10 . , Tolerably good. Ditto, West 11 42 .. .. .. Ventilation bad; stables badly drained. Gower Mews Upper 21 94 • • • • 2 Paving and drainage in some stables good; in some bad; ventilation also in many bad. Grafton Mews 10 41 2 48 4 For the most part bad. Howland Mews, West 5 23 1 43 4 Stables badly paved and drained; rooms badly ventilated. London Mews 6 23 • • .. 1 Some badly paved and drained, and badly ventilated. Regenfa Park SubDistrict. North Street Mews 1 5 .. .. 1 Arrangements tolerably good. Percy Mews 1 2 .. .. 1 Badly ventilated. Russell Mews 7 24 1 41 2 Arrangements bad. Richardson's Mews 5 22 2 99 4 Ditto. Stephen Mews .. .. .. .. 1 Thorhaugh Mews 2 6 .. .. .. Arrangements bad. Tottenham Mews .. .. 1 .. 3 Warren Mews 6 29 1 34 1 Arrangements bad. Albert Mews, Albert .. Terrace 9 . . . . .. 1 Cambridge Mews 37 37 2 54 4 Chester Mews .. 172 2 12 5 Early Mews 11 .. 1 .. 2 Frederick Mews .. 51 1 19 3 Several stables very bad. Raneleigh Mews 11 .. 2 .. 2 Robert Mews .. 42 4 95 5 Drainage bad in 6; ventilation in 9 stables. William Mews .. 65 • • • • 4 Arrangements bad. Gray's Inn SubDistrict. Brownlow Mews .. 70 1 14 1 Lansdown Mews .. 10 .. .. .. Arrangements good. New Millman Mews .. 62 .. .. 1 Sidmouth Mews .. 92 Regent's-square Mews .. 17 1 58 2 Wakefield Mews .. 67 1 15 2 Doughty Mews 17 63 • • • • 4 Arrangements good in many; drainage of some bad. Somers Town bub-District. Drummond Mews .. .. .. .. 3 Euston Mews 12 53 1 .. 6 Drainage defective and ventilation. Frederick Mews 16 51 .. 2 Grenville Mews .. .. 2 .. 4 Railway Mews .. .. 1 .. 2 Seymour Row Mews 5 23 1 .. 1 Drainage bad; ventilation wanting. Kentish Town Sub-District. Southampton Mews 11 51 1 .. 6 Ventilation and drainage. Camden Mews .. .. .. .. 2 Rochester Mews .. .. 1 .. 4 Torriano Mews .. .. 1 .. 2 9 In looking to the causes of death, which, are given at length in Table I., appended to this Report, it will be found that the following have been more active last year than in 1857 :— Amongst Zymotic diseases, Scarlatina, which gave 406 instead of 99 deaths; Measles 184 instead of 126; Hooping Cough 182 instead of 163; Small Pox 22 instead of 11. Then Dropsy was the registered cause of 52 instead of 39 deaths. The Tubercular class of diseases gave 712 deaths in 1858, only 647 in 1857. Diseases of the Heart and Blood Vessels, 173 instead of 140. Bronchitis killed 490 this year, and 406 in the previous year; Pneumonia 289 instead of 209. Teething was fatal to 53 children instead of 38; and 226 persons died of Old Age, instead of 177. Other causes of death have been either rather less active this year than last or about equally so in the two years. In Tables II. to VI. inclusive, the mortality is tabulated according to the sub-districts for the several quarters and the whole year; the deaths under 5 years, and those from six epidemic diseases are also distributed in the same manner ; the births also are given for the quarter and for the whole year in the several sub-districts. In Table VII. the mortality and temperature of each week are placed together, and compared with the average mortality and temperature of the corresponding weeks in other years. In Table VIII. the births, deaths, and temperature of the several quarters arc collected and compared with other years. These tables require to be attentively studied, in order that the important facts which they contain, may become apparent, but I fear that I should be too prolix were I to set them forth at length. The death-rates from the undermentioned diseases to every 100,000 living in St. Pancras and the Metropolis respectively were, during 1858 :— St. Pancras. London. Pulmonary Affections (a) 723 708 Phthisis alone 276 271 Measles 94 87 Scarlatina 208 151 Hooping Cough 93 99 Alvine Flux W 65 88 Typhus Fever 56 69 Nervous Diseases of Children (c) 125 158 From all causes 2312 2356 So that while the mortality from all causes was a little greater in London than in St. Pancras, the mortality from Pulmonary Affections, as a whole, from Phthisis or Consumption, from Measles, and from Scarlatina severally, was larger in St. Pancras than in the whole of London. The death-rate from Scarlatina is the one most notably in excess. Prom Hooping Cough, from Alvine Flux, from Typhus Fever, and from the Nervous Diseases of Children, the death-rates were lower in St. Pancras than in London. During the past year, a book has been published by the General Board of Health, containing papers by Dr. Greenhow, the results of a very elaborate (a) This heading includes Phthisis, Laryngitis, Bronchitis, Pleurisy, Pneumonia, Asthma, and other diseases of the Lungs. (b) This includes Diarrhœa, Dysentery, and Cholera. (c) This includes Hydrocephalus, Convulsions, and Teething. 10 enquiry into the different proportions of deaths produced by certain diseases in different districts in England. It is there shown that the three classes of disease given above as Pulmonary Affections, Alvine Flux, and the Nervous Diseases of Children, are both absolutely and relatively the chief causes of high mortality. Of these three classes then, it appears that this parish had a very high death-rate from one, the Pulmonary class, and a moderately low death-rate from the other two. Of every thousand deaths, 313 were due to the pulmonary class, whilst in the whole metropolis only 301 of every thousand were due to this class of causes. Of every thousand male deaths, 323 were from pulmonary disease, and of every thousand female deaths, 303 were from that class of disease. Till recently it had generally been supposed that the amount of Zymotic disease was the best criterion of the insalubrity of places, or their need of sanitary improvements; but more careful investigation seems to indicate that Pulmonary disease is equally important, if not more so as a measure of this condition. If this be so, the mortality registers of St. Pancras show the necessity for sanitary reform, and render it highly important to enquire to what cause a pulmonary mortality, so much above the average of England generally, and somewhat in excess of the rest of London, is to be ascribed. Some of these causes will be alluded to in a later part of this Report. Zymotic Diseases.—The number of deaths from these diseases was 1,168, being more than a quarter of the total mortality. Last year the number was only 839 ; the great excess in this year's return is due to Scarlatina chiefly, which, together with Diphtherite, was fatal to 406 persons, of whom 369 were children under 10 years of age. This is a most fearful mortality, higher than that of the cholera in 1848-49, which gave in St. Pancras 360 deaths. It is also higher than the cholera mortality of 1854. Of every thousand children living in 1858, under the age of 10 years, rather more than 8 died of Scarlatina and Throat Disease. Scarlatina is a disease of an infectious nature, always present in London, but every few years coming with greatly increased virulence; it appears to be less under the control of sanitary measures than most of the epidemic disorders. It can most frequently be traced to infection, and its spread might be much diminished by greater care on the part of those whose families are suffering from the disease. It is very frequently propagated in the public schools by children being sent to them from houses or rooms in which persons are suffering from the disease, or before they themselves are sufficiently recovered from an attack to be free from infection ; it is also often spread by means of bed linen, which is not properly purified before being again used. In the houses of the poor, too, it very readily spreads from room to room; each being occupied by its crowd of inmates. It is also at times propagated by street cabs, which are used to convey patients suffering from such diseases to and from Hospitals, as well as the corpses of those who have died from these maladies. The Scarlatina deaths have been distributed among the sub-districts as follows :— Regent's Park 50 Tottenham Court 74 Gray's Inn 52 Somer's Town 101 Camden Town 41 Kentish Town 41 The deaths ascribed to Diphtherite and Malignant Sore Throat, not Scarlatinal, have numbered 47, and have been thus distributed :— Regent's Park 13 Tottenham Court 4 Gray's Inn 3 Somer's Town 12 Camden Town 5 Kentish Town 10 11 Of the deaths registered under the last -named headings, I have strong reason to believe, from enquiries made in reference to them, that 11, if not more, were due to a masked form of Scarlatina; so that the deaths from Diphtherite are reduced to 36. It will be noticed that the deaths have not been most numerous in those sub-districts which have the highest mortality, but that in Tottenham Court and Gray's Inn, which stand highest in the scale of mortality, the deaths from this disease have been fewest. In examining the houses and streets where the deaths have occurred, both from Scarlatina and from Diphtherite, it is not very obvious, in most cases, on what external conditions, if upon any, the fatality of the disease was dependent. As an illustration of the manner in which infectious diseases may be spread from the poor to the rich, I may mention that during last year in the course of my inspections, I met with a woman living in a garret, occupied by herself and several children, who were suffering from Small Pox. This poor woman was employed in making up a handsome silk dress, which was designed for the back of some young lady, who would thus probably contract the loathsome disease, and might communicate it to a number of her companions. During the year there have been 22 deaths from Small Pox, nearly all of unvaceinatcd persons; in 1857 there were only 11 deaths. There is reason to fear that the practice of vaccination is still very much neglected. From a return recently obtained by the Registrar-General from the District Registrars, it appears that whilst 6314 births were registered in St. Pancras in one year, only 3695 certificates of vaccination were received ; whereas, by the law, all vaccinated children ought to be certified as having been vaccinated. This great difference between the number of births and the number certified to be vaccinated depends on a combination of causes; first, about 400 children die under the age of 3 months at which age vaccination is usually performed; secondly, many medical men who vaccinate children, in fact, nearly all who are not public vaccinators, and some even of the latter class, fail to send the certificate to the Registrar; nor is this to be wondered at seeing that they have no compensation for so doing; then thirdly, very many children are not vaccinated at all, owing either to ignorance, prejudice, or apathy on the part of those who have charge of them. The registration of a birth is not compulsory, and is not always attended to; where this is omitted the parents receive no authoritative information as to the necessity of having it vaccinated. With the present very incomplete system of registering vaccination, it is very difficult to get evidence of its non-performance, so that the penalty may be enforced. Further, it is not any one's special business to undertake the prosecutions under this A.ct, although by the Public Health Act, 1858, it is provided that " Proceedings for Penalties, under the Acts for time being in force on the subject of Vaccination, may be taken on the complaint of any Registrar employed for the Registration of Births, Deaths, and Marriages, Public Vaccinator, or Officer authorised by the Board of Guardians, or by the Overseers respectively; and the cost of such proceedings shall be defrayed out of the Poor Rates." But although the Registrars and Public Vaccinators may institute proceedings for the recovery of these penalties, yet there is no inducement for them to do so, unless they are actuated entirely by public spirit. The consequence of all this is, that the so-called Compulsory Vaccination Act is almost a dead letter. It requires very great amendment to make it of much practical utility. The more general adoption of Vaccination must, however, be brought about in other ways than by direct compulsion, which is contrary to the spirit of the English laws, and should only be adopted in extreme cases. If the circumstance of having been successfully vaccinated, or of having had the Small Pox, were an essential condition to the entry of all public or private schools, or to the obtaining any appointments in the public scrvice, and if employers would ascertain before engaging servants whether 12 they had been vaccinated, just as the Government does before taking passengers on board an emigrant ship, such measures as these would very much extend the prevalence of it. Within the last week or two, I was visiting a Ragged School in this Parish, and of about 50 children, nearly 20 had never been vaccinated. Amongst the causes of death which should be noted, are those from violence of various kinds. Under this heading are 7 men killed on the railway; 2 by falling from heights ; 3 men and 3 women from falls in walking; 3 men and 4 women by injuries from different horse conveyances; 2 men killed by machinery ; 19 children and 3 women burnt or scalded; 3 men and 1 woman committed suicide by cutting their throats; 1 man by shooting himself; 3 adults, 1 man, and 2 women committed suicide by poisoning themselves, one using prussic acid, one laudanum, and one oxalic acid; two children were poisoned through the careless administration of drugs. No fewer than 12 were drowned, of whom 8 were children, some being accidentally and others murderously drowned; and 4 adults, who probably committed suicide. 3 women hanged themselves; 1 woman intentionally killed herself by suffocation; 14 male and 16 female children were stifled, all except one, under clothes. They are nearly all said to have been accidentally suffocated, but one cannot help strongly suspecting that many of them were murdered. 23 children died from the want of breast milk. 2 men were choked from pieces of food lodging in the air passages ; 2 persons died from privation; 7 persons, 2 men and 5 women, are returned as dying directly from intemperance. This number gives but a very imperfect conception of the number whose lives are abridged, and whose deaths are fearfully hastened by the abuse of strong drinks. Of the Diseases of the Brain, of those of the Liver, of those of the Kidney, of the deaths from Premature Old Age, a very large proportion may be fairly ascribed to Alcohol; and amongst the violent deaths, I have little doubt that more than one-half may be set down to the same agent as the direct or indirect cause. Whatever renders the house of the poor more comfortable, tends to draw them from the gin-shop, and to diminish intemperance. Convinced as I am of the fearful results of intemperance, and also of its great prevalence, I cannot but regret that the liberal offer of Mr. Gurney, to erect a drinking fountain in an open situation in the Parish was not gratefully accepted, even although the water supplied to it must have been paid for from the rates. Many a poor man would take a draught of water if he could get it ready to his hand, and of good quality, where now he resorts to the public-house. I wish we could have seen St. Pancras taking the lead in this mode of benefitting the working classes, and improving the district, but already several districts have anticipated us. The ages at which deaths have occurred, are worthy of note. Under the age of 5 years 1980 deaths took place, which is 44 per cent. of all the deaths. During the second five years of life, there were 244, or 5 per cent. of all the deaths; during the third five years, that is, between the ages of 10 and 15 years, only 69, or 1½ per cent, of the deaths; between 15 and 25 years of age, 214 or 4.7 per cent. of the deaths; between 25 and 35 years, 274 or 6 per cent; and for the several consecutive periods of 10 years up to the age of 85, deaths occurred to the following degrees,—297 or 6-5 per cent, 345 or 7.6 per cent., 373 or 8.2 per cent., 365 or 8 per cent., and 268 or 5-9 per cent. of the deaths. Above the age of 85, 79 or 17 per cent. of the deaths occurred; of these, 3 were females above the age of 95 years; between the ages of 85 and 95 there were 30 male and 46 female deaths. The death-rate under the age of 5 years is very high; of every thousand children of both sexes living at that age, more than 79 died in 1858 ; of every thousand male children, 82 died, and of every thousand female, 76 died. To every thousand births of both sexes there were 148 deaths under the age of 1 year; of every thousand male children born, 150 died ; and of every thousand 13 female children, 147. The death-rate of infants in the different sub-districts presents very great diversities, even greater than the diversities presented by the death-rate at all ages. Population under the age of 5 vears in 1851. Estimated Population under 5 in 1858. (i) Deaths under 5 in 1858. -rate at that age calculated. Regent's Park 3891 4195 318 76 Tottenham Court (a) 3216 3371 314 94 Gray's Inn 3123 3248 296 91 Somers Town 4788 5328 408 76 Camden Town (a) 2775 3166 245 80 Kentish Town 3108 4881 350 71 From this table it is seen that of a thousand children living under 5 years in Kentish Town sub-district, only 71 died, whilst of the same number in Tottenham Court and Gray's Inn sub-districts respectively, there died 94 and 91. Of the two sexes, the mortality is different at different ages, and also the total mortality is different. There are many more females than males living in St. Pancras, as in most other places—probably 106,000 females and 89,000 males; so that more females than males died in the year 1858, yet in proportion to the number living of each sex, the mortality was considerably lower amongst females than amongst males. The death-rate of males was 249 in the ten thousand ; of females only 205 in the same number. The general rule is that more male children than female are born; more males than females die, and the excess of male deaths is proportionally greater than the excess of male births, so that there remain to survive more females than males. I have again this year, as last, tabulated the deaths of all males above 20 years of age, according to their Occupations. (See Table X.) There is a difficulty in estimating the rate of mortality amongst the different classes, owing to the fact that we do not exactly know what numbers are living in the Parish belonging to the several occupations ; the only guide we have is the number living at the time of the census of 1851. Taking this as a standard for the present population, by a study of Table X, it will be found that the following had last year high rates of mortality ; arranging them in the order of their insalubrity they are,—Coachmen and Cabmen,* those engaged in the East Indian Service, Actors, Ministers of Religion, Pensioners, Jockeys,* Commercial Travellers, Coal-heavers,* Jewellers, Costermongers,* Gardeners, Cab owners,* those engaged in Gas "Works' service, House Painters, Brickmakers, Printers, Butchers, Soldiers,* "Watchmakers, Engravers, Coal Merchants, Railway Engine Drivers,* Licensed Victuallers,* and Shoemakers. Those marked with an asterisk (*) were also found to show a high mortality in 1856, 1857. The whole of those enumerated above died at a rate of more than 25 to every 1000 of that occupation living in 1851. Accidental circumstances may place any one occupation high on the list, especially when the numbers engaged in it are small; but when the same occupation stands high for a succession of years, we may be sure that there is something in the habits of those engaged in such pursuits, or in the occupation itself, which raises the rate of mortality. (a) In these two sub-districts allowance has been made for the Workhouses, the deaths in which have been excluded. (b) This column is calculated on the assumption that the same proportionate number of the entire population in each district is under 5 years of age, as at the census of 1851. 14 WORKHOUSE. The number of deaths in this establishment has been 438, more than in 1857. This circumstance cannot fairly be regarded as an indication that the sanitary conditon of the building has been inferior. The great mass of those who die in the workhouse are persons who have been long suffering from chronic diseases, many of them at very advanced ages. There has been no high fatality from Zymotic diseases, with the exception of Measles, which caused 29 deaths, taking off chiefly the unhealthy young children. The ages at death wore as follows:—Under 5 years of age, 86; from 5 to 10 years, 2; between 10 and 20 years, 5; between 20 and 30, 20; between 30 and 40, 19; between 40 and 50, 44; between 50 and 60, 60; between 60 and 70, 75 ; between 70 and 80, 82 ; between 80 and 90, 40; between 90 and 100, 5. So that above the age of 50 years, 262, or considerably more than half of the deaths occurred. And of the deaths between 20 and 50, by far the largest proportion occurred from Consumption and Bronchitis, a few from Diseases of the Kidneys, and some from Cancer. I believe that the condition of the Building generally has been satisfactory. There is a marked improvement of late as regards cleanliness and general order throughout the Establishment. "Within the last few months, the drainage of the Infirmary has been defective, owing to leakage from some of the soil pipes ; this, however was remedied as soon as the cause was detected. At the present time there is at intervals a very offensive drainage smell noticed in the male lunatic wards. There is reason to think that it arises from the close proximity to the Burial Ground, the soakage from which probably finds its way under the flooring of part of the abovenamed wards. I am at the present time investigating the matter, and I have not the least doubt that so soon as the exact cause is ascertained, and a remedy suggested, the Directors will have the evil removed. TAUTER SICKNESS. Whilst the registers of death are a most valuable guide in judging of the salubrity of a place, they frequently fail most signally as a guage of prevailing sickness. It is not always the case when the rate of mortality is low, that but a small amount of disease exists. If we were enabled to register all cases of illness that came under medical treatment, whether parochially, in public institutions, or privately, we should have a much more accurate indication of the state of public health than we have at present. At the present day such a register cannot be obtained, but in default of that I have kept a register of the cases of disease that are treated at the expense of the Parish, both in the Workhouse and out of doors. I am enabled to do this through the kindness and public spirit of the Medical Officers, who have, since Michaelmas, continued to supply me with returns of their cases, although the salary allowed them as Assistant Officers of Health, was discontinued at that period. These returns, which they furnish mo from week to week, are attended with a considerable amount of labour on their part, but rather than the parish should suffer they have willingly undertaken it. Table IX embodies the chief results obtained from an analysis of the number given in those returns. It will be seen that no fewer than 11,139 cases of sickness have been under the treatment of the Parish Surgeons during the year 1858 ; of these 8866 were out-door poor, and 2273 were in the Workhouse. The number of sick has been considerably higher this year than in 1857 There have been a larger number of cases of Low Fever, of Diarrhoea, of Scarlet Fever, of Small Pox, of Measles, and of Hooping Cough, than in the previous year. The greatest excess has been underthe head of Scarlet Fever, 425 instead 15 of 117. It is remarkable that only 7 cases of Diphtherite have been returned by the Parochial Officers, which would seem to indicate that this disease has not prevailed so much amongst the poor as amongst the richer classes. "Whilst referring to the information given me by the District Surgeons, I may mention that they still continue to direct my attention to any places in which they observe that inspections are required by myself or the Inspector of Nuisances; they thus render the parish a great service, by enabling the Sanitary Officers to devote their energies to the spots which arc the focuses of epidemic, endemic, and infectious diseases. An erroneous impression has occasionally existed that the District Medical Officers thus render the work of the Officer of Health and the Inspectors of Nuisances unnecessary ; the fact being exactly the contrary. The more information given to the officers, the more labour is thrown upon them, as they have to use the means for abating the evils to which their attention is directed. SANITARY WORKS REQUIRED OR EXECUTED. The streets that were previously reported as being without sewers, remain in the same condition, seeiug that no new sewers have been made. The open sewers previously reported, in and near the Gospel Oak Fields, as well as the open ditch in Winchester Terrace, are still unclosed.* The unpaved district between the Gray's Inn and Bagnigge Wells Roads, and many parts of Agar Town are still in the same state; but I am glad to know that the Vestry has recently decided to borrow money for the purpose of paving these hitherto neglected portions of the Parish ; you will, in this way, very much improve the salubrity of those localities which have been justly the subject of numerous complaints. Some of the old sewers in the Parish are in a very imperfect state ; some of them are not deep enough to drain the lower parts of the houses, others have an insufficient fall, so that the drainage stagnates, and the more solid part remains to putrify in the sewer, and give off offensive and noxious gases, which escape either into the streets, through the gulleys or ventilators, or into the houses whose drains arc untrapped, and even forcing its way into those which have traps. It must never be forgotten that none of the traps in ordinary use are a complete protection against the passage of sewer gases. The shackle trap usually employed at the entrance of the house-drain into the sewer, admits air through the upper part of it from the sewer into the house-drain, whenever water passes through the lower part of the trap. The other traps in common use, such as the Syphon Trap, the D Trap, and the Bell Trap, are all dependent on water; in these, when there is no water, which must often happen, no protection whatever is afforded; and even when water is present, the depth of it is so small that it is insufficient to resist any pressure of gases, such as often exists; and when once saturated with the sewer gases, it offers little or no obstruction. Other sewers lie in holes from not being well constructed, the brick-work having giving way at points, or the sewer having been built piecemeal, and the levels not well observed. The consequence of this is, that the sewer, instead of being as it should be, a channel with smooth sides and bottom, having a uniform fall, so as always to have a flowing stream of water holding feculent matter in suspension, and almost free from smell, is a succession of overflowing cesspools, with the most putrid and noxious accumulations in them. This is of course an *One open drain at the back of Gloucester Place, Kentish Town, which, till recently, received very many house drains, is now restored to its original condition, that of a simple water course, and, by carrying the drainage into the sewer in front, a very considerable nuisance has been removed. 16 extreme case, but such instances do actually exist. I believe that the flushers are very diligently employed in removing accumulations in the sewers, and keeping the passages as free as possible; and I am informed by your Chief Surveyor that the sewers are more free from deposits at the present time than they have been for years; but when a sewer is badly constructed, no diligence on the part of the flushers can prevent the deposition of putrifying matter in it. When a sewer is inefficient, it is no matter for surprise that the gulley gratings and sewer ventilators should disgust the passers-by, and poison the air with noxious gases. There is then an outcry that the gulleys be trapped ; if this demand is acceded to, and the trapping is effectual, foul gases are concentrated in the sewer, and the sewers-men ran the risk of being suffocated either with or without explosions. These accidents are by no means of very rare occurrence. If the foulness of the sewer does not reach such a degree as that above indicated, yet still, from the increased pressure of air in them, caused by the traps, there is a greater tendency for the gases to force themselves into dwellings in the various methods I have above alluded to. A very able Report on the Ventilation of Sewers has been written by Mr. Haywood, the Surveyor to the Commissioners of Sewers, and another on Sewer Gases and the Ventilation of Sewers, by Dr. Letheby, the Medical Officer of Health for the City. There appear to be very great practical difficulties in efficiently ventilating sewers, and the methods alluded to by Mr. Haywood are attended with a very great expense. Dr. Letheby proposes a method not exactly of ventilating the sewers, but of deodorizing the gases which escape from them. For this purpose he has suggested the use of vegetable charcoal, which has for some time been known to have a very remarkable power in absorbing gases, and rendering those which arise from decomposition completely innocent by promoting rapid oxidation after the manner of combustion in a fire. Dr. Letheby says, " It is manifest that we have in common wood charcoal a powerful means of destroying the foul gases of sewers. How it is to be applied is fortunately a matter of but little embarrassment, for let the sewers be ventilated as they may, either by open gratings in the street, or by the rainwater pipes of the houses, or by the pillars of the gas lamps, or by tubes carried up at the landlord's expense from the drains of every house, or by especial shafts in the public streets; in fact, let the gases go out of the sewers how they will, and where they will, you have but to place a small box containing a few pennyworths of charcoal in the course of the draft, and the purification of the air will be complete." The experiment is about to be tried in one large district in the City, and it will be better to await the results of this experiment before much is said as to the general adoption of such a scheme as this. The suggestion is no doubt ingenious, and will probably lead to useful results ; the points to be feared are that the charcoal will soon lose its power through damp and saturation with the sewer products, and that the friction of gases on the charcoal filters, though not offering great obstruction to the exit of air, will be quite sufficient to divert the currents into other channels. It is quite certain that to be of much use, the filters must be applied to all the openings out of the sewers within the district to which they are applied. The principle may be used in a variety of ways; an ingenious apparatus has been contrived by Mr. Burge, the Medical Officer of Health for Hammersmith, for deodorizing the gases escaping by the galley gratings and sewer ventilators, and this may be advantageously applied to sewers at isolated points, where, from any cause the gases are very foul, and the persons exposed to them are very numerous, and yet a complete trapping of the sewer is undesirable. For instance, in a crowded court, with a sewer not very efficient, and terminating in a blind extremity (at which point the sewer gases are usually concentrated), such an apparatus would be very useful. Mr. Burge finds that charcoal is not the best ingredient for these filters, and is at present engaged on experiments as to what disinfectant is 17 most efficient. An objection has been raised to the trapping and the deodorising of sewers by means of charcoal or other filters; and the objection is not without weight. It is that by the use of any of these expedients there is danger of overlooking and being careless about the efficiency and perfection of the sewer itself, and after all this should be the main object. If the sewer give off an undue amount of the noxious gases it will be impossible, except by the adoption of most expensive appliances, to prevent these gases finding their way to human beings, either in the public streets or (which is worse) in private houses. For myself, I fully sympathise in the main with those who urge this objection, and believe that you, to whom is entrusted the drainage of this large district, should not rest satisfied until every street, and court, and alley are provided with a thoroughly well-acting sewer, and every house is made to communicate directly with that sewer. During the long interval which must necessarily elapse before such works can be carried out, I believe that it will be advisable in many cases to resort to the use of gulley traps or air filters as temporary expedients. The efficiency of the sewers is now more important than ever it was, on account of the much larger number of houses whose drains run directly into them, owing to the abolition of cesspools. As I pointed out above, where a sewer is imperfect, it becomes a large elongated cesspool, or a succession of smaller ones; even this, I believe, is better than having cesspools under the house, but it is of course very injurious, and cannot fail to swell the tables of mortality, and to perpetuate the race of puny, pale-faced, and unhealthy persons. During the year there has been a large number of houses, previously in a very bad sanitary state, rendered wholesome. The operations of your Sanitary Committee, and the officers of that department, as recorded in the Books, are given below. In addition to the places recorded there are many others that have been improved, in which no formal notice has been given, and many inspections have been made, which are not specially reported. 945 houses have been inspected, and specially reported. (These have been in consequence either of complaints from parishioners, or of prevailing sickness, made known to the Officer of Health in a variety of ways). 343 new drains have been constructed. 219 old drains improved. 1007 traps supplied to drains. 411 cesspools abolished. 418 water closets furnished with pan, trap, and water supply. 470 old water closets supplied with water; 21 new ones erected where none previously existed. 148 dust bins erected. 107 old ones repaired. 157 cellars or yards newly paved, or pavements relaid. To 14 houses, previously without water, there has been a supply of water for domestic purposes furnished. 130 houses have been cleansed and lime-whited. 25 houses have had their ventilation improved. 47 other nuisances have been abated. 5 cowsheds have been repaved and had their drainage improved. To effect these improvements 642 notices have been served; in 99 instances secondary notices have been issued; and in 64 instances summonses have been taken out under the Nuisances Removal Act. This step is only adopted after all the officers' powers of persuasion have been exhausted, and ample warning has been given. 18 To abate overcrowding, 16 notices have been issued, and have been effectual, without resorting to the Police Magistrates' authority. There are 104 licensed slaughterhouses; besides these, to 15 places for which application was made, a license was refused. During the year, 5 butchers have been summoned and fined for slaughtering in unlicensed places. The Magistrates at the Special Sessions decided that no slaughter-house can be established, or newly carried on within forty feet from any public way, or within fifty feet from any dwelling-house, in accordance with the provisions of the Metropolitan Building Acts (18 and 19 Yict., c. 122, sec. 109, and 7 and 8 Vict., c. 84, sec. 55). The two Inspectors have been very actively engaged during the year in carrying out the improvements above alluded to. In addition to the investigation of all complaints made to the Sanitary Committee by any inhabitant of the Parish, they have to inspect and enquire into the condition of all houses where such cases of disease as I consider preventible, whether fatal or not, occur; they have, as frequently as possible to inspect all licensed slaughter-houses, to be on the watch for butchers killing in places not licensed; also to inspect all cowhouses from time to time; also all mews and wharves used to receive manure ; they have to visit sausage-makers shops, and the street markets, to see what kinds of provisions are offered for sale, and, if necessary, to seize the articles and take them before a magistrate, that he may condemn them to be destroyed. They have to write out notices and summonses, to serve the notices, to attend at Police Courts to give evidence against those parties whom the Committee order them to summon. When notices have been served on the persons by whose act or default the nuisance exists, they have, when the time allowed on the notice has expired, to revisit the place to ascertain whether the works ordered have been commenced; if they are commenced they have to watch them during their progress, to see that they are properly performed; if this portion of their work be not done well, all the rest is useless, and often worse than useless, because the evil frequently is not at all removed, but merely rendered less obvious, and a feeling of false security is induced. I could mention numberless instances where cesspools were being covered over without being emptied; where drains were being very indifferently patched instead of thoroughly renewed, where the communication with the sewer was not properly established, where the fall in the drains was being left too slight, where bad pipes were being put in instead of good ones, where defective brick drains were left instead of stoneware pipes, which had been ordered ; and it has only been by the vigilance of the Inspectors that these and similar jobs have been detected. In addition to the out-door work, the Inspectors have to keep a record of what they do, and books to register the results of their notices, summonses, &c. When it is remembered that the Parish is in area 2716 acres, and in circumference more than 16 miles, that it has a population of nearly 200,000, that it has at least 21,000 inhabited houses, that many localities in the parish are most densely populated by the very poor and those who disregard what is required for the maintenance of health, it will surely be admitted that there is enough to engage two Inspectors of Nuisances.* There are many parts of the Parish from which low forms of disease are never absent; they are densely crowded, some houses containing 8 or 10 families, or 50 individuals ; some of these people have become so used to filth that they appear to prefer it to cleanliness ; at any rate they have not the energy to *St. Pancras is in population one-fourteenth of the whole Metropolis. In the various districts included in the Metropolis Local Management Act, excluding St. Pancras, there are employed 47 Inspectors of Nuisances. 10 get rid of it and improve their condition. Such houses as those above referred to ought to be visited at least two or three times a year; if a drain gets blocked up, or a trap is defective, this may remain so for weeks without any complaint being made, to the injury of the health of all who live in the house ; or if the water supply is cut off, owing to some defect in a pipe or butt, or the improper action of a ball-cock, or if the water is made poisonous by the foul state of the butt, these things may remain for weeks until some accident brings them under the notice of myself or the Inspectors. If an infectious disease occurs in the house, no means are probably adopted to disinfect the bedding, the clothes, or the walls, unless the parties responsible are required to do so. A house of this kind may be put into a good sanitary condition to-day, but unless the landlord or his agent be very careful as to what class of tenants occupy it, and looks to it occasionally when he collects his rents, by this day twelvemonths it will be in such a state as to be a perfect hot-bed for all kinds of infectious diseases. As a good example of the salutary effects upon mortality of simple sanitary measures, may be mentioned the town of Ely, which is a small city (of 6176 inhabitants in 1851)* in the neighbourhood of the low lands and marshes, which are still very imperfectly drained. The Ely Board of Health was founded in 1851, and set on foot two great works, one for supplying the town with water, the other for thoroughly draining the houses. The public works were completed at the end of 1854, and the houses were gradually connected with the public sewers, leaving, however, in 1859, 200 out of 1200 houses still out of connection. In 7 years (1843-49), before the Works were commenced, the mortality was at the rate of 26 deaths annually to every thousand living; in the 7 subsequent years, when the sanitary measures were only partially carried out, the mortality fell down to the rate of 19 deaths annually to every thousand living; in the two last years, 1856-57, the mortality was at the rate of 17 in a thousand ; so that the mortality has fallen from 26 to 17 per thousand; that is to say, it is reduced by more than one-third. METEOROLOGY. The average temperature of the year was very nearly that of 17 previous years; viz., 49°,2, or 0°-l above the average. The first quarter of the year was 1°.6 cooler than the average of 17 years; the second quarter was 1°.6 wanner than the average ; the third quarter l°.0 warmer; and the fourth quarter 0.8° colder than the average. The mean daily range of temperature wasl7°.3, being 1°7 more than the average of 17 years. Humidity was 3 degress less than the average. Themean height of the barometer was 29.834 being .059 higher than the average of 17 years. Only 17.2 inches of rain fell, being 6.6 inches less than the average of 40 years. The average rate of movement of the wind was 86 miles a day instead of 110 miles, which is the average rate of former years. The chief peculiarities in the meteorological phenomena were the very great slowness of the wind's movements, the unusual dryness of the atmosphere, and the small amount of rain. There was also a higher daily range of temperature than usual; also slightly higher barometric readings. The whole of these items are obtained from the Registrar General's Report, and are only strictly correct for Greenwich, though not very incorrect for St. Pancras. I have the honour to remain, Gentlemen, Your obedient Servant, 21, Upper Gower Street, THOMAS HILLIER. May, 1859. *See Quarterly Report of Registrar General, No. 39, page 5. [ TABLE I. ] Shewing the causes of Death at different Ages during the year 1858. CAUSES OF DEATH. MALES AND FEMALES. All Ages. Ages at Death. Total under 1 year. 1 2 3 4 5— 10— 15— 25— 35— 45— 55— 65— 75— 85— 95 &upwds ? I. 1 Small Pox 22 5 2 3 3 4 3 ... ... 2 2 Measles 184 27 68 36 19 15 16 2 3 Scarlatina 406 36 52 73 51 47 110 16 10 4 3 2 2 4 Hooping Cough 182 55 60 30 17 9 11 5 Croup 31 9 6 3 4 2 7 6 Thrush 8 8 . 7 Diarrhœa 115 75 16 5 ... ... 1 ... 1 2 ... ... 3 9 3 8 Dysentery 7 3 ... 1 ... ... 1 ... ... ... ... ... ... 2 9 Cholera 5 3 2 10 Influenza 3 ... 1 ... ... ... ... ... ... ... ... ... ... ... 2 11 Purpura 4 ... ... ... 1 ... 1 ... ... ... 1 12 Ague 1 ... ... ... ... ... ... ... ... 1 13 Remittent Fever 3 ... ... 1 ... ... 1 ... ... ... ... ... 1 14 Infantile Fever 2 ... ... 1 1 15 Typhus 110 3 3 8 9 4 17 8 12 11 8 10 8 5 2 2 16 Metria 14 ... ... ... ... ... ... ... 3 6 4 1 17 Rheumatic Fever 21 ... ... ... ... ... 3 1 6 2 3 3 2 1 1 18 Erysipelas 31 10 1 ... ... ... ... 1 1 ... 4 5 4 3 2 19 Syphilis 19 15 ... ... ... ... ... ... 1 2 1 II. 20 Haemorrhage 15 2 ... ... ... ... ... 1 1 1 1 3 1 1 4 21 Dropsy 52 3 3 ... ... 1 1 1 2 2 3 6 12 13 5 22 Abscess 9 2 ... ... ... ... ... ... 1 3 2 ... ... 1 23 Ulcer 8 2 ... ... 1 1 ... ... ... ... ... 1 1 2 24 Fistula 3 ... ... ... ... ... ... ... ... ... 1 ... ... 2 26 Mortification 7 1 ... ... ... ... ... ... ... ... ... 1 2 2 ... 1 26 Cancer 90 ... ... ... ... ... ... ... ... 3 13 23 26 18 4 3 27 Gout 10 ... ... ... ... ... ... ... ... ... 2 ... 3 1 3 1 III. 28 Scrofula 31 5 2 7 ... 2 6 3 2 4 29 Tabes Mesenterica 60 28 16 6 2 4 ... ... 4 1 30 Phthisis 538 18 16 9 8 5 11 14 98 121 109 75 43 10 1 31 Hydrocephalus 83 32 17 16 7 4 6 ... 1 IV. 32 Cephalitis 40 4 3 5 4 2 3 1 3 6 3 3 5 4 1 33 Apoplexy 132 13 9 2 2 3 1 ... 7 3 9 26 25 18 12 2 34 Paralysis 52 ... ... ... ... ... ... ... ... 1 1 6 16 13 14 1 35 Delirium Tremens 11 ... ... ... ... ... ... ... 1 4 3 2 1 36 Chorea 1 ... ... ... ... ... ... ... 1 37 Epilepsy 21 ... 1 ... ... ... 2 1 ... 4 3 1 5 2 2 38 Tetanus 5 ... ... ... ... ... ... ... 1 2 ... 2 39 Insanity 6 ... ... ... ... ... ... ... ... 2 2 1 ... 1 40 Convulsions 107 78 15 6 4 3 1 41 Disease of Brain 35 6 4 1 2 ... 2 2 1 2 1 5 4 3 2 V. 42 Pericarditis 7 1 ... 1 ... ... 2 ... 1 ... 2 43 Aneurism 5 ... ... ... ... ... ... ... ... 1 2 1 ... 1 41 Disease of Heart 161 1 1 ... 1 ... 3 9 6 8 16 28 28 40 19 1 VI. 45 Laryngitis 7 2 1 1 2 ... ... ... 1 46 Bronchitis 490 84 47 16 12 2 6 "i 4 15 23 48 79 87 59 7 47 Pleurisy 12 ... ... ... ... ... ... ... 3 3 ... 1 ... 3 2 48 Pneumonia 289 85 62 27 18 7 9 ... 12 8 17 16 18 7 3 49 Asthma 36 ... ... ... ... ... ... ... ... 1 2 7 12 12 2 50 Disease of Lungs 38 9 3 1 1 ... 1 1 2 4 3 2 4 4 2 1 VII. 51 Teething 53 30 22 1 52 Quinsy 6 1 2 ... 2 ... ... ... ... ... ... ... 1 53 Gastritis 8 ... ... 1 ... 2 ... ... 1 1 ... ... 3 54 Enteritis 24 5 1 ... ... ... 2 1 1 2 2 3 2 3 1 1 55 Peritonitis 14 1 1 ... ... ... 2 ... 4 1 ... 1 2 1 1 56 Ascites 7 ... ... ... ... ... ... ... ... ... 2 2 2 1 57 Ulcerated Intestines 7 ... ... 1 ... ... 1 ... 1 1 ... 2 ... 1 58 Hernia 6 ... ... ... ... ... ... ... ... ... ... 1 1 1 3 59 Heus 11 4 ... ... ... ... ... ... 1 ... 1 1 1 3 [TABLE I.—continued.\ Shewing the Causes of Death at different Ages during the year 1858. CAUSES OF DEATH. MALES AND FEMALES. All Ages. Ages at Death. Total under 1 year. 1 2 a 4 5— 10— 15— 25— as- 45— 55— 65— 75— 85— 95 &upwds ? 60 Intussusception 4 2 ... ... ... ... ... 1 ... ... ... ... 1 61 Stricture Intestinal. 1 ... ... ... ... ... ... ... ... ... ... ... 1 62 Disease of Stomach 9 1 ... ... ... ... ... ... 1 ... 1 ... 3 2 1 63 Disease of Pancreas 1 ... ... ... ... ... ... ... ... ... ... ... 1 64 Hepatitis 8 ... ... ... ... ... ... ... ... 1 1 1 5 65 Jaundice 10 5 ... ... ... ... ... ... ... ... ... 1 1 ... 3 66 Disease of Liver 53 2 ... ... ... ... ... ... 1 2 11 19 10 6 2 67 Disease of Spleen 1 ... 1 VIII. 68 Nephritis 1 ... ... ... ... ... ... ... 1 69 Nephria 29 ... ... ... ... ... 2 ... ... 9 6 6 4 ... 1 1 70 Ischuria 71 Diabetes 3 ... ... ... ... ... ... ... 1 1 ... ... ... 1 72 Stone 1 73 Cystitis 7 ... ... ... ... ... ... ... ... ... ... ... 2 5 74 Stricture of Urethra. 8 ... ... ... ... ... ... ... ... 1 1 2 2 2 75 Dis. of Kidneys, &c. 20 ... ... ... ... ... ... ... ... ... 4 2 5 2 7 IX. 76 Paramenia 77 Ovarian Dropsy 3 ... ... ... ... ... ... ... ... 1 1 1 78 Childbirth 19 ... ... ... ... ... ... ... 1 9 8 1 79 Uterine Disease, &c. 9 ... ... ... ... ... ... ... ... ... 4 3 ... 2 X. 80 Arthritis 81 Rheumatism 5 ... ... ... ... ... ... ... ... ... 2 ... 2 1 82 Disease of Joints 10 ... ... ... ... ... ... ... 1 2 1 3 3 XI. 83 Carbuncles 2 ... ... ... ... ... ... ... 1 ... ... 1 84 Disease of Skin 1 ... ... 1 XII. 85 Cyanosis 1 1 86 Spina Bifida 2 2 87 Other Malformations 11 11 XIII. 88 Premature Birth & Congenital Debility 104 100 2 1 1 XIV. 89 Atrophy 104 81 11 5 1 ... ... 1 ... 1 2 ... 2 XV. 90 Age 226 ... ... ... ... ... ... ... ... ... ... 4 6 60 100 54 2 XVI. 91 Sudden 1 ... ... ... ... ... ... ... ... ... ... ... 1 XVII. 92 Intemperance 7 ... ... ... ... ... ... ... ... 2 2 2 ... 1 93 Privation 2 ... ... ... ... ... ... ... 1 1 94 Want of Breast Milk 23 23 95 Neglect 1 ... ... ... 1 96 Poison 6 2 ... ... ... ... ... ... 1 3 97 Burns, &c 22 1 5 4 3 ... 5 1 1 ... 1 ... ... ... ... ... 1 98 Hanging and Suf- focation 38 30 1 ... ... ... 1 ... ... 1 2 1 1 1 99 Drowning 12 2 2 1 ... ... 2 1 ... ... 2 ... 1 ... ... ... ... 1 100 Fracture 25 ... ... ... ... ... 1 1 4 3 2 6 4 1 2 1 101 Wounds 13 ... ... ... ... 1 1 1 4 1 ... 2 1 2 102 Other violent causes 16 8 ... 1 1 ... 1 ... ... 2 1 1 ... 1 103 Not Specified 19 6 5 1 ... 1 ... ... ... 1 1 2 ... 2 Total 4509 941 464 275 178 119 214 69 214 274 297 345 373 365 268 76 3 1 [TABLE II.] Saint Pancras, Middlesex—Register of Births and Deaths in the Sub-districts and Public Institutions, for the 52 Weeks ending 1st day of January, 1859. LOCALITIES. Area in Acres. Population in 1851. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From Small Pox. From Measles. From Scarlatina. From Hooping Cough. From Diarrhoea. From Low Fever. M. F. M.&F. M. F. M.&F. Regent's Park 427 31918 548 513 1061 339 347 686 318 5 24 57 28 19 21 Tottenham Court 27813 299 222 621 311 3 24 77 34 21 20 University College Hospital 145 500 439 451 890 100 44 144 3 .. .. 2 .. .. 2 Strand Union 120 68 72 140 23 .. 3 1 .. 4 Gray's Inn Road 155 26462 426 432 858 291 311 602 293 7 20 54 32 19 13 Royal Free Hospital 60 45 38 83 3 .. .. .. .. 1 4 Somers Town 184 35641 627 699 1326 403 420 823 408 1 47 108 34 30 10 Camden Town 171 19515 455 439 894 227 231 458 245 3 30 46 28 18 17 Saint Pancras Workhouse 1600 209 22.9 438 86 .. 29 1 1 3 2 Kentish Town 1634 23326 667 651 1318 353 360 713 350 3 14 53 29 20 26 Hospitals out of the Parish TOTALS 2716 166956 3162 3185 6347 2334 2374 4708 2040 22 191 399 186 135 115 [TABLE III.] FIRST OR "WINTER QUARTER 1858. Saint Pancras, Middlesex—Register of Births and Deaths in the Sub-district and Public Institutions, for the 13 Weeks ending 3rd day of April, 1858. LOCALITIES. Area in Acres. Population in 1851. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From Small Pox. From Measles. From Scarlatina. From Hooping Cough. From Diarrhoea. From Low Fever. M. F. M.&F. M. F. M.&F. Regent's Park 427 31918 137 120 257 86 97 183 84 .. 4 6 12 2 Tottenham Court 27813 125 97 78 175 76 2 3 11 8 1 9 University College Hospital 145 500 108 233 29 13 42 1 .. .. .. .. .. 1 Strand Union 120 18 25 43 8 .. .. .. .. 1 Gray's Inn Road 155 26462 101 124 225 75 89 164 62 4 2 5 9 3 6 Royal Free Hospital 60 9 7 16 2 • • •• •• . •• •• 2 Somers Town 184 35641 167 203 370 100 98 198 85 1 6 19 3 1 2 Camden Town 171 19515 135 115 250 51 65 116 66 •• 6 13 13 •• 7 Saint Pancras Workhouse 1600 64 85 149 37 .. 22 .. .. .. 1 Kentish Town 1634 23326 153 148 301 110 92 202 91 .. 2 2 7 1 8 Hospitals out of the Parish. < TOTALS 2716 166956 818 818 1636 639 649 1288 512 7 45 56 52 7 38 [ TABLE IV. ] SECOND OE SPRING QUARTER 1858. Saint Pancras, Middlesex—Register of Births and Deaths in the Sub-districts and Public Institutions, for the 13 Weeks ending 27th day of June, 1859. tlfVU u»J| ui ' LOCALITIES. Area in Acres. Population in 1851. BIRTHS. DEATHS From all causes From all causes junder 5 years 1of age. From Small Pox. From Measles. From Scarlatina From Hooping Cough. From Diarroea From Low Fever. M. F. M.&F. M. f. :m.&f. Regent's Park 427 31918 133 112 245 76 78 154 73 .. 14 10 7 2 2 Tottenham Court 27813 46 66 112 59 1 5 4 6 3 4 University College Hospital 145 500 I 97 96 193 19 7 26 .. .. .. 1 Strand Union 120 13 11 24 3 .. .. 1 .. 2 Gray's Inn Road 155 26462 100 85 185 63 58 121 62 3 7 10 2 Royal Free Hospital 60 10 10 20 .. .. .. .. .. 1 Somers Town 184 35641 123 137 260 71 87 158 70 15 19 12 3 1 Camden Town 171 19515 110 105 215 53 48 101 53 2 4 5 9 1 3 Saint Pancras Workhouse 1600 45 38 83 8 .. .. .. 1 Kentish Town 1634 23326 147 143 290 71 62 133 70 .. 1 5 11 1 6 Hospitals out of the Parish TOTALS 2716 166956 710 678 1388 467 465 932 398 4 42 52 56 15 16 [TABLE V."] THIRD OR SUMMER QUARTER 1868. Saint Pancras, Middlesex.—Register of Births and Deaths in the Suh-districts and Public Institutions, for the 13 Weeks ending 25th day of September, 1858. LOCALITIES. Area in Acres. Population in 1851. BIRTHS. DEATHS From all causes From all causes under 5 years of age. From Small Pox. From Measles. From Scarlatina. From Hooping Cough. From Diarrhoea. From Low Fever. M. F. M. & F. M. F. M.&F. Regent's Park 427 31918 125 139 264 66 86 152 72 .. 4 17 6 16 7 Tottenham Court 27813 62 68 130 77 .. 2 18 6 14 2 University College Hospital 145 500 98 120 218 22 8 30 1 Strand Union 120 15 17 32 6 .. .. .. .. 1 Gray's Inn Read 155 26462 107 95 202 63 64 127 61 •• 1 9 7 14 4 Royal Free Hospital 60 5 8 13 • • 2 Somers Town 184 35641 162 166 328 103 90 193 111 .. 15 22 6 19 4 Camden Town 171 19515 97 98 195 57 51 108 62 •• 8 6 6 15 5 Saint Pancras Workhouse 1600 38 47 85 12 .. .. .. .. 2 1 Kentish Town 1634 23326 170 154 324 67 81 148 63 1 2 6 3 13 7 Hospitals out of the Parish * TOTALS 271G 166956 759 772 1531 498 520 1018 465 1 32 78 34 94 32 [TABLE VI.] ' FOURTH OR AUTUMN QUARTER 1858. Saint Pancras, Middlesex.—Register of Births and Deaths in the Sub-district and Public Institutions, for the 13 Weeks ending 1st day of January, 1859. LOCALITIES. Area in Acres. Population in 1851. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From Small Pox. From Measles. From Scarlatina. From Hooping Cough. From Diarrhoea. From Low Fever. M. F. M.&F. M. F. M.&F. Regent's Park 427 31918 153 142 295 111 86 197 89 5 2 24 3 1 10 Tottenham Court 27813 94 110 204 99 •• 14 44 14 3 5 University College Hospital 145 500 119 127 246 30 16 46 1 •• •• 1 •• .. 1 Strand Union 120 22 19 41 6 •• 3 Gray's Inn Road 155 26462 118 128 246 90 100 190 108 2 14 33 6 3 Royal Free Hospital 60 21 13 34 1 Somers Town 184 35641 175 193 368 129 145 274 142 •• 11 48 13 7 3 Camden Town 171 19515 113 121 234 66 67 133 64 1 12 22 .. 2 2 Saint Pancras Workhouse 1600 62 59 121 29 •• 7 1 •• 1 Kentish Town 1634 23326 197 206 403 105 125 230 136 2 9 40 8 5 5 Hospitals out of the Parish TOTALS 2716 166956 875 917 1792 730 740 1470 665 10 72 213 44 19 29 Table VII. -Table shewing the Mortality and Temperature of each week in the year 1858, and the average of corresponding weeks in ten preceding years. No. of Week. No. of Deaths registered in each week. Average of 10 years. Mean Temperature of Week. Mean Temperature of corresponding w.eek in 10 preceding Years. Xo. of week. No. of Deaths registered in each Week. Average of 10 Years. Mean Temperature of Week. Mean Temperature of corresponding week in 10 preceding Years. 1st. * 84 87.0 — 345 394 27th. — 74 67.6 — 55.9 62.2 2nd. + 92 81.4 + 39.8 38.9 28th. + 88 56.7 + 664 62*3 3rd. + 90 79 2 — 375 38.7 29th. + 86 71.9 + 629 62.3 4th. + 92 82.0 — 37.5 37.8 30th. — 76 77*2 — 59.6 62.6 5th. + 93 77.5 — 37.8 38.5 31st. + 83 74.1 + 62.4 62.3 6th. + 116 81.0 — 31.3 40.6 32nd. — 68 78 6 + 65.4 625 7th. + 110 88.0 — 340 38.4 33rd. — 92 83.8 + 63.3 62.3 8th. + 121 87.3 — 33.1 39.6 34th. — 84 79.8 — 59.2 61.3 9th. + 96 78.0 — 315 40.6 35th. — 72 805 — 59.4 60*3 10th. + 92 75.9 — 347 40.6 36th. — 72 83.0 + 59.4 592 11th. + 103 84.9 + 48.0 41.2 37th. — 64 79.7 + 634 57.1 12th. + 101 85.3 + 46.6 40.7 38th. — 70 72.6 + 586 567 13th. + 98 85.7 + 44.6 43.0 39th. — 55 80.2 + 57.6 55.4 14th. — 68 77.2 — 40.3 46.9 40th. — 69 65.1 — 521 52.7 15th. — 82 78.7 + 46.7 45.3 41st. + 80 63.5 + 531 51.6 16th. + 106 72.2 + 52.8 46.8 42nd. + 94 63.3 + 511 49.9 17 th — 66 79.1 + 47.1 45.5 43rd. + 93 70.3 — 47.2 50.2 18th — 78 75.9 — 45.6 47.3 44th. + 88 68.4 — 43.3 482 19th + 83 71.3 — 49.6 50.0 45th. + 120 69.7 — 39.0 45.4 20th + 91 73.8 + 54 9 53.5 46th + 130 75.5 — 35.5 42.6 21st — 63 71.9 — 53.9 55.3 47th + 139 77.1 — 37.4 413 22nd — 64 663 + 66.2 551 48th + 148 79.5 + 46.3 403 23rd — 65 666 + 63.8 57.1 49th + 117 77.1 — 36.5 42.1 24th + 90 63.8 + 67.7 57.2 50th + 107 83.8 — 38.9 42.9 25th + 80 63.6 + 64.5 59'2 51st + 108 77.1 + 44.5 39.4 26th — 87 79.8 — 58.6 61.0 52nd + 122 90.8 + 41.4 38.7 * The signs .}. and —indicate that the Mortality and Temperature were respectively higher or lower than the average of the several corresponding weeks in ten preceding years. [ TABLE VIII.] Births, Deaths, and Temperature during the Four Quarters of 1858. Total Number of Deaths. Mean Number in 10 former Years. Mean raised to allow for increase in Population. Difference of actual Number of Deaths from corrected mean of 10 years. Mean Temperature of Air.* Difference from the Mean of 17 years at Greenwich. Number of Births. First Quarter 1288 1073.2 1180 + 108 37°.8 — 1.6 1636 Second Quarter 1023 940.2 1034 — 11 55°.0 + 2.3 1388 Third Quarter 984 985.7 1095 — 101 61°.2 + 1.2 1531 Fourth Quarter 1415 961.2 1057 + 358 43°.6 — 1.0 1792 Sum of the Four Quarters 4710 3960-3 4356 + 354 49°-2 + 0.1 6347 * This column is taken from the Registrar General's Report. Opposite the First Quarter and the whole year, are the Mean Temperatures calculated from the Registers at Greenwich. Opposite the 2nd, 3rd, and 4th Quarters are the Temperatures calculated from those Registered at Camden Town by G. J. Symons, Esq., who communicates his Meterological observations to the Registrar General. [TABLE IX.] Cases of Sickness under the care of the Parochial Medical Officers during the 52 Weeks ending 1st of January, 1859. Districts. Names of Medical Officers. Total Number of Cases. Low Fevers. Diarrhoea. Dysentery. Influenza. Scarlet Fever. Small Pox. Erysipelas & Pyoemia. Puerperal Fever. Measles. Hooping Cough. Bronchitis, Pleurisy, and Pneumonia. Croup. Carbuncles. Rheumatic Fever. Diphtherite. North-West Mr. Adams} Dr. Hayne 1273 13 18 .. .. 83 7 8 1 60 25 99 3 8 40 6 South-West Dr. WlLDBORE . 2184 12 40 •• .. 142 45 10 •• 44 25 224 •• 4 14 •• South-East Dr. Davis 1732 17 103 .. .. 96 33 4 .. 61 20 183 • • 3 3 .. Central Mr. SutherIn 1858 31 115 1 .. 46 10 11 1 103 57 214 4 3 8 1 North Mr. Jefferys 1819 34 110 .. .. 58 16 24 .. 71 48 89 1 • • 2 •• Workhouse Mr. Coster 2273 10 251 19 7 •• 61 2 103 31 561 •• 31 25 •• Totals 11139 117 637 1 19 432 111 118 4 442 206 1370 8 49 92 7 Totals of 52 Weeks, 1858, ex- } eluding Workhouse 8866 107 386 i •• 425 111 57 2 339 175 809 8 18 67 7 Totals of 53 Weeks, 1857, ex-} eluding Workhouse 7797 138 257 2 126 117 75 55 1 237 118 792 not calculated. 39 not calculated. 0 [TABLE X.] Deaths Registered in St. Pancras in the Year 1858 of Men above the age of 20, arranged according to the Occupations of the Deceased. OCCUPATIONS. MALES. Living at the Census of 1851, above 20. Ages at Death. Total 20— 25— 45— 65— 85— I. 1 Engaged by Post Office 167 2 ... 2 Custom House and other Government Officers 397 8 ... 4 ... 3 1 2 Police and Officers of Local Boards 494. 8 1 4 1 2 3 East India Service 55 4 1 ... ... 2 1 II. 1 Army Officers 66 2 1 ... ... 1 Army Half-pay Officers 19 2 ... ... ... 1 1 Soldiers 335 10 3 3 3 1 Chelsea Pensioners 123 6 ... 1 3 2 2 Navy Officers 25 1 ... ... 1 Navy Half-pay Officers 19 3 ... ... 1 2 Seamen of the Royal Navy 13 1 ... ... ... 1 III. 1.Clergymen 99 5 ... 2 1 1 1 Protestant Ministers 49 4 ... ... ... 3 1 Other Religious Teachers 61 3 ... ... ... 2 2 Barristers 127 1 ... ... ... ... 1 Solicitors 414 7 ... ... 2 2 Other Lawyers 120 3 Physicians 45 1 ... ... 1 Surgeons 302 8 ... 3 4 1 Other Medical Men 168 5 ... 4 ... 1 5 Law Clerks 560 12 1 7 3 1 IV. 1 Authors, Editors, and Writers 138 2 ... 1 1 2 Painters (Artists) 447 4 ... 2 ... 1 1 Architects 132 2 ... 1 ... 1 Others engaged in Fine Arts 72 1 ... ... 1 4 Music Masters 171 1 ... ... 1 Schoolmasters 118 5 1 1 2 1 Other Teachers 195 5 ... 3 2 V. 1 Sons, Grandsons, Brothers, and Nephews (not otherwise specified) 2755 1 1 VI. 1. Inn-keepers 15 1 ... ... 1 Lodging-house-keepers 33 1 ... ... 1 Officers of Charitable Institutions & others engaged in Boarding and Lodging } 156 3 ... ... 2 1 2 Domestic Servants (General) 850 16 2 4 5 5 Coachmen and Grooms 78 18 1 5 7 4 1 8 2 2 Inn Servants 351 8 2 1 1 4 3 Hair-dressers 123 3 ... 2 1 Hatters 75 Tailors 1679 35 ... 7 5 20 3 Hosiers, Haberdashers, and Glovers . 45 1 ... ... ... 1 Shoemakers 1759 46 2 7 17 18 2 Others providing Dress 277 3 ... ... 1 2 VII. 1 House Proprietors, Merchants,* Bankers, and Ship Agents . . . . . . . } 436 Brokers, Agents, and Factors . 94 8 ... 2 2 4 Auctioneers 62 3 ... 1 2 Accountants 134 Commercial Clerks 851 15 5 3 5 2 Commercial Travellers 223 10 ... 5 5 Pawnbrokers 68 2 1 1 Shopkeepers 111 1 1 Hawkers, Pedlars, & other General Dealers & Agents 501 18 i "5 8 3 1 VIII. 1 Railway Engine Drivers, and Stokers 144 4 3 ... 1 Others engaged on Railway Traffic 677 15 2 6 6 1 2 Coach and Cab Owners 142 5 ... 2 2 1 Coachmen (not Servants) 401 36 2 14 17 3 Carmen, Carriers, Carters, and Draymen . 474 16 2 2 10 1 1 Omnibus Owners, Conductors, and Drivers 111 1 ... 1 Others engaged on Road Conveyance 508 4 ... 2 2 [TABLE X.—continued.'] Deaths Registered in St. Pancras in the Tear 1858 of Men above the age of 20, arranged according to the Occnpations of the Deceased. OCCUPATIONS. MALES. Living at the Census of 1851, above 20. Ages at Death. Total 20— 25— 45— 65— 85— 43 1 1 105 5 "i 1 ... 2 115 2 1 1 6 Messengers, Porters (not Government), and others ) employed about Messages , . f 936 16 2 8 4 2 rx. 1 Land Proprietors and Farmers ..... 190 2 ... 1 1 Farm Bailiffs ........ 1 1 Agricultural Labourers (out-door) .... *39 3 i "i 1 3 Gardeners and Nurserymen 327 12 2 1 *8 1 X. 1 Horse-dealers 11 1 1 Jockeys, Grooms, and Horsekeepers . ,. . . 338 15 6 5 4 Farriers and Veterinary Surgeons .... 155 3 2 1 Cattle, Sheep-dealers, Salesmen, and Drovers . 90 2 ... 1 1 XI. 1 Publishers and Booksellers 158 4 1 1 1 1 Bookbinders ......... 151 5 i 3 1 Printers Others engaged about Publication .... 614 41 20 3 9 2 7 1 4 2 Actors and others engaged about Theatres 50 3 ... 1 2 153 2 1 1 Musical Instrument-makers 954 19 "i 8 4 3 187 1 1 291 9 "2 "i 3 3 Others engaged about Pictures and Engravings 259 5 Engaged about Carving Figures .... 267 7 2 4 1 6 Engaged in Shows, Games, and Sports 62 1 ... 1 7 Civil Engineers 104 1 1 Pattern Designers, & other Designers & Draughtsmen 41 1 8 Medallists and Die-sinkers 10 1 1 9 Watchmakers 165 5 2 2 1 Philosophical Instrument-makers .... 74 5 "i ... 1 10 Gunsmiths 11 Engine and Machine-makers 36 252 1 12 "2 "2 5 "i 3 Tool-makers 20 622 8 2 4 1 1 13 Saddlers, and Harness and Whip-makers . 142 2 2 14 Shipwrights, and Ship, Boat, and Barge-builders . 11 15 Surveyors . . , . 92 2 1 1 Builders 228 6 "i ... 4 1 Carpenters and Joiners 1934 32 "e 9 15 2 1136 23 "i 6 11 5 413 13 2 9 2 Slaters 28 1 1 Plasterers Painters, Plumbers, and Glaziers .... 407 1494 11 50 4 19 4 19 3 11 16 Wheelwrights, Millwrights, and other Implement- \ makers ... 139 3 2 1 17 Dyers and Scourers 80 2 1 1 Engaged in the manufacture of Chemicals 67 2 ... 2 XII. 1 Cow-keepers and Milk-sellers , 258 6 1 1 4 Cheesemongers 178 Butchers 467 14 2 3 5 4 Poulterers 33 1 1 Fishmongers 116 1 1 2 Tallow-chandlers 70 3 2 1 Others dealing in Grease, Bones, &c. ... 33 1 i 3 Others working in Leather 42 1 1 4 Dealers in Feathers 5 Brush and Broom-makers,! and others dealing or\ working in Hair ...... I 27 160 1 2 1 1 1 6 Clothiers 28 1 1 Carpet and Rug-manufacturers 43 3 i "2 Others dealing in Wool 42 2 ... 1 1 7 Silk-manufacturers and Silk-mercers 39 1 1 Others working or dealing in Silk .... 40 2 1 1 XIII. 1 Greengrocers 245 3 2 1 Corn-merchants . 07 i I Bakers 702 22 1 s s 5 2 Confectioners 123 5 1 1 3 [TABLE X.—continued.'] Deaths Registered in St. Pancras in the Year 1858 of Men above the age of 20, arranged according to the Occupations of the Deceased. OCCUPATIONS. MALES. Living at the Census of 1851, above 20. Ages at Death. Total 20— 25— 45— 65— 85— 2 Maltsters 3 Brewers 145 2 ... 1 1 Licensed Victuallers and Beershop-keepers 368 10 ... 3 6 1 Wine and Spirit-merchants 111 2 ... 1 1 Grocers 421 4 ... ... 2 2 Tobacconists 83 1 ... 1 Others dealing in Drink, Stimulants, &c. 142 4 ... ... 3 1 3 Oil and Colourmen 82 1 ... ... 1 French Polishers 218 4 ... 1 2 Others dealing in Oils, Gums, &c. 38 1 ... ... ... 1 4 Timber-merchants 60 2 ... ... ... 2 6 Sawyers and Lath-makers 192 7 1 2 2 2 7 Cabinet-makers and Upholsterers 893 22 ... 3 9 10 Turners 88 4 ... 3 1 Chair-makers 137 2 ... ... ... 1 Others dealing in Wood Furniture 162 5 1 2 2 8 Coopers and other makers of Wood Utensils 33 5 ... 1 2 2 9 Frame-makers and other Wood Tool-makers . 59 2 ... 2 10 Basket-makers and others working in Cane & Straw 64 2 ... 1 ... 1 12 Drapers 495 3 ... 2 1 13 Stationers 146 3 ... 2 1 Others working or dealing in Paper 94 1 ... ... 1 XIV. 1 Coal-miners 1 1 ... 1 Coal-merchants and dealers 116 3 ... ... 2 1 Coal-heavers and labourers 109 4 ... 1 1 2 Chimney-sweepers 67 Engaged in Gaswork's service 173 6 ... 3 3 Others working in Coal 16 2 Stone and Slate-quarriers 1 Limestone-burners 5 1 ... ... 1 Marble-masons 32 4 ... 3 1 Brick-makers 86 3 ... 1 1 1 Road-labourers 25 4 ... 2 1 1 Railway-labourers 232 2 ... 1 1 Others working in Stone, Clay, &c 226 3 ... ... 3 3 Earthenware-manufacturers and Earthenware and) Glass-dealers 104 1 ... ... 1 4 Glass-manufacturers and others working in Glass. 65 2 ... 2 6 Water-providers 35 1 1 7 & 8 Workers in Precious Stones and Goldsmiths 373 13 ... 3 6 4 Carvers, Gilders, & others working in Gold & Silver 282 2 ... ... 1 1 10 Tinmen 55 2 ... ... 1 1 11 Zinc-manufacturers and others working in Zinc 45 2 ... 1 ... 1 12 Lead-manufacturers and others working in Lead 33 1 ... 1 13 Locksmiths and Bell-hangers 51 1 ... ... 1 Braziers 73 1 ... ... ... 1 Wire-makers, workers, and weavers 34 1 ... ... ... 1 Others dealing in Mixed Metals 143 1 ... ... ... 1 14 Whitesmiths 85 2 ... ... 2 Blacksmiths 388 4 ... 1 2 1 Ironmongers 127 4 ... 4 Cutlers 34 1 1 Others working or dealing in Iron or Steel 39 1 1 XV. 1 Labourers (branch undefined) 1910 52 2 16 20 13 1 2 Mechanics, Manufacturers, and Shopmen (branch undefined) 103 1 ... 1 Others of indefinite 34 4 ... ... 2 2 XVI. 1 Gentlemen and Independent 243 65 2 7 15 36 5 Annuitants 474 2 ... ... ... 2 XVII. 1 Paupers (no stated occupation) 18 6 ... 2 ... 4 Lunatics (no stated occupation) 2 Others of no stated occupation 697 7 1 3 2 1 Henry Mitchencr, Printer, 26, Eversholt Street, Oakley Square, N.W. 21 Stpan 15 REPORT ON THE SANITARY CONDITION OF SAINT PANCRAS, MIDDLESEX, DURING- DECEMBER, 1857, BY THOMAS HILLIER, M.D., Medical Officer of Health for the Parish of Saint Pancras. January 5th, 1858.] [No. 21. TO THE SANITARY COMMITTEE. Gentlemen, During the four weeks which ended on December 26th, 1857, 375 deaths were registered in this Parish, showing an average weekly mortality of 94. This number is much higher than that given in the Report for November, namely, a weekly average of 83¼. The mean number obtained from the registers of the corresponding months in the ten years, 1847-1856, is 346.6; which should for comparison be raised 10 per cent., to allow for increase of population, when it becomes 381. The present return, though giving a very high mortality, is not more unfavourable than the corrected average of ten years. It must, however, be stated, that the average is very much raised by the great fatality of influenza in 1847. The number of deaths registered in the corresponding month last year was 324, so that the mortality of the late month was certainly high; and this circumstance cannot be explained by any unusual severity of the weather, which has been, on the contrary, very mild for the season, as will be shown under the head of Meteorology. The high rate of mortality is not due to the unusual prevalence of measles, small pox, scarlet fever, hooping cough, diarrhoea, or typhus, which it will be seen from Schedule B have not been especially fatal. The diseases most fatal have been those involving the lungs and breathing organs, which have occasioned 96 deaths, besides 55 from consumption, 6 from influenza, and 2 from croup, giving altogether 159. The number of new cases of sickness amongst paupers during the month of December has been much less than in November, only 694 instead of 1,101. Pulmonary complaints have diminished in number from 210 to 101. From a comparison of the above-stated facts, it would appear that the diseases which have proved fatal during December are many of them those which began in November. Under the age of 5 years, there have been 134 deaths, and above the age of 60, 100 deaths. WORKHOUSE. The number of deaths in this building has amounted to 24; in the corresponding period last year there were 34. The general health of the inmates has been better than during November. Measles has recently appeared amongst the infants; the disease has commenced this year within a day or two of its appearr ance last year. As yet it has assumed a less virulent type than it did in the previous epidemic. Several fatal cases have, however, occurred during the last week, but are not included in the present tables. The average number of inmates, including those in the separation wards, has been 1,630; in December of last year it was 1,432, exclusive of casuals, who averaged about 100. Meteorology.—The mean temperature of the month has been 46°, which is 2 6° above the mean of other years. The maximum was 57°, and occurred on the 17th of the month; the minimum was 32°, and occurred on the 20th. The wind has been for the most part south-westerly. The air has been less saturated with moisture than in November, so that the meteorology of this month does not explain the great fatality of pulmonary disease. REVIEW OF THE AUTUMN QUARTER. The number of deaths registered in this Parish during the quarter which ended December 26th, 1857, was 1,029; in the corresponding quarter of 1856, it was 1,018. Low fevers and diarrhoea have been less fatal than last year, scarlatina rather more so. There have been only 2 deaths from small pox. In the Workhouse the number of deaths has amounted to 64, whilst in the same quarter of 1856 it was 85, and in 1855 it was 109. As usual in the fourth quarter of the year more deaths have been registered than in either the second or third, and fewer than in the first. "With reference to the cases of sickness under treatment by the Parish Medical Oflicers, it will be seen that the total number is slightly in excess of the previous quarter; that the number of cases of fever has diminished from 52 to 36, of diarrhoea from 614 to 100, of small pox from 30 to 17. An increase has occurred in the cases of scarlet fever from 23 to 35, of measles from 53 to 80, of hooping cough from 27 to 41, whilst in pulmonary diseases (including influenza) there has been a great increase, from 78 to 591. Meteorology.—The average temperature has been 48°, which is 4° above the mean of other years. The number of deaths in the entire metropolis was 15,115; and as the population of St. Pancras is about one-fourteenth part of that of London, if this Parish had been as unhealthy as the rest of London, about 1,080 persons would have died, instead of 1,029. Sanitary Works.—302 houses have been visited, in which sanitary improvements were required, besides very many more in which there were none required. 106 notices have been served for the abatement of nuisances, and improvement of house property. 28 summonses have been taken out before Police Magistrates. The owner of premises in Chad's Row used for melting down the refuse from seal skins, has been repeatedly summoned under the Nuisances' Removal Act, but the Magistrate at last decided that this Act was not applicable to the case, inasmuch as we had not proved to his satisfaction that the best available means to prevent nuisance had not been employed, and states that he considered the case ought to be taken before a special sessions. A summons was then taken out under the Buildings' Act, 7 and 8 Vict., c. 84, sec. 55, which provides that any person who shall establish or newly carry on any one of certain offensive businesses, therein enumerated within 50 feet from a dwelling house, shall be liable to a penalty of fifty pounds a day. The owner did not feel disposed to stand out against this, and gave a written agreement to remove the business entirely before the middle of February, if the prosecution was suspended. This course was adopted. The slaughter-houses and cow-houses have all been visited some several times. About 60 rabbits in a putrid state have been seized, also 4 lots of fish, and one of poultry. The average degree of humidity at Greenwich (if 100 be taken to represent complete ntenation) was in November 93, and in December 87½. I have the honour to remain, Gentlemen, Your obedient Servant, 21, Upper Gowee Stbeet. THOMAS HILLIER, M.D., L.R.C.P. [SCHEDULEA.] St. Pancras, Middlesex,—Table for the Four Weeks ending 26th day of Dec., 1857. LOCALITIES. Area in Acres. Population in 1851. Births. Deaths From all causes. From all causes under 5 years of age. From Small Pox. From Measles. From Scarlatina. From Hooping Cough. From Diarrhœa. From Low Fever. | M. F. M.&F. M. F. M. & F. Regent's Park 427 31918 45 50 95 25 31 56 25 .. .. 2 7 i Tottenham Court 27813 22 30 52 21 .. 3 3 2 .. i University College Hospital 145 500 38 34 72 6 3 9 Strand Union 120 12 12 24 5 Gray's Inn Road 155 26402 35 34 69 18 24 42 18 .. 4 2 •• 1 i Royal Free Hospital 60 3 .. 3 Somers Town 184 35641 39 44 83 27 39 66 24 .. 6 1 1 9 Camden Town 19515 13 21 34 15 .. 1 .. 2 1 St. Pancras Workhouse 171 1600 41 26 67 15 9 24 3 Kentish Town 1634 23326 57 49 106 32 33 65 23 .. 2 .. 2 Middlesex Hospital (out of the Parish) 2 2 4 2 Totals 255 237 492 175 204 379 134 .. 16 12 l4 2 10 [SCHEDULE B.] Deaths Registered in St. Pancras during the Four Weeks ending Dec. 26th, 1857. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. Causes of Death. At all Ages. Under 20 years old age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. I. Zymotic : 1 .. .. .. 1 Small Pox Peritonitis 1 .. .. .. 1 Measles 16 1? T> Ascites 1 i Scarlatina 11 1 Ulceration of Intestines 1 I Hooping Cough 14 14 Hernia (Kupture) Croup 2 1 Ileus 2 Thrush Intussusception 2 2 Diarrhœa 1 1 Stricture of Intestinal 1 Dysentery Canal • a .. •. Cholera Disease of Stomach, &c. Influenza 6 3 I Disease of Pancreas Scurry and Purpura Ague Inflammation of Liver (Hepatitis) 1 .. 1 Remittent Fever 3 1 Jaundice Ingantile Fever Disease of Liver 1 1 Typhus Fever Disease of Spleen Puerperal Fever (Metria) Rheumatic Fever 2 2 VIII. Kidney, &c.; Erysipelas 1 1 Syphilis Nephria (Bright's Dis.) Ischuria Noma (Canker) Hydrophobia Diabetes stone 1 1 II. Dropsy, &c.: Cystitis 1 1 Hœmorrhage 1 1 Stricture of Urethra Dropsy 4 2 1 1 Disease of Bladder, &c. Abscess 3 ? 1 IX. Childbirth: Ulcer 1 1 Fistula Paramenia Mortification 1 1 Ovarian Dropsy 1 1 Cancer 13 5 8 Childbirth(see Metria) Disease of Uterns, &c. 1 1 Gout 1 1 III. Tubercular: X. Joints, Bones, &c. : i 6 1 Rheumatism 6 Arthritis Phthisis (Consumption) 55 8 33 11 3 Disease of Joints, &c 1 ,, 1 Hydrocephalus 8 b IV. Brain and Nkrves : XI. Skin, Cellular Tissue: Cephalitis 7 2 1 ?, 2 Carbuncle 15 2 1 5 5 2 Phlegmon 3 1 9 Disease of skin, &c. Delirium Tremens .... 1 " 1 XII. Malformations: 2 " 1 'i 1 Cyanosis Spina Bifida Other Malformations 8 8 Disease of Brain, &c... 3 2 •• ... 1 XIII. Premature Birth and Debility 9 9 V. Heart and Blood XIV. Atrophy fi 7 1 Vessels : XV. Old Age 16 9 7 XVI. Sudden Disease of Heart, &c... 10 .. .. S 5 XVII. Violent Death: VI. Lungs and Organs of ke8piration : Intemperance Privation of Food . Want of Breast Milk Neglect 2 •• • * 1 1 1 3 63 13 5 X3 27 5 Cold Poison q,4 19 2 1 2 Burns and Scalds 1 1 ? ?, Hanging o 1 1 Suffocation 4 4 VII. Stomach and Digestive Organs: Drowning Fractures & Contusions 5 ,, 1 2 1 1 Wonds VI 1 1 Other Violence Teething 1 1 Causes not Specified Quinsey 1 1 Gastricts Totals 375 163 54 58 81 19 [ SCHEDULE C. ] St. Pancras, Middlesex.—Cases of Sickness under the care of the Parochial Medical Officers during the Four Weeks ending the 26th of December, 1857. Districts. Names of Medical Officers. Total No. of Cases. Low Fevers. Diarrhoea. Influenza. Scarlet Fever. Small Pox. Erysipelas. Puerperal Fever. Measles. Hooping Cough. 1 Bronchitis, Pleurisy, and Pneumonia. Croup. Carbuncles. Rheumatic Fever. Other Diseases. North-West Mr. Adams . 92 4 .. .. 2 .. 2 .. 2 13 .. i 3 65 South-West Dr. wildbore 117 .. .. .. 4 1 3 .. .. •• 17 •• 3 •• 89 South-East Dr. Davis 130 2 10 .. 1 3 • • .. 4 .. 24 •• •• •• 86 Central Mr. Sutherin 107 1 2 i .. 3 • • .. 12 1 16 1 •• 1 69 North Mr. Jefferys 95 .. 3 6 1 .. .. .. 2 8 2 •• •• 2 71 Workhouse & ( Infirmary Mr. Coster and 1 Dr. Andrew 153 1 1 •• •• •• •• .. 10 .. 29 •• 2 1 109 Totals 694 8 16 7 8 7 5 .. 28 11 101 1 6 7 489 TABLE (No. I.) FOR AUTUMN QUARTER, 1857. St. Pancras, Middlesex,—Table for the Thirteen Weeks ending 26 th day of Dec., 1857. LOCALITIES. Area in Acres. Population in 1851. Births, Deaths From all causes. From all causes under 5 years of age. From Small Pox. From Measles. From Scarlatina. From Hooping Cough. From Diarrhœa. From Low Fever. M. F. M.&F. M. F. M.&F. Regent's Park 427 31918 145 134 279 85 78 163 76 .. 1 5 15 4 5 Tottenham Court 145 27813 1 65 63 128 55 .. 3 5 13 1 4 University College Hospital Strand Union 500 134 112 246 17 13 30 120 22 24 46 6 Gray's Inn Road Royal Free Hospital . 155 26462 1107 48 71 6 119 19 55 .. 12 4 8 4 4 60 99 206 13 1 Somers Town 184 35641 144 165 309 82 111 193 89 2 15 15 5 6 9 Camden Town 171 19515 1128 102 220 39 56 95 52 .. 1 4 4 2 1600 ?fi 38 64 8 1 1 Kentish Town 1634 23326 195 153 348 83 86 169 73 .. 4 3 7 2 6 Hospital out of the Parish 2 1 3 •• .. •• .. .. •• 2 Totals 853 765 1618 482 547 1029 414 2 36 34 52 18 34 Corresponding Quarter in 1856 786 702 1488 489 529 1018 436 2 26 .. 23 47 TABLE (No. II.) FOR AUTUMN QUARTER, 1857. Deaths Registered in St. Pancras during the Quarter, ending Dec. 26th, 1857. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. Causes of Death. At all Ages. Under20 ye rs ol age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. I. Zymotic : 206 169 22 5 4 6 Enteritis Peritonitis Small Pox Ascites Measles Ulceration Of Intestines Scarlatina Hernia(Rupture) Hooping Cough Ileus Croup intussusception Thrush Stricture of Intestinal Diarrahœa Canal Dysentery Disease of Stomach, &c. Cholera Disease of Pancreas Influenza Inflammation of Liver Scurvy and Purpura (Hepatitis) Ague Jaundice Remittent Fever Disease of Liver Infantile Fever Disease of Spleen Typhus Fever Disease Puerperal Fever (Metria) Rheumatic Fever VIII. Kidney, &c.; 17 1 3 6 5 2 Erysipelas Nephritis Syphills Nephria (Bright's Dis.) Noma(Canker) Ischuria Hydrophobia Diabets Stone II. Dropsy, &c: 65 9 9 17 27 3 Cystitis Hæmorrhage Stricture of Urethra Dropsy Abscess IX. Childbirth : 1 2 1 1 Ulcer Fistula Paramenia Mortification Ovarian Dropsy Cancer Children (see Metria) Gout Disease of Uterns, &c. III. Tubercular: 155 46 67 36 6 X. Joints, Bones, &c. : 3 1 i 1 Scrofula Rheumatism Tabes Mesenterica Arthritis Phthisis (Consumption) Hydrocephalus Disease of Joints, &c... IV. Brain and Nerves : 101 40 4 18 33 6 XI. Skin, Cellular Tissue ; Cephalities Carbuncle Apoplexy Phlegmon Palsy(Paralysis) Disease of Skin, Ac Delirium Tremens XII. Malformations : 1 .. 1 Chorea Epilepsy Tetanus Cyanosis Insanity Spina Bifida Convulsions Other Malformations.. Disease of Brain, &c... Xm. Premature Birth and Debility 35 35 V.Heart and Blood Vessels: n* , Vessels XV. Old Age 59 .. .. .. 31 28 Pericarditis XVI. Sudden Aneurism Disease of Heart, &c... XVII. Violent Death : 26 13 2 7 3 1 VI. Lungs and Organs of Respiration : 247 127 16 31 64 9 Privation of Food Larngitis Bronchits Cold Pleurisy Ashtma Disease of Lungs VII. Stomach and Di- gestive Organs 54 25 4 13 12 Fractures & Contusions Teething Other Violence Quinsey Causes not Specified ... 4 3 1 Gastritis 1026 491 134 145 200 50 TABLE (No. III.) FOR AUTUMN QUARTER, 1857. St. Pancras, Middlesex.—Cases of Sickness under the care of the Medical Officers during the Thirteen Weeks ending the 26th of December, 1857. Districts. Names of Medical Officers. Total No. of Cases. Low Fevers. Diarrhoea. Influenza. Scarlet Fever. Small Pox. Erysipelas. Puerperal Fever. Measles. Hooping Cough. Bronchitis, Pleurisy, and Pneumonia. Croup. Carbuncles. Rheumatic Fever. Other Diseases. North-West Mr. Adams 353 11 5 2 8 3 3 .. 2 15 34 .. 1 3 * 266 South-West Dr. Wildbore 445 4 1 3 10 1 4 .. 2 5 70 .. 3 • • 342 South-East Dr. Davis 546 8 38 .. 5 8 .. .. 37 .. 132 1 • • 2 315 Central Mr. Sutherin 395 2 19 7 3 5 4 .. 25 8 65 1 • • 3 253 North Mr. Jefferys 381 4 15 31 9 •• •• .. 3 12 20 •• •• 2 285 Workhouse 652 7 12 126 •• •• 5 .. 11 1 101 •• 8 9 372 Totals 2772 36 100 169 35 17 16 .. 80 41 422 2 12 19 1833 REPORT on the SANITARY CONDITION OF SAINT PANCRAS, MIDDLESEX, DURING JANUARY, 1858. by THOMAS HILLIER, M.D., Medical Officer of Health for the Parish of Saint Pancras. Febkuahy 9th, 1858. No. 22. TO THE SANITARY COMMITTEE. Gentlemen, There were registered in this Parish during the five weeks that ended on the 30th of January 470 deaths, being at the rate of 94 in each week, which was exactly the weekly average recorded in last month's Report. January is usually a month in which the mortality is high, chiefly from an excess in the diseases of the chest amongst old people. The late month has had a mortality above what is customary even in January. The average of the corresponding period in the 10 immediately preceding years was 420, which, for comparison, must bo raised 10 per cent, to allow for the increase in population, thus making 462 instead of 470. Diseases of respiration have been fatal to 116 persons, of whom 35 have been under 5 years of age, and 48 above 60 yearB. Tubercular disease has been fatal in 80 cases. Diseases of the heart have been unusually fatal, namely to 23 persons. There have been 29 deaths from old age. Amongst zymotic diseases, hooping cough has been fatal to the largest number (24), scarlatina to 14, measles to 17 (of whom 6 have been in the Workhouse), typhus or typhoid fevers to 6, diarrhœa to 3, small pox to 2 (both unvaccinated as usual). Of the cases of small pox, one occurred in Draper's Place, and the other, which occurred in Somers Town, was communicated from the same place. I have also received information that the infection was conveyed from here to St. Marylebone Parish and proved fatal. There have been a great number of cases of small pox in this crowded place, but only one has proved fatal, owing probably to the prevalence of vaccination. But, as I have stated, the infection has been conveycd to other parts, and there occasioned the deaths of several. Of the cases registered under the head of scarlatina, one was a case of Diphtlierite, a disease of the throat, the chief character of which is the production of a plastic material in the form of layers, which has a great tendency to extend to the air passages. It has been of late very prevalent and very fatal in some parts of this country, but I have heard of a few cases only, and these not very fatal in this parish. In France it has been long well known as a not very uncommon disease, occurring usually under bad hygienic conditions and propagated by infection. Meteoboloqy.—The mean temperature of the month has been 37°7 which is 1° above the average of 43 previous years. The highest temperature was 51°.9 on the 9th; the lowest was 20°9 on the 6th. 2 "Wobkhoote.—There have been no fewer than 61 deaths in this building. There have been 7 deaths from measles, 7 from consumption, 22 from chest diseases, 4 from renal disease, 5 from old age, and 4 from cerebral disease. One man died the day after Christmas-day from suffocation produced by plum pudding, of which he appeared to be very fond, passing down into his windpipe. A very large quantity of pudding was found in his stomach and some in the air passages. There have been a great many cases of measles during the month, (35), and although the mortality has been high the epidemic has not yet been so fatal as it was last year; but there are still a considerable number of children very ill with the disease. For the most part however it carries off the children who were previously delicate and unhealthy. The rooms to which the children, between one and twelve months of age with their mothers, have been recently removed, are in their present state ill adapted to the purpose to which they are allotted There is no water supply, nearer to them than the basement floor; the rooms being on the second floor. There is no water closet within twenty yards of the bottom of the stairs, and no sink to receive refuse water. It is, I believe, intended that a water supply lavatories, and water-closets should be provided, but the works are not yet commenced. It is very important that they should be put in hand, and completed without delay. In one of the rooms there is a small iron stove with an iron flue passing for some distance in the room, around which the women congregate and dry the children's wet napkins, producing a very offensive odour. They allege that they have not a sufficient supply of linen to admit of their having all the washing done at the laundry, and thus they are compelled either to use dirty things or wash for themselves. Now that the washing apparatus is in full operation and appears to answer so well, all laundry operations should be strictly forbidden in any other part of the establishment. At the other end of the Infant School Building, there is an evil of another kind. The water closets are constructed in my opinion on a bad principle; the soil drops into a trough containing water which is run off and fresh water supplied only once a day. The water should be changed at least three times a day, and even then the closets would not be always without objection. From these closets there is a communication into the governess's closet. The purpose assigned to this opening was to ventilate the latter; but its real effect is to ventilate the children's closet into the private one which opens directly into the main building. This may be readily ascertained by the strong inward current passing from one of these places to the other, and from the evidence of those who are constantly there. The opening ought properly to be not into the children's closet; but into the open air by means of a small shaft passing outwards. Tho average number of inmates has been 1622, many more than in the same month of 1857. I have the honour to remain, Gentlemen, Your obedient Servant, 21, Uppeb Gowee Sibeet. THOMAS HILLIER, M.D., L.R.C.F. [ SCHEDULE A. ] St. Pancras, Middlesex—Table for the Five Weeks ending 30 th day of January, 1858. LOCALITIES. Area in Acres. Population in 1851. Births. Deaths From all causes. From all causes under 5 years of age. From Small Pox. From Measles.| | From Scarlatina. From Hooping Cough-| From Diarrhœa. From Low Fever. M. F. M.&F. M. F. M.&F. Regent's Park 427 31918 47 45 92 28 32 60 23 .. .. .. 6 1 Tottenham Court 145 27813 57 54 111 35 38 67 29 1 1 5 4 1 1 University College Hospital 500 14 4 18 Strand Union 120 6 8 14 3 Gray's Inn Road 155 26462 129 51 80 17 28 45 15 .. 1 .. 1 1 1 Royal Free Hospital 60 6 2 8 1 .. .. .. .. .. 2 Somers Town 184 35641 73 61 134 43 37 80 32 i 6 5 .. .. 1 Camden Town 171 19515 jso 49 99 15 20 35 14 •• 2 2 6 St. Pancras Workhouse 1600 28 33 61 17 .. 6 Kentish Town 1634 23326 63 52 115 46 36 82 36 .. 1 1 5 1 Middlesex and Fever Hos pitals (out of the Parish) 3 4 7 .. .. .. 1 •• •• 3 Totals 319 312 631 241 236 477 170 2 17 14 22 3 9 [ SCHEDULE B. ] Deaths Registered in St. Pancras during Five Weeks, ending January 30th, 1858. Corresponding weoks of 1857. Causes of Death. At all Ages. 1 Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. Corresponding weeks of 1857 Causes of Death. At all Ages. Under 20 years age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. I. Zymotic : Enteritis 3 1 1 .. 1 Peritonitis 2 Small Pox 2 2 Ascites 1 .. .. 1 20 Measles 17 17 Ulceration of Intestines 1 1 1 4 Scarlatina 14 13 1 o Hernia 3 .. .. 2 20 Hooping Cough 24 24 1 Ilus 2 Croup 3 3 1 Intussusception 1 1 1 Thrush Stricture of Intestinal Canal 5 Diarrahœa 3 3 Cholera Disease of Stomach, &c. 2 1 .. 1 Croup Disease of Pancreas ... Inflammation of Liver Influenza Scurvy and Purpura ... 1 Ague (Hepatitis 1 .. .. .. .. 1 1 Remittent Fever Jaundice 9 .. .. 2 Infantile Fever Disease of Liver 11 Typhus Fever 6 4 2 Disease of Spleen 8 Puerperal Fever (Metria) 2 1 1 VIII. Kidney, &c.: 7 Erysipeas 3 1 .. 1 1 Syphilis 2 2 4 Nephria (Bright's Dis.) 8 1 2 2 2 1 2 Noma (Canker) 1 Ischuria Hydrophobia Diabetes 1 Stone II. Dropsy, &c. : Cystitis Structure of Urethra Hæmorrhage 3 1 2 Structure 1 3 Dropsy 5 2 I 2 Disease of Bladder ? Absces 1 1 IX. Childbirth : 1 Ulcer 2 2 Fistula 1 • • Paramenia mortification 2 Ovarian Dropsy 9 1 Cancer Gout 11 •• 2 4 5 Childbirth (see Metria) Disease of Uterns, &c. III. Tubercular: X. Joints, Bones, &c. : 1 Scrofula 6 5 1 3 Rheumatism 2 .. .. 1 1 Tables Mesenterica 8 8 1 Arthritis 35 Phthisis (Consumption) 59 14 25 15 4 1 Disease of Joints, &c.... 14 Hydrocephalus 7 0 1 IV. Brain and Nerve.s : XI. Skin, Cellular Tissue : 3 Cephalitis 1 .. .. .. 1 1 Carbuncle 10 Apoplexy 13 5 2 2 3 1 Phlegmon 11 Palsy(Paralysis) 4 .. .. 1 3 Disease of Skin, &c. ... Delirium Tremens 1 .. .. 1 XII. Malformations : Chorea 1 Epilepsy 4 1 3 Cyanosis Tetanus Spina Bifida Insanity 1 Other Malformations... 1 1 15 9 Convulsions 8 8 Disease of Brain, &c... 9 6 .. 3 17 XIII. Premature Birth and Debility 9 9 V. Heart and Blood Vessels : 11 XIV. Atrophy 10 10 21 XV. Old Age 29 .. .. .. 15 14 Pericarditis 1 .. .. 1 1 XVI. Sudden Aneurism 2 .. .. 2 15 Disease of Heart, &c... 23 'I 1 3 16 1 XVII. Violent Death: VI. Lungs and Organs of Respiration : 2 Intemperance Privation of food Want of Breast Milk 3 3 Laryngitis 1 .. .. .. .. 1 Neglect Bronchitis 68 11 5 14 32 6 Cold Pleurisy 1 .. 1 2 Poison 2 ., 2 3 Pneumonia 33 25 3 3 2 3 Burns and Scalds 2 2 Asthma 8 1 2 5 Hanging 2 6 Disease Of Lungs 5 1 1 1 2 2 Suffocation 5 3 1 1 2 Drowning VII. Stomach and Digestive Organs; 6 Fractures & Contusions 6 2 1 2 1 9 Wounds 1 1 1 Other Violence 2 2 Teething 4 4 4 Causes not Specified 9 4 2 2 1 Quinsey Gastrits 1 .. .. 1 406 Totals 470 210 61 70 102 27 [ SCHEDULE C. ] St. Pancras, Middlesex.—Cases of Sickness under the care of the District Medical Officers during the Five Weeks ending the 30 th of January, 1858. Districts. Names of Medical Officers. Total No. of Cases. Low Fevers. Diarrhœa. Influenza. Scarlet Fever. Small Pox. Erysipelas. Puerperal Fever. Measles. Hooping Cough. Bronchitis, Pleurisy, and Pneumonia. Croup. Carbuncles. Rheumatic Fever. Other Diseases. North-West Mr. Adams 122 2 .. .. 2 .. 1 .. 5 18 8 .. 1 6 79 South-West Dr. wildbore 203 5 .. .. 6 .. .. .. 5 1 14 .. .. 1 171 South-East Dr. Davis 190 5 11 .. 3 12 1 .. 1 2 38 .. 1 .. 116 Central Mr. Suthrin 171 .. 7 .. 5 1 1 .. 6 1 19 1 .. .. 130 North Mr. Jefferys 172 4 .. .. 6 1 1 .. 1 8 5 ,, ,, .. 146 Workhouse Mr. Coster and Dr. Andrew 259 3 1 .. •• •• 4 .. 35 6 70 •• 2 3 135 Totals 1117 19 19 •• 22 14 8 .. 53 36 154 1 4 10 777 REPORT on the SANITARY CONDITION OF SAINT PANCRAS, MIDDLESEX, DURING FEBRUARY, 1858, by THOMAS HILLIER, M.D., Medical Officer of Health for the Parish of Saint Pancras. March 9th, 1858.] [No. 23. TO THE SANITARY COMMITTEE. Gentlemen, During the month of February there were registered in this Parish no fewer than 440 deaths, which is a mortality of 110 per week. The average of corresponding periods in ten previous years raised for an increased population only amounts to 367; so that the present return exhibits a mortality nearly 20 per cent, above the average. The number of deaths in February, 1857, was only 355. It is the highest number of deaths that I have ever had to record in a Monthly Report. It becomes then important carefully to analyse the mortality, and determine to what causes the increase can be referred. Is the excess peculiar to St. Pancras, or is it shared by other parts of the metropolis ? The mortality of all London has been high during the late month, but not above the average of ten years. In the whole of the northern division of the metropolis (which includes Marylebone, Hampstead, Pancras, Islington, and Hackney) the mortality has been much above the average; in the western a little above, whilst in the three other divisions it has been considerably below the average. What diseases have been unusually fatal, and at what ages has the excess of deaths occurred ? As compared with last year, Scarlet Fever has been very fatal, causing 21 deaths instead of 4; Hooping Cough also, giving 20 deaths instead of 7; and Measles, 22 instead of 15. Six deaths are registered as having been due to Diphtherite, a disease to which I referred last month. The subjects of this disease were 5 of them infants, and one aged 17 years, who was carried off by it in 36 hours. I am keeping a record of these cases, and inquiring into the particulars concerning them, in order that I may learn what conditions especially favour the disease. The larger number of cases have been in Somers Town and its neighbourhood. The disease is believed to be infectious; those attacked with it should therefore be as much as possible isolated. It is essentially a disease of a low type, in which the patient requires much nourishment and stimulants; it is rendered more virulent by want of ventilation, damp, and defective drainage. Scarlet Fever is at the present time very prevalent in some parts of the Parish; this is a disease propagated almost solely by infection, and if more care were used to keep the healthy (especially children) from the sick, its extention might be very much checked. Tubercular disease has not been more fatal than it was in February, 1857, nor have diseases of the nervous system. Diseases of the heart and blood vessels have been slightly more fatal. Bronchitis and pneumonia have been fatal to 76 and 34 persons severally, to be compared with 70 and 15 last year. There have 2 been 23 deaths from old age, whilst there were 13 last year. No fewer than 7 infants are registered as "accidentally suffocated;" there must be culpable negligence, or intentional murder in some of these cases. On referring to the ages at which death occurred, we see that the chief excess is amongst those under 20 years, seeing that there have been 220 deaths under that age, whilst last year there were only 156. There has also been a slight excess between the ages of 20 and 60. Meteorology.—The average temperature at Greenwich has been 34°.8, which is 3°.6 below the average of other years. The lowest temperature was 23°.5 on the 26th of the month; the highest was 52°.8 on the 5th. The prevailing winds have been from the east and north-east; during the first week they blew from the south-west. Woekhouse.—There have been 65 deaths in this establishment during the month, of which 16 have been from measles. The average number of inmates during the month has been 1,564. I have the honour to remain, Gentlemen, Your obedient Servant, 21, Uppeb Goweb Steeet. THOMAS HILLIER, M.D., L.R.C.P. [ SCHEDULE A. ] St. Pancras, Middlesex,—Table for the Four Weeks ending 27 th day of February, 1858. LOCALITIES. Area in Acres. Population in 1851. Births. Deaths From all causes. From all causes under 5 years of age. 1 From Small Pox. From Measles. From Scarlatina. |From Hooping Cough- From Diarrhœa.| From Low Fever. M. F. M.&F. M. F. M.&F. Regent's Park 127 31918 11 31 72 27 26 53 26 .. .. 3 5 .. 2 Tottenham Court 145 27813 36 33 69 35 25 60 28 1 1 3 2 •• 1 UniversityCollegeHospital 50 8 3 11 Strand Union 120i 5 8 13 5 Gray's Inn Road 155 26462 ' 26 1 38 64 29 28 57 21 1 i 1 3 •• 3 Royal Free Hospital 6C 4 3 7 1 .. Somers Town 184 35641 68 73 141 32 36 68 35 .. 1 8 2 i Camden Town 171 19515 41 38 79 16 21 37 17 .. 1 5 5 •• 2 St. Pancras Workhouse 1600 25 40 65 18 .. 16 Kentish Town 1634 23326 51 47 98 38 31 69 38 2 1 3 •• 5 Middlesex and Fever Hos pitals (out of the Parish) I 1 2 Totals 263 260 523 220 222 442 189 2 22 21 20 1 13 [ SCHEDULE B. ] Deaths Registered in St. Pancras during Four Weeks, ending February 27th, 1858. Corresponding weeks of 1857. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. Corresponding weeks of 1857. Causes of Death. At all Ages. Under 20 years ol age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 year8 of age. At 80 years of age and upwards. I. Zymotic : 2 Enteritis 1 .. .. .. .. 1 2 Peritonitis Small Pox 2 2 Ascites 1 .. .. .. 1 Measles 22 21 1 15 4 Scarlatina 21 21 Ulceration of Intestines 1 .. 1 Diphtherite 6 Hernia (liupture) 3 1 2 7 Hooping Cough 20 20 Heus 1 1 .. .. 3 Croup 2 1 1 Stricture of Intestinal Canal Thrush 1 1 3 1 .. .. 2 Diarrhœa Disease of Stomach, &c Scurvy and Purpura 1 (Hepatitis) 1 1 Ague 1 4 Disease of Liver 5 .. 1 2 2 1 Remittent Fever 1 Disease of Spleen 4 Infantile Fever 1 12 7 3 .. 1 1 VIII. Kidney, &c. : Puerperal Fever (Metria) Rheumatic Fever 2 .. 1 .. 1 1 Nephritis 1 1 Erysipealas 2 1 1 Nephria (Bright's Dis.) Ischuria 3 .. 2 1 Syphills 2 Noma(Canker) Diabetes Stone II. Dropsy, &c,: Cystitis 1 .. .. .. 1 4 Hæmorrhage 1 .. 1 2 Stricture of Urethra 2 1 .. 1 1 Dropsy ? .. .. 1 1 Disease of Bladder, &c. Abscess 3 2 .. .. 1 IX. Childbirth: Uleer 1 .. 1 Fistula Paramenis 1 1 Mortification 2 Overian Dropsy Cancer 6 .. .. 3 3 Children (see Metria) 2 1 1 1 Gout Disease of Uterns, &c. 2 .. 1 1 III. Tubercular: X. Joints, Bones, &c. : 1 Scrofula 3 3 Rheumatism 8 Tabes Mesenterica 9 9 Arthritis 53 7 Phthisis (Consumption) Hydrocephalus 47 6 6 6 28 13 Disease of Joints, &c.... IV. Brain and Nerves : XI. Skin, Cellular Tissue: 3 Cephalities 2 1 .. 1 3 Carbuncle 13 Apoplexy 12 4 1 2 4 1 Phlegmon 9 Palsy (Paralysis) 4 .. .. 2 1 1 1 Disease of Skin, &tc. ... Delirium Tremens 2 .. 1 1 XII. Malformations : Epilepsy 1 .. .. .. 1 Tetanus Cvanosis Insanity 1 .. .. Spina Bifida Convulsions 14 14 .. 2 Other Malformations. 2 2 5 Disease of Brain, &c... 1 1 12 XIII. Prf.mature Birth and Debility 9 9 V. Heart and Blood Vessels : 2 XVI. Atrophy 4 4 13 XX. OI.d Age 23 .. .. 1 10 12 Pericarditis XVI. Sudden 1 Aneurism 1 12 Disease of Heart, &c... 16 3 4 5 4 XVII. Violent Death: VI. Lungs and Organs of Respiration : Intemperance Privation of Food Want of Breast Milk 2 2 2 70 Laryngitis Bronchitis 76 14 5 24 32 1 Neglect Cold Pleurisy 2 Poison 1 1 15 Pneumonia 34 30 2 1 1 Burns and Scalds 2 10 Asthma 5 .. 2 Hanging 3 Disease of Lungs 1 1 2 Suffocation 7 7 Drowninjg 1 1 VII. Stomach and Digestive Organs: Fractures & Contusions Wounds 2 1 1 6 Other Violence 2 1 1 Teething 1 Causes not specified 4 2 1 .. 1 Quinsey 2 1 1 Gastritis 355 Totals 440 220 58 67 76 19 [ SCHEDULE C. ] St. Pancras, Middlesex—New Cases of Sickness under the care of the District Medical Officers during the Four Weeks ending the 27th of February, 1858. Districts. Names of Medical Officers. Total No. of Cases. Low Fevers. Diarrhœa. Influenza. Scarlet Fever. Small Pox. Erysipelas. Puerperal Fever. Measles. Hooping Cough. Bronchitis, Pleurisy, and Pneumonia. Croup. Carbuncles. Rheumatic Fever. Other Diseases. North-West. Mr. Adams. 111 1 .. .. 1 .. 1 .. 4 .. 6 1 .. 1 96 South-West Dr. Wildbore 178 2 .. .. 5 3 .. .. 8 2 37 .. .. 2 119 South-East Dr. Davis 147 • • 1 .. .. 5 .. .. 2 1 33 .. .. .. 105 Central Mr. sutherin 135 1 7 .. 5 2 .. 1 2 2 19 .. 1 .. 95 North Mr. Jefferts 102 5 1 .. 3 1 1 .. .. 1 3 .. .. .. 87 Workhouse Mr. Coster and Dr. Andrew 139 •• 1 .. •• •• 1 •• 11 2 28 .. 1 3 92 Totals 812 9 10 .. 14 11 3 1 27 8 126 1 2 6 594