STPAN 20 EIGHTH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, FOB THE YEAR 1863. TO THE VESTRY OF ST. PANCRAS. Gentlemen, The season has arrived when it is my duty to lay before you a Report for the year 1863. The Tables appended to this Report shew that the deaths in St. Pancras during 53 weeks, which ended on the 2nd January, 1864, including those in the Strand Union, numbered 4854. After deducting 108, which was the number of persons who died in the Strand Union "Workhouse, the result is 4746; to obtain the exact number of deaths which occurred in the year 1863, 89 must be subtracted, to allow for deaths occurring in 1862, which were registered in the 53 weeks mentioned, and 16 added for deaths occurring in 1863, which were registered in 1864. After making these corrections, the number obtained is 4673, which may be taken as indicating most nearly the mortality of last year.* To determine the death-rate, it is necessary in the next place to ascertain the probable population of St. Pancras in the middle of the year 1863. At the census in April, 1861, the population numbered 198,788, it is now no doubt very much higher than this. If we assume that the population has increased in the same ratio per annum as it did between 1851 and 1861, we get a population for 1863 of 205,802, which may be adopted as a probable * A still further correction would be required to determine what exact number of deaths should be set to the account of St. Pancras. There were 154 persons who died in the University College and Royal Free Hospitals, who came shortly before death from other districts—these should be deducted; and on the other hand, a number of St. Pancras people went to hospitals in adjoining parishes, and died there—these cannot be fully ascertained, but through the kindness of Dr. Buchanan, I am in possession of the figures obtained from the most important hospitals in which St. Pancras people are likely to have died. In King's College Hospital there were 17 such deaths, in Middlesex 53, in the Hospital for Sick Children 8, in St. Bartholomew's Hospital 13, in the London Fever Hospital 23, and in the Small Pox Hospital 27. The total thus obtained is 141; if these were all the St. Pancras people who died out of the parish, the corrected net mortality would be 4660, instead of 4673. 2 approximation to the actual number. The death-rate then is easily calculated and found to be 2.306 per cent., or 230 6 to every ten thousand living. In 1862 the death rate was 2.16 per cent.; in London, as a whole, the death-rate of 1863 was 2452 percent.; and in the northern group of districts to which St. Pancras belongs, the death.rate was 2.381. So that the mortality of 1863 was higher than that of 1862, both in St. Pancras and in other parts of London, but the mortality of St. Pancras was lower than the rest of London; it was also a little lower than the mortality of the other northern districts. The deathrate, however, was much higher that it should be. It is found that the mortality of towns in England, where sanitary measures are thoroughly carried out, does not exceed 1.7 per cent., instead of amounting to 2.306 per cent. If this standard of salubrity had been maintained in St. Pancras last year, the deaths, instead of numbering 4746, would have been only 3499, 1247 fewer lives would have been lost, to say nothing of the improved health and strength of those who survived. The birth-rate during the year was 34.79 per thousand, assuming the number of births in 1863 to have been 7161* instead of 7277, which was the number registered in 53 weeks. In 1862 the birth-rate was 33.5 per thousand. The rate of mortality in the several sub-districts ranged from 21.2 per thousand in Camden Town to 25.2 in Somers town. Placed in their order of salubrity, they stood as follows: Camden Town, Kentish Town, Regent's Park, Gray's Inn, Tottenham Court, and Somers Town. In regard to Infant Mortality, which 1 have estimated by comparing the numbering of deaths under 5 years with the number of births, the sub-districts stand in the following order, beginning with the most healthy: Kentish Town, Tottenham Court, Gray's Inn Road, Regent's Park, Camden Town, and Somers Town. In the parish at large, to every 1000 children born, 290 died under 5 years of age; in Somers Town, to every thousand born, 312 died at that age; and in Kentish Town only 257. In the entire parish the births were to all the deaths in the proportion of 1000 to 657; in Tottenham Court Road they were as 1000 to 713; in Somers Town as 1000 to 713; whilst in Kentish Town they were as 1000 to 602 only. Table I. appended to this Report gives a detailed account of the causes of all the deaths so far as they could be ascertained, and the ages at which they proved fatal. The classification followed is that adopted by the RegistrarGeneral, which is not free from objection, but has the advantage of being extensively known and generally employed in this country. The separate causes of deaths may be summed up under the following heads, still using the terms of the Registrar-General:— I. Zymotic Diseases. 1253 2 Enthetic 39 3 Dietic 38 4 Parasitio 24 II. Constitutional Diseases. 1 Diathetic 149 2 Tubercular and Rickety 695 * That is to say, by reducing them in the proportion which a calendar year is less than 53 weeks. 3 III Local Diseases. 1 Nervous System 481 2 Vascular System 228 3 Respiratory System 739 4 Digestive System 208 5 Urinary Organs 73 6 Generative Organs 23 7 Organs of Locomation 20 8 Skin 25 IV. Development Diseases. 1 Infantile 122 2 Middle Age 19 3 Old Age 225 4 Diseases of Nutrition 175 V. Violent Deaths. 1 Accidental or from Negligence 134 2 Homicidal 11 3 Suicidal 27 VI. causes not specified 37 The Miasmatic Diseases (the class which is specially under the influence of sanitary measures) were the causes of an unusually large number of deaths, namely, 1253. In 1862 the number from this class of diseases was 984, and the average in five years was only 979. Small Pox was fatal to a larger number than during any year that I have had to report on the statistics of this Parish. There were 80 deaths registered in St. Pancras, besides 27 deaths in the Small Pox Hospital. Of the 80 deaths, 14 were of persons said to have been previously vaccinated; in 12 cases no mention is made of vaccination, and in the remaining 54 cases vaccination had not been performed. When it is remembered that by far the largest proportion of the population have been vaccinated, the amount of protection afforded by this operation will appear more considerable than it does on first hearing the figures. There is reason to believe that in St. Pancras there are 24 persons who have either been vaccinated, or have previously had Small Pox, to every one not so protected ; nevertheless, of those who died from Small Pox, nearly seven-tenths were from amongst the relatively small unprotected class, and less than two-tenths were from the larger class protected by vaccination, successful or unsuccessful; whilst concerning three-twentieths of the whole deaths, no information is given. In other words, the deaths amongst the unprotected were nearly four times as many as those amongst the protected, although the latter class was 24 times as numerous as the former; from this it would appear that the fatal cases of Small Pox were, relatively to the members liable to suffer, 96 times as numerous amongst the unvaccinated, as amongst the vaccinated. There is no doubt that, during last year, there prevailed in the whole of London a very strong epidemic tendency to Small Pox; this was shown not only by the number of vaccinated persons who took Small Pox, but by the large number of persons who had Small Pox for a second time, as well as the large number of deaths from the disease. It was also observed that there was greater susceptibility to re-vaccination than is usual at seasons when Small Pox 4 has not been epidemic. If it is borne in mind that the vaccine disease is really Small Pox modified by transmission through a lower animal, it need not occasion surprise that, at a season when an unusual susceptibility to Small Pox exists, there is also an unusual susceptibility to the vaccine disease. Nothing is known of the conditions which induce such epidemics as these; we know only that, in the course of time, there shows itself in different places a tendency in certain diseases to attack large numbers of people, and the cases of these diseases assume a more severe form than is usual at other times. In the case of some maladies, we do not know how epidemics can be warded off; in the case of others, it is known that certain precautionary measures will either prevent the occurrence of an epidemic, or very much mitigate its severity. Thus Cholera may be kept in abeyance by attention to drainage, and the use of pure water. Typhus Fever may be kept in check by the precaution of overcrowding, and a sufficient supply of food; whilst epidemics of Small Pox may be still more effectually prevented than either of the preceding diseases, by the general adoption of vaccination judiciously and carefully performed. When no epidemic prevails, there is a disregard of precautionary sanitary measures, and it seems almost impossible for people to be convinced of the value of such precautions, except by the occurrence of fatal epidemics. When Small Pox is not prevalent, vaccination is neglected; there had been a growing neglect of vaccination in St. Pancras from 1860 to 1862. In the year which ended September 29th 1862, of 6692 children born, only 2854 were vaccinated by the parish vaccinators; whereas, with a smaller number of births, the average number of parochial vaccinations in 1858-59 was 3561. In the year which ended September 29th, 1863, the number of registered births was 7269; the number successfully vaccinated by the parish vaccinators was increased, owing to the prevalence of Small Pox, to 10,259, of whom 3357 were children under one year of age, and 6902 were above that age, a large proportion of them having been previously vaccinated. It must be remembered, in judging of the proportion of children vaccinated in St. Pancras, that, besides parochial vaccinators and private practitioners who vaccinate, there are two national vaccine stations, where a large number of vaccinations are performed; in 1862, at Tottenham Court Chapel Station, there were 1329 vaccinations, and at Russell Place 518. The number last year was no doubt much larger than the number in 1862, in consequence of public attention being forcibly directed to the subject. A very large proportion of those vaccinated at these stations are no doubt parishioners of St. Pancras. Some persons have been led, by the recent prevalence of Small Pox, to doubt whether vaccination is of much value as a preservation against its invasion. A careful examination of the evidence on this subject will lead to absolute conviction, that just in proportion to the thoroughness and prevalence of vaccination is the immunity of any population from Small Pox greater or less. Before the introduction of vaccination, Small Pox was one of the most fearful scourges to which humanity was liable, destroying entire populations; for instance, at one period, in Mexico, it struck down 3½ millions of people, leaving none to bury them; in Greenland it proved fatal to two-thirds of the community; its annual ravages in Europe were estimated at half a million; and in France, a tenth of all the deaths came from Small Pox. It had no respect for royalty any more than for the poor; in the circle of William III., for instance, it was fatal to his father, mother, and wife, to his uncle and two cousins, and he himself suffered most severely, having his constitution permanently impaired by it. During the year 1863, there were in all London, 2012 deaths, whilst 5 the mortality from all causes was 72,346; so that in this year of its extreme prevalence, the deaths from Small Pox bore the proportion to those from all causes of 1 to 36 only, instead of 1 to 14, as was the usual annual proportion in England before the introduction of vaccination, at a time when the mortality from other causes was nearly double what it is now. The average annual number of deaths from Small Pox in 12 years preceding 1863, was only 638, which is in the proportion nearly of 1 per cent, to the gross mortality. This improvement has taken place even with a very incomplete and unsatisfactory observance of vaccination. What is now looked upon as an extreme prevalence of Small Pox, would, two centuries ago, have been regarded as a comparative freedom from the disease. So much for a comparison of the fatality of this disease now and before the employment of vaccination; but what is noticed in regard to its occurrence amongst a population, part of which is vaccinated and part not? Br. Buchanan, who was employed by the Privy Council to report on the state of vaccination in St. Pancras has supplied me with the following figures, which afford valuable evidence on the matter now under consideration. The children in a number of public schools were examined as to their having been vaccinated, the nature of their vaccine scars, and the presence or absence of scars of Small Pox. The number of children examined was 2563; of these, 2457, or 96 per cent., presented marks of vaccination, 93 exhibited no marks of vaccination, and 13 others presented scars of a dubious character. Of the 2457 children known to have been vaccinated, there were only 6 who hud undoubted marks of having had Small Pox, and 3 others who exhibited dubious signs of it. The children with marks of vaccination were classed under three heads—those who exhibited signs of very good vaccination, those who had signs of but moderately good vaccination, and those in whom the signs of vaccination were unsatisfactory. Of the first class there were 1111 children, and not one of thune was marked with Small Pox; of the second class there were 500, and of these there was one bearing slight scars of Small Pox, and one about whom them was doubt whether he had had Small Pox or not; of the third class there were 422, and of these 5 were distinctly scarred by Small Pox, and 2 scarred in a way which left the point undecided. On the other hand, amongst the 93 unvaccinated, and the 13 whose vaccination was not proved, there were 30 eases obviously scarred with Small Pox, and 2 doubtfully scarred. That is to say, amongst the vaccinated those marked with Small Pox were only in the proportion of 3 to 819, or 1 to 273, whilst amongst the unvaccinated they were in the proportion of 32 to 93, or if those whose vaccination was doubtful be included, in the proportion of 32 to 106 or about one-third of the whole. In other words, these statistics prove that scarring from Small Pox is 91 times more common amongst the unvaccinated than amongst the vaccinated, reckoning as vaccinated all who bear upon them any marks of vaccination. Amongst 1111 who bore marks of thorough vaccination, such as it is desirable to have generally practised, there was not one child marked with Small Pox. It is impossible to have more satisfactory proof that vaccination is a real protection from serious Small Pox; and it also appears evident that the amount of protection is proportionate to the quality of the vaccination. Between February and 20th June, 1863, there were seen, by the Parochial Surgeons, 257 cases of Small Pox. In 155 cases a note was made in reference to vaccination; 113 were vaccinated and 52 were not vaccinated. Now from the examination of the schools, it appears that there are 24 times as many vaccinated as unvaccinated persons in St. Pancras. Before making a comparison between the tendency of the vaccinated and the unvaccinated to catch Small 6 Fox, allowance must be made for the great disparity in the numbers of each class living in the parish. The 113 cases of Small Pox from the vaccinated class must be divided by 24, to admit of comparison with the 52 from the unvaccinated; this gives 47. Taking then equal numbers of the vaccinated and unvaccinated populations in St. Pancras, 47 cases occurred amongst vaccinated persons to 520 amongst unvaccinated; that is to say, 11 unvaccinated persons were attacked with Small Pox for every one vaccinated. It has been proved by Mr. Marson, Resident Surgeon of the Small Pox Hospital, that persons who are marked with not fewer than three or four good vaccine scars are more effectually protected from the danger of Small Pox than those who have a smaller number of scars, or in whom the scars are imperfect. The mortality amongst those with four or more scars was rather less than half of one per cent.; amongst those with three scars it was 1.85 per cent.; with two scars it was 4.13 per cent.; with one scar it was 7.57 per cent.; amongst those stated to have been vaccinated, but having no scar, it was 21.73 per cent. The mortality amongst those unprotected by vaccination or previous vaccination was 35.5 per cent. The mortality amongst those who had Small Pox after having been in early life inoculated for Small Pox was 23 per cent., which is about four times as great as amongst those who had been vaccinated, shewing that inoculation for Small Pox is not so sure a safeguard against a natural attack of the disease as is vaccination. SMALL POX IN THE WORKHOUSE. There were admitted into the Workhouse during the year 248 cases of Small Pox; 42 of these were sent on to the Small Pox Hospital, but the others were retained in special wards reserved for the purpose, and treated there. The mortality was very low indeed amongst the vaccinated cases; there were 110 persons vaccinated, 35 unvaccinated, and 60 about whose vaccination no information was obtained. There was one case of a person who had been inoculated for Small Pox in infancy. Of the 110 vaccinatid persons, only two died, whilst of the 35 not vaccinated, ten died, shewing a difference in the rate of mortality represented by the proportions of less than 2 per cent, and 28 per cent., that is to say, there was 14 times as great a mortality amongst the unvaccinated cases as amongst the vaccinated. Of the 60 whose vaccination is not mentioned, four died, which is a mortality of 7 per cent. The experience of Mr. Marson, at the Small Pox Hospital, was that the mortality in 16 years from Small Pox amongst unprotected persons was 35 per cent., while amongst those who had any mark of vaccination, it was only 5¼ per cent. It may astonish some persons, who have been led to regard vaccination as a certain preventive of Small Pox, to hear that so many as 110 out of 206 cases of Small Pox occurred after vaccination. It was a remarkable feature in the late epidemic, that not only were vaccinated persons attacked in larger proportions than usual, but that persons who had previously suffered from natural Small Pox, or had been inoculated for the disease, were also attacked in considerable numbers. To judge of the extent to which vaccination was a protection from the occurrence of the disease, it is necessary to bear in mind that there were in the parish of St. Pancras about 24 times as many vaccinated persons as unvaccinatcd, so that, although there were brought to the Workhouse three times as many cases of Small Pox in vaccinated persons as there were in unvaccinated persons, yet the attacks of Small Pox were eight times as many in proportion to the entire populations concerned amongst the unvaccinated as amongst the vaccinated. 7 So that, from the statistics of these cases, it would appear that vaccination reduced the liability to the occurrence of Small Pox to one-eighth of what it would have been without vaccination, and reduced the mortality amongst the persons actually attacked from 28 in a 100 to less than 2 in 100.* The advantage to be derived from re-vaccination, when judiciously practised, was shewn at the Orphan Working School, where several children were suddenly attacked with Small Pox; all the children were carefully examined by Mr. Harris, the Surgeon of that establishment, and those who were thought to need it were re-vaccinated; there was not a single case of the disease after this precaution had been adopted. No case came to my knowledge of any permanently bad results accruing from re-vaccination in this parish, but many cases were reported, in which the spread of the disease was arrested by this means. This operation is not one which should be indiscriminately and universally recommended, but in epidemic seasons, such as occurred last year, or when persons are strongly exposed to infection, there is indisputable proof that, if adopted with discretion, it is of great value, especially where the marks of the first vaccination are not satisfactory, and the person exposed to infection is above the age of from 7 to 10 years. The cases of Small Pox congregated in the separation wards of the Workhouse led to the spread of the disease, to a small extent only, amongst the inmates of other parts of the house; its extension would probably have been greater, if Dr. Saul had not exercised great vigilance in keeping these wards as distinct as possible, and in re-vaccinating a number of the inmates. There was a remarkable outbreak of the disease in that part of Agar Town which immediately adjoined the Small Pox Wards. Within a few days at the beginning of May, 19 cases of Small Pox occurred in Cambridge Eow, Cambridge Crescent, and Cambridge Street. Before that date, not a single case of Small Pox had been heard of in these streets. The distance from the Small Pox Wards to the houses attacked was very small; four cases were within 50 feet, 6 within 100 feet, and 8 within 200 feet; there was no communication between them, as no patients or persons in attendance passed in or out of the Workhouse on that side. Such a sudden and extensive outbreak cannot be ascribed to one or two imported cases from other parts, because this disease always lies dormant in the system 12 or 14 days after exposure to infection; we can only therefore believe that the emanations from the Small Pox Wards were carried by the wind into these houses, and that those inhabitants who were in a susceptible condition contracted the disease. These streets are situated east and south-east of the Small Pox Wards; and it is remarkable that the prevailing winds during the week when these cases must have been contracted, were from the north-west and west. The history of this outbreak is very interesting in connexion with the spread of epidemic diseases, showing that infection can, when concentrated, be conveyed by the atmosphere for a considerable distance. The commonest modes of conveyance are no doubt from person to person, and by means of clothes. The deaths from Measles were 132 in number ; from Scarlatina, 380 ; from Hooping Cough, 176; from Typhus, Typhoid, and Eemittent Fevers, 119, from Diphtheria, 74; from Croup, 40; Erysipelas, 36; from Puerperal Fever, 14; * There were two children who were exposed to Small Pox at birth, and vaccinated a few days later, who died. These are counted as unprotected cases. 8 rom Pyoemia, 7 ; from Diarrhoea, 135; and from Cholera, 9 (seven of these eing children). The epidemic diseases, which were more fatal in 1863 than in 1862, were Scarlatina, Measles, Hooping Cough, Diphtheria, Erysipelas, Puerperal Fever, Pyoemia, and Diarrhoea. Scarlatina has been of late years one of the most fatal diseases, and unfortunately is not dependent on the want of any obvious hygienic conditions. It is, however, in all probability, always propagated by infection, so that the utmost care should be taken in separating the sick and the healthy, in not allowing children recently affected with the disease to associate with other children in schools and other public places, and in the employment of measures to disinfect the bedding and clothes used by those who have suffered from the complaint. The mortality from Scarlet Fever since 1855 has been annually as follows:— in 1855, 229; 1856, 95; 1857, 99; 1858, 406; 1859, 277; 1860, 86; 1861, 201; 1862, 257; and in 1863, 380.* The average of the 9 years was 225. The annual mortality from Scarlet Fever in St. Pancras is nearly as high as the mortality from Cholera in the years of its epidemic prevalence; in 1832-33, the deaths from Cholera were 230 in this Parish; in 1849, 360; and in 1854, 240. So that actually, in 1863, there were more deaths from Scarlet Fever than there were from Cholera in the year when its mortality was at the highest it has ever been in St. Pancras. In proportion to population, the mortality from Scarlet Fever, in the year 1858 to 1863, has been highest in Somers Town, next in Kentish Town, then in Camden Town, Regent's Park, Gray's Inn, and Tottenham Court Road. From Syphilis there were registered 32 deaths; and from Glanders, a disease contracted by contact with a glandered horse, there was one death. From alcoholic excesses were registered 20 deaths, 7 being from Delirium Tremens, and 13 from Intemperance. No doubt that many more deaths should be ascribed to this cause, which are now placed under Diseases of the Brain, of the Liver, Kidneys, and other categories. From Cancer 103 deaths occurred; from Scrofula and Rickets, 22; from Tubercular Diseases of the Mesenteric Glands, 50 deaths; from Consumption, 546; and from Water on the Brain, 77 deaths occurred. This last class of diseases are very much under the control of sanitary measures; want of pure air is the most prolific source of all the Tubercular Diseases. From Convulsions of Infancy and Teething there were 150 deaths. From Childbirth, besides the cases of Puerperal Fever, there were 19 deaths. The Deaths from Violence numbered 172, 134 being from accident or negligence, 31 suicidal, and 12 homicidal. Of the Accidental Deaths, 6 were on railways; 17 on the roads by means of horses or vehicles drawn by horses; there were 28 deaths by burns and scalds, 15 from the clothes catching fire, 7 from scalds, and 2 from houses on fire; there were 28 deaths from suffocation, nearly all young children, who were stifled in the bed clothes from negligence or ignorance. There were 2 deaths by accidental poisoning, and 6 by suicide. Cyanide of potassium, a substance now much used in photography, was twice used, oxalic acid once, essential oil of almonds once, prussie acid once. Arsenic was not used for this purpose, owing probably to the laws regulating its sale. Several cases have been reported to me of injury to health from the employment of * This is about one death out of every 539 persons living—a little less than two in the thousand. 9 green papers in dwelling-rooms. The majority of these green papers contain a quantity of arsenic, and are especially noxious in rooms where there is much heat, or when the rooms are not very freely ventilated, but in all cases the use of this colour should be avoided. Six persons committed suicide by hanging, 6 by cutting their throats, 6 by drowning, and 1 by a pistol shot. There are every year a number of deaths registered without either medical certificate or inquest. The following are illustrations: a child, 7 months' old, from convulsions; another, 2 months old, from inflammation of the stomach; another, 4 months old, from an unknown cause; another, 1 day old, from collapse of lung; and another, 1 year old, from a couching fit. These are all cases in which a careful enquiry should have been made; it is impossible to say how far these returns are correct, and in some of them there is prima facie ground for suspecting foul play. WORKHOUSE. There were 434 deaths in this building, which is 30 fewer than in 1862. Over 60 years of age there were 187 deaths, and under 5 years 78. From Small Pox there were 16; from Measles, 8; from Diphtheria, 1; from Hooping Cough, 1 ; from Diarrhoea, 3; from Low Fevers, 2; from Erysipelas, Pyoemia, and Puerperal Fever, 6. PAUPER SICKNESS. During the vear 1863, there wore 14836 persons who came under the care of the Parochial District Surgeons; this is 2438 more than were treated in the year 1862. The cases were distributed amongst the several districts as follows:— North—Mr. Jefferys 2946 North-West—Mr. Claremont 2410 Central—Mr. Sutherin 3326 South-East—Dr. Davis 3209 South-West—Dr. Wildbore 2945 One-eleventh part of the whole number of deaths takes place in the Workhouse; but it is not easy to calculate what proportion of the whole sickness in the parish is treated by the Parish Surgeons; the cases of pauper sickness bear the proportion to the whole population of St. Pancras of 1 to 16; and as it is probable that to every three paupers in the parish there was one attack of acute illness, it would appear that about one-fifth of the sickness of the parish comes under the care of the Parish Surgeons. METEOROLOGY. The mean temperature of the year was 50°.3, which was 1°.9 above the average of 92 years. The temperature of the first quarter was 42°.6, which was 4°.2 above the mean of other years; of the second quarter it was 53°.0, which is 0o.9 above the mean; of the third quarter it was 58°.8, which was 0°.7 lower than the average; and of the fourth quarter, 46°.8, which was 3°.2 higher than the mean. The mean daily range of temperature was 16°.9, which is 1°.2 more than usual. The degree of humidity was 80, which is 2 lower than the mean. Rain fell to a depth of 20.0 inches which was 5.3 less than the mean of 47 years, and 6.4 inches less than in 1862. 10 The chief meteorological features were a mild winter, an average summer, and a deficiency of rain, with an increase in the daily range of temperature, and more than an average horizontal movement of the air. The only circumstance which can be supposed to have favoured the prevalence of the Zymotic Diseases was the dryness and deficiency of rain. SANITARY "WORKS. During the year which ended on the 31st March, 1864, the following improvements were carried out by order of the Sanitary Committee, under my superintendence and that of the Inspectors:— New drains were constructed in 98 houses. New traps were furnished to 393 drains. The drainage was improved in 86 houses. Cesspools emptied, filled up, and water closets supplied in 47 houses. 47 cesspools were emptied. New pans, traps, and water supplied to 151 closets. 14 new water closets erected, Water laid on to 87 closets. 43 new dust-bins were erected. 21 old dust-bins were repaired. The paving of yards and cellars improved in 141 houses. Water supplied to 27 houses, previously without water. 135 houses were cleansed and whitewashed. Overcrowding was abated in 21 houses. Pigs removed from 15 places. Heaps of manure removed from wharves, mews, &c., in 210 instances. Other nuisances, not named above, were removed to the number of 19. The Inspectors report, that in carrying out these improvements, 5357 inspections were made, slaughterhouses visited 814 times, cowhouses 1027 times, and the markets 416 times. Preliminary notices were issued to the number of 584, secondary notices to the number of 39. In consequence of notices being neglected, 21 summonses were taken out before the Police Magistrates. There have been seized and destroyed, as unfit for food, 49 cod fish, 32 pads of plaice, 3½ bushel of perriwinkles, 6 pads of mackerel, 4 trucks of soles, 1 salmon and 5 pieces of salmon, 1 bushel of shrimps, 8 boxes and 6 barrels of herrings, 1 piece of pork, 3 breasts of mutton, 1 flank of beef, 43 ostend rabbits, 5 fowls, 1 goose, and half a barrel of salt fish, besides a number of rotten oranges, apples, strawberries, cocoanuts, and plums. The only new sewerage constructed by the Vestry during the year ending 31st March, was 301 feet in James Street, Camden Town, 225 feet in Wcedington Street, 50 feet in Murray Street, and 632 feet in Winchester Street. 11 The Vestry has given an order for new sewers in John Street and Windmill Street, Tottenham Court Road, but the work is not yet commenced. There are now 100 licensed slaughterhouses in the parish, all of which are visited by the Inspectors at least four times a year. One application for a license for a new slaughterhouse was refused by the Justices, at their Special Sessions, in October last, on the ground that the premises were within 50 feet of a dwelling-house, and consequently, as a new application, was contrary to the requirements of the Building Act. The place was situated in South Crescent Mews, and was in other respects suited for the purpose. The Sanitary Committee requested the Justices to require that the number of cows allowed in licensed cowhouses should be so limited as to admit of at least 600 cubic feet of breathing space for each cow. The Justices went further than this, and required that 800 cubic feet of space should be given to each cow. This requirement has the effect of reducing very considerably the number of cows kept in some sheds. On the ground of an opposition on the part of the inhabitants of Gordon Square and Byng Place, the magistrates refused to license the cowsheds in Upper Gower Mews, belonging to Henry Bannister, Joseph Bannister, and George Field, except upon the condition that the occupiers should undertake not to use the premises for cowkeeping after the 24th June instant. A license was refused to William Philips, for a cowhouse at the rear of Grove Terrace, Kentish Town. During the Session 1862-63, an Act of Parliament was passed for the regulation of bakehouses. By this Act the Medical Officer of Health and Sanitary Inspectors were appointed to inspect and report on the mode in which its provisions are complied with, and the Vestry is the local authority for enforcing the requirements of the Act. The main provisions of the Act are— That no person under the age of 18 years shall be employed in any bakehouse between 9 o'clock at night and 5 o'clock in the morning. That the walls and coiling of every bakehouse, as well as the passages and staircases leading thereto, shall be well cleansed at least twice a year. That every bakehouse shall be kept clean, well ventilated, well drained, and free from all offensive smells. That no place on the same level with a bakehouse, forming part of the same building, shall be used as a sleeping room, unless it is effectually separated from the bakehouse by a partition extending from the floor to the ceiling, and unless there be an external glazed window, of at least 9 superficial feet in area, of which at least 4½ superficial feet are made to open for ventilation. Notices were printed and distributed to all the bakers in the parish, calling their attention to the requirements of the Act, and informing them that the Vestry intended to enforce them. All the bakehouses in the parish, about 220 in number, have since that time been inspected. It was found that more than four-fifths of the whole number were underground. The great defect in a very large proportion of them is want of space, and consequent want of good ventilation. At the time of the inspection, in 44 of them, the walls and passages required limewhiting, being very dirty; in 19 the walls were but indifferently clean. The ceilings were very dirty in 55, and in 23 others they were but indifferently clean. In 17 the general state of the premises was very dirty, and in 14 others it was far from clean. In 4 there was the most imperfect provision for ventilation, and in 10 others it was unsatisfactory. In very many other places the means of ventilation were sufficient, but owing to the smallness of the places, they are not kept well ventilated, because it is impossible to do so without creating very strong draughts of cold air into the small heated space where the men work. Another objection raised against the admission of 12 pure air from without into the bakehouse is, the injury which the dough sustains by being allowed to cool much during the process of fermentation. There are, however, hours every day when air might be freely admitted into the bakehouse, without any injury to the bread, but in many places advantage is not taken of these hours to change and purify the air of the place. It is important to remember, that the gas which is evolved from dough during fermentation, and the fumes which arise from the charcoal and ashes when withdrawn from the ovens, are of a most poisonous nature, and unless fresh air be freely admitted to the bakehouse, and provision be made for the escape of the noxious gases, the atmosphere of them must exert a most injurious effect on the health of those employed in them. The gases are not odorous, and have rather a stupifying effect, so that workmen are not likely to complain, a circumstance which makes it more necessary that others should enquire into this matter. In 13 places the drainage was not good, or there was too direct a communication with the water closets. In 15 there were sleeping rooms on the level of the bakehouse; in only 4 of them were these rooms opposed to the requirements of the Act. In one place only was it ascertained that a youth under 18 years of age was employed between the forbidden hours. In two places youths, said to be over 18 years of age, did not look to be so old. Since the inspection, all the bakehouses, with one exception, have been brought into conformity with the provisions of the Act; but it will be necessary that they should be periodically inspected, to see that the regulations are not from time to time disregarded. Some bakehouses in this parish are probably equal to any in London, and might be referred to as models of excellence. The system of night work and long hours is very objectionable, and it is to be hoped that it will be soon given up in all establishments, as it has been already in some of the best. The employment of machinery, instead of manual labour, is not only more cleanly, but also more healthful, and has the advantage of being more expeditious, and thereby shortening the hours of labour. The carrying out of this Act of Parliament, in addition to the two recent measures requiring the licensing of slaughterhouses and cowhouses, has entailed on myself and the Sanitary Inspectors much additional labour. Independently of these new departments of work, the parish itself is increasing so rapidly in population, that the sanitary measures required are more and more extensive, and the labours of the Sanitary Staff thereby increased. I remain, Gentlemen, Tour obedient Servant, THOMAS HILLIER. [ Table I.] Shewing the causes of Death at different Ages during the year 1863. CAUSES OF DEATH MALES AND FEMALES. At all Ages. Ages at Death. Under 1 year. 1 2 3 4 5— 10— 15— 25— 35— 45— 55— 65— 75— 85— 95— Double ful Agee. I.-1. Diphtheria 74 8 21 11 13 6 8 2 2 1 1 1 Small Pox 80 24 9 6 5 6 10 ... 6 8 4 ... 1 Measles 132 19 44 29 13 9 17 ... ... 1 Scarlatina 380 27 43 68 61 52 92 18 8 9 1 1 Quinsy 5 1 ... ... ... ... ... ... ... 1 ... 1 1 1 Croup 40 5 12 9 6 5 3 Whooping Cough 176 52 64 35 14 6 5 Typhus 113 6 8 10 2 6 10 10 13 10 10 10 6 7 6 Erysipelas 36 12 2 1 ... ... ... 2 2 1 2 4 3 2 5 Metria 14 ... ... ... ... ... ... ... 4 4 6 Carbuncle 2 ... ... ... ... ... ... ... ... ... ... 1 ... 1 Pyæmia 7 ... ... ... ... ... ... ... 1 2 ... ... 3 1 Influenza 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Dysentery 8 2 1 ... 1 ... ... ... ... 2 ... ... 2 Diarrhoea 135 91 17 5 ... ... 5 ... 2 ... ... 3 3 6 1 2 Cholera 9 4 2 1 ... ... ... ... ... ... 1 ... ... 1 Ague 1 ... ... ... ... ... ... 1 Remittent Fever 6 2 3 l Rheumatism 31 ... ... ... ... 1 1 3 4 4 5 6 3 5 2 1 2. Syphilis 32 29 1 ... ... ... ... ... 2 Stricture of Urethra 6 ... ... ... ... ... ... ... ... ... 3 2 ... ... 1 Glanders 1 ... ... ... ... ... ... ... ... ... ... 1 3. Privation 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Want of Breast Milk 13 l3 Purpura and Scurvy 4 1 ... ... ... ... ... ... 2 ... ... ... 1 Delirium Tremens 7 ••• ... ... ... ... ... ... ... 3 2 l 1 Intemperance 13 ... ... ... ... ... ... ... ... 3 5 4 1 4. Thrush 21 21 Worms, &c 3 ... ... ... ... 1 ... ... ... 1 ... 1 II.—1. Gout 4 ... ... ... ... ... ... ... ... ... ... 1 1 1 1 Dropsy 25 l 1 1 ... ... ... 3 ... 2 2 ... 2 3 6 4 Cancer 103 ... ... 1 1 ... 1 1 3 15 27 24 26 4 Noma 1 ... ... 1 Mortification 16 2 ... ... ... ... ... ... ... ... 1 1 4 1 3 3 1 2. Scrofula and Rickets 22 3 5 1 ... ... 1 5 2 2 1 1 1 Tables Mesenterica. 50 24 13 3 2 1 3 3 1 Phthisis 546 22 14 12 7 6 12 7 96 131 119 77 32 7 4 1 Hydrocephalus 77 25 16 9 9 3 10 1 3 1 III.-l. Cephalitis 63 10 11 3 3 1 5 2 3 4 3 3 4 9 2 Apoplexy 133 4 9 2 2 1 1 1 ... 7 12 17 30 36 7 2 2 Paralysis 58 ... 1 ... ... ... ... ... l 3 4 7 7 16 18 1 Insanity 4 ... ... ... ... l ... ... ... ... 1 1 1 Epilepsy 25 3 1 ... 2 ... ... 2 1 3 2 2 3 4 2 Convulsions 139 92 31 9 1 1 2 1 1 ... ... 1 Brain Diseases 59 8 3 4 2 2 3 3 1 1 6 7 8 7 4 2. Pericarditis 16 1 ... 1 1 ... 3 1 2 1 1 1 1 3 Aneurism 12 ... ... ... ... ... ... ... ... 1 5 3 3 Heart Diseases 200 3 2 1 ... ... 3 10 11 17 26 34 39 34 19 1 3. Laryngitis* 25 9 7 2 3 ... 2 ... ... 1 1 Bronchitis 428 85 51 19 5 6 10 1 3 6 19 40 61 74 44 4 Pleurisy 14 4 ... ... ... ... 2 1 ... ... 4 2 ... ... 1 Pneumonia 220 84 51 21 5 4 5 2 8 2 5 10 11 8 3 1 Asthma 36 ... ... ... ... ... ... ... ... 1 4 11 7 10 3 Lung Diseases 16 1 ... ... ... ... 1 1 1 2 2 5 1 2 4. Gastritis 5 2 ... ... ... 1 ... ... ... ... ... 1 ... ... 1 Enteritis 26 11 ... ... ... 1 2 ... 1 1 1 2 2 3 1 1 Peritonitis 11 1 ... ... ... ... 1 ... 1 3 ... 1 2 2 Ascites 5 ... ... ... ... ... 1 ... ... 1 ... 1 2 * This line includes 10 cases of Laryngismus Stridulus. Table I.—continued. Shewing the causes of Death at different Ages during the year 1863. CAUSES OF DEATH MALES AND FEMALES. At all Ages. Ages at Death. Under 1 year. 1 2 3 4 6 10— 15— 25_ 35— 45— 55— 65— 75— 85— 95— Doubt- ful Age. Ulceration of Intestines 8 1 .. .. .. .. .. .. 2 1 .. 2 .. 2 Hernia 15 .. .. .. .. .. .. .. .. 2 .. 2 3 5 2 1 Ileus & Intussusception 14 2 .. .. .. .. 1 .. 1 .. 1 1 2 4 2 Stricture of Intestines 6 1 .. .. .. .. .. .. .. .. .. 2 2 .. 1 Stomach Diseases 28 6 1 .. .. 1 1 .. 2 2 6 4 5 1 Hepatitis 14 .. .. .. .. .. .. .. .. .. 1 6 2 4 .. 1 Jaundice 15 5 .. .. 1 .. .. .. .. 1 .. 3 2 3 Liver and Spleen Diseases 61 1 2 .. .. .. 2 .. 1 3 12 16 13 11 5. Nephritis 4 1 .. .. .. .. .. .. .. .. .. 2 1 Ischuria 4 .. .. .. .. .. .. .. .. .. .. 2 .. 1 1 Nephria 24 .. 1 .. .. .. 1 .. 3 3 4 2 7 2 1 Diabetes 3 .. .. .. .. .. .. .. .. 2 .. .. 1 Stone 3 .. .. .. .. 1 .. .. .. .. .. 1 .. 1 Cystitis 3 .. .. .. .. .. .. .. .. .. .. 1 .. 2 Kidney Diseases 32 .. .. .. .. .. .. .. 1 3 5 7 3 9 4 6. Ovarian Dropsy 10 .. .. .. .. .. .. .. .. 1 3 3 3 Uterine Diseases 13 .. .. .. .. .. .. .. 1 2 7 1 .. 2 7. Joint Diseases 20 .. 1 .. .. 1 1 4 4 2 .. 3 1 3 8. Phlegmon 16 6 .. 1 .. .. .. .. .. 2 .. 3 3 1 1 Ulcer 4 .. .. .. .. .. .. .. .. .. .. .. 1 3 Skin Diseases 5 1 •• 1 2 .. .. .. .. .. .. 1 IV.-1. Premature Birth 81 81 Cyanosis 7 6 1 Spina Bifida 7 7 Other malformations 11 9 .. .. .. 2 Teething 16 7 8 1 2. Childbirth 19 .. .. .. .. .. .. .. 3 8 8 3. Old Age 225 .. .. .. .. .. .. .. .. .. .. 1 11 52 117 43 1 4. Atrophy & Debility 175 151 13 6 2 .. .. .. .. 1 .. 1 1 V.-l. (Accident or Negligence.) Fractures and Contusions 57 1 1 2 .. 1 1 4 1 8 11 10 9 2 4 2 Burns and Scalds 29 1 6 4 2 .. 4 2 .. .. 5 1 2 .. 1 Poison 2 .. .. .. .. .. .. 1 .. .. 1 Drowning 8 1 1 .. .. 2 2 1 1 Suffocation 28 25 .. 2 .. .. 1 Otherwise 11 5 .. .. 1 .. .. .. .. .. 2 .. 1 2 2. Murder and Manslaughter 11 10 .. .. .. .. .. .. .. 1 3. (Suicidal.) Gun-shot Wounds 1 .. .. .. .. .. .. .. .. .. .. 1 Cuts and Stabs 6 .. .. .. .. .. .. .. .. 1 2 1 1 Poison 6 1 .. .. .. .. .. .. 1 .. 1 2 .. 1 Drowning 6 .. .. .. .. .. .. .. .. .. 3 3 Hanging 6 .. .. .. .. .. .. 1 .. 1 1 1 1 1 Otherwise 3 .. .. .. .. .. .. .. .. .. 1 .. 1 1 VI.—Sudden deaths 1 1 (cause unascertained) Cause not specified, or ill-defined 87 3 1 1 .. .. 1 .. .. .. 1 3 1 .. .. .. .. 26 Total 4746 1042 479 284 166 127 234 94 206 299 361 374 349 362 271 68 4 26 [ Table II. ] FIRST OR WINTER QUARTER, 18C3. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Thirteen Weeks ending the 28th March, 1863. LOCALITIES. Area in Acres. Population in 1861. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From all causes over 60 years of age. From Small Pox. From Measles. From Scarlatina. From Diphtheria. From Hooping Cough From Diarrhoea. From Typhus, Typhoid, and Relapsing Fevers. From Erysipelas, Pyoemia, and Puerperal Fever. From Phthisis. From Bronchitis, Pneumonia, & Asthma M. F. M.&F. M. F. M.&F. 427 34927 162 134 296 77 100 177 87 32 4 5 7 6 10 2 6 4 21 37 Tottenham Court 75 74 149 68 26 I 2 5 1 12 1 6 1 20 28 University College Hospital 145 28348 118 117 235 28 14 42 2 5 .. .. .. 1 .. .. .. 3 1 3 Stand Union 14 18 32 2 19 .. .. .. .. .. .. .. .. 7 9 Gray's Inn Road 155 27807 110 111 221 62 68 130 60 30 1 6 4 1 7 1 3 1 19 25 Royal Free Hospital 19 8 27 .. 2 .. .. .. .. .. .. .. 2 3 1 Somers Town 184 39096 175 181 356 91 136 227 121 38 1 8 22 4 25 3 7 3 24 45 Camden Town 171 23406 150 132 282 69 65 134 73 26 2 6 5 5 11 1 1 2 13 31 Saint Pancras Workhouse 65 68 133 22 57 .. 2 .. .. .. .. .. 2 20 30 Kentish Town 1634 44298 224 217 441 104 117 221 105 37 5 10 24 5 16 1 6 3 29 37 Totals 2716 198784 939 892 1831 604 668 1272 540 272 12 39 67 23 81 9 29 21 157 246 (Table III. ] SECOND OR SPRING QUARTER, 1863. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Thirteen Weeks ending the 27th June, 1863. LOCALITIES. Area in Acres. Population in 1861. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From all causes over 60 years of ages. From Small Pox. From Measles. From Scarlatina. From Diphtheria. From Hooping Cough From Diarrhoea. From Typhus, Typhoid, and Relapsing Fevers. From Erysipelas, Pyoemia, and Puerperal Fever. From Phthisis. From Bronchitis, Pneumonia, & Asthma M. F. M.&F. M. F. M.&F. 427 34957 130 130 260 83 69 152 61 33 3 5 10 4 7 1 7 .. 24 16 Tottenham Court 62 56 118 52 23 8 3 4 .. .. 2 5 .. 17 27 University College Hospital 145 28348 139 113 252 22 12 34 .. 5 .. .. .. .. .. .. .. 3 3 2 Stand Union 7 17 24 4 11 .. 1 .. .. .. .. .. .. 1 8 Gray's Inn Road 155 27807 128 102 230 68 60 128 58 23 .. .. 2 1 8 3 1 2 25 25 Royal Free Hospital 12 5 17 .. 1 .. .. .. .. .. .. .. .. .. 2 Somers Town 184 39096 177 161 338 90 132 222 107 45 2 6 24 5 19 3 6 3 26 24 Camden Town 171 23406 135 122 257 63 50 113 58 16 4 6 9 .. 7 2 3 .. 7 10 Saint Pancras Workhouse 54 55 109 13 61 9 .. .. .. .. 1 .. 3 15 15 Kentish Town 1634 44298 219 224 443 109 106 215 103 39 6 3 25 2 7 1 7 4 20 25 Totals 2716 198784 928 852 1780 570 562 1132 456 257 32 24 74 12 48 13 29 15 138 154 [ Table IV. ] THIRD OR SUMMER QUARTER, 1863. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Fourteen Weeks ending 3rd October, 1863. LOCALITIES. Area in Acres. Population in 1861. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From all causes over 60 years of age. From Small Pox. From Measles. From Scarlatina. From Diphtheria. From Hooping Cough From Diarrhoea. From Typhus, Typhoid, and Relapsing Fevers. From Erysipelas, Pyoemia, and Puerperal Fever. From Phthisis. From Bronchitis, Pneumonia, & Asthma M. F. M.&F. M. F. M.&F. Regent's Park 427 34927 149 176 325 97 100 197 97 27 2 4 24 7 3 16 3 2 21 14 Tottenham Court 69 78 147 73 16 13 5 12 2 2 13 6 1 16 16 University College Hospital 145 28348 134 106 240 21 19 50 4 4 • • .. 1 2 1 .. 2 4 2 Stand Union 7 12 19 .. 12 .. .. .. .. .. .. .. 1 2 5 Gray's Inn Road 155 27807 103 123 226 63 55 118 52 20 .. .. 9 2 .. 18 3 3 13 12 Royal Free Hospital 11 2 13 1 1 1 .. .. .. .. .. 1 2 4 Somers Town 184 39096 188 206 394 85 118 203 118 22 2 11 27 4 2 29 5 4 14 12 Camden Town 171 23406 140 134 274 73 57 130 61 27 1 4 14 3 3 12 3 1 12 13 Saint Pancras Workhouse 50 57 107 21 40 6 .. .. 1 .. 2 2 1 17 9 Kentish Town 1634 44298 259 243 402 139 127 266 147 43 1 1 51 4 14 23 7 4 22 18 Totals 2716 198784 973 988 1961 625 625 1250 574 212 26 25 138 25 24 114 30 21 125 101 [ Table V. ] FOURTH OR AUTUMN QUARTER, 1863. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Thirteen Weeks ending the 2nd January, 1864. LOCALITIES. Area in Acres. Population in 1861. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From all causes over 60 years of age. From Small Pox. From Measles. From Scarlatina. From Diphtheria. From Hooping Cough From Diarrhoea. from Typhus, Typhoid, and Relapsing Fevers. From Erysipelas, Pyoemia, and Puerperal Fever. From Phthisis. From Bronchitis, Pneumonia, & Asthma M. F. M.&F. M. F. M.&F. 427 34927 155 125 280 87 69 156 72 28 5 10 5 1 5 2 10 3 21 25 Tottenham Court 86 46 132 53 23 2 2 13 .. 1 1 1 2 24 29 University College Hospital 145 28348 124 105 229 32 13 45 .. 14 .. .. .. .. .. .. .. 4 9 2 Stand Union 20 20 40 3 18 .. 1 .. .. .. .. .. .. 12 7 Gray's Inn Road 155 27807 137 86 223 80 86 166 75 29 1 4 15 2 4 3 3 2 26 39 Royal Free Hospital 7 9 16 1 1 .. .. .. .. .. .. .. 2 1 Somers Town 184 39096 165 157 322 109 116 225 104 42 .. 19 19 2 13 5 7 2 23 47 Camden Town 171 23406 112 113 225 49 157 106 52 21 .. 2 10 3 3 3 3 1 8 21 Saint Pancras Workhouse 39 46 85 22 29 1 6 .. .. 1 .. .. • • 11 12 Kentish Town 1634 44298 210 216 426 109 120 229 111 34 3 2 42 3 3 •• 6 3 23 33 Totals 2716 198784 903 802 1705 618 582 1200 493 239 12 46 104 11 30 14 30 19 158 215 [Table VI. ] TOTAL OF THE FOUR QUARTERS, 1863. Register of Births and Deaths in the Sub-Distiicts and Public Institutions, for the Fifty-three Weeks ending the 2nd January, 1864. LOCALITIES. Area in Acres. Population in 1861. BIRTHS. DEATHS From all causes. From all causes under 5 years of age. From all causes over 60 years of ages. From Small Pox. From Measles. From Scarlatina. From Diphtheria. From Hooping Cough From Diarrhoea. From Typhus, Typhoid, and Relapsing Fevers. From Erysipelas, Pyoemia, and Puerperal Fever. M. F. M. & F. M. F. M. & F. Regent's Park 427 34957 596 565 1161 344 338 682 317 120 14 24 46 18 25 21 26 9 Tottenham Court 297 256 553 246 88 24 12 34 3 15 17 18 4 University College Hospital 145 28318 515 441 956 113 58 171 6 23 •• •• 1 3 .. 1 .. 12 Strand Union 43 65 108 9 60 • • 2 .. .. .. .. .. 1 Gray's Inn Road 155 27807 478 422 273 269 542 245 102 2 10 30 6 19 25 10 8 Royal Free Hospital 49 24 73 2 5 1 .. •• •• • • .. 1 6 Somers Town 184 39096 705 705 1410 375 502 877 450 147 5 44 92 15 59 40 25 12 Camden Town 171 23406 537 501 1038 254 229 483 244 90 7 18 38 11 24 18 10 4 Saint Pancras Workhouse 208 226 434 78 187 16 8 • • 1 1 3 2 6 Kentish Town 1634 44298 912 900 1812 461 470 931 466 153 13 16 142 14 40 25 26 14 Totals 2716 198784 3743 3534 7277 2417 2437 4854 2063 980 82 134 383 71 183 150 118 76 20 [ Table A. ] Names of Sub-Districts. Population in 1861. Rate of increase per cent. per annum between 1851 & 1861. Estimated Population, April, 1863.* Regent's Park 34927 0.9 35558 Tottenham Court 28348 0.3 28518 Gray's Inn Road 27807 0.48 28074 Somers Town 39096 0.93 39826 Camden Town 23406 1.03 28476 Kentish Town 44298 6.6 50338 The whole Parish 198784 1.75 205802 * Calculated on the assumption that the population has increased since 1861 in the same annual proportion as it did between 1851 and 1861. [ Table B. ] Names of Sub-Districts. Deaths registered in 1863. Estimated Mortality in 1863. * Rate of Mortality to every 1000. Regent's Park 682 798 22.4 Tottenham Court 553 646 23.0† Gray's Inn Road 542 631 22.5 Somers Town 877 1005 25.2 Camden Town 483 575 21.2†† Kentish Town 931 1091 21.6 University Hospital 171 Royal Free Hospital 73 St. Pancras Workhouse 434 Strand Workhouse 108 The whole Parish (Without Strand Workhouse) 4746 23.6 * This column is calculated by excluding the deaths which occurred in the Strand Workhouse, and distributing the deaths in the Hospitals and St. Pancras Workhouse amongst the Sub-Districts in the proportion of their several populations. † The population is assumed to have been 28018, 500 being subtracted for the inmates of the Strand Workhouse. †† The population is assumed to have been 26976, 1500 being subtracted for the St. Pancras Workhouse. [ Table C. ] Names of Sub-Districts. Ratio of Births to Deaths under 5 years. Ratio of Births to Deaths at all ages. Regent's Park 1000:273 1000:687 Tottenham Court 1000:271* 1000:713 Gray's Inn Road 1000:272 1000:700 Somers Town 1000:312 1000:712 Camden Town 1000:291† 1000:686 Kentish Town 1000:257 1000:602 The whole Parish 1000:290 1000:657 * A deduction of 50 is made for births in the Strand Workhouse, † A deduction of 200 is made for births in the St. Pancras Workhouse.