£TPA~nI %\ NINTH ANNUAL REPORT OF THE MEDICAL OFFICES OF HEALTH, FOR THE YEAR 1864. TO THE VESTEY OF ST. PANCEAS. Gentlemen, The year 1864 was an unusually unhealthy one in London; the rate of mortality was 2.645 per cent. of the population, whilst the average in twenty-five years, including two periods of epidemic Cholera was only 2.432. The death rate was higher than in any of the preceding twenty-four years, excepting 1847, the Influenza year, and 1849 and 1854 the Cholera years. In common with other parts of the Metropolis, St. Pancras suffered from a high mortality, about 2.535 per cent. of the population having died during the year. This is a higher death rate than has occurred for many years past. The death rate in St. Pancras was very nearly that in the northern group of districts, viz., St. Marylebone, Hampstead, Islington, Hackney, and St. Pancras. The mortality in the central and east districts was considerably higher, whilst that in the western districts was decidedly lower than in St. Pancras. The diseases which proved unusually fatal in London were bronchitis, typhus, scarlatina, diarrhoea, and measles. In St. Pancras the diseases which were much more fatal than in 1863, were Bronchitis, giving 645 deaths instead of 428 ; Pneumonia, 312 instead of 220; the tubercular diseases (including consumption) 866 deaths instead of 695; and diseases of the nervous system 535 instead of 481. From Measles, Typhus, and Diarrhoea there were a few more deaths in 1864 than in 1863. 2 The developmental diseases of infancy and old age were much more fatal than in 1863. There were more violent deaths, but fewer from suicide. The Miasmatic diseases, which are usually most fatal in unhealthy years, were fatal to a much smaller number than in 1863, 1100 instead 1253 ; but this number was higher than the average of six years. The total number of deaths from all causes during the year was 5308, which were thus distributed : I. Zymotic Diseases. 1 Miasmatic 1100 2 Enthetic 39 3 Dietic 29 4 Parasitic 15 II. Constitutional Diseases. 1 Diathetic 176 2 Tubercular and Rickety 866 III. Local Diseases. 1 Nervous system 535 2 Vascular system 229 3 Respiratory system 1054 4 Digestion system 210 5 Urinary organs 71 6 Generative organs 15 7 Organs of locomotion 14 8 Skin 27 IV. Diseases of Development. 1 Infantile 384 2 Middle age 24 3 Old age 267 V. Violent Deaths. 1 Accidental or from negligence 191 2 Homicidal 14 3 Suicidal 21 VI. Causes not specified 27 From Small Pox the deaths numbered 14, 12 of which occurred in Kentish Town Sub-district. Three cases were in vaccinatcd persons, in three cases no information was obtained as to vaccination, and eight were in non-vaccinated persons. Measles was fatal to 140 children ; this is a high mortality from that disease. Scarlatina caused no fewer than 232 deaths ; a large number, though not so high as in 1863. The average annual mortality from Scarlatina in 9 previous years was 225. Diphtheria appears as the cause of 64 deaths. This disease appears to be now naturalised amongst us ; it caused 74 deaths in 1863, 68 in 1862, 51 in 1861, 34 in 1860, 51 in 1859, and 47 in 1858; before that year it had not appeared on the register as a cause of death. 8 Typhus and Typhoid fevers caused 125 deaths in the Parish, besides 33 which occurred amongst St. Pancras people in the Fever Hospital. This is a higher mortality than in 1863, when the deaths from those fevers numbered 113, but lower than in 1862, when they numbered 156. In London, as a whole, the Typhus deaths were 3689, so that St. Pancras did not furnish, in proportion to its population, so many deaths from fever as other parts of the Metropolis. Still, the mortality from this cause is too high, considering the natural advantages St. Pancras possesses, and the number of open spaces, and, as compared with many metropolitan districts, the sparse distribution of its inhabitants. It is to be regretted that under the heading Typhus, two distinct forms of fever are registered, one which is mainly aggravated by overcrowding ; the other (known as Typhoid or Gastric) which is aggravated by defective drainage, attacks rich and poor alike, and is never absent from London, especially in the autumn. The first form, Typhus proper, has been epidemic in London since December, 1861, previously to this having been absent for several years. It is a disease which never occurs in those under favourable sanitary conditions, except by contagion. The contagion does not spread widely, but is very powerful in its action when ventilation is not well carried out, and especially when a number of cases of the disease are brought together. It is one of the diseases in which sanitary measures are most obviously of use ; so much is this the case, that if overcrowding and privation could be prevented, isolation of the sick enforced, and thorough cleansing of clothes and bedding well carried out, an epidemic of typhus might probably be always arrested in its course. It is, however, impossible at present to prevent overcrowding. The law relating to this matter is not sufficiently explicit, and such as it is cannot be fully enforced without crowding the workhouses to an enormous extent. House-rent is higher than ever in London, and the dwellings of the poor are constantly being removed by railway extension and in other ways. In this parish a great part of Agar Town has been pulled down, and much of Somers Town is condemned to the same fate. Rooms, adapted to accommodate a family with 6 or 8 children, so as to ensure a fair amount of ventilation, cannot be obtained at less than from 5s. to 8s. per week, or from £13 to £20 per annum, which would swallow up an undue proportion of most labouring men's wages. The result is, that men having large families, and earning less than £ 1 a week, must live in rooms too small for them, and as a consequence, disease is engendered, and infectious diseases are propagated to a lamentable extent. It has been shown that consumption and the so-called tubercular diseases are developed by want of pure air more than by any other cause; these diseases account for 866 deaths last year, about one-sixth of the total number of deaths. There is a clause in the Nuisances Removal Act which authorises you, as the local authority, to take proceedings for the abatement of overcrowding, when any house whose inhabitants consist of more than one family is certified by me, as medical officer of health, to be so overcrowded as to be dangerous or prejudicial to the health of the inhabitants. If I were to give certificates to this effect in all cases in which the health of families is suffering from the small size of their dwellingrooms, the number of such certificates would be very large ; and if proceedings were taken in all these cases, many families would be turned into the streets from their inability to pay for rooms large enough for them. It is a most difficult point to decide what degree of overcrowding shall be permitted to remain undisturbed, and when interference is absolutely required. A line must be drawn somewhere, and after consultation with other Metropolitan Medical Officers of Health, it is thought that a cubic space of 300 feet should be required as as a minimum for each individval, or 400 for each adult and 250 4 for each child under 12 years of age. This is about the amount of space required by the Police Surveyors, appointed under the Common Lodging House Act, for bedrooms not occupied at all in the day-time, and in which sick persons are not allowed to remain. Very few proceedings have been hitherto taken under the overcrowding clause in this Parish, but the Sanitary Committee heve recently instituted proceedings in a number of cases. The presence of Typhus amongst us for the last three years and a half, with a tendency to increase rather than to abate, together with the presence of it in an aggravated form in Russia, accompanied by another epidemic (relapsing fever) which has not been seen in London since 1854, must be taken as clear indications to all local authorities to carry out sanitary measures to the full extent to which the legislature enables them to proceed. In all rooms in which infectious disease occurs a thorough cleansing and whitewashing should be enforced, and in houses let out in separate tenements, periodical whitewashing is required, even though no disease of an infectious nature has occurred. The passages and walls of the rooms in these houses should not be papered, unless the landlord is prepared frequently to renew the paper. There is one thing of much importance, which it is not easy to enforce, that is, the cleansing of bedding and body linen in cases of infection. The opportunities for washing amongst the poor are very defective, many having no place for the purpose besides the one room in which they all eat, drink, and sleep, in which their children are born, where they are ill, and die. Amongst 191 violent deaths from accident or negligence, 9 occurred on the railroads, 19 by conveyances, on the public roads, 4 from injuries by horses, 5 by falls from scaffolding, 21 from burns, 11 from scalds; 33 children were suffocated in bed, 4 children and 1 adult were choked by food. One child was accidentally poisoned by an overdose of medicine. Five persons committed suicide by poison, two using oxalic acid, one acetate of lead, one laudanum, and one taking prussiate of potash. There were 57 more accidental deaths in 1864 than in 1863, three more homicidal, and six less suicidal. Of the deaths from burning, 3 were ascribed to the use of crinoline, 10 were in children from two to six years of age, an age at which children able to walk, but not old enough to take care of themselves, are often left in rooms with a fire, without any attendant or fireguard. The deaths from scalding were in ten cases of children from one year to three years of age. Four persons committed suicide by cutting their throats, 5 by hanging themselves, and 2 by drowning. Eleven newly born children were murdered. There were 27 deaths, the causes af which are not specified or ill-defined. Infantile mortality is always regarded as a test of the sanitary condition of a place. In 1864 there were 1236 deaths in children under the age of one year ; the number of children living at that age may be assumed as 7200, so that of every hundred living at that age, rather more than 17 died. Of every ten thousand persons living at all ages, one hundred and nine children died under five years of age; at the census of 1851, the numbers living under five years of age were in the proportion of 125 to 1000, so that the death-rate amongst children under five years may be assumed as about 87 to every 1000 living at that age. Some parts of the Parish exhibit a higher mortality than others. From the impossibility of ascertaining the present population of different parts, the rate 5 of mortality can only be determined approximately. If the population of the several sub-districts is assumed to have increased since 1861 in the same annual ratio as between 1851 and 1861, and the deaths in the workhouses and hospitals are distributed in the way which I have explained in the note to Table A, the death-rate per thousand varied from 22.2 in Camden Town to 26 9 to Tottenham Court, whilst in Kentish Town the rate was 23.1, in Regent's Park, 24.6, in Somers Town 25.4, and Gray's Inn Road 26.7. (See Table A.) Comparing the number of deaths under five years with the number of births, the sub-districts are ranged in the following order, beginning with the one in which the infantile mortality is lowest—Kentish Town, Regent's Park, Camden Town, Grays Inn Road, Somers Town, and Tottenham Court. (See Table C.) WORKHOUSE. The mortality in this building was very high, the deaths numbering 538. Of these 254 were of persons over 60 years of age, and 77 under 5 years of age. The average mortality in three preceding years was 457. PAUPER SICKNESS. During the year 1864, there were 14944 orders issued for medical relief; this was 108 more than in 1663, and 2546 more than in 1862. The cases were thus distributed amongst the several districts:— North—Mr. JefFerys 2060 „ Mr. Knaggs 340 „ Dr. Thompson 276 North-West—Mr. Claremont 2669 Central—Mr. Sutherin 3336 South-East—Dr. M. Davis 3320 South-West—Dr. Saul 2943 There were sent to the Fever Hospital during the year, 179 cases, of which 126 were cases of Typhus Fever, 30 of which died; 22 were Scarlet Fever; 13 of Typhoid Fever ; and 18 other diseases. Of the cases other than Typhus sent to the Fever Hospital 13 died. There were sent to the Small Pox Hospital by the Parish during the year 45 patients. METEOROLOGY. The mean temperature of the year was 48°.5, which was 0°.8 less than the average of 23 preceding years, and 0o.l more than the average of 93 years. The daily range of temperature was on the average, 16°.4, which was 0°.6 above the mean daily range in 23 years. The degree of moisture was 7°.8 which is 5° below the average. The mean reading of the barometer was 29.806 inches, which was 0.021 above the mean in other years. The rainfall measured 16.7 inches which was 20.1 less than the mean in 47 years. The first quarter of the year was l°.8 colder, the second quarter 0°.8 warmer, the third quarter 0°.5 cooler, and the fourth quarter was l°.3 cooler than the corresponding quarters in 23 previous years. January, February, November and December, were decidedly colder than usual. The mean weekly movement of the air was 1596 miles, which is considerably less than the mean of ten proceding years, 1669.5. 6 It thus appears that the winter was cold, the rainfall was unusually small, and there was much less wind than usual. All these three circumstances had no doubt, an unfavourable influence on the health of London. Other atmospheric influences, which at present we can very imperfectly estimate, were also in operation. In a Table appended to this Report, I have taken some streets and ascertained the number of deaths during the year, comparing this number with the population of the streets. Several of these require special notice. In Midford Place, a court with only eight houses, occupied by about 200 people, mostly Irish, there were 8 deaths, which is a death-rate of 39.4 per thousand; in Holbrook Court, with five houses and 66 people, there were 3 deaths, a rate of mortality equal to 45 per thousand; in Drapers Place, the death-rate per thousand was nearly 32; in Henry Street, Hampstead Road, it was 39; in Pancras Square it was only 14; in Compton Place it was nearly 34; in Poplar Place, 56 ; in Ashby Street, although there has been Typhus Fever epidemic, the deaths were only 8 in a population of 300, or at the rate of nearly 27 per thousand. The death-rate amongst children under five years of age was very high in some of those places, as in Thornley Place, where it was in the proportion of 40 to every thousand persons living ; iu Henry Street, where it was 26.6 per thousand, in Poplar Place where it was 24 per thousand, and Mary Place, 22.5 per thousand. In the Parish at large it was a little less than 11 per thousand. These results show what might be expected, that some streets are much more unhealthy than others ; the statistics of one year in a small population must not be considered as an absolutely reliable gauge of the health of a place ; but when a similar result is obtained year after year, it is then quite fair to regard the rate of mortality as an indication of its sanitary condition. SANITARY WORKS. During the year ending the 31st March, 1865, 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 90 houses. New traps were furnished to 405 drains. The drainage was improved in 97 houses. In 50 houses cesspools were abolished. 75 cesspools were emptied. New pans, traps, and water were supplied to 130 closets. 16 new water closets were erected. Water was laid on to 118 closets. 33 new dust-bins were erected. 21 dust-bins were repaired. The paving of yards or cellars were improved in 97 houses. 103 houses were cleansed and whitewashed. Overcrowding was abated in 15 houses. 7 Pigs were removed from 13 places. Heaps of manure, &c., removed from wharves, mews, &c., in 240 instances. Other nuisances, not above enumerated, were removed to the number of 18. In carrying out these improvements, 4609 inspections were made, 860 visits paid to slaughter-houses, 802 to cow-houses, and the markets visited 441 times. 520 primary notices and 39 final notices were issued. 25 summonses were taken out and heard before the police magistrate, in consequence of notices being neglected. There have been seized and destroyed, as unfit for food, 17 pads of plaice, 4 barrels of sprats, 6 pads of mackerel, two trays of soles, 1 sheep, and 143 rabbits, besides a large quantity of rotten apples, oranges, strawberries, plums, pears, cocoa-nuts, and pine-apples. At the Special Petty Sessions 99 cowsheds were licensed, and 6 applications of dairymen for licenses were refused; 97 slaughter-house licenses were granted, and two applications refused. During the year 4 cow-keepers have been fined for keeping cows in places not licensed for the purpose. The bakehouses have been inspected from time to time. They are kept much cleaner than before the passing of the Act. No infringement of the Bakehouses Regulation Act has been detected. Wherever the bakehouses have been found to require whitewashing, the bakers have at once complied with a notice calling on them to cleanse and whitewash. Owing to their not having been any inspection during the night, nothing positively is known as to the employment of boys within the forbidden hours, or as to men sleeping in the bakehouses. Owing to the illness and death of Inspector "William Timewell, in September last, for three months the work of the Sanitary Department was performed with the help of one inspector only. During the year a new sewer has been constructed by the Vestry in John Street, to a length of 1500 feet, and one in Windmill Street of 300 feet. These streets were previously very badly drained. There are still many streets in the Parish unsupplied with sewers. The main drainage of London is now complete, so far as it concerns this Parish ; it is very important that all the inhabited part of St. Pancras should be able to avail themselves of it. The north part of Kentish Town up to Highgate stands greatly in need of sewerage ; there are, amongst other places, Torriano Avenue, King Street, Queen Street, Little Camden Street, and Warren Street in Camden Town ; in the neighbourhood of the Gas "Works, besides Ashby Street where a sewer has just been ordered, Suffolk Street and several shorter streets are almost without sewerage. It is to be hoped that you will now take into your serious consideration the provision of sewers for such parts as are not already furnished with good ones, the abolition of disused sewers and the covering over of sewers in places where they are left open to the air, as in some of the northern parts of the Parish. Last year there was an unusually high death-rate in London at large, and St. Pancras was one of the districts in which the increase of mortality over that of other years was most marked. A great deal has been done to improve the dwellings of the poor since the passing of the Metropolis Local Manage- 8 merit Act. There arc, however, several things which tend to counteract the benefits arising from those measures. One is that just alluded to, the absencc of proper sewers into which house-drains can discharge their contents. Besides places where there are no sewers, there are others where the sewers are badly constructed, so that the effluvia arising from them into the streets and dwellings are very noxious. The ventilation of sewers is very unsatisfactory, it now takes place either into public roads or into private dwellings. Another obstacle to improvement is the destruction of house'property, and the consequent scarcity of accommodation and increased rent of lodgings for the poor. It is impossible, at present, entirely to prevent overcrowding. The habits of the people again are in some cases so bad, that sanitary improvements are rendered nugatory ; these will only be improved gradually by the progress of education, religious and secular. Those amongst the poor who would like to be cleanly, and bring up their families respectably, have great difficulty in doing so. from the difficulty of finding, at any moderate price, rooms suited for a family. The majority of the poor with families are obliged to occupy only one, or at most two rooms, in houses occupied by several other families, houses constructed for but one family, having but one water supply, one closet, one coal-cellar, and no proper wash-house. The erection of model lodging houses, such as those in the Old Pancras Road, now called Pancras Square, and others newly erected by the Improved Industrial Dwellings Company in the Pancras Road and King's Cross Road, near King's Cross, are steps in the right direction. The rents of such buildings are, unfortunately, too high for many, and the poor often entertain a prejudice against them, owing to the restrictions which it is found necessary to observe in order to maintain their respectability. The Metropolitan Buildings in Pancras Square now pay remarkably well, the mortality in them is much lower than in other places occupied by a similar class of inhabitants. I believe that much good may be accomplished by benevolent men of property buying existing houses, slightly improving their arrangements as regards water supply, privy accommodation, &c., and by the employment of respectable overseers to collect the rents and maintain the property from dilapidations. Capital thus expended might be very usefully applied, and it would yield a moderate per centage of profit. The resolution of the Vestry to establish Baths and Washhouses is one on which the Parish is to be congratulated. These establishments cannot fail to improve the habits of the people by encouraging the practice of cleanliness ; they will also tend to benefit their health. Public washhouses are an immense boon in London to all respectable mothers of families amongst the poor. "Without them it is almost impossible for them to wash their linen, and at the same time keep their dwelling-room fit for themselves, their husbands, and children to live in; in cases of illness this must be especially true. A very natural consequence is that the men are driven away from home to the beer shop, spending there money which ought to be spent on food or clothing for the family, or invested in a Savings Bank or Provident Society, to provide for time of illness or want of work. The improvidence of the poor is most lamentable; it is a matter of some doubt whether our system of Poor Law relief, and the tendency to multiply charities without discrimination, do not tend to perpetuate the evil. Philanthropy in the present day should be directed towards helping the people to help themselves, and teaching them to exercise prudence in regard to pecuniary and domestic matters. The opening of Post Office Savings Banks and the Government Annuity scheme, are measures of which the poor should be urged to avail themselves. 9 The rapid increase in the population of this parish, together with the new labours thrown upon the sanitary department, since all the slaughterhouses, cowhouses, and bakehouses have been placed under the supervision of the sanitary officers, render systematic house-to-house visitations impossible, with the existing staff. Their time is fully occupied in investigating places formally complained of, in inspecting slaughterhouses, cowhouses, bakehouses, mews, wharves, &c., in inspecting houses where epidemic sickness is known to prevail, in taking legal proceedings for the abatement of nuisances thus detected, and in visiting the markets, butchers' shops and sausage-makers to seize articles unfit for food. All houses in which nearly every room is occupied by a separate family, should be inspected once, if not twice, in every year, and should be placed under the same kind of regulations that are in force in common lodging houses. It is only in this way that epidemic infectious diseases can be checked in places, such as Drapers Place, Ashby Street, Henry Street, Mary Place, Gresse Street, Midford Place, &c. Such an inspection would of itself more than occupy the whole time of one Inspector in this Parish. Appended to this Report are the various Statistical Tables referred to above. I have the honour to remain, Gentlemen, Your obedient Servant, THOMAS HILLIER. [ Table I. J Shewing the causes of Death at different Ages during the year 1864. CAUSES OF DEATH MALES AND FEMALES. At all Ages. Ages at Death. Under 1 year. 1 2 3 4 5— 10— 15— 26— 35— 45— 55— 65— 75— 85— 95— DoubtIfhl Age. I.—1. Small Pox 14 6 4 1 ... ... 1 1 ... 1 Measles 140 23 65 22 18 6 5 ... 1 Scarlatina 232 14 26 37 49 34 57 8 4 2 1 Diphtheria 64 5 8 13 9 8 15 2 1 2 1 Quinsy 2 1 ... 1 ... Croup 67 8 16 14 8 2 9 Whooping Cough 162 53 54 23 16 6 8 2 Typhus 125 6 6 5 6 9 17 14 10 10 9 16 6 9 4 Erysipelas 44 12 2 ... 1 1 ... ... 1 2 3 7 8 6 ... 1 Metria 28 ... ... ... ... ... ... ... 7 15 6 Carbuncle 3 ... ... ... ... ... ... ... 1 ... ... ... 1 1 Influenza 5 ... ... ... ... ... ... ... ... ... ... ... 2 ... 3 Dysentery 13 6 ... 3 ... ... ... ... ... ... 1 2 ... 1 Diarrhoea 171 119 21 4 1 ... 3 ... ... ... 2 2 6 6 7 Cholera 5 ... 1 ... ... ... ... ... ... 1 2 1 ... 1 Ague 1 ... ... ... ... ... ... ... ... ... 1 Remittent Fever 4 2 1 ... ... 1 Rheumatism 30 ... ... ... ... ... 2 6 2 6 5 6 1 3 2. Syphilis 37 25 3 ... ... ... ... ... 2 3 4 Stricture of Urethra 2 ... ... ... ... ... ... ... 1 ... ... ... 1 3. Want of Breast Milk 11 11 Purpura and Scurvy 1 ... ... ... ... ... ... ... ... 1 Delirium Tremens 14 ... ... ... ... ... ... ... ... 4 3 6 1 Intemperance 3 ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 4. Thrush 15 15 II.-l. Gout 8 ... ... ... ... ... ... ... ... ... 1 2 2 3 2 Dropsy 31 3 1 1 1 1 ... ... 1 ... 3 2 5 6 5 2 Cancer 123 1 ... 1 1 ... 1 ... 5 5 20 31 25 25 6 Noma 2 ... 1 ... ... ... 1 Mortification 12 2 ... ... ... ... 1 ... ... ... 2 2 1 2 2 2. Scrofula and Rickets 30 6 6 3 1 ... 4 ... 3 2 2 Tables Mcsenterica. 74 40 20 6 1 3 2 ... ... 1 Phthisis 633 22 13 4 5 3 13 14 133 137 156 81 36 13 3 Hydrocephalus 129 45 40 13 11 6 6 3 1 2 1 1 III.-1. Cephalitis 62 11 6 3 2 2 6 3 2 1 1 11 6 5 3 3 Apoplexy 172 10 8 3 3 1 1 1 3 7 14 25 26 43 24 2 Paralysis 66 ... ... 1 ... ... ... 1 ... 2 6 10 16 15 14 1 Insanity 2 ... ... 1 ... ... ... ... ... 1 Chorea 1 ... ... ... ... ... ... ... ... ... ... ... 1 Epilepsy 18 ... ... ... 1 ... ... 2 2 4 2 5 1 1 Convulsions 157 110 26 11 4 1 4 1 2 Brain Diseases 57 7 4 2 3 2 3 ... 1 5 4 8 8 7 1 2. Pericarditis 5 ... ... ... ... ... ... ... 1 2 1 1 Aneurism 9 ... ... ... ... ... ... ... 1 ... 4 2 ... 1 1 Heart Diseases 215 "i 1 1 1 2 10 10 12 31 45 42 45 12 3. Laryngitis & Laryngismus Stridulus. 30 9 12 2 4 ... 2 ... ... 1 ... 5 Bronchitis 645 108 60 28 12 1 6 3 5 13 29 56 115 128 76 Pleurisy 17 ... 1 ... ... ... ... 1 2 3 2 2 3 2 Pneumonia 312 125 51 31 9 3 8 1 7 16 15 14 14 14 4 Asthma 37 ... ... ... ... ... ... ... ... ... 4 8 13 7 5 Lung Diseases 13 ... ... ... ... ... ... ... 2 1 2 2 3 2 1 4. Gastritis 11 2 ... ... ... ... 1 ... ... 1 1 1 2 2 1 Enteritis 28 14 2 1 ... ... 1 ... ... 2 1 ... 4 2 1 Peritonitis 29 5 ... ... ... ... 2 ... 3 6 5 3 ... 1 3 Ascites 4 ... ... ... ... ... ... ... ... ... ... 1 1 1 1 Ulceration of Intestines 12 ... ... ... ... ... ... ... ... 1 1 6 3 ... 1 Hernia 18 ... ... ... ... ... ... ... 2 1 ... 3 5 2 5 [Table I—continued.] Shewing the causes of Death at different Ages during the year 1864. 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— Doubt- ful Age. Ileus 5 .. .. .. .. .. 1 .. .. 3 .. .. .. 2 Intussusception 2 .. .. .. .. .. .. .. .. 1 Stricture of Intestines 6 .. .. .. .. .. .. .. .. 1 1 2 1 Stomach Diseases 19 3 .. .. .. 1 .. .. .. .. 2 .. 8 6 Hepatitis 14 .. .. .. .. .. .. .. .. 3 6 .. 2 3 Jaundice 10 7 .. .. .. .. .. 1 .. .. .. .. 1 1 Liver Diseases 53 .. .. .. .. .. 1 2 .. 3 16 14 7 9 1 Spleen Diseases 1 .. 1 5. Nephritis 3 .. .. .. .. .. .. .. .. 1 1 .. 1 Ischuria 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Nephria 37 .. .. 1 1 .. 2 1 5 2 5 10 8 2 Diabetes 5 .. .. .. .. .. .. .. 1 1 1 1 1 Stone 3 .. .. .. .. .. 1 .. .. 1 1 Cystitis 2 .. .. .. .. .. .. .. .. .. 1 1 Kidney Diseases 20 .. .. .. .. .. .. .. 1 1 2 4 3 4 3 2 6. Ovarian Dropsy 9 .. .. .. .. .. .. .. .. 3 1 1 1 2 1 Uterine Diseases 6 .. .. .. .. .. .. .. 1 .. 1 3 7. Joint Diseases 14 .. .. .. .. .. 1 .. .. 2 2 3 3 2 1 8. Abscess 24 8 .. 2 .. 1 1 .. 3 2 1 1 1 1 1 Ulcer 2 .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Skin Diseases 1 1 IV— 1. Premature Birth 97 97 Cyanosis 11 11 Spina Bifida 4 4 Other malformations 12 11 .. .. .. .. .. 1 Teething 47 20 26 1 2. Childbirth 24 .. .. .. .. .. .. .. 1 7 16 3. Old Age 267 .. .. .. .. .. .. .. .. .. .. 4 20 83 121 36 3 4. Atrophy & Debility 213 179 19 8 2 3 2 V.-l. (Accident or Negligence.) Fractures and Contusions 90 2 2 2 .. 1 8 5 9 12 14 14 9 9 2 1 Cuts and Stabs 7 .. .. .. .. 1 .. 1 1 .. 1 .. 2 .. 1 Burns and Scalds 35 .. 6 5 5 4 6 3 2 1 1 .. .. 1 1 Poison 1 .. .. .. 1 Drowning 5 .. .. .. .. .. 4 .. .. .. 1 Suffocation 46 38 3 1 1 .. 1 .. .. 1 1 .. 1 Other violence 7 5 .. .. .. .. .. .. .. .. 1 .. 1 2. Murder and Manslaughter 14 11 .. .. .. .. .. .. .. 2 1 3. (Suicidal.) Gun-shot Wounds 2 .. .. .. .. .. .. .. .. 1 .. 1 Cuts and Stabs 4 .. .. .. .. .. .. .. 1 2 .. .. 1 Poison 5 .. .. .. .. .. .. .. .. 1 1 1 1 1 Drowning 2 .. .. .. .. .. .. .. .. .. 2 Hanging 5 .. .. .. .. .. .. .. .. 1 .. 1 2 .. 1 Other violence 2 .. .. .. .. .. .. .. .. .. .. .. 1 1 Other violent deaths (not classed) 1 1 Cause not specified, or ill-defined 27 11 2 1 .. .. .. .. 1 .. 3 4 2 3 Total 5308 1236 517 255 176 101 209 87 240 325 130 119 137 186 319 58 4 [ Table II. ] FIRST OR WINTER QUARTER, 1864. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Thirteen Weeks ending 2nd April, 1804. 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.[###/] M. F. M.&F. M. F. M.&F. Regent's Park 427 34927 148 139 287 102 120 222 85 57 1 1 .. 16 1 8 Tottenham Court 145 28348 118 107 225 102 85 187 76 50 .. 4 3 1 7 3 1 University College Hospital 24 26 60 1 8 Strand Union 20 25 45 .. 29 Gray's Inn Road 155 27807 115 124 2391 81 102 183 79 39 .. 3 10 •• 11 3 6 Royal Free Hospital 16 8 24 1 1 Somers Town 184 39096 185 175 360 142 142 284 135 61 .. 11 17 6 11 1 5 Camden Town 171 23406 129 131 260 58 77 135 49 40 .. 6 8 •• 9 2 6 Saint Pancras Workhouse 73 105 178 24 93 Kentish Town 1634 44298 245 229 474 144 163 307 135 73 2 2 22 3 15 1 5 Totals 2716 198784 940 905 1845 772 853 1625 585 451 2 27 61 10 69 11 31 [ Table III. ] SECOND OR SPRING QUARTER, 1864. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Thirteen Weeks ending the 2nd July, 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.[###/] M. F. M.&F. M. F. M.&F. Regent's Park 427 34927 142 130 272 85 89 174 84 29 .. 2 8 1 9 3 7 Tottenham Court 145 28348 116 102 218 79 55 134 71 26 .. 2 10 6 4 6 3 University College Hospital 45 25 70 6 7 Strand Union 16 17 33 3 12 Gray's Inn Road 155 27807 101 131 232 110 74 184 102 24 33 3 1 4 2 6 Royal Free Hospital 13 18 31 2 2 Somers Town 184 39096 171 174 345 102 89 191 99 34 •• 7 8 3 8 10 5 Camden Town 171 23406 138 117 255 54 42 96 53 14 .. 3 7 4 6 2 2 Saint Pancras Workhouse 59 63 124 16 56 Kentish Town 1634 44298 219 233 452 93 109 202 81 36 6 4 8 3 8 4 4 Totals 2716 198784 887 887 1774 656 583 1239 537 240 6 51 44 18 39 27 27 [ Table IV. ] THIRD OR SUMMER QUARTER, 1864. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Thirteen Weeks ending the 1st October, 1864. LOCALITIES. Area in Acre3. 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.[###/] M. F. M.&F. M. F. M.&F. Regent's Park 427 34957 162 140 302 72 77 149 72 22 4 11 .1 4 13 8 Tottenham Court 145 28318 106 96 2021 73 69 142 84 14 .. 4 16 1 3 23 7 University College Hospital 22 14 36 1 2 Strand Union 18 10 28 3 12 Gray's Inn Road 155 27807 123 108 2311 63 64 127 65 19 4 3 2 3 16 2 Royal Free Hospital 11 12 23 4 2 Somers Town 184 39096 187 138 325 77 85 162 89 19 .. 7 5 4 1 32 3 Camden Town 171 23406 121 114 235 49 63 112 56 10 .. 10 7 2 5 13 3 Saint Pancras Workhouse 46 64 110 19 50 Kentish Town 1634 44298 273 258 531 120 133 253 146 32 3 3 10 6 4 29 7 Totals 2716 198784 972 854 1826 551 594 1142 539 182 3 32 52 16 20 126 30 [ Table V. ] FOURTH OR AUTUMN QUARTER, 1864. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Thirteen Weeks ending 31st December, 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 CO years of age. From Small Pox. From Measles. From Scarlatina. From Diphtheria. From Hooping Cough From Diarrhoea. From Typhus, Typhoid, and Relapsing Fevers.[###/] M. F. SI. & F. M. F. M.&F. Regent's Park 427 34927 158 139 297 91 108 199 90 27 .. 1 16 4 .. 5 5 Tottenham Court 145 28348 120 93 213 71 109 180 82 37 1 8 12 4 9 •• 6 University College Hospital 30 18 48 4 7 Strand Union 18 24 42 10 17 Gray's Inn Road 155 27807 115 122 237 72 80 152 58 31 1 4 5 1 •• 1 3 Royal Free Hospital 9 13 22 2 2 Somers Town 184 39096 158 183 341 122 112 234 151 34 .. 13 16 1 9 .. 8 Camden Town 171 23406 107 134 241 72 74 146 83 24 .. 6 14 7 3 9 Saint Pancras Workhouse 57 69 126 18 55 Kentish Town 1634 44298 229 232 461 116 144 260 129 42 1 2 10 5 10 1 9 Totals 2716 198784 887 903 1790 658 751 1409 627 276 3 34 73 15 35 10 38 [ Table VI. ] TOTALS OF THE FOUR QUARTERS, 1864. Register of Births and Deaths in the Sub-Districts and Public Institutions, for the Fifty-two Weeks ending the 31st December, 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.[###/] m. F. M.&F. M. F. M.&F. Regent's Park 427 34927 610 548 1158 350 394 744 331 135 .. 8 36 6 29 22 28 Tottenham Court 145 28348 460 398 858 325 318 643 313 127 1 18 41 12 23 32 17 University College Hospital 133 83 216 12 24 Strand Union 70 76 146 16 70 Gray's Inn Road 155 27807 454 485 939 326 320 646 304 113 1 44 21 4 18 22 17 Royal Free Hospital 49 51 100 9 7 Somers Town 184 39096 701 670 1371 443 428 871 474 148 .. 38 46 14 29 43 21 Camden Town 171 23406 495 496 991 233 256 489 241 88 .. 25 36 6 27 20 20 Saint Pancras Workhouse 235 303 538 77 254 Kentish Town 1634 44298 966 952 1918 473 549 1022 491 183 12 11 50 17 37 35 25 Totals 2716 198784 3686 3549 7235 2637 2778 5415 2268 1149 14 144 230 59 163 174 128 17 [ Table A. ] Names of Sub-Districts. Deaths registered in 1864. Estimated Mortality in 1864 * Rate of Mortality to every 1000. Regent's Park 744 885 24.6 Tottenham Court 643 758 26.9† Gray's Inn Road 646 756 26.7 Somers Town 871 1027 25.4 Camden Town 489 604 22.2 Kentish Town 1022 1239 23.1 University College Hospital 216 Royal Free Hospital 100 St. Pancras Workhouse 538 Strand Union 146 The whole Parish 5415 6952 * This column is calculated by excluding the deaths which occurred in the Strand Union, and distributing the deaths in University College Hospital, Royal Free Hospital, and St. Pancras Workhouse amongst the Sub-Districts in the proportion of their populations, † In estimating this, the number 500 has been subtracted for the Strand Union. § The number 1600 has been subtracted for the Workhouse, [ Table B. ] Names of Sub-Districts. Population in 1861. Rate of increase per cent. per annum between 1851 & 1861. Estimated Population, April, 1864 * Regent's Park 34927 0.9 35878 Tottenham Court 28348 0.3 28603 Gray's Inn Road 27807 0.48 28208 Somers Town 39096 0.93 40296 Camden Town 23406 1.03 28769 Kentish Town 44298 6.6 53660 The whole Parish 198784 1.75 †209399 * This column is calculated on the assumption that the populations of the several Sub-Districts have increased since 1861 in the same proportion per annum as they did in the years between 1851 and 1861. These numbers are, of course, only approximative. The estimate for Camden Town is probably much too high, especially from the removal of houses in Agar Town, and the discontinuance of building, † This number is less than the sum of the other numbers. [ Table C. ] Names of Sub-Districts. Ratio of Births to Deaths estimated. Ratio of Births to Deaths under 5 years. Regent's Park 1000:764 1000:286 Tottenham Court 1000:883 1000:387† Gray's Inn Road 1000:805 1000:324 Somers Town 1000:749 1000:344 Camden Town 1000:763* 1000:305 Kentish Town 1000:646 1000:256 The whole Parish 1000:728 1000:313 * A deduction of 200 for children born in the Workhouse. † A deduction of 50 has been made for births in the Strand Union Workhouse. [TABLE D.] No. of Houses. Population. No. of deaths in 1864. Death-rate per 1000 in 1864. Death-rate under 5 years to every 1000 living at all ages. Death-rate under 5 years to every 1000 living at that age. Drapers Place 32 663 21* 31.6 15.1 Gresse Street 36 676 26† 38.4 19.2 141 Midford Place 8 203 8†† 39.4 22 125 Tottenham Place and Upper Place 33 754 12§ 15.9 7.8 714 New Inn Yard n 79 2 25.3 0 0 Holborn Court 5 66 3 45.4 15.1 91 Eden Street 13 230 6 26.1 13.0 Henry Street 60 900 35 39.0 26.6 172 Mary Place 19 310 8 25.1 22.5 194 Pancras Square 110 650 9 14 9.1 Little George Street, Hampstead Road 56 725 11 15.1 12.4 Compton Place 19 296 10 33.9 20.2 Cromer Street 115 1540 33 21.4 14.2 James Street 18 294 8 27.2 17.0 Poplar Place 11 125 7 56.0 24.0 Speedy Place 23 123 3 24.4 8.0 "Wilson Place 13 181 2 11 11.0 Wellington Square 18 260 5 19.2 14.0 Ashby Street 23 300 26.7 13.3 Thornley Place 17 98 5** 51.0 40.0 * Of these, 3 were at the Fever Hospital, 10 were under 5 years of age, 8 were from Zymotic diseases, † Of these, 1 was at the Fever Hospital, 6 were under 1 year, 6 between 1 and 2, and 2 between 2 and 3 years of age; only one from Zymotic disease. § Of these, 1 was at the Fever Hospital, 6 were under 5 years of age, 7 from Zymotic disease. †† Five were under 5 years of age, 4 were from Zymotic diseases. † One of these was in the Fever Hospital. **Of these 4 were under 5 years. Henry Mitchener, Printer, 26, Eversholt Street, Oakley Square, N.W.