STAPN 42 THIRTIETH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH ON THE Sanitry Condition of Saint Pancras, MIDDLESEX. REPORT FOR THE YEAR 1885, BY JOHN F. J. SYKES, Medical Officer of Health to the Parish of St. Pancras, Bachelor of Science (Public Health), Bachelor of Medicine, Lecturer and Examiner at the Parses Museum of Hygiene and Sanitary Institute of Great Britain. St. Panrras, Middlesex. THIRTIETH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, Being the Report for the Year 1885. TO THE VESTRY OF ST. PANCRAS. Gentlemen, In presenting to you my first annual Report as your Medical Officer of Health, I have the honour of recording the lowest death-rate in the annals of St. Pancras, but I have laboured under some disadvantage in not entering into my duties until the middle of the second quarter of the year 1885. This Report follows on the lines of previous Reports in order to maintain their consecutiveness, although the condition of the statistics during the transition period has added to the difficulty of my task. POPULATION. In estimating the population of St. Pancras to the middle of the year 1885, the numbers in the annual Reports of my predecessor, since the census of 1881, have assisted me. In the decade, 1871 to 1881, the population increased at the rate of 0.66 per cent., and on this basis the population should have advanced to considerably over 142,000, but with the low birth-rate and the stagnation in building a population of 241,000 may be taken as an accurate estimate, distributed in the following manner:— Sub-registration Districts. Estimated Population. Exclusive of the residents in certain Public Institutions. Regent's Park 89,400 39,880 Tottenham Court Read 27,800 26,870 Gray's Inn Road 80,500 80,850 somers Town 84,500 34,470 Camden Town 17,150 15,800 Kentish. Town 92,250 91,950 Totals 241,000 238,320 The estimates of population in the second column are used 4 for the purpose of calculating the tables, showing the comparative death-rates from various diseases in the several subdistricts. MARRIAGES. The number of marriages celebrated in St. Pancras during 1885 was 2,115. This number is 119, or 5.6 percent. below the average for the preceding ten years, notwithstanding the population, during the same period, has increased by 10,000 persons. BIRTHS. The number of births registered in St. Pancras during 1885 was 7,520. This number is 575, or 11.5 per cent. below the average for the preceding decade, notwithstanding the abovementioned increase of population. The number 7,520 is equal to a rate of 31.2 per 1,000 living, the lowest rate of which I can find record, looking back 80 years. DEATHS. During the 52 weeks of 1885, ending January 2nd, 1886, 4,981 deaths were registered in St. Pancras. By excluding the deaths of non-parishioners dying in St. Pancras, and including the deaths of St. Pancras parishioners dying without the Parish, the corrected number of deaths becomes 4,794, within one of the same number of deaths last year, which consisted of 53 weeks. This, with the increase of population, is equal to a rate of 19.89 per 1,000 living. The death-rate of all London for the year 1885 is 19.7, the lowest on record. It is somewhat surprising that in such a healthy year the death-rate of St. Pancras should be higher than in the years 1883 and 1884, which were respectively 19.72 and 19.55 per 1,000, and that the same death-rate should prevail as in 1882. The explanation is this: The Registrar-General has this year, for the first time, supplied Metropolitan Medical Officers of Health with a quarterly return of the lunatics of each parish dying in extra Metropolitan Asylums. These deaths, numbering 95 in 1885, have not before been added to the annual death-rate, and if subtracted from the 4,794 deaths, so as to bring the numbers into comparison with former years, we obtain a deathrate of 19.50, the lowest death-rate on record in St. Pancras. 5 The following table gives the birth and death-rate in each year since the passing of the Metropolis Local Management Acts. year. Census Population. Births, Birth-rate per 1000. Deaths. Death-rate per 1000. Decennial average annual death-rate re-calculated. 1856 ... 6051 32.3 3857 20.62 ... 1857 ... 6127 33.3 3831 20.23 ... 1858 ... 6347 33.1 4708 24.58 ... 1859 ... 6604 34.0 4415 22.24 ... 1860 ... 6491 33.0 4234 21.56 ... 1861 198788 6831 34.2 4701 23.00 ... 1862 ... 6808 33.5 4539 21.80 ... 1863 ... 7277 34.7 4854 23.28 ... 1864 ... 7235 34.6 5415 26.03 ... 1865 ... 7419 34.6 5220 24.80 23.02 1866 ... 7289 33.4 5251 24.45 ... 1867 ... 7489 34.1 4845 24.25 ... 1868 ... 7729 35.1 4858 22.51 ... 1869 ... 7580 33.7 5942 22.81 ... 1870 ... 7632 31.6 5420 24.15 ... 1871 221455 7538 33.8 5430 25.19 ... 1872 ... 7891 35.1 4930 21.28 ... 1873 ... 8095 35.1 5276 22.32 ... 1874 ... 8010 35.0 4986 21.75 ... 1875 ... 8000 34.5 5401 23.33 23.22 1876 ... 8317 35.7 5019 21.54 ... 1877 ... 8126 34.4 4927 20.88 ... 1878 ... 8249 34.6 5068 21.71 ... 1879 ... 8226 34.2 5189 21.62 ... 1880 ... 8038 34.2 501l 21.32 ... 1881 236209 7943 33.6 5000 21.16 ... 1882 ... 7772 32.6 4730 19.89 ... 1883 ... 7719 32.2 4677 19.55 ... 1881 ... 7905 32.5 4795 19.72 ... 1885 ... 7520 31.2 4794* 19.89 20.79 The figures in the right hand column of the accompanying table are re-calculated on the actual number of deaths occurring in the ten years, and the enumerated population according to the Census in the middle of the decennium, so that the chance of error is reduced to a minimum, and the decennial figures are fairly comparable. If we compare the decennial annual average death-rate for the years 1876 to 1885, when the effects of sanitation are beginning to bear fruit, with the death-rate of the previous decade, we find * Including 95 Parishioners dying in Extra-Metropolitan Lunatic Asylums in former years not added to the number of deaths, if omitted as previously, the death-rate would be 19.50 for 1885. 6 a diminution of 2.43 per 1,00 per annum living, or, in actual, numbers, 5,740 deaths less during the last ten years than would have occurred during the previous ten years. Taking the minimum capitalized value of human life in the United Kingdom, man, woman, and child, at £159 per head ( Vital Statistics. Dr. Farr, page 61;, then, from an economical point of view, the monetary saving of life alone in St, Pancras equals £912,660 in ten years. To attempt to place an economic value upon the amount of sickness saved is more difficult; but it is approximately true that for every person dying annually at least two persons are constantly sick throughout the year, and the maintenance and attendance of the sick probably cost half the produce of their labour in health. ( Vital Statistics, Dr. Farr, page 498.) The ratio of the actual numbers of the sick to the dying is very much greater; but the duration of the temporary periods of sickness in the aggregate amount to 57 persons per 1,000 per annum of the population of England constantly sick during the year (Mulhall's Dictionary of Statistics, page 41.2) when an average death-rate of 22.0 per 1,000 prevailed, and these numbers represent an annual ratio of 2.5 persons constantly sick to one death. Taking Dr. Fair's lower figures, which are well within the mark, then for every death per 1,000 per annum the value of two year's sickness is saved, or on the number of lives saved in the decennium there will be 11,480 years of sickness less. Again, taking the mean duration of life as 43.56 years (MulhalVs Dictionary of Statistics, page 288), which is high for St. Pancras, and therefore reduces the economic saving lower than probable, then 11,480 years of constant sickness will represent the value of 263 lives, which is equal to £ 11,817; and if the cost of maintenance and attendance be half the produce of labour per head which the £159 estimate of Dr. Farr represents, then the total amount saved in sickness will be half as much again, or £62,725 in the ten years, making a total saving in death and sickness of £975,385. If calculated with less allowance for error, and with collateral expenses included, the economic savingeffected by sanitation during the last ten years in St. Pancras would amount to close upon a million of money. AGES AT DEATH. The corrected number of deaths registered under one year of age amounted to 1,158, equal to 153.8 per 1,000 of registered births, or 1.2 above the average of the preceding ten years, and equal to 241.5 per 1,000 of the corrected total of deaths from all causes, or 3.9 below the decennial average. 7 The corrected number of deaths registered under five years of age amounted to 1,853, or a proportion of 386.5 per 1,000 of total deaths, and 18.6 below the average of the preceding ten years. The proportion per 1,000 deaths for London being 411.4 The corrected number of deaths occurring between the ages of 5 and 65 was 2,030, and over 65 years of age there were 911 deaths. PUBLIC INSTITUTIONS. The total number of deaths that took place in Public Institutions in the Parish were 1,420, and 1,175 St. Pancras parishioners died in Public Institutions both within and without the Parish, equal to a proportion of 245.0 per 1,000 of the total deaths, and 13.3 above the 10 years average. DEATHS FROM VARIOUS DISEASES. ZYMOTIC DISEASES. The number of persons dying from the nine principal Zymotic Diseases amounted to 629, the average number during the previous ten years being 769. The proportion per 1,000 deaths from all causes was 130.9, and the proportion per 1,000 of population was 2.6. In London, the proportions were 146.3 and 3.3 respectively. The proportion to 1,000 in St. Pancras for the previous ten years was 154.0. The following table gives the relative proportion of deaths from Zymotic Diseases in the several sub-registration districts, excluding 16 deaths from these diseases that could not be referred to the sub-districts to which they belonged. Sub-registration District!. No. of Deaths. Proportion per 1,000 of Population. Proportion per 1,000 of Total Deaths. Regent's Park 84 2.18 129.6 Tottenham Court Road 48 1.78 94.6 Gray's Inn Road 73 2.40 126.0 Somers Town 79 2.29 111.5 Camden Town 44 2.87 148.7 Kentish Town 288 3.13 176.0 8 SMALL-POX. The deaths caused by this disease, which in 1884 numbered 61, in 1885 numbered 63. The outbreak which commenced in March, 1884, continuing into August, 1885. The proportion per 1,000 deaths from all causes in St. Pancras was 18.1, in all London 16.5; per 1,000 of population in St. Pancras 0.26, in London 0.22. The average annual number of deaths from Small-pox in St. Pancras for the preceding ten years was 48.8, equal to a proportion of 8.7 per 1,000 of the deaths from all causes. The distribution of deaths was as follows, excluding three deaths that could not be assigned to any district. Sub-registration Districts. Vaccinated. Unvaccinated. Not stated. Totals. Regent's Park 1 3 2 6 Tottenham Court Road 1 2 1 4 Gray's Inn Road 0 1 2 3 Somers Town 3 1 1 5 Camden Town 3 1 2 6 Kentish Town 10 15 11 36 339 cases of Small-pox were removed from the Parish into the Hospitals of the Metropolitan Asylums Board during the year 1885. The following tabular statements, kindly supplied by the Vaccination Officers, show the number of children vaccinated from the 1st June, 1884, to the 80th July, 1885. Report for the Six Months ending December, 1884. Registration Sub-Districts comprised in the Vaccination Officer's District. Number of Births returned in the "Birth List Sheets" registered during the six months ended Dec., 1884. "Successfully Vaccinated." Insusceptible. Number of Cases "Dead." Postponement by Medical Certificate. Removal to Districts the Vaccination Officer of which has been duly apprized. Removal to Places unknown, or which cannot be reached; and Cases not having been found. Number of Cases outstanding. 1 Kentish Town 1477 1235 9 152 13 .. 68 2 Regent's Park 565 463 2 50 26 .. 24 3 Camden Town 339 302 .. 18 4 .. 15 4 Somers Town 556 454 1 58 18 .. 25 5 Tottenham Court Road 379 296 .. 45 17 .. 21 6 Gray's Inn Road 478 365 2 57 17 .. 37 Total 3794 3115 14 380 95 .. 190 .. Report for the Six Months ending June, 1885. Registration Sub-Districts comprised in the Vaccination Officer's District. Number of Births returned in the "Birth List Sheets" registered during the six months ended June, 1885. "Successfully Vaccinated." Insusceptible. Number of Cases "Dead." Postponement by Medical Certificate. Removal to Districts the Vaccinaticn Officer of which has been duly apprized. Removal to Places unknown, or which cannot be reached; and Cases not having been found. Number of Cases outstanding. 1 Kentish Town 1479 1262 9 120 20 .. 68 2 Regent's Park 537 450 2 37 14 .. 34 3 Camden Town 355 306 1 23 4 .. 21 4 Somers Town 587 470 .. 54 24 .. 39 5 Tottenham Court Road 373 312 1 34 10 .. 16 6 Gray's Inn Road 480 394 2 46 16 .. 22 Total 3811 3194 15 314 88 .. 200 11 MEASLES. This disease caused 190 deaths, being 101 more than in the previous year. The proportion was 39.6 per 1000 deaths from all causes, and 0.79 per 1000 of population living. In London Measles caused 36.7 in every 1000 deaths from all causes, and 0.72 per 1000 of population living. The following is the distribution of Districts, excluding four deaths which could not be referred to any particular district. Sub-registration Districts. No. of Deaths- Proportion per 1,000 of Population. Proportion per 1,000 of Total Deaths. Eegent's Park 20 0.53 30.8 Tottenham Court road 11 0.26 21.6 Gray's Inn road 15 0.87 25.9 Somers Town 21 0.55 29.6 Camden Town 19 0.48 60.7 Kentish Town 100 2.53 61.1 SCAELET FEVEE. 31 deaths occurred in St. Pancras from Scarlet Fever, or 6.5 per 1000 of deaths from all causes, and 0.13 per 1000 of population, the 10 years' average per 1000 deaths being 25.1; the proportions for London in 1885 being 8.7 per 1000 deaths, and 0.17 per 1000 of population. The following table shows the relative proportions of the disease in the various sub-registration districts. One death could not be referred to any district. Sub-registration Districts. No. of Deaths. Proportion per 1,000 Population. Proportion per 1,000 Total Deaths. Regent's Park 4 0.10 6.1 Tottenham Court Road 2 0.07 3.9 Gray's Inn Road 7 0.23 12.0 Somers Town 2 0.05 2.8 Camden Town 3 0.19 9.5 Kentish Town 12 0.13 7.3 78 cases of Scarlet Fever were removed from the Parish by the Metropolitan Asylums Board into their hospitals during the year. 12 DIPHTHERIA. From this disease 37 deaths took place, or 7.7 per 1000 of the total deaths, and 0.15 per 1000 of population. The proportions in all London being 11.2 and 0.22 respectively. The decennial average in St. Pancras is 8.8 per 1000 deaths. The following table shows the proportion of the deaths from this disease in the various sub-registration districts. Sub-registration Districts. No. of Deaths. Proportion per 1,000 Population. Proportion per 1,000 Total Deaths. Regent's Park 8 0.20 12.3 Tottenham Court Road 6 0.22 11.8 Gray's Inn Road 5 0.15 8.6 Somers Town 7 0.20 9.8 Camden Town 3 0.19 9.5 Kentish Town 8 0.08 4.8 The Metropolitan Asylums Board have not yet decided to remove cases of Diphtheria into their hospitals, but these cases are taken in by the general hospitals. WHOOPING COUGH. There were 144 deaths from this cause, or 30.0 per 1,000 of total deaths, the decennial average being 38.5 per 1,000; per 1,000 of population the proportion is 0.59. In all London, per 1,000 deaths the proportion was 31.2, and per 1,000 of population 0.61. This table shows the distribution of deaths in the sub-registration districts. One death could not be referred to any particular sub-district. Sub-registration Districts. No. of Deaths. Proportion per 1,000 Population. Proportion per 1,000 Total Deaths. Regent's Park 21 0.53 32.4 Tottenham Court Road 7 0.26 13.8 Gray's Inn Road 17 0.56 29.3 Somers Town 10 0.29 14.1 Camden Town 4 0.26 12.7 Kentish Town 84 0.91 51.2 13 TYPHUS FEVER. No deaths occurred in St. Pancras from this disease, but 28 deaths from this disease were registered in London during 1885, equal to 0.3 per 1,000 deaths from all causes. TYPHOID OR ENTERIC FEVER. The deatlis from this disease numbered 37, against a decennial average of 63. The proportion per 1,000 deaths from all causes in 1885 was 7.7, and for the previous ten years the average was 12.6 per 1,000 of population; the proportion was 0.14, the same proportion for London taken as a whole. The following is the proportional distribution in districts, exclusive of one death undistributed. Sub-registration Districts. No. of Deaths. Proportion per 1,000 Population. Proportion per 1,000 Total Deaths. Regent's Park 3 0.07 4.6 Tottenham Court Road 4 0.14 7.8 Gray's Inn Road 7 0.23 12.1 Somers Town 9 0.26 12.7 Camden Town 3 0.19 9.5 Kentish Town 10 0.18 6.1 Seven cases of Enteric Fever were removed by the Metropolitan Asylums Board into hospital, the reason such a small number were removed to Board hospitals is that general hospitals also take these cases in, SIMPLE CONTINUED FEVER. Two deaths from undefined continued fever took place, a proportion of 0. per 1,000 deaths, in London the proportion being 1.3. DIARRHOEA. From diarrhoea the corrected number of deaths was 125, or 26.1 per 1,000 of deaths from all causes, the decennial average was 36.9 per 1,000 of population in 1885, the proportion was 0.51. In all London it was 0.66 per 1,000 of population, and 33.3 per 1,000 of total deaths. 14 The following table gives the proportion for each sub-registration district; six deaths are excluded from inability to place them in any particular district. Sub-registration Districts. No. of Deaths. Proportion per 1,000 of Population. Proportion per 1,000 of Deaths. Regent's Park 22 0.55 33.9 Tottenham Court Road 14 0.52 27.6 Gray's Inn Road 19 0.62 32.8 Somers Town 23 0.66 32.4 Camden Town 6 0.39 19.1 Kentish Town 35 0.38 21.4 PUERPERAL FEVER. This disease caused 15 deaths, or one less than in 1884. The proportion in St. Pancras was 3.1 per 1,000 deaths from all causes; in all London 4.0. The distribution of the deaths was as follows:— Sub-registration Districts. No. of Deaths. Regent's Park 8 Tottenham Court Road 2 Gray's Inn Road 2 Somers Town 6 Camden Town 0 Kentish Town 4 PULMONARY DISEASES. Pulmonary Diseases, other than Phthisis, viz.:—Asthma Bronchitis, Pneumonia, Pleurisy, and other Diseases of the Respiratory System, caused 925 deaths, equal to 3.8 per 1,000 of population, and 192.9 per 1,000 deaths from all causes. In London the proportion per 1,000 of population and per 1,000 of total deaths were respectively 4.1 and 211.0. This table shows the numbers and proportions of deaths from the Pulmonary Diseases, other than Phthisis, occurring in 15 each sub-registration district; 33 deaths could not be assigned to their sub-districts. Sub-registration Districts. No. of Deaths. Proportion Per 1,000 of Population. Proportion per 1,000 of Deaths. Regent's Park 124 3.1 191.3 Tottenham Court Road 109 4.0 214.9 Gray's Inn Road 112 3.6 193.4 Somers Town 178 5.1 251.4 Camden Town 51 3.3 162.9 Kentish Town 318 3.4 194.3 TUBERCULAR DISEASES. 677 deaths occurred from the principal Tubercular Diseases during the year; this number is equal to 2.8 per 1,000 of population and 141.2 per 1,000 of total deaths. In London during the year the proportions were respectively 2.6 per 1,000 of population and 134.9 per 1,000 of total deaths. The following table shows the relative mortality in the various sub-districts, exclusive of 39 deaths which could not be assigned to any particular districts. Sub-registration Districts. No. of Deaths. Proportion per 1,000 Population. Proportion per 1,000 Total Deaths. Regent's Park 104 2.7 160.4 Tottenham Court Road 84 3.1 165.4 Gray's Inn Road 102 3.3 176.1 Somers Town 108 3.1 152.5 Camden Town 54 3.5 172.5 Kentish Town 186 2.0 113.6 WASTING DISEASES OP INFANTS. There were 284 deaths of children under one year of age from Wasting Diseases, equal to 37.7 per 1,000 births and 245.2 per 1,000 of total deaths under one year. 16 The following table shows the proportions of these diseases distributable to the various sub-districts. Sub-registration Districts. No. of Deaths. Proportion per 1.000 of Population Proportion per 1,000 Deaths under one year. Regent's Park 36 0.96 233.7 Tottenham Court Road 31 1.15 231.3 Gray's Inn Road 33 1.08 215.6 Somers Town 39 1.13 214.2 Camden Town 11 0.71 183.3 Kentish Town 117 1.28 272.7 CONVULSIVE DISEASES OF INFANTS. There were 187 deaths of children under one year of age from convulsive diseases, equal to 24.8 per 1,000 births and 161.4 per 1,000 of total deaths under one year. This table shows the relative incidence of deaths from these diseases iu the sub-districts. Sub-registration Districts. No. of Deaths. Proportion per 1.000 of Population. Proportion per 1,000 Deaths under one year. Regent's Park 19 0.48 123.3 Tottenham Court Road 18 0.66 134.3 Gray's Inn Road 22 0.72 143.7 Somers Town 15 0.43 82.4 Camden Town 12 0.78 200.0 Kentish Town 55 0.59 128.4 VIOLENT DEATHS. The corrected number of deaths due to violence was 157, of which 128 occurred from accident or negligence, 6 from homicide and 28 from suicide. Burns and scalds caused 9 deaths, and 40 children under one year were suffocated. These numbers are slightly below the average. 17 UNCERTIFIED DEATHS. The number of uncertified deaths in St. Pancras was 11, an increase of two on the number of 1883 and 1884. This number is in the proportion of 2.2 per 1,000 deaths from all causes, the proportion in all London for 1885 being 11.3. COMPARATIVE MORTALITY OF THE REGISTRATION SUB-DISTRICTS. Taking the figures previously given and arranging them as a comparative statement of the death rates per 1,000 of total death from three classes of diseases prevailing in the various sub-districts we have the following result. Sub-registration Districts. Tubercular Diseases. Pulmonary Diseases. Zymotic Diseases. Regent's Park 2.7 3.1 2.1 Tottenham Court Road 3.1 4.0 1.7 Gray's Inn Road 3.3 3.6 2.4 Somers Town 3.1 5.1 2.2 Camden Town 3.5 3.3 2.8 Kentish Town 2.0 3.4 3.1 And the death rate of infants under one year bear the following proportions to 1,000 births in each sub-district:— Regent's Park 140.6 Tottenham Court Road 188.7 Gray's Inn Road 166.6 Somers Town 159.9 Camden Town 85.3 Kentish Town 145.1 These figures are comparative statements, and do not include all the deaths. The difficulty of obtaining the last addresses of those removed to Public Institutions has prevented a number of deaths being distributed to their respective districts. The subdistrict registrars have latterly endeavoured to supply the addresses of persons dying in other districts than those in which they lived, but yet it will be necessary to obtain more accurately the addresses of all persons dying in the Parish, in order to construct reliable statistical tables for each sub-district. My endeavours at present are directed towards attaining this object; 18 It is of the utmost importance that the mortality statistics of particular districts, and specially of particular areas and streets, should bo of such exactitude as to form accurate guides to the conditions influencing the health of their inhabitants. STATISTICAL TABLES. The tables at the end of this Report are those adopted by the Society of Medical Officers of Health, except Table VII., which is an additional statement, the tables show:— Table I.—The population, number of inhabited houses, marriages, births, and deaths during 1895 aud the ten preceeding years. Table II. —The annual birth-rate, death-rate, death-rate of children, and proportion of deaths in Public Institutions. Table III.—The number of deaths at various ages and from different causes. A summary of the same. Table IV.—The number of deaths at all ages from Zymotic, Pulmonary, and Tubercular Diseases, in the year, and the proportions to 1,000 of population, and to 1,000 deaths from all causes; also the number of deaths of infants under one year of age from Wasting and Convulsive Diseases, aud the proportions to 1,000 births, and to 1,000 deaths under one year. Table V.—The number of deaths from the principal Zymotic diseases in the year and the ten preceeding years, and the proportions of these deaths to the total deaths during the same periods. Table VI.—The Sanitary works carried out in the year 1885. Table VII.—A statement of the Sanitary works carried out in each year from 1874 to 1885 inclusive. METEOROLOGY IN 1885. The mean temperature for the year was 48.6 degrees, or 0.8 degrees below the average of 44 years, and the mean daily range of temperature was 15.7 degrees, or 0.1 below the average. The mean barometric pressure was 29.754 inches, .019 below the average. 24 inches of rain fell during the year, 1.28 inches short of the average. As a whole the year was slightly cooler and drier than the average, but with all favourable to health. NOTIFICATION OF INFECTIOUS DISEASE. The haphazard manner in which cases of Infectious Disease become known to the Sanitary Department is greatly to be regretted. At present no system exists by which Medical Officers can obtain information at all adequate to the needs of control. It is a question which sooner or later will have to be faced. The 19 public must realize the fact that compulsory "protection" from Infectious Disease is in the best interests of the community, and that uncontrolled "free trade" in Infectious Disease is the least desirable form of free trade, or, to put it in other terms, the "liberty of the subject" means the liberty to spread disease broadcast, a cruel liberty worse than license. Appended is a table of the infectious cases that have come to tbe knowledge of the Department during the year 1885. Disease. Total No. of Cases. Removed to Metropolitan Asylums Boards' Hospitals. Removed to* other Infectious Diseases Hospitals. Removed to General Hospitals. Treated at Home. Small Pox 377 339 14 – 24 Scarlet Fever 151 78 4 – 69 Typhoid Fever 43 7 1 7 28 Diphtheria 37 – 1 21 15 Total 608 424 20 28 136 With the exception of Small Pox these cases form only a small proportion of the cases that actually occur in the district. ISOLATION OF INFECTIOUS DISEASE. Of the nine principal Zymotic Diseases, three -viz., Measles, Whooping Cough, and Diarrhoea, are unprovided for; and six —viz., Small Pox, Scarlet Fever, Continued Fever, Typhus Fever, Enteric Fever, and Diphtheria, are isolated where possible by removal to hospital. The last two, if not four, are admitted into general hospitals, and the first five are admitted into the hospitals of the Metropolitan Asylums Board. Sooner or later it is hoped that the last will also be admitted into the Board's Hospitals; and, at the same time, it would be very advisable to exclude all of these diseases from general hospitals. The Asylums Board have resolved to remove all cases of Small-Pox out of London to the Ships, so that the Metropolis will be freo from the risks of treating this disease in the midst of populous areas. Unfortunately this will not apply to the Highgate Small-Pox Hospital on the confines of St, Pancras, Highgate Small Pox Hospital and London Fever Hospital, both in Islington Parish. 20 DISINFECTION. During the year 678 houses have been disinfected, and also the following articles in the disinfecting apparatus, viz.:— Beds 269 Mattresses 95 Pillows 707 Sheets 412 Blankets 604 Counterpanes 287 Carpets 4 Bugs 5 Quilts 9 Articles of wearing apparel 985 SANITABY WORK. In Table VI. will be found a summary of the year's sanitary work. Besides the frequent inspection of slaughter-houses, cow-sheds, bake-houses, and canal boats, 8,471 houses and premises have been inspected, and 13,264 re-inspections have been made, A large amount of work, shown in Table VI., the result of these inspections, has been accomplished. SLAUGHTEB-HOUSES. There are now 38 licensed slaughter-houses in St. Pancras, and during the year they have been kept in cleanly condition, and with due observance of the bye-laws regulating them. COW-SHEDS. There are 48 licensed cow-sheds in the Parish, and they also have been kept in cleanly condition, and the regulations complied with. BAKE-HOUSES. There are 214 bake-houses in the Parish, and they have been inspected twice during the year. With the exception of a very few cases they have been found cleanly, and in compliance with the regulations. CANAL BOATS. Canal boats have from time to time been inspected during the year. It has not been found necessary to prosecute for using any unregistered boat as a dwelling, and no infectious disease has been reported to the Department as occurring on board such boats. 21 DAIRIES AND MILKSHOPS. It is greatly to be regretted that the control of milk storage and distribution in the Parish is not in the hands of your Sanitary Department. Milk, more than any other kind of food, requires great precautions to be taken to prevent its contamination, and places where milk is kept should be under closer and more constant supervision than at present. WATER SUPPLY. During the year a foul surface well, which supplied several households at Highgate, has been closed. With the facilities for obtaining pure water no reason exists for the continued use of shallow wells for domestic water supply. The risks attending the use of such water are still insufficiently appreciated. Especial attention has also been paid to the cleanly condition of cisterns, particularly as a precaution against one fatal Zymotic disease ravaging Europe. Before another year rolls over our heads the whole Parish of St. Pancras will be supplied with water on the constant system, with the exception of a narrow belt of houses contiguous to Regent's Park supplied by the West Middlesex Water Company. Unfortunately the improvement thus effected by the New River Company is accompanied with some heartburning created by the stringent requirements of the Company. Nevertheless a sanitary safeguard of such benefit to St. Pancras should be gratefully welcomed by parishioners who estimate health above all other considerations. DUST REMOVAL. The removal of domestic refuse does not directly form part of the duties of your Sanitary Department, except that it concerns the health of the inhabitants. The method adopted in London generally is scarcely in accordance with the best interests of the public health. OPEN SPACES. During the year the Burial Ground of St. Andrew's has been opened as a public garden and a breathing space for the inhabitants of the closely crowded district of Gray's Inn Road, or No, 8 Ward, and cannot fail to have a beneficial effect. The Burial Ground of St. George's, Bloomsbury, which has now for some time past been maintained as a public garden, fails partly in its purpose from want of easy access. The adjoining Burial Ground of St, George the Martyr might with advantage be thrown into the same open space, and the combined gardens 22 could possibly acquire an eastern entrance in conjunction with the improvements to be effected by the erection of the new Board School on the Wellington Square site. This open space would then become a useful and healthful recreation ground. In the next Ward, No. 7, the Burial Ground adjoining the Whitfield Tabernacle, between Tottenham Court Road and Whitfield Street, is fast becoming a serious nuisance from the accumulation of rubbish cast there, and only partly hidden from public gaze by an unsightly hoarding. This spot should form a pleasant oasis in the desert of houses by which it is surrounded. A movement has also been on foot for adding the Parliament Hill Estate to Hampstead Heath, and devoting it to the open air use of the public instead of to building purposes. It is to be trusted that a movement of such great benefit to St. Pancras will receive strong support, and ultimately prove successful. MORTUARY BUILDINGS AND DISINFECTING APPARATUS. The provision of a mortuary, now in course of erection, both for infectious and for non-infectious cases, will prove a valuable addition to the sanitary requirements of the Parish, although if utilized to the extent that health would demand provision for a score of bodies should prove inadequate for a population of close upon a quarter of a million inhabitants. When once the prejudices of the poorer classes are overcome, experience will be gained of the accommodation necessary. The structure now completing will be a notable landmark in the sanitary progress of St. Pancras. The disinfecting apparatus will also provide in a more efficient manner for the great amount of disinfection necessary in this large parish. The steam process of disinfection has proved successful in various public institutions, but your engineer and architect considered it inapplicable, because of the initial expense, of the skilled labour required, the risks in the use of steam, and the difficulty of drying. The hot air process adopted in its stead is ingenious in its arrangements, and I trust will prove as efficacious in its working. The proposed Coroner's building will allow enquiries into the cause of death to be conducted with greater facilities for medical examination, and with the dignity and the decorum that the cause of justice demands. 23 UNHEALTHY DWELLINGS. The first care of the Sanitary Department must necessarily he the close supervision of the worst class of dwellings. Attention has been specially directed to No. 8 Ward, many blocks of buildings which have been erected in former years, without any consideration except that of covering space and packing them in as closely as possible. There are three such blocks that particularly occur to me, viz:—Brantome Place, backing on to Crescent Mews North; Peace cottages, backing on to Speedy Place, and Brunswick Grove. The latter is a very unhealthy collection of dwellings, and has already been reported. At my last visit little seemed to have been done to improve them. Whitewash and wall-paper are not the sole requirements of a reasonably healthy abode. With regard to single dwellings, I would in conclusion strongly urge upon the Vestry to adopt the bye-laws for "Houses let in Lodgings," a not very happy definition for "tenemented dwellings." In some directions it should prove an economical advantage, in preventing the waste of time of your Inspectors in serving notices on cellar-dwellings already condemned by your Sanitary Committee, which have become re-occupied, in cases of overcrowding when the nuisance recurs after no great interval, and in other cases of recurring nuisances which absorb the time of your Inspectors. In cases where legal proceedings are necessary, they would be much facilitated and a large amount of time would be saved. By working the bye-laws directly under the control of your Sanitary Committee it would act with a powerfully moral effect, inasmuch as it would be necessary to place only the worst form of tenements on the register, a condemnation which conscientious owners would seek to avoid by maintaining the premises in a reasonably healthy condition. It is not at all necessary that a large register should be kept; in fact, it would be well to make merely a tentative effort at first. I strongly commend this to your early attention as tending to improve the efficiency of your Sanitary Department. I have the honour to be, Gentlemen, Your obedient Servant, JOHN F. J. SYKES. Medical Officer of Health. Table I. Showing the Population, Inhabited Houses, Marriages, Births, and Deaths for the year 1885, and 10 years preceding. Gross Numbers. The Year. Estimated Population. Estimated No. of Inhabited Houses. Marriages. Registered Births. Corrected Number of Deaths, Deaths in Public Institutions. Total all Ages. Under One Year. Under Five Years. 1885 241,000 24,576 2,115 7,520 4,794 1,158 1,853 1,175 1884 240,000 25,000 2,288 7,905 4,795 1,224 1,952 1,066 1883 239,000 25,000 2,199 7,719 4,677 1,100 1,772 1,069 1882 237,800 24,850 2,394 7,772 4,730 1,110 1,953 868 1881 236,600 24,701 2,212 7,943 5,000 1,234 2.055 1,047 1880 235,000 24,605 2,083 8,038 5,011 1,286 2,166 1,244 1879 240,000 25,020 2,154 8,226 5,189 1,231 2,100 1,295 1878 238,000 25,800 2,168 8,249 5,063 1,344 2,212 1,095 1877 236,000 25,580 2,235 8,126 4,927 1,169 1,947 1,159 1876 234,000 25,350 2,310 8.317 5,019 1,259 2,001 1,119 1875 231,000 2.5,140 2,289 8,000 5,401 1,272 2,017 1,091 Average of 10 Years, 1875-84 25,205 2,234 8,095 4,981.7 1,222.9 2.017.7 1,105.3 1. Population at Census 1881, 236,209. 2. Average No. of Persons in each house at Census 1881, 9.5. 3. Area of District in acres, 2,672. Table II. Showing the Annual Birth and Death Rate, Death Rates of Children, and Proportion of Deaths in Public Institutions in a thousand Deaths for the Year 1885, and 10 years preceding. The Year. Birth Rate per 1000 of the population. Corrected Death Rate per 1000 of the population. Deaths of Children under 1 year, per 1000 of Registered Births. Deaths of Children under 1 year per 1000 of total deaths. Deaths of Children under 5 years, per 1000 of total deaths. Deaths in Public Institutions, per 1000 of total deaths. 1885 31.2 19.89 153.3 241.5 386.5 245.0 1884 32.5 19.72 154.8 255.2 407.0 222.3 1883 32.2 19.55 142.5 235.1 378.8 228.5 1882 32.6 19.89 142.8 234.6 412.8 183.5 1881 33.6 21.16 155.3 246.8 411.0 209.4 1880 34.2 21.32 159.9 256.6 432.2 248.2 1879 34.2 21.62 149 6 237.2 404.7 249.5 1878 34.6 21.71 162.9 265.1 436.0 216.0 1877 34.4 20.88 143.8 237.2 395.1 235.2 1876 35.7 21.54 151.3 250.8 398 6 222.9 1875 34.5 23.38 159.0 235.5 375.3 201.9 Average of 10 years 1875.1884 33.8 21.07 152.1 245.4 405.1 221.7 Note—All the Death Rates are calculated on the corrected number of Deaths. Table No. III. PARISH OF SAINT PANCRAS. Deaths Registered at several groups of Ages from different causes during the Year 1885. CAUSE OF DEATH. AGES. 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Total under 5 years Total CLASSES. 1. Zymotic Diseases 232 293 50 89 36 27 8 9 12 5 1 525 712 2. Parasitic Diseases 4 — — — — 1 — — — — — 4 5 3. Dietic Diseases 3 — — — 7 9 2 3 2 — — 3 20 4. Constitutional Diseases 113 68 41 79 167 168 159 88 41 10 — 199 952 5. Developmental Diseases 139 3 1 — — 1 — 4 60 139 48 142 395 6. Local Diseases 136 296 78 72 136 165 221 351 353 171 40 732 2319 7. Deaths from Violence 40 13 4 7 15 18 14 22 12 5 1 59 157 8. Ill defined 185 4 2 1 3 5 9 8 9 2 — 189 228 Total 1158 695 176 198 364 394 413 485 489 332 90 1853 4794 Class I.—Zymotic Diseases. Order 1.—Miasmatic. 1 Smallpox. Vaccinated ... ... ... 8 8 3 ... 1 1 ... ... ... 21 2 Unvaccinated 5 2 5 3 3 4 ... ... ... 1 ... 7 23 3 No Statement 3 2 2 3 3 4 ... 1 l ... ... 5 19 4 Measles 36 135 18 1 ... ... ... ... ... ... ... 171 190 5 Scarlet Fever ... 23 8 ... ... ... ... ... ... ... ... 23 31 6 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Whooping Cough 49 93 1 1 ... ... ... ... ... ... ... 142 144 8 Diphtheria 6 19 9 1 ... ... ... 1 1 ... ... 15 37 9 Simple Continued Fever ... 1 1 ... ... ... ... ... ... ... ... 1 2 10 Enteric or Typhoid Fever ... 5 2 13 7 5 3 ... 2 ... ... 5 37 11 Chicken Pox l 1 ... ... 1 ... ... ... ... ... ... 2 3 Order 2.—Diarrhœal 1 Simple Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Diarrhœa, Dysentery 103 11 2 ... ... 2 1 2 2 1 1 111 125 Order 3.—Malarial. 1 Remittent Fever ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Ague ... ... ... ... ... ... ... ... ... ... ... ... ... Order 4 —Zoogenous. 1 Cow pox and Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Other Diseases (e g., Hydrophobia. Glanders) ... ... 2 ... 1 ... ... ... ... ... ... ... 3 Order 5.—Venereal. 1 Syphilis 27 ... ... ... 2 ... 1 ... ... ... ... 27 30 2 Gonorrhœa, Stricture ... ... ... 1 ... ... 1 ... 1 ... ... ... 3 Older 6 — Septic. 1 Erysipelas 2 1 ... 2 2 4 2 3 3 3 ... 3 22 2 Pyæmia, Septicæmia ... ... ... 1 3 1 ... 1 1 ... ... ... 7 3 Puerperal Fever ... ... ... 5 6 4 ... ... ... ... ... ... 15 Class II.—Parasitic Diseases. 1 Thrush, and other Vegetable Parasitic Diseases 4 ... ... ... ... ... ... ... ... ... ... 4 4 2 Worms, Hydatids, and other Animal Parasites ... ... ... ... ... 1 ... ... ... ... ... ... 1 Class III.—Dietic Diseases. 1 Want of Breast Milk, Starvation 3 ... ... ... 1 ... ... ... ... ... ... 3 4 2 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Chronie Alcoholism ... ... ... ... 3 9 2 3 2 ... ... ... 19 4 Delirium Tremers ... ... ... ... 3 ... ... ... ... ... ... ... 3 Class IV.—Constitutional Diseases. 1 Rheumatic Fever, Rheumatism of the Heart ... ... 5 ... 7 1 ... ... ... ... ... ... 13 2 Rheumatism 1 ... ... 3 ... 1 ... 3 2 ... ... 1 10 3 Gout ... ... ... ... ... ... 2 1 5 ... ... ... 8 4 Rickets 4 4 ... ... ... ... ... ... ... ... ... 8 8 5 Cancer, Malignant Disease ... ... ... 1 7 19 41 42 28 7 ... ... 148 6 Tabes Mesenteriea 35 17 5 1 ... ... ... ... ... ... ... 52 58 7 Tubercular Meningitis, Hydrocephalus 25 33 9 ... 1 1 ... ... ... ... ... 58 69 8 Phthisis 8 9 10 65 145 141 103 39 4 1 ... 17 525 9 Other forms of Tuberculosis, Scrofula 36 22 12 3 3 5 5 ... ... ... ... 58 86 10 Purpura, Hæmorrhagic Diathesis 2 ... ... ... ... ... ... ... ... ... ... 2 2 11 Anæmia, Chlorosis, Leucocythæmia.. 2 ... ... ... 1 ... 1 ... 1 ... ... 2 5 12 Diabetes ... ... ... 6 2 ... 4 3 ... 1 ... ... 16 13 Other Constitutional Disease* ... 1 ... ... 1 ... ... ... 1 1 ... 1 4 Class V.—Developmental Diseases. 1 Premature Birth 101 ... ... ... ... ... ... ... ... ... ... 101 101 2 Atelectasis 22 ... ... ... ... ... ... ... ... ... ... 22 22 3 Congenital Malformations 16 3 1 ... ... ... ... ... ... ... ... 19 20 4 Old Age ... ... ... ... ... 1 ... 4 60 139 48 ... 252 CAUSE OF DEATH. AGES. 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Total under 5 years Total Class VI — Local Diseases. 1. Nervous System. 1 Inflammation of Brain or Membranes 55 43 20 3 2 2 4 3 ... ... ... 78 112 2 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... 5 7 18 29 61 82 49 14 ... 268 3 Insanity, General Paralysis of the Insane ... ... 1 ... 9 13 13 15 24 12 4 ... 91 4 Epilepsy ... 2 2 ... 7 5 4 1 3 ... ... 2 30 5 Convulsions 67 23 1 ... 1 ... ... ... ... ... ... 90 92 6 Laryngismus Stridulus (Spasm of Glottis) 13 3 ... ... ... ... ... ... ... ... ... 16 16 7 Disease of Spinal Cord, Paraplegia, Paralysis Agitans 1 ... 1 ... 2 1 1 1 6 ... ... 1 13 8 Other Diseases of Nervous System ... 2 4 2 ... 3 2 1 3 ... ... 2 17 2. Organs of Special Sense. 1 3 ... 1 1 ... ... ... ... ... ... 4 6 3. Circulatory System. 1 Pericarditis ... ... ... ... 1 2 1 1 ... 1 ... ... 6 2 Acute Endocarditis ... ... 2 2 1 ... ... ... ... ... ... ... 5 3 Valvular Diseases of Heart ... ... 6 2 10 5 7 14 9 4 ... ... 57 4 Other Diseases of Heart 2 1 10 12 10 13 25 50 45 15 2 3 195 5 Aneurism ... ... ... 1 2 ... 1 3 ... ... ... ... 7 6 Embolism, Thrombosis ... 1 ... ... 1 1 3 1 1 1 ... 1 9 7 Other Diseases of blood Vessels ... ... ... ... 1 ... 3 2 4 2 ... ... 12 4. Respiratory System. 1 Laryngitis 9 2 1 ... 1 1 2 ... ... ... ... 11 16 2 Croup 6 13 2 ... ... ... ... ... ... ... ... 19 21 3 Emphysema, Asthma ... ... ... 1 2 3 4 12 6 1 ... ... 29 4 Bronchitis 29 109 10 3 10 18 6 97 107 53 14 318 681 5 Pneumonia 31 46 4 5 15 8 12 16 9 7 3 73 119 6 Pleurisy 2 1 2 1 5 5 3 4 3 1 ... 3 27 7 Other Diseases of Respiratory System 6 3 2 1 3 2 5 1 1 ... ... 9 21 5. Digestive System. 1 Dentition 16 21 ... ... ... ... ... ... ... ... ... 37 37 2 Sore Throat, Quinsey ... 1 ... ... ... ... ... ... ... ... ... 1 1 3 Diseases of Stomach 10 3 1 ... 2 ... 3 7 5 2 ... 13 33 4 Enteritis 5 3 1 3 ... 1 2 ... ... ... ... 8 15 5 Obstructive Diseases of Intestine 7 1 1 1 3 1 3 7 7 6 ... 8 17 6 Peritonitis 3 2 1 4 4 3 ... 3 6 1 ... 5 27 7 Ascites ... 2 ... ... 2 2 2 2 1 2 ... 2 13 8 Cirrhosis of Liver ... ... ... ... 2 15 8 8 10 2 ... ... 45 9 Jaundice and other Diseases of Liver 3 2 ... 3 1 4 4 6 3 4 2 5 32 10 Other Diseases of Digestive System 2 3 ... 2 1 ... ... 2 3 2 ... 5 15 6. Lymphatic System. Disease of Lymphatics and Spleen 1 3 ... ... ... ... ... ... ... ... ... 4 4 7. Bronchocele and Addison's Disease ... ... ... 1 ... ... ... ... ... ... ... ... 1 8. Urinary System. 1 Nephritis 1 ... ... 4 3 2 4 3 1 ... ... 1 18 2 Bright's Disease, Albuminuria ... ... ... 5 10 11 15 l6 8 2 ... ... 67 3 Disease of Bladder or of Prostate ... ... ... ... ... ... ... 3 4 2 ... ... 9 4 Other Diseases of the Urinary System 1 ... ... ... ... 1 2 2 ... ... 1 1 7 9. Reproductive System. A—Of Organs of Generation. 1 M ale Organs ... ... ... ... ... ... ... 1 ... ... ... ... 1 2 Female Organs ... ... ... 1 5 2 3 2 ... ... ... ... 13 B—Of Parturition. 3 Abortion, Miscarriage ... ... ... ... 1 3 ... ... ... ... ... ... 4 4 Puerperal Convulsions ... ... ... 1 1 2 ... ... ... ... ... ... 4 5 Placenta prævia, Flooding ... ... ... ... 4 2 ... ... ... ... ... ... 6 6 Other Accidents of Child Birth 1 ... ... 1 4 2 ... ... ... ... ... 1 8 10. Bones and Joints. 1 Caries, Necrosis ... 1 5 1 1 2 ... 1 1 ... ... 1 12 2 Arthritis, Ostitis, Periostitis 1 1 1 ... 1 2 ... ... 1 1 ... 2 8 3 Other Diseases of Bones and Joints ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Integumentary System. 1 Carbuncle. Phlegmon ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Other Diseases of Integumentary System 2 1 ... ... ... ... ... ... ... 1 ... 3 4 Class VII—Violence. 1. Accident or Negligence. 1 Fractures and Contusions 3 4 2 3 7 9 7 13 7 3 1 8 00 2 Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Cut, Stab ... ... ... ... 1 ... ... ... ... ... ... ... 1 4 Burn, Scald ... 4 1 ... ... ... 1 1 1 1 ... 4 9 5 Poison 1 2 ... ... ... 1 1 1 ... ... ... 3 6 6 Drowning ... ... ... ... 1 ... ... ... ... ... ... ... 1 7 Suffocation 40 2 ... ... ... ... ... 1 1 ... ... 42 44 8 Otherwise ... 1 1 ... ... 1 ... 1 2 ... ... 1 6 2. Homicide. 1 Manslaughter ... ... ... 1 ... 2 1 ... ... ... ... ... 4 2 Murder 2 ... ... ... ... ... ... ... ... ... ... 2 2 3. Suicide. 1 Gunshot Wounds ... ... ... 2 ... ... 1 ... ... ... ... ... 3 2 Cut, Stab ... ... ... 1 ... 1 ... 1 1 ... ... ... 4 3 Poison ... ... ... 1 1 1 1 1 ... ... ... ... 5 4 Drowning ... ... ... ... 1 ... ... ... ... ... ... ... 1 5 Hanging ... ... ... ... 1 ... 2 3 ... 1 ... ... 8 6 Otherwise ... ... ... ... 2 ... ... ... ... ... ... ... 2 Class VIII.—Ill-defined Causes. 1 Dropsy 2 ... 1 ... ... ,1 2 2 2 1 ... 2 11 2 Debility, Atrophy, Inanition 180 3 1 1 ... ... 1 ... 1 1 3 183 192 3 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Tumour ... ... ... ... ... 1 1 ... 1 ... ... ... 3 5 Abscess 2 ... ... ... ... ... 1 ... ... ... ... 2 3 6 Hæmorrhage 1 ... ... ... 1 ... ... ... ... ... ... 1 2 7 Sudden Death (cause not ascertained) ... ... ... ... 1 ... 1 1 1 ... ... ... 4 8 Causes not Specified or Ill-defined ... 1 ... ... 1 2 3 2 4 ... ... 1 13 31 SUMMARY OF TABLE III. No. of Deaths. I.—Specific Febrile, or Zymotic Diseases. 1. Miasmatic Diseases 507 2. Diarrhœal „ 125 3. Malarial ,, ... 4. Zoogenous ,, 8 5. Venereal „ 33 6. Sceptic ,, 44 II. Parasitic Diseases 5 III.—Dietic Disease 26 IV.—Constitutional Diseases 952 V.—Developmental Diseases 395 VI.—Local Diseases. 1. Diseases of Nervous System 630 2. Diseases of Organs of Special Sense 6 3. Diseases of Circulatory System 291 4. Diseases of Respiratory System 962 5. Diseases of Digestive System 255 6. Diseases of Lymphatic System 4 7. Diseases of Gland-like Organs of Uncertain Use 1 8. Diseases of Urinary System 101 9. Diseases of Reproductive System 36 (a) Diseases of Organs of Generation 14 (b) Diseases of Parturition 22 10. Diseases of Bones and Joints 20 11. Diseases of Integumentary System 4 VII.—Violence. 1. Accident or Negligence 128 2. Homicide 6 3. Suicide 23 4. Execution ... VIII.—Ill-defined and not Specified Cases 228 Total 4785 32 Table IV. PARISH OF ST. PANCRAS. Showing the number of deaths at all ages in 1885 from certain groups of diseases, and proportions to 1000 of population, and to 1000 deaths from all causes; also the number of deaths of infants under one year of age from other groups of diseases, and proportions to 1000 births and to 1000 deaths from all causes under one year. Division I. Total Deaths. Deaths per 1000 of Population, of all ages. Death per 1000 of Total Deaths at all ages. 1. Principal Zymotic Diseases 629 2.6 181.2 2. Pulmonary Diseases 925 8.8 192.9 8. Principal Tubercular Diseases 677 2.8 141.2 Division II. Infants under One Year. Total Deaths. Deaths per 1000 of Births. Deaths per 1000 of Total Deaths under one year. 4. Wasting Diseases 284 87.7 245.2 5. Convulsive Diseases 187 24.8 161.4 Notes. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Typhus, Enteric (or Typhoid), and Simple Continued Fevers, Diarrhoea, and Cholera. 2. Includes Asthma, Emphysema, Bronchitis, Pneumonia, Pleurisy, and Other diseases of the Respiratory System. 3. Includes Phthisis, Scrofula, Tuberculosis, Rickets, and Tabes Mosenterica. 4. Includes Marasmus, Atrophy, Debility, Want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. Table V. Showing the Number of Deaths from the principal Zymotic Diseases in 1885, and in the 10 years 1875 to 1884. Disease. 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 Annual Average of 10 years, 1875-84. Proportion of Deaths to 1000 Deaths in 10 years, l875-84. Total Deaths in 1885. Proportion of Deaths to 1000 Deaths in 1885. Small-Pox 2 22 129 94 19 18 84 6 3 61 43.8 8.7 63 13.1 Measles 82 117 143 48 129 58 172 130 99 89 106.7 21.4 190 39.1 Scarlet Fever 240 137 89 138 144 156 180 66 61 44 125.5 25.1 31 6.5 Diphtheria 55 38 22 23 25 34 70 51 78 45 44.1 8.8 37 7.7 Whooping Cough 232 198 141 217 154 293 122 288 72 202 191.9 38.5 144 30.0 Typhus Fever 8 5 20 4 4 1 1 •• 2 1 4.6 0.9 . .. Enteric Fever 35 60 58 59 57 43 66 69 132 55 63.4 12.6 37 7.7 Simple Continued Fever 16 7 10 4 5 4 8 •• 2 .. 5.6 1.1 2 0.4 Diarrhœa & Simple Cholera 178 239 155 229 118 204 211 119 162 227 184.2 36.9 125 26.1 Totals 848 823 767 816 655 811 914 729 611 724 769.8 154.0 629 131.2 Totals—London 13,240 12,536 12,232 14,619 12,010 13,735 13,811 13,553 10,801 13,629 13,026 1600 11,647 146.8 Table VI. Report of the Sanitary Work carried out in the year 1885. No. of Complaints received during the year. Inspections. Results of Inspection. House Drains. Privies and W.C.'s. Dust Bins. Water Supply. Miscellaneous. No. of Houses, Promises, Ac., inspected. No. of Re-inspections of Houses. Premises, Ac. Orders issued for Sanitary Amendments of Houses and Premises. Houses, Premises, Ac., Cleansed, Repaired, Whitewashed, Ac. Houses Disinfected after illness of an Infectious Character. Renewed, Repaired, Cleansed, Trapped, Ac. Ventilated. Repaired, Ac. Supplied with Water. New provided. New provided. Repaired. Covered, Ac. Cisterns (new) erected. Cisterns Cleansed, Repaired and Covered. Cistern Overflow Pipes connected with Drains, Ac., abolished. No. of Lodging Houses registered under 35th Section of the "Sanitary Act, 1866," or 90th section of " Public Health Act, 1875." Dust Removal-No. of Communications received and attended to. Removal of Accumulations of Dung, Stagnant Water, Animal and other Refuse. Animals Removed, being improperly kept. Regularly Inspected. Legal Proceedings, i.e., Summonses. Bake-house3. Licensed Cowsheds. Licensed Slaughter-houses. Totals 538 8471 13264 4075 1632 678 1322 Arequirement hitherto in abeyance, but very desirable 729 863 14 100 447 10 185 Water Companies efficiently control these in their own interests. Bye-Laws not in force in St. Pancras. Over this the Sanitary Department has no control. 91 16 214 48 38 107 Table VII.-PARISH OF ST. PANCRAS. Return shewing the Sanitary Work accomplished during the past 10 years. 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 No. of Complaints received during the year 1815 2166 1717 1830 1411 2965 513 506 649 538 No. of Houses, &c., Inspected 2000 3000 3641 3046 3485 6687 4259 10218 9211 8471 No. of Houses, &c, Re-inspected • •• •• •• •• •• •• •• •• 13264 Results of inspection, Orders issued for Sanitary Amendments 1347 1900 1346 1304 888 2469 2600 4840 4557 4075 Houses, &c., Cleansed, Repaired, or Whitewashed 937 1305 768 724 603 1552 578 425 417 1632 Houses Disinfected after Infectious Disease 293 247 423 271 270 872 296 341 690 678 House Drains Renewed, Repaired, Cleansed, Trapped, &c. 794 709 497 486 343 757 383 395 331 1322 Ventilated •• •• •• •• •• •• •• •• •• •• Cesspools abolished •• •• •• 12 9 4 3 7 7 0 Privies and w.c.'s Repaired Cleansed &c. 432 610 234 465 422 506 154 250 250 729 Supplied with Water 288 355 160 316 207 1138 1474 1607 1560 863 New provided •• •• •• •• •• •• •• •• •• 14 Dust-bins—New provided 65 48 42 22 25 72 105 256 221 100 Do. Repaired, Covered, &c. 77 171 131 116 101 254 281 237 289 447 Water Supply. Cisterns—New erected 18 15 9 11 9 22 11 23 31 10 Do. Cleansed, Repaired, and Covered 248 196 141 168 95 235 123 254 260 485 Miscellaneous. Removal of Dung, Stagnant Water, Refuse, &c. 97 102 58 62 45 114 24 35 45 91 Animals Removed, being improperly kept 19 17 24 17 1 16 2 5 19 16 Licensed Cow-sheds Inspected 65 66 66 51 57 56 49 50 49 48 Licensed Slaughter-houses Inspected 3i 59 59 51 50 45 50 40 38 38 Legal Proceedings, i.e., Summonses 59 10 •• 7 27 63 81 60 72 107 Cases of Overcrowding •• 109 35 14 13 20 37 75 202 143 Smoke Nuisance •• •• •• 5 16 23 24 6 11 Paving Defects •• •• •• •• •• •• 29 165 191 Bake-houses inspected •• 196 196 225 225 •• •• •• 211 214