Board of Works, Whitechapel District. WHI 5 52 REPORT on The Sanitry Condition of the WHITECHAPEL DISTRICT, FOR THE THREE MONTHS ENDING MARCH 28, 1857. Read to the Board, May 25th, 1857. m imp rofula as by LONDON: feinted by t. penny, leman street, whitechapel. 1857. REPORT. Gentlemen, During the thirteen weeks that ended on the 28th March, 1857, 669 deaths were registered in the Whitcchapel District. For the corresponding period of last year, 631 deaths were registered. There has been, therefore, an increase of 38, or about 3 weekly, in the number of deaths during the first quarter of the current year, over that of the corresponding quarter of 1850. The deaths from epidemic diseases for the first three months of this year were 117, against 123 for the same period of last year. As regards, therefore, the class of epidemic or preventible diseases, there has been a diminution of 6. Only one case of small pox (the most loathsome, and most easily prevented of all epidemics) was recorded during the quarter recently terminated, whereas 12 cases were recorded in the corresponding quarter of last year. The relative mortality of the several epidemic diseases will be readily seen by referring to the tables of the Causes of Death, Nos. 5 and 13. Diseases of the respiratory organs, excluding phthisis or consumption, (which is usually classed with the scrofulous or tubercular diseases) have been fatal to 121 persons, (51 males, and 70 females), a mortality greater than that from epidemic diseases. Bronchitis was fatal to 47, viz: l9 males, and 28 females,—Pneumonia, or inflammation of the lungs, to 62, viz: 28 males, and 34 females, 50 of which occurred to children under 5 years of age. Asthma, to 2 males, and 8 females. 24 deaths only, out of the 669, were recorded as due to old age, or the natural decay of the vital powers. Inquests were held on 70 persons, 14 of whom died from the effects of burns and scalds, (three of which number lost their lives by being burnt or suffocated in dwelling houses, 2 in Gower's-place, and 1 in Mansell-street) ; 23 from violence of various kinds; 3 from poison ;* and 2 from drowning. In 28 instances the verdict recorded was, either "found dead," or "died by the visitation of God." 130 deaths were attributable to scrofulous diseases, amongst which, we may class convulsions of infants, 18 in number. Disease of the mesenteric glands, (tabes mcsenterica), proved fatal to 20; hydrocephalus, or water on the brain, to 19 ; and and phthisis, or consumption, to 77. How far this large amount of scrofulous disease can be prevented, is a question of the greatest importance, and if our investigations should lead us to discover all the causes of this fatal malady, and enable us to prevent its occurrence, the happiness of many thousand families will be promoted. As I might be considered by many members of the Board, overstepping my duties as the Medical Officer of Health, to discuss all the points of this most important question, I shall merely state my conviction, that the chief cause of scrofula is the want of pure air, which amongst the poor is occasioned, in many instances, by necessity ; and amongst the rich, by ignorance of the laws of health. The overcrowding of workshops, and the want of efficient ventilation of public buildings, are, among others, the causes of mortality arising from tubercular diseases. * One of these cases was from an overdraught of alcohol, not taken with the intention to destroy life; one from laudanum; in the other case the poison is not specified. 4 During the last month, my attention was directed to the condition of a work-room, in Plummer's-row, Fieldgate-street, in which 23 persons were engaged at slop-work. No means whatever were provided to get rid of the foul air of this room ; and instead of each individual having at least 500 cubic feet of air, 112 feet only was the allowance to each worker.* At night several gas-lights were used, which must have added considerably to the poisonous effects of the atmosphere of this room. When I entered this close apartment, I could scarcely breathe, and I requested one of the workwomen to open a window, but on her doing so, the rush of cold air into this heated apartment was so great, that she was obliged almost immediately to close it. The stifling effect of such a contaminated atmosphere cannot be described—it must be felt for any person to have a conception of it. Persons compelled to remain any length of time in such a polluted atmosphere, soon lose their health, and become subjects of scrofulous disease, which disease is frequently transmitted to their children, and is continued through several generations. If the public at large were fully sensible of the importance of ventilation, which means the carrying away the impurities generated and given off by respiration and artificial heat, more efficient means for that purpose would be adopted in every instance, where several persons are assembled in one room. It is frequently but erroneously considered, that holes made in the ceiling, and communicating with the exterior of the building, are sufficient for the purposes of ventilation; but these openings, for the most part, afford inlets only for the cold fresh air, and thus render the apartment, during the winter season, so intolerably cold, that persons remaining in it soon become the victims of disease of the respiratory organs; hence, a cause of large mortality in some public institutions. system of ventilation can be perfect, unless sufficient means are adopted for carrying out of the apartment the air which has been breathed, and the deleterious gases which are generated by artificial heat, and by the admission of a sufficient quantity of pure air. The former, or egress openings, must be placed at the top of the room, commnnicating with a shaft, provided with heat, (a gas light will answer the purpose) so as to occasion a draught or current outwards, and must have a valve to prevent the foul air from passing back into the apartment ; it must also have a cowl or some other covering, to keep out the rain. The latter, or ingress openings for fresh air, must be placed near to the bottom of the room, not along the floor, in consequence of the coldness which is thereby occasioned to the feet, (except in churches, where the fresh air can be admitted along the aisles, which should be covered with hair cloth, so that the air may be admitted in small streams, and become uniformly distributed over the whole building), but just above the skirting board, or at a distance of about two feet from the floor. The admission of the requisite quantities of fresh air could be regulated by a damper. A simple mode of ventilating a building, is by running up a foul air shaft alongside the chimnies, and by making communications into it from every room, by air tubes placed across the ceilings, with openings into the room. The grand object to be attained in effectually ventilating rooms, is to produce a slow but constant movement in the air. Ventilation through open windows is too rapid and sudden, and the inconvenience of this mode is so great, that persons sitting near them, almost * Dimensions of the room:—Height, 8ft., width, 9ft., length, 3ft. 6in. Cubic space of room if entirely empty, 2529ft. Tables, chairs, and slop-work, were in the room, diminishing to some extent the quantity of air. 5 invariably shut them, or move away from them. Rooms warmed by cooked or heated air, are by some persons considered neither healthful nor agreeable, and if the apartment be well warmed by a fire, it is not necessary to introduce it. I am not aware of a single public building in this large district, with the exception of the Model Lodging House, in Albert-street, which is properly ventilated, and I would respectfully call the attention of the Churchwardens and others, holding official positions in the district, to the fact above stated, and urge upon them the propriety, not to say the necessity, of considering the most efficient and economical means of ventilating the churches and other public buildings, over which they have control and management. When only a few persons are assembled together in a large room, the ordinary mode of ventilation by means of doors and windows, may be sufficient; but when rooms are crowded, and gas lights burning, unless other means are used of getting rid of the foul air, and ample provision made for the ingress of fresh, the sense of oppression to many persons exposed to such influence is so great, that injury to their health will be the certain result. The drowsiness and restlessness which are frequently felt in crowded churches, are owing to the inhalation of air which has been breathed, and deteriorated by the combustion of gas. Fourteen deaths only, out of the 669 recorded in your district during the last quarter, were not certified. In the Artillery District, 3 were not certified; in the Spitalfields, 2; in the Whitechapel North, 3; and in the Goodman's-fields, 3. In the Aldgate Registration District, every case of death was certified. It must not, however, be inferred that because nearly all the deaths were certified by qualified medical practitioners, that every case of death occurred while the patient was under their treatment; for it is a common practice among the poor to bring their children, at the last stage of disease, to a qualified medical practitioner, merely for. the purpose of obtaining a certificate of the cause of death, fancying that the child cannot be buried unless such certificate be obtained. The mortality among young children under one year of age, is appalling: nearly one-fifth of the total mortality occurring under that age. Scrofula, and pneumonia (or inflammation of the lungs) are recorded as being the chief causes of death, but when certificates of death are given in the hurried manner which I am informed in many instances is the case, a correct diagnosis cannot be formed. Many eases of hydrocephalus and syphilis are possibly registered under the heads of bronchitis, pneumonia, and other diseases. How to lessen this frightful amount of mortality among infants, is a question well worthy the most serious attention of the community. If the cause of death in all these instances could be seen, the greatest excitement would be occasioned, and the most rigid inquiries instituted, but because this large annual mortality takes place silently, the deaths are considered as being in the course of nature, or in other words, as unavoidable, and the matter creates but little interest. Public health is now becoming a national concern, and I have no doubt that in the course of a few years, remedies will be suggested, and plans carried into execution, whereby the melancholy fact of so many children being born merely to die in the course of a few months, will no longer be recorded. Proceedings were taken, in January last, under the Building Act of 18-14, against the proprietor of a newly established bone-boiling business, and since the date of my last Report, the business has been discontinued. Three persons who carried on this offensive trade, have left the district, since the formation of your board. The following tables will show the work done by the Inspectors of Nuisances, since the period of their appointment, in February, 1856. TABLE I. SUMMARY OF INSPECTIONS made by INSPECTORS OF THE BOARD OF WORKS FOR THE WHITECHAPEL DISTRICT. From February, 1856, to the Quarter ending December 27th, 1856. For the Quarter ending 31st March, 1857. Works in progress but not completed. Number of Nuisances inspected. Number of Houses systematically visited. Number of Nuisances entered in Complaint Book. Number of Summonses taken out. Number of Notices served. Works in progress but not completed. Number of Nuisances inspected. Number of Houses systematically visited. Number of Nuisances entered in Complaint Book. Number of Summonses taken out. Number of Notices served. For defective Drainage For other Nuisances. For defective Drainage. For other Nuisances. Total. 89 3164 499 2385 24 51 496 *1137 2113 1248 1913 1 21 487 * The Inspectors state that the number of Works not completed as shown in the Seventh Column, appears large, and requires explanation. This has arisen from a desire on their part to visit as many Cases of Nuisances as possible, before the hot weather should set in, and therefore primary notices only have been served. During the next Quarter, a small amount of new work will probably be shown in the Eeturn, as the incompleted cases will occupy much of their attention. TABLE I.— continued. NUMBER OP HOUSES VISITED SINCE THE 27th DECEMBER, 1856, WHERE THE UNDERMENTIONED NUISANCES WERE FOUND TO EXIST. OTHER WORKS, &c. Requiring Limewashing and Cleansing. Without Dust Bins. Requiring Repair. Cellars and Yards ill paved. Without Water for domestic use. Inadequate water supply. Cesspools existing within lOOfeet of Sewer. Cesspools and Drain to Sewer. Cesspools not within distance of Sewer. Defective Drainage. Filth in Cellars. Privies in filthy condition. Requiring Water to Soil Pans. Privies in Cellars in an offensive condition. Inadequate Privy accommodation. Offensive Common Privies in Courts. Overflowing Cesspools. Stagnant Water on Premises. Overcrowded Houses. * Houses unfit for human habitation. Privies having Water Supply but without Soil Pans. Defective and Offensive Gullies. Gullies stopped. Accumulation of Filth in open places. Cow-houses and Yards visited. Slaughter-houses visited. Dangerous structures. Offensive Privies. Privies without Soil Pans or Water Supply (with Drains). Dangerous Cellar Flaps and Area Gratings. Works in progress. Works allowed to stand over from various causes. Works done without notice. 191 403 98 235 9 25 494 404 132 192 7 94 680 10 3 61 62 235 9 4 52 148 77 9 13 40 17 680 408 40 1058 79 58 * Filthy and Dirty Houses where Illness very frequently existed. TABLE II. SUMMARY OF WORKS EXECUTED UP TO 27th DECEMBER, 1856. Limewhiting and Cleansing. Dust Bins erected. Houses repaired. Yards and Cellars re-paved. Water supplied for domestic use. Larger supply of Water given. Cesspools abolished. Cesspools removed & Drains connected with Sewers Cesspools cleansed.—No Sewerage. New House Drainage made. House Drainage improved. Cellars cleansed. Filthy Privies cleansed. Water supply to Soil-pans. Filthy Privies in Cellars cleansed, &c. New Privies constructed. Stagnant Water on Premises removed. Over-crowded Houses remedied. Houses unfitted for Human habitation. Defeetive Gullies remedied. Gullies cleansed. Filth in open places removed. Cow-houses and Yards cleansed, &c. Slaugnter-houses improved. Dangerous structures. Other Nuisances removed, Dust, &c. Dangerous Cellar Flaps and Area Gratings. 228 124 145 223 5 15 328 343 230 328 118 63 137 328 66 23 223 *2 None 78 223 17 9 40 ‡6 763 31 SUMMARY OF WORKS EXECUTED FROM DECEMBER 27th, 1856, TO 28th MARCH, 1857. 80 143 60 118 5 5 315 284 132 348 170 7 94 417 10 2 118 *9 †4 148 77 9 13 None †17 420 40 Total. 308 267 205 341 10 20 673 627 362 676 288 70 231 745 76 25 341 11 4 226 300 26 22 40 23 1183 71 * These cases came under the Lodging-house Act, and have been prosecuted by the Police, † Filthy and Dirty Houses where Illness very frequently existed. The Tenants had notice to quit, and the Houses were thoroughly cleansed. ‡ Notice given to Police, who have had the same repaired, and, in some instances, pulled down. TABLE III. Cases of Sickness of the Zymotic and acute classes, which were recorded in the Books of the Medical Officers of the Union for the Three Months that ended on the 28th March, 1857. Districts. Names of Medical Officers. Small Pox. Measles. Scarlatina. Hooping Cough. Diarhœa. Typhus or continued Fever. Erysepilas. Carbuncle Bronchitis and Catarrh pneumonia Croup. Phthisis. Other Diseases. Total. Average number of Fever cases per Week. Spitalfields Mr. Hart 35 3 13 36 99 1 1 254 6 2 9 362 821 Mile End New Town Mr. Champneys 31 6 13 66 3 96 2 273 490 Whitechapel Dr. Payne 2 2 12 69 2 109 12 135 345 Goodman's Fields Mr. Sequeira 5 26 8 35 55 93 8 7 221 31 548 1037 Total 5 94 11 56 116 327 14 8 680 6 2 54 1318 2091 25 TABLE IV. Number of New Cases of Sickness attended by the Medical Officers of the Whitechapel Union during each Week, commencing 3rd January, 1857. Names of Medical Officers. Week ending Jan. 3rd. Jan. 10th. Jan. 17th. Jan. 24th. Jan. 31st. Feb. 7th. Feb. 14th. Feb. 2lst. Feb. 28th. March 7 th March 14th March 21st March 28th Totals. Corresponding Quarter of last Year. Mr. Hart 73 66 71 52 62 59 62 67 78 77 44 58 52 821 824 Mr. Champneys 52 36 36 33 27 43 31 42 42 46 27 39 36 490 558 Dr. Payne 46 21 25 20 20 29 28 30 20 34 28 26 16 343 326 Mr. Sequeira 73 68 76 81 80 100 94 82 65 83 83 82 70 1037 838 I have not attempted to give the result of the cases which came under the care of the Medical Officers of the Union, as they cannot be accurately ascertained. Some of the Patients are, after a longer or shorter time, removed to the Workhouse or Hospitals, and in many instances, they apply for Advice and Medicines at other Charitable Institutions. TABLE V.— Table showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 28th March, 1857. Districts. Small Pox. Measles. Scarlet Fever. Hooping Cough. Diarhœa. Typhus. Total. Grand Total. Grand Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1857 1856 Artillery 0 0 1 0 0 2 6 1 0 0 2 0 9 3 12 4 Spitalfields 0 0 0 4 1 0 0 7 0 0 3 2 4 13 17 12 Mile End New Town 0 0 5 2 0 1 0 2 3 0 10 3 l8 8 26 34 Whitechapel, North 0 0 2 2 1 1 2 5 0 0 5 10 10 18 28 35 Whitechapel Church 0 1 0 0 1 1 1 1 1 0 2 0 5 3 8 7 Goodman's Fields 0 0 1 1 0 0 3 6 0 1 2 0 6 8 14 11 Aldgate 0 0 1 1 1 3 0 0 1 2 2 1 5 7 12 20 1 10 10 4 8 12 22 5 3 26 16 57 60 117 123 1 20 12 34 8 46 117 Deaths from Epidemics tor the corresponding Quarter of last year. 12 4 9 30 4 64 123 TABLE VI.— Table showing the number of Births in each Week in the Whitechapel District, for the Three Months ending on the 28th March, 1857.* Districts. weeks ending Total Males 345 January February March 3 10 17 24 31 7 14 21 28 7 14 21 28 Total Females 372 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. m. F. Artillery 1 3 6 1 1 4 5 2 1 3 3 3 3 4 4 6 2 2 2 3 1 1 2 2 1 2 Spitalfields 5 6 6 8 4 4 3 5 9 3 8 13 2 5 8 8 6 8 4 10 7 5 4 7 3 7 Grand Total 717 Mile End New Town 10 6 4 8 4 4 4 4 8 5 8 7 4 8 6 4 5 3 4 4 10 4 7 7 7 5 Whitechapel, North 5 4 3 8 5 6 5 2 4 5 5 6 5 4 6 9 7 6 3 2 4 7 4 8 3 6 Whitechapel Church 2 1 4 6 1 2 2 3 6 5 2 2 2 1 2 1 1 2 3 0 1 1 5 2 2 2 Total Births for the corresponding Quarter of last year 717. Goodman's Fields 5 6 3 3 2 2 1 3 4 5 2 2 5 6 3 4 5 5 5 1 1 0 3 7 5 10 Aldgate 3 1 5 2 3 5 3 2 4 3 3 6 3 1 2 2 2 0 2 2 3 2 2 2 5 2 Total 31 27 25 36 20 27 23 21 29 29 31 39 24 29 31 28 28 26 23 22 27 20 27 35 26 34 * All the Births which occur in the District, are not Registered. The Parents frequently neglect the duty of Registering the Birth of their Child, being nnder the impression that Baptism is all that is required ; and it sometimes happens that the religious service of Baptism is neglected, when the civil duty of Registration has been performed, and vice versa. TABLE VII Table showing the number of Deaths in each Week in the Whiteehapel District, for the Three Months ending on the 28th March, 1857. Districts. WEEKS ENDING January February March 3 10 17 24 31 7 14 21 28 7 14 21 28 Total Males 334 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Artillery 1 0 3 2 3 1 0 3 2 0 2 2 2 1 1 3 4 3 1 3 0 1 2 0 2 3 Total Females 335 Spitalfields 5 11 2 4 3 2 5 3 3 1 0 2 1 3 1 3 1 4 0 5 2 4 2 8 2 0 Mile End New Town 7 8 7 6 6 4 7 2 11 8 7 2 9 2 6 2 10 2 2 1 7 3 5 4 5 0 Grand Total 669 Whitechapel, North 6 3 3 10 5 11 3 9 3 3 1 8 4 6 2 8 3 2 4 3 4 10 4 1 3 7 Whiteehapel Church 9 7 2 6 4 5 5 4 3 5 5 3 8 4 5 4 4 3 9 6 2 1 4 4 7 3 Goodman's Fields 6 8 3 4 4 3 1 2 4 3 1 4 6 3 4 1 2 3 1 4 4 1 4 0 3 3 Aldgate 2 2 3 1 4 4 5 3 6 3 7 2 3 3 1 1 5 0 1 1 1 2 1 1 2 5 Total Deaths for the corresponding Quarter of 1856, 631. Totals 36 39 22 33 29 30 26 29 32 23 33 23 33 23 20 22 29 17 18 23 20 22 22 30 24 21 75 55 59 55 55 56 56 42 46 41 42 52 45 Inquests 16 4 7 0 4 15 0 3 2 15 5 0 3 Total 70 12 Deaths in the London Hospital for the Three Mouths ending 28th March, 1857. Males, 56. Females, 25. Total, 81. Of this number 36 were non-residents in the Whitechapel District, and 32 were eases of violent death; 13 therefore only properly belonging to thi3 district died of disease in that Institution. TABLE VIII. Ages at Death in the Whitechapel Workhouse. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Unknown Total. 10 4 4 8 9 20 2 1 58* Inquests were held on two of the above recorded cases. TABLE IX. Ages at Death in Christchurch Workhouse. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total. 0 0 2 5 14 11 0 32† Inquests were held on two of the above recorded cases. TABLE X. Ages at Death in the London Hospital. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total. 1 7 5 28 24 13 3 81 TABLE XI. Ages at Death in the Whitechapel District, including those in the above-named Institutions. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total under 5 Grand Total. 117 154 37 102 137 112 10 271 669 * Epidemic diseases were fatal to 12 or about 1 in 5 of the total mortality of the Whitechapel Workhouse. † Fever was fatal to 7, or about 1 in 4 of the total mortality of Christchurch Workhouse 13 Excluding the deaths in the London Hospital, 1 in 6.5 of the total mortality of this district has occurred in the "Workhouses during the last quarter. In calculating the amount of mortality for the Whitechapel District, we must exclude the deaths of the non-residents which occurred in the London Hospital (36), and the deaths which occurred in that institution, and other parts of the district from violence (42), from the total number of deaths. The mortality, therefore, for the quarter ending March 28th, for the Whitechapel District, is 591, or about 45 per week and not 669 as appears from the returns of the local registrars. As some of the residents in the district die in other charitable institutions in London, they must of course be added to the total, which will perhaps raise the mortality to an average of 46 per week. TABLE XII.—Inquests. Districts. No. Found Dead. Natural Death. Burns and Scalds Falls. Fractures, &c. Wounds Poison. Drowning. Artillery 0 Spitalfields 3 2 1 Mile End New Town 13 7 5 1 Whitechapel, North 4 1 1 2 Whitechapel Church 37 2 3 10 4 10 5 3 Goodman's Fields 6 1 2 3 Aldgate 7 2 2 1 2 Total 70 14 13 14 8 10 5 3 2 In five of the cases under the columns of "Found Dead" and "Natural Death,'' the verdicts of the coroner's juries were, that the deaths were occasioned or accelerated by want of nourishment and exposure to cold. One was that of a seaman, aged 18 years, whose death is thus registered, "Natural death, accelerated by exposure to cold, on expulsion from his ship in a state of disease." Two of the cases occurred in the London Hospital, two in the Mile End New Town District, and one in the District of Goodman's Fields. TABLE XIII. Causes of Death at seven periods of life, registered in the Whitechapel District for the Three Months ending 28th March, 1857. Causes of Death Sex. 0 and under 1 1 and under 5 1 5 and under 20. 20 and under 40 40 and under 60. 60 and under 80 80 and upwards. Total under 5. Grand Total Small Pox Males Females 1 1 1 Measles Males 3 6 1 Females 10 19 20 Scarlatina Males 3 1 Females 1 4 2 1 8 12 Hooping Cough Males 4 8 Females 6 16 34 34 Croup Males 1 4 Females 3 8 8 Diarrhœa Males 2 1 1 I Females 1 1 1 4 8 Dysentery Males Females TABLE XIII.— continued. Causes of Death Sex. 0 and under 1 1 and under 5 5 and | under 20. 20and under 40. 40 and under 60 60 and under 80 80 and upwards. Total under 5. Grand Total. Infantile Fever Males. Females. l 1 Typhus Males 5 1 6 6 8 Females 1 3 2 2 5 3 10 22 Erysipelas Males 1 4 Females 1 1 1 Syphilis Males 2 1 1 2 4 Females Noma (or Canker) Males 1 1 Females 1 2 Dropsy Males 2 5 1 Females 2 3 7 2 2 22 Abscess Males 1 Females 1 2 Fistula Males 1 Females 1 Mortification Males 1 1 Females Cancer Males 1 1 Females 1 3 1 7 Scrofula Males 1 Females 1 1 2 Tabes Mesenterica Males 4 7 2 Females 4 3 18 20 Phthisis (or Consumption) Males 1 1 2 12 13 2 Females 3 3 3 21 14 2 8 77 Hydrocephalus Males 3 8 Females 3 5 19 19 Apoplexy Males 3 1 Females 2 6 Paralysis Males 2 2 Females 2 2 4 2 14 Delirium Tremens Males 1 Females 1 Epilepsy Males 1 Females 1 1 Insanity Males 1 Females 1 Convulsions Males 11 3 1 Females 7 2 23 24 Disease of Brain Males 1 1 1 Females 1 1 1 5 Pericarditis Males 1 Females 1 1 2 5 Disease of Heart Males 1 1 4 2 1 14 Females 1 2 3 Laryngitis Males 1 1 2 Females 1 Bronchitis Males 4 1 1 1 9 2 1 Females 2 4 7 15 11 47 Pleuritis Males 3 Females 3 Pneumonia Males 11 15 2 Females 15 15 3 1 56 62 Asthma Males 1 1 Females 1 2 5 10 Teething Males 1 Females 1 1 Gastritis Males 1 Females 1 Enteritis Males 1 1 Females 1 3 Peritonitis Males 1 Females 4 5 TABLE XIII.— continued. Causes of Death Sex. 0 and under 1 1 and under 5. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards Total under 5 Grand Total. Ascites Males 1 1 2 Females Ulceration of Intestine Males Females 1 1 Hernia Males 3 Females 2 5 Ilius Males 1 2 Females 1 1 5 Stricture Intes. Canal Males 1 Females 1 1 Disease of Stomach Males 1 Females 1 Disease of Liver Males 1 1 Females 1 I 4 Diabetes Males 1 Females 1 Cystitis Males I 1 Females 2 Stricture of Urethra Males 1 1 Disease of Kidneys Males 1 1 2 1 6 Females 1 Ovarian Dropsy Females 1 1 Child-birth Females 4 4 Disease of Joints Males 1 1 Privation of Food, &c. Males 4 1 5 Want of Breast Milk Males 2 Females 1 3 3 Poison Males 1 1 1 3 Burns and Scalds Males 5 1 1 Females 3 3 1 8 14 Drowning Males 2 2 Wounds Males 3 3 6 Violence Males 1 6 2 2 Females 1 2 1 2 4 17 Causes not specified Males 3 2 3 6 5 Females 4 1 6 8 6 7 44 Sudden Males 1 3 Females 1 1 1 2 7 Age Males 7 Females 13 4 24 Debility from Premature Birth. Males 7 Females 9 16 16 It is necessary for me to add, that Mr. Coward, since his appointment as Sanitary Inspector, has taken before the Police Magistrate, two persons, engaged in selling putrid fish. In each instance the fish was ordered to be destroyed. Such cases of gross immorality as described by Dr. Letheby in his report to the Commissioners of Sewers for the City of London, have not been found to exist in the Whitechapel District. This is probably in consequence of the vigilance of the police appointed by virtue of the act for the better regulation of common lodging-houses, which act does not extend to the City of London. I have the honor to be, Gentlemen, 15, Great Alie Street, 23rd May, 1857. Your most obedient Servant, JOHN LIDDLE. 53 Board of Works, WHITECHAPEL DISTRICT. REPORT on The Sanitary Condition of the WHITECHAPEL DISTRICT, FOR THE THREE MONTHS ENDING JUNE 27th, 1857. READ TO THE BOARD, JULY 27TH, 1857. LONDON: PRINTED BY MEAD & POWELL, 101, HIGH STREET, WHITECHAPEL, and 6, 7 & 9, Railway Arcade, London Bridge, 1857. REPORT. Gentlemen, It is gratifying to me to be able to report that the rate of mortality in the Whitechapel District has not been greater during the quarter ending on the 27th of June, 1857, than it was for the corresponding quarter of last year— a year remarkable for the favorable state of the public health. 521 deaths were registered in this district for the quarter ending on the 27th June last, and the same number (521)* for the corresponding quarter of last year. Although the actual number of deaths registered in this district is the same, yet, when we take into account the greater mortality in the London Hospital (103 against 69), and refer to the table of the Causes of Death in that institution, and deduct the deaths of the non-residents in the district, the difference in the rate of mortality for the corresponding quarters of 1856 and 1857 is very striking. Diseases of the respiratory organs (lungs, heart, and larynx) have been fatal to 100 persons, 50 of whom were under 5 years of age. Scrofula or tubercular diseases (consumption, hydrocephalus, mesenteric disease, and convulsions of infants) destroyed 134, 64 of whom were children under 5 years of age. The deaths from epidemic diseases were 73, whereas for the corresponding quarter of last year they numbered 91. The deaths from measles increased from 1 to 14; scarlet fever from 6 to 7; hooping cough from 12 to 22; diarrhoea from 5 to 14; while the deaths from typhus fever, a disease which has always been so prevalent and fatal in this district, has diminished from 55 to 16. The saving of expense to the rate-payers by so large a reduction in the rate of mortality from typhus fever is considerable; this disease being of frequent occurrence among the poor; and, from the debilitating effects of which, few when attacked, in cases not fatal, are able to resume work under 5 or 6 weeks, during which time not only is the patient frequently obliged to be supported out of the parochial rates, but when the father of the family is the victim of this disease, the wife and children must also be supported from the same fund. It is important to bear in mind, that on looking at the tables of mortality whenever the death rate from fever is low, the amount of suffering among the poor is diminished, (each fatal case showing 10 or 12 recoveries) and the expenditure of the rates lessened. Not a single death from small pox was registered in your district during the last quarter, neither has any case of that disease been recorded in the books of the Medical Officers of the Union. * In the Quarterly Report just issued of the Registrar General, the mortality for the quarter ending June, is represented as 515. 4 The mortality in the workhouses is also considerably less; the deaths for the quarter ending June, 1856, were 95; and for the same quarter of the current year, 56, showing a difference of 39 in favor of the quarter recently terminated. The cases of death not certified were 14 in number; 4 were uncertified in the Aldgate Registration District; 4 in the Spitalfields; 4 in the Whitechapel, North; 1 in the Mile End New Town; and 1 in the Goodman's Fields. Some of these cases are, however, recorded under the heads of those diseases which were supposed to be the cause of death. The cases "not specified" are such as "found dead," "natural death" "debilitas," under which latter term is recorded the death of a youth, aged 18, in the London Hospital. In the Artillery District, a case of death is thus registered—"natural decay, accelerated by neglect, filth, and imperfect " nutrition." Inquests were held on 57 persons, 7 of whom were cases of suicide, 7 were returned as cases of "natural death:" in 3 cases, the verdict was "found dead," in 1, the verdict was "manslaughter," in .1 case (a female), which I have classed under the head of " Intemperance," the verdict was " accidentally suffocated while "tiding in a cab in a state of intoxication;" 1 inserted in the column headed "Hanging," was a lad, aged 14, "accidentally strangled by his neckerchief being "fixed in the spindle of a crane;" 1 in the column headed "Violence," was a man, aged 39, " accidentally killed from the fall of sugar caused by the breaking of a "sling chain." In the case just recorded, it would have been desirable if the local registrar had stated the premises where the accident occurred. The cases in the column headed " Burns and Scalds," are principally children who were accidentally burnt by their clothes taking fire—an accident which might easily be prevented by parents dressing their children in uninflammable materials. In the same column is recorded the death of a child in consequence of its drinking hot water from a tea kettle. This accident is of frequent occurrence, and arises from the foolish practice of giving cold drink to children out of a tea-pot or tea-kettle; the poor children being unable to discriminate whether the vessel contains hot or cold water. There are 2 cases of suicide by poison, to which I think it right to call your attention, with the view of pointing out the danger to which persons are exposed by the indiscriminate sale of poisons. One of these cases was a woman who poisoned herself by laudanum; the other was a man who, in a temporary state of insanity, took a quantity of arsenic, which he purchased at a druggist's shop in this district. The jury in this instance appended to their verdict a strong condemnation of the druggist, "in selling arsenic contrary to the act." The case in the column headed " Starvation," is a man, aged 45, who at the time of his death resided in North East Passage, St. George's in the East, and evidently registered by mistake in the Aldgate District. The jury, in this instance, recorded the following verdict— "starvation, not having made known his destitution from his eccentric character." I have, of course, excluded this case from the mortality returns of your district. In calculating the mortality for the last quarter I have deducted from the total 5 number 521, the 50 non-residents and the 41 cases of death by violence, 39 of which occurred in the London Hospital, and 2 in the other districts. The cases recorded as "natural death," "found dead," and the cases of suicide, such being the result of disease, are included in the mortality arising from disease proper to this district. The mortality, therefore, for the quarter ending June 27th, was 430 instead of 521. Some addition must be made to this number for persons dying in public institutions in other districts of the metropolis. There has been an increase of 20 in the total number of new cases of sickness attended by the Medical Officers of the Union. More persons have been attacked with diarrhoea; and ague, a disease hitherto of comparatively rare occurrence, appears now to be very prevalent. The work done by the Inspectors of Nuisances will be readily seen by referring to the table No. 1. In addition, however, to the recorded work done by the Inspectors of Nuisances, these officers have visited all the cow-houses in the district, and have prepared a table showing the length, breadth, heighth, and cubic capacity of each cow-house, its condition as regards paving, drainage, ventilation, cleanliness, &c.; the number of cows, the health of the cows, and the state of the yards adjoining the cow-houses; from which report it appears that there are 23 cow proprietors who keep about 287 cows in the district, and that each cow has upon an average about 900 cubic feet of space. Some of the cows are, however, kept in such confined places, that less than 500 cubic feet is all the space that is allowed to each animal. The health of the cows appears to have been generally good. In one instance only did the Inspectors learn that the health of the cows was bad, and in another instance two had lately died. In all the cases when nuisances existed on the premises orders were given for their abatement. Proceedings by indictment were taken against two sugar refiners in the district for carrying on, in an offensive manner and injurious to health, the processof re-burning animal charcoal, and a verdict of "guilty," was recorded against one of the parties, the foreman of the jury adding, "that the nuisance was injurious to health." In t other case the trial is postponed until November next. TABLE I. SUMMARY OF INSPECTIONS. For the Quarter ending 27th June, 1857. Works in progress but not completed. Number of Nuisances inspected. Number of Houses systematically visited. Number of Nuisances entered in Complaint Book. Number of Summonses taken out. Number of Notices served. For defective Drainage. For other Nuisances. 962 908 133 510 4 17 263 TABLE I.— continued. NUMBER OF HOUSES VISITED SINCE THE 28th MARCH, 1857, WHERE THE UNDERMENTIONED NUISANCES WERE FOUND TO EXIST. OTHER WORKS, &c. Requiring Limewashing and Cleansing. Without Dust Bins. Requiring Repair. Cellars and Yards ill paved. Without Water for domestic use. Inadequate water supply. Cesspools existing within 100 feet of Sewer. Cesspools and Drain to Sewer. Cesspools not within distance of Sewer. Defective Drainage. Filth in Cellars. Privies in filthy condition. Requiring Water to Soil Pans. Privies in Cellars in an offensive condition. Inadequate Privy accommodation. Offensive Common Privies in Courts. Overflowing Cesspools. Stagnant Water on Premises. Overcrowded Houses. *Houses unfit for human habitation. Privies having Water Supply but without Soil Pans. Defective and Offensive Gullies. Gullies stopped. Accumulation of Filth in open places. Cow-houses and Yards visited. Slaughter-houses visited. Dangerous structures. Offensive Privies. Privies without Soil Pans or Water Supply (with Drains). Dangerous Cellar Flaps and Area Gratings. Works in progress. Works allowed to stand over from various causes. Works done without notice. 101 120 42 110 4 27 110 130 51 110 110 30 230 8 2 30 3 110 — — 43 60 62 7 11 40 31 230 110 32 962 85 74 * Filthy and Dirty Houses where Illness very frequently existed. TABLE II. SUMMARY OF WORKS EXECUTED UP TO 28th MARCH, 1857 Limewhiting and Cleansing. Dust Bins erected. Houses repaired. Yards and Cellars re-paved. Water supplied for domestic use. Larger supply of Water given. Cesspools abolished. Cesspools removed and Drains connected with Sewers. Cesspools cleansed.—No Sewerage. New House Drainage made. House Drainage improved. Cellars cleansed. Filthy Privies cleansed. Water supply to Soil-pans. Filthy Privies in Cellars cleansed, &c. New Privies constructed. Stagnant Water on Premises removed. Over-crowded Houses remedied. Houses unfitted for Human habitation. Defective Gullies remedied. Gullies cleansed. Filth in open places removed. Cow-houses and Yards cleansed, &c. Slaughter-houses improved. j Dangerous structures. Other Nuisances removed, Dust, &c. Dangerous Cellar Flaps and Area Gratings. 308 267 205 341 10 20 673 627 362 676 288 70 231 745 76 25 341 11* 4† 226 300 26 22 40 23‡ 1183 71 SUMMARY OF WORKS EXECUTED FROM 28th MARCH, TO 30th JUNE, 1857. Total. 200 45 40 125 2 0 137 137 51 137 68 98 38 137 8 4 125 0 0 51 62 7 3 1 31 600 32 508 312 245 466 12 20 810 764 413 813 356 168 269 882 84 29 466 11* 4† 277 362 33 25 41 54‡ 1783 103 * These cases came under the Lodging-house Act, and have been prosccuted by the Police, † Filthy and Dirty Houses where Illness very frequently existed. The Tenants had notice to quit, and the Houses were thoroughly cleansed, ‡ Notice given to Police, who have had the same repaired, and, in some instances, pulled down. TABLE III. Cases of Sickness of the Zymotic and acute classes, which were recorded in the Books of the Medical Officers of the Union for the Three Months that ended on the 27th June, 1857. Districts. Names of Medical Officers. Small Pox. Measles Scarlatina. Hooping Cough. Diarhœa. Typhus or continued Fever. Erysipelas Carbuncle. Puerperal Fever. Ague. Pneumonia and Pleuritis. Bronchitis and Catarrh. Laryngitis. Dysentery. Cholera. Phthisis. Other Diseases. Total. Average number of Fever cases per Week. Spitalfields Mr. Hart - 11 3 14 42 94 1 0 1 13 16 176 0 8 6 12 354 751 Mile End New Town Mr. Champneys — 24 0 5 23 84 0 0 0 6 0 4 0 0 0 5 297 448 Whitechapel Mr. Richardson — 23 1 3 15 30 0 0 0 3 5 52 0 0 0 10 195 337 Goodman's Fields Mr. Sequeira — 39 4 18 28 127 7 7 0 16 11 51 1 2 0 17 659 987 Total — 97 8 40 108 335 8 7 1 38 32 283 1 10 6 44 1505 2523 25 TABLE IV. Number of New Cases of Sickness attended by the Medical Officers of the Whitechapel Union during each Week, commencing 4th April, 1857. Names of Medical Officers. Week ending April 4th. April 11th. April 18th. April 25th. May 2nd. May 9th. May 16th. May 23rd. May 30th. June 6th. June 13th. June 20th. June 27th. Totals. Corresponding Quarter of last Year. Mr. Hart 52 61 63 53 65 61 70 48 54 67 45 58 54 751 2523 855 2433 Mr. Champneys 33 32 29 32 32 41 37 53 33 24 27 34 41 448 479 Mr. Richardson 19 28 25 22 24 30 33 36 23 27 21 22 27 337 300 Mr. Sequeira 86 60 77 75 85 84 77 77 67 81 78 70 70 987 799 I have not attempted to give the result of the cases which came under the care of the Medical Officers of the Union, as they cannot be accurately ascertained. Some of the Patients are, after a longer or shorter time, removed to the Workhouse or Hospitals, and in many instances, they apply for Advice and Medicines at other Charitable Institutions. TABLE V.— Table showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 27th June, 1857. Districts. Small Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhœa. Typhus. Total. Grand Total. Grand Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1857. 1856. Artillery 0 0 2 0 0 0 1 1 0 0 0 0 3 1 4 7 Spitalfields 0 0 0 2 1 0 2 2 2 1 1 0 6 5 11 13 Mile End New Town 0 0 0 0 0 0 1 1 2 2 3 0 6 3 9 25 Whitechapel, North 0 0 5 0 0 0 3 1 0 2 0 4 8 7 15 30 Whitechapel Church 0 0 1 0 0 1 0 2 0 0 4 0 5 3 8 5 Goodman's Fields 0 0 2 0 2 1 2 1 0 1 1 0 7 3 10 4 Aldgate 0 0 1 1 1 1 1 4 4 0 0 3 7 9 16 7 11 3 4 3 10 12 8 6 9 7 42 31 73 91 14 7 22 14 16 73 Deaths from Epidemics for the corresponding Quarter of last year. 12 1 6 12 5 55 91 TABLE VI.—Table showing the number of Births in each Week in the Whitechapel District, for the Three Months ending on the 27th June, 1857.* Districts. WEEKS ENDING. Total Males 376 April. May. June. Total. 4 11 18 25 2 9 16 23 30 6 13 20 27 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Total Females 331 Artillery 53 1 4 1 0 6 5 3 2 2 2 1 3 0 1 5 2 3 0 3 2 1 1 1 2 2 0 Spitalfields 137 4 7 6 6 2 6 10 10 6 2 9 6 3 2 7 3 9 4 7 4 2 2 8 6 3 3 Mile End New Town 126 6 8 3 2 2 6 4 4 1 7 6 10 6 8 9 3 7 4 2 1 4 2 3 5 6 7 Grand Total 707 Whitechapel, North 135 2 6 4 8 6 9 5 5 5 0 6 6 5 4 5 1 4 9 6 2 4 8 6 4 6 9 Whitechapel Church 54 4 3 2 0 3 3 4 2 2 1 2 1 1 0 2 2 1 1 3 3 2 2 4 2 3 1 Goodman's Fields 103 2 6 6 7 7 6 1 1 5 3 5 6 4 4 4 0 2 4 2 3 12 1 4 3 3 2 Total Births for the corresponding Quarter of last year 730. Aldgate 99 3 5 7 5 5 7 8 4 4 2 7 5 1 1 5 1 3 0 3 3 5 3 2 1 5 4 Totals 707 22 39 29 28 31 42 35 28 25 17 36 37 20 20 37 12 29 22 26 18 30 19 28 23 28 26 * All the Births which occur in the District, are not Registered. The Parents frequently neglect the duty of Registering the Birth of their Child, being under the impression that Baptism is all that is required; and it sometimes happens that the religious service of Baptism is neglected, when the civil duty of Kegistration has been performed, and vice versa. TABLE VII. Table showing the number of Deaths in each Week in the Whitechapel District, for the Three Months ending on the 27th Jane, 1857. Districts. WEEKS ENDING. April May June Total. 4 11 18 25 2 9 16 23 30 6 13 20 27 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F M. F. M. F. Total Males 304 Artillery 29 3 1 0 0 1 3 2 1 2 1 2 2 1 0 1 0 0 2 2 0 2 1 0 1 1 0 Spitalfields 71 1 3 2 1 2 2 7 2 3 3 1 4 3 3 3 3 5 4 2 2 2 0 2 1 6 4 Total Females 217 Mile End New Town 80 11 3 4 I 4 1 5 3 5 5 3 1 4 1 4 4 5 2 3 0 0 1 4 1 2 3 Whitechapel, North 103 5 3 4 4 2 4 4 7 4 6 5 7 3 5 4 2 3 2 2 2 5 5 6 3 3 3 Grand Total 521 Whitechapel Church 135 10 5 3 1 3 6 2 1 7 3 14 7 1 0 9 1 6 4 4 1 13 6 13 6 4 5 Goodman's Fields 45 2 7 1 1 0 2 0 2 1 2 2 0 3 0 3 3 0 2 2 1 3 1 1 0 5 1 Aldgate 58 2 1 3 5 1 2 5 0 1 3 2 6 2 4 1 0 3 3 2 0 3 0 3 1 4 1 Non-Residents 50 Totals 34 23 17 13 13 20 25 16 23 23 29 27 17 13 25 13 22 19 17 6 28 14 29 13 25 17 Total Deaths for the corresponding Quarter of 1856, 521. 521 57 30 33 41 46 56 30 38 41 23 42 42 42 Inquests 14 0 0 0 0 18 0 0 0 0 11 8 6 Total 57 Deaths in the London Hospital for the Three Months ending 27th June, 1857. Males, 73. Females, 30. Total 103. Of this number 49 were non-residents in the Whitechapel District, and 39 were cases of violent death. TABLE VIII. Ages of Death in the Whitechapel Workhouse. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total. Corresponding Quarter of 1856. 5 3 2 8 4 9 2 33 51 An Inquest was held on one of the above recorded cases. TABLE IX. Ages at Death in Christchurch Workhouse. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total. Corresponding Quarter of 1856. 0 0 1 5 7 10 0 23 44 An Inquest was held on one of the above recorded cases. TABLE X. Ages at Death in the London Hospital. 0 and under 0 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total. Corresponding Quarter of 1856. 0 7 20 28 33 14 1 103 69 TABLE XI. Ages at Death in the Whitechapel District, including those in the above-named Institutions. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total under 5 Grand Total. 110 103 40 73 113 74 8 213 521 Three cases of Fever, 1 of Child-birth, and 1 of Child-bed fever, died in the Whitechapel Workhouse Three cases of Fever died in Christchurch Workhouse. TABLE XII.— Inquests. Districts. No. Found Dead. Natural Death. Burns and Scalds. Violence Poison Suffocation and Drowning. Hanging. Starvation. Artillery 0 - - - - - - - - Spitalfields 6 2 I 1 1 — 1 — — Mile End New Town 1 — 1 - - - - - - Whitechapel, North 3 1 1 — — — 1 — — Whitechapel Church 43 — 3 12 25 2 — 1 — Goodman's Fields 2 — 1 — — — — 1 — Aldgate 2 — — — 1 — — — 1 Total 57 3 7 13 27 2 2 2 1 TABLE XIII. Causes of Death at seven periods of life, registered in the Whitechapel District for the Three Months ending 27th June, 1857. Causes of Death. 0 and under 1. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Total under 5. Grand Total. Small Pox - - - - - - - - - Measles 4 9 — 1 — — — 13 14 Scarlatina — 6 1 — — — — 6 7 Hooping Cough 7 15 - - - - - 22 22 Croup — 2 - - - - - 2 2 Diarrhœa 9 1 — 1 2 1 — 10 14 Dysentery 1 - - - - - - 1 1 Puerperal Fever - - - 1 - - - - 1 Typhus — — 5 3 7 1 — — 16 Erysipelas — — 1 — 1 1 1 — 4 Syphilis 2 — — 1 — — — 2 3 Rheumatic Fever — — 2 — — — — — 2 Dropsy — 2 — — 5 5 — 2 12 Abscess 1 2 1 — 1 1 — 3 6 Mortification 1 — — 1 1 — — 1 3 Cancer — — — 2 3 2 — — 7 Scrofula — 1 1 — — — — 1 2 Tabes Mesenterica 15 5 — — — — — 20 20 Phthisis (or Consumption) 1 5 6 28 29 4 — 6 73 Hydrocephalus 2 8 2 — — — — 10 12 Apoplexy — — — 1 10 4 1 — 16 Paralysis — — — — 1 1 — — 2 Chorea - - 1 - - - - - 1 Epilepsy - - - 1 - - - - 1 Convulsions 24 3 - - - - - 27 27 Disease of Heart 2 2 2 — — — — 4 6 Pericarditis — — 1 — — — — — 1 Disease of Brain — 1 2 2 3 6 — 1 14 Aneurism - - - - 1 - - - 1 Laryngitis 1 1 1 — — — — 2 3 Bronchitis 3 5 1 2 7 4 — 8 22 Pleuritis — — — — — — — — — Pneumonia 17 21 2 2 5 — — 38 47 Disease of Lungs — 2 — — 1 1 — 2 4 Asthma — — — 1 3 3 1 — 8 Teething 4 3 - - - - - 7 7 Gastritis — 1 — — — — — — — Total 94 95 29 48 80 34 3 188 381 TABLE XIII.— CONTINUED. Causes of Death. 0 and under 1. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Total under 5. Grand Total. Brought over 94 95 29 47 80 34 3 189 381 Enteritis — 1 — — - - - 1 1 Peritonitis — — — 1 - - - - 1 Ascites — — — - 1 - - - 1 Ulceration of Intestine — — - - 1 2 - - 3 Hernia — — — 1 3 1 - - 5 Ilius — — - - 1 1 - - 2 Stricture Intestinal Canal — — - - - - - - - Disease of Stomach — — - - 2 1 - - 3 Disease of Liver — — — 1 2 2 - - 5 Diabetes — — - 1 - 2 - - 3 Acute Hydrocele — 1 - - - - - 1 1 Stricture of Urethra — — - - - 2 - - 2 Disease of Kidneys - - - 3 4 1 - - 8 Child-birth - - - 3 - - - - 3 Disease of Joints - - - 1 - 1 - - 2 Privation of Food, &c. — — - - 1 - - - 1 Want of Breast Milk 1 - - - - - - 1 1 Poison - - - - 2 - - - 2 Burns and Scalds - 5 6 1 1 - - 5 13 Hanging - - 1 - 1 - - - 2 Drowning - - - - 1 - - - 1 Wounds - - 1 2 1 1 - - 5 Violence - 2 1 9 7 3 1 2 23 Causes not specified 2 - 2 3 4 4 - 2 15 Intemperance - - - - 1 - - - 1 Sudden - - - - - 1 - - 1 Age - - - - - 18 4 - 22 Debility from Premature Birth 13 - - - - - - 13 13 Total 110 103 40 73 113 74 8 213 521 I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. 15, Great Alie Street, July 24th, 1857. SPECIAL REPORT. to the board of works—whitechapel district. Report of the Medical Officer of Health upon the state of the ventilation of the Sailors' Home and Destitute Sailors' Asylum, situated in Well Street, near the London Docks. Gentlemen, Agreeably to the order of the Board of Works, I visited on Wednesday last the Sailors' Home and Destitute Sailors' Asylum, and respectfully present the following report upon the state of the ventilation of the dormitories in the two establishments. Sailoks' Home. The cabins or sleeping berths in this institution are arranged in a similar manner throughout the building, viz., in 2 rows, each row consisting of a series of cabins, varying from 9 to 13 in number, placed one above the other. Each dormitory, therefore, is calculated to hold from 36 to 52 persons. There is an open space, about 10 feet wide, between these double rows of cabins, and there is a ladder in the centre, by which the upper tier of cabins is approached. The cubic capacity of each dormitory, if entirely empty, is about 19,212 feet; but as the cabins, with the necessary furniture, together with a lavatory and one or more private rooms, occupy a considerable space, the cubic contents are very materially diminished. But supposing the 19,212 cubic feet to be entire space, no more than 369 cubic feet are allowed to each person sleeping in the dormitory set apart for the apprentices, in which are 52 cabins. Each cabin is 3 feet 10 inches in width, 7 feet 3 inches in height, and about 8 feet in length. In appropriating to the apprentices a smaller space than to the other inmates, a very important physiological fact is lost sight of, viz., that the respiration in young persons is more rapid, and consequently they consume a larger quantity of the vital portion of the atmosphere in proportion than adults. The total amount of space allowed for each person sleeping in any of the dormitories would not be sufficient for the healthy enjoyment of life, even if means had been contrived for the renewal of the air in them; but as no means whatever are provided in any of the dormitories for getting rid of the foul air which is given off by the respiration of so many persons, and the product of the combustion of two gas lights, unprovided with glasses, which are burning during the whole night, they are not proper to be used as sleeping apartments without some alteration being made in them. The windows, one at each end of the dormitories, are kept open during the day, 16 but at night they are necessarily shut—for it would be highly imprudent to keep them open at that time, as the rush of cold air into such a heated room would have a tendency to produce inflammatory affections in those who slept near them. The want of light in the centre cabins is a great defect in the sanitary arrangement of the building, and the fact of those who sleep in the upper tier respiring the air which has already been breathed by those who sleep below is a very serious evil. I can bear testimony in my own person, when visiting a patient at night, of the oppressive state of the air in the dormitory. As I had not an opportunity of consulting the plans of the building, I am not aware of the capacity and course of the flues; but, from the survey of the premises which I made, it appeared to me, that a flue ran up one side of each dormitory; and if such be the case, an improved state of ventilation might easily and cheaply be effected by making an opening from the upper part of each apartment into the flue. Air bricks and perforated zinc plates might be introduced at each extremity of the dormitory for the admission of fresh air. Sailors' Asylum. There are no means of ventilation provided in the dormitory of this institution, except from open windows. From the dimensions given me about 2½ years ago by Me. Partridge, the Superintendent, it appears that the cubic contents of the dormitory are about 17,000 feet, into which space, during the winter months, upwards of 60 men have been frequently admitted. The oppression felt on entering this crowded room has been described to me as very great indeed. The ventilation of this room might also be easily and cheaply improved. I have the honor to be, Gf.ntlemem, Your most obedient Servant, JOHN LIDDLE. 15, Great Alie Street, June 29th, 1857. 54 BOARD OF WORKS, Whitrchapel District. REPORT on The Sanitary Condition OF THE WHITECHAPEL DISTRICT, FOR THE THREE MONTHS ENDING SEPTEMBER 26th, 1857. Read to the Board November 2nd, 1857. Jonboit: Priated by T. PENNY, 121, Leman Street, Whitechapcl, and 9, Loudon Terrace, Hackncj Road. 1857. REPORT Gentlemen, The total mortality in the Whitechapel District for the three months that ended on Saturday, September 26th, 1857, as recorded in the returns of the local registrars, was 551. For the corresponding period of last year, the mortality was 510. In both these returns are included all the deaths in the London Hospital, whether residents, or non-residents, and cases of violent death. The variations in the amount of mortality in the London Hospital, and in the two workhouses situated within the district, have not been very great ; a difference of 10 only is observed in the returns of the London Hospital, and of 3 in the two workhouses. The disease which has caused the largest amount of mortality during the last quarter, is diarrhoea; 102 persons having died of it; 82 of whom were under 5 years of age, and of these 82, 51 were under 12 months. Fever, and small pox, have proved less fatal; of the former, there were 21 cases against 33, and of the latter, 2* against 7. Measles shows an increase of 13, (16 against 3), and scarlet fever of 1 (13 against 12). In the total number of deaths from epidemic diseases, there is an increase of 42, which may be accounted for by the unusual amount of mortality from diarrhoea (102 against 63). The deaths from diseases of the respiratory organs, (heart and lungs) amounted to 49, 31 of which occurred to children under 5 years of age. Scrofula or tubercular diseases (consumption, hydrocephalus, mesenteric disease, and convulsions of infants) proved fatal to 141, of whom 88 were under 5 years of age. Six deaths from cholera were recorded, five of which occurred to young children under 5, and one to an adult aged 62. The local registrars record 47 inquests, 30 of which were held on persons dying in the London Hospital. During the last quarter, 12 of the deaths were uncertified, viz.—6 in the MileEnd New Town Sub-district, 2 in the Whitechapel North, 2 in the Goodman's * It would be desirable to note in the Returns of Deaths from Small Pox, whether the patient had, or had not, been vaccinated. In one of these cases it is recorded that the child, aged 2 years, had not been vaccinated. 4 Fields, and 2 in the Aldgate Sub-district. Among these, are recorded the deaths of two children, one aged 12 days, and the other 16 days, both said to be caused by debility from birth. Another case is that of a woman, aged 51, which is registered as "diarrhoea.' Four cases were registered as "convulsions," one as " thrush," one as "decay," one as "broke a blood vessel," (male, aged 55) one as "consumption," the others, as "diarrhoea." All these cases are registered in the table of deaths under their respective headings. In order, however, to prevent crime, and insure the greatest possible accuracy of the causes of death, when uncertified by a legally qualified medical practitioner, the strictest enquiry at the house of the diseased should be instituted by the local registrars, and, if any suspicion be raised in his mind, as to the cause of death, an inquest should be held, and a post-mortem examination made. Amongst the deaths, is recorded that of a female, aged 47, as caused "from the effects of a severe blow received in a scuffle six weeks ago, haemoptysis." In this case no inquest was held, neither was any post-mortem examination instituted. Among the "unspecified" causes of death, are those of "Found Dead," "Natural Death," except where the cause is given, " Inanition," a term so vague, (meaning emptiness), that it may imply death from wilful starvation, or it may be the result of disease, "Diseased Face," a female aged 14, in the London Hospital. Dyspnoea is recorded as the cause of the death of a patient in the London Hospital. This is a mere symptom of disease, the meaning of which is simply difficulty of breathing. Of the 47 inquests above alluded to, are 9 cases returned as "found dead," and 7 as " natural death," but in no instance does it appear that a post-mortem examination took place. One of these cases is thus registered, " found dead in bed, a single woman, in no business, aged 26." In three others, the verdict was "found dead in the River Thames, without marks." In another, that of a young woman, aged 22, the verdict was "found dead in the River Thames, with an incised wound in the throat, not sufficient to account for death." In another case, the verdict was " died from effusion on the brain, how caused unknown." In another, " natural death from consumption, accelerated by destitution." If it be really necessary to hold inquests in all such cases as above recorded, it is surely advisable that the body should be submitted to a post-mortem, examination; for the information which is afforded to the pnblic by the judicial enquiry of the coroner's jury, without such examination, is absolutely nil, and tends, in a limited degree only, to prevent crime. Among the cases on which inquests were held, I 'think it necessary to draw your attention to the following :—1st. A case of burn, through the clothes catching fire, (male, aged 4). 2nd. The death of a male, aged 42, from the fall of shears imperfectly secured. 3rd. The three cases of death from the noxious and mephitic vapour from the sewer in the Whitechapel Road. And 4th. The case of accidental death from a fall from an open window in the Sailors' Home. The deaths of children, from their clothes catching fire, are of frequent occurrence in this district, and I bring this case before your notice, with the view of 5 reiterating the fact alluded to on a former report, that this accident could be prevented if the children's clothes were dipped in a solution of alum—an article which is cheap and of easy application. The death of a man from the fall of shears imperfectly secured, is mentioned with a view of inducing more care in the erection of such machinery. The melancholy fact of three men in the prime of life (aged 32, 22, & 26 years) being suffocated by noxious gas, while engaged in destroying an old sewer in this district, requires to be more specially alluded to. Complaints having been repeatedly made during the spring and summer months by several inhabitants of the Whitechapel Road, of an intolerable nuisance, highly prejudicial to health, from sewer-water making its way into the basement of their houses, it was resolved by the Board that the sewer should be destroyed, as it was unfit for use, it being, in fact, an elongated cesspool. The destruction of the sewer was accordingly proceeded with, and the drainage of the several houses which had been connected with the old sewer, was carried into the deep sewer in the middle of the road. The men, who unfortunately lost their lives in this work, had very nearly completed one of the junctions, and had worked at it until breakfast time without injury. Upon their return in about half-an-hour, one of them removed a piece of board which had been placed upon the orifice of the connecting pipe, which was at the bottom of a large square opening several feet deep, when the gas which was emitted from the sewer, caused his instant death. The others lost their lives in attempting to help their unfortunate comrade. The coroner, in summing up the evidence which was given at the inquest, said, "That nobody was to blame for the occurrence, and that so far as human prudence could be exercised, it was gratifying to find that precautions had been taken, and that the accident was solely attributable to the want of care on the part of the men." I have been thus particular in alluding to this case, because some persons attributed blame to the Board and its officers for opening so foul a sewer during the hot weather, when diarrhoea was very prevalent. Before, however, the work was commenced, the question of opening the sewer at that particular time, was maturely considered; and, as the complaints of nuisance were so numerous, and sickness being likely to prevail amongst the inhabitants living along the course of the sewer, which was in a very dilapidated condition, and could not be repaired, it was very properly deemed advisable to proceed with the work. As the remaining portion of this sewer extends into the districts of Bethnal Green and Mile End Old Town, and is in as bad and foul a condition as that which was along the Road-side, Whitechapel, the vestries of these districts will probably think it expedient to destroy and fill it up at once, before complaints of nuisance are made, and before the warm weather re-commences. From the fact of so many lives having been lost within the last few years from the mephitic vapours generated within the sewers, Dr. Letheby and other scientific gentlemen have been requested to investigate the whole subject in connection with 6 the danger arising from the present condition of the sewerage, with a view of suggesting the best mode of ventilating the sewers and destroying the noxious gazes generated within them; and when their enquiries and experiments are completed, the result of their labours will be laid before the public. The fourth and last case to which I think it necessary to draw attention, with a view of preventing a similar occurrence, is that of a Sailor, aged about 33, a boarder in the Sailors' Home, Well Street, who, while in a state of intoxication, was removed up stairs to one of the dormitories, and where, having occasion to relieve his bowels, went to an open window for that purpose, there being no water closet in any of the dormitories, and accidently fell on the pavement below, which caused his instant death. The Jury, on delivering their verdict, recommended, that men, while in a state of intoxication, should be kept below, and that a water-closet should be erected in each dormitory. Out of the sixty-seven deaths in the London Hospital, 44 were occasioned by disease. One was a case recorded as "found dead," and all the rest were cases of violent deaths, upon which inquests were held. Out of the whole number, four only were residents. Sixty-three deaths in the London Hospital must therefore be deducted from the total mortality of the district, for the quarter ending September 26th, to which we must add the accidental deaths from drowning and suffocation, (5 in number) these not being cases of suicide. The total number to be deducted from the published mortality returns, (551) is 68. The mortality for the Whitechapel District for the last quarter, is therefore 483, to which must be added, the deaths of those who die in the several institutions in the metropolis, but of which number I have no means of ascertaining. It is of great importance for statistical purposes, that the births should be as accurately registered as the deaths. From the fact of the latter, in the Aldgate District, exceeding the former, I have too much reason to believe that all the births in that sub-district, and probably in the others, are not registered. Many of the inhabitants in this district are Irish, and in very poor circumstances; the men are engaged principally as casual dock labourers, and the women as hawkers of fruit, vegetables, lucifer matches, &c. During a portion of the year, many of both sexes leave their habitations to seek work in the country; and it not unfrequently happens, that within a short time after a woman is confined, the whole family leaves; and before they return, the six weeks has expired, in which a child can be registered free of expense—the parents having no money to spare for that purpose, the duty of registering the birth is neglected. Again, many of the inhabitants are foreigners, and are not acquainted with the law in this country relating to the Registration of Births. It will be necessary to make an alteration in the law before a correct system of registering the births is effected. During the last quarter, many complaints of nuisances from various premises where certain trades are carried on, have been made to your Board and its officers, and have been visited by your Medical Officer of Health and Inspectors of Nuisances, 7 and reported to your Board, and I am happy to say that several of the occupiers of the premises complained of, have readily made such alterations in them, which it is to be hoped, will prove effectual in preventing the recurrence of complaints. The Soap Manufactory of Messrs. Soames, in Wheeler Street, of which great complaints were made, is now entirely removed, a portion of the building having been pnlled down. I may here briefly state, that there is no desire on my part to use the powers conferred on me by the Act of Parliament under the provisions of which I hold office, to the oppression of any individual, or to insist upon the adoption of such arbitrary and stringent measures as shall drive the wealthy manufacturers from the district. All that is necessary to be insisted upon is, that the business be so conducted, that the health and comfort of the inhabitants shall not be injured. Sanitary science, by suppressing how nuisances arising from offensive trades by providing better drainage, and improving the houses and localities of the poor, by opening new thoroughfares, &c., has tended to reduce the rate of mortality in the metropolis, and contributed to the comfort of the people generally. Encouragement is therefore afforded us to continue our exertions in (he same direction, and so far from those sanitary improvements which manufacturers have been compelled to adopt, to render innocuous the offensive vapours arising from the carrying on of their trades, interfering with the operations of their business, and crippling their resources, they have, in many instances, tended to utilize and turn to great pecuniary profit, many of the most offensive products, which were formerly allowed to escape into the earth and air, contaminating both, and proving destructive to the health of man. As the guardian of the public health, it is the duty of the Medical Officer of Health to endeavour to preserve the purity of the atmosphere, and he must, at all times, and under all circumstances, refuse to give his sanction to any thing that will injure it. The mode in which the refining department in the mint is now carried on, is of so injurious a character, that I must especially allude to it in this report. The acid vapours which are given off from this establishment, occasion severe cough, difficulty of breathing, smarting of the eyes and face, destroy wearing apparel, and brass-work in those houses which are within the influence of the vapours. Now, as this nuisance can be prevented, I have every reason to believe that Sir Anthony Rothschild will avail himself of the first scientific talent in the country to obviate it, and I hope to be able, in my next report, to announce that the nuisance no longer exists. Mons. Poizat's refinery in Paris, which is said to be the most spacious and best arranged in the world, is so judiciously fitted up, that the neighbourhood is free from those injurious effects which are produced by the escape of the acid vapours from the refinery in the mint. The condensible gazes are condensed in properly fitted up leaden chambers, and the incondensible gazes are discharged into a high chimney.* * See Dr. Ure's Chemical Dictionary. 8 I have to bring under your notice, another subject which demands attention, viz:— the overcrowded state of some of the private infant schools in certain poor neighbourhoods in the district. Perhaps there is no single influence to which a human being is exposed more prejudicial to his health, than overcrowding in rooms, the air of which cannot be perpetually and rapidly changed. I have recently visited three of these schools, two in Charlotte Street, and one in Goulston Street. The dimensions of the room at No. 18, Charlotte Street, in which were 15 persons, viz:— 14 children and the mistress, were 8ft. in height, 7ft. in width, and 10ft. in length; thus allowng 37 cubic feet only of space to each individual. At No. 17, Charlotte Street, matters were still worse, for a space of 20 cubic feet only was allowed to each. In this room, situated underground, about 7ft. high, 10ft. wide, and 10ft. long, were 36 persons, 35 children and the mistress. The cubic contents of the room at No. 2, Goulston Street, were 672ft., in which I found 31 children and the mistress. In all these cases the mistresses were remonstrated with; the danger arising from such excessive overcrowding pointed out to them ; and an intimation, in each case, was given, that such a state of things would not be permitted to continue. The Inspectors have had directions to visit these schools occasionally, in order to see that my remonstrances are attended to. As the cholera appears to be giving us some threatenings of its approach, two cases of death having recently occurred in this district from that disease, and several other cases in West Ham and Poplar, I have caused to be specially inspected those localities in the district which were stated by Dr. John Sutherland in his report to the General of Health in 1852, to be the principal seats of this disease; and in every instance where sanitary improvements were required, and which were practicable to be carried out, notices have been served upon the landlords, who, for the most part, have readily complied with the orders, and the necessary works have been executed. Not merely have the localities been visited by myself and your Inspectors of Nuisances, but the houses therein have been systematically visited, that is, a system of house-to-house visitation has been instituted, and improvements in the drainage, cleanliness, water supply, &c., have taken place in nearly all those places mentioned by Dr. Sutherland; but as many of the streets are still unprovided with sewers, improved drainage in those cases could not be effected. Under these circumstances, the landlords have been directed to empty the cesspools, limewash and repair the houses ; and where the houses were found to be overcrowded, orders were given to reduce the number of inmates. In consequence of a case of cholera having recently terminated fatally in Fisher's Alley, Spitalfields, a house-to-house visitation was immediately instituted in that locality. The houses and cellars have been cleansed and limewhited, and are now undergoing an efficient system of drainage. Hairbrain Court, formerly the seat of extensive ravages of cholera, is now well paved and drained, and the old houses on the north side have been pulled down, and improved new buildings erected in th«ir stead. 9 I have also thought it advisable at the present moment, to submit again for analysis, the water from the pump in Love Court, Middlesex Street ; it being supposed that the use of bad water, under certain circumstances, is likely to produce cholera. In August, 1856, the water from this pump was submitted to analysis, when the total impurity was found to be 188.80 grs. in a gallon; and on examining the water taken from the same pump on Wednesday last, the total impurity was found to be 199.20 grs. in a gallon, in which were 12 grains of organic matter.* Nitric acid was also detected in this water, proving most satisfactorily that it is derived from an impure source. There is, however, fortunately not very much danger to be apprehended from the inhabitants using this pump, for the water has a very unseemly appearance, and so convinced are they of its bad quality, that they will only use it for cleansing their houses and yards. As the landlord is about to supply water to the water-closets of all his tenants in this locality, it is probable that this useless pump will be taken away. Were the water more pleasing to the eye, very great danger might be apprehended were it used for drinking. It will be seen, by referring to the tables Nos. 1 & 2, that a large amount of work has been done by your Inspectors of Nuisances during the last quarter. 456 houses have been systematically visited, and 191 notices for sanitary improvements served. These notices relate to the various subjects set forth in the tables above referred to. On comparing the table for the past quarter with that ending June 27th, it will be observed, that instead of the 962 cases then reported as not completed, there are now 624 cases only. 338 of these works have therefore been completed since the last report. I have also to mention, that your Inspectors seized a large quantity of putrid and unwholesome meat, which was exposed for sale in Rosemary Lane, aud summoned the offending party before the Magistrate at the Thames Police Office, who inflicted a fine of 40s. and gave orders for the meat to be destroyed. After the decision of the Magistrate in this case, your Board ordered hand-bills to be distributed over the district, warning persons of the penalty attending the exposing for sale all kinds of unwholesome food. This appears to have had a good effect in preventing the recurrence of like practices, as nothing of the kind has since been heard of. A summons was taken out by one of your Inspectors of Nuisances against a butcher, for using an unlicensed place for slaughtering animals for human food'; upon which occasion the Magistrate fined the defendant in the mitigated penalty of five shillings and costs. The Magistrate had the power, under the act, of inflicting a penalty of £5. * About the same time, an analysis of the water supplied by the several Water Companies in the Metropolis, was made by Dr. R. D. Thomson, Professor of Chemistry at Saint Thomas' Hospital, and the following is the result of such analysis;—West Middlesex, Total Impurity, per gallon, 18.6. Grand Junction, 19.12. Lambeth, 21.12. Chelsea, 22.4. New River, 18.6. East London, 21.2. The organic matter in each varied from 1.04 to 2.24 grs. per gallon. 10 Proceedings have been taken against several parties in the North District for keeping swine, and those nuisances are now abated. Many of the efforts which have been made to improve the domestic conveniences of the poor, have proved unavailing, and great expenses have been incurred by landlords in fixing soil-pans and traps, and laying on of water for the purpose of flushing them. The poor, generally, are so utterly ignorant of the requirements of civilized life, never having had the means of practising them, that they cannot appreciate the efforts which are now made to add to their comfort, and induce among them habits of self-respect. It not unfrequently happens, that when they have any old useless articles which they wish to get rid of, they throw them down their water-closets, causing the drains to become stopped, when violent efforts, by means of a poker or heavy stick, are made to dislodge the impediment in the drains, whereby the trap becomes broken, and a worse state of things is the result, rendering it necessary to supply a new apparatus. It appears that more than a hundred newly fixed pans and traps in this district, have been rendered useless within a short time after they had been fixed. These disheartening results of our labours, must not, however, check our exertions to raise the moral condition of the poor. Within my recollection, a vast improvement has taken place in the habits and general condition of the poor, and by our more frequent intercourse among them, and showing them the comforts and health promoting influences of cleanliness and decency, we shall succeed in raising them above their present squalid condition, and teach them to value and seek for those comforts which cleanliness and decency alone can provide. I am, Gentlemen, Tour obedient Servant, 15, Great Alie Street, JOHN LIDDLE. 27th Oct., 1857 APPENDIX. TABLE I. SUMMARY OF INSPECTIONS. For the Quarter ending 29th September, 1857. Works in progress but not completed. Number of Nuisances inspected. Number of Houses systematically visited. Number of Nuisances entered in Complaint Book. Number of Summonses taken out. Number of Notices served. For defective Drainage For other Nuisances 624 940 456 394 6 17 191 TABLE I.— continued. NUMBER OF HOUSES VISITED SINCE THE 30th JUNE, 1857, WHERE THE UNDERMENTIONED NUISANCES WERE FOUND TO EXIST. OTHER WORKS, &c. Requring Limewashing and Cleansing. Without Dust Bins. Requiring Repair. Cellars and Yards ill-pared. Without Water for domestic use. Inadequate water supply. Cesspools existing within 100 feet of Sewer. Cesspools and Drain to Sewer. Cesspools not within distance of Sewer. Defective Drainage. Filth in Cellars. Privies in filthy condition. Requiring Water to Soil Pans. Privies in Cellars in an offensive condition. Inadequate Privy accommodation. Offensive Common Privies in Courts. Overflowing Cesspools. Stagnant Water on Premises. Overcrowded Houses. *Houses unfit for human habitation. Privies having Water Supply but without Soil Pans. Defective and Offensive Gullies. Gullies stopped. Accumulation of Filth in open places. Cow-houses and Yards visited. Slaughter-houses visited. Dangerous structures. Offensive Privies. Privies without Soil Pans or WaterSupply (withDrains).1 Dangerous Cellar Flaps and Area Gratings. Works in progress. Works allowed to stand over from various causes. Works' done without notice. 195 170 110 192 18 48 262 120 49 310 89 51 388 15 13 17 19 29 1 10 46 82 110 6 9 40 42 388 262 45 624 63 289 * Filthy and Dirty Houses where Illness very frequently existed. TABLE ii. SUMMARY OF WORKS EXECUTED UP TO 30th JUNE, 1857. Limewhiting and Cleansing. Dust Bins erected. Houses repaired. Yards and Cellars re-paved. Water supplied for domestic use. Larger supply of Water given. Cesspools abolished. Cesspools removed & Drains conctd. with Sewers. Cesspools cleansed.—No Sewerage. New House Drainage made. House Drainage improved. Cellars cleansed. Filthy Privies cleansed. Water supply to Soil-pans. Filthy Privies in Cellars cleanscd. &c. New Privies constructed. Stagnant Water on Premises removed.; *Over-crowded Houses remedied. †Houses unfitted for Human habitation. Defective Gullies remedied. Gullies cleansed. Filth in open places removed.| Cow-houses and Yards cleansed, &c. Slanghter-houses improved. ‡ Dangerous structures. Other Nuisances removed, Dust, &c. Dangerous Cellar Flaps and Area Gratings. 508 312 245 466 12 20 810 764 413 813 356 168 269 882 84 29 466 11 4 277 362 33 25 41 54 1783 103 SUMMARY OF WORKS EXECUTED FROM 30th JUNE, TO 29th SEPTEMBER, 1857. Total. 85 51 78 67 6 2 122 122 49 122 132 89 51 192 15 4 29 1 10 82 110 6 9 29 42 723 45 593 363 323 533 18 22 932 886 462 935 488 257 320 1074 99 33 495 12 14 359 472 39 34 70 96 2506 148 * These cases came under the Lodging-house Act, and have been prosecuted by the Police, † Filthy and Dirty Houses where Illness very frequently existed. The Tenants had notice to quit, and the Houses were thoroughly cleansed, ‡ Notice given to Police, who have had the same repaired, and, in some instances, pulled down. TABLE III. Cases of Sickness of the Zymotic and acute classes, which were recorded in the Books of the Medical Officers of the Union for the Three Months that ended on the 26th Sept., 1857. Districts. Names of Medical Officers. Small Pox. Measles. Scarlatina. Hooping Cough Diarrhœa. Typhus or continued Fever. Erysipelas. Carbuncle. Rheumatic Fever. Ague. Pneumonia and Pleuritis. Bronchitis and Catarrh. Laryngitis and Croup. Dysentery. Cholera. Phthisis. Other Diseases. Total. Average number of Fever cases per Week. Spitalfields Mr. Hart 0 14 5 4 265 95 2 2 1 1 9 96 3 6 9 4 476 922 Mile End New Town Mr. Champneys 0 11 4 1 183 97 2 1 0 1 0 1 0 1 0 2 303 609 Whitechapel Mr. Richardson 0 1 0 2 102 38 3 0 0 1 2 81 1 1 0 7 176 415 Goodman's Fields Mr. Sequeira 1 24 5 18 295 154 3 0 0 1 23 22 0 2 0 12 628 1188 Totals 1 50 14 25 845 384 10 3 1 4 34 200 4 10 9 25 1583 3134 29 TABLE IV. Number of New Cases of Sickness attended by the Medical Officers of the Whitechapel Union during each Week, commencing 4th July, 1857. Names of Medical Officers. Week ending July 4th. July 11th. July 18th. July 25th. August 1st. August 8th. Augt. l5th. Aug. 22nd. Augt. 29th. Sept. 5th. Sept. 12 th. Sept. 19th. Sept. 26th. Totals. Corrresponding Quarter of last Year. Mr. Hart 54 72 87 101 80 70 85 68 69 68 58 63 47 922 3134 905 2603 Mr. Champneys 47 31 48 56 54 51 59 76 40 35 41 39 32 609 564 Mr. Richardson 26 35 36 38 29 37 37 31 43 30 25 21 27 415 244 Mr. Sequeira 94 89 81 114 113 104 106 104 106 74 62 82 59 1188 890 I have not attempted to give the result of the eases which came under the care of the Medical Officers of the Union, as they cannot be accurately ascertained. Some of the Patients are, after a longer or shorter time, removed to the Workhouse or Hospitals, and in many instances, they apply for Advice and Medicines at other Charitable Institutions, TABLE V.— Table showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 26th September, 1857. Districts. Small Pox. Measles. Scarlet Fever. Hooping Cough Diarrhœa† Typhus. Total. Grand Total. Grand Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1857 1856 *Artillery 0 0 1 1 1 0 0 0 3 2 0 0 5 3 8 4 Spitalfields 0 0 1 1 3 2 0 0 6 4 0 1 10 8 18 20 Mile End New Town 0 0 1 6 1 1 0 2 6 9 5 5 13 23 36 30 Whitechapel, North 0 0 1 1 0 0 2 2 7 15 1 2 11 22 33 18 Whitechapel Church 0 1 0 0 1 0 0 1 4 8 2 1 7 10 17 14 Goodman's Fields 0 0 1 1 2 2 1 1 12 9 0 3 16 16 32 17 Aldgate 1 0 1 0 0 0 2 2 9 8 1 0 14 10 24 23 1 1 6 10 8 5 5 8 47 55 9 12 76 92 168 126 2 16 13 13 102 21 168 Deaths from Epidemics for the corresponding Quarter of last year. 7 3 12 8 63 33 126 * In the Artillery District, the case of a child four months old, is thus registered by the Local Registrar:—" Varicella, Phlegmonous Inflammation of the Thigh," which case is recorded by the Registrar General as Small Pox. I have inserted it under the head of Erysipelas. t Five deaths from Cholera, in addition to some registered as " Choleraic Diarrhœa," are recorded in the Whitechapel District. TABLE VI.— Table showing the number of Births in each Week in the Whitechapel District, for the Three Months ending on the 26th Sept., 1857.* Districts. WEEKS ENDING. Total Males 359 July. August. September. Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Total Females 337 Artillery 58 3 2 5 0 3 4 1 0 2 2 3 4 3 2 0 2 1 3 2 4 1 3 1 2 3 2 Grand Total 696 Spitalfields 131 8 2 4 5 11 6 3 4 5 5 3 3 5 10 3 5 5 5 4 4 5 0 4 3 9 5 Mile End New Town 128 5 11 0 3 9 3 5 7 13 4 4 5 9 3 3 6 8 2 4 4 3 0 6 4 2 5 Whitechapel, North 124 4 3 4 2 8 12 8 9 7 2 5 2 1 1 3 3 10 6 6 3 2 4 4 7 1 7 Wbitechapel Church 75 5 3 3 1 2 2 3 2 2 3 2 2 6 3 4 1 2 1 3 2 3 3 6 4 4 3 Total Births for the corresponding Quarter of last year 650 Goodman's Fields 110 9 3 1 4 4 2 2 4 2 4 5 4 4 4 3 7 8 4 5 6 6 6 3 5 0 5 Aldgate 70 5 1 3 3 1 3 0 6 3 8 2 4 8 4 2 0 0 6 1 3 2 2 1 1 3 4 Totals 696 39 25 20 18 38 32 22 32 34 28 24 24 36 27 18 24 34 21 25 26 22 22 25 26 22 29 * All the Births which occur in this District, are not Registered, The Parents frequently neglect the duty of Registering the Birth of their Child, being under the impression that Baptism is all that is required; and it sometimes happens that the religious service of Baptism is neglected, when the civil duty of Registration has been performed, and vice versa. TABLE VII. Table showing the number of Deaths in each Week in the Whitechapel District, for the Three Months ending on the 26th September, 1857. Districts. WEEKS ENDING. Total Males 290 July. August. September. Total. M. F. M. F. M. F. M. F. M. F. M. F M. F. M. F. M. F. M. F. M. F. M. F. M. F. Total Females 261 Artillery 24 1 2 0 0 2 1 1 2 1 0 2 0 0 4 0 2 0 1 0 1 1 0 1 2 0 0 Grand Total 551 Spitalfields 73 3 1 2 1 6 7 2 1 4 1 4 3 3 1 0 2 4 5 2 5 4 2 4 3 2 1 Mile End New Town 115 10 2 3 0 6 6 5 4 6 3 4 3 6 5 6 3 2 4 2 5 7 4 3 7 7 2 Non-Residents 63 Whitechapel, North 92 2 3 0 3 3 6 4 3 4 6 6 4 4 2 2 4 1 3 2 5 3 8 3 6 1 4 Wliitechapel Chnrch 107 6 6 3 3 6 2 1 1 17 4 2 0 5 2 0 1 10 10 0 3 14 2 2 4 1 2 Cases of Violent Death 5 Goodman's Fields 63 1 2 2 1 2 1 1 5 2 4 3 3 3 2 4 6 3 3 2 3 0 2 0 2 5 2 Aldgate 77 1 2 1 0 2 1 1 2 2 5 9 3 4 3 4 1 7 3 8 6 2 1 1 2 2 4 68 24 18 11 8 27 24 15 18 36 23 30 16 25 20 16 19 27 27 16 28 31 19 14 26 18 15 Total Deaths for the corresponding Quarter of last year 510 Totals 551 42 19 51 33 59 46 45 35 54 44 50 40 33 Inquests 4 0 0 0 9 6 0 0 9 6 10 0 3 Total 47 Deaths in the London Hospital for the Three Months ending 26th September, 1857. Males, 50. Females, 17, Total, 67. Of this number 63 were non-residents in the Whitechapel District. TABLE VIII.— Ages at Death in the Whitechapel Workhouse. 0 and. under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total. Corresponding Quarter of 1856 8 0 1 4 3 8 5 29 34 TABLE IX.— Ages at Death in Christchurch Workhouse. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total. Corresponding Quarter of 1856. 0 0 0 9 10 9 0 28 26 Inquests were held on two of the above recorded cases. TABLE X.— Ages at Death in the London Hospital. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards Total. Corresponding Quarter of 1856. 3 3 17 27 6 2 67 77 One case of Choleraic Diarrhoea, two of Diarrhoea, one of Scarlet Fever, and two of Erysipelas, died in the London Hospital. TABLE XI. Ages at Death in the Whitechapel District, including those in the above-named Institution 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards. Total under 5 Grand Total. 170 134 34 58 84 55 16 304 551 Three cases of Fever, died in the Whitechapel Workhouse. Four cases of Fever and one of Diarrhoea died in Christchurch Workhouse. TABLE XII.— Inquests. Districts. No. Found Dead. Natural Death. Burns and Scalds. Violence. Poison Suffocation and Drown ing. Hanging. Starvation. Artillery - - - - - - - - - Spitalfields — - - - - - - - - Mile End New Town 6 2 3 - 1 - - - - Whitechapel, North - - - - - - - - - Whitechapel Church 28 1 2 1 21 - 3 - - Goodman's Fields 1 — - - 1 - - - - Aldgate 12 6 2 — 2 — 2 — — Total 47 9 7 1 25 - 5 — - TABLE XIII.— Causes of Death at Seven Periods of Life, registered in the Whitechapel District, for the Three Months ending 26th September, 1857. Causes of Death. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 4o and under 60 60 and under 80 80 and above. Total. Causes of Death. 0 and under 1. 1 and under 5. 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Total. 1.— Zymotic:— Brought forward ... ... ... ... ... ... ... 442 Small Pox ... 2 ... ... ... ... ... 2 Stomach and Digestive Organs. Measles 1 15 ... ... ... ... ... 16 Scarlatina (Scar.Fev.) ... 9 4 ... ... ... ... 13 Hernia (Rupture) ... ... ... 1 1 1 ... 2 Hooping Cough ... 3 10 ... ... ... ... 13 (Ileus (Inflammation and Gangrene of the Muscular Coat of the Intestine) 1 ... ... ... 1 1 ... 3 Croup 1 6 ... ... ... ... ... 7 Thrush 1 1 ... ... ... ... ... 2 Diarrhœa (bowel complaint) 51 31 2 2 7 8 1 102 Intussusception, (a part of the Bowels introduced into the part below.) ... ... ... ... ... ... ... ... Dysentery 4 ... ... ... ... 2 ... 6 Cholera 2 3 ... ... ... 1 ... 6 Influenza ... ... ... ... ... ... ... ... Scurvy and Purpura ... ... ... ... ... ... ... ... Stricture of Intestinal Canal ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Remittent Fever ... 1 ... ... ... ... ... 1 Disease of Stomach, &c. ... ... ... ... ... ... ... ... Infantile Fever 1 ... ... ... ... ... ... 1 Typhus Fever ... 2 4 6 6 3 ... 21 Disease of Pancreas ... ... ... ... ... ... ... ... Puerperal Fever (Metria) ... ... ... ... ... ... ... ... Inflammation of Liver (Hepatitis) ... ... ... ... ... ... ... ... Rheumatic Fever ... ... ... ... ... 2 ... 2 Jaundice ... ... ... ... ... ... ... ... Erysipelas (Rose) 2 ... ... 1 2 ... ... 5 Disease of Liver ... ... ... ... 2 2 ... 4 Syphilis 2 ... ... ... ... ... ... 2 Cirrhosis ... ... 1 1 ... ... ... 2 Noma (Canker) ... ... ... ... ... ... ... ... Disease of Spleen ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... VIII. Kidney, &c. II.—Dropsy, &c. Nephritis ... ... ... ... ... ... ... ... Hæmorhage ... ... ... ... ... ... ... ... Nephria (Bright's disease 1 ... 2 2 1 ... ... 6 Dropsy ... 2 ... ... 3 2 ... 7 Abscess (Gathering) ... 1 ... ... ... ... ... 1 Ischuria ... ... ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Diabetes ... ... ... 1 ... ... ... 1 Fistula ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Mortification ... ... ... ... ... ... ... ... Cystitis ... ... ... ... ... ... ... ... Cancer ... ... ... 1 4 1 ... 6 Stricture of Urethra ... ... ... ... 2 2 2 6 Gout ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... ... III.— Tubercular IX. Childbirth Scrofula ... 1 2 ... ... ... ... 3 Paramenia ... ... ... ... ... ... ... ... Tabes Mesenterica 23 17 ... ... ... ... ... 40 Ovarian Dropsy ... ... ... ... ... ... ... ... Phthisis(Consumptn) 1 2 4 19 24 1 ... 51 Childbirth (See Metria) ... ... ... ... ... ... ... ... Hydrocephalus(water on the Brain) 13 12 ... ... 1 ... ... 26 Disease of Uterus, &c. ... ... ... ... ... ... ... ... X. Joints, Bones, &c IV.- Brain & Nerves Rheumatism ... ... ... ... ... ... ... ... Cephalitis ... ... ... ... ... ... ... ... Arthritis ... ... ... ... ... ... ... ... Apoplexy ... ... 2 ... 4 2 ... 8 Disease of Joints, &c. ... ... ... ... 1 ... ... 1 Palsy (Paralysis) ... ... ... 1 2 3 1 7 XI. Skin, Cellular Tissue, &c. Delirium Tremens ... ... ... 1 ... ... ... 1 Chorea ... ... ... ... ... ... ... ... Carbuncle ... ... ... ... 1 ... ... 1 Epilepsy ... ... ... ... 1 ... ... 1 Phlegmon ... ... ... ... ... ... ... ... Tetanus ... ... ... ... ... ... ... ... Diseases of Skin. &c. ... ... ... ... ... ... ... ... Insanity ... ... ... ... ... ... ... ... Convulsions 18 2 ... ... ... ... ... 20 XII. Malformation. Disease of Brain, &c. ... 2 ... 1 2 ... ... 5 Cyanosis ... ... ... ... ... ... ... ... V.—Heart & Blood Vessels:— Spina Bifida ... ... ... ... ... ... ... ... Other Malformations ... ... 1 ... ... ... ... 1 Pericarditis ... ... ... ... ... ... ... ... XIII. Premature Aneurism ... ... ... 1 ... ... ... 1 Birth & Debilily 12 ... ... ... ... ... ... 12 Disease of Heart, &c. ... ... 1 1 3 ... 1 6 XIV. Atrophy 1 ... ... ... ... ... ... 1 VI.— Lungs and Organs of Respiration:— XV. Old Age ... ... ... ... ... 14 10 24 XVI. Sudden ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... XVII. Violent Death Bronchitis 8 ... ... ... 3 1 ... 12 Pleurisy ... ... ... ... ... ... ... ... Intemperance ... ... ... ... ... ... ... ... Pneumonia 12 10 ... 1 3 3 ... 29 Privation of Food ... ... ... ... ... ... ... ... Asthma ... ... ... ... 1 2 ... 3 Want of Breast Milk ... ... ... ... ... ... ... ... Disease of Lungs 1 ... ... ... ... 1 ... 2 Neglect ... ... ... ... ... ... ... ... Cold ... ... ... ... ... ... ... ... VII.— Stomach and Digestive Organs: Poison ... ... ... ... ... ... ... ... Burns and Scalds ... 1 ... ... ... ... ... 1 Teething 2 4 ... ... ... ... ... 6 Hanging ... ... ... ... ... ... ... ... Quinsey ... ... ... ... ... ... ... ... Suffocation ... ... ... 3 ... ... ... 3 Gastritis ... 1 ... ... ... ... ... 1 Drowning ... ... 1 1 ... ... ... 2 Enteritis ... ... 1 1 ... ... 2 4 Violence 3 ... 5 7 8 2 ... 25 Peritonitis ... ... ... ... ... ... ... ... XVIII. Not Specified. 4 1 3 4 1 1 ... 14 Ascites ... ... 1 1 ... ... 1 3 Ulceration of Intestines ... ... ... ... ... ... ... ... Carried Forward ... ... ... ... ... ... ... 442 Grand Total ... ... ... ... ... ... ... 551