39 WHI 7 BOARD OF WORKS, WHITECHAPEL DISTRICT. ANNUAL REPORT ON THE Satvttarg Contotiom OF THE WHITECHAPEL DISTRICT, FOR THE YEAR ENDING JANUARY 1st, 1859. Read to this Board, February 14th, 1859. LONDON: PIUNTED BY T. PENNY, 121, LEMAN STHfiEI? WHITECHAPEL, and 9, london ter11ace, Hacknet road. 1859. REPORT. Gentlemen, The third year of my office as your Medical Officer of Health being now completed, I have again the honor of laying before you, in accordance with my annual practice, an account of the mortality of the Whitechapel District for the year that ended on the 1st January, 1859, together with a tabular statement of the improvements effected in those houses and localities to which the attention of the Inspectors has been directed. The total number of deaths registered in this district, for the year 1848, was 2444, viz: 1331 males, and 1113 females. The deaths of the non-residents in the district were 216, of which number 211 died in the London Hospital, and 5 in the Military Hospital in the Tower. The deaths in the London Hospital, which were the result of violence, I have placed to the account of the mortality of this district, except in those very few cases where the previous residences of the parties are given. The deaths in the Military Hospital in the Tower, occurred among the garrison, which not being included in the population of the district, I have considered as non-residents. The mortality for the last three months was 673, and, for the corresponding quarter of last year, it was 609, including, in both instances, the deaths of the nonresidents. The period of the greatest mortality was during the five weeks, commencing in the second week of November, and terminating in the 6econd week of December, when the deaths amounted to 323, or an average of nearly 65 per week. The great increase of the mortality which occurred at that time, was not confined to this locality, but it extended over the whole metropolis, and may be accounted for, by the great reduction in the temperature of the air, which took place at that period. In the third week of October, when the mean temperature of the air was 51.1°, the deaths in the Whitechapel District were 31. In the third week of November, the temperature of the air became reduced to the extent of 16°, and the mortality was increased to 62 in the week. In the first week of November, the mortality was 40 ; in the two following weeks it rose to 60 and 62 respectively; and in the week ending Saturday, November 27th, the mortality was also 62. The mean temperature of the air in the first week of November was 43.3°. In the last three weeks 4 of the same month, it was successively 39.0°, 35.5°, and 37.4°. On Wednesday, the 24th November, the thermometer was 20.5°, or 11,5° below the freezing point. In the week following this very severe weather, the mortality was 65. It is during the colder months of the year, that the diseases of the respiratory organs prove so fatal, particularly to the aged and to the young. The powers ef life in old persons, and in young children, are unable to withstand the depressing effects of cold, unless the individuals are provided with adequate clothing, sufficient food, and fuel to supply artificial heat. These necessaries cannot be procured by the very poor, either for themselves or for their children, and both suffer in their health from the want of them; while the rich, on the other hand, although able abundantly to provide for the comfort of their offspring, yet, from the tyranny of fashion, from their confirmed habits and customs, and from their imperfect knowledge of physiology, allow their children to be exposed to the chilling atmosphere, without protecting them bv proper clothing. The " hardening process," which is founded in ignorance, is the cause of much suffering, and of many untimely deaths. The total deaths which occurred during the year, from diseases of the resDiratory organs, were 484; of which, 333 (or more than two-thirds,) took place during the six colder months. The deaths from zymotic diseases were 572, or 23.3 per cent, of the total mortality. During the previous year, the mortality from zymotic diseases was 22.4 per cent, of the total number of deaths. Fever, however, has proved somewhat less fatal during the last year, the number being 104, whereas, for the previous year, it was 117. Scarlet fever, on the other hand, was far more fatal, 87 against 43. Diarrhoea shows a decrease of 31, while the deaths from measles increased from 60 to 78, and hooping cough from 89 to 117. During the last two years, there have been only 7 deaths from small pox, viz: 4 in the year 1857, and 3 in 1858. The relative mortality of males and females, caused by epidemic diseases, during the last two years, has been as follows:—Of 137 deaths from measles, there were 71 males, and 66 females. Of 130 deaths from scarlet fever, 72 were males, and 58 were females. Of 205 deaths from hooping cough, there were 91 males, and 114 females. Of 248 deaths from diarrhoea, there were 125 males and 123 females. Of 220 deaths from fever, there were 114 males, and 106 females. Diphtheria proved fatal to 9 children, 7 males, and 2 females, during the year ending 1st January, 1859. From the resemblance which this disease bears to scarlet fever, it is frequently mistaken for it. The Registrar General has recorded the deaths from diphtheria under the head of scarlet fever. There were 55 deaths uncertified by any medical practitioner during the year; 15 of which are recorded in the returns of the last three months. The inquests have been rather less numerous; 216 having been held in 1858, while 227 were held in 1857. The deaths of children, under 5 years of age, were 1154, or nearly one-half of the total number of deaths. During the year, 112 died of old age, of whom 56 were above 80 years of age. This is a very small number, when we consider that old 5 age is the only natural cause of death. All premature deaths, from whatever causes, are calamities to be deplored. Accidents from various kinds of mechanical violence proved fatal to 89. Burns and scalds were fatal to 33, of which number, 23 were in consequence of the clothes of the parties catching fire. There were 5 deaths occasioned bypoison, one of which was accidental, from an over-dose of laudanum, taken to procure rest. The total number of deaths in the "Workhouse, was 269, which is 3 less than what occurred in the previous year. The deaths from fever in the Workhouse, were 34; and from diarrhoea, 18; which numbers approximate closely to those of 1857, when the deaths from the former disease were 36, and from the latter, 14. During the last quarter, the mortality from fever was 10, and from diarrhoea, 3. It must not be inferred, because so many cases of death, from fever and from diarrhoea, occurred in the Workhouse, that the establishment is unhealthy; for, upon enquiry, I learn that all the deaths from fever, which happened in the workhouse, were brought into it from various parts of the district; and that some of the cases were, when admitted, in the very last stage of the disease. The births during the year 1858, were 2742; and the deaths, deducting the non-residents, (amounting to 216,) were 2228; the excess of births over deaths, therefore, was 514, while, for the previous year, embracing a period of 53 weeks, the excess of births over deaths was 817, the births being 2868, and the deaths, after deducting those of the non-residents, 2051. It appears, from the returns of the Medical Officers of the Union, that 11,718 cases of sickness, excluding those in the Workhouse, have been attended by them during the year. This is about one in seven of the whole population. When we consider that within this district there are two Dispensaries, and the London Hospital, the number of sick poor is enormous. The out-door cases of sickness for 1857, were 10,714; and the fever cases, during that period, were 1441, or about one in seven of the total number. The cases of fever, during the last year, were only 600, or about one in nineteen of the total number of the cases of sickness. While, therefore, there is an increase of about 1000 in the cases of sickness, there is a diminution of 841 cases of fever. The total number of cases of sickness in the Workhouse, was 1,413, including 153 cases of fever. In my last Annual Report, I laid before the Board a table, showing the number of cases of fever attended by the Medical Officers of the Union, and the deaths from zymotic diseases which occurred in each locality in the district. As such a table is likely to be useful, I have subjoined a similar one to this report. On comparing the table for the last year with that for the preceding year, it will be seen that several of the localities present the same features of unhealthiness; and it will be found that in the most unhealthy places, the greatest sanitary defects still exist. For instance, Prince'sstreet, which separates Mile End New Town from Whitechapel, presents nearly the same appearance of unhealthiness as in the previous year, notwithstanding the labour which your Inspector has bestowed upon it, in visiting each house, and seeing that it 6 was limewhited and cleansed, and the cesspool emptied. It is in this densely crowded and poor locality that a sewer is so urgently required. Grey Eagle-street, which is very imperfectly sewered, still retains its pre-eminence for unhealthiness. The same may be said of Pelham-street, Spicer-street, and some others. On the other band, I am much gratified in being able to state, that Little Love-court, where, during the year 1857, no less than 14 fever cases, and one death from zymotic disease occurred, only two fever cases were attended during the year 1858, and not a single death has been recorded. This favorable result may be fairly attributed to the improvements effected, viz: the paving of the court, the cleansing of the houses, and the increased water supply. Other localities, where fever prevailed, have also been improved in their sanitary condition, with similarly happy results. The ignorance and uncontrolled selfishness, of the past and preceding gene* rations, in erecting houses unfit for the healthy enjoyment of life, have entailed upon us, in the present day, a large expense in alleviating the sickness, and consequent poverty, of the inhabitants of these unhealthy localities. The demolition of these plague spots,— the result of so many years of misrule, cannot be accomplished without the expenditure of considerable sums of money ; yet, in the course of time, the public will learn, that sickness, with its concomitant evils, viz :—the loss of wages, the calls upon clubs and friendly societies, the increased amount of charitable contributions, a heavier poorrate, &c., entails more expense upon the community than would be required to carry out sanitary improvements in widening streets, converting the culs-de-sac into thoroughfares, and in erecting more commodious houses for the poor. The over-crowding of the houses occupied by the poor, is a subject now engaging the attention of the public ; but what is meant by over-crowding is not defined in any Act of Parliament. It is held, however, by some magistrates, that any house occupied by more than one family, and not being a common lodging-house under the supervision of the police, is over-crowded within the meaning of the Act, if the cubic space available for each inmate fall short of four hundred cubic feet. Two children, under 12 years, are allowed to count as one person. A room, therefore, 15ft. long by 10ft wide, by 8ft. high, cannot lawfully be occupied by more than three persons. Cheap, and at the same time, healthy and commodious dwellings for the poor, is the great desideratum of the present time. The poor spend a large amount of their earnings in house-rent, which, if rents were cheaper, might be spent in procuring an increase of food. Unfortunately for the poor, the expense of their lodgings, in some instances, becomes increased, in consequence of landlords employing agents, who again employ sub-agents to collect the rents. This plan may, perhaps, be unavoidable, but it is very disadvantageous to the honest and industrious poor. Various schemes have been proposed to mitigate the evils of over-crowding, »nd lessening the house-rent of small houses occupied by the poor, but nothing, on a scale commensurate with its importance, has been adopted. Model lodging-houses have been built in some places with good results, facilities have been afforded by the legislature to parishes to erect lodging-houses for the labouring classes ; and the latest 7 scheme put forth to remedy this growing evil of over-crowding, is to have a system of cheap railways to the outskirts of the metropolis, so as to enable the labouring classes to live out of town. I do not think that a faubourg of the metropolis entirely inhabited by work-people is desirable. The rich and the poor, the learned and the unlearned, should live near to each other, so that the example of the more elevated in rank might prove profitable to their humbler fellow citizens. On referring to table No. 2 in the appendix, it will be seen among other sanitary improvements effected, that 1164 cesspools have been abolished, and a complete system of drainage effected in their stead. Although, so much care is taken to fill up cesspools, it is strange that more effective measures are not taken to remove daily all dung-heaps from stables and cow-sheds, the effluvia from which are similar to those arising from cesspools. It is also very singular, that the antiquated notion of the wholesomeness of cow-sheds should still be prevalent—that the effluvium from the excrementious matter of cows is really beneficial to the health of some invalids—that consumptive patients, and children suffering from hooping cough, have resorted to those places, and have derived benefit from inhaling the atmosphere in them! Scientific men, however, who have investigated this subject, have arrived at a different conclusion respecting the alleged wholesomeness of the atmosphere of cow-houses, and they have adduced numerous instances showing that they are injurious to health. I am inclined to look upon the assertion of the beneficial effects of cow-houses upon health to be merely a tradition, not founded upon fact; but, if invalids have really derived benefit from visiting such places, the benefit is to be attributed to the hygeianic accompaniments of such visits, such as the early rising, the daily walk in the country, the diversion of the mind, and the drinking of a glass of pure rich milk from cows fed on good pasture land. The number of houses systematically visited by the Inspectors during the last quarter, was 362, and during the year, the number was 1111. It was found, upon inspection, that the back yards belonging to several of the houses which were visited, were in a damp and unwholesome condition, from their being unpaved. In every instance, where this sanitary defect existed, a notice was served upon the landlord to pave the yard, so that the noxious exhalations arising from the earth, which had become saturated with decaying animal and vegetable matter, might be prevented. In the course of visitation, the Inspectors also found that several houses occupied by the poor had not been limewhited for very many years. In all those cases, where the walls were found to be in a dirty condition, and where fever had recently existed, orders were given to the landlords to limewhite the rooms. The frequent limewhiting of rooms is of great importance to the health of the tenants, for walls retain the poison which is emitted from the lungs in respiration, and from the exhalations of the skin. The importance of making a house-to-house visitation, is almost universally admitted, and I am happy to find it 13 now becoming generally adopted in the several districts in the metropolis, and the advantage derivable from this proceeding will be felt by the whole community. It is well known, that fever, and analogous diseases, do not 8 confine their ravages to the locality where they are generated, but they extend to other places ; which clearly shows that all the inhabitants of this vast metropolis are equally interested in endeavouring to prevent fever occurring in any locality. It is to the interior of the houses that our attention must be most particularly directed—for it is here, that the source of diseases is generally to be found. I regret to be compelled to state that the syphoned traps to privies, in many instances, continue to be broken ; and when repaired, they have been, and shortly afterwards, again destroyed. This is much to be deplored, but if landlords would suggest any better plan than the syphoned traps now in use, which would be more durable and less expensive, and at the same time as efficient in preventing the escape of the effluvia of privies, such plan would be readily adopted. In the mean time, however, we have no alternative, in cases of nuisance from privies, but to continue to order the further use of such traps. Landlords, and their agents, might, upon every occasion of collecting their rents, take some pains to instruct their tenants in the use of such apparatus which has been constructed for their health and comfort; and it will be found, that the poor will as readily receive instruction, and can as readily profit by it, as their more wealthy fellow citizens. In the month of December last, Mr. Coward, one of the Sanitary Inspectors of the district, seized about one cwt. of unsound meat which was unlawfully exposed for sale, at a butcher's shop in Spitalfields ; and it was conveyed by him to the Police Office, in Worship Street. The magistrate, upon inspection of the meat, being satisfied that it was unfit for human food, ordered it to be destroyed, and he inflicted a penalty of £5 on the person who exposed the same for sale. An appeal against the conviction of the magistrate was prosecuted at the Guildhall, Westminster ; but the conviction was confirmed, with £10 costs, in addition to the fine imposed by the magistrate. Amongst other sanitary improvements which have been effected during the past year, in this district, I may mention the paving of Little Love Court, Hebrew Place, Little Middlesex Street, Love Court, Boar's Head Yard, Spring Gardens, and Mason's Court; the opening out of Quaker Street, by the removal of some old warehouses and dwelling-houses, and the converting of Iieate Court into a thoroughfare. The paving of courts, and the opening out of thoroughfares in confined neighbourhoods, will prove not only beneficial to the health of the inhabitants, but will contribute to their comfort. It is a well ascertained fact, that whenever a Court has been well paved, the landlords have been induced to improve their houses, and the tenants have shown a disposition to keep their rooms and passages in a cleaner state. The attempt to keep the interior of a house clean is fruitless, if the immediate approaches to it are in a filthy condition. The nuisances arising from the carrying on offensive trades have been much mitigated ; and, although complaints are occasionally made, I have invariably found a disposition on the part of the manufacturers to use their utmost endeavours to prevent annoyance to the neighbourhood. Iu several parts of the district, the houses are very old and dilapidated, and it 9 will be necessary, from time to time, to inspect them, so that timely notice may be given to the Police, before they become absolutely dangerous. About 100 houses have been pulled down in the district during the past year. The nuisance arising from the keeping of pigs is continually occurring, notwithstanding the several convictions which have taken place before the magistrates. Thomas' Street, which is in the immediate vicinity of the Union Workhouse, is the iocality where this nuisance is most frequently found to exist. In consequence of the irregularity in the numbering of many of the Streets, great inconvenience is experienced by the officers of your Board, and by the dustmen, who are required to call at those houses where nuisances are complained of, and where the dust has not been removed ; and it not unfrequently happens, that the parties complaining make fresh application to the Office of the Board, saying, that no attention has been paid to their complaint, when, upon enquiry, it turns out, that the dustmen went to the wrong house, there being more than one house of the same number in the street. In order to remedy this inconvenience, I shall, at an early day, lay before the Board, a list of the streets in the district which require numbering, accompanied with a suggestion of the best mode of accomplishing this desirable object. As complaints continue to be made by the inhabitants of their not knowing where to make application in cases of nuisance, I would again respectfully request, that notice boards be fixed in conspicuous parts of the district, informing the inhabitants where to make such application. In conclusion, permit me to direct your attention to the desirability of erecting "DRINKING FOUNTAINS" in the district. Great benefits to the inhabitants, both morally and physically, have resulted, wherever these fountains have been erected, and I firmlv believe, that if the working classes could procure, without much trouble, a draught of pure water, they would not so frequently resort to the public-house or to the gin palace. I am, Gentlemen, Your obedient Servant, 15, Great A lie Street, 1st February, 1869. JOHN LIDDLE. APPENDIX TABLE L SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED since the 1st of January, 1856, to the 31st of December, 1858. From February, 1856, to the 2nd of October, 1858. For the Quarter ending 3lst December, 1858. Total number of Nuisances removed. Works in progress but not completed. Number of Nuisances inspected in houses and yards. Number of Houses systematically visited. House-to- house visitation. Number of Nuisances entered in Complaint Books. 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 ot Notices served. For defective Drainage For other Nuisances For defective Drainage. For other Nuisances. 13,056 †l455 7882 3459 5681 24 82 1750 329 1014 362 324 2 4 161 *This total refers to Nuisances of every description, including the non-removal of Dust, Sc., complaints of which had been made at the Office. †This number appears large, but it chiefly refers to works completed, with the exception of Water Apparatuses to Closets, and Covered Dust Bins in Yards, TABLE I.—continued. NUMBER OF HOUSES VISITED FROM OCT. 2nd, 1858, TO THE 31st DEC., 1858, WHERE THE UNDERMENTIONED NUISANCES WERE FOUND TO EXIST. OTHER WORKS, &e 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. Dangerous Cellar Flaps and Area Gratings. Works in progress. Works allowed to stand over from various causes Works done without notice. 163 137 51 83 13 0 150 39 91 104 21 134 139 3 4 97 5 32 3 2 41 45 98 7 9 44 28 378 48 329 320 410 *Filthy Houses where Illness frequently existed TABLE II. SUMMARY OF WORKS EXECUTED UP TO OCTOBER 2nd, 1858. Limewliiting 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 cleansed.—No Sewerage. New House Drainage made. House Drainage improved, Trapped, &c. Cellars cleansed. Filthy Privies cleansed. Water supply to Soil-pans. New Privies constructed. Pans to Privies provided. *Over-erowded Houses remedied. †Houses unfitted for Human habitation. Ventilation improved. Private Courts Paved. Filth in open places removed. ‡Dangerous structures. Othernuisances removed,Dust,StagnantWater,&c. Dangerous Cellar Flaps and Area Gratings. 1395 695 524 755 23 36 1605 1070 1189 813 391 510 1585 47 1391 26 39 11 12 59 149 8348 276 SUMMARY OF WORKS EXECUTED FROM OCTOBER 2nd, 1858, TO DECEMBER 31st, 1858. Gross Tolal. 72 67 39 43 12 0 59 87 14 74 21 134 42 3 38 4 2 3 2 6 28 1986 48 1467 762 563 798 35 36 1664 1157 1203 887 412 644 1627 50 1428 30 41 14 14 65 177 10, 334 324 * It will be seen in Table No. 1, Column No. 1, that the total number of Nuisances removed is 13,056, but that "number does not give the detail of each separate case. For instance : The case may be an Offensive Privy—requiring, 1st. Cesspool to be emptied and filled up. 2nd. To and Pan'd. 3rd, Pipes to be laid from Pans to Sewer. &c. If each of these were shown, as a distinct work ixeculed, the number in the Table and Column above alluded to, would be about 24,032. 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 1st January, 1859. Districts. Names of Medical Officers. Small Pox. Measles. Scarlatina. Hooping Cough Diarrhoea. Typhus or continued Fever. Cholera. Erysipelas. Pyæmia. Puerperal Fever. Carbuncle. Bronchitis and Catarrh. Pneumonia and Pleuritis. Croup. Diphtheria Rheumatic Fever. Ague. Dysentery. Other Diseases. Total. Average number of Fever cases per Week. Spitalfields Mr. Blackwell 4 12 18 7 34 28 0 9 0 0 2 47 22 0 0 0 0 1 654 838 Mile End New Town Mr. Cliampneys 1 2 12 3 19 63 0 6 0 0 0 6 5 0 0 0 1 0 327 445 Whitechapel Mr. Richardson 3 0 30 6 11 5 0 2 0 0 1 73 0 1 0 0 0 0 355 487 Goodman's Fields Mr. Sequeira () 6 17 47 57 60 0 9 0 0 0 102 58 0 1 1 12 0 752 1122 Totals 8 20 77 63 121 156 0 26 0 0 3 228 85 1 1 1 13 1 2088 2892 12 TABLE IV.—Table showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 1st January, 1859. 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. 1858 1857 Artillery 0 0 0 0 0 2 0 1 1 0 0 1 1 4 5 3 Spitalfields 0 1 1 0 7 6 2 3 0 0 2 2 12 12 24 16 Mile End New Town 0 1 0 0 5 8 1 2 2 2 8 8 16 21 37 17 Whitechapel North 0 0 0 0 8 1 3 2 0 1 2 1 13 5 18 17 Whitechapel Church 0 0 0 0 3 1 0 0 0 0 2 1 5 2 7 19 Goodman's Fields 0 0 0 0 2 1 9 3 1 1 1 3 13 8 21 13 Aldgate 0 0 0 1 0 0 3 3 1 1 1 0 5 5 10 9 0 0 1 1 25 19 18 14 5 5 16 16 65 57 122 94 2 2 44 32 10 32 122 Deaths from Epidemics for the corresponding Quarter of last year. 0 10 11 20 15 38 94 14 TABLE V.—Ages at Death in the Workhouse. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 90 80 and upwards. Total Males 30 Females 37 Corresponding Quarter of 1857. 10 7 1 16 10 18 5 67 59 TABLE VI.—Showing the Deaths from Epidemic Diseases in the Whitechapel District during the years 1857 and 1858. 1857. 1858. Districts. Small Pox. Measles. Scarlet Ferer. Hooping Cough. Diarrhoea. 1 Typhus. Total. Small Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhoea. Typhus. Total. Artillery 0 6 4 9 5 3 27 1 4 9 3 5 7 29 Spitalfields 0 9 9 19 15 10 52 0 24 22 14 15 18 93 Mile End New Town 0 18 4 6 24 36 88 1 5 24 33 34 38 135 Whitechapel, N 1 11 2 20 25 34 93 0 6 18 19 22 22 87 Whitechapel Church 1 2 8 10 14 15 50 1 7 6 7 7 11 39 Goodman's Fields 0 8 9 15 29 8 69 0 15 6 25 12 4 62 Aldgate 1 6 7 10 27 11 62 1 17 2 16 13 4 53 3 60 43 89 139 117 451 4 78 87 117 108 104 498 TABLE VII.—Showing the Mortality in the Workhouses and Hospitals in the District during 1856, 1857, and 1858. Union Workhouse. London Hospital. Military Hospital. 1856 353 1856 297 1856 0 1857 272 1857 338 1857 2 1858 269 1858 325 1858 5 TABLE VIII.—Showing the Mortality per cent, in the Whitechapel District in the undermentioned years. From 1857 to 1858., From 1839 to 1844. From 1844 to 1850. From 1854 to 1855. From 1856 to 1857. From 1857 to 1858. 4.5 3.3 2.9 2.8 2.4 2.6 From 1855 to the present time, the population of this District is estimated at 84,000. 15 TABLE IX.—Showing the Births and Deaths in the Seven Registration Districts in each Quarter of the year 1858. BIRTHS. DEATHS. Districts. March, July. October. January. Total. March. July. j October. January. Total. Excess of Births over Deaths. Excess of Deaths over Births. Arillery 52 57 50 50 209 26 30 34 40 130 79 0 Spitalfields 135 148 108 135 526 86 86 95 110 377 149 0 *Mile End New Town 131 139 132 157 561 146 106 121 172 515 16 0 Whitechapel, North 148 116 94 98 456 144 67 83 85 379 77 0 †Whitechapel Church 87 52 66 77 282 142 112 106 139 499 0 217 Goodman's Fields 99 85 92 106 382 66 60 54 78 258 124 0 ‡Aldgate 90 90 62 84 326 76 77 54 49 256 70 0 744 687 604 707 2742 686 538 547 673 2444 515 217 *The Workhouse is situated in this District. †The London Hospital is situated in this District; in which Institution, exclusive of the Deaths caused by violence, there died 211 non-residents. The actual excess of Deaths over Births therefore is 6. ‡The Military Hospital in the Tower is situated in this District, in which Institution, there were 5 deaths, all non-residents; the Garrison of the Tower not being included in the population of the District. TABLE X.—Showing the total Mortality in the Whitechapel District, without deductions for Non-residents, in each year during 11 years, from 1848-58. 1848 1849 1850 1851 1852 1853 1854 1855 1856 1857 53 weeks 1858 Mortality 2648 2778 2061 2377 2286 2444 2878 2453 2237 2360 2444 16 TABLE XI.—Summary of the various causes of Death in the Whitechapel District for the year ending January 1st, 1859. March. July. Oct. Jan. Total 1857 Total. 1. Zymotic 128 120 181 143 572 537 2. Dropsy, &c. 22 17 11 19 69 100 3. Tubercular 114 96 87 106 403 436 4. Brain and Nerves 80 58 65 52 255 212 5. Heart and Blood Vessels 18 12 17 21 68 58 6. Organs of Respiration 170 85 66 163 484 385 7. Organs of Digestion 30 37 22 32 121 115 8. Kidney, &c. 9 5 10 11 35 46 9. Childbirth, &c. 2 4 2 1 9 11 10. Joints, Bonce, &c. 2 2 0 5 9 6 11. Cellular Tissue, &c. 0 0 1 0 1 2 12. Malformations 3 0 2 1 6 2 13. Premature Birth & Debility 15 11 17 17 60 59 14. Atrophy 0 2 0 2 4 2 15. Old Age. 30 28 20 34 112 112 16. Violent Death 46 42 34 47 169 179 17. Not specified 17 19 12 19 67 88 686 538 547 673 2444 2350 Non-residents dying in the London Hossital 211 297 Increase in the number of Deaths over that of last Ditto in the Military Hospital in the Tower 5 2 216 299 Of the 572 Deaths from, Zymotic Diseases, 104 were cases of Fever, and 108 of Diarrhoea; and out of the total deaths there died— 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. 1858 563 591 188 317 402 300 83 2444 1857 523 509 153 350 434 328 53 2350 TABLE XII.—Causes of Death at Seven Periods of Life, registered in the Whitechapel District, for the Three Months ending 1st January, 1859 Causes of Death. 0 and under 1 1 and under 5 5 and under 20 20 and under 4o 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 j 60 and under 80 80 and above ,/ 1.—Zymotic:— Brought forward 122 153 46 70 81 44 6 522 Small Pox ... 1 1 ... ... ... ... 2 Stomach and Digestive Organs. Measles ... 2 ... ... ... ... ... 2 Scarlatina (Scar.Fev.) 5 28 10 1 ... ... ... 44 Hooping Cough 10 22 ... ... ... ... ... 32 Hernia (Rupture) ... ... ... ... 1 ... ... l Croup 1 3 1 ... ... ... ... 5 (Ileus (Inflammation and Gangrene of the Muscular Coat of the Intestine) Thrush Diarrhoea (bowel com- Plaint) 5 2 ... ... ... 2 1 10 Dyseentery 1 ... ... ... ... ... ... 1 Intussusception, (a part of the Bowels introduced into the part below.) Cholera Influenza Scurvy and Purpura Ague ... ... ... 1 ... ... ... 1 Stricture of Intestinal Canal Remittent Fever ... ... ... 1 ... ... ... 1 Infantile Fever Disease of Stomach, &c ... ... ... 1 ... ... 1 2 Typhus Fever ... 4 5 10 8 4 1 32 Puerperal Fever (Metria) ... ... ... 1 ... ... ... 1 Strict, of (Esophagus ... ... ... 1 ... ... ... 1 Inflammation of Liver (Hepatitis) ... ... ... ... 2 ... ... 2 Rheumatic. Fever ... ... ... 3 1 ... ... 4 Erysipelas (Rose) ... ... ... 1 1 ... ... 2 Jaundice Syphilis 4 ... ... ... ... ... ... 4 Disease of Liver ... 1 ... 1 2 ... ... 4 Noma (Canker) Cirrhosis ... ... ... 2 2 ... ... 4 Hydrophobia Disease of Spleen Diphtheria ... 1 1 ... ... ... ... 2 VI1I. KIDNEY, &C. Nephritis ... ... ... 1 ... ... ... 1 II.—Dropsy, &c. Haemorrhage Nephria (Bright's dis- ease ... ... ... 2 5 1 ... 8 Anaemia Dropsy ... ... 1 1 1 1 ... 4 Ischuria Abscess (Gathering) ... ... 1 1 2 ... ... 4 Disease of Prostate ... ... ... ... ... 2 ... 2 Ulcer Diabetes Fistula Stone Mortification 1 ... ... ... 1 ... ... 3 Cystitis Cancer Stricture of Urethra Gout ... ... ... 1 6 1 ... 8 Disease of Bladder III.—Tubercular:— IX. ChildbirthParamenia Scrofula ... 1 ... 1 ... ... ... 2 Tabes Mesenterica 12 10 2 ... ... ... ... 24 Ovarian Dropsy Phthisis(Consumptn) 1 5 6 34 24 3 ... 73 Childbirth(SeeMetria) Hydrocephalus (water 011 the Brain) 2 4 1 ... ... ... ... 7 Disease of Uterus, &c Ext. Uterine Fœtation ... ... 1 ... ... ... ... 1 X, Joints, Bones, &c Rheumatism IV.—Brain & Nerves Cephalitis Arthritis Apoplexy ... ... ... ... 3 4 ... 7 Disease of Joints &c. ... ... 1 ... ... ... ... 1 Palsy (Paralysis) ... ... ... 3 3 3 1 10 Spinal Disease ... ... 1 2 1 ... ... 4 Delirium Tremens ... ... ... ... 1 ... ... 1 XI.—Skin, Cellular Tissue &c. Chorea Epilepsy ... ... 1 ... ... ... ... 1 Carbuncle Tetanus Phlegmon Insanity Disease of Skin, &c Convulsions 21 9 ... ... ... ... ... 30 XII. Malformation. Cyanosis 1 ... ... ... ... ... ... 1 Disease of Brain, &c ... 2 1 ... ... ... ... 3 Idiocy Spina Bifida V.—Heart & Blood Vessels :— Other Malformations Pyœmia ... 1 1 ... 1 ... ... 3 XIII Premature Birth & Debility . 17 ... ... ... ... ... ... 17 Pericarditis Aneurism XIV. Atrophy 2 ... ... ... ... ... ... 2 Disease of Arteries 1 ... 1 2 10 3 ... 17 XV. Old Age ... ... ... ... ... 14 20 34 Disease of Heart, &c. XVI. Sudden Uraemia 1 ... ... ... ... ... ... 1 Sun Stroke VI. Lijngs Organs of Respiration:— XVII. ViolentDeath Intemperance Laryngitis ... 3 1 ... ... ... ... 4 Privation of Food ... ... ... 1 ... 1 ... 2 Bronchitis 17 12 6 4 4 12 2 57 Want of Breast Milk 2 ... ... ... ... ... ... 2 Pleurisy ... ... 1 1 ... 1 ... 3 Neglect 2 Pneumonia 38 38 3 2 6 3 1 91 Cold Asthma ... ... ... ... 3 2 ... 5 Poison Disease of Lungs ... ... ... 1 1 1 ... 3 Burns and Scalds ... 6 3 ... ... 1 ... 10 VII.—Stomach and Digestive Organs: Hanging iv Suffocation 1 ... ... ... ... ... ... 1 Teething 2 3 ... ... ... ... ... 5 Drowning Quinsey Wounds Gastritis Violence 1 2 4 11 13 1 ... 32 Enteritis ... 1 ... ... 1 2 ... 4 XVIII. Not Specified, 8 1 1 3 4 2 ... 19 Peritonitis ... ... 2 1 2 ... ... 5 Ascites ... 1 ... ... 2 1 ... 4 Grand Total 154 163 57 95 111 66 27 673 Ulc. of Intestines Corned Forward 122 153 46 70 81 44 6 522 LONDON HOSPITAL.—TABLE Xlll. Causes of Death at Seven periods of Life, registered in the London Hospital, for the Three Months ending 1st January, 1859. Causes of Death. 0 and under 1 1 and under 5. 5 aud under 20. 10 and under 40. 40 and under .10. 60 and under SO 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 unoer 60 60 and under 80 80 and above Total. i.—Zymotic:— Brought forward ... 1 8 14 13 4 ... 40 Small Pox Stomach and Digestive Organs. Measles Scarlatina (Scar.Fev.) Hernia (Rupture) ... ... ... ... 1 ... ... 1 Hooping Cough Ileus (Inflammation) and Gangrene of the Muscular Coat of the Intestine Croup Thrush Diarrhoea (bowel com- Plaint Intussusception, (a part of the Bowels introduced into the part below.) Dysentery Cholera influenze Scurvy and Purpura Ague Stricture of Intestinal Canal Remittant Fever Disease of Stomach, ... ... ... 1 1 ... ... 2 Infantile Fever Typhus Fever I l Disease of Pancreas Puerperal Fever (Metria) Inflammation of Liver Jaundice Rheumatic Fever Disease of Liver 1 Erysipelas (Rose) 1 1 2 Cirrhosis Syphilis Disease of Spleen Noma (Canker) VIII.—Kidney, &c. Nephritis Hydrophobia Diphtheria Nephria (Brigbt's disease) ... ... ... 1 3 ... ... 4 II. Dropty, &c. Hæmorrhage Ischuria Anæmia Disease of Prostate ... ... ... ... ... 2 ... 2 Dropsy Diabetes Abscess (Gathering) ... ... 1 2 ... 1 ... 4 Stone Ulcer Cystitis Fistula ... ... ... ... ... 1 ... 1 Stricture of Urethra Mortification ... ... ... 1 1 ... ... 2 Disease of Bladder Cancer IX.—Childbirth. Gout Ext Uterine Foetation III.—Tubercular Ovarian Dropsy Childbirth(seeMetria) Tabes Mesenterica Disease of Uterus, &c. ... ... 1 ... ... ... ... 1 Phtliisis(Consumptn) 1 2 2 5 X.—Joints, Bones, &c. H ydrocephal us (water on the brain) Rheumatism Arthritis IV.—Brain & Nerves Disease of Joints, &c. ... ... 1 ... ... ... ... 1 Cephslitis Spinal Disease ... ... 1 2 ... ... ... 3 Apoplexy ... ... ... ... 1 ... ... 1 XI —Skin, Cellular Tissue, &c. Palsy (Paralysis) ... ... ... 1 ... l ... 2 Delirium Tremens Carbuncle Chorea ... ... ... ... 1 ... ... 1 Phlegmon Epilepsy Disease of Skin, &c Tetanus XII.—Malformation Insanity Cvanosis Convulsions Spina Bifida Disease of Brain, &c. Other Malformations Idiocy V.—Heart & Blood Vessels:— XIII. — Premature Birth & Debility. Pyaemia XIV.—AtropAy. Pericarditis Aneurism XV.—Old Age. Disense of Arteries ... ... 1 2 3 1 ... 7 Disease of Heart, &c. XVI. Sudden Deaths VI—Lungs & Organs of Respiration:— XVII.Violent Death Intemperance Laryngitis ... 1 ... ... ... ... ... 1 Privation of Food Bronchitis ... ... ... 1 1 ... ... 2 Want of Breast Milk Pleurisy ... ... 1 ... ... ... ... 1 Neglect Pneumonia ... ... 3 1 1 ... ... 5 Cold Asthma Poison Disease of Lungs Burns aud Scalds ... 6 3 ... ... 1 ... 10 VI. — Stomach and Digestive Organs: Hanging Suffocation Teething Drowning Quinsey Wounds gastritis Violence ... 1 5 9 12 1 ... 28 Enteritis Peritonitis ... ... ... 1 ... ... ... 3 XVIII.—Not Specified. ... ... ... 1 2 ... ... 3 Ascites ... ... ... ... 1 ... ... 1 Ulc. of Intestines Carried forward ... 1 8 14 13 4 ... 40 Grand Total ... 8 19 28 33 8 9S 19 TABLE XIV.— Showing the Name of the Locality, the Number of the Houses in such Locality, the Cases of Fever attended by the Medical Officers of the Union, and the Deaths from Zymotic Diseases for the year ending 1st January, 1859 Name of Place. No; of Homes. Cases of Fever. Deaths from Zymotic Disease. Name of Place. No. of H ouses. Cases of Fever. Deaths from Zymotic Disease. Whitechapel. Brick - lane 21 1 5 Thomas-street 48 2 3 Osborn-place 12 - 2 Buck's-row 12 — 1 Chicksand-street 33 - 1 Queen Ann-street 60 2 7 Little Halifax-street 15 - 5 John-street 31 1 2 Little John-street 15 - 1 BAth-place 29 — 1 John-street 20 1 1 Wellington-street 13 — 1 Ely-Place 15 1 3 Little North-street 16 — 1 Luntley-place 17 - 1 Nelson's alley 9 — 1 Hanover-court 4 1 — Harrison's-buildings 10 — 1 Finch-street 56 — 2 Raven-row 19 1 — Montague-street 24 - 2 Raven-street 41 — 1 Frosic-count 6 - 1 Cotton-street 21 — 2 Old Montague-street 31 2 2 Green-street 15 — 1 Old Montague-court 8 1 — New-road 32 — 2 Black Lion-yard 31 — 1 Oxford-street 26 — 3 Easington's-buildings 18 — 1 Charlotte-streett 76 — 2 Montague-place 14 — 2 Charlotte-court 56 1 — Green Dragon-yard 26 — 2 Vine-court 18 2 — *Went worth-street 106 8 9 Hampshire-place 14 1 2 Angel-alley 15 — 1 Fieldgate-street 44 — 3 George-yard 27 3 2 John-street 16 — 2 Garden-count 4 — 1 Drum-yard 8 1 — New-court 27 4 3 Barleymow-count 8 — 4 Crown-court, W entworth-st. 11 4 — Mansell-street 54 1 3 Old Castle-street 16 3 — Haydon-square 6 — 1 Newcastle-place 40 — 1 Swan-street 11 — 1 Goulston-couit 92 18 10 Grigg's-count 10 1 4 Goulston-street Knock's-court 6 1 — Goulston-alley Newn ham-street 27 — 4 Three Tun-alley Great Alie-street 47 2 1 Marlborough-court 8 1 1 Half Moon-passnge 12 1 — Horse-shoe-place 7 — 1 Leman-street 131 — 4 Elizabeth-court 3 1 — Buckle-street 21 5 1 Swan-yard 21 1 — Plough-street 26 3 2 Little Love-court 5 2 — Colchester-street 35 4 1 Love-court 38 — 1 Little Alie-street 28 — 4 Hebrew-place 12 — 1 Chamber-street 72 3 6 Boar's Head-yard 22 8 1 Chamber-court 5 — 1 High-street 141 — 1 Bond's-buildings 5 1 — Castle-alley 30 5 1 Leman-row 13 7 2 Tewksbury-buildings 14 — 6 Rupert-street 23 3 2 Inkhorn-count 7 1 1 Lambeth-street 50 12 7 Koad-side 238 - 5 White Bear-court 23 2 — King's Arm's-court — 1 — Gower's-walk 59 2 2 Crown-court 14 2 1 Jones'-buildings 30 3 2 Moss-buildings 17 1 2 Webb's-place 4 — 2 Fann-court 5 1 — Back Church-lane 83 2 3 White's-row 16 — 1 Friendly-buildings 12 - 1 *Including Spitalfields. 3 Cases of Scarlet Fever occurred at 3, Elizabeth Place; 3 Cases in Dunk Street; 3 Cases in John Street; 3 Cases at 117, Rosemary Lane. A Case of Small Pox occurred at 52, Flower and Dean Street, and was sent to the Small Pox Hospital. 20 TABLE XIV.—(continued.) Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Disease. Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Disease. Willam's-rents 22 1 1 Providence-place 12 1 2 Brunswick-place 17 — 1 Cartwright-square 16 1 1 Conat's-place 10 1 1 Peter's-court 23 3 2 Cable-street 43 — 3 Well's-yard 8 3 1 Gower's-place 16 — 3 Lower East Smithfield 18 — 1 Grower's-place 10 2 1 Burr-street 40 — 1 Well's-place 38 6 5 King-street 29 — 2 Well's-yard Postern-row 14 — 1 *Kosemary-lane 117 10 8 Holy Trinity, Minories. Able's-buildings 6 3 1 Minories 15 — 1 baker's Arm's-alley 6 1 — Church-street 18 2 — Swallow's-gardens 30 1 3 Haydon-square 3 1 1 John son's-change 19 3 3 Old Artillery Ground. White Horse-court 9 3 1 Christopher-court 9 2 — Artillerv-street 19 — 2 Blue Anchor-yard 14 3 3 Duke-street 33 — 4 Hairbrain-court 13 5 — Fort-street 30 — 2 Parson's-count 7 — 1 †Spital-square 15 — 2 Holloway-count 10 2 1 Gun-street 45 — 3 Kittleby-court 9 3 — Bracey's-buildings 11 3 1 Norton Folgate. Cooper's-court 14 4 — High-street 40 — 3 Kose-court 10 1 2 Elder-street 12 — 1 Crown-court 21 10 5 Moor's-gardens 22 1 2 Slater;s-count 10 — 1 White Lion-street 17 — 1 Russell-court 10 3 1 Spitalfields. Windmill-court 13 4 2 Rachael-court 9 5 4 Raven-row 8 — 1 Swan-count 9 1 1 Crispin-street 49 2 1 Glasshouse-street til 1 1 Lamb-street 33 — 1 Compasses-court 6 1 — Church-passage 3 — 1 garden-count 12 4 1 Wheeler-street 20 — 1 New Martin-street 22 3 3 Chapel-street 15 1 1 Providence-count 8 — 1 King-street 17 5 3 Cherubim-court 6 1 1 Matthew-court 7 — 1 Haye's-count 7 3 — Brick-lane 111 — 2 Dock-street 20 1 — Phœnix-street 28 — 3 Shorter's-rents 11 2 — Canterbury-court 9 2 2 Charles-count 10 — 1 Wood-street 7 1 1 Grace's-alley 19 — 2 Wood's-yard 5 1 — Wellclose-square 22 — 2 Quaker-street 50 7 7 Aldgate, Tower, and St. Katherine's. Crown-count 16 8 — Jeffries-buildings 4 — 1 Grey Eagle-street 68 6 11 Butler's-buildings 18 1 1 Hope-street 27 3 3 Crown-court 39 1 1 Queen-street 33 2 — Cartwright-strcet 22 8 5 Wilke's-street 26 1 2 Hurn's-building 8 1 1 Pope's Head-court 17 1 4 Farthing-alley 8 1 1 Great Pearl-street 31 3 2 Norwich-court 7 1 — New-court 14 — 1 Turner-street 14 1 — Little Pearl-street 25 3 2 Walton's-court 8 1 1 Vine-court 17 — 2 *Including Aldgate. †Including Norton Folgate. 21 TABLE XIV.—(continued.) Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Disease. Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Disease Vine-place 3 3 - Mile End New Town. Brown's-lane 35 1 2 Church-street 88 11 1 LAmb-street — — 1 Unanimous-row 6 5 3 Jhon-street 12 4 2 Charles-street 10 3 2 Pelham-street 33 2 5 Underwood-street 48 9 6 Montague-street 38 2 2 Buttress-gardens 5 - 1 Booth-street 37 3 — Luck-street 48 5 3 Speck's-buildings 8 — 3 *Preinces-street 104 27 12 Purcer's-court 17 — 1 Princes-place Rose and Crown-court 5 1 — Bell-palce 10 4 2 North-street 11 — 1 Bell-yard 16 4 — Red Lion-court 9 — 1 Eele-place 12 1 — White's-row 29 1 — King-street 16 1 — Tenter-street 36 2 2 King Edward-street 35 10 5 Butler-street 23 1 4 Eele-place 12 1 1 Shepherd-street 33 — 1 Spring-gardens 27 7 — Palmer-street 29 — 2 Halifax-street 18 5 3 Tilly-street 24 — 3 Dunk-street 42 16 1 Dorset-street 34 1 5 High-street 63 11 1 Eosetta-place 7 — 1 George-street 38 5 1 Sandy's-row 15 — 1 George-court 6 — 1 Fryingpan-alley 14 1 — Mason's-count 8 3 1 Tuson-court 6 1 — Garden-place 14 3 — Dinah's-bnildings 12 1 — Chicksand-street 36 3 2 Fisher's-alley 12 4 1 Cliicksand-place 18 4 1 Cobb's-yard 18 — 1 Jon's-place 6 11 — Cox's-square 18 — 3 pugh's-row 7 — 2 Bell-lane 40 1 2 Rama-place 10 1 — Wentworth-court 10 — 1 Well-street 37 12 2 Ann's-place 11 — 1 Booth-street 5 2 — George-street 28 — 3 Spital-street 41 11 — Thrawl-street 31 1 1 Deal-street 12 7 1 Flower and Dean-street 51 5 7 Pelham-street 48 18 2 Dale's-court 26 — 1 Spicer-street 36 17 4 Willson-place 16 1 — Hunt-street 40 7 4 Upper Iteate-street 19 — 1 Hunt-court 8 11 3 Lower Keate street 13 2 — Sarah'splace 3 — 1 Keate-court 4 2 1 Buxoton-street 42 — 2 Heneage-street 34 2 4 North-place 24 — 1 Fashion-street 55 2 2 Ellerm's-place 8 1 — Adelaide-place 4 — 1 Hobson's-court 5 1 1 Neatsby-court 8 1 — Union-street — — 2 Church-street 2 *Including Whitechapel. Table XV.—Tabular Summary of House Improvements up to the 2nd of October, 1858. Name of Street or Place. No. of Houses in Place or Street. No. of Houses Inspected. Drains. Cesspools. Water Closets. Dust Bins. Pavement. General Water Supply. General Improvement Remarks. Number constructed. Improvement or Repair. Traps fixed. Abolished. Cleansed and Disinfected. Pans and Traps furnished. New ones constructed. Water supply provided. Constructed. Repaired. Constructed. Keiaid or Repaired. Receptacles provided. Receptacles repaired. Water supply provided. Generally repaired. Cleansing and Limewhiting. Ventilation. I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 4006 3459 207 1080 338 1105 167 1240 84 832 435 115 16 362 38 7 31 313 922 5 Tabular Summary of House Improvements for the Quarter ending 31st December, 1858. Great Garden-street 17 17 0 0 0 2 0 2 0 2 0 0 0 0 0 0 0 0 0 0 The totals in this Table do not correspond with the totals in Table 2. The improvements recorded in this table halftaen effected since the adoption of the system of house-to-house visitation. Table No. 2, shows the total improvements effected eince Jan. 1856. High-street, M.E.N.T 63 63 0 32 32 18 0 32 0 32 32 0 1 14 0 0 0 11 32 1 Masan's-court 8 8 0 8 8 0 0 4 0 0 1 0 1 0 0 0 0 0 8 0 Jon-street 42 39 0 17 17 17 0 17 0 0 17 0 0 17 0 0 0 0 17 0 Little John-street 8 8 0 6 5 5 0 6 0 0 5 0 0 5 5 0 0 0 5 0 Heneage-street 43 39 0 39 39 39 0 39 0 0 21 0 0 19 0 0 0 0 27 0 Adelaide-place 4 4 2 0 2 2 0 2 0 2 1 0 0 0 0 0 0 0 4 0 Church-st, M.E.N.T. continued 88 31 14 17 31 31 1 31 0 31 14 0 14 17 0 0 0 0 14 0 Wells-place and Yard 34 34 0 10 10 10 0 0 0 10 0 0 0 0 0 0 0 0 10 0 Colchester-street 35 35 0 0 0 0 6 0 0 0 0 6 0 0 0 0 0 0 6 0 Gower's-place 16 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Buckle-street 12 12 0 0 0 0 6 0 0 0 0 6 0 0 0 0 0 0 6 0 Plough-street 26 26 0 0 0 0 4 0 0 0 0 4 0 0 0 0 0 0 4 0 Gower's-row 10 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Bracey's-buildings 11 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Kittleby-court 9 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 Total 426 362 16 128 144 124 17 132 0 77 91 16 16 72 5 0 0 11 142 1 Gross Total 4432 3821 223 1208 482 1229 184 1372 84 909 526 131 32 434 43 7 31 324 1064 6 Much of the above work is now in hand, but it has been delayed in consequence of the Winter Season. 60 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT on The sanitary Condition of the WHITECHAPEL DISTRICT, for the THREE MONTHS ENDING APRIL 2nd, 1859. Bead to the Board, May 10th, 1859. LONDON: PRINTED BY MEAD & POWELL, 101, HIGH ST., WHITECHAPEL, and 6, 7, & 9, arcade, london bridge. 1859. REPORT. Gentlemen, The Sanitary condition of the Whitechapel District during the Quarter ending 2nd of April, 1859, has been much more satisfactory, both as regards the actual number of deaths, and the deaths by epidemic, or what are usually considered as preventible diseases, than it was during the corresponding quarter of last year. The mortality for the quarter recently terminated, was 611, including 59 nonresidents, and 33 cases of death in the London Hospital, the result of violence; the latter, for reasons stated in a former report, are included in the mortality returns of this district. The mortality for the corresponding quarter of last year was 686, including 77 non-residents, and the deaths from epidemic diseases were 108; whereas for the corresponding quarter of this year, the deaths from epidemic diseases were only 86. It is certainly very gratifying to me in being able to report the gradual diminution of the number of deaths from fever, which has taken place in the first three months of each year since 1856. In the quarter ending April 1st, 1856, the deaths from fever were 64; during the same period of 1857, they were 42. In the corresponding quarter of 1858 they were 32; and in the quarter recently terminated they were reduced to 24, or more properly to 21, as three of the cases occurred in the London Hospital, and had been removed to that Institution from other districts. The improvement in the state of the public health, as regards the decrease in the number of cases of fever, will be still more manifest on comparing the returns of sickness, furnished by the Medical Officers of the Union, for the corresponding quarters ending April 1st, of the years 1857 and 1858, with that of the current year. It will be seen that, during the first-named period, the number of sick was 2,091, and the fever cases were 327, or 15.6 per cent. of the total number of the cases of sickness, or an average of 25 per week. In the following year, the cases of sickness were 3,009, including 195 of fever, or 6.4 per cent., or an average of 15 per week; while, for the corresponding quarter of this year, the total number of cases of sickness was 2,936, 4 including 93 cases of fever, or 3.1 per cent., or an average of 7 per week. The fever cases appear to be very unequally distributed over the district. Thus, in Mr. Champney's district, out of 455 cases of sickness, there are recorded 48 of fever, or 105 per cent. In Mr. Richardson's district, out of 506 cases of illness, only 4 cases of fever are recorded, which is less than 1 per cent. In Mr. Blackwell's district, out of 805 cases, there are 17 of fever, or 2.1 per cent. And in Mr. Sequeira's district, out of 1,170 cases, there were 24 of fever, or 2 per cent. of the total number. I cannot explain this great discrepancy in the returns of the fever cases, as the deaths from fever in the registration districts bear a much more equal proportion to the population than do the returns of the cases of fever, made by the Medical Officers of the Union. It is possible that the cases of fever which are recorded in one district are only severe cases, while in the other districts, all cases, whether mild or severe, are recorded as fever. The same remark applies to the discrepancies that occur in the cases of bronchitis and catarrh. The deaths from fever in the several registration districts for the quarter ending the 1st of April, are as follow, viz.:—In the Artillery district, no death from fever is recorded; in the Spitalfields, the deaths from fever are 3; in the Mile End New Town, they are 6; in the Whitechapel North, 4; in the Whitechapel Church, 4; in the Goodman's Fields, 3; and in the Aldgate registration district, 2. During the last three months, 53 inquests were held on persons dying within the district, the majority of which were held at the London Hospital. The deaths of 14 persons were occasioned by burns or scalds, 11 of which were in consequence of the clothes of the parties catching fire. The ages of the sufferers will be seen on referring to Table No. VIII. In one instance, it is stated that the clothes of the child caught fire from the want of a fire-guard; two females, aged respectively 15 and 33, were burnt to death at the fire in Whitechapel High Street, on the 12th of February last; in twentyfour instances, death was occasioned by mechanical violence; two children were said to have been accidentally suffocated in bed, but in neither instance was a post mortem examination of the body made. Among the records of the Coroner's Inquests held during the last quarter, are the two following:—"Apparently drowned," and "Found dead in the River Thames;" no post mortem examination was instituted in either case. In one instance, the following verdict was returned:— "Sudden death while in the act of eating;" no further explanation of the case is given. There were seven deaths uncertified by any medical practitioner during the last quarter; among which are recorded the following:—"Termination of lloodto the head" male, aged 38. "Found dead in bed," a female, aged76. In neither of these cases was an inquest held. In one of the uncertified cases, death is said to have been caused by "ulceration of the bladder;" in another by "fever;" and, in three instances, the death is registered as "convulsions." In some of the above mentioned cases, it would have been better to have recorded that the cause of death was unknown. As medical advice is so easily obtained in this district, there ought not to be any case of death uncertified. The "Friendly Societies' Act," which was passed in 1855, requires, before any money is paid, a certificate of the cause of death, in every instance, from a qualified medical practitioner. This is a valuable provision for insuring skilful medical 5 aid, and there can be no doubt but that it will tend to diminish the great mortality of children, which now prevails in all our large towns. In this district, the mortality of children under 5 years of age is about 45 per cent. of the total deaths after deducting the deaths of the non-resident adults. This large mortality of young children need not surprise us, when we see how they are neglected by the natural guardians (perhaps from necessity) and left to the care of other children little older than those who are intrusted to them, while the mothers are engaged at work. The deaths of 16 persons, between 80 years of age and upwards, are recorded during the last quarter, one of whom was a female, aged. 99. A woman aged 92, met with her death by contusions produced by a fall while in a state of intoxication. The number of births registered during the last quarter was 759, viz., 383 males, and 376 females; and the deaths, excluding those of the non-residents, were 552. The increase of births over deaths, therefore, has been 207, but the increase is probably greater, for all the births are not registered,* the act in England for the registration of births, not being compulsory, as it is in Scotland.† The cases of illness among the out-door poor, attended by the medical officers of the union, during the last quarter, were 2936, or about 225 new cases per week. The cases of illness which occurred in the Workhouse were 375, including 1 of smallpox, 1 of scarlet fever, I of hooping cough, 26 of diarrhoea, 4 of erysipelas, and 40 of fever. The whole of the cases of fever and the greater number of the other epidemic diseases occured among the out-door poor, and were removed into the Workhouse. Although I am able, at the present moment, to speak so favorably of the comparative immunity of this district from the ravages of fever, yet it is with much regret that I have to record so many deaths from small-pox. No less than eight deaths from this disease have occurred within the last three months; whereas, during the preceding two years, only seven deaths were recorded, viz., 3 in 1857 and 4 in 1858. The number of cases of small-pox attended by the Medical Officers of the Union during the last quarter was 44, while only 20 were attended during the twelve months terminating on the 1st January, 1859. The increase in the number of cases of this loathsome disease is much to be lamented, more especially as it is known that, by proper precautions, its fatal effects can be prevented. The disease appears to have prevailed more extensively in the north-eastern districts of the Union, which are under the medical charge of Mr. Richardson and Mr. Champneys. It appears from the returns of Mr. Richardson, that 3.7 per cent. of the total number of cases of sickness, were cases of small-pox; and from the returns of Mr. Champneys, the proportion of small-pox cases to the cases of sickness was 2.6 per cent. The proportion in Mr. Blackwell's district was 1.3 per cent.; and in Mr. Sequeira's district, only 2 cases of small-pox are recorded out of 1,170 cases of sickness. In the records of the 44 cases of small-pox attended by the Medical Officers of the Union, it is stated that 6 were unvaccinated, and that 4 had been previously vaccinated; but the particulars relating to the number and appearance of the cicatrices are not given. In the remaining cases, no particulars are given as regards the previous vaccination or otherwise of the patients. * See report for the quarter ending 26 September, 1857. t 17 & 18 Vict. c. 80, sec. xxvii. 6 Notwithstanding all the care that is taken by the Medical Officers of the Union and the other public vaccinators, and the zeal and self-devotion manifested by them in the dis • charge of their onerous duties, in searching out the unvaccinated cases among the poor; and notwithstanding the anxiety manifested by the Guardians to promote vaccination by their causing to be issued hand-bills and placards, informing the public of the danger arising from small-pox, and pointing out the penalty which is incurred by parties refusing to have their children vaccinated when they are four months old, and by giving publicity to the names and residences of the public vaccinators, yet the deep rooted prejudices of some unthinking and self-conceited persons occasionally prevail, and they refuse to accept the proffered boon. In more than one instance, to my own knowledge, parents hatfe actually declared to a medical man, anxious to vaccinate the young members of their families, when small-pox had just proved fatal to one of them, "that they would rather see all their children dead with small-pox, than that one of them should be vaccinated." It is really difficult to know what to do with such cases as these, but so long as parents obstinately and ignorantly refuse to have their children vaccinated, so long shall we be unable to eradicate small-pox, or mitigate its severity. When small-pox prevails, no age appears to be exempt from its ravages; for the infant of a week old, and the very aged,* have not escaped its fatal influence. The prejudice against vaccination is generally strongly manifested in a poor neighbourhood, whenever a child has suffered from an eruptive disease after vaccination. The eruption, whether syphilitic, eczematous, or of any other kind, common to children at the time of teething, is always attributed to vaccination, and the surgeon is erroneously blamed for using "foul and dirty matterNow every medical man knows that children, at all ages, are liable to eruptive diseases; and that syphilis does not always manifest itself on the child at birth, but many weeks frequently elapse before the peculiar eruption appears; and when it happens that a child, whose constitution from birth is tainted with syphilis, has been vaccinated, the parents, although they themselves are alone to blame for the diseased condition of their offspring, take the opportunity of casting the blame on vaccination. It may be satisfactory to know that no other disease than the cow-pox can be communicated from one child to another, by the operation of vaccination, if the lymph be taken from a true Jennerian vesicle : I may therefore boldly affirm, that the assertions of parents interested in concealing their own shame, that their children have been inoculated with other diseases at the time of vaccination, are incorrect. That the operation of the Vaccination Acts has not been attended with the beneficial result which the public had anticipated, is obvious from the following facts:— 1.—That many children, above four months old, are unvaccinated, and die of small-pox, as is shown by the returns of the local registrars of the district.† 2.—That many children die of small-pox after vaccination, as is shown in the returns of the Small-pox Hospital. The records of this valuable institution, the only hospital exclusively devoted to small-pox in Europe, inform us *A woman aged 83 died of the disease in the Small-pox Hospital. †n Dunk Street the death of a child from small-pox, 3 years old, is registered, and the registrar makes the following note:—"The mother states that this child has been twice vaccinated, but without success. Three other children in the same family have been attacked, but, having been successfully vaccinated, they have recovered." The local registrar should state in every instance, whqn death is occasioned by small pox, whether the child was vaccinated or not. In some cases the registrars have done so, and in others tiiey have not. 7 that out of 5,797 patients admitted from 1836 to 1851 inclusive, 3,094, or 53 per cent., were after vaccination: and since that period, as might have been anticipated, from the great increase in the number vaccinated, the per ceptage is much larger, amounting now to about 72 per cent. 3.—That, from a table kindly given to me by Mr. Farr, the Clerk to the Guardians of the Union, it appears that out of 2,783 registered* births, 'only 1,824, or 65.5 per cent., were successfully vaccinated by the public vaccinators; of which number 225 were above 12 months old. Although considerable allowance must be made for the children who die in early infancy, and for the cases which are vaccinated by private practitioners, and at the public vaccine institutions, still, there are a great many in this district who are not vaccinated. Universal vaccination, if properly performed, would be, in the concurrent opinion of the most experienced medical men, a great and lasting benefit, both to the state and to every family; and hence the great necessity for the operation being performed in such a manner as will render the patient, if not entirely free from an attack of small-pox, at all events, exempt from its fatal influence-† From the most extensive statistical returns of the Small-pox Hospital, carefully prepared by Mr. Marson, the resident Medical Officer, it appears that the mortality from small-pox in the unvaccinated—of cases taken generally—is 35 per cent.; but of children under 5 years of age, it is 50 per cent. The natural small-pox may be said to destroy one-third of all whom it attacks. On the contrary, the mortality among the vaccinated attacked with small-pox, is only 7 per cent, taken generally ; but among what may be characterised as the badly vaccinated, it is 15 per cent. The danger, therefore, arising from an attack of small-pox, may be said to be chiefly determined by the badness or insufficiency of vaccination. Such being the case, it is impossible to estimate too highly the importance of properly performing vaccination in infancy. A careless vaccination cannot be too strongly deprecated, for, " by such a proceeding, the vaccination takes effect badly, and will never afterwards take effect properly, and yet the individual may take small-pox severely." The minutest particulars in the performance of the operation should be regarded, for not only is the credit of the vaccinator concerned, but the lives of the people, and the pecuniary interests of the ratepayers are involved in the success of the operation. Vaccination should only be performed by a qualified medical "practitioner; whereas, many children are vaccinated, not only in this Union, but probably in other districts in the Metropolis, by chemists and druggists, and other unqualified individuals. This circumstance may tend to explain why so many cases of small-pox occur, and the fatality attending them. It further appears, from the elaborate tables *As very many of the children who are brought to be vaccinated, have not been registered, it would be very desirable if the public vaccinators would kindly insert among their valuable observations, the fact of any child presented for vaccination, whose birth had not been registered, for it would show to a great extent, how defective is the existing law relating to the registration of births, and the necessity of making the registration of births compulsory. t Cows have been inoculated with small-pox, and with the matter taken from the resulting resides ot these animals, children have been vaccinated. The process, therefore, of preventing small-pox by vaccination, is really only carrying people through small-pox in a modified lorm. " The vaccinatcd are sate against small-pox, bccause they in fact have had it." 8 of Mr. Marson, that the mortality in those who are attacked with small-pox after vaccination, but having only one good cicatrix, is 4½ per cent.; in those having an indifftjrent cicatrix, it is 12 per cent.; in those with two good cicatrices, is per cent.; with indifferent cicatrices, per cent.; in those with three good cicatrices, it is 1½ per cent.; with indifferent cicatrices, 2¼ per cent.; and in those patients who have four good cicatrices, the mortality is under 1 per cent.; and from more recent returns, out of 353 patients admitted into the Small-pox Hospital, having four or more vaccine cicatrices, 1 only has died of small-pox. It has been said, and perhaps with truth, that persons riding in cabs, after such vehicles have been used for conveying patients with small-pox to the Hospital, have been attacked with the disease. If, therefore, so serious a disease as small-pox can ba propagated in this way, it is the duty of the public authorities who have the regulation of these vehicles, to endeavour to prevent them being used for carrying sick persons to the public hospitals ; and it would be desirable that the local authorities in each metropolitan district, should keep in readiness a vehicle for the conveyance of all persons attacked with small-pox or fever. The Tables in the Appendix show the amount of work done by the Inspectors of Nuisances, and the improvements effected in the district. The only point to which I deem it necessary to particularly direct your attention is the numerous complaints of the smoke nuisance. It appears that no less than 33 cases of nuisance from opaque smoke issuing from the chimneys of factories have been brought before your Board; in several instances the complaints relate to the same parties. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. 15, Great Alie Street. APPENDIX. TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED since the 1st Of JANUARY, 1856, to the 31st MARCH, 1859. From February, 185(5, to the 1st of January, 1859. For the Quarter ending 31st March, 1859. Total number of Nuisances removed. Works in progress but not completed. Number of Nuisances inspected in houses and yards. Number of Houses systematically visited. House-to- house visitation. Number of Nuisances entered in Complaint Books. 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. 13,385 †69 8224 3821 6005 26 86 1911 288 1412 247 725 1 4 218 *This Total refers to Nuisances of every description, including the non-removal of Dust, Gullies overflowing, &c., complaints of which have been made at the office, and afterwards personally inspected. †it will be observed that a great decrease has taken place in this Number; this arises from the fact that the Inspectors have devoted a considerable portion of their time in visiting and urging the completion of works partially done, such as the requiring of water apparatus to aoil-pans, covered dust-bins to yards, &c., &c. TABLE I.—Continued. Number of HOUSES VISITED from JANUARY 1st, 1859, to the 31st MARCH, 1859, 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. Dangerous Cellar Flaps and Area Gratings. Works in progress. Works allowed to stand over from various causes. Works done without notice. 143 110 52 78 0 0 173 109 49 114 23 167 218 17 5 78 11 29 2 0 53 39 93 13 11 13 29 49 288 230 458 TABLE II.—Summary of WORKS EXECUTED up to the 1st JANUARY, 1859. 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 cleansed.—No Sewerage. New House Drainage made. House Drainage improved, Trapped, &c. Cellars cleansed. Filthy Privies cleansed. Water supplied to Soil-pans. New Privies constructed. Pans to Privies provided. Over-crowded Houses remedied. Houses unfitted for Human habitation. Ventilation improved. Private Courts paved. Filth in open places removed. Dangerous structures. Other Nuisances removed, Dust, Stagnant Water, &c. Dangerous Cellar Flaps and Area Gratings. 1467 762 563 798 35 36 1664 1157 1203 887 412 644 1627 50 1428 30 41 14 14 65 177 10,334 324 Summary of WORKS EXECUTED from 1st JANUARY, 1859, to 31st MARCH, 1859. Total 98 49 43 34 0 0 67 49 24 65 23 167 49 6 69 2 0 0 2 13 29 1309 49 Gross Total 1565 811 606 832 35 36 1731 1206 1227 952 435 811 1676 56 1497 32 41 14 16 78 206 11,643 373 It will be seen in Table No. 1, Column No. 1, that the total number of Nuisances removed is 13,385, but that number does not give the details of each separate case. For instance: The case may be an Offensive Privy—requiring, 1st. Cesspool to be emptied and filled up. 2nd. To be Trapped and Panned. 3rd. Pipes to be laid from Pans to Sewer, &c. Pf each of these were shown as a distinct work executed, the number in the Table and Column above alluded to, would be about 24,032. 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 2nd APRIL, 1859:— DISTRICTS. Names of Medical Officers. Small-pox. Measles. Scarlatina. Hooping Cough. Diarrhœa. Typhus, or Continued Fever. Cholera. Erysipelas. Pyaemia. Puerperal Fever. Carbuncle. Bronchitis and Catarrh. Pneumonia and Pleuritis. Croup. Diphtheria. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Other Diseases. Total. Average number of Fever Cases per W eek. Spitalfields Mr. Blackwell 11 1 11 4 27 17 0 4 0 0 3 113 16 0 0 3 3 ? 0 693 805 Mile End New Town Mr. Champneys 12 6 0 4 16 48 0 1 0 0 0 8 2 0 0 0 0 1 0 357 455 Whitechapel Mr. Richardson 19 2 9 8 7 4 0 1 0 0 0 24 0 0 0 0 0 0 0 432 506 Goodman's Fields Mr. Sequeira 2 4 8 58 38 24 0 11 0 l 0 56 34 0 0 1 30 1 0 902 1170 Totals 44 13 28 74 88 93 0 17 0 1 3 201 52 0 0 1 33 4 0 2384 2936 7 TABLE IV.—Table showing the DEATHS from EPIDEMIC DISEASES in the Whitechapel District, for the Three Months ending on the 2nd APRIL, 1859:— 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. 1859. 1858 Artillery 0 0 0 0 4 . 1 2 3 0 0 0 0 6 4 10 5 *Spitalfields 0 1 0 1 2 2 1 4 0 1 1 1 4 10 14 16 †Mile End New Town 2 3 1 1 0 0 4 0 0 0 4 2 11 6 17 26 †Whitechapel, North 1 1 0 1 0 1 2 2 0 0 1 2 4 7 11 22 ‡Whitechapel Church 0 0 1 0 0 2 2 1 0 0 5 0 8 3 11 11 Goodman's Fields 0 0 0 0 1 0 1 7 1 0 1 3 4 10 14 10 0 0 0 0 1 1 2 1 0 0 2 2 5 4 9 18 3 5 2 3 8 7 14 18 1 1 14 10 42 44 86 108 Deaths from Epidemics for the corresponding Quarter of last year. 8 5 15 32 2 24 86 1 17 7 37 14 32 108 *In the Spitalfields District two Cases of DIPHTHERIA (Males) are recorded. †Two Cases of CHILD-BED FEVER are recorded; one in the Mile End New Town District, the other in the Whitechapel North. ‡Three of the Cases of FEVER recorded in this District were non-residents. 13 —Table showing the BIRTHS and DEATHS in each District, for the Three Months ending on the 2nd APRIL, 1859:— DISTRICTS. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. REMARKS. M. F. M. F. Artillery 29 37 66 19 15 34 32 .. In the Total mor- tality the Deaths of 59 non-residents are re- corded; 58 in the London Hospital, & 1 in the Barracks in the Tower, The excess of Births over Deaths is not, as appears from this Table 146, but 207. Spitalfields 67 65 132 52 45 97 35 .. Miie End New Town 94 88 182 76 70 146 36 .. Whitechapel North. 62 50 112 34 30 64 48 .. Whitechapel Church 32 41 73 90 57 147 74 Goodman's Fields 51 56 107 27 37 64 43 .. Aidgate 48 39 87 34 25 59 28 .. Totals 383 376 759 332 279 611 222 74 TABLE VI.—AGES at DEATH in the Union Workhouse. 0 and under 1. 1 and under 5. 5 and under 20. 20 and under 40. 40 and <ndcr 60. 60 and under 80. 80 & upwards. Total. Corresponding: Quarter of 1858. 11 0 3 8 16 21 3 62 101 Four Deaths from FEVER (two Males, and two Females) occurred in the Workhouse. TABLE VII.—VACCINATION EXTENSION ACT. WHITECHAPEL UNION. NAMES of the whole of the Public Vaccinators of the Union. Year ended 29th SEPTEMBER, 1858. Number ol Registered Birttis, of All Classes during the Year, including the Workhouse Observations. VACCINATION DISTRICTS. Number and Ages of Persons Vaccinated by the Public Vaccinators. Number of such Coses Successfully Vaccinated. Under Above one year. TOTAL. Under one year. Above one year. TOTAL.. UNSUCcessful. Thos. Seal Black well Christ Church 268 13 281 261 13 274 524 7 James Edmunds Artillery Ground 244 9 253 238 9 247 216 6 Alex. M. Champneys Mile End New Town 275 72 347 275 72 347 535 0 Edward Richardson Whitechapel North 252 24 276 251 24 275 508 1 Chas. T. Blackman Whitechapel Church 64 4 68 64 4 68 287 0 Henry L. Sequeira Goodman's Fields 498 101 599 463 100 563 384 36 Chas. E. Jenkins Aldgate 48 3 51 47 3 50 329 1 Totals 1,649 226 1,875 1,599 225 1,824 2,783 51 The Successful Cases of VACCINATION for the Quarter ending Lady-day, 1859, were 545, or 74.6 per Cent. of the total Registered Births. TABLE VIII.—Causes of Death at Seven periods of Life, registered in the Whitechapel District, for the Three Months ending 2nd APRIL, 1859. Causes of Death. U and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under GO 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 I. —Zymotic. Brought forward 92 120 33 56 98 61 7 467 Small-pox 1 6 1 .. .. .. .. 8 Stomach and Digestive Organs. Ulc. of Intestines.. Hernia (Rupture) .. .. .. 2 2 1 .. 5 Measles .. 5 .. .. .. .. .. 5 Scarlatina (Scar.Fev.) .. 12 3 .. .. .... .. 15 Hooping Cough 11 21 .. .. .. .. .. 32 Croup 1 1 .. .. .. .. .. 2 Ileus (Inflammation and Gangrene of the Muscular Coat of the Intestine) Thrush Diarrhoea (Bowel complaint) 2 .. .. .. .. .. .. 2 Dysentery 1 .. .. .. .. 1 .. 2 Intussusception, (a part of the Bowels introduced into the part below) .. .. .. 1 .. .. .. 1 Cholera Influenza Scurvy and Purpura Ague Stricture of Intestinal Canal .. .. .. .. 1 .. .. 1 Remittant Fever .. 1 .. .. .. .. .. 1 Infantile Fever Disease of Stomach &c .. .. .. 1 1 .. .. 2 Typhus Fever .. 5 5 4 8 2 .. 24 Puerpl. Fever (Metra) .. .. .. 2 .. .. .. 2 Disease of Pancreas.. Rheumatic Fever .. .. .. .. .. 1 .. 1 Inflammation of Liver Erysipelas (Rose) .. .. .. 1 2 .. .. 3 Jaundice Syphilis 1 .. .. .. .. .. .. 1 Disease of Liver .. .. .. .. 1 .. .. 1 Noma (Canker) Cirrhosis Hydrophobia Disease of Spleen Cynanche 1 .. .. .. 1 .. .. 2 VIII.—Kidney, &c. Diphtheria .. 2 .. .. .. .. .. 2 Nephritis II.—Dropsy, &c. .. Nephria (Bright's disease) .. .. 1 3 6 2 .. 12 Hæmorrhage .. 1 1 2 .. .. .. 4 Anæmia Ischuria Dropsy .. 2 .. 1 .. 1 1 5 Disease of Prostsats .. .. .. 1 1 1 .. 3 Abscess (Gathering) .. .. 1 .. 2 1 .. 4 Diabetes Ulcer Stone Fistula Cystits Stricture of Urethra Mortification .. .. .. .. 1 ] 1 3 Disease of Bladder .. 1 .. .. .. 2 .. 3 Cancer .. .. .. 1 4 2 1 8 IX.—Childbirth. Gout .. .. .. .. 1 1 .. 2 Extra Uterine Foetation .. .. .. 1 .. .. .. 1 III.—Tubercula. Scrofula Ovarian Dropsy .. .. .. .. 1 1 .. 2 Tabes Mesenterica 4 8 2 .. .. .. .. 14 Childbirth (seeMetriaJ .. .. .. 2 .. .. .. 2 Phthisis (Consumpn.) 2 10 25 26 2 65 Disease of Uterus,&c. Hydrocephalus (water on the brain) 3 5 8 X.—Joints, Bones. &c IV. — Brain and Nerves. Rheumatism Arthritis Cephalitis .. 1 .. .. .. .. .. 1 Disease of Joints, &c. .. 1 1 .. 1 1 .. 4 Apoplexy 1 .. .. 4 8 8 1 22 Spinal Disease 1 2 .. .. .. .. .. 3 Palsy (Paralysis,) .. .. .. .. 3 6 .. 9 XI.—Skin, Cellular Tissue, &c. Delirium Tremens Chorea Carbuncle Epilepsy .. .. 1 .. .. .. .. 1 Phlegmon Tetanus Disease of Skin, &c. 1 1 Insanity XII. — Malformation. Convulsions 21 6 .. .. .. .. .. 27 Disease of Brain, &c. .. 1 2 2 1 .. 1 7 Cyanosis Idiocy Spina Bifida V. — Heart and Blood Vessels. Other Malformations 1 .. .. .. .. .... .. 1 XIII. — Premature Birth and Debility. 19 .. .. .. .. .. .. 19 Phlebitis Pericarditis .. .. 1 1 1 1 .. 4 Aneurism .. .. .. .. 2 .. .. 2 XIV.—Atrophy. 1 1 .. .. .. .. .. 2 Disease of Arteries .. .. .. 1 .. .. .. 1 XV.—Old Age. .. .. .. .. .. 23 8 31 Disease of Heart, &c. .. 1 2 3 6 6 1 19 XVI. — Sudden Deaths, (causes unknown). Uræmia VI. — Lungs and Organs of Respiration. XVII. — Violent Death. Laryngitis .. 3 .. .. .. .. .. 3 Intemperance Bronchitis 12 11 1 1 12 12 1 50 Privation of Food Pleurisy .. .. .. .. 1 .. .. 1 Want of Breast Milk 2 .. .. .. .. .. .. 2 Pneumonia 30 23 3 5 7 6 .. 74 Neglect Asthma .. .. .. .. 5 4 .. 9 Cold Disease of Lungs .. .. .. .. 2 1 .. 3 Poison VII.—Stomach and Digestive Organs. Burns and Scalds .. 5 8 1 1 2 .. 17 Hanging Teething 3 3 .. .. .. .. .. 6 Suffocation 2 .. .. .. .. .. .. 2 Quinsey Drowning .. .. 1 .. .. .. .. 1 Wounds Gastritis Violence .. .. 3 7 6 4 1 21 Enteritis .. .. .. 1 1 1 .. 3 Peritonitis .. .. .. 2 1 2 .. 5 XVIII.—Not Specified .. .. .. .. 4 3 .. 7 Ascites .. .. .. .. 3 2 .. 5 Carried forward 92 120 33 56 98 61 7 467 Grand Total 119 130 47 75 123 101 16 611 LONDON HOSPITAL. TABLE IX.—Causes of Death at Seven periods of Life, registered in the London Hospital, for the Three Months ending 2nd APRIL, 1859. Causes of Death. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under GO 60 and under 80 80 and above. Total Causes of Death. 0 and under 1. 1 and under 5. 5 and under 20. 20 i nd under 40 40 and under Go 60 and under 80 80 and above Total I.— Zymotic.— Brought forward 0 I 7 17 19 10 1 55 Small-pox Stomach and Digestive Organs. Measles Scarlatina (Scar.Fev.) .. 1 1 .. .. .. .. 2 Hernia (Rupture, .. .. .. 2 2 1 .. 5 Hooping Cough Ileus (Inflammation and Gangrene of the Muscular Coat of the Intestine) Croup Thrush Diarrhoea (Bowel complaint) Intussusception, (a part of the Bowels introduced into the part below) Dysentery Cholera Influenza Scurvy and Purpura Ague Stricture of Intestinal Canal .. .. .. .. 1 .. .. 1 Remittant Fever Disease of Stomach, Infantile Fever Typhus Fever .. .. .. 1 2 1 .. 4 Disease of Pancreas Puerperal Fever (Metria) Inflammation of Liver Jaundice Rheumatic Fever .. .. .. .. .. 1 .. 1 Disease of Liver Erysipelas (Hose) .. .. .. 1 2 .. .. 3 Cirrhosis Syphilis Disease of Spleen Noma (Canker) VIII.—Kidney, &c. Hydrophobia Nephritis 11.—Dropsy, &c. Nephria (Hright's Disease) .. .. .. 2 4 .. .. 6 Hæmorrhnge .. .. 1 2 2 .. .. 3 Antemia Retention of Urine .. .. .. 1 1 .. .. 2 Dropsy .. 1 .. 1 .. .. .. 2 Ischuria Abscess (Gathering) .. .. 1 .. 1 1 .. .. Disease of Prostate Diabetes Ulcer Fistula Stone Mortification .. .. .. .. .. 1 .. 1 Cystitis Cancer .. .. .. .. .. 3 .. 5 Stricture of Urethra Gout Disease of Bladder III.—'Tubercula. IX.—Childbirth. Scrofula Paramenia Tabes Mesenterica .. .. 2 .. .. .. .. 2 Ovarian Dropsy Phthisis (Consumptn) .. .. .. 4 3 .. .. 1 Childbirth (see Metria) Hydrocephalus (water on the brain) Disease of Uterus, &c X.—Joints, Bones, &c. IV.—Brain and Nerves. Rheumatism Cephalitis Arthritis Apoplexy .. .. .. 1 4 2 .. 7 Disease of Joints, &c. .. 1 .. .. 1 1 .. 3 Palsy (Paralysis) Spinal Diseaae Delirium Tremens XI.—Skin, Cellular Tissuk, &c. Chorea Epilepsy Carbuncle Tetanus Phlegmon Insanity Disease of Skin, &c. Convulsions XII.— Malformation. Disease of Brain, &c. .. .. .. 2 .. .. 1 1 Idiocy Cyanosis V.—Heart & Blood Vessels. Spina Bifida Other Malformations Phlebitis XIII.— Premature Birth& Debility Pericarditis .. .. 1 1 .. .. .. 2 Aneurism .. .. .. .. 1 .. .. 1 XIV.—Atrophy. Disease of Arteries XV.—Old Age. Disease of Heart, &c. .. .. .. 2 2 2 .. 6 XVI. — Sudden Deaths (causes unknown). Urtamia VI. — Lungs and Organs of Respiration. XVII. — Violent Death. Laryngitis Intemperance Bronchitis .. .. .. .. .. 1 .. 1 Privation of Food Pleurisy Want of Breast Milk Pneumonia .. .. 1 1 .. .. .. 2 Neglect Asthma Cold Disease of Lungs Poison VII.—Stomach and Digestive Organs. Burns and Scalds .. 4 7 .. 1 2 .. 14 Hanging Suffocation Teething Drowning Quinsy Wounds Gastritis Violence .. .. 3 5 6 4 1 19 Enteritis XVIII.—Not Peritonitis .. .. .. .. 1 .. .. 1 fied. Ascites Ulc. of Intestines Carried forward 0 1 7 17 19 10 1 55 Grand Total 0 6 17 27 35 18 2 105 TABLE X.—Tabular Summary of HOUSE IMPROVEMENTS up to the 1st JANUARY, 1859 Name of Street or Place. No. of Houses in Place or Street. No. of Houses Inspected. Drains. Cesspools. Water Closets. Dust Bins Pavement General Water Supply. General Improvement. Remarks. Number constructed. Improvement or Repair. Traps fixed. Abolished. Cleansed and Disinfected. Pans and Traps furnished. New ones constructed. Water supply provided. Constructed. Repaired. Constructed. Relaid or Repaired. Receptacles provided. Receptacles repaired. Water supply provided. Generally repaired. Cleansing and Limewhiting. Ventilation. I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 4432 3821 223 1208 482 1229 184 1372 84 909 526 131 32 434 43 7 31 324 1064 6 Tabular Summary of HOUSE IMPROVEMENTS for the Quarter ending 31st MARCH, 1859. Ely Place, Finch Street 15 15 0 0 0 0 0 5 0 5 0 2 0 0 0 0 0 15 15 0 Improvements, from paving, Sic., have taken place in the under-mentioned Courts, &c.: Boar's Head Yard, Keate Court, Cobb's Yard, Cox's Square, Bull Court, and Parliament Court. Thirty-three cases of Smoke Nuisance have been reported to the Committee during the past quarter: 23 on North District. 10 on South do. Seven cases of Nuisance from the keeping of Swine,on the north side of the District, have been removed. In three of these cases, it was necessary to take out summonses. Luntley Place, do 17 17 0 2 0 fi 0 6 0 6 0 0 0 0 0 0 0 8 8 0 Dowson Place, do 11 19 n 3 0 5 0 10 0 0 0 2 0 0 0 0 0 4 10 0 Little Halifax St., do 15 15 o 2 0 2 0 3 0 0 0 1 0 0 0 0 0 7 7 0 Cobb's Yard, Middlesex Street. 22 22 0 22 0 0 0 0 0 0 0 4 0 0 0 0 0 7 7 0 Parliament Court do. 4 4 0 4 0 0 0 0 0 4 0 1 0 4 0 0 0 4 4 0 Bull Court, do 12 12 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 Little Keate Ct., Commercial St. 10 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 Commercial Court, do. 13 13 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 13 0 Tenter St. North, Whitechapel 14 14 0 10 0 0 0 0 0 0 10 0 0 10 0 0 0 0 0 0 Church Lane, continued . 64 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 White Bear Court 23 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Little Alie Street, continued . 28 19 0 6 0 6 0 6 0 6 0 0 0 0 0 0 0 0 0 0 Swan Street 11 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Russell Court 10 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 Christopher Court 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total 280 247 0 55 0 19 0 31 0 21 10 10 0 14 0 0 0 48 80 0 Gross Total 4712 4068 223 1263 482 1248 184 1403 84 930 530 141 32 448 43 7 31 372 1144 6 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON The Sanitary condition OF THE WHITECHAPEL DISTRICT, FOR THE THREE MONTHS ENDING JULY 2nd, 1859. Read to the Boakd, Jult 11th, 1859. < LONDON: PRINTED BY T. PENNY, 121, LEMAN STREET, WIIITECBAPEL, and 9, london terrace, hackney road. 1859 REPORT. Gentlemen, In the course of the quarter which terminated on Saturday, 2nd July, 1859, the deaths in the Whitechapel District have been 488, including 47 non-residents. The registered births during the same period have been 715. The excess of births over deaths is therefore 274. In the corresponding quarter of last year, 687 births, and 538 deaths, including 58 non-residents, were recorded; the births, then, exceeded the deaths by 207. The mortality returns for the quarter indicate, on comparison with those of the corresponding quarters of 1857 and 1858, a favorable state of the public health. The average number of deaths per week has been 38, while for the corresponding quarter of the previous two years, it was respectively 40 and 41. It is the generally received opinion, that the number of deaths in a given population indicates the amount of sickness; such, however, is not always the case, for sickness may prevail to a very great extent, yet, the death-rate shall not be increased, the prevalent diseases being of a mild character ; and on the other hand, the deaths may be much above the average, and the cases of sickness comparatively few, but of a more fatal kind. In order, therefore, to estimate rightly the state of the public health, a return of the cases of sickness, embracing the same period, should be published with the returns of death. The average number of deaths per week is, as above stated, 38, and that of births, 56. Unless, therefore, emigration take place, or more commodious houses be built on the sites of those now existing, (there being scarcely any vacant ground on which additional houses for the poorer classes are likely to be built), the demoralization, filth, and squalor, the probable results of the excessive over-crowding, now so common, will increase; and sickness prevail to a greater extent. The uncertified cases of death are 13. They may be divided into three classes, viz: those where there was no medical attendant—where an unqualified medical person had prescribed, and—where a medical practitioner had seen the patient only a few hours hefore death, and was unable to certify the cause. The deaths in the workhouse are 52, viz : 29 males, and 23 females. In the corresponding quarter of last year, there died in the workhouse 56, viz : 32 males, and 24 females. It is very satisfactory to find that a great diminution has taken place in the comparative number of deaths of children under 5 years. In this quarter, 190 deaths under 5 years of age are recorded, or 38 per cent, of the total mortality; whereas, for the corresponding quarter 4 of last year, the number was 265, or 49 per cent. The number of deaths ascribed to old age is 32, or 65 per cent. The deaths of several under 70 years of age might, with more correctness, have been classed under a specified disease; while others, which occurred at more advanced periods, should have been registered as "Natural Decay," or "Old Age." The most fatal class of diseases during the quarter was the tubercular. In this class there were 98 deaths, of which 68 were due to consumption. Bronchitis, pneumonia, and other diseases of the respiratory organs, proved fatal to 62. Bronchitis and pneumonia are two distinct forms of inflammation of the lungs, but the diagnosis is not always accurately made, and they are consequently indiscriminately registered. Bronchitis more generally attacks old people, and pneumonia the young. The greater number of the deaths, therefore, under 5 years of age, which are registered as bronchitis, ought to be registered as pneumonia. A considerable reduction is observed in the mortality from epidemic diseases, 65 deaths only being recorded for this quarter, while for the corresponding quarter of last year, the number was 106. Although the mortality from the epidemic class of diseases has decreased, I am sorry to say that smallpox, so far from its showing any tendency to diminish, has even proved more fatal than in the previous quarter of this year, when the disease began to prevail as an epidemic. The deaths from small-pox are 13, exclusive of the 4 deaths, which occurred in the Small-pox Hospital, of persons resident in this district. From the statistical returns of small-pox, among cases taken generally, the old and the young, the vaccinated and the unvaccinated, it appears that this disease proves fatal in the proportion of about 1 in 8. A more correct notion of the prevalence of the disease will therefore be formed by multiplying the number of the deaths by 8, when it will appear that no less than ] 36 cases have occurred in this district, of which, the medical officers of the union attended 96. In 28 instances, the children had been vaccinated; in 25 vaccination had not been performed; and in the other instances there is no record. Thirteen cases of small-pox were removed to the Small-pox Hospital at the expense of the Union, among which, 3 died, 6 recovered, and 4 are now in the hospital. Five other cases of this disease were admitted into the Small-pox Hospital, from this district, at the expense of the respective parties or their friends; of which number 1 died, and 4 recovered. The number of inquests was 44; of these, 27 were holden at the London Hospital, to which institution accidents from all parts of the East of London are conveyed. Out of the total number of inquests in this district, during the quarter, 22 were holden on persons whose death was occasioned by mechanical injuries; in one of these cases, death was the result of injuries received from the falling of "sugar bags" out of a sling. The frequent occurrence of fatal accidents from goods falling from slings, ought to induce all persons having the charge of such machinery, to observe greater care in its application. As some of these cases arise from negligence, the strictest investigation should at all times be made, to ascertain whether or not blame is attributable to any person. In 5 instances, death was caused by burus and scalds. A female child, aged 5½ years, died from " drinking oil of vitriol," The cause of death in all these cases was, perhaps, obvious, and needs no comment. But, upon some of the other cases in which inquests occurred, I may, perhaps, be permitted to make a few observations. Inquests were holden on 4 cases in which death was supposed to have been caused by drowning. In two of these instances, the verdict was, " Found dead in the river without marks" In another, "from suffocation and drowning, how came into the water not proved." In another instance, a man was found dead in a bath, in the Goulston-square Baths, when the verdict recorded was, "Found dead from drowning." Now, in not one of these instances, does it appear that a post mortem examination was made, and the verdict of the jury throws no more light upon the cause of death than had been previously ascertained by the constable or 5 beadle, or the police officer, who gave information of the death to the coroner. The body was found dead, and the public obtained no further information from the deliberation and verdict of the jury, than it had before the inquest. In regard to some of these cases, and particularly that of the man found dead in one of the baths in Goulston-square, there is as much reason to believe that death was occasioned by poison, or by internal disease, as by the cause alleged. Investigations before the coroner ought to be circumstantially and solemnly made, an d the cause of death ascertained. The security of the subject which is afforded by the coroner's court, cannot be too highly prized. According to the ancient law, an inquiry before the coroner involves no suspicion against any person, while it affords security against unfounded suspicions which will occasionally arise in neighbourhoods on the occasion of a sudden death. In all cases, therefore, when the cause of a sudden death is not certified by a medical practitioner, and when the coroner is of opinion that a jury should be summoned, a post mortem examination of the body ought to be made, so that the cause of death may be correctly ascertained." If a rigid inquiry were made by a competent medical officer, into the cause, not only of every sudden death, but of every death not certified by a qualified medical practitioner ; infanticide, secret poisoning, and other kinds of homicide would be checked, if not altogether prevented, and the safety of the public increased. There appears to be no settled rule for the holding of inquests; the necessity of the inquiry seems to be chiefly determined by the constable or beadle of the parish, and unless these officials entertain the idea that there is something mysterious or suspicious in the cause of death, a jury is not called. It is generally supposed, that all deaths which are the result of injury, are inquired into by the coroner, but this is not the case, for, during this quarter, two deaths occurred in the London Hospital, one by asphyxia, from injury to the spinal chord, and the other from inflammatory fever, occasioned by an accident to the arm. In neither of these eases was an inquest deemed necessary. Two deaths occurred in the London Hospital from excessive drinking; in one, an inquest was holden, when the verdict returned was " Apoplexy from excessive Drinking" ; in the other case, the patient was admitted in a state of coma, from drink, and subsequently died, but an inquest was not holden. An inquest was holden on the body of a child, whose death was caused by scalds, from the overturning of a tin pot of boiling water ; while, in the previous week, there was recorded the death of a child from drinking hot water from a tea-pot, when a jury was not summoned. The drinking of hot water from a tea-pot is a frequent cause of death to children, and in each case, which has previously occurred in this district, a judicial inquiry was made. Again, an inquest was holden on the body of a child, aged 4 months, whose death was caused by convulsions ; and the verdict was " Sudden death from convulsions; while in the mortality table (No. 7.), 31 deaths are registered as occasioned by this disease, of which, several are uncertified by a medical practitioner; and yet in no other instance was there an inquest. Further, it was deemed necessary to hold an inquest on the body of a man who died of typhus fever, on board of ship in St. Katharine's Docks, when the verdict was " Typhus Fever, unsound mind," wrhile in 19 other cases of death from fever, an inquest was not holden. Among the records of the coroners' inquests which are included in the mortality returns of the district, is the following verdict, " Found dead, if born alive, and if so, how death caused unknown." Here, a child is found dead, and an inquest is deemed necessary, while, on the other hand, a, female, aged 76, is found dead in bed, and an inquest is not held, notwithstanding that the cause of death was uncertified by a medical practitioner. * See Report for the Quarter ending September 26, 1857, page i. 6 Although it is my duty to point out the anomalies that exist in the ordering of inquests, and to make known the defects in the registration of the deaths that have been the subjects of enquiry before the coroner, I have not thought it necessary at present to suggest any alteration whereby such anomalies may be reconciled, and such defects remedied; neither to express an opinion regarding the necessity or otherwise of a judicial inquiry on any of the eases above mentioned; but would rather leave the whole question to be considered by persons better qualified to deal with it. It is, however, obvious, from what has been stated above, that the regulations now acted upon in the holding of coroner's inquests are very unsatisfactory, and require pmendment. The medical officers of the Union record 2742 cases of sickness among the out-door poor, including 531 cases of zymotic diseases. In the corresponding quarter of last year, the total number was 2955, including 696 cases of zymotic diseases. The cases in the workhouse are 345, including 14 of fever, 16 of diarrhoea, and 2 of small-pox. The amount of sanitary work done during the quarter will be seen by referring to the tables in the Appendix, from which it appears that 169 houses have been visited, and a detailed report of each house has been made by the inspectors. Since the commencement of their labours, the total number of houses visited and reported upon in detail has been 4237. About 4000 more houses remain to be inspected. The visitation of the entire district, might, ere now, have been accomplished, had it been necessary to visit once only the tenements of the poor, but the structural improvements which the owners of property have made, after notices served by the inspectors, have, in many instances, remained in an efficient state for a short time only, when, from the thoughtlessness, or ignorance of the occupiers, the improvements that had been made at considerable expense, were not appreciated, and the locality soon relapsed into its previous state of filth and unhealthiness, demanding a re-inspection of every house. An habitual and detailed inspection of the houses occupied by the poorer classes, is therefore essential; and however much we may lament that our efforts to improve the habits of the people are not crowned with success, we must still persevere in our exertions to remove the evils which surround the greater number of the houses in this district. The education and sanitary improvement of the people cannot be effected suddenly, but may be accomplished by a steady perseverance in visiting the abodes of poverty, and in endeavouring to instruct the people in the laws of health, and in the necessity of observing them. While despotic powers may be required for dealing with property which is not fit for human habitation, more conciliatory means should be adopted with the owners of that kind of property which may be improved by an outlay of money, and the powers of the law should not be had recourse to, until every endeavour has been made to induce them to effect the necessary improvements for the health of their tenants. The public mind is gradually becoming educated in the science of hygiene, and now sees the intimate connection between filth and disease. The pecuniary advantages arising from the healthy condition of the people is also beginning to be felt and acted upon ; for, where we formerly had opposition to the removal of nuisances to contend with, we now readily obtain the hearty co-operation of the owners of property to remove, without delay, existing nuisances, and to carry into effect the necessary improvements to prevent their recurrence ; and in many instances, all that is necessary for the officers of health to do, is to visit the locality complained of, point out to the landlord the existing evils, and to suggest the remedy, when the needful improvements are commenced, and duly completed. This is the plan which I have adopted in carrying out the provisions of the Nuisances Removal Act, and which has been attended with the most satisfactory results, as are shown by the tables of the sanitary improvements, all of which have, during the quarter, been effected without the assistance of the magistrates, except in the case of the four houses in Leman-row, where it was necessary to 7 obtain an order from the magistrate to compel the owner to remove the tenants, and shut up the houses, until they were rendered fit for human habitation. It will be seen, on reference to Table No. 2, that 1371 cesspools are reported to have been abolished; but it is greatly to be regretted, that in some of these cases the inspectors have been deceived, the landlords contenting themselves by fixing a pan and syphon-trap over the drain leading to the cesspool, but leaving untouched the cesspool, which was the cause of the nuisance. This neglect and evasion of the order have not been discovered until a complaint of the nuisance has again been made. I have not thought it necessary to enlarge this report by detailing the instances of indecent overcrowding which have come under the notice of the Inspectors in the course of their investigations, and which they have for a time succeeded in removing, by serving notices upon the owners. There is no law that I am aware of, which gives power to any local authority effectually to prevent the gross immorality of adults of both sexes living together; for, if a room, although occupied by adults of both sexes, be not overcrowded, and if the occupiers are members of the same family, which is generally alleged to be the case, although such indecent practices have been brought to light, the local authority cannot interfere. If, however, any room be too small for the number of persons living therein, without danger to their health, proceedings can be taken against the owner, to compel him to diminish the number, provided the house be let to more than one family. If a room be let to, and occupied by, more than one family, then the police can compel the owner to register the house as a common lodging house; but in the practical working of the acts of parliament relating to overcrowding, the difficulty is found to be very great; for, no sooner are proceedings threatened than a change of tenancy occurs, or the overcrowding for the time is diminished, only to be again renewed on the first opportunity. Before the police can compel the owner or occupier of a house, let out in tenements to the poorer classes, to register it as a common lodging house, a notice must be served upon the premises, giving the owner or occupier a month to comply with the provisions of the notice; the delay thus occasioned defeats the object of the act of parliament; for, before the expiration of the month, the party leaves, and carries on elsewhere this dangerous and immoral practice. The evils of overcrowding were recently made painfully evident at No. 51, Grey Eagle Street. In a small room in this house, there were three cases of typhus fever in one family, viz: a man, his wife, and child. The room, occupied by this family, was divided unequally by a partition, which converted one part of it into a kind of cupboard. In this cupboard, which was lighted and ventilated only by an opening into the other part of the room, was a bed on which the man slept. The woman, and the child, who was about 10 years of age, occupied a bed in the front part of the room. A few days after my visit, the man died. The evils arising from the want of sufficient space, then became greatly aggravated, by the corpse being kept in the same room with the other members of the family; and owing to the poverty of the relatives, the dead body was retained in the room for eleven days, when a complaint of the nuisance was made by the neighbours, and after a visit from the Inspector, the funeral took place. Another case of the prolonged retention of a corpse, in an advanced stage of decomposition, occurred in a court where several Irish families resided, and considerable difficulty was ' experienced in getting the corpse interred, owing to the desire of the relatives to "wake the body." Every possible impediment was thrown in the way of the Inspector, (Mr. James), to prevent him removing the body ; and it was only after a lapse of several hours, (during which he was actively engaged in obtaining the necessaiy assistance,) that the body was taken to the cemetery.* *Since the reading of this Report, the Board has directed a communication to he addressed to the Secretary of State, for the purpose of drawing the attention of the Privy Council to the fact of the improper retention of the bodies of the dead (a fact which is notorious throughout the Metropolis, and has been productive, to say the least of it, of much personal inconvenience to the living), in order that some provision may be made to afford a remedy. I am not aware of any existing law authorizing the interference of Local Boards to inforce the interment of the dead. 8 I wish to draw the attention of the Board to a nuisance continually occurring in Some of the confined neighbourhoods, from the want of public dust-bins. The poor people, not having a yard attached to their house, in which to place a dust-bin, throw the dust and house refuse into the streets; which, in wet weather, add to the filth of the locality, and obstruct the flow of water down the channels and gullies; and, in dry weather, the dust is blown into the houses of the neighbouring inhabitants, producing thereby great annoyance and discomfort. If public dnst-bins were erected in convenient places, and the scavengers were to remove their contents every other day, before putrefaction commenced, not only would the poor be benefited, but the public generally would be relieved from much inconvenience. If the Board desire it, the Inspectors will point out a few placcs where public dust-bins might be advantageously placed. During the prevalence of the hot weather, it would be very conducive to the health of the inhabitants, if the scavengers were to cleanse the narrow and densely populated localities every day; for no person, unless he has experienced it, can form an idea of the horrible stench that arises in them, where a large quantity of decaying animal and vegetable refuse is being swept up by the scavengers. If a copious and powerful stream of water were applied to the surface of some of these filthy localities, after the scavengers had removed the solid refuse, a refreshing coolness would be imparted to the atmosphere, instead of the sickening effect now produced by the emanations of stirred-up filth. Two parties, carrying on businesses of a disgusting and offensive character, have removed from the district, after notices had been served by the Inspectors. One of the parties lived in Green Street, Whitechapel, where he stored fat and other similar refuse, which he occasionally melted in the back kitchen, and causcd great annoyance to the neighbourhood. The other lived in Grey Eagle Street, Spitalfields, where the entrails and bladders of bullocks were prepared and diied. Many of the houses in the district are without any water supply, and many more are without an adequate supply. I regret that the powers of your Board are not at present sufficient to compel the owners of small house property to provide an adequate supply of water for their tenants. The meaning of the term "adequate supply," should not be determined by the opinion of the tenants, but by a committee of the Board, or by its officers ; for, the more dirty are the habits of the people, the less is their desire for the means of cleanliness, or in other words, the greater is the necessity for an adequate supply of water, the less is the demand for it. I have the honour to be, Gentlemen, Your obedient Servant, JOHN LIDDLE. 15, Great Alie Street. APPENDIX. TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED SINCE THE 1st of January, 1856, to the 30th of June, 1859. From February, 1856, to the 30th June, 1859. For the Quarter ending 30th June, 1859. Total number of Nuisances removed. Works in progress but not completed. Number of Nuisances inspected in houses and yards. Number of Houses systematically visited. House-to- house visitation. Number of Nuisances entered in Complaint Books. 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 ot Notices served. For defective Drainaga For other Nuisances For defective Drainage. For other Nuisances. 14,797 • †357 9636 4068 6730 27 90 2129 306 953 169 465 1 1 213 *This total refers to Nuisances of every description, including the non-removal of Dust, &c., complaints of which had been made at the Office. †This number appears large, but it chiefly refers to works completed, with the exception of Water Apparatuses to Closets, and Covered Dust Bins in Yards. TABLE I.—continued. NUMBER OF HOUSES VISITED FROM MARCH 31st, 1859, TO THE 30th JUNE, 1859, WHERE THE UNDER MENTIONED 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. Dangerous Cellar Flaps and Area Gratings. Works in progress. Works allowed to stand over from various causes Works done without notice. 205 98 50 97 1 0 198 102 79 120 19 245 281 23 2 72 31 28 5 4 37 62 105 21 12 22 9 58 297 813 511 *Filthy Houses where Illness frequently existed TABLE II. SUMMARY OF WORKS EXECUTED UP TO THE 31ST MARCH, 1859. 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 cleansed.—No Sewerage. New House Drainage made. House Drainage improved, Trapped, &c. Cellars cleansed. Filthy Privies cleansed. Water supply to Soil-pans. New Privies constructed. Pans to Privies provided. *Over-crowded Houses remedied. †Houses unfitted for Human habitation. Ventilation improved. Private Courts Paved. Filth in open places removed. ‡Dangerous structures. Othernuisances removed,Dust,StagnantWater,&c. Dangerous Cellar Flaps and Area Gratings. 1565 811 606 832 35 36 1731 1206 1227 952 435 811 1676 56 1497 32 41 14 16 78 206 11643 373 SUMMARY OF WORKS EXECUTED FROM 31st MARCH, 1859, TO 30th JUNE, 1859. Total 109 98 39 58 0 0 73 199 23 73 19 245 95 45 73 5 4 2 21 9 134 9 58 Gross Total 1674 909 645 890 35 36 1804 1405 1250 o to 454 105C 1771 101 1570 37 45 16 20 99 215 12,99 2 431 It will be seen in Table No 1, Column No. 1, that the total number of Nuisances removed is 14,797, but that number does not give the details of each separate case. For instance : the case may be an Offensive Privy—requiring, 1st. Cesspool to be emptied and filled up. 2nd. To he Trapped and Panned. 3rd, Pipes to be laid from Siphons to Sewer. &c. If each of these were shown, as a distinct work executed, the number in the Table and Column above alluded to, would be about 26,397. 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 2nd July, 1859. Districts. Names of Medical Officers. Small Pox. Measles. Scarlatina. Hooping Cough Diarrhoea. Typhus or continued Fever. Cholera. Erysipelas. Pya:mis. Puerperal Fever. Carbuncle. Bronchitis and Catarrh. Pneumonia and Pleuritis. Croup. Diphtheria ' Rheumatic Fever. Ague. Dysentery. Other Diseases. Total. Average number of Fever cases per Week. Spitalfields Mr. Blackwell 24 2 9 4 76 13 0 3 0 0 1 85 4 1 0 0 2 0 509 733 Mile End New Town Mr. Champneys 14 5 1 11 18 30 0 2 0 0 0 2 5 2 0 0 9. 1 387 480 Whitechapel Mr. Richardson 40 4 12 9 18 5 0 2 0 0 1 2 0 0 0 1 2 2 404 502 Goodman's Fields Mr. Sequeira 18 7 6 19 66 66 0 6 0 0 0 30 17 1 0 8 13 6 764 1027 Totals 96 18 28 43 178 114 0 13 0 0 2 119 26 4 0 9 19 9 2064 2742 7 TABLE IV.—Table showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 2nd July, 1859. Districts. Small Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhoea Typhus. Total. Grand Total. Grand Total. Artillery M. F. M. F. M. F. M. F. M. F. M. F. M F. 1859 1858 0 0 0 0 1 0 0 2 0 1 1 0 2 a 5 8 Spitalfields 0 3 0 0 1 0 1 2 1 0 1 1 4 6 10 21 Mile End New Town 1 3 0 0 0 0 1 3 1 2 2 3 5 11 16 26 *Whitechapel, North 2 1 0 0 2 0 1 3 1 0 1 1 7 5 12 17 Whitechapel Church Goodman's Fields 1 0 0 0 0 0 0 0 1 0 3 1 5 1 6 10 1 0 1 0 4 3 0 0 1 0 1 0 8 3 11 15 Aldgate 0 1 0 0 2 0 0 0 1 0 4 0 7 1 8 9 5 8 1 0 10 3 3 10 6 3 13 6 38 .30 68 106 13 1 13 13 9 19 68 Deaths from Epidemics for the corresponding Quarter of last year. 1 37 9 26 13 20 106 * Three of the cases of Fever in this District were non-residents. Four cases of Diphtheria are recorded, viz : 1 in the Whitechapel Church District, 2 in the Aldgate, and 1 in the Goodman's Fields. Five cases of Child Bed Fever are recorded, viz : 2 in Spitalfields, 2 in Goodman's Fields, and 1 in Mile End New Town. 13 TABLE V.—Showing the Births and Deaths in each District, for the Three Months ending on the 2nd July, 1859. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths. over Births. Remarks. M. F M. F. Artillery 40 31 71 16 9 25 46 ... Spitalfields 60 65 123 52 45 77 46 ... Mile End New Town 71 73 144 58 57 125 29 ... Whitechapel, N 63 52 106 30 32 62 53 ... Whitechapel Church 48 24 72 72 45 117 ... 45 45 Non-residents. Goodman's Fields 69 48 117 27 23 50 67 ... Aldgate 39 34 73 22 20 42 31 ... 2 ” 390... 325 715 257.. 231 488 272 45 47 Non-residents. TABLE VI.—Ages at Death in the Union 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 1858. 2 1 0 10 13 23 3 52 56 Three Deaths from Fever, (two Males and one Female), occurred in the Workhouse. TABLE VII—Causes of Death at Seven Periods of Life, registered in the Whitechapol District, for the Three Months ending 2nd July, 1859. Causes of Death. 0 ana 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. I.—Zymotic :— Brought forward 122 153 46 70 81 44 6 522 Small pox 5 6 ... 2 ... ... ... 13 Stomach and Digestive Organs. Measles ... 1 ... ... ... ... ... 1 Scarlatina (Scar.Fev.) 4 3 6 ... ... ... ... 13 Peritonitis ... ... ... 1 ... ... ... 1 Hooping Cough 7 5 1 ... ... ... ... 13 Ascites ... ... ... ... 2 ... ... 2 Croup ... Ulc. of Intestines Thrush Hernia (Rupture) ... ... ... ... 3 1 ... 4 Diarrhoea (bowel plaint 6 2 ... ... 1 ... ... 9 (Ileus (Inflammation and Gangrene of the Muscular Coat of the Intestine) ... ... ... 1 ... ... ... 1 Dysentery Cholera Influenza Intussusception, (a part of the Bowels introduced into the part below.) Scurvy and Purpura Ague Remittent Fever Infantile Fever Stricture of Intestinal Canal Typhus Fever ... 3 5 5 5 1 ... 19 Puerperal Fever (Metria) ... ... 1 4 ... ... ... 5 Disease of Stomach, &c. ... ... ... ... 2 ... ... 2 Rheumatic Fever ... ... ... ... 1 ... ... 1 Strict. of (Esophagus Inflammation of Liver (Hepatitis) ... ... ... ... 1 1 ... ... Erysipelas (Rose) 2 ... ... ... 1 ... ... 3 Syphilis 1 ... ... 1 ... ... ... 2 Noma (Canker) Jaundice Hydrophobia Disease of Liver ... ... 1 ... ... 1 ... 2 Diphtheria ... 3 ... ... ... 1 ... 4 Cirrhosis ... ... ... ... ... 1 ... 1 II.—Dropsy, kc. Disease of spleen Haemorrhage VIII. Kidney, &c, Aæmia Nephritis 1 ... ... ... ... 1 ... 2 Dropsy ... 2 1 ... ... .. .. 3 Nephria (Bright's ease ... ... ... ... 1 2 ... 3 Abscess (Gathering) Ulcer Ischuria Fistula Disease of Prostate ... ... ... ... ... 1 ... 1 Mortification ... ... ... ... 2 ... 1 3 Diabetes Cancer ... ... ... ... 4 2 ... 6 Stone Gout Cystitis Disease of Rectum ... ... ... 2 ... ... ... 2 Stricture of Urethra III.—Tubercular:— Disease of Bladder ... ... ... ... ... 1 ... 1 Scrofula IX. Childbirth : Tabes Mesenterica 6 10 3 ... ... ... ... 19 Paramenia Phthisis(Consumptn) 1 ... 6 37 19 5 ... 68 Ovarian Dropsy Hydrocephalus (water on the Brain) 7 4 ... ... ... ... ... 11 Childbirth (SeeMetria) Disease of Uterus, &c ... ... ... 1 2 ... ... 3 IV.—Brain & Nerves Ext. Uterine Fœtation X Joints, Bones, &c Rheumatism Cephalitis ... ... 2 ... ... 1 ... 3 Apoplexy ... ... 1 2 4 8 ... 15 Palsy (Paralysis) ... ... ... 1 4 7 ... 12 Arthritis Delirium Tremens ... ... ... 1 ... ... ... 1 Disease of Joints, &c. ... 2 1 2 ... ... ... 5 Chorea Spinal Disease ... ... 1 ... ... ... ... 1 Epilepsy XI.—Skin, Cellular Tetanus Tissue, &c Insanity Carbuncle ... ... ... ... 1 ... ... 1 Convulsions 25 6 ... ... ... ... ... 31 Phlegmon Disease of Brain, &c 1 5 ... 1 I ... ... 8 Disease of Skin, &c Idiocy XII. Malformation. Miningitis 1 1 ... ... l ... ... 3 Cyanosis V.—Heart & Blood Vessels:— Spina Bifida Other Malformations 1 ... ... ... ... ... ... 1 Pyœmia XIII. Pre,atire Pericarditis ... ... 1 1 2 ... ... 4 Birth & Debility 13 ... ... ... ... ... ... 13 Aneurism ... ... ... ... 1 ... ... 1 XIV. Atrophy Disease of Arteries XV. Old Age. ... ... ... ... ... 22 9 31 Disease of Heart, &c. ... ... 3 4 4 5 ... 16 XVI. Sudden Uraemia Sun Stroke VI.—Lungs & Organs of Respiration:— XVII. ViolentDeath Intemperance ... ... ... 2 ... ... ... 2 Laryngitis 1 2 .. ... ... ... ... 3 Privation of Food Bronchitis 5 5 1 2 7 4 2 26 Want of Breast Milk Pleurisy ... ... ... 1 ... ... ... 1 Neglect Pneumonia 8 13 ... ... 2 ... ... 23 Cold Asthma ... ... ... ... 1 6 ... 7 Posion ... ... 1 ... ... ... ... 1 Disease of Lungs 1 ... 1 ... ... ... ... 2 Burns and Scalds ... 3 2 1 ... ... ... 6 VII.—Stomach and Digestive Organs: Hanging Suffocation ... ... ... ... ... ... ... 1 Teething 3 1 ... ... ... ... ... 4 Drowning ... ... ... 1 1 ... ... ... Quinsey Suicide ... ... ... ... 1 ... ... 1 Gastritis 1 2 1 ... ... ... ... 4 Violence 1 5 10 9 1 ... 26 Enteritis ... 1 ... ... ... ... ... 1 XVIII. Not Specified. 1 1 1 ... 3 ... ... 6 Carried Forward 122 153 46 70 81 44 6 522 Grand Total 103 87 45 85 86 72 12 88 TABLE VIII.—LOUDON HOSPITAL. Causes of Death at Seven periods of Life, registered in the London Hospital, for the Three Months ending 2nd July, 1859. Causes of Death, 0 and under 1 1 and under 5. 5 and under 20. 20 and under 40. 40 and undergo. 60 and under 80 80 aud 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, I.—Zymotic:— Brought forward... 1 2 4 8 14 2 31 Small Pox Stomach and Digestive Organs. Measles Scarlatina (Scar.Fev.) Peritonitis ... ... ... 1 ... ... ... 1 Hooping Cough Ascites Croup Ulc. of Intestines Thrush Hernia (Rupture) ... ... ... ... 3 1 ... 4 Diarrhoea (bowel complaint ... ... ... ... 1 ... ... 1 Ileus (Inflammation) and Gangrene of the MuscularCoat of the Intestine Dysentery Cholera Influenza Intussusception, (a part of the Bowels introduced into the part below.) Scurvy and Purpura Ague Remittent Fever Infantile Fever Stricture of Intestinal Canal Typhus Fever ... ... 2 1 1 ... ... 4 Puerperal Fever (Metria) Disease of Stomach, &c Rheumatic Fever Disease of Pancreas Erysipelas (Rose) ... ... ... ... 1 ... ... 1 Inflammation of Liver Syphilis Jaundice Noma (Canker) Disease of Liver ... ... 1 ... ... ... ... 1 Hydrophobia Cirrhosis Diphtheria ... 1 ... ... ... ... ... 1 Disease of Spleen II.—Dropst, &c:- VIII.—Kidney, &c. Hæmorrhage Nephritis Anæmia Nephria (Bright's ease) ... ... ... ... 1 1 ... 2 Dropsy Abscess (Gathering) Ischuria Ulcer Disease of Prostate ... ... ... ... ... 1 ... 1 Fistula Diabetes Mortification ... ... ... ... 1 1 ... 2 Stone Cancer ... ... ... ... 2 ... ... 2 Cystitis Gout Stricture of Urethra Disease of Rectum ... ... ... 2 ... ... ... 2 Disease of Bladder III.—Tubercular :— IX.—Childbirth. Scrofula Ext.Uterine Fœtation Tabes Mesenterica Ovarian Dropsy Phthisis(Consumptn) ... ... ... 2 1 ... ... 3 Childbirth(seeMetria) Hydrocephalus (water on the brain) Disease of Uterus, &c. X.—Joints,Bones,(fee. IV—Brain & Nerves Rheumatism Cephalitis Arthritis Apoplexy ... ... ... 1 ... ... ... 1 Disease of Joints, &c. ... 1 2 2 ... ... ... 5 Palsy (Paralysis) Spinal Disease Delirium Tremens ... ... ... 1 ... ... ... 1 XL—Skin, Cellular Tissue, dec. Chorea Epilepsy Carbuncle ... ... ... ... 1 ... ... 1 Tetanus Phlegmon Insanity Disease of Skin, &c Convulsions XII.—Malformation Disease of Brain, &c. ... 1 ... 1 ... ... ... 2 Cyanosis Idiocy Spina Bifida • Miningitis 1 ... ... ... ... ... ... 1 Other Malformations V.—Heart & Blood Vessels :— XIII. — Premature Birth ds Debility. Phlebitis ... ... 1 ... 1 ... ... 2 XIV.—Atrophy. Pericarditis ... ... ... ... 1 ... ... 1 XV.—Old Age. ... ... ... ... ... 2 ... 2 Aneurism XVI. SuddenDeaths (causes unknown.) Disease of Arteries ... ... ... ... 3 1 ... 4 Disease of Heart, &c. XVII.Violent Death Uræmia Intemperance ... ... ... 2 ... ... ... 2 VI.—Lungs & Organs of Respiration :— Privation of Food Want of Breast Milk laryngitis ... ... ... ... 2 ... ... 2 Neglect Bronchitis Cold Pleurisy *Poison ... ... 1 ... ... ... ... 1 Pneumonia Burns and Scalds ... 1 2 1 ... ... ... 4 Asthma ... ... 1 ... ... ... ... 1 Hanging Disease of Lungs Suffocation VI. — Stomach and Digestive Organs : Drowning Suicide. Cut throat ... ... ... ... 1 ... ... 1 Teething Violence ... ... 6 6 7 1 ... 20 Quinsey XVIII.—Not Specified. – Gastritis Enteritis Carried forward 1 2 4 8 14 2 31 Grand Total 1 4 16 20 27 8 ... 76 * Following operation for Nœvus. | * A Child aged 5½ Y=years,from drinking " Oil of Vitriol." TABLE IX.—Tabular Summary of House Improvements up to the 31st of March, 1859. Name of Street or Place. No. of Houses in Place or Street. No. of Houses Inspected. Drains. Cesspools. Water Closets. Dust Bins. Pavement. General Water Supply. General Improvement. Remarks. Number constructed. Improvement or Repair. Traps fixed, Abolished. Cleansed and Disinfected. Pans and Traps furnished. New ones constructed. Water supply provided. Constructed. Repaired. Constructed. Reiaid or Repaired. Receptacles provided. | Receptacles repaired. Water supply provided. Generally repaired. Cleansing and Limewhiting. Ventilation. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 4712 4068 223 1263 482 1248 184 1403 84 930 536 141 32 448 43 7 31 372 1144 6 Tabular Summary of House Improvements for the Quarter ending 30th June, 1859. Lansdowne Place 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Thirty cases of smoke nuisance have been reported to the Committee during the past Quarter, 21 on the North District, and 9 on the South District. Burr Street 34 34 0 0 0 0 0 8 0 8 0 0 0 0 0 0 0 0 0 0 Nightingale Lane 4 4 0 0 0 0 0 0 0 0 o 0 0 0 0 0 0 0 4 0 Scarborugh Street 28 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 Tenter Street 14 14 0 0 0 4 0 4 0 4 0 0 0 0 0 0 0 0 4 0 Spital Square 40 40 0 0 0 3 0 3 0 3 0 0 0 0 0 0 0 0 0 0 Maria Place 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 Eleven cases of nuisance for keeping swine, have been removed; 10 of which were on the North side. In one of these cases only, a summons was required. Fann Court 5 5 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 5 0 cox,s Court 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 John's Place 10 10 0 0 0 0 10 0 0 0 0 0 0 1 0 0 0 0 10 0 Prince's Place 10 10 0 0 0 0 10 0 0 0 0 0 0 1 0 0 0 0 10 0 Improvements to paving of courts, etc. as under; John's-place, Pririce's-place, Wentworth-court. East, Wentworth - court, West, and New-court, Dorset-street. Wentworth Courts, E. & W. 16 16 16 0 16 4 0 16 16 16 16 0 16 0 16 0 16 16 0 0 Total 169 169 16 0 16 11 20 31 16 31 16 0 16 4 16 0 16 16 48 0 Gross Total 4881 1237 239 1263 498 1259 204 1434 100 961 552 141 48 452 59 7 47 388 1192 6 62 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON The Sanitary Contrition of THE WHITECHAPEL DISTRICT, for the THREE MONTHS ENDING OCTOBER 1st, 1859. By JOHN LIDDLE, Medial Officer of Health. Read to the Board, Nov. 14th, 1859. LONDON: PRINTED BY T. PENNY, 121, LEMAN STREET, WHITECHAPEL, and 9, london terrace, hackney road, 1859. REPORT. Gentlemen, The mortality in the Whitechapel District, for the quarter ending on Saturday, October 1st, is 624, including 39 non-residents. The deaths for the corresponding quarter of the previous year were 547, including 37 non-residents, the augmentation, therefore, in the mortality is 77. This great increase is mainly due to the numerous cases of diarrhoea which occurred during the months of July, August, and September, when this disease prevailed as an epidemic, and proved fatal to 114 persons, of whom 106 were under 5 years of age, and of this number 70 were under 12 months. Cholera, or choleraic diarrhoea, proved fatal in six instances. During the corresponding quarter of the previous year, the mortality from diarrhoea was only 71, and four cases of cholera were then recorded. The number of registered births is 648, The excess of births over deaths is, therefore, 63. For the corresponding quarter of 1858, the registered births were 604, and the excess of births over deaths was 94. The deaths of children under 5 years of age, are 309, or about 49 per cent. of the total mortality. The deaths under 12 months are 180, or nearly 29 per cent. Of those 57, or 9.1 per cent., of the total mortality, died before they reached the 10th week of their existence.* In my quarteily reports, I have repeatedly alluded to the enormous mortality of young children, and I am glad to find that this subject is now engaging the serious attention of the public, so that effectual measures are likely soon to be devised whereby this frightful evil will be diminished. I am very reluctant to believe that direct child-murder is of frequent occurrence in this country, although circumstances continually arise to render it far from improbable. The children's burial clubs, and other small insurance offices, in which the lives of children are insured, have long been suspected of offering a temptation for infanticide; but without these alleged inducements for the committal of so base a crime, the facilities of disposing of children said to be still-born, are very great, for the law does not require a competent authority to inspect the body of any child said to be still-born, before it is interred, notwithstanding that the parties seeking for the interment are not provided with a medical certificate, stating it to be a case of still-birth. When application is made to the Relieving Officer for the burial of a child said to be still-born, a certificate from a Medical Practitioner, or from an accredited Midwife, is, of course, asked * In England it is estimated that 8 per cent, of the children born, die under three months. 4 for; but as there are very many of the poor, particularly among those who reside on the south side of the district, who are confined without their having any assistance, either from a medical man or from a Midwife, the Relieving Officers in such cases accept the certificate of any friend cr neighbour, who, out of sympathy or charity rendered assistance to a lying-in woman ; no further enquiries are made, and the child is buried at the expense of the union. The number of still-born children interred at the public expense in this district during the last 12 months, was 73, or 2.5 per cent. of the total births (2839.) This number is irrespective of those buried at the expense of private individuals, of those which may have been surreptitiously buried in the same coffins with adults, and of those made away with by persons calling themselves midwives ; so that we need not feel surprised if it should be subsequently proved, that infanticide is more frequent, than the records of onr police courts at present indicate. The proportion of still to living births is estimated at about 7 or 8 per cent. This does not include abortions before quickening. Whether or not, however, direct child-murder be of frequent occurrence, there is no doubt that indirect infanticide is extensively practised, for it is well known that numerous young children, particularly the illegitimate, are put out to nurse at the earliest possible period, at a very small weekly payment, and they soon cease to exist. The use of narcotic drugs, improper and unwholesome food, and the exposure to cold without sufficient clothing, are the agents in continual operation, which shorten infant life. In addition to these agencies, there is the prevalence of superstition or fatalism among the uneducated classes, which operates so powerfully on the minds of some parents, that they will not seek for medical attendance on the appearance of illness in a child, believing that sickness is an event, over which professional skill has no controul, and is therefore unnecessary. It appears from the last annual report of the Registrar General, that in this district, one birth in 21, or 4.7 per cent. is illegitimate, and in the whole of England, the proportion is one in 15, or 6.6 per cent.; but as many of the illegitimate births are not registered, these proportions cannot be accurately depended upon. I may here, perhaps, be permitted to observe that the extent of the immorality of a district is not to be estimated only by the number of illegitimate births in it. The causes of death, and the number of persons to whom each disease has proved fatal will be seen on referring to the Mortality Table in the Appendix. The disease next in fatality to diarrhoea, (which I have previously stated proved fatal to 114) is consumption. It numbers 76 victims, nearly the half of whom (35) died in the district of Mile End New Town. Fever proved fatal to 28*, small-pox to 16+, scarlet fever to 27, measles to 8, and hooping-cough to 3. Two cases of death occurred in the second week of July, from the heat of the sun. In one of these cases (a sugar-baker, aged 34), an inquest was holden at the London Hospital; in the other, (also a sugar-baker, aged 32, whose death occurred in Great Alie Street) an inquest was not deemed necessary. Two persons came by their deaths while in a state of intoxication, one from the effects of a burn, the other from a fall down stairs. Delirium tremens, a disease caused by the excessive use of intoxicating drinks was fatal in three instances. Five deaths, * Four of the deaths from fever were of persons non-resident in the district, and they occurred in the London Hospital. † The number of cases and deaths in the Small-Pox Hospital of those who belong to this district, I have not yet obtained. 5 therefore, in this quarter, are the result of intemperance. Among the unusual causes of death, there is recorded the death of a child, from a rupture of the internal carotid artery, during an attack of severe scarlet fever ; and the death of a woman, on the ninth day of her confinement, from small-pox, and in four days after, her infant child, aged 10 days, died of the same disease. The uncertified cases of death are 13, and are registered as follows :—5 are ascribed to " convulsions," 1 is stated to have lived half an hour, 1 is registered as " premature," having lived 11 days, 2 are registered "debility", X " marasmus," aged 7 weeks, 1 " curvature of the spine," aged 5 years, 1 "syphilis and convulsions," aged 9 weeks, and 1 "phthisis," aged 51. It will be observed that technical terms are used in the registration of several of the uncertified cases of death ; but whather death was caused by the above-mentioned diseases, I have no means of ascertaining. In uncertified cases of death, it would be safer to state that the cause of death was unknown. The number of inquests holden during the last quarter is 39. In several of the instances the cause of death is not stated. For example : the verdicts in two cases are thus recorded— " Sudden death, cause not proven." In another, " Sudden death, natural causes." In a third, the verdict is " Sudden death, exhaustion." In none of the above-mentioned cases is there a record of a post mortem examination having been made. If these bodies had been examined by a surgeon, more satisfactory verdicts would have been given. The use of the terms "not proven," by a coroner's jury, is a mis-application of that verdict which is received by the judges in Scotland only, in criminal cases, when a conviction exists in the minds of a j ury, of the guilt of a prisoner, but where the legal evidence is deficient. This verdict is very properly entirely ignored in England. The death of a female, aged 65, said to have been an opium eater, is thus recorded, " Diarrhoea, sudden." An inquest was not holden in this case ; neither was one holden on a man, aged 43, who died from inflammation of the bowels, consequent upon an injury to the abdomen and chest; but an inquest was deemed necessary on the body of a female aged 50, who died of cholera, when the verdict was " Sudden death, English cholera." At the London Hospital, an inquest was holden on the body of a person whose death was caused by poison ; but the particular poison was not recorded by the local Registrar. Such information might surely have been easily obtained, and recorded at the inquest. The number of new cases of sickness attended by the Medical Officers of the union, is 3261, which is an average of about 250 per week. Amongst these cases, are 44 of small-pox; 78 of measles; 74 of scarlet fever; 21 of hooping-cough ; 787 of diarrhœa; and 107 of fever. The cases of illness in the workhouse are 411 ; of which, 228 were attended by Mr. Champneys, and 183 by Mr. Richardson. There are included in the total number, 45 of diarrhoea, 23 of fever, and 4 of small-pox. In several of the cases of small-pox, which came under the notice of the Medical Officers of the union, vaccination had not been performed ; in some, it had been imperfectly performed; and in others, there is no record. Mr. Farr, the Clerk to the Guardians, has again kindly furnished me with a return of the number of cases of vaccination ; from which return it appears that out of 2972 cases successfully vaccinated during the year that ended September 29th, 1859, there were only 755 under one year of age, or one-fourth of the registered births. The total number successfully vaccinated exceeds the registered births by 143. Itappears, however, that no lessthan2197 of the cases of successful vaccination were performed on persons above one year of age. During the previous year, the number of cases 6 successfully vaccinated was 1,821; of which, 1,599 were under one year, and 255 above that age. The unsuccessful cases of vaccination are 42, and for the previous year they were 51. During the quarter, I have visited and reported upon several trades-nuisances, viz :— the two malt-roasting premises in Spitalfields ; one belonging to Mrs. Backhouse, the other to Mr. Johnson; the premises belonging to Mr. John Davis, sugar-refiner, where animal charcoal is re-burned ; the premises of Mr. Quantrall, in Buck's Row ; and those of Mr. Smith, in Thomas-street, where the businesses of bone-boiling, &c. are carried on ;-also other premises where offensive trades, such as the making of tarpauling, tripe-boiling, &c., arc conducted. In speaking of trades-nuisances, I must not omit to lay before you the result of my frequent visits to the refinery premises belonging to Sir A. Rothschild, adjoining the Royal Mint. It appears that when the process of refining is in full operation, 100 carboys (each containing about 1 cwt.) of sulphuric acid, commonly kno wn as " oil of vitriol," are used every day ; about 50 per cent. of which was, before the improvements recently completed, allowed to escape into the neighbourhood, producing the greatest possible discomfort to all who unfortunately breathed the air thus contaminated by so acrid a vapour, as that issuing from the boiling of " oil of vitriol." It now appears from the statement of Sir A. Rothschild, that he is enabled to condense and save a very large portion of the sulphur gases which caused so much annoyance, aud by this means, effect a considerable saving of expense to himself. Sir A. Rothschild estimates the outlay already made in his endeavours to abate the nuisance, at £2,030. As Sir Anthony is still engaged in making further improvements in the apparatus recently erected, the outlay will exceed that amount. It affords me, however, much pleasure to state that Sir Anthony Rothschild values the product, or saving effected by the alterations, at about £ 10 each day the men are in full work; thus proving most satisfactorily, that the application of sanitary science to the removal of nuisances, is alike beneficial to the public aud to the manufacturer. I have, upon more than one occasion, brought before your notice the unhealthy condition of several small private school-rooms, and I have also pointed out the necessity, upon physiological grounds, of allowing as large, or nearly as large, a cubic space for the respiration of a child, as for an adult. What then can be thought of the unhealthy condition of a schoolroom in Tenter Street, Spitalfields, which your Inspector discovered on making a house- to-house visitation, which room was only 10ft. X 8 X 7i, in which were 23 children, and 2 adults! The cubic contents of this room allowed only 24 cubic feet to each person, which is rather less than would be afforded by a box 3ft. cube. As healthy respiration cannot be carried on in a less space than 300 cubic feet, the danger of this over-crowded school must be apparent. Upon notice being served, the proprietor abandoned the school, saying that if he reduced the number of his scholars, it would not pay. My attention has recently been called to the over-crowded condition of Inkhorn Court,* in which three new houses have recently been erected, on a site where houses had not previously stood. This court, which contains a superficial area of 3295 feet, measured from the backs of the houses on each side, (making, however, a deduction for the thickness of the walls), has 10 houses, which are occupied by 117 persons. This area affords to each person a free space only of 28 superficial feet. The entire court would not afford healthy accommodation for 40 horses, supposing stables to be built upon the site. At the southern extremity, and adjoining these newly erected houses, are three privies and a dust-bin, in a narrow, unpaved, and filthy passage, about 2ft. wide, which is situated within lift, of the front door of * The special attention of the Metropolitan Board has since been called to the condition of this Court, and to other places similarly circumstanced. 7 the first house in the court. These privies, which are built for the accommodation of the 60 persons living in these new houses, hut which may be used by all persons indiscriminately, are, as may he supposed, in a very filthy condition, and are likely to be injurious to the health of all the inhabitants in the court. Whether thesehouses have been legally erected or not, must be determined by the legal construction of the 29 th Sec. of the Building Act. In my opinion, a house cannot be sufficiently lighted or ventilated, which is not situated in a thoroughfare, and where the space opposite to each room is less than 16 feet. The over-crowding in places not sufficiently ventilated, is a matter which deeply affects the interests of the rate-payers, who have to provide for the numerous cases of illness which are produced by these unhealthy localities ; and unless the most strenuous efforts are made to prevent over-crowding, and the further erection of houses in every vacant spot of ground, however unfit for such purpose, the expenses which are now being incurred by the ratepayers, in extending the sewers, and in other sanitary improvements, will not produce that amendment in the public health which is anticipated. Other houses in an equally objectionable locality, where warehouses formerly existed, are, I regret to say, now in the course of erection in the district, which, if the law permit to be completed and occupied as dwellings, will tend to deteriorate the public health, and a higher death-rate will be the result; for it is a well-ascertained fact, that the rate of mortality, ceteris paribus, depends upon the density of the population; and here, perhaps, I may be permitted to draw the attention of the Board to the very valuable clause of the Building Act of 1844, wherein it was enacted, that every alley must have two entrances, each being, at the least, the full width of the alley, and one of the two, at the least, open from the ground upwards. Yet, strange to say, the legislature, by a retrograde movement, repealed this act, with the exception of those clauses relating to noxious trades. It is most earnestly to be desired that this wholesome regulation, relating to the proper ventilation of courts and alleys, should be inserted in the proposed Bill for amending the Metropolis Local Management Act. If the public is to enjoy health, and a freedom from the ravages of epidemic disease, a stop must be put to the present scheme of erecting houses in crowded situations ; for, although the rights of property are to be respected, yet, in my opinion, such rights are of secondary consideration when compared with the public health, and the increased burdens which must be borne by the ratepayers to support those whose sickness is occasioned by the unhealthiness of the localities where they reside. During the year 1858, the Medical Officers attended no less than 11,718 sick paupers. This number is exclusive of those who were attended in the workhouse.* Not only are the ratepayers called upon to provide for the poor during sickness, but from the debility which is occasioned by the over-crowded and ill-ventilated localities, labourers are unable to give " a fair day's work for a fair day's wages" ; they are consequently not employed, and therefore become chargeable to the rates. How important, therefore, is it for the local authorities to diminish, as far as practicable, the existing over-crowding, and prevent—or if they have not the power to prevent—at least, to remonstrate against the erection of every new building intended for the habitation of the poor, which is not sufficiently lighted or ventilated! The importance of sufficient space and ventilation to the health of horses and cattle is now well understood, and is almost universally acted upon by the holders of this kind of property; but until society at large feel the same pecuniary value in the health of their fellow citizens as is shown by the class above alluded to, effectual means will not be adopted to effect those objects. There is every reason to believe that by improved sanitary regulations, the death-rate, which is now 24 in 1000, would be reduced to 16 in 1000. * In addition to this number relieved at the expense of the union, there are several thousands annually relieved by the London Hospital, and the two dispensaries which are situated in the district. 8 On referring to the tabular summary of house improvements, it will be seen that 476 houses have been systematically visited during the quarter, making a total of 4713 ; and that 83 cesspools have been abolished making a total of 1342 since the formation of your Board. The sanitary condition of Russell Court, Slater's Court, Three Tun Alley, Wentworth Courts (East and West) and Saw Yard, have been improved by the laying down of new pavement. The nuisance arising from keeping swine has, in 11 instances, been removed. A summons was taken out against the Eastern Counties Rail way Company, for the defective drainage and filthy condition of Blobbs Court, Canterbury Court, and Wood's Yard, when, upon evidence being adduced of the disgusting and unhealthy state of these localities and honses, the Magistrate made an order for the necessary sanitary improvements to be forthwith carried into effect. A summons was taken out by Mr. Coward against a man living in Froetic Court, for obstructing the scavengers in the removal of the dust. The penalty for this offence, according to the 126th Section of the Metropolitan Local Management Act, is a sum not exceeding £5, but owing to some extenuating circumstances, the fine was remitted. The cow-houses and slaughter-houses are from time to time visited by your Inspectors and myself, and notices for limewhiting and better drainage, &c., are served when necessary. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. 15, Great Ame Street. Not, 8th, 1853. APPENDIX TABLE L SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED since the 1st of January, 1856, to the 1st of October, 1859. From February, 1856, to the 30th June, 1859. For the Quarter ending 1st October, 1859. Total number of Nuisances removed. Works in progress but not completed. Number of Nuisances inspected in houses and yards. Number of Houses systematically visited. House-to- house visitation. Number of Nuisances entered in Complaint Books. Nnmber 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 ot Notices served. For defective Drainage For other Nuisances For defective Drainage. For other Nuisances. 15,603 * †663 10,589 4327 7195 28 91 2342 496 1459 476 413 2 4 269 * This total refers to Nuisances of every description, including the non-removal of Dust, &c., complaints of which had been made at the Office. † This number appears large, but it chiefly refers to works completed, with the exception of Water Apparatuses to Closets, and Covered Dust Bins in Yards. TABLE I.—continued. NUMBER OF HOUSES VISITED FROM JUNE 30TH 1859, TO THE 1st, OCTOBER, 1859, WHERE THE UNDERMENTIONED NUISANCES WERE FOUND TO EXIST. OTHER WORKS, &c. Requiring Limewashiing 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 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. Dangerous Cellar Flaps and Area Gratings. Works in progress. Works allowed to stand over from various causcs Works done without notice. 149 198 61 186 0 0 139 97 269 29 298 312 32 1 89 110 25 5 4 28 39 209 28 7 42 7 39 311 196 610 * This refers to Cellars and Rooms occupied as dwellings. TABLE II. SUMMARY OF WORKS EXECUTED UP TO THE 30TII JUNE, 1859. 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 cleansed.—No Sewerage. New House Drainage made. House Drainage improved, Trapped, &c. Cellars cleansed. Filthy Privies cleansed. Water supply to Soil-pans. New Privies constructed. Pans to Privies provided. Over-crowded Houses remedied. *Houses unfitted for Human habitation. Ventilation improved. Private Courts Paved. Filth in open places removed.] Dangerous structures. Othernuisances removed, Dust, StagnantWater,&c. Dangerous Cellar Flaps and Area Gratings. 1674 909 645 890 35 36 1804 1405 1250 1025 454 1056 177 101 1570 37 45 16 20 99 215 12992 431 SUMMARY OF WORKS EXECUTED FROM 30TH JUNE, TO 1st OCTOBER, 1859. Total 112 99 82 55 0 0 95 212 28 154 23 395 51 17 87 5 4 6 6 28 7 2059 39 Gross Total 1786 1008 727 945 35 36 1899 1617 1278 1179 432 1451 1822 118 1657 42 49 22 26 127 222 15,051 470 * It will be seen in Table No 1, Column No. 1, that the total number of Nuisances removed is 15,603, but that number does not give the details of each separate case. For instance : the case may be an Offensive Privy—requiring, 1st. Cesspool to be emptied and filled up. 2nd. To be 1 rapped and Panned. 3rd, Pipes to be laid from Siphous to Sewer, &e. If each of these were shown, as a distinct work executed, the number in the lable and Column above alluded to, would be fully doubled. FABLE 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 1st October, 1859. Districts; Names of Medical Officers. Small Pox. Measles. Scarlatina, Hooping Cough Diarrhoea. Typhus or continued Fever. Cholera. Erysipelas. Pyaemia. Puerperal Fever. Carbuncle. Bronchitis and Catarrh. Pneumonia and Pleuritis. Croup. Diphtheria Rheumatic Fever. Ague. Dysentery. Other Diseases. Total. Average number of Fever cases per Week. Spitalfields Mr. Blackwell 28 6 12 3 229 10 0 6 0 0 0 36 1 0 0 0 1 4 512 848 Mile End New Town Mr. Champneys S 42 2 5 180 36 0 9 0 0 0 8 1 0 0 0 0 4 400 692 Whitechapel Mr. Iiichardson 6 12 27 12 152 5 0 6 0 0 1 6 0 0 0 1 0 0 384 612 Goodman's Fields... Mr. Sequeira 5 18 33 1 226 56 1 4 0 0 1 19 10 0 0 0 6 2 727 1109 Totals 44 78 74 21 787 107 1 25 0 0 2 69 12 0 0 1 7 10 2023 3261 8 TABLE IV.—Table showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 1st October, 1859. Districts. Small Pox. Measles. Scarlet Fever. Hooping Cough Diarrhoea Typhus. Total. Grand Total. Grand Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1859 1858 Artillery 0 0 0 0 0 1 0 0 2 2 1 1 3 4 7 10 Spitalfields 2 3 0 1 3 1 0 0 14 11 1 0 20 16 36 33 Mile End New Town 2 1 2 2 0 2 1 0 11 13 7 4 23 22 45 46 Whitechapel, North 2 0 2 1 4 0 1 0 15 8 1 3 25 12 37 30 Whitechapel Church 1 2 0 0 3 2 1 1 4 6 4 1 13 12 25 11 1 2 0 0 7 4 0 0 5 3 2 1 15 10 25 16 Aldgate 0 0 1 1 1 0 0 0 8 12 O 2 10 15 25 16 8 8 5 5 18 10 3 1 59 55 16 '. 12 109 91 200 162 16 10 28 4 114 28 200 Deaths from Epidemics for the corresponding Quarter of last year. 0 22 27 22 71 20 162 TABLE V.—Ages of Death in the Union Workhouse. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 6'' 60 and under 80 80 and upwards. Total Corresponding Quarter of 1858. Males 35 Fem. 27 6 1 1 8 13 28 5 62 47 Seven deaths from Fever, and one from Small-pox, occurred in the Workhouse. TABLE VI.—Table showing the Births and Deaths in each District, for the Three Months ending on the 1st Oct., 1859. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths. over Births. Remarks. M. F. M. F. Artillery 24 19 43 12 14 25 17 — Spitalfields 64. 70 134 45 37 82 52 — Mile End New Town 74 70 144 83 72 155 — 11 Workhouse. Whitechapel, N 49 43 92 48 31 79 13 — London Hospital. Whitechapel Church 30 34 64 80 58 138 — 74 Goodman's Fields 52 41 93 38 36 74 19 — Aldgate 51 27 78 40 30 70 8 — Mil. Hosp. Tower. Non-residents, 39. Totals 344 304 648 346 278 624 109 85 Excess of Births over deaths, 63. TABLE VII.—Vaccination Extension Act.—Whitechapel Union. Names of the whole of the Public Vaccinators of the Union. Vaccination Districts. Year ended 29th September, 1859. Number and Ages of Persons vaccinated by the public vaccinators Number of such cases successfully Vaccinated. No. of Reg. Births, all classes, during; the Year, including; Workh , and whole of parishes in union Unsuccssful cases. Under 1 year Above 1 year Total. Under 1 year Above 1 year Total. Thomas Seal Blackwell Christchurch 187 351 538 185 348 533 526 5 James Edmunds Old Artillery Ground 154 265 414 147 260 407 230 12 Alex. M. Champneys Mile End New Town 101 332 433 101 332 433 627 0 Edward Richardson Whitechapel North lfiO 577 737 159 572 731 410 6 Charles P. Blackman Whitechapel Church 65 307 373 65 307 372 288 0 Henry L. Sequiera Goodman's Fields 101 319 420 101 307 408 423 12 Charles E. Jenkins 19 76 95 17 71 88 325 7 Totals 787 2227 3014 775 2197 2972 2829 42 TABLE VIII.—Causes of Death at Seven Periods of Life, registered in the Whitcchapel District, for the Three Months ending 1st Oct., 1859. Causes of Death. 0 and under 1 1 and under 5 5 and under 20 20 and under 4o 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 and under 40 40 and under 60 6u and under 80 80 and above Total. I.—Zymotic:— Brought forward 147 123 40 73 57 51 7 496 Small pox 1 10 2 2 ... 1 ... 16 Stomach and Measles 10 ... ... ... ... ... 10 tive Organs. Scarlatina (Scar.Fev.) 3 18 7 ... ... ... ... 28 Peritonitis ... ... 1 ... 1 1 ... 3 Hooping Cough 3 1 ... ... ... ... ... 4 Ascites ... 1 1 ... 4 ... ... 6 Croup 1 1 ... ... ... ... 2 Ulc. of Intestines Thrush 5 ... ... ... ... ... ... 5 Hernia (Rupture) Diarrhoea (bowel complaint) 70 36 2 ... ... 3 3 114 (Ileus (Inflammation and Gangrene of the Muscular Coat of the Intestine) ... ... ... ... 2 ... ... 2 Dysentery Cholera 2 2 ... 1 ... ... 5 Influenza Intussusception, (a part of the Bowels introduced into the part below) 1 ... ... ... ... ... ... 1 Scurvy and Purpura ... ... ... 1 ... ... ... 1 Ague Remittent Fever Infantile Fever Stricture of Intestinal Typhus Fever ... 3 7 7 3 8 ... 28 Canal Puerperal Fever (Metria) ... ... ... 1 ... ... ... 1 Disease of Stomach, &c. Rheumatic Fever Disease of (Esophagus ... ... ... 1 ... ... ... 1 Erysipelas (Rose) 2 ... ... 3 1 ... ... 6 Inflammation of the Liver ... ... 1 ... ... ... ... 1 Syphilis 3 ... ... ... ... ... ... 3 Noma (Canker) Jaundice 1 ... ... ... ... 1 ... 2 Hydrophobia Disease of Liver ... ... ... ... 2 2 ... 4 Diphtheria 1 ... ... ... ... ... ... 1 Cirrhosis II.—Dropsy, &c. Disease of Spleen Hæmorrhage ... ... ... ... 1 ... ... 1 A uæmia VIII. Kidney, &c. Nephritis Dropsy ... ... 1 ... ... 4 ... 5 Abscess (Gathering) ... ... 1 1 1 ... ... 3 Nephria (Bright's ease ... ... ... 1 1 2 1 5 Ulcer Tschuria Fistula Disease of Prostate Mortification ... ... ... ... 2 2 ... 4 Diabetes Cancer ... ... ... 2 2 ... ... 4 Stone Gout Cystitis III.—Tubercular :— Stricture of Urethra Disease of Bladder Scrofula 1 ... ... ... ... ... ... 1 IX. Childbirth: Tabes Mesenterica 17 17 1 2 ... ... ... 37 Paramenia Phthisis(Consumptn) 1 2 3 39 24 7 ... 76 Ovarian Dropsy Hydrocephalus (water on the Brain) *8 5 ... ... ... ... ... 13 Childbirth(SeoMetria) ... ... ... ... 1 ... ... 1 Disease of Uterus, &c ... ... ... ... 1 ... ... 1 IV.—Brain & Nerves Ext.Uterine Fœtation Cephalitis ... ... 2 2 ... ... ... 4 X. Joints, Bones, &c Apoplexy ... ... 1 1 ... 4 3 9 Rheumatism Palsy (Paralysis) ... ... ... 1 1 4 2 7 Arthritis Delirium Tremens ... ... ... 2 1 ... ... 3 Disease of Joints, &c. Chorea ... ... 1 ... ... ... ... 1 Spinal Disease ... ... 3 ... ... ... ... 3 Epilepsy ... ... ... ... ... 1 ... 1 XI.—Skin, Cellular Tissue, &c Tetanus Insanity Carbuncle ... ... ... ... ... 1 ... 1 Convulsions 17 6 ... ... ... ... ... 23 Phlegmon Disease of Brain, &c 1 2 ... 3 1 1 ... 8 Disease of Skin, &c Idiocy XII. Malformation. V.—Heart & Blood Cyanosis Spina Bifida Vessels:— Other Malformations Phlebitis XIII Premature Birth & Debility . 30 ... ... ... ... ... ... 30 Pericarditis ... ... 3 1 ... ... ... 4 Aneurism XIV. Atrophy 1 1 ... ... ... ... ... 2 Disease of Arteries XV. Old Age ... ... ... ... ... 10 13 29 Disease of Heart, &e. ... ... 1 3 8 4 ... 16 XVI. Sudden Uræmia Sun Stroke VI.—Lungs & Organs op Respiration:— XVII. Violent Death Intemperance Laryngitis Privation of Food Bronchitis 2 1 3 2 4 5 ... 17 Want of Breast Milk Pleurisy ... ... ... ... ... 1 ... 1 Neglect Pneumonia 8 6 2 ... 2 2 ... 20 Cold Asthma ... ... ... ... 1 3 ... 4 Poison ... ... ... ... ... 1 ... 1 Disease of Lungs ... ... ... ... 1 1 ... 2 Burns and Scalds ... 3 ... 2 1 1 ... 7 VII.—Stomach and Digestive Organs: Hanging ... ... ... ... 1 ... ... 1 Suffocation Teething 1 1 ... ... ... ... ... 2 Drowning ... ... 1 1 ... ... ... 2 Quinsey Suicide Gastritis 1 ... 1 ... ... 2 Violence ... 1 3 2 6 6 ... 18 Enteritis 1 1 2 ... 2 ... ... 6 XVIII. Not fied. ... ... ... 2 1 2 ... 5 Carried Forward 147 123 40 73 57 51 7 195 Grand Total 18O 129 50 82 78 81 21 624 TABLE TX.-LONDON HOSPITAL. Causes of Death at Seven periods of Life, registered in the London Hospital, for the Three Months ending 1st Oct., 1859. Causes of Death. 0 and under 1 l and uuder 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 aud above. Total. Causes of Death. 0 and uuder 1. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under GO 60 and uuder 80 80 and above Total. 7.—Zymotic :— Brought forward ... 2 11 17 9 7 46 Small Pox ... 1 ... 1 ... ... ... 2 Stomach and Digestive Organs. Measles Scarlatina (Scar.Fev.) Peritonitis ... ... 1 ... ... 1 ... 2 Hooping Cough Ascites Troup ... ... 1 ... ... ... ... 1 Ulc. of Intestines Thrush Hernia (Rupture) Piarrhcea (bowel Plaint Ileus (Inflammation) and Gangrene of the Muscular Coat of the Intestine ... ... ... ... 1 ... ... 1 Dysentery Cholera Infantile Fever Intussusception, (a part of the Bowels introduced into the part below.) Scurvy and Purpura Ague Remittent Fever Infantile Fever Stricture of Intestinal Typhus Fever ... ... 2 2 ... ... ... 4 Puerperal Fever (Metria) Disease of Stomach, Rheumatic Fever Diseaso of Pancreas Erysipelas (Rose) ... ... ... 2 ... ... ... 2 Inflammation of Liver ... ... 1 ... ... ... ... 1 Syphilis Jaundica Noma (Canker) Disease of Liver ... ... ... ... 1 ... ... 1 Hydrophobia Cirrhosis Diphtheria Disease of Œsophagus ... ... ... 1 ... ... ... 1 II.—Propst, &c:— VIII.—Kidney, &c. Hæmorrhage Nephritis Anæmia Nephria (Brigbt's ease) ... ... ... 2 1 2 1 6 Dropsy ... ... 1 ... ... ... ... 1 Abscess (Gathering) ... ... 1 1 ... ... ... 2 Ischuria Ulcer Disease of Prostate Fistula Diabetes Mortification ... ... ... ... ... 1 ... 1 Stone Cencer ... ... ... 2 2 1 ... 5 Cystitis Gout Stricture of Urethra Disease of Rectum Disease of Bladder III.—Tubercular :— ix. Childbirth Scrofula Ext.Uterine Fœtation Tabes Mesenterica Ovarian Dropsy Phthisis(Consumptn) ... ... 2 4 2 ... ... 8 Childbirth(seeMetria) Hydrocephalus (water on the brain) Diseaso of Uterus, &c. X.—Joints,Bones,&c. Rheumatism IV.—Brain & Nerves Arthritis Cephalitis ... ... 1 1 ... ... ... 2 Disease of Joints &c. Apoplexy ... ... ... 2 ... 1 ... 3 Spinal Disease Palsy (Paralvsis) XI.—Skin, Cellular Tissue &e. Delirium Tremens Chorea ... ... 1 ... ... ... ... 1 Carbuncle Epilepsy Phlegmon Tetanus Disease of Skin, &c Insanity XII.—Malformation Convulsions Cyanosis Disease of Brain, &c. ... ... ... 1 ... ... ... 1 Spina Bifida Idiocy Other Malformations V.—Heart & Blood Vessels :— XIII. — Premature Birth & Debility. Phlebitis XIV.—Atrophy. Pericarditis ... ... 2 ... ... ... ... 2 XV.—Old Age. Aneurism XVI. Sudden Deaths (causes unknown.) ... ... ... ... ... 1 3 4 Disease of Arteries Disease of Heart, &c. ... ... ... 1 1 1 ... 6 XVII.Violent Death Uræmia Intemperance VI.—Lungs & Organs of Respiration :— Privation of Food Want of Breast Milk Laryngitis Neglect Bronchitis ... ... ... ... ... 1 ... 1 Cold Pleurisy ... ... ... ... ... 1 ... 1 Poison ... ... ... ... ... 1 ... 1 Pneumonia ... 1 ... ... 1 1 ... 3 Burns and Scalds ... 3 ... 2 1 1 ... 7 Asthma Disease of Lungs Hanging Suffocation VI. — Stomach and Digestive Organs : Drowning Suicide. Cut throat Teething Violence ... ... 3 2 4 5 ... 14 Quinsey XVIII.—Not Specified. Gastritis Enteritis Carried forward ... 2 11 17 9 7 ... 46 Grand Total ... 5 16 24 17 18 4 81 TABLE X.—Tabular Summary of House Improvements up to the 30th of June, 1859. Name of Street or Place. No. of Houses in Place or Street. No. of Houses Inspected. Dhains. Cesspools. Water Closets. Dust Bins. Pavement. General Water Supply. General Improvement Remarks. Number constructed. Improvement or Repair. Traps fixed. Abolished. Cleansed and Disinfected. Fans and Traps furnished. New ones constructed. Water supply provided. Constructed. Repaired. Constructed. Reiaid or Repaired. Receptacles provided. Receptacles repaired. Water supply provided. Generally repaired. Cleansing and Limewhitine. Ventilation. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 4881 4237 239 1263 498 1259 204 1434 100 961 552 141 48 452 59 7 47 388 1195 6 Tabular Summary of House Improvements for the Quarter ending 1st October, 1859 01(1 Castle-street—continued 23 10 0 3 3 3 0 3 0 3 2 0 0 3 0 0 0 0 3 0 * Cox's Square.—Dust Bins have been provided to each house, where it has been practicable. Bell Lane 42 22 0 12 4 5 0 4 0 0 7 0 0 12 0 0 0 14 12 0 *Cox's Square 19 19 0 0 0 2 0 2 0 0 0* 5 0 7 0 0 0 7 5 0 Goulston Street, Upper & Lower 59 59 0 15 0 10 0 10 0 13 10 0 0 9 0 0 . 0 11 19 0 Goulston Court & Alley 33 33 0 5 5 0 0 5 0 2 2 0 0 0 0 0 0 0 21 0 † Tewkesbury Buildings.-A letter was sent by the Medical Officer of Health to the owner of this Court, recommending him to erect a public Dust bin instead of that in the basement of each house, as the smell from it is very offensive, and produces illness, particularly in those tenants in the upper rooms. †Tewkesbury Buildings 14 14 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 ‡Goulston Square 14 14 0 0 0 0 0 0 0 3 5 0 0 7 0 0 0 3 7 0 Whites Row, Spitalfields 37 37 19 0 19 22 0 22 9 19 9 0 9 0 9 0 0 19 5 0 Dorset Street, Spitalfields 40 40 8 11 11 11 0 11 8 11 8 0 0 8 8 0 0 11 7 0 Finch Street 60 60 0 30 30 30 0 30 0 0 4 0 0 0 0 0 0 8 8 0 Buxtion Street 42 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Saint Mark Street 28 28 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ‡Goulston Square Baths,—These baths are in a very satisfactory condition, both as regards the baths,and the washing department. The water-closets are very clean, and everything connected with the establishment reflects great credit upon the Superintendent. §Spicer Street 36 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Finis Court 4 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 0 Newnham Street 31 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Chamber Court 5 5 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 §Princes Street, Whitechapel 27 22 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 1 0 0 Total 514 476 28 82 72 83 2 87 17 51 47 5 9 46 17 0 0 77 99 0 § Spicer Street & Princes Street.— The work is standing over for the want of a sewer. Gross Total 5395 4713 267 1345 570 1342 206 1521 117 1012 599 146 57 498 76 7 47 465 1291 6 63 BOARD OF WORKS, WHITECHAPEL DISTRICT. FOURTH ANNUAL REPORT on The Sanitary Condition of THE WHITECHAPEL DISTRICT, for the YEAR ENDING DECEMBER 31st, 1859 By JOHN LIDDLE, Medial Officer of Health. Read to the Board, Feb. 27TH, 1860. LONDON: PRINTED BY T. PENNY, 121, LEMAN STREET, WHITECHAPEL* AND 9, LONDON TERRACE, HACKNEY ROAD 1860. REPORT. Gentlemen, According to my annual practice, I have to lay before you an account of the mortality and sickness in the district, and also of the sanitary improvements which have been effected during the twelve months, terminating on the 31st December. It will be perceived, on referring to the tables of mortality, that, out of a population, estimated at 84.000, 2321, including 189 non-residents, have died daring the year 1859. This number, on the deduction of the non-residents, represents a death-rate of 25 per 1000. During the previous year the deaths, including those of the non-residents (216), were 2444, representing a death-rate of 26 per 1000. The decrease in the mortality during the year 1859 is 95, when compared with the mortality in 1858. On comparing the births during the same periods, it will be seen, that in 1858 they were 2742, and in 1859, 2826, showing an increase of 84. During the quarter recently terminated, the mortality, including the deaths of 41 nonresidents, is 598, while, in the corresponding quarter of the previous year, it was 673, including 52 non-residents, There is, therefore, a decrease of 63 in the mortality of the last three months, when compared with that in the corresponding quarter of 1858. The births registered in the quarter are 704, viz, 381 males, and 323 females; and for the corresponding period of the preceding year, they were 707, viz., 363 males, and 344 females. The week, during the last quarter, in which the greatest mortality prevailed, was that ending December 31st, when 64 deaths were registered. The cold, about a week before this period, was very severe, the thermometer, on Saturday, the 17th December, standing at 15.5° or 16.5° below the freezing point, a degree of cold greater than on any day since the 22nd December, 1855. On the 24th November, 1858, when the thermometer stood at 20.5°, or 11.5° below the freezing point, the mortality in the following week was 65. The fact that a greater mortality always immediately accompanies or succeeds very cold weather, is most important to be borne in mind by every one, especially by those who have the charge of institutions containing a large number of inmates ; for by proper care, in regulating the temperature of the day and sleeping rooms, and in providing an increase of food and warmer clothing for the inmates, the mortality may, to a certain extent, be lessened. The deaths from epidemic diseases, during the last quarter, are 119, viz., 23 from smallpox, 15 from measles, 40 from scarlet fever, 3 from diphtheria,* 1 from hooping-cough, 15 from diarrhoea, and 22 from typhus. In the corresponding quarter of the previous year, the total number was 122, viz , 2 from small-pox, 2 from measles, 44 from scarlet fever, 32 from hooping-coagb, 10 from diarrhoea, and 32 from typhus. The increase in the mortality from these diseases is principally observed in small-pox, measles, and diarrhoea ; while, in fever, hoopingcough, and scarlet fever, the mortality is diminished. The mortality from epidemic diseases, in the year 1859 is less by 27 than it was in 1858 ; the deaths in the former named period, being 471, and in the latter, 498. On perusing table No. 5, which shows the mortality from epidemic diseases, it will be observed, that while there is an increase in small-pox, diarrhoea, and scarlet fever, the deaths from fever have diminished. Not only is the mortality from fever diminished, but the cases which have been attended by the medical officers of the union have been fewer, the number for 1859 being 411, and for 1858, 590. *The total deaths from diphtheria for the year are 10. The medical officers of the union have not recorded a single case of this disease during the year, and 6 only were recorded by them in 1858. The records of the Eastern Dispensary do not show a single case of diphtheria during the year ending March, 1859. This district has, therefore, been comparatively free from the ravages of this fatal disease. 4 Consumption, although very fatal, appears to boar a less proportion in this district, to the total deaths, than in the adjoining parishes of the City of London, where, for the quarter ending at Christmas last, out of 730 deaths, this disease was fatal to 103, or about 1 in 7 ; whereas, in the Whitechapel district, out of 598 deaths, consumption was fatal to 64, or about 1 in 9. The difference in the mortality produced by consumption in these contiguous districts, may arise, from the greater number of persons being employed as clerks, warehousemen, and needlewomen, in the city than in this district, for it is amongst these classes that this disease is so fatal. The total number of deaths in this district from consumption, for the year 1859, is 273. This large mortality from consumption shows the want of sanitary measures fully as much as the mortality from zymotic diseases, and perhaps even more so, for the causes, such as want of light, especially of solar light, and defective ventilation, are, in the narrow courts, continually in operation, whereas, the ravages of epidemic diseases are only occasional ; although, it is in these confined localities, that epidemic diseases find the most numerous victims. In order, therefore, that the Board may know the localities where this fatal scourge has prevailed during the year, I have added a column to the table, in which the deaths from zymotic diseases and cases of fever are shown, indicating the localities where consumption was fatal; and it will be seen, on reference to this table, that consumption has found its greatest number of victims in those localities which are the most confised and worst ventilated. It will also be seen, on referring to the general mortality table, that out of 273 deaths from this disease, 130 were of persons between 20 and 40 years of age, and 93 between 40 and 60. The importance, therefore, of endeavouring to prevent the developement of this disease cannot be over-estimated, for it is most fatal to those in the prime of life,—at that period of their existence, when they are the most useful members of society, having families to provide for, and to educate. In order to mitigate the suffering induced by this disease, the attention of the local authorities must be most particularly directed to improve those localities where there is a deficiency of light, and imperfect ventilation. The ill effects of confined and overcrowded places, are manifested, not only in the production of consumption, but are shown in the developement of other scrofulous and tubercular diseases, in the imperfect growth of the system, and in the numerous instances of deformity. Diarrhoea was very fatal in July and August; in the eight weeks, from July 9th to August 27th, there were 91 deaths from this disease, and the medical officers of the union attended 634 cases. For the week ending July 23rd, there were 16 deaths from diarrhoea, and 130 cases were attended by the medical officers of the union. There are 16 deaths registered under the several headings of convulsions, bronchitis, measles, consumption, diarrhoea, small-pox, and age, which were not certified by a medical practitioner. The total number of uncertified causes of death for the year, was 47. This is three more than the number recorded during the previous year. The local registrars record the following unusual causes of death:—a child, aged 5 years, from tetanus, or "locked jaw," the result of inflammation of the eye-lid; a child, aged 3 months, from exhaustion, occasioned by repeated hæmorrhage from the umbilical chord; a case of acute laryngitis, occurring in a child on the fourteenth day of the eruption of small-pox; a child, aged 2 years, whose death was caused from inflammation of the cerebellum, six weeks after the bite of a dog. The mortality under five years, although excessively high, is rather lower than it was in the previous year, when, out of 2444 deaths, the mortality under 5 was 1154, or 47.2 per cent.; and under 1, the mortality was 563, or 23 per cent.; while, in this year, the total mortality is 2321, and the mortality under 5 is 911, or 42.6 per cent.; and under 1 is 513, or 22.1 per cent. As small-pox still continues to prevail as an epidemic, not only in this district, but in the metropolis generally, I am again under the necessity of especially directing your attention to the subject. The present epidemic has now continued for a period of 12 months and upwards; during which time it has caused the death of 60 persons in the district, exclusive of those who were removed from it, and who died in the small-pox hospital, and elsewhere. 5 The following table, for which I am indebted to the Medical Officers of the Small-pox Hospital, is a valuable record : — Table of SMALL-POX EPIDEMICS, in the present Century. Year, Duration. Period. Admissions into the Small Pox Hospital. Deaths. Mortality per cent. Of those admitted there were Vaccinated 1825 7 Months February to September 419 120 28 per cent. 32 per cent. 1838 14 Months Nov. 1837, to Dec. 1838 712 188 26. „ 40. „ 1844 14 Months May, 1844, to July,1845 647 151 23. „ 48. „ 1848 16 Months Oct. 1847, to Jan. 1849 686 168 24. „ 62. „ 1851 & 1852 19 Months December, 1850—1851 to May, 1852 667 104 15. 141/3 64. 66 800 110 13.75 69. 1854 29 Months February, 1854 696 99 14. 15 69. 71 1855 „ „ 1855 954 147 15. 72.85 1856 July, 1856 619 102 16. 72.85 1859 From the commencement of 1859, to the present time, and still continues. 1860 The mortality from Small-pox, for the quarter ending Christmas 1858, was 2, and the cases attended by the medical officers of the union were 8. During the succeeding quarter, the deaths were 8, and the cases 44. In the quarter terminating 2nd July, the mortality was 13, and the cases 96. In the following quarter, the deaths were 16, and the cases 44; and during the last quarter, the deaths were 23, and the cases 58. The mortality from small-pox, as shown by the returns of the local Registrars, and the number of cases attended by the medical officers of the union, do not indicate the full amount of the ravages of this disease among your population, for many cases are attended by private practitioners, by whom no public return is made; several cases are taken to the Small-pox Hospital, and others are removed to the residences of their friends ; of the result of which cases we have no record. Through the kindness of Dr. Munk, the physician to the Small-pox Hospital, I have been favored with a return of the cases which have been received within its walls, from this district. It appears that the total number received during the last six months, has been 26, of whom, 4 died. During the quarter terminating July 2nd, there were 18 patients of whom, 4 died. During the quarter terminating April 2nd, the number admitted was 9, none of whom died. The total mortality therefore from small-pox in this district for the year 1859, of which we have a record, is 68, which number, if multiplied by 8, the disease being fatal in about 1 in 8, will show that about 544 cases of small-pox have probably occurred in the district. On looking over the account of the cases of small-pox admitted into the hospital from this district during the last six months, I find that, in the four fatal cases, 2 of the patients had not been vaccinated; and in the other 2, the cicatrices are described as "doubtful" and "indifferent." In the other 22 cases, the patients had been previously vaccinated, but five of them only, presented good cicatrices. It is recorded that one of the patients, a youth aged 18, " was cut three times for the cow-pox without effect." From the same return it also appears, that out of the 26 patients, there were six who were employed in one establishment in this district. The first of these six cases was admitted on the 11th July, the second on the 30th of the same month, the third on the 25th August, the fourth on the fifth of September, the fifth on the 15th October, and the sixth on the 24th October. It appears that the interval between each of these cases varied from 9 to 45 days; but as all the cases which occured in this establishment were not removed to the Small-pox Hospital, but some were taken charge of elsewhere, the interval between each case may have been of less duration. It is the generally received opinion that the poison of small-pox does not take effect, unless from inoculation, before the 12th day from exposure to its influence. This is an important fact to be borne in mind by those intrusted with the care of public institutions; for, no person, except well protected by efficient vaecin- 6 ation, coming from a locality where small-pox is prevalent, can be placed with others, without the risk of communicating the disease, unless a period of 12* days has elapsed from the time of leaving such locality. In order to prevent the spreading of small-pox in schools or in other places where persons are congregated together, it would be most desirable, on the appearance of the first case of the disease, to vaccinate every one in such establishments, and to limewash and thoroughly ventilate the day and sleeping rooms. The prevention of small-pox is a matter now engaging much public attention, and it is highly probable that an alteration will be made in the Compulsory† Vaccination Act, as the provisions of that act have not produced the desired effect in bringing the whole of the infant population under the influence of vaccination ; but until an amended general act be passed, it behoves all public authorities having the care of large establishments, when small-pox is epidemic, to take the best advice that can be obtained on this important subject, and to act upon it. Much might be done in the way of extending the protecting influence of vaccination, by a co-operation on the part of all guardians of the poor and district vaccinators, in devising a plan, whereby, the name and address of every child born in their district, might be brought to the knowledge of the vaccinators, who should be required to call at every house, where a birth had taken place within four months of the date of the birth. The vaccinator should be required to visit, from time to time, all public schools in the district, and examine each child to ascertain whether it has been properly vaccinated. In order that uniformity may be observed in the performance of vaccination, and greater protection from Small-pox insured, ‡ it has been suggested that not less than five or six punctures be made in the arms of each child,—that lymph should never be taken after the seventh or eighth day (the seventh much to be preferred) from the period of the performance of the operation ; and then only, when the lymph is pellucid,—that lymph should be taken from a healthy child only, and who is born of healthy parents,—that lymph should never be taken from a child who has been re-vaccinated. The Board having received a letter directing their attention to the cause of the great increase of small-pox, the letter was committed to my charge, in order that I might make a report upon the subject. The preceding remarks upon the disease having been previously prepared, I respectfully submit them for the consideration of the Board. The number of inquests held during last year was 195, during the previous year the number was 216. In most of the cases of sudden death, in which inquests have been held during the last three months, the causes of death have been ascertained by a post mortem examination. Whenever the cause of death, in cases of sudden death, is not apparent, a post mortem examination of the body should always be made, for, by this proceeding, not only will the statistics of the causes of death be more accurate, but crime may be to some extent prevented. In the quarter terminating December 31st, 59 inquests were held, among which, are three children, whose deaths wrere occasioned by suffocation ; in one case, the jury returned the verdict "Found dead, Suffocation, but they thought it was not accidental,"—another case, the verdict was "Suffocation in bed accidentally,"—in the third case, the child is registered as illegitimate, and the verdict, " Suffocation in bed." * Fourteen days intervene before the eruption appears. + This act is very unsatisfactory to the local registrars, inasmuch as it gives them a great deal of trouble in filling up a paper for the parent or guardian at the time of the registration of a birth, containing directions respecting vaccination, while the registrars are not paid the small fee allowed by the act, until they have received a certificate from the vaccinator of the district, that the child has been successfully vaccinated. If the child be vaccinated out of the district, notwithstanding all the registrar's previous trouble, he loses his fee ; and upon enquiry I learn, that a great number of the children registered in one district, are vaccinated in another. The act is also unsatisfactory to the public vaccinators; for many persons on bringing children to be vaccinated, give a false address to the vaccinator, with a view of preventing him from obtaining a supply of lymph from the child all traces of such child are therefore lost, and whether it has been successfully vaccinated or otherwise is, unknown, The act does not authorize the inliictiou of a penalty for the giving of a false address. ‡ See Report for April, 1859* 7 There are also recorded the following cases:—" Sudden death," a child, 2 years old, from diphtheria, the patient not having a medical attendant, but was treated by its father, under Dr. Coffin's system,—a child, aged 5 years, whose death was caused by burns, through the parents' neglect, they having left her alone,—a sailor, 18 years old, met with his death from inhaling noxious vapours arising from the burning of coals. Four persons committed suicide, two (males) by hanging, and two (females) by poison, one by prussic acid, and the other by " oil of vitriol." There was one death from the inhalation of chloroform which was administered to a patient while under delirium tremens. A death is recorded as the result of exposure to cold, and from the effects of excessive drinking. Although a more correct record than formerly is now kept of the cause of death, in cases where inquests are held, yet, from the two subjoined cases, there appears to be no certainty when such investigations will take place, for in neither of them was an inquest held, although death in each case was apparently produced by violence ; one being registered " Congestion of the brain, from a fall," and the other " Concussion of the brain, convulsions." Having compared the mortality in the year 1859 with that of 1858, I now pass to the consideration of the sickness during the same periods. It appears, from the returns of the medical officers of the union, that the total number of cases for the past year is 16,701, and for the previous year, the' cumber recorded is 16,718. For the quarter, the number is 2762. This is exclusive of the 498 cases in the workhouse. The total number of cases of sickness in the workhouse for the year is 1625. The cases of zymotic diseases attended to in the workhouse during the quarter were,—3 of small-pox, 33 of fever, 25 of diarrhoea, 9 of erysipelas, 7 of carbuncle, 4 of ague, 1 of diphtheria, and 6 of rheumatic fever. There were five cases of delirium tremens, the result of intemperance, admitted into that institution. Although the total number of eases of sickness among the out-door poor, during the year is only 17 less than that for the previous year; yet, the number in the several epidemic diseases varies very materially. Thus, small-pox rose from 20 to 242 ; scarlatina from 146 to 175; diarrhoea from 946 to 1209; while measles diminished from 427 to 179, hooping-cough from 330 to 146 ; and fever* from 590 to 411. It is not so much the number, as the class of cases of sickness amongst the poor, which shows the unhealthiness or otherwise of a district; the obtaining an order for medical attendance, being too frequently made the pretext for soliciting relief in food or money. Having brought under your notice the mortality and sickness iu the district for the past year, and compared them with the mortality and sickness of the preceding year, it remains for me to point out the places where deaths from zymotic diseases have been the most prevalent, and where cases of fever have been most numerous. It is to those localities, that the labours of your sanitary officers must be particularly directed; for, from the concurrent testimony of the medical profession, the whole class of diseases called "zymotic" may, to a great extent bg prevented, and their severity modified. I have appended to this report a table containing the names of all the places, where this class of diseases has occurred ; from which it appears that the following localities are the most unhealthy:— Whitchapel: Osboru-place, Wentworth-street, Marlborough-court, Queen Ann-street, Plough-street, Buckle-street, Holloway-court, and Slater's-court. Aldgale: Crown-court and Queen-street. Spitalfields: Quaker-street, Grey Eaglestreet, Corbett's-court, Flower and Dean-street, Keate-street, and Thrawl-street. Mile End New Town: Church-street, Princes-street, Dunk-street, King Edward-street, Pelham-street, Hunt-street, Well-street, and Spring-gardens. Some improvements have been effected in several of the densely crowded localities, by the government, in forming new streets,—by societies of philanthropic individuals, in erecting model lodging houses and more healthy habitations for the working classes,—by the registration of the common lodging houses, &c., the result of which has been a diminution in the rate of mortality from 45 per 1000, which was the rate in 1838 to 25 per 1000, which is the rate of mortality in 1859.† This interesting fact affords us great encouragement to persevere in the * The term "fever,'' used in this report, embraces simple continued fever, typhus and typhoid. Typhus is said to owe its origin to overcrowding; and typhoid, to the emanations from decomposing organic matter Typhoid fever is sometimes called enteric fever, and sometimes pythogeuic fever. + See table No. 9. 8 good work of sanitary reform, but before this district can be brought up to the healthy* standard, all the densely crowded and badly ventilated localities must be demolished, the present system of over-crowding prevented, more convenient and better ventilated houses constructed, the people provided with a more ample supply of pure water and rendered easily accessible to them ; for without these requirements all other sanitary improvements will be comparatively of little avail. I feel persuaded, that it will be found far more economical to invest money in the purchase and demolition of many of the existing habitations of the poor, and substituting for them a better and more commodious class of houses, whereby, their health may be preserved, and their independence and self-reliance promoted, than in expending double the amount in pharity, which at the best, is merely a palliative, whether it be expended in the distribution of alms, or in the support of asylums for the relief of sickness and poverty. That disease may, to a great extent, be prevented by properly constructed houses, is illustrated in the report of the Metropolitan Chambers which has been furnished to me by Mr. Coward. These chambers have now been open for a period of ten years, and no death from fevert has been recorded therein during that time, although 4178 persons have resided there. The rent required for a room in the model lodging houses is more than many of the labourers in this district can afford, and it is to provide homes for the "very poor" that the earnest attention of the philanthropist should be directed. The pictures of squalor which many of the rooms, now occupied by the very poor, present, is a great hinderance to their social advancement. In no sense of the word can their wretched hovels be looked upou as "homes," or places whera the homely affections can be cultivated. The consideration of the question of the working classes being provided with healthy habitations leads me again to bring under your notice the buildings lately erected in the vacant space, entered between 80 and 81 High-street, Whitechapel, to which, your attention was especially directed in my last report. Communications on this subject have since been addressed, by your directions, to the Metropolitan Board. An investigation has been the result of those communications, and a report has been made by Mr. Markablb, the superintending architect, to the effect, that the provisions of the Building Act relating to open spaces had not, in this instance, been complied with. Upon that report, the surveyor appointed for the supervision of the works, received instructions to institute certain proceedings, and the surveyor to the buildings has subsequently reported, that, by the demolition of part of the houses, the requirements of the act referred to, as regards open spaces, had now been complied with. From the tenor of the communications received from the Metropolitan Board, it may be concluded that they are of opinion, that it is desirable, in a sanitary point of view, to discourage the erection of dwellings for the poor like those in question. A suggestion has been made by your Board to the Metropolitan Board, that they may procure a remedy against the recurrence of the evil complained of, by the introduction, into the proposed new bill, of such clauses as will render their powers of control sufficient for the proper management of all similar cases. To this suggestion, the Metropolitan Board have replied, that the matter has been referred for consideration, in connexion with the amendment of the act. In my report for the preceding quarter, I also directed your attention to the newlyerected houses in Inkhorn Court. These houses, owing to representations made by your Board, have likewise been specially reported upon by the superintending architect of the Metropolitan Board ; but it appears from his report, that as they are constructed in conformity to the act, the Board have no power to interfere ; but he suggests that there are powers to purchase. It may be true, that certain powers to purchase do exist, but when one law permits builders to erect houses in unsuitable places, and another law gives power to local boards to purchase them after they have been built, such laws must certainly require amendment. The acts of parlia-. * 18 per 1000. t Not only has no death from fever been registered as having occurred in this lodging house, but, not a single case of disease has been recorded in the book kept by the superintendent containing an account of all the cases of sickness which have occurred since the opening of the building. 9 ment now in operation, relating to sanitary matters, are very defective, from the want of definitive terms, such as the precise meaning to be attached to "ventilation," "lighting," and "over-crowding." As regards lighting and ventilation, the building act requires, that " every building used, or intended to be used as a dwelling-house, unless all the rooms can be lighted and ventilated from a street or alley adjoining, shall have in the rear, or on the sida thereof, an open space exclusively belonging thereto, of the extent, at least, of 100 square feet." Nothing is said about the sufficiency of such lighting and ventilation ; and therefore any builder can erect houses, in places however unsuitable for health they may be, provided that air and light are admitted into each room, without regard to the size of open space in front of each room. I have no hesitation in stating my opinion, that all narrow courts, with houses on each side, unless ventilated by a free current of air passing through them, arc most dangerous to the public health; and I sincerely hope that the last building act will be so amended, that houses in future shall be built in thoroughfares only. The clause in the Nuisances Removal Act, relating to over-crowding, although, perhaps, somewhat more definite than the clause in the Building Act relating to lighting and ventilation, is nevertheless imperfect; inasmuch as the over-crowding of a room is to be determined by the Medical Officer of Health of the district* but as the minimum space for each inmate is not fixed, a difference of opinion may occur on the part of those who have to determine the requisite amount of space. If the minimum space for each inmate were determined by the act, then the fitness or unfitness for habitation of any particular room, might, in other respects, be properly left to the discretion of the Medical Officer of Health, who would judge whether such room could be safely occupied. The minimum space allowed in the wards of a workhouse for each inmate, is determined by the Poor Law Board: that space is 300 cubic feet in dormitories, and 500 cubic feet in sick wards, or rooms occupied by day and by night, and this space is to possess the requisites of efficient ventilation. The inspectors have completed a large amount of sanitary work during the last quarter. Nearly every house in the Hamlet of Mile End New Town has been inspected, and wherever a sewer existed within 100 feet of any house, which was not drained into such sewer, notice has been served upon the owner or occupier to do so. Since the commencement of the operations of the Board, 5350 houses have been systematically visited, 2054 cesspools abolished, 1870 soil-pans have been provided with water, 1905 houses have been lime-whited, and 1207 dust-bins have been erected. The full particulars relating to the work done by the inspectors, will be seen on reference to the tables in the appendix. The following trades-nuisances have been abated during the last quarter:—the bleaching of cane, the re-burning of animal charcoal, the roasting of malt, &c. A great many of the noxious vapours arising from the several manufactories can be destroyed by causing them to pass through a fire. The simple expedient of having a gas fire in the chimney shaft, and the building so arranged, that all the noxious vapours shall pass through that fire, would go far to obviate the nuisance arising from the escape of sush vapours. The vaults under Spitalfields Church, Whitechapel Church, Trinity Minories Church, and the Lutheran Chapel, in Hooper Square, having, for several years past been closed against further interments, an order in council, to the following effect, was sent to the churchwardens in the respective parishes:— 1. That where aceessible, the vaults be freely lime-whited. 2. That the coffins in the vaults be covered with fresh earth, and powdered charcoal: that the existing entrances and ventilating openings be closed, and that a ventilating tube be carried from each vault, to the roof of the building. 3. That the works be effected under the superintendence of the Medical Officer of Health for the district, and that disinfectants be used whenever necessary. These orders have been complied with in the vaults under Whitechapel Church, and the Lutheran Chapel, and are about to be complied with by the authorities in Trinity Minories, in the vaults underneath that Church; but in consequence of the vaults under Spitalfields 10 Church, being separately walled up, and the ventilation being so ample and well arranged, Mr. Grainger, the government inspector, deemed it sufficient to order that the several gratings opening into Church Street, and the grating opening opposite to the rectory, should be closed; which order has been executed. In conclusion, permit me to mention, in a few words, what in my opinion, are the most prolific sources of disease,—the want of cleanliness of the person and of the clothing,—the want of cleanliness, and of efficient ventilation in inhabited rooms, especially in sleeping-rooms, —the non-removal of all offensive odours, particularly the offensive odour from over-crowding, —the cesspool odour, from want of drainage,—the cesslake or sewer emanations from the defective construction of the sewers,—the deficiency of light, especially of solar light, caused by the closely-packed houses in narrow courts,—the want of an ample supply of pure water,— and the deficiency of food and clothing, It is, therefore, to these points that both public and individual attention must be directed, in order to improve the moral and physical condition of the people, and to diminish the burdens of the rate-payers, in providing for the sick and infirm. The laws of health have been established for the well-being of mankind, and it is our duty to study them, for we shall find, that just in proportion to our non-observance of them, the amount of sickness and death will correspond. 15, Great Alie Street. 14th Feb., 1860. I am, Gentlemen, Tour obedient Servant, JOHN LIDDLE. APPENDIX TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED SINCE THE 28th of January, 1856, to the 31st of December, 1859. From January, 1856, to the 1st October, 1859. For the Quarter ending 31st December, 1859. Total number of Nuisances removed. Works in progress but not completed. Number of Nuisances inspected in houses and yards. Number of Houses systematically visited. House-to- house visitation. Number of Nuisances entered in Complaint Books. 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. 17,262 †413 12,048 4801 7608 33 96 2611 218 1610 520 549 5 6 179 * This total refers to Nuisances of every description, including the non-removal of Dust, &c., complaints of which had been made at the Office. † This number is still very large, although it has been considerably decreased during the past quarter. It chiefly refers to works completed, with the exception of Water Apparatuses to Closets, and Covered Dust Bins in Yards. TABLE II.—SUMMARY OF WORKS EXECUTED UP TO THE 31st DECEMBER, 1859. Limewhiting and Cleansing. Dust Bins erected. Houses repaired. Yards and Cellars re-payed. Water supplied for domestic use. Larger supply of Water given. Cesspools abolished. Cesspools cleansed.—No Sewerage. New House Drainage made. House Drainage improved, Trapped, &c. Cellars cleansed. Filthy Privies cleansed. Water supply to Soil-pans. New Privies constructed. Pans to Privies provided. *Over-crowded Houses remedied. †Houses or Rooms unfitted for human habitation. Ventilation improved. Private Courts Paved. Filth in open places removed. Dangerous structures. Othernuisances removed,Dust,StagnantWater,&c. Dangerous Cellar Flaps and Area Gratings. 1786 1008 727 945 35 36 1899 1617 1278 1179 482 1451 1822 118 1657 42 49 22 26 127 222 15051 470 SUMMARY OF WORKS EXECUTED FROM 1st OCTOBER, TO 31st JANUARY, 1859. Total 119 199 110 59 2 1 155 221 81 187 39 315 48 32 107 4 5 2 1 42 6 1099 45 Gross Total 1905 1207 837 1004 37 37 2054 1838 1359 1366 521 1766 1870 150 1764 46 54 24 27 169 228 16,150 515 It will be seen in Table No. 1, Column No. 1, that the total number of Nuisances removed is 17,262, but that number does not give the details of each separate case. For instance: the case may be an Offensive Privy—requiring, 1st. Cesspool to be emptied and filled up. 2nd. To be Trapped and Panned. 3rd, Pipes to be laid from Siphons to Sewer, &c. If each of these were shown, as a distinct work executed, the number in the Table and Column above alluded to, would be fully doubled. * The number of houses shown as over-crowded have been remedied by the Inspectors alone, the cases not being such as could be referred to the police. + The houses or rooms referred to as unfit for human habitation, have also been remedied by the Inspectors, the Police having no power to act. Three of them were cellars or kitchens, not constructed according to the requirements of the Metropolis Management Act, relating to the occupation of underground rooms as dwellings. TABLE III.—Cases of Sickness of the Zymotic and Acute classes, which are recorded in the Books of the Medical Officers of the Union for the Three Months that ended on the 31st December, 1859. Names of Medical Officers. Small-Pox. Measles. Scarlatina, Hooping Cough Diarrhoea. Typhus or continued Fever. Cholera. Erysipelas. Pyemia. Puerperal Fever. Carbuncle. Bronchitis and Catarrh. Pneumonia and Pleuritis. Croup. Diphtheria Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Other Diseases. Total. Average number of Fever cases per Week. Mr. Blackwell 35 16 16 2 37 15 0 10 0 0 3 117 18 0 o 0 1 2 0 514 787 Mr. Champneys 8 31 8 3 32 21 0 1 0 0 0 8 4 0 0 0 0 3 0 385 504 Mr. Richardson 8 25 6 1 25 5 0 0 0 0 1 19 1 0 0 0 7 0 0 361 459 Mr. Sequeira 7 8 15 2 62 55 0 7 0 0 0 76 26 0 0 3 10 2 1 738 1012 Total 58 80 45 8 156 97 0 18 0 0 4 220 49 0 0 3 18 7 1 1998 2762 7 Total for Quarter ending April 2nd 44 13 28 74 88 93 0 17 0 1 3 201 52 0 0 1 33 4 0 2384 2936 7 „ July 2nd 96 18 28 43 178 114 0 13 0 0 2 119 26 4 0 9 19 9 0 2064 2742 7 „ Oct. 1st 44 78 74 21 787 107 1 25 0 0 2 69 12 0 0 1 7 10 0 2023 3261 8 Total for year 1859 242 179 175 146 1209 411 1 73 0 1 11 609 139 4 0 14 77 30 1 8469 11701 7 „ „ 1858 20 427 146 230 946 590 0 70 0 2 16 1411 210 3 6 16 65 39 1 7507 11718 11 „ „ 1857 6 266 49 150 1324 1441 16 45 0 2 19 1727 166 9 0 9 53 28 0 6231 10708 27 „ „ 1856 115 71 105 98 898 1929 0 0 0 0 0 0 0 0 0 0 0 0 0 6284 9897 37 TABLE IV.—Showing the Deaths from Epidemic Diseases in the Whitechapel District, daring the years 1856, 1857, 1858, and 1859. 1856, 1857. 1858. 1859. Population in 1851. Persons to an Acre. Mean elevation in feet above high water Trinitv-mark. Districts. Small-Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhoea. Typhus. Total. Small-Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhoea. Typhus. Total. Small-Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhoea. Typhus. Total. Small-Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhoea. Typhus. Total. Artillery 0 2 4 3 3 8 20 0 6 4 9 5 3 27 1 4 9 3 5 7 29 1 0 8 7 5 4 25 6769 271 41 Spitalfields 3 1 7 15 10 22 58 0 9 9 19 15 10 52 0 24 22 14 15 18 93 20 8 17 8 29 7 89 15336 289 36 Mile End New Town 8 1 2 14 18 63 106 0 18 4 6 24 36 88 1 5 24 33 34 38 135 17 13 8 9 31 33 111 14543 227 36 Whitechapel N 10 3 9 9 11 57 99 1 11 2 20 25 34 93 0 6 18 19 22 22 87 9 4 15 9 27 9 73 12530 216 36 Whitechapel Church 3 2 6 2 8 20 41 1 2 8 10 14 15 50 1 7 6 7 7 11 39 4 2 13 5 13 16 53 7818 166 32 Goodman's Fields 5 1 5 7 12 9 39 0 8 9 15 29 8 69 0 15 6 25 12 4 62 8 1 26 8 12 12 67 12069 237 28 Aldgate 2 2 12 14 19 9 58 1 6 7 10 27 11 62 1 17 2 16 13 4 53 1 3 4 24 12 53 10694 99 19 Totals 31 12 45 64 81 188 421 3 60 43 89 139 117 451 4 78 87 117 108 104 498 60 31 96 50 141 93 471 79759 The fatal cases of Diphtheria for the year 1859 are 10. TABLE V.—Showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 31st December, 1859. Districts. Small Pox. Measles. Scarlet Fever. Diphtheria. Hooping Cough. Diarrhoea Typhus. Total. Total for corresponding Quarter, 1858. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Artillery 1 0 0 0 1 0 0 0 0 0 0 0 1 0 3 0 1 4 Spitalfields 2 9 3 3 4 4 1 0 0 0 1 1 1 1 12 18 12 12 Mile End New Town 1 4 3 4 1 5 0 1 0 0 2 2 2 9 9 25 16 21 Whitechapel, North 2 0 0 0 3 5 0 0 0 0 0 3 0 0 5 8 13 5 Whitechapel Church 0 0 0 1 1 5 0 1 0 0 1 1 1 1 3 9 5 2 Goodman's Fields 3 1 0 0 4 3 0 0 0 0 1 1 3 1 11 6 13 8 Aldgate 0 0 0 1 3 1 0 0 0 1 1 2 2 0 6 5 5 5 Deaths from Epidemics for the corresponding Quarter, 1858 9 14 6 9 17 23 1 2 0 l 6 10 10 12 49 71 65 57 23 15 40 3 1 16 22 120 122 2 2 44 32 10 32 122 122 15 TABLE VI.—Table showing the Births and Deaths in each District, for the Three Months ending on the 31st December, 1859. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks. M. F M. F. Artillery 26 25 51 12 12 24 27 — Spitalfields 74 71 145 52 47 99 46 — Mile End New Town 87 68 155 75 75 150 5 — Workhouse. Whitechapel, N 51 55 106 34 33 67 39 — Whitechapel Church 27 30 57 70 63 133 — 76 Goodman's Fields 63 45 108 38 3O 68 40 — Aldgate 53 29 82 31 25 57 25 41 Non-residents died in Lon. Hos. 381 323 704 312 285 598 182 76 Excess of births over deaths, deducting the 41 non-residents147. TABLE VII.—Showing the Births and Deaths in each District, for the Tear ending on the 31st December, 1859. BIRTHS. DEATHS. Districts. April, July. October. December. Total. April. July. | October. December. Total. Excess of Births over Deaths Excess of Deaths over Births. Artillery 66 71 43 51 231 34 25 26 24 109 122 Spitalfields 13? 123 134 145 534 97 77 82 99 355 179 Mile EndNew Tow. 182 144 144 155 625 146 115 155 150 566 59 Whitechapel, N. ... 112 116 92 106 426 64 62 79 67 272 154 Whitechl. Church 73 72 64 57 256 147 117 138 133 535 — 269 Goodman's Fields 107 117 93 108 425 64 50 74 68 256 169 Aldgate 87 72 78 82 319 59 42 70 57 228 191 759 715 648 704 2826 611 488 624 598 2321 874 269 Excess of births over deaths deductingl80non residents, 694. 16 TABLE VIII.—Showing the Mortality in the Workhouse and Hospitals in the District, during 1856, 1857, 1858, and 1859. Union Workhouse. London Hospital. Military Hospital. 1856 353 1856 297 1856 0 1857 272 1857 338 1857 2 1858 269 1858 325 1858 5 1859 239 1859 354 1859 3 TABLE IX.—Showing the Mortality per cent. in the Whitechapel District, in the undermentioned years. From 1837 to 1838. From 1839 to 1844. From 1844 to 1850. From 1850 to 1855. From 1856 to 1857. From 1857 to 1858. From 1858 to 1859. 4 5 3 3 2 9 2 8 2 4 2 6 2 5 From 1855, to the present time, the population is estimated at 84,000 TABLE X.—Showing the total Mortality in the Whitechapel District, without deduction for non-residents, in the undermentioned years. Years 1848 1849 1850 2061 1851 1852 1853 1854 1855 1856 1857 53wks. 1858 1859 Mortality 2648 2778 2377 2286 2444 2878 2453 2237 2360 2444 2321 TABLE XI.—Showing the Ages at Death in the Workhouse, for the Quarter ending 31st December, 1859. 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 1858. Males 29 Fem. 34 11 0 2 13 14 19 4 63 67 TABLE XII.—Summary of the various causes of death in the Whitechapel District, for the year ending 31st December, 1859. 1.Zymotic April. July. Oct. Decr. Total, 1858. Remarks. 102 89 224 133 548 572 The deaths from consumption are included in the tubercular class. In the first quarter of the year, they were 65, in the second 68, in the third 76, and in the fourth 64, making a total of 273. During the previous year, the deaths from consumption were 252. 2. Dropsy, &c 26 14 17 26 83 69 3. Tubercular 87 98 127 86 398 403 4. Brain and Nerves 67 73 56 57 253 225 5. Heart & Blood Vessels 26 21 20 28 95 68 6. Organs of Respiration 140 62 44 131 377 484 7. Organs of Digestion 29 24 30 28 111 121 8. Kidney, &c. 18 7 5 7 37 35 9. Childbirth, &c. 5 3 2 5 15 9 10. Joints, Bones, &c 7 6 3 0 16 9 11. Cellular Tissue, &c 1 1 1 2 5 1 * The deaths from intemperance recorded in these columns give but a very imperfect idea of the number of persons who fall victims to this vice. All cases of delirum tremens, many cases of dropsy, and of renal disease, and numerous cases of violent death, are the result of intemperance. 12. Malformations 1 1 0 1 3 6 13. Premature Birth, &c. 19 13 30 16 78 60 14. Atrophy 2 0 2 2 6 4 15. Old Age 31 31 29 28 119 112 16. Violent Death 43 37 29 44 153 169 *17. Intemperance 0 2 0 1 3 — 18. Not Specified 7 6 5 3 21 67 Totals 611 488 624 598 2321 2444 Of the 548 Deaths from Zymotic Diseases, 93 were cases of Fever, and 141 of Diarrhœa; and out of the total Deaths there died in the year— 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. Non-* residents. 1859 513 478 201 319 411 334 65 2321 189 1858 563 591 188 317 402 300 83 2444 216 1857 523 509 153 350 434 328 53 2350 299 * All the deaths in the London Hospital, which are the result of violence, are placed to the account of the mortality of the district; but as no account of the deaths of the parishioners who die in the several charitable institutions in the metropolis is obtained, the defect in the record of the one will compensate for the excess in the other. 18 TABLE XIII.—Showing the name of the Locality, the number of houses in such Locality, the cases of Fever attended by the Medical Officers of the Union, the Deaths from Zymotic Diseases, and from Consumption, for the year ending 31st December, 1859. Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Diseases. Deaths from Consumption. Remarks. Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Diseases. Deaths from Consumption. Remarks. Whitechapel. Mount-terrace 7 ... ... 2 Brick-lane* 132 ... 10 5 Osborn-place 12 1 6 5 Mount-street 34 ... 1 1 Luntley-place 17 ... 1 1 Oxford-street 26 ... ... 2 Dawson's-place 19 ... 1 1 Charlottc-court 56 ... ... 2 Finch-street 56 ... 1 ... Queen's Head-ct 4 ... 1 ... Montague-street 24 ... 1 1 Crown-court ... 1 ... ... Frostic-court 6 ... 1 1 Vine-court 18 ... 2 ... Great Garden-st 10 ... 1 ... Fieldgate-street 44 ... 2 4 OldMontague-st 55 2 1 ... Mountford-street 23 ... 1 1 Black Lion-yard 19 1 1 ... Church-lane 58 ... 2 1 Easington-buildgs. 18 3 3 ... John-street 16 ... 1 ... Osborn-street 33 ... 1 ... Spectacle-alley 11 ... ... 1 Wentworth-st.* 106 4 13 3 Barley-mow-ct 8 1 ... ... Angel-alley 15 1 2 ... Mansell-street 54 1 1 ... George-yard 27 3 4 3 Haydon-square 6 3 1 ... Several houses have been taken down in Goodman'syard and Little Pres cott-street. Garden-court 4 ... 1 Fives-court 4 1 ... 1 Old Castle-street 16 2 2 Swan-street 11 ... ... 1 Newcastle-place 40 1 Goodman's-yard ... 2 2 ... Goulston-court 92 8 5 2 Grigg's-court 10 2 2 1 Goulston-street Enoch's-court 6 1 ... 1 Three Tun-alley Little Prescott-st ... ... ... 2 Marlborough-ct. * 8 12 2 *Inhabited by a very low class Great Prescott-st 80 ... 1 ... Petticoat-lane 39 2 1 St. Mark-street 28 1 ... ... Swan-yard 21 ... 1 Scarborough-st 40 ... 2 1 Little Love-court 5 1 ... Tenter-street, (S.) 21 ... 1 ... Love-court 38 ... Tenter-street, (E.) 4 ... 1 ... Boar's Head-yard 22 7 2 1 Great Alie-street 47 ... 2 ... Castle-alley 30 3 3 The cases of Fever occurred at 94, High-st. Smith's-buildings 5 ... 3 ... These deaths occurred at No 2,Smith's buildings. High-street 141 3 3 Hf. Moon-passage 12 1 ... ... Newcastle-street 44 1 1 1 Duncan-street 12 ... 1 ... Kent & Essex-yd 3 ... 1 Brownsou's-court 6 ... 1 2 Tewksbury Bdgs.* 14 ... 2 1 * Inhabited by Foreign Jews. Leman-street 131 1 2 2 Inkhorn-court 10 ... 1 1 Buckle-street* 12 4 2 5 *These strts. are without sowers. Bull-court 4 ... 1 ... Plough-street* 26 10 4 2 Road-side 238 ... 6 2 Colchester-street* 35 3 ... 3 Baker's-row 29 ... 3 ... Little Alie-street 28 ... 3 1 White's-row 16 ... ... 1 Chamber-street 72 2 10 3 Thomas-street 48 2 4 1 Chamber-court 5 ... 1 ... Queen Ann-street 60 2 10 2 Bond's-buildings 5 2 ... ... Elizabeth place 8 ... 3 ... Leman-row 10 4 2 ... John-street 31 ... 5 1 Rupert-street 23 ... 1 ... North-street 46 ... 1 1 Christopher-court 6 ... 1 ... Nearly all the houses in Lamboth-st. are let in tenements. Bath-street 29 ... 1 ... Lambeth-street 70 6 10 3 Wellington-street. 13 ... 1 ... Gower's-walk 59 2 ... ... Little North-street 16 ... 1 ... Jones's-buildings 30 3 2 ... Wood's-buildings. 14 ... 1 ... Back Cburch-lane 83 4 9 1 Court-street 19 ... 2 ... Friendly-buildings 12 1 ... 1 Cannon-place. 3 ... 1 ... William's-rents 22 1 1 ... Raven-row 19 ... 1 ... Brunswick-place 17 1 ... ... South-street 5 ... 2 ... Everard's-place 20 ... 3 ... Raven-street 41 ... 1 1 Table-street 43 ... 1 1 Hereford-place 8 ... 2 ... Gower's-place 16 5 1 ... Cotton-street 24 ... 2 1 Gower's-row 10 1 ... 1 * Including Spitalfields. 19 TABLE XIII,—(continued.) Name of Place. No, of Houses. Cases of Fever. Deaths from Zymotic Diseases. Deaths from Consumption. Remarks. Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Diseases. Deaths from Consumption. Remarks. Wells-place 36 5 1 ... 0. Artillery Gr. AND Wells-yard Wells-row Norton Folgate Davis's-buildings 11 1 ... ... Artillery-street 19 ... 2 ... Wagoner's-bdgs 41 ... 3 ... Duke-street 33 ... 2 3 Abel's-buildings 4 ... 1 Parliament-court,. 3 1 ... ... Bakers'Arms-alley 8 2 ... ... Steward-street 31 ... 1 ... Swallow's-gardens 30 2 1 ... Fort-street 30 ... 2 1 Johnson's-change. 19 3 4 3 Gun-street 45 1 1 2 Whitellorse-court 9 ... 2 1 Union-street 26 ... 2 1 Christopher-court 13 1 4 1 * Six of these Fever cases occurred at No. 7. Spital-square 12 ... ... 2 Blue Anchor-yard 14 *8 1 1 High-street 40 ... 1 ... Harebrain-court 13 3 2 ... White Lion-street 17 ... ... 1 Crown-court 21 2 2 ... Blossom-street 22 ... 2 ... Holloway-court 10 8 1 1 Worship-street 11 ... 2 ... Kittleby-court 9 2 ... ... Green Dragon-yd. 4 ... 1 ... Bracey's-buildings 11 4 1 2 Moor's-gardens 22 1 3 ... Coopers-court 14 2 ... ... Spitalfields. Slater's-court 10 8 3 ... Crispin-street 49 ... 2 ... Russell-court 10 ... 1 ... Church-passage 3 ... 1 ... Windmill-court 13 3 1 ... Wheeler-street 20 ... 4 2 Rachael-court 9 2 1 ... King-street 17 ... 2 2 Glasshouse-street 61 5 7 ... Phoenix-street 28 ... 2 ... Compasses-court 6 1 1 ... Wood-street 7 ... 1 ... Garden-court 12 2 ... 1 Wood's-yard 5 3 ... ... New Martin-street 22 ... ... 1 Quaker-street 50 4 3 3 Cherubim-court 6 1 1 ... Crown-court 16 1 3 ... Hayes-court 7 2 2 ... Grey Eagle-street 68 7 7 2 Badly drained Sliorter's-rents 11 2 3 ... Black Horse-court ... ... 1 ... Charles-court 10 ... 1 1 Shorters-place ... ... 1 ... Grace's-alley 19 ... 1 1 Lamb-street ... 2 2 ... Wellclose-square,. 22 ... 3 ... Paradise-row ... ... 1 ... Aldgate, Tower St. Katherine's, & Trinity Minories U. E. Smithfield 38 ... 2 ... Hope-street 27 1 2 1 Queen street 33 ... 1 ... Wilke's-street 42 ... 6 2 Corbetts-court 11 ... 6 ... Butler's-buildings. 18 2 1 ... Poole's-place 12 ... 2 1 Crown-court 39 5 1 ... Popes Head-court 17 2 1 2 Darby-street 14 3 ... ... Union-court 3 ... 1 ... Cartwright-street 22 2 2 ... This is a very confined court. Great Pearl-street 31 ... 2 4 Hurn's-buildings 8 2 2 ... New-court 14 ... 2 ... Carter-buildings 2 ... 1 ... Diamond-court 3 ... 1 ... Rose-court 14 ... 1 1 Little Pearl-street 25 1 ... 1 A New Sewer has been made in Brown's-la. and John-str. Sun-court 8 ... 2 1 Vine-court 17 ... 2 ... Queen's-street 23 3 1 2 Browns-Lane 35 1 1 1 Loat's-buildings 2 ... ... 1 John-street 12 3 ... ... Royal Mint-street. 117* 5 11 2 Montague-street 38 3 2 ... Turner-street 14 1 1 ... Specks-buildings 8 ... 1 ... Walton's-court 8 1 ... 1 Wood-street 27 ... 1 ... Providence-place 12 ... 2 1 Several houses have been taken down in Peters-court. Union-street 34 ... 1 1 Cartwright-square 24 1 ... ... West-street 5 ... ... 1 Peter's-court 23 1 1 ... East-street 7 ... 1 ... Wells-yard 8 1 ... 1 Commercial-street ... ... 1 ... Burr-street 40 ... 1 2 A now sewer has been'made in King-st. & in Queen-st. Whites-row 29 ... 2 ... A New Sewer has been mad® in these streets. King-street 29 ... 2 ... Tenter-street 36 ... ... 1 Minories 15 ... ... 1 Butler-street 23 ... 1 1 Haydon-square 6 ... ... 2 Shepherd-street 33 1 ... 3 * Including Whitechapel. 20 TABLE XIII.—(Continued.) Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Diseases. Deaths from Consumption. Remarks. Name of Place. No. of Houses. Cases of Fever. Deaths from Zymotic Diseases. Deaths from Consumption. Remarks. Bell-line 45 ... 2 2 Bell-place 26 4 ... ... Freeman-street 24 ... 3 ... Bell-yard Palmer-street 29 ... ... 1 King-street 16 2 ... ... Tilley-street 24 ... ... 1 King Edward-st 35 8 1 ... Dorset-street 34 2 3 3 Johnson's-street 5 ... 1 ... Little Paternosterrow 12 ... 1 ... Ely-place 12 2 ... ... Spring-gardens 27 7 3 2 Rosetta-place 7 ... 1 ... Halifax-street 18 ... 1 1 Frying-Pan-alley 14 1 ... ... Dunk-street 42 8 7 1 New-court 22 1 ... ... High-street 63 6 5 1 Mill-court 4 ... 1 1 Old Montague-st 31 2 ... 1 Tuson-court 6 ... 1 ... George-street 38 2 2 1 Fisher-alley 12 1 ... ... Mason's-court 8 3 ... ... Cox's-square 18 2 ... 2 Garden-place 14 4 ... ... Bull-court 11 ... 1 ... Chicksand-street 36 5 2 1 Short-street 7 ... ... 1 Heneage-street 5 ... 2 2 Eastmans-court 12 ... 1 ... Pugh's-row 7 2 1 ... Ann's-place 11 ... 1 ... Rama's-place 10 ... 2 ... Adam's-buildings. 2 ... 1 ... Well-street 37 8 6 4 George-street 28 ... 3 ... Boundary-court ... 1 ... ... Thrawl-street 31 1 4 4 Samuel-street 6 2 ... Plower & Dean- st. 51 3 5 6 A New Sewer has been contracted for in these streets. Both-street 5 ... 2 1 Dale's-court 26 1 1 ... Spital-street 41 6 2 3 Wilson-place ... 1 1 2 Lombard-street 7 1 ... 1 Keate-street 36 5 3 4 Silver-street 9 ... 1 ... Fashion-street 55 1 4 3 Dea;-street 12 3 ... 1 Nelson-court 12 ... 1 ... Pelham-street* 60 16 5 ... Union-court 15 ... 1 ... Spicer-street 36 4 4 1 Church-street 36 ... 1 ... Charlotte-place 11 ... 1 1 Mile End N.T, Hunt-street 40 7 2 2 Church-street 88 6 6 ... A New Sewer has been made in Church-st. Hunt-court 13 6 ... ... Unanimous-row 6 1 1 ... Buxtpm-street 42 ... 1 1 Metropolitan Buildings. Charles-street 65 5 ... 1 Albert-street ... ... 3 4 Underwood-street. 48 5 1 ... North-place 24 ... 1 1 Luke-street 48 8 1 ... Ellerms-place 8 2 ... ... Buttress-street 7 1 ... ... Carter's-rents 2 2 ... ... Prince's-street 104 12 5 5 Hobson's-court 5 4 ... ... Prince's-place * Including Spitalfields, TABLE XIV.—LONDON HOSPITAL. Causes of Death at Seven periods of Life, registered in the London Hospital, for the Three Months ending 1st Dec., 1859 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. Causes of Death. 0 and under 1. 1 and under 5. 0 and under 20. 20 and under 40. 40 and under 60 60 and under 80 80 and above Total. T.—Zymotic :— Brought forward ... 2 9 10 13 5 39 Small Pox Stomach and Digestive Organs. Measles Scarlatina (Scar.Fev.) Peritonitis ... ... ... 1 ... ... ... 1 Hooping Cough Ascites ... ... ... ... 1 ... ... 1 Croup Ulc. of Intestines , Thrush Hernia (Rupture) ... ... ... ... 4 ... ... 4 Diarrhoea (bowel complaint ... ... 1 ... 1 ... ... 2 Ileus (Inflammation) and Gangrene of the MuscularCoat of the Intestine ... ... ... ... 1 ... ... I Dysentery Cholera Influenza Intussusception, (a part of the Bowels introduced into the part below.) Stricture of Intestinal Canal ... ... ... 1 ... ... ... 1 Scurvy and Purpura Ague Remittent Fever Infantile Fever Typhus Fever ... ... 2 ... ... ... ... 2 Puerperal Fever (Metria) Disease of Stomach, &c Rheumatic Fever Disease of (Esophagus ... ... ... ... 1 ... ... 1 Erysipelas (Rose) Inflammation of Liver Syphilis ... ... ... 1 ... ... ... 1 Jaundice Cynanche(Tonsill) ... ... 1 ... ... ... ... 1 Disease of Liver Hydrophobia Cirrhosis ... ... ... ... 1 ... ... 1 Diphtheria ... 1 ... ... ... ... ... 1 Disease of Pancreas II.—Dropsy, &c:— VIII.—Kidney, &c. Hæmorrhage Nephritis Anæmia Nephria (Bright's dis- ease) ... ... ... 2 2 ... ... 4 Dropsy Abscess (Gathering) ... ... 1 ... ... ... ... 1 Ischuria Ulcer .. .. .. .. 1 ... .. 1 Disease of Prostate ... ... ... ... ... 1 ... 1 Fistula Diabetes ... ... ... ... 1 ... ... 1 Mortification ... ... ... ... ... 1 ... 1 Stone Cancer ... ... ... 1 3 ... ... 4 Cystits Gout Stricture of Urethra Disease of Rectum Disease of Bladder III.—Tubercular :— IX.—Childbirth. Scrofula Ext.Uterine Fœtation Tabes Mesenterica. Ovarian Dropsy ... ... ... 1 ... ... ... 1 Phthisis(Consumptn) ... ... 1 2 1 ... ... 4 Childbirth (seeMetria) Hydrocephalus (water on the brain) Disease of Uterus, &c. ... ... ... ... 1 ... ... 1 X.—Joints,Bones,Ac. IV.—Brain & Nerves Rheumatism Arthritis Cephalitis Disease of Joints, &c. Apoplexy ... ... ... ... ... 2 ... 2 Spinal Disease Palsy (Paralysis) ... ... ... 1 ... ... ... 1 XI.—Skin, Cellular Tissue,&c. Delirium Tremens Chorea Carbuncle Epilepsy Phlegmon Tetanus ... ... 1 ... ... ... ... 1 Disease of Skin, &c Insanity XII.—Malformation Convulsions Cyanosis Disease of Brain, &c. ... 1 1 ... ... 1 ... 3 Spina Bifida Idiocy Other Malformations V.—Heart & Blood Vessels:— XIII. — Premature Birth & Debility. Phlebitis XIV.—-Atrophy. Pericarditis XV.—Old Age. * ... ... ... ... ... ... 1 2 Aneurism XVI. SuddenDeaths (causes unknown.) Disease of Arteries Disease of Heart, &c. ... ... 1 2 2 1 ... 6 XVII.Violent Death Uræmia Intemperance ... ... ... ... 1 ... ... 1 VI.—Lungs & Organs of Respiration Privation of Food Want of Breast Milk Laryngitis Neglect Bronchitis ... ... ... 3 3 ... ... 6 Cold Pleurisy Poison ... ... 1 ... 1 ... ... 2 Pneumonia Burns and Scalds ... 5 6 ... ... 1 ... 12 Asthma Hanging Disease of Lungs ... ... ... ... 1 ... ... 1 Suffocation VI. — Stomach and Digestive Organs : Drowning Suicide. Cut throat Teething Violence ... ... 2 4 4 5 ... 15 Quinsey XVIII.—Not Specified. Gastritis ... ... ... ... 1 ... ... 1 Enteritis Carried forward ... 2 9 10 13 6 ... 39 Grand Total 7 18 19 31 13 1 89 TABLE XV.—Causes of Death at Seven Periods of Life, registered in the Whitechapel District , for the Three Months ending 31st Dec., 1859. 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, I.—Zymotic :— Brought forward 84 124 47 62 94 52 4 467 Small Pox 5 11 4 2 1 ... ... 23 Stomach and Digestive Organs. Measles 1 14 ... ... ... ... ... 15 Scarlatina (Scar.Fev.) 2 26 12 ... ... ... ... 40 Peritonitis ... ... 1 2 2 ... ... 5 Hooping Cough ... 1 ... ... ... ... ... 1 Ascites ... ... ... ... 3 ... ... 3 Croup ... ... ... ... ... ... ... 1 Ulc. of Intestines Thrush ... ... ... ... ... ... ... 1 Hernia ... ... ... ... 4 ... ... 4 Diarrhoea (bowel complaint) 5 5 2 ... 3 1 ... 16 (Ileus (Inflammation and Gangrene of the Muscular Coat of the Intestine) ... ... ... ... 1 2 ... 3 Dysentery Cholera Influenza Intussusception, (a part of the Bowels introduced into the part below,) Scurvy and Purpura Ague Remittent Fever ... 1 ... ... ... ... ... 1 Infantile Fever Stricture of Intestinal Canal ... ... ... 1 ... ... ... 1 Typhus Fever ... 2 5 4 7 3 1 22 Puerperal Fever (Metria) Disease of Stomach, &c. Rheumatie Fever Disease of œsophagus ... ... ... ... 1 ... ... 1 Erysipelas (Rose) 2 ... ... ... 1 ... ... 3 Inflammation of the Liver ... ... ... ... 2 1 ... 3 Syphilis 5 ... ... 1 ... ... ... 6 Cynache Tonsill ... 1 ... ... ... ... 1 Jaundice 1 ... ... ... ... ... ... 1 Hydrophobia Disease of Liver Diphtheria ... 3 ... ... ... ... ... 3 Cirrhosis ... ... ... ... 1 ... ... 1 II.—Dropsy, &c. Disease of Spleen Hæmorrhage 1 ... ... ... ... ... ... ... VIII. Kidney, &c. Anæmia Nephritis 1 ... ... ... ... ... ... 1 Dropsy ... 2 1 2 ... 4 ... 8 Nephria (Bright's dis- ease ... ... ... 2 2 ... ... 4 Abscess (Gathering) 1 ... 2 1 ... ... ... 4 Ulcer ... 1 ... ... 1 1 ... 3 Ischuria Fistula Disease of Prostate ... ... ... ... ... 1 ... 1 Mortification 1 ... ... ... ... 2 ... 3 Diabetes ... ... ... ... 1 ... ... 1 Cenver ... ... ... 1 4 1 ... 6 Stone Gout ... ... ... ... ... 1 ... 1 Cystitis Stricture of Urethra XII —Tubercular :— Disease of Bladder Scrofula 1 2 1 ... ... ... ... 4 IX. Childbirth : Tabes Mesenterica 10 2 1 ... ... ... ... 13 Paramenia Phthisis(Consumptn) 1 3 4 29 ... 3 ... 64 Ovarian Dropsy ... ... ... 1 ... ... ... 1 Hydrocephal us (water on the Brain) 1 4 ... ... ... ... ... 5 Childbirth (SeeMetria) ... ... ... 3 ... ... ... 3 Disease of Uterus, &c ... ... ... ... 1 ... ... 1 IV.—Brain & Nerves Ext.Uterine Fœtation Cephalitis ... 1 ... ... ... ... ... 1 X. Joints, Bones, &c Apoplexy ... ... ... 4 4 6 ... 11 Rheumatism Palsy (Paralysis) ... ... ... 4 4 3 2 13 Arthritis Delirium Tremens Disease of Joints, &c. Chorea Spinal Disease Epilepsy ... ... 1 ... ... ... ... 1 XI.—Skin, Cellular Tissue, &c Tetanus ... ... 1 ... ... ... ... 1 Insanity Carbuncle Convulsions 20 3 1 ... ... ... ... 24 Phlegmon Disease of Brain, &c ... 1 2 ... 1 2 ... 6 Disease of Skin, &c 1 1 ... ... ... ... ... 2 Idiocy XII. Malformation. Cyanosis V.—Heart & Blood Vessels :— Spina Bifida 1 ... ... ... ... ... ... 1 Other Malformations Phlebitis XIII Premature Pericarditis ... ... 1 ... 1 ... ... 2 Birth & Debility 16 ... ... ... ... ... ... 16 Aneurism XIV. Atrophy ... ... ... ... ... ... ... 2 Disease of Arteries XV. Old Age ... ... ... ... 2 ... 11 28 Disease of Heart, &e. ... 1 3 6 13 2 1 26 XVI. Sudden Uraemia Sun Stroke VI.—Lungs & Organs of Respiration:— XVII. Vioi.entDeath Intemperance ... ... ... ... 1 ... ... 1 Laryngitis ... 1 1 1 1 ... ... 4 Privation of Food Bronchitis 6 13 1 7 20 16 ... 63 Want of Breast Milk Pleurisy Neglect Pneumonia 19 24 3 3 3 3 ... 55 Cold Asthma ... ... ... 1 3 4 ... 8 Poison ... ... 1 ... 1 ... ... 2 Disease of Lungs ... ... ... 1 ... ... 1 Burns and Scalds ... 6 6 ... ... 1 ... 13 VII.—Stomach and Digestive Organs Hanging ... ... ... 1 1 ... ... 2 Suffocation 5 ... 1 ... ... ... ... 6 Teething 3 1 ... ... ... ... ... 4 Drowning ... ... ... 2 ... ... ... 2 Quinsey Suicide Gastritis ... ... ... ... 2 ... ... 2 Violence ... 1 3 4 6 5 ... 19 Enteritis XVIII. Not Specified, ... ... ... 1 1 1 ... 3 Carried Forward 84 124 47 6 2 94 52 4 467 Grand Total 111 132 59 79 124 78 15 598 TABLE XVI.—Tabular Summary of House Improvements up to the 31st of December, 1859. Name of Street or Place. No. of Houses in Place or Street. No. of Houses Inspected. Drains. Cesspools. Water Closets. Dust Bins. Pavement. General Water Supply. General Improvement Remarks. Number constructed. Improvement or Repair. Traps fixed. Abolished. Cleansed and Disinfected. Pans aud Traps furnished. Hew ones constructed. Water supply provided. Constructed. Repaired. Constructed. Jieiaid or Repaired. Receptacles provided. Receptacles repaired. Water supply provided. Generally repaired. Cleansing and Ventilation. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 5395 4713 267 1345 570 1342 206 1521 117 1012 599 146 57 498 76 7 47 46. 129 6 Tabular Summary of House Improvements for the Quarter ending 31st December, 1859. •Church Street, M. E. N. Town. 94 94 13 2 22 14 37 22 10 6 22 0 0 3 4 0 0 12 21 0 Queen Street, „ „ 9 9 0 1 1 0 7 1 1 0 2 1 0 0 0 0 1 † 3 3 0 Unanimous Row, „ „ 11 11 0 1 1 0 0 1 1 0 0 1 0 0 0 0 1 † 3 3 0 † Larger amount supplied. Charles Street, ., „ 26 26 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 † Ditto ditto. New Charles Street, „ 26 26 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 New Court, Wcntworth Street.. 15 15 0 15 0 0 0 0 0 0 15 0 0 15 0 0 0 15 0 0 Butler Street, Spitalfields 23 23 9 0 9 9 0 9 3 3 9 0 0 7 0 0 0 7 0 0 Freeman Street, ,, 24 24 13 0 13 13 0 13 3 4 7 0 0 4 0 0 0 4 3 0 Palmer Street ., 20 20 6 0 6 6 0 6 0 0 3 0 0 7 0 0 0 3 0 0 Tilley Street, „ 24 24 20 0 17 20 0 20 0 0 6 0 0 2 0 0 0 5 2 0 Tenter Street, ,, 35 35 19 11 21 19 0 21 0 5 11 0 0 12 0 0 0 8 2 0 Much of the work in Mile End New Town remains incomplete, the owners being dilatory in carrying out the notices with which they have been served. In some of the localities there is no sewer. Tenter Court, „ 3 3 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Emery's Place, „ 4 4 0 4 4 0 0 4 0 0 4 0 0 4 0 0 0 0 2 0 Hunt Street, M. E. N. Town 40 40 1 0 1 1 0 1 1 1 12 0 0 0 o 0 0 0 9 0 Hunt Place, „ „ 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Hunt Court, ,, „ 8 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Deal Street, „ ,, 12 12 0 0 0 0 0 0 0 0 5 0 0 5 0 0 0 5 0 0 Lombard Street, „ „ 7 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pleasant Row, ,, „ 14 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 § No sewer on the North sido of § Underwood Street „ 48 48 0 8 8 8 0 8 0 8 0 8 0 0 0 0 0 8 0 0 New Underwood Street, 13 13 0 0 0 0 0 0 0 0 0 13 0 13 0 0 0 13 0 0 Royal Mint Street, South 47 47 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 9. o Buttress Gardens and Street 12 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 || No Sewer. Total 520 520 81 65 105 91 44 107 16 27 96 23 0 81 4 0 2 86 40 0 Gross Total 5915 5233 348 1410 675 1433 250 1628 133 1039 695 169 57 579 80 7 49 551 1331 6