84 WHI 9 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT on The Sanitary Condition OF THE WHITECHAPEL DISTRICT, FOR THE THREE MONTHS Ending 30th March, 1861. by JOHN LIDDLE, Medical Officer of Health. HEAD TO THE BOAHD, MAY 6th, 1861. London: PRINTED BY MEAD & POWELL, 101, HIGH STREET, WHITECHAPEL, And 6, 7, & 8, Arcade, London Brudge. 1861 REPORT FOR THE QUARTER TERMINATING 30tli MARCH, 1861. Gentlemen, The Report which I have now the honor to lay before you comprises a return of the births and deaths in the Whitechapel District, the number and classification of the cases of sickness that have come under the care of the Medical Officers of the Union, and a statement of the sanitary improvements effected in the quarter, terminating on Saturday, the 30th March. The number of births registered in the district is 712, viz., 362 males and 350 females. These numbers are in the proportion of 103 of the former to 100 of the latter. The deaths, including those of the non-residents (57), are 700. Of that number, 379 are males, and 321 females, which is in the proportion of 118 to 100. The excess in the number of deaths of males over that of females, may be accounted for by the larger number of the deaths of males in the London Hospital ; the deaths of males in that Institution being 68, and of females only 44. On comparing the mortality in. this quarter with that of the corresponding quarter of the previous year, it will be seen that the deaths are less by 34. The births are also less. The number in this quarter, as stated above, being 712 against 737. The excess of births over deaths is only 12; but if the deaths of the nonresidents are excluded, then the births have exceeded the deaths by 69. The proportion of births to deaths varies very considerably in the several registration districts, as may be seen on referring to Table No. 6, from which it appears that, in the Artillery, Spitalfields, Whitechapel North, Goodman's Fields, and Aldgate districts, the births have exceeded the deaths ; while in the districts of Mile End New Town, and Whitechapel Church, the deaths have exceeded the births. In the former district the Workhouse is situated, and in the latter the London Hospital. Although the total number of deaths is less than in the corresponding quarter of 1860, yet the mortality in some of the districts has considerably increased. Thus, in the subdistrict of Spitalfields, the deaths have increased from 89 to 121; but in Aldgate and in Mile End New Town, they have decreased respectively from 89 to 49, and from 205 to 186. There has not been much variation in the number of deaths in the other registration districts. Of the 700 deaths, there were 329, or 47 per cent. under 5 years of age, and of these, 138 were of infants under the age of twelve months, or in other words, nearly the half of the total deaths occurs before the population has arrived at the age of 4 five years; and one in five dies before it has reached the age of one year. The proportion per cent. in the mortality of children under five years varies in the several sub-districts, thus—in the Spitalfields it is 69.4; in the Whitechapel North, 61.6; in the Artillery, 58.5; in the Aldgate, 571; in the Goodman's Fields, 52.7; in the Mile End New Town, 39.2; and in the Whitechapel Church, it is 22 per cent. In the entire district, 44 persons only, or 6.3 per cent. of the total mortality died from the infirmities of age, of that number, 17 were between the ages of 80 and 96. Having thus briefly considered the general return of the births and deaths, I shall now proceed to lay before you a statement of those diseases which have caused the greatest amount of mortality in the District. Of the several groups of diseases, as arranged by the Registrar-General, it appears that the diseases of the respiratory organs have been the most fatal; for not less than 174 deaths, or nearly 25 per cent. of the total mortality have been occasioned by pneumonia, bronchitis, and other lung diseases, exclusive of consumption. Consumption, which is classed among the tubercular diseases, proved fatal to 61, or 8.7 per cent. of the total deaths. From the four above enumerated diseases, the deaths were 235, or 33.5 per cent. of the total mortality, and in the corresponding quarter of last year, the deaths from the same diseases were 290, or 395 per cent. The diminution in the number of deaths from these diseases, and in their proportion per cent. of the total mortality, may be accounted for, by the fact of the mean temperature of air during the quarter being above the average temperature (39° 7), and nearly one degree above the mean temperature of the corresponding quarter of 1860 (38° 9). The excessive cold weather, however, which prevailed during the first two weeks of the year, when the mean temperature of the air was only 29° 4 or 6° 8 below the average, the lowest point on one day being 16°, was productive of a very high mortality, for in those twa weeks the total mortality was 147, or 40 above the average. As the spring advanced, the temperature of the air increased, which caused a diminution in the number of deaths, so that in each of the last nine weeks, (with one exception, and that owing to the numerous deaths in the Londou Hospital occasioned by violence,) the mortality was below the average. Croup, which is classed among the zymotic diseases, was unusually severe, 21 young children having died from its effects. The total deaths resulting from epidemic diseases was 83, or 11.6 per cent. In the winter quarter of 1860, the deaths from these diseases were 88. A considerable increase in the number of deaths from hooping cough has taken place, 26 against 12. The mortality from fever has been reduced from 31 to 8. The deaths from small-pox are nearly the same in number, viz., 13 against 12. Of these deaths, one was an infant at the tender age of 14 days. The continued quarterly diminution in the mortality from fever, which I have had the satisfaction to report, taken in conjunction with the decrease of the cases of this disease among the poor, as is shown by the returns of the Medical Officers of the Union, is a most happy result attendant on the steady application of those hygienic measures which have been adopted by your sanitary Officers, under the sanction of your Board; and, although the sanitary state of the district is still far from being in a satisfactory state, it has nevertheless been much improved within the last four years. Unfortunately, such is the close, confined, and ill ventilated 5 condition of some of the property in this district, that the powers which can be exercised by the Board are inadequate to effectually improve it; all therefore that can be done in such cases, to mitigate the evils consequent upon the want of ventilation in these badly constructed places, is, for the inspector to visit them frequently, in order to see that the utmost possible cleanliness is observed. Diseases of the heart and bloodvessels were fatal to 26. Hydrocephalus, or water on the brain, scrofula, and mesenteric disease, all of which are generally considered as the result of constitutional debility, were fatal to 34, or 4.8 per cent. of the total mortality. This is a large number; but when the poverty of a very great proportion of the population, and the confined localities in which so many of the poor reside are considered, this large mortality from constitutional diseases need not excite much surprise. Not only is it to be deplored that the houses in most of the poor neighbourhoods are already too closely packed together, but the evil is increasing; for wherever there is a vacant spot of ground, more houses are built, thereby still further diminishing the healthiness of those already existing. It is a well ascertained fact that a thorough ventilation, and a free admission of solar light, into dwelling houses, are as necessary for the healthy nutrition of the human being, as they are essential to the growth of the plant. It is found that the inhabitants of dark rooms soon become pale and sickly, and in extreme cases the children are scrofulous, and in some instances, even deformed. Convulsions in children, which, although classed with diseases of the nervous system, are frequently produced by the same causes as hydrocephalus, proved fatal to 29. The mortality from childbirth was high, 6 mothers having died during the quarter. Cases of violent death have been much more numerous in this quarter than they were in the corresponding one of last year, (57 against 45). Burns and scalds proved fatal to 21 ; of these deaths, three were of children in one family, residing in Back Church Lane, who were burnt in a house which took fire. Violence of various other kinds was fatal to 24. Two males committed suicide by taking poison. Five children were suffocated in bed. Two persons were drowned. Three died from the effects of exposure during the inclement weather; one, a mariner, from disease of the heart, accelerated by exposure to cold while intoxicated; one from tetanus or locked jaw, supervening on frost-bite; and one from mortification of the feet from frost-bite. A child aged 15 months, residing in Barley Mow Court, died from exhaustion from a sloughing wound of the chest., caused by too long ar. application of a mustard poultice. A child aged 4 months, died from spinal irritation, resulting in tetanus. A waiter, aged 48, died from drinking a large quantity of whiskey. Two children were murdered. A domestic servant, aged 42, died in consequence of her own neglect, in not calling to her assistance a Surgeon, while giving birth to an illegitimate child. A seaman, aged 28, died in the London Hospital from the effects of scurvy. As this disease has now altogether disappeared from the British Navy, owing to the adoption of improved dietetic and other hygienic rules, it is equally in the power of those in authority in the mercantile marine, by adopting similar means to those employed in the navy, to prevent the occurrence of scurvy on board a merchant vessel; and in order to protect the crew from the direful effects of this disease, it would be desirable whenever scurvy has occurred on 6 board of ship, to institute an inquiry with a view of ascertaining the quality and kind of food which has been supplied to the crew. There is too much reason to believe, that in many instances, not only is the lime juice which is supplied to ships of inferior quality, but the provisions generally are not sufficiently nutritious. The deaths uncertified by a Medical Practitioner are 19; of these, 9 were in the Spitalfields sub-district. Out of the total number of uncertified deaths there was one of small-pox, one of croup, one of diseased heart, one of apoplexy, one of bronchitis, one of phthisis, and one of diphtheria. How this last named disease, and indeed several of the others above enumerated, could have been ascertained by nonprofessional persons, I am at a loss to conjecture ; and it is to me a matter of surprise that such diseases should be recorded by the Local Registrars as the cause of death, upon the information conveyed by unqualified persons. One case of premature birth, and 12 cases of convulsions complete the number of the uncertified deaths. The deaths in the Workhouse were 107 against 115 in the winter quarter of 1860. Of the deaths in the Workhouse, 31 were between the ages of 60 and 80, and 6 between the ages of 80 and 96. On examining the returns of sickness among the out-door poor as recorded by the Medical Officers of the Union, and comparing them with the returns for the corresponding quarter of the preceding year, it will be seen, that, although there is a difference of only twenty-two in favour of the present quarter, (3,334 against 3,356), yet, the number of fever cases have diminished from 78 to 17. As regards the cases of sickness in the workhouse, the number was 550, which is one more than the number in the corresponding quarter of 1860. The cases of sickness are very equally divided between the two medical officers, for out of the 550 cases, Mr. Champnets attended 273, and Mr. Richardson 277, the former number being males, and the latter females. There have been comparatively very few cases of epidemic disease in the workhouse. The total number was 39, viz. 2 of small-pox, 2 of measles, 1 of scarlet fever, 3 of hooping-cough, 22 of diarrhcea, and 9 of fever. In the winter quarter of 1860, the total number of epidemic diseases was 70, including 16 of fever. From the returns of the Inspectors, I may now report that all the houses in the district, with the exception of about 100 on the north side, now in the course of visitation, have been inspected, and the particulars respecting their general sanitary condition have been ascertained. It will, therefore, no longer be necessary for the inspectors to systematically visit the houses in the best localities, but they will confine their attention to those places where nuisances are continually occurring. The sanitary improvements which have been effected during the quarter will be seen on referring to the tables in the appendix. I have the honor to be, Gentlemen, Your obedient Servant, 15, Gkeat Awe Street. JOHN LIDDLE. APPENDIX TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED since the 1st of JANUARY, 1861, to the 30th MARCH, 1861. From February, 1856, to the 1st of January, 1861. For the Quarter ending 31st March, 1861. 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. 2,656 †310 22,123 8,685 10,539 47 120 3,520 312 2,089 ‡2,316 369 1 7 271 *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 to Yards. ‡The number of houses systematically visited during this Quarter appears large in comparison with others, but it is accounted for by the Inspectors not making a return of the houses visited until the sanitary improvements, which, at the time of visitation, were ordered to be carried into effect, were completed. TABLE II.-SUMMARY OF WORKS EXECUTED UP TO THE 31st DECEMBER, 1860. 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. Other nuisances removed, Dust, Stagnant Water, &c. Dangerous Cellar Flaps and Area Gratings. 2836 2029 1206 1307 45 52 3002 2581 2172 2511 747 3738 2142 203 2466 62 70 27 39 808 247 23,197 803 SUMMARY OF WORKS EXECUTED FROM DECEMBER 31st, I860, TO MARCH 30th, 1861 461 97 124 81 0 0 211 365 211 194 83 522 39 7 211 8 9 0 6 187 3 2,007 61 3297 2126 1330 1388 45 52 3213 2946 2383 2705 830 4260 2181 210 2677 70 79 27 45 995 250 25,204 864 It will be seen in Table No. 1, Column No. 1, that the total number of Nuisances removed is *29,801, 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 Siphon to Sewer, &c. If each of these were shown, as a distinct work executed, the number of the Table and Column above alluded to would be fully doubled. TABLE III.—Cases of Sickness of the Zymotic and Acute Classes, recorded in the Books of the Medical Officers of the Union, for the Three Months ending on the 30th March, 1861. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Continued Fever. (Typhus & Typhoid.) Erysipelas. Carbuncle. Puerperal Fever. Acute Pulmonary Inflammations. Croup. Rheumatic Fever. Delirium Tremens. Dysentery. 1 All other Diseases. Total. Average number of Fever cases per Week. Bronchitis and Catarrh. Pleuritis and Pneumonia. Mr. Blackwell 19 13 12 27 44 1 12 1 0 155 10 0 i 0 5 601 901 Mr. Champneys 3 6 6 24 21 5 2 0 0 17 0 0 0 0 2 445 531 Mr. Richardson 10 9 9 13 20 1 1 0 0 26 1 0 0 0 5 580 675 Mr. Sequeira 7 4 2 36 52 10 1 0 0 79 24 3 2 1 5 1001 1227 Total 39 32 29 100 137 17 16 1 0 277 35 3 3 1 17 2627 3334 1-3 TABLE IV.—Showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 30th March, 1861. Districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhœa. Fever. Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M F. Artillery 0 0 0 0 1 0 0 0 3 2 0 0 0 0 4 2 Spitalfields 2 5 1 3 2 0 0 0 0 5 1 0 0 0 6 13 Mile End New Town 1 2 8 3 2 1 0 0 1 2 1 2 3 3 16 13 Whitechapel North 0 0 0 0 0 0 0 0 3 1 0 I 0 1 3 3 Whiteehapel Church 0 3 0 0 3 2 0 0 3 0 0 1 0 0 6 6 Goodman's Fields 0 0 1 0 0 1 0 0 1 2 0 0 0 0 2 3 Aldgate 0 0 0 0 0 0 1 0 2 1 1 0 1 0 5 1 3 10 10 6 8 4 1 0 13 13 3 4 4 4 42 41 13 16 12 1 26 7 8 83 Deaths from Epidemics for the corresponding Quarter, 1860 12 12 9 1 12 11 31 88 TABLE V.—Showing the 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 80 80 and upwards. Total. Corresponding Quarter of 1860. Males 62 Females 45 12 15 0 20 23 31 6 107 115 TABLE VI.—Ages at Death in each Registration District, for the Three Months ending 30th March, 1861. Districts. 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. Remarks. Artillery 12 12 3 1 6 7 0 41 Spitalfields 40 44 5 8 6 13 5 121 Mile End N. Town 30 43 2 25 36 40 10 186 Workhouse. Whitechapel, N. 25 20 4 6 8 8 2 73 Whitechapel Church 4 31 17 36 38 26 4 156 Hospital. Goodman's Fields 15 25 3 9 19 11 1 74 Aldgate 12 16 2 6 9 2 2 49 Totals 138 191 36 91 113 107 24 700 TABLE VII.—The Births and Deaths in each Registration District, for' the Three Months ending on the 30th March, 1861. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks. M. F. M. F. Artillery 37 33 70 22 19 41 29 — Spitalfields 74 69 143 53 68 121 22 — Mile End New Town 79 68 147 98 88 186 — 39 Workhouse. Whitechapel, N 60 58 118 41 32 73 45 — Whitechapel Church 30 35 65 87 69 156 — 91 London Hospital. Goodman's Fields 53. 58 111 44 30 74 37 — Aldgate 29 29 58 34 15 49 9 — 5 7 Non-residents died in Lon. Hos. Totals 362 350 712 379 321 700 142 130 Excess of births over deaths, deducting the 57 non-residents 69 WHITECHAPEL. TABLE VIII.—Causes of Death at Seven periods of Life, registered in the Whitechapel District, for the Three Months ending 30th MARCH, 1861. Causes of Death. 0 and under 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 5 and under '20 20 and under 40 40 and under 60 60 and under 80 80 and above. Total. 1. -Zymotic. Brought forward 100 170 20 60 81 59 5 495 I.—Miasmatic. IV.—Digestive Organs. Small-pox 2 9 1 1 .. .. .. 13 Bleasles 3 13 .. .. .. .. .. 16 Cancerum Oris Scarlatina .. 9 3 .. .. .. .. 12 Gastritis .. .. .. 1 .. .. .. 1 Diphtheria 1 .. .. .. .. .. .. 1 Enteritis .. 1 .. .. .. 1 .. 2 Quinsy Peritonitis .. 1 1 1 3 .. .. 6 Croup 6 14 1 .. .. .. .. 21 Ascites .. .. .. 3 3 .. .. 6 Hooping-Cough 5 20 1 .. .. .. .. 26 Ulc. of Intestines .. .. .. 1 2 .. .. 3 Typhus Fever .. 2 1 1 .. 4 .. 8 Heus (Rupture) .. .. .. .. .. 2 .. 2 Erysipelas 2 2 .. 2 1 .. 1 8 Ileus .. .. .. .. 1 .. .. 1 Puerperal Fever Intussusception 1 .. .. .. .. .. .. 1 Carbuncle Fistula Influnza Stomach Disease, &c. .. .. .. .. .. 1 .. 1 Dysentery 1 .. .. .. 1 .. .. 2 Pancreas Disease, &c. .. Diarrhœa 4 3 .. .. .. .. .. 7 Hepatits .. .. .. .. 1 .. .. 1 Ague .. .. .. .. .. .. 1 Liver Disease, &c. 1 .. 1 1 6 5 .. 14 Remittent Fever Spleen Discase, &c. Rheumatism V.- Urinary Organs. Pyaemia .. .. 1 .. 1 .. .. 2 II.—Enthetic. Nephritis Syphilis 2 .. .. .. .. .. .. 2 Disease of Bladder .. .. .. 1 1 .. .. 2 Stricture of Urethra .. .. .. .. .. 1 .. 1 Nephria (Bright's Disease) .. 1 .. 3 2 1 .. 7 Hydrophobia III.—Dietic. Diabetes .. .. 1 1 .. .. .. 2 Privation .. .. .. .. 1 .. .. 1 Stone Want of Breast Milk 3 .. .. .. .. .. .. 3 Prostate Disease Purpura and Scurvy .. .. .. 1 .. .. .. 1 Kidney Disease, &c. Alcoholism - Delirium Tremens .. .. .. .. 1 .. .. 1 VI.- Organs of Generation. ,, Intemperance .. .. .. .. 1 1 .. 2 Ovarian Dropsy .. .. .. 1 2 .. .. 3 Lead Poisoning Uterus Disease, &c. .. .. .. 1 1 3 .. 5 IV.—Parasitic. VII. Organs of Locomotion. Thrush Worms, &c Locomotion. .. .. .. 1 .. .. .. 1 2,—Constitutional. I.—Diathetic. Joint Disease, &c. .. 2 .. .. .. .. .. 2 VIII. — Integumentary System. Gout Phlegmon Dropsy .. .. .. .. 1 1 .. 2 Skin Disease, &c Cancer .. .. .. .. 1 2 .. 3 4.—Developmental I.—Diseases of Children. Mortification .. 2 .. .. 1 .. .. 3 Abscess .. 1 .. 4 .. 1 .. 6 Anaemia Premature Birth 12 .. .. .. .. .. .. 12 II.—Tubercular. Cyanosis Scrofula .. 1 1 .. 1 .. .. 3 Spina Bifida Tabes Mesenterica 11 12 .. .. .. .. .. 23 Other Malformations 1 .. .. .. .. .. .. 1 Phthisis (Consumptn) .. 4 3 32 19 3 .. 61 Teething 2 7 .. .. .. .. .. 9 Hydrocephalus 2 5 1 .. .. .. .. 8 II.—Diseases of Adults. 3—Local. I.—Nervous System. Paramenia Childbirth .. .. .. 5 1 .. .. 6 Cephslitis .. 2 .. .. .. .. .. 2 III.—Diseasesof Old People. Apoplexy .. .. .. .. 9 12 Palsy (Paralysis) .. .. .. 2 1 2 .. 5 Old Age .. .. .. .. .. 27 17 44 Insanity IV.—Diseases of Nutrition. Tetanus 1 .. 1 .. .. .. .. 2 Epilepsy Atrophy and Debility 14 .. .. .. 2 .. .. 16 Convulsions 22 8 .. .. .. .. .. 30 5.—Violent Deaths. I.—Accidents or Negligence. Chorea .. .. 1 .. .. .. .. 1 Brain Disease, &c. .. 3 .. .. 2 .. .. 5 II.—Organs of Circulation. Burns and Scalds .. 8 6 3 .. 3 1 21 Poison Pericarditis .. .. .. .. .. 1 .. 1 Suffocation 4 1 .. 1 .. .. .. 6 Aneurism .. .. .. .. 1 2 .. 3 Violence I .. 6 6 5 5 1 24 Heart Disease, &c .. 1 2 5 10 3 1 22 Drowning .. .. .. 1 1 .. .. 2 Phlebitis III.—Homicide. Murder and Disease of Arteries 111.—Respiratory Organs. slaughter 2 .. .. .. .. .. .. 2 VI.—Suicide. Laryngismus 1 .. .. .. .. .. .. 1 Wounds Laryngitis .. 1 .. 1 1 .. .. 3 Poison .. .. 1 .. 1 .. .. 2 Bronchitis 12 24 .. 8 20 17 1 82 Hanging Pleurisy .. .. 1 .. 1 1 .. 3 Drowning Pneumonia 22 34 1 2 5 1 .. 65 Otherwise Lung Disease, &c. .. .. .. 1 9 10 i 21 Not Specified Carried forward.. 100 170 20 60 81 59 5 495 Grand Total 138 191 36 91 113 107 24 700 LONDON HOSPITAL. TABLE IX.—Causes of Death at Seven periods of Life, registered in the London Hospital for the Three Months ending 30th March, 1861. Causes of Death. 0 and under 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 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above, Total. 1.—Zymotic. Brought forward.. 3 5 15 17 7 47 I.—Miasmatic. IV. — Digestive Organs. Small-pox Measles Cancrum Oris Scarlatina .. .. 1 .. .. .. .. 1 Gastrits Diphtherina Enteritis Quinsy Peritonitis .. 1 .. 1 .2 .. .. 4 Croup .. 1 .. .. .. .. .. 1 Ascites Hooping-Cough Ulcer. of Intestines .. .. .. .. 1 .. .. 1 Typhus Fever Hernia (Rupture) .. .. .. .. .. 2 .. 2 Erysipelas .. .. .. 2 1 .. ., a Ileus Puerperal Fever Intussusception Cabuncle Fistula Influenza Stomach Disease, &c. Dysentery Pancreas Disease, &c. Diarrhœa Hepatitis Ague Liver Disease, &c. .. .. 1 1 4 1 .. 7 Remittent Fever Spleen Diseease, &c. Rheumatism V.—Urinary Or- cans Pyeemia .. .. .. .. 1 .. .. 1 II.—Enthetic. Nephritis Syphilis Disease of Bladder .. .. .. .. 2 .. .. 2 Stricture of Urethra .. .. .. .. .. 1 .. 1 Nephria (Bright's Disease) .. .. .. 1 2 1 .. 4 Hydrophobia III.—Dietic. Diabetes .. .. 1 .. .. .. .. 1 Privation .. .. .. .. 1 .. .. 1 Stone Want of Breast Milk prostate Disease Purpura and Scurvy .. .. .. 1 .. .. .. 1 Kidney Disease, &c. Alcoholism- Delirium Tremens .. .. .. .. 1 .. .. l VI.—Organs of Generation. ,, Intemperance .. .. .. .. 1 .. .. 1 Ovarian Dropsy .. .. .. 1 1 .. .. 2 Lead Poisoning Uterus Disease, &c. VII.—Organs of IV.— Parasitic. Thrush Worms, &c. Joint Disease, &c. .. .. .. 1 .. .. .. 1 2.—Constitutional. I.—Diathetic. Bones, &c. VIII. — Gout mentary System Dropsy Phlegmon Cancer .. .. .. .. 1 2 .. 3 Skin Disease, &c Mortification 4.—Developmental I—Diseases of Abscess .. 1 .. 3 .. 1 .. 5 Anæmia II—Tubercular. Premature Birth Scrofula Cyansis Tabes Mesenterica Spina Bifida Phthisis(Consumptn) .. .. 1 3 2 .. .. 6 Other malformations Hydrocephalus .. .. 1 .. .. .. l Teething 3.—Local. I.—Nervous System. II.—Diseases of Adults. Paramenia Cephalitis Childbirth Apoplexy .. .. .. .. .. 1 .. 1 III. — Diseases of Old People. Palsy (Paralysis) .. .. .. 2 .. 1 .. 3 Insanity Old Age .. .. .. .. .. 1 .. 1 Tetanus .. .. 1 .. .. .. .. 1 IV. —Diseases of Nutrition. Epilepsy Convulsions Atrophy and Debility Chorea .. .. 1 .. .. .. .. 1 5,—Violent Deaths I.—Accidents or Negligence. Brain Disease, &c. .. .. .. .. 1 .. .. 1 II.—Organs of Circulation. Burns and Scalds Pericarditis Poison .. 7 3 3 .. 3 I 17 Aneurism .. .. .. 2 3 .. .. 5 Suffocation Heart Disease, &c. Violence Phlebitis III. Homicide Murder and Man- Slaughter .. .. 5 6 2 6 1 20 Disease of Arteries III.—Respiratory Organs. III. Homic1de. Murder and Man- Slaughter IV. Sucide Laryngismus Wounds Laryngitis Poison Bronchitis .. 1 .. 1 4 .. .. 6 Drowning .. .. 1 .. 1 .. .. 2 Pleurisy Hanging Pneumonia .. .. .. 1 1 .. .. 2 Other wise Lung Disease, &c. , .. .. .. .. 1 .. 1 Not Specified Carried forward,. 3 5 15 17 7 47 Grand Total.. 11 16 29 32 22 2 112 Table X.—Tabular Summary of House Improvements up to the 31st of December, 1860. Name of Street or Place. No. of Houses in Place or Street. No. of Houses Inspected. Dkains. Cesspools. Water Closets. Dust Bins. Pavement. General Water Supply. Genernl 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. Grenerally 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 9081 7615 410 1824 744 1823 289 1942 142 1124 852 189 62 746 100 16 55 672 1981 Tabular Summary of House Improvements for the Quarter ending 30th March, 1861- Hunt Street, Mile End New Town 40 40 6 .. 6 6 .. 6 .. 6 6 .. .. 6 .. .. .. 6 .. .. With the exception of about one hundred houses, all in the district have now been systematically visited. Many of the Streets, &c., have been twice or more frequently visited, where illness or other causes rendered it desirable. Underwood Street, ditto 48 48 28 .. 28 28 .. 28 18 .. .. .. .. 18 .. .. .. .. 11 .. Fashion Street, Spitalfields 55 55 10 18 10 .. 18 .. .. 5 2 .. 8 .. .. .. .. 31 .. Spring Gardens 39 39 39 .. 39 39 .. 39 22 .. 3 .. .. 9 .. .. .. .. .. .. All the Streets, &c., in the Tenter Ground, Spitalfields, containing 179 houses 179 179 149 30 179 149 •• 179 7 •• 41 59 •• 63 .. .. .. 64 110 .. Thomas Street 48 48 11 4 11 11 .. 15 .. .. 7 .. .. 9 .. .. .. 11 17 .... Three Tun Alley 43 43 .. 32 32 .. .. 10 2 .. 3 .. .. .. .. .. .. .. 11 ..* • Brown's Lane 39 39 35 35 35 • • 35 1 35 1 .. .. 2 .. .. .. .. 2 .. George Yard 27 27 18 .. 18 18 .. 18 2 .. .. .. 1 .. .. .. .. 6 18 .. The names of all the Streets have not been enumerated in the different Quarterly Returns, but they will be found in detail, entered in the Medical Officer's District Books. Castle Alley 30 30 .. 30 .. .. 30 .. .. .. .. .. .. .. .. .. .. 30 .. Pelham Street, (throughout) 81 81 22 7 22 22 .. 22 22 .. 9 .. .. 9 .. .. .. 9 47 .. Crown Court, Quaker Street 16 16 .. 2 .. .. .. .. .. 1 .. 1 .. .. .. .. .. 16 .. Brick Lane, Spitalfields (continued) 132 39 .. 5 .. 5 .. 5 1 5 1 .. .. 11 .. .. .. .. 11 .. Union Court, Fashion Street 19 19 .. 19 .. 19 .. 19 2 .. 4 .. .. 8 .. .. .. .. 19 .. Inkhorn Court 11 11 2 .. 11 7 .. 11 2 2 1 .. .. .. .. .. .. .. 7 .. Osborne Court 4 4 .. .. 2 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. St. Mary Street 9 9 1 .. 1 1 .. 1 .. 1 .. .. .. .. .. .. .. .. 2 .. Upper East Smithfield 38 38 4 2 4 4 .. 4 .. 4 .. .. .. .. .. .. .. .. •• .. Church Lane, Whitechapel 64 64 10 .. 10 10 .. 10 .. 10 .. .. .. 12 .. .. .. .. .. .. Garden Count 12 12 .. .. .. .. .. .. .. .. .. .. .. .. .. 12 .. Barley Mow Count 12 12 12 .. 12 12 .. 12 .. 1 .. .. .. .. .. .. .. 12 .. Minories 15 15 1 .. 1 1 .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. Haydon Square 6 6 2 .. 2 2 .. 2 .. 2 .. .. .. .. .. .. .. .. 4 .. Haydon Street 8 8 .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. Mundy's Place 11 11 .. 11 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Wagener's Buildings 41 41 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. Turner's Street, Aldgate 7 7 .. .. •• .. .. .. .. .. .. .. .. .. .. .. .. .. 7 .." Total 936 843 350 144 431 379 .. 465 80 66 84 61 2 155 .. .. .. 126 384 .. Gross Total 10017 8458 760 1968 1175 2202 289 2407 222 1190 936 250 64 901 100 16 55 798 2365 6 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT on The Sanitary Condition of THE WHITECHAPEL DISTRICT, for The THREE MONTHS ENDING 29TH JUNE, 18G1. By JOHN LiDDLE, Medical Officer of Health. Read to the Board, July 22nd, 1861. LONDON: PRINTED BY T. PENNY, 121, LEMAN STREET, WHITECHAPEL, AND 9, LONDON TERRACE, HACKNKT ROAD. 1861. ANNUL REPORT, Ending 29th June, 1861. Gentlemen, Since the publication of my last quarterly Report, the census of the United Kingdom has boon taken, and the Registrar-General has published tables of the population and houses, enumerated in England and Wales, and in the Islands of the British Seas, on the 8th April, 1861. From this return, it appears that the population of the Whitechapel District is 78,964, or 795 less than in 1851, when the population was 79,759. The diminution in the number of residents in this district, which is now recorded to have taken place, has, I apprehend, occurred principally, if not entirely, within the last three years, as it is only within that period, that so many of the bouses occupied by the poor have been taken down for the purpose of providing suitable sites for the erection of extensive warehouses. In my Report lor the year 1857, 1 estimated the population at 84,000, and I arrived at that result upon the sapposition, that the same annual increase of 1,1 per cent. which had occurred in the interval between 1841 and 1850, had continued to that time, and also upon the calculation of the cxcess of births over deaths which gave nearly the same result. The excess of registered births over registered deaths in the the ten years 1851-60, xat 3,626, but if the deaths in the London Hospital of the non-residents be deducted from the registered deaths, the excess of births over deaths will be about 5.200. To this number there must also be added the births that are not registered, which, in this district, from causes alluded to in some of my former Reports, are probably very numerous. The registration of births in England is not, as in Scotland, compulsory, and a birth cannot be registered after the child has become six months old. 4 In order to show in which of the sub-districts the population has increased and decreased, I have been able, from information kindly afforded to me by the Registrar-General, to construct the subjoined Table:- DISTRICTS. Population enumerated. Increase + Decrease No. of distinct Families. Houses. No. of Persons in Public Buildings. 1861. Total. 1851. Inhabited Uninha bited Building Buildings. M. F. Total. M. F. Artillery 3080 3477 6557 6769 —212 1503 732 17 0 Workhouse 253 385 638 Spitalfields 7889 7811 15700 15336 + 364 3163 1535 35 6 London 217 188 405 Mile-end N. Twn. 7703 7689 15392 14543 + 849 3485 1641 42 0 Hospital Whitechapel N 6097 6012 12109 12530 —421 2510 1547 40 19 Sailors' 202 0 202 Whitchpl. Church 4000 4060 8060 7818 + 242 1921 1000 38 0 Borne Goodman's Fields 5485 5681 11166 12069 —903 2546 1263 72 0 Tower 616 167 783 Aldgate 5551 4429 9980 10694 —714 1963 949 36 1 Docks, &c. 415 0 415 Total 39805 39159 78964 79759 —795 17091 8667 280 26 1703 740 2443 From this Table it appears that an increase in the population has taken place in the Spitalfields, Mile End New Town, and Whitechapel Church sub districts, amounting in the aggregate to 1.455, while, the Artillery, Whitechapel North, Goodman's Fields, and Aldgate sub-districts have fallen off to the extent of 2.250. Several causes have contributed to this result, for instance—the taking down of numerous inhabited houses and erecting warehouses on their sites—the building of the Victoria Docks at the extreme east of the metropolis, which has induced a great many of the labouring class, who lived in the southern part of this district, to leave their habitations, and to locate themselves in the more immediate vicinity of the newly-, constructed works, in the expectation of employment—the operation of the Common Lodging House Act, which has limited the number of persons to the cubic dimensions of each room, and to the emigration of families to other parts of the world. The effect of the house to house visitation which has been for some time practised ia this district, may, to a certain extent, have prevented that further overcrowding of the remaining houses, which might have been expected, as the result of displacing so many of the working classes as the recent improvements have occasioned. In all the neighbouring districts, with the exception of each of the three divisions of the City of London, the population has increased since the taking of the census in 1851. In the East London, West London, and London City, the number of houses is less by 1,228, and the population in these districts has decreased to the extent of 15,804. In order to estimate, with some degree of accuracy, the relative proportionate mortality of each district, every circumstance relating to a difference in the condition of the population must be considered, such as the number of children in proportion to the adults, the ages of the adults, the occupation of the people, &c., which information, so soon as I am myself acquainted with it, I shall lay before you, with my deductions therefrom. In the mean time, I am able to state the number of the population, the number of distinct families, and the number of inhabited houses in each sub-district; from which data we can calculate the number of persons residing on an average in each house, and the average number in each family. Thus, it appears that in the Artillery sub-district, there are 1,503 distinct families, and 732 inhabited houses, whiph, on an average, is 4.3 in each family, and 8.9 in each bouse. In the Spitalfields sub- 5 district, there are 3,163 distinct families, and 1.535 inhabited houses, which, on an average, is 4.9 in a family, and 10.2 in a house. In the Mile End New Town sub-district, excluding the inmates of the workhouse, (638) the average number to each family is 4.2. and to each house 8.9. In this sub-district are situated the metropolitan chambers, which will contain 234 single men. The average number in each family and in each house in the Whitechapel North sub-district, is 4.8 to a family, and 7.8 to a house. In the Whitechapel Church sub-district, deducting the inmates of the London Hospital (405), the average number in each family is 3.9, and in cacll house 7.6. In the Goodman's Fields, the average number in each family is 4.3, and in each house 8.8 ; and in the Aldgate sub-district, deducting the number in the Sailor's Home, (202), the garrison in the Tower (say 600), and those living on board of the ships in the docks, and in that portion of the river which is included in the district (415), the average number in each family is 4.4, and in each house 9.2 The average number of persons in each family iu the entire district, deducting the inmates of the public institutions is 4.6, and in each house the average number of persons is 8.8. If, for the purpose of comparing the average number of persons in each house at the census in 1861, with that in 1851, we include, in both instances, the residents in the public buildings, it will be found that the average number of inmates in each house is at the present time 9.1 against 9.0 at the previous census. In 1851 the inhabited houses were 8,812, whereas they are now only 8,667, being 145 less, which is a diminution at the rate of 1.6 per cent., while the population has decreased 795, or rather less than one per cent. during the same period. The density of the population in the entire district, is, on an average, 196 persons to an acre, but as the area of the sub-districts is not equally proportioned to the number of persons residing in them, some of the sub-districts must necessarily be more crowded than others. The difference in each sub-district will be seen on referring to the subjoined Table, in which the area and population of each sub-district are shown. The sub-districts are arranged in the order of the density of persons to an acre. *DISTRICTS. Area in Statute Acres Density. Average No. of Persons to each Mean elevation in feet above high water Trinity mark. Persons to an Acre. House. Family. †Spitalfields 53 296 10.2 4.9 36 Artillery 25 262 8.9 4.3 41 Mile End New Town 64 240 8.9 4.2 36 Goodman's Fields 51 218 8.8 4.3 28 Whitechapel North 58 208 7.8 4.8 36 Whitechapel Church 47 171 7.6 3.9 32 Aldgate 108 92 9.2 4.4 19 *The total area of the Whitechapel District is 406 statute acres. In making the above calculations, the inmates of the public buildings and sailors in the docks, &c., are omitted. t It appears from the returns of the house to house visitation,that out of the 1,585 inhabited houses in the Spitalfields sub-district, there are about 212 which consist of two rooms only. In 123 of these two roomed houses, there are two distinct families residing. 6 As a rule, it is found, that the more densely a district is populated, the greater Is its irate of mortality ; it might therefore be expected that, as Spitalfields is more densely crowded than Aldgate, in the proportion of about 3 to 1, the rate of mortality in each would be in the same proportion : but this is not the case; for the rate of mortality in the two districts will be found nearly equal, whether it be calculated by the number of deaths in the whole population, or by the proportion of the deaths of young children to the total number of deaths, which is a mode of estimating the comparative unhealthiness of a district the least liable to error, as children do not long exist in a healthy state in crowded localities. The greater part of the area of the Aldgate sub-district is made up by the open spaces of the St. Katharine's Docks, and by the adjoining portion of the river. These large open spaces are peopled only by persons living on board ships; but that part of the sub-district which is occupied by in? habited houses is small, and is probably more densely peopled than the Spitalfields subdistrict. Before we can expect to see the rate of mortality in the Whitechapel District reduced much nearer to the healthy standard, we must prevent the few remaining open spaces from being occupied by small tenements, and reduce the number of tenants in those houses already inhabited. This leads me to make allusion to that gigantic evil in operation in this district—the erecting of houses intended for the occupation of the poor, in localities where there is not adequate space to afford a due supply of air for the efficient ventilation of the house ; or in other words, the building of three houses where there is only room for two; and this is done, notwithstanding the provisions of the Building Act, which provides, that " unless all the rooms can be lighted and ventilated from a street or alley adjoining, the house shall have, in the rear or on the side thereofaxi open space exclusively belonging thereto, of the extent at least of one hundred square feet. To an unsophisticated mind, it would appear to be a difficult matter to set at naught the wholesome provisions of the Act, but as such has been the case, the Act must necessarily be defective; and if houses can by law be erected on spaces not sufficient for the health of the intended occupants, the sooner the law be altered the better it will be for the health of the whole district and for the pockets of the ratepayers. Unless the crowding together of houses in unsuitable places be prevented, the good results attendant on the labours of your sanitary officers will be frustrated. All that I can do, however, in' the meantime is, to protest most strongly against the practice now prevailing, and to express a hope, that before the next session of Parliament is concluded, there wijl be passed an amended Building Act, containing more ample provisions for carrying into effect such sanitary regulations for the construction of houses, especially as regards light and ventilation, as experience has declared to be necessary for the health of the inhabitants. The number of males in the entire district is 39,80S, and of females 39,159, which is in the proportion of 101.6 of the former to 100 of the latter. This is at variance with the returns of all other large towns, in which it appears, that the number of females exceeds that of males, In England and Wales the proportion of females to males is as 105'6 to 100. In four of the sub-districts in the Whitechapel District, viz : the Spitalfields, Mile End New Town, White* chapel North and Aldgate, the males exceed in number the females; while in the other sub-districts, the females are in excess of the males. The great excess of males over females, which appears in the Aldgate sub-district, is accounted for by the presence of the garrison in the Tower, the inmates of the Sailors' Home, and the persons living on board ship in the Docks and in the Biver. From a return kindly furnished to me by Mr. Price, the Inspector of Registered Lodging Houses, it appears, that on the south side of the district, there are fifty registered common lodging houses, consisting of 173 rooms, which are capable of accommodating 855 7 persons, and on the north side, there are sixty-seven, consisting of 265 rooms, and capable of receiving 1,765 persons. The total number of common lodging houses in this district that are under police inspection is 117, in which are allowed 2,620 persons, the great majority of whom are males. There are likewise a great number of houses under the observation of the police which are as yet not registered, but are being prepared for approval; these probably amount to about 100, and are calculated to afford accommodation to about 1000 persons. The registered lodging houses in this district will therefore be able to accommodate about 3,500 persons. I am indebted to Mb. Hems, Juh , one of the Local Registrars, for several interesting particulars in the Whitechapel Church sub-district, which ho obtained from the returns of the census papers. The most valuable portion of the information is that which relates to the ages of the population; for it is by the classifying of all persons living in a district, according to their ages, that we are able to compare the proportionate amount of the sickness and mortality in each. Thus, if we find that there is a larger infantile population, or that there are many more aged persons residing in one district than in another, we may expect to find, ceteris paribus, that in the former district the mortality will be greater. The rate of mortality in the entire Whitechapel District, (deducting the whole of the deaths in the London Hospital, which it is always necessary to do in comparing the rate of mortality of this district with that of others), during the last quarter, was, of persons under five years of ago, fifty-three per cent., and of those between the ages of five and sixty, it was only thirty-one per cent., and of those above sixty years of age, it was sixteen per cent. For the purpose of being able to make a more correct comparison of the mortality in this and in the other sub-districts, I have classified the ages of the population under three headsinfancy, youth and manhood, and old age. Under the first head are included all persons under the age of ten years.* This may be considered as the dependent class. Under the second head are included all those between the ages of ten and sixty, at which period of life, health is most vigorous, and the power of producing wealth is most abundant. This class constitutes the strength of a district. Under the third head are included all above sixty years of age, or that class, who, from physical infirmity, are unable to support themselves by bodily labour, and who, to a certain extent, may also be considered as belonging to the dependent class. In the first division there are 1858, which number, after deducting the 405 persons in the London Hospital, and the fifty-seven persons whose ages are not returned from the total population of the sub-district (8060) is 24.4 per cent. In the second division there are 5329 or 70'1 per cent. Or if we add to the first class those (653) whose ages are between ten and fifteen, and deduct them from the second class, then the proportion of the former will be 33 per cent. and of the latter Gl'5 per cent. In the third division there are 411, or 5'4 per cent. The census shows that in this sub-district there are nine blind persons, six males and three females, whose ages are from forty-two to ninety-eight. There are seven deaf persons whose ages are from nineteen to seventy years, of whom, five are males and two are females. There are two dumb persons, one male and one female, aged respectively, sixteen and fifty-three. The deaf and dumb are six in number, viz.: four males and two females, aged respectively, twelve, thirty-nine, twenty-three, twenty-four, forty, and fifty-seven years. In this sub-district, there are 405 Irish, 74 Scotch, 42 Welsh, 355 Germans, 92 Prussians, 19 Hanoverians, 5 Austrians, 96 Dutch, 51 Poles, 10 French, and 3 Danes. The total number of persons living in this district, who are not natives of Great Britain and Ireland, is 625, or about *All under fifteen years, in most districts, would bo a better number to include in the dependent class, but as there are, iu this locality, many young persons at the ago o£ ton years earuiDg their own subsistonco, I havo included those only under ten years of age. 8 one in twelve. In the London Hospital there are nine foreigners, natives of Russia, Prussia, Poland, Hanover, Mauritius, and Australia. This valuable institution may therefore be considered as a hospital for all nations. Of the sixty-four courts and streets comprised in this sub-district, thirty of them contain a less number of inhabitants than in 1851, thirty-two contain a greater number, and one has the same number. A new street (Cotton-street), containing 202 persons, has been recently built. Having thus briefly laid before you a few statistical facts which the late census has revealed, I shall now proceed to the consideration of the mortality and sickness which have been recorded in the quarter ending on the 29th June last. In the thirteen weeks comprising the last quarter, the total number of deaths, including the deaths of 42 non-residents, was 526, of which number, 267 were males, and 259 females. The births, in the same period, were 697, viz.: 369 males, and 328 females. The excess of births over deaths, including those of the non-residents is 213. In the corresponding quarter of 1860, the deaths, excluding those of the non-residents (52) were 483. The mortality therefore is greater by one in this, than in the Spring Quarter of last year. The births are eleven in excess, 797 against 686. The mortality for the quarter is at the annual rate of twenty-two in 1000. For the year ending June 29th, the rate of mortality (deducting the deaths of 170 non-residents) is twenty-six m 1000, or one in thirty-eight of the entire population, but if we deduct the total deaths in the London Hospital, then the rate of mortality for the year is twenty-four per 1000, or one in forty-one of all living. This is a high rate of mortality, arid it shows that there are noxious causes in operation in this district, which will require the most strenuous efforts of your sanitary officers to investigate, and, if possible, to remove. Of the 526 deaths, there are 238, or forty-five per cent. under five years of age, and 113, or twenty-two per cent. under one year. The proportion of deaths of children under five years varies in the several sub-districts, as may be seen on refering to Table No. 5. How many of these children die from the want of pure air it is impossible to tell, as the deaths in the mortuary returns are all classified under distinct heads of disease, and there is not a column wherein to record the causes of disease; if there were such a column, the total caused by impure air would probably be very great. The deaths of persons above eighty years, are 18, or 3.4 per cent. I may here remark that the alleged ages of very old persons ate hot always to be relied upon; they are sometimes exaggerated, and many aged persons are really ignorant of the date of their birth. There is, however, recorded the death of one aged person, whose years numbered 102; she was the widow of a laborer, and the Registrar, Mr. Hodson, writes "I have good reason to believe that that this age is correctly stated. A daughter is now living aged eighty-one years. Last year the deceased was brought to the notice of the inhabitants of this district, by being elected a pensioner in the Norton Folgate Pension Society, in conjunction with a man living at Wanstead, two years her senior. The committee were satisfied froni inquiry made, that she was of the age stated.'* On referring to the table showing the caitses Of death, it will be Seeh that the diseases of the respiratory organs where fatal to ninety. This number is less by twenty-one than in the coresponding quarter of last year, but it is greater than that in 1859. Diseases of the breathing organs seem, to fluctuate with the changes in the temperature of the atmosphere, the mean temperature of which, during the quarter recently terminated, was 51-6° which is 1-1° greater than in the corresponding quarter of 1860. In both periods, however, it was below the mean temperature, in each of the three corresponding quarters ot 1857-9, which was 54 degrees. During these last mentioned period?, the deaths from diseases of the lungs, ex* 9 clusive of consumption, were eighty-four, eighty-five, and sixty-two respectively, which is six, five and twenty-eight less than the number recorded in the quarter now under consideration. Consuniption was fatal to sixty, or 11.4 of the total deaths; Convulsions caused the death of 23; scrofula, or tubercular diseases, 29 ; violence of various kinds proved fatal to 34, or 6.4 per cent. of the total mortality; and the epidemic diseases were fatal to seventy-four, of which number, two died from small-pox, seven from measles, six from scarletfever and diphtheria, thirty-two from hooping-cough, fourteen from diarrhceo, and thirteen from fever. On comparing the number of deaths from epidemic diseases, with that in the corresponding quarter of the preceding year, it will be seen, that measles, scarlet-fever, and fever have been less fatal by twenty-two; while hooping-cough and diarrhoea have been more fatal by thirty-two. There lias been an increase of ten in the total number of deaths from epidemic diseases, seventy-four against sixty-four. The returns of deaths from fever are satisfactory, thirteen against sixteen. There are eleven deaths uncertified by a medical practitioner ; they principally relate to convulsions of children, a frequently alleged cause of death, when a medical practitioner had not been in attendance. One of these cases is thus reoorded, " convulsions after a burn." In this instance an inquest was not held, while in nine other teases where death was caused by burns and scalds, inquests were held. Congenital syphilis proved fatal to four, but it is highly probable, that many more died from this disease than are recorded in the mortality returns. The frequency of death from this disease ought to make those persons, who are in search of a wet-nurse, very careful in their inquiries respecting the death of the wet-nurse's child, or if the child be living, respecting the state of its health ; for, if the mother be constitutionally diseased, as she would be, if the child had died from syphilis, she would be unfitted for the duties of a wet-nurse. The cases of illness attended by the medical officers of the Union, exclusive of those in the workhouse, were 3,266. This is an increase of 536 on the cases attended in the corresponding quarter of last year. The cases of diarrhoea have increased from 112 to 238. This increase of diarrhoea is probably owing to atmospheric causes. The eating of fruit is frequently alleged to be the cause of this disease, but I believe that this is not correct. On the contrary, I am of opinion that the moderate use of ripe and fresh fruit is, during the hot weather, very beneficial, when the same is substituted for, and not added to, food of a more stimulating nature. The cases of small-pox have slightly increased — seventeen against fourteen. Out of the fifty-five cases of small-pox which have been attended by the medical officers of the Union, during this and the preceding quarter, thirty-three had not been vaccinated, eighteen had the marks of the cow-pox, and ten were not specified. The fever cases are nearly the same—eighteen against seventeen. The cases of illness in the workhouse were 539, of which number, Mr. Champness attended 217, including one of scarlet-fever, eighteen of diarrhoea, and five of fever; and Mr. Richardson attended 322, including thirteen of measles, one of scarlet-fever, one of hooping-cough, six of diarrhoea, and four of fever. The total number of sick, during the past quarter, which have been attended by the medical officers of the Union, amounts to the enormous number of 3,805. The amount of the sanitary work performed by the Inspectors for the last quarter may be seen on referring to the first Table in the Appendix. I am, Gentlemen, Vour obedient Servant, JOHN LIDPLE, Board of Works, 15, Great Alie Street. APPENDIX. TABLE I SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED Up to the 30th day of June, 1861 From February, 1856, to the 30th March, 1861 Total number of Nuisances removed Works in progress but not completed Number of Nuisances inspected in houses or in other premises Number of Houses systematically visited House-to- house visitation Number of Nuisances entered in Complaint Book Number of visits to Slaughter Houses Number of visits to Cow Houses Number of Summonses taken out Number of Notices served For Sanitary defects For other Nuisances, Obstructions&c Total 44,856 213 23,483 11,001 10,908 254 97 48 127 3,791 Summary of Inspections for the Quarter ending 30th June, 1861 Total 2,049 132 1,510 366 421 40 33 1 8 250 Gross Total 46,905 345 24,993 11,367 11,329 294 130 49 135 4041 This total refers to Nuisances of every description, including the non-removal of Dust, Overflowing Gullies, &c, complaints of which have either been made at the Office or discovered by the inspectors Several cases of keeping Swine have come under the notice of the Inspectors during the past quarter, all of which have been removed agreeably to notices issued by them. TABLE II—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 ending the 29th June, 1861 Names of Medical Officers Small-Pox Measles Scarlatina Hooping-Cough Diarrhoea Continued Ferer (Typhus and Typhoid) Eysipelas Carbuncle Ague Acute Pulmonary Inflammations Croup Pyasmia Delirium Tremens Dysentery All other Diseases Total Average number of Fever eases per Week Bronchitis and Catarrh Pneumonia and Pleuritis Mr Blackwell 0 12 5 12 '76 3 9' 3 0 113 10 1 0 0 2 544 790 Mr Champneys 5 6 1 26 52 2 5 0 0 14 2 0 1! 0 0 419 533 Mr Richardson 3 3 5 21 49 1 1 1 1 27 2 1 0 0 4 624 743 Mr Sequeira 9 7 3 50 61 12 2 0 8 43 9 0 0 0 0 996 1200 Total 17 28 14 109 238 18 17 4 9 197 23 2 1 0 6 2583 3266 1-3 TABLE III—Showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on tile 20th June, 1861 Districts Small-Pox Measles Scarlet-Fever Diphtheria Hooping-Cough Diarrhœa Fever Total. M F M E M F M F M F M F M F M F Artillery 0 0 0 1 1 0 0 0 0 1 0 0 0 0 1 2 Spitalfields 0 1 1 0 0 1 (1 0 2 8 1 3 1 1 5 !4 Ahle End New Town 0 1 2 1 0 0 0 0 4 3 1 1 2 4 9 10 Whitechapel, North 0 0 1 (1 1 0 0 0 1 2 1 0 1 2 5 4 Whitechapel Church 0 0 0 0 1 0 0 0 0 0 0 1 0 2 1 3 Goodman's Fields 0 0 0 0 0 0 0 0 1 3 2 1 0 0 3 4 Aldgate 0 0' 1 0 1 0 0 1 4 3 0 3 0 0 6 7 0 2 5 2 4 1 0 1 12 20 5 9 i 9 30 44 2 7 5 1 32 14 13 74 Deaths from Epidemics for the corresponding Quarter, 1860 2 15 15 2 7 7 16 64 One of the deaths from fever was that of a non-resident TABLE IV—Showing the 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 80 80 and upwards Total Males 33 Femls26 Corresponding Quarter of 1860 9 2 1 4 19 18 6 59 70 TABLE V—Ages at Death in each Registration District, for the Three Months ending 29th June, 186. Districts 0 and under 1 i and under 5 5 and under 20 20 an d under 40 40 and under GO 60 and under 80 80 and upwards Total Remarks Artillery 5 11 0 3 5 3 2 30 Spitaltields 22 22 5 12 10 7 2 79 Mile End N Town 29 24 6 9 27 26 7 127 Workhouse Whitechapel, N 20 20 4 10 6 5 1 66 WhitechapelChurch 8 13 10 32 34 17 2 117 Hospital Goodman's Fields 16 19 5 3 7 4 4 58 Aldgate 13 17 5 3 9 2 0 49 Totals 113 126 35 72 98 64 18 526 TABLE VI—The Births and Deaths in each Registration District, for the Three Months ending on the 29th June, 1861, Districts Births Total Deaths Total Excess of Births over Deaths Excess of Deaths over Births Remarks M E M E Artillery 26 21 47 14 16 30 17 — Spitalfields 65 57 122 30 49 73 43 — Mile End New Town 79 80 159 77 50 127 32 — Workhouse. Whitechapel, N 60 57 117 37, 29 66 51 — Whitechapel Church 35 40 76 60 57 117 — 41 London Hospital. Goodman's Fields 61 42 103 29 29 58 45 — Aldgate 42 31 73 20 29 49 24 42 Non-residents died in Lon. Hos. Totals 369 338 697 267259 526 212 41 Excess of births oyer deaths, deducting the 42 non-residents 213 TABLE VII.—LONDON HOSPITAL. Causes of Death at Seven periods of Life, registered in the London Hospital, for the Three Months ending 29th June, 1861. 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. 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 6 11 21 6 45 Order l—Miasmatic Small-Pox Order 4—Digestive Organs, Measles Cancrum Oris Scarlatina Gastritis Diphtheria Enteritis Quinsey Peritonitis Croup Ascites Hooping-Cough Ulc. of Intestines ... ... ... 1 ... ••• ... 1 Typhus Fever ... ... ... 1 1 ... ... 2 Hernia (Rupture) ... ... ... 2 ... 2 1 5. Erysipelas ... ... ... ... 1 1 ... 2 Iieus ... ... ••• ... 1 ... ... 1 Puerperal Fever Intussusception Carbuncle Fistula Influenza Stomach Disease, &c. Dysentery Pancreas Disease, &c. Diarrhcea Hepatitis ... ... ... 1 1 2 ... 1 Ague Liver Disease, Sec ... ... ... 1 ... 2 ... 3 Remittent Fever Spleen Disease, &c. Rheumatisim ... ... ... 1 ... ... ... 1 Order 5—Urinary Pyasrnia Order 2—Entiietic. Nephritis Syphilis ... ... ... 1 ... ... ... 1 Disease of Bladder Stricture of Urethra ... ... ... ... ... 1 ... 1 Nephria (Bright's disease) Hydrophobia Order 3 - DIETIC. Diabetes ... ... ... 1 ... ... ... 1 Privation Stone Want of Breast Milk Purpura and Scurvy Alcohlsm. Del.Trmins Prostate Disease, &c. Kidney Disease, dec. Order 6—Organs op Genration. ,, Intemperance Dead Poisoning Ovarian Dropsy Order 4—Parasitic Disease of Uterus, &c Thrush Order 7—Organs of Locomotion. Worms, &c. II.- CONSTITUTIONAL Joint Disease &c ... ... 1 2 ... ... ... 3 Order 1 - DIATHETIC Bones, &c ... ... ... 2 1 ... ... 3 Gout Order 8—Integumentqary System. Dropsy ... ... ... 1 2 ... ... 3 Phlegmon Cancer ... ... ... 1 3 ... ... 4 Skin disease, &c Mortification IV.-DEVELOPMENTAL Abscess ... ... 2 ... ... ... ... 2 Order l — Diseases OF CHILDREN Anæmia Order 2—Tubrclr. Premature Birth Scrofula ... ... ... 1 ... ... ... 1 Cyanosis Tabes Mesenterica Spina Bifida Phthisis (Consumptn ... ... ... 3 1 ... ... 4 Other Malformations Hydrocephalus 1 ... ... ... ... ... ... 1 Teething III.—Local. Order 2 — Diseases of Adults. Order l—Nervous System. Paramenia Cephalitis Childbirth Apoplexy ... ... ... ... 2 ... ... 2 Order 3— Diseases of Old People. Palsy (Paralysis) Insanity Old Age Tetanus ... ... 1 ... ... ... ... 1 Order 4 — Diseases of Nutrition. Epilepsy Convulsions Atrophy and Debilty Chorea V.—Violent Deaths Brain Disease, &c. ... ... ... ... 1 1 ... 2 Order 1—accidents Order 2—Organs o Circulation. Burns and Scalds ... 5 i 1 i ... ... 8 Pericarditis Poison Aneurism Suffocation Heart Disease, &e. ... ... 2 1 5 ... ... 8 Violence ... ... ... 6 5 ... 1 13 Phlebitis Order 3—Homicide Disease of Arteries Murder and Manslaughter ... ... ... 1 ... ... ... 1 Order 3—Respiratory Organs. Order. 4—Suicide. Laryngismus Wounds ... ... ... ... ... 1 ... 1 Laryngitis ... ... ... ... 1 ... ... 1 Poison Bronchitis ... ... 1 1 2 3 ... 7 Drowning Pleurisy Hanging Pneumonia ... ... ... ... 2 ... ... 2 Otherwise Lung Disease, &c. Not Specified. Carried forward. 1 ... 6 11 21 6 ... 45 Grand Total 1 5 9 28 30 11 2 86 TABLE VIII.—Causes of Death at Seven Periods of Life, registered in the Whitechapel District, for the Three Months ending 29th June, 1861. 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 uuder 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 76 108 27 49 79 40 3 382 Order 1—Miasmitio Small-Pox l 1 ... ... ... ... ... 2 Order 4—Digestive Oroans. Measles 3 3 1 ... ... ... ... 7 Scarlatina ... 4 ... 1 ... ... ... 5 Cancrum Oris Diphtheria ... 1 ... ... ... ... ... 1 Gastritis ... 1 ... ... 2 ... ... 3 Quinsy Enteritis ... ... ... 1 ... ... ... 1 Croup ... 7 ... ... ... ... ... 7 Peritonitis ... ... ... ... 1 ... ... 2 Hooping-Cough 8 22 1 1 ... ... ... 32 Ascites ... ... ... 2 ... ... ... 2 Typhus Fever ... 6 1 l 3 2 ... 13 UIc. of Intestines ... ... ... 1 ... ... ... l Erysipelas 1 ... ... ... 1 1 ... 3 Hernia (Rupture) ... ... ... 2 ... ... l ... Puerperal Fever Ileus ... ... ... 1 ... ... 2 Carbuncle Intussusception ... 1 ... ... ... ... ... 1 Influenza Fistula Dysentery ... ... ... ... 1 ... ... 1 Stomach Disease, &c. ... ... ... ... ... 1 ... 1 Diarrhoea 8 1 ... 1 1 2 l 14 Pancreas Disease, &c. Ague Hepatitis Remittent Fever Liver Disease, &c. 3 ... ... 1 3 2 ... 9 Rheumatism ... ... ... 1 1 ... ... 2 Spleen Disease, &c. Pyæmia Order 5— Urinary Organs. Order 2—Enthetic. Syphilis ... ... 1 1 ... ... ... 5 Nephritis ... ... ... ... ... 1 ... 1 Stricture of Urethra. ... ... ... ... ... 1 ... 1 Disease of Bladder Hydrophobia Nephria (Bright's esse) ... ... ... ... 1 1 ... 2 Order 3—Dietic. Privation 1 ... ... ... ... ... ... 1 Diabetes ... ... ... 1 ... ... ... 1 Want of Breast Milk Stone Purpura and Scurvy Prostate Disease Alcoholism—Delirium Kidney Disease. &c. Tremens ... ... ... ... 1 ... ... 1 Order 6—Organs of Generation. „ Intemperance Load Poisoning Ovarian Dropsy Order 4—Parasitic. Uterus Disease, &c. Thrush Order 7—-Organs of Locomotion. Worms, &c II.Constitutional. Joint Disease, &c ... ... 1 2 ... ... ... 3 Order 1—Diathetic Bones, &c. .. 1 1 2 l ... ... 5 Gout Order 8 — mentary. Dropsy ... ... ... 2 4 ... ... 6 Phlegmon Cancer ... ... ... 2 6 ... ... 8 skin Disease, & c. Mortification ... ... ... 1 1 ... ... 2 IV.-Developmental Abscess 1 ... 2 ... ... ... ... 3 Order 1 - Diseases of Children. Anaemia 1 ... ... ... ... ... ... 1 Order 2-Tubrclr. ... ... ... Premature Birth 10 ... ... ... ... ... ... Scrofula ... 2 2 1 1 ... ... 6 Cynosis 1 ... ... ... ... ... ... 10 Tabes Mesenterica 8 8 4 ... ... ... 20 Oninn Bfirlo 1 Phthisis (Consumptn) ... 3 7 28 26 6 ... 70 Other Malformations. Hydrocephalus 1 7 ... ... ... ... ... 8 Teething 1 7 ... ... ... ... ... 1 11 III.—Local. Order 2 — Diseases of Adults. Order 1—Nervous System. Paramenia Cephalitis ... 2 1 ... ... ... ... 3 Childbirth ... ... 1 1 1 ... ... 3 Apoplexy ... ... ... ... 3 3 ... 6 Order 3—Diseases of Old People. Palsy (Paralysis) ... ... ... ... 3 1 ... 4 Insanity Old Age ... ... ... ... ... 15 13 28 Tetanus ... ... 1 ... ... ... ... 1 Order 4 —Diseases of Nutrition. Epilepsy ... ... ... ... 1 ... ... 1 Convulsions 16 6 1 ... ... ... ... 23 Atrophy and Debilty 16 1 ... ... ... ... ... 17 Chorea V.—Violent Deaths. Drain Disease, &c 3 4 1 2 1 3 ... 14 Order l—Accidents or Negligence. Order 2—Oroans of Circulation. Burns and Scalds ... 6 1 2 1 ... ... Pericarditis ... ... ... 1 1 ... ... 2 Poison 10 Aneurism ... ... ... 1 ... ... ... 1 Suffocation 3 3 Heart Disease, &c. ... ... 2 2 8 4 1 17 Violence 2 g o 1 15 Phlebitis ... ... ... ... ... 1 ... 1 Drowning 1 1 Disease of Arteries Order 3—Homicide. Order 3—Respiratory Organs. Murder & Manslaghtr. Order 4—Soicide. ... ... ... 1 ... ... ... 1 Laryngismus ... ... ... ... 1 ... ... 1 Wounds ... ... 1 ... ... 1 ... - Laryngitis 1 ... ... ... ... ... ... 1 Poison ... ... ... ... ... ... ... 2 Bronchitis 7 8 1 2 6 11 1 36 Drowning Pleurisy ... ... ... ... ... ... ... Hanging ... ... ... 1 1 ... ... 2 Pneumonia 13 23 1 1 7 2 ... 47 Otherwise Lung Disease ... ... ... ... ... 3 ... 5 Not Specified Carried Forward 76 108 27 49 79 40 3 382 Grand Total 113 126 35 72 98 64 18 526 ■ , . v - ...... ' - ' •' , ... : ... ... .... .. , ■■ J BOARD OF WORKS, WHITECHAPEL DISTRICT REPORT on The Sanitary Condition of THE WHITECHAPEL DISTRICT, for the THREE MONTHS ENDING 28th SEPT, 1861 By JOHN LIDBLE, Mcdical Officcr of Health Read to the Boaed, Nov 11th, 1861 LONDON: FEINTED BY T PENNY, 121, LEMAN STEEET, WHITECHAPEL, AND 9, LONDON TEEEACE, HACKNEY BOAD 1861 QUARTERLY REPORT, Ending 28th September, 1861 Gentlemen, In the thirteen weeks that ended on Saturday, September 28th, the total number of deaths registered in the Whitechapel District are 549 (including those of thirty-eight non-residents who died in the London Hospital), of which 280 are males and 269 females The births during the same period are 612, viz: 313 males and 299 females The excess of births over deaths, excluding those of the non-residents, is 101 The population being 78,964, the birth-rate is in the annual proportion of 31 per 1000, and the death-rate of 258 per 1000 By excluding the total deaths in the London Hospital (eighty), the annual proportional rate of mortality is reduced to 237 per 1000 On comparing the mortality in this quarter with the corresponding one of last year, it will be found that the deaths are more numerous by thirtyfour This increase in the mortality may be accounted for by the greater number of deaths from diarrhcea, (68 against 35), which took place during the quarter recently ended The increased number of deaths from diarrhoea may, perhaps, be attributed to the greater heat of the weather—the temperature of the air during the months of July, August, and September, being 604°, whereas in the corresponding months of the preceding year, the mean temperature of the air was 568° or 36° less It is supposed that a low temperature during the summer months is less favourable to the development of epidemic diarrhcea During the quarter, small-pox has been fatal in five instances The deaths from scarletfever and diphtheria, which are considered modifications of the same disease, and are now generally registered under the same head, rose from eight to sixteen; hooping-cough, from sixteen to twenty-two; fever, from eleven to seventeen; while, on the other hand, the deaths from measles fell from thirty-nine to three Cholera was fatal in four instances, while in the corresponding quarter of the previous year, not a single death from this disease occurred The total increase of mortality from epidemic diseases is 21, viz, 123 against 111 4 Although the warmer temperature of the summer may have occasioned an augmentation of the various forms of bowel complaint, yet, on the other hand, it appears that the genial warmth of the summer months has been beneficial to those persons who were suffering from diseases of the respiratory organs; the deaths from these diseases being fiftynine against sixty-two The mortality from croup has likewise decreased, viz, from seventeen to six; and the deaths from consumption are less by 15, viz, 49 against 64 Three children were suffocated in bed A newly-born infant was found dead in the streets Another newly born infant was found drowned in the river One case of suicide is recorded—a female aged forty died in the workhouse from concussion of the brain, occasioned by throwing herself out of window. Intemperance was fatal to six, of which number, three died from delirium tremens This disease is of more frequent occurrence in hot weather, and the action of alcoholic liquors is more dangerous in summer than in winter The number of deaths recorded in the mortality tables, under the head of intemperance, gives but a very imperfect idea of the number of persons who die indirectly from the excessive use of intoxicating beverages Many of the deaths from dropsy, disease of the heart, head, and liver; also several of those deaths that are occasioned by violence may be traced to the same cause The number of inquests were fiftyseven, of which twenty-seven were held on persons who died in the London Hospital The uncertified deaths were twenty-one This is an increase of nine on the number of the corresponding quarter of the preceding year It is in the district of Mile End New Town, that the greater number of deaths, uncertified by a medical practitioner, are recorded ; for, out of the total number of such deaths, there are ten or nearly one-half, registered in that district Among these uncertified deaths, there are registered one from chronic bronchitis, one from enteritis, one from scarlatina, and one from diarrhoea In a district like the Whitechapel Union, where there are such facilities afforded to the poor for obtaining medical advice and assistance, it is strange that so many persons should die without having been attended during their last illness, by a medical practitioner For, that these facilities are great, is testified by the number of applicants at the hospital and dispensaries in the district, and the medical relief given by the union medical officers, whose advice appears to be so readily obtained, that upwards of 11,000 annually avail themselves of it With such advantages, it is also strange that the causes of death, being reported by unqualified persons only, should receive, from the local registrar, a scientific classification The deaths in the workhouse were sixty, viz: thirty-seven males and twenty-three females Of the sixty deaths, there were twenty-six of persons between the ages of sixty and eighty, two of persons above eighty, six of children under twelve months, and the remainder (twenty-six) were of persons between the ages of two and sixty years of age In the corresponding quarter of last year, the deaths in the workhouse were fifty-one The cases of illness among the out-door poor, attended by the medical officers of the union, were 3,635 This number is an increase of 967 upon that of the corresponding quarter of last year I am unable to assign a cause for the annual increase of sick pauper patients During this quarter, the increase is observable in each medical district, but the greatest increase occurred in Mr Richardson's district, in which the number has risen from 557 to 885, or 37 per cent The most prevalent disease was diarrhoea, 864 cases having been attended, while the number in the corresponding quarter of the preceding year was only 383 Small-pox shows an increase of 6, viz, 12 against 6; scarlet-fever of 4, viz, 28 against 26; hooping-cough of 89, viz, 108against 19; whilst measles shows a decrease of 153, viz, 6against l59 Although cases of febricula, or slight fever, have been much more numerous, the severer forms of fever have decreased to the extent of 24, viz, 12 against 34 It is, however, highly probable, that many of these slight cases of fever become in their course severe ones, and in some instances, even fatal; for we observe that, by the mortality returns, the deaths from fever are on the increase, and from the many slight cases of this disease, which are recorded, I am apprehensive that fever cases will become more prevalent as the season advances The cases of sickness in the workhouse were 575, of which number, 209 were males, who were attended by Mr Champneys, and 266 were females, who were under the care of Mr Richardson The total number of cases in the workhouse during the corresponding 5 quarter of 1860, were 390 There are included in the returns of sickness in the workhouse one case of measles, one of scarlet-fever, three of hooping-cough, nineteen of diarrhoea, one of cholera, and seven of fever The ages at death during the quarter are recorded in the General Mortality Table, where it will be seen that 152, or 276 per cent died under one year of age—that 266, or 48 per cent died under five years—that 15, or 27 per cent died above the age of eighty, and 268 or 49 per cent between the ages of five and eighty The large relative mortality of children under one year of age, which takes place annually, not only in this district, but in all crowded neighbourhoods, does not receive that attention from the community at large which its importance, as bearing upon the general interests of society, demands Out of the 152 deaths of infants, eighty are attributable to constitutional diseases, such as scrofula, convulsions, mesenteric disease, water on the brain, teething, atrophy, &c These diseases are produced by neglect, by defective nutrition, and by the breathing of impure air That impure air is the cause of a large mortality of infants is now so universally admitted, that I need not enlarge upon the subject, but will merely allude to the fact, that in the Dublin Lying-in Hospital, the mortality of infants after the ventilation of the building was improved, was reduced from 170 per cent to 17 per cent Mr Farr, the Clerk to the Guardians, has, as usual, kindly furnished me with the annual return of the number of cases vaccinated by the public vaccinators in the union ; from which return, it appears, that while the births, for the year ending 29th of September, are 2,717, the children under twelve months who have been vaccinated at the expense of the union are 1,933, or seventy-one per cent of the total registered births ; and those above twelve months are 235, or rather more than eight per cent of the births The importance of vaccination is strikingly shown in the following case which came under the care of Mr Sequiera:— At No 11, Shorter's Rents, two children were simultaneously attacked with small-pox, neither of whom had been vaccinated; a fortnight afterwards, two other children in the same house were attacked with the disease; then three more, making together seven, all unvaccinated Of this number, four died; but by vaccinating with success two other children in the same house, they escaped the virulence of the disease, a few pustules only appearing on each child. The inspectors having completed a house to house visitation of the entire district, and thereby ascertained the general sanitary condition of each house as regards its drainage, cleanliness and repair; they have recently been directed to inquire into the particular state of each room inhabited by the poorer classes From the returns made of twenty courts, comprising in all 175 houses, it appears, that out of the 433 rooms contained in the several houses of these courts, twenty-seven of them, or rather more than six per cent were indecently occupied ; that is to say, adults of both sexes occupied at night the same sleeping apartment; nearly all of these rooms were over-crowded, for there was scarcely one so occupied, that a cubic space of 400 feet was allotted to each inmate, (a less space than that for each person having been decided by the Magistrates at the Clerkenwell Police Court, to constitute an over-crowded room"), and some of the rooms were both indecently occupied and over-crowded. In a room in Windmill Court, it was ascertained that there slept, the mother, two adult daughters, and two adult sons In another room in the same court, were a man and his wife, the daughter aged sixteen, and three adult sons In a room in Swan Court, having only one window, seven persons slept, viz, a man and his wife, the daughter aged twenty-four, who was in a consumption, and lying in bed, and four younger children The cubic contents of this room are 910 feet, which allows to each person only 130 cubic feet In a room in Pool's Place, two adult males, two adult females, and three children slept The Inspector remarks, that in this room, at the time of his visit, there were a number of men, women, and children, who were to sleep there at night, and to go "hopping" on the following morning In Bell Court, Princes Street, four persons occupied a room, the dimensions of which were 378 cubit, feet, affording only ninety-four cubic feet to each person A room in thiscourt was occupied 6 by an adult male and two adult females In Marlborough Court, a woman and her son aged twenty-six, slept together In Inkhorn Court, six persons occupied a room, viz, a man and his wife, the wife's sister aged nineteen, a servant girl aged fourteen, but looking twenty, and two children In a room in Commercial Place, there were a woman, her son aged eighteen, a child aged five years, a female lodger and her infant These, and a similar case in Hayes Court, where more than one family occupied a room, have been reported to the police, who will cause the landlord to register these houses as common lodging houses In another room there slept a man and his wife, and a son aged eighteen years; in another, a woman, her son aged eighteen years, and her two adult daughters A woman, with three grown up sons and two grown up daughters occupied another room A father and daughter occupied another room in this court In a room in Orange Row, the Inspector learnt that there slept a brother and sister, the former about twenty-three years of age, and the latter about eighteen The unfortunate feature in this case is, that the female, on being spoken to on the subject, thought that there was no impropriety in occupying the same sleeping apartment with her brother In three rooms in Hayes Court, the dimensions of each room being 10 feet 8 X 8, it was ascertained that each of these rooms was occupied by eight persons; the number that each is calculated to hold being only two, or at the utmost three, the entire cubic space is 640 feet, which is only eighty cubic feet to each person An idea of the space of eighty cubic feet may be readily formed, by imagining a box five feet long, four feet wide, and five feet deep Each of these small rooms has only one window, which opens into a narrow court Other instances of indecent occupation and over-crowding might be given, but enough has been quoted to show how the poor crowd together in this district I have no doubt that a similar state of things will be found to exist in other districts in London, if pains were taken by a house to house visitation, to ascertain how the poor live It may well be asked, how in a population so circumstanced can morality or virtue exist, where decency is so totally disregarded! Although I have brought to your notice so many cases of over-crowding and indecent occupation, I have not thought it expedient to urge the Board to take legal proceedings to reduce the number in any of these over-crowded rooms, but I have contented myself by addressing a few words to the father or mother in the occupation of such room, upon the indecency and great impropriety of permitting their adult children of both sexes to sleep together in the same room; and also, upon the danger which will accrue to the health of the whole family by breathing such an impure atmosphere, as is engendered in an over-crowded room; and I have also called upon, or written to, the landlord, and remonstrated with him on the subject This has been attended with some advantage, for in a few of the worst pases, the landlord has given notice to the tenants to quit the premises In order to carry out, beneficially, any law made for the welfare of the community, it is necessary that the public generally should be informed of the advantages which may reasonably be expected to flow from the operation of such law; for unless a cordial co-operation of the public be obtained, it will be difficult to enforce obedience to any law ; and hence, I am desirous that, before compulsory measures be adopted to enforce obedience to the sanitary regulations as regards over-crowding, the importance of them should be generally felt and acknowledged, especially so by the working classes, who form the great bulk of the community In order that the law upon the subject of over-crowding may be mqre generally known, I would respectfully suggest that the Clause in the Nuisances Removal Act, relating to the subject, be printed, and a copy of it sent to every landlord holding property, which is let out in tenements, in this district The danger of allowing a deadly atmosphere to be engendered by the crowding together of persons in a small room without efficient ventilation, is unfortunately not confined to the inmates of that particular room, but those diseases which are therein 'generated, extend far beyond its immediate vicinity, and under some circumstances, a large portion of a district will suffer in consequence The subject of over-crowding is perhaps one of the most difficult that the local authorities have to deal with Poverty is an evil which it is not in their power to relieve It has been remarked by some of the poor inhabitants of these crowded localities, that they can only occupy such a, sized room as their, 7 circumstances will enable them to pay for The evil of over-crowding is, however, so great, that unless it be checked by the interference of the authorities, it will probably increase to such an extent, as to be most dangerous to the public health, as well as to individual and public virtue. During the last three months I have visited several public schools in the district, and I found them, generally speaking, to be over-crowded For instance, in one of the schoolrooms, a cubic space of seventy-two feet was allotted to each scholar ; in another, the cubic space was sixty-five feet, in another, eighty-five feet, whilst in another, the cubic space for each child was only forty-six feet The ventilation in all these over-crowded schools was very defective, and in more than one instance, the smell of the room was most offensive In an atmosphere rendered impure by the exhalations from the lungs and skin of many persons congregated in a confined space, the nervous system becomes so depressed, that, from the inability of fixing the attention, scholars cannot learn, and teachers cannot teach; and if the breathing of such an impure atmosphere be long continued, the health of both scholars and teachers will become impaired The evils resulting from an over-crowded and ill-ventilated school room might be much diminished, by keeping the children for a shorter time in school, or by adopting what is called "the half-time system," which will reduce the evil to at least one-half, and during the interval of school instruction, permitting the children to engage in out door amusement; and during the absence of the children, opening all the windows and doors It is to me a matter of regret that a model school, on sanitary principles, has not been, as yet, recommended by the educational department of the Privy Council The recommendations, hitherto put forth by that body for the construction of a school, are faulty in the extreme In the minutes of the Council of Education, 1B51-52, relating to the organization of schools, it is recommended that, "in planning a school-room, if it be not more than eighteen feet in width, then about eight or nine square feet will be sufficient for each child in actual attendance; if the width be greater, there must be a proportionate increase of area allotted to each child" Here, the height of the ceiling is not mentioned, the omission of which, renders the recommendation of but little practical utility Again, if the school-room be lighted from above, which the Committee say "is the best possible mode, care should be taken to prevent the skylight from leaking,' &c "It is very important," say this Committee, "that the dimensions of a school-room should be graduated to suit the sizes of the elder and younger children" The recommendation of regulating the area of a school to the size of a child, is at variance with the laws of physiology, which demand the same space for a child as for an adult, in consequence of the greater rapidity of its respiration A child is more susceptible to the bad effects of an impure air than is an adult; and more air is required for the proper nourishment of its body during its growth, than is required for it in after life It is of the utmost importance that the school-room should be of a genial temperature, but this cannot be sustained if there be a glass roof, even if care be taken " to prevent it from leaking," because, during the winter the warm air of the room rapidly escapes through the glass roof, and during the summer, the heat of the sun passing through and reflected from the glass, makes the room so hot that it is almost insupportable The usual plan of building an infant gallery is also bad as regards the health of those children who occupy the upper form; for they inhale the air which has been vitiated by those on the lower forms, and the nearer the upper form is to the ceiling, the worse is the arrangement. On referring to the first table in the Appendix, it will be seen, that the total number of nuisances removed during the quarter, were 1,987, that three summonses have been taken out for defective drainage, and ten for other nuisances, and that eighty-two cesspools have been abolished or emptied This is the 26th recommendation, and the italics are in the original In the preliminary observations, page 78, it is stated " that the main end to be attained in planning schools, is the concentration of the attention of the teacher upon his own separate class, and of the class upon its teacher " The only sanitary provision in these recommendations is contained in the 24th rule, which says great care should be taken that the valves which admit the fresh air into tho school-room should be placed so as not to create a draft where the teachers and children sit. 8 In consequence of Mr Coward's attention having been directed to the exposure for sale of fish unfitted for food, he, in three instances, seized the fish so exposed, and summoned the parties in whose custody the fish was found, before the Magistrate In each case the Magistrate ordered the fish to be destroyed, and he inflicted a fine, varying from eight shillings to twenty-shillings, with costs, or an imprisonment of fourteen days to a month, with hard labour The Magistrate, in adjudicating in one of these cases, observed that, under the 5th section of the 10th and 11th Vict, c XLIII, the abettor or instigator of the offence was liable on conviction to the same forfeiture and punishment as the principal offender On each day that these cases were heard, the Court was crowded with vendors of fish, so that these prosecutions_will to some extent put a stop to the sale of unwholesome fish. The undermentioned trades-nuisances have been complained of—a soap manufactory, a wadding manufactory, a lucifer manufactory, a skin dressing manufactoiy, &c All these premises have been visited by me, and in every case, the proprietor has made such alterations in the mode of conducting the business as to abate the nuisance The offensive smell arising from the exposure for sale of cats' meat has been lessened by requiring the vendors to keep the bulk of such offensive substance in covered barrels, and to expose for sale a small quantity only at a time. Complaints against persons having large quantities of manure on their premises are very numerous If the manure be allowed to remain more than two days, the smell arising from it is very offensive; and if the manure has been allowed to accumulate for several days, then the smell from it, while in the course of removal, is almost intolerable I have personally visited all the premises in the district which have formed the subject of this complaint, and I have, in each instance, given directions to the proprietors to remove the dung every other day. Cesspools are now nearly abolished in the district, and it is only consistent with this proceeding that all the manure heaps, which are equally as offensive and contaminating to the air of the neighbourhood, should be disallowed The public privies in courts form a constant subject of complaint, and orders are, on each occasion, served upon the landlord to abate the nuisance It is greatly to be desired that in any new building act, the erection of publio privies will be forbidden. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE Board of Works, 15, Great Alie Street APPENDIX. TABLE I SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED For the Quarter ending the 30th day of September, 1861 Prom the 1st July, to the 30tll September, 1861, both inclusive Total number of Nuisances removed, of every denomination Works in progress but not completed Number of Nuisances inspected in houses or in other mises Number of Courts visited according to new system Number of Nuisances entered in Complaint Book Number of Summonses taken out Number of Cesspools abolished and emptied Number of Notices served For defective Drainage, &c For other Nuisances Abolished Emptied, &c Preliminary Compulsory Total 1,987 119 1,039 20 362 3 7 39 43 207 27 TABLE II—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 ending the 2Sth Sept, 1861 Names of Medical Officers Small-Pox Measles Scarlatina Hooping-Cough Diarrhoea Continued Fever (Typhus and Typlioid) Eysipelas Carbuncle Ague Acute Pulmonary Inflammations Croup Puerperal Fever Rheumatic Fever Dysentery All other Diseases Total Average number of Fever cases per Week Bronchitis and Catarrh Pneumonia and Pleuritis Mr Blackwell 0 3 6 16 243 2 7 2 1 67 2 0 0 0 1 512 862 Mr Champneys 2 1 2 28 216 2 3 0 2 7 1 0 1 0 3 515 783 Mr Richardson 1 0 5 23 193 0 3 0 1 16 5 2 0 2 5 629 885 Mr Sequiera 9 2 15 31 212 8 6 0 0 7 8 0 0 0 0 813 1105 Total 12 6 28 108 864 12 19 2 4 97 16 2 1 2 9 2469 3635 1 TABLE III—Showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 428th Sept, 1861 Districts Small-Pox Measles Scarlet -Fever Diphtheria Hooping-Cough Diarrlicea Fever Total M F M F M F M F M F M F M F M F Artillery 0 0 0 I 0 0 0 0 1 0 2 3 0 1 3 5 Spitalfields 0 0 1 0 2 1 0 0 2 1 5 4 0 3 10 9 Mile End Hew Town 0 0 0 0 1 0 0 0 1 2 3 12 3 2 8 16 Whitechapel, North 0 0 0 0 0 0 0 2 3 4 5 3 0 0 8 9 Whitechapel Church Goodman's Fields 0 0 0 0 2 1 0 1 1 0 5 7 3 0 11 9 0 0 0 0 3 4 0 0 2 2 2 9 1 1 8 16 Aldgate 2 3 1 0 0 0 0 0 0 3 4 4 1 2 8 12 2 3 2 1 8 6 0 3 10 12 26 42 8 9 56 76 5 3 14 3 22 68 17 132 Deaths from Epidemics for the corresponding Quarter, I860 2 39 8 0 16 35 11 11! TABLE IY—Showing the Ages at Death in the Workhouse 0 and nder 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 Males 37 Femls23 Corresponding Quarter of 1860 6 1 1 11 13 26 2 60 51 TABLE V—Ages at Death in each Registration District) for the Three Months ending 28th Sept, 1801 Districts 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 Remarks Artillery 10 4 4 2 5 2 2 29 Spitalfields 31 20 3 5 6 3 1 69 Mile End N Town 39 19 5 19 18 32 2 134 Workhouse Whitechapel, N 25 20 4 3 6 6 3 69 WhitechapelClmrch Goodman's Fields 14 15 15 36 17 19 5 121 Hospital 16 20 6 7 3 12 2 66 Aldgate 17 14 7 7 10 6 0 61 Totals 152 114 44 79 65 80 15 549 TABLE VI—The Births and Deaths in each Registration District, for the Three Months ending on the 28th Sept, 1861 Districts Births Total Deaths Total Excess of Births over Deaths Excess of Deaths over Births Remarks M E, M F Artillery 28 21 49 8 21 29 20 — Spitalfields 59 58 117 33 36 69 48 — Mile End New Town 75 83 158 73 61 134 24 — Workhouse Whitechapel, N 36 29 65 34 35 69 — 4 Whitechapel Church 35 29 64 74 47 121 — 57 London Hospital Goodman's Fields 44 47 91 31 35 66 25 — Aldgate 36 32 68 27 34 61 7 — 38 Non-residents died in Lon Hos Totals 313 299 612 280 269 549 124 61 Excess of births over deaths, deducting the 38 non-residents101 TABLE VII—Vaccination Extension Act—Whitechapel Union Names of the whole of the Public Vaccinators of the Union Vaccination Districts Year ended 29th September, 1861 Number anrl Ages of Persons Vaccinated by the public Vaccinators Number of such cases successfully Vaccinated No of Reg Births, all classes, dnring the Year, including Workb, and whole of parishes iu uiron Unsuccessful cases Under 1 year Above l year Total Under 1 year Above 1 year Total Thomas Seal Blackwell Christchurch 169 11 180 168 1 179 504 1 James Edmunds Old Artillery Ground 334 9 343 331 9 340 221 3 Alex M Champneys Mile End New Town 292 54 346 288 54 342 617 4 Edward Richardson Whitechapel North 495 46 541 492 44 536 418 5 Charles T Blackman Whilechapel Church 294 27 321 294 27 321 285 0 Henry L Sequiera Goodman's Fields 322 86 408 312 83 395 414 13 Charles E Jenkins Aidgate 50 10 60 48 7 55 258 5 Totals 1956 243 2199 1933 235 2168 2717 31 For the year ended 2Dth September, 1800, 2015 400 2415 2004 398 2402 2754 13 For the year ended 29th September, 1859 2227 787 3014 2197 775 2972 2829 42 TABLE VIII.—LONDON HOSPITAL. Causes of Death at Seven periods of Life, registered in the London Hospital, for the Three Months ending 28th Sept., 1801. 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. 5 and under 20. 20 and under 40. 40 and under 60 60 and under 80 80 and above Total, I.—Zymotic:— Brought forward ... 2 7 15 3 6 ... 33 Order 1—Miasmatic Order 4—Digestive Organs. Small-Pox Measles Cancrum Oris Scarlatina ... ... 1 ... ... ... ... 1 Gastritis Diphtheria Peritonitis Quinsey Ascites ... ... ... 1 ... 1 ... ?. Croup Ulc. of Intestines Hooping-Cough Hernia (Rupture) ... ... ... 1 ... ... ... ... Typhus Fever ... ... ... 2 ... ... ... 2 Ileus 1 3 2 ... 6 Erysipelas ... ... 1 ... ... ... ... 1 Intussuscuption ... ... ... ... 1 ... ... 1 Puerperal Fever Eistula Carbuncle Stomach Disease, & c. Influenza Hepatitis ... ... ... ... 2 ... ... 2. Dysentery Pancreas diseas, &c. Diarrhoea ... 1 ... 1 ... 1 ... 3 Hepatitis Ague Liver Disease &c. Remittent Fever Sapleen Disease, &c. Rheumatism Order 5—Urinary Organs. Pyaemia Cholera ... ... 1 ... ... ... ... 1 Order 2—Enthetic. Nephritis Syphilis Disease of Bladder ... ... ... 2 ... ... ... 2 Stricture of Urethra Nephria (Bright's Disease) Hydrophobia. Order 3 - Dietic, Diabetes Privation Stone ... ... ... ... l 3 ... 4 Want of Breast Milk Purpura and Scurvy ... ... ... 1 ... ... 1 Piostate Disease, &c Kidney Disease, dsc. „ Intemperance Lead Poisoning ... ... ... 1 ... ... ... 1 Generation. Ovarian Dropsy ... ... ... 1 ... ... ... 1 Order 4—Parasitic. Disease of Uterus, &c. ... ... ... 1 ... ... ... 1 Thrush Order 7—Organs op Locomotion. Worms, &c II.-Constitutional Joint Disease &c Order 1—Diathetic. Bones, &c Gout Order 8-Integumentary System. Dropsy Cancer ... ... 1 1 ... 1 ... 3 Phlegmon Mortification ... ... ... ... ... 1 ... 1 skin Disease, &c. Abscess ... ... ... 1 ... ... ... 1 Order 2—Tubrclr. Order 1 — Diseases of children Scrofula Premature Birth Tabes Mesenterica ... ... ... 1 ... ... ... 1 Cyanosis Phthisis (Consumptn) ... ... ... 1 ... ... ... 1 Spina Bifida Hydrocephalus III.—Local. Other Malformations Teething Order 1—Nervous System. Order 2 — Diseases of old adults. Cephalitis Paramenia Apoplexy ... ... ... ... ... 1 ... 1 Childbirth Palsy (Paralysis) Order 3 — Diseases of old people. Insanity Tetanus ... ... 1 ... ... ... ... I Old Age Epilepsy ... ... 1 ... ... ... ... 1 Order 4— Diseases of nutrition, Convulsions Chorea Atrophy and Debilty Brain Disease, &c. v. - violent Deaths. Order 2—Organs of Circulation. Order 1—Accidents of negligence Percarditis Burns and Scalds ... 1 1 3 1 1 ... 7 Aneurism Poison Heart Disease, &c. ... ... ... 2 1 ... ... 3 Suffocation Phlebitis Violence ... 1 5 7 3 3 ... 19 Order 3- Respiratory organs. Order, 4- SUICIDE. Disease of Arteries Murder and Manslaughter Order 3—Respiratory Organs. Order, 4 - Suicide Laryngismus Wounds Laryngitis ... ... ... 1 ... ... ... 1 Poison Bronchitis ... ... ... ... 1 2 ... 3 Drowning Pleurisy Hanging Pneumonia ... 1 1 3 1 ... ... 6 Otherwise Lung Disease, &c. Not Specified ... ... ... ... 1 ... ... 1 Carried forward. ... 2 7 15 3 6 ... 33 Grand Total ... 4 13 32 15 6 ... 60 TABLE IX.—Causes of Death at Seven Periods of Life, registered in the Whitechapel District, for the Three Months ending 28th Sept., 1861. Causes of Death. 0 and under 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 60 and under 80 80 and above Total, I.—Zymotic Brought forward 114 106 33 51 47 43 4 398 Order 1—Miasmatic 1 2 2 2 ... ... ... 5 Order 4—Digestive Organs. Measles 1 1 1 ... ... ... ... 3 Scarlatina 1 8 5 ... ... ... ... 14 Cancrum Oris Diphtheria ... 2 1 ... ... ... ... 3 Gastritis ... 1 ... ... 1 ... ... 2 Quinsy Enteritis .. ... 2 1 ... ... ... 3 Croup 3 3 ... ... ... ... ... 6 Peritonitis ... ... ... 2 1 ... ... 4 Hooping-Cough 10 12 ... ... ... ... ... 22 Ascites ... ... ... ... 1 ... ... 1 Typhus Fever 3 4 5 1 4 17 UIc. of Intestines ... ... ... 1 ... ... ... 1 Erysipelas 1 1 1 ... 1 ... ... 3 Hernia (Rupture) ... ... ... 1 3 ... ... 7 Puerperal Fever ... ... ... ... 1 ... ... 1 Ileus ... ... ... ... 1 ... ... 1 Carbuncle ... ... ... ... ... ... ... ... Intussusception ... ... ... 1 ... ... ... 1 Influenza Fistula Dysentery 1 ... ... ... 1 ... ... 2 Stomach Disease, dec. ... ... ... ... 2 ... ... 2 Diarrhcea 35 25 2 1 1 4 ... 68 Pancreas Disease, &c. Ague ... ... ... ... ... ... ... ... Hepatitis Remittent Fever Liver Disease, &c ... ... ... ... ... 3 ... 3 Rheumatism ... ... ... 1 ... ... ... 1 Spleen Disease, &c. Pyaemia Order 5 —Urinary Organs. Cholera.—. ... ... ... ... ... ... 1 4 Order 2—Enthbtic. Nephritis Syphilis Disease of Bladder Stricture of Urethra.. Nephria (Bright's disease) ... ... ... 3 ... ... ... 3 Hydrophobia Order 3—Dietic. Diabetes Privation Stone Want of Breast Milk 1 ... ... ... ... ... ... 1 Prostate Disease ... ... ... ... 1 4 ... Purpura and ... ... ... ... 1 ... ... 1 Kidney Disease. &c. Alcoholism--Delirium Order 6—Organs of Generation. Tremens ... ... ... 2 1 ... ... 3 „ Intemperance ... ... ... 1 2 ... ... 3 Ovarian Dropsy ... ... ... 1 ... ... ... 1 Lead Poisoning Uterus Disease, &c. ... ... ... 1 ... ... ... 1 Order 4—Parasitic. Order 7—Organs of Locomotion. Thrush Worms, &c Joint Disease, &c. II.—Constitutional. Bones, &c. Order 1—Diathetic Order 8 — Integumentary System. Gout Dropsy 1 6 4 1 12 Phlegmon Cancer 1 1 3 Skin Disease, &c. Mortification 1 ... 2 3 IV.—Developmental Abscess 1 4 Order 1 — Diseases of Children. Order 2—Tubrclr. Scrofula 3 4 ... ... ... ... ... 7 Premature Birth 5 ... ... ... ... ... ... 5 Tabes Mesenterica 19 14 ... ... 1 ... ... 35 Cyanosis Phthisis(Consumptn) 1 3 6 20 16 3 ... 49 Spina Bifida Hvdrocephalus 3 3 1 ... ... ... ... 7 Other Malformations III.—Local. Teething 3 3 ... ... ... ... ... 6 Order 1—Nervous System. Order 2 — Diseases Cephalitis 2 1 1 ... 1 ... ... 5 Paramenia Apoplexy ... ... ... 1 2 6 ... 9 Childbirth ... ... ... 2 ... ... ... 2 Palsy (Paralysis) ... ... ... 2 1 2 ... 5 order 3 - Diseases of old people. Insanity Tetanus ... 1 ... ... ... ... 1 Old Age ... ... ... ... ... 19 11 30 Epilepsy ... ... 2 ... ... ... ... 2 Order 4 —Diseases of Nutrition. Convulsions 17 8 1 ... ... ... ... 21 Chorea ... ... ... ... Atrophy and Debilty 24 1 ... ... ... ... ... ... Brain Disease, &c 1 ... ... 2 ... 1 ... 4 V.—Violent Deaths. Order 2—Organs of Circulation. Order l—Accidents or Negligence. Pericarditis Burns and Scalds ... 1 1 ... ... ... ... ... Aneurism Poison Heart Disease, &c ... ... 1 3 3 5 1 13 Suffocation 3 ... ... ... ... ... ... 3 Phlebitis Violence 1 1 6 4 4 5 ... ... AiiEemia Drowning Disease of Arteries ... ... ... 1 1 ... ... 2 Order 3—Homicide. Order 3— Respiratory Organs. Murder Manslaghtr. Order 4—Soicide. Laryngismus 1 ... ... ... ... ... ... 1 Wounds Laryngitis ... 1 1 ... ... ... 2 Poison Bronchitis ... 5 ... ... 4 5 1 20 Drowning 1 ... 2 ... ... ... ... ... Pleurisy ... ... ... ... 1 ... ... 1 Hanging Pneumonia 6 14 1 4 2 4 ... 31 otherwise ... ... ... ... ... 1 ... 1 Lung Disease ... ... ... 1 ... 3 ... 4 Not specified 1 1 ... ... 1 ... ... 3 Carried Forward 114 106 33 51 47 43 4 398 Grand Total 152 114 44 79 65 80 15 549 * One of these deaths was occasioned by eating indigestible food. BOARD OF WORKS, WHITECHAPEL DISTRICT SIXTH ANNUAL REPORT ON The Sanitary Contrition OF THE WHITECHAPEL DISTRICT, FOR THE YEAR ENDING 28th DECEMBER, 1861 By JOHN LIDDLE, Medical Officer of Health Read to the Board, February 10th, 1862 LONDON; PRINTED BY MEAD & POWELL, 101, WHITECHAPEL, E, AND 73, CHEAPSIDE, EC 1862, SIXTH ANNUAL REPORT For the Year ending 28th December, 1861 Gentlemen, The sixth year of my office as your Medical Officer of Health having recently terminated, I have again the honor of laying before you my Annual Report of the sickness and mortality in your district The returns of the local registrars show that in the course of the fifty-two weeks comprised in the year 1861, the registered births have been 2,686, of which 1,373 are males, and 1,313 are females The deaths during the same period have been 2,331, viz: 1,217 males and 1,114 females, including those of 179 non-residents This is at the rate of 27-2 per 1,000, or one in 37 of the entire population; but if all the deaths (366) which occurred in the London Hospital be excluded from the calculation, then the rate of mortality in the district is 25-2 per 1,000, or 1 in 40 of the entire population In the previous year 2,746 births, and 2,302 deaths were registered; the number of births therefore in this year is less by 60, and that of deaths greater by 29 The deaths from epidemic diseases are 388, which number is an increase of 42 upon that of the previous year Small-pox shows an increase of 7 deaths, scarlet fever and diphtheria of 11, hooping cough of 49, and diarrhcea of 54; whilst the deaths from measles arc less by 54, and those from fever by 5 The deaths from epidemic diseases during this year are in the proportion of 16-2 per cent of the total mortality, whilst in the preceding year the deaths from these diseases were in the proportion of 15 per cent On referring to table No XIII in the appendix, the number of deaths from epidemic diseases in each year since 1856 will be seen; from which table it appears that the deaths from this class of diseases have greatly diminished, viz: from 421 to 346 The greatest mortality from epidemic diseases occurred in 1858, when 498 deaths were registered If the number of deaths under the head of typhus be referred to, it will be seen that from 1856 to the present period, it has been annually less Thus, in 1856 the deaths from fever were 188; in 1857, they were 117; in 1858, 104; in 1859, 93; in 1860, 69; and in 1861 they were 64 This table is further interesting, as showing the increase and diminution of the several epidemic diseases This term includes typhus, typhoid, eutcric, gastric, pythogenic, and low fever The word typhus is derived from a Greek word, signifying stupor, which is only one of the symptoms of the disease Typhoid means "like typhuspythogenic is the term applied by Dr Murchison to typhoid fever, and is derived from two Greek words signifying generated from putrescence 3 Thus, during the year 1856 the deaths from measles were only 12; in 1860 they were 81; and in 1857, the deaths from small-pox were only 3, while in 1859 they were 60 I cannot offer any explanation of the increase of one class of epidemic diseases, and the diminution of another; but, whatever may be the primary cause of any of these diseases, there can be no doubt that, for the most part their effects are intensified by filth, overcrowding, and defective ventilation The bad effects of overcrowding, and of the nonobservanee of other hygienic rules are seen in the large mortality of all the registration districts; but, from the circumstance of so many of the poor, when they are ill, being conveyed either to the workhouse or to the hospital, it is extremely difficult to ascertain in which registration district the greatest relative mortality prevails Of the 2,331 deaths, there were 1,074, or 46-0 per cent of persons under five years of age, and of these, 501, or 21-4 per cent were of infants under the age of twelve months The mortality under five years of age during the preceding year was 1045, or 45-3 per cent of the total deaths It is chiefly amongst the poor that the greatest infantile mortality prevails The laws of health, as regards the bringing up of children, are not alike observed by the rich and the poor During the year, 145 persons died of old age, of whom, 72 were above 80, and of these, one had arrived at the advanced age of 99; and another, at the still more advanced age of 102 It must not, however, be inferred from a few instances of longevity, that a district is healthy, but it is to the smallness of the mortality among young children that the healthiness of any particular district must be inferred; for children of tender years are more susceptible to the influences of impure air than are adults It would also be found, if records had been kept of the number of still-born children, and of premature births, that in those districts where sanitary regulations were the least observed, there would be the greatest proportionate number of such cases There are 63 deaths uncertified by a medical practitioner The number of inquests that have been held during the year is 237 This is an increase of 17 upon the number held during the preceding year The deaths in the workhouse are 287, or 12-3 per cent of the total deaths; those in the London Hospital are 366, or 15-7 per cent of the total mortality in the district The deaths from diseases of the respiratory organs are 460, or 19 per cent The tubercular class of diseases, including consumption, which alone numbers 248 deaths, exhibits a mortality of 391, or 16-7 per cent Violence and accidents of various kinds proved fatal to 214, or 9-1 percent; of these,42 were the result of burns and scalds The cases of illness attended by the medical officers of the union, exclusive of those in the workhouse, were 13,724 Of these, 3,489 occurred during the quarter recently terminated In the workhouse the number of cases of sickness was 2,191; and of these, 527 occurred during the last quarter; the total number of cases therefore that have come under the care of the medical officers of the union during the year was 15,915 During the preceding year the total cases of sickness attended by the medical officers of the union were 13,069, viz: 11,392 among the out-door poor, and 1,677 in the workhouse The births during the last quarter of the year 1861, have been 665, viz: 329 males and 336 females This is in the proportion of 102 females to 100 males The number of females to males being greater is very unusual, for the normal proportion of births of males and females is as 106 of the former, to 100 of the latter The total number of deaths registered in this district during the same period was 556, of which 321 were deaths of males, and 265 those of females, including the deaths of 42 non-residents In the corresponding quarter of the previous year, the registered births were 696, and the deaths 530 The number of births therefore is less by 31, and the number of deaths greater by 26 The deaths from epidemic diseases are 100; of these, 34 are recorded as having been caused by scarlet fever, and 27 by fever; while in the corresponding quarter of the previous year the total number of deaths from epidemic diseases was 81, of which number, 24 were caused by scarlet fever, and 11 by fever The deaths from small-pox have likewise increased (8 against 5) Dr Munk, the Physician to the Small-pox Hospital has kindly forwarded to me a return of the cases admitted into that institution during the last three months; from which it appears that, out of the 49 cases admitted, 13, or rather more than a fourth of the total number were from this district; and recently, three more cases from this district have been sent to the Small-Pox Hospital Notwithstanding all the efforts of the legislature, and the zeal of 4 medical practitioners to promote vaccination among all classes, it is apparent from the notes of the local registrars of deaths, and from the remarks of the medical officers of the union, that vaccination is not universally practised During the quarter, six cases of suicide occurred; two persons put a period to their existence by hanging; two died from self-inflicted wounds of the throat, two destroyed themselves by taking poison, one of them by laudanum, and the other by corrosive sublimate A man killed himself by drinking raw spirits in excess A case of manslaughter is recorded Among the records of death is that of a child having died from the effects of a scald of the glottis from drinking boiling water from a tea kettle A case of death in the London Hospital is thus recorded by a Coroner's jury:—"Diphtheria, caused by severe burns" A man, aged 45, died from inflammation of the lungs, caused by severe injury from the falling of a log of wood on his fingers A death is recorded to have occurred from exhaustion, caused by destitution Erysipelas, occurring after vaccination, is said to have caused the death of a child six months old The number of inquests held during the quarter is 56, of which, 28 were held on persons dying in the London Hospital Several cases of sudden death, occasioned by natural causes, have very properly been made the subject of medico-legal inquiry; but the majority of the deaths on which inquests have been held was on those which were caused by violence The deaths in the workhouse during the quarter are 61, and in the London Hospital 89 In the former-named institution, four deaths from fever occurred; and in the latter, five; of which number two were of non-residents The cases of illness attended by the medical officers of the union were 3,489, exclusive of 527 cases in the workhouse Of these latter, Mr Champneys attended 234, and Mr Richardson 293 The cases of fever have been very numerous, both in and out of the workhouse, 42 having been treated in the workhouse, and 62 among the out-door poor, besides 267 cases of febricula or slight fever Some of these terminated in fever of a serious form: several of the cases of fever, however, which were at first seen as out-door cases, were subsequently admitted into the workhouse, and are therefore recorded twice It is with a feeling of deep regret that I have to announce the prevalence of fever in this district; although fewer deaths from this disease occurred in this district during the year 1861 than in any previous year; yet, in the last quarter they amounted to 27, which is 16 above that of the corresponding quarter of the previous year Fever is at present principally confined to the localities of the poor; a few instances, however, of persons in easy circumstances have died from its effects For the week ending January 25th, five deaths from fever occurred in the workhouse; and the cases, both in and out of the workhouse, still continue to be very numerous The disease is nevertheless of comparatively trifling extent, if we compare the present number of its victims with that in the year ending Lady-day, 1838; when out of a total of 5,312 pauper cases of sickness, 2,134, or nearly one-half, were cases of fever In this number there were included all cases of the disease, whether they were of a mild or severe nature Of these cases 214* died, 82 were sent to the Fever Hospital, and at the time of making up the return, 107 were under treatment It appears from the return furnished by the late Mr John Smith, that the extra expense incurred by the union for fever cases alone, was estimated to have been £400 for one quarter of the year only Those members of the Board who can recollect what was the general sanitary condition of the district about 24 years ago, and more especially the condition of the houses of the poor as regards their filthy and overcrowded state, together with the dirty state of the courts and alleys, and the almost total absence of draina ge in these places, and will compare the sanitary state of the district at that time with that which now exists, cannot fail to notice that a vkst improvement has taken place Although, in order to effect this improvement, large sums of money have been expended, yet the result of the outlay has been most advantageous to the poor, as is evident not only from the diminished rate of mortality among them, but also from the less protracted period of sickness and convalescence of those who recover The benefit of these improvements has not been confined to the poorer classes, but is shared by the rate-payers, who are not now called upon to expend so much of the rates in supplying additional assistance to the sick poor, and in providing for the increased number of widows and orphans, which a severe epidemic of fever always occasions If the sanitary condition of the district had not been improved, it is highly probable that the present epidemic of fever would have been as severe as it was in 1838 * This number does not include all the deaths from fever which occurrcd in the Union, but those only which occurred amongst the pauper population 5 It is the generally received opinion that typhus fever—the disease that in the time of the illustrious Howard was fatal to so many of the prisoners in jail—is occasioned by the emanations of the body in crowded and ill ventilated rooms; and that typhoid, gastric, or pythogenic fever is caused by the emanations of offensive cesspools, and badly constructed drains These last-mentioned sources of disease are frequently not known to exist in houses tenanted by the upper and middle classes of society; bad smells, which are disregarded, frequently pervade the basements, and it is only when disease has attacked one or more members of the family, that upon a diligent investigation being made, an old cesspool is discovered, or the joints of the drain-pipes are found to be imperfectly cemented; or that, if the drains are constructed with bricks, they are discovered to have become dilapidated I have too much reason to believe that, in several instances, where orders have been given to landlords to destroy the cesspool, and to connect the drainage of the house with the main sewer; instead of filling up the cesspool with dry rubbish, a drainpipe has been inserted near the top of it, by which, the more fluid contents only of the cesspool pass away, and it is when bad smells frequently occur, that the cause is sought for, and the offending cesspool detected Although much has been accomplished to improve the drainage of the metropolis generally, and many new sewers have been constructed in this district, yet it must be admitted that much more is required to be done in a similar direction before the system of drainage will be complete Even if all the localities in the district were provided with sewers, yet it would be found that, so long as the present defective mode of constructing the public sewers is persisted in, it would be impossible to prevent their offensive and dangerous emanations from discharging themselves into the public streets and inhabited houses Until all decomposing animal matter is effectually removed from our cities and towns, an occasional outbreak of typhoid fever may be expected; but the more complete our system of drainage shall be made, the less extensive and severe will be the ravages of typhoid fever Dr Murchison says "That typhoid fever is less contagious than typhus, and it is quite independent of the causes which give rise to it; typhoid fever being generated by the putrid emanations from decaying organic (animal) matter Typhoid fever is always more prevalent in autumn, or after a long continuance of hot weather Typhoid fever is not, like typhus, limited to the poor, but is met with among the poor and rich alike Typhoid fever is not confined to overcrowded localities, but appears alike in the most dense, and in the least populous districts of large towns, and even in isolated houses in the country" Dr Budd, of Bristol, states that "The emanations from patients suffering from typhoid fever are infectious, and that the infectious power of the alvine discharges may be destroyed by placing two ounces of chloride of zinc in the night-stool on each occasion before it is used by the fever patient Typhoid fever rarely re-attacks a person who has once suffered from it" The temperature of the atmosphere during the quarter has been rather above the average Mr Glashier, the astronomer royal, in his remarks upon the weather, states that we must travel back to 1831 for an October so warm as the last, and then back to 1811 for a second example The mean temperature of last October was 5° in excess of its average In November the weather was cold On the 18th November, the thermometer was below 32°; but from the 25th, until the 24th of the following month, the weather was warm, when a change again took place, and the 'w eather was cold until the end of the year The variable temperature of the quarter was severely felt by those persons whose delicate constitution could not resist the effects of the sudden rise and fall in the temperature of the air From the returns of the sanitary inspectors, it appears that during the past year 429 cesspools have been destroyed, and the houses which were drained into these receptacles are now drained into the main sewers In almost every instance the sanitary improvements have been carried into effect without obtaining the aid of the Board in instituting legal proceedings Improvements have been effected in the drainage and paving of Inkhorn Court, and Jones' Buildings The houses in George Court, George Street, have been converted into a common lodging-house, and are now under the inspection of the police This court was one of the worst places in the district, and notices were from time to time served upon the owner to cleanse and repair the property, and it is now greatly improved 6 During the last six months, about 70 houses, inhabited principally by the poor, have been pulled down in Swallow's Gardens and its immediate vicinity, owing to the extension of the Blackwall Railway It is estimated that about 700 persons have been compelled to remove from this locality and seek lodgings elsewhere; not, it is to be hoped, in the already overcrowded courts in this district, otherwise, so far from the taking down of houses for the extension of traffic being beneficial to the health of the inhabitants of a district, the reverse will be the case The keeping of pigs is a continually recurring nuisance; notices in six instances have been served upon the owners to discontinue the practice Information was given at the office of the board that, in North Street, the dead body of a child had been kept, during a fortnight, in a room occupied by a family as a living and sleeping room; upon inquiry, the statement was ascertained to be correct, and a notice from the inspector was immediately served upon the father of the child to bury it forthwith, who, in the course of the following day, complied with the order, and had the child buried On referring to Table XII, it will be seen that 43 courts, inhabited by the poor, have been visited by the inspectors, and particulars obtained respecting the drainage, paving, water supply, general condition of the rooms, and how occupied, &c These courts contain 388 houses, in which are 1,076 rooms, and are occupied by 3,132 people From information obtained by the inspectors, it appears that in 68 instances the rooms were indecently occupied, that is to say, adult brothers and sisters, or a father and daughter, slept together in the same room The particulars of each case are recorded in the appendix We may well inquire how such gross indecency, and want of self-respect can exist in this country, which is usually considered to be the centre of civilization, and where so much money is annually expended in imparting religious and moral instruction to the people; yet, such is the state in which many of the inhabitants of this district live, as is ascertained on a house to house visitation It is a common and true remark "that one half of the world does not know how the other half lives" Before, therefore, the existing evils can be remedied, they must first be made known, and it is to be hoped, that in course of time, public opinion will be brought to bear upon the demoralised condition in which so many of our fellow citizens live, that a change for the better will then take place It is not among the " arabs," or vagrants of society only that this indifference to decency is found to exist, but it is also seen among the industrious labouring population, in whom we should expect to find a more general feeling of self-respect When I have pointed out to the respective parents the impropriety of living together in the promiscuous manner above described, I have been told by some it was poverty that prevented them taking two rooms for the family; and by others, that they did not consider it in any way improper for all the members of the same family to live and sleep in the same room As regards the first named plea, it is in every instance, except in cases of illness, inadmissible, for it is surely possible, for adults in health, to earn a sufficient sum weekly to pay for a lodging, notwithstanding the very high rents the poor people pay for their lodgings These high rents are the result of the system adopted by landlords in employing agents, who again employ sub-agents to collect the rents and manage the estate; and also by the expense landlords incur by the wilful destruction of their property by the tenants, and likewise by the loss of rent occasioned either by the dishonesty of the tenants, or by their inability to pay the rent As regards the second plea advanced, viz,—ignorance of the impropriety of all the family occupying the same room by night, as well as by day ; this must be overcome by the lessons of the moralist, and by the instruction of the ministers of religion I have the honor to be, Gentlemen, Your obedient Servant, JOHN LIDDLE 15, Great Alie Street TABLE I SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED For the Quarter ending the 28th day of December, 1861 'From September 30tb to December 28th, 1861, both inclusive Total number of Nuisances removed of every denomination Works in progress but not completed Number of Nuisances inspected in houses or in other Premises Number of Courts visited according to new system Number of Nuisances entered in Complaint Book Summonses taken out Cesspools Notices served Public Privies in Courts, &c, Cleansed For defective Drainage, &c For other Nuisances Destroyed* Emptied j Preliminary Compulsory Total 1,741 108 1,135 23 355 3 5 11 52 314 25 211 * Total number of Cesspools destroyed since the formation of the Board, 3431 TABLE II—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 ending the 28th December, 1861 Names of Medical Officers Small-Pox Measles Scarlatina Hooping Cough Diarrhoea Continued Fever (Typhus andTyphoid) Cholera Erysipelas Pysemia Puerperal Fever Carbuncle AcutePulmonary Inflammations Croup Rheumatic Fever Ague Dysentery Delirium Tremens Diphtheria Other Diseases Total Average number of Fever cases per Week Bronchitis and Catarrh Pneumonia and Pleuritis Mr Blackwell •• 2 9 4 50 6 •• 7 •• •• 1 130 9 i 1 667 887 Mr Champneys 4 4 14 35 27 •• 7 •• •• •• 31 1 1 498 632 Mr Richardson 5 5 25 46 16 •• 5 •• •• 1 31 4 1 i 1 • 708 839 Mr Sequeira 9 2 11 28 48 23 •• 4 •• •• •• 40 10 •• •• 3 •• i •• 956 1131 Total 18 4 29 71 179 62 •• 23 •• •• 2 232 30 2 5 2 i •• 2829 3489 5 Total for the year ending Dec28, 1861 86 70 100 388 1418 109 •• 75 1 i 9 803 104 9 5 18 34 2 10508 13724 2 „ year 1860 65 520 93 83 773 190 i 52 i 9 845 141 3 7 41 28 6 8526 11392 36 ,, ,, 1859 242 179 175 146 209 411 i 73 i 11 609 139 4 •• 14 77 30 1 8469 11701 77 „ „ 1858 20 427 146 230 946 590 •• 70 2 16 1411 210 3 6 16 65 39 1 7507 11718 113 „ „ 1857 6 266 49 150 1324 1441 16 45 •• 2 19 1727 166 9 •• 9 53 28 •• 6231 10708 277 „ „1856 115 71 105 98 898 1929 •• •• •• •• •• •• •• •• •• •• •• •• •• 6284 9897 371 TABLE III—Showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 28th December, 1861 Districts Small-Pox Measles Scarlet Fever Diphtheria HoopingCough Diarrhrea Fever Total M F M F M F M F M F M F M F M F Artillery 0 0 0 0 3 2 0 1 0 0 0 0 3 0 6 3 Spitalfields 0 0 0 0 4 2 0 0 2 2 0 5 3 1 9 10 Mile End New Town 1 2 0 0 4 0 1 0 2 3 4 0 3 5 15 10 Whitechapel North 0 0 o • 0 1 1 0 0 1 1 0 0 0 1 2 3 Whitechapel Church 0 0 0 0 3 3 0 0 0 1 1 1 2 3 6 8 Goodman's Fields 1 0 0 0 3 4 0 0 2 4 0 1 1 3 12 7 Aldgate 2 2 0 1 2 0 0 0 0 0 0 0 1 1 5 4 4 4 0 1 20 12 1 1 7 11 5 7 13 14 55 45 8 1 32 2 18 12 27 100 Deaths from Epidemics for the corresponding Quarter, 1860 5 15 19 5 12 14 11 81 TABLE IV—The Births and Deaths in each Registration District, for the Three Months ending on the 28th December, 1861 Districts Births Total Deaths Total Excess of Births over Deaths Excess of Deaths over Births Remarks M F M F Artillery 17 33 50 16 13 29 21 — Spitalfields 47 53 100 37 48 85 15 — Mile End New Town 94 71 165 84 73 157 8 — Workhouse Whitechapel, N 51 52 103 31 23 54 49 — Whitechapel Church 30 39 69 72 49 121 — 52 London Hospital Goodman's Fields 44 47 91 28 33 61 30 — Aldgate 46 41 87 23 26 49 38 - 42 Non-residents died in Lon Hos Totals 329 336 665 291 265 556 161 52 Excess of births over deaths, deducting the 42 non-residents 151 TABLE V—Showing the Births and Deaths in each District, for the Year ending on the 28th December, 1861 BIRTHS DEATHS Districts April July October December Total April July October December Total Excess of Births over Deaths Excess of Deaths over Births Artillery 70 47 49 50 216 41 30 29 29 129 87 Spitalfields 143 122 117 100 482 121 79 69 85 354 128 Mile End New Town 147 159 158 165 629 186 127 134 157 694 25 Whitechapel, N 118 117 65 103 403 73 66 69 54 262 141 Whitechapel Church Goodman's Fields 65 111 76 103 64 91 69 91 274 396 156 74 117 58 121 66 121 61 515 259 137 241 Aldgate 58 73 68 87 286 49 49 61 549 49 208 78 Totals 712 697 612 665 2686 700 526 556 2331 596 241 Excess of births over deaths deducting 179 nonresidents 534 TABLE VI—Ages at Death in each Registration District, for the Three Months, ending 28th December, 1861 Districts 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 Remarks Artillery 8 10 2 2 2 5 0 29 Spitalfields 16 29 4 10 13 11 2 85 Mile End New Town 28 37 8 21 31 26 6 157 Workhouse Whitechapel, N 15 17 3 4 9 5 1 54 Whitechapel Church 7 20 17 31 29 15 2 121 Hospital Goodman's Fields 12 20 1 9 8 7 4 61 Aldgate 12 9 6 6 8 7 1 49 Totals 98 142 41 83 100 76 16 556 TABLE VII—Showing the Mortality in the Workhouse and Hospitals in the District during 1856, 1857, 1858, 1859, 1860, and 1861 Union Workhouse London Hospital Military Hospital 1856 353 1856 297 1856 0 1857 272 1857 338 1857 2 1858 269 1858 325 1858 1859 239 1859 354 1859 3 1860 282 1860 326 1860 2 1861 287 1861 366 1861 0 TABLE VIII—Showing the total Mortality in the Whitechapel District, without deduction for non-residents, in the undermentioned years Years 1848 1849 1850 1851 1852 1853 1854 1855 1856 1857 53 wks 1858 1859 1860 1861 Mortality 2648 2778 2061 2377 2286 2444 2878 2453 2237 2360 2444 2321 2302 2331 TABLE IX—Showing the Ages at Death in the Workhouse, for the Quarter ending 28th December, 1861 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 1860 Males 34 Females 27 4 1 1 16 19 15 5 61 45 WHITECHAPEL. TABLE X.—Causes of Death at Seven periods of Life, registered in the Whltechapel District, for the Three Months ending 28th December, 1861. 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 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above. Total. 1.—Zymotic. Brought forward 85 126 34 62 78 56 5 446 I.—Miasmatic. IV.—Digestive Organs. Small-pox .. 4 3 1 .. .. .. 8 Cancrum Oris Measles .. 1 .. .. .. .. .. 1 Gastritis Scarlatina 3 13 16 .. .. .. .. 32 Enteritis .. .. .. 1 .. .. .. 1 Diphtheria .. 2 .. .. .. .. .. 2 Peritonitis Quinsy Ascites .. 1 1 2 2 1 .. 8 Croup .. 8 .. .. .. .. .. 8 Ulc. of Intestines .. .. .. .. 1 .. .. 1 Hooping-Cough 4 13 1 .. .. .. .. 18 Hernia (Rupture) .. .. .. 1 .. 1 .. 2 Typhus Fever 1 8 7 3 4 4 .. 27 Ileus .. .. .. .. 1 .. .. 1 Erysipelas 3 .. .. .. 2 1 1 7 Intussusception Puerperal Fever .. .. .. .. 2 .. .. 2 Fistula Carbuncle Stomach Disease, &c. .. .. .. .. 2 .. .. 2 Influenza Pancreas Disease, &c. Dysentery .. .. .. .. 2 .. .. 2 Hepatitis .. .. .. .. 2 3 .. 5 Diarrhœa 3 5 .. .. 2 2 .. 12 Liver Disease, &c. .. .. .. .. .. 2 .. 2 Ague Spleen Disease, &c. Remittent Fever .. 2 .. .. .. .. .. 2 Disease of Rectum .. .. .. .. 1 .. .. 1 Rheumatism .. 1 .. .. 1 .. .. 2 V.—Urinary Organs. Pyæmia II.—Enthetic. Nephritis Syphilis 2 .. .. .. .. .. .. 2 Disease of Bladder Stricture of Urethra Hydrophobia Nephria (Bright's Disease) .. .. .. 1 2 1 .. 4 III.—Dietic. Diabetes Privation .. .. .. .. .. 1 .. 1 Stone Want of Breast Milk 2 .. .. .. .. .. .. 2 Prostate Disease .. .. .. .. .. .. 1 1 Purpura and Scurvy Alcoholism— Delirium 1 .. .. .. .. .. .. 1 Kidney Disease, &c. .. .. .. .. 2 .. .. 2 Tremens VI.—Organs of Generation. „ Intemperance Lead Poisoning Ovarian Dropsy Uterus Disease, &c. IV.-Parasitic. Thrush VII.—Organs of Locomotion. Worms, &c. Joint Disease, &c. .. .. .. 1 .. .. .. 1 2.—Constitutional. Bones, &c. .. .. .. 1 .. .. .. 1 I.—Diathetic. VIII.—Integumentary System. Gout Dropsy .. .. .. .. 1 1 .. 2 Phlegmon Cancer .. .. .. 1 1 4 .. 6 Skin Disease, &c. 4.—Developmental Mortifiaction .. .. .. .. 1 1 1 3 Abscess .. .. .. 1 .. .. .. 1 I.—Diseases of Children. II.—Tubercular. Scrofula 2 2 .. .. .. .. .. 4 Premature Birth 5 .. .. .. .. .. .. 5 Tabes Mesenterica 11 4 .. .. .. .. .. 15 Cyanosis Phthisis(Consumptn) 2 5 1 28 25 7 .. 68 Spina Bifida Hydrocephalus 3 4 .. .. .. .. .. 7 Other Malformations .. 1 .. .. .. .. .. 1 Teething l .. .. .. .. .. .. 1 3.—Local. I.-Nervous tem. II.—Diseases of Adults. Paramenia Cephalitis .. 1 .. .. .. .. .. 1 Childbirth .. .. .. 1 1 .. .. 2 Apoplexy .. .. .. 2 5 4 1 12 III.— Diseases of Old People. Palsy (Paralysis) .. .. .. 2 3 4 .. 9 Insanity Old Age .. .. .. .. .. 11 9 0 Tetanus IV.—Diseases of Nutrition. Epilepsy .. .. 1 .. 1 .. .. 2 Convulsions 14 6 .. .. .. .. .. 20 Atrophy and Debility 6 4 .. .. .. .. .. 10 Chorea 5.—Violent Deaths. Brain Disease, &c. 2 .. .. 2 4 .. .. 8 I.—Accidents or Negligence. II.—Organs of Circulation. Burns and Scalds .. 6 1 1 .. .. .. 8 Pericarditis .. .. .. .. 1 .. .. 1 Poison .. .. .. .. 1 .. .. 1 Aneurism .. .. .. 2 1 .. .. 3 Suffocation l .. .. .. .. .. .. 1 Heart Disease, &c. .. .. 4 8 7 .. .. 19 Violence .. 3 7 4 1 1 19 Phlebitis III.—Homicide. Disease of Arteries Murder and Manslaughter .. .. .. .. 1 .. .. 1 III.—Respiratory Organs. IV.—Suicide. Laryngismus Wounds .. .. .. 1 1 .. .. 2 Laryngitis .. 2 1 .. .. .. .. 3 Bronchitis 15 19 4 9 17 66 Poison .. .. .. 1 1 .. .. 2 Pleurisy .. .. .. 2 1 .. .. 3 Drowning .. .. .. 1 .. .. .. 2 Pneumonia 17 26 .. 4 4 2 .. 53 Hanging .. .. .. 2 .. .. .. 2 Otherwise Lung Disease, &c. .. .. .. 2 1 8 .. 11 Not Specified .. 1 .. .. .. 1 .. 2 Carried forward 85 126 34 62 78 56 5 446 Grand Total 98 142 41 83 100 76 16 556 LONDON HOSPITAL. TABLE XI.—Causes of Death at Seven periods of Life, registered in the London Hospital for the Three Months ending 28th December, 1861. 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 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above. Total. 1. -Zymotic. Brought forward 1 2 9 13 18 7 .. 50 I.—Miasmatic. Small-pox IV.— Digestive Measles Cancrum Oris Scarlatina .. .. 1 .. .. .. .. 1 Gastritis Diphtheria Enteritis Quinsy Peritonitis Croup Ascites Hooping-Cough Ulcer. of Intestines Typhus Fever .. 2 1 1 1 .. .. 5 Hernia (Rupture) .. .. .. 1 .. 1 .. 2 Erysipelas .. .. .. .. .. 2 .. 2 Ileus Puerperal Fever Intussusception Carbuncle Fistula Influenza Stomach Disease, &c. Dysentery .. .. .. 1 .. .. .. 1 Pancreas Disease, &c. Diarrhœa Hepatitis Ague Liver Disease, &c. .. .. .. .. .. 1 .. 1 Remittent Fever Spleen Disease, &c. Rheumatism Disease of Rectum .. .. .. .. 1 .. .. 1 Pyæmia V.—Urinary gans. II.—Enthetic. Syphilis Nephritis Stricture of Urethra Disease of Bladder Hydrophobia Nephria (Bright's Disease) .. .. .. 1 2 1 .. 4 III.—Dietic. Privation Diabetes Want of Breast Milk Stone Purpura and Scurvy Prostate Disease .. .. .. .. .. .. 1 1 Alcoholism—Delirium Tremens Kidney Disease, &c. .. .. .. .. 1 .. .. 1 VI.—Organs of Generation. „ Intemperance Lead Poisoning Ovarian Dropsy IV.—Parasitic. Uterus Disease, &c. Thrush VII.—Organs of Locomotion. Worms, &c. 2—Constitutional. Joint Disease, &c. .. .. • • 1 .. .. .. 1 I.-Diathetic. Bones, &c. .. .. .. 1 .. .. .. 1 Gout VIII.— Integumentary System Dropsy .. .. 1 1 1 .. .. 3 Cancer .. .. .. 2 .. 2 .. 4 Phlegmon Mortification .. .. .. .. 1 1 .. 2 Skin Disease, &c. Abscess .. .. .. 1 .. .. .. 4.—Developmental II.—Tubercular. I.—Diseases of Children. Scrofula 1 .. .. .. .. .. .. 1 Tabes Mesenterica Premature Birth Phthisis (Consumptn) .. .. .. .. 1 .. .. 1 Cyanosis Hydrocephalus Spina Bifida 3— Local. Other Malformations I.—Nervous System. Teething II.—Diseases of Adults. Cephalitis Apoplexy .. .. .. 1 .. 2 .. 3 Paramenia Palsy (Paralysis) Childbirth Insanity III.— Diseases of Old People. Tetanus Epilepsy .. .. 1 .. 1 .. .. 2 Old Age Convulsions IV.—Diseases of Nutrition. Chorea Brain Disease, &c. .. .. .. 2 1 .. .. 3 Atrophy and Debility II.—Organs of Circulation. 5.—Violent Deaths Pericarditis I.-Accidents or Negligence. Aneurism .. .. .. 2 1 .. .. 3 Burns and Scalds .. 4 1 1 .. .. .. 6 Heart Disease, &c. .. .. 3 .. 4 .. .. 7 Poison Phlebitis Suffocation Disease of Arteries Violence .. 2 3 7 4 .. 1 17 III.—Respiratory Organs. III.—Homicide. Murder and slaughter Laryngismus Laryngitis IV.-Suicide. Bronchitis .. .. 1 1 2 1 .. 5 Wounds .. .. .. 1 1 .. .. 2 Pleurisy .. .. .. 1 1 .. .. 2 Poisons .. .. .. 1 .. .. .. 1 Pneumonia .. .. .. .. 2 .. .. 2 Drowning Lung Disease, &c. .. .. 1 .. .. 1 .. 2 Hanging Otherwise Carried forward 1 2 9 13 18 7 .. 50 Not Specified Grand Total 1 8 13 27 28 10 2 89 TABLE XII—Summary of Courts and Places visited by the Inspectors from July, 1861; to the 28th day of December, 1861. Total. Names of Courts or Places. Number op Houses and Rooms, and Number of Inmates when Visited. Courts or Places where Adults of both Sexes were ascertained to be Living and Sleeping in the same room, and Particulars of such Indecent Occupation. Remarks. Number of Houses. Number of Rooms. Number of Inmates 1 Union Court, Fashion Street 11 33 113 1st case. Mother and son, 17 years old, sleeping in same room Rooms average 15 by 18 by 8 2nd do. Father, mother, daughter, 19 years old, and two children ditto 3rd do. Father, daughter, 17 years old, and two children ditto 4th do. Husband, wife, and child, and husband's sister, a grown-up woman, ditto 5th do. Father, daughter, 15 years old, and three children sleeping together 6th do. Husband and wife and wife's father in one room 7th do. Husband, wife, and daughter, 18 years old, sleeping together, ditto 8th do. Ditto ditto ditto ditto ditto ditto 1 Union Place, ditto 3 6 6 No Case of Indecent Occupation. 1 New Court, ditto 15 30 81 1st case. Father, mother, and two grown-up daughters in one room Rooms average 8 by 8 by 7½ 2nd do. Ditto ditto and one grown-up daughter ditto 3rd do. Ditto ditto ditto ditto ditto 1 Rosemary Court, ditto 4 12 13 1st case. Father, mother, and one grown-up daughter in one room 1 Harriott Court, ditto 8 17 42 1st case. Father and daughter, 17 years old, sleeping together 1 Neatsby Court, ditto 8 28 65 No case of Indecent occupation. 1 Crown Court, Glasshouse Street 12 44 160 1st case. Aged mother, three sons, adults, and a child in one room Rooms average 13 by 11 by 7 2nd do. Two men, with their wives and three children, ditto 1 Garden Court, ditto 12 32 88 No case of Indecent Occupation. 1 Providence Court, ditto 8 17 49 1st case. Mother and son, 18 years old, sleeping together 2nd do. Father, mother, mother-in-law, and two children in one room 1 Swan Court, ditto 10 30 75 1 st case. Father, mother, 2 daughters, 18 and 25 years old, and 3 children in one room Room 13 by 10, by 7 1 Hayes Court, ditto 8 24 83 1st case. Two men, with wives and two children, in one room 2nd do. Mother, daughter, 17 years old, and son, aged 18, in one room I Shorter's Rents, ditto 10 30 85 No case of Indecent Occupation. 1 Hobson's Place, Pelham Street 14 35 73 1st case. Brother and sister, 21 and 16 years old, sleeping in one room Rooms average 13 by 12 by 7½ 1 Hobson's Court, ditto 14 39 90 1st case. Mother, son, and daughter, son 16, daughter 15yrs. old, sleeping in one room Rooms average 9 by 10 by 7½ 2nd do. Brother, 17 years old, and sister, 15 years old, sleeping together 1 Rose Court, Blue Anchor Yard 5 15 66 No case of Indecent Occupation. 1 Slaters Court, ditto 10 31 170 1st case. Father, mother, and two sons, 16 and 20 years old, in one room 2nd do. Mother and three sons, 16, 18, and 20 years old, ditto 1 Holloway Court, ditto 9 27 94 1st case. Father and mother, daughter, 20, and two sons, 14 and 22 old, in one room 2nd do. Father and mother, and son and wife ditto 3rd do. Father and mother, son 20 years old, and child ditto 1 Cooper's Court, ditto 14 36 129 1st case. Father and mother, son, 21, and daughter, 20 years old, in one room 2nd do. Husband and wife and wife's sister ditto 3rd do. Father, mother, three daughters, 17, 18, and 20 yrs. old, and a child ditto 4th do. Mother, adult daughter, and son, 15 years old, in one room 5th do. Mother, daughter, 19, and son 20 years old ditto 6th do. Mother, daugher, 19, sibm 17 yrs. old, and a child ditto 1 Kittleby Court, ditto 11 29 113 1st case. Father and mother and two sons, 16 and 18 years old, in one room 1 Russell Court, ditto 10 30 117 No case of Indecent Occupation.  Tewkesbury Buildings, Whitechpl 14 68 136 1st case Father, mother, and adult son, sleeping together Rooms average 10 by 16 by 9 2nd do Father, mother, and two sons, adults, in same room 3rd do Father, mother, mother-in-law, and two children in same room 4th do Husband and wife and brother-in-law ditto 5th do Man, wife, and grown-up daughter sleeping together 7th do Man, wife, and three adult daughters, ditto 9th do Ditto ditto ditto 10th do Father and daughter, 17 years old, slept together 11th do Husband and wife, son, 15 years old, and two children in one room 1 Inkhorn Court, ditto 10 30 138 1st case Man and wife, sister-in-law, 19, servant girl, 14, and 2 children in one room 2nd do Father, mother, and son, 18ears old, ditto 3rd do Mother, son, 18, and two daughters, one 14, yrs old (looking 20; ditto 4th do Mother, with three adult sons, and two daughters, ditto 5th do Mother and son, 25 years old, ditto 6th do Father and mother, two sons, 18 and 20, and daughter, 22 yrs old, ditto 7th do Father and daughter, 20 years old, sleeping together ] Commercial Place, ditto 13 42 99 1st case Father, mother, and daughter, 18 years old, sleeping together Rooms average 10 by 8 by 7½ 2nd do Mother, son, 18 old, and child, also female lodger 25 old, and child, ditto Notice given to Police, the house 3rd do Mother and son, 20 years old, sleeping together Lodging-House Act" I Fann Court, Whitechapel 4 8 17 No case of Indecent Occupation Rooms average 12 by 12 by 8 1 Maria Court, ditto 3 6 7 Ditto ditto Rooms average 10 by 10 by 7 1 Hebrew Place, Middlesex Street 16 36 89 1st case Father and mother and three adult daughters in same room Rooms average 9 by 12 by 8 1 Dinah's Buildings, ditto 12 24 44 No case of Indecent Occupation Room» average 11 by 9 by 8 1 7 20 82 2nd do Mother and son, 26 years old, sleeping together 1 Walton's Court, Lower Aldgate 10 30 89 No case of Indecent Occupation 1 Vine Place, Spitalfields 4 18 27 Ditto ditto Rooms average 11 by 12 by 7 1 Minkie's Court, Royai Mint Street 10 23 70 Ditto ditto Rooms average 12 by 9 by 7 1 Baker's Arms Alley, ditto 7 21 61 1st case Mother, daughter, 17, and two sons, 16 and 18 years old, in one room Room 12 by 9 by 8 1 Windmill Court, ditto 13 39 137 1st case Mother, two sons,14 and 16,and two daughters, 17 and 23 yrs old, in one room 2nd do Father and mother, daughter, 16, and three sons, 21, 23, and 24 old, ditto I 6 18 60 2nd do Mother, daughter, 20, and son, 25 yrs old, ditto 3rd do Mother, two daughters, 15 and 17, and son, 16 years old, ditto ] Orange Place, Charlotte Street 4 15 25 1st case Brother and sister, adults, in one room 1 Rosetta Place, Sandy's Row 7 14 35 No case of Indecent Occupation Rooms average 11 by 10 by 8£ 1 Pool's Place, Quaker Street 8 21 85 Ditto ditto Rooms average 16 by 12 by 7 I Harrison's Court, ditto 4 8 25 Ditto ditto 1 Pope's Head Court, ditto 12 32 63 1st case Father, mother, son, 17, and daughter, 19 years old, in same room 1 New Square, ditto 5 9 27 No case of Indecent Occupation 1 Jefferies Court, Grey Eagle Street 5 9 27 Ditto ditto 1 Brownson'9 Court, Great Alie St 6 12 22 Ditto ditto 1 Bell Place, Mile End New Town 12 26 56 1st case Mother, son, 16, and daughter, 15 years old, slept together The other rooms in this Court were for the most part overcrowded but not indecently so The rooms averaged 12 by 10 by 6£ 43 388 1076 3132 JAMES COWARD, Inspector TABLE XIII—Showing the Deaths from Epidemic Diseases in the Whitechapel District, during the years 1856, 1857, 1858, 1859, 1860, and 1861 1 8 6 • 1 8 5 7 • 1 5 8 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 0 2 4 3 3 8 20 0 6 4 9 5 3 27 1 4 9 3 5 7 99 Spitalfields 3 1 7 15 10 22 58 0 9 9 19 15 10 52 0 24 22 14 15 18 93 Mile EndNewTown 8 1 2 14 18 63 106 0 18 4 6 24 36 88 1 5 24 33 34 38 135 Whitechapel, N 10 3 9 9 11 57 99 1 11 2 20 25 34 93 0 6 18 19 22 22 87 WhitechapelChurch 3 2 6 2 8 20 41 1 2 8 10 14 15 50 1 7 6 7 7 11 39 Goodman's Fields 5 1 5 7 12 9 39 0 8 9 15 29 8 69 0 15 6 25 12 4 62 Aldgate 2 2 12 14 19 9 58 1 6 7 10 27 11 62 1 17 2 16 13 4 53 Totals 31 12 45 64 81 188 421 3 60 43 89 139 117 451 4 78 87 117 108 104 498 TABLE XIII—CONTINUED 1 85 9 1 86 0 18 61 Districts Small-pox Measles Scarlet Fever Hooping-cough Diarrhoea Typhus Total Small-pox Measles Scarlet Fever and Diphtheria Hooping-cough Diarrhoea Typhus Total Small-pox Measles Scarlet Fever and Diphtheria Hooping-cough Diarrhoea Typhus Total Artillery 1 0 8 7 5 4 25 0 2 9 7 1 1 13 0 9 8 7 5 4 26 Spitalfields 20 8 17 8 29 7 89 8 11 17 3 11 11 61 8 6 13 22 19 9 77 Mile End New Town 17 13 8 9 31 33 111 7 8 14 14 23 23 89 7 14 8 18 25 25 97 Whitechapel, N 9 4 15 9 27 9 73 3 16 6 11 9 6 51 0 1 5 16 10 5 37 Whitechapel Church 4 2 13 5 13 16 53 1 4 10 6 5 13 39 3 0 16 5 15 10 49 Goodman's Fields 8 1 26 8 12 12 67 2 17 6 7 12 8 52 1 1 15 17 15 6 55 Aldgate 1 3 9 4 24 12 53 0 23 4 1 6 7 41 9 3 5 13 12 6 48 Totals 60 31 96 50 141 93 471 21 81 59 49 67 69 346 28 27 70 98 101 65 389