84 WHI 10 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT on The Sanitary Condition of THE WHITECHAPEL DISTRICT, for the THREE MONTHS ENDING 29th MARCH, 1862. By JOHN LIDDLE, Medical Officer of Health. Presented to the Board, April 28th, 1862. LONDON: PRINTED BY T. PENNY, 121, LEMAN STREET, WHITECHAPEL, and 9, london terrace, hackney road. 1862. REPORT FOR THE QUARTER ENDING, The 29th MARCH, 1862. Gentlemen, In the thirteen weeks that ended on Saturday, 29th March, there are registered in the Whitechapel District 640 deaths, including 98 in the London Hospital, of which number, 51 are of non-residents, and 38 the result of accident. Of the total number of deaths, there are 331 males and 309 females. The births during the same period are 733, viz., 376 males and 357 females. On comparing the registered numbers of births and deaths with those in the corresponding quarter of the previous year, it appears that the number of births is greater by 21, and that of deaths less by 60. The mean temperature of the air during the quarter was 40.6°, and in the corresponding months of 1861, it was 39.7° or nearly one degree less. The difference of the average temperature of the two seasons will probably account for the smaller number of deaths occurring in the present quarter. The mortality of children under 5 years of age is 240, of which number 124 died before they had completed the first year of their existence. The deaths of persons above 80 years of age are 18, of these, one had reached 92 years, one 94, and another 98. The rate of mortality per cent. of children under 5 years is 38.9, which is a diminution of about 8 per cent. upon that of the corresponding quarter of last year; but this is more than counterbalanced by the mortality of persons between the ages of 5 and 60, being 38.9 per cent. against 34.2 percent. of the preceding year. This increase may perhaps be accounted for by the greater prevalence of 4 fever, which is most fatal at the middle period of existence, the time when the life of man is the most valuable to his family and to society. Although there is a diminution in the rate of mortality of young children over the whole district, yet, in the sub-district of Goodman's Fields, the deaths of children under 5 years are 25 out of 46 or 54.8 per cent. A striking difference is observed in the number of deaths in some of the registration sub-districts when compared with that of the corresponding quarter of last year; thus, in the Spitalfields subdistrict the present return of deaths is only 76 against 121. In the Goodman's Fields it is reduced from 74 to 46. In both of these sub-districts the births have very little varied; in the former they have increased from 143 to 149, and in the latter have decreased from 111 to 100. The diminished number of births and deaths recorded in the Goodman's Fields sub-district may be accounted for by the population having been reduced in consequence of the taking down of more than of 60 houses for the extension of the Blackwall Railway. While the total number of deaths in this quarter is considerably less than in the corresponding three months of last year, (the weekly average being 49.2 against 53.8,) the mortality from epidemic diseases has increased from 83 to 108, of which number, 53* or 49 per cent. are from fever. The week in which the greatest number of deaths from epidemic diseases was registered, was in that ending March 15th, when out of a total mortality of 54 there were 11 deaths from epidemic diseases, of which, 10 were from fever. Small-pox has declined from 13 to 3, measles from 16 to 10, hooping-cough from 26 to 22, diarrhoea from 7 to 3, while scarlet fever and diphtheria have increased from 13 to 16, and fever from 8 to 53. The deaths from diseases of the respiratory organs have decreased from 174 to 142, the mortality from consumption has increased from 61 to 78. Croup was fatal to 11 young persons; six or more than half of these deaths occurred in the sub-district of Aldgate. Disease of the heart proved fatal to 24. Three deaths are attributed to privation, 20 died from mechanical injuries, 12 from burns and scalds, two from accidental drowning, and three from suicide—two of which were from wounds in the throat, the other from taking prussic acid; 10 deaths are registered as having occurred in children prematurely born, of which number, three were born at a single birth; the mother is a poor woman residing in Plough Street; one of these children lived six days, and the other two lived seven days. A Sailor's wife, aged 48, died from lead colic. Two deaths were caused by stricture of the oesophagus or gullet. A child aged 13 months died from spasm of the glottis. Two children died from suffocation in bed. * The deaths from fever during this quarter, although comparatively very numerous, are few when compared with the number of deaths from this disease iu the corresponding quarter of 1838, when the deaths, exclusive of those which occurred among the patients who were removed to the Fever Hospital (and these were very numerous) from this district, and who died in that Institution and whose deaths were recorded in the Islington sub-district, were 141. The deaths from fever for the last quarter of the year 1837, when according to the census of 1831 the population was 64,141, were 155, making, with the 141 deaths of the preceding quarter, a total in six months of 296, or .461 per cent., whereas the deaths from fever during the last six months in a population of 78,964 were 80, or only .101 per cent., or it may be read thus : in the autumn and winter quarters of 1837 and 1838, 46 in 10,000 died from fever, while in the corresponding quarters of 1861 and 1862 only 10 in 10,900 died from the same disease. The annual death rate per cent. from all causes in this district, excluding the deaths in the London Hospital, in the two and a half years ending 31st December, 1839 was 3,552, whereas in the four quarters terminating 30th December, 1861, it was only 2,488 per cent. The total deaths in the six months from 1st July to 31st December, 1837, were 1.450, which is at the annual rate of 4.521 percent. Can any better proof be afforded of the advantages derived from sanitary improvements which since that time have been carried out in this district, the rate of mortality being reduced from 45 in 1000 to 24 in 1000 J 5 The deaths in the Workhouse are 118 against 107 for the corresponding quarter of the previous year. This number is in the proportion of 18.4 per cent. of the total mortality of the district. It is not, however, from this return to be inferred that the Workhouse is unhealthy, for, on perusing a table of the deaths in 1861, prepared by Mr. Craven, one of the Guardians, I find that out of 297 deaths, including 12 still-born children, 117 were resident in the Workhouse for a period of less than a month, of which number, 43 were inmates for four days only—that is they were in a dying state before they came into it—116 remained from 1 to 11 months, and 52 above one year. In the same year there were 107 births, 38 were legitimate, and 69 illegitimate. Of the deaths in the Workhouse, 26, or about 22 per cent. were from fever. It appears from the returns of the Local Registrar that out of these 26 cases, two of the patients came from Wentworth Street, (Nos. 48 and 126), six from Flower-andDean Street, Nos. 1, 2, 7, 20, 36 and 57,; two from No. 8, Lower Keate Street,; one from 24, Luke Street; one from 12, Quaker Street; one from 7, Plough Street; one from 14, Little Halifax Street; one from 13, Blue Anchor Yard; one from 5, Gower's Bow; one from Essex Street; one from 5, Brick Lane; one from 21, Norton Folgate; one from 16, Colchester Street; and one from 4, New Montague Street. The remaining five cases appear to have originated in the Workhouse, and are supposed to have been caused by contagion. It thus appears that fever has existed in each of the sub-divisions of the district, but the greatest number occurred in Flower-and-Dean Street. This Street is densely inhabited by a very low class of society, and it contains several common lodging houses, where "tramps" pass one or more nights whilst migrating from one place to another. Several of these persons were removed from the registered lodging houses to the Workhouse.* I may here observe that so soon as it is ascertained that a lodger in one of these registered houses is taken ill with any of the severe epidemic diseases, he is at once removed either to the Workhouse or Hospital, and the room which he occupied is closed for two or three days, during which time it is lime-washed and ventilated, and the bed clothes and bedding used by such person are cleansed and purified, and in some cases destroyed. It is supposed, and I believe correctly so, that many of these tramps had the premonitory symptoms of fever before they came into this district, but where they inhaled the poison of the disease, it is impossible to ascertain, the parties on their travels having perhaps lodged in several places, for a single night only, before they arrived in this district. It is not known how long the poison of fever remains in the system before it manifests itself. The period of the incubation of fever may be for a few days only, or it may be like small-pox, for a fortnight. In the sub-district of Mile End New Town 33 deaths occurred from fever, 26 of which, as above stated, occurred in the Workhouse. In the sub-district of Whitechapel Church there are recorded seven deaths from fever, of which number, six occurred in the London Hospital. There were five deaths in the Goodman's Fields sub-district, two in the Spitalfields, two in the Aldgate, one in the Artillery, and one in the Whitechapel North subdistrict. On comparing the relative amount of mortality from fever in one district with that in others, it must be borne in mind that different arrangements are made respecting fever cases in the several districts; in some, all the fever cases are sent to the Workhouse, while in others * Seven deaths occurred in the Workhouse, from among those sent from the registered lodging houses, five of which were of persons removed from Flower-and-Dean Street. 6 they are sent to the Fever Hospital. In the Whitechapel District, all the pauper cases are sent to the Workhouse, and hence the comparatively large mortality in the sub-district in which that Institution is situated. The question has been frequently asked, what is the cause of epidemic diseases ? I regret to say that I am unable to answer the question. There is however no doubt in my mind that overcrowding will produce typhus fever, and more especially in those whose constitutions are impaired by insufficiency of food. During the winter, distress and poverty have prevailed to a greater extent than usual among the working classes, many of whom have been unable to procure a sufficient quantity of food to sustain a healthy condition of the system, and have also been without sufficient clothing and fuel to keep the body warm. These persons have consequently herded together in small rooms insufficiently ventilated, and they have thus been poisoned by the emanations of the many persons being crowded together. On visiting some of the houses in accordance with the plan of the house-to-house visitation, it has been ascertained that some families have preferred congregating together at night in a single room, although by renting two rooms they had it in their power to divide the family. The reason alleged for doing so, was, in consequence of the warmth engendered by the whole family sleeping together. It is generally admitted that want of employment and consequent poverty powerfully contributes to the extension of typhus fever, and that a prosperous state of trade, whereby the circumstances of the people generally are improved, tends to lessen the susceptibility of the people to the influence of the disease, and to diminish its fatal effects upon those who are attacked by it. But to what extent meteorological changes in the atmosphere may be productive of diseases in man—in the lower animals—and in vegetables, our present knowledge does not enable us to determine; nevertheless, when a serious epidemic prevails, our most zealous attention in the application of such remedial measures as experience has pointed out to mitigate the sufferings of the patients and to prevent the further spreading of the disease. For these purposes our attention must be directed to the enforcement of the thorough ventilation of the apartment of the sick person, to the recommendation of the use of clean clothing, and of wholesome food and water, to the prevention of overcrowding, and the removal of nuisances, more especially the immediate removal of the excreta of the patient. This last suggestion is of the utmost importance, for the disgusting and nauseating smell which pervades the sick rooms of the poor has a most injurious effect upon all who remain in them, and also upon those who merely enter them for the purpose of rendering advice and assistance, It is probably owing to this cause that medical men, ministers of religion, and relieving officers, are such frequent victims of fever when the disease is extensively prevalent. From the mortality returns it appears that in this district fever has been principally confined to the abodes of the poor,—that hitherto in very few instances has the disease attacked those in comfortable circumstances. But, I regret to say that since the 29th March, the day on which the present quarter terminated, the disease has extended to some houses inhabited by the wealthier classes, and I may observe that it is essentially necessary at all times, but especially at this season of the year, for all persons to cleanse periodically, say every three or four weeks, their cisterns or water-butts; for I am persuaded that much injury to health arises from the use of water which has been long kept in foul tanks. My attention has been on several occasions directed to the filthy state of some of the water receptacles in houses of the poor, and I have directed the Inspectors while visiting these houses to insist upon the periodical cleansing of the water-butts. 7 Cases of sudden death, and deaths occasioned by violence, calling for judicial investigations, have been very numerous, there having been held 69 inquests during the present quarter. The wife of a Cigar Maker, aged 41, died from an "unknown" cause. In this case, although there was no medical attendant, an inquest was not held, neither was an inquest held on a woman who is reported to have died in child-birth, where also there was no medical attendant. There were 13 deaths uncertified by a medical practitioner, amongst these there is one registered as Pertussis, another as Paralysis, and another as Bronchitis ! The cases of sickness among the out-door poor have been very numerous. They are 421 in excess of the number attended by the Medical Officers of the Union during the corresponding three months of the preceding year. The fever cases have amounted to 199, which is an average of 15.3 per week, whereas the number of such cases during the corresponding period of 1861 were only 17, or an average of 1.3 per week. The cases of illness in the Workhouse have been 820, of which number, Mr. Champneys attended 405, and Mr. Richardson 315. The cases of epidemic diseases have been unusually numerous in this establishment during the present quarter. They have amounted to 239, viz., 2 of small-pox, 4 of hooping-cough, 29 of diarrhoea, and 204 of fever. The fever cases therefore are in the proportion to all the other cases of sickness of 25 per cent. The total number of cases of epidemic diseases that were attended by the Medical Officers of the Workhouse in the corresponding quarter of 1861 was 39, of which, 9 only were of fever. Twenty Courts have been systematically visited by the Inspectors. These Courts contain 203 houses, in which are 514 rooms, and have a population of 1367. In addition to the visitation of these Courts, of which a detailed report of each is prepared by the Inspectors and submitted to the Board at each of its meetings; all the houses where fever has existed among the labouring population have been inspected; and in almost every case, orders have been given to the landlords to limewash the rooms and passages. In 18 instances it was found that rooms were indecently occupied, the particulars of each case are recorded in Table VIII. The number of rooms of this description is now greatly diminished, owing to the fact of the visitation being generally known and expected by the landlords, who, to a certain extent, endeavour to prevent their rooms being indecently occupied. Some of the rooms at the time of visitation were densely crowded. In one instance, it was found that only 95 cubic feet of space was allowed to each occupant, and in another the still less space of 79 cubic feet. Under such circumstances, can it be wondered at that ill health prevails! From the report of the Inspector it appears that the inhabitants of Tuson's Court, Spitalfields, are without water— the landlord not having paid the water rate, the water company cut off the supply. The Inspectors hare served 245 notices for sanitary improvements. There have been entered in the complaint book kept by the Inspectors 212 cases of complaint, among which are several of nuisance from the keeping of pigs. In all these latter cases, the nuisance has been removed without any summons having been taken out. A crate of decayed broccoli exposed for sale was seized by the Inspector, and a sample of it taken before the Magistrate at 8 the Worship Street Police Court, who said that it was unfit for food. The broccoli was taken to the Green Yard and buried there. The body of a man who had died from fever was kept for seven days in a room occupied as a day and sleeping room by the surviving members of the family, when, before the interment of the body, a child was taken ill of the same disease. So soon as the Inspector heard of the prolonged retention of the body, an order was served for its immediate interment. The order was complied with. Instances of more than one family occupying a single room have come under the notice of the Inspectors in the course of their house-to-house visitations. In all these cases, information was given to the Police, who caused the landlord either to remove the parties occupying such room, or to register the house as a common lodging house. I am, Gentlemen, j Your obedient Servant, JOHN LIDDLE, 15, Great Alie Street, APPENDIX. TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED For the Quarter ending the 29th day of March, 1862. From the 28th December, 1861, to the 29th March, 1862, 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, &c. Preliminary. Compulsory. Total 1,994 78 1,209 20 212 0 0 19 31 245 13 363 Total number of Cesspools destroyed since the formation of the Board, 3450. Number of houses inspected, 10,017. Estimated length of new Sewers, 14,050 feet. Closets to which water has been laid on or traps and pans furnished, 2407. New dust bins erected, 2126. Houses partly or wholly limewashed, about 4000. Total number of nuisances removed, 48,691. Population in 1831, 64,141; in 1841, 71,87.9; in 1851, 79,756; in 1861, 78,964. 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 March, 1862. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhœa. Continued Fever (Typhus and Typhoid.) Erysipelas. Carbuncle. Puerperal Pever. Acute Pulmonary Inflammations. Croup. Rheumatic Fever. Ague. Dysentery. All other Diseases. Total. Average number of Fever cases per Week. Bronchitis and Catarrh. Pneumonia and Pleuritis. Mr. Blackwell 2 19 6 4 39 19 12 0 0 107 12 0 0 0 1 704 1025 Mr. Champneys 1 0 1 7 29 88 2 0 0 26 4 1 0 0 0 423 582 Mr. Richardson 6 3 1 18 14 21 1 2 0 59 1 1 0 3 4 660 794 Mr. Sequiera 5 20 1 10 58 71 2 0 0 33 7 0 1 4 2 1238 1354 Total 14 42 9 39 140 199 17 2 0 225 24 4 1 7 7 3025 3755 15.3 TABLE III.—Showing the Deaths from Epidemic Diseases in the Whitechapel District, for the Three Months ending on the 29th March, 1862. Districts. Small-Pox. Measles. Scarlet-Fever. Diphtheria. Hooping-Cough 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 1 0 0 0 3 0 0 0 1 1 5 Spitalfields 0 0 2 1 1 3 0 1 2 4 0 0 2 2 7 11 Mile End New Town 1 1 1 0 1 3 0 0 0 3 1 0 22 11 26 18 Whitechapel, North 0 1 0 0 0 0 0 2 1 4 0 0 0 1 1 8 Whitechapel Church 0 0 0 0 0 0 0 2 1 2 0 1 3 4 4 9 Goodman's Fields 0 0 1 1 1 2 0 0 0 1 0 0 0 3 4 7 Goodman's Fields 0 0 0 2 0 0 0 0 0 0 0 1 1 1 3 4 Aldgate 1 2 6 4 4 9 0 5 4 17 1 2 30 23 46 62 3 10 13 5 21 3 53 108 Deaths from Epidemics for the corresponding Quarter, 1861 13 16 12 1 26 7 8 83 TABLE IV.—Showing the Ages at Death in the Workhouse, and in the London Hospital. 0 and under 1 1 and under 5 5 and Under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards Total Males 77 Femls. 41 Corresponding Quarter of 1861. Workouse 7 8 3 5 30 33 12 118 107 L. Hospital 1 6 5 34 32 18 2 Males 66 Femls.32 98 112 TABLE V.—Ages at Death in each Registration District, for the Three Months ending 29th March, 1862. 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 15 3 2 6 8 0 42 Spaitalfields 22 24 3 8 13 4 2 76 Mile End N. Town 30 26 11 34 40 39 13 193 Workhouse. Whitechapel, N. 17 10 3 12 21 8 1 72 Whitechapel Church 17 16 8 40 32 20 3 145 Hospital. Goodman's Fields 15 10 4 8 4 4 1 46 Aldgate 15 15 4 12 12 7 1 66 Totals 124 116 36 116 128 99 21 640 TABLE VI.—The Births and Deaths in each Registration District, for the Three Months ending on the 29th March, 1862. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks. M. F. M. F. Artillery 31 29 60 17 25 42 18 — Spitalfields 79 70 149 35 41 76 73 — Mile End New Town 71 97 168 113 80 193 — 25 Workhouse. Whitechapel, N. 69 60 129 32 40 72 57 — Whitechapel Church 37 25 62 80 65 145 — 83 London Hospital. Goodman's Fields 57 43 100 22 34 46 54 — Aldgate 32 33 65 32 34 66 — 1 51 Non-residents died in Lon. Hos. Totals 376 357 733 331 309 640 202 109 Excess of births over deaths, deducting the 51 non-residents 144. TABLE VII.—Causes of Death at Seven Periods of Life, registered in the Whitechapel District, for the Three Months ending 29th March, 1862. Causes of Death. 0 and under 1 l and under 5 5 and under 20 20 and under 4o 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 79 105 30 90 104 64 1 473 Order 1—Miasmatic Small pox ... 1 1 1 ... ... ... 3 Order 4—Digestive Measles l 8 1 ... ... ... ... 10 Organs. Scarlatina l 7 4 1 ... ... ... 13 Cancrum Oris Diphtheria 1 3 1 ... ... ... ... 5 Gastritis ... ... ... ... ... 1 ... l Quinsy Enteritis Croup ... 9 2 ... ... ... ... 11 Peritonitis ... ... ... 1 ... 1 ... 2 Hooping-Cough 9 12 ... ... ... ... ... 21 Ascites ... ... ... 2 3 ... ... 5 Typhus fever 1 7 6 13 18 8 ... 53 Ulc. of Intestines Erysipelas 2 ... ... ... ... 1 ... 3 Hernia (Rupture) 1 ... ... ... 3 3 1 8 Puerperal fever Ileus ... ... ... 1 1 ... ... 2 Carbuncle ... ... ... ... ... 1 ... 1 Intussusception Influenza Fistula Dysentery Stomach Disease, &c. Diarrhœa ... 2 ... 1 ... ... ... 3 Pancreas Disease, &c. Ague Hepatitis Remittent Fever Liver.Disease, &c. ... ... ... ... 2 ... ... 2 Rheumatism ... 2 ... ... ... ... ... 2 StrictureofCEsopliagus ... ... ... ... 1 1 ... 2 Pyæmia Order 5 — Urinary Organs. Cholera Order 2—Enthbtic Morbus Addisonii ... ... ... ... 1 ... ... Syphilis Disease of Bladder ... ... ... ... ... 1 ... 1 Stricture of Urethra Nephria (Bright's disease) ... ... ... 3 2 1 ... 1 Hydrophobia Order 3—Diktic. Diabetes ... ... ... 1 ... ... ... Privation ... 1 ... ... 1 1 ... 3 Stone ... ... 1 ... ... 1 ... 2 Want of Breast Milk Prostate Disease Purpura and Scurvy Kidney Disease, &c. ... ... ... ... ... 1 ... 1 Alcoholism-Delirium Order 6—Organs of Generation. Tremens ... ... ... ... l ... ... 1 „ Intemperance Ovarian Dropsy ... ... ... ... 1 1 ... 2 Lead Poisoning ... ... ... ... 1 ... ... 1 Utorus-Disease, &c. Order 4—Parasitic. Order 7—Organs of Locomotion. Thrush Worms, &c. Joint Disease, &c. ... ... ... 1 ... 1 ... 2 II —Constitutional. Bones, &c. ... 1 ... ... ... ... ... 1 Order 1—Diathetic Order mentary System. Gout Dropsy ... ... ... 1 ... ... ... 1 Phlegmon Cancer ... ... ... 1 2 2 ... 5 Skin Disease, &c. 1 ... ... ... ... ... ... 1 Mortification ... ... ... ... ... 3 ... 3 IV.—Developmental Order l —Diseases of Children. Abscess ... ... ... ... 1 ... ... 1 Order 2—Tubrclr Scrofula 1 1 ... 1 ... ... ... 3 Premature Birth 10 ... ... ... ... ... ... 10 Tabes Mesenterica 6 7 2 ... ... ... ... 15 Cyanosis 1 ... ... ... ... ... ... 1 Phthisis(Consumptn) 1 ... 5 42 26 4 ... 78 Spina Bifida Hydrocephalus 4 7 ... ... ... ... ... 11 Other Malformations III.—Local. Teething 3 3 ... ... ... ... ... 6 Order 1—Nervous Order 2 — Diseases System. of Adults. Cephalitis ... ... ... ... 1 ... ... 1 Paramenia Apoplexy ... ... ... 3 4 8 ... 15 Childbirth ... ... ... 1 1 ... ... 2 Palsy (Paralysis) ... ... ... 1 2 9 ... 12 Order 2 — Diseases of Adults. Insanity Tetanus Old Age ... ... ... ... ... 17 18 35 Epilepsy ... ... ... 1 2 ... ... 3 Order 4 —Diseases of Nutrition. Convulsions* 19 2 ... ... ... ... ... 21 Chorea Atrophy and Debilty 24 ... 1 ... 1 1 ... 27 Brain Disease, &c. 1 ... 2 2 1 2 ... 8 V.—Violent Deaths. Order l—Accidents or Negligence. Order 2—Organs of Circulation. Pericarditis Burns and Scalds 1 6 4 ... ... ... 1 12 Aneurism ... ... ... ... ... 1 ... 1 Poison Heart Disease, &c. ... ... 1 9 5 8 ... 23 Suffocation 2 ... ... ... 1 ... ... Phlebitis Violence ... 1 ... 11 6 2 ... 20 Anæmia Drowning ... ... ... 2 ... ... ... 2 Disease of Arteries Order 3—Homicide. Order 3— tory Organs. Murder & manslaghtr. ... ... ... ... ... 1 ... 1 Order 4- Sucide. Laryngismus ... 2 ... ... ... ... ... 2 Wounds ... ... ... 1 ... 1 ... 2 Laryngitis ... 2 ... ... ... ... ... 2 Poison 1 1 Bronchitis 15 8 3 3 20 12 ... 61 Drowning Pleurisy Hanging Pneumonia 17 24 2 5 9 ... ... 57 Otherwise Lung Disease ... ... ... 5 9 5 1 20 Not Specified 2 ... ... 1 1 1 ... 5 Carried Forward 79 105 30 90 104 64 1 473 Grand Total 124 116 36 116 128 99 21 640 * Many deaths from convulsions arc caused by the improper administration of Opiates to children, and from foul air. Table VIII Summary of Courts and Places visited by the Inspectors, from December 1861, to the 29th day of March, 1862. Total. Names of Courts or Places. Number of 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. No. of Houses No. of Rooms No. of Inmates 1 Bell Court, Bell Lane 8 18 52 No case of Indecent Occupation. Rooms average 7 by 12 by 7 1 Nelson's Court, Fashion St. 8 13 44 Ditto ditto Rooms average 13 by 13 by 9 1 Hairbrain Ct. Blue Anchor Yd. 12 40 138 Ditto ditto 1 Crown Court, ditto 12 36 122 Ditto ditto 1 Well's Yard Gower's Walk 18 54 142 Ditto ditto Rooms average 11 by 11 by 6½ 1 Montague Court, Whitechapel 5 10 16 At No. 5, on 2nd floor, father, mother, and daughter, 16 years of age slept together Rooms average 9 by 9 by 7½ 1 Ely PL, Mile End New Town 10 26 48 No case of Indecent Occupation.* Rooms average 9 by 11 by 6 * The sleeping room at No. 3. in this Court is overcrowded, but it arises from the parties preferring to do so as they rent the entire house. 1 Swan Yd.,High St ,Whitechpl. 11 33 48 Ditto ditto 1 Chicks and PL., M. E. N. T. 10 20 60 1st case. * Father, mother, 2 daughters (adults) and 3 children sleeping in 1 room. Rooms average 10½ by 9 by 7 2nd do. Mother, (a widow,) son, 20 years old, and 2 adult daughters ditto * 95 cubic feet of space for each occupant. 3rd do. Father, Mother, and 2 adult daughters 4th do. Father, mother, adult daughter, and 1 child 5th do. Ditto ditto ditto ditto 1 Garden PL, Chicks and St. 14 28 83 1st case. Mother, daughter, 24 years of age. & 2 sons, aged respectively 19 & 29 do. Rooms average 10 by 9 by 7 2nd do. Father, daughter 44 years of age, and her 2 sons acred 15 and 18. ditto * 79 cubic feet of space for each occupant. 3rd do.* Father, mother, daughter 17, son 16, and 4 children (8 persons) ditto 4th do. Father, mother, and adult daughter, ditto 5th do. Ditto ditto ditto 1 Well's Place, Gower's Walk 10 22 56 No case of Indecent Occupation. 1 Leman Row, Leman Street 9 24 50 Ditto ditto 1 Hunt Place, Hunt Street 5 20 41 Only one case, viz :—Father, mother, and son 18 years of age ditto Rooms average 14 by 14 by 8 1 John's Place, Hunt Street 11 23 57 1st case. Father, mother, son 17, 2 daughters 14 & 22 yrs. old, & 4 children. do. Rooms average 14 by 8 by 8 2nd do. Father, 2 sons 16 & 19 years old, and daughter 18, ditto 3rd do. Father, mother, and daughter 17 years of age, ditto 1 White Bear Ct., Whitechapel 23 47 108 No case of Indecent Occupation. 1 Davis Buildings 11 22 58 Ditto ditto 1 Charlotte Place, Hunt street 2 6 18 Ditto ditto Rooms average 15 by 11 by 8 1 Ellerm's Place, Spicer Street 8 24 65 Ditto ditto Rooms average 12 by 15 by 5 1 Bracey's Bldgs. B. Anchor Yd. 12 36 116 1st case. Father, mother, and adult son ditto 2nd do. Man and wife, and wife's brother, 19 years of age ditto 3rd do. Husband and wife and husband's mother, ditto 1 Fives Court, Mansell Street 4 12 45 No case of Indecent Occupation 20 203 514 1367 88 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON The Sanitary Condition OF THE WHITECHAPEL DISTRICT, FOR THE THREE MONTHS ENDING 28TH JUNE, 1862. By JOIIN LIDDLE, Medical Officer of Health. Presented to the Board, July 14th, 1862. LONDON: PRINTED BY T. PENNY, 121, LEMAN STREET, WHITECHAPEL, and 9, london terrace, hackney road, 1862. REPORT FOR THE QUARTER ENDING, The 28th JUNE, 1862. Gentlemen, I have the honour to submit to you my Report of the births, deaths, and sickness in the Whitechapel District for the three months ending the 28th June, 1862, together with a statement of the amount of sanitary work performed in the same period. From the returns of the local registrars it appears that 730 children were born in this district, the number of male children was 375, and of female children 355. The deaths were 610, of which number 327 were males and 283 females. In the corresponding quarter of the previous year the births were 697, and the deaths 526. The total deaths in the London Hospital were 69, of which 27 were of non-residents in the district, and 32 were the result of accident or were sudden deaths. The mortality of children under 5 years of age is 250, or 40.9 per cent. of the total mortality; but if all the deaths in the London Hospital (69) are deducted from the total deaths, then the proportion of deaths of children under 5 years is 45.3 per cent. The deaths from epidemic diseases amounted to 172, or 28 per cent. of the total mortality. Out of the 172 deaths from this class of disease, 84, or 48.8 per cent. were caused by fever. The deaths f'rom small-pox were 6, from measles 44, from hooping-cough 15, from scarlet-fever 12, from diphtheria 3, from diarrhoea 8, and from fever 84. Of the last named disease, 49 died in the sub district of Mile End New Town, of which number 41 died in the workhouse, into which institution patients were brought from all the sub-districts. Thus, one case was taken from 16, Wilson's-place, one from 18, Deal-street, two cases from Georgeyard, six from Flower and Dean-street, four from Wentworth-street, one from Diamondcourt, three from Keate-street, one from Blue Anchor-yard, one from Queen-street, two from Chieksand-street, one from Cartwright-street, one from Halifax-street, one from Hollowaycourt, one from Chamber-street, two from Gower's-walk, one from George-street, one from Jones'-buildings, one from Tuson's-court, one from Newcastle-street, one from Plough-street, one from Hope-street, one from Church-lane, cine from Brownson's-court, and five cases originated in the Workhouse. 4 The deaths from diseases of the respiratory organs were 86. The tubercular class of diseases was fatal to 83, of which number 43 died from consumption, 4 from scrofula, 13 from Hydrocephalus (water on the brain), and 23 from mesenteric disease: 29 died from the effects of violence, six persons destroyed themselves, one of them by inflicting wounds on the throat, two by jumping out of window, one by hanging, one by taking poison, and one from a wound in the groin. Two deaths were caused by privation, both at the workhouse, viz., on the 1st March a male aged 35, "sudden death, exhaustion from want of proper necessaries;" on 9th April a washerwoman, aged 40, "violent death, exhaustion from privation, with Asthma." At the London Hospital the death of a widow aged 55 years, from St. George's, is recorded to have occurred from "mercurial salivation." Three deaths occurred from pyæmia in this institution during the quarter. At Royal Mint-street on the 12th May, a refiner at Sir Anthony Rothschild's works, Royal Mint-street, aged 35, "died from the effects of chloroform administered before an operation for fistula." This death was certified by two medical practitioners. At 4, Fieldgate-street, on 20th May, a sugar baker, aged 35 years, "died from coma (10 hours), exhaustion from heat of sugar-house." A female, aged 24 years, died from elephantiasis of the left leg and foot, 15 years duration. A female, aged 43, died from catalepsy. The number of inquests held was 58. Two of them were held on children who were suffocated in bed, in one of these cases the verdict was "suffocation in bed by another child laying across it." A child aged 13 weeks, in the Whitechapel north sub-district is certified to have died a violent death from suffocation in bed. No inquest appears to have been held on this case, while in the same sub-district an inquest was held on a child aged 8 months, who died from measles, when the verdict returned was "sudden death, suppressed measles." A child newly bom was found in the grounds belonging to the London Hospital, the verdict returned was "found dead!" In two cases the verdicts recorded are "sudden, natural causes." An inquest was held on the body of a child aged 2 years, whose death was occasioned by swallowing oil of vitrol. On the week ending 5th April there were 20 deaths recorded in the Miie End New Town District, but the mortality proper to this week was only 15, as five of the deaths formed the subject of inquiry by a coroner's jury, and were not returned to the Local Registrar until a fortnight elapsed after the deaths took place. The deaths uncertified by a medical practitioner in this quarter amount only to 6, while in the corresponding quarter of the previous year they were 11. The uncertified cases of death are principally those of children, and although the number of such cases is comparatively small, yet, from inquiry, I learn that many certificates of death are given by medical pracitioners when they have only seen the patients once. The poor generally are most desirous of obtaining a certificate of the cause of death of their children; they appear to have some idea that they cannot get their children buried without a certificate of the cause of death from a qualified medical practitioner; or they imagine that a certificate of the cause of death will aid them in getting the club money for the burial of the child. It frequently 5 happens that children are prescribed for by druggists, and it is only when the children are in a dying state that they are taken to a medical practitioner. The most common cause assigned for the death of children who have not been attended by a medical practitioner is convulsions. Now, convulsions may be occasioned by the use of opiates, by improper food, by foul air generated in ill-ventilated apartments, and from other causes over which a man of science would have had sufficient control had the suffering child been brought to him in the early stage of the disease, and its life might have been saved; but the struggle for existence among the poor is sometimes so great that mothers have not time, neither have they ability from defective education, to devote sufficient time or skill to the welfare of their infant children. The deaths in the Workhousa were 120, of which 40 or 33.3 per cent. were occasioned by fever. The cases of illness in the Workhouse were 876, of which number Mr. Champneys attended 445, including 14 of diarrhoea, and 182 of fever, and Mr. Richardson attended 448 including 2 of measles, 5 of diarrhoea, and 141 of fever. The deaths from fever in the Workhouse are in the proportion to the cases as 1 to 8. The cases of illness attended by the Medical Officers of the Onion, exclusive of those in the Workhouse, were 3,409. In this number are included 258 cases of fever, 302 cases of Febricula or slight fever, 200 diarrhcea, 113 of measles, and 20 of small-pox. Several cases of fever were removed to the Workhouse from the Common Lodginghouses, especially from those situated in Spitalfields. Upwards of 40 cases are recorded by Mr. Blackwell as having been seen by him in the Common Lodging-houses in his district. Cases of fever are for the most part removed from these Lodging-houses so soon as they are seen by a medical man, thus preventing the possibility of the disease spreading by contagion. The owners of the Common Lodging-houses are liable to a penalty for not giving immediate notice to the police of the existence of any case of fever in them, and in some instances they have been summoned before the Magistrate and been fined for this neglect of duty. Although a great many cases of fever have been removed from these Lodging-houses, it does not follow that the disease is generated in them. They are open to all wanderers who have a few pence to pay for their night's lodging, and many of the tramps who enter them have had the symptoms of fever upon them for several hours, or perhaps days, before applying for admission. These houses are well looked after by the police, and every precaution is taken by them to prevent the spread of any contagious disease. In my last report I stated that the inhabitants of Tuson's Court, Spitalfields, were entirely deprived of water, in consequence of the Water Company refusing to continue any longer the supply, as the landlord had not paid the water rate. I am sorry to say that up to this time, now a period of about four months, the inhabitants have been obliged to obtain water from the neighbouring courts. This circumstance has induced me to draw your special attention to the water Supply as provided generally for the poor of the district. It is impossible to over-estimate the importance to the health, comfort, and moral condition of the inhabitants of large towns and crowded neighbourhoods being supplied with a sufficient quantity of pure water for domestic use. The fact is on record, that, where persons living in the poorer localities of large towns have had an efficient supply of water in the immediate 6 vicinity of their houses, that the health and moral condition of the people have been raised, and I do not hesitate to express a decided opinion, that if all the poor localities were supplied with an adequate quantity of water for washing and for other domestic uses, there would be more personal cleanliness, and a greater feeling of self respect among the people, than now prevails. Many of the poor have been so long accustomed to have a very scanty supply of water, that they make no complaint of it. This is a melancholy feature in the social economy of the poorer classes, who, from not having felt the comfort of cleanliness in their persons and houses, are insensible of the advantages arising from having a constant supply of water. This insensibility is manifested in the dirty condition of their houses and clothes, and it clearly shows that where a good supply of water is most needed, the want of such supply is least felt; and it is amongst this class that if the question be asked, if they have plenty of TVater, although they have only such a supply as is afforded by the flow from a stand tap once a day* for the short period varying from ten minutes to half-an-hour, that they will answer "Oh yes, plenty." The desire among the poorer classes for an abundant supply of water can only be stimulated by the spread of education among them, and by their having more frequent intercourse with persons in a superior position to themselves. The plans now in general use for supplying water to the inhabitants of the poorer localities are for the most part very objectionable. In some places, the water flows from a single stand-tap for a limited period. In. others, the water is received and stored in butts. In some few instances, slate cisterns are provided; while in two or th ree courts only, water is constantly at hand, there being a pipe from the main. This pipe, which is constantly charged with water, is furnished with a kind of valve, which being pressed, the water flows so long as the pressure is continued. This last-mentioned plan of supplying water is the best for the purpose, and the one which ought to be generally adopted : for, by this contrivance a sufficient quantity of water is provided for each inhabitant, and very little runs to waste. The next best plan for providing water for the poor is by tneans of a slate tank or cistern, the tap in which must be so secured as to prevent its being stolen, and the ball tap so placed as to be rendered difficult of access, so that any person attempting to steal it might be readily detected. The slate tank or cistern, being provided with a suitable cover, may be fixed in substantial brickwork and placed, if there be room, in the centre of the court, or if the court be narrow so as not to admit of a tank being erected in it, then the water receptacle may be placed under the pavement of the court, so that by means of a pump being fixed in the tank the inhabitants may have a constant supply of water. As regards the use of butts for storing water, I may state that they are highly objectionable. In the first place they are seldom properly prepared for the purpose; some of them having been formerly used as wine casks or as rum puncheons, and are seldom, if ever, lined with pitch, a dressing of which material ought to be applied every year to any wooden vessel used for the purpose of holding water for domestic use. A proper cover to these butts is fpund to be the exception and not the rule, and from the want of this cover the water soon acquires a layer of soot and dust, the sight of which is so offensive that few persons would be induced to drink it. Butts or cisterns, unless effectually * Formerly the Water Companies supplied water to the inhabitants only three days in the week. It is now supplied every day in the week, with the exception of Sunday. As water is equally necessary on Sundays as on other days, the Companies ought to distribute it daily. 7 covered so as to exclude the impurities of the air in the densely crowded neighbourhood of the poor, ought to be thoroughly cleansed once a fortnight at least, and all receptacles for storing water, even when they are covered and within the houses of the more wealthy classes should be cleansed regularly once every three or four weeks—a practice which I believe is seldom followed. However cheaply the butts, which are placed in the small backyards of the houses occupied by the poor, may be bought, they nevertheless are of some pecuniary value, and the outlay for the purchase of them might be saved if the water were supplied by a pipe from the main. These butts also occupy space, which, in some ot the small yards, can be very illspared. They are frequently leaky,whereby the yard and house are rendered damp; they are in some instances placed in close proximity to the privy, whereby the water is contaminated. The last and most objectionable, and yet the most common mode of supplying water to the courts and alleys in the district, is by means of a stand tap placed in the court. As the water flows from this tap for a very short period every day, with the exception of Sunday, it is necessary for the inhabitants of the court to be at home when the water is turned on, otherwise they must go without a supply, or beg it from their neighbours. If all the inhabitants are at home at the hour when the water flows each person must wait his or her turn for a supply; and when all the inhabitants have filled such vessels as they may be possessed of, the water is kept in their crowded rooms, in which the family wash, cook, take their meals, and sleep; and in which there is frequently a sick person. Water kept in rooms so occupied soon acquires a bad taste, and is quite unfit to be used as a beverage. The use of water so contaminated is not the only evil arising from this mode of supply. Great discomfort and injury to health arise from the water soaking into the earth, which, in those courts that are not paved with a good flag pavement, contains a large quantity of decomposing animal and vegetable matter, and from which noxious exhalations are given off. By this mode of supply, a great waste of water occurs and occasions a very considerable expense to the Water Companies, who are now under the necessity of filtering all the water supplied to houses and manufactories. From what I have above stated, it must not be inferred that no improvement in the supply of water to the public generally has within the last six years taken place; for, by virtue of the Metropolis Water Act, the several Water Companies are now required not only to filter all the water which flows through the mains, but they are required, under certain conditions, to supply water at high pressure. The Water Companies have complied with the requirements of the act, and the two Companies which supply this district have stated to me in writing, that if landlords on their part will make the needful arrangements for giving their tenants a constant supply of water, the directors will immediately do what devolves on the Company in the matter. The question, therefore, of supplying the small tenements with a sufficient quantity of water appears from this statement to rest entirely with the landlords. I am nevertheless of opinion that the Water Companies have it in their power to do a great deal to bring about this desirable result, as they can refuse to supply water to any tenement unless the necessary provisions are made by the landlords to prevent the same running to waste. The local authority can only insist upon the tenements being provided with a proper supply of water, but the mode of supply must be settled between the landlords and the Water Companies. It is probable, however, that under the provisions of the 37th section of the Metropolis Water Supply Act, the Churchwardens and Overseers might insist upon some better mode of supply of water being provided for the smaller tenements than by 8 means of the stand tap; the words used in the section of the Act being a proper supply of water. The water which is now supplied to this district has been much improved in quality since 1881, for, by the analysis then made of the water supplied by the New River Company, the organic impurity was 2,79 grains per gallon, or per 70,000 grains, and that supplied by the East London Company contained 4.12 grains in a similar quantity; whereas the water of the first named Company now contains only 1.32 grains in a gallon, and the latter 1.64 grains. The analysis of the several waters supplied to the inhabitants of London by the Public Companies are periodically made by Dr. R. D. Thomson, and they are published every month by the Registrar General in his weekly returns. The Inspectors have visited 20 courts; the particulars of the Sanitary Condition of each may be seen on reference to table No. VIII. Montague Court has been recently paved; Goodwin's Buildings has been paved, and an improved water supply has been given to the inhabitants. The surface drainage of Wagoner's Buildings has been improved. Six baskets of cherries were seized by Mr. Coward, and were destroyed, the same being unfit for food. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE 15, Great Alie Street. APPENDIX. TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED For the Quarter ending the 28th day of June, 1862. From the 28th March to the 28th June, 1862, 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, &c. Preliminary. Compulsory. Total 2,340 94 1,849 20 660 0 0 7 41 599 11 397 Total number of Cesspools destroyed since the formation of the Board, 3457. Number of houses inspected, 10,017. Estimated length of new Sewers, 14.050 feet. Closets to which water has been laid on or traps and pans furnished, 2414. New dust bins erected, 2146. Houses partly or wholly limewashed, about 4212. Total number of nuisances removed, 51,031. Population in 1831, 64,141; in 1841, 71,879; in 1851, 79,756; in 1861, 78,964. TABLE II.—Cases of Sickness of the Zymotic and Acutc classes, which are recorded in the Books of the Medical Officers of the Union for the Three Months ending the 28th June, 1862. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Continued F'ever (Typhus and Typhoid.) Erysipelas. Carbuncle. Ague. Acute Pulmonary Inflammations. Croup. Rheumatic Fever. Delirium Tremens. Dysentery. All other Diseases. Total. Bronchitis and Catarrh. Pneumonia and Pleuritis. *Mr. Blackwell 1 55 4 9 39 76 4 0 0 61 12 0 1 0 0 631 893 Average number of Fever cases per Mr. Champneys 5 1 2 14 61 72 5 0 0 11 17 1 1 1 0 372 567 Mr. Bichardson 12 24 7 7 52 22 2 0 1 22 1 0 0 1 1 574 726 Mr. Sequiera 23 33 6 5 58 88 1 1 7 15 9 0 0 0 0 1000 1225 Total 20 113 19 35 200 258 12 1 8 109 39 1 2 2 3 2577 3409 19.8 Fight of the cases of Small-pox occurred in children who had not been vaccinated. Two children, aged respectively seven and eight years, had each a second attack of Small-pox, one of whom had been previously vaccinated. Twenty-three cases of Fever are recorded by Mr Blackwell as having been removed to the Workhouse from Flower and Dean-street, during the last quarter; ten of which were from No. 32 (a common lodging-house) in that street. The common lodging- houses, particularly in the district of Spitalnelds. have furnished a very large proportion of the Fever cases Fever has also prevailed extensively in certain localitiesthus, ten cases occurred in Princes-street, eleven in Wagoners buildings, twelve in Halifax-street, five in Garden-place, &c., Typhus Fever appears to have prevailed far more extensively than Typhoid during the last six months;—the first cases occurred in persons out of employment and suffering from the effects of destitution Destitution however alone will probably not engender Typhus Fever; an "atmospheric constitution" spoken of by Sydenham, must be added but about the nature of Which we still remain in ignoranc. When this atmospheric constitution is presen, then it is found that those agents which depress the mind and debilitate the body render the individual suspect of the fcbrile poison. * only forty-seven out seventy-six out seventy-six cases recorded bu Mr. Blackwell, are entered in his Medical Return Book The other cases being immediately sent into the Workhouse, are entered in a separate book. TABLE III.—Showing the Deaths from Epidemic Diseases for the Three Months ending 28th June, 1862. District. Small-pox. Measles. Scarlet Fever. Diphtheria. Hooping-cough Diarrhœa. Fever. Total. Remarks. Artillery 0 7 0 1 3 0 3 14 Spitalfields 0 19 1 1 4 3 9 37 Mile End N. Town 3 4 4 0 2 2 49 64 Workhouse. Whitechapel, N. 2 6 1 0 2 1 9 21 Whitechapel Church 0 2 2 1 1 0 3 9 Hospital. Goodman's Fields 0 5 0 0 2 0 5 12 Aldgate 1 1 4 0 1 2 6 15 Total 6 44 12 3 15 8 84 172 Death from Epidemics for the corresponding quarter, 1861. 2 7 5 1 32 14 13 74 TABLE IV.—Showing the Ages at Death in the Workhouse, and in the London Hospital. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards Total Males 58 Femls. 62 Corresponding Quarter of 1861. Workhouse 9 1 4 25 46 33 2 120 59 L. Hospital 1 4 9 23 1.9 12 1 Males 50 Femls. 19 69 86 TABLE V.—Ages at Death in each Registration District, for the Three Months ending 28th June, 1862. Districts. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under CO 60 and under 80 80 and upwards. Total. Remarks. Artillery 9 17 1 2 0 6 2 37 Spitalfields 24 40 5 4 11 11 2 97 Mile End N. Town 28 21 13 29 59 39 2 191 Workhouse. Whitechapel, N. 18 17 6 14 9 5 3 72 WhitechapelChurch 5 14 10 24 32 18 2 195 Hospital. Goodman's Fields 15 16 1 6 9 8 0 55 Aldgate 10 16 7 12 5 3 0 53 Totals 109 141 43 91 125 90 11 610 TABLE VI.—The Births and Deaths in each Registration District, for the Three Months ending on the 28th June, 1862. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks. M. F, M. F. Artillery 31 35 66 21 16 37 29 — Spitalfields 79 79 158 47 50 97 61 — Mile End New Town 80 90 170 93 98 191 — 21 Workhouse. Whitechapel, N. 68 45 113 43 29 72 41 — Whitechapel Church 36 25 61 72 33 105 — 44 London Hospital. Goodman's Fields 48 42 90 27 28 55 45 — Aldgate 33 39 72 24 29 53 19 27 Non-residents died in Lon. Hos. Totals 375 355 730 127 282 610 195 65 Excess of births over deaths, deducting the 27 non-residents 147 TABLE VII.—Causes of Death at Seven Periods of Life, registered in the Whitechapel District, for the Three Months ending 29th March, 1862. Causes of Death. 0 and under 1 1 and under 5 5 and under 20 20 and under 4o 4o and under 60 60 and under 80 80 and above. Total. Causes of Death. 0 and under 1. 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Total I.—Zymotic:— Brought forward 87 129 33 74 98 50 4 475 Order 1—Miasmatic Small-Pox 1 2 2 ... 1 ... ... 6 Order 4—Digestive Organs. Measles 7 36 1 ... ... ... ... 44 Scarlatina 1 8 3 ... ... ... ... 12 Cancrum Oris Diphtheria ... 2 1 ... ... ... ... 3 Gastritis Quinsy ... 2 ... ... ... 2 Enteritis 1 2 ... ... ... ... ... 3 Croup 1 2 ... ... ... ... ... 3 Peritonitis ... ... 1 ... ... ... ... 1 Hooping-Cough 6 9 ... ... ... ... ... 15 Ascites ... ... 1 ... 2 3 ... 6 Typhus Fever ... 6 7 25 37 9 ... 84 Ulc. of Intestines Erysipelas 1 ... 1 ... ... 1 ... 3 Hernia (Rupture) ... ... ... ... 3 ... ... 3 Puerperal Fever Ileus Carbuncle Intussusception Influenza Fistula Dysentery Stomach Disease, &c. ... ... ... ... 1 1 ... 2 Diarrhoea 1 3 ... ... 2 2 ... 8 Pancreas Disease, &c. Ague Hepatitis 1 I Remittent Fever ... 1 ... ... ... ... ... 1 Liver Disease, &c. ... ... ... ... 2 1 ... 3 Rheumatism ... ... 1 ... ... ... ... 1 Stricture of Œsophagus Pæmia ... ... ...... 3 ... ... ... 3 Order 5 — Urinary Organs. Cholera Order 2—Enthetic. Morbus Addisonii Syphilis 2 ... ... ... ... ... ... 2 Disease of Bladder Stricture of Urethra Hydrophobia Nephria (Blight's disease) ... ... ... ... 2 ... ... 2 Order 3—Dietic. Diabete ... ... 1 ... ... ... ... 1 Privation ... ... ... 1 1 ... ... 2 Stone ... ... ... ... ... 1 ... 1 Want of Breast Milk Prostate Disease ... ... ... ... ... 1 ... 1 Pufpura aud Scurvy ... ... ... ... 1 ... ... 1 Kidney Disease. &c. Alcoholism -Delirium ... ... ... 2 ... ... ... 2 Order 6—Organs of Generation. Tremens „ Intemperance Ovarian Dropsy ... ... ... 1 ... ... ... 1 Lead Poisoning Uterus Disease, &c. ... ... ... 1 1 ... ... 2 Order 4—Parasitic. Order 7—Organs of Locomotion. Thrush 1 ... ... ... ... ... ... 1 Worms, &c. Joint Disease, &c. ... ... ... 1 ... ... ... 1 II.—Constitutional. Bones, &c. ... 1 2 1 ... ... ... 4 Order 1—Diathetic Order 8 — Gout mentary System. Dropsy ... ... ... ... 2 4 ... 6 Phlegmon Cancer ... ... ... ... 3 3 ... 6 Elephantiasis ...... ... ... 1 ... ... ... 1 Mortification ... ... ... ... 1 2 1 4 IV.—Developmental Abscess ... ... 1 2 ... ... ... 3 Order 8 — mentary System. Order 2—Tubrclr. Scrofula 1 1 2 ... ... ... ... 4 Premature Birth 2 ... ... ... ... ... ... 2 Tabes Mesenterica 13 10 ... ... ... ... ...... 23 Cyanosis Phthisis(Consumptn) ... ... 3 23 16 1 ... 43 Spina Bifida Hydrocephalus 2 10 ... 1 ... ... ... 13 Other Malformatious 2 ... ... ... ... ... ... 2 III.—Local Teething 2 4 ... ... ... ... ... 6 Order 1—Nervous System. Order 2 — Diseases of Adults. Cephalitis ... 2 1 1 ... ... ... 4 Paramenia Apoplexy ... ... ... 1 7 4 1 13 Childbirth ... ... 1 ... ... ... ... 1 Palsy (Paralysis) ... ... 1 ... 3 1 ... 5 Order 3—Diseases of Old People. Catalepsy ... ... ... ... 1 ... ... 1 Tetanus Old Age ... ... ... ... 1 20 6 27 Epilepsy Order 4 — Diseases of Nutrition. Convulsions * 21 6 1 ... ... ... ... 28 Neuralgia ... ... ... ... 1 ... ... 1 Atrophy and Debilty 9 ... ... ... 1 ... ... 12 Brain Disease, &c. 2 2 3 3 2 2 ... 14 V.—Violent Deaths. Order 2—organs of Order 1—Accidents or Negligence. Circulation. Pericarditis ... ... 1 ... ... ... ... 1 Burns and Scalds 1 3 2 ... ... ... ... 6 Aneurism ... ... ... 1 1 ... ... 2 Poison ... 1 ... 1 1 ... ... 3 Heart Disease, &c. ... ... 1 7 6 9 ... 23 Suffocation 3 ... ... ... ... ... ... 3 Phlebitis Violence ... 1 1 5 11 10 1 29 Disease of Arteries Drowning Disease of Veins ... ... ... 1 ... ... ... 1 Order 3—Homicide. Murder & Manslaghtr Order 4—Suicide. Order 3—respiratory Organs. Laryngismus Wounds ... ... ... ... 1 1 ... 2 Laryngitis 1 1 ... ... 1 ... ... 3 Poison ... ... ... 1 ... ... ... 1 Bronchitis 8 8 1 1 6 7 2 33 Drowning Pleurisy ... ... 1 1 ... ... ... 2 Hanging ... ... ... ... ... 1 ... 1 Pneumonia 18 18 1 1 3 2 ... 43 Otherwise ... ... 1 1 ... ... ... 2 Lung Disease ... ... ... ... 2 3 ... 5 Not Specified 2 ... ... 1 1 1 ... 5 Carried Forward 87 129 33 90 104 64 1 475 Grand Total 109 141 43 91 125 90 11 610 * Many deaths from convulsions are caused by the improper administration of Opiates to children, and from foul air. Summary of Courts and Places visited by the Inspectors, from 29th march, to the 30th day June, 1862. Total. Names or Courts or Places. Numbers of houses and Rooms. and Numuer 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. No. of Houses. No. of Rooms No. of Inmate* fuson's-court, Middlesex-st. 7 18 48 1st case.—Father, mother, and adult daughter sleeping in 1 room. Rooms average 9 by 9 by 7½ 1 2nd do. Man and wife, also a woman and child ditto As this comes under the Common Lodging House Act it has been reported to the Police. 1 Mason s-ct. High-st M.E.N.T. 8 16 35 Only one case, Father, mother, adult daughter, and child sleeping in 1 room. Rooms average 12 by 12 by 7½ 1 King's Arms-ct., Middlesex-st. 2 8 19 No case of Indecent Occupation. Rooms average 9 by 13 by 7½ 1 Nelson s-ct., Little North-st. 9 20 50 1st case.—Mother, son, (18 yrs. of age) and 2 children sleeping in 1 room. Rooms average 11 by 11 by 7¾ 2nd do. Mother, son, (16 years of age) and 1 child sleeping together. Spratt's-alley, Little North-st. 8 16 45 1st case.—A House consisisting of 2 rooms occupied by 1 family as follows:— Kooms average 12 by 12 by 8 1 Father, mother, and daughter, 20 years of age sleeping in same bed, and 2 sons (17 & 18 years old) and child in another bed, but in same room. (*) See note below. 2nd case.—Father, mother, and son (18 years of age) in one room. 3rd do. Ditto do. do. 20 ditto ditto ) and child ditto. 1 Boundary-court, John-street 4 8 21 Only 1 case, father, mother, daughter, (17 years ot age) and 3 children ditto. Rooms average 12 by 12 by 8 John's-place, Mile End N. T. 13 21 108 1st case.—Brother and sister adults, sleeping together. Rooms average 11 by 9 by 8 1 2nd do. Father, mother, son, 21 years old, and 2 chicken in one room. 3rd do. Ditto do. 16 do. ditto. 4th do. Ditto do. 17 do. ditto. 1 Anns-court, Preston-street 4 12 13 Only 1 case, father, mother, and daughter, 30 years of age sleeping in one room. Rooms average 11 by 12 by 8½ 1 George-court, George-street 6 12 28 No case of Indecent Occupation Rooms average 12 by 11 by 6½ 1 Goodwins-bids., Wentworth-st. 6 12 38 Ditto ditto Rooms average 14½ by 9 by 9 1 Gt.Tongue-yd.,Whitechapl,-rd 10 18 27 Ditto ditto Rooms average 12 by 10 by 7 1 L.Tongue-yd.,WhiteChapel-rd. 4 8 23 Ditto ditto Rooms average 11 by 10 by 7 1 Hampshire-ct.,Whitechapl.-rd 15 37 90 Ditto ditto Rooms average 12 by 9 by 8 1 Swan-court, Mansell-street 6 24 66 Ditto ditto Rooms average 12 by 12 by 7 At Nos 4 & 5, nnlicensed Lodginghouses, notice given to Police. 1 Sugar Loaf-ct. Mansell-street 9 27 70 Ditto ditto Rooms average 12 by 10 by 7 1 Brunswick-pl.,BackChurch-ra. 19 46 92 Ditto ditto Rooms average 12 by 12 by 7 1 Providence-place, do. 7 14 11 Ditto ditto Rooms average 11 by 8 by 6 1 Williams-rents, do. 18 40 58 Ditto ditto Rooms average 12 by 11 by 7 1 Providence-court, do. 5 10 20 Ditto ditto Rooms average 10 by 10 by 8 1 Bond-court, Chamber-street 5 10 13 Ditto ditto Rooms average 12 by 10 by 7 20 Courts 165 514 875 * This room is not only indecently occupied by the whole family as a sleeping apartment, but it is also overcrowded; the room being 12 by 11 by 8, which gives only 176 cubic feet to each person. No steps, however can be taken to prevent the it-decent occupation. This family rents two rooms, both of which, if they liked, could be used as sleeping apart incuts. Expostulation with persons of this class, is generally treated with ridicule. 89 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON The Sanitary Condition of THE WHITECHAPEL DISTRICT, FOR THE THREE MONTHS ENDING 27th SEPTEMBER, 1862. By John Liddle, Medical Officer of Health. Presented to the Board, November 10th, 1862. LONDON: PRINTED BY T. PENNY, 121, LEMAN STREET, WHITECHAPEL, AND 9, LONDON TERRACE, HACKNEY ROAD. 1862. REPORT FOR THE QUARTER ENDING, The 27th SEPTEMBER, 1862. Gentlemen, The total number of deaths in the Whitechapel District in the quarter terminating on Saturday, 27th September, was 631,* viz., 342 males, and 289 females. The births during the same period were 629, of which number, 304 were males, and 325 females. From the fact of the number of deaths having exceeded that of the births, it is probable that many of the latter have not been registered, and I am led to make this remark by observing that in the Aldgate Registration Sub-district, the births, as compared with the deaths, are less by ten, (viz., 64 deaths, 54 births). . This Sub-district is inhabited by a large number of the laboring class of Irish, the majority of whom are in very poor circumstances, who gain a very precarious subsistance by working as occasional laborers in the Docks and by the River Side. At this season of the year, many entire families residing in this Sub-district leave for the county to seek employment in the fields and hop grounds. If a birth occur within a short time of the family leaving home, that birth is seldom registered, and when the family returns, the six weeks has expired in which the birth of a child can be registered, free of expense, consequently) the registration of the birth of such child does not take place. During the other three quarters of the year, the average number of births above that of deaths during the last six years in the Aldgate sub-district has been 20; whereas at this season of the year the births generally fall below the deaths. On comparing the total number of births and deaths during this quarter with that of the corresponding quarter of 1861, it will be seen, that the births have increased 17 in number, and the deaths 82. The deaths in the London Hospital were 70, of which, 36 were of non-residents, and 23 were the result of accident. The chief causes of death during the quarter recently terminated are from diseases of the epidemic class. These diseases have proved fatal to 209 persons; a number greater than that in any previous quarter within the last six years. The nearest approach to this number was in the corresponding quarter of 1859, when the deaths from epidemic diseases were 201, in which were included 114 from diarrhoea. In the quarter now under consideration, the mortality from diarrhoea is * One death (fever) is recorded by mistake in the Aldgate sub-district. This death occurred in the district of Wapping. 4 only 36, while from measles and fever it is respectively 6G and 62. Diarrhoea has been considerably less fatal during this quarter than it was in the corresponding one of the preceding year, when the mortality from this cause was 68. This decrease may be accounted for by the fact of the mean temperature of the air being below that of the corresponding quarter of 1861. The mean temperature of the summer quarter in 1861 was 60'4°, and in 1862 it was 58/7°, or 1.7° less. In the corresponding quarter of 1859, when the mortality from diarrhoea was as above stated 114, the mean temperature of the air was 62.9°. The epidemic class of diseases bears a large proportion to the total deaths; it forms 33.1 per cent. of the total mortality. The mortality from diseases of the lungs, exclusive of consumption, was 76, or 12 per cent. of the entire deaths. This great disproportion between the fatal effects of lung diseases and epidemic diseases, shows that preventible causes of disease are very prevalent in the district,'and notwith standing all the vigilence and attention of the sanitary officers, it is impossible, under the existing state of things, to entirely remove the numerous causes of ill health and premature death. Many of the houses are scarcely fit for human habitation, the same being situated in confined and ill ventilated neighbourhoods; and the only remedy for this state of things is, to pull them down, and wherever such a state of things is found to exist to rigidly enforce the law relating to overcrowding. Notwithstanding the improvements that have been effected in extending the sewerage of the district, the cesspool effluvium has not been removed: many of our principal sewers are great cesslakes, and they emit most noxious gases from the ventilated openings, and from the untrapped gullies. This, in many instances, is owing to the original faulty construction of the sewers in not providing them with a sufficient fall. The sewers have been constructed in detached portions, and no regard has been paid to any general and comprehensive system of sewerage. The only practicable plan therefore of now keeping the sewers free from deposit, and so preventing the generation of noxious gases, is to adopt a regular and frequent system of flushing; so that, the deposit may be removed before it has time to putrify. Although the general sewerage of London may be greatly improved, and local Boards may construct additional sewers, and cause all the houses in their respective districts to be drained into them; and although all the streets and bye-places may be paved, water laid on, rooms limewhited, and an increased number of scavengers employed; all this will be found to be insufficient to improve, in any material degree, the health of the people, and diminish the rate of the general mortality, and especially that of young children under five years of age, unless we obtain the hearty co-operation of the people themselves; and that cannot be obtained, until they are instructed and made to understand and apply the rules of health. The people must be first made to feel the necessity for improvement, and this can only be accomplished by extending practical information among them. To show how little regard some people pay to the observance of cleanliness, I may here mention the following fact which recently occurred in this district: A death from fever having been reported, the room in which the patient died was visited by the inspector, who gave directions to have the same limewhited. When the workman; employed to limewhite the room commenced operations, he found a very large quantity of dirty rags under a bed in the room, in which lay a worn an with a sore leg. It appeared that these rags had been used as dressings for the leg, and they had been allowed to accumulate, no person removing them to the dust heap. These 5 dirty rags were stated to be covered with innumerable maggots, and the stench from the whole mass was intolerable. The limewasher collected this accumulation of filth in a pail and burnt it in the yard at the back of the house. The rent collector, the landlord, and all persons engaged from humane and religious motives, in visiting the abodes of the poor may do a great deal by persuasion towards inducing the inmates to observe personal and household cleanliness. The following fact, as witnessed by Ma. Coward one of the Sanitary Inspectors, induces me to believe that there is a larger proportional amount of destitution in this district than in many others; and if so, it may, in some measure, account for the large number of cases of illness and deaths from fever and other diseases which have for the last nine months occurred in this district. Mr. Coward remarks that he has seen some of the very poor collect the heads of fish which are thrown away at the fish market in Petticoat Lane, and also vegetables and fruit in Spitalfields Market which have been considered by the dealers as unfit for food, and when the persons collecting this refuse from the fish and vegetable markets have been asked for what purpose they were. collecting it, the reply given was to take it home for food. The deaths from diseases of the respiratory organs were 76 against 59 for the corresponding quarter of the preceding year; those from diseases of the organs of circulation were 21 against 15, from tubercular diseases 49, the same number as in the previous year; the deaths from consumption were 44 against 49. The death of a child aged eight months from purpura is recorded, attended with bleeding from the nose and gums. For the week ending August 23rd, the death of a child aged 10 months, son of a cigar maker residing in Tewksbury Buildings, is recorded as having died from debility caused by squalid misery and dirt. In the Workhouse there occurred the death of a female aged 56, "from burns self caused, while of unsound mind." Nineteen persons died from the effects of violence, one from hanging, one from the effects of corrosive poison, but whether the poison was taken accidentally or intentionally with a view to self destruction, is not specified. Five persons were drowned in the river; and five died from the effects of burns and scalds. - One death from pyæmia and one from the effects of lead poisoning occurred in the London Hospital, Scarlet fever and diptheria were fatal to 27 persons; of these cases, seven occurred within a very short distance of each other, viz., at Everard's Place, "Wells Place, and Gower's Row. This locality is not well drained. Three deaths from cholera are recorded; one of which occurred in Underwood Street; respecting this case the medical attendant states that it was a well marked' one of Asiatic cholera. Another occurred at No. 4 Cartwright Street, and was also a decided one of Asiatic cholera; it was attended with rice-water purging, suppression of urine, and collapse. The other ease occurred at Three Tun Alley. Besides the cases of Asiatic cholera, two deaths of children from choleraic diarrhœa are recorded. There were seven deaths from small-pox. The patients for the most part had not been vaccinated. One death however from this disease is recorded as having occurred to a child nine months old who had been vaccinated. 6 The number of inquests was 41. For the corresponding quarter of last year the number was 57. In the Local Registrar's return for Aldgate, for the week ending Saturday 13th September, there is recorded the death of the wife of a bootmaker age 33, said to have been caused by a fracture of the skull on the 28th July, which was followed by compression and suppuration, yet, in this case, an inquest was not held The public is not much enlightened by the following verdict which was retured in two instances "natural causes," the one on the body of a child aged four months, the other on that of a man aged 72 years. The uncertified deaths were nine, viz., two in Spitalfields, one recorded "inanition," the other "consumption"; five in Mile End New Town recorded under the heads of measles, diarrhoea, hooping-cough, and scarlet fever; and two in Aldgate, one of which is registered as measles, the other as "pneumonia!" a classical term for inflammation of the lungs. The deaths of children under five years of age were 320 or 50.7 per cent. of the total mortality. In the Spitalfields sub-district, the proportion of deaths of young children under five was 61.2 per cent.; in the Goodman's Fields sub-district it was 64.7 per cent., and in the "Whitechapel North sub-district it was as high as 67 per cent. The enormous mortality among young children shows that there is a lamentable want of information among a large class of persons respecting the laws of health, and the proper care to be observed in the bringing up of children. The giving instruction to the masses living in the poor localities of this district would afford a large field of usefulness to the members of visiting societies and to other persons who have leisure and inclination for this truly benevolent occupation. The deaths in the "Workhouse were 76, including 16 from fever. Several of the cases of fever were removed into that Institution from the common lodging houses in the district. For the corresponding quarter of last year, the mortality in the Workhouse was 60, including one death from fever. The Medical Officers of the Union have attended 3,600 new cases of sickness, including 16 of small-pox, 243 of measles, 41 of scarlet fever, 548 of diarrhœa, and 234 of fever. The total number for the corresponding quarter of the previous year was 3635, including 12 of small-pox, 6 of measles, 28 of scarlet fever, 864 of diarrhoea, and 12 of fever. There have been 625 cases of illness in the "Workhouse, in this number there are included 13 of measles, 1 of scarlet fever, 37 of diarrhoea, and 115 of fever. Of the total number, Me. Champneys attended 293 and Me. Richardson 332. It appears from Table No. I in the Appendix, that 26 courts have been systematically visited by the Inspectors. Detailed particulars of every inhabited room in these Courts have been prepared, the summary of which may be seen on referring to Table No. X. The particulars required to be filled up are, the description of the Court or Place, its length and width, the number of houses, their state of repair and cleanliness, the number of inhabitants, the state of the pavement, the condition of the drainage, the period of the water supply, the nature of receptacles for water and where situate, the privy accommodation, and whether the privies are supplied with water, the number and state of the dust bins, the complaints of inhabitants (if any), the number of the house, name and address of owner, the number of persons in each room, distinguishing them as males, females, and children, the number of beds in each room, the condition of the back yards, the condition of 7 the cellars and how used. On visiting the houses in low neighbourhoods, it is by no means of unfrequent occurrence to find an adult brother and sister, a father and an adult daughter, a mother and an adult son, occupying the same bed What good citizenship can be expected to be manifested by a class in whom the moral feeling is so low ? The total number of cesspools destroyed since the formation of the Board is 3468. I have no doubt that this removal of filth from the immediate locality has been attended with great benefit to the public health; for, although epidemic diseases have been of late very numerous, yet, it is highly probable that the mortality from these diseases would have been increased had not this essentially necessary sanitary work been accomplished. A larger amount of similar work is still required to be done, before the public can be relieved from the injurious effects of the exhalations from decomposing animal and vegetable matter, which is allowed to remain in the form of lay-stalls and dung heaps, within a short distance of inhabited rooms in confined localities. The provisions of the Nuisance Removal Act must be more rigidly enforced to prevent these health destroying agencies; and on no pretext should dung of any kind be allowed to remain near a dwelling house for a longer period than two or three days. Similar gases are given off from these laystalls to those which are exhaled from cesspools, and they are attended with the like evil results to the public health. On passing by one of these abominable accumulations of filth, the other day, I learnt, that it had been allowed to remain without being disturbed for a fortnight; and I observed the steam arising from the stirring up of this heap, which was being removed, making its way into the neighbouring houses. The system of house-to-house visitation which is still being carried out in this district is attended with very beneficial results in preventing to some extent overcrowding, and in directing the attention of the police to those rooms in which the Inspectors have discovered that more than one family resides; so that the houses so occupied may be brought under the operation of the Common Lodging House Act. In alluding to the work done by the Sanitary Inspectors I may mention, that Mr. Coward made on one occasion a night visit to Tewksbury Buildings, a place chiefly occupied by foreign Jews. It was found that all the basements or underground kitchens were used as dwelling and sleeping apartments—as many as four beds being in one room. The water closets which are in the areas and close to the doors of these rooms were in a filthy condition, and the smell from them pervaded the whole house. In one of these rooms there was discovered a female lunatic. She had neither bed nor bedding, her only covering was filthy rags. The Inspector says that the evils discovered in this place could not have been ascertained by a visit in the day time. Numerous cases of keeping swine have come under the notice of the Inspectors. The swine in every instance have been removed without the necessity of taking out a summons. Queen Ann Street and John Street have been paved, Minke's Court, Rosemary Lane has been closed by an order from the Magistrate in consequence of its being unfit for human habitation owing to its dirty and dilapidated condition. 8 Information was given at the office respecting a dead body having been kept for ten days in a house in Buckle Street. Immediate attention was given to this case, and the body which was much decomposed was removed to the dead-house previous to interment. I recently visited two rooms used as school-rooms at No. 4, Darby Street, in. one of which (the lower) there were crammed 35 boys, and in the room above, 25 girls. The dimensions of these rooms were respectively 15×12×8 and 15×9×7, the former affording only 41 cubic feet for each boy, and the other 37 cubic feet for each girl. In both of these rooms the windows and doors were closed. Notwithstanding the stifling atmosphere of the boy's room, the master said that he had accommodation for eight more in the corner; and he added that if he could not have the room full, he must go to the Workhouse. I need scarcely say that it Would be much more economical to support one man in the Workhouse, than to lay the foundation of consumption and other scrofulous diseases in so many young persons. Tuson's Court, which I alluded to in my last report, has been again visited by me. It is still without any water supply, the same having been discontinued, as I am informed, for a period of two years. Such is now the dirty and dilapidated condition of the place, that unless the landlord improve its sanitary condition, and lay on a proper supply of water, proceedings will be taken to obtain the Magistrate's order to close the entire Court. Complaints have been made at the office respecting a nuisance from a Pickle Manufactory in old Montague Street, and also respecting a nuisance from a house in the Tenter Ground, Spitalfields, in which, bladders are prepared for containing the mixture for sausages. In both these cases, the nuisance has been abated without the necessity of adopting legal proceedings. The nuisance arising from the escape of the vapours from the factory of Sib Anthony Rothschild has been again complained of. It appeared, upon inquiry, that some parts of the apparatus used for condensing the vapours had become worn out. At the time of my visit the apparatus was said to be under repair, and additional condensers were about to be constructed, which, when completed, I trust will be found to be effectual to relieve the neighbourhood from the dangerous effects of the escape of the vapours of sulphuric acid and their diffusion in the atmosphere; and I further trust that the improvements will reimburse Sir A. Rothschild to the same proportional extent as on the first occasion* of Sir Anthony having erected the several condensers for collecting the acid vapours which used to produce the most injurous effects upon the health and property of the neighbourhood. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. 15, Great Alie Street. * Sir Anthony Rothschild stated that he valued the product, or saving effected by his first improvements at about £10 each day the men were at full work This was in 1859. As the neighbourhood is now suffering from the emanations of the refinery premises, it is to be hopecj that no time will be lost in completing the alterations. APPENDIX. TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED For the Quarter ending the 27th day of September, 1862. From the 28th June, to the September 27th, 1862, 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, &c. Preliminary. Compulsory. Total 1,786 59 1,641 26 620 1 0 17 52 676 13 498 Total number of Cesspools destroyed since the formation of the Board, 3468. Closets to which water has been laid on or traps and spans furnished, 2464. New dust bins erected, 2646. Houses partly or wholly limewashed, during the quarter, 612. 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 27th Sept., 1862. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhœa. Continued fever (Typhus and Typhoid.) Cholera. Erysipelas. Acute Pulmonary Inflammations. Croup. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. All other Diseases. Total. Bronchitis and Catarrh. Pneumonia and Pleuritis. Mr. Blackwell - 51 8 12 154 48 - 2 47 10 0 3 1 0 0 538 874 Average number of Fever cases per Weeks. Mr. Champneys 6 34 8 10 136 103 — 4 6 11 - 0 0 0 0 395 714 Mr. Richardson 1 70 16 10 130 15 1 2 11 2 1 0 0 5 0 597 861 Mr. Sequiera 9 88 9 6 128 68 — 2 8 12 0 1 5 2 1 812 1151 Total 16 243 41 38 548 234 1 10 72 35 2 4 6 7 1 2342 3600 18 TABLE III.—Showing the Deaths from Epidemic Diseases for the Three Months ending 27th September, 1862. District. Small-pox. Measles. Scarlet Fever. Diphtheria. Hooping-cough. Diarrhœa. Fever. Total. Remarks. Artillery 0 4 0 0 2 2 2 10 Spitalfields 0 25 3 0 2 7 12 49 Mile End N.Town 5 13 3 0 4 5 24 54 Workhouse. Whitechapel, N. 0 7 8 0 0 8 5 28 Whitechapel Church 0 0 2 1 1 2 3 9 Hospital. Goodman's Fields 0 10 7 3 1 6 7 34 Aldgate 2 7 0 0 1 6 9 25 Total 7 66 23 4 11 36 62 209 Death from Epidemics for the corresponding quarter, 1861. 5 3 14 3 22 68 17 132 Fiye deaths from Cholera are recorded. TABLE IV.—Showing the Ages at Death in the Workhouse, and in the London Hospital. 0 and under 1 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and upwards Total Males 39 Femls. 33 Corresponding Quarter of 1861. Workhouse 7 5 1 14 19 24 2 72 59 L. Hospital 0 7 6 23 20 13 1 Males 45 Femls.25 70 80 TABLE V.—Ages at Death in each Registration District, for the Three Months ending 27th Sept., 1862. 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. Remaks. Artillery 13 4 2 3 5 3 1 31 Spitalfields 22 46 9 11 11 10 2 111 Mile End N. Town 42 38 10 24 26 29 2 171 Workhouse. Whitechapel, N. 31 26 5 10 6 6 1 85 WhitechapelChurch 8 15 9 29 23 14 3 101 Hospital. Goodman's Fields 13 31 6 7 7 3 1 68 Aldgate 14 17 8 11 10 4 0 64 Totals 143 117 49 95 88 69 10 631 Of the tea who died above 80 years of age, two were 92 years of age, one 88, one 87, one 86, two 85, and one 84. TABLE VI.-The Births and Deaths in each Registration District, for the Three Months ending on the 27th September, 1862. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths oyer Births. Remarks. M. F, M. F. Artillery 24 21 45 14 17 31 14 - Spitalfields 63 69 132 54 57 111 21 — Mile End New Town 64 69 133 96 75 171 — 38 Workhouse. Whitechapel, N. 49 56 105 48 37 85 20 — Whitechapel Church 30 36 66 61 40 101 — 35 London Hospital. Goodman's Fields 46 48 94 30 38 68 26 — Aldgate 28 26 54 39 25 64 — 10 36 Non-residents died in Lon. Hos. Totals 304 325 629 342 289 631 81 83 Excess of births over deaths, deducting the 36 non-residents 34. TABLE VII.—Vaccination Extension Act—Whitechapel Union—for the Year ending September 29th, 1862. Names of the whole of the Public Vaccinators of the Union. Vaccination Districts. Number and Ages of Persons Vaccinated by the Public Vaccinators. Number of such cases successfully Vaccinated. Number of Registered Births of all classes during the Year, including the Workhouse and the whole of the Parishes in the Union. Unsuccessful Cases. Under One Year. Above One Year. Total. Under One Year. Above One Year. Total. Thomas S. Blackwell Christchurch 174 10 184 174 10 184 539 0 James Edmunds Old Artillery Ground 314 14 328 314 14 328 221 0 Alex. M. Champneys Mile End New Town 165 18 183 165 18 183 636 0 Edward Richardson Whitechapel North 422 43 465 408 41 449 450 16 C. T. Blackman Whitechapel Church 273 19 292 273 19 292 258 0 H. L. Sequeira Goodman's Fields 283 60 343 279 60 339 375 4 C. E. Jenkins Aldgate 59 2 61 58 2 60 278 1 Totals 1690 166 1856 1671 164 1835 2757 21 For the Year ended September 29th, 1861 1956 243 2199 1933 235 2168 2717 31 „ „ 1860 2015 400 2415 2004 398 2402 2754 13 TABLE VIII.—Causes of Death at Seven Periods of Life, registered in the Whitechapel District, for the Three Months ending 27th Sept., 1862. Causes of Death. 0 and under 1 I and under 5 5 and under 20 20 and under 40 4o and under 60 60 and under 80 80 and above. Total. Causes of Death. 0 and under 1. 1 and under 5 5 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Total. I.—Zymotic:— Brought forward 117 167 44 81 67 35 1 512 Order 1- Miasmatic Small-Pox 2 2 2 1 ... ... ... 7 Order 4—Digestive Measles 9 54 3 ... ... ... ... 66 Organs. Scarlatina ... 18 1 4 ... ... ... 23 Cancrum Oris Diphtheria ... 4 ... ... ... ... 4 Gastritis Quinsy ... 2 1 ... ... ... ... 3 Enteritis 1 ... ... 1 ... ... ... 2 Croup 1 6 1 ... ... ... ... 8 Peritonitis ... ... ... ... 2 1 ... 3 Hooping-Cough 4 6 1 ... ... ... ... 11 Ascites ... ... ... ... 1 2 ... 3 Typhus Fever 1 5 15 19 17 4 1 62 Ulc. of Intestines Erysipelas 1 1 ... ... ... 1 ... 3 Hernia (Rupture) ... ... ... 1 1 3 ... 5 Puerperal Fever Ileus Carbuncle Intussusception Influenza Fistula ... ... ... 1 ... ... ... 1 Dysentery Stomach Disease, &c. Diarrhœa 18 14 ... 1 ... 3 ... 36 Pancreas Disease, &c. Ague ... ... ... ... 1 ... ... 1 Hepatitis Remitted fever ... Liver Disease, &c. ... ... ... 1 3 1 ... 5 Rheumatism ... ... ... ... ... 1 ... 1 Stricture of CEsophagus Pyæmia ... ... ... ... 1 ... ... 1 Order 5 Urinary Organs. Cholera 1 ... 1 ... 1 2 ... 5 Order 2- Enthetic Morbus Addisonii Syphilis 1 ... ... ... 1 ... ... 2 Disease of Bladder ... ... ... ... ... 3 ... 3 Stricture Stricture of Urethra Nephria (Bright's disease) ... 1 ... 2 2 1 ... 6 Hydrophobia Diabetes ... ... ... 2 ... ... ... 2 Order 3—Dietic. Prostste Diesease Want of Breast milkPrivation Kidney Disease &c. Purpura and Scurvy 1 ... ... ... ... ... ... 1 Alcoholism-Delirinum Pyelitis ... ... ... 1 ... ... ... 1 Tremens ... ... ... 3 ... ... ... 3 Order 6—Organs of Generation. „ Intemerance ... ... ... 1 ... ... ... 1 Lead poisoning ... ... ... 1 ... ... ... 1 Ovarian Dropsy Order 4-parasitic. Uterus Disease, &c. ... ... ... ... 1 ... ... 1 Thrush 3 ... ... ... ... ... ... 3 Order 7—Organs of Locomotion. Worm, &c. II.- Constitutional. Joint Disease, &c. Order 1- Diahetic Bones, &c. Gout Order 8 — Mentary System. Dropsy ... 1 1 1 3 2 ... 8 Cancer ... ... ... 2 4 2 ... 8 Phlegmon Mortification ... 1 ... 1 3 2 ... 7 Elephantiasis Abscess ... 1 1 ... ... 1 ... 3 IV,—Developmental Order 2- tuberclr. Scrofula 1 1 ... 1 ... ... ... 3 Order l —Diseases of children. Premature Birth 2 ... ... ... ... ... ... 2 Tabes mesenterica 23 11 1 ... ... ... ... 37 Cyanosis Phthisis(Consumptn) ... 3 4 27 8 2 ... 44 Spina Bifida Hydrocephalus 4 5 ... ... ... ... ... 9 Other Malformatious III.- Local. Teething 5 3 ... ... ... ... ... 8 Order 1- Nervous System. Order 2 — Diseases of Adults. Cephalitis 1 1 ... 1 ... ... ... 3 Paramenia Apoplexy ... 1 ... 1 4 1 ... 7 Childbirth Palsy (paralysis) ... ... ... 1 1 5 ... 7 Order 3—Diseases of Old People. Catalepsy Tetanus Old Age ... ... ... ... ... 18 8 26 Epilepsy ... 1 1 2 ... ... ... 4 Order 4 —Diseases of Nutrition. Convulsions ... 5 ... ... ... ... ... 26 Neuralgia Atrophy and Debilty 15 1 ... ... ... ... ... 16 Brain Disease, &c. 1 1 1 2 2 ... ... 7 V.—Violent Deaths. Order 2—organs of Circulations Order l—Accidents or Negligence. Pericarditis ... ... 1 1 ... ... ... 2 Burns and Scalds ... 4 ... ... 1 ... ... 5 Aneurism ... ... ... 1 ... ... ... 1 Poison Heart Disease &c. ... ... 2 2 10 4 ... 18 Suffocation Phlebitis Violence ... 1 2 4 7 4 1 19 Disease of Arteries Drowning ... ... 3 1 1 ... ... 5 Disease of veins Order 3—Homicide. Order tory Organs. Murder & Manslaghtr. Order 4—Suicide. Laryngismus Wounds Laryngitis ... 2 ... ... ... ... ... 2 Poison ... ... ... ... 1 ... ... 1 Bronchitis 2 8 2 4 3 3 ... 22 Drowning Pleurisy 1 ... ... ... 1 ... ... 2 Hanging ... ... ... ... 1 ... ... 1 Pneumonia 21 13 5 2 5 1 ... 47 Otherwise Lung Disease ... ... ... ... 2 1 ... 3 Not Specified 3 ... ... ... ... 1 ... 4 Carried Forward 117 167 44 81 67 35 1 512 Grand Total 143 177 49 95 88 69 10 631 30th June, to the day of 27th Sept., 1862. Total Name of Courts or Places No. of Houses NO. Of Rooms No. of Inmates 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. 1 Grigg's Court 10 30 94 1st case.— Father, Mother and son 16 years of age. sleeping in same room. Rooms average 12 by 12 by 8. 1 Enock's Court 6 18 42 No case of indecent occupation. Rooms average 14 by 9 by 8. Vine Yard, Spitalfields 8 27 67 1st case,—Man, wife and daughter, 16 years old, in same room. Rooms average 12 by 10 by 8. In case No. 3 there averages only 149 cubic feet lor each person. 1 2nd case.—Man, wife, and wife's sister, an adult, with one child, in same room 3rd case.—Mother, daughter, son in-law, and two children in same room. 1 * Crown Court, Little Pearl Street. 7 16 44 1st case.— Man, wife and two daughters, respectively 18 & 20 years of age. sleeping in same room. Rooms average 11 by 12 by 8.* 1 † Racbaels Court, Royal Mint Street 10 23 74 1st case—Mother, daughter on-in-law sleeping in same room. Rooms average 8 by 8 by 7. † 1 Charles Court. Whitechapel 10 18 29 No case of indecent occupation. Rooms average 8 bv 7 by 7 1 Wentwortn Court, East 10 20 44 Ditto ditto Rooms average 9 by 11 by 8. 1 Wentworth Court, West 10 20 39 1st case.—Two brothers and two sisters, aged respectively 22, 19, 18, and 16 years, sleeping in same room, the father and mother sleeping down stairs. The Inspector was laughed at by the mother when remonstrated with on the subject. Rooms average 9 by 11 by 8. 1 Miller's Court, Dorset Street 6 12 21 No case of indecent occupation. Rooms average 12 by 9½ by 9. 1 Drum Yard 8 23 46 Ditto ditto Rooms average 10 by 12 by 8. 1 New Court, Dorset Street 3 9 16 1st case —Father, mother, and daughter, 19 years of age, sleeping together. Rooms average 9 by 15 by 9. 1 Barleymow Court 8 24 69 No case of indiacent occupation. Rooms average 12 by 10 by 8. Canterbury Court, Phœnix Street. 9 18 48 1st case —Father, mother, daughter, 18 years old, and two children, sleeping in same room. Rooms average 12 by 12 by 7. 1 2nd case.—Father, mother, daughter, 20 years old, in same room. 3rd case —Father, mother, daughter, 21 years old, and three children in same room. 1‡ Conant's Place, Whitechapel 11 22 75 No case of indecent occupation Rooms average 10 by 9 by 8. ‡ 1 Everard's Place, Whitechapel 20 83 151 Ditto ditto Rooms average 9 by 8 by 8. Wood's Yard, E. & W. Phoenix St. 7 14 46 1st case.—(West Court) Father and daughter, 14 years old, sleeping together. Rooms average West 12 by 16 by 8. 2nd case.— „ Father, mother, and two sons, 14 and 16 years old in one room. Ditto East 11 by 11 by 7. 3rd case.- „ Mother and son, 16 years old, sleeping together. At No, 3 West Court, a room was found let out to lodgers, not being registered. l 4th case.—(East Court) In a room averaging 11 by 11 by 7, six persons lived and slept; the same giving 141 cubic feet for each. The family consisted of father, mother, two sons, 15 and 20 years old, and two daughters 14 and 18. 5th case —Father, mother, two daughters, 15 and 16 years old, and one child in same room. l Friendly Buildings 12 24 58 No case of indecent occupation. Rooms average 12 by 10 by 8. 1 Mundy's Place 10 20 42 Ditto ditto Rooms average 12 by 10 by 8. Elizabeth Place, Middlesex Street 3 9 27 1st case.—Mother and son 21 years old sleeping in one room. Rooms average 18 by 12 by 8½. l 2nd case.—Mother and son 16 years old and two children in one room. 3rd case.—Mother with two sons and a daughter, adults ditto 1 Horse Shoe Alley 7 14 36 No. case of indecent occupation. Rooms average 8 by 12 by 8½. Little Love Court 5 24 49 1st case.—Father, mother and son 20 years old, sleeping in same room. Rooms average 18 by 9 by 8½ At No. 3a room was found under- let for lodgins, not being registered. 2nd case.—Ditto do, and daughter 23 years old, ditto l 3rd case.—Mother and son, 40 years old, sleeping in same room. 4th case.—Mother, son, 28 years old, and daughter 19, ditto 5th case.—Father, mother, and two sons, 20 and 15 years old ditto l Vine Court, Whitechapel 15 68 121 No case of indecent occupation. Rooms average 12 by 14 by 8. l Charlotte Court 40 137 263 1st case.—Father, mother, three sons, 11, 13 and 15 years old, and two daughters 7 and 18 years old in one room. Rooms average 11 by 8 by 8. Hunt Court, Hunt street. 8 32 158 1st, case —Brother and sister, 18 and 19 years old, and four children slept in same room. Rooms average 18 by 9 by 8. 2nd case —Father, mother, daughter 15 years old and four children ditto 3rd case.—Ditto ditto and son 7 years old and one child ditto 1 4th case.—Ditto ditto 18 years old, and three children ditto 5th case-Ditto ditto 17 years old 6th case —Mother, daughter 17 years old, son 15 years old, and one child ditto 1 Sarah's Place, Hunt Street 5 15 23 No case of indecent occupation, Rooms average 10 by 9 by 7½ 25 248 720 1682 * In a house in this Court on ground floor 8 persons, all one family, slept in one room, averaging 125 cubic feet to each person. † This Court has been closed by order of the Magistrate, the same being unfit for human habitation. ‡A man and wife with 7 children slept in one room in this Court, giving only 80 cubic feet to each person. 90 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT on The Sanitary Condition of THE WHITECHAPEL DISTRICT, For the Year ending 27th December, 1862, by JOHN LIDDLE, Medical Officer of Health. PRESENTED TO THE BOARD, 9th FEBRUARY, 1863. London: PRINTED BY MEAD & POWELL, 101, HIGH STREET, WHITECHAPEL, And 73, Cheapside. 1863. SEVENTH ANNUAL REPORT, For the ending 27th December, 1862. Gentlemen, In conformity with my "usual practice at this season of tlie year, I submit to you, in addition to my Quarterly Report, a statement of the sickness and mortality of the District during the year terminating on the 27th December, 1862, a period embracing fifty-two weeks. It appears, from the official returns, that in the last quarter of the year the total number of births was 721, viz., 367 males and 354 females; and the deaths 670, viz., 355 males and 315 females. The Sub-Districts, in which the births have exceeded the deaths, are the Artillery, Spitalfields, Whitechapel North, and Goodman's Fields, while in the Sub-Districts of Mile End New Town, Whitechapel Church, and Aldgate, the deaths have exceeded the births. The total mortality in this quarter far exceeds that of any of the corresponding quarters of the preceding six years, the average mortality in each of which is 567, while in the quarter now under consideration the mortality is 670, or 103 in excess of such average, or at the rate of 8 per week. In the corresponding quarter of last year the total mortality was 556, the increase in the mortality, therefore, of this quarter over that of the corresponding one of last year is 114, which is an increase on an average of 8.7 per week; and, as we have no reason to believe that the population has increased, we are led to the conclusion that the season has been unusually unhealthy. The greatest mortality (65) occurred in the week ending November 15th, when for that week the mean temperature of the air was 37.3°, which is a very low temperature for this period of the year and may account for the excess of mortality. The mean temperature of the air for the quarter was 45.6°, and for the corresponding quarters of the four preceding years it was respectively 44.0°, 43.1°, 42.8°, and 46.4°. All parts of London appear, from the Registrar General's Report, to have suffered equally with Whitechapel a larger amount of mortality; the deaths in the entire metropolis having increased from 15,866 for the quarter ending Christmas, 1861, to 17,717 for the corresponding quarter of 1862. The chief causes of death have been diseases of the epidemic class; 169 persons having fallen victims thereto. The returns show that 17 died from small-pox (six of whom had not been vaccinated; of the others there is no 4 record as regards vaccination). I cannot too strongly impress upon the minds of all persons engaged in vaccinating children the importance of attending to the rules laid down for properly performing the operation of vaccination. From the returns of the Small-pox Hospital (which I need scarcely say are of undoubted authority) it appears that the mortality from small-pox is in the inverse proportion of the number of well-formed cicatrices; thus, if four good cicatrices are apparent not one person in 100 attacked will die of the disease; but in those having only one imperfect or indistinct cicatrix one in every eight or nine attacked will die. In those unvaccinated, including adults and children, the mortality is 35 per cent; but of children under 5 years of age it is 50 per cent. The mortality among the vaccinated, including all, whether well or indifferently vaccinated, is from 7 to 8 per cent. It is of the utmost importance to the well-being of the public, as regards the immunity from small-pox, that every child should be vaccinated in at least 4 places* at or about the age of 3 or 4 months; and, in order still further to extend the benefits of vaccination to all the children born in the district, a list of the births with their residences should be given to the public vaccinator by the district registrar once a month or oftener, so that the parents of such children who are likely to neglect the duty of having their children vaccinated might be called upon by the district vaccinator, who, if he obtained the consent of the parent or guardian of the child, might at the time of his visit vaccinate the child. As many poor persons cannot afford the time to take the child after vaccination to the public vaccinator for inspection some pecuniary inducement might with propriety be held out to those to whom time is of importance. The deaths from measles were 33; from scarlet fever 29 ; from diphtheria 1; from hooping cough 15; from diarrhoea 22; and from fever 52. In the corresponding quarter of last year the deaths from epidemic diseases were 100. Diseases of the lungs proved fatal to 103; consumption was fatal to 72; diseases of the heart to 29; and tubercular diseases to 37. The deaths arising from accidents or negligence were 35, of which 14 were caused by burns or scalds, 19 from violence, 2 from suffocation in bed, and 1 (a child 8 months old) from poison. In this last-mentioned case an inquest was not held, the cause of death having been certified to have been from" diarrhoea, accelerated by, if not wholly originating in, arsenical paper-hanging." The death of a child, aged 8 months, is recorded to have been caused by erysipelas after vaccination. This is the second death from this cause during the past year. Two children died from small-pox at the early age of 17 days. In my report for the quarter ending March, 1861, a death is recorded to have ensued from * The returns of the Small Pox Hospital show that 80 per cent of the patients admitted had been previously vaccinated. Many of the patients have been imperfectly vaccinated. 5 small-pox in a child at the still eai-lier age of 14 days. In these cases it is probable that the children received the poison of small-pox before birth, as a period of 14 days elapses from the time of imbibing the poison of small-pox to the appearance of the eruption. The death of a labouring man, aged 20, took place in the London Hospital from chloroform during amputation of the leg. A female, aged 20, died in the same institution from a ligature of a venous ncevus. The death of a man, aged 50, was caused by exhaustion after the removal of the upper jaw. Three deaths occurred in the district from pyoemia, and 3 from alcoholism or from the effects of drink. The number of inquests held during the quarter is 57. This is one more than in the corresponding quarter of 1861. In the records of the Coroner's Inquests there is one record of wilful murder of a newly-born child—one of suicide, by oxalic acid, of a man, 53 years of age—of another suicide by hanging—and of a death from the want of the necessaries of life. The deaths in the workhouse were 69 against 61 for the Christmas quarter of 1861. Of these deaths there were 7 from fever, 2 from measles, and 1 from diarrhoea. The uncertified deaths were 14. One was recorded as scarlatina—one as disease of the heart—and the others as convulsions and premature birth. The mortality per cent of children in the entire district, under 5 years of age, in relation to the total mortality was 45.9. In the Whitechapel North Sub-District the mortality under 5 years was 69.9 per cent. The Medical Officers of the Union attended 3,506 new cases of sickness, including 63 of small-pox, of which 15 had not been vaccinated, 12 had been vaccinated, and of 36 there is no record, 125 of measles, 49 of scarlet fever, 41 of hooping cough, 197 of diarrhoea, and 131 of fever. Diarrhoea has been more prevalent than usual; the cases attended by the Medical Officers being 197 against 179 for the corresponding quarter of last year, and the deaths 22 against 12. The cases of small-pox have increased from 18 to 63. The return of cases of disease by the Medical Officers of the Union gives but an imperfect idea of the prevalence of any particular disease, as it is next to impossible to obtain a return of the cases of sickness attended by private medical practitioners; I have, however, been favoured by Dr. Munk witl^a return of the persons attacked with small-pox in this district who were admitted into the Small Pox Hospital, from which it appears that the number was 19, of which 1 died. For the corresponding quarter of the preceding year the number admitted from this district was 13. The number of cases of sickness in the workhouse was 657, including 4 of small-pox, 5 of measles, 2 of scarlet fever, 1 of hooping cough, 23 of diarrhoea, and 121 of fever. Of the total number, Mr. Champneys attended 318, and 6 Mr. Richardson 339. In the corresponding quarter of the*previous year the total number of cases of sickness in the workhouse was 527; Mr. ChampneyS having had under his care 234, and Mr. Richardson, 293. The number of births registered in the year was 2,813, of which 1,422 were males, and 1,391 females. The deaths were 2,551, viz., 1,355 males and 1,196 females. The deaths of non-residents were 162; the excess of births over deaths, excluding the deaths of non-residents, was 424. The deaths exceeded the births in the Mile End New Town, Whitechapel Church, and Aldgate Sub-Districts. It is highly probable that, from the several causes which I have alluded to in my former reports, all the births are not registered. The deaths during the year 1862 have exceeded the number in the preceding year by 220, viz., 2,551 against 2,331; the mortality, therefore, has increased upon an average of 4 every week. Of the total deaths there were 658, or 25'7 per cent, from epidemic diseases, of which 251, or 38 per cent, were from fever. The proportion of deaths *from epidemic diseases is larger than has occurred in any year since the formation of your Board. If we take the total deaths which have been caused by the whole class of zymotic diseases during the year, and calculate the per-centage of deaths from them in relation to the total deaths, we shall find that they are 28.6 per cent. In the quarter ending March the deaths from zymotic diseases were 125, in that ending June 185, in the Michselmas quarter they were 231, and in the Christmas quarter they were 191. Total in the year 732. In 1858 (the most unhealthy, until now, of the last seven years) the total mortality was 2,444, and the deaths from zymotic diseases were 537, or 21.9 per cent of the total deaths. During the year 1861 the proportion of deaths from zymotic diseases was only 20'4 per cent, the total mortality being 2,331, and the deaths from zymotic diseases 476. The excessive mortality which has occurred during the last 12 months has not been confined to this district, but has prevailed all over the metropolis.* Of the epidemic diseases it appears that fever has been the most fatal, 251 persons having died from it during the year. The deaths from smallpox have likewise been very numerous, viz., 33; measles has been particularly fatal, 153 young persons having died from this cause. The average number of daaths annually from measles is 48, that from small-pox is 26. Owing to the diminished temperature of the summer months diarrhoea was not nearly so fatal as usual at this season, the average number of deaths from this disease being 106 annually, whereas during the year 1862 the deaths from this cause were only 69. The group of diseases next in order to that of zymotic diseases as regards its * It appears from the return of the Registrar-General, that 65,001 died in London in 1861, and 66,950 in 1862; of these there died of fever respectively 1,754, and 3,635. The mortality from fever in London in 1860 was only 1,302, or 35-5 per cent, less than in 1862.—See Tahle XII. 7 amount of mortality is that of the respiratory organs. The deaths from this class, exclusive of consumption which is arranged under the tubercular class, were 408 or 15.9 per cent, of the total mortality. Consumption was fatal to 237. Violence and accidents of various kinds proved fatal to 159, or 6.2 per cent, of the total deaths; of these 37 were the result of burns and scalds. The excessive use of alcoholic drinks proved fatal to 9 persons; this number gives but a very imperfect idea of the numerous victims to the degrading vice of intoxication—many of the deaths arising from accident are attributable to this cause, as are also many fatal diseases, such as diseases of the liver, brain, and kidneys. The deaths in the workhouse were 372 or 14-5 per cent, of the total mortality in the district, or, in other words, it may be said that 1 in every 7 of the total deaths occurred in the workhouse. The deaths from fever in the workhouse were 89, viz., 26 in the quarter ending March, 40 in that ending June (when the total mortality in that institution was 120), 16 in the following quarter, and 7 in the Christmas quarter. Of the total deaths in the workhouse the fever cases formed 23.9 per cent. The total deaths in the workhouse during the preceding year were 287; the excess of deaths, therefore, in the workhouse during the past year is 85. The deaths in the London Hospital were 330 including those of 162 non-residents. The deaths of children under 1 year of age were 498 or 19.5 per cent, of the total mortality. The deaths under 5 years of age were 1,118 or 43.4 per cent of the total deaths, and from the age of 60 and upwards 300 died, which is 11.7 per cent, of the total mortality; of these only 50 or 1.9 per cent, had reached their 80th year. The deaths of children, under 1 year old, are in relation to the births (2,813) as about 1 in 6 or 17.7 per cent.; under 5 the mortality is 39.7, or, in other words, out of every 1,000 born 397 die annually before they are 5 years old, and 177 die within a year after their birth. This is more than 3 per cent above the proportion in all England. If we compare the number of deaths of young children under 5 years of age with the entire population of all ages in the district (78,970) it will be seen that 14 die annually out of every 1,000 of the population. This mortality, however, varies in the several Sub-Districts, as may be seen on referring to Table No. X., the lowest (Goodman's Fields) being 10, and the highest (Mile End New Town) 17 in every 1,000. In order to draw a just comparison, as regards infant mortality, between the several Sub-Districts in relation to the sanitary condition of the localities we must be acquainted with the exact number of children in proportion to the adults in each district; the wealth and poverty of the districts must also be considered, for, although an excess of infant mortality is generally taken as a proof of a defective sanitary condition of a place, the peculiar circumstances of each locality must be known before we can 8 arrive at just conclusions upon the subject. During the last year it appears that in the Whitechapel District out of every 1,000 of the population 32.3 died; but if we deduct the deaths of the non-residents (162) then the deathrate is reduced to 30.2 in every 1,000 or 1 in 33 of the entire population.* The births are in proportion of 35 per 1,000 or 1 in 28 of all living. The death rate for all England is 22.3 per 1,000, and the birth rate is 33'1 per l,000.f The number of inquests held during the year was 225 against 237 in the preceding year. The uncertified deaths are 42 against 63. In a district like this, where such facilities are afforded to the poor for obtaining medical assistance, very few uncertified deaths ought to be recorded, and every such case, before it is registered, ought to be inquired into; and more especially is a searching investigation into such cases required at the present time when child murder is of frequent occurrence. The uncertified deaths are chiefly of young children. Mr. Castleden, the registrar for the Eastern Sub-Districts of Mile End Old Town, informs me that out of 730 deaths registered by him only 2 are returned as "not certified," and 1 of these he distinctly recollects as being a "chemist's case." If the uncertified deaths in this district were in the same proportion as those in the Eastern Sub-District of Mile End Old Town instead of being 42 they would be only 7. The Medical Officers of the Union have attended, exclusive of the 2,978 in the workhouse, 14,270 new cases of sickness, including 113 of small-pox, 525 of measles, 118 of scarlet fever, 153 of hooping-cough, 1,085 of diarrhoea, and 822 of fever. During the preceding year the total number of the cases of sickness was 13,724 of which 109 were of fever. I may here remark that the pauper list of sick cases in this district has been annually increasing from 9,897‡ in 1856 to the large number of 14,270 in 1862. In the total number of cases of sickness in the workhouse, viz., 2,978 there are included 763 or 25.5 per cent, of fever. In the month of September last all the slaughterhouses in the district (37 in number) were inspected by myself and the inspectors previous to the owners of such premises applying for the annual license. The amended Metropolis Local Management Act, 25 and 26 Vict., c. 102, section 93, enacts that all cowhouses shall be licensed annually. In order, therefore, that the Board should be satisfied that all the cow-houses in the district were in a proper sanitary condition they were inspected by Committees of the Board, and in all cases, where the pavement, drainage, ventilation, &c., were defective, orders were given that these defects should be remedied. The penalty for keeping cows, * In the Eastern Districts of London the average number living to one death annually is 39; in all London it is 42. + In all London the birth-rate is nearly 34 per 1,000 annually. ‡See Table No. 2. 9 without a license is not to exceed £5 for each ofTence. The number of licensed cow-houses in the district is 35, of which 22 are on the north and 13 on the south side. The total number of cows is 396. The smallest space for each cow in any cow-house where more than 1 cow is kept is 240 cubic feet, and the largest is 2,933 cubic feet. The dimensions of each cow-house and the number of cows kept in each are given in the Tables Nos. 1 and 2 in the Supplemental Appendix to this Report. A return of 133 courts in the district has been made by the Inspectors, showing the number of houses in each court and the number of inhabitants, the mode of water-supply and the length of time the water flows in those courts when the supply is intermittent. From this return it appears that out of the 133 courts there are 48 which contain 388 houses, and have a popular tion of 3,233, in which the water-supply is by stand-taps only, from which the water flows daily (Sundays excepted) for a period varying from a quarter to half-an-hour. Complaints are frequently made by the inhabitants of the scarcity of water, and it must be obvious to everybody who considers the important question of water-supply to the poor that this intermittent supply is totally inadequate to the wants of the people. I am, however, glad to find that by the 67th clause of the last amended Metropolis Local Management Act, it is provided that, "In any case if it shall appear to any Yestry or District Board that the existing supply of water to any house would be sufficient for such house if the same were inhabited by a less number of persons, but is insufficient by reason that the same is inhabited by numerous persons (beingmore than a single family), it shall be lawful for such Yestry or District Board to give notice in writing to the occupier of such house requiring him, within a time specified, to obtain such further supply (not exceeding a supply at the rate of 30 gallons * per day for each person) as shall to them appear necessary," &c. The quantity of water above what is required for the domestic purposes of the tenants of each house might be advantageously used by its being allowed to run through the drains for the purpose of keeping them clear of deposit. Impi-ovements in the mode of supplying water to the inhabitants have been effected in the undermentioned courts:—King's Arms Court, Farm Court, Maria Court, Marlborough Court, Inkhorn Court, Commercial Court, Vine Place, Osborne Plaee, Mason's Court, Goodwin's Buildings, Wentworth Court West, Wentworth Court East, Little Love Court, Great Tongue Yard, Shorter's * Thirty gallons of water daily for each inhabitant appears a very large amount, but if we take into consideration that the water-closets require several gallons daily to keep them clean, and that a considerable quantity is also necessary for cleansing the court and houses, as well as for washing and other domestic purposes, the quantity is not too large. 10 Rents, Drum Yard, and Cherubim Court. In some of these courts there is a constant supply of water from the main, and in others tanks or cisterns are provided. The water-butts, which are very generally used, are highly objectionable, being for the most part old and unprovided with a proper cover. I am in great hopes that before the issuing of my next report a great improvement will be made in the water supply of the district; for, as the watercompanies are not bound to supply water to any premises where the waste of it exists or is likely to occur from the defective state of the apparatus provided for its reception, I shall urge them to insist upon landlords complying with the Act of Parliament, and providing proper cisterns, so that the inhabitants in all the courts in the district shall have a constant supply of water. All the stand-taps, therefore, which now exist in the district, will, I trust, be speedily abolished, and proper cisterns erected in their stead. The Inspectors have systematically visited and reported upon the sanitary condition of 17 courts during the last quarter, and on 82 during the currency of the whole year. I am, Gentlemen, Tour obedient Servant, JOHN LIDDLE. 15, Great Alie Street. APPENDIX TABLE I. SUMMARY OF INSPECTIONS MADE AND WORKS EXECUTED For the Quarter ending the 31st day of December, 1862. From the 27th September to the 31st December, 1862, 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 Nuisanccs. Destroyed. Emptied, &c. Preliminary. Compulsory. Total 1,642 43 1,310 17 681 4 3 3 43 462 17 511 Total number of Cesspools destroyed since the formation of the Board 3471. Closets to which water has been laid on or traps and pans furnished 2,490. New dust-bins erected 2,670. Houses partly or wholly limewashed during tho quarter 410. This large number of houses limewhited has been occasioned by the prevalence of Fever and other Epidemics occurring in 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 27th December, 1862. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping Cough. Diarrhoea. Continued Fever, (Typhus and Typhoid.) Cholera. Erysipelas. Pyaemia. Puerperal Fever. Carbuncle. AcutePulmouary 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. Black well 21 29 10 10 55 36 .. 6 .. .. 1 90 19 .. 5 .. .. .. .. 579 861 Mr. Champneys 12 27 14 8 43 23 .. 2 .. .. .. 17 7 1 1 .. 1 .. .. 514 670 Mr. Richardson 2 23 15 2 41 33 .. 3 .. .. .. 19 1 1 1 .. .. .. .. 661 802 Mr. Sequeira 28 46 10 21 58 39 .. 6 .. .. .. 25 10 •• 2 3 3 1 •• 921 1173 Total 63 125 49 41 197 131 •• 17 •• •• 1 151 37 2 9 3 4 1 .. 2675 3506 10 Total for the year ending Dec.27,1862 113 525 118 153 1085 822 1 56 .. .. 4 557 135 9 16 24 21 4 .. 10627 14270 15.8 „ year 1861 86 70 100 388 1418 109 .. 75 1 1 9 803 104 9 5 18 34 2 .. 10492 13724 2.0 „ „ 1860 65 520 93 83 773 190 1 52 .. 1 9 845 141 3 7 41 28 6 .. 8534 11392 3.6 „ „ 1859 242 179 175 146 1209 411 1 73 .. 1 11 609 139 4 .. 14 77 30 1 8379 11701 7.7 „ „ 1858 20 427 146 230 946 590 .. 70 .. 2 16 1411 210 3 6 16 65 39 1 7520 11718 11.3 „ „ 1857 6 266 49 150 1324 1441 16 45 .. 2 19 1727 166 9 .. 9 53 28 .. 5398 10708 27.7 „ 1856 115 71 105 98 898 1929 .. .. .. .. .. .. .. .. .. .. .. .. .. 6681 9897 37.1 Total number of cases of Sickncss in the "Workhouse in 1860 were 1,677 Ditto — — ditto — ditto in 1861 were 2,191 Ditto — — ditto — ditto in 1862 were 2,978 Neither in the "Workhouse returns nor in the returns of out-door cases are the Midwifery cases included. TABLE III.—Showing the Deaths from Epidemic Diseases for the Three Months ending 27th December, 1862. District. Small-pox. Measles. Scarlet Fever. Diphtheria. Hooping-cough. Diarrhcea. Fever. Total. Remarks. Artillery 0 0 4 0 0 0 6 10 Workhouse. Spitalfields 4 6 2 0 3 4 3 22 MileEndN.Town 5 8 10 2 2 5 14 46 Whitechapel, N. 5 10 6 0 2 5 9 37 Whitechapel Ch. 0 2 2 0 1 2 6 13 Hospital. Goodmn's Fields 0 1 3 0 3 0 6 13 Aldgate 3 6 2 0 4 6 7 28 Total 17 33 29 2 15 22 51 169 Death from Epidemics for the corresponding quarter, 1862. 8 1 32 2 18 12 27 100 TABLE IV.—Showing the Ages at death in the "Workhouse, and in the London Hospital, for the Quarter ending 27th December, 1862. 0 and under 1 1 and under 5 5 and undr20 20 and under 40 40 and under 60 60 and under 80 80 and upwards Total Corresponding Quarter of 1861 Males 35 Femls. 34 Workhouse 3 4 2 15 19 23 3 69 61 L. Hospital 0 9 17 21 30 15 1 Males 66 89 Femls. 27 93 TABLE V.—The Births and Deaths in each Registration for the Three Months ending on the 27th December, 1862. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks. M. F. M. F. Artillery 27 27 54 19 11 30 24 — Workhouse. Spitalfields 82 61 143 54 46 100 43 — Mile End N. Town 83 86 169 89 94 183 — 14 Whitechapel, N 56 60 116 45 51 96 20 — Whitechapel Ch. 27 35 62 89 50 139 — 77 London Hospital. Goodman's Fields 67 49 116 23 24 47 69 — Aldgate 25 36 61 36 39 75 — 14 48 Non-residents died in Lon. Hosp. Totals 367 354 721 355 315 670 156 105 Excess of births over deaths, deducting the 48 non-residents 99 TABLE VI.—Showing the Births and Deaths in each District for the Year ending on the 27th December, 1862. BIRTHS. DEATHS. Districts. April. July. October. December. Total. April. July. October. December. Total. Excess of Births over Deaths. Excess of Deaths Births. Artillery 60 66 45 54 225 42 37 31 30 140 85 Spitalfields 149 158 132 143 582 76 97 111 100 g84 198 Mile End N. Town 168 170 133 169 640 193 191 171 183 738 — 98 Whitechapel, N. 129 113 105 116 463 72 72 85 96 325 138 Whitechapel Ch . 62 61 66 62 251 145 105 101 139 490 — 239 Goodman's Fields 100 90 94 116 400 46 55 68 47 216 184 Aldgate 65 72 54 61 252 66 53 64 75 258 — 6 Totals 733 730 629 721 2813 640 610 631 670 2551 605 343 Excess of births over deaths deducting 162 non-residts. 424. TABLE VII.—Ages at Death in each Registration Distriot, for Three Months, ending 27th December, 1862. Districts. 0 and under 1 1 and Tinder 5 5 and under 20 20 and n der 40 40 and under 60 60 and under 80 80 and upwards. Total. ation in 1861. Artillery 6 9 4 1 4 5 1 30 78,970 Spitalfields 21 32 4 12 14 16 1 100 MileEndN.Twn. 31 47 11 28 35 28 3 183 Whitechapel, N. 23 44 5 3 13 8 0 96 Whitechapel Ch. 12 18 19 28 41 19 2 139 Goodmn's Fields 10 11 6 8 4 7 1 47 Aldgate 19 25 5 7 10 9 0 75 Totals 122 186 54 87 121 92 8 670 For the yearl862 498 620 182 389 462 350 50 2551 Of the total mortality for the year the proportion, of deaths under 5 years is 43.8 per cent. TABLE VIII —Showing the Mortality in the Workhouse and Hospitals in the District during 1856, 1857, 1858, 1859, 1860, 1861 and 1862. Union Workhouse. London Hospital. Military Hospital. 1856 353 1856 297 1856 0 1857 272 1857 338 1857 2 1858 269 1858 325 1858 5 1859 239 1859 354 1859 3 1860 282 1860 326 1860 2 1861 287 1861 366 1861 0 1862 369 1862 330 1862 2 TABLE IX.—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 1858 1859 1860 1861 1862 53 wks. Mortality 2648 2778 2061 2377 2286 2444 2878 2453 2237 2360 2444 2321 2302 2331 2551 TABLE X.—Ages at Death in each Registration District for the Year ending 27th December, 1862. 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. Population 1861. Mortality per cent under 5 Artillery 36 45 10 8 15 22 4 140 6557 1.23 Spitalfields 89 142 21 35 49 41 7 384 15700 1.46 MileEndN.Twn. 131 132 45 115 160 135 20 738 15392 1.70 Whitechapel N. 89 97 19 39 49 27 5 325 12122 1.53 Whitechapel Ch. 42 63 46 121 128 80 10 490 8062 1.28 Goodnm's Fields 53 68 17 29 24 22 3 216 11166 1.08 Aldgate 58 73 24 42 37 23 1 258 9971 1.31 Total 498 620 182 389 462 350 50 2551 78970 1.41 The births during the year were 2813, and the deaths under 5 years of age were 1118 or 39-7 per cent, of the total births. Of every 1000 of the population 32*3 died in the course of the year. TABLE XI.—Showing the Deaths from Epidemic Diseases in the "Whitechapel District during the years 1856, 1857, 1858, 1859, 1860, 1861 and 1862. 1 8 5 6. 1 8 5 7. 1 8 5 8. Districts. Small-pox. Measles. Scarlet Fever. Hooping-cough. Diarrhoea. Typhus. Total. Small-pox. Measles. Scarlet Fever. Hooping-cough. Diarrhea. Typhus. Total. Small-pox. Measles. Scarlet Fever. Hooping-cough. Diarrhoea. Typhus. Total. Artillery 0 2 4 3 3 8 20 0 6 4 9 5 3 27 1 4 9 3 5 7 29 Spitalfields 3 1 7 15 10 22 58 0 9 9 19 15 10 62 0 24 22 14 15 18 93 Mile End N. Town 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 9.5 34 93 0 6 18 19 22 22 87 Whitechapel Ch 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 63 Totals 31 12 45 64 81 188 421 3 60 43 89 139 117 451 4 78 87 117 108 104 498 TABLE XI.—Continued. 1 8 5 9. 1 8 6 0. 18 6 1. 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 2 7 1 1 13 0 2 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 N. 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 Ch 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 69 316 28 27 70 98 101 65 389 table xi.—continued. 1 8 6 2. Districts. Small-pox. Measles. Scarlet Fever and Diphtheria. Hooping-cough j Diarrhoea. Typhus. Total. Artillery 0 11 7 8 2 12 40 Spitalfields 4 53 12 15 14 28 126 Mile End N. Town 15 26 23 11 13 120 208 Whitechapel, N 8 23 17 9 14 24 95 Whitechapel Ch 0 4 10 6 5 19 44 Goodman's Fields 0 18 16 7 6 23 70 Aldgate 6 18 6 6 15 24 75 Totals 33 153 91 62 69 250 658 TABLE XII.—Causes of Death at Seven periods of Life, registered in the Whitechapel District, for the Three Months ending 27th December, 1862. 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 90 165 39 68 110 49 1 522 I.-Miasmatic. IV.—Digestive Organs. Small- pox 6 9 ... 2 ... ... ... 17 Measles 6 26 1 ... ... ... ...... 33 Cancrum Oris ... 1 ... ... ... ... ... 1 Scarlatina 1 22 6 ... ... ... ... 29 Gastritis Diphtheria ... 1 ... ... 1 ... ... 2 Enteritis ... ... ... ... ... 1 ... 1 Quinsy ... 1 ... ... ... ... ... 1 Peritonitis ... 1 1 2 ... ... ... 4 Croup ... 10 ... ... ... ... ... 10 Ascites ... ... 1 ... 1 2 ... 4 Hooping-cough 1 14 ... ... ... ... ... 15 Ulc. of Intestines Typhus Fever ... 14 10 12 10 5 ... 51 Hernia (Rupture) ... 1 ... ... ... 4 1 6 Erysipelas 4 ... 1 ... ... ... ... 5 Ileus ... ... ... 1 ... ... ... 1 Puerperal Fever ... ... ... 1 ... ... ... 1 Intussusception Carbuncle Fistula Influenza Stomach Disease, &c. ... ... ... ... ... 1 ... 1 Dysentery Pancreas Disease, &c. Diarrhœa 10 6 ... ... 2 4 ... 22 Hepatitis Ague Liver Disease, &c. ... ... ... 1 ... 1 ... 2 Remittent Fever Spleen Disease, &c. Rheumatism ... ... 1 1 ... ... ... 2 V.— Urinary Organs. Pyæmia ... ... ... 1 1 1 ... 3 II.—Enthetic. Nephritis Syphilis 2 ... ... ... ... ... ... 2 Disease of Bladder ... ... 1 ... ... ... ... 1 Stricture of Urethra Nephria (Bright's Disease ... ... ... 3 ... 1 ... 4 Hydrophobia III.-Dietic. Diabetes Privation ... ... ... ... 1 ... ... 1 Stone ... 1 ... ... ... ... ... 1 Want of Breast Milk Prostate Disease ... ... ... ... 1 1 ... 2 Purpura and Scurvy Kidney Disease, &c Alcoholism—Delirium Tremens. ... ... ... ... 3 ... ... 3 VI.—Organs of Generation. „ Intemperance Ovarian Dropsy Lead Poisoning Uterus Disease, &c ... ... ... ... ... 1 ... 1 IV.-Parasitic VII.—Organs of Locomotion. Thrush 1 ... ... ... ... ... ... 1 Worms, &c Joint Disease, &c. ... ... 4 ... ... ... ... 4 Bones, &c ... ... ... 2 1 ... ... 3 2—Constitutional VIII.—Integu- mentary System. I.—Diathetic. Gout Phlegmon Dropsy ... ... 2 ... 2 3 ... 7 Skin Disease, &c. Cancer ... ... ... 2 7 1 ... 10 Mortification ... ... ... ... ... 1 ... 1 4.-Developmental Abscess ... ... 2 ... ... 3 ... 5 I.—Diseases of Children. Unlcer ... ... ... 1 ... 1 ... 2 II.-Tubercular. Premature Birth 5 ... ... ... ... ... ... 5 Scrofula ... 2 1 1 ... ... ... 4 Cyanosis Tabes Mesenterica 11 11 2 ... 1 ... ... 25 Spina Bifida Phthisis (Consumtn.) ... 2 2 35 32 1 ... 72 Other Malformations Hydrocephalus 7 1 ... ... ... ... ... 8 Teething 6 7 ... ... ... ... ... 13 3.—Local. II.—Diseases of Adults. 1.—Nervous Sys- tem Paramenia Cephalitis ... 2 ... ... ... ... ... 2 Childbirth ... ... ... 1 ... ... ... 1 Apoplexy ... 1 ... ... 5 3 ... 9 III.—diseases of Old People. Palsy (Paralysis) ... ... ... ... 2 4 ... 6 Old Age ... ... ... ... ... 25 6 31 Insanity IV.—Diseases of Nutrition Tetanus Epilepsy ... ... ... 2 ... ... ... 2 Atrophy and Debility 16 3 ... 1 ... ... ... 20 Convulsions 20 6 ... ... ... ... ... 26 Chorea 5.—Violent Deaths Brain Disease, &c ... 1 2 1 4 3 ... 11 I.-Accidents of Neglilence II.—Organs of Circulation. Burns and Scalds ... 6 4 2 1 1 ... 14 Pericarditis ... ... 1 ... 1 ... ... 2 Poison 1 ... ... 1 ... ... ... 2 Aneurism Suffocation 2 ... ... ... ... ... ... 2 Heart Disease, &c ... ... 2 2 16 7 ... 27 Violence 1 ... 4 5 5 4 ... 19 Phlebitis ... ... ... 1 ... ... ... 1 III.—Homicide. Disease of Arteries Murder and Man- slaughter 1 ... ... ... ... ... ... 1 III.—Rispiratory Organs. IV.-Suicide. Laryngismus Wounds Laryngitis ... 2 ... ... ... ... ... 2 Poison ... ... ... ... 1 ... ... 1 Bronchitis 8 10 ... 1 12 7 1 39 Drowning Pleurisy ... ... ... ... 1 ... ... 1 Hanging ... ... ... ... 1 ... ... 1 Pneumonia 13 24 6 2 5 1 ... 51 Otherwise Lung Disease, &c. ... ... ... 3 4 4 ... 11 Not Specified ... 1 ... ... ... 1 ... 2 Carried Forward 90 165 39 68 110 49 1 522 Grand Total 122 186 54 87 121 92 8 670 SUPPLEMENTAL APPENDIX. TABLE I.—Return of Licensed Cow Houses on the North Division of the Whitechapel District, December, 1862. Names of Proprietors. Establishments. Where situate. Dimensions of Cow Houses. Cows. Length. Feet. Breadth Feet. Height. Feet. Cubic Capacity. Number. Cubic Ft. for each. Andrews, William Bell Lane 36 14 13 6552 0 0 Anderton, Old Montague Street 16 14 9 2016 3 672 Brown, Walter Preston Street 60 29 14 24360 19 1292 Base, Henry 19, Charles Street 68 38 8 20672 53 390 Brown, Frederick Old Montague Street 31 10 20 6200 4 1550 Barker, Saw Yard 46 17 14 10948 12 9121¼ Bastin, Thomas 3, Spital Street 33 12 11 4356 12 363 Davis, John Black Lion Yard 108 18 16 31104 40 777½ Foster, Edward 27, Pelham Street 40 30 11 13200 20 660 Foster, 58, Goulston Street 37 27 9 8991 17 528 Hurley, John Crispin Street 53 12 14 8904 14 636 Johnson, Archibald Boar's Head Yard 18 12 12 3080 5 616 May, Robert 29, White Lion Street 24 19 17 7752 8 969 Martin, Wentworth Street 112 17 12 22848 0 0 Neill, Thomas Brown's Lane 12 13 9 1404 3 468 Smith, William 46, Wentworth Street 33 21 9 6237 7 891 Young, Whitechapel Road 31 13 12 4836 5 967 Williams, Elizabeth 19, Brown's Lane 76 25 14 26600 21 1277 Williams, White's Row, C.C. 55 16 20 17600 6 2933 AVatson, Thomas Speck's Yard 16 16 15 3840 3 1280 Watson, Thomas Speck's Yard 16 11 8 1408 4 352 Webb, John Grey Eagle Street 20 12 12 2880 5 576 Tlie total number of Cows in this Division of the District is 261. Return of Licensed Cow Houses on the South Division of the Whitechapel District, December, 1862. Names of Proprietors. Establishments. Where situate. Dimensions of Cow Houses. Cows. Length Feet. Breadth Feet. Height Feet. Cubic Capacity Number. Cubic Feet for each. 1. Ayres, Jolin 59, Back Church Lane 15 6 8 720 3 240 2. Ayres, Thomas 2, Gower's Walk 50 14 12 8400 5 1680 3. Bird, William Gower's Walk 52 24 16 19968 28 713 4. Davis, John Holloway Court 78 18 10 14040 21 668 5. Dewson, John Lambeth Street 60 16 8 7680 14 541 6. Gilbert, J. 63, Royal Mint Street 178 12 10 9360 9 1040 7. Jones, J. Cartwright Street 60 24 10 14400 8 1800 8. Le Beau 127, Royal Mint Street 30 14 10 3200 8 400 9. M'Avoy 8, Colchester Street 43 20 9 7700 14 552 10. Moore, John Darby Street 21 18 10 3780 6 630 11. Martin, George 61, Royal Mint Street 8 4 6 192 1 192 12. Sole, Isaac Lambeth Street 64 14 8 7168 14 512 13. Leeman, A. Royal Mint Street 21 18 10 3780 4 945 The total number of Cows in this Division of the District is 135. TABLE II.—Number of Persons in Public Institutions on the 8th April, 1861. District and Sub-District. Parish or Place. Name of Institution Total number in Institution. Number of Special Inmates as Paupers, Patients, Lunatics, &c. Whitechapel. Union Workhouse. Persns. Males. Femls. Persns. Males. Femls. 638 252 386 629 248 381 St. Ann's Monastery 20 20 — 17 17 — Mile End N. Town Mile End N. Town King Edward's Refuge for Destitute Girls 46 - 46 42 - 42 Whitechapel North "Whitechapel Boys' Refuge, Commercial Street. 104 101 3 100 100 - Whitechapel Ch Whitechapel, London Hospital. 405 217 188 310 199 111 Goodman's Fields "Whitechapel. Jews' Orphan Asylum. 47 27 20 36 23 13 Aldgate Tower of London. Tower of London Barracks. 584 523 61 479 479 - Precinct of the Tower. Sailors' Home. 202 202 — 189 189 — Destitute Sailors' Asylum. 17 16 1 13 13 — The Hospitals in London (General and Special), 44 in number, contained on the 8th April, 1861, 5,623 Patients; the Workhouses, including Schools for Pauper Children, contained 23,803 persons exclusive of the families of the Officers, &c. TABLE III.—Persons on Board Vessels on the Night of April 7th, 1861. British. British and Colonial. .  Aldgate. St. Botolph Without Aldgate. 95 56 151 St. Katherine-by-the Tower. 94 46 140 Tower Precinct. 124 — 124 TABLE IV.—-Extent of Water included in the Areas of Parishes. Area in Acres. Land Water. St. Botolph Without Aldgate; or, East Smithfield Liberty. 30 7 St. Katherine-by-theTower. 17 6 Old Tower Without Precinct. 27 10 Tower of London. The extent of Water included in the area of the above-named Parishes is nearly one-third. TABLE V.—Whitechapel District. Area; Houses and Inhabitant, 1851, and 1861, Parishes, &c. Superintendent Registrar's District. Area in Statute Acres. 1851. 1861 Persons. Males. Females. Total Increase+ or decrease.— Sub-District. Parish or Place. Inhabited. Uninhabited Building. Inhabited. Uninhabited. Building. 1851 1861 1851 1861 1851 1861 Houses 1861 Population. 1 Artillery Old Artillery Ground—Liberty 5 182 15 192 5 1972 2618 897 1027 1075 1141 + 646 Norton Folgate—Liberty 9 223 6 227 7 1771 1873 807 869 964 977 + 5 + 102 Christ Church, Spitalfields, part of Parish a 11 357 20 312 6 3026 2516 1454 1159 1572 1357 -59 -510 2 Spitalfields Christ Church, Spitalfields, part of * Parish a 53 1548 48 1 1533 37 6 15336 15700 7696 7920 7640 7798 -21 + 364 3 Mile End New Town Christ Church, Spitalfields, part of * Parish a 10 249 4 218 4 2598 2377 1333 1221 1265 1156 -31 + 221 Mile End New Town ‡ Workhouse. Hamt. b 42 1172 20 13 1178 35 10183 10845 5140 5333 5043 5512 + 6 + 762 Whitechapel, part of * Parish c 12 232 10 238 10 1762 2170 865 1154 897 1016 + 6 + 408 4 Whitechapel North Whitechapel, part of † Parish d 58 1494 69 3 1508 43 19 12530 12122 6170 6115 6360 6007 +14 + 408 b W hitechapel Church Whitechapel, part of † Parish e 47 967 33 1 999 36 7818 8062 3882 4010 3936 4052 + 32 + 224 6 Goodman's Fields Whitechapel, part of † Parish f 46 1319 45 15 1215 70 11497 10746 5708 5323 5789 5423 -104 -751 Holy Trinity, Minories, Parish g 5 63 2 45 4 572 420 265 203 307 217 -18 -152 7 Aldgate Whitechapel, part of † Parish h 11 412 27 435 15 4241 4354 2176 2211 2065 2143 + 23 + 103 St. Botolph-without- Liberty 37water. 485 15 470 19 1 4163 4000 2078 2070 2085 1930 -15 -163 Aldgate, or East Smithfield. St. Katharine-bythe-Tower. Precinet 23water. 12 9 517 208 455 161 62 47 -3 -309 Old Tower Without Precinct * 37water. 41 2 41 2 819 626 609 448 210 178 -193 Tower of London 44 44 964 783 736 615 218 168 -181 Entire Parishes. * Spitalfields 74 2154 72 1 2063 47 6 20960 20593 10483 10282 10477 10311 -91 -467 † Whitechapel 174 4424 184 19 4395 174 19 37848 37454 18801 18813 19047 18641 -29 -394 ‡Stepney (Mile End Old and New Town) and part of Ratcliff 812 11930 548 169 13991 547 75 80218 98836 37128 46331 43090 52505 + 2061 + 18618 The Whitechapel District, which includes a portion of the River Thames, contained in 1851 8,812 inhabited houses, and in 1861 only 8,664 or 148 less, while the population is only 789 less. In 1841 the inhabited houses were 8,834, and the population was 71,879, which gave upon an average 8.1 each house. a The part of Spitalfields Parish comprised in Spitalfields Sub-District is bounded on the north by the Parish of Bethnal Green, on the south by the Parish of Whitechapel, on the east by the centre of Brick Lane, and on the west by the centre of Wheeler Street, Crispin Street, and Bell Lane. The Artillery Sub-District contains all that part of the Parish which is westward, and the Mile End New Town Sub-District all that part of the Parish which is eastward of the said boundary. b The Hamlet of Mile End New Town is part of the ancient Parish of Stepney, but is a distinct Parish for the relief of the poor. c The part of the Parish of St. Mary, Whitechapel, comprised in the Mile End New Town Sub-District, is bounded on the north and west by the Parish of Christ Church, Spitalfields, on the east by the Hamlet of Mile End Old Town, and on the south by the centre of Montague Street. d Whitechapel North Sub-District is bounded on the north partly by the Parish of Christ Church, Spitalfields, partly by the centre of Old Montague Street, and the Hamlet of Mile End New Town, and partly by the Parish of Bethnal Green, and on the south by the centre of Whitechapel High Street and Whitechapel Road. e Whitechapel Church Sub-District includes all that part of Whitechapel Parish which is bounded on the north by the centre of Whitechapel High Street and Whitechapel Road, and on the south partly by the centre of Great Alie Street, Little Alie Street, Goodman's Stile, and Church Lane, and partly by the Hamlet of Mile End Old Town. f The portion of Whitechapel Parish included in the Goodman's Fields Sub-District is bounded on the north by the centre of Great Alie Street, Little Alie Street, Goodman's Stile, and Church Lane, and on the south by the centre of Royal Mint Street and Cable Street. g Several houses in the Parish of Holy Trinity, Minories, have been demolished since 1851 for the construction of Warehouses. h The part of Whitechapel Parish in Aldgate Sub-District is that lying southward of a line drawn through the centre of Royal Mint Street and Cable Street. i In 1851 there were 979 persons on board vessels in the St. Katharine's Docks and off the Tower, while in 1861 the number was only 264. The Tower of London is a " Royal Palace and Fortress," and is under the peculiar jurisdiction of the Constable of the Town. TABLE VI.—Table showing the aggregate number of Marriages, Births, and Deaths Registered in the Superintendent Registrar's District in the Ten Tears 1851-60, and the excess of Registered Births over Deaths. Population. Registered in the ten years 1851-60. Excess of Registered Births over Deaths 1851-60. Decrease of Population in the interval of the Censuses 1851-61. Density of Population—number of square yards to each person. 1851 1861 Marriages. Births. Deaths. 79,759 78,970 7,317 27,753 24,132 3,621 789 24.3 TABLE VII.—Houses and Population, 1851 and 1861, and Annual Value of Property Assessed in the several Parishes within the Whitechapel District. 18 5 1. 18 6 1. Annual Value of Property as per Country Rate, or like basis, Jan., 1862. Annual Value of Property as per Poor Rate, Nov., 1862. Inhabited Houses. Population. Inhabited Houses. Population. 1 Whitechapel 4424 37848 4395 37454 £111,866 £118,880 10 2 Spitalfields 2154 20960 2063 20593 37,876 40,137 0 3 Aldgate 485 4163 470 4000 50,920 33,979 0 4 Holy Trinity Minories 63 572 45 420 6,089 5,865 0 5 Precinct of St. Katharine. 12 517 9 208 17,328 15,649 0 6 Hamlet of M. E. N. Town 1172 10183 1178 10845 13,132 15,833 10 7 Liberty of Norton Folgate 223 1771 227 1873 8,108 7,552 0 8 Old Artillery Ground 182 1972 192 2168 4,059 4,252 0 9 District of the Tower 97 1773 85 1409 2,799 2,912 0 Totals 8812 79759 8664 78970 £252,177 £245,060 0 TABLE VIII.—Ecclesiastical Districts. New Parish or Ecclesiastical District. Original or Mother Church. Houses. Population. Date of Formation. Inhabited. Uninhabited. Building. Persons. Males. Females. St. Jude Whitechapel. 721 10 10 6652 3393 3259 1848 St. Mark Whitechapel. 1656 85 — 15326 7747 7579 1841 St. Stephen Spitalfields. 535 15 4 5090 2514 2576 1858 All Saints, Mile End New Town Stepney. 1178 35 - 10845 5333 5512 1841 St. Mary, Spital Square Old Artillery Ground 192 5 - 2168 1027 1141 Liberty, Norton Folgate. 227 7 — 1873 896 977 1842 TABLE IX.—Area; Houses and Inhabitants, 1851 and 1861, in Sub-Districts. Sub-Districts. Area in Statute Acres. Houses. Population. 18 5 1. 18 6 1. Persons. Males. Females. Inhabited Uninhabited Building. Inhabited. Uninhabited Building. 1851 1861 1851 1861 1851 1861 Artillery 25 762 41 - 731 18 — 6769 6557 3158 3082 3611 3475 Spitalfields 53 1548 48 1 1533 37 6 15336 15700 7696 7902 7640 7798 Mile End N. Town 64 1653 34 13 1634 49 — 14543 15392 7338 7708 7205 7684 Whitecpi. North 58 1494 69 6 1508 43 19 12530 12122 6170 6115 6360 6007 Whitechapel Ch. 47 976 33 1 999 36 — 7818 8062 3882 4010 3936 4052 Goodman's Fields 51 1382 47 15 1260 74 - 12069 11166 5973 5526 6096 5640 Aldgate 108water. 1006 44 — 999 36 1 10694 9971 6054 5505 4640 4466 From the above Table it appears that the total number of inhabited Houses in the entire District in 1851 was 8,821, and the population was 79,759, which upon an average is 9 persons to each House. In 1861 the number of Houses was 8,664, or 157 less, and the population was 78,970, or 789 less. The average number to a house is now 9.1. In the Mile End New Town Sub-District the number of Houses in 1861 was less by 19 than it was in 1851 while the population has increased 849. In 1851 the average number to a House in this Sub-District was 8.7, while it is now 9.4. In the Spitalfields Sub-District the number of Houses is less by 15, and the population is greater by 364. The average number of persons to each house has increased from 9.9 to 10.2.