WHI 21 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT on the Sanitarg Conditio of THE WHITECHAPEL DISTRICT, FOR THE QUARTER ENDING 29th MARCH, 1873, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Feinted by T. Penny & Co., 121, Leman Stbeet, Whitechafel, E. 1873. REPORT OF THE MEDICAL OFFICER OF HEALTH, For the Quarter ending 29th March, 1873. To the Boakd of "Works, Whitechapel Disteict. Gentlemen, In the Quarter that ended on Saturday, March 29, 1873, the births registered in the Whitechapel District were 720; viz., 376 males and 344 females. During the same period the deaths have been 628 : of these, 335 have been of males and 293 of females. In the correspondingQuarter of the previous year the births were 720 and the deaths 608. The number of births is the same as in the corresponding quarter of last year, and an increase of 20 has taken place in the number of deaths. The deaths in the London Hospital have been 163 ; viz., 105 males and 58 females. Of the total deaths in this institution there were 18 of persons resident within the District, 93 of non-residents, and 52 of persons who died either suddenly or from the result of accident. The total mortality of this District is increased by the deaths of residents withiu the District which have occurred in other hospitals in the Metropolis; but of those I have no complete record. No death from epidemic diseases occurred in the London Hospital during this quarter. Four deaths occurred in this institution from pyaemia. The deaths in the Workhouse have been 111; viz., 55 males and 56 females. No death from epidemic disease occurred in this establishment. The deaths from epidemic diseases in the entire District have been 37 ; viz., 1 from measles, 2 from scarlet-fever, 23 from hooping-cough, 2 from diarrhoea, and 9 from fever. One death from fever occurred in the Fever Hospital. There were 5 deaths from erysipelas, 4 from pyaemia, 4 from croup, 1 from rheumatism, and 1 from remittent fever. In the corresponding quarter of the previous year the deaths from epidemic diseases were 69; viz., 11 from small-pox, 8 from measles, 2 from scarlet-fever, 1 from diphtheria, 41 from hooping-cough, 1 from diarrheea and 5 from fever. The deaths caused by diseases of the respiratory organs, exclusive of consumption, have been 145 ; of these, 89 were caused by bronchitis, 46 by pneumonia, 2 by laryngitis, 1 by laryngismus, 1 by pleuritis, and 6 by 4 asthma. Consumption was fatal to 77 persons. The deaths from other tubercular diseases were 33; viz., 19 from mesenteric disease, 8 from tubercular meningitis, 5 from hydrocephalus or water on the brain, and 1 from scrofula. Diseases of the organs of circulation were fatal to 54 persons; of these, 41 died from disease of the heart, 6 from aneurism, 1 from disease of the arteries, and 6 from pericarditis. The deaths from diseases of the urinary organs were 17 ; of these, 13 were caused by nephria or Bright's disease, 2 by diabetes, and 2 by other diseases of the urinary organs. Convulsions caused the deaths of 18 children. There were 5 deaths from teething, and 21 from atrophy and debility. The deaths from syphilis were 7 ; of these, 4 were of children under 1 year of age. Two deaths occurred from stricture of the urethra. The death of 5 persons is recorded to have been accelerated by destitution, 1 from excessive drinking, and 1 from a fall whilst drunk. The death of 32 persons is attributed to old age: of these, 20 were above 80 years of age; two of these, one a female and the other a male, reached the advanced age of 96 and 95 years respectively, and 3 died from premature decay under 64. There were 41 deaths from mechanical violence,; of these, 5 were caused by horses and vehicles in the streets. Burns and scalds were fatal to 9 persons. Three persons were accidentally drowned. Four persons committed suicide. Four children were suffocated in bed. Childbirth was fatal to 2 persons. The number of inquests has been 96. In the corresponding quarter of last year the number was 7 5. The deaths which have not been certified by a medical practitioner have been 13 ; of these, 9 were recorded in the Spitalfields sub-district. The mortality of children under five years of age was 170. This is 27.0 per cent, of the total mortality. In the corresponding quarter of the previous year the rate of mortality of children under 5 was 33.8 per cent, of the total mortality. In the Artillery sub-district the rate is 40.0 per cent.; in the Spitalfields, 44.9 per cent. ; in the Mile End New Town, 24.8 per cent ; in the Whitechapel North, 43.7 per cent.; in the Whitechapel Church, 13.4 per cent.; in the Goodman's Fields, 34.0 per cent.; and iu the Aldgate, 22.2 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the last quarter, 1387 new cases of illness out of the Workhouse, including 1 of measles, 2 of scarlet-fever, 23 of hooping-cough, 16 of diarrhoea, 9' of fever, 78 of febricula, 5 and 13 of erysipelas. In the corresponding quarter of the previous year, the number of pauper cases of illness was 1428, including 28 of small-pox, 27 of measles, 6 of scarlet-fever, 42 of hooping-cough, 27 of diarrhoea, 6 of fever, 94 of febricula, and 13 of erysipelas. The total number of cases in the Workhouse has been 802, including 2 of hooping-cough, 14 of diarrhoea, and 38 of febricula. Meteorology oe Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the quarter has been 5.73 inches. During the corresponding quarter of last year the rain-fall was 5.66 inches. The mean temperature of the air was 39.5°. In the corresponding quarter of last year the mean temperature was 43.3°. The coldest days during this quarter were Sunday, the 2nd February, Monday, 24th February, and Tuesday, the 25th Februaiy, when the thermometer indicated respectively 25.8°, 25.0°, and 25.0°. In the corresponding quarter of the previous year the greatest degree of cold was on Thursday, the 2lst March, when the thermometer indicated 26.2°. In the week ending March 1st, 1873, the rain-fall was 1.44 inches The following table, taken from the returns of the Registrar-General shows the comparative results of the Quarter :— LONDON. Jan. 4th Jan. 11th Jan. 18 th Jan. 25th Feb. 1st Feb. 8th Feb. 15 th Feb. 22nd Mar. 1st Mar. 8th Mar. 15th Mar 22nd |Mar 29th Deaths from Small 4 5 6 7 1 2 3 2 3 5 2 1 5 Deaths from Fev- 25 22 22 25 25 24 27 37 19 18 24 35 34 Mean ture of the air 45.2° 47.9° 46.1° 37.4° 33.3° 32.9° 36.0° 33.4° 36.0. 43.3 38.6 39.1 45.3 Rain-fall in inches 0.80 0.92 0.26 0.62 0.02 0.59 0.04 0.08 1.44 0.24 0.40 0.31 0.01 Deaths in London 1212 1202 1143 1247 1336 1554 1620 1664 1790 1617 1499 1546 1540 Deaths in Whitechapel District 41 32 42 39 44 50 51 61 66 56 44 56 46 Deaths in ditto from Fever 1 2 0 0 0 1 0 0 1 0 0 3 1 Water Supply. Since my last quarterly report eight additional water-waste-preventers have been erected in this District, and consequently there has been a considerable diminution in the number of butts and cisterns. From the satisfaction which these machines give to the poor I hope that the time is not far distant when butts and cisterns in the poor localities will be entirely abolished, and that water will be supplied to the poor on the constant service, direct from the main. Small-Pox. During this quarter not a single case of small-pox has been attended by the Medical Officers of the Union; and from the returns of mortality, as given by the local Registrars, no death from this disease has been registered. 6 The returns of the mortality from epidemic diseases, as are shown in Table II. in the Appendix to this Report, are very satisfactory, the number of such deaths having been only 37, while the average number for the last eight quarters has been 89. Vaccination. WHITECHAPEL UNION.—Return of the number of Cases vaccinated by the Public Vaccinator and the Medical Officer of the Workhouse, together with the number of Births Registered during the same quarters. Quarter ending— PUBLIC VACCINATOR workho USE. Totals. Births Registd. Primary Cases. Re-Vaccination. Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination. June, 1871 357 538 21 0 378 538 569 September 186 12 35 0 221 12 602 December 134 6 27 0 161 6 653 March, 1872 219 16 43 1 262 17 720 June 289 9 32 0 321 9 684 September 306 1 26 4 332 5 640 December 263 0 3 1 2S6 1 685 March, 1878 290 6 23 0 313 6 720 Totals 2014 588 230 6 2274 594 5273 From the above Table it appears that vaccination is carried out in this District in a very satisfactory manner; and great credit is due to Mr. Blackman, the Public Yaccinator, for the zeal and energy he has displayed in the performance of the duties of his office. I am happy to be able to record that the Government has recognized Mr. Blackman's services, in awarding to him a gratuity of £81. Such an acknowledgment of services rendered by a public officer is not only exceedingly gratifying to that gentleman, but must be very satisfactory to the Board of Guardians, who appointed Mr. Blackman to the office of Public Yaccinator. Sanitary "Works Performed during the Quarter. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ending March 29th, 1873:— Number of inspections of houses as shown in the official returns 3634 Houses specially visited 217 Ditto specially re-visited 666 Preliminary notices served, such notices embracing 319 premises 203 Compulsory orders issued, embracing 58 premises 28 Summonses heard at Police Courts 4 Cellars used as dwellings discontinued for such use 2 Houses in which the rooms or passages have been whitewashed 75 Rooms disinfected with sulphurous acid gas after the occurrence of 11 small-pox, fever or scarlet-fever, therein Articles disinfected consisting of beds, bedding, clothing, &c 52 7 Yards of houses paved or the pavement repaired 38 Drains in houses improved 86 Dust-bins provided 35 Privies lime-washed, cleansed, and repaired 139 Water-butts and cisterns provided or repaired 24 Water-waste preventers erected 8 Nuisances from dung and other offensive matter removed 37 Area gratings and cellar flaps repaired 6 The cow-houses in the District, 24, the slaughter-houses, 88, in number, have been visited during the quarter. In addition to this return, the Inspectors report that they have forwarded to the Metropolitan Board of Works several notices of dangerous structures, which notices the Metropolitan Board have promptly attended to. Reports of the Inspectors upon the sanitary improvements effected in Commercial Court, Gower's Walk, and in the Ragged Schools, Wentworth Street, Spitalfields. On the sanitary improvements effected in Commercial Court and Gower's Walk, Mr. Battram reports as follows:— Commercial Court. " The pavement in Commercial Court was, upon inspection, found to be in a very bad condition; the water supply was obtained from a cistern built underneath the pavement, by means of a pump which was fixed in the cistern. There was another cistern over the public privies, and a cistern was placed over the privy in each of the four back yards belonging to the houses on the north side of the Court. The water from these filthy receptacles was totally unfit for drinking purposes, The privies were dilapidated, and not properly trapped, and the 12-inch pipe drain, which passed along the entire length of the Court, into the sewer, was very defective. The dust-bin was situated inside one of the houses. In consequence of notices being served upon the owners, the old pavement has been removed, and asphalte has been laid down in lieu thereof; the cisterns have been abolished, and a water-waste-preventer erected. The three old privies have been pulled down, and two new ones built; the drain has been made good, and the dust-bin removed from the house and fixed in a more convenient place." Gower's Place.] "The houses in Gower's Place were, in many cases, in a most dilapidated condition; the privies were in a bad state, and not properly trapped, and the drain leading down the centre of the Court was completely choked. The whole of the houses have, since the date of my visit, been thoroughly repaired—indeed four of them have been rebuilt—the old privies, two in number, have been pulled down, and three new ones built, which are fitted with proper pans and traps; the drain also has been put in thorough repair." RAGGED SCHOOLS. Wentwobth Street, Spitalfields. Upon inspection of the above schools on the 10th February last, in which about 70 children meet daily, Mr. Wrack reports as follows:— "I found 8 one closet only for the use of all the children. There was a most offensive smell in the schools, arising from the basement, which, upon examination, was found to proceed from a cesspool in the yard, which received the filth from the closets and drains of two adjoining houses. There was no proper water supply upon the premises. I wrote to Mr. Molyneux, the secretary of the schools, and the owner of the adjoining houses, upon the matters complained of, and the result of my communication has been, that the houses are now properly drained into the sewer; the cesspool upon the premises of the Ragged Schools filled up, and three new closets and a urinal have been built for the use of the children. A water-waste-preventer has been erected in lieu of the dirty and defective cistern which formed a roof for the closet, and the yard has been repaved with new York stone." Baths and Laundries for the use of the Poor. It is almost impossible to over estimate the advantages which the poor of such a crowded district as that of Whitechapel would derive from the establishment of baths and wash-houses in their midst; and although I brought the question of the probable re-opening of the baths and washhouses in Goulston Street before the Board in my report for the quarter ending at Michaelmas last, I have, in consequence of the importance of the subject, again thought it advisable to notice it; more especially as several influential persons are at this time interesting themselves in obtaining funds to put the building in Goulston Street into repair, so that the poor may again be able to enjoy the same boon which they formerly possessed. As a proof that the baths and wash-houses in Goulston Street were held in great estimation by the poor, I may refer you to a report issued by the Committee of the establishment in 1850, wherein it is stated, that whilst in 75 weeks (from the 26th July, 1847, to the 31st December, 1848,) 81,694 persons bathed, paying £914 19s. Id.; in 35 weeks, (from the 1st January, to the 1st September, 1849,) 82,219 enjoyed that cheap luxury for the collective sum of £1058 Is. Id. From the 1st May, to the 1st September, 1849 3013 women washed, dried, and ironed their own family linen, at the expense of Id. per hour; the average time occupied by each being 3 hours and 20, minutes; thus enabling families to wear clean linen at a weekly expense of from Id. to 3½d. Although the poor are now better supplied with water than they were twenty years ago, the discomfort of a washing day is still the same as it was then, the same custom prevailing, viz: that of a family occupying only a single room in which the processes of cooking, personal washing, washing, drying and ironing clothes, are carried on. In this single room, while these operations are going on, a member of the family is sometimes lying in bed suffering from illness, who, being exposed to a damp and offensive atmosphere which is generated in the room, does not recover so rapidly as he otherwise would, if he were surrounded by a more healthy atmosphere. The 9 result of these inconveniences is that persons so situated too frequently become regardless of decency and self respect, and consequently have a very limited idea of the pleasure arising from a clean skin, and the wearing of clean clothes. The discomfort above mentioned is not all that a poor family occupying a single room has to endure ; for when occupying the upper room of a house three storeys high, the labour of carrying water up stairs, and conveying the same after it has been used down again, is so great that the linen is never properly washed, owing to the small quantity of water which is used in the washing of it, and when dried has an offensive smell. The present high price of coals is a very serious drawback to all those persons whose means are limited towards their obtaining a sufficient supply of boiling water for washing purposes. I may here remark that the houses in this District, which are occupied by the poor, are not adapted for the operation of washing, for scarcely a house is to be found in the poor Districts in which there is a sink into which the waste water can be thrown ; and, so long as the poor are compelled to occupy such inconvenient houses very little improvement can be expected to take place either in their moral or physical condition. As a step, therefore, in the right direction, I can confidently recommend the establishment of baths and wash-houses in every District where the poor reside ; and, from the experience which has been gained by the knowledge of the benefits arising from the laundries in Goulston Street, it may be fully anticipated that, by the re-opening of that institution, there will be not only a diminution in the amount of disease, but the rate of mortality will be materially lessened. Mrs. PiLBROW, the late Superintendent of the Baths and Wash-houses in Goulston Street, informs me that the Laundries were such a boon to the poor women in the neighbourhood, that they afforded to them a means of subsistence, by washing, for a small charge, their neighbours' linen, and so relieving several families from the inconveniences of a washing-day at home. Mrs. Pilbkow also says that the poor people would come to the Laundries in the morning with large bundles, containing the soiled linen of several poor families, where, by a constant supply of hot and cold water, and by the use of a steam pipe, which boiled the linen, the clothes, however dirty, were returned to their respective owners on the same evening in a clean and wholesome condition. The late Superintendent further remarks, that she has known, on a very hot Saturday, or during a particular Jews' holiday, every bath in the building occupied, and the long settle, which extends the whole length of the bathing corridor, to be filled with expectant bathers, each one taking his turn as a bath-room became empty. 10 Density of population and death-rate in certain localities. The total area of the Whitechapel District is 406 acres, or 1,965,040 square yards ; and the population at the last census was 76,332. The water area of the District is 23 acres. The density of the population is therefore 25.7 square yards for each inhabitant. The deaths, excluding those of non-residents and those which were the result of accident, were, for the quarter ending, March 1873, 2023, which gives a death-rate of 26.4 per 1000. This rate of mortality, however, varies in different sub-districts. Thus, in a block of buildings, bounded on the north by the south side of Royal Mint Street; on the east by the west side of Dock Street; on the south by the north side of Hog Yard; and on the west by the east side of Glasshouse Street, the rate of mortality was 43.3 per 1000. This block, which I will designate as No. 1, comprises, according to the measurement kindly made for me by Mr. S. W. Iron, the Surveyor, 3689 square yards, and contains a population, as enumerated by Mr. Battram, on a house-to-house visitation, of 415, viz. 242 adults and 173 children, allowing 18 persons either for rooms which were found to be empty, or into which the Inspector could not gain admission. The density of population in this block is 8.8 per square yard. The total deaths in this population have been 18, which, as above stated, is at the rate of 43.3 per 1000. This block contains Hayes Court, Cherubim Court, Glass House Buildings, a portion of Royal Mint Street, a portion of Glass House Street, and a portion of Dock Street. In this block there are 47 houses, which contain in the aggregate 191 rooms. No. 2 block is bounded on the north by the south side of Boyal Mint Street; on the east by the west side of Glass House Street; on the south by the north side of New Martin Street and Bracey's Buildings; on the west by the east side of Darby Street, as far as the late "Weigh House Schools; from thence to the backs of the premises in Crown Court, Aldgate, to the north-west corner of Bracey's Buildings. This block comprises one side of New Martin Street, Crown Court, Blue Anchor Yard, Garden Court, Bracey's Buildings, Kettleby Court, Cooper's Court, Blue Anchor Yard, Bussell Court, Slater's Court, Holloway Court, Parson's Court, Hairbrain Court, east side of Darby Street, Compasses Court, a portion of Royal Mint Street, a portion of Glass House Street, Crawford's Court, Christopher Court, and Seven Star Court. This block has a superficial area of 13,056 square yards, and comprises 171 houses, containing 547 rooms, and has a popution of 1609, allowing three persons for eaeh unoccupied room, or for a room to which the Inspector could not gain admission. The adults were ascertained to be 876, and the children 733. The density of the population is 8.1 square yards to each person. The deaths among this population were 59, which is at the rate of 36.6 per 1000. 11 Block No. 3 is bounded on the east by the west side of Dock Street; on the south by a factory ; on the west by the east side of Glass House Street; and on the north by the south side of Hog Yard. In this block are comprised Vincent's Place, Providence Court, Shorter's Rents, part of Glass House Street and a part of Dock Street. The number of houses in this block is 37, which contain 148 rooms. The population is 345, viz. 217 adults and 128 children. The area is 2739 square yards, which gives 7.9 square yards to each inhabitant. In this space the deaths during the year have been 12. The rate of mortality therefore is 34.7 per 1000. The total area of these three blocks is 19,482 square yards. In this area there are lodged 2369 people, to each of whom there is allotted upon an average 8.2 square yards. The mortality in this population has been 89, which gives a death rate of 38.4 per 1000, or 12 per 1000, above the rate of mortality of the entire district. Crown Court, which is a narrow alley about nine feet in width, connecting Blue Anchor Yard with Glass House Street, and is comprised in No. 2 block, has an area of about 812 square yards, and contains 24 houses, in which are 72 rooms. In this court or alley there is a population of 242, to each of whom is allowed on an average the small space of only 3.4 square yards. The mortality among this population was 10, which is at the annual rate of 41.3 per 1000. I may here observe, that in both the districts selected for inquiry, viz, that on the North side of Whitechapel High Street, and that on the South side of Royal Mint Street, the deaths from epidemic diseases have been during the year very few. The mortality has been chiefly caused by diseases of the respiratory organs, congenital debility, by convulsions and hooping-cough, teething and consumption. We will now turn our attention to the north side of the District. There exists a block of buildings bounded on the south by the rear of the buildings on the north side of Whitechapel High Street; on the north by the south side of Wentworth Street; on the east by the west side of Goulston Street; and on the west by the east side of Middlesex Street. This block comprises Horse Shoe Place, Elizabeth Court, Three Tun Alley, Boar's Head Yard, Love Court, Little Love Court, Swan Court, Hebrew Place, Marlborough Court, portions of Middlesex Street, Goulston Street and Wentworth Street. This block has a superficial area of 16,760 yards, and contains 248 houses, in which there are about 1488 rooms, and a population of 1937, viz. 1046 adults and 891 children. Here the space for each person is on an average 8.6 square yards. The deaths among the population have been 41, which shows a death-rate of only 21.1 per 1000. The facts which are above stated, relating to the density of the population and the rate of mortality in the blocks of buildings on the north and south sides of the District, are very remarkable, and are highly suggestive. It appears that in both of these localities the density of population is about the same, yet the rate of mortality on the north side is 21.1 per 1000, while 12 on the south side it is 38.4 per 1000. To a superficial observer the physical condition of the two localities would not appear to differ materially the one from the other ; and if inquiry were made into the water supply in the two districts, it would be found that each is supplied by the same two companies, viz., the East London and the New River ; and so far as the pavement and sewerage are concerned, little or no difference exists. No cesspool is known to exist in cither locality. Let us now see in what respects the one district differs from the other. Firstly—as regards the population. The inhabitants on the south side are chiefly Irish labourers, who earn a very precarious living by working in the docks and on the wharves by the river side. The women are for the most part engaged in sack making and wood chopping; while on the north side the population chiefly consists of English Jews, who, although for the most part poor, are a sober and industrious class, and who possess some feeling of self-respect, which is manifested by tho greater cleanliness of their houses and of their wearing apparel.* While, on the other hand, the inhabitants of the south district are dirty in their persons, and have but little self-respect, either in their desire to wear clean clothes or to keep their rooms clean. Secondly—as regards the houses. On the north side the houses are for the most part smaller, consisting only of two rooms each, are in tolerably good repair, and are occupied by only one family. Most of the houses have back yards, in which the privy is situated, which, being only used by one family, is kept clean. While, on the south side, the majority of the houses are without back yards, are very old, and are constantly requiring repair. The great evil which is found to prevail on the south side is not only the small size and inadequate ventilation of the rooms, but the overcrowding of many of them. In ten rooms, recently measured by Mr. Battram, the cubic space allotted to each person varies from 94 feet to 269 feet. Nearly all the Courts in this locality are provided with public privies. These are found to be great nuisances, for it is impossible to keep them clean, and the smell from them is frequently perceptible in the houses contiguous to them. Since this report was presented to the Board, (about three weeks ago) 22 cases of fever have occurred in this locality. What is to be done with this mass of old and badly-constructed houses, the inhabitants of which suffer a rate of mortality nearly double to that of other districts ? This question is more easily asked than answered. I may, however, venture to suggest to the Trustees of the Peabody Fund, that a more appropriate site for the building of commodious and healthy dwellings for the dock labourers, and others working on the wharves and on the river, cannot be found. I am, Gentlemen, Your obedient Servant, 15, Great Alie Street. JOHN LIDDLE. * The comparative immunity of the Jews from cholera was mentioned in my Report to the Board of Health, in 1849, and was published at page 82 of the Report on Cholera, by the late Mr, Grainger, APPENDIX. TABLE I.—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 on the 29th March, 1873. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic Diarrhœa. Continued Fever, Typhus & Typhoid. Febricula. Pyaemia. Erysipelas. Puerperal Fever. Croup. Acute Pulmonary Inflammation. Carbuncle. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. Total. Bronchitis and Catarrh. Pleuritis and Pneumonia. Dr. Swyer 0 1 0 5 3 0 1 17 0 2 1 0 32 9 0 16 0 0 0 0 17o 257 Mr. Champneys 0 0 0 4 0 0 0 9 0 6 0 0 66 2 0 9 0 0 0 0 214. 310 Mr. Sequeira 0 0 0 2 3 0 3 18 0 2 0 0 13 2 0 8 1 0 0 2 179 233 Mr. H. Braye 0 0 o 9 4 0 2 19 0 3 0 0 70 4 1 4 1 0 0 4 247 370 Mr. Loane 0 0 0 3 6 0 3 15 0 0 0 0 27 0 0 8 2 0 0 1 162 227 Total 0 1 2 23 16 0 9 78 0 13 1 0 208 17 1 45 4 0 0 7 962 1387 Corresponding Quarter of previous Year. 28 27 6 42 27 0 6 94 0 13 1 0 223 14 1 29 7 1 2 8 899 1428 Workhouse Mr. C. Ilott. 0 0 0 2 14 0 0 38 0 5 0 0 86 23 2 46 5 0 4 10 567 802 Mr. Ilott states that there have been admitted during this winter an unusual number of cases of syphilis and gonorrhoea chiefly among women. TABLE II. Showing the Deaths from Epidemic Diseases, for the Three Months ending 29th March, 1873. Districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhoea. Fever. Total. Remarks. Artilery 0 0 0 0 1 0 0 1 Workhouse. Spitalfields 0 1 1 0 5 0 3 10 Mile End New Town 0 0 0 0 4 2 0 6 Whitechapel, North 0 0 0 0 5 0 1 6 Whitechapel Church 0 0 0 0 4 0 0 4 Hospital. Goodman's Fields 0 0 0 0 2 0 2 4 Aldgate 0 0 1 0 2 0 3 6 Totals 0 1 2 0 23 2 9 37 Deaths from Epidemics for the corresponding Quarter, 1872. 11 8 2 1 41 1 5 69 Four deaths from Pyaemia occurred in the Whitechapel Church sub District. One death from Fever occurred in the Fever Hospital, thus making the total deaths from Fever, 10. TABLE III. Showing the Ages at Death in the Workhouse, and in the London Hospital for the Quarter ending 29th March, 1873. 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, 55 Females, 56 Corresponding Quarter of 1872. 6 7 2 20 23 46 7 111 75 London Hospital 2 11 28 50 53 19 0 Males, 105 143 Females, 58 163 TABLE IV.— Ages at Death in each Registration District, for the Three Months ending 29th March, 1873. Districts. 0 and under 3. 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. 5 3 0 2 5 5 0 20 Workhouse. Spitalfields 22 18 4 10 19 14 2 89 Mile E. N. Town 26 16 2 27 32 58 9 170 Whitechapel, N 14 14 2 7 13 10 4 64 Whitechapel Ch 9 16 28 50 56 27 1 187 Hospital. Goodman's Fields 10 5 4 6 10 6 3 44 Aldgate 8 4 5 11 14 11 1 54 Totals 94 76 45 113 149 131 20 628 TABLE V.— The Births and Deaths in each Registration District, for the Three Months ending 28th March, 1873. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks M. F. M. F. Workhouse. 34 25 59 11 9 20 39 0 Spitalfields 73 63 136 38 51 89 47 0 Mile End N. Town 98 83 181 88 82 170 11 0 Whitechapel, N. 56 52 108 27 37 64 44 0 Whitechpl Church 45 42 87 119 68 187 0 100 London Hospital. Goodman's Fields 43. 45 88 24 20 44 44 0 Aldgate 27" 34 61 28 26 54 7 0 93 Non-residents died in the London Hospital. 376 344 720 335 293 628 192 100 Excess of Births over Deaths deducting the 93 Deaths of non-residents, 185 Population in 1871, 76,332. Population in 1861, 78,970. BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE Sanitarg Condition OF THE WHITECHAPEL DISTRICT FOR. THE QUARTER ENDING 28TH JUNE, 1873, BY JOHN LILDLE, MEDICAL OFFICER OF HEALTH. London: Printed br T. Penny & Co., 121, Leman Street, Whitechaped., E. 1873. REPORT Of THE MEDICAL OFFICER OF HEALTH, FOR THE Quarter ending 28th June, 1873. To the Board of Woeks, Whitechapel Distbict. Gentlemen, In the Quarter that ended on Saturday, June 28th, 1873, the births registered in the Whitechapel District were 655 ; viz., 340 males and 315 females. During the same period the deaths have been 538 : of these, 316 have been of males and 222 of females. In the corresponding Quarter of the previous year the births were 684 and the deaths 564. The number of births is less by 29 than in the corresponding quarter of last year, and a decrease of 26 has taken place in the number of deaths. The deaths in the London Hospital have been 144 ; viz., 102 males and 42 females. Of the total deaths in this institution there were 13 of persons resident within the District, 95 of non-residents, and 36 of persons who died either suddenly or from the result of accident. The total mortality of this District is increased by the deaths of residents within the District which have occurred in other hospitals in the Metropolis; but of those I have no complete record. It is a matter for regret to all persons who are interested in estimatiug the rate of mortality in small districts inhabited by the poorer classes, that the records of the deaths which occur in the public institutions are not forwarded to the sanitary authorities of the Districts from which the patients had been removed. I obtain the addresses of all the patients who die in the London Hospital, and, by the courtesy of Mr. Vallance, the Clerk to the Board of Guardians, I receive a list of the deaths of those patients belonging to this District, and of their addresses, before they were removed to the Small Pox and Fever Hospitals; but, as a great many of the poor in this District avail themselves of the advantages so freely offered by the several great Hospitals in London, it is much to be desired that such arrangements should be made with the several Hospital authorities as will enable the Medical Officer of Health to record, with accuracy, the actual mortality of his District. 4 A death, of a non-resident from typhoid, or enteric fever, occurred in the London Hospital. The deaths from pysemia in this institution have been six in number; of these, 4 occurred in the week ending June 28th; there were also 6 deaths from erysipelas. The deaths in the Workhouse have been 76; viz., 47 males and 29 females. No death from epidemic disease occurred in this establishment. The deaths from epidemic diseases in the entire District have been 61; viz., 1 from Small-pox, 3 from measles, 4 from scarlet-fever, 31 from hooping-cough, 11 from diarrhoea, and 11 from fever. Ten deaths from fever occurred in the Fever Hospital; thus making a'total of 21 deaths from fever. There were 7 deaths from erysipelas, 6 from croup, 1 from puerperal-fever, and 1 from rheumatism. In the corresponding quarter of the previous year the deaths from epidemic diseases were 85; viz., 42 from small-pox, 14 from measles, 1 from scarlet-fever, 11 from hooping-cough, 8 from diarrhoea and 9 from fever. The deaths caused by diseases of the respiratory organs, exclusive of Consumption, have been 90 ; of these, 46 were caused by bronchitis, 30 by pneumonia, 1 by laryngitis, 1 by laryngismus, 4 by pleuritis, 5 by asthma, 1 by spasm of the glottis, 1 by oedema of the glottis, and 1 by spasm of the larynx. Consumption was fatal to 68 persons. The deaths from other tubercular diseases were 34; viz., 14 from mesenteric disease, 9 from tubercular meningitis, 8 from hydrocephalus, or water on the brain, 2 from scrofula, and 1 from purpura. Diseases of the organs of circulation were fatal to 36 persons; of these, 34 died from disease of the heart, 1 from disease of the arteries (ossification), and 1 from pericarditis. Cancer was fatal to 12 persons. The deaths from diseases of the urinary organs were 22 ; of these, 9 were caused by nephria or Bright's disease, 3 by nephritis, 5 by disease of the bladder, 1 by disease of the prostate gland, 1 from retention of urine, and 3 from disease of the kidneys. Convulsions caused the deaths of 18 children. In the corresponding quarter of last year the deaths by convulsions were 17. There were 8 deaths from teething, 20 from atrophy and debility, and 2 from premature birth. In the corresponding quarter of the previous year the deaths from these three causes were 30. There was one death from congenital syphilis. One death occurred from stricture of the urethra. One death occurred from privation, 3 from excessive drinking, and 1 from want of breast milk. The death of 13 persons is attributed to old age: of these, 8 were above 80 years of age. 5 There were 36 deaths from mechanical violence ; of these, 7 were caused by horses and vehicles in the streets. In the corresponding quarter of last year the deaths from mechanical violence were 29, including 8 caused by horses and vehicles in the streets. One death by manslaughter is recorded. Burns and scalds were fatal to 4 persons. Three persons committed suicide. Eight children were suffocated in bed. A man, aged 35, was suffocated by a piece of meat sticking in his throat. Three women died in childbirth. The number of inquests has been 68. In the corresponding quarter of last year the number was 87. Uncertified Deaths. The deaths which have not been certified by a medical practitioner have been 18 ; of these, 11 were recorded in the Spitalfields sub-district. Mortality of Young Children. The mortality of children under five years of age was 187. This is 34.7 per cent. of the total mortality. In the corresponding quarter of the previous year the rate of mortality of children under 5 was 35.9 per cent. of the total mortality. In the Artillery sub-district the rate is 40.0 per cent.; in the Spitalfields, 60.3 per cent. ; in the Mile End New Town, 29.4 per cent ; in the Whitechapel North, 56.7 per cent.; in the Whitechapel Church, 14.2 per cent.; in the Goodman's Fields, 52.9 per cent.; and in the Aldgate, 44.4 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended during the last quarter 1143 new cases of illness out of the Workhouse; including 1 of smallpox, G of measles, 6 of scarlet-fever, 40 of hooping-cough, 22 of diarrhoea, 109 of febricula, 55 of fever, and 5 of erysipelas. In the corresponding quarter of the previous year the number of pauper cases of illness was 1151; including 26 of small-pox, 31 of measles, 3 of scarlet-fever, 29 of hoopingcough, 30 of diarrhoea, 79 of febricula, 4 of fever, and 10 of erysipelas. The total number of cases of illness in the Workhouse has been 588, including 6 of hooping-cough, 11 of diarrhoea, and 34 of febricula. In the corresponding quarter of the previous year the total number in the Workhouse was 486; including 1 of fever, 3 of measles, 2 of hooping-cough, 68 of diarrhoea, and 24 of febricula. Meteoeology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the quarter has been 3.79 inches. During the corresponding quarter of last year the rain-fall was 5.86 inches. The mean temperature of the air was 50.7°. In the corresponding quarter of last year the mean temperature was 52.6°. The hottest days during the quarter were Saturday, the 21st June, Sunday, 22nd June, and Friday, 27th June 6 when the thermometer indicated respectively 78.1°, 79.9°, and 81.2°. The hottest day during the corresponding quarter of last year was on Monday, the 17th June, when the thermometer indicated 86°.0 The following table, taken from the returns of the Registrar-General, shows the comparative results of the Quarter:— LONDON. Apl. 5th Apl. 12th Apl. 19 th Apl. 26th May 3rd May 10th May 17th May 24 th May 31st June 7th June 14 th June 21st June 28th Deaths from Fever 20 25 29 19 20 25 34 22 22 22 24 16 20 Deaths from Scarlet Fever 12 6 5 8 7 5 7 6 8 11 9 9 10 Mean Temperature of the air 48.6° 41.7° 52.1° 42.5° 48.5° 48.4° 50.1° 49.6° 5.34° 55.4° 56.8° 60.4° 62.0° Rain-fall in inches 0.21 0.14 0.06 0.07 0.27 0.90 0.15 0.27 0.17 0.68 0.26 0.76 0.00 Deaths in London 1438 1421 1603 1252 1326 1355 1271 1213 1182 1219 1090 1191 1129 Deaths in Whitechapel District 52 37 56 52 52 34 46 31 19 49 25 44 41 Deaths in ditto from Fever 0 1 2 0 2 0 2 1 1 0 2 0 0 Water Supply. Since my last quarterly report nine additional water-waste-preventers have been erected in this District. There are now in this District 183 waterwaste-preventers. From the satisfaction which these machines give to the poor I hope that the time is not far distant when butts and cisterns in the poor localities will be entirely abolished, and that water will be supplied to them on the constant service, direct from the main. Butts and cisterns are not adapted for the poor in densely populated districts. Vaccination. VHITECHAPEL UNION.— Return of the number of Cases Vaccinated by the Public Vaccinator and the Medical Officer of the Workhouse, together with the number of Births Registered during the same quarters. Quarter ending— PUBLIC VACCINATOR Workhouse. Totals. Births Registd. Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination Primary Cases. Re-Vacci nation. September, 1871 186 12 35 0 221 12 602 December 134 6 27 0 161 6 653 March, 1872 219 16 43 1 262 17 720 June 289 9 32 0 321 9 684 September 306 1 26 4 332 5 640 December 263 0 23 1 286 1 685 March, 1873 290 6 23 0 313 6 720 June 331 2 17 0 348 2 663 Totals 2018 52 226 6 2244 58 5367 7 Small Pox. During this quarter only one case of small-pox has been attended by the Medical Officers of the Union; and from the returns of mortality, as given by the local Registrars, one death only from this disease has been registered. Sanitary Works Performed during the Quarter. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ending June 28th, 1873 :— Number of inspections of houses as shown in the official returns 3689 Houses specially visited 609 Ditto specially re-visited 1218 Preliminary notices served, such notices embracing 502 premises 258 Compulsory orders issued, embracing 84 premises 45 Summonses heard at Police Courts 2 Cellars used as dwellings discontinued for such use 2 Cases of overcrowding and indecent occupation abated 6 Houses in which the rooms or passages have been whitewashed 200 Rooms disinfected with sulphurous acid gas after the occurrence of 61 small-pox, fever or scarlet-fever, therein Articles disinfected consisting of beds, bedding, clothing, &c 351 Trades' Nuisances abated 2 Yards of houses paved or the pavement repaired 56 Drains in houses improved 49 Dust-bins provided 7 Privies lime-washed, cleansed, and repaired 111 Water-butts and cisterns provided or repaired 28 Water-waste-preventers erected 9 Nuisances from dung and other offensive matter removed 12 Animals (Pigs) kept so as to be a nuisance, removed 8 Area gratings and cellar flaps repaired 7 The cow-houses in the District, 24, the slaughter-houses, 35, and the bakehouses 72, in number, have been visited during the quarter. In addition to this return, the Inspectors report that they have forwarded to the Metropolitan Board of Works several notices of dangerous structures, which notices the Metropolitan Board have promptly attended to. Sanitary Improvements effected in the South Side of the District, viz., in Peter's Court, Cowpee's Court, Crown Court, Blue Anchor Yard, and Brownson's Court, Great Alie Street. On the sanitary improvements effected in the above-named places, Mr. Batteam states that, by direction of the Medical Officer of Health, he intimated to the landlord that a certain house in Peter's Court was not only in itself unfit for habitation, in consequence of its being insufficiently ventilated, but also by its obstructing the current of air to the adjacent houses, which belonged to the same landlord, whereby they were rendered unfit for 8 habitation. It was therefore, in the opinion of the Medical Officer of Health, absolutely necessary to take down this house. The landlord, after a little consideration, pulled down the house referred to, whereby the adjacent houses were rendered more healthy. Arrangements are being made with the Water Company to supply this locality on the constant service. The public privies in Cooper's Court, which were built entirely of wood, and which, from age, had become so saturated with filth as to be a nuisance, have been re-constructed and covered with cement, so that the nuisance is now considerably abated. The drainage of the houses on the north side of Crown Court, Blue Anchor Yard, in which several cases of fever had occurred, was found upon inspection to be defective, when the landlord was served with notice to lay down new pipe drains, to re-construct the privies, and to properly pave the back yards. This work has been carried out to the satisfaction of the Inspector. The water-supply in Brownson's Court, which consists of six small houses, was defective. The receptacles were old wooden butts. These butts have been taken away, and a water-waste-preventer has been fixed in the yard of each house. My attention was drawn to the back rooms of two houses in Chicksand Street, Nos. 21 and 22, which were then under repair, my informant stating that the said rooms were in his opinion unfit for habitation. This opinion I confirmed, for the following reasons : the floors of these rooms were more than a foot below the level of the back yards, and the rooms did not exceed 6-ft. 4-in. in height. The landlord, on being made acquainted with my opinion as to the unfitness of these rooms for habitation, called upon me, and promised that they should not he again used as habitable rooms. Several weeks have elapsed since my interview with the owner, and these rooms still remain closed. TRADES' NUISANCES. Skin Dyeing and Dressing. A memorial, signed by several inhabitants in the neighbourhood of "Wood Street, Spitalfields, was addressed to the Board, complaining of a nuisance injurious to health, which was caused by the dyeing and dressing of skins in the cellar of No. 26, Wood Street. On visiting these premises it was manifest that they were not adapted for the carrying on of such a business; and as the nuisance was, in my opinion, injurious to health, a notice was served on the owner to discontinue the business of skin dyeing and dressing in those premises. Shortly after the serving of this notice, the occupier of the cellar removed. Glucose Factory in Booth Street. Several complaints having from time to time been made of the offensive smell from these premises, I visited them late one evening, and ascertained that the nuisance arose from the escape of offensive steam 9 from a pipe which passed from the vessel in which the materials for making the glucose are boiled, through the roof of the building. There was no doubt whatever that the smell of this steam was very offensive, and I suggested that, instead of carrying the pipe through the roof of the building, it should be conveyed into or sufficiently near the furnace so as to destroy all the offensive products. The manufacturer promised to carry out this suggestion. At all events, no complaints have recently been made to me upon the subject of this nuisance. The prevalence of Fever in some parts or the District. From the daily records of cases of illness attended by the Medical Officers of the Union, which I have the privilege of examining every week at the Workhouse, I learnt that in the months of March and April last, cases of febricula, or slight febrile attacks, began to be very prevalent in some parts of the District, especially in that which is situated on the south side of Royal Mint Street, and which is under the medical superintendence of Mr. Loane. From the prevalence of these febrile disorders, I was led to infer that an outbreak of fever would sooner or later take place. This event unfortunately happened, and on the 2nd of June I reported to the Board that, from the 1st April to that date, 37 cases of fever had occurred in Mr.LoANE's district; and, on the 16th June, I again reported to the Board that, for the fortnight ending 7th June, the Medical Officers of the Union had attended 14 cases of febricula and 13 of fever. The fever cases were entirely confined to the districts of Mr. Loane and Mr. Sequeira, whose district is contiguous to that of Mr. Loane's, being separated from it by Royal Mint Street. At this date, viz., 7th June, no less than 7 cases of fever had been attended by Mr. Sequeira in the preceding four weeks, in two houses in Jones's Buildings, numbered 19 and 20. These two houses, which contain two rooms each, are only about two feet from the two public privies, which are placed back to back, and are situated between these two houses. These privies are used by the inhabitants of the four or six contiguous houses, all of which contain two rooms each. Owing to a temporary defect in the drain or soil-pipe, offensive emanations pervaded all rooms in these two houses. It is a very significant fact, that it was only in these two houses, which were subjected to the emanations of the privies, that fever occurred; and up to the 28th June these 7 cases were the only ones that occurred in this court. Having intimated to the landlord that several of the houses in Jones' Buildings were unfit for habitation, it was deemed by him advisable to pull down 17 of them. From Table No. I., in the Appendix, it appears that the cases of fever in the entire District, for the quarter, have been 55 ; of these, Mr. Loane has attended 47, and Mr. Sequeira 7 ; whereas, for the corresponding quarter of the previous year, the cases of fever in the entire District were only 4. In this quarter, the deaths from fever recorded in the District 10 have been 11. To this number, however, must be added the 10 deaths in the Fever Hospital of persons belonging to this District; thus making the total number of deaths from fever 21. So soon as I became acquainted with the fact that fever, said by Mr. Loane and Mr. Sequeira to be typhoid, was prevalent in certain courts in the District, I requested the Surveyor to make application to the "Water Companies for a sufficient supply of water to enable his staff of men to flush out, three times every week, not only the courts in which fever prevailed, but also the public privies and drains. The flushing was well carried out, under the direction of the Surveyor; and at the first meeting of the Board I reported what had been done. The Board fully approved of the same, and sanctioned its continuance. This proceeding has apparently been attended with very satisfactory results, for since the two privies above-men tioned were thoroughly flushed out, no other case of fever has occurred in the court. I may, however, observe, that 6 out of the 7 patients in these two houses were sent to the Fever Hospital, where three of them died. The cases of fever in the other courts rapidly declined in number, so that no new case was recorded in the District for a period of eight or nine days, when the flushing was discontinued. There are, however, a few cases scattered over the District. In addition to the flushing, above-mentioned, which was continued for a period of about four weeks, (at a cost of £61 15s.) carbolic acid was freely used in the courts and privies wherever fever cases existed. The clothes and bedding of the patients were disinfected by heat in the disinfecting apparatus, and the rooms were disinfected by sulphurous acid gas. Steps were also taken to diminish the over-crowding of all the rooms in the neighbourhood where it was found that space less than 300 cubic feet was allotted to each inmate. The landlords were served with notices to repair and trap all drains which were found to be defective, and all available means were used to induce persons suffering from fever to be removed to the hospital. At first, great difficulty was experienced in inducing patients to be removed, but after a time this difficulty decreased. The 26th section of the Sanitary Act gives power to the local authorities to obtain an order from the Magistrate to compel the removal of a patient suffering from any infectious disease, who is not provided with proper lodging, to a hospital; but as there is no specified penalty for not complying with the order of the Magistrate, it is almost useless for the Officers of the Board to obtain such order. This section of the Sanitary Act certainly requires to be so amended as to give the officers of the local boards power to remove any person suffering from infectious disease, when, by such person remaining at home, the lives of others living in the same house may be endangered. Only a few days ago the Inspector, in visiting a case of fever, found that a boy, aged about 13 years, had been ill for several days with fever (probably typhus). This room has a cubic space of 1050 feet, and was tenanted by a man, his wife, and four children. Of these four children, three have had fever. The boy above- 11 mentioned was in bed, on which the mother, who was not ill, was lying down; and the father was sitting on the chair by the side of the bed, with his head resting upon it. Mr. Loane urged the removal of the patient, but the boy refused to be taken away. The smell of this room was very offensive, although the window was open. Notice was served upon the landlord to diminish the overcrowding of the room; but, owing to three of the inmates having been attacked with fever, it was deemed advisable not to enforce immediate compliance with the notice, but to wait until the patients had recovered. The last severe epidemic of fever was in 1862, when 250 deaths occurred in this District, and 822 cases were recorded in the books of the Medical Officers of the Union. In 1838, however, the severest outbreak of fever known to this generation occurred in the metropolis, when, in a population of less than 2,000,000, (the population being, according to the census of 1831, 1,594,890) the deaths from fever were 4078 ; and in the Whitechapel District, in a population of about 69,000, the deaths were 368, exclusive of those which occurred in the Fever Hospital. The death-rate for the year 1837-8, in the Whitechapel District, was 4.5 per cent. ; while the death-rate for the last year was reduced to 2.5 per cent., or nearly one-half. The extra expense incurred by the Union, for fever cases alone, for the quarter ending Lady Day, 1838, was estimated by the late Mr, John Smith to be £400. Although much has been done to improve the sanitary condition of this % District, much more is required to be done ; and, so long as the numerous narrow and confined courts remain, in which the houses are old, dilapidated, ill-constructed, and without sufficient ventilation, we cannot expect to have a much lower rate of mortality than is now found to exist. School Board School, Old Castle Street. In my Eeport for September, 1872, I drew attention to the fact that the School Board for London had purchased a piece of ground in Old Castle Street, which had been for many years the site of a brewery. The school building is now completed, and is intended to receive within its walls 1272 children, viz., 396 boys, 396 girls, and 480 infants, for all of whom ample accommodation appears to have been provided. But the great drawback to the full advantages which may reasonably be expected to be derived from this institution, the first which has been completed in London, is the very confined locality in which it is situated. My object in adverting to the confined situation of this building, into which so many of the children of the poorer classes will assemble daily, is not to express any feeling of regret that this particular site has been selected, (for I believe it is the only one available for that purpose in Whitechapel) but to draw the attention of the Sphool Board and the public to the desirability, I may almost say necessity, for maintaining the health and comfort of the numerous children who will attend that School, to widen the approaches to it. Although there are three 12 ways by which the School can be approached, not one of them is convenient. The first, or most direct, is by Castle Alley. This is a very narrow thoroughfare, leading from Whitechapel High Street, which is entered by a covered way, several feet in length and only about three feet in width. Owing to the frequent deposit of filth in this narrow passage, and from its defective ventilation, it is generally in an offensive condition. This alley contains an area, including the space on which the houses [stand, of about 1496 square yards, and has a population of 347, consisting of the very poorest class, each person having an average space of only 4 square yards. Some of the houses on the east side of this alley are very old, and so badly constructed that, a few years ago, I presented a report to the Board, under the Artizans and Labourers Dwellings Act, stating that, in my opinion, the said houses were unfit for habitation. On my report being referred to the late Mr. Fricker, the Surveyor to the Board, some alterations under his direction were carried out by the landlord, and my report was necessarily withdrawn. These houses have been still further improved, but, owing to the defective ventilation of this part of Castle Alley, they are far from being in a satisfactory sanitary condition. The eight houses on the west side of the court are very old—the walls and flooring of the cellars are wet, and a most unwholesome smell comes through the floors of the lower rooms, which renders such rooms unfit for habitation. The privy of each house is in the cellar, the nuisance from which, there being no other means for its escape, ascends by the staircase, and makes its way into every room of the house. It is almost impossible for the tenants of these houses to keep the rooms clean, for the houses are three stories high, the privies in the cellars, which are difficult of access, and the water supply is in the court. As there are no sinks in the houses, all the dirty water must be either carried down four flights of narrow stairs to the privy, or thrown into the open court. In conformity with the 12th section of the Artizans and Labourers Dwellings Act, four householders, living near to this alley, have represented to me, in writing, that the said eight houses are in a condition or state dangerous to health, so as to be unfit for human habitation. In compliance with this representation, I have specially inspected the said houses, and I confirm the opinion as above expressed, and have reported my opinion thereon to the Board. The second way by which this School can be approached is through New Castle Street, the entrance to which is also from Whitechapel High Street, and is situated only a few yards to the east of the opening leading to Castle Alley. The entrance to New Castle Street is likewise under an arch, formed by a very old house in High Street, and is only of sufficient width to admit one carriage at a time ; and, at the north end of the street, there is a small, narrow, arched passage, which leads to the School. The third way by which access to this School is obtained, is at the north end of Old Castle 13 Street, which is also very narrow, and opens into Wentworth Street. Wentworth Street is a long, narrow thoronghfare, extending from Osborn Street to Middlesex Street, and abounds in narrow courts, in all of which the ventilation is very defective. From the mortality returns of this locality it is very unhealthy, and it is not to be wondered at, when it is one of the most densely, if not the most densely populated locality in London. All these places, viz., Castle Alley, New Castle Street, and Wentworth Street, should certainly be so widened as not only to make convenient approaches to this large and important School, but, what is of far more importance, to improve the sanitary condition of this overcrowded locality. "When the public are further initiated in sanitary science, and the necessity of a free current of air and sunlight being admitted into all the courts and alleys which are occupied by the poorer classes is better understood, then we shall find that more vigorous efforts will be made towards the opening out of such places. If some of those confined courts which are found leading out of most of the principal thoroughfares in London were exposed to view, by the taking down of the houses which form archways over the entrances to them, the hideousness of many of them would be so apparent, that the public would insist upon the local authorities taking the necessary steps to get them improved. It is true that Public Boards might not gain much eclat by such proceedings, but the ratepayers would soon reap the benefit of them, in the enjoyment of better health themselves, and by having to pay a less amount in support of the poor, in consequence of diminished sickness and a lower rate of mortality. The members of the School Board appear to be thoroughly alive to the importance of having an open space adjoining the School. They are convinced that, while cultivating the mental faculties of the poor children, their physical development should at the same time be attended to ; knowing full well that instruction cannot be readily imparted to a child, unless that child is surrounded by a healthy atmosphere ; and although the School Board cannot make new and wide thoroughfares, which the Metropolitan Board of Works only can do, yet, towards the improvement of the health of the children who will be committed to their charge, they propose to retain, for the recreation of the children, a piece of ground, of about 9,000 square feet, at the north end of the building. When this proposition was made by Lord Lawrence, at the opening of the School, it was received with great applause by the large audience that was present on that interesting occasion. If the entire open space which is proposed to be appropriated for a recreation ground were to be planted with trees, shrubs and flowers, the healthiness of the locality would be still further promoted. As there is now a reasonable prospect of re-opening the Baths and Wash-houses, which are situated in Castle Alley and Goulston Street, and 14 are in close proximity to the School, advantage may be taken by the School Board, in inculcating lessons of cleanliness, and enabling the children to practice such lessons, by affording them the opportunity of bathing; and as there will be a swimming bath provided, the children may be taught the art of swimming. It must be obvious to everyone who is acquainted with this locality, that there is no part of the District in which sanitary improvements are more required than in the locality of this School; and I may add, that if the surplus land belonging to the School Board had been let for building purposes, and if high houses had been built upon it, the circulation of air, which is now defective, would have been rendered much worse. I am, however, happy in being able to say that arrangements have been recently entered into between this Board and the School Board, not only to widen the thoroughfare at the north end of Old Castle Street, but still further to increase the size of the open space which was originally intended to be appropriated for a play-ground. When this arrangement is carried out, the public will have the benefit of about 1,160 square feet of open space. Memorandum of the Medical Officers of Health of the Metropolis on the measures neoessary for arresting the spread of scarlet-fever. In consequence of the prevalence of typhoid fever in this District, and the ominous warnings which have been given to us respecting cholera, I have deemed it advisable to add the following memorandum, which was published in 1869, to this report, for the same observations which are made respecting the prevention of the spread of scarlet-fever are equally applicable to prevent the spread of fever or of cholera. " It is quite possible to cheek Scarlet-Fever, if adequate means be taken to destroy the emanations of the sick, so that they shall not infect the healthy. For this purpose the sick must be separated, either by putting them into rooms apart, or, by sending them out to a Sick-House, or, which is better, by removing the healthy to another house. The infecting matter of the disease resides in the excretions of the mouth, throat, and lungs, of the bowels and kidneys, of the skin, and of the suppurating surfaces common towards the close of the disease. Disinfection should be applied assiduously to the mouth, nose, and throat, as each case may require, by gargling, swabbing, or syringing with a teaspoonful of Condy's Fluid to a pint of water; the excreta of the bowels and kidneys should be well dosed with strong carbolic acid before they leave the bedside ; the air of the sick room should be occasionally freshened by dispersing Condy's Fluid (diluted as above) by means of a vaporizer ; and the doorway should be hung with a sheet well sprinkled with carbolic acid, so that there may be no mixing of tainted air with that of the body of the house. It can do no harm to oil the skin during the height of the fever, but what is of real consequence is the persevering use of warm soapy baths so soon as the patient can take them, and through the convalescence, till the skin has done peeling and the throat and nose are healed. All handkerchiefs, towels, and linen. before leaving the room should be steeped in boiling water containing a teaspoonful of solution of chloride of soda, or of Condy's liquid, to a pint; and when the disease is over, the bedding and clothing of the patient and his attendants, all floors, walls, and ceilings, and the surface of all furniture on which infectious matters may have settled, should be scraped, or cleaned with a disinfectant, and fumigated. Moreover, disinfecting fluids (as carbolic acid) should be poured freely after the slops from the sick room into the closets, sinks, drains, and sewers, and into every place around the house where decaying organic matter can be harboured. " The persons attending on the sick should wear glazed or smooth dresses by preference ; they should often wash their hands, especially before eating, and should mix as little as possible with the family. 15 "For fumigating infected rooms and their contents nothing is better than sulphur. A quarter of a pound of brimstone, broken into small pieces, should be put into an iron dish (or the lid of an iron saucepan turned upside down), supported by a pair of tongs over a bucket of water. The chimney and other openings are then closed with paper pasted on, and a shovelful of live coals is put upon the brimstone. The door is then quickly shut, the crevices covered with paper and paste, and the room kept closed for five or six hours. After this a thorough cleansing should be effected ; everything washable should be washed, and all other things cleansed by proper means. " Fumigation of clothes, &c., may be easily carried out on a small scale by burning a sufficient quantity of brimstone matches. " Provided there be no unsuspected drain, sewer, gulley, watercloset, pipe, or cistern, or other source whence the inmates receive fresh infection, scarlet-fever can be and is daily arrested in private houses by the above means carried out in detail; but only by persons having space, wealth, intelligence, and the wish to save life. It is far otherwise in the crowded houses of the poor, where the healthy are mixed with the sick and even with the dead. " Public hygienic measures are then necessary, and the following are the measures which the Medical Officers of Health recommend. "Measures of Public Hygiene, and the present Impediments to their Adoption. "1. Information should be diffused through every family by printed bills as to the contagiousness of scarlet-fever, and the mode of preventing it. " 2. Every ease of scarlet fever, and especially every first case, should be immediately reported to the sanitary authority. At present this is not done. There is no provision by which cases of infectious disease, even in poor law and public practice, shall be made known to the Medical Officers of Health. In some districts, by an act of courtesy, information is forwarded at more or less prolonged intervals, and so, usually, at a late period of the illness. It is only when death occurs that the Health Officers with certainty hear of the occurrence, and by that time (often a week or ten days after death) the contagion may have spread more or less extensively. They neveT hear officially of pri vate eases ; it is held to be the interest of all parties to conceal their occurrence. Without early and ample information, it is impossible to put in force the provisions of the Sanitary Act directing the disinfection of houses, &c, and forbidding the exposure of disinfected persons and. articles. " 3. Every case so reported should be immediately visited by the Medical Officer of Health or his skilled assistant, who should see that all proper precautions are in operation. But even with full and early information, adequate precautions could only be superintended by the devotion of all the time of the Health Officer to public work, for which the sanitary authorities have made no provision, and by the aid of a staff of assistants such as was given to few of them even during the cholera epidemic. "4. The streets and courts, and the yards of infected houses, should be watered with a disinfectant solution, such as carbolic acid. " 5. Public day and Sunday schools in an infected district should be authoritatively closed. The out-patient rooms of hospitals and dispensaries are even more dangerous than schools. It should be a punishable offence to send a child to any day school, public or private, from a house or family in which fever exists. There is, however, no power or authority for this. " 6. Sufficient hospital accommodation should be provided for the poor, with arrangements at each hospital for the disinfection of the person and clothing of the patient on his discharge. " 7. Where it appears to the Medical Officer of Health necessary that the sick person should be removed, he should be able to enforce the removal, certainly in any case where the sick is under no medical care, or is being treated at the public expense. Very limited powers of this kind are at present conferred by the 26th section of the Sanitary Act, 1866, and these are only applicable after considerable dangerous delay. This section is practically useless. "8. An appropriate carriage should be provided in every district for the conveyance of the sick to the hospital. At present public cabs are still largely used, because few local authorities in London have provided appropriate carriages, as they are empowered to do by the 24 th section of the Sanitary Act, and sometimes because the sick refuse to use them. " 9. The Sanitary Act (sections 24 and 38), as it relates to the use and disinfection of public carriages for the conveyance of persons with infectious diseases should be enforced : this is not done. "10. There should be in every district one or more proper mortuary houses for the reception of the dead of any class of society, and removal thereto should be capable 16 of being enforced where necessary. There are many of the districts of the metropolis in which the local sanitary authorities have not yet provided the mortuary house, which they are empowered to provide by the 27th section of the Sanitary Act; even where it has been provided the limitations imposed by that section render the statute practically valueless. In all cases a packet of Mc Dougal's or of Calvert's disinfecting powder should be strewed over the body before the coffin-lid is screwed down, which should be done as quickly as possible. " 11. The sanitary authorities should provide such a staff of assistants, or labourers, and such appliances as may be necessary to carry out the disinfection of houses, clothing, bedding, &c., where people are too poor or ignorant to be trusted with the work ; and also proper means of destroying certain things by fire. " 12. There should be arrangements by which articles of clothing, bedding, &c., destroyed by order of the Medical Officers of Health may either be replaced or paid for. At times when the " Diseases Prevention Act" is not in operation by order of the Privy Council, no such arrangement can be made. " 13. During the disinfection of a house or apartment, or when the sick person cannot be removed, it is necessary to remove the healthy; for this there should be one or more houses of refuge provided, in which poor families may be temporarily lodged, and with means of disinfecting the persons and clothing of those removed. A house of refuge is a thing at the present time utterly unknown to the sanitary arrangements of the Metropolis. " 14. The " Diseases Prevention Act" should be put into operation by order of the Privy Council on any severe outbreak of scarlet-fever in London, or at times when, from season or cyclical period, it is probable that the disease will spread extensively. Practically, this otherwise invaluable Act is a dead letter, except on certain occasions, when an unusual disease prevails in the country, such as an epidemic of cholera. "15. The services of public nurses to superintend the administration of nourishment and medicine, and the disinfection of discharges, would be invaluable. One bad case of scarlet-fever furnishes quite occupation enough for one woman. " 16. The Medical Officers of Health desire to put in force the lodging-house clauses of the Sanitary Act, 1866, sect. 35, which, by restricting the number of inmates, and by enforcing periodic cleansing of the homes of the poor, might in some degree limit zymotic disease." It cannot be too strongly impressed upon the public mind that the contagion of typhoid fever, and probably of all other epidemic diseases, is conveyed by the exposure, without previous disinfection, of the excrements of patients suffering from any of those diseases ; and hence the importance of pouring carbolic acid, or some other powerful disinfectant, on all the excretions immediately they are discharged. I have on several occasions pointed out the danger to which persons are exposed who live in those rooms on the ground floor into which the staircase opens and forms a part, and which are necessarily used as thoroughfares by the occupants of the upper rooms of the house on their way to the privy, or house-drain, to empty house slops and the discharges of persons living in the upper rooms, when they are attacked with epidemic disease. The danger to persons living in the upper rooms of houses so constructed is also very great, when any person on the ground floor is attacked with contagious disease, in consequence of the emanations from the sick making their way up the staircase, which necessarily forms a ventilating shaft of the lower room, and conveys the foul air of the lower room into the rooms above. Houses so constructed are, in my opinion, except in special cases, unfit for habitation. I am, Gentlemen, Tour obedient Servant, JOHN LIDDLE. APPENDIX. TABLE I.—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 on the 28th June, 1873. Names of Medical Officers, Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic-Diarrhoea. Continued Fever, Typhus & Typhoid. Febricula. Pyaemia. Erysipelas. Puerperal Fever. Croup. Acute Pulmonary Inflammation. Carbuncle. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. Total. Bronchitis and Catarrh. Pleuritis and Pneumonia. Dr. Swyer 0 1 2 4 9 0 0 21 0 0 0 0 18 12 0 5 0 0 1 0 138 211 Mr. Champneys 0 1 1 7 4 0 1 12 0 2 0 0 29 1 1 2 1 1 0 0 138 201 Mr. Sequeira 0 3 1 7 2 0 7 27 0 2 0 0 13 3 1 0 3 0 0 0 125 194 Mr. H. Braye 1 1 1 10 3 0 0 27 0 0 1 2 21 5 0 3 2 1 0 0 209 287 Mr. Loane 0 0 1 12 4 0 47 22 0 1 0 0 12 2 1 4 2 0 0 0 142 250 Total 1 6 6 40 22 0 55 109 0 5 1 2 93 23 3 14 8 2 1 0 752 1143 Corresponding Quarter of previous Year. 26 31 3 29 30 0 4 79 1 10 0 0 101 19 1 14 3 1 1 6 792 1151 Workhouse Mr. J. J. Hott. 0 0 0 6 11 0 0 34 0 6 0 0 97 18 5 69 12 2 7 4 317 588 TABLE II. Showing the Deaths from Epidemic Diseases, for the Three Months ending 28th June, 1873. Districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhoea. Fever. Total. Remarks. Artillery 0 0 0 0 2 0 0 2 Workhouse. 0 0 1 0 7 2 2 12 Mile End New Town 1 1 0 0 2 3 2 9 Whitechapel, North 0 1 1 0 6 4 1 13 Whitechapel Church 0 1 1 0 4 1 1 8 Hospital. Goodman's Fields 0 0 1 0 4 0 2 7 Aldgate 0 0 0 0 0 1 3 10 Totals 1 3 4 0 31 11 11 61 Deaths from Epidemics for the corresponding Quarter, 1872. 42 14 1 0 11 8 9 85 Six deaths from Pyæmia, 7 from Erysipelas, and 1 from Puerperal Fever, occurred in the District A death from Typhoid Fever of a non-resident occurred in the London Hospital, and 10 occurred in the Fever Hospital. Of these, six patients were removed from No. S I District, and 4 from No 3 District. The total number of deaths from fever of Persons belonging to this District has been 21. TABLE III. Showing the Ages at Death in the Workhouse, aud in the London Hospital, for the Quarter ending 28th June, 1873. 0 and under 1. 1 and under 5. 5 and under 20. j 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Total Males, 47 Females, 29 Corresponding Quarter of 1872. Workhouse 6 2 0 16 29 23 • 0 76 77 London Hospital 1 9 16 52 53 12 1 Males, 102 Females, 42 144 126 TABLE IV.—Ages at Death in each Registration District, for the Three Months ending 28th June, 1873. Districts. 0 and under 3. 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. 6 4 2 4 1 6 2 25 Workhouse. Spitalfields 21 17 0 8 5 10 2 63 Mile E. N. Town 20 18 5 23 36 27 0 129 Whitechapel, N 26 12 0 9 9 10 1 67 Whitechapel Ch 12 13 17 56 56 18 3 175 Hospital. Goodman's Fields 12 6 3 2 6 5 0 34 Aldgate 12 8 5 5 11 4 0 45 109 78 32 107 124 80 8 538 TABLE V.—The Births and Deaths in each Registration District, for the Three Months ending 28th J une, 1873. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks M. F. M. F. 26 26 52 11 14 25 27 0 Workhouse. Spitalfields 67 51 118 30 33 63 55 0 Mile EndN.Town 79 76 155 79 50 129 26 0 Whitechapel, N. 53 59 112 38 29 67 45 0 WhitechplChurch 30 33 63 119 56 175 0 112 London Hospital. Goodman's Fields 57 42 99 18 16 34 65 0 95 Non-residents 28 28 56 21 24 45 11 0 died in the London Hospital. 340 315 655 316 222 538 229 112 Excess of Births over] Deaths deducting the 95 Deaths of non-residents 212. Population in 1861, 78,970. Population in 1871, 76,573. Decrease in Population between the Censuses of 1861 and 1871, 2,397 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTRICT FOR THE QUARTER ENDING 27TH SEPT., 1873, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. Uontron: Pkixtfd by T. Penny & Co., 121, Leman Stkeet, W n xtecu a rut, E. 1873. REPORT of the MEDICAL OFFICER OF HEALTH, foe the Quarter ending 27th September, 1873. To the Board of Works, Whitechapel District, Gentlemen, In the Quarter that ended on Saturday, September 27th, 1873, the births registered in the Whitechapel District were 633; viz., 325 males and 308 females. During the same period the deaths have been 573 : of these, 332 have been of males and 241 of females. In the corresponding Quarter of the previous year the births were 640, and the deaths 670. There has been, therefore, a decrease of 7 in the number of births, and a decrease of 97 in the number of deaths. The deaths in the London Hospital have been 144 ; viz., 96 males and 48 females. Of the total deaths in this institution there were 14 of persons resident within the District, 90 of non-residents, and 40 of persons who died either suddenly or from the result of accident. The total mortality of this District is increased by the deaths of residents within the District which have occurred in other hospitals in the Metropolis; but of those I have no record. There were four deaths from fever in the London Hospital during this Quarter—2 from Typhoid, and 2 from Typhus. Of these 4 deaths, 3 were of non-residents. There were also 2 deaths from Diarrhoea, one of which was of a non-resident. Five deaths from Pyaemia, and 3 from Erysipelas occurred in this institution during this Quarter. The deaths in the Workhouse have been 54; viz., 32 males and 22 females. One death from Hooping-Cough occurred in this establishment. The deaths from epidemic diseases in the entire District have been 128 ; viz., 3 from measles, 6 from scarlet-fever, 3 from diphtheria, 10 from hooping-cough, 87 from diarrhoea, 13 from fever, and 6 from choleraic diarrhoea. Five deaths of patients from this District occurred in the Fever Hospital; thus making a total of 18 deaths from fever; but from these there must be deducted 3 deaths of non-residents which occurred in the Londou Hospital, thus reducing the total number of deaths from fever to 15. There were 3 deaths from erysipelas, 6 from croup, 1 from puerperal-fever, 1 from carbuncle, 3 from rheumatism, 5 from pyæmia, and 1 from ague. 4 In the corresponding quarter of the previous year the deaths from epidemic diseases were 114; viz., 6 from measles, 2 from scarlet-fever, 18 from hooping-cough, 78 from diarrhoea, 5 from fever, and 5 from choleraic-diarrhoea. The deaths caused by diseases of the respiratory organs, exclusive of consumption, have been 60 ; of these, 20 were caused by bronchitis, 37 by pneumonia, 2 by asthma, and 1 by spasm of the glottis. Consumption was fatal to 70 persons. The deaths from other" tubercular diseases were 44; viz., 29 from mesenteric disease, 10 from tubercular meningitis, 1 from hydrocephalus, or water on the brain, and 4 from scrofula. In the corresponding Quarter of the previous year the deaths from consumption were 66, and from other tubercular diseases 41. Diseases of the organs of circulation were fatal to 30 persons; of these, 25 died from disease of the heart, and 5 from aneurism. Diathetic diseases were fatal to 23 persons ; of these 6 died from dropsy, 13 from cancer, 3 from mortification, and 1 from abscess. There was 1 death from acute myelitis, 1 from cerebro-spinal meningitis, 11 from disease of the brain, 7 from apoplexy, 1 from epilepsy, and 1 from tetanus. Convulsions caused the death of 27 children. In the correspondingquarter of last year the deaths by convulsions were 23. The deaths from diseases of the digestive organs were 20 j viz., 1 from disease of the stomach, 1 from ulceration of the oesophagus, 1 from cancrum oris, 1 from ascites, 2 from stomatitis, 3 from peritonitis, 2 from hernia, 1 from ileus, 5 from disease of the liver, 2 from ulceration of the intestines, and 1 from ulceration of the rectum. The deaths from diseases of the urinary organs were 21; of these, 12 were caused by nephria or Bright's disease, 2 by diabetes, 2 by stone in the bladder, and 5 by other diseases of the urinary organs. During the corresponding quarter of the previous year the deaths from these causes were 22. Two persons died in childbirth. There were 15 deaths from premature birth, 3 from teething, and 1 from malformation. Two children died from want of breast-milk, and one person, an adult, died from privation. Two children died from congenital syphilis, and 1 adult from syphilis. Thirteen persons died of old age ; of these, 9 were above 80 years of age. The deaths from premature decay were 4, all of which were of persons under 70 years of age. The deaths from atrophy and debility were 16, while in the corresponding quarter of last year they were 34. There were 33 deaths from mechanical violence; of these, 12 were caused by horses and vehicles in the streets. 5 One person died from the effects of burn. The deaths from mechanical violence and from burns were for the corresponding quarter of last year, 28 and 8 respectively. A labourer, aged 29, died from sun-stroke on the 16th September. In the corresponding quarter of last year, 2 children died from sun stroke, aged respectively 6 and 2½ years. A man, non-resident, aged 24, died in the London Hospital from necrosis (diseased bone) caused by the poisonous vapour of phosphorus given off in the process of lucifer-match making. Three persons were drowned. One child was suffocated in bed. In the corresponding quarter of last year 6 children were suffocated in bed. One death is recorded by manslaughter. The number of inquests has been 65. In the corresponding quarter of last year the number was 84. Uncertified Deaths. The deaths which have not been certified by a medical practitioner have been 20 ; of these, 17 are recorded in the Spitalfields sub-district. Mortality of Young Children. The mortality of children under five years of age was 269. This is 46 9 per cent. of the total mortality. In the corresponding quarter of the previous year the rate of mortality of children under 5 was 34.7 per cent. of the total mortality. In the Artillery sub-district the rate is 62.5 per cent.; in the Spitalfields, 68.7 per cent.; in the Mile End New Town, 48.8 per cent.; in the Whitechapel North, 67.8 percent.; in the Whitechapel Church, 16.0 per cent.; in the Goodman's Fields, 72.4 per cent.; and in the Aldgate, 48.9 per cent. Palter Illness in the District. The Medical Officers of the Union have attended, during the quarter, 1110 new cases of illness out of the Workhouse; including 24 of measles, 10 of scarlet-fever, 13 of hooping-cough, 160 of diarrhœa,79 of febricula, 45 of fever, 2 of choleraic diarrhœa and 5 of erysipelas. In the corresponding quarter of the previous year the number of pauper cases of illness was 1227; including 5 of small-pox, 13 of measles, 5 of scarlet-fever, 9 of hooping-cough, 189 of diarrhoea, 87 of febricula, 5 of fever, 3 of choleraic diarrhcea, 1 of pyaemia, and 16 of erysipelas. The total number of cases of illness in the Workhouse has been 554; including 12 of hooping-cough, 48 of diarrhoea, 28 of febricula, 2 of fever, 49 of rheumatic fever, and 10 of erysipelas. In the corresponding quarter of the previous year the total number of cases in the 'Workhouse was 375; including 1 of fever, 18 of diarrhœa, 26 of febricula, 1 of carbuncle, 30 of rheumatic fever, and 8 of erysipelas. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the quarter has been 7.41 inches. During the corresponding quarter of last year the rain-fall was 6.39 inches. The mean 6 ture of the air was 56.3°. In the corresponding quarter of last year the mean temperature was 61.2°. The hottest days during the quarter were Tuesday, July 22nd, Wednesday, July 23rd, and Friday, August 8th, when the thermometer, in the shade, indicated respectively 88.7°, 87.2°, and 87.3°. In the corresponding quarter of the previous year, the highest reading of the thermometer, in the shade, was on Thursday, July 25th, when it indicated 90.9°. The following table, taken from the returns of the Registrar-General, shows the comparative results of the Quarter:— LONDON. July 5 July 12 July 19 July 26 Aug 2 Aug 9 Aug 16 Aug 23 Aug 30 Sept 6 Sept 13 Sept 20 Sept 27 Deaths from Fever 24 20 21 37 22 25 30 31 38 27 26 34 39 „ Diarrhœa 68 100 205 305 375 470 405 362 277 229 162 127 85 „ Cholera 3 6 13 12 23 16 17 16 12 8 13 2 3 Mean Temperature of the air 61.6° 62.6° 59.4° 68.8° 63.7° 66.0° 63.5° 60.0° 61.9° 56.0º 55.0° 55.0° 54.4º Rain-fall in inches 0.98 0.49 1.21 0.03 0.27 0.45 0.55 0.65 0.20 0.51 1.10 0.97 0.00 Deaths in London 1198 1181 1381 1C09 1508 1711 1608 1546 1477 1286 1319 1236 1177 Deaths in Whitechapel District. 35 48 51 35 61 47 52 38 35 40 36 57 31 Deaths in ditto from Fever 2 0 0 4 1 0 2 0 0 0 0 1 3 Small-Pox. During this quarter no death from small-pox has occurred in this district, and not a single case of that disease has been recorded in the books of the Medical Officers of the Union. Vaccination. WHITECHAPEL UNION.—Return of the number of Cases Vaccinated by the Public Vaccinator and the Medical Officer of the Workhouse, together with the number of Births Registered during the same quarters. Quarter ending— PUBLIC VACCINATOR Workhouse. Totals. Births Registd. Primary Cases. Re-Vaccination. Primary Cases. Re-Vaccination Primary Cases. Rc-Vacci nation. December, 1871 134 6 27 0 161 6 653 March, 1872 219 16 43 1 262 17 720 June 289 9 32 0 321 9 684 September 306 1 26 4 332 5 640 December 263 0 23 1 286 1 685 March, 1873 290 6 23 0 313 6 720 June 331 2 17 0 348 2 663 September, 266 0 36 0 302 0 644 Totals 2098 40 227 0 2325 46 5409 7 The number of cases of vaccination, as shown by the preceding table, is not so large as that for the corresponding quarter of the previous year. As the number of births is about the same, the falling off in the number of cases vaccinated may be accounted for by the indifference of parents, as regards the vaccination of their children, when there is no epidemic of small-pox. Sanitary Works Performed during the Quarter. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ending Sept. 27th, 1873:— Number of inspections of houses as shown in the official returns 3489 Houses specially visited 195 Ditto specially re-visited 682 Preliminary notices served, such notices embracing 406 premises 210 Compulsory orders issued, embracing 156 premises 50 Summonses heard at Police Courts under Sanitary Act 2 Ditto ditto Adulteration of Pood Act 4 Cellars used as dwellings discontinued for such use 7 Cases of overcrowding and indecent occupation abated 5 Houses in which the rooms or passages have been whitewashed 220 Rooms disinfected with sulphurous acid gas after the occurrence of 28 fever, scarlet-fever, or cholera, therein Articles disinfected, consisting of beds, bedding, clothing, &c 149 Trades' Nuisances abated 1 Yards of houses paved or the pavement repaired 33 Drains in houses improved 68 Cesspools abolished 2 Dust-bins provided 8 Privies lime-washed, cleansed, and repaired 104 Water-butts and cisterns provided or repaired 20 Houses pulled down, the same being unfit for human habitation 2 Water-waste-preventers erected 5 Nuisances from dung and other offensive matter removed 14 Animals (Pigs) kept so as to be a nuisance, removed 14 Area gratings and cellar flaps repaired 6 The cow-houses in the district, 24, and the slaughter-houses, 35 in number, have been visited during the quarter. In addition to this return, the Inspectors report that they have forwarded to the Metropolitan Board of Works several notices of dangerous structures, which notices the Metropolitan Board have promptly attended to. Water Supply. Prom the above Table it will be seen that five additional water-wastepreventers have been erected. There are now 188 water-waste-preventers in this District, and the number of butts is becoming gradually reduced. I am at a loss to conceive why the use of water-waste-preventers is not made universal in the poor neighbourhoods. These machines appear to be as beneficial to the Water Companies as they are serviceable to the poor. The water-waste-preventers are not now entirely confined to the poorest class of houses, but they are being extended to private houses. There is a great variety of water-waste-preventers now in use ; and a new one, which appears to be approved of by the New River Company, is being introduced, the 8 machinery of which is very simple, and the cost of the apparatus, (which is known as Lambert's Patent Water-waste-preventer Bib Tap) is comparatively small, about 7s. 6d. each. Mr. Samuel Blow, of Swan Street, Minories, Plumber, has erected four of these Bib Taps in this District. Pigs kept contrary to the Statute. It will also be seen from the above Table that 14 pigs have been removed from this District. Pigs have recently been found on three premises in Hunt Street. The several parties have had notice to remove them. The keeping of pigs within 40 yards of any public street is illegal. Sanitary Improvements effected in the South Side of the District, which is under the inspection of Mr. battram. Garden Court. The public privies in Garden Court, which were used in common by the inhabitants of some of the houses in Crown Court, had been frequently complained of as a nuisance. These privies, which were built of wood, had become dilapidated and saturated with filth, have been pulled down, and new slate ones erected on their site. These new privies are constructed upon the trough principle, similar to those in use in the large School for Jewish Children in Bell Lane, Spitalfields, which are used daily, without occasioning a nuisance, by upwards of a thousand boys. The trough, which is constantly kept filled with water, except during the periods of flushing, is placed on an incline, so that by pulling out the plug at the lower end of the trough, all the filth is rapidly carried away into the drain. This operation can be performed several times a day, if needed. Privies so constructed, if properly attended to, are, in my opinion, the best adapted for courts, where, owing to the want of back yards to the houses, public privies are necessarily required. Slater's Court. In this court there Avere four public privies, which were situated within a few feet of the fronts of two or three of the houses in the occupation of several very poor families; which privies at times were so offensive as to render these houses unfit for habitation. It was therefore necessary either that these houses should be closed, or the privies abolished, and new ones erected in another situation. In a corner of this court, the whole of which belongs to the same landlord, there was situated a house which, from the want of proper ventilation, was in my opinion unfit for habitation. I suggested to the owner that he should pull down this house and erect new privies on its site, for the use of the inhabitants of the three houses abovementioned. The landlord adopted my suggestion. The result has been satisfactory. Hairbrain Court. The public privies in Hairbrain Court were built of wood, and were almost always in an offensive condition. It was recommended that these privies should betaken down, and others built of some impermeable substance. This improvement has been carried out with good effect. 9 Walton's Court. The owner of the houses Nos. 6, 7 and 8, in this court, in order to improve the ventilation of them, pulled down the division walls of the small back yards, took down one of the privies, removed the water-butts and erected a water-waste-preventer in lieu thereof. He also improved the pavement in the yards. Wells Yard, Peter's Court. The sanitary condition of the houses in Wells Yard, Peter's Court, has been greatly improved by the landlord. These houses have no back yards, and the water supply to each house was taken from a butt which was situated in the cellar, in close proximity to the privy and drain. The cellars to all these houses were difficult of access, and the smell from them was very offensive. The landlord, having a stable near to these houses, was advised to pull down the stable and erect on its site a sufficient number of privies, and abolish those which were situated in the cellars. Instead of continuing the water supply in butts the landlord has fixed water-waste-preventers, so that his tenants are now supplied with water direct from the main. Jones' Buildings. The seventeen houses in Jones' Buildings, which, in my last Report, I stated were about to be pulled down, are now entirely demolished. Chapel Street, Spitalfields. My attention was directed by Mr. Whack, the Sanitary Inspector for the Northern Division of the District, to the defective sanitary condition of Nos. 7, 8 & 9, Chapel Street. Upon inspection I found that there were two cellars and two yards belonging to these three houses, viz.; one cellar and one yard belonged to No. 7, and Nos. 8 and 9 had one cellar and one yard in common. In each of the cellars the dust-bin and water-butt were situated. Both these cellars were dark and difficult of access. The privies were in the yards, but in order to get to them tenants were obliged to descend by a flight of steps to the cellars, then to pass along the cellars, and to ascend another flight of steps opening into the yards. As two of these houses, Nos. 8 and 9, were let out in tenements, it happened, as might reasonably be expected, that the slops and filth, instead of being conveyed through the cellars to the privy in the yard, were only carried to the ground-floor room of each of these two houses, which were occupied by separate families, and from thence thrown into the public street. The danger to health, and the indecency of such a proceeding were so obvious, as to require my immediate interference. I therefore directed the Sanitary Inspector to serve notices upon the owners to remove the water-butts and dust-bins from the cellars, and to place them in the yards; to provide a convenient access to the yards, by discontinuing the use of the ground-floor rooms as living rooms, and converting them into passages leading to the yard; to remove the flight of steps leading to the yards, and to block up the back openings of the cellars, 10 so that they could no longer he used as thoroughfares. All these alterations have been carried into effect, and I am. informed that the slops, &c., are now not thrown into the public street. One of the cellars is used for keeping coals, and the other, which has an opening into the street, is used by a basket maker for storing canes, &c., for the purposes of his trade. Houses Closed, the same being unfit for Human Habitation. On the 26th July last, Mr. Wrack, the Inspector, drew my attention to the unhealthy condition of nine houses in Pratt's Alley, Little North Street, Whitechapel. Upon inspection of the same I was of opinion that the houses were totally unfit for habitation, in consequence of the court being very harrow, and two feet below the surface of the street. The floor of the groundfloor room of each house is one foot below the level of the court; the height cf the rooms is only about six feet, and the ventilation of the houses is most defective. After inspecting the court I called upon the owner (Mr. Baylis) and informed him of the unfitness of these houses for habitation; whereupon Mr. Baylis intimated that the houses should be immediately closed. This was done, and the entrance to the Court is blocked up. Trade Nuisance Abated. In April last several complaints were made of an offensive smell arising from the trade of a Marine Store Dealer, carried on in the rear of 28, Great Pearl Street, Spitalfields. The premises are surrounded by houses in New Court Quaker Street, Half Wilk Court, Wilk Court, and Great Pearl Street, all of which are occupied by poor people. The inhabitants complained that they were unable to open their windows in consequence of the offensive smell from the premises in question, arising from a large accumulation of filthy rags and other offensive matter. Upon notice being served upon the occupier he removed his business to more suitable premises. Unlicensed Slaughter House used for the Slaughtering of Cattle. A summons was taken out against a butcher for slaughtering cattle on his premises, the same not being licensed for such purpose. The case was heard at the Thames Police Court, and the Magistrate inflicted a fine of £2 10s. and costs. In August, 1865, the same person was summoned for a similar offence, and fined £2 and costs. The full penalty for the offence of slaughtering cattle in unlicensed places is £5. Milk and Typhoid Fever. It having been proved, by most unquestionable evidence, that typhoid fever may be caused by the use of milk which has been exposed to the emanations of persons suffering from that disease, and by the mixture with the milk of a very small quantity of water which has been contaminated by the excretions of patients so affected, it is, for the safety of the public, of the greatest importance that all the dairies, not only in London, but in the country, should be frequently inspected by the Sanitary Officers, to see that the water used in them is taken from a pure source, and that the milk is kept at a sufficient distance from an inhabited house, so as to prevent the possibility of the milk being contaminated by the excretions from any person who may 11 be suffering from contagious disease. The instances of persons being seized with typhoid fever in different parts of London, in Glasgow, in Leeds, and, perhaps, elsewhere, by the use of milk which had either been exposed to the emanations of persons suffering from typhoid fever, or from impure water bein g mixed with it, are sufficiently numerous to prove, almost to demonstration, the great danger to which the public is exposed by using milk so contaminated; and hence the necessity of public authorities taking every means in their power to prevent the contamination of such an important article of food. In my report for the Quarter ending 29th Sept., 1866, I stated that "in some of the cow-sheds pumps are used not only for the purpose of cleanliness, but, probably, for the dilution of milk, and that the use of such pumps ought to be discontinued, and the supply of water obtained from the Water Company." I further added, "that the water in all the superficial wells in London is more or less contaminated; and in the cow-houses the well-water is in constant danger of being still further polluted by the soakage of the fluid filth of the premises. Milk diluted with impure water from these pumps is unwholesome, and may at times be dangerous." As a cow-keeper in this district has a pump on his premises contiguous to his cow-shed, I gave him notice to remove it, considering that, after the experience we have gained of the danger to health from the use of water derived from such a source, the further use of this pump should be discontinued ; and that unless the said pump be removed, it will be my fluty to urge the Board to oppose a further grant of his license for keeping cows. The water from this pump has been analyzed by Dr. Tidy, and the following is the result of the analysis. Sample of Water received by vie from Inspector Wrack, of Whitechapel, in a stoppered Winchester quart bottle, labelled " Sample of Water taken October 27 th, 1873," and received the same day at the Laboratory of the London Hospital Medical College. The Water was clear, but somewhat coloured when examined in bulk. The Water yields an analysis as follows:- Actual or saline ammonia, grains per gallon 0.255 Organic ammonia „ „ 0.04 Carbonates of lime and magnesia, grains per gallon 29.30 Sulphate of lime „ „ 50.28 Sulphate of magnesia „ „ 3.10 Chloride of sodium „ „ 20.06 Silica „ „ 1.45 Organic matter „ „ 2.69 Earthy nirates „ „ 0.61 Total solid matter per gallon Grains 107.49 Hardness before boiling 80.2 „ after boiling 15 minutes 64.7 I am decidedly of opinion that the water is a dangerous one. The very large amount of organic matter and ammonia present is a proof that it is totally unfit for drinking purposes. I consider that the evidence of extensive sewage contamination renders it imperative that the well should be immediately closed. CHARLES MEYMOTT TIDY, M. B., Joint Lecturer on Chemistry & Professor of Medical Jurisprudence at the London Hospital; Master of Surgery; Medical Officer of Health and Analyst for Islington; Food Analyst for Whitechapel, &c. The Laboratory, London Hospital Medical College, 12th November, 1873. 12 The argument so frequently used in favour of the continued use of the pump water in London (that it has been drunk with impunity for a great many years,) is of little value after the experience which has been gained from the fatal effects of the use of the well-water from the pump in Broad Street, St. James's, at the time of the cholera in 1854; for the poison of epidemic diseases may, when such diseases are prevalent, be readily conveyed to any of these superficial wells, all of which are, more or less, contaminated by sewage. Cholera. Two cases of cholera having occurred, on the 29th of July last, at the "Hoop and Horse-shoe" public house, situated at No. 10, Queen Street, Tower Hill, I visited the house immediately on receiving intimation of the fact, when I found that a child of about 12 years had died therein of cholera, after a few hours illness, and that a man was then suffering from the same disease. Both these patients had just arrived from an infected port in the Baltic, and were, with a large number of emigrants, on their way to New Zealand. The Port Sanitary Authority having provided a ship for the reception of cholera patients, the patient was, with as little delay as possible, conveyed to it. This man died after a few days of consecutive fever. The means which I deemed advisable to be carried out for the prevention of the spreading of the disease in this district were as follows, viz:—The bedding and the clothes worn by the patients were disinfected; disinfectants were freely used in the rooms; the dead body of the child was coffined as quickly as possible, and disinfectants were placed both inside and outside the coffin, and the body was buried on the day following the death. The Inspector, Mr. Battram, being fully impressed with the importance of using disinfectants, attended personally to the application of them, and for this purpose, visited the house several times in the course of the day. Mr. Battram likewise visited No. 147, Royal Mint Street, where the father of the child who died was lodged. This man was suffering from diarrhcea, and was lying in the same bed with his wife and three young children. The children were removed into another bed, and disinfectants were freely used in the room. The Inspector visited the several houses in which the emigrants were lodged two or three times every day, until they were removed to the ship at Gravesend. Notice was given to the owner of the house to strip the paper off the walls of the rooms in which the patients had been ill, and to thoroughly cleanse the walls and ceilings. This work was efficiently carried into effect. I examined all the emigrants, 82 in number, and wrote to Mr. Harry Leach, the Port Sanitary Medical Officer, and enclosed for his use a list of the names of the emigrants, with remarks upon the condition of health of each of them. The Board, by unanimous resolution, tendered their thanks to the Port Sanitary Authority for their promptitude in acting so efficiently in this case. As the jurisdiction of this Board is coterminous with the District of the Board of Guardians facilities are afforded for mutual co-operation in carrying 13 out sanitary arrangements, and I am happy in being able to report that if cholera had visited this part of London in the months of August or September last, provision had been made for the reception and treatment of cholera patients. The following correspondence between the Local Government Board and the Board of Guardians upon the subject, is of sufficient importance to be made known to the inhabitants of this district. LOCAL GOVERNMENT BOARD, Whitehall, S.W. 16th September, 1873. Sir, I am directed by the Local Government Board, to state, that they have had under their consideration the question of the amount of accommodation available for the reception and treatment of Cholera patients, in the event of an outbreak of that disease in the Metropolis. The Board are not aware of the existence of any case of Asiatic Cholera at the present time in England ; but, as the disease is prevailing in places on the Continent, in close and frequent communication with London, the Board think it necessary that they should be informed what provision the Guardians of Whitechapel Union would be in a position to make for the accommodation and treatment of pauper patients, in the event of the Metropolis being visited by a recurrence of the disease. The Board will, at the same time, be glad to be informed within what period the accommodation which the Guardians may be able to provide would be available. I am, Sir. Your obedient Servant, To FRANCIS FLETCHER, W. VALLANCE, Esq., Assistant Secretary. Clerk to the Guardians of the Whitechapel Union, Workhouse, Charles Street, Whitechapel Road, E. 17th September, 1873. My Lords and Gentlemen, I am directed by the Board of Guardians to acknowledge the receipt of your letter of yesterday's date, in which you request to be furnished with information as to the provisions which the Guardians would be in a position to make, for the accommodation and treatment of pauper patients in the event of the Metropolis being visited by Cholera. I am directed to state that, to meet the exigencies of the situation during the late epidemic of small-pox, anterior to the provision of Hospital accommodation by the Managers of the Metropolitan Asylum District, and later, by reason of the insufficiency of such accommodation, and of some patients not being in a fit state to be removed to Hospitals, the Guardians fitted up temporary Wards adjacent to the Labour Yard of this Union, which is unconnected with the Workhouse, although sufficiently near to enable such Wards to be administered under the direction of the Matron, and as part of the Workhouse. These wards having been disinfected, have recently been limewashed and cleansed in view of a threatened epidemic of Cholera, and they are now available in the event of the district being visited by the disease. The Poor Law Board, by certificate dated 27th March, 1871, declared the accommodation of such Wards to bo sufficient for 30 patients. With regard to the period within which the wards would be ready for the reception of Patients, I am directed to state, that the final cleansing and the provision of necessary bedding and furniture would probably occupy three or four hours; and therefore, it may be said, that in a few hours the accommodation would be available. I have the honour to be, My Lords and Gentlemen, Your most obedient Servant, Local Government Board, W. VALLANCE, Whitehall, S.W. Clerk. 14 It is of the utmost importance that every Local Board, to which the sanitary arrangements of a district are entrusted, should be in possession of a vacant site on which might be erected in cases of any sudden outbreak of epidemic diseases, a temporary Hospital for the reception and treatment of persons suffering from such disease. As the Guardians merely hold those buildings mentioned in Mr. Vallance's letter as tenants from year to year, steps should be taken by this Board to secure a suitable freehold site, which could be used, when required, for all sanitary purposes. By the 47th section of the Sanitary Act, land may be purchased by the Board, otherwise than by agreement, for necessary purposes in connection with the Act. The necessity for Sanitary Purposes of obtaining a new Building Act during the ensuing Session of Parliament. I have, from time to time, in my Quarterly Reports pointed out the sanitary defects in the Building Act, and I find from the agenda papers of the Metropolitan Board of Works, that the question of preparing a new Building Act has been again under discussion. The public mind, during the last few years, has been much enlightened upon the subject of providing healthy habitations for the people, especially for those living in large and populous districts; and the public, I apprehend, have arrived at the conclusion that the first thing to be done is to lay down such rules for the building of a house as shall effectually put a stop to the further erection of unhealthy ones. But as unhealthy houses are permitted to be erected, not only in London, but in the suburbs thereof, and in the cities and large towns in the United Kingdom, it appears to me that the Government should undertake the duty of bringing in a Bill for the amendment of all the Building Acts, and which should be applicable to all large towns in the country. In such a Bill it would be most desirable to give additional powers to the Metropolitan Board of Works, and in the provinces to the Municipal authorities, for the purpose of acquiring land, otherwise than by agreement, for the purpose of effecting sanitary improvements in unhealthy courts and narrow places; for unless such power be obtained, and carried into effect, very little improvement will take place in the unhealthy districts of London and of other populous places. If any alteration should be made in the constitution of the Metropolitan Board of Works, it would be desirable to add to its functions that of a sanitary supervision over the whole Metropolis, with power to appoint a highly-qualified Medical Officer of Health, who, from his position, administrative talent, and scientific attainments, would command the respect of the Metropolitan Health Officers, and who, in all cases of doubt or difficulty, might be consulted by them. A system of uniformity in all the reports of the Medical Officers of Health should be adopted, and a copy of each report should be sent to the Superintending Medical Officer, who should be required to make a digest of them, for publication and general distribution. 15 The Adulteration of Food Act. This Act has been in force in this District during the last six months. On the 13th January last the Board appointed Dr. Tidy, Lecturer on Chemistry at the London Hospital, as Analyst to this District, subject to the approval of the Local Government Board, for a period of six calendar months, to make such analyses as may be required to be made within the District, for the purposes named in, and contemplated by, the Act for the Prevention of the Adulteration of Food and Drink and of Drugs; and that for such analyses Dr. Tidy be paid at and after the following rate, viz.: for the first one hundred cases, at the rate of a guinea for each analysis: for the next fifty cases, at the rate of half-a-guinea for each analysis; and for any number of subsequent cases during that period, at the rate of six shillings for each case. At the same meeting, Mr. Battram and Mr. Wrack, the Inspectors of Nuisances for the District, were appointed Inspectors for the purposes of the Adulteration of Food Act, 1872. On the 6th October the Board resolved that Dr. Tidy be continued in office as Public Analyst for the next twelve months. The Inspectors report that, during Dr. Tidy's period of office, they have submitted to him twenty-one samples of various articles of food to be analysed; viz., 8 of bread, 12 of milk, and 1 of butter, all of which were found to be more or less adulterated. In the six worst cases the Inspectors took out summonses against the vendors. The two bakers, who had mixed a large quantity of alum with their bread, were each fined £5, and £1 3s. costs. In the case of the four dairymen who were summoned, two were fined £2, and £1 3s. costs each, or 14 days' imprisonment; and the other two were each fined £5, and four shillings costs, or 14 days' imprisonment. In all these cases the fines were paid. I may add that summonses were taken out by the Inspectors so soon as they received certificates from the Analyst stating that the samples which he had analyzed were largely adulterated. Although it may be desirable to amend some of the sections in this Act, it cannot be said to be inoperative in this District, as convictions have been obtained in every case which was taken before the Magistrates. As the tables printed on the next page may be interesting to some of the inhabitants of this district, I have thought it advisable to add them to this report. I am, Gentlemen, Your obedient Servant, 15, Great Alie Street. JOHN LIDDLE. 16 Whitechapel Board of Works District- Area in Statute Acres. 1861. 1871. 1871. Inhabited Houses. Population. Inhabited Houses. Population. Number of rated Householders. Rateable Annual Value of Property. Whitechapel, part of 170 4395 37656 4061 34821 3620 £ 136387 Christchurch, Spitalds. 73 2063 20593 1966 20783 1547 64689 St. BotolphWitht. Aid. 33 470 4000 443 3812 364 45770 Holy Trinity, Minories 4 45 420 34 417 45 8094 Prect. of St. Katharine 15 9 203 11 241 6 17778 Hamlet Mile End N. T. 42 1178 10845 1296 11110 1278 22174 Lib. of Norton Folgate 9 227 1873 192 1550 191 9177 Old Artillery Ground 5 192 2168 186 2167 157 6395 District of the Tower 27 85 1207 75 1329 43 4561 378 3664 78970 8264 76520 7251 315025 Wards of Whitechapel Parish. 1 East Ward 72 1662 12322 1586 12205 1466 48640 2 Middle Ward 39 1123 10032 968 8810 851 37797 •3 South Ward 59 1650 15302 1507 13806 1303 49950 170 4395 37656 4061 34821 3620 136387 Acreace of Land and Water. Land. Water. Tidal Total Water. Water. Botolph Without Aldgate 33 - 8 8 Katharine by the Tower, Precinct 9 6 7 13 Old Tower Without & Tower of London Precinct 27 — 12 12 Area, Population, and Date of Formation of the Ecclesiastical Districts. Area in Acres. Population. 1871. Dale of Formation. St. Mary, Whitechapel 90 14767 - St. Jude, Commercial Street 21 6273 1848 St. Mark, Tenter Ground 47 9992 1841 *St. Paul, Dock Street Part of 77 8505 1864 †Christchurch, Spitalfields 53 16383 — St. Stephen, Commercial Street Part of 28 4836 1858 All Saints, Mile End New Town 42 1100 1841 ‡St. Mary, Spital Square 14 4017 1842 * The ecclesiastical District of St. Paul, Dock Street, comprises part of the Parish of St. Botolph "Without Aldgate, and parts of the mother Parishes of "Wapping and Whitechapel. + The ecclesiastical district of St. Stephen, Commercial Street, comprises parts of the mother Parishes of Bethnal Green, Shoreditch, and Spitalfields. The parts situate in Bethnal Green and Shoreditch were attached by Supplementary Order in Council 5th February, 1864. ‡The ecclesiastical district of St. Mary, Spital Square, comprises Norton Folgate Liberty, and Old Artillery Ground Libeity. The area in acres of each respectively is 9 and 5. APPENDIX. TABLE I.—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 on the 27th Sept., 1873. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic-Diarrhœa. Continued Fever, Typhus & Typhoid. Febricula. Pyaemia. Erysipelas. Puerperal Fever. Croup. Acute Pulmonary Inflammation. Carbuncle. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. Total. Bronchitis and Catarrh. Pleuritis and Pneumonia. Dr. Sweyer 0 16 3 1 45 0 1 8 0 1 0 0 6 6 1 6 0 0 0 0 106 200 Mr. Champneys 0 0 4 2 39 0 1 13 0 2 0 0 20 5 0 0 0 1 0 1 135 223 Mr. Sequeira 0 4 1 3 24 0 14 21 0 1 0 0 20 6 0 2 0 0 0 0 87 183 Mr. H. Braye 0 4 1 4 41 2 10 19 0 0 0 1 6 3 0 2 1 2 1 3 216 316 Mr. Loane 0 0 1 3 11 0 19 18 0 1 0 0 11 2 0 1 1 0 0 0 120 188 Total 0 24 10 13 160 2 45 79 0 5 0 1 63 22 1 11 2 3 1 4 664 1110 Corresponding Quarter of previous Year. 5 13 5 9 189 3 5 87 1 16 0 1 73 13 2 6 3 3 2 7 784 1227 Workhouse Mr. J. J. Ilott. 0 0 0 12 48 0 2 28 0 10 0 0 55 12 1 49 3 2 1 8 323 554 TABLE II. Ages at Death in each Registration District, for the Three Mouths ending 27th Sept, 1873. 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 17 8 3 3 4 3 2 40 Spitalfield 39 16 4 5 8 7 1 80 Mile E. N. Town 35 22 4 11 20 19 4 115 Workhouse. Whitechapel, N 29 9 1 5 7 4 1 56 Whitechapel Ch 14 14 19 56 43 28 1 175 Hospital. Goodman's Fields 33 9 2 3 6 5 0 58 Aldgate 15 9 6 5 12 2 0 49 Totals 182 87 39 88 100 68 9 573 It appears, on perusal of the above Table, that the rate of mortality of children under 5 years of age, in relation to the total deaths in the entire District is 46.9 per cent. It varies, however, in the several sub-districts. Thus in the Artillery sub-district it is 62 5 per cent; in the Whitechapel North it is 67.8 per cent.; in the Goodman's Fields it is 72.4 per cent.; in the Spitalfields it is 68.7 per cent.; in the Aldgate it is 48.9 per cent. while in the districts of Mile End New Town and of Whitechapel Church, the rate is respectively 48.8 and 16.0 per cent.; the former district contains the Workhouse, and the latter the London Hospital. TABLE III. The Births and Deaths in each Registration District, for the Three Months ending on the 27th Sept., 1873. Districts. Births. Total. Deaths. Total. Excess of Births over Deaths. Excess of Deaths over Births. Remarks M. 39 F. 24 63 M. 23 F. 17 40 23 0 Spitalfields 65 52 117 49 31 80 37 0 Mile End N. Town 61 81 142 67 48 115 27 0 Workhouse. Whitechapel, N. 57 51 108 25 31 56 52 0 WhitechplChurch 35 30 65 112 63 175 0 110 London Hospital. Goodman's Fields 39 36 75 30 28 58 17 0 90 Non-residents died in the London Hospital. Aldgate 29 34 63 26 23 49 14 0 Totals 325 308 633 332 241 573 170 110 Excess of Births over Deaths, deducting the 90 Deaths of non-residents, 150. Population in 1871, 76,332. Population in 1861, 78,970. TABLE IV. Showing the Deaths from Epidemic Diseases, for the Three Months ending 27th Sept., 1873. Districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhoea. Fever. Cholera & Cuoleraic Diarrhea. Total. Remarks. Artillery 0 0 2 0 2 8 1 0 13 Spitalfields 0 0 2 0 0 19 1 2 24 Mile End New Town 0 0 1 2 2 22 3 1 31 Workhouse. Whitechapel, North 0 1 0 0 1 10 0 0 12 Whitechapel Church 0 1 0 0 0 10 4 1 16 Hospital. Goodman's Fields 0 0 1 1 2 12 1 0 17 Aldgate 0 1 0 0 3 6 3 2 15 Totals 0 3 6 3 10 87 13 6 128 Deaths from Epidemics for the corresponding Quarter, 1872. 0 6 2 0 18 78 5 5 114 The deaths from Pjeemia were 5, from Erysipelas 3, from Croup 6, from Rheumatism 3, from Ague 1, from Carbuncle l,and from Puerperal Fever 1. Five deaths from Fever of persons belonging to this District occurred in the Fever Hospitals, and 3 of non-residents in the London Hospital. Wellcome Library for the History and Understanding of Medicine table v. Showing the Ages at Death in the Workhouse, and in the London Hospital, for the Quarter ending 27th Sept., 1873. 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, 32 Females, 22 Corresponding Quarter of 1872. Workhouse 6 4 3 7 14 16 4 54 64 London Hospital 1 9 17 56 39 21 1 Males, 96 Females, 48 144 168 i .