WHI 23 BOARD OF WORKS, WH1TECHAPEL DISTRICT. REPORT on the of the WHITECHAPEL DISTRICT, for the QUARTER ENDING 2nd JANUARY, 1875, BY JOHN LIDDLE, medical officer of health, London: printed by T. Penny & Co., 121, Leman Street, Whitechapel, E. 1875. REPORT of the MEDICAL OFFICER OF HEALTH, For the Quarter ending 2nd January, 1875. To the Board of Works, Whitechapel District. Gentlemen, Having been deprived for the last two months of the local Registrars' weekly returns of mortality, I am unable to lay before you a quarterly account of the births, deaths, and causes of death, in the form which, for several years, I have adopted, and which 1 have found to be well suited for the purposes of reference and comparison. It is of importance, not only that the causes of death should be recorded, but that the ages at death should be duly registered. Nevertheless, I am enabled, by the aid of the weekly and quarterly returns of mortality, and the annual summary of the births, deaths, and causes of death in London, which are regularly published by the Registrar General, to make you acquainted with the total mortality of your District, and with the deaths from the several epidemic diseases, some of which are always more or less prevalent. I am also enabled, by the privilege which is afforded to me by the Board of Guardians, to peruse the books of the Medical Officers of the Union, which are placed every Saturday for my inspection in the Board Room of the "Workhouse, to lay before you a return of all cases of sickness occurring among the out-door paupers. From the examination of these books I ascertain the localities in which contagious and infectious diseases exist; and, by the courtesy of Mr. Vallance, I can supplement the returns of the deaths from small-pox, scarlet fever, and fever, which are recorded in this District of those patients who were removed to, and died in, the Metropolitan Asylums, but whose deaths are not recorded, as they should be, in this District, but are registered in the Districts of the respective Asylums. Having for the last eighteen years been favored by the Registrar General with the weekly returns of the local Registrars, after such returns had been 4 utilized in his Office, and for whose courtesy in doing so the Local Board and its Sanitary Officers have been under great obligation, it is a matter for regret that these useful Returns have been discontinued, for no sufficient substitute is obtainable. I may observe that all the original records of the local Registrars, for the last eighteen years, have been carefully preserved by me, and they may be seen on application at my Office. But it being now decided by the Registrar General that the weekly returns are not to be any longer sent to the Medical Officers of Health, it becomes a subject for consideration how the returns of mortality for the District can bo obtained, so as to make them of the most service to the public. In order to render the returns of mortality of increased value, it is of the utmost importance that a list of all the deaths from epidemic diseases, and the localities in which they occur, should be given upon application at the Registrar's Office daily to the Medical Officer of Health, so that he may take prompt measures to disinfect the houses, and adopt such other means as may be deemed advisable to prevent the spreading of such diseases. As the Local Board will necessarily have to pay for the extra trouble which will devolve upon the local Registrars, by their sending a weekly return to the Medical Officer of Health of all the deaths which have occurred in the District, it would seem that the Registrars should either, for this purpose, be the Officers of the Board, or else, by statute, be compelled to make such a return. Indeed, legislation being necessary, the expedient course would be to make such return to the Medical Officer of Health obligatory upon the Registrars, and at a fixed rate of remuneration) to be paid by the Local Boards. The local Registrars are elected and paid by the Guardians, but the Guardians have no control or authority over them; these Officers being under the direction of the Registrar General, to whom alone they are responsible. To enable the Medical Officer of Health to estimate more accurately the mortality of each locality, it is essential that, in recording the deaths in "Workhouses and Hospitals, the Registrars should insert, in the weekly returns, the previous residences of the patients. This plan has always been adopted by the Registrars of this District ; and at the present time it is of the utmost importance, in consequence of the "Bill for facilitating the Improvement of the Dwellings of the Working Classes in Large Towns" being now before the House of Commons; for the Medical Officers of Health may soon be called upon to furnish their Yestries or District Boards with a return of the mortality of defined areas, which he cannot do unless the deaths in the "Workhouses and Hospitals be allocated to the Districts from which the patients were removed. Births and Deaths in the Disteict. In the quarter that ended on Saturday, the 2nd January, 1875, the total births in the District were 675, and the deaths 731. The excess of 5 deaths over births has therefore been, during this quarter, 56; but if we deduct the deaths of the non-residents, which occurred in the London Hospital, the births have exceeded the deaths by about 38. The returns of deaths in the London Hospital not having been sent to me for this quarter, I am obliged to make an approximation of the number of deaths of non-residents. In the Artillery Sub-district, the births were 57, and the deaths 45; in the Spitalfields, 117 and 79; in the Mile End New Town, 186 and 185; in the Whitechapel North, 98 and 62; in the Whitechapel Church, 74 and 242 (in this Sub-district the London Hospital is situated); in the Goodman's Fields, 92 and 58; and in the Aldgate, 51 and 60, The deaths have exceeded the births in the Whitechapel Church and in the Aldgate Subdistricts. In the corresponding quarter of the previous year, embracing 14 weeks, the births were 719, and the deaths 732. The deaths in the London Hospital have been 199. In the corresponding quarter (14 weeks) of the previous year, the deaths in this Institution were 194. The deaths in the Workhouse have been 89, and in the corresponding quarter of last year they were 99. The deaths from epidemic diseases in the entire District have been 88; viz., 5 from measles, 59 from scarlet-fever, 3 from diphtheria, 1 from hooping-cough, 3 from diarrhœa, and 17 from fever. Five deaths of patients from this District occurred in the Fever Hospital; thus making a total of 21 deaths from fever. There were no deaths from scarlet-fever or from smallpox, of patients belonging to this District, in the Hospitals under the management of the "Metropolitan Asylum District." In the corresponding quarter (14 weeks) of the previous year, the deaths from epidemic diseases were 128; viz., 37 from measles, 9 from scarlet-fever, 15 from hooping-cough, 13 from diarrhœa, 11 from fever, and 2 from choleraic-diarrhœa. Mortality of Young Children. The mortality of children under one year of age was 122. This is 167 per cent. of the total mortality. In the corresponding quarter of the previous year the rate of mortality of children under 1 was the same, viz., 46.7 per cent. of the total mortality. In the Artillery sub-district the rate is 35.3 per cent.; in the Spitalfields, 27.8 per cent; in the Mile End New Town, 17.8 per cent.; in the Whitechapel North, 27.4 per cent.; in the Whitechapel Church, 4.5 per cent.; in the Goodman's Fields, 25.8 per cent.; and in the Aldgate, 13.3 percent. In the Artillery Sub-district, the deaths under 1 year were 16, and the total deaths 45; while in the Whitechapel Church Sub-district the deaths under 1 year were only 11, and the total deaths 242. This difference is explained by the deaths in the London Hospital, in which institution the deaths of children under 1 year are very few. 6 Pauper Illness in the District. The Medical Officers of the Union have attended, during the quarter, 895 new cases of illness out of the Workhouse; including 8 of measles, 33 of scarlet-fever, 6 of hooping cough, 12 of diarrhœ, 82 of febricula, 20 of fever, and 10 of erysipelas. In the corresponding quarter of the previous year the number of pauper cases of illness was 1247, including 1 of small-pox, 7 of measles, 4 of scarlet fever, 10 of hooping-cough, 14 of diarrhoea, 59 of febricula, 17 of fever, and 16 of erysipelas. The total number of cases of illness in the Workhouse has been 726: including 5 of scarlet-fever, 2 of hooping-cough, 8 of diarrhœa, 15 of febricula, 2 of fever, 71 of rheumatic fever, and 20 of erysipelas. In addition to the above, there were 43 cases of syphilis. In the corresponding quarter of the previous year the total number of cases in the Workhouse was 721; including 1 of small-pox, 2 of measles, 1 of scarlet fever, 1 of hooping-cough, 11 of diarrhœa, 26 of febricula, 1 of carbuncle, 85 of rheumatic fever, and 13 of erysipelas. 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— PUBL1C VACCINATOR. workhouse. Totals. Births Registd. Primary Cases. Re-Vaccination. Primary Cases. Re-Vaccination Primary Cases. Rc-Vaccination. 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 December, 256 2 39 1 295 3 673 March, 1874 335 1 37 0 372 1 640 June 411 2 30 0 441 2 726 September 329 0 30 0 359 0 630 December, 1871 185 2 31 0 216 2 689 Totals 2403 15 243 1 2646 16 5385 Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the quarter has been 7.02 inches. During the corresponding quarter (14 weeks) of last year the rain-fall was 5.18 inches. The mean temperature of the air was 41.5°. In the corresponding quarter of last year the mean temperature was 44.4°. The coldest days during the 7 quarter were Wednesday, December 23rd, Thursday, December 31st, and Friday, January 1st, when the thermometer indicated respectively 18.9°, 18.5°, and 18.2°. The coldest day during the corresponding quarter of last year was on Monday, the 29th December, when the thermometer indicated 22.1°, or 9.9° below the freezing point. The rain-fall during the year was 18.31 inches, and in the previous year, comprising 53 weeks, the rain-fall was 22.61 inches. The following table, taken from the returns of the Registrar-General shows the comparative results of the Quarter:- LONDON. Oct. 10 Oct. 17 Oct. 24 Oct. 31 Nov 7 Nov 14 Nov 21 Nov 28 Dec. 5 Dec. 12 Dec. 19 Dec. 26 Jan. 2 Deaths from Fever 39 33 30 43 39 41 38 45 47 41 37 33 30 Deaths from Scarlet Fever 107 118 105 128 107 97 124 97 92 91 76 65 69 Mean Temperature of the air 49.1° 55.9° 47.9° 53.3° 49.5° 41.1° 44.1° 32.8° 38.6° 39.1° 32.9° 29.9° 28.8° Rain-fall in inches 1.08 0.58 0.09 1.29 0.00 0.04 0.44 0.20 1.49 0.82 0.41 0.03 0.55 Deaths in London 1242 1344 1293 1368 1445 1517 1795 1925 2122 2082 1947 1646 2442 Deaths in Whitechapel District. 43 60 63 56 51 69 48 59 68 57 51 33 68 Deaths in do. from Scarlet Fever 8 8 12 6 3 3 4 1 4 6 3 0 1 The Registrar-General, in his Report of births and deaths for the week ending December 26th, 1874, in speaking of the deaths in London, from the cold weather, says, "Men, as well as other animals with warm blood, have the power of producing heat so as to maintain their temperature very constant; but this power varies under different circumstances. And the demands on it vary still more; for the loss of heat by the surface of the body, and especially by the lungs, which lose heat by evaporation, and by contact with the cold air inspired at an inconceivably more rapid rate in cold weather than in warm. The heat has to be supplied by the food consumed, and the conversion into heat is accelerated by exercise. If food is the fuel, exercise is the blast that makes it burn. "It was well established, by the researches of Villermé and Edwards, that young children die in considerable proportions by exposure to cold, and it was known in a general way that the winter is more fatal to old people than to young. "The weekly Tables carry us much further, and show that the mortality after 20 increases with age rapidly, and that after a determined law. Thus, if we divide life into vicennial stages, then beginning at 20, 40, 60, 80, the result in London in the six weeks of very cold weather ending 24th February 1855 was found to be that the mortality due to cold at the four 8 ages, was 2.0, 7.5, 44.9, 181.8; so rapidly did the power of resistance decline with age. Taking the increase of mortality by cold between 20—40 as one, then the mortality became 2, 4, 8, and so on, doubling every 9 years. "The effects of the cold of the five weeks that ended on the 19th of this December have been tested in the same way by comparing the deaths at each age with the deaths in the five previous average weeks. The deaths were raised from 6967 to 9871; so the excess due to cold was 2904 in the five weeks, and on an average 581 weekly. The mortality, higher than before, increased with age at the same rate; it was in every 1000 living at the four ages, 2.2 at 20—40; 9.4 at 40—60; 46.9 at 60—80; and 218.3 at 80 and upwards. "The mortality from cold increased 8 per cent. for every year of age; or it doubled every 9 years from the age of 20, as it did in 1855. There is thus a law of mortality from excess of cold. But it must not, therefore, be assumed that the mortality is beyond control. The air we inhale at 28° or lower is raised not to blood heat but to something approaching 98° when it is exhaled; and as about a gallon of air is thus heated every minute, and as the evaporated vapour in the breath also carries off a considerable quantity of heat, the loss by the lungs is large, however warm the clothing may be. "The cold is most effectively combated by exercise which excites the heating energy of the system, and warmth is sustained by nutritious food; by artificial heat; by warm woollen or fur clothing; and by the respirator which retains the heat exhaled by respiration." The facts as given above by the Registrar General are so important, as showing the causes of the increased mortality during cold weather, that I make no apology for quoting them in this Report; and I would only add to the above valuable suggestions relating to the benefits to be derived from the use of artificial heat during very cold weather, that not only is it essential to wear warm, not necessarily heavy, clothing on going out of doors, but to wear sufficiently warm clothing in-doors, so that the body may be always kept warm, whereby it will not only be better able to resist the cold atmosphere out of doors, but will enable it to endure with impunity the cold air of the passages, and of the unoccupied rooms of the house. Sanitary Works Performed during the Quarter. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ending January 2nd, 1875:— Number of inspections of houses as shown in the official returns 3270 Houses specially visited 139 Ditto specially re-visited 656 Preliminary notices served, such notices embracing 253 premises 150 Compulsory orders issued, embracing 72 premises 32 Summonses heard at Police Courts under Sanitary Act 3 9 Cases of overcrowding and indecent occupation discovered 3 Houses in which the rooms or passages have been whitewashed 167 Rooms disinfected with sulphurous acid gas after the occurrence of fever, and scarlet-fever, therein 27 Articles disinfected, consisting of beds, bedding, clothing, &c. 47 Yards of houses paved or the pavement repaired 78 Drains in houses improved 53 Cesspools abolished 0 Dust-bins provided 13 privies lime-washed, cleansed and repaired 131 Water-butts and cisterns provided or repaired 11 Nuisances from dung and other offensive matter removed 13 Area gratings and cellar flaps repaired 4 Cellars used as dwellings discontinued for such use 3 The cow-houses in the District, 25, the slaughter-houses, 33, and the bake-houses, 71 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. Prolonged Retention of a Dead Body in a Room Occupied by a Family. Mr. Whack reports that, upon visiting No. 28, Church Street, Spitalfields, on the 5th December last, he found in the second floor front room the dead body of a child, which had died of scarlet-fever on the 1st of the month. The body was not coffined, and it lay exposed on a table in one corner of the room. The room was occupied as a living and sleeping room by five persons, viz.: the father and mother, their child, a girl about 3 years old, and by two adults, viz., the grandfather and grandmother of the child, who were engaged at tailors' work. The child was playing on the floor. The room was about 14 feet square, and 8 feet high, thus affording only 260 cubic feet of space to each person. The smell on entering the room was most sickening. Upon remonstrating with the people for keeping the body so long unburied, and especially for not having it coffined, they replied that they were waiting to raise the means for burying it; and, being Irish, said that it was not their custom to coffin their dead until the day of the funeral. The body was not buried until the 9th of December, and then it had to be buried by the Parish Authorities. Mr. "Wrack also visited No. 24, Princes Street, Spitalfields, on the 5th January, and found in the second floor front room the dead body of an aged woman, who died on Christmas-day. The room was occupied by the daughter of the deceased, a person about 40 years of age, who lived and slept in the same room. Upon asking the reason of her keeping the body so 10 long unburied, she stated that she had been waiting for suitable things to be made for the funeral; and upon asking when the funeral would take place, she stated that the body would not be buried until the 8th January, a period of 15 days from the death. The Board had no power to compel the removal of the corpse, as there is no mortuary belonging to the Board in the District. Unlicensed Cowhouse used for Keeping Cows. A Cowkeeper, residing in Whitechapel Parish, was summoned before the Magistrate at the Worship Street Police Court for keeping cows in an unlicensed shed. The case being proved, the defendant was fined forty shillings and costs. BILL For Facilitating the Improvement or the Dwellings of the Working Classes in Large Towns. Since this Report was presented to the Board the above-named Bill has been read a second time, and has met with such general approval that, with certain amendments, it is likely to become an Act. I regret, however, to find that, while it provides for the pulling down of unhealthy houses, it does not contain a clause requiring a proper inspection to be made by the Medical Officer of Health and the Surveyor to the Vestry or District Board of the sanitary arrangements of the houses which may be erected in the place of those pulled down. It is true that the words ''proper sanitary arrangements of the area," are inserted in clause 5, but these do not refer to the houses; and in order to provide that healthy houses shall be erected, clauses to the following effect should be added to the Bill:— 1. —That, before the building of any new house is commenced, plans of the drainage, and of all the sanitary arrangements of the house, shall be submitted for approval to the Local Board. This Board shall be invested with power to compel the builder of any new house within the District so to alter his plans, if necessary, as to render such house fit for healthy occupation. 2.—It shall likewise be made compulsory upon every builder to provide a separate water-closet or privy and ashpit for each house, within the curtilage of the house. This provision would prevent the erection of public privies in courts occupied by the poorer classes, which are now for the most part nuisances, and injurious to the public health. 3.—That during the progress of the building of any house, the Surveyor to the Local Board shall be required to inspect the foundation thereof; and if such Surveyor be of opinion that the materials which are being used for such foundation are not proper for the purpose, he shall make known his objections to the builder, and shall report the same to the Board. This 11 report having been made, the Board shall have power to prevent the use of all such improper materials. 4.—That the Avails and foundation of every house shall be so constructed as to prevent the rise of damp. 5.—That every new house shall at all times have at the rear an open space of sufficient extent for the thorough ventilation of the staircases and passages. That no house shall be permitted to be occupied unless the person letting such house shall have a certificate, signed by the Surveyor and Medical Officer of Health to the Local Board, that all the rooms therein are of sufficient size and fit for healthy occupation. ANNUAL REPORT. The number of births registered in this District during the year, has been 2688, and the deaths 2613, including those of non-residents in the London Hospital (377). In the preceding year (consisting of 53 weeks) the births were 2727, and the deaths 2471, including the deaths of 393 nonresidents. The deaths in the "Workhouse have been 354, against 340 for the previous year; and the deaths in the London Hospital 675, against 645. The population of the District at the taking of the census was 76,573 which is 2397 less than when the census was taken in 1861. The deaths being (excluding 377 of non-residents) 2236, the rate of mortality has been during the year 29.2 per 1000, or 1 in 34.2 of all living. The rate of mortality during the last year was 26.5 per 1000. In making a comparison, however, of the rate of mortality of this District with that of others, the total deaths in the London Hospital must be eliminated, which this year, as above stated, amount to 675. This gives a rate of mortality of 25.3 per 1000. In the year 1872 the rate of mortality was 26.3 per 1000; but on deducting the total deaths in the London Hospital from the total deaths in the District, the rate of mortality was only 23.1 per 1000. Principal Causes of Death. Of the total deaths during the year, there were 384 from epidemic diseases, viz., 1 from small-pox, 33 from measles, 201 from scarlet fever and diphtheria, 16 from hooping-cough, 76 from diarrhoea, 54 from fever, and 3 from choleraic diarahœa. During the last two years only 2 deaths from small-pox have occurred in this District, viz., 1 in 1873, and 1 in 1874, and none occurred in the "Metropolitan Asylums" of any patient resident in this District. 12 The death-rate from epidemic diseases for this year, in relation to the total mortality, is 14.6 per cent. There have been, for the 12 months ending October 3, 1874,* 24 deaths from pyæmia, 8 from puerperal fever, 43 from croup, and 22 from erysipelas. If these are added to the deaths from epidemic diseases, as given above, the the rate of mortality from miasmatic diseases is 18.4 per cent. The deaths from tubercular diseases, exclusive of consumption, have been 148; from consumption 296, from cancer 47, from convulsions in children 86, from atrophy and debility 79, from teething 22, from premature birth 22, from congenital syphilis 7, from suffocation in bed 13, from diseases of the urinary organs 91, from burns and scalds 36, and from mechanical violence 138; of these, 26 were caused by horses and vehicles in the streets. The average number of deaths per week, caused by horses and vehicles in the streets of London, are 45, and if this number is multiplied by 8, it will give about the number of accidents which occur weekly in London from these causes. The deaths from consumption and other tubercular diseases amount to 444; and if we add to these the deaths of children who die from kindred diseases, such as convulsions, atrophy and debility, and teething, it will be seen that they amount to 631, which is at the rate of 24.1 per cent. of the total deaths in this District, and exceeds that which is caused by the whole class of miasmatic diseases by 5.7 per cent. The deaths from diseases of the respiratory organs, exclusive of consumption, were 440, which is at the rate of 16.8 per cent. of the total mortality. From the above statistics it appears that while the deaths from epidemic diseases are 14.6 per cent. of the total mortality, the deaths from diseases of the respiratory organs are 16.8 per cent., and from tubercular and allied diseases 24.1 per cent. As all these diseases are as preventible, and perhaps more so than those of the epidemic class, more attention should be given to the prevention of them than has hitherto been bestowed. This want of attention may be to some extent accounted for by the defects of the sanitary laws, as they give very little power to Local Boards either to demolish houses unfit for human habitation, of which there are several hundred in this District, or to regulate the construction of houses, although they give large powers relative to the drainage and ventilation of them. "We must therefore content ourselves by simply advising the public how the large mortality arising from diseases of the respiratory organs may be diminished. The advice upon this subject, as given by the Registrar General, and quoted in pages 6 and 7 of this Report, will, if followed, lead to a large reduction of *I am obliged to substitute the year ending October 3rd, 1874, for the year ending 2nd January, 1875, as I have not received the returns of the causes of death for the last quarter, with the exception of those from epidemic diseases, which are published by the Registrar-General in his weekly returns. 13 tality from diseases of the respiratory organs. I commend it to the attentive consideration of the public. Pauper Illness in the District. The number of out-door sick paupers which have been attended by the Medical Officers of the Union has been 3685. During the previous year the number was 4887. The extraordinary annual diminution of the out-door sick paupers, from upwards of 17,000 to 3685, is a matter of great satisaction to the ratepayers of this District. Illness in the Workhouse. The cases of illness in the Workhouse during the year have been 2522, including 43 cases of syphilis, and 18 of lead poisoning. The 43 cases of syphilis, and 13 of the 18 cases of lead poisoning, occurred during the last quarter. The following Table shows the rate of mortality of children under 1, and under 5 years of age in relation to the total deaths, and to the total births, in each Sub-district, for the year ending 3rd October, 1874. Districts. Total deaths. Deaths under 1 year of age. Deaths under 5 years of age. proportion per cent. Total births. Remarks. Of deaths of children under 1 year to total deaths. Of deaths of children under 5 years to total deaths. Of deaths of children under 1 year to total births. Of deaths of children under 5 years to total births. Artillery 131 33 71 25.1 54.2 14.5 31.2 227 Spitalfields 334 82 182 24.5 54.4 15.9 35.3 515 Mile End N. Town 653 120 212 18.3 32.4 18.0 31.9 664 Workhouse Whitechapel North. 265 81 147 30.5 55.4 18.0 32.6 450 Whitechapel Church 824 44 124 5.3 15.0 18.0 45 2 274 L.Hospital. Goodman's Fields 200 47 97 23.5 48.5 13.3 27.4 353 Aldgate 207 37 114 17.8 55.0 16.1 49.7 229 Totals 2614 444 947 16.9 36.2 16.3 34.9 2712 On perusing the above Table, a great discrepancy is observed in the rate of mortality of children under 1, and under 5 years of age, in the Whitechapel Church Sub-district, and in all the other Sub-districts. This is explained by the deaths in the London Hospital, which institution receives patients from all the eastern parts of London, and from many parts of the country, and these patients are principally adults. If, therefore, we were to draw the conclusion from the fact, that, as the rate of mortality of young children, in relation to the total deaths in that Sub-district, is so 14 much lower than it is in any of the other Sub-districts, it is therefore the most healthy in the entire District, such a conclusion would be erroneous. From the Table which is printed in my last Annual Report, it appears that, with the exception of the Goodman's Fields Sub-district, which was the lowest for that year, not much difference is found to exist in the rates of mortality in the several Sub-districts. The death-rate of children is, however, higher in the Whitechapel District, both in relation to the total deaths and the total births, than in the whole of London. From the following Table it will be seen that a large amount of sanitary work has been accomplished during the year. To the amount of work set forth in this Table, there must be added that which the Inspectors have done under the Adulteration of Food Act; but as only one prosecution has taken place during the last twelve months, although several analyses of food have been made by Dr. Tidy, I have not recorded the particulars in this Report. Sanitary Works Performed during the year 1874. Number of inspections of houses, as shown in the official returns 12,732 Number of rooms found to be over-crowded, the space being less than 300 cubic feet for each person, reckoning 2 children under 10 years of age for one adult—nuisance in each case abated 28 Number of cases of indecent occupation discovered 28 Houses specially visited 748 Houses specially re-visited 3266 Rooms disinfected with sulphurous-acid gas, after the occurrence of fever and scarlet-fever therein 100 Articles disinfected, consisting of beds, bedding, clothing, &c. 128 Preliminary notices served, such notices embracing 1241 premises 911 Compulsory orders issued, embracing 362 premises 143 Summonses heard at Police Courts, under Sanitary Act 21 Ditto ditto, Adulteration of Food Act. 1 Houses in which rooms or passages have been whitewashed 646 Ventilation of houses improved 0 Yards of houses paved or the pavement repaired 224 Cesspools abolished 7 Drains in houses improved 239 Dust-bins 74 Privies lime-washed, cleansed and repaired 432 Water-butts and cisterns provided or repaired 35 Area gratings, cellar flaps, &c., repaired 17 Cellars used as dwellings discontinued for such use 11 Nuisances from dung and other offensive matter removed 74 The cow-houses in the District, 25, and the slaughter-houses, 33 in number, have been visited four times during the year. 15 The bake-houses, 71 in number, have been twice specially visited during the same period. The efficient manner in which the Inspectors have performed their duty is shown by the fact that, although there is a public complaint book in the office, not a single complaint has been entered therein during the last two years. I am, Gentlemen, Your obedient Servant, 15, Great Alie Street. 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 2nd January, 1875. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and" Choleraic-Diarrhoea. Continued Fever, Typhus & Typhoid. Febricula. Pyæmia. 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 8 6 0 5 0 5 10 0 2 0 0 10 8 0 6 0 0 0 0 92 152 Mr. Champneys 0 0 8 2 4 0 7 16 0 3 0 1 26 4 0 7 0 0 0 1 103 182 Mr. Sequeira 0 0 6 4 0 0 4 19 0 3 0 0 22 3 0 0 0 0 0 1 75 137 Mr. H. Braye 0 0 8 0 1 0 2 24 0 1 0 0 55 4 0 4 0 0 1 3 180 283 Mr. Loane 0 0 5 0 2 0 2 13 0 1 0 0 21 0 0 4 2 0 0 0 91 141 Total 0 8 33 6 12 0 20 82 0 10 0 1 134 19 0 21 2 0 1 5 541 895 Corresponding Qr. of previous Year. (14 weeks.) 1 7 4 10 14 0 17 59 0 16 0 1 175 29 0 18 3 1 1 4 707 1247 Workhouse Mr. J. J. Ilott. 0 2 5 2 8 0 2 15 0 20 0 0 180 26 0 71 4 4 4 13 307 726 In addition to the cases attended by Mr. Ilott in the Workhouse there were 43 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases, for the Three Months ending 2nd January, 1875. Districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhœa. Fever. Cholera & Choleraic: Diarrhoea. Total. Remarks. Artillery 0 1 5 0 0 0 1 0 7 Spitalfields 0 2 9 0 0 0 3 0 14 Mile End New Town 0 0 13 0 1 0 6 0 20 Workhouse. Whitechapel, North 0 0 10 0 0 1 2 0 13 Whitechapel Church 0 1 6 3 0 1 3 0 14 Hospital. Goodman's Fields 0 0 6 0 0 0 1 0 7 Aldgate 0 1 10 0 0 1 1 0 13 Totals 0 5 59 3 1 3 17 0 88 Deaths from Epidemics for the corresponding Quarter, 1874. (14 weeks) 0 37 9 0 15 13 11 2 87 Four deaths from fever of patients belonging to this District occurred in the Fever Hospital at Homerton. TABLE III., Showing Sub-districts, Enumerated Population, Total Births, and Deaths from all causes. Deaths under 1 year of age and above 60 years, Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. Persons aged 60 ye?rs and upwards. Violence. Inquest cases. Deaths in Public Institutions. Artillery 6651 57 45 16 7 0 5 0 Spitalfields 15848 117 79 22 13 1 11 0 Mile End New Town 15550 186 185 33 34 7 12 89 Whitechapel North 11597 98 62 17 8 3 4 0 Whitechapel Church 7322 74 242 11 35 48 58 199 Goodman's Fields 10381 92 58 15 6 3 4 0 Aldgate 9224 51 60 8 9 2 7 0 Totals 675 731 122 112 64 101 288 TABLE IV. Total number of the undermentioned Diseases recorded in the Books of the Medical Officers of the Union, from 1861 to 1874, and the total cases of illness. Years. Erysipelas. Puerperal Fever Carbuncle. Bronchitis and Catarrh. Pneumonia and Pleuritis. Croup. Rhenmatic Fever. Ague. Delirium Tremens. Lead Poisoning Total. 1864 92 1 6 786 95 0 14 13 1 0 14932 1865 97 2 1 745 123 0 14 12 4 0 15594 1866 62 0 7 546 244 7 66 12 13 0 16502 1867 65 1 5 642 228 5 183 10 10 0 17181 1868 80 2 5 450 208 3 157 18 10 20 17417 1869 75 1 6 632 258 1 100 35 11 12 14031 1870 82 0 1 825 195 0 134 44 5 12 14148 1871 56 3 7 1149 153 3 77 14 5 35 10194 1872 51 2 6 511 61 1 71 14 5 22 4864 1873 89 2 5 539 91 4 88 17 3 15 4887 1874 20 1 2 443 53 5 65 9 7 21 3785 TABLE V. Showing the total Births, Deaths, Deaths of Non-residents, Residents, and total Deaths in the London Hospital in each year, from 1864 to 1874. Year. Population. Total Births. j Total Deaths. Total Deaths in the London Hospital. Deaths of non-residents, exclusive of deaths from accidents. Deaths of Residents. Proportion of Deaths of non-residents to the deaths of residents in hospital. Kate of mortality per 1000, deducting the deaths of nonresidents. Sudden deaths and deaths from accidents. 1864 78,970 2803 2792 453 212 36 16.9 32.6 205 1865 ... 2684 2532 416 208 47 22.5 29.4 161 1866 ... 2561 3495 733 432 114 26.3 38.7 187 1867 ... 2686 2331 445 241 59 24.4 26.4 145 1868 ... 2611 2519 536 324 50 15.4 27.7 162 1869* ... 2571 2675 504 283 55 19.4 29.6 166 1870 ... 2690 2465 599 374 66 17.6 26.4 159 1871 76,573 2571 2465 551 339 64 18.8 27.7 148 1872 ... 2705 2390 616 375 89 23.7 26.3 152 1873* ... 2727 2471 645 393 74 18.8 26.5 178 1874 ... 2688 2613 675 377 75 19.8 29.2 223 *These years contain 53 weeks. In making this calculation, one week's average of deaths is deducted, viz., 50 and 46 respectively. The number of Inquests which have been held this year in this District has been 327. In the preceding year the number was 336. TABLE VI. Showing the Deaths from Epidemic Diseases in the Whitechapel District during the last 15 years. Name of Disease 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 Small Pox 21 28 33 69 5 22 44 40 11 1 56 159 19 1 1 Measles 81 27 153 26 137 28 139 38 69 71 36 42 23 44 33 Scarlet Fever & Diphtheria 59 70 91 200 50 80 76 26 48 208 59 25 9 24 199 Hooping Cough 49 98 62 52 74 97 94 72 55 113 50 43 96 79 16 Diarrhœa 67 101 69 114 109 122 119 100 138 97 107 125 99 113 76 Fever 69 65 250 158 170 167 100 82 109 95 52 40 26 44 47 Cholera &Cho leraic-Diaha 1 4 5 5 2 4 904 9 10 7 6 3 6 8 3 Totals 347 393 663 624 547 520 1476 362 440 592 366 437 277 313 375 London | Fever 1302 1754 3635 2802 3689 3232 2681 2174 2483 2211 2049 1755 1003 1548 1553 Searlta. & Diph. 2457 3058 4194 5799 3806 2614 2316 1836 3418 6162 6306 2220 1063 932 3037 Small Pox 577 215 345 2012 537 646 1388 1339 606 273 958 7834 1532 114 56 The deaths from Fever in the Fever Hospital belonging to the Asylum Board of patients removed from this District were 9, and 2 died of scarlet-fever, thereby increasing the deaths from epidemic diseases by 11; but, on the other hand, the deaths from fever of non-residents which occurred in the London Hospital, must be deducted. The deaths, therefore, from epidemic diseases in this District were 384 for the year 1874. TABLE VII. Showing the cases of Epidemic Diseases among the pauper population in the Whitechapel District during the last 15 years. Name of Disease 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 Small Pox 65 86 113 253 21 86 261 254 93 5 302 625 60 2 1 Measles 520 70 525 80 482 51 679 155 323 212 257 178 76 128 59 Scarlet Fever & Diphtheria 93 109 118 305 156 164 197 60 54 311 97 32 16 22 161 Hooping Cough 83 388 153 169 217 280 217 219 144 308 140 102 94 86 30 Diarrhœa 773 1418 1085 1108 1127 1342 1664 1471 1631 1033 1097 590 283 212 150 Fever 190 109 822 464 295 573 343 308 586 385 325 201 19 126 84 Cholera & Cho| leraic-Diaha. 1 0 1 1 4 4 58 5 8 1 4 2 3 2 0 Totals 1725 2180 2817 2380 2302 2500 3419 2472 2839 2255 2222 1730 551 578 485 The cases of Febricula have been 285. In the preceding year the cases of Febricula were 325. *In the above Tables the years 1863, 1869, and 1873, consist of 53 weeks. BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE OF THE WHITECHAPEL DISTRICT, for the QUARTER ENDING 3RD APRIL, 1875, BY JOHN LIDDLE, medical officer of health. London: Printed by T. Penny & Co., 121, Leman Street, whitechapel., E. 1875. REPORT of the MEDICAL OFFICER OF HEALTH, For the Quarter ending 3rd April, 1875. To the Board of Works, Whitechapel District. Gentlemen, In the quarter that ended on Saturday, the 3rd April, 1875, the total births in the District were 703, and the deaths 685. The excess of births over deaths has therefore been, during this quarter, 18; but if we deduct the deaths of the non-residents, which occurred in the London Hospital, the births have exceeded the deaths by about 142. The returns of deaths in the London Hospital not having been sent to mo this quarter, I am obliged to make an approximation of the number of deaths of non-residents, which in the corresponding quarter of last year was in the proportion to the total deaths in that Institution of nearly 65 per cent. Out of the total deaths, therefore, in this District during the quarter, there must be deducted about 124 for the deaths of non-residents. The figures will therefore be as follows : births 703, deaths 561. Since my last report the sub-districts of Artillery and Spitalfields have been united, and now form the sub-district of Spitalfields. In the Spitalfields sub-district the births were 173, and the deaths 111; in the Mile End New Town 200 and 192; in the Whitechapel North 89 and 44; in the Whitechapel Church 82 and 232 (in this sub-district the London Hospital is situated); in the Goodman's Fields 105 and 43; and in the Aldgate 54 and 63. The deaths have exceeded the births in the Whitechapel Church and in the Aldgate sub-districts. In the corresponding quarter of the previous year the births were 635, and the deaths 643. The deaths in the London Hospital have been 194. In the corresponding quarter of the previous year the deaths in this Institution were 164. The deaths in the Workhouse have been 126, and in the corresponding quarter of last year they were 113. The deaths from epidemic diseases in the entire District have been 28; viz., 1 from small-pox, 1 from measles, 8 from scarlet fever, 4 from diphtheria, 3 from hooping cough, 6 from diarrhœa, and 5 from fever. Two deaths of patients from this District occurred in the Asylums District Fever Hospital; thus making a total of 7 deaths from fever. There were no deaths 4 from scarlet-fever or from small-pox of patients belonging to this District in the hospitals under the management of the Metropolitan Asylums District Board. In the corresponding quarter of the previous year the deaths from epidemic diseases were 56; viz., 21 from measles, 13 from scarlet-fever, 3 from diphtheria, 9 from hooping-cough, 1 from diarrhœa, and 9 from fever. As I have not received the mortality returns from the local registrars since October, 1874, I am unable to report, as I have been hitherto accustomed to do, the specific diseases which have proved fatal to the inhabitants of this District. Neither am I able to specify the localities in which deaths have occurred, nor to report the proportionate number of deaths of males to females, nor to specify the ages at death. The deaths occasioned by violence in this District were, according to the Report of the Registrar General for the year 1874, 225. "The deaths in London caused by horses and vehicles in the streets were 211—28 by horses without carriages, 11 by carriages, 17 by omnibuses, 14 by tram cars, 33 by cabs, 4 by drays, 36 by carts, and 63 by vans or waggons. The kind of carriage producing 5 deaths was not described. 2805 cases of injury in the streets are reported by the Police." Mortality of Young Children. The mortality of children under one year of age was 103. This is 15.0 per cent. of the total mortality. In the corresponding quarter of the previous year the rate of mortality of children under 1 was 13.8 per cent. of the total mortality. In the Spitalfields sub-district the rate is 23.4 per cent.; in the Mile End New Town 13.0 per cent.; in the Whitechapel North, 27.2 per cent.; in the Whitechapel Church 4.7 per cent.; in the Goodman's Fields 32.5 per cent.; and in the Aldgate 23.8 per cent. In the Goodman's Fields sub-district, the deaths under 1 year were 14, and the total deaths 43; while in the Whitechapel Church sub-district the deaths under 1 year were only 11, and the total deaths 232. This difference is explained by the deaths in the London Hospital, in which institution the deaths of children under 1 year are very few. Pauper Illness in the District. The Medical Officers of the Union have attended, during the last quarter, 757 new cases of illness out of the Workhouse; including 7 of scarlet-fever, 6 of hooping cough, 9 of diarrhoea, 3 of fever, 39 of febricula, and 3 of erysipelas. In the corresponding quarter of the previous year the number of pauper cases of illness was 1062, including 39 of measles, 9 of scarlet fever, 9 of hooping-cough, 13 of diarrhœa, 15 of fever, 48 of febricula, and 5 of erysipelas. The total number of cases of illness in the Workhouse has been 756, including 16 of diarrhoea, 19 of febricula, 2 of fever, and 13 of erysipelas. Meteorology of Greenwich. The returns of the Registrar-General show that the rain-fall in the Metropolis during the quarter has been 3.83 inches. During the 5 ponding quarter of last year the rain-fall was 2.80 inches. The mean temperature of the air was 40.1°. In the corresponding quarter of last year the mean temperature was 41.6°. The coldest days during the quarter were Tuesday, the 23rd February, Wednesday, the 24th February, and Friday, the 5th March, when the thermometer indicated respectively 23.5°, 23.3°, and 25.5°. The coldest day during the corresponding quarter of last year was on the 11th February, when the thermometer indicated 21.0°, or 11.0° below the freezing point. The following table, taken from the returns of the Registrar-General shows the comparative results of the Quarter:— LONDON. Jan. Jan. 16 Jan. 23 Jan. 30 Feb. 6 Feb. 13 Feb. 20 Feb. 27 Mar. 6 Mar. 13 Mar. 20 Mar. 27 Apr 3 Deaths from Fever 33 43 44 33 27 23 29 24 23 27 33 15 30 Deaths from Scarlet Fever 61 59 58 61 43 46 38 38 36 38 36 24 32 Mean Temperature of the air 43.1° 46.0° 44.7° 43.2° 36.0° 34.5° 37.5° 33.5° 33.9° 43.5° 37.0° 42.7° 45.8° Rain - fall in inches 0.12 0.32 0.77 1.25 0.04 0.33 0.25 0.20 0.21 0.23 0.10 0.01 0.00 Deaths in London 2296 1911 1569 1650 1552 1726 1801 1854 1880 1847 1728 1680 1873 Deaths in Whitechapel District. 69 54 48 53 40 57 40 56 46 53 58 46 65 Deaths in do. from Fever 3 0 0 1 1 0 0 0 0 0 0 0 0 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. Re-Vacnation. June, 1873 331 2 17 0 348 2 663 September 266 0 36 0 302 0 644 December, 256 2 39 1 295 3 673 March, 1874 335 1 37 0 372 1 640 June 411 2 30 0 441 2 726 September 329 0 30 0 359 0 630 December 185 2 31 0 216 2 689 March, 1875 292 2 44 0 336 2 687 Totals 2405 11 264 1 2669 12 5352 6 Sanitary Works Performed during the Quarter. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ending April 3rd, 1875:— Number of inspections of houses as shown in the official returns 3187 Houses specially visited 155 Ditto specially re-visited 620 Preliminary notices served, such notices embracing 253 premises 223 Compulsory orders issued, embracing 72 premises 42 Summonses heard at Police Courts under Sanitary Act 2 Ditto under the Adulteration of Food Act 1 Cases of overcrowding and indecent occupation discovered 5 Houses in which the rooms or passages have been whitewashed 113 Rooms disinfected with sulphurous-acid gas, after the occurrence of fever and scarlet-fever therein 6 Articles disinfected, consisting of beds, bedding, clothing, &c. 0 Yards of houses paved or the pavement repaired 45 Drains in houses improved 65 Cesspools abolished 0 Dust-bins provided 5 Privies lime-washed, cleansed and repaired 114 Water-butts and cisterns provided or repaired 13 Nuisances from dung and other offensive matter removed 15 Area grating, cellar flaps, &c., repaired 7 Cellars used as dwellings discontinued for such use 2 The cow-houses in the District, 25, and the slaughter-houses 33 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. Adulteration of Pood Act. Pour samples of milk were purchased by the Sanitary Inspector for the north side of the District, and were submitted to the analyst, Dr. Tidy, for analysis. One of the samples was found to be adulterated with water, and the defendants (who were brothers) were summoned, and a fine of forty shillings and costs was inflicted. Nuisance arising from keeping Pigs. The Inspector has upon several occasions served notice on a person residing at No. 12, Hunt Street, Mile End New Town, for keeping pigs in the small back yard of the house, thereby causing the place to be in a filthy condition, and a nuisance to the neighbourhood. The house in question was occupied by four families; and several cases of fever having occurred there and in the houses adjoining, the Sanitary Inspector informed the agent of the property of the facts above-mentioned, who visited the premises with the Inspector, and ordered the tenant to pull 7 down tie pig-sty and a shed in which ducks were kept, and intimated to the occupier that unless his orders were obeyed he should serve him with a notice to quit the premises. The nuisance was immediately removed. Fever Cases in the District during 1874. A Letter was forwarded to me by Mr. Vallance, upon the subject of the prevalence of fever in this District, of which the following is a copy:— WHITECHAPEL UNION. Clerk's Office, Workhouse, E., 23rd April, 1875. My dear Sir, The attention of the Guardians has been drawn by the Managers of the Metropolitan Asylum District to the fact, that of 199 cases of Typhus Fever admitted into the Homerton Fever Hospital during the year 1874, 35 were sent from this Union, and furnishing particulars of such cases for the consideration of the Guardians. By direction of the Guardians, I have replied to the letter of the Managers, to the effect that in this Union there already exists concerted action by the Poor Law and Sanitary authorities—that the Medical Officer of Health attends at the Board Room weekly, for the purpose of inspecting the District Medical Relief Books—and all cases of Fever or other epidemical disease are extracted for the purpose of securing a prompt visitation of infected localities by the Sanitary Inspectors. At the same time, the Guardians think it desirable that the List which has been supplied by the Managers should be forwarded to you. I therefore venture to enclose it herewith. Yours faithfully, John Liddle, Esq., W. VALLANCE, Clerk 8, Campbell Terrace, Bow Road, E. In the list which accompanied Mr. Vallance's letter, 35 cases are recorded, with the residences of the patients. The whole of them, with one exception, viz., 39, Glass House Street, are included in the following return which has been prepared from the weekly records of the Medical Officers of the Union; and every room in which a case of fever or scarlet-fever occurred was disinfected without loss of time by the Inspectors. The following are the localities in Inspector Battrak's District in which cases of fever and scarlet-fever occurred, and which were attended by the Medical Officers of the Union during the year 1874. FEVER CASES. May No. 35, Wagener's buildings 1 „ 115, Back Church lane 1 „ 4, Maypole court 1 „ 5, Ditto 1 „ 113, Royal Mint street 2 „ 8, Everard's place 1 „ 2, Sun court 1 „ 9, Rose court, Aldgate 1 „ 2, Crawford's court 1 June Farthing alley 5 „ 3, Russell court 1 July „ 3, Glasshouse buildings 1 „ 3, Garden court 2 „ 19, Queen street 2 „ 6, Glasshouse buildings 1 „ 6, Crawford's court 1 „ 33, Little Alie street 1 „ 38, Haydon street 2 Aug. No. 3, Cooper's court 1 „ 24, Raven row 1 „ 14, Peter's court 3 „ 2, Crown ct.,Blue Anchor yd. 2 „ 18, Cartwright street 1 „ 141, Royal Mint street 1 „ 12, Butler's buildings 1 „ 3, Slater's court 3 „ 17, Darby street 1 „ 33, Crown court, Aldgate 1 Sept. „ 6, Compasses court 1 „ 25, Goodman's yard 1 „ 43, Glasshouse street 1 „ 1, Enock's court 1 „ 11, Butler's buildings 1 ,, 34, Charlotte street 1 „ 5, Cotton street 1 „ 4, Charles court 1 8 FEVER CASES—continued. Oct. No. 3, Wilson's place 1 „ 8, Providence place 2 „ 4, Grigg's court 1 Nov. „ 4, Charlotte court 1 „ 22, ditto 1 „ 2, Lansdown cottages 3 „ 3, ditto 1 „ 4, ditto 1 „ 3, Charlotte court 1 Nov. No. 4, Norwich court1 Dec. „ 37, Lambeth street 1 „ 28, Chamber street 2 „ 10, George yard 1 „ 19, Crown court, Aldgate 1 Total 67 SCARLET FEVER. Jan. No. 18, Crown ct. Blue Anchor yd. 1 „ 2, Slater's court 2 Feb. „ Ditto ditto 5 „ 6, Kettleby court 1 April „ Ditto ditto 1 May „ 9, Maypole court 5 June „ Ditto ditto 2 „ Ditto ditto 1 „ 20, Fieldgate street 1 July „ 38, Wagener's buildings 1 „ 42, Lambeth street 1 „ 11, Glasshouse buildings 1 „ 3, Queen street 1 „ 9, Enock's Court 4 „ 10, Ditto 3 „ 4, New Martin street 1 „ 9, Maypole court 1 18, Crown ct. Blue anchor yd. 1 Aug. „ 4, New Martin street 1 Aug. No. 3, Sugar Loaf court, W. C. 1 „ 4, New Martin street 1 „ 12, Ditto 1 ,, 9, Rose court, Aldgate 1 ,, 9, Maypole court 1 ,, 14, Peter's court 1 „ 3, Compasses court 1 Sept. „ 1, Glasshouse buildings 1 „ 5, Kettleby court 1 „ 5, Ditto 1 „ 9, Ditto 1 „ 1, Wells yard 1 „ 5, Kettleby court 1 Oct. „ 32, Crown court, Aldgate 1 „ 15, Glasshouse buildings 1 Dec. „ 33, Lambeth street 1 Total 50 The following are the localities in which the cases of scarlet-fever attended by the Medical Officers of the Union occurred in Inspector Whack's District during the year 1874. Apr. No. 21, Brown's buildings 1 May „ 11, Wood's buildings 1 „ 7, John's place, M.E.N.T. 1 „ 4, Chicksand street 1 „ 13, Corbett's court 1 June „ 62, Grey Eagle street 1 „ 5, King street, Spitalflelds 2 July „ 5, Hunt place 1 „ 31, Duke street 3 „ 3, Parliament court 2 „ 2, Boar's Head yard 1 „ 5, Ely place 1 „ 7, Green's place 1 Aug. „ 3, Boar's Head yard 1 „ 22, Castle alley 1 „ 39, Gun street 1 „ 11, Court street 3 „ 12, Great Garden street 1 „ 3, Duke street 1 „ 14, Dorset street 1 „ 23, Duke street 1 „ 41, Luke street 1 „ 11, Court street 1 „ 5, Devonshire place 1 „ 15, Wood's buildings 1 „ 11, Thomas street 1 „ 4, Bell lane 1 „ 4, Gun street 2 „ 10, Frying-pan alley 1 Sept. „ 2, Tenter street, Spitalfields 1 Sept. No. 4, Montague court 1 „ 6, North street 1 „ 35, Quaker street 1 „ 11, Thomas street 1 „ 26, Great Pearl street 2 „ 7, King street, Spitalfields 3 „ 21, Castle alley 1 „ 22, Ditto 1 „ 16, Great Pearl street 1 „ 13, Castle alley 1 „ 11, Thomas street 1 Oct. „ 2, New court, Gt. Pearl street 1 „ 18, Jacob's court 1 „ 4, Butler street 1 „ 1, Hobson's court 1 „ 21, Castle alley 1 „ 4, Black Lion yard 1 „ 12, Little Halifax street 1 „ 2, Spital street 1 „ 2, New court, Gt. Pearl street 1 „ 5, Thomas street 1 Nov. „ 28, Church street, Spitalfields 2 „ 29, Wellington street 1 „ 48, Peabody buildings 1 „ 1, New court, Gt. Pearl street 1 Dec. „ 16, Hunt street 3 „ 51, Church street, M. E. N. T. 1 Total 70 9 The following are the localities in which the cases of fever attended by the Medical Officers of the Union occurred in Inspector Wrack's District during the year 1874. Feb. No. 30, Spital square 1 „ 9, Dowson's place 1 Apr. „ 15, Pelham street 1 May „ 1, Hobson's court 1 Aug. „ 10, Jacob's court 1 „ 39, Spicer street 1 Sept. „ 6, Artillery passage 1 „ 88, Church street 1 „ 1, Green's place 1 Oct. ,, 23, Brown's lane 1 Oct. No. 6, Artillery passage 1 „ 4, Samuel street 1 „ 4, Lamb street 1 Nov. „ 11, "Wood street 2 „ 15, Steward street 1 „ 20, Hunt street 5 Dec. „ 2, Little North street 1 Total 22 The following are SUGGESTIONS BY THE SOCIETY OF MEDICAL OFFICERS OF HEALTH, For Preventing the Spread of Infectious or Contagious Diseases, such as Scarlet Fever, Small Pox, Fever, &c. 1.—Separate the sick person from the rest of the family directly illness Separation of the sick. appears, placing him, if possible, in a room at the top of the house, and taking care to remove carpets, curtains, and all unnecessary articles of furniture and clothing therefrom. 2.—Admit fresh air by opening the upper sash of the window. The fire- Ventilation of sick room and house. place should be kept open, and a fire lighted if the weather permits. Fresh air should be freely admitted through the whole house by means of open windows and doors. The more air that passes through the house, the less likely is the disease to spread. 3.—Hang up a sheet outside the door of the sick room, and keep it wet with a mixture made either with a quarter of a pint of carbolic acid (No. 4), or a pound of chloride of lime, and a gallon of water. The floor should frequently be well sprinkled with either of the same disinfectants, and cloths, wetted with either, hung up in the room. Disinfection of room. 4.—Every thing that passes from the sick person should be received into vessels containing half a pint of solution of green copperas, made by dissolving one pound of the copperas in a gallon of water. A like quantity of the solution of copperas should be added to the discharges before emptying them into the closet. Disinfection of matter passed from the sick. 5.—Every sink, closet, or privy, should have a quantity of one of the above-named disinfectants poured into it daily, and the greatest care should be taken to prevent the contamination of well or drinking water by any discharges from the sick person. Disinfection of sinks, &c.; care of well or drinking water. 6.—All cups, glasses, spoons, &c., used by the sick person should be first washed in the above-named solution of carbolic acid, and afterwards in hot water, before being used by any other person. Disinfection of utensils. 7.—No article of food should be allowed to remain in the sick room. No food or drink that the sick person has tasted, or that has been in the sick room, should be given to anyone else. Disinfection of linen, &c 8.—All bed and body linen, as soon as removed from the sick person, and before being taken from the room, should be first put into a solution of 10 carbolic acid o£ the above-mentioned strength, remaining therein for at least an hour, and afterwards boiled in water. Handkerchiefs not to be used. 9.—Instead of handkerchiefs, small pieces of rag should be used, and these, when soiled, should be immediately burnt. Nursespersonal cleanliness. 10.—Persons attending on the sick should not wear woollen garments, as they are likely to retain infectious poison.; dresses of cotton, or of some washable material, should be worn. Nurses should always wash their hands immediately after attending to the sick person, using carbolic acid soap instead of ordinary soap. Precautions with regard to visitors. 11.—It is of the utmost importance that the sick room be not frequented by others than those in immediate attendance on the sick, as the clothing of visitors is very liable to carry away infection. Precautions during recovery. 12.—The scales and dusty powder which peel from the skin in scarlet fever, and the crusts in small pox being highly infectious, their escape may be prevented by smearing the body of the sick person all over every day with camphorated oil. This, and the after use of warm baths, and carbolic acid soap, are most essential. The sick person must not be allowed to mix with the rest of the family until the peeling has entirely ceased, and the skin is perfectly smooth; clothcs used during the time of illness, or in any way exposed to infection, must not be worn again until they have been properly disinfected. Final disinfection of sick room, bed, &c. 13.—When the sickness has terminated, the sick room and its contents should be disinfected and cleansed. This should be done in the following manner:—Spread out and hang upon lines all articles of clothing and bedding; well close the fire-place, windows, and all openings ; then take a quarter to half a pound of brimstone, broken into small pieces ; put them into an iron dish, supported over a pail of water, and set fire to the brimstone, by putting some live coals upon it. Close the door, and stop all crevices, and allow the room to remain shut up for twenty-four hours. The room should then be freely ventilated, by opening the door and windows, the ceiling should be whitewashed, the paper stripped from the walls and burnt, and the furniture, and all wood and painted work, be well washed with soap and water containing a little chloride of lime. Beds, mattresses, and articles which cannot well be washed, should, if possible, be submitted to the action of heat in a disinfecting chamber, usually provided by the local authorities. Until this Process of disinfection is effectually carried out, the room, cannot be safely occupied. Attendance of children at school. 14.—Children should not be allowed to attend school from a house in which there is infectious disease, as, although not ill themselves, they are very likely to carry the infection, and so spread the disease. No child should be allowed to re-enter a school without a certificate from the medical attendant, stating that he can do so without any danger of infecting other children. Precautions in case of death. 15.—In case of death, the body should not be removed from the room, except for burial, unless taken to a mortuary, nor should any article be taken from it until disinfected, as before directed in Rule No. 13, The body should be put into a coffin as soon as possible, with a pound or two of carbolic powder. The coffin should be fastened down, and the body buried withot any delay. 11 Attention is particularly directed to the following provisions of the Sanitary Laws, in reference to "Infectious Disorders ":— 1.—The owner or occupier may be required to cleanse and disinfect any house or room, or the cabin or berth of any ship or vessel, and the articles contained in it likely to retain infection—where infectious disease has existed—under a penalty not exceeding 10s. a day for neglect. 2.—If any person, suffering from any dangerous infectious disorder, shall enter a cab or other public conveyance, without informing the driver thereof that he is so suffering, shall be liable to a penalty not exceeding £5. 3.—Any person suffering from any dangerous infectious disorder—such as fever, scarlet-fever, small-pox, &c., who exposes himself in any street, school, church, chapel, theatre, or other public place; or in any omnibus or other public conveyance; and any person in charge of one so suffering, who so exposes the sufferer, shall be liable to a penalty not exceeding £5. 4.—Any person who, without previous disinfection, gives, lends, sells, or moves to another place, or exposes any bedding, clothing, rags, or other things which have been exposed to infection, becomes liable to a penalty not exceeding £5. 5.—Any person who lets a house, room, or part of a house, in which there has been infectious disease, without having such house or room, and all articles therein liable to infection, disinfected to the satisfaction of a qualified medical practitioner, is liable to a penalty not exceeding £20. This applies to public-houses, hotels, and lodging-houses. 6.—If any person who lets, or shows for hire, any house or part of a house, makes any false statement as to the fact of there being then in such house, or having within six weeks previously been therein, any person suffering from an infectious disease, such person answering falsely shall be liable to imprisonment, with or without hard labour, or to a penalty not exceeding £20. J. NORTHCOTE VINEN, M. D., St. John's, Southwark, W. H. CORFIELD, M.D., (Oxon.,) 10, Bolton Row, Mayfair. Hon. Secs. March, 1875. Water Supply. Major Bolton, in his remarks on the water supply of the metropolis, dated 9th April, 1875, says, "That the New River Company have in a number of cases afforded constant supply, by means of stand-pipes, to a large number of the houses of the poor situated in courts within the city bounds, and sanction has recently been obtained from the authorities for a further extension of these benefits to a considerable number of courts and alleys." " The East London Company have completed the extension of the constant system of supply in a considerable part of their district which is densely populated, and are bringing their whole district, section by section, underconstant supply." From the above quotations from Major Bolton's report it 12 appears that the East London Company are greatly in advance of the New River Company in their arrangements for giving their respective districts water on the constant service; and so far as this district is concerned, the East London Company are not only willing but desirous to supply the whole of it with water on the high-pressure system. I can state that a very large number of houses, and nearly the whole of courts, on the north side of "Whitechapel, which are in the district of the East London Company are now supplied with water upon the constant service; and I am informed that the whole of the houses, with the exception of those from the east of Baker's Row to the boundary of this District, will be so supplied by the end of the summer ; but I regret that 1 cannot report so favorably of the progress made in the extension of the constant service by the New River Company; for in Love Court, Whitechapel, in which there are 38 houses, 33 of them are supplied with water by the New River Company, and 5 by the East London. Those houses which are supplied by the New River have an intermittent supply, while those supplied by the East London are upon the constant service. The New River Company having cut off the supply of water to the houses numbered 1, 2, 3, and 4, Love Court, owing to the fittings being defective, they informed me of the fact, when I immediately directed the Inspector to serve a notice on the owner to forthwith re-connect the pipes and put up proper fittings, or proceedings would be taken under the provisions of the Nuisances' Removal Act to compel him to supply the houses with water. In this instance the Company, instead of insisting that the fittings should be made suitable for receiving water on the constant service, directed that cisterns should be erected, and the houses are again supplied on the intermittent service; although the owner stated that he was anxious to have the water on the constant service, in a similar manner to that of his two other houses, Nos. 5 and 6, in the same court, which are supplied by the East London Company. The New River Company however declined to accede to his request; and their officer, when spoken to by your Inspector on this and some other cases, said that the Company were unwilling to put the owners of such property to the expense of so altering their fittings as to adapt them for the reception of water on the constant service. If this statement be confirmed by the Directors of the Company I shall be sorry for it; for, in my opinion, it is just this kind of property which should be supplied with water direct from the main, without the intervention of butts or cisterns. The "Water Companies have the power, under the seventh section of the Water Act, to supply all the houses in their respective districts with water on the constant service, which in crowded neighbourhoods ought to be done; for the appearance of the water which is usually found in the receptacles now in use in such localities is repulsive, and is unfit for dietetic purposes. I suppose there can be no difficulty on the part of the New River Company supplying all the houses in their district with water on the constant service; for it appears from the observations of Mr. Baxter, who attended with a deputation of the Metro 13 politan "Water Companies to the Local Government Board, that the Companies would do so, as soon as the houses were ready to receive water on the constant service. If, however, they wait until the houses are made ready for that purpose by the voluntary act of the owners of tenements, it will be a long time before such a plan is carried out. So fearful axe the New River Company of the poor inhabitants wasting water, when supplied on the constant service, that they do not afford them a sufficient supply for domestic use; for the Company have determined to permit only a recently-invented apparatus to be erected, which in several cases does not allow more than a quart to flow at each turning of the key, and sometimes not even that. Prom the experience I have had in this matter, I am decidedly of opinion, that unless the pressure of public opinion be put on the New Eiver Company to furnish water on the constant service, and then to give a better supply, such as can be obtained by the use of the screw-down tap, which is really the best, and I believe the cheapest contrivance, the complaints of the poor will become more general. It is really most disheartening to see how our efforts to obtain water on the constant service in the poor localities of this District are thwarted by the New River Company. The number of houses in this District which are supplied by the New Eiver Company is about 900, and of this number there are only 194 supplied on the constant service; whilst in the district which is supplied by the East London Company there are upwards of 7000 houses; and I am informed that nearly the whole of these will, by the end of the approaching summer, be so supplied. I am, Gentlemen, Your obedient Servant, 15, Geeat Alie Street, 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 3rd April, 1875. 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 0 1 0 1 0 1 13 0 1 0 0 12 12 0 5 0 0 0 0 74 120 Mr. Champneys 0 0 2 0 0 0 2 3 0 1 0 1 25 1 1 4 0 0 1 0 106 147 Mr. Sequeira 0 0 3 1 2 0 0 11 0 1 0 0 29 4 0 2 0 0 0 0 92 145 Mr. H. Braye 0 0 1 4 2 0 0 5 0 0 0 3 43 4 0 10 0 0 0 2 129 203 Mr. Loane 0 0 0 1 4 0 0 7 0 0 0 0 21 0 0 5 4 0 1 3 95 142 Total 0 0 7 6 9 0 3 39 0 3 0 4 131 21 1 26 4 0 2 5 496 757 Corresponding Qr. of previous Year. 0 39 9 9 13 0 15 48 0 5 0 2 109 15 0 15 1 1 1 0 780 1062 Workhouse Mr. J. J. Ilott. 0 0 0 0 16 0 2 19 0 13 0 0 228 24 2 74 2 2 7 10 311 756 Included in the total number of cases of illness in the Workhouse there were 46 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases, for the Three Months ending 3rd April, 1875. Distriots. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhœa. Fever. Uholcra & Cholcraic Diarrlœa. Total. Remarks. Spitalfields 1 0 1 0 0 1 1 0 4 Workhouse. Mile End New Town 0 0 3 0 0 3 1 0 7 Whitechapel, North 0 0 1 1 2 1 0 0 5 Whitechapel Church 0 1 0 2 1 0 3 0 7 Hospital. Goodman's Fields 0 0 0 1 0 0 0 0 1 Aldgate 0 0 3 0 0 1 0 0 4 Totals 1 1 8 4 3 6 5 0 28 Deaths from Epidemics for the corresponding Quarter, 18 74. 0 21 13 3 9 1 9 0 56 Two deaths from fever of patients belonging to this District occurred in the Asylum District Fever Hospital at Homerton; one of these was removed from 52, Flower and Dean Street' and the other from 19, Crown Court, Butler s Buildings. TABLE III., Showing Sub-districts. Enumerated Population, Total Births, and Deaths from all causes. Deaths under 11 year of age and above CO years, Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. Persons aged 60 years and upwards. Violence. Inquest cases. Deaths in Public Institutions. Spitalfields 22499 173 111 26 21 6 16 0 Mile End New Town 15550 200 192 25 61 71 16 126 Whitechapel North 11597 89 44 12 11 3 4 0 Whitechapel Church 7322 82 232 11 2.9 52 57 194 Goodman's Fields 10381 105 43 14 13 3 5 0 Aldgate 9224 54 63 15 13 2 9 0 Totals 703 685 103 148 137 107 320 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTRICT, FOR, THE QUARTER ENDING 3RD JULY, 1875, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Printed By T. Penny & Co., 121, Leman Street, Whitechapel, E 1875. REPORT OF THE MEDICAL OFFICER OF HEALTH, For the Quarter ending 3rd July, 1875. To the Board of Works, Whitechapel District. Gentlemen, In the quarter that ended on Saturday, the 3rd July, 1875, the total births in the District were 669, and the deaths 558. The excess of births oyer deaths has therefore been, during this quarter, 111. As the deaths of the non-residents, which occurred in the London Hospital are included in the mortality returns, a deduction of such deaths must be made in order to estimate the correct mortality of the District. These deaths are on an average 66 percent., exclusive of sudden deaths and deaths from accidents, of the total mortality in this institution; and as the total deaths are 166, 109 must be deducted for the deaths of non-residents, thereby reducing the mortality of the District to 449, and increasing the number of births above deaths to 220. In the Spitalflelds sub-district the births were 212, and the deaths 88; in the Mile End New Town 153 and 154; in the Whitechapel North 102 and 39; in the Whitechapel Church 76 and 191 (in this sub-district the London Hospital is situated); in the Goodman's Fields 84 and 48; and in the Aldgate 42 and 38. The deaths have exceeded the births in the Whitechapel Church, and in the Mile End New Town districts; in the former by 115, and in the latter by 1. In the corresponding quarter of the previous year the births were 727, and the total deaths 594. The deaths in the London Hospital have been 166. In the corresponding quarter of the previous year the deaths in this Institution were 159. The deaths in the Workhouse have been 88. In the corresponding quarter of last year they were 104. The deaths from epidemic diseases in the entire District have been 67 ; viz., 1 from small-pox, 7 from measles, 9 from scarlet fever, 5 from diphtheria, 19 from hooping cough, 16 from diarrhoea, and 10 from fever. One death of a patient from this District occurred in the District Fever Hospital; thus making a total of 11 deaths from fever. 4 In the corresponding quarter of the previous year the deaths from epidemic diseases were 64, viz., 3 from measles, 42 from scarlet fever, 3 from hooping-cough, 13 from diarrhoea, and 3 from fever. As I have not received the mortality returns from the local registrars since October, 1874, I am unable to report, as formerly, the specific diseases which have proved fatal to the inhabitants of this District. Neither am I able to specify the localities in which deaths have occurred, nor the sudden deaths, nor the deaths from accidents. I am also unable to report the proportionate number of deaths of males to females, nor to record the ages at death. Mortality of Young Children. The mortality of children under one year of age was 117. This is 20.9 per cent. of the total mortality. In the corresponding quarter of the previous year the rate of mortality of children under 1 was 15.4 per cent. of the total mortality. In the Spitalfields sub-district the rate is 38.6 per cent.; in the Mile End New Town 21.4 per cent.; in the Whitechapel North 33.3 percent.; in the Whitechapel Church 6.7 per cent.; in the Goodman's Fields 33.3 per cent. ; and in the Aldgate 21.0 per cent. In the Goodman's Fields sub-district, the deaths under 1 year were 16, and the total deaths 48; in the Whitechapel North sub-district the total deaths were 39, and those under 1 year were 13; while in the Whitechapel Church sub-district the deaths under 1 year were only 13, and the total deaths 191. This difference is explained by the deaths in the London Hospital, in which institution the deaths of children under 1 year are very few. In the corresponding quarter of the previous year the rate of mortality of children under 1 year in the Spitalfields sub-district was 20.2 per cent.; in the Mile End New Town it was 15.8 per cent.; in the Whitechapel North 35.0 per cent.; in the Whitechapel Church 4.3 per cent.; in the Goodman's Fields 22.2 per cent.; and in the Aldgate sub-district it was 17.3 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the last quarter, 580 new cases of illness out of the Workhouse; including 7 of measles, 4 of scarlet-fever, 21 of hooping-cough, 28 of diarrhœa,, 4 of fever, 22 of febricula, and 6 of erysipelas. In the corresponding quarter of the previous year the number of pauper cases of illness was 889, including 1 of small pox, 7 of measles, 23 of scarlet-fever, 6 of hooping-cough, 21 of diarrhoea, 7 of fever, and 76 of febricula. The total number of cases of illness in the Workhouse has been 653, including 2 of measles, 1 of hooping-cough, 20 of diarrhoea, 16 of febricula, 2 of fever, 10 of erysipelas, 1 of pyfæmia, and 32 of syphilis. Meteorology OF Greenwich. The returns of the Registrar-General show that the rain-fall in the Metropolis during the quarter has been 6.23 inches. Of the 6.23 inches of rain which fell during this quarter, 1.23 inches fell in the week ending April 5 10th, and 1.34 inches in the week ending July 3rd. One-inch deep of rainfall on an acre weighs (allowing 10-lbs. to a gallon, which is the weight of a gallon of distilled water) nearly 101 tons. During the corresponding quarter of last year the rain-fall was 3.61 inches. The mean temperature of the air was 53.9° In the corresponding quarter of last year the mean temperature was 50.7°. The hottest days during the quarter were Thursday, the 3rd May, Friday, the 4th May, and Saturday, the 15th May, when the thermometer indicated respectively 83.2°, 83.3°, and 81.9°. The hottest day during the corresponding quarter of last year was on the 2nd July, when the thermometer indicated 86.7°. The following table, taken from the returns of the Registrar-General, shows the comparative results of the Quarter:— LONDON. Apr. 10 Apr. 17 Apr. 24 May 1 May 8 May 15 May 22 May 29 Jun. 5 Jun. 12 Jun. 19 Jun. 26 July 3 Deaths from 24 22 13 15 11 15 15 23 29 31 54 77 107 Diarrhœa Deaths from Scarlet Fever 24 28 34 35 35 59 31 42 41 70 53 62 69 Mean Temperature of the air 44.5° 42.8° 46.6° 52.1° 54.6° 59.3° 53.9° 54.1° 59.9° 58.9° 560° 58.6° 59.7° Rain-fall in inches 1.23 0.00 0.32 0.37 0.57 0.01 0.27 0.24 0.00 1.37 0.43 0.08 1.34 Deaths in London 1739 1675 1600 1532 1489 1427 1322 1294 1323 1335 1321 1413 134.8 Deaths in Whitechapel District. 36 45 35 47 37 39 33 61 39 42 50 41 53 Deaths in do. from Diarrhœa 0 0 1 1 1 0 0 3 2 1 3 2 2 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. Quakteb ending— PUBLIC VACCINATOR Workhouse. Totals. Births Registd. Primary Cases. Re-Vaccination. Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination. September, 266 0 36 0 302 0 644 December, 256 2 39 1 295 3 673 March, 1874 335 1 37 0 372 1 640 June 411 2 30 0 441 2 726 September 329 0 30 0 359 0 630 December 185 2 31 0 216 2 6S9 March, 1875 292 2 44 0 336 2 687 June 376 0 26 0 402 0 673 Totals 2450 9 273 1 2723 10 5362 6 Sanitary Works Performed during the Quarter. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ending July 3rd, 1875:- Number of inspections of houses as shown in the official returns 2663 Houses specially visited 233 Ditto specially re-visited 754 Preliminary notices served, such notices embracing 397 premises 179 Compulsory orders issued, embracing 147 premises 46 Summonses heard at Police Courts under Sanitary Act 2 Cases of overcrowding and indecent occupation discovered and abated 5 Houses in which the rooms or passages have been whitewashed 146 Room3 disinfected with sulphurous-acid gas, after the occurrence of fever and scarlet-fever therein 4 Articles disinfected, consisting of beds, bedding, clothing, &c. 17 Yards of houses paved or the pavement repaired 24 Drains in houses improved 61 Cesspools abolished 1 Dust-bins provided 28 Privies lime-washed, cleansed and repaired 106 Water supply provided or improved 36 Nuisances from dung and other offensive matter removed 16 Area gratings, cellar flaps, &c., repaired 7 Cellars used as dwellings discontinued for such use 3 The cow-houses in the District, 25, and the slaughter-houses 32 in number, have been visited during the quarter. Water Supply. Since my last quarterly report, the New River Company have supplied Rose Court, Blue Anchor Yard, consisting of six houses, with water on the constant service. All the Courts in that locality are now supplied on the constant service, with the exception of Hairbrain Court, which is held by two owners; and if the Company would use their powers, this Court would likewise be so supplied. Unhealthy Localities. It will be seen, on referring to page 4, that the average rate of mortality of children under one year of ago is greater both in this quarter and in the corresponding quarter of the previous year in the Whitechapel North sub district than in any of the other sub-districts. The fact of so large a proportion of infantile mortality speaks very unfavorably of the sanitary condition of that particular locality, for a high rate of mortality among young children is generally found to co-exist with overcrowding and defective ventilation; and this opinion appears to be borne out in the sub-district of 7 Whitechapel North, where the rate of infantile mortality, in proportion to the total deaths, has been in the two quarters mentioned above 34.1 per cent. The sub-district of Whitechapel North comprises that portion of the Parish of Whitechapel which is bounded on the North partly by the Parish of Spitalfields, partly by the centre of Old Montague Street and the Hamlet of Mile End New Town, and partly by the Parish of Bethnal Green, and bounded on the South by the centres of Whiteehapel High Street and Whiteehapel Road. In this sub-district there are the crowded localities of all the Courts on the East side of Middlesex Street, the South side of Wentworth Street throughout its whole extent, Goulston Street and Goulston Court, Castle Alley, George Yard and New Court in George Yard, Inkhorn Court, Queen's Place, &c.; the whole of which places for density of population is probably not exceeded in any other district in London. As regards Castle Alley, I have, on three separate occasions, reported it to be unfit for habitation, in consequence of the faulty construction of the houses, the want of ventilation, and the impurity of its atmosphere. It contained in May last, on a house-to-house visitation made by Mr. "Wrack, a population of 375 persons; viz., 208 adults and 167 children. There are 31 houses in which there are 108 rooms. The entire area of the place is 1,496 square yards, which gives an average of about 4 square yards to each person. Castle Alley is entered by a covered way several feet in length and only about 3 feet in width, and owing to the filth which is daily deposited in this narrow passage it is always in an offensive condition. The backs of the houses in Whiteehapel High Street completely prevent a free current of air from entering this densely crowded locality, so that the foul emanations which are given off from so many people congregated together in this narrow place, extending from the entrance in Whiteehapel High Street to the new Board School, cannot escape, and hence the atmosphere is always close and fetid. In short, a privy smell pervades the the whole place. This being so, it is in vain, in a sanitary point of view, to enlarge the existing windows or make new ones in the houses ; for, by so doing, an unhealthy atmosphere will only be admitted into the rooms. The total mortality in the year ending October 10th, 1874, was 12; which gives a death-rate of 32 per 1000; while the total mortality for the whole District, excluding the deaths of non-residents in the London Hospital, but including the deaths from accident in the same year, was 28.1 per 1000. Although the rate of mortality in Castle Alley is 4 in 1000 in excess of the rate of mortality in the entire district, yet the rate of mortality taken by itself does not sufficiently indicate the comparative unhealthiness of any particular locality; and in order to obtain the best information on this subject, I made application to Mr. Sequeira, one of the Medical Officers of the Union, to give me his opinion in writing of the sanitary condition of Castle Alley. In his letter to me, dated 1st May, 1875, he states that during the whole 8 of the period that he has been Medical Officer of the Union, he has never been able to return a clean bill of health for that place—that he has had under his care, in proportion to the number of houses, more cases of sickness therein than in any other place in his Medical District. Although cases of fever, scarlet-fever, and febricula are of frequent occurrence, yet, cases of consumption, scrofula, and tuberculous diseases, which, in his opinion, are either caused, or aggravated, by the continual breathing of a vitiated atmosphere, have been very numerous. The opinion of Mr. Sequeira is valuable, for it is founded upon a long experience; and if my testimony can add to the force of Mr. Sequeira's opinion I can state that during the fifteen years that I held a similar appointment to that of Mr. Sequeira, scarcely a day passed without my having occasion to visit some person in Castle Alley. As Castle Alley, owing to its confined area, does not admit of effectual sanitary improvement being carried out, the only thing that can be done with it is to demolish all the houses therein. In my report for the Quarter ending Juno, 1873, I stated that if Castle Alley, New Castle Street, and Wentworth Street, were so widened as to make a convenient approach to the new Board School, not only would a great public improvement be effected, but the sanitary condition of the adjacent localities would be greatly benefited. Artizans' Dwellings Improvement Act. As the above-named Act has now come into operation, it is expedient that I should draw the attention of the Board to some of the most unhealthy localities of this District: and this I am enabled to do by simply referring you to my Quarterly Report for March, 1873, where, at page 10, there will be found a few particulars respecting the unhealthiness of certain blocks of buildings situated between the South side of Royal Mint Street and Upper East Smithfield. The total area of the several blocks mentioned in that Report is about 19,482 square yards, or a little more than four acres. In this area there are 2369 people, each person having only on an average 8.2 square yards; and the rate of mortality in this locality was in the year 1873 38.4 per 1000, or 12 per 1000 above the rate of mortality for the entire District. The mortality in the entire District was in 1873, 2471, but in this year there were 53 weeks; deducting therefore the average number of deaths (46) for the extra week, and deducting also the deaths (393) of nonresidents in the London Hospital, the total number of deaths in the District was 2022, which gives the annual rate of mortality of 26.4 per 1000. The rate of mortality therefore in the area above mentioned is 50 per cent. in excess of the rate of mortality of the entire District. In such overcrowded localities, although deaths from epidemic diseases are usually very prevalent, yet the deaths from consumption and other tubercular diseases are far more numerous; for in the year 1874 the deaths from these causes were 623, or 30.8 per cent. of the total deaths, while the deaths 9 from epidemic diseases were 313, or 15.4 per cent. If any one, or the whole, of these areas were cleared of houses, it would form a most convenient locality for the erection of suitable dwellings for the working classes, as it is situated close to the London and St. Katharine Docks. Slaughter Houses. The Metropolitan Board of Works having, in accordance with the fourth section of the Slaughter Houses Act, 1874, made a code of bye-laws for regulating the conduct of slaughter-houses within their jurisdiction, and the same having been confirmed by the Local Government Board, are now in force. These bye-laws have been printed and a copy has been delivered to every person carrying on the business of a slaughterer of cattle within this District. The Bye Laws relating to Slaughter Houses within the Metropois (except the City of London and the Liberties thereof) are here subjoined. Metropolitan Board of Works. The Slaughterhouses, &c., (Metropolis) Act, 1874, 37 and 38 Vic., c. 67. Bye-Laws for regulating the conduct of the business of a slaughterer of cattle, i.e., a person whose business it is to kill any description of cattle, including sheep, goats, or swine, killed for the purpose of its flesh being used as butchers' meat, and the structure of the premises on which such business is being carried on, and the mode in which application is to be made for sanction to establish such business anew, within the limits of the Metropolis (except the City of London, and the liberties thereof). In pursuance of the above Act, by which the Metropolitan Board of "Works is constituted the Local Authority for the Metropolis (except the City of London and the liberties thereof), the said Metropolitan Board of Works (for the purposes of these Bye-laws called the "Board") doth hereby make the following Byelaws; but it is to be understood that nothing in such Bye-laws shall in any way lessen or otherwise affect the statutory authority now vested in the Vestries and District Boards, or their officers, in relation to slaughter-houses. Throughout, and for the purposes of these Bye-laws, "the premises" shall include the slaughter-house and all the premises used for the business of a "slaughterer of cattle; "and "slaughter-house" shall mean the portion of the premises used for the slaughtering and dressing of cattle; "occupier" shall mean the occupier of premises where the business of a slaughterer of cattle is carried on; and "slaughterer of cattle" Definitions. 10 shall mean a person whose business it is to kill any description of cattle, including sheep, goats, or swine, which is killed for the purpose of its flesh being used as Butchers' meat. As to the conduct of the business of a Slaughterer of Cattle. Cattle keeping. 1.—The occupier of a slaughterhouse shall not keep, or permit to be kept, any cattle in the premises, except for the time absolutely necessary, previous to slaughter; or permit to bo slaughtered therein any animal that is not intended or fit to be used for human food. Exclusion of fowls, pigs, dogs, &c. 2.-—The occupier shall not keep, or permit to be kept, any fowl, pig, or other animal used for human food (except cattle about to be slaughtered), in or about the premises; nor shall keep, or permit to be kept, any dog thereon. Inhabited rooms. 3.—The occupier shall not allow any room situated over a slaughterhouse to be inhabited under any pretext whatsoever. Use of Slaughter houses. 4.—The occupier shall not allow the slaughterhouse to be used for any purpose other than that for which it is licensed, nor any slaughtering to be conducted within public view. Removal of manure, garbage, &c. 5.—The occupier shall provide and keep a sufficient number of tubs, boxes, or vessels, formed out of proper non-absorbent materials, with tight and close-fitting covers thereto, for the purpose of receiving and conveying away all manure, garbage, offal, and filth; and shall, in all cases, immediately after the killing and dressing of any cattle, cause all such manure, garbage, offal, and filth, to be placed in such tubs, boxes and vessels; and shall cause Removal of blood. all the blood arising from the slaughtering of cattle to be put into separate tubs or vessels formed with the like materials as above, with close-fitting covers, and every such tub, box, and vessel, together with their contents, to bo removed from the premises within twenty-four hours. Walls and roofs. 6.—The occupier shall keep the inner walls of every slaughter house always thoroughly clean and in good order and repair, and shall cause the internal surface of the roof and upper portions of the walls to be thoroughly washed with quicklime, at least once in every three months. Cleansing. 7.—The occupier shall cause the slaughterhouse to be thoroughly washed and cleansed within three hours after the slaughtering is completed. Cleansing receptacles. 8.—The occupier shall keep every covered and other receptacle used in the slaughterhouse at all times thoroughly cleansed and purified, so as to avoid any offensive smell. Removal of fat, hides. &c. 9.—The occupier shall cause the fat of any cattle slaughtered in a slaughterhouse to be kept freely exposed to the air until the time of its removal from the premises, and all such fat, as also all hide 11 skins, and tripes to be removed from the premises within twentyfour hours after the slaughtering is completed. 10.—The occupier shall remove, or cause to be removed, from the premises every carcase, bone, hide, skin, and all moat, fat, offal, blood, garbage, and other articles, before the same have become putrid or offensive. Putrid or offensive articles. 11.—In case of any diseased cattle being brought to a slaughter house the occupier shall forthwith give information thereof to the Board, and to the Cattle Inspector for the district, with all particulars in his knowledge as to when, from whom, and from what place it was received. Diseased Cattle. 12.—The occupier shall allow every Member of the Board, in addition to all other persons lawfully entitled to admission, to have free access to the premises during the times of slaughter, and at all reasonable hours. Access. 13.—The occupier, if he neglect or omit to observe or perform, or shall in any way break any one of the above Bye-laws, shall be subject to a penalty of the sum of £3, and in case of a continuing offence the sum of £1 for every day during which such offence is continued after a conviction for the first offence. Penalties. 14.—Every Court of Summary Jurisdiction as defined by the Slaughterhouses, &e., (Metropolis) Act, 1874, having Jurisdiction to hear and decide complaints of the breach of these bye-laws, may, by Summary Order, suspend or deprive any occupier of a slaughter house altogether of the right of carrying on any such business, as a penalty for the breach of any one of these Bye-laws. Suspension, As to the structure of the premises on which the business of a Slaughterer of Cattle- is carried on. 15.—Every person occupying a slaughterhouse shall cause it to be provided with an adequate tank or other proper receptacle for water and water supply, and so placed that the bottom thereof shall not be less than 6 feet above the floor level; and the slaughterhouse to be well and thoroughly ventilated. Water supply and ventilation. 16.—Every person occupying a Slaughterhouse shall cause it to be well paved with asphalte or flag stone set in cement, and to bo laid with proper slope and channel towards a gulley, and to be effectually drained by an adequate drain of glazed pipes or in other sufficient manner communicating with the public sewer, and the gulley to be trapped by an appropriate trap, and to be covered with a grating, the bars of which shall not be more than three-eighths of an inch apart. Paving and drainage, 17.—Every person occupying a slaughterhouse shall cause every inner wall to be covered with hard, smooth, impervious material, Walls. 12 to the height of four feet at the least, and to be always kept thoroughly clean and in good order and repair. Alterations. 18.—Every person occupying a slaughterhouse shall cause all needful works and repairs to the premises to be forthwith done and executed as and when the same shall become requisite; and shall not allow any alteration whatsoever to be made in respect of the paving, drainage, ventilation, or water supply to or in the premises which have been licensed, without the consent of the Board. Water closets, &c. 19.—Every person occupying a slaughterhouse shall not allow any water-closet, privy, cesspool, urinal, or stable to be within, or to communicate directly with the slaughterhouse. Rooms or lofts. 20.—In the case of any slaughterhouse now existing, or to be erected hereafter, neither the Owner, nor the Occupier, shall allow any room, or loft to be built over it. P enalties. 21.—The occupier, if he neglect or omit to observe or perform, or shall in any way break any one of the Bye-laws, numbered 15, 16, 17, 18, 19, and 20, shall be subject to a penalty of the sum of £5, and in the case of a continuing offence, the sum £ 1 for every day during which such offence is continued after a conviction for the first offence. As to the mode in which application is to be made for sanction to establish anew the business of a Slaughterer of Cattle. A pplication for sanction to a Slaughterhouse anew. 22.—Any person who shall make application to the Board for sanction to establish anew the business of a Slaughterer of Cattle, within the jurisdiction of the Metropolitan Board of Works, shall furnish with such application a plan of the premises and sections of the building in which it is proposed to carry on such business, drawn to a scale of a quarter of an inch to the foot, and showing the provision made, or proposed to be made, for the drainage, lighting, ventilation, and water supply of the same; and shall also furnish a key plan of the locality, showing the buildings and streets within 100 yards of the premises, drawn to a scale of five feet to the mile. Sealed by Order, J. E. WAKEFIELD, (L.S.) Cleric of the Board. Allowed by the Local Government Board this twenty( L.S.J seventh day of May, 1875. CLARE SEWELL BEAD, G. SCLATEB-BOOTH, Secretary, President. 13 The Bye-laws as set forth above will probably have the effect of improving the sanitary condition of the several slaughter-houses, and as they apply to all the districts in the Metropolis which are under the jurisdiction of Vestries and District Boards, a uniformity of laws relating to the regulation of these places will be enforced, and the Bye-laws which have been made by the several Yestries and District Boards will be superceded. I am of opinion that if the Metropolitan Board of Works had similar powers to frame Bye-laws for the regulation of cow-houses, many of the evils now arising from cow-houses in the Metropolis would be abated. I am, Gentlemen, Your obedient Servant, 15, Great Alie Street. 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 3rd July, 1875. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhœa. Cholera and Choleraic-Diarrhœa. Continued Fever, Typhus & Typhoid. Febricula. Pyæmia. Erysipelas. Puerperal Fever. Croup. Acute Pulmonary Inflammation. Carbuncle. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. . Bronchitis and Catarrh. Pleuritis and Pneumonia. Dr. Swyer 0 4 2 1 5 0 1 5 0 1 0 0 6 7 0 2 0 0 0 1 59 94 Mr. Champneys 0 0 0 4 7 0 1 1 0 1 0 0 19 1 0 5 1 0 0 0 94 134 Mr. Sequeira 0 2 1 11 4 0 2 8 0 0 0 0 8 2 0 1 0 0 0 0 78 117 Mr. H. Braye 0 0 1 4 9 0 0 2 0 3 0 0 18 5 0 0 0 0 0 3 89 134 Mr. Loane 0 1 0 1 3 0 0 6 0 1 0 0 9 0 0 5 0 0 0 3 72 101 Total 0 7 4 21 28 0 4 22 0 6 0 0 60 15 0 13 1 0 0 7 392 580 Corresponding Qr. of previous Year. 1 7 28 6 21 0 17 76 0 0 1 2 51 10 1 16 5 0 0 7 650 889 Workhouse Mr. J. J. Ilott. 0 2 0 1 20 0 2 16 1 10 0 0 145 25 4 64 2 0 5 11 354 653 Included in the total number of cases of illness in the Workhouse there were 32 cases of syphilis. TABLE II. Showing tho Deaths from Epidemic Diseases, for the Three Months ending 3rd July, 1875. Districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhoea. Fever. Cholera & Choleraic Diarrhœa. Total. Remarks. 0 4 1 0 2 2 1 0 10 0 0 1 0 8 8 4 0 21 Workhouse. Whitechapel, North 0 1 1 1 1 0 0 0 4 Whitechapel Church 1 0 1 4 4 2 2 0 14 Hospital. Goodman's Fields 0 1 3 0 2 2 1 0 9 Aldgate 0 1 2 0 2 2 2 0 90 Totals 1 7 9 5 19 16 10 0 67 Deaths from Epidemics for the corresponding Quarter, 1874. 0 3 42 0 3 13 3 0 64 One death from fever of a patient belonging to this District occurred in the Asylum District Fever Hospital at Homerton. The Patient was removed from 6, Wentworth Street. TABLE III., -Showing Sub-districts, Enumerated Population, Total Births and D»aths from all causes. Deaths under 1 year of age and above 60 years ; Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital, for the Quarter ending 3rd July, 1875. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. Persons aged 60 ye?rs and upwards. Violence. Inquest cases. Deaths in Public Institutions. 22499 212 88 34 13 4 11 0 Mile End New Town 15550 153 154 33 46 3 9 88 Whitechapel North 11597 102 39 13 5 3 3 0 Whitechapel Church 7322 76 191 13 18 25 27 166 Goodman's Fields 10381 84 48 16 6 0 1 0 Aldgate 9224 42 38 8 1 4 5 0 Totals 669 558 117 89 39 56 254 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE Samotarn Condition OF THE WHITECHAPEL DISTRICT, FOE. THE QUARTER ENDING 2nd OCTOBER, 1875, BY JO HN LIDDLE, MEDICAL OFFICER OF HEALTH. London: PRinted BY T. Penny & Co., 121, Leman Stkeet, Wnitechaifi, ii 1875. REPORT of the MEDICAL OFFICER OF HEALTH, For the Quarter ending 2nd Oct.., 1875. To the Board of Works, Whitechapel District. Gentlemen, ln the quarter that ended on Saturday, the 2nd October, 1875, the total births in the District were 635, and the deaths 568. The excess of births over deaths has therefore been, during this quarter, 67. As the deaths of the non-residents, which occurred in the London Hospital, are included in the mortality returns, a deduction of such deaths must be made in order to estimate the correct mortality of the District. These deaths are on an average 66 percent., exclusive of sudden deaths and deaths from accidents, of the total mortality in this institution ; and as the total deaths are 163, 108 must be deducted for the deaths of non-residents, thereby reducing the mortality of the District to 460, and increasing the number of births above deaths to 175. In the corresponding quarter of the previous year the births were 631, and the total deaths 645. In the Spitalfields sub-district the births were 165, and the deaths 92 ; in the Mile End New Town 162 and the deaths 132; in the "Whitechapel Forth 96 and the deaths 46; in the Whitechapel Church 58 and 192 (in this sub-district the London Hospital is situated); in the Goodman's Fields 94 and 49 ; and in the Aldgate 60 and 57. The deaths have exceeded the births in the Whitechapcl Church district by 134. 4 The deaths in the London Hospital have been 163. In the corresponding quarter of the previous year the deaths in this Institution were 153. The deaths in the "Workhouse have been 62. In the corresponding quarter of last year they were 48. The deaths from epidemic diseases in the entire District have been 98 ; viz., 10 from measles, 7 from scarlet fever, 3 from diphtheria, 15 from hooping cough, 57 from diarrhosa, and 6 from fever. One death of a patient from this District occurred in the District Fever Hospital; thus making a total of 7 deaths from fever. In the corresponding quarter of the previous year the deaths from epidemio diseases were 167, viz.; 1 from small-pox, 4 from measles, 78 from scarlet fever, 1 from diphtheria, 3 from hooping-cough, 59 from diarrhoea, 18 from fever, and 3 from choleraic-diarrhoea. As I have not received the mortality returns from the local registrars since October, 1874, I am unable to report, as formerly, the specific diseases which have proved fatal to the inhabitants of this District. Neither am I able to specify the localities in which deaths have occurred, nor the sudden deaths, nor the deaths from accidents. I am also unable to report the proportionate number of deaths of males to females, nor to record the ages at death. Mortality of Young Children. The mortality of children under one year of age was 149. This is 26.2 per cent. of the total mortality. In the corresponding quarter of the previous year the rate of mortality of children under 1 was 22.7 per cent. of the total mortality. In the Spitalfields sub-district the rate is 40.2 per cent. ; in the Mile End New Town 28.0 per cent.; in the AVhitchapcl North 52.0 per cent.; in the Whitechapel Church 6.7 per cent; in the Goodman's Fields 51.0 per cent.; and in the Aldgate 24.5 per cent. In the Goodman's Fields sub-district, the deaths under 1 year were 25, and the total deaths 49; in the Whitechapel North sub-district the total deaths were 46, and those under 1 year were 23; while in the Whitechapel Church sub-district the deaths under 1 year were only 13, and the total deaths 192. This difference is explained by the deaths in the London Hospital, in which institution the deaths of children under 1 year are very few. In the corresponding quarter of the previous year the rate of mortality of children under 1 year in the Spitalfields sub-district was 29.3 per cent. ; in the Mile End New Town it was 24.8 per cent.; in the Whitechapel North 24.4 per cent. ; in the Whitechapel Church 8.1 per cent. ; in the Goodman's Fields 28.3 per cent.; and in the Aldgate sub-district it was 25.8 per cent. 5 Pauper Illness in the District. The Medical Officers of the Union have attended, during the last quarter, 549 new cases of illness out of the Workhouse; including 17 of measles, 3 of scarlet-fever, 15 of hooping-cough, 49 of diarrhoea, 6 of fever, 21 of febricula, and 6 of erysipelas. In the corresponding quarter of the previous year the number of pauper cases of illness was 939; including 5 of measles, 91 of scarlet-fever, 2 of hooping cough, 104 of diarrhoea, 42 of fever, and 79 of febricula. The total number of cases of illness in the Workhouse has been 613; including 2 of measles, 1 of scarlet-fever, 4 of hooping-cough, 33 of diarrhoea, 10 of febricula, 3 of fever, 8 of erysipelas, and 35 of syphilis. Cases op Illness in the London Hospital of Persons belonging to this District. By the courtesy of the House Committee of the London Hospital I have been favoured with a return of all the patients belonging to this District who have been admitted into the London Hospital during this quarter. The total number, including both medical and surgical cases, is 165; including 3 of diphtheria, 1 of scarlet fever, 6 of diarrhoea, 1 of measles, 3 of rheumatic fever, 2 of erysipelas, 2 of bronchitis, 8 of pneumonia and pleuritis, 11 of consumption, 5 of lead poisoning, 1 (a silverer) of mercurial poisoniDg, 1 of poisoning by ammonia, and 30 of fractures. Of the three cases of diphtheria, one was from 2, G-oulston Street, one from 3, Green Street, and tho address of the other was mislaid. Meteorology of Greenwich. The returns of the Registrar General show that the rain-fall in the Metropolis during the quarter has been 10.03 inches. Of the 10.03 inches of rain which fell during this quarter, 3.27 inches fell in the week ending July 17th, and 2.25 inches in the week ending September 25th. One inch deep of rain-fall on an acre weighs (allowing 10-lbs. to a gallon, which is the weight of a gallon of distilled water) nearly 101 tons. During the corresponding quarter of last year the rain-fall was 6.72 inches. The mean temperature of the air was 58.3°. In the corresponding quarter of last year the mean temperature was 60.58. The hottest days during tho quarter were Monday, the 16th August, Tuesday, the 17th August, Saturday, tho 18th September, and Sunday, the 19th Septemler, when the thermometer indicated respectively 81.0°, 83.6°, 81.0°, and 80.0°. The hottest day during the corresponding quarter of last year was on Thursday, tho 9th July, when the thermometer in the shade indicated 92.0°. The following table, taken from the returns of the Registrar-General, shows the comparative results of the Quarter :— 6 LONDON. July 10 July 17 July 24 July 31 Aug. 7 Aug 14 Aug 21 Aug. 28 Sep. 4 Sep. 11 Sep. 18 Sep. 25 Oct 2 Deaths from Fever 15 26 22 23 9 22 18 24 29 26 24 IS 25 Deaths from Scarlet Fever 58 90 96 87 73 87 59 71 99 71 82 90 113 Mean Temperature of the air j 58.5° 06.2° 60.2° 60.3° 59.8° 65.2° 66.6° 62.2° 60 0 60.30 63.2° 60.1° 55-1 ° Rain-fall in inches 0.54 3.27 0.49 O.04 l.2o 0.21 039 0.34 0.23 0 00 0.18 2.25 0.84 Deaths in London 1400 1481 1471 1422 1340 14S3 1453 14 40 1429 1492 1338 '.319 1401 Deaths in Whitechapel District. j 38 60 39 34 43 42 46 46 60 43 46 37 44 Deaths in do. from Scarlet-fever 1 2 0 1 2 1 0 0 0 0 0 0 0 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 VACCINATOK workhodse. Totals. Births Primary Cases. Re-VaccinatioD. Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination. Registd. December 256 2 39 1 295 3 673 March, 1874 335 1 37 0 372 1 640 June 411 2 30 0 441 2 726 September 329 0 30 o 359 o 030 December 1S5 2 31 0 216 2 639 March, 1875 292 2 44 0 336 2 637 June 376 0 26 o 402 0 673 September, 350 1 35 0 385 1 650 Totals 2534 10 272 1 2806 11 6368 Diakrhcea. It will be observed on referring to Table 2 in the Appendix, that the deaths from diarrhoea for this quarter are two in number less than in the corresponding quarter of the previous year, while the mean temperature of the air was less by 7.4°. From this fact we may learn to correct, to some extent, a prevalent opinion that summer diarrhoea, and especially the diarrhoea of infants, is caused by the heat of the weather. Tho Registrar-General, in his return of births and deaths for the week ending July 17, makes the following remarks: "Notwithstanding tho low temperature and the heavy rain-fall, the fatality from diarrhoea not only showed a lurther increase, but exceeded the average for the corresponding weeks in 7 the last ten years. Tho deaths referred to diarrhcca in the metropolis, which in the three previous weeks had been 77, 107, and 179, further rose to 204 last week, of which 158, or 77 per cent., were of infants under one year of age, and 34 of childron aged between one and 5 years." " The annual death-rato from diarrhoea in London, for the week ending 17th July, averaged 3.1 per 1000, and ranged from 1.9 in the west, to 4.6 in the east groups of districts." Again, for the week ending September 25th, when the mean temperature was 60.1°, the deaths from diarrhoea were 125, while for tho previous week, when the mean temperature of the air was 63.2°, or 3.1 in excess, the deaths from diarrhoea were 147. On the other hand, for the weeks ending August 14th, August 21st, August 28th, when the mean temperature was respectively 65.2°, 66.6°, and 62.2°, the deaths from diarrhoea were 147, 181, and 215, which was tho highest number in any week during the quarter, when the mean temperature had fallen 4.4° from that of the previous week. It is, however, generally admitted by scientific inquirers into the causes of summer diarrhoea, that neither temperature alone, nor the eating of unripe fruit, nor both combined, are sufficient to account for the increased number of deaths from diarrhoea which usually occur in the summer months. The cause still requires to be investigated. " Evidence," says the Registrar-General, " appears strongly to point to the intimate relation between the sanitary condition and the death-rate from diarrhoea. If temperature only were the cause of summer diarrhoea, it would be difficult to account for the difference in the rate of mortality of the several towns in England; for instance, the diarrhoea-rate during this quarter ranged from 1.6 and 2.5 in Bristol and London, to 7.0 and 9.2 in Birmingham and Leicester. Why should the diarrhoea rate be 3.8 in Nottingham and 9.2 in Leicester ? And why 5.7 in Salford, when it was only 2.6 in [Oldham ? " Fatal diarrhoea," the Registrar-General, in his last quarterly report, remarks, " is essentially an infantile disease. In town popnlations the deaths of infants from diarrhoea bear a large proportion to the total deaths referred to this disease than they do in rural populations. In London last quarter 74 per cent. of the 2128 deaths from diarrhoea were of infants under one year of age, 19 per cent, of children aged between one and live years, 2.7 per cent. of persons aged between 5 and 60 years, and 4.4 per cent. of persons aged upwards of 60 years." In the same report of the Registrar-General there is given a table of mortality from diarrhoea, and meteorology, in London, in the summer months of each of the 15 years 1861-75; and it appears from this table that in some years, when the mean temperature of tho air is comparatively high, the mortality from diarrhoea is less than when the temperature is comparatively low. Thus, in the year 1861, the annual death-rate per 1000 from diarrhoea was 2.66 when the mean temperature of the air was 60.4°; in the year 1864 the deaths from diarrhoea were 2.80 per 1000, and the mean 8 temperature of the air was 50.4°, and in 1873 the deaths from diarrhoea were 3.79 per 1000, and the mean temperature of the air 60°3. Sanitary Works Performed during the Quarter. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ending October 2nd, 1875:— Number of inspections of houses as shown in the official returns 1918 IIouses specially visited 150 Ditto specially re-visited 475 Preliminary notices served, such notices embracing 181 premises 141 Compulsory orders issued, embracing 57 premises 31 Summonses heard at Police Courts under Sanitary Act 0 Cases of overcrowding and indeccnt occupation discovered and abated 2 Houses in which the rooms or passages have been whitewashed 220 Rooms disinfected with sulphurous-acid gas, after the occurrence of fever and scarlet-fever therein 5 Articles disinfected, consisting of beds, bedding, clothing, &c 18 Yards of houses paved or the pavement repaired 161 Drains in houses improved 109 Cesspools abolished 1 Dust-bins provided 7 Privies lime-washed, cleansed and repaired 158 Water supply provided or improved 20 Nuisances from dung and other offensive matter removed 10 Area gratiDgs, cellar flaps, &c., repaired 7 Cellars used as dwellings discontinued for such use 1 The cow-houses in the District, 26, and tho slaughter-houses 32, and the bake-houses 74 in number, have been visited during the quarter. Slaughter-Houses. Out of tho 32 slaughter-houses in the District, four of the occupiers did not apply for a renewal of their licenses; 15 were opposed by the Metropolitan Board of Works; of these, 14 were refused, and 1 was adjourned, to afford an opportunity to the proprietor to carry out the necessary improvements which the regulations of the Metropolitan Board of Works required. The number of slaughter-houses in this District is now reduced to 14. In my last Quarterly Report I published, for the convenience of the members of your Board, a copy of the bye-laws for regulating the conduct of the business of a Slaughterer of Cattle, which were prepared by the Metropolitan Board of Works, and sanctioned by the Secretary of State for the Home Department. These bye-laws have now the force of an Act of Parliament. 9 It appears from a Report of Mr. "Wakefielb, the Clerk to tho Metropolitan Board of Works, dated 24th September, 1875, and read on the same day at the meeting of the Board, that the whole of the slaughter-houses in the metropolis had been thoroughly inspected by their own Inspectors; and it was found that the condition of the slaughter-houses generally was such that considerable alterations were necessary, and in a very large number of cases almost re-construction was required. Mr. Wakefield has every reason to believe, from a subsequent inspection of a large number of premises, that in the majority of cases the necessary works have been, or are being, carried out; and he thinks that it will be shortly found that of the 1337 licensed slaughter-housps in London, about 1000 of them will be creditable places, properly drained, lighted, and ventilated, and having every appliance for being kept thoroughly clean and wholesome. The remaining 337 are those which, from unauitability of position, structure, and other causes, are reported as unfit for the purposes of slaughtering. Although these bye-laws come far short of what I deem necessary for preserving the health of the District, and for guarding the public from the danger which is inseparable from the driving of cattle through the crowded streets of the metropolis, they are nevertheless an improvement on the existing state of things. Each Local Board has hitherto framed its own regulations for the conduct of the business of a Slaughterer of Cattle, and as may be expected, there is a want of uniformity as regards the bye-laws for the regulation of the slaughter-houses in the metropolis. I take it that the bye-laws now in force regarding slaughter-houses are merely tentative, or experimental: and that they will be from time to time so altered as to meet the requirements of the public. If the Metropolitan Board of Works should deem it advisable to make alterations in them I would suggest the following :— 1st. That the entrance to a slaughter-house should be of such a width as to occasion no difficulty in getting the animals into the slaughter-house; for I have seen great cruelty practised in getting cattle through an entrance of only three feet in width. 2nd. That no underground place, for obvious reasons, should be licensed as a slaughter-house. 3rd. That the lairs for cattle should not form any part of the slaughterhouse, so that the animals which are being kept for slaughter should not witness the act of slaughtering. The custom now is, as regards the position of lairs, that they form a part of the slaughter-house, whereby the excretions of the animals awaiting slaughter contaminate the atmosphere of the slaughter-house. 10 4th. Every slaughter-house should be provided with a separate sideentrance, so that animals should not be driven over the public footpath. The present practice of driving animals over the footway is not only a nuisance occasioned by the droppings of the animals, but is attended with much danger to the passers by. The evil of driving cattle through the public streets is admitted by a Committee of the Metropolitan Board of "Works; but they say that in the absence of thoroughly efficient substitutes this evil must be tolerated. 5thly and lastly. No place should be licensed as a slaughter-house unless it be a detached building, and has an open space surrounding it of several feet in width. I am firmly of opinion that if the Metropolitan Board of "Works would obtain powers to build public slaughter-houses in different parts of London, and in sufficient number to be of easy acccss to the butchers, the majority of the existing slaughter-houses would be discontinued ; the result of which would be not only a great benefit to the public, but a very considerable pecuniary gain to the butchers, who, by discontinuing to slaughter in their present slaughter-houses, would find that they could slaughter their cattle with very little cost. The meat of animals when slaughtered in a well ventilated slaughter-house, will keep sweet for a longer period than when slaughtering is performed in an insufficiently ventilated slaughterhouse ; and butchers, who have slaughter-houses attached to their shops, might so utilize the space, so as to render their premises of much greater value. It is manifest that unless public slaughter - houses are provided the existing state of things must continue. It will be found the greatest benefit to the public if butchers are compelled to slaughter cattle in the public slaughter-houses, for it will compel the public authorities, who should have the entire control of these places, to keep one man constantly on the premises to thoroughly examine every animal when it enters the slaughter-house, to see that the same is in a healthy state, and after slaughter to see that the flesh is sound and fit for the use of man; and another man to keep the slaughter-house in a clean and wholesome state. The existence of so many slaughter-houses as there are now in London affords facilities for tho slaughtering of diseased animals, and for the disposing of unsound meat; for it is manifestly impossible that all the slaughter-houses can be so supervised as to prevent diseased animals from being driven into the slaughter-houses, and the unwholesome meat disposed of to the public to be used as food. Under the existing state of things it is impossible to compel the occupier of a slaughter-house to fulfil the conditions of the seventh bye-law, which relates to the thoroughly cleansing of the slaughter-house within three hours after the slaughtering is completed, for in some of the existing 11 slaughter-houses slaughtering is carried on nearly the whole day, and in some cases at night; the slaughter-house being let to any person who is willing to pay for the use of it. Such a practice ought unquestionably to be prohibited. Aetizans' and Labourers' Dwellings Improvement Act, 1875. The following official representation was made by me to the Metropolitan Board of Works, of the unsanitary condition of certain localities in this District. To the Metropolitan Board of Works, the Local Authority as respects the Metropolis, appointed by the said Act. Gentlemen, I the undersigned John Liddle, the Medical Officer of Health of the District of Whitechapel, within the Metropolis, desire to make to your Board an official representation of the unhealthiness of a certain area within your jurisdiction as such local authority appointed by the said Act, and which area is situated partly within the Parish of Whitechapel, and partly within the Parish of Aldgate, both within the Whitechapel District, and extending from Dock-street, Whitechapel, on the east, to Peter's-court on the west; being bounded on the north by Royal Mintstreet, and on the south by the portion of Upper East Smithfield extending from Cock-alley, and thence eastward to the boundary of the Pariah of Aldgate, and following the boundary of that Parish northward to its junction with the southern boundary of the Parish of Whitechapel, and thence eastward along the line of the boundary of the last-mentioned Parish to Dock-street. This area may be roughly estimated as containing six acres or thereabouts, and has a population of about 3750, and it comprises some courts and alleys of the most wretched description, and includes the following streets, &c. Hogg-yard, Shorter'srents, Vincent-place, Glasshouse-buildings, Glasshouse-street, Hayes-court, Cherubimcourt, Providence-court, New Martin-street, Crown-court, Whitechapel, Garden-court, Compasses-court, Blue-anchor-yard, Russell-court, Hairbrain-court, Parson's-court, Holloway-court, Slater's-court, Rose-court, Cooper's-court, Kettleby-court, Bracey'sbuildings, Brown-bear-alley, Butler's-buildings, Hurn's-buildings, Farthing-alley, Cock-alley, Cartwright-square, Crown-court, Aldgate, Cartwright-street, Walton'scourt, Providence-place, Providence-row, Turner-street, Darby-street, Christophercourt, Crawford's-court, Alma-place, Wells-yard, Little Peter's-court, and Peter's Court. I desire to represent to your Board, that by reason of the closeness, narrowness, and bad arrangement, as well as by reason of the bad condition of the courts and houses within such area, diseases indicating a generally low condition of health amongst the population have been from time to time prevalent ; and the death-rate of such population has been excessive, such excess being more than 50 per cent, above the ordinary rate of the District of Whitechapel, of which it forms a part. I further desire to represent that the evils connected with such houses, courts, and alleys, and the sanitary defects in such area cannot be effectually remedied otherwise than by an improvement scheme for the re-arrangement and re-construction of the streets and houses within such area, or some of such streets and houses. The density of this entire area is such as to afford upon an average 8.2 square yards to each person ; but in Crown-court, a court connecting Blue-anchor-yard with Glasshouse-street, there is only a space of 3.4 square yards to each person. The average number of persons to a house in the entire area is 8.3. I am, Gentlemen, Your obedient Servant, 11th July, 1875, JOHN LIDDLE. 15, Great Alie Street, Whitechapel 12 The number of houses in the above-named area is about 450 ; and of this number there are about 239 without any back yards, and consequently without any thorough ventilation. 213 have back yards, although for the most part they are very small. The houses without back yards have the privies either in the cellars or in the open Court, and are accessible to the public; and in both instances are nuisances and render such houses unhealthy. Some of the houses which arc provided with back yards have no access thereto, except either by descending a flight of stairs into the cellars, and then ascending another flight of stairs into the yards; or in some instances, where there are no cellars, thoroughfares are made of the lower rooms, which are occupied by separate families, into the yards, through which rooms the slops and filth of the up-stairs tenants are carried. In some of the houses the lower room is ventilated by a staircase, which forms a part of it, into the room above. Goulston Street. The following Memorial, which was signed by 25 inhabitants of this District, amongst whom is Mr. James Scott Sequeira, the Medical Officer of the Union who has the medical charge of that part of the District, was referred to me. London, Sept. 10, 1875. The Board, of Worlts, Whitechapel District. Gentlemen, We, tlie undersigned inhabitants of the Parish of St. Mary, Whitechape], beg leave to draw the attention of your honorable Board to the shocking condition of the houses situate in Goulston-street, in this Parish, which we are satisfied are unfit for human habitation, detrimental to the health and well-being of the whole District, and in such a sanitary condition as cannot be effectually remedied otherwise than by an improvement scheme for the arrangement and re-construction of the street and louses. We therefore ask you to take such steps as may be necessary to put in force the provisions of the " Artizans' and Labourers' Dwellings Act, 1875." Upon the receipt of this Memorial I inspected the locality, and I am of opinion that the majority of the houses in the narrow part of Goulston Street, extending from High Street, Whitechapel, to Goulston Square, viz., Nos. 6, 8, 12, 22, on the east side, and Nos. 1, 2, 3, 5, 7, 9, 11, 13 and 15, on •the west side, are unfit for habitation from defective sanitary arrangements ; while the remaining houses, numbered 2, 4, 14 and 16, on the east side, and Nos. 17, 19, 21, 23 and 25 on the west side, although not defective in their sanitary arrangements, are unhealthy in consequence of the offensive emanations arising from the filth of the street, which are breathed by the inhabitants of the last-mentioned houses; and I may state that the daily cleansing of the street, however effectually performed, is insufficient to render the locality hoalthy. 13 Particulabs of the Condition of Houses in the Narrow tart of Goulston Street, "Whitechapel. The narrow part of this street consists of three warehouses and eight dwelling-houses, numbered 2, 4, 6, 8, 12, 14, 16 and 22, on the east side, and fifteen houses on the west side, numbered 1, 2, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25 and 27, making a total of twenty-three houses. The houses are occupied by 377 persons, namely, 196 adults and 181 children. The average number of persons in each house is 16.3. The width of this portion of the street is in its widest part 15 feet, and in the narrowest 12 feet 3 inches, while the houses on each side of the street are on an average 35 feet in height. This street is always in a very offensive condition, in consequence of the inhabitants of most of the houses throwing their house refuse and slops into the public way, the necessary conveniences of the houses being difficult of access, especially of tho numbers 6 and 8. East Side. Nos. 2 and 4. These houses consist of sixteen rooms, and are occupied by 30 persons. They might be deemed to be well ventilated if the surrounding atmosphere were not vitiated by the foul smells from the open street. Each of these houses has a yard, in which the water supply, dust-bins, and privies are placed. The privies being accessible to the public are generally in a filthy condition. • Nos. 6 and 8. These houses consist of twenty-five rooms, and are occupied by 70 persons. The houses are badly ventilated, the staircases and some of the rooms are dark; neither of the houses has a yard; the watersupply is placed upon the staircases; the privy accommodation for each house is upon a flat which forms a roof to the back addition of No. 6; a shaft is fixed from this flat to a dust-bin in tho yard of No. 4, for the occupiers of Nos. 6 and 8 to throw down their house dust. Both of these houses are at all times very offensive, owing to their defective sanitary condition and faulty construction, and are in my opinion totally unfit for habitation. No. 10. These premises are occupied by Messrs. Hill & Jones, and are used as a warehouse for carrying on the business of a confectioner. No. 12. This house consists of eight rooms, and is occupied by 30 persons. The house is badly ventilated ; it has no yard; the water supply, dust-bin, and privy, are in the cellar, which is dark, as is also the staircase leading thereto. The privy and cellar are always in a wet and filthy condition, and the smell arising therefrom renders the house totally unfit for human habitation. 14 Nos. 14 and 16. These houses consist of sixteen rooms, and are occupied by 21 persons. The houses are comparatively new. Each house has a yard, in which the water supply, dust bins, and privy accommodation are placed. Nos. 18 and 20 axe warehouses, which, when visited, were not occupied. No. 22. This house consists of three rooms, and is occupicd by three persons. The ground floor is used as a stable. The room above is used as a store room, and on the landing, adjoining, the privy is situated ; both the landing and the privy are perfectly dark. The house has no yard, and the water supply is upon the first floor landing, adjoining the privy. The privy is always in a wet and filthy condition, and tho refuse of the house is kept in a tub on the second flight of stairs. This house is unfit for habitation. West Side. No.' 1. This house consists of four rooms, and is occupied by thirteen persons. It is badly ventilated, and has neither a yard nor dust bin. The water supply and privy are in a small dark recess at the foot of the second flight of stairs. The privy is frequently in a wet and filthy condition, and a bad smell pervades the whole house. This house is unfit for habitation. Nos. 2 and 3. These consist of fourteen rooms, and are occupicd by thirty-eight persons. The houses are frequently in a very dirty state. Each house has a very small yard, in which the water supply, dust bins and privies are placed. The privies are always in a wet and offensive condition, which render the houses unfit for habitation. Nos. 5 and 7. These houses consist of fifteen rooms, and arc occupicd by twenty-four persons. The houses are badly ventilated, and neither of them has a yard nor dust bin ; the water supply and privy accommodation for both houses are in a dark passage on the ground floor of No. 5. The privies are always very wet and offensive, and render the houses unfit for habitation. The ground floor rooms of No 5 have been closed for some time, by my order, in consequence of want of light and proximity to the privies. Nos. 9, 11, and 13. These houses consist of twenty-four rooms, and are occupied by fifty-five persons. There is a narrow yard in the rear, which is common to all three. The water supply, privy accommodation, and dust bin are in this yard, which is only about three feet in width. The dust bin is the only receptacle in which the inhabitants of Nos. 5, 7, 9, 11, 13 and 15, can deposit their house refuse. These houses, owing to their faulty construction and defective sanitary arrangements, are unfit for habitation. 15 No. 15. This house consists of seven rooms, and is occupied by thirtyone persons. The house has no yard, and is badly ventilated. The water supply and privy accommodation are placed in the passage on the ground floor, and an offensive smell generally pervades the house, which renders it unfit for habitation. Nos. 17, 19, 21, 23, 25 and 27. These houses consist of thirty-six rooms, and are occupied by sixty-two persons. These houses, as -well as Nos. 14 and 16, on the east side, arc of a somewhat better class, and are tolerably well ventilated; each house having a yard, in which the water supply, privy accommodation, and dust bin are placed; but being situated in a street from which offensive emanations are almost always given off, they are rendered unhealthy. The rate of mortality in this part of the street was, for the year ended 3rd January, 1874, 29.2 per 1000. The rate of mortality for the entire District, excluding the deaths in tho London Hospital, was, for the same period, 23.9 per 1000. The unhealthiness of this locality is however more satisfactorily proved by the following letters, kindly given to me by Dr. Dyte. Board of Guardians for the Relief of the Jewish Poor. Medical Department, 8 a, Duke Street, Aldgate, E.C. Monday, Nov. 8th, 1875. Dear Sir, Reporting at your request, on the condition of the Houses at the south end of Goulston Street, I beg to say that, as Medical Officer of this Board, these houses have been constantly under my notice during the last ten years ; and I can unhesitatingly assert that throughout the whole of the district over which my official duties extend, (a space of which the radius is one mile from Aldgate Church) there is no locality of the thoroughly unwholesome condition of which I have had more reason to complain, that that now under consideration. The want of cleanliness, of light, of ventilation, the filthy condition of the waterclosets and their approaches, the rickety (and in some cases, dangerous) condition of the staircases—everything in fact, which can make a dwelling-place the reverse of healthy is to be found here. Accordingly, as might be expected, when there has been an epidemic of smallpox, fever or cholera, this has always been the place in which the disease has first appeared, and here also it has been more prevalent than elsewhere. Under these circumstances therefore, being of opinion that these houses are wholly unfit for human habitation, I cannot but think it highly desirable that the proposal to pull them down and widen the street should be carricd out. I am, Dear Sir, Yours very faithfully, J. H. DYTE. Licentiate of the Royal College of Physicians of London ; Medical Officer to the Board of Guardians for the Relief of the Jewish Poor. To John Liddlb, Esq., Medical Officer of Health. P.S.—I append hereto a memorandum from Dr. W. G. Tiley, who assists me in my duties as Medical Officer to the Board, and who has, for the last nine months, performed the greater portion of the work. 16 12, Artillery Lane, E., 6th November, 1875. dear Sir, In reply to your inquiry respecting the salubrity, or the contrary, of Goulston Street, I beg to say, that, as acting Medical Officer to the Jewish Board of Guardians, in conjunction with Dr. Dyte, during the last nine months, 1 have almost daily noticed, and frequently reported the want of ventilation, drainage, and light, in addition to overcrowding and filth, in the houses at the narrow (Whitechapel) end of that street. My duty being to visit cases too severe to call upon me, I have had constantly under treatment a larger number of diseases of a low type, (viz. : enteric fever, tuberculosis, marasmus, and scrofula in milder forms), and found them less amenable to remedies or relief, than in any other street, court, lane, alley, place or buildings in the district. My daily register of visits since February last, justifies amply my opinion that the re-building and widening of the narrow portion of that street is urgently needed. I am, Dear Sir, Yours faithfully, W. G. TILEY. John Liddle, Esq. Mr. Sequeika, the Medical Officer of the Union in charge of this part of the District, says, that the cases of illness in the south end of Goulston Street, are generally low fever and miningeal affections, dependent principally on the vitiated air the inhabitants have to breathe. I am, Gentlemen, Your most obedient Servant, 15, Great Alie Street. JOHN LIDDIE, APPENDIX. T ABLE 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 2nd October, 1875. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic Diarrhoea. Continued Fever, Typhus & Typhoid. Febricula. Pyasmia. 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 3 0 4 10 0 2 1 0 2 0 0 1 5 0 7 0 0 1 0 46 82 Mr. Champneys 0 2 0 2 18 0 0 4 0 2 0 .0 8 1 0 1 0 1 0 0 73 112 Mr. Sequeira 0 3 0 3 6 0 2 6 0 0 0 0 6 0 0 4 0 0 1 1 63 95 Mr. H. Braye 0 3 3 1 10 0 0 6 0 2 0 0 7 1 1 2 0 0 0 4 135 175 Mr. Loane 0 6 0 5 5 0 2 4 0 0 0 0 4 1 0 3 0 0 1 3 51 85 Total 0 17 3 15 49 0 6 21 0 6 0 0 26 8 I 17 0 1 3 8 368 549 Corresponding Qr. of previous Year. 0 5 91 2 104 0 42 79 0 5 0 0 49 9 1 13 1 0 5 9 524 939 Workhouse Mr. J. J. Ilott. 0 2 1 4 33 0 3 10 0 8 0 0 co 9 2 52 0 0 10 12 339 613 Included in the total number of cases of illness in the Workhouse there were 35 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases, for the Three Months ending 2nd October, 1875. Districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhosa. Fever. Cholera & Choleraic Diarrhea. Totle Remarks. 0 4 2 1 2 18 5 0 32 Mile End New Town 0 0 0 0 3 13 1 0 17 Workhouse. Whiteohapel, North 0 0 0 0 3 7 0 0 10 Whitechapel Church 0 0 1 2 1 6 0 0 10 Hospital. 0 4 1 0 3 9 0 0 17 0 2 3 0 3 4 0 0 12 0 10 7 3 15 57 6 0 98 Deaths from Epidemics for the corresponding Quarter, 1874. 1 4 78 1 3 59 18 3 167 One death from fever of a patient belonging to thia District occurred in the Asylum District Fever Hospital at Homerton. TABLE III., Showing Sub-distriets, Enumerated Population, Total Births, and Deaths from all causes. Deaths under 1 year of age and above 60 yeara ; Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital, for the Quarter ending 2nd October, 1875. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. Persons aged 60 years and upwards. Violence. Inquest cases. Deaths in Public Institutions. 22499 165 92 37 7 1 6 0 Mile End New Town 15550 162 132 37 36 6 14 62 Whitechapel North . 11597 93 46 23 6 1 6 0 Whitechapel Church 7322 58 192 13 23 40 47 163 Goodman's Fields 10381 94 49 25 3 1 3 0 9224 60 57 ... 7 6 11 0 Totals 635 568 149 82 55 87 225