WHI 27 BOARD OF WORKS, WHITECHAPEL DISTEICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTEICT, FOR THE QUARTER ENDED MARCH 29th, 1879, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Penny & Hull, Steam Printers, 121, Leman Streft, Whitechapel, E. 1879. 76 REPORT of the MEDICAL OFFICER OF HEALTH, For the Quarter ended 29th March, 1879. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 29th March, 1879, the total births in the District were 753, viz.: 356 males and 397 females ; and the deaths 647, viz.: 347 males and 300 females. The excess of births over deaths has therefore been, during this Quarter, 106. As the deaths of 108 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, thereby reducing the total mortality to 539, and increasing the number of births above deaths to 214. An allowance, however, must be made for the deaths of residents in public institutions outside the District ; but of those I have no return. In the corresponding Quarter of the previous year the total births were 705, and the total deaths 619. The rate of mortality for this quarter, deducting the deaths of nonresidents, is 7 per 1000 of the total population, which is about the same rate as for the corresponding quarter of last year, or at the annual rate of 28 per 1000. For the year ended 29th March, 1879, the rate of mortality in the entire District was 25.6 per 1000. While, however, the deaths from epidemic diseases are reduced from 73 to 38, the deaths from diseases of the respiratory organs, including phthisis, have increased from 225 to 280. This increase may be accounted for by the low temperature which has prevailed during the whole of the last three months. Bronchitis proved fatal to 150 persons, pneumonia to 62, and consumption, or phthisis, to 52; while in the corresponding quarter of last year bronchitis caused 113 deaths, pneumonia 57, and consumption, or phthisis, 48. 4 In the Spitalfields sub-District the births were 235 and the deaths 124 ; in the Mile End New Town 214 and the deaths 183 ; in the Whitechapel North 97 and the deaths 65 ; in the Whitechapel Church 74 and the deaths 191 (in this sub-District the London Hospital is situated); in the Goodman's Fields 90 and the deaths 47 ; and in the Aldgate 43 and the deaths 37. The deaths have exceeded the births in the Whitechapel Church District by 117, but from this number the deaths of the 108 non-residents must be deducted ; the proportion of births to deaths is therefore 74 to 83. The total deaths in the London Hospital have been 150. In the corresponding quarter of the previous year the deaths in this Institution were 175. The deaths in the Workhouse have been 108. In the corresponding quarter of last year they were 79. A shoemaker died in the Workhouse whose age was stated to be 102 years. The deaths from epidemic diseases in the entire District have been 38 ; viz.: 1 from measles, 3 from scarlet-fever, 2 from diphtheria, 23 from hooping-cough, 3 from diarrhoea, and 6 from fever. In the corresponding quarter of the previous year the deaths from epidemic diseases were 73 ; viz.: 7 from small-pox, 9 from measles, 6 from scarlet-fever, 2 from diphtheria, 35 from hooping-cough, 5 from diarrhoea, and 9 from fever. There were 257 persons killed in the streets of London in 1878 by horses, carriages, vans, waggons, omnibuses, tram-cars and cabs ; 73 were killed by vans and waggons, 63 by carts and 34 by cabs, and the remaining 87 by other vehicles and by horses. Mortality of Young Children. The mortality of children under 1 year of age was 115. This is 17.7 per cent. of the total mortality. In the corresponding quarter of the previous year it was 18.4 per cent. In the Spitalfields sub-District the rate is 28.2 per cent.; in the Mile End New Town 14.2 per cent.; in the Whitechapel North 32.3 per cent.; in the Whitechapel Church 7.8 per cent.; in the Goodman's Fields 23.4 per cent.; and in the Aldgate 16.2 per cent. The difference in the rate of mortality of young children in the Mile End New Town and Whitechapel Church sub-Districts is thus explained :- in the former the Workhouse is situated, and in the latter the London Hospital; in both these Institutions the children under 1 year bear only a small proportion to the adults. The total deaths under 5 years are 209 ; which shows a rate of mortality of 32.3 per cent. in relation to the total deaths, including those of non-residents, and 27.7 per cent. to the total births. The rate of mortality under 1 year, in relation to the total births, is 15.2 per cent. 5 Pauper Illness in the District. The Medical Officers of the Union have attended, during the past quarter, 957 new cases of illness out of the Workhouse ; including 2 of measles, 5 of scarlet-fever, 10 of hooping-cough, 7 of diarrhoea, 12 of febricula, 1 of fever, and 4 of erysipelas. In the corresponding quarter of the previous year the number of pauper cases of illness was 790 ; including 23 of small-pox, 1 of measles, 12 of scarlet-fever, 10 of hooping-cough, 6 of diarrhoea, 20 of febricula, 3 of fever, and 3 of erysipelas. The total number of cases of illness in the Workhouse has been 1006; including 4 of measles, 2 of hooping-cough, 8 of diarrhoea, 6 of erysipelas, and 15 of febricula. In addition to the above cases there were 37 of syphilis ; thus making a total of 1043. Uncertified Deaths. The total number of uncertified deaths in this District for the quarter ended 29th March, 1879, was only 4, or 1 in about 162 of the total deaths. Of these uncertified deaths 2 were in the Spitalfields sub-District ; 1 in the Mile End New Town ; and 1 in the Whitechapel North sub-District. The proportion of uncertified causes of death in the twenty large English towns averages 2.7 per cent. In London, the per centage of uncertified deaths did not exceed 1.6 ; whereas in the united provincial towns it averaged 3.7. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis, during the quarter, has been 7.28 inches. During the corresponding quarter of last year the rain-fall was 3.07 inches. The mean temperature of the air was 37.1°. In the corresponding quarter of last year it was 41.6°. The coldest days during the quarter were Sunday, the 12th January, Friday, the 10th January, and Saturday, the 11th January, when the thermometer indicated respectively 19.4°, 21.4°, and 21.6°. The coldest day during the corresponding quarter of last year was on Sunday, the 24th March, when the thermometer indicated 21.3°. The low temperature of the first three months of this year very unfavourably affected the public health ; but not to the same extent as the cold weather in the first quarters of 1870 and 1875. The meteorology of the year presented some peculiarities. The mean temperature of each of the first three quarters of the year was somewhat above the average, while that of the last three months was below the average. There was a great downfall of rain in the spring quarter, or in April, May and June, amounting to 13.2 inches, which was 7.6 inches above the average. The rain in the other quarters was below the average ; but the rain-fall of the year was 29.2 inches, which is 3.8 inches above the average. 6 Table of Weekly Mortality, &c., in London and in the Whitechapel District. The following Table, taken from the Returns of the Registrar-General, shows the comparative results of the Quarter:— Week ended Deaths in London. Deaths in Wchpl. District Rainfall. Mean Temperature of the air. Diarrhoea. Fever. Small-pox From all causes. From Smallpox. From all causes. Inches- Degree. Jan. 4 9 37 13 1900 0 56 2.03 41.4 „ 11 9 26 12 1873 0 53 0.03 28.2 „ 18 13 27 12 1947 0 51 0.85 35.4 „ 25 13 25 24 1812 0 36 0.02 29.2 Feb. 1 16 17 28 1821 0 46 0.05 31.6 „ 8 13 20 17 1839 0 60 0.85 39.8 „ 15 15 18 20 1646 0 39 1.29 43.8 „ 22 16 14 17 1645 0 47 1.41 35.8 March 1 19 16 22 1771 0 41 0.25 34.8 „ 8 12 12 17 2023 0 57 0.08 42.1 „ 15 11 22 15 1989 0 43 0.19 42.1 „ 22 12 20 15 2085 0 53 0.04 43.6 „ 29 18 22 9 2078 0 65 0.17 35.5 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-Vacciation. June, 1877 382 5 24 1 406 6 696 September 336 — 26 — 362 — 607 December 241 3 32 — 273 3 704 March, 1878 288 13 29 — 317 5 688 June 443 5 46 — 489 6 672 September 480 5 30 1 510 4 644 December, 1878 258 4 26 — 284 13 638 March, 1879 273 1 37 — 310 1 753 Totals 2701 36 250 2 2951 38 5402 7 The Committee of the London Hospital have kindly forwarded to me the following return of Medical Cases admitted into the Hospital, for the Quarter ended 29th March, 1879. WHITECHAPEL DISTRICT. (Including Spitalfields, Mile End New Town, the Tower, Mint, &c.) OCCUPATIONS. MALES. Total No. of cases. Fatal cases- General Diseases, Class I. General Diseases, Class II. Arthritic Diseases. Diseases of Nervous System. Diseases of Vascular System. Diseases of Respiratory System- Diseases of Digestive System- Diseases of Urinary System. Diseases of Generative Organs- Zymotic Diseases Laborer, in-door—Heavy work 3 1 2 1 — „ „ Light „ 10 1 1 2 6 1 — ,, out-door, Heavy „ 11 1 2 6 2 — „ Light ,, 3 l 1 1 1 — l Seamen 4 3 l 1 l 1 — Poisonous or injurious 1 1 — Professional 1 1 — Clerks Children 2 l 1 — Total No. of cases 35 2 3 4 4 1 16 2 3 — l Fatal cases 6 2 l 3 — FEMALES. Domestic 12 1 1 1 1 1 2 1 2 1 2 l In-door Trades 21 1 2 3 l 8 3 3 1 Out-door „ 1 1 Poisonous or injurious Professional No occupation 1 1 Total No. of cases 35 2 4 4 2 3 9 5 1 5 2 Fatal cases l 1 " General Diseases, Class I.," embraces measles, scarlet fever, typhus fever, enteric fever, cerebro-spinal meningitis, pyaemia, ague, erysipelas, puerperal fever, acute tuberculosis, pyrexia (from undetermined causes.) "General Diseases, Class II.," embraces purpura, scurvy, scrofula, rickets, anaemia, cancer, fever, syphilis, diabetes, general dropsy, &c. FRANCIS WARNER, M.D., Medical Registrar. 8 Table, showing the cases of Fever admitted into the Infirmary during the Quarter, and the localities from which they were received. Nature and description of Fever. Localities from which the cases were received. Date of admission into the Infirmary. Date of admission into the Fever Hospital. Length of time in the Infirmary before appearance of Fever. Whether or no the cases had Fever upon admission. Enteric 10, Fleur-deLis-street Jan. 18 Jan. 20 Two days. No. Enteric 9, Flower-&Dean-street Feb. 5 Feb. 7 Two days. No. Typhus Refuge in Crispin-street Feb. 13 Feb. 13 One day. Slightly. Enteric No. 15, Wellstreet Feb. 11 Feb. 14 Three days. No. Enteric 187a, Bricklane Feb. 19 Feb. 21 Two days. No. Three of the above cases occurred in Registered Common Lodging Houses. Small Pox, Scarlet Peter and Fever in the Asylum Board Hospitals. In the Returns of the Registrar-General for the week ended January 11th, 1879, it is stated that during the year 1878, according to the weekly returns of the Metropolitan Asylums Board, it appears that 6064 completed cases of small-pox, scarlet-fever, enteric fever, and typhus were recorded in the several hospitals for infectious diseases under the management of that Board. These included 4995 recoveries and 1069 deaths; the average mortality being equal to 17.6 per cent. of the completed cases. The number of completed cases of small-pox was 4762, among which the mortality was equal to 17.6 per cent. against 17.2 per cent. among the 7242 completed cases recorded in these hospitals during 1877. In the Highgate Small-pox Hospital the proportional mortality among the 422 completed cases recorded last year did not exceed 14.2 per cent. This difference in the rate of mortality in the hospitals in London requires explanation. Again, it appears that the proportional mortality among the 316 cases of enteric fever recorded at Homerton did not exceed 15.8, while it was 24.1 per cent among the 187 cases at Stockwell. In the London Pever Hospital 103 completed cases of this disease were recorded, of which 14 or 13.6 per cent. were fatal. Of typhus, 203 completed cases were reported in the Metropolitan Asylum Hospitals in 1878, and the rate of mortality was equal to 23.2 per cent.; in 1876 and 1877 the typhus cases in these hospitals did not exceed 145 and 141 respectively, and the mortality was equal to 19.3 and 25.5 per cent. The recorded cases of scarlet-fever in these hospitals, in 1878, were 596, against 824 and 419 in the two preceding years. The mortality in 1878 averaged 15.1 per cent. in the two fever 9 hospitals, and was equal to 12.4 at Homerton and 18.7 at Stockwell. The rate of mortality both from enteric fever and scarlet-fever, at the Stockwell Hospital compared with that which prevailed at Homerton, showed a marked excess. Among 398 scarlet-fever cases recorded last year at the London Fever Hospital the mortality was only 10.6 per cent. It is satisfactory to note, says the Registrar-General, that the appreciation and use of these Metropolitan infectious diseases hospitals is becoming more general. In 1876, the proportion of the total deaths from enteric fever in London occurring in these hospitals was 7.2 per cent., while it rose to 9.0 and 9.4 in 1877 and 1878. Of the scarlet-fever deaths in London, only 3.7 and 3.5 per cent. occurred in these hospitals in 1876 and 1877, whereas the proportion rose to 5.0 per cent. in 1878. Relative Proportion of Deaths occasioned by the mobe ob less constant Epidemic Diseases. "Whilst small-pox, scarlet-fever, and fever, occasion the greatest anxiety in the mind of the public, and the utmost efforts are used by the sanitary authorities to prevent their extension among the people, it perhaps is not generally known that the other three epidemic diseases, viz.:— diarrhoea, hooping-cough and measles, receive much less attention, although the mortality which is caused by the three last-named diseases is much greater. Thus, the deaths in London from epidemic diseases, as shown in the table at page 11 of my report for the quarter ended March, 1877, from the year 1838 to 1877 inclusive, are in the aggregate 474,445; those caused by small-pox, scarlet-fever and fever are 228,230; and those caused by diarrhoea, hooping-cough and measles are 246,215. By arranging the deaths in the form of a table, as under, the relative number of deaths from each of the six epidemic diseases will be readily seen: Deaths from Numbers. Deaths from Numbers. Scarlet-fever 97,533 Diarrhoea 94,449 Small-pox 42,695 Hooping-cough 90,410 Fever 88,002 Measles 61,356 Total 228,230 Total 246,215 The last named diseases are those which principally attack children in arms, who are carried about by their mothers from place to place ; and hence the contagion becomes diffused with greater facility than the other three, which more usually attack older children and adults, and who can be with proper care and attention more easily isolated. Still, the question of preventing the spread of infantile diseases is a most important one, and deserves the greatest attention, notwithstanding the difficulties in the way of enforcing it. 10 The Advantages of Preserving Open Spaces. In my last report I directed your attention to what I conceived to be a mistake in the fifth section of the Artizans' Dwellings Act (1875), which made it compulsory for the purchasers of the land rendered vacant by the pulling down of the unhealthy houses inhabited by the poorer classes, to erect on the site house accommodation for the same number of persons as may have been displaced. The object of this Act is to provide more open spaces than now exist in the immediate surroundings of the dwellings of the poor. It is stated upon the high authority of Dr. Farr, in the fortieth Annual Report of the Registrar-General, in the chapter on density of population, that the atmosphere becomes deleterious in proportion as the population becomes more dense, and within certain limits this deleteriousness is expressed by the mortality ; and that the mean duration of life varies in accordance with the proximity of people, or in other words the nearer people live to each other the shorter are their lives. Dr. Farr also observes that the law of proximity would lead us to lay down some standard, and to fix some invariable rule ; that beyond a certain density, no further houses should be built on the town areas. This being so, it is evident that if the health of London is to be improved, means must be taken to reduce the number of the houses in the dense parts of the metropolis, and not to rebuild the rookeries which are about to be abolished under Mr. Cross' Act. As we are now paying very dearly both in health and money for the errors of preceding generations, in their having allowed houses to be so closely packed together, wo certainly ought not to transmit similar evils to posterity ; for we now know that if people are allowed to crowd in confined places, the health of the community will be impaired. I am induced to again bring this subject under your notice in consequence of several cases having occurred in this District of landlords erecting dwelling-houses in the back yards of those houses which were formerly occupied by a single family. This is a serious evil, and ought to be prevented. We have power to prevent the overcrowding of rooms, and we certainly ought to have power to prevent the cramming together of houses on sites of insufficient size for the healthy existence of the tenants. Much, however, may be done to improve the health of the metropolis by forming parks in the outskirts. Dr. Farr states that London, with an area of 75,362 acres and an estimated population in 1879 of 3,620,868, is provided with nine royal parks, containing 1790 acres, all of which are planted and ornamented. The cost of maintaining the parks is said to be about £74,553 annually. It has also two people's parks and several commons and open spaces, covering an area of about 1459 acres, under the management of the Metropolitan Board of Works, who are negotiating for the acquirement of other open spaces near the metropolis. Excluding Plumstead and Welling Commons, the Board of Works have 11 expended about £346,033 in the purchase, formation and improvement of the two people's parks, commons and open spaces, which cost annually about £7390 for maintenance. The Board has also paid £20,450 for a part of Victoria Park, which the Government were about to devote to building purposes. It is stated that in Paddington there is still time to save nearly 100 acres from the builder. The land is adjacent to Kilburn and Maida Vale, and is surrounded on all sides by an ever increasing population, which is practically out of reach of any park or recreation ground. The following tables, extracted from the Annual Report for London of the Registrar-General, may be useful for reference. The first shows population ; persons to an acre ; annual birth and death rate ; mean temperature and rainfall in 1878 in London and in eight other of the most populous towns and cities in the United Kingdom ; and the second, population, births and deaths in greater London during the year ended 28th December, 1878: Cities & Towns. Estimated population in the middle of the year 1878. Persons to an acre, 1878. Annual rate of mortality per 1000 living in each year. Mean temprture. in 52 wks. ending 28th Dec., 1878. Rain-fall in i tithes in 52 wks. ending' 28th Dec., 1878. 1874 1875 1876 1877 1878 London 3,577,304 47.5 22.6 23.7 22.3 21.9 23.5 49.6 28.83 Glasgow 566,940 94.0 31.1 28.6 25 3 24.8 24.9 48.4 — Liverpool 532,681 102.2 32.1 27.5 27.6 26.5 29.4 48.5 28.93 Birmingham 383,117 45.6 26.9 26.6 22.7 24.2 25.5 — — Manchester 360,514 84.0 30 5 30.0 29.2 27.4 27.9 — — Leeds 304,948 14.1 28.8 26.5 25.1 22.3 23.8 48.5 30.95 Sheffield 289,537 14.7 26.9 24.9 24.3 21.9 25.0 48.2 32.91 Dublin 314,666 31.3 26.0 27.0 25.8 28.0 29.6 49.4 28.21 POPULATION :—Births and Deaths in Greater London (The Metropolitan and City Police Districts), during the 52 weeks ending 28th Dec., 1878. Districts. Estimated Population middle of 1878. Annual rate per 1000 living. Total Births. Total Deaths. Deaths of Infants under 1 year of age. Persons aged 60 years and upwards. Births. Deaths. Seven Zymotic Dis. Greater London 4,450,015 35.4 22.3 3.8 156,988 98,882 25,067 20,692 Inner London 3,577,304 36.2 23.5 4.1 129,184 83,695 21,176 16,991 Outer Ring 872,711 32.0 17.5 2.6 27,804 15,187 3,891 3,701 The seven zymotic diseases are small-pox, measles, scarlet-fever, diphtheria, hooping-cough, fever and diarrhœa. 12 In my report for the quarter ended September, 1877 (page 16,) I stated that the estimated population was 3,533,484, and which is now 3,577,304, an estimated increase of 43,820. The population of London increased 16.1 per cent. in the decenniad 1861-71, and the density of persons to an acre from 25 to 42. The density of persons in 1871 was 103 to a * hectare, 42 persons to an acre, 26,674 to a square mile. It is now estimated that the density of persons to a square mile is 29,322 Annual rate of increase of population, per cent. 1851-61, 1.73. 1861-71, 1.50. The density of the population in London is continually increasing ; thus, while in 1842 there were 16,367 persons to a square mile, there were 22,602 to a square mile in 1876. If it were not for the sanitary improvements which are continually taking place in London, the rate of mortality owing to the greater density of the population would have been materially raised. The mortality in London has been reduced from 25 to 23 per 1000, which is considered to be at least 3 per 1000 above what it ought to be, and which we may hope will be soon attained. The Registrar-General observes that the mortality of none of our towns should now exceed 20 per 1000. In the "Whitechapel District, as stated on the third page of this report, the rate of mortality for the year ended March, 1879, was 25.6 per 1000. Room Overcrowded by Young Children. Mr. Wrack, Sanitary Inspector, on recently visiting some houses in Freeman Street, Spitalfields, found on the ground-floor room of No. 24, a woman and 25 children, all of whom were apparently under the age of 3 years, and several of them not more than 18 months old. These children were left in charge of the occupier of the room, who was paid 3d. per week for each child to take care of them during the day. The room was badly ventilated ; the floor of which was in a wet and dirty condition. The children were on the floor, there being neither chairs nor seats for their accommodation. The size of the room was 15-ft. X 7-ft. X 7 ; thus affording only 28 cubic feet of space for each child. The children were kept here from nine o'clock in the morning until half-past five in the evening. The atmosphere of this room as might be expected was exceedingly offensive, and many of the children looked very pale and weakly. The Inspector served notice on the occupier to abate the overcrowding. If children are thus found huddled together in the manner described, it is not surprising that the rate of mortality among them is so large. An infant nursery or creche, if properly conducted, is one of the most valuable institutions of modern times. In these establishments, infants * A hectare is a French measure, containing 2.471143 statute acres, 13 and children under three years of age can be left by their mothers] during the day while they are engaged at work, with a feeling of confidence that the little ones will be under proper supervision and carefully attended to ; and where, by the good sanitary arrangements of the rooms, their health will be preserved. But such rooms as above described by Mr. Wrack are simply abominations and ought to be suppressed. Sanitary Works Performed during the Quarter ended 29th March, 1879. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 29th March, 1879 :— Number of inspections of houses as shown in the official returns 2777 Houses specially visited 286 Houses specially re-visited 1001 Preliminary notices served, such notices embracing 359 premises 143 Compulsory orders issued, embracing 130 premises 53 Summonses heard at Police Courts, under Sanitary Act 1 ,, under Act for the prevention of Adulteration of Food, &c. 0 Cellars used as dwellings discontinued for such use 3 Cases of overcrowding and indecent occupation abated 5 Houses in which rooms or passages have been whitewashed 134 Rooms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet-fever therein 16 Articles disinfected in rooms, consisting of beds, bedding, clothing, &c. 104 Yards of houses paved, or the pavement repaired 19 Drains in houses improved 81 Dust-bins provided 31 Privies lime-washed, cleansed and repaired 94 "Water supply provided or improved 20 Nuisances from dung, and other offensive matter removed 21 Area gratings, cellar flaps, &c., repaired 9 Animals kept so as to be a nuisance removed 3 Cesspools abolished 2 The bake-houses are now under the supervision of the Factory Inspectors. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. reat Alie Street. 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 ended on the 29th March, 1879. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhœa. 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 0 0 3 2 0 0 1 0 2 0 0 39 10 0 8 0 0 0 0 141 206 Mr. Champneys 0 1 0 0 3 0 1 3 0 1 0 0 92 1 0 9 0 0 0 0 306 417 Mr. Sequeira 0 1 2 3 2 0 0 7 0 0 0 0 9 0 0 2 0 0 0 0 52 78 Mr. H. Braye 0 0 2 4 0 0 0 1 0 1 0 0 39 2 2 0 0 0 0 0 132 183 Mr. Loane 0 0 1 0 0 0 0 0 0 0 0 0 19 3 0 4 1 0 0 0 45 73 Totals 0 2 5 10 7 0 1 12 0 4 0 0 198 16 2 23 1 0 0 0 676 957 Corresponding Qr. of previous Year. 23 1 12 10 6 0 3 20 0 3 0 0 154 28 1 35 0 l 1 1 491 790 Workhouse Mr. J. J. Ilott. 0 4 0 2 8 0 5 15 0 6 0 0 216 28 3 92 4 3 1 1 618 1006 In addition to the cases attended by Mr. Ilott in the Workhouse, there were 37 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended . 29th March, 1879. Sub-districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhoea. Fever. Cholera & Choleraic Diarrhea. Total. Remarks. Spitalfields 0 0 0 1 7 1 0 0 9 Mile End New Town 0 0 0 0 8 0 1 0 9 Workhouse. Whitechapel North 0 1 3 0 2 1 2 0 9 Whitechapel Church 0 0 0 0 4 1 3 0 8 Hospital. Goodman's Fields 0 0 0 0 2 0 0 0 2 Aldgate 0 0 0 1 0 0 0 0 1 Totals 0 1 3 2 23 3 6 0 33 Deaths from Epidemics for the corresponding Quarter, 1878. 7 9 6 2 35 5 9 0 73 No deaths from small-pox of patients belonging to this District occurred in the SmallPox Hospital at Homerton. No death from fever occurred in the Fever Hospital. TABLE III. Showing Sub-districts, Enumerated Population, Total Births, and Deaths from all causes— Deaths under 1 year of age, 1 and under 5 years, and above 60 years ; Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital, for the Quarter ended 29th March, 1879. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. 1, and under 5 years. Persons aged 60 years and upwards. Violence. Inquest cases. Deaths in Public Institutions. Spitalfields 22499 235 124 35 23 28 5 20 5 Mile End New Town 15550 214 183 27 20 64 7 19 108 Whitechapel North 11597 97 65 21 17 11 1 7 0 Whitechapel Church 7322 74 191 15 17 35 29 30 150 Goodman's Fields 10381 90 47 11 9 13 1 3 0 Aldgate 9224 43 37 6 8 7 2 6 0 Totals 76573 753 647 115 94 158 45 85 263 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTRICT, FOR THE QUARTER ENDED JUNE 28th, 1879, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Penny & Hull, Steam Printers, 53, Leman Street, Whitechapel, E. 1879. REPORT of the MEDICAL OFFICER OF HEALTH For the Quarter ended 28th June, 1879. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 28th June, 1879, the total births in this District were 656, viz : 358 males and 298 females ; and the deaths 550, viz.: 293 males and 257 females. The excess of births over deaths has therefore been, during this Quarter, 106. As the deaths of 114 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, thereby reducing the total mortality to 436, and increasing the number of births above deaths to 220. An allowance, however, must be made for the deaths of residents in public institutions outside the District ; but of those I have no return. In the corresponding Quarter of the previous year the total births were 671, and the total deaths 622. In the Spitalfields sub-District the births were 201, and the deaths 88 ; in the Mile End New Town 162, and the deaths 169 ; in the Whitechapel North 108, and the deaths 43; in the Whitechapel Church 61, and the deaths 181 (in this sub-District the London Hospital is situated) ; in the Goodman's Fields 78, and the deaths 38 ; and in the Aldgate 46, and the deaths 31. The deaths have exceeded the births in the Whitechapel Church sub-District by 120, but the deaths of the 114 non-residents must be deducted ; the proportion of births to deaths is therefore 61 to 67. The deaths have exceeded the births in the Mile End New Town sub-District, but in this sub-District the Workhouse is situated. 4 The deaths in the London Hospital have been 150. In the corresponding Quarter of the previous year the deaths in this Institution were 177. The deaths in the Workhouse have been 92. In the corresponding Quarter of last year they were 100. The deaths from epidemic diseases in the entire District have been 52 ; viz.: 10 from measles, 11 from scarlet-fever, 3 from diphtheria, 19 from hooping-cough, 5 from diarrhoea, and 4 from fever. Two deaths from small-pox, however, occurred in the Hospital, but neither of these were of persons strictly belonging to this District. One of these patients was a child in arms, who had been brought from Hamburgh, and when landed at St. Katharine's Wharf was suffering from a severe form of confluent small pox. The other death was that of a patient (residence not known) who was sent from the London Hospital. In the corresponding Quarter of the previous year, the deaths from epidemic diseases were 50, viz.: 3 from small pox, 5 from measles, 4 from scarlet-fever, 1 from diphtheria, 24 from hoopingcough, 8 from diarrhoea, and 5 from fever. Four deaths from smallpox occurred in the Small-pox Hospital, and 3 deaths occurred in the Fever Hospital. The total deaths from epidemic diseases were therefore 57. Mortality of Young Children. The mortality of children under 1 year of age was 94. This is 17.9 per cent. of the total mortality. In the corresponding Quarter of the previous year it was 16.8 per cent. In the Spitalfields subDistrict the rate is 22.7 per cent.; in the Mile End New Town 15.3 percent.; in the Whitechapel North 27.9 per cent.; in the Whitechapel Church 7.7 per cent.; in the Goodman's Fields 34.2 per cent.; and in the Aldgate 29.0 per cent. The difference in the rate of mortality of young children in the Mile End New Town and Whitechapel Church sub-Districts is thus explained:—in the former the Workhouse is situated, and the latter the London Hospital; in both these institutions the children under 1 year bear only a small proportion to the adults. The total deaths under 5 years are 189 ; which shows a rate of mortality of 34.3 per cent. in relation to the total deaths, including those of non-residents, and 27.2 per cent. to the total births. The rate of mortality under 1 year, in relation to the total births, is 14.4 per cent. 5 Pauper Illness in the District. The Medical Officers of the Union have attended, during the past Quarter, 953 new cases of illness out of the Workhouse ; including 1 of small pox, 2 of measles, 17 of scarlet-fever, 3 of hoopingcough, 20 of diarrhoea, 18 of febricula, 5 of fever, and 3 of erysipelas. The number of cases of fever which were sent from this District to the Hospital was 15, but no death is recorded among them. In the corresponding Quarter of the previous year the number of pauper cases of illness was 745 ; including 21 of small-pox, 2 of measles, 1 of scarlatina, 5 of hooping-cough, 11 of diarrhoea, 29 of febricula, 2 of fever, and 1 of erysipelas. The total number of cases of illness in the Workhouse has been 766 ; including 3 of measles, 3 of hooping-cough, 8 of diarrhoea, 10 of erysipelas, and 11 of febricula. In addition to the above cases there were 34 of syphilis ; thus making a total of 800. During this Quarter it appears from the return of Mr. Ilott, the resident Medical Officer of the Workhouse, that no case of fever has been admitted into the Infirmary. Uncertified Deaths. There are no uncertified deaths recorded. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis, during the Quarter, has been 10.31 inches. During the corresponding Quarter of last year the rain-fall was 12.43 inches. The mean temperature of the air was 49.2°. In the corresponding Quarter of last year it was 54.3°. The hottest days during the Quarter were Tuesday, the 10th June, Saturday, the 14th June, and Saturday, the 21st June, when the thermometer indicated respectively 71.2°, 72.7°, and 72.7°. The hottest day during the corresponding Quarter of last year was Wednesday, the 26th June, when the thermometer indicated 85.8°. The rain-fall during this Quarter, although more continuous than it was in the corresponding Quarter of the previous year, has not been so heavy. The immense rain-fall in the weeks ended April 13th and May 10th, 1878, did not occur during this Quarter. Although the unusually cold and wet weather which has been experienced in June and July of this year is most unpleasant, and has caused great anxiety to farmers and market gardeners, it has nevertheless been remarkably healthy, the death-rate being exceptionally low. According to the report of the Registrar-General for the week ended 6 July 5th, the annual death-rate from all causes has been considerably below the average number in the corresponding week of the last ten years. The annual death-rate from all causes, which had been equal to 19.5, 19, and 18.3 per 1,000 in the preceding weeks, further declined last week to 17.4, the lowest rate that has prevailed in London since the middle of September, 1877. In the week ended July 12th the rate of mortality fell to 17.0 per 1,000, and in the week ended July 19th it was 17.2 per 1,000. The fatal cases of diarrhœa in the twenty towns were, for the week ended 12th July, only 47 against 669, 243 and 602 in the corresponding weeks of the three years 1876-7-8. In London the deaths from diarrhœa for the weeks ended July 5th, 12th, 19th, were respectively 13, 29, 27. The fatal cases of Diarrhœa, which had been 13 and 29 in the two previous weeks, did not exceed 27 last week, and were as many as 263 below the corrected average for the correspondng week of the last ten years. The nearest approach says the Registrar-General, during the past thirty years, to so small a fatality of diarrhœa during the first three weeks of July occurred in 1860, when the temperature was considerably below the average. Table of Weekly Mortality, &c., in London and in the Whitechapel District. The following Table, taken from the Returns of the Registrar-General, shows the comparative results of the Quarter:— Week ENDED Deaths in London. Deaths in Wchpl. District Rainfall. Mean Temperature of the air. Diarrhœa. Fever. Small-pox From all causes. From Smallpox. From all causes. Inches. Degree. April 5 23 13 17 1958 0 42 0.22 45.4 „ 12 13 19 12 1786 0 44 1.05 43.0 „ 19 12 17 13 1757 0 42 0.62 40.1 „ 26 14 18 10 1771 0 52 0.72 44.7 May 3 17 23 10 1648 0 54 0.26 43.9 „ 10 10 18 5 1582 0 47 0.18 43.1 „ 17 13 16 6 1532 0 46 0.42 47.9 „ 24 13 16 17 1497 0 32 0.35 53.7 „ 31 10 12 8 1427 0 25 2.22 51.7 June 7 13 14 11 1351 0 51 1.71 54.7 „ 14 18 12 11 1351 0 23 0.32 57.3 „ 21 15 8 12 1316 0 45 0.82 58.4 „ 28 21 19 8 1272 0 47 1.42 56.5 7 VACCINATION. WHITEGHAPEL 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 VACCINATION Workhouse. Totals. Births Registd. Primary Cases. Re-Vaccination. Primary Cases. Re-Vac- cination Primary Cases. Re-Vaccination. September, 1877 836 — 26 — 362 — 607 December 241 3 32 — 273 3 704 March, 1878 288 13 29 — 317 5 688 Jane 443 5 43 — 489 6 672 September 480 6 30 1 510 4 644 December 258 4 26 — 284 13 638 March, 1879 273 1 37 — 310 1 753 June 539 24 25 — 564 24 656 Totals 2858 55 251 1 3109 56 5362 It is satisfactory to note that there has. been a large increase in the number of Vaccinations during this Quarter. Small Pox. This disease appears to have very nearly left this District ; for according to my returns for the last four Quarters, there have only been 3 deaths (two of which occurred in the Small-pox Hospital), and those are recorded for the Quarter ended 28th September, 1878. The total cases of this disease for the above-named period, which are recorded in the books of the Medical Officers of the Union, have been only 5 ; of which number 4 took place in the Quarter ended 28th September, 1878. Cases of scarlet-fever have, however, been much more prevalent. The deaths from this disease show an increase of 7 in the number recorded in the corresponding Quarter of the previous year, and the cases as shown in the returns of the Medical Officers of the Union have increased from 1 to 17. When scarlet-fever and fever are prevalent a large amount of extra work devolves upon the Sanitary Inspectors in their carrying out the disinfection of the clothes, bedding, &c., which have been used by the patients, and which occasionally occupies their time until late at night, and in cases of emergency even on Sunday morning. The cases of this disease have been very numerous on the North 8 side of the District, which has called forth much energy and zeal on the part of the Inspectors in their endeavours to prevent the spreading of the disease. Whenever a case, either of fever or scarlet-fever, is reported to the office of the Sanitary Department, (and I may here observe that all such cases which occur among the pauper population are, by order of the Guardians, notified to the Sanitary officers) the same is immediately visited by one of the Inspectors, and means are promptly taken to disinfect the rooms occupied by the patient by sulphurous acid gas ; and the bedding and clothes of the patient are conveyed to the disinfecting apparatus, where they are submitted to a heat of 250 degrees or thereabouts, and then they are returned to the house from which they had been removed. The subjoined is a copy of a handbill and placard which are extensively distributed in the District. From which it may be seen that all persons, whether rich or poor, can avail themselves, free of charge, of the services of the officers of the Sanitary Department as regards the use of the disinfecting apparatus, and the disinfecting of the rooms in which contagious disease has existed. "Board of Works, Whitechapel District. "Disinfecting Apparatus "The Inhabitants of this District are hereby informed that "the Board of Works, by the advice of the Medical Department "of the Privy Council, have erected an apparatus for the pur"pose of disinfecting any Bedding, Clothing, &c., which have "been used by persons while suffering from Small Pox, Scarlet "Fever, or any other contagious Diseases. All such infected "Bedding, Clothing, etc., will be disinfected Free of Charge, "on application being made to the Sanitary Department of this "District, No. 15, Great Alie Street." Mr. Battram, the Sanitary Inspector for the South and part of the North District, reported that he had received intimation of a youth, suffering from small-pox, having been landed at St. Katharine Wharf (which is in this District) from the steamship " Hawk," from Antwerp. The patient was taken to a lodging-house in Upper East Smithfield, immediately adjoining the Whitechapel District, but which is situated in the Limehouse District. Dr. Rogers, the Medical Officer of Health for that District, was made acquainted with the fact, and prompt measures were taken for the removal of the patient to the Small-pox Hospital, and for the disinfection of the room, &c. Mr. Battram communicated the facts of the case to Mr. Harry Leach, the Medical Officer to the Port Sanitary Authority, when measures were promptly taken for the disinfection of the vessel, Mr. Battram was 9 informed that the patient had been ill for two days before leaving Antwerp. The subjoined case which came under the notice of Mr. Wrack shows how cases of infectious disease are concealed from the Sanitary Authorities of the District. A young man, 19 years of age, died of small-pox on the 16th July, 1879. The patient resided at No. 49, Queen Ann Street, and had been attended by a medical practitioner for 11 days. As Mr. Wrack was not informed of the number of the house in which the young man died, he had great difficulty in finding the case, as the inhabitants of the street, who are principally Irish, obstructed him in every possible way in his endeavours to find it. The body was uncoffined, and although only a day or two after the death of the patient, was in a very offensive condition. It is surely time that the law made it imperative on the owners of the house to give immediate notice to the Sanitary Authority of the District of the existence of such cases. Although in this District there has been an almost perfect immunity from small-pox during the last four quarters, yet, situated as this District is by the side of the River, and having wharves where foreign ships land their passengers and cargoes, we cannot prevent the importation of this disease from abroad, as is shown by the report recently made to the Board by Mr. Wrack, one of the Sanitary Inspectors. From this report it appears that the Inspector's attention was directed to a child, 18 months old, who was suffering from small pox, at No. 106, Old Montague Street. The child, with its mother, had only arrived at the house above-named at six o'clock in the evening, within a few hours after landing at the wharf, and it was immediately taken to the Medical Officer of the Union, who ordered its removal to the Small-pox Hospital ; and the child, that same evening, was admitted into the Hospital. The case was a very severe one, and the child died in the course of a few days. Mr. Wrack, without loss of time, had all the articles of bedding, clothing, &c., (118 in number) conveyed to the disinfecting chamber, where they were submitted to a heat of 250 degrees. Mr. Harry Leach, the Medical Officer of the Port Sanitary Authority, was immediately written to, giving him all the particulars that could be then obtained respecting the case. The house to which the child was taken on its arrival in London was visited daily for several days, with a view of ascertaining if any more cases had occurred, but no other person, either in that house or in the neighbourhood was attacked with the disease. 10 Houses Recently Demolished under the Artizans' and Labourers' Dwellings Act, 1875. The following return shows the number of houses taken down during the past Six months by the Metropolitan Board of Works, under the Artizans' and Labourers' Dwellings Act, 1875. Situation of Property taken down. Number of houses demolished. Average number of rooms in each locality Number of persons occupying the said rooms, allowing 4 persons to each room. Butler's Buildings 17 40 Cooper's Court 13 35 Cherubim Court 5 15 Christopher Court 6 18 Compasses Court 6 12 Crown Court 24 74 Glasshouse Street 30 57 Garden Court 12 28 Hayes Court 8 20 Hayes Back Court 3 9 Holloway Court 6 18 Kettleby Court 10 21 Providence Court 8 17 Rose Court, U.E.S. 7 17 Bussell Court 8 24 Hose Court, B.A.Y. 5 15 Seven Star Court 7 15 Shorter's Bents 12 34 Total number of persons displaced. Slater's Court 10 30 Vincent's Place 5 15 Windmill Court 14 42 216 556 2,224 With very few exceptions, all these 216 houses were very old and dilapidated, and were unfit for habitation. The persons who have been displaced, Mr. Battram remarks, have gone to live in 11 other localities, for he has not discovered any extra over-crowding in his District from the displacement of so large a number of people. It is probable, and earnestly to be desired, that the census of 1881 will show a decrease in the population of this District. Sanitary Works Preformed during the Quarter ended 28th June, 1879. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 28th June, 1879:— Number of inspections of houses as shown in the official returns 3274 Houses specially visited 339 Houses specially re-visited 1056 Preliminary notices served, such notices embracing 264 premises 194 Compulsory orders issued, embracing 174 premises 40 Summonses heard at Police Courts, under Sanitary Act 1 ,, under Act for the prevention of Adulteration of Pood, &c. 3 Cellars used as dwellings discontinued for such use 1 Cases of overcrowding and indecent occupation abated 4 Houses in which rooms or passages have been whitewashed 141 Rooms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet-fever therein 33 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the Apparatus 562 Yards of houses paved, or the pavement repaired 38 Drains in houses improved 74 Dust-bins provided 29 Privies lime-washed, cleansed and repaired 56 Water supply provided or improved 14 Nuisances from dung, and other offensive matter removed 46 Area gratings, cellar flaps, &c., repaired 20 Animals, (a horse and fowls) kept so as to be a nuisance, removed 474 Cesspools abolished 2 The Cow-houses in the District, 25 in number, and the Slaughterhouses, 14, 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. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. Great Alie Street, 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 ended on the 28th June, 1879. 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. Total. Bronchitis and Catarrh. Pleuiitis and Pneumonia. Dr. Swyer 0 0 12 3 3 0 3 8 0 1 0 0 25 2 0 4 0 0 0 0 149 210 Mr. Champneys 0 1 3 0 7 0 0 0 0 1 0 0 80 0 0 13 0 0 0 1 270 376 Mr. Sequeira 0 1 1 0 7 0 0 8 0 0 0 0 14 0 0 0 0 0 0 0 79 110 Mr. H. Braye 1 0 1 0 8 0 2 0 0 1 0 0 33 1 0 1 0 0 0 0 142 185 Mr. Loane 0 0 0 0 0 0 0 2 0 0 0 0 29 0 0 2 0 0 0 0 39 72 Totals 1 2 17 3 20 0 5 18 0 3 0 0 181 8 0 20 0 0 0 1 679 953 Corresponding Qr. of previous Year. 21 2 1 5 11 0 2 29 0 1 0 1 93 12 0 21 0 0 1 3 542 745 Workhouse Mr. J. J. Ilott. 0 3 0 3 8 0 0 11 0 10 5 0 135 11 6 52 1 2 6 4 509 766 In addition to the cases attended by Mr. Ilott in the Workhouse, there were 34 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 28th June, 1879, Sub-districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhœa. Fever. Cholers 4 Choleraic Diarrhœs. Total. Remarks. Spitalfields 0 1 6 0 6 2 0 0 15 Mile End New Town 0 2 3 0 4 2 2 0 13 Workhouse. Whitechapel North 0 1 1 0 4 0 0 0 6 Whitechapel Church 0 0 0 3 3 1 1 0 8 Hospital. Goodman's Fields 0 0 1 0 0 0 1 0 8 Aldgate 0 0 0 0 2 0 0 0 2 Totals 0 10 11 3 19 5 4 0 52 Deaths from Epidemics for the corresponding Quarter, 1878. 3 5 4 1 24 8 5 0 50 Two deaths from small-pox of patients sent from this District, but not strictly belonging to it (the particulars of which are recorded at pages 8 and 9 of this Report), occurred in the Small-Pox Hospital. No death from fever occurred in the Fever Hospital, among the 15 patients sent from this District. TABLE III Showing Sub-districts, Enumerated Population, Total Births, and Deaths from all causes— Deaths under 1 year of age, 1 and under 5 years, and above 60 years; Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital, for the Quarter ended 28th June, 1879. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. 1, and under 5 years. Persons aged 60 years and upwards. Violence. Inquest cases. Deaths in Public Institutions. Spitalfields 22499 201 83 20 29 6 7 13 2 Mile End New Town 15550 162 169 26 25 53 6 17 92 Whitechapel North 11597 108 43 12 11 4 1 3 0 Whitechapel Church 7322 61 181 14 15 19 23 28 150 Goodman's Fields 10381 78 38 13 9 7 2 3 0 Aldgate 9224 46 31 9 6 5 7 7 0 Totals 76573 659 550 94 95 94 46 71 244 BOARD OF WORKS, WHITECHAPEL DISTEICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTEICT, FOR THE QUARTER ENDED SEPTEMBER 27TH, 1879, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Penny & Hull, Steam Printers, 53, Leman Street, Weitechapel, E. 1879. 6 415 REPORT of the MEDICAL OFFICER OF HEALTH For the Quarter ended 27th September, 1879. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 27th September, 1879, the total births in the District were 658, viz.: 337 males and 321 females; and the deaths 532, viz.: 312 males and 220 females. The excess of births over deaths has therefore been, during this Quarter, 126. As the deaths of 93 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, thereby reducing the total mortality to 439, and increasing the number of births above deaths to 219. An allowance, however, must be made for the deaths of residents in public institutions outside the District; but of those I have no return. In the corresponding Quarter of the previous year the total births were 644, and the total deaths 566. In the Spitalfields sub-District the births were 184, and the deaths 125; in the Mile End New Town 183, and the deaths 130; in the Whitechapel North 98, and the deaths 51; in the Whitechapel Church 68, and the deaths 149 fin this sub-District the London Hospital is situated); in the Goodman's Fields 80, and the deaths 43; and in the Aldgate 45, and the deaths 34. The deaths have exceeded the births in the Whitechapel Church sub-District by 81, but the deaths of the 93 non-residents in the London Hospital must be deducted from the deaths in that Institution; the proportion of births to deaths is therefore 68 to 56. 4 The deaths in the London Hospital have been 128; of these, 93 were of non-residents, 11 of residents, and 24 of persons who died from the result of accident and from sudden death. The deaths of persons who had resided in this District previous to their admission in the London Hospital, form but a very small proportion of the total deaths in this institution. Excluding the deaths caused by accident, (the previous residences of such persons not always being given in the weekly returns) the proportion of deaths of residents is only 10.5 per cent. In the corresponding Quarter of the previous year the deaths in this Institution were 151. The deaths in the Workhouse have been 58. In the corresponding Quarter of last year they were 74. The deaths from epidemic diseases in the entire District have been 114, viz.: 6 from small pox (including 5 in the Small Pox Hospital), 12 from measles, 30 from scarlet-fever, 3 from diphtheria, 17 from hoopingcough, 46 from diarrhoea, and 5 from fever. Five deaths from fever of paupers from this Union occurred in the Asylum Board Hospital; one of which was that of a non-resident who was removed from the London Hospital. The deaths from fever in this District have therefore been 9, thus making the total deaths from epidemic diseases 123. The deaths from diarrhoea have fallen from 71, the number in the corresponding Quarter of last year, to 46. On the subject of mortality from diarrhoea, the Registrar-General in his weekly report for August 30th, remarks that "the deaths referred to diarrhoea, which had risen in the five preceding weeks from 25 to 174, further increased last week to 209, and exceeded the corrected average for the corresponding week of the last ten years by 11; in the corresponding week of the last three years, the recorded fatal cases of diarrhoea were 134, 154, and 148 respectively. No less than 165 of the 209 fatal cases last week were of infants under one year of age. The annual death rate from diarrhoea was equal to 3.0 per 1000 in London last week, whereas it did not average more than 1.9 in the aggregate of the nineteen large provincial towns; it ranged from 2.3 in the central, to 4.2 in the east group of Metropolitan Districts." This is certainly a significant fact, and it points to a difference in the sanitary condition of the several Districts. The residences of the paupers from this Union who have died in the Fever Hospital during this Quarter, are as follows:—29, Commercial Street; 9, Tuson's Court; 29, Grey Eagle Street; 21, Fort Street, and a non-resident from the London Hospital. The five paupers who died in the Small Pox Hospital were removed from the under-mentioned places, 5 viz.:—1 from 53, Queen Ann Street; 3 from 2, Angel Alley; and 1 from 47, Queen Ann Street. In the week ended July 19th, the Registrar-General reports that "the fatal cases of fever in London, which had been 19, 11, and 12 in the three preceding weeks, further declined to 5 last week, and were no less than 23 below the corrected average; so few deaths from fever have not been registered in London in any week since 1840, when the Eegistrar-General's weekly returns were first published. The five deaths referred to fever last week were all certified as typhoid or enteric." In the corresponding Quarter of the previous year, the deaths from epidemic diseases were 104, viz.: 1 from smallpox, 5 from measles, 3 from scarlet-fever, 20 from hooping-cough, 71 from diarrhoea, and 4 from fever. Two deaths from small pox occurred in the Small Pox Hospital. The total deaths from epidemic diseases were therefore 106. Mortality of Young Children. The mortality of children under 1 year of age was 120. This is 22.5 per cent, of the total mortality. In the corresponding Quarter of the previous year it was 25.2 per cent. In the Spitalfields sub-District the rate is 27.2 per cent.; in the Mile End New Town 27.6 per cent.; in the Whitechapel North 31.3 per cent.; in the Whitechapel Church 5.3 per cent.; in the Goodman's Fields 32.5 per cent.; and in the Aldgate 35.2 per cent. The difference in the rate of mortality of young children in the Mile End New Town and Whitechapel Church sub-Districts is thus explained:— in the former the Workhouse is situated, and the latter the London Hospital; in both these institutions the children under 1 year bear only a small proportion to the adults. The total deaths under 5 years are 237; which shows a rate of mortality of 44.5 per cent, in relation to the total deaths, including those of non-residents, and 35.7 per cent, to the total births. The rate of mortality under 1 year, in relation to the total births, is 18.2 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the past Quarter, 867 new cases of illness out of the Workhouse; including 7 of small pox (all of which occurred in Mr. Braye's District, viz., 3 in Queen Ann Street, 1 in Little North Street, 1 in Hope Street, and 2 in Angel Alley), 35 of measles, 31 of scarlet-fever, 11 of hooping-cough; 38 of diarrhoea, 28 of febricula, 4 of fever, and 2 of erysipelas. In the 6 ponding Quarter of the previous year the number of pauper cases of illness was 695: including 4 of small-pox, 3 of measles, 1 of scarlatina, 1 of hooping-cough, 43 of diarrhoea, 2 of choleraic diarrhoea, 15 of febricula, 3 of fever, and 2 of erysipelas. The total number of cases of illness in the Workhouse has been 741; including 2 of measles, 3 of hooping-cough, 35 of diarrhoea, 6 of erysipelas, and 6 of febricula. In addition to the above cases there were 41 of syphilis; thus making a total ot 782. During this Quarter it appears from the return of Mr. Ilott, the resident Medical Officer of the Workhouse, that no case of fever has been admitted into the Infirmary. Uncertified Deaths. The uncertified deaths recorded during the Quarter were 9, viz.: 6 in the Spitalfields sub-District, 2 in the Mile End New Town, and 1 in the Aldgate sub-District. Of the 6 uncertified deaths in the Spitalfields subDistrict, 4 were sudden deaths, said to be from disease of the heart. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis, during the Quarter, has been 11.41 inches. During the corresponding Quarter of last year the rain fall was 7.28 inches. The mean temperature of the air was 58.2°. In the corresponding Quarter of last year it was 60.9°. The hottest days during the Quarter were Wednesday, the 30 th July, Friday, the 15th August, and Tuesday, the 29th July, when the thermometer indicated respectively 80.6°, 79.7°, and 78.5°. The hottest day during the corresponding Quarter of last year was Friday, the 19th July, when the thermometer indicated 84.6°. The Registrar-General, in his last Quarterly return of marriages, births, and deaths (page iv), states, that "at the Royal Observatory, Greenwich, 11.75 inches were measured on 53 of the 92 days of the Quarter, exceeding the average in 64 years by 4.4 inches; 3.7 inches were measured in July, 5.2 inches in August, and 2.8 inches in September. The rainfall exceeded the average in each month of the Quarter; the excess was largest in August. The rainfall at Greenwich during the first nine months of this year amounted to 29 inches, against 22.8 inches in the corresponding period of last year, and exceeded the average in 64 years by 10.9 inches. The number of hours of bright sunshine measured during the quarter at the Greenwich Observatory, was 354.9 against 441.4 in the corresponding periods of 1877 and 1878; the most marked deficiency of sunshine occurred during July. 7 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-Vacci nation Primary Cases. Re-Vaccination Primary Cases. Ro-Vaccination. December, 1877 241 3 32 — 273 3 704 March, 1878 288 13 29 — 317 5 688 June 443 5 46 — 489 6 672 September 480 5 30 1 510 4 644 December 258 4 26 — 284 13 638 March, 1879 273 1 37 — 310 1 753 June 539 24 25 — 564 24 656 September 464 2 27 491 2 658 Totals 2986 57 252 1 3238 58 5413 Table of Weekly Mortality, &c., in London and in the White chapel District. The following Table, taken from the Returns of the Registrar-General, shows the comparative results of the Quarter:— Week ended Deaths in London. Deaths in Wchpl. District Rainfall. Inches. Mean Temperature of the air. Degrees Diarrhoea. Fever. Small-pox From all causes. From Smallpox. From all causes. July 5 13 11 11 1208 0 31 1.73 56.5 „ 12 29 12 4 1179 0 33 0.58 56.0 „ 19 27 5 6 1190 1 46 0.23 58.4 „ 26 25 15 6 1208 0 34 1.09 67.4 Aug. 2 46 13 3 1349 0 41 0.26 64.0 „ 9 90 14 5 1223 0 36 0.51 59.5 „ 16 127 20 4 1349 0 48 0.03 63.1 „ 23 174 19 4 1322 0 54 2.98 58.7 „ 30 209 13 7 1391 0 46 1.51 58.4 Sept. 6 146 25 7 1393 0 43 0.02 56.8 „ 18 134 22 3 1262 0 41 0.72 57.6 „ 20 92 21 1 1366 0 41 0.29 57.6 „ 27 72 36 2 1193 0 39 1.46 53.1 8 Kate of Mortality for the Year ended 27th September, 1879. The rate of mortality for the year ended 27th September, deducting the deaths of non-residents in the London Hospital, was 24.7 per 1,000. During this Quarter the mortality is only at the annual rate of 22.9 per 1,000. These comparatively low rates of mortality arc calculated for the entire District; but if we inquire into the rate of mortality for separate Districts, it will be found to vary very materially, as may be seen from the subjoined table. Rate of mortality in the entire District for twelve months ended 27th September, 1879 (deducting the deaths of non-residents), is, as above stated, 24.7 per 1000; while the rate of mortality in the undermentioned localities for the same year is, per 1000, as follows:— Population. 83 Grigg's Court 60.2 159 Everard's Place 56.6 92 AVhite Bear Court 54.4 375 Castle Alley 40.0 152 Frying Pan Alley 26.3 160 Artillery Passage 25.0 873 Goulston Street 22.0 234 Boar's Head Yard 21.3 400 Spital Square 5.0 East Mount Terrace, no deaths; population 96. Trinity Square (in the part belonging to this District) no deaths; population about 84. I may here state that the rate of mortality in many of the poorer Districts varies considerably in each year. The average rate of mortality in a given District—the rate being calculated for the entire area—does not always indicate the healthiness or unhealthiness of that particular District; and if we were to conclude that a District, merely on account of its having a lower average rate of mortality than another, was therefore the more healthy, we might be led into error. In making a comparison between one District and another, as regards their relative healthiness, we must inquire into the social condition of the people, their habits, ages, occupation, &c. The greater the number of illegitimate children born and living in a locality will, to some extent, increase the death rate; it being a well known fact, that where there is a large proportion of illegitimate births in a given population, there will be a comparatively larger death rate, probably owing to the want of care bestowed on those unfortunate beings. 9 As regards the District of Whitechapel, there is not sufficient evidence to conclude that the population therein has diminished since the last census; for although several houses within the last few years have been taken down, and very few new ones erected in their stead, yet, from the large influx of foreigners of the poorer class, who crowd into the tenemented houses at night, the population, so far from being lessened, may be increased; and if the census were taken at night, and by personal inspection of the rooms, in some of the poorer localities in this District, the population would be found to be greater than is given in the published returns. Nuisance from Offensive Matter being conveyed in Waggons through the streets. The Inspector, Mr. Battram, reports that on the 6th October his attention was directed to a most offensive smell arising from a waggon, which was laden with damaged rice, on its way to a manufactory known as the Patent Grape Sugar Works in Lambeth Street. I am not aware that there is any power given to the Inspector of Nuisances to prevent offensive matter being conveyed along the streets outside the City of London, where, I am informed that carts or waggons, in which any offensive matter is being carried through the streets after a given hour in the morning and before a given hour in the evening, are stopped, and proceedings taken against the persons so offending. It is most desirable that similar powers should be given to all the other Districts in the Metropolis. There are very few persons who pass frequently through the streets of London but who have cause to complain of the stench arising from these passing nuisances. The local authorities ought to have power to insist upon all precautions being taken by persons engaged in conveying offensive materials along the streets, not only to hide them from public view, but to prevent them from occasioning a nuisance. Mr. Battram also reports that there is an accumulation of filthy rags in Sugar-loaf Court, Spitalfields, which causes an offensive nuisance, and is injurious to the health of persons living in the vicinity of that locality. Against Mr. Isaac Cohen, the owner of these premises, a summons was taken out on the 2nd October, and the case was heard by Mr. Bushby, at the Worship Street Police Court, who, after hearing the case, made an order on the owner to remove the whole of the rags, and the other offensive matter, within one calendar month. This order was not obeyed; Sir. Isaac Cohen only removing a portion of the offensive materials during the period allowed. A summons for penalties was therefore taken out, when a fine of £2 10s. and 2s. cost was imposed, or 14 days' imprisonment The fine was paid. 10 Plages Unfit for Habitation. Mr. Inspector Wrack reports, that on visiting some houses in Wentworth Street, he discovered a small wooden shed, which had been recently erected in the yard, at the rear of No. 124, which is used as a baker's shop. This shed abuts against the window of the house. Three men, in the employ of Mr. Simon Cohen, the owner of the shop, slept in this shed. The beds were on the bare earth, and the only access to the shed was by creeping through the window of the back room. A notice was served on Mr. Simon Cohen, prohibiting the use of the shed as a sleeping room, which was at once complied with. On visiting some houses in Great Garden Street, Mr. Wrack found an old man living in a filthy state in a dark cellar at No. 67. Several cats were kept in the same place, and the smell arising from the cellar was most offensive. The cellar had been sub-let by a foreigner named Abraham Lewis, who occupied the ground floor rooms of the same house. The rent of the cellar was two shillings per week. A notice was served on Mr. Lewis, prohibiting the further use of the cellar as a dwelling. Such revelations show the necessity of making frequent visits to the houses which are occupied by the poorer classes. Bakehouses. Although the Bakehouses are now, by a recent Act of Parliament, placed under the supervision of the Factory Inspectors, it does not appear from the report of the Sanitary Inspectors of this District, that any advantage has accrued to the public from the duties of the Sanitary Inspectors of the Local Board, as regards these businesses, having been transferred to the Inspectors of Factories. Mr. Battram states that some of the bakehouses in his District, particularly those used for "baking small goods," are in a filthy state. Mr. Wrack reports that some of the bakehouses in his District, notably three in Wentworth Street, two in Artillery Passage, one in Commercial Street, Spitalfields, and one in Brushfield Street, are in an unsatisfactory condition as regards their cleanliness. Each of the Inspectors has, under my direction, written to Mr. Redgrave, the Chief Factory Inspector, directing his attention to the dirty condition of some of the Bakehouses in the Whitechapel District. Before the last amended Factory Act came into operation, all the bakehouses were regularly inspected every six months, and where necessary, orders were given to the owners to cleanse them, and to improve their ventilation. 11 Sanitary Works Performed during the Quarter ended 27th Septembee, 1879. The following return shows the amount of work done by tho Sanitary Inspectors during the Quarter ended 27th September, 1879:— Number of inspections of houses as shown in the official returns 2341 Houses specially visited 452 Houses specially re-visited 1356 Preliminary notices served, such notices embracing 303 premises 178 Compulsory orders issued, embracing 56 premises 18 Summonses heard at Police Courts, under Sanitary Act 1 ,, under Act for the prevention of Adulteration of Pood, &c. 0 Cellars used as dwellings discontinued for such use 4 Cases of overcrowding and indecent occupation abated 4 Houses in which rooms or passages have been whitewashed 194 Rooms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet-fever therein 93 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the Apparatus 1305 Yards of houses paved, or the pavement repaired 33 Drains in houses improved 55 Dust-bins provided 6 Privies lime-washed, cleansed and repaired 68 Water supply provided or improved 10 Nuisances from dung, and other offensive matter removed 30 Area gratings, cellar flaps, &c., repaired 4 Animals, (swine and fowls) kept so as to be a nuisance, removed 25 Cesspools abolished 1 The Cow-houses in the District, 25 in number, and the Slaughterhouses, 14, 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. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. 15, Great Alie Street. 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 ended on the 27th September, 1879. 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 18 16 3 5 0 1 12 0 2 0 0 9 3 0 2 0 0 0 0 127 198 Mr. Champneys 0 9 4 1 7 0 0 0 0 0 0 0 38 0 0 9 0 0 0 2 246 316 Mr. Sequeira 0 5 0 1 16 0 0 13 0 0 0 0 7 1 0 5 0 0 0 0 98 155 Mr. H. Braye 7 3 2 5 8 0 3 1 0 0 0 0 16 2 0 1 0 0 0 4 101 153 Mr. Loane 0 0 0 1 2 0 0 2 0 0 0 0 5 0 0 2 0 0 0 1 32 45 Totals 7 5 31 11 38 0 4 28 0 2 0 0 75 6 0 19 0 0 0 7 604 867 Corresponding Qr. of previous Year. 4 3 1 1 43 2 3 15 0 2 0 1 66 6 1 11 0 2 3 3 528 695 Workhouse Mr. J. J. Ilott. 0 2 0 3 35 0 0 6 0 6 0 0 64 9 6 51 1 2 8 5 543 741 In addition to the cases attended by Mr. Hott in the Workhouse, there were 41 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 27th September, 1879. Sub-districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhoea. Fever. Cholera & Choleraic Diarrhœa. Total. Remarks. Spitalfields 0 3 15 2 2 7 1 0 30 Mile End New Town 0 1 8 1 3 17 1 0 31 Workhouse. Whitechapel North 1 1 4 0 4 11 0 0 21 Whitechapel Church 0 3 0 0 1 1 3 0 8 Hospital. Goodman's Fields 0 3 3 0 3 5 0 0 14 Aldgate 0 1 0 0 4 5 0 0 10 Totals 1 12 30 3 17 46 5 0 114 Deaths from Epidemics for the corresponding Quarter, 1878. 1 5 3 0 20 71 4 0 104 Five deaths from small-pox, of patients sent from this District, occurred in the Small-Pox Hospital. Four deaths from fever occurred in the Fever Hospital, among the patients sent from this District. The total number of deaths from small-pox is therefore 6, and from fever 9, thus making the total deaths from epidemic diseases 123. TABLE III. Showing Sub-districts, Enumerated Population, Total Births, and Deaths from all causes— Deaths under 1 year of age, 1 and under 5 years, aud above 60 years ; Deaths from Violence, Inquest cases, and Deaths in Workhouse aud London Hospital, for the Quarter ended 27th September, 1879. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. 1, and under 5 years. Persons aged 60 years and upwards. Violence. Inquest cases. Deaths in Public Institutions. Spitalfields 22499 184 125 34 41 18 9 19 5 Mile End New Town 15550 183 130 36 26 28 3 6 58 Whitechapel North 11597 98 51 16 16 3 1 1 0 Whitechapel Church 7322 68 149 8 13 20 24 28 123 Goodman's Fields 10381 80 43 14 15 8 2 8 0 Aldgate 9224 45 34 12 6 3 6 6 0 Totals 76573 658 532 120 117 80 45 68 191 BOARD OF WORKS, WHITECHAPEL DISTEICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTRICT. FOR THE QUARTER ENDED DECEMBER 27TH, 1879, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Penny & Hull, Steam Printers, 53, Leman Street, Whitechapel, E. 1880. REPORT of the MEDICAL OFFICER OF HEALTH For the Quarter ended 27th December, 1879. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 27th December, 1879, the total births in the District were 655, viz.: 340 males and 315 females; and the deaths 697, viz.: 411 males and 286 females. The excess of deaths over births has therefore been, during this Quarter, 42. It is a very unusual occurrence for the deaths to exceed the births, but this is not the only quarter in which I have had to record this event. As the deaths of 119 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, thereby reducing the total mortality to 578, and thus increasing the number of births above deaths to 77. An allowance, however, must be made for the deaths of residents in public institutions outside the District; but of those I have no return. In the corresponding Quarter of the previous year the total births were 638 and the total deaths 593. In the Spitalfields sub-District the births were 221 and the deaths 128; in the Mile End New Town 157 and the deaths 183 (in this subDistrict the Workhouse is situated); in the Whitechapel North 103 and the deaths 69; in the Whitechapel Church 69 and the deaths 235 (in this sub-District the London Hospital is situated); in the Goodman's Fields 65 and the deaths 52; and in the Aldgate 40 and the deaths 30. The deaths have exceeded the births in the Whitechapel Church sub-District by 166, but the deaths of the 119 non-residents in the London Hospital must be deducted from the deaths in that Institution; the proportion of births to deaths is therefore 69 to 116. The deaths in the London Hospital have been 187; of these, 119 were of non-residents, 20 of residents, and 48 of persons who either died suddenly or from the result of accident. The deaths of persons who had resided in this District previous to their admission into the 4 London Hospital form but a very small proportion of the total deaths in that Institution. Excluding the deaths caused by accident (the previous residences of such persons not always being given in the weekly returns), the proportion of deaths of residents is only 10.7 per cent. In the corresponding Quarter of the previous year the deaths in that Institution were 168. The deaths in the Workhouse have been 74. In the corresponding Quarter of last year they were 97. The deaths from epidemic diseases in the entire District have been 97, viz.; 26 from measles, 31 from scarlet-fever, 6 from diphtheria, 14 from hooping-cough, 13 from diarrhoea, and 7 from fever. One death from small-pox occurred in the Small-pox Hospital belonging to the Asylums' Board, and 7 deaths from fever of paupers who were removed from this Union. The deaths from fever in this District have therefore been 14, thus making the total deaths from epidemic diseases, including 1 from smallpox as stated above, 105. The residences of the paupers from this Union who died in the Fever Hospital during this Quarter are as follows:—three from No. 5, Brick Lane, one from No. 12, Fieldgate Street, two from No. 16, Buckle Street, and one from No. 50, Goulston Street. The residence of the person who died from small-pox was No. 85, Old Montague Street. The number of patients suffering from fever who were removed from this District was 37, including 2 from the Workhouse Infirmary, and 12 from the London Hospital, 10 of whom were from other districts. In the corresponding Quarter of the previous year, the deaths from epidemic diseases were 42, viz.: 13 from measles, 5 from scarlet-fever, 3 from diphtheria, 5 from hooping-cough, 5 from diarrhoea, and 11 from fever. No death from epidemic disease occurred in the Asylum Hospitals of any person belonging to this District. Mortality of Young Children. The mortality of children under 1 year of age was 125. This is 17.9 per cent, of the total mortality. In the corresponding Quarter of the previous year it was 17.5 per cent. In the Spitalfields sub-District the rate is 28.1 per cent.; in the Mile End New Town 19.1 per cent.; in the Whitechapel North 30.4 per cent.; in the Whitechapel Church 7.2 per cent.; in the Goodman's Fields 21.1 per cent.; and in the Aldgate 16.6 per cent. The difference in the rate of mortality of young children in the Mile End New Town and Whitechapel Church sub-Districts is thus explained:—in the former the Workhouse is situated and in the latter the 5 London Hospital; in both these Institutions the children under 1 year bear only a small proportion to the adults. The total deaths under 5 years are 289; which shows a rate of mortality of 41.4 per cent, in relation to the total deaths, including those of non-residents, and 44.1 per cent, to the total births. The rate of mortality under 1 year, in relation to the total births, is 19.0 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the past Quarter, 1056 new cases of illness out of the Workhouse; including 2 of small-pox, 76 of measles, 18 of scarlet-fever, 9 of hooping-cough, 26 of diarrhoea, 36 of febricula, 3 of fever, and 2 of erysipelas. In the corresponding Quarter of the previous year the number of pauper cases of illness was 877; including 5 of measles, 4 of scarlatina, 16 of diarrhoea, 11 of febricula, 9 of fever, and 7 of erysipelas. The total number of cases of illness in the Workhouse has been 745; including 3 of measles, 10 of diarrhoea, 8 of erysipelas, and 8 of febricula. In addition to the above cases there were 45 of syphilis; thus making a total of 790. During this Quarter, from the return of Mr. Ilott, the resident Medical Officer of the Workhouse, it appears that one case of fever was admitted into the Infirmary on the 28th November, from No. 25, Castle Alley, Whitechapel. Uncertified Deaths. The uncertified deaths recorded during the Quarter were 6, viz.: 3 in the Spitalfields sub-District, 1 in the Mile End New Town sub-District, 1 in the Whitechapel North sub-District, and 1 in the Whitechapel Church sub-District. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis, during the Quarter, has been 2.24 inches. During the corresponding Quarter of last year the rain-fall was 6.05 inches. The mean temperature of the air was 41.0°. In the corresponding Quarter of last year it was 61.7°. The coldest days during the Quarter were Sunday, December 7th, Tuesday, December 2nd, and Saturday, December 6th, when the thermometer indicated respectively 13.7°, 14.1°, and 18.4°; or 18.3°, 17.9°, and 13.6° below the freezing point of water. The coldest day during the corresponding Quarter of last year was Wednesday, the 25th December, when the thermometer indicated 12.2°, or 19.8° below the freezing point of water. 6 The Registrar-General, in his last Quarterly return of marriages, births and deaths (pages iii. and iv.) states, that the rain-fall at Greenwich, during the Quarter, was 2.3 inches, and was nearly 5 inches below the average for the corresponding period in 64 years. The rain-fall which was measured of 34 of the 92 days in the Quarter, amounted to 0.8 of an inch in October; 0.9 in November; and 0.6 in December; and showed a marked deficiency in each month of the Quarter. The rain-fall, however, in consequence of the excess in preceding months, amounted to 31.3 inches, and was heavier than in any year since 1860. Mr. Glaisher remarks, that the month of October was perhaps the finest month in the year, yet it was cold, dull, and sunless, with a smaller rain-fall than in any October since 1834. From November 1st to December 27th the weather was most winterly and very severe. The day of the lowest temperature was December 7th; its mean temperature was 28.6°, being 17.9° below the average. The mean temperature of the 38 days ending December 27th was 31.1°, or 9.7° below the average. The month of December was the fourteenth month in succession of low temperature. Table of Weekly Mortality, &c., in London and in the Whitechapel District. The following Table, taken from the Returns of the Registrar-General, shows the comparative results of the Quarter:— Week ended Deaths in London. Deaths in Wchpl. District Rainfall. Inches. Mean Temperature of the air. Degrees Diarrhoea. Fever. Scarlet Fever. From all causes. From Scarlet Fever. From all causes. Oct. 4 61 38 61 1318 2 52 0.57 54.5 „ 11 60 29 66 1366 2 57 0.00 51.5 „ 18 48 26. 73 1-199 2 49 0.02 45.0 „ 25 35 31 79 1561 4 54 0.48 49.4 Nov. 1 30 32 69 1501 0 52 0.06 46.6 „ 8 26 41 101 1524 2 43 0.01 43.2 „15 23 20 113 1609 4 61 0.02 40.3 „ 22 20 S3 106 1760 4 57 0.68 37.4 „ 29 13 28 102 1802 3 55 0.19 33.2 Dec. 6 9 31 90 1888 2 44 0.12 27.1 „ 13 11 19 119 2132 4 70 0.05 31.1 „ 20 4 26 100 2204 0 58 0.01 32.7 „ 27 8 18 . 86 1878 1 20 0.03 31.4 7 On referring to the tables of the weekly returns of births and deaths of the Registrar-General, it will be seen that whilst small-pox has become less fatal, scarlet-fever has greatly increased in severity. Small-pox, as an epidemic, has apparently passed away, as only 30 deaths, or rather more than an average of 2 per week, have been recorded in London during this Quarter; and no death from small-pox was recorded in the weeks ended October 11th and November 15th, and only 1 in the weeks ended October 18th, November 1st, and November 22nd. The deaths from scarlet-fever in London during this Quarter have been 1165. This large mortality has called forth the following remark of the Registrar-General, "that scarlet-fever is more fatal in London than it has been since November, 1875; the Metropolitan Asylum Hospitals contained 290 scarlet-fever patients on Saturday last (against 257 and 259 at the end of the two previous weeks), and 59 new cases were admitted during the week." Scarlet-fever appears, from the subjoined table, to be very fatal to young persons; thus, out of a total of 55 deaths, 38, or 69 per cent. occurred in children under 5 years of age. Ages at death of persons who have died of scarlet-fever in the Whitechapel District during the six months ended 27th December, 1879. 0 and under 1 year 2 1 year and under 2 years 8 2 „ 3 „ 12 3 „ 4 „ 8 4 „ 5 „ 8 5 „ 6 „ 8 6 „ 7 „ 1 7 „ 8 „ 6 8 „ 9 „ 1 9 „ 10 „ 1 Total 55 During last year, the Registrar-General, in his return of deaths for the week ended on Saturday, January 16th, 1880, states that in the year 1879, comprising fifty-two weeks, 454 deaths from small-pox were registered in London, against 2544 and 1416 in the two preceding years. "The deathrate from small-pox in London last year was equal to 126 per million of the population, against an average annual rate of 410 per million in the forty-two years, 1838-79. During the sixteen years, 1838-53, the deaihrate from small-pox in London averaged 512 per million; whereas, in the twenty-six years, 1854-79, since the first Compulsory Vaccination Act was passed, the annual rate has not averaged more than 348 per million." 8 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-Vaccination. March, 1878 288 13 29 — 317 5 688 June 413 5 46 — 489 6 672 September 480 5 30 1 510 4 644 December 258 4 26 — 284 13 638 March, 1879 273 1 37 - 310 1 753 June 530 24 25 — 564 24 656 September 464 2 27 - 491 2 658 December 378 — 33 — 406 — 655 Totals 3118 54 253 1 3371 55 5364 Return of the number of Primary Cases Vaccinated by the Public Vaccinator and the Resident Medical Officer of the Workhouse, for the under-mentioned Quarters:— Quarter ending Public Vaccinatr. Primary Cases. Workhome Primry. Cases. Totals. Quarter Ending Public Vaccinatr. Primary Cases. Workhouse Primry. Cases. Totals. March, 1871 727 10 737 Sept. 1875 350 35 385 June „ 357 21 378 Dec. „ 178 23 201 Sept. „ 186 35 221 March, 1876 236 25 261 Dec. „ 134 27 161 June „ 369 36 405 March, 1872 219 43 262 Sept. ,, 354 40 394 June ,, 289 32 321 Dec. „ 347 41 388 Sept. „ 300 26 332 March, 1877 408 37 445 Dec. ,, 263 23 286 June „ 382 24 406 March, 1873 290 23 313 Sept. „ 336 26 362 June „ 331 17 348 Dec. „ 241 32 273 Sept. „ 266 36 302 March, 1878 288 29 317 Dec. „ 256 39 295 June „ 443 46 489 March, 1874 335 37 372 Sept. „ 480 30 510 June „ 411 30 441 Dec. „ 258 26 284 Sept. „ 320 30 250 March, 1879 273 37 310 Dec. „ 185 31 216 June „ 539 25 564 March, 1875 292 44 336 Sept. „ 464 27 491 June 376 26 402 Dec. „ 373 33 406 9 The Unhealthy Condition of Certain Portions of the District. The Inspectors, in the two subjoined reports, have directed the attention of the Board to the defective sanitary condition of some of the houses situated both in the north and south sides of the District. These reports are of great importance, and well deserve the best attention of every member of the Board. I feel perfectly convinced that whenever such facts as are set forth in these reports are known, means will soon be taken to get the evils removed. I can state, for the information of the Board, that the Inspectors, by frequent visitation of these places, have caused the landlords, to a limited extent, to comply with their orders for improvement; but it is found to be almost impossible, from the old and worn out condition of the property, to get such structural alterations effected as will permanently improve the sanitary condition of the tenements. Even if some of the owners were willing to do so, it would be found impracticable, owing to the want of space and from the faulty construction of the houses. Under existing circumstances, while negotiations between the Metropolitan Board of Works and the landlords of some of these localities are in progress, it is not probable that any improvements will be carried on, but as may be reasonably expected, matters will become worse and worse. The only effectual remedy, therefore, is either to close the houses or to demolish them with as little delay as possible. Some inconvenience may be expected to be felt for a time when masses of the people are removed from a locality; but, in my opinion, greater inconvenience will be experienced in allowing those wretched houses (the condition of which is well described by the Inspectors) to remain. On referring, however, to my Reports for the quarters ended July, 1865, page 7; September, 1877, pages 17 and 18; and June, 1879, pages 10 and 11, it will be seen that the working classes who have been compelled to remove in consequence of their houses being demolished for public improvements readily find lodgings elsewhere; and hence, in my opinion, there was no necessity to make extensive provision in the Act for the building of houses for the labouring class. Indeed, it would be interesting to be informed of a single instance in which such provision has been made, and appropriated to the actually dislodged families. BOARD OF WORKS, WHITECHAPEL DISTRICT. Dwellings in Goulston Street and Localities adjacent. Gentlemen, As the Sanitary Officer of the North portion of the Whitechapel District, I feel it to he my duty to ask your attention to the bad sanitary condition of some of the courts and alleys in an area called the Goulston Street Scheme; respecting which your Medical Officer of Health made an 10 official representation to the Metropolitan Board of Works of its unhealthiness on the 31st May, 1876. This area may be roughly estimated as containing four acres or thereabouts, and about 314 houses with a population of about 2757, and comprises some courts and alleys of the most wretched description, which have been condemned by. the Metropolitan Board of Works under the Artizans' and Labourers' Dwellings Act, 1875, as unfit for human habitation. I desire to inform your Board that the sanitary condition of several of the places in this area are becoming worse every day, and the difficulties of getting anything done to improve the condition of the houses by the landlords are very great. It is only by daily visiting the localities and frequently urging the landlords of some of the property to effect the necessary improvements that I am able to get any sanitary works carried out. The claims of the several owners of property in the area are being considered by the Metropolitan Board of Works, and some of them, I believe, have already been settled; but up to the present time not one of the houses in this wretched locality has been closed or pulled down under the Act. The shocking condition of the dwellings in Castle Alley, Jacob's Court, Goulston Street, Goulston Court, Marlborough Court and Little Love Court, and the unhealthy appearance of the persons occupying such places, especially the young children, are very lamentable, and cause me great anxiety. I have served Notices for the Sanitary Improvement of some of the houses in Castle Alley, Jacob's Court, Goulston Street, Goulston Court, Marlborough Court, Little Love Court, Wentworth Street and Boar's Head Yard, and, to some extent, the orders have been complied with. The extremely bad condition of the area in question, and the fact of its being much overcrowded, has caused me to make this Report to you. I may add, that should epidemic disease make its appearance in this area, I fear that the consequences would be very serious. I am, Gentlemen, Your obedient Servant, RICHARD SKIDMORE WRACK, 19th January, 1880. Sanitary Inspector. BOARD OF WORKS, WHITECHAPEL DISTRICT. Dwellings in Royal Mint Street. Gentlemen, I have to direct your attention to the dilapidated and bad sanitary condition of the houses in the courts and turnings south of Royal Mint Street, more especially to the following, viz.: Searl's Buildings, Hairbrain Court, Bracey's Buildings, Walton's Court, Well's Yard, and Peter's Court. A more deplorable state of things could not possibly exist. The houses in themselves are in a very dirty condition. Some of them are entirely without privy accommodation, and, in other cases, the privies are so dilapidated and filthy as to render them unfit for use. In some cases there is no water supply; in others the fittings are so defective that the water flows over and the yards are flooded in consequence of the drains being defective. The yards are also badly paved and there are no dust-bins. On the west-side of Well's Yard and Peter's Court the closets were in the basements but, from the bad smell arising from them, notice was given to the owner to have them removed, and such notice was complied with, excepting in three or four of the houses where the tenants 11 kept them in good order, and new ones were erected on the opposite side of the street, in a yard at the rear of the houses in Cartwright Street. These closets have, however, been taken down by the Metropolitan Board, and the tenants are consequently left without the necessary accommodation, and they have to go wherever they can to find a convenience. In some cases the soil is thrown into the streets. The whole of the above-named houses are the property of the Metropolitan Board, and they receive the rents thereof. Every room is occupied by a separate family, and some of the rooms are overcrowded or indecently occupied. Some steps should be taken either to close the houses entirely, or to put them into a proper sanitary condition ; for should they be allowed to remain in their present condition till the hot weather sets in, there will be great danger of an outbreak of fever or other contagious disease. I am, Gentlemen, Your obedient Servant, ISAAC BATTRAM, 2nd February, 1880. Sanitary Inspector. A copy of each of the foregoing reports was sent to the Metropolitan Board of Works. In reply to Mr. Wrack's report, the Metropolitan Board, in a letter addressed to Mr. Turner, the Clerk to your Board, states, "that it does not appear the complaint of the Inspector extends to any part of the property already acquired by this Board, and that they are not therefore in a position to take any action towards remedying the evils' to which their attention is directed." As all the houses which Mr. Wrack has reported are comprised in the Goulston Street Scheme, which has been approved of and determined by the Metropolitan Board to be carried out, I sincerely trust that the work of demolition and re-construction will, with as little delay as possible, be carried into effect. Sanitary Works Performed during the Quarter ended 27th December, 1879. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 27th December, 1879:— Number of inspections of houses as shown in the official returns 2647 Houses specially visited 280 Houses specially re-visited 980 Preliminary notices served, such notices embracing 273 premises 185 Compulsory orders issued, embracing 114 premises 48 Summonses heard at Police Courts, under Sanitary Act 4 „ under Act for the prevention of Adulteration of Food, &c. 0 Cellars used as dwellings discontinued for such use 15 Cases of overcrowding and indecent occupation abated 1 12 Houses in which rooms or passages have been whitewashed 157 Booms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet-fever therein 68 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the Apparatus 1855 Yards of houses paved, or the pavement repaired 64 Drains in houses improved 49 Dust-bins provided 17 Privies lime-washed, cleansed and repaired 87 Water supply provided or improved 16 Nuisances from dung and other offensive matter removed 22 Area gratings, cellar flaps, &c., repaired 8 Animals (swine, horse, rabbits and fowls) kept so as to be a nuisance, removed 10 Cesspools abolished 0 Mr. Battram reports that he had removed from the wharves, Lower East Smithfield, and destroyed by consent, the same being unfit for the food of man, 147 baskets of potatoes, 600 baskets of fruit, and 1 case of mutton. ANNUAL REPORT. The number of births registered in this District during the year has been 2722, and the deaths 2426, including those of non-residents in the London Hospital (434). In the preceding year the births were 2658 and the deaths 2430, including the deaths of 469 non-residents. The increase in the number of births has, therefore, been 64, and the decrease in the total number of deaths has been 4. The deaths in the "Workhouse have been 332, against 350 for the previous year; and the deaths in the London Hospital 615 against 671. The population of the District, at the taking of the last census, was 76,573; which is 2397 less than when the census was taken in 1861. For the reasons stated in my last Quarterly Report, I do not think that the population in this District is decreasing, as might be inferred by the demolition of several houses which has lately taken place. The births in 1872 were 2075 when the population was 76,573, while in the current year they have been 2722. 13 The deaths being (excluding 434 of non-residents) 1992, the rate of mortality has been, during the year 26.0 per 1000, or 1 in 38 of all living. The rate of mortality during the preceding year was 25.6 per 1000, or 1 in 39 of all living. In making a comparison, however, of the rate of mortality of this District with that of those in which there is no hospital, the total deaths in the London Hospital must be eliminated, which this year, as before stated, amount to 615. This gives a rate of mortality of 23.6 per 1000. The annual rate of mortality since the year 1S66, which was the year when cholera was epidemic, may be seen on referring to table No. 5 in the appendix. Deaths From Epidemic Diseases. Of the total deaths recorded in this District during the year, there were 318 from epidemic diseases, viz.: 1 from small-pox, to which must be added the 6 which occurred in the Hospital, thus making a total of 7; 49 from measles, 89 from scarlet-fever and diphtheria, 73 from hooping-cough, 67 from diarrhoea, and 33 from fever, including 11 which occurred in the Hospital. In the first quarter of this year there were no deaths from small-pox; in the second quarter there were 2 in the Hospital; in the third quarter 6, 5 of which occurred in the Hospital; and in the present quarter there was 1 and that occurred in the Hospital. The deaths from fever, including those which occurred in the Fever Hospital, have been 33. In the whole of London, the deaths from fever have been 1084. The death-rate from epidemic diseases, including those in Hospitals for the year, in relation to the total mortality, is 13.1 per cent. Small-Pox in London. In the fifty-three weeks ending January 3rd, the deaths in London from small-pox were 458. No less than 280, or 61 per cent. of these 458 deaths from small-pox were recorded in the Metropolitan Asylum Hospitals. The small-pox deaths in London were equal to 126 per million of the population. Pauper Illness in the District. The number of out-door sick paupers who have been attended by the Medical Officers of the Union is 3833. During the previous year the number was 3107. The extraordinary annual diminution in the number of the 14 door sick paupers from upwards of 17,000 in the years 1867 and 1868, to 2060 in 1877, is a matter of great satisfaction to the ratepayers of this District. Illness in the Workhouse. The cases of illness in the Workhouse during the year have been 3258, including 157 cases of syphilis and 15 of lead poisoning. Sanitary Works performed during the Year 1879. Number of inspections of houses, as shown in the official returns 11039 Number of rooms found to be overcrowded, the space being less than 300 cubic feet for each person—nuisance in each case abated 14 Houses specially visited 1357 „ re-visited 4393 Rooms disinfected with sulphurous acid gas after the occurrence of fever and scarlet-fever therein 210 Articles disinfected, consisting of beds, bedding, clothing, &c. 3826 Preliminary notices served, such notices embracing 1199 premises 700 Compulsory orders issued, embracing 474 premises 159 Summonses heard at Police Courts, under Sanitary Act 6 ,, under Act for the prevention of Adulteration of Food, &c. 3 Houses in which rooms or passages have been whitewashed 626 Yards of houses paved or the pavement repaired 154 Cesspools abolished 5 Drains in houses improved 259 Dust-bins provided 83 Privies lime-washed, cleansed and repaired 305 Water-supply provided or improved 60 Area gratings, cellar flaps, &c., repaired 41 Cellars used as dwellings discontinued for such use 23 Nuisances from dung and other offensive matter removed 119 Animals kept so as to be a nuisance removed 539 All the Cow-houses and the Slaughter-houses have been visited four times during the year. 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. I am, Gentlemen, Your obedient Servant, JOHN LIDDLE. 15, Great Alio Street. 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 ended on the 27th December, 1879 Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrœa. Cholera and Choleraic-Diarrhœa. Continued Fever, Typhus & Typhoid. Febricula. Pyæmia. Erysipelas. Puerperal Fever. Croup. Acuta Pulmonary Inflammation. Carbuncle. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. Total. Bronchitis and Catarrh. Pleuritis and Pneumonia. Dr. Swyer 0 24 0 3 5 0 0 5 0 0 0 0 24 13 0 6 0 0 0 0 137 217 Mr. Champneys 1 29 6 3 8 0 0 2 0 2 0 0 66 0 0 13 0 0 0 2 248 380 Mr. Sequeira 0 17 5 0 7 0 1 26 0 0 0 0 53 0 0 12 0 0 0 0 113 234 Mr. H. Braye 1 4 7 3 2 0 1 2 0 0 0 1 29 0 0 2 0 0 0 1 132 185 Mr, Loane 0 2 0 0 4 0 1 1 0 0 0 0 5 0 0 3 0 0 0 0 24 40 Totals 2 76 18 9 26 0 3 36 0 2 0 1 177 13 0 36 0 0 0 3 654 1056 Corresponding Qr. of previous Year. 0 5 4 0 16 0 9 11 0 7 1 0 108 18 0 22 0 2 2 4 608 877 Workhouse Mr. J. J. Ilott. 0 3 0 0 10 0 0 8 0 8 0 0 151 24 1 58 2 0 3 5 472 745 In addition to the cases attended by Mr. Ilott in the Workhouse, there were 45 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 27th December, 1879. Sub-districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhœa. Fever Cholera & Choleraic Diarrhœa. Total. Remarks. Spitalfields 0 9 0 1 5 9 1 0 25 Mile End New Town 0 8 11 1 7 3 0 0 30 Workhouse. Whitechapel North 0 7 5 0 1 0 0 0 13 Whitechapel Church 0 1 8 3 0 0 5 0 17 Hospital. Goodman's Fields 0 1 4 1 1 1 1 0 9 Aldgate 0 0 3 0 0 0 0 0 3 Totals 0 26 31 6 14 13 7 0 97 Deaths from Epidemics for the corresponding Quarter, 1878. 0 13 5 3 5 5 11 0 42 One death from small-pox, of a patient sent from this District occurred in the Small-Pox Hospital. Seven deaths from fever occurred in the Fever Hospital among the patients sent from this District The total number of deaths from small-pox is therefore 1, and from fever 14, thus making the total deaths from epidemic diseases 105. TABLE III. Showing Sub-districts. Enumerated Population, Total Births, and Deaths from all causesDeaths under 1 year of age, 1 and under 5 years, and above 60 years; Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital, for the Quarter ended 27th December, 1879. Sub-districts. Enumerated Population in 1871. Births. Deaths. Under 1 year of age. 1, and under 5 years. Persons aged HO years and upwards. Violence. Inquest cases. Deaths in Public Institutions. Spitalfields 22499 221 128 36 43 14 6 15 7 Mile End New Town 15550 157 183 35 44 41 11 20 74 Whitechapel North 11597 103 69 21 23 5 2 6 0 Whitechapel Church 7322 69 235 17 31 22 55 56 187 Goodman's Fields 10381 65 52 11 13 11 1 2 0 Aldgate 9224 40 30 5 10 5 3 5 0 Totals 76573 655 697 125 164 98 78 104 238 TABLE IV. Cases of illness attended annually by the Medical Officers of the Union, from the year 1856. Tears ending Total oases attended during the year. Years ending Total cases attended during the year. Years ending Total cases attended during the year. 1856 12485 1864 14932 1872 4864 1857 10714 1865 15594 1873 4887 1858 11718 1866 16502 1874 3685 1859 11701 1867 17181 1875 2474 1860 11392 1868 17417 1876 2281 1861 13724 1869 14031 1877 2060 1862 14270 1870 14148 1878 3107 1863 14564 1871 10194 1879 3833 TABLE V. Showing the total Births, Deaths, Deaths of Non-residents, Residents, and total Deaths in the London Hospital in each year, from 1866 to 1879. Year. Population. Total Births. Total Deaths. Total Deaths in the London Hospital. Deaths of non-residents, exclusive of deaths from accidents. Deaths of Children under 1 year of age. Proportion of deaths per cent. of Children under 1 yr. to the total deaths deducting the deaths of non-residents. Rate of mortality per 1000, deducting the deaths of nonresidents. Rate of mortality of Children under 1 yr. per 1000 of the population. 1866 78,970 2561 3495 733 432 465 15.1 38 7 5.8 1867 ... 2686 2331 445 241 525 25.1 26.4 6.6 1868 ... 2611 2519 536 324 513 23.3 27.7 6.4 1869* ... 2571 2675 504 283 526 21.9 29.6 6.6 1870 ... 2690 2465 599 374 515 24.6 26.4 6.5 1871 ... 2571 2465 551 339 545 25.6 27.7 7.1 1872 76,573 2705 2390 616 375 540 26.7 26.3 7.0 1873* ... 2727 2471 645 393 507 24.3 26.5 6.6 1874 ... 2688 2613 675 377 444 19.8 29.2 5.7 1875 ... 2650 2470 710 465+ 509 25.3 26.1 6.6 1876 ... 2754 2348 716 511 451 24.0 23 9 5.8 1877 ... 2751 2506 728 567 516 26.6 25.2 6.7 1878 ... 2658 2430 671 469 482 24.5 25.6 6.2 1879 ... 2722 2426 615 434 454 21.2 26.0 5.9 These years contain 53 weeks. In making this calculation, one week's average of deaths is deducted, viz., 50 and 46 respectively. † Estimated number. The number of Inquests which have been held this year in this District has been 328. In the preceding year the number was 331. TABLE VI. Showing the Deaths from Epidemic Diseases in the Whitechapel District daring the last 24 years. Name of Disease 1856 1857 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 Small Pox 31 3 4 60 21 28 33 69 5 22 44 40 11 1 56 159 19 1 1 2 8 23 11 7 Measles 12 60 78 31 81 27 153 26 137 28 139 33 69 71 36 42 23 44 33 40 16 96 32 49 Scarlet Fever & Diphtheria 45 43 87 96 59 70 91 200 50 80 76 26 48 208 59 25 96 24 199 51 18 28 24 89 Hooping Cough 64 89 117 50 49 89 62 52 74 97 94 72 55 113 50 43 9 79 16 61 57 44 84 73 Diarrhœa 81 139 108 141 67 101 69 114 109 122 119 100 138 97 107 125 99 113 76 93 103 89 89 67 Fever 188 117 104 93 69 65 250 158 170 167 100 82 169 95 52 40 26 44 47 30 27 26 29 33 Cholera&Cho leraic-Diaha. 0 10 6 5 1 4 5 5 2 4 904 9 10 7 6 3 5 8 3 0 0 0 0 0 Totals 421 461 504 476 347 384 663 624 547 520 1476 362 440 592 366 437 277 313 375 277 229 306 269 318 London Fever 2674 2203 1902 1796 1302 1754 3635 2302 3689 3232 2681 2174 2483 2211 2049 1755 1003 1548 1552 1282 1206 1240 1361 1084 Scarlta. & Diph. 1795 1587 4118 4197 2457 3058 4194 5799 3806 2614 2316 1836 3418 6162 6306 2220 1063 932 3037 4038 2673 1776 2350 3212 Small Pox 522 154 247 1156 877 215 345 2012 537 646 1388 1339 606 273 958 7834 1532 114 56 75 739 2544 1416 454 * In the above Table the years 1863, 1869, and 1873, consist of 53 weeks. In the column of deaths for 1879, the deaths from small-pox and from fever, which occurred in the Hospitals, are included. TABLE VII. Showing the cases of Epidemic Diseases among the pauper population in the Whitechapel District during the last 24 years. Name of Disease 1856 1857 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 Small Pox 115 6 20 242 65 86 113 253 21 86 261 254 93 5 302 625 60 2 1 0 19 125 48 10 Measles 71 266 427 179 520 70 525 80 482 51 679 155 323 212 257 178 76 128 59 32 32 64 11 115 Scarlet Fever & Diphtheria 105 49 147 176 93 100 118 305 156 164 197 60 54 311 97 32 16 22 161 17 6 8 18 71 Hooping Cough 98 150 230 146 83 388 153 169 217 280 217 219 144 308 140 102 94 861 30 44 15 24 16 33 Diarrhœa 898 1324 946 1209 773 1418 1085 1108 1127 1342 1664 1471 1631 1033 1097 590 283 212 150 101 120 61 76 91 Fever 1929 1441 590 411 190 109 822 464 295 573 343 308 586 385 325 201 19 126 84 24 34 17 17 13 CholeraiCholeraic-Diaha. 0 16 0 1 1 0 1 1 4 4 58 5 8 1 4 2 3 2 0 0 0 1 2 0 Totals 3216 3252 2360 2364 1725 2171 2817 2380 2302 2500 3419 2472 2839 2255 2222 1730 551 578 485 218 226 300 188 333 * In the above Table the years 1863, 1869, and 1873, consist of 53 weeks. The annual rate of mortality in the 14 weeks ending 3rd January, 1880, was 24.9 per 1000.