WHI 28 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTRICT, FOR THE QUARTER ENDED APRIL 3RD, 1880, BY JOHN IILDLE, MEDICAL OFFICER OF HEALTH. Uontron: Penny & Hull, Steam Printers, 53, Leman Stkeet, Whitechapel, E. 1880. REPORT of the MEDICAL OFFICER OF HEALTH For the Quarter ended 3rd April, 1880. To the Board of Woeks, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 3rd April, 1880, (comprising 14 weeks), the total births in the District were 846, viz.: 426 males and 420 females; and the deaths 772, viz.: 425 males and 347 females. The excess of births over deaths has therefore been, during this Quarter, 74. As the deaths of 106 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 666, and thus increasing the number of births above deaths to 180. 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 (13 weeks) the total births were 753, and the total deaths 647. The weekly average of births was 57.2, and of deaths, 50.0, and in the present Quarter the weekly average of births has been 60, and of deaths 55.1. In the Spitalfields sub-District the births were 229 and the deaths 128; in the Mile End New Town 239 and the deaths 234 (in this sub-District the Workhouse is situated) ; in the Whitechapel North 131 and the deaths 75; in the Whitechapel Church 97 and the deaths 216 (in this sub-District the London Hospital is situated); in the Goodman's Fields 98 and the deaths 68; and in the Aldgate 52 and the deaths 51. The deaths have exceeded the births in the 4 Whitechapel Church sub-District by 119, but the deaths of the 106 non-residents in the London Hospital must be deducted from the deaths in that Institution; the proportion of births to deaths is therefore 97 to 110. The deaths in the London Hospital have been 171; of these, 106 were of non-residents, 17 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 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 10.0 per cent. In the corresponding Quarter of the previous year the deaths in that Institution were 150. The deaths in the Workhouse have been 152. In the corresponding Quarter of last year they were 108. The deaths from epidemic diseases in the entire District have been 50, viz.: 3 from small pox, 10 from measles, 7 from scarlet fever, 3 from diphtheria, 23 from hooping-cough, 2 from diarrhcea, and 2 from fever. One death from small-pox occurred in the Small-pox Hospital belonging to the Asylums' Board, thus making the total deaths from this disease 4. The prevalence of small-pox in London, judged by returns from the Metropolitan Asylums Hospitals, showed a marked increase during this Quarter. The number of small-pox cases under treatment in these hospitals, which was but 56 on the 3rd January, steadily increased to 172 on 3rd April. The number of patients suffering from fever who were removed from this District to the Asylums' Board Hospital was 11; six of these patients were sent from the London Hospital, and were non-residents in this District; no death occurred among the 11 patients sent to the Fever Hospital from this District. In the corresponding Quarter of the previous year, the deaths from epidemic diseases were 38, viz.: 1 from measles, 3 from scarletfever, 2 from diphtheria, 23 from hooping-cough, 3 from diarrhoea, and 6 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 132. This is 17.0 per cent, of the total mortality. In the corresponding Quarter of the previous year it was 17.7 per cent. In the Spitalfields sub- 5 District the rate is 30.4 per cent.; in the Mile End New Town 12.3 per cent.; in the Whitechapel North 25.3 per cent.; in the Whitechapel Church 6.4 per cent.; in the Goodman's Fields 26.4 per cent.; and in the Aldgate 25.5 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 252; which shows a rate of mortality of 32.6 per cent. in relation to the total deaths, including those of non-residents, and 29.6 per cent, to the total births. The rate of mortality under 1 year, in relation to the total births, is 15.0 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the past Quarter, 1175 new cases of illness out of the Workhouse; including 6 of small-pox, 14 of measles, 4 of scarlet-fever, 5 of hooping-cough, 9 of diarrhoea, 28 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 957; including 2 of measles, 5 of scarlatina, 10 of hooping-cough, 7 of diarrhoea, 12 of febricula, 1 of fever, and 4 of erysipelas. The total number of cases of illness in the Workhouse has been 995 ; including 10 of measles, 14 of diarrhoea, 9 of erysipelas, and 9 of febricula. In addition to the above cases there were 59 of syphilis ; thus making a total of 1054. During this Quarter, from the return of Mr. Ilott, the resident Medical Officer of the Workhouse, it appears that no case of fever was admitted into the Infirmary. Uncertified Deaths. The uncertified deaths recorded during the Quarter were 5, viz.: 3 in the Spitalfields sub-District, 1 in the Mile End New Town subDistrict, and 1 in the Goodman's Fields sub-District. Hooping Cough. The deaths from hooping cough having been greatly in excess of the usual number during this Quarter, I have deemed it advisable to direct your attention to the subject. Although the deaths from hooping-cough are not very much in excess of the usual number in this District during the Quarter, yet, 6 in all London the mortality from this disease is excessive; the total number of deaths being, for the 14 weeks ended April 3rd, 2121. This gives an average of about 151 per week, and shows a greater mortality from hooping-cough alone than from small pox, measles, scarlet fever and diphtheria combined; the total deaths from the above-named four diseases being 1506, (viz., from small-pox 126, measles 379, scarlet-fever 854, diphtheria 147) or 615 less than from hooping-cough. If the mortality from hooping-cough were to be maintained at the same rate per week throughout the year, the total deaths would be about 7800—a fearful sacrifice of infant life. From the fact that hooping-cough principally attacks infants and young children who are carried in their mother's arms from place to place, and are allowed to run about and play with other children, and are frequently seen in public conveyances, it would be impracticable, owing to the unwillingness of the mothers to be separated from their children, to adopt the usual plan for preventing the spreading of contagion, such as complete isolation of the patients, and the thorough disinfection of rooms and the clothing used by the sufferers. In the present state of our knowledge respecting contagion, isolation appears to be the only effectual plan for arresting it. The following are the localities where deaths have occurred from hooping-cough in this District during the Quarter ended April 3rd, 1880; from which it appears that the disease has not been confined to any particular locality, but has been diffused generally throughout the entire District, with the exception of the Aldgate sub-District, in which no death has been recorded. The deaths from hooping-cough in England for the Quarter were 4872, and exceed the deaths from scarlet-fever by 331. Localities where deaths have occurred from Hooping-cough during the Quarter ended 3rd April, 1880. Spitalfields. 44, Grey Eagle Street 1 22, Church Street 1 3, Paternoster Row 2 4, Dorset Street 1 33, White Lion Street 1 5, Frying Pan Alley 1 Mile End New Town. 12, King Street 1 Metropolitan Buildings 1 172, Hanbury Street 1 183, Hanbury Street 1 20, Victoria Cottages, Pelham Street 1 7 White chapel North. 10, Thomas Street 1 14, George Yard 1 112, Old Montague Street 1 41, Newcastle Street 1 11, New Buildings, George Yard 1 38, Ditto ditto 1 5, Caroline Place 1 6, Nelson Court 1 58, Queen Ann Street 1 Whitechapel Church. 43, Oxford Street 1 Goodman's Fields. 109, Back Church Lane 1 Aldgate. No deaths from such disease. - Total 23 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. Jan. 3 13 20 69 1505 2 63 0.44 45.7 „ 10 10 22 73 1754 1 39 0.05 34.8 „ 17 9 17 89 1730 0 48 0.20 33.1 „ 24 14 11 83 1900 0 46 0.01 29.7 „ 31 5 19 70 2200 0 45 0.00 29.2 Feb. 7 11 23 66 3376 0 98 0.25 38.8 „ 14 19 19 56 2495 0 107 0.61 40.6 „ 21 14 23 57 2016 0 53 1.12 46.7 „ 28 9 13 46 1662 1 56 0.35 40.5 Mar. 6 14 14 44 1607 0 48 0.11 4S.5 „ 13 14 19 51 1442 0 43 0.07 46.3 „ 20 14 10 45 1465 1 46 0.00 41.3 „ 27 9 18 46 1505 2 32 0.00 42.4 April 3 11 10 59 1732 0 43 0.54 44.9 8 Dr. William Farr, F.R.S., in a most valuable and instructive letter* addressed to the Registrar-General, and published in the supplement to the 35th Annual Report of that officer, directs attention to the difference in the mortality in the healthy districts of the country, and that of England, and of the Liverpool District, which serves to represent the most unfavourable sanitary conditions, where out of the same number born, 400,370, nearly half of the number born die in the five years following their birth. This is 284,960 in excess of the deaths in the healthy Districts. TABLE Showing out of 1,000,000 children born alive (1) in the healthy Districts, (2) in All England, and (3) in the District of Liverpool, the numbers dying under 5 years of age by 11 groups of causes. Healthy District?. England. Liverpool District. Deaths from all causes 175,410 263,182 460,370 Total Zymotic Diseases 49,761 87,099 171,009 1. Small Fox C02 3,331 5,175 2. Measles 5,257 11,507 25,514 3. Scarlet Fever 11,373 17,959 26,818 4. Diphtheria 4,184 2,425 3,395 5. Hooping Cough 9,650 14,424 32,551 6. Typhus (with Enteric ifc Common Fever) 2,807 5,401 9,297 7. Diarrhcea and Dysentery 9,354 20,344 51,911 8. Cholera 399 1,129 4,255 9. Other Zymotic Diseases 6,135 10,579 12,093 10. Scrofula and Tubes 5,335 8,115 11,694 11. Consumption 2,656 4,469 5,116 *This letter extends to 82 pages, and contains remarks on epidemic diseases in general, and matters which relate to the increase and decrease of population; the relation between death rates and birth rates; the effects of density of population on health ; the beneficial results arising to the Army and Navy from the operation of the Contagious Diseases Act; the history of syphilis, &c. y From the preceding table it appears that diphtheria is not influenced by the existence of defective sanitary arrangements as are all other diseases. Thus, while in the healthy districts 4,184 die from diphtheria, 2,425 die in all England, and 3,395 die in the Liverpool District. Hooping-cough, on the contrary, appears to be greatly aggravated by the want of sanitary arrangements, for, while 9,650 deaths occur from hooping cough in the healthy districts, 14,424 take place in all England, and in the Liverpool District 32,551. It is important to note the mean age at death of persons dying from certain causes. In a table prepared by Dr. Farr, it appears that hooping-cough is at its maximum in the first year of life, measles in the second, scarlatina and diphtheria in the third and fourth years. The mean age at death by hooping cough is L8, measles 2.7, scarletfever and diphtheria 5.8, small-pox 11.9, and typhus, including typhoid and continued fever, 2.60. The last-named disease may be prevented, and is of the utmost importance to prevent, seeing that it is most fatal to the middle aged, at which period man is most useful to the community; and if he die prematurely the burden of supporting his family is frequently thrown upon the ratepayers. Dr. Farr, in speaking of the diffusion of Epidemic Diseases, further remarks:— "The air, which Professor Tyndal shows in his elegant experiments, carries dust, carries in it also the zymotic particles (zymads) of small-pox, scarlet-fever, diphtheria, measles, hooping-cough, typhus and plague, in the atmosphere that surrounds the sick; in other cases it carries the widely diffused elements that induce influenza, marsh fevers, neuralgia, and rheumatism. These zymads are attacked in many ways: (1) by the free admission of fresh air (ozone) into the chambers of the sick; (2) by the various disinfectants—such as camphor, carbolic acid, permanganate of potash (ozone), chlorine, sulphurous acid; (3) by the isolation of the sick during the inlections in separate rooms or separate dwellings; (4) by the chemical destruction of the excreta: (5) Pasteur showed, by many experiments, that organic germs, which set up formations, are arrested by their aspiration through cotton wool, and by analogy some persons might be disposed to try the effect of breathing through cotton wool when they enter sick chambers." 10 Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis, during the Quarter (14 weeks), has been 4.05 inches. During the corresponding Quarter of last year the rain-fall was 7.28 inches. The mean temperature of the air was 40°. In the corresponding Quarter of last year it was 37.1°. The coldest days during the Quarter were Tuesday, January 27th, Tuesday, January 20th, and Thursday, January 29th, when the thermometer indicated respectively 17.2°, 17.6° and 17.7°; or 14.8°, 14.4°, and 14.3° below the freezing point of water. The coldest day during the corresponding Quarter of last year was Sunday, the 12th January, when the thermometer indicated 19.4°, or 12.6° below the freezing point of water. January was an exceedingly cold month, with the smallest rainfall since 1826. The amount measured was only 0.3 inches. From the remarks upon the meteorology of the Quarter, by Mr. James Glaisher, F.R.S., it appears that the mean temperature was 39.8 (13 weeks), and the rainfall only 3.2 inches. The mean temperature at the Royal Observatory, Greenwich, was below the average during each of the 15 months ending January last; the mean of this cold period was only 44°, and was lower than in any previous corresponding period since 1813—15. There is, however, no previous instance on record of the mean temperature being below the average for 15 successive months. The measured rainfall at Greenwich during the last Quarter (13 weeks) was only 3.2 inches, and was 1.8 inches below the average for the corresponding period in G5 years. The rainfall showed a marked deficiency in January and March. The number of hours of bright sunshine recorded during the Quarter at the Greenwich Observatory was 2359, against 141.0 and 137.5 respectively in the first Quarters of 1878 and 1879. There was a marked increase in the recorded amount of sunshine in each of the three months of the Quarter. The last two winters have been very severe, the cold of the winter of the preceding year being rather less intense than that of 1878—9, which although somewhat milder, was more fatal in its effect upon the public health. 11 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. June, 1878 443 5 46 - 489 5 672 September 480 5 30 1 510 6 644 December 258 4 26 — 284 4 638 March, 1879 273 1 37 — 310 1 753 June 539 24 25 — 564 24 656 September 464 2 27 — 491 2 658 December 373 — 33 — 406 — 655 April 3rd, 1880 (14 weeks) 380 2 31 — 411 2 846 Totals 3210 43 255 1 3465 44 5522 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. Workhouse Primry. Cases. Totals. Quarter ending Public Vaccinatr. Primary Cases. Workhouse Primry. Cases. Totals. March, 1871 727 10 737 March, 1876 236 25 261 June ,, 357 21 378 June ,, 369 36 405 Sept. 186 35 221 Sept. „ 354 40 394 Dec. 134 27 161 Dec. ,, 347 41 388 March, 1872 219 43 262 March, 1877 408 37 445 June ,, 289 32 321 June ,, 382 24 406 Sept. „ 306 26 332 Sept. ,, 336 26 362 Dec. „ 263 23 286 Dec. ,, 241 32 273 March, 1873 290 23 313 March, 1878 288 29 317 June ,, 331 17 348 June ,, 443 46 489 Sept. ,, 266 36 302 Sept. 480 30 510 Dec. „ 256 39 295 Dec. 258 26 284 March, 1874 335 37 372 March, 1879 273 37 310 June „ 411 30 441 June ,, 539 25 564 Sept. ,, 320 30 350 Sept. „ 464 27 491 Dec. ,, 185 31 216 Dec. ,, 373 33 406 March, 1875 292 44 336 April 3rd, 1880 380 31 411 June ,, 376 26 402 Sept ,, 350 35 385 Dec. „ 178 23 201 11 Adulteration of Food Act. The Inspectors report, that they had submitted to Dr. Tidy, for analysis, eleven samples of milk. Three of these samples were found to be largely adulterated ; that summonses were taken out against the respective sellers, and the following fines were inflicted, viz., £5 and costs, 40s. and costs, and 10s. and costs. In the case in which £5 and costs were inflicted, the milk was adulterated with 27 per cent, of added water. The same person was summoned for a similar offence on the 4th July, 1878, when he was fined 40s. and costs. In all cases in which summonses are taken out by the officers of your Board, the costs charged are only those which the officers have paid for the summonses. Sanitary Works Performed during the Quarter ended 3rd April, 1880, (14 weeks). The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 3rd April, 1880. Number of inspections of houses as shown in the official returns 1881 Houses specially visited 273 Houses specially re-visited 955 Preliminary notices served, such notices embracing 338 premises 201 Compulsory orders issued, embracing 221 premises 71 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 2 Cases of overcrowding and indecent occupation abated 12 Houses in which rooms or passages have been whitewashed 131 ltooms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet-fever therein 38 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the Apparatus 1133 Yards of houses paved, or the pavement repaired 28 Drains in houses improved 74 Dust-bins provided 8 Privies lime-washed, cleansed and repaired 69 Water supply provided or improved 25 Nuisances from dung and other offensive matter removed 37 Area gratings, cellar flaps, &c., repaired 27 Animals (cats) kept so as to be a nuisance, removed 13 Cesspools abolished 0 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 3rd April, 1880 (14 weeks.) Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic-D iarrhœa. Continued Fever, Typhus & Typhoid. Febricula. Pyaemia. Erysipelas. Puerperal Fever. Croup. Acute Pulmonary Inflammation. Carbuncle. Rheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. Total. Bronchitis and Catarrh. Pleuritis and Pneumonia. Dr. Swyer 0 1 0 3 5 0 0 10 0 0 0 0 43 26 0 9 0 0 0 0 176 273 Mr. Champneys 4 0 0 1 2 0 0 1 0 3 0 0 94 1 0 20 0 0 0 0 273 399 Mr. Sequeira 1 8 0 0 1 0 0 14 0 0 0 0 82 1 0 9 0 0 0 0 97 213 Mr. H. Braye 1 1 4 1 0 0 0 0 0 1 0 0 58 2 0 4 0 0 0 3 125 200 Mr. Loane 0 4 0 0 1 0 1 3 0 0 0 0 29 1 0 0 0 0 0 0 51 90 Totals 6 14 4 5 9 0 1 28 0 4 0 0 306 31 0 42 0 0 0 3 722 1175 Corresponding Qr. of previous Year. 0 2 6 10 7 0 1 12 0 4 0 0 198 16 2 23 1 0 0 0 676 957 Workhouse Mr. J. J. Ilott. 0 10 0 o 14 0 0 9 0 9 3 0 257 20 1 85 4 4 9 2 568 995 In addition to the cases attended by Mr. Ilott in the Workhouse, there were 59 cases of syphilis. TABLE II. Showing the Deaths from Epidemic Diseases for the Three MonthB ended 3rd April, 1880 (14 weeks). Sub-districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhœa. Fever. Cholera 4 Choleraic Diarrhea. Total. Remarks. Spitalfields 0 0 0 0 7 0 0 0 7 Mile End New Town 3 0 2 2 5 1 0 0 13 Workhouse. Whitechapel North 0 0 1 0 9 0 0 0 10 Whitechapel Church 0 4 1 1 1 0 2 0 9 Hospital. Goodman's Fields 0 5 1 0 1 0 0 0 7 Aldgate 0 1 2 0 0 1 0 0 4 Totals 3 10 7 3 23 2 2 0 50 Deaths from Epidemics for the corresponding Quarter, 1879. 0 1 3 2 23 3 6 0 38 One death from small-pox, of a patient sent from this District, occurred in the Small-Pox Hospital. The total number of deaths from small-pox is therefore 4. 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 3rd April, 1880 (14 weeks.). 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 229 128 39 31 20 5 13 4 Mile End New Town 15550 239 234 29 21 80 5 23 152 Whitechapel North 11597 131 75 19 25 11 1 6 0 Whitechapel Church 7322 97 216 14 23 36 40 46 171 Goodman's Fields 10381 98 88 18 13 18 1 5 0 Aldgate 9224 52 51 13 7 8 4 8 0 Totals 76573 846 772 132 120 173 56 101 327 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE Sanitary Condition OF THE WHITECHAPEL DISTRICT. FOR THE QUARTER ENDED JULY 3ED, 1880, BY JOHN L ID D LE, MEDICAL OFFICER OF HEALTH. London: Penny & Hull, Steam Pkinteks, 53, Leman Stheet, Whitechaph., E. 1880. REPORT of the MEDICAL OFFICER OF HEALTH For the Quarter ended 3rd July, 1880. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 3rd July, 1880, the total births in the District were 076, viz.: 346 males and 330 females; and the deaths 472, viz.: 277 males and 195 females. The excess of biiths over deaths has therefore been, during the Quarter, 204. 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 379, and thus increasing the number of births above deaths to 297. 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 656, and the total deaths 550. The weekly average of births was 50.4, and of deaths, 42.3 ; and in the present Quarter the weekly average of births has been 52, and of deaths 36.3. The number of deaths recorded in this District during this Quarter is less than it has been in any other Quarter since the formation of your Board. The deaths for this Quarter, as above stated, are only 379, after deducting the deaths of non-residents in the London Hospital." The annual death-rate from all causes is therefore equal to 19.8 per 1000. In the Spitalfields sub-District the births were 173 and the deaths 82; in the Mile End New Town 181 and the deaths 122 (in this subDistrict the Workhouse is situated); in the Whitechapel North 116 and the deaths 51; in the Whitechapel Church 58 and the deaths 166 (in this sub-District the London Hospital is situated); in the Goodman's fields 108 and the deaths 30; and in the Aldgate 40 and the deaths 21. The deaths have exceeded the births in the Whitechapel Church sub District by 108, but the deaths of the 93 non-residents in the London Hospital must be deducted from the total deaths in that Institution ; the proportion of births to deaths is therefore 58 to 73. 4 The deaths in the London Hospital have been 133; of these, 93 were of non-residents, 9 of residents, and 31 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 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 persons so dying not always being given in the weekly returns), the proportion of deaths of residents in this Quarter is only 9.G per cent. In the last Quarter, ended April 3rd, the proportion of deaths of residents to non-residents was 16 per cent. The deaths in the Workhouse have been 67. In the corresponding Quarter of last year they were 92. The deaths from epidemic diseases in the entire District have been 27; viz.: 2 from small-pox, 1 from measles, 2 from scarlet fever, 1 from diphtheria, 8 from hooping-cough, 12 from diarrhoea, and 1 from fever. Three deaths from small-pox occurred in the Small-pox Hospital belonging to the Asylums Board, thus making the total deaths from this disease 5. The total number of patients, who, while suffering from small-pox were admitted into the Hospitals from this District, was 13. In addition to this number, 3 mothers who accompanied their infant children were admitted into the Hospitals. The residences of those patients who died in the Small-pox Hospital were respectively at No. 4, East Mount Terrace, 12, Gower's Place, and 22, Thrawl Street. The number of patients suffering from fever who were removed from this District to the Asylum Hospitals was 2, neither of whom died. In the corresponding Quarter of the previous year, the deaths from epidemic diseases were 52, viz.: 10 from measles, 11 from scarlet-fever, 3 from diphtheria, 19 from hooping-cough, 5 from diarrhoea, and 4 from fever. Mortality of Young Children. The mortality of children under 1 year of age was ] 01. This is 21.4 per cent, of the total mortality. In the corresponding Quarter of the previous year it was 17.9 per cent. In the Spitalfields sub-District the rate is 36.5 per cent.; in the Mile End New Town 18.8 per cent.; in the Whitechapel North 39.2 per cent.; in the Whitechapel Church 8.4 per cent.; in the Goodman's Fields 30.0 per cent,; and in the Aldgate 23.8 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. 5 The total deaths under 5 years are 169, which shows a rate of mortality of 35.8 per cent, in relation to the total deaths, including those of non-residents, and 23.3 per cent, to the total births. The rate of mortality under 1 year, in relation to the total births, is 14.9 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended during the past Quarter 760 new cases of illness out of the Workhouse; including 13 of small-pox, 5 of measles, 1 of scarlet-fever, 5 of hooping-cough, 13 of diarrhoea, 26 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 953; including 1 of small-pox, 2 of measles, 17 of scarlatina, 3 of hooping-cough, 20 of diarrhoea, 18 of febricula, 5 of fever, and 3 of erysipelas. The total number of cases of illness in the Workhouse has been 716; including 14 of diarrhoea, 10 of erysipelas, and 10 of febricula. In addition to the above cases, there were 34 of syphilis and gonorrhœa; thus making a total of 750. Uncertified Deaths. No uncertified deaths are recorded during this Quarter. Hooping Cough. The deaths from hooping-cough, which were so numerous during the last Quarter, and to which I directed the attention of the Board, have been considerably less during this Quarter. The number of deaths from this disease in London was, for the week ended 17th April, 111, whilst for that ended July 3rd was only 44. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the Quarter, has been 5.53 inches One inch deep of rain-fall on an acre weighs (allowing 10-lbs.to a gallon, which is the weight of a gallon of distilled water) nearly 101 tons. During the corresponding Quarter of last year the rain-fall was 10.31 inches. The average annual rain-fall at Greenwich in 63 years was 25.4 inches. The mean temperature of the air was 52°.7. In the corresponding Quarter of last year it was 49°.2. The hottest days during the Quarter were Wednesday, the 26th May, Tuesday, the 29th June, and Wednesday, the 30th June, when the thermometer indicated respectively 87°.5, 80°,0, and 80°.2. The hottest day during the corresponding Quarter of last year was on Saturday, the 21st June, when the thermometer indicated 72°.7. The highest mean temperature during any week in the Quarter was in that which ended July 3rd, 6 when it was 74°.5. "The mean temperature for the year 1879 was 46°.2, which was 3°.3 below the average of the previous 38 years. Low temperatures were recorded in every month of the year, and the month of December was colder than in any December in this century, its mean temperature being 6°.7 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. Inches. Mean Temperature of the air. Degrees Diarrhœa. Fever. Small-pox. From all causes. From Smallpox. From all causes. April 10 10 15 13 1532 0 44 0.41 44.8 „ 17 11 16 9 1519 0 43 0.98 46.4 „ 24 8 15 15 1417 1 37 0.30 51.9 May 1 12 13 18 1387 0 34 0.08 41.8 ,, 8 13 21 10 1416 0 31 0.17 47.1 ,, 15 13 8 8 1389 0 45 0.00 52.1 „ 22 18 18 10 1297 0 28 0.00 53.9 „ 29 17 14 10 1333 0 23 1.02 58.4 June 5 20 16 8 1306 0 34 0.55 51.7 „ 12 16 13 10 1294 0 37 0.38 53.9 „ 19 21 14 6 1243 0 32 0.88 58.9 „ 26 32 14 14 1273 0 32 0.75 59.9 July 3 64. 15 13 13Q0 1 49 0.01 62.3 Artizans' Dwellings Act, 1875. Pearl Street Area Scheme. In a Report recently submitted to the Metropolitan Board of Works by the Works and General Purposes Committee, it was recommended that the Medical Officer of Health be informed that it is not the intention of the Board to prepare a scheme under the Artizans' Dwellings Act, for the Great Pearl Street Area, defined in his representation dated 20th July, 1877. This area, as may be seen on referring to pages 10, 11, and 12 of my Report for the Quarter ended 30th June, 1877, was brought under the notice of the Medical Officer of Health by a communication, signed by 34 inhabitants of Spitalfields, including the firm of Truman, Hanbury, Buxton & Co., complaining of the unhealthy condition of the said area, and requesting me to inspect the same, under the provisions of the Artizans' and Labourers' Dwellings Improvement Act, 1875. The area is about 8650 square yards (or nearly two acres), and 7 contains a population of about 1050, thus giving about 8 square yards to each person, among whom the rate of mortality is 33.3 per 1000. The area comprises Great Pearl Street, a portion of Little Pearl Street, a few houses in Grey Eagle Street, Vine Court, Crown Court, New Court, Wilk Court, Half Wilk Court, and Diamond Court; all in the Parish of Spitalfields. The reason assigned by the Metropolitan Board of Works for not preparing a scheme is, "that the area, as defined by the Medical Officer of Health, is too small to enable the Board to make a comprehensive improvement scheme. The Board has, accordingly come to the conclusion not to prepare a scheme under the Act, for the area in question, and has, in accordance with the requirements of the 8th section of the Act, communicated this decision to the Secretary of State." Small-pox. During this Quarter 144 deaths from small-pox were registered in London; the weekly record of which varied from 6, the number that was registered in the week ended June 19th, to 18 in that ended May 1st. "The deaths by small-pox, which were 2544 in 1877, and 1416 in 1878, fell, in 1879, to 458, of which 298 occurred in the 5 Metropolitan Small-pox Hospitals; the mortality from this disease declined through the year, for the deaths were thus distributed through the 4 Quarters: 221, 140, 63, and 34." "The annual rate of mortality from small-pox, in London, to 10,000 living, in the thirty years 1841-70, was 3.1, but owing to the severe epidemic of 1871-2, it rose in the nine years 1871-9 to 4.9. During the recent epidemics of small-pox, conclusive evidence was recorded by the authorities of the Metropolitan Small-pox Hospitals, showing that, where the operation had been efficiently performed vaccination proved an excellent safeguard; indeed, protection against an attack was found to be in proportion to the efficiency of the operation. In other words, the constitution will be as well protected from subsequent attacks of small-pox as if the patient had gone through all the stages of that disease." It is much to be regretted that attempts are being made to alter, I will not say amend, the existing Vaccination Act, so far as not to allow repeated prosecutions of persons who refuse to give their children the protection against one of the most loathsome and dangerous diseases to which all people are liable; and it is earnestly to be desired that all Boards of Guardians and Sanitary Authorities will petition the Houses of Parliament against making the proposed alteration in the existing Act. Vaccination, as I have on more than 8 one occasion pointed out in my Quarterly Reports, is exceedingly well performed in this District, and if the proposed alteration is carried into effect, the consequences to the community may be very serious. From the Vaccination Returns which were laid before the Board of Guardians and by them submitted to the Local Government Board, it appears that during the year 1879, 2735 births had been registered in the Union. Of that number 2409 had been successfully vaccinated; one was unsusceptible of vaccination; 227 died (or 8.3 per cent, of the number born); 22 had been postponed, and 26 had removed to other Districts, or gone abroad. This Report, so far as the vigilance of the Vaccination Officer is concerned, in tracing the children whose births were registered in the District, and inducing the parents to obtain vaccination for their children, is highly satisfactory, and reflects great credit upon all those who are intrusted with the working of the Vaccination Act; for it shows that only 61, or 2.2 per cent, were lost sight of; and as the authorities of those Districts where it was ascertained the children had been removed were apprised, it is probable that some of the children were vaccinated in their new abodes. The above Return seems to show that, with care and diligence on the part of the Vaccination Officer, the provisions of the existing Act work very satisfactorily, and certainly no fresh regulations are, in my opinion, required to secure greater efficiency in promoting the vaccination of nearly all the children born in the District, and consequently it is better to let well alone, and not try to amend the Act. It'will be seen on referring to the Table on page 10, which has been kindly forwarded to me by Mr. Vallance, that, in addition to the number of children whose births have been registered in this District, 212 unregistered children have been successfully vaccinated. In order to insure the vaccination of every child of suitable age, it is necessary that diligent and frequent visitations should be made to all houses which are let out in tenements, not only when small-pox prevails but at all other times, to ascertain if any of the children are unvaccinated, and kindly urge upon the parents the necessity of taking such children to the Public Vaccinator for vaccination. I am desirous of calling the attention of all medical practitioners to the importance of certifying as to deaths from small-pox, whether or not the deceased child had been vaccinated. 9 VACCINATION. VHITECHAPEL UNION.—Return of the number of Cases Vaccinated by the Public Vaccinator and the Medical Officer of the Workhouse, together with the number of Births Registered during the same quarters. Quarter ending — PUBLIC YACCIJI1T0R workhodse. Totals. Births Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination Primary Cases.' Re-Vaccination. Reoistd. September, 1878 480 5 30 1 510 6 644 December 258 4 26 — 284 4 638 March, 1879 273 1 36 — 310 1 753 June 639 24 25 — 564 24 656 September 464 2 27 — 491 2 658 December 373 — 33 — 406 - 655 April 3rd, 1880(14 weeks) 380 2 31 — 411 2 846 June 533 — 25 — 558 - 676 Totals 3300 38 234 1 3534 39 5526 Registration of Births. It is of the utmost importance, lor statistical and other purposes, that all births should be registered. The register of births is also becoming increasingly important for private, as well as public purposes. It is frequently required for purposes connected with the Factory Acts; in proof of age of candidates for Civil Service clerkships, and of those seeking employment in many Government Offices, and for purposes of life assurance. So far as it concerns the upper and middle classes of society, we shall probably find that all births are duly registered. But the poorer'classes do not appear to be impressed with the duty of registering the birth of their children, and some, it is to be feared, are persuaded by the anti-vaccinationists against the registration of the birth of their children in order to avoid the vigilance of .the Vaccination Officer. It might tend to promote a better registration of births, if the Clergyman, at the time of registering the baptism of a child, were to require the parent to produce the certificate of the registration of the birth of the child. In short, all legitimate means should be taken to point out the importance of registering the birth of every child. One of the means for accomplishing this object might be adopted by distributing placards and hand-bills in the District, directing the attention of the public to the principal provisions contained in the Act for the Registration of Births and Deaths (37 and 38 Vict., ch. 88, and dated 7th August, 1874). By the first section of this Act, it is enacted that, 10 "in the case of every child born alive, after the commencement of this Act, it shall be the duty of the father and mother of the child, and in default of the father and mother, of the occupier of the house in which, to his knowledge, the child is born, and of each person present at the birth, and of the person having charge of the child, to give to the Registrar, within forty-two days next after such birth, information of the particulars required to be registered concerning such birth, and in the presence of the Registrar to sign the register." The 39th Section of the Act provides that, "every person is required by this Act to give information concerning any birth, and failing to give such information, is liable to a penalty not exceeding forty shillings." At my request, Mr. Vallance, the Clerk to the Board of Guardians, has kindly furnished me with the following particulars respecting the operation of the compulsory Registration of Births Act. In the year ended 30th September, 1874, there were 2G70 births registered in this District. In the next year, 1875, there were 2700; in 1870, 2705 ; in 1877, 2774; in 1878, 2727; and in 1879, 2718. Mr. Vallance supposes, that, during these years, there has been a diminishing population, and he adds, that it is impossible to say how many births have escaped registration, but he has no doubt that there are some. VACCINATION RETURN OF THE WHITECHAPEL UNION for 1879. Made 23rd July, 1880. Districts. Births registered. Successfully Vaccinated. Died Unvaccinatcd. Insusceptible of Vaccination. Had Small-pox. Postponed. Removed to other Districts, referred. Removed Abroad. Cases Not Found. Removed, Not Traced. Cases Lost, being columns 9. 10. 11 1 2 3 4 5 6 7 8 9 10 11 12 Spitalfields 840 740 63 ... ... 11 3 5 6 12 23 Mile End New Town 720 638 63 ... ... 4 2 2 8 3 13 Whitechapel North 407 359 33 ... ... 2 3 1 4 5 10 Whitechapel Church 281 248 24 ... ... 1 2 1 1 4 6 Goodman's Fields 313 275 27 ... ... 3 2 1 1 4 6 Aldgate 174 149 17 1 ... 1 3 1 0 2 3 Total 2735 2409 227 1 ... 22 15 11 20 30 61 Miscellaneouscases(un- der the age of 14) be- ing removals from other Districts and from Abroad, unre- fiistered cases, etc. 212j 11 Deaths of Persons aged 100 years and upwards. In my Report for Dec., 1878,1 directed the attention of your Board to the fact that, in the Registrar-General's Report for the year 1874, there was published a Table, showing that 69 persons (16 males and 53 females), were returned as aged 100 years and upwards in England and Wales, and that 6 of that number attained the age of 104 years. At page lxxxvi. of the Registrar-General's Report for the year 1878, a similar Table is published, showing that the deaths of 88 persons (24 males and 64 females) were registered in England Wales, and returned as aged 100 years and upwards; of these, 5 reached the advanced age of 105, and 4 of 104 years. Among the 88 deaths recorded in this Table, there were 2 in the Whitechapel District, 1 of which occurred at 49, Queen Ann Street, and was that of the widow of a labourer, whose age was 104, and the other was that of a labourer, aged 103 years, whose place of death was at No. 12, Wood Street, Spitalfields. It has been for a long time'denied that any person ever reaches 100 years of age, and that those whose ages are said to have exceeded 100 years are not reliable, but when there are so many deaths exceeding 100 years as have lately been annually recorded by the RegistrarGeneral, it appears to me to be impossible to doubt that both men and women do occasionally exceed their hundredth year. Open Spaces. At page 10 of my Report ended March 29th, 1879, I brought under the notice of your Board the advantages that would be afforded to the health of the people living in London by providing in every District an open space which could be used as a recreation ground. It is now most satisfactory to me to have to record that, during this Quarter, final arrangements have been made by your Board for the purchase of the lease of a piece of ground situated in Baker's Row, Whitechapel, known as the Quakers' Burial Ground, which had, for a considerable time, been discontinued to be used as a place of sepulture. This piece of ground has an area of 5445 square yards, or about an acre and one-eighth of an acre, and has been laid out by Mr. Iron with much taste, and ornamented with shrubs and flowers. This recreation ground was opened by the Prince and Princess of Wales, on Thursday, the 24th June, 1880, and it will now form an enjoyable play-ground, where children can amuse themselves in safety, and where adults may find temporary rest and repose away from the crowded and confined courts in which so many of the poorer inhabitants of this District reside. 12 The public is much indebted to the Rev. J. F. Kitto, the Rector of Whitechapel, and the Rev. S. A. Barnett, Vicar of St. Jude's, Whitechapel, for their strenuous exertions in obtaining this vacant space for the use of the inhabitants of this District. There are still two other open spaces in the Whitechapel District, viz.: the disused burial grounds of Whitechapel and Spitalfields Churches, which, I sincerely hope, will shortly be made available for the recreation of the inhabitants of this densely crowded District with its population, according to the last census, of 76573. The acreage of the whole area of the District is only 405 statute acres, or 1,958,200 square yards, including the 38 acres of the River Thames; thus affording only about 25½ square yards for each inhabitant. For the health of the people it would be better not to erect another house in the District until the population is sensibly diminished. Density of Population. The number of persons to an acre in this District is 189, or, as above stated, about 25½ square yards to each. In his Annual Summary of Births and Deaths in London for 1879, the Registrar-General says that, "a considerable improvement has taken place in the health of London in recent years; thus, the average mortality to 1000 inhabitants was 24.1 in the thirty years 1841-70, whereas in the nine years 1871-9, it fell to 22.9, showing a a decrease of 5 per cent. In the year 1879 the death-rate was 23.3, nearly the same as that in the previous year. This result may, as is said by the Registrar-General, be greatly attributed to improved sanitation. In the 53 weeks of 1879, the births amounted to 134,090, the deaths to 85,540; so the natural increase of population was 48,556, or at the rate of 131 daily."* Diminished Death-rate in London. By the continued progress of sanitary improvements the deathrate of London, which is now about 23 per 1000 annually, may, says the Registrar-General, "be reduced to at least 20 per 1000. A diminution of 1 per 1000 in the annual death-rate of the present population of London implies the saving of about 3600 lives; a reduction, therefore, from 23 per 1000 to 20 per 1000, would show a saving of more than ten thousand lives annually." * On an average there was in London one birth in every four minutes, and one death in every six- and-a-quarter minutes. 13 Sanitary Works Performed during the. Quarter ended 3rd July, 1880. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 3rd July, 1880. Number of inspections of houses as shown in the official returns 2975 Houses specially visited 300 Houses specially re-visited 1050 Preliminary notices served, such notices embracing 310 premises 184 Compulsory orders issued, embracing 126 premises 60 Summonses heard at Police Courts, under Sanitary Act 2 ,, under Act for the prevention of Adulteration of Food, &c. 3 Cellars used as dwellings discontinued for such use 6 Cases of overcrowding and indecent occupation abated 6 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 29 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the Apparatus .. 1031 Yards of houses paved, or the pavement repaired 24 Drains in houses improved 61 Bust-bins provided 4 Privies lime-washed, cleansed and repaired 159 Water supply provided or improved 12 Nuisances from dung and other offensive matter removed 28 Area gratings, cellar flaps, &c., repaired 6 Animals (rabbits, fowls and geese) kept so as to be a nuisance, removed 12 Cesspools abolished l Nuisance from smoking and curing of fish 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 3rd July, 1880. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic-Diarrhoea. Continued Fever, Typhus & Typhoid. Febricula. Pysemia. 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 2 0 0 3 0 0 11 0 1 1 0 3 4 0 10 0 0 1 2 95 133 Mr. Champneys 6 1 0 0 4 0 0 0 0 2 0 0 29 0 0 7 0 0 0 2 231 282 Mr. Sequeira 6 0 1 3 3 0 0 14 0 0 0 0 9 0 0 2 0 0 0 0 108 146 Mr. H. Braye 1 2 0 0 2 0 1 0 0 1 0 0 12 2 0 3 0 0 0 2 109 137 Mr. Loane 0 0 0 0 1 0 0 1 0 0 0 0 9 0 0 4 0 0 1 0 46 62 Totals 13 5 1 5 13 0 1 26 0 4 1 0 62 6 0 26 0 0 2 6 589 760 Corresponding Qr. of previous Year. 1 2 17 3 20 0 5 18 0 3 0 0 181 3 0 20 0 0 0 1 679 953 Workhouse Mr. J. J. Ilott. 0 0 0 3 14 0 1 10 0 10 0 0 73 16 5 89 3 0 5 7 480 716 In addition to the cases of illness in the Workhouse, which are above recorded, there were 34 cases of syphilis and gonorrhœa. TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 3rd July, 1880. Sub-districts. Small-Pox. Measles. Scarlet Fever. Diphtheria. HoopingCough. Diarrhœa. Fever. Cholera 4 Choleraic Diarrhœa. Total. Remarks. Spitalfields 0 1 0 1 2 3 0 0 7 Mile End New Town 1 0 0 0 1 4 0 0 6 Workhouse. Whitechapel North 1 0 0 0 1 3 0 0 5 Whitechapel Church 0 0 0 0 2 1 1 0 4 Hospital. Goodman's Fields 0 0 1 0 1 1 0 0 3 Aldgate 0 0 1 0 1 0 0 0 2 Totals 2 1 2 1 8 12 1 0 27 Deaths from Epidemics for the corresponding Quarter, 1879. 0 10 11 3 19 5 4 0 52 Three deaths from small-pox, of patients sent from this District, occurred in the Small-Pox Hospital. No death from fever occurred in the Fever Hospital of patients sent from this District. The number of small-pox patients sent from this District was 13, and of fever 2. 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 3rd July, 1880. 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 173 82 30 19 9 5 10 2 Mile End New Town 15550 181 122 23 7 27 3 14 67 Whitechapel North 11597 116 51 20 15 5 6 6 0 Whitechapel Church 7322 58 166 14 18 24 33 40 133 Goodman's Fields 10381 108 30 9 7 3 1 3 0 Aldgate 9224 40 21 5 2 3 0 0 0 Totals 76573 676 472 101 68 71 48 73 202 BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT on the SANITARY CONDITION of the WHITECHAPEL DISTRICT, for the QUARTER ENDED 2nd OCTOBER, 1880, BY JOHN LIDDLE, medical officer of health. LONDON: Penny & Hull, Steam Printers, 53, Leman Street, Whitechapel, E. 1880. 76 ??? 50 REPORT OF THE MEDICAL OFFICER OF HEALTH For the Quarter ended 2nd October, 1880. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 2nd October, 1880, the total births in the District were 590, viz.: 289 males and 301 females; and the deaths 556, viz.: 334 males and 222 females. The excess of births over deaths has therefore been, during the Quarter, 34. As the deaths of 125 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 431, and thus increasing the number of births above deaths to 159. 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 658, and the total deaths 532. The weekly average of births was 50.6, and of deaths, 40.9; and in the present Quarter the weekly average of births has been 45.3, and of deaths 42.7. In the Spitalfields sub-District the births were 183 and the deaths 110; in the Mile End New Town 150 and the deaths 127 (in this subDistrict the Workhouse is situated); in the Whitechapel North 85 and the deaths 48; in the Whitechapel Church 60 and the deaths 195 (in this sub-District the London Hospital is situated); in the Goodman's fields 78 and the deaths 52; and in the Aldgate 34 and the deaths 24. The deaths have exceeded the births in the Whitechapel Church sub-District by 135, but the deaths of the 125 non-residents in the London Hospital must be deducted from the total deaths in that Institution; the proportion of births to deaths is therefore 60 to 70. The deaths in the London Hospital have been 158; of these, 125 were of non-residents, 17 of residents, and 16 of persons who either 4 died suddenly or from the result of accident. The deaths of persons who had resided in this District, previous to their admission into the 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 persons so dying not always being given in the weekly returns), the proportion of deaths of residents in this Quarter is 10.2 per cent. In the last Quarter ended July 3rd, the proportion of deaths of residents to non-residents was only 9.6 per cent. The deaths in the Workhouse have been 68. In the corresponding Quarter of last year they were 58. The deaths from epidemic diseases in the entire District have been 98; viz.: 4 from measles, 9 from scarlet fever, 4 from diphtheria, 7 from hooping-cough, 70 from diarrhœa, and 4 from fever, including one death which occurred in the Fever Hospital. Two deaths from small-pox of persons removed from this District occurred in the Smail-pox Hospital belonging to the Asylums Board, but only one of whom was a resident; there was, therefore, only one death from small-pox in the Hospital of a resident in this District. The number of patients suffering from fever, who were removed from this District to the Asylum Hospitals, was 18, one of whom died; thus making a mortality of 5 from fever. In the corresponding Quarter of the previous year, the deaths from epidemic diseases were 114, viz.: 1 from small-pox, 12 from measles, 30 from scarlet-fever, 3 from diphtheria, 17 from hoopingcough, 46 from diarrhœa, and 5 from fever. Mortality of Young Children. The mortality of children under 1 year of age was 138. This is 24.8 per cent. of the total mortality. In the corresponding Quarter of the previous year it was 22.5 per cent. In the Spitalfields subDistrict the rate is 37.2 per cent.; in the Mile End New Town 29.2 per cent.; in the Whitechapel North 43.7 per cent.; in the Whitechapel Church 8.7 per cent.; in the Goodman's Fields 28.8 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 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 247; which shows a rate or mortality of 42,4 per cent. in relation to the total deaths, including 5 those of non-residents, and 41.8 per cent. to the total births. The rate of mortality under 1 year, in relation to the total births, is 22.3 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended during the past Quarter 821 new cases of illness out of the Workhouse; including 2 of small-pox, 5 of measles, 8 of scarlet-fever, 2 of hooping-cough, 78 of diarrhœa, 31 of febricula, 1 of fever, and 9 of erysipelas. In the corresponding Quarter of the previous year the number of pauper cases of illness was 867; including 7 of small-pox, 35 of measles, 31 of scarlatina, 11 of hooping-cough, 38 of diarrhoea, 28 of febricula, 4 of fever, and 2 of erysipelas. The total number of cases of illness in the Workhouse has been 679, including 1 of measles, 3 of hoopingcough, 39 of diarrhœa, 11 of erysipelas, and 9 of febricula. In addition to the above cases, there were 39 of syphilis and gonorrhœa; thus making a total of 718. Uncertified Deaths. No uncertified deaths are recorded during this Quarter. Meteorology of Greenwich; The Returns of the Registrar-General show that the rain-fall in the Metropolis during the Quarter, has been 7.99 inches. One inch deep of rain-fall on an acre weighs (allowing 10-lbs. to a gallon, which is the weight of a gallon ot distilled water) nearly 101 tons. During the corresponding Quarter of last year the rain-fall was 11.41 inches. The average annual rain-fall at Greenwich in sixty-three years was 25.4 inches. The mean temperature of the air was 61°.3. In the corresponding Quarter of last year it was 58°.2. The hottest days during the Quarter were Thursday, the 2nd September, Friday, the 3rd September, and Saturday, the 4th September, when the thermometer indicated respectively 82°.5, 85°.0, and 87°.2. The hottest day during the corresponding Quarter of last year was on Wednesday, the 30th July, when the thermometer indicated 80°.6. The highest mean temperature during any week in the Quarter was in that which ended September 4th, when it was 67°.3.3 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 perature of the air. Diarrhœa. Fever. Small-pox. From all causes. From Smallpox. From all causes. Inches. Degrees July 10 93 16 4 1326 0 47 0.29 59.0 „ 17 165 16 3 1441 0 38 0.33 63.1 „ 24 202 16 3 1482 0 37 0.34 63.7 „ 31 350 18 4 1746 0 39 1.84 62.2 Aug. 7 367 18 2 1698 0 60 0.72 60.2 „ 14 348 19 6 1670 0 51 0.15 63.8 „ 21 265 20 4 1492 0 39 0.00 63.8 „ 28 270 17 3 1488 0 45 0.10 62.7 Sept. 4 232 23 5 1460 0 34 0.00 67.3 „ 11 223 18 5 1391 0 38 1.51 62.8 „ 18 214 24 3 1438 0 43 2.31 55.7 „ 25 142 16 5 1441 0 48 0.19 56.4 Oct. 2 110 17 2 1353 0 37 0.21 56.6 It will be seen from the above Table that the deaths from diarrhœa in London have been during the Quarter 2,981; and the greatest weekly numbers of such deaths occurred in the weeks ended July 31st, August 7th, and August 14th, while the mean temperature in each of those weeks was respectively 62°.2, 60°.2, and 63°l,; the deaths from diarrhoea were in each of those weeks respectively 350, 367, and 348, while in the week ended September 4th, when the mean temperature of the air was 67°.3, the deaths from diarrhoea were only 232. This shows that the large mortality from diarrhoea in the lastnamed weeks, was owing to other causes than the higher temperature of the atmosphere. The largest excess of cases of diarrhœa was manifested in the east, north, and south registration Districts. 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 Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination. Registd. December, 1878 258 4 26 — 284 4 638 March, 1879 273 1 37 — 310 1 753 June 539 24 25 — 564 24 656 September 464 2 27 — 491 2 658 December 373 — 33 — 406 — 655 April 3rd, 1880(14weeks) 380 2 31 — 411 2 846 June 533 — 25 — 558 — 676 September 387 6 15 - 402 6 590 Totals 3207 39 219 — 3426 39 5472 Quarterly Return of Small Pox and Fever Cases and Deaths in the Asylum Board Hospitals, June 30th to September 30th. FEVER.—18 Admitted. Wo- Chil- Men. men. dren. Total. North District 1 1 0 2 South District 1 3 12 16 *18 Of these 18*— 5 were admitted from Boys' Home, 86, Leman Street. 5 were admitted from London Hospital. (4 being non-resident in Union,) 1 Died. Mary A. Bannister, Aged 6, from 107, New Road. SMALL POX.—7 Admitted. Wo- Chil- Mcn. men. dren. Total. North District 0 0 2 2 South District 2 0 3 5 *7 * Of these 7— 3 were sent per London Hospital, and were non-resident in Union. 2 Died. Thomas Booth, Aged 38, from "Rose and Crown" P.H., Queen Street, Tower Hill. Charles Miller, Aged 2½, from London Hospital, (late of 25, Duke Street. North Street, Bethnal Green.) Fever. In the term fever are included cases of typhus, typhoid or enteric, and continued fever. These three divisions of fever, although for many years were well known to Dr. Murchison and other scientific physicians, were returned to the local registrars of death as simply 8 deaths from fever, and they appeared in the Returns of the RegistrarGeneral under the head typhus; but since the year 1869 the Registrar-General has made a distinction in his weekly returns of births and deaths, and records the deaths from fever under the separate headings above mentioned. It appears from the later returns of the Registrar-General that the deaths from typhoid or enteric fever are far more numerous than those from typhus, or from continued fever. In the Quarter ended October 2nd, the deaths from typhus in London were 17, and from continued fever 39, while the deaths from typhoid fever were 184. In the Report of Dr. Collie, the Medical Superintendent of the Fever Hospital at Homerton, there were 9 cases of typhus admitted during the year. Of these, 3 died. Of enteric fever there were 143 cases and 18 deaths. Although it is a matter of great importance to medical practitioners engaged in the treatment of disease, to distinguish one kind of fever from another, it is not of the same practical importance to the Medical Officer of Health, whose duty it is not to treat disease but to ascertain the causes of disease, and take such measures as, in his judgment, will prevent their occurrence, and, when existing, to stop their extension. It is generally admitted that the emanations from filth, in its various forms, are the chief causes of fever, whether such emanations arise from visible filth as is frequently found in the surroundings of the densely inhabited places of the poorer classes, or from the effluvia of drains, or from the effluvia which are given off from human beings who are crowded in houses that are not sufficiently ventilated, or from the emanations arising from the alvine excretions of those suffering from fever. With the view, therefore, of preventing the occurrence of fever, it is clearly the duty of the sanitary officers to see that all the streets—particularly the bye streets—are cleansed daily by the scavengers—to frequently inspect the interior of all tenemented houses, to see that the rooms and staircases are clean—that the back yards are free from any accumulation of filth, and are properly paved and drained—that the privies are provided with pans and traps, and that they are always kept clean—that all the drains in the house and yard are so trapped that effluvia cannot escape from them—that the cistern for holding the water supply is clean, and is free from all sources of contamination—that no room in the house is overcrowded, that is to say, that every person living in a room has a space of at least 300 cubic feet. In all cases of a person suffering from small-pox, scarlet-fever, diphtheria, typhus, enteric fever, and cholera, when not properly lodged, to cause such patients to be removed to a 9 hospital. If the patient cannot be removed to a hospital, then he should be so isolated that only the person acting as nurse should remain in the room of the sick person, and that all the excretions of the patient should be, so soon as passed, submitted to the action of a disinfecting solution and removed from the room as quickly as possible; and that, so soon as practicable, the room, bedding, and clothing, which have been used by the patient, should be thoroughly disinfected. There appears to me to be no practical advantage in saying that one kind of fever is more contagious than another; it may be so; but as all those diseases above enumerated are contagious, the same mode of preventing the spreading of them, with, perhaps, some modifications, should be adopted. As enteric fever is now prevalent in London, and elsewhere, it is my intention, in all cases of that disease which come under my notice, to cause such means to be adopted as will destroy the germs, or contagium, of the disease. The germs are said to be minute living organisms, and are supposed to be the principal agent in producing disease. Mr. Simon, in the note at page 25, in his Supplementary Report to the Local Government Board, dated 29th July, 1874, speaks of small-pox, diphtheria, scarlet-fever, and enteric fever, as dangerously infective diseases, and adds that, every tangible discharge which passes from the patient, every sheet, or towel, or handkerchief, which any discharge from him has fouled, should be so treated as to prevent the spreading of his infection. It is now universally admitted by the more eminent medical practitioners, that the discharge from the bowels of patients suffering from enteric fever have, in innumerable instances, been the apparent cause of the spreading of that disease. In dealing with the best means of preventing contagious diseases, it is necessary that the kindly co-operation of the medical profession should be solicited by the District Medical Officer of Health, in carrying into effect those measures of prevention which experience has pointed out to be the best. I believe that the best way of Medical Officers of Health obtaining the co-operation of the medical profession, in dealing with contagious diseases, is for the Medical Officer of Health to be independent of private practice; for, unless that be the case, it can hardly be expected, in every case, that the cordial co-operation of the medical profession will be given. It is, however, most desirable in the interest of the public health, that the District Medical Officer of Health should be furnished, as early as possible, with the fact of 10 the existence of contagious disease, and the locality where such disease is to be found. Mr. Simon, at page 5 of report above quoted, states that, the deaths which are in each year registered in this country (now about half a million), are, on a rough estimate, fully 125,000 more numerous than they would be if the existing knowledge of those who have studied the chief causes of diseases, as affecting masses of the population, were reasonably well applied throughout England. "Looking at England as a whole, we see from the Reports of the Registrar-General, that of each 100 persons who die, not quite 10 have reached the standard old age of seventy-five years; and that of each 100 children born, hardly 74 complete five years of life. This rate of mortality varies in the different registration districts. In some of the Districts the death-rate of infants ranges from 8 to 12 per cent., while in others, it ranges from 19 to 30 per cent., and, as a whole, the infant death-rate of England stands at the high average of 18 per cent. Taking the death-rate of the population at all ages living, we find that the average death-rate is about 22½ per 1,000 per annum, while the local death-rate ranges from 13 to 17 to 30 and upwards per 1000." It is surely worth while for all persons, and especially those in authority, to make themselves acquainted with these facts, and endeavour to learn the reason why the death-rate should be in some Districts so much in excess of that in others, and so to use the powers intrusted to them for the purpose of promoting the public health, that the death-rate in the unhealthy Districts may become diminished. Sanitary measures, in their full efficiency, will, I am afraid, not be carried out until the public mind is thoroughly imbued with the importance of them, and for this purpose they must be instructed in the laws of public and of individual health. The expense involved in carrying out sanitary improvements is, however, the main hindrance to their adoption. Privies in Poor Neighbourhoods. Although it is essential that the privies in use in the poorer localities should be provided with pans and traps, it is not at the present time desirable that the usual water supply apparatus which is in use in the better class of houses in which only one family resides should be adopted, but it will be found to be infinitely preferable to flush the pans with pails of water once or twice a day, or oftener, if required, for the purpose of thoroughly cleansing them, and for the prevention of the choking of the drains. This plan of cleansing the pans and drains has been practised in this District for many years, and has very satisfactorily answered 11 the intended purpose. The ordinary water supply apparatus for closets frequently gets out of order, and when that is the case, it causes a most disgusting and dangerous nuisance, and is, therefore, an ineligible form of closet for those who are unlikely to take proper care of it, or are, from poverty, unable to afford the expense of properly repairing it. While on this subject it may not be out of place to allude to the position of the water-closets in the large buildings which are now in the course of erection on a large scale for the artizan class; these conveniences ought never to be placed where they cannot have two outside windows, opposite each other, for the purposes of light and ventilation. "They ought, if possible, to stand as projections from the body of the house, and with windowed lobbies dividing them from it." Reports of the Sanitary Inspectors on the Registered Common Lodging Houses in Spitalfields, and on the Houses let out in Tenements in Flower-and-Dean Street, and Upper and Lower Keate Street. Board of Works, whitechapel District, Inspector's Department. To the Committee of Works. Gentlemen,—At the Meeting of the Committee of Works, held on Thursday, the 15th day of July last, it was resolved, that your Inspectors should make an inspection of all the Registered Common Lodging Houses situated within the Parish of Spitalfields. In accordance with such resolution we respectfully present to your Committee the following Report:— The number of Registered Common Lodging Houses in the Parish of Spitalfields, is 109, containing 454 rooms; such rooms being registered to accommodate 3,992 lodgers. We discovered no case of overcrowding. The bedding was clean; the yards and closets were in a good sanitary condition; there was a good water supply, and the walls and ceilings of the houses were clean. Each room, with the exception of two or three, had a ticket hung on the walls, showing the number of the room, and the number of lodgers such room is registered to accommodate. In 1876, we made a special inspection of the whole of the Registered Common Lodging Houses in the District—167 in all; a large number of which were then found to be overcrowded, that is to say, there was less than 300 cubic feet of space for each lodger. This fact was brought under the notice of the Commissioners of Police by your Medical Officer ; and the Commissioners directed 12 the said rooms to be re-measured, and the number of lodgers to be so reduced as to allow, as nearly as possible, 300 cubic feet of space to each lodger. We failed to learn (although we made inquiries at every lodginghouse) that any respectable mechanic, with his wife and family, ever applied at these houses for lodging accommodation. The class of persons occupying these houses are chiefly dock and wharf labourers, street hawkers, and prostitutes. Very few children were found in these houses, and, so far as we could learn, a birth was of rare occurrence in them; but when women were near their confinement, they went into the workhouse to be confined, and afterwards they returned to their lodgings. In conclusion, we think it right to state that the houses are in a much better condition now than they were in 1876. We are, Gentlemen, Your obedient Servants, ISAAC BATTRAM, RICHARD SKIDMORE WRACK, Inspectors. 9th Sept., 1880. Board of works, Whitechapel District, Inspectors Department. To the Committee of Works. Gentlemen,—In continuation of the report submitted to your Committee on the 9th September instant, on the condition of the Registered Common Lodging Houses in Spitalfields, signed by myself and Mr. Wrack, I have to state that I have made an inspection of all the private houses, or houses let in apartments, in the undermentioned streets, namely—Flower and Dean Street, Upper Keate Street, and Lower Keate Street. The houses, 38 in number, contain 143 rooms, and are occupied by 298 persons; 210 adults and 88 children. I discovered 4 cases of overcrowding only, 2 in Flower and Dean Street, and 2 in Lower Keate Street. The interior condition of these houses is not good, they are worn out, and many of the walls and ceilings are dirty and dilapidated. The greater portion of these houses have been condemned under the Artizans and Labourers Dwellings Act, and three of their number, 5, 7, and 8, Lower Keate Street, should either be taken down, or at once closed, as they are in such a dirty and dilapidated condition. The houses in Keate Court and Wilson's Place, are in a similar state, and should also be taken down at once. 13 The houses in which overcrowding exists are those occupied by the poorer class of foreigners who are to be found in all parts of the District. I made inquiries but could find no case where a respectable mechanic had ever applied for lodging in the houses. I am, Gentlemen, Your obedient Servant, ISAAC BATTRAM, 23rd September, 1880. Sanitary Inspector, Sanitary Works Performed during the Quarter ended 2nd October, 1880. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 2nd October, 1880. Number of inspections of houses as shown in the official returns 2275 Houses specially visited 427 House specially re-visited 1708 Preliminary notices served, such notices embracing 314 premises 192 Compulsory ordeps issued, embracing 172 premises 41 Summonses heard at Police Courts, under Sanitary Act 1 „ under Act for the prevention of Adulteration of Food, &c. 2 Cellars used as dwellings discontinued for such use 0 Cases of overcrowding and indecent occupation abated 5 Houses in which rooms or passages have been whitewashed 122 Rooms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet-fever therein 34 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the Apparatus 722 Yards of houses paved, or the pavement repaired 42 Drains in houses improved 61 Dust-bins provided 8 Privies lime-washed, cleansed and repaired 85 Water supply provided or improved 11 Nuisances from dung and other offensive matter removed 30 Area gratings, cellar flaps, &c., repaired 26 Animals (pigeons, fowls, geese, and 1 pig) kept so as to be a nuisance, removed 72 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, 15, Great Alie Street, JOHN LIDDLE. APPENDIX. TABLE I.—Cases of Sickness of the Zymotic and Acute Classes, which are recorded in the Books of the Medical Officers of the Union, for the Three Months ended on the 2nd October, 1880. 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. Pleuritis and Pneumonia. Dr. Swyer 0 4 0 0 21 0 0 5 0 3 0 0 8 0 0 3 0 0 0 1 119 164 Mr. Champneys 1 0 1 0 29 0 0 1 0 0 0 0 40 0 1 11 0 0 0 2 238 324 Mr. Sequeira 0 1 4 1 12 0 1 19 0 3 0 0 20 2 0 2 0 0 0 0 82 147 Mr. H. Braye 1 0 3 1 12 0 0 4 0 1 0 0 19 1 0 1 0 0 1 1 102 147 Mr. Loane 0 0 0 0 4 0 0 2 0 2 0 0 3 0 0 1 0 0 0 0 27 39 Totals 2 5 8 2 78 0 1 31 0 9 0 0 90 3 1 18 0 0 1 4 568 821 Corresponding Qr. of previous Year. 7 35 31 11 38 0 4 28 0 2 0 0 75 6 0 19 0 0 0 7 604 867 Workhouse Mr. J. J. Ilott. 0 1 0 3 39 0 0 9 0 11 0 0 49 17 4 49 2 3 7 3 482 679 In addition to the cases of illness in the Workhouse, which are above recorded, there were 39 cases of syphilis and gonorrhœa. TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 2nd October, 1880. Sub-districts. Small-Pox. Measles. Scarlet Fever Diphtheria. HoopingCough. Diarrhœa. Fever. Cholera & Choleraic Diarrhœa. Total. Remarks. Spitalfields 0 1 2 1 4 19 2 0 29 Mile End New Town 0 0 2 0 1 18 0 0 21 Workhouse. Whitechapel North 0 1 2 0 1 7 1 0 12 Whitechapel Church 0 2 2 2 0 5 1 0 12 Hospital. Goodman's Fields 0 0 1 1 1 18 0 0 21 Aldgate 0 0 0 0 0 3 0 0 3 Totals 0 4 9 4 7 70 4 0 98 Deaths from Epidemics for the corresponding Quarter, 1879. 1 12 30 3 17 46 5 0 114 Two deaths from small-pox, of patients sent from this District, occurred in the Small-Pox Hospital. One death from fever occurred in the Fever Hospital of patients sent from this District, thus making 5 deaths from fever. The number of small-pox patients sentfrom this District was 7, and of fever 18. 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 2nd October, 1880. 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 183 110 41 28 15 5 11 5 Mile End New Town 15550 150 127 37 16 33 0 9 68 Whitechapel North 11597 85 48 21 8 8 0 1 0 Whitechapel Church 7322 60 195 17 34 15 22 25 158 Goodman's Fields 10381 78 52 15 17 5 2 4 0 Aldgate 9224 34 24 7 6 3 5 6 0 Totals 76573 590 556 138 109 79 34 56 231