WHI 31 BOARD OF WORKS, Whritechapel District. REPORT on the SANITARY CONDITION OF THE WHITECHAPEL DISTRICT, FOR THE QUARTER ENDED 31st MARCH, 1883, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Printed br Penkt & Hull, 53, Leman St., Whiteohapel, E. 1883. REPORT of the MEDICAL OFFICER OF HEALTH, For the Quarter ended, 31 st March, 1883. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 3lst March, 1883, the total births in the District were 634, viz.: 334 males and 300 females ; and the deaths 598, viz.: 333 males and 265 females. The excess of births over deaths has therefore been, during the Quarter, 36. As the deaths of 150 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 448, and thus increasing the number of births above deaths to 186. 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 656. The weekly average of births was 49.5 and of deaths 50.4 ; and in the present Quarter the weekly average of births has been 48.7, and of deaths 46-0. In the Spitalfields sub-Distri£t the births were 179 and the deaths 86; in the Mile End New Town 188 and the deaths 170 (in this sub-Districft the Workhouse is situated); in the Whitechapel North 84 and the deaths 40 ; in the Whitechapel Church 65 and the deaths 243 (in this sub-District the London Hospital is situated) ; in the Goodman's Fields 78 and the deaths 37 ; and in the Aldgate 40 and the deaths 22. The deaths have exceeded the births in the Whitechapel Church sub-District by 178, but the deaths of the 150 nonresidents in the London Hospital must be deducted. The proportion of births to deaths is therefore 65 to 93. 4 The deaths in the London Hospital have been 217 ; of these 150 were of non-residents in the District, 21 of residents, and 46 of persons who either died suddenly or from the result of accident. The deaths of persons who resided in the 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 to non-residents in this Quarter is 14.0 per cent. The deaths in the Workhouse Infirmary, Baker's Row, have been 91. In the corresponding Quarter of last year they were 114. Four deaths occurred in the Metropolitan Free Hospital, which is situated in the Spitalfields sub-District, 3 were residents and 1 non-resident. The deaths from epidemic diseases in the entire District have been 28, viz.: 10 from measles, 2 from scarlet fever, 5 from diphtheria, 3 from hooping-cough, 5 from diarrhoea, and 3 from fever. To this number must be added 1 who died of fever in the Fever Hospital; and 1 who died at the Small Pox Hospital ; thus making a total of 30 deaths from epidemic diseases. In the corresponding Quarter of the previous year, the deaths from epidemic diseases were 92, viz.: 3 from small-pox (including 2 which occurred in the Small-pox Hospital), 4 from measles, 7 from diphtheria, 59 from hooping-cough, 10 from diarrhoea, and 9 from fever (including 2 which occurred in the Fever Hospital). Mortality of Young Children. The mortality of children under one year of age is 108. This is 18.0 per cent, of the total mortality. In the corresponding Quarter of the previous year it was 16.0 per cent. In the Spitalfields subDistrict the rate is 29.0 per cent.; in the Mile End New Town 22.3 per cent.; in the Whitechapel North 30.0 per cent. ; in the Whitechapel Church 7.3 per cent. ; in the Goodman's Fields 32.4 percent.; and in the Aldgate 9.0 per cent. The difference of 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 during the Quarter are 199, which shows a rate of mortality of 31.6 per cent, in relation to the total deaths, including those of non-residents, and 31.3 percent, to the total births. The rate of mortality under 1 year, in relation to the total births, is 17.0 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the past Quarter, 1023 new cases ol illness out of the Workhouse ; including 1 of small-pox, 12 of measles, 3 of hooping-cough, 7 of diarrhoea, 2.5 of febricula, and 4 of erysipelas. In the corresponding Quarter of the previous year the number of pauper cases of illness was 1066; including 0 of small-pox, 3 of measles, 24 of hooping-cough, 8 of diarrhoea, 9 of fever, 24 of febricula, and 7 of erysipelas. The total number of cases of illness in the Workhouse has been 1033 ; including 11 of diarrhoea, 3 of fever, 9 of erysipelas, and 11 of febricula. In addition to the above cases, there were 40 of syphilis and gonorrhoea ; thus making a total of 1073. Uncertified Deaths. Nine uncertified deaths are recorded during the Quarter. Three are returned in the Mile End New Town sub-Distri(ft, 3 in the Whitechapel North sub-District, 1 in the Whitechapel Church subDistricft, and 2 in the Goodman's Fields sub-Distriift. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the Quarter has been 5.47 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 3.63 inches. The mean temperature of the air was 40.0. In the corresponding Quarter of last year it was 42.6. The coldest days during the Quarter were Friday, 9th March, Saturday, 10th March, and Saturday, 24th March, when the thermometer indicated respectively 23.4°, 22.6°, and 20.6°. The lowest mean weekly temperature was for the week ended 10th March, which was 27.4° ; last year it was 34.20. The coldest days during the corresponding Quarter of the previous year were Thursday, the 2nd February, Wednesday, the 25th January, and Saturday, the 4th February, when the thermometer indicated respectively 24.8°, 25.4°, and 25.7°. The results of the meteorological observations are to be understood as applying to the civil day, or from midnight to midnight. 6 Table of Weekly Mortality, &c., in London and in the Whitechapel District. Week ENDED Deaths in London. Deaths in Wchpl. District Rainfail. Inches. Mean I'em- perature of the air. Degrees From Diarrhcea and Dysentery. From Fever. From Small-pox. From all causes. From Smallpox. From all causes. Jan. 6 15 25 5 1556 0 56 0.42 46.2 „ 13 12 15 7 1567 0 44 0.07 38.3 „ 20 18 20 3 1663 0 47 0.56 42.9 „ 27 13 20 8 1548 0 48 0.38 38.9 Feb. 3 19 19 5 1643 0 47 0.83 40.3 ,, 10 14 20 2 1631 0 50 1.24 42.7 „ 17 15 30 3 1525 0 42 0.64 42.9 „ 24 12 20 6 1554 0 43 0.54 42.8 Mar. 3 12 18 7 1590 0 29 0.14 43.0 „ 10 9 14 2 1648 0 41 0.15 33.8 „ 17 18 21 1 1854 0 43 0.09 34.7 „ 24 18 16 3 1887 0 45 0.32 35.1 „ 31 17 32 0 2148 0 63 0.09 38.6 Return of Cases sent to Fever and Small-pox Hospitals durin g the Quarter ended Lady-Day, 1883. FEVER. Men. Women. Children. Total North District 2 1 0 3 South „ 0 0 2 2* * Both these were from the London Hospital and non-resident. SMALL POX. Men Women. Children. Total North District 1 0 1 2 South 2 0 1 3* * These were all from the London Hospital and non-resident. Only death from Fever : Hannah Welch, 3, Hanover Place, Brick Lane. Only death from Small-pox : Jonathan Field, 5, Quaker Street, Spitalfields. FEVER Cases sent from the Whitechapel Union Infirmary to the Fever Hospital, at Homerton, during the Quarter ended March 31st, 1883. Description of Fever. Where Admitted from. Length of time in the Infirmary. Whether Patient had Fever on admission. Date of sending to Fever Hospital. Enteric 11, Flower-andDean Street 1 day Slightly. Jan. 15 Enteric South Grove Workhouse 19 days No. ,, 30 Typhus Refuge, Crispin Street 21 days No. Feb. 27 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 ended PUBLIC VACCINATOR workhodse. Totals. Births Reoistd. Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination Primary Cases. Re-Vaccination. June, 1881 582 250 49 150 631 400 674 September 371 34 34 420 405 454 536 December 394 4 25 179 419 183 578 March, 1882 360 17 31 145 391 163 644 June 513 f) 36 125 579 131 520 September 441 25 45 105 486 130 588 December 328 2 33 135 361 137 617 March, 1883 409 6 25 160 434 166 634 Totals 3428 344 278 1420 3706 1764 4841 The subjoined excerpt taken from a Report of Mr. Wrack, addressed to the Board of Works, and dated 23rd of April, 1883, exemplifies in a striking manner the necessity of providing a new and efficient Building Acft as shall prevent the erection of unhealthy houses. " A block of dwellings has recently been erected (within the last two years), partly in Commercial Street, and partly in Shepherd Street, Spitalfields, and are named Shepherd's Buildings. These premises are five storeys high ; the ground floor is occupied as shops, and the five floors above are divided into 89 separate tenements, of which 34 consist of two rooms each and 5 of one room, making a total of 73 rooms, 20 of which were empty at the time of my visit. These tenements, consisting of 53 rooms, are occupied by 151 persons, viz. 59 adults and 92 children. The sanitary arrangements of these buildings are very unsatisfactory, for there is no yard or open space for the use of the occupiers. The water-closets, 14 in number, are placed in the passages on the several floors and adjoining the rooms. The want of light renders eight of these rooms totally unfit for human habitation, and a notice was served upon the owner a short time ago respecting the same and they have since been closed. Mr. Wrack further says that on a bright clear day when he visited these rooms, the occupiers were obliged to resort to the light of candles and lamps to enable them to perform their domestic work. 8 The superficial area of the building is about 323 square yards, which affords only 2.1 square yards for each person ; but if the twenty empty rooms were occupied the superficial area would be much less." Mr. Wrack further reports upon the condition of the premises known as Plough Street Buildings, Whitechapel. The ground floor of the place is occupied as shops ; the other part of the building is divided into 42 tenements which consist of 83 rooms ; four of the rooms were empty at the time of his visit, the remaining 79 rooms are occupied by 178 persons, viz. 91 adults and 87 children ; the tenants are of the lower order of foreigners and are very dirty. There is no yard or open space to the Building, several of the rooms are so dark as to render them unfit for habitation, and some of the passages are also dark. There are 21 water closets which are placed in the several passages adjoining the rooms. The place generally is in a very dirty condition. The superficial area of the same is about 418 square yards which gives 2.3 yards for each person. The construction of the Building is similar to that in Shepherd's Buildings, Spitalfields, and has been built about four years. Sanitary Works Performed during the Quarter ended 31st March, 1883. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 31st March, 1883. Number of inspections of houses as shown in the official returns 2630 Houses specially visited 217 Houses specially re-visited 868 Preliminary notices served, such notices embracing 242 premises ls8 Compulsory orders issued, embracing 60 premises 36 Summonses heard at Police Courts, under Sanitary Act 0 Summonses under Act for the prevention of Adulteration of Food, &c 2 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 83 Rooms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet-fever therein 20 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the Apparatus 778 9 Yards of houses paved or the pavement repaired 24 Drains in houses improved 58 Dust-bins provided 9 Privies lime-washed, cleansed, and repaired 78 Water-supply provided or improved 5 Nuisances from dung and other offensive matter removed 42 Area-gratings, cellar-flaps, &c., repaired 13 The cow-houses in the District, 24 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 31st March, 1883. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic-Diarrhoea. Continued Fever, Typhus & Typhoid. Febricula. Pycemia. Erysipelas. Puerperal Fever. Croup. Acute Pulmonary Inflammation. Carbuncle. Bheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. Total. Bronchitis and Catarrh. Pleuiitis and Pneum onia. Mr. Champneys 1 4 0 0 3 0 0 18 0 4 0 1 120 0 0 6 0 0 0 0 480 637 Mr. Sequeira 0 5 0 3 2 0 0 7 0 0 0 0 38 0 0 9 0 0 0 0 243 307 Mr. Loane 0 3 0 0 2 0 0 0 0 0 0 0 26 0 0 5 0 0 0 0 43 79 Totals 1 12 0 3 7 0 0 25 0 4 0 1 184 0 0 20 0 0 0 0 766 1023 Corresponding Qr. of previous Year. 6 3 0 24 8 0 9 24 0 7 0 0 219 3 0 0 0 0 0 5 758 1066 Workhouse Mr. J. J. Hott. 0 0 0 0 11 0 3 11 0 o 0 0 19g 29 3 134 0 0 5 0 632 1033 In addition to the cases of illness in the Workhouse, which are above recorded, there were 45 cases of syphilis and gonorrhoea. 11 TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 31st March, 1883. Sub-diutricts. Small-Pox. Measles. Scarlet Fever Diphtheria. HoopingCough. Diarrhcea. Fever. Cholera & Choleraic Diarrhoea. Total. Remarks. 0 2 0 2 1 3 2 0 10 Workhouse. Mile End New Town 0 1 0 0 1 1 1 0 4 Whitechapel North 0 4 0 1 0 0 0 0 5 Whitechapel Church 0 0 1 2 0 1 0 0 4 Hospital. Goodman's Fields 0 2 0 0 1 0 0 0 3 Aldgate 0 1 1 0 0 0 0 0 2 Totals 0 10 2 5 3 5 3 0 28 Deaths from Epidemics for the corresponding Quarter, 1881. 1 4 0 7 59 10 7 0 88 One death from small-pox, of a patient sent from this District, occurred in the Small-pox Hospital. One death from fever occurred in the Fever Hospital of a person belonging to this District, thus making a total of 4 deaths from fever. TABLE III. Showing Sub-districts, Enumerated Population, Total Births, and Deaths from all cause3— 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 31st March, 1883. Sub-districts. Enumerated Population in 1881. j 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 22585 179 86 25 14 15 3 10 4 Mile End New Town 15473 188 170 38 16 43 5 18 91 Whitechapel North . 10001 84 40 12 12 3 1 4 0 Whitechapel Church 7489 65 243 19 29 37 44 49 217 Goodman's Fields 9713 78 37 12 14 5 1 4 0 Aldgate 6102 40 22 2 6 1 0 2 0 Totals 71363 634 598 108 91 104 54 87 312 BOARD OF WORKS, Whitechapel District. REPORT on The SANITARY CONDITION OF THE WHITECHAPEL DISTRICT, FOR THE QUARTER ENDED 29TH SEPTEMBER, 18837 BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: furnted br Penny & Huli, 63, Leman St., Whitechapel, E. 1883. REPORT of the MEDICAL OFFICER OF HEALTH, For the Quarter ended 29th September, 1883. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 29th September 1883, the total births in the District were 590, viz.: 283 males and 307 females; and the deaths 534, viz.: 304 males and 230 females. The excess of births over deaths has therefore been, during the Quarter, 56. As the deaths of 141 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 393, and thus increasing the number of births above deaths to 197. 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 588, and the total deaths 550. The weekly average of births was 45.2 and of deaths 42.3 ; and in the present Quarter the weekly average of births has been 45.3, and of deaths 41.0. In the Spitalfields sub-Distridt the births were 184 and the deaths 75; in the Mile End New Town 171 and the deaths 135 (in this sub-Distridt the Workhouse is situated) ; in the Whitechapel North 73 and the deaths 37 ; in the Whitechapel Church 48 and the deaths 222 (in this sub-District the London Hospital is situated); in the Goodman's Fields 80 and the deaths 38 ; and in the Aldgate 34 and the deaths 27. The deaths have exceeded the births in the Whitechapel Church sub-District by 174, but the deaths of the 141 nonesidents in the London Hospital must be deducted. The proportion of births to deaths is therefore 48 to 81. 4 The deaths in the London Hospital have been 195 ; of these 141 were of non-residents in the District, 26 of residents, and 28 of persons who either died suddenly or from the result of accident. The deaths of persons who resided in the 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 to non-residents in this Quarter is 18.4 per cent. The deaths in the Workhouse Infirmary, Baker's Row, have been 58. In the corresponding Quarter of last year they were 76. Four deaths occurred in the Metropolitan Free Hospital, which is situated in the Spitalfields sub-District; 1 was a resident, and 3 were non-residents. The deaths from epidemic diseases in the entire District have been 95, viz.: 1 from small-pox, 25 from measles, 9 from scarlet fever, 3 from diphtheria, 3 from hooping-cough, 46 from diarrhoea, and 8 from fever. To this number must be added 1 who died at the Small Pox Hospital; thus making a total of 96 deaths from epidemic diseases. In the corresponding Quarter of the previous year the deaths from epidemic diseases were 79, viz.: 16 from measles, 5 from scarlet fever, 5 from diphtheria, 14 from hooping-cough, 37 from diarrhoea, and 2 from fever. To this number must be added 3 who died of smallpox in the Small Pox Hospital, and 4 who died of fever in the Fever Hospital. Mortality of Young Children. The mortality of children under one year of age is 117. This is 21.9 per cent, of the total mortality. In the corresponding Quarter of the previous year it was 21.4 per cent. In the Spitalfields subDistrict the rate is 29.3 per cent.; in the Mile End New Town 34.8 per cent.; in the Whitechapel North 43.2 per cent. ; in the Whitechapel Church 6.3 per cent. ; in the Goodman's Fields 28.9 percent.; and in the Aldgate 25.9 per cent. The difference of 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 Ihe total deaths under 5 years during the Quarter are 218, which shows a rate of mortality of 40.8 per cent, in relation to the total deaths, including those of non-residents, and 36.9 per cent, to the total births. The rate of mortality under 1 year, in relation to the total births, is 18.8 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the past Quarter, 718 new cases of illness out of the Workhouse; including 1 of small pox, 30 of measles, 9 of scarlatina, 1 of hooping-cough, 31 of diarrhcea, 48 of fever, 9 of febricula, and 2 of erysipelas. In the corresponding Quarter of the previous year the number of pauper cases of illness was 780 ; including 5 of small-pox, 19 of measles, 7 of scarlatina, 15 of hooping-cough, 30 of diarrhoea, 2 of fever, 33 of febricula, and 9 of erysipelas. The total number of cases of illness in the Workhouse has been 721; including 22 of diarrhoea, 7 of erysipelas, and 1 of febricula. In addition to the above cases there were 30 of syphilis and gonorrhoea ; thus making a total of 751. Uncertified Deaths. One uncertified death is recorded during the Quarter, which is returned in the Spitalfields sub-Distxidt. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the Quarter has been 6.27 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 6.00 inches. The mean temperature of the air was 59.6. In the corresponding Quarter of last year it was 59.2. The hottest days during the Quarter were Monday, 13th August, Monday, 20th August, and Tuesday, 21st August, when the thermometer indicated respectively 83.3°, 81.9°, and 85.1°. The highest mean weekly temperature was for the week ended 25th August, 78.9° ; last year it was 74.1°. The hottest days during the corresponding Quarter of the previous year were Wednesday, 2nd August, Saturday, 12th August, and Sunday, 6th August, when the thermometer indicated respectively 80.0°, 80.6°, and 81.0°. The results of the meteorological observations are to be understood as applying to the civil day, or from midnight to midnight. Table of Weekly Mortality, &c., in London and in the Whitechapel District. Week ended Deaths in London. Deaths in Wchpl. District Painfull. Inches. Mean Temperature of the air. Degrees From Diarrhoea and Dysentery- From Fever. From Small-pox. From all causes. From Smallpox. From all causes. July 7 167 11 1 1521 0 40 0.12 64.3 „ 14 325 18 0 1736 0 37 0.87 61.4 „ 21 351 11 0 1781 0 47 0.44 56.0 „ 28 254 16 6 1605 0 48 0.41 57.4 Aug. 4 168 7 1 1465 0 42 0.22 60.6 „ 11 94 16 2 1312 0 30 1.28 59.4 „ 18 119 12 2 1437 0 47 0.07 62.3 „ 25 63 19 1 1356 0 56 0.01 64.0 Sept. 1 74 23 4 1292 0 34 0.36 62.5 „ 8 87 36 1 1257 0 41 0.81 54.7 „ 15 62 31 1 1260 0 30 1.52 57.8 „ 22 54 25 2 1286 0 42 0.24 58.4 „ 29 61 17 2 1257 1 40 0.92 57.1 Fever and Small-pox Return for Quarter ended Michaelmas, 1883. SMALL POX. Men Women. Children Total North District 0 0 0 0 South „ 2 2 0 4* * Of these 3 were from the London Hospital and non-resident. 1 death—Thomas Rush. 32, Upper Constance street, West Ham. Fever Men. Women. Children. Total North District 0 0 5 5 South 1 1 15 17* * Of these, 8 were from the London Hospital and non-resident. 2 deaths Walter Doubleday, 6, George s gardens, Bethnal Green. James McArdell, 2, Norwich court, Upper East Smithfield. 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 durinff the same quarters. Quarter ended— PUBLIC VACCINATOR workhouse. Totals. Births Registd. Primary Cases. Re-Vaccination. Primary Cases. Re-Vaceination Primary Cases." Re-Vaccination. December, 1881 394 4 25 179 419 183 578 March, 1882 360 17 31 146 391 163 644 June 543 6 36 125 579 131 520 September 441 25 45 105 486 1-30 588 December 328 2 33 135 361 137 617 March, 1883 409 6 25 160 434 166 634 June 463 1 57 53 520 54 564 September 419 3 42 3 461 6 534 Totals 3357 64 294 906 3651 970 4679 7 The Unhealthy Condition of certain Newly-erected Premises in Booth Street, Spitalfields. Mr. Wrack, one of the Sanitary Inspectors of this District, having directed my attention to certain newly-erected buildings in Booth Street intended for habitation, I thought it expedient that a special Report should be made by him to me in writing on the general condition of the premises; and, in accordance with my direction, Mr. Wrack has written the subjoined memorandum on the subject:— TO THE MEDICAL OEFICEE OF HEALTH. Blocks of buildings have recently been erected in Booth Street, Spitalfields. These premises are three storeys high, and contain 230 rooms, which are occupied by about 700 persons. The space occupied by these buildings, with their appurtenances, is about 24,795 superficial feet. The water supply, -water-closets, sinks, wash-houses, and dust shoots from which the house refuse is discharged into bins in the yards, are placed on each floor for the use and convenience of the tenants. The occupiers are of the lower order of foreigners, who appear not to know the proper use of the conveniences which have been erected for their comfort, and they permit all the closets, sinks, and dust shoots to be constantly stopped up, from which offensive matter flows into the rooms and passages below, thereby causing not only serious damage to the property, but render the buildings unfit for human habitation. The nuisance caused by such carelessness became so serious that I have been compelled to visit the places almost daily, and to frequently communicate with the owners upon the subject, and to intimate to them that, unless means were adopted to prevent the nuisance complained of, legal proceedings would have to be taken to close the buildings. On the 8th instant I received a letter from Mr. Gundry, the surveyor of the property, asking me to meet him there on the following day to inspect the buildings and to consider what could be done to prevent the nuisance in question. The surveyor proposed to remove the water supply, water-closets, sinks, wash-houses, and dust shoots, and place such conveniences in the several yards. With regard to the water-closets, it is proposed to erect them on the trough system, which plan has been adopted with success in this District. It consists in placing what may be called, by way of distinction, " a trough closet," instead of the trap and pan system. It is fitted with an ordinary seat, placed over an iron or glazed earthenware trough nearly filled with water. The trough is so fixed as to afford a sufficient incline for it to be quickly emptied into the drain by the removal of a plug. When the trough is emptied it is immediately refilled with water. Each trough is provided with a pipe to prevent any overflow into the closets. The removing of the conveniences in question from the interior of the buildings and placing them in the yards, is, in my opinion, the best thing that can be done towards keeping the houses healthy and free from nuisance. As the forecourt of the buildings was, at one time, unpaved and undrained, I gave notice to the owners to pave and drain the same, which has been done. RICHARD SKIDMORE WRACK. 10th October, 1883. $ In my last two Quarterly Reports I brought the subject of certain newly-constructed unhealthy dwellings under your notice, and expressed my regret that, owing to defects in the law relating to buildings intended for habitation, there is inadequate security for healthy houses being built in the first instance. Indeed, 1 am strongly of opinion that no recently erected house should be allowed to be inhabited until certified by the Local Board to be fit for habitation, upon inspection and report by the Medical Officer of Health and Surveyor. In order that all the houses which are let out in tenements should be kept in a healthy condition, it will be necessary for the Sanitary Inspectors to present at each meeting of the Board a Report as to the general condition of such houses as may be found overcrowded, and whether free from nuisance of every kind. As the Local Board have an efficient staff of officers under their jurisdiction, all matters, in my opinion, relating to the health of the District, should be vested in these Boards, and they should be the appointed authority for the superintendence of all matters relating to the health of the District. Most important results may be anticipated from the operation of the several Artizans' and Labourers' Dwellings Acts, which have for their object not only the clearing away of filthy slums in crowded districts, but the building for the poorer classes of better and more healthy houses. I am decidedly of opinion that a frequent and periodical inspection of houses is required, in order that this desirable measure may be effectually carried out. In all tenemented houses, all the domestic conveniences should be placed outside the building. This is a matter which can only be dealt with by Act of Parliament. The Bell Lane Scheme, in respect to which in the year 1877 I made an official representation of its unhealthy condition, has recently been considered by the Metropolitan Board of Works with a view to its improvement; and it being deemed expedient that Mr. Wrack, the Sanitary Inspector, should make a further Report to the Metropolitan Board on the locality, he has presented to that Board the subjoined Report. BOARD OF WORKS, WHITECHAPEL DISTRICT. SANITARY DEPARTMENT. Artizans' and Labourers' Dwellings Improvement Act, 1875 BELL LANE SCHEME. Names of Streets, Courts, or Places. Number of Houses. Number of Rooms. Number of Families N umber of Occupiers. Number of Adults. Number of Childrn. Bell lane 39 206 20 shops 79 368 192 176 Bell court 7 14 6 28 14 11 Cobourg court 3 6 3 16 9 7 Raven row 7 40 4 shops 6 33 29 4 Artillery street 9 73 5 shops 21 90 57 33 Sandy's row 35 202 34 shops 56 274 160 114 Middlesex street 8 44 8 shops 10 45 36 9 Wentworth street 16 60 15 shops 16 99 48 51 Artillery passage 18 98 17 shops 27 153 88 65 Dinah's buildings 12 24 11 48 23 25 Tuson's court 9 24 11 62 28 24 Tripe yard 7 18 7 45 19 26 Lardner's buildings 10 25 11 49 34 15 Fisher's alley 12 46 17 87 48 39 Paradise place 2 5 3 13 9 4 Bull court 11 40 15 70 42 28 New court 15 45 14 69 41 28 Cobb's court 3 8 3 19 9 10 Cobb's yard 21 71 20 91 67 24 Parliament court 3 24 12 59 38 21 Rosetta's place 7 14 7 38 14 24 Frying-pan alley 10 49 18 85 44 41 Little Montague street 7 21 8 34 23 11 Short street 7 24 7 38 25 13 Cox's square 20 76 1 shop 50 203 111 92 Totals 298 1257 438 2106 1208 898 The population of the area at the present time is, as above-stated, 2,106. In 1877 it was 2,307. There are now forty empty rooms within the area, and several ground floor rooms have recently been converted into shops, which accounts for the reduction of the population. The total number of shops in the area is 104. In addition to the 298 houses in the area, there are the Jews' Free Schools, which have been recently erected, the London General Omnibus Company's Yard and Stables, and other buildings. RICHARD SKIDMORE WRACK, 18th Octobee, 1883. Sanitaey Inspector. 10 Several schemes for the improvement of this District, under the Artizans' and Labourers' Dwellings Acts, have, since 1875, been submitted by this Board to the Metropolitan Board of Works, and have resulted in the removal of extensive areas of uninhabitable houses, and in the present or prospective provision of improved dwellings for the poor. While, however, expressing my great satisfaction that so much in the way of improvement has been adopted by the Metropolitan Board, it is matter for regret on my part that the Board has omitted to take into their consideration the Great Pearl Street Scheme; but I am not without hope that it will yet receive that attention which it certainly deserves. The area contains 8650 square yards, and comprises courts and houses of a very unhealthy character, and has a population of about 1050. The death-rate is 33.3 per 1000, while, during the same period, the death-rate for the whole District was 26.4 per 1000. According to the evidence of Dr. Swyer, the Medical Officer of the Union, who had the superintendence of that portion of the Parish of Spitalfields, the diseases which prevailed among the children living in that locality were of a very low type, such as scrofula and mesenteric disease. The names of the localities in this unhealthy distridt are Great Pearl Street, Little Pearl Street, Vine Court, Vine Yard, Crown Court, New Court, Wilk Court, Half Wilk Court, Diamond Court, and a portion of Grey Eagle Street. Sanitary Works Performed during the Quarter ended 30th September, 1883. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 30th September, 1883. Number of inspections of houses as shown in the official returns 2279 Houses specially visited 283 Houses specially re-visited 1132 Preliminary notices served, such notices embracing 275 premises 184 Compulsory orders issued, embracing 87 premises 33 Summonses heard at police courts under Sanitary Act 0 Summonses under Act for Prevention of Adulteration of Food, &c a Cellars used as dwellings discontinued for such use 2 Cases of overcrowding and indecent occupation abated 0 Houses in which rooms or passages have been whitewashed 156 11 Rooms 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 2043 Articles burnt by consent 23 Yards of houses paved or the pavement repaired 50 Drains in houses improved 74 Dust-bins provided 2 Privies lime-washed, cleansed, and repaired 124 Water-supply provided or improved 16 Nuisances from dung and other offensive matter removed 77 Area-gratings, cellar-flaps, &c., repaired 5 Several tortoises kept so as to be a nuisance removed. Seventy-one baskets of plums were removed from the British and Foreign Wharf and Carron Wharf and destroyed, the same being unfit for human food. The cow-houses in the District, 23 in number, and the slaughterhouses, 13, 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. ANNUAL REPORT. The number of births registered in this Distridl during the four quarters of the year ended 29th September, 1883, has been 2504, and the deaths 23 72, including 7 deaths of residents in the Fever Hospital, and 2 deaths of residents in the Small Pox Hospital, and including those of non-residents in the London Hospital (561). In the year ended 30th December, 1882, the births were 2545, and the deaths 2345, including the deaths of 544 non-residents. The deaths in the Workhouse have been 357, against 365 for the year ended 30th December, 1832; and the deaths in the London Hospital 805 against 762. The population of the District, at the taking of the last census, and published weekly in the Returns of the Registrar General, was 71,363. 12 The inhabited houses are 7594. In 1871 the population was 76,573, and the inhabited houses 8264. The deaths (excluding 561 of non-residents) being 1811, the rate of mortality has been, during the year, 25.3 per 1000. The rate of mortality during the year ended 3Oth December, 1882, was 25.2 per 1000. In making a comparison, however, of the rate of mortality of this District with that of others in which there is no hospital, the total deaths in the London Hospital must be eliminated, which, this year, as before stated, amount to 805. This gives a mortality of 21.9 per 1000. The annual rate of mortality since the year 1866, 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 four quarters of the year ended 29th September, 1883, there were 252 from epidemic diseases, viz., 3 from small-pox, including 2 which occurred in the Small Pox Hospital, 79 from measles, 26 from scarlet fever, 19 from diphtheria, 14 from hooping-cough, 74 from diarrhcea, and 37 from fever, including 5 deaths which occurred in the Fever Hospital. The death-rate from epidemic diseases, including those in hospitals for the year, in relation to the total mortality, is 10'6 per cent. Pauper Illness in the District. The number of out-door sick paupers who have been attended by the Medical Officers of the Union is 3455. During the year ended 30th December, 1882, the number was 3728. The extraordinary annual diminution in the number of the out-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. I am, Gentlemen, Your obedient Servant, 15, Great Alie Street. JOHN LIDDLE. APPENDIX. TABLE I.—Cases of Sickness of the Zymotic and Acnte Classes, which are recorded in the Books of the Medical Officers of the Union, for the Three Months ended on the 29th September, 1883. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic D iarrh oe a. Continued Fever, Typhus & Typhoid. Febricula. Pyaemia. Erysipelas. Puerperal Fever. Croup. Acute Pulmonary Inflammation. Carbuncle. Bheumatic Fever. Ague. Dysentery. Delirium Tremens. Lead Poisoning. All other Diseases. Total. Bronchitis and Catarrh. Pleuiitis and Pneumonia. Mr. Champneys 0 12 5 0 20 0 0 2 0 1 0 0 46 i 0 0 0 0 0 3 312 402 Mr. Sequeira 1 14 1 0 7 0 4 7 0 1 0 0 16 0 0 0 0 0 0 0 192 243 Mr. Loane 0 4 3 1 4 0 0 0 0 0 0 0 10 0 0 1 0 0 0 0 50 73 Totals 1 30 9 1 31 0 4 9 0 2 0 0 72 1 0 1 0 0 0 3 554 718 Corresponding Qr. of previous Year. 5 19 7 15 30 0 2 33 0 9 0 0 78 4 0 0 0 0 0 1 577 780 Workhouse Mr. J. J. Hott. 0 0 0 0 22 0 0 1 0 7 0 0 76 14 3 70 1 0 12 5 510 721 In addition to the cases of illness in the Workhouse, which are above recorded, there were 30 cases of syphilis and gonorrhoea. 14 TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 29th September, 1883. Sub-districts. Small-Pox. Measles. Scarlet Fever Diphtheria. HoopingCough. Diarrhoea. Fever. Cholera 4 Choleraic Diarrhœa. Total. Remarks. Spitalfields 1 6 3 0 1 6 4 0 21 Mile End New Town 0 7 1 0 1 20 1 0 30 Workhouse. Whitechapel North 0 6 2 0 0 6 0 0 14 Whitechapel Church 0 2 2 3 0 6 3 0 16 Hospital. Goodman's Fields 0 3 0 0 1 6 0 0 10 Aldgate 0 1 1 0 0 2 0 0 4 Totals 1 25 9 3 3 46 8 0 95 Deaths from Epidemics for the corresponding Quarter, 1882. 0 16 5 5 14 37 2 0 79 One death from small-pox, of a patient sent from this District, occurred in the Small-pox 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 September, 1883. Sub-districts. Enumerated Population in 1881. 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 22585 184 75 22 18 11 8 9 4 Mile End New Town 15473 171 135 47 23 26 4 8 59 Whitechapel North 10001 73 37 16 9 3 3 4 0 Whitechapel Church 7489 48 222 14 35 24 26 33 195 Goodman's Fields 9713 80 38 11 11 7 0 2 0 Aldgate 6102 34 27 7 5 2 3 6 0 Totals 71363 590 534 117 101 73 44 62 257 TABLE IV. Cases of illness attended annually by the Medical Officers of the Union, from the year 1856. Years ending Total cases attended during the year. Years ending Total cases attended during the year. Years ending Total cases attended during the year. 1856 12485 1865 15594 1874 3685 1857 10714 1866 16502 1875 2474 1858 11718 1867 17181 1876 2281 1859 11701 1868 17417 1877 2060 1860 11392 1869 14031 1878 3107 1861 13724 1870 14148 1879 3833 1862 14270 1871 10194 1880 3660 1863 14564 1872 4864 1881 4229 1864 14932 1873 4887 1882 3728 Year ended 29th 3455 Sept., 1883. 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 1883. Year. j 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. Bate 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 76,573 2571 2465 551 339 545 25.6 27.7 7.1 1872 ... 2705 2390 616 375 510 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 710 405+ 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 1880 ... 2733 2302 631 439 450 24.1 24.3 5.8 1881 71,363 2566 2351 654 446 472 21.7 26.6 6.6 1882 ... 2545 2345 762 544 435 24 1 25.2 6.0 Year ended 29th ) Sept., 883. 2504 2372 805 561 400 22.0 25.3 5.6 * The years marked with an asterisk contain 53 weeks. + Estimated number. The number of Inquests which have been held this year in this District has been 334. In the preceding year the number was 329. TABLE VI. Showing the Deaths from Epidemic Diseases in the Whitechapel District during the last 27 years. Name of Disease 1857 1858 1859 I860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 • 1873 1874 1875 1876 1877 1878 1879 1880 1881 18S2 Yr. ended 29 Sep.1883 Small Pox 3 4 60 21 28 33 69 5 22 44 40 11 1 56 159 19 1 1 2 8 23 11 7 16 47 7 3 Measles 60 78 31 81 27 153 26 137 28 139 33 69 71 36 42 23 44 33 40 16 96 32 49 26 88 47 79 Scarlet Fever & Diphtheria 43 87 96 59 70 91 200 50 80 76 26 48 208 59 25 S6 24 199 51 18 28 24 89 37 35t 35 45 Hooping Cough 89 117 50 49 89 62 52 74 97 94 72 55 113 50 43 9 79 16 61 57 44 84 73 39 48 90 14 Diarrhoea 139 108 141 67 101 69 114 109 122 119 100 138 97 107 125 99 113 76 93 103 89 89 67 90 91 61 74 Fever 117 104 93 69 65 250 158 170 167 100 82 1C9 95 52 40 26 44 47 30 27 26 29 33 16 36 42 37 Cbolera&Choleraic-I>iarrh<Ea 10 6 5 1 4 5 5 2 4 904 9 10 7 6 3 5 8 3 0 0 0 0 0 0 0 0 0 Totals 461 504 476 347 384 663 624 547 520 1476 362 440 592 366 437 277 313 375 277 229 306 269 318 224 345 282 252 LOndon Fever 2203 1902 1796 1302 1754 3635 2302 3689 3232 2681 2174 2483 2211 2049 1755 1003 1548 1552 1282 1206 1240 1361 1084 887 1195 1117 1102 Scarlta. & Diph. 1587 4118 4197 2457 3058 4194 5799 3806 2614 2316 1836 3418 G102 6306 2220 1063 932 3037 4038 2673 1776 2350 3212 3624 2772 2867 2979 Small Pox.. 154 247 1156 877 215 345 2012 537 646 1388 1339 606 273 958 7834 1532 114 56 75 739 2544 1416 454 475 2371 431 140 * In the above Table the years 1863, 1869, 1873 and 1880, consist of 53 weeks. In the column of deaths for 1879,1880,1881,1882 & 1883, the deaths from small-pox & from fever which occurred in the Hospitals are included, † Scarlet-fever and diphtheria in the earlier records of the Registrar-General were not separated, but were classed under one • heading, viz.: scarlet-fever. For some years past these diseases have been recorded under separate headings. ‡ The deaths from scarlet-fever during this year were 26 and from diphtheria 19. In London, the deaths from scarlet-fever were 2087, and from diphtheria 892. TABLE VII. Showing the cases of Epidemic Diseases among the pauper population in the Whitechapel District during the last 27 years. Name of Disease 1857 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 1881 1882 Yr. ended 29 Sept., 1883. Small Pox 6 20 242 65 86 113 253 21 86 261 254 93 5 302 625 60 2 1 0 19 125 48 10 37 135 17 3 Measles 266 427 179 520 70 525 80 482 51 679 155 323 212 257 178 76 128 59 32 32 64 11 115 40 164 58 83 Scarlet Fever & Diphtheria 49 147 176 93 100 118 305 156 164 197 60 54 311 97 32 16 22 161 17 6 8 18 71 21 15 15 18 Hooping Cough 150 230 146 83 388 153 169 217 280 217 219 144 308 140 102 94 86 30 44 15 24 16 33 12 30 45 4 Diarrhoea 1324 946 1209 773 1418 1085 1108 1127 1342 1664 1471 1631 1033 1097 590 283 212 150 101 120 61 76 91 119 97 65 75 Fever 1441 590 411 190 109 822 464 295 573 343 308 586 385 325 201 19 126 84 24 34 17 17 13 9 12 23 12 Cholera&Choleraio-Diarrbosi 16 0 1 1 0 1 1 4 4 58 5 8 1 4 2 3 2 0 0 0 1 2 0 0 1 0 0 Totals 3252 2360 2364 1720 2171 2817 2380 2302 2500 3419 2472 2839 2255 2222 1730 551 578 485 218 226 300 188 333 238 454 223 195 * In the above Table the years 1863, 1869, and 1873, consist of 53 weeks. BOARD OF WORKS, Whitechapel District. REPORT ON THE SANITARY CONDITION OF THE WHITECHAPEL DISTRICT, FOE THE QUARTER ENDED 29TH DECEMBER, 1883, BY JOHN LIDDLE, MEDICAL OFFICER OF HEALTH. London: Printed by Penny & Hull, 53, Leman St., Whitechapel, E. 1884. THE 110th QUARTERLY REPORT.* REPORT of the MEDICAL OFFICER OF HEALTH, For the Quarter ended 29th December, 1883. To the Board of Works, Whitechapel District. Gentlemen, In the Quarter that ended on Saturday, the 29th December, 1883, the total births in the District were 585, viz.: 297 males and 288 females; and the deaths 509, viz.: 25S males and 251 females. The excess of births over deaths has therefore been, during the Quarter, 76. As the deaths of 111 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 398, and thus increasing the number of births above deaths to 187. 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 617, and the total deaths 619. The weekly average of births was 45.0 and of deaths 39.1; and in the present Quarter the weekly average of births has been 47.4, and of deaths 47.6. In the Spitalfields sub-District the births were 179 and the deaths 70; in the Mile End New Town 185 and the deaths 134 (in this sub-District the Workhouse is situated); in the Whitechapel North 58 and the deaths 35 ; in the Whitechapel Church 54 and the deaths 212 (in this sub-District the London Hospital is situated); in the Goodman's Fields 61 and the deaths 30 ; and in the Aldgate 48 and the deaths 28. The deaths have exceeded the births in the White- * All my Quarterly Reports are bound together and preserved in the Office of the Sanitary Inspectors. 4 chapel Church sub-District by 158, but the deaths of the 111 nonresidents in the London Hospital must be deducted. The proportion of births to deaths is therefore 54 to 101. The deaths in the London Hospital have been 179 ; of these 111 were of non-residents in the District, 28 of residents, and 40 of persons who either died suddenly or from the result of accident. The deaths of persons who resided in the 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 to non-residents in this Quarter is 25.2 per cent. The proportion of deaths of residents to non-residents for the six years ended December, 1883, is 14.1 per cent. The deaths in the Workhouse Infirmary, Baker's Row, have been 67. In the corresponding Quarter of last year they were 102. One death occurred in the Metropolitan Free Hospital, which is situated in the Spitalfields sub-District, and was of a resident in the Whitechapel District. The deaths from epidemic diseases in the entire District have been 34, viz.: 2 from measles, 3 from scarlet fever, 5 from diphtheria, 4 from hooping-cough, 8 from diarrhoea, and 12 from fever. To this number must be added 1 who died at the Small-pox Hospital ; thus making a total of 35 deaths from epidemic diseases. In the corresponding Quarter of the previous year the deaths from epidemic diseases were 59, viz.: 22 from measles, 11 from scarlet fever, 3 from diphtheria. 2 from hooping-cough, 5 from diarrhoea, and 1G from fever. To this number must be added 1 who died of small-pox in the Small-pox Hospital; thus making a total of 60 deaths from epidemic diseases. Mortality of Young Children. The mortality of children under 1 year of age is 91. This is 17'8 per cent, of the total mortality. In the corresponding Quarter of the previous year it was 15T per cent. In the Spitalfields sub-District the rate is 34.2 per cent.; in the Mile End New Town 17'0 per cent.; in the Whitechapel North 22.8 per cent.; in the Whitechapel Church 8.9 per cent.; in the Goodman's Fields 16.6 per cent.; and in the 5 Aldgate 4.64 per cent. The difference of 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 during the Quarter are 160, which shows a rate of mortality of 314 per cent, in relation to the total deaths, including those of non-residents, and 27.3 per cent, to the total births. The rate of mortality under 1 year, in relation to the total births, is 15.8 per cent. Pauper Illness in the District. The Medical Officers of the Union have attended, during the past Quarter, 730 new cases of illness out of the Workhouse; including 3 of small-pox, 5 of scarlatina, 6 of hooping-cough, 11 of diarrhoea, 2 of fever, 10 of febricula, and 6 of erysipelas. In the corresponding Quarter of the previous year the number of pauper cases of illness was 970; including 1 of small-pox, 25 of measles, 7 of scarlatina, 15 of diarrhoea, 8 of fever, 25 of febricula, and G of erysipelas. The total number of cases of illness in the Workhouse has been 775 ; including 2 of hooping-cough, 8 of diarrhoea, 4 of fever, 7 of erysipelas, and 8 of febricula. In addition to the above cases, there were 43 of syphilis and gonorrhoea ; thus making a total of 818. Uncertified Deaths. Four uncertified deaths are recorded during the Quarter; 2 are returned in the Spitalfields sub-District, 1 in the Goodman's Fields sub-District, and 1 in the Aldgate sub-District. Meteorology of Greenwich. The Returns of the Registrar-General show that the rain-fall in the Metropolis during the Quarter has been 5.48 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 9.29 inches. The mean temperature of the air was 45.1. In the corresponding Quarter of last year it was 44.6. The coldest days during the Quarter were Monday, 12th November, Tuesday, 13th November, Wednesday, 14th November, and Thursday, loth November, when the thermometer indicated respectively 29.2°, 27.8°, 29.9°, and 29.7°. The 6 lowest mean weekly temperature was for the week ended Sth December, 33.6°. The coldest days during the corresponding Quarter of the previous year were Sunday, 10th December, Monday, 11th December, and Tuesday, 12th December, when the thermometer indicated respectively 23.6°, 22.2°, and 22.9°. The results of the meteorological observations are to be understood as applying to the civil day, or from midnight to midnight. FEVEK Cases sent from the Whitechapel Union Infirmary to the Fever Hospital at Homerton, during the Quarter ended 29th December, 1883. Nature of Fever. Date of admission into Infirmary. Where admitted from. Length of time in Infirmary. Whether Patients had Fever on admisn Date of sending to Fever Hospital. Enteric 3rd Oct. 3, Upper Keate-street 4 days Slightly 7th Oct. Enteric 7th „ Found in Commercial-st 2 „ Slightly 9th Oct. Typhus 26th „ Found in Brick-lane 1 „ Slightly 27th Oct. Enteric 26th „ 17, Dorset-street 3 „ Slightly 29 th Oct. Table of Weekly Mortality, &c., in London and in the Whitechapel District. Week ended Deaths in London. Deaths in Wchpl. District Rainfall. Inches. Mean Temperature of the air. Degrees From Diarrhoea and . Dysentery From Fever. From Small-pox. From all causes. From Smallpox. From all causes. Oct. 6 48 22 3 1252 0 31 0.66 47.7 ” 13 26 28 3 1438 0 24 0.00 51.4 ” 20 38 25 0 1408 0 51 1.03 51.3 ” 27 31 30 2 1450 0 46 0.16 50.9 Nov. 3 17 27 3 1440 0 40 0.02 49.0 ” 10 27 39 2 1556 0 33 1.00 44.1 ” 17 19 40 0 1681 0 34 0.31 39.4 ” 24 17 35 1 1670 0 40 0.71 43.9 Dec. 1 9 36 5 1655 0 31 0.83 46.3 ” 8 14 28 2 1628 0 35 0.05 37.8 ” 15 12 29 7 1722 0 56 0.53 44.0 ” 22 11 32 2 1609 0 49 0.09 40.9 ” 29 10 21 2 1503 0 39 0.09 40.0 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 ended— PUBLIC VACCINATOR Workhouse. Totals. Births Reqistd. Primary Cases. Re-Vaccination. Primary Cases. Re-Vaccination Primary Cases." lie-Vaccination. March, 1882 360 17 31 146 391 163 644 June 543 6 36 125 579 131 520 September 441 25 45 105 486 130 588 December 328 2 33 135 361 137 617 March, 1883 409 6 25 160 434 166 634 June 463 1 57 53 520 54 564 September 419 3 42 3 461 6 534 December 311 2 26 324 337 326 585 Totals 3274 62 295 1051 3569 1113 4686 Fever and Small-pox Return for Quarter ended Christmas, 1883. SMALL POX .. Men Women. Children Total North District 1 1 2 4 South „ 0 0 0 0 FEVER. Men. Women. Children. Total North District 4 2 9 15 South ,, 3 1 11 15* * Of these, 8 were from the London Hospital and non-resident. 2 deaths Turner, 6, Dunk Street, Mile End New Town. Sarah Ruthon, 5, Caledonian Terraoe, Pelley Road, Plaistow. Sanitary Works performed during the Quarter ended 29th December, 1883. The following return shows the amount of work done by the Sanitary Inspectors during the Quarter ended 29th December, 1883. Number of inspections of houses as shown in the official returns 2500 Houses specially visited, that is to say every room in such houses has been inspected 280 Houses specially re-visited in order to see that the works for which notices have been given are carried out 1260 Preliminary notices served such notices embracing 216 premises 164 Compulsory orders issued embracing 33 premises 30 Summonses heard at Police Courts under Sanitary Act 0 Summonses under Act for Prevention of Adulteration of Food, &c 1 8 Cellars used as dwellings discontinued for such use 9 Cases of overcrowding and indecent occupation abated 2 Houses in which rooms or passages have been whitewashed 68 Rooms disinfected with sulphurous-acid gas, after the occurrence of small-pox, fever, and scarlet fever therein 61 Articles, consisting of beds, bedding, clothing, &c., removed from rooms to the Stone Yard and disinfected in the apparatus 1083 Articles burnt by consent 23 Yards of houses paved or the pavement repaired 48 Drains in houses improved 32 Dust-bins provided 7 Privies lime-washed, cleansed, and repaired 89 Water-supply provided or improved 20 Nuisances from dung and other offensive matter removed 28 Area-gratings, cellar-flaps, &c., repaired 4 Twenty-six baskets and barrels of pears were removed from Iron Gate Wharf and destroyed, the same being unfit for human food. ANNUAL REPORT. The number of births registered in this District daring the year has been 2472, and the deaths 2253, including those of non-residents in the London Hospital (529). In the preceding year the births were 2545, and the deaths 2345, including the deaths of 544 non-residents. The deaths in the Workhouse have been 322, against 365 for the previous year; and the deaths in the London Hospital 783 against 762. The population of the District, at the taking of the last census, and published weekly in the Returns of the Registrar-General, was 71,363. The inhabited houses are 7,594. In 1871 the population was 76,573, and the inhabited houses 8,264. The deaths (excluding 529 of non-residents) being 1,724, the rate of mortality has been, during the year, 24.1 per 1,000. The rate of mortality during the preceding year was 25.2 per 1,000. 9 In making a comparison, however, of the rate of mortality of this District with that of others in which there is no hospital, the total deaths in the London Hospital must be eliminated, which, this year, as before stated, amount to 783. This gives a mortality of 20 5 per 1,000. The annual rate of mortality since the year 1866, 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 223 from epidemic diseases, viz., 1 from small-pox, to which must be added the 3 which occurred in the Small-pox Hospital, thus making a total of 4; 59 from measles, 18 from scarlet fever, 21 from diphtheria, 16 from hooping-cough, 77 from diarrhoea, and 26 from fever, to which must be added the two deaths which occurred in the Fever Hospital, thus making a total of 28 deaths from fever. In the whole of London, the deaths from fever have been 1081. The death-rate from epidemic diseases, including those in hospitals for the year, in relation to the total mortality, is 9.8 per cent. Pauper Illness in the District. The number of out-door sick paupers who have been attended by the Medical Officers of the Union, is 3,215. During the previous year the number was 3,728. The extraordinary annual diminution in the number of the out-door sick paupers, from upwards of 17,000, in the years 1867 and 1868, to 2,060 in 1877, is a matter of great satisfaction to the ratepayers of this District. Sanitary Works performed during the Year 1883. Number of inspections of houses, as shown in the official returns . 9312 Number of rooms found to be overcrowded, the space being less than 300 cubic feet for each person—nuisance in each case abated 20 Houses specially visited, that is to say, every room in such houses has been inspected 961 Houses specially re-visited in order to see that the works for which notices have been served are carried out 3644 Rooms disinfected with sulphurous acid gas after occurrence of fever and scarlet fever therein 172 Articles disinfected, consisting of beds, bedding, clothing, &c. 6690 Articles burnt by consent of the owners 46 Preliminary notices served, such notices embracing 1060 premises 716 10 Compulsory orders issued, embracing 252 premises 144 Summonses heard at the police courts under Sanitary Act 0 Summonses under Act for the Prevention of Adulteration of Food, &c. 4 Houses in which rooms or passages have been whitewashed 473 Yards of houses paved or the pavement repaired 148 Drains in houses improved 244 Dust-bins provided 30 Privies lime-washed, cleansed, and repaired 389 Water-supply provided or improved 62 Area-gratings, cellar-flaps, &c., repaired 30 Cellars used as dwellings discontinued for such use 36 Nuisances from dung and other offensive matter removed 178 During the last six years 5836 houses have been specially visited, that is to say, every room in such houses has been inspected. 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 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 December, 1883. Names of Medical Officers. Small-Pox. Measles. Scarlatina. Hooping-Cough. Diarrhoea. Cholera and Choleraic Diarrhœa. Continued Fever, Typhus & Typhoid. Febricula. Pyemia. 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. Mr. Champneys 3 0 3 1 8 0 0 3 0 4 0 0 100 1 0 0 0 0 0 0 315 438 Mr. Sequeira 0 0 1 5 3 0 2 7 0 2 0 0 28 0 0 0 0 0 1 0 172 221 Mr. Loane 0 0 1 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 59 71 Totals 3 0 5 6 11 0 2 10 0 6 0 0 139 1 0 0 0 0 1 0 546 730 Corresponding Qr. of previous Year. 7 8 8 16 15 0 12 28 0 8 0 0 151 4 0 0 0 0 0 0 752 1009 Workhouse Mr. J. J. Ilott. 0 0 0 2 8 0 4 8 0 7 0 0 117 14 0 69 0 0 8 4 534 775 In addition to the cases of illness in the Workhouse, which are above recorded, there were 43 cases of syphilis and gonorrhœa. 12 TABLE II. Showing the Deaths from Epidemic Diseases for the Three Months ended 29th December, 1883. Sub-districts. Small-Pox. Measles. Scarlet Fever Diphtheria. HoopingCough. Diarrhoea. Fever. Cholera & Choleraic Diarrhoea. Total. Remarks. Spitalfields 0 0 2 0 1 3 0 0 6 Mile End New Town 0 0 0 1 0 2 3 0 6 Workhouse Whitechapel North 0 1 1 0 1 1 1 0 5 Whitechapel Church 0 0 0 4 0 1 7 0 12 Hospital. Goodman's Fields 0 1 0 0 0 1 0 0 2 Aldgate 0 0 0 0 2 0 1 0 3 Totals 0 2 3 5 4 8 12 0 34 Deaths from Epidemics for the corresponding Quarter, 1882. 0 22 11 3 2 5 16 0 59 One death from small-pox, of a patient sent from this District, occurred in the Small-pox Hospital. TABLE III. Showing Sub-districts, Euumerated Population, Total Births, and Deaths from all causes— Deaths under 1 year of age, 1 and under 5 years, and above GO years; Deaths from Violence, Inquest cases, and Deaths in Workhouse and London Hospital, for the Quarter ended 29th December, 1883. Sub-districts. Enumerated Population in 1881. j 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 22585 179 70 24 9 13 3 5 1 Mile End New Town 15473 185 134 23 15 44 2 9 67 Whitechapel North 10001 58 35 8 7 5 2 4 0 Whitechapel Church 7489 54 212 18 32 19 41 46 179 Goodman's Fields 9713 61 30 5 4 6 1 2 0 Aldgate 6102 48 28 13 2 1 2 4 0 Totals 71363 585 509 91 69 88 51 70 247 TABLE IV. Cases of illness attended annually by the Medical Officers of the Union, from the year 1856. Years ending Total cases attended during the year. Years ending Total cases attended during the year. Years ending Total cases attended during the year. 1856 12485 1865 15594 1874 3685 1857 10714 1866 16502 1875 2474 1858 11718 1867 17181 1876 2281 1859 11701 1868 17417 1877 2060 1860 11392 1869 14031 1878 3107 1861 13724 1870 14148 1879 3833 1862 14270 1871 10194 1880 3660 1863 14564 1872 4864 1881 4229 1864 14932 1873 4887 1882 3728 1883 3215 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 1883 Year. Population. Total Births. j 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 76,573 2571 2465 551 339 545 25.6 27.7 7.1 1872 ... 2705 2390 616 375 510 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 1880* ... 2733 2302 631 439 450 24.1 24.3 5.8 1881 71,363 2566 2351 654 446 472 21.7 26.6 6.6 1882 ... 2545 2345 762 544 435 24.1 25.2 6.0 1S83 ... 2472 2253 783 529 420 24.0 24.1 5.8 * The years marked with an asterisk contain 53 weeks. † Estimated number. The number of Inqnests which have been held this year in this District has been 31S, In the preceding year the number was 329 TABLE VI. Showing the Deaths from Epidemic Diseases in the Whitechapel District daring the last 27 years. Name of Disease 1857 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 * 1S73 1874 1875 1876 1877 1878 1879 1880 1881 1882 1883 Small Pox 3 4 60 21 28 33 69 5 22 44 40 11 1 56 159 19 1 1 2 8 23 11 7 16 47 7 4 Measles 60 78 31 81 27 153 26 137 28 139 33 69 71 36 42 23 44 33 40 16 96 32 49 26 88 47 59 t Scarlet Fever & Diphtheria 43 87 96 59 70 91 200 50 80 76 26 48 208 59 25 96 24 199 51 18 28 24 89 37 35 35 39* Hooping Cough 89 117 50 49 89 62 52 74 97 94 72 55 113 50 43 9 79 16 61 57 44 84 73 39 48 90 16 Diarrhoea 139 108 141 67 101 69 114 109 122 119 100 138 97 107 125 99 113 76 93 103 89 89 67 90 91 61 77 Fever 117 104 93 69 65 250 158 170 167 100 82 1C9 95 52 40 26 44 47 30 27 26 29 33 16 36 42 28 Cholera&Choleraic-Diarrhffla 10 6 5 1 4 5 5 2 4 904 9 10 7 6 3 5 8 3 0 0 0 0 0 0 0 0 0 Totals 461 504 476 347 384 663 624 547 520 1476 362 440 592 366 437 277 313 375 277 229 306 269 318 224 345 282 223 London Fever 2203 1902 1796 1302 1754 3635 2S02 3689 3232 2681 2174 2483 2211 2049 1755 1003 1548 1552 1282 1206 1240 1361 1084 887 1195 1117 1081 : Scarlta. & Diph. 1587 4118 4197 2457 3058 4194 5799 3806 2614 2316 1836 3418 6162 6306 2220 1063 932 3037 4038 2673 1776 2350 3212 3624 2772 2867 2940‡ Small Pox.. 154 247 1156 877 215 345 2012 537 646 1388 1339 606 273 958 7834 1532 114 56 75 739 2544 1416 454 475 2371 431 134 * In the above Table the years 1863, 1869, 1873 and 1880, consist of 53 weeks. In the column of deaths for 1879,1880,1881,1882 & 1883, the deaths from small-pox & from fever which occurred in the Hospitals are included, ‡ Scarlet-fever and diphtheria in the earlier records of the Registrar-General were not separated, but were classed under one heading, viz.: scarlet-fever. For some years past these diseases have been recorded under separate headings. ‡ Ths deaths from scarlet-fever during this year were 18 and from diphtheria 21. In London, the deaths from scarlet-fever were 1989, and from diphtheria 951. TABLE VII. Showing the cases of Epidemic Diseases among the pauper population in the Whitechapel District during the last 27 years. Name of Disease 1857 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 1881 1882 1883 Small Pox 6 20 242 65 86 113 253 21 86 261 254 93 5 302 625 60 2 1 0 19 125 48 10 37 135 17 5 Measles 266 427 179 520 70 525 80 482 51 679 155 323 212 257 178 76 123 59 32 32 64 11 115 40 164 58 58 Scarlet Fever & Diphtheria 49 147 176 93 100 118 305 156 164 197 60 54 311 97 32 16 22 161 17 6 8 18 71 21 15 15 16 Hooping Cough 150 230 146 83 388 153 169 217 280 217 219 144 308 140 102 94 86 30 44 15 24 16 33 12 30 45 10 Diarrhoea 1324 946 1209 773 1418 1085 1108 1127 1342 1664 1471 1631 1033 1097 590 283 212 150 101 120 61 76 91 119 97 65 71 Fever 1441 590 411 190 109 822 464 295 573 343 308 586 385 325 201 19 126 84 24 34 17 17 13 9 12 23 6 Cholera & Choleraic-Diarrbea 16 0 1 1 0 1 1 4 4 58 5 8 1 4 2 3 2 0 0 0 1 2 0 0 1 0 0 Totals 3252 2360 2364 1725 2171 2817 2380 2302 2500 3419 2472 2839 2255 2222 1730 551 578 485 218 226 300 188 333 238 454 223 166 * In the above Table the years 1863, 1869, 1873 and 1880, consist of 53 weeks.