WHI 32 BOARD OF WORKS, Whitechapel District. REPORT on the SANITARY CONDITION of the WHITECHAPEL DISTRICT, for the QUARTER ENDED 29th MARCH, 1884, BY JOSEPH LOANE, medical officer of health, SURGEON TO THE LONDON SAILORS' HOME, &c. London: printed by Penny & Hull, 53, Leman St, Whitechapel, E. 1884. REPORT. Office of the Board of Works, Whitechapel District, No. 15, Great Alie Street, Whitechapel, April 5th, 1884. Gentlemen, I have to report that during the quarter ended on Saturday, March the 29th, there were registered in the Whitechapel District 630 births and 476 deaths. The particulars of these births and deaths are set out in Table A. of the Appendix. As the Whitechapel Union Infirmary is in the Mile End NewTown sub-district, I have distributed the 25 births which took place in that institution, amongst the subdistricts where the mothers previously resided, as shown in Table B. The Whitechapel district has experienced so many changes since the last census return in 1881, that it is difficult to accurately estimate its present population ; but on reference to the birth statistics for that year, and basing my calculations upon the birth-rate deduced therefrom, it is probable that the population of the district has been reduced by 2,000 persons. My calculations therefore are based upon the assumption that the estimated population of the Whitechapel District is 69,363. The number of deaths registered in the district was 476, but from 1 his total must be deducted the 166 deaths of non-residents which took place in the district, chiefly in the public institutions : to the 310 now arrived at, must be added the deaths of 14 residents, registered in districts other than our own. Thus we have resulting the deaths of 324 inhabitants, and with these figures I propose to treat somewhat in detail. Tables C. and D. will explain the arrangement I have described. The natural increase of births over deaths, is 306. To render of value the figures which I have collected belonging to the district, it is necessary to be able to institute a comparison with similar sets of figures appertaining to the same district at a different period, or with those of other districts. I have thought it preferable to compare our own statistics with those of the metropolis and have 4 used the form advocated by the Registrar-General for that purpose. Reference to the Table alluded to will indicate the total deaths for London and for the Whitechapel District residents, as well as the names of the diseases with the numbers attached ; information which I trust will prove useful for present and future reference. We thus find that our district has a mortality at the rate of 18.9 per 1000 per annum against that for London of 19.4 per 1000. It will indicate also that, whilst the death-rate of London from the chief zymotic diseases for London is equivalent to an annual rate of 2.6 per 1000, the death-rate for the Whitechapel District from the same class of diseases is only 1.6 per 1000. I have only to remind you that the estimated population of London is nearly 58 times that of the estimated population of the Whitechapel district, and a key is at once forthcoming whereby a useful comparison can be readily instituted for any disease, or class of diseases, between London and our own district. In that class of diseases called " Constitutional," amongst which appear those diseases often brought about or increased by impure air and overcrowding, the Whitechapel district compares favorably with the metropolitan statistics. From a general inspection of the tables under consideration, it would appear, that where the district deaths are comparatively greater than the London deaths, as in croup, bronchitis, pleurisy, dentition, &c., the diseases are exactly those which, through ignorance or carelessness, would probably be negledted in the early stage, when treatment could have availed. Again, a comparison of the district infant mortality with that for London, proves, that while of the children born in London one in about 7 survives the first year of its existence, and one in about 4 lives to the age of five years ; in the Whitechapel District one child in about 8 survives the first year, and one in 5 attains the age of 5 years. In London, the infants who died under one year equalled 23.19 per cent. of the resident deaths, and 13.5 per cent. of the registered births. The deaths of children under 5 years of age equalled 42.18 per cent. of the total deaths. In the district, the infants dying under one year of age, equalled 23.7 per cent. of the deaths, and 12.2 per cent. of the births; whilst the deaths which took place under the age of 5 years equalled 38.8 per cent. of the total deaths. The remaining columns of the same table exhibit the cases of sickness attended upon new orders by the District Medical Officers, and also the cases admitted into the Union Infirmary. It is necessary 5 to mention that 463 cases were sent into the Infirmary by the Medical Officers, and therefore are included in both columns. The next table contains the return by the Vaccination Officer, Mr. W. M. S. Sherman, for the quarter. An inspection of the numbers will show the efficient performance of his duty by that officer. No death from small-pox has been registered in the district, and only two cases of the disease have come to our knowledge. It is however well to call attention to the great increase in the number of cases now in the various Metropolitan asylums' hospitals and ships. During the past three weeks, the new admissions have been respectively 21, 65 and 92; and the last week's record gave, as the total number of cases in those institutions, and in the Highgate Hospital, 278. I regret to notice the increased opposition to vaccination which has lately been experienced, so incontestable are the proofs of its efficiency, and so little evidence of mischief from it has been adduced, that I sincerely hope every means will be taken to enforce the Act of Parliament in its present condition, so that this dire scourge may be successfully combated. The vigilant care of our vaccination officer is the probable explanation of our immunity from the disease. Vaccination, whilst protecting during the earlier years of life, requires repeating to afford a life immunity from small-pox. Mr. Marson, during an experience of thirty-five years as Medical Officer of a Small-pox Hospital, never knew a nurse to contract the disease. All nurses were re-vaccinated. During 1871, no persons were attending upon the sick in a Metropolitan Small-pox Hospital; all these, with two exceptions, were re-vaccinated, and all but these two escaped small-pox. Such experiences could be multiplied if requisite, proving conclusively the necessity for re-vaccination to stamp out small-pox. A few words respecting the Cholera investigations in the East may be interesting. In his final report to the Foreign Office, Dr. Hunter devotes a great deal of labour in his endeavour to prove his previously expressed opinion as regards the " non-contagious " theory of cholera. His facts and figures however do not appear to tend in the direction he would wish, and I think a reference to the course of the disease last year in Egypt points out that cholera spread directly by those routes most chiefly frequented by man. The careful reports which Dr. Koch has forwarded to his Government are most valuable. Divesting his last statement of its technicalities, he infers that the germ or bacillus, which he first discovered in Egypt, 6 is a specific element in the disease. He also states that the cholera germ multiplies rapidly outside the human body in damp soiled linen, and that it can be readily destroyed by drying. Very slightly acid fluids are equally fatal to the germ. It is impossible to overrate the importance of these discoveries in the prophylactic treatment of the disease. In considering our future work, it is apparent that a sharp look-out must be maintained to prevent over-crowding in the district, especially whilst so many houses are being demolished. The people must crowd into any rooms they can obtain. It will probably be thought advisable to register tenement houses, and to remain satisfied with generally improving those existing houses which need it, until the land in the district, which is now vacant, shall afford accommodation for the very poor. For this purpose, houses should be erected where single rooms can be let at low rents, and where all modern sanitary requirements can be introduced; or, better still, in all model dwellings, some rooms should be reserved for the very poor, so that by association with a class above themselves, their habits would be improved, and their morals elevated. The necessity for a Public Mortuary is so apparent, that I trust the district will not remain long without one. Scarcely a week passes without some case occurring which renders the want of a Mortuary likely to promote danger. From the Government returns, as well as from the Water Companies' analyses, I gather that the water supplied to the districfl was excellent in quality and sufficient in quantity. So important are the statements, in his official report, of Colonel Sir Francis Bolton, C.E , that I quote them for your perusal: " In houses supplied on the constant system, all danger of drinking stale or contaminated water from cisterns may readily be avoided if the following recommendation is carried into practice, viz., to attach a small draw-off tap to the communication pipe which supplies the cistern from the main in the street, from which water may be drawn at any minute, day or night, direct from the works, thereby taking full advantage of any efforts made by the Companies to purify the water to the utmost extent." " The water drawn from the Lee, and distributed by the New River and East London Companies contained less organic matter than any of the Thames waters. Both waters were clear and transparent." The mean temperature of the air during the quarter was 43.1°. The highest temperature recorded was 68.0° on March 15th, and the 7 lowest was 27 3o on the 3rd March. Rain fell upon 38 days to an aggregate of 4.58 inches. There was an average quantity of ozone in the air. The general direction of the wind was W.S.W. It may be interesting to note that the City of London has referred to "the Sanitary Committee" for report, the proposal to construct a " Crematorium " in the Cemetery at Ilford. In the last table of the Appendix will be found collected the joint work of the Sanitary Inspectors. I cannot allude to this without bearing testimony to the aid I have received from these officers. I am also indebted for much assistance in obtaining the statistics necessary for this Report to Doctors Ilott and Case, the Secretaries to the London and Metropolitan Free Hospitals, and also to the Registrars of the sub-districts. I have the honor to remain, Gentlemen, Your obedient Servant, JOSEPH LOANE. To the Board of Works, Whitechapel District. Table A.—Births and Deaths registered in the Whitechapel District during the thirteen weeks ending March 29th, 1884. Total Births Registered—630. Total Deaths Registered—476. Spitalfields. Mile End New Twn. Whitchpl. Church. Goodman's Fields. Aldgate. Males. Females Spitalfields; Mile End New Twn. Whitchpl. Church. Goodman's Fields. Aldgate. Males. Females. 200 164 131 82 53 312 318 75 116 242 24 19 264 212 Table B.—The Whitechapel Infirmary being in the Mile End New Town District, the 25 births which took place in that Institution have been deferred to the sub-Districts where the mothers previously resided. As the deaths of 166 non-residents took place in the District, chiefly in the London Hospital which is in the Whitechapel Church sub-District, and 14 residents died outside the District, I have referred the deaths of the 324 residents to their proper sub-Districts. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. 191 166 136 84 53 111 68 86 34 25 Table C.—The 166 deaths of non-residents which took place in the District were registered in the sub-Districts as follows:— The deaths of the 14 residents which took place in Public Institutions outside the District were disposed as follows (Spitalfields, Met. Free Hos.) Mile End New Town. (Infirmary.) Whitechapl. Church, (Lond. Hos.) Goodman's Fields. Aldgate. The German Hospital at Dalston 3 The Mile End Old Town Infirmary 1 St. Bartholomew's Hospital 7 4' 1 160 0 1 The Middlesex Hospital 1 The Jews' Hospital, Mile End Road 1 The Military Station Hospital, Rochester Row 1 Table D. Diseases. deaths. cases. Diseases. deaths. cases. London. Whtechpl. District. Dist. Med Officers. Union Infirmary. London. Whtechpl District. Dist. Med. Officers. Union Infirmary All causes 20382 324 813 987 46 Croup 184 9 ... 2 ZYMOTIC DISEASES. 47 Bronchitis 2921 72 119 119 48 Pneumonia 1149 19 3 12 „ „ 1 Small-pox Vaccinated 20 1 1 49 Pleurisy 62 2 3 14 Unvaccinated 19 ... 50 Other respiratory dis- eases 418 8 75 19 No statement 21 ... 2 Measles 549 ... 3 5 51 Dentition 215 7 13 5 390 5 1 4 4 Typhus fever 3 ... ... ... 52 Quinsy, sore throat 25 ... 4 3 5 Relapsing fever 1 ... ... ... 53 Enteritis 76 ... ... 3 6 Influenza 2 3 54 Peritonitis 89 1 ... 4 7 Whooping cough 1104 21 10 8 55 Diseases of liver 346 4 1 4 8 Diphtheria 208 1 1 56 Other diseases of diges- tive system 404 3 29 21 9 Simple, Continued, and ill-defined fever 22 ... 35 12 57 Diseases of lymphatic" system and ductless; glands 32 ... 4 5 10 Enteric fever 216 ... ... 3 11 Simple cholera 6 ... ... ... 12 Diarrhoea, Dysentery 147 2 7 21 13 Remittent fever 4 ... ... ... 58 Diseases of urinary system 474 8 3 12 14 Hydrophobia ... ... ... ... 15 Glanders ... ... ... ... 16 Cow-pox and effects of vaccination ... ... ... ... 59 Diseases, generative system 84 ... 12 46 17 Venereal affections 120 2 ... 42 18 Erysipelas 100 2 ... 15 60 Accidents of child-birth. 48 ... 5 25 19 Pyaemia and Septicaemia. 33 1 ... ... 20 Puerperal fever 98 ... ... ... 61 Diseases of locomotive system 89 ... 30 20 21 Other zymotic diseases 25 ... ... 5 22 Thrush 15 ... ... ... 62 Ulcers ... ... 74 69 23 Worms and other para- ) sitic diseases 9 ... ... ... 63 Diseases of integumentary system 63 ... 54 33 24 Starvation, want of breast-milk 15 ... 5 VIOLENT DEATHS. Accident. 64 Fracture and contusion 252 8 33 65 25 Alcoholism 54 10 26 Rheumatic fever and rheumatism of heart 117 ... ... 12 65 Gun-shot wounds 3 ... ... ... 27 Rheumatism 34 1 136 92 66 Cut, stab 5 ... ... 6 28 Gout 36 ... 7 13 67 Burn and scald 102 4 4 8 29 Rickets 53 ... 2 ... 68 Poison 12 ... 1 ... 30 Cancer 676 5 4 7 69 Drowning 64 1 ... ... 31 Tabes mesenterica 289 3 3 70 Suffocation 199 3 ... ... 32 Tubercular meningitis __ 317 11 4 5 71 Otherwise 29 ... ... ... 33 Phthisis 2104 28 7 16 34 Scrofula, tuberculosis 2CG 8 Homicide. 72 Murder & manslaughter 22 ... ... ... 35 Other constitutional . diseases 130 14 43 54 36 Premature birth 460 1 ... 2 Suicide. 73 Gun-shot wounds 13 ... ... ... 37 Atelectasis 29 ... ... ... 74 Cut, stab 21 ... ... ... 38 CoDgenitl. malformations 95 5 75 Poison 15 ... ... ... ...39 Old age 609 15 6 34 76 Drowning 17 ... ... ... 40 Apoplexy 513 7 10 77 Hanging 11 ... ... ... 71 Otherwise 11 ... ... ... 4! Epilepsy 82 5 3 10 42 Convulsions 629 8 2 5 Execution. 79 Hanging 43 Other diseases of brain and nervous system 1142 16 33 42 44 Diseases of organs of special sense 31 ... 2 11 80 Inquests 1495 ... ... ... 81 Other causes 752 3 33 ... 45 Diseases of circulatory system 1442 24 7 25 82 Uncertified deaths 279 1 ... ... Table E.—Showing the Ages at which Death occurred in all cases. Under 1 year. Between 1 and 5. Between 5 and 20. Between 20 and 40 Between 40 and 60. Between 60 and 80. Over 80 years of age. Resident. Non-resident. Resident. Non-resident. Resident. Non-resident. Resident. Non-resident. Resident. Non-resident. Eesident. Non-resident. Resident. Non-resident. 77 8 49 11 21 19 42 48 54 49 67 30 10 1 85 60 40 90 103 87 11 Of the eleven persons who died after 80 years of age, six were registered in the Spitalfields sub-District, of whom two were of the age of 96. A person died in the Goodman's Fields sub-District at the age of 98. The remaining deaths from old age were registered as follows: — One in the Mile End New Town sub-District; one in the Aldgate sub-District; and two in the Whitechapel Church sub-District. Total Births and Deaths in London, and Deaths under 5 years of age. No. of Births in London during the Quarter 34,889 „ Deaths „ „ „ 20,382 „ „ „ under 1 year old 4,728 ,, ,, ,, between the ages of 1 and 5 3,871 Table F.—VACCINATION STATISTICS. Certificates of successful Vaccination registered by the Vaccination Officer Born in the Union 571 Resident, but born elsewhere 64 025 Vaccination Primary Public Vaccinator 379 Superintendt. Infirmary 37 416 Pie-Vaccination Public Vaccinator . 1 Superintendt. Infirmary . .345 346 Table G.—Sanitary Work performed by the Inspectors during the Quarter ended March 29th, 1884. Number. Numbers of Inspections of Houses as shewn in the Official Returns 3944 Houses specially visited 191 „ „ re-visited 764 Preliminary Notices served, such Notices embracing 376 premises 232 Compulsory Orders issued, embracing 55 premises 33 Summonses heard at Police Court under Sanitary Act 1 „ under Act for the Prevention of Adulteration of Food, &c 2 Cellars used as dwellings discontinued for such use 15 Cases of overcrowding and indecent occupation abated 2 Houses in which rooms or passages have been whitewashed 99 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 485 Articles burnt by consent 23 Yards of houses paved or the pavement repaired 58 Drains in houses improved 118 Dust bins provided 11 Privies lime-washed, cleansed and repaired 139 Water-supply provided or improved 16 Nuisances from dung and other offensive matter removed 58 Area gratings, cellar flaps, &c., repaired 1 Animals (dogs, &c.) kept so as to be a nuisance removed 1 Houses closed by Magistrate's order as unfit for human habitation 1 Cow-houses visited in the District 23 Slaughter-houses visited in the District 13 Bakehouses visited in the District 82 In addition to this Return, the Inspectors report that they have forward to the Metropolitan Board of Works several notices of dangerous structures, which notices the Metropolitan Board have promptly attended to. Thirty-nine samples under the Food and Drugs Act, were submitted to the Public Analyst, four were found to be adulterated, in two cases the vendors were cautioned, and in two cases summonses were taken out against the vendor, and fines inflicted amounting to 10s. and 4s. costs. BOARD OF WORKS, Wbiterjmjxel gi strut. REPORT ON THE SANITARY CONDITION OF THE WHITECHAPEL DISTRICT. FOR THE QUARTER ENDED 28TH JUNE, 1884 BY JOSEPH LOANE, medical officer OF health, SURGEON TO THE LONDON SAILORS HOME, &c. London: Printed bt Penny & Hull, 53, Leman St , Whitechapel, E'. 1884. REPORT. Office of the Board of Works, Whitechapel District, No. 15, Great Alie Street, Whitechapel, July 14th, 1884. Gentlemen, I have to report that during the quarter ended on Saturday, June the 28th, there were registered in the Whitechapel District 683 births and 531 deaths. The particulars of these births and deaths are set out in Table A of the Appendix. As the Whitechapel Union Infirmary is in the Mile End New Town sub-district, I have distributed the 28 births which took place in that institution amongst the subdistricts where the mothers previously resided, as shown in Table B. I have assumed, for statistical purposes, that the population of the Whitechapel District still remains 69,363. The number of deaths registered in the District was 531, but from this total must be deducted the 172 deaths of non-residents which took place in the three public institutions, viz.:—the London Hospital, the Metropolitan Free Hospital, and the Whitechapel Union Infirmary; to the 359 now arrived at, must be added the deaths of 21 residents, registered in districts other than our own. Thus we have resulting the deaths of 380 inhabitants. Tables C and D will explain the arrangement I have described. The natural increase of births over deaths is 303, against 306 last quarter. To appreciate correctly the value of the above figures, I have Continued the same plan which I adopted in my last Report, and side by side with our own District figures will be found, those which refer to the deaths of London inhabitants, as reported weekly in the valuable returns issued from the office of the Registrar-General. We thus find that the Whitechapel District has a mortality at the rate 4 of 21.9 per 1000 per annum, whilst that for London is at the apparent rate of 19.9 per 1000 per annum. The real death-rate could be arrived at by adding the deaths of those inhabitants of London, who dying outside registration London, at the Metropolitan Asylums Hospitals and ships at Darenth, are not included in the figures from which the death-rate above is compiled. The same remark applies with increased force when calculating the zymotic death-rate, which for London seems to be only 3.6 per 1000, but would be much higher were the deaths at Darenth from small-pox added. The Whitechapel District zymotic death-rate is only 2.8 per 1000. All the deaths from diarrhœa were amongst infants who, with one exception, were under a year old. Improper and irregular feeding is no doubt responsible for many deaths in infants from this disease. A careful inspection of the Tables alluded to calls for congratulation at the low mortality from epidemic diseases, as only 5 deaths are recorded from small-pox, and only 1 of these took place in the District. Concerning infant mortality—a matter of the highest importance in these Reports—I notice that the infants who died under one year in London equalled 22.2 per cent. of the total deaths and 13.1 per cent. of the registered births. The deaths of children under five years of age, including the above, equalled 44.0 per cent. of the total deaths, and 25.9 per cent. of the registered births. In the Whitechapel District, the infants who died under one year, equalled 20.2 per cent. of the total deaths, and 12.7 per cent. of the registered births, whilst the deaths of children under the age of five, including the above, equalled 38.9 per cent. of the total deaths, and 21.6 per cent. of the registered births. On the same table to which I have been referring, will be found the cases attended by the Dislrict Medical Officers during the quarter, as also those under treatment in the Infirmary, which were admitted during the same period. From the first of the two columns I have excluded the 450 cases which were sent into the Infirmary, or removed to special hospitals, as they mostly appear in the adjoining column, which was compiled for me by Dr. Ilott. The Vaccination Returns by the Vaccination Officer, Mr. W. M. S. Sherman, again show much useful work. In my last Report I called attention to the necessity which existed for the enforcement of Vaccination and Re-Vaccination. I should strongly advise that the Public Vaccinators should have power to re-vaccinate children after seven years of age, and for this reason : Extracting the details 5 of the deaths from small-pox in London during the past thirteen weeks, it appears that out of a total of 352 deaths registered from this disease, 92 are certified as "vaccinated," 135 as " unvaccinated," and to the remaining 125, no statement is appended. A scrutiny of the first-mentioned class indicates that 1 death occurred under one year old ; 4 between the ages of one and five ; 12 between the ages of five and twenty; 56 between the ages of twenty and forty; 14 between the ages of forty and sixty ; and 5 between the ages of sixty and eighty. It is clear, therefore, that the protection afforded by vaccination should be renewed, and I am of opinion that this renewed protection should be afforded at an earlier age than 12. As I think that no pains should be spared to convince the honest opponents to vaccination of the risk they run by avoiding the protection it offers. I append the Registrar-General's list of deaths amongst the unvaccinated for the same time:—under one year old, 27 ; between the ages of one and five, 39 ; between the ages of five and twenty, 37 ; and so on. How grievous that so terrible a punishment as the sacrifice of so many lives is necessary to teach so simple a lesson. During the past two weeks the Public Vaccinator has re-vaccinated 478 persons, and I have not yet heard of one who regretted having submitted to this trifling operation. I rejoice to state that there are signs that the epidemic is now subsiding. The Whitechapel District has contributed during the quarter to the Metropolitan Asylums Board Institutions 77 cases, but of this number 12 were non-residents sent from the London Hospital. In addition to the above, 5 cases, which were not removed, have come under our notice. During the past three weeks, there have been under treatment in the various hospitals, an average of 1367 cases; thus, by comparison, the District health, as well as the District mortality from this disease is very favourable. Scarlet Fever—22 cases of this disease have been reported during the quarter ; all, with the exception of an infant, were removed to the Homerton Fever Hospital. Cholera. It is now an established fact that this disease, which has proved so fatal at Toulon and Marseilles, is Asiatic cholera. Our present knowledge of this terrible disease is sufficient to indicate what must be done in order to keep the enemy out, or to destroy it should it gain admission. Cholera poison to spread must fall upon prepared soil; and that soil, so necessary to its vitality, is produced and 6 maintained by filth and disease. A community in good health, with good water supply and perfect cleanliness in every way, might rest assured that cholera could not produce much mischief were it imported. Isolation, sanitary precautions and immediate recourse to medical treatment, are the means to be adopted should this disease appear. Anything like a panic is to be avoided. Public Mortuary. During the quarter 74 inquests have oeen held in the District ; 34 of this number took place in the London Hospital; 40 would therefore have been held at the Inquest Room of the Mortuary House had there been such a building in the District. Deodorising Gullies. During the summer months, the following plan is carried out under the direction of the Surveyor:—The District is divided into three parts, and the gullies in each division are disinfected twice a week. To each van-load of water (about 450 gallons) is added 45 pounds of sulphate of iron and 6 gallons of carbolic acid. All the gullies in this District (about 800) are liberally treated with this mixture. Water Supply. The water supplied to the District by the East London and New River Companies still remains, according to the latest analysis, excellent. One cannot, however, too frequently repeat the caution against using stored water for drinking purposes. As only a few houses in the District are now without supply, this can easily be avoided. London cannot be congratulated upon the means whereby its sewerage is disposed of at present. The main drainage system, with the outfalls at Barking and Crossness, will soon (if they have not already) become sources of danger, and it is to be hoped that the present Royal Commision may devise a plan to deodorize the excreta before they are discharged into the River. School Board and Home Lessons. Justices Matthew and Day, in the Queen's Bench Division, respecting a case from Bradford have decided that the School Board has no power to enforce the learning of home lessons. The Medical Press is generally in favour of this decision. I think it is manifestly illogical, and unfair to the poor scholars, to expect those children, whose progenitors were illiterate, to 7 develope equal aptitude for imbibing knowledge, with those whose parents possess brains of a higher type of development. If this be so, it would be more scientific to advance the Educational Standard, with the advance in the mental capacity of the pupils, rather than to expect complete ignorance to be transformed in a single generation into an intellectual vigour, which can absorb all that is taught in the higher standards. Education could not then be charged with causing disease and death, as it has been in many instances of late. Meteorology. The mean temperature of the air during the quarter was 52.i°. The highest temperature recorded was 82.6° on June 27th, and the lowest was 27.0° on April 23rd. Rain fell upon 34 days to an aggregate of 4.20 inches. I have the honour to remain, Gentlemen, Your obedient Servant, JOSEPH LOANE. To the Board of Works, Whitechapel District. Table A.—Births and Deaths registered in the Whitechapel District during the thirteen weeks ending June 28th, 1884. Total Bieths Registered—683. Total Deaths Registered—531. Spitalfields. Mile End New Twn. Whitchpl. Church. Goodman's Fields. Aldgate. Males. Females. Spitalfields; Mile End New Twn. Whitchpl. Church. Goodman's Fields. Aldgate. Males. Females. 197 218 152 70 46 337 346 101 139 257 21 13 299 232 Table B.—The Whitechapel Infirmary being in the Mile End New Town District, the 28 births which took place in that Institution have been referred to the sub-Districts where the mothers previously resided. As the deaths of 172 non-residents took place in the District, chiefly in the London Hospital which is in the Whitechapel Church sub-District, and 21 residents died in Public Institutions outside the District, I have referred the deaths of the 380 residents to their proper sub-Districts. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. 213 195 155 72 48 150 83 95 29 23 Table C.—The 172 deaths of non-residents which took place in the District were registered in the sub-Districts as follows:— The deaths of the 21 residents which took place in Public Institutions outside the District were disposed as follows :— The German Hospital at Dalston 3 (Spitalfields, Met.Free Hos.) Mile End New Town. (Infirmary.) Whitechapl. Church, (Lond. Hos.) Goodman's Fields. Aldgate. St. Bartholomew's Hospital 3 Children's Hospital at Shadwell 3 Evelina Children's Hospital 1 The Metropolitan Asylums Hospitals, Camp and Ships 6 5 1 166 0 0 Charing Cross Hospital 1 Military Station Hospital, Vauxhall 2 Chest Hospital, Victoria Park 2 8 Table D. deaths. cases. deaths. cases. Diseases. London. Whtechpl. District. Dist. Med. Officers. Union Infirmary. Diseases. London. Whtechpl. District. Dist. Med. Officers. Union Infirmary All causes 19944 380 268 851 46 Croup 188 5 3 ZYMOTIC DISEASES. 47 Bronchitis 2067 53 32 67 48 Pneumonia 1083 19 ... 7 1 Small-pox Vaccinated 71 1 1 ... 49 Pleurisy 56 ... 1 8 Unvaccinated 120 ... ... ... 50 Other respiratory diseases 327 5 21 18 No statement 102 4 4 2 2 Measles 1024 7 9 3 3 Scarlet fever 343 9 2 3 51 Dentition 247 11 9 5 4 Typhus fever 9 ... ... 2 52 Quinsy, sore throat 28 1 5 3 5 Relapsing fever ... ... ... 53 Enteritis 62 1 ... 2 6 Influenza 1 ... ... 5 54 Peritonitis 83 2 ... 2 7 Whooping cough 1296 20 11 7 55 Diseases of liver 362 4 3 8 8 Diphtheria 207 1 ... 2 56 Other diseases of diges- tive system 391 .5 17 19 9 Simple, Continued, and ill-defined fever 18 ... 6 16 10 Enteric fever 196 1 ... 6 57 Diseases of lymphatic system and ductless glands 27 ... 1 6 11 Simple cholera 10 ... ... ... 12 Diarrhoea, Dysentery 201 7 11 25 13 Remittent fever 5 ... ... ... 14 Hydrophobia 5 ... ... ... 58 Diseases of urinary system 428 9 ... 8 15 Glanders ... ... ... ... 16 Cow-pox and effects of vaccination 1 ... ... ... 59 Diseases, generative system 88 2 7 27 17 Venereal affections 117 4 2 35 18 Erysipelas 73 3 1 9 60 Accidentsof child-birth 40 2 6 4 19 Pyæmia and Septicaemia. 47 ... ... 3 20 Puerperal fever 59 ... ... 2 21 Other zymotic diseases .. 36 ... ... 6 61 Diseases of locomotive system 93 3 6 18 22 Thrush 15 ... ... 4 23 Worms and other parasitic diseases 1 ... ... 4 62 Ulcers ... ... 4 44 63 Diseases of integumentary system 72 3 24 33 24 Starvation, want of breast-milk 8 ... ... 6 25 Alcoholism 56 2 ... 17 VIOLENT DEATHS. 26 Rheumatic fever and rheumatism of heart 89 ... ... 8 64 Fracture and contusion 258 6 3 53 65 Gun-shot wounds ... ... ... ... 27 Rheumatism 32 ... 18 62 66 Cut, stab 8 ... ... 19 28 Gout 41 ... 2 3 67 Burn and scald 59 1 ... 5 29 Rickets 56 1 ... 4 68 Poison 15 ... ... ... 30 Cancer 630 8 ... 5 Drowning 78 ... ... ... 31 Tabes mesentcrica 293 8 ... 5 70 Suffocation 143 6 ... ... 32 Tubercular meningitis 375 4 1 2, 71 Otherwise 33 3 ... ... 33 Phthisis 2174 43 4 28 34 Scrofula, tuberculosis 257 ... ... 3 Homicide. 35 Other constitutional diseases 129 16 12 35 72 Murder & manslaughter 17 ... ... ... 36 Premature birth 484 7 ... 8 Suicide. 73 Gun-shot wounds 10 ... ... ... 37 Atelectasis 24 ... ... ... 74 Cut, stab 20 ... ... ... 38 Congenitl. malformations 80 ... ... 3 75 Poison 19 1 ... ... 39 Old age 554 15 2 | 35 76 Drowning 13 ... ... ... 40 Apoplexy 509 11 ... 13 77 Hanging 22 ... ... ... 71 Otherwise 10 1 ... ... 41 Epilepsy 105 1 ... 24 42 Convulsions 612 14 ... 5 Execution. 43 Other diseases of brain and nervous system 1132 28 16 23 79 Hanging 44 Diseases of organs of special sense 29 1 17 80 Inquests 1328 40 ... ... 81 Other causes 660 ... 25 38 45 Diseases of circulatory system 1311 21 1 14 82 Uncertified deaths 253 nil ... ... This Total does not include "Inquests" or "Uncertified Deaths." Table E.—Showing the Ages at which Death occurred amongst Residents. Under I year. Between 1 aud 5. Between 5 and 20. Between 20 and 40. Between 40 and 60. Between 60 and 80. Over 80 years of age. 87 61 28 57 67 72 8 Of the eight persons who died after 80 years of age, four were registered in the Spitalfields sub-District. The greatest ages attained were:—one, 94 years old, in the Whitechapel Church sub-District; and one, aged 98, in the Mile End New Town sub-District. Dr. Ilott informs me that the last-mentioned case, "Ann Hughes, died in the Infirmary on June 22nd. She was cheerful and retained her faculties to the last." Total Births and Deaths in London, and Deaths under 5 years of age. No. of Births in London during the Quarter 33,807 „ Deaths „ „ „ 19,944 „ „ „ under 1 year old 4,444 „ „ „ between the ages of 1 and 5 4,332 Table F.—VACCINATION STATISTICS. Certificates of successful Vaccination registered by the Vaccination Officer Born in the Union 660 Resident, but bom elsewhere 130 - 790 Vaccination Primary Public Vaccinator 635 Superintends Infirmary 31 - 5(56 Re-Vaccination Public Vaccinator 238 Superintendt. Infirmary 162 - 400 Table G.—Sanitary Work performed by the Inspectors during the Quarter ended June 28th, 1884. Number. Numbers of Inspections of Houses as shewn in the Official Returns 2109 Houses specially visited 338 „ „ re-visited *1352 Preliminary Notices served, such Notices embracing 315 premises 252 Compulsory Orders issued, embracing 58 premises 51 Summonses heard at Police Court under Sanitary Act 2 „ under Act for the Prevention of Adulteration of Food, &c.... 5 Cellars used as dwellings discontinued for such use 7 Cases of overcrowding and indecent occupation abated 5 Houses in which rooms or passages have been whitewashed *191 Rooms disinfected with sulphurous acid gas after the occurrence of small-pox, fever, and scarlet-fever therein *156 Articles consisting of beds, bedding, clothing, &c, removed from rooms to the stone-yard and disinfected in the apparatus •2250 Articles burnt by consent *124 Yards of houses paved or the pavement repaired 73 Drains in houses improved 56 Dust bins provided 40 Privies lime-washed, cleansed and repaired 149 Water-supply provided or improved 16 Nuisances from dung and other offensive matter removed 44 Area gratings, cellar flaps, &c., repaired 9 Fowls and ducks kept so as to be a nuisance removed 3 Houses closed by Magistrate's order as unfit for human habitation 3 Cow-houses visited in the District 23 Slaughter-houses visited in the District 13 * Increased number due to Small-pox cases. In addition to this Return, the Inspectors report that they hare forwarded to the Metropolitan Board of Works several notices of dangerous structures, which notices the Metropolitan Board have promptly attended to. Thirty-six samples under the Food and Drugs Act, were submitted to the Public Analyst and seven were found to be adulterated. The vendors were summoned and fines inflicted, BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE SANITARY CONDITION OF THE WHITECHAPEL DISTRICT, FOR THE QUARTER ENDED 27TH SEPT., 1884, BY JOSEPH LOANE, MEDICAL OFFICER OF HEALTH, SURGEON TO THE LONDON SAILORS' HOME, &c. London Printed by Penny & HuLL, 53, Leman St,, Whitechapel, E. 1884. REPORT. Office of the Board of Works, Whitechapel District, No. 15, Great Alie Street, Whitechapel, October 8th, 1884. Gentlemen, I have to report that during the quarter ended on Saturday, September the 27th, there were registered in the Whitechapel District 573 births and 595 deaths. The detailed particulars of these births and deaths are indicated in Table A. of the Appendix. As the Whitechapel Union Infirmary is in the Mile End New Town sub-district, and as 25 births took place in that Institution, I have distributed those births amongst the sub-districts, where the mothers previously resided, as exhibited in Table B. The number of deaths registered in the district was 595, but from this total must first be deducted the deaths of 188 non-residents in district public institutions, or in private houses in the district; to the 407 now arrived at, must be added the deaths of 16 residents registered in other parts of London. The resulting total of 423 represents correctly the district mortality. Tables C and D are compiled to explain this arrangement. That the figures recorded may be serviceable for future as well as present comparison, the same plan is adopted, as in previous Reports, and on the same Table with our own district figures, I have arranged those which refer to the deaths of London inhabitants. The latter portion is compiled from the Weekly Returns issued by the Registrar-General. The natural increase of births over deaths is 150, against 303 last quarter. 4 The Whitechapel District has a mortality at the rate of 24.3 per 1000 per annum, whilst that for London is at the apparent rate of 20.9 per 1000 per annum. The London real death-rate could be arrived at only by adding the deaths of those residents who, dying outside registration London, are not included in the figures upon which the death-rate above-mentioned is based. Nearly 80 such deaths were registered outside registration London as having died from small-pox at the various Metropolitan Asylums Hospitals. The London zymotic death-rate is, of course, also materially affected in the same manner. In alluding to the Whitechapel zymotic deathrate (7.3 per 1000 per annum), I am anxious to explain that this increase over last quarter is due solely to the deaths of 76 infants from diarrhoea, a disease due not to zymotic causes, but to inability to assimilate food, even when such food be administered properly. The doubt implied is due to the knowledge that such deaths are most frequent amongst the poorer classes. If, therefore, we remove these 76 deaths to the class of " diseases of the digestive system," to which they more properly belong, our death-rate from zymotic diseases would be thereby reduced to less than 3 per 1000 per annum. The only other deaths from diarrhoea were, 3 between the ages of 5 and 20, and 2 above the latter age. Infant Mortality.—During the quarter, those infants who died in London under the age of 1 year, equalled 34.8 per cent, of the total deaths, and 22.2 per cent, of the registered births. The deaths of children under 5 years of age, including the above, equalled 50.7 per cent, of the total deaths, and 32.4 per cent, of the registered births. In the Whitechapel District, the infants who died under 1 year old, equalled 35.2 per cent, of the total deaths, and 26.0 per cent, of the registered births ; whilst the deaths of children under the age of 5, including the above, equalled 56.0 per cent, of the total deaths, and 41.3 per cent, of the registered births. Pauper Illness.—The last columns of Table D set out in detail the 300 cases of illness which were attended throughout by the District Medical Officers, and also those cases which were under treatment in the Union Infirmary. The Relieving Officers issued a total of 727 Medical Orders, of which number 427 were for admission to special hospitals, or into the Union Infirmary. As these cases are accounted for in the Union column, I have not included them in the preceding one. 5 There were 33 cases of small-pox, and 42 cases of fever, mostly scarlet-fever, dealt with, nearly all the patients being sent to Metropolitan Asylums Hospitals. The Sanitary Work performed by the Inspectors appears upon Table G. It is interesting to notice that out of a total of 196 deaths from small-pox in London, only 51 were amongst the vaccinated; whilst 80 were registered as " unvaccinated," and the remainder " no statement." Of the vaccinated, 15.6 per cent, died under the age of 20; and 84.3 per cent, above that age, when the protective power of vaccination has diminished ; whilst of the unvaccinated 66.2 per cent, died under the age of 20, and 33.7 per cent, over that age. On reference to Table D, it will be observed that 43 more deaths are recorded this quarter than in the quarter ended June 28th, and that this difference is on account of the altered positions occupied by diarrhoea and the respiratory and nervous diseases, which produced death in the two last quarters; for, whilst 78 more deaths occurred this quarter from diarrhoea, there were 27 fewer deaths from respiratory and nervous diseases. No great variation occurred amongst the remaining classes of diseases. Cholera.—Whilst so fatal in the South of France, and in Spain, this disease has mercifully spared our own country; not a single authenticated case having been reported. During the quarter, every existing house in the distridt, where, in 1866, a death occurred from cholera, or diarrhoea, has been carefulfy inspected, and all sanitary defecfts have been remedied. The disinfection of all gullies in the district has been regularly carried on, and I do not propose to discontinue this practice until the advent of colder weather. Public Mortuary.—Fifty-five inquests were held in the district, 29 of which took place at the London Hospital. The necessity of a room for the temporary accommodation of the dead net infrequently arises. A woman died in an adjoining Parish, whence the body was removed into a room in Thrawl Street, where it remained in company of a number of people for several days, Before the corpse was isolated by order of the Inspector it had become much decomposed. A somewhat similar condition of things is reported by the same Inspector as having occurred in George Street, Spitalfields, where 6 the surviving members of the family were associated continually for several days with the dead body of a woman, thus giving rise to danger, as well as nuisance, to those residing in the neighbourhood. In consequence of the Works connected with the London, Tilbury, and Southend Railway, it is necessary (by order from the Home Office) to remove 71 coffins from the vaults and ground of the German Reformed Church in Hooper Square. The interments had taken place between the year 1821 and 1853. Satisfactory arrangements have been made, and will shortly be carried out, for the removal of the coffins to the City of London Cemetery at Ilford. Water Supply.—Quantity and quality are alike excellent. Artizans' and Labourers' Dwellings Act.—Under this A6t of Parliament, in consequence of a communication which I received, signed by some of the inhabitants of Spitalfields, I have made an official representation to the Metropolitan Board of Works, respecting the property known as " The Great Pearl Street Scheme." This Scheme had been previously reported to the Metropolitan Board by Mr. Liddle. Ventilation of Sewers.—It has been decided by the Commissioners of Sewers to arrange for the future ventilation of the City sewers by means of shafts, when new buildings are in course of construction. This is very satisfactory, but still more so will it be, when I can report that throughout the Metropolis, not only are the sewers ventilated into the air, above the house-tops, but that all emanations conveying possible disease germs, are destroyed in transit. Apropos of sewers, I may mention that Sir Joseph Bazalgette has suggested a new scheme for dealing with the sewage of London, in addition to that of the Lower Thames Valley. He proposes that South London shall receive the Lower Thames Valley sewage, and pass it on, with its own, under the Thames, to join that from North London, whence the united stream shall be carried to Sea Reach and discharged into the sea at ebb-tide somewhere near the Essex shore. That something must be done before long is evident, but if this proposal be undertaken at all, several years must elapse before it could be completed, and in the interval, the existing nuisance, near the present outfalls, can only be kept in abeyance by the use of enormous quantities of disinfectants. Many 7 scientific men would gladly hear that it was decided to utilize the Metropolitan sewage, instead of casting such valuable material into the sea. Meteorology.—The mean temperature of the air during the quarter was 63°.4. The highest temperature recorded was 94°.2 on August nth, and the lowest was 42°.3 on July 26th. Rain fell upon 36 days, to an aggregate of 4.54 inches. The mean weekly reading of the barometer, in inches, was 29.81. The weekly average of registered bright sunshine was 35.4 hours. During the quarter south-west winds prevailed. I have the honor to remain, Gentlemen, Your obedient Servant, JOSEPH LOANE. To the Board of Works, Whitechapel District. Table A.—Births and Deaths registered in the Whitechapel District during the thirteen weeks ending Sept. 27th, 1884. Total Births Registered—573. Total Deaths Registered—595. Spitalfields. Mile End New Twn. Whitohpl. Church. Goodman's Fields. Aldgate. Males. Females. Spitalfields; Mile End New Twn. Whitchpl. Church. Goodman's Fields. Aldgate. Males. Females. 177 181 110 67 38 281 292 128 124 283 39 21 325 270 Table B.—The Whitechapel Infirmary being in the Mile End New Town District, the 25 births which took place in that Institution have been referred to the sub-Districts where the mothers previously resided. As the deaths of 188 non-residents took place in the District, chiefly in tho London Hospital which is in the Whitechapel Church sub-District, and 16 residents died in Public Institutions outside the District, I have referred the deaths of the 423 residents to their proper sub-Districts. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. 189 160 114 69 41 163 86 103 55 16 Table C.—The 188 deaths of non-residents which took place in the District were registered in the sub-Districts as follows: — The deaths of the 16 residents which took placo in Public Institutions outside the District were disposed as follows :— Spitalfields, (Met. Free Hos.) Mile End New Town. (Infirmary.) Whitechapl. Church, (Lond. Hos.) Goodman's Fields. Aldgate. St. Bartholomew's Hospital 2 Children's Hospital at Shadwell 2 1 2 183 0 2 The Metropolitan Asylums Hospitals, Camp and Ships 11 Guy's Hospital 1 Table D. Diseases. deaths. cases. Diseases. deaths. cases. London. Whtechpl. District. Dist. Med. Officers. Union Infirmary. London. Whtechpl. District. Dist. Med. Officers. Union Infirmary All causes *20965 423 300 1177 46 Croup 126 3 ... ... ZYMOTIC DISEASES. 47 Bronchitis 1159 30 22 78 48 Pneumonia 698 23 2 6 1 Small-pox Vaccinated 51 ... ... ... 49 Pleurisy 60 1 ... 19 Unvaccinated 80 2 ... ... 50 Other respiratory dis- eases 273 7 12 19 No statement 65 6 1 3 2 Measles 419 9 24 6 3 Scarlet fever 346 14 3 2 51 Dentition 192 11 4 11 4 Typhus fever 9 ... ... ... 52 Quinsy, sore throat 22 1 7 20 5 Relapsing fever ... ... ... ... 53 Enteritis 131 ... ... 1 G Influenza ... ... ... 8 54 Peritonitis 82 2 ... 1 7 Whooping cough 505 8 3 4 55 Diseases of liver 434 5 1 15 8 Diphtheria 243 2 ... ... 56 Other diseases of digestive system 443 3 29 34 9 Simple, Continued, and ill-defined fever 15 ... 17 24 10 Enteric fever 286 6 ... 2 57 Diseases of lymphatic" system and ductless glands 21 1 1 18 11 Simple cholera 145 1 ... ... 12 Diarrhoea, Dysentery 3097 81 35 35 13 Remittent fever 3 ... ... 10 58 Diseases of urinary system 411 14 4 25 14 Hydrophobia 4 ... ... ... 15 Glanders ... ... ... ... 16 Cow-pox and effects of vaccination 9 ... ... 3 59 Diseases, generative system 59 ... 3 52 17 Venereal affections 164 6 5 41 18 Erysipelas 79 ... 2 22 60 Accidentsof child-birth 50 4 4 40 19 Pyannia and Septictcmia. 35 1 ... 3 20 Puerperal fever 50 ... ... 2 61 Diseases of locomotive system 91 ... 3 2 21 Other zymotic diseases 17 ... ... 12 22 Thrush 53 ... ... ... 62 Ulcers ... ... 4 65 23 Worms and other parasitic diseases 3 ... ... ... 63 Diseases of integumentary system 63 4 19 63 24 Starvation, want of breast-milk 34 ... ... 3 VIOLENT DEATHS. Accident. 25 Alcoholism 66 1 ... 9 26 Rheumatic fever and rheumatism of heart 96 ... ... 7 64 Fracture and contusion 267 2 4 75 65 Gun-shot wounds 4 ... ... ... 27 Rheumatism 32 2 19 96 66 Cut, stab 6 ... ... 21 28 Gout 50 2 16 67 Burn and scald 54 1 ... 10 29 Rickets 38 ... ... 4 68 Poison 13 ... ... ... 30 Cancer 617 3 1 6 69 Drowning 115 ... ... ... 31 Tabes mesenterica 610 3 1 9 70 Suffocation 95 7 ... ... 32 Tubercular meningitis 347 7 ... ... 71 Otherwise 59 ... ... ... 33 Phthisis 2115 38 4 31 Homicide. 34 Scrofula, tuberculosis 273 1 1 14 35 Other constitutional diseases 101 30 9 42 72 Murder &manslaughter 16 ... ... ... Suicide. 36 Premature birth 448 10 1 4 73 Gun-shot wounds 12 ... ... ... 37 Atelectasis 30 ... ... ... 74 Cut, stab 22 ... ... ... 38 Congenitl. malformations 90 1 ... 4 75 Poison 21 1 ... ... 39 Old age 556 8 6 39 76 Drowning 23 ... ... ... 77 Hanging 23 ... ... ... 40 Apoplexy 474 17 2 15 71 Otherwise 6 ... ... ... 41 Epilepsy 84 2 ... 21 42 Convulsions 738 12 ... 6 Execution. 43 Other diseases of brain and nervous system 1079 14 23 45 79 Hanging ... ... ... ... 44 Diseases of organs of special sense 21 ... ... 24 80 Inquests 1332 23 ... ... 81 Other causes 1217 ... 18 ... 45 Diseases of circulatory system 1120 19 1 32 82 Uncertified deaths 243 8 ... ... * This Total does not include "Inquests" or "Uncertified Deaths." Table E.—Showing the Ages at which Death occurred amongst Residents. Under 1 year. Between 1 and 5. Between 5 and 20. Between 20 and 40 Between 40 and 60. Between 60 and 80. Over 80 years of age. 149 88 27 43 58 49 9 * Of the nine persons who died after 80 years of age, there were registered in the Spitalfields sub-District 1, in Mile End New Town 3 (all in the Whitechapel Infirmary); in the Whitechapel 3, in Goodman's Fields 1, and in Aldgate 1. One of these deaths was registered at 90, and two at 94 years of age. Total Births and Deaths in London, and Deaths under 5 years of age. No. of Births in London during the Quarter 32,813 „ Deaths „ „ „ 20,965 „ „ under 1 year old 7,313 „ „ „ between the ages of 1 & 5 3,336 10,649 Table F.—VACCINATION STATISTICS. Certificates of successful Vaccination registered by the Vaccination Officer Born in the Union 590 Resident, but born elsewhere 196 786 Vaccination Primary Public Vaccinator 573 Superintends Infirmary 33 - 006 Re-Vaccination " Insusoeptible " 1 Public Vaccinator 767 Superintends Infirmary . 177 - 944 Table G.—Sanitary Work performed by the Inspectors during the Quarter ended Sept. 27th, 1884. Number. Numbers of Inspections of Houses as shewn in the Official Returns 2504 Houses specially visited 410 „ „ re-visited 1650 Preliminary Notices served, such Notices embracing 591 premises 342 Compulsory Orders issued, embracing 98 premises 21 Summonses heard at Police Court under Sanitary Act 1 „ 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 2 Houses in which rooms or passages have been whitewashed 240 Rooms disinfected with sulphurous acid gas after the occurrence of small-pox, fever, and scarlet-fever therein 94 Articles consisting of beds, bedding, clothing, &c, removed from rooms to the stone-yard and disinfected in the apparatus 2974 Articles burnt by consent 67 Yards of houses paved or the pavement repaired 89 Drains in houses improved 65 Duet-bins provided 54 Privies lime-washed, cleansed and repaired 197 Water-supply provided or improved 19 Nuisances from dung and other offensive matter removed 39 Area gratings, cellar flaps, &c., repaired 4 Places closed by Magistrate's order as unfit for human habitation 3 Cow-houses visited in the District 20 Slaughter-houses visited in the District 13 Bakehouses visited in the District ... 42 Baskets of Plums destroyed as unfit for human food 55 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. Forty-three samples under the Food and Drugs Act, were submitted to the Public Analyst and six were found to be adulterated. In four cases the vendors were cautioned, and in two cases summonses were taken out against the vendors. A fine of 20s. was inflicted in one case, whilst, by the advice of the presiding Magistrate, the summons was withdrawn in the other case. BOARD OF WORKS, WHITECHAPEL DISTRICT. REPORT ON THE SANITARY CONDITION OF THE WHITECHAPEL DISTRICT, FOR THE QUARTER ENDED 3RD JANUARY, 1885, (Also for thE. Year 1884), BY JOSEPH LOANE, MEDICAL OFFICER OF HEALTH, SURGEON TO THE LONDON SAILORS' HOME, &c. London Printed by. Penny & hull, leman street, "wflltechapei., E. 1885. Office of the Board of Works, Whitechapel District, No. 15, Great Alie Street, Whitechapel, E. Junuary 27th, 1885. REPORT. Gentlemen, I have to report that during the Quarter ended on Saturday, January 3rd, which consisted of fourteen weeks, there were registered in the Whitechapel District 614 births and 617 deaths. As usual, the detailed particulars of these births and deaths are set forth in Table A* of the Appendix. From this Table it will appear that of the total births, 324 were males and 290 were females; whilst 344 males died to 273 females. Of the births, there were 18 registered in the Mile End New Town Sub-District, as having taken place in the Whitechapel Infirmary; these 18 births I have distributed amongst the Sub-Districts where the mothers previously resided. This arrangement will be seen by reference to Table B.* From the total number of deaths registered, which I have stated to be 617, those of non-residents must be deducted. Table C* shows that number to be 196; of which number 189 took place at the London Hospital. After the subtraction suggested has been effected, and the deaths of those residents occurring in Public Institutions outside the District have been added, the resulting number, viz. : 444, will correcftly represent the mortality of the Whitechapel District. An examination of the Table I have prepared will explain that I have relegated to the Sub-District where the deceased previously resided every resident death which took place in any Public Institution, either in the District or without it; thus, it will found that of the total deaths 158 belonged to Spitalfields, 77 to the Mile End New Town, 111 to the Whitechapel Church, 51 to the Goodman's Fields, and 47 to the Aldgate Sub-District. * See page 9. 4 Upon Table D* will be found a record of the total deaths which occurred during the Quarter in London, as well as in the Whitechapel District. I have also arranged opposite the name of each disease specified by the Registrar-General the number of deaths which were due to that disease amongst the inhabitants of London and the Whitechapel District respectively. Table Ef indicates the ages at which death took place amongst the Whitechapel residents, as arranged by the Registrar-General. The natural increase of resident births over resident deaths for the fourteen weeks is 170. Assuming the population for the last Quarter of the year to be the same as estimated at the commencement, and correcting the figures for comparison with a quarter having thirteen weeks, a mortality appertains at the rate of 237 per 1000 per annum. Of course it must be remembered, that so far as possible, I have collected the deaths of Whitechapel residents from all parts so as to correctly register them, whilst not only is this not done in the London figures I have quoted, but the deaths of those known London residents, to the number of 177, which took place at the Asylums Hospitals outside Registration London, are withheld from the total given. Not only will this lessen the difference in the comparative returns, but it will considerably favour the Metropolis against Whitechapel District, when the zymotic mortality returns are compared. Without the proportional addition to the sum total of London deaths, but merely taking them as they are given, the Whitechapel District confesses to a zymotic death-rate equal to 117.1 per 1000 of the total deaths; and the London deaths from the same causes are equal to 110.0 per 1000 of the total deaths. An analysis of zymotic deaths in the Distridt shows that 3 deaths occurred from small-pox, 10 from measles, 17 from scarlet-fever, 1 from whooping-cough, 4 from diphtheria, 2 from simple fevers, 8 from enteric fever, and 7 from diarrhoea. During the Quarter, those infants who died in London under the age of one year equalled 22.4 per cent, of the total deaths, and 13.6 Infant Mortaility per cent, of the registered births. The deaths of children under 5 years of age, including the above, equalled 36.7 per cent. of the total deaths, and 25.0 per cent. of the registered births. In the Whitechapel District, the infants who died under the age of one year equalled 20.4 per cent. of the total deaths, and 14.8 per cent. of the registered births ; whilst the deaths of children under the age of 5, including the above, equalled 38.0 per cent. of the total deaths, and 27.5 Per cent. of the registered births. * See page 10. † See page 11, " 5 In the last columns of Table D* will be found the cases of pauper illness which have been under treatment throughout by the District Pauper Illness. Medical Officers, and also those cases which were attended in the Whitechapel Union Infirmary by Dr. James John Ilott, the Medical Superintendent, to whom I am indebted for the figures I have tabulated. To avoid error in the perusal of those figures, I must explain that the 16 cases set down to "Accidents of Childbirth " merely refer to ordinary " Confinements." In all 980 cases have been treated in the Infirmary. In Table F†, as usual I embody the statistics appertaining to Vaccination, furnished by Mr. W. M. S. Sherman, the excellent Vaccination Officer to the Whitechapel Union. Many instances have recently been published of escape from small-pox through efficient vaccination, but I cannot resist quoting one typical example which occurred recently within my own knowledge. A man was removed to the small-pox hospital from a room in which were two unprotected children, both of whom were at once vaccinated. Neither received the disease, although the elder child was exhausted by long standing hip disease. In both cases the vaccination was successful in preventing the reception of the small-pox. The Sanitary work performed by the Inspectors appears in detail upon Table G†. From the Report to the Local Government Board by Dr. E. Frankland, F.R.S., for December last, it appears that " of the water " drawn from the Lee and distributed by the New " River and East London Companies, the East " London Company's water experienced the same " increase in organic matter as the Thames water, " whilst the New River Company's supply fully maintained the " quality of the previous month's sample, and ranked, as regards the " proportion of organic matter, with the best of the deep-well waters. " Both waters were clear and bright on delivery." Water Supply. I have the satisfaction to record that by degrees the land in our District formerly occupied by dwellings which were removed under the "Artizans and Labourers' Dwellings Acts" is becoming occupied by suitable dwellings. In Goulston Street there are several blocks of buildings approaching completion, and some Labourers' Dwellings in Cartwright Street will soon be ready for occupation. I believe over 3500 people will be accommodated. These dwellings are constructed upon plans which Artizans and Labourers' Dwellings. *See page 10. † See page 12. 6 have received the sanction of the Metropolitan Board of Works, and therefore I do not propose to offer criticism respecting them, but through the courtesy of the respective "Clerks of the Works," I have been able to inspect the works at various stages, and I would strongly advise anyone interested in such matters to carefully examine the very capital buildings erected at the south end of Goulston Street, comprising, as they appear to do, many modern applications of Sanitary Science. I shall watch with interest the future mortality returns of these houses, feeling confident that they will compare favourably with those returns appertaining to other blocks of buildings not so well or so carefully constructed. The mean weekly temperature of the air during the quarter was 440-o. The highest temperature recorded was 670.1 on September 28th, and the lowest was on the nth November, when the thermometer fell to Fahrenheit. Rain fell upon 43 days to an aggregate of 4.66 inches. The mean weekly reading of the barometer in inches was 29.14. The mean weekly average of registered bright sunshine was 8.12 hours. Meteorology. It would, perhaps, be as well to remind your Board that by the new arrangement to which your Board accorded its sanction, the present will be the last Quarterly Report which I shall have the honour to produce ; but in lieu thereof, in furtherance of that arrangement, I shall furnish every week a series of Tables, upon which may be seen the more important statistics which refer to the health of the District. Such a "health sheet" I have had inserted with this Report. It will be seen that most of the information required for the compilation of a Quarterly Report will here appear ; and, as usual, I shall with these "health sheets" present my customary Fortnightly Statements. By this means your Board will be an courant with information up to date. 7 SPECIMEN HEALTH SHEET. No. 53. TABLE OF DEATHS for the Fifty-third Week ending January 3rd, 1885. CAUSES OF DEATH. LONDON. WHITECHAPEL DISTRICT. Cases of Sickness attended by District Medical Officers. Corrected average. All agea. 0 to 1. 1 to 5. 5 to 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Spitalfields. Mile End New Town. Whitechapel Church. Goodman's Fields. Aldgate. All ages. 0 to 1. 1 to 5. 5 to 20. 20 and under 40. 40 and under 60. 60 and under 80. N M S Total. All causes 1986.6 1918 406 248 142 261 331 429 101 3 10 13 3 2 31 9 2 3 6 5 6 57 23 3 83 ZYMOTIC DISEASES. In this column find recorded deaths of Residents in outlying Institutions. 56 admissions. 1 Small-pox Vaccinated 19.2 4 ... ... ... 1 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Un-vaccinated 12 1 3 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No statement. 17 3 2 6 2 2 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... 2 Measles 60.3 22 5 14 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Scarlet-fever 58.6 28 2 16 7 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Typhus 2.4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Relapsing fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... G Influenza 0.1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Whooping cough 70.4 33 10 21 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 Diphtheria 15.3 28 2 13 12 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Simple, Continued and 111- defined fever 40 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 Enteric fever 19.4 11 ... ... 7 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... U Simple cholera 0.2 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Diarrhoea, dysentery 15.9 15 6 4 ... ... ... 4 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 13 Remittent fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 Cow-pox and effects of vaccination 0.5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1/ Venereal affections 11.6 9 8 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18 Erysipelas! 9.1 6 2 ... ... 1 ... 2 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 19 Pyemia and septicemia 4.0 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 Puerperal fever 7.1 12 ... ... ... 12 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 21 Other zymotic diseases 3.5 4 1 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Thrush 2.4 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 23 Worms and other parasitic diseases 0.2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 24 Starvation, want of 1.5 3 2 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 Alcoholism 4.6 5 ... ... ... 3 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 26 Rheumatic fever and rheumatism of heart 13.7 10 ... ... 8 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 27 Rheumatism 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 1 ... 28 Gout 3.6 3 ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 29 Rickets 2.5 4 1 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 30 Cancer 44.8 48 ... ... 1 3 20 20 4 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 31 Tabes Mesenterica 23.4 19 12 4 1 1 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 32 Tubercular Meningitis 31.4 21 5 11 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 33 Phthisis 184.0 198 4 3 19 93 60 19 ... ... 1 1 ... ... ... ... ... ... 1 1 ... ... ... ... 34 Scrofula, tuberculosis 12.4 14 5 1 3 5 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 35 Other constitutional diseases. 6.5 12 ... ... ... 3 4 5 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... 1 ... 36 Premature birth 33.9 52 52 ... ... ... ... ... ... ... ... 1 1 ... ... 2 ... ... ... ... ... ... ... ... 37 Atelectasis 1.5 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 38 Congenital malformations 6.0 7 (5 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 39 Old age 72.4 78 ... ... ... ... 3 35 40 ... 1 1 ... ... ... ... ... ... ... ... 2 ... ... ... 40 Apoplexy 56.9 57 ... ... 2 6 15 31 3 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 41 Epilepsy 9.6 13 ... ... 1 1 5 4 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 42 Convulsions 53.4 52 45 7 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 43 Other diseases of brain and nervous system 93.2 104 19 12 5 15 10 34 9 ... ... ... 1 ... 1 ... ... ... 1 ... ... 2 ... ... 44 Diseases of organs of special sense 1.5 5 1 1 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 45 Diseases of circulatory sysstem 123.4 127 1 ... 9 22 36 52 7 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 46 Croup 16.9 34 2 26 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 47 Bronchitis 373.5 320 66 44 5 8 54 123 20 ... 3 2 1 ... ... 1 ... ... 2 1 2 20 2 1 48 Pneumonia 116.4 118 14 23 3 23 31 18 6 ... 2 1 ... ... 1 1 ... 1 ... ... ... ... ... 49 Pleurisy 6.0 11 1 ... 2 ... 5 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 50 Other respiratory diseases 63.1 54 11 11 6 5 9 11 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... Continued on following page. 8 TABLE OF DEATHS—(Continued.) CAUSES OF DEATH LONDON. WHITECHAPEL DISTRICT. Cases of Sickness attended by District Medical Officers. Corrected average. All ages. 0 to 1. 1 to 5. 5 to 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Spitalfields. Mile End New Town. Whitechapel Church. Goodman's Fields. Aldgate. All ages. 0 to 1. 1 to 5. 5 to 20. 20 and under 40. 40 and under 00. 60 and under 80. N M S 51 Dentition 18.0 16 8 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 52 Quinzy, sore throat 2.5 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... 53 Enteritis 5.9 5 3 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 54 Peritonitis 9.3 5 ... ... 1 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 55 Diseases of liver 31.7 21 1 1 2 5 4 / 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 56 Other diseases of digestive system 33.0 37 8 2 2 3 10 12 ... ... ... ... ... 1 ... ... ... ... ... ... 1 2 2 1 57 Diseases of lymphatic systern and ductless glands 1.5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 58 Diseases of urinary system 37.8 48 ... 1 1 ... 20 17 ... ... ... 2 ... ... ... ... ... 1 ... ... 1 ... 1 59 Diseases of generative system 6.6 5 ... ... ... 2 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 60 Accidents of childbirth 5.8 5 ... ... ... 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 61 Diseases of locomotive system 6.5 7 ... 1 1 3 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 62 Ulcers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... 63 Diseases of integumentary system 8.1 8 1 ... ... 3 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 violent deaths. (Accident). 64 Fracture and contusion 20.4 37 1 2 3 7 12 10 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 65 Gun shot wounds 0.4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 66 Cut, stab 0.7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 67 Burn and scald 11.1 11 1 3 ... 1 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 68 Poison 1.3 3 ... ... ... ... 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 69 Drowning 5.1 6 ... ... ... 4 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 70 Suffocation 21.6 ... 21 1 ... ... 1 ... ... 1 ... 3 ... 1 ... 2 ... 2 ... 1 ... ... ... ... 71 Otherwise 4.1 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (Homicide.) 72 Murder and manslaughter 1.3 2 ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (Suicide.) 73 Gun shot wounds 0.4 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 74 Cut, stab 1.5 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 75 Poison 1.7 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 76 Drowning 1.3 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 77 Hanging 1.0 2 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 78 Otherwise 0.4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (Execution.) 79 Hanging 0.0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 80 Inquest ... 198 ... ... ... ... ... ... ... ... ... ... ... ... 8 ... ... ... ... ... ... ... ... ... 81 Other causes 67.5 82 69 2 1 ... 2 7 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 82 Undcertified deates ... 29 ... ... ... ... ... ... ... ... ... ... ... ... nil ... ... ... ... ... ... ... ... ... One resident died in an outlying Public Institution. Correct number of resident deaths 32. Spitalfields. Mile End. Whitechapel Church. Goodman's Fields. Aldgate. Totals. BIRTHS Males 4 9 8 2 4 27 48 Females 2 9 7 3 — 21 DEATHS Males 3 3 16 2 2 25 44 Females 1 7 9 2 — 19 9 Table A.—Births and Deaths registered in the Whitechapel District during the Quarter ending January 3rd, 1885 (14 weeks.) Total Bihths Registered—614. Total Deaths Registered—617. Spitalfields Mile End New Twn Whitchpl. Church. Goodman's Fields. Aldgate. Males. Females Spitalfields. Mile End New Twn. Whitchpl. Church. Goodman's Fields. Aldgate. Males. Females 189 196 131 62 36 324 290 94 164 288 33 38 344 273 Table B.—The Whitechapel Infirmary being in the Mile End New Town sub-District, the 18 births which took place in that Institution have been referred to the sub-Districts where the mothers previously resided. As the deaths of 196 non-residents took place in the District, chiefly in the London Hospital which is in the Whitechapel Church sub-District, and 23 residents died in Public Institutions outside the District, I have referred the deaths of the 444 residents to their proper sub-Districts. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. 198 180 133 63 38 158 77 111 51 47 Table C.—The 196 deaths of non-residents which took place in the District were registered in the sub-Districts as follows:— The deaths of the 23 residents which took place in Public Institutions outside the District occurred as follows:— Spitalfields, (Met. Free Hos.) Mile End New Town. (Infirmary.) Whitechapl. Church, (Lond. Hos.) Goodman's Fields. Aldgate. The German Hospital at Dalston 4 St. Bartholomew's Hospital 3 Children's Hospital at Shadwell 1 Metropolitan Asylums Hospitals Homerton Fever Hospital 9 Hospital Shin "Castalia" 1 Highgate Small-pox Hospital 1 5 2 189 0 0 The Surrey County Lunatic Asylum 1 The City of London Chest Hospital 1 The Woolwich Union Infirmary 1 The Royal London Ophthalmic Hospital 1 10 Table D. DEATHS. CASES. DEATHS. CASES. Diseases. London. Whtechpl. District. Dist. Med Officers. Union Infirmary. Diseases. London. Whtechpl. District. Dist. Med. Officers. Union Infirmary  All causes *21760 444 348 980 46 Croup 246 6 ... 1 47 Bronchitis 3064 88 64 98 ZYMOTIC DISEASES. 48 Pneumonia 1324 36 3 16 1 Small-pox Vaccinated 107 ... ... 2 49 Pleurisy 83 1 ... 9 Unvaccinated 105 1 ... ... 50 Other respiratory diseases 466 8 27 15 No statement 158 2 ... ... 2 Measles 293 10 13 3 51 Dentition 142 1 7 6 3 Scarlet fever 365 17 1 ... 4 Typhus fever 10 ... ... ... 52 Quinsy, sore throat 27 1 3 13 5 Relapsing fever ... ... ... ... 53 Enteritis 67 ... ... 5 6 Influenza 3 ... ... 13 54 Peritonitis 86 ... ... 7 Whooping cough 283 1 1 ... 55 Diseases of liver 413 9 ... 8 8 Diphtheria 315 4 ... 2 56 Other diseases of digestive system 421 8 25 25 9 Simple, Continued, and ill-defined fever 23 2 41 18 57 Diseases of lymphatic system and ductless glands 25 ... ... 7 10 Enteric fever 238 8 ... ... 11 Simple cholera 2 ... ... ... 12 Diarrhœa, Dysentery 336 7 10 21 13 Remittent fever 8 ... ... 11 58 Diseases of urinary system 565 7 1 17 14 Hydrophobia ... ... ... ... 15 Glanders ... ... ... ... 16 Cow-pox and effects of vaccination 2 ... ... ... 59 Diseases, generative system 84 ... 6 25 17 Venereal affections 136 2 1 35 18 Erysipelas 120 4 1 17 60 Accidents of child-birth 55 2 4 16 19 Pyœmia and Septicœmia 44 ... ... 12 20 Puerperal fever 120 ... ... 2 61 Diseases of locomotive system 108 1 6 12 21 Other zymotic diseases . 24 ... ... 15 22 Thrush 36 ... ... 3 62 Ulcere ... ... 3 61 23 Worms and other parasitic diseases 4 ... l 6 63 Diseases of integumentary system 81 2 25 42 24 Starvation, want of breast-milk 30 ... ... 6 VIOLENT DEATHS. 25 Alcoholism 67 ... ... 13 26 Rheumatic fever and rheumatism of heart 142 1 ... 15 Accident. 64 Fracture and contusion 65 Gun-shot wounds 288 1 2 4 66 27 Rheumatism 42 3 27 70 66 Cut, stab 8 1 ... 11 28 Gout 30 ... 1 11 67 Burn and scald 73 4 ... 12 29 Rickets 43 ... ... 3 68 Poison 20 ... ... ... 30 Cancer 700 9 ... 6 69 Drowning 47 ... ... ... 31 Tabes mesenterica 402 9 1 5 70 Suffocation 165 10 ... ... 32 Tubercular meningitis 277 14 2 ... 71 Otherwise 47 ... ... ... 33 Phthisis 2488 40 3 42 Homicide. 34 Scrofula, tuberculosis 258 3 ... 12 35 Other constitutional diseases 155 30 9 6 72 Murder & manslaughter 15 ... ... ... 36 Premature birth 519 7 ... ... Sdicide. 73 Gun-shot wounds 7 ... ... ... 37 Atelectasis 43 ... ... ... 74 Cut, stab 17 ... ... ... 38 Congenitl. malformations 88 1 ... ... 75 Poison 15 ... ... ... 39 Old age 754 17 4 26 76 Drowning 18 ... ... ... 40 Apoplexy 645 8 ... 7 77 Hanging 15 ... ... ... 41 Epilepsy 107 1 2 14 71 Otherwise 6 ... ... ... 42 Convulsions 623 5 1 6 43 Other diseases of brain and nervous system 1085 19 19 69 79 Hanging 2 ... ... ... 44 Diseases of organs of special sense 40 1 2 21 80 Inquests 1577 34 ... ... 81 Other causes 872 ... 29 ... 45 Diseases of circulatory system 1599 31 1 20 82 Uncertified deaths 276 1 ... ... 11 Table E.—Showing the Ages at which Death occurred amongst Residents. Under 1 year. Between 1 and 5. Between 5 and 20. Between 20 and 40. Between 40 and 60. Between 60 and 80. Over 80 years of age. 91 78 30 68 84 76 18 Of the 18 persons (residents) who died after 80 years of age, there had resided in the Spitalfields sub-District 5; in the Mile End New Town sub-District 5; in the Whitechapel Church sub-District 2 ; in the Goodman's Fields sub-District 3; and in the Aldgate sub-District 3. Total Births and Deaths in London, and Deaths under 5 years of ago. No. of Births in London during the Quarter 35,944 „ Deaths „ „ „ 21,760 ,, „ ,, under 1 year of age 4,884 8,006 „ „ „ between the ages of 1 & 5 3,122 12 Table P.—VACCINATION STATISTICS. For the Quarter ended January 5th, 1885. Certificates of successful Vaccination registered by the Vaccination Officer:- Born in the Union 591 Resident, but born elsewhere 196 787 Vaccination... Primary Public Vaccinator 320 Superintendt. Infirmary 32 352 Re-Vaccination Public Vaccinator 11 Superintendt. Infirmary 238 249 Table G.—Sanitary Work performed by the Inspectors during the Quarter ended January 3rd, 1885. Number. Numbers of Inspections of Houses as shewn in the Official Returns 1938 Houses specially visited 314 „ „ re-visited 1376 Preliminary Notices served, such Notices embracing 365 premises 3 83 Compulsory Orders issued, embracing 293 premises 170 Summonses heard at Police Court under Sanitary Act 2 „ under Act for the Prevention of Adulteration of Food, &c. 1 Cellars used as dwellings discontinued for such use 8 Cases of overcrowding and indecent occupation abated 5 Houses in which rooms or passages have been whitewashed 181 Rooms disinfected with sulphurous acid gas after the occurrence of small-pox, fever, and scarlet-fever therein 143 Articles consisting of beds, bedding, clothing, &c , removed from rooms to the stone-yard and disinfected in the apparatus 3761 Articles burnt by consent 29 Yards of houses paved or the pavement repaired 87 Drains in houses improved 81 Dust bins provided 47 Privies lime-washed, cleansed and repaired 179 Water-supply provided or improved 32 Nuisances from dung and other offensive matter removed 31 Area gratings, cellar flaps, &c., repaired 0 Places closed by consent, being unfit for human habitation 1 Cow-houses visited in the District 21 Slaughter-houses visited in the District 13 Bakehouses visited in the District 41 Fowls kept so as to constitute a nuisance 24 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. Twenty-five samples under the Food and Drugs Act, were submitted to the Public Analyst and several were found to be adulterated. In these cases the vendors were cautioned by the Inspectors. As they were first offences no summonses were applied for. A trade nuisance arising from the drying of damaged pepper upon premises at No. 18, Gun Street, has been abated. 13 Having thus in accordance with custom presented the statistics which accompany this Report for the fourth Quarter of the year 1884, it becomes my duty to review the Sanitary Work of the entire District for the completed year of 53 weeks, so that by comparison with the whole Metropolis, or with the neighbouring Districts during the same year, or with the Whitechapel District at other periods, some reliable clue may be afforded by which we may ascertain the condition of our District at the present time. ANNUAL REPORT. If it were easy to ascertain with certainty our present population no great difficulty would present itself in following ont the work I suggest ; but it must be remembered that since 1881, when the last census was taken, many and great changes have occurred in the Districl. Whole areas have been swept clear of houses for improvement schemes, under the "Artizans and Labourers' Dwellings Adts " or by railway enterprise ; and, as a set off, certain portions of vacant ground have been built upon. Then again, the constitution (as regards the population of the District) has changed very considerably, because, until recently, our poor consisted almost entirely of people from the South of Ireland, but now by far the greater proportion comprise Russian and Polish Jews, and so rapidly have the latter poured into the District within the last few years, that according to the Registrar-General's Report for 1881, I find that in a total population of 71,363 persons, there were no fewer than 9660 foreigners. An analysis of these immigrants reveals the fact that 4458 were Russian Poles, 835 were Russians, 1850 were Dutch, 1805 were Germans, and 203 were Austrians ; leaving a balance of 509 to be claimed by other nations. Our population in 1881 therefore consisted of foreigners to the extent of 13.5 per cent.; whilst of the total number of foreigners 6.2 per cent. belonged to the wretchedly filthy class known generally as "Polish Jews." It will be now readily seen why I referred to the changed constitution of the District, for although, as I shall show, our total population in 1884, as compared with 1881, has only decreased by some 2000 persons, yet we know that the number of foreigners has enormously increased. Those who have any experience of the 14 poor people to whom I allude—people who have been so cruelly treated abroad, that they flock here in droves and settle in the Whitechapel District as permanent paupers, will know how much anxiety and work is necessary to enforce habits amongst them, which although natural to more civilized people, are not understood by the class to which I allude. It was no doubt the result of this undue proportion of foreigners to our own inhabitants in the District that originated a letter to your Board from the Sanitary Committee to the Jewish Board of Guardians, a copy of which is appended to this Report, together with the reply from your own Sub-Committee, which was sent to the gentlemen who framed the complaints. The reply of your Sub-Committee was based upon personal investigation by the individual gentlemen who formed that Sub-Committee, aided by the opinion of your Surveyor when necessary, and strengthened by communications from many offlcers in the Union; and although a further communication has been received from the complainants, the results of your Sub-Committee's inspections and meetings adopted by the Committee of Works and also by your Board remain unaffected. But to return to the subject of our estimated population. In 1881 the census return gave the total inhabitants of the Whitechapel Distnct as 71,363, divided out amongst the Sub-Districts as follows:-- In the Spitalfields Sub-District 22,585 ,, Mile End New Town Sub-District 15,473 ,, Whitechapel Church ,, 17,490 ,, Goodman's Fields ,, 9,713 „ Aldgate ,, 6,102 The figures here quoted from the Registrar-General's Report prove that a birth-rate appertained to the District for the year under consideration of 36.2 per 1000 Now supposing the birth-rate to have remained uniform, the population for the year 1884 would have been 69,335. It will be seen upon reference to my previous Reports that I had estimated the population at 69,363, and as this calculation had been arrived at by carefully taking all circumstances into consideration which could affect the emigration and immigration of the Whitechapel people, I felt satisfied that the estimate mentioned was not far wrong, but I was not prepared to find such satisfactory support derived from the evidence which I have produced. Carrying 15 the calculations into detail as regards each Sub-District, it will be seen that the Spitalfields Sub-District contained 21,906 people. Mile End New Town Sub-District contained 19,364 ,, Whitechapel Church ,, ,, 14,917 ,, Goodman's Fields ,, ,, 7,955 ,, Aldgate „ „ 5,193 „ Assuming, therefore, that in 1881 each District was proportionately peopled, it is clear that the Mile End New Town Sub-District must now be over-populated. A scheme is under consideration for presentation to your Board, which I hope will deal satisfactorily with this matter. As however, exception may be taken to the estimated population which I have named, I have preferred in drawing attention to the year's births and deaths and other matters affecting the District, to argue upon premises which are definite, rather than from figures based more or less upon hypothesis. Thus the number of births registered during the year was 2500, whilst the total deaths amounted to 2219. Excluding the non-resident deaths and adding the deaths of those residents who, dying in outlying public institutions, were registered in other parts of London, the correct District mortality for the year is found to be 1571. The natural increase therefore is 929, and our District death-rate is equal to 22.6 per 1000 for the year 1884, which consisted of 53 weeks, or, corrected to a year of 52 weeks, is equal to 22.2 per 1000 per annum. The corrected London death-rate for the same period is equal to 21.5 per 1000, and this calculation is made without allowing for those details which I have arranged for in the calculations which apply to our own District mortality, and which adversely influence our District returns by comparison. I desire to draw attention to the advanced ages attained by some of the Whitechapel residents ; for whilst 45 deaths were registered over 80 years of age, nine of these were recorded at over go, and two died at the unusual age of 98. These various items of information are tabulated in Table E* of the Appendix, as arranged for the whole year. Upon Table D† in the same series will be found amongst other information a comparison of the Whitechapel District deaths with the deaths for the whole of London. Adding the 251 deaths of London residents which were registered during the last six months of the year from small-pox in Districts outside Registration London, the total zymotic deaths for London were 15,603, and for *See page 27. † See page 26. 16 the Whitechapel District 284. I append a Table to illustrate the value of these columns. CLASS OF DISEASE. Percentage of Deaths to Total Deaths. London. Whitechapel. Zymotic Diseases 18.7 18.0 Constitutional Diseases 20.3 21.3 Nervous ,, 11.5 10.6 Circulatory „ 6.5 6.2 Respiratory „ 19.2 25.1 Digestive ,, 5.7 5.0 Urinary ,, 2.2 2.4 Violent Deaths 3.5 3.9 In thus comparing the deaths, little variation is observable excepting as regards the "Respiratory Diseases," and with a view to complete analysis I have carrisd out into detail the examination into each disease, into which, for convenience, this class has been sub-divided. The result is as follows:— NAME OF DISEASE. Percentage of deaths from each disease to total deaths from Respiratory Diseases. London. Whitechapel. Croup 46 58 Bronchitis 57.7 615 Pneumonia 26.6 24.5 Pleurisy 16 10 Other Respiratory Diseases 9.3 7.0 Bronchitis, therefore, is the disease which proportionately is more fatal with us than amongst the inhabitants of London generally. 17 The following Table is based upon figures which have been extracted from the Registrar-General's Weekly Returns for the year 1884, and each District appertaining to those belonging to the official "East Districts" is included:— NAME OF DISTRICT. Total Deaths registered in the District. Deaths from Zymotic Diseases. Proportion per 1000 of deaths from Zymotic diseases to total deaths. Bethnal Green 2894 483 166.8 St. George-in-the-East 1192 172 144.2 Limehouse 1350 248 183.7 Mile End Old Town 2223 384 172.7 Poplar 3758 544 144.8 Shoreditch 2909 485 166.7 Whitechapel 2215 274 123.7 The infant mortality statistics for the 53 weeks of the year 1884, show that in London the deaths of infants under the age of one year equalled 25.7 per cent. of the total deaths, and 15.6 of the registered births; whilst in the Whitechapel District they were equal to 25.7 per cent. of the total deaths, and 17.7 per cent. of the registered births. The deaths of children under five years of age, including the above for London, equalled 43.3 per cent. of the total deaths, and 26.2 per cent. of the registered births; whilst for the Whitechapel District they equalled 43.2 per cent. of the total deaths, and 27.2 per cent, of the registered births. In instituting comparisons with reference to the above figures, and also with reference to the deaths from zymotic diseases, it must be remembered that in the third quarter of the year our increased deaths from infantile diarrhoea placed our District at considerable disadvantage compared with some other Districts. I stated in my Report for that Quarter that such deaths belonged to the class of "diseases of digestive system" and not to the class of "zymotic diseases," because it is most generally caused by the administration to infants of foods which they are unable to assimilate. That this is so every medical man could bring abundant evidence to demonstrate. 18 The simple withdrawal of such foods from the diet of an infant apparently dying from diarrhoea, and the substitution of a diet more closely allied to its natural food, frequently produces almost miraculous results. I have been supplied with the statistics of these blocks of buildings by Mr. W. Grimes, the Superintendent, who (with two assistants), has charge of them. The population on the 31st December, 1884, was 1183, of which number 23 were over 60 years of age, 182 between 40 and 60, and 627 below 20 years of age, leaving 351 persons between the ages of 20 and 40 years. The births during the year were 61 and the total deaths 27. Thus a death-rate for the year was produced equal to 22.7 per 1000. Artizans and Labourers' Dwellings in Glasshouse Street. Three cases of small-pox and 22 cases of scarlet-fever occurred, all but one case being transferred to Metropolitan Asylums Hospitals for treatment. A curious predilecftion for these diseases in favour of the ground floor rooms was noticed, as no less than n out of the 25 cases took place in those rooms. So far as one can judge from the few figures at our disposal, there seems little to choose in point of health between these excellently maintained dwellings, and the houses generally inhabited by the Districft inhabitants; on the contrary the zymotic death-rate is above the average for the District. I shall watch with interest in the future the mortality returns connected with these buildings, as they will contain eventually a very large proportion of the population of the Whitechapel Districft. During the past year 287 cases of small-pox, scarlet-fever, and enteric-fever have been brought under the notice of the sanitary staff, of which number 232 cases were removed to Metropolitan Asylums Hospitals, and 55 cases were treated at the residences of the patients. There were 151 cases of small-pox with 144 removals ; 119 cases of scarlet-fever with 79 removals; and 17 cases of enteric-fever with 9 removals. Zymotic Diseases. The following list indicates the streets where the diseases above mentioned occurred:— 19 NAME OF PLACE. Small Pox. Scarlet Fever. Enteric Fever. NAME OF PLACE. Small Pox. Scarlet Fever. Wnteric Fever Albert street ... ... 1 Heneage street 1 1 ... Alie street, Little ... 4 ... Hooper square ... 1 ... Angel alley ... 1 ... Hope street ... 1 ... Artillery passage ... 1 ... Hunt street 1 4 ... Artillery street 2 ... ... John's court 1 ... ... Backchurch lane 1 ... ... John's pl. O.Montague st. 1 ... ... Baker's row 1 ... ... John Street 1 ... ... Bath place 2 ... ... King street 1 2 ... Bell lane ... 1 ... Lamb street ... 2 ... Black Lion yard ... 1 ... Lambeth street ... 1 1 Blossom place 1 ... ... Leman street 2 ... ... Blossom street ... 1 ... Mansell street 2 1 ... Booth street 1 ... ... Montague place 1 1 ... Boundary court 1 ... ... Mount street ... 2 ... Brady street 2 ... ... New road 2 ... ... Brick lane 3 1 3 Newcastle street ... 2 ... Brushtield street l ... ... Old Castle street ... 2 ... Buck's row 2 ... ... Old Montague street 3 3 ... Buckle street buildings ... 1 ... Osborn place 1 ... ... Bull court 2 ... ... Oxford street 3 ... ... Burr street ... 3 ... Parliament court ... 1 ... Butler street 1 ... ... Paternoster row 1 1 ... Buxton street 2 3 4 Pelham street 3 1 ... Cable street 3 ... ... Pereira street 2 ... ... Chamber street 5 1 1 Plough street buildings ... 2 ... Charlotte court 1 3 ... Princes street 1 1 ... Chicksand street 2 ... ... Providence place 1 ... ... Church passage ... 1 ... Queen street, Aldgate ... 1 ... Corbett's court ... 1 ... Queen street, M. E. N. T 8 ... ... Cotton street 1 ... 1 Ramar place ... 2 ... Cox's square ... 1 ... Raven row ... 1 ... Crispin street ... 1 ... Baven street 1 ... ... Dock street 3 ... ... Bed Lion court 1 ... ... Dorset street 4 1 ... Royal Mint street 7 ... ... Elder street 1 ... ... Scarborough street ... 2 ... Elizabeth place 1 ... ... Shepherd street 4 ... ... Ely place ... 1 ... South street 2 ... ... Fashion street 4 ... ... Spectacle alley 1 ... ... Fieldgate street ... 1 ... Spellman street 1 1 ... Fisher's alley ... 1 ... Spital street ... 3 ... Freeman street 3 ... ... Spring gardens 1 ... ... Friendly buildings ... 1 ... Stewart street 2 ... ... Flower and Dean street 3 1 ... Tenter street 1 ... ... Frving-pan alley 1 ... ... Thomas street 2 ... ... George yard ... 1 ... Thrawl street 3 ... ... Glasshouse st.Pbdys.blds. 3 20 ... Underwood street 2 2 ... Goodman's yard ... 1 ... Union court ... 1 ... Goulston street 1 ... ... Upper East Smithfield I ... ... Great Garden street ... 3 ... Wellclose square ... 1 ... Great Pearl street 1 1 ... Went worth street 2 ... 1 Great Prescot street 1 2 ... Whitechapel high street. 1 1 1 Green street ... ... 1 Whitechapel road 5 3 2 Green dragon yard ... 2 ... White Lion street ... 2 ... Greenfield street 1 ... ... White's row ... 5 ... Gun street ... 2 ... Wilk street 2 ... ... Hanbury street 4 1 ... Winthrop street 4 ... ... Hanover court 2 ... ... Wood street ... 1 1 Harod's place 1 ... ... Yeokley's buildings 4 ... ... Haydon square 5 ... ... 20 My object in thus bringing specially before you the streets where these diseases occurred is to show the sporadic nature of the affecftions, and that being pretty evenly scattered throughout the District, no one part of it can be fairly accused of having been a source of danger to its neighbours. I may mention that during the last three months 2633 cases of small-pox were admitted into Asylums Hospitals and into the Highgate Hospital ; 527 cases of scarlet-fever and 169 cases of enteric-fever were also received into Asylums Hospitals, so that Whitechapel may be congratulated upon having contributed so few cases of these diseases. I cannot speak too highly of the manner in which all the arrangements for the removal of patients have been carried out by the Metropolitan Asylums Board Managers. Coming upon them so suddenly, the severe epidemic of small-pox must have cause'd them immense anxiety, and have taxed their resources to the utmost. Yet, with now and again, a little unavoidable delay, the exigences of the cases seem to have been admirably met. In the summer I went to the Darenth Camp, and was courteously allowed by the Assistant Medical Officer to view each tent and to examine into all the arrangements for the treatment of the patients, and the various administrative departments were also exhibited to me. It is only just on my part to record the that that in my opinion every care and attention seemed to be forthcoming that could increase the comfort of the patients and lessen that inconvenience which must attend compulsory residence in such an Institution. Communications have emanated from the Asylums Board Managers upon this subject with a view to an arrangement for payment in such cases being entered into by the various Sanitary Authorities. The matter (so far as our District is concerned) is already so well provided for that I do not think any reason exists for alteration. Should a case of infectious disease arise, either it can be readily removed through the machinery of the Board of Guardians, or by direct communication from the Medical Attendant to the Asylums Board Secretary, who will send an ambulance for the removal of the patient. In either case the Guardians are credited by the Asylums Board with the cost of removal and maintenance, and this cost is recovered from the patients if they are in a position to pay. I am afraid matters would be complicated by any other Hospital Treatment of Non-Pauper Cases of Infectious Disease. 21 arrangement, unless it be such as proposed by the Kensington Vestry in a series of resolutions as follows:— (a) That the Managers of the Metropolitan Asylums Board should be empowered to make adequate provision of hospital accommodation for infectious disease for all classes of the population in need of such accommodation. (b) That patients should be admitted into the Managers' hospitals upon certificates signed by any duly qualified medical practitioner. (c) That as the hospitals of the Managers have been established for the common good at the public cost, no compulsory payment should be exacted from persons whom the Sanitary Authority may deem it necessary or expedient to remove to the hospitals for the purpose of isolation. (d) That all expenses incident to the maintenance and treatment of such persons in the hospitals should be defrayed out of a Common Sanitary Fund, the Metropolis being treated for the purpose as a single district ; and (e) That steps should be taken to alter, by Act of Parliament, the constitution of the Board, by severing its connexion with pauperism, in so far as relates to the treatment of infectious disease, and by providing for the election of a certain proportion of the Managers by the several Sanitary Authorities, i.e., the Vestries and District Boards of Works. The Society of Medical Officers of Health have adopted the following resolution framed by their Council:—"The Council having taken into consideration the Special Report of the General Purposes Committee of the Metropolitan Asylums Board, with the knowledge of the fact that in some parishes and districts, from want of co-operation between the Poor Law and Sanitary Authorities, difficulty has been experienced in obtaining the removal to the Asylums Board Hospitals of cases of infectious diseases, cannot but approve the plan of contracts suggested by the Managers under the provisions of the Poor Law Act, 1879, sec. 15. At the same time the Council are of opinion that, as relief in the hospitals no longer entails pauperisation, cases should be admitted upon the certificate of any medical practitioner, that the expense of treating cases in the hospitals should be defrayed out of a Common Sanitary Fund (the Metropolis being treated as a single district for the purpose), and that no compulsory payment should be extracted from persons removed to hospitals for the pupose of isolation." I can only repeat that through the kind co-operation of Mr. W. Vallance, on the part of the Board of Guardians, so far as our District is concerned, I have had no reason to find fault with existing arrangements. Licensed Cow-Houses. The following received renewal of licenses in October, 1884:— WHITECHAPEL. Brown, Frederick William 33, Old Montague-street. Davies, John 11, Black Lion-yard. Edwards, Evan 6, White's-row. James, William 3, Finch-street. Jones, John Evan (late Eliza) 20, Chamber-street (rear of) Lewis, William Plough-square. Sole, Isaac Walton's-yard, Cable-street. Watson, Thomas 64, Old Montague-street. CHRISTCHURCH. Barker, Daniel Saw-yard, Tenter-street. Edwards, Abraham 6, White's-row. Morgan, Evan David 155, Commercial-street. Underwood, Edward 15, Tilley-street. Webb, John 16, Grey Eagle-street. Williams, Ann 37, Hanbury-street. 22 MILE END NEW TOWN. Bryant, William 26, Underwood-street. Evans, Samuel 23, Dunk-street. Foster, Henry 64, Pelham-street. Gibbs, Henry 73, Baker's-row. Williams, John (late A. Muggins) 4, Spital-street. NORTON FOLGATE. May, Elizabeth 7, White Lion-street. Slaughter-Houses. The following were allowed to receive renewal of licence in October, 1884:— WHITECHAPEL. Horwitz, Solomon Lialter, Joseph 6 H.gh-street. Kefford, Thomas (late Jane) 27, High-street. Knight, Charles Henry 4, High-street. Lankester, Robert Lawrence Chamberlain, Joseph High-street. Monkton, George 269, Whitechapel-road. Nathan, Joseph 52, High-street. Pettitt, Mary 52, Cable-street. Shave, George 2. Well-street. Stanton, David 38, Charlotte-street. Wood, Benjamin James 3, High-street. CHRISTCHURCH. White, Lewis Abraham 5, Middlesex-street. MILE END NEW TOWN. Garton, John Arthur 147, Hanbury-street. NORTON FOLGATE. Covell, Edwin 29, Norton Folgate. It will be noticed that from January 1st, 1884, the Sanitary Authority in each District has, by Act of Parliament, the duty again cast upon it of attending to so much of the "Factory Act" as applies to Retail Bakehouses. Up to 1878 the same authority had been responsible for carrying out such provisions of the Act as referred to Retail Bakehouses, but in the interval between the periods named, the Sanitary Authority gave place to the Government Inspectors of Factories, as custodians of the health of people employed in Retail Bakeries. A reference to the statement of work performed by our experienced Inspectors, Messrs. Battram and Wrack, will indicate that they have well executed this branch of their duty. During the year I have also myself inspected every such facftory in the Districft. Bakehouses in the District. 23 I append a Table showing the locality of each of the thirty Schools in the District, with other important and interesting information extracted from the last half-yearly Report of the School Board for London. At the commencement of the year I was exercised as to the best means to prevent infectious diseases being conveyed by children attending School. It had hitherto been the custom to forbid children whose friends were affedted by epidemic diseases to attend school, and the teachers of such school were also informed of the particulars in every case ; but complications arose where children from the same family attended different schools, and even various departments in the same school. To assist in this difficulty, the co-operation of S. Mather, Esq., Superintendent of School Board Visitors for the Tower Hamlets, was enlisted, and in all cases we now communicate with this gentleman, and by means of his staff of Visitors the requisite exclusion is more satisfactorily effected. Educational provision in the District. The mean weekly temperature of the air during the year was 5o°. Fahrenheit. The highest temperature recorded was 82°. on June 27th, and the lowest was 24°.5 on November 11th. Rain fell upon 151 days to an aggregate of 17.98 inches. Meteorology. Mem. —One inch deep of rain-fall on an acre (allowing 10-lbs. to a gallon) weighs nearly 101 tons. I have the honour to remain, Gentlemen, Your obedient Servant, JOSEPH LOANE. To the Board of Works, Whitecliapel District. P.S.—Since I wrote the Report, your Board has adopted the recommendation of the Committee of Works that " so soon as arrangements can be made, there shall be erected in the District a Destrudtor, built upon the model of that which a Sub-Committee of your Board inspected at Ealing." The importance of such a work it would be impossible to over-rate. 24 No. NAME OF SCHOOL. Accommodation . Total. Average No. on the Roll. Average Attendance of Half-year. Total. Boys. Girls. Mixed. Infants. Boys. Girls. Mixed. Infants. 1 All Saints' National, Spicer Street 225 148 .. 177 650 550 155 104 .. 144 403 2 St. Anne's (R.C.) do. 467 196 .. 196 859 581 245 98 .. 149 492 3 St. Agatha's, London Docks .. .. .. 187 187 160 .. .. .. 130 130 4 Berner Street (Permanent) 207 245 .. 376 823 899 224 241 .. 254 719 5 Bucks Row do. 256 256 .. 270 782 810 225 217 .. 196 638 6 Chicksand Street do. 391 391 .. 398 1186 1089 271 251 .. 338 860 7 St. Crispin (R.C.) Crispin Street .. .. 311 .. 311 170 .. .. 120 .. 120 8 Christ Church, Brick Lane 134 .. 170 .. 304 318 97 138 .. 235 9 Darby Street (Trans.) .. .. .. 158 158 131 .. .. .. 86 86 10 George Yard (Free) .. .. 289 .. 289 265 .. .. 219 .. 219 11 German Mission, Leman Street .. .. 150 .. 150 135 .. .. 115 .. 115 12 Gower's Walk (Free Industrial), Great Alie Street 83 83 .. .. 166 139 62 54 .. .. 116 13 Hanbury Street (Trans.) 330 350 .. 210 890 742 211 204 .. 160 581 14 Jews' (Free), Bell Lane 2100 1200 .. .. 3300 3032 1730 1120 .. .. 2850 15 Jews' Infant, Commeroial Street .. .. .. 603 603 721 .. .. .. 604 604 16 do. Tenter Street .. .. .. 375 375 437 .. .. .. 351 351 17 St. Jude's, Whitechapel 114 110 .. 114 338 317 95 84 .. 63 242 18 St. Mary's (National), St. Mary Street 450 104 .. 150 704 494 195 111 .. 135 441 19 St. Mark's, Whitechapel 242 194 .. 165 601 444 .. 99 .. 95 194 20 St. Mary's, Spitalfields .. .. .. 190 190 135 .. .. .. 94 94 21 Mr. Moss, New Castle Street .. .. .. 64 32 .. .. 24 .. 24 22 Old Castle Street (Permanent) 473 396 .. 480 1349 1427 420 401 .. 376 1197 23 Parochial, Tower Hill .. .. 108 108 99 .. .. 92 .. 92 24 St. Paul's, Wellclose Square 182 182 .. 337 701 563 104 140 .. 188 432 25 St. Peter's, Broad Street 164 136 .. 200 500 621 160 120 .. 175 4.55 26 Rector's Infant, Charlotte Street .. .. .. 72 72 79 .. .. .. 64 64 27 St. Stephen's (National), Quaker Street 218 207 .. 210 635 601 182 146 .. 190 518 28 Sion Chapel, Whitechapel Boad .. .. 216 .. 210 75 .. .. 50 .. 50 29 Tower Hill (R.C.), Chamber Street 251 239 .. 251 741 580 146 174 .. 157 477 30 Wood Street, Spitalfields (Permanent) 154 .. 211 .. 365 168 154 .. 209 .. 363 17,522 13,225 25 Table A.—Births and Deaths registered in the Whitechapel District during the 53 weeks of the Year 1884 which terminated January 3rd, 1885. Total Births Registered—2500. Total Deaths Registered—2219. Spitalfields. Mile End New Twn. Whitchpl. Church. Goodman's Eields. Aldgate. Males. Females Spitalfields; Mile End New Twn. Whitchpl. Church. Goodman's Fields. Aldgate. Males Females 763 759 524 281 173 1254 1246 398 543 1070 117 91 1232 987 Table B.—The Whitechapel Infirmary being in the Mile End New Town sub-District, the 96 births which took place in that Institution have been referred to the sub-Districts where the mothers previously resided. The amended Table is therefore given:— As the deaths of 722 non-residents took place in the District, chiefly in the London Hospital which is in the Whitechapel Church sub-District, and 74 residents died in Public Institutions outside the District, I have referred the deaths of the 1571 residents to their proper sub-Districts. Spitalfields. Mile End New Town. Whitechapl. Church. Goodman's Fields. Aldgate. Spitalfields. Mile End j New Town. Whitechapl. Church. Goodman's Fields. Aldgate. 791 701 540 288 189 582 314 395 169 111 Table C.—The 722 deaths of non-residents which took place in the District -were registered in the sub-Districts as follows:— The deaths of the 74 residents which took place in Public Institutions outside the District occurred as follows:— Spitalfields, (Met. Free Hos.) Mile End New Town. (Infirmary.) Whitechapl. Church, (Lond. Hos.) Goodman's Fields. Aldgate. German Hospital at Dalston 10 Jews' Hospital, Mile End-road 1 St. Bartholomew's Hospital 1 5 Chest Hospital, Victoria Park 2 Metropolitan Asylums Hospitals, Camp and Ships 27 Military Station Hospital 3 City of London Chest Hospital 1 Highgate Small-pox Hospital 1 Surrey County Lunatic Asylum 1 15 6 698 0 3 Guy's Hospital 1 Woolwich Union Infirmary ... 1 Charing Cross Hospital 1 Mile End Old Town Infirmary 1 Middlesex Hospital 1 Royal London Ophthalmic Hospital 1 Children's Hospital, Shadwell 6 Evelina Children's Hospital 1 26 Table D.—Statement for Year 1884 (Fifty-three Weeks.) Diseases. deaths. cases. Diseases. deaths. CASES. London. Whtechpl. District. Dist. Med Officers. Union Infirmary. London. Whtechpl. District. Dist. Med. Officers. Union Infirmary All causes 83051 1571 3113 399J 46 Croup 744 23 ... 6 ZYMOTIC DISEASES. ‡ 47 Bronchitis 9211 243 411 362 48 Pneumonia 4254 97 8 41 lfSmall-pox Vaccinated 249 1 ! 4 3 49 pleurisy 261 4 8 50 llnvaccinated 324 3 1 2 ... 50 Other respiratory dis- eases 1484 28 211 71 No statement 346 11 . 64 5 2 Measles 2285 26 51 17 3 Scarlet fever 1444 45 35 9 51 Dentition 796 30 34 27 4 Typhus fever 31 ... 2 52 Quinsy, sore throat 102 3 30 39 5 Helapsing fever 1 ... ... ... 53 Enteritis 336 1 ... 11 6. Influenza 6 ... ... 29 54 Peritonitis 340 5 ... V 7. Whooping cough 3188 50 25 19 55 Diseases of liver 1555 22 8 35 8 Diphtheria 973 8 5 56 Other diseases of diges- tive system 1662 19 156 102 9 Simple, Continued, and ill-defined fever 78 2 114 . 70 10 Enteric fever 930 15 5 11 57 Diseases of lymphatic) system and ductless glands 105 1 9 36 11 Simple cholera 163 1 ... 12 Diarrhcea, Dysentery ... 3781 91 73 105 13 Remittent fever 20 ... ... 21 58 Diseases of urinary system 1878 38 20 62 14 Hvdrophobia 9 ... ... ... 15 Glanders ... ... ... ... 16 Cow-pox and effects of vaccination 12 ... ... 3 59 Diseases, generative system 315 2 42 150 17 Venereal affections 537 14 34 153 18. Erysipelas 381 9 8 u3 19 Pytemia and Septicffimia. 159 2 18 60 Accidentsof child-birth. 193 6 §32 §85 20 Puerperal fever 327 ... 6 21 Other zymotic diseases .. 102 ... ... 38 61 Diseases of locomotive system 381 4 114 52 22 Thrush 119 ... ... 7 62 Ulcers ... ... 225 239 23 Worms and other para- sitic diseases 17 ... 2 10 63 Diseases of integumentary system 289 9 239 171 24 Starvation, want of breast-milk 87 ... 1 20 VIOLENT DEATHS. Accident. 25 Alcoholism 243 3 3 49 26 Rheumatic fever and 1 rheumatism of heart 444 1 ... 42 64 Fracture and contusion 1065 18 115 259 65 Gun-shot wounds 8 ... ... ... 27 Rheumatism 140 6 461 320 66 Cut, stab 27 1 3 f>7 28 Gout 163 ... 24 42 67 Burn and scald 288 10 6 35 29 Rickets 190 1 2 11 68 Poison 60 ... 4 ... 30 Cancer 2623 25 6 "3 69 Drowning 304 1 ... ... 31 Tabes mesentcrica 1594 23 2 22 70 Suffocation 602 26 ... ... 32 Tubercular meningitis 1316 36 7 7 71 Otherwise 168 3 ... ... 33 Phthisis 8881 149 26 11/ Homicide. 34 Scrofula, tuberculosis 994 4 4 37 35 Other constitutional . diseases 515 90 97 137 72 Murder & manslaughter 70 ... ... ... 36 Premature birth 1911 25 1 14 Suicide. ... ... ... 73 Gun-shot wounds 42 ... ... ... 37 Atelectasis 126 ... 74 Cut, stab 80 ... ... 38 Congenitl. malformations 353 2 ... 12 75 Poison 70 2 ... ... 39 Old age 2473 55 25 134 76 Drowning 71 ... ... ... 77 Hanging 71 ... ... ... 40 Apoplexy 2141 43 ... 45 71 Otherwise 33 1 ... ... 41 Epilepsy 378 9 10 69 Execution. 42 Convulsions 2002 39 3 22 43 Other diseases of brain and nervous system 4438 77 160 179 79 Hanging 2 ... ... ... 44 Diseases of organs of special sense 121 1 14 73 80 Inquests *5732' *141 ... ... 81 Other causes 3501 3 151 38 45 Diseases of circulatory system 5472 98 21 91 82 Uncertified deaths *1051 *10 1 ... * Numbers thus marked are not included in the sums total. + These numbers are exclusive of the deaths of Londoners from small-pox outside Hegistration London; for the last half-year these amounted to 251. J Inclusive of residents who died in outlying institutions. § Accouchement cases. 27 Table E.—Showing the Ages at which Death occurred amongst Residents during the Year. Under 1 year. Between 1 and 5. Between 5 and 20. Between 20 and 4 0 Between 40 and 00. Between 60 and 80. Over 80 years of ago. 404 276 109 213 267 257 45 Of the 45 persons (residents) who died after 80 years of age, there had resided in the Spitalfields sub-District 15; in the Mile End New Town sub-District 10 ; in the Whitechapel Church sub-Distiict 9 ; in the Goodman's Fields sub-District 0 ; and in the Aldgate sub-District 5. Included in the above were 2 deaths at 98 years of age. 2 „ 90 3 „ 94 2 „ 90 2 „ 89 1 „ S8 Total Births and Deaths in London, and Deaths under 5 years of age. No. of Births in London during the Year 137,453 „ Deaths „ „ „ 83,051 ,, „ ,, under 1 year of age 21,369 36,030 „ ,, ,, between the ages of 1 & 5..14,661 28 Table F.—VACCINATION STATISTICS. For the Year ended January 5tli, 1885. Certificates of successful Vaccination registered by the Vaccination Officer Born in the Union 2412 Resident, but born elsewhere 576 2988 Vaccination. Primary Public Vaccinator 1807 Superintends Infirmary 133 1940 Re-Vaccination Public Vaccinator .1017 Superintends Infirmary . 922 1939 Returned as "Insusceptible" 1 Table G.—Sanitary Work performed by the Inspectors during the Year 1884. Number. Numbers of Inspections of Houses as shewn in the Official Returns 10555 Houses specially visited 1283 „ „ re-visited 5142 Preliminary Notices served, such Notices embracing 1647 premises 1209 Compulsory Orders issued, embracing 504 premises. 275 Summonses heard at Police Court under Sanitary Act 6 „ under Act for the Prevention of Adulteration of Food, &c.... 10 Cellars used as dwellings discontinued for such use 29 Cases of overcrowding and indecent occupation abated 14 Houses in which rooms or passages have been whitewashed 711 Booms disinfected with sulphurous acid gas after the occurrence of small-pox, fever, and scarlet-fever therein 413 Articles consisting of beds, bedding, clothing, &c , removed from rooms to the stone-yard and disinfected in the apparatus 9470 Articles burnt by consent 243 Yards of houses paved or the pavement repaired 307 Drains in houses improved 320 Dust-bins provided 152 Privies lime-washed, cleansed and repaired 664 Water-supply provided or improved 83 Nuisances from dung and other offensive matter removed 175 Area gratings, cellar flaps, &c., repaired 14 Animals (dogs, &c.), kept so as to be a nuisance, removed 1 Fowls, &c. „ „ 27 Baskets of plums destroyed as unfit for human food 55 Houses closed by Magistrate's order, or by consent, as unfit for human habitation 8 Cow-houses visited in the District 87 Slaughter-houses visited in the District 52 Bakehouses visited in the District 165 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. One-hundred and forty-three samples under the Food and Drugs Act, were submitted to the Public Analyst and 20 were found to be adulterated. Ten summonses were taken out against the vendors and fines were inflicted in nine cases. In all the other cases, as they were first offences, the vendors were cautioned. To the Board of Works for the Whitechapel District. Report of the Committee appointed to consider certain charges lately made by the Members of the Sanitary Committee of the Board of Guardians for the Relief of the Jewish Poor, with reference to Sanitary defects stated to exist within the Whitechapel District. Gentlemen, The communication addressed to your Board, signed by Mr.CoHEN, [the Chairman] and other members of the Sanitary Committee of the Board of Guardians, for the relief of the Jewish Poor, referred to your Committee for consideration and report has been carefully considered by your Committee; and Sub-committees have been appointed to inspect, and have inspected, various houses included in a supplemental letter sent by Mr. Schloss, the Hon. Secretary of the Committee of the Jewish Guardians, and the whole of the houses referred to in such supplemental letter have been inspected by your Medical Officer of Health. It may be premised that during the past year considerable interest with regard to the condition of the dwellings of the poor has been awakened, and an intelligent work for good has started into existence, under the designation of the Mansion House Council, on the dwellings of the poor. A local representation of that body has been established in this District, under the auspices of Mr. Bolton King, and your Committee believe that the Sanitary Committee of the Jewish Board of Guardians have been identified with the Council, or, at any rate, working upon the same lines in the interest of the poor of this District. Your Committee believe that much good has resulted from the voluntary system that has been adopted, and by these bodies employing Inspectors, or by members of these bodies volunteering as Inspectors, to visit the habitations of the poor, and that much more good (if the practice be persisted in) will result in the future, when what may be termed the enthusiasm of the commencement of the enquiry has toned down to sober work. By this voluntary movement your Committee believe that the whole of the Whitechapel District has undergone most searching and complete investigation, and with a minuteness that reflects the greatest credit upon the zeal of those engaged in the enquiry. It will be remembered by the Board that Mr. Schloss, the Hon. Secretary of the Sanitary Committee of the Jewish Board of Guardians, 2 at the early part of last summer applied to your Board, through your Medical Officer of Health, to have the Inspector appointed by the Jewish Board, recognised as such by your Board : that suggestion was not adopted, and your Committee think rightly so, but every assistance on the part of the Officers of the Board was to be given and your Committee believe has been given to advance the common object of the improvement of the district. The communication referred to your Committee appears to be a summary of a period of investigation made by the Jewish Guardians upon the condition of a large portion of the Whitechapel District, which your Committee have perused and considered with mingled feelings of satisfaction and regret; with satisfaction, because it has been shewn that the number of complaints hitherto reported to your officers has been exceedingly small, and small as they are in number, many of those have had reference to the absence of water supply to closets, the advisability of which depends, as your Committee believe, rather upon experience with regard to the habits of the people than individual views. Your Committee have perused the communication with regret, because, with the exception of a passing compliment paid to the Medical Officer and Inspectors, it is a continuous outpour of condemnation and complaint. There is, perhaps, the redeeming feature in it, that the florid nature of part of its composition acts as an antidote, and renders it impossible for the most casual reader to accept it as a plain and unvarnished statement of faCts. It appears that, on the question of water supply to closets, the Jewish Guardians were, from the first, impressed with the importance of a water supply apparatus being provided to every house ; that system has, of course, very great merit under certain circumstances ; but Dr. Liddle, the late Medical Officer of Health, long since discarded it as being unfitted to the habits of the people in the poorer portions of the District, and the system of a care-taker being appointed to flush the closets with water was substituted. Your late Medical Officer was indefatigable in his endeavours to procure a constant supply of water to courts for the use of the inhabitants, which was accomplished throughout the District, and the flushing of the closets with water thrown into them was adopted, and this mode of cleansing closets is approved by Dr. Loane, your present Medical Officer of Health, where the closet is not actually in the house, and in this view your Committee also concur. The divergence of views on the subject of water supply to closets was the occasion of a large number of the complaints which were sent from the Jewish Guardians. The desire to have a water supply apparatus to closets appears to be the common mistake made by all upon their outset to improve such places as the courts in this District, 3 It may be convenient here to mention that, in the course of three months, the Secretary and Inspectors of the Jewish Board of Guardians sent in all, sixteen written communications to the officers of your Board; in those communications a total of 261 houses are referred to ; of those 261 houses, the complaint as to 188 houses is, amongst other details, that they are not provided with a water supply to the closets. The extremely general nature of the charges or complaints in the communication from the Jewish Guardians renders it difficult for your Committee to do other than deal with the subjeCt in a similar mode, but two matters appear with some prominence, namely, that the complaints made by them were not dealt with satisfactorily, and that a large number of houses in the district are, from foulness or decay, or from both causes, absolutely unfit for habitation. In order to fix, with some degree of certainty, what houses were thus classed by the Jewish Board of Guardians, information was asked as to the houses complained of; a list was furnished, and that list your Committee have dealt with exhaustively. With regard to the first matter of complaint, your Committee have made enquiry and find that every complaint made by the Officers ofthejewish Board of Guardians was investigated, and, except as to compelling water supply apparatus to be put to closets, the necessary action for the removal or abatement of the nuisance was taken. Some of the complaints were of the filthy condition of closets, or an accumulation of dust; all these cases have been found recorded in the Inspector's books, and, where; necessary, the entries have been followed up by a record of the results of the action of the Inspectors. Your Medical Officer has expressed himself perfectly satisfied that the Inspectors have been able to meet the necessities of the cases as they arose, and your Committee are of opinion that they have done so. With reference to the more important complaint, that a large number of houses in the district are unfit for human habitation from causes mentioned in the communication to your Board your Committee, having obtained a list of the houses complained of, find that they number 123, of which 87 are described as unfit for human habitation. A special visit has been made to the whole of the premises so described, and most of them have been visited by sub-committees composed of members of your Committee, and your Committee unhesitatingly assert, that the sensational description of these houses contained in the communication from the Jewish Guardians is not warranted by the facts. That many of the houses in the district have been subjected to very hard wear, and to much ill usage, is' 4. perfeCtiy true. Occupied as they are, such has been and must ever be the case, because there is hardly a house in the district which is in the occupation of the poorer inhabitants, but that is occupied by more than one family ; and the consequence is, that every house so occupied has to be continually watched by the Sanitary Officers of the Board. The remedy suggested by the Jewish Guardians is, to your Committee, so startling, that your Committee think it better to quote from their own letter, that it may appear as adtually made ; it is as follows:— " The compulsory closing of pestilential dwellings here suggested will " involve no cost to the ratepayers, and the method is therefore not " open to the objection of expense that would be involved by condeming " the houses under Torrens' (Amended) ACt. The houses, when closed, " being unproductive of rent, would certainly be promptly pulled down " by the owners and their sites covered by improved dwellings. In " this manner whole areas might, little by little, be improved, and the " buildings thereon removed, without the costly processes involved by " the Artizans' Dwellings Act." This " little by little" process seems to your Committee to read as a satire upon the present condition of the Whitechapel District. For acres upon acres of houses have just been demolished in the District, under the Artizans' and Labourers' Dwellings Acts, and for railway purposes; many thousands of the residents have been turned out of their dwellings; acres more of houses are about to be pulled down under the Scheme known as Bell Lane Scheme, which is about to be put in force by the Metropolitan Board of Works ; and under a representation recently made by the Medical Officer of Health, upon a requisition signed by several inhabitants, complaining of certain houses described as the Pearl Street Scheme, it is proposed that a further area shall be cleared. It is self evident that under the Schemes promoted by the Metropolitan Board of Works for the Improvement of the District and by the absorption of property by Railway Companies, a vast number of houses have been destroyed and it is estimated that about 12,000 inhabitants have been displaced whilst accommodation has at present been provided for, only about one fourth part of the number of those disturbed; and there is a still worse feature, which is that the new and better buildings very rarely indeed become occupied by the class of persons who have been disturbed. In addition to the destruction of the houses of the poor which have been referred to, your Committee would also call to the recollection of your Board the fact that in the alteration of Baker's Row in which your Board expended £"35,000 in improving that locality, and in the widening of Royal Mint Street, where your board expended upwards of £"38,000, many dwellings of the poorer classes were also disturbed. 5 The facts referred to by your Committee do not of course prove that the houses which at present remain are either good or desirable residences for human habitation but they do prove that revenue to a large extent in rates has been lost and that a vast number of the most indifferent houses in the District have been removed, and also that, wisely or otherwise, a large number are about to be removed, and it further brings your Board face to face with the faCt that great overcrowding of such houses as remain, must of necessity take place. The demand for room is urgent beyond the conception of those who are unacquainted with the circumstances, and the rents are exorbitant as compared with the accommodation, and thus the wholesale or indiscriminate destruction of the residences of the very poor makes what was bad, infinitely worse. This evil has, within the last few years, been greatly intensified by the arrival within the district of a vast number of foreign Jews. The number in the district, in 1881, was upwards of y,ooo, which number has been swelled very considerably since that period, they are of the very poorest class, whose views of decency and cleanliness appear, from evidence which has been before your Committee, to be of the very lowest possible order, and whose habits degrade the condition of every house they occupy to the lowest level. The condition of the houses so occupied by these poor Jews, is such as to form a considerable demand upon the attention of your Medical Officer and Inspectors, as these houses have to be constantly under supervision to endeavour to counteract the filthy condition of the rooms, yards and waterclosets occupied and used by these people ; and your Committee are clearly of opinion, that it is the habits of the people more than the condition of the structural repair of the houses that has misled the agents of the Jewish Guardians in framing their reports. This question is one to which, your Committee are of opinion, most serious attention should be directed, and one as to which the Jewish Board of Guardians could, in the opinion of your Committee, co-operate with your Board with very great advantage in two ways ; firstly, by exercising some supervision with regard to the housing of newly arrived immigrants, which could readily be effected, as all members of the Jewish persuasion naturally congregate to a common centre; and secondly, by inducing Jewish ladies to volunteer to visit the houses of these poor people, or by the formation of a staff of visitors for that purpose, to instruct ar.d encourage them in the sanitary principles to be observed by them in their habitations; such a system would,' your Committee think, be of vast use and greatly assist the efforts of the Sanitary Officers of your Board, and the sanitary condition of the people would be much improved. 6 Some cases, called "typical cases," of noxious or offensive trades, are referred to in the communication from the Jewish Guardians, into all of which your Committee have enquired ; two only appear to your Committee to deserve mention—one a pickle business in Newman's Buildings, which appears to your Committee to be a very well condudted business, and there appears to your Committee no pretence for the statement that the salting of decomposed fish forms part of the business ; the other, the business of making cream cheese in Perry Avenue, Booth Street, that business was offensive, but it is not now in operation. The remaining matters to which reference is made in the communication under consideration, relate to the condition of drains,, dust-bins, underground rooms occupied as dwellings, and the paving of yards, these are all dealt with only in general terms, and therefore can only be referred to by your Committee in like terms; but your Committee may add, that, with reference to all these matters, much has been done, much is being done, and much remains to be done. The improvements which are being effected to day, have to be followed up and repeated next week, or next month, and a constant watch has to be kept upon the recurring nuisances, and it is in this manner the attention of the Sanitary Officers of the Board is directed, and must continue to be directed, not only to the smaller houses which remain in the district, but also to the large buildings which are in course of erection. Your Committee desire to express their conviction that the Sanitary department of the Board has been long served with fidelity and zeal on the part of its officers, and that there is every desire on their part to meet the necessities of the District. Your Committee have hitherto believed, and still believe, that immense improvements have been effected in the sanitary condition of the District, and that every effort is being made to meet these requirements, and notwithstanding all the disadvantages referred to in this report, your Committee desire, in support of their belief, to point to the fact that the rates of mortality in the District, were for the four quarters ending September last respectively 22-9, 18-9, 21-9 and 24-3 per 1000. The last quarter's rate was raised in consequence of the increased deaths amongst infants from diarrhoea. Before closing this report your Committee desire to add, that it is their belief, that the officers of the Board recognise the value of the aid which is being given to the Sanitary improvement of the District by the Volunteer system which has been referred to, and that they are very anxious to assist such efforts to the best of their ability, and in so doing your Committee feel assured that they will receive the 7 approval of your Board. It appears, however, that it is the custom of the Volunteer friends in the District to encourage the practice of sending complaints of nuisances to their local head-quarters, instead of forwarding them to the Office of the Board. And it is their practice also to issue notices for the abatement of nuisances. Your Committee forbear in this report to offer criticism upon those practices, but would simply remark that they tend somewhat unduly to inflate the value of the voluntary efforts at the expense of the recognised authority and to offer the temptation to write such communications as that which has formed the subjeCt of this report. In closing this report your Committee have to add that for the sake of convenience it has been directed that it shall be signed by their Chairman on their behalf, and that a Copy of the communication from the Jewish Board of Guardians which has been the subject of enquiry shall be annexed to this report. Dated this 15th day of December, 1884. (Signed), R. GLADDING, Chairman, The following is a Copy of the communication referred to in the annexed Refort. Board of Guardians for the Relief of the Jewish Poor. 13, Devonshire Square, Bishopsgate, E. October 30th, 1884. To the Chairman & Members of the Whitechapel District Board of Works. Gentlemen. We the members of the Sanitary Committee of the Board of Guardians for the Relief of the Jewish Poor, beg leave to call your attention to the fact, that in a very large number of cases of sanitary defects brought to your notice in the months of June, July and August last, no remedial action has been taken by the owners. While we readily acknowledge the great courtesy with which our representations are invariably received by your Medical Officer and your two Sanitary Inspectors, yet, judging from practical results, we are under the strong impression that the action of your Board, in these and similar cases, is neither as prompt nor as cogent, nor as effectual as the needs of the cases demand; and we respectfully suggest that you appoint additional Inspectors, in order to compel a more prompt and complete compliance with sanitary requirements. After careful investigation we are of opinion that the general sanitary state of the houses inhabited by the poor in your district is most unsatisfactory, and we believe that in the event of the outbreak of any epidemic in the metropolis, the result would be disastrous to your district, where all the external conditions favourable to the spread of disease exist to the fullest degree. Moreover we find in most particulars, the sanitary condition of the dwellings to be far below the very moderate standard required by the Regulations framed by you, under the provisions of the Sanitary Act 1866. The yards at rear of the houses are seldom, if ever, sufficiently paved with proper and suitable materials " nor sufficiently drained " so as to run dry and effectually take off all waste or surface water," as required by the 17th clause of your Regulations, and the result usually is that the rainfall penetrates into the foundations of the houses, carrying with it the impurities of the yards and open dust bins, rendering the woodwork of the floors rotten, and converting the sub-soil into a quagmire of putrid filth. 9 Although in most cases some sort of drainage to the yards is provided, it is almost invariably ineffectual. The fall of the paving, which consists usually of fragments of flagstones, is generally in the wrong direction, so as to harbour instead of discharging the moisture; while the trap into which the water is intended to discharge, is most frequently either a sink-stone or a bell-trap, the latter usually without a bell. Your igth Regulation requires " all drains or sinks to be properly trapped;" and we submit that a bell-trap (even if the bell be there) is, in consequence of its insufficiency and the liability to the loss of the bell, not a proper trap, and that a dip-trap of sufficient dimensions should be insisted upon to supersede the trap-less sinkstones and the bell-traps, which have long since been discarded by all authorities on sanitation. Your 16th Regulation requires every house to be provided with a dustbin of sufficient size and with proper cover. There are numerous cases where no dustbin is provided; Many others where the basement itself is the dustbin, or where the dustbin is formed inside the house under the stairs. In most instances it is found in the yard, but is seldom fitted with cover. The three defects above enumerated—the imperfect paving of yards or back areas, the absent or defective traps, and the uncovered dustbins together constitute an evil of the greatest magnitude; for all the air entering the back windows of the houses is thus tainted by the foul emanations from these untrapped, ill drained and filthy yards, and from the putrescent contents of the open dustbins. The condition of the waterclosets throughout the District is such as appears to us also to call for special comments. They are almost invariably without water supply; and the flushing byhand which is supposed to be done by the occupier being rarely attended to in the absence of any facilities for that purpose, there is an insufficient quantity of water to carry off the sewage; the consequence being a permanent stench and a frequent stoppage of the waterclosets and drains. In many cases the closets are found to be in a permanently filthy condition, with the doors not hung. Whatever may be the habits of the inhabitants of the District, the average arrangements of the waterclosets are such as not to admit of cleanliness, and are quite incompatible with all ideas of sanitation or decency. In the case of certain combined dwellings, where the trough system of waterclosets has been adopted at the instance of your officers (as at Booth Street) the system has failed in consequence of insufficiency of accommodation and the absence of urinals for the men, and special arrangements suitable for the use of children, and the evil there sought to be remedied has consequently been intensified. 10 In the course of our inspections, several underground rooms have been found inhabited, of these some were only 6-ft. high and wholly unsuitable to be occupied either as a living room or a sleeping room. It is not surprising that such cases have escaped the notice of your two Sanitary Inspectors, notwithstanding their great zeal and industry, seeing that these two officers have the sanitary charge of above 7500 houses, and have many other important duties to perform under your direction besides those of inspection. Among the most crowded neighbourhoods several nuisances prejudicial to health have been found to arise from the presence of noxious or offensive trades either in the houses themselves or their immediate proximity. We will give a few typical examples:—At Newman's Buildings Cox' Square, the basement is occupied as a pickle factory, where fish and vegetables apparently in various stages of decomposition are salted. In this house, the inmates are always ill. At 41 Booth St., there is a constant & sickening stench caused by the furnace of an adjoining brewery, erected close to the watercloset of the house, the heat probably acting on the contents of the drains in immediate proximity. At Perry Avenue, Booth St., a great nuisance arises from a manufactory of cream cheese, the skimmed milk used for the purpose probably being in a state of semi-decomposition. At 15 Duke St. the air is rendered suffocating by the presence in the yard of a large number of portable potato steamers or ovens heated by charcoal or coke stoves. At 33 Pelham St. there is an open charcoal or coke stove in the yard at rear without any chimney, the effect being the same as in the case last described. At 44 Pelham St. there is a permanent smell from a great manure heap in the stable at rear. There are also frequent exhalations from the ventilating grates of the sewers in the neighbourhood of large factories which discharge their refuse (frequently in a hot condition) into the public sewers. It is suggested that where these noxious exhalations from sewer ventilators exist, theventilatinggrates might be stopped up, and upright shafts or pipes next the houses substituted, similar to those recently adopted by the City Commissioners of Sewers. A large number of the houses in your District have been found so dilapidated as to be absolutely past remedy from a sanitary point of view. These are either so old, or have been neglected by the owners for so many years, that they may be considered rotten and poisonous throughout. The floors, walls and ceilings reek with the impurities of perhaps half a century of neglect. There are also cases in which, apart from the rottenness of the structures themselves, the nature & position of the sanitary arrangements render the houses unfit for human habitation. We allude to such houses as have their 11 waterclosets situated in the basement, immediately under inhabited rooms, or such as have their waterclosets, dustbins and water taps accessible only through the cellars, which thus become receptacles of filth. It appears to us that you as the Local Authority might wisely exercise your powers, under the Nuisances Removal Act, sect. 13 by procuring Magistrates' Orders for closing such houses, as being unfit for human habitation. These houses may fairly be regarded as putrid and pestilential dwellings, and we submit that they should be prohibited to be let just as putrid meat is prohibited to be sold. You possess the statutory power of setting the law in action for the prohibition of such dwellings, and whatever hardships such a course may entail on the owners (who after all have no real grievance, seeing that they have fully exhausted all reasonable use of these worn out houses), we feel sure that you as the Health Authority will in dealing with these dwellings regard solely the safety and welfare of those for whose lives and health you are legally and morally responsible. The compulsory closing of pestilential dwellings here suggested will involve no cost to the Ratepayers, and the method is therefore not open to the objection of expense that would be involved by condensing the houses under Torren's (Amended) Act. The houses when closed, being unproductive of rent, would certainly be promptly pulled down by the owners, and their sites covered by improved dwellings. In this manner, whole areas might little by little be improved, and the buildings thereon removed without the costly processes involved by the Artizans' Dwellings Acts. The displacement of the poor from such prohibited dwellings would now, happily, involve no inconvenience, there being a much larger number of tenements than would have to be vacated, just ready for the reception of the displaced tenants in the admirable model dwellings erected by the City Commissioners of Sewers in Middlesex St., and in several other blocks of similar dwellings approaching completion in Goulston St. & its vicinity. For obvious reasons we have refrained from giving herein a list of the houses which seem to us proper to be closed, as unfit for human habitation, but we shall be prepared, if you desire it, to supplement this letter with further particulars. We desire to state in conclusion that though the efforts of this Board are directed, as its name implies, to the amelioration of the condition of the poor of the Jewish Community, a condition, like that of all poor, most difficult to improve, when the majority of their homes are in the state herein described, yet it must be obvious that in the course of the enquiries instituted, the general condition of the 12 District came under observation. Hence most of the remarks and suggestions herein made should be taken as not applying solely to the homes of the Jewish poor in your District, but to have a much wider scope and application. We have the honor to be Gentlemen Your obed'- Servants LIONEL L COHEN Chairman NATHAN ROTHSCHILD N. S. JOSEPH LIONEL. L. ALEXANDER. A. ASHER. M.D. FREDK. LOUIS. LUCAS. FREDK. S. COWEN DAVID F. SCHLOSS MAURICE DAVIS M.D. ALGERNON. E. SYDNEY ARTHUR MONTEFIORE SEBAG. JOHN HARRIS. Wellcome Library for the History smd Under of Medicine