WH140 THE ANNUAL REPORT on the Sanitary Condition of the WHITECHAPEL DISTRICT (WITH VITAL AND OTHER STATISTICS), FOR (53 Weeks of) THE YEAR 1892, by JOSEPH LOANE, M.R.C.P. Ed.,&c., diplomate in public health, university of cambridge fellow of the incorporated society of medical officer of health associate of the college of state medicine; member of the sanitary institute; MEDICAL OFFICER OF HEALTH and public vaccinator to the whitechapel Union examiner in and instructor of vaccination by order of the local government board. LONDON. PRINTED BY PENNY AND HULL, 53, LEMAN STREET, E 1893. Offices of the Board of Works for Whitechapel District. Sanitary Department: No. 15, Great Alie Street, London, E. January 2yd, 1893. Gentlemen, Readers of the Reports which I have hitherto had the honor to present to your Board, are aware that in the classification of the various statistics which form the backbone of these Reports, I have used, as a model, those tables which are issued from the Office of the Registrar-General for England. By adopting this arrangement, a scale for comparison purposes is presented, so that I am enabled to invite attention to matters which contrast both favourably and unfavourably between the Metropolis as a whole and the Whitechapel District. With this object in view, all the most important Tables which are included in the Appendix to my Reports, are built up week by week, thus enabling your Officers to take stock every week of the chief events which influence the health of the inhabitants. By this arrangement attention is at once directed to any unusual occurrence, which might otherwise escape observation for a time. I am so deeply impressed by the usefulness of the plan I have indicated that I propose to adhere to it in the present Report. When the year 1892 had almost expired, an Order was issued by the Local Government Board, which required that all Reports of Medical Officers of Health, should contain certain information a 2 4 prepared after a Model which was appended to the Order. The reason for such Order being issued was stated to he the advantage which would accrue from the uniformity in the Tables which would thus be included in the Reports issued by Medical Officers of Health. Of course, when some months hence, all such details have been collected and arranged, much valuable information will be in the possession of the Local Government Board, and also of the London County Council. I have therefore at the end of the text of my Report, and anterior to the Appendix proper, produced the Two Tables prepared in accordance with the Order to which I have alluded. Let me now consider some questions as to the births and deaths which have taken place in the Whitechapel District during the year 1892. The total number of births which were registered in the four Sub-Registration Districts during the 53 weeks, amounted to 3121. Of such number 116 occured in the Whitechapel Union Infirmary, which is in the Mile End New Town Sub-Registration Distridt. In ten of these cases the children were born of women not belonging to the District, and of the remainder, the mothers had previously resided in the Sub-Registration Districts as follows:— 56 in the sub-Registration District of Spitalfields; 28 in that of Mile End New Town; 9 in that of Whitechapel Church; and 13 in that of Goodman's Fields. Correctly disposed therefore in the same order as the deaths are arranged, the births may be distributed as follows Spitalfields. Mile End New Town. Whitechapel Church. Goodman's Fields. Total. 879 955 826 451 3111 Corrected to equal a year of 52 weeks the births would number 3051. In 1891 the births numbered 3063, or 12 more than in the year under consideration. It is probable therefore that the population of the District remains almost stationary when compared with the last Census enumeration. The total deaths which were registered 5 during the year amounted to 2404. Table B* may be consulted for the numbers registered in each Sub-Registration District. I may remind readers of this Report that on and after the first day of January the Sub-District of Aldgate became merged into that of Goodman's Fields. From the total deaths must be deducted the deaths, numbering 746, of persons not belonging to the District, although they were resident in the District at the date of death. It will be seen from the Appendix Tables that nearly all such deaths took place in the London Hospital. Again the District must be credited with the deaths of those Residents who died in Public Institutions, and elsewhere, outside the Whitechapel District. Such deaths to the number of 220 are also set out in detail. It follows therefore that the correct total District deaths amounted to 1878, or corrected to equal a year of 52 weeks, to 1843. In the year 1891, the correct total deaths numbered 1839, a difference of four as compared with the present year. The deathrate therefore was again 24.7 per 1000. The natural increase of births over deaths was 1233 or an increase of nine as compared with the preceding year. Table Ft of the Appendix shows the ages at death of the Residents who died during the year. The Precentage of Deaths for each Age period was as follows:— 25.9 %of the total deaths took place under the age of 1 year 18.5 ,, between the ages of 1 and 5. 5.8„ „ „ 5 and 20. 12.5 „ „ 20 and 40. 18.4,, ,, ,, 40 and 60. 15.9,, ,, 60 and 80. 2.7„ „over the age of 80. Compared with the Metropolitan deaths, including Whitechape), I iiote that the infant deaths were as follows:— The deaths of infants under the age of one year, in London equalled 22-9 per cent, of the total deaths, and i4'7 per * Page 27. †page 28. 6 cent. of the registered births; whilst in the Whitechapel District. those infants who died under the age of one year. equalled 25.9 per cent. of the total deaths. and 15.6 per cent. of the registered births. The deaths of children under five years of age. including the above. were for London equal to 39.1 per cent. of the total deaths. and 26.5 per cent. of the registered births; and for the Whitechapel District. they were equal to 44.5 per cent. of the total deaths. and 26.8 per cent. of the registered births. The increased number of deaths from certain infantile diseases during the year. accounts for the increased percentages recorded in the last two paragraphs. It is interesting to contrast the District deaths from each class of disease with those deaths which occurred in London as a whole. and a glance at Table I* of the Appendix will enable the reader to observe the percentage of deaths under each class respectively to total deaths. The result is not dissimilar from that recorded in preceding years. Thus in the zymotic class. a difference of i'30 appears in favor of the Whilechapel District. and nearly the same observation will apply to diseases of the heart. As usual. however. the Metropolis. as a whole. has a better record for Constitutional diseases. and also for diseases of the Digestive System. No death from small.pox has been registered in the District during the year. Cases of the disease have appeared from time to time. In an adjoining District many cases had been reported. and. in at least one instance. the disease was thus imported into our District. In many cases I was unable to trace the source of the disease. but all cases were personally investigated. and the greatest care was taken to prevent the spread of the disease. In all. 26 cases were reported between March 15th and December 28th. Five of the cases occurred in the London Hospital. and in only one of these was the patient a District Resident. I am desirous of recording the fact that I took much trouble to re. vaccinate all persons who had been exposed to risk of contagion. So far as I could learn in only one instance was any other member of the family attacked after the removal of the patient. This * Page 30. 7 Happened to a woman. two of whose children had been removed for discrete small.pox. and who had escaped the protection of re. vaccination. She was sent to hospital two or three days after her confinement. and I vaccinated the infant when it was five days old at the request of its mother. The baby escaped. Over and over again have I seen instances proving the remarkable power of vaccination and re.vaccination as a modifier and as a prophylactic in small.pox. where the only element present in the case of those escaping the disease which was not present in the case of those who contracted it. was that of vaccination. I fear the long sessions which have been taken up by the exhaustive inquiries of the members of the Royal Commission on Vaccination. have caused in many places great laxity on the part of Boards of Guardians in carrying out the Vaccination Laws. I hope for the sake of the Country at large that their Report will not be much longer delayed. When it appears I am persuaded it will prove to be of national importance. So far as the White. chapel Union is concerned. the statistics which I append as usual. show that Mr. Sherman has been most active during the year. I am of opinion that increased facility should be offered to those who prefer to have calf.lymph used. As Public Vaccinator. I support this opinion by using lymph from the calf where so desired. I frequently revert to calf.lymph to renew my stock. as it enables me more readily to trace my cases in the event of necessity. A great increase has to be recorded in the number of cases of Scarlet Fever. and Diphtheria. which have been notified during the year. Table 0* contains a complete list of the principal zymotic diseases which were reported. From this table. and from the Table of deaths. I glean the fact. that although Scarlet Fever and Diphtheria were epidemic. so as to cause much anxiety and inconvenience to Sanitary Authorities. and also to the Managers of the Metropolitan Asylums' Board. yet the type of these diseases was mild in comparison with preceding years. In 1891. 32.4 per cent. of the cases of Diphtheria which had been notified. died. In 1892. 23.5 „ In 1891. 7.8 per cent. of the cases of Scarlet Fever .. In 1892. 5.8 * Pages 34 and 35. 8 Concerning the etiology of these diseases, much has been written during the last few years. It has been thought by many that Scarlet Fever was often the outcome of a similar disease in the cow, and could be disseminated through the medium of the milk. This theory has been controverted by some eminent bacteriologists who. however, oppose arguments to the facts which the other side adduce. On the whole, it appears reasonable, from much evidence which has been sifted, and brought to the front, by Sir George Buchanan and others, that undoubted cases of Scarlet Fever have been thus produced. The Hendon epidemic may be instanced in illustration. More recently an epidemic claimed to be due to this method of causation, was investigated by Dr. Hamer; and Dr. Klein enunciated the same proposition at the last Medical Congress, and his facts certainly seemed potent enough to support his view that milk might be the means of initiating an epidemic of Scarlet Fever. It is of course difficult to obtain an exhaustive investigation, because many factors are brought into the question, and each has to be eliminated as an exciting cause. With regard to Diphtheria, I have before shown that since that disease appeared more frequently, a corresponding reduction in the number of cases of Croup became evident. When in active practice, I regarded the diseases as similar in respect to appearances and treatment. I am interested to observe that so high an authority on most subjects concerned in "medicine," as Mr. Jonathan Hutchinson, has recently advanced certain propositions which he logically and consistently maintains. Amongst others, I only extract those which are of interest to the non-professional reader. "Diphtheric inflammations may be induced by cold-catching, and when so induced they may become, as ordinary colds often do, contagious to other persons. There is no difference in nature between croup and diphtheria, excepting that in the latter malady the inflammation has developed in high degree its contagious properties. The spread of diphtheria in epidemics, in hospitals and in families, is to be wholly accounted for under the known laws of contagion, and that it is not probable that local conditions, such as defective drainage, &c., apart from exposure to cold and damp, take any material share in its production." There is an almost universally prevailing popular opinion, that diphtheria and defective drainage are associated in the relation of 9 cause and effect. It cannot be too strongly stated that conclusive evidence in support of such opinion, so far as I am aware, cannot be produced. Of course the inhalation of sewer air may reduce the vital energies of a person, and so render him more susceptible to be the victim of diphtheria, as well as many other diseases. Influenza was prevalent during the earlier part of the year. It was a primary cause of death in 61 cases, and in 9 others it was certified as a secondary cause. Of these 70 cases of Influenza, 49 took place in January; 11 in Febuary; 4 in March; 5 in April; and 1 in May. At the Whitechapel Infirmary and Workhouse, 58 of the total deaths from the disease occurred, thus supporting the experience of the previous year. Thirty-three men died to thirty-seven women. The age mortality was as follows:— 1 died from Influenza between 10 and 20 years of age. 9 „ „ 20 and 40 „ „ 25 „ „ 40 and 60 „ „ 24 „ „ 60 and 80 „ „ 11 „ „ at over 80 years of age. The Sub-Registration Districts wherein the patients had previously resided, and the number belonging to each I also append:— In the Spitalfields Sub-Registration District, 27. „ Mile End New Town „ 11. „ Whitechapel Church „ 23. „ Goodman's Fields „ 9. In concluding this part of my Report I wish to mention that one death from Typhus Fever was registered during the year. I have sufficient reason however to state that most probably there was an error in diagnosis in this case. It occurred in a model dwelling. The patient was an elderly man living by himself in one room. He was looked after by his daughter and her husband, who occupied an adjoining room. The man had not been from home for some weeks, and a medical gentleman who saw the case in consultation with the doctor who certified, was of opinion that Typhus was not B 10 present. From a careful investigation of the whole case, including a history of the man's symptoms derived from his daughter, I have arrived at the conclusion I have indicated. Last year, in inviting your special attention to Table O, wherein is set out, as I have said, the principal zymotic diseases, I asked you to remember that "there are seasons when certain diseases are prone to become epidemic, and other years when such diseases are comparatively absent. Scarlet Fever in 1890 appeared in 237 cases, and in 1891 only 102 cases were reported." I regret to report that during last year 533 cases were dealt with by your Officers. Altogether 1153 cases of zymotic disease were separately investigated, and disinfected, after either removal to hospital, or after recovery when the patients were treated at home. You will thus readily understand that the additional Inspector, whom you so willingly placed at my disposal, had very little time to devote to other matters. With a less efficient staff it would have been impossible to battle with the enormous amount of work which had to be undertaken; but with the hearty co-operation of my fellowworkers, the labour has been with us all, one of enthusiasm and success. This work has often necessitated continuously long hours of application, but your Inspectors have always cheerfully seconded every suggestion I have made in the interests of the District. That all necessary assistance is at once given by the Board I must gratefully acknowledge. Towards the close of the year I requested to be furnished with an apparatus whereby articles could be disinfected with super-heated steam. This request was immediately met by the formation of a Committee to select the best machine in the market. After a painstaking inquiry, your Committee recommended the machine known as " Goddard, Massey and Warner's disinfecting apparatus." The recommendation was unanimously adopted by your Board, and I trust before this Report is placed in your hands, the District will have the advantage of a disinfecting appaatus of a most practical and efficient description. As a matter germane to the question of disinfection, it is fitting that I should record the decision arrived at by your Board, to enlarge the existing works concerned in the destruction of houserefuse by fire. At a considerable cost new cells are to be added, so that the entire refuse from houses within the District may be 11 consumed as rapidly as it becomes collected. This arrangement is another stage in the scheme of daily collection and destruction of house garbage. The closing scene will be arrived at when every house, or block of houses, shall have its pail or other receptacle called for daily by the scavengers. The Autumn of 1892 stands out conspicuously from recent years, by the presence upon the Continent of a serious epidemic of true Asiatic Cholera. The daily press conveyed most minutely to its readers hideously graphic accounts of the progress of the disease. I do not propose to reproduce any of the news so reported, but will rest content with placing on record the precautions which were adopted by your Board, and by your Officers, to meet any visitation which might take place. For that purpose I propose to introduce a report which I prepared, in reply to a communication from the Local Government Board, requesting information concerning our preparedness in the event of an epidemic appearing in our District:— November 7th, 1892. To the Sanitary Committee, Gentlemen, The communication which has just been received from the Local Government Board, referring to that Board's Memorandum of the 25th Angust last, on the subject of Cholera, contains the request to be furnished with any Report by myself upon the Sanitary condition of the Whitechapel District, which I may have presented to your Board. As all Reports upon the subject were orally communicated either by myself directly, or in combination with statements made by your Clerk, it may be advisable that I should now briefly recapitulate the chief details which will inform the Local Government Board as to the condition of the Whitechapel District. In 1884 I reported to the Committee of Works as follows:—"Although in "1866. about 35 per cent. of our Residents suffered from Cholera, Choleraic "Diarrhoea, or Diarrhoea; and 566 lives (or over 7 per 1000 of the population) "were sacrificed to this terrible epidemic, I feel justified in asserting that a "repetition of such a history cannot occur in Whitechapel. Not only have many "of the worst houses been removed, but the entire District is in every way in a "far better Sanitary condition now. The water supply is also sufficient and " good." To a still greater extent these remarks are applicable to our District at the present time. More Model Dwellings occupy the site of former insanitary houses, and although certain parts of the Distridt—as much on account of the habits of immigrant foreigners, as from the condition of the houses—require to be improved, B 2 12 yet they are surrounded by a cordon of wholesome domiciles, so that, although sporadic cases of Cholera might become imported into the District, I do not think the conditions exists which are required for the Disease to become seriously epidemic. Notwithstanding this opinion, your Clerk and myself lost no time in looking to our fortifications, and we made active preparations to deal with any cases which might arise. For this purpose additional assistance was obtained, so that more constant inspection of the District should take place, and a larger system of general disinfection might be effected. Preparations were made to use some cottages, either as hospitals, or for shelters for the residents of houses where disease existed ; probably the latter, because previous experience has demonstrated that Cholera patients can only be removed safely in the very earliest stage of the disease. All the Medical Men in the District were communicated with. They were requested to report cases of Diarrhoea which occurred in their practices. They were asked to co-operate with the Sanitary Department, should such assistance be required. The replies from my friends were eminently satisfactory. It was proposed to rely upon existing Poor Law arrangements, and private Medical attendance, until Cholera actually appeared in the District. Should the disease manifest itself, it was suggested that a Medical Man should be appointed to take charge of the particular area incriminated. For the purpose the District should, in the first place, be divided into three parts, co-existent with the Poor Law Boundaries. Each of these divisions should then be sub-divided as occasion required, and thus, without waste of material, any portion of the District could be, at short notice, medically cared for. Our stock of Disinfectants was increased, to provide for sudden emergency. Arrangements were made to destroy any clothing or bedding which had been exposed to contagion, and preparations were made for the immediate removal to the Mortuary of any body which had died from disease of a suspicious nature. In one case of death from sudden Acute Diarrhoea, the body was placed in a well-pitched coffin, filled with disinfectants, and screwed down. It was removed to the Mortuary, and the Coroner was written to. That Officer dispensed with the viewing of the body, under the urgent circumstances of the case. Nothing was done which might create a panic. No large posters were placarded over the District, but arrangements were ready whereby such might be done at very short notice, if it had become necessary to do so. Small bills were judiciously distributed amongst those inhabitants, to whom it was thought proper to bring the information which was printed. I append a copy of this bill:— "WHITECHAPEL DISTRICT BOARD OF WORKS. INSTRUCTIONS TO INHABITANTS.— "Perfect cleanliness in person and Dwelling, and avoidance of all nuisances "in and around the house is of utmost importance. Freely use water and carbolic "acid to cleanse drains and sinks, No food which looks bad or which has an "unpleasant smell, should be eaten. Draw all drinking water from the main tap, "'and boil all drinking water and milk. Avoid overcrowding, and ventilate all "rooms. Every case of sickness must be notified to the Board Offices, No. 15, "Great Alie Street, E. Do not neglect the mildest attack of Diarrhœa, or other "illness. Report to the Officers of the Board when any unpleasant smells or "nuisances of any kind are noticed." 13 All the above preparations were made by your Officers during the recess of the Board, but a special Committee of Works meeting was summoned for the 1st September, at which your Clerk explained what had taken place, and the measures which were in contemplation by your Officers, should the occasion require them. The Committee assented to the proposed arrangements, and gave power to the Officers to do what they deemed necessary. Since then, the vigilance of your staff has been maintained. The matters referred to in the memoranda and circulars of the Local Government Board have been carefully borne in mind. Every person, whose address has been forwarded by a Port Sanitary Authority—such persons coming from an infected port—has been visited, and such visits have been continued daily for a week, when the addresses given have been correct. Personally, I have visited most of the Model Dwellings in the District, with a view to having general thorough cleansing of such premises effected during the present year. In this work, I have been most kindly assisted by the owners of the buildings, who have promised to co-operate in every way. In conclusion, I may mention, that the general systematic inspe&ion from house to house has been carried out to as great an extent as possible. I have the honor to be, Gentlemen, Your obedient Servant. JOSEPH LOANE. At the next meeting of the Board, it was ordered that a copy of the above Report should be forwarded to the Local Government Board. Violent Deaths:— Total number of Deaths, 59 Males, 38. Females, 21. Age Distribution of Violent Deaths. Sub-Registration Districts Distribution. Under the age of 1 year 22 Spitalfields Sub-District 19 Between the ages of 1 and 5 5 5 „ 20 6 Mile End New Town 14 „ „ 20 „ 40 11 Whitechapel Church 14 „ „ 40 „ 60 12 „ „ 60 „ 80 3 Goodman's Fields 12 Over the age of 80 0 14 Causes of Deaths from Violence :— Accidents—Fradlures, Run over, etc. 21 Burns and Scalds 8 Accidental suffocation in bed, etc. 23 Suicide 2 Manslaughter 2 Other causes 3 Old Age Deaths:— Age Distribution of the Deaths. Sub-Registration District Distribution. Between the ages of 8o and 85 30 Spitalfields Sub-District 12 85 „ 90 12 Mile End New Town do 4 Whitechapel Church do 27 Above the age of 90 9 Goodman's Fields do. 8 Registered Cause of Deaths:— Old Age 29 Heart Disease 2 Nervous Diseases 4 Respiratory Diseases 6 Influenza 9 Other Disease 1 No Uncertified Death was reported during the year. The Public Mortuary and Coroner's Court have now been in active operation for nine months. In that time exactly 100 entries were made in the books. Great satisfaction with the general arrangements have been expressed by the Coroner for that part of the District wherein the building is contained, as well as by the Doctors who have had occasion to use the post-mortem room. It is an open secret that, owing to the Whitechapel District possessing the doubtful advantage of being subject to the jurisdiction of two Coroners, neither of whom may officially step over his own boundary, difficulty occasionally arises. I propose shortly to call the attention of the Board to this matter, so that the County Council, or the Home Office may be officially informed of the certainty that, at some time, a scandal must be the outcome of the present arrangement. Should such representation fail to effect the conveyance to the District Mortuary of those deceased residents who require removal, I shall follow out my original plan most strenuously—that plan your Board is already familiar with. I have already adopted it partially. 15 I have no report concerning the quantity and quality of our water supply. According to the official returns, Water Supply which are furnished to me monthly, the Companies to the District. continue to afford their customers excellent water. REGISTERED COMMON LODGING HOUSES, 1892. Name of Street. No. of Houses registered. Deaths in Infirmary and elsewhere of Lodgers. Brick lane 7 12 Brushfield street 1 ... Buckle street 1 ... Bull court, Whitechapel 4 ... Commercial street 2 14 Dorset street 14 37 Flower and Dean street 4 19 Garden court 1 ... George street 5 5 George yard 6 1 Grace's alley 2 1 Great Garden street 2 2 Great Pearl street 1 ... Gun street 5 3 Hanbury street 5 1 Heneage street 1 8 Lambeth street 1 1 Leman street 5 4 Little Pearl street 1 ... Mill yard 1 ... Old Montague street 1 ... Osborn place 6 21 Osborn street i ... Paternoster row 3 12 Princes street 1 6 Tenter street North 1 ... Thrawl street 3 5 Upper East Smithfield 2 5 Well street 2 ... Wellclose square 1 ... Wentworth street 5 14 Wheeler street 1 ... Whitechapel road 2 4 White's row 3 3 Totals0 101 178 Note.—Since last year 45 old Lodging houses have been abolished and 5 new ones have been opened, making a total of 40 houses less. Lodgers in the above houses died during the year to the number of 178. 16 The Deaths took place as follows:— In the Whitechapel Infirmary 141 „ London Hospital 11 „ German Hospital 1 „ St. Bartholomew's Hospital 1 „ Homerton Hospital 1 „ Guy's Hospital 1 „ Banstead Asylum 1 At the several Lodging-houses 21 178 It is obvious that no useful statistics can be compiled from these data, because the necessary factors are absent. The persons occupying the beds in Common Lodging-houses are migratory in their habits, and although they are often belonging to other Districts, when illness overtakes them, their natural destination as shown above, is the Union Infirmary. REGISTERED CAUSES OF DEATH In the cases of persons living in Registered Common Lodging Houses. Syncope 11 Laryngitis 1 Morbus Cordis 9 Ulcerative Endocarditis 1 Phthisis 45 Meningitis Rheumatism 2 Cardiac Disease 1 Intestinal Obstruction 1 Syphilis 1 Senile Decay 5 Apoplexy Bronchitis 23 Scarlet Fever 1 Hepatic Disease 1 Paralysis 1 Hemiplegia 1 Tuberculosis Pneumonia 12 Sacro. Iliac. Disease 1 Cirrhosis of Liver 1 Peritonitis 1 Malig. Dis. of Pylorus 1 Malig. Dis. of Neck 1 Hoemorrhage 1 Tabes Dorsalis 1 Cancer of Liver 1 Fradlured Spine 1 Lardaceous Kidney 1 Empyema 1 Epithelioma of Tonsil 1 Asthma 1 Bright's Disease 3 Rupture 1 Tetanus 1 Debility 1 Influenza 15 Mal-nutrition 1 Alcoholism 2 Uroemia 1 Lymphadenoma 1 Serous Effusion on Brain 1 Premature Birth 1 Inflam. of Lungs 1 Measles 2 Carcinoma Uteri 1 Convulsions 3 Coma 1 Puerperal Fever 1 Erysipelas 1 Pleurisy 2 Total 178 Paraplegia 1 Cellulitis 2 17 I regret to report that the Home Secretary has been interviewed by the County Council of London in respect of these Common Lodging-houses. The Government has been requested to transfer the supervision of these houses from the police to the Local Sanitary Authorities. I must at once declare that when the class of house is taken into consideration, together with the persons who lodge therein, my* experience compels me to assert that the change proposed would not be a good one. At present the police sergeant (who acts under his superintendent) admirably supervises the arrangements for the health of the lodgers, and in matters requiring their intervention, the Sanitary Authorities are called in to co-operate. The regulations governing accommodation and ventilation are well framed under the provision of the Lodginghouses Acts, and I am sorry that all houses, where the comparatively destitute are housed, have not the advantage of similar supervision. It has been my duty on account of a case of small-pox occurring at each, to investigate the sanitary condition of two large shelters provided by a philanthropic association for sleeping the poorest persons. I will not here detail all that I have been compelled to note concerning the places themselves, and the sleeping accommodation provided; but I feel unable to answer the question which arises in my mind, namely :—What good purpose is here being served, which could not be better attained by the police registered and supervised Common-lodging Houses ? Suffice it to add, that I shall not fail in future to closely watch all similar houses, and when the 94th section of the Public Health (London) Act, 1891, shall be in operation in the District, all such establishments will probably be registered by your Board. That proper and sufficient lodging should be supplied for the nomadic labourer, to whom his lodging-house becomes his club, must be apparent to all; I am only anxious that such persons shall be surrounded by proper hygienic conditions. Last year I included in my Report a list of admissions into the Union Infirmary upon Medical Orders only, of persons lodging in the various shelters within the District. To the number of houses then given, another has been added. I append the correct list:— 18 Shelters. No. of Admission Orders given by the District Medical Officers. Salvation Army Shelter for men, 272, Whitechapel-road 182 „ „ women, 194, Hanbury-street 222 „ „ men, Quaker-street 102 „ men, Royal Mint-street 56 Church Army Shelter for men, 83, Whitechapel-road 2 Tenter-street Shelter for Foreign Jews 21 Barnardo's Shelter for women, 12, Dock-street 62 647 When to this list is added the many cases where admission is obtained on the score of "urgency," without the intervention of the District Medical Officers, it will be apparent that such shelters influence the statistics in a very considerable degree. MODEL DWELLINGS. Number of Apartments, Population, and Number of Deaths, 1892. Name and Situation of Dwellings. Number of Apartments. Number of Inhabitants. Total Population. Deaths. Adults. Children. Albert buildings 40 130 67 197 1 Alexandra buildings 29 83 75 158 1 Alfred buildings 26 60 28 88 3 Blackwall buildings, Thomas street 156 298 354 652 32 Booth street buildings 154 361 391 752 15 Brady street buildings 286 609 584 1193 20 Brunswick buildings 280 812 510 1322 21 Buckle street buildings 30 61 59 120 4 College buildings 85 81 69 150 5 Glasshouse buildings 25 50 39 89 3 Gt. Eastern buildings, Fieldgate St. 47 95 70 165 5 Gt. Eastern buildings, Quaker st. 92 181 159 340 15 Howard's buildings 83 357 126 483 8 Katherine buildings 263 422 277 699 29 Lolesworth buildings 202 383 234 617 13 Metropolitan buildings 60 304 95 399 4 Morrison's buildings (south) 54 104 57 161 4 New buildings, Tenter street 25 64 48 112 3 Peabody buildings, Commercial St 60 159 76 235 4 Peabody buildings. Glasshouse St. 286 698 413 1111 22 Plough street buildings 46 77 43 120 3 Rothschild's buildings 228 513 636 1149 18 Royal Mint buildings 225 384 305 689 22 Shepherd street buildings 34 93 88 181 3 St. George's house 42 71 45 116 6 Strafford houses 40 129 60 89 4 Tenter buildings 25 41 35 56 - Went worth buildings 222 5*9 636 1155 28 Totals 3145 7139 5579 12718 296 19 The above Deaths took place as follows:— In the London Hospital 30 „ Homerton Hospital 20 „ Whitechapel Infirmary 11 „ Shadwell Hospital 4 „ City of London Chest Hospital 2 „ City Infirmary 1 „ Guy's Hospital 1 „ St. Bartholomew's Hospital 1 „ Hanwell Asylum 1 „ Grove Hall Asylum 1 „ Colney Hatch Asylum 1 „ Brompton Hospital 1 „ St. George's Hospital 1 At the several Model Dwellings 221 296 Causes of Deaths. Bright's Disease 2 Fatty Deg. of the Heart 1 Gastritis 2 Malnutrition 1 Cyanosis 1 Inanition 2 Bronchitis 29 Debility 8 Marasmus 9 Catarrh 2 Phthisis 15 Asthenia 3 Pneumonia 28 Dyspepsia 4 Meningitis 18 Post Partum 1 Malig. Dis. of Jaw 1 Hoemorrhage 2 Nephritis 1 Rickets 1 Morbus Cordis 7 Erysipelas 1 Paralysis 3 Albuminuria 1 Suffocation 6 Measles 6 Senile Decay 8 Tonsilitis 1 Enteritis 9 Hepatic affedtion 1 Spinal Caries 1 Cancer 2 Diphtheria 16 Laryngismus 1 Syncope 8 Burns 2 Diarrhœa 6 Atelectasis 2 Dentition 7 Scalds 1 Childbirth 1 Empyema 1 Premature Birth 7 Tuberculosis 3 Typhus Fever 1 Mem. Croup 2 Pertussis 11 Hoemoptysis 1 Peritonitis 6 Septicaemia 1 Brain Disease 1 Apncea 1 Cirrhosis of Liver 1 Hydrocephalus 4 Abscesses 2 Atresia-Ani-Colotomy 1 Convulsions 4 Laryngitis 2 Atrophy 2 Arthritis 1 Monstrosity 1 Ruptured Spleen 1 Asthma 1 Melancholia 1 Concussion of Brain 1 Parturition 1 Tabes Mesenterica 7 Total 296 Gangrene of Lung 1 Scarlet Fever 9 20 The general death.rate for the Model.dwellings within the District, was 23.2 per 1000. The zymotic death.rate was 4 per 1000. and it equalled the death.rate for constitutional diseases. More than 25 per cent, of the residents of this class of dwellings died in Public Institutions, and 10 per cent, of the total selected the London Hospital. Classifying these Model.dwellings into "fit" and "unfit," the death.rate becomes 22.8 for the former, and 26.2 for the latter. I may explain, that more frequently the habits of the tenants mark the division into either class. Concerning the usefulness of this Acft, I have previously expressed some doubt. Excepting under certain conditions, I am of opinion that much can be obtained more Housing of the readily from other legislative enactments. In. Working deed, even where the 1890 Act seemed to be the Classes Act, one best adapted to obtain the object desired, I 1890. have frequently obtained from owners of property the closing and even demolition of houses by consent. As an illustration of a difficulty which took place, where no other suitable means appeared to be available for the purpose, I ask your consideration of the following case. Two houses, entered from different streets, had been connected by irregular structures of wood, so as to become virtually one large building. This building was used partly as a Restaurant, and partly as a Turkish bath. The upper premises were occupied for residential purposes. Nothing more unwholesome than this jointly occupied place could be imagined. A summons was taken out under Section 32 (1) of the Housing of the Working Classes Act, 1890, against the owner, who is defined in the Act, as being the person having an interest in the premises of not less than 21 years. The lessee had a lease unexpired of 15 years. He was represented by a solicitor. The owner appeared by counsel, and declared his willingness to consent to any Order the Magistrate might make. Your Clerk also appeared on behalf of your Board. After two adjournments, although the case was proved up to the hilt, the magistrate diredted another summons to be issued against the lessee, and after four attendances at court on the part of your Officers, he made an Order for closing the premises both against the owner and 21 also the lessee. Of course we only availed ourselves of the Order which we originally asked for. Before the final decision was arrived at, the County Council intervened, and condemned the building as dangerous. Before the case was decided, a great part of the property had already been pulled down. The proceedings were ultimately terminated satisfactorily, but at a considerable cost to the Board. Such an experience is not likely to induce me to again resort to the Act when the Public Health (London) Act, 1891, can be substituted for it. The Report concerning the working of these Acts of Parliament is embodied in a letter to myself from your Inspector who has charge of this particular department. I comFood and mend it to your notice.* I have also introduced Drugs Acts, a joint memorandum from your Inspectors conconcerning their labours. As it details their own observations, I have deemed it worthy of a place in a Report which deals with the Sanitary condition of the District.† The Factory and Workshops' Act 1891, became operative towards the close of the year 1892. Briefly stated, it imposes upon the Local Authorities certain duties which New had previously devolved upon the Home Office Legislature. Officials. By a provision of the Aft, the Local Government Board was empowered to issue an Order. Such Order has been circulated. It requires lists to be kept of out-workers in the following business, viz. : The manufacture of Articles of Wearing Apparel. Cabinet and Furuiture making and Upholstery work. The manufacture of Electro-plate. The manufacture of Files. The occupier of every Workshop and Factory in which such businesses are carried on, and any contractor employed by such occupier, is required to prepare and keep these lists of out-workers up to date; and the lists are to be open to inspection by any Inspector of Factories, or by any Officer of a Sanitary Authority. All Local Authorities are urged by a letter of the Local Government Board, to examine such lists frequently, so as to make themselves aquainted with all places where out-workers in these trades are employed, with a view to remedy any Sanitary defects which may be found to exist. *Page 39. †Page 40. 22 We have, therefore, concerned in this work, first, the Home Office Officials, next the Local Sanitary Authorities, and lastly, the London County Council, who have under the Public Health (London) Act, equal powers with the Sanitary Authorities, and in fact, a general supervision over them. Now the difficulty arises, how are your Officers to carry out this work apart from their already over-taxed, and multefarious duties ? Generally, it must be admitted, that they are bound to become aquainted with every part of their District. This means of course, that house to house visitation must form an important routine. When one reflects, however, how constantly changing are the so-called " domestic workshops " in our District, I am at a loss to discover how, even with an increase in your staff, such new duties can be efficiently performed. Only by the establishment of a Central Bureau, to which all such lists of out-workers must be forwarded by all employers, can any really satisfactory result be arrived at. Then the Clerks at the Central Bureau could forward to every Sanitary Authority such names and addresses as are within each District. It would then become more practicable for such places to be visited and inspected. The measure is undoubtedly a useful one, and I have enlisted the co-operation of the heads of the Government Department who are concerned primarily in the work, and thus I hope to carry out the provisions of the Act in the spirit in which it was framed. In conclusion, Gentlemen, I desire to offer some excuse for the many difficiencies in this Report; but I am anxious that it shall be in the hands of the printer before the month of January has expired. I attach great importance to the statistical portion of every Report, and I estimate the remainder as of much less value, therefore, I do not hesitate to ask your perusal of this Report as a whole. I trust it will convey to you the impression that your Sanitary Staff, aided by the kind co-operation of your Clerks, and of your Surveyor, have been somewhat advancing with the general tide in the direction of improvement, and also that the Sanitary condition of the District over which you preside will be found to have become improved. I have the honor to be, Gentlemen, Your obedient Servant, JOSEPH LOANE. 23 APPENDIX. AREA AND POPULATION OF THE DISTRICT OR DIVISION TO WHICH THIS RETURN RELATES. AREA IN ACRES, 406 (Including 23 Acres of Water) POPULATION (1891), 74,261. Statistics Compiled by Order of the Local Government Board.] I—TABLE OF DEATHS DURING THE YEAR IN THE METROPOLITAN SANITARY DISTRICT OF WHITECHAPEL Classified according to Diseases, Ages and Localities. Names of Localities. Mortality from all causes at subjoined ages. For the 53 weeks of the year 1892, ending 31st December. 1 2 3 4 5 6 7 & 9 10 11 12 13. 14 15 16 17 18 19 20 21 22 Small-pox. Scarlatina. Diphtheria. Membranous Croup. FEVERS. Cholera. Erysipelas. Measles, Whooping Cough. Diarrhœa and Dysentery, Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other causes. Total. At all ages. Under 1 year. 1 and under 5. 5 & under 15. 15 & under 25. 25 & under 65. 65 & upwards. Typhus. Enteric, or Typhoid. Continued. Relapsing. Puerperal. Spitalfields— (Sub-Registration District) 335 125 51 10 6 101 42 Under 5 1 2 - - - - - - - 1 17 15 10 - - - 31 - 9 86 175 5 upwards 1 2 — — 1 — — 3 — 1 - - 1 — — 22 45 32 1 51 160 Mile End New Town (Sub-Registration District) 678 148 75 11 24 294 126 Under 5 2 — 1 — — — — — — — 16 11 11 - - 5 - - 4 140 223 5 upwards - - - - 2 - - 1 1 4 - — 2 3 - 99 91 49 9 194 455 Whitechapel Church— (Sub-Registration District) 1181 188 232 78 102 501 80 Under 5 1 34 1 — — — — — — 4 14 16 11 - - 1 110 2 28 197 418 5 upwards - 7 - - 15 - - 1 - 3 - - 5 4 1 33 98 116 96 383 762 Goodman's Fields— (Sub-Registration District) 210 67 36 7 11 58 31 Under 5 - - - - - - - - - - 3 6 3 - - - 17 1 10 63 103 5 upwards - - - 1 - - - 1 - - - - 1 1 - 15 20 14 4 50 107 Deaths occurring in the London Hospital 907 81 167 74 97 443 45 Under 5 — 30 - - - - - - - 4 5 7 6 - - - 62 1 27 105 247 5 upwards - 6 - - 15 - - 1 - 3 - - 2 3 1 23 82 98 94 332 660 Deaths occurring in the Whitechapel Infirmary 431 50 25 1 16 233 106 Under 5 - - - - - - - - - - - - 3 - - 2 13 - 1 49 75 5 upwards - - - - 2 - - 1 - 3 5 2 1 3 - 80 74 33 5 49 154 356 Deaths within the Whitechapel District of NonResidents 746 60 n6 54 77 398 41 Under 5 - 22 - - - - - - - - 3 6 3 - - - 40 1 23 83 181 5 upwards - 6 - - 15 - - 1 - 3 - - 2 3 1 20 61 86 86 281 565 Deaths of District Resi dents in out- lying Public Institutions 220 24 66 28 14 57 31 Under 5 20 2Q — — - - - - - - 5 1 - - - 1 9 - 1 24 90 5 upwards 7 ii - - - - - - - - - - 1 - - 13 14 16 2 66 130 II-TABLE of POPULATION. BIRTHS, and New Casks of INFECTIOUS SICKNESS coming to the knowledge of the Medical Officer of Health during the year 1892, in the Metropolitan Sanitary District of Whitechapel ; Classified according to Diseases, Ages and Localities. Names of Localities, &c. Population at all ages. Census Population, 1891. Births during 53 weeks of 1892. Cases of Infectious Disease Notified. Cases Removed to Hospitals. Ages. Small-pox. Scarlet Fever. Diphtheria. Membranous Croup. Typhus Fever. Enteric Fever. Contind. Fever. Relapsing Fever Puerperal Fever Cholera. Erysipelas. Small-pox. Scarlet Fever. Diphtheria. Membranous Croup. Typhus Fever. Enteric Fever. Contnd. Fever. Relapsing Fever Puerperal Fevei Cholera. Erysipelas. Spitalfields— Sub-Registra tion District Males. Fmales. — Under 5 yrs. 5 85 37 5 - - - - - - 4 5 61 32 2 - - - - - - - 11468 10988 5 yrs. & over 13 4 33 - — 12 — — 4 - 40 13 81 28 - - 8 - - - - 1 Mile End New Town— Sub-Registratn. District (including the Infirmary) 9433 8475 — Under 5 vrs. — 61 24 4 — 1 — — — — 1 — 49 15 1 - 1 - - - - - [See Table, page 4.] 5 yrs. & over - 30 22 - - 9 - - 1 - 20 - 22 18 - - 4 - - - - - Whitechapel Church— Sub-Registratn. District (including the London Hospital) 10419 9879 U nder 5 yrs. — 70 33 5 - - - - - - 1 - 47 2 3 1 - - - - - - - 5 yrs. & over - 97 49 1 - 10 - - 2 - 34 - 64 26 - - 7 - - - - 4 Goodman's Fields— 5 ub-Registration District 7421 6178 Under 5 yrs. — 26 14 - - - - - - - 1 - 13 12 - - - - - - - - 5 yrs. & over 3 37 14 - 1 5 - - - - 20 3 23 9 - - 4 - - - - 4 London Hospital— — — — Under 5 yrs. — 2 3 - - - - - - - - - - - - - - - - - - - 5 yrs. & over 5 10 7 - - 1 - - - - - - - - - - - - - - - - Whitechapel Infirmary— 624 inmates on the 31st Dec. '92. — Under 5 yrs. - - 1 - - - - - - - 1 — — — — — - - - - - - 5 yrs. & over - 1 5 - - 3 - - 2 58 - - - - - - - - - - - Totals 26 533 242 15 1 41 — — 9 — 180 21 360 163 4 — 24 — — — — 9 26 SLAUGHTER-HOUSES. WHITECHAPEL. Address. 3, High Street, 6, „ „ 27, „ „ 4, „ „ 2, „ „ 52, „ „ 52, Cable Street To whom Licensed. Benjamin James Wood. Solomon Horwitz and Joseph Lialter Thomas Kefford. Morris Bosnian. Robert Lancaster. Joseph Nathan. Charles Pettitt. MILE END NEW TOWN. 147, Hanbury Street John Arthur Garton. COW-HOUSES. WHITECHAPEL. Address. To whom Licensed. 11, Black Lion Yard (both sides) 5, Whites Row 33, Old Montague Street Plough Square 64, Old Montague Street John Evans. Evan Edwards. Thomas William, William Lewis. Thomas Watson. CHRIST CHURCH. Saw Yard 37, Hanbury Street 155, Commercial Street 15, Tilley Street 16, Grey Eagle Street Daniel Barker. David Felix. Evan David Morgan. David Felix. James Webb. MILE END NEW TOWN. 44, Dunk Street 21, Spital Street Samuel Evans. William Davies. NORTON FOLGATE. 7, White Lion Street Elizabeth Morgan. 27 Table A.—Births Registered in the Whitechapel District during the year 1892. Sub Registration Districts. Spitalfields. Mile End New Town Whitechapel Church. Goodmans Fields. Total. Boys. Girls. First Quarter. 212 261 198 122 386 407 Second „ 230 288 245 92 433 422 Third „ 184 264 186 101 358 377 Fourth „ 197 230 188 123 386 352 Total 823 1043 817 438 1563 1558 3121 Table B.—Deaths registered in the Whitechapel District during 1892. Sub-Registration Districts. Spitalfields. Mile End New Town Whitechapel Church. Goodmans Fields. Total. Males. Females. First Quarter. 111 181 315 63 382 288 Second „ 74 172 281 52 353 226 Third „ 74 162 263 40 325 214 Fourth „ 76 163 322 55 361 255 Total 335 678 1181 210 1421 983 2404 Table C.—The 746 Deaths of Non-Residents which took place in the District were Registered as under: Spitalfields. Mile End New Town (Whitechapel Infirmary). Whitechapel Church (London Hospital). Goodman's Fields. (River Thames.) Total. 1 18 724 3 746 Table D.—Outlying Public Institutions, &c., where Residents of the Whitechapel District Died during the Year. Asylums' Board Hospitals— Brought over 163 Homerton Fever Hospital 58 Hackney Infirmary 1 Northern „ 2 Hand-in-hand Asylum 1 North Eastern „ 7 Holborn Workhouse 1 North Western 3 Hoxton House Asylum 1 South Eastern „ 3 Islington Infirmary 1 Banstead Asylum 7 Jewish Home 5 Cane Hill „ 2 King's College Hospital 1 Caterham „ 2 Lock Hospital 1 Colney Hatch„ 13 Middlesex Hospital 1 Darenth „ 3 Mile End Infirmary 1 Han well „ 3 Mint Street Workhouse 1 Leavesden „ 9 Poplar Hospital 1 Bethnal Green Workhouse 1 Royal Free Hospital 1 Bethnal House Asylum 2 St. Anne's House 2 Brompton Hospital 2 St. Bartholomew's Hospital 18 Charing Cross Hospital 2 St. George's Hospital 1 Children's Hospital,Gt. Ormond St 1 St. George-in-the-East Infirmary 1 1, „ Shadwell 13 St. Mark's Hospital 1 City Infirmary, Bow 2 Shoreditch Infirmary 1 City of London Chest Hospital 8 Station Hospital 3 Evelina Hospital for Children 1 Strand Workhouse 1 French Hospital 1 Whitechapel Workhouse, South Grove 7 German Hospital 13 Grove Hall Asylum 1 Other places 5 Guy's Hospital 4 Total 220 Carried over 163 28 Table E.—Correct District Mortality Table. Residents' Deaths, wherever registered, being correctly referred to their proper Sub-Districts. Sub-Registration Districts Spitalfields. Mile End New Town Whitechapel Church. Goodmans Fields. Total. First Quarter 208 82 154 99 543 Second „ 158 83 138 76 455 Third „ 123 118 131 57 429 Fourth „ 151 87 138 75 451 Total 640 370 561 307 1044 834 Males. Females. Table F.—Showing the Ages at Death of the Residents who died during the year. ISt Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. Under the age of 1 year 120 111 157 100 488 Between 1 and 5 years 84 116 70 79 349 5 „ 20 „ 29 23 26 31 109 „ 20 „ 40 „ 61 58 54 62 235 „ 40 „ 60 „ 119 68 65 94 346 „ 60 „80 104 69 53 74 300 Over the age of 80 years— 26 10 4 11 51 Total 543 455 429 451 1878 Table G.—Total Births and Deaths in London, and Deaths under 5 years of age. Number of Births in London during the year 134.724 „ Deaths „ „ 91,149 „ „ under 1 year of age 20,938 35.710 „ „ between the ages of 1 and 5 14.772 29 Table H.—DISTRICT MEDICAL OFFICERS' ANALYSIS OF CASES FOR 1892. Diseases. 1 st Quar. 2nd Quar. 3rd Quar. 4th Quar. Total. Diseases. 1st Quar. 2nd Quar. 3rd Quar. 4th Quar. Total. All Causes 1646 1157 1274 1465 5542 40 Apoplexy 2 2 1 ... 5 41 Epilepsy 7 2 4 2 15 ZYMOTIC DISEASES. 42 Convulsions ... 1 1 ... 2 43 Other diseases of brain and nervous system. 58 54 67 43 222 1 Small Pox Vaccinated ... ... ... ... ... Unvacci ... ... ... ... ... 44 Diseases of organs special sense 17 13 18 15 63 No statement ... ... ... ... ... 2 Measles 2 47 33 5 87 3 Scarlet Fever ... 3 7 4 14 45 Diseases of circulatory system 29 14 17 18 78 4 Typhus ... ... ... 1 1 5 Relapsing Fever ... ... ... ... ... 6 Influenza 121 15 20 42 198 46 Croup ... ... ... 1 1 7 Whooping cough 6 7 1 1 15 47 Bronchitis 213 99 52 121 485 8 Diphtheria 2 1 1 2 6 48 Pneumonia 5 1 3 6 15 9 Simple, Continued-and ill-defined fever ... ... 2 ... 2 49 Pleurisy 6 4 2 5 17 50 Other respiratory diseases 250 134 125 238 747 10 Enteric fever ... ... ... ... ... 11 Simple cholera ... ... ... ... ... 51 Dentition 5 1 3 2 11 12 Diarrhcea, Dysentery 13 8 32 15 68 52 Quinzy, sore throat 14 14 21 24 73 13 Remittent fever ... ... ... ... ... 53 Enteritis ... ... ... ... ... 14 Hydrophobia ... ... ... ... ... 54 Peritonitis ... 1 ... ... 1 15 Glanders ... ... ... ... ... 55 Diseases of liver ... 1 2 2 5 16 Cow pox and effects of vaccination ... ... ... ... ... 56 Other diseases of digestive system 71 48 79 59 257 17 Venereal affections 13 20 12 24 69 18 Erysipelas 1 2 8 17 28 57 Diseases of lymphatic system and ductless glands ... 2 3 4 9 19 Pyæmia and Septicaemia ... ... ... ... ... 20 Puerperal Fever ... ... ... ... ... 21 Other Zymotic diseases 1 2 2 ... 5 58 Diseases of urinary syst'm 35 15 35 29 114 22 Thrush ... ... ... ... ... 23 Worms and other parasitic diseases 1 1 3 3 8 59 Diseases of generative system 57 62 50 75 244 24 Starvation, want of breast-milk 6 7 13 11 37 60 Accidents of childbirth ... 1 3 ... 4 25 Alcoholism 9 8 4 7 28 61 Diseases of locomotive system 120 122 126 134 502 26 Rheumatic fever and rheumatism of heart ... ... ... ... ... 62 Diseases of integumentary system 92 72 80 85 327 27 Rheumatism 120 111 118 144 493 28 Gout 4 11 8 8 31 29 Rickets ... ... ... ... ... VIOLENCE.—Accident. ... ... ... ... ... 30 Cancer 1 1 5 ... 7 31 Tabes Mesenterica ... ... 2 1 3 63 Fracture and contusion 44 25 35 41 145 32 Tubercular Meningitis ... ... ... ... ... 64 Gun shot wounds ... ... ... ... ... 33 Phthisis 12 11 13 15 51 65 Cut, stab 6 4 ... 3 13 34 Scrofula, Tuberculosis ... 2 2 2 6 66 Burn or scald 3 1 ... ... 4 35 Other constitutnl.diseases 8 2 6 7 23 67 Poison ... 2 ... 1 3 36 Premature birth ... ... ... 1 1 68 Drowning ... ... ... ... ... 69 Suffocation ... ... ... ... ... 37 Atelectasis ... ... ... ... ... 70 Otherwise ... ... ... ... ... 38 Congenital malformations ... ... ... ... 71 Other Causes 287 196 244 238 965 39 Old age 5 9 11 9 34 30 Table I.—CLASSIFICATION OF CAUSE OF DEATH. Class of Disease. Percentage of Deaths to Total Deaths. London including Whitechapel. Whitechapel Zymotic Diseases (as named in the Registrar-General's Weekly Sheets) 17.72 16.40 Parasitic Diseases 0.09 0.00 Privation and Alcoholism 0.68 0.58 Constitutional Diseases 18.39 22.31 Premature Birth and Old Age 5.99 5.05 Diseases of Nervous System 10.15 9.63 ,, Organs of Special Sense 0.16 0.15 „ Circulatory System 8.09 7.77 ,, Respiratory ,, 22.70 22.89 ,, Digestive ,, 4.96 7.56 Lymphatic ,, 0.10 o.oo Urinary 2.44 2.39 ,, Generative „ 0.28 0.10 Accidents of Childbirth 0.33 1.17 Diseases of Locomotive System 0.37 0.42 ,, Integumentary „ 0.37 0.26 Violent Deaths—Accident 3 .09 2.92 Homicide 0.58 0.21 Suicide Other Causes 3.44 0.00 Table J.—VACCINATION STATISTICS. Certificates of successful Vaccination registered by Mr. W. M. Sherman, Vaccination Officer :— Born in the Whitechapel Union 2711 Resident in the Union but born elsewhere Five were returned as " Insusceptible " 239 Total 2950 Public Vaccinator's Statistics :— Primary By Public Vaccinator 2065 By Infirmary Medical Superintendent 131 2196 Re-Vaccination By Public Vaccinator 7 By Infirmary Medical Superintendent 1 8 31 Table K.—CLASSIFICATION OF CAUSE OF DEATH. Zymotic Diseases, as named in the Registrar-General's Weekly Sheets 309 Parasitic Diseases 0 Privation and Alcoholism 11 Constitutional Diseases 419 Premature Birth and Old Age 95 Diseases of Nervous System 181 Organs of Special Sense 3 ,, Circulatory System 146 Respiratory ,, 430 ,, Digestive „ 142 Lymphatic „ 0 „ Urinary ,, 45 ,, Generative ,, 2 Accidents of Childbirth 22 Diseases of Locomotive System 9 „ Integumentary ,, 5 Violent Deaths- Accidents 55 Homicide 2 Suicide 2 Other Causes 0 Total 1878 Table L.—Deaths belonging to the several Sanitary Areas of Registration London registered in the 52 weeks ending on 31st December, 1892, so far as the Eastern Division is concerned. Name of District. Shoreditch. Bethnal Green. Whitechapel. St. Georgein-the-East. Stepney. Mile End Old Town. Poplar. Cause of Death— Total Deaths 2839 2984 i85i a* 1262 1456 2489 3754 Small-pox 4 5 —B* 1 — 1 — Measles 103 136 65 C* 62 72 67 140 Scarlet Fever 36 56 34 d* 34 28 39 64 Diphtheria 44 117 59 E* 33 25 81 78 Whooping Cough 105 128 43 F* 24 72 110 178 Typhus Fever 1 — 1 G* — — — — Enteric Fever 13 20 5 H* 9 7 16 26 Simple Fever 2 — — J* — — — 3 Diarrhœa 104 79 42 K* 59 37 73 109 Deaths of Infants under 1 year of age 740 775 574 L* 344 359 612 963 Deaths under 1 year to 1000 Births registered 658 629 624 m* 751 741 612 656 A* = i878. B* = Nil. C* = 56. D* = 31. E*=57. F*=43. G* = 1. H*=3. J* = Ni1 K*=38. L*=488. M*=639. ^°te—I have introduced the corredt numbers in this manner to exhibit the extraordinary approach to accuracy which is represented by the above returns from the office of the Registrar-General. 32 TABLE M.—WHITECHAPEL DISTRICT DEATHS FOR 1892. Causes of Death. 1st Quar. 2nd Quar. 3rd Quar. 4th Quar. Total. Causes of Death. 1st Quar. 2nd Quar. 3rd Quar. 4th Quar. Total. All causes 543 455 429 451 1878 45 Diseases of circulatory system 45 27 33 44 149 ZYMOTIC DISEASES. 1 Small Pox Vaccinated ... ... ... ... ... 46 Croup 5 4 1 4 14 Unvaccin't'd ... ... ... ... ... 47 Bronchitis 87 36 18 51 192 Nostatement ... ... ... ... ... 48 Pneumonia 44 55 26 41 166 2 Measles 4 33 13 6 56 49 Pleurisy ... 1 2 3 6 3 Scarlet Fever 2 4 13 12 31 50 Other respiratory dis'es 18 8 11 12 49 4 Typhus ... ... ... 1 1 5 Relapsing fever ... ... ... ... ... 51 Dentition 2 4 7 4 17 6 Influenza 55 6 ... ... 61 52 Quinzy, sore throat ... 1 1 ... 2 7 Whooping cough 20 19 2 2 43 53 Enteritis ... ... ... ... ... 8 Diphtheria 16 10 21 10 57 54 Peritonitis 2 4 1 4 11 9 Simple, continued and ill-defined fever ... ... ... ... ... 55 Diseases of liver 3 5 8 7 23 56 Other diseases of digestive system 16 13 37 23 89 10 Enteric fever ... 1 1 I 3 11 Simple cholera ... ... ... ... ... 12 Diarrhoea, dysentery 2 7 25 4 38 57 Diseases of lymphatic syst'm& ductless glands ... ... ... ... ... 13 Remittent fever ... .. ... ... ... 14 Hydrophobia ... ... ... ... ... 15 Glanders ... ... ... ... ... 58 Diseases of urinary sys'm 11 10 9 15 45 16 Cow pox and effects of vaccination ... ... ... ... ... 59 Diseases, generative system 1 ... 1 ... 2 17 Venereal affeftions 1 2 2 2 7 18 Erysipelas ... 1 4 3 8 60 Accidents of childbirth 3 5 8 6 22 19 Pyaemia and Septicaemia ... ... 1 ... 1 20 Puerperal fever 1 ... 1 1 3 21 Other Zymotic diseases ... ... ... ... ... 61 Diseases of locomotive system 1 5 3 ... 9 22 Thrush ... ... ... ... ... 62 Diseases of integumentary system 1 1 ... 3 5 23 Worms and other Parasitic diseases ... ... ... ... ... 24 Starvation, want of breast milk 4 1 ... 1 6 VIOLENT DEATHS. A ccident. 25 Alcoholism 1 2 ... 2 5 63 Fracture and contusion 4 7 4 6 21 64 Gun-shot wounds ... ... ... ... ... 26 Rheumatic fever and rheumatism of heart 2 ... 1 1 4 65 Cut, stab ... ... ... ... ... 66 Burn and scald 3 1 1 3 8 27 Rheumatism 1 ... 1 1 3 67 Poison ... ... ... ... ... 28 Gout ... 1 1 ... 2 68 Drowning ... ... ... ... ... 29 Rickets ... 4 2 2 8 69 Suffocation 5 4 3 11 23 30 Cancer 6 14 11 14 45 70 Otherwise 1 1 ... 1 3 31 Tabes Mesenterica 4 2 9 6 21 Homicide. 32 Tubercular Meningitis 4 8 5 8 25 33 Phthisis 41 43 31 45 160 71 Murder & manslaughter ... ... 2 ... 2 34 Scrofula, Tuberculosis 5 5 5 3 18 35 Other constitut'l diseas's 35 29 44 25 133 Suicide. 72 Gun-shot wounds 1 ... ... ... 1 36 Premature birth 7 7 16 6 36 73 Cut, stab ... ... ... ... ... 37 Atelectasis ... ... ... 2 2 74 Poison ... ... ... ... ... 38 Congenital malformatns. ... ... ... ... ... 75 Drowning ... ... ... ... ... 39 Old age 21 14 3 19 57 76 Hanging ... ... ... 1 1 77 Otherwise ... ... ... ... ... 40 Apoplexy 5 9 6 7 27 Execution. 41 Epilepsy 1 1 1 1 4 42 Convulsions 12 14 12 13 51 78 Hanging ... ... ... ... ... 43 Other diseases of brain and nervous system 40 25 22 12 99 79 Inquest ... ... ... ... ... 80 Other causes ... ... ... ... ... 44 Diseases of organs of special sense ... 1 ... 2 3 33 Table N.—METROPOLITAN DEATHS FOR 1892. Causes of Death. 1st Quar. 2nd Quar. 3rd Quar. 4th Quar. Total. Causes of Death. 1st Quar. 2nd Quar. 3rd Quar. 4th Quar. Total. All Causes 31577 20421 18292 20859 91149 40 Apoplexy 671 536 489 589 2285 41 Epilepsy 125 106 88 88 407 ZMOTIC DISEASES. 42 Convulsions 669 459 563 513 2204 43 Other diseases of brain and nervous system 1346 1081 890 1039 4356 1 Small Pox Vaccinated 2 7 4 2 15 Unvaccinated ... 9 4 1 14 44 Diseases of organs of special sense 35 38 38 35 146 No statement 3 6 2 1 12 2 Measles 899 1598 656 394 3547 3 Scarlet fever 156 257 354 421 1118 45 Diseases of circulatory system 2382 1672 1386 1938 7378 4 Typhus „ 3 3 4 1 11 5 Relapsing fever ... ... 1 ... 1 6 Influenza 2101 99 31 70 2301 46 Croup 126 50 41 65 282 7 Whooping Cough 1573 681 227 176 2657 47 Bronchitis 6909 1777 878 2546 12110 8 Diphtheria 350 414 475 683 1922 48 Pneumonia 2533 1664 810 1413 6420 9 Simple, continued and ill-defined fever. 7 2 8 4 21 49 Pleurisy 80 101 52 81 314 50 Other respiratory dis's 712 293 192 373 1570 10 Enteric fever 78 82 109 178 447 11 Simple cholera 4 11 65 7 87 51 Dentition 154 130 109 97 490 12 Diarrhœa, Dysentery 223 280 1744 324 2571 52 Quinzy, sore throat 23 26 25 25 99 13 Remittent fever ... 1 ... 2 3 53 Enteritis 150 134 349 153 786 14 Hydrophobia ... ... ... ... ... 54 Peritonitis 75 81 90 85 331 15 Glanders ... ... 1 2 3 55 Diseases of liver 313 305 330 317 1265 16 Cow pox and effects of vaccination 7 2 2 9 20 56 Other diseases of digestive system 409 351 394 398 1552 17 Venereal affections 108 119 139 148 514 18 Erysipelas 57 54 74 112 297 57 Diseases of lymphatic system and ductless glands 29 18 19 30 96 19 Pyæmia & Septicaemia 22 19 34 38 113 20 Puerperal fever 60 50 92 120 322 21 Other zymotic diseases 23 19 28 19 89 58 Disea's urinary system 622 539 467 599 2227 22 Thrush 26 12 22 15 75 23 Worms and other parasitic diseases 1 5 7 2 15 59 Diseases of generative system 51 57 56 93 257 24 Starvation, want of breast-milk 37 20 29 32 118 60 Accidents of childbirth 77 71 68 92 308 25 Alcoholism 123 111 119 144 497 26 Rheumatic fever and reumatism of heart 86 89 81 159 415 61 Diseases of locomotive system 94 87 78 81 340 27 Rhematism 30 37 22 33 122 28 Gout 51 39 28 41 159 29 Rickets 86 97 54 56 293 62 Diseases of integumentary system 76 80 81 107 344 30 Cancer 794 783 791 864 3232 31 Tabes mesenterica 323 275 431 292 1321 32 Tubercular meningitis 288 354 323 293 1258 33 Phthisis 2482 2003 1708 2101 8294 VIOLENT DEATHS. 34 Scrofula tuberculosis 272 258 275 224 1029 35 other constitutnl. dis's 165 148 148 185 646 36 Premature birth 674 577 551 637 2439 63 Accidents 794 718 606 707 2825 37 Atelectasis 44 38 39 45 166 64 Other than accidental. 117 159 132 124 532 38 Congnitl malformatns 102 91 78 112 383 65 Other causes 826 66l 848 801 3136 39 Old age 919 577 453 523 2472 34 TABLE 0—PRINCIPAL ZYMOTIC DISEASES DEALT WITH DURING THE YEAR 1892. NAME OF PLACE. Small Pox. Scarlet Fever. Typhus Fever Enteric Fever Diphtheria. Measles Erysipelas. Membrns Croup NAME OF PLACE. Small Pox. Scarlet Fever. Typhus Fever Enteric Fever Diphtheria. Measles. Erysipelas. Membrns.Crou ] Albert cottages ... ... ... ... ... ... 1 ... Fashion street ... 9 ... ... 5 3 2 ... Anns place ... 1 ... ... ... ... ... ... Fieldgate street ... 2 ... ... 2 1 ... 1 Artillery passage . 3 ... ... ... ... ... ... Finch street ... 2 ... ... 1 1 ... ... Artillery street ... 1 ... ... 2 ... 2 ... Fishers alley . 4 ... ... 1 ... ... ... Alexandra buildings ... 3 ... ... ... ... ... ... Fort street 3 3 ... 1 1 1 3 ... Albert buildings ... ... ... 1 ... 3 1 ... Freeman street ... 7 ... ... 2 2 1 ... Back Church lane ... 1 ... ... 3 ... ... ... Friendly buildings ... 1 ... ... ... ... ... ... Baker's row ... 1 ... ... 2 ... 1 ... Frostic court ... 1 ... ... ... ... ... ... Bath place ... 1 ... ... ... ... ... ... Fleur de lis buildings ... 4 ... ... ... ... ... ... Bell lane ... 1 ... ... 2 ... 1 ... Garden court ... ... ... ... ... ... 1 ... Bennetts place ... 1 ... ... ... ... ... ... Garden place ... ... ... ... ... 1 ... ... Black Lion yard ... 2 ... ... ... ... ... ... George street ... ... ... 1 ... 1 ... ... Blossom street ... ... ... ... ... ... 2 ... Goulston street ... 7 ... ... 1 ... ... ... Blossom place ... ... ... ... ... ... 1 ... Goodmans stile ... ... ... ... 1 ... ... ... Booth street ... 5 ... 1 ... 1 ... ... Goodmans yard ... 3 ... ... ... ... ... ... Brick lane ... 10 ... ... 3 2 5 ... Gower's walk ... ... ... ... 1 ... ... ... Bucks row ... ... ... ... 1 1 ... ... Graces alley ... ... ... 2 ... ... ... ... Buckle street ... ... ... ... . ... 1 ... Great Alie street ... 2 ... 2 ... 1 ... Burr street ... 4 ... ... ... ... ... ... Great Prescot street ... 5 ... ... 1 1 ... ... Butler street 4 1 ... ... ... ... 1 ... Great Garden street ... 3 ... 1 ... 5 1 ... Buxton street ... 3 ... 1 3 3 1 Great Pearl street ... 5 ... ... ... 1 ... ... Brushfield street ... 6 ... ... 1 ... 1 ... Greens place ... ... ... ... 1 ... ... ... Brady street ... 1 ... ... 1 ... ... ... Green street . 3 ... ... ... ... ... ... Blackwall buildings ... 5 ... ... 7 7 1 ... Greenfield street ... 1 ... ... ... ... ... ... Brunswick buildings ... 13 ... 2 5 ... 4 1 Green Dragon yard ... 2 ... ... ... 3 ... ... Brady street buildgs ... 9 ... ... 5 3 1 ... Grey Eagle street ... 3 ... ... 2 2 ... ... Buckle street buildgs ... 2 ... ... ... ... ... ... Griggs court ... 1 ... ... ... ... ... ... Booth street buildgs ... ... ... ... 1 10 ... ... Gun street ... 5 ... ... ... 1 2 ... Cable street ... 2 ... ... ... ... 1 ... Great Eastern bdgs., ... 24 ... 2 ... 2 ... Casson street ... 1 ... ... ... ... ... Quaker street Glasshouse buildings ... 2 ... ... ... ... 1 ... Cannon place ... 2 ... ... ... ... ... ... Carter street ... 1 ... ... ... ... ... Halifax street, Little ... 1 ... ... ... 1 ... ... Chapel street ... 2 . ... 1 ... ... ... Hampshire court ... 6 ... ... ... ... 1 ... Chamber street ... ... ... ... 2 ... ... ... Hanbury street ... l6 ... ... 3 11 3 ... Charlotte street ... 9 ... 1 1 2 1 ... Harriot place ... 1 ... ... 1 ... ... ... Charlotte crt.M.E.N.T ... ... ... ... ... ... 1 ... Harrisons court ... 1 ... ... ... ... ... ... Charlotte court, w.c. ... 1 ... ... 1 ... ... ... Heneage street ... 4 ... ... 3 1 ... ... Chicksand street ... 4 ... ... 1 ... 1 ... Hobsons cottages ... 1 ... ... ... ... 1 ... Church street, c.c ... 1 ... ... ... 1 ... ... Hope street C.C. ... 3 ... ... ... ... ... ...... Church lane ... ... ... ... 1 ... ... ... Hope street W.C. ... 1 ... ... 1 1 ... ... Church St., Minories ... ... ... 1 ... ... ... ... Hunt street ... 1 ... ... ... ... ... ... Colchester street ... 1 ... ... ... ... ... ... Hunt place ... 3 ... ... ... ... ... ... Commercial street ... 4 . 1 3 2 1 1 Howard's buildings ... ... ... ... 2 ... 2 ... Commercial road ... ... ... ... 2 ... ... ... Helena terrace ... 1 ... ... 3 ... ... ... Corbett's court ... 2 ... ... ... ... 1 ... John street C.C. ... ... ... ... 1 ... ... ... Crispin street 1 2 ... 1 1 1 ... ... John street W.C. ... 3 ... ... ... ... ... ... Deal street ... ... ... ... 1 ... ... ... Johns ct., Casson St. ... 1 ... ... ... ... ... ... Dinah's buildings ... ... ... ... 1 ... ... ... Johns place, Hunt st. ... ... ... ... ... 1 ... ... Dock street ... ... ... ... ... 1 ... ... King street ... 1 ... ... ... 2 ... ... Dorset street ... 4 ... 1 3 6 2 ... King Edward street ... 1 ... ... 2 1 ... ... Drum yard ... 1 ... ... ... ... ... ... Katharine buildings- 1 4 1 ... 3 ... ... ... Duke street ... 4 ... ... ... ... ... 1 Lamb street . 3 ... ... ... ... 1 ... Dunk street ... 3 ... 1 ... ... 3 ... Lambeth street ... 3 ... . 1 ... 2 ... Duncan street ... 2 ... ... ... ... ... ... Leman street ... 8 ... ... 5 ... 1 ... East Mount street ... ... ... 1 ... ... ... ... Little Alie street ... 5 ... ... 3 ... ... ... Eastmans court ... ... ... ... 2 ... ... ... Little John street ... 1 ... ... ... ... ... ... Eagle place ... ... ... ... ... 1 ... ... Little Pearl street 1 1 ... ... ... ... ... ... Eele street ... 1 ... ... ... ... ... ... Lombard street ... 2 ... ... ... 2 ... ... Elizabeth place ... ... ... ... 1 ... ... ... London Hospital 5 12 ... 1 10 ... ... ... Ely place ... 1 ... ... 4 ... ... ... Lolesworth buildings ... 2 ... ... 12 ... 1 ... 35 Table O (Continued).—PRINCIPAL ZYMOTIC DISEASES DEALT WITH DURING THE YEAR 1892. name of place. Small Pox Scarlet Fever Typhus Fever Enteric Fever Diphtheria. Measles. Erysipelas. Membrns.Croup name of place. Small Pox. Scarlet Fever Typhus Fever Enteric Fever Diphtheria. Measles Erysipelas. Membrns.Croup Mansell street ... 1 ... ... 1 ... ... ... Royal Mint street 1 3 ... ... 2 1 1 ... Montague place ... 5 ... ... ... ... ... ... Rupert street ... 1 ... ... 2 1 ... ... Montague st„ Little. ... 1 ... ... ... ... ... ... Royal Mint square ... 2 ... ... 1 ... 2 ... Moss's buildings ... 2 ... ... ... ... ... ... Regal place ... 1 ... ... ... 2 ... ... Mount street ... 2 ... ... ... 1 ... ... Rothschilds buldngs ... 17 ... 2 4 ... 2 2 Mountford street . ... 4 ... ... 1 ... ... ... Royal Mint ... 1 ... ... 1 ... ... ... Mundys place ... ... ... ... 2 ... ... ... Sandys row ... 2 ... ... ... ... ... ... Morrison's bldgs. (S) ... 1 ... ... ... 1 ... ... Scarborough street ... 4 ... ... ... ... 1 ... Metropolitan bldgs ... ... ... ... 2 ... 1 ... Shepherd street ... ... ... ... 1 ... ... ... Nelson court W.C. ... 2 ... ... 3 ... 1 ... Spectacle alley ... ... ... ... ... ... 1 ... New ct. Dorset st. ... ... ... ... ... 1 1 ... Spital street ... 3 ... ... 1 ... 2 ... New ct. Hanbury st. ... ... ... ... ... 1 ... ... Spital square ... 1 ... ... ... ... ... ... New ct. Fashion st. ... 1 ... ... ... ... ... ... Spring gardens ... 1 ... ... ... ... ... ... New road ... 1 ... ... ... ... 2 ... Steward street ... 1 ... ... ... ... 1 ... New square ... ... ... ... 1 ... ... ... St. Mark's street ... 1 ... ... ... ... 1 ... Newnham street ... 4 ... ... ... ... ... ... St. Mary's street ... ... ... ... 1 ... ... ... Newcastle street ... 2 ... ... 2 ... 1 ... Spelman street ... 6 ... ... ... ... 1 1 North place ... 1 ... ... 3 ... ... ... Sugar Loaf court ... ... ... 1 1 ... ... ... Norton folgate High ... 1 ... 1 ... ... ... ... Shepherd st. buildngs 1 ... ... ... ... ... ... ... street Newman's buildings, ... 1 ... ... ... ... 1 ... Strafford houses ... 1 ... ... 7 ... ... 1 Shepherds buildings ... 3 ... ... ... ... ... ... Cox square New ct. Wentworth ... 1 ... ... ... ... ... ... St. George's house ... 3 ... ... 4 ... ... ... Tenter street C.C. 2 10 ... ... 1 ... ... ... street Newcastle place ... 2 ... ... 3 1 ... ... Tenter street North ... 2 ... ... 1 ... ... ... Tewkesbury bldgs ... ... ... ... 1 ... 1 ... Old Montague street. ... 11 ... ... 5 3 1 2 Thomas street ... ... ... ... 1 ... ... ... Osborn street ... 3 ... 1 2 ... 1 ... Tilley street ... 4 ... ... ... ... ... ... Osborn place ... 1 ... ... 1 1 ... ... Tripe yard ... 1 ... ... ... ... ... . Oxford street ... 3 ... ... ... ... ... ... Turner street ... 3 ... ... ... ... ... ... Palmer street 5 3 ... ... 1 ... ... ... Tusons court ... ... ... ... ... ... 1 ... Parliament court ... ... ... ... 1 ... .. ... Tower of London 1 ... ... ... ... ... ... ... Paternoster row ... 3 ... 1 ... ... 2 ... Tower Hill ... 1 ... ... ... ... ... ... Pelham street ... 9 ... 1 2 3 1 1 Tenter buildings ... ... ... ... ... 2 ... ... Pereira street ... 2 ... 2 1 ... ... ... Underwood street ... 2 ... ... 2 ... 1 1 Plough street ... ... ... ... ... ... 1 ... Upper East Smthfild ... ... ... ... ... .. 1 ... Pool's place ... 1 ... ... ... ... ... ... Vine court W.C . ... ... ... ... ... .. 2 1 Pope's Head court ... ... ... ... 1 1 ... ... Victualling Office sq. ... 1 ... ... ... ... ... . Prince's place ... 1 ... ... ... ... ... ... Vicloria cottages ... 1 ... ... ... ... ... ... Prince's street ... 2 ... ... 3 ... ... ... Victoria buildings ... 1 ... ... ... ... ... ... Pauline terrace ... 1 ... ... ... 1 ... 1 Well street ... 1 ... ... ... ... 1 ... Peabody bdgs. Commercial street ... 1 ... ... ... ... ... ... Wellclose square ... 1 ... ... 1 ... ... ... Wheeler street ... 2 ... 1 ... 1 1 ... Peabody bdgs. Glasshouse street ... 7 ... ... 2 ... 3 ... White's row C.C. ... 2 ... ... ... 1 4 ... White Lion street 1 1 ... ... 2 . ... ... Pavilion yard ... 1 ... ... ... ... ... ... Whitechapel high st. ... 5 ... 1 1 ... 1 ... Plough street buldgs. ... ... ... ... 2 ... ... ... Whitechapel road ... 13 ... 2 3 1 2 . Quaker Street ... 8 ... ... 1 ... 1 ... Wilk street ... 2 ... ... ... 1 2 ... Queen st., M.E.N.T. ... 1 ... ... ... ... ... ... Wood street ... 5 ... 1 ... ... 2 ... Queen street, C.C. ... 1 ... ... 1 ... 1 ... Winthrop street ... 3 ... ... 2 ... ... ... Queen street Aldgate ... ... ... ... ... ... 1 ... Wentworth bldngs ... 11 ... ... 13 2 4 ... Queen Anne street ... 1 ... ... 2 5 ... ... Whitechapel Infirmy ... 1 ... 3 6 ... 59 ... Raven row C.C. ... 1 ... ... ... ... ... ... Yeoman's yard ... ... ... 1 ... ... ... . Raven row W.C. ... 1 ... ... 2 ... ... ... Yoakley's buildings ... ... ... 1 ... ... ... Raven Street ... 5 ... ... 3 ... ... ... Totals .. 26 533 1 41 242 115 180 15 Red Lion court ... 2 ... ... ... ... ... ... Regents court ... 1 ... ... ... ... ... ... Total No. of Cases 1153 501 of above were removed to Hospitals. 28 ,, ,, In-patients at London Hospital. 69 ,, ,, ,, Whitechapel Infirmary. 475 ,, ,, attended at their respedtive homes. Total 1153 36 Table P.—SANITARY AND OTHER WORK PERFORMED BY THE INSPECTORS. 1892. Classification of Work. Quarter ending Mar. 26th. Quarter ending June 25th. Quarter ending Sept. 24th. Quarter ending Dec. 31st. Totals for the year. Numbers of Inspections of Houses as shewn in the Official Returns 2431 2970 4029 8755 18185 Houses specially visited 725 433 638 962 2758 Preliminary Notices served 300 352 750 827 2229 Compulsory Orders issued 17 13 32 80 142 Number of Letters sent 76 87 128 115 406 Number of Telegrams sent 12 40 127 156 335 Summonses taken out under Public Health London, Act ... ... ... .. .. ,, ,, Adulteration of Food and Drugs Acts ... ... ... ... ... „ ,, Housing of Working Classes Act ... 1 ... ... ... Cellars used as dwellings, caused to be discontinued to be so used 4 9 16 17 46 Cases of overcrowding and indecent occupation abated ... 1 14 5 20 Houses in which walls and ceilings have been cleansed or repaired 82 224 423 469 1198 Roofs of houses repaired 7 28 74 83 192 Ventilation of houses improved ... 22 26 16 64 Houses in which floorings of rooms, staircases, risers or treads, window sashes and frames, baluster rails, or fire stoves have been repaired 8 45 48 40 141 Eaves, gutters and stackpipes provided or repaired 9 20 45 55 129 Nuisances from smoke abated ... ... 3 1 4 Rooms disinfeited with sulphurous acid gas, after the occurrence of cases of infedtious diseases 78 93 468 421 1160 Articles consisting of beds, bedding, clothing, &c., removed and disinfected 2318 4900 12772 10237 30227 Articles burnt by consent 2 10 61 27 100 Courts and yards of houses paved, or paving repaired 31 63 139 168 401 Drainage of houses altered, improved, or re-constructed. 51 71 172 126 420 Traps to drains in houses, yards, or courts, improved 42 76 243 193 554 Closet pans and traps re-set 5 18 69 34 126 Closets provided with a water supply and flushing apparatus or defective water fittings repaired 28 60 115 85 288 Closets cleansed or repaired 73 104 213 183 573 Walls of yards or courts limewashed ... 42 86 53 181 Water supply to houses improved 9 29 31 24 93 Nuisances from dung and other offensive matter removed 11 27 31 27 96 Area-gratings, cellar-flaps, &c., repaired ... 8 4 22 34 Houses closed by Magistrate's order, or by consent, as unfit for human habitation 1 ... 3 3 7 Dust-bins provided, or repaired, or removed and galvanised iron dust pails substituted 6 35 24 33 98 Samples under sale of Food and Drugs Act submitted to the Public Analyst 32 30 33 46 141 Animals, kept so as to constitute a nuisance, removed ... ... 4 ... 4 Casks, baskets, churns, &c., of putrid meat, fruit, milk, &c., destroyed as unfit for human food 6 26 13 70 115 Urinals cleansed ... ... 2 ... 2 Urinals provided with water supply ... ... 1 ... 1 Cesspools abolished 2 ... ... ... 2 Bakehouses used for sleeping purposes discontinued 1 ... ... ... 1 37 Table Q.—METEOROLOGICAL STATISTICS. No. of Hours of Registered Bright Sunshine. Mean of Degree of Humidity (saturation represented by 100). Mean Reading of Barometer (in inches). Mean Temperature (Fahrenheit). Rainfall (in inches). Greenwich. Lewes. 1 st Quarter 118.9 235.6 82 26.69 37°7 3.56 2nd „ 579.3 622.8 69 29.83 52°1 4.97 3rd „ 458.2 569.1 77 29.82 59°7 6.06 4th 126.5 203.9 88 29.73 43°0 8.03 Total or Mean 1282.9 1631.4 79 29.01 48° 1 22.62 Weekly Mean of direction of Wind = 18 weeks, variable; 3 weeks, North ; 5 weeks, N.E.; 2 weeks, E.; 2 weeks S.; 1 week, S.E.; 4 weeks, W. ; 18 weeks, S.W. TABLE R.—METEOROLOGICAL STATISTICS.—HIGHEST AND LOWEST RECORDS. No. of Hours of Registered Bright Sunshine in London. Humidity of Atmosphere. Reading of the Barometer (in inches). Temperature (Fahrenheit). Ozone. 1st Qr. Highest 12th wk. 27.9 4th week 90 7th wk. 30.08 7 th week 43°.3 1st & 12th week 2.9 Lowest 3rd „ 1.3 8th „ 72 8th „ 29.33 8th „ 30°.7 2nd week 0.6 2nd ,, ■ Highest 15th „ 73.3 26th „ 76 14th ,, 30.13 22nd „ 62°.8 23rd week 3.8 Lowest 2ISt „ 27.3 20th ,, 61 16th „ 29.59 16th „ 41°.3 15,16,18,19 &2oth wk 0.0 3rd „ Highest 28th „ 57.4 39th ,, 85 31st „ 30.04 34th ,, 63°.9 36th week 7.6 Lowest 29th ,, 10.5 28th ,, 68 36th „ 29.54 37th ,, 53°.8 39th 0.6 4th „ - Highest 40th „ 26.7 49th ,, 95 48th ,, 30.06 40th „ 53° 9 45th week 4.7 Lowest 48th „ 0.0 43rd & 53rd week 84 41st „ 2935 53rd „ 28°2 41st & 43rd week , 0.1 Highest Temperature, 85°.9 on June roth. Lowest Temperature on December 27th. Rain or Snow fell on 151 Days during the Year. 38 39 FOOD AND DRUGS ACT. To Dr. Loane, Medical Officer of Health for the Whitechapel District. Sir, During the year ended 31st December, 1892, 141 Samples of Food were purchased by me and submitted to the Public Analyst for analysis, viz., Milk, 37; Bread, 35; Flour, 35; Sugar, 23 ; Oatmeal, 5 ; Coffee, 5 ; and Butter, 1. Five of the Milks were adulterated with water to the extent of 9, 11, 13, 16, and 23 per cent. respectively, and one sample of Milk was deficient in cream to the extent of 36 per cent.* I am, Sir, Your obedient Servant, RICHARD SKIDMORE WRACK, Inspector appointed under the Act. * In the first two cases the sellers were cautioned. In the other cases (street vendors) as false addresses had been given no action could be taken. 40 Board of Works, Whitechapel District. Sanitary Department. To Dr. Joseph Loane, Medical Officer of Health. Sir, In accordance with the usual custom, we hand you herewith a complete tabulated statement, which shows the large amount of work carried out by us during the past year, the details of which have been under your notice and supervision. The Public Health (London) Act, 1891, has very much augmented the duties of this department, but we have endeavoured throughout to keep pace with the great increase of work, which, through the whole of the Summer months, caused your Inspectors to work both early and late, on Sundays as well as on week-days. The very large increase in the number of cases of infectious disease caused great anxiety during the year, as well as extra work, for which, in conjunction with the other extra duties, additional assistance was absolutely necessary. As will be seen by the Tabulated Return, the total number of cases amounted in all to 1,153. This exceeds the total number of last year by 767, and also exceeds the total of 1890 and 1891 together by 197. The extensive precautions taken to prevent an epidemic of Cholera, we are thankful to say, have been attended with good results. We are, Sir, Your obedient Servants, RICHARD SKIDMORE WRACK, THOS. P. WRACK, GEORGE HARVEY, ALFRED COOK, Sanitary Inspectors. 31st December, 1892.