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ing. During this year only 14 deaths were uncertified by a medical practitioner
; while during the preceding year the number of such deaths was 25,
and in 1863 the number was 32.
The Medical Officers of the Union have attended 15,594 new cases of
illness, including 573 cases of fever. In the preceding year the total number
of cases was 14,932, including 395 cases of fever. In the Workhouse the
total number of new cases of illness has been 3,535, including 535 of fever.
From these returns, it appears that fever has prevailed very extensively in
this district during the year 1865. The number of deaths from this disease
has been 167, exclusive of the deaths which occurred in the Fever Hospital of
those belonging to this district. The practice of sending cases to the Fever
Hospital has only prevailed during the last three or four months; all the cases
of fever occurring in the district before that time having been treated either at
the residences of the patients or in the Workhouse.
From table No. 8, it appears that fever has been epidemic since 1862, in
which year the number of deaths from it was 250 ; in 1863 the number was
158, and in 1864 it was 170. This melancholy fact clearly indicates that our
sanitary arrangements are very imperfect, and that much greater exertion must
be made, and further scientific inquiries must be instituted, if this plague is to
be checked. The deaths from fever during the last four years have been in
proportion to the total mortality as 1 in 14, or 7 per cent.; and if we exclude
from this calculation the deaths in the London Hospital, where very few cases
of this disease are admitted, the proportion will be much greater.
It may be fairly asked by any ratepayer how it happens, that after the
Metropolis has been heavily taxed for sanitary improvements, fever should
still so extensively prevail ? It is true that great improvements in drainage
have taken place in this district since the passing of the Metropolis Management
Act. Between 3,000 and 4,000 cesspools have been abolished, and about
£10,000 has been expended in the formation of new sewers; and at the present
time, with few exceptions, all the houses in the district communicate by drains
with the main sewers ; and as two or three new sewers will probably be soon
constructed, the owners of the few houses now undrained will be enabled to
abolish the existing cesspools, and form drains to communicate with the public
sewers. But when all this is done, I am afraid that fever will still continue to
prevail among us, unless all those sewers, in which large deposits are continually
taking place, are reconstructed. We have, it is true, removed the filth from cesspools,
which formerly festered in close proximity to our houses, to the public
sewers ; but if these are little, if any better, than cesspools, not much has been
gained by transferring the filth from the rear of our houses to the front of them;
for the public Sewers, for the most part, pass along the centres of our streets.
Out from the ventilating openings of some of these sewers the most abominable
emanations are given forth, whereby disease and death are spread through many
families living in their viciuity. The smell is at times so bad that the inhabitants
complain of it; and they have recourse to the covering of them with
pieces of matting, to prevent the nuisance from making its way into their
houses.
Such is the faulty construction of some of these sewers that they cannot be
cleansed by flushing them; and it is dangerous, owing to the large quantity of
decomposing animal matter lodged in them, for any one to enter them. The
only way that the offensive deposit can be got rid of is to open the sewer from
the road, remove the filth to the surface, and then cart it away through the
crowded streets of London, thereby occasioning an additional nuisance to the
inhabitants. It would certainly be most desirable that the Surveyor should
make a return to the Board of all those sewers in which deposits are continually