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The number of deaths which have not been certified by a medioal
practitioner has been 19; of these 15 were recorded in the Spitalfields
sub-District. The Registrar for this sub-District makes a note to the effect
that the majority of the certificates are informal, that is to say, the certificate
of death has not been given in accordance with the form prescribed
by the Registrar-General, although the certificates were signed by a duly
qualified medical practitioner. The form of certificate as now used is faulty,
and it ought to be amended. Unless the death of a patient is expected by the
medical practitioner in attendance at the date of the last visit speedily to take
place, it is questionable whether a medical man is justified in stating that his
patient died on such a day, and more especially when he has not verified the
fact that his patient is actually dead; all that he can correctly say in the
certificate of death is, that he was informed of the day when the patient died,
and in his opinion the cause of death was , unless a post mortem,
examination of the body has been made by him, when he can then speak with
more certainty as to the cause of death.
Paupers' Illness in the District.
The Medical Officers of the Union have attended, during the last Quarter,
3,526 new cases of illness out of the Workhouse, including 2 of small-pox,
54 of measles, 135 of scarlet-fever, 90 of hooping-cough, 560 of diarrhoea,
72 of fever, and 13 of erysipelas. In the corresponding Quarter of the
previous year, the number of pauper Cases of illness was 4, 765, including 13
of small-pox. 51 of measles, 17 of scarlet-fever, 23 of hooping-cough, 1,041 of
diarrhoea, 7 of cholera and choleraic-diarrhoea, 113 of fever, and 25 of
erysipelas. There has, therefore, been a marked decrease in the number of
sick paupers during this Quarter, when compared with the number returned
for the corresponding Quarter of last year. Scarlet-fever, however, has been
extremely prevalent among the paupers in this District, the disease having
increased from 17, in the corresponding of last year, to 135 in this Quarter.
Upon the extensive and still existing prevalence of scarlet-fever, the RegistrarGeneral
remarks:—" This highly contagious disease finds in the crowded
quarters of our large towns all the conditions favourable to its extension.
The skill and energy of the medical profession, and more particularly of the
Officers of Health, are taxed to the utmost in dealing with the disease. in
endeavouring, when possible, to separate the sick and the dying, and in
making generally known the precautions most needful; their humane efforts
are, however, beset with difficulties Until better habitations are within reach
of the labouring and poorer classes, until decent public mortuaries are
provided in all populous towns, and, perhaps also, until the rudiments of
physiology are included in the education of our youth, so that all who read
may know something of the laws by which we live and have our being. We
cannot extinguish with needful rapidity the oft recurring visitations of
epidemics like that we are now suffering from ; for ignorance is the fostermother
of disease as well as of crime." There are some places in this District
(particularly those large blocks of buildings bounded by Castle Street and
Castle Alley on the east, and by the east side of Middlesex Street on the
west, and bounded on the north by Union Street), where the houses are so old,
ill-constructed, and confined, that from the want of efficient ventilation and
of proper privy accommodation persons occupying them cannot enjoy good
health; and as it is impossible to improve these houses they ought to be taken
down. They would soon be demolished if the same anxiety were displayed
by the public authorities for the improvement of the health of the people
as such authorities now manifest in improving the traffic and embellishing the