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since 1862, when it was only 10.9. The comparatively cold
July and September, and the high mean temperature of
November and December, account almost entirely for this
reduced rate.
The death-rate from all causes in Hackney was only 19.3
per 1,000 which is below the average for the seven years
1871-77, and of the ten years 1861-71, so that considering how
rife small-pox has been amongst our inhabitants, we may congratulate
ourselves on this return.
The next point to which I desire to draw your attention is
the diphtheria outbreak at Clapton, which, although it did not
occur until early in 1878, yet as it excited considerable attention
and discussion, I think it advisable to insert the report whioh I
presented to the Board on the 22nd of March, 1878.
"The first notification that I had of the outbreak was
contained in a letter which I received concerning some cases at
Warwick Road, and on making an inspection of these and other
houses in which they occurred, it was found that in almost every
instance a direct communication existed between their interior and
the sewer. Complaints were also made at the same time of the
offensive smells from many of the Gullies in Clapton, as low
down as Lea Bridge Road. I, therefore, requested Mr.
Lovegrove to have them examined, which was done when
some were found to be untrapped. I also had a circular
letter sent to everyone of the medical practitioners of
Upper Clapton and Stamford Hill, asking for information as
to the existence of cases of diphtheria, but did not receive any
reply whatever except from Messrs. Toulmin, who informed me
that they had cases in their practice, but did not give any names
or addresses, so that I am unable to state the number of cases,
except as regards those in the 134 houses visited, to which
reference will be made. There have not been, so far as I know,
any fresh cases or deaths since March 8th, with one exception,