APPENDIX. No. 5. of Chichester, polluting air and water cannot be otherwise than injurious in a sanitary · point of view. III. The sanitary authority: The local sanitary authority of Chichester is the town council; but, beyond appointing an inspector of nuisances, they do not appear, for a long time at least, to have exercised any sanitary functions. They had at one time a nuisances removal committee, which met at stated times; but whether the committee exists or not now, any regular meetings have been long discontinued; it is certainly a year, and probably a great deal longer than a year, since there has been any meeting at all. No reports are made by or expected from the inspector of nuisances. The Local Government Act has not been adopted. IV. To sum up I report 1. That the death-rate of Chichester is unnecessarily high, and that preventible disease often prevails. 2. That the causes of this are absence of proper drainage; polluted water; a large cattle market held in the city streets; an inefficient administration of the Nuisances Removal Acts. 3. That the removal of these causes is of urgent necessity, and that steps ought without delay to be taken (a.) For establishing a complete system of drainage : (b.) For removing the cattle market outside the city: (c.) For the more efficient administration of the Nuisances Removal Acts. No. 6. No. 6.-REPORT by DR. HENRY JULIAN HUNTER on Circumstances endangering the PUBLIC HEALTH of LEEDS. I. STATISTICAL FACTS. In the summer and autumn of 1865 the high death-rate of the Borough of Leeds, as made public by the Registrar General's Weekly Reports, awakened much attention in the borough to sanitary subjects; and at public meetings, and in printed letters and newspaper articles, it was repeatedly stated that disease was very excessively common, and was localized in certain poor and dirty districts, and that either the law or its administration was too weak to deal with some obvious nuisances which were universally asserted to exist, and to which the presence of disease was very freely and with apparent reason imputed. A high death-rate had been usual in Leeds, as will be seen in the table subjoined, but the present rate was in excess of that of former years, and there had long been a growing opinion that the rate might be diminished, if proper laws were enforced for the protection of public health. The annual average of deaths per 100,000 living of each class, from 1851 to 1861, as given in Parliamentary Paper, 1864, No. 12., is as follows: APPENDIX. No. 6. On the Thus the death-rate usual in Leeds has now been obtained by the Department, with a clearness and minute division impossible at the time of Dr. Greenhow's visit in 1859. Comparisons between past and present mortality in this and other tables must be taken with great Sanitary State care against inaccuracy through misunderstanding the area described of Leeds, by as Leeds. The township and union of Leeds are the same. Borough of Leeds contains, in addition, the following townships of The Dr. Hunter. Hunslet union: Hunslet, Holbeck, Bramley, Wortley, Kirkstall, Chapeltown, and Whitkirk. The population of Leeds union was in 1851, 101,000; that of Hunslet, 88,000; but such is the rapid increase that the Weekly Returns are calculated on a population of 224,000 for the borough only. Therefore no comparison should be attempted between the data supplied for the unions and those now supplied for the borough, nor should the results of the two unions be combined, as the ages and the rate of increase of the respective populations cannot be the same. Leeds union is almost entirely urban, while Hunslet, although containing much of the worst of the town, has the compensation of also containing a large area of healthy country, consequently while the present death-rate of the sub-districts of Leeds union only varies (according to Dr. Braithwaite's valuable tables) from 26 3 in the west to 29.5 in the north, the death-rate of Hunslet varies from 15 in Potternewton to 29 in Burley. As being applicable to the state of Leeds at the present moment, this table has been extracted from the local returns of the registrars : In addition to these returns we have a return of deaths registered from the 1st of July to the 13th of September, distinguishing the Wards. The death-rate in the eight wards of the township shows a large increase during the period named, when compared with the same time of 1864. In the north and north-east wards there were 389 deaths against 324 last year; in the Mill-hill, west and north-west wards, 294 against 237; and in the east, Kirkgate, and south wards, 210 against 158. The following is the statement which the Registrar General makes on the subject in his Weekly Return of births and deaths in the Borough of Leeds, 36th Week, 1865: "In Bristol again prevailed last week the lowest rate of mortality in any of the eight towns, 200 In the other towns the rates ranged in order from the lowest were as follows: London, 20:4; Birmingham, 214; Hull, 25-6; Liver APPENDIX. pool, 227; Manchester, 310; Leeds, 316; and the highest rate during the week 34.8 in Salford. No. 6. "In the borough of Leeds 136 deaths were registered last week. The births were 74, and the deaths 22, above the corrected average weekly numbers, the deaths exceeding those returned in the previous week by 25. This large increase occurred in the North Leeds and Hunslet sub-districts, and would appear to arise in a great measure from the continued fatality of diarrhoea, whereas this disease in an epidemic form is fast disappearing from nearly all the other large towns. The annual rate of mortality to 1,000 persons estimated to be living in the borough, which in the two previous weeks had been 30-2 and 25.8, rose again last week to 31·6. "In South-east Leeds 17 deaths, the corrected weekly average, were recorded. Of these six resulted from phthisis, three from typhoid fever, and one from diarrhoea; four of the deaths were of infants under two years of age, and three of persons aged sixty years and upwards. The 40 deaths in North Leeds were 15 above the average number; they included two which were recorded in the workhouse, and six in the House of Recovery; 11 deaths were referred to diarrhoea, seven to typhoid fever, and one to measles; 13 of the deaths were of infants under one year of age, including doubtless a considerable number of the diarrhoea cases. In West Leeds, of the 26 deaths (two in excess of the average), two were registered in the General Infirmary during the week. "The 19 deaths in Hunslet township exceeded the corrected average by five; 13 of these were of children under five years of age, and two of persons aged more than 70 years; five of the deaths were from diarrhoea, and one each from croup, measles, and diphtheria. The deaths in each of the sub-districts of Holbeck, Bramley, and Wortley were within one of the corrected averages; in Kirkstall only two deaths were recorded, the average being five. In the municipal portions of Chapeltown and Whitkirk the number of deaths recorded were respectively three and one. * The particulars as to the sub-districts of Leeds are not of official authority, but are no doubt authentic. and also for the 38th Week, 1865: "London experienced the lowest rate (197) of any of the towns, and Bristol is the next lowest in the scale. The other towns range in the following order :-Salford, 22·1; Birmingham, 22·7; Hull, 24']; Leeds, 330; Liverpool, 334; and Manchester, 33.9. "In the borough of Leeds, 142 deaths were registered last week. The births were 67 and the deaths 28 above the corrected average weekly numbers, the deaths being, moreover, five in excess of those recorded in the previous week. The annual rate of mortality was 330 per 1,000 persons living in the borough which is even higher than the high rate of last week, and is 7 per 1,000 above the average rate in 10 years. "The registrars make no mention of any special disease as accounting for the large number of deaths registered, but one of them attributes the unhealthiness of the town in great measure to the cellar kitchens and cellar dwellings in which the majority of the wives and children of the working classes live. "In south-east Leeds the deaths were 23, or two more than in the previous week, and six more than the corrected weekly average. "In north Leeds 11 deaths in excess of the average were recorded, two of which occurred in the workhouse and four in the House of Recovery. The 26 deaths in West Leeds are two above the average, and include one death in the General Infirmary. "In Hunslet 22 deaths were registered, the average number being 14. Two deaths from fever and two from diarrhoea occurred in Holbeck, where the 11 deaths were three above the weekly average. In Wortley, 11 deaths were recorded, or four less than the average, and fewer by 13 than the deaths in the previous week; three of the deaths were caused by diarrhoea. In Bramley the seven deaths were three in excess of the average; in Kirkstall the weekly average number is five; the actual deaths in the week were only three. Thus in the 36th week of this year the Registrar-General, calculating the population of Leeds to be 224,500 persons, stated the death-rate of the week to be 31.6, or 5.3 over that of the decennium 1851-61. In the 38th week he states the death-rate to be 33, or 6.7 above that APPENDIX. No. 6. Sanitary State of Leeds, by Dr. Hunter. standard. No corresponding exacerbation of mortality prevailed else. where. The rate in various towns was in some above and in some below the average, as in Liverpool where the usual rate of 30 had risen to 33.4, and in Bristol where the usual rate of 23.2 had sunk to 20. In this last week, which ended 23d September 1865, two deaths from diarrhoea and two from fever occurred in Holbeck, three from diarrhoea in Wortley. In the present year, Dr. James Braithwaite has published an Inquiry into the causes of the high death-rate in Leeds," in which he attributes much of the excess to the want of light and air in the poorer dwellings, and to the emanations from putrifying animal matter. The locality of fever in Leeds is shown at pages 26 and 27 of his pamphlet; but after a superficial survey of the whole town your inspector fails to find any poor parts much better or much worse cleaned than the rest. Perhaps the filthiest place of all was Ebenezer Street, and this is reported by Dr. Braithwaite to be a focus of fever. Dr. Braithwaite's pamphlet is so full of matter as not to bear abstraction, and is sent in to the Department. Inquiry was made in order to bring the facts on the alleged prevalence of disease up to the latest dates. At the Women and Children's Hospital, the total number of patients admitted in August and September 1863 had been 175, in 1864, 198; in 1865, 212; and of these cases the diarrhoeas had been only 9, 5, and 6 in the respective years. The number of deaths from diarrhoea registered in the borough, in the week ending 16th September, had been 30. At the Leeds Public Dispensary, the number of deaths since 5th August had been 92, of which 32 were caused by diarrhoea, fever, and gastritis. A copy of an important report from the medical officers of the union is here attached. For the Leeds Board of Guardians have recently paid special attention to the saritary condition of the township, and have two inspectors regularly employed in hunting out nuisances, and, as far as possible removing them. Owing to the high rate of mortality, the board recently requested the medical officers to report as to the state of their respective districts. These reports were presented at the usual meeting, and were read by Mr. Lampen. They are as follow: Mr. Cottam says, "I have visited almost every part of the No. 1. district, comprising the Kirkgate and East Wards, and I must confess that the sanitary condition of it is infinitely more satisfactory than it has been for years. I notice that such places as St. Saviour's Row, Zion's Square, Poke Alley, &c., are now in a much cleaner condition than what they have hitherto been; unquestionably from your valuable exertions in suppressing any existing nuisance. There are certain portions of my district to which I think it is my duty to draw your attention, viz., Walker's Yard, East Street, the cellar dwellings in Brighton Court, Foundry Street, the accumulation of stagnant water in the channels in Crispin Street. I think also, that Timble Beck, in East Street, ought to be entirely covered, to protect the inhabitants from the abominable exhalations which occur in hot weather. I am also of opinion that a considerable amount of disease, especially of an infectious character, arises from insufficient sleeping accommodation afforded to the working classes generally. The inspectors would do well to look after the disagreeable exposure of the collection of feculent matter and urine in the cesspools in connexion with the garden houses in Accommodation Road." Mr. Beardshaw says,— "The district which comes more immediately under my supervision comprises the north and north-west wards. "In reference to its sanitary condition, the neighbourhood of Union Street, Ebenezer Street, Back George Street, and the yards and streets adjoining Kirkgate, as well as some of the streets in the Leylands, are still in a very filthy |