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subdivision, according as the disease affects the different classes of organs of the body.

4. Diseases which have a general, and not a definite certain seat or effect, should form a distinct class.

5. Deaths from old age, and from external causes, should each form a distinct class.

6. The still born should be classed separately, and never included in the aggregate number of deaths, having never had a separate living existence.

The following classification of the diseases named in the alphabetical nomenclature, is given as an illustration of the above rules:

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7. Fever,Intermittent, 44. Organs, dis. of,

8. Fever, Remittent, 9. Fever, Typhus, 10. Hooping Cough, 11. Influenza, 12. Measles, 13. Scarlatina, 14. Small-Pox, 15. Syphilis, 16. Thrush.

SPORADIC DISEASES. II. Uncertain Seat. 17. Abscess, 18. Atrophy,

19. Cancer,

20. Debility,

21. Dropsy, 22. Gout,

23. Hæmorrhage,

24. Infantile Disease,

25. Inflammation,

26. Malformation,

27. Mortification,

28. Scrofula,

29. Sudden,

30. Tumor.

III. Nervous Organs.

31. Apoplexy,

32. Cephalitis,

33. Chorea,

34. Convulsions, 35. Delirium Tremens, 36. Epilepsy, 37. Hydrocephalus, 38. Insanity,

V. Respiratory
Organs.

45. Asthma,
46. Bronchitis,
47. Consumption,
48. Hydrothorax,
49. Laryngitis,
50. Pleurisy,
51. Pneumonia,
52. Organs, dis. of,
VI. Digestive Organs.
53. Ascites,

54. Bowels, dis. of, 55. Colic,

56. Dyspepsia,

57. Enteritis,

58. Gastritis,

59. Hernia,

60. Intussusception,
61. Peritonitis,
62. Quinsy,

63. Stomach, dis. of,

64. Teething,

65. Ulceration,

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75. Kidney, dis. of, 76. Nephritis,

77. Organs, dis. of, VIII. Generative Or

gans. 78. Childbirth,

79. Paramenia, 80. Puerperal Fever, 81. Organs, dis. of. IX. Locomotive Org. 82. Rheumatism, 83. Joints, &c., dis. of, 84. Hip, dis. of, 85. Spine, dis. of, X. Integumentive Org. 86. Fistula,

87. Purpura,
88. Ulcer,

89. Skin, dis. of,
XI. Age.

90. Old age,

XII. External Causes.

91. Accident,

92. Burns and Scalds,

93. Drowning,

94. Execution,

95. Freezing, 96. Glanders, 97. Heat, 98. Hydrophobia, 99. Intemperance, 100. Lightning, 101. Malpractice, 102. Murder,

103. Necusia,

104. Poison,
105. Starvation,
106. Suffocation,
107. Suicide,
108. Wounds,
109. Unknown,

110. Still born.

XVI.

COMMUNICATION RELATING TO THE CELLAR-DWELLINGS AND LODGING-HOUSES OF LIVERPOOL, RECEIVED BY THE COMMISSION FROM W. H. DUNCAN, M. D., MEDICAL OFFICER OF HEALTH. (p. 165.)

Public Offices, 2 Cornwallis Street, Medical Officer of Health's Department, Liverpool, 10th December, 1849. The description of the inhabited cellars of Liverpool will be found in the appendix to the First Report of the Health of Towns Commission, page 14, folio edition.

The greater liability of the cellar population to disease had been long notorious, and in particular it was found that they suffered from fever in a proportion 35 per cent. greater than the rest of the working population. So long ago as 1802, the late Dr. Currie (Burns' biographer) called the attention of the common council of Liverpool to the unhealthiness of the cellar-dwellings; but nothing was done in the matter until forty years afterwards, when (in 1842) the council obtained power (5 and 6 Vict. c. 44) to prevent the separate occupation of any cellar less than 7 feet in height, or the floor of which was more than 5 feet below the level of the street, or which had not an area in front of at least 2 feet wide, from 6 inches below the level of the floor to the surface of the street.

The occupation of cellars in courts was declared illegal.

Under this act about 3,000 cellars were cleared of their inmates up to the end of 1846; but it being found that the provisions of the act were not sufficiently comprehensive to embrace many cellars unfit for habitation, the council, in their local sanitary act, (9 and 10 Vict., c. 127,) which came into operation on the 1st January, 1847, took pow ers to prevent the separate occupation of any cellar, the floor of which was more than four feet below the level of the street, or which had not an area in the front of not less than two and a half feet in width. Cellars built or altered under the former act, were, however, exempted from the operation of this clause.

At the time of the passing of this act, there were in the borough 14,084 cellars, of which 7,668 were inhabited, and the remainder either had been let or were intended to be let for separate occupation. The inhabited cellars contained nearly 30,000 inmates.

Of the entire number of cellars, 12,877 were found to be, under the provisions of the act, unfit for habitation; but of these about 1,300 have been claimed as having been built or altered under the former act, and may therefore be legally occupied, so that the total number of cellars in Liverpool, which may be legally used as separate habitations at the present time, is about 2,500. After the passing of the act of 1847, the clearing of the illegal cellars was rapidly proceeded with for some months, when, it appearing that it had the effect, in many instances, of over-crowding the court houses, the health committee, at my recommendation, (in order to give time for the supply of new habitations to overtake the demand,) resolved that not more than 100 cellars per month should be cleared of their inmates. Up to the present time, upwards of 4,700 cellars have been thus cleared, exclusive of 355 cellars in courts, which had continued to be inhabited, notwithstanding the prohibition of the act of 1842. The number of inmates ejected amounts, in round numbers, to 20,000. The illegal cellars

still inhabited, and which remain to be cleared, are 2,256, containing about 8,500 inmates.

Of the 7,668 inhabited cellars, 5,869 were found, on inspection, to be damp, wet or filthy. A good deal of difficulty has been experienced in carrying out the act, from the reluctance of the inmates to leave their miserable abodes, and the expedients to which they have recourse in order to evade the law. Their reluctance seems to be founded chiefly on the convenience offered by the separate entrance to the cellars, and the facilities for selling cakes, fruit, vegetables, chips, &c. ; and so strong is this feeling, that were it not for the constant vigilance of the police, and of the inspectors employed for the purpose, the cellars would be reoccupied nearly as fast as cleared.

In 1,381 cases, where the parties refused to obey the notice to leave their cellar habitations, it has been found necessary to summon them before the magistrates; and in 743 cases, cellars which had been reoccupied after having been cleared, have been cleared a second time. To bring a cellar within the provisions of the act, the magistrates require proof of its being occupied during the night; and, in order to withhold this proof, the parties are in the habit of concealing, in the day-time, the beds, or the sacks, straw or shavings, which they use as bedding. There can be no doubt that many cellars are, at the present moment, inhabited in Liverpool, which in this way evade the operation of the act. Many illegal cellars, also, are occupied during the daytime only, the occupants finding accommodation during the night in the house above or in some adjoining dwelling. Although this is a compliance with the clause, as interpreted by the magistrates, it is clearly an evasion of the spirit of the act.

With regard to the effect of this measure on the health of the 20,000 ejected cellar inhabitants, as it is obviously impossible to trace their further history in their new abodes, no direct answer can be given to the question. An approximate answer may be derived, however, from a comparison of the ravages in a particular district of the epidemic fever of 1847, which visited us before the clearing of the cellars was commenced, with those of the cholera epidemic of 1849, which did not come upon us until nearly 5,000 cellars had been cleared of their inmates. The district in question is selected, because it is the one with regard to which I am in possession of the most accurate statistics respecting both epidemics, and the one which formerly contained the largest proportion of inhabited cellars of the worst description.

In 1847, the cellar population formed about 12 per cent. of the entire population of the district, and at the present time it amounts to less than 2 per cent. In connection with this fact, I submit it as significant of the sanitary value of the measure in discussion, that while the epidemic, which raged previously to the clearance of the cellars, carried off upwards of 500 of the inhabitants of the district, that which prevailed after the cellar population had been reduced to one sixth of its former amount, caused only 94 deaths in the same district; the total number of victims throughout the borough, from each epidemic, being very nearly alike.

I do not wish it to be inferred that the whole of this marked difference is to be ascribed to the reduction of the cellar population, for

there is no doubt that much had been done in the interim, in other ways, to improve the sanitary condition of this, in common with the other districts of the town; but in this district the cellars were of the worst description, and the ejection of their inmates had been effected to a greater extent than in any other.

I am aware that, from the different nature of the two epidemics which have been compared, this may not be considered very satisfactory proof of the sanitary value of the cellar clearances; but the nature of the case admits of no better proof, and it is to be remembered that the two epidemics, although differing in name, have generally attacked the same districts. In conclusion, I may state, that, although instances must, no doubt, have occurred where parties ejected from cellars have taken up their abode in dwellings even more injurious to health than those which they were compelled to quit, (an evil, perhaps, inseparable from a measure of this nature,) yet no one, who has personally inspected the worst description of the Liverpool cellars, can hesitate to admit the policy of investing the authorities with power to prevent their being used as the habitations of human beings.

14th December, 1849.

The power to compel the registration of lodging-houses in Liverpool, to enforce cleanliness and ventilation therein, and to fix the number of lodgers to be received, was conferred on the Town Council, by their local sanitary act, (9 and 10 Vict, c. 127, sec. 125.)

The clause has been interpreted by the magistrates to apply exclusively to houses receiving nightly lodgers.

The by-laws made under the powers of this act, and of which a copy is transmitted herewith, came into operation in August, 1848.'

1 The following "Ticket," issued to the keepers of registered houses, is extracted from these "By-Laws respecting Lodging-Houses:"

No. [Insert number on register.] Lodging-house, [Insert the number and situation of the house in respect of which the ticket is granted.] kept by [Insert keeper's name ] registered to accommodate

1.-No greater number than this house at any one time.

lodgers.

RULES AND INSTRUCTIONS.

lodgers are to be received or accommodated in

2.-The Windows of every sleeping-room in this house are to be opened, and kept open to their full width, from nine to ten o'clock every morning, and from two to three o'clock every afternoon, (weather permitting) unless in case of sickness in any room requiring the windows to be closed.

3.-The floors of every room in this house shall be well swept every morning before the hour of ten, and shall be well washed during the morning of every Friday.

4-This house shall be thoroughly cleansed, and the walls and ceiling of every room in this house shall be well and sufficiently lime-washed, and the blankets, rugs, and bed clothes, and covers used in this house, shall be thoroughly cleansed and scoured in the first week of each of the months of April, August, and December.

5.-Upon any person in this house, whether a lodger or one of the family, being affected with fever or any infections or contagious disorder, the Keeper shall forthwith give notice thereof to the Medical Officer of Health, at his office, and the Medical Officer will visit the house and take such proceedings as he shall think proper in compliance with this act.

6.-If any person in this house shall be affected with fever or any infectious or contagious disorder, the blankets and bed-clothes used by such person shall be thoroughly cleansed and scoured, and the bedding fumigated immediately after the removal of such person; and where the bedding used consists of shavings or straw, the same shall be purned immediately

after such removal.

7.-The keeper of this house shall provide sufficient accommodation for washing, together with a sufficient supply of water for the use of the lodgers herein.

8.-The keeper of this house shall reduce the number of lodgers, or shall cease to receive and accommodate lodgers altogether, immediately upon receiving notice to that effect from the Medical Officer, or the Inspector of Nuisances.

9.—This ticket shall be placed and kept in such situation in this house as the Inspector of

Up to the present time, the following are the numbers of applica tions to register, and of lodgers applied for, together with the number of houses actually registered and of lodgers allowed, after inspection of the houses :

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Nearly one hundred houses for the registration of which application has been made, remain for inspection, the registration having been suspended during the late cholera epidemic, from the time of the medical health officer having been absorbed by other duties. About two hundred others have not been registered, as not being lodginghouses of the kind contemplated by the act.

The first effect of the operation of the by-laws was to reduce, materially, as will be observed, the overcrowding of the common lodginghouses, a most prolific source of evil. But the difference between the number of lodgers allowed and that applied for, by no means represents the whole amount of the benefit derived, as it is well known that the keepers of the worst description of lodging-houses, on finding that the powers of the act were about to be enforced, reduced the number of their beds before applying for the registration of their houses, and did not venture to ask for more than a portion, in some cases not exceeding one half of the number of lodgers they had been accustomed to receive. It should be stated, also, as a consequence of the limited number of lodgers allowed to the lowest class of houses, that many of these have ceased to be occupied as lodging-houses, the keepers not finding the occupation a remunerative one, under the restrictions imposed in virtue of the act.

A second effect of the regulations has been to produce a manifest and most decided improvement in the cleanliness of the registered houses, an improvement which has struck every one acquainted with their previous condition.

A third effect has been to improve the ventilation of the houses in numerous instances. This has been chiefly brought about by fixing the number of lodgers to be allowed, in the first instance, below that which the cubic contents of the sleeping rooms would justify, with the inducement held out that an additional number would be allowed on certain alterations being made to facilitate ventilation. Under this arrangement, additional lodgers have been allowed to 109 registered lodging-house keepers, the number of additional lodgers so allowed being 614.

On the by-laws coming into operation, the inspectors and sergeants

Nuisances shall from time to time direct, and shall be produced and delivered to such Inspéctor on demand.

N. B.-The keeper of any Lodging-house defacing or removing this ticket, or disobeying the above Rules and Instructions, will be liable to the several penalties in that behalf provided by By-Laws for regulating Lodging-houses, a copy whereof may be obtained by application at the office of the Town Clerk, in the Town Hall.

By order of the Health Committee,
(Signed)

This Ticket was issued on the

day of

A. D.

TOWN CLERK.

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