"As regards their powers--the Vestries already possess (except as to

police) the great urban powers possessed by other municipalities.

Certain powers agreed upon between the Vestries and the London County

Council at certain recent conferences will be added, and there would

be transferred to them the powers relating to baths and wash-houses,

libraries, and burial boards."

"On an appointed day every elective Vestry and District Board in the

County of London is to cease to exist. He hoped the plan would come

into operation in November, 1900."

The Bill became an Act--"The London Government Act"--in 1899.

The new municipal boroughs numbered twenty-nine--"the City of London"

and twenty-eight others; sixteen of them consisting of single parishes,

and the remaining twelve of several amalgamated parishes.

A few extra duties were cast upon them. Among them the duty of

enforcing within their borough the bye-laws and regulations with

respect to dairies and milk, slaughter-houses, and offensive

businesses; and in some respects their powers were enlarged, the

principal addition being the power to adopt and use the provisions of

Part III. of the Housing of the Working Classes Act, 1890, within their

borough.

All preparations for the change were completed by the autumn of 1899;

the new Municipal Councils were elected on the 4th of November, the

forty-three Vestries and District Boards ceased to exist, and London

entered upon a new stage of her career.

Here, at the close of 1900, the Vestries and the District Boards of

London came to their decreed end, and disappeared from the scene of

London civic life. That end was not regretted by the general public,

whose opinion may be gauged from the fact that the name "Vestry" had

become almost synonymous with incapacity, mismanagement, neglect,

sometimes even of graver transgressions, though in later years the

Vestries did something towards removing from themselves that reproach.

They certainly had done much useful work, and even at the outset of

their existence were a great improvement upon their predecessors. They

had found their parishes and districts forty-five years previously in

the state described in the first and second chapters of this work--a

chaos of filth, a slough of insanitation and deadly disease, and the

great mass of the people living in misery indescribable--and the task

before them was one which might have daunted the stoutest heart.

In many ways they did their work well; local sewerage and house

drainage were effectually carried out; the refuse of the great city

was regularly removed; the paving, and lighting, and cleansing of the

streets were greatly improved.

But in many parts of London, and by many Vestries and District Boards,

the larger, graver problems with which they were confronted were

scarcely dealt with at all. Powers entrusted to them by Parliament were

not used, vitally important duties imposed upon them by Parliament were

ignored or neglected. Had this been pure incapacity it would have been

deplorable, but upon many of the Vestries were men who either were

themselves interested in continuing existing evils and abuses, or whose

friends were, and so laws which should have removed or mitigated the

evils were not administered.

And the result was the non-prevention of diseases which led to deaths,

and the continuance of miseries (consequent on disease) which might

have been warded off, and the sowing of the seeds of evils of which we

are still reaping the crop.

As years went by the pressure of public opinion upon them became more

insistent, and their administration improved, but even to the end many

of them grievously failed to fulfil the responsibilities of their

position.

One class of workers under them must, however, be excluded from such

blame, namely, the Medical Officers of Health.

It is not too much to say that the greater part of the sanitary

progress which was made all through the period of Vestry rule was

directly due to the unceasing labour, the courageous efforts, the

insistence of many of these officers. Their recommendations were often

ignored, their requests constantly denied, their opinions made light

of; but in spite of such discouragement they persevered. And not alone

did they bravely stand between disease and the people, but they were

ever striving to drive it back, and to destroy its prolific sources and

its power; ever urging upon their employers the necessity for action

to relieve the people from the worst of the evils they were suffering

under.

The description given in 1856 by one of them that their work was "a

war of the community against individuals for the public good" had been

proved to be absolutely true.

And in that war, of them generally, it is to be said that there were no

sturdier fighters on the side of the community than they proved to be.

In 1885 Dr. J. Liddle, "a pioneer of reform," died after thirty years

of "unflinching adherence to duty" as Medical Officer of Health for

Whitechapel.

In 1889 Dr. N. Vinen died after thirty-four years' service as Medical

Officer of Health for St. Olave, Southwark.[185]

In 1895 Dr. J. S. Bristowe passed away after forty years of service as

Medical Officer of Health for Camberwell.

And there are still in the service men whose labours have extended

over prolonged periods. Such men as these, and others of them who gave

their best to the service of the community, have indeed a claim to the

lasting gratitude of the citizens of London.

FOOTNOTES:

[174] See General Report of Census Commissioners, P.P. 1904, vol.

cviii.

[175] See speech of the President of the Local Government Board, Mr.

Ritchie, in introducing the Bill in April. Hansard, 1891, vol. ccclii.

[176] Statement by the Clerk of the London County Council.

[177] See his Report for 1899, p. 63.

[178] P.P. 1890, vol. xvii. See fifth Report from the Select Committee

of the House of Lords on the Sweating System.

[179] See the Order made by the Home Secretary in November, 1892, as to

"outworkers."

[180] Not much interest appears to have been taken in the proceedings

of some of the Vestries. Thus, in 1891, the Vestry of Westminster

complained of the lack of public interest in the record of their

proceedings. "Only eleven ratepayers out of 8,800 have purchased copies

(price 2d.) of the Reports of the Vestry in each of the last three

years." (A few years later they reduced their Reports to a few pages.)

And in 1896 the Vestry of Kensington complained of the limited demand

for their Annual Report, though it only cost 2d.

[181] See 3rd Report from Select Committee of the House of Lords on

Metropolitan Hospitals, 1891.

[182] See the Report of Select Committee of House of Lords on

Hospitals, P.P. 1892, vol. xiii.

[183] See Report of Royal Commissioners on the Amalgamation of the City

and County of London, 1894.

[184] See Hansard, 1899, vol. lxvii. p. 354.

[185] In his last report he recorded the death of J. Munro, who had

been Inspector of Nuisances for thirty-three years, so for that long

period they had worked together.

CHAPTER VII

1901-1906

ONCE more the census placed on record the actual population of the

great metropolis, no longer divided, so far as local government

was concerned, into parishes and districts, but now into a smaller

number of municipal boroughs. The figures of this census are the last

available for reliable deductions as to numerous important matters

forming part of that comprehensive subject, the sanitary evolution of

London.

The enumerated population of London had reached the great number of

4,536,541, and showed an increase of 308,224 during the ten years 1891

to 1901. The rate of increase, however, continued to show a decline,

having fallen from 10·4 to 7·3 per cent. during the intercensal period.

The same movement of the population noted in previous censuses was

recorded in this one.

In the City of London and six of the central metropolitan boroughs the

enumerated population showed an actual decline of over 67,000 in the

ten years, notwithstanding that the recorded excess of births over

deaths in that period amounted approximately to 70,000.

In all the other boroughs there had been increases. In the Eastern

group the increases had been very small, with the exception of Stepney,

where, owing to the immigration of aliens, the population had increased

13,484. In the Northern group the greatest increase had been in Hackney

(19,666). In the Western group Fulham showed the highest increase,

namely, 45,500; whilst on the south side of the river, Wandsworth had

increased 76,500, and several others showed large increases.

Outside the boundaries of the county the "outer ring" had attained to a

population of 2,044,553 persons--an increase of 639,000.

If the metropolis and this "outer ring" were regarded as one city--and

in many matters it is hard to consider them apart--the total population

in 1901 was 6,581,372.

The information as to the birthplaces of the people showed that of the

4,536,541 persons, 3,016,580 were natives of London. The proportion

of natives of London had increased; the proportion from the rest of

the United Kingdom had decreased; whilst there had been an increase of

40,000 foreigners, the number having considerably more than doubled

since 1881. Of every 1,000 inhabitants, 668 were born in London, and

332 elsewhere, as against 653 and 347 respectively in 1891.

Once again the arrivals and departures by the gates of life and death

were recorded. In the ten years from the 1st of April, 1891, to the

31st of March, 1901, 1,329,428 births had been registered, and 838,454

deaths. The excess of births over deaths, therefore, was 490,974; and

as the increase of population was 309,228, it followed that 181,746

persons had migrated. As the migration had only been 114,000 in 1891,

it was manifest that migration to outside the County of London was

increasing.

The total number of inhabited houses was 571,768, as against 547,146

in 1891; but owing to a variation in the manner of collecting the

information, the figures have little value for comparative purposes.

The accurate figures given of the population of London enabled the

death-rate to be calculated on facts instead of upon estimates.

The death-rate was 17·1 per 1,000 living in 1901, a decrease from 18·6

in the previous year, and from 21·0 in 1891.

But to be set against this was the portentous fact that the birth-rate

had declined from 31·8 per 1,000 in 1891 to 29·0 per 1,000 persons

living in 1901, the lowest recorded in London since civil registration

began.

The public health of London was now altogether on a better level than

it had been before, but in the course of the year 1901 some cases

of smallpox appeared in various parts of London, and in 1902 there

was the most severe outbreak of it--with the possible exception of

1884-5--since 1871, nearly 9,000 cases being admitted to the hospitals

of the Metropolitan Asylums Board between September, 1901, and July,

1902. Ninety-three patients were removed to hospital in one day, and

on one day (March 11th) 1,604 cases were under treatment. Over 1,300

persons died of it in the year.

The cost of disease to the community has often been referred to in

previous chapters. The Metropolitan Asylums Board stated that so far as

it was concerned, the cost for 1901-2 might be put at £500,000--equal

to about a threepenny rate--a sum which was wholly apart from loss of

wages to the individual, and various other expenses, and apart from the

charge upon the rates of those who were pauperised by the death of the

breadwinner of the family.

1903 was "a year of comparatively very slight prevalence of infectious

disorders."

In 1904 there was "a marked absence of undue activity amongst the

infectious diseases of the metropolis."

And 1905 was the healthiest year in the records of London since

registration, the death-rate being 15·1 per 1,000.

In the five years which have passed since the census of 1901,

Parliament has passed three Acts of the utmost consequence to the

sanitary condition of the people of London, marking, in their

respective spheres, definite stages in the sanitary evolution of the

metropolis.

The sanitary evils to which many of the people were subject might, as

has already been stated, be roughly divided into two classes--those of

their dwellings at night, and those of their workplaces in the day.

"The Factory and Workshop Act" of 1901 dealt with the latter. It

was the amendment and final codification of a mass of piecemeal

legislation which had been spread over a period of years.

In 1878, previous enactments on the subject had been consolidated

into one Act. That Act was amended in 1883, 1891, and 1895. All were

now finally embodied in this Act of 1901 with several additions

and amendments. Additional sanitary provisions were made as to the

ventilation of factories and workshops, and as to the drainage of

floors. Bakehouses came within the scope of the Act, and the law was

made much more stringent as to them. After January 1, 1904, it would

be unlawful to use any underground bakehouse unless certified by the

Borough Council to be suitable.

A register of workshops was to be kept, and the Medical Officer of

Health was, in his annual report, to report specifically on the

administration of the Act in workshops and workplaces--a direction

which ensured publicity as to the action of the local authorities.

The powers of the sanitary authorities were extended by the Act, and

certain duties necessary for efficient administration imposed upon them.

The Act also ensured the inspection of dwelling-houses where there were

outworkers.

The work imposed on the Sanitary Authorities was very considerable as a

very large number of premises came under their supervision, and every

workroom in each workshop had to be measured in order that its cubic

space might be ascertained; and when the subsequent routine inspection

of the premises, and of outworkers' premises, remedying of defects and

other duties, were taken into consideration, the magnitude of the work,

and the necessity of an adequate staff of officers, were evident.

The records show that at the end of 1904, 34,488 workshops in London

were under the supervision of the local authorities. The necessity of

inspection was demonstrated by the fact that 18,922 conditions required

remedying.

Improvement was testified to by the Medical Officers of Health,

overcrowding was diminished, and it was further stated that "employers

are found to co-operate willingly with the local authorities in the

remedy of faulty conditions."

Altogether, then, when a comparison is made between the conditions of

the factories and workshops, and workplaces in which the people worked

in the middle of the last century and now, the contrast is remarkable.

The worst of the evils have been swept away, and healthy conditions of

work have taken their place.

And the limitations put upon the labour of children and young persons

and women have all been to the good of those subjected to them. And the

public health of London, so far as this very large and very valuable

portion of the population is concerned, has been immensely the gainer.

The second of the three Acts since 1900, which had a vital bearing on

the sanitary condition of the people of London, was "The Metropolis

Water Act" of 1902.

That the water supply should be under the control and management of the

municipality had long been advocated, but though hundreds of County and

Municipal Authorities in Great Britain--many of them not the hundredth

part of the size of London--had a Municipal Water Supply, that great

boon was denied to London. The reform was vigorously pressed by the

central representative body of London--the London County Council--and

after several Royal Commissions of Inquiry, Parliament dealt with the

subject in 1902. But the manner of dealing with it was unfortunate and

retrograde.

A new public Board--the Metropolitan Water Board--was established

for the purpose of acquiring, by purchase, for the inhabitants of

London, and of certain areas outside London, the undertakings of the

eight Metropolitan Water Companies, and for managing and carrying on

the supply of water. The great bulk of the purchase money was to be

provided by the ratepayers of London, and the great bulk of the debt to

be a charge on the rateable property of London.

The Board was to consist of 66 members, 14 of whom were to be nominated

by the London County Council, 31 by the Metropolitan Borough Councils

and the City Corporation, and the remaining 21 by the authorities of

localities outside London hitherto supplied by the Companies.

The Board, therefore, was not a representative body directly elected

by the ratepayers or electors of London, but was constructed, on the

discredited precedent of the Metropolitan Board of Works, of delegated

instead of elected members; and though the people of London were

emancipated from the control of trading Water Companies, they got

in their place a body over which they can exercise no direct, and

therefore very little actual, control.

The new Board was constituted in the spring of 1903, and took over the

undertakings of the Water Companies on the 24th of June, 1904, at the

cost to the ratepayers of London of not much less than £40,000,000, a

sum immensely higher than that at which they could have been acquired

many years before.

And inasmuch as the Board can call upon the ratepayers of London to

make good any deficiency of income resulting from their management,

the unsatisfactory result is the establishment in London of a new

indirectly-elected public body vested with enormous financial powers

affecting the interests of the ratepayers of London, and yet but little

responsible to public control.

The third of the three important Acts, the Education London Act, was

passed in 1903, and carried in its bosom possibilities of the most

far-reaching benefits to the health and physical welfare of future

generations.

By this Act the London School Board was abolished, and its duties

transferred to the London County Council, which was constituted the

Education Authority for London.

Though, indirectly, the schools of the Board were having considerable

effect upon the physical well-being of the rising generation, it cannot

be said that the School Board had utilised its vast opportunities

for improving the general health. By instruction, by influence, it

might have done so much, might have moulded the physical future of

generations. But education was always much more in the minds of the

Board than health, though the two might well have been considered

together, and without health education is of little use.

The Board in their "Final Report" endeavoured to offer an explanation

of their inaction.

"It has always been a question how far the Board are authorised to

spend public money on the medical care of children. On the one hand

suggestions have been made for the inspection of their teeth, and the

treatment of cases of anæmic condition and arrested development. On the

other hand a legal opinion has been expressed that the Board are not

entitled to do anything, or to take any measures except such as spring

from the fact that the attendance of the children is compulsory. On

this account it has been thought right to take action only in those

cases in which on account of contagious disease, it is necessary to

exclude children from school."[186]

Even the sanitary condition of the schools does not appear to have been

well looked after.

In January, 1890, one of the Committees submitted a report to the

Board, on which the resolution was passed--

"That the Committee be authorised to thoroughly examine the whole

of the drainage of any school of the Board where they may think it

necessary," &c.

The drainage was subsequently examined. In 181 schools the drainage was

all right. In 292 of the schools re-drainage was required. For how long

that fertile source of disease had been scattering its evil germs among

the tens of thousands of children attending these insanitary schools,

no information is available.

In 1890, just twenty years after its formation, the Board appointed a

Medical Officer, and he gave only a portion of his time to the work.

"Before 1891 there was no attempt on the part of the Board to prevent

the spread of infectious diseases by precautionary measures being

adopted in the school."[187]

In 1895 the Medical Officer of Health for Paddington wrote:--

"School teachers should be required to inform the Sanitary Authority of

any special amount of illness which may occur among the scholars. Half

a school may be away through sickness if the disease be not a notified

one, but no information of such fact comes to the Sanitary Authority."

And in 1896 he wrote:--

"The past year had emphasised the need of definite instructions to

school teachers to keep the Medical Officers of Health informed of the

existence of infectious disease among their pupils. It is surmised

that there were upwards of 2,000 cases of measles in the parish in the

earlier part of the year."

And "measles is the most fatal disease of childhood."

In evening schools "efforts were made between 1899 and 1903 to teach

the simple laws of health.... Prior to 1898 gymnastics were taught in

only a few schools."[188]

In 1902 the Medical Officer resigned, and a new one was appointed

who should give his whole time to the work. His first report (1903)

is enlightening as to the methods of the School Board in matters

pertaining to the health of the children attending the schools.

He wrote:--

"The maintenance of sanitary conditions as regards heating, lighting,

ventilation, and cleanliness both of the buildings and persons of the

pupils, the detection of early cases of illness ... ill-health from

many causes, school habits, and school work in their influence on

health ... these ... come under the daily work of the teacher, and

there is no requirement that any knowledge of such matters should be

possessed by him. It is left to his own common-sense, and he muddles

through. The definite requirement of hygienic knowledge as part of the

equipment of every teacher is a necessity if a great part of the work

of this department is not to be useless in result."[189]

And in his Report of the following year he wrote:--

"The provision of medical oversight for school life is rapidly becoming

a necessity. Five-sixths of the population spend a seventh part of

their lives under the exceedingly artificial conditions of the schools,

and during the plastic period of life. Their chief function in the

earlier part of that period is to grow, and it is necessary that they

should not only do this, but do it under favourable circumstances for

development."[190]

Soon after the transfer of the administration of the Education Acts to

the London County Council, the medical work of the late School Board

was amalgamated with that of the London County Council. The change

is one which is likely to be of the greatest benefit to the children

in the schools, and through them, as times go on, to the population

of London as a whole. The great value of health will receive greater

recognition than it has done hitherto, whilst greater facilities for

instruction in health matters, and better physical training, cannot

fail to have the most beneficial effect. The vast field for this work

is evident when it is called to mind that nearly half a million of

children are in average attendance at the London County Council Schools.

Three other matters legislated upon by Parliament claim mention.

In 1902 the Midwives Act was passed. It provided for the constitution

of a Central Midwives Board with power to frame rules for the

registration of midwives and for regulating and supervising the

practice of midwives. After the 1st of April, 1905, no person might use

the title of midwife without being certified under the Act. The London

County Council was constituted the local supervising authority for

London, and under its supervision much good has already been done.

Also in 1902 the Cremation Act, which empowered burial authorities to

provide and maintain crematoria, and empowered the Secretary of State

to make regulations as to the conditions under which cremation might

take place.

And to complete the tale of sanitary legislation since 1900, a few

reforms were secured by sections in the annual General Powers Acts

which the London County Council obtained from Parliament. Among these

was one rather important one.

In 1894 the duty of supervising and regulating the common

lodging-houses in London, which hitherto had been performed by the

Commissioner of Police, was transferred to the London County Council.

In that year 654 such houses were on the register, and the authorised

number of lodgers was close upon 30,000 persons. In 1902 the Council

obtained powers for the annual licensing of such houses. These larger

powers enabled the Council to improve the sanitary condition of

many of these houses. The supervision of these houses has been most

satisfactorily carried out, and has been of immense value in securing

sanitary abodes for the miserable people who frequent them, and in

diminishing what would otherwise doubtless often be a source of

infection to the community.

The sanitary evolution of London having begun a little before the

middle of the nineteenth century, the figures of the censuses of 1851

and 1901 afford the means for measuring many of the great changes which

have taken place in the intervening period.

And a comparison of the state of those things which most affect the

public health at these two dates enables a reliable deduction to be

drawn as to whether there has been evolution to a higher level of

public health, or a retrogression; and, if the former, the progress

which that evolution has made.

In 1851 the population of London was 2,362,236. In 1901 it had reached

4,536,541. And when to this is added the fact that all through the

intervening years so enormous a mass of people has been cooped up in

an area of 117 square miles, and that at the present time there are

over 4,500,000 within that small area, the multiplicity of the matters

decisively influencing their health and physical well being, and the

vastness of the issues at stake, come into vivid light.

As has been often said, the very basis or foundation of the sanitation

of a city is an efficient system of drainage. Without it sanitation is

impossible.

What the main drainage of London was up to 1858 has been described

in the earlier chapters of this book. In effect, nothing less than

an entire system had then to be designed and constructed to provide

London with this first essential. This was done, and the result was

of immediate and enormous benefit to London, and ever since then the

maintenance and extension and improvement of this work has received the

solicitous attention of the Central Authority. Originally designed for

3,500,000 people, it had, as London grew, to be considerably enlarged

and extended, and as some of the districts outside the boundaries of

London were allowed by Parliament to drain into the London sewers,

still larger works had to be constructed. And now the system serves a

resident population of, in round figures, 5,500,000 people spread over

an area of about 140 square miles. It comprises close upon 90 miles of

great intercepting and outfall sewers, 176 miles of main sewers, and 26

miles of large relief sewers, constructed for the special purpose of

conveying storm-water away.

This, however, was but part of the provision which had to be made.

During the _régime_ of the Metropolitan Board of Works, more than 1,100

miles of new sewers were laid by Vestries and District Boards in their

respective districts, and since the creation of the London County

Council of 1888, further additions of 1,516 miles have been made,

making a total of over 2,600 miles.

All this work was essential to enable a proper system of house drainage

to be carried out, and as the drainage of houses into the local sewers

was compulsory, the general system of drainage was thus rounded off or

completed.

The change effected thereby in the conditions of life in London has

been remarkable. There are no longer open ditch-sewers polluting the

air with their pestilential abominations; no longer streets without

sewers, and houses without the possibility of drainage.

In the Report of the County Council for 1902-3, prepared by the Clerk

of the Council, there is given a calculation of what these works

annually accomplish.

"The flow of sewage during the year, namely 87,556 million gallons,

represents a canal 24 feet wide with a depth of 9 feet, running day and

night at the rate of 2 feet per second; or it may be considered as

equivalent to a lake of 44 square miles, or about one-third of the area

of the county of London, with a depth of 11-1/5 feet."

To the efficiency and thoroughness of the present system is primarily

due the greatly improved condition of the public health of London as

compared with 1855.

Water was another of the absolute necessities of existence and of

sanitation. An ample supply of good water is essential for health; and

the numerous outbreaks of typhoid fever which in recent years have

occurred in England with a heavy death-roll, testify to the dangers

incurred by bad water, and the necessity for the utmost care being

taken to secure its being pure and uncontaminated.

The supply of water in the eighteen-fifties had been very limited in

quantity, and, with the exception of that supplied by one company,

abominable in quality. And progress to a better state of things was

slow. Improvements were made most unwillingly and haltingly by the

Water Companies, and only under Parliament's reluctant compulsion,

whilst the inaction of most, and the obstruction of some, of the

Vestries and District Boards, and the hostility of "owners" of houses

to being put to expense for water fittings, still further impeded

reform, and perpetuated the evils inflicted upon the inhabitants of

London--suffering, disease, and death.

The "slaughter wells" and the sewer-ditches were, however, filled up

and those evil sources of supply ended. And a supply of water was

gradually extended to the streets which were without any, and an

increased supply to others which had but little; but it was not until

1899, the very end of the century, that the County of London was, for

the first time, receiving a constant supply in accordance with the

provisions of the Metropolis Water Act of 1871. And by slow degrees

the sources of defilement of the water were reduced, and a larger

proportion of the dirt ingredients filtered out, until at last some of

the worst evils connected with the supply were rectified. And in 1891

it was enacted by Parliament[191] that a dwelling-house without a

proper and sufficient supply should be a "nuisance" liable to be dealt

with summarily.

The main cause of all the grave disadvantages the people of London had

so unceasingly suffered under in this matter arose from the fact that

the interests of the Water Companies and the interests of the people of

London ran directly counter to each other. London, in fact, had from

the very outset been at the mercy of trading companies for its supply

of this necessity of life, and bitter cause, indeed, had London to rue

it.

It is too soon to know what improvements will result in the supply

of water to the people of London, but in the interests of the public

health it is most unsatisfactory that the public should even now be

debarred from that direct control which alone can secure them the

fullest benefits.

In another of the numerous branches of the great subject of the public

health of London--the widening of the streets and thoroughfares--the

improvements made in process of years was marked, and the better

provision of light and air and breathing space has been considerable.

The total gross cost of new streets and improvements carried out by

the Metropolitan Board of Works had amounted to over £12,000,000,[192]

whilst it had contributed another million and a half to the cost

of smaller street improvements carried out by the "City" and other

districts, which latter also expended considerable sums.

The London County Council continued the policy of the Metropolitan

Board of Works, and by the year 1904-5 it had carried out, or was in

process of carrying out, improvements at an estimated gross cost of

over £11,000,000,[193] the greatest and most costly of all being the

new thoroughfare--Kingsway and Aldwych--connecting Holborn with the

Strand, which swept away some of the most notorious and worst slums in

London.

In addition to these, many local improvements have been carried out by

the "City" and by the Vestries and District Boards, and later by the

Borough Councils. These were estimated to cost about £1,800,000. The

total work accomplished, therefore, has been very considerable, but the

cost has been huge; amounting in the whole to about £27,000,000.

Of greater value to the health of the people has been the increase of

the number of parks and open spaces in London, not merely in preventing

land being built over, but in the opportunities afforded the people,

and especially the younger portion of them, for exercise.

Here considerable acquisitions have been made since the time of the

Metropolitan Board of Works. Immediately after the creation of the

London County Council two generous gifts were made to the citizens of

London--Waterlow Park of 30 acres and Myatt's Fields--and the Council

had acquired Hackney Marsh, with 337 acres; Brockwell Park, with 127

acres; and Avery Hill, 84 acres; and some distance from London, 803

acres of Hainault Forest. In addition to these several small pieces of

ground were acquired and thrown open as public gardens and recreation

grounds.

The "City" had also acquired, outside the County of London, Epping

Forest, about 5,560 acres in extent, Burnham Beeches, 375 acres;

Coulsdon Common, 347 acres; and a few small open spaces in the "City"

itself.

And many acquisitions had been made by the Vestries and District

Boards, and, since their supersession, by the Borough Councils.

Purity of air was another of the important elements of a satisfactory

health condition.

Once that the Thames had ceased to be the main sewer of London, and

once that the hundreds of thousands of cesspools were filled in and

abolished, the most persistent and fruitful and worst of the causes

of the impurity and unwholesomeness of the atmosphere were removed.

Gradually too, but only too slowly--a slowness resulting in widespread

loss of health and life--were the noxious trades in London made

amenable to the law, and somewhat less noxious to those living in their

immediate neighbourhood; this, too, without that ruin to trade and

manufactures which was always predicted when any effort was made to

prevent the prevalence of intolerable nuisances.

The duty of administering the provisions of the law relating to the

abatement of smoke nuisances rested with the police. Under their action

a steady reduction had taken place in offences against the law. In

1882, 1,248 cases were reported, and there had been 162 convictions;

and in 1890 the numbers had sunk to 702 reported cases and 46

convictions.

In 1891, by the Public Health London Act, the duty was transferred to

the Sanitary Authorities. Considerable use has been made by them of

the Act. In many cases severe penalties were imposed, and the general

result has been a very satisfactory improvement. Much, however, of the

fouling of the atmosphere is caused by factories outside London, and

consequently outside the control of the local authorities of London.

And yet another of the great branches of the general subject of the

public health is the food supply of the people. It would be difficult

to give any approximate estimate even of the part which good or bad

food has in its effect upon the public health, or to produce any

statistics on the subject, but, undoubtedly, it is a very large part;

and every now and then the outbreak of some serious illness and heavy

loss of life, directly traceable to the consumption of bad food, shows

how important it is to safeguard the people from such disasters.

Thus in 1901 there was an outbreak of scarlet fever, in which some 300

persons were attacked, directly traced to an infective milk supply.

Previous to the date of the Nuisances Removal Act of 1855 there was,

so far as London was concerned, practically no control or supervision

over the food sold to and consumed by the people. That Act contained

a section providing for the inspection of food by the local sanitary

authority, so the importance of securing wholesome food for the people

was then recognised. Little, if any, use was made of the power thus

given, and the Act was amended and extended; but even then it was

almost a dead letter.

As years advanced great scientific discoveries demonstrated the fact

that some of the most dangerous diseases, such as typhoid and scarlet

fever, could be conveyed in food of various sorts, and opened up a

new vista of dangers as to the conveyance of disease.[194] And the

huge size of London, and the vast numbers of its population, increased

enormously the difficulty of safeguarding the public from the dangers

of contaminated food.

The first and greater portion of this work was done by the Corporation

of the City of London. Its Committee, the Port Sanitary Authority,

was able to prevent large quantities of bad meat which arrived by sea

being put upon the markets; and the Corporation, which administered

the principal markets of London--the cattle-markets at Deptford

and Islington, the fish-market at Billingsgate, and the others at

Smithfield and Leadenhall and Spitalfields--by a system of inspection,

prevented large quantities of bad or diseased food being sold to the

public.

In 1905, 415,000 tons of meat reached the Central Smithfield Market,

of which 2,128 tons were seized as being diseased and unsound. At

Billingsgate, 211,600 tons of fish were delivered, of which 674 tons

were condemned. And there were 28 wharves and warehouses in the City

where tinned food and tinned meat and vegetables were received. 173

tons were seized. All these places were daily inspected.

This, however, was only a portion of the food which reached London. The

responsibility for inspecting food in other parts of the metropolis

rested (under the Public Health (London) Act of 1891) with the various

Sanitary Authorities, and the reports of the Medical Officers of Health

contain accounts of inspections by them, and of the seizure of meat,

fish, poultry, rabbits, tinned food, vegetables, eggs, and sweetmeats,

and of prosecutions, and of a few convictions. And many other articles

of food were, under the Food and Drugs Act of 1875-99, also liable to

inspection so as to secure that they should not be adulterated; so that

theoretically, and in a very great measure actually, provision exists

for protecting the people of London from adulterated articles of food,

and from food unfit for human consumption.

All this is an immense advance upon the time when there were no laws

against the sale of unsound or adulterated food.

But there is great room for improvement, for the inspection and means

of prevention are far from adequate to secure the protection of the

public from this danger; indeed, the existing system of government for

dealing successfully with this most important element in the well-being

of the people is very defective.

The experiences of the past sixty years or so in London have abundantly

shown how great is the extent to which the public health is dependent

upon the system of local government in existence at the time, and upon

the administration of the laws relating to the public health by those

authorities.

The considerable changes which have taken place in the fifty years

since the creation of a Central Authority, the Metropolitan Board of

Works, have been described.

So far as regarded the local authorities over the separate areas into

which London was divided, the "City" remains practically as it was,

with the exception of the addition to its sphere of action of the

important duties of Port Sanitary Authority, and such further powers as

the exigencies of the times required, and certain changes consequent

upon the creation of the London County Council.

In the metropolis the other local sanitary authorities instead of being

Vestries and District Boards--43 in number--are now Municipal Borough

Councils--28 in number--with some larger powers, including wide powers

of rating.

The Poor Law Guardians, also with wide powers of rating, have remained

much as they were, their sphere of work being a definitely limited one.

Various Commissioners, such as the Commissioners of Baths and

Washhouses, Library Commissioners, and Burial Boards, have ceased to

be; their powers being now exercised by the Borough Councils.

The important changes in the local government of the metropolis have

mainly been in the Central Authorities, whose sphere of duties extends

over the whole area of London.

The principal Central Authority, the London County Council, which

superseded the Metropolitan Board of Works in 1889, instead of being

indirectly elected as was that body, is a directly elected body,

elected by and representative of the whole electorate of London. Its

duties and powers have undergone extension and increase; the latest

material addition to them being its appointment as the Education

Authority for London.

In 1867, owing to the default of the Vestries and District Boards to

make provision of rate-supported hospitals for paupers suffering from

infectious or contagious disease, a Central Authority--the Metropolitan

Asylums Board--constituted on the indirectly elected system, with

considerable powers to spend money which had to be provided out of the

rates of the metropolis, was created to do that work.

In 1870 another central body was created, the London School Board,

to deal with the elementary education of the children of London, and

though not a health authority, its work was closely associated with the

public health. It also possessed the widest powers for spending money,

which had to be provided out of the rates of the metropolis. It was a

directly elected body, but elected on a system peculiar to itself, and

one which in great measure removed it from any financial public control.

By an Act of Parliament in 1903 the London County Council was made the

Education Authority for London, and the work of the School Board was

transferred to it.

To the two existing central authorities was added, in 1903, another

wholly gratuitous central local authority, the Metropolitan Water

Board, an indirectly elected body with ultimate rating power over the

metropolis.

There is a third sphere of government in matters pertaining to the

public health--namely, that occupied by the State. It is charged

with many duties connected with the public health, and is in close

relationship with the various central and local authorities in London.

It has undergone large changes since the middle of the last century.

At that time some of the powers possessed by the State Government in

health matters were exercised by one of the Secretaries of State.

Others, for some years, through the General Board of Health appointed

by the Government. In 1858, when that Board ceased to exist, some of

its powers were transferred to the Privy Council, others lapsed to the

local sanitary authorities.

So great, as time went on, was the development of local government

throughout the country, and so essential was it to have some central

government State supervision over the largely increased number of local

sanitary authorities, that in 1871 a new Government Department, the

Local Government Board, was created to perform this work. To it were

transferred most of the powers in connection with sanitation and health

matters possessed by the State Government, and the various authorities

in London came more or less under its supervision. Since then, as the

sanitary needs of the community grew, and as legislation became more

voluminous, fresh duties have been constantly imposed upon that Board.

Summing up these changes, and their broad effects, it is to be said

that the machinery for the administration of the sanitary laws in

London is undoubtedly far more potent and effective than it has been at

any previous time. Instead of the Vestries and District Boards there

are now the Borough Councils; instead of the Metropolitan Board of

Works there is the London County Council; instead of the Privy Council

and Board of Health there is the Local Government Board, whilst the

Metropolitan Asylums Board and the Water Board had no predecessors.

But on the other hand the system now in existence is very complex, and

in many ways cumbersome, and in recent years there has been a most

unfortunate tendency on the part of Parliament to revert to that which

was the curse of London before the Act of 1855--the multiplicity of

local authorities--all of them, too, with separate rating powers.

So far, then, in the way of the machinery of local government has

London come on its way to an improved condition of the public health.

And Parliament, as has been narrated, had, since 1855, multiplied the

health laws, which these bodies were charged with the administration

of. Then, the passing of an Act dealing with matters affecting the

public health was so rare as to constitute a remarkable event. Now Acts

of Parliament and "Provisional Orders" as to health matters are quite

common events.

With such numerous laws covering so many phases of the public

health, with so much larger and more powerful a machinery for their

administration, the crucial point of all is the administration of those

laws by the various authorities. It is obvious that the administration

is much more searching and effective and wide-reaching than it has ever

been before.

The Central Authority, the London County Council, has done great work,

as has already been shown, in extending and maintaining the efficiency

of the drainage system of London, in the clearance of insanitary

areas, and the erection of houses for the working classes; in the

acquisition of open spaces, in great street improvements, in its

efforts to help towards a solution of the great housing problem by the

facilities of traffic it has created by its tramways, in the inquiries

it has instituted into the insanitary condition of various districts

in London, in the unifying of administration by the local sanitary

authorities, and in many other ways too numerous to be recited. It has,

in fact, vigorously used such powers as it possessed.

The Metropolitan Asylums Board has also used its powers effectively,

having erected hospitals, and having each year successfully isolated

and treated many thousands of cases of infectious and contagious

disease.

The Water Board is still too young to have a record.

The Poor Law Guardians had improved the workhouses and the

infirmaries, and the dispensaries were continuing to do their useful

work.

The Metropolitan Borough Councils were grappling with their numerous

duties. The perusal of the annual reports of these bodies shows their

multiplicity. House-to-house inspection--the inspection of factories

and workshops, and workplaces, and outworkers; of bakehouses, cowsheds,

dairies, and milkshops; of food and the places where food is prepared;

of offensive trades and slaughter-houses, and of houses let in

lodgings; the management of baths and wash-houses, the removal of dust

and filth, disinfection, proceedings under the Housing of the Working

Classes Acts; measures for the prevention of disease, for the abatement

of nuisances, and many other duties connected with sewerage, drainage,

and paving and cleansing of streets--all and every one of which closely

affect the health of the people.

The amount of work done varied considerably. In a well-administered

municipality the number of Sanitary Inspectors had been increased, the

number of inspections was high, and the work continuous and heavy.

In some, however, the work was less satisfactorily done, and the old

Vestry antipathy to the expenditure of money upon Inspectors appeared

to have been handed on.

Much, nevertheless, was being done, and on the whole matters appeared

to be progressing satisfactorily, and in many respects undoubtedly were

doing so.

But every now and then some revelation occurred of insanitary

conditions under which large numbers of the people were living which

showed a grievous omission somewhere, and for which some persons were

responsible.

Thus when, under the Education (London) Act of 1903, the County Council

had to take over the non-provided schools in London, the schools were

inspected, and it was found that their drains were generally in a very

bad condition. No fewer than 342, or 78 per cent. of the school drains

which were tested, were declared unsatisfactory. A most prolific source

of disease and death was thus laid bare, a source which for years must

have been working grave evil--and as in these schools there were about

135,000 children in attendance, the number of persons involved in

danger was enormous.

Again, some of the figures published by the Census Commissioners in

1902 disclosed a condition of things of the utmost gravity.

Similar figures in the census of 1891 had passed almost unnoticed;

these of 1901 reiterated the story, and as the evils they laid bare

were on a somewhat smaller scale they were hailed more as a mark of

progress and improvement, than as something portentous in themselves.

Yet they go down to the very roots of the sanitary condition of the

people of London, and show how great is the task to be accomplished

before the sanitary condition can be considered satisfactory or even

safe.

They bring into sudden view the fact that the problem of the housing of

the people is still unsolved.

The census of 1901 had recorded that there were 4,536,541 persons

in London. It also recorded that the total number of tenements was

1,019,546. It further showed that of these tenements no fewer than

672,030 were tenements of less than five rooms; and then going into

details of these 672,030 tenements it showed that--

149,524 were tenements of one room.

201,431 " " two rooms.

181,542 " " three "

139,533 " " four "

Comparing these figures with those for 1891 it appeared that--

"A marked improvement had taken place in the manner in which persons

occupying tenements of less than five rooms are housed in London. The

shifting of the population in the ten years from the tenements of one

or two rooms to the more ample accommodation provided in tenements of

three or four rooms is conspicuous."[195]

There had been a reduction in the number of one-room tenements, which

are justly regarded as the worst of all from 172,503 in 1891, to

149,524 in 1901, whilst there had been an increase in the number of

two, three, and four-room tenements.

As to the numbers of persons living in these 672,030 tenements--

304,874 persons lived in tenements of one room.

701,203 " " " two rooms.

752,221 " " " three "

691,491 " " " four "

---------

Total 2,449,789

Still, therefore, well over half the population of London lived in

tenements of less than five rooms; whilst over 1,000,000 lived in

tenements of one or two rooms--and between one- and two-room tenements

there is not much to differentiate.

By further details given (as in 1891) each Sanitary Authority was

"provided with the means of examining with much precision into the

house accommodation of its district."

The Medical Officer of Health for the Borough of Finsbury, utilising

the figures for that Borough, deduced some most instructive conclusions

as to the effect of the one-room and two-room tenements upon the

death-rates.

Forty-six per cent. of the population lived in such tenements; the

death-rate in one-room tenements was 38·9 per 1,000; the death-rate

in two-room tenements was 22·6 per 1,000. And the number of deaths

occurring in them was 63 per cent. of all the deaths in the Borough.

"The conditions of life obtaining in one-room tenements," he added,

"are such as tend towards poor physique, disease, and death. The

density of population is higher, the physical restrictions are greater,

and there is less fresh air and more uncleanliness."

The information thus given by the Census Commissioners as to tenements

was striking enough, but of deeper interest and import even than these

figures was the information as to "Overcrowding."

The Medical Officer of Health for the London County Council, utilising

the figures of the census, worked out the facts as regarded the

overcrowded tenement population of London.

There were 726,096 persons living in an overcrowded state in 124,773

tenements of less than five rooms. Of these--

147,771 lived in 40,762 one-room tenements.

296,659 " 50,304 two " "

187,619 " 23,979 three " "

94,047 " 9,728 four " "

------- -------

726,096 124,773

There had been a reduction of overcrowded tenements from 145,513 in

1891, containing 829,765 persons, to 124,773 in 1901, containing

726,096 persons.

There would appear then to be some hope that the acme or climax of

overcrowding has been passed. But even from the most sanguine point

of view the improvement is not great, and many decades would have to

elapse before "overcrowding" ceased to be a power for evil.

A few illustrations show the dreadful condition of things in this

respect in certain localities.

In the Borough of Finsbury, over 35,000 persons lived in overcrowded

tenements of less than five rooms; in Stepney, 99,000; in Islington,

56,000; in St. Pancras, 56,000; in Lambeth, a few short of 37,000; and

in Southwark, over 46,000.

And if some of the figures about overcrowding were looked into a little

more minutely it was to be seen that in St. Marylebone there were 1,020

two-room tenements inhabited by five persons each, 685 by six persons

each, 366 by seven persons each, and 170 by eight persons each.

In Islington there were 1,253 such tenements with six persons each, 624

with seven persons, and 258 with eight persons.

In St. Pancras there were 1,414 two-room tenements with six persons in

each, 743 with seven persons in each, and 323 with eight in each.

In Shoreditch there were 694 two-room tenements with six persons in

each, 380 with seven in each, and 155 with eight in each.

Stepney was the worst of all--with 1,126 two-room tenements with seven

persons in each, 577 with eight persons in each, and 278 with nine

persons in each; but this was the result of alien immigration.

In Lambeth there were 699 tenements of two rooms with six people in

each, and 322 similar tenements with seven each, and 118 with eight

each.

It must have come as a revelation to many of the Borough Councils to

find such a condition of things existing in their municipality.

These are the most recent reliable figures. Not much change can have

taken place since then, and they may be regarded as presenting fairly

well the existing condition of the housing of the people of London.

The main fact emerging from them is that a population of 726,096

persons in London are living in 124,733 overcrowded tenements of less

than five rooms.

The accumulated testimony of the most experienced and capable observers

during half a century is clear and precise that overcrowding is

disastrous to the physical welfare of the individual. The conditions

of life are not much better in one- and two-roomed tenements, and the

conclusion is thus forced upon us that, speaking broadly, a fifth of

the population of London are at present living in circumstances where

physical well-being is impossible, and where even a moderate standard

of public health is unattainable.

For some time back, fears as to the physical deterioration of certain

classes of the population have found public expression, and to such

a point did these misgivings come that, in 1903, a Committee was

appointed by the Lord President of the Council to inquire into the

subject throughout the kingdom.

The idea of physical deterioration being at work found expression

sometimes in the reports of the Medical Officers of Health even far

back. Thus, in 1869, the Medical Officer of Health for Paddington

wrote:--

"In Paddington overcrowding in its worst forms cannot be said to exist,

but there is an over-concentration of building which will some day be

considered a disgrace to our civilisation. It may safely be predicted

that besides a high infantile death-rate a concomitant deterioration of

race will result.... This high (infantile) death-rate is not the only

check to population. Another and more painful form of evil manifests

itself in the sickly and puny race around us. Young men and young women

are unable from low vitality to cope with their contemporaries in the

labour market, where prolonged muscular exertion is required. We find

in this class the seeds of debility and disease."

In 1871 he gave a table with particulars of five hundred heads of

families of the wage-earning class engaged in industrial occupations

living in tenement-houses in certain streets near the Great Western

Railway terminus. "Sixty-four per cent. were born in country places.

This," he added, "confirms my statement in former reports that large

numbers of men born in cities have poor constitutions and deficient

vital stamina, who cannot cope with their competitors from the country,

nor command the best labour markets of the world. In the struggles of

town-life large numbers are prematurely crushed out at early periods of

their existence."

And he added: "This deterioration of race has for some time been

recognised by Medical Officers of Health."

Unfortunately the conditions of life conducive to deterioration did not

cease to exist in 1871, as evidenced by the figures of the censuses of

1891 and 1901, of the population living in overcrowded tenements of

less than five rooms.

The Committee reported in 1904, but while both the Report and the

evidence are of great interest, it cannot be said that they advanced

the question much.

The Committee stated that--

"There are no sufficient 'data' at present obtainable for a comparative

estimate of the health and physique of the people."

That being undoubtedly so, the best light obtainable on the subject

must be sought for in a different way. Fortunately that way exists--and

it is possibly the soundest of all--the method of inference from

well-established facts.

The reports of the Medical Officers of Health for London during the

last half-century enable this method to be applied to London.

In cases innumerable it has been demonstrated beyond dispute that

the death-rate was highest in overcrowded houses or localities, that

the sick-rate was proportionately higher, that disease assumed more

virulent form in them, and left the victim in a more impaired condition.

"It is almost an axiom that the greater the crowding, the greater the

sickness and the higher the death-rate."

That these conditions affect the health and stamina of persons of

all ages, and more especially of the children who are to constitute

the new generation, is a truism, and thus the health and stamina of

a large proportion of the population is, of necessity, damaged and

deteriorated, and a heritage of suffering and debility passes to a

succeeding generation. Were these evils mere passing events like an

epidemic of cholera which sweeps away its thousands of victims and is

gone, the results would not be so disastrous.

But when to these clearly proved facts is added the awful fact that

these evils have been unceasingly in active operation for considerably

more than half a century, that the past is still exerting a powerful

and pernicious effect upon the present, and that the seeds of evil

then sown are still producing a deadly crop, it is a necessary and

unavoidable conclusion that there has been a considerable deterioration

of race.

Counteracting these deadly forces have been those which have been

described in this book:--

Efficient sewerage and drainage, water supply improved in quantity

and quality, sounder food, wider thoroughfares, cleaner streets, open

spaces, new dwellings, prevention of the defilement of the atmosphere,

prevention of the spread of infection--all these, together with better

knowledge of health matters, the vast advance in medical science, the

better provision for the treatment of the sick, greater temperance,

and the great work carried on by numerous philanthropic workers and

organisations, have effected vast improvement--an improvement testified

to in the fall in the death-rate of London from 23·38 per 1,000 in 1851

to 17·1 in 1901 since which year it has further decreased.

Painfully and laboriously, and in the face of persistent obstruction

and hostility, has the present sanitary position been attained. "Vested

rights in filth and dirt" have offered a prolonged and dogged fight

against reforms which curtailed their privileges. Hundreds of thousands

of lives have been needlessly cast away, an uncountable number blighted

and made useless by diseases which were preventable, and which were not

prevented, and an incalculable injury inflicted upon the community.

And the expense to the community has been enormous. Millions upon

millions of money have had to be spent to make good--so far as could

be made good--the ravages of past neglect and culpable management.

Millions upon drainage, upon hospitals, upon houses for the working

classes, upon open spaces--tens of millions upon water supply, and

most unjustifiable and regrettable of all, millions to compensate slum

owners for their iniquities.

And even yet we have not arrived at our goal. What, then, are still the

causes of failure? What the impediments? Where the shortcomings?

The failure is in part due to a great omission by Parliament--in part

to the non-administration of existing laws by local authorities--in

part to a great defect in the system of local government.

Parliament had, most unfortunately, omitted from all its enactments

affecting London any provision for the supervision of the great

movement in part economic, in part social, which has been going on

in London for well-nigh two-thirds of a century--namely, the change

of houses inhabited by one family into tenement-houses, or houses

inhabited by several families.

That movement with its appalling attendant evils was allowed to go on

practically unregulated, uncontrolled, and unsupervised.

The great evil of this movement was, that a house which had been

structurally and sanitarily designed for one family was sanitarily

unsuited for its altered career as the abode of several families.

Nothing was done to obviate this evil. And so these houses became

packed with people and families who had to live in one or two rooms in

them without the primary necessities of a healthy existence--without

ventilation--without an adequate supply of water--without facilities

for cooking food--with the scantiest and filthiest sanitary

accommodation--had to live under conditions which put a high premium

upon dirt and insanitation, and which absolutely invited disease and

death.

Even the Sanitary Act of 1866, and its amending Act of 1874, did not

deal with this crucial matter; and no legal obligation was created by

Parliament to ensure that the houses undergoing such a change should be

adapted to their altered circumstances.

The Sanitary Act of 1866 only in part dealt with the evils inherent

in such houses. It imposed on the Sanitary Authority the duty of

making regulations which prescribed a standard of the air space for

each person, and thus made an effort to prevent overcrowding; it

imposed upon the "owner" the duty of maintaining a certain standard

of cleanliness--the rooms were to be painted or lime-whitened every

year--it laid upon the tenants certain duties also as to maintaining

cleanliness.

But even this imperfect legislation was completely brought to naught by

the opposition of the Vestries and District Boards to such action as

would have secured at any rate some degree of decent accommodation in

the tenement-houses of London.

By the Public Health Act, 1891, the London County Council was empowered

to make bye-laws enforcing a certain standard of sanitary accommodation

in them, and did make them. But in other respects nothing was done;

and so the process still goes on, large numbers of houses hitherto

occupied by one family are passing into the occupation of several

families devoid of the primary necessaries of a healthy existence.

The great movement has by no means spent its force; for long to come

houses will be going through this transition, and until legislation

deals definitely with this matter the inevitable evils attendant on the

change will continue.

The second main cause of failure lies at the door of the local

authorities who would not and did not administer the existing laws.

The local governing authorities are now more active than they have ever

been before; the amount of work done in every branch of sanitation is

far greater than ever before; the number of Sanitary Inspectors has

been increased from 188 in 1893 to 313 in 1904. But the regulations

or bye-laws under the Act of 1891 which Parliament had imperatively

directed them to make and to use as regarded the tenement-houses in

London, are very far from being enforced to the extent they should be.

The total number of houses let in lodgings which were on the various

registers in 1905 was 22,257.

With only a few exceptions the Borough Councils, like their

predecessors the Vestries, make comparatively little use of this power,

though there is a concurrent mass of testimony as to the beneficial

results following its use. Stepney, under the inrush of aliens, found

the benefit of exercising the power, and heads the list with 2,672

houses on the register. Kensington has 2,107; Westminster 1,641; St.

Pancras 2,192; Hammersmith 2,266; and Finsbury 1,169. These amount

to 12,047, or 10 per cent. of all the inhabited houses in those six

boroughs. In the whole of the rest of London with 451,596 inhabited

houses, only 10,207 of the houses let in lodgings are registered: so

that only 2-1/4 per cent. of the houses in them, as against 10 per

cent. in the others, are registered.

It is manifest, therefore, how imperfectly the greater number of

even the present local authorities perform the duty which has been

imperatively imposed upon them by Parliament.

The Borough of Shoreditch, for instance, with 22,940 tenements of less

than five rooms, of which 6,269 were overcrowded with 35,500 persons

living in them, has only 283 of the houses let in lodgings on the

register. The Borough of Lambeth with 44,495 tenements of less than

five rooms, of which 6,548 were overcrowded with 36,900 people living

in them, had only 372 houses on the register. The Borough of Bermondsey

with over 25,000 persons living in overcrowded tenements had only 221

houses on the register.

This, as has been explained (see p. 377), is not a matter in which the

Central Authority, the London County Council, has any authority to

interfere. The Borough Councils are their own masters in this matter,

as were their predecessors the Vestries, and the responsibility as to

administering or not administering in their areas the Act of Parliament

rests entirely with them. The consequences of the non-administration of

these bye-laws to the health and physical well-being of great masses of

the people are disastrous.

Various legal decisions in recent years have somewhat impeded the

effective administration of the bye-laws in this matter, but the real

impediment is the dislike to them of the Borough Councils.

The condition of the vast tenement-house population in this great

city is of such immeasurable consequence to the community at large

that matters can only be allowed to continue in their present most

unsatisfactory state at the most dire cost. The sooner it is thoroughly

inquired into by Parliament and drastically dealt with the better;

great evils will be stayed, great benefits will be secured.

The third principal cause of failure to attain a higher level of the

public health in London than at present enjoyed has been the want

of a real central Health Authority. The Metropolitan Board of Works

was never such. The London County Council is only such in a very

limited way. A real central Health Authority for London is an absolute

necessity--that is the great moral to be drawn from the history of

the last half-century so far as local government in health matters in

London is concerned.

Disease recognises no boundaries, and in a great city like London it is

essential that in so vital a matter as the public health full authority

should, subject to Parliament, be vested in one supreme authority--a

central authority which shall secure uniformity of administration; a

central authority which shall be able to compel a local authority in

London to do that which if it neglects is a danger to the community;

a central authority which, in the event of such neglect, shall be

authorised itself to undertake that work; a central authority which

shall be able to act at once for London as a whole in presence of

any sudden or great emergency--that is absolutely essential for the

sanitary safety of this great city and of the millions who live in it.

The want of such an authority has throughout the whole sanitary

evolution of London been a disaster of the greatest magnitude, and is

an ever-present peril to this great metropolis. The existence now of a

central popularly elected representative body for the metropolis would

render this reform quite a simple matter.

Further measures are also required to aid in the removal of the worst

of London evils.

In 1903 a Royal Commission was appointed to inquire into the means of

locomotion and transport in London. It reported in 1905, having done

its work more thoroughly than even most Royal Commissions do their work.

A great portion of its report deals directly or indirectly with the

sanitary condition of the people of London.

"The question of locomotion," said the Commissioners, "affects the

health, comfort, and efficiency for work of the whole community....

"Witnesses who have special knowledge of the subject are of opinion

that the remedy for overcrowding is to be found in the removal of the

people to outside districts by providing additional facilities for

locomotion, and in this opinion we agree....

"We have come to the conclusion that in order to relieve overcrowding

means must be provided for taking the population into and out of

London, not in one or two directions but in many directions, at rapid

speed, frequent intervals, and cheap rates."

To this recommendation of the Commission it should be added that means

must be devised for preventing in "outer London" a repetition of those

circumstances and conditions of life which, for more than half a

century, entailed such sufferings and evils upon the people of London.

* * * * *

In reviewing the principal events, and studying the powerful underlying

forces of the great movement of the sanitary evolution of London, the

bitter experiences of the time gone by would indeed have been in vain

if they did not point the way to an avoidance of past blunders and

iniquities, and towards a better and happier future for the people. The

lines upon which reform should move gradually become apparent as the

events unroll themselves; and the measures now to be taken evolve and

shape themselves from the successes and failures of the past.

The reforms just suggested are undoubtedly those which are most

imperatively necessary. The whole experience of the past justifies the

belief that they would soon work a great change for the better in the

physical, mental, and moral conditions of life of large masses of the

people of London. And from improved and healthier homes would come to

the people increased comforts and happiness, and more physical energy

and greater strength to fulfil the duties of their lives, and to meet

whatever demands the future may make upon them and upon our nation.

The strength and even the existence of a nation depend upon the health

of its masses. The stake at issue is a vital one to people and nation;

and now more than ever is it necessary that the health and vigour

of our race should be maintained at the highest possible attainable

standard.

FOOTNOTES:

[186] Final Report of the School Board for London, p. 326.

[187] See Report of Medical Officer of the late School Board for

1903-4.

[188] Final Report, p. 297.

[189] First Report of Medical Officer for year ended March 25, 1903,

p. 24.

[190] Second Annual Report to March 25, 1904.

[191] In the Public Health (London) Act.

[192] The recoupments arising from the sale of surplus lands reduced

the actual or net cost to less than £8,000,000.

[193] Here the net cost is estimated to be about £5,500,000.

[194] The International Congress of Hygiene, held in Brussels in 1903,

passed a resolution declaring meat to be unfit for human food when

it was derived from animals attacked by bacterial anthrax, glanders,

rabies, tetanus, tuberculosis, in certain cases, and several other

diseases.

[195] See Report of the Medical Officer of Health of the London County

Council, 1902, p. 10.

INDEX

ADULTERATION OF FOOD ACT, 1860, 182-4

Aldwych, 413

Allison, Dr., evidence quoted, 28

Alteration of Food and Drink and Drugs Act, 1872, 238

Artizans' and Labourers' Dwellings Act, 1868, 212-3, 254-5, 282

Artizans' and Labourers' Dwellings Improvement Act, 1875, 256-8, 264

Amendment Act, 1879, 265, 292-5

Avery Hill, 414

BAKEHOUSES, 171-2, 275, 374, 381-2, 404

Bakehouse Regulation Act, 1863, 183, 275

Balfour, Rt. Hon. A. J., 396-7

Ball, Decimus, 323

Ballard, Dr., 252

Barnett, Canon, 294

Bateson, Dr. Henry, reports quoted, 150, 286-7

Baths and Wash-houses, 39, 126, 252

Baths and Wash-houses Act, 1846, 39, 252

Battersea, 98, 177, 203, 229, 284, 392

Beaconsfield, Lord, 287

Beale, James, 186

Bedfordbury, 259-60

Bermondsey, 17, 23, 98, 116, 144, 177, 188, 220, 250-1, 300, 309,

332-3, 347-8, 354, 431

Bethnal Green, 46-7, 74, 97, 103, 108, 120, 129, 138, 145, 177,

188, 190, 202, 219, 222, 268, 288, 291, 293, 303, 308-10,

333-4, 353, 364, 375, 383, 386-7, 393

Billingsgate Market, 416

Birth-rate, decline of, 350, 402-3

Bloomsbury, 314

Boundary Street Area, 364

Bow, 393

Bristowe, Dr. J. S., 400

Brockwell Park, 414

Bromley, 159

Building Act, 1844, 30, 164

Burial grounds, 35-7, 54-5, 64, 67, 231, 309-10

Burnett, J., report quoted, 335

Burnham Beeches, 414

CAMBERWELL, 98, 104, 137, 144, 155, 190, 219, 222, 267, 288, 291,

305, 309, 334, 354, 406

Census of 1851, 56, 410

of 1861, 155-7

of 1871, 221-2

of 1881, 288-9

of 1891, 349-52

of 1896, 379

of 1901, 401-2, 422

Central Health Authority needed, 195-6, 277-8, 431-2

Cesspools, 18, 51, 104, 128, 159, 229

Chadwick, Edwin, 47

Chamberlain, Rt. Hon. Joseph, 293, 308

Cheap Trains Act, 1863, 362

Chelsea, 98, 141, 197-8, 255, 267, 288, 354

Children's Employment, Commission on, 210-1

Cholera epidemics, of 1832, 2, 46

of 1848, 45-6

of 1849, 46-9, 63

of 1853, 72-5, 164

of 1866, 189-92

Chichester, Bishop of, speech in 1850, 66

"Christopher Court," Whitechapel, 28

"City," the, its commercial character, 7-9

its government, 9, 417

its sanitary condition, 50

its declining population, 94-5, 155, 222, 224, 288, 352, 401-2

construction of business premises, 367, 394

Amalgamation Committee, 396

Clare Market scheme, 364

Clerkenwell, 22, 74, 97, 102-3, 109, 115, 120, 124, 126, 185, 245,

261-2, 288, 303, 307-8, 314, 321, 323, 333, 353, 355

Common lodging houses, 67, 132, 145, 253

erected by L.C.C., 366, 410

Common Lodging Houses Act, 1851, 67, 132

Commons, acquisition of, 206, 282

Compulsory Vaccination Act, 1867, 208

Consumption, 146, 170

Contagious Diseases Animals Act, of 1869, 237

of 1878, 275-6

Coulsdon Common, 414

Cowhouses and dairies, 275, 318

Cremation Act, 1902, 409

Cripplegate, 165

Cross, Sir R. A., 256

Customs and Inland Revenue Act, 1890, 344-5

DENSITY OF BUILDING, 25, 28, 98, 203, 329-30

Deptford, 74, 347

Derby, Lord, 165

Dickens, Charles, on burial grounds, 36

speech in 1850, 65

Dilke, Sir Charles, 308

Diphtheria, 146, 386

Diseases Prevention Act, 1848, 79, 152

Diseases Prevention (Metropolis) Act, 1883, 318-9

Disinfection, 194, 248, 252, 358, 385

Dispensaries, 389

District Boards created, 83-9

inefficiency and inactivity, 183-7, 267-73, 301-8, 321-2, 398-9

abolition, 398-9

Drunkenness connected with overcrowding and insanitation, 130,

142-3, 157-8, 176, 263, 391-2

Dunraven, Lord, 336-7

EAST LONDON WATER CO., 106, 191-2

Education (London) Act, 1903, 406, 421

Elementary Education Act, 1870, 219, 346

Epping Forest, 414

FACTORIES, overcrowding in, 113, 173-4, 193, 334-7

Royal Commission of 1876, 274

need of inspection, 373-4

Factory Act of 1864, 183

of 1867, 210-1

of 1878, 274-5

of 1891, 370

of 1901, 403-4

Farr, Dr. W., 189

Fever, prevalence of, 4, 32-4

connection with cholera, 47

Finsbury, 16, 314-5, 423-4, 430

Finsbury Park, 206

Flight, 323-4

Forster, W. E., speech quoted, 242

Fulham, 98, 100-1, 112, 115, 131, 159-61, 166-7, 191, 204, 214,

219, 222, 226, 228, 252, 288, 307, 374, 380, 393, 401-2

GLADSTONE, W. E., 312

Godwin, George, 173, 181

Goulston Street scheme, 293

Grainger, Dr., evidence quoted, 48-9

Granville, Lord, 165

Gray's Inn Road, 295

Greenwich, 17, 74, 98, 101, 124, 222, 309, 332

Grey, Sir G., 70

Griffith, Dr. J., evidence quoted, 21-2

Grosvenor, Lord Robert, 66

HACKNEY, 17, 97, 100, 103, 117, 123, 136, 179, 190, 197-8, 222,

228, 230, 267, 288, 309, 334, 373, 393, 401

Hackney Marsh acquired, 414

Hainault Forest, 414

Hall, Sir Benjamin, 73

Hammersmith, 101, 204, 226, 383, 430

Hampstead, 97, 100, 125, 351, 375

Hampstead Heath acquired, 206

Harcourt, Sir William, 311

Hickson, W. E., evidence quoted, 26

Holborn, 97, 123, 127, 155, 164, 170, 255, 314, 353-4

Hornsey, 351

Hospitals for infectious diseases, 209-10, 283, 318-9, 387-8

Hospitals, voluntary, 390

Houses, defective building of, 227-9, 232, 273

Housing of the Working Classes Act of 1885, 325-6

of 1890, 342, 363-6, 398

Housing of the Working Classes Commission, 317, 319, 321-5

Hunter, Dr., 185-6

IMMIGRATION INTO LONDON, 156, 221, 225-6, 288-91, 336, 349, 402

Infectious and contagious diseases, 194, 208-9, 239-40, 263, 266,

276, 283, 318-9, 343-4, 357, 385-8, 403, 407-8

Infectious Diseases Notification Act, 1889, 342-3

Inspectors of Nuisances, 86, 91, 188-9, 193-4, 307-9, 324-5,

334-5, 358

their insufficient number, 379-80, 382-3

Islington, 97, 99, 108, 120, 127, 155, 177, 180, 188, 201, 222,

224-5, 279-80, 288, 351, 355, 374, 380-1, 392-3, 424

JACOB'S ISLAND, foul water in, 23

Jewish sanitary laws, 143, 146, 149

KENRY, LORD, 371

Kensington, 98-9, 105, 121, 188, 219, 222, 225, 230, 278-9, 288,

355, 375, 383, 430

Kingsway, 413

LABOURING CLASSES LODGING HOUSES ACT of 1851, 69-70, 326

of 1867, 326

Lakeman, 371

Lambeth, 12, 17, 30, 98, 103, 105, 116, 122-4, 155, 188, 203, 222,

251-2, 267, 300, 309, 352, 354-5, 375, 424-5, 431

Lambeth Water Company, 73

_Lancet, The_, description of the Thames, 77

Lankester, Dr., 189

Laundries, public, 126

Lea Conservancy Board, 208

Lewisham, 98, 102, 144

Liddle, Dr. J., 399

Limehouse, 97-8, 111, 120, 163, 188, 251, 258, 279, 393

Little Coram Street, Bloomsbury, 262-3

Local government of the "City," 9

of Greater London, 11-4

lack of central authority, 13

Act passed in 1855, 82

Local Government Board Act, 1871, 232-3, 419

Local Government (England and Wales) Act, 1894, 382

Locomotion, additional facilities needed, 432

London, Bishop of, speech in 1850, 64

London County Council created, 338-9

powers given by Public Health Act, 1891, 359-61

and by Housing Act, 1890, 363-6

constituted education authority, 406-9, 418

summary of its work, 420

London Fever Hospital Report, 1845, 32

London Government Act, 1899, 396-7

London Government Bill, 1884, 311-3

Lynch, Dr. J., 33-4, 261

MARYLEBONE. _See_ St. Marylebone

Measles, 408

Meat, inspection of imported, 318

Medical Officers of Health, their duties, 86, 91, 96

their reports, 92-3

their treatment by local authorities, 189

their labours, 399-400

Metropolis Local Management Act, 1855, 82, 110, 185

Metropolis Turnpike Trusts Act, 1828, 24

Metropolis Water Act, 1852, 71, 160, 191

Metropolitan Asylums Board, 210, 418, 420

Metropolitan Board of Works constituted, 83-5

abolished, 337-41

Metropolitan Building Act of 1844, 24, 76

of 1855, 88, 164, 204, 231

Metropolitan Burials Act, 1852, 55

Metropolitan Gas Act, 1860, 184

Metropolitan Market Act, 1851, 247

Metropolitan Paving Act, 1817, 12, 24

Metropolitan Poor Act, 1867, 208-10

Metropolitan Sanitary Association, 106

Metropolitan Sewers Commission, evidence before, 18-9

Metropolitan Water Amendment Act, 1871, 233-5

Metropolitan Water Board, 405-6, 418, 420

Middlemen, 323-4

Midwives Act, 1902, 409

Mile-End-Old-Town, 97, 99, 131, 163, 166, 227, 278, 288, 309,

333, 347, 383

Milk trade, 275, 318

Millbank estate, 366

"Model dwellings," 368-70

Morpeth, Lord, 43-4

Mortality, in the fifties, 120-1, 129-30, 144-5, 148, 150

in the sixties, 153, 156, 176-8, 191, 219-20, 223

in the seventies, 263, 278-81, 283

in the eighties, 292, 346-8

in the nineties, 350-1, 364, 392-3, 402

Mortuaries, 252, 358

Municipal Corporations Act, 1835, 78

Municipal Councils, created, 397-8, 417

their work, 421

Munro, J., 400

NATIONAL ASSOCIATION FOR PROMOTING SOCIAL SCIENCE, 181

New Oxford Street formed, 29

New River Company, 20

Newington, 12, 98, 101, 115, 122, 124, 144, 155, 185, 190, 214,

220, 224, 248, 250, 285, 309, 347, 354, 376

Notting Dale, 121, 177

Noxious trades, 37-8, 53-4, 87, 114-7, 145-8, 246-7, 252, 415

Nuisances Act, 1846, 39-40, 45

Nuisances Removal and Diseases Prevention Act, 1855, 82-3, 86,

117, 415

OVERCROWDING, in the forties, 29-34

in the fifties, 55-6, 107-14, 119, 127, 133-4, 145

legislation against, 87, 147-9, 193-4, 197

in the sixties, 165-77, 198-200, 202-3

in the seventies, 224-5, 243-6

in the eighties, 313-6, 332-3

in the nineties, 354-6, 371, 375-6

in 1901, 422-6

PADDINGTON, 98, 100, 102, 123, 155, 163, 168, 180-1, 184, 188,

201, 203-4, 220, 222, 224, 226, 248-9, 252, 279, 288, 290,

309, 376, 407-8, 425-6

Palmerston, Lord, 75

Parks and recreation grounds, 122, 206, 282, 414

Pauperism, 139

Paving boards in middle of nineteenth century, 12

Peabody Trustees, 265, 296

Pear Tree Court, Clerkenwell, 261

Pennethorne, J., 28

Phillips, J., 19

Physical deterioration, 426-7

Plumstead, 98, 267

Poor Law Act of 1879, 283

of 1889, 344

Poor Law Guardians, 407

Poplar, 97, 120, 123, 126, 155, 190, 199, 222, 227, 230, 254,

279, 284, 288, 300, 309, 331, 376, 393

Population, growth of, 9-10, 80, 155-7, 221-5, 288-9, 349-52,

401-2, 410

Port of London Sanitary Authority, 239-41, 283, 317-8, 416

Printing works, 172-3

Privy Council, medical department of, 152, 171

Public Health Act of 1848, 51-2, 79

of 1858, 152

Public Health (London) Act, 1891, 356-60, 385, 408, 412-3,

415-6, 429-30

Purvis, W., 237-8

REDESDALE, LORD, 165

Registrar-General's Report after census of 1861, 154

Rendell, Dr. William, 142-50, 175, 186-7, 189

Ritchie, C. T., 338, 359

Rodwell, Hunter, 271

Rosebery, Earl of, 341

Rotherhithe, 17, 36, 74, 98, 101, 105, 108, 114, 116, 117, 144,

177, 206, 220, 252, 280-1, 333-4

Ross, 323

Russell, Lord John, 66

Russell Court, Drury Lane, burial ground in, 36

ST. GEORGE, Hanover Square, 98, 137, 188, 212, 288, 351

St. George-in-the-East, 102-3, 106, 120, 233, 253, 278, 288, 303,

352-4, 391, 393

St. Giles', 28, 68, 97, 99, 100, 105, 108-10, 113, 124, 130, 139,

168, 176, 178, 191, 199-200, 224, 250, 252, 255, 260, 262-3,

305, 313-4, 375-6

St. James', Westminster, 97-8, 102, 109, 125, 130, 155, 170, 179,

189-90, 222-3, 249-52, 256, 272, 288, 290, 352, 369, 394

St. Luke, 97, 108, 219, 231, 255, 293, 314, 334, 353, 355, 364, 368

St. Martin-in-the-Fields, 97, 102, 129, 155, 161, 214, 352

St. Marylebone, 30, 97, 100, 105, 124, 181, 188, 222, 225, 232, 250,

280, 288, 299, 309, 354, 369, 374

St. Pancras, 97, 108, 115, 125-6, 128-9, 132, 155, 164, 169, 175,

188, 256, 268, 273, 279, 299, 304, 309, 348, 353, 367, 424,

430

Salisbury, Marquess of, 317, 322, 325-6

Sandhurst, Lord, 337

Sanitary Act, 1866, 193, 199-202, 217-8, 254, 266, 300, 302, 324, 429

Sanitary Law Amendment Act, 1874, 266, 305, 429

Scarlet fever, 249, 386, 415

Schools, overcrowding in, 113-4, 174, 244-6

defective drainage in, 421-2

School Board for London, 283-4, 292, 313-5, 406-7, 418

Scrofula, 58, 170

Sewers, early statutes relating to, 14

glaring inefficiency in the forties, 15-7

in the City in the fifties, 50-1, 60

plan adopted by the M.B.W., 90-1

medical officers' reports in 1856, 100-3

attention paid by Vestries and District Boards, 123, 249-51

M.B.W.'s scheme carried out, 158-9, 281, 411

L.C.C.'s report, 411-2

Sewers, Commissioners of, before Act of 1848, their authority, 9,

11, 15

their incapacity, 15-7

after Act of 1848, 41-2

superseded, 84

Shaftesbury (Ashley), Lord, 32, 47, 64, 66, 165, 174, 176, 274,

307, 366

carries Act to regulate common lodging houses, 67-8

Labouring Classes Lodging Houses Act, 69

Shops, 172

Shoreditch, 37, 97, 105, 111-2, 120, 166, 188, 228, 251, 267, 288,

309, 353, 355, 368, 380-1, 393, 425, 430

Simon, Dr. John, 50-62, 120, 171, 192, 215-7, 248, 286

Simpson, W., 29

Slaughter-houses, 247

Smallpox, 38-9, 146, 150, 208, 235-6, 269, 319, 386, 403

Smith, Dr. Southwood, 4, 6, 25-6, 151

Smithfield Market, 416

Society for Establishing Public Baths and Washhouses, 126

Society for Improving the Condition of the Working Classes, 70

Soho, 391

Southwark, 17, 98, 111, 120, 128, 131, 135-6

parish of St. George-the-Martyr described, 142-52, 167, 189,

214-5, 222, 224, 228, 230, 267, 279, 284, 305-6, 334, 347,

354, 364, 369, 374, 375, 393, 400, 424

Southwark Water Company, 21, 73, 192

Spitalfields, 28, 161, 245-6, 253

Stanley, Lyulph, 295

Stepney, 401, 424-5, 430

Strand, 97, 100, 110, 112-3, 115, 117, 123, 128, 133, 140, 176,

212, 223-4, 259, 288-90, 347, 352, 364, 392

Street improvements, 29, 205-6, 413-4

Sutherland, Dr., 75

Sweating, Select Committee on, 337, 370-2

TENEMENT HOUSES, 313-6, 353-6, 358, 375, 422-5, 428-31

_See_ also "Overcrowding"

Thames, the, sewers discharged into, 15-6, 21

source of water supply, 21-2

_The Lancet's_ description, 77

a Medical Officer's words in 1858, 117-8

Embankment constructed, 207, 282

Thames Purification Act passed, 207-8

scope of Conservancy Board extended, 208

Port of London regulations, 239-41, 283

new treatment of sewage adopted, 332

Torrens, Mr., 213

Towns Improvement Act, 1847, 79

Tramways Act, 1870, 219

Tremenheere, H. S., 171

Typhus, prevalence of in 1838, 4

in 1847, 43

in the "City" in the fifties, 58, 112, 147

VACCINATION ACT OF 1836, 208

of 1871, 237

Vestries created, 83-9

inefficiency and inaction, 183-7, 266-73, 301-8, 321-2, 398-9

abolition, 398-9

Victoria sewer, 76

Vinen, Dr. N., 400

Vulliamy, G., 229

WALES, THE PRINCE OF (now King Edward VII.), 317, 364

Wandsworth, 98, 100, 124, 155, 177, 219, 222, 228, 230, 250, 279,

289, 402

Water supply, disgraceful condition of, 20-3, 104-7, 160-2, 191-2

for the "City," 51-2

Act of Reform passed in 1852, 71

Act of 1871, 233-5

Act of 1887, 331

Royal Commission of 1892-3, 383-4

Act of 1902, 405-6

general survey, 412-3

Waterlow Park, 414

Webber Row scheme, 364

Westminster (_see_ also St. James), 16, 97-8, 108, 110, 115,

126, 161, 167, 177, 201, 222, 288, 300, 303, 346, 375, 377,

430

Whitechapel, 33, 97, 99, 103-4, 114, 117, 121, 126-7, 130-1, 153,

160-1, 166, 168-9, 178, 200-1, 219, 229, 231, 243, 245-6,

253, 278, 288, 290, 293-5, 353, 368, 391-2, 399

Williams, T. Marchant, 313-6

Window tax, 26

Woolwich, 98, 332

Workhouses and infirmaries, 209, 389-90

Workmen's trains, 296-7

Workshop Regulation Act, 1867, 211-2

ZYMOTIC DISEASES, 42-3, 118, 131, 163, 170, 260-1

UNWIN BROTHERS, LIMITED, THE GRESHAM PRESS, WOKING AND LONDON.

* * * * *

Transcriber's note:

Minor typographical errors have been corrected but inconsistent accents

and punctuation are as in the original text unless noted below. Archaic

spellings have been left unchanged.

* CORRECTIONS TO THE ORIGINAL TEXT

The following misprints and other errors have been corrected:

Page 42 - the text "was it a" changed to "it was a" ("but none the

less it was a forward step towards a sounder and wiser system of

government").

Page 96 - the text "it amounted it" changed to "it amounted to" ("And

that is what, undoubtedly, it amounted to").

Page 121 - "61·3 of the total deaths." changed to "61·3 per cent. of

the total deaths."

Page 145 - the text "illness resulting difficult of cure" changed to

"illness resulting in difficulty of cure" ("each from illness

resulting in difficulty of cure, constantly recurring.").

Page 199 - the text "precisely the powers which not last year only,"

changed to "precisely the powers which, not last year only,"

("Section 35 gives precisely the powers which, not last year only,

but every year since the constitution of the Board, the Medical

Officer has demanded").

Page 203 - sentence changed from

"And another example near Paddington Road--where 275 houses had been

built, and the population was 493 to the acre; showing"

to read

"And another example near Paddington Road, where 275 houses had been

built, and the population was 493 to the acre, showing--"

Page 207 - the text "acccess of energy" changed to "excess of energy"

("The visitation of cholera was doubtless in the main accountable for

the excess of energy displayed by Parliament about this period").

Page 219 - comma added after "50 per cent." ("the high rate, nearly

50 per cent., of infantile mortality").

Page 246 - the text "in the yards of some of them slaughter-houses"

changed to "in the yards of some of them were slaughter-houses"

("indeed, in the yards of some of them were slaughter-houses, with

all their unpleasant concomitants.").

Page 304 - the text "for there many" changed to "for there were many"

("for there were many and considerable advantages in this form of

procedure").

Page 314 - the text "was 382" changed to "as 382" ("He gave the number

of families ... residing in more than two rooms as 382, ....").

Page 353 - "inhabitating" changed to "inhabiting" ("number of persons

inhabiting each").

Page 357 - "prejudical" changed to "prejudicial" ("injurious or

prejudicial to health").

Page 375 - the text "76·1 of the population" changed to "76·1 per cent.

of the population" ('In Bethnal Green (1894), "76·1 per cent. of the

population lived in tenements of less than five rooms. No houses had

been registered."').

* OTHER CHANGES AND NOTES

The following changes to the original text have been made for clarity

or consistency:

In CHAPTER I, the section numbers have been prefixed with the words

"CHAPTER I, PART" for clarity. This means that the headings of the

sections in this chapter are now--

CHAPTER I

CHAPTER I, PART II

CHAPTER I, PART III

CHAPTER I, PART IV

CHAPTER I, PART V

The word "death roll" changed to "death-roll" throughout to match the

more numerous instances of the latter form in the original text.

Page 254 - reference to "The Artisans' and Labourers' Dwellings Act

(Torrens) of 1868" changed to "The Artizans' and Labourers'

Dwellings Act (Torrens) of 1868".

Page 437 - reference in the Index to "Metropolitan Markets Act, 1851"

changed to the correct title of "Metropolitan Market Act, 1851"

as cited on page 247.

Footnotes have been re-indexed using numbers and collected together at

the end of each chapter. Where there were multiple references on a page

to the same footnote, the second and subsequent reference is now

sequentially numbered with its own footnote which says "Ibid."

The following variations of a word or descriptive term are common

in the original text and have been retained:

"Common Lodging House", "lodging house" and "lodging-house"

"back-yard" and "backyard"

"cow-houses" and "cow houses"

"lime-washed" and "limewashed"

"over-crowded", "overcrowded"

"over-crowding", "overcrowding"

"re-built", "rebuilt"

"re-build", "rebuild"

"re-inspection" and "reinspection"

"sub-soil" and "subsoil"

"tenement-house" and "tenement house"

"Wash-houses" and "Washhouses"

"water-course" and "watercourse"