94, _Lisson Grove_, _N.W._

THE

SANITARY CONDITION OF THE POOR,

IN RELATION TO

DISEASE, POVERTY, AND CRIME.

THE relation of the rich to the poor, and the poor to the rich, has

always been a subject of interest to the philosopher, moralist,

economist, and philanthropist. This relation was, in feudal times,

clearly enunciated, and as vigorously acted upon. The dark days and

long evenings that witnessed the tolling of the curfew bell have passed

away. Since those days we have made advances in social and political

freedom, and class distinctions have become less obvious. Freedom of

thought has developed a greater equality of social rights; but are

the poor really any better off now than they were in the days when

William hunted in the New Forest? I confess that many will reply in the

affirmative; but when I see around me on every side so much disease,

poverty, utter wretchedness, and crime, I conceive it difficult for

the condition of man to be worse than that in which thousands in this

metropolis exist. Look at the condition of the overcrowded dwellings

of the poor; they are not _homes_. The word home in its full and happy

significance and association is unknown to them. The proud boast of

every Englishman, that his house is his castle, is a mere fiction.

“There is no place like home, be it ever so humble,” is a truth that

meets with the faintest response from thousands of miserable tenants

who live in yet more miserable tenements.

That the condition of the dwellings of the poor does not free them

from the obligation to observe personal cleanliness is perfectly true,

neither does the neglect of personal cleanliness on their part justify

the landlord in neglecting the sanitary condition of his houses. It

is to be regretted that more liberal and enlightened measures are not

adopted. I feel confident that if the dwellings of the poor were made

healthy and comfortable, there would be a marked improvement in the

status of the poor. With improved health, cleanliness, and comfort we

should obtain improved industry and prosperity; and this would not

be confined exclusively to the poor, but its influence would be felt

through every grade of society. It would tend to lessen the selfishness

of the prosperous, and the suspicious jealousy and impostures of the

unfortunate. We are apt to forget that:—

“Is there for honest poverty

That hangs his head, and a’ that?

The coward slave, we pass him by,

And dare be poor, for a’ that.

The rank is but the guinea stamp,

The man’s the gowd, for a’ that.”

Man is to a very great extent the creature of circumstances, and is

greatly influenced by external objects. That which we like we become

like. The fine arts cultivate the æsthetic part of a man’s nature;

painting, sculpture, and poetry develop a man’s imagination. One man

by a constant contemplation of the beautiful acquires the habit of

admiring the beautiful; another man by the constant association with

dirt becomes dirty. Repeated acts of thought grow into action, and

actions repeated grow into habits, and habits form the character of

the man: hence the importance of a cleanly, comfortable, and healthy

home. A family that lives in a dirty room, with nothing but dirty

associations, must grow up dirty. Thoughts grow in us as grain in

wood. The mental qualities of the poor are undeveloped, and especially

the moral force of character which is requisite to raise them above

their circumstances is hardly to be looked for. If the poor could be

accommodated with healthy dwellings they might reasonably be expected

to better their condition; but what man can wage a successful war

against disease and poverty combined? Unhealthy dwellings not only

keep them poor, but foster a reckless indifference as to how things

go with them. This apathetic condition is the worst that can befall

either the individual or society. Idleness, dirt, poverty, disease,

and crime are intimate companions, though not inseparable. The logic

of the indifferent poor amounts to this: that those who work must pay

for those that don’t; and hence arises one of the great difficulties in

dealing with and relieving the poor. There are many limited companies

formed to carry out various commercial enterprises; but if a limited

company could be formed to erect suitable dwellings for the poor, at

such a rental as they now pay, it would confer an unspeakable benefit

on the poor, benefit society generally, and pay the really patriotic

shareholders an equitable percentage. This I merely throw out as a

suggestion, but I am convinced if carried out, it would be one of

the best means of effectually helping the poor to help themselves. I

conceive that whatever tends to smooth the rugged surface of life,

and to soften its harsher features, and to multiply the sources of

human health and enjoyment, must be held worthy of notice; and in so

far as it tends to improve the condition of the poor, and foster in

them provident and careful habits, just so far ought it to receive our

generous sympathy and support. That this may not be mistaken to be

merely philanthropic statement, but that it is based upon a principle

of true social economy, I quote the following from Smith’s Wealth of

Nations:

“Servants, labourers, and workmen of different kinds, make up by far

the greater portion of every great political society. But what

improves the circumstances of the greater part can never be regarded

as an inconveniency to the whole. No society can surely be

flourishing and happy of which the far greater part of the members

are poor and miserable. It is but equity—besides that they who feed,

clothe, and lodge, the whole body of the people should have such a

share, as to be themselves tolerably well fed, clothed, and lodged.

The liberal reward of labour, as it is the effect of increasing

wealth, so it is the cause of increasing population. To complain of

it is to lament over the necessary effect and cause of the greatest

public prosperity. It deserves to be remarked perhaps, that it is in

the progressive state, while the society is advancing to the further

acquisition, rather than when it has acquired its complement of

riches, that the condition of the labouring poor, of the great body

of the people seems to be the happiest and most comfortable. It is

hard in the stationary, and miserable in the declining state.”

In a visit I paid to a poor patient in Burne Street, I could not help

being struck with the cold, damp, dirty condition of this “attic near

the sky.” The cold wind pierced through every crevice. The rain had

come in plentifully through the ceiling and soaked the bed. The walls

were black and grimy; the fire in the grate, like the life of my

patient, feebly struggled for existence.

What dirt and neglect had done for the room—dirt, disease, and poverty

had done for the inmate. I feel sure that had the dwelling been in

a better condition my patient would have been in better health, and

consequently stood better in every relation to society.

’Tis an old proverb that “prevention is better than cure;” yet how few

there are who practically believe it. The principle embodied in this

proverb received the approval and sanction of past ages, but which it

is most difficult to enforce at the present time; it may be explained

by the fact, that men not being forewarned cannot be forearmed, and

further, because another principle which is expressed in the words,

“men think all men mortal but themselves,” lies deep in the human

mind. The blessing of health is not valued till it is lost. Let the

mysterious hand of disease touch us, and we throb with painful anguish.

Then do we long most earnestly for our valued health and strength;

we resolve that once well again we will adopt such regulations and

precautions as shall ensure a continuance of the invaluable blessings

of health: such is the reasoning of the sick and afflicted. To the

invalid the quantity and quality of the air he breathes is of vital

importance, but to the man in comparative health, it is a matter of

indifference. The laws which regulate the diffusion of gases on which

ventilation depends, or the action of pure or impure air on the animal

economy, is to him a subject of indifference; it does not yet affect

him, and he has enough to do without it. The subject of ventilation

bears such an important relation to health, and health is one of the

greatest blessings of life, that I conceive it to be the duty of all

to be fully alive to its value. In these days when the schoolmaster

is abroad, and the march of intellect so rapid, it is not a little

remarkable that the knowledge of the laws of health, based upon

scientific data, are so little known.

If therefore, some of the general laws which govern the preservation

of health be simply stated and illustrated, it may be the beginning of

much good, by teaching or inciting men to become the guardians of their

own health. One of the primary laws of health is to have a good supply

of fresh air. The voice of nature cries aloud for fresh air, the cry

comes to us alike from the newly born babe in the cellar, and the aged

sufferer worn out in life’s troubles in the garret. It is the cry of

the weary and worn; their thin blood flows feebly, and their life is

ebbing fast as they cry, “Oh, for one short hour to breathe the breath

of the cowslip sweet and to feel as I used to feel.” This is all that

is craved ere the weary one welcomes the stifling hand of death. Such

is the cry of thousands in our city. Who wonders at it? Not those who

are practically acquainted with the dwellings of the poor. For those

who are not, I shall in general terms indicate some of the features of

the _homes_ in my district. It is not my object to raise the veil of

poverty to satisfy idle curiosity, or to awaken a morbid philanthropy.

Scenes which are photographed on my mind, I shall from feelings of

delicacy alike for the subject and the reader omit. As parochial

medical officer for Christ Church district, it is very often my duty to

visit East Cottages, and Little Church Street, and I am daily called

upon to witness the suffering and sickness in crowded rooms, which is

fostered by bad ventilation and insufficient drainage; here small-pox

and typhus fever are frequent visitors. It is not an uncommon thing

for a family of eight or ten to occupy one small room. In this single

apartment, men women and children of all ages eat, drink, and sleep; in

such a place as this, and under such circumstances, where little air

enters, and less light, can it be a matter of surprise that sickness

and death are frequent visitors. Death is so frequent a visitor,

that to those who witness his work he has lost all his terrors; yea,

he is rather a friendly visitor when he calls the younger members

home. Think, reader, of such _a home_ as this in the day of sickness,

in the hour of nature’s woe, in the gloomy night of death. Picture

children of tender years becoming familiar with these scenes, and can

it reasonably be expected that they should grow up healthy either in

mind or body. I could not but allude to the number of occupants in one

small apartment, as it bears directly on the amount of air supplied

to each one, and the necessity for free ventilation; overcrowding

also tends very materially to demoralise the rising generation. In

a word, it degenerates both body and mind. At an early age they sow

the seeds of consumption, bronchitis, rheumatism, and a whole list of

complaints, which may be traced more or less to the violation of the

ordinary sanitary laws of health. The youth of our cities before they

are young grow old, before the bud blooms the blossom is blasted; as

flowers without the light of heaven, they are blanched, withered, and

die. These sickly ones crawl into their homes, such as they are, from

which the light of day is almost excluded, and with it the light of

hope. Under these circumstances the parish doctor is sent for, but too

often it is his lot only to be a passive witness of the irreparable

mischief which has been done. I have a vivid and painful recollection

of a visit I paid to Devonshire-place. The room was small, dark, dirty,

and gloomy. There were but few squares of glass left in the frame,

through which the yellow light feebly struggled to enter; the chimney

was stopped up, the air stagnant and very oppressive, even for the

few minutes I was present, yet there were no less than five people

sleeping in this apartment, two children ill with scarlet fever, and

one resting in death. The ventilation was so bad, that the recovery of

my little patients was doubtful, and the deterioration of the health

of their parents certain. In cases of this kind how important it is

for every one to know, that by excluding the breath of heaven, we are

extinguishing the breath of life. It is of the highest importance that

we should have fresh air in health, but it is imperatively necessary

in disease. Then more than ever does nature feel the necessity for

fresh air. A lowered vitality like a fire that is dying out, requires

a larger supply of atmospheric air, but alas! how often is this innate

craving for fresh air stifled by prejudice and ignorance. Close rooms

are rendered closer by chimneys being blocked up, and every crook and

crevice being stuffed up by rags and paper, as if the great object to

be attained was effectually to prevent one breathing. All this is done

from the purest motive, and with the best intention; it is done to

prevent the patient taking cold. So the patient has to struggle against

sickness, poverty, and impure air.

Those who are in health, though they may sleep in overcrowded rooms,

have the advantage of being out in the open air some part of the day,

and this in some measure compensates for their close confinement. The

open air quickens the pulse and restores the vitality of the various

functions of the body. Fortunate are those whose employment is out of

doors. This obtains rather with the male than the female poor. They too

often leave a closely confined and overcrowded bed-room to go into a

still worse work-room, there to work _twelve_ or _fourteen_ hours under

flaring gas-lights in a heated and impure atmosphere. Those who live

like this succumb at an early period of life to disease:—

“With fingers weary and worn,

With eye-lids heavy and red,”

they rush out of their overcrowded work-rooms and seek to palliate

their physical sufferings at the gin-shop.

The air which surrounds us on every side, though invisible, is not

inactive. To the casual observer its existence might be doubted if

it did not manifest itself in the gentle breezes which bear the

faded leaves of the widowed trees to their resting place; or in the

wintry blast which uproots the sturdy oak of the forest, or lashes

the white-crested billows of the ocean into a storm. In this way

does the air we breathe make itself known to us. The composition of

atmospheric air, the laws which govern it, as illustrating the theory

of ventilation, the action of air on the animal economy, on the

vegetable and mineral kingdoms, we must pass by. Suffice it to say

that atmospheric air is a compound; that oxygen is the life-sustaining

element; and that carbonic acid gas has an opposite effect; also the

nitrogen; and that when we breathe we take in oxygen and give out

carbonic acid gas. There is a law which governs cases called gaseous

diffusion, by which gases pass equally into one another, and thus

become equally diffused. If it were not for the operation of this law,

there would be no variation of climate, no winds to waft the mariner

over the briny deep, no provision for the scattering of the sun’s

golden rays of light. The beauty of a summer’s sky would have been

lost. No clouds would have hung around the portals of the setting sun

tinged with crimson and with gold. No verdure in the meadow would have

greeted our eye. No ark of hope would have spanned the clear vault of

heaven. But, by the combination of oxygen and hydrogen, and the laws

which govern them, provision is made for all these blessings. Light

and heat are freely scattered. Animal and vegetable life rejoice. The

priests of the morning chant their matins when the sun arises, and the

flowers scatter their evening incense when the sun descends to glorify

the western world.

In a sanitary point of view the law of gaseous diffusion is of

importance, because noxious gases are thereby diluted by the

atmosphere, and are thus rendered comparatively harmless; hence, by

free ventilation, we may do much to lessen the predisposition to

epidemics, and the virulence of poisonous malaria.

The labouring man, above all others, should rise in the morning

refreshed by nature’s sweet restorer—balmy sleep. But, by neglecting

ventilation, it is not so. Drowsiness, sickness, headache, and languor

are his lot; and in order to bring himself up to the mark, he is

obliged to have recourse to artificial stimulants. Scavengers are

necessary to maintain the comfort and cleanliness of our streets, so

oxygen is necessary to maintain the health and comfort of our bodies.

By depriving our bodies of pure air, we deprive them of the power

to throw off infectious diseases. This may simply be illustrated by

placing a lighted candle under a shade when a limited amount of air

only can be introduced. If not supplied the candle will go on burning

for a while, giving out less light and less heat; but when the oxygen

is exhausted, the candle will die out. Thus it is with man. The candle,

when deprived of pure air, gave evidence of less light, so to man under

the same conditions would give evidence of less life. A lower vitality

is equivalent to a closer approach to death. Day is opposed to night.

Life to death. But even as between day and night there is twilight, so

in our experience there is the twilight of disease. Thousands in this

metropolis, through the neglect of the laws of health, live in the

twilight of disease, rather than in the noon-day brightness of health.

I have endeavoured to show that fresh air is a necessary of life just

as much as food. I have indicated its importance in relation to health

and how imperatively necessary it was in sickness to aid the body to

overcome disease. If overcrowding in small dwellings and its consequent

ill effects upon health, morality, and industry be a necessary social

evil, it is evidently our duty to lessen that evil, if we cannot

altogether remove it. This, in some measure, may be accomplished by

free ventilation and paying due regard to the ordinary sanitary laws

of health. If we turn a deaf ear to the warning voices of conscience

and reason, and go on living and breaking the laws of health, we must

expect to pay the penalty for breaking those laws. If men habitually

sleep in an atmosphere of carbonic acid gas and fetid exhalations, they

must of necessity exhaust the vitality of their bodies.

The defective sanitary condition of hundreds of houses in this district

render it imperative that something should not only be said, but

done. But the question arises—who is to do it? I take it that the

duty lies not alone with either the tenant, or landlord, or parochial

authorities. It is a work of co-operation in which there is work for

each; and each must do his work. In endeavouring to urge this sanitary

reformation it may be Utopian to expect a perfect result; yet I am

convinced that much can be done to render even the present wretched

dwellings of the poor much more healthy than they are at present.

I have frequently in my visits to Charles-street, Stephen-street,

Stephen’s-court, and, in fact, in the houses contiguous, met, on going

upstairs in the morning, a hot, fetid air. On going into the rooms I

have observed that the walls were damp with exhalations caused by so

many herding together. I have naturally requested the windows to be

opened, in order to let out the hot and impure air, and, to my dismay,

I have almost invariably found that the upper sash was a fixture. This

state of things is to be deplored, inasmuch as it prevents efficient

ventilation and is not only injurious to health but beyond the means

of poor lodgers to remedy. I would venture to suggest the propriety

of landlords seeing that all windows be made to open at the top, or a

square of glass be removed and a perforated tin plate be inserted in

its place, or better still, a window ventilator. A brick removed out of

the chimney, close to the ceiling, and a valve fitted so as to allow

the escape of foul air up the flue, is a good means of ventilation.

There are many ways of ventilating an apartment; and it matters little

how it is done if it be done efficiently. If any one of the above

methods be adopted I feel sure it would be a great boon to many poor.

There is one subject that bears a most important relation to the health

and comfort of those over-crowded dwellings, and that is the supply of

water. This is anything but adequate to the requirements of the many

people that are sheltered under one roof in my district. The tubs and

cisterns are in many cases only sufficient to supply one family, but

in the houses where the poor live, each room is occupied by one or two

families at the least; the consequence is, that there is a great demand

for water, and not being sufficient, impurities of all kinds abound;

personal cleanliness is neglected to a frightful extent, washing the

skin is looked upon as a terrible innovation, and the result is often

dreaded. To suggest a bath is often looked upon with as great a horror

as a surgical operation. If there were a more plentiful supply of

water, there would not be the excuse for such a neglect of washing

and cleansing the dwellings of the poor. Personal cleanliness and the

washing out of rooms, &c., is the duty of the tenant quite as much as

paying the rent. It would be well if cleanliness were made a condition

of tenancy,—if the rent collector insisted on the cleanliness of the

rooms with the same firmness that he insists on the punctual payment of

the rent, yea, rather allow a week’s rent to stand over than a dirty

room to go unwashed.

The sewerage to the houses is not adequate to carry off the

enormous waste of fifty people. These houses were only built for

the accommodation of fifteen to eighteen people. If there be not a

sufficient supply of water to flush the drains at least once a-day,

they become clogged up and generate poisonous gases, which enter the

houses and bring on a lowered state of health; skin diseases, scabies,

typhus, and choleraic diarrhœa are the results. That this is not an

overstatement may be shown by the fact, that outbreaks of choleraic

diarrhœa have over and over again been suddenly stopped by a heavy fall

of rain. This beneficial result has come about by the rain flushing the

sewers and clearing off the morbid poisons.

There are other nuisances which contribute to contaminate the air. I

have, in visits from house to house, noticed that the dust heaps are

allowed to accumulate to a frightful extent, they are neither more nor

less than one vast mass of decayed animal and vegetable matter, with a

good proportion of the remains of decomposed fish. The consequence was

that if windows were opened for the purpose of ventilation, a worse

condition of the room was induced. Further, I cannot help remarking

that the sanitary condition of the streets and courts in my district,

especially part of Bell-street, Charles-street, George-street, part of

Devonshire-street, is far from satisfactory. Those that live in the

cellars in these streets are constantly inhaling poisonous exhalations

arising from putrid animal and vegetable matter, and I am sure the

stench which arises from stinking muscles and cockle shells, must be

injurious to health. I would ask upon what principle do the authorities

do their work? Broad streets, squares, and open thoroughfares appear to

me to be oftener watered and swept than these out-of-the-way courts,

alleys, and narrow streets, which are overcrowded with a teeming dirty

population. Surely these are just the places that require the greatest

care, for these are the places which, if they do not breed an epidemic,

would readily foster it. The slums of a city ought to be made as

healthy as possible, not only for the good of those who live in the

slums, but for the good of the community at large. Society is like the

body; one member cannot be affected without the whole body suffering.

It is not only right, but profitable to make the dwellings of the poor

healthy, and to surround them by all the protection that preventive

measures can do. Sickness is one of the worst calamities that can

befall the poor labouring man. When laid low, all his resources are cut

off. His family, and so must he, go without the necessaries of life,

or run up a heavy score at the small huxter’s shop. His rent cannot

be paid; and should his illness last long, both he and his family

become a burden to the ratepayers; and should he recover his health,

it is weeks, aye, months before he can recover his position and stand

free from debt. Now, suppose that this illness was brought on by the

defective sanitary condition of his dwelling, and his own neglect of

proper attention to cleanliness, why it is at once evident that it is

the interest of the landlord to see that his houses are healthy, for

a dead man pays no debts, and a sick man pays no rent; further, it is

the interest of the tenant to observe the laws of health. What pen can

describe the racking torture of disease and poverty combined? I have

visited houses where the head of the family has been thrown of work,

by ill-health. I have witnessed the gradual departure of articles of

ornament from his little room, soon to be followed by other pieces

of furniture, until even the necessary utensils of civilised life

were gone. The bedstead and bedding have been put away, and a sack of

shavings supplied its place. The room has been literally stripped. The

children have been equally deprived of their clothes, and were huddled

up in a corner in quite as primitive a fashion as their forefathers

the ancient Britons. The mother went out washing for two or three

days a week; what she earned they all lived on. It may be asked why

did he not go to the workhouse? I reply that the deserving poor, the

earnest, striving poor, have the greatest possible objection to go to

the house. They would rather die in want and wretchedness than become

an inmate of the house. Whether this dislike be well founded or no, it

is not my object now to inquire, but I must state that there are some

clamorous for admission. From what has been said, I think it may fairly

be inferred that if a liberal and just regard be paid to the sanitary

condition of the dwellings of the poor it would, to look at it from the

£ s. d. point of view, be a benefit to tenant, landlord, and ratepayer.

It would also tend very materially to improve the physical, moral and

mental condition of the poor; it would make them healthier men, happier

men. It would materially better fit them for all the social conditions

of life.

I know of no subject in a sanitary point of view that demands a more

careful consideration than the possibility of a choleraic epidemic

next spring. I wish not to alarm, but to try and urge people to be

on their guard so as effectually to lessen if not prevent the dire

effects of a cholera visitation. Should cholera visit this part of the

metropolis—and we have no guarantee that it will not—it is our duty to

be prepared to deal promptly and effectually with it.

The news has been already flashed through the land that it has made

its appearance. Although confined at present to two places, this has

made many a stout heart tremble. But this is not a time for fear. “Let

us, then, be up and doing with a heart for any fate,” and seek by

an earnest endeavour to render our homes untenable to this terrible

pestilence. Every man this day must do his duty. These are stirring

words, and they call us to action, for a deadlier foe now threatens

the happiness of our sea-girt island than that which Nelson fought.

Cholera, an unseen foe, is nevertheless a real one. Many a hero that

has braved a hundred fights has blanched before this deadlier foe. Like

a mighty conqueror and destroyer, it has marched onward as regardless

of the ermine of the judge as the swaddling clothes of the infant. In

vain has the mother wrung her hands in passionate anguish over the

death of her little one; husband has mourned for wife, and wife for

husband; children have been left fatherless; and fathers have been left

childless; nothing but darkness, blackness, death, and desolation, have

marked the route of this potent enemy to man.

One of the best preventive measures is to have a plentiful supply of

pure water. We can then keep our sewers flushed—our homes clean, and so

render our hearths and homes comparatively safe from the devastating

pest of cholera.

There is nothing in nature that possesses more interest than water. It

is composed of oxygen and hydrogen. This may be easily demonstrated by

throwing a piece of potassium on water, when it will instantly take

fire: because of the rapid affinity of the oxygen of the water for

the metal potassium the hydrogen is liberated, which burns during the

decomposition which takes place. This experiment, which is equally

simple and beautiful, shows the composition of water. The combinations

into which water enters in the animal and vegetable kingdoms are as

various and as beautiful as the magic forms of the kaleidoscope.

Neither animals nor plants can live without water. It is, therefore,

a necessary of life. On the purity of water, in a great measure, our

health depends. Various are the sources of water, and equally various

the degrees of the purity or impurity of water: for this reason—that

water is the great solvent in nature. The first great source of our

water supply is from the ocean, which receives the water from all

the sparkling rills that murmur as they leap down the mountain side,

which unite and form rivulets. These rivulets unite again, and form

the mighty flowing rivers with majestic water-falls, cataracts, and

cascades; and these flow on till they empty themselves into the ocean.

Reader, did you ever stand on the sea beach shore and see day go out

in a flood of glory—the bosom of the ocean blush as the monarch of day

smiled his parting beams of light—tinging the clouds with golden hue

and shedding a light on all creation and making it beautiful? These

clouds were not alone created for the poet or the painter, nor to give

scenic beauty to the landscape; but to supply the wants of the flowers

of the valley, the beasts of the forest, and to be a source of health,

power, and wealth to man. The heating rays from the sun so act upon the

water as to cause a mist like a gossamer veil to arise. This is tossed

about in the atmosphere by the various currents of winds which set in

from the Equator to the Arctic and Antarctic regions. Thus is it that

rain-bearing clouds are distributed over the land. The vapour contained

in these clouds is condensed by the various degrees of temperature

through which they are wafted, and form either snow or rain. This sinks

down into the earth, and forms springs; or the snow, melting on the

mountains, runs down and forms rivulets: and hence our chief water

supply.

“Look around on this world, it is sweet, it is fair,

There is light in the sky, there is _life_ in its air,

Sublimity breathes from the forms of its hills,

And beauty winds on with its rivers and rills;

The dew as with diamonds its mead hath bespread,

From its groves are a thousand wild melodies sent;

While flowers of each tint are by morning imparted,

Oh! why is there woe in so lovely a world.”

Rain water, when collected in the country, is doubtless the purest

and best adapted for ordinary household purposes, but in London and

large cities it contains many impurities; when collected in our tubs

or cisterns, it is impregnated with all the dust, dirt, and smoke that

hangs more or less like a funeral pall over smoky cities; the air

contains more or less sulphurous acid, and the carbon that escapes from

our chimneys and is deposited on the tops of our houses, hence the

sooty taste that soft or rain water has.

Well or spring water always partakes more or less of the character of

the ground or the strata through which it passes, hence the explanation

of the great differences which exist. Water that passes through chalk

is characterised by its hardness, because it holds a large quantity

of carbonate of lime in solution. Thus it is with chalybeate springs,

which contain a large proportion of the salts of iron, and others,

that contain sulphate of magnesia; these instances illustrate the fact

that water is a great solvent, and partakes of the character of the

materials through which it passes, and hence the differences which

we find existing in the water we derive from wells. There are not

many public pumps in my district, and fortunately they are not in the

vicinity of churchyards, nor in communication with cesspools. There

is not therefore much danger of wholesale poisoning by drinking water

from these sources. The water, as supplied by the West London and

Grand Junction Companies, is, I believe, of good quality; for from the

samples I have examined, and the reports furnished by Dr. Whitmore, the

water appears free from those organic impurities which are indications

of danger, and are specially to be guarded against in times when

cholera threatens us. The water, which in not a few of the houses in my

district, is supplied by the water companies pure, is rendered impure

in the tubs and cisterns in which it is stored. Water not only has the

property of becoming impregnated with mineral substances, but also the

property of absorbing gases. It is strange, but nevertheless true, that

the worst place possible for tubs, cisterns, and water reservoirs, is

selected, viz., next to or over water closets, or over dust bins; this

obtains almost universally in my district. The consequence is, in the

one case feculent exhalations arise, and are absorbed by the water; and

in the other, exhalations from the decomposed and decomposing vegetable

and animal refuse; further, the tubs and cisterns in many cases

appear to have been neglected for a long time. The lids do not fit,

consequently these cisterns are receptacles for all kinds of filth.

Those who live in the upper rooms are not over-scrupulous as to how,

when, or where, they dispose of their waste matters, but it often finds

a lodgement on the outbuildings, and not seldom is washed more or less

into the cisterns. These cisterns, like the people and the rooms they

inhabit, are not characterised by cleanliness. If I might judge from

appearances, I should conclude that they are seldom washed out. If I

ask when the tub or cistern was last cleaned out, nobody seems to know;

for, what is everybody’s duty is nobody’s work.

It is a well-known fact, that when animal and feculent matters are

suspended in water, and that water is used for drinking purposes, that

it has produced diarrhœa. In water that is contaminated with sewerage

the diarrhœa is accompanied with choleric symptoms, such as purging,

vomiting, cramp, and even some loss of heat. This should be a warning

not to allow impurities of any kind to abound in our drinking water.

Fetid gases absorbed by water render the water bad; not that the

sulphuretted hydrogen in itself is the thing to be dreaded, but because

its presence fosters the growth of vegetable and animal products that

are highly detrimental to health, and are, I believe, predisposing

causes, if not virtually the agents in choleraic diarrhœa. It is in

water under these conditions that plants and animals abound. They

are minute, microscopic, I admit, but on that account none the less

dangerous. The living plants and animals are not to be regarded with so

much horror as the dead, because they rapidly undergo decomposition;

and, while in this state, if taken into the system, act as ferments

disturbing the normal functions of the body, and often giving rise to

diarrhœa. This is not a mere assertion or hypothesis, but is supported

by well-observed cases by some of the most competent men in the medical

profession. In support of the above, I quote the following words from

Dr. Parkes, professor of military hygiène. He says:—“An epidemic of

diarrhoea in a community is almost always owing to either impure air,

_impure water_, or bad food.” The practical deduction is, that if we

would maintain the health of a parish and prevent cholera, diarrhœa,

typhus, or any other epidemic, we must improve our sanitary condition.

Pure water lies at the foundation of all sanitary improvements. Let

it be well known that impure water is to be dreaded, and the fear of

an epidemic may prove a healthy stimulus to increased activity and

cleanliness in connection with a subject of such vital importance.

Whether cholera visits us or not, we shall be all the better for having

paid proper attention to our sanitary arrangements. I would suggest

the propriety of having all tubs, cisterns and reservoirs cleaned

out; all waste matters removed from the roofs of outhouses; all back

premises thoroughly cleaned. I think from what I have said, this can

hardly be regarded an unnecessary work; but should this be deemed

impracticable—though I cannot see how it can be—I would suggest the

desirability of all water used for drinking and culinary purposes being

filtered; that is, where there is any suspicion of decomposed organic

matter in the cistern, tub, &c. Any working man with ordinary ingenuity

might contrive to filter his water through a little sand and vegetable

charcoal. I know of no filters that could be purchased for 1s. 6d. or

2s., which I presume is about the extent that many of the poor in my

district could go to. A rough-and-ready filter might be made out of a

large flower-pot, the hole at the bottom being plugged up with sponge,

and then a layer of charcoal and another layer of sand. The water would

percolate through these substances, and be as clean and pure as the

water from the mountain rill. The flowerpot might be suspended over

another vessel, which would receive the pure water, or it might be so

placed as to stand on two pieces of wood over another vessel. There

are many ways of filtering water, but it is only my object to show

how simple, inexpensive it is, and that it is within the means of the

poorest to protect themselves from the disastrous effects of impure

water, at a little cost of labour and at a still less cost of money.

There can be no doubt that water is not appreciated as a sanitary

agent. This may arise either from ignorance or indifference; but,

after what has been said, I trust that the apathetic neglect of the

primary laws of health, and that blind confidence in an overruling

Providence, that in the end all will come well—may vanish as the

baseless fabric of a vision. It is in vain to call upon the local

authorities to supply a larger quantity of water, if we either from

ignorance or indolence neglect to use it. It is in vain to call upon

landlords to build houses properly drained and ventilated if those who

take them are ignorant and indifferent to the value of fresh air and

good drainage. Dirt is allowed to begrime the walls, so as to render

it difficult to tell what the original colour was; in a word, many of

the rooms in George-street, Charles-street, Little Bell-street, Little

Church-street, East-cottages, and many others in my district, are so

neglected by the tenants as to become neither more nor less than fever

nests. Soap and water and white lime, to judge from the condition of

very many of the rooms in my district, might be as expensive a luxury

as salt in Abyssinia. Every traveller that visits tropical countries

is sure to complain of the annoyance and inconvenience of mosquitoes,

and I am equally sure that every visitor to the dwellings of the

poor in the locality I have indicated might reasonably complain of

the visitors, who, on account of the dirt, have taken up a permanent

residence, but whose name it is not deemed polite to mention, though as

far as number is concerned they might be justly termed legion.

Almost without exception the poor bear the marks on their own body of

their careless indifference to the laws of health and cleanliness.

I do not believe that the poor are too bad to be mended, nor that

they are too dirty to be taught the necessity and desirability of

cleanliness. Those who suffer thus from sanitary mismanagement are not

to be improved by calling them filthy, incorrigible, and worthless,

but by kindly pointing out the evils which arise from their own

carelessness, and suggesting remedies which they themselves can

carry into operation. The very worst have some good in them, and by

appealing to that good in a kindly, honest spirit we may arouse that

laudable ambition of self-respect and self-help, which will do more to

improve the sanitary and social condition of the needy poor than could

be accomplished by extraneous help, if it did not secure the hearty

sympathy and co-operation of the poor. Until the poor take an interest

in their homes and feel a pride in preserving them clean, healthy, and

comfortable, we shall always be hearing of and seeing the homes of

the poor in a dilapidated condition. Flooring and doors will be used

as firewood—sewers will be blocked up by materials that ought never

to have been thrown down—dirt, filth, and all manner of rubbish will

be allowed to accumulate—how is this to be remedied? To remedy this

evil, mere obstructiveness and selfishness must get out of the way. The

homes of the poor must be cleansed, repaired, and made comfortable;

and then if cleanliness were made a condition of tenancy as I have had

occasion before to suggest, it would go a long way to keep the property

in repair. I feel confident that where tenants keep their rooms clean

they acquire an interest in them, and do not destroy nor wilfully

damage them. Further, every effort ought to be made to instruct the

poor in the knowledge of the laws of health. Let it be clearly shown

to them that dirt, disease, and poverty, are intimate companions, and

that if they would escape from the bitter experience of poverty, they

must each sweep before their own doors; then a future, gilded with the

promise of a joyous hope, shall open up before their view. Dirt with

all its disgusting associations shall be supplanted by cleanliness with

all its cheering comforts; disease manifesting itself in the emaciated

body, the anxious brow, the glazed eye, and shrivelled face, shall give

place to joyous health, with firm elastic step, with ruddy face, bright

sparkling eye, and the alacrity and pleasure with which labour and toil

is welcomed. Poverty in all its intensified bitterness, when associated

with disease shall give place to a comfortable competency. This and

much more may justly be expected, if we sow aright the seeds of the

science of life, and teach men the laws which govern their health

and life. The proper study of mankind is man; a more comprehensive

principle has seldom been enunciated. Man in all his relations is

too vast a subject for us to contemplate, therefore we purpose the

consideration of man in his social relations, in so far as these

relations bear upon the health of the individual or the community of

which we form a part. It would be well if we all took a deeper interest

in the welfare of each other, if we felt that any disease, epidemic,

or misfortune, that affects any member of the community, must by the

common law of relationship, affect us; the man who wilfully breaks the

laws of health, not only injures himself and his next of kin, but he

injures society, of which he is a member, by depriving society of the

creative wealth of labour; hence we see that the individual welfare and

the prosperity of the commonwealth, depends upon a right understanding

of those great laws by which the Creator governs the health and life

of man. I know of few places where personal cleanliness is at a lower

standard than in many of the small streets in my district, therefore at

the risk of being personal, I must press the subject of the importance

of baths. All nations have valued baths, some have regarded ablutions

as a necessary part of their religion, and have accordingly most

faithfully carried into daily practice their ablutions. Others have

regarded the bath as a luxury, and only to be indulged in occasionally.

There are those who inhabit the far, far north, where mountains of

ice wreathed in the scintillations of the northern lights tower in

colossal grandeur. The cold is so intense, that animal and vegetable

life struggle feebly to maintain an existence, nevertheless there

man prizes his bath. There are nations basking beneath a tropical

sun, where vegetation revels in luxurious richness, where birds with

gorgeous plumage carol in the clear blue sky, and dolphins as they

sport in the water sparkle and glitter like a thousand gems, and here

man values the bath as one of the best gifts of the great Creator. Nor

was ancient Greece or Rome backward in discovering the value of the

bath as a sanitary and curative agent. They bear us ample testimony of

the high value they put upon baths. In this short paper it would be

an impossibility to discuss the various kinds of baths, hot, shower,

swimming, cold, Turkish, and vapour baths; neither can it be expected

that I should indicate the relative value of each to particular

conditions of health or disease, but we may rest assured that each kind

of bath may, when rightly used, be regarded as a health preserving and

health restoring agent.

In order fairly to estimate the value of baths, we ought to know

something of the structure and functions of the skin. The skin is

furnished with millions of little holes and tubes, these holes are

called the pores of the skin, through which watery vapour or sweat is

poured out; it is estimated that there are no less than 3,000 of the

tubes and holes pouring out sweat in space not larger than a shilling,

so that as long as the skin is kept clean, sweat or watery vapour is

poured out from the skin. This sweat contains decaying and poisonous

waste matter, which is worse than useless to the system. Hence the

importance of baths and personal ablutions. Further, the healthy action

of the skin bears a greater relation to our health than we might at

first imagine. The function or office of the skin is closely correlated

with the office of other internal organs. The skin performs the various

functions of absorption, secretion, excretion, &c. If the skin fails in

its duty, the work is thrown upon the liver and kidneys, consequently,

they are doing double duty, and if not soon relieved they become

overtaxed, and consequently injured. Further, a dirty skin affects our

spirits; if the skin is dirty the terminal branches of nerves and blood

vessels are not benefited and strengthened by atmospheric air. I hope

the above is simple and intelligible, and that I have shown that it is

impossible to enjoy life if we allow our skin to be clogged with dirt.

We have seen the vital importance of fresh air and pure water. Yet,

as Dr. Lankester so suggestively remarks in his address upon public

health at the last Social Science Congress, “As the animal organism

cannot live in air and water, but requires the varied compounds of

carbon, oxygen, hydrogen, and nitrogen for its existence, the whole

question of the relation of the elements used as food becomes the

subject of our inquiries. Here our researches are based especially on

chemical facts, and we must take for our guides Mülder and Liebig, and

the great school of chemical physiologists. The freshest air and the

purest water will be no protection from disease and death, unless the

human system is supplied in its food with the elements necessary for

the play of those chemical forces which result in life. Not only must

there be food supplying the materials of combustion and nutrition,

but each tissue is built up and constituted its own peculiar way. The

blood must be supplied with chloride of sodium and iron, the bones with

phosphate, carbonate, and fluate of lime; the muscles with potash; the

bile with sulphur; the saliva with cyanogen; the teeth, hair and nails

with silica. A diet deficient of any of these materials may be the

source of disease. Our navy was formerly decimated for want of fresh

vegetables, our army was starved on an excessive diet of salt beef, our

children die if fed alone on arrowroot or corn-flour. Those who inhale

abundance of fresh air, and have access to infinite stores of pure

water, nevertheless fall easy victims to diseases which result from the

rebundance or deficiency of the compounds which, in natural quantities,

constitute the source of their daily life.”

From the above comprehensive sketch of the principles of diet, we see

to what an extent food influences the health of the individual, and

consequently the prosperity and happiness of the nation. The subject of

diet is so important, so full of interest, and opens so wide a field

for interesting investigation, that I feel I cannot do better than

refer those who wish for scientific information conveyed in popular

terms on the subject of food, to Dr. Lankester’s “Lectures on Food;”

and, in conclusion, I would say that it is only when the processes of

digestion, respiration, and elimination, are in proper correlation,

that we can expect either to enjoy or preserve good health.

The Sanitary Condition of the Poor in Relation to Disease, Poverty, and Crime With an appendix on the control and prevention of infectious diseases · 第 6 / 7 题