│ │ │
│ │ │
│ │ │
│ │ │
│ COUNTIES. │Number of Deaths during the Year ended │
│ │ 31st December, 1838 from │
│ │ │
│ │ │
│ │ │
│ ├───────────────────────────────────────┤
│ │ │
│ │ │
│ │ 1 │
│ │ Epidemic, Endemic, and Contagious │
│ │ Diseases. │
│ │ │
│ │ │
│ ├───────────┬──────────┬────────┬───────┤
│ │ Fever: │ │ │Hooping│
│ │ Typhus, │Small-pox.│Measles.│Cough. │
│ │Scarlatina.│ │ │ │
├───────────┼───────────┼──────────┼────────┼───────┤
│ ENGLAND. │ │ │ │ │
│Bedford │ 155│ 75│ 40│ 66│
│Berks │ 204│ 288│ 21│ 86│
│Bucks │ 256│ 85│ 61│ 27│
│Cambridge │ 231│ 136│ 57│ 90│
│Chester │ 592│ 279│ 178│ 87│
│Cornwall │ 443│ 135│ 168│ 491│
│Cumberland │ 165│ 188│ 11│ 83│
│Derby │ 394│ 77│ 79│ 71│
│Devon │ 615│ 460│ 287│ 312│
│Dorset │ 137│ 255│ 80│ 58│
│Durham │ 347│ 316│ 139│ 304│
│Essex │ 417│ 460│ 83│ 163│
│Gloucester │ 352│ 457│ 440│ 244│
│Hereford │ 84│ 83│ 17│ 36│
│Hertford │ 160│ 116│ 45│ 48│
│Huntingdon │ 61│ 18│ 1│ 17│
│Kent │ 955│ 510│ 169│ 214│
│Lancaster │ 2866│ 1628│ 898│ 910│
│Leicester │ 273│ 98│ 17│ 70│
│Lincoln │ 370│ 138│ 29│ 88│
│Middlesex │ 4422│ 3359│ 487│ 1749│
│Monmouth │ 328│ 321│ 49│ 91│
│Norfolk │ 515│ 126│ 63│ 109│
│Northampt^n│ 348│ 148│ 36│ 36│
│Northumb^d │ 366│ 149│ 46│ 113│
│Nottingham │ 222│ 73│ 18│ 80│
│Oxford │ 222│ 81│ 51│ 59│
│Rutland │ 11│ 2│ │ 13│
│Salop │ 213│ 154│ 112│ 138│
│Somerset │ 560│ 710│ 401│ 46│
│Southampt^n│ 454│ 164│ 78│ 148│
│Stafford │ 610│ 249│ 182│ 268│
│Suffolk │ 480│ 325│ 53│ 158│
│Surrey │ 1348│ 814│ 177│ 565│
│Sussex │ 391│ 80│ 159│ 88│
│Warwick │ 454│ 415│ 153│ 164│
│Westmorel^d│ 41│ 40│ 6│ 41│
│Wilts │ 246│ 259│ 263│ 140│
│Worcester │ 381│ 305│ 122│ 258│
│York, E. R.│ 194│ 92│ 167│ 149│
│York, N. R.│ 123│ 28│ 69│ 114│
│York, W. R.│ 1298│ 993│ 799│ 507│
│ │ │ │ │ │
│ WALES. │ │ │ │ │
│North. │ 660│ 575│ 4│ 210│
│South. │ 1613│ 1004│ 199│ 398│
├───────────┼───────────┼──────────┼────────┼───────┤
│Total, 1838│ 24,577│ 16,268│ 6514│ 9107│
╞═══════════╪═══════════╪══════════╪════════╪═══════╡
│Total, 1839│ 25,991│ 9131│ 10,937│ 8165│
└───────────┴───────────┴──────────┴────────┴───────┘
┌───────────┬────────────────────────────────┐
│ │ │
│ │ │
│ │ │
│ │ │
│ COUNTIES. │Number of Deaths during the Year│
│ │ ended 31st December, 1838 from │
│ │ │
│ │ │
│ │ │
│ ├────────────────────────────────┤
│ │ │
│ │ │
│ │ 2 │
│ │ Diseases of Respiratory Organs │
│ │ │
│ │ │
│ │ │
│ ├────────────┬──────────┬────────┤
│ │ │ │ All │
│ │Consumption.│Pneumonia.│ other │
│ │ │ │Classes.│
├───────────┼────────────┼──────────┼────────┤
│ ENGLAND. │ │ │ │
│Bedford │ 457│ 97│ 57│
│Berks │ 739│ 231│ 162│
│Bucks │ 575│ 131│ 61│
│Cambridge │ 686│ 156│ 70│
│Chester │ 1742│ 366│ 345│
│Cornwall │ 1270│ 342│ 124│
│Cumberland │ 562│ 75│ 142│
│Derby │ 905│ 200│ 205│
│Devon │ 1649│ 564│ 298│
│Dorset │ 571│ 146│ 106│
│Durham │ 1007│ 362│ 207│
│Essex │ 1250│ 276│ 234│
│Gloucester │ 1395│ 578│ 476│
│Hereford │ 333│ 56│ 57│
│Hertford │ 620│ 107│ 90│
│Huntingdon │ 216│ 45│ 42│
│Kent │ 1701│ 564│ 526│
│Lancaster │ 8124│ 2660│ 1916│
│Leicester │ 941│ 243│ 154│
│Lincoln │ 874│ 248│ 242│
│Middlesex │ 6220│ 3097│ 2334│
│Monmouth │ 481│ 183│ 78│
│Norfolk │ 1388│ 325│ 281│
│Northampt^n│ 762│ 192│ 124│
│Northumb^d │ 715│ 287│ 240│
│Nottingham │ 911│ 225│ 201│
│Oxford │ 655│ 108│ 152│
│Rutland │ 64│ 14│ 8│
│Salop │ 995│ 242│ 168│
│Somerset │ 1446│ 426│ 373│
│Southampt^n│ 1222│ 338│ 331│
│Stafford │ 1809│ 539│ 419│
│Suffolk │ 1306│ 315│ 184│
│Surrey │ 2196│ 978│ 700│
│Sussex │ 1047│ 222│ 181│
│Warwick │ 1495│ 678│ 361│
│Westmorel^d│ 248│ 33│ 44│
│Wilts │ 869│ 268│ 212│
│Worcester │ 990│ 353│ 235│
│York, E. R.│ 725│ 194│ 176│
│York, N. R.│ 550│ 102│ 135│
│York, W. R.│ 4253│ 1202│ 848│
│ │ │ │ │
│ WALES. │ │ │ │
│North. │ 1227│ 102│ 223│
│South. │ 1834│ 129│ 277│
├───────────┼────────────┼──────────┼────────┤
│Total, 1838│ 59,025│ 17,999│ 13,799│
╞═══════════╪════════════╪══════════╪════════╡
│Total, 1839│ 59,559│ 18,151│ 12,855│
└───────────┴────────────┴──────────┴────────┘
┌───────────┬───────────────────────────────┬───────────┬───────────┐
│ │ │Proportion │Proportion │
│ │ │ of Deaths │ of Deaths │
│ │ │ from the │ from all │
│ │ │ preceding │ Causes of │
│ COUNTIES. │ Number of Deaths during the │ Causes in │ Mortality │
│ │Year ended 31st December, 1838 │every 1000 │ in every │
│ │ from │ of the │1000 of the│
│ │ │Population,│Population,│
│ │ │ 1841. │ 1841. │
│ ├─────────┬─────────┬───────────┤ │ │
│ │ 3 │ │ │ │ │
│ │Diseases │ 4 │ Total │ │ │
│ │of Brain │Diseases │Deaths from│ │ │
│ │ Nerves │ of │ the four │ │ │
│ │ and │Digestive│ preceding │ │ │
│ │ Senses. │ Organs │Classes of │ │ │
│ │ │ │ Diseases. │ │ │
│ │ │ │ │ │ │
│ │ │ │ │ │ │
│ │ │ │ │ │ │
│ │ │ │ │ │ │
├───────────┼─────────┼─────────┼───────────┼───────────┼───────────┤
│ ENGLAND. │ │ │ │ │ │
│Bedford │ 304│ 131│ 1382│ 13│ 22│
│Berks │ 467│ 201│ 2399│ 15│ 25│
│Bucks │ 348│ 152│ 1696│ 11│ 19│
│Cambridge │ 318│ 189│ 1933│ 12│ 21│
│Chester │ 1442│ 421│ 5452│ 14│ 21│
│Cornwall │ 631│ 228│ 3832│ 11│ 18│
│Cumberland │ 278│ 169│ 1673│ 9│ 21│
│Derby │ 777│ 268│ 2976│ 11│ 18│
│Devon │ 1237│ 471│ 5893│ 11│ 18│
│Dorset │ 380│ 159│ 1892│ 11│ 19│
│Durham │ 1138│ 274│ 4094│ 13│ 21│
│Essex │ 782│ 268│ 3933│ 11│ 19│
│Gloucester │ 1142│ 510│ 5594│ 13│ 20│
│Hereford │ 238│ 62│ 966│ 8│ 18│
│Hertford │ 453│ 155│ 1794│ 11│ 20│
│Huntingdon │ 140│ 72│ 612│ 10│ 18│
│Kent │ 1650│ 651│ 6940│ 13│ 21│
│Lancaster │ 7457│ 3231│ 29690│ 18│ 25│
│Leicester │ 668│ 314│ 2778│ 13│ 21│
│Lincoln │ 1090│ 358│ 3437│ 9│ 17│
│Middlesex │ 6643│ 2492│ 30803│ 20│ 27│
│Monmouth │ 550│ 100│ 2181│ 16│ 24│
│Norfolk │ 793│ 395│ 3995│ 10│ 19│
│Northampt^n│ 503│ 212│ 2361│ 12│ 21│
│Northumb^d │ 709│ 388│ 3013│ 12│ 21│
│Nottingham │ 901│ 287│ 2918│ 12│ 20│
│Oxford │ 389│ 180│ 1897│ 12│ 21│
│Rutland │ 56│ 28│ 196│ 9│ 17│
│Salop │ 550│ 284│ 2856│ 12│ 21│
│Somerset │ 982│ 473│ 5417│ 12│ 21│
│Southampt^n│ 881│ 372│ 3988│ 17│ 19│
│Stafford │ 1251│ 597│ 5924│ 12│ 18│
│Suffolk │ 538│ 275│ 3634│ 12│ 20│
│Surrey │ 2325│ 763│ 9866│ 11│ 25│
│Sussex │ 863│ 295│ 3326│ 11│ 18│
│Warwick │ 978│ 638│ 5336│ 13│ 20│
│Westmorel^d│ 154│ 46│ 653│ 12│ 21│
│Wilts │ 606│ 241│ 3104│ 12│ 20│
│Worcester │ 645│ 446│ 3735│ 16│ 29│
│York, E. R.│ 1009│ 251│ 2957│ 13│ 21│
│York, N. R.│ 553│ 1861│ │ 9│ 17│
│York, W. R.│ 4374│ 1494│ 15768│ 14│ 21│
│ │ │ │ │ │ │
│ WALES. │ │ │ │ │ │
│North. │ 1311│ 198│ 4510│ 13│ 18│
│South. │ 1200│ 380│ 7034│ 14│ 21│
├───────────┼─────────┼─────────┼───────────┼───────────┼───────────┤
│Total, 1838│ 49,704│ 19,306│ 216,299│ 14│ 22│
╞═══════════╪═════════╪═════════╪═══════════╪═══════════╪═══════════╡
│Total, 1839│ 49,215│ 20,767│ 214,771│ 14│ 21│
└───────────┴─────────┴─────────┴───────────┴───────────┴───────────┘
Extent of evils which are the subject of inquiry
The registration of the causes of death for the year 1838 is selected,
as that was the year when the report was made on the sanitary condition
of the labouring population in the metropolis, which has served as the
foundation of the extended inquiry.
There are no returns, and no adequate data for returns, to show the
proportion in which deaths from the several causes above specified occur
amongst the population of Scotland, but there is evidence to which
reference will subsequently be made tending to prove that the mortality
from fever is greater in Glasgow, Edinburgh, and Dundee than in the most
crowded towns in England.
The registered mortality from all specified diseases in England and
Wales was, during the year 1838, 282,940, or 18 per thousand of the
population. These deaths are exclusive of the deaths from old age, which
amounted to 35,564, and the deaths from violence, which amounted to
12,055. The deaths from causes not specified were 11,970. The total
amount of deaths was 342,529 for that year. In the year following the
total deaths were 338,979, of which the registered deaths from old age
were 35,063, and the deaths from violence 11,980. The proportion of
deaths for the whole population was 21 per thousand.
It appears that fever, after its ravages amongst the infant population,
falls with the greatest intensity on the adult population in the vigour
of life. The periods at which the ravages of the other diseases,
consumption, small-pox, and measles take place, are sufficiently well
known. The proportions in which the diseases have prevailed in the
several counties will be found deserving of peculiar attention.
A conception may be formed of the aggregate effects of the several
causes of mortality from the fact, that of the deaths caused during one
year in England and Wales by epidemic, endemic, and contagious diseases,
including fever, typhus, and scarlatina, amounting to 56,461, the great
proportion of which are proved to be preventible, it may be said that
the effect is as if the whole county of Westmoreland, now containing
56,469 souls, or the whole county of Huntingdonshire, or any other
equivalent district, were entirely depopulated annually, and were only
occupied again by the growth of a new and feeble population living under
the fears of a similar visitation. The annual slaughter in England and
Wales from preventible causes of typhus which attacks persons in the
vigour of life, appears to be double the amount of what was suffered by
the Allied Armies in the battle of Waterloo. It will be shown that
diseases such as those which now prevail on land, did within the
experience of persons still living, formerly prevail to a greater extent
at sea, and have since been prevented by sanitary regulations; and that
when they did so prevail in ships of war, the deaths from them were more
than double in amount of the deaths in battle. But the number of persons
who die is to be taken also as the indication of the much greater number
of persons who fall sick, and who, although they escape, are subjected
to the suffering and loss occasioned by attacks of disease. Thus it was
found on the original inquiry in the metropolis, that the deaths from
fever amounted to 1 in 10 of the number attacked. If this proportion
held equally throughout the country, then a quarter of a million of
persons will have been subjected to loss and suffering from an attack of
fever during the year; and in so far as the proportions of attacks to
deaths is diminished, so it appears from the reports is the intensity
and suffering from the disease generally increased. It appears that the
extremes of mortality at the Small-pox Hospital, in London, amongst
those attacked, have been 15 per cent. and 42 per cent. But if,
according to other statements, the average mortality be taken at 1 in 5,
or 20 per cent., the number of persons attacked in England and Wales
during the year of the return, must amount to upwards of 16,000 persons
killed, and more than 80,000 persons subjected to the sufferings of
disease, including, in the case of the labouring classes, the loss of
labour and long-continued debility; and in respect to all classes, often
permanent disfigurement, and occasionally the loss of sight.
In a subsequent part of this report, evidence will be adduced to show in
what proportion these causes of death fall upon the poorer classes as
compared with the other classes of society inhabiting the same towns or
districts, and in what proportions the deaths fall amongst persons of
the same class inhabiting districts differently situated.
The first extracts present the subjects of the inquiry in their general
condition under the operation of several causes, yet almost all will be
found to point to one particular, namely, atmospheric impurity,
occasioned by means within the control of legislation, as the main cause
of the ravages of epidemic, endemic, and contagious diseases among the
community, and as aggravating most other diseases. The subsequent
extracts from the sanitary reports from different places will show that
the impurity and its evil consequences are greater or less in different
places, according as there is more or less sufficient drainage of
houses, streets, roads, and land, combined with more or less sufficient
means of cleansing and removing solid refuse and impurities, by
available supplies of water for the purpose. Then will follow the
description of the effects of overcrowding the places of work and
dwellings, including the effects of the defective ventilation of
dwelling-houses, and of places of work where there are fumes or dust
produced. To these will be added the information collected as to the
good or evil moral habits promoted by the nature of the residence. These
will form so many successive sections of the report, and will be
followed by information in respect to the means available for the
prevention of the evils described, and an exposition of the present
state of the law for the protection of the public health, and of
modifications apparently requisite to secure the desired results.
I.—GENERAL CONDITION OF THE RESIDENCES OF THE LABOURING CLASSES WHERE
DISEASE IS FOUND TO BE THE MOST PREVALENT.
The following extracts will serve to show, in the language chiefly of
eye-witnesses, the varied forms in which disease attendant on removable
circumstances appears from one end of the island to the other amidst the
population of rural villages, and of the smaller towns, as well as
amidst the population of the commercial cities and the most thronged of
the manufacturing districts—in which last pestilence is frequently
supposed to have its chief and almost exclusive residence.
Commencing with the reports on the sanitary condition of the population
in Cornwall and Devon, _Mr. Gilbert_, when acting as Assistant
Commissioner for those counties, reports, that he found the open drains
and sewers the most prominent cause of malaria. He gives the following
as an instance of the common condition of the dwellings of the labouring
classes in Devon, where it will be observed that the registered deaths
from the four classes of disease amounted in one year to 5893 cases.
“In Tiverton there is a large district, from which I find numerous
applications were made for relief to the Board of Guardians, in
consequence of illness from fever. The expense in procuring the
necessary attention and care, and the diet and comforts recommended by
the medical officer, were in each case very high, and particularly
attracted my attention.
“I requested the medical officer to accompany me through the district,
and with him, and afterwards by myself, I visited the district, and
examined the cottages and families living there. The land is nearly on
a level with the water, the ground is marshy, and the sewers all open.
Before reaching the district, I was assailed by a most disagreeable
smell; and it was clear to the sense that the air was full of most
injurious malaria. The inhabitants, easily distinguishable from the
inhabitants of the other parts of the town, had all a sickly,
miserable appearance. The open drains in some cases ran immediately
before the doors of the houses, and some of the houses were surrounded
by wide open drains, full of all the animal and vegetable refuse not
only of the houses in that part, but of those in other parts of
Tiverton. In many of the houses, persons were confined with fever and
different diseases, and all I talked to either were ill or had been
so: and the whole community presented a melancholy spectacle of
disease and misery.
“Attempts have been made on various occasions by the local authorities
to correct this state of things by compelling the occupants of the
houses to remove nuisances, and to have the drains covered; but they
find that in the present state of the law their powers are not
sufficient, and the evil continues and is likely so to do, unless the
legislature affords some redress in the nature of sanitary powers.
Independently of this nuisance, Tiverton would be considered a fine
healthy town, situate as it is on the slope of a hill, with a swift
river running at its foot.
“It is not these unfortunate creatures only who choose this centre of
disease for their living-place who are affected; but the whole town is
more or less deteriorated by its vicinity to this pestilential mass,
where the generation of those elements of disease and death is
constantly going on.
“Another cause of disease is to be found in the state of the cottages.
Many are built on the ground without flooring, or against a damp hill.
Some have neither windows nor doors sufficient to keep out the
weather, or to let in the rays of the sun, or supply the means of
ventilation; and in others the roof is so constructed or so worn as
not to be weather tight. The thatch roof frequently is saturated with
wet, rotten, and in a state of decay, giving out malaria, as other
decaying vegetable matter.”
The report of _Dr. Barham_, on the sanitary condition of the town of
Truro, gives instances of the condition of the town population in that
part of the country. He states—
“The perfect immunity from deaths by _febrile_ and _acute_ diseases,
enjoyed by Lemon-street during the long period of three years and a
half, is a strong testimony to the value of the breadth of its
roadway, the openness of its site, and the judicious construction of
the houses; for it has to contend with a great deficiency of sewerage.
Fairmantle and Daniell-streets are modern, and are occupied by small
traders, and by decent artisans and labourers; the _former_ lies
rather low, the _latter_ is on a considerable elevation; both are
fairly drained, and are healthy. Charles, Calenick, and Kenwyn-streets
present some of the worst specimens of defective arrangement, rendered
worse still by the recklessness of the very poor, which can be met
with in Truro. The amount of _pauper sickness_ is considerable, the
deaths not few. The two latter streets are, in the greater part of
their length, but little raised above high-water mark. Passing into
_St. Mary’s_ parish, the proportion of sickness and even of deaths in
Castle-street and Castle-hill is, to their extent and population, as
great, perhaps, as that of any part of Truro; yet their situation is
elevated and favourable. There is, however, no mystery in the
causation. Ill-constructed houses, many of them old, with decomposing
refuse close upon their doors and windows, open drains bringing the
oozings of pigsties and other filth to stagnate at the foot of a wall,
between which and the entrances to a row of small dwellings there is
only a very narrow passage; such are a few of the sources of disease
which the breeze of the hill cannot always dissipate. Similar causes
have produced like effects in the courts adjacent to Pyder-street, to
the High Cross, and to St. Clement’s-streets, and in Bodmin-street and
Good-wives’-lane, the situations being all more or less confined. The
benefits, on the other hand, derived from open rows, and cottages of a
better construction are evidenced in Boscawen and Paul’s-row, and St.
Clements’-terrace, which are well ventilated, and consequently suffer
less from the scanty provision of drains and other conveniences.
“A detailed account of the public sewers is given in the Appendix, and
is believed to be nearly, if not quite, complete. Many of these are of
recent date, and owe their existence to the alarm excited when the
cholera was near at hand. Some of them are made to discharge
themselves into the rivers; and such of these as are swept by a stream
of water are unobjectionable in themselves. Several others stop short
of this desirable termination, and, after collecting filth from
various localities, deposit a portion in catch-pits here and there,
and finally open on the surface, frequently in some street or lane,
where a neglected deposit of a mixed animal and vegetable nature is
allowed to become a probable source of annoyance or mischief. Much of
this incompleteness may be removed (as regards the main lines of
sewerage) at no great expense; and it is said to be the intention of
the commissioners of improvement to remedy the deficiency, when they
are free from the debt with which they are now encumbered. Many of the
smaller sewers are, however, much too narrow to be effective, and some
of them are no better than covered drains. But the greatest evils in
this department are unquestionably those which spring from the
ignorance, cupidity, or negligence of landlords. It is useless to have
a good sewer carried through the centre of a street, if the houses at
the sides, and still more those situated in courts and lanes
adjoining, have no communicating drains; and it is worse than useless
to furnish these backlets with the mere semblance of drains—gutters
forming pits here and there—then as they approach the street, perhaps
slightly covered so as to produce obstruction more frequently than
protection, a concentrated solution of all sorts of decomposing refuse
being allowed to soak through and thoroughly impregnate the walls and
ground adjoining. One or more of these mischievous conditions is to be
found in connexion with a large proportion of the older houses in
Truro, excepting the better class; and in many of the courts and
backlets all these evils are in full operation. I have repeatedly
noticed in the country that the occurrence of fever has been connected
with _near proximity to even a small amount of decomposing organic
matter_; and it is certain that all measures for effecting improvement
in the sewerage of streets, the supply of water, and ventilation, may
be rendered nearly inoperative for the obviating of the causes of
disease, if a little nidus of morbific effluvia be permitted to remain
in almost every corner of the confined court; where the poor man opens
his narrow habitation in the hope of refreshing it with the breeze of
summer, but gets instead a mixture of gases from reeking dunghills,
or, what is worse, because more insidious, from a soil which has
become impregnated with organic matters imbibed long before; and now,
though, perhaps, to all appearance dry and clean, emitting the
poisonous vapour in its most pernicious state. Nothing short of the
placing in proper hands a peremptory authority for the removal of what
is hurtful, and the supply of what is defective, making the exercise
of that authority a duty, can remedy the existing evils.
“The houses occupied by the lower orders do not often exceed two
stories in height, and it is rare to find families occupying less than
two rooms. The more recent additions to the town—I speak of residences
of the humbler class—have mainly consisted of rows of moderate
cottages, having, the majority of them, gardens in front, and usually
containing four rooms, commonly occupied by a single family. Some
instances have, however, occurred of the building of a very inferior
class of dwellings, which will be hereafter pointed out.
“No interments now take place in the town, the present burying-ground
being at the distance of a third of a mile to the north of the church.
The slaughter-houses are all, or nearly all, situated in populous
parts, and occasionally constitute a decided nuisance. No
manufactories exist which can be looked upon as prejudicial from any
effluvia to which they give rise. The gas-works and smelting-houses
are so placed that no mischievous effects can fairly be attributed to
them.”
The state of the dwellings of many of the agricultural labourers in
Dorset, where the deaths from the four classes of disease bear a similar
proportion to those in Devon, is described in the return of _Mr. John
Fox_, the medical officer of the Cerne union, who, remarking upon some
cases of disease among the poor whom he had attended, says,—