(formerly a poor house) occupied by nearly 50 persons on the
ground-floor; the rooms are neither boarded nor paved, and generally
damp; some of them are occupied by two families. The up-stairs rooms
are small and low, and separated from each other by boards only.
Eleven persons slept in one room. The house stands in a valley between
two hills, very little above the level of the river, which
occasionally overflows its banks, and within a few yards of it. There
is generally an accumulation of filth of every description in a gutter
running about two feet from its front, and a large cesspool within a
few feet behind. The winter stock of potatoes was kept in some of the
day-rooms, and generally put away in a wet state. The premises had not
been white-limed during three years; in addition to this state of
things, the poor were badly fed, badly clothed, and many of them
habitually dirty, and consequently typhus, synochus, or diarrhœa,
constantly prevailed. No house-rent was paid by the occupants. Many,
under more favourable circumstances were clean and tidy, and if their
wages were sufficient to enable them to rent a decent cottage, I have
no doubt they would soon regain their lost spirit of cleanliness. In
this same parish I have often seen the springs bursting through the
_mud_ floor of some of the cottages, and little channels cut from the
centre under the doorways to carry off the water, whilst the door has
been removed from its hinges for the children to put their feet on
whilst employed in making buttons. Is it surprising that fever and
scrofula in all its forms prevail under such circumstances?
“It is somewhat singular that seven cases of typhus occurred in one
village heretofore famed for the health and general cleanliness of its
inhabitants and cottages. The first five cases occurred in one family,
in a detached house on high and dry ground, and free from
accumulations of vegetable or animal matter. The cottage was
originally built for a school-room, and consists of one room only,
about 18 feet by 10, and 9 high. About one-third part was partitioned
off by boards reaching to within three feet of the roof, and in this
small space were three beds, in which six persons slept; had there
been two bed-rooms attached to this one day-room, these cases of
typhus would not have occurred. The fatal case of typhus occurred in a
very small village, containing about sixty inhabitants, and from its
locality it appears favourable to the production of typhus, synochus,
and acute rheumatism. It stands between two hills, with a river
running through it, and is occasionally flooded. It has extensive
water meadows both above and below, and a farm-yard in the centre,
where there is always a large quantity of vegetable matter undergoing
decomposition. Most of the cases of synochus occurred under
circumstances favourable to its production. Most of the cottages being
of the worst description, some mere mud hovels, and situated in low
and damp places with cesspools or accumulations of filth close to the
doors. The _mud floors_ of many are much below the level of the road,
and in wet seasons are little better than so much clay. The following
shocking case occurred in my practice. In a family consisting of six
persons, two had fever; the mud floor of their cottage was at least
one foot below the lane; it consisted of _one_ small room only, in the
centre of which stood a foot-ladder reaching to the edge of a platform
which extended over nearly one-half of the room, and upon which were
placed two beds, with space between them for one person only to stand,
whilst the outside of each touched the thatch. The head of one of
these beds stood within six inches of the edge of the platform, and in
this bed one of my unfortunate patients, a boy about 11 years old, was
sleeping with his mother, and in a fit of delirium jumped over the
head of his bed and fell to the ground below, a height of about seven
feet. The injury to the head and spine was so serious that he lived a
few hours only after the accident. In a cottage fit for the residence
of a human being this could not have occurred. In many of the
cottages, also, where synochus prevailed, the beds stood on the
ground-floor, which was damp three parts of the year; scarcely one had
a fire-place in the bed-room, and one had a single small pane of glass
stuck in the mud wall as its only window, with a large heap of wet and
dirty potatoes in one corner. Persons living in such cottages are
generally very poor, very dirty, and usually in rags, living almost
wholly on bread and potatoes, scarcely ever tasting animal food, and
consequently highly susceptible of disease and very unable to contend
with it. I am quite sure if such persons were placed in good,
comfortable, clean cottages, the improvement in themselves and
children would soon be visible, and the exceptions would only be found
in a few of the poorest and most wretched, who perhaps had been born
in a mud hovel, and had lived in one the first 30 years of their
lives.
“In my district I do not think there is _one_ cottage to be found
consisting of a day-room, three bed-rooms, scullery, pantry, and
convenient receptacles for refuse and for fuel in the occupation of a
labourer, but there are many consisting of a day-room and two
bed-rooms, constructed with a due regard to ventilation and warmth,
pantry, and fuel house, with a small garden and pigsty adjoining, and
the labourers occupying such cottages, generally speaking, are far
superior to others less advantageously situated. Their persons and
cottages are always neater and cleaner, they are less disposed to
frequent the beer-houses or to engage in poaching, whilst their
children are generally sent daily to some school, in many instances
chiefly supported by the clergyman of the parish. As a corroboration
of my opinion, I need only state that I am frequently employed by the
labourers in the good cottages to attend their wives during their
confinement, and generally receive my guinea before I leave the house,
whilst the labourer less favourably situated invariably applies to his
parish for medical relief under such circumstances. I think there
cannot be a doubt if the whole of the wretched hovels were converted
into good cottages, with a strict attention to warmth, ventilation,
and drainage, and a receptacle for filth of every kind placed at a
proper distance, it would not only improve the health of the poor by
removing a most prolific source of disease, and thereby most sensibly
diminish the rates, but I am convinced it would also tend most
materially to raise the moral character of the poor man, and render
him less susceptible to the allurements of the idle and wicked.”
The tenor of much information respecting the condition of many of the
labouring classes in Somerset, where the deaths from the four classes of
disease were still higher than in the two other counties, and amounted
during the one year to 5417, is exhibited in the sanitary report of _Mr.
James Gane_, the medical officer of the Axbridge union, who states
that,—
“The situation of this district where the diseases herein mentioned
prevail, is a perfect flat called the South Marsh, in the main road
between Bristol and Bridgewater. There are numerous dykes or ditches
for the purpose of drainage. The cottages of the poor are mostly of a
bad description, frequently mud wall, and often situated close to the
dykes, where the water for the most part is in a state of stagnation.
Oftentimes not more than one room for the whole family; sometimes two;
one above the other; with the really poor, the latter is seldom to be
met with, (unless it should happen now and then in a parish where a
poor-house was built a short time before the formation of the Union).
A pigsty where the inmates are capable of keeping a pig is frequently
attached to the dwelling, and in the heat of summer produces a stench
quite intolerable; the want of space however prevents it being
otherwise. The regular poor-house (those mentioned above being
detached cottages) in most of the parishes in this district are of a
much worse description, several large families existing under the same
roof, occupying only one room each family, and having but one entrance
door to the dwelling; here filth and poverty go hand-in-hand without
any restriction and under no control. The accumulation of filth being
attributable to the want of proper receptacles for refuse, and the
indolent and filthy disposition of the inhabitants, in no instance
_have_ such places been provided. The floors are seldom or never
scrubbed; and the parish authorities pay so little attention to these
houses, that the walls never get white-limed from one end of the year
to the other. The windows are kept air-tight by the stuffing of some
old garments, and every article for use is kept in the same room. The
necessary is close to the building, where all have access, and
producing a most intolerable nuisance. In a locality naturally
engendering malaria, the diseases with which the poor are for the most
part afflicted are, fevers such as are stated in this report and which
sometimes run into a low typhoid state. The neighbourhood in general
is considered in as good a state of drainage as it will admit of. The
occurrence of disease among the poor population is for the most part
at spring and autumn, at those times agues and fevers prevail.
Small-pox and scarlet fever are met with at all seasons of the year,
but prevail as epidemics, the former in spring and summer, and the
latter about autumn or the beginning of winter. I attribute the
prevalence of diseases of an epidemic character, which exists so much
more among the poor than among the rich, to be, from the want of
better accommodation as residence, (their dwelling instead of being
built of solid materials are complete shells of mud on a spot of waste
land the most swampy in the parish, this is to be met with almost
everywhere in rural districts,) to the want of better clothing, being
better fed, more attention paid to the cleanliness of their dwellings,
and less congregated together. The health of persons even where a
large family is, and where superior cottage accommodation is afforded
to them, is much better generally than others less advantageously
situated. The influence over their habits will also be very
beneficial, they will be less likely to run to a beer-house with their
last penny, the comforts of a home after the toils of the day keeps
them by their own fireside; they become better contented, less liable
to disease, make better husbands, better fathers, better neighbours,
and with each other better friends. There is a subject which I wish
particularly to press on the attention of the Commissioners; the
presence throughout the country, and to be found in every parish, of
low lodging-houses, where persons of the lowest grade of society,
beggars, thieves, and such like, take up a temporary abode in passing
from one part of the kingdom to another, bringing with them the seeds
of infectious diseases and oftentimes the actual disease itself into a
neighbourhood previously in a comparative state of health. I have
observed, where persons are living in a locality habitually affected
with malaria, that when becoming convalescent from any other disease,
are often attacked with ague, more particularly among the poorer
classes.
“There is a class of persons called the ‘second poor,’ who for the
most part are constantly employed throughout the year as farmers’
labourers, and who are in much better circumstances than those to whom
I have above alluded; they have much better cottage accommodation,
their houses being provided with one, sometimes two day-rooms, two
bed-rooms, a pantry, and other conveniences for fuel and for refuse,
and whose general health and condition is much better than those less
advantageously situated. Therefore detached cottages for the poor,
with a moderate sized day-room, two or three bed-rooms, a pantry,
receptacles for refuse and for fuel, with casement windows or some
such contrivance for ventilation, will be a blessing to them, and very
available sanitary regulations. I know of no better method than is to
be seen in all cottages for the economical management of fuel, both in
cooking and maintaining a proper temperature of the rooms.”
The following extract from the report of _Mr. Aaron Little_, the medical
officer of the Chippenham union, affords a specimen of the frequent
condition of rural villages which have apparently the most advantageous
sites:—
“The parish of Colerne, which, upon a cursory view, any person
(unacquainted with its peculiarities) would pronounce to be the most
healthy village in England, is in fact the most unhealthy. From its
commanding position (being situated upon a high hill) it has an
appearance of health and cheerfulness which delight the eye of the
traveller, who commands a view of it from the Great Western road, but
this impression is immediately removed on entering at any point of the
town. The filth, the dilapidated buildings, the squalid appearance of
the majority of the lower orders, have a sickening effect upon the
stranger who first visits this place. During three years’ attendance
on the poor of this district, I have never known the small-pox,
scarlatina, or the typhus fever to be absent. The situation is damp,
and the buildings unhealthy, and the inhabitants themselves inclined
to be of dirty habits. There is also a great want of drainage.”
_Mr. William Blower_, the surgeon of the Bedford union, to whose
evidence on the influence of moral causes on the health of the
population, we shall again have occasion to refer, states:—
“Throughout the whole of this district, there is a great want of
‘superior cottage accommodation.’ Most of the residences of the
labourers are thickly inhabited, and many of them are damp, low, cold,
smoky, and comfortless. These circumstances occasion the inmates to be
sickly in the winter season, but I have not observed them to generate
typhus, the prevailing form of disease being principally catarrhal;
such as colds, coughs, inflammations of the eyes, dysentery,
rheumatism, &c. However, when any contagious or epidemic malaria
occurs, the cases are generally more numerous.”
_Mr. Weale_ reports instances of the condition of large proportions of
the agricultural population in the counties of Bedford, Northampton, and
Warwick. The medical officer of the Woburn union states, in respect to
Toddington, that—
“In this town fever prevailed during the last year, and, from the
state of the dwellings of the persons I called on, this could not be
wondered at. Very few of the cottages were furnished with privies that
could be used, and contiguous to almost every door a dung heap was
raised on which every species of filth was accumulated, either for the
purpose of being used in the garden allotments of the cottagers, or to
be disposed of for manure. Scarcely any cottage was provided with a
pantry, and I found the provisions generally kept in the bed-rooms. In
several instances I found whole families, comprising adult and infant
children with their parents, sleeping in one room.”
The medical officer of the Ampthill union states:—
“Typhus fever has existed for the last three or four months in the
parish of Flitwick, and although the number of deaths has not been
considerable as compared with the progress of the disease, new cases
have occurred as those under treatment became convalescent, and
several are still suffering under this malady. The cottages in which
it first appeared (and to which it has been almost exclusively
confined), are of the most wretched description: a stagnant pond is in
the immediate vicinity, and none of the tenements have drains; rubbish
is thrown within a few yards of the dwellings, and there is no doubt
but in damp foggy weather, and also during the heat of summer, the
exhalations arising from those heaps of filth must generate disease,
and the obnoxious effluvia tends to spread contagion where it already
exists. It appears that most of the cottages alluded to were erected
for election purposes, and have since been allowed to decay; the roofs
are repaired with turf dug in the neighbourhood, and the walls
repaired with prepared clay, without the addition of lime-washing.
Contagious disease has not been remarkable within the Union in any
other spot than the one alluded to.”
_Messrs. Smith_ and _Moore_, the medical officers of the Bishop
Stortford union, state,—
“We have always found the smallest and most slightly-built houses the
seats of the lowest forms of disease; and although, during the last
year, no epidemic or infectious disease here prevailed, it is but just
to state that, generally speaking, the cottages of labourers in this
district are small, badly protected from both extremes of weather,
badly drained, and low in the ground.”
_Mr. J. S. Nott_, the medical officer of the Witham union, states,—
“As medical officer of my district, I am glad to have an opportunity
of recording my opinion of many of the causes of fever that uniformly
prevails in the autumn and spring in this neighbourhood. I must first
state that the situation of the town is exceedingly low, with two
small rivers passing through it, and numerous open sewers intersecting
the town and its environs, the effluvia of which is frequently
exceedingly offensive, and at all times prejudicial to the general
health, and calculated to create, by its malaria, the various kinds of
fevers, (typhus and remittent). Part of the town is subject to floods;
added to which, the cottages are small and crowded together. A great
number of the inhabitants accumulate filth and manure for the purpose
of sale. There are also many open slaughter-houses, where the refuse
and filth is allowed to accumulate for weeks together without removal;
and innumerable pigs are kept and fattened on the back of the premises
of a great number of the inhabitants; and altogether it would be
difficult to find any town of its size where so little regard is paid
to cleanliness and ventilation; but where we do find the exception,
roomy and well-ventilated cottages, (and they are but few,) the cases
of fever are more manageable, and recover sooner.”
The state of Windsor affords an example that the highest neighbourhoods
in power and wealth do not at present possess securities for the
prevention of nuisances dangerous to the public health. _Mr. Parker_, in
his report on the condition of his district, states—
“With regard to the drainage of the towns in the counties of
Buckingham, Oxford, and Berks, it may be observed that there is no
town in which great improvements might not be effected. In Reading
there are commissioners appointed under a local Act to make provision
for cleansing the town and removing nuisances; but their duties do not
appear to be performed with due regard to the importance of the trust,
for the Board of Guardians of the Reading union, by resolutions
entered in their minutes, frequently point out nuisances, and remind
the commissioners of the filthy condition of many of the courts and
back streets. But extensive as the improvements in the state of the
drainage of almost every town in these counties might be, there is no
town amongst them in which there is so wide a field for improvement as
Windsor, which, from the contiguity of the palace, the wealth of the
inhabitants, and the situation, might have been expected to be
superior in this respect to any other provincial town. Such, however,
is not the case; for of all the towns visited by me, Windsor is the
worst beyond all comparison. From the gas-works at the end of
George-street a double line of open, deep, black, and stagnant ditches
extends to Clewer-lane. From these ditches an intolerable stench is
perpetually rising, and produces fever of a severe character. I
visited a cottage in Clewer-lane in which typhus fever had existed for
some time, and learnt from a woman who had recently lost a child the
complaint was attributable to the state of these ditches. Mr. Bailey,
the relieving officer, informs me that cases of typhus fever are
frequent in the neighbourhood; and observes that there are now seven
or eight persons attacked by typhus in Charles-street and South-place.
He considers the neighbourhood of Garden-court in almost the same
condition. ‘There is a drain,’ he says, ‘running from the barracks
into the Thames across the Long Walk. That drain is almost as
offensive as the black ditches extending to Clewer-lane. The openings
to the sewers in Windsor are exceedingly offensive in hot weather. The
town is not well supplied with water, and the drainage is very
defective.’ The ditches of which I have spoken are sometimes emptied
by carts; and on the last occasion their contents were purchased for
the sum of 15_l._. by the occupier of land in the parish of Clewer,
whose meadows suffered from the extraordinary strength of the manure,
which was used without previous preparation.”
_Mr. Harding_, medical officer of the Epping union, states,—
“The state of some of the dwellings of the poor is most deplorable as
it regards their health, and also in a moral point of view. As it
relates to the former, many of their cottages are neither wind nor
water tight. It has often fallen to my lot to be called on to attend a
labour where the wet has been running down the walls, and light to be
distinguished through the roof, and this in the winter season, with no
fire-place in the room. As it relates to the latter, in my opinion a
great want of accommodation for bed-rooms often occurs, so that you
may frequently find the father, mother, and children all sleeping in
the same apartment, and in some instances the children having attained
the age of 16 or 17 years, and of both sexes; and if a death occurs in
the house, let the person die of the most contagious disease, they
must either sleep in the same room, or take their repose in the room
they live in, which most frequently is a stone or brick floor, which
must be detrimental to health.”
_Mr. J. D. Browne_, medical officer of the West Ham union states that,—
“The cases of typhus (21 cases in the parish of Walthamstow) have
occurred periodically in certain localities, arising partly from want
of personal cleanliness, and also from being situated near ditches
into which putrefactive matter was deposited, such as the privies and
pigsties emptying themselves. The medical officer called the attention
of the Board of Guardians, vicar, and parochial officers to the
subject; and though it was unanimously admitted that the evil was
great, and an anxious desire was expressed in vestry to remove the
existing evil, yet the case fell to the ground, there being no funds
to meet the exigency. The medical officer feels persuaded that a power
should be invested in the Board of Guardians or parochial officers to
meet such cases.”
_Mr. Thomas H. Smith_, the medical officer of the Bromley union,
states,—
“My attention was first directed to the sources of malaria in this
district and neighbourhood when cholera became epidemic. I then
partially inspected the dwellings of the poor, and have recently
completed the survey. It is almost incredible that so many sources of
malaria should exist in a rural district. A total absence of all
provision for effectual drainage around cottages is the most prominent
source of malaria; throughout the whole district there is scarcely an
attempt at it. The refuse, vegetable and animal matters, are also
thrown by the cottagers in heaps near their dwellings to decompose;
are sometimes not removed, except at very long intervals; and are
always permitted to remain sufficiently long to accumulate in some
quantity. Pigsties are generally near the dwellings, and are always
surrounded by decomposing matters. These constitute some of the many
sources of malaria, and peculiarly deserve attention as being easily
remedied, and yet, as it were, cherished. The effects of malaria are
strikingly exemplified in parts of this district. There are localities
from which fever is seldom long absent; and I find spots where the
spasmodic cholera located itself are also the chosen resorts of
continued fever.”
Passing the metropolis and the adjacent districts, I proceed to the
evidence as to the condition of the dwellings of the poorest classes in
the midland counties.
The report from Mr. Hodgson and the physicians of the town of Birmingham
will be considered a valuable public document, as exhibiting the effect
of drainage produced by a peculiarly fortunate situation. The houses, of
which I requested drawings, are on the whole built upon an improved
plan. This town, it will be seen, is distinguished apparently by an
immunity from fever, and the general health of the population is high,
although the occupations are such as are elsewhere deemed prejudicial to
health.