and who is considerably advanced in life, has frequently observed to
me, that intermittents are so much diminished in his circuit, that an
ounce of the cinchona goes further at this time in the treatment of
agues than a pound of it did within his own recollection. During his
father’s practice at Boston, they were still more obstinate and
severe. For my own part, I have declared, for several years, in
various companies, that marsh miasmata are the cause of both agues and
the rot. And as miasmata are admitted, by the concurring testimonies
of medical practitioners in every part of the globe, to be produced by
the action of the sun upon low, swampy grounds, I hope this
interesting subject will be fully investigated, and effectual plans
carried into execution, for the preservation of man, and of the
animals which are so useful to him.”
I may here mention a circumstance which occurred at the Poor Law
Commission Office, and which with succeeding information tended to
direct our attention to the subject of sanitary measures of prevention
for the protection of the rates. A medical officer of one of the Unions
who came to town for the transaction of some business before the Board,
begged to be favoured by the immediate despatch of his business,
inasmuch as, from a change of weather which had taken place since his
departure, he was certain that he should have a number of cases waiting
for him. On being asked to explain the circumstances from which he
inferred the occurrence of disease with so much certainty, he stated
that within his district there was a reservoir to feed a canal: that
they had let out the water as they were accustomed to do in spring time
for the purpose of cleansing it; and that whenever such weather occurred
as then prevailed during the process, he was sure to have a great number
of fever cases amongst the labourers in the village which immediately
adjoined the reservoir. It appeared to be, in fact, a case in which the
rot was propagated amongst the labourers in the village under
circumstances similar to those before cited in which it was propagated
amongst the sheep.
The following portions of evidence afford instances of the condition in
which a larger proportion of the country remains, from the neglect of
general land drainage, than would be conceived from any _à priori_
estimate of the amount of prevalent intelligence and enterprize.
_Mr. R. W. Martyr_, one of the medical officers of the Langport union,
thus describes the condition of a large proportion of his district:—
“The parishes of Kingsbury and Long Sutton being the district No. 1 B
of the Langford union, the population of which amounts to above 3,000;
Kingsbury, containing 2,000; and Long Sutton 1,000, or thereabouts.
Both these parishes are partly surrounded by low meadow land, and are
liable to frequent inundations, often covering many thousand acres,
and sometimes to a great depth; the level of much of this land being
below the bed of the main river or drains, makes it very difficult
(when once inundated) in very wet seasons to drain or carry off the
immense body of water they often contain.
“These inundations are caused by the banks of the main rivers not
being sufficiently strong or elevated, and from the bridges not being
capacious enough to carry the immense body of water brought down from
the neighbouring hills and country higher up, which, in heavy rains,
sometimes takes place so rapidly as to completely overflow the banks
in twenty-four hours; but besides the casual or accidental giving way
of the banks of the rivers, it is sometimes done by interested persons
for the purpose of warding off the mischief from themselves by
throwing it on their neighbours.
“When these floods occur in the winter season, and there is but little
herbage, or early in the spring, and are followed by dry weather, the
surface of the ground becomes dry and healthy, and they are then
highly beneficial to the land, and but little prejudicial to the
health of the surrounding inhabitants; but when, as is sometimes the
case, these floods take place late in April, May and June, and cover
hundreds of acres of hay, some cut and some uncut, and which must of
course rot on the ground, the effluvia and stench is then often
unbearable, and highly prejudicial to the health of the neighbouring
villages, and it is sometimes years before the land recovers its
healthy state, producing nothing but rank herbage, and causing agues,
fevers, dysentery, and numerous other diseases. Many of these evils
may, I think, be remedied if the owners of large estates in this
neighbourhood would interest themselves in the matter: I am persuaded
the increased value of their property would amply repay the outlay
necessary for the purpose. When the land is in this unhealthy state,
it appears to be equally prejudicial to the animal as the human
subject, producing numerous diseases among cattle, particularly among
sheep, many farmers losing the whole of their flocks.
“Although much remains to be done to remedy the mischief complained
of, yet a considerable improvement has taken place within the last
twenty years by enclosing many of the large commons, and by that means
partially draining them; and also by enlarging the back drains which
carry the water to a lower level into the main river, by which means
it is carried off much sooner, and less mischief is done, than if it
remained longer on the surface of the land.
“It is stated in a very old history of Somerset, that about 300 years
ago, nearly the whole of the inhabitants of Kingsbury, Muchelney, and
Long Load, were carried off by a pestilence (without doubt meaning a
malignant fever); and that for many years afterwards it was considered
so unhealthy that it was inhabited solely by outlaws, and persons of
the worst character, a clear proof the country is in a much healthier
state now than it was in former times.
“In addition to the more general causes of disease arising from the
flat state of the country, and its liability to inundations, are many
others of a more local character, and much easier of removal, in the
village of Kingsbury; and in many others there are numerous pits or
ponds in the winter season filled with muddy water, and, in summer,
mud alone: these are often situated in the front or at the back of the
cottages, and are receptacles for all manner of filth, and in certain
seasons are productive of very serious diseases, and at all times
highly injurious to health. Besides the mud pits above mentioned,
there is scarcely a cottage that is not surrounded with all manner of
filth, oftentimes close to the doors of the inhabitants, very few of
the cottages being provided with privies, or if there be any, they
only add to the general nuisance from being open and without drains.”
_Mr. Oldham_, the medical officer of the Chesterfield union, gives the
following account of his district:—
“Wessington is situated upon an elevation, but the houses are arranged
around a green or unenclosed common, upon the surface of which are a
great number of small pools, which, for the most part, are stagnant.
In the winter season they overflow, and at this season the
neighbourhood appears less infected with fever. In the summer months,
and greater part of the spring and autumn, they are stagnant, and
undoubtedly a fruitful source of malaria; indeed the neighbourhood of
Wessington is scarcely ever free from fever at these seasons of the
year.
“It perhaps may not be amiss to mention, I have attended a number of
persons in the neighbourhood of this common who have been attacked
with fever, who were at the same time well fed, and lived in
comfortable and tolerably well-ventilated houses.”
He then adduces instances, and proceeds—
“From the facts before mentioned, I am led to conclude that the
decomposition constantly going on in these small pools is the source
of the malaria, and that the malaria so engendered propagates fever.
1st. Because there are cases of fever in this locality nearly all the
year. 2d. Because paupers, and persons who are better fed, and live in
more comfortable and better ventilated houses in the neighbourhood of
this green or common, are attacked with the disease, and, I may say,
almost indiscriminately. 3d. Because during the years I have attended
the paupers of the district, there has scarcely been a case of fever
in the winter season when the pools are overflowed, and the atmosphere
is colder, and consequently unfavourable to fermentation and
decomposition. In my opinion the only method to remedy this evil would
be to drain the common, which is small, and its situation being
elevated, would greatly facilitate its drainage. The condition of a
few of the smaller and more confined of the tenements might be greatly
improved.”
_Mr. L. Reynolds_, one of the medical officers of the Dore union, thus
describes in his report the district where some fever cases occurred:—
“Of those cases the six first have occurred on Colston Common, a small
marshy spot, never drained, and containing several pools extremely
unhealthy, from decaying vegetables that never are removed. This year
the same families have been again attacked, and shall be so every year
till that nuisance be removed. In a medical point of view, such
commons are injurious, and they are extremely expensive to the unions,
for they cause fever, asthma, and rheumatism, from their incipient
moisture, thus injuring the labouring classes, and heavily taxing the
parish.
“The four next have occurred at a place called Toad Ditch: it well
deserves the name; it is a collection of badly-built houses, rendered
unhealthy from the large ditch, into which every kind of refuse is
poured; the removal of that nuisance is imperatively called for. All
these houses have one privy in common, but the ditch is the place
generally used.
“This district would be much served by enclosing and draining Colston
Commons, by keeping the sewers at Kingston clean, and by draining the
ditch at Toad Ditch. These are the only removable nuisances of which I
have any knowledge.”
_Mr. Blick_, medical officer of the Bicester union, describes the
prevalence of typhus:—
“This disease has been very prevalent in this district during the past
year, indeed we are never free from it. I think its origin may be
traced, in most instances, to a constant exposure to an atmosphere
loaded with malaria, and propagated, in the second place, by
contagion, so little attention being paid to prevent its diffusion.
“The malaria alluded to arises from the decomposition of vegetable
matter left upon Otmoor (a marsh of about 4000 acres), by the previous
winter’s flood, and acted upon by the sun, &c., during the summer.”
_Mr. J. Holt_, the medical officer of the Leighton Buzzard union,
reports:—
“I have had only 34 cases of remittent and intermittent fevers during
the last year, which is a small number in comparison to the amount
usually occurring in hot summers. The great prevalence of these fevers
at such times is attributable principally to the number of stagnant
ponds and ditches which are situated in the very midst of many of the
towns and villages of this union, and which, in hot weather, become
quite putrid and offensive from the quantity of decaying animal and
vegetable matter. I have generally observed that the greater number of
these fevers occur in houses situated in the immediate vicinity of
these ponds, and have no doubt is the chief cause of nearly all the
fevers of this description. The villages to which I more particularly
refer are Egginton, Eddlesbon, Cheddington, &c.”
The sanitary effects of road cleansing, to which house drainage and road
drainage is auxiliary, it appears is not confined to the streets in
towns and the roads in villages, but extends over the roads at a
distance from habitations on which there is traffic. Dr. Harrison, whose
testimony has been cited on the subject of the analogy of the diseases
of animals to those which affect the human constitution, in treating of
the prevention of fever or the rot amongst sheep, warns the shepherd
that, if after providing drained pasture and avoiding “rotting-places”
in the fields, all his care may be frustrated if he do not avoid, with
equal care, leading the sheep over wet and miry roads with stagnant
ditches, which are as pernicious as the places in the fields designated
as “rotting-places.” He is solicitous to impress the fact that the rot,
_i. e._ the typhus fever, has been contracted in ten minutes, that sheep
can at “any time be tainted in a quarter of an hour, while the land
retains its moisture and the weather is hot and sultry.” He gives the
following instance, amongst others, of the danger of traversing badly
drained roads. “A gentleman removed 90 sheep from a considerable
distance to his own residence. On coming near to a bridge, which is
thrown over the Barling’s river, one of the drove fell into a ditch and
fractured its leg. The shepherd immediately took it in his arms to a
neighbouring house, and set the limb. During this time, which did not
occupy more than one hour, the remainder were left to graze in the
ditches and lane. The flock were then driven home, and a month
afterwards the other sheep joined its companions. The shepherd soon
discovered that all had contracted the rot, except the lame sheep; and
as they were never separated on any other occasion, it is reasonable to
conclude that the disorder was acquired by feeding in the road and ditch
bottoms.” The precautions applicable to the sheep and cattle will be
deemed equally applicable to the labouring population who traverse such
roads.
Such instances as the following, on the prejudicial effects of undrained
and neglected roads, might be multiplied. _Mr. E. P. Turner_, the
medical officer of Foleshill union, in accounting for some cases of
fever, states:—
“These cases of typhus all occurred in the same neighbourhood, where
the road is bad and a dirty ditch of stagnant water on each side of
it; the road is generally overflowed in the winter. The disease broke
out in the month of October; other cases occurred in the same
neighbourhood at the time.”
The nature of the more common impediments which stand in the way of the
removal of the causes of disease and obstacles to production described
in the preceding, are noticed in the instances following. Others will be
adduced when the subject of the legislative means of prevention are
stated.
_Dr. Traves_, on the sanitary condition of the poor in the Malton union,
states,—
“The whole of the low district above alluded to, and extending into
the Pickering union, (known by the name of the Marishes, or Marshes,)
has at different times within the last few years been the seat of
typhus and other fevers.
“Attempts were made by some of the landed proprietors a few years ago
to effect a system of drainage and embankments likely to prevent the
inundations of these rivers in wet seasons, but the attempt was
abandoned in consequence of the reluctance of certain townships to
bear their portion of the necessary outlay, and any partial system of
embankment is positively injurious, inasmuch as the water that is let
in upon the land at a higher point of the river is prevented returning
into the stream again by an embankment at a lower point, so that this
water, containing vegetable matters in a state of decomposition, must
remain stagnant until evaporated by the sun’s rays, or dissipated by
the wind; cases of fever occurring under these circumstances have
repeatedly come under my observation, as well as that of other medical
men familiar with the district, and this fruitful source of disease
(in seasons like 1839 more especially) will probably now remain in
full force until an Act of the legislature shall effect a change.”
_Mr. Thomas Marjoribanks_, the minister of Lochmaben,—
“No means of any consequence, so far as I am aware, have yet been
tried to remedy the evil, the removal of such substances as generate
malaria. There are no scavengers appointed for the removal of
nuisances. One great mean of preventing the generation of malaria (in
my opinion) would be the lowering of the bed of the river Annan, which
would to a great extent free the surrounding lands of stagnant water,
give greater facilities for draining, improve the system of farming,
lessen the risk of damage, and increase the quantity as well as
improve the quality of the food which the low lands produce, and in
every way conduce to the comfort and cleanliness of the inhabitants.
It is computed that in consequence of the flooding of the Annan,
damage during the last four years has been done to the amount of
6,000_l._, and this along only about three miles of its course. The
property is very much subdivided, and, in consequence, poverty and
want has increased to a great extent among the small proprietors.”
In closing this exposition of the state of the chief external evils that
affect the sanitary condition of the labouring population, it may be
observed that the experience, on which the conclusions rest as to the
principles of prevention is neither recent nor confined to this country.
That which is new, is the advantages we possess beyond other times, and
perhaps beyond all other countries, in capital and practical science for
its application. The experience of the advantage of public sewers to the
health of a town population is nearly as old as Rome itself. I may refer
with M. Du Châtelet to the experience of that city, to illustrate the
consequences of neglects, such as are manifest amidst large masses of
the community throughout the country, and are partially displayed in the
mortuary registers first cited. He gives the details from the treatise
_De Adventitiis Romani Cœli Qualitatibus_, by the celebrated Italian
physician Lancisi, who deeply studied the sanitary condition of Rome,
and wrote several admirable works on the subject, which had the happy
effect of inducing the pope to cleanse and drain the city:—
“The barbarians of every tribe having several times pillaged and
sacked the city of Rome, the aqueducts were destroyed, and the water,
spreading into the surrounding plains, formed marshes, which
contributed greatly to render uninhabitable the surrounding country.
“The aqueducts existing no longer, the sewers and privies were alike
neglected, and produced serious and frequent sicknesses, which were
more effectual in destroying the population than the arms of the
barbarians. All the historians of these remote times, and particularly
St. Gregory, in his Homilies, and the deacon John, in the Life of that
saint, give a frightful picture of the city of Rome. The air became so
vitiated that plagues and fevers of a malignant character continually
carried on their ravages to such a point that Peter Damien, writing in
the eleventh century to Pope Nicholas II., to intreat him to accept
his resignation, alleged as the pretext the danger he ran every
instant of losing his life by remaining in the town.
“It was principally during the abode of the popes at Avignon that all
which regards health was neglected at Rome, and some historians have
not hesitated to attribute to this negligence the depopulation of the
town, which was reduced in a little time to 30,000 inhabitants.
“Things remained in this state to the end of the fourteenth century,
an epoch at which the popes, resuming the ancient labours, restored
things to their proper condition; a new title to glory of Leo X., who
of all the popes was the one who occupied himself with this important
object in the most especial manner.
“It is, in part, to these precautions that we are to attribute the
rapid increase of the population of Rome, which, from 30,000 souls,
reached in a short time to 80,000; and it is a thing worthy of our
attention that after the death of this pontiff the population quickly
fell to the number of 32,000, because, according to the contemporary
authors, everything having been neglected, the first calamities were
renewed.
“Happily for Rome this state of things did not continue long, because
all successive popes, instructed, it appears, by the experience of
ancient times, having carried on immense labours, and constructed
fresh sewers, have given to the air of this city the necessary
purity.”
Italy presents instances, though comparatively modern, of the removal of
disease by land drainage:—
“At Vareggio,” observes M. Villermé, “in the principality of Lucca,
the inhabitants, few in number, barbarous, and miserable, were
annually, from time immemorial, attacked about the same period with
agues; but in 1741 flood-gates were constructed, which permitted the
escape into the sea of the waters from the marshes, preventing at the
same time the ingress of the ocean to these marshes both from tides
and storms. This contrivance, which permanently suppressed the marsh,
also expelled the fevers. In short, the canton of Vareggio is at the
present day one of the healthiest, most industrious, and richest on
the coast of Tuscany; and a part of those families whose boorish
ancestors sunk under the epidemics of the _aria cativa_, without
knowledge to protect themselves, enjoy a health, a vigour, a
longevity, and a moral character unknown to their ancestors.”
The histories of other cities, and particularly of Paris, afford
illustrations of the effects of the neglect of public cleansing, which
begin in the ignorance and carelessness of the superior officers, and
continue in the predominance of ignorance and obscure interests of a
multitude in the present day:—
“For several years the suppression of an enormous cesspool at Paris
near the Barrière des Fourneaux was implored by the inhabitants.
Placed under the predominant winds, it was a permanent cause of
annoyance to the quarters of St. Germain and St. Jacques. But all
petitions were in vain. A singular occurrence brought about the event
for which the people had prayed more than 50 years. In a hunting
party, the Prince of Conde was carried by a fiery horse towards this
same cesspool; finding it impossible to turn the animal, the prince
had the presence of mind to throw himself on the ground, but the horse
darted forward into the cesspool and disappeared. The next day an
order was issued from Versailles, enjoining M. Lenoir, the lieutenant
of police, to fill up the cesspool, which was accordingly done.”
A particular evil had attracted the attention of an able minister, who
had recourse to the expedient which we have seen recently re-discovered
and introduced into practice into one section of the sewerage of
London:—
“The great sewer of Montmartre being uncovered, and the fall
exceedingly small, it was easily choked, and spread infection through
all the neighbourhood. Turgot thought that the best method to obtain a
ready flow for the muddy waters it received was to wash it by frequent
currents. A vast reservoir, capable of containing about 22,000
measures of water, was in consequence established at the opening of
the sewer, opposite the Rue des Filles-du-Calvaire. The waters of
Belleville were conducted there, together with those of two wells dug
in the vicinity. This volume of water was, on certain days, let into
the main sewer by means of flood-gates, which could be opened at
pleasure. The scouring of the sewer by a current of living water
attracted the public attention, and produced the most happy results.
Shortly the people could dwell on the confines of this ancient ditch
without fear of dangerous exhalations. The quarters of the Faubourg
Montmartre, of the Chaussée-d’Antin, of the Ville-l’Evêque, and of the
Faubourg St. Honoré, became populated. At length the land was so
valuable in these different quarters that the possessors of the banks
of the sewer demanded and obtained the permission to cover it over at
their own expense.”
The mode of cleansing had, however, been before proposed by another
minister:—