state of health of the population surrounding the prisons concur in
vouching to the fact, upon their own knowledge, that the health of the
prisoners is in general much higher than the health almost of any part
of the surrounding population; that the prisoners, as a class, are below
the average of health when they enter the prisons; that they come from
the worst neighbourhoods; that many of them come from the
lodging-houses, which, in those towns, as will be shown, are the
constant seats of disease; that they are mostly persons of intemperate
habits; that many of them come in in a state of disease from
intemperance and bad habits; and notwithstanding the depressing
influence of imprisonment, the effect of cleanliness, dryness, better
ventilation, temperance, and simple food, is almost sufficient to
prevent disease arising within the prison, and to put the prisoners in a
better working condition at the termination than at the commencement of
their imprisonment. At the Glasgow bridewell, the prisoners are weighed
on their entrance and at their discharge, and it is found that, on the
average, they gained in weight by their imprisonment.[33] At Edinburgh,
there were instances of poor persons in a state of disease committed
from motives of humanity to the prison, that they might be taken care of
and cured. The tables are to be taken as showing imperfectly the
comparative effects of the different circumstances; because, when a
labourer is obliged to leave work he loses wages; and it is known of
large classes of them, that they often work improvidently and
injuriously to their chances of recovery by continuing at work in
impaired health too long; the prisoner, on the contrary, by absence on
the sick list, gains ease and exemption from slave labour; and the
officers have constantly to contend against feigned sickness to avoid
task-work and punishment. It should also be noted that a large
proportion of the sickness of the prisoners is of a character that is
excluded from all tables of insurance, from the benefit societies as
being specially excluded from their benefits. The numbers imprisoned at
the lower ages, or above 36 years of age, were too few to form any
comparison:—
┌────────┬─────────────────────────────┬──────────────────────────────────┐
│ │ Average Annual Sickness of │ │
│ │ Male Prisoners in the │ Labourers and Operatives. │
├────────┼─────────┬─────────┬─────────┼───────────┬───────────┬──────────┤
│ │ │ │ │ │ No. 5. │ │
│ │ │ │ │ │ Average │ │
│ │ │ │ │ │duration of│ │
│ │ │ │ │ No. 4. │ Sickness │ No. 6. │
│ │ No. 1. │ No. 2. │ No. 3. │Employed in│ per annum │ Males of │
│ │ Glasgow │Edinburgh│ Salford │East-India │ of every │ Families │
│ │ Prison. │ Prison. │ Prison. │ Company’s │ person │ in Wynds │
│ │ │ │ │Warehouses.│employed in│ of │
│ │ │ │ │ │ Cotton │Edinburgh.│
│ │ │ │ │ │ Factories │ │
│ │ │ │ │ │ of │ │
│ │ │ │ │ │Lancashire.│ │
├────────┼─────────┼─────────┼─────────┼───────────┼───────────┼──────────┤
│ AGE. │ Days & │ Days & │ Days & │ Days & │ Days & │ Days & │
│ │Decimals.│Decimals.│Decimals.│ Decimals. │ Decimals. │Decimals. │
│Under 16│ │ │ │ │ │ 3·5│
│ Years │ │ │ │ │ │ │
│16 to 21│ 3·05│ 4·01│ 3·10│ 4·02│ 4·42│ 2·3│
│21 to 26│ 1·83│ 2·04│ 1·64│ 5·40│ 4·91│ 5·1│
│26 to 31│ 2·65│ 2·33│ 2·72│ 4·49│ 6·88│ 11·0│
│31 to 36│ 2·83│ 3·10│ 2·63│ 4·55│ 3·85│ 8·3│
│36 to 41│ 9·00│ 5·10│ ·85│ 5·57│ 4·13│ 4·1│
│41 to 46│ ·49│ 2·75│ ·51│ 5·18│ 5·69│ 15·1│
│46 to 51│ │ │ │ 5·43│ 7·18│ 30·0│
│51 to 56│ │ │ │ 6·80│ 3·47│ 16·2│
│56 to 61│ │ │ │ 7·21│ 12·68│ 30·4│
│61 to 66│ │ │ │ 10·24│ │ 42·7│
│66 to 71│ │ │ │ 9·93│ │ 64·2│
│71 to 76│ │ │ │ 10·60│ │ 41·0│
│76 to 81│ │ │ │ 12·67│ │ 83·6│
└────────┴─────────┴─────────┴─────────┴───────────┴───────────┴──────────┘
┌────────┬─────────┬─────────┬──────────┐
│ │ │ │ No. 8. │
│ │ │ │ Average │
│ │ │ │ Annual │
│ │ │ No. 7. │ Sickness │
│ │ │ Average │ of │
│ │ │ Annual │provident │
│ │ │Sickness │portion of│
│ │ │ of │ Working │
│ │ │ Members │ Classes │
│ │ │ of │throughout│
│ │ │ Benefit │ Great │
│ │ │Societies│ Britain, │
│ │ │ in │according │
│ │ │Scotland.│ to the │
│ │ │ │experience│
│ │ │ │ of Mr. │
│ │ │ │Finlaison.│
├────────┼─────────┼─────────┼──────────┤
│ AGE. │Years of │ Days & │ Days & │
│ │ Age. │Decimals.│Decimals. │
│Under 16│ │ │ │
│ Years │ │ │ │
│16 to 21│ 18│ 2·5│ 5·18│
│21 to 26│ 23│ 3·8│ 6·75│
│26 to 31│ 28│ 4·6│ 6·78│
│31 to 36│ 33│ 5·6│ 6·33│
│36 to 41│ 38│ 6·2│ 7·86│
│41 to 46│ 43│ 8·8│ 9·02│
│46 to 51│ 48│ 9·1│ 11·76│
│51 to 56│ 53│ 14·8│ 16·77│
│56 to 61│ 58│ 17·8│ 23·57│
│61 to 66│ 63│ 20·0│ 33·22│
│66 to 71│ 68│ 36·0│ 61·22│
│71 to 76│ 73│ 38·6│ 101·44│
│76 to 81│ 78│ 70·9│ 164·72│
└────────┴─────────┴─────────┴──────────┘
The total number of male prisoners in the three prisons from which the
returns were compiled was 7,328; of which number, in the Glasgow prison
there were 1,796, in the Edinburgh prison 1,256, and in the Salford
prison 4,276 prisoners. The columns inserted in the above table from the
prisons give only the amount of sickness prevalent amongst the males.
The returns which are given in full in the Appendix contain the amount
of sickness prevalent among the female prisoners also.
The information as to the actual amount of sickness prevalent amongst
the labouring classes is at present extremely defective for the purposes
of insurance. One of the most authentic tables is that compiled by Dr.
Mitchell, from returns we obtained under the Factory Commission of
Inquiry, of the experience of sickness amongst the labourers employed by
the East India Company in their warehouses in London. The experience was
from 2461 workmen employed during ten years. (Return No. 4.)
This is a highly favourable table, inasmuch as the men were, in the
first instance, select, nearly as much so as recruits in the army; care
was also taken to give men who became infirm such labour as they could
perform without exertion; but, above all, they had the benefit of
medical advice without any expense, and being thereby induced to make
early application, disease was cut short at once on its first
appearance. Moreover, they were not allowed to return to work until they
had a medical certificate of their cure.
Another table (No. 5) given is one of the amount of sickness experienced
by the male operatives in the cotton mills in England, also deduced from
the returns directed to be made under the Factory Commission of Inquiry.
But these returns do not include the experience of the mills in
Manchester, which was not collected by the district commissioners.
The table (No. 6) is that made up by Mr. Tait, surgeon, from his
inquiries of the experience of sickness in the wynds of Edinburgh.
The next table (No. 7) is made up from the experience of benefit
societies in Scotland, subsequent to the experience tables which were
compiled by the Highland Society; but this is the experience of a select
class, which appears to me to be too favourable for general use in
Scotland.
The next table (No. 8) is one in use by Mr. Finlaison, the actuary at
the National Debt Office, prepared from various sources of information.
It has been tried by the experience of a large benefit society in
Bethnal Green, and the allowance for sickness was found to be low as
compared with the sickness occurring amongst the labouring classes in
that district.
The account given by Mr. Tait, of his investigation of the sickness
which had prevailed amongst 335 persons in 180 families, exhibited in
column No. 5, is as follows:—
“The parts visited may be considered a fair specimen of the Edinburgh
wynds and closes. They consist of Gillon’s and Gibb’s Closes,
Canongate, Blackfriars’ Wynd, Bremot’s and Skinner’s Closes, High
Street, and Meal-market Stairs, Cowgate. The drainage of all these
places is bad; the sewers are without exception open, and those in
Gillon’s and Gibb’s Closes being nearly on a dead level, keep these
places constantly in a filthy condition. The poverty of the
inhabitants who reside in Gibb’s Close, especially, is also extreme,
five out of seven families living in apartments without furniture. The
ventilation in general is also bad: several apartments are so close
that it is difficult for a person when he first enters them to
breathe. In several instances I had to retreat to the door to write
down my notes, as I found the stench and close atmosphere produce a
sickening sensation which, on one occasion, terminated in vomiting.
Although some of the apartments visited were tidy and clean, in
general they were the reverse. It is impossible to conceive or
describe the filthy condition of some of them. Many of them were very
small, and others rather capacious, considering the quantity of
furniture they contained. The diseases mentioned were such as to throw
the persons affected out of employment. There were many cases of
slight and continued ailment of which no notice was taken. No case of
rheumatism was taken down unless so severe as to lay the person
entirely off work.
“About 180 families were visited, but only 117 of them had been one
year and upwards in their present dwelling: all the cases of sickness
occurred between Martinmas, 1840, and Martinmas, 1841, and none of the
patients,” _i. e._ of whom any account was taken, “were under ten
years of age,” those under that age being intentionally excluded.
Mr. Hill states, that he has no doubt the results, which will be
apparent from the examination of the several tables which are placed in
juxta-position, would be corroborated by similar returns obtained from
other well-regulated prisons in Scotland. The returns from the prisons
in England up to the year 1834–5 (which do not, however, give the days
of sickness, but only the number of prisoners attacked with sickness
during the period for which the return was made) further corroborate
these results. Even in the Milbank Penitentiary, the situation of which
is insalubrious, the average annual amount of sickness to the prisoners
who are confined two years and a half is only about eight days to each
person, which, for the average ages, is little above the standard
obtained from the experience of the East India Company’s labourers. The
sickness amongst the metropolitan police is about 10½ days per annum for
each of the force, 2¾ per cent. being constantly on the sick-list. The
sickness in the army is on the average 14½ days each soldier. Mr.
Finlaison informs me he can venture to state, that were any benefit
society to use scales of premiums founded on the prison experience, they
would inevitably be insolvent in less than three years.
M. Villermé has shown the diminution of mortality that has taken place
in the prisons of France, chiefly from stricter attention to
cleanliness, ventilation, and diet, to be equally striking. At Lyons,
from 1800 to 1806, the annual mortality in the prisons was 1 in 19; from
1806 to 1812, it was 1 in 31; from 1812 to 1819, it was 1 in 34; and
from 1820 to 1826, 1 in 43: a similar amelioration has also been
remarked in the prisons of Rouen, and some other large towns in that
kingdom.
The following is a summary return of the diseases of the duration of
each, amongst the population of the wynds, examined by Mr. Tait:—
┌───────────────────────────┬──────┬────────┬───────┬────────┬────────┐
│ NATURE OF DISEASE. │No. of│Average │No. of │ No. of │ No. of │
│ │Cases.│duration│Deaths.│Families│Persons │
│ │ │ of │ │visited.│visited.│
│ │ │Disease.│ │ │ │
├───────────────────────────┼──────┼────────┼───────┼────────┼────────┤
│ │ │ Weeks. │ │ │ │
│Disease of Lungs │ 23│ 5½│ 1│ 117│ 335│
│Rheumatism │ 9│ 9│ │ │ │
│Accidents │ 9│ 4½│ │ │ │
│Erysipelas │ 3│ 8│ │ │ │
│Inflammation of Throat │ 3│ 5│ │ │ │
│Fever │ 15│ 5¼│ 1│ │ │
│Palsy │ 4│ │ 1│ │ │
│Dropsy │ 1│ 7│ │ │ │
│Disease of Liver │ 1│ │ │ │ │
│Jaundice │ 1│ 4│ │ │ │
│Carbuncle │ 1│ 5│ │ │ │
│Affection of Urinary Organs│ 1│ 17│ │ │ │
│Acute affection of Brain │ 2│ 3│ 1│ │ │
│Small-pox │ 2│ 5│ 1│ │ │
│Opthalmia │ 1│ 6│ │ │ │
│Whitlow │ 1│ 3│ │ │ │
│Lumbago │ 2│ 7│ │ │ │
│Eruptive disease │ 1│ 9│ │ │ │
│Inflammation of Stomach │ 1│ │ │ │ │
│Ague │ 1│ 4│ │ │ │
│Abscess of Loins │ 1│ 5│ │ │ │
├───────────────────────────┼──────┼────────┼───────┼────────┼────────┤
│ Total │ 83│ │ 5│ 117│ 335│
└───────────────────────────┴──────┴────────┴───────┴────────┴────────┘
It may be safely pronounced that if such an amount of sickness were
known to prevail in a prison containing between 300 and 400 prisoners,
the circumstance would excite public alarm and attention.
Any of the preceding tables of the lower amounts of sickness may be
taken as practicable standards of the extent to which it were possible,
by the removal of the causes of disease, to bring the health of the
labouring population.
I may here observe, that the tables of sickness above referred to
exhibit the very unsatisfactory footing on which the means of insurance
against sickness and mortality within the reach of the labouring classes
are now placed. An artisan of the condition of the East India Company’s
labourers who insures for an allowance for sickness between the age of
61 and 66 years, which, according to the experience of his own class,
would be a period of 10 days, would have to pay for 20 days, or 10 days
in excess if he insured on the tables of the experience of benefit
societies in Scotland, or 23 days in excess if he insured on tables
founded on the experience collected by Mr. Finlaison. On the other hand,
were a benefit society composed of members living under depressed
circumstances, as in close courts or ill-drained districts, to adopt the
table of the experience of the East India Company’s labourers, and to
take members, living under the circumstances indicated by the Highland
societies or Mr. Finlaison’s tables, the allowance on such a rate of
insurance would be fraught with certain and speedy loss of the funds of
the contributors. Having received contributions for an allowance on the
chances of 10 days’ sickness, they would, upon insurances from the wynds
of Edinburgh, have to pay for 40 days. The range of variation in the
chances of life in different districts, such as have been shown in the
returns from the different towns, exhibiting the mortality amongst the
different classes, all present instances of the ruin to which benefit
societies are exposed in acting upon tables calculated only for select
classes, or on the mean experience of large classes, or of many classes
differing widely in their circumstances. The probabilities of life at
infancy for the whole population of Liverpool, as deduced from the
actual ages of deaths of the whole population, would be 17 years; but on
the Northampton tables of probability, payment would be required for the
insurance of 25 years at infancy; for 38 years according to the Carlisle
table; and if a male, for 37 years, according to the Swedish table. Yet
such are the data and their applications on which large masses of
savings and property are frequently invested and made dependent in
various forms of insurance in benefit societies. The ruin of such
societies is, I lament to say, by no means an unfrequent occurrence. The
most painful spectacle that is presented in a painful and difficult
service is that of a hardworking, industrious labourer, who has lived
frugally and saved rigidly, who in his old age is stripped of his
savings and reduced to destitution. One such example is enough to
destroy the frugality of a whole village, and of all the labourers to
whom it is presented. The necessity of a revision of all the tables
which govern the subscriptions to friendly societies and the allowances
from them, is strongly suggested by the evidence. It is to be lamented
that, before giving tables of sickness or mortality to the members of
benefit societies, many of the actuaries who have advised them have made
no inquiries as to the condition of the neighbourhoods where the members
reside or as to their general circumstances. The best advice to the
labourers for the future will, however, be proved to be, that the most
safe, economical, and efficient outlay as an insurance, will be in their
own contributions, in rates or extra rent where needful for the
execution of sanitary measures.
The further example adverted to as to the efficiency of preventive
measures, is furnished by the naval medical service.
So dreadful was once the condition of the navy that, in the year 1726,
when Admiral Hosier sailed with seven ships of the line to the West
Indies, he buried his ships’ companies twice, and died himself of a
broken heart. Amongst the pictures then presented, as in Anson’s
Voyages, 1740–44, were those of deaths to the amount of eight or ten
a-day in a moderate ship’s company; bodies sewn up in hammocks and
washing about the decks, for want of strength and spirit on the part of
the miserable survivors to cast them overboard. Dr. Johnson, in the year
1778, thus describes a sea life:—“As to the sailor, when you look down
from the quarter-deck to the space below, you see the utmost extremity
of human misery; such crowding, such filth, such stench!” “A ship is a
prison, with the chance of being drowned,—it is worse, worse in every
respect; worse air, worse food, worse company.”
_Dr. Wilson_, in his preface to the Medical Returns, observes that,
within the limits of the South American command, the Centurion, exactly
a century ago, lost in a few weeks 200 out of 400 men by scurvy. During
the years from 1830 to 1836, the British _squadron_ employed in South
America, lost by diseases of every description only 115 out of 17,254
men. He observes—
“There is no reason to doubt that instead of every second man
perishing miserably within a few weeks, the rate of mortality might
have been as low as that exhibited in the South American Report, viz.,
one death annually by disease out of 150 men. Now there was nothing
new nor mysterious in the pestilence either as to its origin or its
essence: it was not a sudden climatorial influence which could not be
resisted nor understood; it was a well-known affection presenting all
the signs of utter prostration and pointing to pure debility as its
source, the effects principally of scanty, unwholesome, unvarying diet
and bad water—partly of inadequate attention to cleanliness, order,
and ventilation, and the nearly total neglect of systematic attention
to measures for amusing, cheering, and improving the mind with which
resulting despondency often cooperated. The remedy therefore would
appear to have been self-evident and at hand, not to the commanders of
ships and fleets, but to the administration. Information on many
points in the animal economy was certainly less exact than it is now,
and vague unfounded notions prevailed of necessary relations existing
between a sea-life and scurvy. Hence it may be concluded that
ignorance rather than inhumanity was the reason why effectual measures
were not long before adopted for the prevention of such terrible
calamities.”
He observes further that—
In 1779 the proportion dying was 1 in 8 of the employed.
In 1811 the proportion dying was 1 in 32 of the employed.
From 1830 to 1836 the average number dying annually was 1 in 72 of the
employed.
But—
“In this calculation, the deaths from all sources are included from
wounds, drowning, and all other external causes as well as from
disease. From the latter source the deaths were in the proportion of 1
to 85 of the number employed annually. When it is considered that the
ratio applies to the whole service, and therefore includes the most
unhealthy sections, the Coast of Africa and the West Indies, it will
be admitted, even without reference to former periods, to be very
low.”[34]
The scurvy, once so fatal in the navy, is now almost unknown in
men-of-war, whilst it still prevails often to a most serious extent in
the mercantile navy where the same care is not taken. It was a popular
opinion in the navy, that the use of lemon juice in the grog was a
specific against scurvy; but it is stated that the health of seamen has
in some instances been advanced by the discontinuance of the grog
itself, and the substitution of coffee. _Dr. Nisbett_ says, “I may state
generally, that this substance (lemon juice) in the quantities usually
issued (one ounce per diem) does not prevent the appearance of scurvy
under circumstances favourable to its production; that in increased
quantities it appears to have some power of arresting, at least for a
time, this disease in its earlier stages, and is thus of great value;
but that it is not to be considered an antidote, and that the only cure
for this disease is a full diet of fresh meat and vegetables;” the
preventives being, general and personal cleanliness, ventilation, and
liberal supplies of good water, in addition to supplies of wholesome
food.
The mortality of the home force ships employed chiefly in harbour duty,
&c. (where of course they were not cut off from communication or means
of infection from the shore,) in Great Britain and Ireland, gives the
rate of mortality obtainable by sanitary means, even now confessedly
imperfect especially in ventilation, amongst a male population ranging
from 15 to 50 years of age, and may be taken as illustrative of the
amount of health attainable on shore.
In 1830 the deaths in the navy from disease independently of external
causes were—
Disease, per 1000. All Causes, per 1000.
1830 6·0 8·7
1831 11·5 3·4
1832 11·9 14·0
1833 6·3 7·9
1834 4·9 6·7
1835 5·9 7·2
1836 7·5 9·5
Mr. Finlaison has lately calculated that the deaths _on shore_ out of
1000 of the population of 29 years of age may be estimated at about 12
per annum. Mr. Rickman calculated that the deaths at that age in Essex
and Rutland would be about 12½ persons per 1000 per annum: for the
metropolis it would be about 15½ deaths. Out of 1000 workmen in the
Government dock-yards, the number of deaths were 15; and hitherto in the
metropolitan police force, which is more select than the navy, the
number of deaths appear to be about 9 per annum; but about the same
number of men is annually invalided from the force. The proportion of
deaths amongst the troops appears to be, amongst the household cavalry,
14·5, amongst the dragoons 15·3, amongst the infantry in depôt, 18·5,
and amongst the foot guards 21·6. Since the Guards have been in Canada
the rate of mortality has been reduced to that of other regiments.
The health of the foot guards is believed to be affected by peculiar
circumstances.
I may add, as respects soldiers, that by proper care such epidemics as
typhus, scarlet fever, are now scarcely known as affecting large groups
in the army, and that such an occurrence would denote to the chiefs of
the army medical board the existence of some great neglect into which it
would be necessary to make inquiry.
_Cost to tenants and owners of the public measures for drainage,
cleansing, and the supplies of water, as compared with the cost of
sickness._
Persons well acquainted with the inferior descriptions of tenements in
Manchester state that a large proportion of them change owners in ten
years, and that few remain in the same hands more than twenty years; and
it is observed in other populous districts that this description of
property most frequently changes hands. The chief obstacle to the
execution of legislative measures for public improvements of tenements
of the class in question in such districts has been, that large
immediate outlays of capital have been required to be made in an
inconvenient manner for permanent improvements, by persons possessing
only short or transient interests, to whom no means are given for
spreading the charge over longer periods of years to make it coincident
with the benefits.
In reference to the structural arrangements which come within the public
authority, the majority of professional persons the best acquainted with
the description of tenements occupied by the poorer classes, and the
importance of getting the work done, agree that it would, on the whole,
be the most advantageous course to execute them, by loans paying
interest on the security of the rates, and spread the charge over 30
years during which the original outlay should be repaid. This would
allow of the annual instalment being charged in fair proportions to the
tenant, and to the holders of short interests.
The outlay for the execution of measures which come within the public
authority are those, 1, for bringing water on the premises; 2, for
applying it to remove refuse by a cheap apparatus; 3, a drain for
conveyance of the refuse to the (4) main drains or common sewer.