ready to take interest in its promotion, is now daily on the increase.
If some minister of Public Health could take his seat in the House of
Commons--some minister knowing his subject and feeling it, I believe he
would find no lack of sympathy and co-operation. The world abounds with
admirable wishes and intentions, that vaguely miscarry for want of
guidance. How many men can get no farther in their psalm of life than
the question, _in quo corriget_. To such--not masters of the subject,
but willing and eager to be its servants, an official leader might be
everything: for in great causes like this, where the scandal of
continued wrong burns in each man’s conscience, the instincts of justice
thirst for satisfaction. What can we do or give--how shall we speak or
vote, to lessen these dreadful miseries of sanitary neglect--is, at this
moment, I believe, the fervent inquiry of innumerable minds, waiting, as
it were for the word of command, to act.
How much of this generous earnestness towards the cause exists in
society--how much desire to grasp any reasonable opportunity of good has
lately happened to fall under my notice. Last winter, when the signs of
the times were making us fear that Cholera would presently again be
epidemic in London, it was remembered that, in the greater part of the
metropolis, nothing whatever had been done since the last invasion to
give immunity against the returning disease. It was remembered--too
late, how indescribably dreadful a thing is the epidemic prevalence of
sudden death. And the poor were thought of--in their unprotectedness,
their filth, their ignorance. Among the persons thus aroused, was a
gentleman whom I reluctantly leave unnamed; saying of him only, that,
from a distinguished position in official life, he had retired to
literary enjoyments, amid which he bears the imputation of many
unacknowledged writings which charm and instruct the public. When the
rumours of the pestilence began, he too heard and read and became
aghast. The notion that ‘in a skilful, helpful, Christian country
nothing should be done’ against these impending dangers--that the poor
should be left ‘defenceless, huddled together in some dismal district,
not more helpful than women’--was felt by him, he wrote, ‘deeply as a
disgrace;’ and he pleaded that, ‘on a great and pressing occasion, it
remains for the thoughtful, the rich, and the benevolent, to try and do
these needful things for the people.’[11] Let us, he urged, endeavour to
meet this shameful reproach; let us combine voluntary charitable
assistance for extemporaneous sanitary measures, rapid, though partial;
let us get a hundred thousand pounds and do what we can in aid of local
authorities in the poorest districts--in Bethnal Green, in Shoreditch.
Eventually this plan was abandoned, at least for the time. There was
argued against it, that prompt legislation might do more good, with less
exoneration of local responsibility. Whether rightly or wrongly, the
latter view was acted on; and in accordance with it, the gentleman first
adverted to (waving his own hopes and wishes in the matter) took active
part in framing suggestions,[12] which Lord Palmerston had expressed
himself willing to accept, for modifying the laws of Nuisance and
Disease-Prevention to a form more suitable for the apprehended
emergency. But, in the meantime, what had happened? The author of the
plan, as it were at a moment’s notice, had seemed to draw round himself
half the intellectual and moral strength of the metropolis. Himself
setting aside the literary ambition of his life, he found others ready
to meet him with their several self-sacrifices. Over-worked men of
science and of business, who afford no time to relaxation; favourites of
society, who might have been suspected of mere shuddering at distasteful
subjects; men of high laborious rank in Church and State; poets; heads
of professions; minds that guide the tastes and morals of the country,
or feed its imagination; not least, the invalid from his distant
wintering-place; men, in short, immersed in all kinds and grades of
occupation, were either bodily present at the deliberations referred to,
or were writing about the plan in terms of warm interest, anxious to
promote whatever usefulness could be shown them. About the means there
was discussion--about the object, none; nor lukewarmness. All were
competing, by gifts of time and labour, to snatch some opportunity of
serving this neglected cause.
[11] I quote from a pamphlet printed by him for private circulation.
It was entitled ‘_Health-Fund for London; some Thoughts for next
Summer: by Friends in Council_.’
[12] These have since been laid before the House of Lords, on the
motion, I think, of Lord Harrowby, who took much interest in the
subject.
Such--to return to my text--such, I am deeply assured, would be the
spirit which a minister of Public Health would find abundantly on his
side in Parliamentary discussion, and in the Press. There is no
attachment to the incongruities I have sketched as belonging to our
abortion of a sanitary system. Still less is there any want of feeling
for the poor--any reluctance to raise their state and better their
circumstances--any unconsciousness that these things are great solemn
duties. On the contrary, everywhere there is the conviction that
_something_ must be done; everywhere a waiting for authority to say
_what_. But, the trumpet giving an uncertain sound, who can prepare
himself to battle? Knowledge, and method, and comprehensiveness, are
wanted--the precise, definite, categorical impulses of a Parliamentary
leader, who can recognise principles and stick to them.
And for such a minister, what a career! It would be idleness to speak of
the blessings he could diffuse, the anguish he could relieve, the
gratitude and glory he could earn. A heathen can tell him this. _Homines
enim ad Deos nullâ re propius accedunt quam salutem hominibus dando.
Nihil habet nec fortuna tua majus quam ut possis, nec natura tua melius
quam ut velis, conservare quam plurimos._
Upper Grosvenor Street,
May 15th, 1854.
REPORTS
RELATING TO
THE SANITARY CONDITION
OF THE
CITY OF LONDON.
FIRST ANNUAL REPORT.
TO THE HON. THE COMMISSIONERS OF SEWERS OF THE CITY OF LONDON.
_November 6th, 1849._
GENTLEMEN,
During the 52 weeks dating from October 1st, 1848, to September 29th,
1849, there died of the population of the City of London 3763 persons.
The rate of mortality, estimated from these _data_ for a population of
125,500, would be about the proportion of 30 deaths to every thousand
living persons.[13]
[13] The Census of 1851, compared with that of 1841, would lead me to
believe that in 1848-9 the population of the City must have been about
129,000. With this correction, the death-rate would have been about
29·16 _per_ thousand.--J. S., 1854.
The lowest suburban mortality recorded in the fifth volume of the
Registrar-General’s Reports, for the year then under estimation, gave a
rate of 11 in the thousand; and we might perhaps be justified in
adopting that rate as a _minimum_ for the purpose of sanitary
comparison.
According to this standard (undoubtedly a very superior one) it would
appear that, during the last year, death has prevailed in the City of
London with nearly three times its recognised _minimum_ of severity.
But, to avoid all sources of fallacy, I will allow a very ample margin
to this estimate; I will take 15 per thousand as a fair standard of
mortality, and will assume that last year’s deaths in the City have
amounted to only double their normal proportion.
Probably no one contends that the lower rate of mortality, as
illustrated at Dulwich or Sydenham, indicates an over-healthy condition
of the locality to which it refers. Probably no one argues that human
life, in those healthier districts, is prolonged beyond enviable limits.
Surely, on the contrary, every one who can measure the large amount of
misery and destitution which results from a high rate of mortality, will
think it most desirable that, by every means within the scope of
sanitary science, exertion should be made to reduce the higher rate to
the level of the lower.
Therefore, Gentlemen, I venture to assure myself, that I shall but have
anticipated the wishes of this Hon. Court, in preparing for your
consideration a statement of those circumstances, which apparently
conspire to determine the larger mortality of the City of London.
* * * * *
In order to prevent any misapprehension of my remarks, I think it well
to observe that, in commenting on this mortality, I purposely avoid
instituting any comparison between it and the mortality of those urban
districts which immediately adjoin us: for the object of my comparison
is not to illustrate how, by similar or worse circumstances, an equally
great mortality may have been procured elsewhere; but rather to suggest
how, by other and better sanitary arrangements here, our present high
mortality may be diminished.
Indeed, while I speak of the causes of that high mortality which
distinguishes the City of London from the healthier sub-districts I have
cited, it will be obvious that many of my observations do not apply to
the City of London exclusively, but admit of equal application to
various other central districts of the metropolis;--relating, in fact,
generally to the characteristic evils of all urban residences.
With those other districts I have nothing to do; but I wish it to be
understood, that in describing the City as healthy or unhealthy, I am
not comparing it with Holborn, or Whitechapel, or Bermondsey, or other
urban localities, where--whatever the relative badness of the places,
the scale of comparison would be essentially vicious, and the results of
comparison worthless. It is my object to test the salubrity of the City
by comparison with a superior standard, in order that some definite aim
may appear, towards which to direct the endeavours of sanitary
improvement.
* * * * *
Starting, then, from our Registrars’ Returns, I invite you to inquire
with me, how it has come to pass that within the City of London there
have died in the last year twice as many persons as it seems necessary
that there should die; and whence has arisen the apparent anomaly, that
here--in the very focus of civilization, where the resources of curative
medicine are greatest, and all the appliances of charitable relief most
effectual, still, notwithstanding these advantages, there has passed
away irrevocably during the year so undue a proportion of human life.
Let it not be imagined that the word _cholera_ is a sufficient answer to
these questions, or that its mention can supersede the necessity for
sanitary investigation. Let it, on the contrary, be observed that the
epidemic which has visited us, extends its ravages only to localities
previously and otherwise hostile to life; so that, while all regions of
the globe in succession are shadowed by its dark transit, the healthiest
districts of each region remain utterly unharmed in presence of the
pestilence. Compare, for instance, the cholera mortality in a healthy
suburban sub-district with that of an unhealthy urban one. Dulwich and
the parish of St. Ann’s, Blackfriars, in the City of London, are
probably nearly equal in population: in the former, there was not a
single death from cholera; in the latter, the deaths from this cause
alone were at the rate of twenty-five to every thousand of the
population. Dulwich is one of the healthiest sub-districts within the
bills of mortality; St. Ann’s belongs to one of the unhealthiest
sub-districts of the City of London; and the cholera visited each in
proportion to its ordinary healthiness.
Such is the general rule; and accordingly I would suggest to you that
the presence of epidemic cholera, instead of serving to explain away the
local inequalities of mortality, does, in fact, only constitute a most
important additional testimony to the salubrity or insalubrity of a
district, and renders more evident any disparity of condition which may
previously have been overlooked. The frightful phenomenon of a periodic
pestilence belongs only to defective sanitary arrangements; and, in
comparing one local death-rate with another, it is requisite to remember
that, in addition to the ordinary redundance of deaths which marks an
unhealthy district, there is a tendency from time to time to the
recurrence of epidemic pestilence, which visits all unhealthy districts
disproportionately, and renders their annual excess of mortality still
more egregious and glaring.
* * * * *
As materials which may aid you to estimate the sanitary defects of the
City, I subjoin two tables[14] illustrating the relative mortality of
the several sub-districts. The first of these tables indicates
numerically the local distribution of the year’s deaths, and gives their
proportion to the population of each district and sub-district. The
second relates particularly to the last quarter, and illustrates the
pressure of the epidemic. The two together furnish a synoptical view of
the several rates of mortality, as calculated for the entire City, for
the Unions separately, for the sub-districts separately; and for the
last quarter of the year separately. In the tedious process of
constructing these tables, I have been careful to avoid every source of
inaccuracy, and believe that they present you with a true measure of the
health of the City during the past year.
[14] I have not reprinted these tables quite as here described. The
local distribution of the 3763 deaths of the year is given in the
Appendix, No. III.; and the sub-district death-rates of the year, as
nearly as I can get them, in a note overleaf, page 6. The high
mortality of this summer quarter (in which 1395 persons died) will be
best appreciated by the reader in referring to Appendix, No. XIV.;
where it can be compared with the mortality of similar periods of time
in the four other years there accounted for.--J. S., 1854.
From these comparative tables it will be observed, that the high
mortality of the population does not affect the entire City equally;
that, in some of its portions, the rate of death approaches the
_minimum_ standard much more nearly than in others; that in those
districts where the general rate is best, the temporary aggravation
from epidemic causes has likewise been least; and that our aggregate
City rate, either for ordinary times or for a period of epidemic
disease, is compounded from the joint result of several very different
proportions. Reference to the Registrar-General’s tables will enable any
one to see that the ordinary rate of mortality for the West London Union
is a fourth higher than the rate for the City of London Union, while the
rate for the East London Union bears a still higher proportion; and
these very different rates are, as it were, merged in the one aggregate
rate, struck for the whole City, as comprising the three unions referred
to. It will be obvious, therefore, that many parts of the City are much
healthier than this aggregate rate would signify, while others are much
unhealthier. In regard of last year, for instance, the aggregate rate of
mortality was (as I have stated) 30 per thousand of the general
population of the City: but if this rate be analysed by examination of
the sub-district mortality, it will be seen that in one sub-district the
rate of death stood nearly as low as 20; that in another sub-district of
the same union it rose to 36, and in a third sub-district (of another
union) to within a small fraction of 40.[15]
[15] On account of changes of population shown by the subsequent
Census, these figures would require correction. The death-rates _per_
thousand in the several sub-districts were probably about as follows,
viz.:--
------------------+-------------+------------------------------
EAST LONDON UNION.|W. L. UNION. | CITY OF LONDON UNION.
---------+--------+------+------+-----+-----+------+-----+-----
St. |Cripple-|North.|South.|S. W.|N. W.|South.|S. E.|N. E.
Botolph. | gate. | | | | | | |
---------+--------+------+------+-----+-----+------+-----+-----
26½ | 32 | 34 | 41 | 38 | 22 | 24 | 21⅔ | 22
---------+--------+------+------+-----+-----+------+-----+-----
J. S., 1854.
If it were possible to furnish you with statistics derived from a still
smaller sub-division of each district, these points would be infinitely
more manifest. In some limited localities of the City you would probably
find an approximation to the average mortality of suburban districts;
while in other spots, if they were isolated for your contemplation, you
would see houses, courts, and streets where the habitual proportion of
deaths is far beyond the heaviest pestilence-rate known for any
metropolitan district aggregately--localities, indeed, where the
habitual rate of death is more appalling than any which such averages
can enable you to conceive.
These facts are quite unquestionable, and I have felt it my duty to
bring them under your notice as pointedly and impressively as I can;
feeling assured, as I do, that so soon as you are cognisant of them,
every motive of humanity, no less than of economical prudence, must
engage you to investigate with me, whether or not there may lie within
your reach any adoptable measures for lessening this large expenditure
of human life, and for relieving its attendant misery. It is, therefore,
with the deepest feeling of responsibility that I proceed to fulfil the
main object of my First Annual Report, by tracing these effects to their
causes, and by explaining to you, from a year’s observation and
experience, what seem to me the chief influences prevailing against life
within the City of London.
* * * * *
My remarks for this purpose will fall under the following heads, viz.:--
I. Defective house-drainage;
II. Incomplete and insufficient water-supply;
III. Offensive or injurious trades and occupations;
IV. Intramural burials;
V. Houses insusceptible of ventilation, and absolutely unfit for
habitation;
VI. The personal habits of the lowest classes, and the influence of
destitution in increasing their mortality.
In treating of these topics, I shall not pretend to bring before you all
the details on which my opinions are founded, or to enumerate under each
head those infinite individual instances which require sanitary
correction. It is my wish at this time to submit to you only such
general considerations as may show you the largeness of the subject, its
various ramifications, and its pressing importance; and it is my hope
that these considerations may suffice to convince you of the necessity
which exists in the City of London for some effective and permanent
sanitary organisation.
HOUSE-DRAINAGE.
I. It is not in my power to lay before you any numerical statement of
the proportion of drained to undrained houses. From such information as
I possess, I may venture to speak of imperfect house-drainage as having
been a general evil in all the poorer districts of the City; and the
latest intelligence on the subject leads me to consider this great evil
as but very partially removed. So far as I can calculate from very
imperfect materials, I should conjecture that some thousands of houses
within the City still have cesspools connected with them. It requires
little medical knowledge to understand that animals will scarcely thrive
in an atmosphere of their own decomposing excrements; yet such, strictly
and literally speaking, is the air which a very large proportion of the
inhabitants of the City are condemned to breathe. Sometimes, happily for
the inmates, the cesspool in which their ordure accumulates, lies at
some small distance from the basement-area of the house, occupying the
subsoil of an adjoining yard, or if the privy be a public one, of some
open space exterior to the private premises. But in a very large number
of cases, it lies actually within the four walls of the inhabited house;
the latter reared over it, as a bell-glass over the beak of a retort,
receiving and sucking up incessantly the unspeakable abomination of its
volatile contents. In some such instances, where the basement story of
the house is tenanted, the cesspool lies--perhaps merely boarded
over--close beneath the feet of a family of human beings, whom it
surrounds uninterruptedly, whether they wake or sleep, with its fetid
pollution and poison.
Now, here is a removable cause of death. These gases, which so many
thousands of persons are daily inhaling, do not, it is true, in their
diluted condition, suddenly extinguish life; but, though different in
concentration, they are identically the same in nature with that
confined sewer-gas which, on a recent occasion, at Pimlico, killed those
who were exposed to it with the rapidity of a lightning stroke. In their
diluted state, as they rise from so many cesspools, and taint the
atmosphere of so many houses, they form a climate the most congenial for
the multiplication of epidemic disorders, and operate beyond all known
influences of their class in impairing the chances of life.
It may be taken as an axiom for the purposes of sanitary improvement,
that every individual cesspool is hurtful to its vicinage; and it may
hence be inferred how great an injury is done to the public health by
their existence in such numbers, that parts of the City might be
described as having a cesspool-city excavated beneath it.
I beg most earnestly to press on the consideration of your Hon. Court,
the extreme importance of proceeding with all convenient speed to alter
this very faulty construction, and to substitute for it an arrangement
compatible with the health of the population.
While addressing you on this subject, and while congratulating your Hon.
Court on the fact, that public attention is so much directed to a matter
in which your exertions are certain to effect large and salutary reform,
I cannot refrain from expressing a wish, that more accurate knowledge
prevailed among the public as to the history and jurisdiction of the
nuisance in question. It seems constantly to be forgotten, that your
responsibility in the matter dates but from last January. The
cesspool-nuisance has been the slow growth of other less enlightened
ages, not in the City merely, but in the whole metropolis, and in all
other towns in England. The extreme injury which it inflicts on the
health of the population, and the vital necessity of abating that
injury, are points which only began to claim attention in this country
about ten years ago; and which have since but very slowly been forcing
their way (chiefly through the indomitable zeal and perseverance of Mr.
Chadwick) into that share of notice which they deserve. House-drainage
with effective water-supply, are the remedies which can alone avail; and
it is only during the present year that authority to enforce these
measures has been vested by the Legislature in any public bodies
whatsoever.
Before the month of January last, when your increased jurisdiction was
established, it appears to me that, for the existence of cesspools in
the City, you had no more responsibility than for the original site of
the metropolis, or for the architecture of Westminster Abbey.
During the last ten months, however, the care of effective
house-drainage has rested solely and entirely with your Hon. Court; for
two of those ten months, I thought it desirable, on account of the
epidemic, that no considerable disturbance of the soil should take place
in the construction of new works; in the remaining eight months, two
miles of new sewer were formed, and 900 houses were drained for the
first time.