III.—CIRCUMSTANCES CHIEFLY IN THE INTERNAL ECONOMY AND BAD VENTILATION OF PLACES OF WORK; WORKMEN’S LODGING-HOUSES, DWELLINGS, AND THE DOMESTIC HABITS AFFECTING THE HEALTH OF THE LABOURING CLASSES. (continued 2)

128One of the circumstances most favourable to the improvement of the condition of an artisan or an agricultural labourer, is his obtaining as a wife a female who has had a good industrial training in the well regulated household of persons of a higher condition. The following instance of the effect of the dwelling itself on the condition of a female servant when married, was brought to my notice by a member of the family in which they had been brought up. One was of a young woman who had been taught the habits of neatness, order, and cleanliness most thoroughly as regards household work.

“Her attention to personal neatness,” says a lady who is my informant, “was very great; her face seemed always as if it were just washed, and with her bright hair neatly combed underneath her snowwhite cap, a smooth white apron, and her gown and handkerchief carefully put on, she used to look very comely. After a year or two, she married the serving man, who, as he was retained in his situation, was obliged to take a house as near his place as possible. The cottages in the neighbourhood were of the most wretched kind, mere hovels built of rough stones and covered with ragged thatch; there were few even of these, so there was no choice, and they were obliged to be content with the first that was vacant, which was in the most retired situation. After they had been married about two years, I happened to be walking past one of these miserable cottages, and as the door was open, I had the curiosity to enter. I found it was the home of the servant I have been describing. But what a change had come over her! Her face was dirty, and her tangled hair hung over her eyes. Her cap, though of good materials, was ill washed and slovenly put on. Her whole dress, though apparently good and serviceable, was very untidy, and looked dirty and slatternly; everything indeed about her seemed wretched and neglected, (except her little child,) and she appeared very discontented. She seemed aware of the change there must be in her appearance since I had last seen her, for she immediately began to complain of her house. The wet came in at the door of the only room, and when it rained, through every part of the roof also, except just over the hearth-stone; large drops fell upon her as she lay in bed, or as she was working at the window: in short, she had found it impossible to keep things in order, so had gradually ceased to make any exertions. Her condition had been borne down by the condition of the house. Then her husband was dissatisfied with his home and with her; his visits became less frequent, and if he had been a day labourer, and there had been a beer-shop or a public-house, the preference of that to his home would have been inevitable, and in the one instance would have presented an example of a multitude of cases.

“She was afterwards, however, removed to a new cottage, which was water-tight, and had some conveniences, and was built close to the road, which her former mistress and all her friends must constantly pass along. She soon resumed, in a great degree, her former good habits, but still there was a little of the dawdle left about her; the remains of the dispiritedness caused by her former very unfavourable circumstances.”

I visited some other dwellings not far from the one above described, and met with another instance of a female who had been brought up as a servant in a well-ordered house, and who, for her 129station, had received a very excellent religious and moral education. Before her marriage she had been distinguished by the refinement with which she sung national airs, and for her knowledge of the Bible and of the doctrines of her church. Her personal condition had become of “a piece” with the wretched stone undrained hovel, with a pigsty before it, in which she had been taken. We found her with rings of dirt about her neck, and turning over with dirty hands Brown’s Dictionary, to see whether the newly-elected minister was “sound” in his doctrine. In this case no moral lapse was apparent, but the children were apparently brought up under great disadvantages.

There, however, as in most cases, the internal economy of the houses were primarily affected by the defective internal and surrounding drainage that produced the damp and wet, and thence the dirt against which the inmates had ceased to contend. On inquiry of the male labourers in the district, it appeared that almost every third man was subjected to rheumatism; and with them, it was evident that the prevalence of damp and marsh miasma from the want of drainage, if it did not necessitate, formed a strong temptation to, the use of ardent spirits. With them as with the females, the wretched condition of the tenement formed a strong barrier against personal cleanliness and the use of decent clothes.

In the rural districts the very defects of the cottages which let in the fresh air, in spite of all the efforts of the inmates to exclude it, often obviate the effects of the overcrowding and defective ventilation. It has been observed, that while the labouring population of several districts have had no shelter but huts, similar to those described by Dr. Gilly, as the habitations of the border peasantry, which afforded a free passage for currents of air, they were not subject to fevers, though they were to rheumatism; but when, through the good intentions of the proprietors, such habitations were provided as were deemed more comfortable from excluding the weather effectually, but which, from the neglect of ventilation afforded recesses for stagnating air, and impurities which they had not the means or had not a sufficient love of cleanliness to remove; though rheumatism was excluded, febrile infection was generated. In the towns the access of the wind is impeded by the closeness of the surrounding habitations, and the internal construction of the dwellings tends to exclude the air still more effectually. Were the closed windows opened, it would frequently be only to admit a worse compound, the air from neglected privies, and the miasma from the wet and undrained court or street.

The close pent up air in these abodes has, undoubtedly, a depressing effect on the nervous energies, and this again, with the uneducated, and indeed with many of the educated workpeople, has an effect on the moral habits by acting as a strong and often 130irresistible provocative to the use of fermented liquors and ardent spirits. Much may be due to the incitement of association of greater numbers of people, but it is a common fact that, the same workpeople indulge more in drink when living in the close courts and lanes of the town than when living in the country, and that the residence in the different places is attended with a difference of effects similar to those described in respect to the tailors working in crowded rooms in towns and the tailors working separately or in the country. The workpeople who have fallen into habits of drinking, strenuously allege the impossibility of avoiding the practice in such places; they do, however, drink in greater quantities in such places, and give increased effect to the noxious miasma by which they are surrounded.

Some inquiries from Mr. Liddle, the medical officer of the Whitechapel union, as to the condition of the workpeople he visited in such places as he has described, brought to notice another indirect effect of the external as well as the internal condition of the dwelling on their domestic economy and general condition.

It appeared that the persons whom he visited for the purpose of administering medical relief, were men earning, when in work, from 16s. to 20s. per week, the women earning proportionably. Yet whenever they were subjected to the frequent attacks of sickness which prevailed amongst them, they were in the most, wretched destitution: the house was bare of everything; they had no provisions and no credit, and their need for relief was most imminent. In answer to the inquiry how this was to be accounted for, inasmuch as with agricultural labourers who earned little more than half that sum, and paid nearly as much for their food, in visiting their cottages with their ministers, I had commonly observed some store of provisions; Mr. Liddle stated that in such places as those in his district, in such atmospheres, a store of provisions would not keep: everything decayed rapidly, and the workpeople consequently lived “from hand to mouth.” On inquiring as to this fact from a respectable butcher, accustomed to sell meat to persons living in such situations, he stated that—

“Meat sold on a Saturday night, in hot weather, to poor people, who have only one close room, in which they sleep, and live, and cook, will certainly turn before the Sunday morning; when, if it were kept in the butcher’s shop, or in a well-ventilated place, it would be in as good a condition on the Monday morning. There is a great deal of loss of meat in consequence of the want of ventilation and bad condition of the dwellings of the poorer classes. The butter kept in such places sooner becomes rancid, and the bread dry and disagreeable.”

Here, then, we have from the one agent, a close and polluted atmosphere, two different sets of effects; the one set here noticed engendering improvidence, expense, and waste,—the other, the depressing effects of external and internal miasma on the nervous 131system, tending to incite the habitual use of ardent spirits; both tending to precipitate this population into disease and misery.

The familiarity with the sickness and death constantly present in the crowded and unwholesome districts, appears to re-act as another concurrent, cause in aggravation of the wretchedness and vice in which they are plunged. Seeing the apparent uncertainty of the morrow, the inhabitants really take no heed of it, and abandon themselves with the recklessness and avidity of common soldiers in a war to whatever gross enjoyment comes within their reach. All the districts I visited, where the rate of sickness and mortality was high, presented, as might be expected, a proportionate amount of severe cases of destitute orphanage and widowhood; and the same places were marked by excessive recklessness of the labouring population. In Dumfries, for example, it is estimated, that the cholera, swept away one-eleventh part of the population. Until recently, the town had not recovered the severe effects of the visitation, and the condition of the orphans was most deplorable. Amongst young artisans who were earning from 16s. to 18s. a-week, I was informed that there were very few who made any reserves against the casualties of sickness. I was led to ask the provost what number of bakers’ shops there were? “Twelve,” was his answer. And what number of whiskey-shops may the town possess? “Seventy-nine” was the reply. If we might rely on the inquiries made of working-men when Dr. Arnott and I went through the wynds of Edinburgh, their consumption of spirits bore almost the like proportion to the consumption of wholesome food. We observed to Captain Stuart, the superintendent of the police at Edinburgh, in our inspection of the wynds, that life appeared to be of little value, and was likely to be held cheap in such spots. He stated, in answer, that a short time ago a man had been executed for the murder of his wife in a fit of passion in the very room we had accidentally entered, and where we were led to make the observation. At a short distance from that spot, and amidst others of this class of habitation, were those which had been the scenes of the murders by Burke and Hare. Yet amidst these were the residences of working men engaged in regular industry. The indiscriminate mixture of workpeople and their children in the immediate vicinity, and often in the same rooms with persons whose character was denoted by the question and answer more than once exchanged, “When were you last washed?” “When I was last in prison,” was only one mark of the entire degradation to which they had been brought. The working-classes living in these districts were equally marked by the abandonment, of every civil or social regulation. Asking some children in one of the rooms of the wynds in which they swarmed in Glasgow what were their names, they hesitated to answer, when one of the inmates said, they called them ——, mentioning some nicknames. “The fact is,” observed Captain Miller, the superintendent of the police, “they 132really have no names. Within this range of buildings I have no doubt I should be able to find a thousand children who have no names whatever, or only nicknames, like dogs.” There were found amidst the occupants, labourers earning wages undoubtedly sufficient to have paid for comfortable tenements, men and women who were intelligent, and so far as could be ascertained, had received the ordinary education which should have given better tastes and led to better habits. My own observations have been confirmed by the statement of Mr. Sheriff Alison, of Glasgow, that in the great manufacturing towns of Scotland, “in the contest with whiskey, in their crowded population, education has been entirely overthrown.” The ministers, it will be seen, make similar reports from the rural districts. On the observation of other districts, and the comparison of the habits of the same workmen in town and country, it will be seen that I consider that the use of the whiskey and the prostration of the education and moral habits for which the Scottish labourers have been distinguished is, to a considerable extent, attributable to the surrounding physical circumstances, including the effects of the bad ventilation. The labourers presented to our notice in the condition described, in the crowded districts, were almost all Scotch. It is common to ascribe the extreme of misery and vice wholly to the Irish portion of the population of the towns in Scotland. A short inspection on the spot would correct this error. Mr. Baird, in his report on the sanitary condition of the poor of Glasgow, observes that “the bad name of the poor Irish had been too long attached to them.” Dr. Cowan, of Glasgow, stated that “From ample opportunities of observation, they appeared to him to exhibit much less of that squalid misery and addiction to the use of ardent spirits than the Scotch of the same grade.” Instances were indeed stated to us, where the Irish were preferred for employment from their superior steadiness and docility; and Mr. Stuart, the Factory Inspector for Scotland, states, that “instances are now occurring of a preference being given to them as workers in the flax factories on account of their regular habits, and that very significant hints have been given by extensive factory owners, that Irish workmen will be selected unless the natives of the place, and other persons employed by them, relinquish the prevailing habits of intemperance.” Dr. Scott Alison, in his report on Tranent, has described the population in receipt of high wages, but living under similar influences, as prone to passionate excitement, and as apt instruments for political discontents; their moral perceptions appeared to have been obliterated, and they might be said to be characterised by a “ferocious indocility which makes them prompt to wrong and violence, destroys their social nature, and transforms them into something little better than wild beasts.”

It is to be regretted that the coincidence of pestilence and moral disorder is not confined to one part of the island, nor to 133any one race of the population. The overcrowding and the removal of what may be termed the architectural barriers or protections of decency and propriety, and the causes of physical deterioration in connexion with the moral deterioration, are also fearfully manifest in the districts in England, which, at the time to which the evidence refers, were in a state of prosperity.

Mr. Baker, in his report on the condition of the population, after giving an instance of the contrast presented by the working people living in better dwellings, situated in better cleansed neighbourhoods (to which I shall advert when submitting the evidence in respect to preventive measures), describes the population living in houses—

“With broken panes in every window-frame, and filth and vermin in every nook. With the walls unwhitewashed for years, black with the smoke of foul chimneys, without water, with corded bed-stocks for beds, and sacking for bed-clothing, with floors unwashed from year to year, without out-offices, * * * * while without, there are streets, elevated a foot, sometimes two, above the level of the causeway, by the accumulation of years, and stagnant puddles here and there, with their fœtid exhalations, causeways broken and dangerous, ash-places choked up with filth, and excrementitious deposits on all sides as a consequence, undrained, unpaved, unventilated, uncared-for by any authority but the landlord, who weekly collects his miserable rents from his miserable tenants.

“Can we wonder that such places are the hot-beds of disease, or that it obtains, upon constitutions thus liberally predisposed to receive it, and forms the mortality which Leeds exhibits. Adult life, exposed to such miasmata, gives way. How much more then infant life, when ushered into, and attempted to be reared in, such obnoxious atmospheres. On the moral habits similar effects are produced. An inattention on the part of the local authorities to the state of the streets diminishes year by year the respectability of their occupiers. None dwell in such localities but to whom propinquity to employment is absolutely essential. Those who might advocate a better state of things, depart; and of those who remain, the one-half, by repeated exhibitions of indecency and vulgarity, and indeed by the mere fact of neighbourship, sink into the moral degradation which is natural to the other, and vicious habits and criminal propensities precede the death which these combinations prepare.”

No education as yet commonly given appears to have availed against such demoralizing circumstances as those described; but the cases of moral improvement of a population, by cleansing, draining, and the improvement of the internal and external conditions of the dwellings, of which instances will be presented, are more numerous and decided, though there still occur instances of persons in whom the love of ardent spirits has gained such entire possession as to have withstood all such means of retrieving them. The most experienced public officers acquainted with the condition of the inferior population of the towns would agree in giving the first place in efficiency and importance to the removal of what 134may be termed the physical barriers to improvement, and that as against such barriers moral agencies have but a remote chance of success.

A gentleman who has had considerable experience in the management of large numbers of the manufacturing population stated to me that in every case of personal and moral improvement the successful step was made by the removal of the party from the ill-conditioned neighbourhood in which he had been brought up. When a young workman married, he interfered to get him a better residence apart from the rest; and when this was done important alterations followed; but if he took up his abode in the old neighbourhood, the condition of the wife was soon brought down to the common level, and the marriage became a source of wretchedness.

Benevolent persons, viewing the bare aspect of some of the most afflicted neighbourhoods, have raised subscriptions for the purchase of furniture, bedding, and blankets, for the relief of the inmates, but by this pecuniary aid they have only added fuel to the flame; that is, they have enabled the inmates to purchase more ardent spirits. The force of the habit, which is aggravated by misdirected charity, is indicated in the following instances, of which one was mentioned to me by the Rev. Whitwell Elwin:—

“I was lately informed by a master tailor of Bath that one of his men, who had earned 3l. a-week at piece-work for years, had never within his knowledge possessed table, chairs, or bedding. I found the statement on examination to be strictly true. Some straw on which he slept, a square block of wood, a low three-legged stool, and an old tea-caddy, are the complete inventory of the articles of a room, the occupier of which, with only himself and his wife to maintain, was wealthier than many in the station of gentlemen. He had frequently excited lively compassion in benevolent individuals, who, supposing that he was struggling for very existence, furnished him with a variety of household goods, which were regularly pawned before a week was out, and afforded to the superficial observer fresh evidence of the extremity of his distress. The cause of all this is quickly told: the wife was to be seen going to and fro several times a-day with a cream-jug of gin, and to gratify this appetite, they had voluntarily reduced themselves to the condition of savages. I could add numerous instances of a similar kind. Indeed, were a stranger to go through the town, and judge only from the appearance of things, I am convinced that he would select his examples of greatest privation not from the really poor, but from men who were in the receipt of more than 30s. a-week. Charity, which when prompted by pure motives, always blesses him that gives, does not always bless him that takes. I am afraid that the indiscriminate adoption of dirt and rags as a test of poverty, especially in a town like Bath, where private charity prevails on an extensive scale, operates as a premium upon ill habits, and as a discouragement to cleanliness, and leads many to affect a vice which was not habitual to them.”

As an instance of that state of voluntary wretchedness which renders all such charity or assistance worse than useless, I may 135give an incident mentioned to me by Sir Charles Shaw, the chief commissioner of the new police force in Manchester:—

“A week since,” says Sir Charles, “I sent an inspector of police to examine a lodging-house. He came back to state that he had never witnessed such a sight. He found in one room, totally destitute of furniture, three men and two women lying on the bare floor, without straw, and with bricks only for their pillows. I observed, that I supposed they were drunk. ‘Yes,’ said the inspector; ‘they were, and I found the lodging-house keeper himself in a tolerable bed, and in another room I found bundles of fine fresh straw. I blamed the man for not giving that straw to his lodgers.’ He answered, ‘I keep that straw for the people who prefer purchasing it to gin: those above stairs preferred the gin.’ It is, I find, a common thing here for lodging-house keepers to have straw for sale.”

In the course of an examination which I took, under the Poor Law Commission of Inquiry, from the late Mr. Walker, the stipendiary magistrate of the Thames Police Office, he observed, in respect to cases of apparent destitution:—

“Casualties occurring among the indigent or profligate are at all times liable to be represented as cases resulting from the neglect of the proper authorities. Some time ago, in going round the parish of Whitechapel with the churchwardens, during service-time, we entered an old building in Rosemary-lane, for which there was then no owner, the stairs were so dark and ruinous that though it was mid-day we were obliged to have a candle, to enable us to go up to them: the first-floor was the receptacle of every description of filth. We entered one room, in which we found two half-naked dirty children; their mother lay in one corner on some dirty straw, covered only with a sack. There was no furniture nor other articles in the place, except a fagot of wood and a few broken plates, a basket of skate, and some sprats strewed on the floor. This woman was a fish-hawker, a business by which, in all probability, she gained enough to have made her extremely comfortable, but she preferred an alternation of great privation and profligate enjoyment. Had she accidentally died in this state, here would have been a scene of misery, and a case of excitement for the philanthropists! In our district there are other premises under similar circumstances, all of which are tenanted by persons of the very lowest grade; and it is surprising, considering the state in which they live, that unaccountable deaths, having the semblance of starvation, do not take place amongst them. From what I have observed of these places, I am fully convinced that if shambles were built on any spot, and all who choose were allowed to occupy them, they would soon be occupied by a race lower than any yet known. I have often said that if empty casks were placed along the streets of Whitechapel, in a few days each of them would have a tenant, and these tenants would keep up their kind, and prey upon the rest of the community. I am sure that if such facilities were offered, there is no conceivable degradation to which portions of the species might not be reduced. Allow these tub-men no education, and you would have so many savages living in the midst of civilization. Wherever there are empty houses which are not secured, they are soon tenanted by wretched 136objects, and these tenants continue so long as there is a harbour for them. Parish officers and others come to me to aid them in clearing such places. I tell the police and the parish that there is no use in their watching these places, that they must board them up if they would get rid of the occupants. If they will give the accommodation they will get the occupants. If you will have marshes and stagnant waters you will there have suitable animals, and the only way of getting rid of them is by draining the marshes.”

The Reverend Whitwell Elwin observes upon this subject that—

“Those who think that labourers will work for themselves a reform in their habitations very much underrate the effects of habit. A person accustomed to fresh air, and all the comforts of civilized life, goes into a miserable room, dirty, bare, and, above all, sickening from the smell. Judging from his own sensations, he conceives that nothing but the most abject poverty could have produced this state of things, and he can imagine nothing necessary to a cure but a way for escape. A very simple experiment will correct these erroneous impressions. Let him remain a short time in the room, and the perception of closeness will so entirely vanish that he will almost fancy that the atmosphere has been purified since his entrance. There are few who are not familiar with this fact; and if such are the effects of an hour in blunting our refined sensations, and rendering them insensible to noxious exhalations, what must be the influence of years on the coarser perceptions of the working-man?

“All who know the lower classes will testify that the last want felt by the dirty is cleanliness, that their last expenditure is on the comforts of their home. Two winters ago I found a painter whose bed was without blankets, whose room was without furniture, who was destitute even of the ordinary utensils of civilized life, whose floor was covered with worse filth than that of the streets—I found this man at dinner with a roast loin of pork stuffed with onions, a Yorkshire pudding, a large jug of ale, cheese, and a salad. I will undertake to say that half the gentlemen in Bath did not sit down on that Sunday to so good a dinner.”

A number of communications simply assign “intemperance” as the cause of fever, and of the prevalent mortality. Of most of these communications, which it were unnecessary to recite, it may be observed, that when intemperance is mentioned as the cause of disease, as being the immediate antecedent, on carrying investigation a little further back, discomfort is found to be the immediate antecedent to the intemperance; and where the external causes of positive discomfort do not prevail in the towns, the workpeople are generally found to have few or no rival pleasures to wean them from habits of intemperance, and to have come from districts subject to the discomforts likely to engender them. In one of the returns from Scotland it is observed that with the people, whether for a fever, a cold, or consumption, or a pleurisy, whiskey is the universal antidote. The popular belief that fermented liquor or ardent spirits are proper antidotes to the effects of damp or cold has been 137universal, and has not wanted even medical sanction. Out-door allowances of beer have been prescribed by some medical officers in marshy and undrained districts as the proper preservatives against ague or rheumatism. The Board will now be in a position to urge the importance of facilitating drainage as a means for the protection of the population by the prevention of disease and the inducement to pernicious habits, as well as a source of profitable industry. It is now beginning to be observed in several dangerous occupations that temperance is the best means of withstanding the effects of the noxious agencies which they have to encounter. Amongst the painters, for example, the men who are temperate and cleanly suffer little from the occupation, but if any one of them become intemperate, the noxious causes take effect with a certainty and rapidity proportioned to the relaxed domestic habits. The Inquiry presents many instances of the beneficial effects of the changes of the popular habit of having recourse to fermented liquors or to spirits as necessary protective stimulants. In several of the mining districts, for example, it is an extensive practice to provide for the accommodation of the miners out of the hot mines a room in which they may drink beer as a preservative against the effects of the change to the cold and damp air to which they are about to expose themselves. Dr. Barham, in his Report to the Commissioners appointed to inquire into the Employment of Young Persons in Mines and Manufactories, notices an admirable example within the province of voluntary exertion, and the beneficial effects produced by it at the Dolcoath copper and tin mine, Camborne, Cornwall. There the proprietors, besides establishing other easy and economical preventive arrangements, provide a warm room for the miners to change their dresses and take hot meat-soup, which is cheaper, probably, than beer. “And the men” (says a witness) “say they never feel cold when they take it. We conceive that there have been much fewer cases of consumption on the club since this practice has been adopted.”

The effects of the noxious physical agencies on the moral condition of the population will receive more full illustration in connexion with the statistical evidence as to their effects, with the evidence on the practical operation of the means of prevention.

Domestic mismanagement, a predisposing cause of disease.

The subsequent examples relate chiefly to the effects of general domestic mismanagement as a concurrent cause of disease.

Dr. Baker, in his report on the sanitary condition of the population of Derby, states that—

“There is also another cause of sickness to be found in their houses, and which, like the former, i. e., the external circumstances, is in constant 138operation: I mean the want of domestic comforts, a want which the wages they earn would, in many instances, enable them to remove if their means were not, as too often happens, expended viciously or improvidently. It is with regret that I speak unfavourably of the poor, whilst my whole aim, in this communication, has been to awaken a sympathy towards those sufferings of which I have been so often a witness. But several years’ experience of the habits of the poor, derived from my situation as an hospital physician, and backed by the additional evidence I have obtained by acting for three years as a guardian of the poor in this large town, has, I am sorry to say, served but to confirm me in the opinion I have just now expressed; and in support of which I shall instance the family of the Slaters mentioned at No. 12, in Short-street.

“The earnings of four members of this family were as follows:—

s. d.

The father 14 0 per week, at gardening, &c.

The eldest son, aged 20 12 0 per week, at a brewery.

Daughter {Twins, } {aged 18} 6 0 per week, at a factory.

Son 9 0 per week, at the same factory.

£2 1 0 per week.

“The mother of this family, it appears, is left disengaged from all but her household duties and the care of the younger children; the house, nevertheless, is nearly destitute of furniture, and presents a picture of disorder and want. On the other hand, at No. 15, (Briggs) although the husband has for some years past been a weak and ailing man, the family is well ordered and cleanly; and to this fact I mainly attribute the milder and modified form of fever which affected the children.”

The Committee of Physicians and Surgeons at Birmingham, in their report, indicate the powerful operation of depraved domestic habits as a predisposing cause to disease:—

“It cannot,” they say, “be doubted that whilst the arts and manufactures of the place prove in some instances injurious to health, and in a few possibly destructive to life, these evil consequences, as well as hereditary predisposition to disease, are promoted by intemperance, not that intemperance is an infinitely more frequent cause of disease and death amongst the artisans than all the various employments of all the manufactories combined.

“In the expenditure of their weekly earnings, improvidence and thoughtless extravagance prevail to a lamentable degree. The observations upon which this opinion is formed are made upon the habits of the people themselves, confirmed by extensive and recent inquiries among the shopkeepers with whom they deal. Tea, coffee, sugar, butter, cheese, bacon, (of which a great deal is consumed in this town,) and other articles, the working people purchase in small quantities from the hucksters, who charge an enormous profit upon them, being, as they state, compelled to do so to cover the losses which they frequently sustain by bad debts. Huckster dealing is a most extravagant mode of dealing; there were in this town, in 1834, 717 of these shops, and the number has greatly increased since that time. Meat is purchased in the same 139improvident manner; the working men generally contrive to have a good joint of meat upon the Sunday; the dinner on the other days of the week is made from steaks or chops, which is the most extravagant mode either of purchasing or cooking meat.

“The improvidence of this class of persons arises in many instances from the indulgence of vicious propensities. Drunkenness, with all its attendant miseries, prevails to a great extent, though it is by no means to be regarded as a characteristic feature of the mechanic of this town in particular. It most generally prevails among that class of workmen who obtain the highest wages, but who are often found in the most deplorable and abject condition. The improvidence of which we are speaking is to be traced in very many instances to extreme ignorance on the part of the wives of these people. The females are from necessity bred up from their youth in the workshops, as the earnings of the younger members contribute to the support of the family. The minds and morals of the girls become debased, and they marry totally ignorant of all those habits of domestic economy which tend to render a husband’s home comfortable and happy; and this is very often the cause of the man being driven to the alehouse to seek that comfort after his day of toil which he looks for in vain by his own fireside. The habit of a manufacturing life being once established in a woman, she continues it, and leaves her home and children to the care of a neighbour or of a hired child, sometimes only a few years older than her own children, whose services cost her probably as much as she obtains for her labour. To this neglect on the part of their parents is to be traced the death of many children; they are left in the house with a fire before they are old enough to know the danger to which they are exposed, and are often dreadfully burnt.”

Mr. Mott’s report on the sanitary condition of the population of his district presents parallel instances of the different economy prevalent amongst these classes:—

Contrast in the Economy of Families.

1. 1.

Cellar in Wellington-court, Chorlton-upon-Medlock; a man, his wife and seven children; income per week, 1l. 11s.; rent 1s. 6d. per week; three beds for seven, in a dark, unventilated back room, bed-covering of the meanest and scantiest kind—the man and wife occupying the front room as a sleeping-room for themselves, in which the whole family take their food and spend their leisure time; here the family, in a filthy destitute state, with an income averaging 3s. 5¼d. each per week, four being children under 11 years of age. In a dwelling-house in Chorlton Union, containing one sitting-room and two bed-rooms; a man, his wife and three children; rent 2s. 6d. per week; income per week 12s. 6d., being an average of 2s. 6d. per week for each person. Here, with a sickly man, the house presented an appearance of comfort in every part, as also the bedding was in good order.

2. 2.

140Cellar in York-street, Chorlton-upon-Medlock; a man—a hand-loom weaver—his wife and family (one daughter married, with her husband forms part of the family), comprising altogether seven persons; income 2l. 7s., or 6s. 8½d. per head; rent 2s. Here, with the largest amount of income, the family occupy two filthy, damp, unwholesome cellars, one of which is a back place without pavement or flooring of any kind, occupied by the loom of the family, and used as a sleeping-room for the married couple and single daughter. In a dwelling-house, Stove-street, one sitting-room, one kitchen and two bed-rooms, rent 4s. per week. A poor widow, with a daughter also a widow, with ten children, making together 13 in family; 1l. 6s. per week, averaging 2s. per head per week. Here there is every appearance of cleanliness and comfort.

3. 3.

John Salt, of Carr Bank (labourer), wages 12s. per week; a wife, and one child aged 15: he is a drunken, disorderly fellow, and very much in debt. George Hall, of Carr Bank (labourer), wages 10s. per week; has reared ten children; he is in comfortable circumstances.

4. 4.

William Haynes, of Oakamoore (wire-drawer), wages 1l. per week; he has a wife and five children; he is in debt, and his family is shamefully neglected. John Hammonds, of Woodhead (collier), wages 18s. per week; has six children to support; he is a steady man and saving money.

5. 5.

George Locket, of Kingsley (boatman), wages 18s. per week, with a wife and seven children; his family are in a miserable condition. George Mosley, of Kingsley (collier), wages 18s. per week; he has a wife and seven children; he is saving money.

6. 6.

John Banks, of Cheadle (collier), wages 18s. per week; wife and three children; his house is in a filthy state, and the furniture not worth 10s. William Faulkner, of Tean (tape-weaver), wages 18s. per week; supports his wife and seven children without assistance.

7. 7.

William Weaver, of Kingsley (boatman), wages 18s. per week; wife and three children; he is a drunken, disorderly fellow, and his family entirely destitute. Charles Rushton, of Lightwoodfields, wages 14s. per week; he supports his wife and five children in credit.

8. 8.

Richard Barlow, of Cheadle (labourer), wages 12s. per week; wife and five children, in miserable circumstance, not a bed to lie on. William Sargeant, of Lightwoodfields (labourer), wages 13s. a-week; he has a wife and six children, whom he supports comfortably.

9. 9.

Thomas Bartlem, of Tean (labourer), wages 14s. per week; his wife earns 7s. per week; five children; he is very much in debt; home neglected. William Box, of Tean (tape-weaver), wages 18s. or 20s. per week; supports his wife in bad health, and five children.

10. 10.

Thomas Johnson, of Tean (blacksmith), wages 18s. per week; his wife earns 7s. per week; three children; he is very much in debt, and his family grossly neglected. Ralph Faulkner, of Tean (tape-weaver), wages 18s. or 20s. per week; supports a wife and five children, three of them are deaf and dumb.

Mr. Harrison, the medical officer of the Preston union, observes that—

“I have known many families whose income has exceeded 100l. a-year, who in times of sickness have been in great distress, and even some who have been obliged to have recourse to the parish for assistance. And I am acquainted with several families now of the best paid 141class of workpeople, whose total weekly earnings will average 2l., and in some cases 3l. a-week, who, should sickness overtake the head of the family, and some of the principal workers among the children, would be thrown upon the parish. I have been convinced from extensive observation, that the masters of these people have it in their power to improve the condition and happiness of their workpeople beyond what can be effected by any other agency.”

These descriptions are not confined to the English towns. Mr. Jupp and others cite instances from the rural districts. They are similarly prevalent in Scotland. As an example I would refer to the description given by Dr. Scott Alison, of the condition of the highly-paid collier population of Tranent. Take another instance of the condition of the same class, the colliers at Ayr, given by Dr. Sym, in his report on the sanitary condition of the population of that town:—

“Although the colliers have large wages, they are, from their want of economy and their dissolute habits, uniformly in poverty; and their families, though well fed, are miserably clothed, ill lodged, uneducated, and less industrious than the families of the weavers; the females of which work with great constancy at hand-sewing. The modes of living of these two classes are very different. The weaver is not intemperate, because he cannot afford to purchase ardent spirits, and the nature of his employment prevents him from having those hours of idleness during the day which the collier is so apt to consume in dissipation. He lives on very innutritious food, seldom eats butchers’ meat, and the most indigent, who are generally Irishmen, subsist chiefly on potatoes. The collier, on the other hand, indulges to excess in ardent spirits, and both he and his family partake of animal food every day. In short, the colliers live better than any of the other labouring classes in Ayr.”

Dr. Scott Alison, speaking of the colliers of Tranent, states that they obtain very high wages. “A man, his wife, and perhaps two children may earn perhaps 40s. a-week, if industriously employed during that time.” On the subject of appearances of destitution, on which medical men sometimes report, he observes—

“I have had occasion to know that medical men, judging from internal appearances of the dwellings of the labouring classes, are liable to be led into erroneous inferences as to the extent of destitution. The appearance of the place or of the person is no test of the want of means or of the highness or lowness of wages. Filth is more frequently evidence of depravity than of destitution; indeed, in places where the wages or means are really scanty, there is very frequently considerable cleanliness. If a stranger went into the house of a collier, he might exclaim, ‘What extreme wretchedness and destitution!’ when, in fact, on the Saturday they had received 30s., which before the Tuesday had all been squandered. I think medical men, who are not intimately acquainted with the character of people, are often drawn into mistakes.”

The domestic condition of this population admits of a contrast with the condition of individuals of their own description of employment, or with the condition of other classes of miners who 142receive no higher wages, but whose condition is highly superior, to show that the depraved habits and condition are not the necessary result of the employment. He contrasts the condition of the colliery population of Tranent with the condition of the agricultural labourers in the immediate vicinity of the town:—

“With very few exceptions, the condition of the interior of the houses of the hind population is excellent, most pleasing to the eye, and comfortable. These respectable people, in spite of the defective construction of their cottages, manage to throw an air of comfort, plenty, neatness, and order around their homes. I have often been delighted to observe these characteristics, and not less so to mark the co-existence of pure, moral, and religious principles in the inmates, the presence of practical religion and practical morals. When the floor wears away, it is repaired; when the walls lose their whiteness, they are whitewashed; and every few days the whole wooden furniture in the house is subjected to thorough cleansing with sand and warm water. The various articles of furniture, and the different household utensils, are kept in places allotted to them; and the earthenware and china well cleaned, are neatly arranged, and made to serve as ornaments to the apartment. The metal spoons, candlesticks, and pitchers for containing milk and water, are well burnished. The milk taken from the cow may be seen set apart in vessels kept in the nicest order; and beside them lie the churning-barrel and strainer. A fire sheds its cheerful influence over the scene; the kettle never wants hot water; and the honest, frugal housewife is ever discharging some household duty in a spirit of placid contentment, attending to her partner when present, or preparing his meals against his return from the fields.

“The external economy of the houses of the hinds is on the whole very good. The ground in front of the cottages is kept clean and free of impurities. The little garden, which is almost invariably connected with the cottage, is kept in good order, and is in general well cultivated.”

The like contrast, derived from an intimate knowledge of the population of another class, is presented in the following portions of a report from Mr. Wood, of Dundee:—

“There are many families among the working classes who are in the receipt of from 15s. to 22s. per week, who are insufficiently clothed, and irregularly and poorly fed, and whose houses as well as their persons appear filthy, disorderly, and uncomfortable. There are other families among them, containing the same number of persons, whose incomes average from 10s. to 14s. a-week, who are neatly, cleanly, and sufficiently clothed, regularly and suitably fed, and whose houses appear orderly and comfortable. The former class care little for the physical comfort, and far less for the intellectual, moral, and religious education of their children; in many cases, indeed, they neglect the education of their offspring when it is offered to them gratuitously, and in place of sending them to school, where they might be fitted for the duties and disappointments of life, they send them at a very early age to some employment, where they will earn the poor pittance of 1s. 6d. to 3s. a-week. The latter class, on the contrary, are most anxious to give their children a good education: they study to obtain it for them by 143every means in their power, and they pay for it most cheerfully. The former class again grasp at every benefit which the charitable institutions of the place have provided for the poor. When, for example, medical attendance is given them gratuitously, they not unfrequently despise and refuse it, unless medicines are given them gratuitously also. Whereas the latter description of families are not only ready and willing to pay for medicines when prescribed to them, but they generally manifest much gratitude, and very often present their medical attendant with a small fee.

“Now it is among the former class of families where generally there appears to me to be a deficiency of wholesome food and of warm clothing; where contagious, febrile diseases are most commonly found; and from whence they are most extensively propagated. Fever is no doubt found among the latter, more frugal, and therefore better conditioned families, but seldom of that malignant, contagious character which it invariably assumes among the other class of families. Here, then, we have on the one hand, filth, destitution, and disease, associated with good wages; and on the other, cleanliness, comfort, and comparative good health, in connexion with wages which are much lower. The difference in the amount of their incomes does not account for the difference in the amount of comfort which is found existing among the working classes. The statements just made make known the fact, that above a certain amount, say 12s. or 14s. of weekly income, wages alone, without intelligence and good habits, contributes nothing towards the comfort, health, and independence of the working population. * * * Were I asked how I would propose to relieve such a family, I would say, show them how they may live comfortably within their incomes; let them be taught and trained to habits of industry, frugality, sobriety, cleanliness, &c., and with this 12s. or 14s. they may live in health and happiness as others in similar circumstances have lived and are now living. The man who maintains himself and his family in comfort on 12s. or 14s. of weekly income, possesses what he well deserves, happiness at home, and he stands forth in his neighbourhood a noble example of honest independence. I am persuaded that the filth, fever, and destitution in many families is occasioned, not by their small incomes, but by a misapplication or a prodigal waste of a part, in some cases a great part, of their otherwise sufficient wages. Frequently cases are found where, with a want of skill and economy, there is combined the intemperate use of intoxicating liquors, and here the misery may be said to be complete.

“Such is the explanation which I have to offer regarding much of the misery now prevalent, and it is the explanation invariably given by the economical working classes themselves when questioned on the subject. Heads of families, having three or four children, whose incomes average from 14s. to 18s. per week, have assured me that a man with a wife and three or four children can live comfortably on 12s. or 14s. a-week; and they generally account for the misery and destitution existing among families by saying, that many who have good wages reduce themselves to poverty and deprive themselves of sufficient food and clothing by their mismanagement, want of frugality, and drinking practices. Cases of waste and dissipation have been related to me, where the husband having gone to the tippling-house to enjoy his glass and his friend, the wife, knowing this, sent for her bottle and her friend, 144and enjoyed herself at home. A single visit to one of these spendthrift families, who are in the receipt of good wages, would convince any one that their persons and houses might be far more orderly, clean, and comfortable, were they but half trained to the tastes and habits of household industry, sobriety, and economy.”

The more closely the investigation as to the causes of epidemic disease is carried the more have the grounds been narrowed on which any presumption can be raised that it is generally occasioned by extreme indigence, or that it could be made generally to disappear simply by grants of money.

In the great mass of cases in every part of the country, in the rural districts and in the places of commercial pressure, the attacks of disease are upon those in full employment, the attack of fever precedes the destitution, not the destitution the disease. There is strong evidence of the existence of a large class of persons in severe penury in some places, as in Glasgow, being subject to fever, but the fever patients did not, as a class, present evidence of being in destitution in any of the places we examined. Dr. William Davidson, the senior physician of the Glasgow Royal Infirmary, who has written a Treatise on the Sources and Propagation of Continued Fevers, for which the prize instituted by Dr. Thackeray, of Chester, was unanimously awarded at the annual meeting of the Provincial Medical and Surgical Association, states in that treatise, when speaking of the influence of delicacy of constitution as a predisposing cause of fever,—

“We have kept a record of the physical habit of the patients admitted into the Glasgow Fever Hospital from May 1st to November 1st, 1839, and the following were the divisions adopted:—

“1. Moderate, by which is meant a person having an ordinary quantity of muscle and cellular substance.

“2. Full or plethoric, having an extra quantity of adipose texture or of blood.

“3. Muscular.

“4. Spare.

“5. Emaciated or unhealthy in appearance.

Males. Females. Total.

Moderate 116 93 209

Full or Plethoric 28 73 101

Muscular 44 44

Spare 24 41 65

Unhealthy or Emaciated 2 8 10

429

“The whole of these 429 cases were characterized by the typhoid eruption, and will therefore be considered as decided cases of typhus. It appears from this table that there were only 10 cases in an emaciated or unhealthy condition; and almost all of them, as far as could be ascertained, 145were engaged in their ordinary occupations at the time of their seizure. The spare and unhealthy, when added together, only form about 17 per cent. of the whole number.”

He gives two tables of the proportionate numbers of persons admitted, during the year 1839, into the Glasgow Fever Hospital, whose persons were clean or filthy:—

“These two tables show that, among 611 cases admitted as continued fever, there were 340 filthy and 271 clean, or about 55 per cent. filthy; that among 395 cases of eruptive typhus, there were 245 filthy and 150 clean, or about 62 per cent. filthy; and that among 48 cases of febricula there were 14 filthy and 34 clean, or about 29 per cent. filthy.”

Amongst the fever patients are found a larger proportion of the highly intemperate than appear to be usually found amongst the labouring classes.

Dr. Davidson, in remarking on the influence of intemperance on fever, adduces the following table to show the proportion of temperate and intemperate individuals who were admitted into the Glasgow Fever Hospital from November 1st, 1838, to November 1st, 1839, whose habits could be ascertained with more or less certainty. He states that the eruptive cases only are included:—

Temperate. A little Intemperate. Intemperate.

Typhus (Males) 125 51 73

Typhus (Females) 76 8 30

I have been informed that those were classed as “temperate” who never indulged in strong liquors to the extent of inebriety; those a “little intemperate” who now and again, perhaps at long intervals, drank to intoxication; and those as “intemperate” who were habitually so—who drank whenever they could get ardent spirits.

He adds,—

“In the Glasgow Fever Hospital there occurred 81 deaths from eruptive typhus in individuals whose habits were ascertained, and 34 of these were reported as intemperate, 19 a little intemperate, and 28 temperate. In Dr. Craigie’s table of the deaths in 31 fever cases that occurred in the Edinburgh Royal Infirmary, there were 15 stated to be irregular or dissipated; only two regular; the habits of the remainder are not stated.

“It is also a singular fact, which has been noticed by several writers, that fever is more fatal among the higher than among the lower classes. Dr. Braken states, in reference to the fever which prevailed at Waterford during the years 1817–18–19, that ‘it would be difficult to adjust the rates of mortality in the upper classes, but it seems probable that one-fourth, or perhaps one-third of all those persons who were attacked with fever fell victims to its power.’

“Drs. Barker and Cheyne, in their historical account of the Irish epidemic, state that, ‘in every part of the country, fever was reported to have been much more fatal amongst the upper than the lower classes.’ To what is this difference of mortality, so generally remarked by experienced hospital physicians, to be attributed, and 146which in Ireland seemed to be very remarkable, namely, in the lower classes about one in twenty-three cases, and in the upper classes one in three or four generally, but in other places about one in seven? Can the difference in the mode of living account for this anomaly? as the first live very much on potatoes, while the others use a larger or smaller proportion of animal food; and the lower classes almost everywhere in this country use less animal food and stimulating dishes than those who are more wealthy and in a higher sphere of society.”

In remarking on the supposed influence of fear and the depressing passions in producing fever, Dr. Davidson, however, remarks:—

“The influence of fear and the depressing passions has also been considered as very powerful in predisposing persons to be affected with typhus contagion. There can be no doubt that fear has a tendency to produce a temporary depression of the physical powers; but, as has been already shown, there is no proof that persons of a naturally spare or weak habit of body, who are generally very sensitive, are more liable to fever than those of an ordinary constitution; this opinion must also be considered hypothetical. Indeed the facts, as far as our inquiries have enabled us to judge, seem to prove that the apprehension of fever, more particularly when it is not epidemic, is very rarely felt until the person is actually seized with the disease; for some cannot recollect of a single circumstance by which they could be exposed to contagion; and a considerable number of those who had undoubtedly been exposed to it were only made aware of the fact when it had been elicited by cross-examination. We are quite aware that cases may be brought forward of sensitive individuals who have been seized with fever soon after visiting a person labouring under the disease; but as this fact can be opposed with at least an equal number of persons who were destitute of fear, and yet caught it after an exposure to contagion, no conclusion whatever can be drawn from them. It must be observed, however, that though there is no proof that persons who are naturally weak in body or of a sensitive disposition are more susceptible of fever than those who are naturally vigorous and robust, yet that, during famine or commercial distress, poverty, by depressing the mind and lowering the physical status from insufficient aliment, does powerfully predispose a community to become affected with fever. This has been already shown in a former part of the essay, and has been again alluded to in order that the distinction might be made between an individual of naturally weak mental and physical stamina, and one who has been reduced to that state by deficient nutriment.”

There appears to be little evidence on one side or the other in support of this last hypothesis, other than such as that cited from Dr. Davidson himself; but it is to be observed that the wet or bad seasons, which suspend agricultural industry and much labour in the towns, is usually of a character of itself to predispose to disease, if not to produce it; and that it does propagate it amongst all classes, high and low, in proportion to their exposure to it. It appears to be highly probable that the privation attendant on the stoppage of work, by diminishing the means for 147the purchase of fuel, of soap, &c., and in various ways by inducing lax habits of life, may increase the amount of exposure to and loss from the all-pervading cause.

The preponderant evidence given on this subject by the great majority of the medical officers in England who are accustomed to visit the labouring classes in their own dwellings, is however of the tenor of the following from the medical officer of the Whitechapel union acting in Spitalfields parish.

Mr. Byles, the medical officer of the Whitechapel union:—

“What is the number of cases you have had to visit during the year 1841 as a medical officer?—I think the number of cases I have had to visit during each year since the commencement of the Union has been upwards of 2,000 cases of various disease, of which 1,400 were cases out of the workhouse.

“Has the present winter been unhealthy?—I do not think it has; there has been an increase of fever cases during the last month. The number of cases is, however, still below the average of 1838.

“Is there not, however, unusual distress in your district, comprehending Spitalfields and a portion of Whitechapel?—Yes, there is: I believe that more than half the looms are out of work.

“Do you not find that fever attacks in greatest number those who are out of work?—On the contrary, the greatest number of the cases of fever we have are those who fall ill during the time they are in employment. I think they are more attacked when in work, when the windows are closed, and there is no ventilation. Many of them are obliged to work with closed windows, to keep out the moist air, and prevent the dust blowing upon their work. When they are out of work, they are more out of doors looking after work, more in the open air, and that very exercise may be the means of keeping them in health. This observation applies to the weavers. I find that they have generally less fever when they are out of work. The reverse, I think, holds as respects out-door labourers, such as those who work at the docks. When they are out of work, they stand about waiting in the cold, and when cold, they generally take cheap gin, and no food: they catch cold, and on going to their close filthy habitations, their cold is apt to generate fever.

“There was an unusual amount of fever prevalent in Spitalfields and Whitechapel, was there not, in the year 1838?—Yes, there was; in the proportion, perhaps, of more than two to one of the present amount. My last account for the year ending Lady-day, 1842, was about 250 fever cases; it has been as high as 800.

“Did it prevail proportionately amongst the weavers?—Yes, I believe it did.

“Was there any marked or unusual distress at that period?—Not that I remember.

“Do you find in the course of your experience that the diminution of food is followed by fever?—Not as a general cause, I should say. If these two persons, casually exposed to the contagion of fever, the one in full vigour, and with a full stomach, the other with an empty stomach, the person with the empty stomach would be the most obnoxious to its influence. In my experience, however, intemperance is a much more frequent antecedent to fever than destitution or want of food.

148“Have you ever observed that habits of intemperance are created by distress of mind?—Such cases may occur, but I have not observed them, and I think it does not operate as a general cause.

“What are the chief remedies which your experience in this district would lead you to recommend for the prevention of fever and contagious diseases?—The promotion of cleanly habits amongst the poor; the promotion of sewerage and drainage; having proper supplies of water laid on in the houses; the removal of privies from improper situations. I could point out in our neighbourhood many houses, and some courts, that ought to be pulled down as wholly unfit for human habitation.

“What is the personal state of the labouring classes in your district?—Generally extremely filthy. I have said that I could almost smell from what street a man came who came to my surgery: I do not think the poor themselves are conscious of it, but the smell to other persons must be extremely offensive. I certainly think that the want of personal cleanliness, and of cleanliness in their rooms, and the prevalence of fever, stand in the relation of cause and effect.

“Your colleague has pointed out that the want of proper and convenient supplies of water is an antecedent to the filth and the fever. Does your experience enable you to concur with him?—My experience entirely agrees with his on that point.”

The late Dr. Cowan, of Glasgow, and the great majority of the medical officers, assign the foremost place to these physical agencies as antecedents to fever.

The medical controversy as to the causes of fever; as to whether it is caused by filth and vitiated atmosphere, or whether the state of the atmosphere is a predisposing cause to the reception of the fever, or the means of propagating that disease, which has really some other superior, independent, or specific cause, does not appear to be one that for practical purposes need be considered, except that its effect is prejudicial in diverting attention from the practical means of prevention.

Dr. Bancroft, one of the controversialists cited by Dr. Davidson, observes,—

“That fever often exists in them” (gaols) “cannot be denied; but this circumstance can afford no evidence of its being generated therein, any more than the multiplication of vermin in such places could demonstrate the spontaneous generation of these and other insects by the nastiness which favours the deposition and hatching of their eggs.”

Taking the controversy at this point, and admitting the force of this statement, the decision upon it will not alter the practical value of cleanliness, or of its protective effects in prevention, whether it remove an original or only a predisposing cause.

Yet it cannot but be regretted that the enlightened force of the professional opinion should sustain any diminution from an apparent want of unanimity on so important a question as the necessity of removing these causes, whether original or predisposing: that, for example, whilst the fleets were ravaged by fever and disease, men of high standing should have occupied the attention 149of the public with speculations on contagion, and infection from the gaols as the original cause, and diverted attention from the means of prevention, cleansing and ventilation, the means by which, as will hereafter be shown, the pestilence was ultimately banished. The main error of those who have ascribed fever to destitution, appears to have been in adopting too hastily as evidence of the fact of destitution, such primâ facie appearances as are noticed by Dr. Scott Alison, an error which non-professional experience may correct. In more than one instance where, in a district in which the demand for labour was still great, and the wages high, benevolent gentlemen have propounded similar doctrines, which, being at variance with the known state of the labour-market, I have requested that the names of these fever cases might be given, that their antecedent circumstances might be examined, and the accuracy of the conclusions tested, by officers of experience in such investigations; but I think it right to state the names or means of inquiry have never been forthcoming. In general, medical practitioners and benevolent individuals are extremely liable to deceive themselves and to deceive others, by what they call the evidence of their own eyes. The occurrence of severe destitution is denied as a general cause of fever, not as a consequence. The evidence shows that the best means of preventing the consequent destitution are those which prevent the attacks of fever and other epidemics upon all classes of the community.

By an extract from a report of the late Dr. Currie, of Liverpool, given in the Appendix, it will be seen that at the time he wrote, 1797, when only 9500 of the population are reported to have lived in cellars, the proportion of fever cases was nearly the same as at present, when the cellar population has risen to 40,000; the disease has been almost as constant as the surrounding physical circumstances of bad ventilation, filth, and damp then pointed out as removable, and the disease has continued in every period of the prosperity of the town in its progress from a population of 77,000 to 223,000 in 1841. So the late Dr. Ferriar, of Manchester, when writing between 30 and 40 years ago, of the state of the population in periods of great prosperity, especially for hand-loom weaving, described the effect of the bad economy of the habitations much as they were described in the year 1829 by Dr. Kay, and as they are described in 1840 by Dr. Baron Howard. Dr. Ferriar, when he wrote to warn the labouring classes as to the choice of their dwellings, stated that—

“The custom of inhabiting cellars also tends to promote both the origin and preservation of febrile infection. But even in them the action of filth and confined air is always apparent when fevers arise. I have often observed that the cellar of a fever patient was to be known by a shattered pane, patched with paper or stuffed with rags, and by every external sign of complete dirtiness.”

The false opinions as to destitution being the general cause of 150fever, and as to its propagation, have had extensively the disastrous effect of preventing efforts being made for the removal of the circumstances which are proved to be followed by a diminution of the pestilence.

The opinion of the majority of the medical officers of the unions in England on this topic, acting in districts in every condition, might be expressed in the terms used by Dr. Davidson:—

“It has already been shown that filth and deficient ventilation tend much to spread the contagion of typhus, being almost constant concomitants; and that while it generally affects the whole members, or the large proportion of a family among the lower orders, it rarely spreads in this manner among the better classes of society, who attend more to cleanliness and ventilation. It is quite obvious that an amelioration of the physical condition of the lower orders, in these particulars, would, in proportion as this was effected, diminish their chances of catching the contagion, which would not only operate in lessening directly its diffusion, but by reducing the number of its sources, must tend to lessen the actual quantity of this principle that might be generated in a given time.

“But can this amelioration be effected to any appreciable extent; or, if effected, could it be maintained for any length of time? We fear that little permanent amelioration could be effected without a legislative enactment; for though our philanthropists are very active in their charities during the prevalence of an epidemic, it no sooner subsides than they relapse into a comparative quiescence, and our working population into their former habits of filth and intemperance. And the evil will continue to assail us so long as our cities contain so many narrow and filthy lanes, so long as the houses situated there are little better than dens or hovels, so long as dunghills and other nuisances are allowed to accumulate in their vicinity, so long as these hovels are crowded with inmates, and so long as there is so much poverty and destitution. Why, then, should we not have a legislative enactment that would level these hovels to the ground—that would regulate the width of every street—that would regulate the ventilation of every dwelling-house—that would prevent the lodging-houses of the poor from being crowded with human beings, and that would provide for their destitution? It may be said that this would interfere too much with the liberty of the subject, and no doubt it would be vehemently opposed by many interested persons. In place, however, of being an infringement on the liberty of the subject, it might rather be designated an attempt to prevent the improper liberties of the subject; for what right, moral or constitutional, has any man to form streets, construct houses, and crowd them with human beings, so as to deteriorate health and shorten life, because he finds it profitable to do so? As well ought the law to tolerate the sale of unwholesome food because it might be profitable to the retailer of it.”

But the professional experience and weight of professional testimony on this subject is not confined to this country. In a report prepared under the superintendence of a commission of the Royal 151Academy of Medicine at Paris,^[16] appointed to investigate the epidemics prevalent in France, similar general conclusions are announced upon similar evidence adduced, of which we select the following instance:—

“If an example,” says the report, “be necessary to justify this placing of circumstances as cause and effect, we shall find one in the terrible epidemic which desolated the commune of Prades, in the department of Ariège, at the end of the year 1838. Out of 750 healthy and vigorous inhabitants of this commune 310 were attacked with the disease, and 95 died, thus the deaths were 1 in every 3¼ cases. The cause of this epidemic, violent and sudden in its nature, and which broke out in all points at once, is not less evident. It proceeded from a sewer, the receptacle of all the water from the neighbourhood, and of the filth which the water brought with it, and of the dead animals of the district. The hot, damp weather which preceded it no doubt augmented the activity of this focus of infection. The first persons attacked were the women employed in washing linen in this pestiferous pool, and the labourers working in the neighbourhood of it. This terrible epidemic recurred three times, which the invalids in their simplicity attributed to the influence of the moon, but which mainly depended upon the wind at certain periods passing over the infected pool, and bringing the miasma in the direction of their dwellings. If for want of sufficient description it is not possible to prove completely the similarity of the epidemic at Prades with the typhus fever, yet it may be inferred from the symptoms, viz. that when the skin was broken deep sores were formed, and that serous abscesses showed themselves in the lymphatic ganglions, that this disease was very similar to the ancient putrid and malignant fevers formerly described by authors, and which are entirely replaced in our nosology by the typhoid affection. The physicians of Ariège, in order to prove that the disease was not contagious, and to re-assure the inhabitants, lay in the beds from which the invalids had been removed.”

Adverting to the local reports they have received, the Commissioners state—“These reports have awakened in us the sad conviction that many localities are quite devoid of even the most simple ideas on public health; the inhabitants live surrounded by marshes, drains, stagnant pools, manure heaps, without having the slightest idea of the dangers they are incurring. Indeed, many of them blindly speculate in these heaps of infection, increasing the manure which is to enrich their fields at the expense of their health, and often of their lives.”

The Commissioners observe,—“Most of the improvements in public health have been brought about through the experience and science united in our large cities; so much so that now epidemics often come to us from the rural districts. These epidemics are generally much less fatal than formerly, but are still very prevalent even in the wealthiest and the most civilized departments. 152It would be an important problem to solve, what are the causes which produce these epidemics in the agricultural as well as in the manufacturing counties, as in ancient Normandy and Picardy. One cause is certainly the unhealthiness of the houses. The inhabitants of these districts are, in general, well fed, well clothed, but ill lodged. We are surprised to find in the midst of a fertile plain wide districts covered with luxuriant vegetation, villages buried in the ground, smothered with large trees, and cottages constructed without any art or plan, and almost entirely without windows.” The Commissioners state, further,—“If you wish to have a robust and healthy people, you must have a care for their physical education, their houses, and their modes of living. Do not allow generation after generation to be depressed under the evil effects of recurring epidemics, which must eventually ruin the strongest constitutions, as is seen to be the case in marshy and ill-drained districts, where fevers, goitres, and scrofulas constantly prevail.”

In another report made on the proceedings of the Conseil de Salubrité, the diseases prevalent amongst the population in the towns is adverted to:—“We must be like the men so well painted by the Psalmist, to reject such evidence—eyes have they, and see not. How shall we explain, or rather to what shall we attribute the difference that is remarked between the mortality of one quarter and that of another quarter of the same town; of one street and that of another street of the same quarter or of the same village; or, lastly, the difference that is observed in this respect between the houses of the same street and those houses which are completely isolated? Misery, it is replied to us, is the cause. Yes, without doubt, misery is a powerful cause; but it is so especially when it is driven back into the most insalubrious quarters, streets, and houses; when it lives habitually in the midst of filth and dirt, that is to say, in the midst of an infected atmosphere; and when there is no misery, or when it exists in the same degree in the quarters, in the villages, in the streets, and in the houses with which the comparison is made; and, stronger still, when poverty is met with precisely there where there is the least mortality; in what is to be found the cause of this difference, if it is not in the insalubrity of the dwelling-places?”

The report on the local epidemics concludes by earnestly recommending to the government—“That sanitary measures be adopted by means of which the constitution of the people may be renewed, and their longevity increased. If this recommendation be fulfilled, we may then hope to see the condition of some of the departments ameliorated, in which now the population is so degenerated that the men seem to diminish in size each time they are measured for the conscriptions.”

Evidence on the mismanagement of expenditure in respect to supplies of food, on mismanagement also in respect to clothing 153and fuel by the labouring classes, might be added to complete the view of the principal causes of disease prevalent amongst them, but these do not come within the immediate scope of the present inquiry, which has been directed chiefly to the investigation of the evils affecting their sanitary condition, that come within the recognized provinces of legislation or local administration.

The information on the means for the prevention of epidemic disease arising in the common lodging-houses maintained for the accommodation of trampers and vagrants, might also have been considered in connexion with the subject of the effects of overcrowding and filth which they strongly exemplify; but it appeared most convenient to consider them apart, from the exposition of what may be termed the indigenous evils that afflict the settled inhabitants of the labouring class.

I would now submit for consideration, 1st, the total expense of the present state of things, so far as a proximate view of it can be obtained, on the health, strength, and life of the lower classes of the population. 2d, a proximate view of the pecuniary expense of such partial remedies as are at present applied or applicable to alleviate the consequences of these preventable diseases.