SECOND ANNUAL REPORT.

TO THE HON. THE COMMISSIONERS OF SEWERS OF THE CITY OF LONDON.

November 26th, 1850.

Gentlemen,

In obedience to that clause in your Act of Parliament under which my office is constituted, and which enjoins on your Officer of Health that he shall ‘report periodically upon the Sanitary condition of the City,’ I now submit to your Hon. Court my annual statement on this subject.

I. Mortality of the City of London.

During the fifty-two weeks, dated from September 30th, 1849, to September 28th, 1850, there died of the population under your charge 2752 persons. The rate of mortality, estimated from these data, for a population[30] of 125,500, would indicate somewhat less than twenty-two deaths (21·92) out of every thousand living persons.

Last year it was my painful duty to record the ravages of pestilence, then indeed hardly terminated, under the pressure of which our general death-rate had arisen to the alarming height of thirty in the thousand. On this present occasion, I have the happier task of laying before you the evidences of a mortality lessened considerably below its habitual average; and I rejoice in congratulating your Hon. Court on the testimony thus borne to the success of your sanitary exertions. For although, without question, some large share of this striking improvement may have depended on circumstances beyond our cognizance or control; although it may in part be but an instance of that tendency to periodical alternations of activity and repose which we recognise in disease, as in other operations of nature; although I should be over-sanguine if I believed, and premature if I stated, that your sanitary measures during the past twelve months had wrought such a change in the City as to ensure a continuance of this year’s comparative healthfulness; yet I may venture without hesitation to assure you, that the labours of the Commission have been fruitful of real and demonstrable advantage to the health of the people; that a sensible diminution has occurred in the physical causes of disease; and that, from various and disinterested sources, I hear grateful mention of improvements which you have effected.

In confirmation of this assurance, I may inform your Hon. Court that, in collecting my materials for the present statement, I solicited from the Union-Surgeons of the whole City of London certain particulars of information which they were peculiarly able to furnish; I inquired of them, namely, whether, during the past year, there had prevailed among the poorer classes in their several districts more or less than the ordinary pressure of epidemic, endemic, and infectious disease; and whether, in case of such difference having been observed, they could refer it, either for better or worse, to any changes recently wrought in the physical conditions of their respective neighbourhoods. They have had the kindness to furnish me with the information requested of them; and their replies testify with remarkable uniformity, both to the abatement of disease within their several provinces of practice, and to the considerable dependence of that improved condition of health on sanitary works effected under your auspices.

In order to form a correct estimate of the average mortality in any district, it is indispensable that one’s records should extend over many years. Thus only is it that fallacies can be avoided which arise from the alternate pressure and remittance of epidemic disease. The havoc effected by a periodical visitation of influenza, cholera, or plague, varies, in like manner as the ordinary death-rate varies, in different localities; and its variation contributes importantly to fix the healthiness or unhealthiness of such localities. But obviously, if we wish for practical purposes to calculate an annual rate of mortality, and to decide, in respect of any district, what are the chances of life for its population, we must distribute the peculiar mortality of the pestilence-period over those years which intervene between visitations of the pestilence.

Hitherto, in respect of the City of London, I have the record of only two years; two years differing from one another in the proportion of 30 to 22, and the mean mortality deduced from that biennial period would be 26 per thousand per annum.[31] I am, of course, unable to tell you with certainty whether that ratio be the true average death-rate of the City; but I incline to believe that an average calculated from a longer period, with less abrupt fluctuations, would give a lower figure as the accurate one.

In future years, so long as I may have the honour of reporting to the Commission, I purpose proceeding, step by step, to the construction of a cyclical average from the materials which will constantly be increasing; and I trust that many years may elapse before any approach shall again be made to the high death-rate with which the cycle commenced.

It may be useful, for the sake of comparison, that I should remind your Hon. Court of some of the more important differences which prevail throughout the country, in regard to the local rates of mortality. The extreme rates recorded in the Registrar-General’s last publication, relating to the septennial period 1838-44, give 14 per thousand per annum as the lowest average, and 33¹⁄₂ as the highest average, for a population male and female in equal proportion. The low average belongs to a district in Northumberland, numbering 27-28,000 inhabitants; the high average is assigned to Liverpool. For the whole south-east division of England (comprising more than a million and a half of inhabitants) the death-rate is but 19; while in parts of the division it falls very considerably below this average. I have thrown these and some similar comparisons into a tabular form, which may perhaps be interesting to you.[32]

Possibly it may occur to you that these comparisons are devoid of practical application—that it is unreasonable to suppose we can mitigate our London death-rate to the likeness of a selected country mortality—that the circumstances of the two populations are essentially and unalterably dissimilar—that the advantages of the one cannot be given to the other—that the traditional ‘threescore years and ten’ of human life are allotted only to rustic existence—that the right of participating in the higher civilisation of the metropolis, or of trading in its larger market, is not too dearly purchased by the tax of half or a third of one’s fair expectation of life.

On general grounds I should not hesitate to combat this objection, and should feel sure of convincing you of its invalidity. I should argue (as indeed I have already argued here) that the main conditions which constitute the unhealthiness of towns are definite, palpable, removable evils; that dense over-crowding of a population—that intricate ramification of courts and alleys, excluding light and air—that defective drainage—that the products of organic decomposition—that contaminated water and a stinking atmosphere, are distinct causes of disease and death; that each admits of being definitely estimated in its numerical proportion to the total mortality which it contributes to cause; that each is susceptible of abatement or removal, which will at once be followed by diminution of its alleged effects on the health of the population. Likewise, I should argue, that if there indeed exist, attached to a metropolitan residence, some really unavoidable and necessary disadvantages to life (a point which however I am not prepared to concede) there are likewise, as respects the poor, some peculiar advantages to counterbalance those evils; that in urban communities the operations of charitable relief are largest and least remitting; that the resources of medicine for curing what cannot be prevented are likewise readiest and most effective.

On all these general grounds I should be prepared to maintain that a lowness of mortality which has been attained in any considerable rustic population, may be attained by an urban population, if only the removable evils be removed, if only the practicable good be made practical.

Surely too, above all, I would maintain this possibility in respect of our capital—the treasury as she is of all means for progress in civilisation, the stronghold of all applicable knowledge. Let but the wealth, the science, the energy, and the benevolence of the metropolis deal with removable causes of death as they have dealt with subjects infinitely more difficult, infinitely less promising, and certainly of not greater importance; and few competent persons will doubt that the mortality of London might speedily be reduced to the level of any district-mortality yet recorded by the Registrar-General.

There may be those in your Hon. Court who will hesitate to accept for themselves the firm conviction which I entertain on this subject; or who, at least, will withhold their assent from the line of argument which I have advanced. To them, what I have now to state may be more conclusive than any other consideration: viz., during the year on which I am reporting, there was one sub-district of the City of London Union—one comprising from twelve to thirteen thousand inhabitants, in which (after including a due proportion of deaths which had occurred in the union-workhouse at Mile-end) the mortality stood only at 15 in the thousand; one in which, if those extramural deaths had been excluded, the local death-rate for the year would have been only 13·32.[33]

For an illustration of low and enviable death-rates, I need then no longer appeal to Northumberland, or to our south-eastern counties—though, no doubt, their septennial periods of low mortality are valuable corroborations of any inference which could be drawn from our more restricted experience;—but I may point to the last year’s death-rate in the north-west sub-district of the City of London Union as one of rare excellence, and may content myself with wishing that that partial rate might become universal for the City, and might be the permanent expression of its average mortality.

A detailed consideration of our sickness and mortality during the last year suggests to me a few other remarks, which may, I think, be of practical utility to your Hon. Court.

First, as regards the ages at which death occurs; the respective proportions of timely and untimely deaths may, generally speaking, be inferred from the local death-rates. In general terms, we know a high death-rate indicates that many die before their time—indicates that a proportion of the population, more or less considerable, instead of reaching old age, becomes prematurely blighted and extinguished. In order to illustrate this subject to you more exactly, I append a table in which the deaths of the last two years are classified according to the ages at which they occurred. Of 3763 persons whose deaths are recorded in my last Report, 1243 died under the age of five years: of 2752 deaths registered in the present year, 1032 belong to the same early period of life.

The City of London appears peculiarly fatal to infant life. Reference to the Registrar-General’s last septennial record shows that of every 1000 male children under five years of age within the City of London (aggregately) nearly 113 die in each year; and the portion of this rate which is deduced from the East and West London Unions is as high as 119 in the thousand. In the subjoined table,[34] which illustrates some points of comparative mortality, I have endeavoured to show the extreme and disproportionate amount of this pressure on infant life. In referring (for instance, in regard of the City of London Union) to the last three columns of that table, you will observe that the mortality of children at the age stated, during the septennial period, was ¹⁄_2·66 of the entire mortality, although their class numerically constituted only ¹⁄_11·09 of the entire population; so that they died at more than four times (4·17) the rate which would have fallen to them as simple participators in the average mortality of their district. The actual infant mortality of the past year holds the same proportion to the general mortality as in the Registrar-General’s septennial period, being ¹⁄_2·66 of the whole.

Lest any undue importance should be ascribed to the influence of bad or inappropriate articles of diet in producing this large infant mortality, I may inform you that the rate of death is highest during that very early period of life when the child depends for nourishment on its mother; so that, of a thousand male children in the first year of life there die within the district of the City of London Union 242; within that of the East and West London Unions, 276.

The causes which thus decimate the young population of London are the common conditions of district unhealthiness—the conditions which it lies within the scope of sanitary legislation to amend. But, inasmuch as the few days of these wretched children are passed mainly within doors, so their high mortality constitutes the readiest and least fallacious evidence of the unwholesomeness of the dwellings in which they die: and hence I am acquainted with no correcter material for estimating the sanitary condition of a district than is afforded by the death-rate of its infant population.

Secondly, with regard to the alleged particular causes of death; I have extracted from our general registry, and have grouped in a separate table, those cases of death from acute disease which seem peculiarly due to physical causes affecting large numbers of persons.

There are deaths by cholera, epidemic diarrhœa, and dysentery, of which during the biennial period we have had nearly 900; by fever, of which we have had 284; by erysipelas and puerperal fever, of which we have had 84; by small-pox, of which we have had 50; and cases of this sort partake of the nature of deaths by violence, not only because they are abrupt and untimely, but because they are avoidable. If in the instances which I have specified it were possible to make inquiry into the antecedent circumstances of the dead, you would find irrefragable evidence that life was lost in each individual instance by the operation of removable causes—by the foolhardy neglect of some familiar precaution, or by the obstinate retention of some notorious ill. The death of a child by small-pox would in most instances call for a verdict of ‘homicide by omission’ against the parent who had neglected daily opportunities of giving it immunity from that disease by the simple process of vaccination; the death of an adult by typhus would commonly justify still stronger condemnation (though with more difficulty of fixing and proportioning the particular responsibility) against those who ignore the duties of property, and who knowingly let, for the occupation of the poor, dwellings unfit even for brute tenants, dwellings absolutely incompatible with health. In addition to the diseases which I have named, there are others which owe their chief malignity and numerical largeness of fatality, though not their existence, to local and removable causes. The proportionate mortality from scarlatina, measles, and hooping-cough, is greatest when the general death-rate is greatest. Under similar circumstances, too, we find among the infant population a frequency and fatality of other diseases, not commonly accounted specific, which warrant us in considering them to be mainly of endemic and avoidable origin. Such are the hydrocephalus and convulsions, the diarrhœa, bronchitis, and pneumonia of infants; often indeed referred to the irritation of teething, but prevailing in different localities with so marked a proportion to the causes of other endemic disease that we may be sure of their partial and considerable dependence on those local and obviable causes. I dwell on this aspect of the subject, and particularly invite the attention of your Hon. Court to the table[35] which illustrates it, because it is in respect of these diseases that your exertions have already effected valuable improvements for the health of the City, and because the future registry of such cases will attest year by year the further progress of your sanitary reforms. In examining this index of preventable deaths you will notice that those from fever are fewer by 29 per cent. in the year just terminated than in the previous twelve months; that those from scarlatina are 75 per cent. fewer; those from infantile zymotic disorders nearly 40 per cent. fewer; those from erysipelas and puerperal fever 9 per cent. fewer. Small-pox, it is true, is doubled; but the prevention of this disease rests, out of your jurisdiction, in the exercise of individual discretion. Under the item of infantile diarrhœa (included in the tenth column) there is likewise an increase of nearly a third;[36] an exception probably dependent on the fact that, during last year, many deaths which might have swelled this column were (on account of the then prevalent influence) catalogued under the head of epidemic diarrhœa or cholera.

I should be misleading your Hon. Court, and practising a deception which next year’s registry would expose, if I pretended that the striking difference between the two years’ several totals of preventable deaths (a difference which, leaving cholera out of the question, probably amounts to a diminution of 30 per cent. on the sum of last year) had resulted wholly, or even chiefly, from sanitary improvement, and could be interpreted as the evidence of permanent physical changes around the dwellings of our poorer population. I guard you against this impression now, because, however satisfactory it might be as a momentary belief, it would lead to subsequent disappointment; and any future rise in the proportion of these deaths would induce the erroneous, but disheartening, supposition that your later sanitary steps had been less successful than the first. In all these matters, and especially in analysing the details of a death-registry, it is requisite (as I have already stated) to deal with cycles of many years. Periods of pestilence are habitually followed by periods of diminished mortality: partly because population is diminished, and especially that share of the population which suffers most from obviable causes of disease; partly because the great alarm of death has induced vigilance and precaution, public and private, against the occasions and beginnings of illness. And, beyond both these circumstances, there are others which we cannot analyse or explain, though we have scientific certainty of their operation; circumstances which seem to ensure a comparative quiescence of the ordinary causes of zymotic disease during those periods which next succeed the prevalence of certain fatal epidemics.[37]

Nevertheless, that the sanitary condition of the City has undergone considerable improvement within the last two years is a fact which no one can gainsay; and that a considerable share of the mitigation in mortality arises from this improvement cannot reasonably be questioned. If even a third of the mitigation in question, if a reduction of ten per cent. on the preventable mortality of the City, may be inferred from the materials which I lay before you, it is indeed matter for the utmost congratulation; and a continuance of the same reduction year by year, perpetuated (as doubtlessly it may be) by a continuance of the same exertions, would soon raise the City of London above all fear of comparison, on the ground of healthiness, with urban or suburban populations.

Thirdly, I would beg the attention of your Hon. Court to those very important local differences of death-rate which may be deduced from a study of our death-register. I have already had the pleasure of citing to you the low rate of mortality which has prevailed during the last year in the north-west sub-district of the City of London Union. The rate of death in the north division of the West London Union was nearly double that proportion; and between these extreme terms of disparity there were many intermediate degrees.

Similar inequalities of mortality were observable in last year’s record. In the healthiest sub-district of the City the year’s death-rate was about 22 in the thousand; while in the worst it stood above 41; and for the whole West London Union exceeded 38.[38]

Mainly and essentially these local differences of mortality depend on the proportion in which preventable deaths enter into the total; the differences, however partial, depending on the operation within certain districts, of removable deleterious influences which do not exist in certain other districts.

In classifying for your consideration the deaths which, during the last two years, have depended on epidemic, endemic, and infectious diseases, I have thought it desirable to distribute them according to the municipal divisions of the City. Strongly believing, as I have endeavoured to express, that this class of deaths is for the main part preventable, I have thought it would interest the representatives of the several Wards, and would more directly enlist their sympathies for sanitary progress, if I could enable them at a glance to recognise the ratio in which their respective constituencies contribute to this annual death-roll. I have included in the table, under eight different heads, all those acute diseases which depend in an important degree on local causation, either for their existence or for their fatality. It will be obvious, even to the unprofessional reader, that local causes are not of equal prevalence in respect of all the diseases there tabulated. Some (as fever and cholera) would not be known at all under perfect sanitary arrangements; others (as scarlatina, measles, and hooping-cough) would be far less malignant in their attacks; others (as those classified in the tenth and twelfth columns) would no doubt exist under the most perfect physical circumstances, but would probably prevail in numbers quite inconsiderable as compared with those actually observed.

On consulting this table[39], it will be observed that in Cordwainers’ Ward, during the last year, not a single death occurred from the causes referred to, and in the preceding year of epidemic visitation, only five; that in Cornhill Ward there have been only two such deaths in each of these years; that in Coleman-street they have been 66; in Queenhithe, 59; in Portsoken, 143; in Aldersgate Within, 30; in Aldersgate Without, 179; in Cripplegate Within, 80; in Cripplegate Without, 299; in Bishopsgate Within, 60; in Bishopsgate Without, 329; in Farringdon Within, 153; in Farringdon Without, 845.

I am unable to state with accuracy, in these several instances, what proportion subsists between the preventable mortality and the number of living persons, for I have no means of ascertaining precisely the population of the separate Wards; and without this knowledge it is impossible to arrange them in a scale of comparative healthiness. I need hardly remind your Hon. Court that the Wards differ very considerably in their magnitude; so that the largest majority of cases occurring in one Ward (as in Farringdon Without) must not unconditionally be taken to imply that the Ward, in proportion to its population, suffers more deaths than one in which the apparent number is less considerable. In the table to which these remarks refer, I have endeavoured to give you the means of comparing (at least approximatively) the healthiness of your several departments, by entering against the name of each Ward the number of holdings for which it stands assessed to your rate. This entry, with some trifling modifications specified in the table, may be taken to express the number of houses contained in each Ward of the City: thus it furnishes indirectly the means for estimating the local population.

It will be noticed, that the more glaring inequalities which I have adduced are in some degree due to the epidemic of last year, which did not press uniformly on all parts of the City. It may, however, likewise be observed, that the chief operation of that epidemic was to exaggerate, but not importantly to misrepresent, the features of each locality; that the habitual sanitary proportions of districts to each other were for the most part preserved; that (with a qualification to which I shall presently revert) the Wards numbering fewest deaths last year numbered also fewest this year.

In my last Report, when the cholera had scarcely subsided, when men’s minds were full of apprehension on the subject, and when it seemed only too possible that, with the recurrence of autumn, we might again suffer from its invasion, I was unwilling to dwell too pointedly on the wonderful pertinacity with which that disease fixes itself on particular localities, and tends to re-appear in them on each new occasion of its rise. Believing that no extemporaneous measures could counteract these local preferences of the epidemic, I refrained from a course which would have produced no good result (unless indeed it had depopulated certain spots of the City), and which might have caused unavailing and hurtful alarm. Now, however, I think it right to tell you that the local predilections of this dreadful disease are so marked and so obstinate, that we may almost certainly predict in what parts of the metropolis it would tend to arise on any renewed visitation. We may anticipate that at any such time its latent power of destruction will kindle again in the districts, the streets, the houses, perhaps even in the very rooms, where it recently prevailed, unless the determining local conditions shall previously have been annulled.

It would be ridiculous if I should pretend to carry you into any medical consideration of this subject, or should make my present Report the vehicle of a professional argument; but I may very briefly acquaint you with such generalisations as will justify you in pursuing a particular course with respect to the haunts of cholera. While doing so, I hope your Hon. Court will believe that I have devoted to this very serious subject the best consideration of which I am capable, and have done my utmost to arrive at conclusions which may be fruitful of practical good.

Cholera visited no localities of which it could be said, that they were generally healthy; but still there seemed to be something peculiar and specific in the kind of local unhealthiness which determined its invasion. On the one hand, it is unquestionably true that many habitual seats of fever were visited by cholera; on the other hand, many of the worst fever-nests in the whole metropolis were unaffected by it; and it struck with extreme severity in a class of houses habitually exempt from fever. See, for instance, how malignantly it prevailed along the line of Farringdon and New Bridge streets, and in Fleet-street and Ludgate hill, where their line intersects that just mentioned; and here, you will observe, not only in those obscure and ill-ventilated courts and by-ways, where fever is the familiar visitant of a hungry and crowded population; but also, and very strikingly, in spacious and airy houses, situate along the main thoroughfare of the City, and inhabited by opulent tradesmen, by members of the various professions, or by officers of assurance-companies. Other infective diseases which habitually desolate the former class of dwellings are almost unknown in the latter. Cholera came as a startling exception. Within the infected district (fulfilling the classical description of pale death) it trod with equal foot the gates of rich and poor.[40]

Personal peculiarities, or vicious habits, or temporary indiscretion, may often have determined its choice of a victim; low nourishment—even temporary emptiness and exhaustion, very manifestly invited its attack; but, speaking generally, I may say that it was a disease prevailing over a certain patch of ground, and (within this limit) tending to strike equally, or nearly equally, in all classes of habitations. Crowdedness of dwellings, defective ventilation, squalor of inhabitants, and many forms of local nuisance, which are omnipotent in giving occasion to fever, and in adding malignity to many disorders of its class, did not by themselves exert so marked and specific a power in determining the onset of cholera.

What then were the conditions determining its local preference? Consideration of its statistics, or inspection of a cholera-map, enables one, with some confidence, to answer—a peculiar condition of soil, of which dampness is one sure and invariable character, and organic decomposition (promoted by dampness) probably another.[41] Its local affinities have much analogy to those of ague, and often appear identical in their range with the sphere of malarious infection. Our entire metropolis, built down to the very margins of a large river—of a river, too, which, at each retreating tide, exposes acres of mud saturated with the reeking sewage of an immense population, is placed generally in circumstances not unfavourable to the development of the disease; and its several parts will be liable to suffer especially, in proportion as they are exposed to these general circumstances, or to special circumstances of their own of a like nature. The lower level of districts on the south side of the river, their attendant failure of natural land-drainage, the consequent soddenness of a soil from which likewise the materials of house refuse were never efficiently removed, accounted sufficiently for the frightful epidemic mortality which prevailed in those quarters of the metropolis.

If you now look to the disease as it raged within your own jurisdiction, you will observe its fatality in two especial directions. First, in the line I have indicated to you, northward from Blackfriars Bridge, in a band of two or three hundred yards width; there, in the parallelogram which lies along the main road, from Stonecutter-street to Bridewell Hospital, were 76 deaths; there, in the little clump of houses forming the angle of Farringdon-street and Holborn-hill, were 17 deaths; there, in a square space behind twenty-seven shop fronts in Fleet-street, were 57 deaths; there, in the small parish of St. Ann’s, Blackfriars, were deaths at the rate of 25 to every thousand of its population. This was incomparably the most afflicted portion of your territory. Those who are acquainted with the ancient geography of the City will readily conjecture a reason; they will remember when ‘the course of water running at London under Old-bourne bridge and Fleet bridge, into the Thames, was of such bredth and depth that ten or twelve ships, navies at once with merchandises, were wont to come to the foresaid bridge of Fleet, and some of them unto Old-bourne bridge;’ they will remember how this broad river (like the Thames of our day) was thronged on both sides with population; how (again like the Thames) it was a draining river, probably with wide banks of putrefying mud; how many fruitless attempts were made to cleanse and preserve its channel; but how (in Stow’s day) ‘the brooke, by meanes of continuall incrochments upon the banks, and casting of soylage into the stream, was become worse cloyed than ever it was before.’ Where that soylage was cast, and where, since the days referred to, so many habitations have arisen that no sign of stream remains visible to the wayfarer above ground, its traces still remain below. Throughout at least a large portion of this district, the sub-soil (your Surveyor informs me) consists of black mud, the bed of the ancient river, in which are set the foundations of the modern houses. The river, which centuries ago fulfilled for a large population those vile uses which now pollute the Thames, has gradually yielded its foul banks to the residence of a growing population; and the sanitary relations of that population are exactly such as might be imitated, if the volume of the Thames were henceforth slowly reduced, and if those banks of mud which are now exposed only at low water, were simultaneously converted into the site of permanent habitations.

The history of the stream at Walbrook is, I believe, not dissimilar; but there is this marked difference between the two cases, that the comparative declivity of the latter district has allowed its soil to acquire a dryness and healthiness which have never been reached on the banks of the Fleet. For, owing to the extreme lowness of level in this district, the tidal influence of the Thames is very inconveniently felt; the cellars of houses are habitually exposed to dampness, even to flooding; and probably the whole porous sub-soil, at least as far north as your jurisdiction extends, is maintained in a sodden and malarious state.

With respect to the second part of the City in which considerable groups of cholera cases were observed, it has a not dissimilar peculiarity. I refer to that northern part of the City which extends (on the other side of London Wall) from Bishopsgate to Aldersgate. The epidemic prevailed there with far less severity than in the Fleet district, but still with a preference which easily shows itself in a cholera-map. At the intersection of Whitecross-street by Beech-lane, in a space that the point of one’s finger would hide in Wyld’s large map, there were 12 deaths: in that small portion of the City which lies north of Barbican and Beech-street there were 40 deaths: in the immediate vicinity of Half-moon-street, Bishopsgate, 60 deaths, of which more than half were in the workhouse. Now, certainly, in all this space (and probably still further in both directions, east and west) without the former gates of the City, there is a marked local character. It is a reclaimed marsh.[42] Throughout this district, in the olden times of the City, there lay (says Stow) ‘a moorish rotten ground, unpassable but for cawswaies purposely made to that intent;’ and one reads how ‘divers dikes were cast, and made to drein the waters of the said Moorefields, with bridges arched over them, whereby the said field was made somewhat more commodious, but yet it stood full of noisome waters;’ till gradually ‘by divers sluces was this fenne or moore made maine and hard ground, which before, being overgrowne with flagges, sedges, and rushes, served to no use;’ while ‘the farther grounds beyond Finsbury Court were so over-heightened with laystalls of dung, that divers windmills were thereon set, the ditches were filled up, and the bridges overwhelmed.’

It is not as matter of literary curiosity that I quote these passages of your old historian, but simply that I may avail myself of his accurate local knowledge for the explanation and the cure of a serious existing evil. For if, as I believe, the unfortunate preference for certain localities evinced by the recent epidemic be, primâ facie, a reason for doubting the effectiveness of their sub-soil drainage, and if the ancient records of the City assure one that these very localities are such as, from conditions then in active operation, would be liable to retain, perhaps for an indefinite period, the materials of malarious poison, useful and practical deductions may be drawn. And as the liability to this severe recurrent epidemic is an extreme detriment to the population of such localities—one too, which, if unremoved, must inevitably lead to the deterioration of property, as well as to the sacrifice of life, I know that your Hon. Court will be solicitous to adopt whatever remedial measures are possible.

To those measures I shall presently return, having here dealt with the question only as it relates to the distribution of our mortality, and explains the preponderance of a large class of deaths in some special districts of the City.

In the Tables which accompany this portion of my Report, I have arranged in a synoptical form, convenient for reference, the chief facts of our sanitary statistics to which I have invited your attention.

In the first[43] you will read a summary of the deaths as they have occurred, male and female, in the several districts and sub-districts of the City, during each quarter of the past year.

In the second[44] table the deaths of the year are classified according to the ages at which they befell.

In the third table,[45] for the sake of comparison in respect both of general and of infant mortality, I have arranged the statistics of certain other localities side by side with our own.

In the fourth[46] (to which I have already especially referred) is contained an enumeration, according to the several Wards of the City, of those deaths, during the last two years, which have arisen in consequence of acute disease partially or entirely preventable.

In tables of this nature perfection is at present impossible; partly because of trifling changes in the population which often occur, but rarely can be estimated; partly because of the slovenly manner in which deaths are occasionally recorded. While, therefore, I would not consider myself responsible for their absolute and infinitesimal accuracy (consisting as they do of so many and so various details) I may assure your Hon. Court that all proper pains have been taken to render them for every useful purpose correct and trustworthy: and that I believe them, in all essential particulars, truthfully to represent whatsoever I have sought to embody in them.

The annual ratio of deaths within your district; the local differences of that ratio; the proportion of infantile mortality; the amount of preventable disease; and, in all these respects, a comparison of parts of the City with each other, and of the whole City with other inhabited districts,—these are the materials on which your judgment must be formed as to the necessity of sanitary measures, whether for the entire City, or for its component parts: and as a main object of the appointment which I have the honour to hold is that I should furnish you with materials for forming that judgment, so I may probably stand excused for troubling you with these considerations at such great length.

II. The Causes and the Prevention of Endemic Disease.

According to the method adopted in my last Annual Report, I now proceed to offer you such observations as another year’s experience may justify, on those physical influences which prevail against life within the City of London, and on such remedial measures as seem aptest to remove them.

Sub-soil Drainage, House-Drainage, and Sewerage.

1. In respect of drainage, I have already adverted to those unwholesome conditions which prevail along the low-lying valley of the ancient Fleet, and have mentioned to you that frequent incursions of the river aggravate whatever mischief is inherent in the soil, by maintaining it as a perpetual swamp, and by favoring in it a constant succession of putrefactive changes. I have likewise illustrated to you the probability that, in some of the higher portions of the City, chiefly in the Out-Wards of Cripplegate and Bishopsgate, there still survive some properties of that old malarious fen, from which these districts were originally reclaimed. Stow seems in his day to have had misgivings on this subject; for after describing the improvements that had been effected there, and the gradual levelling and heightening of the ground, he adds, ‘it seemeth to me that if it be made level with the battlements of the city wall, yet will it be little the dryer, such was then the moorish nature of that ground.’

From a consideration of this former geography of the place, and from observation of the diseases which prevail there, I am led to think it highly probable, that some of its sanitary defects depend less on defective house-drainage than on a still marshy undrained condition of the ground itself, and that these defects would be removed by an efficient application of sub-soil drainage.

I would therefore respectfully recommend to you, under this head, that the state of soil in the specified districts be referred to competent authorities, and that such measures be adopted as inquiry may prove requisite, for relieving those parts where the sub-soil drainage is imperfect, and for protecting the house-foundations, and sewers, and sub-soil adjacent to the river, from being soaked or flooded by the tide.

2. With respect to house-drainage, I have no addition to offer to those remarks which I submitted to you in my last Report. Your Hon. Court has fully recognised that immense peril to life which is connected with the presence of cesspools beneath houses, and which depends on their poisonous emanations. At the commencement of the present year, your Surveyor stated that he might take ‘5414, as a fair approximation of the number of cesspools’ then in existence within the square mile of the City of London. This proportion, dangerously large as without doubt it is, presented an important diminution from the number which existed a year previously, when your Commission first obtained from the Legislature authority to enforce their closure; and it may reasonably be anticipated that at the termination of this present year, a still further abatement will be recorded in the magnitude of that destructive nuisance.

3. Notwithstanding the variety of stink-traps to which you have given trial, and notwithstanding the fact (recorded by your Committee of Health on the Surveyor’s authority) that ‘there does not exist within your jurisdiction a single gully which is untrapped,’ there continue to be frequent complaints of offensive exhalations from the sewers.

The mechanical difficulties in this matter of trapping have appeared to be, from the nature of the case, almost insuperable. It may, indeed, easily be conceived, how incompatible are the common uses of a gully-hole with such fineness of adjustment and delicacy of balance as would render the apparatus air-tight from within, and effectually preclude an escape of the gaseous contents of a sewer. Under such circumstances, your Hon. Court has desired that I should express my opinion, how far a different course might be adopted in respect of these exhalations; how far, namely, they might be neutralised within the sewers; how far it might be chemically feasible, and in a sanitary point of view expedient, that a systematic use should be made of deodorising agents; so that any gas escaping from the sewers should at least be divested of its original smell.

On this subject, I would submit to you the following considerations. As respects its feasibility (putting aside as foreign to my province all questions of the expense, and all details of the daily arrangement) a first and obvious objection is this: Granted in the abstract, that sewer-gases can be converted by appropriate agents into inodorous compounds; in the practical application of these agents, you would find impediments with which you are already familiar. Theoretically, there may be no difficulty in providing air-tight traps; practically there is said to be every difficulty. Just as that mechanical problem has defeated you in practice, so would the chemical one; and for the same reason. The fulfilment of either problem is a matter of nice adjustment. In proportion as your gully-hole is exquisitely trapped, it becomes liable to obstruction; it loses its use as an inlet to the sewer, nearly in the same measure as it becomes an effective obstacle to regurgitant gases. Similarly, in proportion as these alleged deodorisers might succeed in completely stifling the characteristic odour of sewage, they would be liable to diffuse perfumes peculiarly their own, and to establish, in the vicinity of gully-holes, the alternation of a new nuisance with the old. To proportion with accuracy the introduction of these chlorinous preparations to the amount of refuse traversing the sewers—an amount varying most considerably at different hours of the day, seems to me quite a visionary hope. Failing such accurate proportions, I am not prepared to say that the result would be useful; and I accordingly consider the scheme as not chemically feasible.

Further—as involving an important sanitary principle, I would say, that the great object which must be aimed at is not the mere chemical neutralisation of certain stinks which arise within your jurisdiction, but the closest possible limitation, and the promptest possible removal of all those materials which are decomposed into fœtid products. Admirable, no doubt, is that arrangement by which Nature, stationing a sense of smell at the inlet of our breath, cautions us by this vigilant sentinel against the inhalation of many poisonous airs; but, in respect of organic decomposition, I am in no degree satisfied that its odorous products are its only, if even its principal, agents of injury; nor have I any reason to suppose that the real detriment to health which arises from breathing the miasms of sewers or marshes, of cesspools, burial-grounds, or slaughter-houses, would in any important degree be lessened by the mere mitigation of fœtor in their effluvia. Offensive as these are, they at least answer the useful purpose of warning us against the other poisons with which they are associated.

Let me likewise take the opportunity of correcting a misapprehension, which, by the use of an inappropriate word, is sometimes shown to exist on this subject. The agents in question are spoken of as dis-infectant. As there is no scientific reason whatever for believing that they in any degree interfere with the spread of epidemic or infectious disease, and as an erroneous opinion on this point may lead to the neglect of measures which are truly precautionary and useful, I think it well to state explicitly, for your information, that I have no evidence of their possessing any other utility, in the respects under consideration, than simply and singly that of removing stink from the atmosphere around them.

For reducing to a minimum the exhalations which arise from sewers and house-drains, it appears to me that the following are the essential principles: First, to render the current through them as rapid as possible; and, above all, by every care for their form, their junctions, their slope, and their material, to provide against the occurrence of obstructions and deposit: Secondly, to employ in their construction, so far as may be possible, such substances as are porous in the least procurable degree; such as consequently will be least apt to imbibe and retain in their interstices any considerable impregnation from the fœtid fluids running over them at intervals; such, too, as will be least likely to permit soakage into the surrounding soil: Thirdly, by reducing the size of drains and sewers to the lowest dimensions compatible with a full performance of their uses, to diminish to the utmost the extent of their interior evaporating surface, and of those large chambers which they now offer for the evolution, retention, and diffusion of gases.

To the application of these principles (together with a sufficient and appropriate distribution of water) far more than to chemical agents, or to the invention of mechanical traps, I believe that you must look for rendering inodorous the vicinity of your numerous gully-holes. I content myself with stating them to you, as a practical deduction from physical laws, without venturing to offer any opinion on the degree in which they are applicable within your jurisdiction, or on the manner in which they should be applied. For although, as principles, they have their foundation in physics, and although their importance to sanitary improvement is beyond measure great, all details relating to their application lie out of my province, and belong to a class of subjects in which your Surveyor’s opinion will, of course, be infinitely more useful to you than mine.

Water-Supply.

During the past year, as in the preceding one, I have given frequent consideration to the subject of water-supply within the City.

I have already endeavoured to convey to you the deep sense which I entertain of its importance, and I have every reason to believe that your Hon. Court recognises, at its full weight, the necessity of providing for the City of London a supply of water which in quantity shall be ample, in quality pure, in distribution constant and accessible.

In my former Annual Report, and in some remarks subsequently addressed to your Committee of Health, I dwelt especially on such defects of our present system as relate to the quantity and distribution of water; endeavouring to illustrate the insufficiency of its supply to the poorer tenements of the City, and the extreme inconvenience which is entailed on their inmates, sometimes by dependence on a common tap, sometimes by the troublesome, expensive, and unwholesome necessity of storing water.

In reverting to this subject, I may correct a fallacy which is apt to prevail with respect to the abundance of supply. I have no reason whatever to doubt that a very liberal allowance of water is daily pumped into the City—enough, or more than enough, so far as I know, to fulfil all necessary purposes.

But those purposes are not fulfilled by it. A certain large figure is stated as representing the average quantity daily driven through the mains of the City; this quantity is divided by the number of residents within your area, and the inference is drawn that each individual inmate of the City has at his disposal 25 gallons a day; or (after deduction for public purposes and the like) 21¹⁄₄ for his domestic supply. As an arithmetical conclusion from the premises this may be true: nothing can be less accurate as a practical representation of the facts. An average amount of three million gallons per diem may, or may not, be pumped through the mains of the City: but to calculate the available water-supply from this dividend, without previous deduction for the immense escape of un-available water by waste-pipes or otherwise, gives a most fictitious result. The large waste which naturally arises in the system of intermittent supply has been well illustrated by some evidence given by Mr. Lovick before the late Metropolitan Commission of Sewers, in respect of a particular block of nearly 1200 houses.[47] Some of the houses were of the higher, and many of the poorer class, but the average might be stated to be of the middle class, and to present a fair example of an urban population. The drainage of all these houses was discharged through one main sewer. The run of water through this sewer was carefully watched and gauged every hour, during the night as well as the day, on days when the water was on, that is to say, when the intermittent supplies were delivered, and also on the ordinary days, when the consumption of the houses was from butts and cisterns, into which the intermittent supplies were delivered. The gaugings of the discharge of waste water into the sewer were checked by gaugings of the consumption of water from the butts and cisterns, during the interval of the delivery of the supply by the company. It was ascertained that the average quantity discharged per diem through the sewers was 44¹⁄₂ gallons per house; but it appeared that, on the days when the intermittent supplies of water were on, the quantity discharged per diem was 209 gallons per house. The waste in this district from defects in house apparatus of distribution, incident to an intermittent supply of water, was, on the water days, three and three quarter times greater than the consumption on those days.

No similar gaugings have, I believe, been made within the City; so I am unable to tell you with accuracy what are the proportions of waste and consumption. In an interview with your Committee on Health, when they were collecting information on the subject, Mr. Mylne, the engineer of the New River Company, stated (as a reason against fulfilling some object desired by the Committee) that within the City of London, in connexion with its distributing apparatus, there existed for the escape and waste of water, during the period of supply, ‘at least 10,000 open cocks.’

Assuming the accuracy of this statement, I doubt whether the average available supply of water for domestic purposes within the City can possibly exceed a quarter of its alleged quantity; and I am persuaded that there must be large numbers of persons to whom the enjoyment even of that reduced average is utterly unknown. Your Hon. Court, observing the incalculable waste, and knowing that the cost of water-supply (as of all other commodities) must of necessity vary according to the quantity supplied, can appreciate the consequences of so much fruitless expenditure.

I would beg likewise to observe to you that this unapplied flood of water is in itself not unobjectionable. It would be of questionable advantage if the drainage of the City were so perfect as to carry all away without inundation of the soil; while under opposite circumstances, in every quarter where drainage is absent or faulty, evil must arise from the extensive and habitual infiltration of moisture.

On the extreme inconvenience which attends the storage of water in the poorer habitations of the City, I have already reported to you, and will now only add that increased experience has given much confirmation to my view. Their receptacles are generally such as contribute to the contamination of water, and are constantly so arranged as to invite an admixture of the most varied impurities.

In the large proportion of them, which are open casks, one sees habitually a film of soot floating on the surface; one sees (if indeed one can see so deeply into water which is often turbid and opaque) that filth and rubbish lie at the bottom; one sees the interior of the cask itself dirty and mouldering.

I now merely glance at this part of the subject, because you have already on other occasions allowed me to state my knowledge at greater length. But there is one evil in particular to which I would beg leave to advert. Those works of drainage which are established under your orders depend for their efficiency on a proper supply of water; and in every case where you enforce the construction of house-drains, you order that those drains shall be served efficiently with water. Your wishes on this subject are nominally complied with by those on whom your orders are served, but are often virtually evaded by a filthy and ineffectual contrivance. The butt or cistern of the house—that on which the inmates depend for their supply of fresh and pure drinking-water, is placed in immediate contiguity to the privy, so as to reduce the requisite length of connecting pipe to the fewest possible number of inches; the application of water is not made discretionary on the users of the privy, nor are any of the cheap and common self-acting contrivances introduced; but the waste-pipe of the butt or cistern is conducted into the discharge-pipe of the privy, so that, periodically, with a frequency varying according to the arrangements of the water-company, the arrears of excrement are removed, so far as the overflow of the water-receptacle may have power to dislodge and propel them. Frequent evidence has been before me of the insufficiency of this arrangement: and, in addition to its actual failure (on the reasons of which your Surveyor can speak more competently than I) there is strong reason to object to its prevalence on other grounds. Water, as you probably know, is a very active absorbent of many gaseous materials; and the open butts, which are thus placed in immediate contact and communication with privies, must rapidly become infected by their foulness. I need not explain to you how injurious an addition this is to the other objectionable incidents of water-storage, or how unattractive as a beverage to the poor inhabitants of the City must be this vapid, privy-flavoured stuff.

For this arrangement I can suggest to your Hon. Court no easy alternative or remedy, so long as the distribution of water continues to be on its present intermittent plan: but it is matter for extreme regret that, by circumstances over which you have no control, the success of your sanitary measures should be seriously diminished. By the enforcement or execution of house-drainage, your Hon. Court has conferred great advantages on many districts of the City; but it is my duty to tell you that, in my judgment, the present condition of the water-trade contributes to neutralise those advantages, and constitutes a restriction on your power of doing good.

As respects the evils to which I have just adverted, unquestionably they admit of abatement by devoting separate water-receptacles to the very different uses of diet and drainage. But the expense of additional cisterns in tenements so poor cannot be considered trifling; and I believe that your Hon. Court would hesitate, even if you have the power, to enforce this double burthen on the owners of house-property, at a time when one may reasonably hope that the necessity for cisterns will be superseded.

There can be no doubt on the extreme degree in which it is desirable for the poor of the City of London, that water should be delivered to their houses on the principle of constant supply, and that they should thus be relieved from the expensive and unwholesome necessity of storing it in small quantities and in improper receptacles. That it is desirable is a certainty within my official knowledge and on which therefore I can give an opinion of my own. That it is practicable is not within my official knowledge; for in this part of the question are involved various considerations of hydraulic engineering, on which I am incompetent to offer an opinion. But I cannot ignore the fact, that in many parts of England and Scotland the practicability of a constant supply has been evinced by the very conclusive evidence of its success. To some such instances I alluded in my last Report, and from the present year I can quote you a striking additional one. At Wolverhampton, in 1849, the system of supply, which had previously been intermittent, was made continuous. Instead of waste ensuing on the change, its immediate effect was a reduction of 22 per cent. on the quantity consumed. So great had been the unpopularity of the intermittent system of supply, that at the time of the change the company had not more than 600 customers. Immediately on the adoption of the new system, their customers increased, and within ten months had risen to 1400. This increase was continuing up to the date of the Report (May 4th, 1850), at which time they were adding to the number of their customers at the rate of 50 each week. The above facts (as is well observed by the resident engineer, Mr. Marten) may be taken as a fair test that the system of continuous supply is one of superior adaptation to the domestic wants of the public.

This case is but an inconsiderable fraction of the evidence which lies before the public on the subject of continuous supply. With such evidence before me, in contrast to what I observe of the distribution of water within the City of London, I cannot refrain from repeating to your Hon. Court my confirmed and deliberate opinion that our method of supply is essentially bad, and that it withholds from the poorer population of the City a large proportion of those sanitary advantages which it is the object of water to confer. No doubt it will occur to you that against evils of this nature—evils arising in the conflictive interests of water-buyer and water-seller, the first principles of commerce imply a resource; and that in this matter, as in others of the sort, a customer holds in his own hands the remedy for his dissatisfaction. But although the supply of water, in the hands of the powerful companies who vend it, is in many respects a common transaction of trade, and as such is in theory open to competition, yet I would beg to point out to your Hon. Court that, in regard of the City under your jurisdiction, no such check and no such stimulus as competition can virtually be said to exist. In every practical sense the sale of water is a monopoly. The individual customer, dwelling in Cripplegate or in Farringdon, who is dissatisfied with his bargain in water, can go to no other market; and however legitimate may be his claim to be supplied with this prime necessary of life at its cheapest rate, in the most efficient manner, and of the best possible quality, your Hon. Court, hitherto, possesses no power to enforce it.

All who have given impartial consideration to the subject seem to concur as to the advantages which result from a control over the supply and distribution of water being possessed by those who are responsible for the drainage and cleanliness of a district. These different duties are in such essential relation to each other that they would seem almost of necessity to require a single direction and control. House-drainage pre-supposes water-supply; water-supply pre-supposes house-drainage; the efficiency of either implies their mutual adaptation; just as the circulation of blood within an animal body implies uninterrupted continuity of arteries and veins, each harmonising with the uses of the other, to ensure the efficiency of the whole. But while the works of drainage executed under your orders lose much of their sanitary usefulness for want of an effectual water-supply, your Hon. Court has no power of interference in the matter, closely associated as it is with the performance of your other functions. These anomalies would be removed, and a most beneficial power over the distribution of water would be vested in the hands of your Commission, if in the renewal of your Act of Parliament you procured authority to represent the citizens in this matter. All the advantages which could possibly be gained by competition, together with many benefits which no competition could ensure, would thus be realised to the population under your charge; if, namely, a clause were inserted in your Bill, empowering you, at your discretion, to contract corporately with any person or any company for the supply of water to the City of London.

In the Public Health Act (passed simultaneously with yours) an enactment of this nature exists, authorising local boards of health to ‘provide their district with such a supply of water as may be proper and sufficient,’ and for this purpose ‘to contract with any person whomsoever to do and execute all such works, matters, and things as shall be necessary and proper, and to require that houses shall be supplied with water,’ and to ‘make and levy water rates upon the premises, at a rate not exceeding twopence per week.’ With a power like this in your hands, you would easily enforce for the City of London whatever method of supply you might deliberately believe to be best; and you would then be enabled and entitled, in the application of other clauses in your Act, to require of landlords acting under your orders, a far completer, though less expensive, improvement of their property than you are yet in a position to obtain.

In submitting to your Hon. Court my views as to the expediency of your having a controlling power over the supply of water, I am glad to find myself supported by the recorded opinion of the present Lord Mayor, himself formerly the Chairman of a Commission of Sewers; and I am induced to believe that such an addition to your functions might not be objectionable to the water companies, as I observe that Sir William Clay, the chairman of two metropolitan companies, has expressed himself strongly on its ‘great and obvious convenience.’

2. Of equal importance with anything which relates to the distribution of water are those momentous questions which relate to its quality, and which tend to determine its fitness for human consumption.

Considering the great share of public attention which these questions at present very properly obtain, the many projects which are broached for improving the quality of our metropolitan supply, and the importance of your being in a position to decide as to the merits of any plan which may affect the City of London, I have thought it desirable in this Report to submit to you some general observations on the subject. During the last few months, I have accordingly been collecting such information as might, in my judgment, be useful for this purpose. In pursuing one portion of my inquiry—that which relates to the chemical constitution of certain waters, I have availed myself of the permission of your Hon. Court to procure a limited amount of assistance from some one more conversant than myself with the practice of analysis. For this purpose I have addressed myself to Mr. Thomas Taylor, lately Lecturer on Chemistry at St. Thomas’s Hospital, a gentleman on whose skill and impartiality I can implicitly trust. His account of the very careful analyses which he has made is subjoined to my Report.[48] Concurrently with the experience of other chemists, it has furnished me with material for many of the conclusions which I am about to lay before you.

The water which is supplied by the New River and East London companies for the consumption of the City of London is substantially of one kind. The River Lea, on which the East London Company entirely depends, furnishes likewise much of the supply conveyed by the New River.[49] The springs in which the latter originate are of the same chemical kind as those which contribute to the Lea; and the artificial aqueduct runs its forty miles of course through much the same country as the natural river. Chemically, therefore, one description may apply to both; and I the rather speak of them conjointly, as any extension of its resources for our supply which the New River might obtain, would apparently be provided by increasing considerably its present draught from the Lea.

The pipe-water consumed in the City has for its general chemical character, that it contains a considerable quantity of carbonate of lime, held in solution by an excess of carbonic acid. To this and another salt of lime (the sulphate) the water chiefly owes the property which is complained of under the name of hardness: it is by reason of these salts, namely, that it decomposes a certain large proportion of whatever soap is used with it; preventing the formation of a lather, till those salts are exhausted by a wasted proportion of soap, by boiling or otherwise, and hindering to that extent the several purposes for which soap is employed. You are probably aware that soda is extensively used in the laundry, as an antidote to this objectionable quality of hard waters; and the excess of its employment tends, by corrosion, very observably to hasten the destruction of washed articles of dress. In the same measure as water possesses the property of decomposing soap, its utility as an universal solvent is impaired; it extends to various other substances which one seeks to dissolve in it (especially to many vegetable matters) that same disposition to waste them in the form of insoluble precipitates. Its conveniences for the purposes of cooking and manufacture are pari passu diminished.

Of the actual extent of which these disadvantages are sustained within the City of London, I have no means of forming an exact opinion; but statements are before the public (from the general correctness of which I have no reason to withhold reliance and belief) rating the pecuniary loss to the metropolis, in the two articles of soap and tea, at a very high figure. You will see from Mr. Taylor’s observations the proportion in which waste occurs, as regards one of these articles; namely that, for the production of a lather in washing, the pipe-water of the City of London, used without boiling, consumes from 13 to 19 times as much soap as distilled water would consume.[50]

The chemical constitution of these waters occasions another inconvenience. Their carbonate of lime is held in solution (in the chemical form of bicarbonate) by an excess of carbonic acid: under the influence of heat this excess is gradually disengaged and driven off; consequently, as they approach the boiling point, they begin to precipitate the earthy salt which that gas was instrumental in dissolving. Each gallon of water under these circumstances would deposit from ten to fifteen grains of earthy matter on the interior of whatever vessel might contain it, or on the surface of whatever solid—linen or mutton, might be contained in the boiler. Hence arises the well-known furring of vessels in which such waters have habitually been boiled.

I refrain from dwelling on the economical considerations which arise in these points of the subject, as very obvious inferences from the result of chemical analysis; and I pass to other matters more strictly within my own province of observation.

Is water thus constituted in any degree detrimental to the health of those who drink it? It is not in a single word that this question can be fairly answered. Almost insuperable difficulty belongs to it, from the absence of any statistical method by which we might isolate the water-drinking portion of our population, and might compare them, in regard of the diseases to which they are liable, with similar sections of population in soft-water districts and in harder-water districts. Obviously, no other method of comparison can be unobjectionable; and, in arguing the subject from such materials as I have, I can pretend to nothing more than a rational approximation to truth.

Except in the comparatively few instances where active medicinal agents are naturally dissolved in a water, its effects, if injurious, would be so slow as to elude ordinary observation. If, as is exceedingly probable, the same constitution of water as impairs its solvency out of the body, do likewise operate against its being the most eligible menstruum or dissolvent for processes occurring within the body—such processes I mean as attend the act of digestion; if the lime and other hardening ingredients which waste soap in our laundries, and tea in our parlours, do similarly waste within us those organic agencies by which our food is dissolved and converted; any result arising from this source would be of gradual operation, would not easily admit of being traced to its source, and (except in susceptible persons) would rarely produce such symptoms as might immediately draw attention to their cause. The ill effects (whatever they may be) arising from the use of hard waters must be looked for in chronic impairment of digestion, and in those various derangements of nutrition in distant parts (the skin and teeth particularly) which follow as secondary results on such chronic disorder. It would be ridiculous to look for the operation of an ill-chosen water, after its habitual use during two centuries, as though one were inquiring for the symptoms of an acute poison. The signs that are to be ascertained among a population, if such signs exist, are those which would evidence a premature exhaustion of the power of digestion, and would testify that the machine on which we depend for that power had been exposed to unnecessary and avoidable fatigue. This, I believe, is the utmost which Medicine, proceeding from theoretical grounds, would venture to say on the subject.

Perhaps I need not inform you that indigestion, with all that follows from it, is so frequent in the metropolis, in persons after the first strength of youth, that, for large classes of society, a perfect discharge of the natural process of digestion (such a discharge of it as a lecturer would describe to be the exact type and intention of Nature), is exceptional and rare. Unquestionably, in large numbers of cases, wine and beer and spirits, rather than water, have to do with this effect. Unquestionably, other influences of metropolitan life—and, not least, the mental wear and tear which belong to its large excitement, contribute immensely to this chronic derangement of health; but there are reasons likewise for believing, that the quality of water consumed is not a matter of indifference to the result. We cannot but give it an important place among those influences of health or unhealth which we consider local; and we cannot refuse to recognise the fact, that in recommending our patients (as we do often recommend them) to try ‘change of air’ for complaints which baffle us by their obstinacy, so long as the subject of them remains in London, the course on which we rely for success implies ‘change of water,’ equally with that other change to which more popular importance is attached.

In illustration of this view, I may quote to you the experience of two other towns. Dr. Sutherland stated, in evidence before the General Board of Health, that having lived for a number of years at Liverpool (where the water is said to be of about the same degree of hardness as ours), he had long entertained a conviction that ‘the hard water, in a certain class of constitutions, tends to produce visceral obstructions; that it diminishes the natural secretions, produces a constipated or irregular state of the bowels, and consequently deranges the health. He had repeatedly known these complaints to vanish on leaving the town, and to re-appear immediately on returning to it, and it was such repeated occurrences which fixed his attention on the hard selenitic water of the new red sandstone as the probable cause, as he believed it to be, of these affections.’ (Rep. p. 51). And Dr. Leach, of Glasgow, stated before the same Board, as the result in that town of two years’ experience of a substitution of soft for hard drinking-water, that in his opinion, ‘dyspeptic complaints had become diminished in number;’ and that it had ‘been observed, since this change, urinary diseases have become less frequent, especially those attended by the deposition of gravel.’

Inferences useful for ourselves cannot be drawn from statements like the above, on the fullest assumption of their accuracy, without comparing the waters referred to with our own, more completely than is done by the one characteristic of ‘hardness;’ and there may likewise be other qualifications requisite for an application of the analogy. But those disorders of health which are specified by the gentlemen quoted, as produced by the use and diminished by the disuse of hard waters, are such as might very probably stand in the relation of effect to their alleged cause; results, namely, primary and secondary, of disordered digestion.

Practically, I may tell you, that there are many individuals whose stomachs are extremely sensitive to the impression of hard water, who derive immediate inconvenience from its use, and who refuse to drink it without artificial reduction of its objectionable quality. I may likewise inform you that a physician, recently deceased, whose knowledge of indigestion and its chronic effects (especially in relation to the skin and urinary organs) was most profound and accurate, and whose consulting practice in such disorders was for many years almost a monopoly (I mean Dr. Prout) was in the habit of enjoining on his patients the use of distilled water. He evidently considered that the consumption of such waters as are habitually drunk in the metropolis was detrimental, at least to an enfeebled digestion. This is an opinion which, I have reason to believe, is generally entertained by medical practitioners in London.

It may not be irrelevant to mention to you (since the influence of imagination or of artificial habits can have little to do with this result) that horses are liable to be much inconvenienced by hard water, if unaccustomed to its use; and it is, I believe, notorious that grooms in charge of racers habitually take the trouble of conveying with them, to their temporary racing stables, a supply of the accustomed water. Veterinary surgeons say that under the continued use of hard water, which horses will avoid if possible, their coats become rough and staring;—an effect, I may observe, analogous to those skin-disorders of the human subject which are apt to occur from impairment of the digestive functions.

Taking into account all these considerations, together with others of a more technical description; and believing that water is eligible for human consumption in proportion as it is free from the admixture of any material foreign to its simple elementary constitution—exception being made only of so much dissolved air as will render it sparkling and palatable; I entertain no doubt that a water, devoid of considerable hardness, would (cæteris paribus) for the purposes of cooking and drinking, be far preferable to that which the companies now distribute through the City of London.

Hitherto, however, I have spoken of the waters supplied to the City, merely as regards that large impregnation of earthy material which they gather from their source; and I have criticised them only in respect of that admixture. Their essential chemical quality is one native to the soil from which they are derived; and whatever censure thus far belongs to them could only have been avoided by the selection of a different source. Chemistry, in the days of Morrys and Myddleton, was not sufficiently advanced to inform the water-merchants of a city on those different conditions which determine the fitness of a soil to serve as the natural or artificial gathering-ground of a supply; and by which (as they vary in different localities) hardness is imparted to the rain-fall of one district, while softness is preserved for that of another.

But there are other evils belonging to these waters, less appreciable indeed by chemistry, but open to universal observation, and meriting unqualified blame. They are conducted to the metropolis in open channels; they receive in large measure the surface-washing, the drainage, and even the sewage of the country through which they pass; they derive casual impurities from bathers and barges; they are liable to whatever pollutions mischievous or filthy persons may choose to inflict on them; and then on their arrival in the metropolis (after a short subsidence in reservoirs, which themselves are not unobjectionable) are distributed, without filtration, to the public. Whatever chemistry may say on this subject (and I need not remind you of very powerful causes of disease which lie beyond its cognisance), I cannot consider it matter of indifference, that we drink—with whatever dilution, or with whatever imperfect oxidation, the excremental and other impurities which mingle in these sources of our supply. Such admixtures, though in their quantity less, are in their quality identical with those which render Thames-water, as taken at London Bridge, inadmissible for domestic consumption, and which occasion it, when stored for sea-use, to undergo, before it becomes fit to drink, a succession of offensive changes strictly comparable to putrefaction.

In this slovenly method of conveyance and distribution there is a neglect of common precaution for the purity and healthfulness of the supply, which I must report to you as highly objectionable: and this—the method of supply to our great metropolis, strikes one the more with astonishment and disgust, as one reflects on the long experience and admirable models which past centuries in foreign countries have supplied; and especially, as one remembers those colossal works which, more than two thousand years ago, were constructed under the Roman government, for the cool and cleanly conduction of water.

The present imperfections of knowledge forbid me to cite, as definite causes of disease, the contaminations to which I have adverted: I cannot say to you—pointing to our classified list of sickness and mortality, this depends on drinking the diluted drainage of Hertford, that on the contributions of Ware. Indeed I know that, under the influence of the river and the atmosphere, very considerable changes occur in the materials thus furnished, tending eventually to render them inert; and if injury to life occur from their ingestion, it is probably only under peculiar and exceptional conditions, increasing their quantity, or delaying their oxidation. In protesting against their continued distribution as articles of diet, I therefore insist less on inferences deducible from medicine, and shall probably have the concurrence of your Hon. Court in grounding my appeal on the common principles of taste.

On the incidental contaminations to which the pipe-water consumed within the City becomes liable, by reason of its storage in receptacles both foul in themselves and surrounded by causes of foulness, I have already addressed you; and I have shown to you the dependence of this evil on the system of intermittent supply as adapted to the houses of the poor.

Of other sources of water-supply existing within the City of London, there are many of small extent in the form of superficial springs. These are eagerly sought after, sometimes from a distance, on account of their coolness and sparkling condition. In the Appendix[51] you will find an account of one of these waters—that in the vicinity of Bishopsgate church, which is very much drunk in that quarter of the City. Any praise given to it illustrates exceedingly the fallacy of popular judgment on such subjects, and shows how easily those qualities of coolness and freshness, which are absent from stored waters, impose on the palate, and induce a preference to be given to waters which are relatively most objectionable.

The chemical faults which belong to our London pipe-water are possessed in a far greater degree by this water of Bishopsgate pump, and the latter has moreover some vices which are absent from the former; but the vapidity and fustiness of water which has been stored in cisterns are so repugnant to the taste, that the water chemically preferable is not in practice preferred.

To the use of waters of this description, within a large city, there is always much objection. In addition to extreme hardness, which in London they universally possess, they are liable, in a dangerous degree, to become contaminated by the leakage of drains, and by other sources of impurity; as, for instance, where situated within the immediate vicinity of grave-yards they derive products of animal decomposition from the soil.[52] Very recently, a celebrated pump within the City of London, that adjoining St. Bride’s church-yard, has been abandoned on account of such impregnations. Or perhaps I should rather say (for the difference again illustrates the readiness with which the palate is deceived or corrupted) that it was not abandoned—for till almost the last moment the neighbours adhered to it with fondness; but the parochial authorities—alarmed by the proximity of cholera—caused its handle to be locked.

As an available source of supply to the City of London, the use of deep (Artesian) wells has been recommended: the clearness and softness of these waters, together with their freedom from organic matters, having concurred to suggest their employment. I feel bound to express the strongest opinion against the fitness of these waters for the purpose of beverage. They uniformly contain a considerable proportion of medicinal ingredients; they are capable of exerting definite and demonstrable influence over the natural actions of the body; and information is before me of various injury to health, affecting large numbers of persons, arising from the continued dietetic use of such waters.

In addressing your Hon. Court on the subject of water-supply for the City, it is impossible that I should do otherwise than advert to the fact, that, during the last few months, under the auspices of Her Majesty’s government, as represented for sanitary purposes by the General Board of Health, a plan has been gradually maturing itself, for the supply of the entire metropolis with pure soft water. Founding itself on very extensive investigations as to the qualities of water, as to the influence of soils on its chemical composition, as to the relation between streams and rain-fall, as to the hydraulic principles of distribution, and the like, this plan proposes to gather water in certain silicious soils, which can impart to it the least possible admixture of foreign ingredients; to conduct it in closed channels, with every precaution for its perfect purity; and to distribute it throughout the metropolis, at a rate which shall be from 30 to 50 per cent. less than our present water-charges. The proposed area for the collection of this supply is in the extensive range of sandy soil in the south of Surrey, extending around Farnham, about ten miles in each direction. Since the publication of the first Report made on this subject by the General Board of Health, unremitting inquiry has been advancing, under their direction, into all details of the plan; and the Hon. William Napier, who, with others, has been engaged in the investigation of the proposed sources, has advocated an important modification, which promises to reduce very considerably the anticipated expense of the undertaking. The essential and most important principles which governed the Board, in arranging their plan, were, first, to seek their supply in a silicious soil, where little soluble material could exist for its contamination; secondly, to take possession of the water so near to its source that all its original purity might be preserved; and, during conduction, to isolate it from those contaminations which are incidental to the onward passage of a stream through miles of promiscuous country. To fulfil these indications, there were two conceivable courses; and studious local inquiries could alone determine which of them was preferable: on the one hand, if the streams which represent the natural drainage of the country should be found uniformly pure and copious, they might admit of being conducted bodily into the artificial river of supply: on the other hand, it might be requisite to carry the interference of art still further, to absorb the filtering moisture of this large sand-district before it had become confluent into streams, and thus from day to day, by extensively ramified works of artificial sub-drainage, to derive immediately from the soil, the varying contributions of rain-fall and dew. The Board, apparently solicitous for the completer security of their plan, preferred to estimate its cost on the latter very expensive supposition; they allowed apparently for the diffusion of drain-pipes over 150 square miles of country, and for a reservoir which should contain storage of water equivalent to a very long metropolitan consumption. The later examination, made by Mr. Napier and confirmed by others, tends and appears to show, that these large sources of expense may be avoided; that the waters may be collected of unusual purity and softness, where they have united themselves into rivulets of considerable volume; that the gauged and estimated discharge of these rivulets is sufficient day by day for the needs of the metropolis, according to the largest construction of those needs; that capillary drain-pipes and very extensive storage-room may thus be dispensed with; and that under the modification of arrangement suggested by these facts, some very large reduction might be inferred for the total estimate of this comprehensive plan.

Many of these particulars are already before the public; but in a matter of so much importance to the health of the City, as that of participating in a supply of pure water, collected and distributed on the soundest principles, and sold at the cheapest rate, I did not think it would become me, as your Officer of Health, to remain an indolent auditor. I have felt it my duty to inform myself, so far as I could, on the real merits of this scheme, and on its probable relation hereafter to the sanitary condition of the metropolis. I have spent three days on the site of the proposed sources, and many other days in informing myself on all the bearings of the subject. I have likewise collected water from a proposed tributary of the future supply, which has been analysed, and which shows (as my Appendix will illustrate to you) a remarkable and rare excellence. On one occasion of visiting the country, I was accompanied by Mr. T. Taylor, and we made on the spot a sufficient number of extemporaneous examinations, to assure us that the essential features, shown in the more elaborate analysis, are (as geological considerations would lead us to believe) the general characters of water throughout the district.

On any other than the sanitary relations of this subject I can have nothing officially to say; but, confining myself to these relations, I may certify to your Hon. Court that the water in question is, in my judgment, of a quality admirably suited for domestic purposes; that its distribution through the City of London would conduce to the health and comfort of the population; and that the principles, proposed by the Board for its collection and conveyance, appear to me such as sanitary science, in its present condition, should counsel for the water-service of the metropolis.

There is, however, one aspect of the subject which must not pass unconsidered. Water that is free from earthy ingredients requires a peculiar distributory apparatus. If conveyed in leaden pipes with access of air, or if stored in leaden cisterns, it corrodes the metal of which they are composed, and is liable to derive from this source an impregnation very hazardous to life. Under certain circumstances, especially under alternations of air and water (such as occur in the intermittent supply), or where organic impurities are held in solution or suspension, or probably where from any cause uncombined carbonic acid is present, even the hardest waters are not free from this risk. Speaking generally, however, it affects soft water chiefly; distilled water most of all: and the Farnham water (in common with all pure water) is decidedly liable to this empoisonment, if used with leaden apparatus of conduction and storage. In my Appendix you will find some interesting particulars on this head; and you will observe that with experiments conducted by Mr. Taylor in imitation of the constant supply (i. e. with total submersion of the metal) the formation of carbonate of lead in the Farnham water was exceedingly gradual. This concurs with the alleged experience of Aberdeen, where it is said by Professor Clark to have been found (to my mind, by a somewhat dangerous trial) that pure and soft water, distributed on the principle of constant supply, does not exert on the leaden pipes any action injurious to the health of the population. You will likewise observe, that when hard water, as at present employed in the City, is softened by boiling, it acquires this property of pure water, and becomes capable of acting on lead; and here is an important observation, as it has been proposed by similar artificial means, employed on a very large scale, to soften all the water now distributed in the metropolis.

Obviously, as regards one and all of the many proposals for supplying water destitute of hardening ingredients, any chemical process, or any change of source, which might lead to the distribution of such pure water through the metropolis, could not be considered as a single and separate reform, but must be undertaken conjointly with such alterations in the distributive arrangements as might be requisite for removing from the new plan any chance, however slight or remote, of injuring the population by metallic poison.

What those alterations must be, it would now be premature to decide. The experience of Aberdeen might seem to suggest, that the system of constant supply (on all other accounts so eminently desirable for the metropolis) would in itself, if accompanied by the total disuse and prohibition of leaden cisternage, give sufficient security against the danger in question; or, on the other hand, further inquiry may show it to be quite indispensable for a safe distribution of the new supply, that leaden pipage should be entirely superseded by the use of some non-metallic material, as earthenware or glass. Should this change become necessary, its adoption would no doubt be facilitated by the comparative cheapness of these preferable materials.

Offensive or injurious Trades.

With respect to offensive or injurious trades and occupations pursued within the City of London, you were reminded by your Committee of Health, in their Report of March 26th, ‘that upon your attempting to put in force the powers of your Act of Parliament in reference thereto, it was found that considerable difficulties were opposed to your efforts. Sufficient powers (the Report proceeds to say) are not given by the City of London Sewers Act to meet some of the cases alluded to, while other legal and technical objections presented themselves to the enforcement of the powers in question.’ The Committee concluded their Report by ‘pointing out to you the necessity, when the question of renewing your Act should come into consideration, of procuring additional powers which may enable you effectually to remedy those evils.’

On the grounds thus expressed by your Committee, I avail myself of the present opportunity for bringing the subject again under your notice.

In my former Report I spoke particularly of those trades and occupations which deal with animal substances liable to decomposition; and in expressing my knowledge of their danger to the health of an urban population, I argued that no occupation which ordinarily leaves a putrid refuse, nor any which consists in the conversion or manufacture of putrescent material, ought, under any circumstances, to be tolerated within a town. To that subject I now revert, only to assure your Hon. Court that the past year has given me no reason to alter my opinion. But the trades to which I wish, on this occasion, more especially to request your attention, are those which are complained of on the ground of their offensiveness, rather than of their injury to health—as nuisances rather than as poisons. During the year, I have received a very considerable number of complaints of this nature; some of them perhaps frivolous, but many well-founded and reasonable.

At the head of this class of evils stands the flagrant nuisance of smoke. Those members of the Court who have visited foreign capitals where other fuel than coal is employed, will remember the contrast between their climate and ours—will remember (for instance even in Paris) the transparence of air, the comparative brightness of all colour, the visibility of distant objects, the cleanliness of faces and buildings, instead of our opaque atmosphere, deadened colours, obscured distance, smutted faces, and black architecture. Those, even, who have never left our metropolis, but who, by early rising or late going to rest, have had opportunities of seeing a London sunrise, can judge, as well as by any foreign comparison, the difference between London as it might be, and London as it is. Viewed at dawn and at noon-day, the appearances contrast as though they were of different cities and in different latitudes. Soon after daybreak, the great factory shafts beside the river begin to discharge immense volumes of smoke; their clouds soon become confluent; the sky is overcast with a dingy veil; the house-chimneys presently add their contributions; and by ten o’clock, as one approaches London from any hill in the suburbs, one may observe the total result of this gigantic nuisance hanging over the City like a pall.

If its consequences were confined to rendering London (in spite of its advantages) the unsightliest metropolis in Europe, to defacing all works of art, and rendering domestic cleanliness expensive, I should have nothing officially to say on the subject; but inasmuch as it renders cleanliness more difficult, and creates a despair of cultivating it with success, people resign themselves to dirt, domestic and personal, which they could remove but so temporarily: or windows are kept shut, in spite of immeasurable fustiness, because the ventilation requisite to health would bring with it showers of soot, occasioning inconvenience and expense. Such is the tendency of many complaints which have reached me, and of their foundation in truth and reason I have thorough conviction and knowledge.

I would submit to your Hon. Court that these evils are not inconsiderable; and that beside the injury to property (with which I have nothing to do) the detriment to health, if only indirect, claims to be removed. Yet, while I am cautious to speak of this latter injury, as though it were only indirect—only by its obstruction of healthy habits, I ought likewise to tell you, that there are valid reasons for supposing that we do not with impunity inhale day by day so much air which leaves a palpable sediment; that many persons of irritable lungs find unquestionable inconvenience from these mechanical impurities of the atmosphere; and (gathering a hint from the pathology of vegetation) that few plants will flourish in the denser districts of London, unless the air which conduces to their nourishment be previously filtered from its dirt.

If the smoke of London were inseparably identified with its commercial greatness, one might willingly resign oneself to the inconvenience. But to every other reason against its continuance must be added as a last one, on the evidence of innumerable competent and disinterested witnesses, that the nuisance, where habitual, is, for the greater part or entirely, voluntary and preventable; that it indicates mismanagement and waste; that the adoption of measures for the universal consumption of smoke, while relieving the metropolis and its population from injury, would conduce to the immediate interest of the individual consumer, as well as to indirect and general economy. For all the smoke that hangs over us is wasted fuel.