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THE SANITARY EVOLUTION 
 OF LONDON 
 
THE 
 
 SANITARY EVOLUTION 
 OF LONDON 
 
 HENRY JEPHSON, L.C.C. 
 
 AUTHOR OF 
 " THE PLATFORM : ITS RISE AND PROGRESS " 
 
 " The discovery of the laws of public health, the determination of 
 the conditions of cleanliness, manners, water supply, food, exercise, 
 isolation, medicine, most favourable to life in one city, in one 
 country, is a boon to every city, to every country, for all can 
 profit by the experience of one." 
 
 G. Graham, Registrar-General, 1871. 
 
 A. WESSELS COMPANY 
 
 PUBLISHERS 
 
 BROOKLYN, N. Y. 
 
 MCMVII 
 
VjLoa x-^s. "^ H^tAv<tH^<t 
 
DEDICATED 
 TO 
 
 THE LONDON COUNTY COUNCIL 
 
 BY ONE OF ITS MEMBERS 
 THE AUTHOR 
 
 4, Cornwall Gardens, 
 S.W. 
 
Digitized by tine Internet Arciiive 
 
 in 2010 witii funding from 
 
 Open Knowledge Commons 
 
 http://www.archive.org/details/sanitaryevolutioOOjeph 
 
CONTENTS 
 
 MAP . . . . . . Facing page 1 
 
 PAGE 
 
 Ohaptek I . . . . . . .1 
 
 Chaptee II (1855-1860) . . . . . 82 
 
 Chaptee III (1861-1870) . . . . .155 
 
 Chaptee IV (1871-1880) . . . .221 
 
 Chaptee V (1881-1890) 288 
 
 Chaptee VI (1891-1901) . . . .349 
 
 Chaptee VII (1901-1906) 401 
 
 INDEX 435 
 
SKETCH MAP OF LOCAL DISTRICTS IN LONDON. 
 
 iv-:^ 
 
 ,PADoiNOToN\ \s 3V..5i^'^^^Try^ ^ 
 
 OLD Town \rurLfli\j 
 
 
 
 GREENWICH DISTRICT 
 
 )CAMBERWCLL\ 
 
 LAMBETH 
 
 .<f 
 
 ,V^ 
 
 .^^ 
 
 ^^^/VDs^ 
 
 ^'sr/?/cr 
 
 REFERENCE TO NAMES OF PARISHES AND DISTRICTS NUMBERED ON THE MAP. 
 
 1. Clerkeawell, 4. Sti-and. 7. St. James', WeBtminBtor. 
 
 2. Holboi-n. 5. St. Maitin-in-thc-Fields. 8. "Westniinster. 
 
 3. St. Giles'. 6. MTiitecbh-pal. 9. St. Saviour's, Southwark. 
 
The Sanitary Evolution of London 
 
 CHAPTER I 
 
 The health of the people of a country stands foremost in 
 the rank of national considerations. Upon their health 
 depends their physical strength and energy, upon it their 
 mental vigour, their individual happiness, and, in a great 
 degree, their moral character. Upon it, moreover, depends 
 the productivity of their labour, and the material prosperity 
 and commercial success of their country. Ultimately, upon 
 it depends the very existence of the nation and of the 
 Empire. 
 
 The United Kingdom can claim no exemption from this 
 general principle ; rather, indeed, is it one which, in the 
 present period of our history, affects us more vitally than it 
 has ever done before, and in a more crucial manner than 
 it does many other nations. 
 
 The more imperative is it, therefore, that every effort 
 should be made to raise the health of our people to the 
 highest attainable level, and to maintain it at the loftiest 
 possible standard. 
 
 The subject is so vast and complicated that it is impossible, 
 within reasonable limits, to treat more than a portion of it 
 at a time. 
 
 London, the great metropolis, the capital of the Empire 
 itself, constitutes, by the number of its inhabitants, so large 
 a portion of the United Kingdom, that the health of its 
 people is a very material factor in that of the kingdom. 
 It has a population greater than either Scotland or Ireland, 
 greater than any of our Colonies, except Canada and 
 Australasia, greater than that of many foreign States — 
 
 2 1 
 
2 THE SANITARY EVOLUTION 
 
 " the greatest aggregate of human beings that has ever 
 existed in the history of the world in the same area of 
 space." 
 
 And, in a measure too, it is typical of other of our great 
 cities. 
 
 A narrative of the sanitary history and conditions of life 
 of the people of London, therefore, would be a material 
 contribution to the consideration of the general subject 
 in its national aspect, whilst it cannot but be of special 
 interest to those more immediately concerned in the 
 amelioration of the existing condition of the masses of 
 the people of the great capital. 
 
 Such a narrative is attempted in the following pages. 
 
 It is, in the main, based upon the experiences, and 
 inferences, and conclusions, of men who, more than any 
 others, were in a position closely to observe the circum- 
 stances in which the people lived, their sanitary condition, 
 and the causes leading thereto and influencing the same. 
 
 It includes the principal measures from time to time 
 passed by the Legislature to create local governing 
 authorities in sanitary matters — the various measures 
 designed and enacted to improve the condition of the 
 people — and the administration of those measures by the 
 local authorities charged with their administration. 
 
 It is a narrative, in fact, of the sanitary — and, therefore, 
 to a great extent of the social — evolution of this great city. 
 
 It is doubtful how long a time would have elapsed before 
 the condition of the people came into real prominence had 
 it not been for the oft-recurring invasions of the country by 
 epidemic disease of the most dreaded and fatal forms. Ever- 
 present diseases, disastrous and devastating though they 
 were, did not strike the imagination or appeal to the fears 
 of the public as did the sudden onslaught of an awe- 
 inspiring disease such as cholera. 
 
 An epidemic of that dreaded disease swept over London 
 in 1832, and there were over 10,000 cases and nearly 5,000 
 deaths in the districts then considered as metropolitan — 
 the population of those districts being close upon 1,500,000. 
 
 For the moment, the dread of it stimulated the people, 
 
OF LONDON 3 
 
 and such governing authorities as there were, to inspection, 
 and cleansings, and purifications, and to plans for vigorous 
 sanitary reform ; but the instant the cholera departed 
 the good resolutions died down, and the plans disappeared 
 likewise. 
 
 There were, however, some persons upon whom this 
 visitation made more abiding impression ; and they, struck 
 by the waste of human life, by the frequent recurrence of 
 epidemics which swept away thousands upon thousands of 
 victims, and distressed by the perpetual prevalence and 
 even more deadly destructiveness of various other diseases 
 among the people, bethought themselves of investigating 
 the actual existing facts, and the causes of them — so far 
 at least as London, their own city, was concerned. 
 
 And then slowly the curtain began to be raised on the 
 appalling drama of human life in London, and dimly to be 
 revealed the circumstances in which the great masses of the 
 working and labouring classes of the great metropolis lived, 
 moved, and came to the inevitable end, and the conditions 
 and surroundings of their existence. 
 
 The slowness with which England as a nation awoke to 
 the idea that the public health was a matter of any concern 
 whatever is most strange and remarkable. It seems now so 
 obvious a fact that one marvels that it did not at all times 
 secure for itself recognition and acknowledgment. But men 
 and women were growing up amidst the existing surround- 
 ings, foul and unwholesome though those were, and some, 
 at least, were visibly living to old age ; population was 
 increasing at an unprecedented rate ; wealth was multiplying 
 and accumulating ; the nation was reaching greater heights 
 of power and fame. What, then, was there, what could 
 there be wrong with the existing state of affairs ? 
 
 Keal social evils, however, sooner or later, force them- 
 selves into prominence. For long they may be ignored, 
 or treated with indifference by the governing classes ; for 
 long they may be endured by the victims in suffering and 
 silence ; but ultimately they compel recognition, and have 
 to be investigated and grappled with, and, if possible, 
 remedied. 
 
4 THE SANITARY EVOLUTION 
 
 The real beginning of such investigations was not until 
 near the close of the fourth decade of the nineteenth 
 century. Information then for the first time was collected, 
 of necessity very limited in extent, crude in form, and of 
 moderate accuracy, but none the less illuminating in its 
 character — information from which one can piece together 
 in a hazy sort of way a general impression of the condition 
 of the working and poorer classes in London at that 
 period. 
 
 Foremost among the diseases which worked unceasing 
 and deadly havoc among the people was fever. By its 
 wide and constant prevalence and great fatality, it was the 
 first upon which attention became fixed. The returns 
 which were collected as regarded it related to twenty 
 metropolitan unions or parishes, and in them only to the 
 pauper population, some 77,000 in number. But they 
 showed that in the single year of 1838, out of those 77,000 
 persons, 14,000, or very nearly one-fifth, had been attacked 
 by fever, and nearly 1,300 had died.* 
 
 Being limited to the technically pauper population this 
 information related only to one section of the community ; 
 but it nevertheless afforded the means of forming a rough 
 estimate of the amount of fever among the community as a 
 whole. 
 
 And another fact also at once became apparent, namely, 
 that certain parts of London were more specially and 
 persistently haunted or infested by fever than others. In 
 "Whitechapel, Holborn, Lambeth, and numerous other 
 parishes or districts, fever of the very worst forms was 
 always prevalent — " tjrphus, and the fevers which proceed 
 from the malaria of filth." The sanitary condition of 
 those districts was fearful, every sanitary abomination 
 being rampant therein, whilst certain localities in them 
 were so bad that "it would be utterly impossible for any 
 description to convey to the mind an adequate conception 
 of their state." And most marvellous and deplorable of ail 
 was the fact that this fearful condition of things was 
 
 * See Parliamentary Papers, 1837-8, vol. xxviii., and P.P. 1839, vol. xx, 
 p. 106, Dr. a. Smith. 
 
OF LONDON 5 
 
 allowed, not merely to continue, but to flourish without any 
 attempt being made to remedy, or even to mitigate, some of 
 the inevitable and most disastrous consequences. 
 
 As regarded the districts in which the wealthier classes 
 resided, systematic efforts had been made on a consider- 
 able scale to widen the streets, to remove obstructions to 
 the circulation of free currents of air, and to improve the 
 drainage — an acknowledgment and appreciation of the 
 fact that these things did deleteriously affect people's 
 health. But nothing whatever had been attempted to 
 improve the condition of the districts inhabited by the 
 poor. Those districts were not given a thought to, 
 though in them annually thousands and tens of thousands 
 of victims suffered or died from diseases which were 
 preventable. 
 
 Keports such as these attracted some degree of atten- 
 tion, and awakened a demand for further information, 
 and in 1840 the House of Commons appointed a Select 
 Committee to inquire as to the health, not only of 
 London, but of the large towns throughout the country. 
 Their report* enlarged upon the evils previously in part 
 portrayed, and emphasised them. 
 
 " Your Committee," they wrote, " would pause, from the 
 sad statements they have been obliged to make, to observe 
 that it is painful to contemplate in the midst of what 
 appears an opulent, spirited, and flourishing community, 
 such a vast multitude of our poorer fellow-subjects, the 
 instruments by whose hands these riches were created, 
 condemned for no fault of their own to the evils so justly 
 complained of, and placed in situations where it is almost 
 impracticable for them to preserve health or decency of 
 deportment, or to keep themselves and their children from 
 moral and physical contamination. To require them to be 
 clean, sober, cheerful, contented under such circumstances 
 would be a vain and unreasonable expectation. There is no 
 building Act to enforce the dwellings of these workmen 
 being properly constructed ; no drainage Act to enforce their 
 being properly drained ; no general or local regulation to 
 1840. P.P., vol. xi. p. 13. 
 
6 THE SANITARY EVOLUTION 
 
 enforce the commonest provisions for cleanliness and 
 comfort." 
 
 Lurid as were the details thus made public of the con- 
 dition in which the vast masses of the people in London 
 were living, neither Parliament nor the Government took 
 any action beyond ordering successive inquiries by Poor Law 
 Commissioners, or Committees of the House of Commons, 
 or Eoyal Commissions. 
 
 Before one of these Commissions* the following striking 
 evidence was given — evidence which it might reasonably 
 be expected would have moved any Government to immediate 
 action : — 
 
 " Every day's experience convinces me," deposed the 
 witness, t "that a very large proportion of these evils is 
 capable of being removed ; that if proper attention were 
 paid to sanitary measures, the mortality of these districts 
 would be most materially diminished, perhaps in some places 
 one-third, and in others even a half. 
 
 " The poorer classes in these neglected localities and 
 dwellings are exposed to causes of disease and death which 
 are peculiar to them ; the operation of these peculiar causes 
 is steady, unceasing, sure ; and the result is the same as if 
 twenty or thirty thousand of these people were annually 
 taken out of their wretched dwellings and put to death — 
 the actual fact being that they are allowed to remain in 
 them and die. I am now speaking of what silently but 
 surely takes place every year in the metropolis alone." 
 
 But the Government took no action — beyond a Building 
 Act which did little as regarded the housing of the people. 
 No local bodies took action, and years were to pass before 
 either Government or Parliament stirred in the matter. 
 
 In dealing historically with matters relating to London 
 as a whole, it is to be remembered that for a long time there 
 had been practically two Londons — that defined and de- 
 scribed as the " City," and the rest of London — that which 
 
 * Commission for inquiring into the state of large towns and populous 
 districts, 1844. 
 
 f Dr. Southwood Smith, P.P. 1845, vol. xviii. 
 
OF LONDON 7 
 
 had no recognised boundaries, no vestige of corporate exis- 
 tence, and which can best be described by the word 
 " metropoHs." 
 
 The "City" was virtually the centre of London — the 
 centre of its wealth, its industry, its geographical extent — 
 a precisely defined area of some 720 acres, or about one 
 square mile in extent, and originally surrounded by walls. 
 Its boundaries had been fixed at an early period of our 
 history, and had never been extended or enlarged. So 
 densely was it covered with houses at the beginning of the 
 nineteenth century, and so fully peopled, that there was 
 practically no room for more, either of houses or people ; 
 and from then to the middle of that century its population 
 was stationary — being close upon 128,000 at each of those 
 periods. 
 
 Apajt altogether from poUtical influences, there were in the 
 " City " powerful economic forces at work which profoundly 
 affected the condition and circumstances of the people, not 
 only of the " City," but of London. 
 
 These, which were by no means so evident at one time, 
 became more and more pronounced as time went on. 
 
 All through the earlier part of the nineteenth century 
 England was attaining to world pre-eminence by her com- 
 merce, her manufactures, and her wealth. The end of the 
 great war with France saw her with a firm grip of all the 
 commercial markets of the world. Her merchants pushed 
 their trade in every quarter of the globe — her ships enjoyed 
 almost a monopoly of the carrying trade of the world. 
 
 In this progress to greatness London took the foremost 
 part, and became the greatest port and trade emporium of 
 the kingdom, a great manufacturing city, and the financial 
 centre of the world's trade. 
 
 It was upon this commerce that the prosperity and glory 
 of London were built : it was by this commerce that the 
 great bulk of the people gained their livelihood, and that a 
 broad highway was opened to comfort, to opulence, and 
 power. And so the commercial spirit — the spirit of acquir- 
 ing and accumulating wealth — got ever greater possession 
 of London. 
 
8 THE SANITARY EVOLUTION 
 
 That spirit had long been a great motive power in London ; 
 it became more and more so as the century wore on, until 
 almost everything was subordinated to it. 
 
 That indisputable fact must constantly be borne in mind 
 as one reviews the sanitary and social condition of the people 
 of London at and since that time. Other constant factors 
 there were, also exercising vast influence — the constant 
 factors of human passions and human failings — but wide- 
 spread as were their effects, they were second to the all- 
 powerful, the all-impelling motive and unceasing desire — 
 commercial prosperity and success. 
 
 Synchronous with the rise in importance of the port of 
 London, and with its trade and business assuming ever 
 huger volume and variety, a noteworthy transformation took 
 place. 
 
 The " City," by the very necessities of its enormous 
 business, became gradually more and more a city of offices 
 and marts, of warehouses and factories, of markets and ex- 
 changes, and houses long used as residences were pulled 
 down, and larger and loftier ones erected in their place 
 for business purposes. 
 
 In some places, moreover, ground was entirely cleared of 
 houses for the construction of docks, or for the erection of 
 great railway termini. 
 
 How marked were the effects of these changes is evidenced 
 by the fact that from 17,190 inhabited houses in the " City " 
 in 1801, the number had sunk to 14,575 in 1851. 
 
 The explanation was the simple economic one, that land 
 in the "City" yielded a much larger income when let for 
 business than for residential purposes. Offices and ware- 
 houses were absolutely essential in the " City" for business. 
 What did it matter if people had to look for a residence in 
 some other place ? London was large. They could easily 
 find room. And the process, without control of any sort or 
 kind, and wholly unimpeded by legislation or governmental 
 regulation, went on quite naturally — entailing though it 
 did consequences of the very gravest character, then quite 
 unthought of, or, if thought of, ignored or regarded as 
 immaterial. 
 
OF LONDON 9 
 
 This then was, at that time, and still is, one of the 
 great, if not indeed the greatest of the economic forces 
 at work which has unceasingly dominated the housing of 
 the people not only in the " City," but in the metropolis 
 outside and surrounding the " City," and, in dominating their 
 housing, powerfully affected also their sanitary and social 
 condition. 
 
 The " City " was in the enjoyment of a powerful local 
 governing body — namely, the Lord Mayor and Corporation, 
 or Common Council, elected annually by the ratepayers ; 
 and numerous Acts of Parliament and Eoyal Charters had 
 conferred sundry municipal powers upon them. 
 
 For that important branch of civic requirements — the 
 regulation of the thoroughfares and the construction of 
 houses and buildings — they had certain powers. The vastly 
 more important sphere of civic welfare — namely, the 
 matters affecting the sanitary condition of the inhabitants — 
 was delegated by the Corporation to a body called the 
 Commissioners of Sewers, annually elected by the Common 
 Council out of their own body, some ninety in number. 
 And these Commissioners had, in effect, authority in the 
 City, directly or indirectly, over nearly every one of the 
 physical conditions which were likely to affect the health 
 or comfort of its inhabitants. They could also appoint a 
 Medical Officer of Health to inform and advise them upon 
 public health matters, and Inspectors to enforce the laws 
 and regulations. 
 
 The " City " was thus in happy possession of a powerful 
 local authority, and a large system of local government. 
 And it stood in stately isolated grandeur, proud of, and 
 satisfied with, its dignity, and privileges, and wealth ; 
 glorying in its own importance and splendour ; content 
 with its own system of government, and its powers for 
 administering its municipal affairs, and indifferent to the 
 existence of the greater London which had grown up 
 around it, and which was ever becoming greater. 
 
 Greater indeed. The population of the " City " in 1851 
 was 128,000 ; that of the metropolis not far short of 
 2,500,000. 
 
10 THE SANITARY EVOLUTION 
 
 The number of inhabited houses in the " City " was 
 hundreds short of 15,000. In the metropolis it was over 
 300,000. 
 
 The " City" was 720 acres in extent: what in 1855 was 
 regarded as the metropoKs was about 75,000 acres in 
 extent. 
 
 And here, with no visible boundary of separation between 
 them, were what were still "Parishes," but what were in 
 reality great towns ; not merely merged or rapidly merging 
 into each other, but already merged into one great 
 metropolis. Some of them even had a greater population 
 than the "City" itself. St. Pancras, for instance, with 
 167,000 persons ; St. Marylebone with 157,000, and Lam- 
 beth with 139,000. 
 
 Of that greater London — or, in effect, of London itself — 
 there is a complicated and tangled story to tell. 
 
 Long before the middle of the nineteenth century had 
 been reached, the time had passed when the " City " could 
 contain the trade, and commerce, and manufactures, and 
 business, which had grown up. They had overflowed into 
 London outside the walls, and just as in the "City" the 
 great economic forces produced certain definite changes in 
 the circumstances and sanitary condition of the people 
 living therein, so, in the greater London, the commercial 
 spirit radiating gradually outwards, produced precisely 
 similar results, only on a far wider scale, and with more 
 potent effect. 
 
 Trade, and commerce, and wealth, and population, were 
 increasing by leaps and bounds ; and like the rings which 
 year by year are added to the trunk of a tree, so year by 
 year, decade by decade, London — the metropolis — spread 
 out, and grew, and grew. From something under one 
 million of inhabitants in 1801, the population increased to 
 nearly two and a half millions in 1851, partly by natural 
 increase, due to the number of those who were born being 
 greater than of those who died, partly by immigration from 
 the country. 
 
 This was London, in the large sense of the title — London, 
 the great metropolis which had never received recognition 
 
OF LONDON 11 
 
 by the law as one great entity, and whose boundaries 
 had never been fixed, either by enactment, charter, or 
 custom.* 
 
 Dependent as is the public health, or sanitary and social 
 condition of the people, upon the circumstances in which 
 they find themselves placed, and the economic forces which 
 are constantly at work moulding those circumstances, it is 
 in as great a degree dependent on the system of local 
 government in existence at the time, upon the scope and 
 efficacy of the laws entrusted to the local authorities to 
 administer, and upon the administration of those laws by 
 those authorities. 
 
 As for local government — unlike the "City" — this greater 
 London was without form and almost void. With the 
 exception of the Poor Law Authority — the Boards of 
 Guardians — whose sphere of duty was distinctly limited, 
 there was, outside the boundaries of the " City," not even 
 the framework of a system of such government ; and the 
 confusion and chaos became ever greater as years went on 
 and London grew. 
 
 There was no authority so important as to have any 
 extended area for municipal purposes under its control and 
 management except certain bodies, five in number, en- 
 titled " Commissioners of Sewers," charged with duties in 
 connection with the sewerage of their districts. 
 
 In some parishes some of the affairs of the parish were 
 managed by the parishioners in open vestry assembled, at 
 which assembly Churchwardens, Overseers of the Poor, and 
 Surveyors of Highways were appointed to carry out certain 
 limited classes of work. In others, the parishioners elected 
 a select vestry to do the work of the parish. 
 
 But for many of the vitally important municipal affairs 
 there were no authorities at all. 
 
 As the non-City and out-districts became more thickly 
 peopled, and streets and houses increased in number, the 
 inconvenience of there being practically no local government 
 at all made itself felt. 
 
 In some cases, the owners of the estates which were 
 -•' Eoyal Commission, 1853-4, p. xii. 
 
12 THE SANITARY EVOLUTION 
 
 being so rapidly absorbed into London and being built 
 upon, applied to Parliament for powers to regulate those 
 estates. 
 
 In other cases, persons with interests in a special locality 
 associated themselves together and obtained a private Act 
 of Parliament giving them authority, under the name of 
 Commissioners or Trustees, to tax and in a very limited way 
 to govern a particular district or group of streets forming 
 part of a parish. Thus it happened that a large number of 
 petty bodies of all sorts and kinds came into existence. 
 Any district, however small, was suffered to obtain a local 
 Act of Parliament for the purpose of managing some of its 
 affairs, and this, too, without any reference to the interests 
 of the immediate neighbours, or of the metropolis as a 
 whole. Most of the limited and somewhat primitive 
 powers possessed by them were derived from an Act 
 passed in 1817, * and related to the paving of streets and 
 the prevention of nuisances therein. Some of these bodies 
 were authorised to appoint surveyors or inspectors ; also 
 ** scavengers, rakers, or cleaners " to carry away filth from 
 streets and houses, but the exercise of such powers was, of 
 course, purely optional. Indeed, there were scarcely any 
 two parishes in London governed alike. 
 
 What the exact number of these various petty authorities 
 was is unknown. Of paving boards alone, it is said that 
 about the middle of the last century there were no less than 
 eighty-four in the metropolis — nineteen of them being in 
 one parish. The lighting of the parish of Lambeth was 
 under the charge of nine local trusts. The affairs of St. 
 Mary, Newington, were under the control of thirteen Boards 
 or trusts, in addition to two turnpike trusts, f 
 
 In Westminster : — 
 
 " The Court of Burgesses and the Vestry retained general 
 jurisdiction over the whole parish for certain purposes ; but 
 the numerous local Acts so effectually subdivided the 
 control and distributed it among boards, commissioners, 
 trustees, committees, and other independent bodies, that 
 
 * The Metropolitan Paving Act, 57 George III. cap. 29. 
 + See Report of Vestry, 1856-7. 
 
OF LONDON 13 
 
 uniformity, efficiency, and economy in local administration 
 had become impossible." * 
 
 There were authorities exclusively for paving ; authorities 
 for street improvements ; authorities for lighting ; even 
 authorities for a bridge across the river. In the course of 
 years, several hundred such bodies had been created, with- 
 out any relation one to the other, and without any central 
 controlling authority, good, bad, or indifferent, by as many 
 Acts of Parliament. They were mostly self-elected, or 
 elected for life, or both; and were wholly irresponsible to 
 the ratepayers, or indeed to any one else ; nor were their 
 proceedings in any way open to the public. Many of them 
 had large staffs of well paid officials ; and there were 
 perpetual conflicts of jurisdiction between them, and an 
 absolute want of anything approaching to municipal ad- 
 ministration. 
 
 It has been roughly stated — roughly because there are no 
 reliable figures — that there were about three hundred such 
 bodies in London — "jostling, jarring, unscientific, cumbrous, 
 and costly " — the very nature of many of them being " as 
 little known to the rest of the community as that of the 
 powers of darkness." 
 
 Add to these numerous, clashing, and incompetent 
 authorities, various great public companies or corporations 
 — the water companies, and gas companies, and dock 
 companies, each with its own special rights — which were 
 far more favourably and generously regarded by Parliament 
 than were the rights of the public, and one has fairly 
 enumerated the local governing bodies then existing in 
 London. 
 
 In fact, in no parish of the great metropolis of London 
 was there a local authority possessed of powers to deal in 
 its own area with the multitudinous affairs affecting the 
 health and well-being of the people. 
 
 Nor was there in the metropolis any central authority — 
 
 no single body, representative or even otherwise — to attend 
 
 to the great branches of municipal administration which 
 
 affected and concerned the metropolis as a whole, and 
 
 - See Special Report of the Vestry, 1889, p. 208. 
 
14 THE SANITARY EVOLUTION 
 
 which could only be dealt with efficiently by the metropolis 
 being treated as a whole. 
 
 The consequences to the inhabitants of London of the 
 absence of any efficient form of local government were dire 
 in character, terrible in extent, and unceasing in operation. 
 The higher grades of society suffered in some degree, as 
 disease, begotten in filth and nurtured in poverty, often 
 invaded with disastrous consequences the homes of the 
 well-to-do ; but it was by the great mass of the industrial 
 classes and the poorer people that the terrible burden of 
 insanitation had to be borne, and upon them that it fell 
 with the deadliest effect. 
 
 The non-existence of a central authority, or of any capable 
 local authorities whose function it would have been to 
 protect them from the causes of disease, had resulted in an 
 insanitary condition which year after year entailed the 
 waste of thousands upon thousands of lives. And the 
 people, in the cruel circumstances of their position, were 
 absolutely powerless to help themselves, and had no possible 
 means of escape from the ever-present, all-surrounding 
 danger. 
 
 The first absolute necessity of any sanitation whatever is 
 the getting rid by deportation or destruction of all the filth 
 daily made or left by man or beast, for such filth or refuse 
 breeds all manner of disease, from the mildest up to the 
 very worst types and sorts, and promptly becomes not only 
 noxious to health, but fatal to life. The more rapidly and 
 thoroughly, therefore, this riddance is effected, the better is 
 it in every way for the general health of the public. 
 
 So far as the metropolis was concerned, this necessity had 
 for generation after generation been very lightly regarded ; 
 and when at last it so forced itself upon public notice that 
 it could no longer be ignored, the measures taken were 
 wholly inadequate and ineffective. 
 
 What system there was in London as to the disposal of 
 sewage throughout the earlier half of last century was based 
 upon a Statute dating so far back as Henry VIII. 's reign, 
 amended by another in William and Mary's reign. Under 
 these Statutes certain bodies had been constituted by the 
 
OF LONDON 16 
 
 Crown as Commissioners of Sewers for certain portions of 
 London, and charged with the duty of providing sewers and 
 drains in their respective districts, and maintaining the same 
 in proper working order. 
 
 But what might have been good enough for London in 
 the sixteenth or seventeenth centuries was certainly not 
 adequate in the nineteenth, when London had extended 
 her borders in every direction, and her population had 
 reached almost two and a half millions. Successive Parlia- 
 ments had not troubled themselves about such a matter; 
 and this neglect, which now appears almost incredible, was 
 typical of the habitual attitude of the governing classes to 
 the sanitary requirements of the masses of the population of 
 the metropolis. 
 
 In the eighteen hundred and forties, five such bodies of 
 Commissioners were in existence in London, each with a 
 separate portion of the metropolis under its charge and 
 exercising an independent sway in its own district; and 
 when we collect the best testimony of that time as to their 
 work and that of their predecessors, we have the clearest 
 demonstration of their glaring incapacity, and of the utter 
 inadequacy and inefficiency of the sewerage in their 
 respective districts. 
 
 Many miles of sewers had, it is true, in process of time 
 been constructed, and did exist, but much of the work had 
 been so misdone that the cure was little better than the 
 disease. 
 
 A river is always a great temptation to persons to get rid 
 of things they want to get rid of, particularly when the 
 things are nasty and otherwise not easily disposed of. 
 Londoners only followed the general practice when they 
 constructed their sewers so that they discharged their 
 contents direct into the Thames. The majority of these 
 sewers emptied themselves only at the time of low water ; 
 for as the tide rose the outlets of the sewers were closed, 
 and the sewage was dammed back and became stagnant. 
 When the tide had receded sufficiently to afford a vent for 
 the pent-up sewage, it flowed out and deposited itself along 
 the banks of the river, evolving gases of a foul and offensive 
 
16 THE SANITARY EVOLUTION 
 
 character. And then the sewage was not only carried up 
 the river by the rising tide, but it was brought back again 
 into the heart of the metropolis, there to mix with each 
 day's fresh supply of sewage; the result being that "the 
 portion of the river within the metropolitan district became 
 scarcely less impure and offensive than the foulest of the 
 sewers themselves." 
 
 This was bad enough, but there were miles of sewers 
 which, through defects of construction or disrepair, did not 
 even carry off the sewage from the houses and streets to 
 the river, but had become " similar to elongated cesspools," 
 and, as such, actual sources and creators of disease. 
 
 Incredible almost were the stupidities perpetrated by 
 these Commissioners in regard to the construction of the 
 sewers. At even so late a date as 1845 no survey had been 
 made of the metropolis for the purposes of drainage ; there 
 was a different level in each of the districts, and no attempt 
 was made to conform the works of the several districts to 
 one general plan. Large sewers were made to discharge 
 into smaller sewers. Some were higher than the cesspools 
 which they were supposed to drain, whilst others had been 
 so constructed that to be of any use the sewage would have 
 had to flow uphill ! 
 
 It might reasonably have been expected that in the nine- 
 teenth century, at least, the twenty parishes which formed 
 the district of the Westminster Commissioners of Sewers 
 would have been equal to producing an enlightened and 
 capable body as Commissioners, but the Westminster Court 
 of Sewers was certainly not such. Even their own chief 
 surveyor, in 1847, stigmatised it as a body "totally incom- 
 petent to manage the great and important works committed 
 to their care and control." 
 
 Upon it were builders, surveyors, architects, and district 
 surveyors — a class of persons whose opinions "might cer- 
 tainly be biassed with relation to particular lines of drains 
 and sewers." 
 
 Of another of the courts — namely, the Finsbury Court 
 of Sewers — one of the Commission had been outlawed; 
 another was a bankrupt. 
 
OF LONDON 17 
 
 It was stated at the time that "jobbery and favouritism 
 and incompetence were rampant," and that the system was 
 " radically wrong and rotten to the core." Certain it is that 
 these bodies failed completely to cope with the requirements 
 of the time. London was spreading out in all directions, 
 and the increase of houses and population was very rapid. 
 Practically no effort, however — certainly no adequate effort — 
 was made by the various bodies of Commissioners to provide 
 these new and growing districts with the means of getting 
 rid of their sewage. And then, inasmuch as the sewage had 
 somehow or other to be got rid of, and some substitute for 
 sewers devised, the surface drains, and millstreams, and 
 ditches were appropriated to use and converted into open 
 sewers or " stagnant ponds of pestilential sewage." 
 
 London was ** seamed with open ditches." 
 
 According to contemporary reports there were in Lambeth 
 numerous open ditches of the most horrible description. 
 Bermondsey was intersected by ditches of a similar cha- 
 racter, and abounded with fever nests. Rotherhithe was 
 the same. Hackney Brook, formerly " a pure stream," had 
 become " a foul open sewer." * In St. Saviour's Union the 
 sewers were in a dreadful condition ..." the receptacle of 
 all kinds of refuse, such as putrid fish, dead dogs, cats, &c. 
 Greenwich was not drained or sewered." 
 
 What certainly was conclusively demonstrated was that 
 the existence of several bodies of Commissioners, each with 
 a district to itself, presented an insuperable obstacle to any 
 general system of sewerage for greater London ; and that 
 one capable central authority was the first essential of an 
 adequate and efficient system for London as a whole. 
 
 Thus, then, in this first essential of all sanitation— one 
 might say of civilisation — no adequate provision was made 
 by Parliament for the safety of the metropolis ; whilst as to 
 other essentials of sanitation, there were no laws for the 
 prevention of the perpetration of every sanitary iniquity; 
 and such authorities as there were failed absolutely to use 
 even the few powers they possessed. 
 
 The defective and inefficient sewerage of the metropolis 
 
 * Eeport of Commission of 1845. 
 3 
 
18 THE SANITARY EVOLUTION 
 
 precluded the possibility of any proper system of house 
 drainage, for there being few sewers there were few drains, 
 and consequently instead of drains from the houses to the 
 sewers there were cesspools under almost every house. At 
 the census of 1841 there were over 270,000 houses in the 
 metropolis. It was known, then, that most houses had a 
 cesspool under them, and that a large number had two, 
 three, or four under them. Some of them were so huge 
 that the only name considered adequate to describe them 
 was "cess-lake." In many districts even the houses in 
 which the better classes lived had neither drain nor sewer — 
 nothing but cesspools ; and many of the very best portions 
 of the West End were "literally honeycombed" with them. 
 And so jealous was the law as regarded the rights of private 
 property that so late as 1845 owners were not to be inter- 
 fered with as regarded even their cesspools, no matter how 
 great the nuisance might be to their neighbours, no matter 
 how dangerous to the community at large. Indeed, the 
 Commissioners of Sewers had no power to compel landlords 
 or house-owners to make drains into the sewers, and of 
 their own motion the landlords would take no action. 
 
 In the lower part of Westminster the Commissioners of 
 Sewers had actually carried sewers along some of the streets, 
 but they found "very little desire on the part of the 
 landlords " to use them. " So long as the owners get their 
 rent they do not care about drainage. . . . The landlords 
 will not move ; their property pays them very well ; they 
 will not put themselves to any expense ; they are satisfied 
 with it as it stands." 
 
 Strange level of satisfaction ! when one reads the 
 following evidence given two years later before the 
 Metropolitan Sewers Commission : — 
 
 " There are hundreds, I may say thousands, of houses in 
 this metropolis which have no drainage whatever, and the 
 greater part of them have stinking, overflowing cesspools. 
 And there are also hundreds of streets, courts, and alleys, 
 that have no sewers ; and how the drainage and filth is 
 cleared away, and how the poor miserable inhabitants live 
 in such places it is hard to tell. 
 
OF LONDON 19 
 
 "In pursuance of my duties, from time to time, I have 
 visited very many places where filth was lying scattered 
 about the rooms, vaults, cellars, areas, and yards, so thick, 
 and so deep, that it was hardly possible to move for it. I 
 have also seen in such places human beings living and 
 sleeping in sunk rooms with filth from overflowing cesspools 
 exuding through and running down the walls and over the 
 floors. . . . The effects of the stench, effluvia, and poisonous 
 gases constantly evolving from these foul accumulations 
 were apparent in the haggard, wan, and swarthy coun- 
 tenances, and enfeebled limbs, of the poor creatures whom 
 I found residing over and amongst these dens of pollution 
 and wretchedness." * 
 
 And this witness was unable to refrain from passing a 
 verdict upon what he had seen : — 
 
 " To allow such a state of things to exist is a blot 
 upon this scientific and enlightened age, an age, too, teem- 
 ing with so much wealth, refinement, and benevolence. 
 Morality, and the whole economy of domestic existence, 
 is outraged and deranged by so much suffering and misery. 
 Let not, therefore, the morality, the health, the comfort of 
 thousands of our fellow creatures in this metropolis be in 
 the hands of those who care not about these things, but let 
 good and wholesome laws be enacted to compel houses to 
 be kept in a cleanly and healthy condition." 
 
 There were, it was said, "a formidable host of diffi- 
 culties " as regarded the execution of improved works of 
 house drainage. 
 
 There was the opposition of the proprietors on the 
 ground of expense ; there were the provisions of the Act of 
 Parliament,! which were so intricate as to be almost 
 unintelligible and unworkable ; there was the want of 
 a proper outfall for the sewage ; and the want of a supply 
 of water to wash away the filth — a possible explanation for 
 the existing state of abomination, but certainly not a 
 justification for the prolonged inaction of successive 
 Parliaments and Governments in allowing affairs to reach 
 
 * J. Phillips, p. 63 Metropolitan Sewers Commission, 1847. 
 f See P.P. 1854-5, vol. liii. p. 249, &c. 
 
20 THE SANITARY EVOLUTION 
 
 so frightful a pass, and for dooming the people to a 
 condition of things which it was entirely beyond their 
 power to remedy even as regarded the single house they 
 inhabited. 
 
 Just as everything connected with sewerage and drainage 
 was so placidly neglected, and so fearfully bad, so also was 
 it as regarded another matter of even more vital neces- 
 sity, namely, the supply of water to the inhabitants of 
 London for drinking, or for domestic, trade, or sanitary 
 purposes. 
 
 "Water is essential as an article of food. Water is 
 necessary to personal cleanliness. Water is essential to 
 external cleansing, whether of houses, streets, closets, or 
 sewers." 
 
 Manifestly, the supply of water was not a matter which 
 the individual in a large community such as London could 
 in any way make provision for by his own independent 
 effort. And yet there was no public body in London, 
 central or local, representative or otherwise, charged vdth 
 the duty of securing to the people even the minimum 
 quantity necessary for life. 
 
 Early in the seventeenth century the New Eiver Company 
 was formed for the supply of water to London. And as 
 years went on Parliament evidently considered it fulfilled 
 its obligations in this respect by making over to sundry 
 private companies the right of supplying to the citizens of 
 London this vital requirement, or, as it has been termed, 
 this "life-blood of cities"; and Parliament had done this 
 vdthout even taking any guarantee or security for a proper 
 distribution to the people, or for the purity of the water, or 
 the sufficiency of its supply. 
 
 Practically, a generous Parliament had bestowed as a 
 free gift upon these Water Companies the valuable mono- 
 poly, so far as London was concerned, of this necessity 
 of life. 
 
 Although by the middle of the nineteenth century there 
 was no portion of the metropolis into which the mains and 
 pipes of some of the companies had not been carried, yet, 
 as the companies were under no compulsion to supply it to 
 
OF LONDON 21 
 
 all houses, large numbers of houses, and particularly those 
 of the poorer classes, received no supply. Indeed, in many 
 parts of London there were whole streets in which not a 
 single house had water laid on to the premises. 
 
 In the district supplied by the New River Company, 
 containing about 900,000 persons, about one-third of the 
 population were unsupplied ; and in the very much smaller 
 area of the Southwark Company's district about 30,000 
 persons had no supply. 
 
 Even in 1850 it was computed that 80,000 houses in 
 London, inhabited by 640,000 persons, were unsupplied 
 with water. 
 
 A very large proportion of the people could only obtain 
 water from stand-pipes erected in the courts or places, and 
 that only at intermittent periods, and for a very short time 
 in the day ; sometimes, indeed, only on alternate days, and 
 not at all on Sunday. 
 
 " To these pipes," wrote a contemporary, " the inhabi- 
 tants have to run, leaving their occupation, and collecting 
 their share of this indispensable commodity in vessels of 
 whatever kind might be at hand. The water is then kept 
 in the close, ill-ventilated tenements they occupy until it is 
 required for use."* 
 
 The quality of the water which was supplied by the com- 
 panies left much to be desired. That supplied by the New 
 Eiver Company was, as a rule, fairly good in quality ; but 
 that supplied by the other companies was very much the 
 reverse. Financial profit being their first and principal 
 consideration, they got it from where it was obtainable at 
 least capital outlay or cost, regardless of purity or impurity ; 
 and almost without exception took it from the Thames — 
 ** the great sewer of London " — took it, too, from precisely 
 the places where the river was foulest and most contami- 
 nated by sewage and other filth ; and as there were no 
 filtering beds in which it could have been to some extent 
 purified before its distribution to householders, its compo- 
 sition can best be imagined. 
 
 Looking at the great river even now in its purified state, 
 * Eeport of Medical Officer of Health for ClerkenweU, 1856. 
 
22 THE SANITARY EVOLUTION 
 
 as it sweeps under "Westminster Bridge, any one would 
 shudder at the idea of being compelled to drink its water 
 in its muddy and unfiltered state, and of one's health and 
 life being dependent on the supply from such a source. 
 How infinitely more repugnant it must have been when 
 the river was "the great sewer" of the metropolis. 
 
 The great shortage of company-supplied water compelled 
 large numbers of people to have recourse to the pumps 
 which still existed in considerable numbers in many parts 
 of London, the water from which was drawn from shallow 
 wells. 
 
 The water of these "slaughter wells," as they have 
 been termed, appears to have combined all the worst 
 features of water, and to have contained all the ingredients 
 most dangerous to health. 
 
 "If," wrote a Medical Officer of Health some years later, 
 " the soil through which the rain passes be composed of the 
 refuse of centuries, if it be riddled with cesspools and the 
 remains of cesspools, with leaky gas-pipes and porous 
 sewers, if it has been the depository of the dead for genera- 
 tion after generation, the soil so polluted cannot yield water 
 of any degree of purity." * 
 
 As all these "ifs" were grim actualities, the water of such 
 wells was revolting in its impurity and deadly in its compo- 
 sition. 
 
 Of Clerkenwell it was indeed stated positively that " the 
 shallow-well water of the parish received the drainage 
 water of Highgate cemetery, of numerous burial grounds, 
 and of the innumerable cesspools in the district." 
 
 On the south side of the river the water in most of the 
 shallow wells was tidal — from the Thames, which is a 
 sufficient description of the quality thereof — and where 
 people did not live close enough to the river to draw water 
 from it for their daily wants, they took it from these tidal 
 wells. Vile as it was, it had to be used in default of any 
 better. 
 
 Where such wells were not available, the water for all 
 
 * See Report of Medical Officer of Health for St. Giles', 
 
OF LONDON 23 
 
 household consumption was taken from tidal ditches which 
 were to all intents and purposes only open sewers. A con- 
 temporary report gives a graphic picture of this form of 
 supply * : — 
 
 ** In Jacob's Island (in Bermondsey) may be seen at any 
 time of the day women dipping water, with pails attached 
 by ropes to the backs of the houses, from a foul, foetid ditch, 
 its banks coated with a compound of mud and filth, and 
 with offal and carrion — the water to be used for every pur- 
 pose, culinary ones not excepted." 
 
 An adequate supply of wholesome water has for very long 
 been recognised as of primary sanitary importance to all 
 populations, but with a densely crowded town population 
 the need of care as to the quality of the supplies is peculiarly 
 urgent. And yet, through the indifference of successive 
 Governments, the people of the great metropolis of London 
 were most inadequately supplied with water, and what water 
 was supplied to the great mass of them, or was available for 
 them, was of the foulest and most dangerous description. 
 The inadequacy of supply not alone put a constant premium 
 upon dirt and uncleanliness, both in house and person, but 
 it intensified the evils of the existing sewers and drains, as 
 without water efficient drainage was impossible. And 
 the horrible impurity of the water affected disastrously 
 and continuously the health of the great mass of the 
 people. 
 
 Many dire lessons, costing thousands upon thousands of 
 lives, were needed before it was borne in on the Government 
 of the country that the arrangements regarding the supply 
 of water for the people of London required radical amend- 
 ment. 
 
 Much of the health of a city depends upon the width of 
 its thoroughfares, the free circulation of air in its streets 
 and around its buildings, and the sound and sanitary con- 
 struction of its houses. 
 
 In every one of these respects all the central parts of 
 London were remarkably defective. The great metropolis 
 had grown, and had been permitted to grow, mostly at 
 * Report of General Board of Health, 1850. 
 
24 THE SANITARY EVOLUTION 
 
 haphazard. Large parks and open spaces there were in the 
 richer and more well-to-do parts, and some handsome 
 thoroughfares ; but " there were districts in London 
 through which no great thoroughfares passed, and which 
 were wholly occupied by a dense population composed of 
 the lowest class of persons, who, being entirely secluded 
 from the observation and influence lof better educated 
 neighbours, exhibited a state of moral degradation deeply 
 to be deplored."* 
 
 Parliament had taken some interest as to the width of 
 the streets, and had shown some anxiety for improvements 
 in them. Hence, much local and general legislation was 
 from time to time directed to control the erection of build- 
 ings beyond the regular lines of buildings. Thus the Metro- 
 politan Paving Act, 1817, contained stringent provisions 
 as to projections which might obstruct the circulation 
 of air and light, or be inconvenient or incommodious to 
 passengers along carriage or foot ways in certain parts of 
 the metropolis. 
 
 In 1828 the Act for Consolidating the Metropolis Turnpike 
 Trusts, also, contained certain restrictive provisions, but 
 these were rendered futile by the construction put upon its 
 terms by the magistrates. 
 
 Again, in 1844, further enactments were made by the 
 Metropolitan Building Act to restrain projections from 
 buildings ; but after a short administration of its provisions 
 it was found that shops built on the gardens in front of the 
 houses, or on the forecourts of areas, did not come within 
 the terms of the Act. And so the Act, in that very impor- 
 tant respect, was useless. 
 
 The action of Parliament had been mainly prompted by 
 the necessity for increased facilities of communication, and 
 by the desire to safeguard house property from destruction 
 by fire ; whilst the most important of all aspects of the 
 housing of the people — namely, the sanitary aspect — 
 received no consideration, and was completely ignored as 
 a thing of no consequence. 
 
 * Eeport of Select Committee of the House of Commons, P.P. 1838, 
 vol. xxviii. 
 
OF LONDON 26 
 
 But whatever the motive of action by Parliament, the 
 ensuing legislation was in the main inoperative or ineffec- 
 tive. The resolution of landowners to secure the highest 
 prices for their property, and the determination of builders, 
 once they got possession of any land, to utilise every inch of 
 it for building, and so to make the utmost money they could 
 out of it, defeated the somewhat loosely drawn enactments. 
 Means of evading the legislative provisions were promptly 
 discovered, and, in despite of legislation, builders, architects, 
 and surveyors of the metropolis were unrestrained in their 
 encroachments upon areas and forecourts — at times even 
 were successful in breaking the existing lines of buildings in 
 metropolitan streets or roads by encroachments which were 
 only discovered too late to be prevented. 
 
 Nor was there anything to prevent houses being built on 
 uncovered spaces at the backs of existing buildings, thus 
 taking 'up whatever air-space had been left between the 
 previous buildings. Hence, great blocks of ground abso- 
 lutely covered with buildings, back to back, side to side, 
 any way so long as a building could by any ingenuity be 
 fitted in. Hence the culs-de-sac, the small and stifling 
 courts and alleys. Nor were there any regulations for- 
 bidding certain kinds of buildings which would be injurious 
 to the health of their inhabitants. Hence the mean and 
 flimsy and insanitary houses which were being erected in 
 the outer circle of the metropolis, and which wrought havoc 
 with the health and lives of the people. Hence, too, the 
 erection, on areas and forecourts, of buildings which 
 narrowed the streets, diminished the air-spaces and means 
 of ventilation, and destroyed the appearance of the localities. 
 
 And once up they had come to stay ; for years were to 
 pass before the Legislature created any effective means for 
 securing their amelioration, and for generations they were 
 permitted to exercise their evil and deadly sway over the 
 people, and to scatter broadcast throughout the community 
 the seeds of disease and death. 
 
 The then existing actual state of the case was summed 
 up by Dr. Southwood Smith in his evidence before the 
 Select Committee of the House of Commons in 1840: — 
 
26 THE SANITARY EVOLUTION 
 
 " At present no more regard is paid in the construction 
 of houses to the health of the inhabitants than is paid to 
 the health of pigs in making sties for them. In point of 
 fact there is not so much attention paid to it." 
 
 Legislation against some of the evils which had already 
 reached huge proportions, and which, as London grew, 
 were spreading and developing, was not alone ineffective, 
 but earlier legislation, in one notorious Act, had been the 
 direct incentive to, and cause of evils. This was the Act 
 which imposed a tax upon windows. * In effect this Act 
 said to the builder, " Plan your houses with as few openings 
 as possible. Let every house be ill -ventilated by shutting 
 out the light and air, and as a reward for your ingenuity 
 you shall be subject to a less amount of taxation," f 
 
 The builder acted upon this counsel, and the tax operated 
 as a premium upon the omission from a building of every 
 window which could by any device be spared ; with the 
 result that passages, closets, cellars, and roofs — the very 
 places where mephitic vapours were most apt to lodge — 
 were left almost entirely without ventilation, | 
 
 In effect, the window duties compelled multitudes to live 
 and breathe in darkened rooms and poisoned air, and with 
 a rapidly increasing population the evils resulting therefrom 
 were being steadily intensified. 
 
 Admirable was the comment passed upon the tax in 
 1843 :— 
 
 " Health is the capital of the working man, and nothing 
 can justify a tax affecting the health of the people, and 
 especially of the labouring community, whose bodily health 
 and; strength constitute their wealth, and, oftentimes, their 
 only possession. It is a tax upon light and air, a tax more 
 vicious in principle and more injurious in its practical con- 
 sequences than a tax upon food." 
 
 Not until 1851 was the tax abandoned, but its evil con- 
 
 * 38 George III, cap. 40, 
 
 f An opening only a foot square cost an additional 8s. 3d. tax per 
 annum. 
 
 I 1843, Commissioners on State of Towns. Evidence of W. E. 
 Hickson, p. 436. 
 
OF LONDON 27 
 
 sequences, wrought in stone and embodied in bricks and 
 mortar, endured many a long year after. 
 
 The existing laws or regulations as to building were 
 wholly inadequate to secure healthy houses. And there 
 was no public authority with power to compel attention to 
 the internal condition of houses so as to prevent their con- 
 tinuance in such a filthy and unwholesome state as to en- 
 danger the health of the public. There was no power to 
 compel house owners to make drains and carry them to the 
 common sewer where it existed. No persons were appointed 
 to carry into effect such communication. No persons were 
 authorised to make inspection and to report upon these 
 matters. 
 
 The poor, or, indeed, the working classes generally, were 
 powerless to alter or amend the construction of the dwellings 
 in which they were compelled to reside, still less to alter 
 their surroundings. Any improvement in the condition of 
 their dwellings could only be by voluntary action on the 
 part of the landlords, or of interference by Government to 
 compel that measure of justice to the poor, and of economy 
 to the ratepayers. 
 
 Parliament failed to interfere with any effect ; and as to 
 the landlords or house-owners, their interest ran all the 
 other way. 
 
 Few persons of large capital built houses as a speculation, 
 or had anything to do with them. Many, however, who 
 were desirous of making the highest possible interest on 
 their money acquired either freehold or leasehold land, and 
 built cheap and ill-constructed houses upon it without the 
 least regard to the health of the future inmates. 
 
 And the small landlords were often the most unscrupulous 
 with regard to the condition of the houses they let, and 
 exacted the highest rents. 
 
 Inasmuch as this freedom as regarded house construction 
 had been going on almost from time immemorial, it was not 
 only the newly-built houses which were bad. Earlier built 
 houses had rapidly fallen into disrepair and semi-ruin, and 
 were steadily going from bad to worse, and becoming ever 
 less and less suitable for human dweUings. 
 
28 THE SANITARY EVOLUTION 
 
 The following description* of parts of St. Giles and 
 Spitalfields shows what, under a state of freedom as to 
 building, had been attained to in 1840, and is typical of 
 what so extensively prevailed in the central parts of 
 London : — 
 
 " Those districts are composed almost entirely of small 
 courts, very small and very narrow, the access to them 
 being only under gateways ; in many cases they have been 
 larger courts originally, and afterwards built in again with 
 houses back to back, without any outlet behind, and only 
 consisting of two rooms, and almost a ladder for a staircase; 
 and those houses are occupied by an immense number of 
 inhabitants ; they are all as dark as possible, and as filthy 
 as it is possible for any place to be, arising from want of 
 air and light." 
 
 Here is another description — that of '* Christopher 
 Court," a cul-de-sac in Whitechapel — given, in 1848, by 
 Dr. Allison, one of the surgeons of the Union : — 
 
 "This was one of the dirtiest places which human 
 beings ever visited — the horrible stench which polluted 
 the place seemed to be closed in hermetically among the 
 people ; not a breath of fresh air reached them — all was 
 abominable." 
 
 It is needless to multiply instances. There is a dreadful 
 unanimity of testimony from all parts of London as to the 
 miserable character and condition of the houses in which in 
 the middle of the nineteenth century the industrial and the 
 lower classes were forced to live ; the deficiency or total 
 absence of drainage, the universal filth and abomination of 
 every kind, the fearful overcrowding, the ravages of every 
 type of disease, and the absolute misery in which masses 
 struggled for existence. 
 
 The density of houses upon an area has long been recog- 
 nised as one of the great contributing causes to the ill- 
 health of a community, but when coupled with the 
 overcrowding of human beings in those houses, the com- 
 bined results are always disastrous in the extreme. 
 
 * Select Committee, 1840. Evidence of J. Pennethorne, p. 166. 
 
OF LONDON 29 
 
 Overcrowding had been a long-standing evil in London ; 
 had existed far back in history. 
 
 As London had grown, the evil had grown ; and about 
 the middle of the last century it was immeasurably greater 
 than ever before, and its disastrous consequences were on 
 a vastly larger scale. 
 
 The great economic forces which resulted, in certain 
 districts of London, in the destruction of houses and great 
 clearances of ground, had largely reduced the available 
 accommodation for dwellings, and the expelled inhabitants, 
 chained to the locality by the fact of their livelihood being 
 dependent upon their residence being close by, were forced 
 to invade the yet remaining places in the neighbourhood 
 suited to their means. As the circle of possible habitations 
 contracted, while the numbers seeking accommodation 
 therein increased, a larger population was crowded into an 
 ever-diminishing number of houses. 
 
 It was also a most unfortunate but apparently inevitable 
 consequence that once a beginning was made to improve 
 some of the streets and thoroughfares of London, and to 
 substitute in any district a better class of houses and shops 
 for those actually existing, the improvements necessarily 
 involved increased overcrowding in that particular locality 
 and in those adjoining it. But so it was. 
 
 Thus, in the eighteen hundred and forties a new street — 
 New Oxford Street — was formed. It was driven through 
 "a hive of human beings, a locality overflowing with human 
 life." Evidence given before the Commission in 1847 
 described the results : — 
 
 " The effect has been to lessen the population of my 
 neighbourhood by about 5,000 people, and therefore to 
 improve it at the expense of other parts of London. Some 
 have gone to the streets leading to Drury Lane, some to 
 St. Luke's, Whitechapel, but more to St. Marylebone and 
 St. Pancras. The vestries of St. Marylebone and St. Pan- 
 eras disliked this very much. Places in the two latter 
 parishes which were before bad enough are now intoler- 
 able, owing to the number of poor who formerly lived in 
 St. Giles'." 
 
30 THE SANITARY EVOLUTION 
 
 And a year or so later, from across the river, came the 
 complaint from Lambeth that " owing to the number of 
 houses pulled down in Westminster and other places, there 
 had been a great influx of Irish and other labourers which 
 necessarily caused a great overcrowding of the miserable 
 domiciles already overfull." 
 
 This Lambeth complaint is specially interesting, as it 
 refers to another great cause of overcrowding — the con- 
 stant immigration into London of labourers and poor people 
 in search of work or food. 
 
 Owing to the ever increasing and urgent demand for 
 house accommodation for the working and poorer classes, 
 it became a very remunerative proceeding for the occupier 
 of a house to sub-let it in portions to separate families or 
 individuals, and the practice gradually extended to and 
 absorbed streets hitherto belonging to the better class. 
 The owner of a property let his whole house to a tenant ; 
 this tenant, seeing an easy way of making money, sub-let 
 the rooms in it in twos or threes, or even separately, at a 
 very profitable rate to individual tenants. Nor did the 
 sub-letting end here, for these tenants let off even the sides 
 or corners of their room or rooms to individuals or families 
 who were unable to bear the expense of a whole room. 
 And so the house sank at once into being a "tenement 
 house " — that prolific source of the very worst evils, 
 sanitary, physical, and moral, to those who inhabited 
 them. 
 
 Even the underground kitchens and cellars, which were 
 never intended for human habitation, were let to tenants, 
 and thus turned to financial profit.* It mattered not that 
 they were without air or ventilation, or even light ; it 
 mattered not that they were damp, or sometimes even 
 inundated with the overflow of cesspools ; it mattered 
 not that they were inhabited contrary to the provisions 
 of Section 53 of the Building Act of 1844, for that section 
 was of no operative effect whatever. It is true that " Over- 
 seers " were to report to the " Official Eeferees," who were 
 
 * P.P. 1854, vol. xlv. p. 2. In part of the parish of St. Marylebone 
 only there were 1,132 underground or cellar dwellings. 
 
OF LONDON 31 
 
 to give notice to and inform the owners and occupiers of 
 such dwellings as to the consequences of disobeying the 
 Statute, and the " District Surveyor" was to carry out the 
 directions of the Eeferees. But nothing was ever done — 
 Overseers, District Surveyors, and Eeferees, all neglected 
 their duties. 
 
 Overcrowding was usually at its worst in one-room 
 tenements, and in an immense number of cases in the 
 metropolis one room served for a family of the working 
 or of the labouring classes. It was their bedroom, their 
 kitchen, their wash-house, their sitting-room, their eating- 
 room, and, when they did not follow any occupation else- 
 where, it was their workroom and their shop. In this one 
 room they were born, and lived, and slept, and died amidst 
 the other inmates. 
 
 And still worse, in innumerable cases, more than one 
 family lived in one room. 
 
 When this one room was in a badly drained, damp, ill- 
 constructed, and unventilated house, reeking with a polluted 
 atmosphere, and that house was in a narrow and hemmed- 
 in, unventilated "court" or "place" or "alley" — as an 
 immense number of them were — the maximum of evil 
 consequences was attained. 
 
 The evils of overcrowding cannot be summed up in a 
 phrase, nor be realised by the description, however graphic, 
 of instance upon instance. The consequences to the in- 
 dividual living in an overcrowded room or dwelling were 
 always disastrous, and, through the disastrous consequences 
 to great masses of individuals, the whole community was 
 affected in varying degree. 
 
 Physically, mentally, and morally, the overcrowded people 
 suffered. Not a disease, not a human ill which flesh is heir 
 to, but was nurtured and rendered more potent in the human 
 hothouse of the overcrowded room ; and the ensuing ill- 
 health and diseases not alone doubled the death rate, but 
 increased from ten to twenty-fold, at least, the number of 
 victims of disease of one sort or another — diseases dealing 
 rapid death, or slowly but surely sapping human strength 
 and vitality. 
 
32 THE SANITARY EVOLUTION 
 
 In the report of the London Fever Hospital for 1845 
 a certain overcrowded room in the neighbourhood was 
 described — a room which was filled to excess every night, 
 sometimes from 90 to 100 men being in it ; a room 33 feet 
 long, 20 feet wide, and 7 feet high. From that one room 
 alone no fewer than 130 persons affected with fever were 
 received into the hospital in the course of the year,* 
 
 One, whose very close experience of the conditions of life 
 and circumstances of the poorer classes of London at the 
 time of the cholera epidemic of 1848-9 entitled him to speak 
 with special authority on the subject, thus summed up his 
 views and conclusions : — 
 
 *' The members of the medical profession, in the presence 
 of these physical evils, when they are, as so often happens, 
 concentrated, find their science all but powerless ; the 
 minister of religion turns from these densely crowded and 
 foul localities almost without hope ; whilst the adminis- 
 trators of the law, especially the chaplains and governors 
 of prisons, see that crime of every complexion is most rife 
 where material degradation is most profound."! 
 
 And he quoted from the report of the Governors of the 
 Houses of Correction at Coldbath Fields and Westminster 
 the following passage : — 
 
 " The crowning cause of crime in the metropolis is, in my 
 opinion, to be found in the shocking state of the habitations 
 of the poor, their confined and foetid localities, and the con- 
 sequent necessity for consigning children to the streets for 
 requisite air and exercise. These causes combine to produce 
 a state of frightful demoralisation. The absence of cleanli- 
 ness, of decency, of all decorum — the disregard of any 
 needful separation of the sexes — the polluting language and 
 the scenes of profligacy hourly occurring, all tend to foster 
 idleness and vicious abandonment. Here I beg emphati- 
 cally to record my conviction that this constitutes the 
 monster mischief." 
 
 And then he himself adds : — 
 
 "If to considerations like these regarding the moral and 
 
 * See Hansard, vol, cxv. 1851 (Lord Ashley's speech). 
 I P.P. 1850, vol. xxi. p. 179 (Dr. Grainger). 
 
OF LONDON 33 
 
 religious aspect of this great question, be added those sug- 
 gested by the indescribable physical sufferings inflicted on 
 the labouring classes by the existing state of the public 
 health in the metropolis, the conviction must of necessity 
 follow, that the time is come when efforts in some degree 
 commensurate with these great and pervading evils can no 
 longer with safety be deferred."* 
 
 This opinion was expressed three years after the Royal 
 Commissioners of 1847 had said in their report : — 
 
 "There appears to be no available (legal) means for the 
 immediate prevention of overcrowding ; all we can do is 
 to point it out as a source of evil to be dealt with here- 
 after." 
 
 One gets a clue to the unceasing insanitary condition of 
 the greater part of London and to the inhuman conduct of 
 so many tenement house-owners when one realises that 
 there was no legal punishment whatever for the perpetra- 
 tion and perpetuation of the insanitary abominations, no 
 matter how noxious or dangerous they were, nor how 
 rapidly or directly they led to disease or death. An order 
 to abate a nuisance (which usually was not obeyed) appears 
 to have been the only penalty, and it was only obtainable at 
 great trouble and after great delays ; and, even if obtained 
 and the nuisance abated, there was nothing to prevent the 
 offender at once starting the nuisance again. Offences of 
 the most heinous description — amounting morally to de- 
 liberate murder — were perpetrated with absolute impunity. 
 Houses which were scarcely ever free from fever cases were 
 allowed to continue year after year levying their heavy death 
 tax from the unfortunate inhabitants. 
 
 In Whitechapel one house, inhabited by twelve or fourteen 
 families, was mentioned as scarcely free from fever cases for 
 as many years. 
 
 "It is also a fearful fact that in almost every instance 
 where patients die from fever, or are removed to the hospital 
 or workhouse, their rooms are let as soon as possible to new 
 tenants, and no precautions used, or warning given ; and in 
 some houses, perfect hotbeds of fever probably, where a 
 - P.P. 1850, vol. xxi. 
 4 
 
34 THE SANITARY EVOLUTION 
 
 patient dies or is removed, the first new-comer is put into 
 the sick man's bed." 
 
 Sanitary improvement was almost a hopeless task. 
 There was a dead weight of opposition to it in the ignor- 
 ance and recklessness and indifference of the poorer 
 classes, the very hopelessness of being able to improve 
 their condition. And there was an active and bitter 
 opposition from those house-owners or lessees who for 
 their own financial profit exploited the poorer classes. 
 
 " There is one house in Spitalfields," said Dr. Lynch, 
 " which has been the constant habitation of fever for fifteen 
 years. I have enforced upon the landlord the necessity of 
 cleansing and lime-washing it, but it has never been done ! ! 
 . . . There are many landlords with whom nothing but 
 immediate interest has any effect." *" 
 
 The favourite principle that an Englishman's house was 
 his castle was used as a defence against any suggestion 
 that the malpractices committed therein should be curbed. 
 
 Others argued, " I am entitled to do what I like with 
 my own." 
 
 ** We everywhere find people ready to declare in respect 
 to every evil : There is not any law that could compel 
 its removal, the place complained of being private pro- 
 perty." 
 
 All sorts of far-fetched and strained arguments were 
 devised by them in the efforts to evade responsibility for 
 the infamous condition of their property, and to defend 
 and justify inaction. 
 
 Fortunately some voices began to be raised as to the 
 persons upon whom both equitably and morally the 
 responsibility lay of improving the condition of things. 
 
 " I would suggest," said a voice in 1837, " the idea of the 
 landlords of many of the wretched filthy tenements being 
 held responsible for their being tenantable, healthy, and 
 cleanly." 
 
 And the Commissioners in 1844 reported : — 
 
 " There are some points on which the public safety 
 demands the exercise of a power on the part of a pubUc 
 
 ''■'■ Dr. T. Lynch, Medical Officer of West London Union (Holborn). 
 
OF LONDON 35 
 
 authority to compel attention to the internal condition of 
 houses so as to prevent their continuance in such a filthy 
 and unwholesome state as to endanger the health of the 
 public." 
 
 And they recommended that : — 
 
 " On complaint of the parish, medical, or other authorised 
 officer, that any house or premises are in such a filthy and 
 unwholesome state as to endanger the health of the public, 
 the local authority have power to require the landlord to 
 cleanse it properly without delay." 
 
 But ideas or recommendations were alike ignored by the 
 Government and Parliament, and several years were to pass 
 before any legislation was attempted which would make 
 owners responsible for their misdeeds in matters affecting 
 the public health, and would subject them to penalties 
 for their misconduct. 
 
 There were many other causes contributing largely to the 
 insanitary condition of the people of the metropolis, pro- 
 minent, if not most deleterious, amongst them being the 
 widely-prevalent practice of interring the dead in the 
 already overcrowded churchyards or burial grounds in the 
 midst of the most densely populated districts of London — 
 a practice resulting in " the slaughter of the living by the 
 dead." 
 
 Burial grounds long since utilised to their utmost for the 
 disposal of the dead were utilised over and over again for 
 graves which could only be dug in the debris of human 
 remains, until the soil reeked with human decomposition ; 
 the surrounding atmosphere was polluted by the horrible 
 process, and they became monstrous foci of infection. 
 
 How extensive this evil was may be realised from 
 figures given by Mr. Chadwick in a report to the 
 Government : — 
 
 "In the metropolis, on spaces of ground which do not 
 exceed 203 acres, closely surrounded by the abodes of the 
 living, layer upon layer, each consisting of a population 
 numerically equivalent to a large army of 20,000 adults, 
 and nearly 30,000 youths and children, is every year im- 
 perfectly interred. Within the period of the existence of 
 
36 THE SANITARY EVOLUTION 
 
 the present generation upwards of a million of dead must 
 have been interred in those same spaces." 
 
 And he asserted that : — 
 
 " The emanations from human remains are of a nature 
 to produce fatal disease, and to depress the general health 
 of whoever is exposed to them ; and interments in the 
 vaults of churches, or in graveyards surrounded by inhabited 
 houses, contribute to the mass of atmospheric and other 
 impurities by which the general health and average duration 
 of life of the inhabitants is diminished." 
 
 Too horribly gruesome and revolting are the descriptions of 
 these graveyards — places where the dead were, so to speak, 
 shovelled in as the filth of the streets is into scavengers' 
 carts, and which "gave forth the mephitical effluvia of 
 death " ; such a one as that in Eussell Court, off Drury 
 Lane, where the whole ground, which by constant burials 
 had been raised several feet, was " a mass of corruption " 
 which polluted the air the living had to breathe, and 
 poisoned the well water which in default of other they 
 often had to drink. Or those in Eotherhithe, where " the 
 interments were so numerous that the half-decomposed 
 organic matter was often thrown up to make way for 
 fresh graves, exposing sights disgusting, and emitting foul 
 effluvia." 
 
 The master hand of Dickens has given a more vivid 
 picture of one of these places than any to be found in 
 Parliamentary Blue Books : — 
 
 ''A hemmed-in churchyard, pestiferous and obscene, 
 whence malignant diseases are communicated to the bodies 
 of our dear brothers and sisters who have not departed. . . . 
 Into a beastly scrap of ground, which a Turk would reject 
 as a savage abomination, and a Caffre would shudder at, 
 they bring our dear brother here departed to receive 
 Christian burial. With houses looking on on every side, 
 save where a reeking little tunnel of a court gives access to 
 the iron gate — with every villainy of life in action close on 
 death, and every poisonous element of death in action close 
 on life — here they lower our dear brother down a foot or 
 two ; here sow him in corruption, to be raised in corrup- 
 
OF LONDON 37 
 
 tion ; an avenging ghost at many a sick bedside ; a shame- 
 ful testimony to future ages, how civilisation and barbarism 
 walked this boastful island together." 
 
 Interments in the vaults of the churches — then a common 
 practice — were also a fruitful source of sickness and death. 
 It mattered not whether or not the bodies were hermetically 
 closed in leaden coffins, for " sooner or later every corpse 
 buried in the vault of a church spreads the products of 
 decomposition through the air which is breathed, as readily 
 as if it had never been enclosed " ; thus adding to the 
 contamination of the atmosphere. 
 
 The death roll from this horrible condition of things 
 cannot be gauged, but those most conversant with the 
 matter were firmly convinced that it was the direct cause of 
 fevers, and of all kinds of sickness among the people. 
 
 Pollution of the atmosphere which people had to breathe, 
 and upon the purity of which the public health in varying 
 degree depended, was caused also by various businesses and 
 processes of manufacture grouped together under the 
 name of "noxious trades," such as bone-boilers, india- 
 rubber manufacturers, gut-scrapers, manure manufacturers, 
 slaughterers of cattle, and many others. 
 
 In 1849* a description had been given of a street in 
 Shoreditch which shows to what extent this evil had 
 attained : — 
 
 "It is impossible to believe, passing through this main 
 street, that so great a number of pigsties, bone-boileries, 
 dog-and-cat's meat manufactories, and tallow-melting estab- 
 lishments, on a large scale . . . should exist in a densely- 
 crowded and closely-built locality. The noxious trades and 
 occupations which so greatly abound here exerted a most 
 deleterious influence upon the health of the inhabitants." 
 
 Parliament, in 1844, had enacted with regard to several 
 of these that it should not be lawful for any person to 
 establish any such business at a less distance than 40 feet 
 from the public way, or than 50 feet from any dwelling- 
 house ; and that it should not be lawful to erect a dwelling- 
 house within 50 feet of such businesses. 
 * P.P. 1849-50, vol. xxi. 
 
38 THE SANITARY EVOLUTION 
 
 But these legislative restraints were utterly inadequate as 
 any sort of check upon the evil ; for, even if a nuisance 
 v^ere abated, there was no law to prevent its repetition, and 
 so the evil promptly re-appeared. The stenches did not 
 limit their sphere of action by feet, but distributed their 
 abominations over large areas ; and the manufacturers cared 
 not what nuisances they subjected people to, nor how far 
 the horrid smells were wafted by the winds, so long as they 
 themselves could carry on a profitable business. And the 
 intentions of Parliament were wholly frustrated by the 
 District Surveyors, who were charged with the enforcement 
 of the Act, and who wholly failed in their duty. 
 
 As for slaughter houses, until 1851 any person could 
 start one who pleased, and practically where he pleased, 
 subject only to the shadowy restriction of the common law 
 as to doing anything which might be considered a nuisance. 
 
 And so these numerous and various abominations, mixed 
 with the impurity of the atmosphere caused by the masses 
 of smoke emitted from the chimneys of factories and 
 private houses, and with the sickening smell from the 
 Thames, spread sickness and death throughout great 
 portions of the metropolis, and were one of the great 
 causes of its insanitary condition. 
 
 II 
 
 Previous to the fifth decade of the last century it was 
 only very rarely that the prevalence of disease, or any 
 subject connected with the health of the community, 
 received recognition by Parliament. 
 
 In 1840 the Medical Society of London, in a petition to 
 Parliament, called attention to the increase of smallpox, 
 and to its preventability by vaccination, and to the im- 
 perfect means of vaccination throughout the country. 
 
 The mortality from this — " one of the greatest pests that 
 ever afflicted humanity "* — was very great. In one city in 
 the south of England no less than 500 persons bad died of 
 
 - Hansard, 1840, vol. liii. p. 1110. 
 
OF LONDON 39 
 
 it in one year. In London in 1839 upwards of 1,000 had 
 died of it. 
 
 And Parliament, after an unusual amount of discussion, 
 passed an Act * for extending the practice of vaccination, 
 and enacted that Boards of Guardians might contract with 
 their Medical Officers or other medical practitioners "for 
 the vaccination of all persons resident in their Union 
 or Parish." 
 
 And at the same time "inoculation " or "otherwise pro- 
 ducing smallpox" was made penal — to the extent of one 
 month's imprisonment. 
 
 In 1846 there was a sudden display of Parliamentary- 
 energy in health matters. 
 
 The total want of baths and wash-houses for the poorer 
 classes of the people in the towns was brought under the 
 notice of the Legislature, and, as it was deemed " desirable 
 for the healthj comfort, and welfare of the inhabitants of 
 towns, &c., to encourage the establishment therein of 
 baths, wash-houses, and open bathing places," an Act 
 was passed giving power to the Parochial Authorities to 
 establish such institutions and to borrow money for the 
 purpose, f 
 
 Their provision would have tended to an increased degree 
 of cleanliness among the people, and consequently an 
 improved sanitary condition, but it was long before many 
 of these institutions were established, the local authorities 
 being slow in availing themselves of the facilities thus 
 offered, and this piece of legislation — like every other of 
 the sort — being purely permissive or facilitatory. 
 
 And in the same year Parliament so far awakened to the 
 fact that certain causes of disease were removable, that in a 
 preamble to an Act| it acknowledged that it was "highly 
 expedient for the purposes of preserving the health of Her 
 Majesty's subjects that better provision should be made 
 for the removal of certain nuisances likely to promote or 
 increase disease." 
 
 * 3 and 4 Vic. cap. 29. 
 
 t Expenses to be charged upon Borough Fund, and receipts to be 
 paid into same. | 9 and 10 Vic. cap. 96. 
 
40 THE SANITARY EVOLUTION 
 
 The better provision made by the Act did not amount to 
 much. There were two forms of insanitary evil to be com- 
 bated : one the chronic insanitary condition of the masses of 
 the people, the other the invasion of the country by some 
 exceptional or unusual epidemic disease. 
 
 As to the former, authority was given to certain public 
 officers, on receipt of a certificate of two medical men, to 
 complain of the existence of certain nuisances. The Justices 
 before whom the case was heard might order the abatement 
 of the nuisance ; and if the order were not obeyed, the 
 parties complaining might enter upon the necessary cleans- 
 ing of such dwelling, and the cost of the same might be 
 imposed on the owner or occupier. 
 
 In London, the power of complaint was vested in the 
 officers of those petty local bodies which have already been 
 described, and, in their default, in the Boards of Guardians. 
 
 Ludicrous, truly, was the idea that the countless thousands 
 of nuisances existing in London could be remedied, or even 
 temporarily abated, by so cumbrous, dilatory, and com- 
 plicated a procedure as the complaint of an individual 
 backed by the certificate (which would have to be paid for) 
 of two doctors to the officer of a more or less hostile and 
 self-interested local body, who might or might not bring the 
 complaint before the Justices, whose decision, even if it 
 were in favour of the complainant, could only effect a 
 reform so far as the precise nuisance complained of was 
 concerned, and that only temporarily, for were the nuisance 
 renewed the whole procedure would have to be gone through 
 again. 
 
 Yet this was the "better provision" propounded and 
 enacted by Parliament in 1846 for the regeneration of the 
 sanitary condition of the great masses of the people of 
 London. Nor was it even intended to be permanently 
 available, for the Act was only to be in force for two 
 years. 
 
 The dreadful nemesis for such dense inappreciation by 
 Parliament of its obligations to the community was, un- 
 fortunately, soon to fall heavily upon the unhappy people of 
 the metropolis. Thousands of miles away in Hindoostan, 
 
OF LONDON 41 
 
 Asiatic cholera of a deadly type had been playing havoc 
 with the people of the country. Thence it was slowly but 
 steadily moving westward ; so much so that the desirability 
 of making some preparations for defence against its invasion 
 of England became apparent ; and in 1847 a Eoyal Com- 
 mission was appointed to " inquire whether any, and what, 
 special means might be requisite for the improvement of the 
 health of the metropolis, with regard more especially to the 
 better house, street, and land drainage, . . . the better 
 supply of water for domestic use, &c., &c., &c." 
 
 One important conclusion was at once forced upon the 
 Commissioners, namely, that the great and vital task of 
 making adequate provision for the sewerage of London could 
 not be accomplished so long as it was entrusted to several 
 bodies, each with a district of its own. 
 
 " Everything," they said, " pointed to the necessity of 
 operations being superintended by one competent body ' ' ; 
 and they declared that it was expedient that a Commission 
 for the entire drainage of the whole of the metropolis should 
 be appointed with a special view to such measures, and 
 with aid to carry them out. 
 
 This report was followed in the ensuing year (1848) by an 
 Act of Parliament* abolishing the various Commissions of 
 Sewers (except those of the City), and creating in their 
 stead one executive body whose members were to be ap- 
 pointed by the Crown. 
 
 Wide powers were given to this central body: among 
 them that no house was to be built or re-built without 
 proper drains, and without proper sanitary conveniences, 
 and that if houses built before the passing of the Act were 
 not properly drained, the Commissioners might order the 
 work to be done. 
 
 The Metropolitan Commissioners of Sewers were duly 
 appointed, and they divided the area over which they had 
 jurisdiction into seven separate sub-districts, with a Com- 
 mission for each. 
 
 The creation of this body constitutes a great landmark in 
 the sanitary evolution of London, for it was the first recog- 
 * 11 and 12 Vic. cap. 112. 
 
42 THE SANITARY EVOLUTION 
 
 nition by Parliament of the great principle of the unity 
 of London ; of the necessity — at least so far as regarded 
 one matter — for one central governing authority for the 
 numerous populations, and bodies, and districts which were 
 becoming welded together into one mighty town and one 
 vast community. 
 
 It is true, the recognition extended only to this one 
 matter, and that the Central Board was to be a Board 
 nominated by the Crown, and without any vestige of repre- 
 sentation upon it, but none the less was it a forward step 
 towards a sounder and wiser system of government than 
 that which had hitherto prevailed. 
 
 That the new body failed to prove equal to the task 
 imposed upon it was due as well to the constituent members 
 thereof as to the imperfections of the machinery devised by 
 the Act. Its failure, however, in no way controverted the 
 soundness of the great principle thus, for the first time, 
 recognised by Parliament. 
 
 The evidence given before the Koyal Commissioners 
 brought into view the enormous area of filth and limitless 
 insanitation in London : it displayed some of the principal 
 sources of the excessive amount of disease and premature 
 mortality ; and to some extent it elucidated the principles 
 and demonstrated the practicability of large measures of 
 prevention. And it also disclosed the regrettable fact that 
 since the epidemic of cholera in 1832 there had been little 
 or no improvement in the sanitary condition of many parts 
 of the metropolis — indeed, in most parts of it the evils were 
 wider spread and acuter in form, whilst, owing to the in- 
 crease of population, the numbers affected were vastly larger. 
 
 All the while the Commissioners were sitting, the evil 
 seeds of insanitation were producing a tremendous crop, 
 and events actually occurring at the moment emphasised 
 the crying need for some means of grappling with the in- 
 tolerable existing evils. The whole class of zymotic diseases 
 — diseases which constitute the true gauge of the healthiness 
 or unhealthiness of a community — received a rapid and 
 immense development.* From 9,600 deaths from such 
 '■■ P.P. 1850, vol. xxi. p. 4. 
 
OF LONDON 43 
 
 diseases in 1846, the number increased to 14,000 in 1847 ; 
 and in this latter year the metropolis was visited by two 
 epidemics which rendered the mortality of the last quarter 
 of the year higher than that of any other quarter of any 
 year since the new system of registration of deaths had been 
 commenced.* Typhus fever produced fourfold its ordinary 
 mortality — other diseases showed a similar increase — and 
 towards the end of November influenza broke out and spread 
 so suddenly and to such an extent that within five or six 
 weeks it attacked no less than 500,000 persons out of 
 2,100,000 — the then population of London. Altogether the 
 excess of mortality in 1847 over 1845 was very close upon 
 50,000 persons. 
 
 The attitude of Parliament and of successive Governments 
 about this period, as regarded the insanitary condition of the 
 masses of the inhabitants of London, is now almost incom- 
 prehensible. -The plea of ignorance cannot be urged in 
 exculpation, for their own Blue Books and official returns 
 were there to inform them. Moreover, the existence of 
 similar evils throughout the country, where they were on a 
 very much smaller scale, was recognised both by the 
 Government and Parliament. 
 
 Lord Morpeth, a member of the Cabinet, speaking in 
 1848 in the House of Commons, said f : — 
 
 " It is far from any temporary evil, any transient visitant, 
 against which our legislation is now called upon to provide. 
 It is the abiding host of disease, the endemic and not the 
 epidemic pestilence, the permanent overhanging mist of 
 infection, the annual slaughter doubling in its ravages our 
 bloodiest fields of conflict, that we are now summoned to 
 grapple with." 
 
 Yet they resolutely shut their eyes to the huge mass of 
 misery and fearful waste of life which was going on at their 
 very doors, and all around them. This was proved beyond 
 controversy by their action in 1848. In that year the 
 Government introduced into Parliament a measure which 
 was, in effect, a comprehensive sanitary code, and which, if 
 
 * Metropolitan Sanitary Commission, 1848, 2nd Report, 
 f Hansard, 1848, vol. xcvi. p. 392. 
 
44 THE SANITARY EVOLUTION 
 
 duly enforced, was capable of conferring vast benefit on the 
 community at large. 
 
 Describing the provisions of the Bill, Lord Morpeth 
 said : — 
 
 " It will be imperative upon the local administrative 
 bodies to hold meetings for the transaction of business ; to 
 appoint a surveyor ; to appoint an inspector of nuisances ; 
 to make public sewers ; to substitute sufficient sewers in 
 case old ones be discontinued ; to require owners or 
 occupiers to provide house-drains; to cleanse and water 
 streets ; to appoint or contract with scavengers to cleanse, 
 cover, or fill up offensive ditches ; ... to provide sufficient 
 supply of water for drainage, public and private, and for 
 domestic use. 
 
 " The permissive powers to be granted to the local admin- 
 istrative bodies . . . include the power to make house- 
 drains upon default of owner or occupier, to make bye-laws 
 with respect to the removal of filth, to whitewash and purify 
 houses after notice ... to require that certain-; furnaces be 
 made to consume their own smoke ... to provide places 
 for public recreation, to purchase and maintain water- 
 works." 
 
 The Bill, which was duly passed and became an Act, in 
 fact provided means for coping with many of the sorest 
 dangers, it curbed some of the powers for evil which so 
 many persons had such little scruple in exercising ; it 
 provided methods for bringing to punishment at least some 
 of the evil-doers who hitherto had gone scot free; and it 
 held out some prospects of the diminution of the huge 
 death rate and still huger sick rate. 
 
 Though a somewhat similar Bill, introduced in 1847, and 
 which was withdrawn, had included the metropolis, this 
 Act did not apply to the metropolis. Its application was 
 limited to the rest of England and Wales. London — the 
 capital of the kingdom — was, it was said, "reserved for a 
 separate Bill." "The separate Bill," however, did not 
 make its appearance. The subtle, all-pervading influence 
 of vested rights was too powerful for any such reform to be 
 
OF LONDON 45 
 
 attempted.* And so, the Government and Parliament, 
 deliberately excluding the metropolis from this beneficial 
 legislation, left untouched the centre and main emporium of 
 disease, and left the people of London exposed on all sides 
 to the merciless onslaught of the direst diseases which can 
 afflict mankind. 
 
 Cholera, however, the only power able to awe the 
 Government, was now so close at hand that some special 
 provision had to be devised for the protection of the public 
 health. Parliament, this time not excluding the metro- 
 polis, re-enacted the trumpery "Nuisance Kemoval and 
 Diseases Prevention Act " of 1846, with some slight enlarge- 
 ments, and one important addition, namely, authority for 
 the appointment by the Privy Council of a General 
 Board of Health, which might issue directions and regu- 
 lations for the prevention of epidemic and contagious 
 disease. 
 
 Upon this slender thread Londoners were left dependent 
 for such measures as might afford them some protection 
 against the impending epidemic. No other help was at 
 hand. Nor was there much time for help to be organised 
 or preparations made, for cholera had reached Egypt and 
 Constantinople, and by June, 1848, had crept forward to 
 St. Petersburg. Isolated suspicious cases occurred in 
 London in the summer of 1848, f then an undoubted case 
 in Southwark on the 22nd of September, and then more 
 undoubted cases, and the disease had secured a footing. 
 As the winter approached it died down and ceased, having 
 carried off some 468 victims. 
 
 The Privy Council had appointed a General Board of 
 Health, and early in November the Board issued regu- 
 lations directing the Guardians to take the necessary 
 measures for the cleansing of houses, the abatement of 
 nuisances, and generally for the removal of all matters 
 injurious to health. To direct is one thing, to get obeyed is 
 
 * " Vested rights in crowded houses, deadly stenches, putrid water, 
 foggy courts, and cesspools." See "Health by Act of Parliament," 
 Household Words, 1850, vol. i. 
 
 f P.P. 1850, vol. xxi. p. 42. 
 
46 THE SANITARY EVOLUTION 
 
 another, and with some few exceptions, these directions 
 were disregarded. Partly, the fault was Parliament's. 
 
 The Act, by naming various local authorities, had created 
 a divided power, and consequently a divided responsibility, 
 which resulted in inaction, neglect, delay, and loss of life ; 
 and though the General Board of Health might require the 
 Boards of Guardians and other local bodies to put the 
 regulations into force, they had no power to compel them 
 to do so, and in default of such power the General Board of 
 Health was almost helpless. 
 
 The cessation of the disease proved to be only temporary. 
 Scarcely was 1849 entered on than the epidemic broke 
 out again, steadily gathering momentum as the summer 
 went on. 
 
 In Bethnal Green there was an outbreak in the night — 
 sudden and panic-striking — "consternation and alarm were 
 spread abroad — the hurried passing and re-passing of 
 messengers, and the wailing of relatives, filled the streets 
 with confusion and woe, and impressed all with a deep sense 
 of awful calamity." 
 
 And the epidemic spread and spread until in one week in 
 September (1849) the deaths from it amounted to 2,026.* 
 
 Were the full facts known, the mortality was doubtless 
 far higher. 
 
 And then the epidemic began rapidly to abate, and by the 
 end of the year had ceased, having slain some 14,600 victims.! 
 
 Numerous and important were the lessons inculcated by 
 this disastrous epidemic. It afforded the most definite 
 evidence that had yet been obtained of the influence upon 
 health of local conditions and pre-disposing causes. 
 
 It showed that in the most violent and extensive out- 
 breaks of the pestilence its virulence was invariably confined 
 to circumscribed localities. It showed that the habitat of 
 cholera and the habitat of fever were one and the same. 
 
 * P.P. 1850, vol. xxi. p. 110. 
 
 f In London in 1832-3 (population 1,682,000), the attacks were 14,144, 
 the deaths were 6,729. 1848-9 (population 2,206,000), the attacks were 
 about 30,000, the deaths about 14,600, so that in the last epidemic the 
 deaths were more numerous than the attacks in 1832-3, whilst the attacks 
 were more than double. 
 
OF LONDON 47 
 
 Deaths from cholera took place in the very same streets, 
 and houses, and rooms, which had been again and again 
 visited by fever ; and rooms were pointed out where some 
 of the poor people had recovered from fever in the spring to 
 fall victims to cholera in the summer. 
 
 As it was tersely summed up by one of the most active 
 and capable medical officers of the Board of Health : — 
 
 "We find but one cause of so much sickness, suffering 
 and death — the prolific parent of all this diversified offspring 
 —'filth.' 
 
 "It is in filth, in decomposing organic matter, that the 
 main causes of epidemic diseases are to be sought out — 
 filthy alleys, filthy houses, filthy air, filthy water, and filthy 
 persons." 
 
 What the General Board of Health could do, it did, as 
 was indeed to be expected from such sanitary enthusiasts 
 as Lord Ashley, Dr. Southwood Smith, and Mr, Edwin 
 Chadwick, but the local authorities were dilatory, lukewarm, 
 or actually hostile, and their proceedings, where anything 
 was done, were altogether inadequate for insuring those 
 prompt, comprehensive, and vigorous measures so urgently 
 demanded in the presence of a great and destructive 
 epidemic such as malignant cholera. 
 
 The system of house-to-house visitation was essential 
 for the discovery and checking of the disease, but, wrote 
 the Board, " nothing effective was done or attempted in 
 the metropolis. We repeatedly and earnestly urged upon 
 the Boards of Guardians the importance to the saving 
 of life of making immediate arrangements for special 
 measures of prevention, but our representations were made 
 in vain. 
 
 " The local authorities could not be induced to carry into 
 effect the preventive measures we proposed." 
 
 Several unions and parishes, among whom were some of 
 the most wealthy and populous, positively refused to comply 
 with the directions of the Board. 
 
 In the case of Bethnal Green, just described, the Board 
 issued a " Special Order." But even under these urgent 
 circumstances " the Board of Guardians appointed no 
 
48 THE SANITARY EVOLUTION 
 
 medical officer for five days, they provided no nurses, they 
 established no hospital, they opened no dispensary, they 
 appointed one inspector of nuisances instead of two, and 
 they made no provision for extensive and effectual lime- 
 washing," 
 
 The explanation of the inaction and hostility of the local 
 authorities lay in the fact that the various measures pre- 
 scribed by the Act interfered with private interests, and 
 especially with interests which were largely represented on 
 the Boards of Guardians. Among the members of those 
 boards there was often "an antagonistic power" at work 
 which prevented proper attention being paid to the sanitary 
 condition of the localities of the poor. In many instances, 
 owners of small houses and cottage property, to which class 
 of dwellings the provisions of the Act more particularly 
 applied, were themselves members of such boards, and 
 when this was not the case, they exerted an influence not 
 the less powerful because it was indirect. This interest 
 often conspired to impede efficient sanitary measures.* 
 
 Local interests also operated, the apprehension being that 
 if active and really efficient measures were adopted the trade 
 of the neighbourhood would suffer. 
 
 In one instance — an instructive one — where the epidemic 
 had extensively prevailed among the poor, its existence was 
 denied, and house-visitation resisted, till, after considerable 
 delay and loss of life, a number of shopkeepers were attacked 
 by the disease, and then, all opposition ceased. 
 
 The evidence of the unfitness of the local authorities 
 charged with the administration of the Act for the duties 
 imposed upon them was overwhelming. The unfortunate 
 position was accentuated and intensified by the fact that 
 the General Board of Health had no power either of com- 
 pelling the local authorities to do their duty or of itself 
 acting in default of their neglect ; and the absence of this 
 first essential of effective administration hampered and 
 crippled its action. 
 
 The Board summed up its experience of this great visita- 
 tion of 1848-9 :— 
 
 * Dr. Grainger, P.P. 1849-50, vol. xxi. 
 
OF LONDON 49 
 
 ** The evidence shows that where combined sanitary 
 arrangements have been carried into effect the outbreak of 
 the pestilence has been sometimes averted ; that where not 
 prevented, its course has been gradually arrested. 
 
 " That where material improvements have been made in 
 the condition of the dwellings of the labouring classes, there 
 has been an entire exemption from the disease, and where 
 minor improvements were made, the attacks have been less 
 severe and less extensive. 
 
 " That with reference to the measure of prevention, the 
 immunity from the disease has been in proportion to the 
 extent to which those measures have been carried into effect 
 systematically and promptly." 
 
 By the end of the year the epidemic was practically over. 
 And then the usual thing took place. 
 
 It is described a few months later by Dr. Grainger, who 
 wrote : — 
 
 "In many of the most densely populated districts the 
 inspectors of nuisances have been dismissed, the cleansing 
 operations have been relaxed, and there is too much reason 
 to apprehend that the courts and alleys will lapse back again 
 into their accustomed filth, . . . that houses proved by the 
 evidence of medical officers, inspectors, and local authorities 
 to be unfit for human habitation will long continue to 
 remain ' pest-houses,' spreading disease around ; and that, 
 in the midst of these tolerated and accumulated evils, 
 the industrious classes will continue as heretofore to 
 be decimated by fever, or, should it again break out, by 
 cholera." * 
 
 III 
 
 The "City" of London, though constituting territorially 
 and by population but a small portion of the metropolis, 
 affords much matter of deep interest in connection with the 
 sanitary evolution of London, totally apart from those great 
 economic forces emanating from it which have dominated 
 the whole of London life. 
 
 * P.P. 1850, vol. xxi. p. 147. 
 5 
 
50 THE SANITARY EVOLUTION 
 
 The " City" differed mainly, as has already been pointed 
 out, from " greater London " in that it had a real and active 
 governing body for its local affairs, and that that body was 
 possessed of considerable powers for dealing with the 
 sanitary condition and requirements of its inhabitants. 
 That those sanitary powers were annually delegated to a 
 body entitled the Commissioners of Sewers in no way 
 diminished its sanitary authority or weakened its efficiency, 
 for that body was practically a Committee of its own, and 
 had authority, directly or indirectly, over nearly every one 
 of the physical conditions which were likely to affect the 
 health or comfort of its inhabitants. 
 
 The "City" differed also in that it was able to obtain 
 from the Government and Parliament powers which neither 
 Government nor Parliament would grant to " greater 
 London." 
 
 It differed too in that from 1848 onwards it was in bene- 
 ficial enjoyment of the services of a Medical Officer of 
 Health. 
 
 But in many respects the " City " was a microcosm of the 
 metropolis; and though possessed of a local government, 
 yet was it cursed with evils which were the terrible legacy 
 left it by the ignorance, indifference, neglect, incapacity, or 
 cupidity, of previous generations. 
 
 The graphic reports of its Medical Officer of Health — 
 Dr. John Simon — have left us a most vivid and valuable 
 contemporary picture of the sanitary condition and sur- 
 roundings of the people living in the favoured area 
 about the middle of the last century, and they disclose, 
 in no hesitating manner, the desperate evils prevalent 
 therein. 
 
 The Thames, "with the immeasurable filth" which 
 polluted it, and its acres of mud banks saturated with the 
 reeking sewage of an immense population, vitiated the 
 atmosphere of the City, just as it did that of other parts of 
 London. But sewers there were in the City, of one sort or 
 another, over forty miles of them, and some of the filth of 
 the City was carried away, at least into the river. 
 
 House drainage into the sewers was, however, either 
 
OF LONDON 51 
 
 lamentably deficient or non-existent, and cesspools abounded 
 — abounded so freely that "parts of the City might be 
 described as having a cesspool-city excavated beneath it." 
 
 "It requires," reported Dr. Simon to his employers, 
 " little medical knowledge to understand that animals will 
 scarcely thrive in an atmosphere of their own decomposing 
 excrements ; yet such, strictly and literally speaking, is the 
 air which a very large proportion of the inhabitants of the 
 City are condemned to breathe. ... In some instances, 
 where the basement storey of a house is tenanted, the cess- 
 pool lies, perhaps merely boarded over, close beneath the 
 feet of a family of human beings whom it surrounds uninter- 
 ruptedly, whether they wake or sleep, with its foetid pollu- 
 tion and poison." 
 
 For such evils, and such a state of things, he said, house 
 drainage, with effective water supply, were the remedies 
 which could alone avail ; and it was only in the Session of 
 1848 that the authority to secure and enforce these remedies 
 was vested by the Legislature in any public body whatso- 
 ever. The City was fortunately included, but the metropolis, 
 with its two and a half millions of inhabitants, was unfortu- 
 nately not. 
 
 The unrestricted supply of water, he pointed out, was the 
 first essential of decency, of comfort, and of health ; no 
 civilisation of the poorer classes could exist without it ; and 
 any limitation to its use in the metropolis was a barrier 
 which must maintain thousands in a state of the most 
 unwholesome filth and degradation. 
 
 Even in the City, however, the supply of water was but 
 " a fraction of what it should have been, and thousands 
 of the population inhabited houses which had no supply 
 of it." 
 
 Nor was what was supplied by the Water Companies 
 much to boast of. 
 
 " The waters were conducted from their sources in open 
 channels; they received in a large measure the surface- 
 washing, the drainage, and even the sewage of the country 
 through which they passed ; they derived casual impurities 
 from bathers and barges, and on their arrival were, after a 
 
52 THE SANITARY EVOLUTION 
 
 short subsidence in reservoirs, distributed without filtration 
 to the pubHc." 
 
 In some cases the scanty distribution was from a stand- 
 pipe in a court or alley, for a very short time of the day. In 
 other cases the water was delivered into butts or cisterns. 
 Their condition is thus described : — 
 
 " In inspecting the courts and alleys of the ' City,' " he 
 wrote, " one constantly sees butts, for the reception of water, 
 either public or in the open yards of houses, or sometimes 
 in their cellars ; and these butts, dirty, mouldering, and 
 coverless ; receiving soot and all other impurities from the 
 air ; absorbing stench from the adjacent cesspool ; inviting 
 filth from insects, vermin, sparrows, cats, and children ; 
 their contents often augmented through a rain-water pipe 
 by the washings of the roof, and every hour becoming 
 fustier and more offensive. Nothing can be less like 
 what water should be than the fluid obtained under such 
 circumstances." 
 
 It is interesting to observe that the evils of the system 
 of water supply by private companies were, even in the 
 " City," so manifest that Dr. Simon expressed his opinion 
 that the only satisfactory solution of the difficulty in 
 connection therewith was the acquisition by the public 
 authority of the control of the supply, and he urged the 
 adoption of the principle of what is now denounced by 
 some people as "municipal trading." 
 
 In every practical sense the sale of water in London 
 was a monopoly. 
 
 " The individual customer," wrote Dr. Simon, *' who is 
 dissatisfied with his bargain 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 Honourable Court (the Commissioners of Sewers) 
 hitherto possesses no power to enforce it." 
 
 In the Public Health Act of 1848 the principle had 
 been recognised by Parliament so far as towns in the 
 country were concerned — local Boards of Health being 
 authorised to provide their district with such a supply of 
 
OF LONDON 53 
 
 water as might be proper or sufficient, or to contract for 
 such a supply. He urged that the City should obtain a 
 similar power. 
 
 ** All the advantages which could possibly be gained by 
 competition, together with many benefits which no com- 
 petition could ensure, would thus be realised to the popu- 
 lation under your charge." 
 
 But that solution of the difficulty was more than half a 
 century in advance of its accomplishment so far as either 
 the "City" or "greater London" was concerned. 
 
 As to the atmosphere in the " City," there seems to 
 have been no limit to the pollutions thereof, all of which 
 were injurious to the health of the public. 
 
 Numerous noxious and offensive trades were carried on 
 in the most crowded places. 
 
 Directly and indirectly, slaughtering of animals in the 
 "City" was .prejudicial to the health of the population, 
 and exercised a most injurious influence upon the district. 
 
 The number of slaughter-houses registered and tolerated 
 in the " City" in 1848 amounted to 138, and of these, in 
 58 cases, the slaughtering was carried out in the vaults 
 and cellars.* 
 
 And there were very many noxious and offensive trades 
 in close dependence upon " the original nuisance " of the 
 slaughter-house, and round about it, " the concomitant and 
 still more grievous nuisances of gut-spinning, tripe-dressing, 
 bone-boiling, tallow-melting, paunch-cooking, &c., &c." 
 
 Certain it is that offensive businesses of these and other 
 sorts were carried on by their owners with an absolute 
 disregard to the comfort or health of the public. 
 
 The matter was a difficult one to deal with, as any 
 severe restrictions might destroy the trade or manufacture 
 and take away from the people the employment which 
 gave them the means of earning a livelihood. Further- 
 more, such restrictions were usually resented as an in- 
 fraction of personal liberty. Dr. Simon forcibly and 
 conclusively answered this contention. 
 
 " It might," he wrote, "be an infraction of personal 
 * This was rendered illegal by the amended City Sewers Act of 1851. 
 
54 THE SANITARY EVOLUTION 
 
 • liberty to interfere with a proprietor's right to make 
 
 offensive smells within the limits of his own tenement, 
 and for his own separate inhalation, but surely it is a still 
 greater infraction of personal liberty when the proprietor, 
 entitled as he is to but the joint use of an atmosphere 
 which is the common property of his neighbourhood, 
 assumes what is equivalent to a sole possession of it, and 
 claims the right of diffusing through it some nauseous 
 effluvium which others, equally with himself, are thus 
 obliged to inhale." 
 
 Some improvement in this respect was rendered possible 
 by the Act of 1851, which enacted that whatever trade or 
 business might occasion noxious or offensive effluvia, or 
 otherwise annoy the inhabitants of its neighbourhood, 
 "shall" be required to employ the best known means for 
 preventing or counteracting such annoyance. 
 
 But the remedy scarcely appears to have been availed of 
 or enforced, and "greater London" was, as usual, excluded 
 from the Act. 
 
 Another more constant pollution of the air was that 
 resulting from intramural burial. " Overcrowding " in the 
 " City " was not limited to the living ; it extended even to 
 the dead, and though the dead themselves had passed 
 beyond any further possible harm from it, yet their over- 
 crowding affected disastrously those they had left behind. 
 Here the evils already described as existing in " greater 
 London " existed also in acute form. Two thousand bodies 
 or more were interred each year actually within the " City " 
 area, and the burial grounds were densely packed. And 
 " in all the larger parochial burying grounds, and in most 
 others, the soil was saturated with animal matter under- 
 going slow decomposition." 
 
 And the vaults beneath the churches were ' ' in many 
 instances similarly overloaded with materials of putre- 
 faction, and the atmosphere which should have been kept 
 pure and without admixture for the living, was hourly 
 tainted with the foetid emanations of the dead. . . ." 
 
 In Dr. Simon's words : — 
 
 " Close beneath the feet of those who attend the services 
 
OF LONDON 55 
 
 of their church there often lies an almost solid pile of 
 decomposing human remains, heaped as high as the 
 vaulting will permit, and generally but very partially 
 coffined." 
 
 The Metropolitan Burials Act of 1852 effected a great 
 improvement in this respect by putting a term to the 
 indefinite perpetuation of this horrible evil. It gave the 
 Secretary of State power to prohibit further intramural 
 burials, and it gave the " City," and other local authorities, 
 the power to establish burial places beyond the boundaries 
 of the metropolis. But, even when thus stopped, years 
 had to elapse before the condition of intramural burial 
 grounds and vaults would cease to vitiate the air around 
 them.* 
 
 The atmosphere of the " City," the air which people 
 breathed, was thus vitiated in varying degrees of intensity 
 by numerous and various abominations — the polluted 
 Thames, defective sewerage and drainage, offensive trades, 
 intramural interments. 
 
 As regards the houses in which the people lived, these 
 were crammed together — packed as closely together as 
 builders' ingenuity could pack them — many of them com- 
 bining every defect that houses could have, and so situated 
 that ventilation was an impossibility. 
 
 ** In very many parts of the City you find a number of 
 courts, probably with very narrow inlets, diverging from 
 the open street in such close succession that their backs 
 adjoin, with no intermediate space whatsoever. Conse- 
 quently each row of houses has but a single row of windows 
 facing the confined court, and thus there is no possibility of 
 ventilation, either through the court generally or through 
 the houses which compose it. . . . Houses so constructed 
 as to be as perfectly a cul-de-sac out of the court as the 
 court is a cul-de-sac out of the street." f 
 
 And the climax of insanitary conditions was reached 
 when these densely-packed houses were overcrowded by 
 human beings. 
 
 * See P.P. 1854-5, vol. x., General Keport of Medical Council, 
 f Simon, 1st Report, 1849. 
 
56 THE SANITARY EVOLUTION 
 
 The process of converting dwelling-houses into ware- 
 houses, or business offices, or for trade or manufactures was 
 in full swing — a constant force — and so the number of 
 houses for people to live in became ever fewer. 
 
 And the " tenement houses," in which the great bulk 
 of the working classes lived, became more and more 
 crowded ; houses wherein " each holding or tenement, 
 though very often consisting but of a single small 
 room, receives its inmates without available restriction 
 as to their sex or number, and without registration of 
 the accommodation requisite for cleanliness, decency, and 
 health." 
 
 The Census of 1851 had shown an increase of over 4,200 
 in the population of the " City," and a diminution of nearly 
 900 houses. 
 
 "Probably," wrote Dr. Simon, "for the most part it 
 represents the continued influx of a poor population into 
 localities undesirable for residence, and implies that habi- 
 tations previously unwholesome by their overcrowdedness 
 are now still more densely thronged by a squalid and sickly 
 population. . . . 
 
 "It is no uncommon thing, in a room twelve feet 
 square or less, to find three or four families styed together 
 (perhaps with infectious disease among them), filling the 
 same space night and day — men, women, and children, in 
 the promiscuous intercourse of cattle. Of these inmates 
 it is nearly superfluous to observe that in all ofiices of 
 nature they are gregarious and public; that every instinct 
 of personal or sexual decency is stifled ; that every naked- 
 ness of life is uncovered there. , . . Who can wonder at 
 what becomes, physically and morally, of infants begotten 
 and born in these bestial crowds? . . ." 
 
 Of overcrowding or "pestilential heaping of human 
 beings," this matter of "infinite importance," he wrote: — 
 "While it maintains physical filth that is indescribable, 
 while it perpetuates fever and the allied disorders, while it 
 creates mortality enough to mask the results of all your 
 sanitary progress, its moral consequences are too dreadful 
 to be detailed." 
 
OF LONDON 67 
 
 Pursuing his masterly analysis of the sanitary con- 
 dition of the people in the " City " and its causes, he 
 wrote : — 
 
 " Last and not least among the influences prejudicial to 
 health in the City, as elsewhere, must be reckoned the 
 social condition of the working classes. . . . Often in dis- 
 cussion of sanitary subjects before your Honourable Court, 
 the filthy, or slovenly, or improvident, or destructive, or 
 intemperate, or dishonest habits of these classes are cited as 
 an explanation of the inefficiency of measures designed for 
 their advantage. It is constantly urged that to bring im- 
 proved domestic arrangements within the reach of such 
 persons is a waste and a folly. 
 
 "It is unquestionable that in houses containing all the 
 sanitary evils enumerated — undrained and waterless, and 
 unventilated — there do dwell whole hordes of persons 
 who struggle so little in self-defence against that which 
 surrounds them that they may be considered almost 
 indifferent to its existence, or almost acclimated to endure 
 its continuance. 
 
 "It is too true that among the lower classes there are 
 swarms of men and women who have yet to learn that 
 human beings should dwell differently from cattle — swarms 
 to whom personal cleanliness is utterly unknown ; swarms 
 by whom delicacy and decency in their social relations are 
 quite unconceived. 
 
 " My sphere of duty lies within the City boundary. 
 
 **I studiously refrain from instituting comparisons with 
 other metropolitan localities. 
 
 "I feel the deepest conviction that no sanitary system 
 can be adequate to the requirements of the time, or can 
 cure those radical evils which infest the under framework of 
 society, unless the importance be distinctly recognised and 
 the duty manfully undertaken of improving the social con- 
 dition of the poor. ... 
 
 " Who can wonder that the laws of society should at 
 times be forgotten by those whom the eye of society 
 
58 THE SANITARY EVOLUTION 
 
 habitually overlooks, and whom the heart of society often 
 appears to discard? 
 
 " To my duty it alone belongs, in such respects, to tell 
 you where disease ravages the people under your charge, and 
 wherefore ; but while I lift the curtain to show you this — a 
 curtain which propriety may gladly leave unraised — you 
 cannot but see that side by side with pestilence there stalks 
 a deadlier presence, blighting the moral existence of a rising 
 population, rendering their hearts hopeless, their acts 
 ruffianly and incestuous, and scattering, while Society 
 averts her eyes, the retributive seeds of increase for crime, 
 turbulence, and pauperism." 
 
 And what was the physical result of this state of 
 living ? 
 
 " In some spots in the City you would see houses, courts, 
 and streets, where the habitual proportion of deaths is far 
 beyond the heaviest pestilence rate known for any metro- 
 politan district aggregately — localities where the habitual 
 rate of death is more appalling than any such averages can 
 enable you to conceive. 
 
 " Among their dense population it is rare to see any other 
 appearance than that of squalid sickness and misery, and 
 the children who are reproduced with the fertility of a 
 rabbit warren perish in early infancy. 
 
 " The diseases of these localities are well marked. 
 Scrofula more or less completely blights all that are born 
 . . . often prolonging itself as a hereditary curse in the 
 misbegotten offspring of those who, under such unnatural 
 conditions, attain to maturity and procreation. 
 
 " Typhus prevails as a habitual pestilence. 
 
 " The death rate during the last five years has been at 
 the rate of about twenty-four per 1,000 per annum. 
 
 " The City of London appears peculiarly fatal to infant 
 life. 
 
 " Of the 15,697 persons who died within your jurisdiction 
 in the five years 1847-8 to 1852-3, nearly three-eighths died 
 in the first five years of life." 
 
 To his employers he mostly appeals. He hopes that the 
 statements in his reports may suffice to convince them of 
 
OF LONDON 69 
 
 the necessity which exists in the " City " of London for some 
 effectual and permanent sanitary organisation. 
 
 " For the metropolis generally there is hitherto no 
 sanitary law such as you possess for your territory." 
 
 He pointed out that — 
 
 " Inspection of the most constant, most searching, most 
 intelligent, and most trustworthy kind is that in which the 
 provisional management of our said affairs must essentially 
 consist. 
 
 " The committee was given power by the Act for the 
 amendment or removal of houses presenting aggravated 
 structural faults. 
 
 " Wherever your Medical Officer of Health may certify to 
 you that any house or building is permanently unwholesome 
 and unfit for human habitation, you are empowered to 
 require of the owner (or in his neglect yourselves to under- 
 take) the execution of whatever works may be requisite for 
 rendering the house habitable with security to life." 
 
 And he urged that : — 
 
 " The principle might be distinctly recognised that the 
 City will not tolerate within its municipal jurisdiction the 
 continuance of houses absolutely incompatible with healthy 
 habitation. 
 
 "Here terminates my statement of the powers now vested 
 in you for the maintenance of the public health. 
 
 •' Authority so complete for this noble purpose has never 
 before been delegated to any municipal body in the 
 country. 
 
 " If the deliberate promises of Science be not an empty 
 delusion, it is practicable to reduce human mortality 
 within your jurisdiction to nearly the half of the present 
 prevalence." 
 
 The most valuable and weighty of all his conclusions was 
 that affixing the responsibility for the existing mass of 
 insanitation and consequent misery. With a courage 
 worthy of all admiration he did not hesitate, regardless 
 of the consequences to himself, to fix the responsibility 
 and blame where they were due. 
 
60 THE SANITARY EVOLUTION 
 
 ** The fact is that, except against wilful violence, life is 
 very little cared for by the law." 
 
 Of Parliament he wrote : — 
 
 " Fragments of legislation there are, indeed, in all 
 directions ; enough to establish precedents, enough to 
 testify some half-conscious possession of a principle; but 
 for usefulness little beyond this. The statutes tell that 
 now and then there has reached to high places the wail 
 of physical suffering. They tell that our law makers, to 
 the tether of a very scanty knowledge, have, not unwillingly, 
 moved to the redress of some clamorous wrong. . . . But 
 . . . their insufficiencies constitute a national scandal, . . . 
 something not far removed from a national sin. . . . 
 
 "The landlord must be held responsible for the decent 
 and wholesome condition of his property, and for such 
 conduct of his tenants as will maintain that condition." 
 
 The clear, precise, and unqualified enunciation of such 
 a principle must have given a shock to many of the 
 members of the governing authority of the " City," and 
 excited their wrath, the more especially as it was so 
 absolutely sound and true. 
 
 "The death of a child by smallpox," he went on to say, 
 ** 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 condemna- 
 tion (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." 
 
 And then he proceeds to explain and justify and enlarge 
 upon his assertion of the responsibility of the landlord, 
 
 ' ' There are forty-five miles of sewerage in your jurisdic- 
 tion, ready to receive the streams of private drainage, and 
 leaving the owners of house property no excuse for the 
 non-performance of necessary works. . . . But . . . the 
 intentions of your Court, and the industry of its officers, 
 
OF LONDON 61 
 
 have been in great measure frustrated by the passive 
 resistance of landlords. Delays and subterfuges have been 
 had recourse to in order to avoid compliance with the 
 injunctions of the Commission." 
 
 In his evidence before the Eoyal Commission of 1853-4 
 he said : — 
 
 " The poorer house property of the City is very often in 
 the hands of wealthy people who have only the most general 
 notion of its whereabouts, have perhaps never visited the 
 place for which they receive rent, and in short know their 
 property only through their agents. 
 
 "Instances have come to my knowledge of the very worst 
 description of property being thus held ignorantly and care- 
 lessly by wealthy persons. Often for years we can get at 
 no representative of the property other than the agent or 
 collector who receives the weekly rent for some anonymous 
 employer." 
 
 In his third Eeport to the Commissioners of Sewers he 
 wrote : — 
 
 "It is easy to foresee the numerous obstacles which 
 interested persons will set before you to delay the accom- 
 plishment of your great task. 
 
 "When your orders are addressed to some owner of 
 objectionable property — of some property which is a 
 constant source of nuisance, or disease, or death ; when 
 you would force one person to refrain from tainting 
 the general atmosphere with results of an offensive 
 occupation ; when you would oblige another to see that 
 his tenantry are better housed than cattle, and that, while 
 he takes rent for lodging, he shall not give fever as an 
 equivalent — amid these proceedings you will be reminded 
 of the ' rights of property ' and of ' an Englishman's inviol- 
 able claim to do as he will with his own.' 
 
 " Permit me to remind you that your law makes full 
 recognition of these principles and that the cases in which 
 sophistical appeal will often be made to them are exactly 
 those which are most completely condemned by a fuU and 
 fair application of the principles adverted to. With private 
 affairs you interfere only when they become of public 
 
J-, 
 
 62 THE SANITARY EVOLUTION 
 
 import, with private liberty only when it becomes a public 
 encroachment. The factory chimney that eclipses the 
 light of heaven with unbroken clouds of smoke, the melting 
 house that nauseates an entire parish, the slaughter-house 
 that forms round itself a circle of dangerous disease — these 
 surely are not private but public affairs. 
 
 "And how much more justly may the neighbour appeal 
 to you against each such nuisance as an interference with 
 his privacy ; against the smoke, the stink, the fever that 
 bursts through each inlet of his dwelling, intrudes on him 
 at every hour, disturbs the enjoyment and shortens the 
 duration of his life. And for the rights of property — they 
 are not only pecuniary. Life, too, is a great property, and 
 your Act (of 1851) asserts its rights." 
 
 "The landlord of some overthronged lodging house com- 
 plains that to reduce the number of his tenantry, to lay 
 on water, to erect privies, or to execute some other in- 
 dispensable sanitary work, would diminish his rental — 
 in the spirit of your Act it is held a sufficient reply that 
 human life is at stake — and that a landlord in his dealings 
 with the ignorant and indefensive poor cannot be suffered 
 to estimate them at the value of cattle, to associate them 
 in worse than bestial habits, or let to them for hire at how- 
 ever moderate a rent the certain occasions of suffering and 
 death." 
 
 " Seeing the punctuality with which weekly visitation is 
 made for the collection of rents in these wretched dwellings 
 it would not be unreasonable to insist on some regulations 
 for the clean and wholesome condition of his premises, 
 water supply, and scavenging, &c." 
 
 Such a regulation would " render it indispensable to the 
 landlord of such holdings to promote cleanly and decent 
 habits among his tenants — even to obtain security for their 
 good behaviour." 
 
 The picture thus presented of the sanitary condition of 
 the people residing in the " City " about the middle of the 
 last century is — it must be acknowledged — a terrible one; 
 but it rests upon unimpeachable testimony. 
 
 The very grave and serious conclusion, however, follows 
 
OF LONDON 63 
 
 from it — that if the evils were thus terrible in the " City," 
 with a comparatively small population, only a little more 
 than a twentieth of that of the metropolis, and where there 
 was a local government with wide powers for dealing with 
 matters affecting the public health — how infinitely more 
 serious was the condition of things in the "greater London" 
 with its huge population, and where there was practically no 
 local government, and no punitive law for insanitary mis- 
 doings and crimes. 
 
 In some degree, the evils the people suffered under were 
 of their own making, though many excuses can be urged in 
 extenuation. In some degree, too, the people were un- 
 questionably the victims of circumstances. But in the 
 main, they were the victims of other people's iniquities. 
 It was those circumstances which the Government should 
 have altered, or, at any rate, have endeavoured to control or 
 modify — it was the unlimited power to do evil that the 
 Government should have checked and curbed ; but "greater 
 London " was virtually left outside the pale of remedial 
 legislative treatment by Parliament. 
 
 IV 
 
 The great cholera epidemic of 1848-9 had deeply stirred 
 public feeling in London. It had destroyed 14,600 people 
 (and diarrhoea, its satellite, had destroyed many thousands 
 more), and it had been " accompanied by an amount of 
 sickness and physical misery beyond computation." But 
 even all its horrors, and all the proofs it afforded of the 
 desperately insanitary condition of the masses in the 
 metropolis, were not sufficient to induce the Government 
 to depart from its policy of neglect, or to wring from 
 Parhament measures which would lay the basis for the 
 alleviation of the sufferings of the working population 
 of the metropolis, or which would remove even a small 
 part of the evils which fell so heavily upon those least able 
 to sustain them, and least able to remove them. 
 
64 THE SANITARY EVOLUTION 
 
 The health of London was becoming worse every year. 
 The number of persons dying from preventable disease had 
 been steadily increasing. 
 
 One gleam of hope there was, however. An increasing 
 number of persons were becoming interested in the health 
 of the people, and were awakening to the gravity of the 
 subject, and to the public discredit and inhuman scandal 
 of the existing condition of things — an awakening of 
 interest which, in February, 1850, reached to the extent 
 of a public meeting. 
 
 The Bishop of London presided, and the meeting was 
 rendered the more remarkable by speeches from Lord 
 Ashley, then actively pressing sanitary and social questions 
 forward, and by Charles Dickens. 
 
 Lord Ashley said : — 
 
 " The condition of the metropolis, in a sanitary point 
 of view, was not only perilous to those who resided in it, 
 but it was an absolute disgrace to the century in which 
 they lived. It was a disgrace to their high-sounding pro- 
 fessions of civilisation and morality. They were surrounded 
 by every noxious influence — they were exposed to every 
 deadly pestilence. . . . The water they drank, the air they 
 breathed, the surface they walked on, and the ground 
 beneath the surface, all were tainted and rife with the 
 seeds of disease and death. . . . 
 
 " Let them look at another abomination — the existence of 
 putrefying corpses in graveyards and in vaults amidst the 
 habitations of the living — an abomination discountenanced 
 by all the civilisation of modern days, as it was by that 
 of the ancient days — the practice of intramural inter- 
 ments. 
 
 " Could anything be worse than the graveyards of the 
 metropolis ? Under a surface of ground not amounting 
 to 250 acres there had been interred within thirty years 
 in the metropolis far more than 1,500,000 human beings. 
 What must be the condition of the atmosphere affected 
 by the exhalations from that surface ? . . . 
 
 "And what were the financial and social consequences 
 of allowing such a state of things to exist ? 
 
OF LONDON 65 
 
 " At least one-third of the pauperism of the country arose 
 from the defective sanitary condition of large multitudes 
 of the people. . . ." 
 
 Charles Dickens said : — 
 
 " The object of the resolution he was proposing was to 
 bring the Metropolis within the provisions of the Public 
 Health Act, most absurdly and monstrously excluded from 
 its operation. . . . Infancy was made stunted, ugly, and 
 full of pain ; maturity made old ; and old age imbecile. 
 
 " He knew of many places in London unsurpassed in the 
 accumulated horrors of their long neglect by the dirtiest 
 old spots in the dirtiest old towns under the worst old 
 governments in Europe. 
 
 " The principal objectors to the improvements proposed 
 were divided into two classes. 
 
 " The first consisted of the owners of small tenements, 
 men who pushed themselves to the front of Boards of 
 Guardians and parish Vestries, and were clamorous about 
 the rating of their property ; the other class was composed 
 of gentlemen, more independent and less selfish, who had 
 a weak leaning towards self-government. The first class 
 generally proceeded upon the supposition that the com- 
 pulsory improvement of their property when exceedingly 
 defective would be very expensive. . . . 
 
 " No one," he went on to say, " who had any knowledge 
 of the poor could fail to be deeply affected by their patience 
 and their sympathy with one another — by the beautiful 
 alacrity with which they helped each other in toil, in the 
 day of suffering, in the hour of death. 
 
 " It hardly ever happened that any case of extreme pro- 
 tracted destitution found its way into the public prints 
 without our reading at the same time of some ragged 
 Samaritan sharing his last loaf or spending his last penny 
 to relieve the poor miserable in the room upstairs or in the 
 cellar underground. It was to develop in the poor people 
 the virtue which nothing could eradicate, to raise them 
 in the social scale as they should be raised, to lift them 
 from a condition into which they did not allow their beast 
 to sink, ... to cleanse the foul air for the passage of 
 
 6 
 
66 THE SANITARY EVOLUTION 
 
 Christianity and education throughout the land, that the 
 meeting was assembled. The object of their assembly was 
 simply to help to set that right which was wrong before 
 God and before man." 
 
 The realisation of this object, noble as it was, was not 
 easily attainable. 
 
 The Vicar of St. Martin-in-the-Fields said that "the 
 difficulty of legislation in these matters was to hit the 
 medium between the rights of property and the rights 
 of humanity." He might have added, with truth, that the 
 difficulty had so far been met by sacrificing the rights 
 of humanity to the rights of property. 
 
 Lord Ashley had pointed out that they " had to contend 
 with ignorance, indifference, selfishness, and interest ; " 
 or as Lord Robert Grosvenor more vigorously expressed 
 it, in a phrase which should live in history as giving the 
 key to the mystery of the slow sanitary evolution of this 
 great city, they had to contend against " vested interests 
 in filth and dirt." 
 
 One thing was already absolutely clear, that it was 
 hopeless to expect anything from the spontaneous action 
 of land-owners or house-owners. 
 
 " They knew it was quite impossible," said the Bishop 
 of Chichester, *' to bring the owners of even one small 
 court or alley, much less the owners or occupiers of any 
 large district, to concur in any measure for the general 
 good of their particular locality." 
 
 The fact was that nothing but the imperative directions 
 of the law would secure the removal of evils or curtail the 
 practice of infamous abuses — and even when the law was 
 enacted for their remedy, nothing but its rigorous enforce- 
 ment with adequate penalties would make it effective. 
 
 As the result of the meeting, a deputation waited on 
 Lord John Eussell, the then Prime Minister. His reply 
 was not encouraging. 
 
 " In this city," he said, " there is very naturally and 
 properly great jealousy of any interference either with 
 local rights or individual will and freedom from control." 
 
 That great jealousy proved to be so powerful that nothing 
 
OF LONDON 67 
 
 was attempted by the Government except an abortive 
 effort to deal with the loathsome and insanitary evils of 
 intramural interments where vested interests were neither 
 powerful nor loud voiced. 
 
 The Act was so defective that it never came into opera- 
 tion, and two more years elapsed before the Government 
 again essayed to deal with the subject. And in the 
 meanwhile that most horrible evil was permitted to work 
 its will upon the dwellers in the metropolis. 
 
 To the enthusiasm of an individual, and not of the 
 Government, was due the first effective attempt to grapple 
 with one of the wide-spread, deep-seated evils which were 
 working such havoc among the people. The most disas- 
 trous and vicious forms of overcrowding were at the time 
 to be found in the so-called Common Lodging Houses — 
 the sink of insanitary abominations. 
 
 These wer^ the temporary and casual abodes of the 
 dregs of London humanity — of the tramps, and the unfor- 
 tunates, and the mendicants and criminals, male and 
 female — when they could afford the penny or pence to 
 pay for their night's lodging. In most cases these houses 
 were low brothels and hotbeds of crime and moral degen- 
 eracy, their foul and filthy condition making them great 
 sources and propagators of contagious and loathsome 
 diseases. 
 
 In the " City " the authorities had power to regulate 
 and control them. Not so, however, in the metropolis. 
 There, no one had any authority in the matter, nor was 
 there any authority for any one to have. 
 
 Lord Ashley, truly discerning that the one and only 
 way of dealing with this evil was by regulation and con- 
 straint, introduced a Bill * and actually carried it through 
 Parliament, and two years later got another Act t embody- 
 ing amendments which made it more effective. 
 
 What the Common Lodging House owner or keeper — 
 anxious to secure the utmost profits from his property 
 and regardless of all consequences to others — would not 
 do, he was, by those Acts, made to do. 
 
 * 14 and 15 Vic. cap. 28. f 16 and 17 Vic. cap. 41. 
 
68 THE SANITARY EVOLUTION 
 
 The houses which he devoted to this purpose, solely 
 for his own profit, were placed under the control and 
 inspection of the police, and had to be registered as 
 " Common Lodging Houses." Overcrowding in them 
 was checked by restricting the number of inmates who 
 might be in each room ; regulations (confirmed by a 
 Secretary of State) were made, and steadily enforced, for 
 the separation of the sexes ; for the proper cleansing of 
 the houses ; and for compelling the keeper to give 
 immediate notice of fever or any contagious or infectious 
 disease occurring therein. The accumulation of refuse 
 was to be prevented, and provision had to be made for 
 adequate sanitary accommodation, for better drainage, 
 and for sufficient water supply. 
 
 A very brief experience showed that great practical 
 benefits resulted from thus regulating these houses, and 
 the amount of sickness and mortality in them became 
 astonishingly small, considering the character of their 
 inmates and the localities where they were situated ; and 
 inasmuch as the number of such houses was nearly 6,000, 
 and the population in them about 80,000, the benefit was 
 a really substantial one. 
 
 How obstinate and pertinacious was the opposition of 
 house-owners, or middlemen, to regulation and supervision 
 of any kind is illustrated by a case reported by the Assistant 
 Police Commissioner.* The owner of certain premises in 
 St. Giles had been often applied to, without success, to 
 remedy some gross sanitary defects therein which had 
 resulted in the loss of life by fever. Brought to bay at last, 
 at the Police Court, and ordered to remedy the evil, he said 
 that he was willing to do all in his power to abate the 
 nuisance . . . but, "he thought he ought not to be dictated 
 to as to the way his property was to be managed." His 
 words embodied the predominant spirit of the time. " There 
 are," wrote the Assistant Police Commissioner in com- 
 menting upon this case, " owners of property whom nothing 
 but the strong arm of the law can move." 
 
 Unfortunately the Act did not go far enough. Single 
 - P.P. 1854, vol. XXXV. p. 7. 
 
OF LONDON 69 
 
 rooms occupied by families did not come within its scope. 
 They constituted an enormous proportion of the habita- 
 tions of the people, and they were allowed to continue 
 the prolific cause of sanitary evils and of physical and moral 
 degradation. 
 
 Limited in its scope though the Act was, it afforded 
 nevertheless one great object lesson — the lesson which since 
 that time has been consistently preached by all who had 
 actual experience as regarded the sanitary condition of the 
 people of London — the lesson that the worst of the sanitary 
 and social evils could only be effectually grappled with, on 
 the one side by the supervision and regulation and constant 
 inspection of the houses in which the poorer classes lived, 
 and upon the other side by insistent compulsion of house- 
 owners to maintain a certain standard of sanitation and 
 cleanliness in those houses. 
 
 That, however, was a course which Parliament for many 
 years did not think it desirable to adopt, and which, when 
 adopted in a tentative and half-hearted sort of way, suffered 
 the usual fate of sanitary legislation — that of being neglected, 
 opposed, evaded, or thwarted by land-owners, house-owners, 
 middlemen, and by hostile local authorities. 
 
 Lord Ashley also originated and succeeded in the same 
 Session in obtaining from Parliament another Act of 
 notable interest, namely, " The Labouring Classes Lodging 
 Houses Act," * which aimed at increasing the quantity of 
 houses for working men by facilitating the establishment 
 of well-ordered houses for such persons. 
 
 It gave power to vestries to adopt the Act, and there- 
 after to purchase or lease land, and to erect houses thereon 
 for the working classes, and to borrow money on the security 
 of the rates for this purpose. 
 
 In advocating his plan in the House of Commons he 
 enforced the importance of the reform. He said : — 
 
 " Until the domiciliary condition of the working classes 
 
 were Christianised (he could use no less forcible a term) all 
 
 hope of moral or social improvement was utterly vain. 
 
 Though not the sole, it was one of the prime sources of the 
 
 * 14 and 15 Vic. cap. 34, 1861. 
 
70 THE SANITARY EVOLUTION 
 
 evils that beset their condition ; it generated disease, ruined 
 whole families by the intemperance it promoted, cut off or 
 crippled thousands in the vigour of life, and filled the work- 
 houses with widows and orphans." * 
 
 He specially mentioned one of the objections urged to 
 this proposal for the construction of better houses — an 
 objection which since then has invariably found expression 
 when any amelioration of the housing of the working 
 classes has been proposed to be done by a public authority. 
 
 " It was said those matters ought to be left to private 
 speculation. He should much object to that. Private 
 speculation was very much confined to the construction of 
 the smallest houses, and of the lowest possible description, 
 because it was out of these the most inordinate profits could 
 be made. Private speculation was almost entirely in that 
 direction." 
 
 He might have added that "private speculation" had 
 hitherto had a completely free field in the sphere of housing, 
 with all the evil results visible before them, and that it had 
 aggravated and intensified the evil instead of removing or 
 mitigating it. 
 
 The debate in Parliament was interesting, as it drew from 
 the Home Secretary an expression of the Government view 
 of the situation. 
 
 " After all," said Sir G. Grey, " it was not to the Govern- 
 ment, it was rather to the efforts of individuals, and asso- 
 ciations of individuals, that they must look for real and 
 general improvement among the great body of the people. 
 All that the Government could do was to remove obstacles 
 in the way, and to present facilities by modifications of the 
 law more useful than direct legislation." * 
 
 An " association of individuals " had already been formed 
 — "The Society for Improving the Condition of the Labour- 
 ing Classes " — and work of this class had to the extent of over 
 £20,000 been carried out by it. The new piles of buildings 
 erected were eagerly availed of by people of the working 
 classes, and in a sanitary point of view they at once demon- 
 strated their very satisfactory immunity from disease. 
 
 ■- See Hansard, 1851, vol. cxv. 
 
OF LONDON 71 
 
 The Act, however, being a voluntary or adoptive Act, was 
 not likely to be adopted and put into force by those by 
 whom a certain amount of financial liability might be 
 incurred as the result. As a matter of fact it never was put 
 in force by any vestry, and it remained a dead letter. 
 
 It was memorable, however, as embodying for the first 
 time in legislation the idea that the housing of the people 
 was a public matter with which a public authority might 
 properly concern itself, even to the extent of competing 
 with private enterprise, and pledging the rates as security. 
 
 The supply of water to London, both as regarded quality 
 and quantity, had, since the epidemic of 1848-9, been en- 
 gaging the attention of Committees of Parliament, the 
 belief that the epidemic of cholera had been increased and 
 propagated by the filthy and impure water having given an 
 impetus to the demand for ameliorative measures. In 1852 
 an Act * was passed by which the companies taking their 
 water from the Thames were required to remove their 
 intakes to some place above Teddington Lock, where the 
 tide would not affect it, and the sewage of London would 
 not be intermixed with it. This was a considerable step in 
 the right direction, for though the river above Teddington 
 Lock received the sewage of many large towns and villages, 
 it was at least free from contamination by the sewage and 
 filth of the metropolis. 
 
 Other improvements were also enacted. Eeservoirs 
 within a certain distance of St. Paul's Cathedral were to 
 be covered in, and all water intended for domestic use was 
 to be filtered before being supplied to the consumer ; and 
 provision was also made for a constant supply of water 
 by every company within five years after the passing of 
 the Act. 
 
 But the companies were given five years within which to 
 effect the removal of the intake from the foulest parts of 
 the river to above tidal reach — and thus for a wholly un- 
 necessary term the cause which had wrought such havoc 
 among the people was permitted to continue its disastrous 
 effects. 
 
 * " The MetropoUs Water Act, 1852," 16 and 16 Vic. cap. 84. 
 
72 THE SANITARY EVOLUTION 
 
 V 
 
 The epidemic of cholera in 1849 had failed to produce any 
 lasting effect upon the local authorities or the public opinion 
 of London, and the nemesis of renewed neglect and in- 
 difference was once again to fall upon the metropolis. 
 
 Cholera had kept hovering about. In 1852 a number of 
 suspicious cases occurred in various districts. In 1853 
 suspicion passed into certainty, and the disease assumed 
 the form of an epidemic — as many as 102 deaths from 
 it occurring in the first week in November. Then it 
 died down. 
 
 In the following year it again appeared in more severe 
 epidemic form over the whole of the metropolis. On one 
 day — September 4th — there were 459 deaths from it. The 
 climax was reached in the second week in September 
 (almost the identical date on which the epidemic of 1849 
 occasioned the highest mortality) and there were 2,050 
 deaths from it.* In that one month 6,160 persons died 
 from it, and from July 1st to December 16th, when it at 
 last disappeared, there was a total mortality from cholera 
 alone of 10,675 persons. 
 
 Every conclusion which had been arrived at as regards 
 the disease during the previous epidemics was confirmed by 
 this third great epidemic, and many previous theories passed 
 into the region of proved facts. Cholera was once more 
 proved to be a filth disease, and in the main confined to 
 filthy localities. The more defective and abominable the 
 methods of drainage, the larger the number of victims. 
 The filthier and more contaminated the water supplied for 
 drinking and household purposes, the more numerous the 
 cases, and the more virulent the disease. This was demon- 
 strated beyond further question. 
 
 The mortality on the south side of the Thames was above 
 threefold what it was on the north side ; and both as re- 
 garded water supply and drainage, South London was in a 
 worse sanitary state than North London. The water con- 
 * See P.P. 1854, vol. xlv. p. 22. 
 
OF LONDON 73 
 
 sumed by the population there was generally worse than 
 that on the north. Lying lower, too, the drainage had less 
 chance of being conveyed away, and in the miles upon miles 
 of open sewer ditches it was left to rot and putrefy in close 
 propinquity to the houses and to poison the air. 
 
 And the most remarkable proof was afforded by the 
 effects of the consumption of water taken from different 
 sources. 
 
 In 1849 both the Lambeth and the Southwark Water 
 Companies pumped the water they supplied to their 
 customers from the very foulest part of the Thames — near 
 Hungerford Bridge — with equally diastrous results. In the 
 course of the following years the Lambeth Company removed 
 its source of supply to a part of the river above Teddington 
 Lock — the Southwark Company, however, went on as 
 before. In the epidemic of 1854 the inhabitants of houses 
 supplied with the water by the latter company suffered eight 
 times as much as those supplied by the better water of the 
 Lambeth Company, whilst the number of persons who died 
 in the houses where the impure was drunk was three and a 
 half times greater than that in the houses where the purer 
 water was supplied. 
 
 Of all the conclusions arrived at by those who had been 
 engaged in combating the disease during this epidemic, the 
 most important was that where cholera had become 
 localised it was connected with obvious removable causes, 
 and was in fact a preventable disease. 
 
 Most unfortunately, and reprehensibly, many of those 
 who could have done most to prevent it failed signally to 
 take action. 
 
 Once more, and this time in an accentuated degree, the 
 wide-spread prevalence of the disease, and the frightful 
 mortality, were distinctly due to the inertia, laxity, or 
 deliberate neglect of those local authorities who by law 
 were charged with the duty of cleansing localities and 
 removing some of the causes of disease. 
 
 The General Board of Health, of which Sir Benjamin 
 Hall was President, did all that it could do. Medical 
 inspectors were appointed by it to visit all the parishes 
 
74 THE SANITARY EVOLUTION 
 
 most severely affected ; and the fullest and minutest 
 instructions were issued to the Boards of Guardians as to 
 the course they should pursue, and the action they 
 should take. 
 
 But several of the Boards of Guardians took no notice of 
 the instructions sent them; others sent unsatisfactory 
 replies. In not one of the parishes in which the epidemic 
 was most fatal was the preventive machinery, sanitary and 
 medical, organised in accordance with the instructions ; and 
 although some parishes did more than others, yet, speaking 
 generally, the administration of the sanitary and medical 
 relief measures by the Boards of Guardians was inefficient 
 in character and extent, except in some of the larger and 
 more healthy parishes where they were least wanted.* 
 
 At Kotherhithe, the Guardians declined to proceed with 
 the removal of nuisances as entailing a useless expense. 
 At Deptford, where cholera was at the worst, no Inspector 
 of Nuisances was appointed, even for the emergency. Nor 
 did Greenwich, where it was also bad, appoint one. In 
 Bethnal Green, where memories ought to have been bitter, 
 the authorities practically did nothing, although promising 
 almost everything. 
 
 In Lambeth, the parish was left without any adequate 
 protection against the epidemic ; and it was only after 
 urgent remonstrances by the Medical Inspector, and after 
 his threatening to place himself in communication with the 
 coroner in any cases of death occurring in localities where 
 the proper cleansing measures had not been carried out, 
 that he succeeded in obtaining the adoption of measures 
 even to a limited extent.* 
 
 In Clerkenwell, the Guardians utterly disregarded the 
 recommendations of the Board of Health, and from the 
 first there was an openly expressed determination not in any 
 way to be interfered with by the Board. 
 
 And the disastrous state of affairs was, that the Nuisances, 
 &c., Removal Acts gave the Board of Health no power to 
 enforce upon the Guardians the execution of the regulations 
 made. 
 
 * See P.P. 1854-5, vol. xlv., Reports of General Board of Health. 
 
OF LONDON 75 
 
 The whole sanitary administration — so far as any existed 
 in London — was in a state of chaos, and the various local 
 authorities were able, with absolute impunity to themselves, 
 to ignore and even defy the General Board of Health. Of 
 these authorities, as has been already said, there was a 
 multiplicity, and it was no infrequent occurrence to find the 
 administrative authority of some of them in the hands of 
 parties directly interested in the continuance of the existing 
 state of matters, evil though those were. In fact, the 
 " vested interests in filth and dirt " were a power in local 
 administration in "greater London," and the practical result 
 was that the great majority of the population of the metro- 
 polis were left without any protection against the ravages of 
 epidemic or other preventable diseases. 
 
 The indifference of Parliament, moreover, had left London 
 without any effective or systematic sanitary supervision ; 
 and in no part -of it, except the " City," was there any 
 officer conversant with the effect of local influences on the 
 health of the population, or who could advise as to the 
 sanitary measures which should be adopted. 
 
 The Board of Health having had it brought home to them 
 that, with their limited powers, they were unable to intro- 
 duce order into this chaos, or to enforce even the most 
 elementary precautions against the spread of the disease, 
 their President addressed a letter on the 29th of January, 
 1855, to Lord Palmerston, the then Home Secretary (and a 
 few weeks later the Prime Minister), in which he set forth 
 the exact state of affairs as ascertained by his own obser- 
 vation and by the experience of some of the best and most 
 well-informed medical men in London. 
 
 In this letter he summarised the main causes of the 
 insanitary condition in which the people of London were 
 forced to live. 
 
 He wrote : — 
 
 " The evidence on the localising conditions of cholera 
 given in the report of Dr. Sutherland points to the follow- 
 ing as among the more prominent of the removable causes 
 of z5n2iotic disease, 
 
 " Open ditches as sewers. Want of sewers. Badly con- 
 
76 THE SANITARY EVOLUTION 
 
 structed sewers accumulating deposits and generating sewer 
 gases. 
 
 " The pollution of the atmosphere in streets and within 
 houses from untrapped drains, from sewer ventilating 
 openings in streets, and from cesspools, whereby the 
 air was contaminated and the sub-soil saturated with 
 filth. 
 
 " Want of house drainage. 
 
 " The absence of any organised daily system of cleansing, 
 and the consequent retention of house refuse in or near 
 dwellings. 
 
 " Bad water, badly distributed. Unwholesome trades. 
 Unwholesome vapours exhaled from the Thames. Cellar 
 habitations. 
 
 " Neighbourhoods, the houses of which are closely packed 
 together with narrow overcrowded streets, alleys and courts 
 so constructed as to prevent ventilation. Houses structurally 
 defective, filthy, unventilated, and overcrowded — absolutely 
 unfit for human habitation." 
 
 And several others which need not be here enumerated. 
 
 ''Lastly, and applying to all these — multiplicity of local 
 authorities, and the want of sufficient powers in such 
 authorities to deal with these evils." 
 
 " Great as these evils are in London," he wrote, "... 
 there is not one among them that cannot be remedied if 
 proper steps be taken. 
 
 " The first and most obvious necessity in the metropolis 
 is to sweep away the existing chaos of local jurisdiction." 
 
 Included in that chaos were two Boards with great powers 
 of taxation over which the ratepayers had no control. * 
 
 One of them consisted of the persons appointed under the 
 Metropolitan Building Act of 1844, who, at a cost of 
 £24,000 a year, entirely neglected their work. The other, 
 the Commissioners of Sewers, who had demonstrated their 
 utter incapacity, the cost of whose establishment was 
 " something extraordinary," and who in the five years of 
 their existence had only attempted one great work — "the 
 
 * See speech of Sir B. Hall in 1885 in House of Commons, Hansard, 
 vol. cxxxvii. p. 715. 
 
OF LONDON 77 
 
 Victoria Sewer" — which cost a large sum, and which not 
 many years after fell to ruins. 
 
 The great epidemic of cholera, its attendant panic, its 
 gruesome accompaniments, its revelation of the actual 
 condition of the masses, and of the rottenness of the local 
 authorities, and the growing outcry against the iniquity of 
 such a state of things in a civilised and Christian country, 
 brought matters to a head. 
 
 The state of the Thames had also become a greater 
 danger than ever to the community, and a more unbearable 
 nuisance. 
 
 As described by The Lancet in July, 1855 : — 
 
 " The waters are swollen with the feculence of the 
 myriads of living beings that dwell upon the banks, and 
 with the waste of every manufacture that is too foul for 
 utilisation. Wheresoever we go, whatsoever we eat or 
 drink within the "circle of London, we find tainted with the 
 Thames. . . . No one having eyes, nose, or taste, can look 
 upon the Thames and not be convinced that its waters are, 
 year by year, and day by day, getting fouler and more 
 pestilential. . . . The abominations, the corruptions we 
 pour into the Thames, are not, as some falsely say, carried 
 away into the sea. The sea rejects the loathsome tribute, 
 and heaves it back again with every flow. Here, in the 
 heart of the doomed city, it accumulates and destroys." 
 
 And the Government, compelled at last by the force of 
 events to take some steps for the better sanitary government 
 of the metropolis, and for remedying some of the evils the 
 people suffered under, decided on taking action. 
 
 Acknowledging the necessity for giving local government 
 to "greater London " — the " City " of course already had its 
 own — it proposed the creation of a central authority which 
 should deal with certain matters affecting London as a 
 whole, and local authorities which should deal with local 
 affairs affecting their own localities. 
 
 And, in 1855, a group of measures giving effect to these 
 views, and containing also what amounted to a sanitary 
 code similar to that in the Public Health Act already for 
 years in force in England, was passed by Parliament. 
 
78 THE SANITARY EVOLUTION 
 
 Those most important measures marked the end of one 
 great period in the sanitary history of this great metropoHs. 
 
 Of that period it is to be said that there is none in the 
 history of London in which less regard was shown for the 
 condition of the great mass of the inhabitants of the metro- 
 poHs ; no period when the spirit of commerciaHsm recked so 
 Httle of the physical condition and circumstances of those 
 upon whom, after all, it depended: no period when the 
 rights of property were so untrammelled by any considera- 
 tion for the welfare of human flesh and blood; no period 
 when private individuals not alone so strained, for their own 
 advantage or aggrandisement, the utmost rights the law 
 allowed them, but far exceeded those rights, and too often 
 successfully filched from the public that to which the law 
 gave them no right. 
 
 Never had there been a time in which the rights of 
 property had been more insisted upon and exercised. Never 
 a time in which land-owners, house-owners, and builders 
 did as freely as they liked with their own, regardless of the 
 injury or damage inflicted upon others ; nor in which 
 manufacturers carried on, without interference, trades for 
 their own benefit, which were not merely offensive, but 
 actually death-dealing to their neighbours. 
 
 And throughout this period the people in their daily lives 
 and circumstances were absolutely unprotected by any 
 public authority, or by any local governing body. There 
 was no one to help them to contend against the extremest 
 exercise of real or even assumed rights. 
 
 In this period London, the metropolis, had grown up, and 
 had not merely been permitted by the Government and the 
 Legislature to grow up practically without government, 
 guidance, supervision, or restraint, but it had been absolutely 
 denied any system of local government, and so been denied 
 all provision for the sanitary needs of the community. 
 
 In 1835 a large and liberal measure of municipal self- 
 government was given to all the cities and towns and 
 municipalities large and small of England and Wales — 
 many of them not a tithe so populous as the great parishes 
 of London — and a governing body, elected by the rate- 
 
OF LONDON 79 
 
 payers, and with almost all the essential powers of local 
 government, was instituted in each. But the Municipal 
 Corporations Act expressly excluded the great towns which 
 surrounded the walls of the "City" and which constituted 
 the metropolis, and the law continued to recognise them 
 only as rural parishes. 
 
 Twelve years later, namely in 1847, the Towns Improve- 
 ment Act was passed, by which towns of much smaller 
 size were given facilities for obtaining considerable powers 
 of local government. By it general sanitary provisions 
 were framed, which, with the sanction of Parliament, 
 might be applied in any town for the management by the 
 local authorities of the supply of water, of drainage, of the 
 paving, cleansing, and lighting of the streets, and the 
 prevention of fires ; and for the regulation of buildings, 
 of slaughter-houses, of public baths, and of the interment 
 of the dead. 
 
 But even this more limited but still liberal system of 
 local government was not extended to London, and once 
 more the metropolis was excluded. 
 
 The " City " did not wish to extend its own borders, and 
 the authorities^of the " City " viewed with dislike the idea of 
 the creation at their very gates of local bodies which might 
 develop into formidable rivals. 
 
 And so " greater London " was left by successive govern- 
 ments and by Parliament to scramble along as best she 
 could, and to suffer. 
 
 And just as there was no local government so were there 
 practically no laws safeguarding the sanitary condition 
 of the people except the temporary and imperfect ones 
 provided by the Nuisances Eemoval and Diseases Prevention 
 Acts of 1848, and such very limited protection as the 
 common law afforded. 
 
 The Public Health Act of 1848 — a sanitary code in 
 itself — was an Act for England and Wales alone. The 
 benefits it conferred were refused to London ; and, as a 
 consequence, the masses of her people were doomed to 
 continue in circumstances of the utmost misery ; year by 
 year tens of thousands of her citizens were sent to an 
 
80 THE SANITARY EVOLUTION 
 
 unnecessarily early death, and ten times their number were 
 made to undergo diseases which even then were recognised 
 as preventable. 
 
 And all the time that she was thus left without a local 
 government, without any permanent sanitary laws, other 
 forces were at work inflicting ever-widening evil, and 
 intensifying already existing evils. 
 
 The population had increased by leaps and bounds, and 
 the increasing trade of London had brought great numbers 
 of workmen to the metropolis. The necessity for offices 
 and warehouses had led to the substitution of such houses 
 for houses previously used as residences. 
 
 And so the growing population was forced to herd 
 ever closer together, houses were packed thicker and 
 thicker, and, in the central districts, every available spot 
 of ground was built upon. And the overcrowding of 
 human beings in those houses, and all the attendant 
 ills, increased countless-fold. And the result was un- 
 paralleled, indescribable, unspeakable misery of the indus- 
 trial and working classes, and of the lower and poorer 
 orders. 
 
 Not merely years, but generations of neglect and in- 
 difference on the part of the governing classes had multiplied 
 and intensified in London every evil to which the poorer 
 classes of a nation are liable. 
 
 For long the great process of social and economic change 
 at work in "greater London," and all that it entailed, was 
 let go its own way — a way which, in default of the regula- 
 tion and the alleviation a government should have given 
 it, was beset with creakings and groanings like those of 
 some badly constructed piece of machinery; only instead 
 of machinery, inanimate and insensitive, they were the 
 groanings, the agonies, of suffering thousands and tens 
 of thousands of sick and perishing people, sinking annually 
 into the abyss. 
 
 All through the earlier half of the nineteenth century, in 
 fact, London, the great metropolis, was left to evolve itself 
 so far as regarded the public health and sanitary condition 
 of the people. 
 
OF LONDON 81 
 
 The tremendous import of such deliberate inaction by 
 Parliament, and by successive Governments, is even now 
 only partly comprehended. But the nemesis has been 
 truly a terrible one. The injury wrought was in many 
 ways irreparable, and we are still reaping the crop of evil 
 sown by such seed — are still far from the end of the 
 appalling consequences such a disastrous policy has entailed. 
 
CHAPTEE II 
 
 1855-1860 
 
 The Act " for the better Local Management of the 
 Metropolis " * which was passed by Parliament in 1855 was 
 the turning point in the sanitary history and evolution of 
 London, 
 
 It put a term to the chaos of local government in " greater 
 London " and swept away the three hundred trumpery and 
 petty existing local governing bodies. It created a legally 
 recognisable metropolis by defining its component parts and 
 boundaries. It established a definite system of local 
 representative government in that metropolis for the 
 administration of its local affairs. It conferred upon the 
 new authorities not only the powers vaguely possessed and 
 imperfectly, if at all, acted on by their predecessors, but 
 a considerable number of new ones. It laid the basis of an 
 organisation for the sanitary supervision of the inhabitants 
 of each parish of greater London. 
 
 And with the object of making provision for the effective 
 treatment of some of the numerous matters affecting 
 London as a whole — matters of a general and not of a local 
 character — with which smaller local authorities could not 
 possibly deal, and with the further object of securing a 
 certain uniformity of administration by the new local 
 authorities, it founded a central governing body for the 
 metropolis. 
 
 Simultaneously Parliament passed a new "Nuisances 
 Bemoval Act for England" f which was made applicable to 
 * 18 and 19 Vic. cap. 120. f 18 and 19 Vic. cap. 121. 
 
SANITARY EVOLUTION OF LONDON 83 
 
 London, and which, coupled with the health provisions in 
 the Metropolis Local Management Act, bestowed upon the 
 metropolis a sort of code of sanitary laws in some degree 
 similar to those enjoyed by other parts of England. 
 
 And also an Act* making stricter provisions as to the 
 construction of buildings in the metropolis. 
 
 Though three Acts were thus passed, they formed but 
 separate parts of one general plan of reform. 
 
 Some little detail must be gone into as regards the system 
 of local government thus initiated. 
 
 For government in purely local matters — in each of the 
 twenty-three largest parishes, definite Vestries, as distin- 
 guished from parishioners meeting in open Vestry, were 
 constituted, the members thereof being elected by the 
 householders of the respective parishes rated to the relief 
 of the poor. The total number of members on any Vestry 
 was not to exceed one hundred and twenty, and each year 
 one-third of them were to retire, and an election to be held 
 to fill their places. 
 
 And as there were many parishes so small that to have 
 constituted them separate local governing authorities would 
 have perpetuated all the evils of small areas of local 
 government, these small parishes were grouped together 
 into " districts " of a fairly large size, for each of which — 
 some fourteen in number — there was to be a governing body 
 
 entitled "The Board of Works for the District," the 
 
 members thereof being elected, not directly by the electors, 
 but by the smaller Vestries constituting the District. 
 
 These new local governing bodies were thus representative 
 bodies, the Vestries elected directly by the ratepayers, the 
 District Boards indirectly elected ; but both were constituted 
 "the sanitary authority" for their respective areas, both 
 were charged with the administration of local affairs, and so 
 the term " Vestry " and the " District Board " may be taken 
 as synonymous. 
 
 The central body which was constituted for dealing with 
 matters affecting London as a whole was named " The 
 Metropolitan Board of Works." 
 
 * 18 and 19 Vie. cap. 122. 
 
84 THE SANITARY EVOLUTION 
 
 It was not directly elected by the ratepayers of London, 
 but was elected by the aforesaid local authorities and by 
 the "City." 
 
 It consisted of forty-five members. Three were elected by 
 " the Mayor, aldermen, and commons of the City of London 
 in common council assembled." 
 
 Each of the six largest Vestries elected two of their 
 members to it ; the other Vestries one each, and the District 
 Boards of Works elected the remainder. 
 
 It was thus representative of the whole of London — City 
 and Metropolis included. Each year one-third of the 
 members were to retire, and one-third to be elected in 
 their place. 
 
 This central Board was charged with many important 
 duties affecting London as a whole. Foremost amongst 
 them was the first essential of any sanitary well-being — the 
 improvement of the sewerage and drainage of London. 
 
 This new body superseded the Commissioners of Sewers, 
 and was specially charged with the task of designing and 
 carrying out "a system of sewerage which should prevent 
 all or any part of the sewage within the metropolis from 
 passing into the river Thames in or near the metropolis : 
 and also make all such other sewers and works as they may 
 from time to time think necessary for the effectual sewerage 
 and drainage of the metropolis." 
 
 It was also given general control over the sewage works, 
 and power to make orders for controlling Vestries and 
 District Boards in the construction of sewers in their 
 respective parishes. 
 
 Furthermore it was given power to make, widen, or 
 improve, any streets or roads in the metropolis for 
 facilitating the traffic, and certain powers of prohibiting the 
 erection of buildings beyond the regular line of buildings. 
 It was given power, too, to make bye-laws — for regulating 
 the plans, level, and width, &c., of new streets and roads; 
 for the plans and level of sites for building ; for the cleansing 
 of drains, and their communication with sewers ; for the 
 emptying, closing, and filling up of cesspools ; for the re- 
 moval of refuse, and generally, for carrying into effect the 
 
OF LONDON 85 
 
 purposes of the Act — all which bye-laws were to be enforced 
 by the Vestries and District Boards. 
 
 Thus it was given large powers to deal with many of the 
 matters which most affected the public health. But in some 
 other such matters — essential for the effectiveness of the 
 whole scheme — it was left strangely helpless. It was given 
 no power to appoint a Medical Officer of Health for the 
 metropolis to advise it as to matters affecting the health of 
 London as a whole ; or to appoint Inspectors of Nuisances 
 to ascertain information upon sanitary matters and to carry 
 out various sanitary duties. 
 
 But, gravest and most deleterious defect of all, no 
 authority was conferred upon the Board to compel any 
 negligent or recalcitrant local authorities to carry out the 
 duties imposed upon them by Parliament or by bye-laws 
 of the Board. Those authorities might with absolute 
 impunity neglect to carry out even the imperative direc- 
 tions of Parliament as embodied in the Act, and thus what 
 Parliament emphatically enacted " shall " be done might 
 be left undone, with the most disastrous consequences to 
 the public health, not merely of the particular parish, but 
 to the great community of London. 
 
 The omission of some such provision made the Vestries 
 practically independent bodies, and arbiters as to the 
 administration or non-administration of various important 
 provisions of existing or future Acts of Parliament, and 
 afforded them the opportunity, so freely and widely availed 
 of, of not performing duties against their own opinions or 
 interests. 
 
 As regarded these newly created local authorities — the 
 "Vestries" and the "District Boards of Works" — the 
 powers and duties conferred upon them were extensive. 
 
 All the powers and duties of the previous local authori- 
 ties as regarded paving, lighting, watering, and cleansing, 
 or improving any parish, were transferred to them. 
 
 The sewers, other than the main sewers, were vested in 
 them, with the contingent duty of maintaining, repairing, 
 and cleansing them, and they were given power to put 
 sewers in every street. Also, they were given power, 
 
86 THE SANITARY EVOLUTION 
 
 under certain circumstances, to compel owners of houses, 
 " whether built before or after the commencement of this 
 Act," to construct drains into the common sewer. 
 
 Furthermore, no house was to be built without drains 
 constructed to the satisfaction of the Vestry, or without 
 sufficient sanitary conveniences, and they were directed to 
 cause open ditches, sewers, and drains of an offensive 
 nature, or likely to be prejudicial to health, to be cleansed, 
 filled up, and covered. And they were required to appoint 
 scavengers to collect the dirt and rubbish, or to contract for 
 its removal. 
 
 And each of the authorities was to appoint one or more 
 Medical Officers of Health, whose duty it should be to 
 inspect and report periodically upon the sanitary condition 
 of the parish or district, and who would act as medical 
 adviser to the Vestry in all matters relating to the public 
 health, and was also to appoint one or more Inspectors of 
 Nuisances to report as to the existence of nuisances or 
 disease, and perform various other duties in connection with 
 the sanitary condition of the parish. 
 
 Provision was also made for the prevention of the sale of 
 food unfit for human consumption. 
 
 The Sanitary Inspector "might at all reasonable times 
 inspect and examine any carcase, meat, poultry, game, 
 flesh, fish, fruit, vegetables, corn, bread, or flour exposed 
 for sale," and in case the same appeared to him to be 
 unfit for such food it might be seized, and the magistrate 
 might order it to be destroyed, and the person to whom it 
 belonged, or in whose custody it was found, should on 
 conviction be liable to a penalty of ^610. 
 
 By " The Nuisances Eemoval Act for England " the word 
 " nuisances " was so defined as to include any accumulation 
 or deposit which was injurious to health, " any premises in 
 such a state as to be injurious to health, any pool, ditch, 
 water-course, cesspool, drain, or ashpit, &c., so foul as to be 
 a nuisance or injurious to health." 
 
 The right to give notice to the sanitary authority of the 
 existence of a nuisance was extended, and the process was 
 facilitated. Notice might be given to the sanitary authori- 
 
OF LONDON 87 
 
 ties by the person aggrieved, by the sanitary inspector, or 
 by a constable, or by two inhabitant householders of the 
 parish ; and certain powers of entry were given to the local 
 authority or their officer. The justices who heard the case 
 might require the person offending to provide sufficient 
 sanitary accommodation, means of drainage, or ventilation, 
 to abate the nuisance, or to whitewash, disinfect, or purify 
 the premises which were a nuisance, and could inflict a 
 fine for contravention of the order of abatement ; and, if 
 the nuisance proved to exist were such as, in their judgment, 
 to render a house unfit for human habitation, they were 
 given authority even to prohibit the using thereof until it 
 was rendered fit. 
 
 Furthermore, as regarded certain noxious trades, includ- 
 ing slaughter-houses and manufactories causing effluvia, 
 which were certified by the Medical Officer of Health to 
 be a nuisance, or injurious to the health of the inhabi- 
 tants of the neighbourhood, the owner or occupier of the 
 premises might be proceeded against, and, on conviction, 
 fined. 
 
 Against the monster evil of " overcrowding " Parliament 
 made an attempt to legislate specifically, thus formally 
 recognising the necessity for dealing with it. 
 
 " "Whenever the Medical Officer of Health shall certify to 
 the local authority that any house is so overcrowded as to 
 be dangerous or prejudicial to the inhabitants, and the 
 inhabitants shall consist of more than one family, the local 
 authority shall cause proceedings to be taken before the 
 justices to abate such overcrowding, and the justices shall 
 thereupon make such order as they may think fit, and the 
 person permitting such overcrowding shall forfeit a sum not 
 exceeding forty shillings." 
 
 And an effort was also made to curtail the practice of 
 living in underground rooms and cellars by defining what 
 such a room or cellar was, and making liable to a penalty 
 " whoever let, occupied, or knowingly suffered to be occupied, 
 any room or cellar contrary to the Act."* 
 
 As money was essential for the working of the Acts, over 
 '■- Section 103 of Metropolis Local Management Act. 
 
88 THE SANITARY EVOLUTION 
 
 and above that for which rates could be levied, power 
 was given both to the Metropolitan Board of Works and 
 to the Vestries and District Boards of Works to borrow 
 money on the security of the rates, and repayable by 
 instalments, "provided always that no money should 
 be so borrowed by Vestries or District Boards without 
 the previous sanction in writing of the said Metropolitan 
 Board." 
 
 There were to be auditors of the accounts of the 
 local authorities, who were to be annually elected at the 
 same time and in the same manner as members of 
 the Vestry. 
 
 Finally, each Vestry and District Board of Works was 
 to make to the Metropolitan Board of Works an annual 
 report of its proceedings, including a report from the 
 Medical Officer of Health ; and the Metropolitan Board 
 was to make an annual report of its proceedings, and 
 present a copy to one of Her Majesty's Secretaries of 
 State. 
 
 The third of these Acts, " The Metropolitan Building 
 Act, 1855," amended the existing laws relating to build- 
 ings in the metropolis, and laid down an elaborate code for 
 the regulation and supervision of all new buildings. Most 
 of this code related to the structure — the thickness of 
 walls, &c., &c. — and had primarily in view the security of 
 the house from destruction by fire. Only a few sections 
 in the Act related to the infinitely more important 
 matter of adequate provision for the health of the 
 inhabitants, and those dealt with it in the most niggardly 
 way. 
 
 A minimum of one hundred square feet was laid down 
 as satisfying the requirements of open space for air and 
 ventilation around a dwelling; a minimum of seven feet 
 in height was held to satisfy the requirements of any room 
 in a house. 
 
 And the supervision of every building, and every work 
 done in or upon any building, was entrusted to the 
 "District Surveyors" — officials taken over by the Metro- 
 politan Board from the previous body, appointed under the 
 
OF LONDON 89 
 
 Building Act of 1844, which had distinguished itself by its 
 incapacity. 
 
 These Acts practically laid down the framework of the 
 machinery of the sanitary government of London, and 
 struck the first real blow at the roots of the insanitary 
 condition of the metropolis. 
 
 The callous indifference and inaction of generations had 
 left not a mere Augean stable to be cleansed, but a great 
 city over 100 square miles in extent and containing two and 
 a half millions of people, and the new authorities, when they 
 came into existence, had not only to meet the daily needs of 
 a vast existing population, but to make good the neglect of 
 centuries, and to build up a sound and effective working 
 system of sanitary administration. 
 
 The task lying before them was one of enormous 
 proportions, for on them rested the responsibility of 
 effecting the sanitary redemption of the millions of the 
 metropolis — as well as the infinitely greater duty of safe- 
 guarding future generations from similar sufferings and 
 wrongs. 
 
 It was, moreover, a task of almost superhuman difficulty, 
 for arrayed against reform and amelioration were the 
 powerful forces of "vested rights in filth and dirt." 
 And adding to the difficulty was the huge inert mass of 
 ignorance, and poverty, and helplessness of masses of the 
 people. 
 
 One principle contained in these Acts was of pre-eminent 
 consequence — namely, the responsibility of " ownership." 
 Hitherto owners had effectually escaped all responsibility 
 as regarded the sanitary state of their property, and had 
 dealt with their property exactly as they pleased, and 
 regardless of the consequences to any one but themselves. 
 Parliament now formally recognised and definitely laid 
 down the principle that the "owner" was the person 
 responsible for the insanitary condition of his property; 
 and in addition declared that individuals would not in future 
 be allowed to deal with their property in such a manner 
 as to cause injury to the public health. 
 But declaration of principles was one thing — their 
 
90 THE SANITARY EVOLUTION 
 
 enforcement was another. Unfortunately, those who were 
 charged with their enforcement were too often the persons 
 directly interested in resisting reform, and in very 
 many instances, where even a partial enforcement of 
 these principles was attempted, the action was resented 
 and vigorously resisted. 
 
 The Metropolis Local Management Act came into force 
 on January 1, 1856, and the Central Authority — the 
 Metropolitan Board of Works — and the local authorities 
 — Vestries and District Boards — having been duly elected, 
 entered upon their duties. 
 
 The first and most urgent work which the Metropolitan 
 Board was charged to carry out was the main drainage 
 of the metropolis, and at the outset, the new Board directed 
 its efforts almost exclusively to the highly technical task 
 of devising and considering and adopting plans for the 
 construction of a great system of sewerage which should 
 intercept the flow of sewage into the Thames, and should 
 convey it by other means to a safe distance below London, 
 whence it might flow into the sea. 
 
 Any plan had, however, to be approved by the Chief 
 Commissioner of Works. To him the Board submitted 
 three plans, but none of them received such approval, and 
 the matter was at a deadlock until 1858, when an Act was 
 passed removing the veto of the Chief Commissioner of 
 Works, and at the same time giving the Metropolitan Board 
 power to raise a loan of £3,000,000, which up to that time 
 it had no power to do. 
 
 Within a week from the passing of that Act, the Board 
 determined on a plan, and began arrangements for carrying 
 it out. 
 
 The plan adopted was to intercept all the sewage flowing 
 into the Thames within the area of the metropolis, and to 
 convey it by sewers to a distance, and to discharge it into 
 the river at such a condition of tide as should take it still 
 further out, so as not to return and become a nuisance to 
 the metropolis. The proposed interception on the north 
 side was by three main sewers, discharging at Barking — 
 the upper, the middle, and the lower, with branches ; on 
 
OF LONDON 91 
 
 the south side, by two main sewers, discharging at 
 Crossness. 
 
 As the result of the Act there had been transferred to the 
 Board 106 miles of main sewers on the north side of the 
 Thames with 33 outlets into the river, and 60 miles on 
 the south side with 31 outlets. A considerable number 
 of these were offensive open sewers, others were defective 
 in design and construction, whilst all required reconstruction 
 to make them effective, and to fit them for connection with 
 the new system. 
 
 The Central Authority had thus a heavy task before it, 
 and one which it would take years to perform. 
 
 The local authorities, with simpler duties to perform, 
 were able to get quicker to work. 
 
 They appointed " Surveyors " in each parish to look after 
 the multifarious duties in connection with the paving, 
 lighting, and cleansing of the streets, with scavenging, and 
 the removal of house and trade refuse, and with the con- 
 struction and maintenance of local sewers and drains. 
 In a sort of way some of this work had been done by the 
 previous petty authorities ; parts of it, therefore, were more 
 or less familiar, and so not wholly new. 
 
 But wholly new, and of very great importance, were the 
 appointments which the new local authorities had to make 
 for their districts of a Medical Officer of Health, and of one 
 or more Inspectors of Nuisances to help him. 
 
 The duties of the Medical Officer of Health were carefully 
 prescribed by the Act. He was to inspect and report 
 periodically upon the sanitary condition of the parish ; 
 to ascertain the existence of diseases increasing the rate 
 of mortality ; to point out the existence of any causes likely 
 to originate or maintain such diseases, as well as to suggest 
 the most efficacious mode of checking and preventing their 
 spread, and various other important sanitary duties. 
 
 These appointments were duly made, and some appoint- 
 ments also of Inspectors of Nuisances. 
 
 Herein was involved the clear recognition of another 
 principle of the utmost consequence — that of inspection — 
 a principle very naturally held in abhorrence by all sanitary 
 
92 THE SANITARY EVOLUTION 
 
 misdoers. It had previously been put spasmodically into 
 operation, and with the best effects, on the occasions when 
 Asiatic cholera was approaching or raging in the country, 
 but when the panic had subsided it was promptly dropped, 
 and every one was practically left free to commit any 
 sanitary enormity with impunity. Henceforth, however, 
 there would be the contingency of being found out for 
 breaches of sanitary laws, and the eye of the law would, 
 at least theoretically, be upon sanitary law breakers. 
 
 The majority of the Medical Officers of Health entered 
 energetically on their work, and thenceforward a constant 
 light was thrown upon the sanitary condition of various 
 parts of the metropolis by men who lived in the closest and 
 most unceasing contact with the devastating evils afflicting 
 the masses of the people. All were not equally efficient or 
 energetic — all were not equally communicative — but the 
 reports of many of them are full of interesting facts, of 
 acute and instructive comment, and of wise counsel ; and 
 though holding office at the pleasure of their employers, 
 many of these officers were courageously independent and 
 outspoken in their criticism and advice.* 
 
 Unfortunately, the reports had practically no circulation 
 beyond the members of the bodies to whom they were 
 made, if even they were read by them, and the recommen- 
 dations made therein were too often absolutely ignored 
 by those bodies, or, for reasons of self-interest, opposed. 
 
 To us now, however, these reports are of the greatest 
 value, being in many respects the most valuable official 
 records existing on the subject. We learn from them, 
 better than we do from any other source, as regards the 
 various parishes of London, the nature, and in some 
 measure the extent of the evils which existed, and the causes 
 of those evils ; we find in them opinions expressed and 
 reiterated as to the best way of remedying those evils, and 
 
 'i' There is in the library of the London County Council an almost 
 complete set of these annual reports inherited from the Metropolitan 
 Board of Works. Unless those sent to the Secretary of State, as 
 directed by the Act, have been preserved, there is no other collection 
 in existence. 
 
OF LONDON 93 
 
 accounts of the results of the efforts made to remove or cure 
 those evils. 
 
 The reports set forth facts demonstrating the appalling 
 misery which the great masses of the people of the metro- 
 polis endured ; the loathsome foulness in which vast 
 numbers of them habitually lived, and were allowed to live ; 
 the dreadful hardships they had to suffer ; the fearful moral 
 and physical contamination they underwent ; the terrible 
 death-roll — in great part preventable — and the ten or 
 twenty-fold larger roll of victims of preventable illnesses 
 and epidemics, with the consequent poverty which sickness 
 entailed. 
 
 We can bit by bit piece together from these reports 
 a realistic picture of the sanitary condition of London as 
 a whole during the successive periods of the latter half 
 of the nineteenth century, and we can discern the action 
 of the silent, steady, and irresistible economic forces which 
 unintermittently dominated that condition. North and 
 south in the metropolis, east and west, it was all the 
 same, varying only in intensity, in extent, and, in some 
 degree, in form ; a harrowing and almost incredible story. 
 And the remarkable concurrence of testimony from men 
 acting independently of each other, and resident in wholly 
 different parts of London, justifies the fullest confidence in 
 statements uniformly harmonious. 
 
 The metropolis is so large a place, with such marked 
 differences between its component parts, differences in 
 situation, and physical characteristics, and degree of de- 
 velopment — differences in wealth and poverty, and in the 
 occupations of their inhabitants — that the attempt to trace 
 any special branch of its history is beset with the greatest 
 difficulties. 
 
 Especially is this the case when the subject treated of is 
 so complex and comprehensive as that of the public health. 
 
 It is manifest that all parts of the metropolis cannot 
 be described simultaneously — whilst to go " seriatim " into 
 the history of the public health in each separate locality 
 would, by the very weight of detail, fail to convey an im- 
 pression of the subject as a whole. 
 
94 THE SANITARY EVOLUTION 
 
 The same objections apply to a " seriatim " historic 
 treatment of the different branches of the pubHc health. 
 
 Moreover, the action of the central authority has also to 
 be described in its proper place. 
 
 And, still more important, the action of Parliament, 
 and the principal Acts of Parliament relating to matters 
 affecting the public health, either directly or administratively. 
 
 How then can the subject be best treated with the object 
 of presenting the main facts of the sanitary evolution of 
 London, and deducing from them the lessons of experience 
 and guidance for the future ? 
 
 Probably by a sort of compromise between these two 
 methods — taking groups of districts instead of separate 
 districts — and groups of matters pertaining to the public 
 health, instead of separate subjects — and, furthermore, 
 dealing with the whole subject in certain definite periods. 
 Groups of parishes have already, for certain health purposes, 
 been classified into central, eastern, northern, western, and 
 southern. That classification can be adhered to here. 
 
 And inasmuch as almost the only reliable statistics as 
 to many matters relating to the public health are those 
 afforded every decade by the census, the narrative can best 
 be treated by taking decennial periods, and utilising the 
 reliable information of the census for the deduction of 
 conclusions which on any other basis might be unsound. 
 This method, then, though in many> respects imperfect, is 
 adopted as probably the best for tracing the sanitary 
 evolution of the great metropolis. 
 
 Foremost among the central group, but standing by itself, 
 and in the main outside the scope of the legislation, was the 
 " City." To the description of its condition already given 
 nothing need be added beyond the statement of the fact 
 that the great economic forces at work therein were dis- 
 playing their results in the " City " itself in very striking 
 manner. 
 
 Under their potent influence the population there had 
 begun to rapidly decHne. In 1851 it had been 127,533. 
 In 1861 it had come down to 111,784. The number of 
 inhabited houses was likewise rapidly declining. In 1851 
 
OF LONDON 95 
 
 there had been 14,483 ; in 1861 there were 13,218. Under 
 the irresistible demands for greater business and trading 
 accommodation, the inhabited houses there were being 
 rapidly converted to the more profitable purpose of business 
 offices, or warehouses. 
 
 As the number of business premises and shops increased 
 in a locality, so did the better-to-do residents leave it, 
 and migrate to pleasanter or more healthy localities. Some 
 of the houses thus vacated became promptly tenanted by 
 numerous families of a lower, or even' the lowest classes ; 
 until they too were converted to business purposes, 
 and their inhabitants once more turned adrift to seek 
 other habitation. Some of these people secured in the 
 neighbouring parishes residence in one or part of one of 
 those jerry-built and insanitary constructions which land- 
 owners and builders were erecting as rapidly as possible 
 upon any unbuilt ground which they owned, or which they 
 could lay hands upon — the majority contented themselves 
 with squeezing somehow into tenement houses already 
 overcrowded. 
 
 It cannot be too constantly borne in mind that this was 
 one of the great forces in unceasing action in the metropolis, 
 extending its sphere of action step by step, and stage by 
 stage, and that as years went on, the various districts of the 
 metropolis were, one and all, in varying degree, subject to 
 the accompaniments and consequences of its different stages 
 of growth. And the transition was further aggravated by 
 the natural increase of population, and by another great 
 force — the unceasing flow of immigrants into the metro- 
 polis, the majority in search of work, others of food given 
 by charitable people, or of any other chance good thing or 
 adventure that might turn up. 
 
 And so, on January 1, 1856, the new local authorities 
 of the metropolis began their great task. And about forty 
 Medical Officers of Health began to examine into and 
 inspect their respective districts, and to inform or advise 
 their respective authorities. 
 
 What did these men find when they got well into their 
 work ? What opinions did they form as to the fearful facts 
 
96 THE SANITARY EVOLUTION 
 
 with which they were promptly brought face to face, and 
 the great social problems with which they were confronted? 
 And what did they and their employers, the Vestries and 
 District Boards, do to carry out the legislation which 
 Parliament had at last enacted ? 
 
 The first impression of one of them was that the possessor 
 of the office of Medical Officer of Health * could never 
 become popular, " his functions bringing him into constant 
 collision with the apparent interests of many influential 
 persons ; " — in other words, with vested interests. 
 
 Others took a less personal and wider view of their duties. 
 Thus one of them f wrote : — 
 
 " We have to remodel an old system — a system on which 
 has been for centuries engrafted by slow degrees all the 
 undesirable elements we now wish to eradicate." 
 
 Another t was impressed by the vast amount to be done 
 even in his own parish : — 
 
 " From what I daily witness, I make bold to state that 
 this Vestry has a Herculean task to perform to abate all the 
 nuisances of Rotherhithe ; nuisances which have grown 
 uninterrupted for ages, and have become inveterate customs 
 with many." 
 
 If it was a Herculean task in one parish, and that a small 
 one, what was the task for the whole of the metropolis ? 
 
 Another, § after a few years' experience of the working of 
 the Act, summed up the actual position — the very kernel 
 of the case — when he wrote : — 
 
 " The working of the Metropolis Management Act might 
 often be characterised as a war of the community against 
 individuals for the public good." 
 
 And that is what, undoubtedly, it amounted it. Hitherto 
 the " individuals " had had their own way unchallenged and 
 unchecked, and countless thousands of the community had 
 been sent to their doom. Now, in a sort of way, it was to 
 be a war — a very just and necessary, and on the part of the 
 community a bloodless war — to enforce upon land-owners, 
 and house-owners and house-middlemen, obedience to the 
 principle that " property has its duties as well as its rights," 
 
 * St. Giles. t Fulham. | Rotherhithe. § Hackney. 
 
OF LONDON 97 
 
 and that those individual rights should not be exercised — as 
 they had hitherto so cruelly been — to the mortal injury of 
 vast numbers of the community. 
 
 And there was yet another aspect of their work being a 
 war. It was war against disease and filth, and all the causes 
 of insanitation, and against the consequent human suffering 
 and misery, and degradation, in some of the very worst 
 forms. 
 
 That, unfortunately, was a never-endable war. Great 
 successes might be won — complete and final victory never. 
 
 The central group of parishes and districts outside the 
 "City" — and lying to the north and west of the "City," 
 consisted of St. Luke, Clerkenwell, Holborn, St. Giles', the 
 Strand, and St. Martin-in-the-Fields, with a population of 
 close upon 288,000 — about one-ninth of that of the metropolis. 
 Already in four of these, under the influence of the economic 
 forces already described, the population was decreasing. 
 Every portion of this central group was densely populated, 
 and it contained two of the most crowded of all the areas 
 of the metropolis — the Strand, which stood highest, and St. 
 Luke's, which had " the questionable distinction " of being 
 the second most densely populated parish. In St. Giles', 
 which was ** amongst the oldest, most densely peopled, and 
 most deteriorated portions of London," the population in 
 1851 " did not appear capable of further increase, the district 
 being incapable of expansion either by packing closer or by 
 the addition of new houses." 
 
 The eastern group consisted of the parishes or districts 
 of Shoreditch, Whitechapel, Bethnal Green, Mile-End- 
 Old-Town, St. George-in-the-East, Limehouse, and Poplar. 
 In Whitechapel the population was stationary ; in all the 
 others increasing. 
 
 The northern group of parishes and districts consisted of 
 Hackney, Islington, St. Pancras, St. Marylebone, and 
 Hampstead. 
 
 In every one of these the population was on the increase, 
 slightly in St. Marylebone, very rapidly in most of them, 
 notably so in St. Pancras and Islington. 
 
 The western group consisted of Westminster, St. James', 
 
98 THE SANITARY EVOLUTION 
 
 St. George (Hanover Square), Paddington, Kensington, 
 Fulham, and Chelsea. 
 
 In St. James' the population was decreasing (having 
 reached its apogee in 1841) ; in Westminster it was slightly 
 increasing ; in all the others rapidly increasing. 
 
 The southern group, with a population roughly of about 
 700,000, consisted of the whole of that portion of the 
 metropolis which was situate on the south side of the 
 river. Beginning on the west, there was Wandsworth 
 (which included Battersea), then Lambeth, Camberwell, 
 Lewisham, with Woolwich and Plumstead on the extreme 
 east, then Greenwich, Rotherhithe, Bermondsey, St. Mary, 
 Newington, St. George-the-Martyr, Southwark, St. Saviour, 
 Southwark, and St. Olave, in Southwark. 
 
 Many of these were still mostly country. 
 
 The various parishes and districts of the metropolis 
 differed remarkably in their rate of increase of population. 
 In all, the number of births was in excess of the number 
 of deaths, but as this excess in no way accounted for the 
 increase in many of them, the rest of the increase could 
 only be accounted for by immigration — immigration either 
 from other parishes or from outside London. 
 
 And as it was with population so it was with the houses 
 in which the people dwelt. 
 
 In most of the central parts of London, houses crowded 
 every available scrap of land, squares and open spaces being 
 few and far between. Where there should have been streets of 
 good width, there were narrow lanes of houses ; where there 
 should have been thoroughfares, there were cul-de-sacs; 
 where there should have been space for through currents 
 of air and for light, there were brick walls stopping both 
 light and air. 
 
 Figures giving so many houses to the acre convey little 
 actual idea of the density of houses. Far more suggestive 
 is such a statement as that made by the Medical Officer of 
 Health in Limehouse (1861) that: "There would be no 
 difficulty in marking out courts and alleys where the 
 problem would seem to have been with the originators, 
 how to enable the greatest number of people to live in the 
 
OF LONDON 99 
 
 smallest amount of space." Or the description of St. Giles',* 
 where, " exclusive of mews, there may be counted on the 
 map upwards of seventy streets, courts, and alleys, in which 
 there is no thoroughfare, or which are approached by 
 passages under houses." Nor is it a matter of surprise 
 that this state of things should have come about, when 
 hitherto there had been practically no check whatever upon 
 building. 
 
 "It is to be regretted," wrote the Medical Officer of 
 Health for Mile-End-Old-Town about his own district 
 (1856), "that the great increase in the number of habita- 
 tions should have been allowed to take place without some 
 municipal direction, or some supervision competent to 
 supply its place ; the general salubrity of the district would 
 certainly have been better secured. . . . But every owner 
 of a piece of ground has had the opportunity of making the 
 most of it for his - own advantage and in real opposition to 
 the public good." 
 
 In nearly all the non-central parts of London houses were 
 increasing rapidly. 
 
 " Bricklayers are spreading the webs and meshes of houses 
 vdth such fearful rapidity in every direction that people are 
 being gradually confined within narrow prisons only open at 
 the top for the admission of what would be air if it were 
 not smoke. 
 
 " Suburban open spaces are being entombed in brick and 
 mortar mausoleums for the suffocation as well as for the 
 accommodation of an increasing populace." t 
 
 Thus in Islington there were 13,500 houses in 1851, and 
 20,700 in 1861 ; in Kensington 6,100 in 1851, and 9,400 
 in 1861. 
 
 But what evoked comment was, that the evils of one sort 
 or another connected with the crowding of houses together 
 were being perpetuated. 
 
 " Not only is it to be deplored," wrote the Medical Officer 
 of Health for Whitechapel, " that the houses in most of the 
 poor neighbourhoods are already too closely packed together, 
 
 * Medical Officer of Health, 1856. 
 
 t " Lungs for London," Household Words, vol. i. p. 45, 1850. 
 
100 THE SANITARY EVOLUTION 
 
 but the evil is increasing : for wherever there is a vacant 
 spot of ground, more houses are built, thereby still further 
 diminishing the healthiness of those already existing " 
 (1860-1). 
 
 From Hampstead — still but little built on — came a com- 
 plaint of " the tendency among builders to cover the new 
 ground as thickly and at as little cost as practicable." 
 
 In Wandsworth " houses were erected and new streets 
 formed without due regard to sanitary requirements, and in 
 situations where good drainage seems impossible." 
 
 In Fulham, " cottages out of number were constructed in 
 the excavations of old brick fields with the soft refuse of 
 bricks, habitations run in swamps and quagmires, and their 
 foundations three parts of the year sopped with surface 
 water." 
 
 Efficient sewerage was so manifestly the basis of all wise 
 sanitation that the want of sewers, and the abominable 
 condition of those which existed, were general subjects of 
 complaint. 
 
 The Strand boasted of being " one of the best sewered 
 districts in the metropolis," which, however, was not saying 
 much for it. And in St. Giles' the sewerage was stated to 
 be good, and "much above the average of the town." 
 
 But such reports were quite exceptional. In Hackney, 
 the principal sewer was the former Hackney Brook, which, 
 from the increase of the population, and the drainage from 
 other sewers, houses, cemeteries, and cattle-market, had 
 become a foul open ditch — with very trifling exception 
 wholly uncovered — and " emitting pestiferous noxious 
 effluvia." 
 
 In St. Marylebone, the sewers, themselves insufficient for 
 the requirements of a growing population (1858), were, in 
 many cases, so shallow as to cause rather than remove evil, 
 for in certain places they flooded the basements, and in 
 more than one house was witnessed the curious spectacle 
 of the daily use of pumps to remove the foul liquids, as in 
 leaking ships. 
 
 In Paddington (1857-8), "the principles of good town 
 drainage were completely ignored. The sewers were those 
 
OF LONDON 101 
 
 which had been constructed at intervals, previous to 1846, 
 in a piecemeal and unsatisfactory manner, as the thorough- 
 fares were formed, vnthout any regard to the requirements 
 of the adjoining streets." The general direction of these 
 sewers was " extremely defective. Numbers of them have 
 a fall towards the summit or highest level of the street 
 through which they pass ; the bottoms are very irregular, 
 running up and down and forming successions of hills and 
 hollows." 
 
 In Fulham, there existed scarcely the trace of a main 
 sewer, open sewers and filthy ditches, conveying some part 
 of the sewage to the river, the rest remaining in the 
 cesspools. 
 
 In Hammersmith, not only were sewers and ditches in a 
 most fearful state of nuisance, but there was also " a morass 
 of several acres in. extent, having no outlet, which received 
 the sewage from a large area, the noxious emanations 
 from which must be regarded as highly detrimental to 
 health." 
 
 On the south side of the river matters were still worse. 
 The greater number of the southern districts were situate 
 nearly on the same level as high-water mark, if not indeed 
 below it, and they differed from the other districts of 
 London in their marshy character, their low level, and 
 in the want of proper drainage dependent on that low 
 level. The whole district suffered under the effects of a 
 tide-locked, pent-up system of sewerage. 
 
 In Greenwich, a very large number of streets were with- 
 out main sewers. 
 
 In St. Mary, Newington, "the great fact meeting us at 
 every turn has been the large number of streets without 
 main sewers therein." 
 
 Eotherhithe, which lay from four to seven feet below high 
 water, was exceptionally bad. The largest portion of the 
 parish had no drainage whatever. There were about fifteen 
 miles of open ditches which had been converted into open 
 sewers, called in some official documents " Stygian pools," 
 and serving "the double debt to pay of watercourse and 
 cesspool." Among the ditches "one of the foulest in the 
 
102 THE SANITARY EVOLUTION 
 
 whole neighbourhood of London " was the King's Mills 
 stream, about one and a half miles long, which had not been 
 cleansed for ten years. The sewer in Paradise Eow was "in 
 reality not a sewer," but "an elongated cesspool a mile in 
 length," and during twenty hours daily it was waterlogged. 
 The very boundary line of the parish for a long distance 
 was " a wide, filthy, black, open sewer." 
 
 In part consequent on the lack of sewers, house drainage 
 was either non-existent or fearfully defective. In every 
 part of the metropolis the evil was evident. 
 
 In Clerkenw^ell the " drainage was either none or very im- 
 perfect. Numberless houses do not drain into the sewers." 
 In St. Martin-in-the-Fields, " in the old streets and courts 
 the drainage was the same as it was when the houses were 
 built, some as far back as the reign of Elizabeth, and many 
 in that of Charles I." 
 
 In St. George-in-the-East (1856), " it is astonishing how 
 few houses have availed themselves of the sewers," 
 
 In Paddington, " the condition of the house-drains is far 
 worse than that of the sewers. They include every possible 
 variety of geometrical construction, from a circle to a 
 square. Some have fallen in ; others are choked with 
 filth." 
 
 In Lewisham (1856-7), " in several places there are 
 reported to be nuisances of the usual character . . . cess- 
 pools, no water, &c. — stinking ditches filled with sewage 
 which can get no further — every abomination, and people 
 apparently doing what they pleased as regards getting rid of 
 their filth." 
 
 Nor was it only in the poorer parts of London that the 
 house-drainage was bad. In St. James' (Westminster) the 
 Medical Officer of Health wrote (1861) :— 
 
 " For the last two or three years the worst cases of 
 neglected drainage have not been in houses inhabited by 
 the poor, but in those inhabited by the wealthier classes 
 of the community. It is to me frequently a matter of 
 great astonishment to find how regardless those classes 
 are, whose circumstances can command every comfort of 
 life, of the sources of disease and death. This is not only 
 
OF LONDON 103 
 
 seen in neglect of attention to drainage, but also in the 
 neglect of ventilation." 
 
 Nor was care being taken to provide drainage even to 
 houses which were in course of erection. The Medical 
 Officer of Health for Hackney, which was a growing 
 district, reported (1858-9) : — 
 
 "Building operations have recently been carried on with 
 considerable activity, numerous new streets have been laid 
 out and built on. . . . Unfortunately there have not been, 
 and there are not at the present time, any means whereby 
 the construction of proper drainage works could be enforced 
 before the erection of buildings along the line of new 
 streets, and the consequence has been that, to avoid the 
 heavy cost of constructing effective sewers, the drainage 
 works have been almost everywhere but very imperfectly 
 carried out, and in many cases not even a brick has been 
 laid for these purposes." 
 
 The internal condition of the houses was very bad. 
 
 In Clerkenwell, where there were over 7,000 houses, 
 many of them were "quite unfit for human habitation"; 
 not more than one-third were "in a satisfactory state." 
 In Bethnal Green there were " disease-inviting houses " ; 
 in Whitechapel, such was the bad condition of many of 
 the 2,734 houses which were inspected, that "they ought 
 to be condemned as unfit for human habitation." 
 
 In St. George-in-the-East, " the sanitary condition of 
 the dwelling-houses is deplorable." 
 
 Lambeth contained a greater number of inhabited houses 
 than any other parish in the metropolis — nearly 22,000. 
 The Medical Officer of Health, after the very limited 
 inquiry possible within the first year of work, reported 
 the unwholesome condition of 1,638 of them. 
 
 From figures such as these — and they related to only a 
 tiny fragment of the whole — one can get some measure of 
 the way the sanitary condition of the houses throughout 
 London had been neglected, and the indifference of the 
 owners to the condition of the premises they let. 
 
 Mention has been made of the vast number of cesspools 
 which existed in London before the passing of the 
 
104 THE SANITARY EVOLUTION 
 
 Metropolis Local Management Act. The investigations 
 of the various Medical Officers of Health soon demon- 
 strated that the previous estimates of their prevalence, 
 and of the disastrous consequences they entailed, had 
 been in no way exaggerated. 
 
 Their disastrous results were at once recognised. 
 
 The Medical Officer of Health for Whitechapel, in his 
 report for 1858, wrote : — 
 
 " I must now direct your attention to the most important 
 subject, in a sanitary point of view, which can be brought 
 before you. I allude to the existence of cesspools, more 
 especially such as are situated either in the cellars of 
 inhabited houses, or in the small backyards, which are 
 surrounded by the walls of houses filled with lodgers . . . 
 
 " No cesspool ought to be allowed to exist in London, for 
 wherever there is a cesspool, the ground in its vicinity is 
 completely saturated with the foul and putrefying liquid 
 contents, the stench from which is continually rising up 
 and infecting the air which is breathed by the people, and 
 in some instances poisoning the water which is drawn 
 from the public pumps. . . . 
 
 "I am thoroughly convinced by the result of experience, 
 that the existence of cesspools and overcrowding are the 
 chief causes of ill-health." 
 
 And the Medical Officer of Health for Camberwell wrote : — 
 
 ". . . Of all the abominations which disgrace and pollute 
 the dwellings of the poor, the imperfect, rarely emptied, and 
 overflowing cesspools are by far the worst . . . they not 
 merely poison the atmosphere without, but pour their 
 emanations constantly, silently, deadly, into the interior 
 of the houses themselves." 
 
 Upon the quality and supply of the water which was 
 essential for the life of the people, and upon which their 
 health, and cleanliness, and sanitation absolutely depended, 
 the information supplied by the Medical Officers of Health 
 as to their respective districts brings home, far more than 
 any general descriptions do, the full import and actualities 
 of the great evils endured by the people, and the disastrous 
 consequences entailed upon them. 
 
OF LONDON 105 
 
 As to the water from the surface and tidal wells, which 
 large numbers of them used and consumed, the opinion, 
 though expressed in various terms, was unanimous. 
 
 From Shoreditch (1860), the Medical Officer of Health 
 wrote: "I have hardly ever exposed a sample of town 
 spring water to the heat of a summer day for some hours 
 without observing it to become putrid." 
 
 In St. Giles' (1858-9), "the water of the wells was 
 not deemed good enough (on analysis) for watering the 
 roads." In St. Marjdebone "44 public wells supplied water 
 which was for the most part offensive to taste and smell." 
 In Kensington (1860) " all the well waters of the parish were 
 foul." In Eotherhithe (1857), " The water from the tidal 
 well smelt as if it had recently been dipped from a sewer." 
 
 The Medical Officer of Health for Lambeth declared (1856) 
 that "the shallow well waters of London combined the 
 worst features — they represent the drainage of a great 
 manure bed." 
 
 The people were driven to the use of the water from these 
 wells owing to the deficient and intermittent supply of 
 water by the various Water Companies — water supplied 
 for less than an hour a day by one single stand-pipe in 
 a court containing hundreds of people — water supplied 
 only every second and third day, and none on Sundays, the 
 day of all others on which it was most wanted ; and the 
 house-owners had provided no cisterns or reservoirs of 
 proper capacity, and the Vestries had not compelled the 
 house-owners to do so. 
 
 In some parishes hundreds of houses had no supply at 
 all. In some houses which had a supply the tenants were 
 deliberately deprived thereof by the Water Companies, 
 because the house-owner had not paid the -water-rate. 
 
 The defective supply had the disastrous effect of putting a 
 constant premium upon dirt — dirt of person, of room, of 
 houses, and their surroundings. And such drains and 
 sewers as there were, were insufficiently flushed. 
 
 Time after time the consequential evils were pointed out, 
 and Water Companies and house-owners were vigorously 
 censured. But the censure had little practical effect. 
 
106 THE SANITARY EVOLUTION 
 
 The great inconveniences and evils, however, evoked 
 the expression of opinion that the duty of supplying 
 water to the community ought to be in the hands of the 
 community. 
 
 Even in 1844 it had been pointed out that : — 
 
 " Water is as indispensable for many purposes as air is 
 for life itself, and its supply ought not to be allowed to 
 depend on the cupidity or caprice of landlords or "Water 
 Companies." 
 
 And the Metropolitan Sanitary Association had enunciated 
 the principle : — 
 
 " That inasmuch as water is a prime necessity of life, 
 attainable in large cities by combined effort only, and not 
 to be denied to any without injury to all, its supply should 
 not be dependent on commercial enterprise, but be pro- 
 vided at the expense of the community for the common 
 benefit." 
 
 And the Medical Officer of Health for St. George-in-the 
 East wrote in 1856 : — 
 
 " The water supply of your Parish is in the hands of a 
 Joint Stock Company, called the East London Water 
 Company, and is managed by persons who represent solely 
 the interest of the shareholders, whose only anxiety is of 
 course the dividends — the consumers are not represented at 
 all. This appears to me to be a strange anomaly, a false 
 position, and a monstrous inconsistency — as great as if the 
 sewerage of London were committed to a Joint Stock 
 Company. But so it is, and however great the danger, 
 the Vestry has no available remedy whatever in its 
 hands." 
 
 The principle had been conceded by Parliament so far as 
 England was concerned — the large cities and even small 
 towns having been authorised to undertake the supply of 
 water ; but London, the capital, was denied the power to 
 do so — the duty was given to private companies, and the 
 population of London was left to undergo untold sufferings. 
 
 The quality of the water supplied by most of the Water 
 Companies after the intakes had been removed to above 
 Teddington Lock, and the filtration thereof before dis- 
 
OF LONDON 107 
 
 tribution for domestic use had been made compulsory, 
 was considerably improved. 
 
 But the filthy and dangerous character of the recep- 
 tacles provided in many houses for it undid much of the 
 good which would have come from the improvement in 
 quality. 
 
 The description given by one of the Medical Officers of 
 Health was in the main true : — 
 
 " There is disease and death in the tanks, wells, and 
 water-butts." 
 
 Thus, in the great primary necessities of the public health 
 — efficient sewerage and drainage, decent houses, good 
 ventilation, pure air, a pure and ample water supply — the 
 general conditions were almost inconceivably bad. 
 
 These evil conditions, however, were far from con- 
 stituting the whole of those under which the people of 
 London suffered. 
 
 Over and above them all was one which compelled the 
 attention of the Medical Officers of Health the moment they 
 had entered on their duties — "the gigantic evil," "the 
 monster evil " of overcrowding. Not the mere crowding of 
 houses together, evil though that was, but the overcrowding 
 of people in those houses, and still worse, the overcrowding 
 of the rooms of those houses by human beings. In every 
 part of the metropolis there was overcrowding ; worst in 
 the centre, and the parts nearest the centre of London, but 
 existing in the outer districts where houses still were 
 comparatively few and population small. Centre, East, 
 North, West, South, there was overcrowding, differing only 
 in extent and acuteness of form. 
 
 " Soon after I was appointed as Sanitary Adviser to your 
 Board," wrote the Medical Officer of Health for Holborn 
 (1856-7), " I found, dwelling in houses which were 
 undrained, waterless, and unventilated, whole hordes of 
 persons who struggled so little in self-defence that they 
 seemed to be indifferent to the sanitary evils by which they 
 were surrounded. 
 
 "It is too true that among these classes there were 
 swarms of men and women who had yet to learn that 
 
108 THE SANITARY EVOLUTION 
 
 human beings should dwell differently from cattle, swarms 
 to whom personal cleanliness was utterly unknown, swarms 
 by whom delicacy and decency in their social relations were 
 quite unconceived, ..." 
 
 He mentions some instances too horrible to quote, and 
 says : " Such were instances that came within my own 
 knowledge of the manner and of the degree in which 
 persons may relapse into habits worse than those of savage 
 life, when their domestic condition is neglected, and when 
 they are suffered by overcrowding to habituate themselves 
 to the lowest depths of physical obscenity and degradation." 
 
 In St. Luke " the houses swarmed with their human 
 tenants." In Bethnal Green "our crowded streets and 
 courts are becoming more crowded." In St. Pancras "in 
 many houses the overcrowding is very great, each room 
 being occupied by a family." 
 
 In Islington, so overcrowded were some of the houses 
 that the Medical Officer of Health had met with as little as 
 220, 190, 170, down to 135 cubic feet of air available for 
 each occupant of a room. 
 
 In Eotherhithe " almost all the houses were overcrowded 
 with inmates." 
 
 In Westminster, the Medical Officer of Health gave (in 
 1858) fifty examples of overcrowding in his district. In one 
 house, in a room 13 feet long by 9 wide, and 7 feet high, 
 there were 5 adults and 3 children ; and in a lower room in 
 the same house, 10 feet long by 9 wide, and 8 high, there 
 were 4 adults and 5 children. 
 
 There are no statistics whatever showing even approxi- 
 mately the number of cases at that time in which a single 
 room was occupied by a family, but it is certain that vast 
 numbers of families had to be content with that limited 
 accommodation. Nor was that even the worst — for, in 
 very many cases, more families than one lived in a single 
 room, or the single family took in one or more lodgers. 
 
 Life under such circumstances must have been, and 
 was, awful. The Medical Officer of Health for St. Giles' 
 wrote : — 
 
 " The houses whose rooms are occupied by single families 
 
OF LONDON 109 
 
 were last year in a condition of squalor and overcrowding 
 which it is difficult to conceive surpassed. . . . 
 
 "In Lincoln and Orange Courts, the most glaring violation 
 of the laws of health and of the requirements of civilised 
 life was found. For instance, there are several small rooms 
 in the backyards of Church Lane. . . . Each of the rooms 
 measures about 10 feet by 8, and between 6 and 7 feet high. 
 Each of them serves a family for sleeping, cooking, and all 
 domestic needs. 
 
 "... The air of these rooms was unbearable to a visitor, 
 and to open the window was only to exchange one foul 
 emanation for another." 
 
 And the Medical Officer of Health for Clerkenwell wrote 
 (1856) :— 
 
 **Li thousands of instances in this district, living, 
 cooking, sleeping, and dying ... all go on in one 
 room. ... 
 
 "If a poor man gets married he is pretty sure to have 
 a large family of children, and at the present rate of 
 mortality several will die of zymotic disease. 
 
 " Hence, when a death occurs, the living and the dead 
 must be together in the same room ; the living must eat, 
 drink, and sleep beside a decomposing corpse, and this in 
 usually a small, ill-ventilated room, overheated by a fire 
 required for cooking, and already filled with the foul 
 emanations from the bodies of the living and their impure 
 clothes. 
 
 " This is an everyday occurrence in Clerkenwell, and 
 constitutes a formidable evil." 
 
 So great was the pressure for accommodation of some 
 sort or kind, that even the cellars and kitchens in the 
 basements of the houses were occupied as dwelling-places 
 and overcrowded. 
 
 In St. James', "the worst feature of the overcrowding 
 was the very common practice of residence in cellars or 
 kitchens. In the majority of cases the places are quite 
 unfit for human residence. 
 
 "... A cellar in St. Giles'," wrote the Medical Officer 
 of Health for that district in 1858, "has been the by- word 
 
110 THE SANITARY EVOLUTION 
 
 for centuries to express a wretched habitation unworthy of 
 humanity. 
 
 "Dating from the time of Charles I., the underground 
 dweUings of our district attained the acme of their 
 miserable notoriety from the pen and pencil of Fielding 
 and Hogarth. 
 
 "... The Building Act of 1844 contained stringent 
 clauses against the use of such rooms unless they possessed 
 requisites of area and ventilation, such as were out of the 
 question in the cellars of St. Giles'. 
 
 " The Metropolis Management Act (1855) repeated the 
 prohibition of 1844, and in defence of the public health the 
 Board have lately put this statute in force. This has been 
 done without compromise. As separate habitations for 
 occupation by human beings at night ' a cellar in St. Giles' ' 
 is no longer to exist." 
 
 This was written in 1858, but in the following year he 
 wrote : — 
 
 " The profit derived from letting the basement of these 
 houses as dwelling-rooms was too strong a temptation for 
 their owners, and many of the kitchens were let again as 
 soon as the Inspector had reported them emptied." 
 
 In the Strand (1856) underground rooms and kitchens 
 were inhabited " notwithstanding that District Surveyors 
 are numerous, and that the Metropolitan Building Act is 
 in operation." 
 
 In Westminster, " an examination of various portions of 
 the parishes shows that large numbers of the poor occupy 
 premises whereby they are not only deprived of the required 
 quantity of air, but being situated below the level of the 
 street, the ventilation is insufficient, the rooms generally 
 damp, and when closed for the night the atmosphere is 
 perfectly insufferable — mostly kitchens and cellars, evi- 
 dently never intended to be used as sleeping rooms " 
 (1858-9). 
 
 The causes of the dreadful overcrowding which existed so 
 extensively were many and deep-seated — springing from the 
 very roots of the social and economic system. And they 
 were of great force and widespread in effect. 
 
OF LONDON 111 
 
 The cause to which the various authorities and Medical 
 Officers of Health directly attributed it was the one 
 immediately before their eyes — namely, the pulling down 
 of houses which hitherto had afforded shelter, of a sort, to 
 the people. 
 
 As the Medical Officer of Health for St. Olave, Southwark, 
 said (1860-1) :— 
 
 " To effect street improvements — to build warehouses, or 
 for some other purpose — the habitations of the working 
 classes are broken up without any provision being made for 
 them elsewhere. They are therefore driven by necessity to 
 crowd into other houses in the same neighbourhood perhaps 
 already overcrowded." 
 
 An actual illustration was the case reported by; the Medical 
 Officer of Health for Limehouse : — 
 
 " The London Dock Company have, for the purpose of 
 enlarging and improving their docks, pulled down not less 
 than 400 houses in the parish of Shadwell, the homes of not 
 fewer than 3,000 persons of the poorer classes. 
 
 "... The neighbouring parishes are now suffering from 
 an augmentation of their already overcrowded population." 
 
 The District Board of St. Saviour, Southwark, stated that 
 the evil of overcrowding " can scarcely be exaggerated, 
 whether it be regarded in a physical, mental, or moral 
 aspect." 
 
 The principal of the causes are : — 
 
 " (1) The arbitrary power exercised by railway companies 
 in ejecting the labouring classes from their homes without 
 any obligation to provide for their domestic convenience. 
 
 " (2) The existing law of (poor law) removal, any break in 
 the three years' residence in the parish rendering them 
 liable to removal to other distant parishes." 
 
 The latter had, however, most probably, but very small 
 effect. 
 
 A great cause was that described by the Medical Officer of 
 Health for Shoreditch : — 
 
 " There is a constant and rapid flow of population into 
 Shoreditch. It is in this circumstance that I see one of the 
 most alarming dangers to the health of the district. 
 
112 THE SANITARY EVOLUTION 
 
 '* The area does not enlarge, and yet year after year dense 
 crowds of human beings are packed and squeezed into that 
 limited area. The growth of the population has far 
 outstripped the growth of the house accommodation. 
 
 " The immense majority of the immigrants are precisely 
 of that class which most largely increases the dangers of 
 disease by thickening the population. You are largely 
 burdened with the pauperism of other and wealthier dis- 
 tricts. The burden is doubly grievous ; for it taxes your 
 property, your labour, and gives strength to the elements of 
 disease amongst you. 
 
 "It is probable that there is no spot in London more 
 crowded with life than many places in Holywell or St. 
 Leonard's. 
 
 "Typhus — a disease more terrible than cholera — has made 
 itself at home in the parish." 
 
 And the Medical Of&cer of Health for Fulham wrote 
 (1857) :— 
 
 "... The daily necessities of the labourer's family draw 
 so heavily on his earnings as to leave only a very small sum 
 for the payment of rent, and hence the most limited house 
 accommodation is sought for and endured. ..." 
 
 The most powerful cause of all, however, was, un- 
 doubtedly, the overpowering instinct of self-preservation, 
 or, in other words, the need of working, no matter under 
 what conditions, for the only means of obtaining food for 
 themselves and their families. That, as a rule, necessitated 
 their being near the work to be done — and rather than lose 
 that work any conceivable hardship or abomination would 
 be put up with. 
 
 Another of the great causes of overcrowding was high 
 rent. 
 
 "It must not be imagined," wrote the Medical 0£&cer of 
 Health for the Strand (1858), "that this system of over- 
 crowding is altogether a direct consequence of a state of 
 poverty. It certainly does not appear to be so, for among 
 the Metropolitan Districts the Strand ranks seventh in 
 order of wealth. 
 
 " The overcrowding seems to be partly a result of the 
 
OF LONDON 113 
 
 high rental which the houses and rooms of many parts of the 
 district — so peculiarly well situate for business purposes — 
 command, and partly of the * middleman ' system, in which 
 so many of the houses in the occupation of the poorer 
 residents are let. 
 
 "The 'middleman' system, which obtains so largely in 
 this metropolis, in the letting of houses of the kind referred 
 to, is ruinous in its action upon the working classes. The 
 rent paid for a single room often exceeds a sixth or fifth of 
 the total income of the family. ..." 
 
 In a case in Bow Street Police Court it was given in 
 evidence that 21, Church Lane, St. Giles', was rented of 
 the owner for £25 a year — that the rents recovered from the 
 sub-tenants were £58 10s. — and the rents received by these 
 sub-tenants from lodgers £120 per annum.* 
 
 Overcrowding was not confined to the sleeping places of 
 the people, for the same causes which cramped the available 
 space for people at night, cramped also the space for very 
 many of them during the day when they were away from 
 their so-called homes. 
 
 Of the overcrowding in factories and workshops, where so 
 many of the working classes spent their days, and of the in- 
 sanitary conditions in which they there worked, no mention 
 is made in these earlier reports of the Medical Officers of 
 Health, not because there were not any, but because the 
 inspection or regulation of factories and workshops did not 
 come within the sphere of their duties. Evidence in plenty 
 there is on this branch of the subject in later years from 
 those who could speak with authority in the matter, and 
 it will be referred to hereafter, and that the state of 
 things then described is equally applicable to this period 
 is an inference so legitimate as to be tantamount to a 
 certainty. That the bad conditions under which the 
 workers worked were a great contributing factor in the 
 insanitary condition of the people is a fact as to which 
 there can be no question. 
 
 Mention is made, however, of the overcrowding which 
 existed in another large section of the community — 
 * P.P. 1852-3, vol. Ixxviii. p. 327. 
 9 
 
114 THE SANITARY EVOLUTION 
 
 namely, the overcrowding of children in some of the schools. 
 The Medical Officer of Health for Whitechapel reported 
 that there was much overcrowding, and in his report for 
 1857 gave some instances of it in his district : — 
 
 18, Charlotte Street. — In a room 8 feet high, 7 wide, 
 10 long : 14 children and 1 mistress = 37 cubic feet 
 each. 
 
 17, Charlotte Street. — Matters still worse ; the room was 
 underground ; 10 feet wide, 10 long ; about 7 feet high ; 
 35 children and 1 mistress = 20 cubic feet each. 
 
 2, Gorelston Street. — 672 cubic feet ; 31 children and 
 1 mistress = 20 cubic feet each. 
 
 In such cases the atmosphere must have been a rapid 
 poison to those breathing it. 
 
 There was another powerful contributory cause to the 
 general insanitation of London, namely, the defilement 
 of the atmosphere which people had to breathe. As 
 one of the Medical Officers of Health said some years 
 later : — 
 
 " We should remember that the air we breathe is as 
 much our food as the solids we eat and the liquids we 
 drink, and as much care should be taken that it is free 
 from adulteration." 
 
 London was already the greatest manufacturing city in 
 the world, and the great volumes of smoke proceeding from 
 the numerous factories undoubtedly deteriorated the quahty 
 of the air. But it was the noxious vapours proceeding from 
 the various processes of manufacture classified as " noxious 
 trades " which rendered the atmosphere in many parts of 
 London dangerous to health. 
 
 Many were the descriptions given of the almost intolerable 
 evils. Thus the Medical Officer of Health for Eotherhithe 
 reported in 1857 : — 
 
 " In the mile length of Eotherhithe Street there are no 
 less than nine factories for the fabrication of patent manure, 
 that is to say, nine sources of foetid gases. The process 
 gives out a stench which has occasioned headache, nausea, 
 vomiting, cough, &c. Many complaints have been made by 
 the inhabitants." 
 
OF LONDON 115 
 
 From St. Mary, Newington, "the terrible effluvium of 
 bone-boiling is freely transmitted over the district." 
 
 Some manufacture in a yard in Clerkenwell (1856-7), 
 which had existed until lately, v^^as " one of the most 
 abominable, exceeding anything that the imagination could 
 picture." 
 
 And in every parish or district of London there were 
 slaughter-houses. 
 
 " There are too many slaughter-houses in crowded dis- 
 tricts," wrote the Medical Officer of Health for St. Pancras 
 (1856-7). "It is impossible that slaughtering of animals 
 can be carried on amongst a dense population without 
 proving more or less injurious to the public health. 
 
 " This it does in several ways — by occasioning the escape 
 of effluvia from decomposing animal refuse into the air and 
 along the drains, and by the numerous trades to which it 
 gives rise in the neighbourhood which are offensive and 
 noxious, such as gut-spinning, tallow-melting, bladder- 
 blowing, and paunch-cleansing." 
 
 Even in the Strand District there were (1856) — 
 
 " Nuisances arising from various branches of industry, the 
 slaughtering of sheep and calves in the back-yards, and even 
 in the cellars and kitchens, and the keeping of cows in the 
 basements under private dwelling-houses, conditions which 
 continue to exist in the most crowded parts of this district, 
 and should on no account be permitted in such a district : " 
 whilst in Westminster " pig-keeping existed to a very 
 considerable extent." 
 
 In some of the outer parishes the " foetid emanations " 
 caused in the process of brickmaking added to the general 
 impurity of the air. 
 
 There were many other local causes of impurity of the 
 atmosphere, some even caused by the Sanitary Authorities 
 themselves. Thus the more thorough scavenging and 
 removal of the filth of streets and houses, vitally necessary 
 as that was, resulted in the accumulation of great heaps of 
 filth in crowded centres. 
 
 Thus the Medical Officer of Health for Fulham reported 
 that':— 
 
116 THE SANITARY EVOLUTION 
 
 "The collection of dust heaps, and dust contractors' 
 depots, constitute a most injurious and offensive nuisance — 
 enormous quantities of animal and vegetable matter are 
 heaped together, from which the most noxious effluvia 
 constantly arise." 
 
 And the Medical Officer of Health for Kotherhithe pointed 
 out (1858) that :— 
 
 "It is little use causing our ov7n dust to be carted away 
 if Eotherhithe is to become the receptacle of all the ashes 
 and offal of a large neighbouring parish (Bermondsey) . On 
 a piece of land near the Viaduct there stands an immense 
 heap of house refuse, covering an acre of ground at least, 
 and forming quite an artificial hillock, the level of the 
 surface having been raised 12-14 feet. The bulk of the heap 
 is composed of ashes with a due admixture of putrefying 
 vegetable matter and fish." 
 
 A little later he reports it as 1| acres in extent, averaging 
 15 feet high, in one place as high as 20 feet. 
 
 How to deal with these noxious or offensive trades was 
 felt by some of the Medical Officers of Health to be a great 
 difficulty. 
 
 " We have the health of the community on the one hand," 
 wrote the Medical Officer of Health for Lambeth ; " the great 
 manufacturing interests on the other. . . . We have all a 
 common right to an unpolluted atmosphere, and it is our 
 bounden duty to withstand any encroachments on that 
 right. The personal aggrandisement of the manufacturer 
 must not be achieved by the spoliation of the property, the 
 comforts, and the lives of his poorer neighbours. . . . 
 
 " But the manufacturing interest is not a thing to be 
 trifled v^ith. Destroy the manufactures of Lambeth, and 
 you starve its population. There are nuisances of more 
 benefit than of injury to the community," and he rather 
 deprecated ** a crusade against those interests, the un- 
 trammelled prosecution of which has raised this country 
 to its present proud pre-eminence." 
 
 Some of the Medical Officers of Health expressed decided 
 views on the subject (1857) : — 
 
 " Those who follow unwholesome trades led on by the 
 
OF LONDON 117 
 
 thirst of gain," reported one Medical Officer of Health, 
 ** have no right to poison a neighbourhood and swell its 
 mortality." 
 
 The Medical Officer of Health for the Strand wrote 
 (1856) :— 
 
 "... The protection of the public health which has 
 been committed to your charge is, beyond doubt, of in- 
 finitely more importance than, and should far outweigh the 
 interests of, private individuals how numerous soever they 
 should be." 
 
 The Nuisances Eemoval Act, 1855, had given the local 
 authority power on the certificate of the Medical Officer of 
 Health to take proceedings against an offender, and had 
 provided the means for inflicting a penalty. And in some 
 instances it was used, for the Medical Officer of Health for 
 Hackney reported : — 
 
 *' Several proprietors of noxious trades having omitted to 
 adopt the best practicable means for preventing injury to 
 health, in some cases legal proceedings were taken against 
 them." 
 
 The Medical Officer of Health for Whitechapel declared 
 there was no desire on his part to use the powers of the 
 Act to the oppression of any individual or to insist upon 
 the adoption of such arbitrary and stringent measures as 
 shall drive wealthy manufacturers from the district. " All 
 that is necessary to be insisted upon is that the business be 
 so conducted that the health and comfort of the inhabitants 
 shall not be injured." 
 
 But whether it was from the unwillingness of the local 
 authorities to prosecute, or the difficulties of enforcing the 
 law, the nuisances continued to the great detriment of the 
 health of the people. 
 
 And over and above this combination of nuisances, there 
 was the abominable smell from the river. That still was an 
 evil. 
 
 " Eotherhithe," wrote the Medical Officer of Health, in 
 July, 1858, *' in common with all other metropolitan river- 
 side parishes, has suffered considerable inconvenience during 
 the last month from the stenches arising from the filthy 
 
118 THE SANITARY EVOLUTION 
 
 state of the Thames water. Perhaps in the annals of 
 mankind such a thing was never before known, as that the 
 whole stream of a large river for a distance of seven or eight 
 miles should be in a state of putrid fermentation. The 
 cause is the hot weather acting upon the ninety millions of 
 gallons of sewage which discharge themselves daily into the 
 Thames. And by sewage must be understood not merely 
 house and land drainage, but also drainage from bone- 
 boilers, soap-boilers, chemical works, breweries, and gas 
 factories — the last the most filthy of all. ... It is quite 
 impossible to calculate the consequences of such a moving 
 mass of decomposition as the river at present offers to our 
 senses." , . 
 
 As one sums up all these disastrous influences, or rather, 
 these evil powers, unceasing in their work, by night and by 
 day — in the overcrowded dwelling and the street — with their 
 victims unable to escape, one realises somewhat the con- 
 ditions under which great masses of the people of London 
 were living. 
 
 The result was a fearful mortality — an awful waste of 
 human life. 
 
 " Death," wrote one of the Medical Officers of Health, 
 " finds easy victims in filthy habits, overcrowded rooms, 
 impure air, and insufficient and ineffective water supply." 
 
 The consequences were inevitable. 
 
 " Wherever there are crowded apartments, imperfect or 
 no drainage, offensive cesspools, dung-heaps resting against 
 houses or close to inhabited rooms — wherever ventilation is 
 impeded by the narrowness of courts and alleys, and where- 
 ever the inhabitants living under these unfavourable circum- 
 stances lose their self-respect, pay no regard to personal 
 cleanliness, and consider a state of filth and offensiveness 
 as their natural lot — there we find zymotic diseases in full 
 force and frequency. Those attacked do not simply recover 
 or die. I shall not be exaggerating when I say that all re- 
 covering from these complaints are permanently injured." * 
 
 It is impossible to apportion the respective shares which 
 these various causes of insanitation had in bringing about 
 * ClerkenweU, 1856. 
 
OF LONDON 119 
 
 these dire results, but overcrowding was undoubtedly one of 
 the principal. As to its disastrous effects the Medical 
 Officers of Health were of one opinion. There was no 
 single exception to the strong-voiced insistence upon this 
 fact. 
 
 " The main cause," wrote the Medical Officer of Health 
 for the Strand (1856), " to which we must attribute the 
 high mortality is the close packing and overcrowding which 
 exists throughout the district. . . . Overcrowding and 
 disease mutually act and react upon each other. 
 
 " There is one circumstance of general prevalence 
 throughout the district which, so to speak, almost paralyses 
 these efforts of sanitary improvement — overcrowding — the 
 overcrowding of parts of it with courts and alleys, the 
 overcrowding of these courts and alleys with houses, the 
 overcrowding of these houses with human beings" (1859). 
 
 " The overcrowding of dwellings," wrote another,* " is one 
 of the most frequent sources of sickness and decay at all 
 ages." 
 
 "Perhaps," wrote a third,t " there is no single influence 
 to which a human being is exposed more prejudicial to his 
 health than overcrowding in rooms the air of which cannot 
 be perpetually and rapidly changed." 
 
 "No axiom," wrote another,! "can be more positive 
 than the connection of epidemic diseases with defects of 
 drainage and ventilation . . . the overcrowded localities 
 being especially scourged by disease." 
 
 The consequences were not confined to epidemic disease ; 
 other fatal diseases were begotten by it. 
 
 "All medical writers," wrote the Medical Officer of 
 Health for St. James' (1858), "are agreed that impure air 
 from want of ventilation is the most potent of all causes 
 of consumption." 
 
 Not merely directly did overcrowding bring about fatal 
 results. Indirectly it also led thither. It was recognised 
 as a cause of intemperance and of the evils, moral as well as 
 physical, which ensued from intemperance. 
 
 ' ' Men whose nervous systems became depressed, and the 
 
 * Fulham, 1857. f Whitechapel, 1857. I St. Giles, 1859. 
 
120 THE SANITARY EVOLUTION 
 
 tone of their system generally lowered, became the subjects 
 of a continued craving for stimulants." * 
 
 Dr. Simon, Medical Officer of the General Board of 
 Health, wrote : — 
 
 "In an atmosphere which forbids the breath to be drawn 
 freely, which maintains habitual ill-health and depresses all 
 the natural spring and buoyancy of life, who can wonder 
 that frequent recourse is had to stimulants ? " 
 
 The evils were disastrous enough for the adult population, 
 but they fell with more dire effect upon infants and young 
 children. 
 
 " Conditions more or less injurious to health gradually 
 impair the matured energies and slowly undermine the fully 
 developed constitution of the adult ; but the self-same con- 
 ditions, exerting their baneful influence on the infant or 
 young child, nip the tender plant in the bud and speedily 
 destroy its young life." + 
 
 Throughout the whole of the metropolis the infantile 
 mortality — that is, of children under five years of age — was 
 very great : Almost without exception it was close upon, or 
 over, 50 per cent, of all the deaths in the various parishes 
 or districts. 
 
 In Clerkenwell the infantile mortality, which was " nearly 
 one-half of all the deaths," was characterised as "enormous" ; 
 but in Shoreditch it was actually one-half, being 50 per cent. 
 (1858) ; in BethnalGreenit was over one-half , being 52percent. 
 (1858) ; in St. George-in-the-East it was 53J per cent. — or, 
 to put it otherwise, of 1,351 deaths in the year, 720 were of 
 children under five. In Poplar it was more th9,n half. In 
 Islington, in 1857, nearly half. In St. Saviour, Southwark, 
 50 per cent, in 1860-1, " a waste of life which appears almost 
 incredible." 
 
 In Limehouse (in 1857) of 1,403 deaths 690 were under 
 five. 
 
 The Medical Officer of Health wrote : — 
 
 "It is when such wretched offspring, ill-nourished, ill- 
 clothed, and in every way neglected, become exposed to the 
 depressing influences of an impure atmosphere that they 
 - St. George the Martyr, 1859-60. i Strand, 1859-60. 
 
OF LONDON 121 
 
 sicken, and such children when they sicken they die. . . . 
 When the habitation of such children is an overcrowded, 
 dilapidated tenement in some close, ill-ventilated court or 
 alley, furnished with an undrained closet, surrounded by 
 untrapped drains, and festering heaps of filth, we find our- 
 selves astonished, not that so many die, but that so many 
 survive." 
 
 In some special places the mortality was still higher. 
 Thus the Medical Officer of Health for Kensington reports 
 in 1866 :— 
 
 "In some places the mortality among infants under five 
 years of age was at the enormous rate of 61 '3 of the total 
 deaths. 
 
 " One of the most deplorable spots, not only in Kensington, 
 but in the whole metropolis, is the Potteries at Nottingdale. 
 It occupies about 8 or 9 acres, and contains about 1,000 
 inhabitants . . . the general death-rate varies from 40-60 
 per 1,000 per annum. Of these deaths, the very large 
 proportion of 8l7*5 per cent, are under five years of age." 
 
 The Medical Officer of Health for Whitechapel (in 1858), 
 after reporting that the total mortality under five years in 
 the Whitechapel district is about 66 per cent., wrote : — 
 
 "How to overcome this frightful and apparently increas- 
 ing amount of mortality of the young is a problem well 
 worthy the attentive consideration of every citizen. The 
 time may be far distant before this problem is solved; 
 nevertheless it is my duty to chronicle facts, and although 
 I may not be able to suggest a remedy to meet this evil, 
 still the knowledge that so large an amount of infant mor- 
 tality does exist in our district — I may say, at our very doors 
 — will perhaps rouse the attention of the philanthropist, the 
 man of science, and the man of leisure, to investigate its 
 cause, and endeavour to mitigate it." 
 
 Once more it must be called to mind that this mortality 
 was not the whole of the evil, for it was indicative of 
 widespread infantile sickness and disease among those who 
 escaped the death penalty — sickness and disease impairing 
 the health and strength of thousands upon thousands of the 
 juvenile population. 
 
122 THE SANITARY EVOLUTION 
 
 The facts set forth by many of the Medical Officers of 
 Health must have enlightened many of the new local 
 authorities as to the nature and extent of the work which 
 it had now become their duty to perform, and the grave 
 problems for which they were expected to find the best 
 solution. 
 
 The earlier annual reports of many of the Vestries and 
 District Boards were poverty-stricken in the extreme, and 
 were mostly confined to bald and uninforming tables of 
 receipts and expenditure, which practically threw but little 
 light upon the condition of their parishes. 
 
 The Vestry of St. Mary, Newington, evidently anxious to 
 prevent disappointment as to immediate results from its 
 action, stated that : — 
 
 " In consequence of the previous want of adequate sanitary 
 powers in the local authorities of this and other suburban 
 parishes, so great an extent of sanitary improvement was 
 required when the Vestry came into operation, that it was 
 impossible the whole could be dealt with at once, at t."e 
 same time acting with consideration for those who have to 
 bear the effects of many years' neglect of those sanitary 
 duties which are now found to be so essential." 
 
 Lambeth Vestry expressed its desire to discover : — 
 
 " In what manner a prompt and beneficial execution of 
 the provisions of the Act can be secured without creating 
 any serious increase in local taxation." 
 
 One of the Vestries, indeed, gave the quaint explanation 
 that one of the things which somewhat retarded sanitary 
 improvement was " the novelty of applying compulsory 
 powers to landlords." 
 
 The desirability of securing parks and places of recreation 
 for the people was one of the matters which first appealed 
 to some of the Vestries and District Boards, and memorials 
 were addressed to the Metropolitan Board urging the 
 importance of their putting in force the powers conferred 
 on them for the purchase of land for such purposes. 
 
 Others directed their attention to the promotion in a 
 small way of improvements in their parishes by widening 
 streets and roads, and preserving open spaces — towards 
 
OF LONDON 123 
 
 which, in some cases, they received a contribution from 
 the central authority. 
 
 A good deal of paving v^as done, and better measures 
 taken for scavenging the streets and courts, and for the 
 removal of refuse and dirt of all sorts. 
 
 To local sewerage, as distinct from main sewerage, they 
 also gave attention, and in 1856 designs for 45 miles of 
 new sewers were sent in to the Metropolitan Board for 
 approval, and d634,700 borrowed for the purpose; and in 
 the following year for 46 miles of new sewers, and loans 
 for £109,000. 
 
 A fair amount of drainage work was also carried out — 
 thousands of cesspools were filled in and drains made. Also 
 a certain amount of inspection, with the disclosure of an 
 enormous amount of insanitation. 
 
 Thus, in the Strand District in 1856 — where 813 houses 
 were inspected — in 774, or 91 per cent, of these, works 
 had to be done to remedy sanitary defects. In the follow- 
 ing year 1,760 -houses were inspected, and in 1,102 sanitary 
 defects were found. In Poplar, of 1,299 houses which were 
 visited, 795 required sanitary improvement. In Paddington 
 2,201 houses were inspected ; in over 1,600 works had to 
 be executed to put them in sanitary order ; figures which 
 showed that, roughly speaking, two out of every three 
 houses were sanitarily defective. 
 
 " The last year," wrote the Medical Officer of Health for 
 Hackney (1857) — where 1,518 houses had been connected 
 with the sewers — "has been a year of drainage." 
 
 Parliament having enacted that the " owner " was 
 responsible for the state of his property, this work had 
 to be done at the expense of the owners; but how many 
 decades had passed in which " owners " had spent nothing 
 on the property, and had been receiving large rents ; and 
 how many cases of sickness and death had occurred in 
 their houses, the result of the insanitary condition in which 
 they had been allowed to fall, and in which they were 
 allowed to continue. 
 
 In Holborn such works cost the owners about £3,400 
 in 1857, and in Lambeth about £10,700. 
 
124 THE SANITARY EVOLUTION 
 
 But the work thus chronicled touched Httle more than 
 the fringe of the matter. Most of the local authorities 
 had, out of a spirit of economy, or for some other reason, 
 appointed only one Inspector of Nuisances; yet in nearly every 
 one of their parishes there were thousands of houses — in 
 Greenwich 11,000, in St. Marylebone 16,000, in Lambeth 
 22,000 — and years would have had to elapse before the solitary 
 inspector could have completed even one round of inspec- 
 tion and got the houses he inspected put in order ; whilst 
 the others would inevitably have been existing in, or falling 
 into, a state of insanitation. For years, therefore, the most 
 vile disease-begetting nuisances might not merely exist 
 throughout the parish, but work endless evil without any 
 interference, as indeed they did. 
 
 Some of the Vestries put forward their economy as a 
 claim for praise. Thus, the Wandsworth Board said that 
 " a due and careful regard to economy had characterised 
 all their proceedings," and the Vestry of St. Mary Newing- 
 ton said, in 1860, that it had carried out its operations out 
 of current income and had incurred no debt. 
 
 The Medical Officers of Health held their offices at the 
 pleasure of the Vestries, and, therefore, if they valued their 
 position, had to be cautious in their criticisms of the 
 management of the affairs of the parishes. 
 
 But their reports convey that the work which ought to 
 have been done was not being done as rapidly as they 
 wished. 
 
 "I wish I could induce the Vestry to insist more upon 
 having the poorer dwellings cleansed and lime-whited." 
 And again, " The Vestry has the power to restrict the 
 operation of underground rooms, yet it has not moved in 
 this important matter." * 
 
 The Medical Officer of Health for St. Giles' (1857) 
 referred to the — 
 
 " Indisposition of the Board to do works and charge the 
 owners " ; and, referring to a special case, he wrote, " It 
 becomes your duty to do something to prevent the produc- 
 tion of disease among the neighbours." 
 - Clerkenwell, 1860-1. 
 
OF LONDON 125 
 
 The Medical Officer of Health for St. Pancras wrote 
 in 1856-7 :— 
 
 " In many houses the overcrowding is very great. There 
 is a clause under the Nuisances Kemoval Act by which 
 the Vestry is called on to take proceedings before a 
 magistrate to abate overcrowding, if it is certified to be 
 such as to endanger health. No prosecutions have been 
 taken under this clause." 
 
 And again in 1859 : — 
 
 " Very little has been done in this parish to abate over- 
 crowding — extreme cases have been proceeded against. No 
 systematic efforts have been made in this direction." 
 
 And the Medical Officer of Health for Hampstead wrote 
 (1856) :— 
 
 " Nothing short of constant vigilance and inspection can 
 keep the dwellings and premises of the people in a tolerably 
 healthy state. I am not sure that your Board is blame- 
 less in some of these respects — an amiable, though weak, 
 reluctance to act severely to any." 
 
 And in 1857 he pleaded for the appointment of an 
 Inspector of Nuisances, which, however, he did not get. 
 
 The local authorities had their difficulties in dealing with 
 many of these matters, even when they were disposed or 
 anxious to do so, owing to — 
 
 " The imperfection of the powers conferred on them by 
 the legislature, and to the great and stubborn apathy of 
 a poor population." 
 
 And the Medical Officer of Health for St. James' (1858) 
 attributed blame to the public generally : — 
 
 " One of the greatest barriers to the practical efficiency of 
 sanitary arrangements is the ignorance and carelessness of 
 the public. It is frequently seen that where infectious 
 illness occurs, little or no attention is paid to its infective 
 character, and an unscrupulous intercourse is carried on 
 between the members of infected families, not only 
 amongst themselves, but amongst their neighbours, and 
 thus these diseases are propagated in spite of every 
 warning and precaution." 
 
 " I regret," wrote the Medical Officer of Health for 
 
126 THE SANITARY EVOLUTION 
 
 Whitechapel, " that the powers of your Board are not 
 at present suf&cient to compel the owners of small house 
 property to provide an adequate supply of water for their 
 tenants." 
 
 The Medical Officer of Health for "Westminster wrote : — 
 
 " Few of the objects of sanitary improvement can be 
 fairly attained without intrenching upon private interests 
 to an extent which would appear harsh and oppressive. 
 One great obstacle consists in the habits of a great portion 
 of the poor — generally deficient in cleanliness or order; 
 they consider any endeavour to improve their dwelling 
 as an interference, and throw every obstacle in the way. 
 On the other hand, a large number are most grateful for 
 what has been effected." 
 
 But in many matters the local authorities would not take 
 action. In only four parishes or districts in London had 
 public baths and wash-houses been established under the 
 Act of 1846, though where they were in existence "the 
 benefits were immense by promoting habits of cleanliness." 
 
 In Poplar in 1858-9 nearly 40,000 men, and 3,000 
 women, and 400 children availed themselves of the baths. 
 
 In St. Pan eras (1856-7) the laundry department, erected 
 by the " Society for Establishing Public Baths and Wash- 
 houses," was of great value in affording the poor housewife an 
 opportunity of washing and drying her linen away from her 
 one room, in which the family had to live night and day. 
 
 " I have frequently seen a small room of this kind with 
 from four to eight or even ten inmates rendered doubly 
 unhealthy by these laundry operations, which produce a 
 damp and almost malarious atmosphere." 
 
 The Medical Officer of Health for Lambeth had pleaded 
 for such an establishment in his district, but "the idea of 
 erecting them seems quite abandoned by the Vestry." 
 
 "I know nothing more objectionable in a sanitary point 
 of view than the washing of foul clothes in the dwellings of 
 the poor, and still worse the drying of them in courts and 
 rooms already deficient of free circulation of air and light." 
 
 Nothing, however, was done. But inaction far greater in 
 gravity and infinitely more reprehensible was that relating 
 
OF LONDON 127 
 
 to the housing of the people. The Medical Officer of Health 
 for Whitechapel drew attention, in his report of 1857, to 
 their power in this respect : — 
 
 " Docks, railways, warehouses, &c., &c.,must be constructed 
 for the increase of the trade of this great metropolis, but 
 our construction of them ought not to prevent us from pro- 
 viding better habitations for the working classes whose 
 labours effect these improvements ; more especially as it is 
 in the power of parishes by virtue of an Act of Parliament 
 to encourage the establishment of lodging-houses for the 
 labouring classes." * Not one single Vestry or District 
 Board ever attempted to deal with the evils of bad housing 
 and overcrowding by putting into operation the provisions 
 of this Act. 
 
 The occasional statement in the report of a Medical 
 Officer of Health as to what was actually done in his 
 parish, by showing what might have been done in any 
 other one, brings into strong relief the incapacity or 
 deliberate inaction of the local authorities of other parishes. 
 Thus, in some parishes the Medical Officers of Health 
 endeavoured to effect some diminution of overcrowding — 
 for instance, the Medical Officer of Health for Islington 
 reported that — 
 
 " In several instances the owners of dwelling-houses had 
 been summoned for permitting the overcrowding of their 
 houses; and the magistrate had fined the offenders." 
 
 And the Medical Officer of Health for Holborn in the 
 same year wrote : — 
 
 "Your Board has already done much to ameliorate the 
 condition of this class of society (the poor and overcrowded) 
 by compelling the owners to cleanse, drain, and ventilate 
 their dwellings; to close cellars, to provide proper water 
 supply, sanitary accommodation, and in many cases had 
 abated overcrowding." 
 
 But few of the Vestries followed, or attempted to follow, 
 these examples, and in many of the most vital matters a 
 deliberate inactivity was the prevailing characteristic of the 
 Vestries and District Boards. 
 
 * 14 and 15 Vic. cap. 34. 
 
128 THE SANITARY EVOLUTION 
 
 ** In several Vestries resolutions were actually moved with 
 the view of averting the construction of sewers. It was 
 thought by many persons of influence to be better to live 
 in the midst of overflowing cesspools than to add to the 
 defilement of the Thames." * 
 
 The Medical Officers of Health did not confine themselves 
 to merely reporting what was annually done to ameliorate 
 the existing state of affairs. 
 
 As was their duty, they made numerous and frequent 
 suggestions to their authorities as to what it was best to 
 do. And some of them, going further than this, sometimes 
 endeavoured to inspire the members of the Vestries and 
 District Boards with a sense of the gravity of their work, 
 and with lofty views of their duty. Occasionally, even, 
 they did not hesitate to censure their employers for 
 inaction or lethargy. 
 
 The Medical Officer of Health for the Strand wrote 
 (1856) :— 
 
 ** To pave streets, and to water roads, to drain houses or 
 even to construct sewers, however necessary these works 
 may be, are among the least important of the duties which 
 devolve upon you. But to improve the social condition of 
 the poorer classes, to check the spread of disease, and to 
 prolong the term of human life, while they are works of a 
 high and ennobling character, are yet duties involving the 
 gravest responsibility. Should less care be bestowed upon 
 our fellow creatures than is daily afforded the lower animals? 
 At the present moment the condition of many of the working 
 classes is degraded in the extreme." 
 
 The Medical Officer of Health for St. Saviour, Southwark, 
 wrote (1866):— 
 
 " In all our efforts at sanitary improvement we are chiefly 
 dealing with persons who in most instances have not the 
 power of helping themselves, and who until of late have had 
 no source to which they might apply for aid in rendering 
 their dwellings clean and wholesome." 
 
 The Medical Officer of Health in St. Pancras wrote : — 
 
 " All who have made themselves acquainted with the con- 
 * Shoreditch, 1859-60. 
 
OF LONDON 129 
 
 dition of many of the poor of London will agree with me 
 when I say that before their moral or religious state is likely 
 to be remedied, their physical condition must be improved, 
 and their houses made more comfortable. On you devolves, 
 to a great extent, the solemn responsibility for carrying out 
 the preparatory work." 
 
 The Medical Officer of Health for St. Martin-in-the-Fields 
 wrote to his Vestry in 1858 : "To permit such grievous 
 evils as are to be seen in the worst localities of this great 
 city is a contradiction to the teaching of Christianity . . . 
 such outrages on humanity as many of the abodes of the 
 poor are permitted to remain. 
 
 " It is unholy, it is unchristian, that people should herd 
 together in such dens ; and so long as such dwellings are 
 allowed to be occupied our assumed religion must be a 
 pretence and a sham. . ." 
 
 And thus, the Medical Officer of Health for Bethnal 
 Green : — 
 
 " To open ou-t avenues through our cul-de-sac courts, to 
 promote the sanitary condition of every house, to arrest by 
 thorough drainage and removal of refuse the elimination of 
 aerial poison, are the great duties that we have day by day 
 to do. Though the task before us be great, the objects in 
 view are immeasurably greater — to exalt the standard of life, 
 to economise rates, and above all to decrease the sum of 
 misery, disease, and death. ... To supply the arm strong 
 to labour, to substitute productive for unproductive citizens, 
 to decrease the death-roll of the young, and to protract life 
 beyond the present span, these are the tasks that sanitary 
 science imposes on us." 
 
 The Medical Officer of Health for Clerkenwell pointed out 
 that — 
 
 " The poorer classes have not the means of remedying 
 the defective sanitary conditions under which they are 
 Hving. But the Vestry has this power." 
 
 The Medical Officer of Health for St. Paneras made a 
 calculation that nearly 1,200 deaths in the parish in 1858 
 were due to causes which might have been prevented by 
 sanitary improvements. '* To every death we may safely 
 
 10 
 
130 THE SANITARY EVOLUTION 
 
 assume more than thirty cases of illness. This gives us 
 36,000 cases of preventable disease in the year." 
 
 "You will see," wrote the Medical Officer of Health for 
 St. James' (1856), " that by diminishing death and disease, 
 you are diminishing poverty and want. . . . The sanitary 
 question lies at the root of all others. It is a national 
 one and a religious one. It is true that in the exercise of 
 your powers you will often be met by the assertion of the 
 rights of property, but the right of life stands before the 
 right of property, and it is this recognition of the sacred- 
 ness of human life that lies at the foundation of sanitary 
 legislation." 
 
 The Medical Officer of Health for "Whitechapel wrote : — 
 
 " I have in this report, as in duty bound, spoken plainly; 
 if in the opinion of some members of the Board too plainly, 
 my apology is — the deep sense I entertain of the importance 
 of sanitary progress ; for upon the success that shall attend 
 the labours of those engaged in this most sacred cause 
 depends the improvement of the social, moral, and intel- 
 lectual condition of the people." 
 
 And the Medical Officer of Health for St. Giles' made this 
 pathetic appeal for action : — 
 
 " While you are listening to the remainder of this report, 
 I trust you will hold in your mind how many lives are 
 being sacrificed every month to deficiencies in sanitary 
 arrangements." 
 
 It is only here and there in the earlier reports of the 
 Medical Officers of Health that specific mention is made of 
 intemperance, but every reference to the subject showed 
 how largely " drink" affected the sanitary condition of the 
 people and intensified and complicated the evil conditions in 
 which the people were placed, and rendered any amelioration, 
 physical, moral, or religious, infinitely more difficult. 
 
 It was becoming more and more generally recognised that 
 a very large proportion of the deaths and of disease were 
 preventable. 
 
 "Any skilled eye glancing over the mortality tables will 
 observe that a considerable number of deaths might have 
 been prevented." 
 
OF LONDON 131 
 
 " We are now to a great extent aware," wrote the Medical 
 Officer of Health for St. Saviour's (1856), " of the physical 
 conditions on which the lives of individuals and communities 
 depend." 
 
 The Medical Officer of Health for Fulham wrote in 
 1857 :— 
 
 " Sanitary science and experience have full clearly proved 
 to us how great an extent the prevention of disease and its 
 extension rests with us." 
 
 But against contagion and infection no precautions 
 whatever were taken, and so disease was sown broadcast 
 throughout the community, and death followed. 
 
 As to suggested remedies and action there was a chorus of 
 absolute unanimity upon some points : — 
 
 *' The principal cause of the extent of zymotic disease," 
 wrote the Medical Officer of Health for Mile-End-Old-Town, 
 in 1859, " is the defective state of the habitations of the 
 poorer classes. The remedy for the evil is only to be secured 
 by a systematic house visitation. 
 
 "... Without a general house inspection it is impossible 
 to secure the proper entry to and use of the expensive sewers 
 which have been and are being constructed, 
 
 "Having done so much for the streets, pavements, and 
 drains, the improvements vdll lose half their salutary effect 
 if the interior of the dwellings are not placed in a corre- 
 sponding condition of wholesome cleanliness." 
 
 "It is," wrote the Medical Officer of Health for White- 
 chapel, " to the interior of the houses that our attention 
 must be directed, for it is here that the source of disease is 
 usually found. . . . An habitual and detailed inspection of the 
 houses occupied by the poorer classes is therefore essential." 
 
 A house-to-house visitation was, indeed, the first essential. 
 By no other means could the actual condition of the abodes 
 of the people be ascertained, and the breeding places of 
 disease be discovered, cleared out, and rendered innocuous. 
 And as there was a never ceasing tendency on the part of 
 the poorer classes to sink into a condition of uncleanliness, 
 and on the part of their abodes to fall into dilapidation, or, 
 as it was expressed, " a pertinacity for dirt," so was constant 
 
132 THE SANITARY EVOLUTION 
 
 inspection and supervision of vital necessity for the main- 
 tenance of any improvements made. 
 
 " There are," wrote the Medical Officer of Health for St. 
 Pancras (1858), " many parts of the parish densely crowded. 
 Some of the people have become so used to filth, they appear 
 to prefer it to cleanliness ; at any rate, they have not the 
 energy to get rid of it and improve their condition. Such 
 houses — perfect hotbeds of infectious diseases — ought to be 
 visited two or three times a year. ..." 
 
 The Medical Officers of Health had one valuable object 
 lesson before them in the common lodging-houses, which, 
 regulated and inspected by the police under the Acts passed 
 by Parliament, had shown that even the very worst con- 
 ditions of life could be ameliorated, and that the very 
 lowest and most miserable classes of society were not 
 beyond improvement. 
 
 " The chief points which are regulated by the authorities 
 (the Police) are cleanliness, drainage and water supply, the 
 separation of the sexes, and the prevention of overcrowding. 
 The testimony of all who are acquainted with the dwellings 
 of the poor is concurrent as to the immense sanitary advan- 
 tages gained by the provisions of the Common Lodging 
 Houses Act, and the results had been to improve in a marked 
 degree the health, habits, and morals of the persons using 
 these places." * 
 
 " The cleanliness, comfort, and ventilation of the licensed 
 rooms in common lodging houses offer a very marked 
 contrast to those which are unUcensed." + 
 
 To more than one of these officers the idea occurred that 
 similar benefits would follow if tenement houses were 
 similarly inspected. 
 
 "I believe considerable good might be accomplished by a 
 legislative enactment placing every house let out in weekly 
 tenements to more than one family under similar regulations 
 to those affecting common lodging-houses, and rendering 
 landlords liable for permitting overcrowding to exist upon 
 their property." 
 
 The success of the common lodging houses was due to the 
 - St. Giles', 1857-8. f St. Olave, South wark, 1856. 
 
OF LONDON 133 
 
 enforcement upon the owner of the first essentials of sanita- 
 tion in the house he let to occupants, and to the regular 
 "inspection" of his house to secure that those essentials 
 were maintained in a state of efficiency. 
 
 But it was just these two things that were most held in 
 abhorrence by the majority of tenement-house owners in 
 London. 
 
 The Medical Officer of Health for the Strand, after de- 
 scribing the overcrowding of tenement-houses, wrote (1858): — 
 
 "No remedy it is feared will be found until all houses 
 of the class alluded to, the rooms of which are let out as 
 separate tenancies, shall be compulsorily registered under 
 the supervision of the Local Authority of the District in 
 which they are situate, as fit for the accommodation of a 
 certain number of persons, and no more." 
 
 " This suggestion will doubtless excite the sneers of the 
 ignorant, the fears of the weak, and the ridicule of the 
 selfish, coupled with the usual expressions about interference 
 with the liberty of the subject; but the upright and 
 unprejudiced will not fail to perceive that it is the liberty 
 and the health of the working classes, forming, as they 
 do, so large a proportion of the mass of the people which it 
 is sought to protect from the tyrannical and grasping 
 covetousness of an avaricious few who care little whether 
 the health of the working man be destroyed, or whether 
 his children be reared up in such a way that disease and 
 vice must almost necessarily result, provided they succeed 
 in obtaining for themselves an additional percentage upon 
 their investment." 
 
 And the following year he again forcibly adverted to the 
 subject. 
 
 " When it is borne in mind that in some of the small courts 
 in this District there are packed together as many persons 
 as almost equal in number the soldiers congregated in a 
 commodious barracks, is the high death-rate a matter of 
 surprise ? But what can be done ? The authorities, general 
 or local, cannot surely be expected toprovide suitable dwellings 
 for the people ! Undoubtedly they cannot ; but it is incum- 
 bent upon these authorities, in the interest of the well-being 
 
134 THE SANITARY EVOLUTION 
 
 of all classes of the community, to place a prohibitive limit in 
 regard of overcrowding upon the class of houses the rooms of 
 which are let out as separate tenements, which would, 
 without hardship upon their occupants, speedily produce 
 the desired effect. Such a condition, practically speaking, 
 already exists in regard of most of the Public Institutions of 
 this country in which large numbers of persons reside ; such 
 a condition is enacted by law in regard of our emigrant ships : 
 such a condition is enforced by Act of Parliament in regard 
 of Common Lodging Houses : and in all these instances the 
 principle works well. Is it reasonable, then, that in relation 
 to the influence of over-crowding upon health and life, less 
 care should be taken of the people who occupy the densely 
 populated districts of our great towns and cities than is 
 already provided by law for the inmates of our Common 
 Lodging Houses, or for the paupers admitted into our Work- 
 houses, or for the emigrants who leave our shores ? Surely 
 the injustice cannot but be apparent." 
 
 Other suggestions were also made. 
 
 The Medical Officer of Health for Whitechapel wrote 
 (1859) :— 
 
 " If the public is to enjoy health, and a freedom from the 
 ravages of epidemic disease, a stop must be put to the present 
 scheme of erecting houses in crowded situations ; for although 
 the rights of property are to be respected, yet, in my opinion, 
 such rights are of secondary consideration when compared 
 with the public health and the increased burdens which must 
 be borne by the ratepayers to support those whose sickness is 
 occasioned by the unhealthiness of the localities where they 
 reside." 
 
 Several urged the vigorous enforcement of the existing 
 law. To the Vestry of Lambeth the Medical Officer of 
 Health wrote in his report in 1856 : — 
 
 " You must proceed actively against those who have raised 
 the value of their possessions by ignoring the value of human 
 life, who wilfully multiply disease by neglect of their 
 pestiferous property." 
 
 The Medical Officer of Health for Hackney wrote (1858) : — 
 
 " I feel assured that it cannot be too widely known that 
 
OF LONDON 136 
 
 individuals will not be allowed to deal with their property 
 in such a manner as to cause injury to the public health. 
 For although individual liberty has long been the boast of 
 England, yet there is a point beyond which it cannot be 
 tolerated with safety; and private good should always be 
 made to give way to the public welfare." 
 
 The greater the light thrown upon the sanitary condition 
 of the people of London, the clearer became the fact that the 
 principal blame therefor rested upon the house-owner, lessee, 
 or middleman, or as Parliament defined him, "the owner." 
 
 Many of the Medical Officers of Health were outspoken 
 and unhesitating in their opinion as to the responsibility of 
 the house-owner for the existing condition of the dwellings 
 of the people. 
 
 " The enemies of the poorer classes," wrote the Medical 
 Officer of Health for Clerkenwell, " are the landlords, who 
 know well that proper lodgings for the really poor do not 
 exist. They know also that if they buy at a cheap rate any 
 old premises not fit for a pig-sty and let them cheaply they 
 will be sure to find tenants." 
 
 If it was not the real owner of the house, it was the 
 middleman or person or persons between the owner and the 
 tenant. Eents were high in most parts of London where 
 there was urgent demand for accommodation, and " the 
 yearly rental is unfortunately in many cases still further 
 increased by the ' middleman system ' ; many of the houses 
 being rented by an individual who sub-lets them in separate 
 rooms as weekly tenancies, and this at an increase of 20 per 
 cent. (Strand 1856) :— 
 
 "And thus it is that health and life are daily sacrificed at 
 the shrine of gain." 
 
 What sort of property some of them held, and the condition 
 in which they allowed it to remain, whilst they drew their 
 " gain " from it, is graphically illustrated by the Medical 
 Officer of Health in St. Olave's, Southwark (1856). 
 
 He thus described the houses in three small courts : — 
 
 " The whole of these houses are held by one person, and 
 it is impossible to imagine any state much worse than the 
 condition of everything connected with their drainage, &c. 
 
136 THE SANITARY EVOLUTION 
 
 "Here, within a small area, are thirty-nine houses, all 
 having open foul privies, cesspools all filled, and many 
 overflowing. The yards are foul, dirty, damp, and 
 wretchedly paved with small, loose, broken bricks — most 
 of them are daily filled with the overflowing of the drains 
 and cesspools, the drains are all untrapped, and scarcely a 
 house has a proper receptacle for water; they are mostly 
 broken, dilapidated, uncovered tubs, placed close to the 
 cesspools, so as to absorb the foul gases emanating from 
 them. The effluvium on entering any of these places is 
 abominable, and greatly complained of. . . . 
 
 " These three courts are thickly inhabited." 
 
 In the following month he reported nineteen houses in 
 two streets very much the same as above. In the next 
 month twenty more — in the month after, thirty more. He 
 might almost have had the general description printed, with 
 blanks for filling up the number of such houses and where 
 situated. 
 
 If it had not been for the new Acts passed in 1855, this 
 condition of things would doubtless have continued in- 
 definitely. That condition had been reached under absence 
 of inspection, or regulation, and freedom on the part of the 
 owner to do as he liked ; and had no laws been enacted 
 to terminate it, no change would ever have been effected. 
 
 And when efforts were made by the local authorities 
 to remedy similar places, strong opposition was met with. 
 Thus in Hackney (1856-7) :— 
 
 "1839 nuisances have been rooted out. In very many 
 cases prosecutions have been ordered by the Board. They 
 were almost invariably opposed by the offenders, generally 
 people of substance, with the advantage of able legal aid, 
 in the most pertinacious and resolute manner. ..." 
 
 The novelty of enforcing upon the owners the improve- 
 ments deemed necessary naturally raised in the minds of 
 some of the Medical Officers of Health the question as to 
 the justice of such a proceeding. Those who discussed it 
 were clear upon the point. 
 
 Thus the Medical Officer of Health for Shoreditch 
 (1856-7) wrote:— 
 
OF LONDON 137 
 
 " The question of putting houses into a condition fit 
 for habitation has two bearings. It is, first, a question 
 between the landlords and the tenants, whose health is 
 sacrificed by neglect. It is, in the next place, a question 
 between the landlords and the ratepayers. 
 
 " If the landlords neglect to make the necessary outlay in 
 improving their property, the expense of maintaining that 
 property in its unhealthy condition is thrown upon the 
 ratepayers, for these have to bear the burden of supporting 
 the sick and the destitute." 
 
 And the Medical Officer of Health for Clerkenwell : — 
 
 "At present the poor rates are raised by the parish 
 having to pay the expenses of afflicted poor persons, whose 
 misery has in most instances arisen from defective 
 sanitary arrangements, the remedying of which ought to 
 have been effected at the expense of the landlords, who 
 derive their substance from the miseries of the poor." 
 
 And the Medical Officer of Health for St. George's, 
 Hanover Square : — 
 
 "I am compelled to say that the number of dingy and 
 dilapidated houses is a proof either that the owners of 
 house property do not exercise sufficient control over their 
 tenants, or that they themselves are grievously neglectful of 
 their duties to their tenants and to society at large. The 
 health of the Parish should not be allowed to suffer through 
 the default of either landlord or tenant. . . . Here there 
 need be no scruple about interference with private property. 
 
 " No man is allowed to sell poisonous food, and none 
 should be allowed to sell poisonous lodgings, more especially 
 as the effects of poisonous food are confined to the persons 
 who eat it — the effects of unwholesome apartments may be 
 diseases that may be spread." 
 
 On the equity of compelling the owners to put their 
 houses in order, there are many insisters. 
 
 " It is but right," wrote the Medical Officer of Health for 
 Fulham (1857), " that those who have hitherto fed their 
 own resources by impoverishing others, should now in their 
 turn make good the damage." 
 
 The Medical Officer of Health for Poplar (1856), wrote:— 
 
138 THE SANITARY EVOLUTION 
 
 " While on the one hand we must not proceed in a 
 reckless manner so to burden property as to render it 
 entirely unproductive, yet on the other we cannot allow 
 the labouring man, whose health is the only property he 
 can call his own, to live in unwholesome places to the 
 destruction of that capital, by which alone he is enabled 
 to support himself and family." 
 
 And the Medical Officer of Health for Mile-End-Old- 
 Town (1856) :— 
 
 "... To charge such property (viz., in bad condition 
 and heavily encumbered) with the costs of thorough repair, 
 would leave the owners in some instances, I am fully aware, 
 destitute, but life is more sacred, and possesses higher rights 
 than property, and it cannot be just to inflict or continue 
 a public injury while endeavouring to spare and sympathise 
 with the inconvenience of an individual." 
 
 That the evil state of the dwellings of the poorer classes 
 entailed a charge upon the public was also pointed out 
 by the Medical Officer of Health for Bethnal Green, who, 
 referring to the miserable homes in the parish, wrote : — 
 
 *' From the cradle to the grave their inmates are a direct 
 charge upon our funds." 
 
 Happily the law was beginning to be enforced, and 
 beginning to create a little alarm among some house-owners. 
 
 " As landlords are now aware that their property will be 
 visited in rotation by the Inspector, the necessary alterations 
 and improvements are frequently effected by them in 
 anticipation." * 
 
 Others did the necessary work when ordered to do it 
 by the sanitary authority. 
 
 Others, however, not until legal proceedings were taken, 
 and they were ordered by the magistrate to do it — and even 
 then some would not obey the magistrate's order, and the 
 work had to be done by the sanitary authority, and the cost 
 thereof levied from the owner. 
 
 One case was recorded by the Medical Officer of Health 
 for St. Giles', in 1858-9, in which the authority of the 
 law was more strongly asserted. 
 
 - Whitechapel, 1857. 
 
OF LONDON 139 
 
 "While speaking of the resistance met with in enforcing 
 sanitary requirements, it may be here mentioned that the 
 extreme step of imprisoning the owner of a certain house 
 has been had recourse to for his obstinate refusal to comply 
 with a magistrate's order." 
 
 That disease and sickness among the people entailed a 
 great loss and heavy burden upon the community appears 
 scarcely to have received any recognition up to this, and yet 
 it was a truth of far-reaching importance. That individuals 
 suffered was of course clear, but that the community did 
 was by no means realised. 
 
 Several of the Medical Officers of Health promptly 
 discerned how true it was, and in their earlier reports dwelt 
 upon it, pointing out the effects, and emphasising their 
 great importance. 
 
 "It cannot be too often impressed upon our minds," 
 wrote one, " that sickness among the poor is the great 
 cause of pressure upon the rates ; and everything that will 
 tend to diminish the number of sick will be so much saved 
 to the ratepayers." * 
 
 " The greater the amount of disease," wrote another, 
 ** the larger the proportion of pauperism." 
 
 " Of the causes of pauperism, none are so common as 
 disease and death," wrote another. 
 
 Indeed, a little consideration must have demonstrated 
 its truth. Difficult as it was for the individual in health 
 to earn a livelihood — when sickness fell upon him there was 
 the instant and complete cessation of his wages, and there 
 were expenses incurred by his sickness. If he recovered, 
 there had been a long disablement from work, and a heavy 
 loss. If, however, he died, the community suffered by the 
 loss of his productive labour, and, where the victim was the 
 bread-winner of a family, his widow and children but too 
 commonly became a charge upon the rates. 
 
 " High mortality in a district," wrote the Medical Officer 
 of Health for Clerkenwell (1858), " especially among the 
 poor who are the principal sufferers, does not relate simply 
 to the dead ; the living are also deeply concerned. Every 
 
 * Whitechapel. 
 
140 THE SANITARY EVOLUTION 
 
 death in a poor family causes an interruption to the 
 ordinary remunerative labour, and produces expenses which 
 have to be paid out of scanty wages. Hence the living 
 suffer from want ; the parish funds must be appealed to ; 
 families become parentless, and next comes crime." 
 
 The Medical Officer of Health for Whitechapel (1858) 
 wrote : — 
 
 " In the course of time the public will learn that sickness, 
 with its concomitant evils, viz., the loss of wages, the calls 
 upon clubs and friendly societies, the increased amount of 
 charitable contributions, a heavier poor rate, &c., entails 
 more expense upon the community than would be required 
 to carry out sanitary improvements in widening streets, 
 converting the culs-de-sac into thoroughfares, and in erecting 
 more commodious houses for the poor." 
 
 And the Medical Officer of Health for the Strand 
 wrote : — 
 
 " Of every death which occurs in this district over and 
 above the ordinary rate of mortality, the number of cases 
 of illness in excess must be a high multiple. And during 
 every attack of severe illness the patient, whatever his 
 position in life may be, must be maintained — if wealthy, 
 at his own expense, if poor, at that of the community at 
 large. And in the latter case, the community at large must 
 thus suffer a direct loss. Health is money, as much as time 
 is money, and sooner or later sickness must be paid for 
 out of the common fund. . . ." 
 
 And the Medical Officer of Health for Shoreditch (1856) 
 wrote : — 
 
 " To communities as well as to individuals there is 
 nothing so expensive, so fatal to prosperity, as sickness. 
 To a productive and labouring community, health is the 
 chief estate. ... A community is but a system of 
 individuals — if one portion of that system be disabled by 
 sickness, every other portion will feel the blow ; the whole 
 community will be taxed to support that part which is 
 rendered incapable of supporting itself. It is then a plain 
 matter of self-interest, as well as of solemn obligation, to 
 exercise the most vigilant care in preserving to the poor 
 
OF LONDON 141 
 
 their only worldly possession, their health and capacity for 
 self-support." 
 
 Nor did the danger to the great community of London, 
 from the prevalence of sickness in any particular district, 
 appear to have received the faintest recognition. 
 
 And yet, in the matter of health, and protection from 
 infection, all classes from the highest to the lowest had 
 equal interest ; for disease commencing or raging in one 
 district is not long in spreading to other districts. 
 
 The Medical Officer of Health for Chelsea (1857-8) 
 wrote : — 
 
 " It cannot need any argument to prove that diseases 
 of an epidemic or infectious nature cannot be arrested in 
 their progress by the imaginary line drawn around the 
 boundaries of the parish — that the smoke from the furnaces 
 in Lambeth and Vauxhall must be wafted across the 
 Thames and influence the health of the inhabitants of 
 Chelsea, if not kept in check, and that evils of minor 
 importance in Pimlico, on one side, and Kensington on 
 the other, may be quite as prejudicial to the health of the 
 neighbours residing on this side of the boundary as to those 
 among whom they are generated." 
 
 That any one locality had a duty to its neighbours, still 
 less to London as a whole, as well as to the people of its 
 own area, was beyond the range of the ideas of the vestries 
 and district boards. Indeed, if their sense of duty did not 
 induce them to look after and safeguard the people for 
 whose sanitary condition they were immediately responsible, 
 how could it be expected of them to be influenced by 
 considerations as to those residing outside their area, and 
 residing many miles away. 
 
 And yet, by the very condition of things, this greater 
 responsibility did exist. 
 
 But the great fact that in the vital matter of the public 
 health London was one great community, the various parts 
 thereof being indissolubly welded together into one great 
 whole, had not as yet apparently dawned upon the minds of 
 the newly-created local authorities ; nor, indeed, had Parlia- 
 ment even reahsed it, for it had left the forty and more of 
 
142 THE SANITARY EVOLUTION 
 
 those authorities full freedom to scatter disease of the 
 deadliest type from one end of London to the other, and to 
 imperil the lives of London's inhabitants. 
 
 The reports of one of the Medical Officers of Health give 
 such an exceptionally complete and vivid description of the 
 condition of the parish to which he had been appointed, and 
 in which he worked, that a series of extracts from them are 
 given. 
 
 The parish was the parish of St. G-eorge-the-Martyr in 
 Southwark, on the south side of the river, just opposite the 
 City; "low-lying and flat, and about half a foot below 
 Trinity high-water mark," with an area of 282 acres, and a 
 population of about 52,000 persons, and the Medical Officer 
 of Health was Dr. William Eendle, who speaks of himself 
 as "an old parish surgeon." 
 
 "If a loose drain conducts stenches into a man's house 
 instead of out of it, if the concentrated filthiness of a gully 
 is blown into a front door or window, if a house often visited 
 with fever has not been cleansed or whitewashed for many 
 years, if there is no water but putrid water filled with dis- 
 gusting living creatures, and no butt except a rotten one, 
 not even the most enthusiastic lover of things as they are 
 can find fault with us if we try to alter these things for the 
 better. . . . 
 
 "Let us picture to ourselves the man of the alley come 
 home from work. 
 
 " The house is filthy, the look of it is dingy and repulsive, 
 the air is close and depressing ; he is thirsty : the water-butt, 
 decayed and lined with disgusting green vegetation, stands 
 open nigh a drain, and foul liquids which cannot run off are 
 about it, tainting it with an unwholesome and unpleasant 
 taste ; the refuse heap with decaying vegetable matter is 
 near, and the dilapidated privy and cesspool send up heavy, 
 poisonous, and depressing gases. Such are the homes, may 
 I say, of thousands in this parish ? " 
 
 He contrasts the public-house with that, and says : " The 
 surprise is not so much that one man here and there reels 
 home drunk and a savage, as that for every such a one there 
 are not twenty. Gentlemen of the Vestry who have seen 
 
OF LONDON 143 
 
 these things can bear me witness that I do not exaggerate. 
 This is no fancied statement. . . . 
 
 "This parish has always been remarkable for its deathly 
 pre-eminence. Hitherto there has been no sufficient law. 
 After this we shall stand without excuse. . . . 
 
 "... Who is to say, when the question is improvement, 
 as to where we shall stop ? No doubt there is a question of 
 more or less rapid progress, so as to hurt existing interests 
 as little as may be. . . . 
 
 " Our intrusive visits, as some would call them, into filthy 
 and diseased houses, benevolent as they are, on behalf of 
 those who cannot always help themselves, have example 
 even in the most remote times and from the highest 
 authority. The ancient authority was more imperative, and 
 made it more a matter of conscience. In the ancient 
 Jewish law it was ordained ' that he that owneth the 
 house shall himself come and tell the Priest, saying: "It 
 seemeth to me there is, as it were, a plague in the house." ' 
 The Priest was "then to command the emptying it, so that 
 "all in the house be not made unclean." He was then to 
 cause it to be scraped within and about, and finally he 
 was to pronounce when the house was clean, and might be 
 again inhabited. 
 
 " The Priest was, you perceive, the Medical Officer of 
 Health under the Jewish law, and this text of Leviticus is 
 the 13th section of the Diseases Prevention Act. . . . 
 
 " From what I see of the parish we cannot without incon- 
 veniently close packing hold many more.* 
 
 " The growth of our parish is not from births alone ; some 
 persons of course immigrate from other parts of England, 
 but the greater part come from Ireland, bringing with them 
 disease and poverty. ... 
 
 "I am afraid that the poor of other parishes are forced 
 upon us. We increase in poverty, and, paradoxical as 
 it looks, the poorer we get the more we shall have to 
 pay. 
 
 " There are now from 6-7,000 cases of illness per year 
 attended by the poor-law surgeons. 
 
 * Popidation went up from 51,824 in 1851 to 60,278 in 1896. 
 
144 THE SANITARY EVOLUTION 
 
 " Our poor work at the waterside, in the city, and at the 
 docks ; their productive labour helps to pay the rates of other 
 parishes, but in difficulty and sickness they live and lean 
 upon us. 
 
 " Now as to overcrowding : — 
 
 In Lewisham there are 2 persons to an acre. 
 
 ,, Camberwell 
 
 >> 
 
 13 
 
 
 
 „ Eotherhithe 
 
 >5 
 
 21 
 
 
 
 „ All London 
 
 >> 
 
 30 
 
 
 
 ,, Newington 
 
 5 J 
 
 104 
 
 
 
 While we have 
 
 
 184 
 
 
 
 And in one of 
 
 the 
 
 
 
 
 parts of the parish 
 
 244 
 
 J ») 
 
 >> 
 
 " Our parish is now almost completely built over. 
 
 " In 1850, out of 1,169 deaths 565 (or one half) were under 
 5 years. 
 
 " In Bermondsey, 506 out of 983. 
 
 " Our parish and Bermondsey are quite ahead (of others) 
 in this unenviable race towards death." 
 
 " The contents of our sewers can only be discharged 4 
 hours each tide — 8 hours each day — the remaining 16 hours 
 daily they are reservoirs of stagnant sewage." 
 
 *' We are sadly deficient in sewers. At least 100 courts, 
 alleys, and back streets are entirely without drainage. . . . 
 Some of our sewers have remarkably little incline. That 
 in Friar Street, a most important one, is so level from 
 Bean Street to Suffolk Street that it has a most curious 
 quality for a sewer, that of flowing either way equally 
 well. 
 
 " One very prevalent evil is loose brick drains which let 
 the deadly gases into houses." 
 
 "... We are a most melancholy parish, low in level 
 and low in circumstances. The lowest and poorest of 
 the human race drop from higher and richer parishes 
 into our courts and alleys, and the liquid filth of higher 
 places finds its way down to us. We receive the 
 refuse as well as the outcomings of more happily situated 
 places." 
 
OF LONDON 145 
 
 His report for 1857 continued his description : — 
 
 "We lose annually 30 per 1,000 — there are only two 
 parishes worse than we are. Some at least of this mortality 
 is preventable. If we could keep to the average of all 
 London we should lose 300 less a year ; or even to that of 
 Bethnal Green we should lose 200 less. 
 
 " Few people believe we are so bad as we really are, and if 
 we do not believe we shall not of course try to mend it, but 
 it cannot be denied. 
 
 " The rich Londoners pay a low poor-rate. The poor 
 Londoners pay a high poor-rate. This bears hardly upon 
 us ; it stifles us : more and more packed, more and more 
 impoverished ; with very little space between the poor rate- 
 payer and the pauper, there is more sickness and death. 
 
 "Density of population brings you more deaths, more 
 sickness, more expense. 
 
 " The dreadfully vitiated air of our courts and close rooms 
 produces and fosters consumption." 
 
 Commenting on the common lodging-houses, he wrote : — 
 
 " The police regulations for order, cleanliness, and preven- 
 tion of disease are in the highest degree satisfactory. . . . 
 The benefits are so great that the employment of the same 
 regulations in the more crowded and filthier houses of the 
 poor can only be a question of time. It is the highest 
 humanity to quicken the progress. 
 
 " Vestries have power sufficient for the purpose. The need 
 is so great, so undoubted by those who have seen the evils 
 with their own eyes, and the benefit to be obtained so 
 certain, that if the local authorities do not enforce the im- 
 provements, the police will have to do it. 
 
 "As to the overcrowding, I have brought many cases before 
 you, each from illness resulting difficult of cure, constantly 
 recurring. ' I can never get out of that house,' said the 
 district surgeon of one of them. The eight rooms in this 
 house were always full, the receipts £2 2s. a week, yet it 
 was dirty, neglected, and overcrowded. So the poor live, 
 and I may say, so they die." 
 
 "As to some manufactories, some of them are very bad, 
 and their pernicious influence spreads widely. I do not 
 
 11 
 
146 THE SANITARY EVOLUTION 
 
 think any manufacturer should be obliged to leave ; trades 
 must, of course, be protected ; but one man must not, to 
 save a little expense in his building and machinery, be 
 allowed to poison a neighbourhood, containing as this does 
 some 30,000 people. 
 
 " There are various ways of making almost all of them 
 bearable." 
 
 " In this parish are at least 4,000 houses rated under ;610 
 a year, and containing 30,000 persons." 
 
 1858. 1st Quarter : — 
 
 " Of smallpox and vaccination there are some who neglect 
 this great precaution, and so not only imperil themselves but 
 others. Here is the evil, and indeed, I believe, the reason 
 why the disease is not altogether banished." 
 
 "... A case registered as diphtheria occurred and 
 died ; it began in one of the very worst localities and then 
 extended to opener and better places. Thus it is that 
 modern society neglects the social condition of its poor, and 
 the poor with a well-ordered revenge bring disease and 
 death as a consequence." 
 
 Eeferring to some tables he compiled, he said : — 
 
 "In this table appear 42 deaths from consumption; it 
 has but recently become prominent how very preventable a 
 disease this is . . . the principal causes have here been 
 made obvious enough : sleeping closely in ill-ventilated 
 rooms, overcrowding, and bad ventilation." 
 
 " It is now quite established that, with close overcrowded 
 rooms — that is, by assiduously causing the continued breath- 
 ing a tainted atmosphere — you may insure consumption in 
 the most healthy. 
 
 "8,500 years ago the Jewish legislator promulgated laws 
 and duties almost identical with those we are now engaged 
 in carrying out as new in the nineteenth century — but so 
 it is." 
 
 ". . . There is a great deal of carelessness touching human 
 life, and a great want of common sense or serious thought 
 in the preserving it. Much is left to chance. There is 
 either fatalism or stolid indifference upon the matter per- 
 vading highest society, and the poor, driven as they are from 
 
OF LONDON 147 
 
 richer districts into poorer neighbourhoods, can scarcely 
 help themselves ; they lose at last all healthy communica- 
 tion with richer or better neighbours, and all taste for pure 
 air and healthy pursuits ; they pack close, they descend a 
 little, often a great deal, toward the lower animals, and so 
 live neither for this world nor the next." 
 
 "There are 7,000 houses in this parish. 890 of these 
 have been visited this year, and in 756 the work ordered has 
 been carried out — sometimes in a most slovenly manner — 
 an apparent compliance with your orders. In the poorer 
 districts the most incompetent men are employed to plaster 
 over, patch over, whitewash, or cover over the evils ordered 
 to be not covered hut amended. Still a great amount of 
 good work has been done. 
 
 "... Overcrowding is the normal state in our poorer 
 districts. Small houses of four rooms are usually inhabited 
 by 3 or 4 families, and by 8, 16, or 24 persons, e.g., 133 
 inhabitants in 8 houses ... a filthy yard generally implies 
 a filthy house and unclean habits "...** this parish with 
 its thousands of refuse heaps." 
 
 " I know that we are on the right track. May Pole 
 Alley, a cul-de-sac with its 23 houses and 180 people, 
 was once a nest of infectious diseases. I attended some 
 10 cases of typhus there, some of them malignant enough 
 to destroy life in 48 hours. With great trouble this court 
 has been cleansed and amended. It is very much more 
 healthy." 
 
 1858. 2nd Quarter : — 
 
 " June — an exceedingly hot and dry month. You may 
 judge of the effect of such temperature upon exposed 
 dung-heaps, wet sloppy yards, and rotten, filthy, uncovered 
 water-butts ; three characteristics of this parish. . , . 
 
 " The Surgeon of the District writes thus to the Board of 
 Guardians : ' The smell is very bad from a horse-boiling 
 establishment in Green Street, which causes a great increase 
 of sickness near that part.' This of course refers to the 
 bone boiling and other like establishments, of which there 
 are, in this one small street, three cat gut manufacturers, 
 one soap boiler, one horse slaughterer, and four bone boilers 
 
148 THE SANITARY EVOLUTION 
 
 — all very offensive trades. I am receiving complaints in 
 all directions as to this matter. I am inclined to think that 
 this is not altogether just to the 20,000 inhabitants who live 
 within the effluvia circle of Green Street." 
 
 As to infantile mortality he writes : " I confess I see but 
 little difference between that sanguinary ancient law that 
 directly destroyed weakly and deformed children, and that 
 modern indifference that insures at the very least an equally 
 fatal result" . . . "these disturbing truths involving so 
 much trouble and expense, and giving us painful reminders 
 of new duties, as well as of old ones neglected." 
 
 He complains of having to neglect a great many cases of 
 insanitation owing to want of staff. " . . . Of those upon 
 whom orders come to remove nuisances, &c., a large number 
 are objectors, and not a few positive obstructors " 
 
 " The items in this last table merit attention, and throw 
 a sad sort of light upon the condition of the poor of this 
 parish. We have visited 73 unclean and ruinous houses ; 
 118 in which the water was stored in a most unwholesome 
 manner ; 163 in which the drains were defective enough to 
 be disease producing; 72 in which the w.c.'s were more or 
 less unfit for use; 110 yards sloppy, not paved, or ill-paved; 
 and 138 in which there was no sufficient provision for house 
 refuse. . . . 
 
 " We are packing more and more closely. 
 
 " In the great mass of our poorer habitations the allowance 
 of breathing room is not more than 200 cubic feet per head 
 — often as low as 120. In one house reported to me there 
 were 30 in four rooms with only 2,410 cubic feet, or 
 80 cubic feet per individual. This must, of course, be pre- 
 mature death to many of them. . . . 
 
 "We cannot overlook what is going on : improvements are 
 being effected elsewhere, the dwellings of the poor are being 
 destroyed, a few parishes are fast becoming pre-eminently 
 poor, over-crowded, and filthy. I need not tell you that this 
 parish is one that gets in this respect steadily worse from 
 the improvement in others. 
 
 " The temptation is very great to overcrowd; the poor 
 family, however large, by crowding into one room, and by 
 
OF LONDON 149 
 
 even taking a casual lodger in addition, obtains a sort of 
 home at a cheaper rate, and the owner gets a much larger 
 revenue out of what I must, I suppose, call human habita- 
 tions. The resulting illness and death are considered inevit- 
 able, or are viewed with a stolid indifference." 
 
 1858. Srd Quarter :— 
 
 Of the greatness of the mass of prevalent evils he 
 wrote : "I have often reported it here, but the very 
 enormity of the evil blunts our appreciation of it. . . ." 
 
 There had been a high mortality in the Quarter. " We 
 are once more, I believe, the worst parish in London. . . ." 
 
 " The back districts of this parish require relief, as much 
 as Ireland ever did, from a class of middlemen who, with 
 some few most honourable exceptions, grind out all they can 
 from the most squalid districts, and carry nothing back in 
 the way of cleanliness or improvement." 
 
 He gives a long list of streets and courts and places where 
 disease was rampant and deadly owing to the insanitary 
 conditions. 
 
 "It may perhaps be said that all this is in the order of 
 nature, and cannot be prevented. My experience of a 
 quarter of a century among these diseases points quite the 
 other way. Providence does not intend that reservoirs of 
 stinking putrid matter shall stand so close to the poor man's 
 door as to infest him at bed and board. ... In the Jewish 
 scriptures the places for the purposes here mentioned are 
 ordered to be without the camp, as far from the breathing 
 and eating places as possible ; and among us, as you see, 
 when we tolerate such abominations. He visits us with 
 death. It is the result of the irrevocable laws of nature 
 often averted by what appear as happy accidents, but at 
 last, when disregarded, deadly. Gentlemen, you are the 
 trustees for life and death to a population of well-nigh 
 30,000 people, who from the force of circumstances are more 
 or less unable to help themselves. ..." 
 
 " Of course it cannot be expected that we can provide the 
 homes of the poor with the orderly arrangements and benefits 
 of these Institutions (Dispensaries, &c.) — that, however, 
 will form no excuse here or hereafter for not carrying out 
 
150 THE SANITARY EVOLUTION 
 
 the improvements we can easily achieve, and which a wise 
 legislature has given us full authority to do." 
 
 " Total deaths in Quarter ended October 2nd, 1858—369, 
 of which 225 were of children under 5 years =61 per 
 cent ! ! " 
 
 The whole tone of this report was such that he could not 
 possibly continue as Medical Officer of Health to a then 
 existing Vestry, and he resigned. 
 
 He was succeeded by another very able man. Dr. Henry 
 Bateson, from whose reports may be continued the descrip- 
 tion of this parish up to the census of 1861. 
 
 " The onward moral and intellectual progress of the 
 human race depends far more upon the sanitary state which 
 surrounds it than has ever yet entered into our imaginations 
 to conceive. . . . 
 
 " We have suffered severely from the ravages of smallpox. 
 Smallpox is a disease over which we have perfect control, 
 and which, were vaccination thoroughly carried out, might 
 be banished from these dominions." 
 
 "... Men whose nervous systems become depressed 
 and the tone of their system generally lowered, become the 
 subjects of a continued craving for stimulants." 
 
 "... Our wells are but the receptacles of the washings 
 from our streets, the off-scourings from our manufactories, 
 the permeations from our cesspools, and the filterings from 
 our graveyards," 
 
 1860-1861. After five years' local government : — 
 
 " The circumstances are various and complicated, which 
 contribute to prevent the improvement of the district, and 
 even make the endeavour seem at times hopeless. No one 
 can know the fertile sources that exist for producing in 
 the mind this feeling of despair save those engaged in sani- 
 tary labours ; or those perchance whose duty it may be to 
 visit our poorest and lowest localities." . . . "It is no light 
 and easy work to remove the aggregate evils of centuries 
 which, like the coral reefs of the ocean, have grown up 
 silently and continuously to their present magnitude. . . . 
 There are hindrances all around, some of which are unsur- 
 mountable, such as those arising from the imperfections of 
 
OF LONDON 151 
 
 the law itself . . . there are also vested rights, customs, 
 ignorance, stupidity, and avarice, all of which have to be 
 dealt with and overcome if possible." 
 
 "Nature never pardons. Obey and it is well; disobey 
 and reap the bitter consequences." 
 
 Referring to some houses " of the worst description, 
 having no yards, nor even windows behind, so that ventila- 
 tion was impossible," he says : " I am sorry to say that there 
 are numbers of similar houses still standing, and occupied 
 by the most ignorant and degraded of our population — a class 
 living almost in the neglect of laws human and divine ; and 
 as heedless about the present and the future as the very 
 heathen themselves. ..." 
 
 " The state and condition of the dweUings of the poorer 
 classes are a stain upon our civilisation." 
 
 "... No one can conceive, nor would they believe, 
 unless eye-witnesses, the wretched circumstances in which 
 vast numbers of families have to spend their lives. It is 
 indescribable.". 
 
 " The daily task of keeping clean their houses and families, 
 once a pleasure to them as well as a duty, having to be 
 performed amid overwhelming obstacles on every side, 
 from which no hope of escape remains to cheer them 
 on, is gradually neglected and ultimately abandoned, their 
 spirits become torpid and depressed, and this is necessarily 
 followed by the derangement of the functions of the body. 
 Finally they become reckless, and this recklessness increases 
 the evil which gave it birth. There is action and reaction. 
 What marvel then that, like unto those about them, they 
 float down the ebb tide towards the dead sea of physical dirt 
 and moral degradation. It has been truly said by Dr. 
 Southwood Smith, ' The wretchedness being greater than 
 humanity can bear, annihilates the mental feelings, the 
 faculty distinctive of the human being.' " 
 
 " The heedlessness shown in the building of houses is 
 astonishing. No care is taken about the nature of the sub- 
 soil, the position, the ventilation, and means of cleanliness. 
 They are run up anywhere and almost anyhow, and too 
 often become the prolific source of disease." And he 
 
152 THE SANITARY EVOLUTION 
 
 quotes : " No man has a right to erect a nuisance, and 
 the public has clearly as good a right, as great an interest 
 in enforcing cleanliness to prevent the outbreak of an 
 epidemic as in requiring walls to prevent the spread of 
 fire. Yet, v^^here one is destroyed by fire, how many 
 thousands are there destroyed by disease, the indirect result 
 of such erections ? " 
 
 " We are desperately careless about our health, and 
 apparently esteem it of small value. A great modern 
 writer has truly said : ' The first wealth is health. No 
 labour, pains, temperance, poverty, nor exercise that can 
 gain it must be grudged. For sickness is a cannibal which 
 eats up all the life and youth it can lay hold of, and absorbs 
 its own sons and daughters.' " 
 
 The descriptions here given enable us to realise how 
 terrible and pitiable a state of things had been reached, 
 and the depths of filth, and misery, and abomination into 
 which the people had been allowed to sink through the 
 indifference of Parliament, the absence of any local 
 government, and the neglect or avarice of the "owners." 
 
 One hope there now was. Parliament had at last 
 made laws to remedy these evils, and local governing 
 authorities had been created to administer and enforce the 
 laws. 
 
 In 1858 a Public Health Act was passed by Parliament, 
 which put an end to the existence of the Board of Health, 
 and transferred to the Privy Council the administration of 
 the Diseases Prevention Act. And the Privy Council was 
 authorised to cause inquiry to be made in relation to 
 matters concerning the public health. In 1861 a medical 
 department of the Privy Council was formed which has in 
 many ways been of immense service to the cause of public 
 health, and which, as time went on, developed towards 
 a true Ministry of Public Health. 
 
 All things considered, by the end of the first five years 
 of the working of the new local constitution conferred upon 
 the metropolis, a real beginning had been made in the 
 sanitary evolution of the great city. Some of the grossest 
 evils had been attacked, and a start made in lifting London 
 
OF LONDON 153 
 
 out of the depths of the appalling slough of abominable filth 
 in which it had become submerged. 
 
 In some of the vitally important matters progress was 
 material. The improvement in the water supply was 
 considerable, the main drainage works had been started ; 
 the construction of many new sewers, the abolition of great 
 numbers of cesspools, and the better drainage of houses, 
 were all events of a decidedly satisfactory character. 
 
 And the death-rate of London as a whole showed a slight 
 decrease— from 23-38 per 1,000 in 1851 to 2318 in 1861. 
 In some districts there was an increase — in the majority, 
 however, there was a decrease. 
 
 But most encouraging of all was the direct evidence 
 afforded by experience as to the effects of sanitary im- 
 provements. 
 
 Thus, in Whitechapel, the Medical Officer of Health, in 
 reporting that the cases of fever had diminished from 1,929 
 in 1856 to 190 in 1860, said :— 
 
 " This diminution may be fairly attributed to the 
 additions made to the sewerage of the district, the improve- 
 ments effected in the drainage of 2,172 houses, the abolition 
 of 3,002 cesspools, the better paving of many of the courts, 
 the systematic inspection, &c., of houses where fever 
 occurred, the removal of 37,607 nuisances, and to the 
 abolition of several offensive trade nuisances." 
 
 And the Medical Officer of Health for Shoreditch wrote, 
 in 1861 :— 
 
 " That the diminished mortality and the lesser frequency 
 of epidemic diseases are really due in great measure to 
 sanitary works and inspection is proved by the diminution 
 and even disappearance of certain forms of sickness from 
 streets, courts, and districts where sewers have been 
 constructed, ventilation provided, and other improvements 
 effected ; whilst, on the other hand, the districts still 
 requiring those necessary reforms furnish far more than 
 their proportion of the epidemic sickness and mortality." 
 
 Philanthropic individuals were increasing their efforts for 
 the improvement of the people ; and societies, working on a 
 self-supporting basis, were taking more active interest in 
 
154 SANITARY EVOLUTION OF LONDON 
 
 the housing problem, and erecting model lodging-houses 
 and more healthy habitations.* 
 
 Public opinion was more interested than before in 
 sanitary matters, and it was thought that the working 
 classes had also in some degree awakened to the care of 
 their own health. 
 
 "Altogether," wrote the Eegistrar General, in his report 
 on the health of London after the census figures of 1861 
 were known, " there is abundant proof of that increased 
 regard for human life that attends civilisation." 
 
 * "The moral and social benefits conferred by these buildings has been 
 immeasurable," wrote one Medical Officer of Health (St. Pancras). 
 
 " They are institutions whose larger acceptance would save the lives 
 of hundreds, and reclaim the morals of thousands," wrote another. 
 
CHAPTEE III 
 
 1861-1870 
 
 The Census of 1861 disposed of the various estimates of the 
 population of London, and of the death-rates in its various 
 parishes, and gave authoritatively the actual figures. 
 
 From 2,363,341 persons in 1851, the population had gone 
 up to 2,808,494 in 1861 — an increase not very far short of 
 half a million; and the number of inhabited houses had 
 increased from 306,064 to 360,065. 
 
 The natural growth of the population, or in other words, 
 the excess of births over deaths, accounted for but part 
 of this increase. The rest was due to the great stream 
 of immigrants into London, which, notable previously, 
 "continued to flow thither with unabated force." 
 
 The increase was not equally distributed. The popula- 
 tion of the central parts showed a decline. There the great 
 economic forces were most powerful, and under their 
 influence the population of the "City" had decreased by 
 more than 15,000 : that of Holborn and St. Martin-in-the- 
 Fields by nearly 2,000 each: that of St. James', West- 
 minster, by about 1,000, and two or three others slightly. 
 
 But elsewhere — east, north, west, south — the increases 
 had been great, and in some instances remarkable. Poplar 
 had increased in the decade by 32,000 ; Islington by 60,000 ; 
 St. Pancras by 32,000 ; Paddington by 29,000. And on the 
 south side of the river, Wandsworth had increased by 
 20,000 ; Newington and Camberwell by 17,000 each ; and 
 Lambeth by 23,000. 
 
 The rate of growth in the various wards or parts of the 
 parishes showed, both as regarded persons and houses, great 
 
 165 
 
156 THE SANITARY EVOLUTION 
 
 differences, the most rapid increases being in the parts 
 nearest to the centre of London. 
 
 A most material factor in the sanitary evolution of any 
 great city, and especially so of London, is the introduction 
 into its population of fresh elements from the outside. 
 
 The returns collected by successive Census Commissioners 
 gave considerable information upon this point. 
 
 "London is the metropolis of the Empire," wrote the 
 Commissioners of 1861, " and thither the representatives of 
 other nations, of the Colonies, and of Scotland and Ireland 
 resort ; but it is chiefly the field in which the populations of 
 the several counties of England find scope for their talents 
 and their industry." 
 
 The majority of the inhabitants of London in 1861 were 
 indigenous, for 1,701,177 were born within its limits ; 
 1,062,812 were born elsewhere. 
 
 Of these 1,062,812, close on 36,000 were born in Scotland, 
 107,000 in Ireland, 19,000 in the Colonies, and 48,000 
 were foreigners. The remainder — amounting to about 
 893,000 — were born in the extra-metropolitan counties of 
 England and Wales. 
 
 "Proximity to the metropolis, and the absence of manu- 
 factures at home, first drew the natives of these counties to 
 London. The stream of immigrants from the south-western 
 counties was large : Cornwall, Devon, Dorset, Somerset, 
 and Wiltshire having sent 128,422 of their natives to be 
 enumerated in London." 
 
 Likewise the stream from Norfolk and Suffolk was large. 
 But the great bulk of the immigrants came from the 
 counties immediately around London. 
 
 To put the figures in simple form — of every 1,000 
 inhabitants of London, 606 were born in London, the 
 remaining 894 were born elsewhere. 
 
 And the census provided also the means for ascertaining 
 as correct a death-rate as could be arrived at. In 1851 the 
 death-rate was 23-38 per 1,000 ; in 1861 it was 23-18— not 
 much of a decrease, but satisfactory in showing that some 
 of the evil powers of insanitation were stayed. 
 
 It is, however, always to be borne in mind that either 
 
OF LONDON 167 
 
 the death-rate, or the number of deaths, gives but an 
 imperfect and incomplete picture of the sanitary condition 
 of a population. It tells but the tale of those who have 
 died of disease — it leaves uncounted and untold the far 
 greater number of those who have been either temporarily 
 disabled or maimed for life by disease. Estimates vary 
 considerably as to the number of persons who suffer from 
 disease and recover; and the proportion of recoveries to 
 deaths varies in different diseases, some diseases being so 
 much more deadly than others. But the sick-rate is always, 
 and under all circumstances, very much greater than the 
 death-rate. 
 
 The mere taking of a census could have no visible or 
 actual effect; the routine of life and the action of the 
 various economic and social forces continued unchanged ; 
 but the information gained was of the utmost value. 
 
 The figures and the facts recorded afforded startling 
 demonstration of the immensity of London, and of the 
 growing gravity and complexity of the great problems 
 of London life. 
 
 London was huge before — appalling almost in size and 
 population ; now it was shown to be huger than ever. 
 Everything was on a more enormous scale. The masses 
 of population were far larger, and were rapidly increasing ; 
 and with this increase everything concerning their existence 
 became more and more complicated, and every reform more 
 and more difficult. The removal of evils affecting their 
 physical and social being would be a heavier task, the 
 supervision of their conditions of life more onerous and 
 exacting, and the provision of a government to secure their 
 well-being a graver problem than ever. 
 
 One of the great forces unceasingly at work, and one 
 of the great contributory causes to insanitation and to the 
 maintenance of a high death-rate was, undoubtedly, drink. 
 It led to poverty and overcrowding, it led to ill-health and 
 greater susceptibility to disease ; and the evils acted and 
 reacted upon each other indefinitely — a vicious circle from 
 which there was no escape, overcrowding leading to a 
 craving for drink, and drink resulting in poverty and there- 
 
158 THE SANITARY EVOLUTION 
 
 fore overcrowding with its attendant evils and high 
 mortality. Since the unfortunate moment in 1830 when 
 Parliament deemed it expedient " for the better supplying 
 the public with beer " to give greater facilities for the sale 
 thereof, and scattered broadcast throughout the nation the 
 seed of unlimited evil, facilities for drink not only of beer 
 but of spirits have been practically unlimited. Against this 
 source of evil, which is often mentioned in their reports, 
 neither Medical Officers of Health nor Vestries could con- 
 tend, and had no power to contend. But all through 
 the history of the sanitary evolution of London this deep 
 underlying curse was present, acting as a perpetual clog 
 upon sanitary and social progress — a horrible, all-pervading 
 and tremendous power for evil. 
 
 In the earlier years of this new decade of 1861-70 the 
 central government — the Metropolitan Board of Works — 
 was demonstrating the great utility of a central governing 
 authority for London, and a task was nearing accomplish- 
 ment which was absolutely the first essential, the very 
 foundation of an improved state of the public health. 
 
 It was engaged in pressing vigorously forward the great 
 system for the sewerage and drainage of London designed 
 for taking off the sewage and refuse waters of a prospective 
 population of three and a half million persons, and the 
 rainfall of a drainage area of 117 square miles. Until 
 those works were completed no great degree of sanitary 
 improvement could be expected. 
 
 In 1861 the Board reported that a portion thereof had 
 been finished, and as the work gradually progressed the 
 Vestries were able to avail themselves of the deeper outfalls 
 afforded, and to undertake drainage works in their several 
 areas. 
 
 By 1865 the great task was virtually accomplished. 
 Eighty-two miles of main intercepting sewers had been 
 constructed, and the sewage was being conveyed away 
 by them several miles distant from London. 
 
 Their completion enabled the Metropolitan Board to fill 
 in the open sewers, which had so long polluted the atmo- 
 sphere, and been such a fertile source of disease in the 
 
OF LONDON 159 
 
 districts where they existed, and took away from the 
 Vestries any excuse for delay in carrying out the con- 
 struction and putting in order of the local sewers for 
 which they were responsible. 
 
 The central authority had thus brought into existence 
 a gigantic system of sewerage by which the river near 
 London ceased to be the main sewer of London, and the 
 whole of the metropolis was relieved of many of the most 
 powerful causes of fever, cholera, and other destructive 
 diseases. It was a great work, admirably and expeditiously 
 carried out, and it cleared the way for other sanitary 
 reforms which were impossible without an effective general 
 system of- sewerage, yet which were essential if a satis- 
 factory condition of the public health were ever to be 
 attained. 
 
 The central body also proved its great utility by securing 
 uniformity in the sewerage and drainage works which fell 
 to the duty of the local authorities to carry out. All plans 
 by the Vestries had to be submitted to the Board so that 
 the Board might see that they were consistent with the 
 main system. 
 
 Both main drainage and house drainage were thus steadily 
 being extended and improved, but in many places things 
 were still outrageously bad. Nor had the creation of fresh 
 evils been effectually prevented, for from Bromley came 
 the complaint that several new estates were rapidly being 
 covered with small house property which drained into 
 cesspools. 
 
 And the Medical Officer of Health for Fulham wrote 
 (1866) :— 
 
 " The active operations of your Board have fortunately 
 relieved the Fulham district to a large extent from that 
 pregnant source of mischief — want of drainage ; still there 
 are large tracts of building land yet unprovided for, on 
 much of which houses by dozens are being squatted without 
 any regard to this great essential by the builders, save the 
 horrid cesspool system. It is enough to have to counteract 
 the evils of past imprudence without perpetuating them by 
 such wilful recklessness. ..." 
 
160 THE SANITARY EVOLUTION 
 
 The supply of water to the inhabitants of London was of 
 equal importance to an efficient system of sewerage. The 
 problem had by no means been solved by " The Metropolis 
 Water Act " of 1852, which had enacted that within five 
 years after the passing of the Act a constant supply should 
 be given by the companies. Unfortunately, the supply was 
 in the hands of various public companies over which the 
 local governing authorities had practically little or no 
 control, and, like all sanitary legislation of this period, 
 the results were not commensurate with the intentions 
 of the Legislature. 
 
 An illustration of how insufficient the supply was, was 
 detailed in a report of the Medical Officer of Health for 
 Whitechapel in 1862 :— 
 
 *' A return has been made by the Inspector of 133 courts 
 in the district. 
 
 " Of these — in 48 which contain 388 houses and have 
 a population of 3,233 persons the water supply is by stand 
 taps only, from which the water flows daily (Sundays 
 excepted) for a period varying from quarter to half an 
 hour. 
 
 " This intermittent supply is totally inadequate to the 
 wants of the people." 
 
 Parliament made an effort in 1862* to amend the law, 
 and enacted that where a house was without a proper 
 supply of water the owner or occupier might be required 
 by the Vestry to obtain such supply, and if such notice was 
 not complied with, the Vestry might do the necessary work 
 and recover the expenses from the owner, and then require 
 the water companies to supply the water. 
 
 But the Act was of little practical value, and was made of 
 less value by the inaction of the local authorities. 
 
 A few extracts from reports of Medical Officers of Health 
 show how thoroughly unsatisfactory and disastrous to 
 the health of the people the existing condition of affairs 
 was. 
 
 The Medical Officer of Health for Fulham wrote in 
 1864 :— 
 
 * 25 and 26 Vic. cap. 102. 
 
OF LONDON 161 
 
 " The powers at present given by Statutes for enforcing 
 a supply of water for domestic use are, within the Fulham 
 district, all but inoperative. The cry amongst the cottagers 
 is still for water — water without which all other sanitary 
 appliances are at best abortive, without which in ample and 
 continuous flow no community can be preserved in health- 
 fulness. On this essential will depend the perfect working 
 of our deep and costly sewers, on this alone will hang 
 success in minor drainage matters. Water, that first and 
 most important element of health and cleanliness, exists 
 in name alone in masses of our cottage property here, and 
 consequently neither purity of person nor of dwelling can 
 be ensured." 
 
 The Medical Officer of Health for St. Martin-in-the-Fields 
 wrote in 1864 deploring that the new laws of the water 
 companies did not provide for water being supplied on 
 Sunday. "It is to be lamented that people should at 
 any time have to go about begging water, and more 
 especially so on Sundays, the very day they most require 
 it." 
 
 And the Medical Officer of Health for Westminster wrote 
 (1864) :— 
 
 " The water supply to many of the courts and alleys is 
 very unsatisfactory. No Sunday supply. 
 
 " It does seem a monstrous arrangement that for 52 
 days in the year the public should be deprived of that 
 which they pay for, but have no means of substituting by 
 anything else." 
 
 And to complete the hardships which the people suffered 
 under in the matter of water supply, if the house-owner did 
 not pay the water rates when called upon to do so, the 
 water company might cut off the supply of the people in 
 the house. This was frequently done, and the Medical 
 Officer of Health for Whitechapel recorded how for four 
 months — 
 
 " The inhabitants of Tuson's Court, Spitalfields, had been 
 entirely deprived of water in consequence of the water 
 company refusing to continue any longer the supply, as 
 the landlord had not paid the water rate." 
 
 12 
 
162 THE SANITARY EVOLUTION 
 
 The quality of the water, though improved by the change 
 of intakes to the part of the Thames above Teddington 
 Lock, left very much to be desired. It was no longer 
 contaminated by the entire sewage of the metropolis, 
 but it was still by sewage poured into the river and 
 its tributaries by towns higher up — Oxford, Reading, 
 Windsor, Chertsey, Hampton, and others — and received, 
 unchecked, the whole of the pollution, solid and fluid, of 
 the district constituting the watershed. And this same 
 water, after it had been so polluted, was abstracted from 
 the river, sand-filtered, and pumped into the metropolis 
 for domestic uses and distributed to the consumers.* 
 
 The housing of the people was the problem which, above 
 all others, was more and more forcing itself upon the atten- 
 tion of those whose work brought them into actual contact 
 with the conditions of life of the great mass of the people 
 who were in their charge ; not merely the construction of 
 the houses or their situation, but the accommodation 
 afforded and the conditions of life therein. 
 
 "Our forefathers," wrote one of the Medical Officers of 
 Health, ** knew nothing about the public health, and cared 
 less. They added house to house, and street to street, 
 according to their own will and apparent benefit, and so 
 have left us this mingled heritage." 
 
 And there were streets and courts and alleys which were 
 not fit for human habitation, and which could never be 
 made so ; and thousands upon thousands of houses where 
 " nothing short of a hurricane would suffice to displace and 
 renew the air." 
 
 London had enough to suffer under from the state of the 
 existing houses, and an appalling task before her to remedy 
 them, but not alone was this enormous evil practically 
 unattacked, but fresh sources of evil were allowed to be 
 created, and new houses were being erected which would 
 carry into the future the evils which efforts were now being 
 made to put an end to. 
 
 " A house may be built anywhere," wrote one of the 
 Medical Officers of Health in 1862, " and almost anyhow, 
 * See P.P. 1866, vol. xvii. Eeport of Eoyal Commission. 
 
OF LONDON 163 
 
 provided all the rooms can be lighted and ventilated from 
 a street or alley adjoining. The object of the builder is to 
 save as much ground, materials, and expense as possible. 
 The result is not difficult to foresee. ..." 
 
 No regard, moreover, was had to the ground on which 
 new houses were being built, though that was all-important 
 for a healthy dwelling. 
 
 "... Some of the new houses are built upon garden 
 mould or old ' slop shoots,' " wrote the Medical Officer of 
 Health for Paddington in 1870-1 ; " these thin and flimsy 
 shells of lath and plaster truly merit the term ' slop 
 buildings.' A dangerous moisture and miasma arises 
 from houses built upon such an unhealthy foundation." 
 
 How disastrous the results were to the inhabitants is 
 pointed out by several Medical Officers of Health. 
 
 The Medical Officer of Health for Mile-End-Old-Town 
 wrote (1866) :— 
 
 "... Many, open places now built upon, or being built 
 upon, have been for years the receptacles for all kinds of 
 animal and vegetable refuse, and have become thoroughly 
 impregnated with the products of their decomposition. . . . 
 The result to the health of the occupants is daily realised 
 by the excessive number of zymotic diseases and deaths 
 which occur in them." 
 
 The Medical Officer of Health for Limehouse wrote : — 
 
 "Ask about the general health and the houses. 'Never 
 been well since coming in, and the children always ailing; 
 and my husband says he feels more refreshed when he 
 comes from his work than after he gets up in the morning. 
 And then everything spoils ; meat put into a cupboard is 
 musty in a night. One can keep nothing.' 
 
 " These are all new houses." 
 
 And a few years later, referring to this same subject, he 
 wrote : — 
 
 " A half mile off, a few years ago, there were some acres 
 of gravel pits. The gravel had gone for road-making, &c. 
 The large pit was then filled up on invitation of the owner, 
 with the aid of the scavenger and others, with all the slush 
 and filth of a large circle of contributors. When this fund 
 
164 THE SANITARY EVOLUTION 
 
 of abominations became consolidated, it was built over in 
 the usual style. They were soon occupied by tenants and 
 lodgers. Now this site during the epidemic (of cholera) 
 has been a great slaughter field — the mortality was 
 shocking." 
 
 And he added, " there are thousands of such houses built 
 about London." 
 
 The Building Act of 1855 was very far from being an 
 effective prevention of such devices as these. It required a 
 notice to be given to the Vestry before any new building was 
 commenced, and a plan to be submitted for approval show- 
 ing the proposed drainage and the levels of the building ; 
 but this requirement appears to have been by no means 
 universally complied with, and some local authorities had 
 great difficulty in getting notices of new buildings com- 
 menced within the district. And its restrictions were not 
 sufficient to prevent the speculative builder in places from 
 raising his block of houses in the fields with neither road or 
 sewer for their accommodation, and with the frequent result 
 of fever-stricken tenants. 
 
 With the increasing knowledge of their districts gained 
 by the numerous Medical Officers of Health distributed 
 over the whole metropolis, the widespread prevalence of 
 overcrowding in London, and the virulent evils, physical, 
 social, and moral, consequent thereon, come into greater 
 prominence and more vivid light than ever before. 
 
 Throughout the central parts of London the process of 
 demolition of houses of all sorts and sizes, inhabited by the 
 well-to-do or by the poorest, was continuing. The street 
 improvements which were being carried out in some places 
 entailed extensive demolitions ; whilst the construction of 
 railways and the erection of large stations necessitated the 
 destruction of hundreds of others, mostly those inhabited 
 by poorer persons. Thus, in the improvements in the 
 Holborn Valley, 348 houses, accommodating 1,044 families 
 and 4,176 persons, were taken down and not replaced. And 
 in St. Pancras, and many other districts, the dwellings of 
 the poor were constantly being removed by railway expan- 
 sion. 
 
OP LONDON 165 
 
 The subject of the displacement of labourers in conse- 
 quence of great public works in the metropolis was brought 
 before the House of Lords in 1861 by Lord Derby.* 
 
 "It affects," he said, "in the most vital manner the 
 interests of a large portion of the population who are utterly 
 unable to protect themselves against legislation, however 
 unfavourably it may bear upon them. 
 
 " In the metropolis and its suburbs sixty to seventy miles 
 of new line (railway) are proposed — a great portion of these 
 passing through the most crowded streets." 
 
 He described specially the parish of St. Bartholomew's, 
 in Cripplegate, with a population of about 5,000 inhabiting 
 500 houses. 
 
 " Throughout it, there are not ten families who occupy a 
 house to themselves, although the bulk of the houses contain 
 only three rooms. The incumbent tells me the aristocracy 
 of his parish consists of families who are able to indulge in 
 the luxury of .two rooms. But the greater number have 
 one room, and one only, and this is sometimes divided 
 between more than one family. 
 
 " Half of these houses are under notice for the railway." 
 
 And Lord Shaftesbury described a great demolition of 
 houses which took place a few years previously in the 
 neighbourhood of Field Lane, City : " 1,000 houses 
 were pulled down ; 4,000 families, comprising 12,000 indi- 
 viduals, were turned out and driven into the surrounding 
 tenements." 
 
 Lord Granville suggested, as a remedy, the provision of 
 cheap trains to carry artisans from healthy dwellings in the 
 suburbs to the scene of their work, and Lord Bedesdale 
 said he had introduced clauses into the Railway Bill pro- 
 viding that the companies should run a cheap train every 
 day. But, as Lord Shaftesbury pointed out,t that would 
 not be sufficient, as — 
 
 " In some cases the men are under an engagement to 
 their employers not to live more than a certain distance from 
 the warehouse," in order that no time might be lost in 
 executing orders. 
 
 * Hansard, vol. clxi. p. 1061. f Ibid., vol. clxii. p. 148. 
 
166 THE SANITARY EVOLUTION 
 
 The remedy, moreover, could only be very gradual in its 
 operation, and was quite inadequate to meet the existing 
 emergency. 
 
 This demolition of houses had thus the twofold result of 
 at once intensifying overcrowding in the remaining houses 
 in the localities affected, and in extending the area of over- 
 crowding by causing a migration to other localities, many of 
 which were themselves rapidly becoming overcrowded. And 
 this, combined with the natural growth of the population 
 and the constant stream of immigration into London, 
 resulted in overcrowding on a far larger scale than had 
 hitherto prevailed. 
 
 In Mile-End-Old-Town the "West Ward had received in 
 the decade 1851-61 an addition of 3,094 persons, whilst 
 but 84 new houses had been built — the South Ward 1,372 
 persons and 71 new houses built. 
 
 In Shoreditch, in 1863, " The tendency to overcrowding 
 was increasing year by year. 
 
 "Being mostly operatives, &c. . . . accustomed to live 
 near their places of employment, they were naturally un- 
 willing to travel further than necessary, and so have accepted 
 the readiest accommodation for their families." 
 
 Of Whitechapel, the Medical Officer of Health wrote in 
 1865 :— 
 
 " The evil of overcrowding is annually increasing, and if 
 means be not adopted to check it, the overcrowding will 
 soon become of an alarming extent. . . . 
 
 " Houses formerly occupied by single families are let out in 
 separate tenements, and every room now contains a distinct 
 family ; and to such an extent is this separate letting of 
 rooms carried out, that from information given me there is 
 not a single street in the parish of Whitechapel that is not 
 more or less a nursery of pauperism in consequence of this 
 sub-division of tenements." 
 
 Away in the west, in Fulham, there had been a " flood of 
 immigrants," chiefly of " the lower and labouring classes." 
 The population had increased 30 per cent., and the Medical 
 Officer of Health wrote (1865) :— 
 
 "In watching the enormous accession of population to 
 
OF LONDON 167 
 
 the Fulham district, one cannot otherwise than observe the 
 constant tendency to overcrowding amongst the labouring 
 people, whilst there seems every possibility of this human 
 tide increasing. The tremendous demolition of the houses 
 hitherto occupied by the working classes more imme- 
 diately in London itself has dislodged thousands of families, 
 whilst no systematised provision has been made for their 
 reception." 
 
 In Westminster the Medical Officer of Health wrote in 
 1865 :— 
 
 " The dwellings of the poor were never in a worse or 
 more unsatisfactory state than they are at present from the 
 large number of houses that have been already demolished. 
 The poor are now driven into the most wretched apartments, 
 and which, in consequence of the increased demand, can 
 only be obtained at the most extravagant rates. They are 
 consequently compelled to herd together in one room, usually 
 barely sufficient for half of those it is now made to hold." 
 
 The south side of the river was much in the same plight 
 as the north ; but there, there was more room for expan- 
 sion. 
 
 The Medical Officer of Health for St, Saviour, South- 
 wark, wrote in 1865 : — 
 
 " The numerous improvements which continue to be 
 made in and about the heart of London have so increased 
 the value of house property that overcrowding has been 
 almost inevitable. 
 
 " . . . In a vast number of instances families numbering 
 four to seven persons, ill or well, live, cook, wash, and sleep 
 in rooms the dimensions of which are not greater than is 
 now demanded for each sick person in the workhouse." 
 
 The Medical Officer of Health for St. George-the-Martyr, 
 Southwark, wrote : — 
 
 '* In many of the districts of the metropolis between 60 
 and 70 per cent, of the population are compelled to live in 
 one small overcrowded room, and in which every domestic 
 operation has to be carried on ; in it birth and death takes 
 place ; there plays the infant, there lies the corpse ; it is lived 
 in by day, and slept in by night." 
 
168 THE SANITARY EVOLUTION 
 
 In the necessity for house accommodation all sorts of 
 places were being pressed into use, and people driven into 
 "places that are themselves unfit for habitation, not having 
 the elements of life and health about them." 
 
 The Medical Officer of Health for Paddington described, 
 in 1867, how mews had been thus utilised : — 
 
 " In fact these back streets, originally built and intended 
 for horses and vehicles, and only those persons without 
 encumbrances who are engaged attending to them, have 
 now become the resort of persons with large families follow- 
 ing all kinds of business — rag, bone, and bottle stores, shops 
 of various kinds, including beer-houses, builders, carpenters, 
 smiths, tailors, sweeps, find accommodation here. Inhabit- 
 ing the rooms above, too small, and unfitted with proper 
 domestic accommodation for a family, live a vast popula- 
 tion of all ages. These evils, rather than otherwise, are 
 increasing." 
 
 Into such houses and such rooms the people were by 
 stress of circumstances compelled to go, and, as the Medical 
 Officer of Health for St. Giles' pointed out (1863) :— 
 
 " A larger rent can be obtained for the same room if it is 
 overcrowded by a large family than if it be hired for only as 
 many inmates as it can properly receive. Hence the interests 
 of landlords are constantly on the one side, the health of the 
 poor on the other. . , ." 
 
 What this pressure upon accommodation produced may 
 be gathered from a few figures given by the Medical Officer 
 of Health for Whitechapel : — 
 
 Houses. Rooms. Inmates. 
 
 In Slater's Court, Whitechapel 10 31 170 
 In Marlborough Court . . 7 20 82 
 
 In Hunt Court ... 8 32 158 
 
 " In one room in Swan Court, having one window, seven 
 persons slept — a man and his wife, the daughter aged 24 in 
 consumption lying in bed, and four younger children ; the 
 cubic contents of the room were 910 = 130 cubic feet to each 
 person. 
 
 "In Bell Court four persons occupied a room with 94 
 cubic feet each. 
 
OF LONDON 169 
 
 "In three rooms in Hayes Court, each 10 x 8 x 8 feet; 
 each with only one window opening into a narrow court ; 
 each occupied by eight persons = 80 cubic feet to each 
 person." 
 
 The Medical Officer of Health for St. Pan eras (1865) 
 described some of the consequences of the conversion of a 
 house, built originally for one family, into one inhabited by 
 several families : — 
 
 " . . . At present these families occupy usually a single 
 room only in a house of six or eight rooms adapted for only 
 one family. The water supply is inadequate, and at some 
 distance from the upper rooms, and there is but one closet, 
 one dust bin, one coal cellar, and one wash house for the 
 whole. No one is responsible for the cleanly condition of 
 the closet, the water tank, the single staircase, the base- 
 ment, the areas, and the yard, or for emptying the dust 
 bin." 
 
 One of the worst forms of overcrowding was when it 
 resulted in what was described as "indecent occupation." 
 For instance, as reported (1861) by the Medical Officer of 
 Health for Whitechapel : — 
 
 " In a room in Windmill Court there slept the mother, 
 two adult daughters, and two adult sons. 
 
 " In another room in the same court, a man and his wife, 
 the daughter aged 16, and three adult sons." 
 
 In 68 instances the rooms were " indecently occupied," 
 that is to say, adult brothers and sisters, or a father and 
 daughter slept in the same room. 
 
 And he wrote : — 
 
 " We may well inquire how such gross indecency and 
 want of self-respect can exist in this country, which is 
 usually considered to be the centre of civilisation, and where 
 so much money is spent in imparting religious and moral 
 instruction to the people — yet such is the state in which 
 many of the inhabitants of this district live, as is ascertained 
 on a house-to-house visitation." 
 
 And in the following year he v^rote : — 
 
 " On visiting the houses in low neighbourhoods it is by no 
 means of unfrequent occurrence to find an adult brother and 
 
170 THE SANITARY EVOLUTION 
 
 sister, a father and adult daughter, a mother and adult son, 
 occupying the same bed. What good citizenship can be 
 expected to be manifested by a class in whom the moral 
 feeling is so low? " 
 
 The Medical Officer of Health for St. James', in his report 
 (1862), wrote:— 
 
 " This close association of several families in one house 
 is productive of immense evil ; it prevents proper parental 
 control ; it encourages an association of the sexes which 
 leads directly to one of our greatest social evils ; and is one 
 of the most fruitful causes of the spread and fatality of 
 zymotic diseases of childhood, and lays the foundation of 
 the scrofula and consumption which every year carry off a 
 fifth of all who die amongst us. . . . 
 
 "It is almost impossible, amidst the filth and stench of 
 dirty houses and imperfect drains, that the working man's 
 family should be able to develop those moral and intellectual 
 qualities which are, after all, more worth to the community 
 than any saving of rates." 
 
 The Medical Officer of Health for St. Martin-in-the-Fields, 
 wrote (1866) :— 
 
 "Kents have become so heavy that few labouring men can 
 afford more than one room. Overcrowding in such rooms 
 must increase, and with it the fearful results of men, women, 
 girls, and boys, all sleeping in the same apartment. Neither 
 religion nor morality can increase under the existing cir- 
 cumstances of our poorer classes. It is almost returning to 
 the habits of our barbarous ancestors or the untutored 
 savages of Africa and Australia." 
 
 And the Medical Officer of Health for Holborn wrote : — 
 
 " Depend upon it, the moral and physical training of the 
 people is more influenced by lessons — whether in health and 
 cleanliness, or in religion and morality — that they are con- 
 stantly receiving at their own firesides than by any extraneous 
 teachings. 
 
 "When a child has been allowed to grow up with a 
 diseased body, and a polluted mind, in a wretched room, 
 without light, without cleanliness, and without any notions 
 of decency, our curative efforts, whether medical, missionary, 
 
OF LONDON 171 
 
 or reformatory, are as mere patchwork compared with the 
 great preventive precaution of keeping his home as pure, as 
 decent, and as wholesome, as possible." 
 
 No more powerful description can be given of the moral 
 evils of overcrowding than that of Dr. J. Simon in 
 1865 :— 
 
 "Where 'overcrowding' exists in its sanitary sense, 
 almost always it exists even more perniciously in certain 
 moral senses. In its higher degrees it almost necessarily 
 involves such negation of all delicacy, such unclean confusion 
 of bodies and bodily functions, such mutual exposure of 
 animal and sexual nakedness, as is rather bestial than 
 human. 
 
 " To be subject to these influences is a degradation which 
 must become deeper and deeper for those on whom it con- 
 tinues to work. To children who are born under its curse, 
 it must often be a very baptism into infamy." * 
 
 Overcrowding was not confined to tenement-house rooms 
 alone. The great bulk of the working classes left their 
 overcrowded abodes to do their day's work in overcrowded 
 factories, workshops, and workplaces ; and in very many 
 such places men, women, and even children were crammed 
 together in rooms where healthy existence was impossible. 
 
 A great deal of information on this great branch of the 
 sanitary condition of the inhabitants of London is given in 
 the Eeports from the Commissioners on Children's Employ- 
 ment, and in the very valuable reports of special inquiries 
 instituted by the Medical Department of the Privy Council. 
 
 One of these inquiries related to Bakehouses, of which 
 there were about 3,000 in the metropolis in 1862. f 
 
 As a rule the place in which the bread of London was 
 made was what in houses in general was the coal-hole and 
 the front kitchen. 
 
 Very many bakehouses in London were stated to be in a 
 shockingly filthy state, arising from imperfect sewerage and 
 bad ventilation and neglect, and the bread must, during 
 
 * P.P. 1866, vol. xxxiii. 
 
 \ See P.P. 1863, vol. xxv. Report by H. S. Tremanheere to the 
 Home Secretary, 1862. 
 
172 THE SANITARY EVOLUTION 
 
 the process of fermentation, get impregnated with the 
 noxious gases. 
 
 The sleeping places were of the worst description,* some 
 of the men sleeping in the bakehouse itself. Many bake- 
 houses were infested with rats, beetles, cockroaches, and 
 noxious smells. The smells from the drains were very 
 offensive — the air of the small bakehouses was generally 
 overloaded with foul gases from the drains, from the ovens, 
 and from the fermentations of the bread, and with the 
 emanations from the men's bodies ; the air thus contami- 
 nated was necessarily incorporated with the dough in the 
 process of kneading. 
 
 Half of the bakehouses in London would, it was stated, 
 require the application to them of the Nuisances Eemoval Act. 
 
 Another inquiry related to the tailoring trade in the 
 metropolis.! The places in which work was done were 
 reported as varying much in their sanitary conditions, 
 but almost universally were overcrowded and ill-venti- 
 lated, and in a high degree unfavourable to health. Some 
 were underground, either in the basement of a house, or 
 built like a large kennel in a small enclosed yard, and 
 were such that no domestic servant would inhabit. In 
 exceedingly few shops had there been any attempts at 
 ventilation. The ventilation through the windows was 
 practically inefficient, and instances were given of what 
 had been found in sixteen of the most important West-end 
 shops. In one an average of 156 cubic feet space was 
 allowed to each operative, in another 150 cubic feet, in 
 another 112 cubic feet. Deficient ventilation, heat, and 
 draughts, were the causes of diseases. 
 
 A paper read by Dr. E. Symes Thompson (Assistant 
 Physician to King's College Hospital) at the Social Science 
 Association Meeting in London, 1862, described the condition 
 under which printers did their work. 
 
 * " In a bakehouse in St. Martin's Lane, eight men slept in one room 
 (separated from the bakehouse) which had nothing that deserves the 
 name of a window " (Report of Medical Officer of Health, 1864). 
 
 f P.P. 1864, vol. xxviii. Sixth Report of the Medical Officer of the 
 Privy Council (1863). 
 
OF LONDON 173 
 
 " Printers often work sixteen to eighteen hours a day 
 in a confined and heated atmosphere; perhaps thirty men 
 and as many gaslights in a low room without ventilation 
 or chimney, where air only enters when the door is 
 opened. . . . 
 
 " Printing is only one of the many trades which entail the 
 sacrifice of every hygienic necessity, and the cause of the 
 unhealthy looks of the workpeople cannot fail to strike any 
 observant person who may visit their workshops. The 
 rooms are mostly low, the windows fixed, and there is often 
 no chimney or other ventilation. 
 
 " This is the case in large and small factories as well as in 
 workshops — in the workroom of the miUiner, the sempstress, 
 or the bookbinder. 
 
 " In many occupations, besides the evils alluded to, the 
 air is charged with foreign matters, which are drawn into 
 the lungs at each inspiration ; e.g., the sorting and tearing 
 up of dirty rags in paper manufactories. The dust and fluff 
 arising in flax, woollen, and cotton factories, and in furworks, 
 produce similar results — and brass finishers." 
 
 And in another paper at the same meeting Mr. George 
 Godwin detailed his experiences as regarded the conditions 
 under which milliners, dressmakers, and other needlewomen 
 worked. 
 
 " In an upper room in Oxford Street, not 10 feet square, 
 I have seen a dozen delicate young women closely shut up 
 making artificial flowers ; and there when business is 
 pressing they work from 8 in the morning till 12 o'clock 
 at night. 
 
 " Many of the workrooms of fashionable milliners are 
 similarly overcrowded, as are those where young girls are 
 engaged in book-stitching." 
 
 He gave as an example a house in Fleet Street. 
 
 " The staircase is confined and without ventilation — the 
 atmosphere is steaming and smells of glue. 
 
 " In the first room looked into, 40 young women and girls 
 were sorting and stitching books. There was a stove but 
 no ventilation. . . . There were more than 200 persons in 
 that house, pent up without provision of the first necessity 
 
174 THE SANITARY EVOLUTION 
 
 of life — pure air. Poor creatures so placed are being slowly 
 slain. 
 
 " Other trades, such as cap and bonnet makers, trimmers, 
 blond-joiners, &c., to which I have looked with some little 
 care, are forced in many places to do just the same thing." 
 
 *' The extent of suffering entailed, and the loss to the 
 community, it would be difficult to calculate. It is time 
 that legislation should be tried to secure wholesome work- 
 places for the people. Interference is needed for thou- 
 sands of persons — especially young females — the debilitated 
 mothers in posse, should they live, of our future population. 
 In our infant schools, too, where incalculable mischief is 
 done by overcrowding, it is greatly required. The evil is 
 sapping the strength of the land." 
 
 " In several parts of London persons employed in making 
 cheap clothing are boxed up in crowds, . . . some striving 
 to get a living in a death-giving atmosphere. 
 
 " Shoemakers are often as ill-placed. In wretched apart- 
 ments, in an ill-drained house, may be found men and boys 
 huddled together without room to breathe." 
 
 It was under such pitiable conditions that large masses of 
 the working classes of London had to earn their daily 
 bread. 
 
 Lord Shaftesbury truly said that " the sanitary condition 
 of these people was of national importance, not only on 
 account of the waste of life, but the waste of health which 
 every year threw thousands and tens of thousands upon 
 the rates.* 
 
 And large numbers of children were also employed under 
 insanitary conditions, and were made to do heavy work for 
 long hours, and the consequences to their health were 
 disastrous.! That their constitutions should be undermined 
 and their physical development should be most seriously 
 deteriorated was a necessary result. 
 
 There was a chorus from the Medical Officers of Health as 
 to the evil sanitary consequences of overcrowding. 
 
 * Hansard, 1864, June 16, p. 1835. 
 
 f See Reports of the Commissioners on Children's Employment, 
 1864-6. 
 
OF LONDON 175 
 
 " Overcrowded dwellings are among the most prolific 
 sources of disease, immorality, and pauperism." * 
 
 " Overcrowding — one of the elements by which disease is 
 not only generated but sustained." t 
 
 " Overcrowding is a constant source of fever." 
 
 " The great difficulty of obtaining lodgment for the working 
 classes has caused overcrowding of the poor in an unpre- 
 cedented manner, and consequently the development of 
 typhus which is considered to be bred in the pestilential 
 atmosphere of overcrowded dwellings." I 
 
 Overcrowding led to numerous, indeed to all sorts and 
 kinds of diseases. 
 
 The Medical Officer of Health for St. Pancras wrote : — 
 
 " It has been shown that consumption and the so-called 
 tubercular diseases are developed by want of pure air more 
 than by any other cause." 
 
 And not alone did the overcrowding lead to disease, 
 but it rendered it difficult if not impossible to check 
 disease. 
 
 ** How is it possible," wrote one of them, " to prevent 
 the spread and fatality of fever and whooping-cough 
 when six or seven persons are shut up in one small room 
 breathing the same air loaded with zymotic poison over and 
 over again?" 
 
 " The danger of allowing a deadly atmosphere to be 
 engendered by the crowding together of persons in a small 
 room without sufficient ventilation is unfortunately not 
 confined to the inmates of that particular room, but those 
 diseases which are therein generated extend far beyond its 
 immediate vicinity, and under some circumstances a large 
 portion of a district will suffer in consequence. § 
 
 Dr. Kendle, previously Medical Officer of Health for St, 
 George-the-Martyr, in his evidence || before a Select Com- 
 mittee in 1866, said : — 
 
 "... The overcrowding exists to such an extent that 
 
 * Shoreditch, 1863. f Westminster, 1861-2. J 1863-4. 
 
 § Whitechapel, 1861. 
 
 II P.P., vol. clxxxvi. Select Committee of House of Commons on 
 Medical Local Government, 1866, p. 259. 
 
176 THE SANITARY EVOLUTION 
 
 the poor cannot by any possibility do other than breed 
 disease, and when they breed it they give it to others." 
 
 Lord Shaftesbury said : — 
 
 " As to the effects of all this overcrowding, can anything 
 be more prejudicial to the human system than the filthy 
 squalor, the foetid air, and depressing influences of these 
 dwellings?- 
 
 "When you ask why so many of the working men betake 
 themselves to the ale-house or gin-palace, the answer lies in 
 the detestable state of their homes. 
 
 "1 have had it from hundreds of both women and men 
 that this cause, and this cause alone, has driven them to the 
 use of ardent spirits. . . . Nine-tenths of our poverty, 
 misery, and crime, are produced by habits of intoxication, 
 and I trace those habits, not altogether, but mainly, to the 
 pestilential and ruinous domiciliary condition of the great 
 mass of the population of this metropolis and the large towns 
 of the country."* 
 
 "No bodily labour induces an exhaustion of the vital 
 powers comparable to that resulting from the habitual 
 breathing of air contaminated by the overcrowding of 
 human beings." t 
 
 For children born under such circumstances of over- 
 crowding and filth, and in such insanitary surroundings, 
 birth was mostly followed by an early death. 
 
 " Infancy in London has to creep into life in the midst of 
 foes," as the Times truly remarked in 1861. 
 
 Among the greatest of these foes was overcrowding. The 
 statistics of infantile mortality are fairly reliable, and, so far 
 as there are errors, those errors were in understating and not 
 overstating it. 
 
 In St. Giles, in 1861, 4S^ per cent, of the total number of 
 deaths were of children under five years of age. 
 
 " This enormous infantile mortality," wrote the Medical 
 Officer of Health, " is unfortunately only what is customary 
 in our district." 
 
 In the Strand, 1861, the percentage of deaths under five 
 
 * Hansard, 1861, vol. clxi. p. 1070. 
 
 f Report of Coromissioners. P.P. 1864, vol. xxii. p. xlix. 
 
OF LONDON 177 
 
 annually exceeded 45 per cent, of the total deaths. In 
 Westminster, in 1861, there were 1,685 deaths, 770 being 
 those of children under five — of which in St. John's parish, 
 out of 834 deaths, 427 were under five — or over 50 per cent. 
 
 In Bethnal Green in 1862 it was close upon 60 per cent. 
 
 In the Potteries, Notting Dale, with a population of 1,100, 
 the deaths of children in 1870 under five were 63 per cent, 
 of all deaths. In 1871, 72 per cent. 
 
 On the south side of the river the same tale was told. In 
 Wandsworth 42 per cent, in 1861 ; in Battersea 45 per cent. 
 in 1862; in Eotherhithe, in 1862, nearly 50 per cent.; in 
 Bermondsey, in 1863, 57 per cent. 
 
 "It certainly," wrote the Medical Officer of Health for 
 Fulham, "could not have been intended by Providence that 
 of all the children bom, nearly one-half should die without 
 attaining one-fourteenth part of the threescore years and ten 
 allotted to mankind — and yet we see the yearly realisation 
 of this astounding fact." 
 
 Other causes besides overcrowding contributed to this 
 great mortality. 
 
 "Poverty," wrote the Medical Officer of Health of Poplar, 
 " with its concomitants — defective nourishment, want of 
 cleanliness and ventilation, malaria, overcrowded dwellings, 
 deficient supply or impure quality of water — these all act 
 with unerring force upon the tender constitutions of the 
 young." 
 
 And another wrote : — 
 
 "What with overcrowding, insufficient food, and inatten- 
 tion to cleanliness, it is almost impossible an infant can resist 
 an attack of the commonest disorder." 
 
 And some places were in such evil sanitary condition 
 that child life was impossible therein. Of two Courts 
 in Islington the Medical Officer of Health reported in 
 1863 :— 
 
 "Young children cannot live there. All that are born 
 there, or are brought to reside there, are doomed to die within 
 two years." 
 
 The state of the public health generally as the result of 
 all these sanitary abominations was very unsatisfactory. 
 
 13 
 
178 THE SANITAUY EVOLUTION 
 
 In 1863 the mortality of London was unusually high. 
 
 The Medical Officer of Health for St. Giles' wrote :— 
 
 *' The year has been conspicuous for a high mortality 
 resulting from the prevalence of epidemics to an unusual 
 degree — smallpox, scarlatina, typhus." 
 
 The following year he reported to have been — 
 
 " A year of exceptional mortality. . . . Death rate 29*74 
 per thousand, or, if the deaths of parishioners in hospitals 
 be included, 31*10. . . . Tubercular diseases, of which 
 consumption affecting the lungs is the most important, 
 were as usual intensely fatal in our district." 
 
 The Medical Officer of Health for Whitechapel drew 
 attention to the increase of mortality in his district. He 
 was evidently puzzled and perplexed by it, and " candidly 
 confessed " his inability to account for it. 
 
 "I may, however, venture a few conjectures." Among 
 them was this very suggestive one — " that a change has 
 taken place in the constitution of the people so that they 
 are now less able to bear the effects of disease than 
 formerly." 
 
 Suggestions and recommendations for ameliorating this 
 appalling condition of things poured in upon many of the 
 local authorities from their Medical Officers of Health. 
 
 Upon several points there was an absolute consensus 
 of opinion. 
 
 One of these was that all houses let out in separate 
 tenements and inhabited by many families should be 
 registered by the local authorities — that rules and regu- 
 lations should be made for their management, and that 
 constant inspection by the sanitary authority was an 
 absolute necessity if the proper conditions of health were 
 to be maintained. 
 
 The Medical Officer of Health for Bethnal Green 
 wrote : — 
 
 "All sanitary evils fall with greatest force upon those 
 who are unable to quit the scene of their misery or to 
 provide the means for its alleviation. 
 
 " Nothing but adaptation of the present houses to the 
 necessities of healthy existence and the demolition of those 
 
OF LONDON 179 
 
 houses that are unfit for human habitation can contribute 
 so much to hfe and strength." 
 
 A Committee of the District Board in Poplar wrote 
 (1866) :— 
 
 "It would be a satisfactory alteration of the law if no 
 houses were allowed to be tenanted unless a certificate that 
 these premises were fit for habitation were first obtained 
 from the District Board of Works." 
 
 And the necessity of constant inspection was even more 
 vigorously expressed. 
 
 The Medical Officer of Health for Hackney wrote 
 
 (1861) :- 
 
 " The experience of the past year again shows the 
 necessity of keeping up a regular and efficient supervision 
 of the interior of houses. . . . 
 
 "It is only by repeated and careful inspection of the 
 dwellings of the poor, and an , inculcation at these visits 
 of the necessity for keeping clean their rooms that epidemic 
 diseases can be kept in check." 
 
 The Medical Officer of Health for St. James' wrote 
 
 (1862) :— 
 
 " The nuisances which are removed, are constantly 
 recurring. It is only by constant inspection and by 
 supervision repeated systematically from day to day, and 
 week to week, that those nuisances can be kept down which 
 are ever ready to destroy the life, and at one and the same 
 time sap the health and undermine the morality of the 
 community." 
 
 The Medical Officer of Health for Whitechapel wrote : — 
 
 "If it were not for the vigilance of the Inspectors in 
 visiting the houses of the poor, nuisances would remain 
 altogether unattended to ; for very few of the poor dare to 
 make a complaint from fear of being compelled to quit their 
 tenements." 
 
 The Medical Officers of Health recognised that much of 
 the bad condition of the dwellings of the poorer classes 
 was due to the people themselves. 
 
 Thus the Medical Officer of Health for Westminster 
 wrote (1865-6):— 
 
180 THE SANITARY EVOLUTION 
 
 "It is much to be regretted that in certain districts 
 of the parish only a temporary good is effected by a 
 sometimes lavish expenditure on the part of the proprietor. 
 The habits of the people are such that it is almost im- 
 possible to do anything for their benefit. Not only are they 
 filthy in themselves, but they take every opportunity to 
 break, destroy, and steal anything that may be of value, 
 and what is even worse they appear to negative any 
 sanitary precaution effected for their benefit." 
 
 But the broad truth was that the real, the primary 
 responsibility rested upon the " owners." 
 
 Theirs was the property. And them it behoved to keep 
 that property in a condition which was not a danger to the 
 community and to the State. 
 
 The Medical Officer of Health for Whitechapel wrote 
 (1865) :— 
 
 " The duty and interests of landlords appear to be at 
 variance as regards their doing to their houses what is 
 absolutely necessary for the well-being of their tenants. It 
 is unquestionably the duty of landlords to keep the houses 
 which they let out in separate tenements to the poor in 
 a healthy condition ; but this is not always done even if 
 compulsory orders are signed and summonses issued. . . . 
 
 " Many of the landlords of small house property fully 
 understand and carry out the rights of ownership, but fail 
 to carry out the duties which are enjoined upon them as 
 owners." 
 
 The Medical Officer of Health for Islington, referring to 
 some vile property in his parish, wrote (1863) : — 
 
 " Landlords of such property as this will rarely do 
 anything out of consideration for the health or lives of 
 their tenants ; compulsion alone will extort amendments. 
 What is needed here is the closure of the fatal houses until 
 made fit for human habitation." 
 
 How an "owner" could manage his property can be 
 gathered from the following report of the Medical Officer ot 
 Health for Paddington (1863), which called attention to "the 
 insanitary condition of a block of houses (about thirty in 
 number) which had been for many years notoriously liable 
 
OF LONDON 181 
 
 to the invasion of epidemics and to the prevalence of those 
 diseases which are the known product of sanitary neglect — 
 badly constructed and dilapidated, and wanting in the 
 commonest appliances of cleanliness. All were the property 
 of one individual who had been repeatedly urged to put them 
 in a proper sanitary state." 
 
 But it was not until stringent compulsory measures were 
 taken that he began to do so, and some years elapsed before 
 they were really done. 
 
 Here is another dreadful case of overcrowding and in- 
 sanitation — this time in St. Marylebone (1868). 
 
 Edwards Place : — 
 
 " Ten six-roomed houses occupied by 84 families, 277 
 persons, houses very dilapidated, many unfit for human 
 habitation. Orders for sanitary work are continually being 
 sent out by the Vestry to the owner of this wretched 
 property. 
 
 "A rental of ^610 per annum would be an extravagant sum 
 to pay for either of these miserable dwellings, yet more than 
 three times that sum is expected from the destitute and 
 indigent people who inhabit them." 
 
 Read by the light of the knowledge that insanitary 
 property meant disease, and disablement, and death to a very 
 high percentage of its occupiers, the proper compulsion to 
 have applied to "owners" such as these would have been 
 proceedings before a Coroner's jury for culpable homicide if 
 not for actually deliberate murder. 
 
 The community has a right to be protected from the evil 
 results of the miserable housing of the poor. 
 
 Mr. George Godwin said in 1862, at the meeting of the 
 National Association for Promoting Social Science : — 
 
 " It should be no answer to the requirement of a certain 
 cubical space for each occupier, that the financial resources 
 of the parties will not admit of it. 
 
 "A man is not permitted to poison withprussic acid those 
 who are dependent on him because he is poor ; neither 
 should he be allowed on that ground to kill them with bad 
 air and set up a fever-still for the benefit of his neighbours." 
 
 Parliament, under the pressure of a slowly-developing 
 
182 THE SANITARY EVOLUTION 
 
 public opinion, and in view of the ever accumulating 
 evidence and proof of the almost incredible insanitary condi- 
 tion in which great masses of the people of London were 
 living, was beginning to show less reluctance to discuss and 
 deal with some of the multifarious matters affecting the 
 public health. 
 
 In 1860 it passed an Act which, however well intentioned, 
 was not of much effect. It was an effort to secure more 
 wholesome articles of food and drink for the public by 
 preventing their adulteration. 
 
 The past history of such legislation was rather interest- 
 ing.* In 1731 an Act has been passed prescribing a penalty 
 for " sophisticating tea." 
 
 " Several ill-disposed people frequently dyeing, fabricating, 
 very large quantities of sloe-leaves, &c., in imitation of tea, 
 and colouring or staining and dyeing such leaves, and vend- 
 ing the same as real tea to the prejudice of the health of His 
 Majesty's subjects." 
 
 " In year 1766-7 a further Act was passed inasmuch as 
 ' such evil practices were increased to a very great degree to 
 the injury and destruction of great quantities of timber, 
 wood, and underwoods.' 
 
 " Coffee had also been the subject of legislation, ' burnt 
 scorched, or roasted peas, beans, &c.,' being used to 
 adulterate it. 
 
 "In 1816 an Act was passed against the adulteration of 
 beer and porter, and the use of molasses, liquorice, vitriol, 
 quassia, guinea pepper, or opium, and a lot of other ingre- 
 dients being prohibited." 
 
 "In 1836 an Act was passed against the adulteration of 
 bread." 
 
 And now in 1860 it was enacted that " every person who 
 shall sell as pure or unadulterated any article of food or drink 
 which is adulterated or not pure," should on conviction be 
 fined. 
 
 The Vestries in the metropolis were empowered to 
 appoint analysts. The appointment was voluntary on the 
 
 * See P.P. 1874. Beport of Select Committee on the Adulteration of 
 Food, &c. Evidence of H. Owen. 
 
OF LONDON 183 
 
 part of the local authorities, and, if analysts were appointed, 
 their duties were confined to receiving and analysing 
 articles submitted to them by the purchasers, and certifying 
 the results. The purchasers had to pay the cost. No 
 officer was appointed to obtain samples or to enforce the 
 Act. And the Act is therefore worthy of note more as an 
 illustration of the inaction of the local authorities than for 
 any effect it had as regarded the prevention of adulteration. 
 
 In 1863 Parliament passed the " Bakehouse Kegulation 
 Act,"* which enacted that every bakehouse should be kept 
 in a cleanly state, should be frequently lime-washed, and 
 should be properly provided with proper means for effectual 
 ventilation, and be free from effluvia arising from any drain, 
 privy, or other nuisance. 
 
 Also its use as a sleeping-place was prohibited, and the 
 onus of enforcing the provisions of the Act was imposed 
 upon the local sanitary authority. 
 
 And in 1863 it declared f that the law made in 1855 as to 
 the inspection and seizure of unwholesome food — meat, 
 poultry, flesh, fish, vegetables, fruit, &c., &c. — was defective, 
 and that other and more effectual provisions should be 
 substituted therefor; and others were accordingly sub- 
 stituted. 
 
 By an Act in 1864 the main principles contained in 
 previous Factory Acts were carried a stage further, in some 
 instances even to trades carried on in private houses. 
 
 " Every factory to which this Act applies shall be kept in 
 a cleanly state and be ventilated in such a manner, &c., as to 
 render harmless dust, &c." 
 
 Unfortunately the main breakdown in the metropolis 
 in regard to nearly all the ameliorative sanitary legislation 
 of Parliament was directly caused by the very local autho- 
 rities who had been specially created for the purpose of 
 administering those laws. Primarily they were responsible 
 for the failure of very much of that legislation, and they 
 never seem to have at all realised, or been impressed by, the 
 gravity of their trust, or by the great responsibility to 
 their fellow-citizens which their position entailed. 
 * 26 and 27 Vic. cap. 40. f Ibid. cap. 117. 
 
184 THE SANITARY EVOLUTION 
 
 Even in comparatively small matters their ingenuity in 
 counteracting the intentions of the Legislature was remark- 
 able, as can be seen from the following passage in a report 
 of one of the Medical Officers of Health : — 
 
 " I refer specially to the Sanitary Acts, to the Adultera- 
 tion of Food Act, and to the Metropolitan Gas Act, in each 
 of which cases the powers entrusted to them have not been 
 carried out. 
 
 " They appointed an examiner under the Adulteration 
 of Foods Act (1860), and also under the Metropolitan 
 Gas Act (1860), but the person appointed had no tools 
 given him with which to perform the work entrusted to 
 him. 
 
 " Both the Acts are dead letters in the parish. As to the 
 Metropolitan Gas Act, it conferred a large benefit, both as 
 to purity and cost, on the metropolis, but the Vestries failed 
 to carry out a single effective or important provision of that 
 Act." 
 
 In 1860, also, an Act had been passed empowering the 
 local authorities in the metropolis to provide vehicles for 
 carrying persons suffering from infectious diseases to 
 hospital, and so obviating the danger to the public of such 
 persons being conveyed in cabs or other public vehicles. 
 That Act was also inoperative. 
 
 The Vestries and District Boards, however, did perform a 
 considerable amount of useful work. Local sewerage and 
 drainage works were on the whole effectively dealt with. 
 The rest of the work done was mostly of the routine order, 
 such as scavenging and paving and lighting, though even 
 that was not always done in the most sensible way, as 
 exemplified in Paddington (1866). 
 
 " The street sweepings of mud collected by the scavengers 
 are stored in enormous quantities in the middle of the parish 
 in a closely inhabited neighbourhood. Here it is allowed 
 to decompose, &c. If it were intended to contrive an 
 arrangement for developing malaria in the midst of a 
 town population nothing could be better adapted for the 
 purpose." 
 
 A few of them had soared to the height of widening a 
 
OF LONDON 185 
 
 street, or acquiring some small open space ; in most, if not 
 all, of these cases receiving financial help from the central 
 authority. 
 
 But as to the main causes of the prevailing insanitary 
 evils, their aversion to active measures v^as constantly in 
 evidence; equally so v^here the enforcement of the law 
 would have entailed cost on the owners of insanitary 
 houses. 
 
 In some matters the plea of defects in the legislation 
 might have been justifiably urged by them ; in others they 
 were often much hampered by the dilatory procedure attend- 
 ing proceedings for enforcing the sanitary provisions of the 
 Metropolitan London Management Act. 
 
 One of the Medical Officers of Health gives an illus- 
 tration : — 
 
 "A very great nuisance was reported to us. We visited 
 it, but had to wait a fortnight before the Vestry met in order 
 to get leave to apply for a summons. The magistrate 
 requires a week before hearing the case, and then he gives 
 a week or two to do the work. So for a month or five 
 weeks the nuisance may remain." 
 
 The result was that infectious disease was given a long 
 opportunity to spread itself unchecked through a whole 
 district ; an opportunity which it freely availed itself of. 
 
 Complaints were also made by some of the Medical 
 Officers of Health that in attempts to enforce the law against 
 " overcrowding " the magistrate leant very much to the 
 landlord. This, too, might have acted as a discouragement 
 to them. What, however, is certain is, that the Vestries 
 and District Boards were not attempting to grapple with 
 the most crucial questions of all — the overcrowding, and 
 the housing. 
 
 The Medical Officer of Health for Clerkenwell pointed 
 this out, so far as his parish was concerned (1861) : — 
 
 " The principal sanitary improvements during the last five 
 years related almost exclusively to the drainage, whilst the 
 overcrowding and impure state of the dwellings of the poor 
 have been but little interfered with." 
 
 The more serious blemish was pointed out by Dr. Hunter 
 
186 THE SANITARY EVOLUTION 
 
 in his report of 1865 to the Medical Officer of the Privy 
 Council on the subject of overcrowding, and the removal of 
 persons from houses about to be destroyed : — 
 
 " There is no authority which can deal with London in 
 these matters as a whole, and they are matters in which 
 uniform treatment is quite necessary. The local authority 
 which finds the whole of its district overcrowded, naturally 
 hesitates before beginning action whicl^may relieve one 
 house only to overfill the next, and may reasonably think 
 that such action, unless done thoroughly, not only through 
 the district, but through the whole capital, might prove 
 hurtful."* 
 
 And his opinion is weighty. But the local authorities 
 were very far from doing what they might have done to 
 abate many of the insanitary evils connected therewith. 
 
 Dr. William Eendell said f : — 
 
 "We have had till now but one Inspector of Nuisances — 
 an unwilling man . . . 
 
 " This is not a question of a defect in the law. These 
 bodies have the power of appointing Inspectors, but when 
 Inspectors are appointed it brings of course a large amount 
 of work in low property, and expense and trouble are 
 incurred. Therefore the easiest way to avoid it is not to 
 have Inspectors enough, so that the work may not be 
 found out." 
 
 In fact, the fuller the information on the subject is, the 
 more clear it is that most of them did not want to move 
 in the matter. 
 
 The evidence of witnesses, not under Vestry control, 
 examined before the Select Committee on Metropolitan 
 Local Government in 1866, throws some light on this 
 point. 
 
 Mr. James Beale, himself a vestryman, said : — 
 
 " I have seen a great want both of intelligence and ability 
 among vestrymen. 
 
 "I should say you may divide Vestries into divisions — 
 one-third, as a rule, are of the right class of men who ought 
 
 * P.P. 1866, vols, xxxiii.-iv. 
 
 f Select Committee on Metropolitan Local Government. 
 
OF LONDON 187 
 
 to be returned, and two-thirds are not of the class who 
 ought to represent the intelligence or the property of the 
 districts from which they are sent. 
 
 " The powers of Vestries are administered with too great 
 a regard to economy. Efficiency is always sacrificed to 
 economy. If an Act of Parliament requires them to do 
 certain things, it is as a rule avoided." 
 
 He attributed the failure of the Vestries to the inferior 
 calibre of the persons composing them — "they agree to 
 resolutions, but do not carry them out. The ratepayers 
 take no interest in the elections in our parish. There is 
 a large number of the owners of small house property in the 
 Vestries who regard with great disfavour any increase of the 
 rates, however beneficial the increase might be to the general 
 health of the district." 
 
 But some witnesses went further. Dr. William Eendell, 
 who had been Medical Officer of Health for St. George- 
 the-Martyr, said : — 
 
 ** I believe, the law being new to the Vestry, they did not 
 quite understand the mode of carrying it out ; but it was 
 partly from corrupt motives, for on one occasion one of the 
 principal members of the Vestry, an owner of considerable 
 property in the parish, called me aside and requested me 
 to pass over certain property of his that I found in an 
 extremely bad condition. I did not pass it over, of course. 
 The chairman of the local committee was, as I thought, 
 appointed as a positive obstructer of sanitary measures ; at 
 all events he acted as such. The obstructions arose from 
 an unwillingness to incur expense for fear of increasing the 
 rates, and from an interest that the members of the Vestry 
 had in keeping up the present state of things." 
 
 Jobbery, and the exercise of influence to obstruct and 
 defeat the law, are hard to prove, especially after the lapse 
 of years, but one fact which stands out conspicuous, and 
 which is incontestable, shows how reprehensibly the great 
 majority of the Vestries and District Boards failed to 
 administer laws which in the interests of the public health, 
 and therefore of the public welfare, it was their duty to 
 administer. Deliberately, and in the light of knowledge, 
 
188 THE SANITARY EVOLUTION 
 
 they would not make adequate arrangements even for the 
 sanitary inspection of their respective districts! 
 
 Thus, in Bethnal Green, in 1861, there was a population 
 of 105,000 persons, and 14,731 houses. The Vestry 
 appointed one single Inspector of Nuisances to cope with 
 the insanitary conditions of this city of houses, and of this 
 mass of people. Shoreditch, with a population of 129,364 
 persons, and 17,072 houses, also one Inspector. St. George's, 
 Hanover Square, with 88,100 persons and 10,437 houses, 
 one Inspector ; Paddington, Bermondsey, and several others, 
 all with large populations and thousands of houses, one 
 Inspector each.* 
 
 A few had appointed two Inspectors : St. Marylebone 
 with 161,680 persons and 16,357 houses, and Islington with 
 155,341 persons and 20,704 houses. 
 
 Kensington, Lambeth, and Limehouse, had appointed 
 three Inspectors each. St. Pancras headed the list with 
 four, but its population was close upon 200,000 living in 
 close upon 22,000 houses. 
 
 How could it be expected that one Inspector could within 
 a year possibly inspect even one tithe of the places which 
 it was his duty to inspect apart altogether from other duties 
 he ought to perform ? The Vestries and District Boards 
 had the facts constantly before their eyes (in the returns of 
 work made to them by the Medical Officer of Health) — the 
 numerous insanitary houses unfit for human habitation, the 
 overcrowding, the terrible amount of sickness and misery, 
 and they could calculate from the one man's work, the 
 number of houses in the parish which were in a condition 
 dangerous to the health of their inmates, and to the public 
 health generally. The salary of an Inspector was so paltry 
 that they had no excuse on the ground of economy ; and 
 the conclusion is inevitable that either they did not care what 
 the sanitary condition of the people was, or that "vested 
 interests in filth and dirt " were so powerful on those bodies 
 that filth and dirt must not be interfered with at the expense 
 of " owners" upon whom the cost of improvement must fall. 
 
 "'■ See P.P. 1867-8, vol. Iviii. Return of Inspectors of Nuisances, &c., 
 1866. 
 
OF LONDON 189 
 
 And a grimmer light is thrown upon these figures by the 
 following statement of the Medical Officer of Health for 
 Lambeth made in 1889, but referring to 1869. 
 
 " The Sanitary Inspector of twenty years ago (that is to 
 say of 1869) was an unskilled workman, holding that which 
 might almost be regarded as a sinecure office ; an official 
 recruited into the services of the Vestry from the rank of 
 ex-sailors, ex-policemen, or army pensioners. A knowledge 
 upon sanitary matters acquired from a course of technical 
 training was not expected from him," 
 
 The treatment meted out to some of the Medical Officers 
 of Health also showed the hostility of the Vestries to action. 
 Numerous are the passages in their reports complaining of 
 their recommendations being ignored. These officers were 
 miserably paid, allowing even for their being able to take 
 private practice. The Medical Officer of Health for 
 Lambeth was stated to have been the worst paid — receiving 
 only £200 a year for the performance of duties attaching to 
 an area of 4,000 acres with 23,000 inhabited houses upon it, 
 inhabited by 162,000 persons. 
 
 Dr. "W. Farr (of the Eegistrar General's Office) said : — 
 
 " I believe that in certain districts in London the Medical 
 Officer of Health is under all sorts of restraints. If he is 
 active, they look upon him with disfavour, and he is in 
 great danger of dismissal." * 
 
 The Vestry of St. James', Westminster (1866), checked 
 the zeal of their Medical Officer, Dr. Lankester, whose 
 salary was £200 a year, by reducing it to £150 after a 
 year or two when they found he was very earnest in his 
 work. 
 
 Dr. Eendell, the Medical Officer of Health for St. George- 
 the-Martyr, South wark, resigned " in disgust that he was 
 not allowed to carry out the duties of his office." 
 
 Once more the approach of Asiatic cholera — the nemesis 
 of insanitation, and of ** faineant " local authorities — created 
 anxiety, t 
 
 It had been widely prevalent in Europe in 1865, and had 
 
 * Select Committee on Metropolitan Local Government, 1866. 
 t P.P. 1867, vol. xxxvii. 
 
190 THE SANITARY EVOLUTION 
 
 even shown itself in England, and it stirred into spasmodic 
 and panicky activity the local authorities of London. 
 
 In Lambeth a systematic house inspection was inaugu- 
 rated ; 987 houses were examined — 735 of them required 
 sanitary improvements. 
 
 In Bethnal Green 2,018 were inspected — 955 required 
 cleansing and purification. 
 
 In many other parishes and districts extra sanitary work 
 was done. The disease made no further demonstration in 
 the winter, but in April, 1866, a case was reported from 
 Bristol, then one from Swansea — then from other places ; 
 and in July the Privy Council issued Orders in Council 
 putting the Disease Prevention Act in force in the metro- 
 politan area. 
 
 On July 18th, from Poplar, the first case in the metro- 
 polis was reported. Two days later an alarming number of 
 cases in parts of East London. 
 
 Kegulations were issued by the Privy Council defining and 
 requiring the specific services which local authorities ought 
 to render the public. 
 
 Some parishes appointed extra Sanitary Inspectors. Thus 
 in Hackney, where there had been but one, four additional 
 ones were appointed; in St. James' two; in Camber well 
 two ; in Lambeth two ; in St. Mary, Newington, five extra 
 were appointed. Some of the work which was reported 
 brings into striking prominence the extraordinary in- 
 efficiency hitherto of the authorities in dealing with insani- 
 tary houses as well as the neglect into which houses had 
 been let fall, and which was tolerated by those who were 
 responsible for the health of their districts. 
 
 In Lambeth 6,935 houses were inspected in 1866 ; 3,983 
 improvements were effected. 
 
 In Camberwell, 5,594 houses were inspected ; in 4,324 
 sanitary work had to be done. 
 
 In St. Mary, Newington : — 
 
 " A house-to-house visitation was commenced August 4th, 
 and concluded on November 20th, in which period the Sub- 
 Inspectors called at 12,919 houses. 
 
 "A record was thus obtained of the condition of nearly 
 
OF LONDON 191 
 
 every house in the parish. The house-to-house visitation 
 was carried out with but little real opposition, and with a 
 great deal of satisfaction. . . . Strict impartiality was the 
 rule of action, and all classes and those in every station 
 were alike subject to inquiry." 
 
 As the summer went on, the mortality from the cholera 
 increased — it reached its acme on August 1st, when there 
 were 204 deaths from it, and in the week ending August 4th 
 when the total of 1,053 was reached.* 
 
 During the 23 weeks of its prevalence 5,548 persons died 
 — of whom 3,909 died in the East Districts alone, and 702 
 on the South side of the river. 
 
 And by the end of the year it had gone. That the mor- 
 tahty should have been so much smaller than on previous 
 visitations was attributed to the fact that London was 
 unquestionably less filthy at the time of this outbreak. 
 
 " A comparison of the mortality with that of former 
 cholera years," .wrote the Medical Officer of Health for 
 St. Giles', demonstrates that sanitary work — imperfect as it 
 is — has deprived the disease of much of its power." 
 
 "The power," wrote the Medical Officer of Health for 
 Fulham, " of sanitary arrangments to check the progress of 
 such a formidable disease was clearly evidenced." 
 
 The Medical Officer of Health for Lambeth wrote : — 
 
 "I believe the great sanitary improvements effected in 
 the parish in providing proper drainage, abolishing many 
 miles of open stinking ditches, and the removal of other 
 nuisances, rendered an outbreak of cholera, such as experi- 
 enced in former years, very improbable. . . . Moreover, by 
 the employment of sanitary arrangements for treating the 
 sick, Lambeth and other parts of the metropolis were saved 
 from the ravages of the pestilence experienced on former 
 occasions." 
 
 That the epidemic had been as disastrous as it was, was, 
 however, attributed to "an illegal and most culpable act of 
 the East London Water Company. In contravention of the 
 4th Section of the Metropolis Water Act of 1852 that 
 company distributed for public use a water (and a most 
 
 '•' P.P., vol. xxxvii. p. 275. 
 
192 THE SANITARY EVOLUTION 
 
 improper water) which had not passed through its filter 
 beds ; and strong evidence was adduced to show that the 
 outbreak was occasioned by this illegal and most culpable 
 act." 
 
 One result of this epidemic was to demonstrate, at the 
 cost of thousands of lives, that the system of private water 
 companies supplying the community with this necessity of 
 life was absolutely opposed to the interests of the community. 
 
 Dr. Simon, in summing up his report (1869) on the water 
 supply to the metropolis, wrote : — 
 
 " I have been anxious to show what enormous risks to 
 the public are implied in any slovenly administration of 
 water supplies : yet as regards the London supply, what 
 imperfect obedience to the law, and in some cases what 
 flagrant and systematic disobedience was exhibited (at the 
 time of the cholera outbreak in East London in 1866) ; and 
 above all what criminal indifference to the public safety was 
 illustrated by the proceedings of the Southwark and Vauxhall 
 Company." 
 
 As regarded this latter company : — 
 
 " Not only had there been the long-standing gross ineffi- 
 ciency of the apparatus of subsidence and filtration, but the 
 administrators of the supply had from time to time dispensed 
 to a great extent with even a pretence of filtration, and 
 during some time had, worst of all, either negligently or 
 wilfully distributed as part of their supply the interdicted 
 tidal water of Battersea Reach. 
 
 " It seems to me that the public is hitherto very imperfectly 
 protected against certain extreme dangers which the mal- 
 feasance of a water company may suddenly bring upon great 
 masses of population. Its colossal power of life and death 
 is something for which till recently there has been no pre- 
 cedent in the history of the world ; and such a power, in 
 whatever hands it is vested, ought most sedulously to be 
 guarded against abuse." 
 
 Cholera was once more a blessing in disguise, though it 
 seems hard that the sacrifice of thousands of lives should 
 have been required to move Government and Parliament to 
 fresh measures for the protection of the people from it and 
 
OF LONDON 193 
 
 the other deadly diseases which unceasingly worked such 
 deadly havoc among them. But the proof given by it was 
 so overwhelming and decisive as to the insufficiency of the 
 existing sanitary law, and the inefficiency of the local 
 authorities, that Parliament felt forced to take action. The 
 measures taken were of such increased comprehensiveness 
 and stringency, that the passing of the Sanitary Act of 1866 * 
 marked another great step in the sanitary evolution of 
 London. 
 
 The Act applied to England and Wales — and this time 
 actually included the metropolis. 
 
 The previous definition of the term "nuisance" was 
 enlarged, and " overcrowding " was now for the first time 
 declared to be a " nuisance." 
 
 " Any house or part of a house so overcrowded as to be 
 dangerous or prejudicial to the health of the inmates " was 
 henceforward a " nuisance " and punishable as such. And 
 it was further enacted that "where two convictions for 
 overcrowding of a house, or for the occupation of a cellar 
 as a separate tenement dwelling-place " should have taken 
 place within three months, it should be lawful for the 
 magistrate to direct the closing of such premises for such 
 time as he might deem necessary. 
 
 Under another extension of the term "nuisance" the 
 industrial classes got the shadowy boon of all factories, 
 workshops, and workplaces (not already under special Acts), 
 being made subject to the sanitary supervision of the local 
 authorities ; and those authorities were given power to 
 inspect such places to ascertain if they were kept in a cleanly 
 state, were properly ventilated, and not overcrowded so as 
 to be dangerous or prejudicial to the health of the inmates. 
 
 A section in the Act aimed at the inefficiency and inaction 
 of the local authorities, and made it obligatory (no longer 
 optional) upon them to make inspection of their districts. 
 
 " It shall be the duty of the Nuisance Authority to make 
 
 from time to time, either by itself or its officers, inspection 
 
 of the district, with a view to ascertain what nuisances exist 
 
 calling for abatement under the powers of the Nuisances 
 
 * 29 and 30 Vic. cap. 90. 
 
 14 
 
194 THE SANITARY EVOLUTION 
 
 Eemoval Acts, and to enforce the provisions of the said Acts 
 in order to cause the abatement thereof." 
 
 An effort was also made to check the spread of infectious 
 disease by giving the local authority considerable powers 
 as regarded disinfection. It was enacted that the local 
 authority might provide a proper place for the disinfection 
 of clothing and bedding which might have been rendered 
 liable to communicate disease to others ; and the authority 
 was empowered to maintain carriages for the conveyance 
 to hospital of persons suffering under any infectious or 
 contagious disease. A blow was struck at the iniquitous 
 but common practice of letting a room where there had 
 been dangerous infectious disorder, until it had been dis- 
 infected. And provision was made for the establishment 
 of a hospital for the reception of the sick. 
 
 All these were most considerable reforms, and would have 
 been most useful had they been given effect to and properly 
 enforced. 
 
 The most important and wide-reaching provision of the 
 Act was that directed against overcrowding. 
 
 The 35th Section enacted that regulations might be made by 
 the Sanitary Authority (in other words, the Vestry or District 
 Board) for fixing the number of persons who might occupy 
 a house, or part of a house, let in lodgings, or occupied by 
 members of more than one family. Houses so let were to 
 be registered by the Vestry. The regulations could fix a 
 certain number of cubic feet of air space which should be 
 available for each person. By this means the number of 
 persons who might live in a house, and in the rooms of the 
 house, could be limited. 
 
 That was the plan — simple enough in appearance — which 
 Parliament devised for contending with the great evil of 
 overcrowding. 
 
 And then, as regarded the sanitation of the houses when 
 registered, it enacted that regulations should contain pro- 
 visions for their being put into and kept in a clean and 
 wholesome state. And to secure this being done, regu- 
 lations were made for their inspection. 
 
 It was an original and comprehensive scheme of reform. 
 
OF LONDON 195 
 
 It struck at the root of the two great evils — overcrowding 
 and insanitary dwellings ; at overcrowding, by the limitation 
 of the number of persons inhabiting a house, or part of a 
 house, and at insanitary dwellings by a series of regulations 
 enforcing the necessary measures for a decent standard of sani- 
 tation. But it was something far more than this. It was the 
 declaration of principles of the utmost importance. It was 
 a declaration of the principle that the responsibility for the 
 condition of the " houses let in lodgings " should be on the 
 shoulders of the " owner " of the house. It was the declara- 
 tion of the principle that the " owner " should not be allowed 
 to use his property to the detriment, to the injury of the 
 public. It affirmed, so far as London lodging or tenement 
 houses were concerned, the great principle, abhorred by so 
 many " owners," that " property has its duties as well as its 
 rights." 
 
 The Act was, however, even more remarkable for the 
 recognition it cfontained of another principle of vital impor- 
 tance to the people of London — the principle of central 
 authority over local sanitary authorities who neglected their 
 duties. 
 
 Hitherto the local authorities were practically their own 
 masters, and could with absolute impunity neglect to put 
 the provisions of the existing health laws into operation ; 
 and " often their inaction had been an absolutely inexcusable 
 neglect of duty." 
 
 A power of appeal against this inaction was given. 
 Where complaint was made to a Secretary of State that 
 a nuisance authority had made default in enforcing the 
 provisions of the Nuisances Eemoval Acts, he could, if 
 satisfied after inquiry that the authority had been guilty 
 of the alleged default, make an order limiting a time 
 for the performance of the duty, and if the duty was not 
 performed within that time, he could appoint some person 
 to perform the duty and charge the costs to the authority. 
 And where the local authority had made default in in- 
 stituting proceedings against some sanitary law breaker, 
 he could order the chief police officer to institute them. 
 These provisions were a recognition of the fact, long 
 
196 THE SANITARY EVOLUTION 
 
 patent to even the blindest, that local authorities did not 
 do their duty, and of the necessity of devising a means of 
 securing that a necessary public duty should be done. 
 
 The fact was emphasised a few years later by the Eoyal 
 Sanitary Commissioners, who pointed out (1871) that — 
 
 " However local the administration of affairs, a central 
 authority will nevertheless be always necessary in order to 
 keep the local executive everywhere in action." 
 
 The real underlying truth now beginning to be discerned 
 was that in the matter of health or disease, London could 
 not be treated in bits, each governed by an independent 
 body, but must be regarded as, what it really was, one 
 single entity or whole. 
 
 In another way also was the principle of central authority 
 very clearly affirmed. The Vestries were not to have a free 
 hand in making their regulations under the 35th Section. 
 Any they made had to be approved by a Secretary of State. 
 
 This was a considerable limitation of the freedom of the 
 Vestries, but it secured more or less uniformity in the powers 
 of the local authorities in this particular matter. 
 
 But the vigorous administration by all the local authorities 
 of the laws passed to secure the health of the public, was 
 even more greatly to be desired ; for, from force of circum- 
 stances, the consequences — one way or the other — could not 
 be confined to the sphere of action of each local authority. 
 
 The lives and welfare of the inhabitants of this vast city 
 are so closely, so inextricably interwoven that, in matters 
 affecting the public health, the action or inaction of one 
 authority may vitally affect the health and the lives, not 
 alone of its neighbours, but even of the people of the city 
 as a whole. Disease and death are no respecters of 
 municipal boundaries, and are not hemmed in or restrained 
 by lines drawn upon maps or recorded in Acts of 
 Parhament. 
 
 This community of interest of the inhabitants of London 
 was, however, scarcely, if at all, recognised by the genera 
 public — it was but seldom the motive to action by the local 
 authorities — but some of the Medical Officers of Health 
 now and then referred to it in their reports. 
 
OF LONDON 197 
 
 Thus the Medical Officer of Health for Mile-End-Old 
 Town pointed out (1863) that — 
 
 " An untrapped drain, an overcrowded house, an un- 
 ventilated alley, a rotting dungheap, or a foul closet, may 
 spread disease and sorrow in an entire neighbourhood." 
 
 And the Medical Officer of Health for Paddington 
 pointed out (1870-1) that— 
 
 " The danger of harbouring a contagious disease is not 
 confined to the individual suffering — it is a matter that 
 concerns the community." 
 
 And the Medical Officer of Health for Whitechapel 
 wrote (1865) :— 
 
 " Here I would remark, that a uniform system of 
 inspection of all the houses in the several districts in 
 London which are let out in separate tenements should be 
 repeatedly and systematically adopted ; for if all the 
 Vestries and local Boards do not act together i'n this 
 important matter, hotbeds of epidemic diseases will remain 
 undiscovered which will serve as centres from whence such 
 diseases may emanate, and extend over the entire 
 metropolis. The whole population of London, therefore, 
 is interested in the prompt removal of nuisances." 
 
 Immediately on the passing of the Act some of the 
 Vestries made efforts to deal with overcrowding under the 
 Section which enacted that — 
 
 " Any house so overcrowded as to be dangerous or 
 prejudicial to the health of the inmates " is to be considered 
 a "nuisance." 
 
 That, however, was only a temporary remedy, and 
 affected only overcrowding. Section 35 went to the root 
 of the matter when it insisted that in addition to the 
 prevention of overcrowding, the house in which the people 
 lived should be kept clean and in sanitary condition. 
 
 " The very foundation of our sanitary structure," wrote 
 the Medical Officer of Health for St. George-the-Martyr, 
 " depends upon the right housing of the poor." 
 
 The Section 35 was promptly put in force by a few of the 
 Vestries — Chelsea and Hackney being the first to make 
 Begulations and to enforce them. 
 
198 THE SANITARY EVOLUTION 
 
 Under the Regulations, whenever the Vestry deemed it 
 desirable to put them in force in respect to any house 
 let in lodgings or occupied by members of more than one 
 family, the number of persons allowed to live in that 
 house was fixed on a basis of 300 ctJIiic feet of air for each 
 adult for sleeping, or 350 for living and sleeping, and the 
 owner had to reduce the number of lodgers to the number 
 so fixed on receiving notice to that effect. 
 
 The Regulations further directed that — 
 
 "The owner of such house shall cause the walls and 
 ceilings of every room, and of the staircase and passages, 
 and yards of such house to be well and sufficiently coloured 
 or limewashed, or otherwise thoroughly cleansed once (at 
 least) in every year. 
 
 " He shall cause every room and the passages to be 
 ventilated. 
 
 " He shall provide such accommodation for washing, and 
 such a supply of water for the use of the lodgers as shall 
 be satisfactory to the Vestry's Officers;" and sundry and 
 numerous minor directions. 
 
 The Medical Officer of Health (Chelsea), after the first 
 year's work, reported that the number of houses in the 
 parish inhabited by two or more families was very great, 
 and in many cases their condition was deplorable, and it 
 was found necessary to embrace whole streets as well as 
 courts and alleys in the registration. 
 
 By 1869 the registration in Chelsea had been completed, 
 and in 1870 the Medical Officer of Health wrote : " I have 
 seen no reason to alter my opinion of the beneficial action 
 of the measure by which we have been able to bring under 
 direct and constant supervision the majority of the houses 
 occupied by the poorer classes in this parish. . . ." 
 
 The most satisfactory results followed also in Hackney. 
 
 Its Medical Officer of Health reported in 1867 that 
 nearly 5,000 houses had been measured and examined, and 
 in a large proportion of cases the numbers of persons 
 allowed to inhabit them had been fixed. And as to the 
 result of the enforcement of the Regulations, he wrote 
 (1869) : "A very large number of families now occupy two 
 
OF LONDON 199 
 
 rooms who formerly lived and slept in one. The gain in 
 health and morality has therefore been considerable." 
 
 Poplar was another of the District Boards which made 
 and enforced the Kegulations. The Medical Officer of 
 Health for the north part of the District reported (1868) : — 
 
 " Extensive improvements have been already effected, 
 but the work must still be systematically continued, for 
 even when every house in the district has been put into 
 good sanitary state (which is far from being the case as 
 yet, it will be necessary to maintain a constant and watch- 
 ful system of re-inspection to ensure their being kept in 
 order. 
 
 " Of the 1,610 houses inspected nearly all required more 
 or less sanitary improvement, and 630 were registered as 
 containing more than one family, and therefore coming 
 under the Board's regulations as to registration." 
 
 But if a few of the Vestries made real efforts to utilise 
 the Act, others of them either made only a pretence of 
 doing so, or refused altogether. 
 
 The reports of the Medical Officer of Health for St. 
 Giles' (1866-7) present a typical picture of the attitude 
 and conduct of these bodies. 
 
 " A most important amendment of the sanitary laws 
 was made by the ' Sanitary Act,' of which Section 35 gives 
 precisely the powers which not last year only, but every 
 year since the constitution of the Board, the Medical Officer 
 has demanded for the efficient discharge of his functions in 
 respect of houses inhabited by the poorer classes. That 
 section has given to the local authority the power of making 
 bye-laws for the regulation of sub-let houses, and of 
 enforcing the observance of its rules by penalties. 
 
 " In St. Giles' District, it is this class of houses almost 
 exclusively which need the supervision of the sanitary 
 authorities, and which become without that supervision 
 nests of filth and disease. 
 
 "Accordingly, soon after the passing of the Sanitary Act, 
 bye-laws were adopted by the Board, and sanctioned by the 
 Secretary of State for the regulation of sub -let houses. . . . 
 
 " The Board proceeded to inform owners of all sub-let 
 
200 THE SANITARY EVOLUTION 
 
 houses that such houses must be registered in conformity 
 with the Regulation. The intention of the Board was to 
 apply with all proper discrimination, but quite universally 
 and impartially, the powers vested in them in regard to 
 sub-let houses. . . . The systematic application of these 
 powers by the Board would have done for sub-let houses 
 what the systematic application of the police of their 
 powers under other Acts had done for common lodging- 
 houses. Cleanliness and decency would have been uni- 
 versally secured, and would have been maintained with a 
 minimum of inspection by a fine for every gross violation 
 of the regulations. 
 
 " But against a system that should work thus directly and 
 efficiently to the sanitary good of the district, the interests 
 of numbers of house-owners and agents were at once 
 arrayed, and these speedily organised an influential deputa- 
 tion to the Board. 
 
 " The opposite interests, those of the families dwelling in 
 the close and miserable rooms of these sub-let houses, 
 found no organised expression. 
 
 " The Board resolved to recall the notices which had been 
 issued for a systematic registration, and to apply their 
 powers, in the first instance, only to selected instances of 
 flagrant and continuous sanitary neglect." 
 
 And yet overcrowding in tenement-houses in St. Giles' 
 was dreadful. 
 
 Here are some instances of it on the authority of the 
 Medical Officer of Health in 1869. 
 
 " These houses have for the greater part a family in 
 every room. 
 
 "In King Street ... there are 254 families in 273 rooms. 
 „ Lincoln Court ... ,, ,, 164 „ „ 168 „ 
 „ Little Wild Street „ ,,139 „ ,,182 „ 
 „ Wild Court ... „ „ 109 „ ,,116 „ " 
 
 In Whitechapel (1867), rules and regulations were 
 adopted by the Board. 
 
 "Unfortunately," wrote the Medical Officer of Health, 
 the Act was permissive, not compulsory. 
 
OF LONDON 201 
 
 " I brought under the notice of your Board several houses 
 which in my opinion ought to be registered. 
 
 "... The Board having reserved to itself the power of 
 determining as to the propriety of causing any house to be 
 placed upon the register, this enactment, which was 
 framed not only for the improvement of the moral and 
 physical condition of the poor, but for the benefit of the 
 whole community, has been carried into effect in only one 
 instance." 
 
 In Islington, draft Eegulations were prepared, but it 
 does not appear that they were ever adopted. 
 
 In Paddington, the Vestry decided against putting the 
 Regulations in force. 
 
 In Westminster, "such obstacles were offered by the 
 holders of small property" to the Regulations that they 
 were not enforced. 
 
 And on the south side of the river the story was very 
 much the same. 
 
 The sting of the enactment was that it put house-owners 
 to the expense of putting the house into, and maintaining 
 it in, habitable and sanitary repair, and to the expense of 
 annually painting or limewashing it ; the provision of 
 proper ventilation — of sanitary and washing accommoda- 
 tion, and for a supply of water : in fact, of doing to the 
 houses that which was essential for the health of their 
 occupants. The Regulations simplified and shortened, and 
 made more effective, the processes for enforcing penalties 
 for breaches of the sanitary laws — all which was of course 
 unpalatable to the sanitary law-breaker. 
 
 And so the great bulk of the local authorities would have 
 nothing to do with this 35th Section or its Regulations. 
 
 The law was not compulsory, but permissive — and they 
 availed themselves of that permission. 
 
 But the Vestries and District Boards who took no action, 
 and allowed the principal provision of the Act to be a dead 
 letter, proved by their conduct their deliberate determination 
 not to impose what was a just expense upon the " owners," 
 even though the not doing so should result in a frightful 
 annual sacrifice of human life, and in an untold amount of 
 
202 THE SANITARY EVOLUTION 
 
 human suffering and misery, and a long train of physical 
 and moral evils of the very worst character. 
 
 That the Act had been successfully administered by some 
 two or three Vestries proved that it was quite a workable 
 measure — so no excuse could be raised on that ground by 
 the recalcitrant Vestries. 
 
 Their attitude is an irrefutable proof of their selfish in- 
 difference to human suffering where it clashed with the 
 " rights of property," and of their incapacity for the position 
 they held as guardians and trustees of the people. 
 
 "The slaughter-houses and cow-houses are ordered to be 
 whited at least twice a year, while the houses of the poor 
 are allowed to remain for years without this important 
 means of purification." 
 
 The problem of overcrowding was, undoubtedly, a most 
 difficult one — and some of the Medical Officers of Health 
 were realising how difficult it was to treat with any hope of 
 success. 
 
 Thus the Medical Officer of Health for Bethnal Green 
 set forth the state of his parish in 1867 : — 
 
 " The population of Bethnal Green has now nearly 
 reached 120,000, and we have no more house room than 
 heretofore. The consequence is that overcrowding is as 
 great as ever ; and although the Public Health Act of 1866 
 was framed to obviate this great evil, it is practically un 
 workable, owing mainly to high rents (which in some cases 
 have increased as much as 50 per cent.), dearness of pro- 
 visions, scarcity of employment, and the imposition of taxes 
 for the first time upon the tenant ; and many families who 
 could ordinarily afford to occupy a whole house have been 
 obliged to let lodgings ; others who have occupied two 
 rooms have been obliged to put up with one ; and where 
 overcrowding has existed, and the law enforced, the people 
 have merely removed to other houses and thus perpetuated 
 the evil which it was the intention of the Legislature to 
 obviate." 
 
 But doing nothing while overcrowding got worse was not 
 likely to make the problem less difficult. 
 
 Except, then, in a few parishes overcrowding was permitted 
 
OF LONDON 203 
 
 to pursue its own course unchecked, to the great benefit of 
 the various " owners," and to the great misery of great 
 masses of the people, and the evil extended itself year by 
 year and became steadily acuter. 
 
 And this, too, after Parliament had placed in the hands 
 of the local authorities large powers specially designed for 
 coping with an evil which was eating into the very vitals of 
 the community. 
 
 So rapid was the increase of population that the increase 
 in the number of houses did little to mitigate the over- 
 crowding ; nor was the construction of the majority of the 
 houses conducive to the health of those who went to inhabit 
 them. 
 
 London ground was being rapidly covered with buildings. 
 
 " Many large tracts of our formerly open spaces have 
 been rapidly covered, nay densely packed with buildings. 
 
 " The operations of the builder have annihilated acres of 
 garden ground by the hundred." 
 
 " Little garden plots, green spots, open spaces, were being 
 absorbed and swallowed up one after another, and covered 
 with houses. . . . 
 
 "Apparently each builder does that which seems good in 
 his own eyes." 
 
 Paddington afforded an interesting example of this 
 growth. A space near Eanelagh Eoad, about 25 acres, 
 had almost all been built upon within the last 15-20 years. 
 The streets were 40 feet wide. Here were 900 houses 
 packed with 12,000 people, or 469 persons to the acre 
 (1871). And another example near Paddington Eoad — 
 where 276 houses had been built, and the population was 
 493 to the acre ; showing 
 
 " A high density of population such as ought not to have 
 been tolerated under a wise municipal policy." 
 
 The rapidity of the increase was extraordinary. In 
 Lambeth in the year 1866-7, 1,078 houses were erected. 
 In Battersea in 1868-9, 1,530 houses were erected — a large 
 number of which were filled with people within a few days 
 or weeks of their completion. 
 
 The newness of a house, however, gave no guarantee of 
 
204 THE SANITARY EVOLUTION 
 
 its sanitary fitness, and a great proportion of them were of 
 the most objectionable and insanitary description. All the 
 art and craft of the speculating builder was too often 
 exercised to evade such legal provisions as there were for 
 the protection of the public, and to get the largest profits 
 he could for the worst constructed house, and the result 
 was that very many of the new houses were little better 
 than the worst of the old ones. 
 
 Unfortunately, the law was very ineffective to prevent 
 this. As was pointed out by the Medical Officer of 
 Health for Fulham (1871), the sanitary legislation for 
 the metropolis had never been accompanied by an amalga- 
 mation of the Building Act with the general sanitary statutes. 
 
 " The Building Act still works an independent course, 
 and it is not too much to say of it that, whilst its provisions 
 deal strictly with the strength and quality of bricks and 
 mortar, they utterly fail to ensure for us dwellings, especially 
 for the working classes, which have the least pretensions to 
 perfection in sanitary conditions. A large number of habita- 
 tions of this description have been completed and occupied 
 during the last few years both in Fulham and Hammer- 
 smith, and take the place of our former fever dens in 
 fostering disease. Unfortunately the Sanitary Authorities 
 see these wretched structures raised before their eyes, and 
 have no power to check their progress. It is truly to be 
 hoped that this anomaly will soon be remedied." 
 
 Such as the houses were, however, they were quickly in- 
 habited. The Medical Officer of Health for Paddington gives 
 a graphic description of the result in his parish (1871) : — 
 
 " There has been for some years a large influx of persons, 
 mostly of the working class, coming from over-crowded and 
 unwholesome houses of other districts of the metropolis. 
 Large numbers of the newly-built houses being let out in 
 tenements and single rooms attract a class of persons 
 barely able to obtain necessaries of life ; amongst these are 
 not a few of intemperate and demoralised habits, with 
 feeble vital stamina, consequently there is, and will be, a 
 larger proportion of sickness, chronic pauperism, and death 
 in the parish than formerly. 
 
OF LONDON 205 
 
 " This deterioration of race has for some time been recog- 
 nised by Medical Officers of Health. 
 
 "It must be remembered that most of the working people 
 are fixed to the spot, and cannot get a periodical change of 
 climate, or remove from a locality in the event of impending 
 ill-health, or of contagious disease breaking out near them. 
 
 "It is of no avail to lament over the laws of absolute 
 necessity, but all parties should combine in a demand for 
 that even-handed justice to the working ranks which, though 
 it may not interfere with a stern destiny which confines 
 them to a life of toil, is bound at least to provide that 
 the theatre of that toil shall be free from the pollutions that 
 endanger the functions of life, and uncontaminated by con- 
 tagion and death. 
 
 " I must say it is a scandal to the present constitution of 
 society that the reverse of this continues from year to year 
 in spite of all suggestions of Medical Officers of Health, and 
 the warnings of experience. In vain does one plague after 
 another ravage the family of industrial orders, and like 
 doomed men they stand amidst the harvest of death 
 looking earnestly, but in vain, to the Legislature for 
 that help which no other power can give. Parents, 
 children, and friends, drop around them, the victims of a 
 poisoned atmosphere ; while they hear and feel successive 
 warnings, the irrevocable law of necessity fixes them to the 
 spot, and they cannot flee from the danger." 
 
 The Central Authority, the Metropolitan Board of Works, 
 had, during the decade, been doing much useful work 
 affecting the public health, of London, in addition to its 
 great work, the great system of main drainage. 
 
 It had undertaken and had completed several large street 
 improvements by 1870, intended to provide new and im- 
 proved means of access from one part of the town to 
 another. 
 
 " The Board had to supply the deficiencies resulting from 
 centuries of neglect : it had also to keep pace as well as 
 it could with the wants of the ever-increasing population, 
 and the needs of a traffic which grew relatively even more 
 
206 THE SANITARY EVOLUTION 
 
 than the population," and each work contributed to the 
 improvement of the public health, by facilitating and in- 
 creasing the circulation of air in crowded neighbourhoods. 
 
 Another matter, important also in reference to the health 
 of the metropolis, had also occupied their attention, namely, 
 the acquisition or preservation of open spaces in London 
 for public recreation and enjoyment. 
 
 A piece of land, of over 100 acres in extent, was acquired 
 and opened to the public as Finsbury Park in 1869 ; and on 
 the south side of the river, in Kotherhithe, some 63 acres of 
 land were purchased in 1864, and converted into a public 
 park a few years later. 
 
 On the outskirts of London there were a number of com- 
 mons and other tracts of open ground available for public 
 resort, to which the public had no legal rights, and which 
 were rapidly being absorbed by railway companies or 
 builders. London was thus in danger of losing open spaces 
 which were urgently required in the interests of the public 
 health. 
 
 Parliament, after an inquiry by Select Committee, passed 
 the "Metropolitan Commons Act"* in 1866, which pre- 
 scribed a mode of procedure under which the commons in 
 the neighbourhood of London could be permanently procured 
 for the people of London, and the Metropolitan Board set to 
 work to procure them. The acquisition of Hampstead 
 Heath was happily arranged in 1870. 
 
 Another great work was also undertaken by the Central 
 Authority — namely, the embankment of the Tharnes. 
 
 The offensive state of the river had been greatly enhanced 
 by the large areas left dry at low water on which sewage 
 matter collected and putrefied ; and the only way of re- 
 moving this cause of mischief was by confining the current 
 within a narrower channel. 
 
 Parliament passed an Act in 1863, entrusting its execution 
 to the Metropolitan Board, and the work was soon after 
 commenced. 
 
 Thus in these matters, all of which were closely associated 
 with the public health, the sanitary evolution of London was 
 * 29 and 30 Vic. cap. 122. 
 
OF LONDON 207 
 
 progressing, and the Board was giving visible demonstra- 
 tion of the necessity of that which had so long been denied 
 to London — namely, a central governing authority to deal 
 with matters affecting London as a whole. 
 
 The Board, in their report for 1865-6, stated they were : 
 " Deeply sensible of what remained to be done to remedy 
 the neglect of past ages, and to render the metropolis 
 worthy of its position as the chief city of the Empire ; " but 
 they were hampered by the want of means to enable them to 
 carry out desired improvements. 
 
 " It cannot be questioned," they wrote, " that direct taxa- 
 tion now falls very heavily upon the occupiers of property 
 in the metropolis. ... It appears to the Board that the 
 most equitable and practicable mode of raising the necessary 
 funds would be by imposing a portion of the burden on the 
 owners of property. It cannot be denied that the interest 
 of the latter in metropolitan improvements is much greater 
 than that of teinporary occupiers, and yet at the present 
 time, the occupiers of property in the metropolis bear almost 
 the whole cost of the improvements effected by the Board. 
 It is hoped that the representations made by the Board will 
 satisfy the Legislature of the injustice of the present state 
 of things, and lead to some equitable remedy." 
 
 The visitation of cholera was doubtless in the main 
 accountable for the access of energy displayed by Parliament 
 about this period in matters affecting the public health. 
 
 In the same session that the Sanitary Act was passed, a 
 measure of considerable importance to the consumers of 
 water in London was passed, though many years would 
 elapse before its effect would be appreciable. This was " The 
 Thames Purification Act." 
 
 " Whereas . . , the sewage of towns situate on the river 
 Thames above the metropolis is carried into the river, and 
 thereby its waters are polluted and the health and comfort 
 of the inhabitants of the valley of the river below those 
 towns of the metropolis are affected," powers were given for 
 the diversion therefrom of the sewage of Oxford, Beading, 
 Kingston, Eichmond, &c., &c., "whose cloacal contributions 
 to the stream were distributed to masses of the people of 
 
208 THE SANITARY EVOLUTION 
 
 London." No less than 56 towns, it was said, cast their 
 impurities into the river. 
 
 And in the following year the scope of the Thames Con- 
 servancy Board was extended and very stringent care 
 exercised to prevent unnecessary pollution of the river. And 
 in 1868 the river Lea, another of the water suppliers, was 
 placed under a Conservancy Board. 
 
 In 1867 an Act of far-reaching consequence was passed, 
 making vaccination compulsory. In 1836 an Act * dealing 
 with this matter laid it down that the parent of a child, 
 or the occupier of the house in which a child was born, 
 might, within 40 days, give notice to the Eegistrar as to the 
 vaccination of the child. There was no punishment for the 
 neglect to do so, and no penalty for refusal to give the 
 Registrar the information. 
 
 This new Act, which came into operation on the 1st 
 of January, 1868, enacted that — 
 
 " Every child shall be vaccinated within three months of 
 its birth." 
 
 The Act was to be administered by the Poor Law Autho- 
 rities; and Boards of Guardians might appoint public 
 vaccinators and establish vaccination stations. 
 
 In 1867, also, another Act of very great consequence was 
 passed dealing with one important element in the sanitary 
 evolution of London, to which no reference has yet been 
 made, namely, the provision of hospitals for the isolation 
 of infectious or contagious disease, for the prevention of 
 mortality, and for the speedy restoration of the sick to 
 health. 
 
 There is, indeed, no part of sanitary work requiring more 
 constant attention than the protection of the community 
 from the spread of infectious diseases, and this is best 
 secured by hospitals affording proper provision for isolation 
 and treatment of infectious cases. 
 
 Next to the adoption of proper measures for the preven- 
 tion of disease, a suitable provision for the speedy restoration 
 of the sick to health is obviously of the greatest importance 
 to the community. 
 
 * 6 and 7 Wm. IV. cap. 86. 
 
OF LONDON 209 
 
 So far as the absolutely destitute were concerned, all had, 
 by the law of England, subject to certain conditions, right 
 to food, shelter, and medical attendance ; and they accord- 
 ingly received gratuitous medical treatment at workhouses, 
 or dispensaries, and in sick wards. 
 
 Indeed, any person suffering from an infectious disease 
 might, if willing to become a pauper, take advantage of such 
 provision as was made by the Guardians of the Poor, the 
 provision being imperfectly isolated wards and buildings 
 attached to the several Metropolitan Workhouses and 
 Infirmaries. Those not so willing were compelled to remain 
 at home, a source of danger to those around them, and if 
 poor, with insufficient medical attendance and nourishment. 
 
 For a long time the only special provision for certain 
 infectious diseases for the whole of London was that in the 
 London Fever, and the London Smallpox Hospitals, both 
 of which were maintained by private charity. 
 
 Happily, where neither the State nor the local authorities 
 did anything, charity stepped in, and on a larger scale sup- 
 plied an inevitable want ; and medical charities grew up to 
 give relief in time of sickness to those of the working classes 
 of society who were unable to provide for themselves, but 
 this was mostly for non-infectious or non-contagious 
 diseases. 
 
 None of the Vestries or District Boards gave any sign of 
 making provision for those who were not paupers, although 
 the duty of giving opportunity for isolation of infectious 
 persons whose dieases made them dangerous to others, be 
 they paupers or not, devolved upon them under the 
 Sanitary Act of 1866 as the Sanitary Authorities concerned 
 in the prevention of the extension of disease. 
 
 " Indeed it must be admitted," wrote the Medical Officer 
 of Health for Chelsea some years later, " that the Vestries 
 never recognised their responsibilities (as sanitary authori- 
 ties) from the very first." 
 
 Grievous scandals having occurred in the treatment of the 
 sick in many of the metropolitan workhouses, the Govern- 
 ment of 1867 decided on a great measure of reform. Once 
 more the necessity of central government had to be 
 
 15 
 
210 THE SANITARY EVOLUTION 
 
 recognised, and by the Metropolitan Poor Act of 1867 a 
 Board — elected by the Poor Law Guardians, who them- 
 selves were elected bodies — was created as a central 
 authority to relieve Poor Law Guardians of the care of and 
 treatment of paupers suffering from fever and smallpox who 
 could not be properly treated in workhouses, and to provide 
 for their treatment and accommodation, as well as that of 
 the harmless insane of the metropolis. 
 
 The Board was entitled the Metropolitan Asylums Board, 
 and consisted of 73 members ; 55 of whom were elected by 
 the various Boards of Guardians in London, and the 
 remaining 18 being nominated by the Home Secretary, 
 
 In the early stage of its existence its duties were strictly 
 confined to those of the pauper class suffering from these 
 diseases.*' Admission to its hospitals could be obtained only 
 on orders issued by the relieving officers, and those admitted 
 became, if they were not so already, "pauperised" by 
 admission and ipso facto paupers ; but later its scope was 
 extended, and it became the Hospital Authority for 
 infectious diseases in London, and afforded another illustra- 
 tion of the necessity for having one central authority for 
 matters relating to the public health of the inhabitants of 
 the metropolis. 
 
 The erection of hospitals was at once commenced. The 
 first was opened in January, 1870, and the isolated treat- 
 ment of many cases of infectious disease was of great 
 benefit to the community. 
 
 In 1867, too. Parliament again dealt with the condition 
 of the workers in Factories and Workshops. The legisla- 
 tion dealt with the kingdom as a whole, but inasmuch as 
 London was so great a manufacturing city, it affected also 
 the masses of the working population of the metropolis. 
 
 The Commissioners on Children's Employment, who had 
 been at work since 1862, had completed their inquiry, and 
 made many recommendations, and in the concluding part of 
 their fifth report, dated 1866, they wrote : — 
 
 "We heartily trust that we may have thus, in some 
 degree, contributed to bring the time nearer when so many 
 * See Report of the Metropolitan Asylums Board for 1886-7. 
 
OF LONDON 211 
 
 hundreds of thousands of your Majesty's poorer subjects of 
 the working classes — especially the very young and those of 
 the tenderer sex — will be relieved from the totally unne- 
 cessary burden and oppression of overtime, and night work ; 
 will be confined to the reasonable and natural limits of the 
 factory hours . . . will perform their daily labour under 
 more favourable sanitary conditions, breathing purer air, 
 amid greater cleanliness, and protected against causes 
 specially injurious to health and tending to depress their 
 vigour and shorten their lives." 
 
 Only in 1867 was factory legislation at last of an 
 approximately general character. 
 
 " Fully two-thirds of the century in which England's 
 industrial supremacy swept to its climax was allowed to 
 pass before even an attempt was made to regulate on sound 
 general principles the recognised and inevitable workings of 
 unchecked individualism in the industrial field." * 
 
 The Act of 1867 t made better provision for regulating 
 the hours during which children, young persons, and 
 women, were to be permitted to labour in any manufactur- 
 ing process conducted in an establishment where fifty or 
 more persons are employed — the regulation being in the 
 direction of less onerous conditions of labour. 
 
 And by another Act passed at the same time — '* The 
 Workshop Kegulation Act, 1867," I the protection afforded 
 to workers in factories was extended to workers in smaller 
 establishments, so far as regarded the regulations relating to 
 the hours of labour to children, young persons, and women. 
 
 " Workshop " was defined as — 
 
 * ' Any room or place whatever (not a factory or bake- 
 house) in which any handicraft is carried on by any child, 
 young person, or woman, and to which the person employ- 
 ing them had a right of access and control." 
 
 No child under 8 was to be employed, and none between 
 8 and 13 was to be employed more than six and a half 
 hours a day — and sundry other directions. The workshops, 
 moreover, were to be kept in a proper sanitary state, and 
 
 * See the Edinburgh Review, January, 1903. 
 
 t 30 and 31 Vic. cap. 103. % 30 and 31 Vic. cap. 146. 
 
212 THE SANITARY EVOLUTION 
 
 the administration of the sanitary provisions of the Act was 
 placed in the hands of the local authorities — the Home 
 Office Inspectors having concurrent jurisdiction. 
 
 These Acts had a two-fold effect in the direction of 
 sanitary evolution : the improvement of the sanitary condi- 
 tions under which the people worked, and the prohibition of 
 work entailing consequences detrimental to the physical 
 well-being of the workers. 
 
 Their effect would have been of the greatest value in 
 
 London had they been vigorously enforced. Some of the 
 
 Medical Officers of Health endeavoured to enforce the Act. 
 
 Thus the Medical Officer of Health for the Strand reported 
 
 to his employers (1868-9) : — 
 
 "During the past year the provisions of the "Workshops 
 Regulation Act, 1867, have, so far as practicable, been 
 enforced." 
 
 And the Medical Officer of Health for St. George, Hanover 
 Square, wrote (1870-1) :— 
 
 " I have endeavoured to carry out the "Workshops Act by 
 the abatement of overcrowding, by enforcing due ventila- 
 tion, and closing at the legal time, so as to prevent the 
 scandal and suffering of dressmakers still being compelled 
 to toil for 16 hours." 
 
 But the silence of others on the subject told its own tale 
 and pointed its own moral. Active inspection was essential 
 for success, but inspection was not encouraged by the 
 Vestries or District Boards, and the intentions of the 
 Legislature were once more frustrated by the failure of 
 the local authorities to do their duty. 
 
 After four years Parliament took the duty away from 
 their incapable hands and transferred it to the Factory 
 Department of the Home Office. 
 
 One other Act of importance Parliament also passed 
 about this time, " The Artizans' and Labourers' Dwellings 
 Act, 1868." 
 
 Sanitary legislation has as yet done little more for old 
 property, and the whole of Central London was old pro- 
 perty, than to improve the drainage, and occasionally to 
 cleanse or whitewash some small fraction of it ; and there 
 
OF LONDON 213 
 
 remained the fact that numerous districts or conglomera- 
 tions of houses were unreformable, and when the most was 
 done to them that could be done under the law were still 
 unfit for human habitation. 
 
 In the previous year a Bill had been introduced into 
 Parliament by Mr. Torrens : — 
 
 " The objects of which were, first, to provide means for 
 taking down or improving dwellings occupied by working 
 men which were unfit for human habitation ; and secondly, 
 for the building and maintenance of better dwellings instead. 
 But the Act of 1868 retained the former only; the latter 
 having been struck out of the Bill during its progress 
 through Parliament. 
 
 " The intention of Parliament was to provide the means 
 whereby local authorities might secure the effectual repair 
 of dilapidated dwellings, or, when necessary, their gradual 
 reconstruction." * 
 
 The Act conferred powers far exceeding any heretofore 
 possessed by the local authority for effectually dealing with 
 houses unfit for human habitation. 
 
 " On the report of the Medical Officer of Health that any 
 inhabited building was in a condition dangerous to health, 
 so as to be unfit for human habitation, the Vestry, after 
 certain inquiries, &c., was to have power to order the owner 
 to remove the premises, and, in default, themselves to 
 remove them ; or they might order the owner to execute 
 the necessary structural alterations, and in default, might 
 either shut up or pull down the premises, or themselves 
 execute the necessary work at the owner's expense." + 
 
 The Act proceeded upon the principle that the responsibility 
 of maintaining his houses in proper condition falls upon the 
 owner, and that if he failed in his duty the law is justified 
 in stepping in and compelling him to perform it. It further 
 assumed that houses unfit for human habitation ought not to 
 be used as dwellings, but ought, in the interests of the public, 
 to be closed, and demolished, and to be subsequently rebuilt. 
 
 * Report of Select Committee on the working of the Artizans' and 
 Labourers' Dwellings Improvement Act, 1882, p. iii. 
 f Ibid., p. iv. 
 
214 THE SANITARY EVOLUTION 
 
 Use began to be made of the Act soon after its passing, 
 but the operations under it can be more conveniently 
 described in the following chapter. 
 
 The energy of Parliament had a most beneficial effect, 
 and many of the Medical Officers of Health bore testimony 
 to the encouraging sanitary progress which was being made. 
 
 Thus the Medical Officer of Health for Fulham wrote 
 (1868) :— 
 
 " Our district is gradually and most manifestly improving 
 in all those great features of hygiene which are truly 
 essential where such masses of people congregate together." 
 
 And the Medical Officer of Health for St. Martin-in-the- 
 Fields, who wrote in 1864 that : — 
 
 " The spread of sanitary knowledge is slow " — 
 Wrote in 1868 :— 
 
 " Upon the whole, I am of opinion that all classes, even 
 the very poorest, are much more alive to their own interest 
 in supporting measures for the maintenance of health." 
 
 The Medical Officer of Health for St. Mary, Newington, 
 wrote (1871):— 
 
 " The knowledge of a compulsory power, as well as the 
 spread of sanitary knowledge, and a greater appreciation of 
 it, has led to a vast amount of sanitary improvement. 
 
 " I can but express a strong conviction that the sanitary 
 measures carried out are working slowly but steadily a vast 
 improvement in both the morale and physique of the inhabi- 
 tants of this metropolis in particular ... a great work is 
 progressing, the effects of which will be seen more and 
 more as years roll on, and will be recognised in the greater 
 comfort, better health, and augmented self-respect of the 
 people, and in an increased and increasing improvement in 
 the homes of those on whose strength or weakness must 
 depend in no slight degree the position for better or worse 
 of the English nation." 
 
 The Medical Officer of Health for St. George the Martyr, 
 in his report for 1870, makes a retrospect of fifteen years : — 
 
 "When the Vestries began (1856) their mighty task they 
 had to contend against evils and prejudices which had their 
 origin in far away back generations, and which have cast 
 
OF LONDON 216 
 
 down their roots deep and intricate into our social 
 system. , . . 
 
 " The Acts under which the Vestries had to work were 
 very imperfect. Opposition was strong on every hand, the 
 magistrates sympathised with the defendants. Property 
 and its rights were apparently invaded ; and property and 
 its rights have always claimed more support than property 
 and its duties. 
 
 " What was our physical condition? (in 1855). 
 
 " In every yard were one or more of ' the foulest recep- 
 tacles in nature,' namely, cesspools ; these gave off, 
 unceasingly, foul effluvia, filling meat safe, cupboard, 
 passage and room. The smell met you on entering the 
 house, abode with you whilst you remained in it, and came 
 out with you on leaving it. The parish was burrowed with 
 them, and the soil soddened with the escape of their con- 
 tents. The emptying of them proved a true infliction. 
 They have now been emptied for the last time, filled up 
 with coarse disinfecting materials. . . . They would not 
 now be endured for a moment, yet with what difficulty 
 they were abolished. They were clung to as if some old 
 and honoured relic was about to be ruthlessly torn from its 
 possessors." 
 
 Dr. Simon, the Medical Officer to the Privy Council, 
 gave, in his report of 1868,* a view of sanitary progress in 
 the country generally, much of which applied equally to 
 London : — 
 
 "It would, I think, be difficult to over-estimate, in one 
 most important point of view, the progress which, during 
 the last few years, has been made in sanitary legislation. 
 The principles now affirmed in our statute book are such as, 
 if carried into full effect, would soon reduce to quite an 
 insignificant amount our present very large proportions of 
 preventable disease. It is the almost completely expressed 
 intention of our law that all such states of property and all 
 such modes of personal action or inaction as may be of 
 danger to the public health, should be brought within scope 
 of summary procedure and prevention. Large powers have 
 * P.P. 1868-69, vol. 32. 
 
216 THE SANITARY EVOLUTION 
 
 been given to local authorities, and obligation expressly 
 imposed on them, as regards their respective districts, to 
 suppress all kinds of nuisance and to provide all such works 
 and establishments as the public health preliminarily 
 requires ; v^hile auxiliary powers have been given, for 
 more or less optional exercise, in matters deemed of less 
 than primary importance to health ; as for baths and wash- 
 houses, common lodging-houses, labourers' lodging-houses, 
 recreation grounds, disinfection-places, hospitals, dead- 
 houses, burial grounds, &c. And in the interests of health 
 the State has not only, as above, limited the freedom of 
 persons and property in certain common respects : it has 
 also intervened in many special relations. It has interfered 
 between parent and child, not only imposing limitation on 
 industrial uses of children, but also to the extent of requiring 
 that children shall not be left unvaccinated. It has inter- 
 fered between employer and employed, to the extent of 
 insisting, in the interests of the latter, that certain sanitary 
 claims shall be fulfilled in all places of industrial occupa- 
 tion. . . . 
 
 " The above survey might easily be extended by referring 
 to statutes which are only of partial or indirect or sub- 
 ordinate interest to human health ; but, such as it is, it 
 shows beyond question that the Legislature regards the 
 health of the people as an interest not less national than 
 personal, and has intended to guard it with all practic- 
 able securities against trespasses, casualties, neglects and 
 frauds. 
 
 " If, however, we turn from contemplating the intentions 
 of the Legislature to consider the degree in which they are 
 realised, the contrast is curiously great. Not only have 
 permissive enactments remained for the most part unapplied 
 in places where their application has been desirable ; not 
 only have various optional constructions and organisations 
 which would have conduced to physical well-being, and 
 which such enactments were designed to facilitate, remained 
 in an immense majority of cases unbegun; but even nuisances 
 which the law imperatively declares intolerable have, on an 
 enormous scale, been suffered to continue ; while diseases 
 
OF LONDON 217 
 
 which mainly represent the inoperativeness of the nuisance- 
 law, have still been occasioning, I believe, fully a fourth part 
 of the entire mortality of the country. And when inquiry 
 is made into the meaning of this strange unprogressiveness 
 in reforms intended, and in great part commanded, by the 
 Legislature, the explanation is not far to seek. Its essence 
 is in the form, or perhaps I may rather say in the formless- 
 ness, of the law. No doubt there are here and there other 
 faults. But the essential fault is that laws which ought to 
 be in the utmost possible degree, simple, coherent, and 
 intelligible, are often in nearly the utmost possible degree, 
 complex, disjointed and obscure. Authorities and persons 
 wishing to give them effect may often find almost insuperable 
 difficulties in their way; and authorities and persons with 
 contrary disposition can scarcely -fail to find excuse or 
 impunity for any amount of malfeasance or evasion." 
 
 To this review by one of the ablest and most experienced 
 of men of the time in matters relating to the public 
 health, it must, however, be added that so far as the 
 metropolis was "concerned, "the meaning of this strange 
 unprogressiveness " was not so much the formlessness of 
 the law, as the fact that the interests against the enforce- 
 ment of many portions of the law were predominant, and 
 the non-administration of the law was due far more to that 
 circumstance than to any ambiguities or obscurities in the 
 laws. " Vested interests in filth and dirt " were all power- 
 ful on the greater number of the local authorities of London, 
 and so the law which would have interfered with those 
 interests was left severely unadministered. 
 
 Against these interests it was difficult to struggle — 
 especially when there was no compulsion upon the 
 administrators of the laws to administer them. Sheltered 
 under a permissive, they would not exercise a compulsory 
 power — a power entrusted to them with the control of 
 public money for public good. 
 
 The true cause of the inoperativeness of the law was, 
 in a way, pointed out by the Medical Officer of Health for 
 St. James', "Westminister, when he wrote (1869-70) : — 
 
 " The great deficiency of the Act of 1866, as of all other 
 
218 THE SANITARY EVOLUTION 
 
 English legislation on sanitary matters, is that no public 
 prosecutor is appointed. If Vestries neglect to prosecute, 
 and individuals do not see their way to it, people may be 
 killed by infectious diseases to any extent," 
 
 And the Medical Officer of Health for St. Giles' expressed 
 a similar opinion when he wrote (1870) : — 
 
 " The duty of making these sanitary improvements 
 should be imperative instead of permissive. It was wise, 
 at first, perhaps, that our sanitary legislation should be 
 tentative and experimental ; but experience having proved 
 its necessity it should be made more stringent." 
 
 But neither of them got so far as to see the natural and 
 simple remedy, that where a local authority for one reason 
 or another would not administer the laws made by Parlia- 
 ment, the central authority should step in and do the work 
 at the cost and expense of the recalcitrant local authority. 
 
 If one set of people failed in their duty to the public, 
 it was but right that where such tremendous issues were 
 at stake as the health and physical well-being, not merely 
 of the people of one parish but of over three and a quarter 
 millions of people — and all that their health and well-being 
 implied — the administration of the law should be placed 
 in hands that would administer it. 
 
 That, however, was but part of the great problem, 
 though it would have gone a long way in ameliorating 
 things. The other necessity was the strengthening and 
 altering of the law which itself stood in need of many and 
 large changes before a sure foundation could be laid for the 
 future health of the great community resident in the great 
 metropolis of London. 
 
 And other matters which ultimately were to have great 
 influence towards the solution of some of the worst of the 
 health difficulties in London were coming into view, and 
 assuming form and substance. 
 
 Tramways, with their facilities of traffic, were about to 
 be started. 
 
 In 1869 three private Acts were passed, authorising 
 the construction and working of tramway lines in the 
 metropolis, and in the following year several more private 
 
OF LONDON 219 
 
 Acts and " The Tramways Act, 1870," which was a general 
 measure. Its main object was to provide a simple, in- 
 expensive, and uniform mode of proceeding in obtaining 
 authority for the construction of tramways, and to give the 
 local authorities the power of regulation and control. 
 
 In London the Metropolitan Board of Works was con- 
 stituted the "local authority" under the Act; and that 
 Board was empowered to apply for a Provisional Order 
 itself to construct tramways, and lease them to other 
 persons, and was given, with the approval of the Board 
 of Trade, a compulsory power of purchase after a period of 
 twenty-eight years on certain conditions. 
 
 And in 1870 another Act of the most far-reaching im- 
 portance was passed, " The Elementary Education Act," 
 which prescribed the establishment of a School Board for 
 London, and which in process of time would exercise vast 
 influence towards a cleaner, brighter, healthier life than any 
 hitherto within the reach of the masses of the population of 
 London. 
 
 But though progress was being made in many ways, the 
 progress had not affected infantile life. 
 
 " The dreary catalogue of human misery " given in the 
 statistics of infantile mortality was as dreary as ever. 
 
 In every part of London those statistics were appalling. 
 
 In 1867, in the Whitecross Street District of St. Luke, 
 no less than 64"4 per cent, of the mortality for the district 
 consisted of deaths among children under five years of age. 
 In 1868 it was close upon 61 per cent. 
 
 In Bethnal Green, in 1869-70, of 3,378 deaths, 1,900 were 
 under five = 56'3 per cent. 
 
 In a sub-division of Whitechapel, in 1865-6, close upon 
 58 per cent, were under five ; in Poplar a fraction short of 
 47 per cent. 
 
 In Kensington, in 1866, 40*6 per cent, were under five. 
 
 Each year the Medical Officer of Health for Fulham 
 drew attention to, and protested against, the high rate, 
 neajrly 50 per cent, of infantile mortality under five, in 
 1867-8. 
 
 In Wandsworth, in 1870-1 = 47 per cent. 
 
220 SANITARY EVOLUTION OF LONDON 
 
 In Camberwell, in 1868 = nearly 50 per cent. 
 
 In St. Mary, Newington, and in Rotherhithe = 50 per 
 cent. 
 
 In Bermondsey, in 1869-70 = 56 per cent. 
 
 In certain streets the percentage was much higher. Thus 
 in Paddington (1870-1) :— 
 
 "Woodchester Street 56 per cent. 
 
 Cirencester ,, 65 ,, 
 
 Clarendon „ 72 „ 
 
 The high infantile mortality betokened high infantile 
 sickness, but of it no records have ever been kept. 
 
CHAPTEE IV 
 
 1871-1880 
 
 In 1871, the decennial Census once more afforded reliable 
 information as to the population of London, and gave the 
 means of ascertaining much else of the greatest value. 
 
 The population had gone up to 3,254,260 in 1871, from 
 the 2,808,862 it had been in 1861, an increase of 445,398. 
 But the rate of increase was declining. The decennial in- 
 crease of population which had been 21"2 in 1841-1851, 
 18-7 in 1851-1861, had further declined to 161 in 1871. 
 
 The returns showed that London contained 2,055,576 
 persons born within its own limits, and 1,198,684 persons 
 born outside its borders. 
 
 ** "Whence came these multitudes of both sexes, equal in 
 themselves, without counting those born there, to a number 
 greater than the inhabitants of any other European city? " 
 
 More than 607,000 of them came from the chiefly agri- 
 cultural eastern, south-eastern, and south-midland counties 
 surrounding the metropolis. 
 
 A large contingent of 147,000 was drawn from Devon- 
 shire, Wiltshire, Somersetshire, and the other south- 
 western counties. 
 
 The west-midland counties sent up 84,000. 
 
 41,000 persons had come from Scotland, 91,000 from 
 Ireland, 20,000 from the Colonies, and 66,000 from 
 foreign parts. 
 
 In fact, over 37 per cent, of the population of London in 
 1871 were immigrants into the great metropolis — a great 
 rushing river of humanity. 
 
 221 
 
222 THE SANITARY EVOLUTION 
 
 The returns were also of special interest in showing the 
 changes in the distribution of the population. Speaking 
 broadly, the previous movements were being continued — 
 a diminishing population in the central parts, an increasing 
 population in the outer parts. 
 
 It appeared to be inevitable that — 
 
 " As the trade of London continued to increase, so the dis- 
 tricts which lay close to the great centres of business must 
 be expected to be occupied more and more with warehouses, 
 and less and less with the miserable dwelling-houses which 
 had hitherto sheltered its poor and working-class population." 
 
 The diminution of the population of the central parts of 
 London was in no way a symptom of decay : it was, in 
 reality, proof of the reverse, being the result of increasing 
 trade, commerce, and wealth, which required more house 
 accommodation for the carrying on of their enormous 
 operations. 
 
 The great economic forces were in fact as active and 
 powerful as ever. In the City the population had fallen 
 in the decade from 111,784 to 74,635. In every one of the 
 six parishes or districts composing the Central group the 
 population had likewise decreased. 
 
 In the Eastern group, the population of three had de- 
 creased, whilst in the others there were increases — notably 
 so in Poplar, where there was an increase of 37,000, and in 
 Bethnal Green, where there was an increase of 15,000. 
 
 In the Northern group all had increased, except St. 
 Marylebone — the increase in Hackney being over 41,000, 
 and in Islington over 58,000. 
 
 In the West, there were also large increases — Fulham 
 27,000, Paddington 21,000, Kensington 50,000. Only St. 
 James' (Westminster) and Westminster had decreased, and 
 they in reality belonged more to the centre than to the west. 
 
 On the South side, with the exception of Christchurch, 
 St. Olave, and St. Saviour's — all in Southwark — and Green- 
 wich, there was an increase in all the parishes or districts, 
 the increases in some being very large ; 40,000 in Camber- 
 well, 46,000 in Lambeth, 55,000 in Wandsworth. 
 
 The figures thus furnished by ^he Census enabled a fairly 
 
OF LONDON 223 
 
 accurate calculation to be made as to the death-rate. It 
 now appeared to be 24'6 per 1,000 living. 
 
 The Registrar General, in his report for 1873, entered into 
 a comparison with previous years which may be assumed 
 to be as accurate as any such calculations could be. 
 
 The mortality was as high as 29*4 in 1854. It was 26'5 
 in 1866 (when cholera was epidemic), and it was as low as 
 21-5 in 1872, and 225 in 1873. 
 
 " The mortality never having been so low in any two con- 
 secutive years since 1840, and by fair inference never so low 
 in any two years since London existed." 
 
 This was distinctly encouraging, demonstrating as it did 
 the good results ensuing upon the great works oE improved 
 drainage and sewerage, and a healthier water supply. 
 
 As to the housing of this huge population, it was shown 
 that the number of inhabited houses had increased from 
 360,035 to 419,642. 
 
 The reports of many of the Medical Officers of Health 
 throw much additional light upon, and explain or elucidate 
 the facts set out in the Census, and carry on the narrative 
 into later years of the matters recorded by the Census 
 Commissioners. 
 
 Thus, as regarded the reduction of the population in the 
 central group of parishes, the Medical Officer of Health for 
 the Strand District ascribed it in part to the new Law 
 Courts, and to the circumstance that residential houses 
 were, in increasing numbers, becoming converted into 
 business premises. 
 
 "But," he added, "it is also probably in some measure 
 due to the greater facihties for locomotion to suburban 
 homes " ; which is notable as almost, if not absolutely, the 
 first recognition of this cause affecting the population. 
 
 In St. James', the decrease of population was " due to 
 the fact that the district had increasingly become the centre 
 for clubs, hotels, and splendid shops. The result had been 
 an enormous rise in the value of houses, and a gradual 
 extrusion of the less wealthy and important residents." 
 
 In St. George-in-the-East, the Medical Officer of Health 
 stated that : — 
 
224 THE SANITARY EVOLUTION 
 
 " The decrease of population was due to houses being 
 taken by a railway company, by the Poor Law Guardians 
 for an infirmary, for a church, &c." 
 
 How considerable the clearances were in some districts 
 may be inferred from the figures given by the Medical 
 Officer of Health for St. Giles' in 1871. 
 
 " The clearances in the City of London for the purposes 
 of erecting a new market, and a viaduct, and in the Strand 
 district to form a site for the proposed Law Courts, have 
 aggravated the evil of overcrowding. To effect these im- 
 provements (or chiefly so) the large number of 18,358 per- 
 sons have been removed. Strand, 6,998; St. Sepulchre 
 (City), 4,188; St. Bride (City), 4,211; Saffron Hill, 2,961." 
 
 And in St. Olave, on the south side of the river, the 
 Medical Officer of Health wrote : — 
 
 " Since the census of 1861, 436 houses have been pulled 
 down, clearing away whole streets and courts for the forma- 
 tion of railways and the extension of warehouses, displacing 
 961 families comprising 3,556 persons." 
 
 Consequent upon these clearances, and the people having 
 to find dwelling room somewhere, the transition of houses 
 built for a single family into tenement-houses continued in 
 full swing. 
 
 The Medical Officer of Health for St. Mary, Newington, 
 reported (1873) that year by year the better class of houses 
 were becoming less and less inhabited by a single family. 
 
 The Medical Officer of Health for Paddington gave a 
 very clear description of the process, 
 
 " There is a very dense packing of population," he wrote 
 (1873), and he mentioned some instances : — 
 
 " Brindley Street with 801 persons living in 65 houses. 
 Hampden Street „ 876 ,, ,, 78 ,, 
 
 WaverleyEoad „ 900 „ „ 72 „ 
 
 " Builders intended these houses at first for one respect- 
 able family, but ... in violation of common sense and 
 decency they are let out in tenements and single rooms, 
 without those essential conditions of a dwelling which land- 
 lords should in all instances be compelled to provide. 
 
OF LONDON 225 
 
 " There is yet in reality no law to prevent the creation of 
 unhealthy districts as long as five or six families are allowed 
 to live in one house intended for a single family. . . . 
 Houses should be built with reference to the future health 
 of the people who will have to live in them. 
 
 "And now, while the fields are open and still unbuilt 
 upon, it would be worth the attempt to overcome the 
 destructive influences likely to be established in building 
 tenement dwellings as the population gathers in this and 
 other neighbourhoods. They will some day be hives of 
 pauperism." 
 
 Furthermore, in some parishes, the natural growth of the 
 population was very rapid. In Islington, for instance, the 
 Medical Officer of Health wrote : — 
 
 " The Life Balance Sheet of your parish for 1875 shows 
 that your losses and gains leave you 4,376 lives to the good, 
 or in other words 4,656 deaths and 9,032 births have been 
 registered in the parish of St. Mary, Islington." 
 
 And the Medical Officer of Health for St. Marylebone 
 wrote (1877) :— 
 
 "If we compare the annual number of births with the 
 deaths, we shall find that every year some 1,200 or 1,500 
 more persons are born in the parish than die in it ; and 
 what, it may be asked, becomes of the surplus population ? 
 The only answer is, that it migrates ; it could not remain 
 in the parish for the simple reason that there is no 
 room, all available spaces in St. Marylebone have long 
 been built upon, and the houses occupied, many of them 
 crowded." 
 
 To the migration rendered necessary by the natural 
 growth of the population, and by the diminishing number 
 of houses in the central parts, was added the ceaseless 
 stream of fresh immigrants into London. These vast 
 numbers had to find house accommodation somewhere, and 
 they found it, in their tens of thousands, in various parts 
 of the less central portions of the metropolis. 
 
 In Kensington, for instance, the Medical Officer of Health 
 stated (1871) that the larger portion of the increase of 
 nearly 41,000 in the ten years was due to immigration. 
 
 16 
 
226 THE SANITARY EVOLUTION 
 
 The Medical Officer of Health for Fulham drew a graphic 
 picture of this inrush of humanity. 
 
 " The steady growth of London westward has thrown 
 among us a vast and teeming population of the working 
 classes, as well as those of more well-to-do condition, and 
 for the housing of the former many blocks of wretched 
 and most miserably constructed dwellings continue to be 
 erected with the most utter disregard for drainage or other 
 sanitary appliances now so essential. That part of Fulham, 
 once open fields, is still being rapidly covered with streets 
 and houses of this character, and many open spots in 
 Hammersmith are being filled in the same way. Our 
 healthy neighbourhood may thus be made ere long a land 
 of sickness and disease unless some check is given to 
 such speculative buildings. Our natural advantage with 
 all our care will not avail us against such utter reck- 
 lessness." 
 
 The increase of 21,000 in Paddington drew from the 
 Medical Officer of Health the query — 
 
 "... "Whether any and what steps should be taken to 
 prevent the wholesale influx of a colossus of pauperism with 
 the consequent burdens of poverty and sickness." 
 
 It had already driven the people underground for shelter, 
 for in 1871 he described how — 
 
 " Many of the underground kitchens in Leinster Street 
 (and four others named) have been inspected where the poor 
 people are found living like Esquimaux in underground cave 
 dwellings — places with impure air, want of light, admitted 
 only through a grating in front, the upper sash of the window 
 being often out of repair, or nailed up." 
 
 The rapid increase of population in London would not 
 have been accompanied with such serious results to the 
 public health as it was, if the houses which were being so 
 rapidly built for the people to inhabit had been constructed 
 on sound sanitary principles. 
 
 But this was very far from being the case, and the evils 
 described in the last chapter in this respect continued over 
 an enlarged area, and in accentuated form. 
 
 It is now almost incredible that the laws should have been 
 
OF LONDON 227 
 
 left in such a state as to enable builders, without any legal 
 check, to put up the houses they did. 
 
 The Medical Officer of Health for Mile-End-Old-Town 
 pointed out (in 1872) that " The position and structure of 
 houses has a very distinct bearing upon the public health, 
 yet very little regard is given to sanitary principles in their 
 construction. . . . The class of small houses for the crowded 
 occupation of the poorer classes is generally built either 
 upon ' made ground ' composed of refuse and debris of all 
 descriptions, the organic portion of which presently fills the 
 houses with various disease-producing gases, or upon newly 
 opened ground saturated with miasma, without the least 
 attempt at protection by means of previous drainage or 
 properly protected excavated foundations." 
 
 And in 1876 he reverted to the subject : — 
 
 " Water, air, and light are nature's disinfectants and pre- 
 ventions of disease. They are abundantly provided, but 
 more meagrely and inefficiently used, and indeed practi- 
 cally ignored, ' by architects, builders, owners, and occu- 
 piers. ..." 
 
 A witness before a Select Committee testified in 1874* 
 that : — 
 
 " Houses were being built upon the soil — any soil, in 
 point of fact — and the foundations of houses consisted very 
 often of nothing but manure, and old boots, old hats, or 
 anything thrown into it." 
 
 The Medical Officer of Health for Poplar wrote (1873) :— 
 
 " The continued rapid increase in the number of new 
 streets and houses in various parts of the district presents 
 many unsatisfactory features. 
 
 " In most cases, before the buildings are commenced, the 
 gravel is dug out, and the hole filled up with so-called 
 brick rubbish, but in reality with road-sweepings, the 
 sif tings of the dust yards and similar refuse. The dwelling- 
 houses, mostly of the poorer class, are largely built of soft 
 ill-burnt bricks, and are tenanted generally as soon as they 
 are finished — frequently even before they are complete. 
 
 -'' Select Committee on Metropolitan Buildings and Management Bill, 
 1874. P.P., vol. X. 
 
228 THE SANITARY EVOLUTION 
 
 " As a matter of course the walls are still damp, the streets 
 unpaved, and the residents suffer often very seriously in 
 their health." 
 
 The Medical Officer of Health described ten acres of 
 houses in Hackney as " almost entirely built upon a 
 great dust heap," built, too, of porous bricks and bad 
 mortar. 
 
 And another witness before a Select Committee in 1882 
 described how, in the other end of London — in Wandsworth 
 — on an estate " which practically might be considered a 
 small town," the ground has been j&lled in to a depth of 
 six or seven feet with filth of every description, and houses 
 have been rapidly built upon it. The results to the health 
 of the inhabitants were disastrous. 
 
 This, however, by no means completed the description of 
 the evil condition of the buildings. 
 
 The Medical Officer of Health for Shoreditch wrote 
 (1876-7) :— 
 
 " Not only was the health of the inhabitants endangered 
 by the presence of a large number of old decayed brick drains, 
 but also by many new drains which had been carelessly laid. 
 Their joints leaked ; in some places neither cement nor clay 
 had been used, and pipes had been connected with drains at 
 right angles." 
 
 And the Medical Officer of Health for St. George-the- 
 Martyr added his testimony (1877-8) : — 
 
 " Not only may the materials of which our buildings are 
 constructed be thus defective, but the drainage may be and 
 is indeed mostly laid carelessly and imperfectly. . . . An 
 eminent Civil Engineer, one who has had a very large 
 experience in this division of his profession, informs me that 
 90 per cent, of the houses built are imperfectly drained, that 
 the drains are laid in a reckless manner, the joints often not 
 cemented, and that the way in which they are laid is 
 unscientific and dangerous. No wonder we have continued 
 ill-health of the occupants." 
 
 The Medical Officer of Health for Fulham described in 
 1872-3 how in " Fulham New Town " the basements of the 
 houses had been built below any available sewerage, with 
 
OF LONDON 229 
 
 the result of constant floodings of cesspool matter to the 
 great danger of the public health. 
 
 And the materials of which the superstructure was made 
 were as bad as they well could be. Porous, and half baked, 
 and broken bricks being used, and mortar mixed with 
 garden mould or road scrapings — "some without a particle 
 of lime in it." 
 
 In Battersea Fields — 
 
 "You will find them there putting the houses together in 
 such a way that you may kick the walls down with your 
 feet. " * 
 
 The Medical Officer of Health for Whitechapel put the 
 subject very tersely when he wrote in 1880 : — 
 
 " In the construction of houses the only thing that appears 
 to be considered is that of cheapness. " 
 
 Until near the end of this decade of 1871-1881, a 
 building could be constructed without any supervision 
 of the materials, and any number of structures which 
 could not be occupied without danger to life or health 
 might be put up, for no one had power to interfere. 
 The London Building Act had no adequate clauses to 
 secure the effectual purity of new dwellings, nor had 
 the Sanitary Authority any power to check the practice 
 of building houses on rotten filth. 
 
 And so all these evil practices were very widely indulged 
 in; for though there were many respectable men among 
 builders of small houses, there were many who, regardless 
 of all consequences, covered the suburbs with " small, 
 rotten houses." And immense numbers of the people 
 were absolutely unprotected either by the Government 
 or by the local authority from abuses which entailed upon 
 them ill-health and death, and from practices which 
 created and spread disease throughout the community. 
 
 The Medical Officer of Health for St. George-the- 
 Martyr, Southwark, referring to " the dishonest and 
 scandalous way " in which some houses were built, said 
 (1877-8) :— 
 
 * Evidence of G. Vulliamy, Select Committee, 1874. Superintending- 
 Architect to that Board. 
 
230 THE SANITARY EVOLUTION 
 
 " From the greed of a few builders this traffic in 
 human life, and in what makes life valuable, is openly 
 and defiantly carried on. Under such circumstances full 
 health is impossible. Yet for the success and per- 
 manence of natural existence a high standard is absolutely 
 necessary." 
 
 Of builders such as these it may be truly said that 
 having created a damnosa hereditas in one place, they 
 moved on to create fresh ones in others, and no one pre- 
 vented them. 
 
 So glaring were these evils that a Select Committee, 
 which sat in 1874 on the Metropolitan Buildings and 
 Management Bill of that year, recommended — 
 
 " That the District Surveyor or the Metropolitan Board 
 shall have full power to stop the progress of any building 
 in which the materials or construction is calculated to be 
 dangerous or injurious to health, and to summon the builder 
 or owner before the magistrate." 
 
 At the rate houses were being built, the defective Building 
 Laws were a grave disaster. 
 
 In the two parishes of Bow and Bromley in Poplar, in 
 the five years ending March, 1878, notices were approved 
 for 1,981 new buildings. 
 
 In Hackney, in the year 1876-7, notices were given of 
 intention to erect 800 new houses, and the extension of 
 streets and houses into the fields had gone on so rapidly 
 that by that time there were but few fields left in the 
 district, or even large grounds belonging to any of the 
 houses. 
 
 In Kensington it was reported in 1875 that the increase 
 in the number of new houses brought into occupation had 
 for a considerable period averaged 700 annually. 
 
 In Wandsworth, in 1874-5, notices were received for 887 
 new houses. 
 
 In 1877-8 for 1,432 new houses. 
 „ 1878-9 „ 1,845 
 „ 1880-1 „ 3,073 
 
 And in every place land was being grabbed for building 
 purposes. 
 
OF LONDON 231 
 
 The Medical Ofl&cer of Health for Whitechapel wrote 
 in 1879:— 
 
 " We are now paying very dearly both in health and 
 money for the errors of preceding generations in their having 
 allowed houses to be packed closely together. . . . Several 
 cases have recently occurred in this district of landlords 
 erecting dwelling-houses in the back-yards of those houses 
 which were formerly occupied by a single family. This is a 
 serious evil and ought to be prevented. We have power 
 to prevent the overcrowding of rooms, and we certainly 
 ought to have power to prevent the cramming together of 
 houses on sites of insufficient size for the healthy existence 
 of the tenants." 
 
 Even burial-grounds were not sacred, nor were public 
 authorities even immaculate in this respect. Thus in 
 St. Luke:— 
 
 " The Quakers' burial-ground by the side of Coleman 
 Street is now (1876) in progress towards being covered with 
 buildings, and .a portion was taken by the London School 
 Board for the erection of a school. In the process of 
 excavation for the foundation, human remains were 
 discovered." 
 
 And the areas at the backs of houses were also being 
 rapidly covered over. The Act of 1855 had provided that 
 100 superficial feet should be left open — 
 
 "But the exigencies of trade have led the Metropolitan 
 Board of Works and the District Surveyors to permit the 
 area on the ground storey to be covered over." * 
 
 In fact, the insufficiency of the laws as regarded build- 
 ings intended for huraan habitation, and the mal-administra- 
 tion or non-administration of those laws which existed, 
 resulted in the creation of evils which inevitably and most 
 injuriously affected the health of the pubHc, not merely at 
 the time, but for many years to come. 
 
 The Medical Officer of Health for St. Giles', in 1871, 
 pointed out the necessity of a change of the law. 
 
 "It is very much to be desired that the law gave more 
 stringent powers to local authorities to prevent the re- 
 * See Report of Select Committee, &c., 1874, Q. 23,445. 
 
232 THE SANITARY EVOLUTION 
 
 erection of buildings upon the old sites, so that the new 
 buildings might not become as unfavourable to health as 
 the old ones. . . . Such a perpetuation of mischief ought 
 not to be permitted, and the rights of landlords should be 
 subordinated to the public good." 
 
 The condition of existing, as apart from new, houses 
 also stood in need of many changes of the law to effect 
 their redemption. The necessity was forcibly portrayed 
 by the Medical Officer of Health for St. Marylebone 
 in 1870. He wrote:— 
 
 " Of all the obstacles that stand in the way of anything 
 like effective sanitary operations, not only in St, Marylebone, 
 but in nearly every other district of the metropolis, there 
 are none so formidable, so apparently irremediable as the 
 miserable house accommodation provided for the labouring 
 classes. Year after year I am called upon to tell the same 
 unvarying story of rotten floors, broken walls and ceilings, 
 windows and roofs that let in the wind and the rain, chim- 
 neys that will not let out the smoke, and of these wretched 
 tenements being crowded with honest, hard-working people, 
 from the cellars to the attics." 
 
 Parliament continued in this decade the greater solicitude 
 about and interest in matters connected with the public 
 health, which it had recently been showing ; and the first 
 year of the decade, 1871, is noteworthy for the adoption by 
 Parliament of a measure which had far-reaching effects upon 
 the sanitary evolution of the metropolis. This was the 
 creation (by " The Local Government Board Act, 1871 ") 
 of a Central Government Authority for the supervision by 
 Government of the sanitary authorities in England and 
 "Wales, and also of those in London. 
 
 Matters relating to the health of the people had become 
 so large a portion of the work of government, that the 
 necessity had forced itself upon Parliament of concentrating 
 in one department of the Government the supervision of 
 the laws relating to the public health, the relief of the poor, 
 and local government. 
 
 The new authority, which was entitled the Local Govern- 
 ment Board, was not a representative body, but was a 
 
OF LONDON 233 
 
 Government Department. It was to consist of a President, 
 appointed by the Queen, and of the following " ex-officio " 
 members — the Lord President of the Privy Council, all the 
 Secretaries of State for the time being, the Lord Privy Seal, 
 and the Chancellor of the Exchequer. 
 
 All the powers of the Poor Law Board were transferred 
 to it, also certain powers and duties vested in Her Majesty's 
 Privy Council. Several of the powers vested in or imposed 
 on a Secretary of State, relative to health matters, were also 
 transferred to it. Henceforth no bye-laws made by the 
 sanitary authorities in connection with their duties were 
 to be of any force until approved by the new Board, 
 
 Also the Board was to possess, in reserve for great 
 epidemic emergencies, a power to issue directions under 
 the Diseases Prevention Act, 1855. 
 
 But with the exception of such special cases, the function 
 of the new Central Authority in regard of local sanitary 
 action was primarily one of observation and inquiry. 
 
 The various Vestries and District Boards of the Metropolis 
 being sanitary authorities thus came under the supervision, 
 and in some respects under the control, of the new Central 
 Government Board, instead of, as previously, under a branch 
 of the office of the Secretary of State for the Home Depart- 
 ment ; but to all intents and purposes they retained their 
 liberty of administration, or, to state it more accurately, 
 their liberty of non-administration. Their relations to the 
 elected central body, the Metropolitan Board of Works, 
 remained unchanged. 
 
 In 1871, also, Parliament dealt with the water supply of 
 London. The essential importance to the health of the 
 population, especially in large towns, of an adequate supply 
 of wholesome water was becoming more generally recognised. 
 
 "Without water life cannot be sustained, cleanliness 
 cannot be maintained, sanitary measures are at a stand- 
 still, drains become blocked, offensive and deleterious gases 
 are retained or driven back into the dwellings, disease is 
 caused and fostered, and public as well as private injury 
 caused in all directions." 
 
 The Act of 1852 had failed to secure for the inhabitants 
 
234 THE SANITARY EVOLUTION 
 
 the advantage which they ought to have long since enjoyed, 
 of a well-regulated supply of water in their houses for 
 domestic purposes. 
 
 A Select Committee of the House of Commons recom- 
 mended that every company should afford a constant supply 
 of water to each house,* so that the water might be drawn 
 direct and fresh from the company's pipes at all times 
 during the twenty-four hours, and free from the pollution 
 so often acquired in dirty receptacles. And a Eoyal Com- 
 mission, appointed in 1867, after an elaborate inquiry, t 
 declared that earnest and prompt efforts ought to be made 
 to introduce the constant service system to the furthest 
 extent possible in the metropolis. The Eeport of the 
 Royal Commission is memorable for the very strong ex- 
 pression of opinion that the water supply of the metropolis 
 should be consolidated under public control. 
 
 The duty of supplying the inhabitants of a city with 
 water had from a very early period been regarded as a 
 peculiarly municipal function, and the supersession of the 
 municipalities by joint stock companies was a comparatively 
 modern innovation. 
 
 Thus far, however, Parliament was not disposed to go. 
 But (by the Metropolis Water Act, 1871) Parhament — 
 contenting itself mostly with "mights" — directed that 
 any company might propose to give a constant supply 
 of water, or the Metropolitan Board of Works might 
 apply to a company for it ; failing both of which, and 
 under certain conditions, the Board of Trade might 
 require a constant supply to be provided. Also every 
 company should — 
 
 " On Sundays, as on other days, supply sufficient pure 
 and wholesome water for the domestic use of the inhabitants 
 within their limits." 
 
 But the Act did not curtail the power of the companies to 
 cut off the supply to a house if the water-rate was not paid 
 by the landlord or owner. An opinion was expressed on 
 this point by the Medical Officer of Health for St. Mary, 
 Newington, in 1872 : — 
 
 - Select Committee of 1867. f P.P., 1868-9, vol. xxxiii. 
 
OF LONDON 235 
 
 "I maintain that water is absolutely necessary for the 
 health, cleanliness, and sanitary condition of every one, 
 and that if a monopoly of its supply is granted to any 
 company, no power of withholding it should be allowed. 
 
 "In the present and increasing crowded condition of our 
 poorer houses the act of one person may enable a water 
 company to refuse it to a household of ten or twelve 
 people. ... I do most strongly protest against a con- 
 tinuation of a power which in its exercise undermines 
 the very foundation of sanitary improvement." 
 
 Little, however, was done either by the Metropolitan 
 Board of Works, the Board of Trade, or the companies 
 to avail themselves of the optional provisions of the 
 Act. 
 
 " Perhaps," wrote the Medical Officer of Health for 
 Wandsworth, " there never was an Act of Parliament so 
 completely ignored in many districts as the one in 
 question." 
 
 " The companies," wrote another Medical Officer of 
 Health, " are too busy in looking after their trade 
 interests to concern themselves much about the health 
 of the people." 
 
 And the constant supply to the people of London was 
 postponed to the distant future. 
 
 In 1871 another subject also claimed the attention of 
 Parliament. 
 
 An epidemic of smallpox of unexampled severity began at 
 the end of the year 1870, " the like of which had not been 
 known in England since vaccination was first practised." 
 It increased in London at an alarming rate until it reached 
 its height in May, 1871, when 288 people died of it in one 
 week, and it killed in London alone, in that one year, 7,876 
 persons. And as it was reasonable to assume that one death 
 represented at the very least eight or ten times the number 
 of cases of that most loathsome disease, the results were 
 frightful, and the injury inflicted upon the community, 
 present and future, disastrous. 
 
 At one time more than 2,000 smallpox patients were 
 under the care of the Metropolitan Asylums Board, and 
 
236 THE SANITARY EVOLUTION 
 
 the admissions into the Board's hospitals about the same 
 time averaged 600 a week. 
 
 In a report on the subject the Committee of the House of 
 Commons wrote : — 
 
 "It is impossible to say what ravages might not have 
 been the result of the smallpox epidemic of 1870-1 had 
 it not been for the efficiency and energy of the Asylums 
 Board. Although the prophylactic virtues of vaccination 
 have been recognised on all sides, it must be remembered 
 that as yet but a small part of the growing population 
 has been subjected to the operations of the Compulsory 
 Vaccination Act." 
 
 And they expressed " their strong sense of the great 
 services rendered to the metropolis by the managers." 
 
 The prevention of smallpox by vaccination was not yet a 
 very potent factor in the diminution of that disease. Only 
 slowly could the Compulsory Vaccination Act of 1867 pro- 
 duce effect, and as the appointment of public vaccinators 
 and the establishment of vaccination stations had been 
 made only optional, the mortality of the outbreak in 1870-1 
 had been but little, if at all, modified by it. The epidemic, 
 however, was used by some to enforce a lesson. 
 
 Thus the Medical Officer of Health for St. James' 
 wrote : — 
 
 "The lesson of the great epidemic of smallpox is the 
 necessity for vaccination. 
 
 " The history of no other disease supplies so assuredly and 
 necessarily the means of its entire destruction." 
 
 And the managers of the Metropolitan Asylums Board, in 
 a report issued in 1871, wrote : — 
 
 " The necessity for re-vaccination when the protective 
 power of primary vaccination has to a great extent passed 
 away, cannot be too strongly urged. No greater argument 
 to prove the efficacy of this precaution can be adduced 
 than that out of upwards of 14,800 cases received into the 
 hospitals, only four well-authenticated cases were treated in 
 which re-vaccination had been properly performed, and these 
 were light attacks." 
 
 Parliament passed an Act in 1871, making the appoint- 
 
OF LONDON 237 
 
 ment of paid Vaccination Officers compulsory on all 
 Guardians, and the law generally more effective. 
 
 Likewise in 1871 Parliament dealt with another matter 
 affecting the public health, and placed on record its opinion 
 of the Vestries and District Boards by relieving them of the 
 duty of enforcing the sanitary provisions of the Workshops 
 Act, which they had failed to carry out, and transferring it 
 to Government Inspectors appointed by the Home Secretary. 
 
 This was quite an unprecedented amount of sanitary 
 legislation by Parliament in one year, and is very notable 
 as showing the greater position health matters were 
 assuming in the opinion of the nation, and the greater 
 necessity Parliament felt itself under for dealing with 
 them. 
 
 An improvement as regarded the food of the people of 
 the metropolis was also commenced about this time. 
 
 The Corporation of the City of London had undertaken 
 to carry out the provisions of Part III. of the Contagious 
 Diseases Animals Act, 1869,* and had purchased the site of 
 Deptford Dockyard for the purpose of a cattle market, and 
 for the reception and slaughter of foreign cattle. The 
 market was opened in 1871, and the system of inspection 
 there inaugurated secured the good quality of a great portion 
 of the meat consumed in London. 
 
 In the following year (1872) the purity of certain articles 
 of the food and drink of the people engaged the attention of 
 Parliament. 
 
 Under the Act of 1860 the Vestries and District Boards 
 might each appoint an analyst, but the great majority of 
 them availed themselves of the permissive character of the 
 Act, and did not appoint one. 
 
 A sidelight is thrown upon the effect of this inaction of 
 the local authorities by evidence given in 1862 by a master 
 baker named W. Purvis. He said : — 
 
 " When the Act passed for preventing the adulteration of 
 articles of food and drink there was an immediate apprehen- 
 sion among those bakers in the trade who adulterate their 
 bread that they would be liable to have their bread fre- 
 
 - 32 and 33 Vic. cap. 70. 
 
238 THE SANITARY EVOLUTION 
 
 quently analysed, &c. But when it was found that no 
 sufficient means were provided by the Act to meet the 
 expenses of this kind of active and constant supervision 
 (the purchaser having to pay the analyst), they became 
 confident again, and have resumed their practice of 
 adulteration without any fear of detection." * 
 
 It was felt now that some further move should be made, 
 and Parliament added another Act for preventing the 
 adulteration of food, drink, and drugs to the long list of 
 those which had gone before. 
 
 " Whereas the practice of adulterating articles of food and 
 drink and drugs for sale in fraud of Her Majesty's subjects, 
 and to the great hurt of their health and danger to their 
 lives, requires to be repressed by more effectual laws than 
 those which are now in force for that purpose — 
 
 "Be it enacted " t 
 
 This Act made it incumbent upon all Vestries and District 
 Boards to appoint public analysts to analyse all articles of 
 food, drink, and drugs, on the request of any parishioners, 
 on payment of a fee ; and imposed the duty upon them of 
 procuring and submitting for analysis articles suspected to 
 be adulterated, and on their being certified to be so, of 
 taking proceedings before a magistrate, who was given 
 power to impose severe penalties. The offences were more 
 clearly defined, and the expense of executing the Act was 
 to be paid out of the rates. 
 
 The Act did much good, but the amount of good was not 
 to be judged by the number of prosecutions and convictions. 
 " Its deterrent effects were undoubtedly great." X 
 
 A Select Committee of the House of Commons, which had 
 been appointed in 1872 to inquire into the subject, recom- 
 mended the repeal of previous Acts dealing with the subject, 
 and the enactment of a new and more compulsory measure, 
 and in concluding their report they said : " Your Committee 
 believe it will afford some consolation to the public to know 
 that in the matter of adulteration they are cheated rather 
 
 * See P.P. 1863, vol. xxv. Eeport by Tremenheere on Bakehouses, 
 p. 113. 
 
 f Adulteration of Food and Drink and Drugs Act, 1872, 86 and 36 Vic. 
 cap. 74. + P.p. 1874, vol. vi. 
 
OF LONDON 239 
 
 than poisoned. Witnesses of the highest standing concur 
 in stating that in the numerous articles of food and drink 
 which they have analysed, they have found scarcely anything 
 injurious to health." 
 
 In 1875 a further Act dealing with this matter was passed 
 amending and strengthening the existing law. 
 
 In September, 1872, another notable step in the sanitary 
 evolution of London was taken in the creation of an 
 authority for the protection of the metropolis against the 
 importation of disease by sea from foreign countries or 
 from home ports. 
 
 " It is now acknowledged," wrote the Port Medical Officer 
 of Health in his first report, " that, as a natural result of the 
 insular position of the kingdom, and the vast extent of our 
 commerce, the sanitary condition of shipping and of the 
 floating population must exercise a considerable influence 
 on the health of the country as regards the importation 
 and transmission of epidemic diseases . . . the urgent 
 advisabihty of -using all means to prevent the introduc- 
 tion of disease into this the largest port in the world is 
 sufficiently apparent." 
 
 Hitherto the prevention of the importation of the various 
 sorts of disease into London by vessels trading to the Port 
 of London from all quarters of the world had been confided 
 to the officers of Her Majesty's Customs, and was of the most 
 superficial and inadequate character. 
 
 The district assigned to the Port of London Sanitary 
 Authority extended from Teddington Lock to the North 
 Foreland, and was 88 miles in length. It included 8 sets 
 of docks and 13 " creeks." 
 
 In the section of river lying between London Bridge and 
 Woolwich Arsenal Pier, about 10 miles in length, there was 
 a constant average of no less than 400 vessels of all descrip- 
 tions moored on both sides of the river, more than 90 per 
 cent, of which had crews on board. 
 
 The creeks were more or less occupied by barges con- 
 taining manure, street-sweepings, gas-liquor, bones and 
 other varieties of foul cargoes, inasmuch as depots for the 
 storage of these materials existed on the banks. 
 
240 THE SANITARY EVOLUTION 
 
 And lying in the docks there was an average of between 
 six to seven hundred vessels, over none of which had the 
 sanitary authorities on the sides of the river any control 
 whatever. 
 
 This was a most unsatisfactory condition of things, and 
 left London open to the practically unchecked importation 
 of infectious and contagious disease of every kind. 
 
 By " Provisional Order " of the Local Government 
 Board, the Corporation of London was constituted the 
 Sanitary Authority of the Port of London,* and was made 
 responsible not only for taking proper steps, under Orders 
 in Council, to prevent the introduction of cholera, but was 
 required also to carry out, within its allotted area, the 
 provisions of the various Nuisances Kemoval Acts and 
 Prevention of Diseases Acts for England, and the Sanitary 
 Act of 1866. 
 
 Its authority extended only to things afloat. Whatever 
 was landed came within the province of the local Sanitary 
 Authority, except things landed in the docks, and things 
 " in bond," which were under the control of Her Majesty's 
 Customs. 
 
 The work was undertaken at considerable expense by the 
 Corporation out of the City's cash, and at no charge to the 
 ^ratepayer. 
 
 And a Medical Officer of Health for the Port and some 
 Inspectors were appointed. 
 
 It was the duty of the Port Medical Officer — 
 
 " To inspect, before landing, all emigrants that arrived in 
 the Port from the Continent for purposes of transhipment, 
 and to isolate all suspected cases, and to carry out all 
 Special Orders in Council relating to the prevention of 
 cholera, or other epidemic diseases." 
 
 He was also charged with the duty of inspecting, at 
 Gravesend, any cases of sickness on inward-bound vessels 
 reported to the authorities by the officers of Her Majesty's 
 Customs. 
 
 As to the prevention of the importation of epidemic 
 
 * Issued on the 17th of September, 1872, and renewed the 25th of 
 March, 1873. 
 
OF LONDON 241 
 
 diseases other than cholera, reliance was placed upon a 
 speedy and proper examination of vessels as soon as possible 
 after they had come to moorings. A large proportion of 
 these vessels required constant general inspection. 
 
 Among the various other duties, fumigation and disin- 
 fection of vessels, also of clothing, were not the least 
 important. 
 
 For isolation of the sick a hospital ship was maintained 
 at Gravesend. 
 
 The work done by the Port Authority was, in spite of 
 many limitations and difficulties, considerable ; and the 
 inspection of thousands of ships, the cleansing and fumiga- 
 tion of foul or infected vessels, the removal to hospital of 
 seamen suffering from infectious or contagious disease, and 
 the disinfection of clothing were, sanitarily, of the greatest 
 advantage to the inhabitants of the metropolis. 
 
 In another matter Parliament, in 1872, made a com- 
 pletely new departure. 
 
 It declared that " it was expedient to make better pro- 
 vision for the protection of infants entrusted to persons to 
 be nursed or maintained for hire or reward in that behalf." 
 And it inaugurated a plan for the protection of the health 
 of the most helpless of its numerous charges — a plan 
 embodied in the Infant Life Protection Act. 
 
 "Houses of persons retaining or receiving for hire two 
 or more infants for the purpose of nursing must be 
 registered." 
 
 The Local Authority (the Metropolitan Board of Works) 
 was to cause a register to be kept and make bye-laws, and 
 might refuse to register an unsuitable house. 
 
 And the registered owner must keep a register of the 
 children, &c., &c. 
 
 If proved to the satisfaction of the local authority that 
 such person has been guilty of serious neglect, or is 
 incapable of providing the infants with proper food and 
 attention, the house might be struck off the Eegister, and 
 penalties be imposed — six months with hard labour, and 
 up to £5 fine. 
 
 The start made was slow, only six houses having been 
 
 17 
 
242 THE SANITARY EVOLUTION 
 
 registered in 1876 ; but the Act laid the foundations of a 
 scheme which has had considerable developments. 
 
 Specially valuable is it to have the views of one of the 
 foremost men of his time upon the phase of opinion 
 existing at this period upon the general question of the 
 public health. They help to mark progress along the 
 road. The late Mr. W. E. Forster, speaking at the meeting 
 of the British Association at Bradford in 1873, said : — 
 
 " I think our aims in this direction are higher than they 
 used to be. "We are aiming not only at preventing death, 
 but at making life better worth living by making it healthy. 
 And we no longer forget that in fighting our battle against 
 disease it is not only those who are killed that are merely 
 to be considered, but also the wounded. In those terrible 
 inflictions of preventable disease throughout the country 
 the loss of life is very sad ; but even more sorrowful to 
 my mind are the numbers of our fellow-creatures — 
 fellow-countrymen and women — who are doomed to strug- 
 gle and fight the battle of life under the most severe 
 conditions because of wounds they have received from 
 preventable diseases." 
 
 While Parliament was thus legislating on several matters 
 considerably influencing the sanitary well-being of the 
 people of the metropolis, the powerful economic and social 
 forces also affecting it were silently and uninterruptedly 
 continuing their work with never-ceasing energy. 
 
 With the marvellous industrial developments of the time, 
 trade, and commerce, and businesses of various kinds and 
 sorts were spreading over a wider area, and constantly 
 claiming accommodation to carry them on ; and the process 
 continued of the conversion of residential houses into offices 
 and shops and warehouses and workplaces. 
 
 The increase of houses in other parts of London, rapid as 
 it was, barely kept pace with the increase of population, 
 whilst it had practically done nothing as yet to relieve 
 overcrowding in the central parts of London. 
 
 The excessive density of the population was a great 
 sanitary evil. 
 
 "It is a well established law," wrote the Registrar 
 
OF LONDON 243 
 
 General in 1872, "that, other things being equal, the 
 insalubrity of a place increases with the density of the 
 population, and that the fevers generated in crowded 
 dwellings have a tendency to spread among the whole of 
 the population." 
 
 And it was already pretty generally recognised by 
 Medical Officers of Health that the chief condition affecting 
 the mortality of a locality was the density of population. 
 
 The Medical Officers of Health never ceased pointing 
 out the evils of overcrowding. 
 
 " Overcrowding," wrote the Medical Officer of Health for 
 Whitechapel in 1877, " concerns the whole community, as 
 is strikingly shown by the spread of many diseases which 
 are, perhaps, in the first instance endemic, and confined to 
 these overcrowded places, but which soon become epidemic 
 and extend over large areas, attacking, indiscriminately, 
 all classes." 
 
 And their reports are full of instances which had come 
 under their observation. 
 
 Thus, in 1871, the Medical Officer of Health for White- 
 chapel wrote : — 
 
 "At No. 13, Goulston Street, I found in the back 
 room of the ground floor, closely contiguous to three 
 closets and a dust hole, one man, six women, and three 
 children sleeping there. The room measured 12 x 9 x 7 feet, 
 giving only a cubic space of 756 feet for ten persons." 
 
 He mentioned also " a room in Cooper's Court, occupied 
 by man, wife, and seven children, which contained about 
 630 cubic feet of space, which allows only 70 feet for 
 each." 
 
 And numerous other cases of overcrowding and indecent 
 occupation, and a case in which the dead body of a child had 
 been retained in a room for fifteen days. 
 
 Passing on to the larger aspects of this dreadful 
 overcrowding, he wrote : — 
 
 *' It is manifest that persons living in such circumstances 
 must become so enfeebled in health as to be unfit for any 
 employment which requires much physical strength. The 
 mental capacity of such persons is also so low as to prevent 
 
244 THE SANITARY EVOLUTION 
 
 them earning a livelihood in any occupation requiring much 
 thought, and the consequence is an increase of paupers or 
 of criminals, or perhaps of both." 
 
 "Consumption and the whole tubercular class of disease 
 are chiefly caused by the defective ventilation of dwelling- 
 houses, and particularly of sleeping rooms, in which at 
 least one-third of one's existence is passed." 
 
 And the Medical Officer of Health for Paddington, in his 
 report for 1871, wrote : — 
 
 " Serious evils of physical and moral character are found 
 to afflict the population of these overcrowded houses. The 
 want of fresh air, habitual uncleanliness, bad washing 
 accommodation, with other unsanitary conditions, favour 
 the spread of contagion. There is a notable increase of 
 tubercular and consumptive maladies in our large cities, and 
 the low form of vitality engendered in people who do not 
 enjoy fresh air, leads to the abuse of stimulants and 
 tobacco." 
 
 In 1874 he wrote : — 
 
 "... Eighteen per cent, of the whole deaths — a formid- 
 able proportion — are from the tubercular class of diseases : 
 a greater proportion than zymotic. The 206 deaths from 
 consumption at ages between 20 and 60 show that 
 there exists some general cause silently working great 
 mischief and undermining the constitution of parents 
 at a period of life in health and strength when they can 
 least be spared from their families." 
 
 And he added : — 
 
 " Large numbers of sickly and weakly children abound 
 in the tenement-houses of our thickly populated streets." 
 
 Nor were the homes of the people the only place where 
 overcrowding worked its evil will. Many children — how 
 many there is no means of knowing — suffered from it in 
 the schools which they attended. 
 
 The following extracts from reports of an Inspector 
 of the School Board * present a vivid picture of the con- 
 dition of many schools in existence so late as the year 
 1874. 
 
 * Final Report of the School Board for London, 1870-1904. 
 
OF LONDON 245 
 
 1. School. 
 
 " This is a wretched place, a disgrace to the metropolis. 
 The * school ' is held in an old dwelling-house in Clerken- 
 well. The house was at one time used as a stable. The 
 approach is most unwelcome, and on entering the school- 
 room (upstairs) a most deplorable picture presented itself 
 to the eye. Fifty children crowded together in a small, 
 dingy, shapeless room with space for sixteen, and the 
 window and door carefully closed — in fact, the latter and 
 the doors downstairs carefully bolted. The sooner this 
 place is closed the better." 
 
 2. School. 
 
 " As regards the accommodation provided, thirty-six 
 young children were sitting in an upper room into which 
 the rays of the sun on a bright day in June could not enter 
 — twilight in mid-day." 
 
 3. School. 
 
 " It would be impossible for words to describe the in- 
 efficient state of this so-called school. Eighty-two children 
 of different ages — boys and girls — huddled together in a 
 miserable, badly lighted, badly ventilated room, affording 
 accommodation for twenty-three at the utmost. 
 
 " No books, no apparatus, no seats ; floor and bare walls : 
 the * teacher ' an aged man, standing in the midst of a 
 crowd of children and wielding a cane to keep the 
 ' scholars ' quiet, and thus the time goes on." 
 
 4. School. 
 
 " This is not a school — it seems a baby-farm. Seventeen 
 children in a small, filthy hovel. There were four infants 
 a few months old ; one lay on a small bed, another in a 
 small cot, and the two others in positions which I cannot 
 here describe. The little ones were quite naked. The 
 woman who pretends to look after this ' school ' was 
 engaged in a back yard washing. From the woman 
 down to the infant, all here seemed steeped in ignorance 
 and wretchedness." 
 
 Here is a case reported by the Medical Officer of Health 
 for Whitechapel, so late as 1880 : — 
 
 " A schoolroom at 11, Pelham Street, Spitalfields ; 9 feet 
 
246 THE SANITARY EVOLUTION 
 
 long X 8 X 8. There were twenty-five children aged 
 4 — 7, and the master and his wife, in all twenty-seven 
 persons, giving 21*3 cubic feet for each." 
 
 And here is a report of an early creche, or baby farm, 
 also in Whitechapel, in 1879 : — 
 
 "The Sanitary Inspector found on the ground floor of 
 24, Freeman Street, Spitalfields, a woman and twenty-five 
 children all under three. They were left in charge of the 
 occupier of the room from nine until 5.30 p.m., who was 
 paid 3d. per week per child. The room was 15 feet x 7 x 7, 
 thus affording 28 cubic feet of space per child ! ! The room 
 was badly ventilated, there were neither chairs nor seats, 
 the children were on the floor, which was in a wet and 
 dirty condition." 
 
 The other causes of insanitation were also flourishing. 
 " Noxious businesses " of various kinds continued to 
 pollute the atmosphere, despite legislation against them, 
 and the existence of local authorities charged with the 
 administration of that legislation — a permanent pollution all 
 the year round, and from which there was no getting away. 
 
 Very commonly the arches under the railways were used 
 for making and storing artificial manures, the smell from 
 which was intolerable. 
 
 The Medical Officer of Health for St. Mary, Newington, 
 1871 :— 
 
 " The private manure-mixing yards have ever been the 
 cause of much annoyance and illness to those living in 
 the neighbourhood. One of these," he added, "had for 
 years been complained of." 
 
 And yet the Vestry had not shut it up. And the air 
 was tainted and vitiated by the emanations from them, the 
 owners having no vestige of regard for other people's health. 
 
 Another cause of insanitation was the existence of 
 slaughter-houses throughout London, in the most crowded 
 parts, and in close propinquity to dwelling-houses ; indeed, 
 in the yards of some of them slaughter-houses, with all 
 their unpleasant concomitants. Cow-houses, too, also 
 close to houses, were numerous, and, in the outer parts of 
 London, even piggeries. 
 
OP LONDON 247 
 
 A great opportunity was lost in 1874 for greatly 
 diminishing, if not actually terminating, the great 
 " nuisance " of slaughter-houses. 
 
 By an Act passed in 1844, it was declared absolutely 
 illegal, on the expiration of thirty years after the passing 
 of the Act, to carry on certain noxious businesses in any 
 premises nearer a dwelling-house than 50 feet, or nearer 
 a public way than 40 feet — the business of slaughtering 
 being among the number. Until 1851 there was no 
 control over slaughter-houses ; any one could conduct a 
 slaughter-house who pleased, subject only to the common 
 law as to doing anything which might be considered a 
 nuisance.* 
 
 The Metropolitan Market Act, passed in that year, 
 required that all slaughter-houses should be licensed by 
 the justices, thus establishing some form of control over 
 them. 
 
 When, in 1874, the expiration of the thirty years drew 
 nigh, doubts were raised by those interested in their con- 
 tinuance as to the interpretation of the Act of 1844. The 
 Select Committee, which was investigating the subject of 
 " Noxious Businesses," stated that no evidence had been 
 given before it to show that any of these trades when 
 properly conducted affect the health of the persons living 
 near the premises, and Parliament, accepting this view, 
 passed an Act which undid the enactment of 1844, and 
 allowed slaughter-houses to be continued indefinitely under 
 license. At the same time it conferred on the central 
 authority, the Metropolitan Board of Works, power to 
 make bye-laws with respect to certain noxious trades. 
 
 And so this fertile cause of insanitation — slaughter- 
 houses — was perpetuated to the present time. 
 
 There was, however, a far more general and potent cause 
 of disease and death, and general detriment to the public 
 health, than the pollution of the atmosphere by noxious 
 trades, and that was the reckless scattering abroad of 
 infectious or contagious diseases by persons afflicted with 
 or in contact with such diseases. 
 * See Select Committee on Noxious Businesses, 1873. P.P., vol. x. 
 
248 THE SANITARY EVOLUTION 
 
 The Metropolitan Asylums Board had already erected 
 hospitals, and were doing a vast amount of good and pre- 
 venting the spread of disease. 
 
 But by the people themselves the seeds of infection 
 were scattered broadcast. 
 
 Dr. Simon, the Medical Officer to the Privy Council, 
 in his Eeport of 1865, wrote : — 
 
 "As to contagions already current in the country, 
 practically any diseased person scatters his infection broad- 
 cast, almost where he will — typhus or scarlatina, typhoid 
 or smallpox, or diphtheria, . . . the present unlimited 
 license seems urgently to demand restriction." 
 
 But the license to kill remained without restriction, 
 except that of entering a public conveyance.* 
 
 As the Medical Officer of Health for St. Mary, Newing- 
 ton, wrote in 1871 : — 
 
 " How many are the ways in which the spread of ' 
 contagious disease is, as it were, invited, no one knows 
 better than a sanitary officer. Washing, mangling, needle- 
 work, go on in many an infected house ; children, aye 
 adults also, the sick and the sound, mix indiscriminately. 
 I have even known the exhibition, as a sight, of the corpse 
 of a smallpox patient. ..." 
 
 And the Medical Officer of Health for Paddington called 
 attention (1873-4) to— 
 
 " The extreme indifference displayed with regard to 
 these diseases (measles, &c.), by many of the lower and 
 middle class is an unmistakable sign of an ignorant 
 belief that they are natural events ; and such a belief 
 leads to a carelessness of management much to be 
 condemned. 
 
 "... The working classes generally visit freely during 
 sickness, allowing their clothes to become saturated with 
 contagious poison." 
 
 The Vestries and District Boards did do a certain amount 
 
 of disinfection ; but more than three years after the 
 
 Sanitary Act of 1866 was passed, in twenty-nine districts 
 
 (out of thirty-eight) no proper disinfecting establishment 
 
 '■'' See Sections 25 and 26 of the Sanitary Act, 1866. 
 
OF LONDON 249 
 
 in accordance with the requirements of the law had been 
 provided (Strand, 1869-70). 
 
 The Medical Officer of Health for St. James', West- 
 minster, pointed out (1870-1) that in London there was — 
 
 " No legal obligation on the part of the head of a family 
 or landlord, or a medical man, to declare the presence of 
 scarlet fever to the sanitary authority. The consequence 
 is, that long before any knowledge of the existence of the 
 disease has been obtained by the Medical Officer of Health 
 the disease has spread far and wide. If it were not so 
 melancholy, one feels inclined to deride the folly and 
 ignorance of a so-called civilised and enlightened nation 
 allowing such a cruel and terrible scourge as this to pass 
 over the country without any attempt to control it." 
 
 "In sixteen years we have lost 479 persons by scarlet 
 fever in St. James'. Where one person dies, 10-20 get 
 it and get well. It is vain to calculate the pecuniary 
 expense of such a curse, but every one can make something 
 like an approximation to the cost of such a waste of human 
 life, and form an opinion of the vast benefit of legislation 
 that should put a stop to this disease." 
 
 The Medical Officer of Health for Paddington referred 
 (1876) to the disastrous results of cases of infectious illness 
 not being notified to the sanitary authority, and so enabling 
 precautions being taken to stamp out the infection. 
 
 " Such a state of matters, with the annual huge mortality 
 consequent thereon, will continue until an educated people, 
 conscious of its duties and jealous of its rights, demands 
 from a tardy executive the intervention of the legislature 
 to prevent it." 
 
 The Vestries and District Boards were gradually doing 
 a good deal of useful work of the sort which did not much 
 conflict with private interests. The great main drainage 
 works of the Central Authority had enabled them to improve 
 and extend their sewerage and drainage works, and from 
 1856 up to March, 1872, they had borrowed from the 
 Metropohtan Board of Works ^6767,000 for this pur- 
 pose;* and the total length of brick and pipe sewer 
 
 =■= See Eeport of Metropolitan Board, 1871-2. 
 
250 THE SANITARY EVOLUTION 
 
 which they constructed in that period was very close 
 upon 700 miles. 
 
 " The large amount which has been expended on works 
 of sewerage and paving, shows that the local authorities 
 in the metropolis have not been unmindful of the require- 
 ments of their several districts." 
 
 St. Giles' reported in 1872 that its sewerage was very 
 complete, "not a single street or court being without a sewer." 
 
 St. Marylebone reported in 1877 : — 
 
 "^33,500 has been spent in new sewers in the parish 
 in the last three years, and ^£7,000 is to be spent. Over 
 three miles of new sewers were constructed. These are 
 large items in our parochial expenditure, but the fact 
 cannot be ignored that the sewerage of the parish had 
 got into a disgraceful and indeed dangerous condition. 
 
 " In some of the finest streets and squares of the 
 parish the sewers were but little better than elongated 
 cesspools." 
 
 Bermondsey reported, in 1872, that the entire district 
 was drained into low level sewers, all open sewers, tidal 
 and other ditches, and cesspools having been abolished; 
 ;05,2OO expended in widening and improving certain 
 streets, £92,000 spent in sewerage, paving, and other 
 improvements. 
 
 St. Mary, Newington, reported in 1871 that the whole 
 of the open sewers and tidal ditches had been covered 
 over ; that the drainage was in a satisfactory condition, 
 and that within a few pounds of £400,000 had been spent 
 since 1856 in various parish works and maintenance. 
 
 In the Wandsworth district (1873-4) :— 
 
 " The enormous sanitary works carried on by the Metro- 
 politan Board of Works and the Board of the District 
 have, by drying the soil and altering the waterlogged 
 condition which formerly prevailed, completely changed 
 the sanitary aspect of the locality." 
 
 Not all the work reported as done, however, was done 
 as satisfactorily as was to be desired. 
 
 Thus the Medical OlB&cer of Health for St. James', 
 Westminster, wrote (1871-2) : — 
 
OF LONDON 251 
 
 " Sewers and drains being out of sight admit of a great 
 amount of * scamping ' work. 
 
 ** Speaking from experience, some of the local sewers in 
 St. James' are specimens, I hope unique, of the extent 
 to which 'scamping' can be carried." 
 
 And the Medical Officer of Health for Shoreditch wrote 
 (1878) that— 
 
 ** Some of the new drains (being so badly laid) are more 
 dangerous than the old." 
 
 The arrangements for water supply were also in 
 some few parishes, in process of years, being slowly 
 improved. 
 
 In Lambeth, in 1872, 646 houses without proper water 
 supply were provided with it ; and in 1873, 804 houses. 
 
 Bead one way, this was satisfactory. Bead the other, 
 it was a revelation of the number of houses in Lambeth 
 which had been left until 1873 without that great essential 
 of health — a " proper water supply." 
 
 A large amo'unt of street paving had been done, 
 and a few small street improvements had been carried 
 out. 
 
 Considering the very limited staff of Inspectors which 
 it suited the policy and purposes of the Vestries to 
 appoint, a fair amount of sanitary inspection was done 
 in some parishes and districts. 
 
 The striking fact about the inspections made is the 
 very high proportion of houses in which the sanitation 
 was defective. 
 
 In Bermondsey, in 1879, where 1,577 houses and premises 
 were inspected, 1,495 notices were served. 
 
 In Limehouse, in 1879, 1,411 houses were inspected; and 
 1,070 orders for sanitary amendments issued. 
 
 In Shoreditch, where there were 15,500 houses, the two 
 Sanitary Inspectors appear to have done a lot of useful 
 sanitary work. In 1877-8, 5,465 separate nuisances 
 dangerous to health were abated. 
 
 If anything like a similar proportion prevailed generally 
 throughout London, the housing of its huge population 
 was indeed in a dreadful state. 
 
252 THE SANITARY EVOLUTION 
 
 In some ways the local authorities were awakening to 
 their responsibilities, and beginning to avail themselves 
 of some of the provisions placed by Parliament at their 
 disposal. 
 
 In Paddington, St. Giles', and Eotherhithe, the Vestries 
 had adopted the Baths and "Washhouses Act of 1846, and 
 thus helped to promote habits of cleanliness, and to diminish 
 some of the insanitary evils consequent on the tenements 
 being turned into temporary wash-rooms. 
 
 And in St. James' (Westminster) and Lambeth, mortu- 
 aries had been provided, which, in some cases, at any rate, 
 obviated some of the insanitary evils consequent on the 
 retention of dead bodies for long periods in single-roomed 
 tenements where death had been caused by contagious or 
 infectious diseases. 
 
 More action was being taken, too, as regards the dis- 
 infection of rooms where there had been cases of infectious 
 disease. Thus in Lambeth in 1877-8, 824 houses were 
 disinfected. 
 
 Here and there, too, the owners of noxious trades 
 were being compelled to adopt methods rendering their 
 businesses less insanitary and objectionable to their neigh- 
 bourhoods. 
 
 The Local Government Board had caused an elaborate 
 inquiry to be made by Dr. Ballard as to — 
 
 " ' In what measure and by what means nuisances and 
 injury to health from offensive businesses might be 
 avoided,' and the report led to quite a satisfactory 
 result. 
 
 "It showed that by the application of such knowledge 
 as was at command, all or nearly all businesses that are 
 in a serious degree offensive might be carried on either 
 without offence, or with such important reduction of 
 offence, as should make it tolerable, or even trivial." * 
 
 In Fulham several piggeries were closed by law; not 
 without regret, apparently, for the Medical Officer of 
 Health stated in his report : — 
 
 "It certainly is very hard on the pig keepers individually, 
 
 * P.P. 1878-9. Beport of Local Government Board, vol. xxix., p. xiii. 
 
OF LONDON 253 
 
 but it is in accordance with the recognised law of civilisa- 
 tion, that the interests of the few must be sacrificed to 
 the welfare of the many." 
 
 Upon one course of action all the Medical Officers of 
 Health were in agreement — the absolute necessity of 
 inspection and supervision of the houses of the people. 
 In season and out of season they advised it, and urged 
 it as the most essential and the most useful of all duties. 
 
 In support of these views they could point to the 
 results of inspection and supervision in the registered 
 Common Lodging Houses. 
 
 In the parish of Spitalfields (in Whitechapel, 1880) 
 there were 109 of these houses containing 454 rooms 
 registered to accommodate 3,992 lodgers. The class 
 of persons occupying them were, notoriously, the very 
 lowest. 
 
 " We failed to learn that any respectable mechanic 
 with his wife and family ever applied at these houses 
 for lodging accommodation. Yet," reported the Sanitary 
 Inspector (1880), "we discovered no case of overcrowding. 
 The bedding was clean ; the yards and closets were in a 
 good sanitary condition ; there was a good water supply, 
 and the walls and ceilings of the houses were clean." 
 
 If these results were obtainable in dealing with the 
 worst classes, in the overcrowded parts of Whitechapel, 
 a fortiori, inspection and supervision would have been 
 productive of similar benefits among the general tenement 
 population. 
 
 The Medical Officer of Health for St. George-in-the- 
 East referred to the low mortality in model lodging- 
 houses, where also there was supervision. 
 
 " There we find good sound dwellings, &c., &c. No 
 overcrowding is permitted, only a certain number in 
 family being accepted as tenants. Cleanliness on their 
 part is expected — enforced if necessary — or a notice to quit 
 is speedily given." 
 
 While thus recommending inspection, supervision, and 
 compulsory rules, another view was also expressed.* 
 
 * By the Medical Officer of Health for Whitechapel, 1878. 
 
254 THE SANITARY EVOLUTION 
 
 ** As laws have been enacted for the abatement of 
 overcrowding, it is easy to say : ' let those in authority 
 put them in force ' ; but I much fear unless the question 
 is taken up with a spirit of love towards the poorer and 
 more ignorant classes by the upper and middle classes, 
 and measures adopted to give instruction to the poor in 
 matters concerning their physical well-being, the existing 
 state of things will long continue." 
 
 " No class will become civilised by being left to them- 
 selves, as unfortunately is the case in the numerous back 
 slums of London, but improvement, physically and 
 socially, can only be effected by a superior class mixing 
 and associating with a class below them." 
 
 The Medical Officer of Health for Poplar wrote : — 
 
 " The poor want more than model dwellings, more 
 than warmth, food and clothing; they want humanity, 
 and the knowledge of the laws governing health." 
 
 Unfortunately those remedies were, at best, a matter 
 of considerable time, and improvement could be but of 
 slow growth. Immediate measures were required to cope 
 with the appalling evils, and for the house-owners, even 
 more than for the unfortunate tenants, were supervision 
 and compulsory rules requisite. 
 
 But not one tithe of the Vestries and District Boards 
 would enforce against owners the regulations under the 
 35th Section of the Sanitary Act of 1866. 
 
 Though something was being done as regarded the 
 inspection of houses and the repair of sanitary defects, 
 hardly any progress could be said to have been made 
 for the improvement of the dwellings of the poor. 
 
 The Artisans' and Labourers' Dwellings Act (Torrens) 
 of 1868 was to a small extent being made use of. 
 
 In some parishes houses considered by the Vestry or 
 District Board as unfit for human habitation had been 
 closed, and were only allowed to be reopened upon proper 
 repairs having been carried out. In other cases where 
 no amount of repairs could put the house into habitable 
 condition, the landlord was directed to pull down the 
 buildings (without his receiving any compensation), and, 
 
OF LONDON 255 
 
 in default, the Vestry could pull it down at his expense. 
 The site remained unoccupied, until the owner or landlord 
 used it again for building purposes, or sold it to some 
 one else. 
 
 In St. Giles' (1873-4) the District Board has been en- 
 abled under the Act to enforce " considerable improve- 
 ments in and immediately adjoining the worst parts of 
 St. Giles'." (Houses in yards and courts were demolished.) 
 
 In St. Luke the total number of houses "pulled down 
 or closed " amounted by the year 1875 to 104.* 
 
 In Holborn the Board had been — 
 
 " Applying or threatening to apply the Act to houses 
 that could be fairly subjected to it. Besides having 150 
 houses, chiefly belonging to one owner, put into a complete 
 sanitary repair, it has been actually applied to 136 houses ; 
 70 thoroughly repaired, 40 demolished, 26 to be rebuilt, 
 and 10 to be closed." 
 
 There were many difficulties in using the Act. Notice of 
 houses being unfit had to be given to "owners." A certain 
 case in Chelsea was mentioned where — 
 
 " There were freeholders, lessees, under-lessees, and sub- 
 lessees, and their trustees and mortgagees, and besides there 
 were the occupiers." 
 
 But in the great majority of parishes or districts no steps 
 were taken under the Act. The Act did not give any com- 
 pensation to the owners of condemned property, as Parlia- 
 ment had declared by it that compensation should not be 
 given to those who permitted their property to fall into 
 such a state, whilst at the same time extracting the 
 fullest benefit from it. 
 
 To such a doctrine there was, of course, the strongest 
 hostility by all those who held the opinion that a man 
 might do as he liked with his own, and extract from it 
 the uttermost farthing regardless of the infliction of disease 
 and suffering and death upon those who were so unfortu- 
 nate as to become his tenants, and reckless as to the injury 
 his action was inflicting upon the community at large. 
 And so : — 
 
 * P.P. 1875, vol. Ixiv. 
 
256 THE SANITARY EVOLUTION 
 
 " The reluctance of the local authorities to take away a 
 man's property was insuperable, and consequently no very 
 great demolition took place." 
 
 The Medical Officer of Health for St. Pancras wrote 
 (1876) :— 
 
 " The Act is almost inoperative. The highly penal nature 
 of this statute, which in the event of demolition gives no 
 compensation to the owner whose property is destroyed, 
 makes Courts of Justice extend every possible leniency to 
 the owner. Moreover it does not contemplate any scheme 
 for the reconstruction of the houses demolished, or other 
 provision for population displaced. ..." 
 
 And the Medical Officer of Health for St. James', 
 Westminster, where no action was taken under it, 
 wrote (1872-3) :— 
 
 "It is scarcely necessary to say that such an Act could 
 not be acted upon without the grossest injustice to the 
 owners of property, and the infliction of the greatest 
 hardship on the poor." 
 
 But there was another view, much nearer justice, which 
 was given expression to before the Select Committee 
 in 1881. 
 
 " An owner of property who allowed his property to fall 
 into such a miserable state as to be unfit for human habita- 
 tion is not a man that deserves the slightest consideration 
 of any kind from Parliament — he ought to be treated rather 
 as a criminal than an owner of property. To compensate 
 him is a mistake entirely." 
 
 And the Medical Officer of Health for Whitechapel said it 
 was his opinion that — 
 
 ** If the landlord leaves his house in a very bad state, and 
 will not listen to any representations, he ought not to be 
 paid by the public when he is creating a nuisance." 
 
 The Act of 1868 having helped so little to a solution of 
 the housing problem, and the matter being one of ever- 
 increasing urgency, an effort was made to deal with it 
 in 1875, when a Bill for facilitating the improvement of 
 the working classes in large towns was introduced into 
 Parliament by Sir K. A. Cross, and was carried. 
 
OF LONDON 257 
 
 It often happened that in some of the worst slums, the 
 houses were the property of several owners, and it was not 
 therefore in the power of any one owner to make such 
 alterations as were necessary for the public health. 
 
 The Act* of 1875 contemplated— 
 
 " Dealing with whole areas, where the houses are so 
 structurally defective as to be incapable of repair, and 
 so ill-placed with reference to each other as to require, to 
 bring them up to a proper sanitary standard, nothing 
 short of demolition and reconstruction. Accordingly, in 
 this case, the local authority, armed with compulsory 
 powers, at once enters as a purchaser, and on completion 
 of the purchase proceeds forthwith to a scheme of 
 reconstruction." f 
 
 An official representation, that the houses within a 
 particular area were unfit for human habitation, was to 
 be made to the Central Authority, the Metropolitan Board 
 of "Works, by the Medical Officer of Health of a Vestry 
 or District Board, and the Metropolitan Board was em- 
 powered to declare the same to be an unhealthy area, 
 and to make an improvement scheme in respect of it. 
 If it decided that an improvement scheme ought to be 
 made, it should forthwith make such a scheme, which, 
 after sundry formalities, was embodied in a Provisional 
 Order which had to be confirmed by Parliament. 
 
 The compensation to be paid for the property so taken 
 might be settled by agreement between the Metropolitan 
 Board of Works and the owner, but where no agreement 
 was arrived at, an arbitrator was to be appointed by the 
 Secretary of State. The arbitrator was to assess the com- 
 pensation at the fair market value of the lands concerned, 
 due regard being had to the nature and then condition of 
 the property, but no additional allowance was to be made 
 in respect of the compulsory purchase of the area. 
 
 The value settled, and the land having passed into the 
 hands of the MetropoHtan Board of Works, the obligation 
 
 * " The Artizans' and Labourers' Dwellings Improvement Act," 
 38 and 39 Vic. cap. 36. 
 
 f See Royal Commission Eeport, 1884. 
 
 18 
 
258 THE SANITARY EVOLUTION 
 
 was imposed on that body of pulling down the buildings, 
 and selling, or letting, the cleared ground for the erection 
 of improved dwellings for the same number of people. 
 
 The hardship of working class and poorer persons being 
 turned out of houses and no other accommodation being 
 provided for them was formally recognised in this matter, 
 and the scheme had to provide for the — 
 
 "Accommodation of at the least as many persons of the 
 working class as may be displaced in the area ... in 
 suitable dwellings which, unless there are any reasons to 
 the contrary, shall be situate within the limits of the same 
 area, or in the vicinity thereof. It shall also provide for 
 proper sanitary arrangements." 
 
 The Act was intended to relieve owners of such property 
 without loss or benefit, and several representations as to un- 
 healthy areas were made to the Metropolitan Board. The 
 facts stated in these representations and subsequently 
 brought out in evidence in the public inquiries held, were 
 illuminating as to the terrible depths which the conditions 
 of life of numbers of the people had been allowed to reach, 
 without the intervention of the law, or the staying hand of 
 the freeholder, lessees, or sub-lessees, who derived financial 
 profit from the property. 
 
 The Medical Officer of Health for Limehouse described 
 one of them : — 
 
 " The area, though not large, contained abominations 
 sufficient for an area three times its size. Here were 
 crowded houses, built no one knows when ; how they 
 stood was a marvel, their walls bulged, their floors sunk, 
 an indescribable musty odour pervaded them ; water sup- 
 ply, drainage, closets, all were bad, and in my opinion, 
 nothing could remedy such a state of things short of 
 pulling down the rickety buildings." 
 
 "The area is inhabited by about 800 people, and the 
 death-rate is about 36 per 1,000." 
 
 In another of these schemes, in one Court (Sugar Loaf 
 Court) the death-rate was 105 "2 per 1,000. 
 
 The Medical Officer of Health for the Strand gave a 
 report on the sanitary state of Bedfordbury : — 
 
OF LONDON 259 
 
 " Bedfordbury is the black spot of this parish. It and the 
 contiguous courts are a Httle over three acres. Population 
 census of 1871 = 2,163. It is a long narrow street of 47 
 houses with courts leading out of it on either side. Some 
 of the courts are blind and very narrow, thus rendering 
 light and air difficult of access. 
 
 '* These 47 houses are so old and dilapidated that it is 
 quite impossible to make them fit and proper habitation 
 for the poor to live in. 
 
 " Even this bright and sunny morning the staircases were 
 so dark that you could not see a single stair — there was not 
 a scrap of ventilation, and no means of getting light or air 
 to them. 
 
 "No. 37 is occupied by 33 people living in six rooms; on 
 the second floor the two rooms are tenanted by two families, 
 respectively five and seven, and the third floor by two 
 families of six each." 
 
 No. 41 was very similar. " These two houses may be 
 taken as a type of the condition of the houses in Bedford- 
 bury." 
 
 " Off this street were various Courts, one of them of six 
 three-roomed houses; its width three feet five. Another 
 Court — seven houses, 20 rooms in all — population 71. All of 
 them apparently as bad, or worse, than those in the street 
 — miserable hovels, the birthplace of disease and vice, 
 and centres for infectious diseases, which are likely to 
 spread through the whole community." 
 
 The births and deaths were almost equivalent. In 1872, 
 there were 92 births and 95 deaths. In 1873, there were 
 108 births and 108 deaths. 
 
 " In 1874, there were 95 deaths and only 82 births. The 
 deaths are exclusive of those people who have been re- 
 moved from the neighbourhood and gone elsewhere to 
 die, either in the hospital or the workhouse, where a 
 great many people at the present time do go to die." 
 
 Of the overcrowded rooms he says : — 
 
 "Here legions of crimes and legions of vices unite, 
 
260 THE SANITARY EVOLUTION 
 
 fostering diseases of body, weakened intellect, and utter 
 destruction of the soul ; leading inevitably to a career of 
 wickedness and sin." 
 
 Confirmatory of the Medical Officer of Health's descrip- 
 tion, was that given in a memorial to the Metropolitan 
 Board by 118 persons : " The Clergy, Medical Men, 
 Bankers, Residents, Professional men, and Traders of the 
 parish of St. Martin-in-the-Fields, in support of a scheme 
 of improvement." 
 
 "Bedfordbury, with its swarming, ill-built, badly venti- 
 lated, rotten, inappropriate, unsavoury tenements, has seemed 
 to us a very forcing pit of immorality." 
 
 "In it there are 797 people living on one acre of 
 land." 
 
 " There is a very large number of interests to be paid for. 
 There is first the freeholder ; then there is the first lessee ; 
 then there are numbers of under-lessees, and all the trades 
 of those little shops, and they ought all to get something." 
 
 And another area was the " Great "Wild Street Scheme," 
 in the parish of St. Giles'-in-the-Fields.* 
 
 " This area has long been a hot-bed of disease. It con- 
 tains about 5^ acres, and 227 houses stand upon it inhabited 
 by 3,897 persons. 
 
 Great Wild Street 58 houses containing 926 persons. 
 Drury Lane 31 ,, ,, 425 ,, 
 
 Princes' Street 14 ,, ,, 315 ,, 
 
 Wild Court 14 „ „ 346 
 
 " Many of the courts and passages are approached by a 
 narrow passage under a house at either end which renders 
 ventilation very defective. Some of the houses are built 
 close together and have dark passages and staircases, others 
 have no back yards, and their sanitary arrangements are 
 placed in the basement. Health under such circumstances 
 is impossible. This part of St. Giles' has long been noted 
 for its heavy sick and death rates, especially from diseases 
 of the respiratory and pulmonary organs, and from typhus 
 fever and other zymotic disorders in their most contagious 
 forms." t 
 * 1877, 24th March, f Inquiry by Cubitt NichoUs, March 24, 1877. 
 
OF LONDON 261 
 
 Dr. Lovett, the Medical Officer of Health, stated that 
 diseases were very rife in it, and a very high rate of 
 mortality as compared with the number of cases. 
 
 And he added, " The district is a nest of zymotic diseases 
 of the most contagious kind. In 1874, 27 cases of typhus 
 were sent to Stockwell Hospital. This state of things 
 cannot be dealt with under Torrens* Act. The houses are 
 built so close together, the people are so huddled to- 
 gether . . . you must make a clean sweep of the 
 buildings." 
 
 Another of these insanitary areas was Pear Tree Court, 
 in Clerkenwell, " consisting of small tenements of an 
 exceedingly inferior description. All are more or less 
 calculated to engender disease and filth. The condition 
 of the property has been such as to be a reproach to the 
 neighbourhood. 
 
 " Occupied by the very poorest of the community. When 
 disease made its appearance it has been fostered and en- 
 gendered and continued by the state in which the property 
 and its surroundings have been — the death-rate is nearly 
 double of that which prevails over the whole parish. 
 
 ** Some of the tenements are of the most wretched descrip- 
 tion — some constructed of lath and plaster — some wooden 
 houses — the floors rotted partly by the cisterns, partly by 
 rain coming in. 
 
 "In some cases the sanitary convenience is in the very 
 rooms themselves — also the water-butt — thereby engender- 
 ing and perpetuating the worst kind of zymotic disease : the 
 chosen home of fever and also of smallpox. 
 
 "An entire absence of ventilation. 
 
 "... When we come to those occupying only one room 
 each, and remembering that in many of these rooms the 
 closet, the water-butt, the water supply, and everything else 
 was contained in the room itself, and that there was no pro- 
 vision for manure, ashes, or refuse of any kind, you can 
 easily conceive what a wretched state of things that presents. 
 On the average there were 2 "80 persons per room per- 
 manently occupying them. So it cannot be wondered at an 
 outbreak of the zymotic disease finding a resting-place 
 
262 THE SANITARY EVOLUTION 
 
 there, and that such a locality becomes a plague spot in the 
 neighbourhood, and extends its ravages thence into healthier 
 neighbourhoods." 
 
 Some of the houses the Medical Officer of Health had 
 known to be in the same state for the last 36 years. 
 
 "... An ill-constructed, unhealthy warren; " some were 
 " regular old shanties — you could hardly find anything like 
 those in the metropolis, they are worth looking at as a 
 curiosity." 
 
 " Some in Clerkenwell Close are large and very old wooden 
 houses, all tumbledown. There is no straight line in roof or 
 windows — the windows are like cabin windows." 
 
 One more case is worth giving details about, as it is one 
 of those rare cases in which one gets a more continuous 
 account of the effects of slum ownership than is usually 
 accessible.* 
 
 This was the Little Coram Street scheme, in St. George, 
 Bloomsbury, in St. Giles' District, comprising 119 houses 
 — 1,027 inhabitants. 
 
 The Medical Officer of Health, in his representation to 
 the Metropolitan Board, gave a minute description of the 
 place. 
 
 " The houses are principally let to cab owners, who stable 
 their horses in the lower floor, and reside with their families 
 in the rooms over ; they are without back yards, and the 
 rooms mainly derive their ventilation from the staircase lead- 
 ing out of the stable, so that the air is contaminated by the 
 noxious gases which issue from it. All the closets are inside 
 the houses ; there are no dustbins, and the drinking-water 
 is often obtained from underground tanks, which serve both 
 for stable, cleaning, and culinary purposes, 
 
 " These houses are unfit for human habitation." 
 
 " The district now represented as unfit, &c., constitutes the 
 worst part of the parish of St. George, Bloomsbury, and 
 has been notorious for years as largely contributing to the 
 sick and death rates of the sub-district." 
 
 In 1862 it was reported that it had " habitually a much 
 higher mortality than the rest of the parish." 
 
 * Appendix. Select Committee Housing, 1881, p. 364. 
 
OF LONDON 263 
 
 In the following years "the mortality was seriously 
 increasing there." 
 
 In 1870 smallpox broke out first in it, and 25 cases occurred 
 in a short time. During the same year the deaths in 
 Chapel Place from three classes of disease — the zymotic, 
 pulmonary, and tubercular — having been 17, the death-rate 
 to population was 70 per 1,000 without reckoning those from 
 other causes. 
 
 In 1871 the general mortality was 50 per cent, greater in it 
 than that in the parish, whilst that of cholera was four times 
 greater. 
 
 In 1874, nine cases of typhoid and typhus fevers occurred 
 in it, " and the locality was conspicuous for diseases and 
 premature deaths." 
 
 In 1876 scarlet fever was prevalent. 
 
 Asked what class of disease the people chiefly suffer from, 
 the Medical Of&cer of Health replied : — 
 
 " Mostly from debility — zymotic diseases, and infectious 
 diseases — such as whooping cough, typhus, typhoid fever, 
 cholera, diarrhoea, measles, scarlet-fever, &c., &c., small- 
 pox, and gin liver disease. . . . They are obliged to resort 
 to gin on account of the close and depressing condition 
 in which the people live in these Courts free from the 
 public eye. 
 
 "The women have to stop at home; they do not get out, 
 and therefore do not get any excitement. Then they take 
 their drops. You can often see women at twelve o'clock in 
 the day drinking in public-houses." 
 
 The Parochial District Medical Officer said : — 
 
 " The houses are so old that the air is really poisonous ; 
 it is full of miasma and dirt ... all the whitewashing and 
 ventilation in the world would do no good. The condition 
 of the property has got worse year by year." 
 
 These are but some of the cases about which " represen- 
 tations " were made to the Metropolitan Board of "Works — 
 sufficient, however, as illustration of others. And what an 
 awful and appalling picture they present. Had the condition 
 described been only temporary, a mere passing phase, it 
 would have been dreadful enough ; but it had been going on 
 
264 THE SANITARY EVOLUTION 
 
 for years — it was permanently so — producing year after year 
 its fearful crop of misery and crime, of disease and death, 
 and scattering broadcast the seeds of disease and death, the 
 " owners " all the while exacting the uttermost farthing 
 they could in rents from the miserable inhabitants, and 
 placidly and remorselessly giving disease and death in 
 return : going on, too, during twenty years of government 
 by " local authority " — Vestry and District Board — and 
 nearly ten years after the passing of the Sanitary Act of 
 1866, with its provisions for the abatement of over- 
 crowding and the maintenance of a certain standard of 
 cleanliness. 
 
 A few years' experience of the working of the Housing 
 Act of 1875 proved that it was dilatory, cumbrous, and 
 costly to the ratepayers of London. 
 
 The arbitrator frequently awarded to owners of places 
 unfit for habitation compensation equal or almost equal in 
 amount to what would have been given if the houses had 
 been good and sound. This the Metropolitan Board felt to 
 be an injustice to the ratepayers upon whom the charge fell, 
 and an encouragement to owners of houses occupied by 
 poor people to allow them to fall into or remain in a 
 dilapidated condition. 
 
 In the year 1879 the Board accordingly made representa- 
 tions to the Government, and suggested that the owners of 
 unhealthy houses should not be compensated in proportion 
 to the profit they derived from such houses, but according 
 to their value as places pronounced unfit for habitation. 
 The Board also pointed out — "the great loss entailed upon 
 the ratepayers by the obligation which the Board was under 
 to provide for the accommodation in suitable dwellings in 
 the same area of at least as many persons as were displaced. 
 This obligation rendered it necessary for the Board to sell, 
 at a very low price, ground, which, with the dilapidated 
 buildings upon it, had cost the Board seven or eight times as 
 much, and which, if the Board had been free to dispose of it 
 for commercial purposes, and to provide for the dispossessed 
 people elsewhere, would have realised a much higher price." * 
 * See Eeport of Metropolitan Board, 1888. 
 
OF LONDON 265 
 
 On the six areas which had been sold to the Peabody 
 Trustees it was estimated that the Board — or in other 
 words, the ratepayers of London — would lose the large sum 
 of £562,000. 
 
 The Board suggested that it should have power to dispose 
 of the cleared groundfor commercial purposes, and to provide 
 for the re-housing of the displaced families in other parts of 
 London. 
 
 This latter suggestion was not adopted, but Parliament 
 passed an Act in 1879 which to some extent lessened, though 
 it by no means removed the defects of which the Board 
 complained, for the Board declared that " after careful con- 
 sideration, it thought it well not to prepare any more im- 
 provement schemes until some further experience has 
 been gained of the working of the Amendment Act of 
 1879." 
 
 And in 1879, also, an Act * was passed which nominally 
 " amended," but in reality destroyed the real good of 
 Torrens' Act of 1868, and gave the owner power to require 
 the local authority to purchase the premises which had 
 been condemned as unfit for human habitation, and which 
 the local authorities were to rebuild and hold — thus prac- 
 tically relieving the worst class of slum house " owners " of 
 any consequences for their malpractices, relieving them, 
 too, in the most open way at the expense of the ratepaying 
 public, as it empowered the Vestry " to levy a rate of 
 twopence in the pound to bear this expense as well as that 
 of building sanitary dwellings on the site." 
 
 By one means or another it invariably worked out that 
 the slum owner obtained large sums for his vile property, 
 and that the public had to pay heavily for his iniquities. 
 
 The work which was within the power of the Vestries 
 and District Boards to do, in connection with the sanitary 
 condition of houses, was far more wide-reaching in extent, 
 and more immediately effective than any the Central 
 Authority could do under its powers. Practically the 
 Vestries had under their supervision the sanitary condition 
 of all the houses of London. Moreover they could act upon 
 * 42 and 43 Vic. cap. 64. 
 
266 THE SANITARY EVOLUTION 
 
 their own initiative, whereas the Central Authority could 
 only act when representations were made to it. 
 
 But with few exceptions, they resolutely fought shy of 
 dealing with the crucial evil — the condition of the tenement- 
 house population of the metropolis. 
 
 " There is no doubt," wrote the Medical Officer of Health 
 for Paddington, in 1871, " from the abundant experience 
 and records of the Sanitary Department of this and other 
 Vestries, that houses let out in single rooms, and to several 
 families, have endangered the life of people, have favoured 
 the spread of contagion, and are a source of pauperism and 
 degradation." 
 
 The various Health Acts gave them power to deal with 
 most of the prevalent nuisances. 
 
 But no Act gave them such rapid and effective means of 
 action, or so fixed upon the owner the responsibility and 
 cost of keeping his houses which he let as tenement-houses 
 in proper sanitary order, as did the Act of 1866 by its 
 35th Section. 
 
 This Act had conferred power upon them to make effective 
 bye-laws or regulations as regarded such houses ; and in 
 1874 the Sanitary Law Amendment Act conferred further 
 powers upon them. Kegulations could now be made as to 
 the paving and drainage of premises, the ventilation of 
 rooms, the separation of the sexes, and to securing notices 
 being given to the Medical Officer of Health, and precautions 
 being taken in case of any dangerously infectious disease 
 occurring in a registered house. 
 
 By such regulations the notification of infectious disease 
 occurring in tenement-houses could have been made com- 
 pulsory, and such notification would have been of the very 
 utmost value in enabling sanitary authorities to combat the 
 ravages of infectious disease. 
 
 The regulations struck at the root of the very worst and 
 most prevalent evils in the homes of the people, and had 
 they been enforced, would have been a charter of health to 
 millions of the people. 
 
 The Medical Officer of Health for Chelsea, in one of his 
 reports, well enforced their importance. 
 
OF LONDON 267 
 
 "When it is remembered that the whole of the labouring 
 population occupies but part of the house in which their 
 families live; that in many houses three or four families 
 live together ; and not infrequently each family occupies 
 only a single room ; and when it is considered that whenever 
 necessary all such houses may be registered, it will at once 
 be seen how important is this regulation." * 
 
 These sections nevertheless remained absolutely a dead 
 letter in nearly every one of the metropolitan districts, and 
 even the newly constituted Local Government Board did 
 not exercise its power of declaring them to be in force in 
 any district. 
 
 From a return compiled in 1874 it appears that : — 
 
 (a.) In only seven parishes or districts f were regulations 
 made and enforced ; how imperfectly even in these is illus- 
 trated by Lambeth where, in 1873, 47 houses only had been 
 registered — there being 29,000 in the parish, one half of 
 which were probably let in lodgings. 
 
 (&) In six districts regulations were made but no attempt 
 made to enforce them, 
 
 (c) And in twenty-five parishes or districts no regulations 
 whatever had been made. 
 
 In Hackney and Chelsea alone was any widespread use 
 made of the regulation. 
 
 The explanation usually put forward of the determination 
 on the part of the Vestries not to enforce the sanitary laws 
 as regarded houses was their regard for the financial interests 
 of the ratepayers. But the real ground of their aversion 
 was that action would put house-owners to expense. 
 "Vested rights in filth and dirt " were strongly represented 
 on the Vestries and District Boards. 
 
 As a witness said before a Select Committee in 1882 : — 
 
 " So long as vestrymen own little properties, and so long 
 as their relations and friends do the same thing, and they 
 are all mixed up in a friendly association, you can never get 
 
 * The Medical [Officer of Health for Chelsea (writing of his own 
 parish). 
 
 f Chelsea, Hackney, Shoreditch, Lambeth, St. George (Southwark), 
 CamberweU, Plumstead. 
 
268 THE SANITARY EVOLUTION 
 
 the prevention of the continuance of unhealthy tenements 
 carried through." * 
 
 And not only was there a passive but often an active 
 opposition to work being performed which it was their duty 
 to do. 
 
 A general inspection would have shown what houses 
 ought to have been made subject to such regulations, but it 
 would also have exposed too publicly the iniquities of house- 
 owners, and would have entailed a heavy expense on those 
 who left the houses in a perpetual state of dilapidation, in- 
 sanitation, and filth ; and so the staff of inspectors was kept 
 as low as possible. 
 
 A thorough enforcement of the regulations would have 
 necessitated a supervision of their houses by the owners in 
 addition to expense. 
 
 Many straws showed which way the wind blew. Thus 
 the Medical Officer of Health for Bethnal Green wrote : — 
 
 "It is by the constant inspection and reinspection of 
 property inhabited by careless and destructive tenants that 
 most good can be done. I recently felt it my duty to 
 recommend a house-to-house inspection of the whole 
 parish — a procedure urgently required to ascertain the 
 condition of the drainage and water supply arrangements. 
 I regret to say this recommendation was not acted 
 upon." 
 
 And the Medical Officer of Health for St. Pancras, in re- 
 ferring to house-to-house inspection, wrote : — 
 
 " This most important branch of all sanitary work has 
 received as much attention as the number of the sanitary 
 staff will admit." 
 
 And so the regulations were not made, or if made were 
 not enforced. And, as the result, the great masses of the 
 working classes, and the poorer classes in the metropolis, 
 were by the deliberate decision of the great majority of 
 Vestries and District Boards deprived of the protection 
 which Parliament had devised and provided for their sanitary 
 and physical well-being ; and all the well-known evils of 
 overcrowding were indefinitely perpetuated. 
 
 * Goddard, 1882, Select Committee, p. 576. 
 
OF LONDON 269 
 
 Apart from the sense of duty or responsibility to the 
 people which ought to have appealed to them, there were 
 other motives which might have done so. 
 
 The Medical Officer of Health for Paddington called 
 attention to one of them in 1872. He wrote : — 
 
 " The costliness of preventable disease is enormous. 
 
 " {a) Sanitary supervision, {h) Eemoval to hospitals, 
 (c) Disinfection, {d) Expenses in hospital, (e) Cost of 
 burial. (/) Loss of work in wages, {g) Loss of life to the 
 community, {h) Cost of widows and children." 
 
 And the Medical Officer of Health for Whitechapel wrote 
 in 1871 :— 
 
 "... As the local rates are continually increasing for 
 the relief of sickness and the support of widows and orphans, 
 the building of asylums for the insane, and the providing of 
 workhouse infirmaries for the debilitated and prematurely 
 old, it is probable that local boards will direct more attention 
 to the condition of the houses of the poor than they have 
 hitherto done." ' 
 
 The cost was brought home to them in 1871 — " an excep- 
 tional year of mortality caused by the continued spread of 
 smallpox." 
 
 " It has been," wrote the Medical Officer of Health for 
 Lambeth, " one of the most alarming and expensive epi- 
 demics that have visited the country for a century. The 
 cost in a pecuniary sense has been great, but it is nothing 
 as compared to the cost of human life. 
 
 "... I know of no disease that can be made so preventable 
 as this." 
 
 The Medical Officer of Health for St. George-the-Martyr 
 wrote : — 
 
 " No extravagance can be compared with that of sanitary 
 neglect. Pounds are willingly paid for cure, where ha'pence 
 would be grudged to prevent. Some diseases we can create, 
 most we can propagate, and send on their errand of misery 
 and destruction." 
 
 In 1878 the Medical Officer of Health for Whitechapel 
 again referred to the subject : — 
 
 ** It may be asserted without fear of contradiction, that all 
 
270 THE SANITARY EVOLUTION 
 
 money laid out for the improvement of the public health 
 will secure an ample dividend. . . . 
 
 " The alleviation of suffering and the prolongation of 
 human life is the duty of every noble-minded man to en- 
 deavour to promote. 
 
 " It cannot be too frequently reiterated, too extensively 
 known, that the rich not only pay a heavy pecuniary penalty, 
 but often suffer a heavy affliction in themselves and families 
 by neglecting to improve the sanitary condition of the 
 houses and localities occupied by the poor. It is well known 
 that defective sanitary arrangements in the poorer localities 
 are the chief causes of disease among the poor, and when a 
 contagious disease is once located it soon assumes an epi- 
 demic form and attacks, indiscriminately, all classes of the 
 people." 
 
 These views were sound and true, but the contingencies 
 described always appeared remote, and arguments of more 
 immediate and remunerative results were constantly present. 
 
 If the conduct of the Vestries and District Boards was 
 reprehensible for not administering the existing laws for the 
 improvement of the sanitary condition of the poorer classes, 
 and if the consequences of their deliberate inaction were so 
 fatal to the lives of countless thousands of the people and 
 so disastrous to the well-being of the community, the conduct 
 of the " owners " of the houses, for the manner in which 
 they allowed their tenants to live, was still more so. 
 
 " I often wonder," wrote the Medical Officer of Health 
 for St. George-the-Martyr (1874-6), "what many of the 
 owners of property think man was created for except indeed 
 that he should be housed in foul, wretched dwellings in 
 order that money may be put in their purses, and so they 
 may reap where they have not sown. A grim kind of 
 harvest that will prove. Surely the owners have neither 
 humanity nor justice on their side when they allow their 
 houses to become hotbeds for the fostering and spreading of 
 disease, moral and physical, and in which it is impossible 
 either to maintain cleanliness, or support health, or practice 
 morality. There are thousands of such houses. . . . 
 
 " The only true and lasting foundation upon which the 
 
OF LONDON 271 
 
 glory and safety of a nation can be built, must be upon the cul- 
 tivation of the moral and physical powers belonging to man." 
 
 The " owners " were of all classes. 
 
 An experienced witness * before the Committee of 1881, 
 who had acted as arbitrator in some of these cases, referring 
 to some of the worst slum areas in London, said : — 
 
 *' It came before me that a great many people in life 
 better than that supposed, do draw considerable incomes 
 from insanitary house property." 
 
 " Some of these worst places are held by rich gentlemen 
 and ladies." 
 
 "The class of landlords we have here are very shrewd 
 money-making men, and they would not show much con- 
 sideration to their tenants." 
 
 The Medical Ofdcer of Health for St. George-the-Martyr, 
 Southwark, reported (1876-7) :— 
 
 "We have heard denounced, times out of number, and in 
 the strongest terms, the conduct of the holders of small 
 property as being most selfish, and they themselves the 
 most persistent and obstinate opponents of sanitary 
 measures and improvements; and moreover that this 
 class formed a considerable portion of our Vestries. How- 
 ever this may be, they cannot claim a monopoly to this 
 unenviable distinction. . . . 
 
 " Much of the small class property is placed in the hands 
 of agents who neither hold nor cultivate any interest in the 
 welfare and comfort of the tenants. 
 
 " To get the most rent with the least possible trouble and 
 outlay seems to comprise their whole duty (of course there 
 are exceptions). 
 
 " How much better in all respects would it be that the 
 owner himself should give some personal supervision to his 
 property and to the state of those who dwell in it." 
 
 And there was another class of "owners" — the middle- 
 men — " the very curse that is incident in all society." 
 
 " There are a great many middlemen dealing with these 
 properties. A great deal of it is to let out in lodgings. A 
 man goes and buys this wretched property at public auction 
 * Mr. Hunter Rodwell, Q.C., M.P. 
 
272 THE SANITARY EVOLUTION 
 
 in different parts of London to pay him 10 or 12 %, and he 
 
 underlets it at so much a room to weekly tenants." 
 
 "It is these small men who go into it to make a profit, 
 and screw the poor, wretched holders down to the last 
 farthing — in fact they get as much as they can out of the 
 property, and do as little as they can." 
 
 Some of the Medical Officers of Health referred to the 
 difficulties of getting the "owners "to do anything to keep 
 their property in order. 
 
 Thus the Medical Officer of Health for St. James' wrote 
 (1877-8) :— 
 
 " On eastern border of parish a large number of houses 
 are now increasingly being underleased in order to be let 
 out as tenement-houses. . . . Dealers in these houses make 
 enormous aggregate rentals out of the improvident working 
 people whom they thus herd together ; and persistent efforts 
 on the part of the sanitary officers are needed to goad some 
 of these * landlords ' into keeping their ' property ' in a decent 
 condition." 
 
 With a very large number of house-owners and other 
 sanitary misdoers, nothing but the vigorous administration 
 of the law would induce them to abate nuisances or do 
 anything for their tenants. 
 
 " I am quite sure," wrote the Medical Officer of Health 
 for Hackney in 1880, " that a prompt and strict enforce- 
 ment of the various sanitary Acts is beneficial not only to 
 tenants, but landlords, because the latter will not allow 
 tenants to occupy their houses who frequently bring them 
 under the notice of the sanitary officers." 
 
 With many, however, the fact that the law had been put 
 in force against them, and would, if necessary, again be put 
 in force was sufficient. 
 
 " The number of statutory notices this year was not 
 much more than half. Owners have carried out the 
 necessary works for fear of being summoned." 
 
 And numerous other reports were to the same effect. 
 But a vigorous administration of the sanitary laws against 
 owners was the very last thing which it was of use looking 
 to the Vestries or District Boards for. 
 
OF LONDON 273 
 
 Some of the Vestries and District Boards put pressure 
 upon their Medical Officers of Health to prevent energy 
 upon their part. 
 
 Thus the Medical Officer of Health for St. Pancras in 
 1875 tendered his resignation, giving the following reasons : — 
 
 " That while I am held responsible for the sanitary condi- 
 tion of the parish, I am denied that assistance in outdoor 
 inspection of houses either visited with contagious diseases 
 or habitually in an unsatisfactory condition, which I believe 
 to be necessary. I feel that the severe condemnation which 
 a house-to-house visitation of the poorer parts of the parish 
 has received from a majority of the sanitary committee 
 must of necessity hopelessly weaken my authority with the 
 sanitary inspectors, and render nugatory my efforts to carry 
 out the Sanitary Acts. ..." 
 
 Parliament was passing some useful legislation for the 
 improvement of the public health, and taking some action 
 against some of the more heinous existing abuses. 
 
 Several of the' evils already described connected with the 
 building of houses were dealt with in an Act * passed in 1878. 
 It was at last declared to be — "expedient to make provisions 
 with respect to the making, filling up, and preparation 
 of the foundation of sites of houses and buildings to be 
 erected within the metropolis, and with respect to the 
 quality of the substances to be used in the formation or 
 construction of the sites, foundations and walls of such 
 houses with a view to the stability of the same, the preven- 
 tion of fires, and for purposes of health." 
 
 The Metropolitan Board of Works was empowered to 
 make bye-laws respecting the foundations and sites of 
 houses to be constructed, and with respect to the material 
 used in the construction of such houses and of the walls and 
 buildings ; and the Board issued a set of comprehensive 
 regulations upon the subject. 
 
 "Considerable opposition was manifested by builders 
 before the Secretary of State." 
 
 But, nevertheless, the regulations were sanctioned and 
 approved. 
 
 * 41 and 42 Vic. cap. 32. 
 
 19 
 
274 THE SALUTARY EVOLUTION 
 
 And in the same year (1878) Parliament had passed an 
 Act which materially improved the sanitary conditions 
 under which men, women, and children worked in factories 
 and workshops.* 
 
 Guided by experience, Parliament had gradually been 
 extending the operation of the previous Acts from one trade 
 to another, and as Lord Shaftesbury said : — 
 
 ** The general result had been to introduce and establish 
 a system of order, content, and satisfaction. The children 
 in the factories presented quite a different appearance from 
 that which was their characteristic in former times; they 
 were now hale and stout." 
 
 And the Factory and Workshops Eoyal Commission f in 
 1876 wrote :— 
 
 "The improvement in the sanitary arrangements and 
 ventilation of factories had been most marked in recent 
 years ; and the cases in which young persons and women 
 suffer in labour unfitted for their years, or in which young 
 persons and women suffer physically from overwork, are 
 now, we believe, as uncommon as formerly they were 
 common. 
 
 " Much of this great improvement is undoubtedly due to 
 factory legislation." 
 
 The Act directed that : — 
 
 "A factory or workshop should be kept in a cleanly state 
 and free from effluvia arising from any drain, or other 
 nuisance." 
 
 And that they should " not be so overcrowded while work 
 is carried on therein as to be injurious to the health of the 
 persons employed therein, and should be ventilated in such 
 a manner as to render harmless, as far as practicable, all the 
 gases, dust, &c., generated in the course of the manu- 
 facturing process and that may be injurious to health." 
 
 By subsequent order of the Secretary of State, 250 cubic 
 feet air space were to be given to each adult during the day, 
 400 cubic feet after eight o'clock at night. 
 
 It was to be *' the duty of the sanitary authority to make 
 such inquiry and to take such action thereon as to that 
 * 41 Vic. cap. 16. t P-P-* vol. xxix. 
 
OF LONDON 275 
 
 authority may seem proper for the purpose of enforcing the 
 law." 
 
 A very material factor in the health of the people was 
 dealt with in this Act — namely, the condition of the bake- 
 houses where the daily bread of the community was 
 prepared. 
 
 Legislation as to bakehouses had been left unchanged 
 since the Act of 1863, and in harmony with the usual 
 disregard of their duties by the local sanitary authorities, 
 little use was made of that Act. 
 
 The Eoyal Commission of 1875 reported that it was "only 
 here and there that any active steps had been taken by the 
 local authorities to carry out the provisions of the Bake- 
 house Act." 
 
 By the Act passed in 1878 the Bakehouse Eegulation Act 
 of 1863 was repealed, and the duty of regulating the sanitary 
 condition of bakehouses was transferred from the local 
 authority to the Inspectors of Factories. 
 
 In 1878, also; the Contagious Diseases Animals Act was 
 passed. Primarily it was directed to the protection from 
 cattle plague of the cattle of the country, and the prevention 
 of the spread of disease, which had been entailing heavy 
 losses upon their owners, and very stringent precautions 
 were imposed. 
 
 But it contained also some very valuable provisions as to 
 the condition of cowhouses and dairies, and early in 1879 the 
 Privy Council issued an Order providing for the registration 
 of all persons carrying on the trade of cowkeepers and pur- 
 veyors of milk, for regulating the lighting, ventilation, 
 cleansing, drainage, and water supply of dairies and cowsheds, 
 for securing the cleanliness of milk stores, milk shops, and 
 milk vessels, and for protecting milk against infection and 
 contamination. 
 
 Inspectors were appointed by the Board. 
 
 " At the time of the passing of the Order the London 
 cowsheds were, with few exceptions, unsuitable in con- 
 struction and in sanitary arrangements. By opposing the 
 renewal of licenses the Metropolitan Board succeeded in 
 abolishing from two to three hundred of the worst of them, 
 
276 THE SANITARY EVOLUTION 
 
 and obtained improvements, amounting to entire recon- 
 struction, in the remainder. In the larger dairies and milk 
 stores much^improvement was also effected." 
 
 It was this Act of 1878 which drew from the Medical 
 Officer of Health for Whitechapel the following remarkable 
 passages in his report ; passages which are enlightening as 
 to the prevalent views of the time. 
 
 *' We have a striking instance of the great interest that is 
 shown in the protection of property and the comparatively 
 little value that is attached to the health of the people in 
 the recent Act — * The Contagious Diseases Animals Act 
 1878.' 
 
 " As regards the laws which are in force for the protection 
 of the health of cattle, which may be looked upon as 
 property, I have nothing to complain ; but as a health 
 officer I may express my surprise that similar laws to those 
 which are now in force respecting disease in cattle are not 
 enacted to prevent the spreading of infectious and con- 
 tagious diseases among the people. At present there is no 
 general law in force to compel persons, who may become 
 acquainted with the existence of an infectious disease in a 
 dwelling-house, to give notice of the same to the Sanitary 
 Of&cer. . . . 
 
 " Surely it is more important to protect the lives of the 
 people than to protect from loss the dealers in cattle ; but 
 until the care of public health is considered to be of more 
 importance than the care of property, little improvement 
 in the laws relating to health can be expected." 
 
 " The preference which is given by our law makers to the 
 protection of the supposed vested rights of property above 
 that of public health is likewise shown by the rejection of 
 the several Building Bills for the amendment of the Build- 
 ing Act. 
 
 " The opinion of the House appeared to prevail that * a man 
 has a right to do what he likes with his own, as regards the 
 building of as many houses as can possibly be packed to- 
 gether on his own land, without taking into consideration 
 the health of the people who are to inhabit them, or the 
 health of those in the immediate neighbourhood.' So long 
 
OF LONDON 277 
 
 as the Building Act as regards open spaces at the rear of 
 houses remains unaltered, so long will unhealthy houses 
 continue to be built." 
 
 Some of the more capable of the Medical Officers of Health 
 in their reports did not content themselves with mere tables 
 of the births and diseases and deaths in their parishes, and 
 a narrative of the principal incidents in their work during 
 the year, but pointed out the defects in the laws, and made 
 suggestions as to the best ways of coping with some of the 
 great sanitary evils daily confronting them. 
 
 Based upon actual experience, their views and suggestions 
 were entitled to great weight, and were often of very great 
 value. 
 
 One point, and that the most important of all, finds expres- 
 sion in the reports of more than one of them, namely, that 
 the administration of many of the health laws should be 
 compulsory instead of permissive, and that mereljPideclaring 
 a law compulsory without providing the means for making 
 it compulsory was of little use. 
 
 What was wanted in London was a real central authority 
 which should have power to make the local authorities carry 
 out the orders of Parliament. This did not exist, for the 
 Metropolitan Board of Works had no such powers, and the 
 Vestries and Districts Boards were independent local 
 governing authorities acknowledging no master and free to 
 obey or disobey Acts of Parliament just as they pleased. 
 
 "It has been one of the great faults of our sanitary 
 arrangements and legislation for London," wrote the Medical 
 Officer of Health for St. James' in 1872, " that the metropolis 
 has not been regarded as a whole, and that through the 
 ignorance, or carelessness, of one District or Local Board 
 the whole of the others may be put in peril." 
 
 " It is impossible, with our present municipal machinery, 
 in London, at any rate, to exercise all that power which is 
 necessary for the prevention of the spread of infectious 
 diseases." 
 
 And the Medical Officer of Health for Whitechapel in 
 1873 wrote :— 
 
278 THE SANITARY EVOLUTION 
 
 " If any alteration is made in the constitution of the 
 MetropoHtan Board of Works it would be desirable to 
 add to its functions that of a sanitary supervision over the 
 whole metropolis." 
 
 And in 1881 the Medical Officer of Health for Kensington 
 wrote : — 
 
 "London is grievously in need of a Central Sanitary 
 Department to establish something like unity in the sanitary 
 arrangements of its 39 divisions. . . . Every other large 
 centre of population has but one sanitary authority." 
 
 Though much more time, thought, and labour, were 
 being devoted than ever before to matters relating to the 
 public health, and with very beneficial results, one 
 matter appeared to be quite unaffected thereby, for none 
 of the great measures of sanitary improvement which 
 had been carried out since the central and local authorities 
 had come into being seem to have had any effect 
 during the 1871-80 decade upon infantile mortality. 
 
 If anything the figures appear higher. In St. George- 
 in-the-East in 1871-2 the deaths of children under five 
 years were 51 per cent, of all the deaths. 
 
 In Mile-End-Old-Town in 1872-3, out of a total of 
 2,200 deaths, 1,087, or practically 50 per cent., were 
 deaths. of children under five, a mortality which evoked 
 the comment from the Medical Officer of Health : — 
 
 "Apart from congenital causes, a large majority of these 
 young lives would, under conditions more favourable to 
 existence, be preserved. ... It is certain that the present 
 generation of London children is physically degenerate." 
 
 And a year later he wrote : — 
 
 " I consider about two-thirds of the infantile mortality 
 attributable to neglect, improper feeding, impure air 
 from overcrowding, and general bad management through 
 ignorance and carelessness of parents and nurses." 
 
 In Kensington, away in the west, the average annual 
 infantile mortality over a period of ten years — 1863-73 — 
 was 42 per cent, of the total deaths. 
 
 The Medical Officer of Health for Whitechapel 
 wrote (1873) :— 
 
OF LONDON 279 
 
 " There must be something very wrong in the condition 
 of the people when we find that out of all children born 
 about one-fifth die before they are one year old, and 
 one-third before they are five." 
 
 In the north part of his district in the quarter ended 
 December 28, 1872, the rate of mortality of children 
 under five was 61'1 per cent., whilst in the quarter 
 ended September, 1873, in Goodman's Fields the rate 
 was 72'4 per cent. 
 
 In St. George-the-Martyr, South wark, in 1873-4, of 
 1,256 deaths 694 (=55*3 per cent.) were under five. 
 
 In the same year the Medical Officer of Health for 
 Paddington wrote : — 
 
 " In taking fifteen streets typical of the ordinary con- 
 dition of the dwellings in which the working-class reside, 
 I find the annual proportion of deaths under five ranges 
 from 41 to 75 per cent, of the total deaths. . . . 
 
 " The deaths from all causes in eighteen such streets varies 
 from 21-7 to 50'per 1,000." 
 
 The Medical Officer of Health for Limehouse wrote in 
 1874 :— 
 
 " As usual we find that of 1,000 deaths more than 500 are 
 those of children under five." 
 
 Two years later it was 53 per cent. 
 
 Nor was it only in the central parts of London that 
 the infantile mortality was so frightful. In Wandsworth, 
 the mean annual rate during the years 1865-74 was 
 49*6 per cent. 
 
 The infantile death-rate did not diminish as the decade 
 proceeded. In Islington in 1875-6 the infant mortality 
 was "much about the same" as it had been twelve years 
 previously. 
 
 In Kensington it had increased to 46"3 in 1878 ; in 
 St. George-the-Martyr to 57"7 per cent. ; in St. Pancras in 
 1877-8, of 5,068 deaths, 2,212 (or 45-6 per cent.) were of 
 children under five. 
 
 The Medical Officer of Health for Poplar wrote 
 (1877-8) :— 
 
 " The deaths of children under five years have been more 
 
280 THE SANITARY EVOLUTION 
 
 than half the total of deaths — truly a 'massacre of the 
 Innocents.'" 
 
 The Medical Officer of Health for Islington wrote 
 
 (1880) :— 
 
 " The number of deaths of children under one year 
 is still painfully large. . . . Children seem to be born for 
 little else than to be buried." 
 
 Passing from record to comment, there are some striking 
 passages in the reports of the Medical Officers of Health. 
 
 Thus the Medical Officer of Health for Paddington 
 wrote : — 
 
 " . . . Of infantile mortality one is tempted to ask 
 whether the provision of so much life, such a prodigality of 
 being, to be followed so soon by an almost Pharaoh sacri- 
 fice of it, is necessary to the multiplication of the race." 
 
 And the Medical Officer of Health for St. Marylebone 
 (1877) :— 
 
 "It is sad, and in a sanitary point of view, humili- 
 ating to contemplate, that for every three children born 
 in Marylebone, one dies before reaching the age of five 
 years ; 'tis true that in this respect Marylebone stands 
 in no worse position than other large parishes in the 
 metropolis, nor so bad as in the majority of them, but 
 the knowledge of this fact will, I apprehend, afford but 
 slender consolation to those who know from experience 
 and daily observation that hereditary diseases, habitual 
 neglect, unwholesome dwellings, together with other 
 preventable causes, are largely concerned in the sacrifice 
 of infant life." 
 
 And the Medical Officer of Health for Eotherhithe 
 
 (1881) :— 
 
 " Whilst the houses' drain-pipes, from defective construc- 
 tion and workmanship, and want of being cut off from the 
 main sewer, act as much as sewer ventilators as channels 
 for removing filth . . . whilst overcrowded houses and foul 
 smells in living and sleeping rooms are taken as a matter of 
 course ; whilst infectious disease is sedulously propagated 
 first by concealment, and then by criminal exposure and 
 neglect, ... so long the yearly recurring Herodean 
 
OF LONDON 281 
 
 massacre of helpless children, whose almost sole use in 
 life appears to be the providing of fees for doctors and 
 undertakers, will continue, in spite of all efforts of sanitary 
 authorities and sanitarians." 
 
 The evil done, however, by bad sanitary conditions was 
 not limited to the children who died. Probably ten or 
 twenty times the number of those who died went through 
 the illness and survived — but of those many were injured in 
 constitution for life. 
 
 |f In other respects, however, sanitary progress was being 
 made, and slowly but steadily the conditions of the health 
 of the public were improving. Undoubtedly the main 
 causes of that progress were the great system of main 
 drainage and sewerage which had relieved London of the 
 incubus of enormous accumulations of the deadliest filth 
 in its houses, and of an open main sewer through its 
 midst ; and the greater quantity, and improved quality, 
 of the water supplied for household consumption which 
 relieved her inhabitants from the necessity of drinking 
 liquid sewage. 
 
 And the construction of sewers in nearly all the streets, 
 and the substitution of an effective system of house 
 drainage instead of the abomination of cesspools, was also 
 a great stride to improvement. 
 
 Since 1856 plans for the construction of a total length of 
 nearly 1,000 miles of local sewers had been submitted to 
 the Metropolitan Board for their approval, many of them 
 being in substitution of old and shallow ones for which the 
 Board's new main and intercepting lines afforded the means 
 of improving the gradient and outlet. 
 
 In their report for 1881 the Metropolitan Board of Works 
 gave "a brief summary" of what it, as the Central 
 Authority, had accomplished since 1856. 
 
 " There was the great main drainage w;ork which had 
 cost about five and three-quarter millions, an undertaking 
 which ' although fruitful of good results, and of greater 
 magnitude than anything of a similar kind that had 
 previously been accomplished, has left, as might be expected, 
 few visible marks of its existence.' " 
 
282 THE SANITARY EVOLUTION 
 
 It is rather the Thames embankments and broad new 
 streets which remind the inhabitants of London of the great 
 changes and improvements that the Board's operations 
 effected. 
 
 " On the north side of the Thames, from Blackfriars to 
 Westminster, and from Grosvenor Road to Battersea Bridge, 
 and on the south side, from Westminster to Vauxhall, 
 embankments have been made which, whilst reclaiming 
 from the river a considerable extent of ground, have substi- 
 tuted for the unsightly and offensive mud banks that formerly 
 prevailed, handsome river walls, with broad and commo- 
 dious thoroughfares, relieved and ornamented by public 
 gardens. New streets have been made, some of the principal 
 of which are Queen Victoria Street, Southwark Street, 
 Northumberland Avenue, Commercial Road, and the new 
 thoroughfare from Oxford Street to Bethnal Green ; many 
 other leading thoroughfares, which had become inadequate 
 for the increased traffic of the present day, have been 
 widened and improved, greatly to the convenience and 
 comfort of the public ; and liberal grants of money have 
 been made by the Board to the authorities in aid of the cost 
 of smaller street improvements which have not been of 
 sufficient extent or importance to be carried out by the 
 Board. 
 
 " Two new parks have been provided, in districts previously 
 unsupplied with such places of needed recreation. Public 
 gardens have been laid out and are maintained in the 
 neighbourhood of dense populations ; and suburban commons, 
 to the extent of about 1,500 acres, have by the action of the 
 Board been secured in perpetuity for the undisturbed 
 enjoyment of the public. 
 
 " Many areas formerly covered with dwellings unfit for 
 human habitation have been cleared, under the operation of 
 the Artizans' and Labourers' Dwellings Improvement Act, 
 and the ground let to societies which have undertaken to 
 build, and in some cases have built, improved dwellings, in 
 which the humblest class of the working population can 
 live with health, decency, and comfort." 
 
 These and many consequential improvements, and the 
 
OF LONDON 283 
 
 better paving of the streets, and the better cleansing of 
 streets, places, and yards, the more rapid removal of filth 
 from London, had made the general conditions of life much 
 less unwholesome. 
 
 The work, too, being done by the Metropolitan Asylums 
 Board was greatly diminishing the dangers of infection in 
 the metropolis, as well as restoring to life and health 
 thousands who would otherwise have fallen victims to 
 disease. 
 
 And by " The Poor Law Act, 1879," the Vestries and 
 District Boards were authorised to enter into contracts with 
 the Board, for the reception and treatment of infectious sick 
 who were not paupers, thus in a measure depauperising the 
 Metropolitan Asylums Hospitals. 
 
 And a very large amount of most valuable work was done 
 by the Port Sanitary Authority ; in the year 1879-80 over 
 15,000 vessels of all classes having been visited and inspected, 
 the infectious sick removed, and disinfection carried out. 
 
 Writing of the year 1877 the Kegistrar General said : — 
 
 *' London maintains its position as the healthiest city in 
 the world. During the past year its prosperity was indicated 
 by a birth-rate above the average of the preceding 10 years, 
 while a remarkably low death-rate bears testimony to the 
 success which has attended the efforts that have been made 
 during the last half of a century to promote the public health 
 and safety." 
 
 Among the public authorities from which much might have 
 been hoped in the way of improving the public health of 
 the inhabitants of London was the School Board. The 
 Board stood in an exceptionally favourable position for 
 moulding the physical constitution of hundreds of thousands 
 of children and of successive generations, but education ap- 
 peared to have almost excluded the consideration of health. 
 
 In 1871 the Board resolved " that it is highly desirable 
 that means shall be provided for physical training, exercise 
 and drill in public elementary schools established under the 
 Board. " But beyond this, little if anything was done, and 
 even it was not made applicable to the girls. And no 
 Medical Officer was appointed, and no systematic means 
 
284 THE SANITARY EVOLUTION 
 
 organised for the prevention of the diffusion of diseases by 
 the schools. Indirectly, however, good results were flowing 
 from the schools. The attendance of the children at the 
 schools took them out of their overcrowded tenement-homes 
 for several hours in the day ; their playgrounds afforded 
 better means of exercise ; the cleanliness expected of them 
 raised their ideas as to cleanliness ; the supervision over 
 them was of great use in improving their conduct and 
 character, all helped to improve their physical condition. 
 But how infinitely greater the improvement might have 
 been, not merely at the time but to the rising generation, if 
 the School Board had given greater attention to this branch 
 of the children's welfare. About 230,000 children were in 
 attendance in the Board's Schools in 1880. 
 
 The really encouraging feature of the general position 
 was that a larger section of the public was taking an interest 
 in matters relating to the public health. 
 
 In Battersea, wrote the Medical Officer of Health 
 (1881) :— 
 
 " Much assistance is now derived from the general public, 
 who are more alive to the necessity of sanitary measures 
 than at any previous period." 
 
 The Medical Officer of Health for St. George-the-Martyr, 
 Southwark, reported : — 
 
 " The health of the people occupies the thought and 
 consideration of an ever-increasing number," and he quoted 
 the declaration of the head of the Government that " the 
 sanitary question lies at the bottom of all national well- 
 being." 
 
 The Medical Officer of Health for North Poplar stated 
 that — 
 
 " Gradually the labouring portion of the population, which 
 so largely outnumbers the remainder with us, is becoming 
 educated to the fact that they must neither breathe air, 
 drink water, nor take food, polluted by filth. " 
 
 But, as a whole, public opinion was more or less inert. 
 
 " The apathy of the public in matters of health is truly 
 lamentable." 
 
 Nor was all the apparent progress as genuine as appeared 
 
OF LONDON 285 
 
 on the surface. The Medical Officer of Health for St. Mary, 
 Newington, in his report of 1874 disclosed this material fact. 
 
 Writing of some Eeturns which he had prepared of 
 sickness in seventeen years, he said : — 
 
 "In the period we have seen the end of many fever 
 haunts. We have seen hundreds and hundreds of the old 
 tenements removed and new abodes raised in their stead ; 
 but with it, alas ! we have seen all the defects of new 
 buildings, all the defects of badly laid drains, all the evils of 
 work ill done, its dangers too often not capable of recognition 
 until sickness and death forced the discovery. We have 
 seen too often in the new houses defects of ventilation, of 
 construction, of drainage, and of overcrowding : we have 
 seen many an evil allowed by law, and over which we 
 cannot extend our sanitary rules. We have also to contend 
 with the indifference, the carelessness, the blindness of the 
 people themselves — intemperance and crime stand in our 
 way. . . ." 
 
 But in 1881 he wrote : " Sanitary work has borne fruit." 
 
 The progress of sanitation is almost necessarily slow. 
 
 "There is not," wrote one of the Medical Officers of 
 Health, " a more difficult task than that of carrying out 
 sanitary reform, for although every one agrees that sanitary 
 laws should be put in force, they are greatly objected to 
 when they interfere with one's self." 
 
 And another wrote : — 
 
 " Nuisances crop up, are removed, and re-appear. It is a 
 continuous warfare due to many causes, such as careless- 
 ness and wilfulness on the one hand, and accidental circum- 
 stances on the other." 
 
 And another : — 
 
 '* The sanitary labours of your officers increase year by 
 year as the population becomes denser, and the need for 
 sanitary precautions grows more urgent." 
 
 And underneath all was the view expressed by the Medical 
 Officer of Health for IsHngton (1881) :— 
 
 " I fear the public have not even yet learned to regard 
 health as a matter of infinitely greater moment than rates 
 and taxes." 
 
286 THE SANITARY EVOLUTION 
 
 How far-reaching were the effects of disease was admirably 
 set forth by Dr. Simon : — 
 
 " I do not pretend to give any exact statement of the 
 total influence which preventable diseases exert against the 
 efficiency and happiness of our population, for it is only so 
 far as such diseases kill, and even thus far but very im- 
 perfectly, that the effect can be reported in numbers. Of 
 the incalculable amount of physical suffering and disable- 
 ment which they occasion, and of the sorrows, and anxieties, 
 the permanent darkening of life, the straitened means of 
 such subsistence, the very frequent destitution and pauperism 
 which attend or follow such suffering, death statistics testify 
 only in sample or by suggestion." * 
 
 Few people realise the infinite importance of health to a 
 great community. 
 
 As one of the Medical Officers of Health truly wrote : — 
 
 "It is a question whether the greatness of countries will 
 not in future to a very large extent depend upon the 
 standard of public health." 
 
 One of the very best and most experienced of the men 
 who held the responsible office of Medical Officer of Health 
 during the last half century — Dr. Bateson, the Medical 
 Officer of Health for St. George in Southwark — in his 
 reports often dwelt upon this aspect of the subject : — 
 
 " The only true and lasting foundation upon which the 
 glory and safety of a nation can be built must be upon the 
 cultivation of the moral and physical powers belonging to 
 man." 
 
 "... The quality of a race is of far more importance 
 than the quantity." 
 
 "Health to the majority of the population is their only 
 wealth ; without it they become pauperised." 
 
 " The welfare and safety of this country need a healthy, 
 stalwart race of men — men who can labour and endure." 
 
 And in his last report (1878), after twenty years' service 
 as Medical Officer of Health, he quoted the Prime Minister 
 (Lord Beaconsfield) as saying : — 
 
 " The health of a people was really the foundation upon 
 
 * J. Simon, vol. ii., 1874. 
 
OF LONDON 287 
 
 which all their happiness and all their powers as a state 
 depended. If the population of a country was stationary, 
 or that it yearly diminished, or that whilst it diminished it 
 diminished also in stature and strength, then that country 
 was ultimately doomed." 
 
 " Nothing," said Dr. Bateson, " could be more solemn 
 and emphatic." 
 
 " For the success and permanence of national existence a 
 high standard of health is absolutely necessary. To main- 
 tain in its integrity the vast power which England now 
 wields, and to retain the high position which she now holds 
 will depend upon the nation's health." 
 
 Before considerations such as these, how lamentable the 
 blindness of those who could not see that even a measurable 
 expenditure in health matters would have been productive 
 of immeasurable benefits ; how reprehensible the conduct of 
 those who refused to administer laws which it was their 
 duty to administer, and the administration of which would 
 have been of inestimable value to their fellow citizens ; and 
 how disastrous their studied inaction to the great metropolis, 
 and through it, to the nation itself. 
 
CHAPTEE V 
 
 1881-1890 
 
 The census of 1881 showed that the population of London 
 was 3,816,483 persons — an increase this time of well over 
 half a million of persons in the decade. 
 
 In the central parts of London, with the single exception 
 of Clerkenwell, the resident population continued to decrease. 
 In the City, the decrease was nearly one-third; in the 
 Strand nearly a fifth, and the parish of St. George, Hanover 
 Square, was now added to the list of those on the decline. 
 
 In the East, in Whitechapel, Shoreditch, and St. George- 
 in-the-East, the population had declined, whilst in Bethnal 
 Green the increase had been at a much slower rate. But 
 Mile-End-Old-Town, where there had been a good extent of 
 unbuilt-on ground, had added over 12,000 to its population ; 
 and Poplar over 40,000. 
 
 In the North, with the single exception of St. Marylebone, 
 all the parishes showed increases ; Hackney, the great 
 increase of over 60,000, and IsHngton the still larger one 
 of nearly 70,000. 
 
 In the West, there were large increases in Paddington 
 and Chelsea, in Kensington an increase of over 42,000, and in 
 Fulham over 48,000. In the parishes nearer the centre — 
 St. George, Hanover Square, St. James' (Westminster), and 
 Westminster, the population had decreased. 
 
 On the south side of the river, with the exception of the 
 parishes of St. Olave, and St. Saviour — both in Southwark, 
 and near the City — every parish or district showed an 
 increase. Notably was this the case in Camberwell, where 
 
OF LONDON 289 
 
 the increase was 75,000, and most remarkable of all, 
 Wandsworth, where the huge increase of over 85,000 
 persons was recorded. 
 
 Thus the movements of population were shown by this 
 census of 1881 to be very much on the same lines as those 
 in 1871 — a diminution in the central parts, and increases of 
 various magnitudes in the outer parts. 
 
 Interesting information was once more given as regarded 
 the constituent parts of the population. 
 
 It was shown that of the residents in London in 1881, the 
 proportion of persons born in London was practically the 
 same as in 1871. Of every 1,000 inhabitants in London, 
 628 were born in London, 308 in the rest of England 
 and "Wales, 13 in Scotland, and 21 in Ireland — the rest 
 elsewhere. 
 
 The flow of people from the country to London was thus 
 continuing at much the same rate, and the metropolis was 
 still being fed with labour at the expense of the agricultural 
 districts.* 
 
 " A contingent untrained in the pursuits of town life " 
 was thus annually thrown upon the labour market of 
 London. But they imported a fresh strain of healthy 
 country people into the constituent elements of the town 
 population, and helped to stay part of the deterioration 
 which necessarily ensued from the insanitary conditions of 
 life in London. 
 
 As to the causes of the shifting of the population in 
 London, the same story continued to be told by the Medical 
 Officers of Health. 
 
 Thus the Medical Officer of Health for the Strand wrote 
 (1882-3) :— 
 
 " The material decrease in population is largely connected 
 with the gradual transition of houses from residences into 
 business premises, the construction of new and wider 
 
 * To the then existing population of London. 
 
 The South Eastern Counties contributed close on 290,000 
 
 ,, South Midland ,, „ „ „ 249,000 
 
 „ Eastern „ „ „ „ 196,000 
 
 „ South Western ,, „ „ „ 168,000 
 
 „ West Midland „ „ „ „ 95,000 
 20 
 
290 THE SANITARY EVOLUTION 
 
 thoroughfares, and the erection of public buildings, com- 
 bined with the resulting consequence inevitably associated 
 with such changes, a considerable augmentation in the 
 rental or annual value of house property." 
 
 In St. James' (1882)— 
 
 "The large decrease of population (3,754 in last decade), 
 coupled with the fact that the rateable value still has an 
 upward tendency, clearly shows that the character of the 
 parish is undergoing rapid change — offices, warehouses, and 
 clubs taking the place of residences as the centre of trade 
 continues to increase and move westward, and greater 
 facilities are afforded for business men to live in the 
 suburbs." 
 
 Some of the Medical Officers of Health were perturbed by 
 the class of persons coming into their district. Thus the 
 Medical Officer of Health for Whitechapel drew attention to 
 the fact that of the 70,435 people in his parish no fewer than 
 9,660 were foreigners, mostly Russian and Polish Jews. 
 Others of them were feeling anxious under the ever increas- 
 ing numbers. 
 
 The Medical Officer of Health for Paddington wrote 
 (1881) :— 
 
 " Occupying, as the population of Paddington does, a 
 limited area with definite boundaries which do not admit of 
 extension, a continually increasing population can only mean 
 a continually increasing complexity of the problems of sani- 
 tation." 
 
 Upon one most interesting point as regarded the influx of 
 population into London the Medical Officer of Health for 
 Lambeth threw some valuable light.* 
 
 " The evil of overcrowding is aggravated by causes which 
 derive their origin from the effects of that condition itself. 
 A lowered standard of health, always the accompaniment of 
 close building, is a factor in the further increase of pressure 
 in an already congested district. An unsatisfied demand in 
 the labour market for physical strength is a necessary out- 
 come of that quality in the district affected. Muscle and 
 
 * The report was made in 1887, but was as true in 1881 as it was in 
 1887. 
 
OF LONDON 291 
 
 bone in such a locality is at a premium, and that which 
 cannot be supplied in its full development from within must 
 be sought and obtained from without." 
 
 "Here, then, is a vicious circle of concurrent cause and 
 effect. Overcrowding is the cause of physical weakness : 
 physical weakness results in an unsatisfied demand in the 
 labour market : the unsatisfied demand is the cause of an in- 
 flux from without : again that influx results in overcrowding." 
 
 Once, then, that the influx of the physically strong began 
 to diminish — the element which had contributed most to the 
 maintenance of the physical vigour and health of the popula- 
 tion of London — it was evident that deterioration would 
 ensue, and the only means of counteracting that result was 
 to improve to the utmost possible the sanitary conditions 
 in which the people lived. 
 
 The census of 1881 is remarkable as being the last to show 
 an increase of country-born immigrants into London. That 
 tide was soon to begin to ebb. 
 
 The immigrants, however, were far from being all of a 
 desirable character. 
 
 The Medical Officer of Health for Camberwell pointed 
 this out : — 
 
 " A considerable percentage of our population is composed 
 of persons whose natural tendency is to grovel — beggars, 
 thieves, prostitutes, drunkards, persons of feeble intelligence, 
 persons of lazy and improvident habits, and persons who 
 (like too many of the poor) marry or cohabit prematurely 
 and procreate large families for which they are totally unable 
 to provide ; and such persons gravitate from all quarters to 
 large towns and there accumulate. ... A large town like 
 London will always attract undesirable residents." 
 
 With the increasing population the number of houses in 
 the metropolis increased also. 
 
 From 418,802 inhabited houses in 1871 the number had 
 gone up to 488,116 in 1881, and the same tale was told as to 
 the crowding of houses on the land as in previous years. 
 
 The Medical Officer of Health for Bethnal Green (1880) 
 stated that in his parish most of the available ground was 
 already fully built over. The Great Eastern Eailway Com- 
 
292 THE SANITARY EVOLUTION 
 
 pany, the School Board for London, and the Metropolitan 
 Board of "Works, were largely demolishing small house 
 property. " If this sort of thing goes on much longer," he 
 wrote, "it looks very much as if London in a few years 
 would become a huge agglomeration of Board Schools, inter- 
 sected by railways and new streets." 
 
 The correct record of the population enabled once more 
 an accurate death-rate to be calculated. The death-rate, 
 which had been 24-6 per 1,000 in 1871, had fallen to 21-3 in 
 1881. 
 
 That was most gratifying testimony to the good results 
 following the sanitary work carried out, under many diffi- 
 culties, in London, and an encouragement to perseverance. 
 
 The vital subject of the housing of the huge masses of the 
 people of London was, during all the earlier years of this 
 decade of 1881-90, uppermost in the minds of those who 
 were solicitous for their welfare. 
 
 The Act of 1879 had done but little to help to a solution 
 of the tremendous problem. 
 
 A short experience of it, and of " Cross's " Housing Act, 
 had shown that instead of " owners " being visited with 
 heavy penalties for their iniquities, they were being actually 
 rewarded. In fact, they secured under these Acts not only 
 a full, but an inordinately high compensation for their 
 property — regardless of its infamous condition — and the 
 ratepayers of London were mulcted in large sums to pay 
 them for it. 
 
 " I desire," said the Medical Officer of Health for 
 Hackney in 1883, " to express a very strong opinion that it 
 is most unfair to the ratepayers that they should be compelled 
 to pay for uninhabitable property which has been allowed by 
 the owners to get into a dilapidated state for want of sub- 
 stantial repairs such as cannot be required under the 
 Nuisances Bemoval Acts. ..." 
 
 The first scheme which was initiated by the Metropolitan 
 Board in 1875 was only completed at a net cost of ^161,763, 
 which sum had to be borne by the ratepayers of London ; 
 though why they should have been made to pay for the 
 "owners" neglect which had led to the evil conditions of 
 
OF LONDON 293 
 
 his property is not very clear, except that Parliament willed 
 it so. 
 
 By 1882 the total number of insanitary areas dealt with 
 by the Metropolitan Board, or in process of being dealt with, 
 was fourteen. The houses in these areas had been inhabited 
 by 20,335 persons in 5,555 separate holdings, 3,349 of which 
 consisted of one room only.* 
 
 They were acquired by the Board at a cost of i91, 661,000. 
 Parliament had imposed upon the Board the obligation to 
 provide accommodation for at least as many persons of the 
 working classes as were displaced by the destruction of the 
 houses on these areas. As the Board were not empowered 
 to undertake the building of the houses in which to re- 
 accommodate the displaced persons, the sites, after having 
 been cleared, had to be sold to persons or companies, who 
 were put under the obligation to erect workmen's dwellings 
 thereon ; but inasmuch as the land had been bought at its 
 value for commercial purpose, which was far higher than 
 its value for residential houses, this Parliamentary obliga- 
 tion entailed upon the Metropolitan Board, and through 
 them upon the ratepayers of London, an enormous loss. 
 
 The Goulston Street scheme in Whitechapel, for instance, 
 was acquired at a cost of £B11,600. When sold, under the 
 conditions imposed by Parliament, it realised only ^987,600 ; 
 and the Whitecross Street scheme (in St. Luke's), which cost 
 ^£391,000, when sold reahsed ^676,350. 
 
 The whole of the transactions, so far, resulted in a net loss 
 to the Metropolitan Board, or in other words, a net charge 
 upon the ratepayers of London of over ^61, 100, 000. 
 
 As Mr. Chamberlain described the result, in an article he 
 contributed to the Fortnightly Beview of December, 1883 : — 
 
 "Torrens' and Cross' Housing Acts are tainted and 
 paralysed by the incurable timidity with which Parliament 
 ... is accustomed to deal with the sacred rights of 
 property. . . . 
 
 " The individual wrong-doer is to remain unpunished — 
 retribution for his sins is to be exacted from the whole 
 community." 
 
 =■= See Report of Select Committee, 1882, p. v. 
 
294 THE SANITARY EVOLUTION 
 
 The enormous cost of carrying the Acts into effect stayed 
 the hand of the Metropolitan Board, while the length of 
 time, stretching out into years, required for the various pro- 
 ceedings, militated against the success of the schemes so far 
 as providing residences for the displaced people. 
 
 An example of the working of the Act was described in 
 1883 by the Kev. S. A. Barnett.* 
 
 " In 1876 the dwellings of 4,000 persons in this parish 
 (Whitechapel) were condemned as uninhabitable, and the 
 official scheme for their demolition and reconstruction was 
 prepared. During the next four years the ' scheme ' ploughed 
 its course through arbitration and compensation with a 
 puzzling slowness. 
 
 " It was indeed a * killing slowness,' for, during all those 
 years, landlords whose claims had been settled spent nothing 
 on further repairs ; tenants, expecting their compensation, 
 put up with any wretchedness ; while the Vestry, looking to 
 the approaching reconstruction of the houses, let streets and 
 footways fall to pieces. It was not until 1880 that the 
 needful demolition was seriously begun. Since that date the 
 houses of some thousands of the poor have been destroyed." 
 
 And then he described the slowness of the reconstruction, 
 and added : — 
 
 " Such is the seven years' history of the Artizans' Dwel- 
 lings Act in a parish under the rule of the Metropolitan 
 Board of Works." 
 
 He expressed his opinion that the prime source of the evil 
 was not in the law, but in the local administration ; but the 
 complications of ownership, the endless legal difficulties and 
 formalities, the numerous arbitrations, necessarily consumed 
 years of time before the land could be cleared for building, 
 and then the actual building of the new houses was by no 
 means rapid. 
 
 The mode of procedure was attended with such difficulties 
 and disadvantages, and the administration of the Acts so 
 clogged, that a Select Committee of the House of Commons 
 was appointed and sat in 1881, and again in 1882, to inquire 
 into the causes of the want of success, and to consider in 
 * Times, 20th November, 1883. 
 
OF LONDON 295 
 
 what way the law might be further amended so as to make 
 it really workable. 
 
 The condition imposed as to re-housing, and which was 
 so rigorously insisted on, did not by any means achieve the 
 desired result. 
 
 According to Mr. Lyulph Stanley* in 1884: **Not 
 one single person of all the poor displaced in the carrying 
 out of the Gray's Inn Eoad improvement, powers for which 
 were obtained in 1877, had been re-housed by the Board." 
 
 The Medical Officer of Health for Whitechapel, in his 
 evidence in 1881, also showed that many of those in the 
 houses which were to be pulled down were not working men 
 at all. 
 
 "Many of the people do not come into the Whitechapel 
 District for the purpose of getting employment. They have 
 other motives ; they come from all parts of the country ; a 
 great many are tramps, and come up for the purpose of 
 begging, some for stealing, and some to obtain the advantage 
 of the charities which exist in London, and many of them to 
 get out of the way and hide themselves." 
 
 By this time, moreover, the possibilities of getting 
 accommodation further afield was beginning to come into 
 view. 
 
 " With the facilities for coming by the early trains and 
 the various tramways that we have now at a cheap rate, 
 the rents of many of the inhabitants of Whitechapel would 
 not be increased by moving from it." 
 
 That the obligation to re-house was imposed alone upon 
 the public authorities and upon railway companies was 
 rather inequitable. In many districts the destruction of 
 houses, and the unhousing of the inhabitants, was carried 
 out on a far larger scale by private owners, and no such 
 obligation was imposed upon them. The policy, therefore, 
 was decidedly onesided, and was very costly to the ratepayer 
 who was in no way responsible for the proceedings of the 
 private house-owner who had caused all the trouble. 
 
 The Committee reported in June, 1882. They expressed 
 their opinion that — 
 
 * See his speech in Parliament, Hansard, 1884, vol. coxc, p. 529. 
 
296 THE SANITARY EVOLUTION 
 
 " Nothing would contribute more to the social, moral, and 
 physical improvement of a certain portion of the working 
 classes than the improvement of the houses and places in 
 which they live." 
 
 They stated that " very great hardship would often follow 
 if the provision for the replacement in or near the area of 
 displacement were wholly done away with." 
 
 " The special calling of many of the work people, the 
 hours of their work, the employment of their children, the 
 maintenance of their home life, the economy of living 
 together in a family, the cheapness of food owing to the 
 nearness of the great evening markets, &c., render it very 
 desirable that a large portion should be enabled to re-house 
 themselves in or near their old houses of living, and if no 
 fresh dwellings be provided the evils of overcrowding will at 
 once increase. 
 
 " Still, it is equally true that these observations do not 
 apply to the whole population. Many without any special 
 calling may live in one place as well as another. The 
 facilities of transit recently offered by cheap trains, by boats, 
 by tramways, &c., have enabled many to live in the suburbs 
 who can do so consistently with their calling." 
 
 "Your Committee are of opinion that the existing law, 
 which requires that the improvement scheme shall provide 
 for the accommodation of, at the least, as many persons of 
 the working class as may be displaced, may be relaxed, and 
 that the accommodation to be required should vary from 
 half to two-thirds." 
 
 As a matter of fact very few, if any, of the families thus 
 dispossessed returned for the purpose of occupying the new 
 buildings. 
 
 Indeed one witness * said that — 
 
 " Neither the Peabody Trustees, nor — more or less — the 
 other Artizans' Dwellings Companies would take in the class 
 of people who had been displaced." 
 
 The Committee called attention to the importance of 
 favouring in every way facilities of transit between the 
 * Eobert Eeid (a Surveyor), p. 805. 
 
OF LONDON 297 
 
 metropolis and its suburbs by an extension of cheap work- 
 men's trains. 
 
 And they also recommended that — 
 
 "All existing sanitary legislation should be more fully 
 enforced, especially in those parts of the suburbs where 
 buildings are so rapidly springing up." 
 
 A Bill was at once introduced into Parliament, the object 
 of which was to lay down such rules for estimating the value 
 of the premises to be purchased as would prevent the owners 
 of insanitary property obtaining an undue price for it — " the 
 intention of Parliament being that the owner should not 
 gain by having allowed his property to fall into an insanitary 
 state." 
 
 It was passed, and as an Act it further empowered the 
 Secretary of State, under certain circumstances, to dispense 
 with the obligation of re-housing the people to a greater 
 extent than one-half of those displaced. 
 
 Into the detailed intricacies of many of these Housing 
 Acts it is really useless to enter; and the enumeration of 
 the details tends to obscure the broad and essential features 
 of the whole subject. 
 
 In the effort of the "owners" to repudiate the responsi- 
 bility for their or their predecessors' infamous neglect, and 
 to shift the blame for the appalling state of affairs on the 
 middlemen and the occupiers ; in the effort of the middlemen 
 to evade their responsibilities by availing themselves of every 
 obstructive device the law so lavishly placed at their disposal, 
 and of both of them to extort the utmost amount of money 
 they could for their disease-begetting, death-distributing 
 property ; the unfortunate occupiers were the immediate 
 sufferers and victims, and a huge wrong and injury was 
 inflicted upon the community. 
 
 It was mere tinkering with the subject to pass an Act 
 removing some petty technical difficulties for putting some 
 previous and very limited Act in force, and to diminish the 
 expense and delay in carrying out the Act. 
 
 It was farcical to amend the Standing Orders of Parliament, 
 fixing twenty instead of fifteen as the minimum number of 
 houses in any one parish which could be acquired by the 
 
298 THE SANITARY EVOLUTION 
 
 Metropolitan Board without preparing a re-housing scheme, 
 as if that would revolutionise the condition of the housing 
 of the people of London, and yet something not far short of 
 revolution was required if the housing of the people was to 
 be reformed, and put on a proper sanitary basis. 
 
 It is manifest that what was being dealt with by these 
 Acts was only a fragment of the great housing question, and 
 that such destruction of insanitary buildings as could 
 possibly be effected by these means would amount to but a 
 fraction of those unfit for human habitation in London, and 
 would not touch the thousands of inhabited houses in every 
 parish of London which were insanitary in varying degree, 
 and dangerous to the individual and public health. It is 
 clear, too, that if the insanitary conditions of the housing 
 of the people were to be dealt with on a large scale, and with 
 success, measures must be taken to secure the sanitary con- 
 dition of the houses which such legislation did not touch. 
 Otherwise general improvement was impossible, and existing 
 conditions must continue indefinitely to flourish, and to pro- 
 duce their inevitable and enormous crop of deadly evil. 
 
 How urgent was the need for reform in some parts of 
 London may be gauged from the description of the condition 
 of things in Bethnal Green in 1883, given by the Medical 
 Officer of Health of the Parish : — 
 
 " The portions of the district I have examined include 
 nearly 2,000 houses. 
 
 " I have visited and carefully examined almost every one of 
 these houses, and I must confess that a condition of things 
 has been thereby revealed to me of which I had no previous 
 conception, for I do not think I visited a single house 
 without finding some grave sanitary defect ; in a very large 
 number the walls of the staircases, passages, and rooms 
 are black with filth, the ceilings are rotten and bulging, the 
 walls damp and decayed, the roofs defective, and the venti- 
 lation and lighting most imperfect. 
 
 " The dampness of the walls is in some instances due to 
 defects in the roof, but in many the moisture rises from the 
 earth owing to the walls being constructed without any 
 damp-proof course. . . . 
 
OF LONDON 299 
 
 " In almost every house I visited I found the yard, paving, 
 and surface drainage, in a more or less defective condition, 
 a quantity of black foetid mud having accumulated in 
 places." 
 
 And all this was nearly thirty years after Bethnal Green 
 had been endowed with a local sanitary authority. 
 
 Keturns given occasionally by the Medical Officers of 
 Health revealed the appalling state of insanitation in which 
 people still lived ; streets where in nearly every house 
 nuisances dangerous to health were found to exist ; a 
 "Place" in St. Pancras where the death-rate in 1881 had 
 been 57 per 1,000, or 2^ times as much as that for London ; 
 a " Place " in St. Marylebone with 22 six-roomed houses, 
 where the births were less in number than the deaths, 
 and the existing population were extinguishing themselves. 
 And overcrowding had increased in many parts of the 
 metropolis, and some of the Medical Officers of Health had 
 come to regard it as inevitable and impossible to prevent. 
 
 The reports of the Select Committees of 1881 and 1882, 
 and the outbreak of cholera in Egypt in 1883 which 
 awakened apprehensions of its spread to England, quickened 
 public interest in the sanitary condition of the metropolis, 
 evoked a stronger expression of public opinion upon the 
 existing evils, stirred up lethargic Vestries and District 
 Boards to some special show of activity, and awakened the 
 Local Government Board, and brought it into the field as 
 an active inciter of the local sanitary authorities to adequate 
 efforts to improve the sanitary condition of the people, 
 and to grapple with the terrible problems of insanitary 
 dwellings, of overcrowding, and the consequent physical 
 misery and degradation of hundreds of thousands of the 
 people. 
 
 The position of affairs had become clearer than it had 
 ever been before, and its magnitude and importance was 
 beginning to be appreciated, and the iniquities which were 
 being allowed, and the evils which were tolerated, were 
 coming more into the light of day and were being better 
 understood and realised. Though in many ways there had 
 been progress and improvement, yet in many others, of the 
 
300 THE SANITARY EVOLUTION 
 
 most vital consequence, it was evident things were scarcely 
 moving at all. 
 
 It was now manifest that at the rate the demolition of 
 slums and the re-housing of the people could be carried out, 
 a very great length of time must elapse ; so great that the 
 remedy must be of the slowest, whilst, by itself, it would be 
 wholly inadequate; and it was beginning to be realised that 
 many of the local authorities, instead of administering the 
 laws they were charged by Parliament to administer, were 
 even obstructing and opposing sanitary reforms. 
 
 Once again the alarm of cholera woke up the Vestries, 
 and some of the recorded results of such wakening are an 
 illuminating exposure of the normal state of inaction on 
 their part, and of the chronic insanitary condition of their 
 parishes not revealed at other times. 
 
 In Westminster : — 
 
 "In anticipation of cholera a thorough inspection by a 
 house-to-house visitation through the whole of the united 
 parishes has been undertaken. Naturally many defects 
 were found, and directions given as to what was required. 
 The work has been completed and I consider that the 
 parishes are now in a very satisfactory condition." 
 
 In Poplar, 2,114 houses were inspected, of which only 334 
 were found to be in good order. 
 
 In Lambeth, six men were engaged temporarily for the 
 purpose of a special inspection. 
 
 " 11,493 houses were visited ; 5,594 required sanitary 
 improvements. ... In many houses several defects were 
 reported, bringing up the total of sanitary improvements to 
 12,014." 
 
 In Bermondsey, no fewer than 5,992 notices were issued 
 for the execution of sanitary works which were required. 
 
 The Sanitary Act of 1866 had enacted that — 
 
 " It shall be the duty of the Nuisance Authority to make, 
 from time to time, either by itself or its of&cers, inspection 
 of the district with a view to ascertain what nuisances exist 
 calling for abatement under the powers of the Nuisances 
 Eemoval Acts, and to enforce the provisions of the said Acts 
 in order to cause the abatement thereof." 
 
OF LONDON 301 
 
 But by many Vestries the duty had been either entirely 
 neglected or very imperfectly performed. 
 
 The Medical Officers of Health were unceasing in pressing 
 upon their employers the necessity of inspection. 
 
 "It is only by the constant inspection and re-inspection 
 of property inhabited by tenants of this class (tenement- 
 houses) that the houses can be kept in decent sanitary 
 condition," wrote the Medical Officer of Health for Bethnal 
 Green. 
 
 " My opinion of the value of regular house-to-house 
 inspection throughout the year," wrote the Medical Officer 
 of Health for Poplar, "is more confirmed than ever, and 
 that such is needed for the proper sanitary supervision of 
 the district." 
 
 "It is by constant inspection," wrote another Medical 
 Officer of Health, "that the Vestry can best do its duty in 
 preserving the lives and health of its parishioners." 
 
 "Facts are stubborn things," wrote the Medical Officer of 
 Health for St. Mary, Newington, after 28 years' sanitary 
 work himself, "and they clearly demonstrate the necessity 
 for a continual supervision of the dwellings of the poor 
 (more especially) and for as constant an attack on all 
 removable insanitary conditions. This after all is the 
 real work to be done." 
 
 But the Vestries and District Boards paid little heed to 
 this advice. 
 
 Naturally, inspection was not welcome to sanitary 
 defaulters or misdoers ; naturally, the light of the sanitary 
 policeman's lantern into the dark places of slum-owners and 
 ' house-knackers ' was resented. It was an invasion of the 
 rights of property, of the privacy of an Englishman's home, 
 even if he did not live in that home himself, but let it to 
 somebody else to live in. " Why should not a man do as 
 he liked with his own ? " 
 
 And so, as inspection was, from the house "owners'" 
 point of view, an unpopular thing, too much money was not 
 spent by Vestries upon Sanitary Inspectors' salaries, and 
 even in the best inspected parishes or districts the portion 
 inspected was small indeed compared with the whole of the 
 
302 THE SANITARY EVOLUTION 
 
 parish or district. How much was left undone, and left 
 undone for years, was proved over and over again by whole 
 areas being represented by their Medical Of&cers of Health 
 as insanitary, or by their having to shut up houses as unfit 
 for human habitation. 
 
 The attempt made by Parliament in 1866 — in the scheme 
 embodied in the 35th Section of the Sanitary Act — to 
 provide a remedy for overcrowding, and to secure the 
 maintenance of a moderate standard of cleanliness and 
 sanitation in the tenement-houses, had been an excellent 
 one ; and Parliament improved the scheme in 1874 by 
 extending its scope. Almost the whole of the existing evils 
 lay in these tenement-houses, for it was there where the 
 great mass of the disease, filth, and misery of London was 
 to be found, and there where the greatest overcrowding, 
 and the deepest moral and physical degradation existed. 
 
 But with the few exceptions already described practically 
 no use had been made of the powers. 
 
 "Vested rights in filth and dirt" had still too large a 
 representation upon, and too powerful a grip of the local 
 sanitary authorities for any action to be adopted which 
 would entail trouble upon the possessors of those rights. 
 
 Some Vestries, for form's sake, had made regulations 
 but never put them in force. A few had tentatively put 
 them in force, and promptly dropped them. A large 
 proportion of them did not take even that much trouble, but 
 simply ignored them altogether; and so, some seventeen 
 years after the Act was passed, the whole scheme had ceased 
 to be operative, and was in complete abeyance. 
 
 In December, 1883, the Local Government Board, having 
 realised the gravity of the situation, endeavoured to get the 
 Vestries and District Boards to take action, but the Local 
 Government Board could not compel them to make such 
 regulations, as there was no power of compulsion, and there 
 was no penalty for refusal to enforce or even to make them.* 
 
 The Vestries and District Boards were, in fact, masters of 
 
 * The regulations suggested by the Local Government Board laid 
 down that the landlord or owner should not allow a greater number of 
 persons to occupy a room than would admit of free air space for each of 
 
OF LONDON 303 
 
 the situation, and could act or not act, just as they pleased — 
 and most of them did not act. 
 
 Various were the excuses made by the Vestries for doing 
 nothing. 
 
 The feeling which prevailed in the Vestry of Clerkenwell 
 was that — 
 
 " The regulations generally were of such an inquisitorial 
 and troublesome character that they were unsuited to an 
 Englishman's home. For instance, it was shown that in 
 some cases even clergymen occupied lodgings which would 
 be reached by these regulations." 
 
 And yet there were 4,700 houses in the parish to which 
 such regulations would have been applicable, and where 
 their application would have been of the utmost benefit to 
 thousands of families. And from 1866 up to 1884 this power 
 might have been, but was not used. 
 
 The Vestry of Bethnal Green was — 
 
 "Unanimously of opinion that it was unnecessary to 
 make the regulations, and considered the existing powers 
 sufficient." 
 
 The Vestry of St. George-in-the-East resolved — 
 
 " That whilst fully recognising the necessity of continuing 
 to carry out with vigour the general sanitary laws, the Vestry 
 did not consider it advisable in the present depressed condi- 
 tion of trade in the parish to incur the additional expense of 
 enforcing special sanitary regulations for houses let in 
 lodgings " (estimated to number above 4,000). 
 
 In Westminster, the District Board resolved that no 
 further steps should be taken as regarded making or enforcing 
 regulations, as the Board — 
 
 300 cubic feet — if used exclusively as a sleeping room — or 400 feet if 
 used day and night. 
 He was to — 
 
 (1) Keep the drainage in good working order, to properly pave the 
 yard, and provide sufficient sanitary accommodation. 
 
 (2) Keep the cisterns clean and in proper order, and keep the structure 
 of ashpit in proper order. 
 
 (3) Cause the ceilings and walls of every room to be whitewashed and 
 papered every AprU. 
 
 (4) Provide all requisite means for the ventilation of every room, and 
 of the common passages and staircases thereof. 
 
 (5) To notify cases of infectious disease. 
 
304 THE SANITARY EVOLUTION 
 
 " Already possessed ample powers under existing statutes 
 to enable it to deal promptly and effectively with such 
 sanitary defects as the proposed regulations are intended to 
 remedy "—a contention which, if true, threw discredit upon 
 themselves, as there were thousands of filthy and insanitary 
 abodes in that district which were not dealt with at all. 
 
 St. Pancras Vestry refused (1883) to make regulations, 
 though its Medical Officer of Health had made more than 
 one appeal to them to do so. 
 
 " I would beg to remind the Vestry that until proper regu- 
 lations are made and enforced in St. Pancras for this class 
 of houses, the Vestry have not exercised to their full extent 
 the powers they possess for improving the condition of their 
 poorer parishioners, and that the moral and physical welfare 
 of those who are least able to help themselves is a question 
 which concerns the Vestry as much, if not more, than any 
 other it is their duty to consider." 
 
 And in the following year he wrote : — 
 
 " Upon the Metropolitan Sanitary Authorities rests a great 
 responsibility, for it is absolutely within their power to insist 
 upon all dwelling-houses being maintained in condition fit 
 for human habitation, and they may, within limits, prevent 
 overcrowding, which is no less disastrous to health than to 
 morality. 
 
 "I have repeatedly recommended the Vestry to adopt 
 regulations for houses let in lodgings, and have pointed out 
 the power they would then possess for ensuring tenemented 
 houses being maintained in proper sanitary condition. I 
 would desire, in my last report, to urge upon them the 
 further consideration of this subject." 
 
 There were doubtless difficulties in putting regulations 
 such as these in operation — as, indeed, there are in putting 
 all laws in operation — but two Vestries had put them most 
 successfully in operation, and therefore the difficulties were 
 not so great as those who were opposed to them insisted. 
 
 Some of the Vestries stated that they could equally well 
 attain the same results under the powers of the Nuisances 
 Kemoval Acts ; but that was not the fact, for there many 
 and considerable advantages in this form of procedure over 
 
OF LONDON 305 
 
 the procedure prescribed in other Acts relating to health 
 and sanitation. Indeed, the Medical Officer of Health for 
 Fulham declared (in 1884) that— 
 
 " This section gave almost all the legal power that could 
 be wished for to place the dwellings of the poor in a proper 
 saaiitary condition." 
 
 And in the following year he wrote : — 
 
 " It will therefore in future be the fault of the Sanitary 
 Authority if the dwellings of the poor are not kept as they 
 should be." 
 
 The Medical Officer of Health for Camberwell, discussing 
 the general aspect of the matter, wrote (1884) : — 
 
 " I cannot help remarking on the feebleness which con- 
 stantly spoils the best intentioned sanitary legislation, and 
 which is conspicuous in the enactments relating to houses 
 let in lodgings. 
 
 " The Local Government Board have declared that certain 
 enactments are in force, but they cannot compel the Vestries 
 to frame any regulations of their own, nor even can they 
 compel Vestries to carry out and enforce regulations which 
 the Vestries have framed and the Board have sanctioned. 
 
 " Now I am one of those who think that by the judicious 
 regulation of lodging-houses of certain kinds, and in certain 
 localities, very much good might be effected, and much 
 advantage would accrue both to the lodgers and to the 
 public. But it is clear that it ought never to have been left 
 to individual Vestries in a place like London, to adopt or not 
 to adopt, the enactments referred to, simply according to 
 their pleasure, still more that they should never have been 
 allowed to frame inconsistent orders or regulations. . . . 
 
 "The opportunity (of the Act of 1874) might have been 
 seized, not for giving an empty power to the Local Govern- 
 ment Board, but for requiring the Metropolitan Board of 
 Works to frame suitable regulations for the whole of the 
 metropolis, which the Vestries might have been required to 
 enforce as they are required to enforce other provisions of 
 the Sanitary Acts." 
 
 A similar opinion was expressed by the District Board of 
 St. Olave, Southwark, which, after stating that it had been 
 
 21 
 
306 THE SANITARY EVOLUTION 
 
 one of the first to make regulations, it had been found un- 
 necessary or impracticable to enforce them, went on to 
 say :— 
 
 " The fact of the enactment having been practically in- 
 operative throughout the metropolis, ... it was considered 
 that it would be unjust to enforce stringent regulations in 
 the district, while in other parts of the metropolis regulations 
 might differ in principle, and be neglected in practice : and 
 what the Board wanted to see was a system of sanitary 
 regulations which should be strictly uniform throughout 
 the metropolis, and in which there should be no option on 
 the part of local authorities of enforcing or neglecting." 
 
 The explanation of this general inaction was the simple 
 and obvious one that on those bodies there were many whose 
 interests ran counter to the adoption of the Act, and what 
 its adoption entailed ; the sanitary obligations, the annual 
 lime- washings, &c., would entail expense ; they were not 
 going to inflict the cost upon themselves or upon their 
 friends if they could avoid doing so. And as they could 
 avoid it, the great bulk of the local authorities deliberately 
 ignored the remedy devised by Parliament, and with most 
 reprehensible callousness let the evils go on and increase. 
 But while they remained inactive, death and disease did 
 not. 
 
 Progress in sanitation was retarded also somewhat by 
 other circumstances. 
 
 The Medical Officers of Health were under no obligation 
 to reside in their district, and were at liberty to take private 
 practice, and so the whole of their time was not given to 
 their public duty.* 
 
 But furthermore, they were in a state of dependence on 
 their employers, which naturally would often prevent their 
 reporting fully upon sanitary matters, though, happily, 
 there appear to have been few who were influenced by this 
 consideration. And some of the Vestries and District 
 Boards did not hesitate to put pressure upon their Medical 
 Officers to prevent energy on their part. It was stated in 
 evidence before the Select Committee in 1882 that a 
 * Boyal Commission, 1884. 
 
OF LONDON 307 
 
 Medical Officer would very soon " bring a hornet's nest 
 round his ears if he attempted to do his duty strictly and 
 independently." 
 
 Lord Shaftesbury declared, in 1884,* that he was quite 
 certain that — 
 
 " They would never have the laws of health properly 
 given effect to, until they asserted the independence of the 
 Health Officers." 
 
 Nor were the Sanitary Inspectors as efficient as they 
 might have been, though there had been a great improve- 
 ment in the class of man appointed. 
 
 The Chief Sanitary Inspector for Clerkenwell t reported : — 
 
 " The two men (in Clerkenwell) are not very active. It 
 is the greatest trouble I have to get the men to do their 
 duty." 
 
 "The Sanitary Inspectors have not always shown as 
 much zeal and interest as they might have done, but lately 
 they have improved, ... It is openly talked about in a 
 good many districts in London that a system of bribing 
 goes on." I 
 
 But those who were energetic were also discouraged by 
 the same pressure which damped some of the energies of 
 the Medical Officers of Health. 
 
 The Medical Officer of Health for Fulham wrote, 
 in 1884:— 
 
 *' So many are the vested interests that Sanitary Officers 
 are obhged in the performance of their duty to interfere 
 with, that they must be prepared to meet with injustice and 
 opposition in almost all directions. It is not at all 
 surprising that the dweUings of the poor in London should 
 be in an insanitary condition seeing the great obstacles 
 public sanitary officers have in the performance of their 
 duties." 
 
 And yet there were many who did their work well, and 
 who did much to improve the conditions of living of those 
 who were under their care or charge ; and did it in the face 
 of many obstacles and much discouragement, and of all the 
 
 * Hansard, 1884. 
 
 f 1884 Eoyal Commission, vol. ii. p. 2938. 
 
308 THE SANITARY EVOLUTION 
 
 opposition that vested interests could bring to bear against 
 them. 
 
 Many of the Vestries and District Boards were not only 
 not above reproach, but were strongly to be condemned. 
 
 Sir Charles Dilke, then President of the Local Govern- 
 ment Board, speaking in 1883, said : — 
 
 " There were some parishes in London which had very 
 zealously tried to work the existing law, but, on the other 
 hand, there were more parishes the government of which 
 was a flagrant scandal." 
 
 And Mr. Chamberlain, in an article in the Fortnightly 
 Beview of December, 1883, wrote : — 
 
 ** In the metropolis, where the evil is greatest, the want 
 of an efficient and thoroughly representative municipal 
 government stands in the way of reform. 
 
 " The Vestries, often in the hands of cliques and chosen 
 at elections which excite no public interest, are largely 
 composed of small house-property owners, who cannot be 
 expected to be enthusiastic in putting the law in force 
 against themselves." 
 
 And in the House of Commons, on the 4th of March, 
 1884, Sir Charles Dilke stated that— 
 
 " In Clerkenwell, the two joint dictators of the parish, 
 who had control of the Vestry and its leading Committee, 
 one of them being Chairman of the principal Committee, 
 were the largest owners in the whole district of Clerkenwell 
 of bad or doubtful property. ... In Clerkenwell there were 
 fourteen house-farmers on the Vestry and twelve publicans 
 who seemed to work very much with them." 
 
 Nothing more decisively demonstrates the hostility of the 
 Vestries to the Act of 1866, indeed to all this branch of 
 sanitary reform, than the fact that they would not make 
 adequate provision for the performance of the sanitary 
 duties imposed on them by divers Acts of Parliament. 
 
 A return compiled by the Medical Officer of Health for 
 Bethnal Green in 1885, from information supplied him by 
 the Medical Officers of Health of thirty-eight Vestries, 
 shows how the local sanitary authorities crippled sanitary 
 work by a wholly inadequate staff of Inspectors. 
 
OF LONDON 
 
 309 
 
 
 Number 
 
 
 Number of 
 
 Parish or District. 
 
 of Inhabitants to 
 
 Inspectors. each Inspector 
 
 Greenwich 
 
 .. 1 
 
 
 . 148,545 
 
 Newington 
 
 .. 1 
 
 
 . 117,870 
 
 MUe-End-Old-Town ... 
 
 .. 1 
 
 
 . 111,607 
 
 Lambeth 
 
 .. 4 
 
 
 . 69,683 
 
 Poplar 
 
 .. 2 
 
 
 . 86,671 
 
 Bermondsey ... 
 
 .. 1 
 
 
 . 88,770 
 
 Shoreditch 
 
 .. 2 
 
 
 . 62,754 
 
 St. Pancras 
 
 .. 4 
 
 
 . 60,889 
 
 Paddington 
 
 .. 2 
 
 
 . 55,567 
 
 Marylebone 
 
 .. 3 
 
 
 . 50,294 
 
 Hackney 
 
 .. 4 
 
 
 .. 56,431 
 
 Bethnal Green 
 
 .. 2i 
 
 
 . 51,958 
 
 Camberwell 
 
 .. 4 
 
 
 . 59,500 
 
 In the whole of the metropolis there were 103 Inspectors 
 of Nuisances — a rough average of one Inspector to about 
 40,000 of the population. 
 
 How could it be expected that one Inspector could look 
 after a town of 40,000 people? 
 
 Consistently,, and, year after year, insistently, did the 
 bulk of the Medical Officers of Health complain of the lack 
 of sufficient Sanitary Inspectors, and point out the necessity 
 for more Sanitary Inspectors ; some begged for them — but 
 to nearly all these appeals the Vestries turned a deaf ear. 
 
 Every now and then some incident occurred or some 
 exposure was made of some abominations of insanitation 
 which were a revelation of the extraordinary methods 
 adopted by some men in utilising land for building houses 
 regardless of all sanitary consequences whatever to others. 
 
 In the Times of December 18, 1883, an article was 
 published entitled " A Curious Site for Industrial Dwellings." 
 
 " The things which are done in London under the shadow 
 of legal right are sometimes startling." 
 
 In Bethnal Green were two disused burial-grounds — 
 " Globe Fields " and " Peel Grove." Parliament authorised 
 a railway line to be constructed through " Globe Fields." 
 
 Foundations had to be made for the arches, and trenches 
 had to be dug in the burial-ground. 
 
 The Medical Officer of Health, on inspecting the place, 
 found a horrible condition of things. But with many 
 precautions against loosing some virulent epidemic in the 
 
310 THE SANITARY EVOLUTION 
 
 locality, the human remains were removed and re-interred 
 elsewhere, and, it is stated, part of the ground was built 
 over. 
 
 Fuller particulars were given as to the Peel Grove 
 Cemetery. The ground, several acres in extent, had been 
 leased by a pawnbroker and started as a cemetery as a 
 speculation. The statements made by the writer in the 
 Times are specially illuminating. The cemetery was 
 opened about 1840 without consecration. The Bishop 
 refused to consecrate the ground as burials had taken place 
 in it already, and as some difficulties were consequently 
 experienced, the speculating pawnbroker acted, it is said, 
 for some years as chaplain. 
 
 Ultimately, somehow or other, a chaplain was appointed. 
 
 About 20,000 persons had been buried in it, six deep, and 
 packed as closely as it was possible to pack them — not even 
 earth between the coffins, so anxious was the owner to 
 economise space ; large numbers who died of cholera in 
 1849 having been buried there. 
 
 The last interment took place in September, 1855. 
 
 In 1883, the ground having served one financial purpose, 
 it became desirable to utilise it for another financial 
 purpose, and the proposal was made to erect houses upon it, 
 and an agreement was entered into with a builder for the 
 erection of blocks of dwellings thereon. This builder 
 commenced excavations for the purpose of laying founda- 
 tions, and he had sent in drainage plans for a block of 
 industrial dwellings to the Vestry of Bethnal Green. 
 
 " Is such an obvious violation of the laws of health and 
 decency to be permitted ? " said the writer. 
 
 " The Vestry are alive to the situation, and appear to be 
 VTilling to do all in their power to avert the catastrophe. 
 But the law on the subject is by no means clear. ... It 
 is little short of scandalous that such doubts should 
 exist. It is repugnant to every feeling of decency and 
 propriety to invite human beings to live in densely packed 
 crowds over a charnel-house." 
 
 The sanitary condition of any city or district must, as 
 has already been pointed out, depend very largely upon 
 
OF LONDON 311 
 
 the system of local government in existence at the time, 
 and its efficiency or inefficiency. 
 
 This was specially true of this great metropolis with its 
 millions of people, its vast extent, its great diversities. 
 
 To all intents and purposes the main features of the local 
 government of London had undergone little change since 
 1855. There was still the " City " with its special law, 
 special area, and special government, to which had been 
 added the Port Sanitary Authority. 
 
 And there was the Central Authority, the Metropolitan 
 Board of Works; and there were the local sanitary authorities, 
 the Vestries and District Boards — and to them had been 
 added the Metropolitan Asylums Board, another indirectly 
 elected central body. But there were very manifest and 
 prominent defects of the very gravest nature in this system 
 of London government, and in 1884 the Government of the 
 day made an effort to construct a better system. 
 
 Sir William Harcourt introduced the London Government 
 Bill into the House of Commons. 
 
 "While London grew," he said,* "the Corporation 
 remained stationary." 
 
 " The central body must deal with the large affairs, ... a 
 central body doing all the great things." 
 
 " The central principle of the Bill is this, that there 
 should be some common control over the Vestries which 
 shall give them a uniform action for the benefit of the 
 whole community instead of leaving them as they now are, 
 independent of any such control." 
 
 "What is the great evil? It is that the metropolis is 
 broken up into fragments acting on a different principle, 
 some doing ill, and those who do well suffering in con- 
 sequence of the ill-doings of their neighbours." 
 
 "When the danger (of invasion of cholera) threatens a 
 great metropolis like London, all must desire and want a 
 central authority which should advise, which should assist, 
 which should compel every part of the community to take 
 those measures of precaution which are necessary for the 
 safety of the whole. No such authority exists at this time. 
 * Hansard, 1884, vol. cclxxxix. p. 41. 
 
312 THE SANITARY EVOLUTION 
 
 " If a Vestry refuses to make sanitary bye-laws, or to carry 
 out a proper system of sanitary inspection, you are absolutely 
 powerless to compel them to do so. A single parish may 
 become a plague-spot in London from which disease may be 
 spread all around, and the Metropolitan Authority have no 
 authority to make the parish do as it ought to do." 
 
 Mr. Gladstone said * : — 
 
 " The local government of London is, or, if it is not, it 
 certainly ought to be, the crown of all our local and 
 municipal institutions. 
 
 " The principle of unity (of London) has already been 
 established under the pressure of necessity as a matter 
 which could not be resisted. It has been established in 
 the Metropolitan Board of Works. . . . There can be no 
 doubt we have established a principle of unity, and that 
 we have found it satisfactory. 
 
 " The supply of water and the supply of gas . . . two 
 of the most elementary among the purposes of municipal 
 government, have been handed over to private Corporations 
 for the purpose of private profit because you have not chosen 
 to create a complete municipality for the metropolis. 
 
 " And that is not all. 
 
 " The defects of the present system are admitted. . . . 
 Surely if there are these great and intolerable defects they 
 ought to be remedied by the action of some genuine popular 
 local authority. But we have got no genuine popular 
 local authority. . . . 
 
 "London, large as it is, is a natural unit — united by 
 common features, united by common approximation, by 
 common neighbourhood, by common dangers — depending 
 upon common supplies, having common wants and common 
 conveniences. 
 
 "... Unity of Government in the metropolis is the only 
 method on which we can proceed for producing municipal 
 reform." 
 
 The Bill was strongly opposed in Parliament, and was 
 withdrawn at a late period of the Session, " but its intro- 
 duction and discussion had done much to awaken interest 
 ■'' Hansard, 1884, vol. ccxc. p. 541. 
 
OF LONDON 313 
 
 and mature opinion on the question of the practicability of 
 the government of London by a single municipality." * 
 
 Up to this time, though overcrowding had occupied so 
 prominent a position in the great health problem of London, 
 no returns of the amount of overcrowding actually existing 
 had been obtained, nor had any estimate even been attempted. 
 The reports of the Medical Officers of Health showed in 
 many graphic descriptions that overcrowding was prevalent 
 in every part of London — more acutely so in some districts 
 than in others — but as to the amount no information was 
 available. 
 
 The first reliable figures over a large area — a large central 
 district of London — were collected by Mr. T. Marchant 
 Williams, Inspector of Schools for the London School 
 Board, and published in the Times of February 22, 1884. 
 
 He wrote giving some of the results of his recent investi- 
 gations into the social conditions of the people residing in 
 his district. 
 
 "My sole desire," he wrote, *' is to record facts. It will 
 be my endeavour to show that these facts are sufficiently 
 typical or representative of the social condition of the 
 elementary school population of London to serve as a 
 trustworthy basis for a fairly accurate estimate of the 
 stupendous difficulties the School Board for London has to 
 contend with." 
 
 " The Division of Finsbury includes the following 
 parishes : — 
 
 (1) St. Giles' -in-the-Fields 
 ( St. George-the- Martyr 
 
 (2) ( St. Andrew, Holborn 
 
 Clerkenwell 
 
 The whole population in 
 1881 = 503,851 ; number 
 of children of school age, 
 3-13 = 91,128, 95 per 
 
 St. Luke cent, of whom have been 
 
 Stoke Newington J scheduled by the Officers 
 
 Islington I of the School Board." 
 
 (1) In St. Giles'-in-the-Fields there were 9 efficient 
 elementary schools, 4 churches, 6 chapels, 102 public - 
 houses, 27 milk shops. 
 
 * See Eeport of Royal Commission on the Amalgation of the City and 
 County of London, 1894. 
 
314 THE SANITARY EVOLUTION 
 
 He gave the number of families scheduled for elementary 
 school purposes residing in more than two rooms was 382, 
 which represents about 14 per cent, of the whole number of 
 scheduled families. 
 
 28 per cent of the families lived each in 2 rooms only, 
 and 58 ,, ,, ,, ,, „ 1 room only. 
 
 (2) In the parishes of Bloomsbury, St. George-the- 
 Mart5rr, St. Andrew, Holborn, and part of St. Giles'. 
 
 The number of families scheduled for elementary school 
 purposes residing in more than two rooms was 395, which is 
 about 10 per cent, of the whole number of scheduled families. 
 
 About 45 per cent lived in 2 rooms only. 
 » » » » 1 room only. 
 
 (3) Lower Division of Clerkenwell and St. Luke's. 
 
 The number of families scheduled for elementary school 
 purposes residing in more than two rooms was 3,886, which 
 is about 37 per cent, of the whole number of scheduled 
 families. 
 
 33 per cent live in 2 rooms only. 
 30 „ »i 1 room only. 
 
 He gave similar information as regarded three other sub- 
 districts, and then went on : — 
 
 " The foregoing statistics show that there were at the 
 beginning of the present year, in the Finsbury division — 
 
 " 10,490 families consisting of 41,044 persons, living, each, 
 in one room only, and 17,210 families consisting of 82,215 
 persons, living, each, in two rooms only, a total of 123,259 
 persons living in one or two rooms. 
 
 " For every efficient elementary school in the division there 
 are more than 8 public-houses, for there are in the division 
 111 efficient schools, while the public-houses number 912 ; 
 the grocers' shops, 682 ; bakers' shops, 409 ; dairies, 350 ; 
 coffee shops, 427 ; churches, 74 ; chapels, 32 ; mission rooms, 
 47 ; registered lodging-houses, 101." 
 
OF LONDON 315 
 
 And then he summarised his figm:es for the City Division : 
 
 Number of children of school age = 6,986 
 „ ,, churches and chapels = 71 
 ,, ,, public-houses = 408 
 
 Nmnber of families living, each, in more than two rooms 
 was 1,972, which is about 33 per cent, of the scheduled 
 families. 
 
 About 43 per cent, live, each, in 2 rooms only, and 
 nearly 24 „ „ ,, 1 room only. 
 
 The Times commented, in a leading article, on this 
 information. 
 
 "Everywhere, and by all sections not immediately 
 affected, the scandal and almost the absurdity of the brutish 
 degradation of an enormous number of habitations in the 
 greatest and most opulent city in the world are thoroughly 
 recognised. . . '. Habits of life such as lodgings of the kind 
 now common among London workmen foster and encourage 
 are a positive danger to the whole of society. Only by one 
 rank is the question treated as of no pressing importance. 
 That happens to be the body of persons directly interested. 
 
 "... No more instructive contribution has been offered 
 towards a clear perception of the dimensions of the problem 
 than those given by Mr. Marchant "Williams. . . . 
 
 "Incidentally the census, by the School Board, of the 
 classes it was founded to teach, contains the precise 
 materials for informing the public of the extent of the 
 overcrowding which has been shocking the moral sense of 
 the nation. Formerly, when instances of overcrowding 
 were cited, it might have been fancied they were exceptions 
 or exaggerations. Mr. Williams' report allows of no pos- 
 sibility of a doubt. 
 
 " The Finsbury educational division contained, in 1881, a 
 population of 503,851. Of these, 41,044 live in single 
 rooms, at an average rate of four a room ; 82,215 occupy 
 suites of two rooms, at a rate exceeding four persons and 
 
316 THE SANITARY EVOLUTION 
 
 three-quarters for each. For a family of two to monopoHse 
 a whole room is a luxury, and to possess two rooms is a 
 marvel. Some rooms are made to hold ten, and many to 
 hold six or seven. . . . 
 
 " A home partakes of the life of the dwellers in it. They 
 mould and incorporate it with their being, and it helps to 
 mould and fashion them. The 123,000 owners of an un- 
 divided and indivisible quarter of a hovel in Finsbury, and 
 the other hundreds of thousands in like case elsewhere in 
 the town, are curtailed of the essential parts of the rights 
 of humanity by the miserable accident that their locality 
 refuses them reasonable standing room. Family life is 
 an impossibility for a whole family collected in the single 
 room 12 to 15 feet by 6 to 10. In a multitude of instances 
 those tenanting a single room are several families, not one. 
 They have to distribute the floor by square inches, and 
 grow up with less regard to decency than a cat or a dog." 
 
 And in another letter written a few days later, Mr. 
 Marchant Williams added : — 
 
 "It was only the other day that I discovered in one 
 of these streets (near Fitzroy Square) a house containing 
 nine rooms, each of which accommodates on an average 
 eight persons ! 
 
 "... The rents in the most crowded parts of my district 
 amount as a rule to about a third or fourth of the maximum 
 wages earned by the tenants." 
 
 He mentions a case, a riveter : — 
 
 " He had recently abandoned the room in which he, his 
 wife, and six children had lived for two years." 
 
 " I have more than once when going my rounds been 
 accosted by a landlord in a state of abject terror, lest I 
 might be arranging to rob him of some of his victims. The 
 landlord's defence invariably is that he is obliged to levy 
 high rents because the tenants frequently run away by 
 night and leave no trace behind them of their where- 
 abouts." 
 
 More and more did the feeling grow that something must 
 be done to ameliorate the conditions under which the 
 working classes and poorer people were living, and on 
 
OF LONDON 317 
 
 the 22nd of February, the Marquess of Salisbury, in the 
 House of Lords, moved in an Address to Her Majesty 
 for the appointment of a Eoyal Commission to inquire into 
 the housing of the working classes.* 
 
 " The attention of persons of every class, of every creed, 
 and school of politics, has been turned to this question," 
 he said. 
 
 H.K.H. the Prince of Wales said : — 
 
 " I feel convinced that your lordships, in common V7ith 
 all classes of Her Majesty's subjects, will be gratified to 
 learn that the noble Marquess has asked for a searching 
 inquiry into this gxeat and momentous question with 
 regard to the housing and the amelioration of the dwellings 
 of the poor and of the working classes, and that Her 
 Majesty's Government have decided to issue a Eoyal Com- 
 mission for that purpose. 
 
 " As your Lordships know I take the keenest and liveliest 
 interest in this question. 
 
 " I can assure you, my Lords, that I am deeply flattered 
 at having been appointed a member of this Eoyal Com- 
 mission." 
 
 The Government accepted the motion, and a Eoyal 
 Commission was forthwith appointed and immediately 
 began its work. 
 
 While the great question of housing and over- 
 crowding was under discussion and was being investi- 
 gated, and efforts being made to deal with it, various 
 other matters forming part of the general sanitary 
 evolution of London were attracting attention, or gradually 
 developing. 
 
 In October, 1882, the limits of the Port of London were 
 extended seawards, and in the following year the powers 
 of the Port Sanitary Authority were extended. + Most 
 of the powers of an Urban Sanitary Authority under the 
 Public Health Act of 1875 were conferred upon it, and 
 the Medical Of&cer of Health reported that he believed 
 
 * Hansard, 1884, vol. cclxxxiv. 
 
 f By the Diseases Prevention (Metropolis) Act, 1883, 46 and 47 Vic. 
 cap. 35. 
 
318 THE SANITARY EVOLUTION 
 
 the legal powers of the Authority would be found " amply- 
 sufficient for the sanitary control and supervision of 
 the Port." 
 
 The Authority extended its attention now to the in- 
 spection of imported meat. It was a matter of the first 
 importance to watch carefully the food supply of the people. 
 The trade of frozen meat had been rapidly growing, and 
 from time to time large quantities arrived in unsound 
 condition, which it was most necessary should be prevented 
 going on to the market. 
 
 In connection with another very important article of food 
 — namely, milk— action was also taken. 
 
 The effect of the order made in 1879 by the Privy 
 Council, as to dairies, cowsheds, and milkshops, had been 
 very beneficial, and a marked change for the better in the 
 conditions under which the milk trade was conducted was 
 the result. That Order was revoked in 1885 by the Privy 
 Council, and a new one passed extending the powers of local 
 authorities in the matter, and prescribing further pre- 
 cautions to secure the sanitary condition of all dairies and 
 cowsheds, and for the protection of milk against infection 
 or contamination. 
 
 Another beneficial sanitary improvement was effected 
 in 1883, by the extension of the benefits of the infectious 
 hospitals of the Metropolitan Asylums Board. 
 
 The Eoyal Commission on Fever and Smallpox Hospitals, 
 in 1882, stated that in their opinion it was of paramount 
 importance that the hospitals of the Metropolitan Asylums 
 Board, to which so many classes of persons might become 
 liable to be removed, should be made as little unattractive 
 as the nature of the case admitted, and they considered 
 that the pauper character which attached to the hospitals 
 of the Board, and which rendered them repulsive to all but 
 the indigent, would disappear if the distinction between 
 paupers and non-paupers were abolished. 
 
 This suggestion was partially given effect to by the 
 Diseases Prevention (Metropolis) Act of 1888, which en- 
 acted that, subject to certain arrangements, the admission 
 of any person suffering from infectious disease into any 
 
OF LONDON 319 
 
 hospital provided by the Metropolitan Asylums Board, or 
 the maintenance of any such person therein, should not 
 be considered to be parochial relief. 
 
 The plan was only partly successful, but as years went 
 on the hospitals were increasingly used by persons other 
 than those of the legally recognised pauper class. 
 
 In the years 1884 and 1885 the hospitals demonstrated 
 their great utility. There was a severe epidemic of small- 
 pox. From its outbreak in 1884, to its subsidence in the 
 autumn of 1885, no less a number than 12,425 patients 
 passed through the hospitals, hospital ships, and camps 
 of the Metropolitan Asylums Board, and the arrangements 
 for the removal to hospital of cases of infectious disease, 
 from the whole of the metropolis, worked smoothly and 
 satisfactorily. 
 
 The gain to the community in thus removing infectious 
 cases from its midst was immeasurable.* 
 
 In 1885 the Eeport of the Eoyal Commission which had 
 been inquiring into the Housing of the Working Classes 
 was published. It presented to the general public a mass of 
 facts of which previously they had taken but little heed, 
 and the vast importance of which they had utterly failed 
 to realise ; and it brought into the forefront of social 
 questions the vital question of the public health, and 
 the imperative necessity of remedying evils which were 
 eating into the very vitals of the community. 
 
 The Eoyal Commissioners depicted the widely prevalent 
 and dreadful overcrowding which existed, and which in 
 certain localities was becoming more serious than ever, 
 and they gave numerous instances of it. They described 
 the fearsome condition of tenement-houses, and of the 
 people living therein — the inadequacy of the water supply 
 — the defective sanitary accommodation in houses — the 
 lack of air space — the absence of ventilation — the use of 
 cellars and underground rooms as dwelling-places — the 
 limitless filth. 
 
 And they pointed out the dreadful results of this condi- 
 tion of things — physical, moral, and material — the preva- 
 * The total net expenditure was ^6401,000 in 1885. 
 
320 THE SANITARY EVOLUTION 
 
 lence of disease, the heavy death-rate, the destruction 
 of bodily health, the dreadful immorality resulting from 
 overcrowding, the degradation to which masses were 
 doomed, the incitement to drink, and depravity, and crime. 
 They declared that : — 
 
 " Even statistics of actual disease consequent on over- 
 crowding would not convey the whole truth as to the loss 
 of health caused by it to the labouring classes. . . . 
 
 " Nothing stronger could be said in describing the effect 
 of overcrowding than that it is even more destructive to 
 general health than conducive to the spread of epidemic 
 and contagious diseases." 
 
 And they pointed out that there was much legislation 
 designed to meet these evils, yet that the existing laws were 
 not put in force, some of them having remained a dead 
 letter from the date when they first found place in the 
 statute book. 
 
 And they investigated the causes of many of these things 
 — and they assigned the blame for some of them — and they 
 passed in review the conduct of the local governing 
 authorities — and they recapitulated the existing laws upon 
 these various matters, and suggested certain alterations, and 
 made various valuable recommendations. 
 
 There was, in fact, placed on record a calm, unim- 
 passioned, and unexaggerated statement of the evils which 
 masses of the population of the great capital were enduring 
 in the last quarter of the highly civilised and enlightened 
 nineteenth century. 
 
 It was a thorough confirmation of all the reports of the 
 Medical Officers of Health, and of the facts set out, and 
 pressed by them, year after year, upon the attention of the 
 Vestries and District Boards, and which had so persistently 
 been ignored by so many of those authorities. 
 
 The Commissioners classified the — 
 
 " Unquestioned causes which produced the overcrowding 
 and the generally lamentable condition of the homes of the 
 labouring classes." 
 
 The first was — 
 
 " The poverty of the inhabitants of the poorest quarters, 
 
OF LONDON 321 
 
 or in other words the relation borne by the wages they 
 received to the rent they had to pay." 
 
 The next was the demolition, for various reasons, of 
 houses inhabited by the working classes and poorer people, 
 and the consequent displacement of the people. 
 
 The third was the relation between the owners of 
 property upon which the dwellings of the poor stood, and 
 the tenants of those dwellings. 
 
 " The other great remaining cause of the evil was the 
 remissness of local authorities." 
 
 From their very origin, these " authorities " were un- 
 satisfactory instruments for the performance of the public 
 duties. 
 
 ** But little interest was, as a rule, taken in the election 
 of vestrymen by the inhabitants," instances having been 
 known of vestrymen in populous parishes being returned 
 by two votes, on a show of hands. 
 
 Elsewhere it is reported they elected each other. 
 
 The Commissioners referred to the "supineness" of 
 many of these metropolitan local authorities in sanitary 
 matters, and to the " laxity of administration of some 
 of them." And still worse, to the self-interested action 
 of vestrymen. 
 
 Thus on the Vestry of Clerkenwell, they said, were — 
 
 ** Thirteen or fourteen persons who are interested in bad 
 or doubtful property, including several ' middlemen ' ; and 
 ten publicans who, with the exception of one or two, had 
 the reputation of working with the party who trade in 
 insanitary property ; and accordingly this party commands 
 a working majority on the Vestry." 
 
 " It is not surprising to find that the Sanitary Inspectors 
 whose tenure of office and salary is subject to such a body 
 should show indisposition to activity." 
 
 "The state of the homes of the working classes in 
 Clerkenwell, the overcrowding, and other evils, which 
 act and re-act on one another, must be attributed in a 
 large measure to the default of the responsible local 
 authority." 
 
 "Clerkenwell does not stand alone: from various parts 
 
 22 
 
322 THE SANITARY EVOLUTION 
 
 of London the same complaints are heard of insanitary 
 property being owned by members of the Vestries and 
 District Boards, and of sanitary inspection being ineffi- 
 ciently done, because many of the persons whose duty it 
 is to see that a better state of things should exist, are 
 those who are interested in keeping things as they are." 
 
 And in another part of their report they wrote : — 
 
 "It is evident that the remedies which legislation has 
 provided for sanitary evils have been imperfectly applied in 
 the metropolis, and that this failure has been due to 
 negligence in many cases of the existing local authorities." 
 
 The part of the evidence which was of greatest value 
 and interest was that which laid bare the responsibility 
 for the dreadful conditions under which such masses of 
 the people lived. 
 
 Apart from the measure of responsibility which fell on 
 Parliament itself, and it was no light one, it is clear that 
 those conditions were due (1) in part to the various classes of 
 " owners," (2) in part to the people themselves, and (3) 
 in part to the local authorities. 
 
 As regarded owners, there were first the ground landlords, 
 who themselves, or whose predecessors had leased their 
 land for building purposes, or with houses thereon to a 
 tenant. 
 
 It would appear clear that these ground landlords or 
 freeholders, or lessors, had power to enforce against the 
 person who held directly from them the repairing clauses 
 of leases. But the existing condition of things showed that 
 they did not do so. 
 
 One of the witnesses, giving evidence about a particular 
 property, said : — 
 
 " By the terms of even the old leases the tenant was 
 supposed to keep the place in proper repair. . . . The 
 property has gradually deteriorated in consequence of 
 neglect." 
 
 And Lord Sahsbury, who asked : — 
 
 " I suppose it is practically impossible for the ground 
 landlord to see that the conditions are kept?" 
 
 "Was told in reply : — 
 
OF LONDON 323 
 
 " The only way in which it is possible for him to do that 
 is to keep a very active supervision over his property. 
 
 " If that was done by ground landlords, and had always 
 been done by them, you would have personal supervision 
 carried out by a sufficient number of people to ensure the 
 conditions being kept." 
 
 Any idea of property having its duties as well as its rights 
 appears to have been non-existent. 
 
 Next to the landowner was the numerous and varied 
 class of house " owners," from the man who leased the 
 land from the landlord and built the house, or who had 
 leased the house and had sub-leased it to some one else. 
 And often there were sub-lessees, until in some cases there 
 was a chain of persons holding different interests in the 
 same house. 
 
 And there was the class of persons who take a house 
 and break it up into tenement-rooms, and who were known 
 as "house-knackers," or house jobbers, or house farmers, 
 or as "middlemen," these last being defined as any one 
 who stands between the freeholder and the one who 
 occupies. 
 
 Some interesting descriptions of some of these "middle- 
 men " were given. 
 
 One of the largest in Clerkenwell was a Mr. Decimus 
 Ball, and there was also a Mr. Eoss — both of whom were 
 on the Vestry. 
 
 The witness stated that these men had neglected the 
 houses, and in many cases were very extortionate in their 
 demands against the occupants. 
 
 Mr. Ball had many houses which were inhabited by 
 families in single rooms, but which up to a short time 
 previously were inhabited by whole families to a house. 
 
 Mr. Ball's profit is "perfectly enormous if he does not 
 do any repairs." And he made very few ; and if the rent 
 were not paid on the Monday morning, he threatened to 
 raise it. 
 
 Probably the most notorious "middleman" was a certain 
 Mr. FHght. 
 
 " He must have been the owner of thousands and 
 
324 THE SANITARY EVOLUTION 
 
 thousands of houses in the metropolis." (18,000, it was 
 said.) 
 
 " He owned property in every part of London, and the 
 squalid nature of that property, the wretched condition in 
 which it has been kept, the avoidance of all decent rules by 
 which habitations are governed, was something very fearful." 
 
 " Middlemen," it was stated, sometimes appeared to be 
 making 150 per cent, per annum, but they assert that repairs 
 have to come out of that. Eepairs, however, were only 
 executed once in three or four years, and in the others they 
 get their 150 per cent. 
 
 " If the house-farmers do no repairs for years the profits 
 are large. . . . They collect their rents very sharply. 
 
 " The middleman makes the tenant pay an excessive rent 
 because he insists upon making an excessive profit." 
 
 The great ^work which the Commission did was in the 
 enlightenment of the public, and the material they afforded 
 for the formation of public opinion in the right direction. 
 Subsequent experience showed that the recommendations 
 made — excellent and helpful as so many of them were 
 — did not by a long way cut deep enough to extirpate 
 the more serious evils. 
 
 "It is evident," wrote the Commissioners, " that the 
 35th Section of the Sanitary Act of 1866 (dealing with 
 tenement-houses) which contains a remedy for some of 
 the evils which have been described is likely to remain 
 a dead letter in many districts of the metropolis until some 
 improved means be devised for putting it into action," 
 They recommended that the local authorities who had 
 not already made and enforced bye-laws under the section 
 " should proceed to do so," 
 
 But no compulsion was suggested to make them do so, 
 or for the only effective alternative, the provision of other 
 machinery to act in their default, and so the local authori- 
 ties were in this matter allowed to remain in their position 
 of complete independence and to continue their policy of 
 inactivity — if not obstruction. 
 
 As to inspection, and the inadequacy of a sanitary staff, 
 much evidence had been given, but, they remarked : — 
 
OF LONDON 325 
 
 "It is evident that where work is performed according 
 to the custom of certain districts of the metropoHs it really 
 does not matter whether the staff of inspectors be large or 
 small." 
 
 They summed up their general view in the following 
 passage : — 
 
 " Without entering upon questions of policy of far wider 
 application than the more immediate 'subject-matter of 
 the present inquiry, " Your Majesty's Commissioners are 
 clearly of opinion that there has been failure in administra- 
 tion rather than in legislation, although the latter is no 
 doubt capable of improvement. What at the present time 
 is specially required is some motive power, and probably 
 there can be no stronger motive power than public opinion." 
 
 And with that view they recommended that inquiries 
 should be held as to the immediate sanitary requirements 
 of different districts, and the reports be presented to 
 Parliament. 
 
 Public opinion, however, is hard to move, and usually 
 slow in moving ; and when it has at last decided on definite 
 action Parliament is slow in giving effect to the decision, 
 and, when Parliament at last acts, the legislation itself 
 is frequently defective. And so the outlook was rather 
 hopeless. 
 
 Various other more concrete amendments were, however, 
 suggested in the various Housing Acts to render them more 
 effective for their purpose. 
 
 And, as a result, in the session of Parliament of 1885 
 a Bill was introduced dealing with the "Housing of the 
 Working Classess." 
 
 Lord Salisbury, in moving the second reading, said * : — 
 
 The Bill he introduced was to a certain extent " a 
 compromise." " No one need expect to find that it contains 
 any magic formula which will cure all the evils of 
 which this House and the public have heard a great 
 deal, and there is nothing startling, sensational or extreme 
 in its provisions. We are hoping to cure these evils by 
 slow and gradual steps, by the application of remedies 
 * Hansard, vol, ccxxix. p. 889. 
 
326 THE SANITARY EVOLUTION 
 
 apparently not far-reaching in their character, but still 
 judiciously directed to the precise difficulties which arose 
 in each department of our inquiry." 
 
 The Bill duly passed (48 & 49 Vic. cap. 72). 
 
 Most of the reforms embodied in it were of a trifling 
 character and such as could have only the most limited 
 and gradual effect. 
 
 This Act extended generally the operation of the Labour- 
 ing Classes Lodging Houses Acts of 1851 and 1867, and 
 substituted the Metropolitan Board of "Works for the 
 Vestries and District Boards as the authority under the Act. 
 
 A really useful plan was authorised by it, namely, the 
 sale, at a fair market price, to the Metropolitan Board 
 of certain prison sites in London for housing purposes. 
 And one other good thing done was depriving the owner 
 of insanitary premises, which had been pulled down by 
 order of the local authority, of the power to require the 
 local authority to purchase such premises. 
 
 But merely again to declare — 
 
 " That it shall be the duty of every local authority en- 
 trusted with the laws relating to public health and local 
 government to put in force the powers with which they 
 are invested so as to secure the proper sanitary condition 
 of all premises within the area under their control " — 
 was futile, considering that the authorities in question 
 had steadily ignored the same direction, made nineteen 
 years previously, in the Act of 1866. 
 
 Lord Salisbury wound up his speech with the following 
 abnegation of Parliamentary power : — 
 
 " We must not imagine that it is anything we can do 
 in this House, or in the House of Commons, that will 
 remove all these evils. It must be done by that stirring 
 up of public opinion which these investigations cause ; 
 it is to this that we must look for any real reform, it must 
 be from the people themselves, from the owners, builders, 
 and occupiers, when their attention is drawn to the 
 enormous evils which past negligence has caused, it is 
 from them that the cure of the sanitary evils which have 
 so largely increased the death-rate must come," 
 
OF LONDON 327 
 
 Considering, however, the accumulated mass of evidence 
 which had shown beyond all question that it was the 
 owners and builders who were mainly responsible for those 
 " enormous evils," and who were still hard at work adding 
 to them and perpetuating them, it was rather hopeless 
 to expect "the cure of the sanitary evils" to come from 
 that quarter. 
 
 Unfortunately two general elections, and the heated 
 discussion of great political questions, threw even these 
 great health questions into the background, and not so 
 much immediate benefit as was to be hoped followed the 
 inquiry of the Eoyal Commissioners. 
 
 It is an awful handicap to the welfare of a community, 
 and of a nation, when those who should take a principal 
 share in the duty of raising the physical, social, and 
 moral condition of the people over whom they can exercise 
 influence, and who are more or less under their control, 
 not alone stand idly aside, but absolutely exploit the 
 misery and helplessness and ignorance of masses of the 
 people. 
 
 The Imperial Government may make most excellent 
 laws, but the physical and sanitary welfare of the people 
 cannot be secured by a local governing authority alone, 
 nor their moral and religious welfare by the Churches alone 
 
 There is a great sphere of life where those who stand 
 in the relation of land-owners or house-owners to tenants 
 could exercise an enormous influence for good, and where 
 nobody else could exercise it so effectually or so easily. 
 
 But the disaster has been that in the great metropolis — 
 the greatest of all cities — a vast proportion of those who 
 ought to have been active in using this influence, have 
 never made the slightest effort to use it, whilst others 
 have used their position, and the dependence of the people 
 upon them, solely to wring from them tho last farthing 
 that could be extracted. 
 
 And these were the men who made the loudest protests 
 and outcry against legislation and against administration 
 which was to make them do that which the vital interests 
 of the community and of the State required to be done. 
 
328 THE SANITARY EVOLUTION 
 
 The root of the evil connected with the housing of 
 the people in London lay with the disregard of "owners " 
 for the condition of their tenants. 
 
 Many "owners" appeared to be under the impression 
 that their investment in house property was to be as free 
 from trouble or labour as money invested in the national 
 funds is ; and so long as they got the rent they expected, 
 they did not trouble themselves about the state of the 
 houses or of the people living therein. They were loth 
 to spend money on them, as that curtailed their income, 
 and the argument was constantly used that it was useless 
 spending money to put the property in order, when 
 anything they did to it would be promptly destroyed. 
 And they cared not who were their tenants so long as a 
 high rent was obtainable from them. 
 
 Some declared that the people were so sunken, so 
 degraded, so filthy, and depraved, and destructive, that 
 nothing they could do could secure their property being 
 kept in a sanitary or decent condition. 
 
 Doubtless in many districts and many cases the conduct 
 of the tenants was as bad as bad could be. As one of the 
 Medical Officers of Health wrote in 1883 : — 
 
 " It must be borne in mind that many of the occupants 
 of tenement property are careless and filthy in their habits ; 
 and in addition are very destructive ; fittings put up one 
 day are pulled dovra. and destroyed the next ; ash-bin covers, 
 closet doors, and even flooring boards, share the same fate." 
 
 And many were the " owners " of various degree who 
 endeavoured to justify their neglect on this ground. 
 
 Were such an argument admitted, the owner could claim 
 to be exonerated from the duty of keeping his property 
 in proper order, and the evil conditions and consequences 
 resulting from his neglect would go on increasing indefi- 
 nitely, until a state of things destructive to the community 
 was ultimately reached. 
 
 Viewed broadly, and impartially, there was much truth 
 as regarded the misconduct and uncleanliness of great 
 numbers of tenants, but the central fact was that the 
 "owner" was the person mainly interested in, and bene- 
 
OF LONDON 329 
 
 fited by possession of the property, and therefore primarily 
 responsible for maintaining it in a condition which should 
 not endanger the health of the community. 
 
 If, through the neglect and indifference of his predecessors, 
 the property had fallen into a bad state, the consequences 
 equitably fell upon him, just as the consequences of any 
 other bad investment by his predecessor would have done. 
 He had inherited something which was not worth as much 
 as he anticipated — that was all ; but the consequences must 
 not be shifted on to the community, nor must his tenants 
 be made the victims. 
 
 And if he allowed his property to become a danger to 
 his tenants, and through them to the community at large, 
 the community had an absolute right to protect itself by 
 insisting that he should be prevented from so doing. 
 
 The only way in which, in the interests of the public, 
 abuses can be prevented is by holding the person responsible 
 for them who has the power of preventing them. And 
 that was just what in this case the " owners " did not 
 like. 
 
 Building constituted an important part of the housing 
 problem. The Medical Officer of Health for Lambeth, 
 in his report for 1887, gave an interesting account of the 
 process of building in London which shows how even the 
 amended Building Acts had failed to secure those conditions 
 of air and space which are essential for health. 
 
 " In proximity to the centres of business every available 
 plot of garden or recreation ground has been converted 
 into building sites. Houses constructed from materials 
 of the poorest quality and by workmen employed only for 
 the cheapness of their labour, have been hurried into 
 occupation. 
 
 " The system of close building, at first confined in its 
 application to the consolidation of the inner zone, has 
 been adopted in the outer, and with the demand for 
 shelter, which increases in a progressive ratio with the 
 growth of the population, the once open suburbs must 
 ere long become indistinguishable in the monotony of house 
 row and pavement. 
 
330 THE SANITARY EVOLUTION 
 
 "The art of close building appears a progressive one. 
 In its infancy, twenty years ago, the art has now arrived at 
 a stage nearly approaching perfection. In the earlier 
 examples the space allotted to garden land was larger 
 than that built on. Then the size of the two quantities 
 reached an equality — then the covered ground becomes 
 a larger quantity than the uncovered land, until the final 
 stage of development is attained when the extreme limit 
 of encroachment permitted by the Building Act is reached, 
 and garden land is represented by a yard 100 superficial feet 
 in area." 
 
 Extraordinary loopholes in the sanitary laws, moreover, 
 were constantly being discovered which almost neutralised 
 the original enactment. 
 
 Thus the Medical Officer of Health for Camberwell 
 remarked in his report for 1888 : — 
 
 " It has been long known to the Sanitary Committee 
 that there has never been any efficent supervision of the 
 drainage and other sanitary arrangements of houses in 
 course of construction. ... It is true that every builder 
 has been required before constructing his private drains 
 and connecting them with the public sewers, to send in 
 a plan of his proposed drainage for the sanction of the 
 Surveyor. But there has been no machinery by which 
 builders could be compelled to carry out their private 
 works in accordance with the plans submitted, and to 
 ensure that the details of their works had been carried 
 out in a workmanlike or efficient manner. The inspections 
 of houses even recently built have shown that sanitary 
 nuisances complained of have been largely due to scanda- 
 lous neglect of duty on the part of those concerned in 
 carrying out the drainage works, and that in most cases 
 the plans sent in have not accorded with the arrangements 
 finally adopted." 
 
 Various, indeed, were matters connected with the public 
 health which unexpectedly came cropping up; sometimes 
 matters thought to have been disposed of but only partly 
 so, sometimes, wholly new origins and ramifications of 
 insanitation. 
 
OF LONDON 331 
 
 Thus in 1886 the Medical Officer of Health for the south 
 part of Poplar District drew special attention to a grievance 
 long previously complained of and for many years endured. 
 
 "A greater scandal cannot well be shown in matters 
 vital to health than that in spite of abundant evidence 
 of the magnitude of the evil, thousands and tens of 
 thousands of families living in houses, the rates of which 
 are payable by the landlords, may at any moment, without 
 a particle of fault of their own, be suddenly denied one 
 of the first necessaries of life — water — through the neglect 
 and wilfulness of others." 
 
 The main remedy open to the water companies to 
 recover rates from defaulting non-resident owners of 
 tenement-houses was the simple expedient of discontinuing 
 the supply of water. This course was open to a double 
 objection — first, tenants who had paid their rent were 
 deprived of that for which they had constructively paid ; 
 and secondly, a tenement-house deprived of water might 
 speedily become a focus of disease. 
 
 " That disease and death are directly traceable to this 
 want," wrote the Medical Officer of Health, " no one ac- 
 quainted with sanitary work in London can doubt. Take 
 this instance. Water cut off, drains stopped, opening 
 up of ground and drains, removal of filth accumulations, 
 horrid stench, diphtheria, death. 
 
 "In Hanbury Place — having six houses — there was no 
 water supply for twenty-six days, and families numbering 
 each seven, nine, two of six, and others had to exist in 
 May, 1885, with choked drains, yard flooded with sewage, 
 and no water — and all because of non-payment of rates by 
 the landlord." 
 
 In 1887 Parliament happily dealt with this evil, and by 
 an Act passed in that year — 
 
 " Water companies were prohibited from cutting off the 
 water supply from any dwelling-house for non-payment of 
 water rate, if such rate were payable by the owner and not 
 the occupier of the premises. ..." 
 
 In the middle of this decade, too, anxiety revived, owing 
 to the state of the Thames, a matter which it was hoped 
 
332 THE SANITARY EVOLUTION 
 
 had been finally disposed of. The discharge of sewage at 
 the new outfalls make the river in those parts much what it 
 had previously been in London. 
 
 A Royal Commission was appointed to inquire into the 
 subject. They reported that they found a condition of 
 things which they " must denounce as a disgrace to the 
 metropolis and to civilisation." They said that in 1884 
 " the sewage water from the outfalls manifestly reached 
 London Bridge." 
 
 "At Greenwich Pier the water was very black, and the 
 smell exceedingly strong." 
 
 " At Woolwich the river for its whole width was black, 
 putrid, sewage — looking as if unmixed and unalloyed. The 
 stench was intolerable." 
 
 "We are of opinion that it is neither necessary nor 
 justifiable to discharge the sewage of the metropolis in its 
 crude state into any part of the Thames." 
 
 This evil was surmounted by the adoption by the 
 Metropolitan Board of Works of a system of treatment of 
 the crude sewage. Chemical precipitation was effected by 
 adding to the sewage certain proportions of lime and 
 protosulphate of iron, and allowing it to remain for an 
 hour or two in settling tanks. The effluent water was 
 let flow into the river, and the sludge was carried down the 
 river in barges and cast into the sea. 
 
 The public interest evoked by the inquiries made by the 
 Eoyal Commissioners on Housing, and the publication of 
 their Report, certainly quickened the activity of many of 
 the local authorities. 
 
 In several of the parishes and districts the Regulations 
 under the Sanitary Acts of 1866 and 1874 were being more 
 readily adopted, and being put into force on a slightly 
 more extended scale ; and in every case it was reported that 
 the results had been satisfactory, a great improvement 
 taking place in the houses which were registered. 
 
 A report of the Inspector of such houses, for Bermondsey, 
 describes this well : — 
 
 " 108 were placed on Register by Vestry. The majority 
 of these houses are situated in the lowest and most densely 
 
OF LONDON 333 
 
 populated parts of the parish. They are occupied by the 
 very poor, costermongers, dock and waterside labourers, &c. 
 They contain 509 rooms, occupied by 386 families, number- 
 ing 1,434 persons. 285 rooms were overcrowded. With 
 three exceptions the overcrowding has been abated. 
 Previous to registration the number in each house was 13, 
 present average 9." 
 
 "The sanitary condition of the said houses has been 
 greatly improved. Staircases, &c., are now regularly swept 
 and washed. In 85 houses the walls have been stripped 
 and whitewashed. Many of the walls had 15 layers of 
 paper, thus hiding filth and harbouring vermin. Ventila- 
 tion in them is also improved. Many owners rendered 
 much assistance." 
 
 Several inquiries of the sort suggested by the Eoyal 
 Commissioners were held in the course of the ensuing years 
 and reports presented to Parliament, but it is much to be 
 doubted whether they had any effect in so inciting public 
 opinion as to make it insist on the recalcitrant local 
 authorities carrjdng the laws into effect. 
 
 Clerkenwell, Mile-End-Old-Town, Bethnal Green, and 
 Kotherhithe, were inquired into, and reported on. The tale 
 was much the same as that set forth time after time, and 
 year after year, by various Medical Officers of Health — want 
 of adequate sanitary supervision, numerous neglects by the 
 Vestries, especially the neglect to make, or, if made, to 
 enforce Regulations under the Sanitary Acts of 1866 
 and 1874. 
 
 The initiative of dealing with the existing condition of 
 things rested with the Vestries. It was forcibly pointed 
 out that complaints could hardly be expected either from 
 the owners of insanitary houses, on whom the cost of the 
 improvements would fall, or from tenants who are too often 
 indifferent to considerations of health and cleanliness, and 
 who in any case would fear to offend their landlords by 
 complaining. 
 
 Eotherhithe came in for the strongest condemnation. Of 
 it the Commissioners reported : — 
 
 " It is, in fact, no exaggeration to say that the results of 
 
334 THE SANITARY EVOLUTION 
 
 lax administration abound in Kotherhithe, and especially in 
 houses occupied by poor persons." 
 
 The increase of the sanitary staff was recommended, but 
 the obdurate Vestry resolved not to increase it. 
 
 The absolute necessity of inspection was demonstrated 
 every day of the year to every Vestry and District Board 
 in the metropolis by the results of such exceedingly limited 
 inspection as was carried out. 
 
 In St. Luke, in 1890, of 1,348 houses inspected 296 were 
 found " in fair sanitary condition." 
 
 In Hackney, in 1887, 6,213 were inspected ; 3,620 of 
 them were found to be wanting in some sanitary require- 
 ment, or were so dirty as to necessitate orders being served 
 for whitewashing and cleaning. In one street 111 houses 
 were inspected, and in 97 nuisances were found. 
 
 In St. Marylebone, in 1884, 2,136 orders were sent out 
 for repairs and various sanitary improvements. In Ham- 
 mersmith, 3,377 notices to abate nuisances were served in 
 1886. In Westminster, 1,609 notices served for sanitary 
 defects. 
 
 The Medical Officer of Health for St. Saviour, South wark, 
 reported (1890-1) :— 
 
 " The importance of house-to-house inspection may be 
 estimated by the fact that of 491 houses inspected, it was 
 found necessary in nearly every instance to serve notice for 
 the carrying out of urgent sanitary requirements." 
 
 In Camberwell there were, in 1889, between 30,000 and 
 40,000 houses in the parish, " of which probably one-half 
 should be inspected periodically." 
 
 The Medical Officer of Health of Bethnal Green stated: — 
 
 " In my district we have a population of about 130,000, 
 and about 18,000 houses, and we have two Inspectors. 
 Of course there should be periodical inspection, that is to 
 say, every house in the parish should be visited at least once 
 a year by a Sanitary Inspector, but that with the present 
 staff would be utterly impossible. In my district there is no 
 house-to-house visitation ; we simply attend to complaints 
 as we receive them, and this completely fills up the time of 
 the two Inspectors." 
 
OF LONDON 335 
 
 And he further stated * : — 
 
 " In my district the Sanitary Inspectors are not under 
 the control of the Medical Officer of Health." 
 
 It is of course manifest that if houses had not been 
 inspected, and the necessary sanitary improvements en- 
 forced, things would have gone on rapidly deteriorating, and 
 with that deterioration would have come all those causes 
 of disease which would endanger the lives of the occupants 
 and create fresh centres for spreading disease broadcast. 
 
 It might have been thought that the numerous inquiries 
 into the condition of the working classes in factories and 
 workshops would have laid bare nearly all there was to 
 lay bare. 
 
 A report to the Board of Trade on the Sweating System 
 in the East End of London, by J. Burnett in 1887, rudely 
 dispelled such an idea, and opened out to public view a new 
 vista of causes, deleteriously affecting the public health, a 
 new area of insanitation. Though the evils depicted had 
 become acuter, they evidently had been going on for 
 years. 
 
 " The system may be defined as one under which sub- 
 contractors undertake to do work in their own houses or 
 small workshops, and employ others to do it, making a 
 profit for themselves by the difference between the contract 
 prices and the wages they pay their assistants. 
 
 " The mass of those employed under the sweating system 
 labour in workshops where much fewer than 20 are engaged, 
 or in the houses which may be single rooms of the ' small 
 sweaters.' " 
 
 After referring to the numerous branches of the tailoring 
 trade, he said : — 
 
 " Immense numbers of people of both sexes and all ages 
 have rushed into the cheap tailoring trade as the readiest 
 means of finding employment. The result has been an 
 enormously overcrowded labour market, and a consequently 
 fierce competition among the workers themselves, with all 
 the attendant evils of such a state of things. . . . Matters 
 have been rendered infinitely worse by an enormous influx 
 * Lords' Committee on Sweating, P.P. 1890, vol. 17. 
 
336 THE SANITARY EVOLUTION 
 
 of pauper foreigners from other European nations. The 
 result has been to flood the labour market of the East End 
 of London with cheap labc>(|^ to such an extent as to 
 reduce thousands of native workers to the verge of desti- 
 tution. ..." 
 
 " There are, of course, in addition many English workers 
 employed in the same trade and in the same shops, but 
 their number is gradually being reduced, owing to the 
 severity of a competition in which those who can subsist on 
 least are sure to be victorious. 
 
 " The object of the sweater being his own gain, the 
 inevitable tendency of such a system is to grind the 
 workers down to the lowest possible level. . . . 
 
 " The character of the workshops, or places used as 
 workshops, varies considerably. The smaller sweaters use 
 part of their dwelling accommodation, and in the vast 
 majority of cases work is carried on under conditions in the 
 highest degree filthy and unsanitary." 
 
 " In small rooms, not more than nine or ten feet square, 
 heated by a coke fire for the pressors' irons, and at night 
 lighted by flaring gas jets, six, eight, ten, or even a dozen 
 workers may be crowded. 
 
 " The conditions of the Public Health Acts, and of the 
 Factory and Workshop Eegulation Acts, are utterly dis- 
 regarded, and existing systems of inspection are entirely 
 inadequate to enforce their provisions even if no divided 
 authority tended to weaken the hands of the Inspectors. 
 
 " Some of the shops are hidden in garrets and back rooms 
 of the worst kinds of East End tenements, and a third of 
 them cannot be known to the Factory Inspectors. 
 
 " It is in regulating the hours of the women that factory 
 inspection should be of most service, but how can two or 
 three Inspectors keep in check the multitude of sweating 
 dens of East London? Basements, garrets, backyards, 
 wash-houses, and all sorts of unlocked for and unsuspected 
 places are the abodes of the sweater." 
 
 Early in the following year Lord Dunraven, in the House 
 of Lords, moved for the appointment of a Select Committee 
 to inquire into the sweating system. 
 
OF LONDON 337 
 
 "The evils which existed there were caused by natural 
 laws which were not by any means of necessity unwhole- 
 some in any degree. . . . But his belief was that though the 
 causes were perfectly natural in themselves they had been 
 allowed to run riot, and had not been put under proper 
 control, and had thus produced the present terrible state 
 of things. . . . 
 
 ** Large workshops were the exception. In the * dens ' of 
 the sweaters there was not the slightest attempt at decency ; 
 men and women worked together for many consecutive 
 hours, penned up in small rooms and basements, garrets, 
 backyards, wash-houses, and all sorts of unlikely places, 
 were the abodes of the sweaters." 
 
 And he quoted the Chief Inspector of Factories and 
 Workshops : — 
 
 " To add to the evils of overwork pursued by these people, 
 we must note the overcrowded, ill-ventilated, and excessively 
 hot state of the workrooms ; ... it is surprising how such 
 people can live under such conditions. 
 
 " . . .It was," he said, " a ridiculous and scandalous 
 thing that Parliament should pass Factory and Sanitary 
 Acts regulating the hours of labour of women and children, 
 and that those Acts should be grossly violated." 
 Lord Sandhurst said : — 
 
 ** It might appear to their Lordships almost incredible 
 that within three or four miles of that House a state of 
 things, involving so much human misery, could possibly 
 exist as was to be found at the East End of London." 
 
 The Select Committee was appointed. The results of its 
 inquiries are stated in the next chapter. 
 
 In 1888 the local government of London underwent a most 
 notable change. 
 
 In the early part of 1887 various rumours gained 
 currency as to questionable dealings in connection with 
 the lettings of land owned by the Metropolitan Board. 
 Certain officials of the Board were mentioned. The details 
 do not fall within the history of the sanitary evolution of 
 London, except so far as they affected the central governing 
 authority of London. The allegations made received in- 
 
 23 
 
338 THE SANITARY EVOLUTION 
 
 creasing confirmation, and early in 1888 a Royal Commission 
 was appointed to inquire into and thoroughly sift them, and 
 early in May the Commission held its first sitting, the 
 Metropolitan Board affording every facility for the thorough 
 investigation of the matter. 
 
 Before that time, however — namely, in March — the 
 Government had introduced into the House of Commons its 
 proposals as regarded the local government of England and 
 Wales generally ; and the opportunity was taken to deal 
 with the great problem of London government which had 
 so long vexed and perplexed successive governments, and 
 which was becoming more and more insistent as years went 
 on, and London was accordingly included in the general 
 scheme. 
 
 By the measure now introduced London was to be 
 created — not a Corporation, nor a Municipality, but a 
 County — with a Council as the governing authority of the 
 County. 
 
 Mr. Eitchie, introducing the Bill into the House of 
 Commons, said * : — 
 
 " We cannot shut our eyes to the fact that whereas every 
 other borough in the country possesses a body directly 
 representing the ratepayers, no such body exists in London. 
 " There is no one elected by, or responsible to the rate- 
 payers. 
 
 " We propose to take London, as defined under the Metro- 
 polis Management Act, out of the counties of Middlesex, 
 Surrey, and Kent, and we propose to create it a County of 
 London by itself, with a Lord Lieutenant, a Bench of 
 Magistrates, and a County Council of its own. 
 
 " We propose that the Council shall be directly elected by 
 the ratepayers, as in all other counties and boroughs — that 
 the franchise shall be the same— and that it shall consist, 
 as in all other cases, of elected and selected members ; th^ 
 elected members sitting for three years, the selected foi: 
 six years (one-half of their number retiring every three 
 years). 
 
 ** It will take over the licensing powers and all the duties 
 ■r- Hansard, p. 1663, March 19, 1888. 
 
OF LONDON 339 
 
 of the Metropolitan Board of Works, which will cease to 
 exist." 
 
 The " City " of London was to be allowed to retain its 
 separate existence within the new County, together with 
 its ancient privileges and immunities for the most part 
 unaltered and untouched. 
 
 The Bill developed into an Act, which created a new 
 central authority for London, under the title of the London 
 County Council. 
 
 The area of the new " Administrative County " of London 
 was made co-extensive with that of the former district of 
 the Metropolitan Board of Works. 
 
 And to the new Authority was transferred the powers, 
 duties, and liabilities of the Metropolitan Board of Works ; 
 and to those were added functions much wider and more 
 extensive than those of that Board. 
 
 The Act also conferred upon the Council the power of 
 appointing a Medical Officer of Health for the County, and 
 additional powers of making bye-laws. 
 
 It did not, however, materially interfere with the 
 Vestries and District Boards, nor did it alter their rela- 
 tion to the Central Authority. Practically it left them 
 untouched. 
 
 The Council was to consist of 137 members, of whom 
 118 were to be elected triennally by direct election in the 
 various metropolitan constituencies, and 19 to be elected by 
 the Council itself as Aldermen. 
 
 Finally, the Act set a limit to the existence of the Metro- 
 politan Board of Works. 
 
 While the Bill was going through Parliament the Eoyal 
 Commission had been pursuing its inquiry into the allega- 
 tions made against that Board, and had ascertained that 
 several of the officials had been carrying on — 
 
 "... A nefarious course of proceeding by which they 
 had been able to obtain for themselves large sums of money 
 out of dealings with the Board's land." 
 And that — 
 
 "... Two of the members of the Board in the archi- 
 tectural profession had availed themselves of their repre- 
 
340 THE SANITARY EVOLUTION 
 
 sentative position to make personal profit out of some of the 
 business which came before them." 
 
 Under the growing disfavour with which public authorities 
 were regarded who were only indirectly elected, and so not 
 amenable to the influence or control of the electorate, it is 
 improbable that the existence of the Metropolitan Board of 
 Works would have been much prolonged. But it was an 
 unfortunate ending to a great public body which had done 
 really great service to London. 
 
 Its own final words * may be quoted in its defence : — 
 
 "It has been a source of pain and sorrow to the Board 
 that, at the close of thirty-three years' administration of the 
 local affairs of London, which has been attended with at least 
 some measure of success, and in the course of which the 
 Board has carried out some of the greatest works of public 
 utility of which any city can boast, its good name has during 
 the last year of its existence been sullied by iniquitous pro- 
 ceedings of which, though carried on in its midst, its 
 members as a body were entirely without knowledge. It is 
 some satisfaction to remember, however, that a body of 
 Commissioners, who in a judicial spirit made the most 
 searching inquiry into the Board's proceedings, were able, 
 while exposing the wrong-doings which were revealed to 
 them, and justly distributing the blame, to speak of the 
 Board, as they do in their report, in the following terms : — 
 
 " ' It has had a multitude of duties to perform, and very 
 great works have been constructed by it, which have trans- 
 formed the face of some of the most important thoroughfares 
 of the metropolis. And there has hitherto been no evidence 
 that corruption or malpractice has affected or marred the 
 greater part of the work which it has accomplished. The 
 same may be said, too, in relation to the conduct of the vast 
 majority of the members of the Board. We have received 
 very numerous communications, some anonymous, some 
 bearing the signature of the writers, impugning the action 
 of the Board and certain of its members, but against the 
 vast majority of them not even a suspicion of corruption or 
 misconduct has been breathed. We believe that many 
 '''■ See the last Report of the Board. 
 
OF LONDON 341 
 
 members of the Board have cheerfully given for the public 
 good much valuable time, and have rendered most important 
 public services.' " 
 
 The change in the constitution, nature, and character of 
 the central authority of London effected by the Act was 
 momentous and far-reaching. 
 
 Instead of an indirectly elected body such as the Metro- 
 politan Board of Works, over which the inhabitants of 
 London had practically no control, there was brought into 
 being a body directly chosen by an electorate of nearly half 
 a million of the ratepayers of the metropolis, responsive to 
 the views and desires of the electorate, endowed with the 
 great authority derived from its representative character, 
 and entrusted with the carrying out of the views and policy 
 of London as one great city. 
 
 London had been unified and welded together into one 
 whole by the constitution of its new central authority ; for 
 the first time in his history it had been given a voice — the 
 voice of one great city — and though much remained to be 
 done before its entrance into its full rights as one city — and 
 that the greatest which has ever existed in the world — the 
 idea had been born, and had been embodied in the statutes 
 of the realm that London was one great city, and not a mere 
 conglomeration of petty jarring authorities. 
 
 The first election of councillors took place on January 17, 
 1889. 
 
 The first meeting of the Council took place on the 21st of 
 March, when the Earl of Bosebery was elected Chairman, 
 and the Council entered energetically on the work lying 
 before it. 
 
 The sanitary evolution of London was vitally involved in 
 the change, but it was at once discovered that the powers 
 of the Council relating to the public health of London were 
 of a very limited and unsatisfactory nature. 
 
 Matters concerning it were regulated by the Metropolis 
 London Management Act and a large number of other Acts, 
 the execution of which was in the hands of the Vestries and 
 District Boards. 
 
 These bodies were practically uncontrolled, and no 
 
342 THE SANITARY EVOLUTION 
 
 machinery existed for securing any uniformity of adminis- 
 tration in the different parts of the county. 
 
 And even the Metropolitan Board had not used certain 
 powers it possessed of making bye-laws for certain sanitary 
 purposes. 
 
 " We cannot," reported the Sanitary Committee of the 
 Council, "too strongly emphasise our opinion that the 
 London County Council should be empowered to frame bye- 
 laws for the proper sanitary government of London, that 
 the new or existing local bodies should put them m force, 
 and that the County Council should be the supervising body 
 to see that they are properly carried out." 
 
 A somewhat similar report was made by the Housing of 
 the Working Classes Committee. 
 
 " The Committee," they said, "feels that until the law is 
 strengthened, and fuller powers to enforce the law are placed 
 in the hands of the Council, its action in dealing with 
 insanitary areas will be of an imperfect character." 
 
 The question of the housing of the poor in London was at 
 once energetically taken up by the new body. 
 
 Representations were made to the Government as to the 
 necessity of the Acts relating to the housing of the working 
 classes being consolidated and amended. 
 
 Consequent upon this, the Government introduced a Bill 
 which was passed — " The Housing of the Working 
 Classes Act, 1890,"* which repealed and codified fourteen 
 enactments, all having for their object the improvement of 
 the dwellings of the artizan and labouring classes, and the 
 clearing away of unhealthy areas. Very large powers were 
 placed in the hands of the Council and of the district autho- 
 rities to secure the better housing of the working classes. 
 And the Act may be said to mark a new era in the history of 
 reform in the matter of insanitary areas, giving full power to 
 the Council as a central authority to enforce its provisions. 
 
 Before the end of this decade Parliament passed two other 
 
 Acts of great advantage to the health of London. One was, 
 
 " The Infectious Diseases Notification Act, 1889," making 
 
 the notification of certain specified diseases compulsory in 
 
 =;= 53 & 54 Vic, cap. 70. 
 
OF LONDON 343 
 
 London — smallpox, cholera, diphtheria, membraneous croup, 
 erysipelas, scarlet fever, typhus, and other fevers. 
 
 In accordance with well-worn usage London had been left 
 behind in this matter. Other cities and even towns had, by 
 means of local Acts, secured the advantages of such legisla- 
 tion long before. So far back as 1874, indeed, machinery 
 had been in existence in London for the notification of 
 infectious disease in houses let in lodgings. But owing to 
 the neglect of the majority of the Vestries and District Boards 
 to make or enforce regulations under the Sanitary Act of 
 1866, that machinery was left unused to the great detriment 
 of the people of London. Thousands of lives must have 
 been sacrificed by this neglect, and innumerable cases of 
 preventable disease not prevented. It was not until a 
 general Act was passed that London became possessed of 
 the advantages resulting from such notification. 
 
 In London, indeed, the health of cattle was better looked 
 after in this respect than that of the people, for cases of 
 infectious disease in cattle had to be notified to the Sanitary 
 Authorities. 
 
 By this Act it was made compulsory on medical attendants 
 to certify, and on householders to notify, the existence of 
 any of these diseases. 
 
 Hitherto information as to infectious illness only reached 
 the Medical Officer of Health after a sufficient time had 
 elapsed to allow of the spread of the infection. 
 
 The results of the Act of 1889 were soon found to be very 
 beneficial in checking the spread of disease. 
 
 The receipt of the notices of infectious diseases led to the 
 more prompt and general disinfection of premises where 
 infectious diseases prevailed, and led also to the discovery 
 of sanitary defects which might not otherwise have been 
 discovered. 
 
 The information, moreover, kept the Medical Officers of 
 Health informed of the progress of disease not only in their 
 own districts, but also in contiguous ones, and so assisted 
 them to take prompt measures for the eradication of disease 
 in their respective districts. 
 
 The other measure which passed the legislature in this 
 
344 THE SANITARY EVOLUTION 
 
 same year contained provisions of the highest importance 
 as affecting the metropolis. This was " the Poor Law Act, 
 1889." 
 
 Until 1889 patients could be admitted only to the in- 
 fectious hospitals of the Metropolitan Asylums Board on the 
 order of the Relieving Officer and District Medical Officer, 
 so, except in certain cases, the hospitals were only open to 
 Poor Law cases. 
 
 This measure made practical concession of two principles. 
 Free admission to the hospitals of the Metropolitan Asylums 
 Board of sick persons in need of isolation, and devolution 
 upon the Metropolitan Poor Fund of all charges incurred in 
 the maintenance of the sick in those hospitals. 
 
 The Managers were, therefore, enabled to admit other 
 than pauper patients reasonably believed to be suffering from 
 fever, smallpox, or diphtheria. 
 
 The system was attended with the happiest results in 
 reducing the amount of infectious disease in the metropolis, 
 and proved a great boon to all classes of the community. 
 
 The Board in its annual report wrote : — 
 
 " The Managers are now, for the first time since the 
 establishment of the Board in 1867, virtually recognised as 
 the Metropolitan Authority for the provision of accommoda- 
 tion for the isolation and treatment of infectious disease — 
 both pauper and non-pauper — and are now empowered to 
 legally perform duties which the Legislature had imposed 
 on the District Sanitary Authorities, but which the 
 Managers had hitherto been called upon to perform in con- 
 sequence of the failure of most of such Authorities to provide 
 accommodation for non-pauper patients." 
 
 The Managers by this date had increased the accommoda- 
 tion for patients afflicted with any of these infectious 
 diseases. There were six fever hospitals, 2,463 beds ; 350 
 beds in smallpox hospital ships ; and 800 beds in the hospital 
 for convalescing smallpox patients. 
 
 One other Act* deserves mention before the close of this 
 decade as it contained an unique section which required the 
 Medical Officer of Health, on notice from the owner of 
 
 ■'• The Customs and Inland Eevenue Act, 1890, 53 & 54 Vic. cap. 8. 
 
OF LONDON 345 
 
 property in which there are separate dwellings let for 7s. 6d. 
 or less a week, to visit them and examine all their sanitary 
 arrangements, &c., so as to he able to certify or not — 
 
 "That the house is so constructed as to afford suitable 
 accommodation for each of the families or persons inhabiting 
 it, and that due provision is made for their sanitary require- 
 ments." 
 
 The certificate, if granted, was to be handed to the owner, 
 who was then able to obtain the remission of the inhabited 
 house duty. 
 
 The owner, therefore, obtained a remission of taxes to 
 which he was justly liable, because the dwelling which he 
 lets was in a sanitary condition ! 
 
 In many ways, then, the sanitary evolution of the great 
 city was developing satisfactorily, though by no means so 
 rapidly as was to be desired, or as it might have developed if 
 local governing authorities had done their duty. 
 
 " The war of the community against individuals for the 
 public good," which had now lasted for over thirty years, 
 and the war against disease in its most dangerous forms, was 
 being waged with good effect ; and though an immensity 
 remained to be done, a great deal had been accomplished. 
 Larger numbers of all classes were beginning to grasp the 
 idea and to realise that the necessity of securing and 
 guarding the public health was not a craze or form of 
 mental aberration, but was of absolutely vital consequence, 
 not merely to certain classes but to the great community of 
 the metropolis and to the nation itself, and that the future 
 welfare and power, even the very existence, of the nation 
 are dependent upon it. 
 
 Larger numbers, too, were beginning to see who really 
 were responsible for the widly prevalent evils, and who really 
 were obstructing progress towards a higher standard of 
 public health, and how little claim they had to considera- 
 tion, either from the hands of the Legislature or of local 
 administrators. 
 
 The reports of the Medical Officers of Health of the 
 latter part of this decade were distinctly more hopeful in 
 tone, and recorded more progress than ever before. 
 
346 THE SANITARY EVOLUTION 
 
 The catalogue of things in which improvement had taken 
 place had lengthened — sewerage, water supply, the removal 
 of refuse, paving, the regulation of offensive businesses, of 
 cowhouses, dairies, and bakehouses, the provision of open 
 spaces, the better disinfection of houses and of infected 
 articles, the erection of hospitals for the isolation of cases 
 of infectious diseases — all of which things were elemental 
 necessaries if the public health was to be assured. 
 
 In some parishes, in place of the smaller class of houses, 
 great blocks of artizans' dwellings had been erected. In 
 others great blocks of flats. 
 
 With the increased wealth of the population finer 
 buildings had been erected in many districts. London 
 had grown enormously in wealth, and the wealth showed 
 itself in finer public buildings and private houses. The 
 District Board of Westminster, for instance, said in their 
 report for 1885-6 :— 
 
 " Whether viewed as to its character, its statistics, its 
 topography, or its sanitary condition, the change which 
 Westminster has undergone in thirty years can only be 
 described as a complete transformation." 
 
 " In the St. Margaret's portion, whole streets of fine 
 houses which were occupied by the nobility and the 
 wealthy for residential purposes are now let out in oflS.ces 
 for the transaction of legal, scientific, or mechanical business, 
 while narrow streets, wretched courts, and melancholy 
 homes of squalid poverty and misery have been replaced 
 by 'mansions,' ' flats,' &c. ; and on the other hand by huge 
 blocks of artizans' dwellings, comprising upwards of 1,200 
 homes." 
 
 The Education Act was indirectly producing some good 
 results as regarded the health of the rising generation. 
 
 A most marked improvement had come over the mortality 
 of children at school ages. Mortality has lessened — 
 
 5-10 years 30 per cent. 
 10-15 „ 32 „ 
 15-20 „ 30 „ * 
 
 * See speech by Sir L. Playfair in House of Commons, March 4, 1884. 
 -Hansard, p. 529. 
 
OF LONDON 347 
 
 due to the fact that children had been gathered into the 
 schools from their crowded and insanitary homes, and had 
 thus escaped some of the perils of disease. 
 
 And the Medical Officer of Health for Lambeth referred 
 to this same subject in his report for 1886 : — 
 
 " The children of the pauper and mendicant are with- 
 drawn from the atmosphere of vice and intemperance to 
 which their fathers had become acclimatised, and are placed 
 under supervision in the schoolroom. . . ." 
 
 Some slight improvement there was also as regarded the 
 mortality of children under five years, though in many 
 parishes it was still fearfully high. 
 
 In Mile-End-Old-Town, for instance, in 1890 the 
 deaths under five years amounted to 51 per cent, of all 
 deaths. In Deptford district in 1890-1 they amounted to 
 50 per cent. In Bermondsey in 1889 they amounted 
 to 52 per cent. In St. Olave, Southwark, in 1888-9 to 
 49^ per cent. In St. Mary, Newington, in 1890, very 
 slightly under 50 per cent. 
 
 Infantile mortality was becoming of greater concern than 
 ever as the birth-rate was showing a decided diminution — 
 that for 1889 being the lowest on record since 1849. 
 
 Though the tables as to death-rate in many of the parishes 
 were still more or less vitiated by various local circumstances, 
 there was considerable unanimity that the death-rate was 
 falling and the public health better. Some diseases which 
 had previously claimed their victims by thousands, now only 
 claimed them by hundreds. Death from tubercular disease 
 had steadily fallen, and the mean death-rate from phthisis 
 in London showed a very satisfactory decrease between 
 1861-70 and 1881-^0.* 
 
 The Lancet of January, 1887, stated that, measured by 
 its recorded death-rate, London was healthier in 1887 than 
 in any year on record. 
 
 In the Strand in 1886 :— 
 
 " The efforts that have been made by the Board and its 
 officers have resulted in a marked and continuous improve- 
 ment in the sanitary state of the district." 
 
 ''''■ See Eeport from Royal Commission on Tuberculosis, 1898. 
 
348 SANITARY EVOLUTION OF LONDON 
 
 In St. Pancras in 1888 the death-rate was ** by far the 
 lowest yet recorded." 
 
 In Bermondsey, in the same year, ** so few deaths have 
 not occurred since 1865." 
 
 These and similar reports from other districts showed 
 that sanitary progress was being made. But, unfortunately, 
 in the autumn of 1888 there was an epidemic of measles of 
 exceptional severity, which raised the death-rate. And in 
 1890 there was a sudden increase from 18*4 per 1,000 to 21*4, 
 a mortality which was higher than any since 1882. 
 
 The increase served to show the great necessity there was 
 for unceasing watchfulness and for steady perseverance in 
 sanitary work. The forces of disease are ever on the watch 
 for the opportunity to work their evil will, and there were 
 still many weak places in the defences against them. The 
 central government of London had been improved enor- 
 mously, but the corrective was not extended to where it was 
 most wanted, namely, the local Sanitary Authorities, the 
 Vestries and District Boards. 
 
CHAPTEE VI 
 
 1891-1901 
 
 In 1891 the census once more gave authoritative figures as 
 to the population of the metropoHs of London. The 
 population had increased from 3,830,297 to 4,228,317. 
 
 The increase had been in a somewhat lower ratio than the 
 population of England and Wales as a whole, and the fact 
 was notable inasmuch as it was the first time that such a 
 phenomenon had presented itself, London having been 
 found in every preceding intercensal period to have gained 
 more or less in its proportions as compared with the country 
 at large. 
 
 The movements of population had followed very much the 
 same lines as in the previous decade. In the central parts — 
 under the pressure of the great economic forces — the popula- 
 tion had increased. In the outer parts it had increased, but 
 " the wide belt of suburbs was beginning to show some 
 signs of repletion." 
 
 Immigration into London had greatly diminished in the 
 decade. Fewer immigrants had come from the various 
 counties of England and Wales, and the proportion of the 
 inhabitants of London who had been born elsewhere had 
 fallen from 308 persons per 1,000 in 1881 to 283 in 1891. 
 
 Thus the influx of country people, mostly in the prime of 
 life, and the admixture of fresh country blood into the urban 
 population of London was undergoing diminution — a cir- 
 cumstance which, in the long run, would materially influence 
 the physique of the people. 
 
 Three important facts came into view with the figures set 
 
 349 
 
350 THE SANITARY EVOLUTION 
 
 out in the census, giving food for thoughtful minds as 
 regarded the future of London. 
 
 The first was that the rate of increase of the population 
 had again slackened off. The flood tide of population was 
 not now flowing so fast. 
 
 The second was that the population was heing affected by 
 migration. The natural increase of the population had been 
 510,384, the actual increase 396,199 — so that London had 
 lost by the excess of emigration over immigration more 
 than 114,000 persons. This was the first time such an event 
 had happened. 
 
 London's boundaries, however, were very arbitrary and 
 haphazard, and this emigration was probably only to places 
 immediately outside London for residence at night, whilst 
 work was performed in London during the day — as illus- 
 trated by the " City " and the Strand, where huge differences 
 existed between the day and night populations. The figures 
 showed, however, a movement of population which was 
 bound to have an effect upon the sanitary condition of the 
 people. 
 
 A third and portentous fact, ascertained correctly by aid 
 of the census figures, was the decline of the birth-rate in 
 London. This had fallen remarkably since 1881. It was 
 then 34"7 per 1,000 living. It was now 81"9. 
 
 Deducible from the census figures, reliable calculations 
 could also be made as to the death-rate in the metropolis. 
 
 In 1891 it was practically the same as in 1881, being 21*4 
 per 1,000. It might be inferred that these latter figures did 
 not afford much testimony to the effects of sanitary adminis- 
 tration and labours, but the pause in the steady decline was 
 only a temporary one. 
 
 The authoritative and accurate records thus afforded 
 decennially by the census are invaluable in tracing some of 
 the most important developments in the sanitary evolution 
 of London. 
 
 Another very noteworthy change was also brought into 
 prominence by the census. This was the continued rapid 
 growth of the population immediately outside the boundaries 
 of the County of London. 
 
OF T.ONDON 351 
 
 Between 1871 and 1881 it had increased 312,000. Be- 
 tween 1881 and 1891 it had increased by 469,000, and now 
 in 1891 it stood at 1,405,000, having more than doubled 
 since 1871. 
 
 A passage in the report of the Medical Officer of Health 
 for Islington in 1895 illustrates this so far as his own 
 district was concerned : — 
 
 " The fact cannot be burked that many of the better 
 classes have gone further into the country to live, induced 
 to do so by the increased facilities for travelling that rail- 
 ways have provided. . . The same facilities have also 
 checked the influx of people to the same extent as formerly, 
 so that now in northern London people are flocking to 
 Hornsea and Hampstead and thereaway." 
 
 The fact was that the metropolis had burst its boundaries, 
 and just as it had grown up around the " City " so now the 
 " outer ring," as it was called, was growing up around it. 
 
 How little reliance could be placed on the intercensal 
 estimates of Medical Officers of Health as to the number of 
 inhabitants and the death-rate, is illustrated by the following 
 passage from the report of the Medical Officer of Health for 
 Islington in 1891 : — 
 
 " There was an error amounting to nearly 50,000 in the 
 estimated population of the parish in 1891 ; consequently all 
 statistics based on the estimated figures during the decade 
 1881-91 are more or less erroneous." 
 
 Also " the mortality returns were not kept in such a 
 manner as to lead to accuracy, for while all deaths of non- 
 residents were excluded, the deaths of residents dying out- 
 side the district in similar institutions were not included. 
 
 " It is impossible to make an accurate statement as to the 
 correct meaning of the mortality returns — the returns are 
 erroneous." 
 
 A similar miscalculation' was made by the Vestry of St. 
 George, Hanover Square. In their report for 1890-1 they 
 stated that they had no reason to believe that the population 
 was much different from what it was in 1871 and 1881. 
 The census, however, showed that it had fallen over 11,000. 
 
 In each successive census the number of inhabited houses 
 
352 THE SANITARY EVOLUTION 
 
 in London was enumerated. In this one the number was 
 547,120— being an increase of nearly 60,000 ; but not much 
 instruction was to be obtained from such general figures 
 beyond the fact that houses were becoming more and more 
 densely packed. 
 
 The substitution of blocks of dwellings for small houses 
 had also made considerable progress during the intercensal 
 period.* 
 
 The same reasons as to the diminution of the number of 
 houses in the central parts of London continued to be given 
 by Medical Officers of Health. 
 
 In St. George-in-the-East it had been brought about " by 
 the extension of warehouses and the demolition of insanitary 
 property." In St. Martin-in-the-Fields it was " due to 
 many former residents having removed to the country, and 
 to the demolition of so many houses for improvements." In 
 the Strand to the fact that the district was becoming like all 
 the central parts of London, "a business, as distinguished 
 from a residential district." The Vestry of St. James' 
 reported that "buildings formerly occupied as dwellings 
 were being replaced by warehouses and business premises 
 commanding a higher rent. As the centre of trade extends, 
 this condition of things must be expected to continue, just 
 as the increasing volume of trade has converted the City of 
 London at night from a populous place to little more than a 
 city of caretakers," and they drew attention to the " enormous 
 number of people engaged in business in the parish during 
 the day time who resided elsewhere." 
 
 On the south side of the river the same story was told. 
 The Medical Officer of Health for Lambeth remarking in 
 his report that — 
 
 " The displacement of population from the central districts 
 of Lambeth, and the settlement of population in those 
 districts which are situated in the outer ring, or on the 
 circumference of the inner, is a part of a greater move- 
 ment which affects the whole metropolitan area." 
 
 The census of 1891 is specially memorable by the fact 
 that for the first time a mass of most valuable information 
 
 * See General Eeport of Census Commissioners, P.P. 1904, vol. cviii. 
 
OF LONDON 353 
 
 was obtained which was wholly new, and which threw a 
 blaze of light upon the condition of the housing of the 
 population of London. 
 
 For the first time full details were obtained and published 
 as to the numbers of the people living in tenements of less 
 than five rooms and the numbers and character of the tene- 
 ments they lived in. 
 
 A tenement was defined as " any house or part of a house 
 separately occupied either by the owner or by a tenant." 
 
 These tenements were classified into those of one room, 
 two rooms, three rooms, and four rooms ; and the number of 
 persons inhabitating each of these classes of tenements was 
 given. 
 
 The nearest approach to information of this sort had been 
 given by Mr. Marchant Williams in 1884, but it was only 
 for a particular area in London. The information now given 
 related to the whole of London. 
 
 The total number of tenements in London in 1891 was 
 stated to be 937,606. 
 
 Of these, 630,569 were tenements of less than five rooms. 
 And of these — 
 
 172,502 were tenements of one room. 
 189,707 „ „ two rooms. 
 
 153,189 „ „ three „ 
 
 115,171 „ „ four „ 
 
 An examination of the detailed figures revealed some 
 astounding facts. 
 
 In the central group of parishes and districts, in the 
 parish of St. Luke 21,937 persons, or over one-half of the 
 population, lived in tenements of one or two rooms ; in 
 Clerkenwell, over 33,000 persons ; and in Holborn, over 
 16,000 — practically one-half. 
 
 In the eastern group, in Whitechapel, close on 33,000 
 people, or over 44 per cent., lived in tenements of one or 
 two rooms. In Shoreditch, over 50,000, or 40 per cent.; in 
 Bethnal Green, 45,000 persons, or 38*4 per cent. ; in St. 
 George-in-the-East, 43 per cent, of the population. 
 
 In the northern group, in St. Pancras 95,000, or over 40 
 per cent., lived in tenements of one or two rooms ; and in 
 
 24 
 
354 THE SANITARY EVOLUTION 
 
 one district of the Parish, namely Somerstown, 57 per cent, 
 of the population were living in such tenements. In St. 
 Marylebone over 58,000 lived in such tenements. 
 
 In the western group over 173,000 persons lived in tene- 
 ments of one or two rooms. 
 
 And on the south side of the Thames, in Bermondsey 
 close upon 24,000 lived in tenements of one or two rooms ; 
 in Camberwell, 30,000 ; in Lambeth, 61,000 ; in Newington, 
 31,000 ; in St. Saviour over 41 per cent., and in St. George- 
 the-Martyr 26,000, or over 43 per cent. 
 
 And examining the numbers of persons living in one-room 
 tenements, it appeared that in Chelsea one-tenth of the 
 population lived in such tenements; in St. Marylebone 
 somewhat less than a sixth ; in Holborn a fifth ; and in St. 
 George-in-the-East between a fourth and a fifth. These 
 figures show how large a proportion of the population began, 
 spent, and ended their existence within the four walls of a 
 single-room tenement. 
 
 The total result shown was that in the metropolis 
 1,063,000 persons, or one quarter of the population, lived in 
 one- or two-room tenements, and 1,250,000 in three- or four- 
 room tenements ; making a total of over 2,310,000, or well 
 over half of the population living in tenements of less than 
 five rooms. 
 
 Of still deeper interest and import was the information 
 obtained as to that dreadful factor in London life — " over- 
 crowding." An effort was now for the first time made to 
 get reliable information upon this matter. Hitherto it was 
 only by piecing together the statements made by some of the 
 Medical Officers of Health as to overcrowding in their 
 respective parishes that one could form even the crudest 
 idea of what the sum total in London actually amounted to. 
 
 Here, at last, was material enabling accurate calculations 
 to be made, not only of overcrowding in each separate 
 parish or district, but in London as a whole. 
 
 The Census Commissioners laid down the principle — 
 
 "That ordinary tenements which have more than two 
 occupants per room, bedrooms and sitting-rooms included, 
 may be considered as unduly overcrowded. 
 
OF LONDON 355 
 
 " We may," they wrote, " be tolerably certain that the 
 rooms in tenements with less than five rooms will not in 
 any but exceptional cases be of large size, and that ordinary 
 tenements which have more than two occupants per room, 
 bedrooms and sitting-rooms included, may safely be con- 
 sidered as unduly overcrowded." 
 
 By using the information given in the tables, and exclud- 
 ing all one-roomed tenements with not more than two 
 occupants, all two-roomed tenements with not more than 
 four occupants, all three-roomed tenements with not more 
 than six, and all four-roomed tenements with not more than 
 eight occupants, the desired information would be obtained. 
 And they added : — 
 
 " Each Sanitary Authority is now provided with the means 
 of examining with much precision into the house accommo- 
 dation of its district." 
 
 Provided with the tables as to the occupants of tene- 
 ments, the Medical Officer of Health for the London County 
 Council, in his report for 1891, worked out the figures 
 for the metropolis. The result showed that there were in 
 London 145,613 tenements of less than five rooms apiece, in 
 each of which there were more than two inhabitants per 
 room, and each of which consequently was " overcrowded." 
 
 But it is when one ascertains the number of persons 
 living in these overcrowded tenements that one realises 
 what the extent of overcrowding was. In round numbers, 
 one-fifth of the entire population of London lived in these 
 tenements. The total population was 4,200,000 ; the 
 number of "overcrowded" persons was 830,000. 
 
 A few illustrations of the overcrowding in certain parishes 
 brings the meaning of these figures home still more. 
 
 In Clerkenwell, 25,600 persons lived in overcrowded 
 tenements ; in St. Luke, 18,700 persons ; in Shoreditch, 
 41,700; in Islington, 64,600; in Kensington, 28,700; in 
 Lambeth, 43,600. The larger proportion of these lived 
 in one- or two-room tenements. 
 
 Figures are dry things to read and difficult to understand. 
 To appreciate the true meaning and import of these, and 
 to enable one who reads them to at all realise the conditions 
 
356 THE SANITARY EVOLUTION 
 
 of existence of these hundreds of thousands of people, one 
 must recall to mind the descriptions given by many of the 
 Medical Officers of Health of tenement-houses; of all the 
 misery, the filth, the sickness, the physical and moral 
 degradation of life in tenement-rooms. 
 
 These facts now for the first time revealed the full 
 magnitude and momentous nature of the problem of the 
 sanitary housing of the people. 
 
 The year 1891 is memorable in the history of the sanitary 
 evolution of London for " the Public Health (London) Act, 
 1891," * V7hich consolidated and amended the laws then 
 existing in connection with the public health of the 
 metropolis. 
 
 The state of the law was recognised as very unsatisfactory, 
 being scattered over some thirty statutes or more — a con- 
 dition of things which was greatly to the disadvantage of 
 the public health of London. 
 
 Moreover, in accordance with the extraordinary custom, 
 London, which on account of its huge population needed 
 sanitary legislation almost more than any other place, had 
 been excepted from much sanitary legislation which had 
 been in operation for many years, with the most beneficial 
 results, in the remainder of the country. Part of this 
 legislation was at long last extended to London. Many 
 amendments were made, recommendations of the Eoyal 
 Commission of 1884 were given effect to, new provisions 
 introduced, and the general result was a Sanitary Code 
 for London — imperfect still in some important respects, but 
 a great advance on anything which London had previously 
 possessed. 
 
 The Act came into operation on the 1st of January, 1892, 
 and it applied to the Administrative County of London 
 only; some few of the provisions extending to the "City." 
 
 And for the first time the new Central Authority — the 
 County Council — with extended powers, occupied a promi- 
 nent place in this legislation. 
 
 Once more did Parliament enact the oft-ignored direction 
 
 ■'• See speech of the President of the Local Government Board, Mr, 
 Ritchie, in introducing the Bill in April. Hansard, 1891, vol. ccclii. 
 
OF LONDON 367 
 
 that " it shall be the duty of every sanitary authority to 
 cause to be made from time to time inspection of their 
 district " for detection of nuisances — a duty so shamelessly 
 neglected — and " to put in force the powers vested in them 
 relating to public health and local government so as to 
 secure the proper sanitary condition of all premises in their 
 district." 
 
 With a view to secure fit and proper persons as Medical 
 Officers of Health and Sanitary Inspectors, their appointment 
 was made subject to the regulations of the Local Govern- 
 ment Board, 
 
 The Act greatly strengthened the law both as to the pre- 
 vention and definition of nuisances. It provided for the 
 immediate abatement of a nuisance, not only where actually 
 proved to be injurious or pre judical to health, but also where 
 it was dangerous to health. It gave to any person the right 
 to give information of nuisances to the sanitary authority 
 instead of that right being limited to the person affected 
 by the nuisance ; and it extended to a Sanitary Authority 
 the power to take proceedings for the abatement of nui- 
 sances arising in the district of another authority should 
 the nuisance injuriously affect the inhabitants of their own 
 district. It transferred from the police to the local authority 
 the enforcement of the provisions of the law against smoke 
 nuisances. It dealt with the removal of refuse. It ex- 
 tended the previous laws as to the adulteration of food and 
 drugs, and the inspection of articles intended for the food 
 of man. It enacted that a newly-erected dwelling-house 
 must not be occupied until a certificate had been obtained 
 of the Sanitary Authority to the effect that a proper and 
 sufficient supply of water exists ; and made the provisions 
 as to the occupation of underground rooms as dwellings 
 more stringent and effective. 
 
 The notification and prevention of the infectious and 
 epidemic diseases, the provision of hospitals, ambulances, 
 and many other branches of the great subject — the health 
 of the public — were legislated upon. Additional duties 
 were imposed on the Sanitary Authority in the matter of 
 disinfection; the practical result of which was that the 
 
358 THE SANITARY EVOLUTION 
 
 whole cost of disinfecting houses, and cleansing and dis- 
 infecting bedding, clothing, &c., was thrown upon the rates. 
 In several matters the option given in previous legislation 
 to local authorities to administer the law was taken away, 
 and the duty made imperative. Parliament evidently had 
 realised the hostility of many of the Vestries to administer- 
 ing some of the principal provisions of sanitary law, and the 
 word " shall " figured much more frequently than ever 
 before. 
 
 The hitherto optional provision of mortuaries by the 
 sanitary authorities was made compulsory, the need for 
 suitable and convenient places for the reception of the dead 
 during the time that bodies are awaiting burial having long 
 been felt, particularly in the poorer districts, where bodies 
 awaiting burial were of necessity frequently kept in living 
 rooms under conditions dangerous to health, especially 
 where the case was an infectious one. 
 
 Among these " shalls " was that most important of all 
 health subjects — overcrowding — and the condition of the 
 tenement-houses of London. In this matter the local 
 authorities had through a quarter of a century been tried 
 in the balance and found wanting, and it was enacted 
 (Sec. 94) :— 
 
 " Every Sanitary Authority shall make and enforce such 
 bye-laws as are requisite for the following matters (that 
 is to say) : (a) for fixing the number of persons who may 
 inhabit a house, or part of a house, which is let in lodgings ; 
 (6) for the registration of houses so let or occupied ; (c) for 
 the inspection of such houses ; . . . {d) for enforcing 
 drainage for such houses, and for promoting cleanliness and 
 ventilation in such houses ; (e) for the cleansing and lime- 
 washing at stated times of the premises ; (/) for the taking 
 of precautions in case of any infectious disease." 
 
 In another matter, which the Vestries had long opposed, 
 their hostility was overborne. They were now required to 
 appoint " an adequate number of fit and proper persons as 
 sanitary inspectors," and, in case of their failure to do so, 
 the Local Government Board was enabled, on the complaint 
 of the Council, to order the appointment of a proper number. 
 
OF LONDON 359 
 
 The new Central Authority, directly representative of the 
 whole of London, was not constituted the chief sanitary 
 authority for London, nor even a sanitary authority. It was 
 given power to make bye-laws for the prevention of nuisances 
 of various sorts in London, except as regarded the " City," 
 to license cow-houses, and slaughter-houses, to appoint 
 Inspectors to inspect them, and also dairies and milkshops, 
 and it could extend the number of infectious diseases to 
 be notified. 
 
 But most important of all was the power given to the 
 County Council (by Section 100), which enacted, on it being 
 proved to the satisfaction of the Council, that any Sanitary 
 Authority (except the Commissioners of Sewers of the City) 
 had made default in doing their duty under this Act with 
 respect to the removal of any nuisance, the institution of 
 any proceedings, or the enforcement of any bye-laws, the 
 Council might institute any proceedings and do any act 
 which the Authority might have instituted and done, such 
 Authority being made liable to pay the Council's expenses 
 in so doing. 
 
 And, furthermore, Section 101 provided that " when 
 complaint is made by the Council to the Local Government 
 Board that a Sanitary Authority have made default in 
 executing and enforcing any provision which it is their 
 duty to execute or enforce under the Act, or of any bye-law 
 made in pursuance thereof, the Local Government Board, 
 if satisfied after due inquiry that the Sanitary Authority 
 have been guilty of the alleged default, and that the com- 
 plaint cannot be remedied under the other provisions of 
 this Act, shall make an order limiting the time for the 
 performance of the duty of such authority in the matter 
 of such complaint. If such duty is not performed by the 
 time Umited in the order, the order may be enforced by 
 writ of mandamus, or the Local Government Board may 
 appoint the Council to perform such duty," and the expenses 
 were to be paid by the Sanitary Authority in default." 
 
 " It seems to me right and proper," said Mr. Eitchie 
 in introducing the Bill, " that in regard to the great question 
 of pubhc health in London the County Council ought to 
 
360 THE SANITARY EVOLUTION 
 
 be charged with the performance of duty, which in the 
 opinion of the Local Government Board after inquiry, has 
 not been adequately and properly performed by the local 
 authority." 
 
 These sections were strongly opposed by some of the 
 prominent Vestries, being held to be " degrading and 
 destructive of local self-government by completely sub- 
 ordinating the local to the central authority." 
 
 The self-government which many people like is the being 
 able to do exactly as they themselves like, regardless of 
 everybody else's likes and rights. And it is the same 
 with many local government authorities. Their idea of 
 self-government too often is to govern for their own objects, 
 and their own interests, regardless of the infinitely greater 
 interests and rights of the great community around them ; 
 and when it is brought home to them that they are only 
 a small integral part of a great community, that their sphere 
 of self-government can only be a very limited one, and that 
 they cannot be allowed either by action or neglect to injure 
 the community, they resent it with no little outcry. 
 
 The principle of self-government, however, was not one to 
 which appeal could be made, for it had been dragged through 
 the mire by too many of the local authorities. Once the 
 unity of London assumed definite shapes, as it did in the new 
 Central Authority representing the whole of London, Vestry 
 self-government, except upon certain lines and within certain 
 limitations, was doomed ; for it would have to make way for 
 a far larger system of self-government — the self-government 
 of London by Londoners. 
 
 Moreover, prolonged experience had proved that the 
 Vestries could not be relied on to enforce the laws, and it 
 was manifest that some effective provision must be devised 
 for preventing them perpetually thwarting the intentions and 
 defeating the imperative enactments of Parliament designed 
 for the welfare of the community at large. 
 
 It was unfortunate, however, for the sanitary welfare of 
 great masses of the people of London that the principle thus 
 recognised and adopted by Parliament was not given fuller 
 effect to than it was, for it is the only principle upon which 
 
OF LONDON 361 
 
 any really sound system of public health administration for 
 London can be based. 
 
 A few years later the principle was reaffirmed by Parlia- 
 ment. 
 
 During the summer of 1892 the appearance of cholera on 
 the west coast of Europe — particularly Hamburg — exposed 
 London to the importation of cases of this disease. The 
 unsatisfactory position of the Council with regard to London 
 administration for the prevention of epidemic disease was at 
 once made evident. 
 
 In order to remove doubts as to the Council's responsi- 
 bilities as to the administration of the law relating to 
 epidemic diseases, a provision defining the Council's posi- 
 tion was included in the Council's General Powers Bill, 
 which was passed by Parliament in 1893. This provision 
 was to the following effect : — 
 
 " The Local Govermnent Board may assign to the Council 
 any powers and duties under the epidemic regulations made 
 in pursuance of Section 134 of the Public Health Act, 1875, 
 which they may deem it desirable should be exercised and 
 performed by the Council. 
 
 " If the Local Government Board are of opinion that any 
 sanitary authority in whose default the Council has power 
 to proceed and act under the Public Health (London) Act, 
 1891, is making or is likely to make default in the execution 
 of the said regulations, they may by order assign to the 
 Council, for such time as may be specified in the order, such 
 powers and duties of the sanitary authority under the regula- 
 tions as they may think fit." 
 
 Parliament thus once more emphasised the policy of the 
 local sanitary authorities being subordinated to the Central 
 Authority. 
 
 The new Central Authority — representative of the people 
 of London — gave early evidence of vitality and energy. The 
 heir had come into his property, with high ideals as to its 
 government, and as to the welfare of the people. A new 
 power had suddenly been brought into London life — an 
 unknown but vigorous force. A capable staff was at once 
 organised, and a Medical Officer and Assistant Medical 
 
362 THE SANITARY EVOLUTION 
 
 Officer of Health appointed. Inquiries and investigations 
 into the various matters most concerning the welfare 
 of the citizens of London were at once undertaken, and 
 conclusions arrived at, and action taken, with a thorough- 
 ness and a rapidity hitherto unknown in the administration 
 of London affairs. 
 
 Bye-laws were made to regulate and unify the administra- 
 tion of sanitary laws by local authorities. 
 
 Several of the water companies were induced to give a 
 constant supply of water to an increased extent. 
 
 And great efforts were made to utilise the powers conferred 
 upon the Council by the recently passed Acts — the Housing 
 of the Working Classes Act of 1890, and the Public Health 
 (London) Act of 1891. 
 
 It was at once felt that the problem which first faced 
 the Council was the housing of the people, and the Council 
 determined to attack it on every side. 
 
 In the belief that facilities of communication between the 
 working centres of London and residences in healthier 
 localities would help considerably to alleviate some of the 
 worst effects of overcrowding, and towards the successful 
 treatment of the great housing problem, action was taken 
 to turn the Cheap Trains Act of 1883 to greater account, 
 and to secure greater numbers of workmen's trains and 
 more moderate fares ; so as to enable workmen to travel 
 cheaply between more distant homes and their places 
 of employment. 
 
 That Act, which gave a large remission in the amount 
 of passenger duty paid by railway companies, if the 
 companies would provide a service of workmen's trains, 
 and would convey workmen at less than the usual fares, 
 had so far not been made much use of. 
 
 On investigation it was found that the facilities afforded 
 to workmen, particularly on certain railways, were very 
 inadequate. There were no workmen's trains at all on 
 one important line — on another only one such train was 
 run, whilst on several others the number of trains run was 
 very small. 
 f Eepresentations were made to the Board of Trade and 
 
OF LONDON 363 
 
 negotiations carried on with the Eailway Companies, and 
 by degrees a considerable extension of the facilities for the 
 conveyance of workmen was secm:ed. 
 
 The Council gave its immediate and more anxious 
 attention to those breeding-places and forcing-pits of 
 disease and misery, the insanitary areas in London. 
 
 The Housing Act of 1890 (by Part I.) constituted 
 the Council the authority for preparing and carrying into 
 effect schemes for the clearance and improvement of 
 insanitary areas which were of such size, and situation, 
 and character, as to render their clearance and reconstruc- 
 tion of general importance to the County. 
 
 The tremendous task of dealing with them was rendered 
 more difficult and costly by the obligation imposed by 
 Parliament of providing housing accommodation for the 
 persons displaced ; for in the lack of easy means of 
 communication with the outer parts of London it was 
 held to be necessary to re-house the greater number of them 
 in the same locality. 
 
 The Metropolitan Board of "Works had simply acquired 
 and cleared the properties, and disposed of the sites to 
 companies or individuals, placing on them the obligation 
 to erect houses for the working classes. Now, however, 
 the Council determined itself to erect, let, and maintain, 
 the necessary dwellings. The chief reason for the change 
 was the difficulty experienced in finding companies or 
 persons who were wilHng to undertake the erection of 
 dwellings on some of the sites. 
 
 The Council had to complete several schemes which it 
 inherited in an unfinished condition from the Metropolitan 
 Board of Works, but it at once initiated many itself, and 
 carried them through to a successful conclusion. 
 
 And as one after another of the insanitary areas was 
 investigated, so again and again was revealed to public 
 view the appalling condition in which thousands of people — 
 in the very heart of London — dragged out an existence 
 more bestial than human ; horrors piled on horrors — a state 
 of things all the more awful because it had been existing 
 for an indefinite number of years — levying annually the 
 
364 THE SANITARY EVOLUTION 
 
 heaviest of tolls on those who came within its deadly sphere, 
 and scattering its poison abroad among the community at 
 large. 
 
 There was the Clare Market (Strand) Scheme, some 3 J 
 acres — 3| acres of human wretchedness and disease and 
 misery and filth. In one sub-area there were upwards 
 of 800 persons to the acre. Here the death-rate was 41-32 
 per 1,000 in 1894 ; in another sub-area, the death-rate had 
 been 50*52 per 1,000 in 1893 ; the death-rate for the whole 
 area having been 39*03 in 1894. And in addition to this 
 was the unknown sick-rate. There was the Webber Kow 
 Scheme in St. George-the-Martyr, Southwark — close upon 
 5 acres in extent, with a death-rate of 30'5 per 1,000. 
 There were the Eoby Street and Baltic Street areas in 
 St. Luke, areas which "have about the worst reputation 
 of any in London." 
 
 The largest scheme which the Council undertook was 
 that known as " the Boundary Street Area " in Bethnal 
 Green. Here some fifteen acres of old, dilapidated, crowded 
 dwellings — dwellings so insanitary that the death-rate in 
 them was over 40 per 1,000 — were swept away, entailing 
 the displacement of 5,719 persons ; and the ground so cleared 
 was laid out with wider streets, and a large open space 
 and excellent buildings were erected thereon to contain 
 5,524 persons without crowding. The Prince of Wales 
 once more testified his deep interest in the welfare of the 
 poorer classes of London by opening the new buildings — 
 a ceremony which took place on the 3rd of March, 1900 — 
 and delivering an impressive speech. 
 
 A summary of the work accomplished by the Council 
 up to this time showed that the Council had provided, 
 or was engaged in providing, accommodation for 35,950 
 persons at a total outlay of close upon ^^2,000,000, an 
 amount of building operations which, if conducted at 
 one spot, would have resulted in the formation of a town 
 of nearly 36,000 inhabitants.* 
 
 The cost of this work was enormously heavy, owing to the 
 fact that the arbitrator could and did award commercial 
 •'• Statement by the Clerk of the London County Council. 
 
OF LONDON 365 
 
 value for the land ; but, as was pointed out by the Medical 
 Officer of Health for the London County Council * : — 
 
 "The primary object of Part I. of the Act is not to 
 provide artizans' dwellings, but to secure the removal from 
 the midst of the community of houses which are unfit for 
 habitation, and the faults of which are in large degree due 
 to bad arrangement. "Where houses are thus situated, and 
 are in a number of ownerships, rearrangement can only be 
 carried out by vesting the property in one ownership, that 
 of a public authority, who can then, by the making of new 
 streets and by complete rearrangement of the area, ensure 
 that the conditions which in future will exist are such as are 
 needed for the health of the inhabitants. The chief value of 
 the Act is, therefore, not so much the provision of house 
 accommodation which is fit for habitation, as the abolition 
 of houses which are dangerous to health. Part I. is not, 
 therefore, in itself so much a Housing Act as an Act for the 
 removal of nuisances on a large scale." 
 
 But another reflection also suggests itself, namely, why 
 should the ratepayers of London have been obliged to pay 
 these high sums for property which, by the culpable neglect 
 of the owners and their predecessors, had been allowed to 
 sink into a condition not alone exceptionally dangerous 
 to the lives of its inhabitants, but a constant danger to 
 neighbouring districts — even to London itself. Surely in 
 common fairness, those who had let it fall into such a state 
 should have paid the penalty therefor, and not the public of 
 London, who had had no part in bringing the property into 
 such an evil condition. 
 
 Part II. of the Act was mostly a consolidation of Torrens' 
 Acts, 1868 and 1882, with amendments. It enabled the 
 Vestries or District Boards to take proceedings before a 
 magistrate for the clearing and demolition of single houses 
 unfit for human habitation, and obstructive buildings, and 
 empowered them and the County Council to undertake 
 schemes for the improvement of areas too small to be 
 dealt with by the Council. 
 
 The owner might elect to retain the site after the demoli- 
 -'= See his Report for 1899, p. 63. 
 
366 THE SANITARY EVOLUTION 
 
 tion of the building, and in that case received compensation 
 for the building only. If the Vestry or District Board 
 acquired the site the same procedure as to compensation 
 had to be followed as under Part I. 
 
 A few schemes were undertaken by Vestries under this 
 Part of the Act, the Council making a contribution to the 
 cost, and a few by the Council. Thus in St. George-in- 
 the-East, from November, 1890, to the end of 1894, 224 
 houses were "represented" as unfit for habitation — grue- 
 some pictures of dirt, dilapidation, and insanitation of every 
 form and variety, and this, too, after nearly forty years of 
 sanitary work by the Vestry. Many were closed by order 
 of the magistrate, some by the owner, some pulled down, 
 some repaired and re-let. 
 
 Part III. of the Act embodied the idea, originally started 
 by Lord Shaftesbury in 1861, as to the erection of labouring 
 classes' lodging-houses by the local authorities, and grafted 
 several amendments thereon. 
 
 Power was given for the acquisition by the Council of 
 land for the purpose of erecting lodging-houses thereon. 
 Such land, however, was to be within the Council's jurisdic- 
 tion. Under this part of the Act the Council erected a 
 common lodging-house in Parker Street for the accommo- 
 dation of over 300 persons. It also acquired several sites, 
 including the Millbank estate, upon which it proceeded to 
 build houses ; and one of 38 acres at Lower Tooting for the 
 erection of cottages thereon. 
 
 Altogether the work performed under the Act was 
 considerable, and the housing for the accommodation of 
 the working classes made sensible progress, the sites sold 
 by the Metropolitan Board of Works to trusts, and public 
 companies, and private persons, having been built upon and 
 covered with artizans' dwellings. 
 
 Private building was proceeding at considerable pace, and 
 in many parts of London the ground was becoming more 
 overcrowded than ever with houses. 
 
 The older parts of London were being rapidly re-built, 
 and open spaces at the rear of buildings were being gradually 
 covered by buildings. 
 
OF LONDON 367 
 
 Of St. Pancras the Medical Officer of Health wrote 
 (1896) :— 
 
 "... There is a prospect that in course of time the 
 whole of the open space about buildings may disappear. . . . 
 Old houses possessing yards, areas, open spaces, in some 
 form at the front or back or both, are being re-built in 
 such a manner as to entirely cover the whole ground area 
 two or three storeys up — leaving not a particle of open 
 space." 
 
 The restrictions imposed by the Building Acts were of 
 the most illusory character, and as the Acts were mostly 
 future in their operation, and not retrospective, their effect 
 was also limited. Any " owner " was entitled to re-build on 
 " old foundations," no matter how crowded the houses were 
 on the spot, so new buildings were usually only a resurrec- 
 tion in huger and more perpetual and objectionable form of 
 the evils which ought, as far as possible, to have been 
 eradicated. 
 
 During the year 1894 the London Building Law was 
 consolidated and amended. The Act recognised, for the 
 first time in London, the principle that, in addition to 
 the height of the building being proportionate to the width 
 of the street on which it abuts, the amount of open space 
 about the rear of a building should also be proportionate to 
 its height, and hence the future crowding of buildings on 
 area was put under limitation. 
 
 But how small was the limitation, how small the con- 
 cessions exacted from " owners " in this matter, and how 
 miserably late they came in the history of London building 
 operations. 
 
 The tendency of house construction in London was to 
 ever larger size, to greater height. To how great an extent 
 this had been carried on in the " City " was described by 
 the Medical Officer of Health in 1894 :— 
 
 " It would be a fair and moderate estimate to put the 
 superficial area (of the City) at four square unites instead of 
 one. We have only to point to the construction of business 
 premises — the piling of one floor over another for many 
 storeys high, each floor being occupied by separate occupiers, 
 
368 THE SANITARY EVOLUTION 
 
 forming in itself a distinct tenancy, having all the rights 
 and privileges of an independent building, and claiming as 
 much attention from every branch of our municipal system 
 as if it stood alone. . . . We have, in fact, to deal with about 
 28,000 separate tenancies, with a day population of 301,384." 
 
 In some of the more well-to-do parts of the metropolis 
 great blocks of buildings were built and let out in flats, 
 most of them with the minimum of light and air prescribed 
 by narrow laws. 
 
 In other districts of London considerable numbers of 
 small houses were removed, and large blocks of artizans' 
 dwellings erected in their stead. Thus, in the parish of 
 St. Luke, nearly one-fifth of the entire population resided 
 in the ten blocks of artizans' dwellings which existed there. 
 
 In the earlier stages of the reform of the housing of 
 London such buildings had been acclaimed as great 
 improvements, as indeed they were. The later opinions 
 of Medical Officers of Health were not so laudatory. Thus, 
 in 1891, the Medical Officer of Health for Whitechapel, 
 after stating that there were in his district 27 buildings 
 having 3,127 apartments containing 12,279 persons, added 
 that he was ' ' not enlisted amongst the enthusiasts of this 
 method of providing for the housing of the working classes." 
 In 1896 he wrote: "All model dwellings are not equally 
 models of good sanitary houses." And in 1897 : — 
 
 " The increased population are housed in huge barrack 
 buildings which sometimes are constructed so as to allow 
 light and air to permeate the rooms and sometimes not. 
 The effect of this modern invention is to increase the 
 density of population to a damaging degree. . . . 
 
 " That the direct influence of these barrack buildings 
 upon the health of their occupants — more especially the 
 children — is adverse, I have not the slightest doubt." 
 
 The Vestry of Shoreditch reported in 1892-3 : — 
 
 " ' Model Artizans' Dwellings ' do not appear to have been 
 quite what their title implied. At Norfolk Buildings, Shore- 
 ditch, on the Medical Officer of Health causing them to be 
 examined for a certificate for exemption from the inhabited 
 house duty, the whole system of drainage was found to be in 
 
OF LONDON 369 
 
 a most defective and dangerous state. A number of cases of 
 typhoid, diphtheria, and other infectious illness had occurred 
 on the premises." 
 
 And a couple of years later the Chief Sanitary Inspector 
 submitted to his Vestry a report on some so-called " model 
 dwellings" : "These blocks of buildings, 50 feet high, are 
 packed together so as to exclude light and air, and four 
 rooms occupy the site of two : evil conditions which the 
 architect and owner were not only privileged to create, but 
 also, and very practically, in so doing were they privileged 
 to condemn unborn generations of people, whose necessities 
 condemn them to live in these tenements, to endure the evils 
 of their creation." 
 
 The Medical Officer of Health for St. James' wrote : — 
 
 " Block dwellings in such an area as St. James' do not 
 provide the conditions in which healthy children can be 
 reared, nor in which there can be a family life comparable 
 with that possible in the open suburbs of London." 
 
 The Medical Officer of Health for St. Olave gave a 
 description of Barnham Buildings : — 
 
 " Many of the rooms, &c., on the ground and first floor 
 are generally very dark, and the buildings have not been 
 maintained in a sanitary condition, notwithstanding the 
 hundreds of notices that have been served the past five 
 years. The average death-rate of the past five years of the 
 unhealthy tenements was at least 49*6 per 1,000 and of the 
 remainder at least 29 'l." 
 
 The Medical Officer of Health for St. Marylebone gave 
 an interesting explanation of the condition of this class of 
 houses : — 
 
 ** The following is a list of applications, under the 
 Customs and Inland Eevenue Act, 1891, from which it 
 will be gathered that it is quite exceptional for a block 
 of artizans' dwellings of even recent construction to be in 
 a tolerable sanitary condition. The reason for this anoma- 
 lous state of things is, that in the building of these dwellings 
 the Sanitary Authority seems to have no power ; a dwelling 
 must be occupied before it comes under supervision." 
 
 In spite of these and many other drawbacks, however, 
 
 25 
 
370 THE SANITARY EVOLUTION 
 
 many of these buildings afforded accommodation far superior 
 to that which had previously existed on the spots where 
 they were erected, and provided residence for large numbers 
 of people who otherwise might have been doomed to living 
 in the worst class of tenement-house. 
 
 Closely connected with the Public Health Act of 1891 
 was another Act passed in the same year — " The Factory and 
 Workshop Act." 
 
 The Select Committee of the House of Lords on the 
 Sweating System had finished their inquiry and reported 
 in 1890. The evidence given before it was, as regarded 
 factories, workshops, and workplaces, very much a 
 repetition of that which for thirty-five years had been 
 detailed by Medical Officers of Health as regarded the 
 dwellings of the people, but now obtaining greater pub- 
 licity attracted more attention. 
 
 Overcrowding and insanitation of almost every conceiv- 
 able kind pursued large numbers of the unfortunate 
 workers from their overcrowded and insanitary tenements 
 to their overcrowded and insanitary workplaces, and with 
 the same disastrous results. And as regarded domestic 
 workshops the conditions were even worse, workers 
 spending their days and nights often in the one room — 
 sometimes with extra workers brought in. 
 
 Want of light and air and overcrowding in workshops 
 and factories are quite as serious matters as they are in 
 inhabited houses. 
 
 The Select Committee, in their conclusions and recom- 
 mendations, said : — 
 
 " The sanitary conditions under which the work is 
 conducted are not only injurious to the health of the 
 persons employed, but are dangerous to the public, 
 especially in the case of the trades concerned in making 
 clothes, as infectious diseases are spread by the sale of 
 garments made in rooms inhabited by persons suffering 
 from smallpox and other diseases. Three or four gas 
 jets may be flaring in the room, a coke fire burning in 
 the wretched fireplace, sinks untrapped, closets without 
 water, and altogether the sanitary condition abominable." 
 
OF LONDON 371 
 
 "A witness told us that in a double room, perhaps 
 nine by fifteen feet, a man, his wife, and six children 
 slept, and in the same room ten men were usually 
 employed, so that at night eighteen persons would be in 
 that one room." 
 
 " In nine cases out of ten the windows are broken 
 and filled up with canvas ; ventilation is impossible and 
 light insufficient — the workshops are miserable dens. 
 We are of opinion that all workplaces included in the 
 above description should be required to be kept in a 
 cleanly state, to be lime-washed or washed throughout 
 at stated intervals, to be kept free from noxious effluvia, 
 and not to be overcrowded — in other words, to be treated 
 for sanitary purposes as factories are treated under the 
 factory law." 
 
 Lord Kenry, Chairman of the Committee, in his draft 
 report, said : — 
 
 " It has been shown that the dwellings or shops in 
 which the sweated class live and work are too often places 
 in which all the conditions of health, comfort, and decency 
 are violated or ignored. . . . Sanitary inspection is totally 
 inadequate, and the local bodies have seldom done their 
 duty effectually. At the East End of London generally 
 the sanitary state of homes and shops could not possibly 
 be much worse than it is." 
 
 And Mr. Lakeman (Government Inspector under the 
 Factories and Workshops Act) said, in reference to work- 
 shops : " I think that the evidence given your Lordships 
 upon the insanitary state of those places is not at all 
 too black." 
 
 Once more the necessity of inspection was insisted upon. 
 " On no point," wrote the Chairman, " was the unanimity 
 of witnesses more emphatic than with reference to the 
 necessity of more efficient sanitary inspection, not only of 
 workshops, but of the dwellings of the poor." 
 
 And just as it was as regarded tenement-houses, inspec- 
 tion here was lamentably deficient, if not absolutely 
 non-existent. 
 
 '* The inspection at present carried on is totally in- 
 
372 THE SANITARY EVOLUTION 
 
 adequate, and nothing was more clearly proved before us 
 than the fact that satisfactory results cannot be looked for 
 from the system as it now stands." * 
 
 "Even when an unmistakable cause of unhealthiness is 
 discovered, and steps are taken to remove it, the process 
 of applying the remedy is slow and uncertain. The Local 
 Board meets once a week or fortnight . . . the landlord 
 is allowed a fortnight to carry out the work ; three weeks 
 may elapse before the inspector can go and see it, then 
 perhaps nothing has been done ; the summons, &c., takes 
 time. In any case much valuable time is lost, and small- 
 pox or fever is allowed to pursue its ravages with the 
 source of the disease daily aggravated in intensity. 
 
 " At present the inspectors under the Factory and Work- 
 shop Act of 1878 have no power to deal with any nuisance 
 which lies within the district over which the local authorities 
 preside. On the other hand, the local inspector cannot 
 interfere should he discover any breach of the Factory 
 Act." 
 
 The Home Secretary, in moving the second reading of 
 the Bill, explained its scope. He said : — 
 
 " The design and object of this Bill is to bring all work- 
 shops and all factories up to the same sanitary level, and to 
 require the same conditions as to ventilation, overcrowding, 
 lime-washing, and cleanliness to be applied to all kinds 
 of workshops in which men alone, or women, children, and 
 young persons are employed. The Bill does not deal with 
 * domestic workshops.' The President of the Local 
 Government Board will introduce a Bill dealing with the 
 public health, and the House may rest content with 
 leaving what is called ' the domestic workshop ' — that is 
 to say, the working-man's home in which he works with 
 the members of his family — subject to the provisions of 
 the law of public health alone. It is obvious that in the 
 domestic workshop you have not got the presence of the 
 employer and the employe. You have the members of 
 the same family . . . and it seems to me that we may 
 
 * P.P. 1890, vol. xvii. See fifth Report from the Select Committee of 
 the House of Lords on the Sweating System. 
 
OF LONDON 373 
 
 allow him and his family to work in a place which is 
 sufficiently good so far as sanitary conditions are concerned 
 for him and his family to live in. Now that we are 
 extending the sanitary provisions of the Factory Act to all 
 workshops throughout the country, of whatever kind they 
 may be except the domestic workshop, so that every 
 cobbler's shop, every blacksmith's shop, every tailor's shop, 
 will come under the provisions of the sanitary law, it 
 seems to me foolish not to take advantage of the existing 
 machinery provided by the local authorities, and the 
 enforcement of the sanitary provisions, so far as workshops 
 are concerned, is by this Bill given to the local authorities." 
 
 The passing of the Factory and Workshops Act (1891) 
 and of the PubHc Health (London) Act of 1891 made the 
 sanitary authorities primarily responsible for enforcing 
 many new provisions. Those authorities were charged 
 with the duty of securing the maintenance of the " work- 
 shops " in a sanitary condition, of preventing overcrowding 
 in them, and of enforcing cleanliness, ventilation, lime- 
 washing, and freedom from effluvia, and securing the 
 provision of sufficient sanitary accommodation. 
 
 Added to this was the sanitary supervision of the places 
 of " outworkers." * 
 
 It would appear, however, that only in exceptional 
 instances was any systematic attempt made in 1892 to carry 
 out the new duties imposed by the Legislature upon the 
 Vestries and District Boards. 
 
 In several instances the Medical Officers of Health drew 
 attention to the impossibility of undertaking workshop 
 inspection with their existing staff. Thus the Medical 
 Officer of Health of Hackney : — 
 
 *' Inquiry has revealed the presence of something like 
 2,000 workshops and dwellings of outworkers which, under 
 this Act and Order, should be inspected to ascertain the 
 presence or otherwise of any insanitary condition. With 
 the present stajQf it is impossible that this can be 
 attempted." 
 
 * See the Order made by the Home Secretary in November, 1892, as to 
 "outworkers." 
 
374 THE SANITARY EVOLUTION 
 
 In St. Marylebone the Medical Officer of Health stated, 
 in 1894, that the number of workshops and workplaces 
 in his parish amounted to 3,550. And in 1895 he wrote : 
 " The workplaces are so numerous in the parish that it is 
 not practicable for them all to be inspected regularly with 
 the present staff." 
 
 "Increased duties," wrote the Medical Officer of Health 
 for Fulham in 1893, " having been placed on the sanitary 
 staff by the ' Factory and Workshop Act ' of 1891, relating 
 to outworkers ; but with the existing number of inspectors 
 it is not possible to attend to them thoroughly, so that the 
 Act in Fulham is almost ' a dead letter.' " 
 
 " In Ishngton," reported the Medical Officer of Health in 
 1895, " neither the factories nor workshops in the district, 
 nor the smoke nuisances receive any attention worth 
 mentioning, and so far as this district is concerned they 
 may be said to have been entirely neglected. 
 
 " I look upon the inspection of factories and workshops as 
 one of the greatest necessities of the present day, not only 
 from a health point of view, but also from the social 
 aspect." 
 
 The manifest solution of this difficulty was the appoint- 
 ment of additional inspectors, but the local authorities 
 had a sort of horror of such appointments, though by this 
 time they must have known that the benefit to workers and 
 to the community generally would have been very great. 
 
 A report in 1892 of the Medical Officer of Health of 
 St. G-eorge-the-Martyr shows the grievous need there 
 was for inspection of one very important class of 
 workshop : — 
 
 "I have inspected sixty-three retail bakehouses within 
 the parish, and found them (with few exceptions) to be 
 in a filthy and unwholesome state, dangerous alike to 
 the health of the journeyman baker, who makes the 
 bread, and to the public who eat it. Twenty-one were 
 completely underground. ... In times of heavy rainfall 
 sewage forces itself through the draintraps of these cellars, 
 soiling the sacks containing flour, and fouling the 
 atmosphere." 
 
OF LONDON 375 
 
 Parliament again legislated about factories and workshops 
 in 1895. 
 
 Under the Act a minimum space was required in each 
 room of a factory or workshop of 250 cubic feet for each 
 person employed. For the prevention of the infection 
 of clothing, the occupier of a factory, &c., was prohibited 
 from causing wearing apparel to be made or cleaned 
 in a dwelling-house having an inmate suffering from 
 scarlet fever or smallpox. An important step was also 
 taken in extending the provisions of the Factory Acts to 
 laundries, of which there were a great number in London, 
 and where the workers stood in great need of improved 
 conditions of work, and of public supervision. 
 
 Lamentable as were the results of the non-protection of 
 the workers in workshops, still more lamentable and dis- 
 astrous were they as regarded the 2,310,000 dwellers in the 
 630,569 tenements of less than five rooms. Up to 1889 
 regulations under the Sanitary Acts of 1866 and 1874 had 
 been adopted in 31 of the 40 London sanitary districts. In 
 only nine of these was any considerable use made of them. 
 Had these regulations been put into force a great amount of 
 overcrowding would have been prevented and the houses 
 kept in a fairly clean and sanitary condition. 
 
 In the whole of London, with its 547,000 houses, only 
 7,713 tenement-houses were on the register in 1897, of 
 which more than a half were in four parishes, namely : 1,500 
 in Kensington, 1,190 in "Westminster, 840 in Hampstead, 
 and 610 in St. Giles' ; leaving 3,573 in the whole of the 
 rest of London — a mere fraction of the tenement-houses of 
 London. 
 
 In Bethnal Green (1894), " 761 of the population lived in 
 tenements of less than five rooms. No houses had been 
 registered." 
 
 In Lambeth over one-half of the population lived in tene- 
 ments of less than five rooms, and of these nearly one-third 
 lived under conditions of overcrowding. There was one 
 Sanitary Inspector to about 60,000 people. The inadequacy 
 of the staff had been pressed upon the Vestry by the Medical 
 Officer of Health from time to time for a number of years. 
 
376 THE SANITARY EVOLUTION 
 
 Considerable ingenuity was in many cases exercised by the 
 opponents of the regulation of tenements in the working of 
 the bye-laws which resulted practically in rendering them 
 inoperative. In some cases all houses were to be exempted 
 where the rent was higher than certain specified weekly 
 sums. The result was that the " owners " promply raised 
 the rent above these sums, and so secured their exemption, 
 at the same time getting an increased rent. In others, the 
 bye-laws gave the Vestry power to decide what houses 
 should be registered, and thus enabled the Vestry to evade 
 the necessity of registering any at all. In others, notices 
 were to be given to the "owner" before a house was 
 registered — the notice was not sent. And so, in one way 
 or another, the imperative "shall" of Parliament was 
 evaded by the largest proportion of the Vestries and District 
 Boards. 
 
 As regarded the Vestries and District Boards who made a 
 show of putting the regulations in force, the Medical 
 Officers explained that, owing to the inadequacy of the staff 
 of Sanitary Inspectors, it was "impossible" to inspect the 
 houses regularly. 
 
 In other parishes and districts the number registered and 
 inspected was but a fraction of the houses which ought to 
 have been registered. In Bow (in Poplar) where none were 
 registered, the Medical Officer of Health VTrote in 1891 : " I 
 should say 4,000 houses require registration." In- St. Mary, 
 Newington : "At least 80 per cent, of the houses are occu- 
 pied by members of more than one family." But as yet 
 none were registered. And this same Medical Officer of 
 Health pointed out how in his parish — " The indisposition 
 that has hitherto been shown on the part of the Vestry to 
 put into force the bye-laws for houses let in lodgings has led 
 to great license in house-farming and house-crowding." 
 
 Where really put into operation the regulations had an 
 excellent effect. Thus the District Board of St. Giles' 
 said : " The advantage of these regulations has been very 
 great." 
 
 And in Paddington the Medical Officer of Health stated : 
 " The work done . . . has had an excellent effect." 
 
OF LONDON 377 
 
 Of some streets where houses were registered (1897-8) — 
 " The whitewashing and cleansing has without doubt 
 had a good effect. The streets have been freer from 
 infectious diseases than they have been for several years 
 past." 
 
 The advantages of the regulations in the administration 
 of the health laws were time after time pointed out and 
 insisted upon by many Medical Officers of Health. 
 
 The Medical Officer of Health for Westminster, where 
 nearly 1,000 houses were registered, wrote (1899) : — 
 
 "The great advantage in legal procedure lies in the fact 
 that a breach of them is a finable offence with a further 
 daily penalty after written notice, and is not a nuisance sub- 
 ject to abatement within a certain time. 
 
 "If the conditions imposed by the bye-laws are carried 
 out, no doubt one of the best methods for preventing over- 
 crowding is thus achieved." 
 
 The advantage of this quicker procedure was manifest, for, 
 under the other Public Health or Sanitary Acts, the whole 
 process of deaUng with, or getting a nuisance abated, took 
 " a long time — a very long time," but the advantages did 
 not appeal to people who did not want to use them. 
 
 Thus there was a most grievous neglect of duty on the 
 part of the great majority of the Vestries and District 
 Boards, with the inevitable result of the most disastrous 
 consequences to the working and poorer classes all over 
 London. 
 
 It must have appeared strange, in view of this glaring 
 and scandalous neglect of duty by the Vestries in enforcing 
 the regulations, that the London County Council as the 
 Central Authority did not use the powers which they were 
 supposed to possess of acting in the default of the local autho- 
 rities, or of making representation to the Local Government 
 Board of the neglect of those authorities. 
 
 The explanation was, that in the administration of this, 
 absolutely the most important of all branches of the housing 
 problem of London, the London County Council, had been 
 left entirely out — had not even been given a voice in the 
 framing of the bye-laws or regulations, and therefore had 
 
378 THE SANITARY EVOLUTION 
 
 no legal power to act. Eegulations or bye-laws, drafted by 
 the Local Government Board as " models " for adoption by 
 the local authorities, suggested " exemptions " to what Par- 
 liament had directed — though there was not a single word 
 in the 94th Section or in any part of the Act to justify 
 such a suggestion — or suggested phrases in them which 
 actually placed the enforcement or non-enforcement of 
 the Act in the discretion of those authorities, this, too, 
 though Parliament had made the explicit imperative enact- 
 ment that these local authorities should make and enforce 
 regulations. 
 
 Most of the Vestries made bye-laws under Section 94 of 
 the Act, nearly all containing exemption or elusive clauses 
 as suggested ; some even avowedly reserving to themselves 
 the option of registering or not registering houses, as they 
 thought fit. 
 
 The London County Council was not in a position to act 
 in their default, as these authorities could shelter them- 
 selves under the option contained in the terms of the 
 regulations, and a representation to the Local Government 
 Board would have been useless, as the same defence would 
 be effectively made by the local authorities if called to 
 account. 
 
 Thus, the deliberate enactment of Parliament was frus- 
 trated ; the Act was prevented being a remedy for over- 
 crowding, or even a protection against it, and except in a 
 few parishes or districts where the great advantages of the 
 Act were appreciated, all the dreadful evils of overcrowding 
 were given free play, and allowed to flourish on as gigantic 
 a scale as ever. 
 
 The effects of the inaction of the Vestries and District 
 Boards were unfortunately not confined to the moment. A 
 legacy of suffering, of misery, and physical deterioration 
 was left to subsequent generations. Once more might 
 hundreds of thousands of voices of the victims and sufferers 
 have cried out: "While you remain inactive, death and 
 disease do not."* 
 
 * Not much interest appears to have been taken in the proceed- 
 ings of some of the Vestries. Thus, in 1891, the Vestry of Westminster 
 
OF LONDON 379 
 
 A special census of the population of London was taken 
 on March 29, 1896, which showed that the popula- 
 tion had increased to 4,443,018 persons, being an increase 
 of 200,900; and the number of inhabited houses from 
 547,120 to 553,119. 
 
 As years had gone by, and the necessity and importance 
 of sanitation had become more widely recognised, and as 
 London had grown in size and increased in population, the 
 duties of the Vestries had grown heavier, and the tendency 
 of legislation was to broaden the basis of their action. 
 
 The mileage of public streets to be paved, lighted, cleansed, 
 and watered, had multiplied two, three, and four times since 
 1855 ; the number of houses in many districts had more 
 than doubled ; the drainage work had increased proportion- 
 ally ; the scavenging and removing of refuse also. Nominal 
 duties had become real ones, and new duties had been 
 added — the disinfection of infected houses and infected 
 clothes, the inspection of food, the working of the Food 
 and Drugs Act — these, with numerous smaller matters, 
 meant a very considerable amount of work, expense, and 
 responsibility. 
 
 But all these were what one of the Vestries in their 
 Report described as " well-worn grooves of familiar routine." 
 In addition thereto, and now more than ever of primary im- 
 portance, was the great duty of inspection — inspection of 
 houses, and of rooms in houses, and of workshops, and often 
 the consequent proceedings for the abatement of nuisances, 
 or the punishment of offenders. 
 
 " House-to-house inspection," wrote the Medical Officer 
 of Health for Islington in 1893, "is the only efficient 
 remedy for extensive sanitary evils. It is the life and soul 
 of sanitary work." 
 
 House-to-house inspection of their districts was the 
 most necessary of all sanitary work — as it was the means by 
 
 complained of the lack of public interest in the record of their proceed- 
 ings. "Only eleven ratepayers out of 8,800 have purchased copies 
 (price 2d.) of the Reports of the Vestry in each of the last three years." 
 (A few years later they reduced their Reports to a few pages.) 
 
 And in 1896 the Vestry of Kensington complained of the limited 
 demand for their Annual Report, though it only cost 2d. 
 
380 THE SANITARY EVOLUTION 
 
 which most sanitary defects and malpractices were detected 
 — but it was the first to be sacrificed under the increased 
 pressure of work, and the last for which adequate provision 
 was made. 
 
 "A house-to-house inspection has been attempted more 
 than once," wrote the Medical Officer of Health for Islington 
 in 1893, " but it has never yet been brought to a complete 
 and satisfactory finish." 
 
 In fact the main breakdown of the Vestry administration 
 in London was their antipathy to inspection, and their 
 refusal to appoint a sufficient number of inspectors. 
 
 " The subject of overcrowding alone," wrote one Medical 
 Officer of Health, " if properly attended to, would pretty 
 well occupy the whole of the time of the present staff." 
 
 The complaints of the Medical Officers of Health were 
 frequent and insistent on the inadequacy of the inspecto- 
 rate. Thus the Medical Officer of Health for Fulham 
 wrote : — 
 
 " The Vestry must clearly understand that the present 
 staff of Sanitary Inspectors is quite inadequate to properly 
 perform the duties devolving upon the Sanitary Authority. 
 There is only one Sanitary Inspector to every 35,000 inhabi- 
 tants. Should the Vestry persist in their refusal to employ 
 an adequate staff, the inference will be unavoidable that 
 they are unwilling that the Acts — for the faithful adminis- 
 tration of which, in the interests of the public health, they 
 as Sanitary Authority are responsible — should be properly 
 carried out." 
 
 Interesting light is often to be found in the reports some- 
 times of the Vestries, and oftener of the Medical Officers 
 of Health, upon various aspects of the great housing 
 problem. 
 
 Sometimes a sentence enables so much else to be under- 
 stood. Thus, in 1892, a Medical Officer of Health wrote : — 
 
 " Many persons think the Public Health Act an innova- 
 tion on their privileges." 
 
 Describing the insanitary condition of 230 houses in 
 Provost Street, Shoreditch, the Sanitary Inspector wrote 
 in 1892 :— 
 
OF LONDON 381 
 
 " The difficulty of dealing with these houses has been 
 greatly increased by the circumstance that the leases will 
 expire in a very few years. There was, therefore, a very 
 natural objection on the part of many of the leaseholders to 
 execute substantial works, of which the freeholder would in 
 a few years reap the benefit, and without contributing any- 
 thing to the expense of the improvements." 
 
 This ** very natural objection " entailed, of necessity, sick- 
 ness and death upon a considerable number of persons. 
 
 The Vestry of St. Pancras wrote in 1893 : — 
 
 " The primary cause of houses and buildings becoming 
 insanitary is the neglect of freeholders to compel lessees 
 to comply with the terms and conditions of their leases. If 
 the Vestry were empowered (where freeholders are negli- 
 gent) to compel freeholders to cause lessees to carry into 
 effect the covenants of the leases, the houses inhabited by 
 the poorer classes would not become so wretchedly dilapi- 
 dated and a scandal, but might be maintained in a fairly 
 habitable condition." 
 
 The Medical Officer of Health forBethnal Green exonerated 
 some property owners, whilst fixing the blame on others. 
 
 " . . . As a rule it is the professional insanitary property 
 owner who has to^be summoned time after time, and who ex- 
 hausts every technicality and raises every possible objection, 
 well knowing that in the usual way only an order costing some 
 few shillings will be made against him." 
 
 Others, however, went further. The Medical Officer of 
 Health for Islington wrote in 1893 : — 
 
 ** Since 1891 there has been a steady forward movement, 
 and . . . one now constantly hears of the persecution of the 
 ' poor property owner.' 
 
 " That owner who for long years had everything his own 
 way, and who did as little as he could to make things healthy 
 for his tenants, knowing well that there were plenty of per- 
 sons ready to occupy any or every house. Property has 
 rights, but so has flesh and blood ; and if it be right that 
 property should be protected from unnecessary exactions, it 
 is surely righteous that the health and lives of human beings 
 should be safeguarded in every way." 
 
382 THE SANITARY EVOLUTION 
 
 And in the following year, writing about some insanitary 
 bakehouses, he said : " It has always seemed to me a very 
 absurd argument that because a place has been allowed to 
 be occupied for a long series of years to the detriment of the 
 health of the people working therein that therefore it must 
 not be now abolished. 
 
 "If those insanitary places have been occupied for such a 
 long time, surely they have more than recouped their owners 
 for the money that has been originally spent on their 
 erection ? " 
 
 The Medical Officer of Health for St. James', after twenty- 
 five years' work as Medical Officer of Health, declared in 
 1898 :— 
 
 " The only practical course is to saddle the landlord with 
 full responsibility for the neglect or misconduct of the 
 tenants whom he harbours, at large rents, for his own 
 profit." 
 
 In 1894 Parliament passed " The Local Government (Eng- 
 land and Wales) Act," which included London in its scope, 
 and which introduced great changes as to the electorate, the 
 mode of election, and the qualification of vestrymen. 
 
 A new electorate on almost the widest basis was 
 created, all persons, male or female, on the Parliamentary 
 or County Council Eegister, including lodgers and service 
 voters, and married women, who were themselves tenants 
 of property, being made parochial electors ; and the Vestry 
 was to be elected under the provisions of the Ballot Act 
 of 1872. 
 
 Thus the scandals hitherto associated with Vestry elections 
 were for the future obviated, and greater publicity — that 
 safeguard of all public bodies — was assured. 
 
 Additional powers were also obtainable under the Act by 
 the Vestries on application to the Local Government Board, 
 who could transfer to the Vestry the powers and properties 
 of the Library Commissioners, the Baths Commissioners, 
 and the Burial Board; the power of appointing the Over- 
 seers of the Poor, and some other powers and duties of more 
 or less importance, possessed orpossessable by Parish Councils. 
 The elections were held on December 15, 1894. 
 
OF LONDON 383 
 
 The new Vestries, however, did not mend the ways of 
 their predecessors as regarded " inspection." 
 
 Of Bethnal Green the Chief Sanitary Inspector said 
 (1897) : " With the existing staff (five Inspectors) and having 
 regard to other work, it would take five years to visit all the 
 houses in the parish — about 17,000." 
 
 The Medical Officer of Health for Kensington wrote 
 (1898) : *' The staff is quite inadequate for the discharge 
 of the duties devolving upon your Vestry as Sanitary 
 Authority." 
 
 And the Medical Officer of Health for Hammersmith wrote 
 in 1899 : " The house-to-house inspection of the district is 
 now nearly completed, and has taken six years to accom- 
 plish. The result of the inspection is in the highest degree 
 satisfactory . . . nevertheless it cannot be contended that 
 inspecting the district once in six years is properly carrying 
 out the 1st Section of the Public Health (London) Act, 
 1891." 
 
 A series of investigations was made by the Medical Officer 
 of Health of the London County Council, or by his assistant, 
 into the sanitary condition of various parishes or dis- 
 tricts, and an instructive light thrown upon the adminis- 
 tration of their affairs by their respective local governing 
 authorities. 
 
 Almost uniformly, so far as they were concerned, it was 
 found that bye-laws as to houses let in lodgings were not 
 enforced, and no, or practically no inspection of workshops, 
 of which there were thousands, nor of "outworkers " had 
 been carried out, and that the sanitary staff was quite 
 inadequate for the work. 
 
 Though much was thus most unsatisfactory, yet in 
 many other important matters which vitally affected the 
 public health, considerable progress was being made. 
 
 In the matter of water supply a steady but slow improve- 
 ment had, under public pressure, taken place. In 1892 a 
 Koyal Commission was appointed to inquire as to whether 
 the existing sources of supply were adequate, and it reported 
 in the following year. 
 
 "We are strongly of opinion," they said, "that the water as 
 
384 THE SANITARY EVOLUTION 
 
 supplied to the consumer in London is of a very high standard 
 of excellence and of purity, and that it is suitable in quality 
 for all household purposes. "We are well aware that a certain 
 prejudice exists against the use of drinking water derived 
 from the Thames and the Lea, because these rivers are 
 liable to pollution, however perfect the subsequent purifica- 
 tion by natural or artificial means may be ; but having 
 regard to the experience of London during the last thirty 
 years, and to the evidence given us on the subject, we do not 
 believe that any danger exists of the spread of disease by the 
 use of this water, provided that there is adequate storage, 
 and that the water is efficiently filtered before delivery to 
 the consumers." 
 
 This statement was to a certain extent satisfactory, but 
 the fact remained that both the Thames and Lea still 
 received sewage effluents above the intakes, and consider- 
 able pollution from other causes ; and that diseases might 
 still be water-borne and water-distributed by them. The 
 thoroughness of the filtration also was often open to doubt. 
 
 Improvement was gradually being effected in the system 
 of removal or disposal of filth and refuse of all sorts and 
 kinds ; the sweepings of the streets, the refuse from houses. 
 According to the general practice of the local authorities the 
 great bulk of this stuff was first brought to yards or places, 
 the property of the authorities, and there sorted or sifted 
 and sent down the river or along the canals in barges, or 
 sometimes even by rail to the country. But the system was 
 costly and insanitary and inefficient, and as was pointed out 
 — " it could not be deemed satisfactory when large metro- 
 politan districts inflict their filth upon smaller communities 
 in urban districts." 
 
 A system of destroying much of this filth by fire had been 
 devised, and gradually was adopted by the local authorities. 
 It was found that with a properly constructed and efficient 
 destructor no nuisance need result, and this method of dis- 
 posing of house refuse was much more desirable from a 
 sanitary point of view than that usually adopted by London 
 Sanitary Authorities. 
 
 A certain number of local authorities adopted this method 
 
OF LONDON 385 
 
 to the great advantage of the community, and though there 
 is still much to be done in this direction, the change, so far 
 as it has gone, has undoubtedly minimised a great evil. 
 
 Both numerous and various are the measures which have 
 to be taken for the protection of the public from disease. 
 One of the most essential of these was disinfection — the 
 disinfection of rooms where there had been infectious 
 or contagious disease, and the disinfection or destruction 
 of clothing or articles used by the person suffering from 
 the disease. The process of disinfection originally was of the 
 most primitive character and doubtful efficacy, but the 
 progress of science had elaborated really effective methods. 
 
 In 1866 the local authorities had been given power to 
 provide a proper place with all necessary apparatus, &c., 
 for the disinfection of infected clothing, &c., free of charge, 
 and to give compensation for articles destroyed. Thus every 
 inducement was given to the public to get infected articles 
 disinfected. But many years were to pass before provision 
 by the Vestries was extensively made. 
 
 By the Public Health London Act, 1891, this provision 
 was made imperative on the local authorities. 
 
 Disinfection by steam was considered practically the only 
 efficient system. By 1895 twenty-four sanitary authorities 
 had provided themselves with this apparatus, six with an 
 apparatus whereby disinfection was effected by dry heat, and 
 eight had arranged with a contractor. 
 
 When it is a fact that a few infected rags could let loose 
 disease of the worst type upon a community, the advantages 
 to the public of the general practice of disinfection were 
 incalculable. And in London the advantages were specially 
 great. 
 
 In almost every district hundreds of houses were dis- 
 infected every year, and thousands — even tens of thousands 
 — of articles. 
 
 The system of the compulsory notification of infectious 
 diseases facilitated greatly the work of disinfection, for by 
 informing the authorities where cases of such disease 
 occurred it enabled them to scotch disease in its breeding- 
 places, and so it was of the greatest benefit to the com- 
 
 26 
 
386 THE SANITARY EVOLUTION 
 
 munity. How great may be gathered from the following 
 figures. 
 
 The number of cases of Infectious Diseases in London 
 notified under the Act of 1889 were: — 
 
 
 29,795 
 
 in 1890 
 
 
 
 46,074 
 
 „ 1892 
 
 
 
 67,485 
 
 „ 1893 
 
 
 
 49,699 
 
 „ 1896 
 
 
 
 42,344 
 
 „ 1899 
 
 
 Of those in 
 
 1893 :— 
 
 
 
 
 36,901 
 
 were cases 
 
 of Scarlet Fever 
 
 
 3,633 
 
 )) )) 
 
 Enteric ,, 
 
 
 22 
 
 >) >> 
 
 Typhus 
 
 
 13,026 
 
 )> )) 
 
 Diphtheria 
 
 
 2,813 
 
 >) >) 
 
 Smallpox 
 
 Great work was being done in the prevention of the 
 spread of infectious disease in London by the Metropolitan 
 Asylums Board, in whose hospitals thousands of persons 
 suffering from such disease were isolated. 
 
 Dr. G. Buchanan, Chief Medical Officer to the Local 
 Government Board, wrote in 1892: — 
 
 "In regard to some infectious cases, notably those of 
 scarlet fever and diphtheria, there are no means at all to 
 be compared to isolation in hospital for preventing the 
 spread of a limited number of cases into a formidable 
 epidemic. 
 
 " And the wonderful and repeated checks to small out- 
 breaks of smallpox in the metropolis in the course of the 
 past seven years bears overwhelming evidence to the truth 
 of this dictum." 
 
 As the population of the metropolis increased in density 
 it became more and more necessary in the interests of the 
 people as a whole to make proper and sufficient provision 
 for the prompt isolation of those of its inhabitants who 
 might be smitten with infectious disorders. 
 
 Home isolation in London was difficult even under the 
 best circumstances, but in the smaller tenements it was 
 impossible. 
 
 " The removal to hospital of so many of the cases (of 
 
OF LONDON 387 
 
 scarlet fever) is a vast blessing to this neighbourhood," 
 wrote the Medical Officer for St. Mary, Newington, in 
 1897. 
 
 For some time a growing tendency on the part of the 
 public to accept hospital treatment for infectious cases had 
 been evinced. 
 
 " The * depauperisation ' of the Hospitals had led to a 
 great increase in the admissions, so that the public are on 
 the whole very willing to take advantage of the facilities 
 offered for having their infectious sick cared for in hospital, 
 whereby the other members of the patient's family can 
 follow their avocations without hindrance and without risk 
 to the public generally." 
 
 The Chief Sanitary Inspector for Bethnal Green gives 
 information as to the numbers who from his parish availed 
 themselves of the hospitals. 
 
 " A satisfactory feature, and of the greatest assistance in 
 dealing with infectious disease, is the large number of 
 patients now sent to hospital. This year nearly two-thirds 
 of the cases notified were removed. The importance of this 
 either to the patients themselves or to the public can hardly 
 be overestimated." 
 
 By the Public Health London Act, 1891, every inhabitant 
 of London suffering from any dangerous infectious disease 
 was entitled to free treatment at one of these hospitals.* 
 On receipt of notice an ambulance was at once sent for his 
 removal. 
 
 Year by year greater use was made of the Board's 
 hospitals, and at times there was not sufficient room in 
 the Metropolitan Asylums hospitals to receive all the cases. 
 In 1892 the total number of patients received amounted to 
 over 13,000, there being at one time 4,389 patients suffering 
 from all classes of fever or diphtheria receiving treatment in 
 the hospitals, whilst in 1893 the admissions amounted to 
 20,316. 
 
 By 1895 the Board had eight fever hospitals, including 
 diphtheria, with 3,384 beds ; three ships for smallpox cases 
 
 * See 3rd Eeport from Select Committee of the House of Lords on 
 Metropolitan Hospitals, 1891. 
 
388 THE SANITARY EVOLUTION 
 
 with 300 beds ; and a large hospital for convalescents with 
 1,200 beds. By 1898 the accommodation had reached the 
 large total of about 6,000. 
 
 The Chairman of the Metropolitan Asylums Board, 
 reviewing in 1897 the thirty years' work of the Board, 
 said : — 
 
 "Whilst, during the first twenty years of the Board's 
 experience, London was again and again visited with 
 epidemics of smallpox, during the past seven years it 
 has, thanks to the action of the managers in having 
 removed to and isolated at Long Eeach all cases of the 
 disease, been practically non-existent as a health disturbing 
 factor. 
 
 " The percentage mortality of smallpox cases treated by 
 the Board decreased from 20'81 in 1871 to 4*0 in 1896, and 
 the annual mortality from 2"42 to practically zero." 
 
 The rate of death from diphtheria also showed a continuous 
 fall, and this fall had been coincident with the introduction 
 and increasing use of the anti-toxic serum treatment of the 
 disease. 
 
 A valuable criticism on the existing machinery for the 
 sanitary government of London was given in a report of 
 the Metropolitan Asylums Board Statistical Committee in 
 June, 1892 :— 
 
 "Although London possesses an ambulance service and 
 a system of hospitals admittedly unrivalled, yet it has no 
 central authority charged with the duties of tracing out an 
 outbreak of this infectious disease (smallpox), and of taking 
 concerted action towards stamping it out by measures of 
 disinfection and vaccination and re-vaccination. 
 
 " These matters still remain in the hands partly of the 41 
 local sanitary authorities, partly of the Local Government 
 Board, and partly of the London County Council. 
 
 " Clearly the present arrangements are not only cumbrous 
 and incapable of that rapid action essential to success in 
 dealing with infectious disease, but they are also excessively 
 expensive." 
 
 In connection with hospital accommodation there were 
 two other factors in the sanitary evolution of London. One 
 
OF LONDON 389 
 
 of these was the provision made by the Poor Law for the 
 treatment and care of the sick poor.* 
 
 Previous to 1867 the accommodation provided by the Poor 
 Law for the sick was in the sick wards of the workhouses. 
 The Act of that year, which had established the Metropolitan 
 Asylums Board, laid the basis for the removal to separate 
 hospitals of paupers suffering from the worst forms of 
 infectious disease. The same Act authorised the building 
 and establishment of Poor Law infirmaries, thus removing 
 most of the sick from the workhouse wards, giving them 
 better treatment and better prospect of recovery. 
 
 In 1892 the number of new infirmaries was 24, containing 
 12,445 beds; but a large proportion of the sick were still 
 kept in the workhouses, the returns for 1890 showing about 
 4,000 occupied beds in them. 
 
 And, in addition to these institutions, there were Poor 
 Law dispensaries. The establishment of these dated from 
 1870, and by 1890 there were 44 of them. The immense 
 amount of work they did is shown by the following figures : 
 "In 1890 nearly 120,000 orders were given to Medical 
 Officers for attendance on patients, 53,572 being seen at 
 their own homes, and 59,149 at the dispensaries. It is 
 calculated that there are about eight attendances on each 
 order. Favourable opinions were expressed as to the quality 
 of the treatment afforded at them." 
 
 There is no means of even forming an estimate of the 
 results of these great remedial agencies, but that they were 
 an immense advance on previous arrangements for the 
 treatment of the sick poor is a well-established fact. 
 
 The Lords Select Committee reported that : — 
 
 " The evidence on the whole appears to indicate a general 
 recognition of the high standard of efficiency attained by the 
 best of the new infirmaries. 
 
 *• The poor do not generally regard the infirmary as they 
 do the workhouse; they look upon it rather as a State- 
 supported hospital; they come to the infirmary, are cared 
 
 * See the Report of Select Committee of House of Lords on Hospitals, 
 P.P. 1892, vol. xiii. 
 
390 THE SANITARY EVOLUTION 
 
 for, cured, and go out again without feeling that they are 
 tainted with pauperism." 
 
 The other great factor in the sanitary evolution of 
 London was the group of great hospitals — general and 
 special — supported, not by the State nor by aid from the 
 local rates, but by the charitable public, and governed and 
 managed and worked not by officials, paid either by the 
 central or local authorities, but by men — lay and medical — 
 who, from the highest and most public-spirited motives, 
 devoted themselves to this responsible work. 
 
 The general hospitals in 1890 numbered nineteen — some 
 of them great institutions, such as St. Bartholomew's, St. 
 Thomas's, Guy's, the London Hospital ; and the number of 
 special hospitals — many of them small — was stated to be 
 67 in 1890. 
 
 "The total number of beds in the general and special 
 hospitals in London combined was stated by Dr. Steele to 
 be 8,500, of which 6,500 are continually employed. But 
 according to Mr. Burdett— 8,094 and 6,143." 
 
 ** The vast numbers of persons who are treated in out- 
 patients' departments of hospitals, the number treated at 
 the eleven hospitals with schools, were estimated by one 
 witness at over half a million." 
 
 Here, again, no precise estimate can be formed of the part 
 these great institutions have taken in the sanitary evolution 
 of London. That their part has been a really great one is 
 evident without figm-es — proved not only by the millions 
 restored to health and capable citizenship, but even more 
 by their adopting and reducing to practice, and placing 
 within the reach of the whole community, the vast benefits 
 following the great scientific discoveries of recent times. 
 
 Among the many causes of insanitation, and all its miser- 
 able accompaniments, one of the most hopeless and most 
 difficult to deal with has always been intemperance or 
 " drink." Statistics give no means of estimating its dis- 
 astrous consequences, but these consequences always have 
 been, and still are, of the most deplorable kind. The 
 overcrowded dwellings and bad sanitary arrangements con- 
 stantly tended to increase the habit of intemperance, and 
 
OF LONDON 391 
 
 the moral degradation caused by drink made people in- 
 different to their housing, and lead to the poverty which 
 increased overcrowding and insanitation. 
 
 In London the facilities for obtaining drink are practically 
 unlimited. In the evidence given before the Boyal Com- 
 mission on Liquor Licensing Laws, which was appointed in 
 1896, it was stated that — 
 
 ** In Soho District, in an area of a quarter of a square mile, 
 there were 1950 inhabited houses and 116 public-houses. 
 In another district, a little over half a square mile in extent, 
 there were 259 public-houses (excluding restaurants and 
 private hotels)." 
 
 Down one mile of Whitechapel Koad there were 45 public- 
 houses. 
 
 "The streets branching off, the hinterland, are also 
 thickly supplied ; some exactly opposite each other." 
 
 "In one street in St. George-in-the-East so crowded are 
 the public-houses that there are 27 licensed houses out of 
 215 houses." 
 
 And these facilities are intensified by the great number of 
 hours during the day in which licensed houses keep their 
 doors open to all comers. 
 
 Parliament has done but little to mitigate this terrible 
 evil. Happily, however, other influences are at work. 
 
 The Royal Commissioners in their Eeport in 1899 said : — 
 
 " Most persons who have studied the question are of 
 opinion that actual drunkenness has materially diminished 
 in all classes of society in the last twenty-five or thirty years. 
 Many causes have contributed to this. The zealous labour 
 of countless workers in the temperance cause counts for 
 much. Education has opened avenues to innumerable 
 studies which interest the rising generation. The taste for 
 reading has multiplied manyfold within a comparatively 
 brief period. The passion for games and athletics, which 
 has been so remarkably stimulated during the past quarter 
 of a century, has served as a powerful rival to 'boozing,' 
 which was at one time almost the only excitement open to 
 working men." And then followed this weighty statement : 
 " Yet it is undeniable that a gigantic evil remains to be 
 
392 THE SANITARY EVOLUTION 
 
 remedied, and hardly any sacrifice would be too great 
 which would result in a marked diminution of this national 
 degradation." 
 
 And the Chairman of the Commission (Viscount Peel), 
 the Archbishop of Canterbury, and seven Commissioners in 
 a Minority Eeport stated that — 
 
 " The broad facts remain unchallenged of the prevalence 
 of the evil arising from drink." 
 
 That drink and insanitary housing constitute a vicious 
 circle should by no means deter the most vigorous efforts 
 being continued to improve the conditions of housing and 
 to raise the standard of the public health. 
 
 There was widespread testimony through the latter half 
 of the decade that the public health in London was im- 
 proving. Thus the Medical Officer of Health for the Bow 
 District in Poplar wrote in 1895: "We have only to 
 remember what London used to be, and consolation can be 
 found in the comparison. Epidemics are not so frequent, 
 disease is not so virulent, and those attacked stand greater 
 chances of recovery through better and more skilful 
 treatment." 
 
 And the Medical Officer of Health for Paddington in 
 1896 : " There has been a steady diminution in water- 
 borne disease since efficiently-filtered Thames water has 
 been substituted for the numerous wells and pumps of 
 former days." 
 
 The Medical Officer of Health for the Strand reported 
 in 1897 : " The Strand District (as to health) compares 
 favourably with other years. The result of your labours is 
 a steady improvement in the health of the inhabitants." 
 
 And the Medical Officer of Health for Islington in 1897 
 reported the death-rate as 15*80 — the lowest since registra- 
 tion was introduced in 1837. 
 
 In Whitechapel " the policy of your Board has resulted in 
 a considerable saving of human life." The death-rate for 
 the district in 1879 was 26-0 per 1,000, and in 1899 it was 
 193 per 1,000. 
 
 In Battersea the death-rate was 26*8 in 1871, and 17'6 in 
 1901. 
 
OF LONDON 393 
 
 But infantile mortality did not show a similar rate of 
 improvement. In many parishes there was a decided im- 
 provement. In many, however, infantile mortality remained 
 at a very high rate. 
 
 In Bethnal Green, in 1893, nearly half the total deaths 
 were of children under five years of age — a figure which 
 drew from the Medical Officer of Health the remark : 
 " The ignorance of women of the working classes on the 
 subject of infant feeding is colossal." In 1896 it was 51*5 
 per cent., and in 1898 it was 49*7 per cent. 
 
 In Poplar the Medical Officer of Health wrote, in 1895 : 
 " I think it my duty to point out the terribly high rate of 
 infant mortality. ..." 
 
 In Of 1,000 Births in 1895 Died under 1 Year. 
 
 Bow 179 
 
 Shoreditch 199 
 
 St. George's-in-the-East 196 
 
 Limehouse 202 
 
 "It is an awful state of affairs that so many young 
 children die every year." 
 
 In Shoreditch, in 1896, 49*1 per cent, of the total deaths 
 were of children under five ; in Islington, in 1896, 42*4 per 
 cent. ; in Hackney, in 1898, 40'9 per cent. ; in Fulham, in 
 1896, 51 per cent. 
 
 On the south side of the river — in St. George-the-Martyr, 
 in 1894, it was 58 per cent, of the total deaths ; in St. Olave, 
 Southwark, 48'6 per cent, in 1896. 
 
 A most hopeful sign was the greater public interest taken 
 in matters pertaining to the public health. 
 
 The Medical Officer of Health for Islington wrote in 
 1892 :— 
 
 " With the advance of education the public and Parlia- 
 ment appreciate the importance of more and more safe- 
 guarding the public health." 
 
 In 1895 :— 
 
 " They (middle class) will not tolerate the sanitation of 
 a few years ago ; indeed, they expect that the houses they 
 live in will at least be rendered safe against the entrance of 
 
394 THE SANITARY EVOLUTION 
 
 sewer gas, and themselves safeguarded against infectious 
 disease." 
 
 And the Medical Officer of Health for the " City " in 
 1894 :— 
 
 " Attention has been more particularly directed to 
 premises and dwellings of the better class, the occupants 
 of which are becoming more and more exacting owing to the 
 increased knowledge acquired by the public on all sanitary 
 questions. Some of these premises are of great size and 
 employ many hundreds of persons, and many enormous 
 insurance, banking, and gigantic commercial establishments." 
 
 And that there is a community of interest in a healthy 
 London was becoming more widely realised. That the fact 
 should have taken so long to be grasped is extraordinary as 
 it was so manifest a one. Over and over again it had been 
 proved that disease was not restrained by the paper boun- 
 daries of parishes, and that once set alight anywhere no 
 limit could be put to its widespread devastations. An un- 
 healthy area in any part of the metropolis constituted a 
 danger to the whole. Nor was disease a respecter of classes. 
 All were interested in keeping it away. 
 
 And, after many painful lessons, people were realising 
 much more than formerly that disease was a most costly 
 infliction. The Medical Officer of Health for St. James', 
 Westminster, in his report for 1893, set out the business 
 aspect of it : — 
 
 "The position of St. James', as the shopping centre for 
 the best retail trade of the West-end of London, makes the 
 district more and more a city of luxurious shops, hotels, 
 clubs, and lodging-houses. Increasing facilities for travel 
 to the suburbs, and the increasing value of premises, neces- 
 sitate its utilisation for business purposes during the day, 
 and its comparative desertion at night, ... Its resident 
 population of 25,000 persons is therefore an inadequate 
 exponent of the activity of its daily life, of the importance of 
 its retail trade, and of the necessity for active sanitation. 
 An outbreak of smallpox or of cholera would at once so 
 damage the trade of the district as to inflict upon its 
 ratepayers a thousand times the cost which is now incurred 
 
OF LONDON 395 
 
 by their preventive sanitary service, and by the prompt 
 removal of infectious cases to suburban hospitals as is novy 
 done." 
 
 But that was only a single and a limited case. 
 
 The industrial classes realised to a greater extent than 
 ever before the disastrous results to themselves and their 
 families of sickness and ill-health ; the prolonged suffering, 
 the loss of work and wages, the ensuing hardships. And it 
 was upon them more than on others that the effects of 
 disease fell most heavily. 
 
 In most matters the interests of the various parts of 
 London, and of the various classes, are one and the same, 
 but in none to anything like the same extent as in the vital 
 matter of public health. Here they are one and indivisible. 
 
 But neither Parliament nor the Government had got so 
 far as to recognise that yet, and London — the great metro- 
 polis — with its four-and-a-half millions of people, was left 
 for its protection against disease to a number of semi-inde- 
 pendent local sanitary authorities who had no authority 
 beyond their own area, and who could take no action for the 
 safety of London as a whole. 
 
 One thing was absolutely certain — and that was that the 
 civic life of London had within the decade been lifted to 
 altogether a higher plane. The publicity of the proceedings 
 of the central representative authority — whether of its 
 meetings in the Council Chamber, or of its constant applica- 
 tions to Parliament for legislation embodying far-reaching 
 civic reforms in London — the triennial elections, when the 
 area of discussion was shifted from the Council Chamber to 
 the constituencies, quickened the interest and awoke the 
 dormant masses of the people to the importance of civic 
 administration and of civic laws. 
 
 In this remarkable change the subject of the public health 
 strode to the front. Men began to realise how it entered 
 into every branch or part of their own lives and of their 
 families, how its ramifications invaded every part of their 
 existence, how much their welfare and comfort and even 
 their existence depended upon it. And the people had a 
 great load lifted off them — the load of despair begotten by 
 
396 THE SANITARY EVOLUTION 
 
 the hopelessness of any amelioration of the conditions of 
 life which so long had weighed them down. They felt now 
 that there was some one to whom they could complain, 
 some public authority who would see that things would be 
 righted, if they could be righted, and hope was born in 
 their lives. 
 
 In 1899 another change was made in the system of local 
 government in London. 
 
 The Act of 1888, while dealing with the central govern- 
 ment of London, had practically not touched the local 
 areas. The work was felt to be incomplete, and in 1893 
 Commissioners were appointed "to consider the proper 
 conditions under which the amalgamation of the City and 
 the County of London can be effected, and to make specific 
 and practical proposals for that purpose." 
 
 They reported in August, 1894. Their general conclusion 
 was contained in the following paragraph.* 
 
 " A consideration of the evidence we have received con- 
 firms the opinion suggested by the course of previous 
 inquiries and of legislation, or, in other words, by the historic 
 development of the metropolis, that the government of 
 London must be entrusted to one body, exercising certain 
 functions throughout all the areas covered by the name, and 
 to a number of local bodies exercising certain other functions 
 within the local areas which collectively make up London, 
 the central body and the local bodies deriving their authority 
 as representative bodies by direct election, and the functions 
 assigned to each being determined so as to secure complete 
 independence and responsibility to every member of the 
 system." 
 
 In February, 1899, Mr. Balfour introduced in the House 
 of Commons a "London Government Bill."t He referred 
 to the Act of 1888 which created the London County 
 Council as effecting a change " so much in consonance with 
 the traditions of English municipal government that it is 
 likely to be permanent," and said : — 
 
 * See Report of Royal Commissioners on the Amalgamation of the 
 City and County of London, 1894. 
 t See Hansard, 1899, vol. Ixvii. p. 354. 
 
OF LONDON 397 
 
 "We recognise to the full that there must be a great 
 central authority in London." 
 
 "Broadly speaking," he said, " the administrative Vestry 
 and the District Board exist now as they were framed in 
 1855." 
 
 " It is with these administrative Vestries and District 
 Boards that the present Bill proposes to deal. It is with 
 the subordinate area, not with the central area, that we are 
 now concerned. 
 
 " We do not propose to touch the City of London. 
 
 " We have determined that, by the appointed day it would 
 be desirable that all London should be divided into areas 
 for local government, and that every area should be simul- 
 taneously provided with all the necessary machinery for 
 government of its local affairs." 
 
 He mentioned the areas. 
 
 " The constitution of the governing bodies in these areas 
 shall be practically identical with the constitution which 
 our great municipal boroughs already possess . . . 
 
 "We propose that there should be mayor, councillors, and 
 aldermen. 
 
 " As regards their powers — the Vestries already possess 
 (except as to police) the great urban powers possessed by 
 other municipalities. Certain powers agreed upon between 
 the Vestries and the London County Council at certain 
 recent conferences will be added, and there would be trans- 
 ferred to them the powers relating to baths and wash- 
 houses, libraries, and burial boards." 
 
 "On an appointed day every elective Vestry and District 
 Board in the County of London is to cease to exist. He 
 hoped the plan would come into operation in November, 
 1900." 
 
 The Bill became an Act — " The London Government 
 Act"— in 1899. 
 
 The new municipal boroughs numbered twenty-nine — 
 " the City of London " and twenty-eight others ; sixteen 
 of them consisting of single parishes, and the remaining 
 twelve of several amalgamated parishes. 
 
 A few extra duties were cast upon them. Among them 
 
398 THE SANITARY EVOLUTION 
 
 the duty of enforcing within their borough the bye-laws and 
 regulations with respect to dairies and milk, slaughter-houses, 
 and offensive businesses ; and in some respects their powers 
 were enlarged, the principal addition being the power to 
 adopt and use the provisions of Part III. of the Housing of 
 the Working Classes Act, 1890, within their borough. 
 
 All preparations for the change were completed by the 
 autumn of 1899 ; the new Municipal Councils were elected 
 on the 4th of November, the forty-three Vestries and District 
 Boards ceased to exist, and London entered upon a new 
 stage of her career. 
 
 Here, at the close of 1900, the Vestries and the District 
 Boards of London came to their decreed end, and dis- 
 appeared from the scene of London civic life. That end 
 was not regretted by the general public, whose opinion 
 may be gauged from the fact that the name "Vestry" 
 had become almost synonymous with incapacity, mis- 
 management, neglect, sometimes even of graver trans- 
 gressions, though in later years the Vestries did something 
 towards removing from themselves that reproach. 
 
 They certainly had done much useful work, and even at 
 the outset of their existence were a great improvement 
 upon their predecessors. They had found their parishes 
 and districts forty-five years previously in the state de- 
 scribed in the first and second chapters of this work— 
 a chaos of filth, a slough of insanitation and deadly 
 disease, and the great mass of the people living in misery 
 indescribable — and the task before them was one which 
 might have daunted the stoutest heart. 
 
 In many ways they did their work well ; local sewerage 
 and house drainage were effectually carried out ; the refuse 
 of the great city was regularly removed ; the paving, and 
 lighting, and cleansing of the streets were greatly improved. 
 
 But in many parts of London, and by many Vestries and 
 District Boards, the larger, graver problems with which 
 they were confronted were scarcely dealt with at all. 
 Powers entrusted to them by Parliament were not used, 
 vitally important duties imposed upon them by Parlia- 
 ment were ignored or neglected. Had this been pure 
 
OF LONDON 399 
 
 incapacity it would have been deplorable, but upon many 
 of the Vestries were men who either were themselves 
 interested in continuing existing evils and abuses, or whose 
 friends were, and so laws which should have removed or 
 mitigated the evils were not administered. 
 
 And the result was the non-prevention of diseases which 
 led to deaths, and the continuance of miseries (consequent 
 on disease) which might have been warded off, and the 
 sowing of the seeds of evils of which we are still reaping 
 the crop. 
 
 As years went by the pressure of public opinion upon 
 them became more insistent, and their administration im- 
 proved, but even to the end many of them grievously failed 
 to fulfil the responsibilities of their position. 
 
 One class of workers under them must, however, be 
 excluded from such blame, namely, the Medical Officers 
 of Health. 
 
 It is not too much to say that the greater part of the 
 sanitary progress which was made all through the period 
 of Vestry rule was directly due to the unceasing labour, the 
 courageous efforts, the insistence of many of these officers. 
 Their recommendations were often ignored, their requests 
 constantly denied, their opinions made light of ; but in spite 
 of such discouragement they persevered. And not alone did 
 they bravely stand between disease and the people, but they 
 were ever striving to drive it back, and to destroy its prolific 
 sources and its power ; ever urging upon their employers the 
 necessity for action to relieve the people from the worst of 
 the evils they were suffering under. 
 
 The description given in 1856 by one of them that their 
 work was "a war of the community against individuals 
 for the public good " had been proved to be absolutely 
 true. 
 
 And in that war, of them generally, it is to be said that 
 there were no sturdier fighters on the side of the community 
 than they proved to be. 
 
 In 1885 Dr. J. Liddle, " a pioneer of reform," died after 
 thirty years of "unflinching adherence to duty " as Medical 
 Officer of Health for Whitechapel. 
 
400 SANITARY EVOLUTION OF LONDON 
 
 In 1889 Dr. N. Vinen died after thirty-four years' service 
 as Medical Officer of Health for St. Olave, Southwark.* 
 
 In 1895 Dr. J. S. Bristowe passed away after forty years 
 of service as Medical Officer of Health for Camberwell. 
 
 And there are still in the service men whose labours have 
 extended over prolonged periods. Such men as these, and 
 others of them who gave their best to the service of the 
 community, have indeed a claim to the lasting gratitude of 
 the citizens of London. 
 
 * In his last report he recorded the death of J. Munro, who had been 
 Inspector of Nuisances for thirty-three years, so for that long period 
 they had worked together. 
 
CHAPTEE VII 
 
 1901-1906 
 
 Once more the census placed on record the actual popula- 
 tion of the great metropolis, no longer divided, so far as 
 local government was concerned, into parishes and districts, 
 but now into a smaller number of municipal boroughs. The 
 figures of this census are the last available for reliable 
 deductions as to numerous important matters forming part 
 of that comprehensive subject, the sanitary evolution of 
 London. 
 
 The enumerated population of London had reached the 
 great number of 4,536,541, and showed an increase of 
 308,224 during the ten years 1891 to 1901. The rate of 
 increase, however, continued to show a decline, having 
 fallen from 10"4 to 7'3 per cent, during the intercensal 
 period. 
 
 The same movement of the population noted in previous 
 censuses was recorded in this one. 
 
 In the City of London and six of the central metropolitan 
 boroughs the enumerated population showed an actual 
 decline of over 67,000 in the ten years, notwithstanding 
 that the recorded excess of births over deaths in that period 
 amounted approximately to 70,000. 
 
 In all the other boroughs there had been increases. In 
 the Eastern group the increases had been very small, with 
 the exception of Stepney, where, owing to the immigration 
 of aliens, the population had increased 13,484. In the 
 Northern group the greatest increase had been in Hackney 
 (19,666). In the Western group Fulham showed the highest 
 
 27 401 
 
402 THE SANITARY EVOLUTION 
 
 increase, namely, 45,500 ; whilst on the south side of the 
 river, Wandsworth had increased 76,500, and several others 
 showed large increases. 
 
 Outside the boundaries of the county the "outer ring" 
 had attained to a population of 2,044,553 persons — an 
 increase of 639,000. 
 
 If the metropolis and this " outer ring" were regarded as 
 one city — and in many matters it is hard to consider them 
 apart — the total population in 1901 was 6,581,372. 
 
 The information as to the birthplaces of the people 
 showed that of the 4,536,541 persons, 3,016,580 were 
 natives of London. The proportion of natives of London 
 had increased ; the proportion from the rest of the United 
 Kingdom had decreased ; whilst there had been an increase 
 of 40,000 foreigners, the number having considerably more 
 than doubled since 1881. Of every 1,000 inhabitants, 668 
 were born in London, and 332 elsewhere, as against 653 
 and 347 respectively in 1891. 
 
 Once again the arrivals and departures by the gates of 
 life and death were recorded. In the ten years from the 
 1st of April, 1891, to the 31st of March, 1901, 1,329,428 
 births had been registered, and 838,454 deaths. The excess 
 of births over deaths, therefore, was 490,974 ; and as the 
 increase of population was 309,228, it followed that 181,746 
 persons had migrated. As the migration had only been 
 114,000 in 1891, it was manifest that migration to outside 
 the County of London was increasing. 
 
 The total number of inhabited houses was 571,768, as 
 against 547,146 in 1891 ; but owing to a variation in the 
 manner of collecting the information, the figures have little 
 value for comparative purposes. 
 
 The accurate figures given of the population of London 
 enabled the death-rate to be calculated on facts instead of 
 upon estimates. 
 
 The death-rate was 17*1 per 1,000 living in 1901, a 
 decrease from 18'6 in the previous year, and from 21*0 
 in 1891. 
 
 But to be set against this was the portentous fact that 
 the birth-rate had decHned from 31*8 per 1,000 in 1891 to 
 
OF LONDON 403 
 
 29*0 per 1,000 persons living in 1901, the lowest recorded in 
 London since civil registration began. 
 
 The public health of London was now altogether on a 
 better level than it had been before, but in the course of 
 the year 1901 some cases of smallpox appeared in various 
 parts of London, and in 1902 there was the most severe 
 outbreak of it — with the possible exception of 1884-5 — since 
 1871, nearly 9,000 cases being admitted to the hospitals of 
 the Metropolitan Asylums Board between September, 1901, 
 and July, 1902. Ninety-three patients were removed to 
 hospital in one day, and on one day (March 11th) 1,604 
 cases were under treatment. Over 1,300 persons died of it 
 in the year. 
 
 The cost of disease to the community has often been 
 referred to in previous chapters. The Metropolitan Asylums 
 Board stated that so far as it was concerned, the cost for 
 1901-2 might be put at ^500,000 — equal to about a three- 
 penny rate — a sum which was wholly apart from loss of 
 wages to the individual, and various other expenses, and 
 apart from the charge upon the rates of those who were 
 pauperised by the death of the breadwinner of the family. 
 1903 was "a year of comparatively very slight prevalence 
 of infectious disorders." 
 
 In 1904 there was " a marked absence of undue activity 
 amongst the infectious diseases of the metropolis." 
 
 And 1905 was the healthiest year in the records of 
 London since registration, the death-rate being 15*1 per 
 1,000. 
 
 In the five years which have passed since the census of 
 1901, Parliament has passed three Acts of the utmost con- 
 sequence to the sanitary condition of the people of London, 
 marking, in their respective spheres, definite stages in the 
 sanitary evolution of the metropolis. 
 
 The sanitary evils to which many of the people were 
 subject might, as has already been stated, be roughly divided 
 into two classes — those of their dwellings at night, and those 
 of their workplaces in the day. 
 
 "The Factory and Workshop Act" of 1901 dealt with 
 the latter. It was the amendment and final codification of 
 
404 THE SANITARY EVOLUTION 
 
 a mass of piecemeal legislation which had been spread over 
 a period of years. 
 
 In 1878, previous enactments on the subject had been 
 consolidated into one Act. That Act was amended in 1883, 
 1891, and 1895. All were now finally embodied in this Act 
 of 1901 with several additions and amendments. Additional 
 sanitary provisions were made as to the ventilation of 
 factories and workshops, and as to the drainage of floors. 
 Bakehouses came within the scope of the Act, and the law 
 was made much more stringent as to them. After January 
 1, 1904, it would be unlawful to use any underground bake- 
 house unless certified by the Borough Council to be suitable. 
 
 A register of workshops was to be kept, and the Medical 
 Officer of Health was, in his annual report, to report 
 specifically on the administration of the Act in workshops 
 and workplaces — a direction which ensured publicity as to the 
 action of the local authorities. The powers of the sanitary 
 authorities were extended by the Act, and certain duties 
 necessary for efficient administration imposed upon them. 
 
 The Act also ensured the inspection of dwelling-houses 
 where there were outworkers. 
 
 The work imposed on the Sanitary Authorities was very 
 considerable as a very large number of premises came under 
 their supervision, and every workroom in each workshop 
 had to be measured in order that its cubic space might be 
 ascertained ; and when the subsequent routine inspection of 
 the premises, and of outworkers' premises, remedying of 
 defects and other duties, were taken into consideration, the 
 magnitude of the work, and the necessity of an adequate 
 staff of officers, were evident. 
 
 The records show that at the end of 1904, 34,488 work- 
 shops in London were under the supervision of the local 
 authorities. The necessity of inspection was demonstrated 
 by the fact that 18,922 conditions required remedying. 
 
 Improvement was testified to by the Medical Officers of 
 Health, overcrowding was diminished, and it was further 
 stated that " employers are found to co-operate willingly with 
 the local authorities in the remedy of faulty conditions." 
 
 Altogether, then, when a comparison is made between the 
 
OF LONDON 405 
 
 conditions of the factories and workshops, and workplaces in 
 which the people worked in the middle of the last century 
 and now, the contrast is remarkable. The worst of the 
 evils have been swept away, and healthy conditions of work 
 have taken their place. 
 
 And the limitations put upon the labour of children and 
 young persons and women have all been to the good of those 
 subjected to them. And the public health of London, so far 
 as this very large and very valuable portion of the population 
 is concerned, has been immensely the gainer. 
 
 The second of the three Acts since 1900, which had a 
 vital bearing on the sanitary condition of the people of 
 London, was " The MetropoHs Water Act " of 1902. 
 
 That the water supply should be under the control and 
 management of the municipality had long been advocated, 
 but though hundreds of County and Municipal Authorities 
 in Great Britain — many of them not the hundredth part of 
 the size of London — had a Municipal Water Supply, that 
 great boon was denied to London. The reform was 
 vigorously pressed by the central representative body of 
 London — the London County Council — and after several 
 Eoyal Commissions of Inquiry, Parliament dealt with the 
 subject in 1902. But the manner of dealing with it was 
 unfortunate and retrogade. 
 
 A new public Board — the Metropolitan Water Board — 
 was established for the purpose of acquiring, by purchase, 
 for the inhabitants of London, and of certain areas outside 
 London, the undertakings of the eight Metropolitan Water 
 Companies, and for managing and carrying on the supply 
 of water. The great bulk of the purchase money was to 
 be provided by the ratepayers of London, and the great 
 bulk of the debt to be a charge on the rateable property 
 of London. 
 
 The Board was to consist of 66 members, 14 of whom 
 were to be nominated by the London County Council, 31 
 by the Metropolitan Borough Councils and the City Cor- 
 poration, and the remaining 21 by the authorities of localities 
 outside London hitherto supplied by the Companies. 
 
 The Board, therefore, was not a representative body 
 
406 THE SANITARY EVOLUTION 
 
 directly elected by the ratepayers or electors of London, 
 but was constructed, on the discredited precedent of the 
 Metropolitan Board of Works, of delegated instead of elected 
 members ; and though the people of London were emanci- 
 pated from the control of trading Water Companies, they 
 got in their place a body over which they can exercise no 
 direct, and therefore very little actual, control. 
 
 The new Board was constituted in the spring of 1903, and 
 took over the undertakings of the Water Companies on the 
 24th of June, 1904, at the cost to the ratepayers of London 
 of not much less than 5640,000,000, a sum immensely higher 
 than that at which they could have been acquired many 
 years before. 
 
 And inasmuch as the Board can call upon the ratepayers 
 of London to make good any deficiency of income resulting 
 from their management, the unsatisfactory result is the 
 establishment in London of a new indirectly-elected public 
 body vested with enormous financial powers affecting the 
 interests of the ratepayers of London, and yet but little 
 responsible to public control. 
 
 The third of the three important Acts, the Education 
 London Act, was passed in 1903, and carried in its bosom 
 possibilities of the most far-reaching benefits to the health 
 and physical welfare of future generations. 
 
 By this Act the London School Board was abolished, 
 and its duties transferred to the London County Council, 
 which was constituted the Education Authority for London. 
 
 Though, indirectly, the schools of the Board were having 
 considerable effect upon the physical well-being of the rising 
 generation, it cannot be said that the School Board had 
 utilised its vast opportunities for improving the general 
 health. By instruction, by influence, it might have done so 
 much, might have moulded the physical future of genera- 
 tions. But education was always much more in the minds 
 of the Board than health, though the two might well have 
 been considered together, and without health education is 
 of little use. 
 
 The Board in their " Final Report " endeavoured to offer 
 an explanation of their inaction. 
 
OF LONDON 407 
 
 "It has always been a question how far the Board are 
 authorised to spend public money on the medical care of 
 children. On the one hand suggestions have been made for 
 the inspection of their teeth, and the treatment of cases of 
 anaemic condition and arrested development. On the other 
 hand a legal opinion has been expressed that the Board are 
 not entitled to do anything, or to take any measures except 
 such as spring from the fact that the attendance of the 
 children is compulsory. On this account it has been thought 
 right to take action only in those cases in which on account 
 of contagious disease, it is necessary to exclude children 
 from school." * 
 
 Even the sanitary condition of the schools does not 
 appear to have been well looked after. 
 
 In January, 1890, one of the Committees submitted a 
 report to the Board, on which the resolution was passed — 
 
 " That the Committee be authorised to thoroughly examine 
 the whole of the drainage of any school of the Board where 
 they may think it necessary," &c. 
 
 The drainage was subsequently examined. In 181 schools 
 the drainage was all right. In 292 of the schools re-drainage 
 was required. For how long that fertile source of disease 
 had been scattering its evil germs among the tens of 
 thousands of children attending these insanitary schools, no 
 information is available. 
 
 In 1890, just twenty years after its formation, the Board 
 appointed a Medical Officer, and he gave only a portion of 
 his time to the work. 
 
 " Before 1891 there was no attempt on the part of the 
 Board to prevent the spread of infectious diseases by pre- 
 cautionary measures being adopted in the school." + 
 
 In 1895 the Medical Officer of Health for Paddington 
 wrote : — 
 
 " Schoolteachers should be required to inform the Sanitary 
 Authority of any special amount of illness which may occur 
 among the scholars. Half a school may be away through 
 
 * Final Report of the School Board for London, p. 326. 
 
 t See Report of Medical Officer of the late School Board for 1903-4. 
 
408 THE SANITARY EVOLUTION 
 
 sickness if the disease be not a notified one, but no informa- 
 tion of such fact comes to the Sanitary Authority." 
 
 And in 1896 he wrote : — 
 
 " The past year had emphasised the need of definite in- 
 structions to school teachers to keep the Medical Officers of 
 Health informed of the existence of infectious disease among 
 their pupils. It is surmised that there were upwards of 
 2,000 cases of measles in the parish in the earlier part of the 
 year." 
 
 And "measles is the most fatal disease of childhood." 
 
 In evening schools " efforts were made between 1899 and 
 1903 to teach the simple laws of health. . . . Prior to 1898 
 gymnastics were taught in only a few schools." * 
 
 In 1902 the Medical Officer resigned, and a new one was 
 appointed who should give his whole time to the work. His 
 first report (1903) is enlightening as to the methods of the 
 School Board in matters pertaining to the health of the 
 children attending the schools." 
 
 He wrote : — 
 
 " The maintenance of sanitary conditions as regards heat- 
 ing, lighting, ventilation, and cleanliness both of the 
 buildings and persons of the pupils, the detection of early 
 cases of illness . . . ill-health from many causes, school 
 habits, and school work in their influence on health . . . 
 these . . . come under the daily work of the teacher, and 
 there is no requirement that any knowledge of such matters 
 should be possessed by him. It is left to his own common- 
 sense, and he muddles through. The definite requirement 
 of hygienic knowledge as part of the equipment of every 
 teacher is a necessity if a great part of the work of this 
 department is not to be useless in result." t 
 
 And in his Report of the following year he wrote : — 
 
 " The provision of medical oversight for school life is 
 rapidly becoming a necessity. Five-sixths of the population 
 spend a seventh part of their lives under the exceedingly 
 artificial conditions of the schools, and during the plastic 
 period of life. Their chief function in the earlier part of that 
 
 ■■'■ Final Eeport, p. 297. 
 
 \ First Keport of Medical Officer for year ended March 25, 1903, p. 24. 
 
OF LONDON 409 
 
 period is to grow, and it is necessary that they should not 
 only do this, but do it under favourable circumstances for 
 development." * 
 
 Soon after the transfer of the administration of the 
 Education Acts to the London County Council, the medical 
 work of the late School Board was amalgamated with that of 
 the London County Council. The change is one which is likely 
 to be of the greatest benefit to the children in the schools, 
 and through them, as times go on, to the population of 
 London as a whole. The great value of health will 
 receive greater recognition than it has done hitherto, whilst 
 greater facilities for instruction in health matters, and 
 better physical training, cannot fail to have the most bene- 
 ficial effect. The vast field for this work is evident when 
 it is called to mind that nearly half a million of children 
 are in average attendance at the London County Council 
 Schools. 
 
 Three other matters legislated upon by Parliament claim 
 mention. 
 
 In 1902 the Midwives Act was passed. It provided for 
 the constitution of a Central Midwives Board with power to 
 frame rules for the registration of midwives and for regulat- 
 ing and supervising the practice of midwives. After the 1st 
 of April, 1905, no person might use the title of midwife with- 
 out being certified under the Act. The London County 
 Council was constituted the local supervising authority for 
 London, and under its supervision much good has already 
 been done. 
 
 Also in 1902 the Cremation Act, which empowered burial 
 authorities to provide and maintain crematoria, and em- 
 powered the Secretary of State to make regulations as 
 to the conditions under which cremation might take 
 place. 
 
 And to complete the tale of sanitary legislation since 1900, 
 a few reforms were secured by sections in the annual General 
 Powers Acts which the London County Council obtained 
 from Parliament. Among these was one rather important 
 one. 
 
 * Second Annual Eeport to March 25, 1904. 
 
410 THE SANITARY EVOLUTION 
 
 In 1894 the duty of Supervising and regulating the com- 
 mon lodging-houses in London, which hitherto had been 
 performed by the Commissioner of Police, was transferred 
 to the London County Council. In that year 654 such 
 houses were on the register, and the authorised number of 
 lodgers was close upon 30,000 persons. In 1902 the Council 
 obtained powers for the annual licensing of such houses. 
 These larger powers enabled the Council to improve the 
 sanitary condition of many of these houses. The super- 
 vision of these houses has been most satisfactorily carried 
 out, and has been of immense value in securing sanitary 
 abodes for the miserable people who frequent them, and in 
 diminishing what would otherwise doubtless often be a source 
 of infection to the community. 
 
 The sanitary evolution of London having begun a little 
 before the middle of the nineteenth century, the jfigures 
 of the censuses of 1851 and 1901 afford the means for 
 measuring many of the great changes which have taken 
 place in the intervening period. 
 
 And a comparison of the state of those things which 
 most affect the public health at these two dates enables a 
 reliable deduction to be drawn as to whether there has been 
 evolution to a higher level of public health, or a retro- 
 gression ; and, if the former, the progress which that 
 evolution has made. 
 
 In 1851 the population of London was 2,362,236. In 
 1901 it had reached 4,536,541. And when to this is added 
 the fact that all through the intervening years so enormous 
 a mass of people has been cooped up in an area of 117 square 
 miles, and that at the present time there are over 4,600,000 
 within that small area, the multiplicity of the matters 
 decisively influencing their health and physical well being, 
 and the vastness of the issues at stake, come into vivid 
 light. 
 
 As has been often said, the very basis or foundation of 
 the sanitation of a city is an efficient system of drainage. 
 "Without it sanitation is impossible. 
 
 What the main drainage of London was up to 1858 has 
 been described in the earlier chapters of this book. In effect, 
 
OF LONDON 411 
 
 nothing less than an entire system had then to be designed 
 and constructed to provide London with this first essential. 
 This was done, and the result was of immediate and 
 enormous benefit to London, and ever since then the 
 maintenance and extension and improvement of this work 
 has received the solicitous attention of the Central Authority. 
 Originally designed for 3,500,000 people, it had, as London 
 grew, to be considerably enlarged and extended, and as some 
 of the districts outside the boundaries of London were 
 allowed by Parliament to drain into the London sewers, still 
 larger works had to be constructed. And now the system 
 serves a resident population of, in round figures, 5,500,000 
 people spread over an area of about 140 square miles. It 
 comprises close upon 90 miles of great intercepting and out- 
 fall sewers, 176 miles of main sewers, and 26 miles of large 
 relief sewers, constructed for the special purpose of convey- 
 ing storm- water away. 
 
 This, however, was but part of the provision which had to 
 be made. During the regime of the Metropolitan Board of 
 Works, more than 1,100 miles of new sewers were laid by 
 Vestries and District Boards in their respective districts, and 
 since the creation of the London County Council of 1888, 
 further additions of 1,516 miles have been made, making a 
 total of over 2,600 miles. 
 
 All this work was essential to enable a proper system 
 of house drainage to be carried out, and as the drainage of 
 houses into the local sewers was compulsory, the general 
 system of drainage was thus rounded off or completed. 
 
 The change effected thereby in the conditions of life in 
 London has been remarkable. There are no longer open 
 ditch-sewers polluting the air with their pestilential abomi- 
 nations ; no longer streets without sewers, and houses without 
 the possibility of drainage. 
 
 In the Eeport of the County Council for 1902-3, prepared 
 by the Clerk of the Council, there is given a calculation of 
 what these works annually accomplish. 
 
 " The flow of sewage during the year, namely 87,556 
 million gallons, represents a canal 24 feet wide with a depth 
 of 9 feet, running day and night at the rate of 2 feet per 
 
412 THE SANITARY EVOLUTION 
 
 second ; or it may be considered as equivalent to a lake of 
 44 square miles, or about one-third of the area of the county 
 of London, with a depth of 11^ feet." 
 
 To the efficiency and thoroughness of the present system 
 is primarily due the greatly improved condition of the public 
 health of London as compared with 1855. 
 
 Water was another of the absolute necessities of existence 
 and of sanitation. An ample supply of good water is 
 essential for health ; and the numerous outbreaks of 
 typhoid fever which in recent years have occurred in 
 England with a heavy death roll, testify to the dangers in- 
 curred by bad water, and the necessity for the utmost care 
 being taken to secure its being pure and uncontaminated. 
 
 The supply of water in the eighteen -j&f ties had been 
 very limited in quantity, and, with the exception of that 
 supplied by one company, abominable in quality. And 
 progress to a better state of things was slow. Improve- 
 ments were made most unwillingly and haltingly by the 
 Water Companies, and only under Parliament's reluctant 
 compulsion, whilst the inaction of most, and the obstruction 
 of some, of the Vestries and District Boards, and the 
 hostility of " owners " of houses to being put to expense 
 for water fittings, still further impeded reform, and 
 perpetuated the evils inflicted upon the inhabitants of 
 London — suffering, disease, and death. 
 
 The " slaughter wells " and the sewer-ditches were, 
 however, filled up and those evil sources of supply ended. 
 And a supply of water was gradually extended to the 
 streets which were without any, and an increased supply 
 to others which had but little ; but it was not until 1899, 
 the very end of the century, that the County of London 
 was, for the first time, receiving a constant supply in 
 accordance with the provisions of the Metropolis Water 
 Act of 1871. And by slow degrees the sources of defile- 
 ment of the water were reduced, and a larger proportion 
 of the dirt ingredients filtered out, until at last some of 
 the worst evils connected with the supply were rectified. 
 And in 1891 it was enacted by Parliament * that a dwelling- 
 
 ■'• In the Public Health (London) Act. 
 
OF LONDON 413 
 
 house without a proper and sufficient supply should be 
 a " nuisance " liable to be dealt with summarily. 
 
 The main cause of all the grave disadvantages the people 
 of London had so unceasingly suffered under in this matter 
 arose from the fact that the interests of the Water 
 Companies and the interests of the people of London ran 
 directly counter to each other. London, in fact, had from 
 the very outset been at the mercy of trading companies 
 for its supply of this necessity of life, and bitter cause, 
 indeed, had London to rue it. 
 
 It is too soon to know what improvements will result 
 in the supply of water to the people of London, but in 
 the interests of the public health it is most unsatisfactory 
 that the public should even now be debarred from that direct 
 control which alone can secure them the fullest benefits. 
 
 In another of the numerous branches of the great subject 
 of the public health of London — the widening of the streets 
 and thoroughfares — the improvements made in process 
 of years was marked, and the better provision of light and 
 air and breathing space has been considerable. 
 
 The total gross cost of new streets and improvements 
 carried out by the Metropolitan Board of Works had 
 amounted to over £12,000,000,* whilst it had contributed 
 another million and a half to the cost of smaller street 
 improvements carried out by the "City" and other districts, 
 which latter also expended considerable sums. 
 
 The London County Council continued the policy of 
 the Metropolitan Board of Works, and by the year 1904-5 
 it had carried out, or was in process of carrying out, 
 improvements at an estimated gross cost of over 
 £11,000,000, t the greatest and most costly of all being 
 the new thoroughfare — Kingsway and Aldwych — connecting 
 Holborn with the Strand, which swept away some of the 
 most notorious and worst slums in London. 
 
 In addition to these, many local improvements have 
 been carried out by the "City" and by the Vestries and 
 
 * The recoupments arising from the sale of surplus lands reduced 
 the actual or net cost to less than J68,000,000. 
 I Here the net cost is estimated to be about ^5,500,000. 
 
414 THE SANITARY EV^OLUTION 
 
 District Boards, and later by the Borough Councils. These 
 were estimated to cost about £1,800,000. The total work 
 accomplished, therefore, has been very considerable, but 
 the cost has been huge ; amounting in the whole to about 
 ^£27,000,000. 
 
 Of greater value to the health of the people has been 
 the increase of the number of parks and open spaces in 
 London, not merely in preventing land being built over, 
 but in the opportunities afforded the people, and especially 
 the younger portion of them, for exercise. 
 
 Here considerable acquisitions have been made since the 
 time of the Metropolitan Board of Works. Immediately 
 after the creation of the London County Council two 
 generous gifts were made to the citizens of London — 
 Waterlow Park of 30 acres and Myatt's Fields — and the 
 Council had acquired Hackney Marsh, with 337 acres ; 
 Brockwell Park, with 127 acres ; and Avery Hill, 84 acres ; 
 and some distance from London, 803 acres of Hainault 
 Forest. In addition to these several small pieces of ground 
 were acquired and thrown open as public gardens and 
 recreation grounds. 
 
 The "City" had also acquired, outside the County of 
 London, Epping Forest, about 5,560 acres in extent, 
 Bumham Beeches, 375 acres ; Coulsdon Common, 347 acres ; 
 and a few small open spaces in the " City " itself. 
 
 And many acquisitions had been made by the Vestries 
 and District Boards, and, since their supersession, by the 
 Borough Councils. 
 
 Purity of air was another of the important elements 
 of a satisfactory health condition. 
 
 Once that the Thames had ceased to be the main sewer 
 of London, and once that the hundreds of thousands 
 of cesspools were filled in and abolished, the most persistent 
 and fruitful and worst of the causes of the impurity and 
 unwholesomeness of the atmosphere were removed. Gradu- 
 ally too, but only too slowly — a slowness resulting in 
 widespread loss of health and life — were the noxious trades 
 in London made amenable to the law, and somewhat less 
 noxious to those living in their immediate neighbourhood ; 
 
OF LONDON 415 
 
 this, too, without that ruin to trade and manufactures which 
 was always predicted when any effort was made to prevent 
 the prevalence of intolerable nuisances. 
 
 The duty of administering the provisions of the law 
 relating to the abatement of smoke nuisances rested with 
 the police. Under their action a steady reduction had 
 taken place in offences against the law. In 1882, 1,248 
 cases were reported, and there had been 162 convictions; 
 and in 1890 the numbers had sunk to 702 reported cases 
 and 46 convictions. 
 
 In 1891, by the Public Health London Act, the duty 
 was transferred to the Sanitary Authorities. Considerable 
 use has been made by them of the Act. In many cases 
 severe penalties were imposed, and the general result has 
 been a very satisfactory improvement. Much, however, 
 of the fouling of the atmosphere is caused by factories 
 outside London, and consequently outside the control of 
 the local authorities of London. 
 
 And yet another of the great branches of the general 
 subject of the public health is the food supply of the people. 
 It would be difficult to give any approximate estimate even 
 of the part which good or bad food has in its effect upon 
 the public health, or to produce any statistics on the 
 subject, but, undoubtedly, it is a very large part; and 
 every now and then the outbreak of some serious illness 
 and heavy loss of life, directly traceable to the consumption 
 of bad food, shows how important it is to safeguard the 
 people from such disasters. 
 
 Thus in 1901 there was an outbreak of scarlet fever, 
 in which some 300 persons were attacked, directly traced 
 to an infective milk supply. 
 
 Previous to the date of the Nuisances Eemoval Act of 
 1855 there was, so far as London was concerned, practically 
 no control or supervision over the food sold to and consumed 
 by the people. That Act contained a section providing 
 for the inspection of food by the local sanitary authority, 
 so the importance of securing wholesome food for the 
 people was then recognised. Little, if any, use was made 
 of the power thus given, and the Act was amended and 
 extended ; but even then it was almost a dead letter. 
 
416 THE SANITARY EVOLUTION 
 
 As years advanced great scientific discoveries demon- 
 strated the fact that some of the most dangerous diseases, 
 such as typhoid and scarlet fever, could be conveyed in 
 food of various sorts, and opened up a new vista of dangers 
 as to the conveyance of disease.* And the huge size of 
 London, and the vast numbers of its population, increased 
 enormously the difficulty of safeguarding the public from 
 the dangers of contaminated food. 
 
 The first and greater portion of this vi^ork was done by 
 the Corporation of the City of London. Its Committee, the 
 Port Sanitary Authority, was able to prevent large quantities 
 of bad meat which arrived by sea being put upon the 
 markets ; and the Corporation, which administered the 
 principal markets of London — the cattle-markets at 
 Deptford and Islington, the fish-market at Billingsgate, 
 and the others at Smithfield and Leadenhall and Spital- 
 fields — by a system of inspection, prevented large quantities 
 of bad or diseased food being sold to the public. 
 
 In 1905, 415,000 tons of meat reached the Central 
 Smithfield Market, of which 2,128 tons were seized as 
 being diseased and unsound. At Billingsgate, 211,600 tons 
 of fish were delivered, of which 674 tons were condemned. 
 And there were 28 wharves and warehouses in the City 
 where tinned food and tinned meat and vegetables were 
 received. 173 tons were seized. All these places were 
 daily inspected. 
 
 This, however, was only a portion of the food which 
 reached London. The responsibility for inspecting food in 
 other parts of the metropolis rested (under the Public 
 Health (London) Act of 1891) with the various Sanitary 
 Authorities, and the reports of the Medical Officers of 
 Health contain accounts of inspections by them, and of the 
 seizure of meat, fish, poultry, rabbits, tinned food, vegetables, 
 eggs, and sweetmeats, and of prosecutions, and of a few 
 convictions. And many other articles of food were, under 
 
 * The International Congress of Hygiene, held in Brussels in 1903, 
 passed a resolution declaring meat to be unfit for human food when 
 it was derived from animals attacked by bacterial anthrax, glanders, 
 rabies, tetanus, tuberculosis, in certain cases, and several other diseases. 
 
OF LONDON 417 
 
 the Food and Drugs Act of 1875-99, also liable to inspection 
 so as to secure that they should not be adulterated ; so that 
 theoretically, and in a very great measure actually, provision 
 exists for protecting the people of London from adulterated 
 articles of food, and from food unfit for human con- 
 sumption. 
 
 All this is an immense advance upon the time when there 
 were no laws against the sale of unsound or adulterated 
 food. 
 
 But there is great room for improvement, for the 
 inspection and means of prevention are far from adequate 
 to secure the protection of the public from this danger; 
 indeed, the existing system of government for dealing 
 successfully with this most important element in the well- 
 being of the people is very defective. 
 
 The experiences of the past sixty years or so in London 
 have abundantly shown how great is the extent to which 
 the public health is dependent upon the system of local 
 government in existence at the time, and upon the 
 administration of the laws relating to the public health 
 by those authorities. 
 
 The considerable changes which have taken place in the 
 fifty years since the creation of a Central Authority, the 
 Metropolitan Board of Works, have been described. 
 
 So far as regarded the local authorities over the separate 
 areas into which London was divided, the " City " remains 
 practically as it was, with the exception of the addition to 
 its sphere of action of the important duties of Port Sanitary 
 Authority, and such further powers as the exigencies of the 
 times required, and certain changes consequent upon 
 the creation of the London County Council. 
 
 In the metropolis the other local sanitary authorities 
 instead of being Vestries and District Boards — 43 in 
 number — are now Municipal Borough Councils — 28 in 
 number — with some larger powers, including wide powers 
 of rating. 
 
 The Poor Law Guardians, also with wide powers of 
 rating, have remained much as they were, their sphere of 
 work being a definitely limited one. 
 
 28 
 
418 THE SANITARY EVOLUTION 
 
 Various Commissioners, such as the Commissioners of 
 Baths and Washhouses, Library Commissioners, and Burial 
 Boards, have ceased to be ; their powers being now 
 exercised by the Borough Councils. 
 
 The important changes in the local government of the 
 metropolis have mainly been in the Central Authorities, 
 whose sphere of duties extends over the whole area of 
 London. 
 
 The principal Central Authority, the London County 
 Council, which superseded the Metropolitan Board of Works 
 in 1 1889, instead of being indirectly elected as was that body, 
 is a directly elected body, elected by and representative 
 of the whole electorate of London. Its duties and powers 
 have undergone extension and increase ; the latest material 
 addition to them being its appointment as the Education 
 Authority for London. 
 
 In 1867, owing to the default of the Vestries and District 
 Boards to make provision of rate-supported hospitals- for 
 paupers suffering from infectious or contagious disease, a 
 Central Authority — the Metropolitan Asylums Board — 
 constituted on the indirectly elected system, with consider- 
 able powers to spend money which had to be provided out 
 of the rates of the metropolis, was created to do that work. 
 
 In 1870 another central body was created, the London 
 School Board, to deal with the elementary education of the 
 children of London, and though not a health authority, its 
 work was closely associated with the public health. It also 
 possessed the widest powers for spending money, which had 
 to be provided out of the rates of the metropolis. It was a 
 directly elected body, but elected on a system peculiar to 
 itself, and one which in great measure removed it from any 
 financial public control. 
 
 By an Act of Parliament in 1903 the London County 
 Council was made the Education Authority for London, 
 and the work of the School Board was transferred to it. 
 
 To the two existing central authorities was added, in 
 1903, another wholly gratuitous central local authority, the 
 Metropolitan Water Board, an indirectly elected body with 
 ultimate rating power over the metropolis. 
 
 I 
 
OF LONDON 419 
 
 There is a third sphere of government in matters per- 
 taining to the public health — namely, that occupied by the 
 State. It is charged with many duties connected with the 
 pubHc health, and is in close relationship with the various 
 central and local authorities in London. It has undergone 
 large changes since the middle of the last century. 
 
 At that time some of the powers possessed by the State 
 Government in health matters were exercised by one of the 
 Secretaries of State. Others, for some years, through the 
 General Board of Health appointed by the Government. 
 In 1858, when that Board ceased to exist, some of its powers 
 were transferred to the Privy Council, others lapsed to the 
 local sanitary authorities. 
 
 So great, as time went on, was the development of local 
 government throughout the country, and so essential was it 
 to have some central government State supervision over the 
 largely increased number of local sanitary authorities, that 
 in 1871 a new Government Department, the Local Govern- 
 ment Board, was created to perform this work. To it were 
 transferred most of the powers in connection with sanitation 
 and health matters possessed by the State Government, and 
 the various authorities in London came more or less under 
 its supervision. Since then, as the sanitary needs of the 
 community grew, and as legislation became more volumi- 
 nous, fresh duties have been constantly imposed upon that 
 Board. 
 
 Summing up these changes, and their broad effects, it is 
 to be said that the machinery for the administration of the 
 sanitary laws in London is undoubtedly far more potent and 
 effective than it has been at any previous time. Instead of 
 the Vestries and District Boards there are now the Borough 
 Councils ; instead of the Metropolitan Board of "Works there 
 is the London County Council ; instead of the Privy Council 
 and Board of Health there is the Local Government Board, 
 whilst the MetropoHtan Asylums Board and the Water 
 Board had no predecessors. 
 
 But on the other hand the system now in existence is 
 very complex, and in many ways cumbersome, and in recent 
 years there has been a most unfortunate tendency on the 
 
420 THE SANITARY EVOLUTION 
 
 part of Parliament to revert to that which was the curse of 
 London before the Act of 1855 — the multiplicity of local 
 authorities — all of them, too, with separate rating powers. 
 
 So far, then, in the way of the machinery of local govern- 
 ment has London come on its way to an improved condition 
 of the public health. 
 
 And Parliament, as has been narrated, had, since 1855, 
 multiplied the health laws, which these bodies were charged 
 with the administration of. Then, the passing of an Act 
 dealing with matters affecting the public health was so rare 
 as to constitute a remarkable event. Now Acts of Parlia- 
 ment and " Provisionial Orders" as to health matters are 
 quite common events. 
 
 With such numerous laws covering so many phases of 
 the public health, with so much larger and more powerful 
 a machinery for their administration, the crucial point 
 of all is the administration of those laws by the various 
 authorities. It is obvious that the administration is much 
 more searching and effective and wide-reaching than it 
 has ever been before. 
 
 The Central Authority, the London County Council, has 
 done great work, as has already been shown, in extending and 
 maintaining the efficiency of the drainage system of London, 
 in the clearance of insanitary areas, and the erection of 
 houses for the working classes ; in the acquisition of open 
 spaces, in great street improvements, in its efforts to help 
 towards a solution of the great housing problem by the 
 facilities of traffic it has created by its tramways, in the 
 inquiries it has instituted into the insanitary condition 
 of various districts in London, in the unifying of administra- 
 tion by the local sanitary authorities, and in many other 
 ways too numerous to be recited. It has, in fact, vigorously 
 used such powers as it possessed. 
 
 The Metropolitan Asylums Board has also used its powers 
 effectively, having erected hospitals, and having each year 
 successfully isolated and treated many thousands of cases 
 of infectious and contagious disease. 
 
 The Water Board is still too young to have a record. 
 
 The Poor Law Guardians had improved the workhouses 
 
OF LONDON 421 
 
 and the infirmaries, and the dispensaries were continuing 
 to do their useful work. 
 
 The Metropolitan Borough Councils were grappling 
 with their numerous duties. The perusal of the annual 
 reports of these bodies shows their multiplicity. House- 
 to-house inspection — the inspection of factories and work- 
 shops, and workplaces, and outworkers; of bakehouses, 
 cowsheds, dairies, and milkshops ; of food and the places 
 where food is prepared; of offensive trades and slaughter- 
 houses, and of houses let in lodgings ; the management 
 of baths and wash-houses, the removal of dust and filth, 
 disinfection, proceedings under the Housing of the Working 
 Classes Acts; measures for the prevention of disease, for 
 the abatement of nuisances, and many other duties con- 
 nected with sewerage, drainage, and paving and cleansing 
 of streets — all and every one of which closely affect the 
 health of the people. 
 
 The amount of work done varied considerably. In a 
 well-administered municipality the number of Sanitary 
 Inspectors had been increased, the number of inspections 
 was high, and the work continuous and heavy. In some, 
 however, the work was less satisfactorily done, and the 
 old Vestry antipathy to the expenditure of money upon 
 Inspectors appeared to have been handed on. 
 
 Much, nevertheless, was being done, and on the whole 
 matters appeared to be progressing satisfactorily, and in 
 many respects undoubtedly were doing so. 
 
 But every now and then some revelation occurred of 
 insanitary conditions under which large numbers of the 
 people were living which showed a grievous omission 
 somewhere, and for which some persons were responsible. 
 
 Thus when, under the Education (London) Act of 1903, 
 the County Council had to take over the non-provided 
 schools in London, the schools were inspected, and it was 
 found that their drains were generally in a very bad 
 condition. No fewer than 342, or 78 per cent, of the school 
 drains which were tested, were declared unsatisfactory. 
 A most prolific source of disease and death was thus laid 
 bare, a source which for years must have been working 
 
422 THE SANITARY EVOLUTION 
 
 grave evil — and as in these sclaools there were about 135,000 
 children in attendance, the number of persons involved 
 in danger was enormous. 
 
 Again, some of the figures published by the Census 
 Commissioners in 1902 disclosed a condition of things of 
 the utmost gravity. 
 
 Similar figures in the census of 1891 had passed almost 
 unnoticed ; these of 1901 reiterated the story, and as the 
 evils they laid bare were on a somewhat smaller scale they 
 were hailed more as a mark of progress and improvement, 
 than as something portentous in themselves. Yet they 
 go down to the very roots of the sanitary condition of the 
 people of London, and show how great is the task to be 
 accomplished before the sanitary condition can be con- 
 sidered satisfactory or even safe. 
 
 They bring into sudden view the fact that the problem 
 of the housing of the people is still unsolved. 
 
 The census of 1901 had recorded that there were 
 4,536,541 persons in London. V, also recorded that the 
 total number of tenements was 1,019,546. It further 
 showed that of these tenements no fewer than 672,030 
 were tenements of less than five rooms ; and then going 
 into details of these 672,030 tenements it showed that — 
 
 149,524 were tenements of one room. 
 201,431 „ ,, two rooms. 
 
 181,542 „ „ three „ 
 
 139,533 „ „ four „ 
 
 Comparing these figures with those for 1891 it appeared 
 that — 
 
 "A marked improvement had taken place in the manner 
 in which persons occupying tenements of less than five 
 rooms are housed in London, The shifting of the popu- 
 lation in the ten years from the tenements of one or two 
 rooms to the more ample accommodation provided in tene- 
 ments of three or four rooms is conspicuous." * 
 
 There had been a reduction in the number of one-room 
 
 * See Report of the Medical Ofi&cer of Health of the London County 
 Council, 1902, p. 10. 
 
OF LONDON 423 
 
 tenements, which are justly regarded as the worst of all 
 from 172,503 in 1891, to 149,524 in 1901, whilst there had 
 been an increase in the number of two, three, and four- 
 room tenements. 
 
 As to the numbers of persons living in these 672,030 
 tenements — 
 
 304,874 persons lived in tenements of one room. 
 701,203 „ ,, „ two rooms. 
 
 752,221 „ „ ,, three „ 
 
 691,491 „ „ ,, four „ 
 
 Total 2,449,789 
 
 Still, therefore, well over half the population of London 
 lived in tenements of less than five rooms ; whilst over 
 1,000,000 lived in tenements of one or two rooms — and 
 between one- and two-room tenements there is not much to 
 differentiate. 
 
 By further details given (as in 1891) each Sanitary 
 Authority was " provided with the means of examining 
 with much precision into the house accommodation of 
 its district." 
 
 The Medical Officer of Health for the Borough of 
 Finsbury, utilising the figures for that Borough, deduced 
 some most instructive conclusions as to the effect of the 
 one-room and two-room tenements upon the death-rates. 
 
 Forty-six per cent, of the population lived in such tene- 
 ments ; the death-rate in one-room tenements was 38*9 per 
 1,000 ; the death-rate in two-room tenements was 22*6 per 
 1,000. And the number of deaths occurring in them was 63 
 per cent, of all the deaths in the Borough. 
 
 ** The conditions of life obtaining in one-room tenements," 
 he added, " are such as tend towards poor physique, disease, 
 and death. The density of population is higher, the physical 
 restrictions are greater, and there is less fresh air and more 
 uncleanliness." 
 
 The information thus given by the Census Commissioners 
 as to tenements was striking enough, but of deeper interest 
 and import even than these figures was the information as 
 to " Overcrowding." 
 
424 THE SANITARY EVOLUTION 
 
 The Medical Officer of Health for the London County 
 Council, utilising the figures of the census, worked out 
 the facts as regarded the overcrowded tenement population 
 of London. 
 
 There were 726,096 persons living in an overcrowded state 
 in 124,773 tenements of less than five rooms. Of these — 
 
 147,771 lived in 40,762 one-room tenements. 
 296,659 „ 50,304 two „ 
 187,619 „ 23,979 three „ „ 
 
 94,047 „ 9,728 four „ „ 
 
 726,096 124,773 
 
 There had been a reduction of overcrowded tenements 
 from 145,513 in 1891, containing 829,765 persons, to 
 124,773 in 1901, containing 726,096 persons. 
 
 There would appear then to be some hope that the acme 
 or climax of overcrowding has been passed. But even 
 from the most sanguine point of view the improvement 
 is not great, and many decades would have to elapse before 
 " overcrowding " ceased to be a power for evil. 
 
 A few illustrations show the dreadful condition of things 
 in this respect in certain localities. 
 
 In the Borough of Finsbury, over 35,000 persons lived 
 in overcrowded tenements of less than five rooms ; in 
 Stepney, 99,000 ; in Islington, 56,000 ; in St.'Tancras, 56,000 ; 
 in Lambeth, a few short of 37,000 ; and in Southwark, over 
 46,000. 
 
 And if some of the figures about overcrowding were 
 looked into a little more minutely it was to be seen that 
 in St. Marylebone there were 1,020 two-room tenements 
 inhabited by five persons each, 685 by six persons each, 
 366 by seven persons each, and 170 by eight persons each. 
 
 In Islington there were 1,253 such tenements with six 
 persons each, 624 with seven persons, and 258 with eight 
 persons. 
 
 In St. Pancras there were 1,414 two-room tenements 
 with six persons in each, 743 with seven persons in each, 
 and 323 with eight in each. 
 
 In Shoreditch there were 694 two-room tenements with 
 
OF LONDON 425 
 
 six persons in each, 380 with seven in each, and 155 with 
 eight in each. 
 
 Stepney was the worst of all — with 1,126 two-room 
 tenements with seven persons in each, 577 with eight 
 persons in each, and 278 with nine persons in each; but 
 this was the result of alien immigration. 
 
 In Lambeth there were 699 tenements of two rooms 
 with six people in each, and 322 similar tenements with 
 seven each, and 118 with eight each. 
 
 It must have come as a revelation to many of the 
 Borough Councils to find such a condition of things existing 
 in their municipality. 
 
 These are the most recent reliable figures. Not much 
 change can have taken place since then, and they may 
 be regarded as presenting fairly well the existing condition 
 of the housing of the people of London. 
 
 The main fact emerging from them is that a population 
 of 726,096 persons in London are living in 124,733 
 overcrowded tenements of less than five rooms. 
 
 The accumulated testimony of the most experienced and 
 capable observers during half a century is clear and precise 
 that overcrowding is disastrous to the physical welfare of 
 the individual. The conditions of life are not much better 
 in one- and two-roomed tenements, and the conclusion is 
 thus forced upon us that, speaking broadly, a fifth of the 
 population of London are at present living in circum- 
 stances where physical well-being is impossible, and where 
 even a moderate standard of public health is unattain- 
 able. 
 
 For some time back, fears as to the physical deterioration 
 of certain classes of the population have found public 
 expression, and to such a point did these misgivings come 
 that, in 1903, a Committee was appointed by the Lord 
 President of the Council to inquire into the subject through- 
 out the kingdom. 
 
 The idea of physical deterioration being at work found 
 expression sometimes in the reports of the Medical Officers 
 of Health even far back. Thus, in 1869, the Medical Officer 
 of Health for Paddington wrote : — 
 
426 THE SANITARY EVOLUTION 
 
 " In Paddington overcrowding in its worst forms cannot 
 be said to exist, but there is an over-concentration of 
 building which will some day be considered a disgrace 
 to our civilisation. It may safely be predicted that besides 
 a high infantile death-rate a concomitant deterioration of 
 race will result. . . . This high (infantile) death-rate is not 
 the only check to population. Another and more painful 
 form of evil manifests itself in the sickly and puny race 
 around us. Young men and young women are unable from 
 low vitality to cope with their contemporaries in the labour 
 market, where prolonged muscular exertion is required. 
 We find in this class the seeds of debility and disease." 
 
 In 1871 he gave a table with particulars of five hundred 
 heads of famiHes of the wage-earning class engaged in 
 industrial occupations living in tenement-houses in certain 
 streets near the Great Western Eailway terminus. "Sixty- 
 four per cent, were bom in country places. This," he added, 
 "confirms my statement in former reports that large 
 numbers of men born in cities have poor constitutions 
 and deficient vital stamina, who cannot cope with their 
 competitors from the country, nor command the best labour 
 markets of the world. In the struggles of town-life large 
 numbers are prematurely crushed out at early periods of 
 their existence." 
 
 And he added : " This deterioration of race has for some 
 time been recognised by Medical Officers of Health." 
 
 Unfortunately the conditions of life conducive to dete- 
 rioration did not cease to exist in 1871, as evidenced 
 by the figures of the censuses of 1891 and 1901, of the 
 population living in overcrowded tenements of less than 
 five rooms. 
 
 The Committee reported in 1904, but while both the 
 Beport and the evidence are of great interest, it cannot 
 be said that they advanced the question much. 
 
 The Committee stated that — 
 
 " There are no sufficient * data' at present obtainable for 
 a comparative estimate of the health and physique of 
 the people." 
 
 That being undoubtedly so, the best light obtainable 
 
OF LONDON 427 
 
 on the subject must be sought for in a different way. 
 Fortunately that way exists — and it is possibly the soundest 
 of all — the method of inference from well-established facts. 
 
 The reports of the Medical Officers of Health for London 
 during the last half-century enable this method to be applied 
 to London. 
 
 In cases innumerable it has been demonstrated beyond 
 dispute that the death-rate was highest in overcrowded 
 houses or localities, that the sick-rate was proportionately 
 higher, that disease assumed more virulent form in them, 
 and left the victim in a more impaired condition. 
 
 "It is almost an axiom that the greater the crowding, 
 the greater the sickness and the higher the death-rate." 
 
 That these conditions affect the health and stamina of 
 persons of all ages, and more especially of the children who 
 are to constitute the new generation, is a truism, and thus 
 the health and stamina of a large proportion of the population 
 is, of necessity, damaged and deteriorated, and a heritage of 
 suffering and debility passes to a succeeding generation. 
 Were these evils mere passing events like an epidemic 
 of cholera which sweeps away its thousands of victims and 
 is gone, the results would not be so disastrous. 
 
 But when to these clearly proved facts is added the awful 
 fact that these evils have been unceasingly in active 
 operation for considerably more than half a century, that 
 the past is still exerting a powerful and pernicious effect 
 upon the present, and that the seeds of evil then sown are 
 still producing a deadly crop, it is a necessary and unavoid- 
 able conclusion that there has been a considerable deteriora- 
 tion of race. 
 
 Counteracting these deadly forces have been those which 
 have been described in this book: — 
 
 Efficient sewerage and drainage, water supply improved 
 in quantity and quality, sounder food, wider thoroughfares, 
 cleaner streets, open spaces, new dwellings, prevention of 
 the defilement of the atmosphere, prevention of the spread 
 of infection — all these, together with better knowledge of 
 health matters, the vast advance in medical science, the 
 better provision for the treatment of the sick, greater 
 
428 THE SANITARY EVOLUTION 
 
 temperance, and the great work carried on by numerous 
 philanthropic workers and organisations, have effected vast 
 improvement — an improvement testified to in the fall in the 
 death-rate of London from 23-38 per 1,000 in 1851 to ITl in 
 1901 since which year it has further decreased. 
 
 Painfully and laboriously, and in the face of persistent 
 obstruction and hostility, has the present sanitary position 
 been attained. " Vested rights in filth and dirt " have 
 offered a prolonged and dogged fight against reforms which 
 curtailed their privileges. Hundreds of thousands of lives 
 have been needlessly cast away, an uncountable number 
 blighted and made useless by diseases which were prevent- 
 able, and which were not prevented, and an incalculable 
 injury inflicted upon the community. 
 
 And the expense to the community has been enormous. 
 Millions upon millions of money have had to be spent to 
 make good — so far as could be made good — the ravages 
 of past neglect and culpable management. Millions upon 
 drainage, upon hospitals, upon houses for the working 
 classes, upon open spaces — tens of millions upon water 
 supply, and most unjustifiable and regrettable of all, millions 
 to compensate slum owners for their iniquities. 
 
 And even yet we have not arrived at our goal. "What, 
 then, are still the causes of failure? What the impediments? 
 WTiere the shortcomings ? 
 
 The failure is in part due to a great omission by Parlia- 
 ment — in part to the non-administration of existing laws 
 by local authorities — in part to a great defect in the system 
 of local government. 
 
 Parliament had, most unfortunately, omitted from all its 
 enactments affecting London any provision for the super- 
 vision of the great movement in part economic, in part 
 social, which has been going on in London for well-nigh 
 two-thirds of a century —namely, the change of houses 
 inhabited by one family into tenement-houses, or houses 
 inhabited by several families. 
 
 That movement with its appalling attendant evils was 
 allowed to go on practically unregulated, uncontrolled, 
 and unsupervised. 
 
OF LONDON ' 429 
 
 The great evil of this movement was, that a house which 
 had been structurally and sanitarily designed for one family 
 was sanitarily unsuited for its altered career as the abode of 
 several families. Nothing was done to obviate this evil. 
 And so these houses became packed with people and families 
 who had to live in one or two rooms in them without the 
 primary necessities of a healthy existence — without venti- 
 lation — without an adequate supply of water — without 
 facilities for cooking food — with the scantiest and filthiest 
 sanitary accommodation — had to live under conditions 
 which put a high premium upon dirt and insanitation, and 
 which absolutely invited disease and death. 
 
 Even the Sanitary Act of 1866, and its amending Act of 
 1874, did not deal with this crucial matter; and no legal 
 obligation was created by Parliament to ensure that the 
 houses undergoing such a change should be adapted to their 
 altered circumstances. 
 
 The Sanitary Act of 1866 only in part dealt with the 
 evils inherent in such houses. It imposed on the Sanitary 
 Authority the duty of making regulations which prescribed 
 a standard of the air space for each person, and thus made 
 an effort to prevent overcrowding ; it imposed upon the 
 "owner" the duty of maintaining a certain standard of 
 cleanliness — the rooms were to be painted or lime- whitened 
 every year — it laid upon the tenants certain duties also 
 as to maintaining cleanliness. 
 
 But even this imperfect legislation was completely 
 brought to naught by the opposition of the "Vestries and 
 District Boards to such action as would have secured at any 
 rate some degree of decent accommodation in the tenement- 
 houses of London. 
 
 By the PubHc Health Act, 1891, the London County 
 Council was empowered to make bye-laws enforcing a 
 certain standard of sanitary accommodation in them, and 
 did make them. But in other respects nothing was done ; 
 and so the process still goes on, large numbers of houses 
 hitherto occupied by one family are passing into the occupa- 
 tion of several families devoid of the primary necessaries of 
 a healthy existence. The great movement has by no 
 
430 THE SANITARY EVOLUTION 
 
 means spent its force; for long to come houses will be 
 going through this transition, and until legislation deals 
 definitely with this matter the inevitable evils attendant on 
 the change will continue. 
 
 The second main cause of failure lies at the door of the 
 local authorities who would not and did not administer the 
 existing laws. 
 
 The local governing authorities are now more active than 
 they have ever been before ; the amount of work done in 
 every branch of sanitation is far greater than ever before ; 
 the number of Sanitary Inspectors has been increased from 
 188 in 1893 to 313 in 1904. But the regulations or 
 bye-laws under the Act of 1891 which Parliament had 
 imperatively directed them to make and to use as regarded 
 the tenement-houses in London, are very far from being 
 enforced to the extent they should be. 
 
 The total number of houses let in lodgings which were on 
 the various registers in 1905 was 22,257. 
 
 With only a few exceptions the Borough Councils, like 
 their predecessors the Vestries, make comparatively little 
 use of this power, though there is a concurrent mass of 
 testimony as to the beneficial results following its use. 
 Stepney, under the inrush of aliens, found the benefit of 
 exercising the power, and heads the list with 2,672 houses 
 on the register. Kensington has 2,107; "Westminster 1,641; 
 St. Pancras 2,192 ; Hammersmith 2,266 ; and Finsbury 
 1,169. These amount to 12,047, or 10 per cent, of all the 
 inhabited houses in those six boroughs. In the whole of 
 the rest of London with 451,596 inhabited houses, only 
 10,207 of the houses let in lodgings are registered : so that 
 only 2J per cent, of the houses in them, as against 10 per 
 cent, in the others, are registered. 
 
 It is manifest, therefore, how imperfectly the greater 
 number of even the present local authorities perform the 
 duty which has been imperatively imposed upon them by 
 Parliament. 
 
 The Borough of Shoreditch, for instance, with 22,940 
 tenements of less than five rooms, of which 6,269 were over- 
 crowded with 35,500 persons living in them, has only 283 of 
 
OF LONDON 431 
 
 the houses let in lodgings on the register. The Borough of 
 Lambeth with 44,495 tenements of less than five rooms, 
 of which 6,548 were overcrowded with 36,900 people living 
 in them, had only 372 houses on the register. The Borough 
 of Bermondsey with over 25,000 persons living in over- 
 crowded tenements had only 221 houses on the register. 
 
 This, as has been explained (see p. 377), is not a matter in 
 which the Central Authority, the London County Council, 
 has any authority to interfere. The Borough Councils are 
 their own masters in this matter, as were their predecessors 
 the Vestries, and the responsibility as to administering or 
 not administering in their areas the Act of Parliament 
 rests entirely with them. The consequences of the non- 
 administration of these bye-laws to the health and physical 
 well-being of great masses of the people are disastrous. 
 
 "Various legal decisions in recent years have somewhat 
 impeded the effective administration of the bye-laws in this 
 matter, but the real impediment is the dislike to them of 
 the Borough Councils. 
 
 The condition of the vast tenement-house population in 
 this great city is of such immeasurable consequence to the 
 community at large that matters can only be allowed to 
 continue in their present most unsatisfactory state at the 
 most dire cost. The sooner it is thoroughly inquired into 
 by Parliament and drastically dealt with the better; great 
 evils will be stayed, great benefits will be secured. 
 
 The third principal cause of failure to attain a higher 
 level of the pubHc health in London than at present 
 enjoyed has been the want of a real central Health 
 Authority. The Metropohtan Board of Works was never 
 such. The London County Council is only such in a very 
 limited way. A real central Health Authority for London 
 is an absolute necessity — that is the great moral to be 
 drawn from the history of the last half-century so far as 
 local government in health matters in London is concerned. 
 
 Disease recognises no boundaries, and in a great city like 
 London it is essential that in so vital a matter as the pubUc 
 health full authority should, subject to Parliament, be 
 vested in one supreme authority — a central authority which 
 
432 THE SANITARY EVOLUTION 
 
 shall secure uniformity of administration ; a central 
 authority which shall be able to compel a local authority 
 in London to do that which if it neglects is a danger to the 
 community ; a central authority which, in the event of such 
 neglect, shall be authorised itself to undertake that work ; a 
 central authority which shall be able to act at once for 
 London as a whole in presence of any sudden or great 
 emergency — that is absolutely essential for the sanitary 
 safety of this great city and of the millions who live in it. 
 
 The want of such an authority has throughout the whole 
 sanitary evolution of London been a disaster of the greatest 
 magnitude, and is an ever-present peril to this great 
 metropolis. The existence now of a central popularly 
 elected representative body for the metropolis would render 
 this reform quite a simple matter. 
 
 Further measures are also required to aid in the removal 
 of the worst of London evils. 
 
 In 1903 a Eoyal Commission was appointed to inquire 
 into the means of locomotion and transport in London. It 
 reported in 1905, having done its work more thoroughly 
 than even most Eoyal Commissions do their work. 
 
 A great portion of its report deals directly or indirectly 
 with the sanitary condition of the people of London. 
 
 " The question of locomotion," said the Commissioners, 
 " affects the health, comfort, and efficiency for work of the 
 whole community. . . . 
 
 "Witnesses who have special knowledge of the subject 
 are of opinion that the remedy for overcrowding is to be 
 found in the removal of the people to outside districts by 
 providing additional facilities for locomotion, and in this 
 opinion we agree. . . . 
 
 " We have come to the conclusion that in order to relieve 
 overcrowding means must be provided for taking the 
 population into and out of London, not in one or two 
 directions but in many directions, at rapid speed, frequent 
 intervals, and cheap rates." 
 
 To this recommendation of the Commission it should be 
 added that means must be devised for preventing in " outer 
 London " a repetition of those circumstances and conditions 
 
OF LONDON 433 
 
 of life which, for more than half a century, entailed such 
 sufferings and evils upon the people of London. 
 
 In reviewing the principal events, and studying the 
 powerful underlying forces of the great movement of the 
 sanitary evolution of London, the bitter experiences of the 
 time gone by would indeed have been in vain if they did 
 not point the way to an avoidance of past blunders and 
 iniquities, and towards a better and happier future for the 
 people. The lines upon which reform should move 
 gradually become apparent as the events unroll themselves ; 
 and the measures now to be taken evolve and shape them- 
 selves from the successes and failures of the past. 
 
 The reforms just suggested are undoubtedly those which 
 are most imperatively necessary. The whole experience of 
 the past justifies the belief that they would soon work a 
 great change for the better in the physical, mental, and 
 moral conditions of life of large masses of the people of 
 London. And from improved and healthier homes would 
 come to the people increased comforts and happiness, and 
 more physical energy and greater strength to fulfil the duties 
 of their lives, and to meet whatever demands the future 
 may make upon them and upon our nation. 
 
 The strength and even the existence of a nation depend 
 upon the health of its masses. The stake at issue is a vital 
 one to people and nation ; and now more than ever is it 
 necessary that the health and vigour of our race should be 
 maintained at the highest possible attainable standard. 
 
 29 
 
INDEX 
 
 Adultebation op Food Act, 1860, 
 
 182-4 
 Aldwych, 413 
 
 Allison, Dr., evidence quoted, 28 
 Alteration of Food and Drink and 
 
 Drugs Act, 1872, 238 
 Artizans' and Labourers' Dwellings 
 
 Act, 186S, 212-3, 254-5, 282 
 Artizans' and Labourers' Dwellings 
 
 Improvement Act, 1875, 256-8, 
 
 264 ; Amendment Act, 1879, 265, 
 
 292-5 
 Avery Hill, 414 
 
 Bakehouses, 171-2, 275, 374, 381-2, 
 
 404 
 Bakehouse Regulation Act, 1863, 183, 
 
 275 
 Balfour, Rt. Hon. A. J., 396-7 
 Ball, Decimus, 323 
 Ballard, Dr., 252 
 Barnett, Canon, 294 
 Bateson, Dr. Henry, reports quoted, 
 
 150, 286-7 
 Baths and Wash-houses, 39, 126, 252 
 Baths and Wash-houses Act, 1846, 
 
 39 252 
 Battersea, 98, 177, 203, 229, 284, 392 
 Beaconsfield, Lord, 287 
 Beale, James, 186 
 Bedfordbury, 259-60 
 Bermondsey, 17, 23, 98, 116, 144, 177, 
 
 188, 220, 250-1, 300, 309, 332-3, 
 
 347-8, 354, 431 
 Bethnal Green, 46-7, 74, 97, 103, 108, 
 
 120, 129, 138, 145, 177, 188, 190, 
 
 202, 219, 222, 268, 288, 291, 293, 
 
 303, 308-10, 333-4, 353, 364, 375, 
 
 383, 386-7, 393 
 Billingsgate Market, 416 
 Birth-rate, decline of, 350, 402-3 
 
 Bloomsbury, 314 
 
 Boundary Street Area, 364 
 
 Bow, 393 
 
 Bristowe, Dr. J. S., 400 
 
 BrockweU Park, 414 
 
 Bromley, 159 
 
 Building Act, 1844, 30, 164 
 
 Burial grounds, 35-7, 54-5, 64, 67, 
 
 281, 309-10 
 Burnett, J., report quoted, 335 
 Burnham Beeches, 414 
 
 Camberwell, 98, 104, 137, 144, 155, 
 190, 219, 222, 267, 288, 291, 305, 
 809, 384, 354, 406 
 
 Census of 1851, 56, 410 ; of 1861, 155- 
 7 ; of 1371, 221-2 ; of 1881, 288-9 ; 
 of 1891, 349-52 ; of 1896, 379 ; of 
 1901, 401-2, 422 
 
 Central Health Authority needed, 
 195-6, 277-8, 431-2 
 
 Cesspools, 18, 51, 104, 128, 159, 229 
 
 Chadwick, Edwin, 47 
 
 Chamberlain, Rt. Hon. Joseph, 293, 
 308 
 
 Cheap Trains Act, 1863, 362 
 
 Chelsea, 98, 141, 197-8, 255, 267, 288, 
 354 
 
 Children's Employment, Commis- 
 sion on, 210-1 
 
 Cholera epidemics, of 1832, 2, 46 ; of 
 1848, 45-6 ; of 1849, 46-9, 63 ; of 
 1853, 72-5, 164; of 1866, 189-92 
 
 Chichester, Bishop of, speech in 1850, 
 66 
 
 "Christopher Court," Whitechapel, 
 28 
 
 " City," the, its commercial char- 
 acter, 7-9 ; its government, 9, 417 ; 
 its sanitary condition, 50; its 
 declining population, 94-5, 155, 
 
 435 
 
436 THE SANITARY EVOLUTION 
 
 222, 224, 288, 352, 401-2; con- 
 struction of business premises, 367, 
 894 ; Amalgamation Committee, 
 396 
 
 Clare Market scheme, 364 
 
 Clerkenwell, 22, 74, 97, 102-3, 109, 115, 
 120, 124, 126, 185, 245, 261-2, 288, 
 303, 307-8, 314, 321, 323, 333, 353, 
 355 
 
 Common lodging houses, 67, 132, 
 145, 253; erected by L.C.C., 366, 
 410 
 
 Common Lodging Houses Act, 1851, 
 67, 132 
 
 Commons, acquisition of, 206, 282 
 
 Compulsory Vaccination Act, 1867, 
 208 
 
 Consumption, 146, 170 
 
 Contagious Diseases Animals Act, of 
 1869, 237 ; of 1878, 275-6 
 
 Coulsdon Common, 414 
 
 Cowhouses and dairies, 275, 318 
 
 Cremation Act, 1902, 409 
 
 Cripplegate, 165 
 
 Cross, Sir R. A., 256 
 
 Customs and Inland Revenue Act, 
 1890, 344-5 
 
 Density of building, 25, 28, 98, 
 203, 329-30 
 
 Deptford, 74, 347 
 
 Derby, Lord, 165 
 
 Dickens, Charles, on burial grounds, 
 36 ; speech in 1850, 65 
 
 Dilke, Sir Charles, 308 
 
 Diphtheria, 146, 386 
 
 Diseases Prevention Act, 1848, 79, 
 152 
 
 Diseases Prevention (Metropolis) Act, 
 1883, 318-9 
 
 Disinfection, 194, 248, 252, 358, 385 
 
 Dispensaries, 389 
 
 District Boards created, 83-9 ; in- 
 efficiency and inactivity, 183-7, 
 267-73, 301-8, 321-2, 398-9; 
 abolition, 398-9 
 
 Drunkenness connected with over- 
 crowding and insanitation, 130, 
 142-3, 157-8, 176, 263, 391-2 
 
 Dunraven, Lord, 336-7 
 
 East London Water Co., 106, 191-2 
 Education (London) Act, 1903, 406, 
 
 421 
 Elementary Education Act, 1870, 
 
 219, 346 
 Epping Forest, 414 
 
 Factories, overcrowding in, 113, 
 173-4, 193, 334-7; Royal Com- 
 mission of 1876, 274; need of 
 inspection, 373-4 
 
 Factory Act of 1864, 183; of 1867, 
 210-1; of 1878, 274-5; of 1891, 
 370; of 1901, 403-4 
 
 Farr, Dr. W., 189 
 
 Fever, prevalence of, 4, 32-4 ; con- 
 nection with cholera, 47 
 
 Finsbury, 16, 314-5, 423-4, 430 
 
 Finsbury Park, 206 
 
 Plight, 323-4 
 
 Porster, W. E., speech quoted, 242 
 
 Fulham, 98, 100-1, 112, 115, 131, 
 159-61, 166-7, 191, 204, 214, 219, 
 222, 226, 228, 252, 288, 307, 374, 
 380, 393, 401-2 
 
 Gladstone, W. E., 312 
 
 Godwin, George, 173, 181 
 
 Goulston Street scheme, 293 
 
 Grainger, Dr., evidence quoted, 48-9 
 
 Granville, Lord, 165 
 
 Gray's Inn Road, 295 
 
 Greenwich, 17, 74, 98, 101, 124, 222, 
 
 309, 332 
 Grey, Sir G., 70 
 
 Griffith, Dr. J., evidence quoted, 21-2 
 Grosvenor, Lord Robert, 66 
 
 Hackney, 17, 97, 100, 103, 117, 123, 
 
 136, 179, 190, 197-8, 222, 228, 230, 
 
 267, 288, 309, 334, 373, 393, 401 
 Hackney Marsh acquired, 414 
 Hainault Forest, 414 
 Hall, Sir Benjamin, 73 
 Hammersmith, 101, 204, 226, 383, 
 
 430 
 Hampstead, 97, 100, 125, 351, 375 
 Hampstead Heath acquired, 206 
 Harcourt, Sir William, 311 
 Hickson, W. E., evidence quoted, 26 
 Holborn, 97, 123, 127, 155, 164, 170, 
 
 255, 314, 353-4 
 Homsey, 351 
 Hospitals for infectious diseases, 
 
 209-10, 283, 318-9, 387-8 
 Hospitals, voluntary, 390 
 Houses, defective building of, 227-9, 
 
 232, 273 
 Housing of the Working Classes Act 
 
 of 1885, 325-6; of 1890, 342, 363-6, 
 
 398 
 Housing of the Working Classes 
 
 Commission, 317, 319, 321-5 
 Hunter, Dr., 185-6 
 
OF LONDON 
 
 437 
 
 Immigbation into London, 156, 221, 
 
 225-6, 288-91, 336, 349, 402 
 Infectious and contagious diseases, 
 
 194, 208-9, 239-40, 263, 266, 276, 
 
 283, 318-9, 343-4, 357, 385-8, 403, 
 
 407-8 
 Infectious Diseases Notification Act, 
 
 1889, 342-3 
 Inspectors of Nuisances, 86, 91, 188-9, 
 
 193-4, 307-9, 324-5, 334-5, 358; 
 
 their insufficient number, 379-80, 
 
 382-3 
 Islington, 97, 99, 108, 120, 127, 155, 
 
 177, 180, 188, 201, 222, 224-5, 
 
 279-80, 288, 351, 355, 374, 380-1, 
 
 392-3, 424 
 
 Jacob's Island, foul water in, 23 
 Jewish sanitary laws, 143, 146, 149 
 
 Kenry, Loed, 371 
 
 Kensington, 98-9, 105, 121, 188, 219, 
 
 222, 225, 230, 278-9, 288, 355, 376, 
 
 383, 430 
 Kingsway, 413 
 
 Labouring Classes Lodging Houses 
 
 Act of 1851, 69-70, 326 ; of 1867, 
 
 326 
 Lakeman, 371 
 Lambeth, 12, 17, 30,98, 103,105, 116, 
 
 122-4, 155, 188, 203, 222, 251-2, 
 
 267, 300, 309, 352, 354-5, 375, 424-5, 
 
 431 
 Lambeth Water Company, 73 
 Lancet, The, description of the 
 
 Thames, 77 
 Lankester, Dr., 189 
 Laundries, public, 126 
 Lea Conservancy Board, 208 
 Lewisham, 98, 102, 144 
 Liddle, Dr. J., 399 
 Limehouse, 97-8, 111, 120, 163, 188, 
 
 251, 258, 279, 393 
 Little Coram Street, Bloomsbury, 
 
 262-3 
 Local government of the "City," 9; 
 
 of Greater London, 11-4 ; lack of 
 
 central authority, 13 ; Act passed 
 
 in 1855, 82 
 Local Government Board Act, 1871, 
 
 232-3, 419 
 Local Government (England and 
 
 Wales) Act, 1894, 382 
 Locomotion, additional facilities 
 
 needed, 432 
 
 London, Bishop of, speech in 1850, 
 64 
 
 London County Council created, 
 338-9 ; powers given by Public 
 Health Act, 1891, 359-61 ; and by 
 Housing Act, 1890, 363-6 ; con- 
 stituted education authority,406-9, 
 418 ; summary of its work, 420 
 
 London Fever Hospital Eeport, 1845, 
 32 
 
 London Government Act, 1899, 396-7 
 
 London Government BUI, 1884, 311-3 
 
 Lynch, Dr. J., 33-4, 261 
 
 Maeylebone. See St. Marylebone 
 Measles, 408 
 
 Meat, inspection of imported, 318 
 Medical Officers of Health, their 
 
 duties, 86, 91, 96 ; their reports, 
 
 92-3 ; their treatment by local 
 
 authorities, 189 ; their labours, 
 
 399-400 
 Metropolis Local Management Act, 
 
 1855, 82, 110, 185 
 Metropolis Turnpike Trusts Act, 
 
 1828, 24 
 Metropolis Water Act, 1862, 71, 160, 
 
 191 
 Metropolitan Asylums Board, 210, 
 
 418, 420 
 Metropolitan Board of Works consti- 
 tuted, 83-5 ; abolished, 337-41 
 Metropolitan Building Act of 1844, 
 
 24, 76; of 1856, 88, 164, 204, 
 
 231 
 Metropolitan Burials Act, 1852, 55 
 Metropolitan Gas Act, 1860, 184 
 Metropolitan Markets Act, 1851, 247, 
 Metropolitan Paving Act, 1817, 12, 
 
 24 
 MetropoUtan Poor Act, 1867, 208-10 
 Metropolitan Sanitary Association, 
 
 106 
 Metropolitan Sewers Commission, 
 
 evidence before, 18-9 
 Metropolitan Water Amendment 
 
 Act, 1871, 233-5 
 Metropolitan Water Board, 405-6, 
 
 418, 420 
 Middlemen, 323-4 
 Midwives Act, 1902, 409 
 Mile-End-Old-Town, 97, 99, 131, 163, 
 
 166, 227, 278, 288, 309, 333, 347, 
 
 383 
 Milk trade, 275, 318 
 Millbank estate, 366 
 « Model dwellings," 868-70 
 Morpeth, Lord, 43-4 
 
438 THE SANITARY EVOLUTION 
 
 Mortality, in the fifties, 120-1, 129-30, 
 144-5, 148, 150 ; in the sixties, 153, 
 156, 176-8, 191, 219-20, 223 ; in the 
 seventies, 263, 278-81, 283 ; in the 
 eighties, 292, 346-8 ; in the nineties, 
 350-1, 364, 392-3, 402 
 
 Mortuaries, 252, 358 
 
 Municipal Corporations Act, 1835, 
 78 
 
 Municipal Councils, created, 397-8, 
 417 ; their work, 421 
 
 Munro, J., 400 
 
 National AsaooiATioN fob Peo- 
 MOTiNG Social Science, 181 
 
 New Oxford Street formed, 29 
 
 New Eiver Company, 20 
 
 Newington, 12, 98, 101, 115, 122, 124, 
 144, 155, 185, 190, 214, 220, 224, 
 248, 250, 285, 309, 347, 354, 376 
 
 Notting Dale, 121, 177 
 
 Noxious trades, 37-8, 53-4, 87, 114-7, 
 145-8, 246-7, 252, 415 
 
 Nuisances Act, 1846, 39-40, 45 
 
 Nuisances Eemoval and Diseases 
 Prevention Act, 1855, 82-3, 86, 117, 
 415 
 
 OvEECEOWDiNG, in the forties, 29-34 ; 
 in the fifties, 55-6, 107-14, 119, 127, 
 133-4, 145 ; legislation against, 87, 
 147-9, 193-4, 197 ; in the sixties, 
 165-77, 198-200, 202-3; in the 
 seventies, 224-5, 243-6 ; in the 
 eighties, 313-6, 332-3 ; in the nine- 
 ties, 354-6, 371, 375-6 ; in 1901, 
 422-6 
 
 Paddington, 98, 100, 102, 123, 155, 
 163, 168, 180-1, 184, 188, 201, 203-4, 
 220, 222, 224, 226, 248-9, 252, 279, 
 288, 290, 309, 376, 407-8, 425-6 
 
 Palmerston, Lord, 75 
 
 Parks and recreation grounds, 122, 
 206, 282, 414 
 
 Pauperism, 139 
 
 Paving boards in middle of nine- 
 teenth century, 12 
 
 Peabody Trustees, 265, 296 
 
 Pear Tree Court, Clerkenwell, 261 
 
 Pennethorne, J., 28 
 
 PhiUips, J., 19 
 
 Physical deterioration, 426-7 
 
 Plumstead, 98, 267 
 
 Poor Law Act of 1879, 283 ; of 1889, 
 344 
 
 Poor Law Guardians, 407 
 
 Poplar, 97, 120, 123, 126, 155, 190, 
 
 199, 222, 227, 230, 254, 279, 284, 
 
 288, 300, 309, 331, 376, 393 
 Population, growth of, 9-10, 80, 
 
 155-7, 221-5, 288-9, 349-52, 401-2, 
 
 410 
 Port of London Sanitary Authority, 
 
 239-41, 283, 317-8, 416 
 Printing works, 172-3 
 Privy Council, medical department 
 
 of, 152, 171 
 Public Health Act of 1848, 51-2, 
 
 79 ; of 1858, 152 
 Public Health (London) Act, 1891, 
 
 356-60, 385, 408, 412-3, 415-6, 
 
 429-30 
 Purvis, W., 237-8 
 
 Redesdale, Loed, 165 
 
 Registrar - General's Report after 
 
 census of 1861, 154 
 Rendell, Dr. William, 142-50, 175, 
 
 186-7, 189 
 Ritchie, 0. T., 338, 359 
 RodweU, Hunter, 271 
 Rosebery, Earl of, 341 
 Rotherhithe, 17, 36, 74, 98, 101, 105, 
 
 108, 114, 116, 117, 144, 177, 206, 
 
 220, 252, 280-1, 333-4 
 Ross, 323 
 
 Russell, Lord John, 66 
 Russell Court, Drury Lane, burial 
 
 ground in, 36 
 
 St. Geoege, Hanover Square, 98, 
 
 137, 188, 212, 288, 351 
 St. George-in-the-East, 102-3, 106, 
 
 120, 233, 253, 278, 288, 303, 352-4, 
 
 391 393 
 St. Giles', 28, 68, 97, 99, 100, 105, 
 
 108-10, 113, 124, 130, 139, 168, 
 
 176, 178, 191, 199-200, 224, 250, 
 
 252, 255, 260, 262-3, 305, 313-4, 
 
 375-6 
 St. James', Westminster, 97-8, 102, 
 
 109, 125, 130, 155, 170, 179, 189-90, 
 
 222-3, 249-52, 256, 272, 288, 290, 
 
 352, 369, 394 
 St. Luke, 97, 108, 219, 231, 255, 
 
 293, 314, 334, 353, 355, 364, 
 
 368 
 St. Martin-in-the-Fields, 97, 102, 
 
 129, 155, 161, 214, 352 
 St. Marylebone, 30, 97, 100, 105, 124, 
 
 181, 188, 222, 225, 232, 250, 280, 
 
 288, 299, 309, 354, 369, 374 
 
OF LONDON 
 
 439 
 
 St. Pancras, 97, 108, 115, 125-6, 
 128-9, 132, 155, 164, 169, 175, 188, 
 256, 268, 273, 279, 299, 304, 309, 
 348, 353, 367, 424, 430 
 
 Salisbury, Marquess of, 317, 322, 325-6 
 
 Sandhurst, Lord, 837 
 
 Sanitary Act, 1866, 193, 199-202, 
 217-8, 254, 266, 300, 302, 324, 429 
 
 Sanitary Law Amendment Act, 1874, 
 266, 305, 429 
 
 Scarlet fever, 249, 386, 415 
 
 Schools, overcrowding in, 113-4, 174, 
 244-6 ; defective drainage in, 421-2 
 
 School Board for London, 283-4, 292, 
 313-5, 406-7, 418 
 
 Scrofula, 58, 170 
 
 Sewers, early statutes relating to, 
 14 ; glaring inefficiency in the 
 forties, 15-7 ; in the City in the 
 fifties, 50-1, 60 ; plan adopted by 
 the M.B.W., 90-1; medical offi- 
 cers' reports in 1856, 100-3 ; atten- 
 tion paid by Vestries and District 
 Boards, 123, 249-51 ; M.B.W.'s 
 scheme carried out, 158-9, 281, 
 411 ; L.C.C.'s report, 411-2 
 
 Sewers, Commissioners of, before Act 
 of 1848, their authority, 9, 11, 15 ; 
 their incapacity, 15-7 ; after Act 
 of 1848, 41-2 ; superseded, 84 
 
 Shaftesbury (Ashley), Lord, 32, 47, 
 64, 66, 165, 174, 176, 274, 307, 366 ; 
 carries Act to regulate common 
 lodging houses, 67-8 ; Labouring 
 Classes Lodging Houses Act, 69 
 
 Shops, 172 
 
 Shoreditch, 37, 97, 105, 111-2, 120, 
 166, 188, 228, 251, 267, 288, 309, 
 353, 355, 368, 380-1, 393, 425, 430 
 
 Simon, Dr. John, 50-62, 120, 171, 
 192, 215-7, 248, 286 
 
 Simpson, W., 29 
 
 Slaughter-houses, 247 
 
 Small-pox, 38-9, 146, 150, 208, 235-6, 
 269, 319, 386, 403 
 
 Smith, Dr. Southwood, 4, 6, 25-6, 
 151 
 
 Smithfield Market, 416 
 
 Society for Establishing Public Baths 
 and Washhouses, 126 
 
 Society for Improving the Condition 
 of the Working Classes, 70 
 
 Soho, 391 
 
 Southwark, 17, 98, 111, 120, 128, 131, 
 135-6; parish of St. George-the- 
 Martyr described, 142-52 ; 167, 189, 
 214-5, 222, 224, 228, 230, 267, 279, 
 284, 305-6, 334, 347, 354, 364, 369, 
 374, 375, 393, 400, 424 
 
 Southwark Water Company, 21, 73, 
 
 192 
 Spitalfields, 28, 161, 245-6, 253 
 Stanley, Lyulph, 295 
 Stepney, 401, 424-5, 430 
 Strand, 97, 100, 110, 112-3, 115, 117, 
 
 123, 128, 133, 140, 176, 212, 223-4, 
 
 259, 288-90, 347, 352, 364, 392 
 Street improvements, 29, 205-6, 413-4 
 Sutherland, Dr., 75 
 Sweating, Select Committee on, 337, 
 
 370-2 
 
 Tenement Houses, 313-6, 353-6, 
 358, 375, 422-5, 428-31. See also 
 " Overcrowding " 
 
 Thames, the, sewers discharged into, 
 15-6, 21 ; source of water supply, 
 21-2 ; the Lancet's description, 77 ; 
 a Medical Officer's words in 1858, 
 117-8 ; Embankment constructed, 
 207, 282 ; Thames Purification Act 
 passed, 207-8; scope of Conser- 
 vancy Board extended, 208 ; Port 
 of London regulations, 239-41, 
 283 ; new treatment of sewage 
 adopted, 332 
 
 Torrens, Mr., 213 
 
 Towns Improvement Act, 1847, 79 
 
 Tramways Act, 1870, 219 
 
 Tremenheere, H. S., 171 
 
 Typhus, prevalence of in 1838, 4 ; in 
 1847, 48; in the "City" in the 
 fifties, 58, 112, 147 
 
 Vaccination Act of 1836, 208; of 
 1871, 237 
 
 Vestries created, 83-9 ; inefficiency 
 and inaction, 183-7, 266-73, 301-8, 
 321-2, 398-9 ; abolition, 398-9 
 
 Victoria sewer, 76 
 
 Vinen, Dr. N., 400 
 
 Vulliamy, G., 229 
 
 Wales, the Pbince op (now King 
 Edward VII.), 317, 364 
 
 Wandsworth, 98, 100, 124, 155, 177, 
 219, 222, 228, 230, 250, 279, 289, 
 402 
 
 Water supply, disgraceful condition 
 of, 20-3, 104-7, 160-2, 191-2; for 
 the "City," 51-2; Act of Eeform 
 passed in 1852, 71 ; Act of 1871, 
 233-5; Act of 1887, 331; Boyal 
 Commission of 1892-3, 383-4 ; Act 
 of 1902, 405-6 ; general survey, 412-3 
 
440 SANITARY EVOLUTION OF LONDON 
 
 Waterlow Park, 414 
 
 Webber Row scheme, 364 
 
 Westminster {see also St. James), 
 16, 97-8, 108, 110, 115, 126, 161, 
 167, 177, 201, 222, 288, 300, 303, 
 346, 375, 377, 430 
 
 Whitechapel, 33, 97, 99, 103-4, 114, 
 117, 121, 126-7, 130-1, 153, 160-1, 
 166, 168-9, 178, 200-1, 219, 229, 
 231, 243, 245-6, 253, 278, 288, 290, 
 293-5, 353, 368, 391-2, 399 
 
 Williams, T. Marchant, 313-6 
 
 Window tax, 26 
 
 Woolwich, 98, 332 
 
 Workhouses and infirmaries, 209, 
 
 389-90 
 Workmen's trains, 296-7 
 Workshop Regulation Act, 1867,211-2 
 
 Zymotic diseases, 42-3, 118, 131, 
 163, 170, 260-1 
 
 UKWIN BROTETERS, LIMITED, THE GRESHAM PRESS, WOKING AND LONDON. 
 
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