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Title: The Sanitary Evolution of London
Author: Jephson, Henry Lorenzo
Language: English
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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
Brooklyn, N. Y.








  MAP                       _Facing page_ 1


  CHAPTER I                               1

  CHAPTER II (1855-1860)                 82

  CHAPTER III (1861-1870)               155

  CHAPTER IV (1871-1880)                221

  CHAPTER V (1881-1890)                 288

  CHAPTER VI (1891-1901)                349

  CHAPTER VII (1901-1906)               401

  INDEX                                 435



  1. Clerkenwell.
  2. Holborn.
  3. St. Giles'.
  4. Strand.
  5. St. Martin-in-the-Fields.
  6. Whitechapel.
  7. St. James', Westminster.
  8. Westminster.
  9. St. Saviour's, Southwark.
  10. St. Olave's, Southwark.
  11. St. George the Martyr, Southwark.]

The Sanitary Evolution of London


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--"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 circumstances in which the people lived, their
sanitary condition, and the causes leading thereto and influencing the

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, 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 surroundings, 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?

Real social evils, however, sooner or later, force themselves 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.

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.[1]

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--"typhus, 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 all
was the fact that this fearful condition of things was 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

As regarded the districts in which the wealthier classes resided,
systematic efforts had been made on a considerable 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.

Reports such as these attracted some degree of attention, 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[2]
enlarged upon the evils previously in part portrayed, and emphasised

"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 enforce the
commonest provisions for cleanliness and comfort."

Lurid as were the details thus made public of the condition 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
Royal Commissions.

Before one of these Commissions[3] 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,[4] "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 described as the "City," and the rest of
London--that which had no recognised boundaries, no vestige of
corporate existence, and which can best be described by the word

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

Apart altogether from political 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 commerce, 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
acquiring and accumulating wealth--got ever greater possession of

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 widespread 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 exchanges, 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 warehouses 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.

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
Royal 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.

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
metropolis 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 Lambeth 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 by the law as one
great entity, and whose boundaries had never been fixed, either by
enactment, charter, or custom.[5]

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, entitled "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 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,[6] 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.[7]

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
uniformity, efficiency, and economy in local administration had become

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, without 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 administration.

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 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 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
Parliaments 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
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

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 nineteenth 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 incompetent 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 certainly 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.

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 character, and abounded with fever nests.
Rotherhithe was the same. Hackney Brook, formerly "a pure stream," had
become "a foul open sewer."[9] 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

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 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
interfered 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

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.

"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 countenances, and enfeebled limbs, of the
poor creatures whom I found residing over and amongst these dens of
pollution and wretchedness."[10]

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, teeming 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

There were, it was said, "a formidable host of difficulties" 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,[11] 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 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 necessity, namely, the supply of water to the
inhabitants of London for drinking, or for domestic, trade, or sanitary

"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 with the
duty of securing to the people even the minimum quantity necessary for

Early in the seventeenth century the New River 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 without
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

Practically, a generous Parliament had bestowed as a free gift upon
these Water Companies the valuable monopoly, 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 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 inhabitants 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."[12]

The quality of the water which was supplied by the companies left
much to be desired. That supplied by the New River 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 contaminated 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 composition can
best be imagined.

Looking at the great river even now in its purified state, 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 generation after generation, the soil so polluted cannot yield
water of any degree of purity."[13]

As all these "ifs" were grim actualities, the water of such wells was
revolting in its impurity and deadly in its composition.

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

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

Where such wells were not available, the water for all household
consumption was taken from tidal ditches which were to all intents
and purposes only open sewers. A contemporary report gives a graphic
picture of this form of supply[14]:--

"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 purpose, 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 amendment.

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 construction 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 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 of better educated
neighbours, exhibited a state of moral degradation deeply to be

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 buildings beyond the regular lines of buildings. Thus the
Metropolitan 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
important 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.

But whatever the motive of action by Parliament, the ensuing
legislation was in the main inoperative or ineffective. 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 absolutely 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 forbidding 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:--

"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

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.[16] 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

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.[18]

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

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
consequences than a tax upon food."

Not until 1851 was the tax abandoned, but its evil consequences,
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 continuance in such a filthy and unwholesome state
as to endanger 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 dwellings.

The following description[19] 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 recognised 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
combined results are always disastrous in the extreme.

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. Pancras disliked this
very much. Places in the two latter parishes which were before bad
enough are now intolerable, owing to the number of poor who formerly
lived in St. Giles'."

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 constant 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.[20] 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 "Overseers" were to report to the "Official Referees," who
were 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 Referees.
But nothing was ever done--Overseers, District Surveyors, and Referees,
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 elsewhere, 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 individual 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.

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.[21]

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 administrators 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."[22]

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 consequent 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 cleanliness, 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 emphatically to record my conviction
that this constitutes the _monster mischief_."

And then he himself adds:--

"If to considerations like these regarding the moral and religious
aspect of this great question, be added those suggested 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."[23]

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 hereafter."

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 perpetration 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
deliberate 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

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 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 ignorance 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."[24]

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 property."

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 public 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

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, prominent, 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

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 débris 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
imperfectly interred. Within the period of the existence of 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 Russell
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 Rotherhithe, 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 corruption;
an avenging ghost at many a sick bedside; a shameful testimony to
future ages, how civilisation and barbarism walked this boastful island

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

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[25] 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 establishments, 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.

But these legislative restraints were utterly inadequate as any sort of
check upon the evil; for, even if a nuisance were 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


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 imperfect means of vaccination throughout
the country.

The mortality from this--"one of the greatest pests that ever afflicted
humanity"[26]--was very great. In one city in the south of England no
less than 500 persons had died of 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[27] 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 producing smallpox"
was made penal--to the extent of one month's imprisonment.

In 1846 there was a sudden display of Parliamentary energy in health

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 health, 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.[28]

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[29] 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."

The better provision made by the Act did not amount to much. There
were two forms of insanitary evil to be combated: 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
cleansing 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 complicated 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

The dreadful nemesis for such dense inappreciation by Parliament of
its obligations to the community was, unfortunately, soon to fall
heavily upon the unhappy people of the metropolis. Thousands of
miles away in Hindoostan, 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 Royal Commission 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[30] abolishing the various Commissions of Sewers (except
those of the City), and creating in their stead one executive body
whose members were to be appointed 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 Commission for each.

The creation of this body constitutes a great landmark in the sanitary
evolution of London, for it was the first recognition 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 representation upon it, but none the less it was 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 Royal 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 increase of population, the numbers affected were vastly

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 intolerable 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.[31] From 9,600 deaths from such 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.[32] 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 incomprehensible. 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[33]:--

"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
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 administrative
  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 waterworks."

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 attempted.[34] 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

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 metropolis, re-enacted the trumpery "Nuisance Removal and Diseases
Prevention Act" of 1846, with some slight enlargements, and one
important addition, namely, authority for the appointment by the Privy
Council of a General Board of Health, which might issue directions and
regulations 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,[35]
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

The Privy Council had appointed a General Board of Health, and early
in November the Board issued regulations 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 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.[36]

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.[37]

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 outbreaks 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.

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

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 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 prescribed 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.[38]

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
compelling 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 visitation of

"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

"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."[39]


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.

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 beneficial
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 surroundings 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 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 cesspool lies,
perhaps merely boarded over, close beneath the feet of a family of
human beings whom it surrounds uninterruptedly, whether they wake or
sleep, with its foetid pollution 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
whatsoever. The City was fortunately included, but the metropolis, with
its two and a half millions of inhabitants, was unfortunately 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 short subsidence in reservoirs, distributed without filtration
to the public."

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

"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 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 competition could ensure, would
thus be realised to the population 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.[40]

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.
Furthermore, such restrictions were usually resented as an infraction
of personal liberty. Dr. Simon forcibly and conclusively answered this

"It might," he wrote, "be an infraction of personal 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
overcrowding 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 undergoing slow

And the vaults beneath the churches were "in many instances similarly
overloaded with materials of putrefaction, 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 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.[41]

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 combining 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. Consequently 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

And the climax of insanitary conditions was reached when these
densely-packed houses were overcrowded by human beings.

The process of converting dwelling-houses into warehouses, 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

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 habitations 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 offices of nature they
are gregarious and public; that every instinct of personal or sexual
decency is stifled; that every nakedness 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."

Pursuing his masterly analysis of the sanitary condition 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 discussion 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 improved 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

"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 condition of the poor....

"Who can wonder that the laws of society should at times be forgotten
by those whom the eye of society 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 metropolitan 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

"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 15,597 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 the necessity which exists
in the "City" of London for some effectual and permanent sanitary

"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 undertake) 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.

"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 condemnation
(though with more difficulty of fixing and proportioning the particular
responsibility) against those who ignore the duties of property, and
who knowingly let for the occupation of the poor dwellings unfit even
for brute tenants, dwellings absolutely incompatible with health."

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 jurisdiction, 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, 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 Royal 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

"Instances have come to my knowledge of the very worst description of
property being thus held ignorantly and carelessly 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 Report 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 accomplishment 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
inviolable 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 full and fair application of the principles adverted to. With
private affairs you interfere only when they become of public 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 complains that to
reduce the number of his tenantry, to lay on water, to erect privies,
or to execute some other indispensable 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 however 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

The very grave and serious conclusion, however, follows 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 misdoings 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 unquestionably 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.


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 Parliament 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.

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

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 professions 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 interments.

"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?

"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

"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 compulsory 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 protracted
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 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

The realisation of this object, noble as it was, was not easily

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

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 enforcement with adequate penalties would make it

As the result of the meeting, a deputation waited on Lord John Russell,
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 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 operation, 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 widespread,
deep-seated evils which were working such havoc among the people. The
most disastrous and vicious forms of overcrowding were at the time to
be found in the so-called Common Lodging Houses--the sink of insanitary

These were the temporary and casual abodes of the dregs of London
humanity--of the tramps, and the unfortunates, 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 degeneracy, 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 constraint, introduced a Bill[43] and
actually carried it through Parliament, and two years later got another
Act[44] embodying 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.

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 5,000, and the
population in them about 80,000, the benefit was a really substantial

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.[45] 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 commenting 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 rooms occupied by
families did not come within its scope. They constituted an enormous
proportion of the habitations of the people, and they were allowed to
continue the prolific cause of sanitary evils and of physical and moral

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,"[46] 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 thereafter 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 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 workhouses with widows and orphans."[47]

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

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 Government, it was
rather to the efforts of individuals, and associations 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."[48]

An "association of individuals" had already been formed--"The Society
for Improving the Condition of the Labouring 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
demonstrated their very satisfactory immunity from disease.

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

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 engaging 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[49] 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. Reservoirs 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 unnecessary term the cause which
had wrought such havoc among the people was permitted to continue its
disastrous effects.


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 indifference 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.[50] 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 demonstrated 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 regarded water supply and
drainage, South London was in a worse sanitary state than North London.
The water consumed 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 disastrous 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 widespread
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 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.[51]

At Rotherhithe, 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

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

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

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.

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 metropolis 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 introduce 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 observation 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 following as among the more
prominent of the removable causes of zymotic disease.

"Open ditches as sewers. Want of sewers. Badly constructed 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.[53]

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 Victoria
Sewer"--which cost a large sum, and which not many years after fell to

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

Those most important measures marked the end of one great period in the
sanitary history of this great metropolis.

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 metropolis; no period when the
spirit of commercialism recked so little 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
consideration 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 ratepayers,
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 Improvement 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 governments 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 Removal 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 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 unparalleled, indescribable,
unspeakable misery of the industrial and working classes, and of the
lower and poorer orders.

Not merely years, but generations of neglect and indifference 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 regulation 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.

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.


[1] See Parliamentary Papers, 1837-8, vol. xxviii. and P.P. 1839,
vol. xx. p. 106, Dr. S. Smith.

[2] 1840. P.P., vol. xi. p. 13.

[3] Commission for inquiring into the state of large towns and
populous districts, 1844.

[4] Dr. Southwood Smith, P.P. 1845, vol. xviii.

[5] Royal Commission, 1853-4, p. xii.

[6] The Metropolitan Paving Act, 57 George III. cap. 29.

[7] See Report of Vestry, 1856-7.

[8] See Special Report of the Vestry, 1889, p. 208.

[9] Report of Commission of 1845.

[10] J. Phillips, p. 63, Metropolitan Sewers Commission, 1847.

[11] See P.P. 1854-5, vol. liii. p. 249, &c.

[12] Report of Medical Officer of Health for Clerkenwell, 1856.

[13] See Report of Medical Officer of Health for St. Giles'.

[14] Report of General Board of Health, 1850.

[15] Report of Select Committee of the House of Commons, P.P. 1838,
vol. xxviii.

[16] 38 George III. cap. 40.

[17] An opening only a foot square cost an additional 8s. 3d. tax per

[18] 1843, Commissioners on State of Towns. Evidence of W. E. Hickson,
p. 436.

[19] Select Committee, 1840. Evidence of J. Pennethorne, p. 166.

[20] P.P. 1854, vol. xlv. p. 2. In part of the parish of St. Marylebone
only there were 1,132 underground or cellar dwellings.

[21] See Hansard, vol. cxv. 1851 (Lord Ashley's speech).

[22] P.P. 1850, vol. xxi. p. 179 (Dr. Grainger).

[23] P.P. 1850, vol. xxi.

[24] Dr. T. Lynch, Medical Officer of West London Union (Holborn).

[25] P.P. 1849-50, vol. xxi.

[26] Hansard, 1840, vol. liii. p. 1110.

[27] 3 and 4 Vic. cap. 29.

[28] Expenses to be charged upon Borough Fund, and receipts to be
paid into same.

[29] 9 and 10 Vic. cap. 96.

[30] 11 and 12 Vic. cap. 112.

[31] P.P. 1850, vol. xxi. p. 4.

[32] Metropolitan Sanitary Commission, 1848, 2nd Report.

[33] Hansard, 1848, vol. xcvi. p. 392.

[34] "Vested rights in crowded houses, deadly stenches, putrid water,
foggy courts, and cesspools." See "Health by Act of Parliament,"
_Household Words_, 1850, vol. i.

[35] P.P. 1850, vol. xxi. p. 42.

[36] P.P. 1850, vol. xxi. p. 110.

[37] 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.

[38] Dr. Grainger, P.P. 1849-50, vol. xxi.

[39] P.P. 1850, vol. xxi. p. 147.

[40] This was rendered illegal by the amended City Sewers Act of 1851.

[41] See P.P. 1854-5, vol. x., General Report of Medical Council.

[42] Simon, 1st Report, 1849.

[43] 14 and 15 Vic. cap. 28.

[44] 16 and 17 Vic. cap. 41.

[45] P.P. 1854, vol. xxxv. p. 7.

[46] 14 and 15 Vic. cap. 34, 1851.

[47] See Hansard, 1851, vol. cxv.

[48] Ibid.

[49] "The Metropolis Water Act, 1852," 15 and 16 Vic. cap. 84.

[50] See P.P. 1854, vol. xlv. p. 22.

[51] See P.P. 1854-5, vol. xlv., Reports of General Board of Health.

[52] Ibid.

[53] See speech of Sir B. Hall in 1885 in House of Commons, Hansard,
vol. cxxxvii. p. 715.



THE Act "for the better Local Management of the Metropolis"[54] 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 Removal Act for
England"[55] which was made applicable to 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[56] 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 distinguished 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

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

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

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 removal of refuse, and generally, for carrying
into effect the 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 directions
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 authorities 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, 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 £10.

By "The Nuisances Removal 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 authorities 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, including
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 inhabitants 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

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

As money was essential for the working of the Acts, over 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 buildings 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 Metropolitan Board from the previous body, appointed
under the Building Act of 1844, which had distinguished itself by its

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
safeguarding 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

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

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 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

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 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 construction 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 appointments 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 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.[58]

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 recommendations 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 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 metropolis 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 development--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

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 impression of the subject as a whole.

The same objections apply to a "seriatim" historic treatment of the
different branches of the public 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 displaying their results in the "City" itself in very
striking manner.

Under their potent influence the population there had begun to rapidly
decline. 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 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 metropolis, 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 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[59] could never become popular,
"his functions bringing him into constant collision with the apparent
interests of many influential persons;"--in other words, with vested

Others took a less personal and wider view of their duties. Thus one of
them[60] 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[61] was impressed by the vast amount to be done even in his own

"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,[62] after a few years' experience of the working of the Act,
summed up the actual position--the very kernel of the case--when he

"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 to. 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," 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

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', 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

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 smallest amount of space." Or
the description of St. Giles',[63] 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 habitations 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

"Bricklayers are spreading the webs and meshes of houses with 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

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, 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 complaint 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 which had been constructed
at intervals, previous to 1846, in a piecemeal and unsatisfactory
manner, as the thoroughfares were formed, without 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 without 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."

Rotherhithe, 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 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 Row 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 Clerkenwell the "drainage was either none or very imperfect.
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 ... cesspools, 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 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 Metropolis Local Management
Act. The investigations of the various Medical Officers of Health
soon demonstrated that the previous estimates of their prevalence,
and of the disastrous consequences they entailed, had been in no way

Their disastrous results were at once recognised.

The Medical Officer of Health for Whitechapel, in his report for 1858,

"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

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.

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. Marylebone "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 Rotherhithe (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.

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

"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 provided at the expense of the community for the
common benefit."

And the Medical Officer of Health for St. George-in-the East wrote in

"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 distribution for domestic use had been made
compulsory, was considerably improved.

But the filthy and dangerous character of the receptacles 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 constituting 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

"It is too true that among these classes there were swarms of men and
women who had yet to learn that 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 Rotherhithe "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 approximately 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 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):--

"In 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 for centuries to express
a wretched habitation unworthy of humanity.

"Dating from the time of Charles I., the underground dwellings 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.

"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, evidently 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

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

"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

"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.

"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

"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 districts. 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 Officer 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

The most powerful cause of all, however, was, undoubtedly, 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 Officer of Health for the
Strand (1858), "that this system of overcrowding 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 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.[65]

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 insanitary 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--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 quality 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 Rotherhithe reported in 1857:--

"In the mile length of Rotherhithe 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."

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, was "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 districts," 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:--

"The collection of dust heaps, and dust contractors' depôts, 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 Rotherhithe pointed out (1858)

"It is little use causing our own dust to be carted away if Rotherhithe
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 1-1/2 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 with.
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
untrammelled 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 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 infinitely more importance than, and
should far outweigh the interests of, private individuals how numerous
soever they should be."

The Nuisances Removal 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.

"Rotherhithe," wrote the Medical Officer of Health, in July, 1858, "in
common with all other metropolitan riverside parishes, has suffered
considerable inconvenience during the last month from the stenches
arising from the filthy 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 conditions 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 wherever the inhabitants living under these
unfavourable circumstances 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 recovering from these complaints are
permanently injured."[66]

It is impossible to apportion the respective shares which these various
causes of insanitation had in bringing about 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,[67] "is one of the most
frequent sources of sickness and decay at all ages."

"Perhaps," wrote a third,[68] "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,[69] "can be more positive than the
connection of epidemic diseases with defects of drainage and
ventilation ... the overcrowded localities being especially scourged by

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 tone of their
system generally lowered, became the subjects of a continued craving
for stimulants."[70]

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

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 conditions, exerting their baneful
influence on the infant or young child, nip the tender plant in the bud
and speedily destroy its young life."[71]

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 Bethnal Green it
was over one-half, being 52 per cent. (1858); in St. George-in-the-East
it was 53-1/2 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 than
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 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 ourselves 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 1856:--

"In some places the mortality among infants under five years of age was
at the enormous rate of 61·3 per cent. 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 87·5 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 56 per cent., wrote:--

"How to overcome this frightful and apparently increasing 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 mortality 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.

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

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 the 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

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 which, in some cases, they received a
contribution from the central authority.

A good deal of paving was 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 £34,700 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 following 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

"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.

But the work thus chronicled touched little 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 inspection 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 Newington 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

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."[72]

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 production of disease among the neighbours."

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 Removal 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 blameless 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

"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 Whitechapel, "that
the powers of your Board are not at present sufficient 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

In Poplar in 1858-9 nearly 40,000 men, and 3,000 women, and 400
children availed themselves of the baths.

In St. Pancras (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

"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 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 providing 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."[73] 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.

"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."[74]

The Medical Officers of Health did not confine themselves to merely
reporting what was annually done to ameliorate the existing state of

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

"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 condition 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 out 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 living. But the Vestry has
this power."

The Medical Officer of Health for St. Pancras 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 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 sacredness 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
intellectual 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."

"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

But against contagion and infection no precautions whatever were taken,
and so disease was sown broadcast throughout the community, and death

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 will lose half their salutary effect if the interior of
the dwellings are not placed in a corresponding condition of wholesome

"It is," wrote the Medical Officer of Health for Whitechapel, "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 inspection and supervision of vital necessity for the
maintenance 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 conditions of life could be ameliorated, and that the
very lowest and most miserable classes of society were not beyond

"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 advantages 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

"The cleanliness, comfort, and ventilation of the licensed rooms in
common lodging-houses offer a very marked contrast to those which are

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 enforcement
upon the owner of the first essentials of sanitation 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 describing 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 to provide
suitable dwellings for the people! Undoubtedly they cannot; but it is
incumbent upon these authorities, in the interest of the well-being 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 Workhouses, or for the
emigrants who leave our shores? Surely the injustice cannot but be

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

"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 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. Rents 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.

"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

If it had not been for the new Acts passed in 1855, this condition of
things would doubtless have continued indefinitely. 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 improvements 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:--

"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:--

"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

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."[77]

Others did the necessary work when ordered to do it by the sanitary

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

"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."[78]

"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
breadwinner 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 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 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

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 Parliament even realised it, for it had left the forty and more
of 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. George-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 Rendle, 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 disgusting 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

"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 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 inconveniently close
packing hold many more.[79]

"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.

"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    "     "     "
   " Rotherhithe   "    21    "     "     "
   " All London    "    30    "     "     "
   " Newington     "   104    "     "     "
  While we have        184    "     "     "
  And in one of the
   parts of the parish 244    "     "     "

"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."

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 ratepayer and the pauper, there is more sickness and death.

"Density of population brings you more deaths, more sickness, more

"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 prevention 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 improvements, the police will have to do it.

"As to the overcrowding, I have brought many cases before you, each
from illness resulting in difficulty 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 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 £10 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."

Referring 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 breathing a tainted
atmosphere--you may insure consumption in the most healthy.

"3,500 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 pervading highest society, and the poor, driven as they
are from richer districts into poorer neighbourhoods, can scarcely
help themselves; they lose at last all healthy communication 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

"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 but 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--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

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

"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
premature 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 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
habitations. The resulting illness and death are considered inevitable,
or are viewed with a stolid indifference."

1858. _3rd 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 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

He was succeeded by another very able man, Dr. Henry Bateson, from
whose reports may be continued the description 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 sanitary 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 unsurmountable, such as those arising from the imperfections of
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

Referring to some houses "of the worst description, having no yards,
nor even windows behind, so that ventilation 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 dwellings 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 subsoil, 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 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, where 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

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 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 23·18 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 improvements.

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,

"This diminution may be fairly attributed to the additions made to the
sewerage of the district, the improvements 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 the housing problem, and
erecting model lodging-houses and more healthy habitations.[80]

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 Registrar 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


[54] 18 and 19 Vic. cap. 120.

[55] 18 and 19 Vic. cap. 121.

[56] 18 and 19 Vic. cap. 122.

[57] Section 103 of Metropolis Local Management Act.

[58] 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.

[59] St. Giles'.

[60] Fulham.

[61] Rotherhithe.

[62] Hackney.

[63] Medical Officer of Health, 1856.

[64] "Lungs for London," _Household Words_, vol. i. p. 45, 1850.

[65] P.P. 1852-3, vol. lxxviii. p. 327.

[66] Clerkenwell, 1856.

[67] Fulham, 1857.

[68] Whitechapel, 1857.

[69] St. Giles', 1859.

[70] St. George the Martyr, 1859-60.

[71] Strand, 1859-60.

[72] Clerkenwell, 1860-1.

[73] 14 and 15 Vic. cap. 34.

[74] Shoreditch, 1859-60.

[75] St. Giles', 1857-8.

[76] St. Olave, Southwark, 1856.

[77] Whitechapel, 1857.

[78] Whitechapel.

[79] Population went up from 51,824 in 1851 to 60,278 in 1896.

[80] "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.



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 population 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',
Westminster, 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 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 manufactures 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 394 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 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

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 therefore 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 contend, 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 accomplishment 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 atmosphere, and been such a
fertile source of disease in the districts where they existed, and
took away from the Vestries any excuse for delay in carrying out the
construction 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 satisfactory 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

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

Parliament made an effort in 1862[81] 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:--

"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 healthfulness. 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

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.[82]

The housing of the people was the problem which, above all others,
was more and more forcing itself upon the attention 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, 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 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 showing 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 commenced 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 expansion.

The subject of the displacement of labourers in consequence of great
public works in the metropolis was brought before the House of Lords in
1861 by Lord Derby.[83]

"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

"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
individuals, were turned out and driven into the surrounding tenements."

Lord Granville suggested, as a remedy, the provision of cheap trains
to carry artizans from healthy dwellings in the suburbs to the scene
of their work, and Lord Redesdale said he had introduced clauses into
the Railway Bill providing that the companies should run a cheap train
every day. But, as Lord Shaftesbury pointed out,[84] 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.

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 two-fold result of at once
intensifying overcrowding in the remaining houses in the localities
affected, and in extending the area of overcrowding 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 unwilling to travel further than
necessary, and so have accepted the readiest accommodation for their

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

"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

"In watching the enormous accession of population to 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 immediately
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 expansion.

The Medical Officer of Health for St. Saviour, Southwark, wrote in

"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,

"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."

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

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 following all kinds of business--rag, bone,
and bottle stores, shops of various kinds, including beer-houses,
builders, carpenters, smiths, tailors, sweeps, find accommodation
here. Inhabiting the rooms above, too small, and unfitted with proper
domestic accommodation for a family, live a vast population 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.

"In three rooms in Hayes Court, each 10 × 8 × 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. Pancras (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 basement, 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

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 wrote:--

"On visiting the houses in low neighbourhoods it is by no means of
unfrequent occurrence to find an adult brother and 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),

"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

"Rents 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 circumstances 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 constantly 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, 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

"To be subject to these influences is a degradation which must become
deeper and deeper for those on whom it continues to work. To children
who are born under its curse, it must often be a very baptism into

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 Reports from
the Commissioners on Children's Employment, 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.[86]

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 the process of fermentation, get
impregnated with the noxious gases.

The sleeping places were of the worst description,[87] some of the
men sleeping in the bakehouse itself. Many bakehouses 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 contaminated 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 Removal Act.

Another inquiry related to the tailoring trade in the metropolis.[88]
The places in which work was done were reported as varying much in
their sanitary conditions, but almost universally were overcrowded and
ill-ventilated, 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.

"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 milliner, the sempstress, or the

"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

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

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 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 workplaces for the people. Interference
is needed for thousands 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 apartments, 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."[89]

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.[90] 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.

"Overcrowded dwellings are among the most prolific sources of disease,
immorality, and pauperism."[91]

"Overcrowding--one of the elements by which disease is not only
generated but sustained."[92]

"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 unprecedented manner, and
consequently the development of typhus which is considered to be bred
in the pestilential atmosphere of overcrowded dwellings."[93]

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

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."[94]

Dr. Rendle, previously Medical Officer of Health for St.
George-the-Martyr, in his evidence[95] before a Select Committee in
1866, said:--

"... The overcrowding exists to such an extent that 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.

"I 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

"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."[97]

For children born under such circumstances of overcrowding 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, 43-1/2 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 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 Rotherhithe,
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 born,
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 inattention 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.

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,

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

"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 regulations 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

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

"Nothing but adaptation of the present houses to the necessities of
healthy existence and the demolition of those houses that are unfit
for human habitation can contribute so much to life 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

And the necessity of constant inspection was even more vigorously

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

Thus the Medical Officer of Health for Westminster wrote (1865-6):--

"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 impossible 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 of 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 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 insanitation--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 £10 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 with prussic 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 public opinion,
and in view of the ever accumulating evidence and proof of the almost
incredible insanitary condition 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

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 interesting.[98] In
1731 an Act has been passed prescribing a penalty for "sophisticating

"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 vending 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 ingredients 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 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 Regulation Act,"[99] 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

And in 1863 it declared[100] 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 substituted.

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 authorities 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.

Even in comparatively small matters their ingenuity in counteracting
the intentions of the Legislature was remarkable, as can be seen from
the following passage in a report of one of the Medical Officers of

"I refer specially to the Sanitary Acts, to the Adulteration 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 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 was constantly in evidence; equally so
where 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 attending proceedings for enforcing the sanitary
provisions of the Metropolitan London Management Act.

One of the Medical Officers of Health gives an illustration:--

"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

The more serious blemish was pointed out by Dr. Hunter 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

"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 which 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."[101]

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 Rendell said[102]:--

"We have had till now but one Inspector of Nuisances--an unwilling

"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

"I should say you may divide Vestries into divisions--one-third, as
a rule, are of the right class of men who ought 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 Rendell, 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, 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.[103]

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.

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 Registrar 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."[104]

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. Rendell, the Medical Officer of Health for St. George-the-Martyr,
Southwark, 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 "fainéant" local authorities--created anxiety.[105]

It had been widely prevalent in Europe in 1865, and had 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 inaugurated; 987 houses
were examined--735 of them required sanitary improvements.

In Bethnal Green 2,018 were inspected--955 required cleansing and

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 metropolitan

On July 18th, from Poplar, the first case in the metropolis was
reported. Two days later an alarming number of cases in parts of East

Regulations 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 Camberwell 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 inefficiency
hitherto of the authorities in dealing with insanitary 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

In Lambeth 6,935 houses were inspected in 1866; 3,983 improvements were

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

"A record was thus obtained of the condition of nearly 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.[106]

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

And by the end of the year it had gone. That the mortality 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

"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 arrangements 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 experienced 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 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 inefficiency 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 Beach.

"It seems to me that the public is hitherto very imperfectly protected
against certain extreme dangers which the malfeasance 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 precedent 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 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[107] 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 Removal 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 disinfected. 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 provisions for their being put
into and kept in a clean and wholesome state. And to secure this being
done, regulations were made for their inspection.

It was an original and comprehensive scheme of reform. 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 sanitation. 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 declaration 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
contained of another principle of vital importance 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 Removal 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
instituting 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 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

The fact was emphasised a few years later by the Royal 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 circumstances, 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 Parliament.

This community of interest of the inhabitants of London was, however,
scarcely, if at all, recognised by the general 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

Thus the Medical Officer of Health for Mile-End-Old-Town pointed out
(1863) that--

"An untrapped drain, an overcrowded house, an unventilated 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)

"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 in 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

"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 Regulations and
to enforce them.

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 cubic 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 rooms who formerly lived
and slept in one. The gain in health and morality has therefore been

Poplar was another of the District Boards which made and enforced the
Regulations. 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
watchful 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

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

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 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
universally 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 deputation 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

"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.

"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 Regulations were prepared, but it does not appear
that they were ever adopted.

In Paddington, the Vestry decided against putting the Regulations in

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
lime-washing it; the provision of proper ventilation--of sanitary and
washing accommodation, 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 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 indifference 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
unworkable, owing mainly to high rents (which in some cases have
increased as much as 50 per cent.), dearness of provisions, 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 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
Ranelagh Road, 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 Road, where 275 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 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

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 amalgamation 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 habitations of this description have been completed and occupied
during the last few years both in Fulham and Hammersmith, 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 inhabited. 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.

"This deterioration of race has for some time been recognised 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 contagion
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

It had undertaken and had completed several large street improvements
by 1870, intended to provide new and improved 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 than the population," and each work contributed
to the improvement of the public health, by facilitating and increasing
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

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 Rotherhithe, 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 commons 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"[108] in 1866, which prescribed 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 Thames.

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 removing 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 progressing, and
the Board was giving visible demonstration 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 taxation 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 temporary 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

The visitation of cholera was doubtless in the main accountable for the
excess 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,
Reading, Kingston, Richmond, &c., &c., "whose cloacal contributions to
the stream were distributed to masses of the people of 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 Conservancy 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[109] 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
Registrar 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 Authorities; and Boards
of Guardians might appoint public vaccinators and establish vaccination

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 prevention of disease,
a suitable provision for the speedy restoration of the sick to health
is obviously of the greatest importance to the community.

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 accordingly 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

Happily, where neither the State nor the local authorities did
anything, charity stepped in, and on a larger scale supplied 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 diseases 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 authorities) from the very first."

Grievous scandals having occurred in the treatment of the sick in
many of the metropolitan workhouses, the Government of 1867 decided
on a great measure of reform. Once more the necessity of central
government had to be recognised, and by the Metropolitan Poor Act of
1867 a Board--elected by the Poor Law Guardians, who themselves 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.[110]
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 illustration 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 treatment 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 legislation 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 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
unnecessary 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

The Act of 1867[112] made better provision for regulating the hours
during which children, young persons, and women, were to be permitted
to labour in any manufacturing 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 Regulation
Act, 1867,"[113] 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 bakehouse) in which any
handicraft is carried on by any child, young person, or woman, and to
which the person employing 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 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 conditions 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

"I have endeavoured to carry out the Workshops Act by the abatement of
overcrowding, by enforcing due ventilation, 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 property, than to improve
the drainage, and occasionally to cleanse or whitewash some small
fraction of it; and there remained the fact that numerous districts or
conglomerations of houses were unreformable, and when the most was done
to them that could be done under the law were still unfit for human

In the previous year a Bill had been introduced into Parliament by Mr.

"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

"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."[114]

The Act conferred powers far exceeding any heretofore possessed by the
local authority for effectually dealing with houses unfit for human

"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."[115]

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.

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

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 inhabitants 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 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 receptacles 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 contents. 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,[116] 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 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;
while 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 interfered 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 occupation....

"The above survey might easily be extended by referring to statutes
which are only of partial or indirect or subordinate 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
practicable securities against trespasses, casualties, neglects and

"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 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 formlessness, 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 enforcement 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
powerful 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', Westminster, when
he wrote (1869-70):--

"The great deficiency of the Act of 1866, as of all other 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

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

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 Parliament, 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 Acts and "The Tramways Act, 1870," which
was a general measure. Its main object was to provide a simple,
inexpensive, 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 constituted 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 importance 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, nearly 50 per cent., of infantile
mortality under five, in 1867-8.

In Wandsworth, in 1870-1 = 47 per cent.

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

  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.


[81] 25 and 26 Vic. cap. 102.

[82] See P.P. 1866, vol. xvii. Report of Royal Commission.

[83] Hansard, vol. clxi. p. 1061.

[84] Ibid., vol. clxii. p. 148.

[85] P.P. 1866, vol. xxxiii.

[86] See P.P. 1863, vol. xxv. Report by H. S. Tremanheere to the Home
Secretary, 1862.

[87] "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).

[88] P.P. 1864, vol. xxviii. Sixth Report of the Medical Officer of the
Privy Council (1863).

[89] Hansard, 1864, June 16, p. 1835.

[90] See Reports of the Commissioners on Children's Employment, 1864-6.

[91] Shoreditch, 1863.

[92] Westminster, 1861-2.

[93] 1863-4.

[94] Whitechapel, 1861.

[95] P.P., vol. clxxxvi. Select Committee of House of Commons on
Medical Local Government, 1866, p. 259.

[96] Hansard, 1861, vol. clxi. p. 1070.

[97] Report of Commissioners. P.P. 1864, vol. xxii. p. xlix.

[98] See P.P. 1874. Report of Select Committee on the Adulteration of
Food, &c. Evidence of H. Owen.

[99] 26 and 27 Vic. cap. 40.

[100] Ibid. cap. 117.

[101] P.P. 1866, vols. xxxiii.-iv.

[102] Select Committee on Metropolitan Local Government.

[103] See P.P. 1867-8, vol. lviii. Return of Inspectors of Nuisances,
&c., 1866.

[104] Select Committee on Metropolitan Local Government, 1866.

[105] P.P. 1867, vol. xxxvii.

[106] P.P., vol. xxxvii. p. 275.

[107] 29 and 30 Vic. cap. 90.

[108] 29 and 30 Vic. cap. 122.

[109] 6 and 7 Wm. IV. cap. 86.

[110] See Report of the Metropolitan Asylums Board for 1886-7.

[111] See the Edinburgh Review, January, 1903.

[112] 30 and 31 Vic. cap. 103.

[113] 30 and 31 Vic. cap. 146.

[114] Report of Select Committee on the working of the Artizans' and
Labourers' Dwellings Improvement Act, 1882, p. iii.

[115] Ibid., p. iv.

[116] P.P. 1868-69, vol. 32.



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 increase of population which had been 21·2 in
1841-1851, 18·7 in 1851-1861, had further declined to 16·1 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 agricultural eastern,
south-eastern, and south-midland counties surrounding the metropolis.

A large contingent of 147,000 was drawn from Devonshire, 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

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 districts 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

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 decreased, 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 Greenwich, there was an increase
in all the parishes or districts, the increases in some being very
large; 40,000 in Camberwell, 46,000 in Lambeth, 55,000 in Wandsworth.

The figures thus furnished by the Census enabled a fairly 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 22·5 in

"The mortality never having been so low in any two consecutive 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 of 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 facilities 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

In St. George-in-the-East, the Medical Officer of Health stated that:--

"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 improvements (or chiefly so) the large number of 18,358
persons 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 formation of railways and the
extension of warehouses, displacing 961 families comprising 3,556

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   "
   Waverley Road     "  900    "       "      72   "

"Builders intended these houses at first for one respectable 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 landlords should in all instances be compelled to

"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

"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

Furthermore, in some parishes, the natural growth of the population was
very rapid. In Islington, for instance, the Medical Officer of Health

"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,

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.

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 recklessness."

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 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 débris 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 preventions
of disease. They are abundantly provided, but more meagrely and
inefficiently used, and indeed practically ignored, by architects,
builders, owners, and occupiers...."

A witness before a Select Committee testified in 1874[117] 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 siftings 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.

"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 filled 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 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."[118]

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

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):--

"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 permanence of natural existence a high standard is absolutely

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 prevented them.

So glaring were these evils that a Select Committee, which sat in
1874 on the Metropolitan Buildings and Management Bill of that year,

"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.

The Medical Officer 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

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."[119]

In fact, the insufficiency of the laws as regarded buildings intended
for human habitation, and the mal-administration or non-administration
of those laws which existed, resulted in the creation of evils which
inevitably and most injuriously affected the health of the public, 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-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, chimneys 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 Government Board, was
not a representative body, but was a 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 Department; 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

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 standstill, 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 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 recommended that every
company should afford a constant supply of water to each house,[120] 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 Royal Commission,
appointed in 1867, after an elaborate inquiry,[121] 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 Report of the Royal Commission is memorable for the very strong
expression 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) Parliament--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:--

"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 continuation 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 the admissions into the Board's
hospitals about the same time averaged 500 a week.

In a report on the subject the Committee of the House of Commons

"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 produce 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

"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

Parliament passed an Act in 1871, making the appointment 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

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

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,[122] 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 apprehension among those bakers
in the trade who adulterate their bread that they would be liable to
have their bread frequently 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."[123]

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----"[124]

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."[125]

A Select Committee of the House of Commons, which had been appointed in
1872 to inquire into the subject, recommended 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 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
advisability of using all means to prevent the introduction 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

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 descriptions 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 containing manure,
street-sweepings, gas-liquor, bones and other varieties of foul
cargoes, inasmuch as depôts for the storage of these materials existed
on the banks.

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,[126] 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 Removal 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

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 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 disinfection 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 fumigation 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 completely new departure.

It declared that "it was expedient to make better provision 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 Register, and penalties be imposed--six months with hard labour,
and up to £5 fine.

The start made was slow, only six houses having been 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 struggle and fight the battle of life under the most
severe conditions because of wounds they have received from preventable

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 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

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," 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

Thus, in 1871, the Medical Officer of Health for Whitechapel 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 × 9 × 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

"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 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 formidable
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[127] present a vivid picture of the condition of many schools in
existence so late as the year 1874.

1. ---- _School_.

"This is a wretched place, a disgrace to the metropolis. The 'school'
is held in an old dwelling-house in Clerkenwell. The house was at one
time used as a stable. The approach is most unwelcome, and on entering
the schoolroom (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 inefficient 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 long × 8 × 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 crêche, 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 ×
7 × 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 were
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.

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.[128]

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 continuance 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.

The Metropolitan Asylums Board had already erected hospitals, and were
doing a vast amount of good and preventing the spread of disease.

But by the people themselves the seeds of infection were scattered

Dr. Simon, the Medical Officer to the Privy Council, in his Report of
1865, wrote:--

"As to contagions already current in the country, practically any
diseased person scatters his infection broadcast, 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.[129]

As the Medical Officer of Health for St. Mary, Newington, wrote in

"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, needlework, 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

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

"... 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 in accordance with the requirements of the
law had been provided (Strand, 1869-70).

The Medical Officer of Health for St. James', Westminster, 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
Metropolitan Board of Works £757,000 for this purpose;[130] and the
total length of brick and pipe sewer 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 requirements 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; £5,200 expended in widening and
improving certain streets, £92,000 spent in sewerage, paving, and other

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 Metropolitan 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 Officer of Health for St. James', Westminster, wrote

"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

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.

Read one way, this was satisfactory. Read 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 amount 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

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 Rotherhithe, 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, mortuaries 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 disinfection 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 neighbourhoods.

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

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, but it
is in accordance with the recognised law of civilisation, 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

"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.[132]

"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

"No class will become civilised by being left to themselves, 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

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 Artizans' 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, 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 enabled under the
Act to enforce "considerable improvements in and immediately adjoining
the worst parts of St. Giles'." (Houses in yards and courts were

In St. Luke the total number of houses "pulled down or closed" amounted
by the year 1875 to 104.[133]

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 compensation to the owners of
condemned property, as Parliament 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
unfortunate as to become his tenants, and reckless as to the injury his
action was inflicting upon the community at large. And so:--

"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 habitation 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 R. A. Cross, and was carried.

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

The Act[134] 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."[135]

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
empowered 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 compensation
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

The value settled, and the land having passed into the hands of the
Metropolitan Board of Works, the obligation 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

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 unhealthy 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
supply, drainage, closets, all were bad, and in my opinion, nothing
could remedy such a state of things short of pulling down the rickety

"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:--

"Bedfordbury is the black spot of this parish. It and the contiguous
courts are a little 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 Bedfordbury."

"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 removed 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, 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 description, 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

"Bedfordbury, with its swarming, ill-built, badly ventilated, 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.[136]

"This area has long been a hot-bed of disease. It contains about 5-1/2
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."[137]

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
together ... 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

"Occupied by the very poorest of the community. When disease made
its appearance it has been fostered and engendered 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

"Some of the tenements are of the most wretched description--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 engendering and perpetuating
the worst kind of zymotic disease: the chosen home of fever and also of

"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 provision 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 permanently occupying
them. So it cannot be wondered at an outbreak of the zymotic disease
finding a resting-place 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.[138]

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 leading 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

In 1862 it was reported that it had "habitually a much higher mortality
than the rest of the parish."

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
Officer 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., smallpox, 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

"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

These are but some of the cases about which "representations" 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 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 overcrowding 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

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

In the year 1879 the Board accordingly made representations 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."[139]

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
ground for 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 consideration, it thought it well not to prepare any
more improvement schemes until some further experience has been gained
of the working of the Amendment Act of 1879."

And in 1879, also, an Act[140] 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 practically
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 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

"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. Regulations 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 compulsory, 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.

"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."[141]

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[142] were regulations made
and enforced; how imperfectly even in these is illustrated 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.

(_b_) 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

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 prevention of the
continuance of unhealthy tenements carried through."[143]

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, insanitation, 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 referring 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.

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. (_b_) Removal to hospitals. (_c_)
Disinfection. (_d_) Expenses in hospital. (_e_) Cost of burial. (_f_)
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 exceptional 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 epidemics 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 money
laid out for the improvement of the public health will secure an ample

"The alleviation of suffering and the prolongation of human life is the
duty of every noble-minded man to endeavour 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 epidemic
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 (1874-5), "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 glory and safety
of a nation can be built, must be upon the cultivation of the moral and
physical powers belonging to man."

The "owners" were of all classes.

An experienced witness[144] 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 consideration to their tenants."

The Medical Officer 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. However 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 middlemen--"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 in different parts of London to
pay him 10 or 12 per cent., 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 enforcement 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

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 condition 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[145] 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 prevention 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.

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.[146]

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 Royal Commission[147] 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

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 manufacturing process and that may be injurious to

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 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 bakehouses 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 Royal 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 Bakehouse Act."

By the Act passed in 1878 the Bakehouse Regulation 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 purveyors 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

Inspectors were appointed by the Board.

"At the time of the passing of the Order the London cowsheds were,
with few exceptions, unsuitable in construction 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, and obtained improvements, amounting to entire reconstruction,
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
contagious 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 Officer....

"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

"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 Building 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 together 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
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 expression 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 merely declaring 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:--

"If any alteration is made in the constitution of the Metropolitan
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

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

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

The Medical Officer of Health for Whitechapel wrote (1873):--

"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, Southwark, 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 condition 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 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 sacrifice 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, humiliating 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

And the Medical Officer of Health for Rotherhithe (1881):--

"Whilst the houses' drain-pipes, from defective construction 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 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.

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

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

"There was the great main drainage work 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.'"

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 substituted for the unsightly and offensive mud banks that
formerly prevailed, handsome river walls, with broad and commodious
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 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 Registrar 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
appeared 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 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

The Medical Officer of Health for St. George-the-Martyr, Southwark,

"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

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 on the
surface. The Medical Officer of Health for St. Mary, Newington, in his
report of 1874 disclosed this material fact.

Writing of some Returns 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 carelessness and wilfulness on the
one hand, and accidental circumstances 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 Islington (1881):--

"I fear the public have not even yet learned to regard health as a
matter of infinitely greater moment than rates and taxes."

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 imperfectly, that the effect can be reported
in numbers. Of the incalculable amount of physical suffering and
disablement 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

Few people realise the infinite importance of health to a great

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

"The health of a people was really the foundation upon 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 maintain 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.


[117] Select Committee on Metropolitan Buildings and Management Bill,
1874. P.P., vol. x.

[118] Evidence of G. Vulliamy, Select Committee, 1874.
Superintending-Architect to that Board.

[119] See Report of Select Committee, &c., 1874, Q. 23,445.

[120] Select Committee of 1867.

[121] P.P., 1868-9, vol. xxxiii.

[122] 32 and 33 Vic. cap. 70.

[123] See P.P. 1863, vol. xxv. Report by Tremenheere on Bakehouses, p.

[124] Adulteration of Food and Drink and Drugs Act, 1872, 35 and 36
Vic. cap. 74.

[125] P.P. 1874, vol. vi.

[126] Issued on the 17th of September, 1872, and renewed the 25th of
March, 1873.

[127] Final Report of the School Board for London, 1870-1904.

[128] See Select Committee on Noxious Businesses, 1873. P.P., vol. x.

[129] See Sections 25 and 26 of the Sanitary Act, 1866.

[130] See Report of Metropolitan Board, 1871-2.

[131] P.P. 1878-9. Report of Local Government Board, vol. xxix., p.

[132] By the Medical Officer of Health for Whitechapel, 1878.

[133] P.P. 1875, vol. lxiv.

[134] "The Artizans' and Labourers' Dwellings Improvement Act," 38 and
39 Vic. cap. 36.

[135] See Royal Commission Report, 1884.

[136] 1877, 24th March.

[137] Inquiry by Cubitt Nicholls, March 24, 1877.

[138] Appendix. Select Committee Housing, 1881, p. 354.

[139] See Report of Metropolitan Board, 1888.

[140] 42 and 43 Vic. cap. 64.

[141] The Medical Officer of Health for Chelsea (writing of his own

[142] Chelsea, Hackney, Shoreditch, Lambeth, St. George (Southwark),
Camberwell, Plumstead.

[143] Goddard, 1882, Select Committee, p. 576.

[144] Mr. Hunter Rodwell, Q.C., M.P.

[145] 41 and 42 Vic. cap. 32.

[146] 41 Vic. cap. 16.

[147] P.P., vol. xxix.

[148] J. Simon, vol. ii., 1874.



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 Islington 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 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

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.[149]

"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 thoroughfares, and the erection of
public buildings, combined 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

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
increasing 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 sanitation."

Upon one most interesting point as regarded the influx of population
into London the Medical Officer of Health for Lambeth threw some
valuable light.[150]

"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 outcome of that quality in the district affected. Muscle
and 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 influx 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 population 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

The immigrants, however, were far from being all of a desirable

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 Railway Company, 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, intersected by railways and new

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 difficulties, 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 substantial repairs such as cannot be required under the Nuisances
Removal Acts...."

The first scheme which was initiated by the Metropolitan Board in 1875
was only completed at a net cost of £151,763, 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
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.[151]

They were acquired by the Board at a cost of £1,661,000. 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
obligation 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 £371,600. When sold, under the conditions imposed by
Parliament, it realised only £87,600; and the Whitecross Street scheme
(in St. Luke's), which cost £391,000, when sold realised £76,350.

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 £1,100,000.

As Mr. Chamberlain described the result, in an article he contributed
to the _Fortnightly Review_ 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."

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 proceedings, militated against the
success of the schemes so far as providing residences for the displaced

An example of the working of the Act was described in 1883 by the Rev.
S. A. Barnett.[152]

"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

And then he described the slowness of the reconstruction, and added:--

"Such is the seven years' history of the Artizans' Dwellings 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 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[153] in 1884: "Not one single person
of all the poor displaced in the carrying out of the Gray's Inn Road
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

"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[154] 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

The Committee called attention to the importance of favouring in every
way facilities of transit between the metropolis and its suburbs by an
extension of cheap workmen'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

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 responsibility 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

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 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 condition of the houses which such legislation did not touch.
Otherwise general improvement was impossible, and existing conditions
must continue indefinitely to flourish, and to produce 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

"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 ventilation
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....

"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.

Returns 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 2-1/2 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 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 officers, inspection of the district with
a view to ascertain what nuisances exist calling for abatement under
the powers of the Nuisances Removal Acts, and to enforce the provisions
of the said Acts in order to cause the abatement thereof."

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 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 Officers 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.[155]

The Vestries and District Boards were, in fact, masters of 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 condition 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

"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

"I would beg to remind the Vestry that until proper regulations 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 Removal Acts; but that
was not the fact, for there were many and considerable advantages in
this form of procedure over 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 sanitary 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 constantly 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

"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 Government 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 one of the first to
make regulations, it had been found unnecessary or impracticable to
enforce them, went on to say:--

"The fact of the enactment having been practically inoperative
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

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.[156]

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 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,[157] that he was quite certain

"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 improvement in the class of man appointed.

The Chief Sanitary Inspector for Clerkenwell[158] 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."[159]

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 obliged
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 dwellings of the
poor in London should be in an insanitary condition seeing the great
obstacles public sanitary officers have in the performance of their

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 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 Government 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 Review_ 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.

                             Number              Number of
  Parish or District.          of              Inhabitants to
                           Inspectors.         each Inspector.
  Greenwich                     1                  148,545
  Newington                     1                  117,870
  Mile-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                   60,389
  Paddington                    2                   55,567
  Marylebone                    3                   50,294
  Hackney                       4                   56,431
  Bethnal Green                 2-1/2               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

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

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 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 foundations,
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 willing 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 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,[160] "the Corporation remained

"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 consequence of the ill-doings of their

"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.

"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[161]:--

"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

"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

"... 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 introduction and discussion
had done much to awaken interest and mature opinion on the question
of the practicability of the government of London by a single

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 investigations 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     {   The whole population in
      { St. George-the-Martyr        { 1881 was 503,851; number
  (2) { St. Andrew, Holborn          { of children of school age,
        Clerkenwell                  { 3-13 == 91,128, 95 per
        St. Luke                     { cent. of whom have been
        Stoke Newington              { scheduled by the Officers
        Islington                    { 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.

He gave the number of families scheduled for elementary school purposes
residing _in more than two rooms_ as 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-Martyr, 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. lived in 2 rooms only.
  30     "       "      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."

And then he summarised his figures for the City Division:

  Number of children of school age == 6,986
    "    "  churches and chapels   ==    71
    "    "  public-houses          ==   408

Number 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 possibility 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 three-quarters for each. For a family of
two to monopolise 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

"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 undivided 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

"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

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 whereabouts."

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 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 Royal Commission to inquire into the housing
of the working classes.[163]

"The attention of persons of every class, of every creed, and school of
politics, has been turned to this question," he said.

H.R.H. the Prince of Wales said:--

"I feel convinced that your lordships, in common with all classes of
Her Majesty's subjects, will be gratified to learn that the noble
Marquess has asked for a searching inquiry into this great 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 Royal Commission for that

"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 Royal Commission."

The Government accepted the motion, and a Royal Commission was
forthwith appointed and immediately began its work.

While the great question of housing and overcrowding was under
discussion and was being investigated, 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.[164] Most of the powers of an Urban Sanitary
Authority under the Public Health Act of 1875 were conferred upon
it, and the Medical Officer of Health reported that he believed 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 inspection 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 precautions 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 Royal 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

This suggestion was partially given effect to by the Diseases
Prevention (Metropolis) Act of 1883, which enacted that, subject to
certain arrangements, the admission of any person suffering from
infectious disease into any 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 smallpox. 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.[165]

In 1885 the Report of the Royal 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 Royal 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 condition of
things--physical, moral, and material--the prevalence 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 overcrowding 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, unimpassioned, 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, 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 unsatisfactory
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 react 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 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
inefficiently 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,

"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 Salisbury, who asked:--

"I suppose it is practically impossible for the ground landlord to see
that the conditions are kept?"

Was told in reply:--

"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 land-owner 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 "middlemen" were given.

One of the largest in Clerkenwell was a Mr. Decimus Ball, and there was
also a Mr. Ross--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. Flight.

"He must have been the owner of thousands and 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.
Repairs, 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 authorities 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:--

"It is evident that where work is performed according to the custom of
certain districts of the metropolis 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 administration 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 Classes."

Lord Salisbury, in moving the second reading, said[166]:--

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 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 Labouring 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 entrusted 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."

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 Royal 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 the 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.

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 down 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 indefinitely, 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 benefited 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

"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.

"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 efficient 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
scandalous 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.

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

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

"That disease and death are directly traceable to this want," wrote the
Medical Officer of Health, "no one acquainted 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 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

"At Woolwich the river for its whole width was black, putrid,
sewage--looking as if unmixed and unalloyed. The stench was

"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 Royal
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 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, numbering 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. Ventilation
in them is also improved. Many owners rendered much assistance."

Several inquiries of the sort suggested by the Royal 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 carrying the laws into effect.

Clerkenwell, Mile-End-Old-Town, Bethnal Green, and Rotherhithe, 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.

Rotherhithe came in for the strongest condemnation. Of it the
Commissioners reported:--

"It is, in fact, no exaggeration to say that the results of lax
administration abound in Rotherhithe, 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, 5,213 were inspected; 3,620 of them were found
to be wanting in some sanitary requirement, 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 Hammersmith, 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, Southwark, reported

"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

In Camberwell there were, in 1889, between 30,000 and 40,000 houses
in the parish, "of which probably one-half should be inspected

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

And he further stated[167]:--

"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 enforced, 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

"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

"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 of pauper foreigners
from other European nations. The result has been to flood the labour
market of the East End of London with cheap labour to such an extent as
to reduce thousands of native workers to the verge of destitution...."

"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

"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 pressers' 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 Regulation Acts, are utterly disregarded, 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 unlooked 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

"The evils which existed there were caused by natural laws which were
not by any means of necessity unwholesome 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

"... 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

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

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 increasing 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. Ritchie, introducing the Bill into the House of Commons,

"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 ratepayers.

"We propose to take London, as defined under the Metropolis 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; the elected members sitting for three
years, the selected for six years (one-half of their number retiring
every three years).

"It will take over the licensing powers and all the duties 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 relation to the Central
Authority. Practically it left them untouched.

The Council was to consist of 137 members, of whom 118 were to be
elected triennially 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 Metropolitan Board
of Works.

While the Bill was going through Parliament the Royal Commission had
been pursuing its inquiry into the allegations 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 architectural profession
had availed themselves of their representative 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[169] 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 proceedings 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 transformed 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
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 Metropolitan 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 Rosebery 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 machinery existed
for securing any uniformity of administration 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 in 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,"[170] 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 authorities 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 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 legislation 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 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 infectious 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

The Managers were, therefore, enabled to admit other than pauper
patients reasonably believed to be suffering from fever, smallpox, or

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 accommodation 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 consequence of the failure of most of such
Authorities to provide accommodation for non-pauper patients."

The Managers by this date had increased the accommodation 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[171] 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 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 be 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 requirements."

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

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 widely prevalent evils, and who really were obstructing
progress towards a higher standard of public health, and how little
claim they had to consideration, 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.

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

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 offices 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    "[172]

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 withdrawn 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 49-1/2 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

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 improvement in the sanitary state
of the district."

In St. Pancras in 1888 the death-rate was "by far the lowest yet

In Bermondsey, in the same year, "so few deaths have not occurred since

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 enormously,
but the corrective was not extended to where it was most wanted,
namely, the local Sanitary Authorities, the Vestries and District


[149] 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

[150] The report was made in 1887, but was as true in 1881 as it was
in 1887.

[151] See Report of Select Committee, 1882, p. v.

[152] _Times_, 20th November, 1883.

[153] See his speech in Parliament, Hansard, 1884, vol. ccxc., p. 529.

[154] Robert Reid (a Surveyor), p. 805.

[155] 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 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 April.
  (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.

[156] Royal Commission, 1884.

[157] Hansard, 1884.

[158] 1884 Royal Commission, vol. ii. p. 2938.

[159] Ibid. p. 724.

[160] Hansard, 1884, vol. cclxxxix. p. 41.

[161] Hansard, 1884, vol. ccxc. p. 541.

[162] See Report of Royal Commission on the Amalgamation of the City
and County of London, 1894.

[163] Hansard, 1884, vol. cclxxxiv.

[164] By the Diseases Prevention (Metropolis) Act, 1883, 46 and 47 Vic.
cap. 35.

[165] The total net expenditure was £401,000 in 1885.

[166] Hansard, vol. ccxxix. p. 889.

[167] Lords' Committee on Sweating, P.P. 1890, vol. 17.

[168] Hansard, p. 1663, March 19, 1888.

[169] See the last Report of the Board.

[170] 53 & 54 Vic., cap. 70.

[171] The Customs and Inland Revenue Act, 1890, 53 & 54 Vic. cap. 8.

[172] See speech by Sir L. Playfair in House of Commons, March 4,
1884.--Hansard, p. 529.

[173] See Report from Royal Commission on Tuberculosis, 1898.



IN 1891 the census once more gave authoritative figures as to the
population of the metropolis 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 population 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 circumstance which, in the long run, would
materially influence the physique of the people.

Three important facts came into view with the figures set out in the
census, giving food for thoughtful minds as regarded the future of

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 being 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 illustrated 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

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 administration 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.

Between 1871 and 1881 it had increased 312,000. Between 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 railways 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

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 outside 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

In each successive census the number of inhabited houses 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.[174]

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

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

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 movement 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 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 tenements 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 inhabiting
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

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 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

In the western group over 173,000 persons lived in tenements 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

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--"overcrowding." 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

"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
considered as unduly overcrowded."

By using the information given in the tables, and excluding 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 accommodation of its district."

Provided with the tables as to the occupants of tenements, 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 145,513 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 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,"[175] which
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 condition 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 Royal 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 prominent place in this

Once more did Parliament enact the oft-ignored direction 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

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 Government Board.

The Act greatly strengthened the law both as to the prevention and
definition of nuisances. It provided for the immediate abatement of a
nuisance, not only where actually proved to be injurious or prejudicial
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 nuisances 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
extended 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 whole cost of disinfecting houses, and cleansing
and disinfecting 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 administering 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; (_b_) 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; (_f_) 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.

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 complaint 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 limited 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. Ritchie in introducing the
Bill, "that in regard to the great question of public health in London
the County Council ought to 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 subordinating 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

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 any really sound system of public health
administration for London can be based.

A few years later the principle was reaffirmed by Parliament.

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 responsibilities as
to the administration of the law relating to epidemic diseases, a
provision defining the Council's position 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 Government 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
regulations 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 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
thoroughness and a rapidity hitherto unknown in the administration of
London affairs.

Bye-laws were made to regulate and unify the administration 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.

Representations were made to the Board of Trade and negotiations
carried on with the Railway Companies, and by degrees a considerable
extension of the facilities for the conveyance of workmen was secured.

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
reconstruction 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
willing 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

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 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 3-1/2 acres--3-1/2
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 Row 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 Roby 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

The cost of this work was enormously heavy, owing to the fact that the
arbitrator could and did award commercial value for the land; but, as
was pointed out by the Medical Officer of Health for the London County

"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 demolition 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--gruesome 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

Part III. of the Act embodied the idea, originally started by Lord
Shaftesbury in 1851, as to the erection of labouring classes'
lodging-houses by the local authorities, and grafted several amendments

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 jurisdiction. Under this part of the Act
the Council erected a common lodging-house in Parker Street for the
accommodation 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

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

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 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
resurrection 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 concessions 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 miles_ 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, 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

"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, Shoreditch, 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 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 29·1."

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 Revenue 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 anomalous 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, 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 publicity attracted more attention.

Overcrowding and insanitation of almost every conceivable 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

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 recommendations, 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."

"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 workshops: "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, inspection here was
lamentably deficient, if not absolutely non-existent.

"The inspection at present carried on is totally inadequate,
and nothing was more clearly proved before us than the fact that
satisfactory results cannot be looked for from the system as it now

"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 smallpox 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 Workshop 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

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 workshops 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 employé. You have
the members of the same family ... and it seems to me that we may
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 Public
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 "workshops"
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

Added to this was the sanitary supervision of the places of

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 staff it is impossible that this can be

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 Islington," 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 appointment 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

A report in 1892 of the Medical Officer of Health of St.
George-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."

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 disastrous 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

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), "76·1 per cent. 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 tenements 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.

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" promptly
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 wrote in 1891: "I should say 4,000 houses require registration."
In St. Mary, Newington: "At least 80 per cent. of the houses are
occupied 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 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 subject to abatement within a certain

"If the conditions imposed by the bye-laws are carried out, no doubt
one of the best methods for preventing overcrowding is thus achieved."

The advantage of this quicker procedure was manifest, for, under the
other Public Health or Sanitary Acts, the whole process of dealing
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 authorities, 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 no legal power to act. Regulations or bye-laws,
drafted by the Local Government Board as "models" for adoption by
the local authorities, suggested "exemptions" to what Parliament 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 enactment 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 themselves 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 frustrated; the Act
was prevented being a remedy for overcrowding, 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."[180]

A special census of the population of London was taken on March 29,
1896, which showed that the population 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

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 proportionally; 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 importance, 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 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 inspectorate. 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 inhabitants. 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 administration 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 sometimes 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 understood. Thus, in
1892, a Medical Officer of Health wrote:--

"Many persons think the Public Health Act an innovation on their

Describing the insanitary condition of 230 houses in Provost Street,
Shoreditch, the Sanitary Inspector wrote in 1892:--

"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
anything to the expense of the improvements."

This "very natural objection" entailed, of necessity, sickness 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 negligent) 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 dilapidated and a
scandal, but might be maintained in a fairly habitable condition."

The Medical Officer of Health for Bethnal 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 exhausts 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 persons 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."

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 (England 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 Register,
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
Overseers of the Poor, and some other powers and duties of more or less
importance, possessed or possessable by Parish Councils. The elections
were held on December 15, 1894.

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

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 accomplish. 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 districts, and an instructive light
thrown upon the administration 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 improvement had, under
public pressure, taken place. In 1892 a Royal 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 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
purification 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 considerable 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 metropolitan 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 disposing 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 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

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 disinfected 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 community. How great may be gathered from the following

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 outbreaks 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 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.[181] 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 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 Reach 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 these was the provision
made by the Poor Law for the treatment and care of the sick poor.[182]

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

"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 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

"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 figures--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 miserable
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 disastrous consequences, but these consequences
always have been, and still are, of the most deplorable kind. The
overcrowded dwellings and bad sanitary arrangements constantly tended
to increase the habit of intemperance, and the moral degradation
caused by drink made people indifferent 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 Royal Commission 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 Road 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

Parliament has done but little to mitigate this terrible evil. Happily,
however, other influences are at work.

The Royal Commissioners in their Report 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 remedied, and hardly any sacrifice would
be too great which would result in a marked diminution of this national

And the Chairman of the Commission (Viscount Peel), the Archbishop of
Canterbury, and seven Commissioners in a Minority Report 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 improving. 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

And the Medical Officer of Health for Islington in 1897 reported the
death-rate as 15·80--the lowest since registration was introduced in

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 19·3 per 1,000.

In Battersea the death-rate was 26·8 in 1871, and 17·6 in 1901.

But infantile mortality did not show a similar rate of improvement.
In many parishes there was a decided improvement. 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

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 Parliament appreciate the
importance of more and more safeguarding 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 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 boundaries of parishes, and that once set alight anywhere no
limit could be put to its widespread devastations. An unhealthy 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, necessitate 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
by their preventive sanitary service, and by the prompt removal of
infectious cases to suburban hospitals as is now 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 metropolis--with its
four-and-a-half millions of people, was left for its protection against
disease to a number of semi-independent 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 applications 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 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

The Act of 1888, while dealing with the central government 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.[183]

"A consideration of the evidence we have received confirms 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

In February, 1899, Mr. Balfour introduced in the House of Commons a
"London Government Bill."[184] 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:--

"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 simultaneously 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 transferred 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 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

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 disappeared 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, mismanagement, neglect,
sometimes even of graver transgressions, 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 described 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 Parliament were
ignored or neglected. Had this been pure 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 improved, but even to the end many
of them grievously failed to fulfil the responsibilities of their

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

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

In 1889 Dr. N. Vinen died after thirty-four years' service as Medical
Officer of Health for St. Olave, Southwark.[185]

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.


[174] See General Report of Census Commissioners, P.P. 1904, vol.

[175] See speech of the President of the Local Government Board, Mr.
Ritchie, in introducing the Bill in April. Hansard, 1891, vol. ccclii.

[176] Statement by the Clerk of the London County Council.

[177] See his Report for 1899, p. 63.

[178] P.P. 1890, vol. xvii. See fifth Report from the Select Committee
of the House of Lords on the Sweating System.

[179] See the Order made by the Home Secretary in November, 1892, as to

[180] Not much interest appears to have been taken in the proceedings
of some of the Vestries. Thus, in 1891, the Vestry of Westminster
complained of the lack of public interest in the record of their
proceedings. "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.

[181] See 3rd Report from Select Committee of the House of Lords on
Metropolitan Hospitals, 1891.

[182] See the Report of Select Committee of House of Lords on
Hospitals, P.P. 1892, vol. xiii.

[183] See Report of Royal Commissioners on the Amalgamation of the City
and County of London, 1894.

[184] See Hansard, 1899, vol. lxvii. p. 354.

[185] 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.



ONCE more the census placed on record the actual population 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

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 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

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 declined from 31·8 per 1,000 in 1891 to 29·0 per 1,000 persons
living in 1901, the lowest recorded in London since civil registration

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 threepenny 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

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 consequence to the
sanitary condition of the people of London, marking, in their
respective spheres, definite stages in the sanitary evolution of the

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 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 bakehouse 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

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 workshops in London
were under the supervision of the local authorities. The necessity of
inspection was demonstrated by the fact that 18,922 conditions required

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 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 Metropolis
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 Royal Commissions of Inquiry, Parliament dealt with the
subject in 1902. But the manner of dealing with it was unfortunate and

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 Corporation, and the remaining 21 by the authorities of
localities outside London hitherto supplied by the Companies.

The Board, therefore, was not a representative body 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
emancipated 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 £40,000,000, 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

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
generations. 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.

"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 anæmic 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."[186]

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 precautionary measures being
adopted in the school."[187]

In 1895 the Medical Officer of Health for Paddington wrote:--

"School teachers 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 sickness if the disease be not a notified
one, but no information of such fact comes to the Sanitary Authority."

And in 1896 he wrote:--

"The past year had emphasised the need of definite instructions 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."[188]

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 heating, 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."[189]

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 period is to grow, and it is necessary that they
should not only do this, but do it under favourable circumstances for

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 beneficial 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 regulating and supervising the
practice of midwives. After the 1st of April, 1905, no person might use
the title of midwife without 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 empowered 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.

In 1894 the duty of supervising and regulating the common
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 supervision 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 figures 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 retrogression; 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 4,500,000 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

What the main drainage of London was up to 1858 has been described
in the earlier chapters of this book. In effect, 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 outfall sewers, 176 miles of main sewers, and 26
miles of large relief sewers, constructed for the special purpose of
conveying storm-water away.

This, however, was but part of the provision which had to be made.
During the _régime_ 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

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 abominations; no longer streets without
sewers, and houses without the possibility of drainage.

In the Report 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 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 11-1/5 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
incurred 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-fifties 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. Improvements 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 defilement 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[191] that a dwelling-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 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,[192]
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,[193] 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

In addition to these, many local improvements have been carried out by
the "City" and by the Vestries and 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

The "City" had also acquired, outside the County of London, Epping
Forest, about 5,560 acres in extent, Burnham Beeches, 375 acres;
Coulsdon Common, 347 acres; and a few small open spaces in the "City"

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.
Gradually 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; 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

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 Removal 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.

As years advanced great scientific discoveries demonstrated 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.[194] 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 work 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 Spitalfields--by a system of inspection,
prevented large quantities of bad or diseased food being sold to the

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 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 consumption.

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

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.

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 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
considerable 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

There is a third sphere of government in matters pertaining to the
public health--namely, that occupied by the State. It is charged
with many duties connected with the public 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 Government 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
voluminous, 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
Metropolitan 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 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 government 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 Parliament and "Provisional 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 administration 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

The Water Board is still too young to have a record.

The Poor Law Guardians had improved the workhouses and the
infirmaries, and the dispensaries were continuing to do their useful

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 workshops, 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 connected 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

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 grave evil--and as in these schools 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 considered satisfactory or even

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. It 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 population in the ten years from the tenements of one
or two rooms to the more ample accommodation provided in tenements of
three or four rooms is conspicuous."[195]

There had been a reduction in the number of one-room 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

Forty-six per cent. of the population lived in such tenements; 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."

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. Pancras, 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 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

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 circumstances where
physical well-being is impossible, and where even a moderate standard
of public health is unattainable.

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 throughout 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

"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
families of the wage-earning class engaged in industrial occupations
living in tenement-houses in certain streets near the Great Western
Railway terminus. "Sixty-four per cent. were born 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 deterioration 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 Report 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 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
unavoidable conclusion that there has been a considerable deterioration
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 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 17·1 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 preventable, 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? Where the shortcomings?

The failure is in part due to a great omission by Parliament--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 supervision 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.

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
ventilation--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

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

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 Public 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 occupation of several
families devoid of the primary necessaries of a healthy existence.
The great movement has by no 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 2-1/4 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 overcrowded with 35,500 persons
living in them, has only 283 of 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 overcrowded 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
public health in London than at present enjoyed has been the want
of a real central Health Authority. The Metropolitan 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 public health full authority
should, subject to Parliament, be vested in one supreme authority--a
central authority which 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 Royal 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 Royal 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 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 themselves 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


[186] Final Report of the School Board for London, p. 326.

[187] See Report of Medical Officer of the late School Board for

[188] Final Report, p. 297.

[189] First Report of Medical Officer for year ended March 25, 1903,
p. 24.

[190] Second Annual Report to March 25, 1904.

[191] In the Public Health (London) Act.

[192] The recoupments arising from the sale of surplus lands reduced
the actual or net cost to less than £8,000,000.

[193] Here the net cost is estimated to be about £5,500,000.

[194] 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

[195] See Report of the Medical Officer of Health of the London County
Council, 1902, p. 10.



  Aldwych, 413

  Allison, Dr., evidence quoted, 28

  Alteration of Food and Drink and Drugs Act, 1872, 238

  Artizans' and Labourers' Dwellings Act, 1868, 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

  Brockwell Park, 414

  Bromley, 159

  Building Act, 1844, 30, 164

  Burial grounds, 35-7, 54-5, 64, 67, 231, 309-10

  Burnett, J., report quoted, 335

  Burnham Beeches, 414

  CAMBERWELL, 98, 104, 137, 144, 155, 190, 219, 222, 267, 288, 291,
        305, 309, 334, 354, 406

  Census of 1851, 56, 410
    of 1861, 155-7
    of 1871, 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, Commission 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 character, 7-9
    its government, 9, 417
    its sanitary condition, 50
    its declining population, 94-5, 155, 222, 224, 288, 352, 401-2
    construction of business premises, 367, 394
    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
    inefficiency and inactivity, 183-7, 267-73, 301-8, 321-2, 398-9
    abolition, 398-9

  Drunkenness connected with overcrowding 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 Commission 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
    connection with cholera, 47

  Finsbury, 16, 314-5, 423-4, 430

  Finsbury Park, 206

  Flight, 323-4

  Forster, 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

  Hornsey, 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

  IMMIGRATION 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, LORD, 371

  Kensington, 98-9, 105, 121, 188, 219, 222, 225, 230, 278-9, 288,
        355, 375, 383, 430

  Kingsway, 413

    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
    constituted education authority, 406-9, 418
    summary of its work, 420

  London Fever Hospital Report, 1845, 32

  London Government Act, 1899, 396-7

  London Government Bill, 1884, 311-3

  Lynch, Dr. J., 33-4, 261

  MARYLEBONE. _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, 1852, 71, 160, 191

  Metropolitan Asylums Board, 210, 418, 420

  Metropolitan Board of Works constituted, 83-5
    abolished, 337-41

  Metropolitan Building Act of 1844, 24, 76
    of 1855, 88, 164, 204, 231

  Metropolitan Burials Act, 1852, 55

  Metropolitan Gas Act, 1860, 184

  Metropolitan Market Act, 1851, 247

  Metropolitan Paving Act, 1817, 12, 24

  Metropolitan 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," 368-70

  Morpeth, Lord, 43-4

  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


  New Oxford Street formed, 29

  New River 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 Removal and Diseases Prevention Act, 1855, 82-3, 86,
        117, 415

  OVERCROWDING, 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 nineties, 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 nineteenth century, 12

  Peabody Trustees, 265, 296

  Pear Tree Court, Clerkenwell, 261

  Pennethorne, J., 28

  Phillips, 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


  Registrar-General's Report after census of 1861, 154

  Rendell, Dr. William, 142-50, 175, 186-7, 189

  Ritchie, C. T., 338, 359

  Rodwell, 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. GEORGE, 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

  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,

  Salisbury, Marquess of, 317, 322, 325-6

  Sandhurst, Lord, 337

  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 officers' reports in 1856, 100-3
    attention 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

  Smallpox, 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 Conservancy 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, 43
    in the "City" in the fifties, 58, 112, 147

    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 PRINCE OF (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 Reform passed in 1852, 71
    Act of 1871, 233-5
    Act of 1887, 331
    Royal Commission of 1892-3, 383-4
    Act of 1902, 405-6
    general survey, 412-3

  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,

  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


       *       *       *       *       *

Transcriber's note:

Minor typographical errors have been corrected but inconsistent accents
and punctuation are as in the original text unless noted below. Archaic
spellings have been left unchanged.


The following misprints and other errors have been corrected:

Page 42 - the text "was it a" changed to "it was a" ("but none the
  less it was a forward step towards a sounder and wiser system of

Page 96 - the text "it amounted it" changed to "it amounted to" ("And
  that is what, undoubtedly, it amounted to").

Page 121 - "61·3 of the total deaths." changed to "61·3 per cent. of
  the total deaths."

Page 145 - the text "illness resulting difficult of cure" changed to
  "illness resulting in difficulty of cure" ("each from illness
  resulting in difficulty of cure, constantly recurring.").

Page 199 - the text "precisely the powers which not last year only,"
  changed to "precisely the powers which, not last year only,"
  ("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").

Page 203 - sentence changed from

  "And another example near Paddington Road--where 275 houses had been
   built, and the population was 493 to the acre; showing"

to read

  "And another example near Paddington Road, where 275 houses had been
   built, and the population was 493 to the acre, showing--"

Page 207 - the text "acccess of energy" changed to "excess of energy"
  ("The visitation of cholera was doubtless in the main accountable for
  the excess of energy displayed by Parliament about this period").

Page 219 - comma added after "50 per cent." ("the high rate, nearly
  50 per cent., of infantile mortality").

Page 246 - the text "in the yards of some of them slaughter-houses"
  changed to "in the yards of some of them were slaughter-houses"
  ("indeed, in the yards of some of them were slaughter-houses, with
  all their unpleasant concomitants.").

Page 304 - the text "for there many" changed to "for there were many"
  ("for there were many and considerable advantages in this form of

Page 314 - the text "was 382" changed to "as 382" ("He gave the number
  of families ... residing in more than two rooms as 382, ....").

Page 353 - "inhabitating" changed to "inhabiting" ("number of persons
  inhabiting each").

Page 357 - "prejudical" changed to "prejudicial" ("injurious or
  prejudicial to health").

Page 375 - the text "76·1 of the population" changed to "76·1 per cent.
  of the population" ('In Bethnal Green (1894), "76·1 per cent. of the
  population lived in tenements of less than five rooms. No houses had
  been registered."').


The following changes to the original text have been made for clarity
or consistency:

In CHAPTER I, the section numbers have been prefixed with the words
"CHAPTER I, PART" for clarity. This means that the headings of the
sections in this chapter are now--


The word "death roll" changed to "death-roll" throughout to match the
  more numerous instances of the latter form in the original text.

Page 254 - reference to "The Artisans' and Labourers' Dwellings Act
  (Torrens) of 1868" changed to "The Artizans' and Labourers'
  Dwellings Act (Torrens) of 1868".

Page 437 - reference in the Index to "Metropolitan Markets Act, 1851"
  changed to the correct title of "Metropolitan Market Act, 1851"
  as cited on page 247.

Footnotes have been re-indexed using numbers and collected together at
the end of each chapter. Where there were multiple references on a page
to the same footnote, the second and subsequent reference is now
sequentially numbered with its own footnote which says "Ibid."

The following variations of a word or descriptive term are common
in the original text and have been retained:

  "Common Lodging House", "lodging house" and "lodging-house"
  "back-yard" and "backyard"
  "cow-houses" and "cow houses"
  "lime-washed" and "limewashed"
  "over-crowded", "overcrowded"
  "over-crowding", "overcrowding"
  "re-built", "rebuilt"
  "re-build", "rebuild"
  "re-inspection" and "reinspection"
  "sub-soil" and "subsoil"
  "tenement-house" and "tenement house"
  "Wash-houses" and "Washhouses"
  "water-course" and "watercourse"

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