Victorian London - Publications - Social Investigation/Journalism - Sanitary Ramblings, Being Sketches and Illustrations of Bethnal Green, by Hector Gavin, 1848 [Sickness, Disease and Mortality, pages 92-117]

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Any one who has perused the facts which have been already developed in these pages must, in some measure, be prepared for the array of figures (the work of hours, and days, and weeks, but the result of which occupies but a few minutes), which tells us of the oppressive amount of sickness, and disease, and mortality unnecessarily suffered by the unfortunate poor in this parish. In the tables I shall exemplify the condition of Bethnal-green, by comparing it with that of the surrounding parishes. In the tables which have been compiled, the sickness and mortality refers to the amount occurring in the 12 months ending Oct. 1, 1847, by which means those sources of error, or exaggeration, at least, in the last quarter of 1847, which the prevalence of influenza would have given rise to, will be entirely avoided. The sickness and mortality may be taken as a fair and ordinary specimen of the unhealthiness of the parish.
    It would have cost me a much greater amount of labour than I am now able to bestow to have analyzed all the diseases which have produced the mortality in this parish. I have confined my analysis to the deaths from zymotic diseases, and from all causes.
    The first table which I have to present illustrates the amount of sickness and disease in the different parochial medical districts. This table is necessarily defective, as illustrating the whole amount of sickness and disease in the districts, because it only displays the amount attended by the parochial medical officers, altogether leaving out the cases of disease attended by dispensary medical officers, by private practitioners, or which obtain relief from hospitals. It is also defective, inasmuch as peculiar circumstances may cause one medical officer to receive many more "orders" than another; such as a character for ability, for attention, for kindness; or the reverse; such as a character for inability, for neglect, and indifference. I am not, however, aware that in any of the districts such causes at all affect the table; and as the proportion of dispensary cases, and of cases receiving relief from hospitals, as far as I can learn, is greatest in the worst districts, they may diminish the force of the facts that sickness and disease chiefly prevail in the worst districts, but do not alter the facts themselves.
    It is earnestly to be desired that when highly-qualified medical officers of health shall have been appointed, some means may be taken to use, for the benefit of the public, the vast amount of information annually collected by the parochial medical officers, and which now remains undigested, and utterly useless. With a proper system of medical relief to the poor, dispensaries would be worse than useless, and out-door relief from hospitals no better. The thousands of out-door cases of disease relieved by these charities (in some measure pseudo-charities), and which are ostentatiously paraded by the governors, to show what has been done, and are put forth to procure still larger contributions, are either cases which ought properly to fall to the lot of parishes adequately to relieve and attend to, or else they are objects altogether [-93-] unfit to receive public charity of any kind. By the suppression of dispensaries and out-door relief from hospitals, the whole sickness and disease of the pauper population of the parish would devolve on the parochial medical officers, and their returns would become to the statistics of disease what the returns of deaths are to the statistics of mortality. The greatest possible benefits would flow from such a grand and comprehensive system of arrangement of medical facts.
    The five Districts have each very nearly the same population, but the relative amount of sickness and disease is widely different, and abundantly evidences the dismal effects arising from over-crowding, and neglected cleanliness.

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    [-96-] An examination of the succeeding table proves that, while the whole amount of cases deriving medical relief under the Poor Law, in the healthy district No. 5, amounted to only 269; in the unhealthy district. No. 4, characterised by the grossest foulness, the cases amounted to 996; - while zymotic diseases prostrated 24.5 per cent, of the sick in the healthy district, they attacked 42.3 per cent. of the sick in the unhealthy district ;-while 23 persons were attacked with fever, and 12 with diarrhoea, in the healthy district, 138 were attacked with fever, and 144 with diarrhoea, in the unhealthy district.
    The expense to the public, for the relief of sickness, should be for that proportion which is unavoidable, and which is inherent to the natural condition of man. All other expence, for avoidable sickness, is a tax paid by the public for their neglect of the health and lives of their fellow men :-Yet, more than 30 per cent, of the cases of sickness, attended by the Poor Law Medical Officers, in Bethnal-green, arises from epidemic diseases, the greater, by far the greater, part of this sickness is unnecessary and preventible. The expence, such as it is, is unnecessary, the labour of the medical officers is unnecessary, and their free and liberal exposure to typhus, is, in a great measure, unnecessary;-because all could be avoided.
    1590 cases of epidemic, or zymotic diseases, proved to be, to a great extent, preventible diseases, sought parochial medical relief; 5226 cases of disease received medical relief at the hands of parish, in the year ending Oct. 1, 1847.
    This relief was distributed by five medical officers, at an expense of 310 to the parish. This remuneration returned to the gentlemen engaged, a clear sum of 1s. 2d, and 2-10 for the trouble of visiting and providing each case with medicine, but, this munificent and liberal conduct of the wise and beneficent guardians of the poor, does not appear in so good a light, when it is considered, that each case was visited many times, and, that if the number of visits to the poor sick, be calculated, it is found that the aggregate amounts to a sum of 43.618. The remuneration, if divided by this sum, presents to each of the medical gentlemen (on an average) the sum of 1d. 4-10 for his visit, out of which must be deducted the cost of the medicine to be supplied.
    Alas! Are not such statements sufficient to prove the absolute mockery, the complete falseness, the utter worthlessness in the working, of the present system of medical relief to the poor. Do they not prove the severity of the labour entailed on the oppressed surgeon, while they exhibit the most considerate regard for the poor.

[-97-] TABLE IV.

The following Table illustrates the amount of mortality and the number of births in the different quarters of the year specified, and in the different districts of the parish:-

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    [-98-] The following Table shows the proportion of deaths and births in the different districts, and in the whole parish:-

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    [-99-] The succeeding Table points out the deaths from zymotic diseases in the periods and districts specified:-

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    [-100-] The following table presents a summary of the preceding table, and has reference to the whole parish:-

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    [-101-] The relative healthiness of the different districts therefore is as follows : -The Green, the Church, Hackney Road, the Town. The relative mortality being 1 in 57, 50, 50, and 43. The relative proportion of deaths from Zymotic diseases, 1 in 132, 260, 195, and in 137. The relative proportion of births is 1 in 31.1, 27.7, 27.8, 27.6.
    It is readily understood by the accounts contained in the preceding pages, why there should be so great a difference in the mortality in the Green, and in the Town districts. The one open and free, the other close and confined. But the great proportion in which it suffers from epidemic diseases could scarcely have been anticipated, but must be traced to the abominable filthiness, and the great amount of vegetable and animal remains surrounding the houses of the poor, as well as to its exposure to the emanations from the marshes which surround it, and against which it has no defence, but itself acts as the barrier to their spread towards London. The facts, however, most clearly point out that in a poor population, surrounded by much filth, with scarcely any drainage and still less sewerage, with street cleansing greatly neglected, and a high mortality from epidemics; a very low rate of mortality can be obtained by the avoidance ot over crowding and an abundant supply of air. And that the causes which destroy the poor, arising from filth and the absence of facilities for its removal, are not only epidemic diseases, but the excess in several, and the greater frequency of all those other diseases to which man is subject.
    The law by which an all wise Providence supplies the loss caused by an excessive mortality is clearly enough demonstrated here; for, while in the comparatively healthy district the ratio of deaths is 1 in 57, and the ratio of births 1 in 31.1., in the unhealthy district the ratio of deaths is 1 in 43, and the ratio of births 1 in 27.6.
    The accompanying lithographic plate of the parish exhibits the Disease Mist which overhangs it, and destroys, and enfeebles, the population; this Angel of death not only breathes pestilence, and causes an afflicted people to render back dust to dust, but is accompanied with that destroying Angel which breathes a moral pestilence; for where the seeds of physical death are thickly sown, and yield an abundant harvest, there moral death overshadows the land, -and sweeps with the besom of destruction to an eternal gulf.


The following Table exhibits the number of males and females that have died in one year, and the ages at which they have died; and also the number living at the termination of a given period: - 


(Extracted and compiled from the returns to the Register-general.


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    [-103-]  From this Table it follows that of 2,000 deaths-

664 occurred under 1 year of age, or . . . 33.1 per cent.
803 occurred under 2 years of age, or . . 40.1  "
959 occurred under 5 years of age, or . . 47.9  "
1,065 occurred under 15 years of age, or 53.2 "
1,528 occurred under 60 years of age, or 79.9 "
And that the average age of death was-
Of males . . 25.2 "
Of females . . . 26.8 "
Of males above 1 year . . . 41.1"
Of females . . . 373"
Of males and females, of all ages, . . 26.6 " 

    It follows that the average age at death has increased by 10 months for every individual during the last 8 years, having been 25 years and 8 months in 1839, but 26 years 6 months in 1847.
    It is likewise proved by the foregoing tables that the relative mortality has not diminished, but rather increased; for while the mortality in 1832 was 1 in 41, and in 1841 1 in 43, it is now, again, 1 in 41. The proportion of births, by the extraordinary law which prevails, has increased, notwithstanding the high mortality; for while the proportion in 1841 was to the population as 1 in 28, the proportion now is 1 in 27.5.

    [-104-] The following Table Illustrates the mortality from epidemic diseases:-

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[WARNING:- the table below is a large file - 1MB in size]

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    [-105-] It is proved from the foregoing Tables, that of the mortality which occurs in Bethnal-Green, more than a fourth arises from epidemic diseases; of 2,000 deaths, 523 were due to epidemic diseases. Of these 523 deaths,
78 occurred under 6 months.
206 " during the first and before the completion of the second year of life.
287 "  "           "    "       "     "            "           "          "   " third year of life, and
305 "  "           "    "       "    before the completion of the fifth year of life.
    In Table No. 6, the relative proportion of these epidemic diseases, one to the other, is shown. It is impossible, with the full knowledge that the fatality of epidemic diseases may be infinitely diminished, if the diseases themselves cannot be entirely averted, to view more than a fourth of the mortality as the result of these diseases, without arriving at the conclusion that a very large proportion of the children which are born are ushered into life but to perish of loathsome dis. eases. And when we consult Table No. 1, we are further taught that these diseases prevail to an alarming extent, and constitute a very great part of the most anxious toils of the medical officers who attend the poor. It is indeed appalling to consider the enormous mortality which takes place among the children of the poor. Thus, in Bethnal-green, among the children of the gentry under 10 years of age, the mortality, in 1839, was, to the total of deaths in the same class, 22.0 per cent.-Tradesmen, 55.3.-Artificers, 65.1.
    During last year, 
    Of 664 deaths at 1 year of age, 206 deaths arose from epidemics.
     "   139 "            " 2 years "  "      81   "             "      "        "
     "     74 "            " 3 "         "  "     40    "             "      "        "
     "      49 "           " 4 "         "  "     35    "             "      "        "
     "     .54 "           " 5 "         "  "     23    "             "      "        "
    The annexed Lithographic Table exhibits in a simple manner the rapid diminution of life which takes place, especially during infancy and childhood. It points out, as Addison has beautifully done, in his "Vision of Mirza," how thickly are set in early years the traps in the bridge of life which man has to traverse.
    Addison compares "human life to a bridge consisting of three score and ten arches, with several broken arches, which, added to those which were entire, made up the number to about a hundred." I see multitudes of people passing over it, said I; and a black cloud hanging on each end of it. As I looked more attentively, I saw several of the passengers dropping through the bridge into the great tide that flowed underneath it; and upon further examination perceived there were innumerable trap doors that lay concealed in the bridge which the passengers no sooner trod upon than they fell into the tide, and immediately disappeared. These hidden pitfalls were set very thick at the entrance of the bridge. "They grew thinner towards the middle, but multiplied and lay closer together towards the end of the arches that were entire." The table represents a stream of 2000 persons "breaking through the cloud, follows them in their passage over each arch, and paints the "hidden pitfalls,", through which they disappear. Alas I how few does it represent as reaching the broken arches. 
    [-106-] The following Tables convey the most distressing information as to the premature death of the great mass of the poor:

    TABLE X.

    "In a return obtained" by Mr. Chadwick, "it appears that of 1,263 deaths in Bethnal Green amongst the labouring classes, in the year 1839, no less than 782, or 1 in 147, died at their own residences under 5 years of age. One in 15 of the deaths occurred between 5 and 10, the age when employment commences. The proportion of deaths which occurred between 10 and 15, the period at which full employment usually takes place, is 1 in 60 only."
    In Bethnal Green the average age of death in the year 1839 was as follows in the several classes ,

No. of Deaths  BETHNAL GREEN
Population 74,087
Average Age of Deceased
101 Gentlemen, Professional Men, and their Families 45
273 Tradesmen, and their Families 26
1,258 Mechanics, Servants, Labourers, and their Families 16

    Let us compare this Table with the following Tables of the average age at death in the same year, in the same classes, in the four adjoining parishes.

No. of Deaths HACKNEY
Population 42,274
Average Age of Deceased
61 Gentry and their Families 47
228 Tradesmen, and their Families 29
237 Artisans, and their Families 27
No. of Deaths SHOREDITCH
Population, 83,552
Average Age of Deceased
86 Gentry and their Families 47
303 Tradesmen, and their Families 23
1,300 Artisans, and their Families 19
[-107-] No. of Deaths WHITECHAPEL
Population, 71,758
Average Age of Deceased
21 Gentry and their Families 47
272 Tradesmen, and their Families 26
1,378 Artisans, and their Families 25
No. of Deaths POPLAR
Population 31,091
Average Age of Deceased
23 Gentry and their Families 43
84 Tradesmen, and their Families 26
475 Artisans, and their Families 25

Let us also recognise the following facts, as conveying instructive lessons regarding the sanitary state of Bethnal Green, compared with the adjoining parishes. It is compiled from the Supplement to the Report on the Sanitary Condition of the Labouring Population, and refers to the Year 1839. It exhibits the absolute waste of life in each of the parishes, the early age at which death takes place, and the relative loss of life to the tradesmen, and artizans, and to every individual in the locality:-

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[-108-] The following Table, referring to the year 1841, demonstrates the extravagance and waste occasioned by the present Death and Dirt Tax. It exhibits the relative proportions of deaths from epidemic, endemic, and contagious diseases, called Zymotic Diseases, to the population ; and the money-loss entailed on the parishes by a neglect of Sanitary Measures, supposing that no greater loss occurred than takes place relatively in Camberwell.



Life One in every  Money*  Sickness.  Funerals. Labour.   Total. 
Bethnal Green 99  31 4,648 830 23,157 28,635
Hackney. 269 " " " " "
Shoreditch 123 47  14,756 2,635  51,982  69,373
Whitechapel 83 114  20,461 3,655  131,328 155,444
Poplar.  140  73  924 165 25,84226,931

 * The calculation of the Money Loss refers to the value of productive labour at 10s. per week for men, and 5s. per week for women; say 7s. 6d. per week for each adult.

    [-109-] IN endeavouring to estimate the actual loss of life to Bethnal-green from the neglect of sanitary measures, and which is capable of prevention, I will assume that the mortality can be reduced to 2 per cent., or 1 in 50. I am quite convinced that such a reduction is not by any means the full measure of the gain, but I am unwilling to use an exaggerated standard; and as a mortality of 2 per cent. has been conceded by the calmest and most dispassionate judges, as well as by the partizans of sanitary reform, I trust that even this standard will be sufficient to arouse every prudent, selfish or benevolent, mercenary or philanthropic man, as well as Christian, to exertion. The motives cannot but be confessed to be all powerful.
    Bethnal-green possessed, on an estimate, corrected for the increase of population, on the 1st of July, 1847, a population of 82,430. The increase of the population, by the influx of new inhabitants into new houses, has been fully counterbalanced by the pulling down of numerous old houses in densely populated neighbourhoods, by the Railway Company. Under the beneficial influence of sanitary regulations, a mortality of 1,648 would occur, but during the year which has been taken 2,000 deaths occurred. A preventible excess of mortality of 352, therefore, has taken place. The annual deaths of 352 persons is the price in life, paid by Bethnal-green to support its present filthy state-a costly, and extravagant, and fearful sacrifice.
    It has been the custom by most sanitary statists to bring forward the average age at death, as a test of the sanitary state of a district. In accordance, therefore, with this custom, though not placing implicit dependence on it as a test, I have given a return of the average ages of males and females at, and above 1 year, and of the whole population, at death. It is to be borne in mind that the death of one person at 103 (the greatest age obtained) counts for the death of 103 infants below 1 year of age.
    Bethnal-green has been exhibited as having a very low average age at death. It is too notoriously unhealthy to necessitate any questioned data to support the fact of its unhealthiness. Let us then examine whether it really has an average so much lower than other spots considered as having a higher average age at death. For instance, the average age of death was, in 1841, in
Bethnal-green . . 26    Marylebone . . 29
Clerkenwell . . 26         St. George's, Hanover-square. 31.3
St. Giles's and St. George's . 28     Kensington . . . 32
    But if the distribution of the population, according to age, be equalized in these several districts, in accordance with the views of some critical statists, it appears that, for the amount of population, St. Giles's and St. George's, Bloomsbury, is the most unhealthy, The order would be as follows: - 
    St. Giles's and St. George's 24.34    Bethnal-green . . 25.80
    Marylebone . . 24.52   Kensington , . 26.71
    Clerkenwell . . 24.84    St. George's, Hanover-square 28.13
    The rate of mortality follows precisely the same order.
    [-110-] It has been asserted, and to a certain extent, conceded that the average age at death, is not a sound or correct means of estimating the sanitary state of a district. On the same ground, it follows that the estimates which have been made of the number of years of life lost by a population are incorrect. By the aid of Mr. Neison's calculations, some approximation can be made as to the amount of error. One of the most unhealthy districts, according to the rough test referred to, is Bethnal-green, where the average age at death in 1841 was 25.80; and of the most healthy is Kensigton, where the average age for the same year was 32.39; being a difference of six years and a half in favour of Kensington. But if the prevailing rate of mortality in Kensington had been applied to the population of Bethnal-green, the average loss of life in 1841 would have been only 1 year. (Bethnal-green 25.80, Kensington 26.71.) Corrected then by the most severe tests, subjected to the closest scrutiny, viewed in the most favourable light, the calculation proves that Bethnal-green inflicted in 1841 a loss on its population of 1764 years of life, compared with that of Kensington.
    A low average age at death is generally the result of two causes-an enormous sacrifice of life among a young population, or the prevalence of unhealthy influences. Both of these causes contribute to the low average age at death in Bethnal-green.
    It is worthy of observation that the proportion of births to the population in Bethnal-green, in accordance with the law which regulates the excess of births by the excess of mortality.
    I am fully aware that the average ages at death of the gentry, tradesmen, and artizans, displayed in the latter tables, are open to some objections, and require some modifications. The objections are, Firstly, the exclusion of paupers in workhouses from the classes of tradesmen and artizans. If this class were distributed in the proportion of 1-10 to the tradesman, and 9-10 to the artizans, the average ages at death of these two classes would be raised: these averages would much more closely approximate to that of the gentry, if we took the average age at death, of all dying above 21. Secondly, that the distribution of the ages of the living has been omitted in the calculation.
    I can see no necessity for comparing the longevity of the class of gentry with that of artizans (and still less for setting up the standard of health obtained by the gentry as that to be desired for the labouring classes), for the purpose of procuring sympathy with their condition, and support to the sanitary measures desired to improve that condition.
    There are causes of mortality which are peculiar to each class of society, and which are common to all classes; certain of those causes which are common to all, but which peculiarly bear hard upon the poorer classes, are capable of being prevented. When, by Sanitary Improvements, these causes of disease have been averted, the solution of the problem will arise whether the occupations of the poor, (and I consider that under Sanitary Improvements, the conducting of trades and manufactures injurious to health will be included, so that their danger to health may be averted or diminished,) are more detrimental to health and life than the occupations of the middle and tipper classes. At present, there [-111-] can be no question, that the poorer classes are peculiarly exposed to the influences of certain proximate and exciting causes of death.
    One evidence of the unhealthiness of Bethnal Green is to be found in the fact that of a Total of 2,000 deaths. 211 only occurred at 70 and upwards.



Total Deaths 1839-40 Deaths at 70, and upwards Deaths at 70 to every 1,000
Country 52,204 10,508 202
England and Wales - - 141
Towns  71,554 6,457 90
Bethnal Green 2,000 211 105

    This return is for the 12 months ending October 1st, 1847. And another evidence is to be found in the fact, that of 1000 boys under 5 years of age there died in 1841 in 
    Surrey 48
    Sussex 50
    London 93
    Bethnal Green 90
    The exact numbers in Bethnal-green are Males, 9.028; Females, 8.102; calculated from the deaths in the seven years 1838-44; the population and deaths in 1841, at the same ages, were, population-Males, 5310; Females, 5429; deaths, Males, 418; Females, 422.
    As there are no Foundling Hospitals, Hospitals, or Public Institutions (except the Lunatic Asylum) in Bethnal Green. These evidences are not open to any objections.
    In endeavouring to estimate the amount of unnecesary sickness endured by a population, it has been customary to employ Dr. Lyon Playfair's estimate of cases of sickness to deaths. This estimate has been cavilled at, as too high ; it has been proposed to reduce it from 28 to 20 or 21. But after a careful consideration of the objections urged, I do not see just grounds to reduce it, when considering Bethnal Green; and the proportionate amount of sickness and mortality occurring in the practice of the Parochial Medical Officers, tends to confirm me in my belief, that the proportion is nearly correct. If, therefore, we [-112-] multiply 352 unnecessary deaths occurring in Bethnal Green by 28, we have 9,856 cases of unnecessary sickness.
    Three hundred and fifty-two deaths, and 9,856 cases of disease, with all the expense and sorrow, suffering and anguish, all the lost time and labour, are at the lowest estimate, the penalties paid by Bethnal Green for its neglect of Sanitary Measures.
    That these penalties do not represent the truth, I am firmly convinced, for if the Green district neglected, and foul, with no Sanitary improvements whatever introduced-has a mortality of one in fifty-seven; and if the Church and Hackney-road districts, have a mortality of one in fifty, the standard proposed in the previous calculation. Surely it is not too much to calculate that when efficient sewerage and drainage shall have been introduced; when nuisances shall be suppressed, and the streets paved and cleansed; when the houses shall be ventilated, and supplied liberally with light and water. When grave-yards shall be abolished in towns, and the physical welfare and comforts greatly increased thereby, surely it is not too much to calculate on a mortality of one in fifty-four, as the probable result. Such a calculation presents us with the following result.

    The larger sum I believe to be the correct estimate of the waste money entailed on Bethnal-green, and it agrees closely with all other calculations which represent the money loss at nearly, or quite 1 per head on the population.
    It is in my opinion, a low estimate which places it at 30,000 annually, to the Parish of Bethnal Green, as in table 12.
    But not only do we find in Bethnal Green an enormous amount of sickness One person in every 8 is undergoing the prostration of disease unnecessarily but it is notorious, that an enormous proportion of the people are unhealthy, without vigour, or physical strength, pallid, and cachetic, stunted in their growth, and of feeble organization, and prone to suffer severely from extraordinary causes of mortality. This has been well exemplified by the effects of the late epidemic, Influenza. The proportion of individuals dying of influenza, in Bethnal Green, in the second week of its prevalence, ending December 4th, was to the population as 1 in 597?, whilst in Hackney, where the same physical causes of disease do not prevail, the proportion was 1 in 1142, and in Poplar, 1 in 864 ; whereas in Shoreditch and Whitechapel, both of which districts resemble Bethnal Green, the mortality was respectively 1 in 751, and 1 in 535. In Lewisham and Wandsworth, the healthiest districts in the Metropolitan returns, [-113-] the proportion was 1 in 3835, and 1 in 2,097. The very police are aware of the feeble physical powers of a Bethnal Green mob. Unhealthy parents beget unhealthy children, and thus premature deaths, and inability to labour, become perpetual misfortunes. Thus the stream of death flows on, feeding the sources which gave it birth.
    It is necessary to advert to two apologies which may be made for a high mortality,-intemperance, and want of food. It is proved, that allowing intemperance to be a cause of high mortality, it is insufficient to explain the mortality in towns, and that the diet-roll of towns is more liberal than the country which has a lesser mortality,
    The moral bearings of the question are too vast to enter upon. "Consider the lilies of the field, how they grow;"and, in the words of an estimable Sanitary Reformer, the Rev. C. Girdlestone, "Can you doubt that much more would God have man, the noblest of his creatures here below, fed, clothed, and lodged in comfort, to his own satisfaction, and to the glory of his Maker."
    I have now placed before my readers a considerable mass of facts, which prove, seriatim, the enormous extent of wretchedness endured by the Community, but chiefly by the poor, from the want of efficient Sanitary Regulations, from the want, in fact, of the application to the artificial, (it can scarcely be termed civilized) state of life, in which we exist, of certain simple, plain, and apparently obvious principles. For what can be more simple, or obvious than that man's real wants are few, and abundantly provided for by a Beneficent God. Firstly Air. Secondly, Water. Thirdly, Food. Fourthly, Protection from Changes of Temperature, and the Inclemencies of the Season, by Houses, Clothing, and Fuel.
    The Am we defile in a thousand ways. The LIGHT which passes through it we reject, and deny to ourselves by our manner of building, and by heavy and oppressive taxation. WATER, we surrender up to Company Monopolists, and render scarce, and dear. FOOD has just been released from an interdict. HOUSES are ill-constructed, and adapted for human habitations, and badly arranged. CLOTHING alone is comparatively liberally supplied. While FUEL is high- priced, and a blessing little known to the poor. These are the physical wants of man ;-these his necessities ; -these the objects at which we must aim Firstly, to raise his physical organisation to a standard of health;-secondly, to graft on a healthy organization the highest enjoyments of existence, namely, an enlightened intellect, and sound religion. The friends of Sanitary Reform have applied themselves to the first object, and look with anxiety to the rich and powerful to aid them in their efforts, and to the poor, to acknowledge, and avail themselves of their labours.


The conclusion at which we must necessarily arrive, when he preceding facts have been duly weighed, is, that if the inhabitants of Bethnal-green must wait till those Sanitary improvements which are so urgently required for their physical and moral welfare, shall be executed by their own authorities; centuries, and even ages may pass away with but little change from the present state of things. As far, at least, as a comprehension of the means already clearly enough demonstrated, which are necessary to, and capable of, improving the Sanitary condition of a town, this parish is steeped in the deepest ignorance. The authorities are not only utterly incapable of designing, superintending, or executing great public works, but they cannot be led to conceive their necessity. No loud demand has ever been made by them for increased sewerage, or appeal to their constituents for support to obtain it. No works of drainage, whether in connexion with the sewers which already exist, or to improve the present miserable condition of house and street drainage, have been executed by them. No supplies of water have been sought to cleanse their drains, or streets; no means but of the most imperfect, character have been adopted to remove refuse from the streets; and the contracts to remove refuse from the houses, whether of rich or poor, but especially from the houses of the poor, have been scandalously neglected; and the short-coming of the contractors most unaccountably glossed over. No knowledge of the economical results which arise from the effectual cleansing of the parish, and the sale of the accruing refuse has ever been exhibited. No investigation has ever been made into the condition of the parish, so that the facts with regard to sewage, paving, drainage, &c., should be properly known, even to the authorities themselves. The very map of the parish, by which its boundaries are ascertained, is, (or was a month ago), so tattered, old, and worn, as to be nearly falling to pieces. No attempts have ever been made to establish baths, or wash- houses, to rect model lodging houses, or to contribute in any way to the improvement of the condition of the poor. No attempts have ever been made, except the talk of one, to remove or suppress the numerous horrid nuisances which abound. And Lord Morpeth's Act, cap. 9. 10. Vie,, for the suppression of nuisances, has been to the authorities itself a very nuisance, in as far as it has permitted them to be responsible to the parishioners for an outrageous and most discreditable indifference as to their comfort and welfare.
    The dwellings of the poor, the courts, closes, alleys, gardens, exhibit now the same condition they did many years ago, and the same degrading, demoralizing scenes of filth meet the eye, and the same sad results of early death, and feeble [-115-] physical and mental organization are everywhere as apparent at the present tim as when first observed and pointed out a long time ago.
    It is presumed that the most solid reason for the wretched condition of the great majority of the houses of the poor, and for the total absence of any attempts at improvement, consists in the fact that the Commissioners and guardians are themselves the chief proprietors of the dwellings of the poor, and that as they, in general pay the rates themselves, and have already exacted for their tenements the highest attainable rents any, even the slightest increase, of rates would only be an increase of their own expenditure. Under such circumstancs, with the narrow and limited views entertained by such parties, to expect permanent and effectual improvements at the most limited present expenditure appears perfectly fallacious.
    I hold it to be established from the foregoing observations:-
    Firstly.-That an enormous amount of physical distress and of demoralisation and waste of life takes place from the existence of the present state of things.
    Secondly.-That the Reports of Sanitary Commissions, and the publications of the Health of Towns and other associations have proved such sacrifices to be unnecessary and avertible.
    Thirdly.-That no hope can possibly be entertained of the necessary charges being effected by the local authorities.
    Fourthly.-That the knowledge of the most economical and effectual means of carrying out the necessary works, must be provided for the local authorities, and that the manner of executing them, must be supervised, by a central power; so as to prevent a wasteful expenditure of the money of the parishioners in works, irregular, imperfect, and inefficient, without any comprehensive plan or unity of design.



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