THE SANITARY CONDITION
                               OF THE POOR


                              IN RELATION TO

                       DISEASE, POVERTY, AND CRIME

                             WITH AN APPENDIX

                     ON THE CONTROL AND PREVENTION OF
                           INFECTIOUS DISEASES.

                   *       *       *       *       *

                                    BY
                        BENSON BAKER, M.R.C.S.E.,

     DISTRICT MEDICAL OFFICER AND PUBLIC VACCINATOR OF CHRIST CHURCH,
           SAINT MARYLEBONE, MEMBER OF THE NATIONAL ASSOCIATION
             FOR THE PROMOTION OF SOCIAL SCIENCE, LICENTIATE
                 IN MIDWIFERY, FELLOW OF THE OBSTETRICAL
                   SOCIETY OF LONDON, L.S.A., F.A.S.L.

                   *       *       *       *       *

                                 LONDON:
                      W. TWEEDIE, 337, STRAND, W.C.

                                  1866.

                             _ONE SHILLING_.

                   *       *       *       *       *

                                 LONDON:
               “MARYLEBONE MERCURY” STEAM PRINTING OFFICES,
                  6, NORTH STREET, MANCHESTER SQUARE, W.




PREFACE.


The following pages having already appeared in the form of letters
in the _Marylebone Mercury_, any preface on my part might be deemed
unnecessary. Having been repeatedly asked to collect and publish them,
I intended to revise if not rewrite the whole, but my professional
duties have deprived me of the time, so at once I place them in the
hands of my indulgent readers. This pamphlet does not pretend to be
a treatise on Hygiène, but simply to hint at some of the evils which
arise from the neglect of sanitary regulations, also to suggest some
simple remedies, and further to try and induce men to regard health as
one of the most valuable and sacred gifts of God.

                                                           BENSON BAKER.

94, _Lisson Grove_, _N.W._




THE
SANITARY CONDITION OF THE POOR,
IN RELATION TO
DISEASE, POVERTY, AND CRIME.


THE relation of the rich to the poor, and the poor to the rich, has
always been a subject of interest to the philosopher, moralist,
economist, and philanthropist. This relation was, in feudal times,
clearly enunciated, and as vigorously acted upon. The dark days and
long evenings that witnessed the tolling of the curfew bell have passed
away. Since those days we have made advances in social and political
freedom, and class distinctions have become less obvious. Freedom of
thought has developed a greater equality of social rights; but are
the poor really any better off now than they were in the days when
William hunted in the New Forest? I confess that many will reply in the
affirmative; but when I see around me on every side so much disease,
poverty, utter wretchedness, and crime, I conceive it difficult for
the condition of man to be worse than that in which thousands in this
metropolis exist. Look at the condition of the overcrowded dwellings
of the poor; they are not _homes_. The word home in its full and happy
significance and association is unknown to them. The proud boast of
every Englishman, that his house is his castle, is a mere fiction.
“There is no place like home, be it ever so humble,” is a truth that
meets with the faintest response from thousands of miserable tenants
who live in yet more miserable tenements.

That the condition of the dwellings of the poor does not free them
from the obligation to observe personal cleanliness is perfectly true,
neither does the neglect of personal cleanliness on their part justify
the landlord in neglecting the sanitary condition of his houses. It
is to be regretted that more liberal and enlightened measures are not
adopted. I feel confident that if the dwellings of the poor were made
healthy and comfortable, there would be a marked improvement in the
status of the poor. With improved health, cleanliness, and comfort we
should obtain improved industry and prosperity; and this would not
be confined exclusively to the poor, but its influence would be felt
through every grade of society. It would tend to lessen the selfishness
of the prosperous, and the suspicious jealousy and impostures of the
unfortunate. We are apt to forget that:—

    “Is there for honest poverty
       That hangs his head, and a’ that?
    The coward slave, we pass him by,
       And dare be poor, for a’ that.
    The rank is but the guinea stamp,
       The man’s the gowd, for a’ that.”

Man is to a very great extent the creature of circumstances, and is
greatly influenced by external objects. That which we like we become
like. The fine arts cultivate the æsthetic part of a man’s nature;
painting, sculpture, and poetry develop a man’s imagination. One man
by a constant contemplation of the beautiful acquires the habit of
admiring the beautiful; another man by the constant association with
dirt becomes dirty. Repeated acts of thought grow into action, and
actions repeated grow into habits, and habits form the character of
the man: hence the importance of a cleanly, comfortable, and healthy
home. A family that lives in a dirty room, with nothing but dirty
associations, must grow up dirty. Thoughts grow in us as grain in
wood. The mental qualities of the poor are undeveloped, and especially
the moral force of character which is requisite to raise them above
their circumstances is hardly to be looked for. If the poor could be
accommodated with healthy dwellings they might reasonably be expected
to better their condition; but what man can wage a successful war
against disease and poverty combined? Unhealthy dwellings not only
keep them poor, but foster a reckless indifference as to how things
go with them. This apathetic condition is the worst that can befall
either the individual or society. Idleness, dirt, poverty, disease,
and crime are intimate companions, though not inseparable. The logic
of the indifferent poor amounts to this: that those who work must pay
for those that don’t; and hence arises one of the great difficulties in
dealing with and relieving the poor. There are many limited companies
formed to carry out various commercial enterprises; but if a limited
company could be formed to erect suitable dwellings for the poor, at
such a rental as they now pay, it would confer an unspeakable benefit
on the poor, benefit society generally, and pay the really patriotic
shareholders an equitable percentage. This I merely throw out as a
suggestion, but I am convinced if carried out, it would be one of
the best means of effectually helping the poor to help themselves. I
conceive that whatever tends to smooth the rugged surface of life,
and to soften its harsher features, and to multiply the sources of
human health and enjoyment, must be held worthy of notice; and in so
far as it tends to improve the condition of the poor, and foster in
them provident and careful habits, just so far ought it to receive our
generous sympathy and support. That this may not be mistaken to be
merely philanthropic statement, but that it is based upon a principle
of true social economy, I quote the following from Smith’s Wealth of
Nations:

    “Servants, labourers, and workmen of different kinds, make up by far
    the greater portion of every great political society. But what
    improves the circumstances of the greater part can never be regarded
    as an inconveniency to the whole. No society can surely be
    flourishing and happy of which the far greater part of the members
    are poor and miserable. It is but equity—besides that they who feed,
    clothe, and lodge, the whole body of the people should have such a
    share, as to be themselves tolerably well fed, clothed, and lodged.
    The liberal reward of labour, as it is the effect of increasing
    wealth, so it is the cause of increasing population. To complain of
    it is to lament over the necessary effect and cause of the greatest
    public prosperity. It deserves to be remarked perhaps, that it is in
    the progressive state, while the society is advancing to the further
    acquisition, rather than when it has acquired its complement of
    riches, that the condition of the labouring poor, of the great body
    of the people seems to be the happiest and most comfortable. It is
    hard in the stationary, and miserable in the declining state.”

In a visit I paid to a poor patient in Burne Street, I could not help
being struck with the cold, damp, dirty condition of this “attic near
the sky.” The cold wind pierced through every crevice. The rain had
come in plentifully through the ceiling and soaked the bed. The walls
were black and grimy; the fire in the grate, like the life of my
patient, feebly struggled for existence.

What dirt and neglect had done for the room—dirt, disease, and poverty
had done for the inmate. I feel sure that had the dwelling been in
a better condition my patient would have been in better health, and
consequently stood better in every relation to society.

’Tis an old proverb that “prevention is better than cure;” yet how few
there are who practically believe it. The principle embodied in this
proverb received the approval and sanction of past ages, but which it
is most difficult to enforce at the present time; it may be explained
by the fact, that men not being forewarned cannot be forearmed, and
further, because another principle which is expressed in the words,
“men think all men mortal but themselves,” lies deep in the human
mind. The blessing of health is not valued till it is lost. Let the
mysterious hand of disease touch us, and we throb with painful anguish.
Then do we long most earnestly for our valued health and strength;
we resolve that once well again we will adopt such regulations and
precautions as shall ensure a continuance of the invaluable blessings
of health: such is the reasoning of the sick and afflicted. To the
invalid the quantity and quality of the air he breathes is of vital
importance, but to the man in comparative health, it is a matter of
indifference. The laws which regulate the diffusion of gases on which
ventilation depends, or the action of pure or impure air on the animal
economy, is to him a subject of indifference; it does not yet affect
him, and he has enough to do without it. The subject of ventilation
bears such an important relation to health, and health is one of the
greatest blessings of life, that I conceive it to be the duty of all
to be fully alive to its value. In these days when the schoolmaster
is abroad, and the march of intellect so rapid, it is not a little
remarkable that the knowledge of the laws of health, based upon
scientific data, are so little known.

If therefore, some of the general laws which govern the preservation
of health be simply stated and illustrated, it may be the beginning of
much good, by teaching or inciting men to become the guardians of their
own health. One of the primary laws of health is to have a good supply
of fresh air. The voice of nature cries aloud for fresh air, the cry
comes to us alike from the newly born babe in the cellar, and the aged
sufferer worn out in life’s troubles in the garret. It is the cry of
the weary and worn; their thin blood flows feebly, and their life is
ebbing fast as they cry, “Oh, for one short hour to breathe the breath
of the cowslip sweet and to feel as I used to feel.” This is all that
is craved ere the weary one welcomes the stifling hand of death. Such
is the cry of thousands in our city. Who wonders at it? Not those who
are practically acquainted with the dwellings of the poor. For those
who are not, I shall in general terms indicate some of the features of
the _homes_ in my district. It is not my object to raise the veil of
poverty to satisfy idle curiosity, or to awaken a morbid philanthropy.
Scenes which are photographed on my mind, I shall from feelings of
delicacy alike for the subject and the reader omit. As parochial
medical officer for Christ Church district, it is very often my duty to
visit East Cottages, and Little Church Street, and I am daily called
upon to witness the suffering and sickness in crowded rooms, which is
fostered by bad ventilation and insufficient drainage; here small-pox
and typhus fever are frequent visitors. It is not an uncommon thing
for a family of eight or ten to occupy one small room. In this single
apartment, men women and children of all ages eat, drink, and sleep; in
such a place as this, and under such circumstances, where little air
enters, and less light, can it be a matter of surprise that sickness
and death are frequent visitors. Death is so frequent a visitor,
that to those who witness his work he has lost all his terrors; yea,
he is rather a friendly visitor when he calls the younger members
home. Think, reader, of such _a home_ as this in the day of sickness,
in the hour of nature’s woe, in the gloomy night of death. Picture
children of tender years becoming familiar with these scenes, and can
it reasonably be expected that they should grow up healthy either in
mind or body. I could not but allude to the number of occupants in one
small apartment, as it bears directly on the amount of air supplied
to each one, and the necessity for free ventilation; overcrowding
also tends very materially to demoralise the rising generation. In
a word, it degenerates both body and mind. At an early age they sow
the seeds of consumption, bronchitis, rheumatism, and a whole list of
complaints, which may be traced more or less to the violation of the
ordinary sanitary laws of health. The youth of our cities before they
are young grow old, before the bud blooms the blossom is blasted; as
flowers without the light of heaven, they are blanched, withered, and
die. These sickly ones crawl into their homes, such as they are, from
which the light of day is almost excluded, and with it the light of
hope. Under these circumstances the parish doctor is sent for, but too
often it is his lot only to be a passive witness of the irreparable
mischief which has been done. I have a vivid and painful recollection
of a visit I paid to Devonshire-place. The room was small, dark, dirty,
and gloomy. There were but few squares of glass left in the frame,
through which the yellow light feebly struggled to enter; the chimney
was stopped up, the air stagnant and very oppressive, even for the
few minutes I was present, yet there were no less than five people
sleeping in this apartment, two children ill with scarlet fever, and
one resting in death. The ventilation was so bad, that the recovery of
my little patients was doubtful, and the deterioration of the health
of their parents certain. In cases of this kind how important it is
for every one to know, that by excluding the breath of heaven, we are
extinguishing the breath of life. It is of the highest importance that
we should have fresh air in health, but it is imperatively necessary
in disease. Then more than ever does nature feel the necessity for
fresh air. A lowered vitality like a fire that is dying out, requires
a larger supply of atmospheric air, but alas! how often is this innate
craving for fresh air stifled by prejudice and ignorance. Close rooms
are rendered closer by chimneys being blocked up, and every crook and
crevice being stuffed up by rags and paper, as if the great object to
be attained was effectually to prevent one breathing. All this is done
from the purest motive, and with the best intention; it is done to
prevent the patient taking cold. So the patient has to struggle against
sickness, poverty, and impure air.

Those who are in health, though they may sleep in overcrowded rooms,
have the advantage of being out in the open air some part of the day,
and this in some measure compensates for their close confinement. The
open air quickens the pulse and restores the vitality of the various
functions of the body. Fortunate are those whose employment is out of
doors. This obtains rather with the male than the female poor. They too
often leave a closely confined and overcrowded bed-room to go into a
still worse work-room, there to work _twelve_ or _fourteen_ hours under
flaring gas-lights in a heated and impure atmosphere. Those who live
like this succumb at an early period of life to disease:—

    “With fingers weary and worn,
    With eye-lids heavy and red,”

they rush out of their overcrowded work-rooms and seek to palliate
their physical sufferings at the gin-shop.

The air which surrounds us on every side, though invisible, is not
inactive. To the casual observer its existence might be doubted if
it did not manifest itself in the gentle breezes which bear the
faded leaves of the widowed trees to their resting place; or in the
wintry blast which uproots the sturdy oak of the forest, or lashes
the white-crested billows of the ocean into a storm. In this way
does the air we breathe make itself known to us. The composition of
atmospheric air, the laws which govern it, as illustrating the theory
of ventilation, the action of air on the animal economy, on the
vegetable and mineral kingdoms, we must pass by. Suffice it to say
that atmospheric air is a compound; that oxygen is the life-sustaining
element; and that carbonic acid gas has an opposite effect; also the
nitrogen; and that when we breathe we take in oxygen and give out
carbonic acid gas. There is a law which governs cases called gaseous
diffusion, by which gases pass equally into one another, and thus
become equally diffused. If it were not for the operation of this law,
there would be no variation of climate, no winds to waft the mariner
over the briny deep, no provision for the scattering of the sun’s
golden rays of light. The beauty of a summer’s sky would have been
lost. No clouds would have hung around the portals of the setting sun
tinged with crimson and with gold. No verdure in the meadow would have
greeted our eye. No ark of hope would have spanned the clear vault of
heaven. But, by the combination of oxygen and hydrogen, and the laws
which govern them, provision is made for all these blessings. Light
and heat are freely scattered. Animal and vegetable life rejoice. The
priests of the morning chant their matins when the sun arises, and the
flowers scatter their evening incense when the sun descends to glorify
the western world.

In a sanitary point of view the law of gaseous diffusion is of
importance, because noxious gases are thereby diluted by the
atmosphere, and are thus rendered comparatively harmless; hence, by
free ventilation, we may do much to lessen the predisposition to
epidemics, and the virulence of poisonous malaria.

The labouring man, above all others, should rise in the morning
refreshed by nature’s sweet restorer—balmy sleep. But, by neglecting
ventilation, it is not so. Drowsiness, sickness, headache, and languor
are his lot; and in order to bring himself up to the mark, he is
obliged to have recourse to artificial stimulants. Scavengers are
necessary to maintain the comfort and cleanliness of our streets, so
oxygen is necessary to maintain the health and comfort of our bodies.
By depriving our bodies of pure air, we deprive them of the power
to throw off infectious diseases. This may simply be illustrated by
placing a lighted candle under a shade when a limited amount of air
only can be introduced. If not supplied the candle will go on burning
for a while, giving out less light and less heat; but when the oxygen
is exhausted, the candle will die out. Thus it is with man. The candle,
when deprived of pure air, gave evidence of less light, so to man under
the same conditions would give evidence of less life. A lower vitality
is equivalent to a closer approach to death. Day is opposed to night.
Life to death. But even as between day and night there is twilight, so
in our experience there is the twilight of disease. Thousands in this
metropolis, through the neglect of the laws of health, live in the
twilight of disease, rather than in the noon-day brightness of health.

I have endeavoured to show that fresh air is a necessary of life just
as much as food. I have indicated its importance in relation to health
and how imperatively necessary it was in sickness to aid the body to
overcome disease. If overcrowding in small dwellings and its consequent
ill effects upon health, morality, and industry be a necessary social
evil, it is evidently our duty to lessen that evil, if we cannot
altogether remove it. This, in some measure, may be accomplished by
free ventilation and paying due regard to the ordinary sanitary laws
of health. If we turn a deaf ear to the warning voices of conscience
and reason, and go on living and breaking the laws of health, we must
expect to pay the penalty for breaking those laws. If men habitually
sleep in an atmosphere of carbonic acid gas and fetid exhalations, they
must of necessity exhaust the vitality of their bodies.

The defective sanitary condition of hundreds of houses in this district
render it imperative that something should not only be said, but
done. But the question arises—who is to do it? I take it that the
duty lies not alone with either the tenant, or landlord, or parochial
authorities. It is a work of co-operation in which there is work for
each; and each must do his work. In endeavouring to urge this sanitary
reformation it may be Utopian to expect a perfect result; yet I am
convinced that much can be done to render even the present wretched
dwellings of the poor much more healthy than they are at present.
I have frequently in my visits to Charles-street, Stephen-street,
Stephen’s-court, and, in fact, in the houses contiguous, met, on going
upstairs in the morning, a hot, fetid air. On going into the rooms I
have observed that the walls were damp with exhalations caused by so
many herding together. I have naturally requested the windows to be
opened, in order to let out the hot and impure air, and, to my dismay,
I have almost invariably found that the upper sash was a fixture. This
state of things is to be deplored, inasmuch as it prevents efficient
ventilation and is not only injurious to health but beyond the means
of poor lodgers to remedy. I would venture to suggest the propriety
of landlords seeing that all windows be made to open at the top, or a
square of glass be removed and a perforated tin plate be inserted in
its place, or better still, a window ventilator. A brick removed out of
the chimney, close to the ceiling, and a valve fitted so as to allow
the escape of foul air up the flue, is a good means of ventilation.
There are many ways of ventilating an apartment; and it matters little
how it is done if it be done efficiently. If any one of the above
methods be adopted I feel sure it would be a great boon to many poor.

There is one subject that bears a most important relation to the health
and comfort of those over-crowded dwellings, and that is the supply of
water. This is anything but adequate to the requirements of the many
people that are sheltered under one roof in my district. The tubs and
cisterns are in many cases only sufficient to supply one family, but
in the houses where the poor live, each room is occupied by one or two
families at the least; the consequence is, that there is a great demand
for water, and not being sufficient, impurities of all kinds abound;
personal cleanliness is neglected to a frightful extent, washing the
skin is looked upon as a terrible innovation, and the result is often
dreaded. To suggest a bath is often looked upon with as great a horror
as a surgical operation. If there were a more plentiful supply of
water, there would not be the excuse for such a neglect of washing
and cleansing the dwellings of the poor. Personal cleanliness and the
washing out of rooms, &c., is the duty of the tenant quite as much as
paying the rent. It would be well if cleanliness were made a condition
of tenancy,—if the rent collector insisted on the cleanliness of the
rooms with the same firmness that he insists on the punctual payment of
the rent, yea, rather allow a week’s rent to stand over than a dirty
room to go unwashed.

The sewerage to the houses is not adequate to carry off the
enormous waste of fifty people. These houses were only built for
the accommodation of fifteen to eighteen people. If there be not a
sufficient supply of water to flush the drains at least once a-day,
they become clogged up and generate poisonous gases, which enter the
houses and bring on a lowered state of health; skin diseases, scabies,
typhus, and choleraic diarrhœa are the results. That this is not an
overstatement may be shown by the fact, that outbreaks of choleraic
diarrhœa have over and over again been suddenly stopped by a heavy fall
of rain. This beneficial result has come about by the rain flushing the
sewers and clearing off the morbid poisons.

There are other nuisances which contribute to contaminate the air. I
have, in visits from house to house, noticed that the dust heaps are
allowed to accumulate to a frightful extent, they are neither more nor
less than one vast mass of decayed animal and vegetable matter, with a
good proportion of the remains of decomposed fish. The consequence was
that if windows were opened for the purpose of ventilation, a worse
condition of the room was induced. Further, I cannot help remarking
that the sanitary condition of the streets and courts in my district,
especially part of Bell-street, Charles-street, George-street, part of
Devonshire-street, is far from satisfactory. Those that live in the
cellars in these streets are constantly inhaling poisonous exhalations
arising from putrid animal and vegetable matter, and I am sure the
stench which arises from stinking muscles and cockle shells, must be
injurious to health. I would ask upon what principle do the authorities
do their work? Broad streets, squares, and open thoroughfares appear to
me to be oftener watered and swept than these out-of-the-way courts,
alleys, and narrow streets, which are overcrowded with a teeming dirty
population. Surely these are just the places that require the greatest
care, for these are the places which, if they do not breed an epidemic,
would readily foster it. The slums of a city ought to be made as
healthy as possible, not only for the good of those who live in the
slums, but for the good of the community at large. Society is like the
body; one member cannot be affected without the whole body suffering.
It is not only right, but profitable to make the dwellings of the poor
healthy, and to surround them by all the protection that preventive
measures can do. Sickness is one of the worst calamities that can
befall the poor labouring man. When laid low, all his resources are cut
off. His family, and so must he, go without the necessaries of life,
or run up a heavy score at the small huxter’s shop. His rent cannot
be paid; and should his illness last long, both he and his family
become a burden to the ratepayers; and should he recover his health,
it is weeks, aye, months before he can recover his position and stand
free from debt. Now, suppose that this illness was brought on by the
defective sanitary condition of his dwelling, and his own neglect of
proper attention to cleanliness, why it is at once evident that it is
the interest of the landlord to see that his houses are healthy, for
a dead man pays no debts, and a sick man pays no rent; further, it is
the interest of the tenant to observe the laws of health. What pen can
describe the racking torture of disease and poverty combined? I have
visited houses where the head of the family has been thrown of work,
by ill-health. I have witnessed the gradual departure of articles of
ornament from his little room, soon to be followed by other pieces
of furniture, until even the necessary utensils of civilised life
were gone. The bedstead and bedding have been put away, and a sack of
shavings supplied its place. The room has been literally stripped. The
children have been equally deprived of their clothes, and were huddled
up in a corner in quite as primitive a fashion as their forefathers
the ancient Britons. The mother went out washing for two or three
days a week; what she earned they all lived on. It may be asked why
did he not go to the workhouse? I reply that the deserving poor, the
earnest, striving poor, have the greatest possible objection to go to
the house. They would rather die in want and wretchedness than become
an inmate of the house. Whether this dislike be well founded or no, it
is not my object now to inquire, but I must state that there are some
clamorous for admission. From what has been said, I think it may fairly
be inferred that if a liberal and just regard be paid to the sanitary
condition of the dwellings of the poor it would, to look at it from the
£ s. d. point of view, be a benefit to tenant, landlord, and ratepayer.
It would also tend very materially to improve the physical, moral and
mental condition of the poor; it would make them healthier men, happier
men. It would materially better fit them for all the social conditions
of life.

I know of no subject in a sanitary point of view that demands a more
careful consideration than the possibility of a choleraic epidemic
next spring. I wish not to alarm, but to try and urge people to be
on their guard so as effectually to lessen if not prevent the dire
effects of a cholera visitation. Should cholera visit this part of the
metropolis—and we have no guarantee that it will not—it is our duty to
be prepared to deal promptly and effectually with it.

The news has been already flashed through the land that it has made
its appearance. Although confined at present to two places, this has
made many a stout heart tremble. But this is not a time for fear. “Let
us, then, be up and doing with a heart for any fate,” and seek by
an earnest endeavour to render our homes untenable to this terrible
pestilence. Every man this day must do his duty. These are stirring
words, and they call us to action, for a deadlier foe now threatens
the happiness of our sea-girt island than that which Nelson fought.
Cholera, an unseen foe, is nevertheless a real one. Many a hero that
has braved a hundred fights has blanched before this deadlier foe. Like
a mighty conqueror and destroyer, it has marched onward as regardless
of the ermine of the judge as the swaddling clothes of the infant. In
vain has the mother wrung her hands in passionate anguish over the
death of her little one; husband has mourned for wife, and wife for
husband; children have been left fatherless; and fathers have been left
childless; nothing but darkness, blackness, death, and desolation, have
marked the route of this potent enemy to man.

One of the best preventive measures is to have a plentiful supply of
pure water. We can then keep our sewers flushed—our homes clean, and so
render our hearths and homes comparatively safe from the devastating
pest of cholera.

There is nothing in nature that possesses more interest than water. It
is composed of oxygen and hydrogen. This may be easily demonstrated by
throwing a piece of potassium on water, when it will instantly take
fire: because of the rapid affinity of the oxygen of the water for
the metal potassium the hydrogen is liberated, which burns during the
decomposition which takes place. This experiment, which is equally
simple and beautiful, shows the composition of water. The combinations
into which water enters in the animal and vegetable kingdoms are as
various and as beautiful as the magic forms of the kaleidoscope.
Neither animals nor plants can live without water. It is, therefore,
a necessary of life. On the purity of water, in a great measure, our
health depends. Various are the sources of water, and equally various
the degrees of the purity or impurity of water: for this reason—that
water is the great solvent in nature. The first great source of our
water supply is from the ocean, which receives the water from all
the sparkling rills that murmur as they leap down the mountain side,
which unite and form rivulets. These rivulets unite again, and form
the mighty flowing rivers with majestic water-falls, cataracts, and
cascades; and these flow on till they empty themselves into the ocean.

Reader, did you ever stand on the sea beach shore and see day go out
in a flood of glory—the bosom of the ocean blush as the monarch of day
smiled his parting beams of light—tinging the clouds with golden hue
and shedding a light on all creation and making it beautiful? These
clouds were not alone created for the poet or the painter, nor to give
scenic beauty to the landscape; but to supply the wants of the flowers
of the valley, the beasts of the forest, and to be a source of health,
power, and wealth to man. The heating rays from the sun so act upon the
water as to cause a mist like a gossamer veil to arise. This is tossed
about in the atmosphere by the various currents of winds which set in
from the Equator to the Arctic and Antarctic regions. Thus is it that
rain-bearing clouds are distributed over the land. The vapour contained
in these clouds is condensed by the various degrees of temperature
through which they are wafted, and form either snow or rain. This sinks
down into the earth, and forms springs; or the snow, melting on the
mountains, runs down and forms rivulets: and hence our chief water
supply.

    “Look around on this world, it is sweet, it is fair,
    There is light in the sky, there is _life_ in its air,
    Sublimity breathes from the forms of its hills,
    And beauty winds on with its rivers and rills;
    The dew as with diamonds its mead hath bespread,
    From its groves are a thousand wild melodies sent;
    While flowers of each tint are by morning imparted,
    Oh! why is there woe in so lovely a world.”

Rain water, when collected in the country, is doubtless the purest
and best adapted for ordinary household purposes, but in London and
large cities it contains many impurities; when collected in our tubs
or cisterns, it is impregnated with all the dust, dirt, and smoke that
hangs more or less like a funeral pall over smoky cities; the air
contains more or less sulphurous acid, and the carbon that escapes from
our chimneys and is deposited on the tops of our houses, hence the
sooty taste that soft or rain water has.

Well or spring water always partakes more or less of the character of
the ground or the strata through which it passes, hence the explanation
of the great differences which exist. Water that passes through chalk
is characterised by its hardness, because it holds a large quantity
of carbonate of lime in solution. Thus it is with chalybeate springs,
which contain a large proportion of the salts of iron, and others,
that contain sulphate of magnesia; these instances illustrate the fact
that water is a great solvent, and partakes of the character of the
materials through which it passes, and hence the differences which
we find existing in the water we derive from wells. There are not
many public pumps in my district, and fortunately they are not in the
vicinity of churchyards, nor in communication with cesspools. There
is not therefore much danger of wholesale poisoning by drinking water
from these sources. The water, as supplied by the West London and
Grand Junction Companies, is, I believe, of good quality; for from the
samples I have examined, and the reports furnished by Dr. Whitmore, the
water appears free from those organic impurities which are indications
of danger, and are specially to be guarded against in times when
cholera threatens us. The water, which in not a few of the houses in my
district, is supplied by the water companies pure, is rendered impure
in the tubs and cisterns in which it is stored. Water not only has the
property of becoming impregnated with mineral substances, but also the
property of absorbing gases. It is strange, but nevertheless true, that
the worst place possible for tubs, cisterns, and water reservoirs, is
selected, viz., next to or over water closets, or over dust bins; this
obtains almost universally in my district. The consequence is, in the
one case feculent exhalations arise, and are absorbed by the water; and
in the other, exhalations from the decomposed and decomposing vegetable
and animal refuse; further, the tubs and cisterns in many cases
appear to have been neglected for a long time. The lids do not fit,
consequently these cisterns are receptacles for all kinds of filth.
Those who live in the upper rooms are not over-scrupulous as to how,
when, or where, they dispose of their waste matters, but it often finds
a lodgement on the outbuildings, and not seldom is washed more or less
into the cisterns. These cisterns, like the people and the rooms they
inhabit, are not characterised by cleanliness. If I might judge from
appearances, I should conclude that they are seldom washed out. If I
ask when the tub or cistern was last cleaned out, nobody seems to know;
for, what is everybody’s duty is nobody’s work.

It is a well-known fact, that when animal and feculent matters are
suspended in water, and that water is used for drinking purposes, that
it has produced diarrhœa. In water that is contaminated with sewerage
the diarrhœa is accompanied with choleric symptoms, such as purging,
vomiting, cramp, and even some loss of heat. This should be a warning
not to allow impurities of any kind to abound in our drinking water.
Fetid gases absorbed by water render the water bad; not that the
sulphuretted hydrogen in itself is the thing to be dreaded, but because
its presence fosters the growth of vegetable and animal products that
are highly detrimental to health, and are, I believe, predisposing
causes, if not virtually the agents in choleraic diarrhœa. It is in
water under these conditions that plants and animals abound. They
are minute, microscopic, I admit, but on that account none the less
dangerous. The living plants and animals are not to be regarded with so
much horror as the dead, because they rapidly undergo decomposition;
and, while in this state, if taken into the system, act as ferments
disturbing the normal functions of the body, and often giving rise to
diarrhœa. This is not a mere assertion or hypothesis, but is supported
by well-observed cases by some of the most competent men in the medical
profession. In support of the above, I quote the following words from
Dr. Parkes, professor of military hygiène. He says:—“An epidemic of
diarrhoea in a community is almost always owing to either impure air,
_impure water_, or bad food.” The practical deduction is, that if we
would maintain the health of a parish and prevent cholera, diarrhœa,
typhus, or any other epidemic, we must improve our sanitary condition.
Pure water lies at the foundation of all sanitary improvements. Let
it be well known that impure water is to be dreaded, and the fear of
an epidemic may prove a healthy stimulus to increased activity and
cleanliness in connection with a subject of such vital importance.
Whether cholera visits us or not, we shall be all the better for having
paid proper attention to our sanitary arrangements. I would suggest
the propriety of having all tubs, cisterns and reservoirs cleaned
out; all waste matters removed from the roofs of outhouses; all back
premises thoroughly cleaned. I think from what I have said, this can
hardly be regarded an unnecessary work; but should this be deemed
impracticable—though I cannot see how it can be—I would suggest the
desirability of all water used for drinking and culinary purposes being
filtered; that is, where there is any suspicion of decomposed organic
matter in the cistern, tub, &c. Any working man with ordinary ingenuity
might contrive to filter his water through a little sand and vegetable
charcoal. I know of no filters that could be purchased for 1s. 6d. or
2s., which I presume is about the extent that many of the poor in my
district could go to. A rough-and-ready filter might be made out of a
large flower-pot, the hole at the bottom being plugged up with sponge,
and then a layer of charcoal and another layer of sand. The water would
percolate through these substances, and be as clean and pure as the
water from the mountain rill. The flowerpot might be suspended over
another vessel, which would receive the pure water, or it might be so
placed as to stand on two pieces of wood over another vessel. There
are many ways of filtering water, but it is only my object to show
how simple, inexpensive it is, and that it is within the means of the
poorest to protect themselves from the disastrous effects of impure
water, at a little cost of labour and at a still less cost of money.

There can be no doubt that water is not appreciated as a sanitary
agent. This may arise either from ignorance or indifference; but,
after what has been said, I trust that the apathetic neglect of the
primary laws of health, and that blind confidence in an overruling
Providence, that in the end all will come well—may vanish as the
baseless fabric of a vision. It is in vain to call upon the local
authorities to supply a larger quantity of water, if we either from
ignorance or indolence neglect to use it. It is in vain to call upon
landlords to build houses properly drained and ventilated if those who
take them are ignorant and indifferent to the value of fresh air and
good drainage. Dirt is allowed to begrime the walls, so as to render
it difficult to tell what the original colour was; in a word, many of
the rooms in George-street, Charles-street, Little Bell-street, Little
Church-street, East-cottages, and many others in my district, are so
neglected by the tenants as to become neither more nor less than fever
nests. Soap and water and white lime, to judge from the condition of
very many of the rooms in my district, might be as expensive a luxury
as salt in Abyssinia. Every traveller that visits tropical countries
is sure to complain of the annoyance and inconvenience of mosquitoes,
and I am equally sure that every visitor to the dwellings of the
poor in the locality I have indicated might reasonably complain of
the visitors, who, on account of the dirt, have taken up a permanent
residence, but whose name it is not deemed polite to mention, though as
far as number is concerned they might be justly termed legion.

Almost without exception the poor bear the marks on their own body of
their careless indifference to the laws of health and cleanliness.
I do not believe that the poor are too bad to be mended, nor that
they are too dirty to be taught the necessity and desirability of
cleanliness. Those who suffer thus from sanitary mismanagement are not
to be improved by calling them filthy, incorrigible, and worthless,
but by kindly pointing out the evils which arise from their own
carelessness, and suggesting remedies which they themselves can
carry into operation. The very worst have some good in them, and by
appealing to that good in a kindly, honest spirit we may arouse that
laudable ambition of self-respect and self-help, which will do more to
improve the sanitary and social condition of the needy poor than could
be accomplished by extraneous help, if it did not secure the hearty
sympathy and co-operation of the poor. Until the poor take an interest
in their homes and feel a pride in preserving them clean, healthy, and
comfortable, we shall always be hearing of and seeing the homes of
the poor in a dilapidated condition. Flooring and doors will be used
as firewood—sewers will be blocked up by materials that ought never
to have been thrown down—dirt, filth, and all manner of rubbish will
be allowed to accumulate—how is this to be remedied? To remedy this
evil, mere obstructiveness and selfishness must get out of the way. The
homes of the poor must be cleansed, repaired, and made comfortable;
and then if cleanliness were made a condition of tenancy as I have had
occasion before to suggest, it would go a long way to keep the property
in repair. I feel confident that where tenants keep their rooms clean
they acquire an interest in them, and do not destroy nor wilfully
damage them. Further, every effort ought to be made to instruct the
poor in the knowledge of the laws of health. Let it be clearly shown
to them that dirt, disease, and poverty, are intimate companions, and
that if they would escape from the bitter experience of poverty, they
must each sweep before their own doors; then a future, gilded with the
promise of a joyous hope, shall open up before their view. Dirt with
all its disgusting associations shall be supplanted by cleanliness with
all its cheering comforts; disease manifesting itself in the emaciated
body, the anxious brow, the glazed eye, and shrivelled face, shall give
place to joyous health, with firm elastic step, with ruddy face, bright
sparkling eye, and the alacrity and pleasure with which labour and toil
is welcomed. Poverty in all its intensified bitterness, when associated
with disease shall give place to a comfortable competency. This and
much more may justly be expected, if we sow aright the seeds of the
science of life, and teach men the laws which govern their health
and life. The proper study of mankind is man; a more comprehensive
principle has seldom been enunciated. Man in all his relations is
too vast a subject for us to contemplate, therefore we purpose the
consideration of man in his social relations, in so far as these
relations bear upon the health of the individual or the community of
which we form a part. It would be well if we all took a deeper interest
in the welfare of each other, if we felt that any disease, epidemic,
or misfortune, that affects any member of the community, must by the
common law of relationship, affect us; the man who wilfully breaks the
laws of health, not only injures himself and his next of kin, but he
injures society, of which he is a member, by depriving society of the
creative wealth of labour; hence we see that the individual welfare and
the prosperity of the commonwealth, depends upon a right understanding
of those great laws by which the Creator governs the health and life
of man. I know of few places where personal cleanliness is at a lower
standard than in many of the small streets in my district, therefore at
the risk of being personal, I must press the subject of the importance
of baths. All nations have valued baths, some have regarded ablutions
as a necessary part of their religion, and have accordingly most
faithfully carried into daily practice their ablutions. Others have
regarded the bath as a luxury, and only to be indulged in occasionally.
There are those who inhabit the far, far north, where mountains of
ice wreathed in the scintillations of the northern lights tower in
colossal grandeur. The cold is so intense, that animal and vegetable
life struggle feebly to maintain an existence, nevertheless there
man prizes his bath. There are nations basking beneath a tropical
sun, where vegetation revels in luxurious richness, where birds with
gorgeous plumage carol in the clear blue sky, and dolphins as they
sport in the water sparkle and glitter like a thousand gems, and here
man values the bath as one of the best gifts of the great Creator. Nor
was ancient Greece or Rome backward in discovering the value of the
bath as a sanitary and curative agent. They bear us ample testimony of
the high value they put upon baths. In this short paper it would be
an impossibility to discuss the various kinds of baths, hot, shower,
swimming, cold, Turkish, and vapour baths; neither can it be expected
that I should indicate the relative value of each to particular
conditions of health or disease, but we may rest assured that each kind
of bath may, when rightly used, be regarded as a health preserving and
health restoring agent.

In order fairly to estimate the value of baths, we ought to know
something of the structure and functions of the skin. The skin is
furnished with millions of little holes and tubes, these holes are
called the pores of the skin, through which watery vapour or sweat is
poured out; it is estimated that there are no less than 3,000 of the
tubes and holes pouring out sweat in space not larger than a shilling,
so that as long as the skin is kept clean, sweat or watery vapour is
poured out from the skin. This sweat contains decaying and poisonous
waste matter, which is worse than useless to the system. Hence the
importance of baths and personal ablutions. Further, the healthy action
of the skin bears a greater relation to our health than we might at
first imagine. The function or office of the skin is closely correlated
with the office of other internal organs. The skin performs the various
functions of absorption, secretion, excretion, &c. If the skin fails in
its duty, the work is thrown upon the liver and kidneys, consequently,
they are doing double duty, and if not soon relieved they become
overtaxed, and consequently injured. Further, a dirty skin affects our
spirits; if the skin is dirty the terminal branches of nerves and blood
vessels are not benefited and strengthened by atmospheric air. I hope
the above is simple and intelligible, and that I have shown that it is
impossible to enjoy life if we allow our skin to be clogged with dirt.
We have seen the vital importance of fresh air and pure water. Yet,
as Dr. Lankester so suggestively remarks in his address upon public
health at the last Social Science Congress, “As the animal organism
cannot live in air and water, but requires the varied compounds of
carbon, oxygen, hydrogen, and nitrogen for its existence, the whole
question of the relation of the elements used as food becomes the
subject of our inquiries. Here our researches are based especially on
chemical facts, and we must take for our guides Mülder and Liebig, and
the great school of chemical physiologists. The freshest air and the
purest water will be no protection from disease and death, unless the
human system is supplied in its food with the elements necessary for
the play of those chemical forces which result in life. Not only must
there be food supplying the materials of combustion and nutrition,
but each tissue is built up and constituted its own peculiar way. The
blood must be supplied with chloride of sodium and iron, the bones with
phosphate, carbonate, and fluate of lime; the muscles with potash; the
bile with sulphur; the saliva with cyanogen; the teeth, hair and nails
with silica. A diet deficient of any of these materials may be the
source of disease. Our navy was formerly decimated for want of fresh
vegetables, our army was starved on an excessive diet of salt beef, our
children die if fed alone on arrowroot or corn-flour. Those who inhale
abundance of fresh air, and have access to infinite stores of pure
water, nevertheless fall easy victims to diseases which result from the
rebundance or deficiency of the compounds which, in natural quantities,
constitute the source of their daily life.”

From the above comprehensive sketch of the principles of diet, we see
to what an extent food influences the health of the individual, and
consequently the prosperity and happiness of the nation. The subject of
diet is so important, so full of interest, and opens so wide a field
for interesting investigation, that I feel I cannot do better than
refer those who wish for scientific information conveyed in popular
terms on the subject of food, to Dr. Lankester’s “Lectures on Food;”
and, in conclusion, I would say that it is only when the processes of
digestion, respiration, and elimination, are in proper correlation,
that we can expect either to enjoy or preserve good health.




APPENDIX.


A few brief observations on the control and prevention of infections
diseases, such as small-pox, measles, scarlet fever, typhus fever,
typhoid fever, cholera, &c.

The above-mentioned diseases are capable of being transmitted from
those who are infected to those who are not. It is at once cheering
and obligatory to know that the spread of these infectious diseases
depends upon certain specific conditions, and that these conditions are
primarily within the control of man. This control and prevention of
infectious diseases is one of the latest and greatest achievements of
modern medicine.

Small-pox is one of the most contagious diseases, but it is controlled
by vaccination. Primary vaccination within certain limits, is a
protection against small-pox, but it is a well ascertained fact that
there is a period in the life of persons when the prophylactic or
protective power of vaccinia dies out, or at the least becomes very
feeble, consequently it is advisable for all who are in the proximity
of those suffering from small-pox to be re-vaccinated, for the
following reasons. Re-vaccination will almost without exception restore
the protective power against small-pox: secondary vaccination is
attended with no danger. The operation is so simple and the protection
so certain and valuable.

Scarlet fever and measles, though regarded as the inevitable
diseases of childhood, and for which the mother is considered the
best physician, and kitchen physic the best medicine, are simple in
themselves, but on account of the sequelæ or diseases which generally
follow, really require more attention in a sanitary point of view than
they generally receive.

Typhus, typhoid fevor, and cholera, are contagious diseases, and where
the conditions of a locality are favourable they rapidly spread death
and desolation around. Typhoid fever is generally caused by a specific
miasm of sewers and neglected water closets, &c.

With respect to the cause of cholera, I may mention decomposed and
decomposing animal and vegetable matter in drinking water, but whatever
may be the essential cause or causes of cholera, I must leave for some
future discussion. What is of the most practical value to know is, that
the laws which govern the endemic influence of cholera, are as well
known as those of typhoid fever, and equally under our control. Those
conditions which are favourable to the spread of typhoid fever, are
equally favourable to the spread of cholera when once it shows itself,
and the same sanitary regulations which are applicable to typhoid
fever, are best calculated to prevent and control cholera.

The following suggestions may be observed with advantage to the sick,
and those connected with them:—

1. In cases of contagious diseases _fresh air_ is of primary importance
to both patient and attendant. The room should be well ventilated, care
should be taken that no draught blows upon the patient, but a continual
supply of fresh air enters the room. In cases where it is not expedient
to have both window and door open a fire ought to be lighted, and the
door kept open. A fire not only is a good means of ventilating a sick
room, but it also dries the air and thus renders it a less susceptible
medium for carrying and retaining infectious poisons.

2. Cleanliness is very desirable in health, but it is imperatively
necessary in disease, both the room and the patient should be kept
thoroughly clean. Both body and bed linen should be frequently changed,
and as soon as the soiled linen is removed it should be placed in
water and thoroughly washed, and not rolled up and kept till the
regular washing day. There is a great objection to change the linen of
patients suffering from fever for fear they should catch cold, this
is an ignorant prejudice. Fever patients do not take cold if ordinary
care be employed. The skin of fever patients not only becomes hot and
uncomfortable but dirty. It is often advisable to sponge them with a
little luke-warm vinegar and water. The room ought to be washed out
daily, and thoroughly dried. It is useful to have a little of Condy’s
disinfectant fluid in the water. All carpets, curtains, and woollen
furniture is better removed out of the sick chamber. All discharges
from the patient ought to be immediately emptied, and the utensils
washed out with Condy’s fluid and water; and further, all water closets
&c., ought, at these times, to be daily (at least) well flushed with
water.

3. Nurses, relatives, friends, and visitors, ought to avoid breathing
the patient’s breath, and ought not to remain in close proximity longer
than duty requires. They should not swallow their spittle, and on
leaving the sick chamber, they should clear their mouth and nostrils.
Smoking is only of service in so far as it promotes expectoration; and
snuff, only because it induces sneezing.

With respect to disenfectants I would say, better that they should
never be used, than that their use should tend to supercede fresh air
and cleanliness. In order to disabuse the minds of some who look upon
disinfectants as charms, I give a list of some of them, with their
supposed action:—

Charcoal absorbs moisture and noxious effluvia; its value depends upon
its being _fresh_ and _dry_; it stops meat from becoming putrid.

Bromine is the most efficient antiseptic known, but it requires great
care and caution in its employment, consequently it is best left to
the direction of the medical attendant as to how, when, and where, it
should be employed.

Condy’s disenfectant, Darby’s fluid and ozonized water, are but
solutions of the permanganate of potassa, and it is upon this that
their value as antiseptics and deodorizers depend. Carbolic acid and
coal tar are also antiseptic and deodorant in their action. McDougall’s
powder contains carbolate of lime, and is a very valuable preparation
in arresting putrescence and controlling effluvia. Chloride of lime is
a common disinfectant, and is useful in destroying noxious compound
gases.

Heat is the last disinfectant that I shall mention. It is at once cheap
and effectual, and is by far the most valuable in destroying contagious
virus, transportable infections. All bedding, garments, &c., should be
purified by hot air or steam, as it will effectually destroy cell life,
cryptogamic and infusorial organisms.