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mined to try the experiment of changing the condition of the pond, from which the disease was believed to have arisen. A ditch was accordingly cut; what little water remained was conveyed off, and the whole surface covered with fresh earth. The effects of this scheme were soon obvious. Not a man was seized with the worst form of the fever after the work was finished, and the sick were not a little benefited, for they generally recovered, though slowly, because the fever became a common remittent, or gradually assumed the intermitting form. A few cases of remitting and intermitting fever occurred occasionally till frost put an end to it in every form. As soon as the contents of the pond were changed by cutting the ditch, the cause, whatever it was, seems to have been rendered incapable of communicating the disease in its worst form.'"-pp. 355-7.

Dr. Smith gives many similarly striking instances of sudden illness attacking men previously healthy, and of their rapid recovery when the causes of discase were removed: these instances being, however, chiefly derived from the experience of military officers abroad, they may not have the same weight as equally conclusive evidence at home would have. But unfortunately so few attempts have been made in England on a large scale to promote the public health, that the report, from which we have quoted, is very deficient in this respect; and we must place more dependance on the fact, that in many illdrained streets, fever is never absent, than we can on any existing proofs of the beneficial results of good drainage, if we would show the imperative necessity of improved sanatory regulations. Putting the case. Putting the case in the weakest point of view, we can argue from the absence of other causes, that imperfect drainage must be a cause, if not the cause, of the frightful prevalence of fever amongst our working classes. Some streets badly, or not at all drained, are never free from fever, according to Dr. Smith: every one's experience will tell him, that in well-drained streets such a thing is unknown. The undrained streets are always inhabited by the poor certainly; but we have already seen that extreme poverty has nothing to do with the liability to disease, since the majority of patients at the fever hospitals are in full employment at the time. Besides, is it probable that the successive residents in one street should all possess means, habits, and occupations, so exactly identical, that they should be equally exposed to sickness? To what cause, then, can we ascribe this fact, if not to the want of drainage? The following extracts,

so far as they go, exhibit the benefits derived from sanatory improvements:

"About thirty years since Beccles began a system of drainage, which it has continued to improve, till at the present time every part of the town is well drained...... Bungay on the contrary, with equally convenient opportunities for drainage, has neglected its advantages, has one or two large reservoirs for filth in the town itself, and some of its principal drains are open ones. The result is, that Bungay, with a smaller proportion of town inhabitants, has become of late years less healthy than Beccles......The proportions of deaths to the population for the last thirty years has been for


"Between the years 1811 and 1821......1 in 67........


BUNGAY. 1 in 69. .1 in 67.

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.1 in 59."

p. 28.

"At Lyons, from 1800 to 1806 the annual mortality in the prisons was 1 in 19; from 1806 to 1812, it was 1 in 31; from 1812 to 1819, it was 1 in 34; and from 1820 to 1826, 1 in 43: a similar amelioration has also been remarked in the prisons of Rouen, and some other large towns in France," in consequence of improved cleanliness, ventilation, and diet.-p. 217.

Thus, from the first of these statements we find, that whilst the average duration of life has been increased between four and five years in Beccles, it has diminished no less than ten years in Bungay; thus reversing the relative position of the two towns, Bungay having been the healthiest during the first period between 1811 and 1821. In the second statement, the effect of greater cleanliness is much more striking. We can easily imagine that the state of the French prisons at the commencement of this century, left no small room for improvement; and the result of this improvement is, that whilst a man committed to prison before 1806, had only 19 years to live; one committed to the same prison since 1820, may reasonably expect to live 43. If such an improvement as this could be effected in Great Britain, we should no doubt have all the disciples of Malthus up in arms at the frightfully increased pressure of population upon food,' which must be the result; and their strenuous opposition to any sanatory measure would probably prove more formidable to combat than even the selfishness and apathy at present existing on the subject. Immensely increased destitution, and consequently increased poor rates, would be confidently predicted

as the reward of the sacrifices to be made in the cause of health. But the invaluable report again comes to our aid, and, together with the equally valuable facts brought to light by Dr. S. Smith's perseverance and industry, enables us to meet the Malthusians on their own grounds. The following table exhibits the astounding paradox, that the greater the mortality is, the more numerous are the births:

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The annual average Proportion of Births


rate of increase of and Deaths to pop- Proportion of Births Excess in every
population has been ulation in the year and Deaths to every 10,000 persons:
per 10,000 persons ended
30, 10,000 persons in of Births above
between 1831 and 1840.
the same period.

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births 1 in 33

births 302)


The fourteen counties where it has been greatest.


deaths I in 39
births I in 29

deaths 259
births 348)


The fourteen counties where it has been intermediate.

The most ultra-Malthusian can find no pleasure in such a picture as this. It will be seen from the above table, that in the fourteen counties where the mortality is lowest, the population has increased at the rate of 1.12 per cent. per annum, whilst in the fourteen counties where it is highest, it has actually increased at the rate of 1.84 per cent.; that is, that 1,120 persons have been added in ten years to every 10,000 healthy persons, and 1,830 to every 10,000 unhealthy persons! Let us now see what Dr. S. Smith says on the effect of sickness on poor rates:

"No returns can show the amount of suffering which the poor have had to endure......during the last year; but the present returns indicate some of the final results of that suffering; they show that out of 77,000 persons (relieved), 14,000 have been attacked with fever, one fifth part of the whole; and that out of the 14,000 attacked nearly 1,300 have died. The public, meantime, have suffered to a far greater extent than they are aware of, from this appalling amount of wretchednes, sickness, and mortality. Independently of the large amount of money which they have had to pay in the support of the sick, and of the families of the sick, pauperized in consequence of the heads of these families having

* Report, p. 182.

become unable to pursue their occupations, they have suffered still more severely from the spread of fever to their own habitations and families......... The expenditure necessary to the adoption and maintenance of these measures of prevention," (sewerage, drainage, &c.) "would ultimately amount to less than the cost of the disease now constantly engendered. The most pestilential of those places, when once put into a wholesome condition, would be maintained in that state at a comparatively small expense; whereas, as long as they are allowed to remain in their present condition, the results must continue the same; it follows that the prevention of the evil, rather than the mitigation of the consequences of it, is not only the most beneficient, but the most economical course."'*

We consider that the above affords one of the strongest arguments that can be advanced in favour of the question, when regarded only in a pecuniary point of view. Here we find no less than one-fifth of all the paupers relieved were compelled to seek relief in consequence of want, probably produced by the inability to labour which results from sickness. If we suppose that for each pauper attacked with fever, two others, (a very small proportion), were brought to destitution through this illness, we shall have three-fifths of the whole number relieved, unnecessarily thrown on the poor rates for support. The Malthusian will also observe, that the population has not undergone any great diminution, the victims of fever having only been decimated-it is seldom more-and that the remaining nine-tenths have been forced to spend a most disagreeable vacation in a bed of sickness.

We trust we have satisfactorily shown that every thing, even on the lowest principles, is in favour of a sanatory measure, and opposed to the late system-or rather absence of all system. We have even shown, that where disease and misery operate most powerfully against the duration of life, their effect in preventing redundancy of population is more than counterbalanced by the increased number of births: for, supposing that the increase of births only kept pace with the increase of deaths, the balance would decidedly be with long life and few births, against short life and many births, for this reason: that as it requires a certain number of years to convert the raw material, children, (in the language of political economists), into the manufactured article labourers, and as this period

Report on the prevalence of Fever in the Metropolis in 1837.8.



is the same for a short-lived, as it is for a long-lived man; it follows, that to produce a given quantity of the manufactured article, a greater quantity of the raw material will be required in the former case than in the latter, and also a larger proportion of the whole duration of life will be passed in unproductive infancy. The check upon population, therefore, which disease and premature death may be supposed to provide, turns out, in this view of the matter, to be nothing more than a useless waste of the raw material, infant life. In a pecuniary light-not to mention higher considerations-this must be allowed to be at least as great an evil, as the heavy charge on the poor rates produced by the ravages of fever among the working classes, when the time, trouble, and expense of rearing children to a useful and productive age are duly considered.

Every one residing in a large town must have occasionally experienced the sensations resulting from the present abominable system of clearing the sewers, by tearing up the pavement, bringing up to the surface, and allowing to remain in the streets for hours, the accumulated filth of ten years. Against this system, and in favour of that of Aushing the sewers, Mr. Roe, civil engineer, gives the following evidence:

Question."The structural expense being lower, is the ultimate expense of cleansing lower also?-Yes: the expense of cleansing the sewers is about 50 per cent. less than the prevalent mode. Our expense (in the Holborn and Finsbury district) of cleansing the sewers was about £1200 per annum; we save £600 of that, and expect to save more; but to this must be added the saving to the public of the cleansing of the private drains, formerly choked by the accumulation in the sewers. This saving, on a moderate calculation, is found to be upwards of £300 per annum.


During what intervals are deposits allowed to remain on the old mode? The average is in one set of sewers about five years, and in another about ten years."-p. 375.

The space we have devoted to the report, and the extensive consideration we are desirous of bestowing on the Public Health Act, will preclude us from saying much on the subject of baths and wash-houses; indeed, no objections are made to their establishment, except on the score of expense, and the provisions of the Act have been already, or are in the course of being, extensively carried out. We shall merely state that the benefits

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