Dr. Southwood Smith: A Retrospect
CHAPTER VII.
THE TEN YEARS' STRUGGLE FOR SANITARY REFORM, 1838-1848.
It is not easy to convince a whole nation of the truth of new principles, however closely they may in reality affect its welfare; not easy to produce a degree of conviction that shall lead to practical, tangible results. The early workers in the public movements, such as that for Sanitary Reform, have first to spread such a knowledge of existing evils as shall create a general feeling of the need for improvement. They have to educate the public until it believes in that need. And when the _vis inertia_ of ignorance and indifference is overcome, they have to encounter the active opposition of those whose interests are bound up with the old abuses, and whose property would be affected were the evil swept away. Even when it is decided that something must be done they have to bear a long time of waiting until it is settled what that something is to be, for decision is not easy when questions arise which closely affect the property of a powerful class.
From these causes arose the long delay which occurred before any mitigation of the suffering took place, and hence it was that the great feature of the period was a succession of "Inquiries" and of bills brought before Parliament and defeated.
The first step in the House of Commons was made in 1840, the year following that which has just been spoken of as the one from which dates the public beginning of the Sanitary movement, when Mr Slaney, M.P. (one of the most earnest and energetic of the early labourers in the cause) obtained a Committee of the House to "inquire into the sanitary state of large towns in England." Mr Slaney wished not only to extend the investigation, but to bring the striking results already obtained directly before Parliament.
My grandfather was the first witness examined by the Committee, and nearly the whole of his evidence was transferred to its minutes. Some of his words were--
"_These miseries will continue till the Government will pass measures which shall remove the sources of poison and disease from these places. All this suffering might be averted. These poor people are victims that are sacrificed. The effect is the same as if twenty or thirty thousand of them were annually taken out of their wretched homes and put to death; the only difference being that they are left in them to die._"
And how long was it before any measure to stop this could be carried through Parliament? Dating from the time when he first examined Bethnal Green and Whitechapel, _ten years_. Not long, perhaps, in reality, considering the difficulties in the way, but very long to one who not only believed, but most deeply felt and realised, the truth of such words as those quoted above.
The history of events was this. In 1841 Lord Normanby brought in a "Drainage of Buildings Bill." It was by no means a perfect one. My grandfather wrote of it many years afterwards in the following words:--
"Subsequent discussion and inquiry greatly improved both the principles and the details of sanitary legislation as compared with the proposals in this bill. Still, honour to the House of Lords who carried it with a cordial and noble spirit through their own House and sent it down to the Commons!"
The session, however, came to an end before any discussion could there be held on it.
Next year, 1842, was presented Mr Edwin Chadwick's Report on the Sanitary Condition of the Labouring Population of Great Britain. He was Secretary to the Poor Law Board, and this Report was, in fact, a Return to the Bishop of London's motion of 1839. It confirmed and extended the results of previous inquiries, and greatly helped to prepare the way for legislation.
In 1843 Lord Normanby made a second attempt. It was again defeated. The Administration of which he was a member was broken up before much progress had been made with the new and improved bill which he had introduced.
Now came another Inquiry. Sir Robert Peel's Government, soon after coming into office, appointed a Royal Commission,[20] of which the Duke of Buccleuch was chairman, "to inquire into the state of large towns and populous districts." My grandfather was again the first witness examined. Their report was presented in June 1844; but during this session no bill bearing on sanitary subjects was even introduced.
My grandfather, however, who was brought daily face to face with the preventible suffering, was not likely to forget it, nor to relax his efforts. With the calm, persistent earnestness which was characteristic of him, he worked on and on. The more defeats, the more necessity for strenuous exertion.
Seeing the difficulty of obtaining any practical result from all the labour that had been devoted to the improvement of the health of the people, he now determined to try to bring together the distinguished men who had taken an interest in the cause, and who had exerted themselves to promote it. He hoped that, thus united, they would have more power in spreading the information which had been acquired, and in forcing it on the attention of the public and the Legislature; and he also thought that a body of men acquainted with the subject would be useful in suggesting and discussing remedies, and in proposing legislative measures.
He succeeded in this effort. He founded the "Health of Towns Association" already referred to, which, numbering amongst its members Lord Normanby, Lord Ashley, Lord Morpeth, Lord Robert Grosvenor, Lord Ebrington, Mr Slaney, M.P., and many other influential men both in and out of Parliament, proved a highly useful instrument in carrying forward the work of Sanitary Reform up to the time of the passing of the Public Health Act.
Its first meeting was held in December 1844, and the facts which the various speakers eloquently brought out are chiefly summed up in the petition which, in accordance with one of the resolutions then passed, was presented to Parliament.
Those to whom sanitary truths are familiar will have little interest in this repetition of what they already know, except as showing what the early sanitary work was before a public opinion had been formed. But it is somewhat curious to look back upon a time when it was necessary to state what now appear self-evident truths. My grandfather gives it as the opinion of the meeting, that--
"From the neglect of sewerage, drainage, a due supply of water, air, and light to the interior of houses, and an efficient system of house and street cleansing, a poisonous atmosphere is engendered, particularly in the districts occupied by the poor, which endangers the health and life of the whole community, but which is particularly injurious to the industrious classes.
"That it appears from indubitable evidence that the amount of deaths attributable to these causes is, in England alone, upwards of 40,000 annually.[21]
"That the great majority of the persons who thus prematurely perish are between the ages of twenty and forty, the period when they ought to be most capable of labour and are heads of families; and that it appears from official returns that in some districts nearly one-third of the poor-rates are expended in the maintenance of destitute widows and orphans rendered destitute by the premature death of adult males: that the number of widows receiving out-relief was, in the year 1844, 86,000; that these widows had dependent upon them 111,000 orphan children; and that there were, besides, receiving relief in the Union houses, 18,000 orphan children.
"That the expense thus constantly incurred for the maintenance of the destitute would in many cases defray the cost of putting the district into a good sanitary condition, and thus prevent the recurrence of these dreadful evils.
"That this poisonous atmosphere, even when not sufficient to destroy life, undermines the strength, deteriorates the constitution, and renders the labourer in a great degree unable to work; and that there is every reason to believe that his healthy life and working ability is abridged in many districts to the extent of twelve years. And lastly--
"That the moral and religious improvement of the industrious classes is incompatible with such a degree of physical degradation as is actually prevalent in numerous instances; and that until the dwellings of the poor are rendered capable of affording the comforts of a home, the earnest and best directed efforts of the schoolmaster and clergyman must in a great degree be in vain."
In 1845 the Government Commission issued their second Report. Another bill, founded on this and their former Report, was brought forward; but it was so late in the year that it could not be passed that session.
Lord Lincoln, who brought it in, avowed that his principal motive was that it might be considered during the recess. "The Health of Towns Association" was here very useful in publishing a report (addressed in the first instance to its own members) criticising the provisions of this bill. My grandfather wrote this report, assisted by the notes and suggestions of various members, and by Mr Chadwick, who, though not connected with the Association, helped greatly on this and other occasions.
Lord Lincoln's bill was not again introduced, and the only sign of progress in these matters during 1846 was to be found in the criticisms offered on that abortive measure.
It was at this juncture that it was thought well to strengthen the hands of the Government by bringing the force of Petition to bear upon the Legislature. It thus became important to arouse the attention of the working classes to the subject.
My grandfather, as one move in this direction, wrote the following address, which I give in full. It was written from his heart, and, with all its calm, philosophical mode of expression, burns underneath with the white heat of that earnestness which made this sanitary cause--this saving of life and of suffering--with him almost a crusade.
AN ADDRESS TO THE WORKING CLASSES OF THE UNITED KINGDOM ON THEIR DUTY IN THE PRESENT STATE OF THE SANITARY QUESTION.
MY FELLOW-COUNTRYMEN,
The artificial distinctions by which the people of a country are divided into different classes have no relation to the capacities and endowments of our common nature. No class is higher or better than another in the sense of having more or different sentient, intellectual, moral, and religious faculties. Every property by which the human being is distinguished from the other creatures of the earth is possessed alike by rich and poor. Wealth can give to the rich man no additional powers of this kind, nor can poverty deprive the poor man of one of them. Before these glorious gifts with which our common nature is endowed, with which all human beings without distinction are enriched, and which can be neither added to nor taken away, the little distinctions of man's creation sink into absolute insignificance.
It is the universal possession of these noble faculties by the human race that makes the gift of human life alike a boon to all. It is the exercise of these noble faculties on objects appropriate to them, and worthy of them, that _makes_ life a boon. It is because these faculties, when duly exercised and properly directed, strengthen and enlarge with time, that the value of life increases with its duration. In the mere possession of the full number of the years that make up the natural term of life there is a larger and higher boon than is apparent at first view. What the natural term of human life may be is indeed altogether unknown; because, although one of the characteristics by which man is distinguished from other animals is, that he is capable of understanding the conditions of his existence, and of exerting, within a certain limit, a control over them, so as to be able materially to shorten or to prolong the actual duration of his life,--yet these conditions have hitherto been so little regarded that there is not a single example on record of a community in which the conditions favourable to life have been present and constant, and in which the conditions unfavourable to it have been excluded, in as complete a degree as is obviously practicable. History is full of instances in which the successive generations of a people have been swept away with extraordinary rapidity; but on no page is there to be found the notice of a single nation, in ancient or modern times, the great mass of the population of which has attained a higher longevity; yet it is certain that a degree of longevity never yet witnessed has always been attainable, because such longevity depends on conditions which are now known--conditions entirely within human control.
I have said that there is involved in the mere length of life a larger and higher boon than is apparent without reflection. First, because length of life is in general a tolerably accurate measure of the amount of health, without a good share of which life is comparatively worthless. The instances are rare in which a person attains to old age who has not enjoyed at least a moderate share of daily health and vigour.
Secondly, because length of life is a perfectly accurate measure of the amount of enjoyment. Long life is incompatible with a condition of constant privation and wretchedness. It is one of the beneficences of the constitution of our nature that when the balance of happiness is against us, a limit is fixed to our misery by its rapid termination in the insensibility of death. In the very brevity of its existence, therefore, a human being indicates his own history for evil; the shortness of his life is the sure and correct index of the amount of his suffering, physical and mental: it is the result, the sum-total, the aggregate expression, of the ills endured.
Thirdly, because length of life is the protraction of that portion of life, and only of that portion of it, in which the human being is capable of the greatest degree of usefulness. I have elsewhere shown that every year by which the term of human life is extended is really added to the period of mature age; the period when the organs of the body have attained their full growth and put forth their full strength; when the physical organisation has acquired its utmost perfection; when the senses, the feelings, the emotions, the passions, the affections are in the highest degree acute, intense, and varied; when the intellectual faculties, completely unfolded and developed, carry on their operations with the greatest vigour, soundness, and continuity: in a word, when the individual is capable of communicating, as well as of receiving, the largest amount of the highest kind of happiness.
These considerations give peculiar interest to the results of the inquiries recently made into the actual duration of life at the present time in our cities, towns, and villages. From these inquiries it appears not only that the rate of mortality in the whole of England at the present day is deplorably high, but that there is an extraordinary excess of mortality over and above what is natural, supposing the term at present attainable to be the natural term of human life. The statement of this excess presents to the mind an appalling picture. From accurate calculations, based on the observation of carefully recorded facts, it is rendered certain that the annual slaughter in England alone by causes that are preventible, by causes that produce only one disease--namely, typhus fever--is more than double the loss sustained by the allied armies in the battle of Waterloo; that 136 persons perish every day in England alone whose lives might be saved; that in one single city--namely, Manchester--thirteen thousand three hundred and sixty-two children have perished in seven years over and above the mortality natural to mankind.
It appears, moreover, that the field in which this annual slaughter takes place is always and everywhere the locality in which you reside, and that it is you and your wives and children who are the victims. In some instances in the streets, courts, and alleys in which you live, the mortality which afflicts you is nearly double, and in others it is quite double, that of the inhabitants of other streets in the same district, and in adjoining districts. While the average age at death of the gentry and of professional persons and their families is forty-four, the average age at death attained by you and your families in many instances is only twenty-two, just one-half,--that is to say, comparing your condition with that of the professional persons, you and your families are deprived of one-half of your natural term of life.
Though the causes by which you and your children are thus immolated are well known; though they have been constantly proclaimed to the public and the Government for nearly ten years past; though their truth is universally admitted; and though it is further admitted that the causes in question are removable,--yet not only has nothing whatever been done to remove them, but their operation during this very year has been far more fatal than at any period since we have had the means of making accurate observations on the subject. Thus we are informed by the Registrar-General, that in the summer quarter of the present year Ten Thousand Lives have been destroyed, in a part only of England, by causes which there is every reason to believe may be removed; that in the succeeding quarter--namely, the quarter ending the 30th of September--the number of deaths exceeded the number in the corresponding quarter of last year by Fifteen Thousand Two Hundred and Twenty-seven; that is to say, in the very last quarter upwards of 15,000 persons perished, in a part only of England, beyond the mortality of the corresponding quarter of last year.
From this same report it appears, further, that in many of our large towns and populous districts--that is, in the places in which you in great numbers carry on your daily toil--the mortality has nearly doubled; in some it has quite doubled, and in others it has actually more than doubled; that this is the case among other places in Sheffield and Birmingham; that in Sheffield, for example, the number of deaths in the last quarter are double those in the corresponding quarter of last year and 149 over; while in Birmingham they are double and 239 over.
"The causes of this high mortality," says the Registrar-General, "have been traced to crowded lodgings, dirty dwellings, personal uncleanliness, and the concentration of unhealthy emanations from narrow streets without fresh air, water, or sewerage."
We are further told by the Registrar-General that "the returns of the past quarter prove that nothing effectual has been done to put a stop to the disease, suffering, and death in which so many thousands perish; that the improvements, chiefly of a showy, superficial, outside character, have not reached the homes and habits of the people; and that the consequence is that thousands, not only of the children, but of the men and women themselves, perish of the diseases formerly so fatal, for the same reason, in barracks, camps, gaols, and ships."
For every one of the lives of these 15,000 persons who have thus perished during the last quarter, and who might have been saved by human agency, those are responsible whose proper office it is to interfere and endeavour to stay the calamity--who have the power to save, but who will not use it. But their apathy is an additional reason why you should rouse yourselves, and show that you will submit to this dreadful state of things no longer. Let a voice come from your streets, lanes, alleys, courts, workshops, and houses that shall startle the ear of the public and command the attention of the Legislature. The time is auspicious for the effort; it is a case in which it is right that you should take a part, in which you are bound to take a part, in which your own interests and the wellbeing of those most dear to you require you to take a part. The Government is disposed to espouse your cause; but narrow, selfish, short-sighted interests will be banded against you. Petition both Houses of Parliament. Call upon the instructed and benevolent men in the legislative body to sustain your just claim to protection and assistance. Petition Parliament to give you sewers; petition Parliament to secure to you constant and abundant supplies of water--supplies adequate to the unintermitting and effectual cleansing both of your sewers and streets; petition Parliament to remove--for it is in the power of Parliament universally and completely to remove--the sources of poison that surround your dwellings, and that carry disease, suffering, and death into your homes. Tell them of the parish of St Margaret, in Leicester, with a population of 22,000 persons, almost all of whom are artisans, and where the average age of death in the whole parish was during the year 1846 only eighteen years; tell them that on taking the ages of death in the different _streets_ in this parish, it was found that in those streets that were drained (and there was not a single street in the place properly drained) the average age of death was twenty-three and a-half years; that in the streets that were partially drained it was seventeen and a-half years; while in the streets that were entirely undrained it was only thirteen and a-half years.
You cannot disclose to them the suffering you have endured on your beds of sickness, and by which your wives and children have been hurried to their early graves--there is no column in the tables of the Registrar-General which can show that; but you can tell them that you know, and you can remind them that they admit, that by proper sanitary regulations the same duration of life may be extended to you and your families that is at present enjoyed by professional persons, and that it is possible to obtain for the whole of a town population at least such an average duration of life as is already experienced in some parts of it. In your workshops, in your clubs, in your institutes, obtain signatures to your petitions: get every labourer, every artisan, every tradesman whom you can influence, to sign petitions. Other things must also be done before your condition can be rendered prosperous; but this must precede every real improvement: the sources of the poison that infects the atmosphere you breathe must be dried up before you can be healthy, and uncleanliness must be removed from the exterior of your dwellings before you can find or make a Home.--I am your friend and servant,
SOUTHWOOD SMITH.
_1st January 1847._
In this same year 1847 a Royal Commission--"Metropolitan Sanitary Commission" (of which my grandfather was a member)--was appointed to inquire "whether any, and what, sanitary measures were required for London."
To the country at large, however, it seemed as if perhaps there had been enough "inquiring." The thing _had_ been considered. Surely something might be _done_; and Lord Morpeth now brought forward a Government measure for "improving the health of towns in England."
In bringing in the bill, Lord Morpeth first gives a history of the principal stages of the various inquiries and commissions which had been helped on by all parties, and by successive Governments. He states that he has nothing new to bring forward, and can but repeat the information gained by others. He goes on to show by elaborate statistics the waste of life in large towns.
"Thus the inhabitants of London," he sums up, "compared with England at large, lose eight years of their lives, of Liverpool nineteen. The population of the large towns in England being 4,000,000, the annual loss is between 21,000 and 22,000."[22]
But all places are not equally unhealthy, as further statistics strikingly show. Where do we find the greatest number of deaths? Is it where wages are lowest and the people poorest? What did Lord Morpeth tell the House?
"Let it not be said," he urges, "that the greater rate of mortality in certain districts is owing to extreme poverty and the want of the necessaries of life. The condition of the labourers of the west, the lowness of their wages and the consequent scantiness of their food and clothing, have been the subject of public animadversion. The mortality of the south-western district, which includes Cornwall, Devon, Somerset, Dorset, and Wilts, is only 1 in 52--not 2 per cent; while that of the north-western, including Cheshire and Lancashire, is 1 in 37. With the exception of the Cornish miners the condition of labourers throughout the western counties is nearly the same, yet in Wiltshire, the county of lowest wages, the deaths are 1 in 49, in Lancashire 1 in 36. The average age at death in Wiltshire was thirty-five, in Lancashire twenty-two. The Wiltshire labourer's average age was thirty-five, that of the Liverpool operative fifteen. At Manchester, in 1836, the average consumption per head of the population was 105 lb. of butcher's meat--about 2 lb. a-week (exclusive of bacon, pork, fish, and poultry); the average age at death was twenty years." He then brings forward evidence of the preventibleness of most of the premature deaths.
Having proved the extent of the evil, Lord Morpeth proceeded to show how it was proposed to meet it,--by what machinery of central board, inspectors, &c; and, lastly, he entered into the money-saving that would be effected were thorough sanitary measures carried out. He cites Dr Playfair's estimates, which give the money loss, through unnecessary sickness and death, at £11,000,000 for England and Wales, and at £20,000,000 for the United Kingdom. This loss arises from many causes: the expenses of direct attendance on the sick; the loss of what they would have earned; the loss caused by the premature death of productive contributors to the national wealth; and the expenses of premature funerals.
But the measure which was framed to relieve this sum of misery, though well and carefully prepared, was again to be thrown out!
It was weary work. The years were passing away, and nothing was being done. My grandfather used to come home saddened by each new defeat. He was sad at the delay, but he was not disheartened; he knew that the thing would be done in time, and that the progress must be slow. He could wait calmly in that belief and enjoy fully the beauty of the sunset light during the summer evenings passed in our beautiful field, overlooking the green slopes and large trees of Caen Wood, Highgate. There our friends used to come to us, amongst others Professor Owen, Robert Browning, William and Mary Howitt, and Hans Christian Andersen; and we spent evenings that I can never forget, staying out constantly till the moon rose or the stars came out. How he loved nature and all happy things!
His faith did not err. The work of urging had not been in vain; the movement could not be stopped; the time was ripe.
The bill had been thrown out in 1847, but in 1848 the first sanitary law, the Public Health Act, passed!
Footnote 20:
"The Health of Towns Commission."
Footnote 21:
The statements as to the saving of life which would be effected if proper sanitary measures were carried out were necessarily various, since the difference which could be made in the death-rate was a matter of opinion, and had yet to be proved by experiment. If, instead of one death annually in every 46 inhabitants throughout England and Wales (the then proportion), there should be an improvement sufficient to secure there being one death in every 50, upwards of 25,000 lives would be saved. Whilst, if the sanitary state of towns could be raised to that of healthy counties, there would be a saving of 49,000 lives. The Association seems to have chosen something between the least probable and the highest probable saving of life.--G. L.
Footnote 22:
Lord Morpeth speaks here of the saving of life in large towns only.