CHAPTER I.

LONDON FROM THE SANITARY POINT OF VIEW.

In considering the sanitary conditions of a great city like London, it behoves us to remember that it has been a place of importance since the days of the Roman occupation of this country--that is, for some 1,500 years.

A place that has been peopled for centuries is very apt, in the absence of special precautions, to become unwholesome by reason of the vast accumulation of refuse. Roman London is many yards beneath the surface of the present City. It has been deeply buried, and by what? By refuse and debris from every source; and this in itself is necessarily a danger to health, and doubtless has in times past greatly tended to produce many of those diseases for which mediæval (and even modern) London was noted.

SITUATION.

The situation of ancient London was most convenient for commerce, and fairly good from a sanitary point of view. The advantages of its situation have been dwelt upon by many writers, and were well summed up by Edward Chamberlayne, who thus speaks of it in his “Present State of England” (1682), a work which was analogous in many respects to the “Whitaker’s Almanack” of the present day.

Chamberlayne says:--“In the most excellent situation of London the profound wisdom of our ancestors is very conspicuous and admirable. It is seated in a pleasant evergreen valley, upon a gentle rising bank in an excellent air, in a wholesome soil mixed with gravel and sand upon the famous navigable river Thames, at a place where it is cast into a crescent, that so each part of the City might enjoy the benefit of the river, and yet not be far distant one from the other; about sixty miles from the sea; not so near, that it might be in danger of surprise by the fleets of foreign enemies, or be annoyed by the boisterous wind and unwholesome vapours of the sea; yet not so far but that by the help of the tide every twelve hours, ships of great burden may be brought into her heaving bosom; nor yet so far but that it may enjoy the milder, warmer vapours of the eastern, southern, and western seas; yet so far up in the country as it might also easily partake even of all the country commodities; in an excellent air upon the north side of the river (for the villages seated on the south side are noted to be unhealthy in regard of the vapours drawn upon them by the sun), but roughed by gentle hills from the north and south winds.

“The highways leading from all parts to this noble city are large, smooth, straight and fair; no mountains nor rocks, no marshes nor lakes to hinder carriages and passengers.” * * *

Chamberlayne, in speaking of the Thames, is, as well he may be, loud in its praise:

“The river whereon is seated this great city, for its breadth, depth, gentle, straight, even course, extraordinary wholesome water, and tides, is more commodious for navigation than any other river in the world. * * * This river opening _eastward_ towards Germany and France, is much more advantageous for traffic than any other river of England. To say nothing of the variety of excellent fish within this river--above all of the incomparable salmon--the fruitful, fat soil, the pleasant rich meadows and innumerable stately palaces on both sides thereof; in a word, the Thames seems to be the very radical moisture of this city, and in some sense, the natural heat too; for almost all the fuel for firing is brought up this river from Newcastle, Scotland, Kent, Essex, etc., or else down the river from Surrey, Middlesex, etc.”

After dwelling on the shipping and commerce of the Thames, he concludes his article on London by stating “that London is a huge magazine of men, money, ships, horses and ammunition, of all sorts of commodities necessary or expedient for the use or pleasure of mankind. That London is the mighty rendezvous of nobility, gentry, courtiers, divines, lawyers, physicians, merchants, seamen, and all kinds of excellent artificers, of the most refined wits, and most excellent beauties; for it is observed that in most families of England, if there be any son or daughter that excels the rest in beauty or wit, or perhaps courage or industry, or any other rare quality, London is their _north star_, and they are never at rest till they point directly thither.”

A writer of a much earlier date, William Fitz-Stephen, who in 1180 prefixed an account of London to his biography of Thomas-à-Becket, has also some remarks about the situation of London, from which I will make a quotation.

“On the north are cornfields, pastures, and delightful meadows, intermixed with pleasant streams, on which stands many a mill, whose clack is so grateful to the ear. Beyond them an immense forest extends itself, beautified with woods and groves, and full of the lairs and coverts of beasts and game, stags, bucks, boars, and wild bulls.”

“The fields above-mentioned are by no means hungry gravel or barren sands, but may vie with the fertile plains of Asia, as capable of producing the most luxuriant crops and filling the barns of the hinds and farmers.

“Round the city and towards the north arise certain excellent springs at a small distance, whose waters are sweet, salubrious, clear,” and

“Whose runnels murmur o’er the shining stones.”

WATER SUPPLY.

This final remark of Fitz-Stephen’s leads me to make a few observations about the water supply of ancient London, which originally was abundant and excellent.

It is probable that in pre-historic times the rising ground upon which the “City” is built was an island, the Thames in those days being much wider and shallower than at present. Even a writer so late as Fitz-Stephen mentions the fact that Moorfields was used for skating, and the derivation of the name “London” which finds most favour with philologists is from the Celtic _Llyn-din_, which means the Lake fortress.

Many watercourses ran from the north into the Thames, the names of which are still attached to districts or streets in the Metropolitan area. Thus, beginning at the East, one has to mention _Langbourn_, a watercourse flowing through what is now Langbourne Ward in the City, taking its course from Aldgate along Fenchurch Street, and probably flowing into the _Wall Brook_, a stream which divided the city into nearly equal halves, and flowed from Moorgate to Dowgate, through the Bank of England and the Poultry, and the name of which still remains in a ward and a street. The river _Fleet_ rose by Highgate Ponds, and meandered through St. Pancras to King’s Cross, where is “Battle Bridge;” thence its course skirted the western side of Clerkenwell, and, flowing at the foot of Saffron Hill, Snow Hill, Holborn Hill, and Ludgate Hill, reached the Thames at Blackfriars.

Farther west was _Tybourne_, which rose at Hampstead and flowed through what is now the ornamental water in the Regent’s Park. Then becoming locally known as the Marybourne, its name was associated with the village of Marylebone; it then took the circuitous course of what is now Marylebone Lane, crossed Oxford Street opposite the end of Davies Street, crossed Brook Street, which was named from this fact, then flowed at the back of Bond Street to Bruton Street. In Bruton Street is a curious circuitous mews, which marks its course, running to the south-east corner of Berkeley Square, whence the Tybourne struck west, dividing Devonshire House from Lansdowne House, where now there is a sunken passage between the garden walls. Thence it reached Piccadilly at its lowest point, and flowed through the Green Park to Buckingham Palace. Here it divided, and reached the Thames near Vauxhall Bridge to the west, and near Westminster Bridge to the east, a smaller delta formed by the eastward branch forming Thorney Island, associated with the palace of Edward the Confessor and the monks of St. Peter’s Abbey.

The _Westbourne_ also rose at the foot of the Northern Hills, flowed through Kilburn and Bayswater, both suggestive names, through the Serpentine to Knightsbridge, another suggestive name, and so to the Thames at Chelsea Bridge, apparently forming by its course the western boundary of the Grosvenor Estate.

These watercourses have all disappeared, because in this Christian country there is no respect for the purity of pure water. They became so swinishly filthy, that for very shame we have covered them up, and when the time arrives for covering up the Thames, which we are so systematically fouling in the same way, I have no doubt that our engineers will be equal to the task.

It is very interesting to follow the course of these old streams, and it will be found that the explanation of the circuitous course of some streets (such, for example, as Marylebone Lane), is explained by their following the line of a forgotten rivulet. Nothing can give us a better idea of the change which has come over London than to go into the City and search for Walbrook or Langbourne, or to come west and look for the Tybourne at the end of Conduit Street and follow its course thence to Piccadilly. I hope that those who amuse themselves by taking such a walk as I have advised, will ponder well upon how much we have lost by being obliged to cover them, and why we were obliged to cover them, and will take a lesson from these reflections. If he does that his time will not be wasted.

In a district so intersected by pure streams, it was an easy matter to have a well of good water, and throughout London there were many such wells. Good water, in fact, abounded on every side, and it is noteworthy that the Romans have left us no remains of gigantic aqueducts, such as they knew well how to construct; for the very good reason that they were not necessary.

The first public waterworks were the Conduits in Cheapside and Cornhill. Those in Cheapside were supplied by the Tybourne, the water of which was captured near what is now Stratford Place, and conducted to the City in leaden pipes. Lamb’s Conduit was another, the name of which remains. This was at Holborn Bridge (a bridge over the Fleet), and its water came from fields near the Foundling Hospital. There were many other Conduits, and it must be borne in mind that local names ending in _well_ generally indicate the position of a neighbouring water source.

When these watercourses were open London was a very different place. The Lord Mayor kept his pack of hounds in those days, and in Aggas’s map, made in the reign of Elizabeth, one may see the “dogge house” in Finsbury Fields, for the Lord Mayor was Lord of the Manor of Finsbury, and here he had his kennels, and frequently he would go a hunting, and when he made his tour of inspection of the Conduit heads at Tybourne, he took his pack with him and combined business with pleasure. Strype records that in 1562 they hunted a hare here, and having dined at the Suburban Banqueting House in Stratford Place, they started out again after dinner and killed a fox. How much inspection the watercourses received on these occasions is not certain.

The first waterworks in London were those constructed by Master Peter Morrys, a Dutch engineer, in 1582. His plan was to utilise the enormous force with which the Thames rushed through the nineteen narrow arches of old London Bridge, and for this purpose the Corporation granted him a lease of the first arch on the City side for 500 years, at a rental of 10s. a year, and two years later the second arch was given on similar terms. In 1701 a third arch was leased to a grandson of Morrys, and at this time the proprietary rights were sold to Richard Soams, a goldsmith, for £36,000, who converted it into a Company of 300 shares of £500 each. In 1761 a fourth arch of the bridge was given to the Company, and two other arches were closed to give additional force to the water-wheels. The passage of the narrow arches of the bridge was at all times difficult, and the process of shooting London Bridge, with a fall of some five feet through the arch, was not without danger. This blocking of the bridge caused great complaints, but, nevertheless, the Company continued to ask for more, and with success, so that in 1767 the first five arches were occupied with immense water wheels, and two arches on the Surrey side were similarly occupied. We gather that the Company at this time also possessed a “fire-engine.” The last wheels were put up under the advice of Brindley and Smeaton. The wheels were of the undershot variety, and by their power 2,000 gallons of water per minute were raised to a height of 120 feet, through a pipe which passed over the tower of St. Magnus’ Church. These wheels continued in use for 240 years, until 1822, when the Act for rebuilding London Bridge caused their removal. The pumping machinery was of its kind excellent, but the mains were very defective, and there was much loss by leakage, and leakage also caused great damage to the bridge. The chief mains ran in Bishopsgate Street, Cheapside, Aldgate, Fleet Street, and Newgate Street. The fact that the London Bridge Waterworks were in use until 1822 is important, as showing that the Thames water up to that time was not so grossly impure as to preclude the possibility of distributing it for household purposes without filtration. It is not conceivable that such a course could be adopted at the present day. The impurities of Fleet Ditch were due to slop water, and to material negligently thrown into it, and it was probable that only during a sharp shower, when the filth of the streets was washed into it, it reached that state of impurity which Swift has described. Water-carried sewage, as we understand it, was not then in common use, and cesspools were not allowed to empty into the sewers; and Public Authorities were not expected to relieve individuals of responsibility and to undertake duties, the satisfactory accomplishment of which is impossible.

The first of the great water companies was the “New River,” constructed by Sir Hugh Myddleton and opened in 1613. This was a conduit on the old pattern, but on a larger scale, and did not involve the use of pumping machinery. It brought the water of Chadwell spring in Hertfordshire, which is 110 feet above ordinance datum, to the New River head at Clerkenwell, whence it was distributed through the City. Many additional sources of water have been added to the original Chadwell spring, and many powerful pumping engines are now in use by the New River Water Company, which is still the biggest of eight metropolitan companies. The areas supplied by the different water companies may be briefly indicated. The “New River” supplies the northern part of the metropolitan area; the “East London,” which dates from 1669, supplies the north-east; the “Kent,” which dates its early beginnings from 1701, supplies the south-east. The “Southwark and Vauxhall” in its present form dates from 1845, the “Lambeth” from 1785, the “Chelsea” from 1723, the “Grand Junction” from 1811, and the “West Middlesex” from 1806.

These eight companies supply about 140,000,000 gallons of water daily (about one half being from the Thames) to 668,525 houses, by means of 145 engines of 17,145 horse-power, through 4,068 miles of mains, and by the aid of a capital of £13,150,318.

It is difficult for us to appreciate such a quantity as 140,000,000 gallons, but we may grasp it better if we imagine this water put into 1,400,000 water-butts, of 100 gallons each, and each 4 feet high. These butts placed end to end would reach considerably more than 1,000 miles, and that, be it remembered, is a statement of the daily water supply of this city, which is certainly well within the mark.

The great fault in the situation of London was the proximity to it on every side of marshy land. The Thames, as I have stated, was formerly much wider than at present. Certain it is that Moorfields to the north was often flooded; to the immediate east and north-east was marshy ground, stretching into Essex; to the west was the low district of Thorney Island, Chelsea, and Fulham, while on the opposite bank of the Thames was the ground around Southwark and Lambeth, which was little better than a swamp, and remained unbuilt upon, except to a very slight extent, until the end of the last century.

Ague is at present a rare disease in London, although one still occasionally meets with cases which are apparently due to local causes. Formerly it was a very potent cause of death, but the discovery of the use of “Jesuits’ Bark,” as Cinchona was at first called, and the gradual and continuous filling up of the soil, combined with drainage, led to its extinction. Possibly the impregnation of the soil with coal-gas may have helped to this end.

MEDIÆVAL LONDON.

Mediæval London was a town in which the clerical element predominated. I have upon the screen a very beautiful drawing which appeared in the _Builder_ newspaper, and which is an imaginative and authoritative reconstruction of the London of Henry VIII., by Mr. W. H. Brewer, whose great talents will be obvious to all who look at his picture. London at that time must have been exceedingly beautiful, filled as it was by grand ecclesiastical and monastic institutions.

The artist’s point of view is from some coign of vantage east of the Tower. In front of him, in the middle distance, forming at once the centre and apex of the picture, is old St. Paul’s, with its lofty steeple towering to a height of 500 feet, and placed on an eminence which enhances its commanding importance.

To the left is the noble river, its broad expanse dotted with many a craft, and forming a superb sweep to the south-west, where it is lost beyond the Abbey of Westminster, which forms the most distant object to the left of the spectator. The chief feature in the foreground is “The Tower,” a noble mixture of military, palatial, ecclesiastical, and domestic architecture. Beyond it, and to the south, is old London Bridge, probably the most picturesque structure of the kind that the world has ever seen, with its quaint houses and graceful chapel, and with the clear water of the Thames roaring through its nineteen narrow arches. On the south side of the bridge is the church of the Priory of St. Mary Overy (St. Saviour’s, Southwark), as it may still be seen, and near it the great palace of the Bishops of Winchester, with the marshy ground of Southwark and Lambeth, and Lambeth Palace in the distance. Running northward from the Tower is the castellated city wall, with its brimming ditch filled with water flowing from the shallow lake of Moorfields. Between the wall and the spectator is a series of grand ecclesiastical buildings, with St. Katherine’s Hospital to the south, and St. Mary Spital to the north, and between them Eastminster or the Abbey of Grace, the Abbey of St. Clare in the Minories, and the church of St. Botolph. Behind the city wall is seen a bewildering wealth of tower and spire and gabled roof.

By the river bank among wharves and quaint mediæval warehouses, St. Magnus’ steeple, the stern towers of Baynard’s Castle, and the buildings of the Blackfriars are conspicuous; while in the same direction, and beyond the Fleet river, is Bridewell Palace, the huge tower of the Whitefriars, the Temple, St. Dunstan’s Church, Exeter House, Arundel House, the Savoy, and York Place. Along the eastern limits of the City are St. Dunstan’s, St. Margaret Pattens, All Hallows Barking, the great Minster of the Friars of the Holy Cross, and the still larger Priory of the Holy Trinity in Aldgate. Near Bishopsgate is the large establishment of the Augustinians, and beyond this again the Grey Friars, the Priory of St. Bartholomew, the Charter House, and the Priory of St. John, Clerkenwell. In the centre of the City is an almost endless array of parish churches, with here and there the high-pitched roof of some guild house, or the residence of a nobleman or wealthy merchant.

GARDENS AND PLEASURE GROUNDS.

These ecclesiastical foundations generally had gardens attached to them, and in the time of Henry VIII. and the subsequent Tudor monarchs, who discouraged building in London, the houses were by no means so closely packed as at present. It is usual to find in walled cities that the houses are packed as closely as possible within the walls; but this most certainly was not the case in London. A glance at Aggas’s or Ryther’s map (a copy of which is given in Mr. Loftie’s admirable “History of London”) will convince one of this. The houses enclose a great deal of garden ground in every direction, especially in the northern and north-eastern portions of the city. It was along the river bank that the crowding of houses was greatest, but even here there were open spaces; and I must remind you that Pepys, who lived in Seething Lane in the time of Charles II., when the crowding in the City had very much increased, makes frequent mention of his garden.

Mr. Loftie tells us that in 1276 an inquiry was held as to the cause of death of one Adam Shott, who had fallen from a pear tree in the garden of one Laurence, in the parish of St. Michael Paternoster, which was close to Thames Street. St. Martin Pomeroy, a church formerly in Ironmonger Lane, is supposed to have derived its name from an adjoining orchard. We know that Sir John Crosbie built Crosbie Place, now a restaurant, in Bishopsgate Street, on part of the land forming the gardens of the adjoining Convent of St. Helen’s. Sir Thomas Gresham’s house in Bishopsgate Street also had its garden, and we know that the College of Physicians had a physic garden, first at Amen Corner, and subsequently in Warwick Lane.

The Priory of the Augustinians, or Austin Friars, included a large tract of land. A part of it was given to the Marquis of Winchester, who built Winchester House, which occupied the site of Winchester Street and Buildings in Old Broad Street; and Drapers’ Hall was originally the house of Thomas Cromwell, who made what till a very few years since was known as Drapers’ Gardens by the simple process of stealing portions from the gardens of his neighbours, they not daring to quarrel with so great and so arbitrary a person. Immediately outside the walls was any amount of open space. The houses of the nobles along the Strand had each of them its ornamental garden. The Templars had their garden, which still remains. The Priory of St. Bartholomew had its garden; the Carthusians at the Charterhouse had their garden. Hotspur lived in Aldersgate Street, Prince Rupert lived in Barbican, and the dismal spot now known as Bridgewater Square was once occupied by the Earl of Bridgewater’s house and garden. Old Gerard, the herbalist, had his garden in Holborn, where he raised the potato, and he superintended Burleigh’s garden in the Strand. Hatton Gardens were famous when Sir Christopher Hatton lived there in state. Gray’s Inn Garden was planted by Francis Bacon. Grocers’ Hall had its garden, with hedge-rows and a bowling alley. The Merchant Taylors, the Ironmongers, the Salters, and the Barber-Surgeons had each of them gardens attached to their halls. The chief garden, or pleasure ground, for the citizens was Moorfields. This was originally a wild, undrained place, which extended from the City wall right away to the villages of Islington and Hoxton. According to Loftie, it appears that in 1274 the citizens called in question certain Acts of the previous Mayor, one Walter Hervey. They accused him of certain “presumptuous acts and injuries,” and the first of these appears to have been that “He had not attended at the Exchequer to show the citizens’ title to the Moor.” From this it would appear that over 600 years ago Moorfields was regarded as a common for the use and enjoyment of all, and it appears to have been used more or less for these purposes down to the close of the last century, and it is to be found in all maps. Moorfields was used for archery and for exercising the train-bands, that is, it was so used after it was drained, which was first attempted in the fifteenth century. At one time, the people living near Moorfields put up fences and showed a disposition to encroach on the moor, but the citizens, taking the law into their own hands, levelled the obstructions. When Moorfields had been drained, a part of it was planted, and it became a fashionable promenade, and in some maps it is shown as planted with intersecting avenues. According to Mr. Denton, the historian of Cripplegate, the northern part of Moorfields was the property of the Dean and Chapter of St. Paul’s being leased merely to the Corporation, together with the Manor of Finsbury. The southern part, however, was, according to the same authority, the gift of Catherine and Mary Fynes to the City Corporation in trust for the citizens. Finsbury Square was built on the northern part in 1768, and finally, in 1812, the Corporation obtained an enabling Act from Parliament and put Finsbury Circus on the lower half, and thus perished the People’s Park after existing 800 years. The building upon this open space was a very short-sighted policy, and it says very little for the spirit of Londoners that such a policy was able to be carried out. The first encroachments on Moorfields took place, probably, after the fire, when thousands of citizens were homeless, and the Moor was used as a temporary place of encampment. Many of the houses then erected appear to have been fairly substantial, and it is probable that encroachments having been made in consequence of a sudden and dire necessity, and possession being nine points of the law, the City of London lost its park. Part of Moorfields had been used during the plague as a plague pit, and towards the end of the 17th century the great burial ground for dissenters, Bunhill Fields, was here established. The Artillery ground, once the exercising ground of the train-bands, still remains, and it is fortunate that the extinction of the Honourable Artillery Company has been averted and has not resulted in this “eligible building plot” being leased at so much a square foot.

Moorfields is gone, the Drapers’ Garden is gone, and the wealthy City of London has now the proud distinction of being without any public recreation ground within its limits.

It is true that the Corporation has bought Epping Forest, in the county of Essex, and Burnham Beeches, in the county of Buckinghamshire, and all honour to them for so doing; but it must be remembered that a third-class return ticket to Loughton, the centre of Epping Forest, costs 1s. 7d., and that to go from and return to Fenchurch Street takes one and a half hours, while a return third-class ticket from Mansion House to Slough, which is, I think, the station for Burnham Beeches, costs 3s. 6d., and the journey to and fro takes four hours at least, so that if each of the 51,000 people who reside in the City pay one visit to each of their parks, they would do so at a minimum cost of nearly £13,000, and at a necessary loss (collectively) of 281,000 hours, which at 3d. an hour means an additional £3,500.

It is at least doubtful whether, if Moorfields could be restored as a playground for the City, it would not be of more use to the City, from the point of view of the health of those who dwell in it, than are the Essex and Buckinghamshire estates. Almost every inch of available ground in the City has been built upon. Goodman’s Fields, once a farm where Stowe used to buy three pints of milk for a halfpenny, is now covered with houses. Spitalfields was once an open space, but it is an open space no longer. Paternoster Square has its centre packed with buildings, and for aught I know there is nothing to prevent the occupation in a similar way of the centres of Finsbury Square and Circus, Lincoln’s Inn Fields, the Gardens of the Temple and Gray’s Inn, of Russell and Bloomsbury Square, and, in short, of every inch of green that can be turned into money.

The gradual obliteration of open spaces in London is seen not only in public and semi-public spaces, but also in the curtilage of private houses. Before the introduction of our modern system of sewerage and water supply, it was not possible to build houses without adequate curtilage for a well and the bestowal of refuse, and this obvious fact is borne out by a reference to the maps of 1558, 1658, and 1720, which are hung upon the screen. It is noteworthy that Newcourt’s map of the time of Charles II. shows that the houses in the City were much more closely packed than in the time of Elizabeth, and it is probable that just before the Plague and the Fire the crowding of houses was excessive.

The diagram (p. 23) shows the growth of London between 1560 and 1889. The notable features being (_a_) the very rapid extension of the London area since 1815, and (_b_) the fact that the marshy land south of the Thames has only been covered with buildings within comparatively recent times. The frontispiece is a reproduction of part of Newcourt’s map (1658) showing that the houses in the centre of London were very densely packed. It also shows the position of Moorfields, and the Drapers’ Garden, which are alluded to in the text.

HEALTH OF OLD LONDON.

That mediæval London was very unhealthy there is no question, but whether it was more or less unhealthy than other cities of the time is doubtful. It would be difficult, however, to conceive a worse state of public health than that prevalent in old London.

Exact information on the subject is not to be had. It was not till 1593 that deaths were registered and published by the parish clerks, but the record of deaths without a knowledge of population does not make it possible to hazard even a guess at the death-rate.

The Parish Clerks’ Bills of Mortality show clearly that from 1593 to the year 1800, _i.e._, for 207 years, the deaths invariably exceeded the births, and often to an enormous extent, the maximum being reached in the memorable year 1665, when the deaths were 87,339, as against 9,967 births. Taking the whole of the 18th century, it would appear from a table given by Henderson, in the “Encyclopædia Britannica,” that of the births and deaths registered, the excess of the latter averaged about 6,000 a year, or 600,000 for the century. At one time leprosy was common in London, and we know that in the reign of Edward III. the “black death,” which was probably plague, committed frightful ravages, and is said to have killed 100,000 in London; and this scourge reappeared at intervals up to the year 1665, the mortality then being enormously in excess of the very high mortality which was habitual.

Between 1485 and 1551 there were epidemics of the sweating sickness, a disease different from plague but scarcely less deadly.

We all know what epidemics of plague and sweating sickness did for London, but it may be thought that epidemics are accidental visitations, and are no criterion of the general health of the city. The numbers I have quoted from Henderson will make it impossible for us to believe that old London was at any time healthy, not even after the fire and the rebuilding.

What were the chief ordinary diseases of London? This question may be answered by reference to the bills of mortality. I will take the year 1661, when 19,771 deaths were registered by the parish clerks, and will note those diseases which are credited with more than 100 deaths. These were: Abortive and still-born, 511; chrisomes and infants, 1,400; ague, 3,490; dysentery (bloody flux, scouring and flux), 314; childbed, 224; aged, 1,302; apoplexy and suddenly, 108; colic, 186; consumption, 3,788; convulsions, 1,198; dropsy and tympany, 967; flox and small-pox, 1,246; griping in the guts, 1,061; jaundice, 141; imposthume, 160; measles, 188; rickets, 413; rising of the lights, 227; spotted fever and purples, 335; stopping of the stomach, 170; surfeit, 212; teeth and worms, 1,195. Looking at the table, and using the best of my judgment in interpreting it, I should say that about one-fourth of the deaths were due to the accidents of parturition and the diseases of infants, and another fourth due to fevers. It is to be noted also that plague is answerable for 20 deaths, although this was not a plague year.

What were the causes of the high mortality in Old London?

The situation was not healthy because of the marshy surroundings of the city. Ague and dysentery were always present, and were terribly fatal. Not only was the ground around the city marshy, but it was probably filthy as well. The old town ditch was used as a receptacle for all kinds of filth, and the cleansing of it was a great work, which was only occasionally undertaken. When Moorfields was drained, and the other marshy districts improved, one great cause of sickness disappeared.

The city itself was certainly as foul as could be. The streets were unpaved, or paved only with rough cobble stones. There were no side walks. The houses projected over the roadway, and were unprovided with rain-water gutters, and during a shower the rain fell from the roofs into the middle of the street. These streets were filthy from constant contributions of slops and ordure from animals and human beings. There were no underground drains, and the soil of the town was soaked with the filth of centuries. This sodden condition of the soil must have affected the wells to a greater or less extent.

The streets were filthy without, the houses were filthy within. The rooms of the poor were more like pig-styes than human habitations, unventilated, and strewn with rushes, which were seldom changed; and the wretched inhabitants closely packed in these miserable hovels must have become very prone to suffer from infection of all kinds. Another great cause of unhealthiness was the diet, which amongst the poor was composed largely of salt meat and fish, and with an absence of fresh vegetables, so that many of the inhabitants must have been on the verge of scurvy. The potato was not imported till the end of the sixteenth century, and the eighteenth was well advanced before it became a common article of diet. Much of the improvement in public health of late years is due to this wholesome and easily stored vegetable. In the days of Elizabeth the children of Christ’s Hospital were often ill from scurvy, and it was not till 1767 that the potato was introduced into the dietary of St. Bartholomew’s Hospital.

A most important factor in the causation of disease was the moral condition of the population, which was very low, and marked by superstition, ignorance, and brutality. An age when even the better classes crowded into Smithfield to see some poor wretch burnt; when the most brutal punishments were inflicted for comparatively slight offences; when kings beheaded their subjects and even their wives, almost as a matter of course; when the ghastly heads of executed persons stared from the city gates; when religious-minded Puritans could do nothing with a misguided king but behead him; and when restored “monarchy” exhumed the dead bodies of political offenders in order that it might wreak an unmeaning vengeance on a corpse; and when even ladies in good positions in society flocked to see these sickening exhibitions,[A] was not an age in which the nobler feelings of Christianity were easily evoked; and without these feelings, measures for securing public health, which cannot be fostered except in connection with public decency, found no place among the ideas of governors or governed.

[A] “To my Lady Batten’s; where my wife and she are lately come back again from being abroad, and seeing of Cromwell, Ireton, and Bradshaw hanged and buried at Tyburne.”--“Pepys’s Diary,” Jan. 31, 1660-61.

The public amusements were many of them brutal and cruel. Tournaments were less brutal than bear-baiting, bull-baiting, and cock-fighting, because they fostered animal courage; but animal courage it most distinctly was.

Fitz-Stephen mentions the drunkenness of the population in the 12th century, and there can be little doubt that when beer was the only drink--the drink which Queen Elizabeth took for breakfast--a state of fuddle from drink must have been exceedingly common. From Chamberlayne’s “Present State of England,” I gather that in the year after the Fire, 452,563 barrels of strong beer, at 12s. 6d. the barrel; 580,420 barrels of ale, at 16s. the barrel; and 489,797 barrels of small beer, at 6s. 6d. the barrel, were consumed in London, which (if we take the population at that time at 500,000) allows about three barrels, or 108 gallons, or some 1,440 pints per head per annum.

Again, Chamberlayne, speaking of the causes of the Great Fire, mentions: 1. “The drunkenness and supine negligence of the baker and his servants in whose house it began. 2. The dead time of night wherein it began, when some were wearied with working, others filled with drink, and all in a dead sleep.”

The brutality of the people’s amusements continued down to the end of the last century, and later. Thus in Pink’s “History of Clerkenwell,” I find the following advertisement culled from a journal of 1716:--

“At the Bear-garden at Hockley-in-the-Hole, at the request of several persons of quality, on Monday the 4th of this instant of June, is one of the largest and most mischievous bears that ever was seen in England to be baited to death, with other variety of bull-baiting, and bear-baiting; as also a wild bull to be turned loose in the Game Place, with fireworks all over him. To begin exactly at 3 o’clock in the afternoon, because the sport continues long.”

Close by, in Spa Fields, female prize fights were held, and there is a lively account of one of these encounters in which “Bruising Peg” terribly damaged her antagonist. In such a time, of course, foot-pads abounded, and it was not without danger that persons crossed Spa Fields after dark; and those who were invited to Sadler’s Wells, to see a man eat a live cock, feathers and all, for a wager of £5, were informed that the New Road and City Road would be patrolled, and that the return home would be without danger.

Such facts as these, which I could multiply to any extent, show the rough moral condition of the populace, and I believe that, with such a state of moral feeling, any real improvement in public health was impossible.

Another cause of the high death-rate was superstition, which regarded disease as a “visitation” which had to be borne without question or inquiry.

With such an attitude towards epidemics, which by some were regarded as due to an unfortunate conjunction of certain planets, it is not to be wondered at that the epidemics were mismanaged; and it is certainly difficult to imagine any measure better calculated to cause the spread of the plague than that of forbidding those affected to leave their houses, and compelling them to stay indoors and infect the rest of the household. The most efficient of all measures which we nowadays adopt for preserving the public health is that of the instant separation of the sick from among the healthy, a plan which had been adopted in old time in the case of “leprosy,” and which we re-introduced in the last century, when the first small-pox hospital was built.

Another great cause of the high mortality was the ignorance of the physicians, who were almost as superstitious as the populace, and who were entirely without any exact or correct knowledge of their art, which they practised almost entirely by the light of the old Greek, Roman, and Arabian writers.

To recapitulate, the causes of the high death-rate were probably the following:--

1. The prevalence of ague from the abundant marshes.

2. The dirt of the city and the houses, and the probable infection of wells from a soil sodden with putrefactive matter.

3. The ill-nourished, drunken, and scorbutic condition of the people, and

4. Their condition of superstition and brutality, which made any rules for public health impossible.

5. The neglect to separate the infected from the healthy.

6. The ignorance of the doctors.

We may get some idea of the state of public health during the sixteenth and seventeenth centuries by a reference to the families of monarchs.

The difficulty of rearing children was very largely experienced in royal families. I have, by the help of Burke’s “Peerage,” made a list of all the children of monarchs (other than those who ascended the throne) whose ages at death are given by that genealogist.

This difficulty of rearing children, which began in the reign of Edward III., becomes very marked with the reign of Henry VIII., who, as we are told by Froude, was disappointed by a succession of still-born children borne to him by his first wife.

Of the children of James I., three out of five died under 3; of the children of Charles I., the ages at death were 29, 26, 20, 15, 4, 1; of eleven children of James II., by two wives, one (the old Pretender) attained the age of 78, and of another the age is doubtful, but eight died under 4, and two others died at 11 and 15; of the six children of Anne, one reached the age of 11, and the remaining six died under 1 year.

With the accession of George I. this difficulty of rearing royal families appears to have ceased, having been more or less marked during the reigns of 21 monarchs, intervening between Edward III. and George I. What the cause may have been I will not discuss, but I mention the fact because it is probable that causes which affected kings affected subjects also.

There can be no doubt that down to the commencement of the present century London was a veritable fever-bed, the causes of death being largely malarial fever, spotted or typhus fever, plague, small-pox, measles, scarlet fever, and whooping-cough, the two latter being comparatively recent introductions.

THE LONDON “DEATH RATE.”

The present writers on London, like their predecessors, are loud in its praises and blind to its defects, and they point to a figure which is called “the death-rate,” and ask us to accept it as evidence that the state of public health in London is as good as can be.

It is quite true that the death-rate of London is low, and that it is not much in excess of the country at large, and is very much below that of some of the big towns scattered through the kingdom. Nevertheless, before we accept this figure and rest contented with it, we must take several facts into consideration.

1. The London of the Registrar-General is very extensive, and no small part of it is rural or semi-rural in character. Many of the dwellers in Lewisham, Wandsworth, Fulham, Hampstead, Hackney, Greenwich, Camberwell, and Woolwich, can hardly be looked upon as dwellers in a city, and it must be remembered that the death-rates in these districts, which contain only from 40 to 8 persons to an acre, tend very materially to reduce the death-rate of the whole town.

2. London is very largely a city of wealthy and well-to-do people, most of whom must be looked upon as sojourners rather than dwellers in the city. Among such as these, who can command every luxury and necessary of life, including change of air, death-rates ought to be low. It is manifestly unfair to contrast the death-rate of St. George’s, Hanover Square, or Kensington, with the death-rate of a town packed with the wage-earning class.

3. The mobility of the London population is so great that it must vitiate any statistics bearing on the health of the inhabitants. “Londoners” are a mixture of races, recruited from every clime from China to Peru. They are, as the phrase goes, “Here to-day and gone to-morrow,” and probably no one fact quickens their departure more than ill-health. I am told by the proprietor of Kelly’s Post Office Directory that the annual correction of addresses amounts to about ten per cent. of the whole, so that the London population shifts on an average completely every ten years, even among classes who have far more stability than the labouring classes. It is also well to point out that these changes in the Directory do not represent all the changes, because in trade it is common for new individuals to trade under an old and established name. I find, on comparing the Directories of 1880 and 1889, that in my own street of 96 houses there have been 87 changes of names, and that 96 houses are now credited with the addresses of 140 individuals, whereas in 1880 the individuals numbered 120.

4. Still more important, as vitiating the value of the “death-rate,” is the abnormal age distribution in London. In London (and especially in the central portions of it) there is a great deficiency of young children and old people, among whom the death-rate is always highest; the population of London is largely composed of selected adults imported from the country, among whom the death-rate ought to be low.

5. The continued low death-rate of London is very largely accounted for by the diminishing birth-rate. Thus the birth-rate for the ten years 1877-86 averaged 34·4 and the death-rate 21·2, while for the year 1887 the birth-rate was 31·6 and the death-rate 19·5. This is a diminution of 2·8 per 1,000 of population in the birth-rate. This, in a population of 4,250,000, means a deficit of 11,900 children; and as out of every 1,000 children born in London in 1887, 158 died before they were one year old (_i.e._, 13 per 1,000 more than in England as a whole, and 66 per 1,000 more than in the county of Dorsetshire), it is evident that this diminution of the birth-rate entails a deficit of 1,940 in the total deaths occurring in London in the year. It is clear from this that in taking account of a diminishing death-rate we have to take into consideration the diminishing birth-rate also.

These considerations make it very doubtful whether the death-rate of London is of much value, as indicating the amount of disease in the City. Even if we accept it we must not draw any hasty conclusions that the disease-rate bears any definite proportion to the death-rate. There may be much disease with comparatively few deaths, as was the case with the scarlet fever epidemic of last year, and there can be no doubt that the improvement and extension of medical knowledge has very largely diminished the death-rate of those who are sick. Further, an enormous proportion of those who fall ill in London return to the country to die.

A fact which must throw considerable doubt on the healthiness (_i.e._, a real vigorous and robust condition, which is the true meaning of health) of the population is the amount of sickness, as evidenced by the ever-increasing work which is thrown upon the hospitals.

According to a table which was published last June in _The Hospital_, it appears that in 1887 there were treated in the London hospitals 79,261 in-patients, and 1,180,251 out-patients, or a total of 1,259,512 persons, excluding those who received relief in the hospitals belonging to the Asylums Board (and these were very numerous, owing to the epidemic of scarlet fever), the workhouse infirmaries, the lunatic asylums, and idiot asylums. Thus it appears that in a city whose death-rate was very low more than 25 per cent. of the population had recourse to the hospitals for relief. We must therefore conclude that the death-rate and the disease-rate bear no fixed ratio to each other, especially when we consider that between 2,000 and 3,000 medical men found sufficient work among the population to furnish them with an income. If deaths be few in London, it is clear that second-rate health is by no means exceptional.

IMPROVED CONDITION OF MODERN LONDON.

Although we have to make many allowances, and take many things into consideration before we can estimate the true value of the London death-rate, it is, of course, undeniable that an enormous improvement in the health of the City has taken place since the beginning of the present century. To what is this due?

The chief cause is the increase of knowledge as to the modes in which diseases are spread. Our knowledge of the mode in which small-pox, scarlet fever, cholera, and typhoid are disseminated has led to the establishment of fever hospitals, and to the improvement of the water-supply, and the inspection of dairies. It is not only that the knowledge of doctors has increased, but what is more important, this knowledge has spread to the public, and as “self-preservation is the first law of nature,” the public has assisted in protecting itself.

The practice of vaccination, and the dealing with epidemics by the method of isolation, have also materially assisted in diminishing the death-rate.

Another very important point is the disappearance of malaria. Drainage, the filling up of low-lying places, and extensive building operations, have banished malaria from our midst, and this, be it remembered, was not only a cause of death in itself, but probably tended to make other diseases more deadly. It is conceivable that the impregnation of the soil by coal-gas may have helped to stop the growth of noxious microbes which make the soil their habitat.

Again, our system of sewers, which has carried filth away from the dwellings, has probably assisted in improving the public health. That sewers have done and are doing much harm as well as good is undoubted, but it is probable that the balance is so far in their favour. For the present typhus fever has disappeared, and this is probably due to two causes--first, the prompt separation of the sick from the healthy, and secondly, to the fact that we have had no scarcity for some years. Typhus is due to overcrowding and want. I have drawn up a scheme which shows by a curve the average price of wheat from the year 1800 to 1886. From this it appears that the staple article of food has, broadly speaking, and with some considerable fluctuation, fallen steadily in price from 1812 to the present time, when it is at its minimum. Not only wheat, but all articles of food and clothing, and also fuel, have of late years been getting steadily cheaper; potatoes and other vegetables are in common use among the masses, and thus we have kept away famine diseases, and also that taint of scurvy, which was undoubtedly a great cause of ill-health in the middle ages. A most important fact has been the removal of the in-take of the water companies to a part of the river containing less sewage than that between the bridges. It is not enough to be able to rejoice in a small death-rate. We ought to be able to look ahead and feel that to the best of our knowledge there is no probability of the return of a high one, and that our sanitary arrangements having been set a-going, will continue _propriâ motu_. We have to remember that diseases disappear or become unimportant, and that others become prominent. In our own day we have seen the rise in importance of diphtheria and enteric fever, and just at present we seem to have lost sight of typhus, for a long time the most important of the febrile diseases. “Leprosy,” which was at one time common in London, has practically disappeared. Plague, sweating sickness, and malarial fever have also gone. Whooping-cough was not recognised till the end of the sixteenth century, and could not, therefore, have been as common as it is now. In like manner, scarlet fever was not distinguished from measles until the seventeenth century, and from that fact we may infer that there could have been no epidemics of it, although we must remember that in the great crowd of fevers it must have been hard to distinguish individuals. The fact that diseases wax and wane must be borne in mind, and should prevent us from indulging in a feeling of false security.

WHAT IS THE OUTLOOK?

Judged by our present standard of knowledge, have we a right to hope that London is likely to remain free from epidemics?

There are certain facts which make me seriously doubt the permanence of the present state of health in London.

The first of these is the fact that some of our hygienic measures have tended to produce overcrowding of houses, which is infinitely the greatest of all sanitary evils. Formerly the sanitary arrangements of houses were such that without some garden or back premises they would have been uninhabitable, and a reference to Aggas’s map, or Norden’s map, or Newcourt’s map, will show that in Old London a large proportion of the houses had gardens or back premises large enough to be shown on a map. These maps also show that in Charles II.’s time, just before the plague, the overcrowding of houses in London was much more marked than in the days of Elizabeth. When every drop of water and all the fuel used had to be carried to the upper storeys by hand, there were practical inconveniences attending upon very high houses which prevented them from being built to any great extent. Now all is changed. Our system of sewerage has made it possible to build houses with no curtilage whatever, and with no outlet but a hole, and the possession of a high pressure of water (the result of steam power) and the modern system of gas has made it possible to have houses of any height, without any great inconvenience to the occupants. “Five hundred rooms, passenger and luggage lifts to every floor, 1,000 electric lights, hot and cold water laid on to every room, bath-rooms on every floor,” is the kind of advertisement put forward by an eight-storeyed hotel without an inch of curtilage. Without steam power, without water under pressure, and without water-carried sewage, such Yankee monstrosities were not possible, whereas nowadays the loftier the hotel so much the greater is the profit, because extra storeys do not increase the ground-rent.

On the other hand, the fact that houses can be and are allowed to be built without curtilage has given an altogether fictitious value to land, the price of which varies in this country (according to situation) from about £200,000 to £10 per acre. It is not surprising that the bias of landlords and builders is very much in favour of our present system of Sanitation. Sanitary authorities are also in favour of it because, having borrowed enormous sums of money, which have to be paid out of the rates, they are naturally quite regardless of hygiene if they can increase the rateable value of the district, and so make the burden of rate-collection lighter. “Black care (in the form of rates) sits behind the councillor.” Everywhere throughout the metropolitan area houses are being pulled down and replaced by others twice as high; extra storeys are being added to old houses, and back-yards and gardens are fetching enormous prices for building purposes, so that the buildings in the centre of London have doubled their height and have lost all their curtilage.

Huge thoroughfares have been driven through London in all directions, but as the ultimate increase in the height of the buildings has been proportionately greater than the increase in the width of the street, locomotion has become more difficult, our traffic has become more in need of police regulations, and it has become an acknowledged rule in the City that if you want to keep an appointment it is dangerous to take a cab, because one can thread one’s way with more certainty on foot.

And yet the overcrowding in London does not appear in official documents. Thus the City of London, on an area of 668 acres, in 1871 had 9,415 inhabited houses, and 3,222 uninhabited, and a population just short of 76,000; whereas in 1881 the inhabited houses had fallen to 6,562, the uninhabited had risen to 4,770, and the population had fallen to 51,439. Some historian of the future may draw the conclusion that the decay of London set in acutely about the year 1871, unless he should perchance discover that within the same period the rateable value had risen from £2,500,000 to £3,500,000; that the day population had risen from 170,000 to 260,000, and that the number of persons entering the City daily for business had risen from 657,000 to 739,000. This population is one mainly of adult males, and since, if they get ill in the City they don’t die in it, the death-rate keeps down, and we like to think it is a wholesome place for a young man to work in. The 50,000 people who have to live night and day on this square mile of ground have not a very cheerful time in this wealthy city, where nature has been most effectually obliterated by the brute force of the almighty dollar. What chance have they of any fresh air with a radius of houses extending to five miles all round them? At one time the Thames served as a recreation ground, but that was in the days before the tide rolled in charged with the excrements of 4,000,000 people, and when it was possible to fish and boat, and perhaps catch a salmon, without the danger of being sunk by some headlong steam-tug. Until a few years ago there was a little green spot called Drapers’ Gardens, but now Drapers’ Gardens is occupied by Throgmorton Avenue, where dwell 322 different firms of stockbrokers and others, and the nearest recreation ground is St. James’s Park, three miles off.

I have lately seen a young man, aged 21, with signs of incipient consumption. He is a fine young fellow, and three years ago entered one of the large City warehouses connected with the drapery trade, in the centre of the City. At first he was employed mainly in the basement, where gas was burning all day. During times of extra pressure he often worked from eight in the morning to past midnight, and when he retired to rest he had to share a bedroom with other men, the windows being shut. I believe this is no uncommon case, and I commend it most heartily to the attention of the “Sweating Committee.” Occasionally on a Saturday afternoon he got a game of football, his very slender resources being severely taxed to pay the railway fare to the spot where the games are contested.

What has occurred in the City has occurred elsewhere in London.

I need hardly say that the crowding of houses means loss of liberty, and increases competition--that competition is the cause of “sweating” and other miseries. Having wilfully produced these evils, I for one do not believe that they are to be removed even by the best intentioned efforts of city missionaries, nor by young men’s Christian associations, nor even by music halls, though tea be the beverage and hymn tunes the melodies.

We have to bear in mind the fact that all writers on sanitary matters are agreed that of all dangers to health, overcrowding is the greatest, and that the death-rate rises in proportion to the density of population. When, therefore, we allow building to go practically unchecked, and move the poor out of two-storeyed dwellings into six-storeyed barracks, we must remember the possible drawbacks of such a system.

The death-rate of Paris is higher than that of London (it was nearly 26 per 1,000 in 1881), but the density of population in Paris is twice that of London, being 117 to the acre, as against 50 in London. Some parts of Paris are very much more crowded than any parts of London, and no parts of it have a density of population so slight as Fulham, Hampstead, Wandsworth, Woolwich, or Lewisham. The effect of overcrowding on death-rate is seen very markedly in the city of New York, which has a population of 1,337,000, which has an almost unlimited water-supply, and the sewage of which is discharged direct into the sea. According to the writer in the “Encyclopædia Britannica,” there is an excessive crowding of the inhabitants into tenement houses, and the houses are to a great extent without back entrances. As a consequence, the death-rate was 26·47 in 1880, 31·08 in 1881, and 29·64 in 1882.

In overcrowded places the danger is great when contagious disease makes its appearance. The spread of such diseases as typhus, measles, and whooping-cough is very much favoured by overcrowding.

I have prepared a table, taken from the Registrar-General’s decennial abstract, which shows this fact very clearly with regard to London. I have arranged the various registration districts of London according to the density of population, and in another column I have given the death-rate per 100,000 from whooping-cough and measles, two diseases which are rarely treated in hospitals, and which are very prone to follow each other in epidemics, so that when we have not measles with us we have whooping-cough, and _vice versâ_.

ANNUAL DEATH-RATE PER 100,000 LIVING OF CHILDREN UNDER 5 YEARS OF AGE FROM WHOOPING-COUGH AND MEASLES DURING THE 10 YEARS 1871-80.

Death-rate per District. Persons to 100,000 from an acre. Measles and Whooping-cough. Westminster 250 1089 St. Giles 200 1152 Holborn 200 1229 Shoreditch 200 1099 Whitechapel 200 1020 St. George’s, E. 200 1327 Bethnal Green 166 1113 Mile End 143 982 St. Saviour’s, Southwark 143 1150 Stepney 125 1220 St. Olave, Southwark 111 1091 Marylebone 100 1145 Strand 100 987 City 100 963 Chelsea 91 856 St. George’s, Hanover Square 83 974 Pancras 83 1046 Islington 77 965 Kensington 66 992 Poplar 59 985 Lambeth 59 960 London as a whole 50 967 Hackney 40 698 Camberwell 35 879 Greenwich 35 778 Fulham 23 850 Hampstead 17 701 Wandsworth 15 701 Woolwich 12 794 Lewisham 6 546 County of Dorset 3 352

The above figures show the effects of overcrowding, on the mortality from two important diseases, very conclusively; and it is interesting to note how very far the mortality from these two diseases in Dorsetshire is below that of even the best parts of London.

Among other diseases which are very common in London are the tubercular and respiratory diseases. Thus the mortality from scrofula, tabes mesenterica, phthisis, and hydrocephalus in London, during the ten years 1871-80, was (collectively) 349 per 100,000 (no correction being made for abnormal age distribution), as against 224 in Dorsetshire, and the death-rate from respiratory disease was 460, as against 315 in Dorsetshire. During the fifteen years 1872-1886 I find that 34,254 in-patients have been treated in University College Hospital. Of these, 3,798 were cases of respiratory disease, and 2,453 were cases of disease of bones and joints, a very large proportion of which, according to recent investigations, are tubercular. Thus we have 6,251 cases of disease (or more than 18 per cent. of the whole) in which tubercle plays an important part.

There were also 459 cases of enteric fever, 276 cases of diphtheria, and 1,020 cases of rheumatic fever. These, taken together, amount to 1,755, or about 5 per cent. of the whole. Rheumatic fever is one of the common diseases of London, which attacks young adults, and very often cripples them for life. It is a disease of great importance, and appears from the last report of the Registrar-General to have been on the increase since 1858.

Besides the greater liability to premature death which is caused by overcrowding, there are other drawbacks which are scarcely less important. One of these, with which we are well acquainted in London, is an increase in the dirtiness and smokiness of the air, which is mainly due to private fireplaces. When huge piles of offices are run up in the City or elsewhere, we like to imagine that, because most of them are tenantless at night, they cause no inconvenience, forgetting that each office has its fireplace, which helps to foul the air, and that each office supplies its quota of sewage to help to foul the river. The state of the air in London is such that the most beautiful of all arts, gardening, has become impracticable from the fact that comparatively few flowers or shrubs will flourish. This absence of green plants entails a great loss of nascent oxygen or ozone, which gives to air its peculiar quality of freshness. It is hardly conceivable that a high level of health can be maintained in a spot where vegetable life languishes, animal life and vegetable life being complementary to each other.

The overcrowding in London has, of late years, been mitigated by the conversion of old grave-yards into gardens, thanks to the society over which the Earl of Meath so ably presides. If cremation as a means of disposing of the dead should become general, and spacious cemeteries be replaced by furnaces, it is clear that these spaces bequeathed us by the dead will not be available for “lungs” in the London of the future, and that cremation, unless it be counteracted by suitable legislation, is certain to intensify our state of overcrowding.

The moral side of overcrowding must not be forgotten, but it is not necessary to dwell upon it, as the Whitechapel horrors are still fresh in the memory, and the difficulty of detecting crime in a labyrinth of hiding-places has been demonstrated. The first aim of a sanitary authority should be to prevent overcrowding, and its most important duty is to control building operations, a duty which is never performed because buildings help to pay the rates.

THE LOOSE END OF OUR SANITATION.

Another reason why it is not possible to regard the present sanitary condition of London with much complacency arises from the fact that our sanitarians have failed to “make both ends meet,” but have left a terrible loose end to their measures, which is a constant menace and an increasing danger.

This “loose end” consists of a daily allowance of 150,000,000 gallons of sewage, which our new councillors have inherited from the late Board, and which is the result of probably the greatest sanitary blunder ever committed in the history of the world. The proper destination of organic refuse is the soil. Nobody doubts this. Why, therefore, in a moment of weakness, did we construct six millions’ worth of machinery to throw it in the water? The great glory of London, time out of mind, has been the Thames, but now certainly our glory has departed. Having adopted a method of sanitation which is based on an utterly wrong principle, the condition of the Thames must get progressively worse as long as that method is pursued.

Some persons talk of a sewage farm as a remedy, but at least 50,000 acres of land would be necessary, and, to say the least of it, that is not a cheerful outlook for the ratepayer in these days of agricultural depression.

At present we are spending £50,000 a year on chemical abominations to mix with the other abominations, but it is very hard to see how that can improve matters. The chemicals will certainly not help the fishing industry, and if added in sufficient quantity they must absolutely destroy the very small manurial value possessed by the sewage or its sludge. My own belief is that the sewage problem in its present form is insoluble. To deal with and filter slop-water, as is done in Paris, is comparatively easy, but here in London the problem is of a wholly different kind, and my firm conviction is that our present system of “water-carriage” must lead us deeper and deeper into the mire.

Until the problem of “What to do with our sewage?” is settled, clearly, we ought to do our best to stop the growth of the evil. Our present system of sewers ought to be closed as far as permission to connect fresh houses is concerned. As it is, the new Council, like the old Board, will have an uncertain quantity of sewage to deal with, for old houses are being everywhere pulled down, and houses of greatly increased capacity erected, and this of course means a proportionate increase in the sewage to be disposed of. In the City there are but 50,000 inhabitants in the official sense, but there are by this time fully 300,000 daily workers and over 700,000 daily visitors to the City, so that, in spite of an official decrease in population, the increase of sewage from that particular spot must be enormous. The same class of facts applies to other districts in the metropolis, so that the evil at the outfall is not only not improving, but is increasing daily. It seems to me quite impossible to make any arrangement for adequately dealing with the sewage of a district, unless you are able to say beforehand what is the maximum quantity which will have to be dealt with. There being no adequate control of building in London, and no relation between the cubic contents of a building and the area it occupies (witness Queen Anne’s Mansions, the huge pile with which we are threatened at Knightsbridge, and the equally large pile projected in the Strand, which is to be 135 feet high, according to the newspapers), it is evident that the volume of sewage to be dealt with may be doubled or trebled without any increase of the area drained by the sewers. Under such conditions as these the sewage problem may well be insoluble. The first and main duty of any sanitary authority should be to exercise a wise control over building. If every house were compelled in the future to have a curtilage bearing a definite proportion to the cubic contents, there would be an end of these towers of Babel, which shut out from us the light and air of heaven; the price of building land would fall; it would be possible to make some calculations as to sewage; and the excessive overcrowding of a city would be prevented. Without such a regulation great sewage schemes must in the end make the sanitary condition of a city worse rather than better.

What to do with our sewage is a very difficult problem--an insoluble problem, I believe, on the present lines. At present the Metropolitan Board is shipping some of the solid matter to be dropped into the sea at the mouth of the Thames. When the Thames Conservancy see this fine ship, “built in th’ eclipse, and rigged with curses dark,” bound on its mission of blocking the port of London, what can they think? They think it worth while, apparently, to have a man fined for throwing a basket of rubbish over one of the bridges.

Again, the House of Commons passed a stringent Act to prevent the pollution of rivers, but when, a year or so since, their own sewage arrangements were at fault, they merely constructed an ingenious apparatus to thoroughly suck the sewage out of their own premises and pass it on more effectually than before to pollute the river on whose bank their stately palace stands. What is the good of legislation without example? If the House of Commons, at some sacrifice (more fancied than real) of personal convenience, had adopted measures in accordance with the spirit of their legislation, I believe we should have been within a measurable distance of seeing the Thames once more meriting the name of silvery. A good example is better than any amount of legislation, and a good example set in high places is much needed in this matter, to which there is undoubtedly a moral side.

How to alter the present arrangements in London now the houses have been almost uniformly deprived of their curtilage is very difficult. Under such circumstances “returning were as tedious as go o’er,” but I am myself inclined to think that the best solution of London’s sewage difficulty lies in the direction of cremation--certainly in the direction of decentralisation.

I believe also that at the outskirts much might be accomplished by an equitable adjustment of sanitary rates, and by encouraging householders to do for themselves what no public authority can do so satisfactorily for them. But as I have dealt with this subject very fully in a paper on “The Shortcomings of Modern Sanitary Methods,” I shall say no more at present.

London gets more than half its water from the Thames, and this is another reason why the sanitary outlook is not satisfactory. The system of water-carried sewage is now almost universal, the sewage ultimately taking its course along the track of the watershed. Wherever water-carried sewage is in vogue the natural watercourses must get fouled, and the fouling will be in proportion to population. The sewage may be deprived of its coarser ingredients by mechanical or chemical means, but it is not possible to believe that any of the methods of treating sewage at present in use render the effluent wholesome enough to drink without danger. The increase of population in the valley of the Thames is therefore a distinct danger to London. The following table gives the population for 1871 and 1881 of some registration districts situated in the Thames valley:--

1871. 1881. Kingston 55,929 77,057 Richmond 26,145 33,633 Reading 33,340 43,494 Windsor 26,725 31,992 Staines 20,199 23,774 Uxbridge 25,538 27,550 Brentford 71,933 101,706 Eton 24,928 27,721 Wycombe 38,366 40,278 Henley 18,916 19,992 Oxford } 21,016 21,902 Headington } 22,756 28,723 --------- --------- 385,791 477,822

I am well aware that some of the districts in the above list are below the intake of the water companies, but the figures serve to show how rapid is the increase of population in the valley of the Thames, which is one of the most popular districts in the whole country. This concentration of people along the banks of the river must have the effect of lessening the purity of the water which we drink.

Thus it is evident that what I have called the loose end of our sanitation is a growing expense and a growing danger. Hygiene, to be a permanent benefit, should move along natural lines, and organic refuse ought to be committed to the soil as quickly as possible, when it would cease to be a danger, and would prove a source of profit. If the evil effects of free trade are to be counteracted, it will be by returning the refuse of our towns free of cost to the impoverished agriculturist. If we in England go on as we are going, and if our brethren in the Colonies follow our example, as they are doing, I believe our race must become extinct, and it will be a Chinaman rather than a New Zealander who will sit in contemplation on the ruins of London Bridge.