Part 1

REPORT

TO

HER MAJESTY’S PRINCIPAL SECRETARY OF STATE FOR THE HOME DEPARTMENT,

FROM THE POOR LAW COMMISSIONERS,

ON AN INQUIRY INTO THE SANITARY CONDITION OF THE LABOURING POPULATION OF GREAT BRITAIN;

WITH APPENDICES.

_Presented to both Houses of Parliament, by Command of Her Majesty, July, 1842._

LONDON:

PRINTED BY W. CLOWES AND SONS, STAMFORD STREET, FOR HER MAJESTY’S STATIONERY OFFICE.

1842.

TO THE RIGHT HON. SIR JAMES GRAHAM, BART. HER MAJESTY’S PRINCIPAL SECRETARY OF STATE FOR THE HOME DEPARTMENT.

_Poor Law Commission Office, Somerset House, 9th July, 1842._

SIR,

On the 14th May, 1838, the Poor Law Commissioners presented to Lord John Russell a report “relative to certain charges which have been disallowed by the auditors of unions in England and Wales;” together with two supplementary reports; one a “Report on the prevalence of certain Physical Causes of Fever in the Metropolis, which might be removed by proper sanitary measures, by Neil Arnott, M.D., and James Phillips Kay, M.D.;” the other a “Report on some of the Physical Causes of Sickness and Mortality to which the Poor are peculiarly exposed, and which are capable of removal by Sanitary Regulations exemplified in the present condition of the Bethnal Green and Whitechapel Districts, as ascertained on a personal inspection by Southwood Smith, M.D., Physician to the London Fever Hospital.” (See Fourth Annual Report, App. A, No. 1.)

On the 29th April, 1839, the Commissioners received from Dr. Southwood Smith a “Report on the prevalence of Fever in Twenty Metropolitan Unions or Parishes during the year ended the 20th March, 1838,” which they appended to their Fifth Annual Report. (App. C, No. 2.)

In August, 1839, Lord John Russell addressed the following letter to the Commissioners:—

_“Whitehall, August 21, 1839._

“GENTLEMEN,

“The Queen having been pleased to comply with the prayer of an humble address presented to her Majesty, in pursuance of an order of the House of Lords, dated 19th August, 1839, that ‘Her Majesty will be pleased to cause inquiry to be made as to the extent to which the causes of disease stated in the Appendix A, No. 1, of the Poor Law Commissioners’ Fourth Annual Report, and Appendix C, No. 2, of their Fifth Annual Report, to prevail amongst the labouring classes in the metropolis, prevail also amongst the labouring classes in other parts of England and Wales, and that Her Majesty will be graciously pleased to cause the results of such inquiry to be communicated to the House’—I have to desire that you will cause inquiry to be made accordingly, and that you will prepare a report upon the result of such inquiry, and transmit the same to me, in order that it may be laid before the House of Lords.

“I am, Gentlemen, your obedient servant. “J. RUSSELL.”

With the view of making the inquiry directed by Lord John Russell’s letter, we addressed, in the month of November following, an instruction to our Assistant Commissioners to report upon such parts of the subject as were likely to come under their observation. We likewise addressed letters to the several Boards of Guardians of Unions in England and Wales, and their respective medical officers, requesting them to furnish us with information in answer to certain queries. (App. Nos. 1, 2, and 3.)

The steps which we thus took for conducting the inquiry which we were instructed to make have produced a large body of information, from which we have selected for our present Report that portion which seemed to us most important to the public, and most worthy of consideration by Her Majesty’s Government.

From the reports transmitted to us by our Assistant Commissioners we subjoin a report from Mr. Gilbert on the sanitary condition of the labouring population in Devon and Cornwall: the reports from Mr. Mott and Mr. Power with relation to the sanitary condition of the population of Manchester and the adjacent manufacturing districts, which will be found to be corroborative of the reports of Dr. Baron Howard and Dr. Duncan: one from Mr. Twisleton with relation to the sanitary condition of the population of Norfolk and Suffolk: one from Mr. Tufnell with relation to the sanitary condition of the labouring population of Kent and Sussex: a report from Mr. Parker on the sanitary state of the labouring population in the counties of Berks, Bucks, and Oxford: one from Mr. Weale on cottage accommodation in the counties of Bedford, Northampton, and Stafford,—a report from Mr. Senior on the sanitary condition of the labouring population in the counties of Leicester, Lincoln, Nottingham, and Rutland: one from Sir Edmund Head on the dwellings of the labouring classes, and on the means of procuring better cottage accommodation in the counties of Gloucester, Hereford, Monmouth, Salop, Worcester, Brecknock, and Radnor; three reports from Sir John Walsham on the condition of the dwellings of the labouring population in Durham, Northumberland, Westmoreland, and Cumberland; and a communication from Mr. Day on the cost of erection, repairs, and rents of labourers’ cottages in Salop, Cheshire, and North Wales.

We have likewise received several valuable reports upon towns and districts in England from medical men resident upon the spot.

We have obtained a report from Mr. Hodgson and a committee of medical gentlemen of Birmingham on the sanitary condition of the labouring population in that town.

We also append a report on the sanitary condition of the dwellings of the labouring classes, &c., in Manchester, which we have obtained from Dr. Baron Howard, physician to the Ardwick and Ancoats Dispensary of that town:

Also, one on the condition of the labouring population in Liverpool, from Dr. Duncan.

One on the condition of the labouring population in Derby, from Dr. Baker.

One on the condition of the labouring population of Truro, from Dr. Barham.

One on the condition of the labouring population of Brighton, from Dr. Jenks.

One on the sanitary condition of the labouring population in the town of Wolverhampton, by Dr. Dehane.

One on the prevalence of fever in the parish of Breadsall, Derbyshire, by Dr. Kennedy and Mr. Senior.

One on the sanitary state of the town of Stafford, by Dr. Edward Knight.

One on an improved description of cottage tenements for the labouring classes, by Mr. Edmund Ashworth.

One on the sanitary condition of the town of Lancaster, Dr. de Vitrié.

One on the sanitary condition of the town of Leeds, by Mr. Robert Baker.

The detailed statements which we received from the Boards of Guardians, and the Union medical officers, were too voluminous for insertion at length in the present Report; but we have caused them to be carefully examined, and some of the most important results which they contained have been extracted in the manner which we shall presently explain.

It will be observed that the inquiry which we were directed by Lord John Russell to make, in accordance with the address of the House of Lords, was limited to England and Wales. Subsequently, however, we received instructions from the Marquis of Normanby, dated 28th January, 1840, directing us to extend our inquiries to the causes of disease and destitution amongst the working classes in Scotland.

On the receipt of these instructions, we caused a circular letter to the medical practitioners to be sent to the provosts of all the Scotch burghs, with a request that they would put us in communication with the officers of the medical charities and establishments within their jurisdiction. In the same letter we stated fully the objects of the inquiry, and requested to be informed as to the general state of the main sewers, drainage, &c., of the several towns. (Appendix, Nos. 4 and 5.)

In Scotland, with a few exceptions, none of the medical profession are engaged in the public service as medical officers; and we were therefore compelled to rely on the exertions of the private medical practitioners, from whom we received extensive, zealous, and efficient aid. The President of the College of Surgeons of Edinburgh communicated to us a resolution passed by that body, recommending that all members and licentiates of the college should give every aid in their power to the inquiry into the sanitary condition of the poor. We directed additional queries to be issued to the members of the college, from some of whom we received information similar to that obtained from the medical officers in England.

With respect to the sanitary state of towns and districts in Scotland, we subjoin the following reports from medical gentlemen:—

A report from Dr. Arnott upon Edinburgh and Glasgow:

One report from Dr. Scott Alison on the sanitary condition of the colliery population of Tranent, and the adjacent districts:

One report on the condition of the labouring population of Musselburgh from Mr. Stevenson, surgeon:

One report on the condition of the labouring population of Ayr from Dr. Sym:

One on the condition of the labouring population, Stirling, from Mr. W. H. Forrest, surgeon:

One on the condition of the labouring population in Dumfries, from Dr. M’Lellan:

One on the sanitary condition of the poor of Aberdeen, by Drs. Kilgour and Galen:

One on the sanitary condition of the town of Lanark, by Mr. John Gibson, surgeon:

One on the sanitary condition of the city of St. Andrews, by Mr. Adamson, surgeon:

One on the sanitary state of the town of Greenock, by Dr. Laurie:

One on the sanitary condition of Tain and Easter Ross, by Mr. James Cameron, surgeon.

We have likewise received a report on the sanitary condition of the labouring population in Inverness, from Mr. Anderson, solicitor; and one on the sanitary condition of the Old Town of Edinburgh, by Mr. William Chambers.

As our inquiries led us to believe that considerable doubt exists as to the provisions of the existing law of Scotland upon matters concerning the public health, and as there is not in Scotland any local administrative machinery similar to that of the English unions which can exercise a superintendence over the health of the working classes, we obtained the services of Mr. J. H. Burton, advocate of Edinburgh, to report on the legal provisions existing in that city and in other parts of Scotland, and on the additional legislative measures which appeared, from the reports of the medical gentlemen, to be expedient for the improvement of the sanitary condition of the population of that part of the empire.

We also obtained the services of Mr. Charles R. Baird, of Glasgow, writer to the signet, who was pointed out to our notice by the circumstance of his having paid much attention to the condition of the labouring population of that city to report on the powers with which the local authorities are at present invested by law, and the additional powers they may need for the protection of the health of the inhabitants.

It will be observed that the letter of Lord John Russell, in accordance with the address of the House of Lords to Her Majesty, merely directed us to make inquiry as to the extent to which the causes of disease, stated in the Reports of Drs. Arnott and Kay, and of Dr. Southwood Smith, to prevail amongst the labouring classes of the metropolis, prevail also amongst the labouring classes in other parts of England and Wales, and to transmit the results of that inquiry to the Secretary of State for the Home Department. We should, therefore, have complied with the letter of our instructions if we had merely laid before you the information which we have collected in answer to the inquiries which we circulated. It appeared to us, however, that so large a mass of miscellaneous evidence would not be likely to convey a distinct view of the subject of inquiry if we presented it in an undigested form to Her Majesty’s Government; and we, therefore, requested our secretary, Mr. Chadwick, to peruse the information which we had received, (including the returns from the boards of guardians and union medical officers,) and, by comparing the different statements with such authentic facts bearing upon the question as he might collect from other sources, to frame a report which should exhibit the principal results of the inquiry which we were instructed to conduct. We subjoin the Report which Mr. Chadwick has prepared in accordance with this request; and we present to you this, and the other accompanying documents, in the full assurance that, as they contain matters seriously concerning the welfare of the community in general, and particularly of the working classes, they will receive the attentive consideration of Her Majesty’s Government.

We have the honour to be, Sir, Your very faithful and obedient Servants GEORGE NICHOLLS, GEORGE CORNEWALL LEWIS, EDMUND WALKER HEAD.

APPENDIX.

1.—_Circular Letter of Instructions to the Assistant Commissioners in England._

Poor Law Commission Office, Somerset House, 8th November, 1839.

Sir,—I am directed by the Poor Law Commissioners to call your attention to the following letter lately addressed to them by Lord John Russell.

Whitehall, August 21st, 1839.

“Gentlemen,—The Queen having been pleased to comply with the prayer of an humble address presented to Her Majesty in pursuance of an Order of the House of Lords, dated 19th of August, 1839, that ‘Her Majesty will be pleased to cause inquiry to be made as to the extent to which the causes of disease stated in the Appendix A., No. 1, of the Poor Law Commissioners’ Fourth Annual Report, and Appendix C., No. 2, of their Fifth Annual Report, to prevail amongst the labouring classes in the metropolis, prevail also amongst the labouring classes in other parts of England and Wales; and that Her Majesty will be graciously pleased to cause the results of such inquiry to be communicated to the House,’ I have to desire that you will cause inquiry to be made accordingly, and that you will prepare a report upon the results of such inquiry, and transmit the same to me in order that it may be laid before the House of Lords.

“I am, Gentlemen, “Your obedient Servant, “J. RUSSELL.”

The Commissioners consider this the proper time for making arrangements to obtain the returns and information on which they may prepare a report to be submitted to the House of Lords in the ensuing Session of Parliament.

The Commissioners request your particular attention to the subject, as one of great importance to the labouring classes, inasmuch as it may lead to the removal of the causes of prevalent and fatal diseases, and of consequent destitution and suffering.

The steps which the Commissioners propose to take for obtaining the information required by the order of the House of Lords, are:—

1. To procure from the medical officers of unions returns of the number of cases of contagious or infectious disease, the spread of which within their respective districts has been promoted by the circumstances referred to in the order of the House of Lords, with their observations thereon; for which purpose the Commissioners will issue the necessary circulars to the medical officers.

2. To obtain information from the Boards of Guardians of districts in which these diseases appear to have prevailed to a considerable extent, and where the guardians have applied to municipal or other authorities for the removal of circumstances promoting the prevalence of such diseases.

3. In large towns, to request some physician,[1] or general practitioner of eminent reputation, to prepare a report (founded upon data obtained from the various dispensaries, infirmaries, fever hospitals, and other similar public establishments) respecting the circumstances promoting the prevalence of contagious and infectious diseases in such large towns.

The Commissioners will be glad to receive from you the name of any physician or general practitioner of sufficient eminence to obtain the requisite data, and who will be willing to furnish them with such a report in each of the towns in your district named in the margin.

4. If the means already indicated should prove insufficient, to obtain a report from yourself founded on personal examination, on spots where, from the returns or from other information, such examination by yourself or the medical officer of the district may appear necessary.

Some of the chief considerations bearing upon the subject are set forth in the reports referred to in the resolution of the House of Lords, and if within your district there were any Boards of Health appointed during the prevalence of the cholera, it is probable that their reports founded on an examination of the condition of those classes amongst whom the prevalence of that disease was apprehended may furnish you with useful information.

The Commissioners wish further to observe that the state of the dwellings occupied by the labouring classes exercises an important influence upon their health, and the nature and frequency of the diseases to which they are subject, as well as indirectly upon the moral state of themselves and their families.

The Commissioners therefore request you to investigate the state of the dwellings of the labouring classes in your district, both in towns and in the country, with reference to the following observations,—

It will be desirable generally, after informing yourself of the various descriptions of cottage tenements in your district and the nature of the accommodation or comforts which they contain, to observe—

1. What is the common cost of erection, and the average cost of repairing each description of these cottage tenements.

2. What are the rents paid by the labourers for each description of these cottage tenements.

3. What is the general proportion of the rent paid by the labourer to his total expenditure.

You may find within your district instances where the employers of labour (whether agricultural or manufacturing) have erected on their own lands tenements of an improved description for the residence of the labourers employed by them. You are requested to take notice of all such instances which may come before you, and examine them as standards of comparison with other tenements of an inferior kind. You will inquire as to the comparative health and condition of the inmates, and whether the advantage of improved dwellings has been observed to have any salutary influence on the moral habits of the inmates;—whether the increased comforts of his house and home have tended to withdraw the labourer from the beer-shop, and from the habits of improvidence to which it leads;—whether residents in separate and improved tenements are superior in condition, as compared with the labourers who hold merely lodgings, or who reside with other families in the same house.

Where you meet with remarkable instances of improved tenements of this description, you are requested to set them forth in your report, and obtain the loan of the plans or drawings of them, together with any information as to their cost and the probable returns in rent, and whether on the whole (other advantages than the pecuniary return being taken into consideration) they are deemed profitable; or what may be the extent of pecuniary loss upon them, or how far it may be countervailed by other considerations.

Although the facts collected by you may not lead to the adoption of any legislative remedies, the publication of successful examples may be useful in stimulating to the voluntary adoption of them.

The Commissioners wish you however to consider whether any legislative measure in the nature of a Building Act (_i. e._ an Act prescribing certain rules to be followed in the building of cottages) would tend to introduce generally the improvements which may have been adopted partially by public-spirited persons in your district.

This may be considered:—

1. In the case of tenements intended for the residence of the labouring classes in towns;

2. In the case of cottage tenements in rural districts.

With regard to the former class of tenements, the wages of the labourers in towns being commonly double those earned in the rural districts, they may be well able to afford to procure such an increase of comfort in their houses as may be obtained by means of a Building Act, even at the cost of an additional rent. You are also requested, in your observations on this subject, to bear in mind another question, namely, the expediency of exempting small tenements from the payment of rates, or wherever rents are collected weekly, of collecting the rates from the landlord.

It has been stated that the exemption from poor’s rate tends to deteriorate the tenements of the labouring classes, inasmuch as many of such tenements are, for the purpose of obtaining the exemption, built of such quality and appearance as may bring them within the exempted class. It has been further stated, that the benefit of the exemption goes to the landlord, the rent for cottages built for letting in towns being very high as compared with rents obtained for other house property, and that such increased rents have been demanded expressly on the ground of exemption from rating. The causes affecting the construction of cottages are not expressly mentioned in the reports referred to in the resolution of the House of Lords, which treat chiefly of the external and immediately-removable causes of disease, such as stagnant pools or other out-door nuisances with which the parochial officers had to some extent been heretofore accustomed to interfere. But the defective construction of the cottages themselves, and the imperfect protection they may afford against cold or damp—the want of means for the due regulation of warmth or of conveniences for cleanliness, may often be the causes of the prevalence of disease; and the Commissioners consider not only that these subjects cannot with propriety be overlooked in any report on the sources of disease among the labouring classes, but that the beneficial moral results which may arise from the suggestion of improvements in the habitations of the labouring classes justify the Commissioners in taking this occasion to direct your attention to the heads of inquiry which are noticed in this communication.

Signed, by Order of the Board, E. CHADWICK, _Secretary_.

_To_ Assistant Poor Law Commissioner.

2.—_Circular Letter of Instructions to Clerks of the Boards of Guardians in England and Wales._

Poor Law Commission Office, Somerset House, 12th November, 1839.

Sir,—I am directed by the Poor Law Commissioners to inform you that they have, in compliance with a communication from Her Majesty’s Secretary of State for the Home Department, directed the enclosed letters to the medical officers of your board, together with the accompanying forms for their answers, and I am to request that you will transmit them accordingly.