Part 7

“My attention was first directed to the sources of malaria in this district and neighbourhood when cholera became epidemic. I then partially inspected the dwellings of the poor, and have recently completed the survey. It is almost incredible that so many sources of malaria should exist in a rural district. A total absence of all provision for effectual drainage around cottages is the most prominent source of malaria; throughout the whole district there is scarcely an attempt at it. The refuse, vegetable and animal matters, are also thrown by the cottagers in heaps near their dwellings to decompose; are sometimes not removed, except at very long intervals; and are always permitted to remain sufficiently long to accumulate in some quantity. Pigsties are generally near the dwellings, and are always surrounded by decomposing matters. These constitute some of the many sources of malaria, and peculiarly deserve attention as being easily remedied, and yet, as it were, cherished. The effects of malaria are strikingly exemplified in parts of this district. There are localities from which fever is seldom long absent; and I find spots where the spasmodic cholera located itself are also the chosen resorts of continued fever.”

Passing the metropolis and the adjacent districts, I proceed to the evidence as to the condition of the dwellings of the poorest classes in the midland counties.

The report from Mr. Hodgson and the physicians of the town of Birmingham will be considered a valuable public document, as exhibiting the effect of drainage produced by a peculiarly fortunate situation. The houses, of which I requested drawings, are on the whole built upon an improved plan. This town, it will be seen, is distinguished apparently by an immunity from fever, and the general health of the population is high, although the occupations are such as are elsewhere deemed prejudicial to health.

The following extract from _Mr. Hodgkins_, the medical officer of Bilston, in the Wolverhampton Union, describes the condition of the population of a colliery district:—

“Bilston, like Wolverhampton, has not been visited by fever to any extent since the cholera in 1832. The awful destruction which then occurred swept off many of those subjects who might afterwards have been victims of fever; in fact Bilston was, after the cessation of cholera, nearly free from disease of any kind for several months. Influenza has occasionally visited us and swept off a few. Small-pox a few years ago was prevalent, but not very fatal, although many children from negligence on the part of the parents are not vaccinated. Scarlet fever has appeared sometimes, but only in straggling cases. The occupations of the poorer classes are chiefly colliers, labourers, &c., great members of the latter being Irish. The houses of those applying for parochial medical relief which I have visited have been dirty and crowded, the habits of the working classes here being generally improvident and dirty, many parties forming heaps of filth close to their doors; and here, as in Wolverhampton, I am afraid it would require the interference of the law to effect any permanent good. Some years ago a large culvert was carried down the principal street which has made a great improvement in that part, but much yet remains undrained. I would mention a place in High-street especially, near to a court, crowded with Irish, there is a pool of green stagnant water or mud continually; another place called the Berry, behind the King’s Arms Inn, and a third in a court in Temple-street, where there appears to be a drain which has been choked up, the stench from which is intolerable.”

_Dr. Edward Knight_ gives the following description of the sanitary condition of the town of Stafford:—

“During the year ending September 29th, 1839, there have been in the fever-wards connected with the Stafford County General Infirmary 76 cases of fever, of which number 10 have died, and the remaining 66 were discharged cured. The far greater part of these cases commenced in the town of Stafford, some being brought to the infirmary in a dying state, which gives a greater rate of mortality. Although the fever-wards are well arranged, and every comfort and attention provided for the patients, there is a general dislike on the part of the poor to be removed to them from their own houses, except in cases of actual necessity.

“Owing to this, and the filthy state of those parts of the town occupied exclusively by the lower classes, as the ‘Broad-eye,’ ‘Back-walls,’ &c., we have generally more or less of infectious diseases during the autumn and winter months in each year, and although such diseases do not extend their ravages to the more respectable inhabitants, the above form but a very small portion of the cases which occur.

“These parts of the town are without drainage, the houses, which are private property, are built without any regard to situation or ventilation, and constructed in a manner to ensure the greatest return at the least possible outlay. The accommodation in them does not extend beyond two rooms; these are small, and, for the most part, the families work in the day-time in the same room in which they sleep, to save fuel.

“There is not any provision made for refuse dirt, which, as the least trouble, is thrown down in front of the houses, and there left to putrefy. The back entrances to the houses in the principal streets are generally into these, the stabling and cow-houses, &c., belonging to them, forming one side of the street, and the manure, refuse vegetable matter, &c., carried into the street, and placed opposite to the poorer houses; so that they are continually subjected to the malaria arising from that, in addition to their own dirt.

“The sedentary occupation of the working classes (shoemaking being the staple trade of the town), their own want of cleanliness and general intemperance, form, also, a fruitful source of disease. One-half of the week is usually spent in the public-houses, and the other half they work night and day to procure the necessary subsistence for their families. There is a great want of improvement in the moral character of the poor; they can obtain sufficient wages to support their families respectably, but they are improvident and never make any provision against illness. A local Act for the improvement of the town empowers the commissioners to remove nuisances; but no notice is ever taken. The situation of Stafford also offers every facility for an efficient drainage; it is nearly surrounded by a large ditch, in which there might be a running stream of water, well calculated to remove all impurities; but it is always choked up, and in a stagnant state. The river ‘Sow’ is also close to the town. There are not any sewers even in the principal streets, the water being carried off by open channels. In the Lunatic Asylum, which closely adjoins the town, and averages 250 patients, great attention is paid to cleanliness, and we never have any infectious diseases.”

In the month of December, 1839, an application was made to the Board for advice and aid to meet the emergencies created by an epidemic which had broken out in the parish of Breadsall in the Shardlow union (Derbyshire). Mr. Senior, the Assistant Commissioner for the district, accompanied Dr. Kennedy to the spot where the fever was prevalent, and that report[2] may be submitted to attention, as containing a picture of the habits of a large proportion of the population of that part of the country, and an exemplification in a group of individual cases of the common causes and effects of such calamities on the labouring population.

The report from Dr. Baker, of Derby, and Mr. Senior’s report, comprising the returns from the medical officers of Nottingham, Lincoln, and other rural and town unions within his district, pourtray the sanitary condition of a large proportion of the population included in them.

Proceeding northward, a report from _Mr. Bland_, the medical officer of the Macclesfield union, gives the following description of the state of the residences occupied by many of the labourers of that town:—

“In a part of the town called the Orchard, Watercoates, there are 34 houses without back doors, or other complete means of ventilation; the houses are chiefly small, damp, and dark; they are rendered worse with respect to dampness perhaps than they would be from the habit of the people closing their windows to keep them warm. To these houses are three privies uncovered; here little pools of water, with all kinds of offal, dead animal and vegetable matter are heaped together, a most foul and putrid mass, disgusting to the sight, and offensive to the smell; the fumes of contagion spreads periodically itself in the neighbourhood, and produces different types of fever and disorder of the stomach and bowels. The people inhabiting these abodes are pale and unhealthy, and in one house in particular are pale, bloated, and rickety.”

_Mr. William Rayner_, the medical officer of the Heaton Norris district of the Stockport union describes the condition of a part of the population of that place:—

“The localities in which fever mostly prevails in my district, are Shepherd’s Buildings and Back Water Street, both in the township of Heaton Norris. Shepherd’s Buildings consist of two rows of houses with a street seven yards wide between them; each row consists of what are styled back and front houses—that is two houses placed back to back. There are no yards or out-conveniences; the privies are in the centre of each row, about a yard wide; over them there is part of a sleeping-room; there is no ventilation in the bed-rooms; each house contains two rooms, viz., a house place and sleeping room above; each room is about three yards wide and four long. In one of these houses there are nine persons belonging to one family, and the mother on the eve of her confinement. There are 44 houses in the two rows, and 22 cellars, all of the same size. The cellars are let off as separate dwellings; these are dark, damp, and very low, not more than six feet between the ceiling and floor. The street between the two rows is seven yards wide, in the centre of which is the common gutter, or more properly sink, into which all sorts of refuse is thrown; it is a foot in depth. Thus there is always a quantity of putrefying matter contaminating the air. At the end of the rows is a pool of water very shallow and stagnant, and a few yards further, a part of the town’s gas works. In many of these dwellings there are four persons in one bed.

“Backwater-street, the other locality of fever, is proverbially the most filthy street in the town, contains a number of lodging-houses and Irish, who mostly live in dark damp cellars, in which the light can scarcely penetrate.

“It is not to be wondered at that such places should be the constant foci of fevers; there is scarcely a house in Shepherd’s-buildings that has not been affected with fever, and in some instances repeatedly: new residents are most liable to be affected, the force of habit, or some other protecting influence seems to render those who have lived there some time less liable to be attacked. The same circumstance has been noticed by others, and M. Louis, who is known throughout Europe, having made this subject one of particular observation, states that it is generally within the first year that new comers take fever, whilst the old inhabitants who are equally exposed to the same exciting causes escape.”

The report of Dr. Baron Howard, on the condition of the population of Manchester, and that of Dr. Duncan, on the condition of the population of Liverpool, will make up a progressive view of the condition of the labouring population in those parts of the country. The Report of one of the medical officers of the West Derby union, with relation to the condition of the labouring population connected with Liverpool, will serve to show that the evils in question are not confined to the labouring population of the town properly so called.

“The locality of the residences of the labouring classes are in respect to the surrounding atmosphere favourably situated, but their internal structure and economy the very reverse of favourable. The cottages are in general built more with a view to the per centage of the landlord than to the accommodation of the poor. The joiner’s work is ill performed; admitting by the doors, windows, and even floors, air in abundance, which, however, in many cases, is not disadvantageous to the inmates. The houses generally consist of three apartments, viz., the day-room, into which the street-door opens, and two bed-rooms, one above the other. There is likewise beneath the day-room a cellar, let off either by the landlord or tenant of the house, to a more improvident class of labourers; which cellar, in almost all cases, is small and damp, and often crowded with inhabitants to excess. These cellars are, in my opinion, the source of many diseases, particularly catarrh, rheumatic affections, and tedious cases of typhus mitior, which, owing to the overcrowded state of the apartment, occasionally pass into typhus gravior. I need scarcely add that the furniture and bedding are in keeping with the miserable inmates. The rooms above the day-room are often let separately by the tenant to lodgers, varying in number from one or two, to six or eight individuals in each, their slovenly habits, indolence, and consequent accumulation of filth go far to promote the prevalence of contagious and infectious diseases.

“The houses already alluded to front the street, but there are houses in back courts still more unfavourably placed, which also have their cellars, and their tenants of a description worse, if possible. There is commonly only one receptacle for refuse in a court of eight, ten, or twelve densely crowded houses. In the year 1836–7, I attended a family of 13, twelve of whom had typhus fever, without a bed in the _cellar_, without straw or timber shavings—frequent substitutes. They lay on the floor, and so crowded, that I could scarcely pass between them. In another house I attended 14 patients; there were only two beds in the house. All the patients, as lodgers, lay on the boards, and during their illness, never had their clothes off. I met with many cases in similar conditions, yet amidst the greatest destitution and want of domestic comfort, I have never heard during the course of twelve years’ practice, a complaint of inconvenient accommodation.”

The following extract from the report of _Mr. Pearson_, medical officer of the Wigan union, is descriptive of the condition of large classes of tenements in the manufacturing towns of Lancashire:—

“From the few observations which I have been enabled to make respecting the causes of fever during the two months which I have held the situation of house surgeon to the Dispensary, I am inclined to consider the filthy condition of the town as being the most prominent source. Many of the streets are unpaved and almost covered with stagnant water, which lodges in numerous large holes which exist upon their surface, and into which the inhabitants throw all kinds of rejected animal and vegetable matters, which then undergo decay and emit the most poisonous exhalations. These matters are often allowed, from the filthy habits of the inhabitants of these districts, many of whom, especially the poor Irish, are utterly regardless both of personal and domestic cleanliness, to accumulate to an immense extent, and thus become prolific sources of malaria, rendering the atmosphere an active poison. The streets which particularly exhibit this condition are Ashton-street, Hanover-street, Stuart-street, John-street, Lord-street, Duke-street, Princess-street, and the short streets leading from Queen-street, into Faggy-lane and Princess-street. It may be also mentioned, that in many of these streets there are no privies, or, if there are, they are in so filthy a condition as to be absolutely useless; the absence of these must, necessarily, increase the quantity of filth, and thus materially add to the extent of the nuisance.

“In addition to the streets above mentioned, there are, besides, two other localities, which must be considered as peculiarly fitted for the generation of malaria—I mean the waste land in front of Bradshaw Gate, and also that situated between Greenough’s-row and Kerfoot’s-row; the latter is one complete pool of stagnant water, mixed with various descriptions of putrifying animal and vegetable matters. Many of the yards and courts in various parts of the town are so built up as to prevent the movements of the atmosphere, and are in a horribly filthy state, in consequence of dunghills which are situated therein being allowed to grow to an immense size, and the water which drains therefrom being permitted to flow over the surface.”

Proceeding northwards, little difference is observable in the condition of the working classes in the ancient towns, where the habitations were crowded for the sake of fortification, and in the manufacturing towns, where the habitations are crowded for the sake of vicinity to the places of work, or from ignorance and inattention, or from the high price of land. We cite the following instances of the condition of the habitations and population in Durham, Barnard Castle, and Carlisle:—

_Mr. Nicholas Oliver_, Durham, states that—

“The city of Durham, like all ancient cities and towns, is built very irregularly, and surrounded on all sides by the river Wear, which is frequently overflown, and much wooded. These in summer and autumn, by the combined influences of heat, moisture, and decaying vegetable substances, become abundant sources of malaria. The streets are very narrow, and the houses are built so much behind each other that the entrance to a great many of the dwellings is by a passage, lane, or alley, either a steep ascent or descent, where, from a proper want of receptacles and sewers, filth is allowed to accumulate, and there necessarily is a constant emanation of fœtid effluvia. The majority of the houses are very old and in a dilapidated state, several not being weather proof. The great bulk of the working classes inhabit these tenements, and they seldom occupy more than two rooms, many only one, where all that is requisite in conducing to cleanliness and comfort has to be performed.

“The spirit of improvement, which is making such rapid strides in other parts of the country, is here quite dormant. Nothing calls louder for the attention of the constituted authorities than the improvements which might be effected in the habitations of the industrious classes, thereby increasing their health, comfort, and happiness.”

_Mr. George Brown_, of Barnard Castle, in the Teesdale union, states that—

“The residences of the labouring population within the Teesdale Union, especially in Barnard Castle and the more populous villages, is mostly in large houses let into tenements. At least four-fifths of the weavers in Barnard Castle live in such residences, and about one half of all the other labouring poor in the Union. The tenements which form the residences of the weavers and other labourers in Barnard Castle are principally situate in Thorngage, Bridgegate, and the lower parts of the town, and in confined yards and alleys. The houses are many of them very large. I am told somewhere there are as many as 50 or more individuals under one roof. There is generally, perhaps, one privy to a whole yard (or onset as they term it), embracing five or six houses. From the crowded state of these dwelling-houses, and the filthiness of many of their inmates, disease would undoubtedly arise more commonly than it actually does, but the river Tees flows at the foot of each yard, running alongside of all the houses in Bridgegate. The impurities are thus speedily carried away, and the evils which might otherwise be expected from the effluvia of vegetable and other bodies in a state of decomposition are prevented; besides which, the houses in general being large and the poorer class in the upper stories, they are more protected against cold and damp.”

_Mr. Brown_, in regard to Barnard Castle, further states, that—

“A surgeon here of great intelligence and practice states that in the town of Barnard Castle he has always found the most obstinate cases of typhus and other epidemics, and also rheumatism, to prevail amongst the houses on the west side of the principal street. These houses slope towards the moat of the old castle, which is not sufficiently drained; and the thick and high walls of the ruins of the castle retain the damp, and prevent the accession of the western winds to the moat and many of the houses. In the interior of the castle, now used as a garden, there is a stagnant pond which ought to be drained off: this pond is nearly opposite the yards, which are full of the residences of the poorer classes, and called the Swamp. Disease is often found to exist in these yards, and the surgeon I have referred to attributes to it the dampness of the moat (upon or on the margin of which the houses are built) and to the pond before mentioned. All the houses on the west side of the street have one step, and some more, down from the street. I am also told by the same surgeon that very many of the cases of fever and rheumatism which he attends may be fairly traced to the dampness of houses or want of sufficient drainage of the ground previously to building, and their being built below the level of the adjoining ground, by which the moisture is thrown into them.”

_Mr. Rowland_, of Carlisle, states—

“Though Carlisle abounds with beautiful walks, it generally has them accompanied with filthy putrid gutters, and there seems no mode of compelling any one to clean them out. The city is surrounded with such nuisances; on the south side at the foot of Botchergate, there is a gutter, perhaps a mile long, which conducts the filth of that quarter through the fields into the river Petteril. The stench in summer is very great. The filth seems to accumulate from want of descent, and probably the whole descent is in the first field next Botchergate. If this gutter was paved and the descent made regular, I have no doubt it would keep itself clean.”

The following is a brief notice of the condition of the residences of the population amidst which the cholera first made its appearance in this country.

_Mr. Robert Atkinson_, Gateshead, states, that—