Reports Relating to the Sanitary Condition of the City of London
Part 12
Is water thus constituted in any degree detrimental to the health of those who drink it? It is not in a single word that this question can be fairly answered. Almost insuperable difficulty belongs to it, from the absence of any statistical method by which we might isolate the water-drinking portion of our population, and might compare them, in regard of the diseases to which they are liable, with similar sections of population in soft-water districts and in harder-water districts. Obviously, no other method of comparison can be unobjectionable; and, in arguing the subject from such materials as I have, I can pretend to nothing more than a rational approximation to truth.
Except in the comparatively few instances where active medicinal agents are naturally dissolved in a water, its effects, if injurious, would be so slow as to elude ordinary observation. If, as is exceedingly probable, the same constitution of water as impairs its solvency out of the body, do likewise operate against its being the most eligible menstruum or dissolvent for processes occurring within the body--such processes I mean as attend the act of digestion; if the lime and other hardening ingredients which waste soap in our laundries, and tea in our parlours, do similarly waste within us those organic agencies by which our food is dissolved and converted; any result arising from this source would be of gradual operation, would not easily admit of being traced to its source, and (except in susceptible persons) would rarely produce such symptoms as might immediately draw attention to their cause. The ill effects (whatever they may be) arising from the use of hard waters must be looked for in chronic impairment of digestion, and in those various derangements of nutrition in distant parts (the skin and teeth particularly) which follow as secondary results on such chronic disorder. It would be ridiculous to look for the operation of an ill-chosen water, after its habitual use during two centuries, as though one were inquiring for the symptoms of an acute poison. The signs that are to be ascertained among a population, if such signs exist, are those which would evidence a premature exhaustion of the power of digestion, and would testify that the machine on which we depend for that power had been exposed to unnecessary and avoidable fatigue. This, I believe, is the utmost which Medicine, proceeding from theoretical grounds, would venture to say on the subject.
Perhaps I need not inform you that indigestion, with all that follows from it, is so frequent in the metropolis, in persons after the first strength of youth, that, for large classes of society, a perfect discharge of the natural process of digestion (such a discharge of it as a lecturer would describe to be the exact type and intention of Nature), is exceptional and rare. Unquestionably, in large numbers of cases, wine and beer and spirits, rather than water, have to do with this effect. Unquestionably, other influences of metropolitan life--and, not least, the mental wear and tear which belong to its large excitement, contribute immensely to this chronic derangement of health; but there are reasons likewise for believing, that the quality of water consumed is not a matter of indifference to the result. We cannot but give it an important place among those influences of health or unhealth which we consider _local_; and we cannot refuse to recognise the fact, that in recommending our patients (as we do often recommend them) to try ‘change of air’ for complaints which baffle us by their obstinacy, so long as the subject of them remains in London, the course on which we rely for success implies ‘change of water,’ equally with that other change to which more popular importance is attached.
In illustration of this view, I may quote to you the experience of two other towns. Dr. Sutherland stated, in evidence before the General Board of Health, that having lived for a number of years at Liverpool (where the water is said to be of about the same degree of hardness as ours), he had long entertained a conviction that ‘the hard water, in a certain class of constitutions, tends to produce visceral obstructions; that it diminishes the natural secretions, produces a constipated or irregular state of the bowels, and consequently deranges the health. He had repeatedly known these complaints to vanish on leaving the town, and to re-appear immediately on returning to it, and it was such repeated occurrences which fixed his attention on the hard selenitic water of the new red sandstone as the probable cause, as he believed it to be, of these affections.’ (Rep. p. 51). And Dr. Leach, of Glasgow, stated before the same Board, as the result in that town of two years’ experience of a substitution of soft for hard drinking-water, that in his opinion, ‘dyspeptic complaints had become diminished in number;’ and that it had ‘been observed, since this change, urinary diseases have become less frequent, especially those attended by the deposition of gravel.’
Inferences useful for ourselves cannot be drawn from statements like the above, on the fullest assumption of their accuracy, without comparing the waters referred to with our own, more completely than is done by the one characteristic of ‘hardness;’ and there may likewise be other qualifications requisite for an application of the analogy. But those disorders of health which are specified by the gentlemen quoted, as produced by the use and diminished by the disuse of hard waters, are such as might very probably stand in the relation of effect to their alleged cause; results, namely, primary and secondary, of disordered digestion.
Practically, I may tell you, that there are many individuals whose stomachs are extremely sensitive to the impression of hard water, who derive immediate inconvenience from its use, and who refuse to drink it without artificial reduction of its objectionable quality. I may likewise inform you that a physician, recently deceased, whose knowledge of indigestion and its chronic effects (especially in relation to the skin and urinary organs) was most profound and accurate, and whose consulting practice in such disorders was for many years almost a monopoly (I mean Dr. Prout) was in the habit of enjoining on his patients the use of distilled water. He evidently considered that the consumption of such waters as are habitually drunk in the metropolis was detrimental, at least to an enfeebled digestion. This is an opinion which, I have reason to believe, is generally entertained by medical practitioners in London.
It may not be irrelevant to mention to you (since the influence of imagination or of artificial habits can have little to do with this result) that horses are liable to be much inconvenienced by hard water, if unaccustomed to its use; and it is, I believe, notorious that grooms in charge of racers habitually take the trouble of conveying with them, to their temporary racing stables, a supply of the accustomed water. Veterinary surgeons say that under the continued use of hard water, which horses will avoid if possible, their coats become rough and staring;--an effect, I may observe, analogous to those skin-disorders of the human subject which are apt to occur from impairment of the digestive functions.
Taking into account all these considerations, together with others of a more technical description; and believing that water is eligible for human consumption in proportion as it is free from the admixture of any material foreign to its simple elementary constitution--exception being made only of so much dissolved air as will render it sparkling and palatable; I entertain no doubt that a water, devoid of considerable hardness, would (_cæteris paribus_) for the purposes of cooking and drinking, be far preferable to that which the companies now distribute through the City of London.
Hitherto, however, I have spoken of the waters supplied to the City, merely as regards that large impregnation of earthy material which they gather from their source; and I have criticised them only in respect of that admixture. Their essential chemical quality is one native to the soil from which they are derived; and whatever censure thus far belongs to them could only have been avoided by the selection of a different source. Chemistry, in the days of Morrys and Myddleton, was not sufficiently advanced to inform the water-merchants of a city on those different conditions which determine the fitness of a soil to serve as the natural or artificial _gathering-ground_ of a supply; and by which (as they vary in different localities) hardness is imparted to the rain-fall of one district, while softness is preserved for that of another.
But there are other evils belonging to these waters, less appreciable indeed by chemistry, but open to universal observation, and meriting unqualified blame. They are conducted to the metropolis in open channels; they receive in large measure the surface-washing, the drainage, and even the sewage of the country through which they pass; they derive casual impurities from bathers and barges; they are liable to whatever pollutions mischievous or filthy persons may choose to inflict on them; and then on their arrival in the metropolis (after a short subsidence in reservoirs, which themselves are not unobjectionable) are distributed, without filtration, to the public. Whatever chemistry may say on this subject (and I need not remind you of very powerful causes of disease which lie beyond its cognisance), I cannot consider it matter of indifference, that we drink--with whatever dilution, or with whatever imperfect oxidation, the excremental and other impurities which mingle in these sources of our supply. Such admixtures, though in their _quantity_ less, are in their _quality_ identical with those which render Thames-water, as taken at London Bridge, inadmissible for domestic consumption, and which occasion it, when stored for sea-use, to undergo, before it becomes fit to drink, a succession of offensive changes strictly comparable to putrefaction.
In this slovenly method of conveyance and distribution there is a neglect of common precaution for the purity and healthfulness of the supply, which I must report to you as highly objectionable: and this--the method of supply to our great metropolis, strikes one the more with astonishment and disgust, as one reflects on the long experience and admirable models which past centuries in foreign countries have supplied; and especially, as one remembers those colossal works which, more than two thousand years ago, were constructed under the Roman government, for the cool and cleanly conduction of water.
The present imperfections of knowledge forbid me to cite, as definite causes of disease, the contaminations to which I have adverted: I cannot say to you--pointing to our classified list of sickness and mortality, _this_ depends on drinking the diluted drainage of Hertford, _that_ on the contributions of Ware. Indeed I know that, under the influence of the river and the atmosphere, very considerable changes occur in the materials thus furnished, tending eventually to render them inert; and if injury to life occur from their ingestion, it is probably only under peculiar and exceptional conditions, increasing their quantity, or delaying their oxidation. In protesting against their continued distribution as articles of diet, I therefore insist less on inferences deducible from medicine, and shall probably have the concurrence of your Hon. Court in grounding my appeal on the common principles of taste.
On the incidental contaminations to which the pipe-water consumed within the City becomes liable, by reason of its storage in receptacles both foul in themselves and surrounded by causes of foulness, I have already addressed you; and I have shown to you the dependence of this evil on the system of intermittent supply as adapted to the houses of the poor.
Of other sources of water-supply existing within the City of London, there are many of small extent in the form of superficial springs. These are eagerly sought after, sometimes from a distance, on account of their coolness and sparkling condition. In the Appendix[51] you will find an account of one of these waters--that in the vicinity of Bishopsgate church, which is very much drunk in that quarter of the City. Any praise given to it illustrates exceedingly the fallacy of popular judgment on such subjects, and shows how easily those qualities of coolness and freshness, which are absent from stored waters, impose on the palate, and induce a preference to be given to waters which are relatively most objectionable.
[51] See page 170.
The chemical faults which belong to our London pipe-water are possessed in a far greater degree by this water of Bishopsgate pump, and the latter has moreover some vices which are absent from the former; but the vapidity and fustiness of water which has been stored in cisterns are so repugnant to the taste, that the water chemically preferable is not in practice preferred.
To the use of waters of this description, within a large city, there is always much objection. In addition to extreme hardness, which in London they universally possess, they are liable, in a dangerous degree, to become contaminated by the leakage of drains, and by other sources of impurity; as, for instance, where situated within the immediate vicinity of grave-yards they derive products of animal decomposition from the soil.[52] Very recently, a celebrated pump within the City of London, that adjoining St. Bride’s church-yard, has been abandoned on account of such impregnations. Or perhaps I should rather say (for the difference again illustrates the readiness with which the palate is deceived or corrupted) that it was not _abandoned_--for till almost the last moment the neighbours adhered to it with fondness; but the parochial authorities--alarmed by the proximity of cholera--caused its handle to be locked.
[52] This is illustrated in the analysis of Bishopsgate pump-water, just alluded to. The very large quantity of _nitrates_, there referred to that water, must be due to the oxidation of human bodies in the adjoining soil, which serves in part as gathering-ground to the spring. I should fear that, during rain-fall, this oxidation of organic compounds may not always have completed itself, and that materials of decomposition _still in progress of decay_ may thus often be mingled in the water. [I have lately had occasion to recommend that the use of Aldgate pump should be discontinued on account of its water containing, in addition to a large quantity of alkaline nitrate, so much unoxidised organic matters, as were sufficient to give it a foul taste.--J. S., 1854.]
As an available source of supply to the City of London, the use of deep (Artesian) wells has been recommended: the clearness and softness of these waters, together with their freedom from organic matters, having concurred to suggest their employment. I feel bound to express the strongest opinion against the fitness of these waters for the purpose of beverage. They uniformly contain a considerable proportion of medicinal ingredients; they are capable of exerting definite and demonstrable influence over the natural actions of the body; and information is before me of various injury to health, affecting large numbers of persons, arising from the continued dietetic use of such waters.
In addressing your Hon. Court on the subject of water-supply for the City, it is impossible that I should do otherwise than advert to the fact, that, during the last few months, under the auspices of Her Majesty’s government, as represented for sanitary purposes by the General Board of Health, a plan has been gradually maturing itself, for the supply of the entire metropolis with pure soft water. Founding itself on very extensive investigations as to the qualities of water, as to the influence of soils on its chemical composition, as to the relation between streams and rain-fall, as to the hydraulic principles of distribution, and the like, this plan proposes to gather water in certain silicious soils, which can impart to it the least possible admixture of foreign ingredients; to conduct it in closed channels, with every precaution for its perfect purity; and to distribute it throughout the metropolis, at a rate which shall be from 30 to 50 _per cent._ less than our present water-charges. The proposed area for the collection of this supply is in the extensive range of sandy soil in the south of Surrey, extending around Farnham, about ten miles in each direction. Since the publication of the first Report made on this subject by the General Board of Health, unremitting inquiry has been advancing, under their direction, into all details of the plan; and the Hon. William Napier, who, with others, has been engaged in the investigation of the proposed sources, has advocated an important modification, which promises to reduce very considerably the anticipated expense of the undertaking. The essential and most important principles which governed the Board, in arranging their plan, were, first, to seek their supply in a silicious soil, where little soluble material could exist for its contamination; secondly, to take possession of the water so near to its source that all its original purity might be preserved; and, during conduction, to isolate it from those contaminations which are incidental to the onward passage of a stream through miles of promiscuous country. To fulfil these indications, there were two conceivable courses; and studious local inquiries could alone determine which of them was preferable: on the one hand, if the streams which represent the natural drainage of the country should be found uniformly pure and copious, they might admit of being conducted bodily into the artificial river of supply: on the other hand, it might be requisite to carry the interference of art still further, to absorb the filtering moisture of this large sand-district before it had become confluent into streams, and thus from day to day, by extensively ramified works of artificial sub-drainage, to derive immediately from the soil, the varying contributions of rain-fall and dew. The Board, apparently solicitous for the completer security of their plan, preferred to estimate its cost on the latter very expensive supposition; they allowed apparently for the diffusion of drain-pipes over 150 square miles of country, and for a reservoir which should contain storage of water equivalent to a very long metropolitan consumption. The later examination, made by Mr. Napier and confirmed by others, tends and appears to show, that these large sources of expense may be avoided; that the waters may be collected of unusual purity and softness, where they have united themselves into rivulets of considerable volume; that the gauged and estimated discharge of these rivulets is sufficient day by day for the needs of the metropolis, according to the largest construction of those needs; that capillary drain-pipes and very extensive storage-room may thus be dispensed with; and that under the modification of arrangement suggested by these facts, some very large reduction might be inferred for the total estimate of this comprehensive plan.
Many of these particulars are already before the public; but in a matter of so much importance to the health of the City, as that of participating in a supply of pure water, collected and distributed on the soundest principles, and sold at the cheapest rate, I did not think it would become me, as your Officer of Health, to remain an indolent auditor. I have felt it my duty to inform myself, so far as I could, on the real merits of this scheme, and on its probable relation hereafter to the sanitary condition of the metropolis. I have spent three days on the site of the proposed sources, and many other days in informing myself on all the bearings of the subject. I have likewise collected water from a proposed tributary of the future supply, which has been analysed, and which shows (as my Appendix will illustrate to you) a remarkable and rare excellence. On one occasion of visiting the country, I was accompanied by Mr. T. Taylor, and we made on the spot a sufficient number of extemporaneous examinations, to assure us that the essential features, shown in the more elaborate analysis, are (as geological considerations would lead us to believe) the general characters of water throughout the district.
On any other than the sanitary relations of this subject I can have nothing officially to say; but, confining myself to these relations, I may certify to your Hon. Court that the water in question is, in my judgment, of a quality admirably suited for domestic purposes; that its distribution through the City of London would conduce to the health and comfort of the population; and that the principles, proposed by the Board for its collection and conveyance, appear to me such as sanitary science, in its present condition, should counsel for the water-service of the metropolis.
There is, however, one aspect of the subject which must not pass unconsidered. Water that is free from earthy ingredients requires a peculiar distributory apparatus. If conveyed in leaden pipes with access of air, or if stored in leaden cisterns, it corrodes the metal of which they are composed, and is liable to derive from this source an impregnation very hazardous to life. Under certain circumstances, especially under alternations of air and water (such as occur in the intermittent supply), or where organic impurities are held in solution or suspension, or probably where from any cause uncombined carbonic acid is present, even the hardest waters are not free from this risk. Speaking generally, however, it affects soft water chiefly; distilled water most of all: and the Farnham water (in common with all pure water) is decidedly liable to this empoisonment, if used with leaden apparatus of conduction and storage. In my Appendix you will find some interesting particulars on this head; and you will observe that with experiments conducted by Mr. Taylor in imitation of the constant supply (i. e. with total submersion of the metal) the formation of carbonate of lead in the Farnham water was exceedingly gradual. This concurs with the alleged experience of Aberdeen, where it is said by Professor Clark to have been found (to my mind, by a somewhat dangerous trial) that pure and soft water, _distributed on the principle of constant supply_, does not exert on the leaden pipes any action injurious to the health of the population. You will likewise observe, that when hard water, as at present employed in the City, is softened by boiling, it acquires this property of pure water, and becomes capable of acting on lead; and here is an important observation, as it has been proposed by similar artificial means, employed on a very large scale, to soften all the water now distributed in the metropolis.
Obviously, as regards one and all of the many proposals for supplying water destitute of hardening ingredients, any chemical process, or any change of source, which might lead to the distribution of such pure water through the metropolis, could not be considered as a single and separate reform, but must be undertaken conjointly with such alterations in the distributive arrangements as might be requisite for removing from the new plan _any chance, however slight or remote, of injuring the population by metallic poison_.