Chapter 12

When one remembers under what conditions the working-people live, when one thinks how crowded their dwellings are, how every nook and corner swarms with human beings, how sick and well sleep in the same room, in the same bed, the only wonder is that a contagious disease like this fever does not spread yet farther. And when one reflects how little medical assistance the sick have at command, how many are without any medical advice whatsoever, and ignorant of the most ordinary precautionary measures, the mortality seems actually small. Dr. Alison, who has made a careful study of this disease, attributes it directly to the want and the wretched condition of the poor, as in the report already quoted. He asserts that privations and the insufficient satisfaction of vital needs are what prepare the frame for contagion and make the epidemic widespread and terrible. He proves that a period of privation, a commercial crisis or a bad harvest, has each time produced the typhus epidemic in Ireland as in Scotland, and that the fury of the plague has fallen almost exclusively on the working-class. It is a noteworthy fact, that according to his testimony, the majority of persons who perish by typhus are fathers of families, precisely the persons who can least be spared by those dependent upon them; and several Irish physicians whom he quotes bear the same testimony.

Another category of diseases arises directly from the food rather than the dwellings of the workers. The food of the labourer, indigestible enough in itself, is utterly unfit for young children, and he has neither means nor time to get his children more suitable food. Moreover, the custom of giving children spirits, and even opium, is very general; and these two influences, with the rest of the conditions of life prejudicial to bodily development, give rise to the most diverse affections of the digestive organs, leaving life-long traces behind them. Nearly all workers have stomachs more or less weak, and are yet forced to adhere to the diet which is the root of the evil. How should they know what is to blame for it? And if they knew, how could they obtain a more suitable regimen so long as they cannot adopt a different way of living and are not better educated? But new disease arises during childhood from impaired digestion. Scrofula is almost universal among the working-class, and scrofulous parents have scrofulous children, especially when the original influences continue in full force to operate upon the inherited tendency of the children. A second consequence of this insufficient bodily nourishment, during the years of growth and development, is rachitis, which is extremely common among the children of the working-class. The hardening of the bones is delayed, the development of the skeleton in general is restricted, and deformities of the legs and spinal column are frequent, in addition to the usual rachitic affections. How greatly all these evils are increased by the changes to which the workers are subject in consequence of fluctuations in trade, want of work, and the scanty wages in time of crisis, it is not necessary to dwell upon. Temporary want of sufficient food, to which almost every working-man is exposed at least once in the course of his life, only contributes to intensify the effects of his usual sufficient but bad diet. Children who are half-starved, just when they most need ample and nutritious food--and how many such there are during every crisis and even when trade is at its best--must inevitably become weak, scrofulous and rachitic in a high degree. And that they do become so, their appearance amply shows. The neglect to which the great mass of working-men's children are condemned leaves ineradicable traces and brings the enfeeblement of the whole race of workers with it. Add to this, the unsuitable clothing of this class, the impossibility of precautions against colds, the necessity of toiling so long as health permits, want made more dire when sickness appears, and the only too common lack of all medical assistance; and we have a rough idea of the sanitary condition of the English working-class. The injurious effects peculiar to single employments as now conducted, I shall not deal with here.

Besides these, there are other influences which enfeeble the health of a great number of workers, intemperance most of all. All possible temptations, all allurements combine to bring the workers to drunkenness. Liquor is almost their only source of pleasure, and all things conspire to make it accessible to them. The working-man comes from his work tired, exhausted, finds his home comfortless, damp, dirty, repulsive; he has urgent need of recreation, he _must_ have something to make work worth his trouble, to make the prospect of the next day endurable. His unnerved, uncomfortable, hypochondriac state of mind and body arising from his unhealthy condition, and especially from indigestion, is aggravated beyond endurance by the general conditions of his life, the uncertainty of his existence, his dependence upon all possible accidents and chances, and his inability to do anything towards gaining an assured position. His enfeebled frame, weakened by bad air and bad food, violently demands some external stimulus; his social need can be gratified only in the public-house, he has absolutely no other place where he can meet his friends. How can he be expected to resist the temptation? It is morally and physically inevitable that, under such circumstances, a very large number of working-men should fall into intemperance. And apart from the chiefly physical influences which drive the working-man into drunkenness, there is the example of the great mass, the neglected education, the impossibility of protecting the young from temptation, in many cases the direct influence of intemperate parents, who give their own children liquor, the certainty of forgetting for an hour or two the wretchedness and burden of life, and a hundred other circumstances so mighty that the workers can, in truth, hardly be blamed for yielding to such overwhelming pressure. Drunkenness has here ceased to be a vice, for which the vicious can be held responsible; it becomes a phenomenon, the necessary, inevitable effect of certain conditions upon an object possessed of no volition in relation to those conditions. They who have degraded the working-man to a mere object have the responsibility to bear. But as inevitably as a great number of working- men fall a prey to drink, just so inevitably does it manifest its ruinous influence upon the body and mind of its victims. All the tendencies to disease arising from the conditions of life of the workers are promoted by it, it stimulates in the highest degree the development of lung and digestive troubles, the rise and spread of typhus epidemics.

Another source of physical mischief to the working-class lies in the impossibility of employing skilled physicians in cases of illness. It is true that a number of charitable institutions strive to supply this want, that the infirmary in Manchester, for instance, receives or gives advice and medicine to 2,200 patients annually. But what is that in a city in which, according to Gaskell's calculation, {104} three-fourths of the population need medical aid every year? English doctors charge high fees, and working-men are not in a position to pay them. They can therefore do nothing, or are compelled to call in cheap charlatans, and use quack remedies, which do more harm than good. An immense number of such quacks thrive in every English town, securing their _clientele_ among the poor by means of advertisements, posters, and other such devices. Besides these, vast quantities of patent medicines are sold, for all conceivable ailments: Morrison's Pills, Parr's Life Pills, Dr. Mainwaring's Pills, and a thousand other pills, essences, and balsams, all of which have the property of curing all the ills that flesh is heir to. These medicines rarely contain actually injurious substances, but, when taken freely and often, they affect the system prejudicially; and as the unwary purchasers are always recommended to take as much as possible, it is not to be wondered at that they swallow them wholesale whether wanted or not.

It is by no means unusual for the manufacturer of Parr's Life Pills to sell twenty to twenty-five thousand boxes of these salutary pills in a week, and they are taken for constipation by this one, for diarrhoea by that one, for fever, weakness, and all possible ailments. As our German peasants are cupped or bled at certain seasons, so do the English working- people now consume patent medicines to their own injury and the great profit of the manufacturer. One of the most injurious of these patent medicines is a drink prepared with opiates, chiefly laudanum, under the name Godfrey's Cordial. Women who work at home, and have their own and other people's children to take care of, give them this drink to keep them quiet, and, as many believe, to strengthen them. They often begin to give this medicine to newly-born children, and continue, without knowing the effects of this "heartsease," until the children die. The less susceptible the child's system to the action of the opium, the greater the quantities administered. When the cordial ceases to act, laudanum alone is given, often to the extent of fifteen to twenty drops at a dose. The Coroner of Nottingham testified before a Parliamentary Commission {105a} that one apothecary had, according to his own statement, used thirteen hundredweight of laudanum in one year in the preparation of Godfrey's Cordial. The effects upon the children so treated may be readily imagined. They are pale, feeble, wilted, and usually die before completing the second year. The use of this cordial is very extensive in all great towns and industrial districts in the kingdom.

The result of all these influences is a general enfeeblement of the frame in the working-class. There are few vigorous, well-built, healthy persons among the workers, _i.e_., among the factory operatives, who are employed in confined rooms, and we are here discussing these only. They are almost all weakly, of angular but not powerful build, lean, pale, and of relaxed fibre, with the exception of the muscles especially exercised in their work. Nearly all suffer from indigestion, and consequently from a more or less hypochondriac, melancholy, irritable, nervous condition. Their enfeebled constitutions are unable to resist disease, and are therefore seized by it on every occasion. Hence they age prematurely, and die early. On this point the mortality statistics supply unquestionable testimony.

According to the Report of Registrar-General Graham, the annual death- rate of all England and Wales is something less than 2.25 per cent. That is to say, out of forty-five persons, one dies every year. {105b} This was the average for the year 1839-40. In 1840-41 the mortality diminished somewhat, and the death-rate was but one in forty-six. But in the great cities the proportion is wholly different. I have before me official tables of mortality (_Manchester Guardian_, July 31st, 1844), according to which the death-rate of several large towns is as follows:--In Manchester, including Chorlton and Salford, one in 32.72; and excluding Chorlton and Salford, one in 30.75. In Liverpool, including West Derby (suburb), 31.90, and excluding West Derby, 29.90; while the average of all the districts of Cheshire, Lancashire, and Yorkshire cited, including a number of wholly or partially rural districts and many small towns, with a total population of 2,172,506 for the whole, is one death in 39.80 persons. How unfavourably the workers are placed in the great cities, the mortality for Prescott in Lancashire shows: a district inhabited by miners, and showing a lower sanitary condition than that of the agricultural districts, mining being by no means a healthful occupation. But these miners live in the country, and the death-rate among them is but one in 47.54, or nearly two-and-a-half per cent. better than that for all England. All these statements are based upon the mortality tables for 1843. Still higher is the death-rate in the Scotch cities; in Edinburgh, in 1838-39, one in 29; in 1831, in the Old Town alone, one in 22. In Glasgow, according to Dr. Cowen, {106} the average has been, since 1830, one in 30; and in single years, one in 22 to 24. That this enormous shortening of life falls chiefly upon the working-class, that the general average is improved by the smaller mortality of the upper and middle-classes, is attested upon all sides. One of the most recent depositions is that of a physician, Dr. P. H. Holland, in Manchester, who investigated Chorlton-on-Medlock, a suburb of Manchester, under official commission. He divided the houses and streets into three classes each, and ascertained the following variations in the death-rate:

First class of Streets. Houses I. class. Mortality one in 51 ,, ,, ,, II. ,, ,, ,, 45 ,, ,, ,, III. ,, ,, ,, 36 Second ,, ,, I. ,, ,, ,, 55 ,, ,, ,, II. ,, ,, ,, 38 ,, ,, ,, III. ,, ,, ,, 35 Third ,, ,, I. ,, Wanting --- ---- ,, ,, ,, II. ,, Mortality ,, 35 ,, ,, ,, III. ,, ,, ,, 25

It is clear from other tables given by Holland that the mortality in the _streets_ of the second class is 18 per cent. greater, and in the streets of the third class 68 per cent. greater than in those of the first class; that the mortality in the _houses_ of the second class is 31 per cent greater, and in the third class 78 per cent. greater than in those of the first class; that the mortality is those bad streets which were improved, decreased 25 per cent. He closes with the remark, very frank for an English bourgeois: {107}

"When we find the rate of mortality four times as high in some streets as in others, and twice as high in whole classes of streets as in other classes, and further find that it is all but invariably high in those streets which are in bad condition, and almost invariably low in those whose condition is good, we cannot resist the conclusion that multitudes of our fellow-creatures, _hundreds of our immediate neighbours_, are annually destroyed for want of the most evident precautions."

The Report on the Sanitary Condition of the Working-Class contains information which attests the same fact. In Liverpool, in 1840, the average longevity of the upper-classes, gentry, professional men, etc., was thirty-five years; that of the business men and better-placed handicraftsmen, twenty-two years; and that of the operatives, day-labourers, and serviceable class in general, but fifteen years. The Parliamentary reports contain a mass of similar facts.

The death-rate is kept so high chiefly by the heavy mortality among young children in the working-class. The tender frame of a child is least able to withstand the unfavourable influences of an inferior lot in life; the neglect to which they are often subjected, when both parents work or one is dead, avenges itself promptly, and no one need wonder that in Manchester, according to the report last quoted, more than fifty-seven per cent. of the children of the working-class perish before the fifth year, while but twenty per cent. of the children of the higher classes, and not quite thirty-two per cent. of the children of all classes in the country die under five years of age. {108a} The article of the _Artisan_, already several times referred to, furnishes exacter information on this point, by comparing the city death-rate in single diseases of children with the country death-rate, thus demonstrating that, in general, epidemics in Manchester and Liverpool are three times more fatal than in country districts; that affections of the nervous system are quintupled, and stomach troubles trebled, while deaths from affections of the lungs in cities are to those in the country as 2.5 to 1. Fatal cases of smallpox, measles, scarlet fever, and whooping cough, among small children, are four times more frequent; those of water on the brain are trebled, and convulsions ten times more frequent. To quote another acknowledged authority, I append the following table. Out of 10,000 persons, there die--{108b}

Under 5-19 20-39 40-59 60-69 70-79 80-89 90-99 100 x 5 years In Rutlandshire, a healthy agricultural district 2,865 891 1,275 1,299 1,189 1,428 938 112 3 Essex, marshy agricultural district 3,159 1,110 1,526 1,413 963 1,019 630 177 3 Town of Carlisle, 1779-1787, before introduction of mills 4,408 921 1,006 1,201 940 826 633 153 22 Town of Carlisle, after introduction of mills 4,738 930 l,201 1,134 677 727 452 80 1 Preston, factory town 4,947 1,136 1,379 1,114 553 532 298 38 3 Leeds, factory town 5,286 927 1,228 1,198 593 512 225 29 2

Apart from the divers diseases which are the necessary consequence of the present neglect and oppression of the poorer classes, there are other influences which contribute to increase the mortality among small children. In many families the wife, like the husband, has to work away from home, and the consequence is the total neglect of the children, who are either locked up or given out to be taken care of. It is, therefore, not to be wondered at if hundreds of them perish through all manner of accidents. Nowhere are so many children run over, nowhere are so many killed by falling, drowning, or burning, as in the great cities and towns of England. Deaths from burns and scalds are especially frequent, such a case occurring nearly every week during the winter months in Manchester, and very frequently in London, though little mention is made of them in the papers. I have at hand a copy of the _Weekly Despatch_ of December 15th, 1844, according to which, in the week from December 1st to December 7th inclusive, _six_ such cases occurred. These unhappy children, perishing in this terrible way, are victims of our social disorder, and of the property-holding classes interested in maintaining and prolonging this disorder. Yet one is left in doubt whether even this terribly torturing death is not a blessing for the children in rescuing them from a long life of toil and wretchedness, rich in suffering and poor in enjoyment. So far has it gone in England; and the bourgeoisie reads these things every day in the newspapers and takes no further trouble in the matter. But it cannot complain if, after the official and non-official testimony here cited which must be known to it, I broadly accuse it of social murder. Let the ruling class see to it that these frightful conditions are ameliorated, or let it surrender the administration of the common interests to the labouring-class. To the latter course it is by no means inclined; for the former task, so long as it remains the bourgeoisie crippled by bourgeois prejudice, it has not the needed power. For if, at last, after hundreds of thousands of victims have perished, it manifests some little anxiety for the future, passing a "Metropolitan Buildings Act," under which the most unscrupulous overcrowding of dwellings is to be, at least in some slight degree, restricted; if it points with pride to measures which, far from attacking the root of the evil, do not by any means meet the demands of the commonest sanitary policy, it cannot thus vindicate itself from the accusation. The English bourgeoisie has but one choice, either to continue its rule under the unanswerable charge of murder and in spite of this charge, or to abdicate in favour of the labouring-class. Hitherto it has chosen the former course.