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43
a map of Finsbury on which are marked the Phthisis
deaths for the past 5 years will show how exactly this is
the case. It is indisputable that Phthisis has been most
prevalent in Finsbury, in those portions of the district which
possess the following four characters, namely:—
Overcrowding of the houses on the land, without open
spaces;
Overcrowding of people in the houses ;
Small, ill-ventilated living rooms;
Ill-ventilated workrooms and workshops.
As a rule, it may be said that such properties are generally
old, worn out, and insanitary. It is extremely noticeable
that in somewhat similar properties to the above, but in
immediate proximity to open spaces the prevalence of Phthisis
is very much less. Around the Squares in the Amwell
District, around the open space of the Charterhouse, and
around the Artillery Ground and Finsbury Square, the
cases of death from Phthisis have been extremely few.
And whilst it is true that in these neighbourhoods there
are some houses of a different class to those in the more
overcrowded districts, yet it is also true that many of the
houses are very similar in every way except that they are
surrounded by open spaces. I attribute the comparative
freedom from Phthisis of the Amwell District in part to
the fact that it stands on rising ground.
3. A third conclusion is that a large number of cases have
occurred in the same houses. Taking the local distribution
of the disease for the last 6 years there are 98 houses
in Clerkenwell alone in which more than one case of
Phthisis has occurred during that period. In some houses
several cases have occurred. I attribute this persistence
of the disease in one house mainly to infected dust, due to
the expectoration of persons suffering from Phthisis, who
previously inhabited the house. This fact alone affords
abundant reason for the vigorous disinfection measures
which we have adopted.