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to be stored, as best it may be, in the dwelling and sleeping rooms, for the lack of an appropriate
receptacle outside the house; or where a dust bin has been provided, it was more frequently
found unenclosed and overflowing with its contents, adding another to the various causes of
miasma already enumerated (Cols. 14, 15). And lastly, there is the water supply (Cols. 18,
19); in some instances there is no water supplied to the houses at all, in others the quantity
is very insufficient, and in some, what is supplied is unfit for drinking purposes, from the
impurities it has gathered in the butts or tanks in which it is preserved.
19. It can scarcely be argued that this coincidence is fortuitous. Such a conclusion would be
opposed to all medical observation and experience, and in this instance might be successfully
combated by the results of special inquiries. Still, I am not prepared to say that all the
sanitary defects enumerated are of equal importance; nor would it be easy to attribute
fatal disease specifically to any one of them, but the difficulty vanishes when we group these
conditions into a class as agreeing in their physical results. Neither would I be understood,
while laying stress upon this class of causes, as ignoring the operation (perhaps even the local
operation), of a variety of other circumstances† which may predispose to zymotic disease and
promote its fatal termination. It is not to be concealed, however, that some of the conditions
I hint at may arise out of domestic discomfort, or the negligence and apathy which it
engenders.
20. The law, restraining the licence of the few for the advantage of the many, places the
remedy in your hands. In "pointing out the local causes," my duty is nearly performed. I have
only further to show one direction in which it would appear your efforts may be made with the
greatest probability of success. In the principle, I hope to carry the Vestry with me; in
matters of detail and in the application of the principle to individual cases, there will always be
abundant room for the exercise of discretion.
1° Enforcing the law against over-crowding of the dwellings of the poor—and as far as
possible, promoting their ventilation.
2° Insisting on landlords keeping the houses of the poor in a cleanly condition, and furnishing
the inhabitants with covered and enclosed receptacles, outside the houses, for dust
and other refuse; a further advantage would be gained, if certain days in each week
could be fixed, on which the contractor should be expected to remove all accumulations
of dust from certain streets and other localities.
3° Requiring that the yards attached to the houses should be properly drained, so that the
surface water should flow away from the walls, instead of towards them, as is the case in
many instances. Much good might be anticipated from a more general paving of the yards.
4° Enforcing the abolition of cesspools, wherever practicable, in the neighbourhood of the
residences of the poor, at least, and the supply, in their place, of wholesome privies,
communicating by impervious drains with the sewer, effectually trapped, and furnished
with appliances for cleanliness and flushing with water, of such a nature that ignorance
and idleness shall be unable to excuse their neglect*
5° The amendment of badly constructed, defective, and untrapped house drains.
6° Compelling an ample supply of water to be furnished, and until the system of conitant
supply be generally adopted, insisting upon proper receptacles for water being provided,
and upon the abolition of tanks and tubs, sunk into the earth, both of which are certain to
gather impurities, which render the water they contain unwholesome, and calculated to
promote disease.
b. Diseases of the Tubercular Class:
21. The diseases included in this class, carried off 414 individuals, or 18.0 per cent. of those
who died during the year.—The per centage of the tubercular mortality in the West Subdistrict
was 18.8—in the East it was 17.2. In London generally these diseases occasioned
17.1 per cent. of the whole of the deaths. The excess of tuburcular deaths was thus only
remarkable in the West Sub-district. Table 5 represents the mortality from this class of
diseases, and from each disease included within it, in Islington and its Sub-districts, and in the
Metropolis generally. The largest number of deaths was occasioned by Phthisis or
* In respect to the particular arrangement applicable in any individual case, I can say nothing; I have no
prejudice upon the subject, and have hitherto, in doubtful cases, been willing to be guided by the skilled
opinion of your Surveyor of Sewers and Drains.
† It may indeed happen, in any future year, that these "other circumstances" may predominate in their
operation over those causes now under discussion.