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10
Taking, however, a more broad view of our position in Islington, and viewing it in
its relation to the eastern districts of London, where cholera broke out in great
severity, one remarkable fact is obvious. Cholera broke out in the east of London
in the 28th week of the year, that ending July 14th. In the week ending July 21st,
it became very severe there, and several deaths from choleraic diarrhoea occurred in
Hackney and Shoreditch. The influence was spreading westward along the low level,
gradually rising, as a ground mist would do, towards our higher level. Towards the
close of the following week it had reached the part of our parish which was just above
the level of 80 feet, and broke out at the first clump of close crowded streets and
houses, and the first low population it would reach in such a progress, viz:— the
vicinity of Elder Walk. Pursuing the same course, and guided by the conformation
of the ground, it passed into the stratum of 100 to 120 feet, and proceeded along the
side of the rise to 120 feet in the north westerly direction to Lower Holloway, Palmer
Street, Hope Place West, and the Queen's Road district—all the nearest crowded,
close, and poor localities that it would meet with in such a course, at such a level. It
was not until a later period—during the second epidemic wave—that localities at
and above 120 feet of elevation were attacked; such as Theberton district, the
Brandon Road, Henry Place, &c. (with the exception of the first isolated imported
case). And thus, having surmounted the ridge of elevated land running northward
from Sermon Lane to Barnsbury Park, persons on the west side of this ridge became
attacked, and we met with the cases in Richard Street, Buckingham Place, Gifford
Street, Belle Isle, &c. It is difficult to describe this course in words, but with a map
marked with the levels of the district, the course of the disease is seen at a glance in
its relation to them.
Let us see, then, what we can learn as to the character of the houses in which
the attacks occurred. Four cases out of the number originated in the London Fever
Hospital. These must be excluded; as also two, the locality of whose origin I do
not precisely know.
Of the remaining 104 attacks, 23 only occurred in houses with fairly large and
airy rooms, and of these 14 or 60 per cent., were fatal. Eighty-one occurred in
houses with small, close, confined rooms, and of these 49 or 60 per cent., were fatal.
The only conclusion I can draw from this is, that the epidemic influence was most
felt in the houses of the latter class ; but when the attack occurred, the result was not
apparently influenced by any circumstance of this nature.
Again, of the 104 attacks 56, or more than half, occurred in houses more or less
remarkable for neglect of general cleanliness. Of these, 36 cases were fatal or 66 per
cent. On the other hand, 48 occurred in houses not thus remarkable; some of them
very clean, even where the rooms were small; and of these 27 or 56 per cent., were
fatal. The uncleanliness of the habitations, then, had a distinct influence, both in
favouring the occurrence of cholera and imparting to the disease a severe and fatal
character.
* I have had the lines of elevation marked in red upon my old " Sanitary Map," with the position of the
cases of cholera in red dote (fatal cases), and little circles (oases which recovered).