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during their stay there, they have cost the parish £142. 14s.; besides this, there
has been the money necessarily expended on them during their period of convalescence,
which we may fairly estimate at £100 more ; there has also been in many
cases the cost of maintaining the wives and children during the illness of the fathers,
and in others the cost of the permament maintenance of widows and orphans. The
additional expense incurred by this last item, it is difficult to estimate ; but, at the
very lowest, it cannot be less than £250. We thus have £400 expended on the
fever cases occurring in one quarter of a year. Now it has been fully proved that
fevers might in nine cases out of ten be prevented by moderate attention to sanitary
matters, so that £360 of this—if not the whole—would have been spared : this is
only one amongst many illustrations that might be adduced, to show that money
spent upon public health is money well spent, even regarded as a commercial
investment.
Since my appointment, I have not been able to do more than take a cursory view
of this large parish ;—the most populous in London ; in area, nearly four times as
extensive as the City of London, within and without the walls, and nearly twice
as extensive as Saint Marylebone; in population, one-third more than the City of
London, about 14,000 more than Saint Marylebone, and about two-thirds that of
Manchester.
I shall only, on the present occasion, call your attention to one class of causes
which is operating to the injury of the health and the destruction of the lives of the
population. I refer to the condition of the houses of the poor, especially in respect
to drainage, water supply, want of cleanliness, and domestic accommodation. These
are all matters of the greatest importance, and which fortunately are now, to a great
extent, under your control. In order to effect any extensive improvements in these
respects, you must institute a very thorough system of inspection of nuisances.
When I have ascertained that a set of houses is generally in a bad state, I should
place in the hands of an Inspector forms for him to fill up, which would give, in
reference to these houses, precise and detailed information. The forms will be of this
kind (see Schedule B). I should then be enabled to come to the Sanitary Committee
with definite recommendations, and they might give notice to the landlords that they
would be required to make the necessary improvements, or that further measures
would be taken against them. The Inspector would subsequently be expected to
ascertain whether the improvements have been effected ; and if not, to summon the
owners before a Magistrate, and to appear against them. So that the Inspector
will often have to visit the locality of a single nuisance three or four times before it
is removed.
We do not want inspection at present to find out nuisances ; the nuisances are,
unfortunately, so numerous and so great that we have no difficulty in finding them.
The difficulty will be in their removal; and it is, as a part of the machinery essential
to their removal, that I ask for inspection; without it, all our discoveries will end in
themselves, and be attended with no beneficial result. There are also many densely
populated places which, after they have once been set right, will require to he
periodically visited, in order to see that they do not return to their former condition
The District Medical Officers have, in several instances, pointed out to me
houses in which formerly there were always cases of illness; but in which, since the
landlords have attended to the drainage, and made a few improvements, there has
been little or no illness. It would be very easy to adduce a hundred illustrations of
the visible benefits which have resulted from such measures, in other places.
It is much to be regretted, that landlords cannot always see that it is to their own
interest to keep their property in a condition such as decent people can inhabit. By
leaving their houses in the state in which many of them are now, they can only
have tenants who, from poverty, can get no better accommodation, or else those who
prefer filth to cleanliness.
The number of the latter description is, I am convinced, not nearly so great as is
often represented; and the class would soon become quite extinct if they were compelled
for a time, by the constant inspection of the sanitary authorities and the
co-opcration of the landlords, to attend to the decencies of life. For they would
soon find the advantages of their new mode of living, not only in comfort, but also