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Although the death rate had fallen to 22 per 1,000 there was no complacency and
Farr wrote 'It will be the office of the Board of Works to reduce this dreadful sacrifice
of life to the lowest point, and thus to deserve well of their country
Although in 1857 there were only 156 deaths from smallpox there were further
outbreaks, notably in 1871, 1877, 1881 and 1902.
Very little will be said about the 1957 table as much is written elsewhere in this
Annual Report. As stated earlier this table has been drawn up to make comparisons
with 1857 but it would be unwise for too much to be read into these comparisons.
Medical nomenclature has changed over the years and there is much more precision,
in diagnosis than there was a hundred years ago.
In 1957 heart diseases, cancer and respiratory diseases were the most important
causes of death and infant mortality was the lowest on record. Probably the main
reasons for the lower mortality were better water supplies and disposal of sewage.
As Morris (1759) said, ' The unhealthiness of the air of London, though not greater than
formerly, has been mentioned before, as one operating cause of the annual destruction
of many people. This, indeed, is the least powerful weapon, in the hands of death;
yet, to obviate its force, as the preservation and health of the people in every instance is
of great importance, it is proposed, that the cleansing of this city should be put under
one uniform public management, and all the filth be carried into lighters, and conveyed
by the Thames to proper distances in the country; where it would be of great benefit
to the lands, instead of being lodged on the outsides of this city; a nauseous noxious
spectacle
Morris's proposals about the management of sewage disposal were eventually put
into effect in 1856 and the general framework of London's main drainage system which
was completed in 1875 remains substantially the same to this day. The dramatic change
in the health of London really stems from this action.
Births and
christenings
Births and christenings together are the other item in the Bills worthy of comment.
The London birth rate has always been low—not as a rate but in relation to the number
of potential mothers; whereas nowadays this can be deduced simply by a comparison
of the age/sex structure of the London population with that of England and Wales,
and in the application of the area comparability factor, in earlier times it was the subject
of curious cogitation. As Graunt put it, and in so doing gave a vivid cameo of the midnth
century with its reference to 'country' parishes: 'The proportion of those subject
to die, unto those capable of breeding, is greater than in the country; that is, let there
be an hundred persons in London, and as many in the country; we say, that if there be
sixty of them breeders in London, there are more than sixty in the country, or else
we must say, that London is more unhealthful, or that it inclines men and women more
to barrenness, than in the country; which by comparing the burials and christenings
of Hackney, Newington and other country parishes, with the most smoky and stinking
parts of the city, is scarce discernable in any considerable degree.
Now that the breeders in London are proportionably fewer than those in the country,
arises from these reasons, viz.:
1. All that have business to the court of the King, or to the courts of justice, and
all country-men coming up to bring provisions to the city, or to buy foreign commodities,
manufactures, and rarities, do for the most part leave their wives in the
country.
2. Persons coming to live in London out of curiosity and pleasure, as also such as
would retire and live privately, do the same, if they have any.
3. Such as come up to be cured of diseases do scarce use their wives pro tempore.
4. That apprentices of London, who are bound seven or nine years from marriage,
do often stay longer voluntarily.
5. That many sea-men of London leave their wives behind them, who are more
subject to die in the absence of their husbands, than to breed either without them, or
with the use of many promiscuously.
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