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20
The first and most obvious characteristic of the
disease is its preference for particular localities. It
is eminently a district-disease. And the conditions
which determine its local settlement are demonstrable
physical peculiarities.
After carefully reviewing the subject, I do not
know that I need qualify, except to express more
confidently, the account I formerly gave you of
those peculiarities, as consisting in the conjunction
of dampness with organic decomposition.
It is in respect of these conditions—especially
among dense urban populations, that the level of
occupied ground, relatively to the nearest watersurface,
becomes of primary importance. The low
level, in itself, or rather in respect of the watery
dampness which it implies, is not enough to localise
the pestilence. To be afloat at sea might be the
safest lodging.
The sub-district of St. Peter's, Hammersmith,
averages only four feet above high water level; that
of St. Olave's, Southwark, two feet higher; yet
among the former and worse placed of these two
populations, the Cholera-mortality was only 18 per
10,000; while among the latter and better placed
it rose to 196—multiplying nearly eleven times the
minor phenomena of a lower level. So also within
your own jurisdiction. Side by side along the river
lie four of your sub-districts; three at the elevation
of twenty-one feet, one at the elevation of twentyfour
feet. The Cholera-mortality, if simply proportioned
to level, should have been nearly the