Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for London, City of ]
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In the matter of light and the effect of deprivation thereof, I would suggest as a theoretical
consideration which is probably not far from the truth, that the English, being a mixed
race of northern and southern peoples, long blended and showing blond and dark children
even in the same families, while different families trend to the predominating blond or the
predominating dark have suffered, will suffer and are suffering to a vast extent from a smoky
urbanisation. The southerner grows pale or tans to meet a variation in sunlight, the
northerner used to less sun, can have too much of it. The past summer can have been very
trying to some constitutions, but dull, dark winters can be more so to all, because of an
unnatural cooping indoors which follows the general change of the race life to urbanisation.
The point is, that in many diseases, and particularly tuberculosis, a little matter of
heartening hygiene, such as natural sunlight and sun warmth, or even diffused daylight in
winter, may turn the scale in favour of the patient's life. Nature could and would, of course,
select, and according to thirty-five years' old information, has been selecting over a number
of generations, whether a lighter or darker English race should predominate. but why should
not human intelligence be thinkingly made, as it indeed is a part of Nature in this matter:
it would be a better nature and one containing less struggle for the generations to come.
Nor is the patient alone or chiefly to be considered; the preventive branch in medicine
thinks of the prospective patient, who is turned back from the danger point before defined
illness sets in. This is the truly economical treatment for the people.
While on the subject of tuberculosis, one should emphasise that there is a very definite
and well-known antecedent to the disease, a hardened fibre of lung, induced by inhalation
of fine particles of silicious grit; it were good that complete combustion of tars be not
effected with an increase in grit—a problem the engineers are setting themselves to solve
for the forced draught chimney.
But with these lengthy preliminaries, what is the root of the matter for London as to
both cause and cure. The cause is the domestic chimney burning household coal, and for
Central London more particularly the office chimney; the cure is smokeless heating, whether
by electricity, gas, or a smokeless solid fuel.
I think it will have been the experience of everybody that a still atmosphere in a room
is oppressive, often the case with electric, gas or central heating, and does not occur in
presence of an open fire, which extracts the air of a room through an open chimney, the fresh
air finding its way in through every crevice, even though visible apertures be shut. The
whole matter is involved in the eternal problem of ventilation; it should be well understood
that a moving atmosphere is an essential to health and activity of brain or finger, and that
the want of this is just the failure of electricity and gas in the heating of a room; to
sneeze or cough into a still atmosphere means that bacteria are floating in the room for a
definitely longer time than in the case of a moving atmosphere, and the cloud of bacteria
is massed instead of spread. To inhale a few catarrhal bacteria may be a stimulant to the
body's reaction, and is probably one of our protective mechanisms over the winter. Just as
certainly to inhale a large number produces a cold; ventilation must be maintained on the
counts of alertness and protection from illness in every office. It can be maintained by
the open grate at a certain expense of fuel, for, of course, much heat goes up the chimney
in carrying the air with it.
The fog of the still winter's night is white; at nine o'clock a.m. it changes to yellow, to
brown, to black over the metropolis. This is the expression of the lighting and maintaining
of countless fires with smoky coal. The fog hangs and increases in density, and at long last,
in the presence of a light westerly air, may drift, has drifted en masse above the river until,
though the lower air be clear so that there is three miles of perfect visibility, even twenty-five
miles away the overhead pall has produced there the darkness of midnight, causing incoming
ships to put up port, starboard and masthead lights. This was an extreme phenomenon;
the more usual is that the town and country to leeward are involved in the tarry mass and
shipping is stopped completely.
Will every ordinary fireplace burn a smokeless fuel such as low temperature carbonisation
products? The answer is No! But many fireplaces, especially those with a long chimney,
will. My experience with a ground floor office is that a low temperature carbonisation product,
practically smokeless, is cheaper, cleaner, warmer and more regulable than coal: the fire
is always bright, has its flicker to a certain extent; moreover, a slow combustion draught
preventer had to be fitted.
Where, on experiment, these products can be, they should be burned as a partial solution
of London's great problem: that in winter the finest weather, i.e., the days of high barometer