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gaseous poisons into the air; and the absence of ventilation will favour the concentration
of the poisons. The unfortunate inhabitants of this house will suffer more than
their neighbours. In several cases which I have investigated, almost every inhabitant
of a house thus situated has been struck down with fever, whilst those of the adjoining
houses have only been affected to a less extent, and in a milder form.
We are thus led to another conclusion: it is not only necessary to dilute
the aerial poisons as they arise by free ventilation, but it is also imperative by every
possible means to get rid of the materials from which they are generated. This is to be
effected mainly by improvements in sewerage and drainage.
III.—MEASURES FOR DIMINISHING THE CAUSES OF SICKNESS.
The means of lessening the sickness and mortality of a district are of two kinds.
First, the removal or diminution of the causes of disease; Secondly, the employment of
measures calculated to lessen the injurious action of those causes which cannot be
altogether removed.
The entire removal of the causes of disease is not attainable in a crowded
population. In all large communities there is necessarily some poverty; and indirectly
poverty is a cause of disease. Although, indeed, no form of government can ever succeed
in giving affluence or competence to all, there is nothing more certain or more demonstrable
than the proposition that an effective and well-sustained sanitary administration
can do much to obviate the most frequent and efficient cause of poverty, that is, disease.
For some three centuries we have had in active operation, laws and machinery for
dispersing over the whole community the cost and burden of maintaining the pauperism
of the country; it is only in our day that the experiment has been tried of reducing
the cost of pauperism by systematic sanitary operations levelled at the root of the evilTo
arrive at an exact estimate of the amount of pauperism caused by disease is a
difficult task. It has been stated at 75 per cent. But whether it reach that proportion
or not, it is easy to satisfy ourselves that the real proportion must be very great; thus,
during 63 days of the last quarter 55 cases of typhus fever alone were admitted into
the workhouse. The cost of maintaining these, must in itself be considerable. A fever
hospital capable of receiving 40 patients forms a distinct part of the establishment; yet
this even is often insufficient to meet the pressure from without. Mr. Clark the
Surgeon, informs me that he is often compelled to draft out the convalescents into the general
infirmary wards, to make room for recent cases. This fever is moreover a disease that
frequently attacks men and women in the most productive period of life. Where it does