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upon the sanitary state of clerkenwell.
exceedingly defective. I believe that to between one-half and one-third of the
houses there are no drains opening into the sewers; the privies have large
cesspools; the water-supply is none or very deficient; the dwellings of the
poor are in a very filthy state; several streets have no sewers; many houses
no privies; and there are no baths nor washing-houses.
Among the deaths in the district during 1856 are 244 from the principal
of the zymotic deseases. The proportion of deaths registered as occurring
from these diseases does not appear very large, amounting to about onesixth
of the whole number; but some of the deaths arising from them have
been omitted, from my not having been enabled to ascertain the number of deaths
from these diseases occurring during the year 1856 in the general and
special hospitals. In the first quarter of the present year they amounted to
78, exclusive of the deaths occurring in the hospitals. These diseases have
received a new name from the Registrar General, and have been formed into
a new class, on account of their being especially important from destroying
those who dwell under circumstances where sanitary measures are defective;
i. e. they are preventible deaths. Wherever there are crowded apartments,
imperfect or no drainage, offensive cesspools, dung-heaps resting against
houses or in close proximity to inhabited rooms; wherever ventilation is
impeded by the narrowness of courts and alleys; and wherever the houses
and their inhabitants, living under these unfavourable circumstances, lose their
self-respect, pay no regard to personal cleanliness, and consider a state of
filth and offensiveness as their natural lot, there we find zymotic diseases in
full force and frequency, not merely striking down for a time all within their
reach, but carrying them off in undue proportion. Now, these zymotic
diseases are of still greater importance than has ever been represented; and this,
because those who are attacked with them do not simply recover or die as is
commonly supposed; but I shall not be exaggerating, when I say that all
those who even recover from these complaints are permanently injured. No
doubt this injury may remain latent for years, but it appears at last, and then
the death arising from it is entered under another head, by which its connexion
with the primary cause is kept from sight. Of the deaths which
occurred in the district during the first quarter of the present year, 78 arose
at once from zymotic diseases.* In the same period 88 deaths from diseases
of the respiratory organs are registered. Now, how many of these deaths,
placed under the separate head, arose really from the remains of zymotic
diseases ? Undoubtedly a large number. A constant result of hooping
cough is emphysema, or rupture of the air-cells of the lungs; this may lie
latent for years, merely rendering an ordinary cough from cold more persistent
and severe. But as years creep on, the cough arising from bronchitis
becomes more and more frequent and severe, and at last carries off its
victim; but in the Registrar's returns the real cause of the mortal ailment is
ignored and entirely overlooked. A constant concomitant or consequent of
measles is inflammation of the lungs, a result of which also is this emphysema,
and hence the subsequent bronchitis and death. Again, scarlatina has
a great tendency to disturb the glandular system, as evidenced in the swellings
of the glands of the neck, the throat, and the abdomen. Hence, the
impaired nutrition of the growing body; the marasmus, and finally consumption.
Unquestionably, again, the large number of tubercular diseases (72 in
* Exclusive of those taking place in hospitals.