London's Pulse: Medical Officer of Health reports 1848-1972

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Clerkenwell 1858

[Report of the Medical Officer of Health for Clerkenwell, St James & St John]

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29
In addition to these works, numerous minor improvements have been
made: such as cleansing water-butts and cisterns, and providing
lids; cleaning and lime-whiting houses; removing pigs and refuse, &c.
and trapping drains.
In regard to the cesspools alone, at a moderate computation, it may
be considered that 256 square yards of surface of concentrated foul
matter, pouring their offensive and noxious emanations into the very
houses of the inhabitants, have been done away with. I wish I could
congratulate the Vestry upon the foul effluvia generated within the
dwellings from over-crowding having been removed to a like extent.
It appears to me that the trapping of the gullies is not carried to a
sufficient extent in the district; the effluvium from many of them is most
offensive to passers by, and to the occupiers of the houses opposite which
they are placed ; and it is no uncommon circumstance to observe paper
or sacking laid over the gullies to keep the effluvium from the shops
and houses.
I must also remark that the removal of the refuse from the dust-bins
is most imperfectly carried out. I have no intention of finding fault
with the present contractor, for the same has been the case when the
duty was in other hands. Your Clerk has explained to me the
arrangement which is adopted, and it appears admirable ; but in practice
it is most unsatisfactory, for into whatever house I go in the district,
I find the dust-bin overloaded and often very offensive, and the
occupants complaining that they cannot get the refuse removed. There
appears to be something wanting in the whole system. Mostly the
dwellings of the poor are let out in tenements, and it is no one's duty to
give notice that the refuse requires removal, therefore it remains.
Probably the real remedy would be found in directing the dustmen to
apply regularly at the houses, at stated intervals, and not remain
satisfied with simply passing through the streets.
I have now reviewed the principal points to which I would direct
your attention. The year on the whole has not been favorable, although
the mortality most amenable to sanitary improvement has been
diminished.
The per centage mortality has been 2.2, whilst it should not exceed
1.7, so that, at the present rate, between 300 and 400 deaths occur
annually beyond the due proportion.
High mortality in a district, especially among the poor, who are the
principal sufferers, does not relate simply to the dead; the living are
also deeply concerned., Consider the waste of time and consequent loss
of income to the parents or friends arising from the preliminary
attendance, the funeral and the burial. Every death in a poor family
causes an interruption to the ordinary remunerative labor, and
produces expenses which have to be paid out of scanty wages, often