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vices of constitution, from consumption, cancer, and many
other chronic forms of disease. On the effects of the second
class of causes however I have something to say, especially as
I believe that they have a very important influence, and that
this influence has been very generally overlooked. The influence
of hospitals, of asylums and of workhouses and of any
institution receiving the aged and sick is well illustrated in
the present report, by the excessive mortality which the presence
of the workhouse and of two lunatic asylums gives to
the sub-district of Camberwell. But it may happen in another
way that, by a kind of process of natural selection, the young
and able-bodied tend to accumulate in certain localities, while
the infants and the aged, and it may be the sickly, remain
in undue proportion in other localities. To illustrate this:
the death-rate of Dulwich has always been remarkably low;
the death-rate of Peckham, without being really remarkably
high, has always been by contrast remarkably high, and it has
been assumed that therefore Dulwich is far more healthy than
Peckham. I believe Dulwich to be very healthy; I know that
Peckham, in its low-lying parts, has many elements of unhealthiness;
but I do not for one moment believe that the difference
of their death-rates indicates a corresponding difference
in their healthiness, still less of course that the excess of
its death-rate is a measure of the degree in which diseases,
preventible by the action of the Vestry, prevail in Peckham.
I have said on former occasions, and I repeat it now, that
there is in many parts of Peckham a large poor population;
that amongst such a population children get neglected and die
of illnesses, from which under other conditions they would
doubtless have recovered; that from their habits of life contagious
diseases spread among them with far greater virulence than
they do among the so-called better classes, and that illnesses are
manufactured amongst them which those who live in different