View report page

52
the same year, I have ample evidence that deaths under five years of age were
greatly too frequent in St. Giles for its population. For in the first place, debility
from birth, and many of the diseases above-mentioned, as being unduly fatal to St.
Giles, are essentially diseases of children ; and in the second place, (the death-rate
among the children of the metropolis appearing to be nearly constant, from year to
year), I may use the numbers dying in London in former years, to elucidate the
history of 1857- From these it appears that in London, of every 1,000 deaths, 3l8
ae of children under two, and 412 of those under five years of age; the corresponding
numbers for St. Giles, are 360 and 477. It will not be forgotten, that there are
fewer children among the residents of St. Giles than in a like number of the metropolis
at large, and hence the infantile mortality should be below the average. The
facts, however, prove to be the reverse. Enormous as the death-rate among children
is in London, they die in St. Giles in the higher proportion of 115 in this district to
every 100 of the town.
What are the conditions which experience has shown to be productive of this
zymotic mortality, these consumptive diseases, these inflammations of the lungs,
these convulsions and other diseases of children ?
In the obscurity which surrounds the early origin of every disease, no prudent
physician would think of making a positive statement that any one condition was the
cause of the malady evolved, but when the question is asked,—given the above
diseases as being those unduly fatal in a community, are there any sanitary defects
which you can indicate as being likely to exist in that community?—experience then
does justify us in giving an answer. Within the limits of this report, I am not able
to debate the grounds on which my opinions rest, but my conclusions are briefly as
follows:—
To contagion a subordinate part is to be assigned, as many of the above
diseases are not communicable, and some of the most contagious, as small pox and
scarlet fever, though they may have existed in the district, have not spread, and are
not among the list of diseases in excess.
To impure water I have already charged a certain proportion of disease; the
instances when bad water directly causes illness are rare, and necessarily rarer from
the fact that it is never suspected of the mischief; still there are not wanting proofs
of its bringing about disease in the individual case.* Among communities, however,
the use of impure water may be shown to have increased the general death-rate, and
especially the mortality from zymotic diseases.
But it is to the impurities in the atmosphere that we must attribute the
main part of the mortality from the diseases named. I shall not here consider emanations
from cow-sheds, and effluvia from burial vaults,"}" as their influence must be
* In this district I have sometimes sought in vain for the cause of Fever, unless it was
found in the drinking water which was impregnated with the foul air of the privy through the
" waste pipe."
+ I think there is reasonable ground for suspecting ill effects from the vaults under
St. George, Bloomsbury. They are by far the most sickening in the district, although a
thorough draught through them is constantly dissipating their effluvia; an excess of zymotic
disease in the streets around has been pointed out in a special report. Anything detrimental,
however, in their vaults will speedily be remedied by the steps that are about to be taken.