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

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Whitechapel 1859

[Report of the Medical Officer of Health for Whitechapel]

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Although it is my duty to point out the anomalies that exist in the ordering of
inquests, and to make known the defects in the registration of the deaths that have been the
subjects of enquiry before the coroner, I have not thought it necessary at present to suggest any
alteration whereby such anomalies may be reconciled, and such defects remedied; neither
to express an opinion regarding the necessity or otherwise of a judicial inquiry on any of the eases
above mentioned; but would rather leave the whole question to be considered by persons
better qualified to deal with it. It is, however, obvious, from what has been stated above, that
the regulations now acted upon in the holding of coroner's inquests are very unsatisfactory, and
require pmendment.
The medical officers of the Union record 2742 cases of sickness among the out-door
poor, including 531 cases of zymotic diseases. In the corresponding quarter of last year, the
total number was 2955, including 696 cases of zymotic diseases. The cases in the workhouse
are 345, including 14 of fever, 16 of diarrhoea, and 2 of small-pox.
The amount of sanitary work done during the quarter will be seen by referring to
the tables in the Appendix, from which it appears that 169 houses have been visited, and a
detailed report of each house has been made by the inspectors. Since the commencement of their
labours, the total number of houses visited and reported upon in detail has been 4237. About
4000 more houses remain to be inspected. The visitation of the entire district, might, ere now,
have been accomplished, had it been necessary to visit once only the tenements of the poor, but
the structural improvements which the owners of property have made, after notices served by
the inspectors, have, in many instances, remained in an efficient state for a short time only,
when, from the thoughtlessness, or ignorance of the occupiers, the improvements that had been
made at considerable expense, were not appreciated, and the locality soon relapsed into its
previous state of filth and unhealthiness, demanding a re-inspection of every house. An
habitual and detailed inspection of the houses occupied by the poorer classes, is therefore
essential; and however much we may lament that our efforts to improve the habits of the people
are not crowned with success, we must still persevere in our exertions to remove the evils which
surround the greater number of the houses in this district. The education and sanitary improvement
of the people cannot be effected suddenly, but may be accomplished by a steady
perseverance in visiting the abodes of poverty, and in endeavouring to instruct the people in
the laws of health, and in the necessity of observing them. While despotic powers may be
required for dealing with property which is not fit for human habitation, more conciliatory
means should be adopted with the owners of that kind of property which may be improved by
an outlay of money, and the powers of the law should not be had recourse to, until every
endeavour has been made to induce them to effect the necessary improvements for the health of
their tenants. The public mind is gradually becoming educated in the science of hygiene, and
now sees the intimate connection between filth and disease. The pecuniary advantages
arising from the healthy condition of the people is also beginning to be felt and acted upon ; for,
where we formerly had opposition to the removal of nuisances to contend with, we now readily
obtain the hearty co-operation of the owners of property to remove, without delay, existing
nuisances, and to carry into effect the necessary improvements to prevent their recurrence ; and
in many instances, all that is necessary for the officers of health to do, is to visit the locality
complained of, point out to the landlord the existing evils, and to suggest the remedy, when
the needful improvements are commenced, and duly completed. This is the plan which I have
adopted in carrying out the provisions of the Nuisances Removal Act, and which has been
attended with the most satisfactory results, as are shown by the tables of the sanitary improvements,
all of which have, during the quarter, been effected without the assistance of the
magistrates, except in the case of the four houses in Leman-row, where it was necessary to