Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Whitechapel]
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The district comprises 415 streets and bye-places, the length of which is upwards
of 21 miles. Of these streets and bye-places, 228 are on the north side
and 187 on the south side of the district. At the last census the number of
houses which were inhabited was 8,664; of those uninhabited the number was
292, and there were 33 in the course of erection. If all these houses were now
occupied, the number would be above 9,000. Of these it may be fairly estimated
that 5,000 are let out in separate tenements, and each house may be estimated
to contain on an average 3^ rooms.
If such a system of supervision were to be carried out, as in my opinion
would be desirable, about 17,500 rooms would require a periodical inspection;
for unless a regular inspection, at very short intervals, be adopted, overcrowding
will exist, and wherever overcrowding is found nuisances will be of continual
recurrence. The public dustbins (about 160 in number) must be inspected
twice at least every week, so that they may be emptied before the vegetable and
animal matter in them putrifies. Every street should also be inspected on the
day that the scavengers are bound to cleanse it. Besides this, it is absolutely
necessary for all the rooms in which fever has recently existed to be inspected,
so that orders may be served upon the owners to have them lime-washed. All
the cow-houses (37 in number) should be inspected at least twice a week, in
order to see that they are properly kept, and that the dung is regularly removed
every second day. The same regular inspection of all lay-stalls and dungpits
is required. The physical labour which such an inspection requires is
more than can be given by two Inspectors ; a third Inspector should therefore
be appointed.*
The overcrowding in this district is of two kinds, viz. that of the houses,
and of the people occupying the houses. Many of the houses are built back to
back, and consequently cannot have a current of air through them, and the
spaces at the rear of others are so small that they are inadequately ventilated.
The former can only be prevented by proper provisions being introduced
into a new Building Act, and the latter by the frequent inspection and
putting rigidly in force the powers entrusted to Local Boards. There can
be but little doubt that density of population exercises a powerful influence in
increasing the rate of mortality. Cases of fever have been caused by overcrowding,
and by the emanations from cesspools. But it cannot be said that
overcrowding is either the sole cause of an increased rate of mortality or of
fever. The poverty of the people, their occupations, their ages, the means of
cleanliness at their command, the state of the drainage, the ventilation, and the
existence or otherwise of efficient sanitary conditions, will produce a difference
in the rate of mortality in any district.
The knowledge of the fact that the want of sanitary arrangements causes
* Since this report was presented to the Board an additional Inspector has been
engaged, whose duty at the present time is to inspect every house where diarrhcea has
occurred, and to report to me the sanitary state of such house. For the week ending
22nd July, 85 cases of diarrhoea were attended by the Medical Officers of the Union, and
for the following week the number of cases was 88,