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State of thc Home Department, setting forth the nuisance and danger to the
public health from this cause in crowded neighbourhoods. The receipt of this
letter was acknowledged, stating that it had been forwarded to the President of
the Council of Health, and there the matter terminated. In order to meet this
evil, it has been suggested that an Act might be passed forbidding the retention
of a dead body in any dwelling house for a longer period than four or five
days, according to the period of the year, unless such dead body should be
inclosed in a well cemented leaden coffin, and not kept in a room occupied as a
sleeping room.
Another prolific cause of the spread of fever is the treating of a case of this
disease in the room in which 'several members of a family reside. The rooms
occupied by the poor are, for the most part, from the want of proper ventilation,
and from other defects, unfitted for the treatment of a person suffering from so
prolonged and dangerous disease. At present, however, persons in destitute circumstances,
suffering from fever, are usually removed to the London Fever
Hospital, the general Hospitals, or to the Workhouses. The London Fever
Hospital, which is situated at Islington, will not accommodate more than 280
or 300 patients; and the deaths from fever in the Metropolis average 70 per
week, the total number for 1864 being 3,689, which number multiplied by 7, the
mortality being 14 per cent., will show the number of cases to be provided for in
the course of the year. From this it is manifest that the present building is inadequate
for the reception of all the fever cases which occur in London ; and even
if it were to be enlarged to three times its present size, it would not be expedient
to remove thereto patients living at a distance of several miles from the locality.
The danger of removing patients suffering from fever to a distance is very
great, and ought, if possible, to be avoided. If patients therefore, are to be
treated away from their homes, several fever Hospitals must be erected in
different parts of the Metropolis, for it appears to have been deemed objectionable
to send patients ill of fever to the Workhouses.
The last cause of ill-health among the population of London that I shall
mention is the dirty state of our public streets, and the accumulation of house refuse
in the dust-bins. These are matters which I have on former occasions brought
to your notice; and as the present contracts for scavengering the districts will soon
expire, I have thought it expedient again to mention the subject. It is indeed
a great luxury, as well as a matter most important to the public health, to have
clean streets; but this cannot be enjoyed without considerable expense being
incurred. It has been considered proper, in a sanitary point of view, that
all the streets in London should be cleansed every day, and that the public
dust-bins should be emptied daily. For the comfort and convenience of the
public, all the main thoroughfares should be cleansed before 10 o'clock in the
morning, and the bye-streets and courts before 11 o'clock, or at a later hour in
the day to be determined by the Board; and in order to accomplish this desirable
object, it would be necessary that a very much larger staff of scavengers
should be employed, and a considerably larger number of horses and carts
engaged, in order that the filth of the streets, instead of being, as it is at present,
suffered to remain for hours in the channels, might be carted away immediately
after it has been collected. If it were ordered that all the streets should be
cleansed daily before a certain hour in the day, there would be no difficulty in
seeing that the contractors did their duty; but no supervision that can be devised
of a practicable nature will insure the effective cleansing of the streets so long
the contractor is allowed to cleanse them at any hour of the day or night.
It might be expedient to engage other contractors to remove the dust than those
engaged to cleange the streets. The thorough cleansing of the streets throughout
the Metropolis would have an excellent moral effect upon the inhabitants
of the poor localities, who would then have a great inducement to keep the