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Metropolis. Upwards of six millions have been expended in ornamentation
and in traffic convenience, whereby the wealthy are principally benefitted, but
not one single street, court, or alley, where the poor are compelled to dwell,
has been improved at the public expense in order to advance the physical
condition of the people. In the densely crowded streets in London, fever and
other contagious or infectious diseases are very seldom or never absent, and
such diseases extend over the whole metropolis when they prevail epidemically;
the whole community, rich and poor, then suffer alike from their influence. It
is surely time that public attention should now be directed to this matter,
so that something effectual may be done to improve the existing state of
things. I may further add, that a great number of the houses in this District
are used as common lodging-houses, which are under the inspection of the
police, and are principally occupied by tramps and persons of the lowest class.
There are also many of the houses, which, from their almost inaccessable
situations, afford shelter to thieves and vagrants, who make their way into
London from all parts of the country ; the former to (obtain a larger field to
carry on their depredations, and the latter to live upon the charity which is
so indiscriminately bestowed by the unthinking members of the community.
Almost the only persons who enter these abodes of wretchedness are the
police officers, the relieving and sanitary officers, and the medical officers of
ihe Union.
Publication of Returns of Sickness.
The information respecting the state of the public health that would be
afforded by a weekly publication of all the cases of sickness which are treated
by the medical officers of the Unions, by the Hospital and Dispensary medical
officers, and by the medical attendants of large establishments, such as
schools, asylums, factories, &c., might prove of great importance by showing
the prevalence or otherwise of epidemic diseases. The deaths which are
published regularly every week by the Registrar-General, valuable as such
publication undoubtedly is, does not give full information respecting the
public health, for it sometimes happens that the deaths are very numerous,
owing to the fatal nature of disease; while, at the same time, cases of disease are
comparatively few in number ; and, on the other hand, the cases of illness may
be very numerous while the number of deaths is of small amount, owing to the
mildness of the prevailing diseases. If the deaths and the cases of illness
among the population were published together, a more correct opinion of the
public health would be obtained.
Ever since your Board has been established, I have published quarterly
the returns of sickness which are made weekly to the Guardians by the
medical officers of the Union, and in the years 1857 and 1858 the Metropolitan
Association of the Officers of Health collected the returns of the cases of
sickness occurring among the pauper population and those in the several
charitable Institutions and Workhouses in London. These returns were
submitted to a member of the Association, who prepared them for publication
weekly. Mr. Simon, the Medical Officer of the Privy Council, in his last
annual report expresses an opinion that, for the purposes of promoting
medical science and health administration, periodical reports of sickness
treated by the medical and surgical staffs of all the medical charities should be
obtained and published. These reports might be sent to the Medical Officers
of Health for the respective districts, who should transmit them to the
medical officer of a central authority having the supervision of the public
health.