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with those of former years. Thus, previously to 1860, the head "Fever,"
chiefly embraced cases of "Typhoid," a form of Fever, which I believe
to be more especially associated with the Sewage-poison. In 1861 and
1862, the Typhoid-fever was largely replaced by "Typhus,'' a form of
Fever more commonly arising in connexion with overcrowding and
destitution. This was still the form of Fever prevalent in 1863. From
a Report of the Fever Hospital in Islington, drawn up by Dr. Buchanan
one of the Physicians to that Institution, and Medical Officer of Health
for St. Giles, I find that there were admitted during 1863, 1319 cases of
Typhus, and only 172 cases of Typhoid. Typhus is still confined to the
poorest class of the population. The localities whence the typhus
patients were derived, were the poorest and most densely crowded.
The following is the number of Fever deaths registered in Shoreditch
since 1855:
1855 1856 1857 1858 1859 1860 1861 1862 1863
153 225 184 135 108 94 110 206 146
This shows a progressive dimunition down to 1860, keeping pace
with, and due, there is reason to believe, to, the advance of Sewage-works
and the improvement of the dwellings. The diminution of "Typhoid,"
the form of fever chiefly included in the returns of the years 1855-1860,
has, I believe, been continued during 1861—2 and 3. The rising figures
of 1861 and 1862 represent as we have seen a different Fever, one not
depending upon Sewage, but upon overcrowding, the evil which has
already attained pre-eminence amongst our sanitary difficulties, and which
looms in still larger proportions in the future.
If we confine our observations to the actual condition of the particular
section of the community of which we form a part, and who are the
immediate subjects of our sanitary administration, it may be difficult to
realise to the full extent, the increase of value of human life which has
been achieved. But this gain becomes strikingly manifest, if we resort
to comparison. We may for instance, compare the actual healthy condition
of our population with that which it presented in former years,
before sanitary improvement formed the highest and direct object of
Metropolitan local administration. And we have unfortunately, still