The Sun.
London, England, 1862-01-18 00:00:00

THE' SANITARY CONDITION OF THE

CITY OF LONDON.

At the weekly meeting of the Commissioners of
Sewers, held at Guildhall, Deputy Christie in the
chair, Dr. Letheby, the Medical Officer of Health,
presented a Report on the Sanitary State of the
City for the quarter ending the 28th of December.
Of this document the material portions are sub-
joined. The births and deaths are below the ave-
rage for the corresponding quarters of the last ten
years. The number of births in the quarter was
760, and of deaths 641 ; the average in the former
case being 834, and in the latter 757. While, there-
fore, the proportion of births has fallen but 9
per cent. below the average, that of deaths has
declined about 16 per cent. 239 of the deaths
were in the Eastern division of the city, 158 in the
Western, and 244 in the Central. These numbers
are i❑ the annual proportion of 23.1 per 1,000 of
the inhabitants of the first named district, 23.6
of the second, and 21 of the third, making toge-
ther an annual death-rate of 22.4 per 1,000 for the
entire city. The average mortality in all England
during the autumn quarter is at a yearly rate of 21.8
per 1,000, and the chief towns of England it is 24'9.
38 per cent. of all the deaths were among children
of less than 5 years of age, and nearly 20 per cent.
among old persons of 60 and upwards ; 13 per cent.
were among adults at from 20 to 40 years of age,
and 19 per cent. at from 40 to 60.. These are nearly
the proportions of former years. Looking, however,
at the numbers which have contributed to this aggre-
gate, it will be observed that the mortality at differ-
ent ages in the several districts of the city has not
been equally distributed. In the Eastern district,
for example, the mortality of children has been 50
per cent. of all the deaths, whereas in the Western
union it has been only 36 per cent. Both of these
divisions of the city have nearly the same kind of
population, and he cannot point to any especial
cause for this high death-rate of children in the first
named district but the great density of the popula-
tion. In the Eastern district there are 266 persons
to an acre, whereas in the Western there are only
200, and in the rest of the city but 105. In the
whole of the metropolis, with a density of only 36
persons to an acre, the mortality of children under
five years of age is nearly 42 per cent. of all the
deaths ; what wonder, then, that in a district so
closely packed as the Eastern the infant mortality
should rise to 50 per cent. P Of every 100 deaths in
the city during the autumn quarter 24 have been
from zymotic diseases, 16 from inflammatory affec-
tions of the lungs, 13 from pulmonary consumption,
9 from tubercular diseases of infancy, 6 from con-
vulsions, and 6 from violence—the rest being from
chronic diseases, chiefly of old persons. Most of
these are nearly in the same proportion as in former
years, although the aggregate numbers in each
case are generally below the average. In the case of
continued fever and of whooping-cough, however,
the numbers are greatly above the average; for
the former has risen from a mean proportion of 28
to 39 in the quarter, and the latter from 19 to 42.
These, indeed, have been the most severe diseases of
the season, for, together, they make more than half
of all the zymotic deaths. It is difficult to perceive
the cause of this; for although the mild and humid
condition of the atmosphere during the quarter may
have contributed to the development of continued
fever by promoting the diffusion of organic miasma
it is hard to understand how it has influenced the
progress of whooping cough: Last year the prevail-
ing malady was measles, and in the autumn of the
year before it was small-pox and scarlet-fever. Why
is it that there are these vicissitudes ? Must the zy-
motic force expend itself by manifesting its action
in some shape or another.; or is it that we have not
yet discovered the conditions which are necessary
for its development, and are therefore unable to ar-
rest its progress P For some years past he (Dr.
Letheby) had watched with satisfaction the gradual
and steady abatement of continued fever, and had
spoken of it as the undoubted result of sanitary im-
provement; but now, without warning, the disease
comes suddenly upon us, and causes a higher mor-
tality than has been seen in any autumn or other
quarter for five years. This would seem to negative
his former conclusions ; but when we come to look
closely at it, there is one fact which is most notice-
able—the disease has not shown itself in its usual
haunts. The time was when fever was only found in
the purlieus of poverty and filth, when like an en-
franchised thing, it flourished in the crowded courts
and alleys of our great cities. There, and there only
it fixed itself and lived endemically, sometimes
getting strength from its active development and
spreading like a pestilence into cleaner ground—
the confines of luxury; but now it has changed its
abode. All through the present quarter it is notice-
able that the poor have not been the chief sufferers
from the disease ; but it has been most active
among the better classes. This is shown not
merely by the mortality returns, and by the gloom
which now hangs upon nations from the loss of
their Erinces, but also by the records of sickness.
In the several districts of the city, even to the pre-
sent moment, there has been a gradual and conti-
nuous abatement of fever among the poor. In the
autumns of 1858-59, when the mortality from the
disease was not nearly so high as now, the number
of fever cases attended among the poor by the me-
dical officers of the City Unions, was from 301 to
313 in the quarter—making an aggregate of 10 per
cent. of all the sickness returns; but during the
quarter which has just expired the number of fever
cases among the city poor has been only 76, which
is barely 3 per cent. of all the sickness. Nothing
can more clearly indicate the fact that fever has
migrated from the haunts of poverty ; and if it be
true, as Dr. Murchison and Dr. Barker have almost
demonstrated, that the form of fever which is now
among us is caused by the miasma of sewers, and
drains, and cesspools, it would seem that the poor
are better provided for in this respect than the rich.
For years past, indeed, the sanitary officers of this
metropolis have been directing their attention to
the state of the drainage and sewerage of the
poorer districts of London, and through their efforts
thousands upon thousands of cesspools have been
abolished. In the city alone above 5,000 of these
abominations have been got rid of, every one of
which was a prolific source of disease. Now and
then, however, with all our vigilance, it is dis-
covered that a drain or cesspool has been neglected;
sickness shows itself in the shape of low fever, or
chronic diarrboa 1, or a general wasting of strength,
and to the medical officer these signs are too strik-
.ie gto be overlooked. He causes search to made be-
low the basement of the house, and there is found
an old forgotten cesspool, which was left untouched
when the new drains were constructed ; or he dis-
covers that the sewer gases make their way into
the building, either from an untrapped opening, or
from the forcing influx of the tide into the sewer.
Even in the public way the emanations from the
sewer gratings have often been most offensive and
have made a neighbouring house unwholesome.
All this has called for remedy, and with it disease
has disappeared. With the poor these matters have
been systematically provided for, but with the rich
they have been neglected, and now there is the
penalty. He hopes soon to be able to report on
the ehymical action of the charcoal filters on the
atmosphere of the sewers. A large and crowded
district of the city has for two years been under ex-
periment, so that all the air from the sewers its
filtered through charcoal before it escapes into the
public way ; and, as far as his observations have
gore, the results are most satisfactory. In examin-
ing the charcoal after two years' work he finds it
charged not only with the sewer miasma in an alka-
line form, but also with the products of their oxy-
dation. The temperature of the atmosphere during
the quarter has been a little above the average of
the last 43 years. 'ln the month of October the
mean temperature (57.1) was nearly 6 degrees above
the average, and on several occasions the thermo-
meter rose to nearly 70 degrees of Fahrenheit. The
following month was rather cold ; but from the be-
ginning of December the temperature has been un-
usually mild, although the daily range of the
thermometer has been somewhat large, for it has
often exceeded 16 degrees of Fahrenheit. This,
with the great humidity of the atmosphere, averag-
ing about 85 per cent. of saturation, has been rather
trying to delicate constitutions; and the warmth of
the season has favoured the development of putrid
miasme. The river, however, has not shown any