The Sun.
London, England, 1853-12-06 00:00:00

valley of the Fleet, and were, therefore, exposed more than
aty other part of the province to the class of evils. I have
described. For a considerable part of this locality may be
regarded as but recently* a creek of the Thames, its shelv-
ing banks, singularly foul from ancient misuse, though now
built over and paved, undergo in their lower levels very
considerable soakage ; while the vast sewers which lie in
the mid channel of the former river are more liable than
any within your jurisdiction to suffer injurious interference
from the action of the tide. At every such interference,
and at every current of air setting up the sewers, all gases
generated in these large chambers would diffuse themselves
not only in the lower levels, but likewise widely east and
west up those important slopes which depend on the valley
for their drainage. I can easily understand that the radi-
oe,l care of this district may be possible only as a part of
those metropolitan improvements to which I have ad-
verted ; but I do think it of supreme importance, in re-
ference to any such visitation as we dread, that during the
next 12 months there should be taken every precaution
which technical knowledge can suggest for restricting, even
by palliative and temporary expedients, those mischievous
effects which I have endeavoured to illustrate.
"In describing to you the local affinities of cholera, I
have intimated that, in its preference for our low metro-
politan levels it selects these soils specifically in respect of
their being damp with organic putrefaction. A moment's
consideration will suffice to show that, if this be true, the
higher levels of the metropolis will be exempt from the
disease only in proportion as they exempt themselves from
the local conditions which invite it ; only in proportion as
they avail themselves of those natural advantages which
their situation enables them to command. Let a district
Ibe defective in house-drainage, so that its soil is excavated
by cesspools and sodden by their soakage; let its sewers
I be ill-constructed and foul, so that offensive gases are ven-
tilated into the immediate breathing air of the inhabit,
tants ; let its pavement be absent or imperfect, scattered
with refuse and puddled with water, you will easily con-
ceive that, under these circumstances, all distinctions of
level are merged in the strong identity of filth, and what-
ever diseases belong to putrefactive dampness of soil will
strike here as readily as on the low-lying mud banks of
the river.

" So, likewise, in still narrower limits, the predisposition
of a house to cholera may be stated in the same terms as
define the liability of a district—viz., that the humid gases
of organic decomposition, in proportion as they are breathed
into one house in a district more than into other houses
there, will engender the greater liability of the house, as
compared with its neighbour, to suffer an invasion of
cholera. And thus it often happens, during epidemic pre-
valence of the disease, that sporadic cases are determined
in localities which might generally claim to be free from
infection • for, what avails it to be on the highest ground
qnd the best soil, with every adjoining facility of sewers
and acavenage, if, owing to individual carelessness and
filth, the condition of dampness and putridity are retained
within a house, and its basement flooded with rotting
liquids or piled with accumulated refuse?
" I might give you many instances in illustration of
these points—showing you how, under the operation of
specific sanitary faults, the cholera mortality of districts
acquires an artificial exaltation ; but few comparisons
will suffice. At the period of the epidemic of 1849,
your best-conditioned sub-district was the north-west of
the City of London Union ; and (among those at the
same level) your worst was the sub-district of Cripplegate,
which, at that time, was in a very unsatisfactory state,
abounding with open cesspools and their consequences.
In the former of these sub-districts the cholera mor-
tality per 10,000 was 19, in the latter 47 ; and it is easy
to show that additional sanitary errors soon develops a
larger satality. Not far from your boundary, at the
same level with these two sub-districts, in the Hackney-
road division of Bethnal-green, it rose to 110 ; this large
mortality being principally confined to a very small por-
tion of the district, wherein (the local registrar reports)

sewers were almost entirely abient, houses were contami-
nated with the filth of years, streets were remaining for
days uncleansed from accumulating dirt, and all waste
waters (including animal secretions) were uniformly thrown
into the public way.
"Such are the conditions under which, at any imagin-
able height in the metropolis, cholera may decimate a po-
pulation ; such, in their worst form, were the conditions
which at Merthyr-Tydvil, several hundred feet above the
water-level, carried the cholera mortality to more than
double the high metropolitan district last mentioned.
Taught by this case the power of human mismanagement
to futilize the favours of nature; taught that perverse in-
genuity can construct poison-beds for the propagation of
cholera, high above the natural tract of its mysterious
ferment, one gladly turns from the horrible instructive-
ness of such a lesson, to gather the kindred evidence of
contrast ; and happily there is abundant evidence to show
how much may De effected, even in the most tainted dis-
tricts, towards earning a circumscribed exemption from
the disease by the judicious application of sanitary care.
" In the remarks which I have made on the local distri-
bution of cholera, you will have observed that I dvtell par-
ticularly on one class of sanitary evils, as concerned in its
production—on that class, namely, which consists in the
retention and soakage of organic refuse, on that class which
has its appointed antidote in a system of inodorous drain-
age, of uninterrupted pavement, of complete and punctual
scavenage. On this I particularly insist, because I believe
that here is the very atmosphere without which cholera
would cease.
" Sanitary evils abound ; and, if I were speaking of other
diseases, I might have more to say of other causes. lam
unwilling, even for a moment, to seem indifferent to those
remaining fertile sources of suffering that surround the
poor of our metropolitan population ; to their overcrowded
condition, to their scantiness of ventilation, to their insuf-
ficient or disgusting water supply, to their frequent per-
sonal dirt, to their habitually defective diet. These several
influences have their own characteristic sequels and retri-
bution, on which I have often addressed you, and which I
am little likely to underrate, believing as I do that the
aggregate of their effects in the lapse of years is infinitely
more fatal than any periodical epidemic visitation. Like-
wise I cannot doubt that, under certain circumstances,
and in respect of particular cases„ they may assist the ope-
ration of the choleraic poison. Nor will I pretend so ex-
actly to limit the affinities of that which evolves this poi-
son, as to deny that rooms fetid with animal exhalations
may (like cesspool-sodden cellars) be ready to answer the
stimulus of its infection. And, at any rate, I think it
highly important to recognise that all sanitary defects
which embarrass the excretive purification of the human
body, whether by breathing or otherwise, do naturally tend
in the same direction as the causes of cholera, and are
liable, if only by indirect means, to become accessory in its
destructive work.
" But, deeply impressed as I am with the importance of
these considerations, I esteem it of still higher consequence,
if measures are ever to be taken for an effective prevention
of the disease, that the principle of its specific causation
should be steadfastly kept in view. What may be the
exact chemistry of this process I do not pretend to say,
urging only that, in all human probability, the poison
arises in specific changes impressed, by some migratory
agent, upon certain refuse, elements of life. Perhaps no-
where, and certainly not before your hon. Court, can it be
desirable, in the present immaturity of pathological know-
ledge, to argue as to the first origin or absolute nature of
that wandering influence which determines in particular
localities the generation of epidemic malaria. Simply, since
it leads to all-important practical conclusions, let this dis-
tinction be recognised. That which seems to have come to
us from the East is not itself a poison, so much as it is a
test and touchstone of poison. Whatever in its nature it
may be, this, at least, we know of its operation. Past •
millions of scattered population it moves innocuous.
Through the unpolluted atmosphere of cleanly districts it
migrates silently, without a blow; that which it can kin-
dle into poison lies not there. To the foul, damp breath
of low-lying cities, it comes like a spark to powder. Here
is contained that which it can swiftly make destructive—
soaked into soil, stagnant in water, griming the pavement,
tainting the air—the slow rottenness of unremoved excre-
ment, to which the first contact of this foreign ferment
brings the occasion of changing into new and more deadly
combinations.

"These are matters which it is hateful to hear, and, be-
lieve me, to speak about. But the thing is worse than the
statement ; and I would suggest to you this easy test of
its reality. Take at random any consecutive hundred en-
tries of cholera—deaths in the Registra• General's metro-
politan returns, where local conditions are described; and
let any man decide for himself whether what I have
sketched in general terms convey more than the essential
features of these several records. In 1849, such an atmo-
sphere as these influences engender existed, continuously
and intensely, on the low-lying south side of the river, and
to some distance inland from Greenwich to Wandsworth ;
it existed also continuously, but in far less intensity, and
with comparatively little extension inland, along the
northern side of the river from Poplar to Chelsea; and it
existed very intensely in several independent centres,
scattered about those healthier levels of the metropolis,
which, by their better position, ought to have been ex-
empted from such a reproach. The cholera struck in the
same proportion as this atmosphere prevailed ; and herein,
I repeat, lies that local condition, except for which the
migratory ferment (whatever it may be) might pass harm-
lessly through the midst of us.
" For, towards the chemical constitution of local atmo-
spheres, it seems that the several principles of epidemic
diseases stand in the same sort of fixed respective relations,
as to the several principles of infective fevers towards
certain elements in the blood of individual persons.
What the infective ferment is for the man the epidemic
ferment appears for the locality. We know that in a given
group of human beings smallpox chooses one victim, scar-
latina another, measles a third, by reason of some material
quality in each person respectively, which his blood pos-
sesses, and which his neighbour's does not possess. By
virtue of this quality—not the less chemical because che-
mists have no name for it—that specific exterior agency,
which we call infection, has the power of affecting each
such person—has the power of producing in him a succes-
sion of characteristic chemical changes which tend to an
eventual close by exhausting this material which feeds
them. Strictly analogous to this, in its principle of choice
and in its method of operation, appears the epidemic ac-
tion—not on persons, indeed, but gn places. The specific
migrating power ha, the faculty o infecting districts in a
manner detrimental to life only when their atmosphere is
fraught with certain products susceptible under its influ-
ence of undergoing poisonous transformation. These pro-
ducts, it is true, are but imperfectly known to us. Under
the vague name of putrefaction we include all those thous-
andfold possibilities of new combination to which organic
matters are exposed in their gradual declension from life.
The birth of one such combination rather than another is
the postulate for a particular epidemic poison.
ainftt"ciWtnefaehe ; fermenttetihwoenhrefttrhhoeemrtshime which induces this particular
change in certain elements of our atmosphere may ever be
some accident of local origin, or must always be the creep-
ing
t impulse,ratmosphe rheesreelsnevwthheerree similarlybegiven
by this agency
or by that—by heat, by magnetism, by
to planetsthe
purposeo r meteors—such
fr
whichl qhuaevset ino
en:
theare
honourwidely
ef
irrelevantaddress-
ing you. The one great pathological fact which I have
sought to bring into prominence for your knowledge and
application is this :—That the epidemic prevalence of
cholera does not arise in some now cloud of venom, floating,
above reach and control, high over successive lands, and
raining down upon them, without difference, its prepared
distillation of death ; but that, so far as scientific analysis
risetn e
xtoploetdheetrnitllns
0;n
et heart
can decide, it depends on one occasional phase of an influ-
ence which is always about us, on one change of materials
are the dense exhala-
infect, in varying
itwhiltlhos
thesewhich,
materials, their
other
o perilously
tpi
which
oiincvneheee
exhala-
tions ef breathanimoafl epidemic
uncleanness,
pro-
portion, the entire area of our metropolis ;. and from
Itvhhennwatitunreessofthtehedcreansed,fnitl minufisiettrieeT
liabil-
ities remain
whetheroptional the with
the requisite
to a degrading calamity, or will employ
to remove from before their
in-
dolently acquiesce in their continued and increasing
skill, science, and energy
thresholds these filthy sources,of misfortune.
" 2. If, gentlemen, I have detained you long in stating
conclusions as to the habits of the disease and as to the sig-
nificance of its local partialities, it has been in order to

* New Bridge-street was built over the Fleet in 1765. The
present site of Farringdon-street had been arched in 30 years
earlier for the purposes of the Fleet-market.