§ THE EARL OF HARROWBY
rose, pursuant to notice, to call the attention of their Lordships to the sanitary condition of the country, more especially with respect to the metropolis. It was of the greatest importance, that the consideration of Parliament should be directed to the subject at the earliest possible moment, that they should not all at once find them- 527 selves in the midst of the cholera, without preparation; for so much was it in the nature of man generally to defer precautionary measures till the emergency arose, that he was afraid, unless public opinion was called to it, they would find that boards of guardians, and even boards of health, would be hardly prepared for the emergency that was likely to arise. They could hardly have forgotten that the cholera had recently appeared amongst them, and with greater intensity than at any former period; it had laid a stronger hold on such portions of the country as it had visited than ever it had done before; and it was not only more severe, but it was more fatal. It possessed also this remarkable peculiarity, that it now gives less warning in individual cases than was the case formerly; for on the recent visitation the premonitory symptoms were immediately followed by the most dangerous stages of the disease; and there was less opportunity of providing medical assistance than existed during the former visits of the epidemic. Therefore it was more especially important that they should be beforehand in their precautions, and look around them and see if they had hitherto taken the best precautions that circumstances would admit of for meeting so great an evil; how far the measure for the improvement of towns had been carried into effect, and whether they were still doing all that circumstances required. He believed it was the fact that they were, in point of legislation, in no better position now than they were in 1849, when the epidemic last raged in this country, and when their legislation was found so inadequate to meet the exigency. At that time the Board of Health was called into existence, and they had also the Commission of Sewers; but that, like the Board of Health, had been found to be inadequately constituted; and he asked in what better position they now were to meet the cholera than they were in on the last occasion? There were two points of view in which the question might be considered; namely, the providing of permanent precautions against the cholera in the way of drainage, and the proper supply of water, which he was afraid Lad been sadly neglected. It was true that some nibbling measures had been introduced in the course of the last three or four years, but he was afraid they were exceedingly imperfect; but, even imperfect as they were, he believed they would be productive of con- 528 siderable good, if means were taken to remove certain difficulties of detail which rendered it impossible completely to carry out their provisions. With regard to the supply of water, the mere transfer of duty from one officer to another would make the whole difference with respect to the inefficiency or efficiency of the means. At present a great portion of the metropolis was brought into close contact with the supply of water; but, from the want of a link between the drains and the water, that supply of water was not available for sanatory purposes. And why were those drains not supplied? It was because the power of making those drains was left in the hands of the churchwardens or local authorities, who were generally slow in operations which would entail immediate expenditure and were calculated to meet a merely threatened evil. If, however, there were some central authority to take measures for the opening of the communication between the water supply and the drains, a considerable improvement would be effected, and they would have no small portion of the metropolis in the possession of most efficient sanitary functions. There were a number of similar cases, but it was not for him to recite them. They would be much better in the hands of his noble Friend on his right (the Earl of Shaftesbury), who was much better acquainted than he was, not only with the general principles, but with every detail connected with those matters. An alteration in their legislation would make the whole difference, as to whether the general principles in an Act would be made efficient or not. With respect, for example, to the Nuisances Act, it was necessary to carry it into effect in a great degree through the agency of the boards of guardians. Notice was given to them to proceed; but they were probably reluctant to do so, and it was even alleged that in many cases they were elected to obstruct the removal of nuisances. Yet it was in the hands of those very parties they reposed almost their whole confidence to carry out their sanitary measures. The moving power was in the Board of Health—the power to carry out the Act was in the hands of the board of guardians. When the Board of Health gave notice to proceed, the board of guardians might refuse; and though there was a remedy by appeal, while the parties were disputing before a court of law, the nuisances that were productive of the spread of cholera would re- 529 main undisturbed and the pestilence might break out in one alley after another. Experience would show where the difficulties lay, and, with that experience before them, was it right that they should come into immediate contact with cholera without some measures being taken to remove those evils? It seemed to him to be highly important to keep in view two distinct classes of objects; one class had reference to the permanent health of the country, and every protection should be given to private property, when it was interfered with by putting the machinery in force necessary for that object. But whenever the country was visited by such a pestilence as the cholera, in his opinion, the ordinary law should be suspended, and the country placed under a dictatorial régime as regarded sanitary measures by an Order in Council; extraordinary powers should be committed to some central authority, which should be enabled to insist on the adoption of every necessary precaution for the preservation of the public health. They might adopt temporary measures to supply water for the cleansing of courts; they might insist upon medical visitations from house to house; they might employ all the measures that had been found from experience to be effectual for the purpose, and the central authority should have peremptory power to overrule every obstacle. What he wished to ask of his noble Friend and the Government was, what steps they were prepared to take in regard to this coming disease? They could have no doubt of its coming. It had reappeared again with all its usual formalities, and was approaching them in exactly the same way as former epidemics of the same kind had done. It had appeared at the same time of the year, in the same quarter of the country, and with no other difference than an increase in intensity. Therefore no delay should take place in the adoption of precautionary measures, particularly with regard to this great metropolis, with its two and a half millions of inhabitants. During its state of siege by the cholera, the metropolis should be placed under some peremptory authority that would cause everything to be done that was essential for the public safety. With regard to a more permanent measure, that was another question. It might be a desirable subject for the consideration of Parliament whether there should not be some steps taken with regard to the drainage of great towns; but what they had a right to know at 530 once was, whether provision was made, or about to be made, without delay, by a summary and effective process, to use all the means of prevention which they had learned from experience were, if not fully effective, at least effective to a considerable extent in the prevention of this terrible disease. With that view he should move for the production of certain papers which he thought might be important in assisting their Lordships to come to a conclusion. He begged to move—An Address for a Copy of Report of the General Board of Health, on the administration of the Public Health Act and the Nuisances Removal and Diseases Prevention Act, from 1848 to 1854 (presented to the Secretary of State for the Home Department in January, 1854).
§ THE EARL OF SHAFTESBURY
said, that the subject which had been brought forward by his noble Friend was an extremely important one; and he was glad it had been brought under their consideration, in order that their Lordships and the country should know the extent of the danger, the extent of the preparations that had been made to meet it, and for the purpose of making those preparations adequate to the emergency. There could be no doubt whatever that that dreadful epidemic was about not only to revisit this country, (which in fact it had already done), but that it was also about to repeat its ravages as it had done in 1831–2 and in 1848–9. It was following exactly the same course, and—the coincidence was really remarkable—it was exactly treading in the same traces, following the same course, and selecting almost the same spots where it had formerly ravaged the country. The two preceding visitations of cholera in 1831–2 and 1848–9, commenced with an attack which was merely premonitory of the epidemic. This was succeeded by a lull, which encouraged the hope that the pestilence was at an end. This lull continued, in the first visitation, for eight months; and in the second, three months; and then in each instance the pestilence returned with ten times more fierceness than before. Judging from experience, they might consider that they were now in the middle of a lull, perfectly similar to that which took place in the two preceding epidemics. The epidemic of 1848–9, which, in February, March, and April, numbered its victims only by one or two in the week, was premonitory of an outbreak that destroyed upwards of 2,000 in a week, and produced a total mortality of 17,000. The present 531 visitation had commenced its career in a manner precisely analogous to the last; and there was no reasonable ground to doubt that it would pursue a similar course. Within the last ten days the disease had broken out in Port Glasgow, Greenock, Gourock, and several other smaller places in the west of Scotland, and also at Leeds. It had alighted suddenly on these several towns, seized a few victims, and then disappeared for a time. This was precisely the course which it took in London and Glasgow in 1848, antecedent to its general attack in 1849; and this appeared to be the character of the pestilence—that it gave notice of its approach. He begged to read a statement which had been made by the special inspectors, appointed to the peculiar character of the present visitation:—Yet, in certain respects, as far as the pestilence has yet advanced, it appears to have been more virulent than on any former visitation. It has been more rapid in its course, and has been, upon the whole, more mortal. It has given shorter warning; it has allowed briefer space for preparation. One stage of the disease, formerly well marked, was now suppressed—namely, that denoted by the term approaching cholera.' At present, diarrhœa passed into cholera, and cholera into collapse, with a more fearful rapidity. In 1848 and 1849 it was rare for persons to perish within twenty-four hours; but now it was not uncommon for death to take place within twelve, ten, and even eight hours. Still the premonitory stage did exist; warning was given; time was allowed, and time enough, to arrest the disease in its diarrhœa stage; to stop the corning on of the fatal condition of collapse; but hours were now as precious as days, and the neglect of a space of time which, in 1849, might have been retrieved, would, in all human probability, in 1854, be attended with the certain loss of life.His noble Friend (Lord Harrowby) had asked what preparations had been made to meet the approach of cholera. In answer, he might state that by an Order in Council, issued in September, under the Nuisance Removal Act, which could only be put into operation when any part of the kingdom was affected or threatened with an epidemic, the Board of Health had obtained powers to issue regulations for the cleansing of streets, for the purifying, ventilating, or disinfecting of houses, for the removal of nuisances, and the adoption of measures generally for the promotion of health. The execution of these directions was entrusted to the local authorities, but principally to the boards of guardians in England, and parochial boards in Scotland, to whom, as well as to the Board of Public Health, power was given to insti- 532 tute prosecutions. From the fact that sixteen years intervened between the first and second visitations of cholera in this country, it was anticipated by some that the interval would be as great between the second and the third, if, indeed, the pestilence should ever again return, which they regarded as doubtful. But the Board of Health had directed its attention to the state of things on the Continent and in the East. From the increased frequency of its recurrence at its sources in India; from its repeated devastations in Persia, Russia, and Poland; from its advance last year to Berlin and Hamburg, and Warsaw, the General Board of Health believed that its return to this country was but too probable, and they apprehended that this event was not distant. On its reappearance on the Continent, a medical inspector was sent by the Board to Hamburg to ascertain the progress and character of the disease, and the probability of its approaching to this country. They had also proceeded to the execution of the powers vested in them for the examination of all suspected places. Medical inspectors were appointed, who re-examined the seats of the pestilence in the metropolis, and forwarded Reports to the several parishes to which they related. Subsequently, similar inspections had been extended to the principal towns throughout the kingdom in which cholera had proved most fatal. In the month of September they obtained the issue of the Order in Council, and means were adopted whereby those parties who were particularly exposed to the influence of the disorder—persons in the seaport towns, and on board ship—would be brought within reach of assistance. They had been assisted by the Board of Trade, and they had done their best to introduce that which had been long desired, namely, a manual of directions to be used by persons who, being remote from medical treatment and medical aid, would be able to administer to themselves or to others such treatment as was required upon a sudden breaking out of the disease. They had never been able to do that before, but on this occasion, by the assistance of the College of Physicians, they had been able to make such regulations, with the authority of and with the sanction of the College, as would form an important manual for all parties on board ship, and for those persons who had not the means to call to their aid at the spur of the moment the necessary medical assistance. He would 533 not detail to their Lordships the states of the various localities or the preparations that were being made, but he wished to show to the country a few choice specimens of the condition in which they were, and to show that no temporary powers would really aid them, but that only by deliberate and steady care and continuous efforts they could be placed in a position to withstand the attacks of cholera. He was sorry to say that little or nothing had been done in the interval between the first and second visitations of cholera to improve the epidemic localities. In the four years between the second and third visitations, some improvements had been effected in certain towns; but in general the epidemic localities remained the same; and there, the localising causes continuing undiminished, the pestilence on its return broke out and raged in the very same streets, blocks of buildings, houses, and even rooms. To prove that neither the Board nor the various localities had any excuse for their neglect, he would cite a few cases showing that the cholera visited the same places, streets, and houses in 1848–9 and 1853, that it did in 1831–2. Thus at Howden, on the north side of the Tyne, the first case of cholera occurred in the very same house in the successive epidemics of 1831, of 1848, and of 1853. At Gateshead, on the south bank of the Tyne, the pestilence first broke out in the same streets in each of the three epidemics. At Newcastle, in Greenhow Terrace, cholera in 1849 carried off three victims. In 1853, out of 118 inhabitants residing in this block of buildings, there were 31 attacks and 11 deaths. In both epidemics the first death occurred in the same house, the family inhabiting which lost during the recent visitation three of its members, the mother and two sons. At Bedlington, the house first attacked in 1853 was the second attacked in 1848. The first case of cholera that occurred in Sheffield, in September last year, was in Brown Street, situate in a low part of the town, in the vicinity of a large open sewer. It was in this same locality that the epidemic raged with the greatest violence in its previous visitations. At Redruth, in Cornwall, in the same streets and houses which were ravaged by cholera in 1849 there have recently occurred 41 deaths from the pestilence. With reference to Scotland, the disease first broke out at Leith, after an interval of sixteen years, in the same house in which it first appeared in 534 1832. At Port Glasgow, where cholera has just reappeared, the house first attacked was the second attacked in 1848. The other day at Glasgow a person died in one room, while in the epidemic of 1848, three persons died in the next room. At Arbroath, houses which exhibited a heavy mortality in 1848 have become the chief seats of the disease within the last few weeks. It was remarkable that in all the houses that had been examined some local cause was found for the existence of the disease. In some there was a large quantity of cesspool matter, in others there was a damp putrid mass hanging on the walls, waiting till the choleraic poison issued, to join with it in an unholy alliance to destroy its wretched victims. In the metropolis the case was precisely similar. At Kensington, in October last, cholera first returned to the very same room in which the first fatal case had occurred in 1849. One of the most fatal spots in the Whitechapel Union was Dunk Street and its immediate vicinity. In the epidemic of 1848 and 1849 there occurred in a circumscribed portion of that district 103 deaths from the pestilence. In 1852, Dr. Sutherland, in the apprehension that another outbreak of cholera was then impending, re-examined the same locality, which had been reported on so long back as 1838, and he stated that the descriptions given by Dr. Southwood Smith fourteen years before, were then perfectly applicable to the same place, and that the great leading causes of the unhealthiness of Whitechapel remained essentially the same. "I do not think," said the registrar," there is a street in the district in which epidemic disease has not been fatal." "During the recent visitation in the month of October last, no fewer than eleven fatal cases of cholera occurred in that very street in which, in 1838, typhus fever was in nearly every house." This showed, beyond question, that the cholera gave premonitory symptoms and indications, and told almost the very spots where it would return. Their Lordships could form no notion of the state of the places where it ordinarily broke out. It was absolutely necessary, if they wished to form an estimate of them, that they should visit them themselves, and bring every sense to bear upon them, for otherwise he defied them to fancy even the abominations which existed within, perhaps, a gun-shot of where they were then assembled. He would describe one place in the north—Gates- 535 head—where the cholera had raged and had occasioned great mortality. Mr. Lee, one of the inspectors of the Board of Health, said:—Now, as on former visitations, one of the most fatal localities in Gateshead is Pipewell Gate. It is a very narrow lane, about 300 yards long. In many parts two carriages could not pass each other, and the average width is only eight or nine feet. It lies parallel to the river, and extends from the bridge westward. On the south side the ground rises very precipitously, and many of the houses are built into the bank, so that the walls are damp and any ventilation impossible. The fires in the rooms draw the foul moisture out of the bank behind, so that in many cases it trickles down the internal walls. In addition to these evils the courtyards are only narrow alleys, with filthy steams of refuse flowing over the surface, and the dilapidated old houses are crowded from bottom to top with human beings. In 1832 the first local outbreak of cholera was in this place, and its devastation was frightful. In two days there were 172 cases, of whom sixty-three died. In 1849 the first outbreak was here, and about half the whole deaths from cholera in Gateshead occurred in Pipewell Gate. It is in the same sanitary condition now as at the former visitations.It was impossible to go through all these details, because there were hundreds—nay, thousands—of such localities; but he would bring one other instance under the notice of the House, because it was a sample of the state in which many of the villages and towns in the mining districts were allowed to continue. He alluded, now, to the town of Merthyr Tydvil; and it would be observed that one of the great evils among the mining population of that town, swarming with human beings, was the almost total want of water, it frequently happening that people were obliged to go a mile or two in order to obtain a glass of fresh water fit for use.The first circumstance," said Mr. Holland, "that must strike every visitor at Merthyr is the extreme and unusual dirtiness and wetness of the town. I can hardly expect credence for such facts as the following, yet it is perfectly free from exaggeration:—I saw a young woman filling her pitcher from a little stream of water gushing from a cinder heap, the surface of which was so thickly studded with alvine deposits that it was difficult to pass without treading in them, in some of which I saw intestinal worms, and the rain then falling was washing the feculent matter into the water which the girl was filling into her pitcher, no doubt for domestic use.He might here observe that, as a preventive against cholera, he did not believe there was one thing more important than a constant supply of clean and healthy water—not only for personal cleanliness, but also for domestic use. Wherever water had been plentifully used it had been able to 536 keep down the disease. Reference had often been made to the city of Hamburg, where, after the fire, the great quantity of water which was introduced there produced such an effect that diseases of the skin, which used to be extremely prevalent, ceased to be known, and not more than a single case of itch occurred in one year. The state of Scotland was not one whit better than that of England. This summary gave a representation of the whole.Damp, earthen, muddy floors; walls saturated with moisture, which, when limewashed, still looked dark and dingy from the impossibility of drying them. Small close windows, admitting of no perflation of air, crowded apartments, thatched root's, saturated like a sponge with water, an undrained soil, and ash and refuse cellars within ten feet of inhabited rooms. The condition of many houses in rural districts in which outbreaks had occurred was represented to be in no respect better. In the parish of Cramond, for example, an agricultural village near Edinburgh, the houses, which were made of whinstone, greedily absorbing moisture, were stated to be covered with decayed thatch, which was itself covered with bright green fungoid vegetation; the floors, consisting of unhardened clay, were hollowed in some places and filled with water, and were situate about a foot below the level of the adjacent soil. The rain soaked through the thatched roof and through the matting hung up overhead.But Dundee the inspectors declared to surpass them all; they thought, until they had inspected this place, that Newcastle was unrivalled. He would now allude to one or two places in the metropolis, and he would direct their Lordships' attention to a place in the neighbourhood of Kensington called the "Potteries." Dr. Milroy, in company with Mr. Frost, the medical officer of the district, recently reinspected the Potteries in the Notting-Hill division of Kensington parish. Special Reports were made of this notorious locality, in 1819, to the General Board of Health, by Mr. Grainger and Dr. Waller Lewis, and to the Metropolitan Commissioners of Sewers by Mr. Lovick. On the re-examination of it, within the last few days, Dr. Milroy stated that he could perceive no abatement of its horrible nuisances, no signs of noticeable improvement since his former inspection of it in August, 1849, with the parochial medical officers. It was represented as being now what it was then, one large slough of loathsome abomination, revolting alike to sight and smell, and most fatally pernicious to health, as attested by the high rate of mortality at all times among the inhabitants, and by the large number of deaths from cholera in the epidemic of 1849. 537At the time of my visit last week," says Dr. Milroy, "the roads and streets were no better than long tracks of black putrescent slush, with pools of foul stagnant water in different parts. It would be difficult to parallel in other part of the metropolis the state of things in Thomas street. To cross from one side to the other without getting ancle deep in stinking mire was impossible. Nor could I but feel the reasonableness of the remark which the people themselves made to me, that the state of the roads was as bad as the pigsties themselves.To meet such a state of things as this it was quite clear that no temporary expedient would suffice, and that nothing could be effectual but the institution of permanent works, such as good drainage, widened streets, a plentiful supply of water, good ventilation, a better construction of buildings, and a reduction of the number of persons living in each dwelling. This would of course demand considerable deliberation and inquiry. Under a recent Act churchwardens had the power to compel the owners of small property to connect their houses with the water mains. If the churchwardens would avail themselves of that power it would be a great engine for good; but he much feared that, unless there were some central power to compel them to do their duty, the state of the water supply of the metropolis would be very little better than it had been twenty years ago. But there were other causes of disease at work, such as the permanent nuisance of slaughter-houses and the like. Their Lordships had no idea of the enormous injury inflicted upon the community by the effects of those abominable trades which, contrary to all the rules of decency and civilisation, were carried on in the very heart of the metropolis. He understood that there were large aggregations of cowsheds, containing no less than 20,000 cows, in the very centre of London, from which exhalations of the worst description were constantly sent forth. In fact, complaints were addressed to the Board of Health day by day and hour by hour, calling for redress, which that Board had no means of affording, except by the slow and very uncertain process of the Nuisances Removal Act. One great and most noxious cause of disease was to be found in the whole system of bone boiling and crushing. Everyone who knew anything of it would know that the nausea which it created was most terrible, and that it not only kept people in a very low state of health who lived in the neighbourhood, but that it produced a condition of body which was predisposed to the attacks of cholera. This was not con- 538 fined to the metropolis, similar complaints having been received from Reading, Wisbeach, Rugby, and elsewhere. To these nuisances must be added numerous piggeries which existed in the midst of a town population, to remedy which the order of the Board of Health was of no permanent avail; for when complaints were made of this nuisance, say on Monday, the owners removed the pigs on Tuesday, and brought them back again on Thursday—so that no real relief was afforded, the whole thing being a farce. The slaughter-houses in this metropolis were productive of incalculable evils, and it was disgraceful that such a state of things should be allowed to continue. What a contrast London presented in this respect to the city of Paris, where everything was conducted with decency, order, and cleanliness. He had himself searched the abattoirs, been over the whole of Paris, and had walked through its streets in search of nuisances day after day, and he had been exceedingly struck, and almost attracted, by the cleanliness of the butchers' shops. Fever was never absent from places where slaughter-houses abounded, and fever prepared the way for the ravages of cholera. Then, again, there were extensive yards for the fabrication of manure from nightsoil. Their Lordships would hardly believe it, but he could state it as a positive fact, that there were, in the heart of London, large yards to which was carried the cleansing of the cesspools and privies of a great proportion of the neighbourhood. In these yards the ordure was kept heaped up in mounds ten or fifteen feet high, and underwent a process by which the solid manure was expressed and prepared for exportation. Hundreds and thousands of people were living in the midst of these centres of filth, and exposed to the most deleterious influences. In one locality there was a very large pond, in which all cesspool contents were thrown, and allowed to decompose; and the people living in the vicinity for a great proportion of the year, and during the hottest period of the summer, were obliged to keep their doors and windows shut to keep out the pestilential effluvia, and their sufferings were exceedingly great. These were only specimens of the innumerable plague-spots now in existence in the metropolis, and which there could be no doubt had immolated their thousands of victims. He thought he had adduced quite enough to indicate what was the state of things which we had to meet, but be would mention a few facts 539 just to show that preventive measures, where resorted to, although they might not always be entirely effectual, yet in some instances absolutely frustrated cholera, and in a great many mitigated its virulence. One of the most remarkable of these occurred at Baltimore, during the prevalence of epidemic cholera in America, in 1849. The population of this city was about 149,000 souls. The site of the town was naturally salubrious, and parts of it were well built; but the districts near the river, occupied by the poorer classes, were low and damp and liable to remittent and intermittent fevers, and, therefore, predisposed to cholera. In the spring of 1849, the pestilence, which had attacked with great violence several neighbouring towns, appeared to be close upon the city. A general conviction prevailed, both among the authorities and the citizens, that uncleanliness had much to do with the development and spread of the disease; they, therefore, spared neither money nor labour to purify the city, and they gave the execution of the cleansing operations to experienced and energetic officers, who performed the work so vigorously that it was generally admitted that never before had the town been in so clean a state, or so thoroughly purified, as during the summer months in the year 1849. That the cholera poison had really pervaded the city was appallingly evinced by an event which occurred in its immediate vicinity. The Baltimore almshouse was situated about two miles from the city, on sloping ground, and was capable of accommodating between 600 and 700 inmates. An inclosure of about five acres, surrounded by a wall, adjoined the main building upon its north side. In the rear of this north wall was a ravine, which was the outlet for all the filth of the establishment. It was dry in summer, but retentive of wet after rain. The physician of the establishment, under the same apprehension of an outbreak of cholera as had prevailed in Baltimore, had taken the same precautions against the disease, and had placed the establishment itself in a state of scrupulous cleanliness. On the 1st of July cholera attacked one of the inmates; on the 7th a second attack occurred. This was followed in rapid succession by other seizures, and within the space of one month ninety-nine inmates of the establishment had perished by cholera. Within the building and grounds the most diligent search failed to discover anything that could account for this outbreak, but, on 540 examining the premises outside the northern wall, there was found a vast mass of filth, consisting of the overflowings of cesspools, the drainage from pigsties, and the general refuse of the establishment. "In short," says the medical officer, "the whole space included between the ravine and the wall, upon its north side, was one putrid and pestilential mass, capable of generating, under the ardent rays of a midsummer sun, the most poisonous and deadly exhalations." During the greater part of the time that this outbreak continued, a slight breeze set in pretty steadily from the north, conveying the poisonous exhalations from behind the north wall directly over the house, and, in every instance, the first persons attacked were those who happened to be particularly exposed to the air blowing from the north side of the building. The very same thing occurred with regard to the barracks at Newcastle last year. The cholera had broken out at Newcastle with unprecedented severity, but this was the report which they had received with regard to the barracks:—The barracks in which the garrison of Newcastle is quartered are situated about three-quarters of a mile from the centre of the town. In houses at distances varying from 20 to 200 yards of the barrack-gates, numerous deaths from cholera took place, and in a village 250 yards from the barracks the pestilence prevailed to a frightful extent for many days, numbering one or more victims in almost every cottage. On the outbreak of the pestilence in the town the medical officers of the garrison, with the sanction and assistance of their superior officers, exerted themselves with great promptitude and energy to carry into effect all the means at their command calculated to lessen the severity of an attack from which they could not hope altogether to escape. The sewers, drains, privies, and ashpits were thoroughly cleansed; all accumulations of filth were removed; the spots where such filth had been collected were purified; the freest possible ventilation was established day and night in living and sleeping rooms; over-crowding was guarded against; the diet of the residents was, as far as practicable, regulated; the men were strictly confined to barracks after evening roil-call, and were forbidden to go into the low and infected parts of the town; amusements were encouraged in the vicinity of the barracks; every endeavour was made to procure a cheerful compliance with the requirements insisted on, without exciting fear; and there was a medical inspection of the men twice, and of the women and children once, daily. The influence of the epidemic poison upon the troops was demonstrated by the fact that, among 519 persons, the total strength of the garrison, there were 451 cases of premonitory diarrhœa, of which 421 were among the men, irrespective of the officers, women, and children, the attacks being in some instances obstinate, and recurring more than once. Yet, such was the success of the judicious measures which had been 541 adopted, that no case of cholera occurred within the barracks during the whole period of the epidemic; and every case of diarrhœa was stopped from passing on to the developed stage of the disease; while in Newcastle, there wore upwards of 4,000 attacks, and 1,543 deaths.The authorities at Tynemouth had also taken the proper precautions by cleansing the lodging-houses and the courts, and in a very short time they had carted away no less than 1,500 loads of refuse from the town. The proceedings of the local board of health had been greatly assisted by the cordial co-operation of the board of guardians of that place. He would refer their Lordships to a document which showed that one of the remedies which could be most advantageously applied to the prevention of the cholera was a minute and careful carrying into effect of the provisions of the Common Lodging-houses Act, by diminishing the number of lodgers, by whitewashing the rooms, and by instituting all those precautions which the Act gave power to institute with regard to lodging-houses. If this were done, it was surprising to what a degree liability to the disease might be prevented. A remarkable instance of the truth of this statement was contained in the official Report which had been presented with regard to the Common Lodging-houses Act. "By the operation of that Act," said that Report, "disease had been wonderfully abated; fever had been nearly abolished." Testimony to that effect had been received from several large towns, but that from Wolverhampton, in June, 1853, was the most remarkable. Out of 200 lodging-houses in the district, frequented by 511,000 persons annually, not one case of fever or contagious disease had occurred since the Act had been in force—namely, from July, 1852. It was most desirable that the local authorities of each district should be required to take the proper precautions in time. The Board of Health had been enabled to carry into effect improvements such as these in many instances, but delay and confusion in doing so had been unavoidable in a number of cases. Many of the boards of guardians to whom they had applied would pay little or no heed to the danger in which they were placed until the disease was actually upon them, and then nothing could equal their confusion. Message after message would be telegraphed to London, asking, for heaven's sake, that a medical man might be sent them. Sometimes nine or ten medical men would be required in one day, when the Board had not two to dispose of. If 542 those boards of guardians had taken warning in time there would have been no confusion and no panic, the local guardians would have had their own medical men on the spot, the system of house-to-house visitation would have been in operation, and the proper regulations would have been carried into effect. When the disorder broke out at Newcastle, washing and cleansing was immediately commenced, numbers of medical men were appointed, reports were made, and all the proper regulations adopted; but when the disease left the town, the services of the medical men were dispensed with, cesspools were again built, the board of guardians went to sleep, and nothing whatever was done, so that if the cholera should again break out suddenly, as it probably would do, by the occurrence of 400 or 500 cases of diarrhœa and 40 or 50 deaths in one locality, there would be the same confusion and perplexity and difficulty in meeting all the necessary requirements over again. It was perfectly true that the Board had the power of enforcing certain regulations by prosecuting the boards of guardians; but if they summoned all these boards before magistrates, and proceeded against them by way of indictment, their whole time would be taken up in carrying on prosecutions, to the neglect of their own proper functions. Besides, it was thought a very invidious thing to prosecute a board for not having made preparations when the danger was not at hand, for it would then be said that they ought not to be obliged to incur unnecessary expense; but when the disorder really came it was almost too late to prosecute. Upon various occasions in 1848 and 1849, when the Board of Health did institute legal proceedings, and summoned a board before a magistrate, the case was argued, and the magistrate, seeing that it was a difficult one, adjourned it to another day, when it was again argued. But the cholera would not wait, and carried its ravages in the district to a frightful extent, while they were debating whether cesspool A or B should be closed, or whether certain streets should be washed. While the magistrate was deliberating the cholera would go on doing its deadly work, and by the time the magistrate had given his decision it would have left that district and gone to another, and carried off its victims there also; in which case similar proceedings had to be repeated before the magistrates of the second locality, and the same delay in arguing, deliberating upon, and deciding 543 upon the question at issue had to be gone through, whilst all the time the deadly work of the disease was going forward without check or pause. He said, from the experience of the Board of Health, that new powers ought to be given to the central authority (putting out of view for the present the question of permanent works) to enable it to deal with cases of emergency similar to the present, or with still more pressing cases which might arise. The powers required, with adaptation to Scotland, would be, power for the central authority, after a certain time, to give orders that the necessary things be done, with power to charge the expense on the board of guardians. This would be necessary, because, while a case was being argued before a magistrate, cholera would be doing its work. Next, the central authority ought to have power to direct that houses of refuge be provided by single or united parishes, to receive the sound and healthy part of the population of any affected locality, or, when it should be considered advisable, to reduce the population of an overcrowded district; and power to order the evacuation of houses unfit for human habitation, and to forbid return until after a report by the medical officer. There were two or three very good reasons why houses of refuge ought to be provided for the healthy and sound part of the population. In the first place, great care must be taken not to raise any notion in the minds of the people that the cholera was a pestilence, and therefore a contagious disease, and that none who valued their life and health would go near those who were afflicted with it. In the next place, when a person was afflicted with the disorder, his greatest hope of recovery was to remain quiet in the place where he was attacked, as nothing could be more dangerous than removing him. A recumbent posture and perfect tranquillity were necessary, and, in many instances, a state of collapse had been produced merely by raising a person in his bed to give him momentary relief. It was also necessary that extreme overcrowding should be prevented. The late epidemic had brought before the public eye a fact well known to those who had considered the subject, the large pecuniary loss inflicted in various ways on the community by preventible disease, and the heavy avoidable sufferings of the working classes. That much of this loss and suffering might have been prevented was shown by the fact that in 544 all the model lodging-houses in London, although a few cases of diarrhœa had occurred, there had, he believed, been only one fatal case of cholera. In order to show the evil effects of over-crowding, and the necessity of improved dwellings for the humbler classes, he would mention only one instance. There was one court in that City, which was extremely overcrowded. One of the inspectors of the Board of Health visited it in 1849, who reported that the court was so narrow, and its population so dense, that he was quite convinced, if cholera broke out there, it would commit the most terrible ravages. The Board of Health addressed a letter to the board of guardians, urging the expediency of removing a portion of the population, and stating their conviction that by so doing they would, in all probability, escape a large pressure on their finances. The board refused to accede to their suggestion. In three days the cholera broke out, and carried off several heads of families, leaving widows and children behind them. On one day twelve orphan children applied for admission to the workhouse, and have since become a permanent charge on the rates. He firmly believed that, if the guardians had followed their advice, the pressure on their finances would not have been one-fifth of what it has proved. He was now anxious to bring a most important document under the attention of the House. It was the last Report of the Royal College of Physicians, from which it appeared that from recent experience they had changed their former belief, and had recorded their final conclusion in the following words:—Cholera appears to have been very rarely communicated by personal intercourse, and all attempts to stay its progress by cordons or quarantine have failed.When a contagious disease prevailed, no one could form an idea of the sufferings which were inflicted on the wretched few whom it had pleased Providence to afflict with it, for they were left to die without any assistance from their friends and relations, who had not sufficient courage to discharge the last duties to them. The opinion he had quoted of the College of Physicians was, therefore, of the greatest importance, as it showed that the cholera was not contagious. The Report went on to say:—From these circumstances the Committee, without expressing any positive opinion with respect to its contagious or non-contagious nature, agree in drawing this practical conclusion—that in a district where cholera prevails no appreciable 545 increase of danger is incurred by ministering to persons affected with it, and no safety afforded to the community by the isolation of the sick.This was a most important document, considering the experience and the science of the persons whose opinion it expressed. There were but two more papers which he had to bring before their Lordships' notice, and he would ask their indulgence while he did so, because it was most important that they should know the precise position in which they now stood. Among the other effects of the cholera, its effects upon the trade and commerce of the kingdom were most pernicious, and it produced great financial suffering, which visited a great number of people. He held a very curious return, out of which he would select only a few instances, although hundreds of similar ones might be adduced. It was a statement which had been made to the Board by several tradesmen in Newcastle with regard to their losses in trade consequent upon the visitation of the cholera, showing the decrease which had taken place in their business in the six weeks ending October 15, 1853, as compared with the corresponding period in 1852. One person, a carpet warehouseman, stated that he had lost during that period 1791. Another firm, grocers and wine and spirit merchants, estimated the falling off in their receipts at no less than 20 per cent. They remarked that—Had it not been for the increased demand for wines and spirits the depreciation would have been much more. The falling off in the tea and grocery business during the last three weeks of the cholera was nearly 50 per cent.One draper had lost 70l., and another 14½ per cent, and he added that "had it not been for the unprecedented demand for mourning the loss would have been 50 per cent." The railway company estimated their loss at 3,000l. and a hotel-keeper had lost 25 per cent on 1,200l. Trade ceased so entirely that provisions were scarcely to be had, and actually at one time bread was becoming scarce, while milk was not to be purchased because the people in the country were afraid to approach the town where the disease was raging. The last fact he would mention would show how much not only the working classes, but the community at large were interested in this subject. The total number of deaths from cholera in 1848–9 in Great Britain and Wales was not less than 90,000, of whom almost 30,000 were supposed to have been heads of families in the prime of life, and 546 numbers of children must therefore have been deprived of their fathers or their mothers, husbands of their wives, and wives of their husbands. Let their Lordships imagine the suffering and misery this must have involved. Suffering unhappy was the position of a father left with a number of children deprived of a mother's care, or of a mother with a fatherless family, or still more, that of the wretched children deprived of both father and mother, as had been the case in many instances, with no prospect but the workhouse! This ought to be a great warning to them, and showed that they ought to do everything in their power to provide against the next visitation. They ought without delay to establish every permanent work that could be required with a view of meeting the next visitation, and, if they did not, let them see what would happen to this country. The epidemic had been raging on the Continent, at Copenhagen, at Stockholm, and at Warsaw; and, if the mortality in England in 1848–9 had been in the same proportion as the mortality at Christiana and at Warsaw in the present year, the number of deaths in Great Britain and Wales alone would have amounted to 591,451. Was this a state of things to look forward to with complacency at a moment when we had not in the country a single able-bodied man more than we required? He hoped that he had stated enough to excite the attention of statesmen and to arouse the attention of the country to this important subject.
§ EARL GRANVILLE
said, Her Majesty's Government had no objection to produce the returns which had been moved for by the noble Earl. He would not attempt to follow the noble Earl through the clear and able account he had given as to the state which the country was in at the moment with regard to the future prevention of cholera. With regard to the superior arrangements which existed at Paris, he could speak from his own experience of their immense superiority over our own; but when his noble Friend went so far as to say that day after day he had gone in search for nuisances, he would suggest that if his noble Friend had extended his search to night after night, it might have been more successful. The question now was, could anything be done which would lead to the object they all had in view? And he could not help observing, in the name of all his Colleagues, how fully they appreciated the advantages of such state- 547 ments as those which had been made by the two noble Earls who had so clearly drawn the attention, not only of Her Majesty's Government, but also of the public, to the question. He thought a good effect would be produced by what had fallen from the noble Earl with regard to the necessity of local authorities attempting to do something for themselves, and the dreadful responsibility that would weigh upon them if they did not do what was within their scope. With regard to what had been done by Her Majesty's Government, he would state that the noble Lord the Secretary for the Home Department had been in communication with both the noble Earls who had spoken to-night, and had acquired information from different parties as to the best mode of proceeding under this emergency. The extraordinary powers which had been given to the Board of Health during the last six months had, by an Order in Council, been continued for another six months. There had certainly been some complaint made on the part of the mercantile marine, that, in consequence of this official indication of the cholera, ships were subjected in different parts of the world to vexatious quarantine regulations; but informed, as his noble Friend had been, not only by the Board of Health, but also by the most eminent physicians in the metropolis, of the practical results of their inquiries, he thought he could not discharge his duty otherwise than by extending those powers, and at this moment he was seeking what, further powers it would be advisable for Government to grant which would not interfere too much with local authorities, and which would also receive the sanction of local opinion.
§ LORD BEAUMONT
wished to ask the noble Earl why measures had not been taken to suppress some evident nuisances? Was it not possible to indict parties possessing manufactories of manure and other equally nasty trades? Why did not the Board of Health indict them?
§ LORD BEAUMONT
said, that an Indictment might be preferred by a private person, and why not by the Board of Health? If they had not the powers a Bill should be introduced for the purpose of conferring them.
§ THE EARL OF SHAFTESBURY
The Board had no funds, and an indictment was a very slow and uncertain process. His noble Friend the head of the Home Office 548 was devising a mode to meet the difficulty, and a Bill should be introduced declaring these trades to be nuisances and abominations. Health and life should not be endangered for any pretended necessities of trade.
§ THE EARL OF HARROWBY
remembered a case in which the corporation of Liverpool had been for many years engaged in an attempt to suppress a nuisance. They had spent thousands of pounds, and the case I had been carried from court to court. If such a powerful body experienced so much difficulty, what would be the fate of a private individual? Cases of this kind required some dictatorial power. He was now quite satisfied to leave the matter in the hands of the Government. Public attention was now aroused. When the cholera last raged, every person was alarmed, and many precautions were taken, but the feelings passed away with the danger; however, he hoped permanent precautions would now be adopted.
§ Motion agreed to.
§ House adjourned till To-morrow.