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^
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tMtv>
Zbe Sodct? of tbe Hew Sort Uospttal,
/Batcb, 1808.
REPORT
CHOLERA EPIDEMIC
OF
1866
IS
ENGLAND.
BUPFLBHENT TO TEE TWBHTT-HIMTH ANNUAL SEPOBT OP THE
BSQIBTBAB-GENEBAL OF BIBraS, DEATHS, AND KABBIAOES
IN SNOLAND.
VnfmtA ta loQ Soutftl a( ^xrlUmrnt bg eamminlr of Srt ^Rafnnii*
LONDON:
PBIKTED BY OEOBGE E. EYHE AIJD WILUAM SPOITISWOODE^
ratNTEBB to IIIK (tl-KCK'a HOST ESCELLBMT tUJIBTr.
rOK U£U UAJESTY'il 6Ti,TlU»E&Y OFHCB.
1868.
CONTENTS.
• •
• •»
• •
• • • •
• • • a •
xl?ii
xl?ii
Page.
Lbtteb to the Eeoistrab-Gekeral bt William Fjlrr, M.D., F.R.S. - - vii
REPORT ON THE CHOLERA EPn)EmC IN ENGLAND :
Introdaction -.-------ix
1, Cholera in London :
1. Origin and Causes of the Disease - - - - - xii
2. Localization of Cholera in East London ~ - - - xv
3. Cholera in the several Water-fields - - - - - xx
4. Inequalities of the Cholera Mortality within the several Parts of the
Water-fields ----- - - xxiv
5. Some Statistical Fallacies ------ xxv
6. The Hospitals --.... - xxiz
7. Rise and decline of Cholera ------ xxx
8. The parallel Case of Newcastle-upon-Tyne - . - xxxiii
9. Indirect diffusion of Choleni hy Water - - - - xxziz
10. Water Supply of London - - . - . zxzix
" • •• •
n. Cholera Field* : ••* I • •• •*
a • • • • •
1. London Cholera* "R^cT *• .*-
2. Portsmouth „
.3. Exeter . m - . - - ■ - - xl^
4. BriMol ^ m - - . . - zlviii
6. Wolverhampton „ - - " - - - xlviii
6. Liverpool »> • • " - - - xlviii
7. Hull ,, . . - - - xlix
8. Tynemouth m ~ - ~ ' * ~ ^^
9. South Wales „ - - - ... xlix
10. Cholera in the Ten Qraii Gitiei . - ^ . ... U
11. Cholera in the Eleven Divifliomi of England • . - .•_ lii
12. Mortality from Cholera in the United Kingdom - . - Hi
nL SdsivTiFio Elements OF Cholbba:
1. Elevation - - . - - - lii
2. Distance -- - • - --Iv
5. Density -- - - ---ly
4. Sewerage - - . - - - - Ivi
5. Wealth and Poverty - • - - • - Ivii
6. Occupations - - • - . . i^iii
7. Sex and Age - - - - - - lix
8. Attacks of Cholera - - • • - bd
9. Duration of fiital Cases - - - - - bdi
10. Cholera Flux — ^its Dispersion over large areas of Water - • Ixiii
11. Days of the Week - . . - . - Ldv
12. Meteorology - - - • . - . iziy
IV. Theobies of Cholera:
1. Zymotic Theory - ------ ixr
2. Mathematical Theory ----- - ixx
3. Air, Water, Contaet— Theories ----- Ixxix
4. Theory of Spontaneous Generation - . - - Ixzxi
CONTBNTB.
V. Pbbtkxtioh op Cholbka:
I. Efflcacjof PrerentivaPeHOBalHeuarui Port Offlce, Cuitoiiu,
NiiYj, Police . , . . .
S. QuAnntine ^ . - .
3. Inteniatioiuil Cholera ConferetiM at Conitaollnople '
TI. Mafb ahd Duokuis :
1. Map ahowing ihe Mortality fiom Cholera is London DigtricU Ii
3. Map (bowing tlie Moitallt; from Cholera in JLondoQ Dirtriet* Ii
t 3. Map showing the Pacition of th« Reserroira of the East London
Companj.
4. Diagramt exhibiting the Deaths by Cholera and Uiatrbna, a
Temperature and Bain-fall in London on each Day of th
MoDthi June to Octi^r 1666.
B. Diagtanu exhibiting the Deathi by Cholera and Dianbea in I
on each Day of the Fire Uonthi June to October in the Yean
18S4,Bndl8eS.
APPENDIX;—
L Tables :— .
I. Mortality by Cholera and Dianhon in £soLjUn> and in Lomi
eachoftbe Years 1838-66 .....
a. DeuhB registered from Cholera and Diarrtuta in LOSDOH and i]
l^Bon Town Dibtiucts of England in each of the Yean IBaS-l
3. Deathi r^utered from ChirienaadDiaR)icMineachDinBioii,C<
and DUTBiCT irfBn^and daring the Yean 1849, 18S4, and ItU
4. Mortality fnnn Cholera and DiaRhoa doling Uie Yean 1849,
Mid 1866. in the eeteral Ditmiokj cJBngJand
5. ITomber of Distrieti in wUch vo Da&THB from Chriera «ere reooi
1649, 1894, and 1S6S • - - - - , •
6. Mortality from ChoUra in 1B49, 1894, and 1B66 In Lohdoh :
eertun Districts of England in which the Endemic of 1886 wt
fttal in proportion to the Popnladon . . -
T. MoRTiLiiT ftom Cholera in Lohsoh and in the DiBTiticTa of E
which were chiefly attacked in 1849, 1854, and 1866, arranged
order of Mortality .--.--
8. Deaths and Bate of Mortality from Cholera and Diarriuaa in
1894, and 1866 in BMSLum of MAixa and fUuLM of vui
9. Affitegate Deaths bam Cholera and Diarrhma of Ualh ai|d n
ot DiFFBunr AoBS dniing the Three Epidemics of 1849, 189
1866 in Eholaics ...
10. Anregate Awnnal Mortality from Cholera and Choleraic Dlairi
Mitna and Fcxaua of ddixxbht Aou in the Three B^diB
1349, 1B94, and 1866 In EkoLud ....
11. Deaths regirteredftomCholEraandDlairhiBa in the Year 1868 of]
and Fkhauw of smBXUR Aou in each of the Begistntion Di
of F.n ffl^njl - . ...
13. Deaihi re^rtered from Cholera in England in tlte Year 1S66 of ]
' and Fkkulib at ditfueht Aobs, with Ihe Period of Ddkati
13. Deathi repitered from IMarrbaa in England in the Year 186S of ]
and FxiuiAa at juwwmmmbt Aoaa, with the Period of Doeaii
14. Deaths registered ftvm Cholera in London in the Year 1866 of ]
and Fehalh at DirmiHi Aana, with the Period of Ddxad
2ai08
!▼
CONTENTS.
Page*
15. Dealiifl registered from Dutfriiflea in London in the Year 1866 of Males
and Femai^bs at different Aoes, with the Period of Dctration of
' Attack .---•---26
16. Occupations of Males dfing at different Aass of Cholera in England
in the Year 1866 27-33
17. Occupations of Females dying at different Aoes of Cholera in
England in the Year 1866 . - . - . 34-35
18. !Pfoportion of Deaths hy Cholera in 1866 to 10,000 Males and Females
lining in England in 1861, of different Occupations - - 87
19. Deaths firom Cholera and Diarrhoea occorring in England on each Dat
ofeach of the Twelve Months of 1866 - - - - 38
SO. Deaths from Cholera and Diarrhoea occurring in London on each Dat
ofeach of the Twdve Months of 1866 - - - - 39
31. Deaths from Cholera and Diarrhoea occnrring in the East Districts of
London and in Uie District of West Ham on each Dat of each ot the
Twelve Months of 1866 - - - - - - 40
S9. Deaths from Cholera and Diarrhoea occnrrinff in London, exdunve of the
East DUtricU, on each Dat of each of the Twelve Months of 1866 - 41
23. Deaths from Cholera occurring on each Dat during Thirteen Weeks
ending 29th September 1866 in the Water-fields of the several
London Water Companies ------ 42^^43
24. Deaths from Cholera occurring on each Dat during Hiirteen Weeks
ending 29th September 1866 m the several Sub-districts of London,
groui^d according to their Water Supplt .... 44-59
25. Water Companies ; Area in Acres ; Number of Inhabited Houses in 1861 ;
Annual value of Property assessed in 1866 ; Estimated Population,
1866 ; and Deaths registered from Cholera and Diarrhoea in 1849, in
1853-54, and in 1866 — in each of the London Districts • - 60
26. Water Companies ; Elevation ; Persons to an Acre ; Persons to a House ;
Annual Value of Property per Head of Population ; Average Annual
Value of Houses ; Poor Relief ; and Numb^ of Deaths to 10,000 Per-
sons living from Cholera and Diarrhoea in 1849, in 1853-54, and in
1866 — in each of the London Dbtricts - - - - 61
27. Water Supply ; Elevation; Area; Enumerated Population ; Deaths ; and
Annual Bate of Mortality from Cholera in 1849, 1854, and 1866—
in each of the London Sub-districts ; - • - - - 62-75
28. Mortality from Cholera in 1849, 1854, and 1866, in each of the London
Sub-districts, arranged in the order of Elevation ... 76>77
29. Mortality from Cholera in Eleven Gboufb of London Sub-districts at
different Eletations during Three Epidemics - - - 78
SO. Deaths fh)m Asiatic Cholera in several Stages of the Disease - - 78
Itl. Population, Deaths, and Mortality from Cholera in 1866, in the London
Sub-districts, grouped according to Elevation in the several Water-
fields - - - - - ... . . 79-81
32. Mortality from Cholera in the London Sub-districts in 1849 and
1853^-54, grouped according to their Elevation and Water Supplt 82
33. & 34. Area ; Enumerated Population 1851 and 1861 ; Kumber of Deaths
registered from Cholera and Diarrhoea in 1849, 1854, and 1866 ; .
Annual Mortality from Cholera and Diarrhoea per 10,000 of Popu-
lation in 1849, 1854, and 1866 ; Annual Rate of Increase per Cent,
of Population 1851-61 ; Density of Population in 1866 ; and Elevation
in Feet above Trinity High-water Mark of the Fields of the different
London Water Companies ...... 83-84
35. Deaths registered from Cholera and Diarrhoea in Streets, &c of Poplar - 85-86
IL Narrative of Proceedings at General Rsoister Office during the
Cholera Epidemic of 1866
- 87-100
in. Mr. Greates's Evidence before the Pollution of Rivers' Com mission
IN reference to the Distribution of Impure Water in East
London - -•-....
100-101
CONTENTS. ▼
Page.
I TV, The Board of Trade and the Water Sufplt of East Lokdov - 102-108
y. Cholera in Loicdok, 1866 :
1. Extracts from the Registrar General's Weekly Retoms during the course
of the epidemic ....... 109-159
2. The Medical Officers of Health on the Water Supply and Causes of
Cholera in their Districts ..... 160-177
3. The Medical Officers of Health on the FreTcntive and other Measures
adopted in their Districts .... . 178-198
4. Dr. Lethehy on Disinfectants ..... 199-200
5. Cholera at Charlton (Woolwich) ..... 201-205
YI. Notes on Cholera, in 1866, in the setebal Districts of Ehglahd - 206-251
Vn. Meteorological Elements of the Period of Cholera Epidemig nr
London, 1866 . . ..... 252-256
Vin. Professor Franklakd's Report on the Quautt of the Londoh
Water Supply in 1866 .... - . 257-259
IX. Water Supply of London :
1. The Water Companies of London ; their Sources of Supply, and the par-
ticulars of their Works for Storage and filtration in 1850, 1856, and
1866 ....... . 260-271
2. Average daily quantity of Water supplied hy each Company in 1849,
1856, and 1866 ....... 272
3. Amount of Capital and Rate of Dividend paid by each Company in 1850
and 1866 ......--272
4. Capital, Receipts, and Houses supplied by each Company in 1866 - 273
5. Distribution of Supply of each Company in 1866 - - - 274
X. Water Supply or Paris ...... 275-279
XL Letter from Dr. Fettenkofer on Cholera in Bavaria - • 280-281
Xn. Cholera in Albano ....... 281-287
XIII. Cholera in Rome .... . - - 287
XrV. Cholera in London, 1848-49 :
1. The Thames and the Water Supply of London ... 288-291
2. Theory of the Propagation of Cholera - - - - -291-293
3. The Zymotic Principle of Cholera - - - - - 294
4. I'recautions against Cholera in regard to Water - - - 294
XV. Cholera in London, 1853-54 :
1. Impure Water ....... 295-302
List of some of the Principal Ekoush Official and other Pubucations
relating to Cholera ----..-- 303-304
Alphabetic.\l Index to Report and Appendix ..... 305-321
TO THE REGISTRAR GENERAL.
Sib,
I HAVE the honour to submit to you the Report on the recent
Cholera Epidemic in England.
In the text I have endeavoured to embody the chief facts and
results of previous observations.
The Appendix contains in a series of tables and notes a view of the
topographical distribution of the disease, and many facts of interest
supplied by health officers in the towns and other medical men in the
provinces.
The Reports for the epidemic weeks have been reprinted as the
first impressions were exhausted. They can thus be read chrono-
logically, and, presenting things as they appeared at the time, form a
partial journal of the plague, and may be useful at future times.
They comprise two of Professor Frankland's valuable reports and an
interesting series of accounts of the sanitary proceedings in each
district by the health officers of London. I have added an accoimt
of the proceedings at this office.
The returns of the water supply of London by the companies and
of the water supply of Paris, that other great city, wiU be studied
with interest. The information that has been obtained respecting the
water supply of Rome is still imperfect. One of the great lessons
we have learnt from the epidemic is the importance of a pure water
supply.
I have great pleasure in calling your attention to the services of
Mr. Knight during the epidemic. Mr. F. J. Williams has calculated
and skilfully compiled many of the tables in the Appendix. To
Mr. James Lewis I am indebted for much valuable assistance in
editing this volume, to which he has prepared an excellent analytical
index.
I have the honour to be,
Sir,
Your very faithful Servant,
Oeneral Register Office^ W. Fabb*
Somerset House, July 25, 1868.
REPORT
ON THB
CHOLERA EPIDEMIC IN ENGLAND,
BT
WILLIAM FARR, M.D., F.R.S.
Asiatic cholera has yisited England four times. It first appeared in October
1831, and in that and in the following year was fatal in many parts of the king-
dom. Many thousands ef the people were attacked, and many thousainds perished
of this new disease. The numbers are unknown, as no registration of the causes
of death then existed. In the United Kingdom the deaths of 52,547 persona
were reported through various channels to the Board of Health. The disease
created consternation ; and although it was observed closely, and combated bj
the most active remedies, little progress was made in the discovery of causes.
Its causes were indeed supposed to bo enveloped in inscrutable mystery, and
to be above human control. No comet was at hand to account for the phenomenay
and there was only a whisper of telluric and meteoric influences on the Con-
tinent. " The cholera," said the Annual Register for 1832, '' left; medical men
" as it had found them, — confirmed in most opposite opinions, or in total ignorance
'* as to its nature, its cure, and the causes of its origin, if endemic,— or the
" mode of transmission, if it were infectious." Thus English history is written.
Now the disease was well described by the Board of Health ; its pathology was
studied, and the effect of a variety of remedies was to some extent tested. Great
core was bestowed upon the sufferers, for whom hospitals and provisions of varioua
kinds were made. The fact^ were published as far as they were known* And
although it was a time of great political excitement, and a year of election riots^
the people nowhere in England entertained the dreadful suspicions of occult
poisoning which excited the populace to madness and to murder, not only in
Hungary, but in Paris.*
And furthermore, an important discovery was made in 1832. It was found that
the cholera in its worst forms was preceded by diarrhoea ; and that this diarrhoea
was in some cases a mild form, in others a first stage of the disease. Now, to
arrest this diarrhoea is to prevent cholera, as to extinguish a spark is to prevent a
conflagration. It is true that perhaps ninety cases out of a hundred of epidemio
diarrhoea left to themselves go no further, but it is equally true that the ten
rcBidual cases turn into cholera if they are not treated in the first stage ; and the
fact that one of the ten, even with treatment, turns into cholera, does not invalidate
the practice.
Sir Thomas Watson, at King's College, delivered in his lectures, with his usual
lucidity, the lesson of 1832, and discussed the qualifications of the doctrine.f
** The epidemic cholera [in 1S32] made its attack in two different modes. In one it seized upon
the patient suddenly, and without warning ; this was comparatively rare. M«ch more commonly
the specific symptoms were preceded for some little time, even for some days perhaps, by diarrhcsa ;
and this I take to be the most important practical fkct that was ascertained daring its prevalence
among us. When the disease was once fairly formed medicine had very little power over iti but
in the preliminary stage of diarrhcea it was easily manageable. Unfortunately people are inclined
(especially those clas^ of the community among whom the cholera most raged) to regard a loose
state of the bowels as salutary, and to make no complaint of it, and to do* nothing for it ; or, in
other cases, they conceive it to proceed from some peccant matter within, which rcqnires to be
carried ofi^, and they take purgative medicines to get nd of it. Both of these are serious and often
fatal mistakes. Mere neglect of the diarrhoea frequently permitted it to run into well-marked and
uncontrollable cholera ; and the employment of purgatives hastened or insured that catastrophe.
* Annual Register, 1832. Historj-, page 306.
t These Lectures were first delivered in the Medical Session 1836-7, and afterwards appeared in
the London Medical Gazette. They were revised and separately published in 1848. The quotation
is taken from the fourth edition ['' Principles and Practice of Physic." 4th Ed., 1857, VoL S.,
p. 526-7] of the Lectures, but it is an exact reproduction of the passage as printed in the number
of the London Medical Gazette for April 15th, 1842.
X Previous Inquiries^
The proper plan of proceeding, I am convinced, was to arrest the diarrhoea as soon as possible after
its commencement by astringents, aromatics, and opiates. You may object, perhaps, that the cases
that were cored in this way were not cases of cholera at all, and never would have been, but simply
ordinary diarrhoea. It is impossible to prove the contrary, no doubt ; but the presumption is strong
that the diarrhsa would in many, and, perhaps, in most instances, have run on, if not checked,
into the more perilous form of the disease. In many places when, taught by experience, the
authorities established diarrhaa dispensaries^ to which those attacked by looseness of the bowels
were warned and invited to apply, that the looseness might forthwith be corrected ; in many such
places the cholera, which had before been cutting ofif the inhabitants by scores and by hundreds,
began instantly to decline in frequency. I venture to advise you, supposing the disease should
reappear, or whenever in the autumn a suspicion arises that this form of cholera is present in the
community, not to try, in cases of diarrhoea, to carry off the presumed offending matter, but to quiet
the irritation and to stop the flux as soon as you can."
The practical importance of the discovery was well established in 1849 and in
1854 ; it led to the system of house-to-house visitation, which has a striking oifect
in limiting the fatality of thie epidemic by restraining the disease in numberless
instances from proceeding to extremities.
Both in pathology and in therapeutics it is of the utmost importance to learn
whether algid cholera is in any case preceded by diarrhcea ; in India it is
asserted such cases are frequent, and in England, according to some observers,
they are not uncommon. Dr. Macloughlin holds that every case of cholera is
preceded by diarrhoea. Experience is deceptive, as Hippocrates tells us, and good
observers are rare. I am inclined to believe that the evidence in respect of
alleged cases not preceded for some hours by loose discharges is exceedingly
imperfect. Dr. Sutton gives a table of 127 cases of cholera, in 85 of which the
diarrhoea commenced less than 24 liour3=one day, before " violent vomiting,
purging, and cramps " set in. In 8 cases the diarrhoea preceded cholera by one
and under two days ; in 12, by 2—3 days ; in 6, by 3—4 days ; in 5, by 4—7 days ;
in 5, by 1 and under 9 weeks. In one case the number of days is not given ; in
five Dr. Sutton leaves us to suppose that he detected no diarrhoea preceding cramp
and vomiting. He cites two cases which at once illustrate his views, and enable
the reader to reconsider his judgment^.* The importance of instant attention to
the first symptoms in an epidemic season is evident.
The Board of Health consisted of Lord Ashley (now the Earl of Shaftesbury),
Mr. Chadwick, and Dr. Southwood Smith in the years of the next epidemic
(1848-49), who had associated with them at that time Dr. John Sutherland, as well
as Mr. Grainger, a man of science, full of humanity, and of indefatigable industry,
now, ala^ I no more. This Board rendered great services to the country in various
ways ; but in none more, perhaps, than in insisting on the universal application of
house-to-house visitation in infected districts, and in the firm expression of faith in
the efficacy of preventive measures. They a.ssert in their report, dated August
14th, 1850, that "the late extended experience has shed no light on the primary
" or proximate cause of this pestilence . . . ; that remains involved in the same
** impenetrable mystery as ever." At the same time they affirm " that the disease
" is not, in the common acceptation of the term, contagious, but spreads by an
" atmosplieric influence, its progress consisting of a succession of local outbreaks." f
The registration system had been in operation since the year 1837, and an the
causes of death are recorded, the registers contained the particulars of every death.
The facts were analyzed at this office, collected in tabular forms, and in every one
of the sub-districts the deaths from cholera and diarrhoea were compared with the
population. The tables were published, with illustrative diagrams, in a volume of
nearly 500 pages. Some of the general results of this extensive analysis of the
facts, involving the deaths of 53,293 of the English people by cholera, 1 8,887 by
diarrhoea, out of 17,564,656 living in a great variety of circumstances, are thus
briefly summed up in the second paragraph of my Report to you : —
" In following cholera through its fatal way, however, the inquirer meets with
" some grounds of consolation. He sees places on every side which the epidemic
• Ninth Report of Med. Off Privy Council : Paper by Dr. Sutton, pp. 369-371.
t The Report of Dr. Sutberland is dated April 24, 1850 ; that of Mr. Grainger, June 10, 1850.
Both these Reports are full of valuable information collected in the large experience of the t>ro
^*Herverf.
The Medical Council. xi
'^ passed over, leaving the inhabitants in the serene enjoyment of health and
'' complete immunity. And the hope is, perhaps, not fallacioas that an examin-
^' ation of the results of the second maj be the means of mitigating if not
*^ preventing a third invasion; for whatever may be the immediate cause of
'* cholera, it will appear evident that in England it is only seriously fatal under
** certain known physical conditions, which admit to a great extent of remedy."
The various theories are discussed, the zymotic theory is developed, the cholera
matter is named cholerine, and an account is given of the doctrine of diffusion by
water. Passages of the Report are reprinted, pp. 288-294.*
The RejK)rt of the College of Physicians by Dr. Baly and Dr. Gull gave a critical
history of the epidemic.
In 1854, Sir Benjamin ITall was the President of the Board of Health. He
addressed a Report to Lord Palmers ton, then Home Secretary. In a letter to
his Medical Council the following paragraph occurs : — " Upon scientific matters
" connected with the sanitary administration of the country, where the medical
** profession are to be consulted, advised with, laid under contribution for service
'' or information, or called upon to act, I wish to have the aid of a medical
'^ council, to whom I may submit questions for consideration, and whom I may
*^ ask to suggest or undertake such inquiries as may from time to time be
" necessary." By this institution the President of the Board took the justest stepa
to induce the heads of the medical profession, and men of science, to devote thkt
attention to the study of the public health which its paramount importance
demands. The Medical Council consisted of Dr. Paris, then President of the
College of Physicians, Sir James Clark, Dr. Aldcrson, Dr. Amott, Dr. Babington.
Dr. Tweedie, Dr. Baly, Mr. Lawrence, Vice-President of the College of Surgeons,
Mr. Simon, Mr. Richard Owen, Mr. Ward, Master of the Society of Apothecariea^
Mr. Bacot, and myself: Dr. R. D. Thomson and Mr. Glaisl^r were appointed
to conduct inquiries in the direction of chemistry and meteorology. Dr. Hassall
applied the microscope to the investigation of the secretions and fluids of cholerft
patients, as well as to the examination of the air and the waters of London.
The special reports gave a fuller account of the proportional numbers of different
forms of this disease, of the mortality of cases, of their duration, and of the effects of
remedies, than had been given before. The report of the scientific committee showed
that nearly all the Thames waters in use were foul, as the companies took them
from the tidal part of the river, which had for some years been the receptacle of
the sewers in communication with a large proportion of the waterclosets of LondoD.f
The waters contained impurities in variable proportions at different dates': on one
day Dr. Thomson found 23, on another 73 grains of foreign matter in a gallon of
water supplied by the Southwark company, then drawing its supply from the
Thames at Battersea. The impurities in the waters of Lambeth, taken from the
Thames above Teddingtou Lock, ranged from 12 to 18 grains by weight in two
samples.^ The final report of the scientific committee proved conclusively the
extensive influence of water as a medium for the diffusion of the disease in its fatal
forms. The zymotic theory was established, and Dr. Snow's view that the cholera*
stuff was distributed in all its activity through water was confirmed. The special
report of Dr. Fraser, T. Hughes, and Mr. Ludlow inculpated the Broad-street
pump to some extent in the terrible outbreak of the St James' district* But tbe
subject was further and more conclusively investigated by a committee, aided by
Dr. Snow and by the Rev. H. Whitehead. §
Thus, by the year 1866, from the observations of the three great plagues, we had
learnt enough of the causation of cholera to justify us in believing that in London
it could be confined within narrow limits, — in the first place, by preventing anj
* lie port may be procured at Longmans.
t See page Ivii.
X Keport of the Scientific Committee, p. 42.
§ Re|K)rt on Cholera in St. James's by a Committee, consisting of Dr. E. Lankester, Chairman;
H. Bidgood; Dr. K. King; J. Marshall, Reporter; Kev. H. Whitehead; J. York, Secretary,
Published by Churchill, 1855. The special Keporta of Dr. Snow and Rev. H. Whiteh^ are printed
in the Appendix. See also two papers by Hev. II. Whitehead in Macmillan's Magaane, December
1865 and July 1866.
xii Four Public Inquiries.
extensivo distribution of the cholora-stuff through water, as the companies, in
compliance with the Water Act of 1852, had, it was believed, since 1854 carried
out all their purifying filtering works ; and in the second place, by the organiza-
tion of Health Officers, who could secure attention to the earlj treatment of pre-
monitory diarrhoea, and to the destruction by disinfectants of the cholera fiux.
How the actual facts turned out is shown in the Weekly Returns of the year,
extracts from which are reprinted in the Appendix, pp. 295-302. Since those pub-
lications appeared four public inquiries have been instituted into the water supply
of East London, and into other circumstances affecting the outbreak. The first
inquiry was by the River Commission, over which Mr. Rawlinson presided ; * and
here Mr. Greaves, the engineer of the East London Company, first admitted that
the water of the open reservoirs had been distributed over the area supplied from
Old Ford. At the instance of the inhabitants of East London, the Board of Trade
instituted an inquiry, which was ably conducted by Captain Tyler, H.E., during
a period extending from November 27th, 1866, to May 27th, 1867. And further
evidence is supplied by Captain Tyler respecting the water of the East London
reservoirs at Old Ford. The East London Company, in a very proper spirit, met
the charge, and admitted their dangerous proximity to the Lea, by applying to
Parliament for extensive powers to improve and augment their water by a large
outlay of capital. And the Committee on the bill, under their chairman,
Mr. Ayrtcm, the zealous member for the Tower Hamlets, also inquired into the
operation of the Metropolis Water Act of 1852, and in an interesting report made
some important practical recommendations.* AH the London Water Companies
wore represented before the Committee by eminent counsel ; and the cause of the
East London Company was skilfully defended by Dr. Letheby, in the character
of a scientific witness. The Royal Commission on Water Supply has taken
evidence, but has not yet reported. The medical officer of the Privy Council has
discussed the subject; and Mr. Radclifie has conducted a careful independent
inquiry into the causation of the explosion in East London. I refer to his report
for a ^reat many interesting details, and for an explanation or a confutation of
eome of the fallacies set afioat. This report, the report of the Lancet Commission,
and some articles in the Medical Times and Gazette^ should also be consulted.
Thus in the year that has followed the outbreak in East London the subject has
been amply discussed under all its aspects. The waters of the Company, their
reservoirs, their works, and their servants, have been examined before several
tribunals ; and it has all been done at leisure after the epidemic had subsided.
But the Registrar-General had to speak in the midst of the tempest, and on his
words at the moment the fate of the ship to some extent depended. " On the
** recent outbreak of cholera in the east of London," says the Parliamentary Com-
mittee, " it was ascribed by the Registrar-General to the bad quality of the water
<* supplied by the East London Waterworks Company to a part of the east of
^* London." This was a serious charge ; and the question was enshrouded in
difficulties; but it will be evident that the elements of a judgment existed in the
accumulated experience of the previous epidemics, in the known laws of the disease,
and in the facts of the case looked at comprehensively. In a subsequent paper I
have given in a narrative form an account of the steps taken at this office to unravel
the mysteries of the catastrophe, in which four thousand ^we hundred persons
perished in East London. It will be seen there how much valuable aid was given
by Professor Frankland. I propose now, when the storm is over, and with all the
ascertained facts before us, to describe briefly the epidemic in London, and to
investigate the causes of its irregular difiusion. The lesson to be learnt is of deep
interest to this country and to all nations.
L— CHOLERA IN LONDON.
1. Origin and Causes of the Disease,
Asiatic cholera had hovered over Europe in the year 1865. In the autumn a
few victims of the disease died in England. Epidemic cases then occurred both
* Beport of Select Committee on East London Water Bills. Session of 1867.
Origin of Epidemic. ziii
in Portsmouth and in Southampton.* At Epping, in Essaex, the Groombridge
familj, the medical attendant, and a woman who laid out their servant, were killed
bj cholera in the last days of September and the first days of October. Nothing
remarkable was observed; in London until the year following, on Wednesdaji
July 1 1th, when five deaths by cholera occurred ; on the 12th and on the two
following days 11, 20, and 15 persons died. Life was then fiercely assailed by
the disease in its quick form : the deaths ran up from 14 on Sunday to 105 on
Saturday July 21st; on Tuesday July 31&t the deaths were 191, on Wednesday 188,
or including the deaths in West Ham and Stratford, 205 ; they then declined.
Proceeding in weeks from Sunday, July Ist, the deaths by cholera in the five
weeks that ended on August 4th were 1 1, 63, 48 1, 1097, 1 178. Then dividing London,
including West Ham and Stratford, into two portions : in that supplied by seven
water companies (Grand Junction, West Middlesex, Chelsea, Southwark, and
Lambeth from the Thames, Kent from chalk wells, New River from wells and Lea
River,) the deaths by cholera were 10, 25, 61, 142, 196 ; but in the sub-districts
supplied wholly or partially by the East London Water Company the deaths in the
contemporaneous five weeks were 1, 38, 420, 955, and 982. Thus in the first week
the East London field had one death, the rest of London had ten deaths ; in the
fourth week the deaths were 142 in the rest of London, and in the East London
field 955 deaths from cholera alone. Several of the earlier deaths by cholera in
other districts happened to persons who had come or been sent from the East
London field. Each death by cholera implied two attacks about two days before
death. And for every attack by cholera there were about four attacks by diarrhoea,
approaching more or less in character to cholera. As the epidemic rose so it
declined more rapidly in the East than in the other regions of London.
The total deaths in London, with West Ham and Stratford, were 5973 by cholera,
3197 by diarrhoea (about 800 referable to the epidemic), 9170 by the two maladies*
It will be observed in the tables that, although unquestionably cases of the disease
occurred in every sub-district of London, and in some the number of deaths was
not inconsiderable, the enormous disparity between the earlier ravages of the
epidemic in the eastern water-field and the rest of London was never efilEkced.
I now proceed to consider the causes of the disparity, and to supply the
induction to justify the charge which was made in the Weekly Return, with
a view of stopping the plague at its source.
It may be stated first, simply as hypothesis, that the cholera is propagated
epidemically by a material substance, analogous iu its nature to the substances
which produce, under given circumstances, small-pox, cow-pox, syphilis, erysipelas.
This matter may be called cholrine,^ for the same reasons as certain substances
were designated sugar long before the chemical constitution of any kind of
sugar had been determined, or before that substance had been obtained pure*
Dr. Snow advanced the view in 1849 that the evacuations containing this matter,
distributed by contact or through water, were the sole means of propagating the
cholera ; which, on the cellular theory, ho held was propagated by cholera-cells.
Dr. Richardson contends that the cholera-matter is an " alkaloidal organic poison,.
** which, soluble in water, but admitting of deposit on desiccation, passes easily
" from one person to another under the agency" of certain peculiar physical
states.^ It is a fact well established in the practice of vaccination that the
specific matter of cow-pox after insertion is developed into full activity day by day
in the pustule, and then loses its qualities, so as no longer to take efiect even under
the most favourable conditions. In this respect the stufi" is like an organism : it is
produced by pre-existing forms out of other matter prepared for its reception ; it is
developed, produces its like, and decays. Brittain, Swayne, and Budd, indeed, held
in 1849 that they had discovered the cause of cholera in a fungus§ : Dr. Buchanan and
♦ See Annual Report of 1865, p. 163.
t Kegistrar-Generars 4th Annual Report, page 200 ; 1842. The matter of dysentery is thers
called enterine, of cholera^ cholerine^ which I now propose to write cholriHe, to avoid any ambiguihr.
X See Dr. Richardson on Theory of Propagation of Cholera. — ^Transactions of EpidenuMOgiod
Society, Vol, II., Part XL, page 432.
§ Report to Registrar-General, Cholera Epidemic, p. Ixxyi
xir. Cholrine^.
Mr. Simon, the medical officer of the Privy Council,* have given an interesting account
of recent researches in this direction by Hallier, pointing to the action of urocystis,
and by Pacini to vibrional molecules in the intestinal canal, as its specific exciter.
. Pettenkofer, who first drew attention to the sanitary importance of the subsoil
water line ( Grundtoasser), which rises and falls more or less in different years,
showed that in Germany the localities which have their water-line nearest to
the surface had suffered most from cholera ; and that the epidemic coincided
with the rise and subsidence of the water in the soil.f Cholera in Bavaria, he says,
prevailed epidemically only in places having a porous soil, with water never
more than from five to fifty feet below the surface. It should be borne in mind
that in many of these Bavarian towns water is drawn from wells by pumps or
otherwise. The excretions of cholera patients give the germ, the soil develops it,
says Pettenkofer. This is founded partly upon the interesting experiments of
Thiersch, which have been repeated by Dr. Saunderson, who has shown conclu-
sively that paper saturated in cholera fiux, and dried, when eaten produces the
disease in a transmissible form in mice. The fresh fiux the first day after exposure
u the air is almost inert, on the second day it grows more active, on the third it
is at its maximum of activity, is less and less active on the fourth and fifth, inert
on the sixth day of transformation. Of 148 mice experimented on, 95 showed no
symptoms, 53 were affected, 31 died. The successful experiments were made between
9iik September and 10th October, when the mean temperature was 5&^i a second series
between 3d and 13th November, when the mean temperature was 49% failed4
: This is thus far confirmatory of the hypothesis that the epidemic is propagated
by cholera matter, which it may be said is not very weU characterized by the
stereotyped words " rice-water evacnations/' In its pure form, after agitation, the
cholera flux has the appearance of thin cream, from which fiocculent matter sub-
sides after the lapse of some hours, leaving a supernatant milky liquid. One volume
was mingled for me by Professor Frankland with ten volumes of distilled water in a
long glass tube : the fiocculi subsided much more readily, leaving an opalescent liquid
above. One volume to one hundred volumes of water in a long tube presented the
same appearances, but in a less marked degree. Mixed in 500 volumes of water
the opalescence was retained after the liquid had been passed through filter paper.
Opalescence is a characteristic feature of the cholrine, even as it exists in a
liquor holding less oxidizable organic matter than the filtered London waters ;
and in these minute quantities it cannot at present be detected by chemical analysis.
If the matter is organized it is necessarily suspended in water and cannot be in
solution. §
Numerous facts prove that cholera is communicated to a certain proportion
of the women washing the clothes of cholera patients ; and I showed that the
parts of London near the warm infected Thames suffered in an ^unusual degree
daring the epidemic of 1849 ;|| hence it is not improbable that cholrine is to some
extent carried up from warm liquids by watery vapour.
The cholera matter is often yielded by children, and even by adults, suffering
fVom diarrhoea, and not afflicted by the characteristic symptoms of Asiatic cholera. %
This property it has in common with scarlatina, syphiUs, small-pox, and other
zymotic diseases, where the mildest types communicate to other bodies diseases in
their most malignant forms.
The cholera flux is of low specific gravity (1008), and thus poured on the
* Ninth Report of MedicAl Officer of Priy:^ Cooncil.
f A clear account of Pettenkofer's doctrine is given by Dr. Weber in Transactions of Epi-
demiological Society, VoL U., Part XL, page 404. See aUo Letter from Professor Pettenkofer in
Appendix, p. 280.
X Ninth Report of Medical Officer of Privy Council, page 452.
§ See Professor Frankland*s interesting account of cholera flux. I procured this matter for the sake
of studying its comportment when mixed with water in glass tubes. The liquids in the hot weather
have undergone little change since the tubes were s^ed, 26th October 1866, except that the
cholera liqmd is browner, and that the fiocculent matter in the hot weather rose to the top of the
water in the tube containing one-tenth of chofaine. 11th September 1867.
H Cholera Report, pp. Iviii-lxi.
^ Virchow's Handbuch der Spedellen Pathologic und Therapie, 2 Band, 2 Abth., page 832.
The article of Qriesenger on Cholera gives all the Qcnoan learning in a weU-digested fi>nn.
Localization of Cholera, xt
surface of water sinks verj slowly ;* but in the end it gradually falls towards the
bottom of the vessel, leaving slight traces in the upper sti-atum, and containing
increasing quantities as the bottom is approached. It is important to bear this
physical property in mind. For cholera flux dropping on the surface of the
Broad-street well would be pumped up in proportions varying with their stage of
descent, and on falling to the bottom might leave the upper water clear. I
mention this simply by way of illustrating the effect of the purely physical
properties of the cholera flux on the doses of it in the same quantity of water at
different hours of the day, or of successive days. For. the same reason the waters
of contaminated reservoirs vary in zymotic strength from hour to hour.
It may appear at first sight impossible that the cholera flux of one or more
patients should produce any effects in the waters of a river like the Thames. But
living molecules endowed with the powers of endless multiplication are incon-
ceivably minute, and may be counted by millions in a drop of water. Pacini, an
excellent microscopic observer, has found that the germs of vibrions (molecule
vibrionali) are less than -^zhisis ^^ ^^ ^^^^ ^^ diameterf ; and placed in immediate
juxtaposition a cubic inch would contain (26000)' = 15,626,000,000,000 germa.
Allowing for interspaces, it is evident that a cubic inch might hold millions of
cholera particles, and one cholera patient might disseminate in water millions of
millions of zymotic molecules. A litre of blood contains, according to the deter*
minations of Yierordt, 6069 millions of corpuscles.^ The water of a city is less in
bulk than its atmosphere ; and disease-molecules, if freely distributed through
both elements, will be rarer in air than in water. If we judge from analogy,
a certain quantity of the cholera matter is necessary to render its effect at all pro-
bable ; as germs of disease are as profusely expended by nature as seeds of plants. §
The infection-power of cholera liquid is essentially transitory : it is developed in
given circumstances in its intenser form, and in a community as well as in an
individual, — in India as well as in England,— -it grows as well as declines by a law of
its own ; it is epidemic only for a time and by periods of years. It has its seed*
time and its harvest in each locality ; and the air or the water which on one day is
poisonous may a iew days afterwards be harmless. There is thus an essential
difference between zymotic venom and a metallic poison like arsenic.
In its weakest form cholrine produces diarrhoea in a great number of persons ;
but in every population a largo number of people appear to resist its iufluenoe.
They are insusceptible. The cases of attacks of the same person twice in this as in
some other zymotic diseases are rare.
2. Localization of Cholera in East London.
We may now discuss the question of the unequal diffusion of cholera OTer London
in the last epidemic. It may be assumed that the cholera in its Aaiatic form was
brought into England in 1866 ; and the argument will not be afiected if the first
cases originated on the banks of the Lea, and not on the shores of the Ganges. It
may be 'further taken as proved that it is propagated by the cholera flux; and let
* Rice-water Evacuations. — Cholera flux is of low specific gravity : takmg pure water as 1000
it Ib given by Dr. Robert D. TbomBon as lOOS; that of blood serum being 10S8 in the healthjl
while in two cholera cases it was 1042 and 1058 respectively. The most abundant matters pratent
are flocculent bodies, which imimrt the characteristic aspect to the fluid. Dr. Hassall says this liquor
after being set aside for some time, let fall a deposit varying from a fourth to a sixth of its bulk!
consisting, as^ seen under the microscope, of innumerable mucous corpuscles, globules of oil and
myriads of vibrions in every drop of every sample of rice water exmxaneA.^ Appendix to Report
of the Committee for Scientific InquirieM on the Cholera Epidemic of 1854, pp. 285-293.
t Appendix to 9th Report of Mescal Officer of Privy Council, page 519; Pacini, SnlUi Ckiwa
Specifica del Col. Asiatic, 1865 ; and the work Delia Natura del Col. As., 1866.
J Carpenter's Physiology, 6th Edition, page 155.
§ ** Newport adds the important fact, established by numerous experiments, that when a very
small number of spermatozoa are applied to the ova of Batrachians, they are only partially
impregnated and the embryo is never fiiUy developed With respect to plants nearly
the same results were obtained by Kdlz«iiter and Giitaer. This last eareftd observer found, aft^
making successive trials on a malva with mofs and man poUso-miBS, that even thirty grains
did not fertiliic a single seed ; bat whan &rty craina wwt appMTto tha sKigiiia a few se^s of
small sise were fumed* The pollen gnuDS of a»ilia a« «aia8iriiHrifar kmu and thi^ «s^%fs^
xvi Diffusion of Cholera.
those who doubt this accept the principle for the moment as hypothesis, which
the subsequent crucial facts will at once either establish or dispeL
Then the elements of the disease must either have been diffused (1) bj personal
contact ; (2) by translation through the air ; (3) or by dissemination in vapour of
sewers ; or (4) by the various waters.
Now the evidence that cholera can be communicated in these ways by choir ine
is conclusive. Instances of a cholera patient brought to a distant house and com-
municating forthwith the disease to an inmate are too numerous to be mere coin-
cidences ; as the chances by the doctrines of probabilities against such numerous
coincidences are inconceivably great. But it is evident that as the population of
every district of London is in free communication with every other district, and
is constantly interchanging its residents on both sides of the river, so by this
mode of communication cases would be, as indeed they were to a limited exteuty
fireely distnbuted all over London. The same might be said of the air : any gas
generated in any point of London is by the law of gaseous diffusion speedily distri-
buted through the atmosphere ; and matters in suspension are distributed by the
winds, which are thus described during the first four weeks, extending from
July 8th to August 4th, which saw the rise and decline of cholera : variable ; N.E.
and E.N.E. ; variable; W. and W.N.W. The winds were not still ; but blew in
various directions over London at the rate of eight miles an hour during the first
three weeks, and then with double that velocity. If they carried cholera on their
wings they must necessarily have shed its poison over all London : the action of the
winds could not have been confined to the small area of East London. In India
the cholera matter is scattered by the natives on the surface of the earth ; and may
be either washed into the tanks or be dispersed in clouds of dust.* But in a
town of waterclosets and privies the diffusion of dry cholera dust must be exceed-
ingly circumscribed.
In the watercloset system the cholera fiux in vapour, if it is not sometimes
generated, is sometimes distributed in sewers, and is driven into the dwellings
of the people. An instance of diffusion in sewer vapour at Southampton
is given by Professor Parkes in his masterly paper, f Professor Parkes in
the same paper shows that the foul water of the Peninsular steamer '* Poonah "
proved much more virulent than sewer vapour. And it is evident that the
amount of zymotic matter evaporated from cholera flux, and entering the
system through air, must be inconsiderable as compared with the amount that
may enter through a water supply contaminated with sewage. | All over London
the sewage exhalations went on during the summer of 1866, and produced certain
effects. It happened, too, that several districts in the group so heavily visited
by cholera lie in the particular region which then derived no advantage from tho
contemplated low-level sewer. But too much importance must not be attached to
this circumstance. The whole of tho region on the Thames from Chelsea to the
city of London inclusive is in the same predicament ; and there the mortality by
cholera in the present epidemic was low ; in the Chelsea water-field, for example,
the deaths by cholera did not exceed 4 in 10,000, nor is the rate exceeded by tho
average mortality of the whole region along the proposed low-level sewer except
contains only a single ovule ; and these c'lrcumstances led Naodin to make the following interesting
experiments : a flower was fertilized bj three grains and succeeded perfectly ; twelve flowers were
fertilized by two grains, and seventeen flowers by a single grain, and of these one flower alone in
each lot perfected its seed ; and it deserves especial notice that the plants produced by these two
seeds never attained their proper dimensions, and bore flowers of remarkably small size. From
these facts we clearly see that the quantity of the peculiar formative matter which is contained
within the spermatozoa and poUen-gituns is an all-important element in the act of fertilisation, not
only in the full development of the seed, but in the vigour of the plant produced from such seed."
[ The Variation of Animals and Plants under Domestication. By
Charles Darwin, MA., FJI.S. Vol II., pp. 363-64.]
* See Fick*s letter on Ziirich outbreak.
{Appendix to Ninth Report of Medical Officer of Privy Council, pp. 244-253.
Dr. Hassall remarks that the sporules of some flmffi are aerial and repel water, but vihrions
are true aquatic productions : he found no vihrions in the water distilled fh>m rice-water flux at
a low temperature.— Appendix to Board of Health Report of Committee for Scientific Inquiries,,
page 305.
Old Ford Beservoirs. Xfii
in the East London water-field, whore the mortality by cholera was at the rate of
72 deaths in 10,000 living! Again, West Ham with Stratford-le-Bow has an inde-
pendent drainage system of its own ; and over this region, where the same water
went, the same dreadfurmortality prevailed.
The cause of the mortality of cholei*a in London, whether on the north or the
south of the river, up to the rate of 5 in 10,000, it may be admitted on all hands is
explained by the diffusion of the cholera-stuff through personal intercourse^
sewers, and the slight contamination of the waters either of wells or of the Thames
and of the Lea after filtration by the water companies. All those companies had
before 1866 professedly carried out extensive works for taking their waters from
better sources, for filtering it, for storing it^ for distributing it, in conformity with
the provisions of the Metropolis Water Companies Act of 1852 ; and their works
had been pronounced very good by three engineers appointed by the President of
the Board of Health. " The requirements," said the thi*ee engineers, *^ set forth in
^'^the Metropolis Water Act, 1852, have^ in all essential respects been fully and
** satisfactorily complied with by the several companies." ♦
The East London water company's works are described in the Engineers' report :
in 1850 it had six open reservoirs, one at Lea bridge, one at Stamford Hill, and four
at Old Ford ; in 1855 the new filter beds at Lea bridge were completed ; the filtered
water was brought, in a four-feet iron pipe, to Old Ford, into two oval reservoirs,
which, used formerly as subsiding reservoirs, were now covered over with brick
arches and earth. ** The other reservoirs of the company near Old Ford and theU
" at Stamford Hill are,'^ say the reporters, ** now thrown out of use. ♦ ♦ ♦
'^ The large depositing reservoirs upon which they had to rely for clearness of the
^ water have now been abandoned, and all communication between them and the
*^ mains has been cut o/f." f In the reporters' map the small covered reservoirs of
2^ acres is engraved ; the two open reservoirs of 9 acres, east of the Lea, are sup-
pressed in the map, on the ground probably above alleged, that " they were thrown
out of use." These open ponds do not figure in the elaborate water map of B. W.
Mylno, C.E., published in 1856. The open reservoirs contain water admitted to
be unfiltered ; and Mr. Greaves the engineer, speaking for the company, in his
letter to the Times^ dated August 1st, 1866, made this statement : << The facts
<« are * ♦ that the canal having been since 1853 disused for all purposes of
" supply^ is only maintained as a drain from the filter to a lower part of the
** river ; that not a drop of unfiltered water lias for several years past been
** supplied by the company for any purposc^^X
This was perplexing ; but the company, by taking the unfiltered water from the
open reservoirs^ violated an Act of Parliament, and on the ground, perhaps, that
they were not bound to criminate themselves, they, in the words of their engineer,
besides pleading ^^ not guilty," boldly proclaimed their innocence on August 1st.
Shortly afterwards Mr. Greaves, however, admitted candidly, that the open re-
servoirs of unfiltered water could be drawn on ; and by the report of Professor
Frankland (August 25th) goes a step further. " Communication," Professor Frank-
land says, *' can be established between these reservoirs and the pumping wells
'' supplying the public, but Mr. Greaves assured me that U was never done^ except
'^ in case of emergency,*^ In his examination before the Pollution of Bivers
Commission on December 10th, Mr. Greaves advances another step, and states,
that ** a small quantity of water was taken out of one of the open reservoirs this
*' spring ;*' << he had not the date ;" '' probably June was the latest date," bat
ho could not say definitely. Further revelations were made by the workmen
under examination by Captain Tyler; and the story is at length thus told by ofiicers
of the company : —
The foreman of the company died quite suddenly of apoplexy early in this
year (1866). In appointing a new man, in giving him discretionary instruction as
to how he was to manipulate the water, ^' I described," says Mr. Greaves, '' this
^' possibility [of drawing on the open ponds] as something which he must keep
♦ Report to Right Hon. W. Cowper, M.P., President of Board of Health, on " Metropolis Watef
Snpply,*' 1856, hy H. Austin, W. Ranger, and A. L. Dickens, Superintending Inspectors, p. 101.
J Ibid, pp. 65, 67.
See Appendix, p. 92.
§ See Appendix, p. 124. '^
xxm T/te opening of the Sluice.
V in mind, rather iban sufier an accident^ and so I suppose he may have acted in
'* that sense." He, Mr. Greaves, kept these open ponds in reserve, as the question
of quantity was important, " to meet such necessities as might arise." *
The Lea, Mr. Beardmore asserts, was full of water in 1866; how then could the
Bupplj be in any way deficient in July ? This is explained to some extent by
Mr. Maine, the manager of the works at Lea Bridge. Tlie rapidity of filtration is
very variable ; and in the month of July every yearf a slimy matter is rapidly
deposited on the sand, blocking up its pores, and stopping this titration altogether.
In August this sluny matter grows, and no sooner produces green confer void fibres
than the power of the filters is restored ; the water flows freely.
The foreman of the works, in his evidence, says that he considered the water
in the open reservoirs available as a reserve in the event of the water getting low
in the covered reservoir, to prevent the damage of the engine with the higher
suction. He kept no notes, but he believed that he allowed the water to run from
the open to the covered reservoir not more than three times during the year 1866 ;
at the latter end of March, at the latter end of June, and some time in the early
part of July, The sluice was never opened after cholera broke out ; ho is certain
of that. He had no fear of its doing harm,\
A carpenter, twenty-four years at Old Ford, appears to have been the only man
who worked the sluice between the open and the closed reservoirs. He did other
jobs, but that was his specialty. Ho opened that sluice frequently in 1864,
frequently in 1865, and three times (I) in 1866. He describes in three cases what
he did. In March he was at the engine house : the engine began to draw air ;
and he was ordered by the engineer of the company to open the sluice. He left it
open two hours. In June he was about the yard, when the engine driver called to
him, and " ordered him to let him have some water." He complied by command
of the foreman. About two p. a/, early in July, and this may have been the first
fatal day, he opened the sluice again, and left it open for about the same period
of the day. " He considered tlio water in the open reservoir to be very good,
" and had often drunk it." {
When this statement is compai^ed with that in Mr. Greaves's letter, § and when it is
borne in mind tliat these dependent men were not giving evidence on oath, that the
opening of the sluice would be precisely one of those acts of which no record
was desired, we can scarcely expect a more explicit statement. It is enough to
have in evidence, that immediately before the outbreak in July the foul water
of the reservoirs was pumped over the parts of East London where cholera was
epidemic.
Again, there was another channel for the entrance of the foul water of the
Lea directly into the covered reservoirs supplying the pumps. Professor Frank-
land sagaciously remarked, that the bottom of these reservoire, within a few yards
of the river, is 16 feet beneath the low ground, which is here only just above the
level of spring tides. When the tide was high, and the water of the reservoir was
low, the permeation of the water through the gravelly bottom into the reservoir was
on hydraulic principles inevitable. Captain Tyler describes graphically how he
put this to the proof, and established the fact, by wading over the bottom. The
reservoir was on Sunday February 24th, at his instance, pumped, in 36 hours, as
low as possible ; the bottom was found foul ; but the water at last came in faster
than it could be pumped out by the powerful engine. The patience of the waiting
company was exhausted ; the water still came in.
Cholera flux, with the other excremental matters in the channel of the Lea,
thus must have found its way from the reservoirs to the pump wells of the
company at Old Ford.
Mr. Greaves himself could not perhaps describe precisely what took place in
July ; but this is substantially what occurred : — The Lea at Old Ford was much
more polluted in the sunmier of 1866 than it was in 1854; for, besides the
aewers emptying into it on the side of East London, the whole sewage of Stratford
and West Ham on the Essex side has since 1861 been discharged into the Bow
* See Extract from l/ir. Greaven's Evidence in Appendix, pp. 100-101.
f See Professor Frankland's Beport, Appendix, p. 123.
^ * Appendix, p. 105.
Appendix, p. 92.
The first Deaths. .
Creek arm of the river at the irou bridge. This sewage is washed up and down
the .stream by the ebb and flow of the tide twice daily between and in close
proximity to the open and the storage reservoirs of the company. The storage
reservoir, full, holds 6,000,000 gallons of water in the morning; in the day
8,000,000 gallons flow into it by the iron pipe from Lea Bridge ; and a^ the
pumps distribute 11,000,000 gallons in the day, 3,000,000 gallons are left in the
reservoir at the close of the day, to be augmented to 6,000,000 in the night when the
distributing pumps cease working. But one day, early in July, probably on Monday
or Tuesday July 9th or 10th, at 2 o'clock in the afternoon, the storage reservoir was
at the lowest ebb, and the dregs of the water were drawn on ; the well was
scantily filled ; the pump gave unmistakeablo signs of distress ; the engine-driver
called out for water ; and then the old carpenter opened the sluice, and let in
the contents of the northern stagnant pond, with its bottom pervious alike to the
waters of the Lea and to the waters of its sister reservoir, which had been
recently refilled by soakage from the Lea, and was slightly turbid and milky on
the 9th of August.* How often this was repeated in July it is in] possible to
tell, as the engineer did not even know that the pond water had been used at
all in that month, and the old carpenter's memory, minute in some respects,
reproduced facts too imperfectly to form a basis for a negative argument. If thia
scanty supply of water was due to slimy obstructions of the Lea Bridge filter bod,
Mr. Maine tells us that the slime lasts till its germination in August. Again, if the
supply from Lea Bridge in July was less than in May the East London Company
must have drawn on its open reservoirs^ for in their return they give the quantities
supplied at 2,167,885 gallons a day more in July than in May, They distributed
636,000,000 gallons of water in July; where did it all come from ?
The lowncss of the water level in the storage reservoir would during the
same month let in impurities from the Lea every evening.
Several cases of cholera and choleraic diarrhoea had occurred over London in
May, and on 27th June, at 12 Priory -street, Bromley, one poor Hedges, a labourer,
and his wife, both of the age of 46 years, died of " cholera Asiatica," the former after
15 hours, the latter after 12 hours illness. Their cases are minutely described by
Mr. Radcliffe, who traces the discharge into the watercloset of 12 Priory-street,
and thence 300 yards down the sewer to its opening into the Lea at Bow Bridge,
half a mile below the Old Ford reservoirs.f He attaches great importance to these
first cases ; and they undoubtedly sufficed to pour into the sewers and waters
millioDs of zymotic molecules, which day by day grew more and more frequent in
the Lea by every hour's choleraic discharges on both sides of the river. On
Wednesday, 11th July, the first four deaths of the explosion occurred, one in each
of four distinct sub-districts ; and allowing for duration and incubation, it is not
improbable that the four persons took the poison early in the week. Nine deaths
occurred on the 12th in seven of the East London sub-districts wide apart. On
Wednesday the 1 8th, were 59 deaths, singly, or sometimes in clusters of 8 or 9 deaths
in 16 sub-districts of the East London wat«rfields ; a few deaths dropped in here and
there in a sub-district of the other waterfields ; but this mass of death in East
London was due evidently to some sux)eradded agency. It operated mainly in every
district supplied by the Old Ford pumps ; that is, in Bow, Bromley, Poplar, Lime-
house, Mile-End-Old-Town, St. George-in-the-East, Whitechapel, parts of Bethnal
Green and West Ham, which Captain Tyler telb us would in the ordinary way bo
supplied " on the greater part of week days from Old Ford."{
The East London field is supplied by the company from pumps at two different
sources, three miles apart : (1) from the Lea Bridge pumps drawing their water
direct from filter beds, and beyond the range of tidal sewage contamination, and
(2) from the Old Ford pumps.
At Old Ford there are houses with five pumps and steam-engines of 640 horse-
power ; at Lea Bridge two engines of 300 horse-power. The power in the gross is
equal to the delivery of 38,000,000 galloris of water daily. The actual supply during
. * See Professor Frankland's Report in Appendix, p. 125. Extract from Letter of Mr. J. Hatchings,
who passed by the East London poodi at Old Ford nearly every day daring the year 1866.
t Appendix to Nmth Report of Medieal Oftoer of Priyy Coancil, p. 885.
t Report na the Qqaat^ and Q^iriiij of Ae East London Water &a^\Vs. ^vKk3ais&Ks^3tix^^^»^*^
Ko. 339, ScirieQ of 1867, p. Ift, ^ ^
XX Meeting of the Water $•
the year 1866 was 19,380,739 gallons daily.* Of this. Captain Tyler says, 1 1,000,000
g^lons are delivered daily from Old Ford, and the rest (8,380,739) from Lea Bridge.
With some variation, this is the order of the work : — the engines at Old Ford are
started at 5^ in the morning and stopped at 7^ p.m. ; and from 7^ in the evening
till 5^ A.M. of the next day the water supply " is entirely produced from the Lea
Bridge station." f " The Old Ford engines do not," says Captain Tyler, " work at
*• night or on Sundaysr " The water from Lea Bridge at those times supplies
" the whole district [water field] passing by Old Ford, and even to the Essex part
" of the district."^}: Three hundred miles of street are traversed by the com-
pany's pipes : the pipes of six inches and upwards, called by the engineer
^ mains,' arc 147 miles long; while the smaller *sei-vice pipes,' some constantly
charged, the others turned on once a day, are 328 miles long. §
The effect of all this is, that the Lea Bridge waters usually meet the Old Ford
waters at a fluctuating line running from Victoria Park, through Bethnal Green,
onwards to Spitalfields. Far south of this line the Lea Bridge waters pass on
Sunday, and even early in the morning, but only in very rare instances could the
Old Ford waters be carried into Hackney north of that line.
It was precisely in the region of the Old Ford waterfield that cholera raged.
There, in three months, it killed little less than 4,000 men, women, and children ;
while in the Lea Bridge field, and in all the other water fields of London, the
epidemic was kept within such narrow limits of fatality as would be accounted for
by difiusion through sewers, direct contact with cholera matter in various ways,
and the slightly contaminated filtered river waters of the other companies.
It must be evident that the dose of cholera matter in a given quantity of the
water supplied from Old Ford would vary indefinitely in different localities ; for
example, assume that the North Woolwich main was filled by water pumped from
^the covered reservoir before 2 o'clock on the fatal afternoon of July, when the old
carpenter confesses that he let in the open pond water, or that it was filled on
Sunday with the water of Lea Bridge, and in either case the water of the main
would be comparatively pure. In fact as the composition of the water in the
fl apply reservoir would vary from day to day and from hour to hour as the level
of the water got lower, and as the tide of the river happened to be in or out, it is
evident that the composition of the water in the supply pipes at any given moment
would vary to an inconceivable extent.
But the cholera matter, after it leaves the body, undergoes changes of which
;8ome may render it more, others less and less, active from day to day ; and, moreover,
this flux holds in suspension active matter heavier than water ; hence it is probable
•that in an aggregate of several districts thrown together, to get rid of accidental
disturbances, the effect of the cholera flux will be least in elevated and in remote
districts supplied by mains constantly filled. The cholera fiux in a six-inch iron
pipe, rising for a mile to an elevation of a hundred feet, would comport itself very
much as we see it in a glass tube ; thus, if the flux was equally distributed from
the reservoir over the field of a company varying in elevation, the quantity of
cholrine in a given quantity of water, like the quantity of cholera in a given
population consuming that water, would vary with the elevation. The cholrine
might also vary with the distance of the point of discharge, as the velocity of
water and the quantity of matter it carries in suspension change under most
complicated hydraulic laws, to say nothing of the laws of the changes afiecting
cholrine itself.
3. Cholera in the several JVaterfelds.
I now proceed to call attention to the mortality from cholera in the various
waterfields of London. || As their areas correspond with none of the other
.recognized divisions of London, the 135 sub-distncts have been distributed into
15 groups, under the various heads corresponding as nearly as possible with the
waterfields. It will be seen that while there is a certain mortality from cholera in
• Appendix to Report of Select Committee on EastLondon Water Bills, Session of 1867, pp. 266,209.
J Evidence of Mr. Qreaves before Rivers Commission, Q. 384, page 11.
Captain Tyler's Report (Parliamentary Paper, p. 16).
I Appendix to Report of Select Committee on East London Water Bills, p. 267.
^ Tablt dd (Appendix, p. 83).
Cholera in the WaterJUlds.
evBTj condition, the excess above this standard is constantly in proportion to the
impurities of the water during the epidemic period.
London is now supplied with water by eight companies. South of the Thames
it is supplied by three companies ; the Lambeth and the Southwark companies
taking their waters from the Thames ; the Kent drawing its waters, the officers say,
from wellri, and not as formerly from the Ravensboume. London, north of the
Thames, is supplied hjfive companies, the Chelsea, the Grand Junction, and the West
Middlesex tidying their waters from the Thames, the East London from the Lea,
the New River from the Lea mainly, and from wells. The area which each company
respectively supplies I call its water-field, and London is consequently divided into
eight such fields. In some cases the water-fields of two or three companies are
intermingled at their edges, and do not coincide precisely with the registration
districts. Pumps exist to some extent, and draw water from shallow wells. By
taking the sub-districts included in each water-field we get, however, eight areas,
each of which is supplied almost exclusively by one of the eight companies, and
where the mortality by cholera in three epidemics can be determined with
sufficient exactness. Then we have a group of the sub-districts supplied con*
jointly by the New River and the East London companies, some streets of each
sub-district getting water from one company, other streets getting water from the
other company ; and so it is in the case of other companies. Thus 15 groups or
sub-districts ha?e been formed ; each of 8 supplied by a single company, and each
of 7 by two companies.
The proportion of deaths by cholera to 10,000 inhabitants in 1865 will show the-
relative fatality of the disease. Thus the deaths by cholera in the field of the
Chelsea company were in the proportion of 4 ; in that of the West Middlesex 4 ;
in that of the Grand Junction 3 ; nor do the proportions differ from those abova
given to any extent in the sub-districts supplied conjointly by any two of the
companies, as is shown in the Table. The rate of mortality in the group supplied
by the West Middlesex Company and the New River is necessarily corrected, for
of the 48 deaths there by cholera 36 took place in Univerdti/ College Hospital^ among
patients brought from all the sub-districts in its vicinity. After a correction for
these imported cases, the proportion is reduced to the average. The deaths in the
water-fields of the three companies, including all the three sub-districts which they
supplied jointly with the New River, amounted to 266 by cholera, 687 by diarrhoea,
among a population of about 739,279, giving 4 in 10,000 as the death-toll by
cholera, and 9 as the death-toll by diarrhoea, which included a certain proportion
of choleraic cases.
The fatal cause, and the means employed to hedge it in, produced a very uniform
result over the first seven groups of Table 33 ; and upon taking the 27 western sub-
distncis of which they consist^ covering an area of 15,020 acres, and extending
from Fulham on the Thames to Charing Cross and Hampstead, the dififerences of
cholera death in the sub-districts are not of any significance.*
The water-field of the New River is extensive ; it covers the large part of London
lying along the Thames from Huugcrford Bridge over the city of London down to
St. Katherine's Dock, and extends northwards to Stoke Newington and Ilighgate.
This company supplies exclusively 39 sub-districts on an area of 8,7oo acres,
inhabited by about 834,617 people. The deaths in this region were 661 by cholera,
846 by diarrhoea. The deaths by cholera were in the proportion of 8 to 10,000
inhabitants, by diarrhoea 10. The mortality by cholera was more than double that
of the western water-fields ; but by diarrhoea there was only a slight excess ;
indeed, the deaths were proportionally less than in the West Middlesex water-field.
The water-field of the East London Company covers all the area of London on
the river Lea, and extends to Stratford and West Ham, which are not yet in
London. The deaths in the 22 sub-districts supplied by this company were 3,947
by cholera, 813 by diarrhoea; the deaths by cholera were thus 72, by diarrhoea 15,
in every 10,G00 inhabitants. This dreadful mortality by cholera was nine times
as great as in the New River sub-districts, and twefity times as gi*eat as in the
north-western sub-districts. In seven populous sub-districts supplied jointly
* Table 84 (Appendix, p. 84.)
xxn South London.
by the East London company and the New River the deaths were in the proportion
of 34 by cholera, 11 by diarrhoja.
And it will bo remarked that the mortality by cholera was excessive in every
one of the 29 sub-districts supplied by this company wholly or partially from the
Old Ford reservoir, except Stamford Hill, which is said by the officers to have got
its water from Old Ford.*
Crossing over the Thames, the whole of South London lies before us. There
the thi'ee high sub-districts of Sydenham, Norwood, and Streatham lost - out of
every 10,000 inhabitants 3 by cholera ; they were supplied by the Lambeth
and Southwark companies. The deaths in the exclusive field of the Southwark
compauy were 7, and in that of the Kent company 16 ; the cholera deaths in the
17 sub-districts supplied conjointly by the Southwark and the Lambeth company
were 6 in 10,000 inhabitants ; and 6 in Peckham, which is supplied by these
companies in conjunction with the Kent company.
In the whole of South London the cholera deaths were 8 in 10,000 iuhabitants,
which stands in strong contrast to the 72 deaths to an equal population in East
London.
It is then evident that in the year 1866 the epidemic cholera matter (cholrine)
found its way into every district of London ; that its quantity varied, and was
limited in every district within narrow limits, except in the water-field of tlie East
Loudon company, where the cholera deaths alsoj varied from place to place, but were
in nearly every locality so excessive as to leave no doubt that an excess of cholrine
was distributed over that field.
That neitlier less poverty, depression of soil, nor density of population suffice to
account for the diminished prevalence of the epidemic in South London is evident on
comparing the cholera deaths of the same sub-districts in the year 1849 and in 1854.
Confining our attention to South London, there is no reason to believe that the
poverty of the districts was greater in 1849 and in 1854 than it was in 1866; the
density of population was leas, the depression of the soil was the same, and yet in
1849 the cholera deaths to 10,000 Inhabitants were 121 ; in 1854 the cholera
deaths were 94 ; and, as we have seen, in 1866 they fell to 8. The cholera deaths
to 10,000 fell at once in the four sub-districts supplied exclusively by the Lambeth
company from 93 in the year 1849 to 17 in the year 1854 ; in the sub-districts
supplied jointly by the Lambeth and the Southwark companies from 138 to 95 ; in
the sub-districts supplied by the Southwark alone the proportions rose from 135 to
154. Some deterioration in 1854 is noteworthy in the Chelsea water-field, but there
is a noteable amelioration in the water-fields of the New River and the East London.
In the water-field of the Grand Junction company, the fatality of cholera greatly
increased in 1854; and that not only in the Golden-square sub-district in the vicinity
of Broad-street pump, but in Kensington town, and St. John, Paddington. The
mortality by cholera in the Chelsea and the West Middlesex water-fields was higher
in 1854 than in 1849; and the waters of the upper Thames had grown impurer.
The companies were appealed to (see Appendix, pp. 297-301 ), and several of them
improved theii' waters materially before the Act of 1852 came into operation; but in
the beginning of the year 1853 the Lambeth company, quitting its source of supply
at Hungerford Bridge, where the Thames was foully polluted with London sewage,
drew its water from Thames Ditton above Teddington Lock and beyond the reach
of London sewage, but even then apparently exposed to the pollution of the drainage
of Thames Ditton. f Still the whole character of the Lambeth water was changed ;
it could no longer be contaminated by the cholera fiux of London, and the result
was astonishing. As the Southwark water then remained the same, while the
Lambeth water was changed, the operation of other causes remaining the same
in the two intermingled fields, the phenomena were analyzed, and the vast diffe-
rences in the mortality of the people living in the two fields were evidently due to
the differences of the water.
The reasoning may be put in this form : the excess of the mortality {x) by
♦ Mr. Greaves in his evidence before the Riven Commismoners says : ** The Stamford Hill dis-
trict I am able to supply either firom Lea Bridge or from Old Ford. . . The Lea Bridge water-
wheel is now (Dec. 10, 1866) working to Stamford Hiil, but for some years past I was entirely
mpplvrng Stamford Ilill horn Old Ford." (Rivers Commission, 2nd Report, Vol. II., Evidence,
Hiis may be inferred from a passage of the Engineers' Report to the Right Hon. W. Cowper, p. 50.
The River Lea. xsdii:
cholera in the Soutliwark and the Lambeth water-fields in 1849 and 1854 was
produced by one or other of the possible causes all existing in 1849, represented
by a, b, c, d^ e, z ; in the second period, as well as the first, all the possible causes
remained unchanged, except the possible cause z, which varied, and with it varied
.X so as to diminish as z diminished ; therefore z was the cause of x. If the
^'.numeration of possible causes is complete, and the assumption that the forces of
abode are substantially unchanged, it is difficult to resist the conclusion that z was
the cause of x. The obvious possible causes are exposure to infection (a), bad
drains (6), crowding (c), poverty (e), imperfect medical relief {/), impure water
z : none of these, as far as it is known, differed, as far as Lambeth is concerned, in
1849 and in 1854, except the water (z), which was very impure in 1849, much
purer in 1854. Again, all these causes, except z, were substantially the same in the
Southwark and the Lambeth water-fields in the year 1854 ; but then the water in
the Southwark w^ter-lield became worse, and there x increased, while in the
adjacent Lambeth field the reverse happened.
In the interval between the year 1854 and the year 1866 the water of all the
eight companies was taken from points higher up the rivers, and filtered, and
following this, in 1866, cholera in every water-field was fatal to comparatively few
when it visited London under nearly the same epidemic circumstances, and, as far
as could be judged from continental experience, with undiminished virulence, except
in the water-field of East London. See coloured map No, 2. at end of the reports
The East London company itself had succeeded by filtration* and other means in
reducing the cholera mortality, which was 59 in 1849, to 34 in 1854 ; and the
deaths by diarrhoea remained nearly stationary. In the years after 1854 the waters
of the Lea grew every year fouler by the discharges of the sewers on its west
bank, and by the drainage of West Ham into its eastern margin ; a work designed
hy an eminent engineer, that has gradually extended since it was first opened
in the autunm of 1861,t and now (1867) pours the contents of the water-closets of
10,000 houses into this tidal tributary of tlie Thames,! above its loop at the iron
bridge, only a mile and a half below the water reservoirs of the East London Com-
])any. A large part of the sewage is dischai*ged by gravitation, but about 4,600,000
gallons were pumped daily into the river in the year 1866. " The effect of the
^ewer outlets," says Mr. Beardmore, the able engineer of the Lea Trust, " is no
*' doubt to keep the tidal water m afoul state, especially during the supnmer and
** autumn months, when there is not an excess of water in the lA^a,** § The river
is as foul, in the opinion of Mr. Marshall, as the West Ham sewage. '' It looks
^' as foul, and certainly no sensible impression is produced on the river Lea that I
^' could ever detect, even when we are pumping into it at all times of the tide. A
*^ large area of bank is exposed every tide ; it is covered with a slimy deposit of
^' mud of a most offensive appearance, and certainly with no agreeable smelL" '^ In
^* hot weather what kind of sensation have you when walking near that mud ?— -I
*' always have the sensation that I should like to be somewhere else." Q ** We
found it expedient during the last summer (1866) to wash out the sewers, I
believe that we should not have had occasion to do so except to please the people
" on account of the cholera"
West Ham is out of London, so, although the great metropolitan sewer passes
over its main sewer at Abbey Mills pumping station, the Lea, instead of deriving
any advantage from that circumstance, thus grew liable to further pollution by the
discharge into its waters of the overflow of the metropolitan great sewer in times
of storm.
The East London Company had apparently no defence against the tidal waters
* Before 1852 the East London Company employed no means of filtration, bnt relied upon its
large depositing reservoirs to which reference has been made. By June 1854, that ii, before the
height of the London epidemic of that year, half of their filtering beds were in operation. Bse
Engineers* Report to the Right Hon. W. Cowper, p. 67.
t First contract let in 1858. J. Meeson.
X J. Q. B. Marshall, C.E., Engineer to Board of Health, West Ham. Eyidence before Biner
Commission, River Lea, 2d Report, VoL IL, BTidenoe p. 128.
§ Letter dated November 1, 1867.
II Evidence of Mr. Marshall, C.E., Engbaw to West Ham Local Board. BiTera Qqrbob&m^
River Lea, Vol. IL, 2d Report, p. U6.
InequalitieSm
encompassing its reservoirs round about, and growing fouler and fouler every year
after 1861 ; thus at Old Ford it lost in 1866 the advantages it gained by filtration
at Lea Bridge, besides being exposed to the temptation of resorting to the vast
stagnant infected ponds in close proximity to the Lea. The cholera deaths from
34 in 10,000 in 1854 rose to 72 in 1866, while the cholera and diarrhoea deaths in
the same epidemics rose from 61 to 87.
4. Inequalities of the Cholera Mortality within the several Parts of the
Waterjields,
As the number of deaths from cholera in London, including West Ham and
Stratford, was 5973, while the number of inhabited houses was about 398,701, it
follows that there was one death from cholera to 67 houses ; and as it happened in
a certain indefinite number of instances that more than one death from cholera
happened in one house, it follows that there must have been more than the above im-
plied proportion of houses {66 out of 67) in which no death from cholera occurred.
This is an average proportion ; but if the whole of London was distributed in
5973 several sections, each of 67 houses, it would frequently happen to an inquirer
to find successive sections in each of which several deaths bad occuiTed, and several
consecutive sections in which no single death had occurred. The irregularities
would be such as are observed in games of chance, for this reason, that the
cholrine, no matter how distributed, is dealt out irregularly, and in various
doses, in various states of activity, to individuals, who are all in exceedingly variable
degrees susceptible or non-susceptible of the zymotic action, and differ in the
greatest extremes in their command of remedies in both the premonitory and the
advanced stages of the malady.
There arc 37 districts in London ; and as each district contains a variable
number of the groups of 67 houses, it is obvious that on comparing the deaths to
the houses, or to the population in the several districts, the results will approximate
more or less to the average as the population becomes more numerous, unlesa
there is some disturbing cause. The same reasoning applies to the sub-districts,
of which there are 135 in London ; but as the numbers are smaller, the accidental
divergences will extend over a wider range. Descending to streets, the differences
will be still greater ; and there will be streets in which no death by cholera occurs,
as there will be others in which the deaths will be numerous ; precisely as at
wbist, the honours may fall to one hand, although each player, except the dealer,
has an equal chance of obtaining his share. The difference is exaggerated in the
-case of cholera, as one case begets another, especially in dirty dwellings, or in
dwellings opening into sewers charged with cholera matter. Where the honours
at play find their way almost invariably into one hand it is pretty evident that
the laws of chance are set aside by some overruling agent ; so if the deaths by
cholera occur in immense disproportion in sub-district after sub-district supplied
water company, the inference is irresistible that there the fatal cards do
not fall by chance, but are dealt out by some sure though invisible hand.
To understand the case, it must be taken into account that a death by cholera
is one of a series of phenomena going on in large numbers of people simultaneously ;
and that as a general rule as many patients recover as die from an attack of
cholera in its algid form, while as many as 98 in 100 recover from diarrhoea of
acme severity.
The mortality in 1854, according to the returns to the scientific committee was
at the rate of 48*335 in 100 cases of cholera ; so 5973 deaths implied that about
12,358 persons had been attacked. Besides this, 3197 persons died in that year
of diarrhoea ; and afler deducting the current 2374 deaths by diarrhosa, about 800
may be ascribed to the direct agency of the cholera matter, from which, upon the
^ata supplied by the same authority,* it may be inferred that more than 48,928
persons were decidedly affected by a diarrhcoa of a choleraic character. The
anmber of casea of cholera, and of its correlative diaiThcea was 61,286 ; which
^ The average deaths in 1855-64 was 2374. Cases of diarrhoea to 1 death 61*161 » ^||^. See
87
Hvt of Scientific Committee on the Cholera epidemic of 1854, p. 92.
Statistical Reoioning.
must have been distributed over less than 61,286 houses, one, two, or more cases
having occurred in the same house. Consequently as the total number of houses was
398,701, the number of inhabited houses in which no death was registered firom
cholera or choleraic diarrhoea must have exceeded 392,728, and the number of houses
in which no case of cholera or choleraic diarrhoea occurred must have exceeded
337,415=398,701 —61,286. The aifected dwellings and the free in fatal districts
will necessarily be found in groups ; hence perfect uniformity of. distribution in
streets is out of the question. To show how much the disease was diffused, I have
taken Poplar ; and it will be remarked how very generally the streets and named
places of the sub-district were attacked. This Poplar sub-district contained, on 1 185
acres, 5868 inhabited houses in 1861, and probably 7050 in 1866, occupied by a
population of 52,180. The proportion hero was of one death by cholera to every
16 houses, or of 64 to every 1000 houses ; consequently in every 1000 houses
there must on an average have been more than 936 in which no fatal case of
cholera occurred, the proportions varying from place to place. Looking at the
irregularities alone, it will be seen that tho diffusion of the disease in so many
streets is remarkable. In a few streets no death was registered, and in some^ such
as the East India Road, the numbers were below the average of the parish.
The list of deaths (pp. 85-6) in streets has been taken from the register books,
and as the names were not always settled, nor the streets well defined, there may
be displacements. A few streets too have less than their due number of deaths,
owing to about 27 of the patients having been sent to the London Hospital, which
at first kept no addresses. Poplar extends over the Isle of Dogs, on which many
new houses and streets not yet laid down in maps have been built*
5. Some Statistical Fallacies.
One fallacy necessarily makes a strong impression upon the mind. House after
house supplied with East London water can bo taken in which no death, or even
case of cholera, occun*cd ; and here the reasoning takes this form : — These houses
were supplied with the East London water during the epidemic ; they were not
visited by cholera ; therefore the East London water was not the cause of cholera.
This fallacy turns on tho use of tho word " water " in two totally different senses.
No one for a moment pretends that pure " water " can bo the cause of cholera : it is
some matter in that ** water," the word serving to designate in chemistry &
compound of oxygen and hydrogen, but in common usage a fluid consisting of the
most various compounds, inorganic and organic, in the state of germ, of full life,,
or of death ; and compounds too which must necessarily, from tlie nature of the
water supply, be unequally distributed in the waters ; in one house in inconceivably
small quantities, in other houses in large doses, in one house among susceptible
and in other houses among insusceptible people. To show that a portion of this
water is taken with impunity, and still less to show that tho people in certain
houses in East London did not die of cholera, is no proof whatever that the cholera
leaven was not present and fatal in other portions of tho East London water sup-
plied to other houses.
Eels, as we have seen, were found in the water of a certain number of houses ia
East London. To argue that in hundreds of other houses no eels were found, and
that therefore the company never distributed eels in the district, would be alMnrd»
The fallacy of such reasoning is transparent. It assumes the form, — if no eels are
found in the waters of a certain number of houses none exist in the waters of any
houses. As the eels are limited in number they cannot be distributed universally,
and the fact that they were discovered in one house and not another would depend
on laws and circumstances so intricate as to moko the ascertained distribution
anomalous, but not necessarily more anomalous than the distribution of the lower
forms of organized matter to which the phenomena of cholera in man are due.
If in a large number of drawings from a series of urns A, one black ball is drawn
to 161 white balls on an average, and if in another series of urns B, eight black balls
are drawn to 154 white balls it is naturally inferred that the proportion of black
balls is greater in the series B than it is in the series A, and it is no valid objection to
this inference to allege either that white balls ai*e drawn in excessive propcntions from
North Woolwich,
one or more of the series B, or that black balls are drawn in exceBsive proportions
from one or more of the series of urns A. We know by the calculus of probabilities
that such runs of white or black will happen, and we know also from the nature of
the case as weU as from the facts admitted by the advocates of the company, and
the laws regulating the flow of fluids in pipes, and of matter suspended in that fluid,
that similar inequalities in the distribution of cholera matter must occur.
As on an average in 18 out of 19 houses in East London no death from cholera
happened, it is certain that in the fatal districts not only houses but entire streets
can be selected where no death from cholera occurred. So in Poplar, no death
appears to have been registered in Gates-street, Evans-street, Wades-place, John-
street, Jeremiah-street, Sarah-street, Newby-place, Church-street, Bedford-street.
Upon being rcfen'ed to, Dr. Bain says these are either short streets with few houses,
or streets of houses generally good and well aired. The East-India-road suflered
slightly. , Upon the other hand 3 deaths by cholera occurred in Oriental-street,
consisting of better houses than those above named, and occupied by respectable
inhabitants. The deaths in High-street were 9, Kerby- street 5, Lion-street 4,
Augusta-street 6, Park-street 6, Pennyflelds 6, Sabbarton-street 7, Suffolk-street 7,
Wells-street 6. In the table of the streets the greatest varieties are observed,
(pp. 85-6.)
It must be borne in mind that some fatal cases of cholera, originating in the
streets of Poplar, terminated and were registered at the London Hospital or elsewhere
oat of the district.
The fact that no death by cholera in a particular street occurred is at onco
accounted for upon the supposition, quite compatible with the principle of dis«
tribution in water, that fatal doses of cholera matter were not distributed in that
street, or if distributed did not come in contact with the mucous membranes, or if
they did come in contact fell on them when they were insusceptible, or, finally,
were extinguished by early treatment before they could prove fatal. The converse
facts account with equal facility for the occurrence of many fatal cases in particular
streets or houses where the morbid matter was besides multiplied and diffused
among the inmates.
Two portions of East London have been selected as places exempt from fatal
cases of cholera. The one is over the border, and includes North Woolwich ; it is
supplied through a main, constantly full, from the Old Ford station. The region is
partly in West Ham partly in Woolwich, and lies north of the Thames. It is on a
marsh, with foul, open drains, and the inhabitants look in as bad or in a worse
condition than the inhabitants of Poplar. " In Plaistow Marsh," Mr. Knowles,
the intelligent surgeon, writes, " the streets that suffered most during the epidemic
" were Burnham-street, Wooldham-street, Roscoe-street, Rathbone-street, and the
** streets leading from Kathbone-street to Cherry Island. In Silvertown there were
** very few cases of cholera, one close to Graving Dock Tavern and a few cases in
" Winchester-street. In Andrew-street there was none to my knowledge, but there
" were many cases of diarrhoea in Silvertown during July and August ; the men
** at the Albert Iron Works, which are supplied with water on the constant system
from the main by meter, suffered much from the complaint, and invariably attri-
buted it to the water they drank. In proportion to the inhabitants diarrhoea was
most prevalent in Silvertown, and cholera on Plaistow Marsh. At the Albert Iron
** Works and at other large works astringent mixtures were kept, and given to the
" men directly they complained of diarrhoea. A few houses have a constant
*' supply of water on the kitchen, but in most houses they have cisterns. Plaistow
" Marsh is drained by the West Ham sewers. At Silvertown there is no drainage ;
^ the sewage from the houses flows into open ditches and mixes with the water that
" cattle drink. In hot weather the ditches are very offensive."*
* Letter of H. Knowles, Esq., 2 Barking Road, CamiiDg Town.
Ague and ferer preyailed in ^orth Woolwich when I yisited the district with Mr. Knowles, and
this 18 evidently Tery much dae to the neglected drainage. The following letter was addressed to
the West Ham Local Board of Health hy Messrs. Campbell, Johnstone, and Co. of the Albert
Works in June 26, 1867» and signalizes a great evil which should be remedied:
'' Our workmen complain to ns verj much of the prevalence of ague and fever, and the oldest
« inhabitants state that it arises throngfa the water being let into the ditches for the cattle. Oar.
New River and East London Water. xxvii
As the direct distance from the Old Ford reaenroir to North Woolwich is above
four miles, and the water appears to travel along one low arterial main, which is
kept always full, it is evident that if suspended cholera matter undergoes anj
change it will bo modified before it reaches North Woolwich, and will neces-
sarily be diluted as the heavier molecules fall down on the way. The main leading
up to Stamford-hill (about 3^ miles) will by gravitation be prevented from con-
veying all the suspended matter of a heavier specific gravity than water up to the
height of that reservoir. But such a sudden infiux of the pond water of Old Ford
as is described by the witnesses would be injected at once with some velocity into
the near empty pipes, yielding water on the intermittent system : and here one
of the many advantages of the constant system of supply is evident ; under it fresh
zymotic matter is less likely to be thrown into people's dwellings at a distance.
In the two remoter regions the epidemic took the milder form of diarrhooa ; and
this may be due, either to the accidental diversion of the matter from their mains^
or from its greater dilution and age.
The greater part of the City of London, including three districts, is supplied
with water by the New River Company, and the mortality from cholera was at the
rate of 10* in 10,000 inhabitants. But in one district, the East London of the City,
34 deaths by cholera happened in 2160 London district houses supplied by the New
River Company, while only two deaths happened in one of 162 houses supplied by
the East London water. And therefore it is argued that cholera matter was not
distributed by the water of the East London Company in any part of its water-
field ; the New River itself being " above suspicion," and the East London being
absolutely harmless, since only two people died in 162 houses ! Now as it
happens there was only a7t« death to 159 houses in the other waterfields of London,
so that even here the East London Company's houses had double their proportion ;
and the New River Company, taking its water from the Lea, is so far from being
'* above suspicion," that it must have supplied a certain though small amount oi
choleraic matter, which again must have been unequally distributed in its pipes.
The mortality by cholera in the New River waterfield is greatest in the Eastern
districts, adjacent to the East London waterfield, and in the eastern parts of the
City ; and, moreover, it turns out that the New River Company has the power to
pump an unlimited quantity of water from the impurest point of the Thames below
Blackfriars Bridge, and so distribute it in the City by '* separate mains," ^* for
sewer uses."t Mr, Muir, the engineer, " can state that no water is now being taken
" from the Thames by the New River Company, or has been for many years, but
'^ they have that power still." This is a consolatory assurance ; but it will be more
satisfactory, after the experience of 1866, to learn that this power no longer exists.
Mr. Liddle shows in his valuable report that in Whitechapel among 9224
persons supplied by the New River Company the deaths were 30 ; that i», 33 per
10,000 ; while in the rest of the district supplied with East London water the
deaths were about 536, or in the proportion of 78 per 10,000.1 Mr. Liddle gives
the distribution of the 30 deaths in the 57 streets supplied by the New River ;
showing in each of the 14 streets one death from cholera, in one street two deaths,
in each of two streets three deaths; in one street. Crown -court. Blue-anchor-yard,
eight deaths ; in 39 streets no deaths. By his estimate 14 of the 30 deaths occurred
six days after the disease first appeared in the Whitechapel district in the courts
of Blue-anchor-yard, among 966 people earning a precarious living on the banks of
the river, and crowded on ground equal to a square of about 40 yards to the side.
The mortality on this small plot was at the rate of 145 in 10,000.
^' workmen "wish us to write to you to see what you can do with the Dagenham Commisaonem
<' towards improying the health of the immediate neighbourhood, as they consider that their health
** should be studied in preference to the cattle. We may add that the water in the ditches, from
" the want of proper drainage for the houses, cannot be good for the cattle.**
The Board in reply said the matter was under the control of the Havering and Dagenham Level
Commissioners, but that steps had been taken to cleanse the ditches.
I learn now, through Messrs. Meyrick and Gedge, that the West Ilam Board has very properly
nndertaken to drain this devoted district. "June 186S.
p, 6, Mr. Mair*i evidence, No. 124 and 127.
t Beport on Epidemic Cholera in Whitechapel, pp. 37-40.
xxviii Refutations,
Then the City has on Bow Common a workhouse drawing its water from a deep
well ; among 617 souls in the workhouse no case of cholera occurred, but in the
detached infirmarj, having in its wards 148 patients, 19 old people died of cholera
in the four days, July 24th to 27th, and eight in the seven days following, chiefly
old women. Tiie cholera was prevalent all around ; the dejectr.ons saturated the
sewage ; and the first woman attacked entered the house with diarrhoea, which
ceased, but at the end of seven days was followed by sudden cholera collapse ; the
explosion immediately took place among a small knot of old paupers in the south
wards of the infirmary. The workhouse itself enjoyed an immunity.* Again, in
the East London workhouse at Homerton only one death from cholera was recorded.
The workhouse in Homerton unquestionably gets its water from Lea Bridge and not
from Old Ford. The exemption of the Limehouse pauper school, where the master
and the medical officer made excellent arrangements for the early treatment of
the young patients, and allowed the free use of water supplied from the main of the
East London Company, is also cited.
It is sufficient to re-state the argument to refute the inferences ; the cholera
matter, varying in activity, was distributed all over London in varying proportions ;
it has the property of propagating itself under favouring conditions ; it can be con-
veyed from person to person by water and by other agencies. In the districts sup-
plied by seven water companies one death by cholera occurred on an average in
159 houses; in the same number of houses supplied by the East London company
from Old Ford eight deaths by cholera happened on an average. A similai* relation
between this special impurity of the water and the mortality when cholera is
epidemic has been observed repeatedly. The argument applies to workhouses as
well as to houses. To cite a case in which the inmates of one or more workhouses
are attacked by cholera, as they might be, without receiving the infection through
water, and to cite other cases in which the inmates of workhouses supplied with
East London water escaped, is to cite examples of the general law ; as all that is to
be accounted for is the excess of seven deaths, or sometimes less, and often more, in
the several sub-districts that got their water generally, but not always, from the
Old Ford pumps, which sometimes supplied fresh, and sometimes foul water.
The bold assertion, that ** there was no coincidence of time" in the outbreak of
cholera in the districts supplied from Old Ford, that " a month elapsed in several
" distncts and^no outbreak appeared," f is disposed of by the Table 24, p. 56-57 of
Appendix. The comparison of the propagating cholera-poison with arsenic which
does not reproduce its like is entirely illusory ; but if arsenic had been distributed
with the water of the Old Ford pond, it would not have reached all the districts
simultaneously.
The pretence that the districts supplied respectively from Old Ford and from
Lea Bridge were absolutely undistinguishable is dissipated by Captain Tyler's
lucid Report. And the assertion is unfounded that the conclusions drawn from the
experience of South London in 1854 are open to doubt, because "it has been found
" since that no one knew what water was given to the houses of any particular
" district," for the two water companies of Lambeth and Southwark gave from their
own books the names of the streets and the numbers of the houses which they
respectively supplied, while the deaths in the houses supplied by each company,
both in 1849 and in 1854, were abstracted from the books at the General Register
office. This was decisive. Dr. Snow describes how he decided, from the chemical
character of the water, all doubtful cases in his series of observations.
The argument founded on the coincidence of the area of water supply from Old
Ford with the high rate of mortality by cholera is thus ingeniously met by
Dr. Letheby. He says in his evidence,! " I might make an exact comparison of a
'* similar kind ; I might say there are two gas companies supplying the East end
^< of London, and it is a remarkable fact that in the district supplied by the Com-
*< mercial Company cholera has existed, and in another district, supplied by the
" City of London Company, the cholera has not existed. There is just the same
'' amount of coincidence and parallelism between these two cases as between the
*^ water companies." The coincidence in question is not the same ; for all the
* See Mr. Badcliffe'e Report in Appendix to 9th Report of Medical Officer of Privy Coancil,
K». 812-17.
t Evidence of Select Committee on East London Water Bills, p. 426 ; and Report on the
Cholera epidemic of 1866, by H. Letheby, Esq., M.B., p. 33.
) Beport and eyidence oflSelect Committee on East London VTtAa BVLXa,^. 49A«
Hospitals.
parishes which suffered excessively from cholera, and were supplied with the waters
of Old Ford, were not supplied with gas by the Commercial Company.* But let
that pass. And to test the parallelism, take the hypothesis, that the Commercial
gas did diffuse cholera over Poplar, and see what tbe hypothesis implies. It
implies that the specific poison finds its way in epidemics into the company's
retorts or into its reservoirs ; that it travels like gas through pipes ; that it is
indestructible in the fiames through which it is difiused with the products of
combustion. But there is no evidence that coal gas, or that any of its poisonous
impurities, will . produce cholera ; that any cholera dejections could get into the
Commercial Company's pipes ; that cholera matter, more than small-pox matter, is
indestructible by fiame. All zymotic matter, on the contrary, it is believed, is
rendered inert by exposure to a high temperature, and is absolutely destroyed by
fiame. It would be as rational to assume that live eels as that this matter could
be distributed quick through fiames. The hypothesis is on the face of it absurd,
and is at once rejected. Not so the hypothesis of difiusion by water, which carries
any living organic matter, and has iucontrovertibly been the channel of cholera
difiusion in numerous instsmces.
6. The Hospitals.
The London Hospital is in the midst of the East London water-field supplied
from Old Ford ; and Dr. Letheby in his evidence before the Parliamentary Com-
mittee made this striking statement respecting this hospital, his '* own hospital :'*
" There were about 487 people residing, excluding the cholera patients, and they
** were all taking the water exactly as it is delivered /rc^m the tnain, without any
" filtering process whatever, and not a single instance of Cholera occurred.'*
As the patients are visited every day it is certain that the first symptoms of
diarrhoea would be treated with the skill for which the staff of this hospital is
distinguished ; and Dr. Jackson, the resident medical ofiicer, tells us in his General
Beport that active measures were taken to prevent contagion in the hospital. The
cholera dejections were received in vessels containing carbolic acid, and buried in
the ground. The linen was passed through a solution of chloride of lime, and
washed with carbolic soap. The carbolic powder was sprinkled freely in all the
wards to such an extent that the nurses complained, and said it produced headache
and sore-throat. These precautions might account for the exemption of the
inmates if it had existed. But there is a confiict of evidence. Dr. Letheby afiirms
that " not one " inmate, '' not one " attendant, was affected by cholera. Mr. Bathurst
Dove, in the ofiicial hospital report, on the other hand, not only states, but gives
the explicit details of seveji cases among the attendants, of whom ^ve died; and
of one patient, a child, that died. Thus out of the number taken at 487 resident
6 died or 123 in 10,000 ; and out of the 130 attendants 5 died, so the mortality was
in the proportion of 385 in 10,000. The laundry woman who died was one of 10
and lived out of the hospital ; of the 6 nurses, &c. attacked 3 are said to have slept
out of the hospital, but all lived day and night within the East London waterfield.
As this is a question of fact it is useless to proceed further in the reasoning. That
the reader may have an opportunity of judging for himself, I subjoin verbatim
copies of the evidence on both sides.f
♦ St George-in-the-East, St Paul Shidwell, St. John Wapping, West Ham and Stratford sab-
districts, are not supplied by this company. Letter of Secretaj^, date 14th September 1867.
t [Evidence of H. Letheby, Esq., M.B., before Select Committee of House of Commons on
East London Water Bills, 23 May 1867.]
Q. 640. Mr. Clerk.'] This water has been used, I believe, for a great many yeaw in the London
Hospital ?— It has been used ever since I have known the hospital, and I think that is pretty nearly
a quarter of a century. It was used during the whole of the .cholera time, when the hospital was
full of cholera patients, and when there were nearly 900} people in the hospital; and there was not
t Probably a misprint : the average number resident was 487 } vis., patients 367, attendants ISO, during tho
7» ¥ I ^^^ {Sfptnt), The ordiuary patients Mr. Hackenuc, the house surgeon, says were fewer in th<^ t&ssc^^'oa^
0i <i w* Augui^ and Sepionber, because new patients were afraid to apply on aAooi^aaoX ^\ODj:\«nK
IloipitaU.
The first case of cholera in the London Hospital was admitted on the 10th' July.
Th& patient, a German woman, had come over from Holland as servant to a cattle-
dealer on the 6th July ; she died on the 11th July. One case came in on the 13tli,
one on the 15th, two on the 17th, three on the 18th, four on the 19th, eight on the
20th. The numbers increased rapidly, and three wards with 138 beds were set
apart for the reception of cholera patients. The largest number at one time in
the hospital either for cholera or diarrhoea was 114. 509 cholera patients, strictly
80 called, were admitted in the seven weeks from 10th July to 30th August ; 281
died, and 228 recovered. The mortality of cases decreased week by week from
85 per cent in the*first to 37 per cent, in the seventh week.*
For the purposes of reasoning on the liability of patients and attendants in the
hospitals of other waterfields, I applied for information to the proper authorities
who have kindly supplied the facts for the year 1866.
Dr. Southey states that 136 cholera patients were treated in Bartholomew's,
where 44 died. The average number of patients in hospital were 550 ; two afflicted
with cancer were attacked by cholera and died. The average number of nurses
and other attendants was 105, of whom three were attacked and none died. The
medical staff consisted of 22 persons ; none died.
Mr. Custance, secretary of Middlesex Hospital, states that 22 cholera patients
were admitted, 10 died ; of 220 patients on an average resident, none were attacked,
none died; of 59 nurses and other attendants, none were attacked, none died;
so of the 27 medical and resident officers.
Dr. Steele supplies an interesting experience of Guy's Hospital. Fifty-five
cholera patients were admitted and 25 died. Of 496 patients on an average none
were attacked by cholera ; of 94 nurses and attendants one was attacked and
died. The medical staff, consisting of six physicians and one resident medical
officer, were all in occasional attendance ; so were eight or ten students.
In 1854 the cholera patients admitted were 92. Nineteen persons, including
attendants and ordinary patients, were attacked by cholera in hospital ; of the total
number of cholera cases 65 ended in death. An eminent member of the staff died
of cholera. The hospital was supplied with the Southwark water which was
impure in 1854 ; in the year 1866, and for the last 10 years, it has obtained
water from an artesian well.
7. Rise and Decline of Cholera.
Cholera in an individual man goes commonly through a regular series of develop-
ment ; commences with diarrhoea, grows hourly more violent until the crisis is past,
and then, if death intervene not, subsides slowly in consecutive fever, lingering
a single instance of cholera in the hospital^ except those who were brought in as affected h/ Hie
disease,
Q. 641. But none of the ordinary inmates of the hospital were affected by cholera ? — Not one.
Q. 642. And not one of the attendants? — Not one. In the hospital I think there were about
487 people residing, excluding the cholera patients, and they were all taking the water exactly as it
18 delivered from the main, without any filtering process whatever, and not a single instance of
•eholera occurred.
Dr. Letheby gave similar evidence before the Boyal Commission on Water Supply.
The .following extract is from the Clinical Lectures and Reports by the Medical and Sorgical
Staff of the London Hospital, Vol HI., 1866, pp. 460-462.
The paper is by Mr. Bathurst Dove, and it is entitled *' Notes of Six Cases of Cholera which
0€CuuK£D in NuBSES or Inmates of the Hospital.
The second paragraph gives a summary of the results :
'< Out of somewhat under 130 persons engaged in attending the cholera patients, and washing
" the sheeting, &c. from the cholera wards, seven were attacked by cholera, of these five died. In
" addition, one patient^ a child, occupying a room adjoining one in which there were cholera cases,
*< died of it. Three others had tolerably severe diarrhoea, and one had an attack of pain in the
'* abdomen, with cramps in the legs, without diarrhcca."
* Dr. Jackson, pp. 436-7 of Hospital Beport
-J
Deaths before and after AuguMt ithm
until the danger is over, and the patient is restored to health. Tliis is a typo of
the course which the epidemic takes in a community. The rapidity both of growth
and decline here, however, depends on the means of diffusion, as well as on the
activity of the diffused ckolrine. High temperature has a sensible effect. The
duration of the epidemic also depends on the magnitude of the community ; thus
it goes through a house in less time than through a great institution ; in less
time through a small town than through a large city. It may in this respect
be compared with a conflagration, which spreads rapidly through houses put in
communication with each other by inflammable materials, and dies out sooner in
a small than in a great city, where the embers smoulder for a long time, and,
unless extinguished, are liable to break out in successive eruptions.
The course of the London epidemic in the year 1849 is that which it follows
naturally when cholera flux gets access by sewers to the rivers, and unfiltered
waters are systematically distributed on the intermittent system of supply. That
epidemic began in the latter part of the year 1848, and subsided in the early part
of the year 1849, to break out again in June, and to proceed in its ravages with
increasing severity until in the week of September (2d — 8th) it killed 2140
persons ; the deaths after that date fell weekly, until the last week of November,
when only one death was recorded.
The epidemic of 1853-4 differed in some respects, as it was more fatal in the
first and less fatal in the second year than the epidemic of 1848-9. The eruption
began in July 1854, culminated in the same week of September as in 1849, when
the deaths by cholera were 2069, and then fell to 3 in the last week of November.
Here is a synopsis of the deaths in the two epidemic years of 1849 and 1854,
during two periods of the year.
Deaths bt Choleba in all London.
Population.
Tears.
In 70 Days,
extendixig ftnom
27th Hay
to 4th Auffust.
In 119 Dmtb,
extending from
0th AuKUitt
to 8d November.
Proportion
of Deaths
in Two Periods.
1849
1854
3,341
614
10,239
10,125
•
1 to 3
1 to 17
8am
3,955
20,364
1 to 5
The numbers agree in showing a large excess of deaths in the second period ;
and on referring to the daily returns, it will be seen that when the cholera
flux was freely poured into the Thames and Lea as sewage, to be pumped up
and circulated again in water in every street by the companies, the mortality
followed a regular law of increase and decline. The power of propagation of
cholera matter in ihe mortal form in the end became spent ; it was no longer able
to vanquish the specific vitality in the population left.
The epidemic of 1866 would have subsided ultimately in that year, in conformity
with the general zymotic law, but here a disturbing cause interfered ; the water
supply partially altered between the years 1849 and 1854 was completely changed
in the next interval ; so the quantity of cholera matter distributed was reduced
to a minimum in 1866 by the general improvement of the water, and presented in
both periods a diminution of death-rate in all waterfields except that of the East
London Company, where a different law prevailed.
Rise and Decline of Cholera.
Deaths bt CnoLERJi in 1866.
Waterfields.
In 70 Dm.
extending from
27th May
to 4th August.
In 119 D&ys,
extending from
6th August
to Sd November.
Proportion.
Waterfields of New Biver and of Thames
Companies ....
313
1,266
1 to 4
Waterfield of East London Company —
Exclusive of West Ham
Inchtgive of West Ham - -
2,265
2,539
1,633
1,747
1 to}
1 to$
The deaths in all London, exclusiye of
West Ham ...
2,578
2,899
ItolJ
If the deatlia by cholera in the second period had borne the same proportion
to those in the first period as in the two previous epidemics, the deaths in the
second period of 119 days would have amounted to 13,274 ; and in the 189 days
to 15,852. But (he plague was stayed, and the actual deaths^ exclusive of West
Ham, were 5477, or 10,375 less than the calculated number.
The treatment of the early stages of cholera, and the destruction of choleraic
matter by chemical agents, had probably a considerable share in reducing the
mortality of 1 866 in the New River and the Thames waterfields ; but it will be
noticed that there the relative number of deaths in the second period was as
before fourfold the deaths in the first period. This proportion was not altered.
In another cause then the excess on tlic first and the defect in the second period
over the East London waterfield must be sought. That excess has been previously
traced to the distribution of impure water from their Old Ford reservoirs in the
first period ; and the diminution in the second period is probably due to the efforts
made by the engineer of the company to set his supply right, so soon as his
attention was called to the source of the dread calamity, which, hanging like a
black cloud over the city, threatened not only East London, but the whole
metropolis with an overwhelming plague
The weekly deaths from cholera in East London and West Ham increased in
four weeks from July 8th to August 4th in this fashion, — 41, 438, 1002, and 1046.
Now, under the same law of increase the deaths by cholera in the two following
weeks would have become 1058 and 2237, and so on in an ascending series, when
the actual deaths by cholera were 664, 341, and so on in a descending series ; thus
far following a law of the same nature as had been observed in former years. The
curves are shown in the diagrams at the end of the report.
The deaths in declining followed a special law in East London and West Ham.
The deaths in the seven successive weeks from July 29th to September 15th were
1046, 664, 341, 169, 117, 81, 79. The fall was first 37 per cent., then 49, then 50,
then 31, then 31, and finally only 2 per cent. ; the mortality scarcely declined at all
further for four weeks. While the deaths in East London were decreasing, the
deaths in the rest of London were nearly constant ; and actually increased when
the deaths in East London were stationary. The epidemic in the rest of London
followed the usual law where the distribution through water is regular ; while in
East London there was an explosive eruption, such as would arise from the sudden
distribution of an excessive quantity of strong cholera water for a short period.
Further light is thrown upon the course of the epidemic by examining the daily
return of deaths. Thus in East London and West Ham the deaths in the seven
days from July 26th to August 1st were 157, 130, 160, 154, 144, 178, and 173 ;♦
that last day Wednesday, August 1st, was the day on which the weekly Table,
published in the newspapers, referred to the state of the East London waters ; on
that day Mr. Greaves came to the General Register OflSce. The deaths rose no
♦ Appendix, p. 40, Table 21,
Parallel Case.
•••
zzxm
more ; on Thursdajj August 2d» the numbers were 162 ; so for three days the
cholera death-rate, as it were, stood still ; then there was a sudden fall in the
four following days to 122 deaths on Friday, 113 deaths on Saturday, 127 deaths
on Sunday, 117 deaths on Monday, August 6th ; a further fall followed on the
seven next days, and the deaths were 87, 98, 94, 70, 71, 72, and 48 on Monday,
August Idth. See Appendix, Table 21, p. 40.
These are the days on which the deaths occurred, and not the days on which
they were registered ; the numbers differ therefore from those in the weekly tables^
where it was only possible to include the current registered deaths. And again it
must be borne in mind that the term of fatal cases is brief. Forty-two per cent of
the fatal cases terminate in less than 24 hours, 67 per cent in less than 48 hours.**
Thus 42 per cent., or 73 of the 173 cases fatal on Wednesday, must have been
attacked on Tuesday or Wednesday; and 68 of the 162 cases fatal on Thursday
must have been attacked on Wednesday or Thursday ; and 51 of the 122 cases
fatal on Friday must have been attacked on Thursday or Friday ; and on that
day, the third after the warning, the cases, instead of increasing, sensibly declined*
The diminution was unequivocaL There is reason to believe that the period of
incubation is as brief as the term of attack in fatal cases of cholera ; the cholrine
often acts as suddenly as any of the poisons.'l' And this is implied by the occar->
pence in the East London instance. But there is a parallel case in which the
supply of contaminated water was admitted before a commission of inquiry, and
the date at which the contaminated supply ceased is positively known.
8. The parallel case of Newcastle-upon' Tyne.
Dr. Robinson wrote to inform the Board of Health on Friday^ September 2d^
1853, that a woman, aged 24, had died at Newcastle-upon-Tyne of cholera ^last
Bight." She had come by steamer from Bill Quay, a village situated on the south
bank of the Tyne in Gateshead, three miles below Newcastle, where she was
attacked on Monday by diarrhoea.
On Thursday he had found cases of diarrhoea unusuallv severe ; and anticipated
that an epidemic might be productive of a fearful loss of Hfe.f
* Table IX. (third serieB, p. 116) of Beport of Committee of Scientific Inquiiy shows that of
S600 cases of cholera, 1744 were iktal ; and of these 784 died on first day, 42S on second, 186 oa
third, 106 on fourth day.
t 8ee Snow on Cholera. Grieainger on Cholera, in VirchoVs Handbuch, cites cases where the
patients were attacked m less than 24 hours after exposure. It is well known that the Broad-street
explosion was traced to a pump, which drew its waters from a well into which the d^eotions of a
child found their way by a circaitons route. The child was attacked on Monday, asth August^
when the dejections were abundant, but ceased on Wednesday 30th August 1854. The chUd
died on Saturday Sd September. The dates of attacks and deaUis in the region of the pump are
thus given by Dr. Snow :—
1854.
August as, Monday
29, Tuesday
80, Wednesday
31, Thursday
September 1, Friday
2, Saturday
8, Sunday
4, Monday
5, Tuesday
6, Wednesday
7, Thursday
n
n
tf
f»
ft
8, Friday
Attacks.
DSATHB.
Child attacked.
1 1
8 2
56 3
143
116
54
46
36
20
28
12
70
127
76
71
45
37
32
80
RepoH m Ckokra Outbreak, Hi. James, Westminster, in IBSAtpp. 159-161, and p. 117.
See ** Cholera Qasette," pp. 2-3, 1832; Bengal Report on Cholera, pp. 22-3; Briquet on
Cliolan» fta '*Mimoitm de rAcad^mb Imp^riale de Mcdecine.'* Vol. 28 ; Fart 1.
{3tagi|jf(:<hMrfaMa en Outbreak of Cholera at Newcastle-apon-Tyne, 1853. Lstter of
Newcastle-upon- Tyne,
An earlier case of cholera was observed at this Bill Quay : a boy, 10 years
old, the son of a coke-burner, was attacked on August 27tb, and after seven days
iUness died, as certified, of " English cholera " on September 3d ; his sister
Hannah, aged 3 years, died on September 1st, after 30 hours illness, and his
mother, aged 40 years, died also on that day after 12 hours illness, of cholera.
Dr. Robinson's patient, Mary Tait, was attacked on August 29th by diarrhcea, on
31st by cholera; in the interval she sailed up the Tyne. Martha Oxley, aged
21 years, the wife of a boat-builder, was attacked on August 28th, and died on
September 2dy of Asiatic cholera. Hers was the first attack so certified. John
Falcus, a mariner, aged 56 years, was attacked on August 30th, and died on
September 3d.
The first 12 cases are given below.* It will be noticed that a child died of
cholera at Elswick itself on September 3d.
A female died on August 31st; and one male with 2 females died on September 1st;
3 females died on September 2d ; the deaths then became 5, 5, 9, 7, 8 La the next
five days ; on September 8th, 18 ; September 9th, 22 ; September 10th, 27 : the
Board of Health on Friday the 9th had directed Mr. Grainger to proceed from London
to Newcastle, and on Saturday he announced by telegraph ^' cholera is epidemic in
Newcastle." It was truly so, and on both the rising banks of the Tyne in Gates-
head as well as in Newcastle the epidemic raged. On September 11th the deaths
were 39. The disease, Mr. Grainger reports on this day, has appeared in all parts
of the town, in different degrees of intensity ; diarrhoea is attacking all classes,,
high and low ; there is a general feeling of apprehension ; several persons die
seven or eight hours after appearing to be in health ; many fall into relapse, and
of them very few recover. The guardians are zealous, and the mayor is anxious
to assist in all measures ; but up to this time no house-to-house visitation has been
instituted. On the 1 2th 58 persons die. Mr. Grainger writes : the epidemic is
by no means confined to the poor ; many of the better classes have been attacked ;
1 have just seen two such cases, one a shopkeeper in good circumstances, and
living in a principal street ; he was dying. The second, a child who had somewhat
rallied. They presented all the characters of malignant cholera. The general
malaria arising out of the miserable parts of Newcastle overhangs, he says, the
whole town, and penetrates every dwelling. The deaths on September 13th were
71. The local measures made no impression ; for on went the plague. A multi-
tude of cases are detected, writes Mr. Grainger ; the surgeons are besieged day
and night ; it is impossible to keep an account of all the attacks. On Sep-
tember 14th all accounts show him that the epidemic is in no way diminished ;
there has been a great development of the disease during the last 24 hours. I
•First cases of epidemic Cholera in Newcabtle-upon-Ttne and Gatesiiead in 1853.
-w 30th August; 3 Lisle-street, St Andrew's, Newcastle — George Ellison, aged 70 years, gentleman,
English cholera, 1 2 hours. Certified.
31st August ; Victoria-street, Gateshead — Mary Tait, aged 34 years, wife of labourer, cholera,
2 days. Certified.
1st September ; Forth-street, St. John's, Newcastle — Robert Forster, aged 52 years, cartman,
cholera Asiatica, 12 hours. Certified.
1st September ; Bill Quay, lleworth, Gateshead — Elizabeth Handy, aged 40 years, wife of coke-
burner, cholera, 12 hours. Certified.
Ist September; Bill Quay, Heworth, Gateshead — ^Ilannah Handy, aged 3 years, daughter of coke-
burner, cholera, 30 hours. Certified.
2d September ; Bill Quay, Heworth, Gateshead — Jane Innes, aged 13 years, daughter of ship-
"wright, cholera.
2d September ; High-«treet, Gateshead— Hannah Skipsey, aged 79 years, widow of banksman,
cholera. Certified.
2d September ; Buzton-street, All Saints, Newcastle — ^Martha Oxley, aged 21 years, wife of boat-
bnilder, Asiatic cholera, 5 days. Certified.
3d September ; New-road, All Saints, Newcastle — John Falcus, aged 56 years, mariner, Asiatic
cholera, 4 days. ' Certified,
w M September ; Buxton-street, All SainU, Newcastle— Martha Nixon, aged 53 years, wife of black-
imith, Asiatic cholera, 24 hours. Certified.
3d September ; Judson-place, Elswick, Newcastle— James Frederick Forster, aged Ij year, son of
ironfuunder, English cholera. Certified.
8d September ; Bill Quay, Heworth, Gateshead-^^'chael Handy, aged 10 years, son of coke*
ourner, English cholera, 7 days. Certified. ^
X
V
Tlie Tyne WaUr.
have to-day seen, he writes, some physicians in large private practice. Thej state
there is an enormous amount of diarrhoea, pain at epigastrium, and other premoni-
tory symptoms among all ranks. The return from Gateshead shows a decided
increase of cases. The deaths in the two districts were 123 on this day. Had
it not been for prompt medical aid a much larger sacrifice of life would have
occurred.
Mr. Grainger advises the use of tents; there is much alarm among the people.
On September 15th authority is given to the medical officers to call in the aid of
any number of private practitioners they deem necessary. The deatlis in 24 hours
are 1 40. Considerable gloom pervades the town, increased ever and anon by the
tolling of the funeral belL In the course of the day lime was dusted over many of
the streets.* As in Poland and Germany so this outbreak is severer here than it
ever was in 1831-2. Committees of the Town Council and Guardians meet. On
September 16th the deaths were 146 ; two of the full churchyards are closed ;
there are two cemeteries, one having ten acres, with the means of getting six
more if needed ; this, Mr. Grainger is assured, has plenty of room for interments.
The dreadful apprehensions of the p>eople were by no means exaggerated. The
population of the two districts was only 144,067 at that time; and the customary
deaths were 1 1 daily from all causes ;t and now the deaths from one strange terrific
cause were 146 in one day, 286 in two days. That would make 1000 a week,
or in the year 62,000 deaths, equal to one third part of the living, without any
regard to the gathering terror which was looming in the dark before them.
But deliverance was at hand. On Monday (1 2th) Mr. Newton at the evening
meeting of the guardians referred to the water supply; on Wednesday evening (14th)
Dr. Robinson declared that the impurities in the water were a predisposing cause,
and that it was absolutely necessary to get water from a purer source than the
Tyne. Mr. Fumess exhibited a bottle of the water of a most noxious quality,
and several guardians complained of the unwholesome supply. Mr. Grainger made
no charge against the company, but said if the Tyne water containing the sewage
was distributed, the sooner a remedy was applied the better for the town. In
1849 it was a well ascertained fact, in a number of instanccs^where water had been
fouled by the sewage, it had been '* a predisposing and aggravating cause of the
epidemic." I quote Mr. Grainger's words, as tliey reflect at that date very accurately
the uncertain state of medical theory, which gave a tone of indecision in action.
An urgent letter was addressed forthwith to the directors of the Whittle Dean
Water Company by the guardians and by the mayor. Upon September loth, at
11 o'clock in the morning, the man Miller got orders from the company to stop
the engine at Elswick, where water was pumped from the Tyne ; ho opened the
fire and let it out gently. The water pumped on that day from the river into the
tank or filter was not distributed. The water of the Pont, a comparatively pure
stream, was turned into the reservoir on September 15th ;J and the Tyne water
diluted in the reservoirs was distributed on the 16th, when the deaths were 146 ; on
the next three days the deaths by cholera fell to 118, 121, 122; on this Monday 4iL
noon Mr. Grainger left the town ; Dr. Gavin had arrived on the previous Saturday,
September 17th. For three days following the deaths fell to 102, 89, 90 ; for the
three days, September 23d— 25th, to 75, 63, 81 ; for September 26th— 28th, to 43,
46, 27 ; on September 29th to 23, and on the last day of September to 16. This
was fifteen days after the supply of the choleraic sewage had been cut off. The
deaths rapidly subsided ; and no death occurred on October 26th or 27th. On
November 23d the last death happened. In four months the deaths by cholera
were 1924. Of 1527 slain, 37 were (according to Dr. Gavin) gentlemen, 316 trades-
men, 701 artisans, 434 labourers, 37 paupers, 2 prisoners.
The history of the water supply of this town is instructive. A water company
was established in 1698 to supply water from the springs round the town, and its
monopoly was broken up by the concession of the right to another company in
* Beport of Commission on Cholera at Newcastle. Eyidence, p. 70.
t The deaths hi the 10 yean 18ai-«0 mat 41S6 ammally, 11 -3 daily.
; Compue Questions 6519 with 5066^ 5667, in Evidence before CommisaiKiii.
zzxvi fFater Supply of Newcastle.
1834 to supply the town with water only from the Tyne. This water was
evcDtually proclaimed bad ; in 1845 the Wliittle Dean Water Company got its
first Act under which it brought water from a drainage area of 3600 acres, 12
miles from Newcastle, in October 1848. It had a reservoir capable of holding
215 million gallons, and its daily consumption was one million gallons. The
supply of water from Whittle Dean in 1849 was abundant, and the demand
increased ; it amounted to a million and a half gallons a day at the end of the year.
The lowest quantity in the reservoir was 100 million gallons. This epidemic year
the mortality by cholera was not so high in Newcastle as in other towns ; it was
at the rate of 42 to 10,000 living in Newcastle and Gateshead. The town was
congratulated by Dr. Headlam on its comparative immunity. In the next year
(1 850) a drought followed, and the Whittle Dean supply failed ; the company then
resorted to the source heretofore condemned by its projectors, but nt the same
time prudently purchased. For 99 days, from July 23d to October 31st, they
pumped water from the Tyne at the rate of about 850,000 gallons a day ; the
water after subsidence in two beds was filtered through a bed of 10,000 feet area.
No cholera ensued ; and the mortality from all causes in that year (23 per 1000)
was below the average (26). The company in 1851 enlarged their drainage area
to 4600 acres, and acquired the overflow of the Pont, which was brought down by
a cut about Mai*ch. The reservoirs were full in May. The supply of water was
abundant in the rainy 1852. In May 1853 the company began to supply the
manufacturers down the river ; and the estimated daily amount abstracted
from the reservoirs was 3,000,000j gallons ; while only 2^ million gallons went
down to the town. So early as May and June the slip of water was suspected,
and the officers of the company estimated the loss at half a million gallons daily
through the bottom of the Arthur's Hill reservoir. What could they do ? they
had engaged to supply 2\ million gallons of water daily. They had the old
resource. They pumped again from the Tyne 50 million gallons, or about 700,000
gallons a day, commencing on July 5th, and ending on the morning of Sep-
tember 15th, when cholera was at its height.
The shallow Tyne is a tidal river, and the tide rising from 11 feet to 15 feet
carries the sewage up by Elswick, where the culvert of the company took up the
water. The tide flows from 4^ to 5 hours, and ebbs from 7 to 7i hours. The
•sewage of the town no doubt is flowing past Elswick two hours after low water
when the water was taken for analysis by Dr. Thomson, and found to contain
■organic matter. The company supplied Miller, their man at the engine, with a
tide t^ible, charged him to commence pumping four hours after high water, and
to go on for 2^ hours while the river was still running down, so as to cease
pumping a little before low water. Whether this instruction was strictly carried
•out or not it is impossible to say, as the town authorities kept no look-out, but
left the aStiir absolutely in the hands of the company. The water was pumped
into two tanks for subsidence, then passed through the old and for a time disused
^J/ier itO feet square, whence it was pumped up to the Arthur's Hill reservoire,
and mingled with the waters from purer sources before delivery.
The company supplied a population of 63,055* people out of 144,067 in the
two districts with water in the year 1853 ; their supply reached directly only
7875 people in 1845.
It is worthy of remark, however, that the Tyne water was supplied for 99 days
in 1850, and for 55 days in 1853, without any perceptible effect on the diseases of
the people, who during both years were immersed hourly in an atmosphere of.
* EvidcDce of Mr. Main (Q. 5768) before Cholem Commission, p. 359. In answer to an inqoirr
0f the Registrar-General in February last, Mr. Main stated that the number of inhabitants rappUM
directly, without reckoning those supplied from public pants or fountains, was 62,740 In 1849^
91,350 in 1853, and 160,305 in 1866. The population of Newcastle and Gateshead was 137,237 la
the year 1851, and 17<t877 in 1861 ; the mean annual increase 3314. Gateshead district
some outside parishes, with a population of 25,822.
Immediate Decline of Epidemic, zzxvu
corruption, ns Xenrcasllo was then bchiiiil ncnrly all Enf^lish towns in llic first
ck-mcnts of civilizntJon. The commission gives a coinputution showin;^ that two
thirds of the population of Xcwcastlo (t'xclusivc of Gntcslicad) had no privnto
privicf, and describes the dirt in the streets and cellars ns i-evolting ; the street
sweepings were charged with excrements whicli iho rain swept down the steep
slopes into the Tyne,* By the year 1853 only 1421 out of 9453 honws hud
watcrclosets ; in 18o2 tho Corporation converted six large public iirivics into
walercloscts. Mr. Main complained ot that us a very lar;To source of coni>uin]ition ;
they felt it Bcnsibly during the year 1IJS3. All this sullices to show that cholera
flux would bo readily carried into tho Tyno in July, and it would hccomo
denser in the water as it was reduced to its dregs in thii reserroirs by the end of
August, when the quantity in store was continually diminishing. The very means
of cleansing the town polluted tho river ; for the authorities commenced, when
rumours of cholera reached them, washing out and flushing sewers on August tjth
occasionally, and then every day when cholora broke out, so that the means pf
ditfusion wero perfectly organized. Yet in July only 2 deaths from common
cholera wero registiTcd ; in August 5 deaths wei-o i-egistured ; tho deaths from
diaiTh<ca were about 3 a week in July, and about 10 weekly in August, when
in tho latter days an increase of diarrheca marked tho origin of the epidemic
cholera.
The witnesses differed about the quality of tho water, but it, evidently viiried in
difierent parls.f Some pronounced it " bad," " very bad ;" some deposi;d that it
bad n " disagreeable taste ;" others sworo that it had an " oH'ensive Emell ;"
while others declared that they had ucver observed anything beyond pealy
discoloi-ation, or turbidity from clay or oaml The water from some of the wells,
it is stated, became oflensive during the outbrenk. A Ini^e proportion of tho
population in the end suffered from diarrhma or cliolera, and tho waters as well
as the air were charged. Tho people themselves took up tho notion so common
in plagues, and hero so true, that the poison was in the water, as is shown by
the answer to the following question addressed to Mr. Ilayne, nine years surgeon
to the police force in Newcastlo :
"Question 3280. With reference to the colour, I believe it was turbid ? — Yes ;
on September 12th, Ifctween tho'Sunduy night at 12 o'clock and 6 o'clock on tho
Monday morning, I saw 5 people die. I was, perhaps, at 20 coses or more of
cliolern between seven at night and that time in the morning. Mr. Simon is
Bwarc of the dreadful degree of thirst in cholera patients, lliey asked me what
they were to drink. I said, 'Cold wnter is tho best thing.' They said, ' \Vo
cannot drink the water ; wo are poisoned with tho water.' And when it cama
from the tap it was perfectly true ; it was in a allocking state. I could compare
it to nothing but porter in colour." Again on Mr. Grainger suggesting to tho
DUiyor that the dirty holes of Siindgate should be cleansed out by the jet and hose,
some gentlemen present said : " To-morrow, then, we shnll drink that water again,
supplied by the water company." (Q. 570.)
'The remarkable fact for which I have cit«d this important can ia to show how
immediately the deathi fhim cholera declined iriien the dietribotion of the Tyns
water ceased as it* preeiu date ia in endeooe. To eotabliih the penllel between
this Newcoatla outbreak and tiiat in Kut London It U nffldent to reanme the
facts briefly. I must flrat obMrvey howerer, thnt the ntortnU^ from ohidem iroa
in Newcastb at the annual rate in 10,000 Urlng of 1B4 1 1 while during the two
days of its utmost Intensity (SeptenW Itlh nd 16ln) it wm at the rate of
3625 ; while in the Eoit London wntKfidd then i«lH wnrs renectivelj 78
for the year, and 1105 for the two dqn (Jti^tlttnAAognat 1st} of higheet
intensity. - . --- ^^^^^^
The impurity of the water was nndoubl
less favourable, in Newcastle than even is.
t Report.' g 8*. p, iiv.
X la the j'eir 1819 the choIeR aionali
riii Parallel between Newcastle and East London.
In the suddenness and the generality of the outbreak all over the two water-
fields, Newcastle and East London, agree. All the various classes of people
and all parts of the locality were attacked with an intensity varying to a great
extent.
The water was pumped before the outbreak at Newcastle from reservoira
lowered unusually, and replenished from the tidal stream of the Tyne, which was
the common receptacle of the dejections. The water was pumped by the East
London Company from reservoirs which were in immediate communication with
the Lea river at a time when it was cliarged with the sewage and cholera dejec-
tions of West Ham and East London.
The sewers and streets in both places were flushed and washed into the rivers
at the height of the outbreak.
At Newcastle we know that the infusion of Tyne water ceased on September
15th ; and although the water in the resei*voirs and mains previously contaminated
w/is distributed on the 16th, and was partially distributed on the 17th and the
following days, the mortality instead of rising fell suddenly from 146 on the 16th
to 118 on the 17th of September. The Newcastle water was supplied from two
reservoirs — virtually one — on the constant system ; the East London supplied water
from two distant stations, — the filter beds, and the contaminated ponds and re«
servoir ; so here the engineer could act with equal or perhaps greater promptitude
by cutting off the supply from the ponds, and filling the small reservoir with pure
water. On Wednesday, August 1st, when the deaths by cholera in East London
and West Ham were 161, the deaths only fell on the first day after to 148, on
the second day after to 117. So the effect here was equally or perhaps more
prompt in East London than it had been in Newcastle.
It is known that the engineer at Newcastle ceased pumping from an impure
source on September 15th, 1853 ; and it is assumed that on August 1st, 1866, the
East London engineer did the same. Now by making these days the centre of a
^roup of deaths in three days we find that the deaths, when the water was
impurest, were 409 in Newcastle, 467 iu East London ; and if the hypothesis holds
as to East London, then the numbers should decline by a similar law in both
populations. This law the numbers obey.
The 7}umher of deaths by cholera run thus : —
Newcastle. East Loudon.
3 days, September 14th, 15th, 16th - 409 467, 3 days, July 30th, 3l9t, August 1st.
„ „ 17th, 18th, 19th - 361 867 „ August 2d, 3d, 4th.
„ „ 20th, 2l8t, 22d - 281 292 „ „ 5th, 6th, 7th.
„ „ 23d, 24th, 25th - 219 233 „ „ 8th, 9th, 10th.
If wo change the initial central days to September 16th and to August 1st
respectively, and so on, the relative proportions are not much altered ; they
become for Newcastle 404, 345, 254, and 187 ; for East London 476, 328, 265, and
215. The three last numbers for Newcastle, when the law of decline was in full
operation, decrease in geometrical progression, while in East London the decline
was also at a uniform rate in geometrical progression. The law may be compared
with that which regulates the ehmination of any contamination from a vessel of
water ;* but it involves various elements, which influence the result.
While Newcastle and Gateshead, intimately united by the bridge, lie some
12 miles up the Tyne, the districts of Tynemouth (including North Shields) and
South Shields lie on both sides of the lower part of the river to its mouth. Their
general sanitary condition in 1853 was as bad as that of Newcastle ; and it could
scarcely be worse. The water was indifferent ; but it was not drawn from the
Tyne. The population 104,750 in number was in intimate connexion with
the 144,067 living in the Newcastle and Gateshead districts ; epidemic cases
occurred, but in the four successive days (September 14th — 18th), when the
mortality was so terrible in Newcastle, the deaths in Tynemouth and South
Shields were 0, 2, 5, 5, and 1, and in no single day during the month of
September exceeded 8 daily ; the disease was difiused more slowly, and in the
middle of October (22d) the deaths by cholera were 18, which the numbers
never exceeded. The mor tality by cholera in Newcastle and Gateshead for the
* See Problem on p. 136.
Results of TiDO great Experiments.
XXXlX
year was 134, for Tynemoath and South Shields 24, in 10,000 inhabitants. Here
the Newcastle waterfield bore the same relation to Tynemouth and South Shields
as the East London waterfield bore to the rest of London, except that in the
northern districts, the mortality was higher, and differed less proportionally in the
two fields than it did in the metropolis, where the mortality by cholera in the
East London waterfields was at the rate of 72 in 10,000, while it was 8 in
the rest of London.
These two great experiments yield analogous results. The parallel is complete.
And it may now be laid down as an established law that water into which cholera
dejections find their way produces cases of cholera all over the district in which it
is distributed for a certain period of time ; and that if the distribution is in any way
cut short, the deaths from cholera begin to decline within about three days of the
date at which the distribution is stopped.
9. Indirect Diffusion of Cholera by Water.
As water conveys cholera matter which multiplies and reproduces itself in the
population, it often opens fresh fountains of disease, which extend their operations
beyond the direct limits of the water supply, either through the medium of well
water, or personal contamination, or linen or sewer vapors.
The Broad-street outbreak is an illustration. The first deaths were traced to
the pump well, which was in communication with the house No. 40, where an
infant died of diarrhoea and sickness (probably cholera) immediately before the
outbreak. How the cholera matter first reached the child or the street could not
be discovered, but it was probably conveyed thither by the water of the Grand
Junction Company, which, containing ammonia and very likely cholrine in com-
paratively weak solution at that time, was evidently of worse quality than it was
in 1849; for Hammersmith and some of the other sub-districts suficred severely
in 1854.* Thus we can conceive that the introduction of a few germs into one
house of a district may, through water, be the cause, as in this instance, of more
than 616 deaths.
Another instance of indirect difiusion is afforded by the experiment with
the Southwark and the Lambeth water in conterminous streets in 1854; the
proportion of cholera deaths in the houses supplied by the Southwark Compai
were to those supplied by the Lambeth Company in the first four weel
20 to 1 (or 286 to 14) ; in the first seven weeks ending Au«yust 26yk^Jfairi
(or 1263 to 98) ; and in the whole year 1854 as 6 to 1 (or 347i! \j5Su^ So that
* Report on Cholera Outbreak in St. James Westminster, 1854, pp. 78 and 159. See also
Table 27, pp. 62-65 of Appendix hereto.
t See Snow on Cholera* pp. 79-85. Alao subjoined Table and Board of Health Heport on Cholera
and impure water (1856), p. 21.
NiXE SUBBET DiSTBICTS OP LONDOK.
Houiea supplied by
{a) Lambeth Company •
(6) Southwark Compuiy
(c) Wells and other soorcea
(0 Total
Estimated
Population,
18*i.»
1S6.9S7
210^6
106,122
611«435
Dbatss from CnouERjL.
8th July to
5th Aug.
14
286
34
sai
6th Aug. to
26th Aug.
84
977
119
U80
27th Auff. to
end of Year.
518
2^3
1.288
4^009
TotaL
8,478
V488
Mas
Southwark water, drawn from Battersea and con-
taining London sewage - . . .
Wells and other sources - . . •
Purer Lambeth water, drawn ftx>m Thames beyond
sewage range -•-...
Deaths from Cholbbi. to 1(^000 liring.
Fir$t
Stage.
lis
82
9
Second
Stage.
392
112
64
Third
Stage.
888
1,208
330
AIlBtagea
ofEpidraiio.
1,895
1«368
• PopuUtlon assumed to be in the proportion of the houses (inhabited and \n:AxCcaii$&^ *x -t^\swr»s*^/^
tiie two compames. The residues supplied ftrom wells and ttom o\»\yet vs^ixqqi Ni%a ^«^>a«5^ Vi ^sA»si*«it
the sums of (a) and (6) from {(),
xl Water Supply of London.
the people supplied by the purer water must in the end have been affected by their
proximity to their neighbours getting contaminated water. Th« same kind of
facts were observed on the borders of the New River and the £a8t London field ;
and in Newcastle, where the houses supplied by the Whittle Dean Company were
in juxtaposition with those supplied from wells.
The tolerably complete drainage of South London in 1866, by carrying off the
cholera flux, was undoubtedly one of the causes of the diminished mortality of
that region ; and the imperfect drainage of East London contributed its quota to
the general excess.
10. Water Supply of London,
The water supply is so intimately connected with the health of London, and
with its epidemics, that it is desirable to present such a general view of the
system as can be drawn either from the reports of parliamentary committees or
from direct inquiries. This has been done ; and the results in a condensed form
will be found in the Appendix, pp. 260-274. These works possess great interest,
not only to the inhabitants of London but to the world at large, which nowhere
now presents a spectacle of such magnitude ; although it was perhaps surpassed
in the aqueducts of ancient Rome.
The water companies, according to their own returns, supplied London with
95,406,731 imperial gallons of water daily on an average through the year 186G;
this is equivalent in quantity to a fourth or fifth part of the waters flowing down
the Thames at Hampton during dry seasons. It is about 34,847 million gallons
a year.
The daily supply is equivalent to 433,476 cubic metres — the annual supply ta
159,323,700 cubic metres, — which differs little in weight from so many tons.
The water was delivered in 440,288 houses or other establishments ; which
received one with another about a ton of water daily.
As the water rates — or rents, as they are returned by the eight companies,—
amounted to 799,536/. a year, the cost to the consumer was less than fi\Q farthings
per cubic metre, or per metric ton ; the annual cost to each person 5s, 3d, per head
'^^r 52 cubic metres, or 52 metric tons of water.
The Diagnitttde of the supply of water will bo evident if we compare it with the
supply of coal, the other heaviest article of household consumption. According
to Mr. Scott's statistics, the coal brought to London by sea, canal, and railway
was 6,013,266 tons in the year ; and this is by weight to each person annually
about IJ tons, or 73 lbs. weekly, and 10^ lbs. daily.* If the cost of a ton of coal
is set down as 26s. Hd,, and the cost at the pit's mouth at 6s, Sd,, one pound
sterling of the price, consisting of cost of carriage and profits, may be taken as
strictly comparable with the price of water, after deducting the small payments
of the Companies to the river conservators or proprietors. A ton of coal costs,
therefore, for conveyance from the source about 200 times as much as a ton of
water.
It is true that the coal is carried from greater distances ; but it is also truo
that the price of water, low as it is, is a monopoly price. The engineer who
^^nstructed the magnificent waterworks of Glasgow and Manchester has given an
estimate, deduced from extensive observation, showing that 300,000,000 gallons,
= 1,363,036 cubic metres, of pure water can be brought 183 miles from the
mountains of Wales, and delivered in the houses of London, at high pressure
under the constant supply system, at a cost of about 1,190,000/. a year, and that
is at the price of 2^ farthings a ton. Nearly half of this too he devotes to the
payment of the dividend and interest on the capital of the existing companies.
The cost of the works would be about lljOOOyXXX)/. sterling. The estimate is
for six millions of population, and for three times the quantities supplied now.
* The iK^mladon in the Metropolitan police area was 3,621,267 ; it does not precisely correspond
with the coal ares.
WaJUn of fFaUi. zH
But, if the entire works had to be erected now, the present quaniity of water
could be supplied direct from Wales at the price of about three farthings a ton
by this estimate : and the cost for each person on the present quantity of a ton of
water a week would be three farthings a week — three shillings and three-pence
a year. Allowing for casualties of every kind the cost could not exceed one penny
a ton, or a penny a week for each person.
The seven London Water Companies, excluding the Kent for the moment^
draw more than one half of their waters from the Thames, and rather less than
half from the Lea. The New River, the oldest of the companies, brings the
greater part of its water in a stream from the Lea between Hertford and Ware
to 21 capacious reservoirs, where it is stored ; afterwards the water is fihered
through ^s^ feet of sand and gravel in 1 1 filtering beds at three stations ; it is
82 feet above Trinity high-water mark at the New River Head ; whence it ia
pumped by steam-power into higher reservoirs after filtration, and thence di8«
tributed, at different heights, to the respective houses, on the intermittent system ;
filtration was first employed in 1855. The East London is lower down the Lea.
The Thames Companies all pumped their waters from the tidal stream which
received the London sewage in 1849 ; since 1855-6 they have all drawn their water
higher up the river, beyond the tidal range-— from 2 miles (Chelsea Company) to
b\ miles above Tcddington Lock. The whole of the London water passes through
the pumps, and is raised by powerful steam engines, with a force — ^reckoning dead-
lift and friction — represented by a lid sny of 30 metres for the waters of the
Lea and 60 or more for the waters of the Thames, making 45 metres or more aa
the average lift. This work sends the waters not only into the houses, but up
one or more stories.
The companies at the present day in carriage alone perform work daily equivalent
to about 20 million metric tons lifted a metre high. It is the work of an in-
numerable host of water carriers. The low cost of the distribution is due to the
application of steam, and the use made of the hydrostatic properties of water.
Mr. Batcman, in his scheme, draws to a still greater extent on the exhaustless
forces of nature. The sun lifts the waters of the ocean in vapours which are
precipitated in floods on the cold rocks of the Wel^h hills ; on the heights the
engineer catches the falling fluid under Caderldris andPlynlimmon ; stores the afliuent
streams in lake rescrvoii-s at various elevations, of which the lowest is 450 feet
above Trinity high-water mark. Two acqueducts form a junction at Montgomery ;
thence the fresh stream descends, crosses the Severn by Bridgnorth, and is led by
Warwick and Watford to Stanmoi'e, Middlesex, into vast service-reservoirs at least
250 feet above Trinity high-water mark. All the work is done without any pumping
at all ; the water is carried to London by gravitation — by the forces of the earth
~[er,in such reservoirs at that elevation the water holds a store of
power sufficient not^eiilyto carry it to nearly every house in and around London, but
to perform work of various kind^ and to render unnecessary the steam and other fire-
engines now used in the extinction of the fires of the Metropolis. As cost depends
on the amount of human labour expended, and as in this case the whole of the
labour is confined to the construction uf works, reservoirs, aqueducts, tubes, it
enables the engineer to bring pure fresh water from Wales to every house in
London at as low a price as has been already specified, after purchasing the land
and even satisfying equitably all vested interests. It is a work for all time and for
an Eternal City.
As this fresh mountain water may be kept free from pollution it requires no
filtration ; it conveys neither cholera matter, nor fever germs, nor any other
zymotic substance generated in the bodies of men or cattle. The organic matter,
ranging from 1 to 3 in 100,000 parts of the water, is innoxious ; the hardness is
under 3 degrees of Prof. Frankland's scale.
Mr. Hcmans and Mr. Hassard have shown that the waters of the lakes of
Cumberland and Westmorland can be carried through artificial channels to London.
Mr. Dale, in his report, vindicates the claim on these sources for the Lancashire
and Yorkshii*e towns. Mr. Fulton shows how 230 million gallons of pore water
can by gravitation be brought from the sources of the Wye t» "E^ac^^ ^^ ^
*3dii fVliut iVittcr London requires.
coat of 9,0(X),00(Wi Mr. Bailey Denton, in an interesting letter to Lord Derby,
advances a proposal for the supply of the metropolis from the higher sources
of the Thames in conjunction with the storage of surplus waters. The Thames,
aays the Parliamentary Committee, yields a daily average in the dry season of
500 million gallons ; whilst the maximum flow in time of flood exceeds 25,000
million gallons ;* should more water be required, they add, it could be got " by
" storing up in reservoirs in the valley of the Thames a portion of the flood water,
** which now yields in a single day a sufficient supply for a whole year."
The fall of rain on the area of London within the police area, two feet deep
over 687 square miles, is equivalent to 663 million gallons — ^nearly 3 million metric
tons— daily, on an average of years ; and on a London house of ordinary size the
rainfall is equivalent to 20 gallons a day.f There are various proposals to collect
parts of this rain and the rain in the Thames valley as it falls pure on glass, or on
fllate, or on gathering grounds ; and some of the proposals are quite feasible. It has
also been proposed to distribute in separate pipes the pure rain-water for '^ drinking
and cooking," and the present Thames water for all ordinary purposes.^
The safe inference from all the evidence that has been accumulated is that the
population of London will not be limited by the lack of water. The supply of
water of the best quality can always be commanded in these islands through the
providential powers of nature.
The only question that arises is as to the quantity and the quality of the water
with which the population should bo satisfied. The daily consumption in London
is at the rate of 32 gallons a head ; from which 6 gallons may be struck as the
consumption in road watering and manufactures. There is a certain consumption
by animals of various kinds ;§ and the washing of carriages is a considerable item
in some districts. The watercloscts are large consumers ; it has been estimated
-that 10 gallons a head is actually taken by the system now in operation. || The
residue is taken for cleaning the house, for cleansing sinks, and for washing up
the services in daily use at table, for cooking, for ablution, for baths, and for
washing linen ; much is wasted. The amount of water actually drunk in
the crude state is inconsiderable. The daily allowance in Government transports
is 3 quarts a day of Altered water for each person out of the tropics, and
4 quarts or one gallon in the tropics, for all purposes. Under ordinary circum-
stances there is no stipulated allowance in Her Majesty's navy ; the reduced
allowance may be a gallon, half a gallon, or even under great sti*aits a pint
a day to each person. The maximum daily consumption of liquids drunk
by men, women, and children all round cannot exceed a gallon a day in hot
weather. It is evident then, that while it is of the utmost importance that the
drinking water should be pure, it would be exceedingly unsafe to supply
people in their homes with 26 gallons a day of contaminated water LC ave n ott tba ,
water they drank was perfectly pure. Who, acquainted wit^4^ sli bject, can for a
moment suppose it safe to take a bath, to wash iiyt ilands, to cook, to wash
china services, to wash linen, in river waters, o^ntaining matter so diflusible as
cholera or fevei* germs. The mere contiga\ty of the Lambeth houses to the
S2/^uthwark houses suQ'pi'ed with dilu>^^ sewage in the water was evidently
attended with danger, how n«ch rmure dangerous then would be the actual presence
in the house of contaminated river waters meeting the inmate at every hour of the
4ay in some shape or other? The diffusion of such matter in the dry dusty
. • Report of Select Committee on East London Water Bills, Session of 1867. P. viii. In the
Jicport on " Supply of Water to London from the sowces of the River Severn/' November 1865,
X F. Bateman, C.E., F.R.S., states that during September 1865 the quantity of water flowing
down the Thames at Hampton was carefully measured, and found to be 300,000,000 gallons, or
1,363,036 cubic metres,
f I set down for this mere illustration the average covered area at 600 square feet, on the authority
w, „ — ^, o ©• \ Practical
fiygiene," by Dr. Parkes, p. 3.)
I By the estimate of the engineers of 6 water companies, 23 out of 56 million gallons, or
40 per cent, of the water for domestic service, is consumed in waterclosets. The New River sets
down two thirds of the domestic supply to this head.
Soft IVater or Hard, xliii
streets daring hot weather might be regarded with some apprehension. The
conception of the supply of two kinds of i(vater — ^the one pure Uie other impare—
could only be entertained if there was no alternative, bat such an altemadve in
London eyidently exists.
As much water runs to waste apparently, the actual consumption might be
reduced : upon the other hand extensions of its nse are expected from varioas
sources. The workmen of London rarely take baths of any kind ; and the same may
be said indeed of a large part of the population. Population has been distributed
into three classes: (1) those who bathe daily ; (2) those who very rarely bathe, but
wash the hands and face daily ; and (3) those who never wash at all, or wash rarely.
The linen of all classes sympathizes with the skin ; and the consumption of water
will necessarily increase as members of the third class pass into the second, and
members of the second into the first class. The intelligent artisan now covered
with a grimy coat of dust and dirt in manufactories would be glad to pass through
such a purifying shower of warm water as could be easily supplied wherever steam
engines and large fires are found. Again, many water-closets at present get little
water ; and so long as these machines remain in use many gallons of water are
required not only to keep houses but sewers sweet, and to carry sewage down to
the natural drainage channels. There is no ground, therefore, for beUeving that
the daily demand of 32 gallons of water per head of population will diminish nay,
it may increase to the same dimensions as in Glasgow.
Now, one thing is worthy of great weight ; for all purposes of ablution, for tea-
making, for washing, for manufacturing purposes, for steam boilers, and for every
conceivable use, except one, it is universally admitted that soft is preferable to hard
water. Soft water gives a silken softness to the skin, while hard water hardens
and roughens the epidermis, to which it fastens soapy impurities. Dr. Frankland
shows* that 212 lbs. of good hard soap are destroyed by 100,000 lbs. of the best
Thames water in washing before any useful detergent encct is produced ; the same
amount of the Kent Company's chalk water destroys 265 lbs. of hard soap ; the
waters of Glasgow destroy only 4 lbs. ; the waters of the Welsh streams referred
to, about 2 lbs., according to the determination of Dr. Robert Dundas Thomson,
F.R.S.f There is no dispute about the superionty of soft water so far as 31 galloni
of the daily supply go. The debate arises on the residual gallon, or half gallon,
or quart, or pint, which is drunk in the crude state as cold water. Pure chalk
water, hard as it is, contains certain lime and other salts with carbonic acid in
solution, which make it, according to some authorities, not only a more agreeable
beverage than the fresh water of a mountain stream but more salubrious. It
snpplies ingredients which are required for the bones, say they, while its adversaries
point to stone and other diseases incident to the dwellers in calcareous formations.
Lists of towns getting hard or soft water are cited to show that the mortality is
higher or lower in support of either side ; and notably the mortality of Glasgow
and of Manchester are adduced by one party to prove that the mortidity since the
introduction of soft water is still much higher than the mortality of London, while
by another party, in evidence of the effects of soft water, their former sufferings
and their recent exemptions from cholera are noted.
. If ancient popularity could settle the question, the sparkling waters of city
pumps near churchyards, charged with carbonic acid and nitrates, would bear the
bell, not only from the fresh water of mountain streams and the waters of the
Thames, but from the waters of chalk formations by some so much applauded.
The precise effect of hard waters uncontaminated with sewage and of fresh soft
water on health has not yet been determined ; it is a difficult scientific problem,
which requires careful analysis by statists and chemists.
The choice, however, does not lie practically between soft and hard waters for
drink. It is quite certain that fresh soft water is an agreeable salubrious drink i
and that hard water, like any mineral water, can be medicated in every house so
as to render its composition suitable to various tastes ; to add chalk, carbonic add,
and even cooling nitrates or nitrites is an easy task, and the composition might be
* See his excellent paper '^On the proposed water supply for the Metropolis" [pi. 18.], read
before the Royal Institution of Great Bntain, April Sd, 1868.
t Bateman on Metropolis Water Supply, p. 80.
zliy Fixity of Zymotic Molecules.
varied with any kind of mineral impregnation, it being certain that the same doses
would not suit every constitution.
The choice in the present case lies practically between the Thames or the Lea
Waters, carefully filtered by the existing London Companies, and fresh soft water.
Now we are bound to give these companies credit for having, since 1849,
made great efforts to get their waters from the Thames and the Lea of the
best qualities. They have, as a general rule, done their utmost to comply with the
Water Act of 1852 in all its requirements. There is this patent fact, that the
Thames Companies, instead of drawing their supplies .from the Thames at London
Bridge or Hungerford Bridge, or Battersea or Hammersmith, have, by going above
Teddington Lock, got fairly rid of the foul waters seething with the sewage of
three millions of people. From that danger London is happily delivered. The first
Bivers Commission — Mr. Kawlinson, Mr. Harrison, and Professor Way — has done
excellent service in showing how the Thames and the Lea may be protected from
the direct sewage of the hundreds of thousands of people living in the valleys
of the Thames and the Lea, above the intake of the existing water supply.* The
water is filtered ; and it is probable that the companies may consent, in con-
formity with the general wish, to supply their clients with water on the constant
system, of which, before Mr. Ayrton's Committee, they enumerated the difficulties
without pronouncing them insuperable. The mitigated form of the cholera epidemic
in every part except in the region that suffered from the disastrous accident in
East London, is satisfactory evidence of an unquestionable amelioration.
But so long as the watercloset system is in use in the upper valley, the Thames
water below can never be free from appreciable accidental contamination : some
organic matter is oxydized in running streams, but as ova of worms, spores,
zymotic germs, developed, some of them, as Pasteur has shown in the absence of
oxygen, are not destroyed by oxygen, they will inevitably, in epidemic and epizootic
seasons, be brought down and distributed by the water. They cannot in some of
their forms be kept out ; and I agree with Sir Benjamin Brodie that it is *^ simply
impossible" to remove all noxious qualitiesf in short runs of river water. The
probable effects of the land on sewage, as well as the fixity of some organic com-
pounds, are authentically expressed by this witness in his answer to Professor Way.
Q. 1497. Do 70a apprehend that if sewage was applied to a sufficient area of land, the liquid
nummg off would be equally likely to foul the river ? — Speaking not from my own experience, but
ttom such information as I possess, I should say that it undoubtedly would not be equally likely.
I do not think that it could be asserted that all injurious matter was removed from the water by
placing it on the land, but certainly it must be very much diminished ; there is very much more
chance of getting rid of it by that means than by throwing the sewage into the river. With regard
to the oxydation, we know that to destroy organic matter the most powerful oxydizing agents are
required ; we must boil it with nitric acid and chloric acid and the most perfect chemical agents*
To think to get rid of the or^^c matter by exposure to the air for a short time is absurd ; when
once the matter was brought into a liquid condition on to the land the oxydizing action would be
■very much more rapid upon it, because there would be a very much lai^er surface exposed to the
action.
The description by the Commissioners of the pollution of the Thames produces
a painful impression,} which is diminished but by no means removed by the
proposal to distribute the sewage by irrigation over fields, previous to its dis-
charge into the stream. " Sewage water," they say, " if passed over a sufficient
** area of grass land, passes off, bright, tasteless, and without smell." That is
true, when the process is performed with the utmost care under favourable circum-
stances ; but the process is unfortunately subject to a thousand accidents through
every day of the year, as they have clearly themselves shown ; and the water,
though clear and bright in a stream, may be animated by countless legions of
invisible molecules most destructive to human life. Mr. Bailey Denton, Engineer
* The population in 1861 of the Lea valley, above the intake of the New River Company, was
73,526; above the intake of the East London Company, 153,030; while the population of the
Thames above the intakes was 8SS,088. This population must now exceed eleven hundred
tboosand.
J Evidence in 1st Report of Pollution of Rivers Commission, Q. I4S3-1502.
Ist Report of Pollution of Rivers Commission, pp. 12-18.
CoitofPurt Water for Londatim zl?
to tho Land Drainage Company, who undontands this subject, after fortif/ing his -
opinions by the testimony of Dr. Odling, and of Dr. Voelcker, the agricaltural
chemist, goes on to say: ^' those who are practically acquainted with land and
*' the working of irrigation know that unless the soil is of a very free character,
*' with a quick natural drainage, or, being more retentive, is closely underdrained,
'' there are times when the land becomes saturated to the surface, and when any
*' additional liquid poured upon it will flow over the surface into the nearest
'' ditches, and by thsm be conducted into the rivers in an unchanged condition*"
He states also, that the soil being saturated, allows the ingredients to pass through
it in winter, when vegetation is dormant, nnclarified ; he dwells on the difficulties
of irrigation all the year round ; and concludes that ^^ practical objections go far
^ to satisfy practical men that the sewage of towns and populous places cannot
^ be rendered harmless, though it may be made profitable."*
Accepting the existing reign of the water«closet, the sewage-irrigation remedy
for rivers as sources of water-supply is a policy of despair.
With the rapidly increasing population of this country, we have arrived at
a pass from which there is but one evident escape : the pure waters, which are the
very life-blood of cities, must be sought in the hills or river-heads, and be brought
where they are required by those admirable and wonderful engineering operations
which Providence has placed at our disposal $ and England, the native home of
canals and railways, is sure of success in obtaining aqueducts to rival and to
surpass, in utility as well as grandeur, those of imperial Bome. Here is no
question of a transitory passion, or of ministering to a passing want, but
to an eternal necessity of our nature. By a whole host of terrible diseases God
forbids the consumption of contaminated waters.
Revised Estucates by Mr. BATEdfAN, C.E., fbr supply of Loxdos with Watib, on the
coNSTAirr System and on inoii Pressure.
1. Estimate for supply of 300 million gallons of fresh water from Wales to 6,000,000 people in
and around London. Required c^tal, 11,000,000/.; interest of same at 4 per cent,
440,000il ; dividends to existing companies, 450,000/. ; working expenses, 300,000^ ;
aggresate annual expenditure 1,190,000/. As a set off there are deductions for sale of
superfluous property <^ company, and sale of water on line of aqueduct for trading and
other purposes.
3. Estimate for aqueduct to supply daily 220 miBon gallons, for reserroirs and pipes to supply
130 mUliou gallons daily, 8,600.000/. ; annual expenditure for interest, 844,000/L ;
existing dividends of companies, 450,000/. ; working expenses, 230,000/. ; aggregate
expenses, 1,024,000/, Then 300,000/. are written off for annual value of surplus property
of companies and profits of sale of water on the line of aqueduct and beyond Metropolitan
area*
3. It appears further that, if no waterworiu existed in London, 100 million gallons of fresh water
a day could be supplied from the same sources for an annual expenditure of 470,000/.,
covering interest of capital (4 per cent, on 8,000,000/.) and woiking expenses at an annual
chargeof 150,000/. :
Aqueducts and reservoirs, &c - 6,500,000
I^pes to houses r * * 1,500,000
£8,000,000
'Tho estimate may be put in another form, which will probably be more
intelligible to the non-professional reader. The dividends of the eight com-
panies for the year 1866 were by their own returns 432,371/. ; the market
value of their shares, by Crossle/s list, Feb. 8, 1868, taking the New Biver (not
quoted) at 20 years' purchase, and the highest quotations for the rest, was
8,220,400/. They have contracted loans, &c. returned at 2,367,144/., the interest
of which is deducted before the dividends are declared. With the dividends the
interest would make the annual clear revenue about 538,729/., or about 5 per
* Letter to Earl of Derby on Water Qaestkm, pp. 4-6.
xlvi Val^ of a New River of Soft Water,
•c6nt. on the share capital and loans engaged in the works, and amounting ta
10,587,544/.
The able staff of engineers of the existing companies would no doubt be retained,
but set down as compensations for contingent losses of office from consolidation of
work and for other contingencies, 179,600/. Then the capital to purchase the
companies' shares, &c. would be 8,400,000/. ; and the capital on Mr. Bateman's
smaller scheme (for 130 million gallons daily) would be 8,600,000/. : the total
capital to be raised in the course of five or six years would be 17,000,000/., secured
on the water-rents of London. This is exclusive of the existing loans, &c»
amounting to 2,367,144/.
If 17,000,000/. had to be raised by the Metropolitan Board it would cost, at
5 per cent, 850,000/. ; at 4 per cent., 680,000/. ; at 3^ per cent., which is a higher
rate than consols or railways in the aggregate now pay, it would yield 595,000/. a
year ; and the security would be found to be perfect. The cost of working is set
down at 150,000/. ; which, without any of the sets-off, taking interest of capital at
800,000/., would make the annual cost 950,000/. With the set-off only of annual
value of 50,000/. for sale of superfluous works, the annual charge would be 900,000/.
for 130 million gallons of sound soft water daily delivered at high pressure ou the
constant system ; while the water-rents for 96,000,000 gallons of hard water
subject to sewer contamination liable to increase, delivered on the intermittent
system generally, were 799,536/. in 1866.
The soft pure water, looking to all its economic uses, would certainly be worth
twice as much as hard river water, if both were sold in the open market. And if
Mr. Bateman's estimates are right, the old water could not long compete with
the new water in London with any chance of keeping its ground ; but the
struggle would be disastrous, and the companies deserve compensation for their
great services to the community under the great difficulties that have sprung
up from the pollution of rivers. Some of their works might perhaps be main-
tained as a reserve against contingencies. The present prices are monopoly prices
in an article of as great necessity as bread, or greater, and could not be sustained
for ever ; but the only course, as competition cannot be brought into the field, is for
London within the police district to take the supply of water into its own hands.
Such a fine stream of water as has been referred to would enhance the relative
value of all the land for ever within the area of supply, and would thus be for
the especial advantage not so much of the occupiers as of the leaseholders and ground
landlords of the 440,000 acres of building land within a circlo having a radius of
fifteen miles from Charing Cross. At 600/. an acre the rateable property in 1861
was worth 264,000,000/. ; and this was rapidly increasing. The annual value of
the rateable property on 77,997 acres within the Weekly Tables was 16,600,682/.
in 1867 ; and this alone, at 18 years' purchase, would be worth 300 million pounds
sterling. The annual value on which the police rate was assesssd in the year
1866 was 16,217,302/., in the year 1867 it was 16,600,682/. Now the expendi-
ture on a pure water supply would necessarily, instead of lessening, enhance the
value, as it would be reproductive.
Then the capital advantage of the supply by gravitation consists in this, that
the expense does not increase in any proportion to the quantity of water consumed ;
for 8,600,000/. Mr.Bateman brings 130 million gallons of water daily to London,
for 11,000,000/. he brings 300 million gallons a day; and the increase of the
subsequent and of the working expenses is comparatively inconsiderable ; simple
gravitation does the work.
Cholem Fields : London, Portsmouth, Exeter.
n.— CHOLERA FIELDS.
Cholera was felt all over the kingdom, and T^hile the deaths by the disease in
London were 5596, the deaths in the other ten divisions of England and Wales
were 8782. The population of the ten divisions is six times the population of
London, and at the London rate the deaths bj cholera would have amounted to
33,576. The mortality in the ten divisions was at the rate of 5 in 10,000 against
18 in London.
The disease was only fatal to any considerable extent in certain regions, which
may be called cholera fields, as here the centres of activity were all in direct com-
munication with each other, and were surrounded by free border- lauds.
L London Cholera Field.
East London was the centre of this field, which extended over West Ham, and
with little severity to Romford and Rochford, including Southend in Essex ; to
Brentford and Edlmonton along the Brent and the Lea ; down the Thames and
round the coast of Kent to Dartford, Gravesend, Hoo, Mailing, Faversham, Milton,
Sheppey, Thanet, Eastry, Dover, and Elham ; up the Medway to Chatham,
Rochester, and Maidstone ; up the Thames to Richmond and Kingston, and across
Surrey to Croydon and Godstone, where some navvies and their families at Oxted,
on a new railway line, suflered severely.
The epidemic was much less fatal in the border-land of this field than it was in
either 1849 or in 1854 ; the deaths were not by a fifth part so numerous as in
1849. The notes contain some interesting information. The water pollution in a
Margate lodging-house and its efiects are well described.
2. Portsmouth Cholera Field.
Portsmouth, Southampton, and Newport in the Isle of Wight, are the centres of
this field, which runs along the Southampton waters, up the Medina, and against
Spithead. The deaths by cholera in the districts of Southampton, Portsea Island,
Alverstokc, Fareham, and the Isle of Wight, were 382 ; and what is to be regretted
is, that the ravages of the epidemic were much more fatal in 1866 than they wcro
in 1854. Southampton, it maybe inferred from the Report of Professor Parkes, has
adopted precautions which may protect it for the future ; and no time should be lost
for assisting, and compelling, rf necessary, the authorities of Portsmouth to reform
altogether their sanitary arrangements, on which in time of war the health of the
British fieets and the safety of the kingdom may depend. Salisbury, which is
connected with this field by the Avon, affords a striking illustration of the results
of sanitary measures ; the deaths by cholera in this district of 9039 inhabitants
were 165, 15, and 2 in the three last epidemics. The water supply and the
drainage were improved in the interval.*
The mortality in nearly all the districts of the South-eastern, Eastern, and the
South Midland Counties was very low, and the mild precautions to prevent the
diffusion of the plague were successfuL
The prevalence of cholera in the Isle of Wight is undonbtedly due to the bad
water supply. The state of things described in the note under Newport f is neither
creditable to the intelligence nor to the public spirit of the authorities. This small
town, which ought to be healthy, has for many years been notoriously the reverse,
for it has been the nursery of the various kinds of zymotic disease.
3. Exeter Cholera Field.
It is very gratifying to find that Plymouth, which had" been a great cholera
field in 1849, is so no longer ; and has thus been more successful than its rival at
Portsmouth. Unfortunately Devon has, however, still its cholera field. Exeter.
and the three neighbouring districts of St Thomas, Newton Abbott, and Totnes
* See Coinmunication from A. B. MiddletOD, Esq., M.R.C.S., in Appendix, p. 218.
t Appendix, p. 214.
zlviii
Bristol, Wolverhampton^ Liverpool
lost 427 lives bj cholera. Dr. Shapter will probably continue his sanitary history
of Exeter, and tell the world of what en-ors in hygiene this beautiful city has been
the victim. The partial and fatal outbreak of cholera in the Paignton sub-district
of Totnes is well described by Dr. Pridham.* He explains the various circumstances
which contributed to the dissemination of the disease. Stoke Gabriel, on the east
bank of the Dart river, has an impervious substratum of slate and greenstone ; and
the rain-fall of the surrounding hills descends through watercourses which receive
the impure surface drainage of the fields and the village in their course. The
impurities accumulated in the dry weather of 1866 were afterwards washed down
by the rain, and thus zymotic matters were disseminated.
4. Bristol Cholera Field.
This is another extinct volcano. The deaths by cholera in the Bristol, Clifton^
and Bedminster districts amounted to 1435 in the yeai* 1849, and to 51 in the year
1866. The measures carried into effect under the guidance of Mr. Davies, the
admirable health officer of Bristol, are well described in the Report of the Health
Committee :f and Dr. W. Budd, whose clear intelligence has contributed to the
adoption of disinfection of the flux in cholera, and in typhoid fever has also
described the measures adopted at Bristol in an excellent paper.}
5. Wolverhampton Cholera Field,
Here again cholera, which in five districts (Wolverhampton, Walsall, West
Bromwich, Dudley, and Stourbridge) slew 2527 people in the epidemic of 1849,
was foiled. The deaths ascribed to cholera were 25 in the epidemic of 1866. In
the potteries the change was equally great. The deaths by cholera in Newcastle-
under-Lyme, Wolstanton, and Stoke-upon-Trent were 423 in the first, 10 in the last
epidemic. A fresh water supply has been "Carried into South Staffordshire, and their
success hitherto will, we may hope, encourage this energetic people to adopt such
measures as will render the whole of the once fatal black region sweet and salubrious,
if not fair to look upon, although even in this direction much may be done.
6. Liverpool Cholera Field,
Liverpool itself was the centre, and in the two districts of Liverpool and West
Derby 1989 persons died of cholera. Judicious measures of disinfection were
carried out under the supervision of Dr. Trench, who has described the epidemic
in his annual report § Had these active steps not been taken, the mortality by
cholera would undoubtedly have been greater ; as it was, the death-rate was not a
third of that of 1849, but it was unfortunately higher than the mortality in 1854.
Districts.
Deaths by Cholbra to 10,000 Fersons living.
1849.
1854.
1866.
liverpool
•
163
41
54
Wert Derby
•
80
12
18
Wirral -
Birkenhead
•-}
26
7
r 28
1 11
Manchetter
-
89
1
2
Salford
-
28
8
2
* Appendix, p. 220.
f Ai^>endiz, p. 224.
1 8ee Paper m BritiMh Mtdkal Journal of 13th April 1867.
I Appendix, p. 229.
H
I
Hull, Tyjiemoutk, South Walet, xliz
Dr. Ti'cncli ilcscrlbcs the judicious And Iinmnno mcn.=urcB ndoptcd in dealing
"with llio Gcniinn cniijiraiits ; ami very |)ro|H'rly denounces the dreadful conso*
qiiences of ;!iiiiikt'n wakes over chulera cm'pse.-'.
It is imiJOshilile not to connect tlio difliTencci^ in the mortnlily l»y cholera in
Manclicsti.r nud Liverpool in some wnj with the differt'iieed in tho water supply of
the tnro pujiulntiun^.
Dr. Buj'lis in IJirkonhend very e fleet ivcly eonibafcil the disease, and the mortality
there waji kept down ns low na U in 10,(X)(), while it was 28 in the rest of tho
Wirrall district.
Wigan is supplied with water of a gooil quality by the corporation, yet tho
deaths ly cltoleni in the district were 137, and more numerous than iu any other
di.rliiet (if Lancashire, except Liveqwol and Wert Uerhy. Wigan district includes
five fiiUlying siilj-iUslrict?, wliere 79 of the deaths occuvrod, chiefly amouji; colliers,
will) are iiej!li;rent and often dirty in their habits. There were S8 deaths in tho
Wigan sul '-district, und the families of coui-mincrH and weavers were the princijHil
8utK'rcr«. Prior to the onlljri'jik in Wignn, ns elsewhere when the water supply is
not eimipnlyiiry, tlif peojile in parts of the town L-oiitiiiued to draw from wells all
their water, which upon nnidysis iv.is coiideiniii'O, and the welU were siih^Miuentl;
closed. Tho progri'^i* of the epidemic is de-icribi-U in the notes.*
474 deailis from choleia neeiirred nil over the other po|iuI<jus districts of Luneoihirc,
'where sanitorr umingemeuts have iicen hitherto in an unsati:ifactory xtnte.
7. IIuU Chohra Fiehl.
Cholera, which raged with di-eadfnl severity iu this region in 1819, found no
footing hero in IStiti ; nnd the deaths by eliolenv in Hull and Sculcuales wei'e only
21, in all Yorksljire 3i>8. Tho few ciisea in Hull arc descril>ed in thi' notes, und
oceuri-ed under peculiar ciraumstauee^. The w:iter supply, now derived almost
cntiri'ly from natural spruigs and artesian wells, is not liable to contumiualiou.
In the epiilemie of 1M9 cholera killed 1178 persons in Hull; the water supply was
drawn iheii directly fi-om llic tidid river itolluted with sewage. In eonjaneliun with
the LLalth ofJicer, cxL-ellent prelimiiniry nriungeinents were maiie in LeeiU, where
1439 p<rsous died of cholera in the epidemic of 184fl, and 4S iu lSo4, and 14
in ISCfJ.
8. Ti/iirmoul/i ChoUra Field.
Here clmUra reappeared with sinic- rigour iit Tynemouih, where 107 fatal ca.?C9
occurred. Tho water supply here again was to blame, hut the wh<de of tho
particulaiv; liitvo not transpired ; it Is st.tted that the Xorili Shii'lJs Wal<'r Coiajiany
I>um[>cd n part of the siipidy from the I'reslun cfillievy, and that suspieiiin nflitcheM
to tho l*rej-toii reservoir. I'iie remarkable explo^il>u of cholera in IS.'S nt Xew-
ra.stle 1ms been already deeeiibed; then Tynemouih, which hatl lost 81.5 of its inha-
bitants bycliolera in 1849, sutfeied lilile iu IS."3. Al Sunderhind, wbiiv the diyeaso
was once so fatal, 92 deaths occurred, and iu all Die eouniy ut' DurJiaiii the deallia-.
were 3<>3. Tiic water Eujiply of the c«Uierv districts of the county is generally
Vail, and the Miuitary oiiiuigeincnts of the colliers' dwcllin;;s, and (to use an Indiau
term) the conservancy, is in a higli degree unsatisfactory. The Washington
Coal Company, it is gratifying to say, deserves honourable mention ; sineo tho
epidemic they havo liberally supplied nil their cottages with water from tho
colliery. It vould be woU if all tho other great colliery comiimies and firms
-would go and do likowiBC.
9. South IFaltt Cholera Field.
This woa described under the name of thn Sfcrthyr Tydfil field iu the cholera
lU'iiort for 1849, and jutfy "Vf" Merthyr Tydfil was then the givat cunlie ui' the
Wolsh attack, and tho lac^tmQf tiborV vas the highest in the kinn;,loni. It was at
the rate of 251 doaiha to 1(^000 tnliDbitaDtB ; in 1854 the rate fell to .''>!), mid in
1866 to 22. Mertiiyr TydlU was in tho most deplorable condition iu 1H49, nnd
Sir HeoiyT.de la Otiche, aft w.jtoji riiig^ that the situation was open, airy, and
1 [ South Wales.
500 feet above the docks at CardlBT, sajs this camp of industry was entirely tin-
drained, and that from " the scai'city of privies," some parts of the town were
completely covered with defilements, soiling the air and polluting the shallow wells
£*om which the people drank. The place has been greatly improved ; but bad
habits arc not easily broken ; still much evil remained in 1866 ; the germs of
cholera found, says Mr. Dyke,* " places where all the necessary elements abounded,
*< in which they could propagate themselves in infinite mulitudes, for eveiywhere
** human excrements were to be seen or smelt." Notwithstanding these subsisting
evils, the mortality was less than a tenth of the mortality in 1849. During the
interval an able health officer has been appointed. And now the water supply both
.of Merthyr Tydfil and Aberdare are pronounced satisfactory. "The water used
" for all domestic purposes by all the inhabitants of the town * ♦ ♦ * is
^* derived directly from the lesser Taff river, ^yQ miles north of the town, dia-
" charged from the main supply-pipe into two uncovered receivers at Penybryn,
" thence it passed into uncovered filtering basins, and then into the covered re-
" servoirs from which Merthyr and Dowlais fti*e supplied. It is true the position
" of these open receivers and filtering beds on the sloping hill side above Penydarren
" renders them liable to receive from the winds that blow over them whatever of
" the seeds of disease may be conveyed through the air ; yet it is scai'ccly possible
" to imagine such should have been the case in this epidemic, when we remember
" the sparseness of the first cases, spread over a widely extended sui-face of hill
" and dale."
Mr. Dyke subsequently states that '* in August a number of persons used water
" from wells which, being situated near old and deep cesspools, were contaminated
" by sewage. As to the pernicious influence of such a water, Mr. AUday states that
" he was in attendance upon a tradesman who was affected with and died of
" cholera ; his wife and son were also ill of the disease, but recovered. This family
*' used the water of a well which, upon inquiry at the time, Mr. Allday ascertained
" became most offensive when kept for 24 hours."
It is noticed that in parts of Wales, privies not being generally in use, accumulations
of the same kind as in India strew the soil, and in cases of typhoid fever, of diarrhoea^
or of cholera, the disease dust is either blown about in diy seasons, or is washed
into the wells, ponds, or streams in wet weather. As the population increases the
quantity of this stuff increases ; and even when it is minute in*quantity in the water
distributed to multitudes of people, the chance of infection, however small as regards
an individual, grows considerable when multiplied by thousands.
The tlu-ee districts of Swansea, Neath, and Llanelly suffered severely from the
epidemic ; and the mortality in the three regions was at the respective rates Ln
10,000 of 88, 79, and 76. The region lies round the rivers Tawe and Burry,
which flow into Swansea Bay on the one hand and Carmarthen Bay on the other.
The population is engac^ed in mining and smelting chiefly, but it is partially mari-
time. Tlie health officer for the borough of Swansea, Mr. I)avies,t reports especially
on ^1^6 area extending over the three sub-districts of Llansamlet in Neath, where
nearly the whole of the deaths occuiTcd among the mining population ; of Llaugafe-
lach and of Swansea. Females suffered most in Llaugafelach among the families
•of the mining and metal-working population; there the epidemic broke out on
May 27th, and ravaged Morriston, where the sanitary condition of the extra muni-
cipal part was very defective. " The cesspool system was general, but on the sides
of the hill above Morriston, where the epidemic was most severe, there was a great
want of even privy accommodation ; the houses thinly scattered about, but some-
times in short rows, were of a poor description. Another feature in this district
deserving of notice is the almost entire absence of grass vegetation in consequcnee
of copper smoke, and as a result the absence of the compensating advantage it
would have afforded when refuse was thrown on the surface of the ground around
the dwellings. Within the municipal boundary there was a supply of water from
the new Swansea waterworks, and the deaths from cholera within and without the
borough boundary in the Llaugafelach sub-district were as follows :
Within the borough - - 51 deaths.
Outside „ - - 100 deaths."
-'..•" * Appendix, p. 243.
: ; - \ . ' f '^ J : : _ + Appendix, p. 246.
^outh Wales ; Ten Great Cities. li
The service regervoir of the new water supplj of Swansea is on the hill above
Moiriston, 291 feet above the tide level ; ami the water is drawn from a river fed
by springs rising iu a gathering ground of mountains occupied hy a few cotter
formers.
A haulier had died of cholera in Flect^street^ Swansea, on May 14th.
A death occurred on July 9th, but the Swansea outbreak began on July 23d, nearly
a month earlier than the outbreak in Merthyr Tydfil. It had begun previoualy in
the Morriston Valley above Swansea, and no doubt diarrhoea from the cholera matter
extensively prevailed over the whole region. The son, age 8, daughter, age 1,
and the wife of a tinplate refiner, age 32, died of cholera (she in 12 hours) on
tlie 20th, 21st, and 23d respectively at Tyrprendy ; one case had occurred before
on May 27th, and Ave cases in June about the same region. The old supply of
water open to suspicion was cut off on July 28th by order of the health officer,
shortly after the outbreak ; and it was assumed that the new supply from the hills
was faultless. The new supply was completed in 1867, and if the cotters are re-
moved from the gathering ground it will probably supply unexceptionable water.
The health officer remarks on the imperfect drainage of the Irish quarter, which
suffered exceptionally, as Church-street, St, Giles, formerly did in London.
Llanelly suffered very severely ; in the district the deaths by cholera were 232.
Dr. Thomas* describes the water supply and the drainage as equally defbctive : —
^* The only special causes present in all the localities were decomposing animal
" and vegetable matters, the evacuations of man and animals, polluting the air and
" the water too. To the neglect of a systematic and thorough removal of these
^* manures into the earth, particularly the excrements of man, I am disposed to
" attribute the heavy epidemic of cholera that visited this place, and to the same
" causes the common presence of typhoid fever over the whole district.
" The river water was suspected as a cause in the attacks at Felin Foel, as well
" as at Penygar, a small place containing a])out 50 inhabitants, who also up to this
** time had used the river water, and to prevent the people using it several cart-
" loads of lime were thrown into it above the village ; whether from this circum-
'^ stance or not I cannot say, but the attacks sensibly decreased in'number and
" severity immediately thereon."
Mr. James Rogers, M.R.C.S., of Swansea, describes vividly the defects of water
supply and of drainage in the sub-districts of Neath.f Tlie houses are especially
defective. In the worst parts, he says, from his experience, whatever the epidemic
is, it persistently sticks to the place ; scarlatina, measles, whooping-cough, small-
pox, each rages in its turn.
The privy is undoubtedly an advance in civilization even in its imperfect stage,
as it prevents the contamination of the streams ; but it is usually a nuisance
without the application of dry earth, which disinfects and prepares the soil for
the food of vegetation. Wales, it is clear, wants a series of sermons by the
di?ciples of the Rev. II. Moule on the diviue law which, in its prinei[)le, has
never been abrogated, but is part of the eternal law of nature, and is enforced,
when violated, by the sacrifice of thousands of lives, Wales is an example. This
law of purity has, for a religious people like the Welsh, the highest religious
sanction : " For the Lord thy God walketh in the midst of thy camp * *
^* therefore shall thy camp be holy,*'J
10. Cholera in the Ten Great Cities,
Deaths from cholera occurred in every one of the ten great cities of England ;
but the mortality was high in none of them ext-cpt in Liverpool, and in London, or
rather the East end of London.
In the epidemic of 1848-49 the mortality was high in every one of these ten
cities, except Birmingham, and jMjrlmps Shetiield.
In the epidemic of 18o3-54 the mortality was still at heavy but reduced rates in
London and Liverpool. Newcastle-upon-Tyne sufifered excessively in 1853, for
reiisons which are assigned elsewhere.
♦ Appendix, p. 2-18.
t Appendix, p. 244.
X Deuteronomy 23; v. H, PS
m
United Kingdom ; Elevation.
11. Cholera in the Eleven Divisions of England.
The mortality of all England was at the rate of 7 deaths bj cholera in 10,000
persons living.
In the three Midland Divisions, the South Midland, North Midland, and West
Midland Divisions, the deaths by cholera were at the rate of 1 in 10,000 ; in York-
shire 2, in the South-westeni Division 3, in the South-eastern and the Eastern
Divisions 4, in the Northern Division 5, in the North-western Division (Lancashire
and Cheshire) 9, in London 18, in the Welsh Division (Wales with Monmouthshire)
18 in every 10,000.
What a strong contrast this presents in every Division to the higher mortality of
the epidemic of 1849. It was only in Wales that the disease was to any extent
more fatal in 1866 than it was in 1854.*
12. Mortality from Cholera in the United Kingdom.
The deaths in the United Kingdom were about 17,793 ; and the mortality by the
disease in the year 1866 was at the rate of 6 deaths in every 10,000 inhabitants.
The reduction of mortality by the epidemic is not due to any diminution in the
force of the cholera virus, as may be inferred from the severity of its ravages in
neighbouring kingdoms.
Estimated
Population
1866.
Deaths
festered
fix>m Cholera
in 1866.
Deaths
from Cholera
to 10,000 of
Population.
United Kinodoh
England and Wales - -
Scotland* - . - -
Ireland* - - - -
29,946,058
17,793
6
21,210,020
3,153,413
5,582,625
14,378
1,000
2,415
t
3
4
* Estimate for Scotland supplied bj Dr. Stark ; registered numbers for Ireland by Dr. Burke.
Ill— SCIENTIFIC ELEMENTS OF CHOLERA.
1. Elevation,
Cholera was very unequally distributed over England. 14,378 people were slaiu
by the disease in 641 districts ; and of that number 10,889 fell in 37 districts of
London, and in 24 other town districts ; 3489 in 342 districts ; while in 238 dis-
tricts no death from cholera was recorded.
All the districts, with the exceptions of Wigan and Merthyr Tydfil, were seaport
towns, or districts in their immediate neighbourhood ; the populations were dense,
and were nearly all dwelling on the lower alluvial soils of the kingdom. These corre-
lations have been observed in all the epidemics. The exceptions are accounted for by
such i>eculiar circumstances as the mortality around the Broad-street pump in 1854,
and in St. Giles's, London, in 1849, where either the people were excessively dirty
and crowded, or took in water large doses of cholera matter in a very active state.
To get a clear idea of the ojieration of elevation it is necessary to exclude tho
notion that the mere fact that i>eople live a few feet above the sea level has ia
itself any direct influence on health. It is the indirect influence of elevation on
the air and water of a place that produces the surprising effects observed.
* Table 4. in Appendix, p. 16.
JElevation. liii
The zymotic matter being organized lives irregularly distributed in air or in
water. It is in suspension either in the atmosphere or iu the waters ; and as it is
necessarily under the influence of gravitation, it is as a general rule in larger
quantities in the lower than it is in the higher strata. Pasteur has proved this by
experiment as far as the atmosphere is concerned. He deposited at the Academy
of Sciences 73 flasks, each holding a quarter of a litre; they were carefully prepared
so as to exclude tdr^ and were one third part full of limpid yeast water, susceptible
in the highest degree of the influence of ferments. Twenty flasks were opened in
the open country at the foot of the Jura ; 20 were opened on the Jura at the
height of 850 metres, and 20 were opened at Montanvert near the Mer de glace
at an elevation of 2000 metres. Of the 20 opened on Montanvert, only 1 sus-
tained any alteration from the air admitted ; of the 20 receiving air on the top of
the Jura,. 5 were affected ; and of the 20 opened on the plain, 8 were thrown into
fermentation. The greatest precautions were taken and are required in these
experiments.* He only closed the other 13 flasks, opened on the heights, after
having left them in the air of the bedroom of the little inn at Montanvert for the
night ; in 10 of the 13 infusoria were found. Thus the atmosphere is in 8<nne
parts pure ; in other parts it is pervaded by mists of living matter ; and the density
of these mists increases near the earth, as would be indeed the case in the unorganized
water globules of clouds, if they were not in the lower strata volatilized by the heat
of the earth into transparent vapor.
The law regulating the distribution of cholera matter in water is very easily
shown by mixing the cholera flux with 10 times, 100 times, 500 times its bulk of
distilled water iu glass tubes a metre longf ; after agitation the liquid is opalescent,
and grows denser and more opaque as the bottom is approached, where there is a
flocculent deposit if the proportion of cholrine is considerable. (See p. xiv.)
Now the waters of London form a continuous communicating sheet resting on
the London clay under gravel and other ground, and as the houses and the water
sheet rise from the river brink up to Ilampstead and Norwood, all round the London
basin, it is pretty certain that sewage matters finding their way into that water exist
in greater proportions in the underground water of the low than in the underground
water of the high districts. The welb of the undrained low level of South London
were excessively impure in 1849 and in 1854 ; since those dates the soil has been
drained, and that is equivalent to elevating it.
The mains and pipes of the waterworks form a subsoil network all over the London
area ; each company has its centre of supply, but in 1849 and even in 1854 their
subdivisions may be treated as pai'ts of one great homogeneous system for the present
purpose. Then round the Thames at the bottom of the basin, to get definite ideas,
take an area under 20 feet of elevation ^4l second area of 20 and under 40 feet of
elevation ; a third of 40 and under 60 feet ; a fourth of 60 and under 80 feet ; a
fifth of 80 feet and upwards, all permeated by water mains and pipes filled by steam
power, with the waters of the Thames and of the Lea "ccmtaining various sewage
ferments, and among others the cholera ferment in suspei^ion ; then it is plain
that if the proportions of the cholera ferment in water as in airv^ary in the various
belts it wUl be densest in tlie lowest belts, and the mortalitj^iL Qe<ifl«ons--5riH^-*-
increase in descending on every successive terrace of the metropolis. This was
observed both in the epidemic of 1849 and in that of 1854.
The greater the quantity of cholrine in a given quantity of water, the greater is
the inequality in its distribution ; thus with one part of cholera fiux in ten of a
water solution a considerable quantity of the matter falls to the bottom ; with the
strength of 1 in 100 or a portion of 1 in 1000 nearly the whole matter remains
after shaking pretty evenly in suspension as far as the eye can judge.
There was a direct relation between the elevation of the ground and the mortality
of cholera when the waters were saturated largely with sewage, and in 1854 a
♦ Pasteur, Annales dee Sciences Naturelles, 4« sorie, Zoologie, tome rvi., pp. 76-8.
t For displaying the distribution of suspended matter in tubes, sewage water or Thimet water at
the old hitakes of the water companies may be used.
liv
Elevatiofu
similar relation obtained in the fields of the several water companies so far as they
could be distinguiehcd.
In 1866 it becomes necessary to separate the supplies of the several companies,
and it is seen that when this is done the same general law prevails. The mortality
in the East London sub-districts was at the rate of 103 in 10,000 living ut elevations
below 20 feet ; it was 71 at the elevation 20-40 feet; 20 at 40-60 feet, and 4 at
60-80 feet above Tiinity high-water mark.
In measuring elevation the height should bo taken above the level from which the
water is lifled, but in 1849 I took the elevations from the ground. The mortality
was inversely as the elevation ; thus let e be any elevation and e' any higher eleva^t
tion of the house ground, c' being the mortality by cholera at the higher, and c the
e' -\- a
mortality by cholera at the lower elevation, thene -f a : e' -f « : s c' : c =. — — — . c/
expresses the general relation between the mortality by cholera and elevation above
the Thames, a is a constant [quantity, and was in 1849 taken as 13. Thus at
e' = 90 feet wc had c' = 22 and c = ^ '^ }^ x 22 = ^^^
€ -f- 13 € -)- 13
gave the series of
mortalities for the elevations 70, 50, 30, 10, feet ; at 27, 34, 53, 99, and 174 deaths
from cholera in 10,000, which agreed very closely with the observ^cd mortality at
those elevations, namely, 27, 34, 65, 102, and 177.* The same law prevailed in
the epidemic of 1854.
The general i^esults are subjoined, as an opportunity will, we may hope, never
recur of measuring the effects of cholrine diluted in water on two or three millions
of people living at such regulated elevations above a tidal river.
Deaths from Choleba in the Tear 1866 to 10,000 Persons living, at different Elevations in the Fields
of the Wateb Companies.
COMFAVIBS
ftunisbing the greater
part of the
Water Supply.
Elevation its Feet abo\'S Teinity Hion-WATEB Mark.
Under
S Feet.
3-10
10-20
Under
20
20-40
40-60
eo-80
80 and
upM'ards.
All
Eleva-
tions.
Thamet Companies t—
Grand Junction, West")
Middlesex, & Chelsea i
Bouthwark and Lambeth
From Blver Lea :—
New River - - -
East London . - -
From tho Bavcnsboumo and
WcU8^-
j£eQt • « • -
(!)• 6*9»
(16) 6*78
(i) 171-ao
(4)* 7-54
(«) 6-76
Z
(«)
(«)
2*53
6'30
(i>-$«-(I§
(a) 05J>^-(3) 101-64
(«) 38"8G , (s) 12-20
(») 4*53
(26) 6-40
0) 66-68
(6)10306
(a) 19*33
(») 2-25
(0 1-71
(•) 10-72
(13)71-30
(«) 3-08 (") 2-93
(») 2-57 («) 2-44
(16)11-66
(4) 20*34
- (1) 1-49
(13) 7*87
(1) 3*66
(3) 13*34
(0 3-48
('^?) 3-6(
(2) 3*10 (32) 5<8|
(4) 3-98
(«)-
(ia) 8-71
(24)70-6(
(»'>)15-3(
"TygC^^jft lll^B tremwUkiirfhese results are calculated ore given in Table 31 (see Apijendix. p. 79.) for each Sub-district
arranged in the order of iU elevation, and grouped according to its water supply.
• Thfi ffm^^^ figures of this Table represent the number of sub-districts at each elevation supplied by the rcspoctive
companies.
In the New River sub-districts the mortality ran down from 57 to 11, to 12, and
to 8 on the four successive twenty feet vertical ten-aces, and as low as 4 ut the
elevations over 80 feet.
Lin the Grand Junction, West Middlesex, and Chelsea fields the mortality was at
the rate of 6 in 10,000 at levels below 20 feet, and it was uniformly 2 or 3 in 10,000
at all the higher levels, that is, it was uniformly low as might be expected where
there was very little effect from the waters.
In the field of the Southwark and Lambeth companies supplying South London
V
I ♦ See Cholera Report for year 1849, pp. Ixi-lxviii.
Distance; Density. It
the mortality was 6 in 10,000 at elevations under 20 feet, and 2 or 3 at the higher
clevatioDS.
The field of the Kent company presented some suspicious circumstances during the
epidemic ; and it now appears that their reservoirs arc in ** dangerous proximi^ **
to the foul waters of the Ravensbourne, and being below its level are in such*
hydraulic conditions as to render occasional contamination not only possible but
probable. This will account to a certain extent for the high rates of mortality
observed there in the advanced state of the epidemic in Woolwich and Deptford.
In this field the influence of elevation was also felt. The mortality was at the rate
of 19 in 10,000 below 20 feet, while above it was 13 in 3 sub-districts.
If we conceive that the water in one vertical column A contains ten times as much
of the cholrine as the water of another column B, it is evident that the lower
sections of B may only contain as much of the stuff as the higher sections of A.;
so the mortality at different elevations would be the same under such circumstances*
The sub-districts of London are arranged in Table 28. in the order of their
elevation ; and it will be noticed that in the epidemic of 1849, when the waters
were generally contaminated, the mortality was regulated by eleration ; the samo
law was observed in 1854 ; and in 1866, after throwing the sub-districts into water-
fields, as there was a striking difference in the quality of the waters, the law is
still found to prevail. The mortalities of the sub-districts, after careAil correction
for deaths in hospitals, are classed and compared in Table 27.
2. Distance,
The cholera flux in suspension undergoes changes as well in water in closed
pipes as in open rivers, dependent to some extent on the quantity of matter, on the
amount of oxygen present, on the temperature and on the time elapsing from the
separation of the cholera corpuscles from the mucous surfaces.
The great explosions of cholera in England have arisen from the use of the water
of tidal rivers into which the recent sewage of largo populations had been poured ;
the temperature of the water ranging at the time from 15^ to 21^ Centigrade (or
60° to TO'' Fahrenheit). At these temperatures certain bodies take up the oxygen
of the water, and then the ferments living in the absence of oxygen, such as the
cholera corpuscle probably is, have free course as long as subsistence remains ; they
then perish unless they are previously incorporated by other bodies.
London (1849-54-66), Newcastle (1853), Hull"* (1849) are striking examples of
the direct and quick administration of diluted cholera water, and the same examples
in 1866 serve to show that the upper waters of the Lea, Thames, Tyne, and llumber
lose much of their noxious energy by flowing a certain number of miles down their
channels.
The highest districts of London are generally, but not always, at the greatest
distances from the intake of the waters of the companies, so that before delivery the
matter travels further, and is exposed for a longer time to the operation of such
changes in energy as have been investigated by lliiersch and Dr. Saunderson. The
experience of North Woolwich in 1866 confirms this view.
3. Density,
It may be stated generally that the cholera is most fatal in densely peopled dis-
tricts, and where it finds its way into a school, a prison, a workliouso, or a barrack
under bad sanitary conditions it is generally fatal in proportion as the inmates are
crowded.
♦ The new waterororks establiahed in 1844 took their supply from the river Hull, 2} miles above
its junction with the llumber. Half the sewage flowed into the llumber, and the other half of the
sewage flowed into the Hull, and was carried up beyond the waterworks by the tide twice a day.
The supply was taken when the tide was down. In the year 1849 the deaths in Hull and Scul-
coatetwere 1,834, at the rate of 200 deaths to 10,000 inhabitants. Of the deaths 45 occurred in
July, 405 in August, 1,307 in September, and 70 in October. On the 6th of September 97 penons
died. — Snow on Cholera, p. 100-1 ; and Keg. Gen. Cholera Report, 1849, p. cxlviii.
Ivi
Density; Sewerage.
But the water-supply and the elevation together have hitherto masked the effectft
of density in London, and if 9 of the densest districts containing from 197 to 258
persons on an acre are placed bj the side of 9 of the sparsest districts containing
trom 5 to 34 inhabitants to an acre it will be observed that the mortality was
highest in the thinly peopled districts both in 1849 and in 1854, the scale being
accidentally turned in 1866 by St. George-in-the-East. This is explained by the
other columns of the subjoined Table ; six of the last nine districts got the worst
water of the Thames, the Lea, and the Ravensbourne, or, as in Rotherhithe, drew
water from the tidal ditches and foul wells. The ground was often undrained^
whereas there was a partial drainage of the higher deuse districts.
When cholera matter is distributed by water as it was in St. James's in the year
1854 among a dense population the consequences are rendered the more appalling.
1
Deaths sy Cholera I
Initial of
Water
Companies.
1S66.
to 10,000.
DiSTBICTS.
Persons
to an Acre.
1849.
1854.
1866.
DBNSEST DiSTBICTS .—
N.R.
51
8t. Luke
2M
84
10
15
N.R.. E.
40
East London
2W
45
23
14
N.R.
60
Strand - - - .
238
35
22
6
N.R.
5S
Holliom
217
35
G
7
N.R.
68
St. Giles - - .
213
53
22
10
N.R.. E.
48
Shoredit<5h -
212
70
23
11
G J., N.R.
68
St. James, Westminster •
203
16
112
5
S.L.
St. George, Southwork
204
1C4
121
1
E.
21
St. George-in-the-£ast
107
42
36
07
—
43
Mean - - - -
221
50
45
18
—
43
Mean - - - -
21
71
59
17
Least De^se Dibtmcts :—
•
E.
8
Poplar -
34
71
42
89
G.JmW.M..C.
Rothcrliitho
S3
205
165
9
40
Kcnsiii^ou -
31
24
88
4
&.. s.
27
Greenwich ■
27
76
49
20
N.R.. E.
53
Hackney
. 25
25
15
11
S.f L.
4
Camberwell -
19
VI
09
N.R.. W.M.
860
Hampstead -
11
R
12
1
Lh s.
.24
Wandsworth
7
100
85
5
K., L.
87
Lcwisliam - - • - -
6
30
22
6
4. Seicerage.
A system of sewerage is the necessarj complement of a water supply. It caiTies
off the water charged with the various impurities of houses, shops, manufactories^
and streets. These impurities are however of subordinate importance. The water-
closet throws into the sewer the evacuations of the sick, and carries them in the
sewage sometimes directly into a river, and sometimes over land. The matters
undergo various transfonnations, and sewage is sometimes innoxious and inoffensive ;
at other times, where there is stagnation or languid circulation, fermentations arise,
and, as at Southampton, the germs of dir?ease ascend into streets and into dwellings.
There is, however, good reason to believe that where the circulation is sustained
and rapid the danger from this source as far as cholera is concerned amounts to
little, and is certainly insignificant when compared with the evils resulting from the
accumulation of the cholera flux in streets and cesspools, whence it often finds its
way into the wells and canals and streams close to inhabited places.
Almost coincidently with the first appearance of epidemic cholera, and with the
striking inoreasc of diarrhoea in England, was the introduction into general use of
the water-closet system, which had the advantage of carrying night^ioil out of the
house, but the incidental and not necessary disadvantage of discharging it into
the rivers from which the supply was drawn.
Introduction of Water Closets ; Wealth and Poverty, Ivii
The water-closet was iuyented bj Bramah, apparently at the close of the last
century ; the dates of its general introduction are thus described by Mr. W. Hay-
wood, the able engineer to the corporation of the city of London : — ♦* Water-closets
" were invented about 45 years ago (1813), and became general in houses of tho
*^ better class about 30 or 35 years since (1833) or (1828), and the entii-c discharge
** of the dejecta from the houses in which the water-closets were fixed in many
" cases took place. Nevertheless even their introduction did not directly in all
^^ cases lead to this, inasmuch as the interdiction of the Commissioners of Sewers
^ prevented it ; and tho custom obtained, to a large extent, of building cess]>ooU
" having ovei*flow drains just beneath their doming, by which means the solid
" matters were deposited, and the supernatant liquid only ran off; but gradually
** the existing mode of construction crept in, and the entire refuse of the better class
" of new houses flowed by the drains into the public sewers.
" In the year 1849 what maybe said almost to be an organic change in tho
" system took place. In 1848 the City Commission of Sewers obtained its Act
" for sanitary purposes, which became operative upon the 1st of January of the
'' following year (1849); for tho first time indeed then was this discharge into the
" sewers legalized. Previously a jwnalty might have been enforced for such an
" usage of them, but henceforth, within the City of London, those incurred a
" penalty who failed, upon notice, to construct the drainage of pi*emises in such a
*' manner as not to discharge all waste waters and Jacal matters directly into the
" public sewers " [i. e. directly into the sources of water supply], " of which the full
" utility was therefore for the first, time recognized by statute ; this Act was
" speedily followed by others for the remaining area of the Metropolis and for the
" entire country, the clauses of the City of London Sewers Act being the basis
** upon which they were framed."
It will be noticed in Table 1* that tho deaths from cholera and diarrhcea
increased in London in 1842; increased still more in 1846, when the potatoe crop
was blighted, and in 1849 culminated in the epidemic cholera.
The experience of South London might be speciallv cited to show the groat
utility of sewerage in conjunction with a liberal supply of such water as is o()taincd
from the Thames above Teddington Lock ; and to prove that cholera mattiT is not
distributed to any considerable extent by such sewers as those of South Lon<loi).
Good sewers lower the level of the wells, and ensure the filtration of the surface
waters through a greater thickness of earth.
5. Wealth and Poverty.
Wealth gives the command of the necessaries of life in food, clothing, dwelling ;
it implies personal purity, and also secures prompt and skilful medical treatment.
Poverty presents the sad reverse. Hence th" poor as a general rule suffer more
than the rich in cholera. But that is by no means always the case, particularly
where the water is impure. Thus in East London many of the victims were in
good circumstances. The poorest man in St. George, South waik, was less likely to
be attacked by cholera than the richest man in Stepney. The pau['»or of IIampr*teiid
escaped in 1849, while the opulent perished in Belgravia. And the same rule
obtained all over the kingdom where there were equivalent differences in the qualities
of the waters.
The relative economical condition of the various districts of London in shown by
the assessed annual value of the houses, but with the value of the ihvelliiig housses
is \mfortunately mixed up the value of the shops, manufactories, and other struc-
tmes so as to give an undue degiee of relative value to tho city and to some
other districts. Still the division of the assessed annual value of the propertv in
each district by its population supplies a good index of its condition.
The Table 26 has been calculated to determine the effects of this iniluonco. On
comparing the four lowest and poorest Surrey ili.stricts of South I^)ndon with tho
wealthiest districts of Middlesex the subordination of this cause to others is evident.
♦ Appendix, p. 1.
Iviii
Wealth and Poverty ; Occupations.
With the density the parks produce some disturbing efTect, and the Broad-street
explosion of 1854 thiowB a heavy charge on; St. James's, Westminster, in 1864.
But it will be observed that in spite of depressed soil, density, and poverty, the
mortality by cholera of the four south districts in 1 866 was very little above the
mortality of the favoured districts of West London, Bethnal Green is by our
standard the poorest district in London, and the deaths by cholera in 1866 were in the
proportion of 63 in 10,000, but even this high rate is not so high as the proportion
in the other and wealthier districts supplied from Old Ford with water. There in
the five districts paying nearly double the mean rent of Bethnal Green the deaths
were 64, 76, 89, 97, and 116 in 10,000.
Initials
of
Water
ComiMinics.
Eleva-
tion.
Density.
Hoii.^
Rout
of each
Person.
Deatus by CnoLSKA
to 10,000 living.
1849.
1853-4.
1866.
BermontlMiy - - - -
St. George Suuthwark -
Nowingtou - - - .
Rotherliitho - - - -
All London - - - -
KcuKiiigton - - - -
St. George llaiiOTcr-sqiiaro -
St. Martln-in-the-Fields
St. Jaiucs Westminster
S.
S.L.
S.L.
S.L.
-1
20i
149
33
£ s.
2 7
2 11
2 12
2 18
161
ICl
lU
205
179
121
112
1C5
6
1
8
33
30
5
G2
4<}
18
G.J.,W.M.,C.
G.J., C.
N.R., C.
G.J., N.E.
-10
3fc
38
58
31
81
70
208
C
11 8
12 8
13 10
21
18
37
IC
88
33
20
U2
4
2
5
8
6. Occupations.
Occupations expose persons in very various degi'ces to epidemical disea.se. lu
the case of cholera seamen living in .seaports are more exposed than other people
fdmply because they live in suffcriug places. Miners perish from the t*aine eau.se
and from the unclean habits they acquire under ground. Where the water is con«
taminated thirsty occupations expose men to danger. Some classes are more likeK-
to neglect diaiThoea than others who, like inedifiai-Hjoh and intelligent people, nppre-
otale t£e importimce of early treatmenU^- Table 18 in Appendix^ p. 37, shows the
tlettthfl at different ages, both oCinen ^d of women, in the ytu-ious professions. 6,995
Budea died of cholera. TiiG following are the numbers in some professions : — One
cj^rgjnman died, 4 Pj^etestant ministers, and 2 other religious teachers; 3 solicitorfli,
no bairlBters; Sjpjjygicians, 3 surgeons, 7 druggists; 2 authors, editors, or writers ;
2 artj ate ^ 10 i^ asicians ; 4 schoolmiustcrs ; 9 hotel-keepers, 27 i>ublicans, 6 beer- ,
" bSSStST^ merchants, 1 banker ; 41 clerks, 13 commercial travellers ; 36 railway
officers and men ; 12 cabmen, 86 carriers, carters, or draymen ; 56 barge, lighter,
•watermeu ; 203 seamen in merchant service ; 4 land proprietors, 58 farmers, 152
4lffricuUural labourers; 27 gardeners; 3 booksellers, 10 printers; 12 watchmakers ;
47c»^ine and machine makers ; 14 coachmakers ; 21 builders, 1 16 carpenters, 67 brick-
2arer»» 49 Miasons, 18 plasterers, 47 plumbers, 34 cabinet-makers; 3 uiKlertakens ;
10 Wl*eelwrights; 7 woollen-cloth manufacturers; 37 silk manufacturers, 41 cotton
^^^jfftcturers ; 10 hairdressers, 62 tailors. 111 shoemakers, 10 ropemakcrs ; 9 cow-
^^^rsormilkscUers, 4o butchers, 10 fishmongers, 21 bakers, 14 greengrocers, 10
*^' refiners, 19 grocers ; 6 tallow-chandlers ; 9 curriers ; 40 sawyers, 23 coopers ;
^^•oal-muiers, 3 copper or tin miners, 12 iron miners ; 22 coalheavers, 13 gas-
\j^e servants; 25 brickmakers, 36 railway labourers, 16 navvies; 6 earthenware .
Occupations ; Sex and Age. lix
makciv, 4 glassmakers ; 15 salt manufacturers; 25 copper man u fact uror?«, 17 tin
manufacturers; 5 lead manufacturers; 147 iron manufacturers; 89 blacksmiths,
22 boiler-makers ; 689 labourers ; 17 emigrants ; 14 gentlemen ; o [)risoners.
2,690 deaths occurred among sons, grandsons, nephews, brothers, so returned,
without any designated occuimtion.
7,383 women and female children were carried off by cholera ; 2,H46 being
simply returned as wives, 1,064 as widows, 2,5ol iw daughters, granddaughters,
nieces, and sisters.
Besides these, 10 were registered innkeepers' wives, 35 publicans' wives, 20
farmers' wives, 15 butchei-s' wives, 88 shoemakei*s' wives; 5 were schoohni stresses,
147 were domestic servants ; 24 nurses, 63 charwomen, 10 hawkers and i>edlars,
14 cotton manufacturers, 11 milliners, 49 seamstresses ; 19 were laundresses.
To show tlie relative mortality these numbers are conipare<l in Table 18 (p. 37 of
Appendix) with the numbei-s living; it will be seen that the range of mortality is
considerable, but the great differences are due to the sanitary condition of thelo(*ality
in which the occupation is carried on. The mortality of salt- workers, copper workers,
and sugar refiners was high. Now of 2,016 men engaged in the salt manufactures of
England 1,237 live in North wich ; 2,236 of 3,827 copi>er manufactuixM's live in
Swansea, Neath, an«l Lhmelly ; and 1,373 out of 2,790 sugar refiners live in the
heart of East London. In all these districts the epidemic raged with great M.^venly
among all classes of the ])opulation, an<l it is clear that if the occupations had been
pursued in other places no such mortality would have occurred. The comfortable
English clergymen, the farmerfi, and the agricultural lalx^urers in open districts
suffered little because they lived in happier sanitiiry regions.
7. Sex and Age,
The fatality of an epidemic depends not only on external conditions but jiUo on
the internal organization. It is found by experience that the two sexes at dilfen iit
ages are not affected to the same extent by all diseiu*es, eiliuT becausr by the
habits of life they are not exi>osed to the same extent to the caur^i'S of di-i-a.-e, or
because the power of resisting the operation of those causes varies.
The three epidemics of cholera supply data for determining the mortality of
cholera at diflerent ages in the two sexes, for the deaths wen? 102, 1S(>, inclusive
of about 14,418 deaths by the epidemic, which were registered under tlir luiul of
diarrliGca. It is im])ortant to include these outside ileaths in estinintin^ the ttrret
of age, inasmuch as the occult form of the disease is not met with in (mhuiI pro-
portions at all ages ; and it is evident iliat we have the niean> of fnniiiiiir mu
estimate by com])aring the deaths registered from dian'hoea in tin* epidennr \vi\\'<
(1849, 1854, and 1866) with the deatlis under the game head in <.r(liii:uv Mars,
such as the three years 1848, 1853, and 1864. This has a«'<*r»rdin'ily be, n <l«»ni',
and the excess is shown in Table 9 (Ap|>endix, p. 20).
The characteristic symptoms, it will be seen at a glance, are nut m> well marked
in early infancy or in the second infancy of old age; and thr iea>nii of this is that
the muscular and nervous systems being then less active, and giving; rise tn less
convulsive and violent symptoms, the medical attendants return the ca-i- as
diarrhoea.
At all ages above 5 and under !i^ the number of such case^ of occult clinlrraic
diarrhoea is not considerable; while under the age of five year>, accordini' in ilii-*
estimate, four cases of diaiThcca must be addetl to every six deaths n-gi^^tind iiuni
cholera to get the actual deaths by the epidemic. At the :ige of 75 and n]«w;.rd>
also there is a large addition of these occult cases.
After correction we find that the mean of the mortality in the three ei>i(K'inIe.^
was, of males 18*0, females 17'8 to 10^000 living at all ages.
The addition for occult cases was nearlT *^ '^'^ to the male and 2 - 5 to
the female mortality. (See Table 10^ ▲
Ix
Sex and Age,
The mean mortality from all causes iu the three cholera years was, for males,
19*3 in excess, for females, 17 "9 in excess of the average mortality to 10,000
living ; so females suffered less than males.*
The mortality is higher in boys than in girls at all the ages under 16; at
the ages of reproduction, 25-45, the mortality of women, many of them pregnant,
exceeds the mortality of men ; but at the ages after 65 the mortality of men
exceeds the mortality of women.
There is evidently a law of mortality involved in the age, independently of sex :
thus in the three first lustres of life the deaths of boys to 10,000 living were 31 '8,
13*2, and 7'6 ; of girls 28*4, 12*6, 6*4; and the mean mortalities of the two
sexes at the same ages were 30*1, 12*9, and 7'0, which differ little from the
series 30' 1, 14 '5, and 7*0, where the numbers arc obtained by assuming that the
mortality is inversely as the age, and decreases about 14 per cent, for every year of
age, or is less than half at 5-10, and less than a fourth at 10-15, what it was in the
fii'st five years of life.
After the age of puberty, or from the age of 15 to 25, the mortality also increases
YOry little ; it is 8* 1 for males and 7*8 for females ; and at the six decennial ages
extending from 25 to 85, the mortality increases from 15*4 to 43*6, at a very
constant rate, as is seen on comparing the calculated series with that observed in
both sexes.
Ages.
25-35 -
35-45 -
45-55 -
55-65 .
65-75 -
75-85 -
85-95 -
95 8t upwards -
Odserved IX 3 Epidemics,
THE Deaths bt Cholera to 10,000
living at bach Age.
Men.
15*2
19 5
23'5
28-4
35-9
42*2
46-0
82*4
"Women.
Mean.
Calculated
Series.
15-6
20-2
23-1
31-4
35*4
44-9
41-4
32-8
15-4
19-8
23'3
29*9
35- 7
43-6
43*7
57-6
15'4
19-0
23*4
28-9
35-7
44-0
54-0
G7-0
Note. — Let Wx = mortality by cholera at age x, then r» jif, = «x + »i =■ mortality at age
X + n. In the series given the logarithm of r is taken at 1*93665. This applies only to the
ages under 15. At the ages from 25 to 85, and even upwards, the logarithm of r is 0' 009 11.
r = i^i^y^Y'^ = (^'V* ^ 1*0212. And logarithm r = 0-00911.
♦ Mean Mortality from all Cacses to 10,000 Living.
All Ages.
Males.
3 years 1849, 1854, 1866,1
when cholera was epidemic j
26 years, 1838 to 1866, cxclu- 1
sive of three above years - J
250-5
231*2
Females.
Under 5 Years.
]^lales. Females.
231-5
213*6
755-9
722-2
658' 1
622*4
19*3
17*9 .
33*7
35
Registrar GenerdC$ 29<A Report^ p. xvi to xx.
Influence of Age; Jttachs of Cholera. Ixi
Thus to 10,000 men living of the age 25 and under 35 the deaths bj cholera
and choleraic diarrhoea, as above defined, were 15*2 ; to 10,000 women the deaths
were 15*6; and the mean mortality of the two sexes in equal numbers is ex-
pressed by 15*4. The mean deaths by cholera at the next age (35-45) were 19-8
to the 10,000 living, and so on. The calculated series approximates very closely
to the observed facts : it is a series in geometrical progression, and may bo con-
ceived as representing this principle, that human life loses the power of resisting
the zymotic life of tiie cholera epidemic year by year after the age of puberty, or
what is equivalent, that the lethal power of the epidemic on the organism
increases at the rate of 2* 12 per cent. Thus, for instance, 1,000,000 persons of the
age 30, are exposed to cholera and 1540 of them die ; then of the same number of
the age 31 exposed to the same epidemic under precisely the same circumstances,
1573 will die ; and to 1,000,000 persons of one year of age older, or age 32, the
deaths will be 1606. So some force is taken away from the organism every year
of life, every second we may conceive, by which its constituents become less able
to resist the action of the cholera leaven. And the diminution of resisting force
obeys a law which is of this nature : the loss is an accumulating quantity, and in
the end becomes so great as to leave the life at the mercy of other forms of life, or
of other forces.
Thus the mortality at one age being given, the mortality at any other ago
within certain limits can be calculated.*
Small-pox, scarlatina, diphtheria, measles, and whooping* cough obey Fi>eciAl laws
of their own, yet all of them agree in this : the mortality by them declines as age
advances ; but the fevers and the other zymotic diseases taken in the aggregate are
more closely allied to cholera, for the deaths by them are most numerous at
advanced ages.f
8. Attacks of Cholera.
The resistance which the body offers at different ages may be of two kinds ; it
may resist an invasion and, as in unsuccessful vaccination and in unsuccessful
inoculation, not take a disease^ as it is called ; or it may take the disease and live
through it, or succumb to it, in variable proportions.
All the cases of cholera have never been registered in any epidemic, and it ia
impossible to determine directly what relative numbers are attacked at each age.
The deaths out of 3635 cases of cholera at different ages were investigated by
the scientific committee of the Board of Health, and the result showotl that, given
100 men attacked at the age 25-35 about 36 died, while of 100 attacked at the
age 35-45 about 44 died ; and generally the mortality of persons actually attacked
increases as age advances, according to a determinable law. So in the ages before
puberty the mortality of cases declines until it reaches the minimum. Here ob-
servation grows more difficult, as the • mortality of cases of choleraic diarrhoea
has not been determined, and it cannot be derived from the mortality of cases
of diarrhoea selected indiscriminately for medical observation at hospitals or
dipensaries.
To avoid fallacies of observation the cases of cholera, and the deaths at the
ages 25-55, when the symptoms are well marked, may be taken ; and having the
number of deaths by cholera given at three ages to a fixed number liviiinr, ^Ye can
calculate the corresponding number of attacks at those ages from tlie scientific
committee's returns. Thus the mean mortality by cholera at the age 25-3.> is by
the three epidemics 15 to 10,000 living ; then by the committee's returns 107 deaths
occur in 300 attacks : therefore in this proportion the 15 deaths imply 42* 1 attacks.
Applying the same method, the attacks at other ages have been calculated.
♦ fii« « T^m» = 28'89 « 15M0r«> « 15-40 X (^0212)3^ By logarithms A 15-40 + 30Ar
: Afii«i » \28*89.
t See Supplement to Begistrar General's 25th Annoal Report, pp. yiii and ix.
Ixii
Influence of Age in Attacks ; Duration of fatal Cases.
Ages.
25-35
85-45
45-55
Fopalation.
10,000
10,000
10,000
Men.
Attacks.
Deaths.
Women.
Deaths.
Attacks.
41-3
42-8
43-8
i4^ir
18^9
22^4
15-1
19^4
21*9
42*8
45-2
44-7
Thus it may be inferred that at these ages the proportion of men attacked differs
little from 43, and of women little from 44 in 10,000 ; men and women in the prime
of life, in the reproductive ages, are nearly equally liable to attack, but the influence
of advancing age is manifest in the advancing mortality.
The proportions attacked appeal* to be gi'eater after than before the age of 65^
but this disparity may be compensated by the cases of choleraic diarrhoea ; all that
is certain is that old women are more liable to attacks of cholera than old men.
The facts are displayed in the annexed Table, deduced partly from the observa-
tions of the Scientific Committee of the Board of Health on the epidemic of 1854.
The morbility differs less than the mortality.
AGES.
DBATn
1 £8TI3£ATED PROPOBTIOX TO 10,000 LiVIIfO.
TO Oke Attack.
1
Males. ' Females.
Males.
1
Females.
Attacks.
r
Deaths. ' Attacks.
Deaths.
AUAges-
0-5
•466
I
'480
81^6
1'
W4 31-9
15-3
•611
1
•682 1
81-5
19-3
* 27^0
17-0
5-10
•642
•424
22-9
12*4
27*7
11^7
10-15
•457
•600 1
16*6
7*2 J! 12-5
6-2
15-25
•328
•389
28^9
7-8 19-2
7*5
25-36
•866
•854
41^3
14*7
42-8
15-1
35-45
•441
•429 1
42-8
18'9
45^2
19-4
45-55
•513
•491 \
43*8
22-4
' 44-7
21*9
55-65
•662
•610
46-5
26-1 550
2S-5
65-76
'589
•678
62- 1
30-7
1 61-8
29*9
75-85
•741
•696
40-1
29*7 ji 40*4
84^3
85-95
•868
•667
81^7
27-a
44-3
29*6
95ftupds.
••
•600
• •
20-6
69-6
29*8
9. Duration of fatal Cases,
The greater the dose of any poison the more fatal it is, and the more rapidly it is
fatal. By parity of reasoning it may be presumed that the more destructive an
epidemic is the more rapid are the cases in their course.
The mortality by cholera in the epidemic of 1849 was at the rate of 30 in 10,000,
and the mean duration of the fatal cases was 50 hours. As the mortality by
cholera in 1866 was only at the rate of 7 in 10,000, we may expect to find the
fatal cases of longer duration, if the duration is in an undetermined dcgi^eo inversely
as the mortality. The duration of fatal cases in 1866 was in fact 61 hours ; and
we have this exponential equation from "^hich the value of x can be found
•yQ/\,o\ /61^4\*
I -^Tq ) = ( 40^ ) • ^^^*^ ya^on trial is found to be a!=7 * 2. Put m for mortality of
cholera in the epidemic when the duration of cases was shortest (<'), and m' for mortality
Law of Martalitj/ and Duration,
Ixiii
for time (/) when the cases were longest; then ^-, = f-j /. f-,ji = -- /.
m
= - (9'
and a
= (5)^ • '•
The value of x w 7*3 or 7'0 according as
U is deduced from the facts of 1849 and 1854, or 1854 and 1866 ; so that 7*2, or
nearly 7, may bo taken as the mean value.
The duration therefore of fatal cases of cholera in two epidemics varies inversely
as the 7th (or more closely 7 ' 2) root of the mortality.
To give an illustration, let us apply this formula, deduced from the observations
of 1849 and 1866, to determine, from the duration of fatal casen, the mortality of
/49-9\^*
the epidemic in 1854. Then (57-4J X 30-3 = 1106 mortality by cholera in
1 854. The observed mortality was 10*9. Thus the calcuUted series is 30 * 3, 1 1 - 1 ,
6-8, while the observed series is 30- 3, 10-9, 6 8.
The numbers and the logariihms (x) are subjoined.
Epidemic
Year.
Mortality
by Cholera.
Deaths to
10,000
(«)
Mean
Duration of
fatal Catet
in houTM
(0
X m
Kt
aO'3
10*9
6-8
49-9
57'4
61-4
1-48U
1-0874
0*8325
1*6981
1-7589
1-7882
It is probable that the mcnrtality, as well as the duration of cajscs of cholera,
follows some such law in different epidemics and localities.
And it may be laid down as a general law of each particular zymotic disease that
the quicker the fatal disease is in its course in any given epidemic the more fatal the
epidemic is to the affected population.
10. Cholera FluXf its Dispersion over large Areas of f rater.
The average quantity of this fluid is large, but it has not boon dotoi*minod dirootly,
and it varies with the severity of the duration of the disease. Applying l^iciiii's
numbers subsequently given, p. Ixxviii, to the fatal cases of different (hii-ations in the
Table on p.78, it is found that the average volume of the dejections in a cholera case is
equivalent to 8 '24 litres. How many cholera corpuHclon this quantity contains cannot
be calculated. They are exceedingly minute. By Pacini's estimate 1,000 millions
would not occupy more space than a cubic millimetre; and there are 1,(XX),()00
cubic millimetres in a litre of water. Assumes for the sake of illustration, tliat tht^ir
numbers in a litre efflux equal the number of globules in a litre of blood, then the
number in 8*24 litres of fluid will be 41,769 millions.
This enables us to conceive how the cholera cori)nscl(>s may bo <lisporsod through
the waters of rivers, not only of the size of the Loa and (.»!' the Thames, but of the
Ganges.
Mr. Beardmore, the able engineer of the Lea Trust, says that the area of the
Thames between Bow Creek and Teddington Lo<*k may be taken at 2,300 acres,
and the volume of its waters at about 2,300 million cubic tvrf Avlien the tide rises
to Trinity high-water-mark at London Docks, after makin«if dne allowance for the
slope of the water. High water at Teddington takes plaee two hours after high
water at London Docks ; the distance being 25^ miles.
The tidal area of the river Lea and its branches alK>ve the mouth of Bow Creek ho
estimates at 95 acres, and the volume of its waters when full at oO million cubic
feet: he is unable to give the volume at low water, but holds that it niijrht be
taken dXfive million cubic feet.
The num]>er of litres in the river Lea at high water is 1,416 millions; at low water
142 million litres; and according to Vioronlt one litre of blood conto^vvi'ts \s^*cv>\\. ^j:*ca
million globules; consequently the corpuscles in the H'2A.\\U<i^Q^ Wv^ ^w^ ^^'^^^ ^
Ixiv
Day$ of the Week.
patient, if in equal number, would run up to 41,769 millions. It is certain that the
flux finding its waj down the sewers would not be equally distributed in the river
Lea for instance, but in the water would be in irregular masses like clouds in
the sky ; and that at some points a quart of the waters might contain hundreds
or thousands of corpuscles capable of propagating their numbers by millions ia
the mucous membranes of the stomach and intestines.
Whether the cholera corpuscle can propagate itself in sewage water at a high
temperature out of the body is not yet known, but its diffusion is adequately
accounted for on the hypothesis that it is only propagated in the living organism.
11. Days of the Week.
In spite of the popular belief in ill-omened Friday, it is evident that the days
of the week can in themselves have no more influence than the deities after which
they are named on the fatality of cholera. It happens that in all England the
fewest deaths in the epidemic occurred on Saturday, and next to it on Sunday.
On Wednesday the greatest number of deaths occurred, and next to it stands
Tuesday. In the epidemic of 1849, the deaths on Tuesday and Saturday stood
highest, on Thursday and Friday lowest. In London the deaths were highest on
gay Monday and Tuesday, lowest on dull Friday. If the temperate or intemperate
habits of any of the working classes of London had any effect on this series of
facts, they therefore raised the deaths on Monday, lowered the deaths on Friday.
The order of deaths in 1866 was quite different in East London. There the
deaths were high on Tuesday, Wednesday, and Thursday ; low on Sunday, Monday,
Friday, and Saturday. The excess was greatest on Wednesday, and the defect
was greatest on Friday. The outbreak there began on a Wednesday, and attained
its maximum on a Tuesday and Wednesday. It will be recollected that the
pumping from Old Ford ceased every Saturday at 7^ p.m., and was only resumed
on Monday morning at 5^ a.m., the whole water field being supplied on Sunday
from the purer Lea Bridge reservoirs.
Deatos from Cuolera on kach Day of the Week in the 23 Weeks ending
3d November 1866.
In England and Wales
In EmI London and West \
Horn - - - -J
In England and Wales,')
exclusive of East Lon- \
don and West Ham 'j
Proportion on each day
to KWO deaths on the .
average dny in East
Londou and West Ham
Proportion on each day
to 1000 deaths on the.
aycraice day in the rest
of England. -
Total
in
23 Weeks.
13,553
9,209
Average.
1,0U0
Defect or Excess
over average
daily deaths -
1,000
Defect or Excess
over average
daily deatlis -
Sunday.
1,897
677
1,320
}
0i3
-57
997
]-
II
Monday.
Tuesday.
Wednes-
day.
Thurs-
day.
1.903
1,987
2,039
1,040
535
1,318
632
1,355
680
1,359
666
1,274
056
095
-5
1,033
+83
1,024
+24
1.111
+111
1,026
+26
1,088
+88
962
-38
Friday.
1,900
510
1,851
897
-103
1,020
+20
Satur-
day.
1,887
595
1,292
972
-28
976
-24
12. Meteorology.
Heat, sunshine, clouds, humidity, winds, storms, rains, lightning, have the same
kind of influence on epidemics as they have on vegetation, blights, and all the
lower forms of life. They do not generate zymotic germs, but they promote or
retard their growth and development.
Zymotic Theory. \x9
The principal meteorological phenomena of the 153 dajs from June to October
are displayed in the Appendix, pp. 252-6, and the diagram at the end of the report.
In the week when the cholera broke out epidemically the temperature of the
Thames water was high, and riaing : it was 64^ on July 9th, and rose to 70^ on
July 15th : the temperature of the air was from 4^ to ll'' above the average for
the same time ; it rose to 87*' in the shade and to 163° in the sun on July 13th ;
and afterwards declined : the highest temperature of air and water fell to 59^ air
and 64^ water on July 3l8t, when the cholera was most fatal in l^ondon. No rain
fell for the 20 days from July 7th to July 26th. The air was dry and calm on the
days of the outbreak : wind variable. The weather was fine, the sky often cloady*
Of ozone no notice is taken until August 4th to 9th, when it is marked at 1, 2, 3,
and 4 degrees. £lectricity presents nothing remarkable during June or July ;
Mr. GJaisher noted the '' blue mist " in the air on July 30th, nearly three weeks
afler the epidemic began, and a few days before it obtained the maximum : he
noted it nearly every day down to August 22d : and recurs again to it occasionally
in September and October. /
IV. THEORIES OF CHOLERA.
1. Zymotic Theory,
The analogy between the phenomena of zymotic diseases and the phenomena of
fermentations, but not the identity, suggested the name of that important class of
maladies ; and the analogy, instead of diminishing, has become more striking since
the researches of Pasteur have shown that ferments of various natures produce
correlative products. The yeast globules containing granulations, with nitrogenous
matter and phosphatic minerals, grow and reproduce themselves in sugar, which
they convert into alcohol, carbonic acid, and other compounds : without living yeast*
globules there is no alcoholic fermentation, and without sugar no yeast-globules
are generated.* It is so with other ferments, which by a previous theory were
held to be nitrogenous matters undergoing changes, which set feimentable bodies
in motion. Pasteur has now in a series of remarkable researches proved that
ferments are organized bodies, difiering in character, and living usually in the
absence of free oxygen, while they have the power of appropriating or detaching this
element from its feebler chemical combinations. Thus the ferment of butyric acid
is a kind of vibrion. Tartrate of lime dissolved with phosphate of ammonia and
alkaline or earthy phosphates in boiled water from which air is excluded, remains
unchanged for an indefinite time ; but so soon as a few infusorial forms from a
previous spontaneous fermentation of the tartrate are sown in the phial the
vibrions multiply rapidly, and the tartrate is converted into a mass of deposited
▼ibriona of about a thousandth of a millimeti*e in diameter and of variable lengths.
The vibrions are reproduced by fissiparity, and during the whole process of
fermentation every particle of the deposit under the microscope exhibits a multitude
in rapid wriggling motion. This vibrion differs from those that create butyrio
acid : there are several varieties.
When the water is unboiled and is exposed to the air the tartrate of lime
ferments spontaneously in the course of a few days, and gives place to a mixture
of animalcules living without free oxygen. The same change of the materials
takes place in a phial full of a solution in aerated distilled water. In such cases
what happens ? This, replies Pasteur. The smallest of the infusoria, monasp
bacterium termOy are developed in the aerated distilled water, because it holds in
solution oxygen, traces of ammonia, with phosphate and tartrate of lime, and these
'*■ Koovel Exemple de Fennentation detennince par des animalcules infusoires pouyant vivrs
sans gai oxygine libre, et en dehors de tout contact avec I'air de Tatmosphere. Par M. L. Pasteur
Comptes Baidos des s6ances de rAcademie des Sciences, tome LYL 9 Mars 1863.
IxVi Zymotic Theory.
aoimalGules take from it integrally, with incredible rapidity, all its oxygen, which
19 replaced by rather more than its volume of carbonic acid. This effect is produced
within 24 or 36 hours at the utmost, at a temperature ranging from 25° to 30^
Centigrade. Then and not till then appear the infusorial ferments which can live
without free oxygen gas. To the question, how can animalcules be generated
which live without oxygen and perish in air? the reply is easy. They are
generated after the birth of a first generation of large consumers of oxygen that
deprive fluids completely of that gas. The proper ferments take their oxygen or
carbon from existing organic compounds ; and even putrefaction in air-tight vessels
is carried on by infusoria living without free oxygen, while in the open air they
are associated with other types that consume free oxygen : the sulphuretted hydrogen
and other compounds affecting the smell are only incidental products. Putrefaction
itself is a struggle of difierent forms of life for organic matter.*
In the microscopic world a multitude of minute bodies form a sort of border
land on the confines of the three kingdoms differing essentially in their nature, and
animated by forces generating forms giving rise to most extraordinary phenomena.
Natural science has advanced so far then as to render it almost certain that the
fermentations are actions of the simplest organic forms ; and following in its
wake we are justified in accepting the hypothesis that the zymotic principles of
disease are specific molecules which have the power of reproducing themselves in
successive generations, growing and decaying by laws like the higher forms of
life, not only under the same but also under modified conditions.
The cholera fiux (rice-water evacuations) contains albuminous matter, silica,
phosphates, sulphates, and carbonates of lime, potash, and soda, as well as a con-
siderable quantity of chloride of sodium.t A characteristic feature under the
mici'oscope is the " granular corpuscle ;" on a mucous base it forms the bulk of the
deposit which subsides in most samples. " Myi'iads of vibrions," says Dr. Hassall,
** have been detected in every drop of every sample (twenty-five) of rice-water
** discharge hitherto subjected to examination. Of these vibnons many formed
'* threads more or less twisted, which under the microscope presented a dotted
** appearance."! " In none of the samples were sporules or threads of fungus
*' present, or a peculiar body of any kind noticed other than the vibrions." He
examined and found them in the small intestine 12 hours after death, and by a
special arrangement at St. Bartholomew's Hospital in two cases immediately and
in several cases within two hours after death. He concludes that they are " con-
tantly present" in the cholera fi uid, that they are developed in it during life, and
are found so high up the bowels as the small intestine. Vibrions he found in
healthv fasces only in small numbers, and thinks they might be generated in the
lower Dowel where incipient decomposition begins. Vibrions thrive in alkaline or
feebly acid organic matter, and sulphuric acid destroying their conditions of life
destroys the vibrions.t " Vibrions are true aquatic productions^ unlike fungi^
*^ which are for the most part aerial, fiulds being the media in which, as far as
** I am aware, they are always developed, and to which they are usually
*' confined." They are not distilled even from rice-water fluid, and yet Dr. Thom-
son found them in small quantities in the distilled water through which the
air of a cholera ward had been drawn, as well as in sewers. Hassall also
found in the breath of cholera patients a few, on their linen abundance of
vibrions.
.* Comptes rendas de I' Academic des Sciences, tome LVI. S^Dce da 9 Mars 1863. See also
IfdnKMre snr les Corpuscoles organises in Annales des Sciences Naturelles, tome 16. 4"^ serie.
Etadei snr le Yin, 1866. M^moire snr la Fermentation Alcoolique (1860) and other papers by the
Mine author.
f See Dr. R. D. Thomson's Anal^^is, pp. 285-8 ; and Dr. Hassall's Microscopic Examination of
Xxcretions of Cholera Patients (pp. 269-^07.) Appendix to Report of Scientific Committee on
Cholera Epdiemic, 1854. These Tibrions are -well exhibited in plate 26.
X Aocun infiisoire n'apparaitra dans le Tin, parce que le vin est acidc et que Tacidite les fait perir.
• ♦ ♦ Encore ne Terra -t-on apparaitre que les ferments -v^taux dont la vie peut s'accommoder
d*ane certaine proportion d'acide et d^alcool. Ainsi Jamais de fermentation butyrique dans les Yua,
pavoe que le yibrions qui determinent cette fermentation perissent dans les Uquides acidet. Pasteur^
Xtodes sor le Yin, p. 64.
' Vibrions cmd Vaceinadi. Ixtu
Am Tibrions are found in impure water and wherever putrefaction is going on in
the absence of acids, Hassall did not venture to regard them as the cause of cholera.
The tendency, in fact, when this excellent microscopic observer* wrote, was to
r^ard vibrions and other ferments as results and not as causes of putrefaction.
The habits of the vibrion, the velocity of its development, and its powers of
disorganizing other organic forms, are seen under the microscope. If vibrions con-
stituted the cholera-ferment, difiusion through water, and to some extent through
sewers or air, rapid multiplication in the intestines in the absence — disappearance in
the presence— of acids would be perfectly intelligible. Two vibrions would become
by fissiparity 4, 8, 16, and at the 100th generation at this uninterrupted rate
126,765,000,000,000,000,000,000 if and as generations succeed each other by the
hour this accounts for the swarms in every drop of cholera fluid. It was infini-
tesimal creatures apparently of some kind or other in infinite number that threw
the Thames and the Lea into the fermentation that excited so much attention some
years ago. Their number, like that of higher forms of life, is limited by sub-
sistence, by struggle with other bodies, and by length of life.
The best microscopists insist that it is organized matter still minuter and at the
utmost verge of vision, that is found in zymotic disease. Pasteur calls the stuff,
or zymine, '^ granulations " in the diseased silkworm. Beale designates it degraded
*' germinal matter ** in the cattle disease.^ Pacini names it in cholera '^choleragenic
molecules" {molecole eoleriffene).^ £very one of these little living molecules
moving under the microscope has the power of producing out of suitable matter,
by conversion of force alono or conjunctively, molecules identical in nature and
power : they have all its character of life ; they generate, they die, that is they
are turned into other forms by other forces ; and as with the ova of higher
species the secret of their metamorphic power has hitheito eluded the finest
analysis of chemistry, the highest power of the microscope.
These molecules are well seen and isolated in the vaccine lymph, which contains
a limpid albuminous, saline fiuid, leucocytes, and a multitude of molecules, which
M. Chaveau calls '^ elementary granulations,** and which I call vtwcinads. Like
the particles of tannate of iron colouring ink, they are never completely deposited
in the lower strata of the lymph, and they pass through all kinds of filters {tous
les Jiltres), By decantation the leucocytes can be separated from the plasma,
while the residue retains all the lymph's activity. The albuminous liquor, with its
salts, withdrawn by absorption into an upper layer of distilled water, standing on
the lymph 48 hours, leaves granules at the bottom. Experiments were made with
the two liquoi's, on children, on horses, and on heifers. (1) No effects were pro-
duced by the albuminous liquor. (2) The granular fiuid produced the full effects-
of vaccine lymph, vaccinine.
This was the first result of M. Chaveau*s researche8.|| In a subsequnt scries of
experiments he tiied the effect of pure and of diluted vnccine lymph. First, he
tested the pure lymph by vaccinating successfully a' certain number of patients,
and then found that tho lymph diluted in from 2 to 15 times its quantity of water
took effect in nearly eveiy puncture. This proved that water did not destroy the
granules, of which the number was so great that 10 milligrams of the fiuid, for
* Dr. Hassall was on the first Lancet Commissioii, which did so mnch to detect adulterations of
food. I am not aware that he was ever conTieted by the keenest antagonist of a single micro-
fcopical error of any consequence.
t Upon the assumption that generation is by flniparity, the produce theoretically possible is
shown by the formula n » 2«. This may be called linear deYelopment.
% Dr. Beale figures in motion minute amtAa of the 'OOOl inch in diameter. Fig. 71. Plate T).
He used a magnifying power of 5,000 diameters. '* U the contagium,*' as he calls it, of cattle
plague *^ exist in the form of living particles, these must be less than the 50,000th part of an incli
*< in diameter ('00002 inch), and yet capable of retaining their active and peculiar properties."
Appendix, Cattle Keport, pp. 14S-9.
§ Pasteur on Silkworm Disease. Beale*s Microscopic Researches on the Cattle Plagiie in A pi>endix
to Third Report of Cattle Plague Commission. See also in the same Appendix the papers of
Dr. Anpns Smith, F.R,S. and }£r, Crookes on Disinfection. Du Choleni A^iatique par Dr. Pacini -.
translation of Dr. Janssens, Bruxelles, 1S65.
II See Comptes rendus de TAcadeinie des Sciences, 17 Feb. 1S68, and a subsequent \i>3Sfi>^s!x.
Ixvtii Experiments on Zymotic Diffusion.
instance, were so diffused in 150 milligrams that every milligram of the solution
on the lancet-point contained vaccine granules enough to ensure their propagation
in children and animals. Diluted in 50 times the volume of water the solution
rarely took effect ; when it did take effect the pustule was pure and unmodified.
With a dilution in 150 times its volume of water M. Chaveau succeeded once. Ho
then diluted 8 milligrams of lymph with 3,200 volumes of water and failed with
this dilution to produce the disease after many trials : but reasoning on the matter
he inferred that as the failure was probably due to his missing the floating vaccine
granules {vaccinads), they being still present, ho should get the usual result by
injecting the whole of the fluid into the veins of a horse. He tried the ex-
periment and produced one of the finest specimens of horse-pox.
We can reason still further upon these experiments. As the eight milligrams of
lymph were distributed through 3,200 milligrams of water then the chance of taking
up on the point of a lancet granules enough to take effect would be inconsiderable.
But if the whole of the 3,208 milligrams of the fluid were inserted in the arms of
3,208 persons it is certain that the great majority would escape, and it is pretty
nearly as certain, as the matter of sll the granules would be present and would bo
inserted, that one, two, or more of the vaccinations would take effect. To fix our
ideas, divide the water into eight portions, each of 401 milligrams, and let the one
milligram of lymph remain fixed in the midst of 400 parts of water. Then if a
milligram of fluid is inserted in the arm of each person only one can be attacked,
while the 400 escape ; and so it might bo in the rest of the eight groups exposed to
4;he chance of infection.
3,200 children could be produced in succession as persons who had been all
vaccinated with the water in question without effect ; and, according to the common
fallacy, it would be asserted that the water was pure and stainless. The positive
infection of one individual would be set aside by the preponderance of 400 over
4>ne.
By the logical method, as the proportions vaccinated with effect are by hypothesis
eight in 3,208, while in other series of cases, where pure or a less infected water is
employed, none or one or two in 3,208 are attacked, it is inferred that the vaccine
granules diffused in the water were the probable cause of the eight vaccine
pustules.
But this is an under statement of the case, for the granules would be distributed
irregularly through the water, and thousands of negative instances might occur in
succession without invalidating the induction.
Our excellent English microscopist Beale had, before Chaveau, declared that the
" active properties of vaccine lymph are entirely and solely due" to these cor.
puscles. He has figured them, and says that under very high magnifying powers
they are seen as multitudes of very minute particles exhibiting most active
molecular movements.*
Zymotic matters, which may for shortness be called zymes, have some property
.analogous to those of ferments, which like the torula thrive in oxygen ; or to
those, on the other hand, which, like the butyric ferment, only live in its absence :
these analogies may throw some light on the preference for the skin and the
breathing passages exposed to the air in some, and for the intestinal tube where
there is no oxygen in other zymotic diseases. The cholera zyme belongs evidently
to the latter class.
Again, vibrions, the ferments of putrefaction, are suppressed or extinguished in
acid solutions : they do not multiply in such conditions. They are not met with
in wines. Their antagonists reign in that kingdom.
The cholera zyme appears also, like the vibrion, to suffer in acid solutions where
it docs not multiply j if we can venture to refer the incontestable efficacy of solutions
of sulphuric acid to its effects on the zymotic matter in premonitory diarrhooa.
The permanganate of potash by giving off oxygen might have some effect on this
kind of ferment, not only in water but in the intestines, if it could travel so far into
* See Appendix to Heport on Cattle Flagne, fig. 69, and page 149 ; also ^ficroscope, in its
applicatioa to Medicine ; by Lionel J. Beale, M.D., F.B.S. 3d edition. Plate VII. fig. 43.
Alcohol, Temperature, Fill rat ion. Ixix
a region usually destitute of oxygen. Camphor, aromatics, creasote, carbolic acid,
chlorine, vinegar, and some salts appear to destroy many ferments, and may render
zymotic matter inert How opium acts, as it unquestionably does, in premonitory
diarrhoea is not yet cleared up.
As the state of the stomach and small intestines varies in the different stages of
digestion, it is evident that vivacious cholera molecules in ingested liquids might
iu nine cases out often be destroyed by the gastric juice, or by the other secretions.
If these molecules have the force of ferments, so have the pty aline, the pepsine, and
the pancreatic juice* ; the gastric molecules also convert matter, and in the
presence of acids either hydrochloric or lactic, into nutritive matter ; so it is only
after a struggle, or under unfavourable conditions, that the zymotic corpuscles
carry the day. 1£ the stomach at the end of a meal holds more food than its
secretions can convert, or if taken at an inopportune ju'ncture, perhaps fasting in
hot weather, a glass of cholerized water may be fatal, whereas at another hour
or in another person it may be destroyed, or pass away innocuous.
Alcohol diluted does not destroy cholrine^ as may be inferred from the ex-
perience of the fleet in the Black Sea, where the sailora who drank grog
(=1 rum + 3 cold water) suffered, and the officers escaped. There are other cases of
infected water taken with brandy, as in a r^ase in the Broad-street eruption, pro-
ducing cholera. Spirit drinkers, it is agreed, enjoy no exemption ; nay, as their
digestion is weakened, the foreign ferment the more easily triumphs.
Heat influences all zymotic matter, and carried up to a certain elevation
destroys it. A temperature of 65>^ centigrade \ destroys, says M. Dumas in his
report to the Institute, all the ferments, the known parasitic vegetables, and their
analogies as yet undistinguished in wine. To destroy the germs of the greater
part of them in water, a temperature of 100^ C. is required, and in some cases a heat
still greater; in wines the presence of alcohol ensures their destruction at the
lower temperature of 65** or even 50®.J Cold upon the other hand suspends the
action of these germs. This is also what is observed in cholera. The waters of
rivers, saturated with sewage ferments, present rapid changes at temperatures above-
1 5^ C, and destroy the oxygen ; at the boiling temperature, or at a temperature,
say, of 130® C, it is probable that zymotic matter is rendered inert. Dr. Henry
disinfected scarlet fever clothing by exposure to a temperature of 100® C.§ Boiling
water is evidently a capital precaution. But it must not be assumed, without
further investigation, that cholera matter is invariably destroyed in boiling water^
nnd still less in the waters used for making coffee or tea, where it so often happens
that the temperature never reaches 100^ C.
Filtration, ns has been shown by Chaveau, does not stop the passage of vaccine
granules, nor does it remove the characteristic opalescence of cholera water. One
volume of cholera flux, mixed with 500 volumes of distilled water, produces an
opalescent liquid, which retains its opalescence after passing through filter paper ;
and after passing this filtered liquid rapidly through animal charcoal, the opales-
cence though diminished is not entirely removed* Effectual filtration, however,
removes a considerable proportion of the choleraic matter, and certainly diminishes
its energy ; but, as the process is usually performed, it is far from affording
in fallible security. || This might be anticipated from the exceeding minutenesa
of the choleraic molecules.
Many zymotic matters retain their activity in the dry state, and are preserved
by exclusion from the air.
To sum up the zymotic theory. It is now held by naturalists that each organ
of the body has its proper life ; and that it consists of minute centres of action,
which have been called cells, globules, organic units, germs, granules, and other
names. The cells like the supposed vesicles of the clouds arc now shown to be
* See Carpenter's Physiology by Power, 6th Edition, Chap. IIL
1 149^ Fahrenheit
i Pastenr sor le Yin, pp. 257—262. Biq»pOTt de M. ]>iiinas, after which a gold medal wis justly
conferred on Pasteur.
§ Parkes on Hygiene, 2d Edition, p. 82.
il See notes by Professor Frankland, in Appendix, j^ 116, 151, and 144*
Ixx Mathematical Theory.
solids, and Beale proposes to call them^ '^ germinal matter," which is perhaps a
description rather than a name. ^^ Monad" would serve to designate these living
particles, but as it, as well as the other names proposed, have been already appro-
priated, these units of force and life may be designated biads,* Nearly alike
under the microscope, biads differ infinitely in power and yariety ; for instance
the brain-cells of man in an early stage of development resemble the pus globules
of ordinary inflammation.'!' " Masses which could not be distinguished from one
" another [even by Dr. Beale], manifest the most remarkable differences in power.**
♦ « « By chemical analysis every kind of germinal matter {biad) yields cme
'' substance resembling fibrin, another allied to albumen, fatty matter, salts, and
*' water." Of these biads all bodies are built up.
It is only with particular kinds of these biads^ then, that we have to do in-
zymosis ; and, to give definite form to the theory, while vaccine lymph may be
briefly called vaccinine^ the granules of Chaveau may be named vaccinads ; while
those of varioline (small-pox lymph) are named variolads ; those of syphiline^
syphilads^ and those of cholrine^ cholrads^ — the ^^choleragenic molecules " of Pacini.
It is life in this low form, where it is developed in isolated particles at war
with those which constitute men, that generates zymotic diseases. An epidemic
is the war of a conquering host of innumerable particles of life. It is therefore
subject to the laws of growth and decay, both in the individual man and in
communities.
2. Mathematical Theory.
* ♦ because our Italy contains stall many men, who, preferring the science of medicine with
its sacrifices, to the trade with its gams, will know how to count the cost of this slight
fruit of twelve years of research and thought ; and if in some respects we fail to attain
our aim, we fain hope they will reflect that in magnis et voluigse sat est — ^Pacini.
Pacini accepts the zymotic theory, and shows that the choleragenic molecules
remove the portions of the absorbent epithelium of the gastro-enteric tube,
which then allows the organic water of the blood to escape. He proceeds further,
and after a careful investigation of all the phenomena, advances what he calls a
** mathematical theory " of cholera. J It is the fruit of twelve years researches and
studies ; it is an illustration of the method to b$ pursued in the application of
analysis to pathology, and aflbrds an example of the facilities to be derived from
symbols in involved chains of reasoning. §
All natural phenomena are complicated, and it is only by a process of abstraction
that their laws can be deduced, and be analytically expressed, Take the simple
case of falling bodies : what inflnite varieties of appearances are presented by the
fall of bodies of vanous sizes and compositions through air and water. Galileo^
setting aside everything unessential, fixed on two facts, the space a heavy body
traverses in falling, and the time of its fall, as fundamental ; and then deduced
the law that the spaces described by bodies in falling are as the square of the time.
( ^=o- j • Here is the law 5 but in its deduction all complications are explicitly
set aside. The formula does not, therefore, suffice to express the space through
which in any given time any single body falls in practice. In falling through a
fluid the body encounters a resistance, which varies as the square of the velocity
(«*) ; and depends further upon the form of the body, and the ratio of its specific
gravity to that of the resisting fluid. This can be expressed hy a constant
coefficient for the same body, and the same fluid, say gh^ ; then the space described
by the falling body in the time t is by the equation
♦ fiia force, fiios life.
+ Beale on the microscope, p. 150, and plate xx.
^ Delia natura del colera Asiatico, sua teoria matematica e sua ccmparazione col colora Europco
e con altri profluvij intestinali. Memoria del Dot F. Pacini, Firenze, 1966.
§ On this subject see De Morgan's Logic, Boole Laws of Thought, and the paper by Sir Benjamin
Brodie on the Calculus of Chemical Operations (Trans. Royal Society, vol. 156, p. 7S1. Year 1866.
Pathology, Ixxi
The formula is much more complicated, and the value of the coefficient varies for
.difibrent forms and specific gravities of the falling body or of the fluid. It
is deduced bj an analysis of which Galileo had not the command ; jet it is not in
contradiction with the law of Galileo, which only asserts the operation of a
prluciple under the simplest conditions. For many uses the complications nmj
be disregarded.
Again, Pacini reminds his readers that the resistance (r) of a fluid passing
through a vessel depends on its velocity (v), in a way expressed by the equation of
Coulomb ; r = a t^ -f ^ v» where a and h are two constant coefficients, dependent
on the special conditions. Applying this formula to the case of the circulation
of the blood, if for our purpose we do not want to know the absolute value of
the velocity, or of the resistance, but only their relations as they vary, this is
shown adequately by r'=^a r*, or even by r=r* ; from which we learn that if the
velocity of the blood fall in the proportion of I to |, the force required to carry
on the circulation falls from 1 to j^, and so on ; thus showing how the feeblest
heart suffices to sustain a slow circulation.
If we take a single case of cholera, it is evidently impossible to introduce the
whole of the phenomena into an equation, so as to predict, for example, the
duration of the choleraic process. It is on the selection of the fundamental facts
that the success of the investigation turns ; and here it is necessary to state briefly
the result of Pacini's researches,* and to give in outline his analysis of the
phenomena.
Pacini's researches confirm the Zymotic Theory. In cholera Pacini examined
the mucous membrane of a considerable proportion of the small intestine, after
having washed it lightly with the minutest precaution, without touching it,
to detach from its surface the abundant detritus with which it is covered in
that disease ; placing it under water to render the villi clearer ho noticed that
a very considerable number of villi were gone, and that on numerous spots the
mucous membrane looked like velvet that had lost its pile. Without all these pre-
cautions the absence of villi would only have been detected where the j«havcn siK)ts
were of some magnitude.t He has in the micrographic museum of the school pre-
pared specimens of these choleraic erosions, which resemble the perforating ulcer
of the stomach. Erosions were not always visible ; in some cases necrosed s|>ots
of one or two centimetres square were discovered, whidi, if detached, would have
left such apparent erosions. Some small fragments and several villi wen* found in
the choleraic dejections. AH the villi which were found detached in tho intestines,
and others still adherent, as well as the necrosed patches of the mucous membmne,
were completely invaded by a thick mass of very fine molecules, about the l(XH)th
part of a millimetre in diameter : with these molecules the tis:iuc of necro>sed
fragments was infiltrated, giving it a whitish, opaque appearance, and an unnatural
density and consistence. On the surface of the patches wore similar molecules
enclosed in mucus ; great numbers were agglomerated in small, globular, white
masses, large enough in some cases to be seen with the nuked eye. He cuuld not
however affirm their identity, as they were very like other corpuscles found in
abundance in tho intestinal fluids mixed with vibrions and other infusoria, con-
stituting both in cholera and in health what Bloch has justly called the *^ chaos of
intestinal infusoria." These infiltrated molecules have been found by other authors
* It may be proper to mention that Pacini ia one of the first microscopiBts in Italy, and that he is the
Pro^ssor of Anatomy at the Hloience School of Medicine. I had, vhvo attending the International
Statistical Congress, the pleasure of seeing him at work in hib " ijuthologicul laborator}-," in the
large Hospital of Santa Maria Nuova. He 'was exaiuiuiiifr the (lijcotions and the intext'nu-s uf a
young Danish artist who had just died of cholera. The luboraton- contained many cholera prepa-
rations, both fluid and solid. He had in bottles cholera flux, dooantod Huccessively after standing,
so as to show the various densities of the fluid, :is 1 show thcin in long tubes, lie u^ed, I
believe, bicl)loride of mercury to preserve them.
t Uu Cholera Asiatiqne par le Dr. Ph. Pacini, Professeur il'llistoloi^ic et d' Anatomic Topopraphique
a PEcole de M6decine de llnstitut Superieur de PlorencL>. Trad, de I'ltalicn, ^^t Ux. ^^\^feaK:v^^
Bnaellefl, 186$.
Ixxii Pathology.
in the mucous membrano.* From the first, Pacini felt certain that the erosions
were not inflammatory but traumatic lesions, where the agent, like the edge of a
knifcy cut point after point away, during the whole of the algid stage, and even
after death, as is proved by the detritus chiefly of epithelium on the surface washed
time after time by the cholera flux. The lesions from the first diarrhoea to the
end of the algid stage are then produced by a cause independent of the life of the
individual ; they are wrought by the infiltrated corpuscles, which in multiplying
themselves break down the tissue of the mucous membrane. The corpuscles thus
jnultiplying are living, as in the case of ferments. Now, he adds, as it is shown
subsequently that it is by the desti'uction of the mere surfiice of the mucous mem-
brane that these corpuscles occasion the characteristic aqueous discharges of cholera,
we are justified in admitting that such molecules constitute the specific cause of
cholera, and that consequently they may be called the cholera ferment (cholrine).
The white fiakes are not epithelium but mucus previously formed and carried
down by the cholei*a flux ; the greater part of the lost epithelium disappear-
ing in the stage of diarrhoea.
The flux of Asiatic cholera diflers from that of common cholera and diarrhoea ;
it is not as in those cases accompanied by irritation ; it is passive and painless ; and
the lymph flows out of the surface denuded of epithelium, as the blood flows in
passive hoemorrhage. In the gravest cases the mucous membrane is said to be
colourless, and apparently in the normal state, for the absence of epithelium makes
Jio change in its appearance, and is not visible to all eyes. The flow is in pro-
portion to the extent of surface aflected, at first inconsiderable, sometimes re*
absorbed, sometimes giving rise to borboiygma but to no flux. As the absorbing
surface is progressively attacked the flux increases, and the moment arrives
when the absorbing surface and the excreting surface are in such proportions
that the loss and the reparation are in equilibrium. That extent of excreting
surface Pacini calls limiting ; it is the fatal limit any excess over which drains the
blood of its water. The abstraction in this way of a pound of water from the
circulation is of much more consequence than the loss of a pound of blood, as
in the latter case thirst ensues and the loss in bulk is soon supplied so that the
tension of the blood in the vessels is sustained ; not so in cholera, for adequate
absorption is impossible, the thirst is inextinguishable, and the patient cries
Dut in vain for water to drink. The water gradually running oflT, the volume
of the blood and its hydrostatic pressure are reduced ; the impulse of the
heart grows feebler, the viscidity and density augment, and the velocity of the
cuiTcnt of blood becomes less and less ; nutritive matter is deposited no more in
the tissues ; haematosis and calorification and the pulmonary function fall to the
lowest ebb ; hence the fearful collapse. The secretions dry up, ulcere dry up, and
as the blood is denser and its hydrostatic pressure is diminbhed, its endosmotic
force is proportionally augmented ; it does not nourish, it is nourished by the tissues ;
venous absorption Increases and the thirsty blood sucks up from every fibre and
cell every drop of accessible organic water. The vocal chords sound no more,
cramps shake the muscles, the glands secrete no tears, no bile, no urine. Tho body
is dried up like a mummy ; yet the brain amidst the vast disorder, shielded bj the
skull, and sustained by the atmosphere, loses little of its organic water and retains
its faculties for some hours, until lulled mercifully into a semi-syncope of sensibility,
it at last dies.
In the cases of cure these steps are retraced, and the shoi*ter, sharper the attack
the speedier the recovery.
As the blood absorbs the decomposed tissues it becomes contaminated ; hence, if
the algid state is protracted and reaction comes late secondary fever follows. I
mnst refer to Pacini's close and well reasoned papers for tho details of pathology.
But I will proceed to show how he has succeeded very happily in constructing
Irom the well observed facts of pathology, physiology, and physics equations to
express tho laws of the phenomena.
^ See Dr. Gull'f lodd Beport to College of Physicians on Pathology of Cholera, London, 1854.
Fundamental EquaHontm Ixxiii
He takes as an example the case of a man of moderate build, weighing 65 kilo*
grams (143 lbs. = 10 stone 3 lbs.) ; of which 20 are solids, 45 are water, com-
prising 20 kilograms of organic water in the targescent tissues. The blood
weighs 7 kilograms; 1*47 are solids, 5*53 water. From a multitude of chemical
analyses of the blood he infers that at the point of death it has lost an average
quantity of its water equivalent to 1 kilogram. The quantity of blood-water lost
at death be expresses by the S3rmbol A. He takes this quantity as constant, for
reasons which he assigns, among others the common observation that '' the blood
*^ is always dense and viscous without notable difference in the several cases, be
" the quantity of the flux or the gravity of the case what it may." The superficies
of the intestinal tube including the superficies of its valves and its four million villi,
equivalent to three times the plane surface upon which they are implanted, he sets
doTin at S = 30,000 square centimetres, including for the stomach 1000, the small
intestine 26,000, the large intestine 3,000 square centimetres.
When a small portion of the intestine ia invaded, the premonitory diarrhosa is
the result, and the symptoms increase as the surface affected extends until the
cholera limit is attained ; this limit he fixes at « = 2000 square centimetres, and
at this initial point the water exuded from this surface (2000) is equal to the water
absorbed from the rest of the intestinal tract (28,000) =: S — «. As the quantity
of superficies c increases, the exudation surface {s -f- c) increaseSy the] absorbing
surface diminishes as it is always S — (« + e).
The initial velocity of exudation at this point when the whole of s is invaded may
be represented by a = 0*2 gram, from one square centimetre of superfices in one
hour ; and the initial velocity of absorption over the sound absorbing surface
being represented by a' we have this equation :
,, ^ _ * /o .\ . ^f as 0-2x2000 400
^ ^ • S — * 30000 — 2000 28000
= =^ = '0143 gram.
Here a = 14 a' and in the unit of time a$ + <ic =■ effusion ; while {a' (S — »)
--^ a'c } = absorption ; then subtracting the quantity absorbed from the quantity
exuded wo have (1) 8 = ac ^^ ^ = quantity of the dejections in the same time
unit = the immediate loss of the blood-water. But this is repaired to a certain
extent by interstitial absorption of water into the thicker blood from the tissues ;
so the real loss of water by the blood is less than ac ^ ^ ; it is in fact (2)
(g -L c\
«^ — e — > if it is in direct proportion to * -f e and inverse proportion to S,
which supplies the whole of the blood in the normal condition. Subtract then this
special loss of the blood- water from the total loss (1) and we have the amount of
oc S 9 '\- c
interstitial absorption (i) in a unit of time = t = k ^ m "" ^^ — ft~" = ^^
These are fundamental equations.
Resuming. To reduce the problem to the simplest form Pacini restricts the
investigation to cases of cholera fatal in the algid stage; the complication of
cases of recovery and of reaction are thus eliminated ; he takes a man of average
size ; he assumes that death ensues when the man loses from his blood a given
quantity of water A, which further to fix our ideas is taken in the figures at 1 Ai7o-
gram by weight. The intestinal tract of a superficies of S (= 30,000 square centi-
metres) is constantly pouring out and absorbing among other matters water by
exosmosis, by endosmosis, or by other forces ; the large balance in favour of
absorption is expressed by the difference between the ingesta and the egeeiOy and it
is all absorbed by the surface S in the normal state; but the cholera molecules rapidly
convert the surface s which was absorbing in excess, into a snrfiMse e>iSDA^^'cv% Vq.
excess and carrying off Wood-water, but not more than la uanv^^AaX^'j x«^J^a#yiA Vj
Ixziv • Collapse,
absorption from the sound surface which may reabsorb some of the flux ; when
the abraded surface extends beyond ^ to ^ + c of the surface the effusion firom
(# + e) exceeds the absorption from the sound surface, and the loss of a part of A
commeDces : cholera has set in. The case goes on until A is exhausted, and the
time (T) in which this takes place bears a definite relation to the variable e. The
surface {s + c) is absorbing as well as exhaling, but only the excess of water
effused after deducting water absorbed by this surface is taken into account ; it is
fixed when the surface c is first attacked at a velocity expressed by a, which for
various reasons is set down as constant. So is the rate of regulating the flow of
water from the undestroyed surface.
The whole of the water (R) effused into the intestine frofn the surface afifected
does not appear in the fiux, as it is diminished by E, the water absorbed. The
flux in a given case is expressed by D = R — E. The greater c grows before
death, from the nature of the equation the less is the effusion, the less is the
absorption, and the less is the flux. This agrees perfectly with the observed
facts ; the more violent the case the less is the absolute amount of the flux. It is
the case not of the cholera sicca for it never occurs, but of something near it.
What is constant in all cases is the absolute loss of the water A by the blood ; bat
the time in which it takes place varies as c varies. Then the quantity of the
aqueous loss is made up by the absorption of organic water (I) from the tissoes,
so that D = A 4- 1. The quantity of water drunk in cholera and merely passing
through the intestine is excluded from D.
The velocity with which blood is lost is of consequence as well as its quantity,
so also is the velocity (A) of the loss by the flux : it is at the rate of about *75
kilogram per hour in the shortest case, half this or '36 in the case of 18 hours
duration, and only '11 in the case of 120 hours duration. It is obtained by
dividing D by T.
The severity of the case is inversely as the time ; Pacini calls it the gravity of
1
the attack. It is expressed by G = y' Thus a case terminating in 12 hours is
ten times as grave as a case fatal in 120 hours. The blood-water escapes with
tenfold velocity.
E
The equation e = i p<^ - > = the fraction of aqueous absorption from the intestine
when that from the whole tube in the normal state is taken for unity ; it is only
0' 103 in a 3 hours case, and 0*803 in a case of 120 hours.
Collapse creeps on as the water — the volume of tbe blood decreases as its
hydrostatic pressure decreases, as it ceases to transmit the stroke of the heart, as
the blood by its viscidity resists the nutritive action of exosmosis on the tissues, on
which nutrition and life hang : this state of debility and syncope is collapse (C) •
which may be expressed by the proportion the water of the blood taken away in
the time t bears to the quantity to be taken away before death. Let the loss in a
unit of time be expressed by a = ^, then Ta = A ; and C = ^ _^ = jr^;- —
This is equivalent, as a is taken to be uniform, to assuming that the loss out of ^
is always proportional to the time t that has elapsed from ttie origin.
It follows from this series, of which examples are given, that the collapse is
in all cases not only the same at death, but is also the same in the middle point
A A
of the time the case continues ; for then -^ has been taken, and -^ has been left,
2 A
and the ratio of one to the other is unity = o~r.
The collapse in the first hours increases much faster in the short cases than in
the long cases.
The degree of collapse alone does not indicate the distance of death. When the
same degree of collapse in one case expressed by 1 = -« has been attained in 8
hours as in another of the same degree has been attained in 12 hours (l = j^)
the latter case will probably go on more slowly and will terminate much later.
Final Equation.
On the contrary tlie degree of collapse in the last hour before death will be
expressed bj 5 in a 6 hours case, and by 23 in a 24 hours case : it will be four times
greater in the slow than in the fast case, which by its greater Telocity reaches
the goal at the same moment as its slow rival.
Pacini makes the quantities represented by A, S, «, o^ and a constant, while c
AS 2# +
and T are dependent variables in the equation T = g— . ^^ . v ; where T (the
duration of case) is a function of c (= efiusing Intestinal superficies in excess of «),
the T varying inversely and more rapidly than c, which is squared. By inserting
arbitrary values of c Pacini obtains the correlative values of T. From these he
readily deduces the other elements. It is the easiest form for calculations such as
Pacini has given. But as T =: the duration of fatal cases is ascertained by direct
observation more readily than c^ it appears to be convenient to enter the table by
the time, and thence to pass to the value of c, as can be done by the subjoined
equation, where 6 = # » 2asT ^ ^^^ ^ ^ ^T* '^ ^ equation is quadratic
the double sign occurs, but the plus sign alone is applicable to the case in hand.
''=-|±¥\/^''+*'
Here 4d= 600^000. „^j^2(^ _ 87^
Pacini remarks that Asiatic cholera differs essentially from European cholera,
in which the fiux is produced by secretional or oatarrhal irritation, proceeding even
to the verge of inflammation.
** Nel colera Asiatico abbiamo veduto, che il fermento colerigeno, per I'azione
meccanica resultante della sua moltiplicazione riproduttiva, distruggendo o distac-
cando I'epitelio, dk luogo ad una vera linforragia traumatica o passiva, come una
emon*agia per ferita. Invece nel colera Europeo h note che il profluvio intestinale
e prodotto da una irritazione secretoria o catarrale della membra mucosa, irrita-
zione che pud avere anche la forma di una decisa infiammazione ; ed ognuno pud
concepire le miile cause esteme ed interne che poisono eccitarla (pp. 114-15)."
In the one case the fluid is aqueous, like Ivmph, in the other bilious and acrid ;'
in the one case there is only a sense of sinxing fulness, in the other sharp and
severe pain, increased by slight pressure. The intensity of the flux from irritation
may drain the water from the blood, and then give rise to the same symptoms as
Asiatic cholera ; but here the superficies a£fected is less extensive than in the
insidious form, and the danger is therefore less.
The extent of superficies affected is the capital fact ; and it is the same in the
case of irritations of the skin, detaching the epidermis and giving rise to effusions
of lymph. A small blister is of little consequence, a large blister may prove fatal
to a child.
In burns and perhaps in small-pox also the relation between the extent of skin
affected and the duration of the patient's life may probably be expressed
analytically.
In bronchitis and in influenza the same method of investigation is applicable ;
as in the prognosis the extent of surface involved measures the danger.
St/mbolt.
A = the blood- water withdrawn by the cholera discharges from the time any
part of c is affected until death — its loss by hjrpothesis is taken to be
fatal. It is set down as 1 kilogram in a man of 65 kilograms weight
(143 lbs.).
Abto.— Pacini estunatss the blood ad 7 kilognms (—1*47 lolids + S * 58 water)
in a man weighing 65 kilograms ; of which 20 kilograms are BoUds, 45 kilograms,
are water ; while of the 45 kilograms no less than 20 kilograms are ezcess of
organic water giying tugeseeiioe to the tissues.
Ixxvi SymhoU.
a == Tp- = the intensitj of the aqueous loss from the blood ; it is the ratio
of the whole Time of the cholera process (T) to A.
a = Telocity of effusion from (s + c) at the origin of c ; that is the qoantitj
effused in a unit of time from a unit of superfices; taken at 0*2
gram, or 0*0002 kilogram, from 1 square centimetre, in 1 hoar.
Note. — By Vierordt's estimate the Ingesta of a strong well-fed man aie
3-209 kilograma daily: deducting 0*172 for feces, 3*037 kilograms nre left.
This is absorbed daily by the mucons membrane of the intestinal tube, at Hat
average rate of 126 grams hourly ; bat this quantity must vary from hour to
hour, and be at a maximum during the process of digestion, when the ^tended
intestine is full of osmatic matter. On dividing by Pacini*s number, 30^000, the
average absorption is at the rate of * 0042 gram per hour for each square centi-
metre of surface. He makes the absorption factor at the time of the eholeni
attack *0143, or more than three times greater than this 24-hoiir average.
And it is very probable that the cholera molecules enter the villi chiefly
during the period of active absorption, when endosmosis is strongest. Nearly
8 * 553 kilograms* of matter, principally water, are, according to the best esti-
mates, poured into the intestine and absorbed again daily, with the 3*036
kilograms of food and water. Pacini only deals with the latter quantity.
a' = velocity of absorption from the absorbing surface of the bowels.
i
C = rp ^ , = collapse at end of each hour of time (t) ; and when i ^T
this becomes - =r oo .
o
c = the excess of effusing mucous surface over and above s, and immediately
giving rise to characterized cholera : now cholera haa beg^n ;
effusion exceeds absoi'ption.
AS*
D = .^ __ V . V = total dejections in declared cholera^ including those
retained in intestine, — exclusive of increment from increase bj
drink. Diminishes as c increases.
D 2 Base
A = rp = /|g ^ ^\ /2g J, c) ~ *^® velocity of the flux— which is importanly
as it is in the correlative case of haemorrhage.
E = AS /g\_ ^ ( 4- ^ • ~ = the whole of the water absorbed fitm the
unassailed superficies of the intestine = (S — « *— c), during the
cholera process.
e = ^S^"" — — = the fraction of absorption from the inteBtine, the
normal absorption being taken for the unit.
6 = ^T-G-7n — x^ V ~ gravity of the cholera case : it increases rapid! j with c»
* Bidder and Schmidt estimate the quantities for a man of 89 kilognmis. The Germaa is sy i
cent heavier than Pacini's model. See Carpenter's Physiology, Sixth JSdition, pp. 825-6.
I^ndoltm Ixxvii
I = A • — T^ 2, \ / \. \ = ^^® whole of tho interstitial aqueous absorption
from tiio tissues of the body during the cholera process. The
quantities are connected with D and with each other by the general
equation ;
D = R — E = A-fI.-. DJ-E = R = A + E + I:
Which may be read thus : — The cholera dejections consist as to
their water of the difference between the intestinal aqueous
effusion (R) from the surface (# + c), and the quantity of water
absorbed (E) from the residual surface (S ^ # — c). The water
which they carry off is made up of that lost (A) from the blood,
and of that taken (I) from the tissues.
S
R = A. - = the whole of the choleraic aqueous effusion from the superficies
c
{$ + e) of the intestines.
S = mucous superficies of tho gasti*o-intestinal tube, taken as 30,000 square
centimetres.
S — (« + ^) = the sound surface of mucous membrano still absorbing the
fiuid matter of the intestines.
s = the limiting superficies^ over which the choleraic effuAion may extend
without producing the characteristic 83rmptoms of algid cholera ;
taken at 2000 square centimetres : cholera dates from the moment
this limit is passed.
s -\- c :=. the whole of the effusing surface in cholera ; it is taken at 2000 + c.
T = time or duration of whole cholera process in hours, reckoned from the
moment that effusion exceeds absorption to death.
Pacini calls attention to the circumstance that the factor of intensity a does
not appear in many of these equations : it is only brought into account where tho
element of Time (T) is concerned. Then if ac -^ - is put as the loss of water
by the blood in a unit of time, and the time to transpire before tbe fatal quantity A
of water be taken from the blood be T', then evidently T* ac ~jr- = -A. ; and
AS
T' = --?-- v~x— • Now, as the velocity both of effosioQ and of absorption depends
upon the velocity of the blood in circulation, it Is evident thai the velocity of
effusion and of absorption will decrease as the circalation decreases i so cnufe
grow less and less, and so will the factors of the velocity of the two absofpftioBS^
which are implicitly involved in a, the factor expressive of the vdodlj of
AS •
Consequently T' = ^^ x is the inferior limii ; it Is the
duration of the fatal case.
To obtain the superior limit of time T'', ummtb Ihai il^^ ^
exceeded by an infinitely small quantiiyi then in ewj iatkm^ *
small portion of A will be lost : hence the eShskii fa' fta i
fnocnu
Belated Pheifiamena of Cholera.
otf + — ; tbeoy as A will'. only .be expended in the time oo^ we hare in that
time for the whole amount of effasion qd cm. + A. Now we have this proportion;
00 cw 4 A : 00 :: R : T" = "^ ^ . = -
AS
or, substituting its value for R^ we have "F' = — , which is the superior limit.
Taking the mean of the lowest and highest limits — ^thus dednced^-the effective
'time is obtained ; and
T+ T" _ AS A§._ A S (25 + c)
2 " 2a(/r H- c)c "^ 2ac8 ~ 2a8{s + c)c'
T =
The duration of cholera when fatal is prolonged by two circumstances ; hy
the realizable draught of the blood for water on the tissues, and hj the retarded
"circulation ; but the supply of water from the tissues is not inexhaustible, and
the retardation of the arterial flow can only stop the flux by stopping nutrition —
that is by death.
The absorption factor e is thus deduced : Let a' be the factor expressing the
velocity of intestinal absorption in the normal condition, then from the ^bole
C2 (2s 4- c\
surfjace S in the time T the absorption will be TSo' = A . n/o \ / i x *
«- o(S — # — c)*
But £ = A .g _ ^\ /, . ^\ • is the total aqueous absorption from the intestines in
declared cholera ; and diriding the last by the first equation ^rg-> = g (2^1^\
= €, the fraction of absorption in cholera when the normal absorption is taken
for unity.
Table of the chief belated Elements of Algid Choleba.
C 8= -
- b ± ^Kd + i« (See p.bxT.)
DUE1TI05
TWTWRTTTtAT.
Velocity of
Ihtebtikal
OF Fatal Oasb
BUPERTICIXS
Flux
Flux
Absosftiok.
(T)
APFECTED.
inKilogranu.
(Ordinary
abflorptioo s l)
•
DfM.
Hours.
(c + 2000)
(D)
(A)
(e)
•
1-48
80.000
1-071
•760
•0000
•
2
22,423
1*484
•717
•0114
8
18,057
2002
•667
•1030
4
12386
2*504
•626
*1543
5
10379
2*965
•691
•1980
8
9358
8*868
•661
•2368
12
6^48
6*282
•486
*3906
18
4,929
6*621
•862
•4824
1
24
4b291
7*491
•812
•6449
80
8398
8*257
•275
*5907
86
8318
6*884
•247
•0261
42
8,415
9*412
•224
•6546
•
2
48
8360
9*860
.•205
•6778
8
72
23S2
11*158
•165
•7406
4
96
2,682
11*985
•125
•7780
6
120
2357
12*671
•105
•8030
e
144
2,471
13008
•090
•8210
■
Tbe Ta)>le.iDay be read thus : (1) in a faUl case of 2 hours duration it may be inferred that 22,423 oentinMftiM
or the intoBtinaTraperfioss are invaded ; that the flux is 1*434 kilograms, (less than 8 pints) : the velodtyoTtha
fin la e i p ro a s edby 717 grams per hour ; the intestinal absorption is '041 i of the ordinary abs(»i>tioii taken iS
tmily. (t) In a flbUl case of S4 hours duration 4,281 centimetres of intestinal superOccs are invadecL Umi flut
•iiUMmt8to7'4911[ilogramii the Telocity of flax if 312 grams per boor; the absorptioa is •Ui9.
Air^ Water, Contact.
Prooxsss or Ooixipbx $ tbowittg tiie Degree of Collapse (C) at the end of f hom m caaes
of 6, S4, 48, and 72 hoars duration (T).
DinUTIOK OT
Fatal Cases.
CojLLAPsa AT DirraaurT Btaois of Fatal Cbolisa. (in t Hours.)
iHoor.
tHoot.
SHonn.
4Haiin.
• 5 Axirs.
OoUaptein
Mi(ldk) Hour
iialwtjt
equal to imtty.
List Hour
befbre
Death.
Death.
6 hour case
48 „
72 „
}
A
A
A
A
A
*
A
1
1
1
1
5
23
47
71
Let X «- duration of case in hours, then collapse at end of first, second, third, x hours is expressed
by this general formula : —
1 2 3 • • • • . ^-^ * ,, -^
The preceding theories deal directly with the material caiiaea and the pathology
of cholera. We now come to theories of the dififhsion of cholera.
3, Air^ fFater, Contact Theories.
Hippocrates in his great work sought the causes of epidemic diseases in earth,
air, aud water. The discoveries of the nature of air by Boyle and others Axed
attention on that element in the last century ; in recent times air has had its
sectaries, and so has water ; but as the air of London is not supplied like water to
its inhabitants by companies the air has had the worst of it, both before parlia-
mentary committees and royal commissions. For air no scientific witnesses have
been retained, no learned counsel have pleaded ; so the atmosphere has been freely
charged with the propagation and the illicit dififusion of plagues of all kinds ;
while Father Thames, deservedly reverenced through the ages, and the water-gods
of London, have been loudly proclaimed immaculate and innocent. If diseases
spread they did it not, it was the air.
In vain did the sewers of London and of twenty towns pour their dark streams
into the Thames and the Lea ; their waters were assoiled from every stain by
chemists who had carefully analysed specimens selected by the water companies,
and demonstrated the inevitable effects of the operation of oxygen on all sewage
in running streams. One scientific witness who was deservedly trusted at the
time in the courts of law, was so convinced of the innocence of his clients, that
he stated in evidence how before delivering his lectures it was his practice to
drink a glass of the Southwark water, in which Dr. Hassall subsequently detected
muscular fibre and the other ingredients of sewage.
Dr. Snow's theory turned the current in the direction of water, and tended to
divert attention from the atmospheric doctrine, which in London has received little
encouragement from experience.
The atmospheric theory has been nowhere clearly announced. But in one form
it assumes that cholera originating in the East, after the lapse of months, traversed
the Continent and found its way to England, '' when the east end of London terribly
** felt its shock, resulting in an extraordinary mortality, mainly attributable to
" masses of filth in various forms :" there was a calm for several days; then, it is
asserted, a continuous wind, chiefly north-west, conveyed this poison-fraught air
direct through the heart of the cholera field, " tolerably co -extensive" with the field
homi Prevention; Poet Office^ Cuetome^
V. PREVENTION OF CHOLERA.
i. Efficacy of Preventive Personal Measures ; Post Office, Ctistoms^ Armj^,
Navy, Police,
The experience of the public services establishes the efficacy of the medical
treatment of the diarrhoeal stage of cholera beyond doubt.
The Post Office, during the epidemic of 1854, had 2865 men in its employ at
the London office ; among them were 2130 cases of cholera and diarrhooa, and 5
cases proved fatal. The death-rate on strength was 17 in 10,000. " Two of the
" men were absent on leave, and were not seen by the medical officer ; the other
'^ three lost their lives entirely because they neglected to apply to the physician
*' until they had been suffering from diarrhoea for some days."* During the two
months, 15th July to 15th September 1866, no less than 262 cases of diarrhoea
occurred among 1325 men attached to the head office ; some of the cases were
obstinate, but none was fatal. In Bethnal-green a man with his wife and child
was attacked ; the wife and child died of the complaint, the man recovered ;
he had immediate recourse to the medicines supplied by the department, and
after three distinct attacks left the neighbourhood alive. Among 975 men nortli
of the Thames, 218 cases of diarrhoea occurred ; the proportions varied from 11
cases in 158 men in the western district to 80 in 165 in tiie south-eastern
district where 49 in 100 men had diarrhoea, while in the west the proportion was
only 7 in 100. There was no death, although the men evidently experienced the
eifects of the poison.
As the men are often attacked in the night, and the diarrhoea in a consideraUe
number of cases turns into cholera in 12 hours or less, the remedy should be
always at hand day and night during the epidemic season, and the men should be
kept constantly on their guard. These conditions were realized by the precautioos
taken at the instance of the medical officer, with the happiest result. The mea
were recommended to take only boiled water, and to attend to tiieir drains ; tber
wore supplied on demand with disinfecting powder, and put on a good regimes.
The letter-carriers, in addition to an astringent mixture, kept in their pockets i
small roll of candied confection of opium, of which a dose was to be taken at (mee
if they were attacked with diarrhoea while delivering letters. f
The utmost precautions were required and were taken in the infected distridii
the men were well handled, and were all carried through the epidemic alive.
Dr. Walter Dickson gives an account of the health of the out-door officeis.
watermen, and other inferior officers of Her Majesty's Customs in 1866. 853 ait
stationed in London, and 600 of them lived in the Tower Hamlets. 296 of tk
men are stationed at Gravesend. Twenty men were placed on the sick list ftf
diarrhoea at Gravesend, and one had choleraic symptoms, but recovered, li
London 55 cases of diarrhoea were put on the sick list; 10 cases were severed aa^
in a few cases convalescence was protracted ; one out-door officer, aged S9 die'
of cholera. He was in the habit of taking Cockle's pills with impunity ; but oi
July 25th he swallowed two pills when on duty ; their action was unusuallr i
<* brisk," and was soon followed by " intense collapse," from which he ralliti
* MS. commonication of Dr. Waller Lewis, by whom the other particulars were also Jdifir
supplied.
t 151 gaUooB of an astriiigent mixture at a cost of 113/., aad 3500 rolls of the candied conftdto
of opium at a cost of 25/., were distributed among the London Post Office establishments.
Dr. Waller Lewis prescribed also what he calls a " sulphuric orangeade," thus compoosie-
Dilute sulphiuic acid, concentrated compound infUsion of orange peel, of each 3 oz. ; synmlS^
boiled filtered water four gallons. A wine-glasslUl may be taken for a draught, with the addil^ I
of more or less boiled and filtered water according to taste. 1350 gallons of this bevenuR ^
eontumed daring the prevalence of the epidemic ; it superseded to a g^eat extent raw 'vnScr ^
bad beer ; iu cost is only A^d, per gallon. The idea is excellent, as in hot weather ma A^'
anytfai]^ and tUt iupenedes noxious waters.
Army, Namf.
\m\\\
to die, however, of consecutive fever on the tenth day.* Another out-door officer,
old, and suffering from heart disease, was carried off bj diarrhoea. There were
four times more cases cf diarrhoea than in the preceding year ; but only one or at
most two deaths. These men are employed all day on or near the river ; they
come more than other people in contact with persons from infected ports, and they
often reside in the very streets which suffered most severely. Their hou.nes are
we are told, with few exceptions, clean and comfortable. The deaths from
cholera among the same class amounted to 27 in 1832-3, to 14 in 1848-9, to 3 in
1853-4, and to 1 in 1866. The mortality decreased in the same proportion as the
precautions increased. The men are all instructed on no account to neglect
diaiThoea in its early stage, but to apply at once for relief; and they are all
supplied with simple and safe remedies. This is another proof of the efficacy of
treatment, even among men exposed to the cholera in every way, and actually
attacked in numbers by diarrhoea.
Dr. Balfour has shown that the deaths of soldiers by cholera in Great Britain
during the epidemic of 1832 were 60, or at the rate of 27 in 10,000.t The Guards
* Eleventh Report of the Commissioners of Her Majesty* s Custonii ftyr thejyesr 1866, p. 120.
I The following extract from a paper by Dr. Balfour gives the history of cholera as it appeared
among the troops quartered in Great Britain and Ireland during the years 1881, 1832, 1833, and
1834. It is particularly interesting, as the deaths of the ctril popolatioii were not then all
registered, and the civil returns were imperfect : —
*^ During the summer and autumn of 1831 bowel complaints were unusually preTalent aild
severe, both among the military and civil population, and several cases closely resembling spasmodio
cholera were reported to have occurred. The first uneouivocal case dT the disease, howerer,
appeared at Sunderland on the 26th October, though not officially notified by the Local Board of
Health to the Central Board in London till the 1st November.
^^ The first recognised case among the troops in Great Britain occurred in the 3d Light Dragoons
at Piersbill Barracks near Edinburgh on the 2d January 1832, and the second in the GreniMlier
Guards at Kni^htsbridge Barracks, London, on the 30th January. No further case occurred
among the military till March, when 7 admissions and 4 deaths were reported in the Coldstream
Guards in London. From this period the cases ^[radnall^ increased, occurring in diir< rent corps
throughout the country, till the disease reached its maximum in Angnit, when the almissions
amounted to 71, and the deaths to 32. It then rapidly subsided, and in November the troops in
Great Britain were entirely free fh>m it. In December it again broke out in Portsea, ano several
cases occurred in that and the following month.
" The greatest number of cases in 1832 occurred in London, Plymouth, and Glasgow.
" In 1833 and 1834 cholera appeared occasionally among the troops, but was chiefly confined to
those quartered in the large towns where it still prevailed among the civil population, the minority
oi the cases having occurred in London, Manchester, Exeter, Portsmouth, and Sheemess.
" The following Table shows the prevalence and mortality by this disease among the troopt
in G&EAT Bbitain and in Ihblaud in each of these years :—
ASMT nr OlBAT Bbitaiv.
Ybabs.
1
Strength
of .
Txoops.
Oases
of
Cholbxa.
Deaths.
Batio per 10,000.
Admitted.
BML
:
1898 \
1838 !
ISM
Total .
22,066
21321
19,251
174
51
27
60
19
7
79
24
14
27
9
4
62,638
252 86
40
14
Aemt 19 ImBLAjrn.
1832
1833
1884
Total -
23,617
21,293
19,336
712
172
127
178
68
54
800
80
65
78
24
28
1
64,146 1,011 179 157 1 4S
*< In Enp^laud in 1832, of 2d Life Guards 5 died. Grenadier Guards 7, Coldstreams 7, Scots Fusilier
Guards 2, m all 21. Then 9 died of cholera in 1833, and 2 in 1834. Three of the Coldstreams
died in Ireland in 1832, and 1 of Scots Fofilier Ootids ill Xasi.**
1^>ttee.
in London lost 16 in 4676 men in the year 1832. In the jenr 1866 the Director
General of the army, Dr. Logan, is able to furnish proofs of the efficacy of preventive
measures. The Guards did not lose a man. Out of a force of abont 8380 men
in London and Woolwich, 2 men died of cholera in Woolwich ; this is a little more
than 2 in 10,000. In all England, including tlioso 2 men, 5 sc^diers died of cholen
out of a strength of 54,500.
The navy, out of a mean force of 23,080 men on the home station, lost 7 by
cholera in 1866; the mortality was at the rate of 3 in 10,000. Dr. Bryson,
the Director General, drew up some judicious ** precautions ;" and great pains were
taken to get the men treated in the first stage.
Observations in various public establishments^ such as the school at Limehosfle^
the Albert Works in North Woolwich, and the houses in the worst districts
brought under efficient house-to-house visitation, tend to show that cholerisation,
if the word is allowed, can be arrested in its first stage by medical treatment.
The Metropolitan Police Force was not quite so fortunate, as in a force of 7S72
teven died of cholera ; and it is a striking fact that these seven men died in three
East London Divisions out of a force of 1162 men. The mortality of the force
stationed in Stepney and Whitechapel — the Old Ford waterfield — ^was at the rate
of 74, in Finsbury 28, in the rest of London 0, in 10,000 living. The agg^gate
mortality was not by a fifth part so high as in 1849, but higher than in tlie
Customs.
METROPOLITAN POLICE.
Bjeturm showing the Kuxbkr of Deaths which haye occurred in the Mbtbopoutait ^uci
FoBCE darmg the under-mentioned years, distinguishing the Number of Dkathb flam
Cholera in each year, and giving the Total Numbers of all Banks who belonged to tht
Police Force on the Ist July in each of the years mentioned.
TlAft.
Total
Strength
of
Police.
Number
of Deaths
from
Cholera. .
Number
of Deaths
from
other
Causes.
Total
Number
of Deaths
from
' all Causes.
1
REMings,
1848
1849
1853
1854
1866
•Of which in 1
EaftLondon /
Elsewhere -
4,900
6,510
5,602
5,681
7,37a
87 i
1
1
2 i
18
7*
1
36
35
39
34
- 57
J
36
62
41
52
64
The deaths fhmi Cholen
in 1866 oceorred in the fol-
lowing Divisions x .
G. or Finsbury - i
H. or Whitechapel - 3
K. or Stepney - s
The strength of each of
those Divisions on the Ist
Julj 1866 was :
G. - - 850
H. • - 235
K. - - 577
1,162
6,210
t
7
1
1
54 201
1
255
MttnnMan PoHct Force,
4, WhiUhaU Place,
lOCfc Februatf 1868.
2, Quarantine.
Gontagion has given rise to passionate controversy, especially in oonnei:ion wam*
^Ukrantine. The word still strikes terror into all the nations on the Mediterranean
woept the Turks ; and vexing quarantine is still their idol, although it forever
*•«» to protect them from violent eruptions of disease.
Quaraniine; the praetiee qf Sngland.
Now contagion is deprived of its terrors by the discovery ihftt it acts throogb
the agency of cholera flax in air or water, and when it actually enters the body
only gives lise to disease in some cases which can generally be arrested by prompt
attention in the premonitory stage.
The rigorous precautions to take are careful abstinence from contaminated water,
the destruction of the flux, the disinfection of soiled linen, and in certain cases the
removal of inmates from ships or houses. The isolation of the sick is generally
unnecessary ; but in a seaport they may be very properly treated in special
hospitals for the reception of the patients suffering either from dlarrhosa or
cholera.
The practice of England, where cholera has been kept within narrower bounds
than in other countries, I humbly submit, deserves the serious attention of the
people of the continent.
It 13 here a settled principle that the sick are under all circumstances to have
the help they require, at any risk either of the lives of nurses, of medical men,
or of the community at large, which, by abandoning the wounded in the battle of
life would violate a fundamental law of its existence. No medical man ever
shrinks from the discharge of his duty. The same spirit has shone in nurses and
sisters during the last epidemic ; and I witnessed myself the devotion of the
women to their husbands and children in Poplar. The succour of their friends
in agony was evidently with them a sacred duty, and a point of honour against
which the risk to their own lives did not weigh.
Est hie, est animus lucis contemptor ; et istum
Qui vit^ bene credat emi, quo tendis, honorem.
I might cite as an example the relief which the people of Liverpool yielded to
the German emigrants in the recent epidemic ; but a simpler instance will serve to
illustrate the usual conduct of the people in a smaller town, and at the same
time to show how well their humanity was appreciated on the other side of the
channel.
'' On a certain dav in September 1866 two French flshing-smacks, *' S. Josephc '*
and the " Franclin,' were off the port of Scarborough, with ten of their crews
affected with cholera. The fact being made known to the then mayor of tfao
town, Mr. Ambrose Gibson, he gave orders for their removal to the workhouso
infirmary, which order was promptly executed. The result, under the skilful
management of Dr. Taylor, the surgeon, the assiduous attention of Mr. White,
the master, and the liberali^ of Mr. Woodall, chairman of the board of guardians,
was that eight of the unfortunate sufferers were restored to health. This fact was
communicated to the French Government by the vice-consul of France to the
district. The poor fishermen returned to Fecamp full of gratitude for the kindness
they had received at the hands of their English neighbours, and they expressed
their gratitude in enthusiastic terms. The inhabitants of Fecamp assembled in
public meeting to express their admiration at the humane and noble conduct of
the authorities at Scarborough, and they voted to Dr. Taylor a case of surgical
instruments, and a bronze plate to Mr. VToodall, to be pemunently placed in the
workhouse infirmary. To each of the gentlemen named above was also presented
a written testimonial of the gratitude of the people of Fecamp. These gratifying
proceedings were terminated by reciprocal hospitalities on the part of Commander
Yence, of the French navy, and the Mayor of Scarborough.
'* This simple narrative exemplifies the truth of the adage that ' peace has its
victories as well as war.' Such acts of humanity tend to cement the friendship
of rival but not hostile countries. They give fresh force to the aphorism of the
greatest amongst Englishmen, that * one touch of nature makes the whole world
kin." —/rom " The Lancet'' of 24eA August 1867.
With this may be contrasted the following case, which represents with equal
fidelity the feeling and the general behaviour of the people of the south of Europe
iu similar cases. The description is abridged from an article entitled '' My
Experience in a Greek Quarantine," which appeared in the Comkiil Magagme of
February 1866, and illustrates the hardship which arises under the Quarantine Laws
as at present administered in the Mediterranean.
MedUerrauean Qiuaraniine.
The narrator states, that having occasion during the summer of 1865 to go iron
one of the Turkish islands of the Mediterranean over to a European port, he was
obliged to go to Sjra, the entrepot of the Levant, to take passage in the Austrian
Lloyd's steamer ; but as the cholera panic had virtunllj stopped regular communi-
cation between Turkish and Greek ports, he was obliged to borrow the yacht of
an English friend to make the passage. ** Our island had had no case of cholera,
** and indeed had never been visited by it ; its general healthfulness was all that
" could be desired by the most exacting Board of Health, and as, moreoveTp we
'' were fortified with English, Turkish, and Greek bills of health, I anticipated,
'' at the worst, a detention of four or five days previous to being permitted to
'' land." But on arriving off Syra a Greek man-of-war's boat stopped the yacht,
and on learning that she was from a Turkish port ordered her off to Delos for
11 days quarantine, the Greek officials declining to look at the yacht's bill of
health or to hear any protest or explanations. Arrived at the quarantine ground
it was found that the so-called lazaretto was only an insignificant collection of
huts, built of rough boards, the coast being of the most hare and desolate
character. At anchor was an English steamer from Alexandria with over 200
passengers on board, mostly Syriotcs and other Greeks fiying from the cholera,
then in the beginning of its fury at Alexandria ; their quarantine term was 14
days, of which nearly a week had passed with no symptoms of sickness of any
kind. The unlooked-for detention had exhausted the steamer's provisions ; '* and
" provisions were not only not supplied by the Board of Health, but permission to
'* carry them off was denied those who would have taken them, so great was the
'' panic at the idea of communication with the ship. Mr. Lloyd (the Cuglish
'' consul) succeeded now and then in sending a small supply by the guartia cotta,
** and they bought now and then a kid of the herdsman on the ' clean ' part of the
*^ island at exorbitant rates. But they too finally rcfuseil to communicate ; and
'* then the captain wrote to the consul. ' For three days my men have had no
*^ bread, and two of them have gone raving mad.' Amongst the cabin passengers
** was a French woman, pregnant and near her confinement ; for her the cajitain
'< begged for a doctor or nurse in vain, none would venture; and when the time
« i^jtb come the poor mother had only the kindly care of the captain and her
'' fellow-passengers, among whom was no woman or person competent to care for
" her. Fortunately she passed through her trial in bufcty." The protests of
Mr. Lloyd to the authorities were met by the argument that it was better a few
should suffer than that 40,000 people should incur the peril of cholera, which
might be communicated if provisions were allowed to be carried to the quarantine
station. Mr. Lloyd was threatened that his house should be burnt over his head
^* if he persisted in attempting to bring cholera into Syra." Ultimately the
Government at Athens ordered an inquiry, and then meagre supplies wen
allowed.
A veiy few days before the steamer's time had expired a ship arrived from
Alexandria which actually had cholera on board. Twenty or more had died and
were thrown overboard on the voyage, and several more were sick. As she
came into the quarantine ground and cast anchor she dragged some distance^ and
seemed in a fair way to drift against the armed cutter doing duty as guarda eosit
and ceqoo guardiano^ whose crew, stricken with fear at the proximity of the
infected ship, ran out their guns to keep her from coming into contact with them.
The scene on board the ship is thus described : — ^* The huddled passengen
'* driven on deck by the pestilence and heat, and doubtless already in a frensj
" of fear from the perils within, found themselves met on the threshold of de-
" liverance from thoir awful fellow-voyager by the open mouths of Gnek
'* carronades. Women shrieked and men howled with fright The
'' guarda casta people were in a worse panic, if possible .... What the
*' extent of the contagion was we, of course, knew not ; but the hurrying and
'* trepidation of the people on board, and in the boat which came alongside, made
'' it evident that something unutsual was going on. The boat lay far ofiT, and the
" officers shouted very loudly, and we heard afterwards from the quarantine host
'' there were four or five dead of cholera on board, whom they wanted to send
^ on shore to be buried, but this was refused as dangerous I then to be permiUed
Cruel Quaranthdtts. Ixxxvii
" to sink them in the sea ; this was still less to be allowed. They begged for a
" doctor — no one would go : guardiani even would not go on board, for any
" compensation, and they rowed away leaving her to her fate. We shortly after
'^ received an intimation that by reason of this new arrival all ships in quarantine
" at that time must stay 14 days more! • . . . Here was the ship of the
" Ancient Mariner, in sooth, anchored only, but with anchors almost useless on
" that tranquil sea, the fiery sun above, and the glassy water below, and nothine
" to break that awful monotony but the merciless quarantine boat coming to asK
" and refuse. We could see the people on the ship gather on the forecastle and
'* in the rigging, looking out to the land, which, brown and dry as it was, was to
'^ them a refuge. The second and the third day came, and the dead multiplied,
^' until ten or a dozen corpses were on board. Still no physician, no landing, no
'^ burial even ; and the plague-stricken ship and its dying cargo lay still under the
<* August sun. The third day the crew received permission to put the bodies
" overboard, tied with ropes, that they might not drift away and carry the plague
" to some Greek community. . • • We saw the dead lowered overboard, one
'* by one, and with glasses could see them floating alongside, horrible to sight
" and fancy No physician could be found in Syra who had humanity
^* enough to hear the cry of Uiat snflering company, or venture on the plague-
'* stricken ship. They did finally get permission to bury the dead, . • . and
<' finally the sick were landed. There had been 140 paasengers on board when
" tho Hbip left Alexandria, and there were over a hundred when she came to
'' quarantine. The untouched remaining on board until they were attacked in
'^ their turn, and were carried ashore to die. Their provisions too were failing,
^' and at last starvation came to help the pestilence."
At the end of the quarantine period the yacht had to undergo a five days'
'- observation " behind the lighthouse island off the port in company with the
English steamer, which was, however, threatened with a third fortnight, and only
escaped it by the energetic remonstrances of the British consul, backed up by the
legation at Athens. A Greek man-of-war was sent from the Pirteus to Syrn
with a commission to ascertain the truth of the complaints made by Mr. Lhtyd,
and finding them well founded, ordered the admittance of the steamer to prati(|ue ;
but so great was the terror of the population, and the timidity of the Commisbion,
that the latter ceded to the threats of a revolution, and compromised the matter
by admitting the passengers to the lazaretto of Syra, and sending tbe ^hip away.
The narrator thus concludes: ^'' If all these things are not recorded in the
'< chronicles of that city, they are in the minds of many who were martyrs to the
'' inhuman cowardice of Syra, and who will bear me testimony that exerj
" occurrence of which public recognition could be taken in the above narrative is
** strictly true."
In Rome, at the close of the cholera epidemic in 1867, I wa?* struck by the
circumstance that no official information was then published, as it was supposed, to
avoid creating a panic among the people. The facts have since bf^n collected,
and the occurrences in the epidemic at Albano have been adminibly dei-cribed
by the ^larchese Cinque Quintili:* the conduct of the residents re|}re»ent4
very accurately the effects of cholera on the people of thf Mediterranean;
while it also displays the devotion of a Roman cmrdinaL What this exalu-d
prelate did in Albano the common people did in Poplar.
The Marchese Cinqne Qnintili dtei^ as an example of the t^lutar}- effects of
isolation, the case of a previoos plague, where a rigid cordon confined its ravages
to one side of the Tiber. Without any cordon at all, and indeeil with the freest
daily communication between the population on both sides of the Thame-, the came
thing has been witnessed in London.
In great cities isolation is impossible. Here what is required is the destruction
of the dejections and the purifi o d o n of the linen. The successful vffects of this
course of precaution is well iUustntcd by the experience of Bristol. \
• Appendix p^ ML f ^ppw*i« p» »*>»
Ixzzviii Subordinate Importance af Quarantine,
In seaports, when a ship witli people on board suffering from cholera arriTes,
the proper course to pursue is to remove as quickly as possible all the passengers
unaffected from the ship, and to place tlic sick, when thej can be mored with
safety, in a hospital, a hou«»e, or a tent, where the medical and nursing arrange-
ments arc goo<l, and where all the dejections can be destroyed. The passengers
at the same time to be cautioned, and supplieil with I'cmedies for the treatment of
diarrhoea.
To dotain unaffected passengers shut up in a ship from an infected port is to
maintain precisely those conditions which favour an eruption, and to transfer
them to a lazaretto is gi-atuitous annoyance and cruelty. The inconvenience
affects every traveller ; it is certain, it is general. The nd vantage amount^
to nothing : neither Spain, Italy, nor F'l-anee, where the quarantine has been in
force, luis ever es('n|x?d the destructive influence of any epidemic of cholera.
They have suffered much more than England. An<l up to the latest dates the
epidemics in the quarnntine countries have shown no abatement of vindence. The
reason is obvious: quarantine absorbs all the attention of the authorities, and
serves as an excuse for the neglect of extensive hygienic mcasui'cs of water supplv,
and purification.
Rational regulation of intercourse is im|M)rtant ; but qunr.nntine is the least
important of all the measures for the mitigation of cholera that have ever been
devised. I might refer to the high rates of mortality from all kinds of di$ea<^e in
Naples and the other cities under the a»gis of (quarantine. The water is contami-
nated, and the air is polluted with exci*emental cflluvia : by shutting out one form
of the seeds of disease, they give freer scope to others. To take an illuf^ti'aiion from
our own cx]»onenee : suppose that during the two years 1848-49 all eoniinimi cation
between London and the rest of th(- world had been entii-ely broken off; tJiat we
had sent out no vessels from the Thames, and warned nil ships away ; — what would
have been the result ? Legitimate commerce would have been intemiptetl but i!
is certain that smuggling would have sought to supply its jdace. and if it succeeded
in anything, would have succeeded in carrying cholera into the lowest haunts ot
the river side : but if cholera had been kept out, other di-^ea'-es would hnvc stepped
in to supjdy its place, for in those veiT years the waters uf London "u-ore con-
taminated with sewage, ditVusing the genns of many diseases, and were i-verv
year gi'owing fouler. The substitution of purer waters cut off the sources of ijl
kind> of diseases: quarantine couM only have cut off one, if it had been crowned
with >uooes^. In truth, all that the cities of theMe<literrnnean can hope to att.iin
fivm quarantine is immunity to live in the midst of imlescribabU* impurities and to
die of other diseases than choleni.
3. Internationa! Chohro Confrrctnc at Consfnnthioplc,*^
AVhile cholera was epidemic in Knglan . a Conference >at in Cou^cantinoideL
Seventeen states took part in it : England. ' .ance. Prussia. Austria, Russia^ Belgium,
Holland. Denmark. Sweden, Italy. Gi\*ece. Spain. Portugal, the Paj^al States Persia.
Turkey, and Kgypt were rooivsonied by 3(> delegate?. The Conference was opened
by His Uighnes-* A:di Pasha, ^linisior tor Foivigu Aliiiirs. on Febmarv 13th ; the ml
work of the Cougiv--* K-^an on March St h. ISfjfj: tlie jaogram wa? then'adopttd,
and the work w;i> divide*! info four parts. They discussed (1) the origin and
dovelepmer.i uf ehoUra; ('2) ihe mode of its pn^pagation : (3) measures of piv-
•^»ivatiori — hygiene — ro^trieiion; «4^ form of resolutions.
I'jxMi the two first ituints they rt po:'i : but ii would be unreasonable to expect a
Cenforoiioe so const ItuttNl. to di?eover or to invent anything new under theaT WailiL
The ohict .sim o:* the Centinnce wa? :o ciMae to *orae agn.>emeni on the BSSIhodbli
}ea.:op:t\i v»r pivvviilin:: the ira-.-mi-siun of the epidemic from Indi%
uitfiisio-.i ovi ! i:\:ro;'e. Here Dr. Gt*o»ieve and Dr. Dick£<in had eridentlj m ,
p.kr: to pl:)y. At tirst ii was intimr«ted that the epidemic originatad m tkm
tho Gar.iios but ihi.4 wa5 ct^mbated ; and the belief thai it ~
L>e«p«tch from H« M^tstj't Anhundor at ^^itntniMir_
International Cholera C<mference. Ixzxix
neglect of tho British GoTemment in keeping up the efficiency of the hyilritulic
works of their predeceeeorB wm "entirely abindoncd." The cholera, said the Con-
ference, ie to be combated step by step from India to the Red Sea; the entrance of
that sea ia to be guarded by an international quarantine establifthmcnt, with its
head quarters in Suez ; and should cholera reach Egypt, it decided, by a majority
of 13 to 3 votes, that an interdiction should be laid on all Egypt, m that all
inlercourge between it and the Mediterranean might be interrupted during the
whole period of the epidemic: the maili only being allowed to pass onteanU!
The minority consisted only of tho two English delegates and Salem Bey ! Four
delegates did not rote on this extravagant proposition.
The influence of the English delegates is, however, evidently perceptible in the
importance, unusual in such a body, attached to hygienic niea-<ares.
The Conference " demands for every man pure and abundant air, pure water, and
" a pare soil. The Conference believes that these elemenfat should constitute the
" permanent privilege of population))," and should not be postponed until cholera
epidemics threaten, or are in the midst of populations. They attach due im-
portance to the hygienic r^nlation of ships. Their views on the destruction of
the chief source of the malady by chemical agents are equally sound. It is only
when tbey come to the chapter on restrictions Uiat the panic teiTor of tho Mediter-
rtmean overwhelms their judgment.
A vessel from a port in which cholera prevails, thongh in perfect health, is,
according to them, to he detained ten days in gitaraniine : that alone would put
ii stop to all maritime intercourse — all steamers running between tho ports of
Europe when cholera was epidemic, while intercourse by land would continue.
A ship in which cases of cholera or choleraic diarrhcea have occurred, it iri
asserted, should be compelled to discharge its cargo, and to land all its healthy
passengers at the lazaretto, there to remain in rigorous quarantine mitU ten days
itfler their isolation from the last person attacked.
As some mitigation of the rigour, a ship that has not had cholera on board, hut
lias been 15 to 29 dayn at HCa, is to be detained ^tv dai/t ; and a ship at scaSOdayn
without cases ia to be let off with 24 hours' quarantine and fumigation, or disinft.>C'
tion : the places of confinement, the Conference hopes, will be made as pleasant as
possible. The lazaretto is to be isolated, and to be well provided wiUi hygienic
conveniences.
Now, science lends no sanction to this irrationBl rigorous system of quarantine ;
and if England does not accept the trammels of the Conference on the lino oi'
her communications with India through the Red Sea, it is not because the
country is indifferent to the invasions of cholera. Everything practical that tho
Conference suggests is accepted. England has a great«r interest in the subjuga-
tion of cholera than any other state. It ia tho scourge of her xplcndld Asiatic
empire ; it impedes the development (^ India ; it consumes the population ; it it
the fell destroyer of the army in the-i ^iit, and is a more formidable enemy than
the flercest barbarians in the field ; it has wasted these shores four several times
within thir^-four ymrs. We cannot, therefore, be insensible to the facts to which
the English Commiadoners caU Lord Stanley's attention. If the Indian Government
has not been amugned DoimBlly at the bar of Europe, it has been reminded of
" the reaponnbility whieh ftttaiches to India as the source of the disease ;" and
" a large shara of the iDMnrea proposed by this Conference are directed towards
" Indi^ and dw dtolar* mrtd between India and Europe."
This reBpondblli^ii sol n^nffiated. All tba pgaotic difficulties will be o^'6rcomQ
if the native popnUkn cum lad to oo-epflrate u the work. India is equal to the
task. The men who won nn empire, and viood ihonlder to shoulder in the presence
of an army in mutiny, can flubduo the kst diro enemy and deliver the populations
not only from Asiatic cholera but from tho immemorial fevers of tho Knst. The
health of the British army in India has aln^ady been improved ; and its losses by
cholera, although still too great, are no longer iriutt th^ were in the yeate Vk^^i^ti^
the Ipntinv. 'Rnitituv. nnlnrrttiL and Miulns ten llnady m\At nrt«VpTt Sm^lVUvV.
so India.
sanitary works* ; and we may hope soon to liear of the snceessfal proflecotioQ
of sach works in the great cities on the Ganges. The irrigati<Hi works are not
all that India requires. Drainage mast carry off the matters which generate
disease ; a consenrancy system adapted to the tropics, and to the circomstances of
the different soils, must be carried oat ; and, above all, provision mast be made to
supply the people with pure water. At the risk of otifending the Busceptibilities
which sustain their stupendous theology, the fatal error of throwing the detd
bodies of the population into the rivers from which their waters are drawn mist
be abandoned ; other practices must be changed ;t and the cities, the pilgrimago,
the religions festivals must be brought under regulation, as they have been to
some extent, to secure the nations of the world from evils against which they
have a right to demand protection. How the health of armies in the field can lie
sustained is described in the Report of the Royal Commission on the Sanitsr
State of the Army in India, and was exemplified by Lord Napier of Magdala id
the Abyssinian campaign.
To render the generation of great epidemics of cholera rare, nay impoasiUe,
India has only to carry out the measares which have proved efficacioafl in
England.
* The mortality of the English troops bj cholera in Bengal was to a strength of 10,O0O in 1880-45
at the average annnal rate of 132 deaths, in 1860-4 it was 99, and in 1865 it was 31 (Report of Boyil
Commission on Sanitarj State of Army in India, voL L, p. 576 ; Statistical, Sanitary, and MedU
Reports of Army Medical Department, year 1 865, p. 1 07). See a good accoimt of the woAb midettikca
in Bombay by the Municipal Commissioner, lir Arthnr Crawford, and the Health Officer, Dr. Hevte
in their Annual Beport for the year 1867. The mortality in the foor yean 1864-5-6*7 was at tlia nfe
per 1000 of 31, 35, 21, 19. The deaths from cholera in the same years were 4847, 2883, 333, and HI.
The estimated population for the four years is 816,562 : the mortality from cholera on ere;
10,000 inhabitants was 59, 35, 4, and 1 in the four years, whereas the mortality from fever wa
164, 229, 121, and 69. The intelligent efforts of the Bombay authorities do them tcij gna
eredit ; and by still further activity they may render Bombay, which was once Ukc graTeyaid d
Europeans in India, a shining shrine of health.
t An lever et an coucher du soleil, des mvriades dTndiens de toutes les classes et de tool b
sexes se rendent en groupes au bord des rivieres pour sacrifier k la d^esse Qoacina ; mala an Ba
de porter leur ofihmde an temple ils Tabandonment avec indi£R^renoe au eoanot da Peau il }
repandent I'infection.
Briquet : Bapport snr let ^pid^mies de Chol6ra-morbus ; Mem. de I'Acad. la^ de Ml^dtnim.
VoL 28 ; Part 1 ; p. 61.
ANNUAL MORTALI TY
Dtalh* fii 10,000 futny
and under Z5 Iridtca//-d fy Tmh N" i I I
ANNUAL MORTALITY
DtathJf (D tO.ltOO ht-mg
jrf ander Z5 Imlirated liy Tint X?/ ' J
i
r
^
APPENDIX.
.Tin jfM«!l'«>J
i
Mortalittf by Cholera and Diarrhaa, 1838-66.
I.-TABLES.
Table i^xaitautr by
■ HOX
AHD.
XDKDOH. 1
DEiTHB
Aimu^L MoBTiUn.
SBim
jlRRirjL HoBtUJIT.
Ybabb.
reffiWored from
Dnthi
to 1/100,000 lirins.
KKiiUredfrom
Dcilhi
to 1,000,000 living.
Choi™.
Cliolen.
DinrrbiiB.
Choloni.
i)iuTlKI».
ClKile™.
DiMThtOL
IBSS
JSl
3,«i
B
IM
18
Ha
g
at
isa»
3M
tKi
»
100
SO
87U
10
!01
IMO
701
3,M8
4S
m
w
*N
SI
IM
1S41
M>
3*«
18
m
88
*aG
It
888
iwe
i,eai
ll,«l
too
SIS
lis
70*
89
m
IMS
-
-
-
-
88*
88**
82
410
IBM
-
-
-
-
08*
7»'
81
3*0
IMS
-
-
-
.-
«B<
841*
80
8*7
18«
»
-
-
_
OS*
fclBJ*
108
907
18*7
788
ll,tlOS
48
•70
117
1,078
88
80S
IMS
1W»
11,007
110
888
<8B
U18
fOl
883
1»«
MJOSt
18,S8!t
S.OM
W76 '
JWS7
S3Bft
0,188
1.705
1810
887
i\m
00
MB
IS
1^
88
B18
18J1
1.1S!
M,7B
w
8»
US
W7*
VO
i,08r—
IKi
i;«i
17,817
77
S8«
101
8,878
87
883
18S3
Mie
IWM
HI
78*
888
8,*e7
800
1.011
18U
Kl,0g7
mSM
1,0M
i.on
10.718
8.1*7
4888
1,857
ISM
8S7
u,m
U
ose
1*8
vm
OS
8U
im
701
18,815
«>
78*
1S8
8,8**
U
BOO
1B5T
i.iw
□ .IB*
80
1,111
810
8,»6
61
1,161
IMS
078
i3,«a
S8
710
m
8,088
(0
7M
isse
SST
18,311
u
MO
im
iam.
71
\S\\
IMO
an
Bl70a
IT
IM
»
1,878
IS
iM
isa
887
18.TM
«£
M*
loe
1,811
00
MS
18M
ni
11,\U
IS
088
108
1,738
87
0U7
isas
807
KMl
«
788
IW
E3S4
M
8:i
lau
«M
IMU
U
7M
IM
tSM
M
081
1869
1«1
njsi
08
1J88
lee
Mil
05
!,»»
'"
MpSTS
n.iKi
«"
81S
RBoa
S.U7
1.8*8
1,030
-•""
iwiUta*
•tb>iiiu«
08k.,tl.ei.b
tncu roitb
«.mrlet«j
»rtlS*3.1S*
l,lBti.«i«l
ifi returned la tlm Cholera Bfport, vm 8S.S03 uid
\ ulau other htal iliMM« »t Iho Uino of ilmth. tho
snU 17^ toDlMThi™: 80 »nd l/WS d(^» Ji^^«.%
ic OT the CBUKi of ibMii.: ftMiai melt »iii 43\n*
2
Mortalittf hy Cholera and Diarrkaa m large Tomu, 18S8-66.
ii
8S3 *S,,| |S8SS SS^SS SaSSg S8g3£ s
1
■•MloqO
ll' I'lll l"=S" ''ir """ "52= 3
d
*«3 88,11 l'"l* ESS3S SSaSS SSKSS B
1
■«8[0q3
1 i~ "iiii ("ses -"■ss=> »»■=«- *«»«r. =
si
»™a
s«« aS|M is^gs i^iia g^sgg ^^gsS S
'.
■B<0|Ol|D
" = * "Sill |-°§S a""** «■»«-, -«-.«. ;
■
1
1
.9
1
1
1
-iHDqiriia
aSB G?,,| |Sg|2 gssg^ g^gss IgSgg g
■BJ*[Oio
ll" ""mi i""-" =^"3- "a-S- "-322 S
3
■wnninid
Sa^ SSlll llliS 8S|§5 iggss SSgsg j
-,.,0
-r ""ill r-E" -j^-s- — "—- > 8
1
^
■•siiiiKia
S2| Sim iSSHS SsliS %%%U ig^Sg i
1
■«3I01D
-"= a* III |H"g2 -ass2 s^ss" 2»"= g
2
■W)HU«HI
«s ss,,, |||ss grsIS §ISii SgSSg 5
i
1
-1UJ10113
-22 -Sill 1*8^1! S3s|3 SUSS- saaas s
S
-iwmJJBMi
"'' SS,|, iljggj g|g|S ^|g|3 sgggs 2
J
■waioiL')
"-S S-'iii |'2S- SS-^" "'— 1 "«*— s
1
■WDyiima
—a =^111 |3SS* SSSS3 gKSSS &«3c:S «
1
-BBIoqo
r" ""ill [""s" """-" "ill" r""i ts
i
i
-wnnW
iS3 IH5S lllil |g||! IIJII mil 3^
h
■«WP«I0
SSE ssass igjsB SSSp 85=8= S;^md|
1
III illll llili illii iSlli ^JH
^rom Cholera ^ Diarrhcea in Divisions jf Counties in 1849, 1854, jf 1866. 3
—ENGLAND. Beatbs registered from Oliolera and BUurrliQMi in each Dnnaiox,
Count r, and District, during the Years 18^9* 1S5^ and 1866.
DIVISIONS
AND
IRATION COUNTIES.
I Popc-
LATIOV,
1861.
I
CHOLERA.
3LAND AND WALES
DIVISIONS.
ON
EI EASTERN COUNTIES
[I MIDLAND COUNTIES
ERN COUNTIES -
« WESTERN COUNTIES
MDLAND COUNTIES
II MIDLAND COUNTIES
II WESTERN COUNTIES
SHIRE - - - -
HERN COUNTIES -
lOUTHSIIIRE & WALES
I.-LONDON.
IZ (pariqf)
(part of) - - - •
P (part of) - - - -
>UTH EASTERN COUNTIES.
iMY {extra-metropolitan)
r (extra-meiropolitan)
8D,(M«J»4
)UTH MIDLAND COUNTIES.
lUmiZ (extra-metropolUan) i
2303,980
1347,061
1.2dS;il5
1, 148^862
13»,714
2,406^568
1,288,028
2A»9,540
2,015,541
1,151372
1312384
2,080314
070,748
103,427
278304
546,272
366336
4S6»654
205,635
187320
177,452
147307
1713SS
281.079
00^187
140370
181308
08308
28^007
14137
8800
1617
870
4504
0174
684
8880
6846
8tf4
4673
7000
0328
814
1206
366
1240
100
406
176
115
141
14
78
207
697
10788
1661
1220
931
838
247
1916
624
632
4063
6006
667
1056
94
ISO
40
97
68
188
162
18
61
270
618
07
tISi
14378
\
5506
866
HI
601
031
130
83
2001
868
610
2M8
4879
877
340
82
284
79
417
8
61
9
10
4
7
1
22
7
471
16
U
DIABBHCBA.
18«9. . 18S«. ; &866.
18387
20362
3880
1400
913
774
1086
2100
764
4200
1066
780
2503
1050
256
144
607
279
300
140
187
128
103
106
123
84
8147
1600
1240
1118
953
8104
907
4404
2179
824
516
2027
911
209
218
621
279
824
168
281
180
186
163
127
40
184
171
17470
8147
519
77»
4518
1004
1185
061
2418
660
100
us
20»
177
77
108
so"
107
loe
\ -\
«A
4 Deatha fiom Cholera and Diarrhaa in Connttet in 1849, 1854, and ISM
EKGIiAKD. — Baatlu BnaiiiTEREV from Cbolara and Bteirl
DtBTBiCT, daring the Teass ISftS. 1S5«, «
PO^.
CHOIKEA.
DIASBBd
BBQISTBATIOIf COlCtTIES.
IBOl.
ISft*.
"•*
1S««.
ia«».
>•••.
So.
T.-80UTH MIDLAKD 00TIWTIB8.
U
wnTsaiK]]
136,027
no
60
11
188
14*
as
SORSETSHIKK -. - - -
iai,i«
ii»
«S
8
es
88
u
DSVONSKIBB - - .- -
we^m
Z38S
IBS
■a
S80
)n
ao
CORITWAZ.& .....
WI348
SM
H
a
140
ua
ai
BOKBSSBTSBXXa - - -
TI.-W-E8T MIDLASD COUNTIEB.
«3.38S
wa
*^
6S
3SB
MB
aa
«liS.CI«l
iier
200
30
411
M
as
Tmn BTfUfmiRrBii - - -
lO&TM
i
1
1
M
IT
aft
SBBOPSHXKIl - - - .
»(I,KN
ni
18
H
lis
M
as
BTArVOBDSSZKB - - -
7«D,M1
MM
410
30
901
IIM
a*
mfna
va
m
36
W
s«
av
WAHWZCXBBZltK - - -
ril.-XOETH MIDLAXC C0UHT1B8.
K\X*
m
80
IS
7«
im
>•
tafia
IS
14
a
IK
*a
a*
1ti7x;L&vi>3Snx - - .
K,*™
e
t
-
7
u
so
SI
sa
Kiircox.xrsBxxE ...
M1,US
»M,TM
a«,974
til
lU
80
17
4S
£48
£88
UD
lU
"^][^^^r^ ; I
4a
»
in
VllL-XORTH WB3TEKH COUNTIES
ss
CHBBHIKa -----
*7I),17*
(M
Ul
3ei
U4
CS6
Sft
IX-TOEKSHIBa.
l.MM6e
8181
1778
acoo
37M
asu
SB
-wasTBXsnro - - - -
rjaam
411)8
470
va
14U
uas
S«
BAST KEBZBa (w.™ Tom) -
tj*,m
2141
70
84
438
Ml
sr
BOBTH Bzsnro . - .
I.-KOB.THERM COXJlfTlES.
euAw
*
84
11
«t
"
••
1>«BKAM - . - - -
M^UI
im
tM
SM
S7>
«a
*»
sfttes
1410
Dl
111
2«>
au
«•
ctn«BB»i.Airp - . . .
EOUTfl
tlA
33
31
lU
Ui
•t
\J.-MC}>010UTH8HiaE IM ■WALBB.
a%Ma
1
1
*
17
u
•a
WOBldOnBBKZfeB- - -
1M,«7
177
IS
KM
Its
lat
•s
SOirVB WAXAS . - . -
•M,7M
UU
8SJ
£033
403
aw
t^
lrO«TBWAX.S.- - . -
tiUS!)
H4
M
KM
toi
«
Oeatltt from Chobra and Diarrhaa in DUtrieU in 184d» 1654, and 18611. 6
xm*». I iBift. latt.
DUBBH<ZA.
'XU*B. I !•>&. I laM.
Mo.
BCatDUraX(p«r<«').
14S
m
a
s
JS
IS
l-OFLA*
mwun (jmw </).
«
.s
H
OonuBniticB - • • •
KBNT (parf 4^).
MMt
Ml
M
«a
M
M7BT
n
M
ZL— SOUTH EASTERN COtmTIESb
X.-BinUUtr (BrfnuKtroiK)
tuw
i
IMU
WIS
giS^r". : ; : :
Beioats
HE,: i : : i
Noam Atusvobs . - •
MBDWir •
6 JJeathi frmn Chokra and Diarrhoea in JXsirieU in 1849, 1854, amd 186&
RBQUTERED from diolera and marrlMMi in eaeh Dibtsict duriog the Team IBM,
1*54« and 1M€€ —eamtmued.
POPU-
CHOLERA.
DURRH(F.A.
DISTRICTS.
LATIOE,
1861.
\B%9.
185«.
18««.
\m%9.
18S«.
ISM.
XL— SOUTH EASTERN COUNTIES
^continued.
ZfMMKT {ertreHmetrop.)—
>
No.
continued.
fiS
Vat.ukg . . • . .
21447
19
46
16
18
18
17
M
Sky^iioaks -
22089
6
16
6
6
11
4
07
TUNBBIDOB
84271
19
68
4
21
46
28
86
Maidstoxb
88670
98
88
23
66
71
m
m
HOLUVOBOUBV
18684
10
10
2
13
4
60
UiuirBsoojc
13412
—
6
8
15
4
61
Tentsbdev
10947
2
5
_
12
S
6
-62
West AsHroBD
1*187
10
9
■*^
8
15
7
68
East Asueoro
12286
1
6
9
6
2
64
Bbidob
11316
5
27
6
9
5
8
65
Cahtebbubt
16643
87
41
%
18
7
U
66
BLEAir •
16161
23
26
6
9
19
U
67
Favbbsham
18S67
16
13
14
12
17
9
48
MiLTOV
14775
68
116
21
16
28
9
68
Sfbppbt -
18104
54
86
22
17
17
17
70
Thaebt
31862
203
206
58
67
89
21
71
Eastbt
26900
7
18
16
24
28
8
72
BOVBB -
3i:>75
94
25
11
80
86
22
78
EUIAK •
20925
1
59
9
15
85
8
74
BOMHBY MaBSH . • .
67U8
1
-8
4
S
76
9.-6nnuiBX.
Rye •••••-
1)027
8
6
4
76
Hastieos -
*
26031
61
4
""3
28
10
ft
77
Battle
■
12680
8
5 1
6
78
Eastboubee
m
10721
2
8
_
1
78
Haiuham -
•
12668
8
1
8
7
6
80
TiCEnUBST -
9 •
14620
11
6
17
14
81
UCKEIEU) -
• 1
17260
8
2
__
9
8
82
East Gbiebteas
• 4
14007
1
4
1
4
12
88
CUCKEIEXD •
» «
17168
17
1
9
4
84
Lewes - • •
* 4
26995
2
2
"7
21
26
It
86
Bbiohtoe -
77693
194
88
14
$6
94
86
Stetnieo -
24053
24
8
.—
9
9
^mm
87
HOBSHAM •
15313
4
6
1
: ,9
11
88
Petwobth -
9307
1
2
■
s
89
Thaebiiam -
7667
4
_
8
6
80
WOBTHINe •
1S921
8
19
7
IS
11
91
Westhampeett
14811
4
1
8
13
28
AA
M
CniCHBSTEB
14775
12
s
12
29
10
88
MiDHUBST -
125SI
1
^"^ •
•9
4
94
Webtboubeb ....
6967
2 2
16
7
3
ft^BJU»8BXWB.
96
Havaet . . • . .
7212
8
1
9
5
S
J^
POBTUBA IflLASB .... •
949S8
568
20
143
128
79
US
Alybbstoks
22653
126
10
19
20
10
Mm^
98
Fabehax -
14864
11
8
14
7
90
Isle of Wienx •
65362
162
4
100
^
81
JJ
160
Ltmixotov
•
12004
—
^
• %
6
7
101
Chbibtchitbch •
10438
—
m^
—
1
»
108
RiEOWOOD . • -
5357
*»
1
_
2
8
186
Fobdibobeidov
6377
9
1
..
1
1
164
New Fobebt •
18600
6
8
16
8
168
SOUTHAVPTOE -
43414
240
48
106
63
68
106
South Stoebeax •
26549
84
4
8
23
88
167
ROXSET ...
10771
16
1
16
^2
8
118
Stockbbidgb •
7286
2
12
1
6
186
Wiecbbstbb
28607
48
25
"*;
^
88
116
Dbozvobd ...
10665
1
» ^
6
HI
Cathbbieotoe •
2497
2
1
■
1 *^
-
lis
Pbtbbsiibld •
7853
8
«.
9
lU
ArXBSPOBD ...
7183
..
^m
^^
lU
Altoe . • • •
12063
9
*.
VHV *
• "«
10
lU
Habtuict 'WnrnrET •
11480
«.
1
1
10
116
BA8IE6BT0XB •
17429
""2
•1
^■^ «
10
18
117
Wuitchubch •
5522
1
1
■ ..
8
^
lU
Aedoteb . • •
17182
9
.M
6
116
Kxxcmcuebs • • •
8617
6
—
—
^
Deaths from Cholera and XHarrhtxa in IHttrieti in 1849, 1954, eaid 1866. 7
X»*9. I !••«. , !■•«.
!■«•. !■>«. xaa«.
It— SOUTH EASTEllN COnSTIES— «iirti»»fd:
l«7l
WtTS
14MS
UfBl
T4M —
; "
_
"■,
-
I "
1
1 "*
t
UL— SOUTH MIDIJiND COUSTIEa
^^_^«,— ,; ,,
112
RlAI^E*
iw;a
tt
W
n
*
U3
flHEiImlt
«
tl
IM
MOU
IM
m
M
IM
!•»!
ss
IK
KABim
in»
t
t»
so
m
TlZt.^^.i--.
IWIB
in
IS
4
IS
tt
B
,.
"
13S
Waeb
1,
M
BlIUOP Stobtioed
»rsil
w
RuvBio.t ■ .
uui*
ss
s
«
UlTCHIN - -
HlDTFOBD - -
'S
,:
~3
%
B
10
43
B«DO
IS
<
s
M
4B
St. Auani '■ '.
Waifoed - .
um
*B
14
}
ft
n
I
«
HEHILllMFnUD
IMtt
u
B
11
11
47
UBBKUAMralBAtl • - •
ISMM
"
'
14
•
148
11
»
1
IS
•1
•
IW
ItWI
I
IS
s
atiM
100
44
tt
SO
B
Aylesiicbt
ID
>
a
ss
IM
WIMSLOW . .
1
t«u
«
1
t
IM
BCCEIROJUII . . . .
TOM
1«1W
1
1
s
IS
8
14
IM
IIISIJV
7
Tiulu- - .
1»W
M
1
171M
■L
M
IS
ts
IM
nsff
U
n
u
SI
S
159
Esk.- :
urn
~1
«
atM
Is
u
tl
s
IM
Cnirnso NorTOK
lt«W
11
11
la
BXSBKBT
M171
^
u
1
ti
14
M
Bb*cklk»
lun
»
B
i
To«-CE»TIB - -
uou
M
iim
tt
OT
HAHDWaBTOSB "
»
70
.NoBrilXHPTO-I -
HsjxwoBTn
WlLUBItBOBOrOn
1*907
1
"s
1
1
1
se
SO
SI
11
KBTtRkiXO
IMH
1
11
v»
7S
uou
s
v *
\ *
74
Oi::i»i.B - •
iMn
- \ \
\ *
\ *>
TS
*■"»»"'■"■
«7t
*
•
\ »
\ »
\ ^
\ ^
8 Pmitha/^om Chokra and Diarrfieea in Diitrictt in 1S49, 1834, and 1860.
Porc-
CIIOLERA.
DUEIIHIEA.
1S*S. 1B». , 1S««.
i««9. IBB*, las*.
HL— SOUTH UIDLAND COnNTIES— eciiiuaiictf.
IS^i
NOBTH WlTCmoU)
WlBOBCU
luin
IS
=
i
g
u
'
1
-
1
•
s
-,
w
i;«
^
IV.— EASTERN COUNTIES.
Ift^-SMBX.
mil
IM
IH
3W
S»
n
»(
WBflT H»JI ■ ■ .
«
1W
Gpi-ixa
io
38
«
'W
OSOAK
t
IT
w
EOUIOBD •
awu
1SI
111
»
4*
n
u
1M
Oum
um
IS
IS
M
■
IN
u
Ml
WBS
S
1
»
M
18
»1
ROCnFOED .
18882
1<M
43
at
10
IB
IT
Haliwr .
Kiua
38
IDl
88
1
fM
nios
S3
B
U
tM
CoI«H»TFB
1
n
SM
Lnnist -
jaw
3
1
S3
t>
t
fOt
WlMAM -
lasst
i
u
•
an
18481
a
M
toa
BBAIITUE
3
S
U
u
!■»
DlUXOW -
I
13
■
•
HAvnos VALDn • - .
W«
'
'
•
•
ElIDBIDeB - - -
TtM
7
u
Sll
1
H
u
KU
CiDFOBD -
TS7S
I
f
«
tl4
THinooa .
1
4
•
BnV 8I.KDMC1
SSIS
3
1
f
na
ones
1
MT
»
11
tis
HAUTinnu
1J«6S
I
3
1
«
<
1MM
1
10
~
tK
BOIVEU -
1
7
ttl
IHM
;
11
Bt
IFIWICII -
S7W1
IS
33
t
S»
1
"1
WOClDBBIBOl
KTM
1
i
1
PLOHUOATI
aiTio
10
k
«Bt8
4
8
a
8
■
LVuaroBs
ucig
10
1
»
MHO
w
U
ft
1 M^-womroiA.
te?7":
SDSM
87
«
_1
44
R
M
U
<i
i«ia
4
11
7
jbntnui
MST*
1
n
'
U
a '
.DmiAt Jnm OuUra and Diarrhtea in Dittriela in 1S49, \85i, and 1866. 9
during the T«m 1M»,
Duiuon.
Poro-
CHOIBRi.
DIARBBfEA.
un.
!•*». !•>«. »•«•.
ia«»< xas«. is«a.
nr.— EASTEBN COnNTIES— waUHiKd.
v.— SOUTH WESTBHN COUNTIES.
W Bkuiidui-«e-&
ar
ll
faumuBrsT
Vmeoun -
aTOJTMMOTM
IB7U
,
U
J
.i
-,
"t
_^
13
,!
J
30
-
«
*
1
I
7
I
ii
13
3
B
(
i«
2
".
u
U
S
10 Deaths from CMera and Diarrhcea in Dutricta in 1849, 18M, and 1868.
BMItll* BBI
is«>. ! las*. I xs««.
ISM. xaB*. !•«•.
v.— SOUTH IVESTEBN COUBTIES -««(«««/.
EnEPToa Miijxt
Welli>
10
7
W
w
■
a
.
.
_
_
>
~^
^^
a
-J
,t
s
K
s
u
-
1
1
..
S
"i
5S
■
1
n
M
'*
n
tt
VI.— WEST MIDLAND COUNTIES.
aa^-OZAirCMBXMBBB.
««,
Wl
7S
17
in
n
s»
Bbwiol
^
3M
CUFTO* - ■
MlbT
MS
OS
10
M
»
ni
CUIFPIKO BODBUBT
m«j
T
»
u
•
144W
1
B
S
tn
Dfmsmv". .
MS91
K4
7
«
IH
M*at
1
1
■
r
(i'^^Ktt -
SWW
110
4S
a
n
n
nr
THIS
17
ns
SSH9
M
ffi
M
u
a>
Teibubt - .
sua
8
uo
loeu
7
Ml
Ml
STOW-On-T II l-WOLD
Ml
WlKCHCOMB
I«M
4
B
«
Ml
CnBLTBlciiAa -
««TtH
«
B
U
Ha
Tewibiucbt - . . .
1«M
H
_'
1
a
Ml
LZMKBV
MT
Bon - - -
lam
a
1
4
Ml
HMEmiD • -
aM87
n
IT
u
Weoblt- • -
Bbom**bi) - -
1
t
1
B»
IMM
1
~
"
I
•
* Jnclnaed wltii Tlrerton tta tbcM t<
DtaAaJnm Ckdera and Dtarrkaa in DUtrieta in 1849, 18S4, and 1866. 11
% b Mcli DitiBiCT during the Yewt I8ft»,
lau, and &•••— coati'iiBtd
I iBSft. , ia«c.
is«*. is«ft. isac
VL— WEST MIDLAND COUNTIES— CDMlfHHri/.
I -
1
■
"J
M
I
»
—
II
1
4
11
11
"
H
t
J»
'«1,
Ml
m
IS
SI
Kl
s
18
SO
u
*«
1
a
10
1
li
VIL— KOBTII MIDLAND COUNTIES.
1
-
"
fl
12 Deaiht from Cholera and Diarrhoea in DUtrkU in 1849, 1854, md 1868.
!■•». isi«. iB«a.
DIAB&EICEA.
Vlt-
COH/lBK*/.
11
♦{*
J
z
17
31EI.T0S MOWDUT - - -
~
~
~
*
"
'
iin
g
1
_
J
„
VrFiSQHAa . . . .
\txi
jj
IB
10
«H
HnBIIClBILJ
*70iB
B
=
1
11
".
".
M677
11
t
"
4U
u
H
MS
n
11
4tt
_}
'!
HiTriUD
52178
10
1
!
"
IS
Vm.— NOBTn WESTERN COUHTlEa
Btockfoht . . - . .
Hacci-eifibld . - . •
Altbi scout . . . .
B[::icoBX . . . . .
NOKTOWICd . . - .
CoirOI-KTOS- . . . .
NlHTTICH . . . - -
GuiT BocafrroK (Chbku)
BlBKIITBElb . . . .
*«.-&AJrOASBZBS.
LlVBRFOai.
Wbit UiaaT . > - -
J
1
u
'S
138
"i
!!j
70
"i
2«»T.l!i
«73
731J7
a
Ub>9wM CMira amd Diarrhaa in Districts in 1649, 1854, and 1866. 13
k and BtanfecMt la each Dinucr daring tbe Tean !•«•,
i««v. iai«. is««.
VnU-NOKTH WESTEUN COUNTIES -eoitti-HedL
4m7B
ISOtM
;l
DL— TORKSHmE.
,
I
_
_'
!
»
= 1
"1
w
/
JO
in
!1
«4
ais
W
■M
„
si
**
* IttdaOad vllh Otlej and Hiinilct dittricli for tlinc yran.
14 Deatha from Cholera and Diarrhcea in Districts in 1849, 1864, end 1860.
i.sa». lasft.
»«•». 1SB«. &•«•.
IX.— rOAKSHIRK— coNA'aHeif.
Ho.
»«.-».Bll>I»B(«-iTuYo«c)
1*
IM
la
DaiPFIBLD
S7.-lrORTH BZDZVO.
IWM
g
-'
"'
"
nu
8CAGB0K01-O1I ... -
aoiu
B
a
iiws
*
*
■!
(fcAoliovon '.'-'.'.
i^
*3
S3
I
!
M9
'
^
-
'
'
*
X-NORTHERN COTINTIES.
EH
».
M1A
SL''ifS?oj> '. '.'.'.'.
MT
31773
»
GimaHKiO ....
l».-JfORTgPWBMH.P.
SMU8
i>
3i
H
US
318(10
U
■
aa
!
,!
11
1
*0.— V V MBBRlJUra.
■
"
SM
.sn
'**""'■*
~
~
-
1
■ Id 1813 Uic ileathi tiom Chalen ia the diitKct ot Gatcahnd were Sl^ ud In
wAMfrmk CMera and Diarrhaa m Districtt in 1849, 1854, and 1866. 15
MEaamaxD from ChtHanL
and SMaiTb<mi in each District during the Tears
ISt^ and lft66— con tmiccc/.
DISTRICTS.
Popu-
lation,
1861.
CHOLERA.
1S«9. ' ISSft. 1S66
DIA£RII(EA.
1S«9. ISS*. 1S9C.
X.— NORTHERN COlTSTlES^amtinued.
Iamt Wabd
Vest Wabd
CMai>AL
Iftftll
sivTa
37463
1
1
"l
16
3
•^
1
12
1
1
u
XI —MONMOUTHSHIRE A5D WALES.
/Hsnrow «
iOSHOVTH
iBDWBLTT
teampooL
ffXWPOBT
OLAMOROAN8HIRE.
IB DWf - • -
teSTTPBIDD
iSBTHTB TtDPIL -
BBIDOBSrS - • -
flATH- - - -
iWAyiBA . - •
30WBB . • .
CARXARTHENSHIRE.
lj*kirWLLT . . - -
Lkavdotbbt ...
LUlVDILOVAWB ...
FBVBROKESHIRE.
ITabssbth . • . •
hnuBOBs . . . .
HArBBPOBDWBSI
CARDIOAKSHIRE.
OASDIftAV . . . .
Hbwcastlb-iv-Ejcltit •
iBBB ATBQg
ilBBlBIWilH •
tBieaBoai . - .
BRECKNOCKSHIRE.
BCILTU
DBICKHOWXXiL -
Bat - - •
RADNORSHIRE.
PBBVfBIOVB
KsiOBToar ...
Rbatadxb . . •
17MI
S024t
1WS7
47565
514U
}
58285
80.'M7 >
03009
26MB
683.13
61260
8316
}
MONTGOMERYSHIRE.
NBWTUWA . • •
iOSTSO^fBBT •
Ulavytius
TLINTSHIRE.
EUaivsll • • •
27^9
14775
17222
86676
2t3i4
2M08
87343
185S5
10081
99M
18640
2M64
10737
8303
17279
22457
1U819
15671
l(t379
6810
12895
23732
19007
21699
a9»u
2
1
— •
14
6
•
22
—
—
6
1ft
8
43S
"i:
1 '
122 S
06
7
31
69
20
9
81
It
216
6
61
81
82
88
896
225
76
*
75
47
4t
•
•
48
•
•
28
1682
455
229
•7 ,
125
44
87
17
HO
8
9
12
738
64
620
61
96
66
262
"{
621
29 i
32
15 {
22
7
45
_
232
11
16
44
14
2
2
6
2
1
40
8
12
3
1
4
142
2
143
to
i
11
13
IS
6
1
7
11
9
42
83
9
10
13
40
40
14
20
17
4
6
1
3
t
—
4
—
2
S
3
»•
w—
8
—
v»
^m
_
1
i
1
""•
^^^
12
1
1
1
1
1
1
1
1
7
51
—
7
7
T
95
4
17
16
8
18
1
~™
1
6
a
_
_
^ ,
«
_
2
1
1
1
—
t
1
8
1
1
1
8
19
«-
10
14
12
37
4
2
5
1
1
4
"^
^
8
1
S
86
2
83
26
y
1«
* Indoded with Cardiff and Mcrihyr TjrdOl for thoto joark
16 Mortality from Cholera and DiarrhoBa in Dwisiatu^ 18495 1854^ md 1866
RXQi8TEBBa> from Oliolera and
1«S«, and
in each Diotbiot dnriag Ihe
— cojUuiikc/.
DISTBICT8.
Popu-
lation,
1861.
CHOLERA.
PTARRHCRA.
lSft9.
ia5«.
1S€6.
1S«9.
1SS«.
xm
XL— MONMOUTHSHIRE akd WAJSES-^omtmued.
Ko.
611
oia
018
014
61S
010
017
618
019
620
621
022
ft«.
romr
con Hn u ed ,
DENBIGHSHIRE.
Ruthin ....
St.Asapb - - • •
Llhtbwbt • • - .
MERI0I7ETHSHIRE.
CoBWBir - . . -
Bala - . - • •
dolobllt . . • •
FBSTmOG . . • •
OARNARVONSHIRB.
PWLLBXLI • • • -
Cabhaxtov ...
BAireoK - • • -
Coinr AT - . - •
ANGLESEY.
AX&LtSBY • • • •
47976
16088
27S18
12770
16107
6852
12482
18289
20006
82426
86809
18806
88167
6
1
4
8
1
a
21
6
66
4
1
11
6
8
1
2
76
14
8
90
2S
2
«.•
12
4
1
""
1
i
1
■*
1
8
2
8
4
i
8
2
9
8
""
8
5
1
1
Table ft«— M«rtaltty from Olioleim and SMarrluBa during the Tears laA^^
1S€6 in the several Divisions of Enolaio).
laM^nl
DIVISIONS
AND
COUNTISS.
ENGLAND • ^
DIYIfilONS.
L LoNvov
IL South Eastiev «
III. Souxn MiDLUrD •
IV. EA8TX&N - -
V. South Wbstbbn
VL WB8T Kidland •
VII. NoBTH Midland
VIIL NoBTH Wssnoui
DL YoBK -
X. NOBTHXBN •
XL Wblsh • • >
Deaths to 10,000 Fenoiu liyinir*
Cholbba.
1849.
1854.
80
11
62
48
29
9
12
10
8
8
25
2
26
4
6
2
87
7
86
8
87
6
80
8
1866.
18
4
1
4
8
1
1
9
8
5
18
Dxabxbcba*
1849.
11
17
9
8
7
12
6
17
11
8
6
1854.
186ft.
11
18
9
10
10
6
14
8
17
12
8
4
10
5
6
4
6
8
14
4
DblliefJ^mJrum Okotera; Mortality from Cholera in certain DiitrieU. 17
LKwiNn •
I. South lIiDi.4m Couxrm
4. BAiniK CoriTiBi •
B. Bom TMmv CoDann
I. Tan 1fii>i.4«D Oorama
f. Nonx Hmuzp CoDxiin
■. HoKia VMcnJt Covami
■ DBlmton fi included with Tinrton In tboa jtmn.
i ftntjpridd li included v
UIIOS.
rcfrlitprcd fmn CnoLCBi.
MoETiLITT rrom
CnoLKHi lo lO.OOO I'cnoni|
DUTBlCn,Ac
.
1B51. 1B61.
1M9.
■854. 1866.
lB4g.
1B54.
1S6G.
I«RM>B ■ • -
t,«IS*»
14.137
10,738
6fiM
«a
43
18
BM»
BJMJ
J
17
g
jj
11<M
i^ns
H
"bi
SIJM
SIMi
MS
3M
SH
19
a,M4
H^T
23
ntiK
>ists
W
tOfiU
UM2
;%
48
IWJ
J*
I
U
VHtHm . • ■
Hase
g«,3i9
3§D
iMftfad . . . .
W,S3S
i8&a
IW
4fi
ss
17
IJ
knaoMdlBran)
4UM
«I.«U>
n
in
u
beta . . . .
stats
33.7*2
um
a^Mi
lOT
i«
31
u
n^
KUm
M«
M
»i
Vl
7
11
tlJM
SUS8
M
IS
7il
IS
»
Awt Bm^toi'
Bt,HO
KAOl
M
14,MB
lS.«n)
IW
,^i
W]
HI
7f
M
U,18t
flLtSoJ
7«J
'l
&^£bi C
laa^M
IW.TU
4.173
1.4N7
lis
m»7»
IK.su
1,1S»
'nie
ift2
»W«7
*<US»
IS
All
IS
77«8
B*JW1
va
IS
13
Qnli
1S,aM
1B.IH
11
BoPghtuulcMliB
U,B«*
I1.T7S
n
ts
!
11
T^miittr^ - -
HUB
n^«5
£t
Bel.nliir . - - .
*i,Be«
ajM
438
s
M
QmUr . . . .
n.101
IWIS
HWTfS
Ki
3M
^{
£fil
-(
a
53F* r ; : I
n.4a
S^
Its
M
KSI
I9«
iJ
18
UJM)
*i
Sill
38
.f
^J :
stjtt
Ka7E
■1
39
40
WM
»,OflS
13
MjS
a7Wi
41)
4»
H4mo . . . -
tIM?
ae>ii
M
i
8S
Ctnarnw ■ -
»hui
st*ai
ai
71
7
~
n
MortaUtg from Cholera in certain DiMtricti « Tliree Epttkmici.
I
!1
1.3
ill
f
llH
111
«|g§3 5|SSS SSflSS g|SS5 KBiSS Sa^SS SJ3S5* 1
i
iiiiiliiiiii-Slliijiil
•
S53 ^SS S33 s?:; S^s USS
jsj 36' SS3 p5 853 S.^S
i
1
..., i..|..
^.t-i^ Kiss »;kI 35a 2^is 3l^
pi
|3|
ill
■3 5-2
111!
ISfi
Ifl
iil.2 '3 ^ SS!^§3 sssf s s^ss:: s^scs 8SSS3
IP I g §jp| sssis a.ssig aisas sssss
31- f
-Ill
hh. tml ill
DealihM and Mortality from Cholera at different Agti.
19
B a«— ENGLAND. BmiOu and Bate of MCortaltty from Olioleni and ]Marrb<»a in
U ISS^ and 18€0f of Males and Flsialkh at Different Ages.
DEATHS FROM CHOLEOA.
Mixn.
= 1
FCXAUS.
' 1849. 1854. 1866. 1849. ' 1854. < 18CG.
I
DEATHS FROM DIAURIKEA.
3Iale«.
FEVAI-ES.
1849. 1854. 18CG. 1849. . 1854. 18CG.
CS - \ 234M 9.MU 4.MS <; S7J85 10,217 ■ 7.98.'}
2<458 j 030
i;)l». 456
1^7, M70
772 J M38
896
I OSl I 547
31887 1,293 I
1AB9 1^1
3,712 i;m«
821
891
I
1.217
2,578
4;803
4^.8
an
351
602
.111
II
030 j 587
1.492 { i.on
l;572 I 1,100
3^417 1,153 887 l! 3^387 J 1.222
ipda.!
2,605
1,610
576
70
2
2S
010
616
SM
24
617
380
883
2,909 ' 1.077 7(ii
123 ,
I
9:
1
1,051
827
07
4
18
723
I
302 ,
V) .
2 '
473
187
3i
3
0.<»7 10^1 1 8^14) 0.250 O.A^n K:i3i)
I
6,103 7.0» 7.010 , 6.652 , 6,o:i:> 6.105
2J2
KKJ
IM
2^2
239
S33
C?J
J21
110
m
o
1
lt8
57
113
120
197
320
5oi)
I
321
112
134
50
MM
it
m
113
175
3<)l
4J3
SOS
ii
3
I
IM
67
111
290
110
222 ,
£11 :
325
331 '
510 '
I
773 ! c:i
204
217
4(K1
(m.
12i
9
C'kS
119
8
112
38
150
173
190
S2'J
500
477
127
I
DEATHS FROM CHOLKaA TO
10,(i<i0 LIVING.
13.
Males.
II
Feaiales.
1849.
■i" I
1834. 1866. ! 1849. , 1854. 1SC6.
IJEATIIS FROM DIARRIKKA TO
10.iM)0 LIVING.
FKiiAi-i:.'*.
Mali::*.
1849. \^:*\. ' 1800. I 1849. ! 18.)4. ' 1800
»'8 I 10-8
6-8 I 80*0
S3'S
23-2 •
13-8 ■
I
15*4 '
29-8
86-3
lG-2
8*6
4*3
6-7
9-5
13*0
10*3
6 2
S-5
2*9
6-9
7-9
V
48-6
14-9
9-1
tvi
18*0
10-2
64*4
19-7
13*1
5r7
20-8
11-0
40*8
18*9
7-S
npdiL
a'l
• •
24*6
23-5
22-3
12*8
14-2
30*3
40*5
40*7
GO'4
678
71*7
48*7
83*0
10-8
13*G
7*3
3*0
fl"H
0-3
5G
2*8
6*2 30
10-2 fl-2
14*0 . 8*3
I
II'O 9'i
19-G . 12-0
21*8 10-9
23-0
20-8
20*0
13*8
17-2
30*3
iri 11-2 8-r
... I
10-2 ■ H»*l
7 rt
i-i*i) 01*:
47*8 . 48*0 67'3 41*7
1-1 .
I'l i
l-l
•t;
1-1
2*8
*4 ; 1*2
1*3 ;
2-7 1-1
•8 !
'4
•6
1-0
4-S
2a
1-S
11*4
0-1
4-8
27-2
20*1
14-0
54*0
62' 3
300
M*7
88-0
C3-7
77-7
ISG'l
1
73-8
1-2
2*1
3*2
4*0
10*6
20*8
62-1
62*3
74-2
1*3
*8
1 1-5
1-8
1-1
•3
•4
•9
1-3
2*7 2*0
7*3 I 5*0
19*2 11*6
61*8
77-4
79*0
35*1
64*2
40*4
Mttrtalitg at different Aget from Cholera in JTtree Epidemiei.
AGES.
DUTDS
(Mm CsoLKOi.
Hid Cqolbsitc
1S«, IM^ Idffl.
DllTDS
MtefTodlnlhe
R««isten
dlroctljto
Chough*
(IStt, IIUM. IMe).
Deiths
■^UMdby
(lM0,18M.lSda).
DUTHS
regiitcred uudirr
theCwue
"DlilEBOtl"
intheThnieTeui
when Cholom mi
epidemifl.
DUXRt
neisteivd under
theCuiM
"DlARBBOA"
la the TbKeTMn
whea'Chole™ wu
M«lM,
Fem«lM.
Malu.
taniiea.
Haloa.
Pomale*.
U>1».
P,n-I«.
Hala.
?emil<«
AUAg«a -
10-
is-
*s-
n~
sa-
UJtupwili.
so,iK3
ita,iM3
4AMS
44,909
7,220
7.108
28,488
2T.*ai
£1,4(8
Kja
M13
WSl
S.7SS
I.B70
1.2M
11
li)3»
4M1
1^
iM7
ijms
6,78*
MM
3.T30
1,731
ist
10
7*71
*.m
1401
*,m
IWT
B,»7*
0,481
*17*
S!,53T
eoe
103
3
a.«M
8,Boa
1,881
*,m
0311
WM
*,im
3.1M
WW
171
*.T70
iw
«33
3S0
4,337
SOS
T*
IW
2U
2811
477
67B
40t
«8
21,SI»
374
«0
378
127
I,1M
IflW
i,Ma
18,7ES
M4
MS
440
m
TW
UN
IJIIB
1.7*1
400
u
1(1,1183
Sll
B8
sn
S8S
7»
1J07
i.oa
14*18
m
no
490
*4«
m
•
Table 10.— ENQLAVD. AnrrevM* *»■»■■■■ Hartallty from
BlMrrbca*, of Halbb and Fehales tx DirfEaEHT Ages, in the Three
!■«•, &•««, and !•••■
EpidelttkB of
Anaiaa Asmii, Diatei to iDjOOO Limra.
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.OenfpctioM f^Makt ^ng Jrom Chokra.
Tabu U^-ESTGLAND.
'frff-'
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»-'.|
«r Local OonmnuvT ^M*
Po^Offl^ -
PoUn ■ ■ - .
Enion iiHl PHi^h Offlccr
"•■--rLoe»Kjncm ■
wlththiAmj
L Knt iAJan or la PmO.
Saws OOwT
Soman, )LM. . - • •
B>iT>IH>na« . - - .
Gncnvicb Peniionor - • -
coBruclMl with Iba Miry
PaorcniOBS. er in Lmiu-
L CThwib. KMtn. aW CT»re>
PmteaUni Hini:
Other Cbuich (M
D^R •
Ar1i*t. Punier . . ■ . .
Baffnter
pluMiBtatihie Artirt • - •
a. IThMmu, nM*«W 4^ JViwitk
SM I BIT I KM lU , 3ST I MT IMO Itt
-'I !;
1 !
28 OeeiipaMMi* of Males dying frtm Giekra.
ES6LAND.— OccupATioHB of Malu djing at di3iR«nt Agei from Cboura In (ke Tew t Sfifr— om(.
o«„.™„
AiL
0-
-
„-
..
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as-
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s
CaiLDEFH or BHUTITM^ OIKI
ScnoLABs.
S. ChadmandBtbMetaattiim*.
SohoUi
OFFicEa/ormiwt.
1. /m Board and Lndeing-
ColTcG-boiue, Eiiing-boiue, Keeper •
Cook (not Domestic Senmat) - -
&i'r'» !<»?»". : :
IniiBcmnt ....''.
VI.— Pn*)w tr*o EITT or Ull, ezef
or LEHD JfoMK. Soimt, or
OocdttfiariOMkindt
JSr ::::::
AtHmt.Fuctor
SiSsSifSS : :
S=r.',ci.,k- : ; : :
Dmnmcrcial Tnvellcr - . . .
Other HewmnlilB Men- - . -
2. OOtr Gti»ral Daalen.
Unrlneilara dealer . . . .
II»wker, Pedlur
1. CarHertmSaawf.
ttniliinurEiipine Driver. Stoker - -
Sniln; Ollloer, Clerk, StatioD-mutcr
B«illif5PDli<.-e ' . .' . .'^.
a£S?",i!Z'.'^?-«-| : : :
Caniun, CBTrier, Csfta-.Drvmm •
OlUfr, oomed m Ho«d amfejMi™ -
3. Oti-runoii Cbiuir*iiiulJifHrf.
S«M
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. Oeenpatiam* of Malt* A/mg from Cholera. 29
ESGLASD.— OoccFATHMa ^ Uusi 'jixB ■> diffifcnt Age* Iram Caaut^x In iha T«h 1EG6 — catt.
Oeconattan.
Au
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10-
18-
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AXUIALB, awl irfAtr prodilcf.
\.InPitid,ai^PaH<,rm.
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Gudour <nD(IK)ai«Ue8«rvM>q -
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L £• n«U>/H-S|wr« Md Sow*.
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30 OcaqKOioHt of Malet dying Jrcm ChoUra,
BSOLAND.— OocopiTioKS of Uaus dying at diffiMtit A«m from Cholbui in the Tew 18G6— Mat.
OccrPinoBS,
Aix
AQBl.
0-
B-
10-
»-
»-
U~
B.-
M-
n-
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6. lHAr,*t.
Gunimitta,OunHuiuhwturer • -
10. /■JfocWMioBiilboit,
SnKlnewulUiicMiHi Maker - •
TeS— Uaker, DHler . . . -
KgilUi-..; : : : :
Othen enjnifred about Toola and HiJ
ehinerj
11. In CarriagH.
Coachnukpr
Otiien cngHROd about Carriiigea • •
\i. In Uarneu.
IS. /• Ship:
Shlpbuildor.Shlnwrinht . . -
other. ongagodluBttiilBSliipi - -
1*. Ti ZToHH and Buildi»g:
HouH AEcnt, Rent CoUector - -
SZ". ::::::
^" : ; ; i ;
IS. In Tnmifnn.
Ghalivnuiker
Picture Pramo Uaker ....
Q^'r, Gilder
StT^^^'i^^r^ftn™- : :
TbedirrlRht
BUIwrighl
CboDica] Workj . . . .
II.-P«*>M «oriing and dMNng
in HiK Tbii1J,k FxBBica, and
i.Jn Wool and Worittd.
Woollen Clolh Manotarturo • -
Wonl«d Muiulhcture . . . •
Cimet, EuK— Mauufketursr . •
1. In aOk.
Silk UannlW-turB
8Uk-Djer, Printer - . . .
3. In O/tUm and Flax.
SS&j ; i :
Calico, CotlOT-Dfw . - . .
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OccM/KiMoiu tf Makt dying from Cholera. 31
3.-Occi'PiTiox* oFMales djing at diK.T!n! A;.'i'i fh)m Ciioi.ktia in the Yvit ISRfl — tml.
OccCTiTWjTfc *"■ 0-1 3- 10- IS-' ii- 13-' IS- :;- '»- t.-,- s.-.- g|
■oMiMdJIatrrntt. 1 1 |
1W« - . . J , . -
- 1 - 1 1 1 -" 1 -" '" -' - "» — 1 -
i.I*Drttt. 1
te^SSS: : :j :
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j;:.iwa;™.i,o;.ioim :i " i : : : ; .' .' 1' 1' '1 ; .' : :
^ ; i ;!■.'! 1 ) :•■» ^.,4 «;. :: M
PWHoL Blick— Maknr -i .... js'-....
'IdlneDrtM " ' • - - | - - . ! - - j . - . .
dMerFthnutltalfTial*} \ I
klnttiDddnliiiBinKcDip, '-!" -'-'-.1-'- - -.- -
CKil>nvf Dbiigi. . , [
In Amimal Food. 1 '
KUWLbT- . . .. B
iwr 1 J
CiiiFT, Dealer . . I ' S
rr'^-: : : : ,5
:: i : 1 ■.-.-.-!!:-':■ :
Im rtgrtMi nml.
cbMLDnkr ■ ■ -
- 1 .;.:-','-' , , , / .'■ .
OtT.AfRnt ....
tt
,-.-,- -'1- - 1- - - -
Hnn-Hnkcr, Vender -
;!:;;:'!■ 1>i:';:^;
\ \ \ ' I . : : ' i '
bcUner («i|Be(d Id di»
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-
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ESGi:«VSD.-Occi-pj
Occupationi of MaUi dying from Clioltra.
.Tioxs ofMiLES dying at diSLTi-ntAoES from Chouiu mlkeVcar 1866— MM
„„„„...
AOEB.
"
-
10-
..-
8S-
35-
«-
M-
«-
,.-
»-
a
In VKaEriSLI SCDWiNCSS.
l.T«GumsaadBe)iM.
Oil and Colmirman . - . .
Pronch Polisher
JapimDcr
i. In Wood.
1
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8!E :::;:: :
S. A Bark.
Others Kiffkiag Id B»rk - - •
*. In Cams, Bmh, and SIraw.
Buket Maker
Hay and Straw Dealer . • • -
SKwklnsin'can;,Rui., Scrawl
S. In Paper.
8JW-Gatherer,DuiIor. - - -
Paper ManutkctUTB - . - .
SWliooer (uot Uw) . . . .
OtE^fi working in P«ier - . -
1. jniten.
li
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I. JM Oant.
Cml-JIerehaiit, Dealer - - •
Coalheaver, Lntwurcr - . . -
Coke-llurno^ Denier ....
ai'vi'Skt^rCfco" '■'.'.'.
(JthorsnorkinginCottl . - -
i.I»aio>te,Clar.
a
.1
.
StoS^-Cutter, Drtawn Pouiber
fllM«QuarTicr ■ - -
Raimray Labourer- - .
Durtt'oliuclor - ■ -
Eirtheuware and Glaw Dwler
B, In Olau.
Glnn Manuhclure • ■
fi. JM Salt.
ULlKr[>.«laninslai . -
3 ., . 1 - i .
-
Oeetpatbta of Md
ENGLAND. — Oaxr^TTO!!! of iLu.cs ipa^ U.
In dyttiff from Chokra. 33
ditferent AgB" from CnotEnA in the Tear 1PC6 — etml.
L Frtmtmert and otien cf Crialital
IAdbw (no itoteil Oeaipatian) •
vCondllkin
zy^
Occupattotu ofFemaltM Hffing from Cholera.
Tadlb 17 EKGLAXD. OoenpaUoiiB of remale* dttso tX different Aoes fi
ia the Year ies«.
OccrrvTioxs.
All
AOE».
.-
'-
10-
IB-
M- 3S-
«-
»-
as-
"-
te-
-■
or Loctt fioTHixnEiiT nT *Af
Om«lrv.
1. SaluiHiii Gowr"""".
Othen cmplDjuJ by Govcmniput
icUh the LBiEWaD Phoibs-
3. Pbtiie.
Midwift!
ITOTHBBS, MlBTttEESBB !(/■ Pi-
Mll.IBB.CllIlJJ«IlI.E«tlIIVE8
Inot othmoire dM-rUied) .
1. n'iw[«^lol>trraUtdeKTiinn.
WiTe. - -
3. Ckildn-n iHii Selntina at Home
(nut olkmi^ijc deirrihal).
^ScSalaniiodtfribfd).
Scbolin
onrf prr/l-rmmg Pza»o>*L
0WCE9>rJf-.
Offlcw of Cluril»bla Ituitiliitloo
BooiMtle SernnUGcBOTl) - -
as™.;. ;:::::
KS.?,-" : ; : : :
Si"—?":™'' .- .-
yi.—Pirfanji ulU BtJT or »BLI, KKBP
nr LEID MoHtr. BoktfM. or
aa-Oti^ParianiKimil.
X OthfT Omrat Dtaltr,.
SawkorandPcdW . . . .
OlberOtnenlDenlera- . . -
TIL— PiPMM e^gaatti it '*« COK-
VBUiiO if Ken. Animall.
0««d,,andir<-t<Vtl.
*. On Road,.
Curier.CutCT
73«>
IWl
era
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IIW
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SOS
no
10
in
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BU
au
MB
Ml
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a
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31
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OeeupatioTU of Females dyint/ from Cholera.
IkHGLAKDv-OcctrPATtoss of Females diing at difftrt'OI A<.[:n from (.'11x1.1:11.1 In the V11
OCCCPIIIOSI. 1 ll 0— 0— 10- la— J5— ,1S— *5- SS— M— T-i-
{Aan. ; '1
H.|
t. OaBuuandBiiHrt.
1. /« R«t».
Bo«*bhidCT
Bo-. B»(. BUI, T»cklc. 4e. Maker .
1;. /> dtmicaU.
Mr Teitiu Fuaica. and in
l.h Wool ami Wontttl.
Byr"_^7'll _ in Wool -
^^^^^ 1. In aUk.
^■mibnahnuK
^H S. .fir CbUm and Flan.
Klrmra HaxunKttira ....
Bl fi.it.Snw.
■k|g»FtiilM>nuf»ctnn ■ ■ -
^H BSMu^Pwmnl. Slick— BUbr
^1 l.A.l>iH<A«l.
■
; : : ;:;:
1
10
1
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36 Occupations o/FemaUt ^ing from CkoUra*
ENGI-AND.-OcciiPJtti'wa of Fesialeb dying at different Ages ftom Choleba in tke Teir
„„„„.,»
All
AaKi,
.-
.-
10- ] IS-
"i-
"'
u-
.-
,.-
ss-
■1
M ^BIHUBcnsTUICEa.
1. lu Giwir, G«l. ^><"- I^if- Ivorv.
S. In jaiH>.TMlhtr: and Ctnilti.
S. I«Bair.
Bnuh, Broom-Uiilier - - ■
XIV.-Per.™. KorUaa nsrf dH>li<vg
LSnOtrntendSctln,.
FreuoliPoli-licr
e. /B Wood.
Bo»MakOT
*. In Cant, Smli, and SIraa.
BaakelMnkcr
B. /■ Paper.
B>«#thcKr, Dcitlor . . - .
ZV.— PmoH worHna tmd ilealina
IB MiasttALS.
n. In Sloit. dag.
Brick MukBi^Dealcr . . . .
4 la SarthmvaM.
fcirthcniraroMsnuficlu™ - - -
Id. /« Ti» and QnltMlim:
TiD Uanufu'turo
OthiTs fforkiiiK snd dcniine In Iron,
Stwl
{BraHcfmr Labonr und^iMl).
Labourer (bnuitli undeflnpd) - .
I. 0/her PcrtoHi of IndtftnUa (ken-
palbn,.
Other* of itideflnlH! OccupBtion - -
XML-Pc^jo.,, of BiSi cr Pno-
PEUIT M.rf nYKnifi/Biir/oi-oii*
.
:
:
:
—
;
:
1
:
-
-
_
-
-
-
:-
:
.
1
-
-
-
-
-
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1
1
1
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1
ITIII.— I^*»I» «DPPOIlTKri m- THB
CoHmritiTT Olid if bo bpeci-
TUD OCCCTiTIOS.
pMlpor (of uo bIbIbI Orcui.Mion)
No luted Owiipalion or Condition -
!
-
^
m
H
87
1
1
u
1
■
I
MortaU^ from ChoUra in difftrent Occtipatioiix.
a.— ENGLAND. Fropoit l oa of Seatiw hy Cbvlen in lB«a to lu.niw livLns
in 1861, of diffi»i'Dt OecBp»UoBa<
■adBiuTCoiu -
idDrugKiati -
(not TMcbers),
InmadHen
Cuiter*. Csrten,
MALE a—eoutimaiL
Cowkcoimi. MllkwillrTt
Biilclivn. Meat Salesmen
B*lE«n ....
OrwiigTotura. Fruitcrcra
I^UKnr BvNiicn -
Gr«-oni,Ti;aUc»lcra-
TbUiiw Cliwidltri -
Cnrhen ■ ■ ■
Cub! HlDi'ra - -
CopiKTwid Tin Miners
Inn »iriL-ni • -
CoalhmTcrs, Labourefi
Ouworki Si^niee
Brlrk MnWcni. bnJen
B*U»«; Lahourcn -
Sicivaton, S'lm-lM -
£i>rlliPowvrc UADuflutaien
Sham Mnnuhrturm
-fiiklt JlanufRetuFon -
Clipper Uinnfleturcn
Tin UmafHtoniri -
"Lead HtanActarera -
Iran Msiiufticlurcn. Moul
l:'c.undi<n
mHi»
FEJULES.
Jnniwpen' TTlTe* •
Publicani' ■Wi»eB •
Pumera'Wirei-
Butvhera' Wives
BhiHiuaWa' VivM -
AcbouImiilnsMa
Uumustlc ind other Serrmnta <
Sur-Lii . . . . ,
CliiLrH'omcn . ■ . .
UowkiTi, K'dlCTS - -
Cutlmi ManiifBClurcrs
Daily Deaths from Cholera and Diarrhaa in Etifflaud.
1
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Da3g Deaths Jrom Cholera and Diarrhaa in London.
a
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in
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42
Daily Deaths from Cholera in the London Water^Fields,
Tadle 23. — BeatlM from Cholera occurring on eaob Bay during the 13 IVoeks ending
29th September 1866 in the mTater-FleHU of the several London Water Companies.
Daj'S.
Grand Junction, West
Middlesex, and Chel-
sea.
Grand Junction, New
River. West Middle-
8ex« and Chelsea.
Southwark and lAm-
beth.
Southwark, Lambeth,
and Kent.
New River.
New River and East
London.
East London.
Total of London.
East London {including
WeHHam),
Total of London (inclu-
ding West JIam),
July 1
1
^_
1
1
^
_
1
8
»
2
3
4
^
—
—
2
—
—
2
a
._
^
—
_
_
—
_
_
_
_
6
—
—
1
—
2
—
—
3
—
3
6
—
—
1
—
—
—
— .
1
—
1
7
—
—
—
—
1
—
1
8
1
a
8
1
—
2
—
—
—
—
3
1
3
9
3
—
—
—
1
—
1
5
1
s
10
—
—
—
—
—
—
—
—
—
11
1
—
—
—
—
—
4
6
4
s
12
—
—
1
—
3
—
7
11
9
13
13
2
—
3
—
2
1
12
20
IS
ai
14
—
—
5
—
—
—
10
16
41
16
15
1
1
—
1
—
11
14
4*
IS
16
1
—
—
1
4
28
29
83
3«
17
—
—
2
1
1
8
60 1
66
SS
S9
18
1
—
8
1
1
8
64
68 ,
69
6S
19
4
3
—
1
4
76
88 1
«5
97
20
2
—
8
1
—
8
71 i
79
3M
90
21
8
^
4
2
8
6
88
105
40f
lis
22
2
1
4
1
3
4
89
104
404
116
23
2
—
2
2
8
2
114
130
4i3
1««
24
1
—
1
1
6
10
128
141
44B
160
26
2
—
6
4
6
10
146
172
460
1S6
26
4
—
—
7
3
10
123
147
4^
17a
27
—
• —
6
4
S
6
108
131
4t4
1««
28
1
—
2
8
8
6
132
162
466
17S
20
—
—
4
8
7
7
129
150
44a
169
80
4
—
1
6
8
6
122
142
499
139
81
3
—
6
1
8
19
164
191
^
ao«
August 1
3
—
4
8
17
17
144
188
461
aos
8
2
—
8
3
7
17
130
161
443
179
8
1
—
2
8
11
4
108
129
in
13S
4
—
—
3
4
6
10
90
112
40M
ia«
5
3
—
6
4
18
11
99 j
135
409
IftS
6
—
1
4
1
9
12
95
122
404
131
7
1
—
8
3
8
9
70
94
79
103
8
—
—
6
1
12
19
71
109
39
lao
9
1
—
8
3
3
8
81
98
33
103
10
1
—
2
1
8
8
62
77
68
7a
11
—
—
2
2
8
8
68
73
64
79
12
3
—
3
8
6
6
67
77
66
•3
13
—
—
8
8
6
7
38
66
43
61
14
8
—
1
8
1
4
87
47
83
%m
16
1
—
9
6
4
6
43
69
49
73
16
2
—
3
6
6
8
48
61
43
61
17
1
—
5
4
8
6
81
49
86
3«
"
""
1
i
8
6
4
84
40
at
«a
Daify Deaths from Cholera in the London Water-Fields.
43
JkeaXbM from Cbotora occarring on eaob Baj during; tho 13 Weeks emiiti;; o^uh Sipt. 186G
ID the ll7'atar-7ieUU of the Mvrral Ix)nd(iu WiitiT Cou\\Kii\\v** — rtmtiniU'l.
h2
ess
a
■2
a
5-
I
I
-1
5
5 ! s;
Aafni&tl9 ■
23 '
I
26
2S '
r
2d ■
:jO
31
Sept. 1
I
2
5
6
7
8 '
9
10
11
IS
13
1-1
15
16
17
18
19
20
21
22
23
24
25
16
27
2
1
27 -
3
•9
3
5
5
2
2
2
3
3
S
6
2
8
2
2
1
2
1
4
3
I _
1
1
1
2
1
2
1
4
1
8
1
2
1
1
2
4
2
2
1
4
1
3
4
2
2
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5
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3
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6
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3
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7
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6
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31
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31
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y
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to
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ToUl . 148
30
229
232
382
323
3ft10
4731
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5137
44 Daily Deatka from Cholera tn Lotion Skd^-Dutriett^
lAsta Sft^-SeaUw ftam ObMom ocearring va MMb ll»r doing Urn U lVa«ka nding Udi S<
8CB-D1STK1CTB.
Iiil
ml
JULT ....
1
a
i
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fl
1
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U
•rand JnooUon, WMt
6t.J„hn-WMtains(*r - -
OhelmSoath ff - - -
CliclK« North-wort HTF«
iSsUw- ; : :
fiV'^^'T"". : : :
BtUurPutdington ITfT -
Bcsmfl P>rk Vuutu • ■
Bt-JohnUmikbonB - • -
CbeUom.
CharineCroM ITff - - •
Uunpi**cl rr - . - -
St. Gairw CamljerKcU - -
St. Puler Wiilivorth ir - -
S;&'"-""°. : : :
tsttsa-^; .■ : :
LunbMhChiirohMPut W ■
Lunbelb Church lit Part - •
Walnloo Bud M Part - -
W«l«rl« E«ul Irt Port ■ -
St. BkTtourBaiithwnrk H - -
Kouiinstini liil PnrC - - •
Pmiar
Clwlutm
Briiton
Kil. : : : : :
Xnrwnod IT - - . .
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u
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L
IMS in the KTertl i
W4,
Da,
tia from Cholera in London Suit-DittricU. t
c^iiimuc
JUI¥,
U
14
IB
18
","
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a MM iB sfl 1 n is
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Daily Deaths from Cholera in London St^Diatrieti.
Deaths from CnoiXM occurring os each Day during the 13 Wetk» enaing S9th S«plenb
ACQtiST
,|,|,
«
s
«
7
■
9
Id
n
t
Orand JonoUoa, IVeit
KliliUeBez, and Chelie*.
|i^»! """";" "'? : :
ChPtuaSuulli H
Che 1«» Sort) j.vf cat flU'io . - -
BromptoD //
-M:VoiEh«:t : : : : :
it. JuOim-t-KIUMD
lia^Vvt W -
boiiiDD-witnrK ir
Kahsl'ii""."'. : : ;
SSi-SHS:'/; -■ : :
BeiBiiRi Park P»nnM ....
Christchun-li MwT'lBbono . . -
St. JolinHni^lcbuDS ....
Cheuea.
ChlrlnKCzflM WB
TDltrnluim-ccurt kB . . . •
Su<'«)rgs CMnhcrwcll ....
8t.Vfler«>l!rorth K - ■ ■ -
llw^cnBowi'f
WasSi*^'."'; : :
UuroiuhBosd W
JBt JoBn HomlcjUown IT - . -
-W.urtooE«d lit Part ....
&inl*nn!U Wit
Pm"tj
Clnpluun
Briiton
I>nli.ich
Nonmcl W
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DaSbf DtaOta fioM Cholera in London SulfDUtricts. 47
In the WTval Snb-diitrieti of Losdom, gmnped according ta thnr Water Supplj^^-fonlimm'.
AUGD8T. 1
U
11 u
IS
u
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11
a
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s
Daily Deaths from Cholera in iMndon Sab-Distriet$.
Deaths from Cholbea occurring on each Dat during the 18 W«*« endiaf B9th S
BCB-DISTHICTS.
SBPTEMBEB ' ' ' ,
1
.
«
«
= |n
7
8
ft
10
..
Orand Junction, Weat
MIddleaex, and ChclseH.
ClieIsM ftnilh B ■ -_ - ■
Clia^Nortb-.ist '- ' . ■
XsMLnitKmTown W ■ ■ -
■fet. Jmnea'KWUoro - . . -
li^VniT lif
Chrintchurch HiU3k'licnp - ■
Sl.JoIu] Mar>'l<i»oiiG - - -
Charing Crosi WB ■ ' ■
lettherlSSm ....
LondDDBnul Z - - ■ >
Lamb«th Church Bd Part TF -
ESbeth Church lat l-art - -
WBrlmBoad id l>ut - - -
■ff^lerlooEMdlitPurt- - -
M!:a.S^- : :
Vandiworth L • ■ - -
Putll.'J -
ChipUnin
Brillou -
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irX."-: : : : ;
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DaiJif Deaths from Cholera in Lowlon f>-tl,-Diatric(.i. 49
1S66 in the HTCnl Sub-diiUicU at Jjoxdos, grouptd according [•> lliiir Watvr Sujiplj— (...I'-m,,,/.
■ SfiPTEJdBEB.
:I.'m,lir..
I'orn mos,
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ilSI
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SS.113
zi.sas
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10,7B3
1Z.BS9
19,773
isIba*
zb'.bsz
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620,099
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29,371
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S3T,yo« 1
DaSy DeaHu from Cholera in London SuB-Districtf.
DsATHS from Cboleba oecDRing ox R:1€h Dat during Uie 19 WeA* <n£nf S9th Bejti
BtTB-DlSTBlCTS.
lm
JULY
1
J
t
4
5
«
1
.
9
u
u
Bonttawark, lAmlietll,
and x«nt.
Rothorhilhe If • - - -
P«lihBni
KSS-i'S- : :
KT-aW^: : :
LewWuuu Tillwe IT. - .
Lm
Blthun
^SSSSSS"^ : :
Woolwich Araanal B- ■ -
Srew MT«r.
London Citf, South • - .
London Citj. Bouth^Mt - -
SaasiKi; ra: :
BI.ClemeattMoCB, Strand B -
Saflhm-hill
gS^.ijor^^t : :
pSFS'''!' ': '. ■.
LonB«CTB
fiomiTB-tflim .....
Old Btnet. St. Luko'a - - •
Wit^iSou'tli W '- '- '
^Iti^^'f : : :
QoawclI-stiMt ....
SSSt; ,;,:::
liliiiHon West JTBB - .
Kcntieh-town ....
BTew aii-or and East
Shadwcll If ... .
AldE«te
Whileehapel North . - .
Artllleiy, Whitcclutpol- - -
g.Kt'Sa"''."' : :
HMkiwy WBk ....
1
10
f
?
n
21
M
a«
w
48
53
BO
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as
78
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DaUy Death* from Cholera in London Sub-DUtricti. 51
ia the Mien] Siib-dislricts of liO!n>ox, gronped according to th«r Water Supplj — eautiiaitd.
JCLT. 1
U
It
u
17
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to
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a
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ta
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=
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1 '»
62 Daily Deaths frma Cholera in London Sub-DlttrieU.
Deaths fmm Cboleka occurring 0:1 each Dat daring the IS Wed:* cnffii^ S9th Septcnt
SUB-DISTRICTS.
AUGUBT . - - .
1
J
8
4
B
«
7
s
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»
I
ana Kent,
Eotherhilhe W
IrNiToto'Dep^fbrd- : I I I
Oremwich EMt WS ■ - • -
sSsS'V : : : :
Lee
ISh'SSSS'S : : ; :
WoolvriihiTBenil ff - - - •
Maw Klv«r.
London Ditj, South-weit ■ . • •
London City, South
London City, Bouth-owt ....
SSKftiSSSVi; : : :
St.ClomentDanei.Stmnd H ■ -
i?^;«i!diho,;iitch i I : I
Finshury
Lon^on^ty, ITorth-weae I I I I
snsasfs-y : : ;
8t. An£tv Eist Holboni IF- - .
City-rond ITL
'WhitsTOgs-Blnx.'t
Sil^tono'wS 7^ I : I I
cHdsSi^B^LuW.: 1:11
Bt.aa^r^-tho.MBrtjT"Ho!imm" H ■
l?:S^^^r!^: : : I I
sLEr^^rnXr'™'? . . i i
Goswfll-Hlrpot
lBii'n™,)i'i ICn'it IFip - . I I I
Inli.,KliTn m.,t IVJia ....
New Klver and But
8h»a<rell W
Ahlrale
Whiln-liapcl North
riS&'Siu.: : : ;
Holyirall BhoToditdl
i
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Daily Deaths from ChoUra in Londoa Sub-IHstneli, 53
(S6 In Oie (crenl Snb-dutriela of Lokdon, grouped according to their Water Sapptf — contiKutd.
AUGUST. 1
Ifl tfl 17
IS
19
so
SI
sa
H
s*
ti
M
JT
*s
»
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a
1
3
2 1 2
- 1 1 1, 8
1
M DaStf Deaths from Cholera in Londmt Sab-XHslriela.
Deaths from Cboi.bra ocenmDg on each Dat dnring the IS W«Am aiding nth S^tca'
BUB-DISTBICTS.
SBFTEUBBB ....
1
s
3
i
fi
8
7
B
9
w
u
11
1
1
1
a
I
a
1
1
1
1
1
3
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S
1
1
i
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i
'^^'. : ; ;
r«e - -
Pluiul«dnndCbiiritOQ' - -
Woolwish Dockjanl B- • ■
■Woolwich Arsenal B ■ . -
IVew KlTor.
aallS™': : ;
■Wwl London! Korth WB - -
Bt. Clement D»n«i.8tniHd ff -
BnSVoii-iiill
Bt. Leunard Bhoredilob £ - -
^fH^ :
giiSSS^n^-SoiW «•■ :
Ony^lM-hsu! B . - - -
HoWon New Town iB . • -
w'^Hll?k'up7"' -"' - " -
Lowi-acre
BoineriHlown .....
ispvt? : : :
S
B
«
s
a
4
8
7
1
7
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i
Goiwell-itreet
isSI?'.%; ': ':
Kew River and But
Bluidwell jr - - - . -
Aiae>hi
WWlechawl North - . - .
Artillery. W hi tcolimwl - . .
U^ywel/sl'ioiJdilth" ""- - ■
Hncknej IfBa ....
I
*
i
i
e
4
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a
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1
1
;
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1
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8
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:
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/
Daify Dea&M Jrem Cholera in Loadon Sub-Dixtrictt. 55
■ m the ■ercral Sab^iitricta of London, grouped accocding to their Water Sapplj — canUnatd.
BEPTBMBEE.
"Xl
POPCLlT10:t,
U
la
It
IS
i»
so
.1
S3
^
U
u
M
X7
IS
£9
i
i
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1
1
i
1
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:
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■
IB
la
23
32
37
•
1;
2«,S02
2S,13S
a,i39
ia.3os
37,a3«
21,090
7,372
11,B07
3,009
32,97ft
1
4
*
4
a
1
1
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1
4
s
2
3
1
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232
235,«S9
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13
3
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9
21
15
19
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14
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7,702
a,ft70
llilfl
IB, 207
il;!iS
12,931
19,097
9,020
ll.S««
ism
1Z,9«7
14778
2«)bis
25,777
Z3,Z60
24,205
ii.oia
39.099
11.504
ISifSI
17,290
17)392
o.eoa
10. zoo
llilll
44.317
«
«
a
«
6
ti
11
9
s
b
B
382
79ft,73a
1
1
a
:
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i
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r
13S
3B
13
39
12,B37
9,971
IS;I!5
3i,4at
*
8
1
-
-
M ^
1
1
^
«
-
-
■
32S
110,971
Zkiiiy Deaths from Cholera la London Sub-JXHrie^
DeATiia &om CaoLKti occurring
05 XACB DAT daring the 13 Wcdu endiiw S9ib
s^
BUB-PIBTBICra.
i
JU LT
1
3
1
.
s
7
■ •
U
" 1
St.JohnSl.GcorgB-in-the-BMt W
Poplar W
a-'S f : : : :
Balclitfo ir . . . .
sfiteKndofdrS^^EaBl' Wk'-
KKS- : : :
Stunford-iiUl ....
Srs-r: : : :
3
H
!S
36
3B
M
BE
i
:
I
1
C
:
;
:
1
:
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■
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.
a
■»
But KDndan.
8t.JohnSt.C«irp>in-ll,.:-E«»t W
e
7
i
13
a
3
I
i
i
4
.1
7
I
1
4
IS
■J
i
s
J
1
li
10
S
e
I
3
i
1
4
9
«
1
"T
M
1
5
1
•
S:a?»°SEi.";SSS,f
HItc Eiul Old ToHii Enat IFn
WliiteolmpiO flinrrh JZ - -
Mile KuaolilTiiwu Wnt- -
Mil^ Eii.l Nqh- TD«-n W- ■
Ch«n-'li. il.Tirn»lGri*a '- -
Green, B.^tlninl Gnvu nilL
ajmll. IInrk..-.y i . - -
^«!;;.^r'U-t : : :
8tanit*ira-hill ....
i\ ;
10
-
130
1M
4
s
4
1
as
»
3
n
Si
3
1
9
Waltlioiusloiv ......
la ; us 117 ^ Ki
IW
10* ^ 7B M£
. .
«.
I^aayDeiOJu from Cholera in London Stib-Dutriett. 57
I Che BTTcnl Sub-diatricB of Loxoos, grouped according to ihvir Wnter Buppty — cimtinue.l.
JULY. 1
m
u
14
IT
U
1*
JA
91
a
a
ti
a
£«
37
»
. « .|
•
i
1
s
*
-<
!
:
1
7
s
i
i
:
1
?
10
e
i
*
i
I
11
18
B
1
:
a
I
1
\
i
,5
1
1
i
8
I
1
t
M
\
\
u
1
i
1
1
IS
1
7
18
*
1
10
1
U
i
1
1
1
li
.1
1
S3
3
«
H
i
ri
•
■:
i*e
»
IM
11
121
i
IM
29
W
S»
ss
S2
m
1(11 .iM
Hi
iw
i«
121
IK
1*8 |1M jioT [
AUGUST. 1
■u
"l»
17
«
le
£11 , » : £2
-='-
M
-^ 1 ^ 1 M : 30
31
*
I
*
i
4
1
1
a
s
3
3
1
1
»
I
1
1
1
i
a
!
i
•
1
1
1
I
i
i
J
i
i
s
i
1
1
*
'_
1
I
i
i
i
1
i
a
1
i
1
1
1
m
%
41
a
n
<
S
£t
ft)
ta
IB
M
I
11
ai
:
IT
M
9
m
«
«
M
M
U US :i ^ Si M i IB
"
« M
F"i » 1 • ;^
58 Daily Deatiu Jrom Cltakra in London Si^JH^rielt.
Deatbb from CaoLBU OMorring ox kach Dav dnriiig the 13 WeA* cn^jig S3th Scpl
SirB-DISTRICTe.
SEPTBIJBBB
I
^
8
■t
=
«
7
8
»
,. 1 ..
u
s
-
I
1
1
1
3
1
■1
"
Bow wici
HiteliDb IF
Bt.M»rjSt.G«irge-in-thi>-EMt -
Mils End Old Toim Eiul W« ■
OoodDMU-a Fidd. . . . .
Wliileduipd Cliupcli B ■ •
Milo End Old Town West . .
MaoEndSewTcnrn IF • -
Bpitalfldds
TowD,BotlinulGreon - - ■
Chunh. BeUiukI Green - - ■
Green, Bcthnal Onsen fTBL ■
SonUiHwkney £. . . .
awsmtoneEMt . . . .
Stunford-hill
WeitHani ww - . - -
Ltryton IV
■WaJllmmBlow
1
t
W
5
1«
10
6
;
U
.0
»
10 1 «
1. N I ,.
"
.. [is
•
B of the inb-dUtricli denote public
Vote. ~ The letters placed against the b
therein, namelj,
H'_ Workhouse i
J/~H0Bpilal ;
i— LunftUo Asylum ;
to— Workhouse not belonging to the district in which it is sitnated.
Included with the deaths in the above Table are the folloviog fatsl Cholera cu
in the sub-diatrict of Belgreve (SL Geo. Hao. Sq.)
„ All SouIb (Marj-lebone) - . .
„ Grab's Inn Lane ....
„ Iilington West
„ St. Clement Danet ....
„ West London North ....
,, Whitechapel Church ....
„ SpilaUelds. .....
„ Sl Ohive and St. SaTioor (Sonthimrli)
In Hospitals r
St. George'e Hospital,
JJiddlese^i Uogpital „
Royal l!>ee Hospital „
Fever Hospital „
King's College Hospital „
St, Bartholomew's Hospital „
Tjoudnn Hospital „
Cholera Hospital „
Guy's Hospital „
XhSif Deatht from Clwlera in London Sub-DUtritis. 59
a tbe semil Sab-diitrietc of Lomdos, graDped according to their Water Snppl;— oontwHerf.
- SEPTEMBER.
DuTm
POPOUTIOJI,
»
IS
M
U
1«
»
«i
a
a
u
bi
la
*>
B8
•9
1
t
1
1
1
I
1
1
1
1
-
1
1
1
3
_
-
1
-
1
-
1
-
a
ftl9
as»
«os
1«»
122
»»
z»o
3S2
ISO
X«8
ia«
ISO
102
a«o
ay
a*
lO
a
»,S09
SB,B«7
ia,B7«
xa,isi
21,01B
3>,»7
ii.iaa
8.0S2
*«,T«T
iB,»a
1B,TOO
21.M6
2S,S2e
3i,Te»
1S,«S8
2«,2»S
17,310
s,«a3
1
«
"
1
:
*
s
I
:
;
i
4
li
SftlO
1S9
aic
1
«3S,8S8
2S,1«S
7.S3S
io,5a«
Li
.|s
11
i«
T
»
B
4
a
7
JL
S7»S
«SS,177
I (hminro WoRXHOtmB :
8t.Q«(nge Hmover Sqmn WoAIioiue, a
Stnnd WoiUioue „
fiLlAke'i WrakhooM „
Eut London WortJwnK „
WfM London WotUioiiM „
LcM&m Cit7 Workhonie „
te in the snb-dictrict of CheUea, Korth-west
„ Tottenham Conn '
„ Hoxton New Town
„ Haclcnej
„ Islington Eut
„ Uile End Old Town
East, and Bow
}"
Dtatht and Mortality fiom Cholera
IjiDLii a».— LOXBOS DISTRICTS.
Kmuberof JnJiaT)ll«aHot»os in
PopiilaU«n, 186Gi aiid Deub*
udJ in iac<.
Water CompaoteB guppljii _
1SG1 ; AOntikl Vklna of FropaT^ a
oU from ObolerBi aad DtaniiaBa, u
DEjTiri rtsJ»'er>;cI
Dei.
Iiiitiiil
Kum.
Tier of
Annual
frem CiuitEejL.
S
h
tj
ofWlltlT
fitntnle
Iiiha-
B«li-
1866.
■°
tho
DISTRICTS.
bitol
of
inalnl
r,.,.ni«-
Uon,
=1
l!
I
rhi..r
Acres.
ra(«l
in
1800.+
1849.
i-
it
IMD
Bupply.
in
ISK.
si
1=)
isei.
1
fi
|.=i
1
£
LOSDOS-
WEiT DlSTBICrg.
77.097
aai,4ai
lB.ffl].BB9
3,OS7,»01
ivaj
tijm
\»W
fi,owi
3.W9
«S
GJ,WM.,0
t;h*
iOpHis
1,U1.S52
sn.im
H3
ss
87
IK
S
C.
Clu-1«» ....
tea
ai9jia»
85,0*7
!17
300
K
23
U
O.JpC.
Si. Georft JUaoTsr.«qium
WOl
iD!*n
iMii-sni
DI,3IG
ISl
103
OS
B.71*
111
«
G^jSSl
gl.M.rtlii-in-tht-Fi«lds -
Mj
awIsM
ei|s7o
BO
S7
iflsi
*)j^
suss
07
M7
IS
18
u
'
NoHTn DisrHicTS.
&vi:
MarjIcLcm . . .
IJW
IBflS?
i,nii.7M
150,871
Ml
3B7
«e
ztt
ILuirittiiJ ■ - -
s,ia:;
!!,IB3
U'TfiU
11
a,7]o
i-JnSja
21l>ii
ISC
13S
1W
ttj
»
wi'i^m ; ; ; :
11'^
7;7,(W2
ioa,(!|i
167
118
ISO
S.K., E.*
Ha<lin<T ....
Cextul Dibtwcts.
»;m
S70.H111
«s
K.II.
KI.Gil«s . . , .
4.m
i:7,.n2
115
11
X.B,
40.WU
118
e»
y.ii.
IWbom '-'.'.'.
1I>0
4.1w
!8l,i75
a
S.R.
CkTkerHrcIl . - .
5WI
7.i«S
s»ajiL'4
vt
u
N.ll.
SI. Luke . . . -
£3D
n.3£i)
lSi,iii
6J
IS
se
11
S.H.. E.
Knrt i/indxii - - -
*.*so
1
(■ 87.0M1
1S2
SO
K.a.
Wc(t London - - -
2,isn
[ a,137.701
i !5,17U
09
X.il.
LoiiaunCily . - -
East DialHicia.
)
I 30,75B
70
so
9»
47
'
N.n,.E.
KlinrediLi'li . - -
QUI
17,072
8.sn.nH
ise,s30
7«P
Me
1»
1H
lai
s
E.'
110,fflll
vn
s
E..* X.1L
WTiilecluiiiel - ■ .
8.0IM
27f.7«
7il,*W
WW
42?
OM
SKO
fl
K.>
SI. GewpNin-lhn.Eirt -
0,100
lMi.7«
100
irs
sss
B^*s.a.
Stoynty - . - .
7,VI1
£H'nt
fiiLlPS
33i
m
E."
^lilc-Ena-Old-Tewn . •
osi
1«;7SS
IMI,™
bSiwb
109
u
u
E.'
Poiilar ....
En cm DiBTniCia.
Wii^
00,7lK
21S
B»J
Si!
n
u
S., L.
Sl.SnviaurSouthwark -
IM
1D.,««
3n,Uj
S2
SI. Olovo SouthWWii -
ii.].7on
18.014
S40
1£
fe;
St. GeorEO Sontbwvk -
CM
N.2»
is«,n>i(i
M.MO
7*1
D2S
38
«
B.,L.
2iS
7^»
i*yioii
ss
11
?;.'.•;
tear- :
4,nia
KS|»IO
tft'owi
moni
007
1.M3
ai
20
119
™«
1>
L.,S,
\yaii<l.«ortti .
ll.ffl'O
luxa
SBl^Hi
811173
4«l
40
8_L.,K.
Ki.'imi
SISKIN
w
"*■-
K'ailertiil^iu -
J'S^I
MJOH
MS
On.-.n*icJ.- .
B.W
M7,Wfl
iii.>WI
if*
«8-1
!•
K.,..
Lcwislmiii - .
i7,aii
ii!:i7
m,!i»i
IKi,120
'oii
se
H
u
in VM Imm two dbillitcl sc
■tL>B BriilEi^ wbm *t'
i .XII at OlilFord, frmnnK'niNniii vhiw pruiluii^tu Ihe BItet Lea. Tlic nnaef I
I ,liut ili«;1incy l8i-hii'ny>'n|i|>lirdfrom L<iiBriil;a': tlic nthifr cLitrirU IW>m OH Krd.
io]iula!iuu of IMi) k) ikdiucl tc<tm the ratio bvlvocn 1S1I mid Ufl. Ii must bo cm^dni
anil Diarrhaa in London Districts^ 61
lU a«.— lOSDON DISTTtlCTS. Water GomDRnlM supplying each District; MleTatlani
VWMOBS io xa Acre Peraoni 10 b Bonis 1 Annaal 'Value of Propertr jkt SbmI 't{ Popu-
iBttOBi jIvttBlGU AnojiL Vttlae of BooMsi f oor Kelleri aail Vambor nf Deatlu to lu.aoo
i
I
ill I
Is !iij
luliSll
a*!'
Ill"
:l^i
VlBT DlSTSICIB.
r
K^
Sl.Ccoiits HnnairerSquun
Hi. Manin-iii-llie-Fielibi ■
CaxTiuL DitnicTS.
Gin DisTBicn.
Bhoiwlitcli - -
Brthwl Qn*n -
VliitivhD|Kl - ■
Ht. Gmrse-in-tlie-Eut
Mile End Old lima '•
BOUTB DinsiCTB.
St. Obip BoDlbawk
SI.G«nKD Bonl
Vuitliirinfh
Cuiilwrwell
BalLtThithc
-gi
VBW
»l
inttliCatuma >ro luhcii frem u farllimcntu? Bcium NkQneloPiMrBcIiPtlnltii! JloIrupolLi.dtta
of the Oitj of London tlif Emt lyiiHlaii. npil the Vat London. Inohidinjt fit. Biirtliolnmew\
ffito or Lopdon, within mid wltliuut Iho Willi i. Mr.Bliooii, Ibo hMJlb olBrer of llie (Hly. baa
-iSlAoai ehoi™ propwly iBlonjdng to tb.w iltalricta wi-re 213, W. MS m 18«. ;nd 7»^». and
IMM beau adqnted in IIig calouUtinns. A auiiuir correctlfln w Tcqiilrea or tho moitLLU.'j t&
— IBS tfinn cither disirlpii died of plnjlp™inSt.Th6vai»'iH<!^'»\
™J In Dniuel'Ei A>jJrmi f jr liifairt ViiiniCTt. t\ie mmlBlW^- (it ^^e^ avA^OTfelSiA-euJfc
hving.
62
Deaths and Mortality from Ckalgra
Table aT— LONDON SUB-DISTRICTS, water Supply i auvattoni Jm«i :
cmotom in the Teoube £pn
Initials
of
Water
Companies.
SUB-DISTRICTS.
Eleva-
tion
in Feet
above
Trinity
High,
water
Mark.
Ajuba
in
Statute
Acres.
PoFDiATiov nruja
186L
No.
2.
Name.
U
CoLl.
3.
4.
5.
6.
G.J.&W.M.
G.J.
W.M.
W. M. & C.
W.M.&WeU8
W.M., G. J.,
& Wells.
W.M., C, &
Wella.
C.
C.
c.
G.J.
G.J.
C.
1
2
3
4
5
6
7
1
2
3
1
2
3
LONDON - - -
West Districts - - -
North Districts - - -
Centrax Districts - - -
East Districts - - -
South Districts - - -
WEST DISTRICTS.
1 . — ^Kensington.
St. Mary Paddington WH
St. John Paddington H ^
Kensington Town ff - -
Brompton H -
St. Peter Hammersmith -
St. Paul Hammersmith
Fulham f F - - - -
2. — Chelsea.
Chelsea South /T - - -
CheLjea North- West HWw -
Chelsea North-East - - -
3. — St. George Hanover Square.
Hanover Square - - -
May Fair fT - - - -
Belgrave // § -
39
77,997
2,362^36
2,80
28
135
49
26
6
10,754
13,533
1,938
6,230
45,542
376,427
490,396
393,256
485.522
616,635
46S
616
671
77J
82
76
28
12
4
8
6
10
12
13
64
56
12
795
450
1244
698
203 '
2118
1834
368
213
284 1
445
136
580
17,252
29,053
29,183
14,870
4,467
13,293
11,886
19,050
17,669
19,819
20,216
12,980
40,034
39
36
51
18
5
19
IS
21
19
21
19
Note. — The letters placed against the names of the sab-diBtricts denote public institatioos ib
therein, namely,
IF— Workhouse ;
// — Hospital ;
L — Lunatic Asylum ;
to — ^Workhouse not belonging to the district in vhich it is situated.
C B — Temporary Cholera Hospital.
* Where many deaths from cholera occurred in Workhouses in 1849, a proportion has bee& diatiiM
the calculation over the other sub-districts of the Union in which the Workhouse is situated.
f Column 13, showing the mortality from Cholera in 1853|-54, to 10,000 persons living, mputmi \
Ileport of the General Board of Health (see Report of the Committee for Scientific Inqniriei la rdrti
the Cholera epidemic of 1854, pp. 111-113), and is corrected for deaths from Cholem in Hio^pitil
Workhouses.
1 Column 10 represents the number of deaths firom Cholera in 1866 registered in each Sab-distiiot
The numbers in Column 11, on which the calculations in Column 14 are based, are c o i Tect e d te p
who died of cholera in hospitals and workhouses not situated in the districts in which tiiey were iM
JSram/f/e: Of 63 deaths from cholera in the Wbitechapel Umou Woxkhouae, 47 were dntfu of penoM
and Diarrhcea in London Sub-Districts^
63
enmnertted in issi and laeii Deatlu and Annnal Sate of affortalitj from^
19. isss-«, and istftf.
J>EATH8 VBOM CbOLERA.
Deaths from Cholrra
to every
10,000 Inhabitants.
SUB-DISTRICTS.
xTom
Itt JqIj
1868
to Silt
Deoember
1864.
1866.
In the
Year
1849.*
From
Ist July
1863
to 31st
December
1864.t
In the
Year
1866.
•
;j»f^ j Corrected
rected I
For Deaths in
HoBpHalB
and Workhouses.
9.
lO.J
u. 1
12.
13.
14.
15.
7
11,661
5,596
6696
62
46
18
LONDON.
West Districts. .
North Districts.
Central Districts.
East Districts.
South Districts.
WEST DISTRICTS.
1 . — Kensington.
St. Mary Paddington.
St. John Paddington.
Kensington Town.
Brompton.
St. Peter Hammersmith.
St. Paul Hammersmith.
Fulham.
2. — Chelsea*
Chelsea South.
Chelsea North-West
Chelsea North-East.
3. — St. George Hanover Sq.
Hanover Square.
May Fair.
Belgmve.
S
4
7
7
2,154
875
676
1,735
6,221
191
417
330
3,941
717
194
361
870
8960
721
34
20
44
66
120
53
16
17
34
94
4
5
10
65
8
*
1
r
r
1
\
)
»
1
r
>
33
71
157
48
33
96
105
128
101
80
21
32
250
13
12
15
4
7
25
9
13
4
5
2
2
14
18
12
16
6
7
26
18
6
6
8
2
7
8
33
18
18
25
51
59
46
27
6
7
28
2
26
49
34
83
80
59
76
38
43
12
12
49
2
3
2
3
12
11
5
6
2
2
2
2
1
v% to MUe End New Town 12 were deaths of persons who were inmates of the worithouse at the time
s« attacked.
' 7 deaths from cholera in St George's Hospital 5, which were deaths of persons who did not belong to
rc^haTe been referred to the sereral sab-districts from which the patienU were brought.
• fcDowhig are Outltiko Wobkhouses :
fit. G^corge Hanorer Square Workhouse is in Chelsea North-west sub-district 2 : i.
TbeStnnd
West London ^
BMtLODdOQ
8l lAkc Ifiddlcfcx
CtBpwgf «
n
y>
99
„ Tottenham-court sub-district 9 : 2.
Islington East sub-district 10 : 2.
Hackney sub-district. 11:4.
Hoxton New Town sub-district 20 : 3.
/Mile End Old Town East, sub-district 246 : 2; uriE
" \ Bow sub-district 25 ; \.
Bow 8ab-dU(trict 25 ; 1«
»9
n
64
. Deatht and Mortt^fy frcm ChoUri
■ \
. LONDON SUB-DISTRICTSv— Water Supplt; Elbvatioh; ARfcic; Popw
in the TfiBEB Ephxebdcs of
Initials
of
Water
Ck>mpanie8.
SUB-DISTRICTS.
Eleva-
tion
in Feet
above
Trinity
High-
water
Mark.
Arsa
in
Statnte
Acres.
POFUULTIOV
bhdm:
186L
No.
2.
Name.
1
CoL 1.
3.
4.
5.
6.
1
WEST DISTRICTS— con^.
4. — Westminster.
c.
c.
1
2
St. John - - - - -
St. Margaret WfT*
5. — St. Martin-in-the-Fields.
2
4
260
657
34,295
31,314
3'
3*
N- R. & C.
N.R.
1
2
Charing Cross WM
Long Acre . - . .
6. — St. James Westminster.
17
60
263
42
12,587
12,053
1
1
N.B.
G.J-
G.J.
1
2
3
Berwick Street - - .
St. James's Square - . -
Golden Square fT -
NORTH DISTRICTS.
65
40
68
25
85
54
10,798
11,469
14,139
1(
1(
1^
7. — ^Marylebonb.
W.M.
W.M.
G.J.&W.M.
G.J.&W.M.
W.M.
W.M.
1
2
3
4
5
6
All Souls ^t-
Cavendish Squai*e ...
Rectory If^ - - . .
St. Mary
Christchurch - - . .
St. John «...
76
73
68
79
92
124
112
lid
116
108
518
542
28,841
14,687
27,633
22,814
33,895
29,826
2<i
15
26
22
34
32
N.R.&W.M.
1
8. — Hampstead.
Hampstead ^ - . .
9. — ^Pancras.
350
2252
11,986
l^
W.M.
N.R.&W.M.
N.R.
N.R.
N.R.
1 N.R.
1
2
3
4
5
6
Regent's Park - - . -
Tottenham Court wH J -
Gray's Inn Lane fr§
Somers Town - - - .
Camden Town IfV -
Kentish Town - - - -
87
73
52
60
62
110
427 :
145 1
155
184
171
1634
31,918
28,433
26^523
85,641
21,11^
23,326
3i
27,1
28,1
♦ Three deaths from cholera were returned in the Westminster Hospital, two of these whidi wm i
of persons who did not belong to St. Margaret, have been referred to the respective sah-districts fnm
tiie patients were brought. One death from cholera in the hospital in Broad auictaarr his been i^
St. John, Westaninster J and 11 deaths from cholera in the Pear Street House have been distributed P
tionally over the two sub-distncts of Westminster.
A n S!}^^^^1 ^™ r^^'^^r' '° .^ddlesex Hospital 8, which were deaths of persons who did not bck
AU ^als, have been referred to the several sub-districts from which the patientswcie broo^
amd DiarrAaa in LondoM Sab-DittricU.
vfttvd in 1851 «nd 1861 j Deaths and Amsoai. Rate of Mortality from Cholbba
4» uid l9G&--eomHnued.
lat July
1853
For Deatlu in
■nd WorbbuuBt
In the
Year
1848.
SUB-DISTRICTS.
200
20
277
WEST DISTRICTS— ««iA
4. — We STMIN 8TER,
•St. John.
St. Margaret.
5.-St. Martix-in-tiie-Fields,
Charing Cross.
Long Acre.
G. — St. JaUE3 WEflTUIKSTER.
Berwick Street.
St. Jnmes's Square.
Golden Square.
NORTH DISTRICTS.
7. — Martledone.
Alt Souls.
Cavendish Square.
Rectory.
St. Mary.
Christchurch.
^t. John.
8 . — IIahpstead,
Hamitatead,
9.— Pancbab.
Regent's Park.
Tottenham Court.
Gray's Inn Lane.
Somcrs Town.
Camden Town.
liential] Town.
to Tottenham Court, have been referred to the (ereisl ■ub-diatriclB from which tie pitientt wctS
„ „™ ™^„ ^ lh*Roj^ Free Hospital 26, which irere dealhs of penoni who did not
fl inn Lmut, have been referred to the several Bub-duiricls from whith the paliems were bno^
66
Deaths and Mortality from ChoUra
LONDON SUB-DISTRICTS.— Water Supply; Elevation; Abea; Popi
in the Thbbs Epideiqcs •
Initials
of
Water
Companies.
SUB-DISTEICTS.
Col.1.
No.
Name.
3.
Eleva-
tion
in Feet
above
Trinity
water
Mark.
KB.
N.R.
N.R.
E.L.
N.R.
EX. & N.R.
E.L.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
N.R.
1
2
1
2
3
4
6
1
2
3
1
2
3
1
2
3
1
2
3
4
NORTH DISTRICTS— co»/.
10. — ^Islington.
Islington West WHff ♦ -
Islington East Ww
11. — Hacknet.
Stoke Newington
Stamford Hill -
West Hackney - - -
Hackney fFwH
South Hacknejf Z «
CENTRAL DISTRICTS.
12. — St. Giles.
St. George Bloomsbary
St. Giles South W-
St. GUes North CE f -
13. — Strand.
St. Anne Soho - - .
St. Mary-le-Strand -
St. Clement Danes H^ -
14. — HOLBORK.
St George-the-Martyr H
St. Andrew Eastern W -
Saffian Hill -
15. — Clerkenwell.
St James W-
Amwell - - - -
Pentonville - - -
Goswell Street - - -
4.
in
Statute
Acres.
5.
100
88
72
76
55
44
44
71
64
68
64
48
36
66
50
40
44
68
84
78
1228
1899
639
615
472
1781
472
122
63
60
53
67
52
103
33
60
74
82
134
90
PopuuLTioN mm
185L
6.
47,881
47,448
4,840
5,549
18,732
20,850
8,458
16,807
19,951
17,456
17,335
11,615
15,467
18,813
13,971
18,837
21,529
15,720
11,904
15,625
^ The Small-pox and Fever Hospitals are situated in the sub-district of Islington West Of 59 di
cholera in the London Fever Hospital 49, which were deaths of persons who did not bdoQg to IdiB|
have been referred to the several sub-districts from which the patients were brought
t Thirty-seren deaths from cholera which occurred in the Shelton Temporary Hos|ntal litotted ii
Korth have been referred to the seyeral sub-districts from which the patients were htoi^jbL
and Diarrhaa in London Sul'Districts.
67
erated in 1851 and 1861 ; Deaths and Annual Bate of Mostalitt from Cuoleha
-4, and ISES^^continued.
Dbaths tbok Cholera.
From
iBt July
1868
to 31st
1864.
9.
72
44
5
9
26
41
10
13
63
39
66
13
34
8
12
8
25
17
11
14
1866.
Uncor-
rected
Corrected
For Deaths in
Hospitals
and Workhouses.
10.
81
39
1
2
23
45
32
3
4
42
3
3
23
7
10
5
22
7
8
8
11.
Deatixs from Cuolera
to every
10,000 Inhabitants.
38
40
1
2
26
48
86
7
22
23
8
6
12
8
12
80
16
8
16
In the
Year
1840.
12.
13
26
17
23
12
30
24
11
72
70
27
16
58
25
41
42
25
11
25
14
From
1st July
1868
to 31st
December
1864.
13.
13
9
11
17
13
19
12
12
22
34
40
12
12
4
9
6
12
II
9
9
In the
Year
1866.
14.
4
5
1
4
'9
13
17
4
12
14
5
6
8
4
10
8
22
9
6
10
SUB-DISTRICTS.
15.
NORTH DISTRICTS— con^.
10. — ^Islington.
Islington West.
Islington East.
11. — Hackney.
Stoke Newington.
Stamford Hill.
West Hackney.
Hackney.
South Hackney.
CENTRAL DISTRICTS.
12. — St. Giles.
St. George Bloomsbury.
St. Giles South.
St. Giles North.
13. — Strand.
St. Anne Soho.
St. Mary-le- Strand.
St. Clement Danes.
14. — HOLBORN.
St. Gcorge-the-Martyr,
St. Andrew Eastern.
Saffron Hill.
1 5. — ClERKEN WELL.
St. James.
Am well.
Pentonville.
Goswell Street.
I
f 19 deaths from cholera in King's College IIoBpital 11, which were deaths of persons who did not
to 8t Ckmcnt Danes, hare be«i referred to the several sulMlistricts from which the patients were
t
68
Deaths and Mortality from Ckriera ^
LONDON SXJB-DISTRIOTS.— Water Supply j Klevjoton ;
in tlieTBXB
; Porm
Eleva-
ForuLAixosr :
BVITli
Initials
of
Water
Companies.
SUB-DISTRICTS.
tion
in Feet
above
Trinity
Hlghr
water
ASKJL
fal
Statute
Aeref.
185L
1
No.
2.
Name.
Mark.
Col. 1.
3.
4.
5.
6.
CENTRAL DISTRICTS--ee)«^
16 — St. Luke.
N.R.
N.R.
N.R.
N.R.
1
2
3
4
Old Street - - . -
City Road JJL
Whitecross Street - - -
Finsbury - - - - -
17- — ^East London.
60
52
52
43
52
77
33
58
10,617
16,840
13,657
12,941
1
1'
1
N.R.&E.L.
N.R.
1
2
St. Botolph CH* -
Cripplegate - - - -
18.-^West London.
36
44
85
68
23,824
20,582
2(
11
N.R.
N.R.
1
2
West London North Wff^
West London Soath - - .
19. — London City.
36
24
47
91
12,946
15,887
1
1
N.R.
N.R.
N.R.
N.R.
N.R.
1
2
3
4
5
London City South-west -
London City North-west -
London City South - - -
London City South-east -
I^ndon City North-east -
EAST DISTRICTS.
20. — Shoreditch.
21
44
21
21
44
67
72
100
las
92
i
!
1
9,204
11,847
11,461
10,594
12,826
1
<
1
N.R. & E.L.
N.R.
N.R.
N.R.
N.R.
E,L.
1
2
3
4
5
6
Holywell - - - - -
St. Leonard Z. + -
Hoxton New Town w -
Hoxton Old Town -
Haggerstone West JF -
Haggerstone East - - .
21. — Bethnal Green.
36
41
52
^2
52
52
68 ;
75 i
130
116
132
125
1
17,245
19,449
23,505
17,431
20,276
11,351
1
l!
2
2
%
V
E.L.
E.L.
E.L.
E.L.
1
2
3
4
Hackney Road - - - -
Green W\ HLX -
Church - - - - -
Town
44
36
36
36
141
391
132
96 .
23,910
23,555
21,787
20,941
2i
81
21
♦ Of 25 deaths from cholera in the Temporary Cholera Hospital, New Street, 10, which w«ra 4
penoDB who did not belong to St. Botolph have been referred to the several sab-districts from wiuditkB
were brought. ^_"
t Of 44 deaths from cholera in St. Bartholomew's Hospital 40, which were deaths of P^'^^^^J™.
belong to We8tLondonNorth,have been referred to the several sub-districts from which the patients wcMl
and DiarrhcBa in London Suh-Districts.
M
nerat«d in 1861 and 1861 ; Deaths and Aiwual Rate op Mortality from Cholera
^-4, and l^S&'^camiinwd.
■ Dmaths waoM. Cholera.
Deaths from Cholera
to every
10,000 Inhabitants.
SUB-DISTRICTS.
from
1st July
1868
tbSltt
December
1864.
1866.
In the
Year
1849.
From
Ist July
1863
to 3l8t
December
1864.
In the
Year
1866.
L9.
Uncor-
rected
Corrected
Por Deaths in
Hospitals
and Workhouses.
9.
10.
11.
12.
13.
1^.
15.
CENTRAL VH^T.—coni.
16. — St. Luke.
.8
i6
8
9
13
21
12
4
6
21
15
8
44
26
12
33
48
37
9
8
16
10
7
5
30
20
Old Street.
City Road.
Whitecross Street.
Finsbury.
17. — East London.
1
1
49
41
46
13
16
42
47
19
23
19
9
St. Botolph.
Cripplegate.
18. — West London.
11
8
116
17
48
12
8
18
70
118
5
12
7
9
West London North.
West London South.
19. — London City.
7
8
11
e
15
15
8
19
24
10
4
1
5
4
6
6
2
6
7
6
107
\9
25
25
30
18
7
18
24
8
7
3
8
?
London City South-west.
London City North-west.
London City South.
London City South-east.
London City North-east.
EAST DISTRICTS.
20. — Shoreditch.
»
25
S6
H
29
59
94
36
22
38
17
14
30
33
18
32
12
18
31
38
20
34
18
144
116
42
23
52
28
41
57
8
14
12
15
10
16
14
7
14
7
Holywell.
St. Leonard.
Hoxton New Town.
Iloxton Old Town.
Hnggerstone West.
Haggerstone East.
21. — ^Bethnal Green.
IS
88
92
81
67
81
32
48
92
246
110
163
116
266
129
187
110
67
51
124
27
27
16
24
44
75
48
87
Hackney Road.
Green,
Church. »
Town.
E«Batic asylums vhere paapert are received. . j. > v i
Of 48 deaths from cholera m the Union Workhouse 15, which 'were deaths of persons who did not belong
• Gtccn sub-districty haye been referred to the several sub-districts from which the patients were brought-
70
Deaths and Mortality from Cholera
LONDON SUB-DISTRICTS.— Water Supply; Elevation; Abxa; Popu
in the Three EpmEMiGs ol
Elera-
POPULATIOH ]
Emm
Initials
of
Water
Companies.
SUB-DISTRTOTS.
tion
in Feet
above
Trinity
High-
water
Mark.
Abea
hi
Statute
Acres.
185L .
No.
2.
Name.
1
Coll.
3.
4.
5.
6.
EAST DISTRICTS— co«^
22. — Whitechapel.
E.L.&N.R.
E.L.
E.L.
E.L. & N.R.
E.L.
E.L.
N.R. & E.L.
1
2
3
4
5
6
7
Artillery
Spitalfields CE* -
Milo End New Town Af f
Whitechapel North - - -
Whitechapel Church HI
Goodman's Fields - - -
Aldgato - - - - -
23. — St. George-in-the-East.
36
36
36
36
32
28
19
25
53
64
58
47
51
108
6,769
15,336
14,543
12,530
7,818
12,069
10,694
(
L
IJ
11
•
E. L.
E.L.
E.L.
1
2
3
St. Mary
St. Paul
St. John W% . . .
24 a. — Stepney.
26
27
2
62
84
97
18,067
20,319
9,990
U
2]
c
E.L. & N.R.
E.L.
E.L.
1
2
3
Shadwell W CJL\
Ratcliff A^ . - - -
Limehouse ?F - - -
24 6.— Mile End Old Town.
7
18
10
179
132
265
16,179
15,212
22,782
11
le
21
E.L.
E. L.
1
2
Mile End Old Town Western -
Mile End Old Town Eastern Ww
25. — ^Poplar.
32
28
191
490
29,582
27,020
32
3£
E.L.
E.L.
1
2
Bow tcwL If **
Poplar ^r - - - -
SOUTH DISTRICTS.
26. — St. Saviour Soutiiwark.
12
3
1428
1490
18,778
28,384
3^
42
L.S.
S.
1
2
Christchurch /|^ - . -
St. Saviour /Tft -
2
4
95
155
16,022
19,709
IT
1ft
* Of 138 deaths from cholera in the Temporary Cholera Hospital, Spitalfields, 103, which were &
persons T^ho did not belong to the district of Whitechapel, have been distributed proportioiiaBy •*
adjoining districts of Stepney, St. George-in-the-East, Poplar, and Bethnal Green.
t Of G2 4^aths from cholera m the Union Workhonse 47, which were deaths of penonswho ^Mt
to Mile End New Town, have been referred to the several sub-districts from which the patients wen bn
X Of 319 deaths from cholera in the London Hospital, 235 were deaths of persons who did not M
the district of Whitechapel in which the hospital is situated. In 41 of the 235 cases the deaths WtJJ
to the several sub-districts in A^liich the patients had resided. In 151 cases the diatrie^ hut not_^
district, from which the patient was brought has been stated, and in these the deftUis an disUHwg
poriionally over the sub-districts. In the remaining 43 deaths, in which neither dbtrictl nor •ob'dillDl
named, the deaths are distributed proportionally over the adjoining sub-distrietk
and Diarrhcea in London Sub^Districts.
71
rated in 1851 and 1861 ; Dsaths and Annual Rate of Mortalitt from Cholera
4y and 1866 — continued.
DzATsa ntOK
Choleka.
Deaths fbom CnoLERA
to every
10,000 Inhabitants.
SUB-DISTRICTS.
from
1st July
1863
to 31st
D€cember
1864.
1866.
In the
Year
1840.
From
l8t July
1863
to 3l8t
December
1864.
In the
Year
1866.
Uncor- coppected
rected
For Deaths in
Hospitals
and Workhouses.
9.
10.
11.
12.
13.
14.
15.
EAST DISTRICTS-nOwt/.
22. — WmTECHATEL.
)
\
I
I
\
24
46
100
52
78
37
90
21
246
152
43
355
56
36
23
166
106
64
121
60
63
28
72
70
50
83
37
97
46
40
50
25
21
38
107
37
107
69
47
150
57
57
Artillery.
Spitalfields.
Mile End New Town.
Whitechapel North.
Whitechapel Church.
Goodman's Fields.
Aldgate.
23.-ST. George-jn-the-East.
1
1
i
1
60
82
33
123
104
158
160
188
160
33
45
47
34
41
33
95
64
171
St. MaiT.
St. Paul.
St. John.
24 a. — Stepney.
1
1
91
82
93
143
171
245
146
208
208
79
63
54
69
64
50
138
122
105
Shadwell.
Ratcliff.
Limehouse.
24 6. — ^MiLE End Old Town.
1
39
131
189
312
104
310
27
22
16
2^
70
Mile End Old Town Western.
Mile End Old Town Eastern.
25. — ^Poplar.
1
1
81
137
414
423
441
461
68
44
42
93
86
Bow.
Poplar.
SOUTH DISTRICTS.
26.-ST. Saviour Southwark.
*
\
127
424
6
26
6
20
144
156
75
208
3
11
Christchurch.
St. Saviour.
91 deaths from cholera in the Union Workhouse 29, which were deaths of persons who did not
to St. John^haye been referred to the several sub-districts from which the patients were brought
46 deaths from cholera in the Temporary Cholera Hospital at Wapping, 30, which were deaths of
who did not belong to Shadwell, have been referred to the sereral sub-distiicts from which the patients
vniglit.
OMlic asylum where paapen are received.
X 87 deaths from cholera in the City of London Workhouse 7, which were deaths of persons who did not
to Bow, hare been referred to the several sub-districts from which the patients were brought
)f 19 deaths from cholera in Guy's Hospital, 15 were registered in St. Saviour*s, and 10 in St (Mave
tiiet. ^ 17 djSitbs of persons who did not belong to St Saviour's sub-district have been referred to the
•ob-distncti from which the patients were brought
f S DaaAa and Mortality Jrom Chohru
LONDON SUB-DISTRICTS.
■Watxr Sttpplt j Eletatioh ) Ama ; . pDruLATiag
in the Thbbe BriDiioct of .1849
f2e^
FOPULUIOB
Initiall
of
W>ter
Comptniet.
SUB-DISTHICra.
tiOD
inPeet
aboTB
Trinilj
in
Statute
Acre
UCL
ISO.
No.
Name.
Mark.
Col. 1.
s.
3.
*■
S.
«•
7.
SOUTH DISTRICTS— «)»<:
27.— St. Olave Soctbwabk.
S,
s.-
1
2
St.Ol8T0 /r» . - -
St. John Horsleydown IF -
2S. — BsRUOHDasr.
6
2
73
94
8,015
11,360
iI:S
s.
s.
8.&L.
1
2
3
SI. JwneH - - . ..
St. Mai7 Magdalen TF - -
Leather Market
29.— St. Georse Southwask.
-1
454
142
92
18,899
13,934
16,295
i(««»
S.&L.
S.&L.
L.&S.
1
2
a
Kent-road - . . .
Borough-road W • - -
London-road L - - -
30. — NEWnTGTOif.
-1
2
105
65
112
18,126
15,862
17,836
.ISHB
>i6,ga
19il»
S.fcL.
S.&L.
L.&S.
1
2
3
Trinity Newington -
St. Peter Walworth TV - -
St. Mary J7 - - . .
—1
-2
-1
142
321
161
20,922
29,861
14,033
Situ
44,461
li^
L.&S.
L.&S.
L. & S.
L.&S.
S.&L.
S.&L.
L.&S.
L.&WcUb.
1
2
a
4
5
6
r
8
Waierloo-rond First - - -
Waterloo-rond Second
Lambeth Church First
Lambeth Church Second /Ff '
Kennington First - - .
Kcnnington Second - - -
Brixton - . - . -
Norwood fV - - . .
32.— Wandsworth.
S
2
2
1
4
8
56
128
91
142
206
186
459
510
1445
976
14,088
18,348
18,409
26,784
24,261
18,848
14,610
3,977
1S»
1V«
1«M
S3
S. & Wells.
S. & Wells.
S. & Wells.
S. & WcllH.
L. & Wells
1
2
3
Clapham -----
Battcrsea Ww , - .
Wandsworth L - • -
Putney
Strcntham ....
21
^l
12
72
123S
2343
2478
2176
3465
16,290
10,560
9,611
5,280
9,023
18,3*1.
inoa
* Of S5 iraiha from cholera ia Guy's HotpitaJ, 15 were ngiilered in St BaTioory and 10 b
nb-dinrict 1 T deaths of penons who did not belong to SL Savioor** mb-ditbiel have been rcfti
MTenl fenb-diBtdcti from which the patienti vere brought.
ami Diarrlma in Lmdon Sub-Dutricti.
1851 and 1861 ; Dea-ths and Axvval Bate of MoBTALnr from Cholera
and 1866 — cofUimud.
Skubi rKoa
Cuoifiu.
Deaths txou Cdoleba
10,000 Inhabitants.
SUB-DISTRICTS.
From
1SS3
WSIit
Decmber
1834.
1886.
In (he
Year
1849.
rrom
1st July
1863
December
1864.
lDlh«
Tear
1866.
UU.
Uncor-
Corrected
For Draths in
■nd Wotkhoujea.
R
9.
10. 1 II.
IS.
13.
u.
15.
SOUTH DISTRICTS— MB*
27.— St. Olate Socthwabk.
MO
^I9<
183
158
15
6
4
8
196
169
163
140
5
7
St. Glare.
St. John Horeleydown.
-
28.— BERMOKDSEr.
249
!S9
■■as
388
27S
19
10
6
21
U
6
142
159
160
201
169
179
7
6
3
St. James.
St. Mary Magdalen.
LeiLtbor Market.
29.-ST. George Soutitwark.
.M7
.(•IS
1M7
219
301
103
7
9
22
8
la
as
158
172
153
142
167
71
4
7
11
Kent-road.
Borough-road.
I.ondo[i-road.
30. — Nb WIN GTO».
446
143
224
419
98
7
17
2
8
18
8
160
141
108
115
136
74
4
3
1
Trinity Newingtoii,
St. Peter Walworth.
St. Mary.
31. — Lambeth.
,193
■ S48
MS
1-(44
187
:« 153
■ 81
2
62
128
63
213
321
148
36
10
4
9
28
46
13
6
6
3
5
10
38
87
14
5
6
8
153
147
130
163
85
90
65
5
49
78
39
63
135
61
39
27
3
5
17
12
4
2
3
3
Waterloo-road First.
Waterloo -road Second.
Lnmboth Church First.
Ijamljcth Church Second.
Kennington First.
Kcnuington Second.
Brixton.
Noi-wood.
32 Wandsworth.
114
111
97
8
154
178
181
66
9
16
4
22
10
1
3
4
32
U
1
s
75
92
107
15
70
109
152
70
18
19
8
1
3
Claphnm.
Battersea.
Wandsworth.
Putney.
Sti'cnthani.
tOflS tea* ftomcholsB in the Union WotUionM 9, vhich were deatbi of perwiu vho did not beloa
ftXaoabeth Cbaich S««oad nb-diitriet, have been referred to the w*enl lub-districU from vliich the patieo'.
74
Deaths and Mortality from Cholera
LONDON SUB-DISTRICTS.— Water Supply; Elevation; Abba; Papuunai
in the Thkbe Epidekics of lS49i
Initials
of
Water
Companies.
Col. 1.
SUB-DISTRICTS.
No.
2.
Name.
3.
Eleya-
tion
in Feet
Abba
above
in
Trinity
Statute
High-
Aoret.
water
Mark.
4.
5.
PopmJLTIOll XSUIIKBAZBI
186L
6.
IML
7.
L. S. & Wells.
1
S.&L.
2
S.L.K&
3
Wells.
L,&S.
4
S.K.&
1
Wells.
K.
1
K.
2
K.
3
K.
4
K.
5
K.
6
K.
1
K& Wells.
2
K.
3
K. & Wells.
4
L.
5
SOUTH DISTRICTS— co»/.
33. — Camberwell.
Dalwich - - - -
Camberwell JVL* L* -
Peckham - - - -
St. George
34. — ROTHERmTHE.
Rotherliithe W
35. — Greenwich.
St. Paul Dcptford -
St. Nicholas Deptford
Greenwich West H^
Greenwich East WH
Woolwich Dockyard H <
Woolwich Arsenal H
36. — ^Lewisham.
Plumstead
Eltham - - - -
Lee - - - - .
Lewisham Village W
Sydenham
68
1423
5
1339
4
1146
—3
434
886
10
1609
4
149
12
326
7
1687
}-{
495
1101
79
5057
167
4350
44
2399
16
3668
188
1750
1,632
17,742
19,444
15,849
17,805
24,899
7,071
18,800
16,228
17,140
15,227
13,191
2,568
8,478
6,097
4,501
1,723
21,297
28,18^
20,833
24^
37,8S4
8^189
21,fiB6
18,m
22,919
18,77«
32,974
8,009
11,807
7,872
1(V»95
♦ Lonatic asylums where paupers are received.
f Twenty deaths of seamen from cholera which occurred on board Her Majesty's Ship <* Belle Isle^" i*
were registered in the Greenwich West sub-district, have been distributed proportionally over the lennK
Bub-districts of Greenwich.
iVote.— The sub-districts of West Ham and Stratford — out of London — are in the waterfidd of Uie EM
London Cx)nipany. The deaths registered in each of the years 1849 and 1866, respectively, were 48 aiA
219 in West Ham, and 64 and 158 in Stratford. The deaths in each sub-district to 10,000 of popnlalioii iR
each of the years 1849 and 1866, respectively, were 58 and 53 in West Ham, and 66 and 80 in Stratfoid.
and DiarrkoML in Ltmdon Sub-DUtrictu
U
lerated in 1851 and 1861 ; Deaths and Annual Rate of Mobtalitt from Cholera
and 1866 — continued.
Bbaihs vbox
Cholbba.
Deaths fbox Choleba
to every
10,000 Inhabitants.
SUB-DISTRICTS.
yrom
litJoly
1868
to Silt
Deeember
1854.
1866.
In the
Year
1849.
From
Ist ^uly
1858
to 31st
December
1854.;
In the
Year
1866.
LO.
Uncor-
rected
Corrected
For Deaths in
Hofpitalfl
and Workhouses.
p
».
10.
11.
12.
13.
14.
15.
SOUTH DISTRICTS— «oii<.
33. — Camber w ell.
1
15
256
187
11
20
14
20
6
127
47
120
101
6
6
Dulwich.
Camberwell.
Peckham.
r6
138
15
15
117
94
7
St. George.
34. — ^Rotherhithe.
m
308
25
27
198
171
9
Rotherhithe.
35. — Greenwich.
so
85
06
84
85
58
108
128
173
124
20
60
61
69
41
32
59
22
75
28
84
68
24
60
50
163
83
20
38
45
206
35
62
12
43
14
86
10
18
24
12
St. Paul Deptford.
St. Nicholas Deptford.
Greenwich West.
Greenwich East.
Woolwich Dockyard.
Woolwich Arsenal.
36. — ^Lewisham.
14
4
86
88
5
23
3
16
81
12
43
2
6
5
48
2
6
6
11
16
41
53
11
16
12
21
41
29
9
2
8
3
Plumstead.
Eltham.
Lee.
Lewisham Village.
Sydenham.
Jliortalify from Cholera in LondM
liiilijiliorV»tcr
BUB-DIBTBICT8.
SI. Georgo Cambennll
St. Peter Walworth
Bt. Junea BarmoTUUBy
6t. H117 XeirinKtoii
TriQiljNewlnglfon
L.a.B.
L.ft8.
E.I,.
W.Sl., C, iWell!
BoUirrldlbo -
lKindun-™u -
Lunbeth Oburch lad
St. JoliD VTeatmlnirtei
C JdIib Sartiej£>wa
ChtifUhnnhBt. SuiouT
8k. John Bt. fle(Rxe4li-tbi
Bonnwh-niad-
"WftterTooraiid &ir
LsmlKib Cliiirvli
St. Nicholu DfptforU
St. HftDfln't Weatminl
Kenninirtoii lit
Greenwich Eut -
Sbwiwpll ■ - -
St. Fiul Etmmemnith
KeimluKioa tnA ■
LnidoD
,/iniloii ntT Roulh-w
X.H,*E.L.
U.K.
li. L. & X. a.
St!Ti«y"8t.'h«)rge-in.thB-E'«t
Sl-Pmif - - . - .
OoodiDiin'ri Fields
Keusiixiitun Toini
MUo End Old lawn Ewtom
MUe End Old Town ■Wcalcra
Vhi(«chipel Church ■
8e. flotgljih - - . .
Gt. Clenipnt Du« •
ArtUlerr Wbitechape) . ■
Town Bethnal Oreen ■
Gmn Betlinil Qrmn -
Chuceh Bechnid Green -
Holywell
Went Londiiii North -
"Whlteliikpel North
UiteRndNewTaim ■ ■
BpiUUlBldj . . . -
Corrected br Dmtlu In Hc«pit4l« tad WmlhoiiM*.
. . Sub-Dutrieti, in.ordtr ofEUvatiotu 11
USSDOS StTB-DISTBICrS.— UoKTU.tn froni Cholbu in ScB-omBiCTB, atranged in
the order of ELtVATiov—eoiiiiimd.
bdtlaborWkler
SUB-WSTBICTS.
IlDeclSH.
H.R-iW.H.
O.J.kff.H.
K.
Q.J.^W.H.
E-AWelU.
L.
ir.K.AW.H.
8>ffroi>.hilL ■ -
1
8t.JaniuC1»keDweU
Loud^^cij, Kortfeou
8LMJiryot*Hiod"
BiAiulrcwEMtom
K
WhitHKwHtrect ■
Ho.lon N«w Town
Oim>-'>-inn-luia -
HoitoQ oi'd Town -
ETr"": :
01d4tr«t
SK": :
St"o£& :
Barwiek-itTCet' -
8[. Oecme-thB-MiirtjT
Woolwlcli DockyuTl
Woolwich Aneiul -
as.: ■■ :
KJS'— :
Chv»adl>l].MUBro -
:)
Hi
m
a
s
a
tt
1 *"
a
I
m
78
Cholera Mortality and Elevation ; Stages of CkolerOm
Table 29.— Mortalltj' of Cliolera in Eleven Groups of London Sab-diatriets at diffierent Eletidonfc.
Eleration
of
8ub-
dutricts
Cx Px
(1866). (in 1866).
(Feet).
Under
-2
0-10-
3
10-20-
12
20-80-
26
80-40-
35
40-50-
43
50-eo-
63
60-70-
65
70-80-
80
8(^-00-
85
90 and^
npwardij
134
-26t,000
1,018,000
4,118.000
5,784.000
8» 106,000
9.255,000
12^417,000
18,730,000
19,875,000
17.791,000
86,309,000
Area
in
Acres.
px » Population.
1849.
1854.
1866.
1,617
16,812
14,506
8,525
1.809
5,394
2,854
4.469
10,916
8,253
18,250
112,578
403,870
1211.520
161,281
219,8S7
195,594
183,887
272,535
182,880
99,619
146,936
502,942
277,170
180,783
228,088
202,920
201.005
282,882
199,968
124,487
177,682
165,112
591,580
360,617
221,015
236,839
213,700
235,380
289.100
241,761
208,847
271,220
Cx ^ Deftths from
CJholeni.
1853i
1849. I to
I 1854.
1866.
1,509
1,466
5,861
4^802
1,462
1,881
793
720
1,679
758
865
856
823
888
733
966
418
466
228
118
174
217
74
1,147
780
uns
SM
217
111
«8
86
1(M)00Mx
. -^10,000.
1849.
1853i
to
1854.
1866.
14fi
116
00
48
•76
44
46
27
18
117
97
60
40
88
17
17
t84
28
9
IS
4
tl
88
81
•M
U
* Upon referring to Table 31 it will be seen that nearly all the sub-dlstricta at this elofiilon were snpplitd
from the River Lea— by the East London Companv. The water was near the Lea; all the Old Ford reeemfat
were then iu use. See Report of General Board of Health on Water Supply of London, App. L, i>. 18.
t Exclusive of the Berwick-street and Golden-square sub-diiitricts, where the mortality was raised by the
explosion around the r^on of the Broad-street pump ; the mortality at the elevati<Mi (00—70) waa n, 19. and 8 in
the three epidemics. Tlio sub-districtii of the terrace above, also supplied by the Gnuid Jonotion Company,
experienced a high rate of mortality.
Table SO. — Deaths from Asiatic Cbolera in several Stages of the Dibbasb.
Term
OP
Disease.
HALES.
FEMALES.
Attacked
and
siurviving.
To die.
Pying.
Recovered
or to
recover.
Attacked
and
surviving.
To die
Pying;
ReeoTCfcd
or to
hoiu^
8.010
4335
61
4576
9593
4608
88
mi
6 „
8819
4274
582
4575
9557
4566
497
4911
12 „
82«7
3002
92i
4575
0060
4009
1081
4B01
18 „
73i3
2768
887
4575
8029
8088
468
Ml
1 diiy
6ur>o
23S1
800
4575
7566
2675
888
4091
2 „
G150
1581
408
4575
6678
1687
411
4891
8 „
57-13
1178
ai3
4575
6267
1276
812
4SII
4 „
6i05
830
232
4575
6955
964
100
4901
5 „
5178
598
153
4575
6696
696
167
4991
6 „
6020
4»
100
4575
6510
628
188
4m
7 „
4914
839
135
4575
6886
806
178
4m
8 „
4779
201
66
4375
6218
222
48
4911
9 »
4723
148
25
4575
6165
174
S9
4091
10 „
4698
123
62
4575
5188
142
08
4091
14 n
4C30
61
88
4575
5070
70
58
4901
21 „
459S
23
16
4575
5012
21
16
4011
2S „
4oS2
7
5
4576
4996
6
S
4801
35 „
4577
2
2
4575
!
4993
2
fl
4091
ynfe.- -Oiii (T 1*.?32 attacks of mnles and 1703 of females, (^10 men and 817 women died. (<S^ Report en
Cholera bv S'-initillc Uomuiilt* o. pa»re Ul.)
l1io mi*!i)>'crs atUu'kc'd iiH gLvrn iii this Table hnvc boon do<1uccd by applying these proportions to the 4SH
d(>i(ths of inaUs and thu 1602 i leu th^ of feuialciK : thu9. !VM) : 1032 : : 4S35 : x =: 8010.
'J iio T.iblo nii<y 1)0 n'iul tbuR : Of H'.HO men nttnckcd by cholera 4335 will die; via., 61 in the tint six boon
lc:.nviiig iiHp rilive. of wliom 4274 will die and 4375 will recover.
Fn}xii th'> .ib'jvi; Tnblo the mean dunitioii of fnt.al cases of cholera is deduced: the mean dunition of fttll
CB^os in iniiU^ wan 2'ol dny» or 00* 2 IiourM, in females 2*01 da^it or 02*0 hoium.
The duration of 2600 ciuKm uuioug men and 271:^1 among wumeu was not btatcd in the Segtoter Books.
Chakra itt London Sub-Diatjictt in 1866.
■ *&.— lANDON SUB-DISTRICTS. PopnlaUan. and I»mi
«••. in the Sun-msTnlCT» of LONDON, »fT«nged ncconling t
IBPP^. <7Se Enimaled Popvlatlon of 1$66 H deduced fma I
t mutt U totuidirtd emty apptoxiualinr.')
u from Cbol«r» in tbs Tmt
tbeir Wlvwaxlnn uid I^Mr
I ratio bttwtai 18*1 and 1861 1
rater
E1e»tlon
Trinitj
POPCUTIOB.
■Enll-
rwrinlere.
IVain
CnoiKtti
mpuij.
1B51.
1861.
1866.
'e"; «: 1
1900. ( t«.tl 1
Omnd Xmumon. IVcat
Wddlesexi and Obelaea
fit John WtaliniiisHif - - -
itSSSrw"™-"!, : :
8t.P«JH<imiimiLilh.' '. '■
ChelMaftouIh
Chelwa Mortb-irut - - -
S£;„.i..; : : ;
ChwtogCroM
KemlDEton Toini ... -
^,™,;™^. . . .
S
»,«»
87,IM
37.338
20
UndorS
SW9S
vi.va
a7j3s
£0
id.4Wcll»
1
3UU
u.m
isiirti
IS
IE
B-IO
B0.1WO
70,798
7S,Bia
37
S
tk -
{d.lChel.
IS
17
le.nsn
12,3*7
18,198
E1.KM
11.071
10,l!O
]0-«D
lufaa
1«,8£1
isa,iM
M
3
Middlem
K
ra.is3
81.010
ea.oH
13
s
SO-*)
ai.is3
01.(11(1
08.041
IS
9
WoKcdou
tto - -
v>
«
1I.MB
ii««i
10.733
lisw
10.(17
\
i
w-tw
2k«»
i3,lM8
ea,:,^
7
3
IJaDetion
r'?5'.^d
HlddlHex
Lira
B>niner«,iuro .
St. John VtMlofxa
u
OS
1
JO
£!,H14
1?,77»
i3.wa
1S.0110
20,^1
30.708
IS
11.0(11
auinis
Si 103
S
'1
1
\
fiO-KO
msis
U'MOO
1B1..M1
B7
3
n.AV.lIM
Hiddlewi
r.*W-.snd.
Chrixtvlmrch Mnrylcbouo
ai.JohnM«7lPbonc -
n,iij
30.010
»+.l>i7
ia,iwi
0fi.-t7*
15
■
Www Klver Cotnpanr-
AUpite -
SOmp-iJ.
l!i^77
1«M»1 \ ISfclM
et
3
>.&BJ,ced
IB
wsat,
0,350
w
B7
10- ti) 1 ia,AM
B,H71
B,3»
BS
87
KiTcr ■
l-SsfLond.
LomlciD atj Sonth-irait
London City Boolh
Veat London Nortli -
St. Botolph Eut I^ndon
Holy-eL Phoreditnh -
St. Clement Danes Stnuid
w
iiiwi
Visa
1«.UM
1B.407
7.76!
W70
8,059
20jeo
17,813
15,!07
(WW
7,1M
7,S50
l*,Wi
ii!ai8
UM8
12
1
8
ai-M 110.(128 1 ifajua
B7,1BS
HIS
11
Cholera in London Sub-DittncU in 1866.
■EU-™tiun
EM-l.
Bbti-
' DuTn!
DB*IBi
In^iiT
■ptru-
r«i-to>B
from
Wnicr
nl«v.-
fttmi
CholeU
BUD-III8TEICT.
Triiillj-
CUOLKIA
CoJiiiJanj-.
Hilfli-
initu'
*1o.I'io7
r™
Inhabi-
JSS*^
■
■
tants.
7!ew R<nr
BntrrDH-liill . . - -
1 ^
itjor
1S.0U
1(L.5M
J,
^
Ditto
St.l^uuinlSlionHlitvU- -
+1
19.WB
ujm
^W
SI
Dilto
Flnsliiirj-
i
llMt
Ditto
IMllo
rxnXnCilyNorih-Twl • -
, *l
isuea
9fM
7^
'a
!
Dlitu
London Cily >'onli-ou<t - -
11.M4
INrto
iU»
17i«UI
It
mto
: St. MiiTiJv^tniiiil •
Jl.lilS
1«M
eSu
Dltlo
Ht. .VbiIte* EmI, HoIlK.rn - -
IWTl
li,W7
luau
li
Ditto
nny*" liin-luic - - - -
MAB
::7Jwa
».7»
DKIo
tUty^Kfl
lAMO
17j«»
17.?»
Ditto
M
1S.BS7
11.778
IMW
«
Dillo
HoxtouKevTovn - ■ -
iMM
mi8
»ja
M
Ullo
llOTtoii Old T..*n - - - -
VMt
WOtt
»i
JHtlo
lIwBTSlOllpWwt. . - -
8H.S78
Kill
JJUlo
- 1 West Ilnckncy . . . -
S4,aos
SOfitii
40-00
KIUBI
isT.lM
SSI.3M
«. .. I
SO
1-m
IIJIW
I
Diltu
w
3B..111
!(B.mD
M
»
Ulllo
(lld-rtnvl. St. Luke'* • - -
Il^il
UnmOi-uToim - . - -
SliUfl
:
Kt.Anu.-S->Iio
17,W
B
ll'.Wl
lil-M
tt
11
Bcrwit'k-^ni'l - . . -
Ditto
agss-r'!""^"' :
3».7*S
Ihtio
9
IHiln
71
IH'iii?
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71
Cholera in London Sub-Districti in 1866,
EtrvBllon
B-rsiitAm,
Esii.
r
P-iri-uTios.
Hirt-
"
CuntRHi
'lllfllw'
iwsu.
llllC*.
ii V 8.jSh"5i»^iiMi '.'.'.'.
jj
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IS
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lt,fllO
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Kent Oampg«r.
SLXicboluDnArurd ■ • •
S.13»
7
l.,5US
1.
3-l«
a,s9»
w,*»
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"
82
Cholera in London Suh^Districts in 1866.
LONDON SUB-DISTRICTS. Population, and Deaths fh>m Cholera in the Year 1866, in the
SuB-DiSTKiCTs of LoKDON, arranged according to their Elevation and Water Supplt—- cofiliniMdl
Water
Ck>mpan7.
SUB-DISTEIOT.
Elevation
in Feet
above
Trinity
High-
water
Mark.
Enuherated
POPrLATIOS.
Esti-
mated
POPU-
latiow.
Deaths
registered
fWnn
CnOLBEA
in the
Year
1806.
DEATH!
from
Choleba
to ©very
10.000
Inhabi-
tanta.
1851.
1861.
1866.
Kent - - -
Ditto - -
Kent A Wells -
Kent - - -
Kent - - -
Ditto -
Ditto - -
Kent & Wells -
St Paul. Deptfbrd - - - -
Greenwich West - - - -
Lcwiaham Village - - - -
Leo ------
Woolwich Dockyard - - .
Woolwich Arsenal - - - -
Plumatcad and Charlton
Eltham
10
12
16
24390
18.800
0.097
87384
21.096
7372
46.483
23306
7324
66
23
6
14
10
8
10-20 49.796
66302
77,463
•5
U
44
8.478
11307
18.448
2
1
40-60
8,478
11307
18,448
2
2
79
17,140
15.227
18.191
22319
18,776
32,974
26387
20,750
60315
63
24
43
24
U
9
60-80 1 45.558
71.669
97.401
130
IS
167
2.568
8.009
8,144
—
—
»
SO«:npwdB.j 2.563
8.009
3.144
_^
~
Table 32.— LONDON. Mortiaitj' from Cliolera in pnb-dUtrioto in 1849 and 1853^-54,
grouped according to their Blewatlon and ^ITater Bnppljr. {Reprinted from Begistrar
GeneraPs Seventeenth Annual Report, Appendix, p, 97.)
Name of Company
and S<iurce of Supply.
Years
80 feet
and up-
wards.
1 60 to 80
feet.
40 to 60
fcot.
20 to 40
feet
I
10to20: 3 to 10
tbet, I feet
Under
Sfeet
Mobtalitt by Cholera to cxery 10,000 Inhabitants.
N.
n.
E.
J.
w.
c.
s.
L.
NEwRn-ER - - - - -f
{Snringt, ArteiicM Wclh, and Hictr
Hampstead . - - - -
(Snriiifj^, ArtejiUtH JFeUtf ami y<u>
JCicr.)
East Tjondojt - - - .
{liivrr Lea at L'a DH'tyf..)
GllAXD JUJfCTIOX -
( Thtiiii >, OC<i sfnnln nbitvc Kctc Jiridgt
West Middlesex - - - -
{Thfiuirft tit Itart,e$, \\ milea' a6ore
ItaimiH'nnuth Lridgr.)
CiTKLSEA
{Thnrnei at IJaftcraca.)
SoVTmVAHK - - - -
( Tfuvitt* at Lattcrsea.)
LAMDETH ------
(T/ifiinff at Thnmea Ditton, S mita t«-
f/uHd the influeiKe ({/ the tide.)
S.&L.' SorxnwAHK and Lambeth
('riiiKiu't at Ifiittersta : aiul Thames at
I Thtunff IHiUih. R mile* biffond the in-
K.&S. Kent asd Southwakk
. ( /{'ivt njihtiitrnr^ br.hnr Lcirifham MilU ;
I and Thaiiitd at IkUtt^rtta.) I
Wells Wells, Pumps, and other Sources - ( : }|^
{
{
{
{
{
{
1849
1854
1849
1S51
1849
1854
1840
1854
1849
1S54
W }? >.)•«
26
(0 12 i (0
10
(0
2
1849
1854
1849
1854
1840
1854
1849
1854
1840
1854
(Oil
(0 \i
(»r)
42
14
(^)
20
18
8
(0
(2)
(0 ^2
00 SJ
46
18 ,
14
10 —
(0 ^;(o\^j,
z ;o).
6
(»)
(0
(0
S3
49
(0
JOU
65
39 —
41
21
y^t 67
f4) ^
l'^ 34
38
44
58
44
^*' 56
(t)
82
(6)
(0
f«)
(0
112
40
62
41
w?i
^*^ 174
(1)
»
(0
<8
(0
96
97
^*M7i
•I
(«)Ig
fa) ^
^'^134
• The small fieuros of this Table represent the number of sulMlistricts at each elevation suDulied bv ths
roswctivc Cc.mifanios. I'l'^vi* u^ mw
J
I
Chdera Mortal^ in the Field* of the Kverai fFater Companies.
^^ S
■BDii-wia
■wimnii 01(1 JO 5(rtK
■W»*-'1»IH 'WnL
*"£
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:: |53
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nooi io w»H pmonY
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l|£
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ri
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^ BIS
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iiiii a
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fe
CAolera Mortality in the Fieldt of the teverat fFater Conpatuett
•SO BJ
t "if
111
1^^
■ao!,u«UI 1
1
s
5
s
^
s
7S.r^^l
k
9
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9
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3
e
s
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a
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WJ3UI ;d Jt>H l"u"Y
'-
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f.
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a
a
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3
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z
3
t
i
t
1
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3
R
-i
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u
S
. i i
1
S
°
S
s
3
■*
t
1 llMi
t
;
£:
si
° ! 1
■s
g
h
a
s
a
s
jt
i
5
2
'■
»
e
"
1
m^ii
i
%
is
*
^
3
t 1
IS
=
$:
e
S
s
s
1
u \ I.
f
s
1
S
!
1
1
1
B
s
1
B
8
5
a
1
t
1
s
i
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s
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n
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1
1 'JINI
1
i
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i
a
1
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g
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a
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1 i
i
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s
1
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1
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1
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1
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1
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o
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sl|
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1.
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;il
r
Jieaiht from Cholera and Diarrhata in Fitplar.
I, Sic, of Poi'LAH,
AlfTHl-Mnet ■ • -
Alpba-mul
AnDJE-acrnt (noir Korlb'Hl .
Aahlnaitrect ■ • •
AietuU^tiMt . - .
B«l1i-«tmt
Belltios-tirrnci
Btrteme-nlKT'
H&rkviril Pier
Caniliiic-iirmn' (no
Chufi'lMlnet -
CohMiarbuur - -
cmiiiixuurt (IliplKl
CMlBvi!-Uni-t - '■
CotU>ii-iitr«.-t ■
Cmn-rtiwt (UlUvall) ■
IM)lii-cD(U)K« . . .
DavM-pUce (Bbw-Une) •
SBM-temM (Uirinll) -
DeBlffutl (CMIaiMIRel)
Dork-fDliBflci ■
tiimaJ liinuo tor Choltnl.
Emflr^lort
* M dMtti rtom cbolcTm itKlatcivil licrv Imvi- ]
Cliolcra. DiarrluDi
[lcn-[iLiiv (WflUlrwl)
.il. [OrclianJ-lioud-
-I^'ffl'iri^lll.vt '■ '■ \
':oiiFtli.^ln,-l - - .
inrii'« Aliii'.hniiiu^ IXnrtli-Kt.
■nrii Mnii-biii- lllll'li-alnvt]
nuol
(:ravi.-o>tnijt Upiwr -
IliBli-iml
Iliiiil-sin'.'I
HuntVpiw (D.wk->l
MnncliMlri^ron (lIill>T:il1)
MiDOT'pluv (Huuir^ln'i'l)
MnvirM-titnwl
UiuEct-mrpat ■ • .
Jr!^ll-'l""t.VWH.ri
llirluiril-iiliKi; -
OrviilHlitTti't ■
(>»l».riir-|anfi' (Uiiioi
UiDinl-UTTiia) (MiJln
!t ihc alnctii, Itx. from whwM the patlmU
86
Deaths from Cholera and Diarrhota in Poplar^
Heaths registered ftcm Cholera and Biarrhoea in Streets, &o. of PoKJUiy alphabetically
arranged — continued.
Deaths
Deaths 1
registered ftom
registered from |
NAacs ov Stbsbt, Ac
Name ov Steeet, Ac
■
Cholera.
Diarrhoea.
Choleim. DiarriMsaJ
Parifl-terrace (Fajnton-street)
1
Unioom-fitreet - • • -
1
Park-buildings -
1
—
Union-buildings • • .
1
-•
Park-place . - • .
2
1
Union-row - - - - -
1
—
Park-street
6
—
Union-street • - . .
8
—
Pennyfields
6
— •
Phcebe-strcot -
Pontifex's Load Works •
Presta^^oHitreet -
4
1
1
Victoriarplare - - - .
Victoria Docks - - - •
Vulcan-street (Millwall) - -
1
%
1
— .
r
lueen's-cotfAges (Millwall) •
1
„^
Wade-street - . - -
8
•^
V
iueen's-terraoe (Millwall)
tuixJy-street (Naval-row)
8
—
Walton-court (High-street) -
I
—
^
1
—
Wellington-alley ...
1
—
Wells-street - . - .
e
—
West-cottsges - - - -
1
— •
IUlph*»K»tt. (New-rd.,High-Bt
.) 1
^
West India Docks - - -
8
—
Randall-streot -
8
—
West India Dook-road - •
1
.—
Beere-Btreet
9
—
West-street ....
1
—
Eefrent-street -
Bichard-atrect -
8
5
1
1
White-hart-place
William-street - - . -
4
4
•^
BfObert-street -
1
_
Woodstock-road - - -
1
—
Robin Hood-lane
6
1
Woolmore-court ...
8
—
Ruxniiey-plnco -
Russell-street -
8
_
Woolmoro^trect - - -
4
1
1
.«
Workhouse - - - -
4
4
Wright's-plaoe (Cotton-street) -
8
1
Sabbarton-street
7
1
BramXejf,
St. LeonardVroad •
Samuda-streot - - • .
Sarah's-oottages
Scoulcr-street - - - .
Sbip-street - - - .
Ship-terrace (Millwall) - -
8
2
1
S
1
1
1
Bishopsgate-street - - •
Bow-lane - . - • -
Nelson-street - - • •
Prospect-plaoe - - - -
Walker-street - - - -
1
1
1
1
1
^
Sidney-place (Cotton-stroet) •
SimpsonVroad (High-street) •
1
—
Bow,
8
—
Slater's-buildings
2
—
Baston-terraco - - - -
1
—
Sophia-street - . • .
S
»•
Cobom-terraoe - - - •
1
—
South Hill-street
M-
1
Stebondale-road (MiUwaU) •
1
—
OJdFbrd,
Stebondale-row . - - >
Stebondale-street
1
8
*
Usher-road . - - -
1
-
Stevens Acre (Naval-row)
Stewarts'-stroct
1
1
Barge in Bow Creek (Orchard
House).
- " William Vokens," West
India Docks.
1
—
Stewarts'-terraco
Suffolk-street . . . .
Sun and Sawyer-ct. (High-st.)
1
1
1
1
—
Susannali-strect
8
1
Ship * Caroline," W. I. Docks -
I
.•
Sussex-place - - - .
8
•■"
„ " Gloria Deo/' South Dks.
1
.•
Sussex-Street . - . .
Sydney-street - - - .
5
8
1
« « Lady Milne." W.L Dks.
„ « Waterford," Thames -
1
I
Tliomas-street - - - .
Tooke-place - . - .
8
1
—
Unknown and no residence -
8
-
Tooke-street - - . .
2
^"
TOTiJi • - -
418
88
NoCfi.'-'4S& deaths from cholera were registered in the sub-district of Poplar, and it has been
that of the fatal cases of cholera in the London Hospital, Whitechapel, about 27 were attacked in
The Table annexed only localizes distinctly 418 deaths by cholera, 89 by diarrhoM.
In several streets no deaths were registered, among them may be mentioned the following:— GateMAreeC^
Evans-street, Wades-place, John-street, Jeremiah-street, Sarah-street, Newby-placei Church-street (Foptar)
and Bedford-street.
Narative of Proeeeditys in 1866. 87
II. NARRATIVE OF PROCEEDINGS AT GENERAL REGISTER
OFFICE DURING THE CHOLERA EPIDEMIC, 1866.
dV^^^V^^^^^^^^^^^X/^rx/ «^W^^ « WV^^'^|«^^ w^^ WN^'V^ ^^^» >^
The foUowiDg is a narrative of the proceedings which were taken in conformity
with the instructions of the Registrar Grencral for giving the public the exactest
informatiQn about the cholera epidemic of the year, and for detecting the causes and
efiects of its prevalence in London.
In this instance the attack was dreadful, threatening the metropolis with
desolation ; but the early discovery of the channel of distribution, and the appli-
cation of hygienic measures, cut it short, and secured the circumscription of its
ravages within the bounds of East London.
Cholera had been prevalent on the Continent, and was very fatal in Paris and
several other cities in 1866.
A few cases occurred in England during the year at Southampton and Ports-
mouth. They are referred to in the Weekly and Quarterly Returns.
I expected that the epidemic would attack English towns in 1866. This expec-
tation was announced so far as was necessary to urge the local authorities into
activity, and no further. (See Quarterly Return, No. 67., for the three months,
July, August, September.) Looking at the improved drainage and to the improved
water supply, I did not expect that the epidemic, when it came to London, would
be very fatal.
Only one case of death by cholera in an adult was registered in the week ending
July 7 ; 13 in children.
For the week ending July 14, the deaths from cholera were 32, including 18
adults. Several of the cases were unequivocally epidemic. It was noticed that
20 of the 32 cases were in the east districts, and the authorities were urged to
institute house-to-house visitation, and to destroy the '' cholera excretions."
The ^'intense heat of the weather," it was stated, favoured the development
of diarrhceal disorders.
Week ending July 21. — Cholera killed 346 persons in the week. The cause
was not clear. It is true it had begun in the East districts chiefly, but would it
spread ? ** This fatal explosion occurred chiefly in the comparatively poor districts
of the East of London." There 308 deaths occurred ; no hint of malpractice on the
I>art of any water company had been given.
Week ending July 28. — ^Deaths from cholera 904. This was alarming. The
drcamscribed area of attack for three successive weeks, and the non-extension of
the attack, led me, however, to suppose that the cause of the mortality was some-
thing locaL I went down to Poplar on Monday morning, visited several streets^
and saw many patients with Dr. Bain, an eminent practitioner of that quarter,
examined the Registrar's books, found at Poplar the Clerk of the Board, at Bow
the health officer,* both dead of cholera, but I met the Registrar, Mr. Dunstan —
vestry derk, an intelligent, well-informed officer — who said that the cases occurred
not in bad atreets only, but all over his district. We spent some time in the
London Hospital. I returned to the General Register Office before 4 o'clock.
Observations in this visit, the returns for each sub-district, and the maps acces-
nble, furnished the materials for the report in the Weekly Return.
* Dr. AnielL I had met hiia at dinner a few days before in apparent health.
88 Narrative of Proceedings in 1866.
The following letters to Professor Frankland show the further progress of the
inquiry : —
« My dear Sir, [^Monday,'] July BOih, 1866.
<< The cholera outbreak is almost confined to the area of the East London
Water Company's region ; the water showing no signs of imxmrity in Poplar,
where I have been, but of course that proves nothing.
" Will you make a searching inquiry ?
" Can the Lea above their source of supply be infected by barges or boats, or
towns ? The Regent's Canal, Limchouse basin, is in an abominable state. It is
about the centre of the attack. The cases are scattered all about the region.
" Ever yours,
" W. Fakh.''
« My dear Sir, [Tuesday,^ July 81#f, 1866.
^' On further studying the subject^ my suspicions of the East London
water are very much strengthened.
'< The weather has been dry, and it is probable that the Lea water has been
scanty, and the canals and cuts, in a vile state, are in dangerous proximity.
" If you will arrange for getting analyses of the water, such as you think may
test it3 present quality, immediately, we will publish it in the next week's table.
Yon must send it to us on Monday at 4 p.m. If you are disposed to go a little
further, and to visit the river Lea, I will accompany you with pleasure to-morrow,
or we could get some one to go to the spot and to the works for informationi I
will write to the engineer to-day. •
" The mortJility is terrible just in the area of East London supply, and in other
parts slight ; it has been so for two weeks, and quite reminds me of the Southwark
slaughter.
« I am, &c.
« W. FARR."t
Professor Frankl an d*s assistant on August Ist {Wednesday) took some of the
Company's waters from pipes coming from Lea Bridge and analyzed it, as the two
sources of supply were then unknown.
Against the hypothesis that the East London water was the channel of in-
fection, it was urged that parts of their field were comparatively free ; I found this
to be the case, and came to the conclusion that their water was distributed from
two different sources. This proved to bo cori'ect.
The Weekly Return (July 28) was published on the morning of Wedneadayi
August 1st in the newspapers. It contained the following passages : —
" It is a peculiarity of the case that the greater part of this slaughter in seven
days of 12.53 people of all ages took place within a limited portion of the London
area. 924 of the deaths, 811 by cholera, and 113 by diarrhoea^ were registered in
the six districts of Bethnal-green, Whitechapel, St. George-in-the-East, Stepney,
Mile- end Old Town, and Poplar, including Bow, among about a seventh part of the
population of London and on one-fourteenth of its area. The attack extends all
along the north side of the Thames, from the River Lea and the Isle of Dogs to the
Tower of London. Limchouse basin and the Regent's Canal are the Central line
of the attack, which stretches as far north as Victoria-park. This is essentially
the port of London, inhabited by its maritime population. The canals and the basin
are full of foul water, and are apparently connected with the Limehouse ca(>
the Hackney cut, and the River Lea. The East London Waterworks canal draws
* From 4 to 8 o'clock on Monday evening, with Wyld's water supply map and the returns, — Mylne'f
map of water supply was with Professor Frankland at the College of Chemistry, and the Report
of the Government Engineers was inaccessible, — as people were dying of cholera at the rate of one
to two hundred a day, it was determined to publish the opinion formed in a way to warn ihA
Company, but not to create panic among the people.
t l*rote88or Frankland in reply from Bettws-y-Cocd stated that his principal assistant Mr. YaloBtiB
would perform any analyses required by the Kegistrar General.
Narrative of Proceedings in 186G. 89
its supply from the river at Lea Bridge, where there is a reservoir, and runs for a
couple of miles by the side of the Hackney cut down to its other reservoirs north
of Bow and near the Lea. The present cholera field derives its waters from these
works. It is right to add, that the water has hitherto borno a coniparisou
with the other London waters in Professor Frankland's analyses. To-day at Poplar
the water looks clear, and no complaints are made of its quality. The Company
will, no doubt, take exemplary pains to filter its waters ; but it is not easy to
guarantee the purity of water drawn from such a river as the Lea, in dangerous
proximity to sewers, cuts, and canals.
" Whoever will take the trouble to go among the people now suffering in crowded
dwellings will sec the danger of the water butt; poor women arc wushiug the
dirtj linen of patients with water drawn from those vessels, which are often found
close to the watcrcloscts. It would be a source of additional safety to London if
the tanks and butts were all abolished, and the pipes were filled on the system o£
constant supply. The time has come for this reform.
" The mortality is overwhelming in some of the districts. In Poplar alone 145,
in Bow 188 people died last week, including Dr. Ansell, the meritorious health
officer, and Mr. Ceeley, clerk to the Board of Works, whose name figures on the
placards. The people are falling ill every hour ; you see them of all age-s children
and adults, lying about their beds like people under the influence of a deadly poison,
some acutely suffering, nearly all conscious of their fate and of all that is going on
around them. Hero the doctor is drawn in by the husband to see the wife now
attacked; there the husband lies in spasms ; here is an old woman seated dead, with
eyes wide open ; there lies a lino four-year old child, his curly head drooping in
death, but his mother says the pulse is strong, and he takes what she gives him.
An older brother just recovered is running about. Several wards of the London
hospital are full of patients, many of them very young children in all stages of the.
disease ; some dying, some well again and playing. The medical men have no
rest, and with the Health Officers are nobly doing their duty ; brave men ready
to lay down their lives for their patients. The people themselves are most
patient ; most willing to help each other, the women always in front, and none
shrinking from danger. There is no desertion of children, husbands, wives, fathers,
or mothers from fear.
" In the midst of this scene the authorities have been to some extent paralyzed.
The nuisance inspectors arc not suiliciontly numerous, neither are the medical
officers. The administrative work htis not been organized with suffieieut prompti-
tude, and is not carried out with sufficient energy.
" Such a calamity as this may well call forth the whole resources of London, and
what is especially wanted is executive power well organized in conjunction with
the Medical Health Officers. The people of East London want help."
It will be observed that this report calls attention to two things : (1) the
sufferings of the people of Kast London, and (2) the probable cause of these
sufferings.
(1) " The people of East London want help" met with a noble and surprisingly
prompt response from the fountain of English charity.
The Bishop of London, on the same day, addressed a letter, of which a copy is
annexed, to the Times, whore it appeared on the day following (2d August).
With the promptitude which characterises her acts of beneificence, Her Majesty
addressed the Bishop of London on 2d August.
On behalf of the little children Mrs. Gladstone made an appeal on the same day.
The Bishop of London wrote the following letter to the Editor of the Times
newspaper, which appeared in that journal on the 2d of August : —
" Sir, — ^I shall feel obliged to you if you will allow me through your columns to
make an appeal on behalf of the families which suffer from the present visitation of
cholera. No one can read the reports of the state especially of the east of London,
without understanding that there must be a great amount of unusual suffering at
this time among the poor. I have information from the clergy, who are labouring
with moch self-denial, and often at the risk of their lives, in visiting th<5 afflicted
90 Narrative of Proceedings in 1866.
districts, that money is imperatively required to purchase the necessary support
both for those who, as yet in health, are exposed with insufficient food and clothing
to the malignant influences prevailing in infected districts, and also for such sufierers
as by Grod's mercy are recovering from illness. We trust, indeed, that parochial
authorities will do all they can, but there are many ways in which additional
charitable relief is much needed. I propose to arrange with the Metropolitan
District Visiting and Relief Association for the proper administration of a Special
Cholera Fund, and I cannot doubt that there will be an immediate and abundant
answer to the earnest i*eque8t that I now make, that those who have the means
will help us, for Christ's sake, in this emergency. It seems my best course to
employ the well-known Society for Relieving the Poor of London, of which I am
President, and which has its machinery already extended all through the infected
districts. A special account will be kept of all donations sent to the Cholera Fund,
and a careful statement published, from time to time, of the way in which the sums
contributed are applied."
The following letter was addressed by Her Majesty's command to the Bishop
of London : —
" My dear Lord, Osborne, August 2.
*^ The sufferings of a large number of poor persons from cholera in a particular
district of London, though fortunately as yet only in a limited one^ have most
painfully attracted the Queen's attention, and Her Majesty consequently learnt
with satisfaction the proposal contained in your letter published this morning, to
arrange with the Metropolitan Relief and District Visiting Association, of which
your Lordship is President, for the proper administration of a special Cholera
Fund.
** Her Majesty, feeling sure that under your Lordship's presidency any funds
which may be collected will be judiciously applied, has commanded me to forward
a cheque for 500/. to Messrs. Herries for the Cholera Fund, to be applied to the
relief of the sufferers, most of whom, the Queen regrets to know, are in such a
position of life as to be totally unable to provide themselves with the necessary
means either to ward off the disease or to support themselves under its influence.
" I have, &c.
" The Lord Bishop of London. T. M. Biddulph.*
" To TiiE Editor of the Times.
'' Sir, — It has struck me that one of the most effectual means at this pressing
moment of assisting the excellent London Hospital is to provide a temporary home
for the children (many of them orphans) who are recovering from cholera. I have
already acted upon this plan, and I now appeal to you for your valuable aid. We
are in want of funds ; and donations, which should be described as intended for
this particular purpose, will be gratefully received by the Rev. Thomas Scott,
London Hospital, E.
" I cannot speak too highly of the work which is being done in this hospital by
the chaplain, the doctors, and the nurses — indeed, by all connected with it.
'< I am, &g.
"11 Carlton-house-tcrrace, S. W., Catherine Gladstonb*
" August 2."
The Prince of Wales subscribed 200/., and other subscriptions from all classes
of persons flowed in with so much promptitude, that in less than a week 10,OOOL,
in less than a month 18,000/., was placed at the disposal of the Committee, for the
Relief of distress arising from cholera. The total amount raised by this fund, the
Mansion House fund^ and other contributions is estimated at 70,000/.*
• 2 let Keport of Association for Relief of Destitution in the MetropdiB, 21 RegeDt-itreet
£
8,
d.
7,003
18
10
2,785
6,611
403
16
Narrative of Proceeding $ t n 1 8 6 6. 91
Mr. Hugbesy the Secretary of the Metropolitan Belief Association, states that
in the interval fix>m August to December the total receipts reached 19,333/. 19^. 3(/. ;
the ezpenditnre was as follows : —
Gnnts to cleigy for relief of cholera ....
Grants to iostitatioiis for ditto .....
Giantft to 661 cholera orphans ....
Expoiflet, sdvertinng, &c - • ....
Balance paid to the Metropolitan Visiting Association, to assist in
meeting increased distress caused by cholera ... 2,530 4 5
The city of London, always conspicuous for its charity, was worthily represented
this time by the Lord Mayor, Sir B. S. Phillips, who placed himself at the head
of a " Cholera Relief Committee," which held its first meeting at the Mansion
House on the 7th of August.
The want of organization in the cholera districts, noticed in the weekly table of
July 21st^ met the committee in the face : ^' the great want,'* they say, " was local
** organization to grapple with the disease ;" and their first care was to create
local committees for relief, house-to-house visitation, preventive and remediid
measares. Through the local committees the grants were administered. They
worked in concert with the Metropolitan Relief Association. The amount col-
lected by this fund was 18,763/. ; and in their report they affirm that 70,000/. is
below the sum contributed from all sources from the relief of '* sufferers from this
calamity." By their latest but incomplete returns they learnt, that, almost entirely
in the east and north-east of London, 10,424 persons were attacked, 4,396 killed
by cholera ; 68,975 attacked,' 647 killed by diarrhoea. Exclusive of paupers, and of
children whose relatives could support them, 1,260 cholera orphans, under 16 years
of age, nearly aU fatherless, were on the list of the two committees. The Lord
"Mi&yoT placed half the number (630) on his list, which rose by additions to 710
orphans, whose fate must have been lightened by distributing amongst them
6,570/., and by placing them in the charge of friendly people.
The following statement shows how the Mansion House fund was expended :—
Bj grants y^iywf in amount from bL to 300/., to 92 committees, com- £
prising hospitals, dispensaries, orphan homes, and district boards - - 9,121
„ amount voted for convalescents, dispensed through 26 local committees - 2,000
„ amount voted to 277 widows .... . . 541
„ amoont voted to 710 orphans ..... 6,570
„ expenses, vis., advertising, printing, stationery, and stamps, &c., 336/. 1«.,
salaries and attendance, 116/. 11 «. ..... 453
Balance at bankers - - .......78
18,763
(2) The second thing to which the Report called attention was the cause of the
excessive mortality. K this cause could bo determined it might lead to its
removal. The epidemic poison must evidently have been diffused either through
the air or through the water of the infected locality. Now, the air is not supplied
by a company, and is consequently left unrepresented in court. It is otherwise with
the water.
Mr. Greaves, engineer to the East London company, came up to the General
Begister Office, and complained that the implied charge against the company was
ill founded, and that tho description of the works was incorrect.
I showed him the information in our possession, and engaged that if he would
send up a covrect description of the works the Registrar General would forward
it to the newspapers that day. He promised to do so, but failed. Instead of doing
this, he sent a letter to the Times and to the other newspapers (on August 2d), at
the same time addressing a private explanatory note to tho office.
Letter from the Times of Thursday y 2d August 1866.
« To THE Editor of the Times.
" Sir,—- I observe in the Weekly Return of the Registrar General, published in
the Times of to-day, a statement so injurious to the East Loudon Waterworks
Company, and so likely to create public alarm, that, although I might on the com-
a Narrative of Proceedings in 1866.
pany's behalf have been prepared to remain silent, I think you will feel me jus-
tified in asking a place in your columns for the purpose of allaying what I fear may
be greatly misapprehended, and may, if unexplained, cause considerable public
alarm.
" In the return to which I allude * the present cholera field ' is reported as
* deriving its water from the East London Waterworks,' of which the 'canal draws
its supply from the river at Lea Bridge, where there is a reservoir, and runs for a
couple of miles by the side of the Ilackney-cut down to the other reservoirs of the
works north of Bow and near the Lea.' It is also added that * the company will,
no doubt, take exemplary pains to filter its waters, but it is not easy to guarantee
the purity of water drawn from such a river as the Lea, in dangerous proximity to
sewers, cuts, and canals.'
" From these passages every reader must infer, that the East London Water-
works Company's supply is, when taken from the water of the Lea, at no higher
point than Lea Bridge ; that it is thereafter led in an open canal in dangerous-
proximity to pollution ; and that, although the company may have intentions about
filtration, they, in fact, supply unfiltered water.
" The facts arc : —
" 1. That, although taken from the I»ea at Lea Bridge, the waters of that river
have been, at the expense of the East London Waterworks Company and
the New River Company, protected from impurity, by intercepting drains
and otherwise, as high as Enfield, which is several miles above Let^ Bridge ;
and the water, although locally taken by the company from the river some
two or three miles above Lea Bridge, has, in fact, the purity of Enfield,
where the river is running in a purely rural district.
" 2. That the water enters the filter beds of the company at Lea Bridge, and is
conducted thence to their pumping establishment at Old Ford in an iron
pipe, and never sees light or risks pollution between the filter bed and the
consumer ; and that the ' canal ' alluded to by the Registrar, having been
since 1853 disused for all purposes of supply, is only maintained as a drain
from the filter to a lower part of the river.
" 3. That not a drop of unfiltered water has for several years past been sup-
plied by the company for any purpose.
** It is true that the Registrar notices that the East London Company's * water
has hitherto borne a comparison with the other London waters in Dr. Frankland'a
analyses,' and that * to-day the water looks clear, and no complaints arc made of
its quality ;' but these statements are in such ' dangerous proximity' to the other
less correct portions of the report and to the affecting facts which appear to be
stated as consequences of the assumed impurity of the water supply, that I have
felt it my duty to request publicity for the above written explanations.
" I impute no intentional misrepresentation, and I make no complaint, althongh
when I found on calling this afternoon at the Registrar General's office that he
was using and acting upon an obsolete map of this district I felt that better infor-
mation should be in use by so important an officer, and that if it had been so the
East London Waterworks Company would have escaped an unmerited censure and
the public mind an unfounded cause of alarm.
" I am, &c.
" East London jyaicrworks^ Old Ford, Charles Greaves,
** August 1 [^Wednesday'], Encfinecr of the East London
Prater works Cotnpanf/J'*
Fridaj/. August 3. — I returned Mr. Greaves's visit with his full permission, and
made myself acquainted with the whole of the works at Old Ford, so far as they
were visible and were explained by Mr. Greaves himself, who was apparently
deeply impressed with the serious nature of the inquiry, and answered candidly
all the* questions which it appeared right to address to him in his responsible office.
While I was there the lAincct Commissioner and one of the health otficers called to
see the engineer and the works. Aftcrwar<ls I walked down to the Registrar's
house (Mr. Dunstan, 3 High-street, Bromley), and made inquiries on the way
Narrative of Proceedings in 1866. 93
where cholera was prevailing. Three persons came in to register a deatli from
cholera while I was there, and I found from the book that Ihc epidemic could not
be localized in any particular portion of the district,* Several deaths had occurred
in the houses drained into the middle-level sewer south of Victoria Park.
On that day, Friday, was formed the plan which is sketched in the subsequent
letter to Mr. Valentin. Mr. Valentin was, like everybody else, out of town. He
came to town from Ramsgate, and set out, note-book in hand, after going over the
subject carefully with me.
*' General Register Office, Somerset House,
« Dear Sir, August 3d, 1866.
•* You will see that the cholera has raged very badly in the East of London.
Professor Frank land tells me that you will kindly undertake any analyses of the
water that may be thought useful.
*' The Registrar General will be very much obliged if you will attend to the
following suggestions at your earliest convenience.
" The East London Water Company pumps its water from two points : —
" (1) The first is the well of the filtering beds at Lea Bridge, where they have
their most powerful engine ; this supply is distributed over the region of their
works north of Victoria Park^ the pipes inosculating with those of the lower region,
which is supplied from the well of the engines at
" (2) Old Fordy Bow, where they have, (a) A covered reservoir, (b) Tteo large
uncovered reservoirs, in connexion with the East London Waterworks : (c) Canal
running from Lea Bridge by the side of the Lea navigation waters.
" The engineer, Mr. Greaves, states that there is still a connexion between the
ivelis of the engines at Old Ford and the uncovered reservoirs, but denies that
these waters are ever used.
" The covered reservoir is separated from the uncovered reservoirs by the river
Lea, in a most filthy state, varying, however, with the state of the tide, for it is
tidal, the tide running up about 1^ miles beyond Old Ford.
^ The East London Water Company takes its water from the Lea about 2^ miles
above Lea Bridge, into subsidence reservoirs, covering 75 acres of land, through
which the water flows down a canal to the filtering beds at I^ea Bridge ; from these
beds the filtered water descends through an iron pipe 48 inches in diameter to the
Old Ford covered reservoir. So much for description of the works, drawn up
chiefly from information supplied by Mr. Greaves.
** The cholera field does not extend over the region supplied from Lea Bridge, and
does extend over all the rest of the region supplied by East London water, namely,
from Isle of Dogs to Tower of London northwards to southern edge of Victoria
Park, and across the Lea in West Ham and Stratford.
" Will you do this : go to Mr. Greaves, whom you will find at Old Ford, and
get him to allow you to take waters for analysis :
" 1. From his covered reservoir at Old Ford.
'* 2, From the two reservoirs uncovered.
" 3. From the Lea Bridge, where you can get the water.
" (1) Before filtration.
" (2) After filtration.
" Whether it is worth.while to get the waters of the Lea for examination above
the point at which the water of the company is taken I do not know. It may
be, but that may be left at present.
" We want especially to know, if you can discover any and what chemical
lifferences between (1) the waters of the Lea Bridge works, before and after
filtration ; (2) the waters of the covered and uncovered reservoirs at Old Ford ;
*Mr. Dunstaa had an ingeniouB scheme for keeping informants at a respectful distance. A
chair wat placed in fhmt of bis desk, and upon attempting to draw it nearer to him I found it
▼ai tied >y a rope, and could not be pulled from its place. In one week (July 14-21) he registered
141 detthi by cholera alone. He was not ill and lost none of his household.
94 Narrative of Proceedings in 1866.
(3) the waters in the pipes of the company in the regions north of Victoria Park,
and in Poplar.
" The Registrar Grencral will publish the analyses.
" It will be very desirable to complete the view, by analyzing the waters of the
Lea at Old Ford ; taking suspended matter into account.
^< I am, &c.
« W. Fakr."
'< Bickleyy Kent^ August ^hy 1866^
" My dear Sir, {Saturday),
" I went over the Old Ford East London works with Mr. Greayes (Friday,
August 3d), and find that they have two separate pumping establishments, one at
Lea Bridge supplying the north, suffering little from cholera ;
" Another at Old Ford supplying the infected districts ; there they have reser-
voirs, 07ie covered.
'^ Mr. Greaves will allow Mr. Valentin to analyse the waters of all his reservoirs,
if you think it desirable.
" I have written to Mr. Valentin, in conformity with the suggestion in your
note, and have told him all that occurs to me.
" My theory is, that in some strait th^y supplied for some day or days
their water from the uncovered reservoirs at Old Ford, contaminated in some way
or oilier. These I'eservoirs are in possible communication with their pumping
wells ; but they do not admit that they ever take water from any but the covered
reservoir containing filtered water.
'^ I propose to print extracts from your notes ; and have communicated ihem to
Mr. Greaves.
<< I am, &c.
" W. Fabb."
Professor Frankland took the water for monthly analysis, published by the
Registrar General, from a main supplied chiefly from Lea Bridge ; this note calls
his attention to the existence of two sources^ which had not been discovered until
they were brought to light by the cholera returns.
** My dear Sir, Bickley, Kent, August 7th, 1866.
*' You will see that the East London water is supplied from two sources,
the pipes inosculating in the centre of their area. The lower portion is the most
extensive ; it appears to lie south of Victoria Park.
** You will perhaps ask Mr. Valentin to look into this, and to ascertain
whether your last water (for ordinary monthly analysis) came from Old Ford or
Lea Bridge.
" Thanks for your excellent letter, extracts from which I immediately printed,
and left with Mr. Greaves (on August 3d). He passes the water now through 12 acres
of filtering beds of sand 3 or 4 feet thick : he does not think he could pass the
water through charcoal of moderate extent in time. He will consider, and will
now have the opportunity of studying your letter, which is published with the
Weekly Return, and which I hope all the papers will publish.
" I am, &c.
" W. FXRR."
Dates of Professor Frankland's Letters and Report
Dated. Publication.'
Letters, August 4tlu - Ketnm for week ending August 4th, published Aiigatt Tth,
"Wednesday.
Report, August 25tb. - Return for week ending September 1st, published on Sep-
tember 5th.
Letter, September 8th. - Return for week ending September 8th, published Sep-
tember 12 th.
Mr. Greaves, at Old Ford, received Mr. Valentin on August 9th (Thur8day)i
and so did Mr. Maine, the officer at Lea Bridge, who incidentally mentioned that
he had enCen some excellent eels out of the Old Ford reservoir. A day or two
Narrative of Proceeding$ in 1866« d5
after Mr. YaJentin Iiad called at the General Register OfHce to report progress I
received by a curious coincidence, the " East-end News " for August 11th, a local
paper, containing letters (one dated August 7th) referring to eels found in the
snppl/ pipes of the company.*
Professor Frankland made some suggestions for purifying the waters, and these
were immediately forwarded privately to Mr. Greaves. His first Report and
extracts from his letters were published in the Weekly Return for August 4th,
with a description by me of the water supply of the East districts, to serve until
Professor Frankland's elaborate inquiry was com2)leted.
Mr. Greaves iu his letter to the Times (August 2d) had stated that all tha
water of the company '* had been filtered ;" this was published in the *' East-end
News,** whereupon Mr. Ferguson a plumber of Bow-lane, and Mr. Russell, wrote
to the Editor, stating that they had found eels in their water pipes. One, nine
inches long, was dead. Others were found alive in the water butts. Mr. Russell^
who found his eel about the second week of June^ asked significantly, '^ can an eel
pass through a filter bed ?"
On a subsequent visit to Poplar I went to the houses, saw the cut pipe fronr ,
which the eels were taken : the facts were certain. These lettei*s were published in
the Weekly Return of September 1st ; but no further reference was made to them,
although the coincidence between Mr. Maine's accidental mention of eels in the
open reservoir and the facts in these letters was singularly striking. Eels are
known to travel by land, but there can be little doubt that they had been dis-
tributed with the waters of the open reservoirs.
Upon the occasion of this visit I found that the panic had subsided ; and proper
hygienic arrangements had been made. The Registrar, an excellent officer, was
in distress ; his wife had died of cholera after a short illness. An example of
a frequent fallacy in these inquiries struck me. ** We never drank water, neither
my wife nor myself." What then do you drink ? " Beer, and a tumbler of spirits
and water at night." Hot water ? " No ; cold."
Professor Frankland came from Wales expressly for the purpose, inspected the
Company's works on 23d, and found them apparently in the same state as they^
were on the 9th, when they were visited for him by Mr. Valentin. Professor
Frankland's Report, dated August 2oth, appeared in the Weekly Return for week
ending September Istf The deaths from cholera in that week were 198 : they
had been, four weeks ago, 1053, when their further rise was arrested. The
immediate decline of the deaths following Mr. Greaves* visit to the General Register
Office was shown in the Return for the week ending August 1 1th.
It happened strangely enough that a part of the afflicted field remained still
without the advootsge to be derived from the lower level sewer, and I wrote
immediately to Mr. Bazalgette on the subject: in his reply ^ he said 'Mt is un*
'' fortunately just the locality where our main drainage works are not complete,
a # # # To-morrow I shall recommend our board to erect a temporary pumping^
'^ station at Abbey Mills, to lift the sewage of this district into the northern outfall
** sewer."
West Ham, over the Lea in Es<9ex, is out of London, and is drained indepen*
dently of the metropolitan works into the Lea : the district is partly supplied by
the £ast London Company ; and it became important to ascertain how far the
ejpidemic extended in that direction. For this purpose I went over to Stratford-
le-Bow on one day, where, after an interview with Mr. Vallance, the surgeon and regis*
trar, I visited the streets where the disease had been most life among the families
of the railway ironworkers and others. Subsequently I went by the Great Eastern
railway from the Shoreditch station to Lea Bridge, passing close by the open
reservoirs on the left, which looked as placidly in the light as if they had never
held poison that had killed thousands. This railway, with the branch to North
Woolwich, gives in one view the greater part of the water field.
—
♦ Set letters, p. 129. t S«« PP- 122-126. % See p. 117.
96 Narrative of Proceedings in 1866.
In going from the station along Lea Bridge road you cross the Companj's supply^
canal and tho Lea. The boa thou se at Lea Bridge looked descried, which the
landlord, who had suffei'ed by no fault of his own, ascribed to the evil reports of the
Eegistrnr General about the innocent river. Here at tho turnpike gate is the
boundary of London. The police on each side of the gate were apparently
dificrcnt ; and the registrars were not the same. A death had occurred in the
night, and after some difficulty I discovered the house in which it happened. It
was on the Hackney side, in a small row of white cottages south of the '* dock," a
mere projecting loop of the Lea, where several pleasure boats lay moored. The
house was empty. The man was a labourer ; he had been attacked in the night
about 2 o'clock, when he and his young wife were alone, and he got no assistance,
except from her, until the morning, when some of the neighbours were roused,
and the doctor was brought from a distance. The man was in collapse, died,
and was immediately buried : the house was disinfected. I walked in the
direction of the doctor ; but returned as I found that it was at a considerable
distance ; and learnt all the particulars from tho wife yesterday, widow to-day, who
was kindly taken in by the husband's sister. She had on the table a bottle m wine
which the clergyman had just left, but neither she nor her sister-in-law bad any
medicine for premonitory diarrhoea. No disinfectants were in the house. Her
husband when she took his dinner yesterday said it was nice, but he did not care
for it ; she did not know whether he had diarrhoea. By the want of such simple
precautions lives are lost.
The Lea Bridge filter beds were all full except one or two ; gnats were playing-
over the waters ; and the swallows in active pursuit clustered over a parUcnlar
reservoir that appeared to attbrd them especially good sport. The workmen were
wheeling away barro"vvs full of gravel or sand. The great engine was at work.
Tho waters lie in the midst of rich meadows, on which many cows were feeding,
and are surrounded by an amphitheatre of houses and churches, crowned to the
north with the Alexandra palace.
The Lea was full to the brim of fresh running water, which looked well to the
eye, although it was not perfectly clear. I was walking by its side with a young
visiting clergyman, where we observed marks on the ground of pipes, and on
inquiries found that the Company, at the instance of the Hackney Board, bad laid
their water on the cottages. A hale man of fifty was indignant at the evil spoken of
the river itself, which had supplied him with water for some thirty or forty years,
and insisted on fetching a glass to show us its excellent quality. He told some
stories he had heard to the disparagement of tho Thames, which he could easily
Lelieve, but insisted strongly on tho spotless purity of the Lea. The cottage at
which the labourer had died of cholera had also had the water laid on a fortnight
ago ; but the wife admitted that she did not always draw her water from the tap,
but took it from the dock of the Lea, in front of the cottage, where a woman was
washing her dirty linen on my return.
I then walked over the low spongy fields, and finding the way long took a
carriage to Walthamstow on rising ground, and saw the registrar, Mr. Browne,
surgeon, in his comfortable house. There had been no deaths from cholera
Mr. Browne said in any previous epidemic, and none in this. The East London
Company supplies many of the new and best houses. The people are also sapplied
by a deep ai*tesian well in the street, as tho wells about are shallow, and the water
brackish.
This further inspection confirmed the conviction that the cholera stuff was not
distributed in the waters supplied from Lea Bridge, and that on the whole the
w^aters of the Lea at that point are not impurer to any appreciable extent than those
of tho Thames.
The account of the West Ham district, including West Ham, Stratford, Leyton,
and Walthamstow, is in the Weekly Return, No. 36 (September 8th),* The
registrar of West Ham was overpowered with work and sickness in his fiuniiy }
the dead were buried hurriedly ; many of tho people fed ; and he had difficnhiet
in getting information.
* See p. 132.
Narrative of Proceedings in 1866. 97
In the course of the inquiry I told Mr. Greaves that we had by the sheer force
of circumstantial evidence come definitively to the conclusion that the company had
used the open reservoirs for a certain time up to the outbreak of the cholera ; but
that if he would of his own knowledge affirm that they had not been used, I would
engage to say that the Registrar General would publish his letter, and that I for
one would accept his statement as conclusively true. He did not answer ; but the
following statement was made and published in November by the health officer
of Stepney, Mr. Orton, in his special Rei>ort on cholera* : " The charge aguin.st the
" Company consists, in an emergency, of distributing foul water from two old
** uncovered reservoirs at Old Ford. It is nothing to the j)oint to say that
** gentlemen sitting on the bench of justice, of unspotted private life, have protested
*^ that the water from the suspected reservoirs at Old Ford has not been u^d,
" and that the sttbordinate employes are all ready to a man to come forward^ if
" reqmredj on oathy to declare that the sluice has not been opened for such purpose
" for the last two years /"
On December 10th, I had the satisfaction of hearing Mr. Greaves, in evidence
before the Rivers Commission, state that his foreman at Old Ford having died he
appointed a snecessor, who was instructed to use the open reservoirs in cases of
absolute necessity. The reservoirs were used in the year 1866, and he believed
they were used in June. (See Evidence cited, pp. 100, 101.)
It is right to state that the Registrar General was supplied with oral and other
evidence from various quarters ; among other things a trustworthy passenger on
the Great Eastern railway stated that one of the open reservoirs had been emptied,
contained much mud, and filled again by soakage of the waters shortly before the
outbreak of cholera. The foul waters of the Lea would get through the bottom,
which was near, and certainly many feet below the water at high tide.
It appeared singular to a casual observer that while the cholera was raging at
Blackwall on the north side of the Thames it was scarcely felt on the southern
shore at Greenwich, although people were freely crossing the river ; and I recollect,
at the time the ministerial white bait dinner was about to take place, calling upon
Mr. Walpole's private secretary at the llomc Office, to inquire if the dinner was to
be at Greenwich or at Blackwall. A dinner at Blackwall was then a hazardous
experiment, while a white bait dinner at Greenwich was attended with no unusual
risk.
After the epidemic had subsided in East London to the ordinary level of the
metropolb, it lingered strangely in the Greenwich district, covering Deptford and
Woolwich, and in the beginning of September a partial outbreak there extended to
the contignoos part of West Charlton. A dis}>ute arose as to the cause. By one
party in Woolwich it was unhesitatingly referred to exhalations from the ill-ven-
tilated, BO said, metropolitan sewer, while by others the outbreak was referred to
bad hygienic conditions. Under these circumstances I visited Woolwich and
Charlton ; and the Registrar, Mr. W. Jackson, an intelligent pensioner, who had
been a petty officer in the engineers, accompanied me to many houses and streets
where deaths had occurred in the Woolwich dockyard sub-district. Several of the
obserFationa there made are recorded in the Weekly Return No. 45.t The people
were here aerioua, as is usually the case, in an attack of cholera, "which kills men
Buddenly. The workmen were at home in the middle day at dinner. One fine
intelligent Scotchman employed at the arsenal had kept the doors of his house
ox>en to purify the air. The skin of this man and others of his class was begrimed
with black dirt Why should not the artisans be supplied at the works with
Irarm water for ablation ? The people generally received us well ; but in some
C^^ea looked at ua with suspicion, as if we were going to seize their goods or do
iiiem some faaim. One woman had a ferocious buU-dog, which she kept behind her,
on the ground that he had an ill-inclination to fly at people's throats. Some of the
hooaes were empty ; the people had fled, and no information could be got. The
i¥at€r of the Kent company is supposed to be good ; but, singularly enough, at the
firat hooie we went to the woman complained that when first on it stank so offcn-
aively that she was obliged to let it run off, and open the window ; it in the end
* See p. 9 of Mr. Orton*8 Report on Cholera in 1866. t See p. 142.
98 Narrative of Proceedings in 1866.
becaino sweet. No sickness, no death had occurred ; but I observed in the retumg
that a child died there a few days afterwards in the bouse. The engineer,
Mr. Morris, was informed of the fact, and he surmised tliat the pollution was due
to corrosion of the lead supply pipe, which he promised should be looked to.
Such coses account for some mysterious local outbreaks.
Charlotte-street is a good looking street, leading down a mount to Woolwicli ;
some deaths had occurred in the street ; and I fioticed at a house where a young
man had died, in a stalwart woman, that peculiar pale dusky hue of the skin,
common alike in cholera and ague regions. The sewage ran down the street to
a cesspool, against a corner house of Mount-street, which is well described by
Mr. Grant.* Tlie house was empty. A woman in the shop opposite said that
it had been inhabited by a family of fine children, of whom three had perished
with their mother and grandmother, who had come to yisit them, and died
on her return home. She pointed out a very clean well-dressed woman of
middle age in black at the door of an adjoining house, who had lodged in
No. 1., and had devotedly nursed the whole of the family to the end. She lived
on the first floor, the other on the ground floor, and told mo there was at the
back of the house one of the sunk Woolwich rain-water tanks which had
recently been cleansed by the landlord. Whether it had been used she did not
know. She had two months ago, 1 was told, herself lost two children by fever.
Subsequently I visited with Mr. Grant the great outfall sewage works at Crossness,
Erith, where there are some excellent cottages for several of ttie workmen and their
families, among whom no case of cholera had been. The wages are good. The South
London sewage is stored in three floors of acres of vaults below ; but the engine
rooms arc as fine as the halls of Eblis, and I perceived no odour, except that
of carbolic acid, which is becoming the fitinkincense of the day. The river was
brimful ; it was the highest tide that for some time had been witnessed ; but as tho
sun declined and the tide turned the flood gates were opened, and the surging
Stygian streams gurgled up in vast volumes from the bottom of the river, flowing
away down the wide tidal way. We were carried back. Mr. Grant the engineer^
and Mr. Lewis accompanied me, with some of the workmen, in a rough horse
carriage, drawn by a horse on a tramway, by Plumstead, over some three miles
«f marsh, as the shades of evening descended, and we reached the Woolwich rail-
way in safety.
I am told that in some circumstances a reflux of the sewage discharged at the
outlets of Barking or Crossness is observed higher up the river than Woolwich,
and I cannot but entertain the hope to see the marshes some day drained, and
irrigated with this sewage water now wasted. It will be necessary to take a part
of the marshes in the river districts, which arc now very unhealUiy, and to drain
them.
Personal inspection, the use of maps, such information as we had the means
of getting from the registrars, the health officers, and other persons, enabled us
week by week to track the epidemic through this vast metropolis. Where testimony
is so much biassed by either the interest and power of well-organized companies, or
by the fears and ignorance of the public, actual inspection of the people suflering
in their houses, and of the mechanism of works either for supplying water or for
carrying away sewage, is indispensable. The eyes help the ears wonderfully.
In conclusion, I may hero state that the general policy of the Registrar deneral,
in plague seasons, is to keep the Government, the scientific world, and the
public accurately informed of the number of deaths by the epidemic and other
diseases, week by week, or day by day, in each district, according to the urgency of
the case. This in itself has several advantages. It shows the extent of th^
danger ; tho place of the danger ; and its progress. It shows the necessity of re-
medies ; and traces their effects ; but its great utility consists in the assistance it
supplies, in conjunction with other knowledge, in the investigation of causes.
In conformity with this policy the Registrar General undertook the publication of
a Daily Return of deaths during the severest manifestation of cholera in 1866.>
This proceeding involved much additional labour for the departmental stafT, but it
— ' — — ^ — "
* See p. 202.
Narrative of Proceedings in 1866. 9&
was felt to be for the public ^ood that it should bo done, and its utility was
acknowledged bj the medical profession and by the sanitary authorities generally.
The Daily Returns were commenced on Monday August 6tli, and continued up to
Saturday October 6th ; the decline of the epidemic tlien appeared to render their
further publication unnecessary, and they were discontinued, but in compliance with
the public wishes they were resumed on Monday October 15th, and only discon-
tinued finally on Saturday December 8th, when the epidemic had entirely ceased.
Our first question in the outbreak of cholera is : trhat is its cause ? or rather tho
cause of its lethality ? For once its cause is discovered the chance arises that the
action of the cause may be mitigated, or even annihilated by human cflTort. The
zymotic theory of cholera was advanced from the first ; it appeared generally to
explain the phenomena. Thus cholera, I assumed, is propagated by a stuff, which
in 1842 I proposed to call cholrinc^ in a paper containing the outline of the theory
of zymotic disease ;* and that stuff is contained in the secretions of the intestines,
ejected by vomiting or by evacuation. In my opinion non-choleraic evacuations
sometimes produce sporadic cases of cholera, and possibly, under favourable con-
ditions, an epidemic cholera itself.
Cfiolrine is a light fluid, inodorous, and probably tasteless. It does not affect
everif person with whose mucous membranes it comes in contact, either directly
through the dirty hands', or contaminated food, or drinking water, or the steam of
water arising from choleraic infusion, as in washerwomen, wlio cannot be sus^pectcd
of drinking the water, or finally of the cholrinc in floating dry clouds of dust.
That cholera stuff can be distributed through the river waters of Iy)ndon was
demonstrated in 1854, in the weekly returns of 1849 and 1854, from the experi-
ment in South London on a large scale of the two qualities of Thames water, one
containing much sewage (the Southwark), the other containing little sewage (tho
Lambeth). Dr. Snow first propounded distinctly tho theory that cholera is pro-
pagated exclusively by cholera discharges, and that trater is the chief medium of
diffusion. He collected many examples (see his book on cholera) ; and in 1853
this passage occurred in the supplement to the Weekly Return No. 47. (November
19th)9 headed " Cholera and the water supply of London." " It is believed that
" through nearly the whole of this Table the inijmrift/ of the waters with which
" the inhabitants of the several districts arc supplied is in nearly a direct prO'
" portion to the mortality from cholera" This was placc<l beyond dispute in tho
observations on the great epidemic of 1S54 ; and was admitted by my friend
IDr. Baly, who had up to that time been sceptical about the water theory. Lord
Llanover, then at tho head of the Board of Health, procured returns from the
water companies (Southwark and Lambeth), and from the General Kegister Oflice,
at my instance, and on a plan which enabled us to s?how the mortality of cholem
in the houses respectively supplied by the two water conipanies.f
I was therefore prepared in 186(3 to closely scrutinize the water supply ; but
there were extraordinary difhculties in the way of getting evidence of any con-
tamination of tho East London water ; for the chemical analysis had led to no
discovery of peculiar impurity in former years ; perhaps because the waters had been
taken by Dr. Thomson and by Pi*ofcssor Frankland from tlie mains chiefly filled
from the Lea-bridge engine pump. Again, neither Mr. Mylne in his map of the
districts supplied by tho nine metropolitan waterworks companies, nor the govern-
znent engineers (Messrs. Austin, Ranger, and Dickens), in their report on tho
A !•_ * 1 .1 .'••111 ?.-_ •_ al-.* a^l.^-.«.
Ci
company employed iiu iiicuua ui luiiunun u*;iv*v5 bn^ ^w.^ w* -.v^^r-. *.-« —^
depositing reservoirs upon which they had to rely for clearnces of the water have
* See Regbtnr General's Fourth Annual Report, pp. 197-205, published in 1842.
t See the Beport of the Board of llealtli Committee for Scientific Inquiries. The committee con-
tfited of Amott, Baly, Farr, Owen, and Simon ; the hitter wrote the Kcport, which was not signed
hy th« other members. The analysis of the facts was conducted at the General Kegister Office, where
idl the ealcnlations for the Report were made. See also the Report of the Medical Council of the
BoMd of Health (p. 7), who did not admit the conclusiveness of the " Broad-street Tump case.
See alio Mr. Simon's Beport on Newcastle epidemic.
100 • Mr. GreavesU Evidence.
'' 710W been abandoned, atid all communication beUceen them and ike maim has
" been cut o/f*." This is explicit. The communication either was not then cut off
in 1866, or it has since been re-established. Who could suspect either alternative ?
Mr. Greaves said that the connexion existed in 1866, and was used in June ; but
this was unknown. Neither Wyld's map nor Stanford's map shows the under^
ground iron pipe ; hence the omission of its notice in the Weekly Return of
July 28th, which gave the company a legitimate ground of complaint and a defence^
until the other facts were discovered. At this wo laboured several weeks until the
cause of the dreadful loss of life, so far above that in every other district, was
distinctly pointed out and removed.
The simple description of some of the scenes I witnessed under the authority of
the Registrar GreneraFs name at once called public attention to the distress and
the courage of the people. The facts expressed in the often-cited sentence, ** the
people of East London want help," was sufficient in England to set hundreds of
benevolent people in motion.
The defective municipal organization of the metropolis became painfully apparent
in the course of the epidemic ; and upon observing the imperfect organization of
East London to meet the calamity I wrote (I believe on Monday, June 30th,) a
private note to Sir John Thwaites, suggesting that the Metropolitan Board should
intervene, send down a superior health officer, an engineer, and a staff of medical
men and nurses, to organize the infected district, and to help the sufiering populations.
In reply I was informed, to my great regret, that the constitution of the Boaitl
allowed no such interference, and that no money could be so expended legally.
I had urged that it was a case in which the life of the whole of London, was
concerned.
London is not only the greatest but the wealthiest city in the world, and it is
quite able to succour the sick, to provide hospitals, and to reliove the orplians
rendered destitute by the deatli of heads of families, provided the whole of Ae
property is evenly rated, and the relief is judiciously administered on a well-con-
sidered plan. Instead of this all was left to hazard, and to the providence extem-
porized of private charity, which shone with splendour, but with unequal and
uncertain light, in the darkest quarters of London.
March 1867. W. Pabr.
Ill.-MR. CREAVES'S EVIDENCE.
^M^^^^^^i«« . ^r B,^^
Extract from the Evidexge of Mr. Charles Greaves, Exginees to the
East London Water Company, before the Royal Commission ox the
Pollution of Rivers. 10th December 1866. [^Second Report of the Com"
missioners nppoijited to inquire. into the best means of preventing the PolhUion
of Rivers {River Lea), Vol. II., pp. 5 and 6.]
142. (Chairman, — Mr. Rawlinson, C.B,) You have 12 acres of filter bed in
use and your pure water reservoirs from which you pump ; have you any conduit
or open reservoirs in which water is stored, or into which you can bring water,
which are not regularly in use ? — I have reservoirs still in existence which were
originally made as depositing reservoirs where the simple water b received firom the
river ; those reservoirs until lately were in a positioji to be drawn upon in the wajf
which you 7ncntion,
143. Are those reservoirs capable of being filled by a conduit or by a pipe, would
they be filled by sluices directly connecting with the Lee, or by what means would they
be filled ? — They were capable of being filled by a sluice connected with a disused
canal, a canal which was in use as the company's principal line of conduit preTiously
to the year 1852.
Mr. Greaves's Evidence. lOl
144. And that conduit and those reservoirs exist now ? — That conduit and the
reservoirs exist at present.
I45n Are they now full of water ? — ^They have been absolutely severed.
146. A^re they full of water ? — One of them is considerably depressed and has l>een
emptied, the other one is not full.
147. Are they now in a position so that you could connect them with your lower
pumping engines ? — No, not now at all.
148. When where they disconnected ? — In the last autumn.
149. Coold they have been connected this spring ? — One reservoir could have
been drawn upon this spnng.
150. To your knowledge were they or were they not drawn upon tliis spring. ?—
A small quantity of water was taken out of one of them.
151. Then the water firom one or other of those open reservoirs was drawn upon
this spring ? — ^Yes.
152. Can yon give us the date ? — ^I have not the date.
152a. Was it drawn upon by your order ? — Not precisely, but there was an
implied sanction.
153. For what purpose was it drawn upon ? Was it because you were short of
water in your store? — ^I should think that it was because the foreman thought so.
154. He thought that it required it ? — ^Yes.
156. Would he do it without consulting you ? — ^Yes, if I were not present. I lost
my foreman early this year ; he died quite suddenly of apoplexy, and I had to appoint
a new man, and in giving him discretionary instruction as to how he was to mani-
pulate the water I described this possibility as something which he must keep m
mind, rather than suffer an accident, and so I suppose he may have acted in that
flense.
156. Do you know about the date when those reservoirs were last drawn upon ?
Was it before the outbreak of cholera in the east end of London ? — I have not the
date. I cannot answer that question now.
157. Do you know whether it was or not before the outbreak of cholera? — ^You
mean the last oecasion that they were drawn upon ?
158. Yes ? — ^I cannot say.
159. Do you remember the period of my visit ? — Quite so ; it was I think on the
2nd. of August
160. Have they ever been drawn upon since that visit ? — Certainly not.
161. Then it was previous to that visit ? — Certainly.
162. I suppose that the cholera had been prevailing a month when I visited you ?
—Yes.
163. Then the probability is that the reservoirs had been drawn upon previously
to that time ? — Probably June was the latest date, but I cannot say.
164. Yon did not think it of sufficient importance to ascertain that fact when that
charge was brought against your company of supplying impure water ?— -I certainly
did inqnire into it, but I cannot give the date now.
182. Why did yon abandon those old works ; that is to say, why did you abandon
their use and yet retain them ? — They were abandoned because the system of filtra*
tion, AS a matter of course, put them out of use, -then they were not applicable to
any other porpose, and I thought myself more justified in keeping them full than I
was in emptying them, considering that the question of quantity was at times of such
importanee with reference to accidents, that it was advisable to keep reservoirs which
were already constructed and which 1 could not apply to any other purpose, to meet
floch neceaaitieB as might arise.
100 ■ Jlfr* G nmtt f * £eid^ ^y.^.
" now /teen abandotud, and off tm^ g--^^"
"been cut off." Thiaisex-'* ^..,. ' ^ WATER SUPPLY OF
in 18S6,or it hu bidco ' . ■ '■' ' jti^.
Mr. GreBTCs Btid ■'- -^•*f^***^„ ,
this was tmknr . -■ ,, ." >>*
grouad iron t A"*" ^^ftdn^.Vo. 574., J^Vmiwi 0/ 1867,]
nntS the o* '*"' * '"■"laJd"'**'! to the Board of Trade \>y certain
cause of tl . ' " "^^^'^■^'''S ""= quantity and quality of the water
distinctly ^^r '-''L^t ^^""^"'^^ Company. The aUegalions contained
the Baff' ^("^^fW' ^jntJy « within tlic iinowledge of your memonidisti
the con ^-K^' > ^'"^
peoDle C'l^^i*' '*1-ff- -il hi'Proft'SSor Franklan J in oOiciat ropovts to tlic Registrar
beM- ■ i,<"'i^^^^ZmoralKii believe, the worits of tlie saiil Company at Old
T ,*;:'/)**'''ji^/"'""',npond?, wlierc nosulKcicnt care is provided to prolcct tho
jn .il'='*lrK""'-w': o'td alM nu underground rescrroir, wliidi is sevprol feut
E- /i^*' ''^''^'''''f^^^^^^'^^ ^"'■'''' i'n'ocdiately toiiliguous ihcrcto, and into which.
i'^"*^f^''^\''ritc'' fwliich is no Iftter than an oi>c'n sower) can and doL's jtcr-
■ '''^'*i'r^' '?vft r««r™''' '* '" communication by a pijic or pipe?, with the said
"tem ""' ifti" *''" '^'"''•' '•'*"" *be™ ™ay be used in time of emergency by the
af^^^ j'n!' suggested by Professor Frankliuid hiis been so used, and tlius been
&l^%' "principal if "<>* *^'^ 8o'« cause of tlie fearful mortality from cbolcra at
tan' ^ , of London.
**'' "riiat '''^ i»fr''3 of the said Company at Lea Bridge, from whence tho whole
* giipply of ihi* portion of f,ondon is derived, ai-e situated at a point wliero
**'rfiiter f"^ been contaminated by tlio sewage of Broxboumc, Hoddesdon, Bishop's
jftrt'i Enfi'^Id, Ware, tiiid many otlitr iilaccs, comprising a [wpuhition of many
rt^jnnd inhabitants."
•OlO mcioorinlisls tliei-efore pmyed tlie Board of Trade, ]>ursuaiit to the pfovi-
flona of ''"' ^^ i'"^ subsequent sections of the 15 & 16 Vict. c. 84, " to apjioiut
^ comiwlciit person to inquire into and concerning ihcso grounds of complaint, and
generally into tlic coniieston of the said water supply with the recent epidemic, and
to (alto tlic stoim prescribed by ilio said Act to require tlie Company to i-emovc the
grounds of Kuch eompkinl^, so as to avert a similar cntamily in tlie future."
The Board of Trade thereupon directed Cnptfiin Tyler to malio llic i n vest igai Ion,
and the following extracts Irom liis Report show the conclusions at which lit;
arrived on the chief points at issue ;
" At Lea Bridge there arc a large stonm engine of 250 horse-power, and n smaller
one of 50 h(irse-iii)wcf, ns well as Iwo water-wlieel^ which work as long as there is
surplus wafer to turn them. The Cirtiipany ore constructing two additional enfjincf
of 150 lioise-i>ower cacii, to be completed in the spring of nest year. There
arc here twelve acres of filter bcils and the Company are scekiiig powers to obtain
land for six additional acres of filtering area. Part of tho water filtered at Lea
Bridge passes tbrougli cast-ii\iii iiiiKS 18 inches in diameter and 2\ miles in lengtk
to the works at Old ford, and tlie remainder is pumped out direct Xa the district.
*' At Old Ford there ore two engines of about 70 horse-power and four larger
engines, altogether of 560 liorsc-power. Tliere are also at these works two covered
reservoirs, measuring at the upper Mufacc of the water when they are full about
2\ aeies, and contninin;! togetlicr abcut 6,000,tX)0 gallons. There are walls of
separation between them, with a connecting channel tlirough tho walls, but these
iralls are five feet under water when they arc full. These resenoirs weio coo-
strueled in IJjOT, and were lirst u.-^ed in 1809. Fi-om the latter date up to the year
lft2f), flic Compmiy took tlieir whole supply fi-om the river Lea at Old Fonl. The
reservoirs wei-e filled liy sluiws with brick channels, which were 0|>ened at high
water, and the river n-as thus emptied twice a day ( l>ut little lias since been done
to the i-c-iwrvdir!', excei't tiiat thoy were covered over in 1854-5 by piers and
arches of l.iiekwork. They were kept dry for several months while this operation
was going on, ami the only soakage into them that was then observed was, as far
Board of Trade and East London Water Supply, 103
•
as the engineers of the Company remember, supposed to come from the sluices, and
it was collected in channels and pumped out. They arc stated to have been at
times nearly emptied for examination since I800 without any soakago being dis-
corered. The latest date at which such examination occurred is believed to have
been six or seven years ago. Tliey have never l>een cleansed since 1855.
'' It was, of course, impossible, to come to any satisfactory conclusion as to the
tiiith or otherwise of the allegation that the water of the Lea found its way into
these reservoirs without actual examination when the water was pumped out of
them, and I therefore intimated to the Company my desire to make such an
examiuatioD. They did not at first sec their way to it without interfering with
the supply of the district, but at length they were good enough to appoint Sunday,
the 24th of February, as being the least inconvenient day for the purpose ; and the
reservoirs were emptied in thirty-six hours, between Saturday morning at 6 a.m.
and Sunday evening at 6 p.m., to within about a foot of the bottom, which was as
far as the engines would draw the water from them. I devoted three hours on the
Sunday afternoon to wading about in the water, and thus making the best exami-
nation which the circumstances would ])ennit. I found a spurt of water issuing
from the brickwork across an old sluice through which water had formerly been
admitted to one of the reservoirs from the nver, and I saw water issuing from
more than one of the piers by which the arched covering was supported. I
observed also a considerable amount of sotikago into the reservoir from the slopes
of the brickwork at its side, and from the gravel at the foot of the brickwork, over
a distance of 210 or 215 feet In one part there was a tolerably distinct line of
soakago some six feet above the foot of the slope. There were also, as it were,
springs issuing below the level of the water, and producing motion at the surface^
which became more visible as the water decreased in depth ; and it was impossible
to avoid the conclusion that if more of the bottom could have been laid bai*e more
of these issues would have been seen, and a greater quantity of water would have
been found to enter the reservoir. There was much discolouration in different
places where the water entered, which appeared to indicate a want of purity,
though the water itself appeared to the eye when taken in a glass from the spurta
£rom the brickwork to be bright and sparkling. It was less agreeable to the taste thaa
the Company's filtered water. Samples were handed by the Company to Dr. Letheby
for analysis, • • • ♦ and it was ascertained that there were 3*3 gi*ains of
matters lost by incineration per gallon, against 1*1, the average by the same
chemist for the Company's filtered water for nine months, from April to December
1BG6; against 2*5 for the water in the main at the London Hospital on the next
day ; against 1 * 76 for the water in the Company's main on the 9th of August
1866 ; and against I *89 for the water in the uncovered reservoir at the same date*
It will further be observed that the water left in the covered reservoir on the
evening of the 24th of February was nearly as bad by this test as that which
issued from the wall in the old sluice, and was worse than that which spurted from
the dope at the north end of the reservoir. But the result of the test by perman-
ganate of potash, relied upon by Dr. Letheby, who nppeared for the Company, and
objected to by Professor Franklaud, is still worse. According to that test, the
water which remained in the reservoir was the worst of all, showing 1 *28 grains of
Oi^anic matter per imperial gallon, against 1*12 grains in the spurt from the old
sluice ; 0'56 grains in the spurt from the slope ; the same in the uncovered reser-
Toir, on the 9th of August 1866 ; '48 in iho London Hospital main at that date^
•80 in the main at the London Hospitid on the 25th of February, and '55 as the
general average of the Company's filtered water for the seven months, April to
December 1866. The question then arises, how did the water in the covered reser-
voirs become, at the end of the inquiry, so strongly tainted with organic matter ?
How could it become, in the case of the first test, nearly as bad as the water
leaking throaeh the old sluice, and worse than that leaking from the slope ; and,
in the ease of the second test, worse than tho water issuing from either of these
places ? The only answer that I can make to these questions is, that there must
naTe been, if these tests are to be relied on, means of contamination woi-se than
those snpplied by the particular issues of water which were tested ; that as tho
Altered water with which the reservou^s had been filled was pumped out, tliQ
104 Board of Trade and East London Water Supply.
remaining mass of the water was contaminated, either by something at the bottom
of the resei'voir, or by water soaking into it. During the investigation^ I noticed
a strong and disagreeable odour, confined within narrow local limits, in two places
near the surface of the water, but I was unable to trace it in either case to anj
source. And there was a considerable amount of deposit from the water in all
parts of the reservoir, wherever such deposit could find a resting-place. But this
deposit, which was analyzed by both Dr. Letheby and Professor fVankland, was
found, as taken from the brickwork, about half way down the slope, to be innocaou9.
It contained, according to Dr. Letheby, only 0-7 percent, of organic matter; it
consisted principally of ciirbonatc of lime ; and it was, according to Professor
Frankland, such a deposit as might have been expected from a hard water stored
in a reservoli* lined with brickwork in mortar. I am therefore driven back to the
conclusion that there must have been some soakagc through some part of the
bottom of the reservoirs of a more hurtful character than the water which issued
from the points at which samples were taken. And I must not omit to mention,
in connexion with this point, that Mr. Knight, the Surveyor to the Vestry of
Mile End Old Town, dug up fi'om below the gravel in one part of the reservoirs
a substance which was offensive to the smell.
'* I learn that the ordinary pond level of the Biver Lea, at Old Ford, is two feet
below Trinity high-water mark, and that the river stood at or near that level
during the above examination. The water in the reservoirs pumped down to a
depth of about one foot, would have been ten feet below the level of the water
then in the river. The river may rise in extreme flood to 1' 6*' or 2' above
Trinity high-water mark, and it would in that case be above the full level of the
water in the reservoirs, which is ordinarily the same as that of the pond level In
the river. The bottom of one reservoir is about twelve, and that of the other
about thirteen feet deep below Trinity high-water mark. They are filled every
night, and pumped down about five feet every day ; and they are thus, taking
into account their irregular shape, emptied daily of about one half of their contents.
About 11,000,000 gallons of water are delivered daily from Old Ford to the
district, all passing through these reservoirs. Of this quantity, about 8,000^000
gallons is drawn through them from Lea Bridge ; and out of 6,000,000 gallons
which they contain each morning, 3,000,000 gallons is drawn upon during the day,
the same quantity remaining in them in the evening, though at times much less
water would remain in them. The water in these reservoirs may thus be above
that in the river in the morning, and would be below it eveiy evening. The sources
of contamination above referred to would come into play as the depth of the water
in the reservoirs decreased during the day, but they would be very much diluted,
and they would not in the practice of daily working have operated so strongly aa
on the 24th of Fe1)ruary, inasmuch as it was necessary to remove some of the
brickwork to enable the engine to draw the water down to so low a level, and the
pumping was prolonged at a slow rate to an unusual extent. * * • •
^' Under all the circumstances of the case, I am of opinion that the all^afion hu
been proved that the water of the Lea finds its way into these covered reserroars.
Tlicre is no doubt as to the impure quality of that water. It would be more or
less naturally filtered in making its way through soil and gravel, and the propor-
tion of contamination would be very small in the ordinary operations of the Com-
pany, though it would increase as the level of the water in the reservmiv
diminished. • • ♦ •
" Li addition to the above covered reservoirs, there are at Old Ford two open
reservoirs, which were formerly used as depositing reservoirs, in connexion with
an aqueduct by which they were supplied until 1855. The one (northern) open
reservoir contains four, the other (southern) about ^vq acres of water. There was
a sluice from the south to the covered reservoirs, which was otherwise applied in
1855 ; and a sluice from the north to the covered reservoirs which was nised ooci-
flionally up to September 1866. The smaller (north) open reservoir receives by
night the 6ui*plu3 water, when there is any, from the covered reservoirs. It womU
run in frequently, but not in great quantity. The sluice into it from the old canal
or aqueduct has been opened since 1855, but rarely. The rain goes to supply loss
by evaporation. The mass of the water in it is therefore unfiltered, and if the soil
Board of Trade and East London Water Supply. 105
below it be permeable, the water from the river would, when differences in level
permit, leak into it.
*^ Commanication was retained between the smaller open and the covered reser-
YoirB afiter 18o5 as a possible resource in case of emergency ; and the water from
the open reservoir might, before the sluice was filled up in September 1 866, have
been drawn bj the engines and supplied to the district without passing through
the coyered reservoirs, but this has never been done. The engineer of the Com-
pany admits that water from the open reservoir was used during a time of drought
in 1864, but be does not believe that it was used in 1866, and he has no knowledge
of its baviDg been used more than three times in 1866. Ho considers that about
three inches of water, or 300,000 gallons, would have been drawn from it on each
of those three occasions ; and this would have been done to maintain such a level
in the covered reservoir as was required to keep both of the engines going. The
engineer of the Company was aware at the time that water from the open reservoirs
was sent out to the district in March 1866, but he was not personally aware of its
beingso used later in the year.
** The foreman of the Works at Old Ford, who entered the Company's service on
the 23d of February 1866, received explanations from the engineer of the Company
as to the use of that sluice at that time, and therefore considered the water in the
open reservoir available as a reserve in the event of the water getting low in the
covered reservoir, to prevent the engine with the higher suction from being damaged.
He made no notes on the subject, but he allowed water to run with that view from
the open to the closed reservoir, he believes not more than three times during tho
year 1866. He thinks that those times would have been at the latter end of
March, the latter end of June, and some time in tho early part of July. He is
certain that the sluice of the open roservou* was never opened after cholera broke
out in the district. He had no fear of its doing harm. But it so happened that
it was not required. He might, of course, have stopped the engine, to prevent it
from being damaged, instead of admitting water from the open to the covered
reservoir, " but that would not have supplied the district, Tho extra water from
the open reservoir was wanted to complete the supply."
" A carpenter at Old Ford, who has been there for twenty-four years, and assists
generally in the engine-houses and on the Works, appears to have been the only
man who worked tho sluice between the open and the closed reservoirs, ife
opened that sluice frequently in 1864, frequently in 1865, and three times in 1866.
In March 1866 he was in or near the engine house when the engine began to draw
air, and he was ordered by the engineer of the Company to open the sluice, which
he did. He left it open for two hours to two nnd a half hours. About two p.m.
on some day in the latter part of June ho was about the yard when tho engine-
driver called to him, and '' ordered him to let him have some water." He went to
the foreman, who ordered him to open the sluice. Ho did so, and left it open for
about the same length of time. Early in July the foreman again gave him orders
to open the sluice, and he opened it and left it open for about the same length of
time at the same period of the day. These were tho only occasions in which ho
worked that sluice in 1866. He considered the water in tho open reservoir to be
very good, and had often drank it.
** Such is the evidence which I have received in regard to tho allegation of
the Memorialists. The truth of it is admitted by tho officers and servants of
the Company. The use of such unfiltcred water so stored in an uncovered reser-
voir is indefensible, and was a distinct infringement of tho provisions of the
Metropolis Water Supply Act of 1852. That Act directs (Clause 2) that every
reservoir within five miles of St. Paul's Cathedral in which water for tho supply
for domestic use of the Metropolis is stored or kept shall, after 1855, be roofed or
covered over ; and TClauso 4) that every Company shall, after 1 855, effectually
filter ail water supplied by them within the Metropolis for domestic use, before
the same shall pass into the pipes for distribution, excepting any water which may
be pumped from wells into a covered reservoir or aqueduct without exposure to
Uie atmospherey and which shall not be afterwards mixed with unfiltered water."
106 Board of Trade and East London JFater Suppfy,
The opinion of the Board of Trade upon Captain T7ler*8 Beport was com-
municated to the Sccretaiy to the East London Wateiivorks Companj in the
following letter : —
^^ Board of Trade (Railway Department)^
Sir, Whitehall, 20th June 1867.
I am directed by the Lords of the Committee of Privy Council for Trade to
inform you that on the 13th November 1866 their Lordships received from certain
inhabitant householders paying rents for, and supplied with water by the East
London Waterworks Company, a memorial complaining of the insufficient quantity
and impure quality of the water supplied by the East London Waterworks
Company.
In pursuance of the 9th Section of the Metropolis Water Supply Act, 1852,
(15 & 16 Vict. c. 84), my Lords appointed Captain Tyler to inquire into the grounds
of that complaint, and to report to their Lordships thereupon. My Lords have
now received from Captain Tyler his report upon the matter so refeired to him,
and I am to transmit to you herewith a copy of it.
Upon consideration of that report it appears to their Lordships that the com-
plaint of the memorialists is well founded, and I am therefore directed, in pursuance
of the 12th section of the Metropolis Water Supply Act, 1852, hereby to give
notice thereof to the East Loudon Waterworks Company, and to point out to you
that, after the receipt of this notice, the Company are by the 13th section of the
same Act required, within a reasonable time, to remove the groimds of such
complaint.
I am to request that the I'cceipt of this notice may be acknowledged, and to state
that my Lords will be glad to be informed of the steps which the Company propose
to take to remove the grounds of the complaint.
I am, &c
The Secretary to the (Signed) Robert G. W. Hebbebt.
East London Waterworks Company,
16, St. Helen's-place, Bishopsgate-street."
In reply to this letter the Secretary of the East London Company addressed,
on 29th July 1867, a rejoinder to the Board of Trade, from which the following is
an extract :
<' Into the question raised by the memorialists respecting the connexion of the
Company's water with the fearful epidemic of last year, the Directors abstain from
entering, not merely because Captain Tyler found it only a ' case of grave suspicion,*
and one in which * proximity to absolute proof had only been ' nearly reached,' or
because the Directors are conscientiously satisfied that the water neilher caused
nor continued the mischief, but because it appears to the Directors that this is by
no means the real issue, for the Board fully admits, and the public is entitled to
expect, that if it were conceded on all hands that the water had no connexion with
or bearing upon the epidemic, the duty of protecting it from impurity, and of
supplying it in the best practicable condition, would still be imperative.
" The Directors do not controvert nor comment upon Captain Tyler's report
respecting the Old Ford reservoirs.
" Unfiltered water was to some slight extent, and under special and unfireqnent
circumstances, admitted into the covered reservoirs from the uncovered reservoirB.
The fact is to be regretted ; although the Directors believe (and in this Captua
Tyler acquiesces) that no actual mischief resulted from it. In September Ust^ at
all events, any repetition of such a proceeding was i-endered impossible by cutting
off the connexion between the uncovered and the covered reservoirs ; and by
clauses introduced by the Company into an Act which has now received the Boyal
Assent (see section 17 of the *East London Waterworks (Powei-s) Act, 1867
provision is made for absolutely filling up the uncovered reservoh-s within a limited
period.
" Again, it was suggested that there was involuntary soakago of water from
these uncovered reservoirs into the covered reservoirs. This suspicion (which
appeared to Captain Tyler not well founded) will of course be at an end by filling
up the uncovered reservou's.
Board of Trade and East London Water Supply. 107
*' It was farther suggested that there was soakage of water under similar cir-
cumstances from the river Lea into the covered reservoirs, or one of them, and the
Companj gave every facility by emptying the reservoir for making the inspection
which Captain Tyler desired. The indications which he then observed may or
may not support the inferences drawn from them, but the Company at once pro-
ceeded to introduce into the same Act a provision (see the section already referred
to) of a fully preventive and remedial character, which I will proceed to explain.
The covered I'eservoirs at Old Ford cannot be to any considerable extent interfered
with, or their depth or capacity lessened until a further filtering area has been
perfected on the Company's supply above them ; but the Company has, by the Act
I have already quoted, acquired the power and undertaken the duty of forming this
further filtering area, and immediately thereupon one of the covered reservoirs at
Old Ford is to be filled up, and the depth of the other (which is to bo rendered
water-tight to the satisfaction of the Board of Trade) is to be considerably lessened.
^ Observance of all these remedial proceedings has been secured by heavy
penalties voluntarily imposed, and the Company wUl of course perform what it has
in this respect undertaken ; thus incurring a very considerable outlay, not perhaps
necessary for the remedy or prevention of any actual mischief, but, at all events,
desirable as cautionary measures, and for quieting the public mind.
'^ Such are the steps which the Directors are taking with reference to the special
cases in respect of the quality of the Company's supply, which were discussed
before Captain Tyler."
In a subsequent memorandum, dated 15th August 1867) Captain Tyler remarks :—
" Upon a review of the whole of the evidence, I found that a case of grave
suspicion had been established against the Company, and that while absolute proof
in such a matter would be exceedingly difficult, a proximity to absolute proof,
which I pointed out, had been nearly reached. Cholera matter would have found
its way into the Lea at an early stage of the epidemic, and might have soaked
from the Lea into the covered reservoirs, and I expressed an opinion that if, as was
possible, choleraic poison did find its way into the Company's mains, it must have
passed directly from the river Lea into the closed reservoirs, rather than from the
Lea into the open reservoirs, and so to the district through the water that was so
improperly supplied from the open reservoirs.
'* The four allegations have reference to the quality only of the water. Chemical
analysis^ though valuable as an auxiliary, is unfortunately a very imperfect guide
as regards the absolute condition of water. Chemical evidence avails but little in
proof of purity when it is known that the Company's filtered water is more or
less contaminated by soakage in the Old Ford covered reservoirs ; that unfiltcred
stagnant water has frequently been served out to the district from the open reser-
voirs at Old Ford ; and that the Lea is itself subject to so much pollution.
Admitting that the Company are now doing, or are ready to, or have done, what
they can towards removing these means of contamination, there still can be no
question as regards the past, that the complaints of the memorialists on the subject
of quality may fairly be said to have been well founded."
The subjoined letter from the Board of Trade to the Secretary of the East
London Waterworks Company closes the official proceedings in regard to the
complaints against the company ^—
** Board of Trade (Railway Department),
Sir, ^ Whitehall, 18th September 1867.
I am directed by the Lords of the Committee of Privy Council for Trade to
acknowledge the receipt of your letter of the 29th July, explaining what the
Directors of the £ast London Waterworks Company have done, and propose to do,
for the purpose of improving their water supply. This letter has been referred
to Captain l^ler for his observations, a copy of which I am now to transmit for
the information of your Directors, and from which it will be seen that the action
taken and contemplated by the Company is, in the opinion of that officer,
satisfaetory.
With reference to the third paragraph of your letter, in which you state that
your Directors feel constrained to reserve the right of objecting, wheneTcr they
Extracts from tFeekly Returns of IS66. : 109
V.-CHOLERA IN LONDON, 1866.
1. Extracts from the Registrar-General's Weekly Returns during
THE Course of the Epidemic.
[KoTE« — The figures quoted throughout the following Extracts are those which were given week hy
week in the several Jietums, and will consequently differ in some degree from the revised
figures given in the Tables prepared speeiaily for the Cholera Report']
ek ending Saturday^ June 2.
Tke deaths registered in London during the week were 1540. It was the
twenty-second week of the year ; and the average number of deaths for that week
was, with a correction for increase of population, 1195. The mortality is still very
high. It is in excess of the estimated amount by 345.
The following two deaths from cholera were registered :—
On 28th M«j, tt 58 North-street, Walworth, the son of a labourer, aged 10 months, died of
" Asiatic cholera (one day)."
On 31st Maj, at 8 Charles-street, Bethnal-green, the son of a warehouseman, aged 5 years, died
of ** choleraic diarrhoea (24 hours) ; conyulsions (6 hours)."
eek ending Saturday, June 9.
The deaths registered in London during the week were 1383. It was the
twenty-third week of the year ; and the average number of deaths for that week
was, with a correction for increase of population, 1 196. The actual number exceeds
the estimated amount by 187.
The following three deaths from cholera were registered in the week : —
At 18 Narth-street, Marylebone, on the Ist June, the widow of a journeyman carpenter, aged
49 years, died of " choleraic diarrhcea (48 hours)."
At 1 Duke's-lane, Eensingtoii, on 2d June, a needlewoman, aged 33 years, '* English cholera."
At 47 Sonth-ftreet, May-fair, on 6th June, the daughter of a physician, aged 6 months,
« choleraic diarrhoea (4 days)."
^eek ending Satwrdagj June 16.
The deaths registered in London during the week were 1370. It was the
twenty-fourth week of the year ; and the ayerage number of deaths for that week
was, with a correction for increase of population, 1218. The actual return exceeds
the estimated number by 152.
The following three deaths from cholera were registered : —
On 12th June, at 3 Archibald-street, Bromley, the daughter of a mariner, aged 8 months,
** choleraic diarrhoea.''
On 12th June, at 16 Dowson's-place, Mile-end New Town, the daughter of a rag^orter, aged
11 montlu, " choleraic diarrhoea (7 days)."
On 13th June, at 6 Swan-court, Newington, a watchman, aged 55 years, ^ cholera (3 days)."
110 Extracts from Weekly Returns of 1866b
fFeek ending Saturday^ June 23.
The deaths registered in London during the week were 1295. It was the
twenty-fifth week of the year ; and the average number of deaths for that week
wa3, with a correction for increase of population, 1208.
Diarrhc&a is increasing with the summer heat, and 43 fatal cases of it are
returned. A death from cholera was registered as follows : —
On 2 1 St Jane, at 4 Nunery-place, Walworth, the daughter of a herhaUst, aged 7 veeki, *^ cholera
(4 days)."
Week ending Saturday ^ June 30.
The deaths registered in London during the week were 1400. It was the
twenty-sixth week of the year ; and the average number of deaths for that week
was, with a correction for increase of population, 1263. The actual return is
therefore higher than the estimated number by 137.
The following six deaths from cholera were registered in the week : —
On 27th Jnne, at 12 Priory-street, Bromley, a labourer and his wife, both of the age of 46 years,
died of cholera Asiatica," the former after 15 hours', the latter after 12 hoars' iUnesB.
On 25th June, at 20 New-street, Berwick-street sub-district (St. James Westminster), two girls,
the daughters of a tailor's porter, aged respectively 2 yean and 6 years, " English cholem
(18 hours)."
On 21st June, at 21 Old Bethnal-green-road, a boy, aged 11 momtlit, *'cholende diantea,
exhaustion."
On 22d June, at 51 Wellington-place, HoUoway, a girl, aged 14 yean, ^English cholera
(38 hours), syncope."
Week etiding Saturday^ July 7.
The deaths registered In London during the week were 1292. It was the
twenty-seventh week of the year ; and the average number of deaths for that ^reek
was, with a correction for increase of population, 1269.
There were 102 deaths from diarrhoea, 92 of which occurred under two years of
age. The corrected average number of deaths from this complaint in the twentf*
seventh or corresponding week of ten previous years is 105. In the corresponding
week of 1863 it was 47 ; in that of 1864 it was 81 ; in that of 1866 it was 301.
Although there is much diarrha3a, it can hardly be considered ezcessire ios the
beginning of July.
The following deaths from cholera wore registered in the week :— «
On 29th June, at 3 George- street. Hammersmith, a labourer, aged 50 years, '< cholera."
On 30th June, at 58 Myddelton-square, Clerkenwell, a boy, aged 7 years, ** 'F^^'^ eholert
(24 hours)."
On 5th July, at 96 Borough-road, a boy, aged 6 weeks, "cholera (38 honra)."
Besides these, eleven deaths of children, chiefly infants, are returned as cauaedby ^cholecue
diarrhcea."
Week ending Saturday^ July 14.
The deaths registered in London during the week were 1540. It was ^
twenty-eighth week of the year ; and the average number of deaths for that "wei
was, with a correction for increase of population, 1293. The actual return ezceedi
the estimated number by 247.
Extracts fr<m Weekly Retunis of 1S66. Ill
The intense heat of the weather has favoured the development of diarrhoeal
disorders. Diarrhoea was fatal in 150 cases ; and 32 deaths by cholera are
recorded in the week, of which 2 were in the West, 4 in the North, 3 in the
Central, 20 in the East, and 3 in the South districts. About half of the number
are cases of death by choleraic diarrhoea, or sunmier cholera. The 17 following
are of a severer character : —
L02ax>N CiTT ; North'west.^Jit 27 London-wall, on 12th July, the wife of a blacksmith, aged
40 yean, " cholera (24 hoon)."
Shobeditch ; Hozton New Toum, — At St Lake's workhouse, on 9th July, a japanner, aged
62 years, ** cholera (2 days}."
BBTmiAL Gbken; Green. — At 29 Wellington-place, on 12th July, a porter, aged 37 years,
«* cholera (12 hours)."
In same sub-district, at the workhouse, on 13th July, a bricklayer, aged 42 years, " Asiatic
cholera (30 hours).**
Whitbohapbl; Church, — ^At the London Hospital from Whitechapel, on llth July, a female,
aged 25 years, ** chdeia."
St. Geobob-ik-thb East; St Pond. — At 14 Lower Chapman-street, on 13th July, a railway
porter, aged 30 years, " Asiatic cholera (9 hours)."
Stefket ; Batdiff. — At 10 The Orchard, on 14th July, a ballast-getter, aged 22 years, '* cholera
(14 hours)."
Stspket; lAmehouie. — ^At 72 Lower North-street, on llth and 13th July, the son and wife of
a dodE labourer, aged respectiTely 9 and 46 years, ** cholera Asiatica (9 hours), exhaustion ;"
*< cholera Asiatica (14 hours)."
In same sub-district, at 73 Lower North-street, on I3th J uly, the daughter of a painter, aged
6 years, ** choksa Asiatica (13 hours)."
Mils-end OldTowv; Ecuiem, — At 1 Washington-street, on 14th July, a rope-maker, aged
S7 yean, "eboLen, Asiatica (22 hours)."
POFLAB ; Bow, — ^At 1 Crown-terrace, Bromley, on llth July, a domestic servant (female), aged
50 years, '* cholera Asiatica (12 hours)."
In same sub-district, at 5 Catherine-street, Bromley, on 12th July, the wife of a shipwright, aged
41 years, ** Asiatic cholera (16 hours)."
In same sub-district, at 8 Wellington-street, Bromley, on 12th July, an excavator, aged 56 years,
** Astatic cholera (14 hours)."
In same sub-district, at 1 Halsey-court, Bow, on 13th July, a mariner, aged 63 years, *' choleraic
dianhoea (30 hours)."
Bbbmovdsst ; Si, James, — At 23 Eeeton's-road, on 8th July, a mate in the merchant service,
aged 29 years, ** Asiatic cholera (1 i hours)." The medical attendant states that the man arrived
with a cargo of fruit on the 7th instant from Rotterdam, where cholera has prevailed.
Cambebwxll ; CamherweU,-' Ax 60 Waterloo-street, on 13th July, a carrier, aged 47 years,
cholera (18 hours)."
Immediate measures should be adopted by house-to-house visitation and other-
wise to treat the disease in its earliest • stage of diarrhoea. And the cholera
excretions should be e£fectuallj removed or destroyed.
%ei ending SatUTday^ July 2K
The deaths registered in London during the week were 1798. It was the
twenty-ninth week of the year ; and the average number of deaths for that week
was, with a correction for increase of population, 1370. The deaths in the present
retam exceed bj 428 the estimated number.
While epidemic cholera has been for months prevalent in several cities on the
Continent, and in some cities, such as Amiens, as Dr. Druitt shows, has been
extraordinarily fatal, London has hitherto remained free from its ravages. At
the end of June the temperature was excessively high, and after that date cholera
caaoB were noticed ; their character was not at first grave ; but in the first week
of 3xkj 14 cases, in the second 32 cases of cholera, were registered, half of them
at least cf the epidemic type. In the week that ended on Saturday lost 346 deaths
h
112 Extracts from Weekly Returns of \%69.
from cholera were recorded. This fatal explosion occurred chieflj in the com-
paratively poor districts of the East of London. The mortality by the epidemic
is much greater than it was in the corresponding week of 1 854, but not so great as
it was in the epidemic of 1849.
Of the 346 fatal cases now recorded, 308 occurred in the East districts of the
metropolis. In the sub-district of Bow, the total number of deaths was 77 ; of
these 39 were referred to cholera. In the sub-district of Poplar 93 deaths were
registered, and the deaths from cholera were S2. In the sub-district of Lime-
house, the deaths were 54 ; of these 43 were from cholera. In the Green sub-
district, Bethnal-grecn, 59 deaths occurred ; 30 of these from cholera. In the
sub-district of Mile-end Old Town Eastern, 57 deaths were recorded, 33 from
, cholera. Eleven deaths from cholera were registered in the West districts^ 6 in
the North, and 20 in the South. Only one death from the epidemic occurred in
the Central districts. Former experience should now be turned to account; and
the authorities should be as prompt in defence as the cholera is in attack.
Week ending Saturday ^ July 28.
The deaths registered in London during the week were 2600. It was the
thirtieth week of the year ; and the average number of deaths for that week is,
with a cori'ection for increase of population, 1387. The deaths in the present
return exceed by 1213 the estimated number.
The excess of deaths is caused entirely by cholera and diarrhcsa. 904 deaths
by cholera, 349 by diarrhoea, were registered in the week, making in the aggregate
1253 deaths. The deaths by cholera in the last five weeks have been 6, 14,. 32,
346, and 904 ; by its allied disease diarrhcca 67, 102, 150, 221, and 249. The
epidemic takes the form of diarrhoea chiefly in young children ; thus 309 of the
349 deaths from diarrhoea last week were children under 5 years of age, inclnding
244 infants. Of cholera 179 children of the same age died ; 160 boys and girls
of o and under 20 years of age ; 455 men and women in the prime of life ; and
110 people of ages above 60,
[/See antCy pp. 88, 89, for the remainder of this Week's Report, "]
Extracts from iVckhj Returns 0/I8G6.
Popui^iroa and Watkr Slpplt of SoB-Disinicra, also Diiatus from Ciioleiu,
Three Wcks ending '>viU Julj 1866.
113
D cocli of the
114 Extracts from Weekly Returns of 1866.
Week ending Saturday, Augnst 4.
The deaths registered in London during the week were 2661. It was the
thirty-first week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1395. The deaths in the present
return exceed the estimated number by 1266.
There is a slight increase in the high rate of mortality that ruled in the previous
week. 1053 persons died of cholera, 354 of diarrhoea, making 1407 deaths from
both forms of disease.
The deaths returned in the four last weeks from cholera were 32, 846, 904, and
1053 ; from diarrhoea 150, 221, 347, 354. The deaths from cholera exceed by 149
the deaths in the previous week ; the excess in the total deaths is only 61.
Of cholera and diarrhoea 573 children under 5 years of age, 114 boys and girls of
the age of 5-10 ; 79 of the age 10-20 ; 255 men and women of the age 20-40 ; 248
of the age 40-60 ; 127 of the age 60-80 ; and 1 1 old people of 80 and upwards.
Deaths from diarrhoea or cholera in small numbers occurred all over the London
districts ; in Kensington, Marylebone, Pancras, Islington, Holborn, the numbers
were considerable. In the West districts of London 12 persons died of cholera ;
in the North districts 46 (including 19 in Islington, 20 in Hackney) ; in the Central
districts 31, including 12 in StBotolph ; in the South districts 47, including 21 in
Deptford and Greenwich ; while in the East districts 916 persons died of unequi-
vocal cholera. Only 16 of the deaths from cholera occurred in one of the largest
of the East districts, Shoreditch. The violence of the attack is stiU expended on
Bethnal-grceu, Whitechapel, St Greorge-in-the-East, Stepney, Mile-end Old Town,
and Poplar, including Bow. There is some subsidence in Poplar and Stepnej,
but increased virulence in Bethnal-green and Whitechapel. The attack has been
circumscribed by nearly the same lines for three weeks in succession. This is no
accident ; the phenomena are due to some specific cause.
These violent outbreaks are almost invariably in England the result of con«
tamination of the waters ; and the question is subsequently noticed. Upon the
assumption that the waters were at some time impure, there is this further aggrava-
tion that in the lower districts the water is not carried away. ''It is unfortunately,"
says Mr. Bazalgette, '' the locality where our main drainage works are not complete."
A temporary pumping station is to be erected forthwith, and will be in operation in
about three weeks at Abbey Mills.
The East London waters have been analyzed by Professor Frankland, whose
report is reassuring ; and Mr. Greaves, the engineer, is fully alivo to the extreme
importance of pure water at the present moment. The waters of shallow weUs
and pumps are polluted ; and in this crisis the health of London is very much in
the hands of our hydraulic engineers.
The local autliorities, who had not instituted generally house-to-houae viaitation,
are now on the alert. The sympathy of the whole nation with the aofienera has
been touchingly expressed by Her Majesty, and has been proclaimed by the Prime
Minister. Under these auspices, and with the intelligent exertions of the people
themselves, we may hope ere long to see the destructive progress of the plague
stayed.
The Water Svpply of the East Districts, — The cause of the epidemic of cholera
consists, as is well known now, of a zymotic matter in various degrees of activitj
all over the London area ; afTccting the people in various ways, throogli air,
contact, and water. Hitlierto, in all great outbreaks here, the cAo/rine, which
this stuff may bo called, has been distributed chiefly through water, as was shown
in the Registrar General's reports on the i^revious epidemics.
When it was observed, therefore, that the present fatal explosion of cholera fell
on the Enst districts in the first week, suspicion was aroused ; and that was
strengthened by the observations of the week ending July 28th, and by personal
inspection, which showed that the attacks were difi^used over a wide areSj, among
many people in bad hygienic conditions, and also among many in or"* »— -—
Extracts from Weekly Returns of\%Q6. 115
often well to do, living in streets by no means so poor or so dirty as the streets of
the soath and of other regions of London. The population was principally in the
port of London, but not exclusively ; and little more exposed to infection than
the districts along the south side of the Thames, which had formerly been
decimated by cholera, when the water supply on that side was polluted. The air
of East London is often charged with impurities, which are undoubtedly noxious ;
and so are other parts ; but any impurity of the air is rapidly diffused all over
London.
Nearly all of the infected districts are supplied by one water company, which now
derives its water, not as was stated last week at Lea Bridge where its filtering
beds lie, but about 2| miles higher up the river, and above Tottenham ; as far as
Enfield the river is protected from sewage by an intercepting drain ; but it receives
the drainage of all the country and towns in its basin.*
The New River takes a large portion of its supply higher up the Lea ; and
engages to deodorize the sewage of Hertford before it is discharged into the
water. There is no such protection against the sewage of Ware. Upon the
whole, the upper waters of the tributary Lea are not worse than the waters of the
Thames, which are exposed to similar contaminations ; and the filtering arrange-
ments of the East London Company arc elaborate, and probably as effective as those
of the Thames companies. The 13 fiitet beds at Lea Bridge cover an area of 12
acres. A part of the water is distributed from the well of those beds by the
most powerful engine of the company ; the rest of the filtered w ater is carried
three miles down to a covered reservoir of about 2^ acres at Old Ford, where it is
distributed over the area now suffering so much from cholera. The water in this
reservoir looks perfectly pure. Close by its side, which is well buUt, flows the tidal
end o£ the Lea^ black and full of the foulest impurities.
The company in its first years drew its waters mainly from the Lea at this point,
and the first improvement was effected by carrying its intake up the river to Lea
bridge beyond Uie tidal range. The water was brought down an open canal by the
side of Hackney cut, and terminated in two large reservoirs on the other side of
the black Lea. This canal and these reservoirs of about nine acres still exist ;
they are marked in the most recent map by Stanford as the '* East London Water*
works canal," and the "East London Waterworks reservoirs." One of these
reservoirs was recently emptied, and was filled again perhaps by springs or soakage.
These old reservoirs are not, it is said, used, the covered reservoirs containing the
only water fit for use ; but the old reservoirs retain their old channels of communi-
cation with the pumping wells, and the company has the power in an emergency
to distribute the water from the old reservoirs all over the region of the cholera
field. But this the company professes not to do, — and it could scarcely be the result
of accident, otherwise the diffusion of the waters of the old reservoirs over the
area would afford a probable explanation of the sudden outbreak in East London.
It is a notable circumstance that the parts north of Victoria park, supplied
hy the East London company direct from their filter beds, have not hitherto suffered
from cholera, notwithstanding contiguity to the infected districts, more than other
districts supplied by other companies. This implies that the East London water as
it leaves the filter beds is as good as any other water in London.
It is natural, as land is valuable in East Loudon, to inquire why a commercial
company has for many years retained some miles of a canal and nine acres of reservoirs
for no purpose ? Mr. Greaves replies that the canal serves to caiTy off the waste
of the filter beds, and that the company proposes to convert one of the old ponds
into a covered reservoir. When this is done, and the other pond, which, we are
told, is of no use, is filled up, or has no longer any connection with the pumping
welLs of the company, the public may well rest satisfied, until some great general
reform is effected in the water supply of London. In the interests of the public
health the country has a right to demand this security.
* Mr. J.K. Baddifie has remarked that the Cobbin, which flows into the Lea through Walthaxn Abbey,
dniiis %piiig, whfife the late small outbreak of cholera was observed. That stream is said to be dry.
116
Extracts from Weekly Returns of 1866.
The following are Extracts* from Letters Trhich have been received from
Professor Frankland, F.R.S. : —
'^ I have soeu au abstract of the Registrar General's Betum. The mortalitj is
frightful. I write to suggest the addition of permanganate of potash to the water
in the Company's reservoirs. The amount required would be 80 lbs. of perman-
ganate to eveiy 1,000,000 (million) gallons of the water. The permanganate
should bo dissolved in a few hundred gallons of the water, and then run into the
reservoirs with the rest of the water in such a manner as to get a thorough,
admixture. If the water retains a pink hue so much the better ; it will lose It
before it reaches the consumer; in fact the permanganate ought to be added until
a pink tint lasting half an hour is obtained in the reservoir. The quantity mav
appear large, but it is of no use to employ a smaller amount. It should be applied,
if possible, q/l^^/^a^to7i, and immediately before transmission to the consumer.
Mr. Coudy, near Battersea, manufactures this material largely, but I do not know
if he could meet so large a demand.
'^ The expense of the permanganate at a shilling per lb. will be considerable ;
but what is such an expense in the face of this mortality ? It will cost much
less than the disinfection of the London sewage, which was contemplated some time
ago. Of course the effect of the permanganate is not a matter of oertiunty, but it
is the only thing, capable in this emergency of such application, that I should have
any faith in. It is quite innocuous, and could therefore do no hann. It is much
better than boiling the water, even if that were possible, for water containing a
slight leakage from a watercloset is not deprived of its noxious qualities by being
boiled for a short time.
'^ When I state that permanganate is the only purifier in which I should have
faith, I have regard of course to what is practicable in the present emergency, for,
if its use were practicable, I should prefer filtration through animal charcoal, which,
as you will see from my three recent reports, removes practically all organic matter.
1^ tons of animal chai'coal would be required for each 1,000,000 gallons sent out
daily. The animal charcoal should be in grains about the size of blasting powder,
and the filtered water would simply have to pass through the mass of this charcoal
contained in a suitable tank. The London Water Purifying Company between the
entrances to King's College and Somerset House use this material, and it is through
one of their filters that the New River water passes for my monthly detei*minations.
I think, after all, that such a mode of purifying the whole of a company's water
is by no means an insuperable undertaking. The charcoal will continue to act for
six months at least. It is the charcoal used by sugar refiners, and care should be
taken that it is fresh, and has not been already used."
Royal College of Chemistry^
Sir, August 4M, 1866.
In compliance with your request I have made a special analysis of the watei
supplied by the East London Company, and collected on the 1st instant. The fol-
lowing aie the results, together with those yielded by the water supplied by the
same Company on the 1st of July, and on the average of a whole year.
Eant London Company's Water, collected
l8tAujmatl8d6
iast London Company's Water, collected
Ist July 1866 . . . .
East London Company's Water (avenure
of one year) ... ^ -^
Solid Matter
in 100,000
parts.
Organic and
other volatile
Matter in
100,000 parts.
26*14
24*38
27*98
V4A
1*94
1*02
Oimren
required to
oxidise the
organic Matt«r.
Deiiree
of HardneM.
•0323
*0344
-0904
9
17-7
16'0
il'U
«« *r . °^0"»t 01 organic matter contained in this water which is of especial
^portanco m conne ction with the outbreak of cholera in the district suppUedby
* Thew «xtnict8 were immediately forwarded to Mr. QreaTes.
Extracts from Weekly Returns </ 1866. 117
ibis compaoj. The above results show that, in this respect, the water supplied on
the 1st of August is considerably better than that supplied on the 1st of July, when
the amount of this ingredient was markedly above the average. Chemical analysis,
therefore, although it shows a larger quantity of organic matter than ought to be
contained in vrater used for drinking purposes, does not reveal any exceptional
degree of pollution in this water. It must be borne in mind, however, that
chemical investigation is utterly unable to detect the presence of choleraic poison
amongst the organic impurities of water, and there can be no doubt that this poison
may be present in quantity fatal to the consumer, though far too minute to be
detected by the most delicate chemical research.
It is thus that the occurrence of cases of cholera, or of choleraic diarrhoea,
upon the banks of any of the streams, firom which the water supply of London is
so largely derived, may at any moment diffuse this poison over large areas of the
metropoIiB. For the prevention of such a catastrophe there is a method which
deserves considerable confidence. In my last three monthly reports to you on the
metropolitan waters, I have shown that filtration through animal charcoal (bone-
black) removes, practically, the whole of the organic matter from the New River
water ; and in numerous other experiments, I have ascertained that this process is
equally efficient even when applied to the foul waters of ponds and ditches. I
have also proved that its action continues unimpaired for three months, and will
probably last for a year, even when very large volumes of water are passed through
it. Animal charcoal alone has this power ; vegetable charcoal being perfectly
inert^
I would, therefore, most earnestly recommend, that during the prevalence of
cholera, the whole of the water supplied to the metropolis should be passed through
animal charcoal immediately before transmission to consumers from the reservoirs
of the respective companies. For this purpose 300 tons of bone-black in the
condition in which it is used by sugar refiners would be required to purify the
total supply of the metropolis, as I find that water passed at the rate of 1,000,000
gallons in 24 hours through 3 tons of bone-black is completely purified. This
operation, even when performed upon the water supply of London (100,000,000
gallons daily), would be neither formidable nor expensive. Three or four days
would suffice to fix the necessaiy filtering boxes, whilst the animal charcoal, being
an article which is now manufactured on a very large scale, can be had on the
shortest notice* It is scarcely necessary to add, that the water should be passed
through the animal charcoal after it has undergone the usual process of filtration.
I have, &c.
£. Frakkland.
In reply to an inquiry Mr. Bazalgette has favoured the Registi*ar General with a
short account of the drainage of the cliolera district.
" It is unfortunately just the locality where our main drainage works are not
complete. The low-level sewer is constructed tlirough the locality, but the pumping
station at Abbey Mills will not be completed until next siumner ; therefore the
drainage of the district does not yet flow into the low-level sewer. We are
deodorizing the sewers and gullies freely with chloride of lime, and to-morrow I
shall recommend the Board to erect a temporary pmnping station at Abbey MiUs
to lift the sewage of this district into the Northern Outfall Sewer. This can be
accomplished in about three weeks time.
" Yours faithfully,
" J. W. Bazalgette."
tek ending Saturday^ August 11.
The deaths registered in London during the week were 2299. It was the
thirty-second week of the year ; and the average number of deaths for that week
ifl^ with a correction for increase of population, 1366. The deaths in the present
return exceed the estimated number by 933.
118 ExtracUfrom Weekly Returns of 1866.
The weekly deaths arc decliniog. 2299 deaths were roistered last week ; 2661
in the week preceding. The deaths are less by 52 daily than they were in the
previous week ; and the whole of the decrement is accounted for by the fall of the
deaths by cholera and diarrhoea from 1407 to 1045.
Of cholera 781, of diarrhoea 264 persons died last week ; of both forms of disease
1045 ; which is less than the numbers in the previous week by 362, thus distri-
buted in respect of ages : under 20 the decrease of children's deaths is 228, at
20-40 the decrease is 80, at 40-60 it is 42, at 60-80 it is 16 ; of old people of 80
and upwards the deaths have increased by 4.
The decrease in the mortality of children is gratifying evidence of the good
effects of increased care for their lives.
As the East districts were devastated to the greatest extent, thsy last week
experienced the greatest relief ; the deaths in them from the epidemic, including
diarrhoea and cholera, fell from 1041 to 774, and the decline is observable in each
of the districts.
10,898 persons have died in London during the last five weeks ; a number ex-
ceeding the corrected average by 4213. Within the five weeks 31 16 persons died of
cholera, 1338 of diarrhoea. The mortality in the West districts was at the annual
rate of 24, in the East districts at the rate of 82 per 1000 inhabitants. In the
West districts 225, in the East districts 3182 persons died of cholera and diarrhoea ;
the estimated population being respectively 511,258 and 607,945.
To facilitate the inquiry into the causes, and to supply information to those
who are engaged in combating the epidemic, the particulars of every death in
London are now published daily; records of all the deaths for instance roistered
on Monday in the districts of London from Fulham to Woolwich can be procured
on Tuesday evening, by scientific men, at the Queen's printers.
The deaths registered from cholera in the East districts during the seven days
of the week wore 223 on Sunday and Monday, 114 on Tuesday; 90, 98, 71, and
78 on the four following days : in all London on the same days 249, 130, 109, 114,
85, 94.
No greater mistake could be made than to relax the efforts for combating the
disease, or for relieving the distress which it has already wrought.
Tlie Water companies, Professor Frankland has suggested, should filter their
supplies through animal charcoal ; and the suggestion is well worthy of the con-
sideration of their engineers at this time, when the waters of no shallow wells
can be used without risk. In epidemic districts the water butts should be emptied,
disinfected, and refilled.
fVeck ending Saturday^ August 18.
The deaths registered in London during the week were 1799. It was the
thirty-third week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1332. The deaths in the present
return exceed the estimated number by 467.
The deaths are less by 500 than the numbers recorded in the previous week.
The deaths by cholera have fallen from 1053 and 781 in the two previous weeks
to 455. The decrease of deaths by the two forms of cholera and diarrhoea is
absolutely greatest in childhood, but relatively greatest in manhood. Thus the
deaths under the age of 20 have fallen in the we«k from 538 to 373, at the age of
20-40 from 175 to 121, at 40 and upwards from 332 to 155. Thus this epidemic
explosion which has slain in a few weeks so many people in the East, and has
threatened the whole population of London, is subsiding. It has been felt in every
district, but its great ravages have not yet extended beyond the original limits.
Mortality of the several London Districts from Cholera.
We may now venture to look back, and draw some deductions from the facts as
they are recorded in the Tables for the five weeks ending August Uth, during
which 4454 men, women, and children died of cholera and diarrhoea.
Extracts from Weekly Returns of 1866 119
The mortality in the five weeks has been at the rate of 37 per 1000 living
annuailj; but in both the South and the West districts, covered by 1,400,000
people, the mortality has scarcely exceeded the average by 1 per 1000. The annual
rate of mortality by cholera was 1 in Kensington and Paddington, 0*3 in Chelsea,
0*4 in St, Greorge Hanover-square, 1 in Westminster, 0*5 in St. Martin-in-the-
Fields, 1*5 in St. James Westminster. The mortality from cholera and diarrhoea
was highest in Kensington (6) and lowest (2) in St. James Westminster, the scene
formerly of the Broad-street pump mortality. The west districts are supplied
chiefly by the Thames water companies, the New River supplying portions of
St. James Westminster and St. Martin's.
The mortality in the Southern Districts by cholera was 3 in 1000 in St. Saviour
Southwark, 2 in St. Olave, 2 in Bermondsey, 2 in St. George Southwark, 0*3 in
NewingtoD, 1 in Lambeth 2 in Wandsworth, 3 in Camberwell, 3 in Rotherhitho,
3 in Greenwich where Mr. Glaishcr has observed the famous "blue mist," and 0*2
in Lewisham. The mortality by cholera and diarrhoea was highest in St. Saviour
Southwark (8)9 and lowest in Lewisham (1). These southern districts are gene-
rally poor ; they lie low ; and they were decimated by cholera in the epidemics of
1849 and 1864, wherever the impure water of the tidal Thames was distributed.
Their water is now drawn above Teddington Tx>ck from the Thames.
The fife north districts fared nearly as the Central Districts; the mortality by
cholera was 0*6 in Marylebone, 0*4 in Hampstead, 1 '2 in Pancras, 1 '9 in Islington,
and 4 • 9 in Hackney ; the mortality by cholera and diarrhoea was lowest in Hamp'
stead (3) and highest in Hackney (8). These districts are chiefly supplied by the
New River, one of the Thames companies, and a portion of Hackney, it is believed,
from the Lea Bridge reservoir of the East London Company.
The dense Central Districts are, some of them, such as St. Luke's, remarkable
for poverty, others, such as the City of London within the walls, for their wealth.
The mortahty by cholera was at the rate of 1 per 1000 in St. Giles, 2 in the
Strand, in Holbom (which appears to return all its cases as diarrhoea), 1 in
Clerkenwell, 1 in St. Luke, 7 in East London, 7 in West London, and 2 in the City
district ; from cholera and diarrhoea the mortality was hif^hest in the City without
the walls, 10 ; and St. Giles, 9 ; lowest in the City within the walls, 3. The whole
of the central districts are supplied by the New River, which draws part of its
supply from the Lea river and part from springs. The East London Company
enters the City sub-district in St. Botolph, where a few deaths from cholera have
been registered.
There are seven districts in the east ; the mortality by cholera in the poor
district of Shoreditch was at the annual rate of 4, by cholera and diarrhoea 8 in
1000 : five of its sub-districts are supplied by the New River, one partially, and
one wholly by the East London probably from Lea Bridge. Li the rest of the east
districts the mortality by cholera was at very different rates ; it was at the rate
of 89 per 1000 in Bethnal-green, 50 in Mile-end Old Town, 60 in St. George-in-
the-East^ 70 in Whitechapel, including deaths in the London Hospital from other
eastern districts, 70 in Poplar and Bow, and 80 in Stepney. Bethnal-green is
one of the poorest districts of London, if we may judge by the annual value of the
houses ; but the people of Bow and Poplar are not conspicuous for poverty. The
. whole of these districts where the mortality from cholera was from thirty to forty-
fold hieber than it was either in the west or the central, in the north or the
south of London, were supplied with water from the Old Ford reservoirs. London
is divided into thirty-seven districts ; six districts are supplied from Old Ford, and
every one has been ravaged by the epidemic ; the other thirty-one districts have for
six weeks in succession sufiered slightly. The 37 districts are sub-divided into
\Z5 sub-districts ; 21 are supplied with the same water, and have all suffered six
weeks in succession; Ho sub-districts have sufiered inconsiderably, except in
St. Botolph and a few other districts, where the same water has crept in, and the
mortality is partially swollen.
By the doctrines of chances, it is impossible that the coincidence between this
particiihr water and the high mortality should be fortuitous, in 135 cases, during
six weeks in succession.
120 Extracts from Weekly Returns of \%66,
The induction extends over all the area of observation in previous epidemics,
where sewage water has so often led to cholera outbreaks.
The persistence of the epidemic in the east London districts is no proof that
the supply of the company is now worse than that of other companies, as its effects
on the place, and on the population only subside slowly.
This great lesson should be taken to heart by every water company and every
community in the kingdom. Unclean water cannot be consumed with impunity ; its
consumption is the sin of which cholera is the punishment.
Week ending Saturday^ August 25.
The deaths registered in London during the week were 1477. It was the
thirty-fourth week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1304. The deaths in the present
return exceed the estimated number by 173.
The mortality from cholera and diarrhoea is declining. 265 deaths from cholera
and 129 from diarrhoea were registered last week. In the five preceding weeks
the deaths from cholera were 346, 904, 1053, 781, 455 ; the deaths from marrhcea
in the same periods were 221, 349, 354, 264, 194. Of the deaths roistered last
week from cholera and diarrhoea, 198 persons died from cholera and 41 firom
diarrhoea in the East districts, 3 from cholera and 15 from diarrhoea in the West,
12 from cholera and 21 from diarrhoea in the North, 13 from cholera and 13 from
diarrhoea in the Central, 39 from cholera and 39 from diarrhoea in the South
districts.
One hundred and fifteen young persons under 20 years of age died from cholera,
and llo from dinrrha?a ; at the fxge of 20 and upwards, 150 deaths occurred from
choleni and 14 from diarrhoea.
Week ending Saturday, Sejttember 1.
The deaths registered in London during the week were 1413. It was the
thirty-fifth week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1259. The deaths in the present
return exceed the estimated number by 154. The excess is accounted for by 198
deaths from cholera.
The deaths from cholera during each of the last five weeks have been 1053, 781,
455, 265, and 198 ; from cholera and diaiThoca 1407, 1045, 649, 394, and 326.
The deaths from cholera and diarrhoea in ten weeks have been 6012.
Of the 198 deaths from cholera, 6 occurred in the West districts, 15 in the
North districts, 9 in the Central districts, 122 in the East districts, and 46 in the
South districts. While in the East districts cholera lias declined i-apidly, it is
nearly stationary in the Southern districts, the deaths happening chiefly by the
river at Deptford and Woolwich ; where it is to be feared the authorities and the
people are negligent. The pumps demand attention. Due care is not taken to
prevent the difiusiou of the cholera matter. Dr. Greenhill gives* a remarkable
instance of mortality due apparently to the introduction of a dirty cholera
bed, thus enforcing the importance of the precept : burn all the dirty beading aad
linen of cholera patients. Undoubtedly much credit is due to the people for their
exertions in suppressing cholera; but with steadier efforts on their part, and on the
part of the water companies, the disease will die out more rapidly.
Cholera and the London Water Companies.
London is divided into fields among the water companies ; the Chelsea oonipany,
the Grand Junction, and the West Middlesex have the west districts, the South-
wark, the Lambeth, and the Kent companies have the south districts^ for their
respective domains ; out of 10,000 inhabitants in each of these fields six deatiis
* See page 130.
Extracts fi'om Weekly Returns of 1866. 121
occurred in seven weeks from cholera and diarrhoea, and the proportion in all the
other fields except one is nearly the same.
The New River company supplies nine north and central districts from the
river Lea^ and from springs ; the deaths by cholera and diarrhoea out of 10,000
inhabitants in these districts were nearly 8.
The East London company supplies six districts with the waters of the Lea^ and
the deaths out of every 10,000 inhabitants were 79 ; or, without calculation, the
deaths were 415 out of 536,676 inhabitants supplied by the New River ; the deaths
were 3721 out of 471,109 inhabitants supplied by the East London company. The
two companies are neighbours, and take their waters from the same Lea river.
Hackney, Shoreditch, and the East London Union are jointly supplied by the two
companies ; the deaths by cholera and diarrhoea were 10 in 10,000 inhabitants. But
the East London company sends water to these districts chiefly from Lea Bridge ;
and, strange to say, only its waters from the Old Ford reservoirs two miles down,
have gone to the fatal districts. Every district to which these waters have ^one
has suffered in an extraordinary degree ; the other districts have not suffered to a
tentb of the extent.
It is of such vital importance to determine accurately the exact operation of the
water in causing so many deaths, that Professor Frankland has been requested to
make a careful analysis of the East London water in the various reservoirs. This
he has done, and briefly described the works in a very able paper. {See next page,)
Underground hydraulic works cannot be easily inspected, and still less easily
described ; much less can their operations, and the flow of their waters in past
months, be now learnt. Mr. Greaves alone can write the history of these eventful
weeks.
But nearly all that is really essential can be learnt from the papers in tho
appendix. The Lea is formed by the confluence of five or six streams in Hertford*
shire ; divides Middlesex from Essex ; and empties its residual waters into the
Thames at Bow Creek. At Lea Bridge tho East London company has its 13 filter
beds in two groups, one on each side of the Lea ; they are fed by an open aqueduct
which carries down the water two or three miles after it has passed through
subsidence beds. Li ordinary circumstances a part of this filtered water is dis-
tributed directly from Lea Bridge over " Tottenham, Hackney, Shoreditch, Hagger-
stone, during the day, and the whole of tho company's district during the night ;"
here cholera^ in the parts north of Victoria Park, was not fatal, The rest of the
water is conveyed down two miles or more of a largo iron main to Old Ford,
where it is lodged in a small covered underground reservoir, for distribution by
three powerful pumping engines : the pipes of Old Ford inosculating freely with
those oi Lea Bridge, the water system in the pipes sways backwards and forwards
at their juncture according as the waters above or below prevail.
"What resource has the engineer if the filter beds in July refuse to act, or if, as
lately happened to the New River, a main bursts, or if any accident happens to
the complicated apparatus ? This has to some extent been provided against. The
waters of the aqueduct at Lea Bridge can be passed directly without filtration into
the midn ; and as the waters from the filter beds at Lea Bridge are carried down
the compainr's canal to two large open reservoirs of nine acres at Old Ford, tho
water of these reservoirs can be used, as they can at once be thrown in any
quantities into the pumping wells.
The bottoms of all the Old Ford reservoirs are much below the dirty sewage
waters of the Lea at Trinitr high- water mark ; and Professor Frankland shows the
possibiliW of the accidental contamination of the waters of the covered reservoir.
It is evidently as difficult to obviate this evil as to keep tho upper waters of the
Lea perfectly free from sewage like that which infests tho Thames.
There ia another hypothesis. During certain days of June or July, perhaps in
the absence of the engineer, there was a hitch in the supply ; and the waters of
* 82 per ec&t of their water m 1S65 was drawn from the Lea. (Appendix to First Report of
Commiuton on PollutioQ of Bivers, p. 37.)
122 ExtracUfrom Weekly Beturat of 1866.
the t^o, open, almost stagnant reservoirs, one filled b; soakage in part fnua the
Lea, were mixed with the comparatively purer water ia the maim of the company.
This hypothesis is in accordance with all the known facta, and with the circum*
stance that the cholera began to subside in all his districts immediately after the
engineer's attention had been directed to the dangerous state of the waters. If this
hypothesis ia ngected the Company can exercise no immediate control over its
supply.
The East London Company is in the condition of a grand hotel which has one
small cellar of good wine and two of bad vintages, which, as in the words of its
manager, it never uses, "except in cases of emergency," its cnstomera would be
pleased to learn were suppressed.
The open reservoirs near the Lea in communication with the pumps of supply at
Old Ford n.re a public danger, not only to the population that has been decimated
in the East, but to the population of all Londou, for the diseases the; engeoder
spread like fire. The reservoirs, as well as the canal, should be abolishea, and
the water be stored somewhere else in safety.
LONDON.— Table ihowing the Estihatbd Popclatioh 1866, the Dems p_
7 WeekB ending August asth, and the Number of Deaths in 7 Weeks to lU/)00 Paaioxa
living ; from all clusas, aud IroiD Cholera and Diarhb<ea, in the bkvebaIi Gbol'fb of
DiBTUiCTS supplied chiefly by ditfbbbnt Water Cokpahibs.
COHFAIIIEB rurnialiinB tlia greater Part
of thoWAiEH ScrriT.
Deitds KEi9tor»l in
t)ie7 Weeks tnding
Augiut 2Sth. tMO.
§■■ i ^ i \tj
■i « e i|lS
in
' Itriiig. '^
t J l| J
S i I b'I
plicil li; tils InAHES Wateb
and JnDClirai. West HiOcllq-
(*)Tij Southwark and Lamlwth -
OiSTRicra lupiiliBcl by tho Lea Wa
from UPP" part "f L*«
, ttom CliadncU Sprii
oiii'-r iou«ca . . - . .
g I'') liv East London ftom Old Ford
Kp«'rvoir
S <')l<yNpwBiver, and bj East London
from LcaBrlcJffo ---.--
DiSTBiCTS simiiitod bv the Gbattd Jufc-
rio!r,NE«a 1™— « —
I, DisikiciB Kunplied mainly by the Keut
C'OHP.vNr from arleslan veils, and pai^
, linlly by SounnrABK slid Laubeiii
1) CompHsinK
(') Coiunr
ro doutliwsrk, Ncwln^n,
MaiTleboi
^n,U(iil
HcutinMon, Chelsea. St. George Han
Bt. Saviour, Bt.Obive, Bermondscy, :
.). and Botherhithe.
8t.lInniiMn-tbe.Fi»Idi, a small part of whidi district ia also sapiilied Ilr O
„. _,. .. . „ .. — ,r£fowell,St.Lukp,WeitLondon,andLotidMl'
iM^iraadt-
awCbdm
, , _jmnnBliw St.l
{') Compri9ii« Belhiial Green, WhilochapcC SL. Geontc-m-tiie-EBsl, Stepney, U^le Bnd Ohl Tawi, and
('I Cumprittiifi Harkncy, East London, and Shorp<IilFh.
C) Compriiinit Bt. Jun« Westminster, Hunpstead, and Pancraa.
(IJ Compriting Greenwich and Lcwigbam.
Professor Fbaxklakd's Hefort on East London Coupant's WoRU-
Boyal College of Ch^iitty,
Sir, August 25th, 186&
At your request I have made a careful inspection of the waterworks of the
East Londou company, and, in addition to my usual monthly analyaia of the «*tei
as delivered to consumers, I have collected and analysed various samples takes on
Extracts from Weekly Returns of \%66. 123
the 9tb instant from the company's reservoirs, consumeiV cisterns, and the river
Lea. In this inspection I have been assisted by Mr. Valentin of this college,
whose valuable aid, promptly and willingly given, I have much pleasure in here
acknowledging.
The whole of the company's works at Lea Bridge and at Old Ford were inspected
on two separate days, viz., on the 9th and on the 23d instant, but, as everything
was in the same condition on the two occasions, it will not be necessary to describe
the visits separately. On both occasions Mr. Greaves, the company's engineer,
and Mr. Maine, the manager of the works at Lea Bridge, gave, in the most
courteous manner, every facility for the inspection of the reservoirs, filter beds,
and machinery^ and furnished, frankly and unreservedly, all the information
asked for.
At Lea Bridge I found the water being brought to the company's premises by a
special open canal leaving the river Lea at Tottenham MUls, above the great
sewage contaminations of the river, but below the outfall of the sewage from
Hertford and Ware. I was informed by Mr. Maine that the sewage of the former
tovm is deodorized by lime and then filtered before it fiows into the river, but that
the sewage of Ware enters the Lea without undergoing any purifying process.
The company's premises at Lea Bridge are chiefiy devoted to filtration, but there
is also a magnificent pumping engine which raises and delivers a portion of the day
supply and the whole of the night supply of the East London company. There is
no storage reservoir upon these premises, the whole of the water not raised by the
pumping engine being transmitted as fast as it runs from the filter beds through a
closed conduit down to a covered storage reservoir at Old Ford. There are 13
large tiering reservoirs at the Lea Bridge works. The area which they occupy
is bisected by the river Lea, with which, however, the reservoirs have here no
connexion. The filtering apparatus is of the most approved construction, and the
filtered water is delivered into the so-called Essex and Middlesex Wells situated
respectively on the right and left banks of the river Lea in a condition of trans-
parency leaving nothing to be desired in this respect. In fact, so far as the removal
of mechanically suspended matters from the water is concerned, the result could
not possibly be better.
The upper stratum of fine sand forming the floor of these reservoirs, and through
which the water filtoi's, requires frequent removal and cleansing, so that one or two
of the reservoirs are usuidly empty and undergoing this operation. Mr. Maine
told me that the rapidity of filtration from these reservoirs is very variable, and
that in the month of July in every year a slimy matter very rapidly deposits upon
the sand, blocking up its pores, and stopping the filtration altogether. In the month
of August (according to Mr. Maine's clear and intelligent description) this slimy
matter begins to grow, producing green confervoid fibres such as I saw on the
2Bd instant in the water of the filtering reservoirs, and especially upon the surface
of the sand of one of them which was being cleaned. As soon as the confervoid
growth begins, the filtering power of the reservoirs is entirely restored ; but during
tiie month of July, whilst the slimy matter continues to be deposited, the work of
filtration is always, as Mr. Maine informed me, attended with great difficulties.
There are two provisions at the Lea Bridge works by which water from the
special canal above mentioned can be transmitted without filtration to the storage
reservoirs at Old Ford. One of these is an iron main at the canal head communi-
cating with the main used for transmitting filtered water, and the other an open
conduit or canal, formerly used to convey the whole of the water from Lea Bridge
to Old Ford. From the condition of the sluice closing the iron main, I am con-
vinced that no unfiltered water has been transmitted through that main for some
xnonths past. On the other hand, unfiltered water is frequently transmitted to Old
Ford through the open conduit, for into this conduit the water from the filtering
reservoirs is discharged whenever the latter require cleansing. It is scarcely
neceiMMfy to remark &at the water so discharged from the blocked-up filters is far
more impure than the unfiltered water from the special canal, because the lighter
portioos of the suspended matter, from large volumes of water which have passed
124 Extracts from Weekly Returns of \%%Q.
through the filter, arc here concentrated in a comparatively small bulk, and as the
open conduit down to Old Ford has much organic mud and slime in its bed, the
water so transmitted down to Old Ford must be exceedin^^ly impure when it arrives
there. At Old Ford lock there is an overflow pipe which conveys this water into
the river Lea, but there is also at the same place a sluice through which this water
can be admitted into the uncovered reservoirs. From the nature of the mud
deposited in these uncovered reservoirs I am inclined to believe that this water is
sometimes admitted into them. Both Mr. Greaves and Mr. Maine assured me that
no un filtered water is ever now transmitted from Lea Bridge to Old Ford for the
supply of the public.
The Old Ford Works may be described as a storage and pumping Btaiion, no
filtering or purifying operations being here performed. There is a covered reservoir
2^ acres in extent, capable of containing water to the depth of 10 feet 6 inches,
and when full the 8ui*face of the water is about 6 feet below the general level of
the ground. Mr. Greaves informed me that, when the reservoir is filled to its
highest point, the surface of the water is at the level of Trinity high-water mark.
From this covered reservoir the water is supplied to the public by three pumping
engines which furnish the greater part of the day supply of the East London
Company. I observed fish of 3 or 4 inches in length swimming about in this
reservoir. As akeady mentioned, there is a direct delivery to the public from Lea
Bridge, which supplies Shoreditcli, Hackney, Haggerstone, and Tottenham during
the day, and the whole of the Company's district during the night ; but, inasmuch
as there is free communication between the branch mains of the Lea Bridge and
Old Ford systems, there is no sharp line of demarcation between the two supplies.
I was informed, however, that, owing to the hydraulic conditions of the two
pumping stations, the above-mentioned districts would be mainly supplied from
Lea Bridge ; the rest of the East London company's district would chiefly receive
its day supply from the Old Ford reservoir ; whilst Stamford Hill is always, on
account of its elevation, specially supplied from Old Ferd.
Along one side of the covered storage reservoir at the latter station, and within
a few yards of it, runs the navigation branch of the river Lea, the water of .wbidi
stands at about the same level as the water in the reservoir when the latter is com-
pletely filled. Pending the completion of the main drainage works, this branch of
the river receives much of the sewage of the surrounding district, and being nearly
.stagnant is in a most offensive condition ; in fact it is here little better than an
open cesspool. A sample of the river water was taken at this point on the
9th instant ; but the river had been flushed out at low water two days previously,
by which its condition had been gi-eatly improved. The sample analysed, bad as it
is, does not therefore represent the quality of the river water at this point in what
may be called its normal condition of filthiness.
On the opposite bank of the river are the two large uncovered reservoirs of
which mention has already been made. These reservoirs have a considerahle
deposit of mud, which is not, however, putrescent ; one was full and the other
partially empty ; the latter, as I was informed, was being emptied by pamping
into the river Lea. Communication can be established between these reaerycnTB
and the pumping wells supplying the public, but Mr. Greaves assured me that it
was never done, except in case of emergency. It was not done in the event of a
Are, but he wished to retain the power of having recourse to these reservoirs in
case of defective supply from the filtering apparatus at Lea Bridge. These
reservoirs, as I am informed by Mr. Greaves, are excavated in gravel ; they are
consequently doubtless subject to considerable soakage, both from the river Lei>
the surface drainage, and the sewage which here saturates the soil.
The samples of water collected on the 9th instant yielded, on analysis the
following results : —
Extracts from Weekly Retnmt of 1866.
125
FlacoofCoUcctiou.
Solid Matter
in 10(»,000
parts.
Organic and
other volatile
matter
(incrliulod in
previous col.)
Amount of
oxvgen required
for oxidation
of organic
matter.
Appearance of Water.
UncoverDd North Boserroir
Uncorered South Beacn'oir
BiTcr Lea at Old Ford
Main leadinr flnom pumpinfc
engine at Old Ford. Water
supplied to oonnmien.
Bssez Wdl, Lea Bridge
TJuAltered water from special
canal at Lea Briilge.
Main in Stewart's Buildings,
High Street, Bromley,
where cholera IumI caused
great mortalitj.
Cistern at the Police Station,
Poplar.
2^*M
23-60
89-03
23-01
24*85
27-39
2&'9i
6'M
1-07
1*53
3-73
1-U
1-10
1-71
1-M
1-20
•0152
•2792
'0204
•0220
-0104
•02C8
•0256
Slightly turbid and of a
milky appearance.
•
Slightly turbid and milky.
\Qry turbid. Suspended
mutter -36 in 100,000 parts
of the water.
Transparent.
Transparent.
Greenish ; slightly turbid.
Dirty, depositing more sedi-
ment tlian the sample of
unfiltercd ^-ater from the
canal at Lea Bridge.
Transparent.
A comparison of the results yielded by the water from the canal at Lea Bridge
with those obtained with the same water taken from the Essex well, after filtration,
.shows the important extent to which the water is purified by passage through the
filtering reservoirs. The substitution of unfiltered for filtered water would at once
increase the organic matter supplied to consumers to the extent of 43 per cent.
With the exception of the dirty sample drawn from the company's main at
Stewart's Buildings, and which contained the same amount of organic impurity as
the water of the uncovered south reservoir at Old Ford, none of the samples of
water upon the company's premises exhibit, in comparison with the Thames water
supplied to the MetropoliiSi any excessive amount of impurity ; but, as I have
already pointed out in a previous report, chemical analysis, like every other mode
of investigation, is .powerless to detect the presence of matter like the choleraic
poison amongst the organic impurities of water, for this poison may be present in
quantity fatal to the consumer though far too minute to be detected by the most
delicate chemical research. Further, when water has once become polluted by
such matters, we possess no certain means, of a practical character, for destroying
or rendering innocuous the poisonous matter. I have conclusive evidence that
even boiling, which is generally regarded as the most efiicacious means, will not
prevent water -which is so contaminated from producing violent cramp and
diarrhcca.* The use of permanganate of potash or of animal charcoal, in the
manner I have already recommended, is the only practicable means in which I
should have inuch confidence for the removal of such noxious matters from water.
This impossibility of proving either the presence or absence of choleraic and
other allied poisons in water, and the uncertainty of all processes for their removal,
renders it the more important to guard with the most scrupulous care against the
possibility of inch contamination. It is precisely at this point that the otherwise
excellent arrangements of the East London company appear to me to exhibit some
grave defects. I do not specially allude to the admission of the sewage of Hertford
and WaiB to the river Lea at a point above that whence the water supply is drawn,
because this defect, though a serious one, is common to the Lea water and to the
sappiies drawn from the Thames ; it is, in fact, an evil which cannot be avoided so
long as we are content to obtain from rivers the water which we use for domestic
purposefl ; but my remark applies to the retention of the means of supplying un->
^ This jhfit is not incompatible with the theory that choleraic and similar poisons are the germs of
uirgammm, Ibrit is weH known that certain organic germs can develop into life after being boiled in
water ibr a dunt tiniA.
126 EziracUfrom Weekly Returns of 1866.
filtered and impure water at Old Ford station, and especiallj to the poeition of the
covered storage reservoir at the same station from wluch the chief part of the daily
supply is now drawn. I was astonished to find that the water after being carefully
brought down from Tottenham Mills in a special canal, porified by a moat elaborate
and;ef!icient system of filtration at Lea Bridge, and then, to secure it from atmo-
spheric impurities, conveyed in an iron main down to Old Ford, is stored in a
reservoir sunk ^o the depth of some 16 feet beneath the low ground, which is here
only just above the level of spring tides, and that when the reservoir is full the
level of the surface of the water in it only reaches that of Trinity high-water mark.
This reservoir, as I was informed, is excavated in clay, bat the side next to the
navigation branch of the foul river Lea is of gravel. No doubt this is well puddled,
and the brickwork sides executed in the best possible manner, neverthe^s, the
position of this reservoir, with its 2^ acres of fioor 16 feet below the surface of a
badly drained district is fraught with much peril during the prevalence of epidemic
disease. Whatever precautions may have oeen taken, soakage, to some extent^
must take place into such an excavation, and it was stated to mo that when the
reservoir is emptied, such soakage water, though not in large quantity, has to be
removed by pumping.
Such being the conditions of storage, the application of any temporary remedy is
obviously surrounded with formidable difficulties. I satisfied myself that filtration
through coarse animal charcoal could easily be applied, in the Essex and Middlesex
wells at Lea Bridge, to the whole of the water supplied by the company ; but
there would be little use in thus purifying the water at Lea Bridge when it has
afterwards to be stored in the reservoir at Old Ford. It is only by passage through
animal charcoal, as the water leaves this reservoir, that the advantages of tibe
charcoal could be secured. Owing to the construction of the works at Old Ford,
I was unable myself to form an opinion^ as to the possibility of such a filtration
being carried out there at a short notice, Mr. Maine thought it could be accom-
plished without difficulty ; but Mr. Greaves, who is much more likely to know, was
of a totally different opinion, and thought that such a filtration could not be
effectively carried out at Old Ford without the construction of new apparatus,
which would require too much time to render it available during the present
emergency. It is to be hoped, however, that means may be taken without delay,
either to alter the place of storage, or to render practicable filtration through
animal charcoal immediately before the water is supplied to consumers*
I have, &C.
77ie Registrar General. E. FRAKXXAHBi
The following letter is from Mr. Beardmore, C.E., the Engineer of the River
Lea Trust. It is in answer to queries the nature of which will be sufficiently
4;vident : —
30, Great George Street^ JVesimimsier^
Sir, August 6th, 1866.
In reply to the queries accompanying your letter of the 3d instant, I beg
to say, —
1st. "The River Lea Water Act, 1855," defines the quantities of water and
priority of rights. By this Act practically the whole surplus waters of the Les,
excepting a comparatively small quantity for the navigation, was divided between
the New River and East London Water companies, and their power of supply was
generally improved. They can also call on the trustees to execute any ftaiher
works for amelioration on tendering the cost ; the New River company have ex-
ercised this power since last summer.
The companies can each take 23,000,000 gallons per diem, and bejond that
quantity as much additional water as they can, gallon for gallon, under ths
powers and with the proper use of reservoirs, the resources of the Lea are «■■
limited for a liberal and pure supply of the eastern metropolis.
Under the Act of 1855 the trustees and the companies have greatly iwiprofSJ
the depths and character of the water, and have made cuts so as to divide Ao
Extracts from Weekly Returns of 1866. 127
navigation from the river. The reservoirs constructed by the East London Water
company within the past four years are very large and complete, but they have
no connexion with the navigation.
j4s to your 2d question. — The river Lea is divided into two portions, both as to
its purity and its character as a water bearing district. Above the parallel of
Tottenham and Walthamstow the valley is full of springs, and practically no sewage
reaches the river, provided the New River company work their purifying establish-
ment at Hertford efficiently.
Although the New Biver takes a great portion of the Lea above Ware, yet it
is so largely supplemented by boiling springs below Ware as to have greater
volume by the time it arrives at Broxbourne than it had before the New River
share was taken out.
On the whole, although there may be two or three small points worthy of amend-
ment, as to drainage above the reservoirs of the East London Water company
at Walthamstow, I believe that there are few town supplies so pure as that of the
East London company. Above Walthamstow from one third to one fourth of the
river must have boiled out of the earth as pure spring water within 18 miles
distance.
My connexion with waterworks and examination of springs and rivers have been
extensive for 30 years past, and 1 have seen few sources for which I should like to
exchange either the Thames or the Lea. The carbonate of lime renders these
waters somewhat hard, but is a wonderful safeguard against solution of impurity.
Below Tottenham sewage passes into the river in a tangible form, and the
scandalous proceedings of the Tottenham Local Board must be stopped.
It 18 at Old Ford about five miles below Tottenham that the river Lea has become
offensive at times, within the last few years, owing to the increase of buildings and
factories within the Metropolitan area ; it also has the disadvantage of being tidal
below Old Ford, and therefore liable to the inflow of impurity from the Thames,
and from the sewage of Stratford and West Ham, whicli is turned into the Bow
Creek arm of the Lea without doodorization.
The trustees have found great difficulty in dealing with wrongdoers below
Old Ford, for it has been evident that nothing effective could be done until the
low level main drainage passing under the river Lea (near Bow) had come into
operation. Tliis Mr. Bazalgette proposes to efficct by temporarily pumping from
the low level into the high level at Abbey mills, and then into the Thames at
Barking.
The District Boards in the East of London must now improve and alter their
sewers, for the new main drainage will operate as if the entire area had been
suddenly lifted about 20 feet with a distant outfall.
Incidentally I may remark that overcrowding, deficiency of drainage, and
inferior articles of food are more likely to have promoted cholera than impurity or
deficiency of water.
This district is populated by dock labourers, sailors, mechanics in the new
factores, and great numbers of laundresses.
In answer io your M question, — The volume of the Lea during the past six
months has been unusually abundant. We had good floods during the winter,
97hich are beneficial in sweeping off* decayed matter. I have never seen the river
in better condition than during the past four months. The volume flowing down
towards Widthamstow is now more than double that of the corresponding period
of last year, and after the companies have taken all their supplies there is a large
^surplus qaantity still passing down the tidal channels into the Thames.
As to your 4th question. — The number of passages made by barges from Wal-
Aamstow upwards during the past six mouths would be about 2,500 against about
three times that number in the lower portion of the river, chiefly grain, malt,
bricks, frc (manure has been prohibited for 12 months past).
But these barges pass up a canal, and do not enter any water taken by the East
XoDdon imtil five miles above Walthamstow, and then again only for two miles out
of the next six miles.
1
128 Extracts from Weekly Returns of IS66. ,
Nothing more occurs to me for your information, but I will call and penonftlly
tender my assistance, adding mj ov^n impression that if people drank more of the
companies' water iu London they would be the better for it.
I suspect that pumps are still common in the Bow and Poplar district^ because
of the fine vein of water in the sandy strata that overlies the London clay there.
I am, &c.
The Registrar- General Nath. Beabduore.
The following extracts are from the 2d Report of the Lancet Commission on
the Outbreak of Cholera in East London. {Lancet j August 25thy 1866, p. 218) :—
" Passing along the river Lea from Iloddesdon, we come to the important towns
of Ware, about five miles up, and Hertford two miles above this. The sewage of
Hertford flows through the town to a place called the * filtering bed,* in which it
is professed to be deodorised by the New River Company. From this place it runs
in an open cutting about twelve feet wide to discharge itself a little above Ware»
This sewage, when it passes into the river, is highly offensive, and causes much
complaint from the inhabitants of Ware. Tlie olfcnsiveness of the river can bo
appreciated by any one standing on Ware bridge. The sewage of Ware itself ia
conveyed by three sewers te the river near the bridge. Below Ware the Lea
receives the sewage from St. Margaret's and Stanstcad Abbots.
" Below Hertford the river Rib flows into the Lea. This river runs for some
miles through Hertfordshire in a southerly direction to Hertford, receiving in ita
course the river Quin. These streams bring the drainage from Buntingford, and
the main towns and villages in this part of Hertfordshire. Just above Hertford
the Beane and Mimram flow into the Lea. The former flows to the Lea in a
southerly direction ; the latter in a south-easterly direction. The Lea itself rises
in Bedfordshire, Bouth-eost of the Chiltei n hills ; and, passing through Luton, runs
in a south-easterly direction through Hertfordshire till it approaches Hatfield in
this county, when it pursues an easterly course to Hertford. It receives the
drainage of Luton, Wheathampstead (and its paper-mill), and, we believe, Hatfield
in Hertfordshire, and with the Beane and Mimram, that of a number of villages.
The Lea is navigable by means of a system of locks as far up as the Mill-bridge in
the town of Hertford. Barges pass up the Lea and the Stort, carrying manure,
bricks, timber, &c., into Essex and Hertfordshire, returning with malt, oom,
wool, &c."
" At Waltham Abbey, the Cobbin pours into the Lea the sewage of this town and
of Epping, in its most offensive state, but three miles above Ponder's-end ; and then,
when there are added to these sources of pollution of the stream, the mills out of
number along its banks, and the barges passing up and down the navigable river by
a system of locks, which go far to give the character of a canal to the river, and to
cause comparative stagnation of its waters, we have sufficient cause to wonder that
the inhabitants of East London do not generally suffer more in health."
" Cobbin's Brook, which takes its rise in the country about Epping, is in parts
but a narrow stream at present, while in other places it forms half stagnant pools.
It receives tlie drainage of Epping, and about fifty yards from its outlet by an open
ditch, that of tlie town of Waltham Abbey. The ditch from Waltham Abbey, wbich
runs at the back of the church, and at least one house where death has been busy,
is in such a condition as to occasion gi*eat complaint, and to cause it to receive in
the neighbourhood the name of the ' cholera ditch.' In its present state the (^bin
is a very undesirable tributary of the Lea."
'• The mention of Epping in connexion with an investigation of the inflnenoe of
the river Lea upon the present cholera outbreak at once attracts our attention to
the fact of the occurrence of cholera there last autumn. Whether there can bo
traced through the Ix?a and its tributary any connexion between that outbresk and
the present one, we are not now prepared to say ; but we believe that ITicydoB
Bois, where the Groombridges lived, is on the other side of the watershed, and, if
that be the case, its drainage must contribute, not to Cobbin's Brook, but to ihe
Hoding, which empties into the Thames direct."
JExtracts from Weekly Returns of 1866. 129
The following statements from the local papers and from trustworthy witnesses
are not unimportant, as they show that eels have passed through the pipes of the
East London Water Company : —
From the "East End News," August 11th :—
Can an Eel pass through a Filter Bed ?
To the Editor of the " East End News:'
" Sir, — Seeing the paragraph in your last week's impression respecting the purity
of the water supplied us through the East London Waterworks that it is thoroughly
filtered, I beg to contradict that statement, more particularly at this crisis, when
cholera and diarrhoea arc making such fearful ravages through these districts, in
order that some steps may be adopted to guarantee a pure supply.
" Now, the second week in June last our water pipe was stopped up, and, as I am
a plumber, I cut the pipe, and to my astonishment found a de.u> eel nine inches
in length, which must have come through the above works, and which is quite
demonstrative that the water is not filtered ; so if you think this hint will be the
means of the company improving the filtering, you will greatly oblige me by
giving this publicity, as it is acknowledged by all scientific gentlemen as well as
the faculty, that it is essential to have pure water supplied.
« I am, &c.
" Baw'lane^ E. I. Boad, R. Furgusson, Plumber.'^
« Aug. 7th, 1866."
Mrs. Furgusson showed the cut pipe to a gentleman from the General Register
Office, and stated that the eel was putrid.
To the Editor of the " EaH End News,"
'^ Sir,*-Afl small beginnings sometimes lead to great ends, so a little information
may, perhaps, lead to the most beneficial improvements iu the sanitary condition
of some portions at least of this great metropolis ; and I consider it to be the duty
of every individual to furnish the authorities and the public generally with such
information as he may be possessed of, as it appears to me to bo the only means
likely to bring about those changes so essentiiJly necessaiy at any time, but more
particularly so at present, when disease is carrying off so many of our fellow
creatures.
" In your last impression a Mr. Furgusson speaks of an eel having got into the
water pipe that supplied his dwelling. Now, strange as this may appear, I can
bear testimony to a similar fact. A short time since the water supply to my
residence was stopped, from what cause I could not imagine, and was without a
supply five days. At length I took ofi* the tap, and to my astonishment found an
eel fourteen inches in length. It was in a putrid state, and the stench arising from
it was most fearful. Since that time I have lost two of my children, who died of
cholera, and my wife and other members of my family have also been suffering
firom that disease.
" I am, &c.
«• 8, Paradise'eottagesy Gray-street, Alexander Russell."
" 8L Leoncard^s-Toadr
The eel was found at the end of the supply pipe of these cottages. It was
seen by Mrs. Russell, who has just recovered from cholera. The date could not
be fixed, but it was probably some months back.
Extract from a Letter of Dr. Bain, M.D.
•• I found to-day a house. No. 2., Wright's-place, Cotton-street, Poplar, where ^t?e
in fhe family have had cholera, one of whom has died. I saw the mother of the
fiuiulj to-day, now recovered, who told me she had taken an eel from her water-*
butt in June last about 3 inches long, which must have come through the tap.
i 2
130 ExtracUfrom Weekly Rehirnt of I860.
^' I send you a live eel which was taken to-day from a tap by a Mrs. Ames,
Leicester-street, opposite to where you saw a woman dying. This Mrs. Ames had
cholera about three weeks ago, and her brother is ill now with it."
A plumber recollects purchasing, some years ago, an eel taken out in his pre-
sence from the main of the East London Water Company. It weighed about
2 lbs., and was alive.
Extract from the " Medical Times and Gazette," September Ist, 1866, p. 226.
'< On August loth two fire plugs opposite Regent's-place, Commercial-road, were
drawn, and a very considerable quantity of small 'mussel' shells, about the size of
a shilling, were discharged, at least a bushel, according to an eye-witness. This is
one of the things that the East London Water Company will be called upon to
explain. Where did the shells come from ? for it is wholly impossible that they
could have been placed from without about the plugs. No doubt they had
travelled along the supply pipe some distance."
CoMMUNiCATiox of Cholera by Bedding.
Note communicated by Dr. Greenhill, M.D., Hastings : —
'^ A straw bed on which a woman had died of cholera was brought into the back
room of No. 12, James-place, St. Greorge-in-the-East, a small house which had
recently been limcwashcd, and which was certainly by no means one of the worst
in the neighbourhood.
*' The father sickens (I believe) the same night, probably August 2d, and dies
August 7th." ( Weekly Beturn o/ 1866, No. 32, p. 335.)
*< A lodger who nurses him sickens, is taken to the cholera hospital* and
recovers.
^' Probably on August 5th, a little daughter sickens, and dies the next day."
(f^'.i?., p.387.)
" On the same day a second little daughter sickens, lingers for six days, and dies
August 1 2th." ( W, B„ p. 387.)
" Then a little nephew, who^'was staying with the family, sickens, and dies in
three days, August 1 1th." ( W. i?., p. 387.)
" After a few days the daughter of the lodger sickens, and dies in three days,
August 20th." ( W, IL, p. 428.)
" And lastly, another little girl, a friend or relation who lived next door, and
who helped to attend on the last-mentioned girl, sickens, and dies in 12 hours,
on August 1 8th." ( JV. i?., p. 428.)
" The bed was probably not destroyed till August loth or leth."
Week e7idi7ig Saturday^ September 8.
The deaths registered in London during the week were 1335. It was the
thirty-sixth week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1245. The deaths in the present
return exceed the estimated number by 90.
The weekly deaths by cholera have fallen progressively from 1053, 781, 455,
265, and 198 to 157 ; by cholera and diarrhoea from 1407, 1045, 649, 894,
326 to 289. In the East districts the weekly deaths by cholera haye fallen from
916 to 74 ; in the South districts from 47 to 39 ; in the rest of London from 90 to
44. The rate of mortality by cholera and diarrhoea in East London is rather more
than double tlic mortality by those diseases in the whole of the metropolis. Of the
deaths in the South districts an undue proportion is still observed ; last week 7
deaths by cholera, 5 by diarrhoea were registered in Deptford ; 7 by cholera ud
4 by diarrhoea in Woolwich, where the rector states that active precantions art
taken by the Health Committee. The efficiency of the measures in boUi ibm
Extracts from Weekly Returns of 1866. 131
iUstricts on the banks of the Thames should bo closely watched. Last week tlie
deaths by cholera in the Poplar district were 7, in Greenwich Union, including
Deptford and Woolwich, 17*
Professor Frankland has related a remarkable case in which boiling did not
deprive cesspool stuff of its poisonous qualities. The experiment is decisive as far
as it goes ; and shows the importance of the absolute exclusion of sewage from
water for domestic use. Boiling the water is a useful precaution, but Professor
Frankland prefers filtration through animal charcoal, or the use of the per-
manganate of potash.
Sporadic cases of cholera have been observed from the cause to which
Professor Frankland refers ; in the dead of the winter of 1838, between January
7th and February 5th, 55 persons died of cholera in the Coventry House of Industry,
evidently from common polluted water, as cholera was not at the time epidemic.
In the Union Workhouse of Epping cholera suddenly broke out on August 5th,
1854, and by the 14th destroyed 23 lives ; " the well of the workhouse was close
to the main sewer," and to this " dreadful state of drainage " the fatality of
cholera was ti^aced.* In this year epidemic cholera prevailed.
Drainage op East London.
The drainage of a part of the cholera field by the low -level sewer will not be
completed until next summer ; but upon the present emergency, in answer to an
application, Mr. Bazalgette informed the Registrar General that he should recom-
mend the Metropolitan Board to erect " a temporary station at Abbey Mills to lifl
** the sewage of this district into the northern outfall sewer." — [Letter, ante^ p. 117.]
The pumping, it is gratifying to learn, was started on August 24th, as appears
from the annexed letter. It would be an excellent arrangement, if it were prac-
ticable, to pump at least a part of the West Ham sewage into the northern outfall-
sewer, and thus further lessen the quantity of sewage in the Lea River.
Metropolitan Boatd of Works, Engineer*^ Department*
Sir, :Spring Gardens, S\W.y September 7th, 1866.
In compliance with the request made at this office yesterday, I beg to inform
yon that the temporary pumping engines for diverting the discharge of sewage
from the river Lea and Limehouse Cut into the northern outfall sewer, near Abbey
Mills, were started on the 24tb ultimo.
I am, &c.,
The Registrar General. F. W. Maul.
The Begisirar General has received the following letter from Professor
Frankland :
Royal College of Chemistry, Oxford-street^
Sir, September Sth, 1866,
In my report to you upon the water supply of the East London Company,
dated August 25th, I stated that boiling will not prevent water which is contami-
nated with pdsonous excrementitious matter from producing violent cramp and
diarrhoea. The case upon which I founded this opinion is the following : — ^A
gentleman and his wife partook of tea made with well-water which was poured*
boiling firom the tea-kettle into the teapot. Between three and four hours afler
partaking of the tea, and after they had been asleep for some time, they were both
awoke by violent cramps, both in the limbs and body, which were soon followed bjr
excessive diarrhoea. The cramps lasted for several hours, and the diarrhoea until
the foUowing afternoon. Both patients were affected in exactly the same way. ITio
weOrwater was suspected, and the well, which was a very shallow one in slate
^Xetjer of Mr. Windug, clerk to Epping Umon, addressed to the Registrar General November liV J
1865, ne water is now pure.
132 Extracts from Weekly Returns of 1866.
rock, was at onco opened and examined. It was soon found that a pipe fWAa ft
watercloset bad burst, and that some of tbo contents had made their way into the
well ; in fact, some fragments of cxcrementitious matter were found floating on
the surface of the water. The water from this well was never again used, for
the well was filled up, and another excavated at some distance, and the aymptomSy
which were entirely novel to the patients, never again occurred.
The attack took place in a very healthy locality in the country, and at a time
when no epidemic dian'ho&a or cholera prevailed. Were such an experiment tried
now, the result can scarcely be doubted. I am intimately acquainted with the
sufferers, and was at once informed of all the circumstances. The evidence afforded
by this case is exceptionally conclusive, — ^first, because the parties never, under any
circumstances, drank this water except in the form of tea or coffee ; and, secondly,
because they were at the time the only inmates of the house, being without a
servant ; there can, thcrefoi*e, be no doubt about the water having been boiled.
The case excited my special interest on account of the unexpected concludon to
which it leads ; and I mentioned it because it is important, at the present juncture,
that we should not place implicit reliance upon a precautionary measure founded
upon the assumption that the noxious qualities of the organic matters of sewage
are destroyed by boiling.
I have, &c.
The Registrar General. E. FsAiniXAXD.
West Ham.
The registration district of West Ham properly belongs to London, with which it
is intimately associated. Its four sub-districts are Walthamstow,Leyton, Stratford,
and West Ham proper ; at the north-cast angle of London, it lies between £pping
Forest and the Thames, the river Lea and the Roding at Barking, without touching
Barking creek. It has docks as well as manufactures ; and at New Stratford are
the extensive works of the Great Eastern Railway. West Ham has been by error
left out of London ; and in consequence sends down its ample sewage by an inde-
pendent channel across the northern outfall sewer of the Metropolitan Board to an
arm of the river Leo, which Mr. Beardmore, C.E., says, '^ has the disadvantage of
" being tidal below Old Ford, and is therefore liable to the inflow of impurity
*' from the Thames, and from the sewage of Stratford and West Ham, turned
" into the Bow Creek arm of the Lea without deodorization."* By this unhappy
an'angemcnt the tide carries the sewage of West Ham up and down the river Liea,
close to the reservoirs from which Stratford and West Ham proper get water.
The population of West Ham was 59,319 in 1861, and has since increased
rapidly : at the rates of 1851 and 1861 it will be 81,718 in the year 1866.
Waltliarastow to the north is supplied with water from a deep well, from spnqgs,
and in part from the Lea Bridge reservoirs of the East London Waterwo^s
Company ; Leyton is supplied partly in the same manner. The deaths from
cholera in these two sub-districts were only eleven in the eight weeks ending
September Ist.
Far otherwise was it at Stratford and West Ham proper, where the mortality in
tho last week of July was appalling enough ; in one week 45 persons were killed in
Stratford, 76 in West Ham, by cholera alone, exclusive of deaths by diarrluea.
The deaths by cholera to 10,000 living were 78 in Stratford and 49 in West Ham
proper during the eight weeks ending September 1st.
Both Stratford and West Ham are detached from the metropolitan draiosge
system, and have a system of drainage of their own. They are both supplied with
water from the Old Ford reservoirs of tho East London company.
♦ See the iatcrestiug letter of Mr. Bcardmorf, C 02., Eugineer of the IViver Lc« Trust, ajife, p. 1S6.
Extracts from Weekly Eetums of 1866.
133
PoFULATHnr 1851, 1861, and 1866, and Number of Deaths by Cholera in the Eight Weeks
ending September let, 1866, in each of the Sub-districts of West Ham.
BrB-DlSTHICTS.
POPULATIOK.
Deaths
n^ster^
from Cholera
in the
8 Weeks
ending Ist
September.
Number
of Dbaths
in the
8 Weeks to
10,000 Persons
living.
1851
enumerated.
1861
enumerated.
1866
estimated.
West Ham -
Waltfaamstow . - -
LeytoD - - - -
West Ham ...
Stratford ...
34,393
59,319
81,718
367
44*9
7,733
6,108
9,968
10,586
10,594
7,536
25,195
15,994
12,493
8,413
40,957
19,855
11
202
154
13-1
49*3
77-6
Cholera and Diabbhcea in the Superintendent Registrar's District of Edmonton
during the Ten Weeks ending September Ist, 1866.
Note. — The Edmonton District is in the Lea basin immediately aboye the Hackney District.
The Registrar General requested the registrars of the Edmonton Superintendent
Registrar's District to supply him with information as to the number of deaths
from cholera and diarrhoea registered by them during the ten weeks ending
September Ist^ 1866| and to state the source of the water supply.
Homsey. — Cholera, none ; diarrhoea, 7, all children, the oldest 1 year. Tho
whole o^ my district is supplied with water by the New River Company.
Thomas Richabd Gbihes, Registrar*
Tottenham, — Cholera, none ; diarrhoea, 10. Water supply from artesian wells
and the New River Company. There are some houses in parts of the district that
still use what are termed surface wells, or wells supplied from tho first bed of
graveL An order has just been issued that in a portion of the district these wells
should be closed, the water being found to be unfit for dietetic purposes.
September 6th, 1866. Geouge Ross, Registrar.
The following deaths have occurred since the above-named date : A male, aged
38 yearSy cholenuc diarrhoea (14 days) ; and a female, aged 4 years, malignant
cholera (9 hours). The latter case occurred in that part of my district where the
water is considered unfit for use.
Edmonton, — Cholera, 1 ; diarrhoea, 3. The case of cholera was an imported one,
the man being a waiter engaged to attend a cricket match on the Southgate
gronnds ; he arrived from London in the morning, felt unwell, went to a chemist,
took a draughty feeling better returned to tho grounds, drank freely of beer, was
seized again in the evening, and died in 1 8 hours. The principal water supply is
the old pomp system from surface wells ; a few houses obtain a supply by private
ammgement from the New River Company, and a small portion from an artesian
well. There is no public supply of water.
John Judd, Registrar*
i^;n/?^/<iL— Cholera, 1 (this case is said to have been brought from Stratford) ;
diarrhoeay A* The source of water supply for this district is, as to the town of
Enfield and Ponders, from the waterworks of the Board of Health, the other parts
icoia wells on the premises of the occupiers.
John Purdey, Registrar.
Waliham Abbey. — Cholera, none ; diaiThoea, one child died July 26th, aged
13 weeks, debility from birth, diarrhoea^ (5 days). Diarrhoea has been prevalent in
all pwli of the sub-district of Waltham Abbey, but only one death from it. The
water supply is good from the river Lea, and plenty of good springs and fountains ^
in most parte. i
Joshua PEGBmi, Registrar.
l-U
.-^ '•^TB
fiiJf
2f7mi V jiM£.
Vi #^- -r Vii ^r.- ■• *:: ■.
•sr^'-TTj. lmj: it 4xisfic CoKiIus^ one
-: -. T".;c-r ^i?iaTU"- ti Cheahonc : the water
■ir-.;:-L -^ -inn -^nraiE? an the premises
~-~ i r'*=^-n 1^ -a»2 N5ew RItcf Companjr
Zi tiEzr \irffKKy Registrar
giwt ^i/T.-i.;
-Ti:- r-t--/.
••^-iti^.rtfi*-."
. 1.
. »•
-..1
• — .-—
'.--^
•v-
-5 . .•
Jf'Ti t
,q -■»*--. r,*r--t :: ."^■-.••. r inr-ir *aie -•«-« ^r«P5 1.171, Ii was the-
. V -^ r* i:- --..r izi .:- \—rns^ 1.1111 «r :c ftiasfis tor that week
•— - - - ' - -_■•-::.•■ - ■ :i...r. 2. .-_•. ITiii teadis in the presfent
.::;:.-: :::::>■-- 7 .7.1. TTii iiiiii!:»;r Lj exceeded bj tho
-V- r^'*-:- "••.-•: -.-'T:-»»r la^? i-rn-r^- rtHni aoted in eholei-a
■/-- vi-e. r -^:-.-2i:»*r !•-=>• -•: Iti*5 ^iiaa :ia26 persons died
•■-'"- Tr^i r" -i-^i-Tfr. ..- .ST- -iii leiriL* bj the same disease
7:..- '.-■'.' ' "7 : 1. --'-i ji -^ ?-■•:•; u-i -r-r^k :c ^Ik« jame jears fell to-
>r.- r- .••■>! -r- li-i :trra je*r "Lirrmniua ; the deaths 8urun<r
- -Tift
-^ '-f?-t
-Ji-^T-i^ii.::^ iJ. ---iii-a wlia derastation, and
^-.- .- f^:s. i-L i--r ieaili bj cholera in tho
.:' *^;--rj.>^.- ^--r 1: i- i '>!- 1?- iz-i 1 10 persons died in
L» • ■
l-LTT- *l-
- i. '•
• ? oo:arred in the West
1 :1 . l-r-iril =1 '^± Ea*:. And -tS in the South
.•■ :•- 71::: :-:Li-f. ii-: -:=:-=: t-:t-".as>? l« nsquired on the
/• . -...•■;■ '.^\-\-'.r •-. V--^ -li: Tr-:r5-i:::j? h-ive >?e^n taken by the
%.'•■:'.' :-. :.'.: '.'..J .'. iri-^".-r -; rrr::lit::"^- b-' "^"^ ?c«::::r to their execution.
TV': :.:■..■... .r: ..-• .: L :. L;:. i^v* r.;::::::-! the R.ji^trur Ln^neral with some
j;. •..•:.-. i*..-. :.i~!".r -~ fu--.. I ■..■.:: ]ri:t::&l tK-ariuj ; :: T^-iU bv found in subse-
/' ■ -. ^ • • ^ 'v^«^ "^ *. *■» ^ 13 ^
R:?E -vNi> Ds Lixi: vf Choleea is Lospos.
r.;.',!-.."a Li? ''-^rr. vtrv •ir.i<-\\.\j 'iNir'.buie'i over Lvnicn : it has been in every
*:!-•.!'•, "'.•:t it :•? cr.Iv il ile r.-:'.l • :' -r^o wait-r company that the violence of the
4r/'\';::..''. recalV.-d th-? ravac^* cf I>4y acd 1SS4, when nearly the whole of tho
•m>.*t:T '■'■•'». 'jrifilv.rt-L and wh»>n r.vjch of it was drawn from parts of the Thames and
j»' triKaJirif? f»^il!uted with sowag*?-. The cholera matter was in those years
diffu-':'] ovor I»ri'lon in large qaaniiiie*, and the mortality pursued its course only
i}i*t\',t't\ hv troatmoLt cf diarrha'a in the earlv stasre of the malady.
'\\\*: L'trubotli ari'l the South wark companit-.s in 1S49 could not improve their
v/afT -.iip|ij/ ; th«- jrround wa* un^lraiiicd ; the pump? were polluted; and the
t',\».'\' \./.*: )fijr-fK:d it-i Latural course. It iix'st appeared in the autumn of 1848,
h\k\if.\'\*'*\ partially to break nut again in the summer of 1849, when week afler
Yfti'V. it au'Vi more }':itul, until in the firi>t week of September it killed, reckoning
di.'irili'iia, 2,2f/S jieivons. The Lambeth water was drawn in 18o3-4 from a purer
y.'fiir'-t-f uu*\ tlic mortality by cholera wa.s immediately shown to have declined in
lh<; t\'i.'.\i'irU it rup]>iir:d '^ ; but no great change was made in the character of the
vfiiU'.r 'iiiriij;; tho course of the epidemic, which was less fatal, and pursued its
tjtrijfil r/furvo, culminating in September.
Nifiily the r-amo grMioral law of ilevelopment in 1866 wa? observed in the districts
ii\' tli<' •^'iijtli, tlif rcntrr*, the north, and the west of London, with this exception,
tiifit in fifiiif; oC tlir;so (li.-itrictHi dill tlie mortality approach the dimensions of previous
« 'piflfmif''. 'I'iu'To it justified the anticipations that had been indulged. In the
iiiiilft (;(' fiiiM (rahii tho whole of Loudon was startled in the three successive weelcs
tti •Ui\y ]ty .'iUi, fi(H, and 1,0.33 deaths from cholera; and it was found that the
?rfi\l ynUy of dcalliH liapftcned in the houses supplied from the reserroira at
)lil Kind Ix'lon^niif; to one company.
* Hvv Hiijijiluimiut to Weekly Kcturn^ November 1 9th, 1853 ; also Weekly Retotn, Oetohsr lithy
IHftl.
ExtracUfrom Weekly Beturns of 1866. 135
To make this investigation more exact, the deaths happening on each daj in
each of the fields of water supply have been taken out. Three deaths from
cholera happened on Wednesday July 11th, 6 on the 12th, 12, 11, 12 on the three
foUowing days in the districts supplied t>y the East Liondon company, including
West Ham on the east side of the Lea. On Monday and the six days following
the deaths ran up to 31, 64, 59, 83, 91, 104, 104. On July 23d there was again
an increase ; the deaths were 130 on Monday, 144 on Tuesday, 166 on Wednesday,
when there was a slight subsidence ; but on Monday, July 30th, the deaths were
141, on Tuesday 171, and on Wednesday, August 1st, 170.
It appeared then right to coll attention at once to the complete coincidence of
the cholera field with the field of supply of the East London Water Company, in
the hope that the state of its water might be immediately looked to. The weekly
report was published on Wednesday morning, August 1st ; on that day the engineer
of the company called at the General Register Office ; and on the day following
he published a letter in the daily journals showing that he fully appreciated the
importance of the crisis. The supply might have been changed on Wednesday
morning, but on that day no result appears; the deaths were 170; on Thursday
the deaths fell to 155, on Friday to 114, on Saturday to 112, on Sunday to 119, on
Monday, August 6th, to 115, on Monday, August 13 th, to 44, on Monday, August
20th, to 31, on Monday, August 27th, to 21, on Saturday, September 1st, to 8.
This coincidence between the intervention of Mr. Greaves and the decisive
fleclcnsion of the cholera in the week following deserves to be noted. It strengthens
the circumstantial inference that a part of the supply between July 8th and
August Ist was drawn from the uncovered reservoirs ; but the unclean matter
might of course have entered the water through other unknown channels.
'So corresponding rise or fall was observed on the same days in the other fields
of water-supply.
The covered reservoir at Old Ford, said to be 2-| acres* in area, and 10^ feet deep,
will not hold more than about 7,126,100 gallons of water; and the company
supplies 90,174 houses with 20^ million gallons daily. The uncovered reservoirs
it is said cover nine acres ; they are seen from the Great Eastern Railway, but are
not depicted either in Mr. Milne's map, or in that of the Government engineers.
The depth of the uncovered reservoirs is unknown ; but they contain perhaps
. three times as much water as the covered reservoir.
The system of the company consists of the water in the reservoirs, in the mains,
in the multitudinous pipes, and in the butts of the consumers' houses ; through
these channels the matter must have been distributed irregularly ; and it will bo
shown subsequently how slowly any zymotic matter once introduced is eliminated
from the water or from the population. (See problem, p. 136.)
The only sure method is to let all the water run ofi* simultaneously, and to let
the fresh supply be scrupulously pure. This, with complete drainage, gets rid of
the zymotic stuff most expeditiously.
Now the epidemic has partly subsided in the East, and the company's water,
as far as we can judge of its eficcts, is returning to the normal state, it is
desirable that Mr. Greaves, who is deservedly held to be one of the best practical
hydraulic engineers of the day, and whose truthfulness, in questions of science, no
one would question, should be permitted by the company to publish all the facts of
the case.
The difficulties of supplying 21 million gallons of pure water daily from the
IjCH, with only one small reservoir, holding a third part of the day's supply, below,
and in close juxtaposition to the tidal portion of that river full of foul sewsjge,
in all seasons of the year, are immense ; and, in the conditions given, casualties,
which no skill can entirely avoid, are almost inevitable.
Tn reply to a circular from the Re gisfrar- General the Lotidon Medical Officers
ofHietuiA furnished the Department tctth information relative to the water supply
and causes of cholera mortality in their districts. (See pp. 160-177.)
• The area of the covered reservoir is 2-5 x 43560 sq. feet ; which, multiplied by 10-5 feet i
deep, gives 1,145,450 cubic feet, or 6-2321 x 1,143,450 « 7,126,100 gallons. For area and depth,
see JProteor FranUand'a B«port (flnu, p. 124).
136 Extracts fnm Weekly Returns of 1866.
PB0BLE3L
A full vessel contaius x gallons of pure water : a gallon is poured out and is
replaced by a gallon of impure water^ wlilch is mixed completely with the pure
water ; this operation is repeated m times : then the operation is reversed and the
liquor drawn off is every time replaced by a gallon of pure water for n times, how
much impure water and how much pure water remain at the end of the (m + n)
operation ?
Taking a as 1 or any proper fraction let ax bo the quantity of pure water
remaining afker the first operation, then a^x will remain after the second operationi
and a'^x after the m^ ; as the vessel is still full the quantity of impure water is
X — a'^x = (1 — a") X, In the reverse operation the impure water is continually
diminished in the constant ratio a, and after the first change becomes a (1 — a") x^
after the second a* (1 — a") a; . . . . after the «'* change, that is the (jw + «)*
operation, the quantity of impure water is a" (1 — a") x = (a" — a"*") x. As in
the reverse operation the impure water is replaced by pure water, the quantity of
pure water is found by subtraction to be —
= (1 — a" + a"*") a;
If, instead of replacing the gallons of water withdrawn in the first m operations
with impure water, a solution of arsenic is substituted, or a solution of a given
quantity of any substance, then if the proportional part of the arsenic or other
matter in 1 measure of water is expressed by ^, then qa"" (1 — ^T) will give the
proiK)rtion of that substance in every unit of the solution, and the total in a; such
units of the solution by weight will bo qa"" {\ — a") a;, and the weight of pure
water will be—
|l — 5'a"(l — a")! X
Putting x'=i\ and a=*9, and assuming the unit of water at first to be pure, the
quantities of pure water will fall respectively at every operation firom I'OOO to
'900, to -810, to '729 at the third operation; when the impure water will from
become 'lOO; -190; "271 ; now reversing the operation, after three repetitions
the impure water will become '2439 ; '21951 ; and * 197659, Assume that of the
impure water *01 by weight is arsenic, then the quantity of arsenic in 1000 lbs. of
the liquor will in three operations increase from zero to 1 -GO lb., 1 '90 lbs., 2*71 lbs.
and after icpeating the reverse operation three times fall to 2*439 lbs., 2' 195 lbs.,
1-976 lbs.
For arsenic substitute cholera matter, say for shortness cholrinCy* and the result
will be the same.
But c/iolrine* is unlike arsenic in this respect ; it has the power of multiplyixig
itself in the bodies of men, varies in strength, and undergoes changes in its
activity.
It will be observed, that the quantity of poison increases faster than it decreases;
and that tlie velocity of both changes increases as a decreases in value. A similar
law is observed in the rise and decline of cholera.
When a=0 this implies that the whole of the liquor is changed at one operation;
and when a=l this implies that the original liquor is unchanged.
Veek ending Saturdag, September 22.
The deaths registered in London during the week were 1350. It WM the
thirty-eighth week of the year ; and the average number of deaths for that week
is, with ft correction for increase of population, 1206. The deaths in the present
* Cholerine is not now used in England for a mild form of cholera, as in that sense it is nseleH i M
to prvvent any potutible ambiguity cholrine may be used as the name of the matter prodoeing chflifin.
Exitattsfrom Weekly Returns of 1866. 137
return exceed the estimated number by 144. This number is exceeded by the
deaths in the week from cholera.
The deaths returned in the four last weeks from cholera were 198, 157, 182, and
150; from diarrhoea in the same periods 128, 132, 110, and 98. The deaths from
cholera are less by 32 than the deaths from that disease in the previous week.
Of the deaths registered last week from cholera and diarrhoea, 14 persons died
fix)m cholera, and 11 from diarrhoea in the West districts ; 28 from cholera, and 19
fix)m diarrhoea in the North districts ; 19 from cholera, and 17 from diarrhoea in
the Central districts ; o6 from cholera, and 24 from diarrhoea in the East districts ;
33 from cholera, and 27 from diarrhoea in the South districts.
Fifty-three young persons under 20 years of age died from cholera, and 81 from
dian-hoea ; at the age of 20 and upwards, 97 deaths occurred from cholera> and 17
from diarrhcsa.
Woolwichy unlike the other parts of the metropolis, had no Medical Health
Officer at the time of the outbreak of cholera. But the Board of Works, on the
appearance of the first case of cholera in London, appointed a committee, who
made the two Union Officers Health Officers for the time being, and took other
active steps to combat the threatening epidemic. In the case of Brewer-place,
where 6 deaths from cholera occurred, it is admitted that there was some delay in
the application of proper measures. Four deaths from cholera occurred last week
in Woolwich, 10 in Deptford.
)ek ending Saturday^ September 29.
The deaths registered in London during the week were 1418. It was the
thirty-ninth week of the year ; and the average number of deaths for that week
iSj with a correction for increase of population, 1239. The deaths in the present
return exceed the estimated number by 179.
177 deaths from cholera, and 67 from diarrhoea were registered during the week.
Of these, 12 deaths fi'om cholera, and 9 from diarrhoea occurred in the West ; 36
from cholera^ and 11 from diarrhoea in the North ; 28 from cholera, and 17 from
diarrhoea in the Central ; 55 from cholera, and 18 from diarrhoea in the East ;
46 from cholera, and 12 from diarrhoea in the South distiicts. During the last
13 weeks, 4714 persons have fallen victims to cholera, and 2298 deaths were caused
by diarrhoea.
The cholera matter is now diffused very equally all over London ; and as the
waters of the upper Thames, of the Lea, and of the wells become infected, the
utmost exertions of the authorities will be required to ensure its decline. Each
Health Officer should consider that the safety not only of the people of his own
distnct, but of three millions of people depends on his activity. It is to be
regretted that these inadequately paid officers cannot devote the whole of their
time ix) the duties of their important office.
Cobbin's Bbook.
The following note occurred in the Supplement to the Weekly Return of
August 1st, in reference to a statement by Mr. Radcliffe, who reported to the Privy
Council officially on the Epping cases of cholera : — '* The Cobbin, which fiows
'^ into the Lea through Waltham Abbey, drains Epping, where the late small
** outbreak of cholera was observed. That stream is said to be dry."*
This note has given rise to some controversy. Mr. Beardmore, the engineer of
the Lea River Trust, said the brook was ** dry." The Lancet Commissioner, after
personal inspection, stated that Cobbin's Brook, which takes its rise in the country
about Epping, is in parts but " a narrow stream at present, while in other places
** it forms half stagnant pools. It receives the drainage of Epping, and about fiftj*
" yards from its outlet by an open ditch, that of the town of Waltham Abbey ."f
♦ Seep. 115. t Seep. 128.
M
138 Extracts from Weekly Returns of 1866L
Mr. J. FowcU Buxton writes to the editor of the Titnes ;—
COBBHTS BROOK.
To the Editor of the ** Times:*
«Sjr, — Since it is of the utmost importance that all the facts relating to
the origin and spread of choleraic infection should be stated with the greatest
attainable accuracy, I venture to occupy, with your permission, a few lines in
which to correct an error that, originating with the Registrar-General, has been
frequently repeated in your columns.
" It is said that the choleraic poison may have been brought by the Lea and its
branch, Cobbin's Brook, from £pping, where occurred the cases that attracted so
much attention last autumn. For two reasons this is impossible. In the first
place, the Cobbin, throughout the six or seven miles of its bed, from near Epping
to Waltham, never flows at all unless it be after an excessive and long-continued
rainfall.
*< But, supposing that the contents of the pools of last year are by this time filling
the pipes of the East London Water Company, there is still no need for alarm ;
for, secondly, the outbreak of cholera occurred, not in Epping, but in They don
parish, which lies entirely within the basin of the Roding, — so that if water is
the vehicle of choleraic infection, it will have to be discovered by the dwellers near
Barking Creek.
" Warlies, Waltham Abbey, I am, &c.
" September 12th. J. FowEix Buxton."
Mr. Radclifie, on this, explains :
** Three of the fatal cases in the outbreak of cholera at Theydon Bois last
autumn occurred to the north of the spot marked Epping Mill in the ordnanoe map
of the district, just beyond the crest of the hill northwards, and overlookiug the
slope from the eastern extremity of which springs one of the principal branches of
the Cobbin's brook."
Mr. Radcliffe called attention to the brook as deserving notice, at a time when
the cause of the great outbreak of cholera in East London was unknown. Cobbin's
brook contributed slightly to the usual impurities of the Lea ; and did nothing
more. The evil had its origin at the Old Ford reservoir.
Elevation and Water Supply.
It was shown in the Report to the Registrar General on Cholera in 1849 (pp.Ixi-
Ixvi), and in the Appendix to his Seventeenth Annual Report (pp. 88-90), that the
mortality of the several districts of London from cholera diminished in the several
districts supplied from the same sources in proportion to the elevation of the soil
on which the houses were built.
This seemed to imply necessarily that the cholera matter (choirine) was not in
solution but in suspension in water, and comported itself very much like the well-
known rice water when mixed in water.
The same law has hitherto been observed in this third epidemic. The mortaliij
in the lowest sub-district (2 feet), St. John (St. George-in-the-East) was 193 deaths
in 10,000 inhabitants ; while it was 3 or 4 per 10,000 in Stamford Hill (76 feet),
which is said to be supplied from a reservoir about 96 feet above Trinity high-water
mark filled at intervals from Old Ford.
pxtractsfrom Weekly Returns of 1866. 139
Veek ending Saturday, October 6,
The deaths registered in London during the week were 1344. It was the fortieth
week of the year ; and the average number of deaths for that week is, with a
correction for increase of population, 1235. The deaths in the present return
exceed the estimated amount bj 109.
One hundred and eightj-two deaths from cholera and 69 from diarrhoea were
registered during the week. 16 deaths from cholera and 8 from dian-hcea occurred
in the West ; 37 from cholera and 8 from diarrhoea in the North ; 31 from cholera
and 18 from diarrhoea in the Central ; 50 from cholera and 17 from diarrhoea in
the East ; and 48 from cholera and 18 from diarrhoea in the South districts.
Eigh^-six young persons under 20 jeai'S of age died from cholera and 49 from
diarrhoea ; at the age of 20 years and upwards 96 deaths occurred from cholera
and 20 from diarrhoea.
Week ending Saturday^ October 13.
The deaths registerc4 in London during the week were 1353. It was the forty-
first week of the year ; and the average number of deaths for that week is, with a
correction for increase of population, 1222. The actual number exceeds the esti-
mated number by 131.
207 deaths from cholera, and 47 from diarrhoea, making 254 deaths from the two
forms, were registered during the week ; 38 in the West districts, 41 in the North,
44 in the Central, 82 in the East, and 49 in the South districts. The mortality is
lowest, taking population into account, in the South and North, highest in the
Central and in the East districts. Many of the deaths occur in the various hos-
pitals. The places in which the patients were attacked are printed in the notes
when registered, with the particulars of each death, either by cholera or by
diarrhoea.
The mortality of epidemic cholera and diarrhoea has only yet attained high pro-
portions in the East London water field from known causes ; and in the last six
weeks the deaths all over Loudon have been 289, 292, 248, 244, 251, 254. In the
epidemic of the year 1854 the deaths by cholera and diarrhoea in the corresponding
weeks were 2326, 1781, 1474, 919, 509, and 351. The deaths since the first week
in September 1866 have been 1578 ; in the corresponding six weeks of 1854, the
deaths from cholera and diarrhoea were 7360. At the cholera rates of 1854, the
deaths in the last six weeks, corrected for increase of population, would have been
8929 ; the deaths have been 1578. Here are 7351 lives saved.
This is enconraging. Incessant attention should be given to the disinfection of
the sewage of towns on the Thames and the Lea above the intake of the London
water companies ; and it would be exceedingly satisfactory to learn that the
engineers see some way, such as Professor Frankland suggested, to the effectual
filtration of the London waters.
To facilitate the extirpation of cholera the Daily Return of Deaths will be con-
tinued, and if the health officers will report what proceedings are taken in each
case, ihe weekly summary will show the vigilance of the local authorities, and the
use they make of the information placed at their disposal.
Experience proTCS that destruction of the cholera poison is rarely ever effected
in bad districts unless it is carried out under the eyes of medical visitors ; and in
the same way premonitory diarrhoea is neglected. The danger of the whole metro-
polls is thus indefinitely protracted.
^mk ending Saturday ^ October 20.
i
The deaths registered in London during the week were 1464. It was the forty-
Becood week of the year ; and the average number of deaths for that week is, with
• ocrvectton for increase of population, 1227. The present return exhibits an
140 ExtracUfrom Weekly Returns ^1860.
excess of 237 deaths above the computed number. The increase of the total deaths
is partly due to bronchitis.
One hundred and forty-four deaths were registered irom cholera^ and 56 from
diarrhoea, making 199 in the aggregate. The deaths from cholera and diarrhcea in
the last six weeks were 292, 248, 244, 251, 254, 199.
The health of London depends very much upon the inflow of pure water, and
the outflow of impure sewage. The nine water companies have, according to their
returns, supplied 100,864,971 gallons daily on an average in the London area
during the month of September.
South London received from its three water companies 30, 186,829 'gallons daily
during the month ; and Mr. Bazalgette has, upon being applied to, supplied a
return of the sewage discharged daily in September at the southern outfidl works.
Crossness ; it amounted to 46,229,675 gallons, including the yield of the streams of
land drainage, which necessarily varies from week to week. The sewage dis-
charged daily was 43,976,300, 37,443,771, and 43,319,041 gallons in the three
weeks ending October 20th.
If instead of gallon, the more convenient cubic metre of French engineers, or
metric ton, agreeing closely with our ton weight, is substituted, we have these
results.* London was supplied with 458,276 metric tons of water daily during
September, or at the rate of 318 tons per minute, 5^ metric tons per second. On
the south side the water supply was 95 metric tons, the sewage discharged at
Crossness 149 metric ion^ per minute.
The northern outfall sewer does not yet carry down to Barking Creek the sewage
of the low level region north of the Thames ; and Mr. Bazalgette fears that ^ it
'' will be quite a year and a half before we shall get the whole of the northern
'' sewage discharged through the outfall sewer, because parts of the low level have
*' to be constructed in the line of the proposed Chelsea embankment of the Metro-
" politan Railway." Such is the present state of the London sewage.
The quality of the water supply in September has been tested as usual by
Professor Franklond. He gives a remarkable instance of the efiects of filtration
through animal charcoal of the East London company's water, supplied to the
tenants of Miss Coutts in Columbia-square. The organic matter was reduced to
the minutest quantity ; the hardness from 20° to 7°. The filtration of the water
supply for 700 people is here performed without the least difficulty.
The Medical Health officers of London have been requesteil to favour the Regis-
trar General with a weekly return of what is done in their respective districts for
extinguishing epidemic cholera. Dr. Ballard has fully described the meosims
which are employed in Islington. It is by scrupulous attention to such details, and
by purifying the water, that this plague can be stayed.
{^The replies of the Health Officers arc given at pp. 178-200.)
Week ending Saturday^ October 27.
The deaths registered in London during the week were 1394. It was the
forty-third week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1271. The present return exhibits
an excess of 1 23 deaths above the computed number. The excess is partly due to
affections of the air passages (bronchitis).
One hundred and twelve deaths from cholera and 32 deaths from diarrhoea weie
registered. The deaths from both forms in the last six weeks were 248, 244, 2^1>
254, 199, and 144.
Of the 1 12 deaths last week from cholera no less than 30 extremely malignant
cases occurred in the Woolwich Dockyard and the Plumstead and ChaAton sub-
districts near the southern outfall ffcwcr. The Plumstead cases occiUTBd in the
marsh district where many low houses are environed by tidal ditches.
* A cubic metre of pure 'nater weighs a mi'tric ton = lUOO litres « 823*1 gallons ^ SSOl&li
avoirdupois, while the common ton is 2240 lbs. Tiie spscif c suavity of eewjge is gnaler «tas
that of water.
Extracts from Weekly Returns of 1%6Q^ 341
The Medical Officers of Health have given an interesting account* of the hygienic
measares now in operation, showing an amount of vigilance and efficiency in some
districts for which the local authorities and their excellent health officers have
not obtained due credit. The evidence of activity in other districts is by no means
equally conclusive.
The health officers of Bristol and Birkenhead, as well as of London, bear ample
testimony to the utility of the disinfection of the cholera dejections by chemical
agents. This can only be done effectively and kindly under medical supervision.
It la a difficult chemical experiment to be performed by a practised operator. To
place carbolic acid or chloride of zinc, or i)ermanganate of potash^ in the hands of
people who have never seen these substances, know none of their properties, and
have jast been terrified by the sudden loss of a father, a mother, or a child, is to do
nothing. The poor people cannot be expected to know how a house is to be
disinfected, and still less to perform the operation.
The decline of cholera can be accelerated, but to ensure success every part of
London must do its duty ; and should expense in the poor districts stand in the
way, the Metropolis will no doubt be as willing to pay a cholera rate as all England
was to pay a cattle rate to meet an emergency.
^ ending Saturdayy November 3.
The deaths registered in London during the week were 1432. It was the forty-
fourth week of the year ; and the average number of deaths for that week is, with
s correction for increase of population, 1316. Tlie actual return exhibits an excess
of 116 over the estimated return. Bronchitis and pneumonia have been unusually
fiUal.
Seventy-three deaths from cholera, 28 from diarrhoBa, 101 from both forms of
disease were registered. The deaths from cholera and diarrhoea in the last six
weeks were 244, 251, 254, 199, 144, and 101. Of the 73 deaths from cholera, no
less than 28 occurred in the two sub-districts of Woolwich Dockyard and Plum-
stead. The bad hygienic condition of the people is discussed in papers by
Dr. Finch, Mr. Ruegg, and Mr. Grant, the assistant engineer of the Metropolitan
BoanLf
The disinfection of houses in which deaths by cholera have been registered is
still proceeding, and if the operation is performed with skill, care, and efficiency
the decline of the epidemic will go on at a still more rapid pace.
Professors of chemistry sometimes fail in their comparatively simple experi-
ments; how much more likely is disinfection to fail in the hands of ignorant
people. It should be performed by officers properly instructed, under medical
-supervision. Inefficient disinfection is a delusion and a snare.
The medical health officers of Bristol, Birkenhead, Liverpool, and LecdsJ have
given an account of the hygienic measures adopted, it is gratifying to add in these
^aaea with signal success.
fek ending Saiurdtqf, November 10.
The deaths registered in London during the week were 1361. It was the
fbrty-fiikh week of the year ; and the average number of deaths for that week
iS| with a correction for increase of population, 1378. The deaths in the present
return are less by 17 than the estimated number.
Sixty-seven deaths from cholera and 33 deaths from diarrhoea were registei-ed
in the week. The deaths from the two forms of disease in the Inst five weeks were
254y 199^ 144, 101, and 100. Seven deaths from cholera occurred last week in
Whitechapcl, and 13 in Greenwich, Deptford, and Woolwich.
A large nmnber of the deaths from cholera have latterly occurred in Woolwich,
And Ji dncription of the outbreak is given on the next page.
* See pp. 178-200. t ^^ PP- 201-205.
$ See *< 2f otes on Cholera '' m those Districts, pp. 224, 928, and 236
142 Extracts from Weekly Returns of 1866.
In reference to the statement that cases of cholera had occurred in Charlton
without any premonitory dian-hcca, Dr. Macloughlin addressed a letter to the
Begistrar General upholding the doctrine which he advocated so forcibly in 1854,
to the effect that cholera is invariably preceded by premonitory diarrhcea. Great
credit is duo to him for the labour which he bestowed in inquiring into the cases
of 18o3, and contributing to establish the doctrine now prevalent.
Eruption of Cholera in Woolwich.
When cholera was declining in London, Woolwich showed signs of a parting
outbreak in September*, and in the last three weeks 73 persons were suddenly killed
in tho town and its suburbs. The area is very narrow on which these people died,
and tho circumstances are peculiar.
Woolwich is one of the principal military stations of England. There is a large
force of the artillery and of mai'ines, and there is the garrison hospital ; amoanting
with cadets, in the ng^egatc, in 1861, to more than 6,000 men.f The dockyard
employs many men ; the great ai*senal of the empire is full of artisans in Grovem-
ment employ. The health of the place in time of war might be of vital importance ;
yet several of the sanitary arrangements are singularly unsatisfactory.
Woolwich extends from thq south banks of the Thames below high-water mark up
the side of a hill, and has Plumstcad on its cast, Charlton on its west flank. Nearly
all the deaths have occurred scattered over tho Woolwich Dockyard sub-district, and
in the marsh region of Charlton, which with Plumstead constitutes the sab-district
of that name. Few deaths occu rred in the parish of Plumstead. Nearly every house
in the afliictcd district has the water of the Kent Company laid on by stand pipe for
a short time every day ; and the people often having no butt^ of any kind collect the
supply as they best can, in vessels of various kinds, dirty or clean, as the case may
be. Tlio only resource when the water supply proves insufficient is an underground
tank of rain water close to the cesspool. The waterclosets have no water laid on ;
the water having, it is said, in many cases been cut off because the landlords or the
tenants have at some time or other neglected to pay the rate ; for tho landlords of
much of the house property appear to entertain insuperable objections to expending
anything on their property, so the tenants suffer for the landlords' as well as for their
own defaults. The offices of the dwellings ai*e in a dirty dilapidated condition.
Dr. Finch has described the outbreak in Charlton (p. 201).
Mr. Grant, C.E., engineer of the Metropolitan Board, has given a graphic
description of the block of 300 small houses, on the marsh, about six feet below
high-water mark ; traversed here by the southern outfall sewer (p. 202).
In descending the green hills of Charlton between mounds and fine spreadixig
trees, in tho sunshine, the land around looks the healthiest that can be iinagine£
The ships iloating in the full flood of the Thames remind you that you are near the
wealthiest commercial emporium of tho world.
At the bottom of the hill is one of the massive engines of tho Kent Water Com-
pany, pumping its daily supply of water from the chalk well on the mai^gin of the
mai'sb, not far from the tidal ditch below, but inaccessible, it may be assumed, to
the ditch waters. A middle-aged man coming out of one of the cottages in the
row looks sad ; his wife is ill, and a young lodger has just died of cholera. Crossing
the railway and the turnpike gate to the right three streets of small houaee are seen
stretching between the lower Woolwich road and the Thames. These houses are
full of artisans of all kinds and their families, with some labourers and gardenera.
In front of a few houses on the left of West-street, whore six or seven deaths have
been registered, a crowd is collected ; a man and woman are quarrelling^ and the
language usual on such occasions is freely interchanged ; the woman msrehing
about with a child in her bare arms, and threatening to have '' the Jaw on the
slanderous ruffian ;" tho man reminding her that a dead child has just been carried
from tho house. The man is a drunkard, and disturbs his neighboursi who an
* See Weekly Returns for veek endiog September Ist and September 8th| when the WooMdk
anthorities were warned,
f See Census, vol L, p. 81 9,
Extracts from JVeekly Returns of 1866. 143
nearly all respectable artisans. A few doors on is a decent woman in a cleaa
house, whose son, a young gardener, was attacked by cholera in the morning at
six o'clock, and died before noon ; his two boys were running about, and the
mother was from homo. This row of houses is on the marsh, and the water
soaking from the tidal ditch is seen through the floor ; the recent heavy rains
have flooded the laud. The market gardens towards Greenwich had l>een
covered with the foulest manure for a week beforo the great outbreak ; tho
ground was opened and 68 deep wide cesspools were emptied which diflfuscd
offensive poisons all around. The works were nearly completed on 3d November ;
and the mortality declined. Tho i>eoplo of East-street and West-street and
Harden*s Manorway were ill in great numbers, and several had died within a few
days. Some of the artisans were sick at home; the wives and children had
all been ailing. Sudden deaths by cholera create inconceivable consternation ;
and the women, often intelligent, complained that they did not know where to get
the medicines liberally offered for nothing by tho Board. Some of the men earn
good wages. A few of the houses in Woolwich, where the greatest number of
deaths occurred from cholera, were deserted, and no information could be obtained.
The people in Charlton, on tho marsh, often, as Mr. Grant says, two families in
a house, worked in the gardens or in the dockyard or the arsenal ; they did
not know what to do ; they had heard that their houses had been condemned, and
had on one hand the terror of cholera, on the other the dread of being driven
away.
These houses were built, it appears, by speculating builders on land entirely
unfit for sites ; bat dwellings for workmen are indispensable. And although there
is land in abundance in the neighbourhood on which healthy dwellings for tlie
artjzans of Woolwich might be erected, it is not clear that it is available without
the intervention of the Legislature ; as much called for in such cases as in the
case of railways.
The question of the sites of dwellings for the working classes is one of the most
pressing, and will no doubt obtain the attention of Ilcr Majesty's Government.
In the meantime by erecting heallliy dwellings on suitable sites and letting them
to their workmen at adequate rents, tho Government establishments might set an
excellent example which other employers would probably in the end imitate.
The abject straits to which married men, sometimes earning good wages in tho
works, are now put in Woolwich and Charlton have been brought to light by tho
cholera, and it is not likely that the lesson will be altogether thrown away.
The great outfall sewer has probably had little effect on the outbreak of cholera ;
but it is by no means clear that the contamination of the Thames by sewago
'will have no effect on the health of the people in the marshes. This must be
looked to by the able engineers of the Metropolitan Board.
Veek eTiding Saturda^^ November 17.
The deaths registered in London during the week were 1428. It was tho
forty-sixth week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1519. The deaths in the present
return are loss by 91 than the estimated number. Thus the mortality hits been
below the average for two weeks in succession.
The eruption of cholera in October, partly due to the sanitary defects of
Woolwich and Lower Charlton, is subsiding ; and tho small houses of Lower
Char]ton are now supplied with a system of drains.
Thirtt^two persons died of cholera, 22 of diarrhoea in the week. The decline of
the disease is deeisi^ ; and with due vigilance in London it will ere long be extin*
gnished in the epidemic form. Tho deaths from cholera in the last Ave weeks
were 144, 112, 73, 67, and 32, among more than three millions of people.
Professor Frankland has investigated some of the physical properties of clioleia
Stuff (cholrine) ; he has shown that it passes through filtering paper, and that M«iXec
k
144 Extracts from Weekly Returns of 1866.
containing ^^J^f^^^ P^^ of the matter is not ontiroly purified by transmisaion through
animal charcoal. "Whether tlie properties of the remaining molecules or organisms
imdergo any change in the filtering process, depriving them of their zymotic
character, has not been determined. The investigation proves the importance of
destroying all the dejections by disinfectants, and of drawing water from sources
free from contamination.
The Registrar General has received the following communication from Professor
Fraukland, F.R.S., of the Royal College of Chemistry : —
November lOM, 1866.
On the 27th ult. T received from Dr. Farr three bottles containing the rice-water
evacuations of a cholera patient collected on the previous day.* After agitation the
rice-water had the appearance of thin cream, from which a small amount of fioccuJent
matter gradually subsided after the lapse of some hours, leaving a supernatant liquid
looking exactly like milk, and from which no further perceptible subsidence took
place even after the lapse of several days.
One volume of this choleraic evacuation was mixed with 10 parts of distilled
water, and sealed up in a long glass tube ; the fiocculcnt matter now subsided much
moi-e readily, leaving an ogalescent liquid above. One volume of the rice-water
was mixed with 100 volumes of distilled water and sealed up in a similar glass tube.
The flocculent precipitate now subsided still more readily. ^ ■
One volume of the rice-water was mixed with 500 volumes of distilled water, and
the mixture passed through filter paper. The filtered liquid was still very ox^alesoen^
proving that a process of filtration, far more perfect than any available for ths
filtration of water upon a large scale, fails to remove entirely the suspended matter
of choleraic evacuations.
Submitted to the action of potassic permanganate, 100,000 parts of the filiered
liquid just mentioned required -0430 ])art of oxygen for the oxidation of the oi^anic
matter contained in it. The average amount of oxygen required to oxlcUse the
organic matter contained in 100,000 parts of filtered Thames water as supplied to
the metropolis is *0724 part. Thus a sample of water containing Tvi^th of its
voltune of choleraic evacuation exhibits, when tested by potassic permanganate, a
much gi-eater degree of purity as I'egards organic matter than the water supplied to
the inhabitants of tlie metropolis ; in fact it may be safely asserted that the addition
of cholera rice-water to the water of the Thames in the proportion of 1 to 1000
would not materially aficct the I'esults of a chemicid analysis of the water.
After rapidly passing the above filtered but opalescent liquid (containing Tvv^h
of choleraic evacuation) through animal charcoal the opalescence was tUminished
but not entirely removed. The organic matter still remaining in 100,000 parts of
it now required only '0103 part of oxygen for its oxidation. Animal charcoal
therefore fails to remove entirely, even from previously filtered water, the suspended
matter of choleraic evacuations.
The foregoing experiments show first that water may become seriously contami-
nated with choleraic matter without the presence of the latter being indicated by
chemical antdysis, and secondly that water so contaminated is not completely de-
prived of this impurity cither by filtration or passage through animal cbamml.
It 8?iill remains to be proved to what particular constituent of choleraic dejectiortf^
the propagation of the disoa.se is due, but it is obvious that if the propagating
matter be a germ or an organism it m\i>i be in suspension and not in solution.
I have, &c.
E. FrA19KLAND.
The followin'* notes by Dr. Sutton dosscribe the course of the disease in the
patient from whom the stuff was taken. It was a well-marked and severe case «
cholera : —
James F., aged 10 years, admitted October 24th, 4 p.m., into the Cholera Hospital, ConnBCK^
street.
"^^ The cholera matter wafi supplied by Dr. Sutton, patliologist to the London Ho^itaL
Extracts from Weekly Returns of 1866. 145
OcU^ter 84lA^ — On admission : face 'pale, skin cold, pupils dilated, pulseless, Tomited just after
admission.
5 P.M. to 7*30 P.M. Vomited five times fluid like rice-water, and purged twice. Evacuations rice-
irater.
7 '30 r.3f. Pace, lips, and tongue cold. Eyes semi-closed ; ver>' restless ; turns himself from side
to ade ; respiration normal ; temperature in the axilla 93" Fahrenheit (in collapse).
During the night purged once; rice water evacuations; extremities cold ; hands cold and shrivelled;
body feels clammy, and is livid; eyes semi-closed.
October 25tk. From 6am. until 10*15 a.m., hot; purged, and vomited once ; fluid like rice-
water ; pulseless at the wrist, and in the bracheal artery. Ue died at 10* 15 a.m. on October 25th,
1866.
jek ending Saturday^ November 24>.
The deaths registered in London during the week were 1435. It was the
fortj-serenth week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1608. The deaths in the present
return are less by 173 than the estimated number.
Eight deatlis from cholera, 2Q from diurrhcua, were registered during the week.
For the first time since the origin of the epidemic the number of deaths by cholera
is less than the namber of deaths by diarrhoea. The deaths by cholera during the
Iftst seven weeks were 207, 144, 112, 73, 67, 32, and 8 ; while the weekly deaths
by diarrhoea fell from 47 to 26 in the same time.
It must be allowed that the circumscription of the most dangeroua epidemic of
the year in London is yery much duo to the measures by which it has been
combated ; and the time has now come for the extension of similar measures to the
extinction of other zymotic diseases, such as .typhoid fever.
The Companies supplied each house with a metric ton of water daily in
October.
Dr. Letheby has described the array of disinfectants which have been employed
under bis instructions in tlie City ; and has laid down rules for their use at once
clear, jadicioas, and practical (p. 199).
In reply to an inquiry, Professor Frankland makes the following observations on
tlie effect of temperature on organic matter in water : —
With regard to the temperature at which the putrefaction and decay of organic
matter in water take place, I find that the following is all that appears in the
printed report of my evidence on the subject in the ctisc '' Duke of Buccleuch and
others v. Alexander Cowan and others," recently tried at Edinburgh, " Where a
•• river becomes sluggish — as where it is pent up by a weir — the quantity of organic
" matter, and also of mineral matter, increases in some cases very considerably ;
" but that is only the case in warm weather, and the temperature of the water
<' must be 65° Fahrenheit and upwardt< for this effect to be produced, llie putre-
" faction of the mud in the bed of the river ensues, and the previously insoluble
*^ matter becomes soluble matter."
The safest and most sensitive test of putrefaction in water is the relative pro-
portion of oxygen to nitrogen in the dissolved gase^. The river North Esk, as it
flowed through the Duke of Buccleuch's grounds at Dalkeith Pnluce in March and
in June last, afibrded striking evidence of this kind as to the effect of temperature
upon the absorption of oxygen by the organic matter of water (it is only when the
whole of the oxygen dissolved in the water is consumed, that the latter assumes a
true and offensive putrefactive condition). On the 3d of March the temperature of
the water in the North Esk wa.s 38° Fahrenheit, and the proportion of oxygen to
nitrogen in the dissolved gases was 0:N = 1 :2'02. This is the normal ])roportion
in water free from organic matter. On the 21st of June the river emitted a putrid
odour, the temperature of the water was 60° Fahrenheit, and the proportion of
oxygen to nitrogen was 0:N = 1 :25 ; thus the amount of dissolved oxygen was
xedaoed to a mere trace, and the organic matter was in a putrescent condition,
k 2
146 Extracts from Weekly Returns of 1866.
Week ending Saturday y December 1.
The deaths registered in London during the week were 1459. It was the
forty-eighth week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1596. The deaths in the present
return are less by 137 than the estimated number.
Three* deaths from cholera were registered during the week ; and the epidemic
is now virtually extinct. The 15 deaths from diarrhcea are below the average
number of previous years.
The total deaths from cholera in the present epidemic have been 5548, exclusive
of 2692 deaths from diarrhoea, due in part to the cholera element. In the year
1849, when the population of London was about two millions and a quarter, cholera
slew 14,137 people of all ages ; in 1854 not less than 10,738 out of two millions
and a half ; and in the present year, when the population exceeds three millions,
the deaths have been 5548, of which 3909 occurred in the East London districts,
and 1639 in the rest of the metropolis.
The deaths to every 10,000 of population were 62, 43, and 18 in the three
epidemics all over London. In the present epidemic the West Districts lost 4,
the North Districts 6, the South Districts 8, the Central Districts 9 ; and it was
only in the East Distiicts where the ravages recalled the violence of former epidemics
that 3909 people, that is 64 in every 10,000 of the unhappy inhabitants^ perished.
Holland and Belgium have published returns down to a recent date, for which
the Registi-ar Greneral is indebted to M. de Baumhauer and M. Heuschling, and
the facts prove that the epidemic is as fatal as it ever was under unfavourable
sanitary conditions. Thus in 22 cities and towns of Belgium and Holland con-
taining less than half the population of London, or 1,460,808 people, the deaths
from cholera alone in the present year were 20,643. So the deaths were 141 in
10,000, and if the same proportion of inhabitants had perished in London the
deaths, instead of five, would have exceeded forty-two thousand. In Brussels the
deaths were in the proportion of 164, Utrecht 271, Amsterdam 42, In 10,000
inhabitants.
By the bulletin published monthly by the Prefect of the Seine it appears that
the deaths from cholera in Paris were 6653 in 1865, that is in the proportion of
39 to 10,000 inhabitants ; while by the second outbreak in the present year 1812
persons had died by the end of July, the date of the lost return, when the epidemic
was increasing rapidly.
In London cholera has not only been less fatal than it was in previous epidemics,
but its fatality has been reduced almost to insignificance in several of the districts
by the mere force of hygienic science, before which the destroyer has retreated step
by step ; never, however, losing an opportunity of asserting its full power wherever
negligence or ignorance presented an opening, either in England or in the cities of
the Continent of Europe.
Cholera obeys certain laws, and the knowledge of those laws renders its sub-
jugation in Europe practicable, provided all the people as well as the governments
will co-operate in the work. This it may be hoped will be done, and it only remains
for the metropolis of this empire to hold its own, and to keep the lead.
* Two of these deaths were not published in the Daily Returns.
•;
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ExtracUfrom Weekly Returns of 1866.
Proportion of Deaths by Choleba to Population in European Cities.
Cities.
EriBEMio Period.
Population.
Deaths
from
Cholera.
Deaths
to 10.000
liTing.
London
Paris
Naples
Vienna
Liverpool - - - -
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Brussels- • . • .
23 Weeks 1306
<• 12 Months !«« ">
\ 7Montii8l806
1865
mil August to 10th Nov., 1866
' 20 Weekit, ending 2kth Novom-'
(. berlSOO - - - -.
June to October 1366
June to October 1366
1st May to 15lh OrloVr 13CC
1st May to 15th October 1866
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1,606,141
416,931
560,000
484^837
826,101
262,601
C3U14
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f 6^53
I 1,812
2,801
2,875
1.764
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1404
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9^028
(a) 18-8
30-8
(») 10-7
Sl-6
51*3
36-8
107-3
42-0
183*6
l«-7
(a) Epidemic ended.
{h) Epidemic going on.
Week ending Saturdai/y December 8.
The deaths registered in Londoii during the week were 1584. It was the
fort j-ni nth week of the year : and the averoge number of deaths for tliat week
is, with a correction for increase of population, 1626. The deaths in the present
return exceed the estimated number by 69. The excess is amply accounted for by
bronchitis, a disease of cold weather.
Only one death from cholera was registered in the seven days ; it was the death
of a labourer's child, aged 2^ years, at 37 Church-street, Poplar. The deaths from
cholera in the last five weeks have been 67, 32, 8, 3, and 1.
The Table, 76, gives definitively the deaths by cholera in each district to
every 10,000 inhabitants, and the results may be thus briefly summed up ; in
St. George Hanover-square 2 in 10,000 died of cholera^ Chelsea 4, Westminster 6,
Marylebono 3, Kensington 4, all on the north side of the Thames, and supplied with
water by the Grand Junction, tlie Chelsea, and the West Middlesex Companies.
The following districts on the south side X)f the river were supplied by the
Southwark and by the Lambeth Companies, and the deaths by cholera to 10,000
inhabitants were in Newington 3, St. George Southwark 7, Wandsworth 5,
Camberwell 6, Rotherhithe 9, Lambeth 7, St. Olave 9, Bermondsey 6, St
Saviour 7.
The Now River taking about eighty-two per cent, of its water from the River lies
supplies St. Martin-in-the-Fields, where the deaths were 4 by cholera in 10,000
inhabit4ints, in the City of London 6, West London, a part of the City witiiout the
Walls, 12, Strand 7, Islington 4, Holborn 6, St. Luke 16, St. Giles 10, aerkenwell
11. In Pancras, chiefly supplied by the New River, the deaths were ^ St. Jamei
Westminster 4, IIainpstc>ad 1.
The East London Company draws all its water from the River Lea» but it his
pum])3 at two diiferent stations, the one at Lea Bridge, and the other two milsi
below at Old Ford, where it has a small covered reservoir, and two open reservoiff
Extracts from Weeklg Betumi of 1866. 149
in " dangerous proximity " to the Lea, at a point where that tidal rirer ia full of
foul sewago ; tbo deaths here wcro ut a very difierent i-ate, namely, 63 in Bethnal
Green, 65 in Mile End Old Town, 93 in St. George- in -the -East, 85 in Poplar, 78
in Whitcchapel, lU in Stepney, There are two sub-districts on the east side of
tbe Lea, also supplied by the East London Company, and the deaths were at the
same rate as on the west side.
In three districts supplied partly by the New Biyer, and partly by the Eaat
London Company, the deaths were in imtcrmediate proportions, namely, 13 in
Shoreditch, 13 in Hackney, 16 in East Loudon Districts, which ia a part of tbe
City of London without the Walls.
The reasons for believing that the choleraic water was only distributed by the
East London Company up to a certain date were stated at the time ; and probably
that Company will now be willing to relate all the circumatauces of that deplorable
and futal accident.
In Lewisham, including Plumateod aud Charlton, the deaths by cholera were 6 in
10,000 inhabitants, in Greenwich, Deptford, and Woolwich 20 : both these districts
are supplied by the Kent Company in conjunction with the Lambeth and the
Southwark Companies.
A most gratifying and conclusive proof of tlie good effects of improved water
supply is afforded by the experience of the South London Distriets, which were
undraioed and were supplied with the foul sewage water of tlio Thames by the
Soutbwark and Laml>etli Companies in 1849. The Lambeth Company got purer
water from the Thames above Tedilington Lock before 1854, but the Soutbwark
Company only succeeded in supjilyiug the purer water after the year 1854.
In the present year both Companies have supplied this better, if not perfectly
pure water, of the Thames ; while the shallow pumps have been dried up by the
drains, — ^rith the following remarkable results: — The deaths by cholera to
XOfiOO iuhabitaats of South London were 120 in the year 1849, 67 in 1854,
and 8 in the year 1866. From cholera and Jiarrhosa the deaths out of the same
numbera living were 142, and 104, and 15! As the water improved the deaths
declined to this marvellous extent. Similar, if less striking, evidence of the
eSecta of pure and impure waters is supplied by the experience of the other
London Companies.
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U ibovlnc th* VAntm Cravixm nipplyln* &
la Un, Fonru.Tiox' 1811, 1861, aid 1880, uid DBa
ftu, C*rni, fttnn Crolbba. and from It
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tlally by BociuwUK and LaDDEtii
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M. wlun a oomiiauy innfillei Ollya unall nrl iirilic iliatrit't II Ii liiillvBtvd Iw a siualfliiitral Mttr.
^ V*^ Va^ •* Hackiu^y Dbtrkt krhI b) Via EiiHt Limilnu (^naiiuiiy iis It h lii-lliivnl, ■mmllcd l>oni Lra Bridge oftur Uta
b*But I>l<triet« DJV HiippUcd flmrn llic merroin Ht Old F<.nl.
t whan penoni hava died a ehidiin in lUMiiilulH uol iiHiMt|.d in Iho tliiitrti.-li In wldrli tbey vvre ullavkcd. the ioM
Wmd In 11m Tiblc. not to Uip biMidtd rtlntriitii, but to t Iumv dislrieO tmai wbkh llm latk-aU bwl VAtm t<:»vis<:^ H-"^
h la ilMVa the Biinber ofcun to whk-k Ibis rule baa be«i n>yili<:d.
lIUi arttmata fcr tba Woit Ham aul>^li6lri.t luu Imii uiaJu an Uie uisuiuptV™ WinV Uio \»vni\u>;«)\\ \«'-'»™f*?S2SjL
^JJ^JU** Mfa tta iDbnoI DctiroeB tlic cciuusca of 1841 and IWl, Ur.Uuiti, ttiu 'iLcs»\.m tot '^v»"&*»-«i»Kmn
X^'giftS.'Sg^KJ?.*'. ''"'*' regfatored from eholoM ia Vast UnuAufojL* D\AtiiA CtaftftT^'O*''***'
Sxtraeitfrom Weekly Retvnu ^1866.
UUtbrnringtlie Vatib Coiifut>b nipL ^ .
BovuM, Amwjiai, V t.i,jii la Boxjat taiTbcor nooJt io mtib Pnaow bitbet, toot Batu in tba t Bt I
HOBTALITT In «ch of the Ten Y«n IMl-SD uiil lUl-M rmm *rT, Ciuua, uid NniiBU of Siathi ii
•ndluglitDoeemberlMS to 10,000 FimoKb iiTing ttani AJX Ci.dh*b. fram Choliki, >pil rnnn Diabbh
1
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Supper p.rt<rfL«.^vef (83 per
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DinBICra Buppliryd miunly by tlie Eekt
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luf »2S'/S?J', ""*■►"«' nWriet .WTVcd by llw Eut London Cmnpnny It, it b bcticved, lupplied ftom Leo Bridge atler Utn
y^^ntlUttiilMMn-Mmiflnt aeluly from Ihe niier.-oi« at Old Foni; -^ 1 '
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Hxtraetifrom Weehltf Xetunu of I
IS^l-SO ftiid 16Sl-fiO,theNuiiBBK of DEATHBngiiteredia the 33 Weeks ending IbI December
186fi from All Causes kud bom CnoLSBA ud Dubrh<b«, Hid dw Pboportionai. Ndmbbk
to 10,000 uvna.
AvrHAQB
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MORIAIJIT
in S3 W-Lfki
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from
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liviiii from
Scn-DiarnicTS.
MZDICAI. OFFICBia.
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158 Extraettfrom Wedtfy Betumt t{f 1966.
Tablx iliownig the Nhdm of the Medical Hoilth Ofioera ippoinled for Ihe Mvenl Milricti of
Loodon the Average ADnnsl Blortalitj fiom All Cainea in etch of the Ten Yean 1811-50
Knd 1851-60, the Nambcr of Deaths Hgiitered in the 23 WVlii eudiu^' Ist December 1866
Itom All Cannea and ftom Choletn and Diarrhoa, and the I'ruiiortLaiiat Number to 10,000
limte— ratlin
&VB
—
DEirnS 11 DKiTHS 1
"rF"
In
aaWeeka to lO.OW living
from II fnm 1
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EEQiaiHASB'
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ExtraeUfrom fVeeUy Returtu of 1866. 151
Tablb diowing the Names of the Medical Health Officer* ap^inted for die leveral Districls of
I^nidon, the Average Annnal Moitalitf ftom Alt CauKi in each of the Ten fears 184I-&0
and 18S1-G0, the Number of Dealhe registered in the 23 Weeks ending lat December 1866
ttom All Caused and fW>m Cholera and Diarrhtea, and the I^portional Number to 10,000 living
-
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158
ExtracUfrom Weekly Returns of 1866.
Table showing the Correctioxs for Dbaths registered by Cholera in Hosfztals in the
Twentj-three Weeks ending Ist December 1866.
District
in which the Hospital
is situated.
St. George Hanover Square
Marylebone - - - -
St. Olave Southwark -
St. Saviour's Soutliwark
Strand
Islington - - . -
"West London - - -
"Vniitecliapcl - - - -
Faucras - - - - -
:}
Name
of Hospital.
St. George's
Middlesex
Guy's •
King's Coliego
Fever
St. Bartholomew'^
r\ Loudon -
I Cholera -
Royal Free •
Number
of Deaths
deducted
belonging to
other
Districts.
2
6
2
37
80
222
87*
11
* In respect to 84 Deaths in the Cholera Hospital, 8pitalflclds,the returns fiiilod to mention fhmi what
Districts the patients had boeu brought. These cases are therefore distributed according to the various
proportions indicated by the complete returns.
In addition to the Deaths in the above Table, 46 Deaths by Cholera wore registered in the 23 weeks in ths
Iiimehousc District Cholera Hospital, situated in Stepney District, but the retiuns neglected to state tram
what district the patients were brought.
Feek ending Saturda?/, December 15.
Tho deaths registered in London during tlio week were 1389. It was the
fiftieth week of the year ; and the average number of deaths for that week is, with
a correction fpr increase of population, 1469. Tho deaths in the present return
are less by 80 than the estimated number.
Two cases of cholera and 25 of diarrhoea were registered last week.
A boiler-maker, aged 18 years, died oh December 9tli of bronchitis after cholera^
at 17 Orchard-street, Woolwich.
The son of a silk dyer, aged one year, died on December 10th of cholera (24 hours),
at 17 Fleet-street, Bethnal Green.
Although tho epidemic has subsided, isolated cases still demand tho vigilant
attention of tho authorities. This is one of the lessons of the year. For while
cholera raged between the Tower, the Isle of Dogs, and Victoria Park,— over the
aiea ti-avcrscd by the Blackwall Railway, and tho Great Eastern Railway as far
as Stratford and West Ilam, — among a population in uninterrupted communication,
through lines of streets, the Regent's Canal, and the Thames, with the rest o£
London and the surrounding districts, to which many of the infected persons living
in the East of London Hed, the conflagration was strictly circumscribed within well-
defined bounds. The fierceness of the disease extended thus far and no further,
although the movements of the people were as free as air. The futility of
quarantine lines is so well known, that their establishment was never proposed
in London. Tlic supply of impure water was at once arrested ; tho water cnginecra
grow careful ; the sewage was now less inefficient than it ever had been before, for
Bouth London was drained ; the health officers became vigilant ; premonitory
diaiThoca was treated ; every case as it occurred was published to the world ; and
the cholera excreta were destroyed by carbolic acid and other disinfectants. Tho
disease was communicated by contact with the poison in a few coses, but its
general diffusion was stopped.
This is the secret of the success of London in controlling an epidemic that
dui'ing the year has been so fatal in continental cities.
Extracts from Weekly Returns of 1866. 15*
H'eek ending Saturdat/y December 22.
The DEATHS registered in London daring the week were 1377. It was the
fiflj-first week of the year ; and the average number of deaths for that week
is, with a correction for increase of population, 1452. The deaths in the present
return are less by 75 than the estimated number.
Two deaths from cholera, and 16 from diarrhoea, were registered during the
week.
A coachmaker's labourer, aged 59 years, died on 17th December at 10 Shouldham-
street, Marylebone, of cholera (35 hours).
The widow of a publican, aged 36 years, died on 18th December at 16 Exmouth*
street, Mile-end Old Town, of choleraic diarrhoea (3 days).
Week ending Saturdcn^^ December 29.
The DEATHS registered in London during the week were 1436. It was the
fifty-second week of the year ; and the average niimber of deaths for that week
is, with a correction for increase of population, 1554. The deaths in the present
return are less than the estimated number by 118.
The daughter of a pen merchant, aged 16 years, died on 23d December, at
3 BoarVhead-yard, Whitechapel, of cholera Asiatica (14 hours).
Fourteen deaths from diarrhoea were registered during the week.
\
160 The Health Officers on the Water Supply ^ Sfc. o/tluir Districts.
2. The Medical Officers of Health on the Water Supply and
Causes of Cholera in their Districtts.
The Medical Officers of Health, in answer to a circnlar of inquiry, kindly
i^pplied the Registrar-General with remarks on the following points : —
1. On the water supply of the district since June last, and the results of any
analyses which have been made.
2. K the district is supplied partly by two or more companies, has any
difference in the mortality of the parts supplied by the respective com-
panies been observed ?
3. On the effects of pump, well, or spring water on disease.
4. Greneral information as to causes of mortality from cholera in the district.
The following replies were printed in the Returny No. 37, for the Week ending
September \6tk.
Paddington.
1. There were in Paddington, at the commencement of the present epidemic, ox spiing wells
accessible to the public, although on private property. Most of these wellB were used by consi-
derable numbers of persons for drinking ; one of them m particular was, and is still, mndi esteemed
for the excellence of its water by the mhabitants of Westboume-terrace and the neig^boorhood.
Water from each of these wells has been subjected to analysis by Dr. Vogt.
In most cases It appeared sufficient to determine the amount of readily oxydixable oiganic matter
contained in each water by the well-known process of Dr. Angus Smith. A standard solution of
permanganate of potash w^ used for the purpose containing one grain of the salt in 5,000 grains
of water. In every case the water was first acidulated with sulphuric acid (20 drops to a litre)
before the addition of the permanganate, and it was ascertained how much it was necessary to add
in order that the liquid should retain a red tinge after the lapse of five minutes. The amoontB of
oxygen required for the oxydation of organic matter in each water were as follows :
Pump in Burwood-mews ... 0-0290 grains in 100,000 grains.
„ Frederick-mews - - 0*0390 „
„ Omnibus Company's stables,
Market street - - 0*0350 ^
„ Other premises belonging to
the company in the same
street . - - - 0*0224 „
„ Cab-yard, Irongate Wharf-
road - - - - 0*0114 „
„ Cab-yard, Charles mews - 0*0090 „
The total quantity of oxydizable matter in each water is no doubt greater than that indicated by
these numbers. Thus 1 00,000 grains of water from Burwood-mews (which contained no less than
122* 17 grains of solid matter, of which 30*4 grains consisted of oiganic and other volatile matter),
when le^ in contact with an excess of permanganate of potash solution for 24 hoars, had at the end
of that period reduced an amount corresponding to 0* 15 grains of oxygen, so that it decolorized
nearly five times as much in 24 hours as in five minutes.
The quantity of chloride of sodium or common salt is regarded by Dr. Smith and others as of
great value, as affording indication of the impregnation of water with sewage ; a deteimination of
chlorine was therefore made in all excepting one of the waters. The results show that the waters
differed from each other extremely in this respect Thus the two wells on the premises of the
General Omnibus Company contained, respectively, 20*76 and 16*68 grains of chloride of sodium
in 100,000. The water from Burwood-mews, already referred to, contained 17*74 j whereas that
of the wells in Frederick-mews and Charles-mews contained only 2*27 and 2*17. These differ-
ences clearly indicate that, so far as regards direct contamination with sewage, these weOs were
comparatively pure.
In all cases the presence of nitrites was investigated, as recommended by Dr. Angus Smith, by
the addition of iodide of potassium and starch. The indications of their piesenoe were Tery
distinct in all of the waters, excepting that from Charles-mews. A bluish colour appeared almott
immediately after the addition of the iodide of potassium and starch, which rapi^y increased in
intensity.
The Health Officers on the Water Supply^ Sfc. of their Districts. 161
2. The district is supplied by the West Middlesex and Grand Junction Water Companies.
3. The only fatal case, not imported, which had occurred in the parish, up to the end of August,
was that of a boy who resided at No. 2, Irongate-whaif, and drank habitually water from a contami-
nated welL
I would add that, in accordance with my advice, the Fubhc Health Committee have taken
effectual measures for closing those of the wells above referred to which were found to be con-
taminated.
September 8, 1 866. J. B. Sakdbason, M. D., F.B.C.P.
Kensington.
The water supply given by the three companies to this parish has been much more ample since
June. Water is supplied twice daily to the poorer localities and once on Sunday. There certainly
is a difference between the mortality of the parts supplied by the three companies, but I do not
attribute this at all to the water, but rather to the drainage, crowding, and more especially the clay
soil of the northern part. We have had only one case of Cholera ; I therefore can give no infor-
mation on that point.
September 7, 1866. F. Godbigh.
FULHAM.
1. The Fulham district is partly supplied by wells, and to a considerable extent also by the
" West Middlesex,'' the " Grand Junction," and the " Chelsea " Water Companies. The water of
the London Companies is regularly submitted to analysis monthly by Dr. Letheby on behalf of the
Metropolitan Association of Officers of Health, that of the West Middlesex company being fhr*
nished to him by me for the purpose.
The results are published in the Medical journals.
I have from time to time, though not very recently, made many examinations of the water of the
sur&ce wells of the district, and find them to abound in organic impurity, the total impurity ranging
from 60 to 100 grs. per gallon, and the organic from 5 to 12 or 14 grs.
2. The districts supplied by the various companies are all more or less supplied by wells also ;
bat I have no special &ct8 relating to either company in connection with disease in consequence.
3. I believe the use of impure well water in this district to have been the cause of frequent
diarrhcea amongst persoiiB using it, as also of scrofulous disease.
4. This district has not suffered materially in its mortality from cholera during the present
epidemic In July a case of cholera arose, and death, from the use of water which had been pent
up in a cistern for a month during the time the house was untenanted, and from the incoming tenant
incautiously allowing her fiimily to drink thereof. The few other deaths from cholera I have had
no reason to associate with the use of impure water.
It may not be out of place, probably, here to express my opinion that the water supplied by the
various companies to London is not derived frt)m proper sources, neither do I think the present
mode of filtration effective in removing its impurities. I believe, however, that much of the odium
thrown on the water supply is also due to the very defective manner in wUch, as a rule, it is stored
for domestic service by the consumer, and I would suggest to the water companies generally the
proprie^ of employing water-tank inspectors, so as to ensure and enforce the periodical cleansing
and repair of these receptacles in private houses, — ^a plan which I think would materially diminish
the present frequent bad results from drinking impure water, and to a great extent protect those
bodies from complaints which frequently lie at me consumers' own doors.
August 5, 1866* Fredebick J. Bubgb.
Chelsea.
I
1. A Sunday supply of water has been obtained from the company. No analysis of the water
has been made.
2. Chdsea is supplied wholly by one company.
3. The pumps have been, so far as possible, closed mnce the appearance of cholera. In one
house which, with half a dozen others, drew their supply frx)m the Thames direct, the water having
been condemned as unfit for drinking purposes, the landlord threw obstacles in the way of obtaining
a better supply. Before leg^ proceedings could be taken a case of choleraic diarrhoea occurred,
which proved fiitaL The patient, however, only slept in the house, and no other individual is known
to have suffered from diarrhoea in consequence of using that water. All in the house professed to
be quite weU.
4. Chelsea has as yet suifered so little firom cholera that I can give no information as to the causes
of iMAated cases. ^
Auffwl a4, 1 866. A. W. BabCLIT, M.D.
1*
162 The Health Officers on the Water Supply ^ ^c. of their Districtt.
Hanover-square and May Fair.
1. The Grand Junction Water Company supply the Hanover and May-iSdr sub-distiicts, and the
Chelsea the Belgrave sub-district These waters have during the last year been analysed for my
colleague, Dr. Aldis, and myself, by Dr. Letheby, the results of whose analyaes are published every
month. The general character of the water has been good since last April, when there were great
complaints of turbidity.
2. The difference in mortality between the Hanover and May-fair and the Bdgraye sob-districts
does not appear connected Mrith their water supply.
3. There are three pumps in Mount Street and its vicinity, which are still used by the owners
and the neighbours, although the evidence of their contamination by sewage is complete. Remon-
strances urged in person have been vain. No case of disease, however, has been traced to the use
of this well water.
4. There has not hitherto been a case of cholera in the Hanover and May-fiur sab-districts. The
chief causes of diarrhoea appear to be the use of beer with the adults, and of milk with the
children.
August 29, 1866. B. Druitt, M.D.
Belgraye.
1. I have lately received complaints of no water supply in two streets in South Belgravia on
Sundays. Generally the water supply is very good, the water being distributed among the poorer
classes twice daily and once on Sundays. It will be supplied in mture throughout the Bdgrave
sub-district on Sundays.
An analysis of the Chelsea water, taken from the main at No. 1 Chester-tenace, Chester-sqoare.
June 4th, 1866, contained — total solid matter 17-7dgrs., lost by ignition 0*74 grs., oxydisable
jorganic matter 0*48 grs.
On July 9th, 1866, the following results were obtained : —
Total solid matter - - - - 16*60 grs.
Lost by ignition - - - - 0* 68 „
Oxydizable organic matter - - - 0*60,,
2. The sub district is supplied by one company.
3. I send my general report containing analyses of these waters several years ago.
4. The first patient died of cholera at 74 Cumberland-street. He appears to have been infected
with the disease at Stratford, whence he had come, su£Pering from diarrhoea, the day before his
death. He was much alarmed, as several persons whom he knew had died of the complaint at
Stratford.
Three persons, two of whom died, were admitted into St. George's Hospital suffering frcmi cholera.
One, a man, was in a very exhausted state after walking up to London frx>m Norwich. A policeman
found him in Hyde-park and took him to the hospital. ' Another, a youth, had left his mother's
residence in Manor-gardens, Manor-street, Chelsea, in perfect health, but was taken iU at Bow a
day or two after, when he was taken to the hospital,
The third, a man, resided at No. 5 Apothecary-row, Wandsworth, but worked at Stanley-bridge,
Fulhara.
On September 5th Dr. Aldis forwarded the particulars of two fatal cases of cholera. The deaths
took place in St. George's HospitaL
1. Mary Anne Johnson, aged 38, residing at No. 16 Walton-street, Chelsea, which is a private
nurses' institution, was admitted in the hospital on Saturday, September 1st, axid died on the same
day at 3*15 p.m. It is remarkable that she nursed the gentleman who died of cholera at
25 Arlington-street. She suffered from diarrhoea the week before attending upon this patient, who
had recently come from Ghent. We may question the propriety of allowing a nurse to attend a
cholera patient under such circumstances.
2. Thomas Good was taken to the hospital, September 2d, at 1 a.m., and died at 9 '30 A.1C The
patient was found by a policeman in Conunerciid-road, Pimlico, and had been nnloading a vessel
called ** The Gratitude " in the Grosvenor Canal. The vessel belongs to Goole, but sailed last from
Portland. It was generally clean, but the forecastle was filthv and swanned with bogs. I went on
board and inspect^ the vessel There is no proper ventilation in the forecastle, where tile food is
cooked. I recommended sulphtir to be burnt in the place, and carbolic acid to be used for disinfec-
tion. Both the men who slept in the forecastle were drunkards, but the deceased was sober on the
day of his death, and had been drinking the water of the canalf which is almost liquid sewage, while
cleaning the outside of the vessel, although there was plenty of good water on board.
September 5, 1866. C. J. B. Aldxs, MJ>.
Westminster. ^
Water, which is good, is supplied by the Chelsea Water Company. Every pomp in the district,
so far as I know, is closed, and there have only been four deaths from cholera, in neither of which
was there any apparent cause for the outbreak.
August 30, 1866. BaBITABD HoLT,
Thf Health Officers on the Water Supply, §v. of their Districts. 163
St. Martin-in-the-Fields.
1. Our poorer people have suffered much from want of water on Sundays, but the New River
Company have very lately been induced to give a supply on that day. The Chelsea Company have
always furnished a supply on Sundays.
2. There is a difference in the mortality of the two districts of our parish, the Charing-cross and
the Long-acre ; Charing-cross is partly supplied with water by the Chelsea Company, but I doubt
whether the water used has any influence. I have always imputed it to the difference of the classes
of society in the two districts. Long- acre district contains a larger proportion of poor dwellings.
In my annual reports I have always pointed out the difference in the mortality as a residt from &e
greater attention to the laws of health among the inhabitants of the Charing-cross district than in
the more densely inhabited Long-acre district.
3. I have never observed any ill effects of pump or spring water on health. Our spring water
contains about 50 grains of solid matter per gallon, of which 6 to 7 grains is destroyed by combus-
tion. We have only two public pumps of spring water, both of which have, for the present at
least, had the handles removed. There are many private pumps, the water of which is consumed by
private fiamilies. The water of three which I have examined is very similar to that of the public
pumps. I have never heard of any evil to have resulted from the use of it. I have myself drank
the water of the pump in Covent-garden Market for 40 years, and never less than a pint daily. I
know many who have done the same, and never heard of the slightest ill effect. I am averse to
contend against the authority of the late Dr. Dundas Thomson, of Dr. Letheby, and of nearly the
whole of my colleagues the medical officers of health, but I cannot yet feel convinced that the water
of our superficial wells is injurious to health. I know of no proofs against any but those of Broad-
street and West Ham, and in both these instances sewage matter was traced direct into the wells.
Seeing that our London water is good enough for all purposes but those of drinking and cooking, I
think our wells should not- all be condemned without further inquiry. For example, if there were
wells in the centre of our large squares,— say, for example, Lincoln's Inn Fields, and half a dozen
pumps in the circumference just outside the railings, — might not the water so obtained be fit for
drinking and cooking purposes ? Chemistry is certainly opposed to the use of London pump water,
but the anticipated results are not confirmed by practical experience.
4. The present outbreak of cholera has not produced one single case in our parish. The only
death occurred at Charing-cross Hospital, and the patient was brought from a house in West-street,
Soho. In the outbreak of 1854 we had very few cases of cholera, although very many of diarrhcea.
Then, as now, we had four stations for the gratuitous administration of advice and medicine ; and I
cannot but connect our immunity, then as now, with the focilities given for the early treatment of
diarrhcea, and we are not free from several closely built and densely inhabited courts.
August 31, 1866. Lionel J. Beale.
St. James Westminster.
1. I have examined a large number of specimens of water from the cisterns in the parish of
St James Westminster, and I find the water is not overcharged with organic matter. In some
instances, when the cisterns or waterbutts have not been cleansed, the water has indicated by the
permanganate test a considerable quantity of organic matter. In such cases the cleaning of the
cistern or butt has invariably corrected the evil.
2. The district of St James Westminster is supplied from three sources : 1, the Grand Jimction
Water Company ; 2, the New River Water Company ; 3, surface wells. I cannot attribute any
cases of diarrhoea directly to the water supply.
3. Since the latter end of July the pumps of the parish have been closed, and I have no evidence
to show that any cases of cholera or diarrhoea have been dependent on the water supply.
Two cases of fiUal diarrhoea in children occurred in this parish at the latter end of June. Both
children drank copiously of water in a cistern which was exposed to the emanations of a
watercloset
4. We have had seven decided cases of cholera ; of these four had been in communication with
cholera districts in the east The other three cases were not traced to any particular locality. One
case wag very remarkable : a boy came from Poplar to stay with his nncle at 5 Little Pulteney-street
on the 7th of Angust ; he died on the 9th ; and his uncle went to his funeral on the 1 1th, and came
back and died (m the 13th.
September 6, 1866. Edwix Lankesteb, M.D.
Martlebone.
1. As regards water supply, the parish of St Marylebone, which contains about 22,000 houses,
is supplied by two water companies, viz., the West Middlesex and the Grand Junction ; the former
supplies by far the largest portion of the parish, the latter some few streets on the southern
boimdary abutting upon Oxford-street
1 valyse these waters eyery month, and for the last five or six months there has been a gradual
improTcsnent in the quality of both of them ; the result of my analysis for July will be seen in
my monthly report
The srerage supply to each person is about 30 gallons. I know of no houses without water
supply J in some few small courts and places, to the extent probably of about 100 houses, there are
164 The Health Officers on the Water Supply y §v. of their Distru^
water tanks, in 'which one tank fumiBhefl a supply for all the houses in the court or place ; bat these
tanks are generally sufficiently capacious, and tolerably clean ; in these cases there is a separate
water tank for the closets. All other houses in the parish have a separate supply, the water
receptacles in many of the small houses being altogether unsuited to the ptupose, and improperly
placed. Every week-day a fresh supply is given to every house, and daring the likst three or four
weeks, at the request of the vestry, Uie West Middlesex Company have given an additional supply
on Sunday mornings to the poorer districts.
2. I .have observed no difference in the mortality of the parts supplied by the two companies ;
each derives its water supply from the same source, and in point of purity they are much alike.
3. Since the prevalence of the present epidemic I have 1^ no opportonity of fbnning an opinion
of the effect of pump, well, or spring water on disease, because immediately on the first oatbreak
of cholera I recommended the vestry to close all the public pumps in the parish, and that recom-
mendation was at once carried into effect.
4. Fortunately up to the present time there have been but very few cases of cholera in this
parish ; not more than four or five. I have inquired into the history of these cases, and cannot trace
the origin of either of them to any local or other cause. Two occurred in highly respectable
funilies, where the sanitary condition of the house and its surroundings were apparently ezceUent ;
and two in the workhouse, where especial attention is and for some time past has been paid to
sanitary precautions. •
In the district of Christ Church (Lisson-grove) diarrhoea has been most prevalent ; here the
most wretched portion of the population of the parish live ; it is here also that house-to-house
inspection has for some months past been going on, and a very great deal of sanitary work has
been done. The diarrhoea has been chiefly amongst children, and I attribute it to their bad diet and
the quantity of decayed and unripe firuit which they had been permitted to eat
Since the 4th of the present month six dispensaries have been opened in the parish for the
gratuitous supply of diarrhoea medicine, and up to Saturday last, the 25th instant, 3,555 cases had
been treated, and in almost every case relieved.
August 31, 1866. J. Whitmorb, MJ).
Hampstead,
There has not been any need to make a special analysis of the water supply to this parish
" since June last" No case of cholera has ansen here, and diarrhoea has been rather below than
above the average. No appreciable difference has arisen fi-om the supply of water, which has been
given to different districts of the parish by the New River and West Middlesex companies ; the
health and death rate have been equal in each case.
There are still some deep wells in use ; the water is good. In one case a public well has been
closed, because an old drain and suspected escape of sewage is running near, llie numerous surface
wells have not been used for years past.
August 27, 1866. ChablesF. J. LORD.
Pancras.
1. I have not made any analysis of the water in my district lately.
2. My district is supplied partly by the New River and partly by the West AGddlesez Company,
but I cannot say that I have detected any difference in the mortiUity of the parts supplied by the
two companies.
3. All the public surface wells in my district have been disused on my recommendation for some
time past. In the workhouse there is a deep well. There has been there this year remarkably little
diarrhoea and no cholera.
4. As to the causes of cholera in St. Pancras. In II cases I have traced cholera to importation
firom the east. In one case a woman had nursed her daughter at Stepney, who was BufEenng firom
cholera, and washed the linen ; she died, and in a short time afterwards two children of another
fiunily in the same house contracted the disease and died. This house was in a bad sanxtaiy
condition. The grandmother of these children visited them frequently during their illness. She
lived in an ac^oining street, contracted the disease, and died. Her son, who wahed upon her, and
occupied the same room, died two days after her.
Another set of cases occurred thus : two children came from a house in Mile End^ where their
brother had died from cholera ; they too died, and conmiunicated the disease to their grand&ther,
who lived in the house to which they came.
^ Another man working at the Isle of Dogs came home to Camden Town suffering with diarriicea ;
his wife, who had not been away, waited on him, sickened with cholera, and died ; and in a day
or two later the husband died.
One gentleman died in a house in which there were cesspools of old standing, and a gravelly
soil, with many cesspools aroimd.
A man and son died on the same day at the upper part of Kentish Town { the cause of their
illness was not made out. Their house was a new one, not very dry ; the water supply was from
the New River Company ; there was no defect m the receptacle, except that it was uncoreied,
situated on the leads.
In this house two other cases occurred, the children of another family.
Two deaths from cholera have occurred at the Royal Free Hospital from Holbozn district
August 31, I8C6. Taos, Hn.T.yB, ItD.
The Health Officers on the Water Supply^ Sfc. of their Districts. 165
Islington.
1. Onr supply of water in Islington is derived from the New River Company. Several private
faooseSy however, in the older parts of the parish, have superficial wells upon their premises, which
the occupants prixe as furnishing a more agreeable water for drinking purposes.
2. I have not observed the occurrence of cholera at any houses thus using their superficial wells.
3. The general quality of the New River supply is excellent. What I complain of is, that it is
damaged by storage after delivery from the company's mains. This damage arises from the use of
old and rotten butts, from the improper places where butts, and cisterns more especially, are com-
monly fixed, and firom the gross neglect of householders to cleanse these receptacles.
The storage of butts is mostly limited to old tenement houses occupied by the lower classes, and
in making an inspection of such premises it is the rule to find the butts decaying and leaky, from
the n^lect of painting outside and of proper pitching inside. It is the rule throughout the district
to find the cistern placed over the watercloset, with an untrapped waste-pipe communicating ¥nth the
house-drains. The houses are very few indeed where the house and closet supplies are separated*
In mews I generally find the butt or cistern placed in the atable, where the water is most likely to
gather vaporous and other impurities, in addition to what comes fit>m the drains through the waste
pipe. In some small houses I have found them placed in some comer, where they regularly receive
the drippings from the roof or leaky gutters of the house, or else side by side with the dust-bin and
privy. An^ odd comer, if convenient, seems to be considered fit for the placing of the cistern.
Sometimes it is so placed (as under the flooring of a aleeping^room or over the portico of the house)
as to be out of reach of cleansing, except at the cost of removing boards or obtaining a ladder to
reach it from outside. The neglect of cleansing is almost universal. In small tenement houses the
children amuse themselves by casting filth and rubbish of all kinds into the butt I have myself
taken filUiy cloths, old hats, &c. out of a conmion cistern in a court Even in most respectable
houses, where the cistern is uncovered, the neglect of cleansing is often observed. Years are some-
times permitted to pass without any attention being paid to the cistern, and I have known bucketsful
of filth removed when an outbreak of disease has at last opened the eyes of the occupants of a house*
Unfortunately, although the law enables local authorities to enforce a supply of water to every house,
no control is given over the mode of storage. I firmly believe that no remedy for this sad state of
affiiira exists but the total abolition of the intermittent system of supply, and the adoption of a
constant supply at high pressure universally.
4. I do not know that the cases of cholera which have been met with here were dependent upon
the condition of the water. The butts and cisterns in the several houses were no worae than in
othen where cholera did not occur, so far as could be discovered by ordinary inspection. Still it
may be that something was present in the former that was not present in the latter. I am disposed
to think this, because I have seen attacks of typhoid fever, and symptoms resembling those of irritant
poisoning, arise mast disUnctly firom the use of water taken from uncleansed cisterns— cisterns with
more or less organic deposit — and yet the deposit has in such cases not been greater or perhaps so
great in amount as where no such attacks of disease have resulted. I can, however, say this, that
while I have seen typhoid fever arise where the cistern has been kept scrupiilously clean, and while
I have seen symptoms like irritant poisoning arise from other causes than^ bad water, I have not met
with an instance this season where cholera has occurred in a house in which the cistern or butt was
not n^ected.
5. An arrangement is now in force here with the New River Company for a constant supply to
stand-posts in some of our poorest neighbourhoods — to last for three months. The stand-posts are
provided with a simple form of self-closing tap.
6. As to the apparent causes of cholera here : our first case was derived firom the East of London ;
the next occurrence was four days later, and then, within two da^, 10 cases (9 fatal) occurred in
two parts of the parish more than half a mile distant from the initial case. Until I can review the
circumstances of all my cases together I should not like to commit myself to an opinion upon their
causes. This, however, I may sav, that in many instances the cause has appeared to be attached to
the houses sereral inmates of different families, and occupying different floora, being attacked in
succession — not t<^gether ; membera of families in these houses who have escaped fully developed
cholera have veiy conunonly suffered from choleraic diarrhoea. At other times persons in the same
house and fiunily have escaped, although living apparently under the same conditions and using (Inn
same water, only one case occurring, and then there being an end to it. Two instances at least of
apparent pezsonal communication of cholera (contagion?) have occurred ; one was of an old nurse
at the Fever Hospital, who, after spending three nights in the cholera ward, was attacked and died.
The other case is a remarkable one. There is a court here called Hope-place West. On 1st August
an old woman was attacked with cholera, and speedily died ; the room was disinfected with carbolic
acid, the drains and privies throughout the court also, the bedding and clothing were destroyed after
a similar disinibction, and the body quickly removed and buried. No one else in the house suffered %
this was at No. 9, At No. 7, on the opposite side of the court, and some ten or twelve yards distant,
lived a man, his grown-up daughter and two children. A son of this man and his wife resided more
than a mile distant in Anglers-gardens, and both were attacked with cholera, the husband on 27th July,
and the wife on 30th July. The wife died at home on Ist August, and the husband then being
Temoved to the hospital, died on drd August. The bedding and clothing were disinfected and all
destroyed. During the conjoined illness at home of this man's wife the sister from 7 Hope-place
West came to and fro to nurse them. On 4th August one of the children mentioned as living at this
boose, a fitde brother of the man and his sister, was attacked with cholera and died in ten hours, and
the other duld had choleraic diarrhoea ; the young woman who went to and fro to nurse did not
suffer at aO. Neither of Uie children had been to Anglers-gardens, and none of the clothes had bci'n
166 The Health Officers on the Water Supply^ 8fc. of their DistricU.
In-onght to Hope-place West The court contains several houses, but no cholera occoired (after the
case at No. 9) in any other inmate of the court. On questioning the young woman, it appeared that,
although exposed to having her dress and person soiled with the dischaiges, she had continued to
wear the same dress while doing what was necessary for the children at home, and ridiculed the
suggestion that it would have l^en well to have washed it Knowing, as all do, the common practice
of women in her rank of life of using the cotton dress for all kinds of purposes, such as wiping hands
upon, or even children's faces, it is quite possible that this dress may have been a medima of com-
municating the disease. It is more likely also that the disease was derived from the young woman
than from the case of the old woman four days previously.
I cannot help thinking (to return to the general question) that all the house cleansing and drainage
works that can be carri^ out will have little result so long as the bedding of the inhabitants remains
uncleansed. Its horribly filthy condition in the houses of the lowest classes, and in many where
cholera has happened, affords a fit nidus for any such virus as that of cholera to fructify in. It
would be one of the best works a charitable society could expend its funds upon to make a wholesale
destruction of such filthy bedding, supplying new in its place.
August 24, 1866. Edwabd Ballard, M.D.
Hackney.
1. The water supply was less than usual until a deputation waited on the Erectors of the Elast
London Company, and the Board wrote to the New River Company. No analysis.
2. Partly by East Loudon, partly by New River. Cholera has spread m T^ngay's-buildin^,
Matthias-place, and 19 Robinson*s-row, supplied by New River Company, as readily as in Silk-mill-
row, Balls-buildings, and other places supplied by East London Company. No difference percepUble.
3. I have no remarks to offer on the effects of pump, well, or spring water on disease.
4. The earliest cases of cholera were imported from other districts. The disease has been most
fatal in houses which have not any back ventilation. I have ordered a small opemng to be made
through the staircase wall, so as to allow of a thorough draught of air. Nearly all our cases have
occurred amongst the poorest and dirtiest of the population.
iScpfemftcr 4, 1866. John W. Tripe, M. D.
St. Giles.
1. The water supply of this district is in the main from the New River Company. In qnab'ty that
supply remains, as &r as I know, imchangcd. In quantity it has somewhat improved, especially in
the particular of Sunday supply, during the present month, in consequence of representations that
have been addressed to the company by this Board. A second source of supply is from sur&ce wells.
In so far as these wells are public, this Board has wholly put a stop to the use of their water through-
out the year for any other purpose than watering the streets. But many such wells are in private
houses, and water from them is probably still used for drinking by the inhabitants, mostly of the
better class, on whose premises they exist. A third source of water is a very limited and almost
private one : — a deep artesian well in Russell-square, from which water has been supplied in the
usual way throughout the year. I have no analyses, of my own, of any of the waters for the present
year. Former analyses have shown the surface well water to be extremely impure, the artesian
well water to be perfectly good and wholesome, and the New River water to be what the Registrar-
General knows it is.
2. No remarks under the head of your second question arise in respect of this district
8. The preventive measures of closiug pumps connected with shallow wells have reduced the
opportunities of getting information tn answer to the third question, and I have nothing from my
own knowledge to communicate.
4. In ccrtam instances out of the few cholera cases that have occurred in St Giles', I have traced
the disease to direct intercourse with infected districts at the East end of London. In other instances
I have thought that proximity to the Strand district (with probable personal intercourse with in-
fected neighbourhoods therein) might have determined the occurrence of cholera. But in one or
two instances I have no notion of the cause of its occurrence. And the number of cases in 8t Gilea^
having been very limited my opportunities for answering this question are also few.
August 24, 1866. George Buchanan, M.D.
Strand.
I and 2. The only company by which the Strand district is supplied with water is the ^ iVeto
JRiver Company," but of their water (as delivered in the district) I have no recent analysis.
Note as to water supply. — The objection to the present mode of water-supply is mainly one of
quantity, or, more correctly, of deficiency, and of impurity by reason of the small capacity and
character of the water receptacles (cisterns or butts) in many of the more densely peopI«l parts of
the district, and of the absence of a supply on Sundays.
In respect of the Sunday supply, however, it is only right to state that the New River Company
has expressed willingness to afford this in the poorer courts and alleys of the district| and during the
past few weeks in several of these localities this has been done.
In regard of the question of the capacity- of water receptacles, the Board of Works of this district
has resolved that evtry house shall have a water receptacle capable of holding at least ten gottouM
per day for each of its inmates (children and adults).
The Health Officers on the Water Supply y &c, of their Districts. 167
The connderation of the whole question of the water supply of London is one which cannot with,
safety to the public be much longer postponed, for, speaking generally, the quality of the water is
not what it should be, and there cannot be two opinions as to Uie expediency of getting rid of water
receptacles altogether, and having a continuous supply, The water companies, the New River
Company at least, express both their readiness and willingness to afiford a constant supply (as indeed
tiiey are under certain circumstances compelled by their Acts to do), provided such means be adopted
by the owners and occupiers of houses as shall prevent all unreasonable waste of the water ; but
these means, it is affirmed, (and all persons practically acquainted with the subject concur, I believe,
in greater or less degree, in the accuracy of this statement,) do not at present exist. From consi-
derable experience, the conclusion at which I have long ago arrived in this matter is, that the entire
system of water supply must in & financial point of view be completely altered, that water receptacles
must be wholly abolished, and that the mains and service pipes must be continuously charged ; but
that in order to effect these objects successfully water must be paid fory just as gas is paid for,
namely, in accordance with the quantity consumed. No one hears of a gas company complaining of
the waste of gas by the consumer ; nor would any similar complaint ever be made of the waste of
water if the latter were paid for by the landlord or tenant at so much per hundred or thousand
gallons.
The present mode in which water is paid for is both unsatisfactory and unjust, the water rate being
«a charge of six or seven per cent, upon the rental of the house supplied ; and the effect of thia
arrangement is practically to compel the tenant of a large house, in which from a variety of circum-
stances but little water is consumed, to pay for the great quantity of water wasted in less costly and
poorer localities. It may be right that the richer neighbourhoods should be taxed more highly than
they already are for the support and maintenance of the poorer ; but it cannot be right that they
should be obliged in this indirect, and in many instances unsuspected manner, to provide in a great
measure the more lowly rated localities with water. Good and pure water is a necessity of exist-
ence, and its supply ought to be the duty and property of the municipality, and not those of any
private companies whatever.
3. The Strand district contains a few public and also a few private pumps. All the former I
caused to be rendered incapable of being used (either by the removal or the locking up of their
handles) in the early part of July. The disuse of private pumps I have no power to compel ; but in
the instructions I have caused to be distributed throughout the district the point upon which I have
most strongly insisted is the boilino of all water, or liquids containing imboiled water, before it is
swallowed.
Partly in consequence of its being found impracticable to cause in a short space of time an efficient
cleansing of the water-butts and cisterns in the poorer parts of this district, and of their snudl
capacity, and partly in consequence of the inconvenience arising from the closure of the public
pomps^ the Board of Works caused (with the consent of the New River Company) several standposts
(furnished with handles easily usable by any one) to be fixed at the entrance to some of our more
crowded courts and alleys ; and these, being charged night and day with water from the main, have
placed a supply of comparatively pure water within the reach of the inhabitants of these localities,
free of all cost
4. In nearly erery instance of a so-called outbreak of cholera in this district, I have succeeded,,
upon close investigation,' in tracing the importation of the disease, either direcUy or indircctiy, from
infected locaUties. Once, however, carried into this district, the malady has in more than one
instance spread to other inhabitants ; but by the daily use of carbolic acid in large quantities, and
other dismfectants, used, not merely for watering the streets and flushing the public urinals, water-
closets, and sewers, bnt also r^ularly and daily applied, under competent medical supervision, in
every house in wluch cholera or diarrhoea has occuired, anything like an extensive spread of the
disease has heen completely arrested.
September 10, 1866. Conway Etans, M.D.
HOLBOUN.
1. This district is wholly supplied by the New River Company, who, since 1862, have most
liberally compfied with the request of this Board to give an extra supply to all the poorer localities
on Satniday evenings. The quality of their water is, I believe, excellent, but have not analyzed it
ance Jmie last. An additional supply is provided by eight wells which were sunk by the local
authorities about 25 years since. With one exception, viz., the well on the west side of Middle-row»
Holbom, which has long been irremediably contaminated with sewage, these wells yield an abundant
supply of drinkable water. I have frequently examined the water from these wells, both chemically
and microscopically. Although the solid constituents are great as compared witii the companies
water, tis., from 40 to 100 grams per gallon, as well as the organic and volatile matters, viz., from 5
to 12^rams, and ihere are abundant nitrates in nearly all of them, I have fiuled, however, to detect
any mtritet or animalcules in any of them. The quantity of ammonia found has never been great ;
oAen onlr a trace. The same, and even less favourable results, have been obtained in the examinar
tioa of toe water from private pumps, of which there are 4 in Gray's-inn, I in Lincoln's inn, 1 in
Staple's-imi, 1 in Bed lion-square, and 1 in Queen-square. Most of these pumps are open to the
piblic, and the water is laigely drank on account of its cool and sparkling character; in two
mstanesi it is, I am told, actually sold to the public, who often send considerable distances for it.
However, I Iult^ no evidence to indicate that the water from these public and private wells has
caused ii^vqr to health.
At a time when cholera was prevalent I felt it my duty, in consequence of the strong pr^umpta.ve
c^odenee tlMore i% that this disease is communicated by means of drinking water that has \>^/^
168 The Health Officers on the Water Supply , S^c. of their JXstriefs,
specially contaminated by the poison, to adyise the Board to remove the handles from the fevetal
pomps under their control, which they did in July last.
2. Only one company supplies "water.
3. Under the first question I have stated my experience of water derived from these sources. I
may add, that I have found the water drawn from underground cisterns mofe dangerous to health
than that from wells. On the 20th of August, just at a time when we had an mrasoal amount of
rain, Asiatic cholera, of a severe type, attacked all the inmates of a house in Great Qrmond-yardy
fifteen persons in all ; three fled in terror. I found that the house No. 10 was one which last spring
I advised your Board to order to be improved. Your orders had been complied with, but not in
so thorough and efficient manner as was desirable. Unable to trace the cholera to any palpable
cause, I instituted a chemical and microscopical examination of the drinking water which is stored
in a tank under the yard. To the naked eye this water had a dull opalescent appearance, and under
the microscope it was seen to contsdn myriads of animalcules, some vegetable fibre, See, I unhesi-
tatingly attributed the disease to the fact of the inmates having drunk of the water of this tank,
which was so imperfectly covered that the heavy rain had caused the surface water of this ill-drained
and worse paved yard to flow into it, filled as this yard is with dung-heaps, stables, cow-stalls, and
slaughter-houses. I need not describe the nature of that surface water. In former years, vis., in
August 1856,'I traced 15 attacks and 4 deaths from cholera at No. 10 Great Ormond-yard to drinking
polluted water from such a cistern. In August 1858 a whitesmith, aged 30 years, died in BlaClf
Bull- yard, after 6 hours illness, from this same disease, probably induced by the same cause. Again,
an ostler in Lamb-yard, Lamb's Conduit-street, in 1862, died, after a few hours illness, frtym the same
cause. These cisterns were all situated in stable yards.
4. Very many of the cases of cholera in this district have occurred to persons who had within a
week previously visited the localities in the east of London where cholera was prevalent l^e three
exceptions are a young woman, aged 23, who was seized after eating eels for dinner on Sunday, and
died in 1 1 hours, and two old women who appear to have been frightened into it
It is a noteworthy fact that out of 19 cases of cholera in this district, 9 were removed to hospital,
of whom 8 died, 10 were treated on the spot by the medical visitors, of whom only 1 has died,
8 have recovered, and 1 almost convalescent from the secondary fever.
August 30, 1866. Septdcts Gibbon, bid.
Clerkenwell.
1. No general complaints of the water-supply. Some of the inhabitants of the district derive
their water-supply from underground tanks ; these I consider very objectionable, and have advised
that they be replaced by above-ground cisterns, which has not been done.
2. The district is supplied by the New River Company only. The well-pumps have been looked.
3. No remarks.
4. The cases have been but few. The first sufferer of four in one &mily apparently brought the
disease from Whitechapel ; this one recovered, as did two others ; the mother, however, died of diolera.
August 30, 1866. J. W. GBOnXH, MJ>.
St. Luke, Middlesex.
TWs parish is only supplied by the New River Company.
Only one public pump now exists, and this has been purposely rendered inoperatiYe dating the
epidemic.
No epidemic outbreak of cholera can be considered to have occurred in StLuke*s, there having
been only a few (under 12) sporadic cases, occurring at distant parts. In some of these cases there
is direct evidence to lead to the inference that the disease was contracted in a cholera locality, and
brought into the parish ; for example, a policeman who died in Mitchell-street had been engaged on
duty in Shoreditch ; a man in Turk's Head-court had been working at the docks, and his death was
assigned to drinking impure dock water; a man in White Horse-court had been working at the water-
side at Billingsgate j and a woman in Garden-court had just removed from Shoreditch, and was ill
when she came into the parish.
F. W. Patt, MJ), F,R.S.
City of London.
Dr. Lethedy, M.B., M.A., Ph. D., Health Officer for the Gty of London, (which includes the
Districts of the CJity, East London, and West London,) has drawn up an elaborate analysis of
the waters in use in the City. The following extracts are from his valuable Report.
** Altogether there are 35 pumps in the City from which the public are in the daily habit of
drawing water for drinking purposes, and as you will perceive from the accompanying table the
quantity of saline and organic matter in the gallon ranges from 26 '63 grains to 129*73,— that of
the New River during the last month being but 1 7 • 16 grains, and of the East London 18-18. Only
fiix of the City wells yield water with less than 50 grains of solid matter in the g^on, and there are
but two others with less than 70 grains. Ten of them contain from 70 to 80 grains ier gallon, nine
have from 80 to 90 grains, two have from 90 to 100 grains, and there are five wA in the City,
namely, those in Aldgate High-street, in Bishopsgate-street, by Dunning's alley in Icadenhall-market,
m AlUton-street, Cripplegate, and in St. Nicholas Clave Churchyard, the water of which contains
from 100 to 130 grains of soUd matter per gallon.
fJn }^ ™°^^^«s too the constituents are remarkably indicative of the souroe and nature of the
^iw* T'/, ^^^ ^^ ^^® ^^^^^ ™«^* markets, for example, as those of Newgate, Aldgtte^ and
x^^eaAaZ/ aA? charged with the pecuHar filth of those \ocaMea-, indeed the water fiumshed hj
uie weu m i^adenhaU-maxket containa neaily 40 gcaina oi comsawi «^\i v« f?S^% heddti » Utfge
The Health Officers on the Water Supply, 8fc. of their Districts. 169
quantity of nitre and organic matter, all of which is derived from the stinking serosity which runs
from the hides, exposed for sale and salted npon the public way. The wells of the City churchyards
and their neighbourhood are also strongly tainted with saltpetre and ammonia, the former to the
extent of from 20 to neariy 30 grains in the gallon, and doubtless it is the final product of the decay
of the animal matter buried in the neighbouring graveyards. Others of the public wells show the
presence of the more or less oxidised products of substances which have escaped from adjoining
drains and sewers ; and nearly all of them are so largely impregnated with compounds which have
percolated through the foul soil of the City that they are entirely unfit for domestic use. Where the
soil is wen protected, and the pump is away from any especial source of pollution, as is the case with
the two pumps at Guildhall, the water is but moderately tainted with impurities, but even there it is
dangerous to use the water for drinking purposes, for there is no saying how soon it may become
foul from a neighbouring sewer or cesspool.
** I have aboidy reported to you that as most of these waters are bright and sparkling, and have
a cool and agreeable taste, they are much sought after for drinking purposes ; but the cocSness of the
beverage, and the briskness of its appearance, are dangerous fiEiscinations, for they are both derived
from oivanic decay. In fact, the dead and decomposing matters accumulated in the soil are partially
changed by a wonderful power of oxidation, and thus converted into carbonic acid and nitre. These
give to the water the agreeable qualities which are so deceptive ; and although they are so frequently
drank without any apparent manifestation of injury to health, yet it cannot be that the products of
such corruption can be admitted into the human body without danger of insidious mischief; and at
the present time there is the still greater danger of the impurities of the soil passing unchanged into
the water, and being a source of quick and certain injury."
CoHPOfimov of the Watbm of the Pumps and Surface Wells of the City of Loitdov.
^AMES OT PUHPS.
Aldgate - - - - - -
Aldgate High-street - -
Bartholomew>lane . - • .
Basinghall-street . . . .
Bell-yard, Gracechurch-street -
Bishopsgate-chnrch - - - -
BishojMgate-street, >y Dunning's -alley
Bow Churchyard . - . .
Bowling-square - - -
Bride-lane - - - - -
Cannon-street West - - - -
Chequer -yard, Dowgate-hill
Cock and Hoop*yard, Houndsditch
Comhill
Cree Chnreh-lane - - - .
Penchurcb-ctreet • . . .
QuildhaU
Guildhall-bnildhigs - - - -
Gatter-Iane . . . . .
Great St Helen'f . - . .
Half Moon-passage - - - -
Herald's Coilege-yaid
Honey Time market - - - *
Idol-kme -••-..
LeedenhaO-awket • • . .
Little Britain
MOiQMCMeli Crippl^ate -
Mitve>«qaeie - . • .
Newoate-Btikflt ...
OldJcwiy • • • •
Bl. Mary-Axe . . . .
S*.KieMuOh;?eChiirchyaid -
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20
Officers
Shoreditch.
1. I have made no special analysis of the New Riyer or East London water.
2. I have long taken pains to suppress pumps and wells ; and believe that companies' water is now
almost exclusively used.
3. At first it appeared that the epidemic was chiefly prevalent within the area of the East London,
but latterly not so, at least to the same extent.
4. I attribute most of our cases to direct importation from the infected bordering districts. A
resident in Shoreditch has been in contact with cholera patients in Bethnal Green, Whitecbapel, &c.,
and has come back to be speedily attacked. Then, this fieu:t is common, — a second, rarely a third,
case follows in the same house as the first. There has been nothing in the nature of spreading
beyond this. Dotted or isolated cases have appeared in various and distant parts of the district, but
these have not become foci of radiation. The active means adopted, in burning infected bedding,
tree use of carbolic acid, a wonderful anti-zymotic in my opinion, and the removal wherever possible
of the sick have, I am convinced, together with the steady house-to-house visitation, been very
effectual in meeting the epidemic step by step.
There is nothing in these very unstatistical notions that is worthy of publication, nothing that
militates against the almost irresistible conclusion that the disease has been propagated through the
East London water supply.
Let me take the opportunity of calling your attention to one point
There is no practical sanitary work more important than the prompt removal of the dead from
an inhabited house. Until the corpse is removed, cleansing and disinfection of the house cannot be
done, and in the meantime a second or third case happens, and in some cases I know of, cholera has
been propa^ted to other houses. Now removal cannot always be effected with sufficient promptitude
unless provision is made for the temporary reception of the corpse in a public mortuary. I have had
such a mortuary erected — in every way as I think suitable for the emergency; but owing to the
prejudice of the people living near to it, I am not allowed to use it ; and the vestry, although disposed
to support me, seem hardly prepared to run counter to the feeling. Strange to say, there seems no
such feeling against the established practice amongst imdertakers of depositing bodies for an unknown
time, in unknown places, cellars, stables, &c., in close proximity to dwellings ; no care being taken —
undertakers despising it— to disinfect them.
September 5, 1866. Robert Babkes, MJ).
Bethnal Green.
The following reply from Dr, Sarvis appeared in the Return, No. 45, for the
Week ending November \OtK
1. There has been no special analysis of water in this district lately. The whole of Bethnal
Green is supplied by the East London Watervv'orks from the Old Ford reservoir. For a long time
prior to the outbreak of cholera the water supply has been very scanty ; it not having been turned
on long enough or with sufficient force to fill the receptacles provided •, the poorer localities have
often been without water, especially on Sunday. Since the outbreak a larger supply has been ^ven,
but even now it is not sufficient for the wants of the inhabitants. I believe the storage of water
to be bad even under the most favourable conditions, and a constant, instead of an intermittent supply,
for the whole of London, greatly needed.
2. Only one company supplies water to this district.
3. There are no public pumps in my district, and I have not been able to trace any case of
cholera directly to drinking impure water, although there is every reason to believe that the present
epidemic arose from that source. The first well-marked case of cholera occurred in this district
dose to the Old Ford reservoir.
Thomas Sarvis, M.D.,
September 29^, 1866. Medical Officer of Health.
Whitechapel.
1. The mode of water supply has not varied since June ; there are now about 20 courts in this
district which are supplied with water direct irom the main without the intervention of cisterns or
butts. The houses in these courts thus supplied contain about 2,000 persons. I have not nuide an
analysis of the water.
2. The district is supplied by the water companies, viz., the East London and the New River.
The entire district contains about 8,664 houses, and the East London supplies about 7,914 of them,
and the New River about 750, or nearly one twelfth of the total number.
The sub-districts which are in part supplied by the New River Company are Aldgate, Whitechapel
North, and Artillery, the mains running along a portion of Upper East Smithfield siad along the
centre of Petticoat lane.
The total deaths in this district firom cholera, in the four weeks terminating on Saturday the
25th August, have been 494, including the deaths in the London Ilo^ital and those in the Chdera
Hospital in Commercial- street, both of which institutions receive patients firom all the neighboming
parishes.
The mortality from cholera during the same weeks in the houses in the three sub-diftiiets trhidi
are supplied with water by the New liiver Company has only been 19.
The Health Officers on the Water Supply^ §-c. of their Districts. 171
3. 1 haye had no experience as to the effects upon health by the use of pump water, but I may
state that the water from two of the pumps recently became so foul that it was deemed advisable to
prevent the further use of it But, notwithstanding this, the inhabitants in Norton Folgate memo-
rialixed the Board to cleanse the well, and to allow the public to continue to use the water. At
present the Board has not complied with the request ; and it is to be hoped that, for the safety of
the public, not only will these two pumps be kept closed, but that all the pumps in the district will
be removed.
4. The extreme poverty of the inhabitants in many parts of the district, owing to their precarious
employment, and their consequent inability to procure a sufficient quantity of good wholesome food,
and from their crowding together in ill-ventilated rooms, thereby diminishing their physical powers,
so that they are unable to resist the poison of epidemic diseases.
We have been left a fearful legacy by our forefathers in their having permitted houses to have
been built without the least regard having been paid to sanitary arrangements. Everybody has been
permitted to do what he liked with his own. Unless these supposed " vested rights " of property are
vigorously attacked by Pariiament, and prevented from being used to the detriment of the public
h^th, the present evil will be perpetuatCNl.
Aupvsi SO, 1866. John Liddlb.
St. George-in-the-East.
No replies were received from the Medical Officer of Health.
LlMEHOUSE.
The water supply is grossly defective, and demands inmiediate change. The complaints among
the poor on tins YkoA are incessant ; it is [seldom let on for more than 10 minutes, and then there is
often a contention for tins limited quantity with the inmates of a dwelling. I have made no analysis
of the water.
2. This district is wholly supplied by the East London Waterworks, excepting 15 houses in Green-
yard, and four in Brown Bear-alley, Wapping, which have their supply fh>m the New Biver Company.
In this limited exception the difference rather tells against the New River Company comparativay
in that neighbourhood, as one death hasjoccurred at No. 6, Brown Bear-alley, and one at No. 4,
having died in hospitaL Three recoveries from diarrhoea happened at Nos. 4 and 9.
3. There are no public pomps or wells in the district in use.
4. Intemperance in food or drink, f^bleness of habits from previous disease or otherwise, fatigue,
anxiety, and scantiness of food have been amongst the markedly predisposing causes of cholera. The
streets selected have very generally been wretchedly built, both as regards materials and especially
the foundations of the houses. I could number houses of this character where deaths have been
remarkable, and whole groups of streets, not old but new streets, not in this alone, but other districts,
where cholera has found victims, while the same class of houses of another structure have com-
paratively escaped. Then again, I believe, the Lea Cut and the Regent's Canal, two bodies of
water little better than cesspools in June under the high temperature, prob&bly ao°, are comparatively
stagnant canals, gave rise to poisonous gases and vapours, and these, favoured by the inmiediate
change of the wind from the north-east, after several days of excessive heat, as in other cases on
record, laigely diffused its virulence in the direction of the recent fatal attacks.
September 1, 1866. Thoxas Obton.
Mile End Old Town.
No replies were reoetved from the Medical Officer of Health.
Bow.
1. Tlie wmter tapply in the older parts of my district is in most cases a dail^ supply into cisterns,
too often M and lU kept ; but in the more recentiy built streets, and especially in North Bow,
nearly all the houses have a constant supply from the mains of the Eaist London Waterworks
Company. I am most anxious to see this system universally enforced through the entire district.
2. The East London Company supply the whole district.
3. We have nather pumps, wells, nor springs in use throughout the district for the supply of
drinkiiig water.
4. I am not able to ascribe the rapid spread of the epidemic amongst us to any single cause. At
the heffimiing of the outbreak the larger number of cases occurred among persons residing near the
Bimlin and the Limehouse cut, this being, however, the poorest and most densely populated portion
of the dteiel ; subsequentiy the disease attacked persons of all ranks, and residing in the h^thiest
frtM of d» a^g^bourhood, many cases occurring among those who were not water-drinkers, and
m whom, thcapefore, the choleraic poison could not thus have found an entrance into the system.
172 The Health Officers on the Water Supply ^ ifc. of their Districts.
Poplar.
1. The water is supplied to every house for about 15 minutes ereiy day, except Sundays.
2. My district is supplied by one company, the East London. I have not observed any difference
in the mortality in any particular part of my district.
3. There are not any pomps or wells in my district.
4. I am at a loss to know the causes of mortality from cholera in my district, but I would suggest
that every house ought to have the water on the constant supply.
August 31, 1866. SufL. K. Eluson.
St. Saviour.
1. The St Saviour's district is supplied with water by two companies, viz., the Lambeth, and
Southwark and Vauzhall.
2. I have not observed any difference in the mortality of the parts of the district supplied by the
respective companies ; nor is it possible I should, as the water is derived from the same locality by
both companies.
3. I have advised that all sur&ce-wells in this district should be closed, or not used for drinking
purposes. This advice has be^n acted upon.
4. The locality where cholera has proved &tal in this district is very crowded, and is adjacent to
Reddin's dust yard. At No. 6, Famham-place, Gravel-lane, a man was attacked with cholera and
died. His son, a boy 10 years old, also died. A boy who went to the house was sazed the next
day, and died in Enight's-court, Bear-lane. Since, a young man has died at No. 7, Famham-place,
and from the 17th August to this date no other case has occurred. I have caused all the houses to
be thoroughly limewa^ed, scrubbed ^i1th carbolic acid, the waterclosets thoroughly cleansed, and
have had all the bedding, wearing apparel, &c., of those who died destroyed.
August 25, 1866. BoBT. BlA370Hl.
St. Olave.
1. I have not made any analysis of the water supplied to my district since June last. Numerous
complaints have been made within the last few weeks of a deficiency in quantity.
2. My district is supplied by the Southwark and Vauxhall Company only.
3. I have no opportunity of forming any opinion on the effect of pump, well, or spring water on
disease. The only pump within my district was removed some weeks smce through the agency of
the Board of Works, in consequence of my report that the water was unfit for driiJcing purposes.
4. Nine cases of cholera have occurred within my district during tiie present summer. Six proved
&tal ; five if not six bf the cases appeared to have been imported from other districts.
^M^^t 29, 1866. J. NOBTHOOTB VonETT, M.D.
Bermondsey,
The water is supplied to Bermondsey by the Southwark and Vauxhall and the Lambeth Water
Companies. The former supplies the greater part of this parish. Since June last the quality has
been good, and more carefully filtered than in times gone by ; but the quantity has been seriously
deficient. In every part of dds company's district there is a general complaint of scarcity of water.
The ofBcers of the vestry are in constant correspondence with the company, the result of which is
an occasional squabble about fittings with the landlords ; the company's officers most inconsistently
showing their ability to give the necessary supply by flooding the yards of the complainants in my
presence. It would seem that the supply is systematically withheld on account of the waste caused
by the objectionable fittings and receptacles. The question of water supply to the parish is becoming
a very serious one indeed.
The Lambeth Company supplies a very small part of Bermondsey. The complaints are so few
that I only happen to know officially that they do supply this veiy small district, in which there has
not been any cholera and no more diarrhoea than elsewhere. I cannot £urly attempt a comparison
between the waters of the two companies, as nothing important has taken place in the part of the
parish supplied by them coi^jointly. The mains of the I^unbeth Company do not go near the part
of Bermondsey where cholera has as yet prevailed.
I have not performed any analysis lately, having adopted that of the late Dr. Dundaa Thompson
and that published by the Registrar -General, with the exception of having used pennanganate of
potash occasionally on account of having great reason to find fault with the storage of water in
cisterns, butts, tubs, jars, &c. &c. I have found the humble jug or jar of the poor more whole-
Bome than the dirty open butts or more pretentious cistern. The former, often rotten, standing over
the drain, and seldom cleaned out ; the latter too often ventilating the sewer or closet by means of an
open waste pipe. The purest water in England would be poisoned by the present system of storage.
I have long been an advocate for a constant supply.
To the third question I have only to say that I have not known the water of any pump to have
been used lately for drinking purposes. The vestry pumps have been chained and locked, at my
suggestion, and are only used to water the streets.
Eighteen deaths from cholera have occurred in Bermondsey between July 8th and Angntt 25th.
The irst victiin was a sailor trading to ]iamb\irg, where the disease prevailed ; honse deio and
i
The Health Officers on the Water Supply, Sfc. of their Districts, 1^3
firee from sanitaiy defects. The next was an a^ed woman, who lived next door to the above, but
without the least communication with him or his family. This was attributed to fear ; house clean
as the fonner ; both houses continue free from cholera. Brickfield a great nuisance. Third case in
a spot inhabited by poor Irish labourers who work by the water- side or whose wives are employed
at cinder-sifting, rag-sorting, or in glue yards. They are dirty, given to overcrowding, and every
sanitary effort foils to keep their dwellings free from fever. Here six deaths have taken place in
three small streets. Efforts are being made to arrest the disease by the free use of disinfectants.
Three other deaths occurred in places of a similar description in another part of the parish ; two of
ihese in one street. The first was the daughter of a man who carts ice to the London Hospital, and
the second had been in communication with her during her illness. Four deaths occiured in one
house in the Bouel-road, a new street of well-drained houses, with only one fault, the storage of
crater in cisterns with objectionable waste pipes. The first of them was an idiot child, which had
been left a few days before its death sitting m a swing in a shower of rain for three hours or more.
It was ne^ected, and allowed to practise Uie filthy habits of idiocy. The mother and another child
followed, and the fiither died in Guy's Hospital. The three last were cut off in 36 hours ; the
husband and wife were both intemperate. Here, without doubt, the cholera was invited by drunken-
ness and dirt. No more cases have occurred in the Rouel-road, though the inhabitants are suffering
much from the nuisance of an a^oining glue factory.
Septtmher 1, 1866. William Fabkeb, MJ>.
St. George, Southwakk.
1. I have not made any analysis, and I have not observed any matter worthy of notice.
2. This district is supplied by two companies, the Lambeth and Southwark. The mortality has
been so small that no inferences can be drawn. Two of the fatal cases of cholera which occurred
were imported fVom Stratford, In all cases the water receptacles were filthy ; in two cases they
were filled with weeds like a stagnant or slow running ditch.
3. All our pumps have been closed for some time ; that is, the public ones. There are many
private pumps ; one situated in the centre of a catgut manu&ctory in Green-street, and from which
the water is fetched for and near, owing to its coolness and deliciousness. The family use it The
well is about 1 7 feet deep.
4. I have no infbnnation to give.
Avgusi 25, 1866. H. Batbson.
Newington.
Onr parish is snpplied by two companies, the Lambeth and the Southwark and Yauxhall, and we
hftTe had so little cholera that no comparison can be drawn bet^'een the two with respect to
mortality ; the latter company's arrangements as regards sufficiency of supply are defective, and
scarcely a week has passed for a long period without complaints being received ; the water supplied
is not thoroughly filtered, and at times there is a great deal of earthy (?) matter diffused throi^ it,
and I have detected by the microscope living organisms as weU. We have not received one com-
plaint for a long time against the Lambeth Company.
I have in former years, on more than one occasion, traced the occurrence of diarrhoea to ^e use
of weQ-water for drmking purposes, and have found, in one instance that I can well remember, that
it was contaminated by connexion with a drain, and on this being prevented the diarrhcea ceased.
September 6, 1866. W. Tipfin Ilitf, M.D.
Lambeth.
The paxidi oCLmbeth is served by two companies drawing their supply from the River Thames,
Tia., the Sonthwaiic and Yauxhall and the Lambeth Water Companies, and some houses are supplied
from wells only.
The condition of the waters since June has been as good as usual, but some complaints have been
made of an inndBSeient quantity in the poorer localities, especially on Sundays. The two water com-
pames hare recently undertaken to fiimish water in poor neighbourhoods on Sunday.
There hare been yery few cases of cholera in Lambeth, and these have been distributed, and not
covifined to nj one water company's district. The number of cases have been insufficient to fonn
any fflfiff%4i< wjr data ; a confflderable proportion were imported into the parish from infected districti^
or arose after great iiregularity of living, or occurred in young children.
SepUmher 5, 1866. George Fuckle, M.D.
Clapham..
This district is supplied by the Southwark and Yauxhall Water Company, and the supply since
Joe last baa been good. I examined the waters of several pumps, See, and found them unfit for
dnnUttff purposes, and gave directions to close them.
In mi district tbere is but little cholera ; there is a great deal of diarrhoea.
Tba bstlth of this district has been very good during the last three or four weeks ; the mortality
Offieeri
Battersea.
1. Water supply is good ; no aiial3rsis has been made lately.
2. By one company, the Southwark and Vauxhall.
3. None has been observed.
4. The localities where cholera has occurred are generally unhealthy, from ^-keeping, defective
drainage, overcrowding, and dirty habits. The first case of cholera that occinred was imported by
a man who had worked at Bow Common ; he died after three days' illneu ; his daughter was
attacked the day after his seizure, and died in 11 hours.
August 27, 1866. Wm. CoyKOB.
Wandsworth.
1. I have made no analysis of the water supplied to this sub-district since 1856.
2. Tables have been lately furnished to the inspectors of nuisances for the purpose of gaining
this information.
3. Much conjecture, but no direct evidence of actual disease having resulted finom the use of these
waters.
4. Five cases of cholera have come under my care during the present epidemic. Three of men
and two of women ; the latter wives^f two of the men. The men were attacked first, then their
wives. Two of the men were employed on the sewer works, and the third digging mud out of the
Wandle, and previously in the manu&cture of artificial manure.
The only etiological deductions which I can extract from these cases are, that the kind of employ-
ment of the men presupposes exposure to malarious influence, or at least to noxious gases ; and the
&ct of the women having been attacked subsequently to the men would appear to indicate a con-
tagious transfer of the disease.
September 3, 1866. G. E. NICHOLAS.
PUTNET.
\
Eighteen years ago, in <' An Address on the Moral and Phy^cal Evils resulting from a Neglect of
Sanitary Measures," I made the following remarks in reference to the supply of water : —
** Let us turn now to another part of our subject, the water supply of the district. I have a very
strong opinion, indeed, from the liability of the water in many of the localities in which the poor
reside to become contaminated by the numerous cesspools in the vicinity of the weUs, that the use
of such fluid filth for drinking and cooking purposes is a finitful source of ^sease ; SAd it is a very
great question with me whether it wiU not one day or other be demonstrated that the drinking of
such impure water gives rise to cholera in too many instances, and possibly to many other diseases
of which we at present know not the origin. I anxiously look forwiurd to the day when these con-
taminated wells shall be closed altogether, and when good and wholesome water shall be supplied to
the poor, in an imlimited quantity, by a water company having mains running directly through the
district."
Within the last six weeks I have examined nearly all the remaining well waters in the parish, and,
with very few exceptions, find them to contain dangerous amounts of organic impurity. E>ven some
water taken from a well on Putney Heath, always considered to be of excellent quality, gave, in a
recent analysis —
Grains per gallon. Grains per gallon.
Total impurities - 56 '0 Oiganic matter - 17*5
Other well waters within the town have also been lately examined, and found to be equally impure.
In one instance, where percolation from a neighbouring privy was but too evident, the water under
the microscope was found to abound in infusorial life.
Those portions of the parish in which surface wells have been abolished are aU supplied by one com-
pany, the Southwark and Vauxhall ; but even this water, though the purest (if it could always be
drawn directly irom the mains) obtainable in the poorer portions of the parish, has often been found
to contain much too great an amount of oiganic matter to be safely used for drinking without being
pre\'iou8ly boiled or filtered.
Contamination of the company's water in passing through unclean water-butts, cisterns, and tanks
is a great evil throughout the district, as is also the want of water for closet flushing, and the Sun-
day's supply, especially to the houses inhabited by the working classes.
Numberless closets exist without any supply of water whatever ; and even where it is laid on, it is,
in many cases, in such small quantities as to be all but useless to float away fscal matter firom drains
into the main sewer ; hence the worst nuisances are continually arising.
The Board of Works of the Wandsworth District have been urged by the medical stafiF to employ
all their influence to obtain a constant supply of the company's water, and if this cannot be accom-
plished, to adopt, during the continuance of the present epidemic, the stand-pipe system wherever
practicable.
August 27, 1866. R. Hakland WmxBMAN, MJ)., L.II.C.P.E.
The Health Officers on the Water Supply ^ Sfc. of their Districts. 175
Streatham.
1. This district is supplied with water by the Lambeth Waterworks Company. I have analysed
the water from several wells, but have found only the minutest quantity of organic matter, and have
not thought it necessary to close any pumps as yet.
2. The district is supplied by one company.
S. The spring, artesian, and well water of this district is very " hard," contuning a great deal of
lime, and is unsuited for some forms of dyspepsia and for constipated habits of system.
4. There has not been a case of cholera.
Dianrhcea has not been very severe, and the only fatal case (in a child) that came under my
observation may be attributed to a misplaced dose of castor oil, given without medical advice.
Auffust 31, 1866. D. C. NOEL.
Camberwell.
1. The water supplied to Camberwell has been analysed monthly for some time past by Dr. Bemays
<yf St. Thomas's Hospital, and the result of these analyses have accorded, as nearly as possible, with
those published monthly by the Registrar General, so that there is no need to quote them. Com-
plaints, I need scarcely say, are conmion with regard to insufficient supply ; in many cases these turn
out to be due to the want of a Sunday supply ; m some cases to smaUness of water receptacles, and
in some cases to purely accidental causes. Complaints too are occasionally made as to impurity of
water ; the impurity, on investigation, turns out to be frequently due to uncleanly condition of water
receptacles, sometimes to local conditions connected with the pipes, and now and then I believe to
imperfect filtration on the part of the companies. No special complaints have arisen since June last.
2. Camberwell is supplied by three water companies, the Lambeth, the Southwark and Vauxhall,
and the Kent. I have never observed special unhealthiness or mortality to arise amongst any one of
the three sections of the population ^mished by these several companies. The Kent Company
supplies a comparatively small portion of the parish only, that, namely, abutting on Deptford.
3. There is stiU. a good deal of well and pump water used throughout the parish, though of late
years the number of wells and pumps has greatly diminished. I have no facts showing the ill efi^t
en health of these waters.
4. Cholera has not prevailed largely in the parish, and although in the begging of the epidemic
more cases occurred in Camberwell than in any of the other southern districts, the cases had some-
tlung of a sporadic character, that is to say, the affected houses were scattered irregularly over the
parish, and the disease did not spread from them to their neighbourhood. Some of these cases (one
or two) were distinctly imported cases, and some occurred in respectable houses where there was no
apparent samtaiy defect. There has, however, during the last week been a distinct outbreak of the
disease in a place called Stockwell-street (Old Kent-road). Since yesterday week there have been
there 9 or 10 cases of cholera, and 6 or 7 deaths. The houses in tins street are occupied for the most
part by low Irish, are generally overcrowded and in bad sanitary condition, yet they have water laid
on, and are for tibe most part more or less perfectiy drained. The first death (that of a gardener>
took place yesterday week in a house occupied in tenements. One of the families at once removed
to another house two or three doors off ; one of this family, the mother, with a baby at the breast,
died of the same disease within the next two or three days. Since then another death has taken
place in the first-named house, and another (not fatal) case in the second-named one. Since then
two other cases and other deaths have occuired in two or three neighbouring houses on both sides
of the street.
The water whieh the people drink is supplied by the Kent Company, but it should be added that
this water is also drunk by poor people in neighbouring streets and by the inhabitants of the neigh-
bourhood generally, and that there has been no suspicion of cholera in any part of the district but
this street.
I may point out that this street very closely adjoins Deptford, that part of South London (Dept-
ford, Greenwich, and Rotherhithe,) in which, if anywhere in the south, the disease seems to have
l>een prevailing epidemically. Most of this part is no doubt supplied by the Kent Company, but it is
also largely connected with shipping interests, and included in the port of London.
September 1, 1866. J. S. Bristowb,
Rotherhithe.
1. Botlieiiuthe is supplied with water by two companies; the upper or western district, by fiir
the mo8t pc^polous, by the Southwark and Vauxhall Company. The water is generally of good
quality, but the supply is scanty, and since June last many complaints have been made of this defi-
cicBcy. During the present epidemic these complaints have been most numerous in the humblest
and poorest parts of this parish.
The lower or eastern district receives its water from the Kent Waterworks. The quantity and
quality ia eirerything that can be desired.
2. Thae have not been above 25 deaths from cholera and diarrhoea in this parish since the
begimung of the psesent epidemic, and they have been scattered in different localities.
178 The Health Officers on Preventive Measures ^ ^
3. The Medical Officers of Health on the Preventive and other
Measures adopted in their Districts.
The Registrar-General addressed the annexed circular to the London Medical
OflBlcers of Health on October 20th : —
The Medical Health OflScers of London will receive daily the Eeturn of Deaths
from Cholera and Diarrhoea in their several districts.
The Registrar-General will feel obliged if they will, for the public information,
furnish brief replies to the annexed inquiries.
The Registrar-General will be glad to receive their replies as early as 10 o'clock,
by post (unpaid), on Monday morning for publication ; and he will be further
obliged if they will forward similar returns for publication on every successive
Monday morning so long as they receive the daily returns.
This will satisfy the public mind that no exertions are spared by the respective
local authorities to stay an epidemic which keeps the whole of the metropolis in a
state of alarm.
!• What is the number of medical visitors and nuisance inspectors employed
in your district ? Are they imder your control ?
2. What steps are taken to secure the early treatment of diarrha*a ?
3. What measures are employed to disinfect or destroy chemically the dejec-
tions of cholera patients ?
4. Is every house in which a cholera patient is attacked visited, and is the
disinfection of beds, linen, &c. carried out under inspection so as to
secure its efficiency ?
5. Are the linen and beds destroyed immediately replaced by the authorities .
6. Have you anything to remark generally in connexion with the bygiemc
state of the houses in which deaths from cholera were registered last
week ?
The following replies were printed in the Return No 42 f(^ ^ Week ending
October 20th. ' '
ISLINGTOX. ^^ ^^^^ ,,e6^
We have had hei^ independently of the cases of "cholemic diarrhcBa,'' ««^^^^f !^^nt til^.
(reported to me), 105 cases of fuUy developed cholera, of which 62 have diea ^P.^^^!^ of cholera
Nine of the cases returned to me as " choleraic diarrhoea " wer»» fatal O^ ^^ ^ on the
happened on July 23d, and on the 27th there was an outburst of 'i c^es 5 nio« I^T^ Mid 9
2Sth. 3 on the 29th, 5 be^een this date and the 1st of Au^t, 8 ca^Toa tUe 1st af_ fu^^ ? per
T.t'TZf:ZT^^^^^^^^^^ ."^^a^r^, -es have nu
180 The Health Officers on Preventive Measures, ^
extremity opposite this the end house in Henij place ; had rubbish remoYed, being the second out-
break in this house ; immediately cleared the house of inhabitants, finding them accommodation and
support elsewhere ; all clothing left in the house, bedding, &c. (except cholera bed) disinfected with
Burnett's fluid ; cholera bed, soiled sheets, &c. soaked with carbolic acid and then burned ; a choked
up drain in narrow backyard ; cleared drain and closet of this and all houses in this and a^oining
streets (similarly occupied); disinfected daily with carbolic acid ; walls, ceilinga, and floors eyery-
where wetted with carbolic acid and water, and windows all thrown open for seTcral days ; lime-
whiting throughout ; other work, and cleansing of water-cistern, yet to be done ; house-to-house
medical visitation daily for a week. No fresh case, except that the woman who attended to the
patient before removal to hospital has had an attack of choleraic diarrhcea.
Wife of a van driver, 46 years, choleraic diarrhooa (3 days), died October 14th, at S6 Sydney-street,
York-road. — Patient was a cleaner at the London Fever Hospital, and is supposed to have acquired
the disease there, cholera patients being received into a special ward ; the house generally dirty ;
area undrained; drains in yard not trapped ; waterbutt not covered, and situated in a wash-house
close to the privy, which is also in the wash-house ; a pony has been also, till just recently, kept in
a shed at the side, so that the water had abundant opportunities for 'gaseous and other defilement ;
butt cleansed by my own officers and disinfected with quicklime, ordered to be removed into a better
situation, and covered, and cleansing of house and trapping of drains, &c to be carried out forth-
with ; bedding and sheets, which were much soiled, soaked with carbolic acid and burned ; floor of
room saturated with carbolic acid, and walls ordered to be stripped of paper and limewhited ; room
in the meanwhile closed.
A death from cholera having occurred in Cock and Castle-lane in Hackney, immediately a^jmning
upon a part of Islington occupied by a low population, I have had all the privies and house drains
in that neighbourhood disinfected with carbolic acid.
Female, 28 years, cholera urtemia, died October 1 4th, at I Brand street — This street sufiTered
most severely in former epidemics ; this was the first case in the street fi^m cholera this year.
Removed the patient in an early stage to London Fever Hospital, where she died, nnemic ; no pre-
disposing conditions discoverable in the house (a two-roomed lean-to) or premises. Rooms had
been repaired and whitewashed during the year under notice from our office. Removed the healthy
members of the family into lodgings, and cleared the house ; saturated walls and floors of infected
room with carbolic acid and water, and put windows of both rooms wide open for aeration for
several days; soaked bedding with carbolic acid, and then burned it; bedclothes, Sec and bed
furniture disinfected with Burnett's fluid ; house now being limewhited and cleansed by owner under
Sanitary Act
Wife of a labourer, 47 years, Asiatic cholera, 36 hours, died 14th October, at 3 Queen's-road. —
Saw the patient soon after seizure, but being cold and pulseless dared not remove her ; set a nurse
to attend to her, and keep away the people whom I found flocking into the room ; on occurrence of
death had the body removed speedily to dead-house. Room let fiumished ; landlord willing to do all
that is necessary ; house had recently been repaired under notice from our office. Cistern over privy
had been cleansed some weeks previously, but being old, out of repair, and lined with zinc, speedily
reacquired impurities ; new cistern ordered to be put up ; bedding, sheets, and pieces of old carpets
and rags soaked \i'ith carbolic acid and burned ; articles of clothing upon the bed, blankets, and
coverlet and bed furniture disinfected with Burnett's fluid and left to be washed ; floor smeared with
carbolic acid and water, and window thrown open for aeration ; landl •>rd has stripped paper off the
walls, and limewhited with limcwosh containing a cup full of carbolic acid to the pail of wash.
Queen's-road and Brand-street lie together in a very low neighbourhood, which was put at once
under medical house-to-house visitation, and privies and drains throughout the district disinfected
daily for some days with carbolic acid.
FULHAM.
October 20th, 1866.
1. There are six medical visitors and four inspectors of nuisances, and they are all under my
control.
2. Prompt treatment by medical visitors.
3. The free use of Condy's fluid, chloride of lime, and carbolic acid,
4. The house is visited, and disinfection carried out
5. Linen and beds destroyed are replaced by authorities.
6. A death registered to-day occurred in a house immediately adjoining a large open creek in the
centre of the town of Hammersmith. Two other deaths occurred in August a4)oming this creek,
which is always in an offensive state. It is a tributary of the Thames, and is under the jurisdiction
of the Metropolitan Board of Works. A considerable quantity of sewage flows into it
I may state, that although the existence of this creek in a sanitary point of view is excesnvely
objectionable, I am of opinion that the existence of cholera in the Fulham district depends mow on
atmospheric than on local conditions. Whilst expressing this opinion, I also believe that the spread
of the disease has in each locality affected received a palpable and evident check from the samtary
regime now in operation here,
Fjledebick J. BUROB,
Medical Officer of Health. •
The Health Officers on Preventive Measures ^ ^c 181
St. George Hanover-square,
Octolfer 20th, 1866.
I. No addidonal medical visitors have been appointed at present, but Dr. W. Bloxam, one of the
liarochial sargeons, attends the patients taken to the special Cholera Hospital provided at Ko. 8
Hereford* street, Park-lane, where only 3 cases have been received. Upon the adxnission of a patient
he immediately communicates with the medical officers of health, who cause a sanitar}- inspection of
the patient's residence to be made. Six nuisance inspectors (now reduced to four) have been
appointed, and are under our control.
2. A house-to-house visitation has just been completed throughout the parish, and bills, one of
which I enclose, have been distributed by order of the local authority, cautioning the inhabitants as
to the best measures to be adopted when any person is attacked with diarrhoea. Two wards are
appropriated at St George's Hospital for the reception of cholera patients, and diarrhoea medicines
are administered to out-patients on application. Tliese are also given to applicants at the St George's
and St James's Dispensary situate in the in-wards, at the lioyal Fimlico and the St Paul and
St Bamabaf Dispensaries, both in the out-wards. These precautionary measures were adopted, bat
the number of patients has hitherto been so limited that nothing further is needed at the present time.
J may add that the vestry clerk, Mr. Chappell, has addressed circular letters to aU legally qualified
medical practitioners in the parish, requesting information as to the presence of cholera or unusual
amount or severity of diarrhoea; and that the four parochial medical officers, Drs. Symes and
W.^ Bloxam in the In-waids; and Drs. Griffith and Webb in the out-wards, attend without orders all
cases of cholera or diarrhoea that are brought before their notice.
3. Carbolic acid and Condy's fluid are used as disinfectants.
4. Every house in which a cholera patient is attacked is visited, and disinfection is properly
carried out
5. No application has been made to the authorities.
6. The only death registered last week was that of Amelia King, aged 11, a school girl residing
at No. 3 St GeorgeVrow, Pimlico, who was admitted into St. George's Hospital suffering from
cholera at 3 vjf. on 9th October, and died at 4*45 p.m. On Monday the 8th October she purchased
a quarter of a peck of apples and ate them all ; cholera supervened. The house was clean.
C. J. B. Aldw, M.D., MJi., F.R.C.P.,
Medical Officer of Health.
St. Martin-in-the-Fields.
October 20th, 1866.
1. Two medical visitors have been appointed, bat have not been called into action, the cases of
cholera not having been in number sufficient to render it necessary. I have one medical inspector
and one sanitary inspector both under ray control.
2. Three dispensaries are established in different parts of the parish for the gratuitous administra-
tion of medicine in cases of diarrhoea. 1330 cases of diarrhoea have been treated, besides a very
large number at the Charing Cross Hospital.
3; Chloride of lime and carbolic acid, liquid and powder, have been freely used, and supplied
gratuitously wherever disinfectants have been required.
4. Every house in which cholera has occurred has been visited, and the disinfecting of beds, &c.
has been efficient, since there has been no instance of the spread of the disease to any attendant or
resident in the house beyond those who were originally attacked.
5. Beds and linen and clothes have been burned in the three instances where the disease has
occurred, and have been replaced with new ones by the authorities.
( 6. We had no death fimn cholera last week. Of parishioners we have had altogether four deaths,
and all snce the m:ddle of September.
LiONKL J. Beale,
Medical Officer of Health.
St, Giles.
October 2Ut, 1866.
In tfast district a very effectual house-to-house visitation was established, and dispensaries
were open day and night for the detection and treatment of cases of diarrhoea. Latterly, however,
dianliflea has almost, disappeared i^m St Giles's, and these arrangements have accordingly been
given up.
In every case of cholera or choleraic diarrhoea, disinfectants, with a paper of instructions for their
use, are fiberally supplied ; and at the Cholera Hospital every discharge from a cholera patient is
instendy disfaifiectedL
Kveij house in which a cholera case occurs is visited by the medical officers and sanitary inspectors
of this Board. Every room in which a cholera patient has lain is thoroughly cleansed and disinfected
by thetervants of the Board, and the privies, drains, and dust-bins are similarly dealt with. ^ AU
*~*^^'^ ef bedding or clothing soiled by cholera discharges are destroyed, and only in exceptional
dinnfected ; and all this action is efficiently done.
and beds destroyed are immediately paid for, or in some few cases replaced by the
aatfaoriliei.
182 The Health Officers on Preventive Measum, f^
The great majority of cholera cases occuning in this district have heen removed, to the SheLtoo
Hospital near St Giles's Church.
Upon recent inquiry, it appeared that out of twenty instances, where 'the first cholera case had
heen so removed, cholera had attacked a second person in the same house once only ; whereas in
some fourteen instances where the first patient was not so removed, it had happened seven times
that a second or a third person was attacked in the house, in spite of all the dismfection that could
be done by the authorities.
George BucsAnA^r,
Medical Officer of Health.
Whitechapel.
October I9th, 1866.
The information contained in the daily returns of deaths from cholera is attended with this
beneficial result, viz., that it enables me to send a qualified medical practitioner. Dr. Duke, to visit the
house where a death is recorded, and to destroy die clothes and bedding of the deceased, and to
inquire into the sanitary condition of the house and locality, and to ascertain the existence or other^
wise of diarrhoea in the neighbourhood.
John Liddlb,
Mescal Officer of Health.
Newington.
October 2Uth, 1866.
1. The extra out-door staff consists of five non-medical sub-inspectors (4 employed in daily house-
to-house visitation, and one whose duty it is to ascertain how &r the suitaiy orders have been
carried out) ; also one water-butt cleaner.
They were all engaged by me, and are entirely under my control.
2. 10,000 bills were distributed throughout the parish iz^orming the inhabitants that medicine for
diarrhoea and chloride of lime could be procured at any hour, day and night, at the dispensazy by the
workhouse, and at the residence of each jof the four parish surgeons. Medicine was also supplied to
all the public schools wherein the children of the poor were taught
3. Disinfectants are freely supplied.
4. Every house in which a cholera patient is attacked is visited by myself as soon as possible after
I receive information. I endeavour to make the inmates understand the object and method of dis-
infecting, and from time to time inquire as to how it has been carried out. The cases in Newington
have been but few.
5. Linen and beds destroyed are replaced by authorities.
6. No deaths occurred in the week ending October 30th from cholera.
Wm. Tiffin Iuff, MD.,
Medical Officer of Health.
The following replies from Health Officers were printed in the Return^ No. 43,
for the Week ending October 27th,
Kensington.
25th October 1866.
1. The number of medical visitors for the past ten weeks has been three, with two qualified
medical gentlemen to act under them, and not living in the houses of the medioil visitors. Notting
Hill Dispensary and Kensington Dispensary have also agreed to attend diairhoea and cholera
patients both day and night, for which they receive remuneration by the vestry; they are under
my control.
2. In addition to this, several chemists' shops have been open where medicine can always be
procured gratuitously both by day and by night, the whole medical staff being also in constant
attendance.
3. Very large quantities of carbolic acid, both in liquid and in powder, are freely distributed at all
the stations, where any one who applies can have it gratuitously. These measures are fully carried
out by the sanitary staff.
4. Every house is visited as soon as a case is reported, and all the beds and linen disinfected and
the place thoroughly cleansed and limewhited.
5. ITiere has been no occasion to have the linen or beds destroyed, but the vestiy have given me
full power to do so if found necessar}*, and they ^rill immediately replace them.
6. The mortality from cholera and diarrhoea has been low. In the few cases that happened,
the houses were cleansed. No case of cholera was registered last week. I may add that all nuisaQCeft
The Health Officers on Preventive Meaeures, ^e. 183
requiring immediate removal have been executed at the expense of the authorities, that every mews
has been by their direction regularly flushed, quantities of perchloride of iron thrown down the
sewers, and chloride of lime down the gulleys.
Francis Godrich,
Medical Officer of Health.
Chelsea.
As soon as the prevalence of diarrhcea and the occurrence of one or two decided cases of cholera
indicated the presence of the epidemic in the parish, a staff of medical visitors, which had been
previously oiganized under my direction, was set in motion to prosecute a daily house-to-house
visitation. It seemed to me that the disease would be more effectually brought under control and
more quickly checked by a large number of persons acting in concert and searching out its haunts,
than by a smaller number occupied during a longer period and only visiting places known to be
infected. Five superintending visitors and ten assistants were therefore employed, and worked under
my direction so long as cases of cholera occurred.
At the same time nine dispensary stations were opened, and were placed in direct conmiunicatlon
with the medical visitors.
After cholera had ceased in the district, the dispensaries were still kept open some weeks longer,
and an engagement was entered into with the parochial medical officers to undertake any case sent
to them from the dispensary stations, at the expense of the vestry.
Prior to the appointment of the visitors a staff of workmen was engaged, who were employe!
daily in deanong privies, water butts, yards, and cellars, and, when necessary, limewashing both
the outside and inside of the houses of the poor.
Three of these acted as foremen or sub-inspectors, one of whom had special charge of the
cleannng of dustbins, a daily report on this subject being made separately by him to the sanitary
committee. The latter officer and a gang of three men with their foreman are still employed.
In addition to their daily work a portion of this gang was employed, whenever a case of cholera
occurred, to disinfect the whole interior of the house ; and by them all bedding and clothing likely
to be infected by the discharges was destroyed, under the onlers of the medical visitors and the
snperintendence of the chief inspector. The articles destroyed, or their value in money, was in
every case made good by the vestry.
I believe that the effect of these precautionary measures has been fully appreciated in tha
parish, and it is gratifying to be able to report that we are at this date entirely free from the
epidemic.
The two chief mles adopted, which differed I believe from those practised in many other parts
of the metropoUs, were : 1 . That the assistants should make inquiries as to the presence of diarrhcea
in every one of a list of streets, courts, and alleys furnished to them by me, once daily. 2. That
the dispensers should nve only one dose of an astringent to patients personally applying, and then
Bend them on to the visitor, furnishing him also with a list of the names for further inquiry.
A. W. Babclat, M.D.,
Medical Officer of Health.
St. George Hanover-square.
' October 27th, 1866.
The fruit hawker, whose death at St George's Hospital from cholera was registered 30th September,
came firom 31 Ihidley*8treet, Soho ; he was taken ill in Piccadilly in the afternoon.
During four weeks, ending 20th October, only five deaths occurred from diarrhcea in the parish
of St George Hanorer-square, the same number as in the corresponding period of last year.
C. J. B. Aldis, M.D., M.A., F.R.C.P.,
Medical Officer of Health.
West^uxster.
October 2Gth, 1866.
1. There are three medical visitors and three inspectors of nuisances in my district under my
coQtroL
2. Notioea are issued all over the parishes that medicines and attendance are furnished gratuitously
by the medieal visitors' dispensary and hospital.
S. The free nse of Condy's disinfectant and carbolic acid.
^» Evay house is immediately visited, and the disinfection, &c. is carried out by the district
mspector under medical supervision.
5. The lixieii and beds are either immediately replaced with others or are paid for by the Diseases
Pverentisa Committeei
B. Holt,
Medical Officer of Health*
184 The Health Officers on Preventive Measures, ^e.
Mabtlebone.
OeioUr 22d, 1866.
1. Eight medical visitors have been appointed by the health committee to take charge of cholera
cases in this parifih, but ih>m the paucity of cases their serv'ices have not yet been call^ into active
requisition ; most of them, however, have attended cases of diarrhoea.
Such cholera cases as have occurred have been attended — Istly, by private practitioners ; 2dly,
by the parochial medical officers, of whom there are five ; Sdly, in the iron cholera hospital in
Capland-street ; and, 4thly, at the Middlesex Hospital.
There are four inspectors of nuisances, two of whom are only temporarily employed. These
officers are under my control.
2. In each of the six districts of the parish a dispensary for the gratuitous treatment of diarrhoea
cases was appointed. These remained in operation from the 4th of August to the 6ih of the present
month, when, in consequence of the great decline of the disease, they were closed by order of the
health committee. Upwards of 7000 cases of diarrhoea were treated in this way, and in one
instance only, as far as I was able to ascertain, did the disease run on to cholera.
3. The dejections of cholera patients are disinfected by carbolic acid, which is gratuitously
supplied to and freely used in all houses where cholera is known to exist.
4. Every house in which it is known that there is or has been a patient suffering from cholera
is visited, and its sanitary condition carefully inspected. All the walls, ceilings, &c. are thoroughly
cleansed and whitewashed by parish workmen, in accordance with my reconmiendations, and under
the personal superintendence of one of the inspectors of nuisances. AH linen, &c. is disinfected by
being immersed first in boiling water, and afterwards in a solution of carbolic acid or chloride oif
lime ; beds, bolsters, and woollen fabrics are destroyed by fire.
5. All linen, beddmg, &c. destroyed by my order is either replaced or paid for at its fnll value by
the vestry.
6. Two deaths occurred last week in the front kitchen of a house No. 14, Sufiblk-place, Lisson-
grove, in which a man, his wife, and three yoimg children lived. The place was filUiy toty, and
too small for the number of inmates. Si^olk-place forms part of a densely populated district
inhabited by the poorest and most destitute classes in the parish. The habits of a large proportion
of them are very dirty and depraved, and it requires the most unceasing vigilxmce to keep their
rooms, closets, yards. &c. in anytlilng hke a proper sanitary state.
J. Whithorb, M.D.,
Medical Officer of Health.
Pancbas.
October 2^ 1866.
1. There are six medical visitors and four nuisance inspectors in St. Fancras, aU acting under
my direction.
2. A number of dispensaries have been opened, 24 in number, where persons suffering firom
diarrhoea can at once obtain medicine, or an onier to see one of the medical visitors.
3. Where cholera or choleraic diarrhoea is known to exist, the friends of the patients are suppUed
with M^Dougars powder, and instructions how to use it. A man is employed to disinfect and
flush the closets and sinks, and to clean oiit the water butts when necessary'. The main sewer of
any street or place in which cholera prevails is specially flushed and disinfected with carbolic add.
4. Every house in which a cholera patient is attacked is visited, and the disinfection of beds and
linen is carried out by my directions, under inspections of one of the sanitary officers. When beds
are soiled, they are burnt by one of the inspectors of nuisances.
5. The linen and beds destroyed are replaced by the Vestr}*, so soon as it is safe to do so iritliouj^
the risk of firesh infection.
6. Of the deaths that occurred in St Pancras last week, 3 were from badly drained houses* and
one was from a kitchen unfit for occupation. In every case the drainage will be set to rights as
soon as it is prudent to disturb the old drains ; in the meantime the drains wDl be daily disinfected
with materials supplied by the Vestry. Owing to the extreme difficulty in finding lodgings for the
poor, it is impossible to enforce all the requirements of the sanitary' Acts as regards underground
kitchens and overcrowdbg. So far as practicable, the requirements are enfor^d. Many of the
cases of cholera have been brought on by intemperance, and a considerable number by unwhole-
some food.
Thomas Hiluer, M.D.,
Medical Officer of Health.
Hampstead.
October 30lk, 1866.
1. Two additional inspectors of nuisances have been appointed in this parish, bat no medical
visitor, as no cholera has arisen in this parish.
2. Placards have been issued, stating where any suffering from diarrhoea may promptly apply.
This facility is in addition to the ordinaiy aid given by parish and dub doctors and by the
dispensary.
3. Carbolic acid, M'Dougal's disinfecting powder, and Condy*s solutloo.
The Health Officers on Preventive MeaiureSy Spc. 185
4. Only three cases of cholera appear to ha\'e ended fktally in the parish ; they were all imported.
In each instance disinfectants, and burning contaminated bedding and linen, were properly adopted.
5. See above for this parish.
6. Hitherto no case has occurred among a class of society requiring such aid ; bat should it arise,
the authorities in Hampstead will fully meet the demand. Those who have hitherto had the epidemic
cholera have resided in very healthy situations, and been surrounded with all the supplies which
hygienic care could desire.
Chaslks F. J. Lord,
Medical Officer of Health.
Islington.
Measures adopted in regard to recent Chokra eases,
12. AlmaHerrace. Woman taken ill on October 15th ; visited the same evening by medical
visitor who induced her to go to hospital, and used M^DougaPs powder about room and premise^,
and closed the room. On the. next morning, bedding and soiled carpet disinfected with carbolic
acid, and burned ; other articles on and about bed soaked in Burnett's fluid, and left to be washed.
House clean and tidy. Floor of room soaked with carbolic acid. Privy and drains of this and
adjoining houses di^nfected with carbolic acid. Water receptacle cleansed by our own men, and
disinfected with lime. [This death was recorded in Supplement to Weekly Return, No. 42.] House-
to-house visitation daily for some days. No fresh case. .
16. Albert-terrace, QueenVroad. Case discovered by our medical visitor on October 15th.
He sent patient to hospital, and brought roe the key of room. Visited house the same day, and
saw soiled flock bed damaged with carbolic acid, and it was burned in the evening. Other articles
disinfected with Bomett's fluid. House had recently been cleansed and repaired under directions
from our office. Privies of this and adjoining houses disinfected with carbolic acid. House-to-house
visitation. No fresh case.
Edwahd Ballard, M.D.,
Medical Officer of Health.
Hackney.
October 22d, 1866.
1. There are five medical visitors, to be reduced to three this day. There are also one chief
sanitary inspector, partly under my control, and four sub-inspectors entirely under my control.
One sub-inspector is chiefly employed in disinfecting the clothing and bedding of cholera patients,
and the houses in which they lived ; attending to their removal to hospitals, and burning the beds,
pillows, and mattrasses.
"2. Medicines and attendance can be had gratuitously at several surgeons' houses; and the
localities in which cholera has appeared are fi^quently inspected by inspectors and members of
cholera committees.
3. The use of Bumett*s fluid. Bottles of Burnett's fluid are supplied gratuitously to the poor for
this purpose.
4. Every house in which a cholera case occurs is inspected immediately a return is made to me ;
the house is thoroughly disinfected with the London Sanitary Company's disinfecting powder-|
Oondy's fluid used in the sick room ; the linen and other clothes disinfected by the distnct officer,
and the beds and pillows burned. The closets and drains of the adjacent houses are also generallj[
dinnfected with carbolic acid.
5. The value of the property destroyed is paid to the owners at the time. The property is
valued, and the vahiation ticket brought to me, and I pay the amount out of money .which the
sanitary- committee have placed at my disposal for that purpose. New beds can therefore be bought
by the owners without delay.
6. Two deaths occurred in one house in Castle-street, which was about to be closed, and in which
the occupier had some stinking rabbit skins.
John W. Tripe, M.D.,
Medical Officer of Health.
HOLBORN.
October 22d, 1866.
1. We hsve had four medical visitors and three inspectors at work in this district, but some three
weeJks sbiee leduoed the number to two medical visitors and two inspectors. They act under me.
S. In addition to the dispensaries of the four medical visitors, the Board of Guardians instructed
thtff fiofor pedicml officers to dispense diarrhoea medicine to all applicants.
3. Cidxilio aeid, in powder and solution, is supplied gratuitously at all the dispensaries, with
diiee^QiMiloriise.
4. £f«3r house is at once visited, and no one is allowed access to the chamber in which a death or
lemofil flpom cholera has taken place until every article of bedding, clothing, &c. has been inunersed
in a miztnre of b<»ling water and carbolic acid, by men in the employ of the Board, under my
186 The Health Officers on Preventive Meaeures, fftm
personal supervision. I attach the greatest importance to this measure, and I maj saj we have never
had a second case in the same house.
5. The beds, if made of flock or straw, are subsequently burnt, the leas being recouped to the
owner. Linen and feathers are washed and purified, and restored to the owners.
6. As to Vine-street, where many cases of cholera have occurred, I wrote at follows to my Board
last week : — " Fortunately the disease has been pretty much confined to Vine-street, which is a
'* wretched 'cul de sac,' having several populous courts, as Lucy's-boildingt, Cotterell-place,
'* Munday's-yard, Omer-place, and Bedford-court, communicating with it In order to stay the
« disease your committee caused, at my suggestion, a stand-pipe, connected with the New Kiver
** Company's main, to be erected, so that the inhabitants could supply themselves with uncon-
^ taminated water, whilst the old water receptacles were cleansed or disinfected, or replaced by new
" ones."
At the house 15 Cross-street, Hatton-garden, where the wife of a wood carver, aged 27 years,
died of cholera (30 hours), the water-butt ^ as old and without cover, but the woman was in very
needy circumstances, having an invalid husband and two children to support, and went daily to an
infected part of Clerkenwell. She was seized whilst washing, but 1 have no proof that the clothing
was infected.
35, Baldwin's-gardens, where a death occurred on 14th October, is, with exception of dirt, in good
state. Patient seized after a Saturday night supper off mussels and gin ; kept a shell-fish stall in
Great Ormond-street.
Septimus Gibbon, M.D.,
Medical Officer of Health.
Clerkenwell.
October 22d, 18CC.
1. Four medical visitors, besides m3r8elf^ with the full power acquired by the Orders in Council
dated 21st July 1866. Two nuisance inspectors, partly engaged in superintending the scavengering
and watering of the roads. They are subject to my control.
2. The appointment of five stations, where remedies may be obtained at any hour of the day or
night.
3. The gratuitous supply of disinfectants by the medical visitors, the inspectors, and at the
vestry hall.
4. The disinfection of beds, &c. is not earned out under inspection ; the destruction by burning
is so. The houses where deaths have occurred are visited repeatedly until sanitaiy defects are
remedied, and until all sickness has disappeared.
5. The commoner articles of bedding, &c. are at once supplied, being kept in stock ; the more
expensive ones are supplied with as little delay as possible, within a day or two.
J. W. Griffith, M.D.,
Medical Officer of Health.
Eethxal Greex.
October 22d, 1866.
1. We have now only one medical visitor, and three nuisance inspectors. They are all under
my control.
2. We have closed our open dispensaries, and patients are referred to the district medical
officers.
3. We have ceased to employ a staff of disinfectors ; but where cholera is known to exist
disinfectants and directions are given for the chemical destruction of dejections, &c.
4. All houses where the disease has shown itself are visited j and beds, linen, &c. are disinfected
under inspection.
5. Beds and linen destroyed are replaced by the authorities.
Thomas Sarvis, M.D.,
Medical Officer of Health.
Whitechapel.
. October 2l8t, 1866.
VV e have now only one medical visitor and four inspectors of nuisances. They are entirely under
my control.
Kot only are the houses where cholera deaths have occurred Visited, but every house in which
fever cases are reported by the medical officers of the union to exist are likewise visited, and in
every instance notice is served upon the landlord to limewash the room if the patient die, or ia
removed to the workhouse or hospital.
JOIIK LiDDLE,
Medical Officer of Health.
The Health Officers on Preventive Measures, ^c. 187
St. George-in-the-East.
October 22d, 1866.
1. At present we possess one yery efficient sanitary inspector, and associated with him during the
late epidemic were an assistant and four others for flushing and didnfecting sewers and gutters,
and washing and limewhiting the courts and alleys. - The clergy and members of thdr congregation
undertook the visiting, and their services have been discontinued.
2. Four Poor Law medical officers attend to the medical wants of the parish.
3. Each medical visitor was furnished with chloride of zinc, and distributed by him for washing
out utennls and closets.
4. Tes. The beds, bedding, and very frequently the clothing of the patient are removed by two
of the parish officers, and consumed in a furnace (made for the express purpose).
5. Yes.
6. The last death that occurred was the son of a poor widow in the receipt of parish relief, and
the room was very dirty. There was an insufficient supply of water to the house.
J. J. Rtgate, M.B.,
Acting Medical Officer of Health.
Mile End Old Town.
October 20th, 1866.
Ist Owing to the cessation of the epidemic the medical visitors were discontinued on the
6th October.
2d. There is one permanent inspector of nuisances, and five sub-inspectors were appointed at
the oatbreak of cholera to make a house-to-house visitation of the hamlet, and report thereon.
These officers are not under my controL
3d. Dianfectaals are suppHed tree at all hours at the vestry hall ; this fiict has been freely
advertised, as also veeommendations and instructions for use.
4th. I personally viiit every house, upon receiving information of the presence of cholera, and
the necessary sanitary measures are adopted forthwith.
5 th. Eyery infected article of bedding, linen, or wearing apparel is destroyed forthwith, under
supervision if inspector of nuisances ; the articles are imme(Uately repUiced or money value given
by the authorities.
As early information if of importance, I think the district registrar should inform the medical
officer of health of any death from cholera as soon as it comes to his knowledge, otherwise much
time is lost.
M. Corker,
Acting Medical Officer of Health.
St. Olave Southwabk.
October 27th, 1866.
Two medical visitors were appointed on the first appearance of cholera ; but as the number of
cases has been mall, they have not been called upon to act. A plan was adopted for obtaining
from each of the medical practitioners in the district a daily return of every case of cholera or
di2UTh(sa wldich occurred in his practice. A very close supervision of the district is kept up by
myself and the inqiector.
Three plaoei were appomted where medicine might be obtained day and night for the treatment of
dianhcea ; and although it has almost disappeared from the district the arrangement still continues
in force.
Every home in vhich a case of cholera occurs is visited ; the room occupied by the patient,
with the WBteickMe^ dustbin, drain, and yard are freely treated with chloride or carbolate of lime.
In ease death tikes place the body is removed as speedily as possible to the dead house, the coffin is
filled up with sawdust well saturated with carbolic acid. In nemdy every instance the infected
beds and dothing have been soaked with carbolic acid, and afterwards burnt All articles destroyed
are imnefiately paid fbr by the authorities. The room in which death occurs is fumigated with
chlorine ; after being closed for some hours it is well ventilated, and thoroughly cleansed and lime-
washed.
The gencnl ntieasnres adopted throughout the district consist of fluslung the sewers, and washing
aU Ihe eonrti twice or three times a week with water mixed with some disinfectant, emptying the
pnhfie daitliinfl^ and sweeping the poorer streets every other day, lime-washing the courts and alleys,
wateriag fte streets with water to which carbolic acid is added, cleansing and disinfecting all the
iDxnala and gnOeja daily. Extra men are employed whose whole duty is to visit regularly every
kooae in Ae poocer localities, to supply disinfectants for use, and to apply some to the waterclosets,
itnm, sad dutbins. Especial attention is also given to the condition of all water receptacles.
These paumta stiU eontimie to be carried on.
Bang ibe week ending to-day three deaths from cholera have occurred in one family ; they
'vt remm siBtt ^m ehOdien of a labourer living at No. 47 Fair-street. They were aged 4, 7, and
1 1 JWM my e ttiycl y, and died within a few hours of each other at periods var}^ng from 6 to
14 Jbom after wdme. The family consisted of a man, wife, and six children, and occupied one
H tttt lop of tfie house, which on visiting I found tolerably clean, 'without any furniture
188 The Health Officers on Preventive Measure^ t^e.
except two chairs and a table ; no bed or bedding of any kind. I understand the parents are of
very drunken habits, the children were nearly half starved, pale, thin, and stunted in growth. On
examining the waterbutts, which are in the yard close to the dustbin, I found two clean and a third
dirty, with a number of maggots at the bottom. I was informed by some of the lodgers that the
two butts then clean also contained a quantity of maggots the day before, but had just been
cleansed. Two dogs were kept in the yard^ and it appeared that some of their food bad been
thrown into the dustbin, where the maggots were generated, and had then found th^ way into the
3ut8 from which water was taken for drmking purposes.
J. NOBTHCOTE VlKEK, M.D.,
Medical Officer of Health.
Bebmokdset.
The medical Officer of Health was preyented by illness from replying to die Begistrar General*^
inquiries.
St. George Soutetwark.
1 . Three qualified medical men were appointed as house-to-house visitors ; they were not in practice,
hence their whole time was devoted to the work. It was their duty to give in daily returns of the
number . and sanitary state of the houses visited, the condition of the occupants, axid to administer
medicines to such as were suffering from diarrhoea, &c. They were under my control.
2. A dispensary was established in the centre of the district, which was kept open day and
night ; any one who applied had suitable medicines given them ; also chloride of ume and carbolic
acid for disinfecting pnrposes. This place was closed on the 12th ins't. ; the number of applicants
having so far decreased, it was considered not advisable to keep it open longer. Should, however,
the necessity arise, the whole machinery' can be set in operation immediately. The vestry are now
trusting to their own inspectors, an additional one having been appointed previous to the breaking
out of the cholera. I may perhaps be allowed to add here, that a conmiittee was appointed, pursuant
to the order of Her Majesty's Privy Council, to carry into execution, &c., to which the full powers
of the vestry were given, so that upon any emergency they could meet and act This conmiittee
still continues.
3. Disinfectants and directions were given to *^ disinfect or destroy the d^ections of cholera
patients.*'
4. Every house was visited and disinfected, under the inspectors' and my own supervision.
5. " The linen and beds destroyed " are replaced as soon as the room or rooms have been
thoroughly cleansed.
6. The disease has attacked houses where the sanitary conditions have been good, and where
they have been bad ; where the occupants have been healthy or ailing, well-fed or ill-fed ; where
great care has been taken, and where no care has been taken. The only imperfection invariably
met with has been in reference to the water, as regards either its supply or receptacle. Nevertheless,
I do not wish the inference to be made that I think this is the sole cause of the attack.
Henrt Bateson, M.D,,
Medical Officer of Health.
Putney and Roehampton.
1 and 2. One sanitary inspector, in addition to the ordinary staff, has been app<mited for a short
period, to assist in discovering and reporting on nuisances, but no special arrangements at present
exist to secure the early treatment of diarrhoea, the services of the medical visitors having been for
some weeks past dispensed with by the local authorities.
3 and 4. Under my personal superintendence, disinfectants have been freely employed in all cases
of choleraic disease requiring the same, and all affected localities have been constantly \i^ted and
supervised by myself and the very active and intelligent inspector.
5. In the single case of cholera that has occurred in this parish, the linen and bedding destroyed
after the death of the patient by my directions was replaced by the authorities, or their value
allowed,
6. The only general remark I desire to make is, that the removal of admitted nuisances is here,
as I believe it is in most parishes throughout the metropolis, much too slow a process to meet the
requirements of either the Order in Council or the Sanitary Act of 1866. What appears to be
required is, more security that nuisances prejudicial to health, and calculated to engender and
pro])agute disease, shall not recur through a too careless and incomplete fulfilment of the object
soaght to be obtained. A make-shift measure of sanitation is much oftener an aggravant of the
evil complained of than a remedy for that evil, and this, I believe, is the experience of every health
officer in the kingdom.
The thorough inspection which the sub-district is undergoing cannot frul to be productive
of the greatest good. The authorities, I am pleaded to add, have been liberal in both their supply
TTie JSeaWi Officers on Preventive Measures, ^c. 189
of disiBiectaiits, &e. to the poor and in meeting the expenses consequent upon the exertions oi
their ofllcera.
The puhlic health of the parish continues favourable, and diarrhoea has ahnost ceased in the
neighboarhood.
R. HARLA2n> TVniTEMAN,
Medical Officer of Health.
Cambeiiwell.
October \^th, 1866.
\. We had had up to the time of the outbreak of cholera two inspectors of nuisances. At the
time of the outbreak two men were appointed ; we have now therefore four. It has recently been
determined that the services of the 4 inspectors shall be retained for at least another twelve
months.
We have not at the present time any medical visitation going on. As soon as possible after the
receipt of the Order in Council we nominated 9 medical men to act, in case of need, as medical
visitors. But we only have had (subsequently to their nomination) one epidemic appearance of
cholera in the parish ; this was in Stockwell Street. Immediately on the appearance of the disease
the medical visitor of the district in which Stockwell Street is was instructed to assume active
duties, and an assistant medical visitor was associated with him. Thirteen deaths from cholerr
occurred in this district, and rather more than a fortnight after the last deaths the medical visitor*s
services were suspended. All nuisance-inspectors, &c. are under my control
2. l^ine di^eiisaries (with one exception, the surgeries of the gentiemen nominated as medical
visitors,^ have been open for the gratuitous supply of medicines. Bills have been distributed
about the parish both to infi>rm parishioners of this fact, and to suggest precautions against
cholera.
3. CarboUc a^ and chloride of lime are supplied gratuitously at the dispensaries ; and in all cases
when cholera is known to be in existence disinfectants are at once provided by one of the inspactors.
4. Every house in wluch a cholera patient is attacked is visited ; and in nearly ever}' case the
bedding has been destroyed. Disinfection of bedding and destruction of bedding is done by or
under the eye of the inspector.
5. Everything thus destroyed has been at once replaced by the authorities.
6. There was only one death from cholera registered in tiie week ending Saturday October 1 2th.
The street in which the death occurred was only sewered about three months ago, and but few of
the houses are yet connected with it The house in which the fatal case occurred was not sewered.
Water is supplied by one of the companies. I believe there have been no deaths from cholera
dnring the week ending this day (Saturday 19th).
J. S. Bkistowe, M.D.,
Medical Officer of Ilcalth.
Charlton.
{See also pp. 201-205.) Ocioher 24th, 1866.
1. A medical visitor and an active inspector are appointed, both under my supervision.
2. A handbill has been printed, and circulated freely throughout the parish, advising the inhabi-
tants as to the precautionary measures to be employed in warding off an attack of diarrhoea, and
giving instructions as to the best measures to be adopted in arresting the first symptoms should
diarrhoea occur. Dep6t8 of medicine, suitable for diarrhoea, have been established in Afferent parts
of the parish, with a placard where it may be obtained. A letter has been addressed by the Clerk of
the Board, Mr. C A Smith, to all the medical practitioners in the district, requesting them to give
the earliest intimation of the existence of cholera or unusual diarrhoea.
3. The dfsmfeetaats which I have chiefly employed have been carbolic acid for drains, sewers, &c.,
and chloride of lime for articles of clothing, bedding, &c., which have been supplied gratuitously ,
and freely used by the inspector wherever occasion requires.
4. Up to tlus date tiie few cases which have occurred in our parish have been promptiy treated.
The houses have been immediately visited and effectually disinfected, and the bedding, if soiled, has
been imme^atdy burnt by the inspector.
5. AH articles that have been destroyed by the authorities have been immediately replaced.
6. Ko deaths from diarrhoea or cholera have occurred in this parish since October 5Ui.
KoBERT Finch, M.D.,
Medical Officer of Health.
Lewisham and Sydenham.
October 2\8t, 1866.
Upontihe fint appearance of diarrhoea in this district six medical visitors were appointed to hold
dRce for two mon^ ; one for so much of Blackheath as is contained in Lewisham parish, one for
Lewjahan village, one for Forest hiU, one for Upper Sydenham, one for Lower Sydenham and thft
village of Sm^head, one for the hamlet of Penge.
190 7%« Health Officers on Preventive Meoiuret, (fCk
During this period all the houses in the district inhabited by the pocnrer etoisei were inq^ected
(in some instances several times), and a moiety of them reported upon daily to the medical officer
of health, who gave written directions upon each item contained in these reports. Between 2,000
and 3,000 houses were thus visited, and orders made relative to tnem.
The two nuisance inspectors were (and are now) engaged in seeing these orders attended to.
An additional clerk was also appointed to assist in tabulating these reports, and take any necessary
action upon them. The medical officers appointments have now lapsed for the past fortnight, power,
however, being given to the medical officer to reappoint any or all of hem, withont previous appli-
cation to the Board, in case of necessitv.
The shops of all the chemists in the district (who would accept the appointments) were thrown
open to the public for the gratuitous supply of medicines and disinfectants, each one bong supplied
with formula by the medical officer of health.
Any case of cholera or diarrhoea was immediately attended to by the medical visitor, whose
prescriptions were dispensed at the chemists* establishments.
In ail cases of epidemic disease the directions given were, that a vessel contuning Burnett's
Disinfecting Fluid mixed with water should be placed in readiness outnde the house into which all
infected articles of clothing should be placed, immediately after removal firom the patient
Carbolate of lime was supplied to be placed in the vessels used for the reception of the dejections
of patients suffering from disease.
Infected articles of wearing apparel, beds, &c. were burnt under the inspection of the inspectors
of nuisances. A small kiln was erected upon a piece of land adjoining the cemetery for that
purpose.
The Board of Works hold themselves responsible for articles of wearing apparel thus destroyed,
the few cases of cholera not having been deemed sufficient to warrant the expense required for
erection of works for disinfecting linen, &c.
One death from choleraic diarrhoea was reported last week ; this occurred in an isolated hoose
which was in a bad hygienic condition, and to which the only supply of water easily obtainable was
£:om a pond.
F. E. Wilkinson, M.D., L.R.C.P., and M.R.C.S., &c..
Medical Officer of Health.
The following replies from Health Officers were printed in the Return^ No. 44,
for the Week ending November Zd,
St. George Hanoter-square.
November Zd, 1866. ^
In answer to circular of the 20th October, I beg to state that the reply given by Dr. Aldis
continues applicable to the present time, so far as the first five questions are concerned. I may
add, however, that the additional nuisance inspectors are employed, in aU cases of zymotic disease,
to disinfect the sinks, closets, &c., and to supply the inmates with carbolic acid for destroying the
dejections of the sick. For if this measure be useful in cholera, it may be useful also in whooping*
cough, scarlet fever, and typhoid, and the vapour of carbolic acid may have some destructive force
over these miasms.
In answer to question 6, 1 beg to give the following particulars as to a case of cholera reported in
Weekly Return No. 42. as follows : —
St. George Hanoner-sqfare ; Hanover^quare. — 8 Hereford-street, F^k*lane, 15th October,
charwoman, about 56 years, Asiatic cholera.
This woman was brought to the Workhouse, Mount-street, late in the evening of the 13th by a
chemist, who had been in attendance, and who came beforehand, and assured the master that she
had a ^^, and had not cholera nor any other contagious disease. So soon as she arrived, Dr. W.
Bloxam was sent for, and found her deep in the collapse of cholera. The street cab in which she
had been brought was therefore well drenched with carbolic acid, and the poor woman removed to
the cholera hospital, where she lingered till the 15th. The house in Old Bond-street, whence she
was brought, was found to have a very filthy and dilapidated watercloset in the back kitchen, the
stench of which, in the opinion of the inspector of nuisances, was enough to poison any one.
This house, like every other, had been visited by one of the inspectors ; but as their instructions
were, not to enter any apartment unless invited by the householder, this nuisance had not been
discovered.
In this parish there is some difficulty in getting intelligence of cases of cholera, if the patient be
not driven by necessity to seek parochial aid.
R. Deuitt.
TVitf Health Officers on Preventive Measures, ^e. 191
Hackney.
1. There are three medical visitors, four nuisance inspectors entirely under my control, and one
partially so.
8. Persons attacked with diarrhoea can haye medicines and attendance at any hour on application
to the medical officers appointed by the Board of Works.
3. Bumett*s fluid is given to the friends of persons suffering from cholera, to disinfect the
dejections.
4. Every house in which a cholera case occurs is visited unmediately, and disinfectants freely
used by die inspector; the premises ventilated, if the ventilation is bad, and all means deemed
advisable for preventing the spread of the disease. This plan has been adopted from the first with
the best results, and one inspector devotes his whole time, or nearly so, to these duties.
5. The linen and beds destroyed are paid for by the authorities on the day they are destroyed.
6. Nothing special to remark as to the hyg^emc state of the houses in which cholera occurred last
week.
JoiiN W. Tbite, M.D.,
Medical Officer of Health.
HOLBORN.
Measures adopted in regard to recent cholera eases.
The daughter of a cigar-maker (a Belgian), 9 yrs., "cholera (21 hours)," died 1st November at
10 Green-street This girl was seized whilst at school, where the sanitary arrangements are not
good ; but there had been no previous case of cholera. It was the national school belonging to
Trinity district parish. The girl was sent home at 1 1 a.m., 31st October. The parochial surgeon saw
her at once, and was unremitting in his attendance up to the time of her death, at 8 A.M. the following
morning.
Her twin brother, 9 years, was seized in the same school at 4 o^clock p.u. same day, and died at
10 Green -street the same night at 1 1 o'clock.
The bouse where these children resided is in clean and fair sanitary condition, but there is an old
and partly disused sewer running close at the back of it, in the rear of Great James street, which
the sanitary authority is unable to destroy, because three houses in Green-street cUum a right to
drain into it.
The water cistern (leaden) is placed at the side of the closet, and is imperfectly covered by tiles,
so that the droppings of several pigeons, which this Belgian family kept, could find their way into it
The only clue to the infection of these children which I can attach any credit to is the father's
illness. He, occupied as a cigar-maker in Cannon-street, has been confined to the house for 8 days
with *• obstinate vomiting " and '* partial obstruction of the bowels." He was of intemperate habits,
and the medical attendant attributed these symptoms to *' gastritis.*' Enemata, both nutritive and
purgative, were frequently given, and no disinfectants were used. In the absence of any other source
of iufection I am inclined to assume that this man's illness was of a choleraic nature, or that the
children actually drank from some vessel contaminated with (may be decomposing) faecal matter.
The man at present has all the symptoms of the fever which follows on attack of cholera.
The room, bedding, clothing, &c. in which these children died were at once disinfected with
carbolic acidl The corpses were removed for interment, after disinfection, within 12 hours after
death. After inmiersion in a solution of boiling water and carbolic acid, the sheets, blankets, &c.
were sent to be washed and the beds to be burned. The sick father was removed into an acyoining
room, and his evacuations were directed to be disinfected, which can only be done effectually by one
who understands the nature and action of the agent employed.
SspTiMcs Gibbon, M.D.,
Medical Officer of Health.
<#.v.<ft t'* %.
St. George-in-thb East, Middlesex.
Questions 1, 2, 3. Nothing to be added to last week's answers.
4. We have always recommended or enforced the speedy burial or removal of the body to the
deadhoose, so that in many cases the body has been removed the same day, and in the cases of more
well-to-do people the body has rarely, if ever, been imburied on the third day, and then lime and
sawdust have been placed in the coffin, which was properly screwed down. The rarity of such a
delayed intennent makes me thus well acquainted with such particulars.
5. Linen and beds destroyed are replaced by the authorities almost invariably within 24 hours.
6. As to the case at 12 Knight's-court, on 24th October, w. of lighterman, 5G years, cholera
(6 days), the house was quite clean ; there was no trap to sink, nor dustbin, nor water to closet
As to the case at 4J Green-bank, the house is next door to the dustyard and lay-stall, the subject
of complaint before the magistrate three times since September 1865.
On Uie two first occasions orders were obtained to abate the nuisance, and on the last an otd^T
to prohibit the recurrence of it was granted. This last order iraa api^eaie^ t^^^umsX \aAX^«^»^K) ^^
-a
192 SThe Health Officers on Preventive Measures, S^e,
the Quarter Sessions at Westminster, and the magistrate's order confirmed, subject to a case being
stated for the opinion of the Court of Queens Bench upon a point of law raised by the appellant
J. J. Ryoate, M.B.,
Acting Medical Officer of Health.
LiMEHOUSE.
October 27/A, 1866.
1. The medical visitors and nuisance inspectors, 12 in number, are now all dismissed, it not being
deemed necessary to maintain the hospital and extra etafif of officers, in consequence of the very
slight and occasional appearance of cholera and diarrhoea in this district.
2. The treatment of the epidemic, so &r ^s the poor are concerned, is now mider the medical
officers of the Stepney Union.
3. Orders have been given to the medical officers of the union by their board, to inform me of
all cases where disinfecting, &c. are necessary, when an officer under my directions will see to the
necessary steps being carried out.
4. All houses where cholera, &c. are found fall under prompt inspection.
5. The disinfection of beds, and the destruction of beds and linen, have been liberally effected ;
the same has been as quickly replaced. Nearly 300/. have been expended on this item idone since
July.
6. I beg emphatically to say that, apart from the exceptional cases, the great bulk of the cholera
deaths and those from diarrhcea have from the first followed in the train of the fever haunts ; that
the cholera field and the fever field arc convertible temis when the former becomes epidemic This
is principally owing to the gross defects of the Building Act, which permits houses to be built over
any filth, the flooring commonly resting on the earth, and the pestilential emanations from which in
a multitude of cases have largely contributed to the desolation of families by cholera, and at other
times by fever. I am speaking not of this alone, but neighbouring districts equally, or still worse
affected in regard to this point in the localization of disease.
TiioMAs Ortok.
Mile End Old Town.
Since my last communication 4 deaths have occurred in the hamlet, one at 23 Calverly-strcet, 2 at
27 James'-street, and one at 95 West street I immediately visited the cases and houses. All in-
fected articles of bedding and clothing were instantly destroyed under supervision of inspector of
nuisances ; the houses were all thoroughly cleansed, purified, and disinfected.
A death had previously occurred m the same house in Calverly-street, but both cases began
simultaneously. The last death was in West-street on the 31st October. No other cases have since
occurred in any of these houses, nor I believe in their locality, although the houses were oc<:upied by
large and poor families.
At 27 James*-street, I directed the remo\'Til of the occupants until the necessary sanitary measures
were completed.
M. COBNER, M.D.,
Medical Officer of Health.
Bow.
October 29M, 18G6.
The special arrangements made in this district during the recent epidemic are now terminated, but
that careful inquiries are made in all fatal cases of diarrhcea, cScc., and the necessarj- measures for dis-
infection, destruction of bedding, &c. are carried out when required.
W. T. G. WOODFORDE, ^LD.,
Medical Officer of Health.
St. OlaiVs Southwark.
November Sd, 1866.
I beg to state, that during the week no fresh case of cholera has occurred in the district.
The hygienic measures adopted at the commencement of the epidemic, which were detailed in my
return of the 27th ult., are still carried on with very slight diminution.
J. NoKTHCOTE Vixen, M.D.,
Medical Officer of Health.
Bermoxdsey.
/ A a soon as possible after the Order in Council was published the vettry deeted a BpecSal sanitaiy
^"Buaittee to meet daily, or as often as necessary-. The committee appointed two extra inspeeton
The Health Officers on Preventive Measures, 8fc, 193
of nuisances, and directed their medical ofl5cers of health to open a dispensary in a central position.
They also sanctioned the immediate appointment of four medical visitors by the medical oflBcer of
health, a dispenser, and an assistant medical visitor to assist the medical officer of health, to assist
the dispenser at night, and to attend to urgent cases at all times. The medical visitors were ex-
perienced medical practitioners ; the others were advanced medical students. The medical staff was
under the control of the medical officer of health ; the inspectors of nuisances were not.
The early treatment of diarrhoea was secured by a house-to-house visitation by the medical
visitors, and by the firee administration of medicine to all applicants at the dispensary. The dis-
pensary and the appointment of medical visitors were made public by large placards, which were also
sent to every factory in the parish. About 1 5,000 handbills were distributed from door to door,
contiuning the usual sanitary' warnings in respect to nuisances, food, water, &c. &c.
The medical visitors each received a copy of the Order in Council, with an explanatory letter
from the vestry clerk. They were empowered to employ nurses when necessary, at such remuneration ■
as they might think proper, reporting the name of the nurse and amount of remuneration to the
medical officer of health. They were likewise empowered to disinfect and destroy articles of
clothing, and from the dispensary disinfectants were furnished for the dejections of cholera patients.
The principal agent used was carbolic acid.
In most instances the disinfection of bedding was carried out under the personal superintendence
of the medical officer of health; sheeting/ pillows, and flock bedding were destroyed by burning.
Wet articles disinfected by carbolic acid, blankets by boiling water, and the room and furniture by
sulphurous acid.
All articles destroyed were replaced by the parish authorities, or the value given in money by
the vestry.
The extra medical staff are dismissed. The poor law medical officers mil be remunerated for ,
Immediate attendance on any cases they may be called to attend. In the event of an outbreak of
cholera the arrangements above described could be renewed at a veiy short notice.
i should add that the vestry, after the gullies had been properly trapped by the water carts,
employed labourers to disinfect them, and all urinals aud waste places, with a composition of lime
and carbolic acid. The yards, closets, and dust bins were also in some neighbourhoods disinfected,
and the small streets and courts watered with carbolic acid.
Wm. Parkeh, M.D.,
Medical Officer of Health.
Newington.
November 3d, 1866.
The extra services of the four district surgeons terminated October 31, but medicine for diarrhoea
may still be obtained at the workhouse dispensary and without an order. The visitation of the
houses in the parish continues ; about 11,250 have been inspected, leaving 1,330 to be seen.
I enclose a copy of the notice sent the next day to the visit, wherever sanitary work is required,
the pen being drawn through those portions of the order which in each particular house may be
unnecessary. Up to October 27th 7,441 orders have been made, included in 2,862 of the forms
enclosed.
We have every reason to be satisfied with the result
. Wm. T. Iuff, M.D.,
Medical Officer of llealtii.
Lambeth.
October i6th, 1866.
Ten district medical officers were appointed for house-to-house visitation, and to supply medicines
freely to cases of cholera and diarrhoea ; a medical visitor was also appointed to assist one of the
district medical officers, all of whom furnish daily returns of any cases of cholera or diarrhoea
arising within their districts.
I have entirely under my control three inspectors of nuisances, in addition to three sub-inspectors
who have been recently engaged by me for the purpose of more efficient house-to-house sanitary
inspection.
I have also a qoalified medical man temporarily to act wholly under my direction, who, as soon
at possible after receiving information, visits every house where cholera occurs, and sees that
disinfectants, gratuitously supplied, viz., MacDougal's powder and carbolic acid, are properly
employed. He examines the bedding and clothing, and causes the bedding, if infected with the
choleraic discharges, to be removed and burnt by one of the inspectors, and the clothing either
disinfected or destroyed. Thirty-six lots of bedding have been burnt, and fresh bedding immediately.
sappHed, in addition to which, articles of clothing directed to be destroyed are paid for by the
aothorities.
limewhiting every room in which cholera occurs is speedily effected, and after death every corpse
is removed as soon as possible to the dead-house previously to interment
Geoboe Puckle, M.D.,
Medical Ofli'ciw ^^^s^iJaDu
194 The Health Officers on Preventive Measures, jr^w
Battersea.
Nooemher Sd, 1866.
1. Kine medical visitors and two inspectors of nuisances were appointed on the 1st August, the
seivices of the medical visitors were discontinued on the 25th September; not under my controL
2. Notices were circulated throughout the district that advice and medicine could be had gratui-
tously by applying to the medical Msitors. llus privilege was withdrawn on the 25th September.
3. The medicu visitors were empowered to employ whatever disinfectants they thought fit
4. Every house in which a person is attacked is visited^ and the disinfection of beds, linen, &c.
carried out under inspection.
5. linen and beds destroyed are replaced by the authorities.
6. The houses were generally unhealthy, from defective drainage, overcrowding, datj habits, Kod
pig keeping.
Wm. Conkob, M.D.,
Medical Officer of Health.
I
Camberwell.
October 29ih, 16GB.
1st That during the last week the gratuitous dispensing of medicines has been discontinued;,
that this course has been adopted simply because during the last few weeks the number of applicants
for medicine has dwindled almost to nothing ; but that the dispensaries and other arrangements for
checking the spread of cholera are in abeyance only, and can be (in case of need) called into active
work at a moment's notice.
2d; That, so far as I am aware, there has been only one fatal case of cholera in the parish
registered during the week ending Saturday the 27th. The case was that of a child five years of
age, who died on the 19th, at 1 Forstcr's-buildings, Neate- street The case was returned as one of
^arrhoea, but there is reason to believe that it was a genuine case of cholera, for a case of non-iatal
cholera has since occurred in the same house, llie house is in good condition, is efficiently
drained, and has water laid on. The chief cause of complaint is the existence, within a few yards
of the door, of an untrapped opening connected with one of the main sewers belonging to the
Central Board of Works. The bedding, &c. were, as usual, destroyed under the eye of the inspector
of nuisances.
J. S. Bbistowe, M.D.,
Medical Officer of Health.
JSote, — The following correction was subsequently received from Dr. Bristowe {Weekly Hetttru,
No, 48) :—
Nooemher 20(A, 1866.
Dr. Bristowe would like to correct a mis-statement in a communication of his published in the
44th Weekly Betum. The untrapped sewer-opening, therein spoken of, belonged to one of the
parochial sewers, and not to one of the sewers under the immediate control of the Central Board.
The following replies from Health Officers were printed in the BeturUy No. 45,
r the Week ending November 10/A.
Marylebone.
November lOih, 1866.
Within the last four days two deaths from cholera have occurred in the All Souls district of this
parish, the duration of the disease in each case not exceeding 18 hours.
The first death was that of a woman aged 61 years, living in the third floor of a house in
Solsover-strcet. The sanitary condition of this house was found to be very good, but on careful
"luiiy — and indeed to get at facts inquiries must always be not only cai^ul but searching — I
md that the grandson of the deceased had two days previous to her. death been brought to her
■n, where he now remsuns, from North Kent-place, Woolwich, where the father and brother of
■ child had just before died from cholera ; and from the evidence which I was enabled to collect
lare no doubt that the contagion was in this case brought from Woolwich.
[n the second case, the evidence of the death being by infection from cholera excreta is very
ar and striking. The victim in this case was a poor woman who resided in Upper Charlton-
-reet, and who, one day before her attack, was engaged in washing the body linen of the first
"Woman that died.
In both these cases the symptoms were well marked and defined, and both terminated, as I have
already stated, in 18 hoiurs.
The body in the latter case was removed immediately after death to the mortuary bouse, and the
l>ody linen, &c, properly disinfected under my personal superintendence.
Tlie Health Officers on Preventive Measures, ^c 195
1 cannot conclude this brief report without appending to it my opinion, based upon personal
observation, that sufficient care is not taken to prevent the spread of infection by means of infected
clothes, bedding, &c.
J. Wbttmobe, M.D.,
Medical Officer of Health.
Islington.
November 12M, 1866.
Two deaths from cholera at 20 Packington-street will be returned this week ; namely, that of a
commercial traveller and his wife. It is a well-ordered and tidy house, and the family in very
comfortable circumstances. Such an event as two deaths within a few days in any house in
Islington has not occurred since our arrangements were perfected, or since the first outbreak of the
disease here ; and on this account the circumstances of these two deaths are instructive. On the
2d of November the husband, in the prosecution of his business, went to the east end of London,
and remained there the greater part of the day. It is not known what houses he visited nor yet
what he ate or drank there. On the 3d he dined in the middle of the day at home ofif some veal,
and in the evening was seized with vomiting. His friends, thinking that the veal had disagreed
with him, gave him some brandy. At a later period diarrhoea came on, and when his medical man
was sent for he found him collapsed, passing rice-water evacuations, and with suppressed urine.
Tlie man died on the 4th, after 26 hours illness. No information of this case or of the death was
forwarded to me, and the first I learned of it was irom the daily return on Wednesday evening.
On the next morning early I called on the medical adviser, and sent an inspector to the house.
The mescal man toM me that the soiled linen had been put into a solution of Condy's fluid, but
the inspector found the bed, soiled with discharges, in the garden. The wife persisted in denying
that her husband had died of cholera, and refused to allow the bed, which was a valuable feather
bed, to be disinfected or destroyed, but brought it back into the house. In the evening, as her
medical man fidled to persuade her to allow its removal, I had her served with a notice under the
S2d section of the Sanitary Act. This was on the 8th November, and on that day her husband
was boned. She went to bed in a room at the top of the house, leaving the back parlour, in which
her husband died, unoccupied. Shortly after she was attacked with diarrhoea, which became so severe
that at 3*30a.h. of the 9th she came down stairs, and could not be got up again. Accordingly she
was taken into the front parlour, and laid upon a chair bedstead, where she died at 3*30 ▲.]£. of the
loth, having been attended by a homoepathic practitioner. Up to this time even the sons would
not believe that their father had died from cholera, but now they expressed great anxiety for the
destruction of all the infected articles. Everthing likely to be contaminated was accordingly
collected, and being previously soaked with carbolic acid was burned. The rooms have yet to be
disinfected. I cannot help feeling that this second case might probably have been prevented had
imme^ate information of the first been forwarded to me, and proper steps been adopted while the
soiling of the infected articles was fresh, to destroy the virus or prevent the decomposition of the
discharged matters.
Edward Ballard, M.D.,
Medical Officer of Health.
IIackney.
November 8th, 1866.
The services of the medical visitors have been discontinued since Saturday last, but will be agtdn
available if occauon should arise. Diarrhoea and cholera have ceased as an epidemic ; a few cases
only of the former and none of the latter having occurred in this district during the last seven
days ; the total mortality of Hackney is below the average rate for the district.
There are still two extra inspectors and two sub-inspectors employed in this district in searching
out and removing nuisances. The rooms of houses occupied as lodging-houses are being measured
under the regulations issued in accordance with the provisions of the Sanitary Act ; and other
measures adopted for keeping the district in a good sanitary state.
John W. Tripe, M.D.,
Medical Officer of Health.
HOLBORN.
November lOth, 1866.
In consequence of having received no intelligence of any cases of cholera the Sanitary Com"
mittee resolved on the 1st instant to suspend the services of the medical visitors from the 3d instant.
The four dispensaries of the parcchlul medical officers remain open for the gratuitous supply of
advice and medicines to all applicants suffering from diarrhoea and cholera. The sen-ices of the
Bedical yisiton which have been of great value not only in arresting the disease in its incipient
itage, bat in famishing this office with copious schedules of sanitary defects can, I am happy to say
(in case of need) be ca&ed into active play at a moment's notice.
So fitf as I am aware no case of cholera, fatal or otherwise, has occurred in the district diuring^
die picieiit ireek. In your daily return of deaths registered on the 7th instant, which I received
196 The Health Officers on Preventive Measures, $ic.
this morning, there was the following entry : " St Bartholomew's Hospital, from 59 Hatton-garden,
6th November, coachsmith, 42 yrs., cholera, exhaustion (9 days)." On making inquiry I find that
this mai>, who worked at Messrs. Laurie and Mamer*s manufactorj', near King's Cross, was brought
home with all the symptoms of cholera on the same day that his wife and family moved into this
house, viz., on 27th ultimo, lie was attended from the Farringdon Dispensary, and at once
removed into the hospital. His daughter, aged 16, was also seized with cholera two or three days
afterwards, but refused to go into the hospital. She has recovered. The house and water supply
are in a good sanitarj' state. The usual method of disinfecting the house, bedddng, clothing, &c.
will be had recourse to without delay.
SEPTiifuft GiBBOK, M.B. (Cantab.),
Medical Officer of Health.
St. Geokge-in-the-East.
November 12/A, 1866.
Two fresh cases occurred in a house recently cleansed, but as speedily made unclean. The
drainage unusually good.
In our last case the child had eaten sprats for tea three hours before being taken iB. I fear that
I am right in thinking that the virulence is in an inverse ratio to the fewness of the attacks.
J. J. Rtoate, M.B.,
Acting Officer of Health.
Mile End Old Town.
November lOUi, 1866.
The preventive arrangements as regards cholera remain the same as at the time of my last
communication. Since then there have been six fatal cases of cholera, two in the eastern and four
in the western di\ision of the hamlet ; the circumstances attending the latter were somewhat
remarkable, the deaths all occurred in the same street, but in dififerent houses, with a mean distancse
apart of about 20 yards, two of the houses were on the west and two on the east side of the street ;
two of the cases were children about five years of age and two adults (male and female) ; the time
of attack and death was almost simultaneous in three of the cases, the fourth about 12 hours later.
I investigated the circumstances of each case, but could not trace their origin to any Tisibie
surrounding conditions ; in one instance there was certainly overcrowding in one room, and in
another, fatal coses had occurred in the same house at the commencement of the epidenuc, but it
was thoroughly cleansed and purified afterwards. In these cases, as in most others, I have come
to the conclusion that the virus of the disease is retained by and circulated through the medium of
the sewers, escaping only at irregular intervals and places influenced by atmospheric conditions.
Upon two or three days preceding these attacks there was a considerable increase in the temperature,
increasing the evaporation of the contents of the sewers, and facilitating the escape of gases, oud
with them doubtless the cholera germ. j^Iidway between the houses alluded to there is a sewer
ventilator (all the houses but one being connected with the main drain, which passes down the
middle of the street) ; the occupants of one of the houses complained of the bad smell arising from
this grating near to his house. In two of the back yards each Iiad an untrapped sink — they will be
inumediately trapped — through these the disease virus may have cscaiied.
My impression, resulting from and confinned by much experience and investigation, is that the
elements or genus of the disease arc still lurking in the sewers, and only kept down by the density
of the atmosphere, but I fear to be again brought forth into activity upon the return of propitious
meteorological conditions. I have discussed this subject more fidly in my report to the Health Com-
mittee of the Vestry of Mile End Old Town. Presuming my supposition to be true, it would be of
the first importance that eficctive measures should be forthwith adopted with a view to the removal
and deKtniction of the cholera matter as contained in the sewers ; to attain this object I imagine the
means most likely to succeed would be in repeated flushings of the sewers at short intervals all over
the Metropolis, but especially in those districts where the sewage is not yet intercepted by the great
level sewers ; in conjimction with this the most powerfid and effective disinfectants kno*T>Ti should
be thrown into the sewers. By these and other anticipatory measures, if adopted forthwith and
continued, I believe we may prevent the otherwise, I fear, inevitable return of the disease. It is
even now only kept in subjection by energetic action and vigilance.
In all the cases which have led to these remarks the necessary sanitary measures were at once
adopted, the houses cleansed and disinfected, and infected articles destroyed by fire.
M. Corner, M.D.,
Medical Officer of Health.
Bermondset.
November 10/A, 1866,
One death from cholera occurred during this week at 4 Hussell-stceet. The house has been
inspected, but no sanitary defect was noticed to which the illness could be attributed. Fever prevmls
in the locality. The bedtick and other articles were burned, blankets soaked in boih'ng water, and
room fumigated with sulphurous acid under my personal superintendence.
WlLLUM PABKSBt M.D.,
Medical Officer of Health.
The Health Officers on Preventive Measures^ j'C 19 1
St. George Southwark.
November lOtJi, 1866.
I hare only to add to the statements made in my letter of 27th October, that since then the
special sanitary committee have passed a resolution to open three chemists* shops, one in each sub*
ditfrict, for the purpose of giving medicine to those who are in need, and who are suffering from
diairfaoBa and cholera.
As an illustration how cholera may be propagated, and the cause of its outbreak remain hidden,
I may mention the following case which came under my own obser\'ation : — A woman, who a few
days previously had come to reside in this district, was suddenly taken ill with cholera, and died.
Tht B<Hkd bed linen was placed in a heap in the yard previous to removal and destruction ; this was
•tolm by some woman who had called to see the deceased. No trace of her, nor the fruits of her
robbery^ eoald be discovered, although made with all diligence.
Henkt Bateson, M.D.,
Medical Officer of Health.
WlIlTECHAPEL.
Dr. Liddle, Medical Health Officer, addressed the following letter to the Regi3ti*ar
General ( Weeklif Return, No. 46) :—
November l^th, 1866.
Although no deaths from cholera were registered in London on Thursday last, we must not
conclude that the disease has left us, and consequently that it is no longer necessary' to continue our
exertions in discovering and in mitigating the numerous causes of disease which are perpetually
•rising among the badly-housed and poor population in the Kast of London. It is true that much
has been done by the exertions of the Vestnes and District Boards, and by the indefatigable and
pnuseworthy labours of the several voluntary associations (headed for the most part by the clergy),
m the various sub-districts of this part of the metropolis, in visiting the houses of the poor, and in
admimstering the funds so kindly provided by the benevolent public for the relief of the needy and
the afflicted ; yet, from the fact that there have been registered in this district during the week
ending on Saturday last, among a population of about 79,000, two deaths from cholera, it is
•till important that the daily return of deaths from cholera should continue to be published, so
&at the promptest measures for destroying the clothes uud bedding of those who have died jfirom
this disease, and for disinfecting the n)oms where deaths have occurred, may be still carrie<l out.
The mode of proeeeding which I have adopted in most of the cases where deaths from cholera
have taken plaee has been (under the superintendence of a qualified medical practitioner) to apply
immediately chloride of lime to the clothes and bedding which have been used, and forthwith
iemo>*e them to the stoneyard, and bum them in a furnace which was erected for the purpose.
The ixwic occQined by the deceased is then disinfected under medical superintendence in the
following manner : on the floor of the room to be disinfected an iron pot containing Stockholm
tar is placed, into which is thrust a red hot poker or a live coal, the door and windows having been
previously closed. The Woke, which issues in large vohmies, is speedily diffused over the room,
and penetrates into every comer. If, therefore, the tarry compounds are capable of destroying
the germs of cholera, this plan of applying them is probably the most effective of any hitherto
ployed.
St. Geouge-in-tiie-East,
In reference to the death of a child from cholera, Dr. Rygate, Medical Officer of
Health, writes ( Weekly Return, No. 46) : —
November 19M, 1866.
A child died ni another parish in August, and the parents removed into St. George-in-the-East,
brining with them the bed upon which the child had died. They had been in their new abode
about diree weeks when cholera broke out down stairs, and the parent, a man, died, and the next
day the brother of the above child died. The bed upon which the first child had died had been
emptied and the tick washed and refilletl with the same flock, and the second child continued to
ileep upon this same bed until taken ill. In this parish we have been very active and liberal b
oor deduction of feathers, flock, bed ticking, and clothing.
198 The Health Officers on Preventive Measures, jr^
Mile End Old Town.
Dr. Corner, Medical Officer of Health, addressed the following letter to the Regis-
trar General {Weekly Return^ No, 47) : —
November 25tlt, 1866.
Two deaths from cholera ha^e taken place daring the past fortnight : in one case there were no
apparent local causes ; the house is in the main thoroughfiure ; the patient's a^ was 73. The other
case, that of a male, 46 years of age, occurred next door to a house in which there was a death
from cholera the week before, when 4 other &tal cases occurred in this street at the same time, and
within a few yards of each other, as already reported. In the last case the only peroeptible local
cause was an untrapped siuk at the back of the house, and communicating with the main drain
passing down the centre of the street. The house was clean, and &ir]y built and ventilated ; the
surrounding neighboureood open and not densely populated. I must reiterate the opinion contained
in my previous reports that the cholera poison is still lurking in a passive state in the sewers and
other low places its favourite haunts, only waiting suitable meteorological conditions to again come
forth into activity, probably more destructive than ever. This being the case, why are not the
preventive measures most likely to succeed at once adopted, and especially in those districts where
the sewage is not yet intercepted by the great level sewers, and which districts I have clearly
defined in my report to the Health Committee of this hamlet as the true cholera field of the recent
epidemic? I have suggested immediate, repeated, and simultaneous flushing of the sewers at many
different points, with Uie use at the same time of the most powerful disinfectants. The necessary
measures to be adopted in other places than sewers are suffidently obvious.
Unless we can during the winter months succeed in removing or destrojdnff the cholera poison,
both precedent and reasoning justify the conclusion that the disease will agam break out with a
return of such weather-conditions as are favourable to its development. No &tal case has occurred
in the hamlet since the 12th inst.
Cambebwell.
Dr. Bristowe, Medical Officer of Health, writes in reference to four cases of
cholera (see St. Olave Southwark and Camber well) as follows ( Weekly Return^
No. 47) : —
November 2Sd, 1866.
A very serious and unfortunate outbreak of cholera has occurred in a house of a somewhat
superior character, occupying an apparently salubrious situation. The fiwjts of the case are as
follows : —
A respectable man, a miller, deserted his wife and seven children five months ago, since which
time they have resided at the above address in considerable poverty. On Saturday, November lOth,
the youngest child, an infant 14 months old, was attacked with diarrhoea, but the diarrhoea seemed
slight and did not alarm the mother, who consequently did not send for any medical man. The
child went to bed with the mother, and in the morning was found dead. The cause of death being
obscure, the Registrar, to whom the mother went on the Monday, directed her to go to the coroner's
officer, through whom an inquest was arranged to be held on the following Friday (the 16th). On
the Tuesday the mother was taken ill with diarrhoea, and on the Wednesday was sent by her
medical man to Guy's Hospital ; on the Thursday two of her children were also sent to the hospital.
All three have since died there of cholera. On Thursday evenmg, for the first time, the fiwts of
the case were brought under the coguizance of the sanitary officer of the vestiy. On that evening
the inspector removed the four children still living in the house to the workhouse, and partly that
evening, partly in the course of the next day, had the premises thoroughly disinfe^ed and cleansed,
and the bedding and certain articles of dress destroyed. On the Friday evening the two elder
children, who were called to give 'evidence at the inquest, were attacked with symptoms of cholera ;
one of these has had a severe attack of the disease, but both of them are, I believe, now doing welL
Thus, out of a family of ei^ht persons, six have had cholera, and four have died of it I must
add that the house is well dramed, the drains are trapped, and the water supply is good. The house
itself was not clean, but the uncleanliness was not more than may be explained by the poverty of the
inmates. There had been no cholera or even diarrhoea in the immediate neighbonriiood, nor has
the disease hitherto shown any tendency to spread beyond that one house. I do not pretend to trace
the origin of the disease in this house.
Dr. Lethely on Disinfectants. 199
4. Dr. Letheby on Disinfectants.
The Registrar General was favoured with the following observations on the
practice of disinfection by Dr. Lethebt, Health Officer of the City of London
(Weekly Return. No. 47) :—
In accordance with your request, I have much pleasure in stating what are the processes of
ftinnfection which I have found most effective in my experience as the Officer of Health for the city
The several disinfectants which I have largely tested are the following : —
1. Chlorine gas.
2. Chloride of lime.
3. Carbolate of lime.
4. Carbolic acid.
5. Chloride of zinc (Sir William Buinett's fluid).
6. Chloride of iron.
7. Permanganate of potash (Condy's liquid).
8. Animal charcoal.
Each of diese disinfectants has its own particular value, and may be used on certain occasions in
preference to any of the others ; thus,
1. Chloruu ga9y being a very diffusive body, is best suited for the disinfection of places which cannot
easily be reached by other disinfectants. I have used it largely for the disinfection of the vaults of
churches, where the atmosphere has been so charged with offensive and dangerous organic vapours,
let loose from fbt contents of the decajnng coffins, that the workmen could not enter Uie vaults with
safety. lb this manner all the vaults of the city churches have been disinfected, and the contents
of them pat in order and covered with fresh mould. I have found also that chlorine is best suited
for the disinfectioii of rooms where, as is the case with the poor generally, the occupant cannot be
removed for a thorough cleansing ; and I have employed it with great advantage in places where
persons have been sick with fever, scarlet fever, small-pox, and cholera. The process which I adopt
is the following : about a teaspoonful of the black oxide of manganese is put into a tea-cup,
and there is poured over it, little by little, as occasion requires, about half a teacupful of strong
muriatic acid (spirit of salt). In this manner the chlorine is gradually evolved, and the action is
increased, when necessary, by stirring the mixture, or by putting the teacup upon a hot brick.
As chlorine is heavier than atmospheric air, it is best diffused through th6 room by putting the
xnixtnre open a hi^ shelf. The quantity of chlorine thus diffused dbould never be sufficient to
cause irritatioo to the lungs of those who occupy the room, and yet it should be sufficient to be
distinctly recognisable by its odour. If it be properly managed the chlorine may be thus diffused
throng^ the atmosphere of the room, even during its occupation by the sick.
S. CHonde of Ume has been very largely used in the city during the recent epidemic of cholera.
The inspectors have sprinkled it upon the floors of the houses occupied by the poor, and have
scattered it about the cellars and yards. In some cases it has been used with water for washing the
paint woik and the floors of rooms. Altogether indeed, with an average staff of 45 men, we have
used latfaer man than seven tons of chloride of lime in this manner in disinfecting every week about
S,000 of the wont dass of houses in the city, and the results have been most sati^actory.
3. CarhtiiaU of lime, which is a mixture or rather a chemical compound of carbolic acid and
lime, has been used in many cases vhere the smell of chloride of lime or its bleaching action has
been objeeted to. It has been used by dusting it by means of a dredger over the floors of rooms
and oeDars ; bat as the disinfecting power of this substance is destroyed by chloride of lime, h .vr <?/
great impo rt an ce that they should not be used together. The carbolate of lime which we have
employed ccmtains 20 per cent of carbolic acid ; it is essential that this should be its minimum
s tr en g th, or its power is not sufficiently efficacious. The stren^ of it may be ascertained by
treatfaig 100 grains of it with sufficient muriatic acid, diluted with its own bulk of water, to dissolve
the fime, wlien the carbolic acid is set free, and floats upon the liquid ; this, when collected, should
weigh SO grains at least. The advantage of carbolate of lime is its continuous action, for the
eaibonie aeid of tilie air slowly lets loose £he carbolic acid, which diffuses itself through the atmo-
sphere in snfident quantity to act as a disinfectant, and it does not destroy thp colour of clothing.
4. CofMie acid has been used as the sole agent of disinfection for privies, drains, and sinks.
and for the sewers and the public roads. In the former case it has been used in its concentrated
state by pouring it at once into the privy or drain, but in the latter case it has been diluted witi
about SOOO times its bulk of water and sprinkled by means of the water carts upon the public way
In tius manner about 1000 gallons of carbolic acid have been used in the city thoroughfELres ;. aw
the aeid getting into the sewers we have observed that the usual decomposition of sewage has been
arrested, and instead of a putrefactive change with the evolution of very offensive gases, the sewerS
have been charged to a alight extent with carbonic acid and marsh gas. As thfit^ ^x% \&as£^ ^^iSiNasL
200 Dr. Leiheby on Disinfectants.
acids now sold for carbolic acid, it is of importance that the adulteration should be recognized.
This may be done by observing the strength of the soda solution which will dissolre the tar acid.
iUl the inferior acids are insoluble in a weak solution of caustic soda.
5. ChUrride of zinc, Sir William Burnett's fluid, or, as it is sometimes called, Drew's disinfectant,
is weU suited for the disinfection of the discharges from sick persons, but it is hardly applicable to
any other purpose. The liquid should be of a proper strength, as having a specific gravity of 1594,
water being 1000 ; and it should contain about from 50 to 54 per cent, of solid ddoride of zinc.
A tablespoonful (k this liquid is sufficient to disinfect each discharge frt)m die body.
6. Chloride of iron is applicable in exactly the same manner as chloride of zinc, and is only suited
for the disinfection of the discharges from the body. It should have a specific gravity of 1470, and
should contain about 40 per cent, of metallic chloride.
7. Permanganate of Potash is only suited for the disinfection of drinking water; for not beinf a
volatile disinfectant, and being very slow in its action, and requiring much of it ibr any practical
purpose, it is not available as a common disinfectant ; besides which it attacks all kinds of organic
matter, and will therefore destroy clothing and be neutralized by every species of organic substance.
As a disinfectant of water, however, in localities where good filters of animal charcoal cannot be
obtained, it may be usefully employed to disinfect water by adding it thereto until the water retains
a very pale but decidedly pink tint. The permanganate which is sold generally has a specific
gravity of 1055, and contains about 6 per cent, of permanganate of potash. It will take more than
a pint of this liquid to disinfect a pint of the rice-water discharge from a cholera patient, and even
then the disinfection is very uncertain.
8. Animal Charcoal. 1 may state, that for the disinfection of water and the removal of dangerous
organic impurity I have ascertained by experiment that the best treatment is first to filter the water
through animal charcoal, and then to boil it for a few minutes. It may then be sa&ly drunk.
The ^sinfection of bedding and all articles of clothing is best effected by exposing them in an oven
to a heat of from 260° to 300^ Fahrenheit The exposure should be sufficiently long to ensure the
thorough heating of every part of the material to that temperature. When such a process cannot be
used, the clothing should be put into boiling water, and kept there until die water cools to the
common temperature.
I refrain from entering into an^ explanation of the mode of action of these sereral disinfectants ;
for whether the agent of disease is a living germ, capable of reproducing itself in the human body
under certain conditions, as most likely it is, or whether it is an unorganized, or even as Dr. Rich-
ardson supposes, a crystalline compound, the practical results are the same and are unquestionable ;
and, in conclusion, I would say, by way of summary that for the disinfection of sick rooms, chlorine
and chloride of lime are the best agents ; for the disinfection of drains, middens, and sewers,
carbolate of lime, and carbolic acid are the best ; for the discharges from the body carbolic acid,
chloride of zinc, or chloride of iron are the best ; for clothing, the best disinfectant is heat, above
260° if a dry heat and 212° if a wet heat ; and for drinking water, filtration throng animal charcoal
and a boiling temperature.
I may mention that the best disinfectant for stables and slaughter-houses is that prepared by
Lewis, Ash, and Co. at Bow. It is a mixed chloride and hypochlorite of zinc, and it has the
advantage of mixing freely with the liquid matters of the slaughter-house, and not tainting the meat
T»ith any unpleasant odours. We have used it very largely for this purpose, and it is also applicable
to the disinfection of houses in place of chloride of lime ; which it much resembles in its chemical
natiure and mode of action.
Cdleye Laboratory , London Hospital,
November 22d, 1866.
Cholera at Woolwich. 201
5. Cholera at Charlton (Woolwich).
( Weekly Return, Xo. 43.)
CllAllLTON', October ^Tithy 1 866.
I am Sony to infonn you that a severe outbunt of cliolera has occurred in our parisli. The
meeting of the Board took place yesterday, and I reported that there had been a continuous
JBiproTcnient in the health of the parish. There had been no case of cholera since the 3d of
October, and less diarrhcea than is usual at this time of the year, only one fatal case having occurred
danDg the month, and but eight fresh cases of diarrhoea (and these chiefly of a mild character)
had been brought under the notice of the ** medical visitor " during the past week. Such being
tbe Avoimble sanitary condition of the parish, it was under discussion whether the senices of
the mffdical visitor should be dispensed with ; it was, however, resolved to continue his services for
a short tnne longer.
Daring the last 24 hours a choleraic wave has passed over our parish, and several have been
■addenly stricken with the disease, and up to this time seven cases have proved fatal, the duration
of the attacks varying from 8 to 1 6 hours. All these cases have occurred in the marsh districts,
in the lower parts of the parish adjoining Woolwich Dockyard. In this neighbourhood there are
streets of small houses, built on the marsh land below the level of high-water mark, and also much
below the level of the high road. The houses are simply placed on the soil without any basement
whatever, and are surrounded by tidal ditches, and from the heavy rain-fall of late the water is in
many of them up to the level of the floor boards. Our authorities have endeavoured, but without
avail, to rectify this state of things. Until the metropolitan main sewer was constructed there was
no means whatever of draining any of these houses, and the sewage simply found its way into the
adjoining tidal ditches. Now, however, the drainage of the district is being expeditiously carried
out by the Board of Works, and as fast as a line of sewer is completed a connexion is made into the
main sewer with each house, and the drain cut ofif from the tidal ditch, but it must be many months
beCoie this can be completed, and until then we can only tnist in a mereiful Providence, for the
sanitary means at our command can be of little avail. In the upper parts of the parish and the
sorroonding neighbourhoods there has been no case of cholera ; they are uniLSually healthy, and are
quite firee from diarrhoea.
Robert Finch, M.D.,
Medical Officer of Health.
{Weekly Return, No. 44.)
Octohtr ?^\8t,
I beg to furnish you with some further particulars of the progress of the outbreak of cholera in
this district, and tlw measures which have been taken to meet the disease.
My letter to yon of the 25th instant informed vou of the extreme suddenness of the outbreak ;
and immediatdy on the report of the existence of cholera in this parish a special meeting of the
board was convened to take such steps as might be necessary, and a daily meeting has since been
held. I have already acqiuiinted you with the precautionary* means that had been adopted ; and in
addition to the ^ medical visitor '' already appointed, two other *' medical visitors '' in the immediate
Tieinity of the outbreak were appointed under my superintendence for the gratuitous attendance of
the rick. Three dispensaries were established at the residences of the three medical visitors for
the gratuitous supply of medicines, and the chemist in the village was empowered to supply medicines
gratuitously under the advice of the medical officer of health.
A placard was circulated announcing the names and addresses of the medical visitors, and also
where medicines could be obtained. The medical visitors were also empowered to supply to the sick
all necessaries, such as nourishments, stimulants, blankets, &Cm at their discretion.
The inspector of nuisances was authorized to obtain any assistance that either the medical officer
of health or himself might require. A close and constant inspection, amounting to house-to-house
visitatioD, has taken place in the district, the roads watered with diluted carbolic acid, and chloride
of lime or carbolic acid poured down all drains and gulley openings, and all sewerage works have
been temporarily suspended.
The disinfection has been carried out eflfectually either under the suiH.T>'isi(m of the medical
victors or the inspector ; everj- house where a case has occurred is visit^-d, and diluted carbolic
acid poured down the drains, &c., the rooms washed with a solution of chloride of lime, and the
clothmg also washed in a solution of chloride of lime, and the beilding, if soiled, has been inmiediately
removed and burnt, it being considered better to destroy the bedding, and to replace it gratuitously,
than to attempt to disinfect it by heat in this district. It was proposed to establish a temporaiy
hospital, but there being no suitable building in this district which the board could obtaiu that
pro/ect had to be abandoned. A contract was taken for burials ; each body to be removed within
two hoars of death to the Charlton dcadhouse (an isolated building far removed from any
dwelling), the corpse to be covered with chloride of lime, and the burial to be completed as early as
practicable.
Such have been the means employed to combat this sudden outbreak, and I am pleased to report
dttt the disease is rapidly subsiding. It attacked us with alarming and sudden severity, but its
Tims was expended m* the first few days, llic early cases were suddenly seized without any
202 Cholera at Woolwich.
premonitory symptoms whatever, and rapidly smik. From the commencement of the ontbieak od
the 24th to the evening of the 26th of October 14 cases have proved fatal, the duration df the attack
Tar}ing from 7 to 18 hours. Since that date the severity of the disease has very much abated, not
only in the number of deaths but also in the encouraging fact that the intensity of the new cases is
less severe ; two deaths only occurred yesterday and only one to-day. There have been no fresh
seizures of cholera for two days, and the cases of diarrhoea brought under the notice of the medical
visitors have much diminished. It is difficult to assign any reason for the suddenness and inten-
sity of this outbreak. It cannot certainly be charged to the water supply. Here I believe every
house has an abundant supply of good water for domestic and other purposes, furnished by the Kent
Water Company. The water is pumped up from artesian wells, bored into the solid chalk about
300 feet deep. It is a ver}- hard water, containing salts of lime in abundance, but very Uttle organic
matter. Since the first alarm of cholera in the metropolis, about three months ago, the supply has
been turned on twice a day during the week, and also once on Sunday, from 10 a.m. to 1 p.m.
I have visited the works, and from their construction I cannot believe that any contaminated suifruse
water can find its way into these wells. Could any impurity in the Kent Company's water have been
the cause of this visitation other parts of the neighbourhood would have suffered, but the disease hasy
with a single exception, been confined to the marsh district and lower parts of the parish.
Most probably the cause of this outbreak is to be attributed to the unfortunate natural poadon of
the locality (it being below high-water mark), to the extraordinary rainfall of late, and also to the fisct
of the diuinage of this district being in a transition state.
The works, though temporarily suspended in consequence of this outbreak, will be resumed Erectly
the emergency has passed, but until completed our sanitary measures can be only palliative.
Robert Finch, M.D.,
Medical Officer of Health .
P.S. — A continuous improvement ; no death to-day (1st November), and no fresh attacks.
The following letter was addressed to the Registrar-General on the outbreak of
cholera at Woolwich ( JVeeklt/ Jietum, No. 44) : —
Sir, October 29M, 1866.
When I wrote last week I was afraid from the severity with which the new attack broke out
that we should have a heavy list of deaths to register ; and I fear by this time the number in Wool-
wich and Charlton cannot be fewer than 40, all since Wednesday evening last, when the attack com-
menced. You will perceive that nearly the whole of the mortality has occurred in a district in which
there is no provision for ventilating the southern outfall sewer. Up to the present time the epidemic
does not appear to have touched any point beyond John-street, but has ravaged the districts lying to
the westward of it both in Woolwich and Charlton, and its lateral range has been confined to pomts
on either side of the sewer. The marsh districts referred to by Dr. Finch are immediately adjoimng
this main sewer. The district in question is very open, and with the exception of the mardi part
of it, above the level of the river and well drained, at least as far as the parish of Woolwich is con-
cerned. Of two deaths from cholera registered in the Arsenal district last week, one waa that of a
man who worked in the part now referred to.
If you refer to the deaths registered throughout the southern districts during the whole duration
of the present epidemic, I think you will find that an undue proportion has occurred on the lower part
of the course of the southern ontfall sewer at Deptford, Greenwich, Woolwich, Plumstead, &c. ; so
that wliilst the close and normally unhealthy parts of Lambeth, Rotherfaithe, and Bermondsey have
escaped, the more open districts lower down have suffered severely. The southern outfall sewer, you
are aware, has a long sluggish course, so that by the time its contents reach the pumping station at
Deptford they are in a fitting state to give out vast volumes of pernicious gases, even if they do not
yield the essential gas cliolcrine.
Two years since we had a formidable visitation of gastro-enteric fever, cleariy traceable to the want
of ventilation in the same sewer ; and it is singular that the dockyard district has on former occasions
1)een singularly free from cholera, the deaths in the epidemic of 1 854 being less than 20. Putting all
these facts together I cannot but recognise an intimate relation between the impure state of the sewer
and the present outbreak.
I remain, &c.
To the Registrar-General. B. Bueoo.
Report to the Chairman of the Metropolitan Board of Works on the locality in
•which the Woolwich outbreak of cholera occurred, by Mr. Grant, Assistant
Engineer ( Weekly Betunt, No. 44) : —
November 3d, 1866.
The following description of the locality in which the recent outbreak of cholera has tak^i place
will, I think, satisfy you that it is unnecessary to go beyond the spot itself to find a reason for the
mortality ; and that to attribute it to the discharge of sewage at Crossness, three to four miles distant,
or to the ventilation or want of ventilation of the outfall sewer, is to divert attention from the evilf
'w Uich really require to be remedied.
Cholera at Woolwich. 203
Pint as to Lower or New Charlton, situate between the Lower Woolwich Road and the River
Tliames. It comprises about 300 small houses, built upon a peaty quaggy marsh six feet below high-
wmter mark, and bounded on the west side by a wide, stagnant, and foul ditch, which has fonued the
outlet for a considerable part of the drainage of West-street, and separates the part built upon from
tlie richly manured market gardens and marsh lands of East Greenwich. The soil, originally most
amtnitaMe for being built upon, has been made much worse by the cesspools and privy pits mode for
bouse drainage, and which, when overcharged, are emptied into pits sunk in the little gardens adjoin-
ing the houses. Jn some cases there are sunk tanks for rain water close to the privies.
Tlie local board has recently laid several lines of pipe sewers and drains for Uie drainage of these
houses into the main outfiill sewer ; and in connexion with this work, closet pans have been fixed in
some of these privies ; some cesspools have been filled up, and others are about to be. In few, if any^
cases I believe has water been laid on to these closet pans, and all those I saw were foul wiih humaa
ezcremenL
In addition to the foregoing, the northern half of West street and also of East-street are ** unmade ;"
a mass of mud, ruts, and stagnant waters.
Between East-street and West-street and elsewhere are a number of piggeries. With few ex-
cq>tioiis, there are no water tanks or cisterns of any kind. Water is supplied for about one hour
dally by a stand-pipe from which the women fill any barrel, tub, or pan they may possess ; the
barrels being often green, mouldy, and leaky.
The houses are built so that the floors are level with the surface, and are consequently damp and
cold. Few, if any, of the houses, though very small, are occupied entirely by one family, two or
more being the rule.
A few recently built houses in North- street are much superior to the rest, and possess good
wrought-iron tanks or cisterns with water hiid on to the closet pans.
The foregoing may be briefly summarised thus : —
The site low, subsoil naturally wet, spongy, and bad, made worse by cesspools, and by having
been made the depository for the foul matter taken out of these ; bounded on the west by a wide
stagnant and foul ditch which has hitherto taken the overflow of some of the cesspools. The
drainage and the water supply are both most imperfect ; the small and wretched houses arc over-
crowded with a population in poor circumstances.
But in addition to that which may be said to be the chronic condition of the locality, I was
mformed that for two or three days before the cholera broke out, about the 24th or 25th of October^
a large quantity of offal and dung from the slaughterhouses of Iblr. Smith of Woolwich was spread
upon the surface of Mr. Shepherd's market garden ground, which bounds this locality on the west
mde; that the smell was most offensive all over this locality. When the disease broke out
Mr. Shepherd's attention was called to this, and he caused the ofial and manure to be ploughed in
or otherwise covered up.
In Moimt-stieet and Charlotte-street, Charlton, on the south or upper side of the Woolwich-road,
there has been a great and sudden outbreak of disease, with many deaths.
In No. 1 Monnt«treet one mother and her three children died, and in the same house there had
been two previous deaths since the beginning of August, making six altogether. Here the site is
eomparatiTely elevated, perhaps 20 to 30 feet above Thames high-water mark, and the subsoil is the
fine grey sand which overlies the Woolwich chalk. The house consists of four small rooms, with a
xery small scuUery at the rear. In each of these four rooms was one family. The lower rooms
aie 7 feet 6 inches high, the upper 8 feet 3 inches, lliere is a small back-yard, in which are a
closet and pan without water, conmiunicating, so far as I could see, with a cesspool, a small rain-
water tank close to it, an iron stand-pipe, but no tank or cistern for receiving the water supplied
by the Kent Waterworks Company. The water is stored from day to day in a mouldy old barrel^
and such tubs and pans as the tenants have. In one comer of the yard was the dead body of a
eat, and the mouldy garbage thrown out during the process of cleaning which has been commenced.
Adjoining the house is a very foul small stable, the floor of which is satiurated with old rank
smelling dung. There is no drainage.
In PlnmsteMl, on the west side of Woolwich, many brick and pipe branch sewers have been con-
structed within the last twelve months ; but much work yet remains to be done. Part of l^lumste^
between the parish church and Plumstead railway station, lies low, A brick sewer has b^pa'con-
structed in connexion with the outfidl sewer near the railway station. A most foul ditch, however,
into which the drainage of a brewery and many houses flows, still takes this drainage down into the
marshes and over the outfall sewer, contaminating the air for a great distance. This ditch might
long ago have been intercepted and the drainage taken into the brick sewer. With respect to the
drainage of all these localities, as the outfall sewer has been completed for four or five years, and
Ihe pumps at Crossness at work for more than a year and a half, the branch sewers might have
been completed long ago ; but, under existing Acts, local boards have many difficulties to contend
with. After the main sewer has been constructed by the Metropolitan Board the local board have
to make the branch, but cannot, without notices and infinite delays, make the branch drains, or
abolish the cesspools, or lay on water. Then they are powerless in such cases as at Xiower Charlton,
where the most wretchedly built houses are erected in rows upon low lying marshy ground, sur-
charged with moisture and vegetable matter. Such sites are really unfit for hiunan habitations. If
the air and all the surroundings were of the purest the houses woidd be barely large enough for one
oidinary family. With foul air, bad drainage, insuflScient and imperfect water supply, damp and
£rt, indoors and out, and at least double the number of a poorly fed jiopulation crowding into theMj
■mdl houses, the wonder is, not that on epidemic should suddenly and occasioiially break out, ba
ttmX the locality should ever be firee from epidemic disease*
/
204 CItolera at Woolwich.
There can be no doubt that people living in such circumstances do not live half their dayg.'
The result of my observations is that the outfidl sewer has nothing whatever to do with this
outbreak of cholera.
The men employed at Crossness and their families (about 150 souls) live at the top of the
reservoir, and not far from the point of discharge into the river, and there is no sickness among
them. The ventilating shafts from Charlton through Woolwich to Plumstead are stopped ap, and
have been for a long time, the ventilation being through the tall chimnies of the dockyard and gas-
works ; and, where causes sufficient to account for the disease may be found in and round the houses
of those affected, it seems to be unnecessary and unwise to look elsewhere. By the increased
vigilance now being displayed by the local authorities much may be done to mitigate the evils to
which I have referred ; but much more will remain so long as such a large number of human beings
are permitted to occupy houses not fit for the healthy occupation of half their number.
To Sir John Thwaites. John Graitt.
Mr. W. R. Morris, engineer of the Kent Waterworks Companj, addressed the
following communication to the Registrar General ( Weekly Return^ No, 45^ : —
November \Oth^ 1866.
I have received your request for particulars of the water supply to the Woolwich Dockyard and
Charlton Districts, and particularly to the localities where the late outbreak of cholera has
prevailed ; and in reply I have to inform you that in these places the water, in common with the
whole supply to the Kent Waterworks Districts, is obtained from deep wells sunk in the ohalk, as
described by Dr. Finch in his letter of 3 1st ult., and published in the Weekly Returns oif your
office. As regards the quantity supplied, the pressure and time will admit a delivery of 1000 gallons
daily to each house, through a J (inch ?) pipe. Whatever quantity may be wasted, there are few or
no instances in the above places where provision has been made for receiving or retaining any such
quantity for use.
You state that in some cases an offensive smell is reported to have been experienced at the
conmiencement of the day's water supply. This must have a local origin, otherwise it would be
continuous, neither would it be the exception, but the rule, as the same pipe supplies the whole of
the houses with water.
Such a smell could arise only from two causes ; a leak on the leaden supply pipe on the premises
nught occur in crossing a drain, in which case, on the cessation of pressure from the main,
impurities, gaseous or otherwise, would fill the leaden pipe, and the first ensuing deUvery of water
would create such an offensive smell as that complained of. This has several times happened^ and
is always readily detected and set right.
A second cause is more common, and occurs more or less frequentiy in a better class of houses*
Water is delivered into cisterns with which an overflow pipe is connected. This pipe discharges
into drains, cesspools, or sewers, and imless it be '* trapped '' (as it rarely is) the foul air from Uie -
drains is brought into immediate contact with the water m the cistern, and thence passes into the
house. The offensive smell is always most perceptible on the first flow of the water from the waste
pipe disturbing the contents of the cesspool or imperfect drain ; and after a flow of clean water It
ceases for a time.
If you will fi[ivour me with the means of ascertiuning the particular houses in Charlton which your ,
informant alludes to, I should be greatiy obliged, and would have a close examination made.
In answer to your inquiry whether it be true that water had been discontinued to waterclosets on
account of nonpayment of rates, I have to state that such is not the fact. There has been no refusal
to pay the charges for water, and the water rate always includes the closet. I apprehend that this
mistake has arisen from the company declining to supply waterclosets direct m>m their mains.
Many houses in Woolwich and Charlton were formerly so supplied by the late Plimistead and.
Woolwich Company, but on the Kent Company taking their works such mode of supply was
discontinued, as contrary to the provisions of the " Metropolis Water Supply Act"
Not only does such direct communication between the pan of a watercloset and the water mam
cause great waste of water, but it has been long known that it leads to the most offensive results }
and hence a clause in the Metropolitan Water Supply Act was inserted, forbidding such a mode
of service.
{Weekly Return^ No. 45.)
November 12<A, 1866.
The epidemic has entirely passed away. There have been no fresh attacks for more than a week.
The two deaths which occurred in the present month were from secondary fever. The services of
two of the medical visitors have been dispensed with ; one is retained to watch over the lately
infected district The drainage works, which were suspended at the time of the outbreak, have
been resiuned, and will be rapidly completed. The total number of fatal cases in Charlton parish
during the late outbreak has been 26,— -all, with a single exception, confined to the lowest parts of
the district, and among the poorest of the population.
HOBEBT Fixcu, IM.D.,
Medical Officer of Health.
Cholera at JVoolwich, 205
( Weekly Return^ No. 46.)
Kent Waterworks, Mill-Jane , Deptford,
November 11 th, 1866.
Mr. W. R. Morris, the engineer of the Kent Water Company, states that the number of houses in
Woolwich and Charlton supplied with water from the works is as follows :
Number of houses supplied in Woolwich - - 4,356
Ditto ditto Charlton - - 1,083
In 1861 Woolwich contained 4,596 inhabited houses, Charlton 1,117.
No extra charge is made for a single watercloset, and we have no record that will enable me to
diitingnish those houses without water supply to their closets.
Dr. Finch, Medical Officer of Health for Charlton, has addressed the following
oommnnication to the Registrar Greneral ( Weekly Betum, No, 49) : —
Ai to tlie statement that ** the epidemic broke out in Charlton and extended to the adjacent parts
of Woolwich,'* it is quite incorrect
Up to the evening of October 24th no case of cholera or even diarrhoea had occurred in Charlton
puish for three weeks, and on that day the epidemic broke out.
Hie fint ease occurred at Woolwich in the Arsenal district (a mile and a half to the east of
Chariton'), at 36 Waterman's Fields. The patient died at 3 o*clock p.m. The second case at
15 Pnnpeet-place, Woolwich Dock>-ard, at 5-30 p.m. The third case at Albion-road, Woolwich
Dockytad, at 7*45 p.m. The next case, and the first in Charlton parish, was at No. 1 Moimt street,
within a few yards of Woolwich, at 8 p.m. Cases Nos. 5 and 6 occurred at Acorn- street, Woolwich
Boekjardy and 3 West-street, Charlton, at 8-30 p.3r. No. 7 at 19 Kast-street at 10*30 p.m. and
Na 8 at Maiyon-grove at 1 1 * 30 v.m. These were all the cases that occurred in both parishes on
the day of the outbreak. The epidemic passed over Woolwich from east to west.
As regards the statement of ** offensive manure being permitted by the Charlton authorities to
be carted on the fields," this is a little unfair. The fact is, this refuse was brought in the night
firoDi Woolwich parish and carted on the fields of CharUon, but as soon as it was discovered the
nupector immediately ordered it to be ploughed in and covered with carbolic acid. The owner of
the £eld wrote a letter of regret and apology, and the police were conaanunicated with to prevent a
lepetition of so flagrant an act.
This is not the first time that refuse has been brought from Woolwich into Charlton, and
fercral summonses have been taken out against persons so offending. Only as late as 1 1th August
ImI a summons was taken out against a man for depositing large heaps of refuse opposite North-
Charlton, which had been brought from Woolwich parish. The Medical Officer of Health
reported to the Board, *Uhat if allowed to accumulate it would become a dangerous
e ;*' therefore the statement that the Medical Officer of Health had allowed these things to
if incorrect. Equally wrong is the statement that ** he did not remonstrate against laige
age operations bemg allowed during the outbreak.*'
One of the first acts of the conmiittee, on the advice of their Medical Officer of Health, and as
Rported by him in his letter to the Registrar General of 31st October, was to order the sewerage
works to be temporarily suspended ; only the few connexions which were in progress were com-
pleted ; and when the old sewer in East-street fell in during the outbreak, the inspector was directed
aoC to disturb it, but simply to cover it over with matting and earth and carbolate of lime.
As regards the level of the ground, site of the honses, and poverty of the population, it is surely
aot affirmed that the Medical Officer of Health is to be held responsible.
206 Notes on Cholera in Districts*
VI.-NOTES ON CHOLERA IN 1866 IN THE SEVERAL
DISTRICTS OF ENGLAND.
n.— SOUTH EASTERN COUNTIES.
I. Surrey (extra-metropolitan).
45 ; I. GoDSTOXE ; Godstone, Population 9,642. Cholera 17 ; Diarrhoea 2. A fiirm lahourer
aged 70 years died in the Union workhouse at Bletchingly on 9th August fVom Asiatic cholera
(3 days) ; the deceased is stated to have come from the neighbourhood of London three days
preyiously to seek for harvest work. No further deaths occurred untU the 1 8th of the same month,
when a railway labourer at Oxted died from cholera (18 hours) ; this was followed by the deaths of
two other adults on 2dd and 27th. A rat-killer aged 76 died at lampsfield on 13th September of
choleraic diarrhcsa; on the 16th September the disease broke out at Oxted among some navyies
employed upon the construction of a neighbouring line of railway. Between 16th and 22d Septem-
ber six of these men and one of their wives died from cholera, described as of a most malignant
type. The registrar states that the huts wherdn these navvies lived were built in a very damp
situation. At Limpsfield the disease appeared again on 7th October when the wife of an agricul-
tiural labourer died of Asiatic cholera (20 hours) ; on 8th, 9th, and 15th the children of a imilway
labourer, and a ndlway labourer also died; the last &tal case, also in Limpsfield, occurred on
18th October to the widow of an agricultural labourer aged 82 years. In the epidemic of 1849
only five deaths occurred from cholera, of which four took place at Bletchingly (three in the
Union workhouse).
46 ; I. Crotdon ; Croydon, Population 37,093. Cholera 9 ; Diarrhoea 34. The 1,061 deaths
registered during last year in this sub-district showed an increase of only 29 upon Uie number
recorded in the previous year, which was fully accounted for by the increase of population. The
first fatal case of cholera was that of a plasterer, aged 29 years (8 hours), on 3 1st July at Pitlake ;
an infant died at Penge on the previous day, but this case was certified as only choleraic diarrhoea
(4 days). On 2d August a labourer died in the workhouse infirmary, aged 45 years, of cholera
(19 hours) ; the remaining six cases were as follow : — On 2d August, at 25 Hig^-street, a porter,
aged 46 years, cholera (28 hours), cerebral congestion. On 3d August, at Thornton Heath, the
Eon of a plasterer, aged one year, cholera (17 hours). On the same day at Sydenham-road, a
domestic servant, aged 43 years, cholera maligna (7 days). On 28th August, at lifyrtlc-street, East
Croydon, the widow of a shoemaker, aged GO years, cholera maligna (10 hours). On 10th September,
at the Oaks, South Norwood, the son of a stock-dealer, aged four months, choleraic diarrhoea (8 days).
On 23d September at Thornton Villas, Upper Norwood, the daughter of a fitter, aged seven years,
choleraic diarrhoea (20 hours). Of the 34 deaths from diarrhoea, 20 were of infants not exceeding
one year, nine of persons over 60 years of age ; the remaining five only being of adults between
18 and 55 years.
46; 2. Crotdon ; Mitcham. Population 9,381. Cholera 6; Diarrhoea 11. The wife of a leather-
dresser, aged 75 years, died of Asiatic cholera on Mtcham Common on the 17 th August No othes
fiital case occurred until 3d September when the wife of a floorcloth-printer, aged 33 years, di^d of
cholera (3 days) ; one child in the same family died on 2Gth September of diarrhoea (48 hours),
and anoUier on 3d October of choleraic diarrhoea. On 5th October the child of a carman, aged
nine years, died from Asiatic cholera (21 hours) at the Causeway, Mitcham. A labourer, ag^ 84»
in Mitcham, from Asiatic cholera (12 hours) ; and the last case was the wife of a labourer, aged
60 years, who died on 16th October of Asiatic cholera (20 hours). The 11 deaths from diarrhoea
were almost all of infiints and old persons.
In the whole district of Ooydon 15 deaths fVom cholera and 45 from diarrhoea were register^ in
ike year against 94 and 43 during the epidemic of 1849, and 90 and 55 in that of 1854. In 1849
the first fatal case of cholera occurred on 13th July in the Watermen's Asylum, Penge; afterwards
13 died in Barrackfield, 1 1 on Ooydon Common, and 1 7 in the Union woridiouse. The disease
was most fatal on 27th August, on which day eeven deaths occurred ; at Pitlake the wife and three
diildren of a sawj-er died in the same house. It was noticed during the epidemic of 1849 that
^ part of the Croydon sub-district situated in the immediate vicinity of the g^asworks was entirely
from the epidemic. In the Mitcham sub-district in 1849 the greatest mortality occurred at
1, in Merton parish, where 12 persons died in September.
7 ; I, 2, 3, and 4. Kingston ; sub-districts Wimbledon, Kingston, Esher, and ffimtpUm, Popn-
•yn of District 36,479. Cholera 17 ; Diarrhoea 15. The only fiital case of cholera in Wimbledon
the child of a carpenter aged seven years on 5th October. In Kingston the first death from cholera
Occurred in the Union workhouse, on ICth July, of a female aged 29 years | no fiirther deaths took
Notes on Cholera in Districts. 207
place vndl Stb Angos^ from wliich day until 27th of the same month seven deaths occurred in Water-
man'a-fov. Back-lane, Waterside, The Marsh, Wanderings, and other parts of the same poor neigh-
bouihood. The last case was of the child of a labourer ag^ six years on 2d November at Wanderings.
In Ether sab-district at Weston-green, Thames Ditton, a sharp outbreak occurred on 9th August
whidi vesnlted in the deaths of five adults between that day and the 12th of the same month. The
man bccrshop on Weston-green, where the disease appeared, was kept by a man and his wife in a
BOtoriomsly uncleanly nuinner. There was a piggery at the back of the house which had become a
pnUic nmsance. (!)n 9th August the beershop-keeper died, the cause of his death being certified as
IdOows : — ** Asiatic cholera (36 hours). Pever and delirium. Vomited large quantities of blood a few
hoars before deatli.** The man's wife, who on the morning of her husband's death was well enough
lo go into Kingston and back, was attacked daring the night, and died on 10th, after an illness of
only mne hoars. A woman who had been called in to nurse the two deceased, and the potman who
lived in the house, both died on the following day, the 11th, after attacks of 14 and 6 hours respec-
tively ; and on the 12th a carpenter, who hud acted as undertaker in the previous cases, died from
diarriMBa and cholera. Immediate measures were taken to prevent the spread of contagion by the
boming of all the infected articles of furniture, and the disinfection of the house and premises.
In the Hampton sub-district the only case of cholera was of a bargeman, aged 19 years, and
oee uiT ed at Hampton Wick on 2d August During the years 1849 and 1854, the deaths from
cholcca in the four sub-districts of the Union taken together were 32, and 48, against the 17 which
oeenrred in the visitation of 1866.
48 ; I. RiGDXo:(D; Richmond, Population 12,665. Cholera 10; Diarrhoea 6. The first case
of chdUsa (certified as choleraic diarrhcca) was of a bricklayer, aged 71 years, who died on 1 6th July,
at 9 Wotplcway, Marshgate. On 23d August the widow of a carpenter died of choleraic diarrhoea,
in Breva'»4ane. Between 31st August and 16th September four deaths from cholera and four
from diairluBa occurred in the Union workhouse. Two other deaths occurred on the 10th October,
one in Artichoke-alley and the other in the workhouse. The last fhtal case was of a railway labourer
at SC John-s-row, Kew-road, on 13th October. In 1849 there were 26 deaths from cholera, of
which Water-lane furnished five and the workhouse one.
48 ; 3. Richmond ; Murtlttke. Population 6,137. Cholera 2 ; Diarrhoea 3. On 22d July the
9oa of a general labourer, aged 1 1 years, ditil of Asiatic cholera (22 hours) ; the other was of a
femaJe in&nt aged nine months from choleraic diarrhoea, at the back of Bames-terrace, on
S4th Angnst
The deaths from cholera in the District of Richmond, which did not exceed 12 in 1866, were
48 and 69 in the visitations of 1849 and 1854.
• 2. Kent {extra-metropolitan),
50 ; 1. Dartvord ; Brxlejf. Population 13,026. Cholera 6 ; Diarrhoea 7. The whole of the
defttha from ciiolera occurred in Erith ; the first fatal case was that of the child of a master shoe-
maker at PJeaidy on the 26th July ; the remaining five took place at intervals during August and
Bcqptanber, the last (of a labourer) occurring on October 9th. Of the six deaths, three were of
adults and thiee of children. In the epidemic of 1849, 46 deaths from cholera were recorded, of
whidi 35 oeenrred in the parish of Cray ford, and three at Bexley ; both these places escaped in
1866, while the deaths in Erith were only one less than those in 1849.
50; a. Dastford; Dartford. Population 13,180. Cholera 4; Diarrhoea 8. The first death
from eholera oeenrred in the Union workhouse on the 28th July ; the wife of a farm labourer died
flo 2d September at Milton Street, Swanscombe, and the two other cases were brought ashore from
Teasels lying in the Thames. In 1849 there were 58 deaths from cholera.
51 ; 1. Gravssend ; Gravesend. Population 18,782. Cholera 19 ; Diarrhoea 16. On the
15th Jnij the ehild of a shipwright, aged seven months, died of choleraic diarrhoea at 46 Kempthome
Street, and on the 22d a seaman died of cholera in the workhouse. On the 8th and 15th August
two chjidzen of a labourer died at 5 Queen*s-terrace, Milton, after but a few hours* illness. The last
iatal esse occtured in the Infirmary, Bath-street, (jravesend, on the 9th October. Of the 19 deaths
from cholera 15 were at Gravesend, and four at Milton ; of the fonner, four occurred on board vessels
in the Thames. Seven cases were recorded in the workhouse, most of which were of women. In
1849, 196 deaths occurred from cholera, and in 1854, 84.
5J ; I. NoBTQ Aylesford ; Northflect Population 9,600. Cholera 5 ; Diarrhoea 8. On the
15th Jnlj a child of 10 months died of *' cholera infantum (2 days) T no further cases occurred until
1 1th Aognst, when two terminated after but a few hourti* illness ; the last two deaths occurred at
4 WcflibQame-terrace, on 17th and 27th August.
$2 ; a. KoKTH Aylesford ; Strocd. Population 9,521. Cholera 2 ; Diarrhoea 3. There were
41 deaths from diolera in 1849.
53; I. Hoc; IIoo. Population 2,861. Cholera 10 ; Diarrhoea 2. The first fatal case of cholera
was that of the wife of a farm labourer on 5th August ; six fatal esses occurred in the workhouse
hetwaen the 9th and the 18th. No death took place between the 24th August and the 15thSeptemp-
her^ when the last occurred. Cholera was more fatal in lioo in 1866 than in 1849, when onlj
deaths were returned.
O
20^ Notes on Cholera in Districts.
54 ; I. Med WAY ; Rochester, Population 17,550. Cholera 6 ; DiarrhcBa 0. The daughter of
a commercial derk died in Colegate-terraoe, Chatham, on 18th Angust. Two other deaths oecorred
in Chatham, on 21st and 29 th. The first death in liochester took place on 23d September, a second
on 25th in St. Bartholomew's Hospital, and the last on 7th October in the same institution. In
1849, 49 deaths resulted from cholera, the first fiital cases occurring among the soldiers at Fort Pitt.
54 ; 2. Medway ; GiiUngham. Population 34,255. Cholera 12 ; Diarrhflea 13. The whole of
the deaths from cholera occurred in Chatham ; the first took place in the workhouse on 28th July,
followed by three in August, and one on September 27th ; from this date no death occurred until
20th October, when the son of a master baker died (14 hours) at Brook ; five deaths resulted
from this second outbreak ; the last on 3d November was that of the son of a watchmaker. Of the
12 deaths from cholera, seven occurred at Brook, Chatham. In 1849 the deaths fttim cholera in this
sub-district were 78.
55 ; I. Malunq ; Aylesford, Population 8,036. Cholera 4 ; Biarrhcea 9. The first death from
cholera was that of the ca\)tain of a barge at Newhithe, East Mailing, on 3 1st July ; the mate of a
barge died at Millhall, Aylesford, on 26th August ; and the last death was at Ryarsh on Sept 13th.
55 ; 2. Mallino ; East Peckham, Population 7,554. Cholera 12 ; Diarrfacsa 7. On 3d May
a butler at the Rectory, Merewortb, died from English cholera (18 hours); but the first &ttd
case of an epidemic character occurred on September 17th at West Peckham, followed by 10 others
in rapid succession, the last (the daughter of a greengrocer, aged seven years) occurring on 30th
September. Of the 12 deaths firom cholera, seven took place at West Peckham, and three at East
Peckham ; eight of these deaths occurred among the hop-pickers and their families. In this sub-
district there were only six f&tal cases of cholera in 1849.
58 ; I. Maidstone ; Yaldin^. Population 4,882. Cholera 1 1 ; Diarrhosa 3. On 12th September
the child of a farm labourer died at Horn's Lodge after an attack of diarrhosa (4 days), ending in
convulsions (12 hours) ; on the following day the mother and another child in the same family
died of cholera (12 and 8 hours) ; on 14th a third child died ; and on 15th, at the same address^
the son of a fish dealer, aged 13. This severe outbreak in one fimiily was followed by seven otlMtr
deaths, two of which occurred in the hospital near the town and two at Shingle Bam. The last
death occurred on 4th October. All the 1 1 deaths occurred in Yalding.
58 ; 2. Maidstone; Harden, Population 4,905. Cholera 2; Diarrhoea 3. The two deaths frtmi
cholera were of the wives of labourers, aged 29 and 47 years, at Marden, and occurred on 6th and
14th September.
58 ; 3. Maidstone ; Loose. Population 5,867. Cholera 1 ; Diarrhoea 5. The only death from
cholera was of a farm labourer at Sutton-street, Bearsted, on 1 2th September. In September 1849
cholera broke out among the hop-pickers, chiefly Irish, and proved &tal to 44 persons ; only two
or three deaths then occurred among the natural residents of East Farleigh^ where the greater part
of the mortality took place.
58 ; 4. Maidstone ; West Maidstone, Population 10,907. Cholera 6 ; Diarrhoea 6. The first
fatal case of cholera in this sub-distriot was that of the mate of a barge, aged 22 years, who died on
6th August in Dann*s-court, High-street (21 hours) ; this death was followed by three others in Daia^'s-
yard on 11th, 16th, and 18th August, the two latter being the wife and daughter of a wharf labourer.
On 5th October a blackfmith died in the cholera hospitJil in the Loose road ; and the last case wm
that of the wife of a quarry labourer, who died on the 25th October. In 1849 there were 26 frital
cases of cholera, and there was a great mortality in Bristow's-yard, Upper Stone-street
58; 5. Maidstone; East Maidstone. Population 12,109. Cholera 3; Diarrhosa 9. Thediree
fatal cases of cholera occurred in Bonny's-yard, on the 20th August and 4th and 5th September^
all male adults (two labourers and a Chelsea pensioner). Of the nine deaths frt>m diarrhoea seTen
were of young children.
67 ; 2. Favershah ; Fauersham. Population 9,473. Cholera 8 ; Diarrhoea 4. On aoth Jolv
an oyster-dredger died of cholera at Upper Brenrs, Preston ; no further death occurred until
5th August, when a mariner died in the Union workhouse ; two brickfield labourers died on 6t}i»
the child of a dredger on 8th, and the last two cases were recorded on 15th and S6th August.
67; 3. Faversiiam; Teynhamy Population 4,061. CJholera 5; Diarrhoea 3. Three deaths
from cholera occurred on 28th and 29th July and 4th August, at Conyer, Teynham, to tluee adults,
(15 to 20 hours) ; the other two cases were of young children, one on 8th September at linstedy
and the last on 12th October at Teynham.
68 ; I. Milton ; Jfi/ton. Population 14,775. Cholera 21 ; Diarrhoea 9. A child aged 7 years
died in Union-road, Milton, on 23d June, of English cholera (27 hours) ; but no further death
occurred until 23d July, when the wife of a seaman died at Upchurch of choleraic diarrhoea
(20 hours); on 29th July a seaman died in High-street, Sittingboume, fbllowed by one in the
Union-road, IMilton, on 3d August The outbreak was most &tal during August, but several deaths
occurred in September, and two in October, both of infants in Sittingboume ; the last took place in
Crown-yard on 23d October. Of the whole 21 deaths from cholera 11 occurred in Sittingbottme,
eight in Milton, and one each in Upchurch and Borden.
69 ; I. SiiEppEY; Minster. Population 16,937. Cholera 22; Diarrhoea 17. An outbreak rf
cholera occurred in this sub-district during the month of August, and was principally fatal to
the artizans in the Royal Dockyard. The two first fatal cases occurred in Shcemess, on 20th August^
Notes on Cholera in Districts. ^ i(S9
fcDowcd in npid noeeirioii by others throughout the month ; in September 10 deaths occurred.
The iMt &tal ease wis that of a child who died on 29th September. With the exception of a few
dtifW m the Union Workouse, Minster, all occurred in Sheemess, and the disease was especially
.ftfai in Blue Town, where a cholera hospital was established.
70; 1. Thaxet; Mifuttr. Population 3,836. Cholera 3 ; Diarrhoea 0. These three deaths from
diolera occnrxed in the Union workhouse on August 28th and 3 1st, and 4th September.
70; 2. Thahbt; Margate. Population 10,019. Cholera 11 ; Diarrhoea 8. The first fiatal case
of cholera was that of the daughter of a fSormer, aged 22, who died at 6 LansellVplace on
16th Angust ; she had been ill for 12 months, but died after an attack of choleraic diarrhoea
(13 hauny. On 38th August, the disease appeared in a serere form at 13 Upper Marine-terrace,
three persons dying there on that day, and a fourth on Ist September ; the fiitaU^ in this house was
traced to the effects of the water of a well which supplied the inmates. (See the subjoined details
to this outbreak which are reprinted from the London Weekfy lietuma.) Two other fstal
of choleraic diarrhoea were recorded bdbre the middle of September. On 3d October, the
again appeared in the fiunily of a farm labourer, living at 14 Dane-hill-row ; the father
died on Sd, followed by a child on 10th, and another son and daughter died at the Cholera Hospital
IB 2fia-lane 00 the 14th and 17th.
Cholera at Margate.
(JBtepnmted/rom the London Weekly Return No. 47, for the Week ending November 24, 1866.)
It sometimes happens that people living in London go to watering places, where
tliej are attacked by cholera. The following painful and typical case was brought
under the notice of the Registrar Greneral, who requested Professor Frankland to
analjBB the water of the well, which appears to have been the means of distiibuting
m one boose the disease among about 20 inmates, of whom several died.
of fATAL Cases of Cholera registered in the District of Margate, during the Tear 1866.
6 IiUiseU*s-place, 26th August, female, 22 years, amenorrhcea, (ill 12 months), choleraic
dianrhflBa (IS hours).
13 Upper Marine-terrace, 28th August, female, 13 years, choleraic diarrhoea (16 hours).
Ditto, ditto, female, 48 years, ditto (15 hours).
Ditto, ditto, male, 17 years, Asiatic cholera (12 hours).
Ditto, Ist September, female, 66 years, ditto (17 hours).
Kiiu^-ftreet, 26th August, male, 4 years, choleraic diarrhoea (8 hours).
21 idjmer Marine-terrace, 1 1th September, female, 52 years, choleraic diarrhoea (SO hours).
14 Dane-lull-row, 3d October, male, 51 years, cholera (12 hours).
Ditto, 10th October, male, 13 years, cholera (6 days).
Cholera Hosintal, 14th October, male, 9 years, and on 17th October, fenuUe,*^ 22 years,
ezhnition by die consecutiye fever after cholera in both cases.
C. R. PiLCHEB, Registrar,
Tvo of the F"f"ft*^ of the house, 13 Upper Marine-terrace, returned to London, were attacked
and died at St John's Wood, where Uieir deaths were registered.
Uftoo Hook, ATemie-road, St. John's Wood, 1st September, governess, 32 yrs., cholera
(5 days).
UftoB HoQse, 75 ATenue-road, 3d September, pupil at Ufton House, female, 12 yn., cholera
(Tdaya).
Tbe fottowhig is a detailed statement of the attack by a gentleman who was
reeidiDg in tbe house at the time : —
ThB wrifer begs to submit the following plain statement of facts in which he took a part himself,
and will be happy, if required, to attend in person and give any information or answer any questions
that nay be put to him. At the same time he trusts that if it be necessary to give publici^ to any
inrcidBatioiia to be made with reference to it, that all names, to save pain and annoyance to those
coDceraed, will be withheld.
On the 18th August last a party consisting of Mrs. , a lady from London, her two daughters,
myself and sitter proceeded to Margate, and took apartments at No. 13 Upper Marine Terrace, where
my aioftfaer, iHio £id preceded us a few days, joined us. We observed during the first hour we were
in Hbt hooae that the water was unusually hard, so much so that the best perfumed soap almost
relMtd to lather and turned to a curdle, but knowing from experience that sea-side places are often
bmdJ^ aopplied with water we took no further notice of it. On the following Monday (20th Au^^),
Mn. — *— . was seized with a slight attack of diarrhcca, but as she was in delicate health it did not
wxtnet special attention. On the succeeding Wednesday or Thursday, however, as it still continued,
she was obliged to call in medical assistance. On the following Sunday evening, August £6th, a
heavy thonderstorm vinted the town, and an unusually large quantity of rain felL The hot water
* This patient was removed from 14 Dane-hill-row; she left her situation, upon hearing of her
ftther's death, and was shortly afterwards taken with symptoms of cholera, lingering several days.
210 Notes on Cholera in Districts.
that was brongHt ap to the bedrooms the next morning was thought to enut a pecoliar smell, and
a glass of cold water that was brought up in the forenoon for the purposes of dnnldng had such an
unpleasant taste and looked so turbid that it was handed round to all in the room and various
opmions expressed on it. We then learnt that the water was supplied from a well at the bottom
of the garden and not from the reservoir of the waterworks. In consequence of which, accompanied
by a gentleman, son of the above lady, I called at the house of the secretary or manager of the
water company, but not finding him at home, related to his daughter the business on which I wished
to see him, and promised to call again later in the day. I saw him a few hours afterwards, and on
asking him in what way we could obtun a supply of the company's water, he said that the
landlord of the house had heard of complaints being nuide of the water and had already seen him
relative to it, and that it had been resolved to have the water laid on immediately. The whole
of our party in the evening went for a long walk, thinking that the coolness of the air would
perhaps counteract the lethargy with which we all seemed to be strangely affected. We retired to
bed about 11 p.m., and between two and three o'clock the next morning Mrs. was seized
with diarrhoea, and such violent cramps that when she got out of bed she was obliged to cling to her
daughter, with whom she had been sleeping, for support. She took a little brandy and a piU, one
of those that had been procured for my mother, and was somewhat relieved. About six o'clock,
however, the daughter came up to the son, who was sleeping in the same room with myself^ and
begged him to go for a doctor. On his preparing to go down stairs, the lady who had taken the
drawing-room floor three days previously accosted him, and asked him if he could oblige her with
some brandy, saying that one of her little pupils, aged about 12 years, had been taken seriously ill,
and she was intending to send for a doctor. He had not left the house before a gentleman who
with his wife and two children had been staying in the house about a week, made his appearance,
and said he had been very unwell himself durmg the night, and was just going to get mescal advice
for his little girl who was seriously ill. The physician, having been previously called up during the
night, sent his partner or assistant, who attended to all the three families at the one visit. This was
shortly after six o'clock on Tuesday morning August 28th. The assistant repeated his visit about
eight o'clock, I believe, and during the whole day was incessant in his attentions. I speak now
about Mrs. who belonged to our party, not knowing the details of what took place in
the other part of the house. About 1 1 o'clock she rallied somewhat, but was still in a low state.
About one o'clock the purging ceased, and from that time she kept everything taken into the
stomach. Nourishment was administered in the shape of essence of beef, champagne wine,
arrowroot, &e., and at one time at not less intervals than five minutes. She then appeared, and
expressed herself as being better, but very weak. At three o'clock it was evident even to an
ordinary observer that she was sinking fast, the colour of her flesh becoming darker, and her
vitality less strong. At a few minutes past six in the evening she breathed her last. I had been
standing the last hour or two by the bedside, and had noticed the change that had been coming
over her, and her breathing becoming fainter and famter. It is right to mention here that she had,
in common with us all, from the beginning of our stay in Margate, lost her appetite and suffered
from constipation of the bowels, accompanied with headache, which no doubt, allowed the system
to absorb an^-thing injurious she may have taken. She was a fiill-bodied person and enjoyed good
health, though the lungs and the liver were the weak points in her constitution, and perhaps she had
not been the last few months quite as strong as usual, I believe from the continual confinement of
city life. She drank on the Monday two botties of soda water manufEictured by Beeve & Co.,
Margate, who we afterwards learnt used water from a well on the premises.
The littie girl referred to above died about nine o'clock the same evening, and the waiting boy of
the house, whom we had seen run across the road about one o'clock in the day, died between eleven
and twelve. Mr. immediately removed his family, and I heard two days after that his littie
fprl had recovered, while his other child had been dangerously attacked. I have heard since that, of
the other party who had returned to their town residence, the governess and two more of the children
had been taken ill, and that the governess and one child had succumbed to it This makes a total
of five deaths out of about 20 people who were stopping in the house. Regarding the medical
certificate, on which the registration was based, giving as the cause of death in Mrs. *s case
" choleraic diarrhoea of 15 hours' duration," I can only say, that though diarrhoea was the disease
that first set in, it seemed to cease about one o'clock, and to be followed by a virulent attack of
cholera.
The water in the bottie enclosed was drawn fi-om the well on the Thursday morning, 30th August,
and is apparently clearer than that used on the Monday, the day after the thunder storm.
I have also to remark that a pubUc pump stands at the comer of a piece of waste land or common,
about 50 feet from the garden of the house, no doubt supplied from the same spring, and apparently
daily used by the surrounding inhabitants. I saw, on the Monday, a party of cluldren round it, some
of whom were drinking the water.
The house we were in, viz., No. 13 Upper Marine-terrace, had the reservoir water laid on before
I left Margate on the 30th, but I understood that there were other houses in the same row using the
well water.
I would observe, in conclusion, that I may be somewhat mistaken in a few of the minutis of the
above statement, but the main facts I will vouch to be correct
The following will, I think, answer Professor Frankland's questions respecting the water drunk
at Margate in the case of the three deaths that occurred there on the 28th August: —
(1) The water was certainly drunk by all those attacked.
Notes on Cholera in Districts. 211
(2) It was drunk, both boiled and unboiled, in about the following quantities by each person :
^ pint in morning boiled for tea or coffee.
i pint unboiled, mid-day, mixed with claret (except by two who drank bottled stout
instead).
5 pint boUed in evening for tea.
pint unboiled for supper, either pure or mixed with claret.
(3) In the case of Mrs. the last administration was about ^ pint unboiled at supper-
time, four hours before the attack commenced ; she had, dunng the previous 48 hours,
drunk at least a quart unboiled extra mixed with spirits of camphor ; she was also
suffering firom constipation of the bowels.
Analtbis of the Water by Professor Frankiavd.
I have analytically examined the water of the well supplying the house, No. 13 Marine-terrace,
Ifngste, in which a sudden outbreak of cholera occurred on the 28th of August last, destroying
five fires. A small sample of the water was collected a few days after this outbreak. It contained
93-40 parts of solid matter in 100,000 parts. Of Uiis the very lai^ amount of 7*36 consisted of
organic and other volatile matter ; unfortunately this sample was too small for detailed examination.
A larger sample of the water collected on the 18th of September by Mr.Pilcher, the Registrar,
ezldbited a totally different composition ; it contained 82-75 parts of solid impurity in 100,000 parts
of water, and of diese only 1*13 part was organic and other volatile matter. The following are the
resolts of the analysis of the larger sample :
Solid matter in 100,000 parts - - - - -82*75
Organic and other volatile matter - - - - 1*13
Oxygen required for oxidation of organic matter - - 0*0885
r Total - - • -30*2
Hardness - -< Permanent - - - - 12*4
[Temporary - - - - 17*8
Tins sunple was also well aerated, and fSeir removed firom putrescence ; one litre of it contained
the following gases :
Cubic centimetres.
Carbonic acid - - - - - _ 21*406
Oxygen ---.-- 5*342
Nitrogen ----.. 14*942
Total - - - - 41*690
Thus the character of the water had entirely changed, and it is highly probable that during a
heavy &11 of rain which just preceded the outbreak of cholera there occurred an overflow of
a oeMpool which, as I am informed, is situated near to the well ; the well-water thus becoming
ff»pfywitmifai^. I have ascertiuned that this water was drunk by all the persons attacked, and Uiat it
vras taken partly boiled and partly unboiled. I have, &c.
£. Franklaivd.
It was asserted that the landlady and other inmates of 13 Marine-terrace afterwards succumbed ;
the Beg^strar's reply to inquiries wiU complete the narrative.
Ifiss . is still alive, and has not been ill for more than a day or two, and that I believe
(firom conversation I had with her) arose more from excitement and worry than firom any other
eause ; a great many of her goods were seized by the sanitary authorities and burned, and when I
last saw nia she was not recompensed in any way, and that appeared to affect her more than any
thing eise that has transpired.
The Sanitaiy Committee has ceased to exist, or rather to meet, as there is no need for them to
doao.
As hir as I can Icam, there was dissatisfaction among the medical men of the town ; for in
Banisgate each medical man had a certain district assigned to him for which he received 30«. per
dajy i^iile in Margate only one, and that the parish medical officer was so employed.
In ftpiy to inquaiea accompanying a copy of the Weekly Betum, Uie following answers were
received from Dr. T. J. Rowe, ilf.2/., who attended the patients attacked by cholera and
dkarrhaa a/ 13 Marine-terrace y Margate ( Weekly Return No, 48.): —
In lopect to your queries, I believe that there were no other deaths than those (six) recorded in
theicpott AH the other cases that left the house (13 Marine-terrace) recovered, i. e., save the
two that £ed at St. John's Wood.
AH the lodgers in the house came firom different parts of London, but I do not think any of them
miBaed firom diarrhoea prior to coming to Margate.
TIk landlady of the house is living and welL
Pcibaps I may add, that the Sanitary Committee caused the water of the public pumps to
be tumbled, and the result was, that ail save one were condemned, and at once closed. The
W.CX water being laid on.
Mngaie, December let, 1866.
212 Nvies an Cholera in Districts.
70 ; 3. Thanet ; J7am4«;Ki«e. Population 18,007. Cholera 43; Diarrhoea 16. Cholera -was &tal
in Ramsgate considerably before the first death occurred in Margate. The first death was of a
publican who died at 12 Rojad-terrace on 8th August ; the disease was &tal throughout August and
September, and the last case occurred on 5th October. The fatality of this disease was almost con-
fined to those parts of the town inhabited by the working classes, fishermen, shipwrights, labourers,
fiy drivers, &c. ; 10 of the deaths occurred in the Cholera Hospital, and four in the Seaman's Infir-
nuuT. The Model Cottages, Hodgman's Cottages, and Mount Pleasant Cottages returned more
deams than most of the other streets, in which only one death occurred.
71; 4. Eastry; Deal. PopuUtion 12,105. Cholera 14; Diarrhoea 5. On 1st August a
seaman died of cholera (3 days) ; on 15th a hawker died in a travelling van ; and on 23d the child
of a shoemaker died in Lower-street (20 hours). This death was followed in rapid succession by 10
others, the last case occurring on 1 0th September. A great mortality occurred at the *' Jolly
Sailor" public-house, in which the deaths of the publican and his wife and three lodgers took place
betwt^n 30th August and 9th September.
72>'i I, l!)ovERi Su James, Population 12,419. Choleni 5 ; Diarrhcea 6. The first death from
cholera was of thQ wife of a travelling hawker, in Fisher Vyard, on the 6th September; this case..
was followed by five others, the last two, the children of a .labourer in an oil mill, occc^red on
lath September.
7a; ». Dover; Sl Mary, Population 10,914. Cholera 5; Diarrhoea 7. On 16th July a
seaman died at Cross Wall of choleraic dysentery (15 hours) ; no fiirther death took place until
4th August, when the infant son of a boilersmith died (6 hours). On August 22d and September
10th and 15th, three further deaths occurred.
73 ; I. Elham; Folkestone, Population 17,341. Cholera 9; Diarrhoea 8. The first fatal case
of cholera in Folkestone was that of the stoker of a steam vessel, aged 64 years, who died in
Alfred-terrace (18 hours).- Of the other eight cases which subsequently occurred, five took place at
Mill Bay ; the child of a railway labourer on- 18th September, a- marine-store-dealer and two of his
children on dd and 9th October, and the wife>of a labourer on 12th October.
3. Sussex.
76; 3. IIastixos; St. Afari/'in-the-Castle. Population 15,884. Cholera 1; Diarrhoea 21.
On 25th August a gipsy chairmaker, aged 60 years, died in a tent near St. Andrew's Gardens after
a five days* attack of diarrhoea, with consecutive fever ; and on the following day his wife died, whose
cause of death was certified as ** cholerine, diarrhoea three days, childbirth 12 hours, exhaustion.''
Of the 21 deaths from diarrhoea, 18 were of infants under two years of age. In the three sub-
districts, Ore, All Saints, and St. Mary-in-the-Castle, comprising the District of Hastings, only three
deaths were referred to cholera in 1866, whereas the number of fatal cases in 1849 was 51, and in
1S54, four.
84; 3. Lewes ; Lewes. Population 10,116. Cholera 7; Diarrhoea 4. The wife of a pedlat
died in the workhouse at Cliffe on 14th August from choleraic diarrhoea (48 hours). No further
death' occurred until 3d October, when a shoemaker died at St. John-under-Castle from English
cholera, brought on by eating unwholesome shell fish ; and on 5th the wife of another shoemaker
died in St John-street from choleraic diarrhoea. Between the 13th and 19th October, lioth inclusive,
two deaths from diarrhoea and four from Asiatic cholera occurred in the workhouse. In Lewes
District (containing six sub-districts) the deaths from cholera were only two in each of the visitations
of 1849 and 1854.
85; 2. Brighton; St. Peter, Population 42,156. Cholera 11; Diarrhoea 49. The first death
occurred on 28th July and the last on the 3d September. Excepting three which were recorded in
the workhouse, no two others occurred in the same street or place, and the deaths were distributed
over the above period. Of the 49 deaths from diarrhoea, 31 were of infants under one year of age.
85; 3. Brightow; The Palace, Population 21,948. Cholera 3; Diarrhoea 10. No death
from cholera occurred until 1 6th October, when a fisherman, aged 38 years, died at 62 HusseU-street
of Asiatic cholera (3 days), and on the 22d another fisherman and his wife died in the same house of
choleraic diarrhoea, (each four days). [In the three sub-districts of Brighton only 14 deaths
from cholera were returned in 1866, while the fatal cases in 1849 and 1854 were 194 and 38 respec-
tively.]
90 ; 2. Worthing ; Littlehampton. Population 6,737. Cholera 14 ; Diarrhoea 4. The first
death from cholera occurred on ist August at Littlehampton to a stone-cutter, aged 56, who had
suffered from diarrhoea for four previous weeks ; two female adults died on 6th and 8th August at the
same place. With the exception of one on 1 6th August, at Leominster, no further deaths took
place until 20th August, when the son of a labourer, aged three years, died. On September Stfa, the
disease appeared in a virulent form, and carried off 10 persons, principally fishermen, seamen, and
their families, iu the space of eight days ; the last case occurred on 1 6th September.
90 ; 3. Worthing ; Arundel. Population 3,797. Cholera 5 ; Diarrhoea 4. Four of the fatal
cases of cholera occurred between 7th and 12th August in Arundel ; the fifth was that of a labooreTf
aged 78 years, who died at Bui-pham on 20th September. No death from cholera oconrred ia
Notes on Cholera in Districts 213
Woctikdng Town, situated in Broadwater sab-district, where great attention has been paid to
cAkient drainage.
In the three snb-districts of Worthing 19 deaths from cholera were recorded in 1866, against 8
and 6 in 1849 and 1854 ; the increase occurring entirely in Littlehampton.
92 ; 3. Crichestbr ; Chichester. Population 8,884. Cholera 12 ; Diarrhoea 6. The whole of
the IS deaths occurred between 22d July and 4th August : eight were of adults and four of children
between two and four years old. The first death occurred in Cavendish-street, to a journeyman
taUowekandler ; three deaths afterwards took place in High-street and three in St Fancras-street ;
Ac luX two deaths were of a tailor and alderman, aged 74 years, in St. John-street, and of the
wife of a carpenter in George-street The sanitary condition of Chichester had for some time been
known to be nniatisiactory. In the three sub-districts of Chichester there were 12 deaths from
cholera in 1849, only three in 1854, and 12 again in 1866.
94; a. Westbousxe; Westboume, Population 3,726. Cholera 17; Diarrhoea 2. Cholera
WIS epidemic here between 22d July and 28th August. The first death was of a fisherman,
aged S3 years, at Bosham, on S2d July ; between 23d and 26th. three children of a shoemaker died
at the Hermitage, Westboume. After this date, excepting one at Nutboume, all the remaining
deaths occnrred in Westboume, and principally at the Ilermitage or Workhouse. Of the 17 deaths
ftom cholera, 10 occurred at the Hermitage, and three at the Workhouse. The last death was of the
daagfater of a fisherman, aged seven years, at the Hermitage on 24th September. Only two deaths
fttm cboksiu were recorded in Westboume Union in each of the yisitations of 1849 and 1854.
4. Hampshire.
95; I. HATAirr; Havant. Population 74212. Cholera 9; Diarrhoea 0. The first two deaths
cholera were of the son and cUiughtcr of a fisherman on 21st and 25th July at Emsworth ; the
third foflowed on 1st August, the remainder taking place between that and the 12th of the same
month, on which day the last occurred at Warblington. Five were recorded at Emsworth, three
at Harant. and one at Warblington ; with the exception of a Scripture reader the whole of the deaths
were of fishermen, or seamen, and their relations.
96 ; I. F0BT8EA IsLAXD ; Kingston. Population 23,089. Cholera 39 ; Diarrhoea 19. The first
death from cholera occurred at North End, Tortsea, on 20th July, and the next few cases appeared
at intcmiU of a day or two, but three deaths took place on 30th July and three on ist August ; deaths
fbllowed in succession till nearly the middle of September, the last case occurring on 12th of
that month. The whole of the deaths occurred in the crowded streets and courts occupied by
the laVmring classes in Fortsea ; five were recorded in Oxford-street and five in Frince's-court, and
three each in Hope*8treet and Salisbury-place, the three in the latter all in one house.
q6 ; 3. F6BTSBA Island ; PorUea Town, Fopulation 19,967. Cholera 15; Diarrhoea 13.
With the exception of the child of a shoemaker, aged nine years, who died in St James'-street on
1st Augnat, nofktal case of cholera occurred until 21st of that month, after which date deaths from
dns eatose took pUce at intervals of a few days until 19th October, when the last case, that of the
wifr ci a blacksmith, occurred in College-street. All the deaths were recorded m the streets and
eoorti occupied by the families of seamen, shipwrights, and labourers.
96 ; ^ P0BT8KA Island ; PorUmouth Town, Fopulation 10,346. Cholera 27 ; Diarrhoea 15.
la diU ftit ot the town the first death from cholera occurred in East-street on 19th July, but 21 of
(he 97 deaiha from this cause took place in the month of August ; the last epidemic case may
be nid to hsve occurred on 7th September, although the child of a waterman, aged fonr months,
diad (» ICHh liorember from debility and diarrhoea, occasioned by an attack of cholera two months
pnewiomlj. Tnt of the deaths (besides several firom diarrhoea) were recorded in East-street and
ns tfrbotuj courts ; ^ve in Crown-street, of which four (all of adults) occurred in one house ; and
two in CSuxeis-conrt, St Mary-street
Tkm B^giitiar states that the water supply for the town of Fortsmouth is obtained fVom springs
r Ha^rant, eight miles distant, and is not liable to contamination of any kind : there are a
wcOs in the district, which are slightly impure, but they are very little used for domestic pur-
: dieie has been no scarcity in the supply of water.
9^1 4. FcHinaA Islawd ; Landport Fopulation 41,426. Cholera 62 ; Diarrhoea 70. The first
cholera was of the daughter of a soldier, aged six years, at 11 Oxlbrd-terrace, Albert-
ITtili July ; this was followed by two other deaths in the -same house on 20th and
hf two others in Southsea. The first death in Landport occnrred 25th July. Cholera
1 fhtal in portions of both Southsea and Landport until the middle of September;
the iaat dcttth occnrred in Brunswick-square, Southsea, on 17th September. The deaths, from
not confined to a few streets, the largest number in single streets being five recorded in
rtreet, and four in Green-street, in wldition to several from diarrhoea in each. With
any exception, all the deaths from cholera occnrred in the families of seamen, shipwrights,
of difierent classes ; a considerable proportion were of children.
la Ac finir anb-districts of Fortsea Island, the total deaths from cholera in 1866 were 143,
568 in 1849, and 20 in 1854. In 1849 the disease was most &tal in Fountain-street and
214 Notes on Cholera in DUtiieii.
Nanoe's-Fow in Kingston ; in CatherineVrow, and White's-row in Portsea Town ; in Ftospectrow,
and East and West streets in Portsmoath Town ; and in Brunswick, Hyde, and Montagne-streets
in Landport.
97; I. Alyerstoke; Aloerstoke, Population 22,653. Cholera 19; Diarrhoea 11. On May
15th, a yeoman died at Brockhnrst of English cholera ; but no fatal case of an epidemic character
occorred until 18th July, when a boy R.N., aged 15, died in Haslar Hospital ; this was followed by
three deaths between 2ist and 25th July in ^uth-street, Gosport From this date to the 4th Sep-
tember deaths continued to be recorded ; the last two deaths occurred on the last-mentioned day
in Haslar Hospital. Of the whole 19 deaths from cholera, five took place in Haslar Hospital, five in
South-street, Gosport, six in other parts of Grosport, and two in Alverstoke. The deatha from
cholera in 1849 in Alverstoke were 126, of which 13 were recorded in Haslar Hospital.
98; I. Fajieham; Fareham, Popuhtion 9,640. Cholera 8; Diarrhoea 7. One death firom
cholera occurred on 26th July in Trinity-street, Fareham ; the remaining seven fatal cases took place
at Porchester. The first death in this parish was on 16th August, two followed on 24th, two on 27th,
one on 28th, and the last on 13th September. Most of the deaths occurred in the fiunilies of
seamen, fish dealers, and labourers.
99; I. Isle of Wight; Cowes» Population 10,449. Cholera 19; Diarrhoea 2. The first
death from cholera occurred on 24th July at Barton's Village, Whippingham. 12 of the deaths
took place in August, two in September, and the last fatal case at West Cowes on 1st October.
Of the 19 deaths, nine each were recorded at Whippingham and West Cowes, and only one at East
Cowes. The whole of the deaths (with only one exception, the wife of a butcher) occurred among
the labouring classes.
90; 2. Isle of Wight; Newport. Population 13,761. Cholera 70; Diarrhoea 12. The first
fiitaf case in this sub-district (and also the first in the whole island), that of the wife of a mariner, aged
20 years, occurred at Little London, Newport, on 17th July ; on the same day also died, the innnt
child of a mariner at the same address, and the child of a labourer, aged five years in Sea-street.
The disease continued very fatal until nearly the middle of September ; after the 9th of that month
only two deaths occurred, one in the workhouse at Carisbrooke on 22d September, and one on
19th October. In July, 21 deaths were recorded; in August, 38 ; and in September, 11. In the
workhouse, Carisbrooke, 28 of the deaths took place ; in Trafalgar-road seven, in Sea-street five,
and in Orchard-street four.
In the quarter ending 30th September 69 deaths from cholera and nine from diarrhoea having
occnrred in Newport sub-district, Mr. Moore, the Registrar, made the following communication to
the Registrar General, in reply to questions relating to the water supply. (^See London Weekly
Beittrn No, 44.):—
That part known as the town of Newport is supplied from rivers, public wells, and private wells.
The largest portion of the town has an additional, but not a copious, supply by the Newport and
Carisbrooke Water Company from the well-known pure Carisbrooke Springs. The hamlet of
** Hunny Hill," a suburb containing about 50 houses, has no other general supply than that obtained
from a polluted mill-pond, about 400 yards distant ; but during the cholera crisis (1866) the
Guardians of the Poor temporarily supplied that part from the Carisbrooke springs, a mile distant,
by means of water-carts, which supply is now discontinued. The hamlets of ** Gunville " and
" Forest-side " are supplied from so^-wells, ponds, and land drainage, the barracks and prison at
Parkhurst from deep wells, and the workhouse from a deep well and a pond. The remainder of the
district, being rural and thinly inhabited, is variously supplied from wells, springs, and rivulets.
Generally speaking, the water in the country is not liable to contamination ; but many of the
town wells are contaminated with sewage and other impurities. The rivers bordering two sides of
the town are polluted with sewage, but the water in them is now little used for drinking purposes.
There has been a scarcity of water in the summer months, both in town and country. In the town the
lower part has been moderately supplied by the water company, while the parts on a higher level
have been inadequately served by reason of the water from the Carisbrooke springs being allowed
to flow slowly and insufficiently through the mains and pipes unassisted by mechanical and
hydraulic pressure. Other parts of the town are wholly dependent upon private wells, and these
mostly of an inferior description, and consequently suffer a scarcity in diy seasons.
99; 3. Isle of Wight; Ryde, Population 17,715. Cholera 12; Diarrhoea 3. (Cholera
was fieitaJ here almost at the same time as at Newport and Cowes ; the first death, of a child,
occnrred in the infirmary on 26th July ; from this day to 7th August inclusive, eight other deaths
followed. One death occurred on 10th September at the Infirmary, and two others (a jeweller,
aged 66 years, and the wife of a labourer, aged 70) at Shanklin, on 20th and 28th October
respectively. Seven of the 12 deaths from cholera were recorded in the infirmary, and two in
Castle-street.
99; 4. Isle of Wight; Godshill. Population 8,020. Cholera 3 ; Diarrhoea I. The death of
a child occurred on 25th July at Ventnor, from choleraic diarrhcea. A labourer, aged 26y died on
2d August, at Godshill, and a journeyman butcher at Niton on 3d August
[In the entire island, composed of five sub-districts, 105 deaths from cholera occurred in 1866,
against 152 during the epidemic of 1849, and only four in 1854. In 1849 the mortality frt>m
cholera in Cowes and Newport was almost the same as in 1866 ; but in Byde, which escaped with
12 deaths in 1866, 55 occurred in 1849.]
Notes on Cholera in DUtricis. 215
loss I. SooTBAKPTON ; Southampton, Population 43,414. Cholera 107; DiarrhoBa 44. In
the aolBmii of 1865 there was in the aab-^fltrict a alifl^t epidemic of cholera and diarrhoea, which
earned 21 and 69 deaths respectiyelj. Professor Parkes, in his report on this outbreak (Eighth
Bepmi tf the Medical Officer of the Privy Council, 1865, p. 392), states that in Southampton and
Hm neu^hbonrhood there occurred altogether between the 22d September and 4th November 60 oases
of efaolera» of which 35 were fiitaL
In 1866 the first fiital case of cholera was that of a child, aged two years, on 13th June, in Berois*
atxteL This child was the son of a fireman of the Peninsular and Oriental steam ^p Poondh,
TtoeaAj aniTed at Southampton from Alexandria ; the father landed from tiie ship on the 10th June,
he was attacked with diarrluBa the next day, and died on the 19th, his child having died in the
BKantime. (^See Profeeeor Parhes* Report on Cholera in Southampton, Ninth Report of the Medical
O0Uer of the Privy Council, 1866, p. 244.)
Tiro eases of choleraic diarrhoea occurred during June. On 6th July the wife of a seaman,
aged 40 years, died in Middle-street after an attack of only nine hours ; other cases followed in rapid
•BeeeaBon, and the disease was severely epidemic until the middle of August, after which date
tibe deaths n^idly declined, but the last case did not occur till 8th October, when the cook
cf a Bteam vessel died after only 12 hours' illness. Three deaths occurred in June, 80 in July,
15 m Angnst, seven in Septemb^, and two in October. The mortality firom cholera was almost
cndrely confined to those parts of the town inhabited by the labouring classes, although it caused
deaths in a large number of differently named streets; 20 were recorded at Anspack House,
8t. Michael, nine in Winchester-street, five in Queen-street and Rose-court running out thereof, and
three each in Edward-street, Marine-parade, and Crosfr-street ; of the remainder of the deaths not
more than two occurred in any one street In 1849 the deaths from cholera in Southampton
940, and in 1854, 48.
J07; I. SoiUET; Romsey. Popuhition 6,795. Cholera 16; Diarrhoea 2. On 18th July the
aon flix a Jonmeyman bricklayer, aged 1 5 years, died in Narrow-Ume of cholera, certified as ** Asiatic ;**
on the same day deaths occurred in Banning-street and at Middlebridge. By the end of July
13th daaths had been recorded, and the last deadi, of a labourer ag^ 77 years, occurred on
19di Angnst Of the whole 16, seven took place at Middlebridge, and four in Banning-street In
1849 sad 1854, 15 and one deaths were respectively recorded from cholera. The disease first
in 1849 in Banning-street, and nine of the 15 deaths occnrred there.
IIL— SOUTH MIDLAND COUNTIES.
6. Middlesex (extra'tnetropoliian),
13a; a. SiAiirss; Staines. Population 8,687. Cholera 1; Diarrhoea 6. The fatal case of
cholcn was that of a greengrocer, aged 58 years, in the workhouse at Stanwell on 5th October,
as * Asiatic," with collapse after an attack of 48 hours* duration. The six deaths from*
were all of infants under one year of age.
133 ; !• UxBsiDGE ; Hillinydon. Population 8,844. Cholera 2 ; Diarrhoea 6. The two deaths
ftmn cholera ooeorred in the workhouse on Slst August and 6th September respectively, both of
133 f 3" XJzBRiDOE; Hayes, Population 9,157. Cholera 1 ; Diarrhoea 6. On August 15th the
ddld of a labourer died in North-hyde-lane of English cholera. The cases of diarrhoea were
mU of *"^*ff, oeept one of a female aged 84 years. In the Uxbridge District, comprising three
nb-dbtrictf, only four deaths were referred to cholera in 1866, against 40 in 1849, and 49 in
1854.
134; I. Brxntford ; Isleworth, Population 15,533. Cholera 7; Diarrhoea 16. Four deaths
fktun efaolendc diarrhoea occurred in Church-street on 2l8t and 22d August On 18th September
tile wife of a gardener, aged 77, died at Scrattage, Ileston, from cholera ; and the last two cases took
place OB 28th and 30th October respectively in the workhouse. Of the 16 deaths from diarrhoea
14 wen of incGuitB under one year of age.
134; 3. Brentford ; Brentford. Population 13,976. Cholera 5 ; Diarrhoea 21. A lighter-
mBDy mud 44 years, died on 27th July of English cholera at New Brentford ; the next three cases
were nose of a labourer and two children in Allen 's-yard on 30th July and 1st and 2d August.
The last death was that of the daughter of a grocer aged 10 years, at Old Brentford on 17^
October. Of the 21 deaths from diarrhoea 16 were of iu&nts not exceeding one year. In 18499
110 deaths fttm cholera were here recorded, of which Old Brentford furnished 86.
S34; 4. BB£iiTfORD; Chiswick, Population 6,505. Cholera 12; diarrhoea 9. On 11th Jnly^
fbe wife of a labourer died in Devonshire-place after an attack of only 12 hours ; and eight additional
dodbs o e cu ri ed before the end of the month. No other death occurred until 12th Septembers
aad the lait two eisesi on 29th September and 7th October, were both recorded at Strand-on-the-
216 NaUs^ an Cholera in Districts.
Green. Three of the deaths from cholera occurred in Wood<street, two in Derooahire-Qtreeti and
one each in Devonahiie-place and ^evondiire-road. Daring the epidemic of 1849, 15 deathg took
place in the neighhoorhood of Strand-on-the-Green.
[In the entire district of Brentford oxdy 24 deaths from cholera occurred in 1866, against 184 and
196 respectiyelj in 1849 and 1854.]
135; 3. HEin>ON; WUlesden. Population 3,879. Cholera 4; Diarrhoea 11. On a5th July
the diaiighter of a grocer, aged fiye months, died from cholera in Manor-mews ; the second case was
that (Mf the child of a labourer, ag^ nine years, in Canterbury-yard, and on the 5th and 6th October
the wife and child of a railway signal fitter died in Alpha-place after attacks of only a few hours*
diuration. All four deaths occurred in Kilbum, three being of young children.
136; 3* Barnbt; Finchley. Population 8,281. Cholera 2; Diarrhoea 3. The first death from
cholera was of a master painter on 17th October in Market-place ; the other was of a newspaper
<iorj;e8ppi)dent in the Lunatic Asylum on 2d Noyember from oholeraic diarrhoea.
137 ; z. EDiroNTOK', ffonuey. Population 11,082. Cholera 3) Diarrtioea 9. . No death from
oholera occurred until 28th October, when a gentleman*s • cbaohman died in Southwood-Iane,
Muswell-hill ; on 30th a labourer who had suffered from diarrhoea for fonr days died of cholera at
North-hiU; and the bist case occurred On 19th November, when a kibourer died at the Wellington-
iiin^ Higfagate, of Asiatic eholek» (10 hours.) All: the nine deaths fW>m diarrhosK were «f ix&nts
not «<ceeding one year.
* «
137 ; 2. Edmontoiy ; Thttenkom, Population 13,240. Cholera 6 ; Diarrhosa 18. The first
<lea& fi'om cholera occurred on 8d September at Sicotland-green, fbllowed by one in the MarkfieH-
Toad on 5th; no other took place tul T9th, when a child died in Grove-court The last three
occurred on 28th and 30th October, and 5th November. Four of the six deaths from cholera wen"
recorded in Markfield^road. Of the 18 deaths from diarrhosa, 15 were of young children, mostly
•of infimts under one year of age.
147; 3* Edmonton; Edmonton/ Population 1Q,980. Choltot ^) Diarrltea 1$. ' Of the three
deaths fV^Dm cholera, two (both of adults) occunidd at ^Outhgate on 4th August leoid Slat September;
the last case was tiiat of an infent in Lower-A)re-street on 26th September. Of the 18 deaths
firom diarrhoea, 11 were recorded in the workhottse, 10 being of adults. During the epidemic in
1849, 41 flEital cases of cholera occulted, of whidi the Cmse, Southgate, fhrnished 18, and the
Workhouse eight
137; 4. Edmonton ; Enfield. Population 12,424. Cholera 4; Diarrhoea 6. On 29th July
a child died of cholera in Metcalf-road, Lock-lane ; the next case occurred in Baker-street on
'27th September ; and the last two cases at Alma-road, Ponder*s-end, and LoveVrow on 20th and
25th October, five of the six deaths from diarrhoea were of infants,
[In the six sub-districts of Edmonton, only 16 deaths from cholera occurred in 1866, while in the
two visitations of 1849 and 1854 the fetal cases were 101 and 90.1
• ••
8. Buckinghamshire.
. .1(0 ; I. Wtcombb } High Wycombe, Population 11,583. Cholera 5 ; Diarrhoea 4. Of the five
deatns from cholera, two occurred in Oxfond-road and two at the Green, Woobum. The first took
place on 25th August, followed by another on the 28tb, and two on 6th and 20th September. The
laat death, that of a (Uiild in Railway-place, Wycombe, occurred on 16th October. All four deaths
from diarrhoea were of children.
12. Bedfordshire.
185 ; 5. Lbiohtok Bvezabd ; Ivrnghoe, Population 2,477. Cholera 9 ; Dian^Msa 2. The ^rst
death from cholera ocourred on 9th September, followed by two on llUi, one each on ISth and 14th
three on 16th, and the last on 2dd. Five were of adults aged 20 years and upwards, and the "^hjiVt
nine were recorded in, the parish of Ivinghoe, which in 1861 contained a decreasing population!
No deaths from cholera occurred in this subrdistrict in 1854.
Note rm the outbreak at Ivinghoe, Communicated by P. H, Holland, Esq,^ M,ILC.S,, Medical
'' Inspector, Burial Acts Office,
Seven of the nine fatal cases of cholera occurred in one littie court, inhabited at the time
1^.01% 26 persons, 12 of whom were attacked. All these deaths ooouned "vithii a fort-
night. Two other fatal cases only occurred in the whole village, and one of those snflcmn had
been staying in the same court. The exciting cause of the outbreak must, therefore, have been
both local and temporary, for the inhabitants of the immediately adjoining houses eses^ed, and the
disease soon ceased in the affected court. The water of the well supplying this one court, though
generally pure, was at this patticular time discovered to be very much polluted with putrescent
matter, some at least of which had evidently been recently introduced, for dead but still undecayed
earth worms were found in if. Water was obtained from another source, and the local epid^nic
quicklv subsided. It did not appear that the first victims had previously been amongst sufferers
from cholera, or that they communicated the disease to others.
Notes en Cholera in Districts, 217
Eight of the nine victims were known to have drank water proved to have been such as would,
in ordimrj Mfoni, have been likely to excite typhoid fever, diarrhoBa, or other kindred disorder
The inmeiiate neighbonrs of die sufferers, apparently equally exposed to all other influences
i fnUiu M to produce cholera, but who did not drink of this polluted water, with only one exception,
escaped its £atal power.
183 ; 4. LEiOHTOsr Bczzabd ; E(Ue$borough. Population S,436. Cholera 6 ; DiorrhoBa 2. An
tfgtkHtanl labour^ died ib Edlesborough on 10th October of Asiatic cholera, followed by one
death on IStli, 14th, 1 6th, and 26th of the same month ; tbejlast fatal case was that of the wife of an
igrleiiltiiral labourer on 1st November. All the six deaths occurred in Edlesborough and in the
ftmilici of imenltural labourers.
[During the epidemic of 1854, 17 deaths fh>m cholera occurred in the entire district of Leighton
Boanrd. against 16 in 1866; in 1854 the mortality from this disease was almost confined to the
Mghtwi BiBxard sub-district, and no deaths occurred in either Ivinghoe or Edlesborough.]
IV.— EASTERN COUNTIES.
14. Essex.
194; f . Ws9T Ham; Stratford, Population 15,994. Cholera 160; Diarrhoea 20. The first
fistal ciae «f diolera was that of a dock labourer, aged 75 years, who died in High-street on 13th July,
after an attaek of only nine hours. The disease, therefore, appeared here almost simultaneously
with the ^Fst deaths in St George-in-tbe-East, Stepney, Poplar, and other of the Eastern districts
of the meCnopolis. During July, 94 deaths occurred, in August 60, in September five, and the last
wsa leeofded on 2d October in Leyton-road. The ftitality of the disease was at its height between
the middle of July and the middle of September ; and the number of deaths occurring either before
or afttf Ih6ee periods wac comparatively small Eleven deaths were recorded in Castle-buildings;
nine in Leyton-road ; six each in Queen-street and New-street ; five each in IHgh-street, Union-
street, and Chapel-street ; and four each in Angel-place, Windmill-lane, Chant-street, Waddington-
-ttreet, West-etreet, and Castle-street In 1849 the deaths from cholera were 64 in this sub-strict,
and it is worthy of remark that High-street, West-street, New-street, and others of those mentioned
nbare, suffered during that epidemic, as well as during 1866.
194 ; 2. West Ham ; West Ham. Population 25,195. Cholera 219; Diarrhoea 30. The first
death from cholera here was of the wife of a ship yard labourer, who died in Bumham-street,
Plaistow on 12th July. On the same day a death occurred in Canning's town, while the two first fiital
casee in West Ham, proper, took place on 16th, and at Forest-gate on 17th. The disease took very
nearly the same course as in Stratford sub-district ; it was severely epidemic only between the
middle 0/ July and the middle of August, after which it rapidly declined, but a few deaths con-
tinned U> occur during September and October, and the last death took pUce in Abbey-lane,
Flaktow, on 8th November. Of the whole 219 deaths fh)m cholera, 111 were recorded in Plaistow,
43 in West Ham, 24 at Forest-gate, and 19 each in East Uam, and Canning's-town. In 1849,
when the population was probably less than a quarter qf what it was in 1866, only 48 deaths from
cholera occurred, divided between West Ham, East Ham, Plaistow, and Forest-gate. {For details of
ike epidemic of 1866 m We»t Ham, see*' Ectracts from Weekly .Returns, 1666,*' ante p, 132 ; and
Mr, RadeUjft^e Report on Cholera in East London in Ninth Report of Medical Officer of Privy CouneiL)
194 • 3- Wm Haic; Ley ton. Population 7,536. Cholera* 11 ; Diarrhoea 6. No death firom
cholera occurred ontil 31st July, when the widow of a cork cutter died in Cooper*s-lane ; eight other
deaths took piace between the 1st and 12th August, of which seven were recorded at Xicytonstone,
fbnr be&g of uunates of the workhouse. The last &tal case of an epidemic character occurred
oo S2d A^agatt' on Wanstead Flats, but a bricklayer's labourer died at Fhillybrook, Leyton, on
11th October of choleraio diarrhcea.
194; 4k WnsrHaic; Walikamsiow, Population 10,594w Cholera 1; Dianhoea 8. The fatal
ease tiit cholerm was that of the daughter of a builder, aged 50 years, at Walthamstow, from
choiemie disrriHMr (two days).
[In the entire -district of West Ham, comprising Uie four preceding sub -districts, a total of 391
dcnths ftvm' cholera occmred in 1866, against 124 in 1854, and 134 in 1849; it must, however,
be bone in mind, t{iat the population in this suburban district has recently increased at an almost
nnezampled rate, and that the mortality from cholera at the two visitations of 1849 and 1854, ir9M
p r op offtiflnately to the population greater than in 1866.]
195; f. Efpikg; ChigweU. Population 5,987. Cholera 5; Diarrhoea 2. On 29th July and
4th Aognt, two deaths from cholera occurred at Buckhurst-hill, Chigwell ; the other three took
pbee at Longhton between 6th and 25th August.
105; 3. Kffiko ; Epping. Population 5,018. Cholera 3 ; Diarrhoea I. The three deaths from
e h awni oecnrred on Epping Plain, Thoydon Gamon ; the first was of an adult on 1 9th July, and
the hit two of the children of a husbandman, aged respectively seven and eight years, on 8th and
I4di Angnst. In 1854 an outbreak occurred in the workhouse at Epping which the Sttperin<t
218 Notes en Cholera in Districts^
tendent Registrar attributes '* to the dreadful state of the drainage at that period :** out of 99 inmates
33 died. In October 1865 there was an outbreak of cholera at Thoydon Bois which within a fort-
night attacked eleven persons, eight of whom died (Eighth Report of the Medical Officer of the Privy
CSuncil, p. 29.).
197 ; I. Romford; Romford, Population 9,741. Cholera 11; Diarrhoea 3. The first fatal
case of cholera was that of a {arm labourer, on 6th October, in ColUer-row, Romford ; at the same
place three more deaths followed on 8th, two on 9th, three on 1 1th, and the last of an epidemic
character on f 3th. The whole of these 10 deaths occurred in the fiunilies of &nn labourers, in
Colller-row,between 6th and 13th October ; six were of young children. The last d^th from
cholera was of the daughter of a hairdresser at Dagenham, on 3d November. In the epidemic of
1849, cholera was fa^ in 68 cases in Romford ; of these four occurred in Ck>llier-row, and 26
in Dagenham parish.
197 ; 2. Romford ; Ilford, Population .5,405. Cholera 1 ; Diarrhoea 5. The death from cholera
was of the widow of a labourer at Aldbro' Cottages, Ilford, on 10th October, after an attack of
only 13 hours* duration. There were here 59 deaths from cholera in 1849.
197; 3. Romford; Barking Town, Population 5,591. Cholera 9 ; Diarrhoea 6. The child of
a blacksmith died in Heath-street on 30th April No further death occurred until 21st July, when
the wife of a sawyer died in Fisher-street ; this case was followed by six others, the last taking
place on 8th August Three of the deaths were recorded in New-street Of the six deaths from
diarrhoea, five were of in£uits, and the other of a female, aged 76 years. At the cholera viatation
of 1849, 29 deaths occurred, of which six each were record^ in Heath and Fisher-streets.
197 ; 4. Romford ; Homchurch, Population 6,228. Cholera 2 ; Diarrhoea 2. Of the two deaths
from cholera, the fint occurred at Homchurch on 1st August; and the last at Great Warley on
88th October. Both were of children.
aoi ; 2. Rochford; PrittleweU, Population 5,394. Cholera 21 ; Diarrhoea 8. On 30th July
the wife of an engraver and on the same day the daughter of a waterman died of cholera at
Southend. The remainder of the deaths occurred at intervals up to the 17th September, when the
last took place in the Leigh-road, PrittleweU. Two occurred in July ; 10 in August, and nine in
September. Six were recorded in Southend, five in PrittleweU, eight in Leigh, and the other two in
Southchurch. In 1849 there were 41 deaths from cholera, of which 16 occurred at Leigh, and
10 at PrittleweU.
210; 3. Saffron Waxden; Radwinter. Population 5,035. Cholera 7; Diarrhoea 1. The
whole of these seven deaths from cholera occurred at Great Sampford, between 4th and 19th Novem-
ber ; in several of the cases the iUness was of very short duration. There was no death from cholera
here in 1849.
V^SOUTH WESTERN COUNTIES.
17. WiLTSHIHB.
264 ; I. Salisburt ; Salisbunf. Population 9,039. Cholera 2 ; Diarrhoea 0.
Tlie Registrar-General has been favoured by A, B. Middleton, Esq., M,R,C,S,, with thefoUowing
information relative to the sanitary condition of Salisbury during the three years of epidemic Cholera^
1849, 1854, aii(/ 1866.
In 1849 the cholera visited Salisbury (as did the plague of former times) with fearful severity,
165 deaths having occurred within three monUis amongst a population of about 9,300. At that
time the subsoil of the city was soaked with moisture almost to its sur&ce, and the sewerage was
partly into smaU canals (Uned with bricks, but not watertight) derived from the river Avon, and
Tunmng through nearly every street, some of them covered, others open ; and partly into cesspools,
many very large, placed in a porous subsoil, often quite close to the wells, whidi were very shaUow.
The water-supply was chiefly from those wells, but many cottagers took their water frt>m the open
channels, which thus, at the same time, served the twofold purpose of fountains and sewers. Much
of the beer was brewed with water from the channels, which received the contents of hundreds of
privies and water-closets. The weU water, generally very bad, was after heavy rains stinking and
coloured with cesspool filth.
In 1851 an Inspector was obtained from the Board of Health, and a plan was made for combined
sanitary works, not only for the city proper, but embracing the whole borough, i,e, taking iu the
Close and the part of Fisherton Anger parish, which is a suburb of Salisbury, across the Avon. It
is worthy of remark, that, notwithstanding the dreadful cholera visit of 1849, the resistance to in-
spection was determined ; and as the promoter of inspection, having fuled to obtain the signatures
of one-tenth of the ratepayers — the smaU proportion then legaJly required by the Public Health Act —
I succeeded by inducing the Board of Health to use the compulsory clause of the Act, whereby an
inspector could be sent to any town having an annual mortality over 22 in 1|000, the mortality of
Salisbury, exclusive of cholera, having for years been nearly 27 in 1,000.
J^ates on Cholera in Districts. 219
In 1853, within two yean from the iospection, a majority' having been obtained at the Local
Board, woTks were actaallj commenced, the objects of those works being, 1, subsoil drainage ;
Sy sewerage; 3, water-supply. The works constructed consist of, 1, larger mains, being brick
calT«rtB ; 2, smaller mains, of glazed earthenware pipes ; 3, subsoil drains, of porous pipes ; 4, house
draisuy of glased earthenware. The main sewers are brought to a conmion outfall into the Avon
bdow the city. The waier-supply is from a well 68 feet deep, sunk in the chalk down, a short
distance north of the city, and is continuous for 16 hours daily at high pressure. A reservoir exists
140 iSeet above the Avon level, and the water is circulated through iron mains and galvanized iron
fcrfice pipes. The water obtained is not hard, but is of very excellent quality, and quite free from
eiganie matters. The daily quantity pumped is about 600,000 gallons, which, taking the borough
popolation at 12,600, gives about 48 gallons per head.
jRiepablic works for drainage, sewerage, and water-supply were completed in 1854. Of course,
IS the connecting of houses therewith extended over a longer period, it will be impossible to fix any
dste for their completion ; indeed, even now some few remain unconnected, but it may be safely said
tint by the end of 1856 a majority of the private work« were finished.
In 1854, daring this transition state, a cholera epidemic happened, and from it 15 deaths were
registered in Salisbury. At that time the public works having been done the subsoil must have
tiready become much drier, although not quite dry, as now it is, because the channels, since
dotroycd, then existed, and were one great cause of diunpness, not being water-tight
Many booses having been connected with the mains at this time, the question arises whether
dioleta happened in any premises so connected, and supplied with the new water ? After a
careAil personal investigation, I record the fact that all the 15 cases occurred in houses remaining
in their old condition.
In 1866, with the public works completed and the private works nearly so, Salisbury may claim an
abaolnte freedom from attacks of the cholera epidemic. It is true that the register contains one
death from cholera and one from choleraic diarrhoea, but the case of cholera was imported under
the following circumstances: A young man, resident for some time near Southampton, was there
attacked with cholera, and brought thence to his ])arents* house in Salisbury- ; he was then in the
stage of collapse, fainted at the railway station, and lingered 3 or 4 days after his arrival at home.
Tbe Sstisbury Local Board of Health district includes the Close, and part of Fisherton lying
within the borough, the deaths of which are registered in Alderbury district. From personal
examination of the registers, I find that the Close in 1849, with a population of about 5G0, had
3 deaths from cholera; it was then midrained. baring cessftools, and wells adjacent with bad
waiter, as m the town; in 1854, in a transition state, no cholera cases ; in 1866, sanitary works done,
also no cholera. Fisherton, undrained, and water bad, in 1849, out of a population oi about 1,800,
had 11 cholera deaths ; in 1854, in transition state, 4 cholera deaths ; in 1866, sanitary works done,
there was 1 death registered as cholera, but that case was of a very questionable character. A
woman, aged 43, of drunken and dissipated habits, during hot weather ate excessively- of bad
cucumber, and drank correspondingly gin and beer ; her death followed, and was registered as
cholera upon the certificate of the assistant of a medical man. ^See a valuable pamphlet by
Mr. Middteton on " The Benefits of Sanitary Reform ;" read before the British Association at Bath
in 1864.]
19. DlIVOXSIIIRE.
281 ; I. St. Tuomas; East Budleujh. Population 4,649. Cholera 1 ; Diarrhoea 2. A farmer,
aged 73, died on September 13tb, at Otterton ; " diarrhcea, 6 days ; Asiatic cholera, 36 hours."
281 ; 2. St. THOM-iS; Exmouth. Population 7,171. Cholera 28; Diarrhoea 5. 19 of the
deaths from cholera occurred in the parish of Littleham, including eight in Fore-street ; the first
fatal ease occurred on September 3d, and the last on October 3lRt; the deaths were not confined to
persons of tny particular occupation, but were much more numerous among adults than children.
281 ; 3. St. Thomas ; Woodbury. Population 3,916. Cholera 11; Diarrhoea 1. The whole of
tiie deaths from cholera took place in the parish of Woodbury ; four died in one family in October.
The first case was that of a sawyer's daughter, on September 23d, and the last that of a labourer's
dai^gbter on November 23d. Of these 1 1 deaths, eight were of females.
fl8j ; c. St. Thomas; Topsham. Population 4,777. Cholera 19 ; Diarrhoea 9. The first death
from cholera occurred on August 12th, followed by three other deaths during the month ; three of
the deaths were of persons aged 75 years and upwards. Four deaths occurred on September 13th.
Whxts-stivet and Fore-street suffered the most. The last death was that of a seaman's son on
25th. There was no death from cholera in this sub-district during the epidemic of 1849.
381 ; (. St. Thomas ; Ileavitree. Population 6,5.'>6. Cholera 14 ; Diarrhoea 1. Seven of the
deaths fram cholera occurred in Jubilee-placc, St. ]^onard*s ; the last fatal case in Jubilee-
place was on October 11th, when a dairyman, aged 52, died from '* diarrhoea, 2 days ; cholera,
7 boars." "Jlie last two deaths occurred on October 22d in Weirfield-street, where the sons of a
eabiaet-niaker, aged respectively six and eight years, died, the first after 16 hours' and the second
after 19 hours' illness.
a8i ; 7. St. Thomas ; St. Thomas. Population 6,053. Cholera 1 ; Diarrhoea 9. This death
from cholera was of a labourer's daughter, aged four years, on September 27th, in Cockle's-court.
fi20 Notes on Cholera in JDistricts.
281 ; 8. St. Thomas; Afyhtngton, Population 4,097. Cholera 2 ; DiarrhcBa 3. First death
from cholera the son of a storekeeper, aged 12, at Alphington, on September 4th ; second, a black-
smith, aged 45, at Tedbum St. Mary, on October 8th. There was no death from cholera in the year
1849.
281; 10. St. Thomas ; Kenton. Population 5,442. Cholera 41; DiarrhoBa 8. Cholera was
&tal to a fiirm labourer, aged 58, at Kenton, on June 2l8t; another fatal ease occurred on the
29th ; in September eight deaths were registered ; in October there were 31 deaths, the last being
that of a labourer, aged 45, on October 26th in the County Lunatic Asylum. 37 deaths of males
(30 of these occurring in the County Lunatic Asylum at Exminster) were recorded against four of
females. The following are the localities, with the number of deaths in each : — ^Exminster 33,
Kenton three, Kenn tbree, and Powderbam two. In 1849 the deaths from cholera were thcee,
not one occurring in the parish of Exminster.
282 ; I. £x£TEB ; St, SidweU, Population 18,530. Cholera 67 ; Diarrhoea 19. The first
death from cholera was tiiat of a labourer, aged 70, in Union-terrace, St. Sid well, on August 12tfa.
The epidemic was at its height in September, more than half of the deaths taking place during that
month. Three members of one family died shortly after each other in September ; a pedlar (gipsy),
aged 28, in Rack-street, on September 26th, after 12 hours* illness ; and his two children in the
workhouse, one on the 28th the other on the 29th. The disease raged very severely io Fkeston-
street, where 17 of the deaths occurred, two or three in a day. The last death was that of a tailor's
wife, aged 49, in Rack-street, on November 10th. The number of deaths from cholera in the year
1849 was 11.
282 ; 2. Exeter ; St. David. Population 15,212. Cholera 45 ; Diarrhoea 81. A labourer's
wife, aged 23, died from cholera, on August 1 1th, in Ewing's-lane. The disease was most fiital in
September, but few deaths occurring in October, and only three in November ; the last two deaths
were those of a herbalist's widow and her son, who died in King-street, the son on November 4th
and the mother on November 10th ; the duration of attack in the minority of cases was very
short. During the epidemic of 1849 the deaths from cholera were 33.
283; I. Newton Abbot; Teignmcuth. Population 11,184. Clholera 23; Diarrhcea 6. The
first death from cholera was that of a seaman's daughter, aged dght years, at Ringwood-road, on
June 6th ; no other death took place until September 10th, when an agricultural labourer, aged
50, and his son, aged two years, died at Cockwood, Cofton ; on the 14th the widow died, making
the third death in this family ; not one of these three deaths was certified. There was no other
death until September 20th, but by the end of the month 15 fatal cases had been recorded^
including four in Park-row, Dawlish. The last death was that of a carpenter's son (who had
previously lost his father iix)m cholera), on October 10th. Only two deaths from cholera occorred
during the epidemic of 1849.
283 ; 2. Newton Abbot ; Chudleigh. Population 6,747. Cholera 4 ; Diarrhoea 2. The first
fatal case of cholera was that of a stoker in the navy, aged 27, who died on September 6th, at
Knighton ; the last two deaths occurred in Fore-street, Bishopsteignton, and were respectively a
gardener and his wife, the wife on October 23d and the husband on the 25th.
283; 3. Newton Abbot ; Moreton Hampstead. Population 2,718. Cholera 1; Diarrhcea 2.
A labourer, aged 46, died at Clay, North Bovey, on October 12th, of cholera, after 22 hours' illness.
283; 5. Newton Abbot; Newton Abbot. Population 10,467. Cholera 15; Diarrhoea 9.
Cholera was fktal principally at Hackney, Newton Abbot, and Kingsteignton, the migority of the
deaths taking place in October. The first fatal case was ^t of a labourer's wife, at Ipplepen, 00
August 20th ; the last, a lighterman's daughter, at Kingsteignton, on November 1 Ith.
283 ; 6. Newton Abbot ; Torquay. Population 21,585. Cholera 9 ; Diarrhoea 10. On
August 20th, cholera was fatal to the wife of a chioa mender, aged 38, in Temperance street ; tiie
next case occurred at Higher Union-lane, on September 3d. Nearly all the deaths took place in
labouring families ; the last being that of a labourer's wife at the Torbay Infirmary, on October 8th.
The number of deaths fW)m cholera in 1849 was 72, the epidemic chiefly prefailmg in Swan-stieet
and Warren-place.
284 ; I. Totnes ; Paignton. Population 4,266. Cholera 31 ; Diarrhoea 1. In 1849 there was
no death from cholera in this sub-district, but in 1866 a sharp outbreak occurred, the duration of
attack in the msgority of cases being very short. A male, aged three yeaM| died on August Ist at
Stoke Gabriel ; on the next day there was another death at the same place. The next fittal case
was not recorded until August 2 Ist, but after that date deaths took place daily, and by the end of
the month numbered 18. la September only three occurred, the last on the 9th, making a total of
21 deaths at Stoke Gabriel. On 6th October three fatal cases were recorded at Paignton, another on
the 7th and 1 Itli, and the last at Goodrington on October 18th. Farm labourers and their families
were the principal sufi^erers.
In compliance with a request from the Registrar General^ Charles Pridham, Esq., L.R.C.P.Ed.^
has kindly supplied the following interesting and detailed account of the circttmstanees attending
the outbreak of cholera in the sub-district of Paignton.
The village of Stoke Gabriel, situated on the east bank of the river Dart, has a substratum of
slate and green stone. The first point that attracts attention in a sanitary point of view is the
occurrence of watercourses which carry the rain-fall from the surrounding hills to the river, and
Notts an Cholera in DUtricU. 221
reoeWe the surface drainage of the village in their course. During wet seasons a plentiful supply
of water carries off most of the impurities which find their way to these streams, but after any
continBtnce of dry weather, as in the fall of 1866, the courses of the streams become almost dry,
and sewage matters becoming deposited form a fertile source of miasmatic disease. In addition
to this, the inhabitants save with great care substances likely to be of service as manure, and the
receptacles for, or rather deposits of, the refuse of fish and other putrefying substances were
apparently kept as near as possible to Uie houses. I should mention that fish is one of the chief
articles of fbod of the inhabitants.
jUthoQgh the general hl\ of the land is obviously towards the river, yet at certain points, as at
tbe Hiffaer Court, where cholera was very &tal, small patches of level ground occur without any
natnraf fkll, and the houses are built below overlying ground ; so mudi so, that fifteen feet from
most of the houses where cholera prevailed the ground is higher than the eaves of the houses, thus
pfefenting the circulation of ftesh dry air in the dwellings, and withholding any chance of natural
dninage mum the back courts. Of artificial drainage there was none ; and I regret to find that
tlic Innited amount which has been carried out since the visitation of cholera does not serve the
dcfired end, a decided fadure in the anticipated amount of discharge having resulted, the ioha^
bstHits declining or neglecting to drain into it The labouring class in this village, in whose homes
fte disease was most fatal, are, with a few exceptions, improvident and dissipated in the extreme.
Lower Court (^Stoke Gabriel), sndWaddeton. Four deaths. In this court three deaths occurred.
A earpcBter (peculiarly exposed from his employment as undertaker to contact with tiie bodies of
thoae who had ^ed) succumbed during consecutive fever. The other two persons resided close to
a pnry (wbieh one of them had cleaned out shortly before his attack) and near one of the streams
prevl o u ilyalladed to, which at this point is particularly offensive, and receives much noxiona
mattcr. The three drank water ih>m a well in the middle of the court, sunk in very low ground,
and in all pnbability receiving soakage fh>m the watercourse and privy. The water, on exam!-
natioia, was found to be very impure.
dofe to this court a man was staying ; he was sufifering from choleraic diarrhoea and cramp,
wat iCBored to his own home at Waddeton, a mile distant, and recovered. A fortnight after a
gardener, who resided in the next house (at Waddeton), was seized with cholera and died. The
water tUs man was in the habit of drinking was good ; but in his employment as gardener at
Waddeton Omrt he dailv used liquid manure of a very offensive description. The pnvy accom-
modation at the rear of his house was bad.
Upper Coiart {Stoke Gabriel). 15 deaths. In this court, in the house of a rag and bone dealer,.
prior to the first undoubted cases of cholera, three cases of an anomalous character occurred, two
of them (in children) fiital. The two first cases of undoubted cholera in this court were those of a
woman and her husband. The woman had attended upon and washed for the two children,
preiiooaly mentioned. The next three deaths were in two houses, one adjoining the premises of the
rag and bone dealer, the other adjoining that of the man and wife previously attacked. The disease
then apread alooc the course of an ill-constructed drain which ran in front of the houses, and into the
open month of which the excreta from the first-named patients had been poured. One or two deaths
oocnired in cMh house in the coarse of this drain, which was not calculated for the conveyance
of wewtige, bat merely for surface water from the road. All the patients had been drinking water
from the same source, which was found on examination to be of a most offensive description, and
cfaai^ged with decomposed animal and vegetable matter. Fifteen deaths occurred in eleven days in
tho efeven houses comprising this group. At two points openings are made in the orchard walla
qppoaite the houses, resembling on a large scale the slits at which before pillar posts were invented
we were accostomed to post our letters, and through these openings the inhabitants discharged
tlieir excreta, stele fish, &c., there to lie and decompose within fifteen feet of the houses.
Combe Shmtt {Stoke Gabriet), Three deaths. This locality is most unfavourably situated, and
the two first daths registered as cholera in the sub-district occurred here. The houses are
within 900 yards of a considerable extent of mud and grass land, which at spring-tides is covered
with water, but at other times is a swamp, and at night a dense fog arises from it. The house in
which the two first cases occurred is of a very inferior description, and the children are reported to
have been ill-nourished and destitute of every comfort. The stream, which runs close to it, rendera
the house very damp and unwholesome ; immediately in front is a sort of catch-pit, generally half
foO ot manure, and when the water springs are high it becomes a pond of dirty water, which, as
the water subsides, fulfils all the qualifications of a pest-pit. The well common to the inhabitanta
ia at a lower level than the houses, and being very shallow appears to derive its supply of water
firom the stream, which carries with it the overflow of the dung-pit and corner used as a privy ;
the water was reported as being bad. A poor man who was attacked in the opposite house left
for Tnckenhay, on the west side of the Dart, and there died in a few hours. The death of a woman
wraa the only one that appeared unconnected with any local causes. She lived in a healthy
aitoatfoB, anj drank pure water, but was what is termed a weakly person.
Goodrinffton (a hamlet a mile and a half from Paignton). Four deaths. The first person attacked
in tfcfg hamlet was a woman who had lately returned from nursing her father, mother, and sister
at Scoke Gabriel ; she recovered. A fortnight later two fatal cases occurred, vix., Mr. and Mrs.
D , ibr whom the woman's husband worked, and they had shown his wife great kindness during
her illness. The water they were in the habit of drinking was contaminated and rendered very
offiensave in consequence of drainage from the closet getting into the well. A fortnight after
Mrs. B , who resided midway between the house of the first woman attacked and that of
222 Notes on Cholera in Districts.
Mr. and Mn. D , took the disease and died ; also a man named F who worked for and
occasionally drank the same water as the D 's. Oat of a population of eighty at most, six took
the disease and four died. I reported the first case which occurred to the Nuisance Committee, but
I regret to state no measures were taken to prevent the spread of the disease until other cases
occurred.
Roundham (a hamlet about a mile from Paignton). Four deaths. The first case that occurred
in this locality was that of a man who was ureqnently in the habit of visiting Brixham, where
cholera was raging. The subsequent deaths (three in number) occurred also to jpersons who were
drinking water of a most deleterious character, containing three times the impunty found in any
of the water supplied by the London companies ; the well it was taken from receiving the sewage
from a completely choked drain which ran in its vicinity. The supply of water was very smaU
as well as deleterious, and only rendered drinkable frt>m the accidental fact that the sewage ran
through a bed of sand before it reached the well. From the day of this well bein^ locked up no
new case of cholera occurred. I had reported to the Local Board, two months previous to the first
of these cases, on the insuflSciency of the water supply and the choked state of the drain ; the only
reply I could get from the Board being, ** The want of water at Roundham Cottages is greatly to
*^ be lamented, but is solely the fault of the owners of that property, who have joined in nmking
'* an excellent well, but cannot agree among themselves as to the placing of a pump."
284 ; 2. T0TNE8 : Brixham. Population 6,750. Cholera 78 ; Diarrhoea 5. Seven deaths
frt>m cholera occurred in August (the first on the 18th), but in September and the early part of
October the epidemic was very fatal, especially amongst the seafaring population ; the last death that
took place was in Higher-street, Brixham, on October 29th. 20 deaths occurred at Upper Brixham;
13 in Higher-street, six in Fore-street, and several in King-street and Greenswood. The number of
deaths in 1849 was 75.
In answer to inquiries, Mr, Lakeman^ the Registrar, writes as follows, —
The parish of Brixham is divided into the districts of Lower and Upper Brixham. The district
of Lower Brixham has adopted ** The Local Government Act," and is under the management of a
Local Board. The inhabitants of this district are supplied with water from two public wells
eituated in the heart of the town ; one of these has been recently sunk by the Local Board, and the
water is considered pure ; the other is a very old well, and has been thought to be polluted. There
is also in this district a reservoir belonging to the Admiralty, which is situated in the midst of the
town, and is supplied by a pipe leading from a stream about a mile from the town ; a conduit,
situated at the quay, from which the public draw water, is supplied from this reservoir, the water
from which is of very questionable purity, as the reservoir is a mere open pond, and the water is
exposed in a large surface to the sun and air.
The district of Upper Brixham is supplied with water from several sources, of these the principal
one being a spring called ** St. Mary*s Well," which, although slack in the summer, has never been
known to be dry : the vrater from this source is considered to be of very good quality. Another
supply is derived from a well at Greenswood, which is in fact in the Lower Bnzham district, although
the people using the water live in Upper Brixham. The means they have hitherto used for obtaining
the water from the well is by dipping pails into the water, but the Local Board intend placing a
pump to prevent pollution of the water by drawing. Another source of supply in this ^dstrict
is a well situated at Polheame, where a pump has been placed recently to avoid the dipping of
pails. Other supplies of water are obtained in both districts from private wells, and from rain-
water caught from the roofs of houses.
The mortality from cholera in 18G6 is attributed, in great measure, to the people living in an
unhealthy state from overcrowding, imperfect conveniences, and defective drainage.
The deaths were almost confined to the poorer classes, and it was a noticeable fact, that cholera
prevailed very severely in the neighbourhood of the three water supplies of Upper Brixham above
spoken of; whether the cause was the pollution of the water or the affinity of any miasm to the
damp localities I do not pretend to say, but the disease was much more concentrated around these
supplies than in any other locality in the parish, except in one part of Lower Brixham, where there
was no public water supply at all.
284; 3. T0TNE8 ; Dartmouth. Population 5,429. Cholera 20; Diarrhoea 15. The epidemic
prevailed here in August, principally in farm labourers* families, at Higher Dittisham, several
families losing more than one member ; there were also a few deaths at Lower Dittisham, the last
case recorded being that of a thatcher*s son, aged 12, on September 4th. More than half the
deaths from diarrhoea were of adults aged 40 years and upwards.
284; 4. ToTXES; Totnes, Population 5,881. Cholera 14 ; Diarrhcea 5. The first death from
cholera was that of a lighterman's daughter, aged three years, at St. Peter's Quay, on July 26th.
The next was on August 16th, when an agricultural labourer died in the workhouse. A labourer
and two daughters died in August at Tuckenhay, Ashprington, after iUnesses of very short duration.
The last fatal case was that of a labourer's widow, aged 50, in the workhouse on September 28th.
287; I. Plymouth; Charles the Martijr. Population 23,390. Cholera?; Diarrhoea 28. The
matron of the Female Home, Hill Street, died of cholera on August 27th ; two other deaths
also occurred in the same house, one on August 30th, and the last on September 12th. The last
death recorded was that of a cliild at the workhouse on October 30th. The K^istrar speaking
of the outbreak in the Female Home, states that it originated from the opening of a drain
Noiei M Cholera in Districts. 223
(vluch liad become choked) nnder the window of the lanndry, and the stench was bo powerful as
to affect almost every one in the house. Prompt means were adopted to remove the inmates during
the neeevary repair of the sewer. A great deal has been done by the authorities within the last
few j«an for effecting a better santtaiy condition of the town. In 1849 the number of deaths from
eholera was 264, chidy occurring in labourers' and tradesmen's families in Plymouth.
387 ; 3. P1.TMODTH ; St Andrew. Population 39,209. Cholera 6 ; Diarrhcea 67. The first fatal
case of cholera was that of a labourer's daughter in Granby-street on August 5th ; the last death
(tZie m&nt son of a soldier alter 23 hours' illness) occurred September 23d at Granby-lane.
In 1849 the deaths fh>m cholera in the district of Plymouth were 830, against 59 in 1854;
and IS in 1 866. The registrar states that the condition of Plymouth is generally healtiiy, and that
fte eases of cholera have not arisen from epidemical influences, but rather from local causes, neglect
«f the rules of health, and from pestiferous vapours in dwellings, caused by filth and the want of
comforts in sickness.
39a; 3. CsEDrrox; Bow, Population 3,516. Cholera 16; Diarrhoea 0. With the exception
of m death at Bow, on October 15, the whole of the deaths from cholera took place at Zeal
Moaachorum ; they occurred as follows: — October 7 th, three deaths; October 8th, eight;
Oetoiber 9th, one; October 13th, two ; and October 14th, one. Mr. Bibbiogs, the llegistrar, states
that the water-supply of Bow is brought in iron pipes from a reservoir about a mile distant from
tike village; all the other parts of the sub -district are supplied from wells, none of which are
liable to pollution excepting at Zeal Monachorum, where the runnings from the roads are apt to leak
into the wella. There was not a single &tal case of eholera in the sub-district during the
epidemic of 1849.
394 ; 3> CsEDrrox ; Crediton. Population 6,533. Cholera 2 ; Diarrhoea I. An innkeeper
died of cholera, after 12 hours' illness, in Dean-street on August 27th ; and the son of a land
drainer, at Bowden-hill on September 14th.
303; I. TiYERTON; 5//o«rf on. Population 5,120. Cholera 4 ; Diarrhoea 2. These deaths from
choKim occurred at Bradninch, the first on September 28th, and the last on October 10th.
393 ; 4. TiYERTON ; Tiverton, Population 10,447. Cholera 26 ; Diarrhoea 10. The deaths
from cholera occurred principally among workmen of different occupations ; the epidemic appears
to hMve subsided for a time, and then broken out afresh, for no death was recorded fit>m
September 18th until October 1st, when a child died of cholerine in Melbourne-street; deaths
continued to occur at intervals during the remainder of the month, the last fatal case being that
of a sawyer, aged 68 (who had previously lost his wife from cholera), atTownsend on October 27th.
394 ; 3. Sourn Molton ; Chulmleigh. Population 5,062. Cholera 8 ; Diarrhoea 2. A sharp
Ootiuieak of cholera occurred among two or three families of farm 1aboun;r8, the disease proving
&tal within a few hours after first attack ; the epidemic was strictly confined to Chulmleigh, and only
lasted a week ; the first death took place on September 9th, and the last on September 1 6th. It was
iktal to three adolts and five children. No death occurred from cholera during the epidemic
of 1849.
397; I. B&>EFORD; Bideford, Population 5,851. Cholera 2; Diarrhoea 3. On August 21st,
a gentieman, aged 44, died in the High-street of ** Asiatic cholera, 20 hours, apnoea, 12 hours;**
and a shipwri^t, aged 17, in Milton-place on October 22d, after 13 hours' illness.
397; 2. BioEFORD ; iVor^am. Population 4,4G0. Cholera 11 ; Diarrhoea 1. Seamen and their
&milies were the chief sufferers from the epidemic, and it was confined to two streets, Meeting-
street (Appledore) and Irsha-street ; there being six deaths from cholera in the former, and five
in the latter. The first fatal case was recorded on July 29, and the last on September 3d.
21. Somersetshire.
316 ; 3. Brtdowatbr ; North Petherton. Population 5,305. Cholera 1 ; Diarrhoea 2. On
August 26th, the widow of a carpenter, aged 56, died in Pore-street from choleraic diarrhoea
(48 hours).
316; 4. BaiDOWATEB; Brtdywater. Population 13,694. Cholera 6; Diarrhoea 14. Four of
the deaths from cholera occurred at Eastover, Bridgwater, in October. The last fatal case recorded
was that of an engineer*s wife, aged 35, in St John-street, on November 1st 213 deaths from
cholera were registered during the epidemic of 1849, Eastover being one of the localities that
sofiSorcd considerably.
316; 5. Bridgwater; Iluntspill. Population 4,003. Cholera 2; Diarrhoea 3. Both the
deaths from cholera occurred at Huntspill ; the first that of a blacksmith, aged 29, on September 30th ;
and tlie last that of a female, aged 55, on October 9th.
316; 6. Brido water; Pulden Hill Population 3,701. Cholera 1; Diarrhoea 1. A farm
labourer, aged 67, died at Burtle, Catcott, from cholera on October 5th.
StS'r a. Wells; Glastonbury, Population 10,635. Cholera 20; Diarrhoea 6. Tlie majority
of die deatiis from cholera occurred in September, to farm labourers and their families ; the last
ted ease recorded was that of a farm labourer's wife, aged 33, on October 15th. Several cases
224 Notes on Cholera in Districts*
occurred in North Load-street ) and in the High-street two persons died in one £Eumly from
choleraic diarrhoea.
32S; I. Bedminster; Bedmmster. Population 22,346. Cholera 6; Diarrhoea 22. The first
death from cholera was that of a mariner, aged 20, in Princes-street, Toll-gate-lane, on April 24th ;
the next case was that of a farrier in Upper Somerset-terrace, on August 19th, his daughter also
dying from cholera on the following day. The last death occurred on October 28th, at Stillhouse-
lane (a sawyer's widow, aged 80). The deaths from cholera during the epidemic of 1849*
were 243.
328 ; 2. Bedmdcster ; Long Ashton, Population 5,864. Cholera 2 ; Diarrhoea 4. A milkman,
aged 48 years, died at Long Ashton, on August 25th, and a tailor's daughter, aged six montilis, at
the workhouse, on November 15th, from cholera.
328; 4. Bedminster; St. George. Population 4,811. Cholera 16; Diarrhoea 3. The whole
of the deaths from cholera occurred at Pill St George ; four fatal cases were recorded in October (the
first on the 22d), and the remainder in November. The epidemic was particularly fatal in Novem-
ber, among railway labourers and their families. Li 1849 the deaths from cholera were 32, and
its fiitality was then strictly confined to Pill St. George.
The following incident (published in the London Weekly JRetum, Ab. 45.) will be sufficient to give
some idea of the state of the village of Pill : —
The sanitary officers found one man sleeping in a watercloset surrounded by rice-water choleraic
discharges, and they learnt on good authority that this man had been in the habit of sleeping in
different waterclosets about the village for the past six months, and when driven away from one he
sought shelter in another.
VI.— WEST MIDLAND COUNTIES.
22. Gloucestebshire.
329; I. Bristol; St. Mary BcdcUffe. Population 14,335. Cholera 4; Diarrhcea 12. First
fktal case of cholera occurred on 19th July, when a grocer's daughter, aged nine years, died in
Temple-street. The last case was the ^ife of a groom, aged 40, in Cart-lane, on 27th October.
In 1849 there were 167 deaths from cholera.
329; 2. Bristol; Castle Precincts. Population 10,194. Cholera 5; Diaxrhcea 13. Two of
the deaths from cholera occurred in St. Peter's Hospital (workhouse), on 18th September. In
1849, when the deaths from cholera were 224, 31 took place in this hospital.
329; 3. Bristol; St. Paul. Population 16,775. Cholera 3; Diarrhoea 13. The first death
from cholera occurred in Unity-street, St. Philip, on 21st July; the second in Old Market-street, on
16th August ; and the third in Lathom-court, St. Philip, on 27th August In 1849 the deaths from
cholera were 117.
329; 4. Bristol; St. James. Population 10,325. Cholera 1; Dianiicea 12. The only fatal
case of cholera occurred on 21st October to a cooper. Of the 12th deaths frt>m diarrhoea 10 were
those of children under one year of age.
329 ; 5. Bristol ; St. Augustine. — ^Population 15,398. Cliolera 4 ; Diarrhoea 14. IFirst fatal case
of cholera occurred on 1 8th September to a tailor's cutter, aged 40, after an attack of nine hours*
duration; on 24th September the daughter of a cab driver, aged 10 months, died from "Asiatic
cholera, 3 days, consecutive fever, 17 days." There were no further deaths until 12th November,
when the two sons of a mason's labourer, aged respectively one and eight years, died in Warren's-
court from Asiatic cholera (13 hours and 7^ hours).
330; 1. Clipton; Clijton. Population 21,375. Cholera 1 ; Diarrhoea 8. A sawyer, aged 50,
died at Cumberland Basin, on 8th September, from ** diarrhoea 48 hours, Asiatic cholera, 3 days."
330; 4. Clifton; St. Philip and Jacob. Population 31,753. Cholera 9 ; IKarrhaea 21. The
first death from cholera took place 26th July, in Canning-street ; and the last, 6th September, in
Jubilee-street.
Mr. David Davies, M.II.C.S., Medical Inspector to the Bristol Board of Health, forwarded to the
Kegistrar General the Report of the Health Committee, from which the following paragraphs arc
extracted {^London Weekly Retumy No. 44.) : —
" With reference to the sanitary condition of the city and county of Bristol, your Committee
have to report that at the present time it is most satisfactory, there not being any cases of cholera,
or, so far as your Committee are informed, of epidemic disease of any kind ; and it appears by
the last week's returns of the Kegistrar General that the rate of mortality for that week was at the
very low annual rate of 14 per thousand. As regards the late visitation of cholera to this district,
it appears from the report of the medical inspector, that the first case of Asiatic cholera in this city
dunng the present year (which was also the first reported in England) occurred at Frincea Street
Notes on Cholera in Districts, 225
Timpike, on the 29d of April, and that the last case -was in a cottage near Bedminster Turnpike, on
tibe Mil of September. Between these dates, and with a clear interval of three months betw;een
ibe first and second cases, it appears that 45 cases of cholera and choleraic diarrhoea of a specific
cteneter have been reported; 27 died and 18 recovered. The disease appeared in isolated cases
M imezrals in 25 di^rent places, and affected 28 different houses. The points wherein Uic epidemic
appeared are scattered pretty equally over the district, within a circle of the most distant ones,
-which were as follows: — Richmond IliU, Montpelier; Windmill Hill, and Parson Street, Bed-
mmater ; Cumberland Basin ; Park Hill, and Kingsdown Parade. In only three cases did the disease
exiend to the adjoining house, and it is the opinion of the medical inspector that this arose from the
Unt case in each of these places not having been rteported at an earlier period for the application of
prerentiTe measures. Fourteen cases have been traced to infection from other places where the
disease prevailed in an epidemic form ; and it is more than probable that the other cases were com-
mimicated in a similar manner, although as yet the medical inspector has not been able to trace the
communication.
^ Anticipating that the district would be visited by the epidemic in the summer and autumn, the
Cominittee gave instructions early in the spring that every part of the district should be minutely
inspected with special regard to the expected epidemic ; and in April they appointed a number of
vorkmen, nnder the supervision of the nuisance inspectors, to cleanse and disinfect all privies
acGesable to them, and to whitelimc all courts, alleys, and passages. All nuisances which were
discovered by the inspectors vere reported, and either the landlord or the occupier was required to
abate the same.
** When the disease reappeared on the 21st July, the measures considered necessary to prevent
the spread of the epidemic were taken in all the early cases by your officers under the instrucUons
of the medical inspector. After the appointment of officers oy the local authorities under the
IMseases IVevention Act, the disinfection of houses, clotlung, and other matters was carried out very
efficiently by them, your officers continuing to disinfect all drains and open privies, and to remove
nninancet. Wherever a case of cholera appeared, all the drains and sewers communicating with it
-were charged with sulphate of iron or other chemicals by the officers of your Board, and all the
aeweiB in the low levels were kept so charged until the end of September.
** In consequence of this, as your Committee believe, none of the drains or sewers became con-
taminated with infection, no case of the disease having been traced to this source.
** The measures adopted appear to have been uniformly successful in arresting the disease at each
point, irrespective of the state of the weather, which during the occurrence of the earlier cases was
diy, and afterwards wet ; and your Committee consider themselves justified in believing that the
preventrve measures adopted by them, and by the local authorities, imder the Diseases Prevention
Act, were, under the blessing of God, the means of saving the city from a widely spread epidemic,
and they hope that similar measures will be adopted in other places, as the prevalence of the dis^e
in one town endangers every other in the countiy%
** IT OUT Comnuttee are sony to find that the epidemic lingers in other places in England. They
cannot but r^ard this fact with some anxiety, but trust the coming winter will eradicate it ; at all
events, it will be their 'endeavour, should fresh cases imfortunately occtir in your district, to meet
tbem by applying remedies with the promptitude and energy which are necessary for the success of
such measures.
** The Committee consider that the expenses incurred by your Board and the local authorities
in canying out preventive measures have been on the soundest principles of economy, as, had the
disease assumed an epidemic form, tbc public would have become responsible for many years for
the aapport of a large number of widows and orphans." [^See also Paper on ** Asiatic Cholera in
Bristol'' hy Dr, W. Budd, published in the British Medical Journal of I3th April J 867.]
2j. Staffordshire.
371; J. Stoke-upon-Tkent ; Hanley, Population 16,848. Cholera 3; Diarrhoea 23. The fatal
of cholera occurred as follows : 1 9th July, in Market-street, a commercial traveller, aged 57 ;
17th November, in Church-street, the wife of a beer seller, aged 50 ; 19th November, in Bath-street,
die widow of a collier, aged 46. Diarrhoea -was almost exclusively confined to children under
one year of age.
371 ; 3. Stokb-upon-Trext ; Shelton. Population 18,331. Cholera 5 ; Diarrhoea 28. The
first iktal case of cholera was that of a female, aged six months, at Etruria, on 2d July ; two more
deaths of children occlirred in July ; one in August (an adult) ; and the last on 4th November (a
It, aged 46, after an illness of 22 hours). Cholera was fatal to 43 persons in 1849.
26. WORCESTERSmRE.
383; 3. Stoukbrtooe ; Kingswinford. Population 34,257. Cholera 13; Diarrhoea 36. The
4nC ntal case of cholera occurred on 1st July, at Wall Heath, when the daughter of a bricklayer,
" one year, died of choleraic diarrhoea (36 hours) ; the next case did not occur until 5th Sep-
r, when the disease appears to have broken out at Bocks Xiill, Brierly Hill, vrhere seven
22^ ^Notes on Cholera in Districts.
deaths were recorded between the 5th and 13th of September, four of them being described as
Asiatic cholera; four deaths also occurred at Delph, the last on 2l8t September. During the
epidemic of 1849 diolera was fatal to 212 persons.
393; 2. Kings Norton ; EdghasUm. Population 16,037. Cholera 2; Diarrhcea 9, The first
£ital case was that of the son of a factor, aged six weeks ; the second, the widow of a steel-pen manu-
facturer, aged 65.
393; 3. Kings Norton; Harbome. Population 16,996. Cholera 6; Diarrhoea 15. The first
death fit)m cholera took place on 12th June at Nursery-lane, Harbome ; the last being that of a
carpenter, aged 70, at Oldbury-road, Smethwick. Four of the deaths occurred in Green's Village,
during the month of October.
27. Warwickshire.
394 ; I. Birvinoham; lAidy Wood, Population 34,728. Cholera 1 ; Diarrhoea 38. This case
of cholera occurred in Ryland-street North, on 1 3th August, to the daughter of a bricklayer, aged
one year. 27 of the deaths from diarrhoea were those of children under two years of age.
394 ; 3. Birmingham ; St. Martin, Population 30,252. Cholera 2 ; Diarrhoea 44. Both these
cases of cholera occurred on 29th August, to widows of labourers, aged J'espectively 52 and 68 years;
394 ; 4. Birmingham ; St, Peter, Population 14,806. Cholera 1 ; Diarrhoea 27. The case of
cholera occurred on 19th July, in No. 3 Court, Duddeston-row, to the son of a brassfinisher, aged
three months, *' English cholera *' 3 days.
394; 7. Birmingham; St, Mary, Population 17,477. Cholera 1; Diarrhoea 29. The son ti
a carrier, aged one year, died of English cholera on 24th October.
394 ; 8. Birminoham ; St, George, Population 44,405. Cholera 5 ; Diarrhoea 76. The first
death from cholera occurred 20th May, and the last 3d September ; they were all described as
English cholera. In three cases inquests were held.
394; 9. Birmingham; All Saints. 'Population 19,820. Cholera 1; Diarrhoea 20. On
4th August, the wife of a gold-cutter, aged 42 years, died from cholera.
In the district of Birmingham, comprising nine sub-districts, with a total population of upwards
of 200,000 persons in 1861, only 11 deaths from cholera occurred in 1866, 17 in 1854, and 29
in 1849 ; in the same years the deaths from dian'hoea were 289, 560, and 427.
VIL— NORTH MIDLAND COUNTIES.
30. LlNCOLNSHIBE.
434; I. Gainsborough; Owston, Population 4.649. Cholera 7; Diarrhoea 3. Three deaths
firom cholera occurred at West Butterwick ; an agricultural labourer, aged 67, on the 10th August,
and two agricultural labourers* widows, aged respectively 73 and 45. Of the seven fiital cases of
cholera four occurred at West Ferry. In 1 849, when there were 16 deaths from cholera and 1 1 from
diarrhoea, the epidemic was most fiiital at West Ferry and West Butterwick.
434; 4. Gainsborough; Gainsborough. Population 7,339. Cholera 20; Diarrhoea 16. After
seven fatal cases of diarrhoea, only two of which were those of adults, cholera broke out at Albion-
pUice, Gainsborough, on 27th July ; first fatal case, the wife of an agricultural labourer, aged 33,
died in 17 hours. Of the 20 deaths from cholera, eight occurred in Bridge-street, where the last
death took place on 13th November. In 1849 there were 211 deaths from cholera, 56 of which
occurred in Bridge-street
Vm— NORTH WESTERN COUNTIES.
S3* Cheshike.
455 » 3- Ru^'CORN ; Runcorn. Population 13,590. Cholera 10 ; Diarrhoea 15. The fii»t death
of an adult from cholera was that of a master mariner on 1st September, after 16 hours' illness.
On 10th October, a mariner also died from "Asiatic cholera, 9 hours," in the cholera hospital.
The last fatal case occurred at Regent-street on 9th November to an engine driver at steam s^w mill,
** cholera, 24 hours, bronchitis, 3 days."
456 ; 2. Northwich ; Northwich. Population 12,941. Cholera 13 ; Diarrhoea 10. Six of the
deaths from cholera occurred at York-buildings, and four at Leftwich-hme. The first death occurred
Notes on ClioUra in Districts, 227
«l lidcester-street, Witton, on 2d July, of a flatman, aged 65. On the 27th and 29th September,
two wiires of flatmen died at Leftwich-lane ; and at York-buildings on 3d November, a son and
dmagbter of horse drivers on river, died, aged respectively two and four years.
45^ > 3- North wich; Over, Population 8,304. Cholera 54; Diarrhcea 4. On 18th June a
pansmith at Wharton, died from Asiatic cholera, aged 42, after 14 hours* illness. The epidemic
oon tinned with increasing violence up to 22d August, when the last death occurred at Over, of a
hrjck«etter, aged 69. In July the epidemic proved fatal to 43 persons, 29 of whom (including
children) were engaged in salt manufacture. Mr. Arrowsmith, the Registrar, states that the water
■apply of the sub-district is derived chiefly from wells, but in some cases from a brook which is
copf minated by a large quantity of sewage running into it at a higher leveL There is no proper
system of sewerage, the water supply is inadequate (many of the inhabitants having to go long
distances to fetch it), and there is an almost total neglect of sanitary measures. In 1849 only four
deaths from cholera were recorded.
456; 4. NoRTHwiCH; Middlewich. Population 5,644. Cholera 8; Diairhoea 1. Cholera was
fttal on !Hh July to a saltmaker^s wife, aged 39, at Merc Ueath, Davenham ; duration of attack,
19 hoars. The last death of an adult was that of a boatman at Canal Side, Middlewich, aged
68 years ; duration of attack, 12 hours.
459; ^. Great Bolghton ; Chester Castle, Population 21,672. Cholera 77; Diarrhoea 2G.
The epidemic was very virulent in this sub-district. Two children died from cholera at Little
Harrow and ^Vshton on the 4th and 8th August ; but the disease was not epidemic until the middle
of September. On the 11th September, the child of a tailor, aged three years, died after only
seven houn* illness at the Newgate ; not more, however, than 1 1 deaths occurred from this disease
before the eod of September. The epidemic was most fatal during October, when 49 deaths occurred ;
14 were recorded in November, and the last (a labourer in a coalyard) on 6th December. During
the cour^ of the epidemic 23 deaths were recorded in the Hospital.
459? 3- Great BouGHTON ; Chester Cathedral Population 19,762. Cholera 41 ; Diarrhoea 24.
The first death from cholera was of an infant on 30th July, after which no death occurred from this
disease until 10th August, when a railway fireman, who had been suffering from diarrhcea for a
week, died after an attack of cholera of a few hours. The disease did not, however, appear in an
epidemic form until the beginning of September, and eight deaths occurred during that month,
2\ in October, and the remaining 10 in November; the last case was recorded in Talbot-street
on 2&th November.
459; 4. GttEAT BouonTON; Haicarden. Population 9,528. Cholera 16; DiarrhoDa 1. A case
of bilious cholera occurred on 5th June, and two other deaths on 10th and 17th August; the
disease, however, did not become epidemic until the middle of September, and 1 1 deaths occurred
bet'Wiren ITth September and 15th October. The last death took place on 8th November. Of the
1 6 deaths from cholera, six were recorded at Queen's Ferry, four at llawarden, and three at Ewloe.
In the entire district of Chester, 136 deaths from cholera were recorded during the epidemic of
1866, against 24 in 1854, and 91 in 1849. The following particulars are the results of inquiries a
to the source of the water supplied to Chester, and were furnished to the Registrar General for
pablication in his third Quarterly Return for 1866, by the Registrar of the Chester Cathedral
sab-district : —
j>anhani-on-theJ{ill, where a death occurred from ** neglected diarrhoea, 5 days, collapse,
<2 days,*' is situate between six and seven miles, N.E. from Chester, and overlooks the river Mersey.
It is considerably elevated, and admirably adapted to the most thorough drainage ; it is nevertheless
most miserably deficient in this respect, and I have noticed for many y«ars that it is much more
liable to attacks of scarlatina, &c. than many villages less favourably situated. It is a mass of
red candstone rock, and the water has in many places been allowed to work hollows in the strata,
in wlucn it lodges, and is frequently (juite green and putrid, where a few hours' work with a pick
und spsde woold remove it all ; it is, however, now much better than it formerly was. The water
supply at that end of the village where the above-mentioned death occurred is derived from a
pump well in the yard of the Wheatsheaf Inn ; this water is apparently very good and pure, and is
used by all the neighbouring cottages, &c., and none of them have suffered anything apparently
ih>in the use of it, except the inhabitants of one house. This house is a very dilapidated one, and
H\^ habits of its inhabitants seem to be on a par with the house, as a more filthy place outside and in
it would be hard to find. It seems to have been used as a kind of lodging house for the poorest
class of travellers, and may have received the infection from that source; at all events 1 yesterday
Tegistered a second death in the same house of a woman, aged 49 years, Asiatic cholera, 48 hours.
Tbe rest of the inmates of the house I undorstand have left it, and the place is now shut up. Two
deaths from diarrhoea have occurred in places near each other, one mile N.E. from Cheater, where
the water is derived from pump wells apparently pure and sweet, clay subsoil, neighbourhood
efficiently drained and healthy. All the other cases have occurred within the limits of the borough
«f ClMSter. The drainage is, I consider, very good, great exertions having been made of late
years in that direction ; but the water supply is very indifferent The whole of the borough is
jopplied by the Chester Waterworks Company with water taken ft^m the river Dee ; the river
cmuit perhaps be considered particularly pure at the best, inasmuch as it receives the sewage of
liangollen, Wrexham, Famdon, Holt, and a variety- of smaUer places before it reaches Chester ;
but nnfortonately the part of the river from which the water is taken is further contaminated by
^p»g the leceptacle of tiie sewage of the whole of the eastern half of the borough of Chester
228 Notes on Cholera in Districts.
itself. This part of the river is formed into a sort of lake of about one mile in length by some 60
to 80 yards broad, bounded at the lower end by a stone causeway erected for the purpose of holding
up the water to supply the mills, and at the upper end by the shallows of Broughton Ford ; into
this basin the drainage of the town is carried by at least four several sewers at different points, and
in its depths lie the accumulated 61th of generations, but from it is daily taken the whole supply of
water for the city. It is only right to say that the Waterworks Company are now engaged in ihe
construction of works to enable them to take the water from the long reach of the river below
Heron's Bridge, where they would certainly escape the contamination of the Chester sewage and
be able to deliver the water as pure as the condition of the upper river will allow. In the mean-
time the citizens are very much dissatisfied with the article supplied, and there afe constant
complaints and debates bom in the town council and out of it, upon the subject of the supply and
the danger to the health of the inhabitants to which we are at present exposed.
460a; I. WiRRAL; Neston. Population 5,223. Cholera 52; Diarrhoea 3. The first death
from cholera occurred at Park Gate, Neston, on 2d September, and during that month 47 of the
52 deaths took place, the disease being most fatal between 7th and 14th. During October four
deaths occurred from the same cause at Little Neston, and the last death took place on 3d November
at the same place. Of the 52 deaths from cholera 36 were recorded at Neston, seven at Park-gate,
Leighton, and six at Little Neston.
460 a; 2. WiBRAL; Eastham. Population 9,167. Cholera 6; Diarrhoea 8. The first death
from cholera occurred on 1 1th September at Brimstage ; the next four between 26th September and
2d October at Bebington ; and the last case, of an infant, also at Bebington, on 7th December.
4606; 1. Birkenhead ; ^('rAeitAeadf. Population 36,212. Cholera 61 ; Diarrhoea 61. Cholera
broke out early in May among some German emigrants in port, and resulted in 10 deaths, which
were recorded in the Hospi^ at the Emigration Depot, in addition to those registered within
Liverpool district. The first death from cholera occurred among the residents of the sab-district
on 29th July in Poole-street ; and on 13th August a ship chandler died at Oak Bank ; but the
disease did not become epidemic until the end of August During September, 21 deaths were
recorded, 19 in October, and seven in November, the last two occurring at 32 Qneensbury-street,
on 16th November. Egerton and Queensbury streets contributed the largest number of deaUis.
4606; 2. BiRKENii£Ai> ; Tranmere. Population 14,485. Cholera 10; Diarrhoea 13. A death
frt>m cholera occurred on 24th August, but no subsequent deaths took place until the middle of Sep-
tember, during which month four were recorded, followed by three in October, and one in November;
the last fatal case occurred on 2d December. The whole of the 10 deaths occurred in IVanmere.
4606; 3. Birkenhead; TFa/Zosfiy. Population 10,723. Cholera 7 ; Diarrhoea 9. On 27th July
a cotton broker died at Wallasey from cholera ; but no further death occurred until iOth September,
when a fatal case appeared at Poulton-cum-Seacombe. Four deaths took place during October,
the last case on 23d of that month. Five of the deaths from cholera occurred at Poulton-cum-
Seacombe, and one each at Wallasey and liscard.
Dr. Baylis, the Medical Officer of Health for the town of Birkenhead, states that many of the
cholera cases in Birkenhead occurred in persons daily or occasionally visiting Liverpool, where the
disease prevailed ; but that he distinctly traced a connexion in 35 deaths (including those of the
10 German emigrants) out of the whole 61, with people, houses, or confined places infected with
ihe disease. Birkenhead is altogether supplied with water from wells in the red sandstone situated
at Spring Hill, Birkenhead, and Flaybrick Hill, Claughton ; each well furnishes about one half of
the regular service of 12,000,000 gallons weekly, but they are capable of yielding 20,000,000
on extraordinary occasions. Spring Hill is becoming covered with dwellings from the natural
extension of the town. Flaybrick Hill has still a country surface. The supply of water is generally
constant during the day, except when shut off for repairs of pipes, &c., but in some parts it is
given only from 6 to 12 a.m. An analysis made by Dr. Muspratt on 4th May 1867, showed that
&e Flaybrick Hill water contained 3*889 grains of chloride of sodium per gallon, a mere trace
of nitrates, and no organic matter : the Spring Hill water contained 3 • 093 grains of chloride of
sodium per gallon, a trace of nitrates, and no organic matter.
The following communication was received from Dr. Baylis (in answer to inquiries) on
October 25th. {See London Weekly Return No. 44.)
The iovra. of Birkenhead is associated with several other townships in forming the Birkenhead
Registration District ; one or two of these are populous, and being conterminous with it, as to houses^
form apparently one town, though these latter are under a different local government. The following
statements refer only to Birkenhead proper.
In addition to the ordinary' means for resisting an epidemic a system of deodorising all the
worst middens in Birkenhead was instituted in prospect of cholera. Quick lime, at first used,
was almost immediately abandoned j chloride of lime (then substituted) has been now almost replaced
by granular peat charcoal, which seems to be at once both effective and convenient for this purpose.
There is only one inspector of nuisances for the town, and he is imder my control and direction.
The indigent poor (of the town) have three parish surgeons to attend them in ordinary, these
also attend cholera cases in their respective districts ; but on the outbreak of the disease here the
board of guardians provided for the use of the whole union a hospital for cholera cases, with a
resident surgeon in charge. None of their arrangements were placed under my care. No medical
visitors were appointed.
Notes on Cholera in Districts. 229
Ibe parish mescal officers and other medical men give their own directions to their own patients,
Vnt Bcr invpcctor and self take evety means, and successfully, of being quickly informed of eveiy
ease vaicli occim, and of instructing the friends in all the required precautions ; the ashpit, as weU
in the Ticinity, is disinfected with chloride of lime ; all the soiled clothes are steeped in a
lolntiony the soiled bedding burnt, and the floors and stairs sprinkled with undiluted carbolic
i the hoose afterwards thoroughly cleansed. When the epidemic had fairly established itself,
die baamg of the soiled bedding was handed over to the parish authorities, who, however, cordially
a ctio imlson "with my requests and advice.
Wheierer a death occurs all the soiled clothes, the house, and ashpits of the vicinity are
dmiroii^hly dimnfected imder my own or inspector's supervision ; but where the cases do not die,
ve cannot always do these things, as I possess no means of certainly ascertaining their existence,
nor haTe I power to improvise them.
The poor are reimbursed for the loss of the bedding and linen destroyed without unnecessary delay.
vhole of the six deaths registered in the week ending 20th October occurred in the worst
and arranged part of the town. The earliest deaths took place in better neighbourhoods,
the spreading of the disease was evidently under check from the means employed. As it
to bad localities, however, these means appeared to lose their efficacy, and I now look
for the effect of cold weather the more anxiously in consequence. Only two deaths, as far as we
jet know, have occurred within the last ten days, and I anticipate that we shall have but few more
34. Lancashire.
The Cholera Epidemic in Liverpool,
461 ; I. Ijterpool; SL Martin, Population 81,228. Cholera 672 ; Diarrhoea 258.
461 ; 3. IiTERPOOL; Howard-street. Population 24,816. Cholera 247 ; Diarrhoea 97.
461 ; 3. LivSRPOOL ; Dale-street, Population 29,078. Cholera 137 ; Diarrhoea 81.
461 ; 4. Xiyzrpool; St, Oeorge, Population 16,827. Cholera 13; Diarrhoea 15.
461; 5. XiTSRPOOL; St, Thotnas, Population 29,142. Cholera 73 ; Diarrhoea 64.
4/6x ; 6u LrviERPOOL; Mount Pleasant, Population 47,410. Cholera 209 ; Diarrhoea 123.
461 ; 7. XiiTERPOOL; Islington, Population 41,241. Cholera 134 ; diarrhoea 93.
46a ; I. Wx8T Derbt ; Toxteth Park, Population 69,284. Cholera 236 j Diarrhoea 138.
4d« ; 2. West Derby; EverUm, Population 70,983. Cholera 178; Diarrhoea 166.
46a; 3. West Derby ; Walton, Population 11,834. Cholera 34 ; Diarrhoea 20.
46^ ; 4- Wasr Derby ; Crosby, Population 5,075. Cholera 5 ; Diarrhoea 5.
462 ; 5. West Derby ; Zitherland. Population 5,084. Cholera 2 ; Diarrhoea 1.
46s ; 6. West Derby ; West Derby, Population 52,740. Cholera 45 ; Diarrhoea 77.
46*5 7. West Derby; Wavcrtree. Population 10,845. Cholera 4 ; Diarrhoea 8.
The following details are chiefly derived from the able report of Dr. Trench, Medical Officer of
Health for Liverpool, on the health of the borough in 1866.
Cholera first appeared in Liverpool in May, when it was introduced by some German emigrant
ships which were in port on their way to America. The disease was at this time entirely confined
to these steamships and their occupants, and not a single death occurred among the residents of
the town, ft» sereral weeks after the departure of the last of these vessels. During the first three
-weehs of May five deaths were registered as having occurred within the Dale-street sub-district
on board the " Helvetia," and 23 on board the hospital ship '^ Jessie Munn,'' in addition to the
10 deaths before noticed as having been registered at the same time in the emigration depot at
Birkenhead. The " Helvetia '' finally left on 28th May, and although ftx>m that date to the
beginning of July scarcely a week passed without one or two deaths being referred to cholera,
yet Dr. Trench says that careful inquiry satisfied him that all these cases " were of the bilious
type, and so purely sporadic ;" they were all, moreover, isolated cases, and were not followed
1^ other deaths *' in the families or neighbourhood of the deceased." During the last fortnight
in June the weather was oppressively hot, but on each day from Ist to 6th July refreshing
Tains cooled the atmosphere, and must, to a considerable extent, have cleansed the streets and
drains. On Sunday, Ist July, a death from cholera, certified as ** English," occurred at No. 2
Court, Bispham-street This locality is described by Dr. Trench as ** one only too well known
" to the sanitary officers, being inhabited by the lowest of the Irish population, and situated
'^ in the worst part of what may be justly described as the chief fever district of the ^parish.
" The court itself contained three straight up-and-down houses and an open midden. It
** was altogether so close confined and unfit for human habitation that the grand Jury had,
•* in July 1865, confiAned my presentment, and ordered the demolition of two of the houses
" and the conversion of the common cesspool into a watercloset ; and there only awaited some
^ legal or other formalities to have the order carried into effect." Directly the medical officer
WMinibrmed of the occurrence of this death in a locality so unfortunately disposed towards the
firtal spread of the disease, every effort was made to induce the relations and friends of the deceased
230 Notes an Clwlera in Districts^,
to consent to the immediate remoTal and burial of the bodj*. They, however, InsiiBted npon
keeping it till Tuesday morning, in order that a " wake " might be held during Monday night ; and
on Tuesday morning, when the medical officer attended to use his influence in hastening the funeral,
he found the three houses "crammed with men, women, and children, while drunken women
" squatted thickly on the flags of the court before the open door of the crowded room where the
** corpse was laid. There had been in the presence of death one of those shameful carousals which,
** to the disgrace of the enlightened progress and advanced civilization of the nineteenth century,
*' still linger, as dregs of ancient manners, among the funereal customs of the Irish peasantry."
Before the end of the week the husband of the deceased was dead ; and before the end of July
48 persons had died of cholera within a radius of 150 yards of the scene of this Irish wake.
Dr. Trench in his report dates the epidemic of cholera in Liverpool from the time and place of the
death above described. Cholera, as an epidemic, was almost entirely confined to the ** lowest,
** dirtiest, most crowded, and most squalid streets of the borough ; and nearly the whole of 1,782
*^ victims of this disease within the municipal boundaries occurred among the lower classes of
'* those dependent for their bread on weekly wages. There was a singular coincidence between
** the streets and localities suflerlng from cholera in 1866 and those in which the greatest number
** of deaths from typhus had occurred during the epidemic of that disease which prevailed more or
*' less during the years 1862-6. Both cholera and typhus were most fatal in those streets situated
" on the low lying ground, either on the border of the river facing the quays, or in the valley
" which sweeps north and south between the sandstone ridges that rise in successive elevations to
" the uplands of Everton, Low Hill, and Windsor." Dr. Trench, in dealing with the subject of
contagion from cholera, remarks, *' I am not aware of any physician, clergyman, or priest in
** the borough having died from the disease." The case of Dr. Koss, the surgeon to the " Helvetia,"
was the only exception to the above statement, and he probably fell a victim to his want of caution
in soiling his hands with the dejecta of a patient while moving him in bed. No stronger proof of
the restricted contagion of cholera need be urged than the fiict that in the " Helvetia '* and other
emigrant vessels in which the disease appeared it did not cross the qimrter deck, nor spread from
the steerage to the cabin passengers.
Of the 1,762 deaths from cholera which occurred in the borough of Liverpool between Ist July
and 30th November, 1 1 took place in the week ending 7th July. The numbers of fatal cases
increased week by week to 174 in the seven days ending 18th August; in the next five weeks the
deaths fluctuated considerably, and were 132, 193, 138, 179, and 146 in the week ending 22d September.
After this date the deaths from cholera fell rapidly, and in the last three weeks of November they
were five, one, and two respectively. In addition to the deaths recorded in the hospital ship'
** Jessie Munn " during the outbreak among the German emigrants, the following deaths from
cholera \fere recorded in public institutions : 236 in the Cholera Hospital in Aahfield-street in the
St. Martin sub-district, 174 in the workhouse in Mo ant Pleasant sub-district, and 25 in the work-
house in Smithdown-road, Toxteth Park. The following is a list of some of the streets which
suflered most severely from cholera during the epidemic of 1866, with the number of deaths from
that disease, and the enumerated population at the census of 1861. The deaths in each street
include those which occurred in the subsidiary courts.
Deaths tram Cholera. 1S6G.
Nanio of Street.
Population. 1801.
Lace
.
.
939
Sawney Pope
-
-
825
Milton
mm
•
1,018
ShervTood
•
.
COS
Bent
•
.
4S7
Re.ffcnt
.
.
903
Midghall
.
.
758
Kew
-
-
1,128
Gladstone
.
.
241
Cavendish
•
a
854
Stockdale
.
.
663
Oriel
«■
.
1,756
Ford
-
.
1,156
Paul
••
*
1,573
Maguire
.
.
316
Lime-kiln-lane
•
.
1,366
Mile End
.
.
357
Dryden
.
•
1,514
Beau
-
-
1,057
Nash Grove -
.
.
489
Gascoyne
-
.
1,076
Eaton
-
..
526
Chisenhale -
-
-
1,415
17
18
28
17
<w
4
27
12
24
8
20
13
24
20
24
11
18
10
16
17
10
24
13
20
Liverpool is supplied with drinking water partly from artificial lakes constructed for the purpose
in the high lands of Rivington, near Chorley, which Dr. Trench pronounces to be free from every
possible source of sewage contamination. The remainder of the supply is drawn from four deep
wells in the red sandstone, situated within or near to the borough of Livefpodl, yiz., in Soho-Btree^
Notes an Cholera in Districts. 231
HoOim-ctreeC, ^Windsor, and Water^treet The two first are onlj used occanonallf, and have not
been ponped at all mnoe September 4th, 1866 ; the two latter supply, the healthiest districts of the
town. Doling 1866 the sapplj was on the intermittent system as follows : —
January 1st to April 30th from 7 to 10 a.m., and from 3 to 5 p.m. = 5 hours daily.
May Ist to June 30th from 7 a.m. to 12 a.m., and from 5 to 7 p.m. a 7 hours daily.
July Ist to November 20th from 7 a-UL to 7 p.nu = 12 hours daily.
November 2 Ist to December 11th. Supply constant
I>ecember 12th to December 3 Ist from 6 a.m, to 9 p.m. » 15 hours daily.
The deaths from cholera in the districts of Liverpool and West Derby during the epidemics of
IM9 and 1854 were 5,308 and 1,290, against 1,989 in 1866 : the deaths from cholera in 1866
in the municipal borough of Liverpool were 1,782. Many of the same streets suffered severely
in an these visitations. During the epidemic of 1849 the diuly deaths averaged 35 in July, 51 in
Aognst, and 29 in September, the most fatal day being 13th August, when 84 deaths occurred.
In 1866 the dally deaths averaged only seven in July, 22 in August, 21 in September, and
Bx in October ; the highest number of deaths occurring on any one day being 36 on
SSd Au^nst.
The follovring information was supplied by Dr. Trench to the Keglstrar General on October 29th.
(^Ste Jjondan WeOdy Betum, No, 44.)
On the first appearance of cholera in the port of Liverpool, the town council rented a block of
w -warebooses near Bank Hall for the reception of emigrant passengers and crews of infected
Tike Testry «f the parish accepted the responsibility of providing for these people ; the owners
<yf vessels paying the daily allowance of U. 6</. for each individual, in accordance with the provi-
sions iff tbe 49th Section of the Passengers' Act, 1865. It was arranged that the slightest case of
Bckness, whether premonitory of cholera or not, should, whether by night or day, be at once
remcrved from the warehouses to the workhouse hospital. For this purpose a surgeon was in
constant attendance, and vans ready horsed were kept opposite the warehouses. The rooms of the
'vrarehooses were daily fumigated with chlorine gas, and the floors sprinkled with a solution of
cfaJoride of zinc before being swept.
The cost incuired by the council in the fitting up of the warehouses, in the purchase of beds and
1>edding, &c.y in the erection of large trough waterclosets, and in the bringing of water to the spot,
amounted to 1,095/. The vestry of the parish were, I understand, far horn being reimbursed by
the arrangements with the owners. After the Orders in Council under the Diseases Prevention
Act were enforced, the vestry of the parish took the lease of these warehouses into their own
hands, and continued them, as houses of refnge, for the temporary accommodation of the families of
the sick of cholera. They have also been found useful, even lately, for emigrants, among whom,
in lodging bouses, or on board ship, cholera had appeared.
In tbe commencement of the epidemic, and before the vestry were able to bring all their arrange-
ments into practical effect, the council undertook the disinfection of houses, and the disinfection or
destruction of the soiled bedding, clothing, &c.
Wlien the parochial authorities had established their staff, it then only devolved upon the council
to put in force, when required, the provisions of the Nuisance Kemoval Act, and thereby to aid the
efforts of the vestry.
Tbe Health Committee of the Council, in order to prevent any delay in the issuing of summonses
or in any of the prescribed requirements of the law, met daily to receive and act upon the reports
of their sanitary officers ; and during the months of July, August, and September they directed
informations to be laid for the abatement of 734 nuisances. But as it was represented to them,
thnt the process by which the owner or agent can be compelled to limewash his house was danger-
oxu^ly ^latory, they directed the borough engineer to undertake in all cases, at the public cost, the
Ilniewashing and cleansing down of infected houses.
The plan pnisned was &e following : In the case of sickness or death from cholera, the vestry
upon removal of the patient, caused the disinfection of the house by chlorine gus; then the lime-
wBj^hers went in and completed the puriHcation.
The number of apartments thus limewashed amounted to 6,184, and the cost was 698/.
The disinfectant used inside houses, where the vapour could be temporanly confined, was
chlorine gas.
The Council cUrected a solution of carbolic acid to be used in the disinfection of the middens,
csesHpools, grids of sewers, and courts of the streets wherein cholera had appeared. It was the out-
door disinfectant
The mode of using the carbolic acid was as follows :
Waterearts were used, and in place of the disperser a proper tap was fitted. Each driver was
providel with a jar of carbolic acid, and a measure which was sufficient for the capacity of the
wafer- hairel. These were sent round to all the courts and alleys, and the carbolic acid used to
diRnfect drains, middens, privies, &c., and to wash the surface of the courts when required.
Other vratercarts were sent to distribute a weaker mixture of carbolic acid and water on the
mrface of the streets in lieu of ordinary watering.
Tlieee carta were used in all weathers.
Tbe street gonies were also treated with carbolic acid in the form of Calvert's powder.
As a role these operations were performed twice a day.
232 Jlfotea on Cliolera in Districts,
The Bcayengers who follow the contractor's men in the removal of night-soil were alflo provided
with a solution of carbolic acid.
£ 9. d.
The cost of carbolic acid amounted to *• 1,098 18 5
„ carbolic powder - - - 17
„ cartage and ^tribution - - 373 14 8
£1,489 13 1
In March of this year, the Council had completed the erection of a disinfecting apparatus upon
Dr. Ilenry^s principle of dry heat ,from compressed steam, with a range of washing-tubs and a
plentiful supply of hot water. The cost of erecting and fitting up this establishment was 892/. 9«. 4d»
and the weekly cost of keeping it in operation averages 4/. 7s. a week. It is open to the public
gratuitously on the recommendation of any medical man, clergyman, district visitor, relieving
officer, or official. The total number of articles disinfected at this apparatus during the last
31 weeks, including beds and clothing, amounts to 15,238, of which 14,218 were from cholera
infected houses. It was however ordered by the Health Committee that no straw mattrass or bed
made of shavings, or any articles which appear to be almost valueless, or upon which the stains of
cholera dejections are evident, shall be disinfected. The superintendent was directed in all such
cases to put them on one side, to sprinkle them freely with carbolic acid, and then to arrange with
an appointed officer of the vestry for their valuation and destruction.
Cholera car. Since the year 1864 the Health Committee have kept two carriages, one for the
use of fever and the other of small-pox patients, not being paupers for whom the parish vans are
mrovided. On the breaking out of cholera they bought a third carriage for cholera patients.
These carriages are horsed by contract ; can be obtained free of charge by a simple note from the
attendant physician of the patient.
It was only used four times ; so strictly limited to the very poor classes was the cholera epidemic
There are in the borough a constant staff of 60 sanitary inspectors, of these eight are constantly
employed in going from house to house in the lower districts of the town, and eight in visiting the
various courts and alleys ; four inspectors are appointed to wateh sub-let houses for overcrowding,
and four are engaged in carrying out the provisions of the Common Lodging House Acta
■ I beg to express to yon, what I have stated publicly in the Health Committee, my perfect
approv^ of all the arrangements made by the vestry of the parish, and also my humble praise of
the wise and liberal spirit which directed those arrangements.
463 ; 5. Prescot,; PrescoU Population 12,377. Cholera 7 ; Diarrhcea 9. Cholera first
appeared fatally in Tea-street, on 30th August, two other deaths following at the same address on
8d September. The next three deaths occurred in the workhouse at Whiston on the 8th, 9th, and
19th September, and the last case was in Eccleston-street, also on 19th September. The whole of
the seven deaths were certified as of the Asiatic type, and most of the attacks terminated &tally
aiier about 25 hours' illness.
463; 6. Prescot; Sl Helens, Population 37,961. Cholera 10; Diarrhoea 44. Two fatal
cases of cholera occurred on 9th and 1 9th July, the first in Ecclcston and the latter in Sutton ;
the next two cases were on 22d and 26th August, the one at Parr and the other in St. Helens.
During October four deaths occurred in Sutton. On 10th November an adult female died after an
attack of only 18 hours, in Arthur-street, Eccleston ; and the last case was of a child in Taylor's-
row, Sutton, on 1 9th November. Five of the ten deaths from cholera occurred in Sutton.
464; 5. Obmskirk ; North Meols, Population 14,661, Cholera 38 ; Diarrhcsa 11. Three
fhtal cases of cholera (certified as " English ") occurred during January, and one on the 30th May.
The disease, however, did not appear in an epidemic form until nearly the middle of August
On 10th of that month the widow of a chimney sweep died at Littie London, Southport, after only
10 hours' illness. This death was followed by seven others during August, and 22 in September,
all in Southport. Nine deaths occurred between 21st and 24th September, both days inclusive ;
but after the last-mentioned day only two more deaths from cholera occurred in Southport, on 1 0th
and 12th October. The last two deaths, both at North Meols, took place on 30th October and 28th
November. Of the whole 38 deaths from cholera 33 were recorded in Southport, a town comprising
a part of North Meols township, and containing in 1,681, an enumerated population of 8,940
persons ; 17 occurred in Littie London, three each in Cemetery-road and at the lime-kilns, and two
in Littie Ireland. Nearly all the deaths were in the families of the labouring class.
464; 9. Ormskirk ; LatJumu Population 4,690. Cholera 12; Diarrhcea 10. The first death
from cholera occurred in I^athom on 12th August ; the next two deaths took place on 28th and 29th
of the same month. Three deaths were recorded during September, two in October, all of which
occurred in Lathom. During November, however, four deaths were recorded in Skelmersdale, the
last of which took place on the 30th. Nearly all the deaths occurred in the fiunilies of cither
boatmen or colliers.
465; I. Wigan; 5/a««/wA. Population 6,894. Cholera 8 ; Diarrhcea 11. The first two death*
from cholera occurred at Shevington, in coal miners' families, on 31st August and 4th September
respectively, The remaining cases were all recorded at Standish ; the first, a boatman's wife, aged
44, on October 11th; the last, a colliery foreman, aged 22, on 11th November. Mr. Price^ the
Notes on Cholera in Districts. 233
Eegiftnr, states that the water used hi the district for drinking porposes is obtained from a spring,
and lor odier purposes from the canal, the river Douglas, or ponds.
46s; a. WioAX; AMpuU. Population 8^72. Cholera 17 ; Diarrhcea 14. Again, as in 1849,
&e epidemic prevailed most &tally in the families of colliers. The first death was that of a licensed
Tictoailer'B son, aged six years, at Blackrod, on 23d July. No other death occurred until the cud
«f September ; in October II deaths occurred ; in November, one ; and the last a collier^s'son, aged
eight y€ar% died on 23d December, at Aspull. Mr. Clark, the Registrar, states that Uiere are yer>' few
Tells in the sab-district, and that the people use chiefly sur^e water drained from the fields and
caught in trongfaa : there is a scarcity of water in dry weather. The mortality from cholera is
maibed to the inadequacy and impurity of the water supply, and to the want of proper drainage.
465; 3. WiOA^f; Wigan, Population 37,658. Cholera 58 ; Diarrhcpa 1 10. Diarrhnea prevailed
during the months of July, August, September, and October, but it was not until 8th July that the
Snt death from cholera was recorded, when a weaver's daughter, aged one year, died at Spring-
pnknsL The next death did not take place until 3d September, when the epidemic may be said to
kave really commenced, for by the middle of the month the deaths from cholera numbered two or
dtree daily, and by the end of the month 31, or more than half the deatlis had been recorded The
disease did not abate much in October, 24 deaths being returned. The last case was that of a
bobbin-tamer's -wife, aged 33, at Ix>we*s-square, off School-lane, on 1st November. With the
eseeption of 13 deaths that took place in yards and courts olF Scholcs-street, the disease seems to
have been generally spread over Wigan. The families of coal miners and weavers were the principal
sofferera. Of the 110 deaths from diarrhtra, 81 were those of children under two years of age.
Sir. HallivrelU the Registrar, states (November 1867) that the majority of the inhabitants of Wigan
are Sknd ba^e been for some time supplied with water from the reservoir belonging to the corpo-
ration ; bat that in some parts of the town prior to the cholera breaking out the people obtained
all the water that they required Arom weUs in their immediate neighbourhoods ; the waters from
these wells were analyzed and condemned, and the wells were then cloRcd. In 1849 the deaths
fixsm choloti were 348.
465; 4. WioJlN; Hmdley, Population 17,654. Cholera 39; Diarrhtra 52. The first death
from cholera (which was not certified by a medical attendant) was that of a coal miner's wife, aged 31 ,
oa 24di September, at Kndley. The epidemic was very fatal in October, at Ince-in-Mackerfield^
In the famiUei of colliers; in November the disease gradtmlly subsided, 13 deaths being recorded in
that mouthy against 23 in October. The last fatal case was that of a schoolmaster's wife, aged 69,
on 26ibL Jfovember, at Ince. Mr. Grime, the Registrar, states that the water supply of the sub-
disCncC is deriyed from wells, ponds, and rain-cisterns or tubs. 112 deaths from cholera were
reoorded during the epidemic of 1849.
465 ; 5. "WiOAS; Pemberton. Population 10,435. Cholera 13 ; Diarrhoea 40. Cholera was
sal to the daughter of a coal miner, aged six years, on 28th September, at Marsh-green, Pemberton.
Seven deaths were recorded in October and five in November ; the last two were those of colliers,
•Q 25th November, one at Marsh-green the other at New Town. Four of the deaths from cholera
took place Bt Usrsh-green and four at Lamberhead-green ; with one or two exceptions they were
all in the famiUes of eoal miners.
465; 6. WioAW; UphollamL Population 6,982. Cholera 2 ; Diarrhcea 14. Both these deaths
from cholera oecuired at Billingc Chapel-end; the first a collier, aged 30, on 6th October ; the last
a qaarryman^s wife, aged 68, on 17th October. In 1849 the deaths from cholera in the district of
Wigan ^ere 563, against 158 in 1854 and 137 in 1866.
468 ; I. BoLXOX ; Famworih, Population 13,723. Cholera 14 ; Diarrhoea 25. Cholera was
fatal to a fiKrm servant (male), aged 64, at Slackey-brow, Kersley, on 5th July ; the next case
occnrred on 5th September. Two members of the same family died in Egerton-street on 14th
Septemher. The last death was that of a cotton piecer, aged 22, in the Workhouse, on 22d
October.
468 5 10. Bolton : Little Bolton, Population 24,942. Cholera 23 ; Diarrhcea 40. The first
death firam cholera was that of a cashier, aged 30, in Hampden-strcet, on 21st Jidy. The next
eholera dnring the epidemic of 1849 were 24.
468; 11. Bolton; Bolton Eastern. Population 24,996. Cholera 7 ; Diarrhoea 40. The first
death from cholera occurred on 20th September when a cotton spinner's wife, aged 59, died in
Tbyrme-ttreet. The last death was tliat of a colliery labourer, aged 37, at Stow Hillock on
$th November, after an attack of Asiatic cholera of 17 hours* duration; this labourer also lost his son
jrom Asiatic cholera on 24th October after an illness of 24 hours.
4^8; la. Bolton; Boiton Western, Population 18,439. Cholera 11; Diarrhoea 36. A weaver's
widow, aged 70, died from cholera on 25th July ; no other death occurred until 29th and 30th Sep-
temher, when there was one on each day in Back James- street. The last was that of a collier,
aged 60, in Cunhffe- court, on 29th October. The deaths firom cholera in the district of Wigan were
lis *m 1849, 16 in 1854, and 64 in 1866.
234 Notes en Cholera in Districts.
470; I. Barton-upon-Ibwell ; Woraley. Population 14,015. Cholera 10; Diarrhcea 14.
Cholera ^as fatal to a canal boatman, aged 68, at Worsley on 1st August ; the next case was on
9th September, the last a coal •miner's daughter, aged nine months, at Worsley, on 26th September
Coal-miners* families and persons engaged in the cotton manufacture were the sufferers. Eight of
the deaths were of females.
470; 2. Barton-upon-Iewell ; Barton, Population 14,216. Cholera 5; Diarrhcea 9. Four of
the deaths from cholera occurred at Barton and one at Patricroft ; the first, on 17th September, a
publican, aged 67 ; the last, a blacksmith*s son, aged 15, on 24th October.
471; 2. Chorlton ; Ardwick. Population 47,752. Cholera 11 ; DiarrhoBa 83. Pirst case of
cholera on 14th May at Hope-street, Gorton, a surgeon's son, aged 12 ; the last fiital case, a packer,
aged 55, in Tonge-strcet, on 31st October. Diarrhoea was prevalent and very fatal among children
during the month of July.
471; .^. Chorltox; Chorlton-upon-Medlock, Population 44,795, Cholera 6 ; Diarrhoea 43. A
blacksmith, aged 51, died from cholera in Hall-street, on 1.4th July ; no other death was recorded
until 23d August, when the infant son of a packer died in Leaf-street. In September there were three
deaths ; the last fiital case was that of a cotton-spinner, aged 45, in Union-street, on 27th October,
471; 4. CnoRLTON; Hulme. Population 71,128. Cholera 8; Diarrhoea 172. Diarrhoea was
very fatal in this sub-district, and prevailed throughout the year, chiefly in July and August ; infant
mortality was very great, upwards of two thirds of the deaths occurring amongst children under
two years of age. Cholera was fatal on 19th July, at Medlock-street, to a shoemaker, aged 35 ;
the next two deaths also occurred in July. Of the other cases two took place in August, and the
last on 29th September at Uulme.
472 ; 1. Salford; Ptf»rf/e^on. Population 24,448. Cholera 10. Diarrhoea 25. The first death
from cholera was that of a worsted dyer, aged 51, in Franchise-street, on 8th September; two
deaths occurred in one family at Ci*oft, Pendlebury, during the same month. The last death was
that of a farm-servant, aged 58, at Eccles New-road, on 22 d November.
472; 3. Salford; Greengate. Population 37,534. Cholera 9 ; Diarrhoea 127. The infant son
of a lithographic printer died of choleraic diarrhoea in Frederick-street on 16th July ; no other case
occurred until 20th September, when it was fatal to a silk-weaver in Lupton's-buildings. The last
death was that of a female, aged 59, in Union-street, on 28th October. Diarrhoea was very preva-
lent and fatal amongst children during the months of July and August.
472 ; 4. Salford ; Regent-road. Population 33,468. Cholera 9 ; Diarrhoea 88. Cholera was
fatal to a joiner's wife, aged 46, in Booth-street, Oldfield-road, on 12th February ; two deaths occurred
in July, one in August, three in September, and two in October; the last being that of an overlooker
at a cotton mill, aged 54, on 26th October, in Parsonage-street.
473; I. Manchester; Ancoats. Population 55,983. Cholera 13; Diarrhoea 180. Cholera
was fatal to a tailor, aged 22, on 17th July, in Three Court Blossom- street, and to his wife, aged
22, on the following day. The other cases occurred at intervals, the last death being that of a
tobacco-pipe maker's wife, aged 42, in Pott-street, on 29th October. The msyorityofthe deaths
from diarrhoea were those of young children under two years of age, and in most instances they had
no medical attendant.
473; 2. Manchester; Deansgaie. Population 29,029. Cholera 18; Diarrhoea 101. Nine of
the deaths from cholera occurred in August, three at one house, but not members of the same fiimily,
in Fleet-street. The other cases occurred in September, October, November, and December ; the
last was that of a porter's wife, aged 26, in Camp-street, on 23d December.
473; 3. Manchester; London-road, Population 28,817. Cholera 4 ; Diarrhoea 72. CholerSi
was first fatal to the wife of a licensed victualler, aged 50, in Mather-street, on 31st July ; the other
cases occurred at Great Ancoats street on 7 th August, at London-road on 25th September, and at
Broome-square on 26th September. Diarrhiea was prevalent during the months of July and August
473 ; 4. Manchester ; Market-street Population 23,526. Cholera 5 ; Diarrhoea 51. Two
deaths from cholera occurred at the same house in Marsdcn's-conrt, one that of a female servant,
aged 19, on the 23d, and a tailor's wife, aged 27, on the 25th July ; two fatal cases took place in the
workhouse, the last a labourer's widow, aged 48, on 26th September.
473 ; 5- Manchester ; St, George, Population 48,055. Cholera 8 ; Diarrhoea 138. Four
deaths from cholera occurred in July, one in August, one in September, and two in October ; the
last, a tailor, aged 31, in Cable-street, on 30th October. Of the 138 deaths from diarrhoea 114 proved
fatal to children under two years of age.
473; 6. I^Ianchester ; Newton, Population 19,311. Cholera 1; Diarrhoea 32. The fiUal
cholera case was that of a sawyer, aged 51, in Church -street, Newton, on 29th August
473; 7. Manchester ; Cheetham, Population 21,731. Cholera 5 ; Diarrhoea 20. The first
fatal case of cholera occurred at Spinner's-row, Lower Crumpsall, where a child died on 1 9th Sep-
tember ; the last death was that of a female servant, aged 48, at Frances-street, on 27th October,
'* cholera (54 hours) after having eaten heartily of mussels and cockles."
473 ; 8. Manchester ; Failsworth. Population 6,312. Cholera 2; Diarrhoea 7. On 6th May,
at Firs Fold, a colliery labourer's wife, aged 39, and at Stakeleech, 25th September, a carter's wife,
aged 22, died of cholera.
Notes on Cholera in Districts^ 235
473; 9. MAsrCBEffTEB; Blackky, Population 4,939. Cholera 4 ; Diarrhoea 11. First fatal case
of cbolen ocscurred 17th July, at Charles Town, Blackley, to a labourer, aged 58, after an attack
of 1 1 htmn ; the second to s blacksmith, aged 58, at Market-street. The last two cases occurred
at PleuHUitHstreet, Harpurbey, to a silk- warper (male), aged 56, on 31st October, and to a silk-
(fiemale), aged 36, on 6th November. The deaths from cholera in ^e three districts, Man-
*, GlunitoD, and Salford combined^ were 1,395 in 1849 ; in 1866 the deaths were only 113.
474; A. A8IIT05-undbb-Ltxe ; Ashton-toum. Population 33.917. Cholera 10; Diarrhcea 67.
Two ebUdrea of a coal-miner, each aged nine weeks, died of English cholera at York-street — one on
19di Jaijt the other on the 23d ; the last death was that of a cotton-twister*s wife at Currier-lane,
oa f9th October. Diarrhcea waa prevalent up to the end of October, and six fatal cases were regis-
tered as luiTing taken place in the workhouse.
474; 3. Abhton-undeb-Lytpe ; Audenshaw. Population 15,125. Cholera 2; Diarrhoea 21.
On 14di October the wife of a power-loom weaver, aged 32, and on 24th October a railway porter,
i^ed 32, died in the Township of Droylsden.
474 f 6- Abhtoh-ukdbr-Ltne ; Dttkinfield, Population 29,953. Cholera 5 ; Diarrhoea 24.
The firat death from cholera occurred on 17th July, to the infant daughter of a cotton- weaver, at
Bfiexiy-atreet ; the next death was not recorded until 6th August There were none in September,
two in October, and the last was that of a fishmonger, aged 52, in Princess-street, on 26th November.
The deaths firom cholera in 1849 in the district of Ashton were 68 against 12 in 1854, and 21 in 186G.
A1^\ !• Ou>HAX; Oldhamrbdouhtown, Population 41,770. Cholera 8 ; Diarrhoea 55. Cholera
m fataH od 19th September to a cotton weaver^s wife, aged 44, at Cocker Fold ; on 27th September,
iron-'woTker, aged 62, died in Bloom-street of diarrhoea, and on the following day his widow, also
62y died air cholera (3 days) ; the last death took place in the workhouse on 12th October, and
that of a Arm labourer, aged 40.
475 ; 2. Ou>HAX ; Oldham-above-iown. Population 30,563. Cholera 7 ; Diarrhoea 37. First
death from cholera occurred on 13th July at Moorside ; the next in Waterworks-street on 28th
An^nat. Two were recorded in September, two in October, and the last (labourer aged 44), at
~ Hill on 7th November.
478; I. BuKruET; Bumiey, Population 42,702. Cholera 16; Diarrhoea 35. Cholera was
fttal to the wUe of a stone quarrier, aged 23, at Extwisle on 8th June ; there were one or two
deaths in July and August. On 28th September the epidemic broke out at Wood Top, Habergham
Sawea, and was &tal to six persons by 1 8tli October ; in two instances two members of the same
ftmiiy died^ The last case recorded was that of a joiner's infant daughter, in Exmouth-street on
S7th October.
478 ; s. BuRiOET ; Padikam. Population 9,906. Cholera 4 ; Diarrhoea 16. The fatal cases
«C cholera occurred on 6th July, in Watt-street, Uead ; on 6th August in the com market, Huncoat ;
« 8th September in St Giles-street, Padiham } and on 9th October at Altham Hall Fold,
Alth*"^-
j^j8 i 3' BcwOBT; Colne. Population 21,203. Cholera 3 ; Diarrhoea 19. These deaths from
diolero took place at Knarr End on 6th May ; at Alkincoats on 10th July ; and at Spring-lane on
lOth Augnst.
480; 4. BlackbubK; Blackburn, Population 63.126. Cholera 7 ; Diarrhoea 110. Cholera
vaa fatal to a female senrant, aged 50, on 15th July, in Cross-street ; to a com millers son, in
Johnson-street, on S5th July. In August there was one death, in September two, and in October
two. The last was that of a weaver's daughter, aged three years, in Duckworth -street, on 19th
October. Of Ae 110 deaths from diarrhoea, 82 were of children under two years of age, and the
most fittal among the fainiilies of those engaged in the cotton manufacture.
4J80 ; 6. Blagkbubic ; Darwen. — Population 21,447. Cholera 17; Diarrhoea 31. The first
^KBth. ftxmk ehokra occurred on 18th July to a millwright's wife, aged 57, in Hacking-street,
Over Darwen ; tiie second, 3l6t August, to a labourer's son, at Bartin Houses, Over Danven ;
Ibe laat, 12th Norember, to a coal miner, aged 61, at Scholes Fold. Half the deaths from cholera
in the ikmilies of coal miners.
481; 4* Chorubt; Charley. Population 18,027. Cholera 10; Diarrhoea 22. Cholera was
htal to a male, aged 82, in Water-street on 4th August ; another death occurred in the same street,
«■ 14th Octoher. There were also two fatal cases in October at Tinkers Barrack. The last death
that of a labourer, aged 69, at Red Banks, on 12th November.
4S« ; I. PaESTOX ; Lon^jon, Population 6,620. Cholera 5 ; Diarrhoea 8. The first death
cholera was that of a labourer's son, aged seven years, at Hutton, on 13th August. The
aining four deaths occurred at Farington, in October (the laat on the 28th), and were, respec-
6re]y, » twister in a cotton mill, aged 12, and three sons of cotton weavers, aged one, two, and five
483 ; 2. Presto:^ ; Preston, Population 82,985. Cholera 14 ; Diarrhcea 166. On 9th March
two deaths from cholera occiured, one in Paradise-street, and one in Brewery-street ; no other
CMe Va^ place until 14th July when the disease was fatal to the son of an engine feeder in Wilton-
In the fl«t week of October five deaths were recorded, but in different localities. The last
that of a brickmaker's labourer, aged 29, at Skcffington Hoad on 2d November. The
236 Notes on Cholera in Districts.
Registrar states that when cholera first made its appearance the auihoritiea adopted the most
energetic measures to prerent the disease from spreading, and opened several places where cholera
medicine might he obtained gratoitonsly by all who would apply for it.
486; 4. Ulyerston; Dalton, Population 11,243. Cholera 10 ; Dianhosa 16. Eight of the
deaths firom cholera occurred at Daltbn Town, and two at Barrow. Iron nuners and their families
were the principal sufferers. The first death was recorded on 5th October, of an upholsterer, aged
46, at Barrow ; the last on 2 2d November at Dalton Town. In 1849 there were three deaths from
cholera in the district of Ulverston, against one in 1854, and 11 in 1866.
IX.— YORKSHIRE,
3j, — West Riding.
495 ; 2. ToDMOBDEN ; TodtRorden, Population 20,287. Cholera 10 ; Diairiusa 7. The fiist
death from cholera occurred 7th August, to the daughter of a carter, aged three yean, at Goshen-
terrace, Langfield ; the last, 5th November, to the wife of a warehouseman, aged 39, at Dobroyd,
Todmorden.
497 ; 8. HuDDERSFiELD ; Kirkheaton. — ^Population 11,923. Cholera 2 ; Diarrhcea 6. The fini
fktal case of diolera took place at Moldgreen, Dalton, on 17th June, and the second at Q^rang«
Moor, Whitley, on 28th November.
497 ; 9. HuDDEBSFiELD ; Huddersfield. Population 34,877. Cholera 8 ; DianhoBa 32. The
first dea^ from cholera took place on 6th June and the last on 29th September.
498 ; 4. Halifax ; Halifax, Population 36,437. Cholera 7 ; Diarrhcea 21. IFlrst fatal case oa
11th February ; three deaths during the month of September and three in November, all of adolta.
Diarrhoea was also fatal to 10 adults and 11 children during the year. In 1849, when the deaths
from cholera were 20, the mortality was chiefly amongst clothiers' and cloth dressers' fiunilies ; in
1 866 not one of the persons dying was described as of that occupation.
499; 4. Bradford; Bowling. Population 14,494. Cholera 3; Dianhoea 15. The first
death from cholera occurred 11th August, to a drab dyer in Boiling-street, aged 53 ; the last^ on
25th November, to the wife of a model maker, aged 55, in Back-lane.
499 ; 5. Bradford ; Bradford East End, Population 28,579. Cholera 15 ; Diarrhcea 27.
On 15th June, in Irving-street, the first death from cholera was that of a woolcomber's widow,
aged 51. No further fatal cases took place until August, when the disease broke out in Warwick-
street, where five deaths took place within a few days, the wife of a cartwright, aged 56, dying
28th August, followed by her daughter, aged 19, on the 30th ; the daughter of a painter, aged seven
years, died on the 30th, his wife, aged 36, on 2d September, and the daughter of a hammennaiiy
aged seven years, on 1st September. With one exception, these cases were registered as Ai^in^g
cholera, the longest [duration being 29 hours. The remaining deaths were spread over the sub-
district, the last bein^ that of an overlooker in a worsted xmll, aged 24, on 27th December in
Otley-road. Warwidt-street suffered severely during the epidemic of 1849.
499 ; 6. Bradford $ Bradford West End, Population 20,067. Cholera 2 ; Diarrhcea 35.
First death from cholera on 8U1 August in Lower West-street ; second on 5th Septeniber in Sedg>
wick-street.
500 c; I. Holbeck; Hdheck, Population 15,824. Cholera 8 ; Diarrhoea 21. The whole of
these deaths from cholera were returned as <* choleraic diarrhcea," six of them being of children
under two years of age. The first death took place on 11th July, at Top Moor Side, and the last
in Domestic-street on 24th August.
501 ; I. Leeds ; South East. Population 29,196. Cholera 4; DiarrhiBa 66. The first &tal
case of cholera occurred on 20th July and the last on 20th September, Diarrhcsa was verj
prevalent during the month of July, there being 22 deaths from that disease.
501; 2. Leeds ; North, Population 41,136. Cholera 6; Diarrhcea 113. One death from
cholera was recorded in July, two in August, and three in September.
501 ; 3. Leeds; West, Population 47,234. Cholera 4; Diarrhcea 67. Krst fiital case, cm
18th August, occurred to the daughter of a carver and gilder, aged seven months, at Alfi^-phiee ;
second and third cases in Rose-court, on the 24th and 25th August, to an excavator, aged 60, and his
daughter aged one ; last case, on 25th September, to a packer aged 47, " dioleraic diarrhcBa,"
accelerated by intemperate habits. In the district of Leeds, during the epidemic of 1849, 1,439
deaths took place from cholera ; in 1854, 48 ; and in 1866, 14.
The following communication was received on 30th October firom M. B. Bohinson, Esq., M^D.^
Medical Officer of Health, in reply to Queries. {See London Weekhf Beham, ^o, 44.)
. ]' T^^ Leeds Board of Guardians directed their four medical officers to make honse-to*honS9
Citations; and authorized each of them to employ a competent assistant for the same pozpose. This
Notes on Cholera in Districts. 237
datj was pcrfonned by them for aboat three months, but in consequence of Asiatic cholera
not pntmiling in an epidenuc fonn in Leeds, their services in this capacity have been recently
dispeRsed with. They worked in perfect harmony with the officer of health, supplied him with
▼alnaUe information, and always willingly adopted his recommendations.
The ]>edB, Hunslet, and Holbeck Bocurd of Guardians also employed five inspectors of nmsances.
Tliey were not under ^e control of the officer of health.
Tlie Leeds Town Council employ regularly one inspector of nuisances, who has also 20 sub-
ordinate officers ; the latter, however, perform also police duty. This stafi is under the control of
the officer of health.
2. The medical officers employed by the guardians have instructions to treat promptly all cases of
fiarrlioea which are brought to their notice.
3. The medical attendants engaged to treat and take charge of the few cases of Asiatic cholera
which have occurred in Leeds have caused the excreta to be immediately disinfected, and the
inspectors employed by the Town Council have also freely distributed disinfectants, not only in the
nuddens, drains, or gullies where cholera dejections might have been thrown, but also throughout
the town.
4. The officer of health has personally "nsitcd every house where a case of cholera has been
reported to have occurred, and caused the bedding and linen to be destroyed.
5. The linen and bedding destroyed have been immediately replaced by the Town Council.
6. No deaths from cholera occurred last week in Leeds. The house in which a labourer died on
the 2 2d of September from Asiatic cholera abutted on a row of privies which were imdnuned, and
from which an intolerable stench had been noticed to arise, the fluid filth probably percolated under
the hoiue. The privies have been since drained.
503; I. J>KW8BVRY ; Moriey, Population 6,840. Cholera 2 ; Diarrhcca 14. Of the two fatal
cases of ebokni, one occurred in Commercial-street on l&th June, to the wife of a woollen
wearer, stged58; the other in High-street on 13th July, to the daughter of a quarryman, aged
lOaMWths.
503; 3. Dewsbitrt; Bailey. Population 14,173. Cholera 4 ; Diarrhoea 21. The first death
frcmi cholera occurred on 3d July at Ward*8-hill, to a woollen weaver, aged 48 } the last at Batley-
on 25th November, to the son of a coal miner, aged one year.
$02 ; 4. Dewsbubt ; Lwer$edge. Population 14,520. Cholera 1 ; DiarrhoBa 16. The only fatal
a that of a female, aged 51, on 16th August, at High Town, after an illness of 14 hours.
$02 i 6. Dewaburt ; Dewdmry, Population 18,148. Cholera 8; Diarrhcea 31. With one
ezcepcioo these cases of cholera occurred to children under two years of age ; the first death was
on 7th Fehnuuy, the last on 28th October ; two of them took place at Daw-green, and two at
Batlcj-
502; 7. Dbwsbtot; SoathiU, Population 6,238. Cholera 1; Diarrhoea 7. On 18th Sep-
tember at Comnumiide, Earlsheaton, the wife of a blanket-raiser, aged 56, died after 17 hours' illness.
So6i 5. WoBTiET; Ecclesfield, Population 12,479. Cholera 9; Diarrhoea 14. These deaths
from cboiera oeeoired between the 7th and 15th of September (five of them at Greenside). In
1849 there were only three deaths from cholera, neither of which occurred at Greenside.
508; 2. Shkefieu); North. Population 33,994. Cholera 4 ; Diarrhoea 67. The first death
from cholera occurred on 9th August in Doncaster-street, to the daughter of a turner ; the second,
to the wife of a labourer, on 11th August, in Club-yard, Mill-sands; the third, to the son of a
type fonnder, on 10th September, in Artizan-street ; and Ac last, to a file hardener in Bellefield-
itreet, on 27th October.
508 ; 3. Shsfrbld; Sovth. Population 17,680. Cholera 6 ; Diarrhoea 27. First fatal case
of cholera on 22d May in Norfolk- lane ; of the other deaths, one took place on 25th July at Union-
boiidings, Union-street, one on 19th September in Castle-street, two on 26th October, one in
Bui^gesf-tftreet, and one in Commercial-street, and the last on 5th November, in Cross Burgess-
508 ; 5. Sheffield ; Biightside. Population 29,818. Cholera 3 ; Diarrhoea 52. These deaths
from cholera occurred on the 5th, 8th, and 13th of July ; the first in Fowler-street, the second in
Edward-street ; and the last in Greystock-street.
508; 7. Sheffield; Ilandsworth. Population 3,951. Cholera 1 ; Diarrhoea 1. The death of
a dressmaker, aged 56, resulted from cholera on 23d August.
510; 3. D0NCA8TES; Doncaster. Population 16,406. Cholera 36; Diarrhoea 35. A coachman,
%ged 71, died of cholera on 23d January in Cartwright-street ; an optician in July in High-street; a
blacksmith in August in Australian-terrace ; then the epidemic became very prevalent, and remained
ID dnriog the month of September, proving fatal to 28 persons, 15 of the deaths taking place in
BohiDsan's-row, Dockin-hili, and seven in St Ann's-square The last two cases occurred on 1 0th
KoTcsnber in St. Thomas-street, to the sons of an engine driver, aged respectively 8 and 10 years,
after 18 and 13 hours illness. The Registrar states that the water supply of the sub-district is
derired from the river and from pumps: the sewers drain into the river.
Sia; I. Ooolb; Swin^eet, Population 4,042. Cholera 3; Diarrhoea 2. Two of these cases
oeeoned «t Swinefleet, and one at Garthorpe ; the first on 29th July, the last on 23d September.
238 X'Jotes on Cholera in Districts^
513; 2. 600LE; Goole. Population 6,994. Cholera 45 ; Diarrhoea 15. Cholera was fatal on
29th Jane, two deaths taking place on that daj ; four more occurred in July. The epidemic became
yery severe in August and September ; there were 1 5 deaths during the former and 24 during the
latter month. The disease was most fatal in Doyle-street, Foundry-street, and Albert-street. 10^
deaths firam cholera were recorded as having taken place in the workhouse, Hook. In 1849, when
the deaths from cholera were 40, Doyle-street suffered severely.
S6. East HmiNa (with York).
516; 3. Pocklinoton; Market Weighton. Population 5,254. Cholera 17 ; Diarrhcea 8. Witb
the exception of three deaths in the township of Shipton, and one in the parish of Seaton Ross, the
whole of the deaths from cholera occurr^ at Market Weighton. The mortality was greatest
amongst agricultural labourers and their &milies. The first &tal case took place on 1 1th September;
the last on 13th October.
520; I. Hull; Humber, Population 10,690. Cholera 1 ; Diorrhcea 9. Cholera was fatal to
a labourer, aged 61, in Dogger-lane on 20th July.
520 ; 2. Hull ; Sl Mary. Population 6,132. Cholera 1 ; Diarrhoea 7. The wife of a
shoenmker, aged 36, died from cholera on 20th July in Duke-street.
520 ; 3. Hull; My ton. Population 40,066. Cholera 14 ; Diarrhoea 44. The first death from
cholera occurred on 4th July in Paradise-place ; the last on 9th October in EngUsh-street
Mr. Middlemiss, the Registrar, has communicated the following particulars in reference to choleia
in this sub-district
The water supply is now derived almost entirely from natural springs and artesian wells, and ib not*
liable to contamination.
The 14 cases of cholera in the sub-district may be classed as follows : Asiatic cholera 6, English
cholera 4, infantile cholera 1, unspecified cholera 3.
Of the six cases of Asiatic cholera, one was a sailor who had come direct from Hamburgh and
had drank the waters of the Elbe which were contaminated. O^^e was infected while nursing her
brother whose wifie had died of cholera at Doncaster, the br^ . jx bei^ taken ill at Hull while
moving his children to the sea side. One is stated by tbe medical Bf i to have been caused by.
overwork and want of food. The remaining three were members <; ' me same family ; the father,
aged 45, a landing surveyor in Her Migestjrs Customs, and his two children, aged two and three
years respectively, who all died on the same day in Roper-street, which is a long narrow street^
15 ft. wide by 450 ft. in length, with small houses and rooms, some without yards, in a closely built
neighbourhood. The house where these deaths occurred has no yard, the watercloset and sink beinff
within the house in the back kitchen, and the smell was often bad. The children were taken iU
first, and then the father. Just before the children were taken ill they had been in the house of a
neighbour, a woman who lay dead of English cholera in a square bdiind the house, the kitchen
window in fact looking into the square.
Of the four cases of English cholera, two are referred by the medical men to the habits of the
patients. One was fireman in a steam-boat, who died in the workhouse ; he had first been taken tD '
the infirmary and refused admission, and then taken to the workhouse, where he died soon afterwardii
Excepting a case of infantile cholera this was the first one in the district One was an excavator*! '
wife, who died in Lumley*s court, Myton-street, adjoining the back of the house in Roper-stzeet ^
where the father and two children died of Asiatic cholera. The house in which the woman died <
is a small house with no yard, the privy being in the court fronting the window of the house and ^
about 8 feet distant The woman died on the 8th August 1 866, and two days afterwards her ')
husband and another excavator who lodged in the house died, having both been taken ill after the ^
wife. The husband and lodger are returned as cholera only. On the same day that the two men •(
died the three deaths took place in Roper-street also. if^
Of the three cases of unspecified cholera, two are the excavators alluded to under the last head. i\^
One was the wife of a ship broker residing in English-street in a wide and lury part of the street ' ^
In the district of Hull, the deaths from cholera during the epidemic of 1849 were 1178, the ^
water supply being derived directly from the river polluted with sewage; in 1854, 15; and in ^
1866, 16. ^
>^
X.— NORTHERN COUNTIES- ^^
38. Durham, >
541 a ; I. Stockton; Yarm. Population 25,079. Cholera 62 ; Diarrhcea 60. A labourer and %,'
his son died from cholera in Cannon-street, Linthorpe ; the former on 20th July, the latter oil v
21st July. There were one or two deaths in August, but the epidemic did not assume any seriotti |>
form until September, when it broke out with great virulence, and it was not before the end ofy*
November that it was finally extinguished. The township of WolvisUm suffered most severdy^ ,^
'«4
Notei on Cholera in Districts. 239
tbene being 22 deatlu, chiefly amongftt labourers and tbeir fumilicfl ; tbe (lii^eaKe wan also very fatal
in tbe parish of Yarm. The last death from cholera was that of a mariner, aged 54, at the Cholera
Hflfpiial, Middlesborough, on 25th November.
tfifl; a. SxocKToy; Stockton, Population 20,240. Cholera 11 ; Diarrha?a 32. There was
Bodc&th from cholera nntil 5th October, when a female survant, a^d 18, died in Ag'iU'S-street,
after an illoefs of eight hours ; the last case occurred in Nile-street on lUth November. Labourers
and thcf jr Cimilies were the chief sufferers.
5414; I. Hartlepool; JJarilepooL Population 20,153. Cholera 28; Diarrlura oO. Cholera
▼s prevalent in August, September, and Octolier, the deaths respectively wen* 1), 1.% and 5.
IW epidemic commenced in Henrietta-street on 29th July, and entirely ceasod on 28th October.
545 ; 5. DcBHAM; Si, Oswald. Population 18.714. Cholera 4; Diarrlia-a 24. The first fatal
case of diolera was at Framwell-gate on SOth July ; the second at Willington on 8th September ;
tbe diird and fourth in South-street, a carpet weaver and his daughter, the fonner on 18th iSeptember,
ui tbe Utter on 13th October.
545; 4. DcitiiAM; St, NicIuiUtM. Population 23,748. Cholera 13; Diarrhcca 17. The whole
of ihe deaths from cholera took place at Quarrington-hill. The population of the township of
(^tamngton in 1861 was 1056. AVith two exceptitms, the deaths were those of coal miners and
^ar &milies. The first fatal case was on 1 1th November, and the last on 18th December.
546; I. EjksrxGTOX; Eimngton, PopuUition 27,293. Cholera 11; Diarrhira 24. The first
death from cholera occurred at the Infinnary, Seaham Harbour, to a seaman, aged 65, on
]9cb August. Two coal miners died at Murton Colliery on 29th Septcml)er. "With the exception •
of anoihiiei £itAl case at the Infirmary on 4th NovemlKT, the whole of the remaining deaths were
those of enal miners and their families at Thornley ; the last fatal case being that of a coal miner's
vidow, aged 45, on 16th November.
54;; f . HorOHTOV-LE-SPBXNO ; IIonfjhtoH'ic-Sprituj. Population 11,238. Cliolem21; Diarrhoea
lA. Tbe epidemic did not make its appearance until October, when it was fatal to 13 persons of
Tnioag cocapations. The remaining eight canes occurred during the month of November ; the last
OB the 2$th. Eight of tbe deaths took place in Newbottle-laue.
547; 2. UoroHTOX-LE-'^pnTXo , Hettm-le-Ihiie. Population lOjri.lS. Cholera 4; Diarrhoea 8.
Fmifau\ case of cholera *■ Four Lane Ends on Ist ScptemlKT; the last was at the same place,
octfui/xug to the widow of a lauourer, aged 69, on 18th NoveinlK*r. The other two deaths were in
EHUgtoa-laiie ; a shoemaker, aged 54, on 15th October, and a labourer, aged 56, on the 16th.
$4$ I !• Cbe8TEB-le-Stbeet ; Chenter-lc-Strect. Population 14,237. Cholera 3 ; Diarrhoea 16..
At Primroae-hiVV, LambCon, a coal-miner, aged 45, died from cliolera on 16th August ; the second
death waa tbax of a miner*s wife, aged 25, at Great Lumley, on 2 Ist September; and the third a
coal-miner, aged 40, on 25lh October, at D pit, Bourn-moor.
S4S ; 2. Cbesteu-le-Street ; HarraUm. Population 13«423. Cliolera 30; Diarrhoea 23.
TZiere wa^ one death from cholera in July, one in August, and one in September. It was not until
October that the epidemic really commenced. During that month it was fatal to 14 persons (coal-
miaen and their families) ; it was also vor\' fatal at Waterloo, there 1>emg 1 1 deaths during the
month of Xovember amongst coal-niiners and their families. The last case was that of a cashier
U a colliery, aged 45, at Springwell, Usworth, on IStli Deeember. Mr. Hodgson, the Kegistrar,
■ates that the water supply of the sub-district is derived principally from wells ; but the township of
"WailuDgton, and Waterloo in the township of Us worth, arc supplied with water pumpi-d from ihe
ccOieneft at Wasfaingtoc.and the water in 1866 was at least half a mile from the dwelling houses,
and was carried in water barrels and sold to the inhabitants. Since the cholera epidemic the
WashinjEton Cool Company have laid pii>es to all their cottnjres, which are now (November 1867)
Uheially supplied vith water from the colliery.
549: f. SrNDKBLjiND ; North Distutjmu'tumonth. Population 23,749. Cliolera 11; Diiuprhoea
irr The first death from cholera occurre<l in Torrington-row, that of an iron-roller, aged 23, on
aOih June. £xcept one or two solitary cases in Augitst, there were no other deaths until October,
^hen there were seven. The last case occurred in ^^■est Trindon- street on 4th November.
549; 2. ScNi>Enr«\yD; Stiuth Bisfioptn-nnnouf/i. Population 2.1,083. Cholera 7 ; Diarrhoea 23.
A.paintrr's daughter, aged 13, died of cholera on ITith August in Lawrence- street. The *«hsequent
OSes were spread over the sub-district, the last occuring to the daughter of a triumier, aged 2t>, in
Back £a9^t Woodbine-street, on 28th November.
5"*9j 3- SrsiiERiJiXD; East SiifuMiifi'I. Pcypulation 0,915. Cholera 13; Diarrluea 20. Eight
of ihsif-K deaths fiTim cholera occurred in Uobinsdu's-lane ; the first on 2d Septemlier ; the last on
Xth OctiAer. Every death that took place was recorded as ** Asiatic," and jLhc duraiiou of each
a*e Tra« ren- short. /'
iifji 4. Sn-SDEnLAXD ; Went SiimUrhui'l. Population 8,517. Choleny/48 ; Diarrhopa 8. The
fint deatli fT*)ra cholera oceurreil on 0th Auirnst ; another death took jflace on the 1 7th. From
Ae 3d September until 21st November the di<e:i^e wns very prevalent 'aud fatal. In Haines-lane
fcre were 14 deaths; in Union-lane 15. The last death was that of a labourer, u-ed 37, on
2lit Norember, hi iJaines-lane.
1
*
/
240 Notei on Cholera in Districti*
549 ; S' SuxDERULND ; Monkwearmouih. Fopulation 23,440. Cholera 13 ; Diarrlicea 33. One
death from cholera occurred in Wear-street, to the wife *of a shipwright, aged 24, on 8d JoIt i
two fatal cases occurred in August, two in September, four in October, and four in NoYember» thft
last death being that of a packer's wife, at Pottery-yard,, on 24th November.
550; I.' Socni Shields ; Westoe, Population 29,382. Cholera 38; Diarrhcea 45. The first
death from cholera occurred at the workhouse, Westoe, on 30th June. There were a few cases in
July, August, and September. After 3d October the disease extended, and was very fatal until
the end of November. Five deaths were recorded in the Cholera Hospital and three in the work-
house. The epidemic was particularly fatal amongst the families of the seafaring population.
The last death was that of a coalmincr, aged 35, on 27(h November, at New Winnings, Boldon.
550; 2. South Shields ; South Shieltls. Population 15,467. Cholera 10; Diarrhcpa 30. Six
of these fatal cases of cholera occurred in Jarrow. One death occurred on board ship in -the river'
Tyne. The first fatal case was on 17th July ; the last on 23d November.
551; I. Gateshead; Heworth. Population 10,315. Cholera 2; Diarrhoea 5. First death from
cholera, that of a chemical labourer, aged 57, at Low Felliug, on 2d September ; second, that of
the daughter of an engine-worker, aged five years, at Felling Shoi*e, on 1 8th October.
5ei ; 2. Gateshead; Gatediead, Population 32,749. Cholera 15; Diarrhcea 34. The first
deatn registered from cholera was that of a seaman on board ship on 10th August. Two deaths
occurred at Wreckenton, where the epidemic raged in 1849. Easton-street contributed three deaths.
The last case occurred on llth November, to t& daughter of a railway labourer, aged six years, in
Grosvenor-street.
39. NOUTHUMBERLAND.
j52 ; I. NewcastlB'UPON-Tyxe ; Westgate. Population 37,477. Cholera 13; Diarrhoea 78,
With the exception of two deaths from cholera in July, no other case is recorded until 3d October,
when a skinner, aged 35, died in Buckingham-street, after an attack of eleven hours* duration.
The disease was fatal to seven persons between the 23d and the end of the month ; two at one hoos6
in John-street. The last death occurred on 26th November, to the dauffhter of a dyer, aged
nine years, in West Blandford-street. Diarrhoea was very prevalent during the months of July and
October.
552; 2. Newcastle-upon-Tyne; St. Andrew. Population 17,100. Cholera 4 ; Diarrhoea !«•
One death from cholera in each of the four months of July, August, September, and October.
The first occurred to the son of a clerk, in Alexandria-terrace; the last, to the son o( a straw-haC
maker, in Simpson-street
55a; 3. Newcastle-upon-Ttne ; St. Nicholas. Population 16,632. Cholera 3; Diarrhoea 10.
On 7th October a hawker (female), aged 60, died of cholera at Denton -chase, St John ; a baker,
aged 45, on 12th October, in Newgate-street, St John ; and a hawker (male), ciged 57, in Westgate-
ttreet, on 28th October.
55a; 4. Newcastle-upon-Tyne; All Saints. Population 26,765. Cholera 18; Diarrhoea 32.-
12 of the 18 deaths from^cholcra occurred in October, but the disease does not appear to have been
confined to any particular locality or to persons of any particular occupation. ' The first death wu
that of a seaman, aged 45, in Stepney-terrace, on 17th July ; the last was the son of a labooreiu
aged three years, at Killing -entry, Pandon, on 6th November.
552; 5. Newcastle-upon-Tyne; ByAfr. Population 12,994. Cholera 5; Diarrhoea 11. Theie
five deaths from cholera were all of young persons under 20 years of age ; two of them died at Stone
Cellars, All Saints. ITie first death occurred on 28th July ; the last on 21st October. During the
epidemic of 1853-4 cholera was fatal to 1,431 persons in the district of Newcastle-upon-Tyne, while
in 1866, when the population had increased by some 20,000 persons, the deaths from cholera
were 43.
5C3; I. Ttnemouth; Wallsend. Population 6,715. aiolera 7 ; Diarrhoea 12. Two of these
deaths fhnn cholera occurred at Wallsend and four at Willington ; they were mostly preceded by
diarrhoea. The first death took place on 21st August and the last on 5th November.
553; 2. Ttnemouth; North Shields. Population 17,138. Cholera 43; Diarrhoea 23. No
death firom cholera took place until 29th September, when the wife of a tailor, aped 37, and the
^[V?^ a coal-miner, aged 58, died at Chirton. There were no other deaths until 13th October,
- • -- number
in the
- ,. r •- ^^^,.^, -...w remaining death from cholera
was at I'reston, noNpne fatal case being re^stered at ^loortown. Mr. Wheldon, the Registrar, states
that the town of NcJ^rth Shields is supphed with water principally by the North Shields Water
Company by pipes anci" taps leading into the houses or at public parts ; the company hare three
reservoirs for the collection of water. A large supply is derived fVom an old quarry, and water is %
taken up
ice. Tho
objection seemn tn fn)i /%» *u^ 1 ^fautr^n Mt^ofx-r^;,, ^r% »«^^..«« ^c .T-r "j z^ ffoinff
t:
\
t
Notes on Cliolera i;i Districts, 241
553 5 ^. TrNEMOxmi ; Tifnenututh, Poimlatioxi 18^66. Cholera 109; Diarrhcea 50. 50 males
59 frmales died from cholera. The first dcutli occurred on Ist Octo?>er, vrYmn. the epidemic
eomnieiiced, and continued ver}' fatal during;: the wliole of that month, no less than 97 of the lu9
dtKths being recorded therein. Nine deaths took place on 2 Ist October, 11 on tlie 22d, 10 on the
i3di ; after that date they diminished day by day until the middle of November, when the disease
finally disappeared. The following streets and localities suffered the most, in the oider named : —
Stephenson-street, Churchway, AVelliuf^ton f^treet, and Toll-sireet. Nearly a fourth of the deaths
occurred amon^t seamen, their wives and families. The last case was the son of a corporal, Koyal
Artilleiy, aged two years, at Clifford's Fort, on Mth November. ^Fr. Irvin, the IJe/ristrar, states
that the water supply is derived from reservoirs of the North ^^hields Water Company by pipes laid
into the town.
558: I. MoKPETH ; Morpvih. Population 8,426. Cholera 4 ; Diarrha?a 3. These four deaths
bvm cholera occurred in the Coimty Lunatic A.sylum, Morpeth, and were, respectively, those of a
gardener, aged 54, on 29th October ; the Mife of a labourei*, a^ed 27, on 2d November ; a £inii
laboni^y aged 52, and a female servant, aged 28, on 4th November.
558; 2. MoRi»ETii ; Bedlintfton. Population 15,577. Cholera 0; Diarrhoea 33. These deaths
trm cholera took pkice in the parish of Heillin^^ton ; thn.>i* of them at w^cotland-gato. With one
exccf^on, they were amongst the mining population. The first death occurred to the M-ife of a
coUier, aged 51, at fiarrington Colliery, on llth July; the last to the son of a collier, aged 17,
at Seotlaod-gatc, on 1 7th November.
40. Ci:mberl.\nd.
567; z, LoNGTow!f ; Low Longtoint, Population 7,178. Cholera 7 ; Diarrhoea 5. At Blackford,
We«{ ^nton, a farm- labourer, aged 65, died of cholera on 30th October ; the next death was that of
a farm-labourer's daughter, aged one, in Swine-street, on 4th November. The epidemic then broke
out in Bridge-street, there being no less than five deaths in that street, all childivn of farm labourers,
who died resipectirely on 4th, 6th, 8th, 9th, and 10th Novemln'r.
570; 3. CoCKEBMOurn; Workington, Population 10,765. Cholera 5; Diarrhcea 17. The
deaths from cholera, with one exception, were confiniHl to Pow-street. The first was that of the
daaghter of a farmer, aged three years, on 4th September ; the last, of the wife of a tailor, aged 34,
at ^ew-yard, on 5th November.
g^O; 4. CocKEttMOCTn; Man/porl. Population l.'^,707. Cholera 2; Diarrhoea 5. On 12th
October, at the Golden-lion Hotel, ^laryport, an hutel-keeper, aged 57, died of " diarrhcea, Asiatic
eholcra (24 hours)"; I4th October, at the same hotel, a waitress, aged 45, ** Asiatic cholera
CSj hour*v"
571 ; 1. WmTEHAVEX ; fforriuifton: Population 6,7 G."*. Cholera 1; Diarrhoea 1. A master
znariT&er, aged 4 J, died at Parton, on 1 st September.
57/ : 2. Whitehaven ; W/iitvhaven. Population 14,064. Cholera 9 ; Diarrhoea 9. W^ith one
exoept/on (the last death, in Flumblandc-lanc, Scotch-street, on 13th October,) the whole of these
deaths from cholera occurred at the fiifirniary, IIo\vgill->treet, principally amongst labourers and
their ftmiiies ; the hrst on 13th September, thelast on 7th (.)ctober.
571 ; 3. WniTEHAVEX; St. Hccs. population 8,681. Cht)lera 4; Diarrhoea 13. First fatal
case of cholera occurred on 2.3d SoptenilKT at 3 (iinns, Whitehaven, to the wife of a collier, aged 55,
-mho died in 13 hours ; the next two deaths on the 24th and 28th. The fourth case was that of the
vidow of a joiner, aged 51, at Thicket, Preston quarter, on 27th October.
571 ; 4. WuiTJsnAVKX; JS'^^/'cfWMN/. Population 10,1 -It). Cholera 2 ; Diarrhoea 5. 'Ilie daughter
of a \aboixrer, aged seven years, died at Cleator Moor, on llth August ; and a factory hand (male),
ag>ed €7, oa 30th October, at Egrcmont.
XL— WKLSII DIVLSION.
42 . MoN MO U TII.SII I UK.
57^; I. Bed^^-eltt; Abert/Atruth, Population 16,o:)5. Cholera 21 ; Diarrhoeas. Ebbw
VaJe f offered severely from cholera, no Ickm than 14 of the deaths taking place there during the
mooth of September, chiefly amongst forge labourers and their families; the first death was that
of aa iron bailer *8 helper, aged 24, on 6th September ; and the last in that locality, that of the
iniant daughter of a seamstress, on 2.')d SioteinlKT. It ysaa also fatal to two persons at Cwm*
*nd three at Blainat The last death was that of a collier's son, on 26ih November, at Countillwy.
S;86 ; 2. BsDWELTT; TraUgar. Population 28.548. Cholera 101 ; Diarrhoea 23. The deaths
frm cholera were 13 in September, 29 in October, 29 in November, and 30 in December. It wt
qa
542 Notes on Cliolera in Districts.
particularly fatal at Kumney in October and November, and at Tredegar in December, amongst
the mining population. The Registrar states that liumney, Ebbw Vale, and Sirfaowy are supplM
-with water from irells and surface water; the surface water may be liable to contaminatioo.
Tredegar is supplied with water from the Tredegar Waterworks. During the epidemic of 1849 it
-was observed that the mining population of Tredegar was attacked with cholera at a later period
than in other localities. The last death occurred to the widow of a collier, aged 76, at Sirhowjr,
on 26th December.
579; I. PoNTTTOOL; Pontypool, Population 22,633. Cholera 18; Diarrhoea 5. The first
fatal case of cholera took place on 16th September, when the son of a labourer, aged five years,
died at Trevethin ; the last death occurred to the son of a puddler, aged 10 months, at liock-hill, on
30th October. During the prevalence of the epidemic its presence was moet marked at Trevethin,
where 12 of the 18 deaths from cholera occurred.
580 ; I. Newpobt ; Caerleon, Population 7,615. Cholera 4; Dlarrboea 2. A child died of
cholera at Christchurch, on 5th July ; a farm labourer and the wife of a farm labourer, eadi aged
50, on 13th September, at the same place; and lastly the daughter of a farm labourer, aged
six months, on 26th October, at Penhow.
580 ; 2. Newfoht ; Newport. Population 24,756. Cholera 29 ; Diarrhoea 21. Cholera was
frital to the infant daughter of a seaman, on 23d July, at Newport ; two or three cases occurred in
August, but it was not until September that the deaths were numerous ; towards the end of that
month the epidemic gradually subsided. The last death occurred in Dolphin Street, to the wife of
a seaman, aged 52, on 23d October.
580 ; 3. Newport ; St WooUos. Population 8,445. Cholera 12 ; Diarrhoea 6. The infant
daughter of a coal miner died at Hisca, on 16th September; the disease continued prevalent
during the remainder of that month at Risca, but gradually declined in October. The Ust death
was that of the wife of a labourer in a coal pit, aged 37, on 29th November.
580 ; 4. Newport ; Mtpiyddyslwyn, Population 10,596. Cholera 16 ; Diarrhoea 4. Cholera
was fhtal on 28tli August to the wife of an innkeeper, aged 78, at Abercame, where, with one
exception, the whole of the deaths from cholera took place. It was prevalent during the month
of September, and was particularly fatal amount the mining population ; the last death recorded
was that of the daughter of a labourer, aged nme years, on 22d September. In 1849 the deaths
irom cholera were four.
43. South Wales.
Glamohoanshire,
581a; X.Cardiff; Whitchurch. Population 5,739. Cholera 4 ; Diarrhoea 1. Two fatal cases
of cholera occurred at Derry Mill, Whitchurch ; one at Pentyrch and one at Glwaclodygarth ; the
first on 11th September and the last on 20th September.
581a ; 2. Cardiff ; Cardiff. Population 46,954. Cholera 72 ; Diarrhoea 38. The first death
from cholera occurred as early as 1 7th February ; there was no other death until June ; two took
place in July ; then in August they became more freciuent, until the epidemic reached its height in
September* when 37 deaths were recorded. In October the disease declined, the last death being
that of a hatter's infant daughter, on 20th October. 37 of the deaths were recorded at St Mary*
and 10 at St. John, including five in the workhouse.
^Sibi 1. Vo^TYymi>D; Pontypridd. Population 17,445. Cholera 10 ; Diarrhoea 11. Cholera
was first fatal to a fitter, aged 50, at Walnut-tree-bridge, Eglwysilan, on 2l8t August ; seven deaths
were recorded in September and two in November, the last case being that of the daughter of a coal
miner, aged seven years, who died at Mountain Ash, on 21st November, after an illness of 10 hours*
duration.
5816; 2, Poxttpridd; lAantrhtaint, Population 9,907. Cholera 7; Diarrhoea 7. Five of
these deaths from cholera occurred at Llantrisaint. Miners and their families were the principal
sufferers. First death on Ist September and the last on 31st October.
5816; 3. Pontypridd; Ystradyfodwg. Population 3,035. Cholera 34 ; Diarrhoea 7. In thif
outbreak of cholera the disproportion of sexes to whom the disease proved fatal was very great, the
deaths being — males 31 ; females 3. Miners were the chief sufferers, and the epidemic appears to
have been most severe at Trcorki, where 17 deaths were recorded, 14 of them being coal minen.
It first made its appearance on 12th September, and reached its height towards the end of October,
finally disappearing in November ; no less than seven deaths occurred in one day, vii., 26th October.
It was also very fatal at Treherbert, where nine deaths occurred. Mr. W. Evans, M.R.C.S., states
that the supply of water is got from surface wells, and is liable to surface pollution. The last filial
case was that of a coal miner, aged 28, on 10th November, at Treorki.
582 J I. MKnTHYR Tydkil ; GclUgacr. Population 5,778. Cholera 5 ; Diarrbcea 4. The fint
death from cholera was that of a coacher in a plate mill, aged 22, at Pontlottyn, on 28th October |
this was followed by three deaths in King-street, Pontlottyn, of two lubonrers and the widow of ^
Notes on Cholera in Districts. 243
Sgricaltaral labonrcr, on the Ist, 14th, and 15th of XoTcmhcr respi'Ctively ; the last death took
place on 23d December, when the son of a coul luiuer died at Tuntywaun.
582; 2. Mkutiiyr TvnriL ; Lttwer. ropiilation 25,3iK). Cholera 61 ; Diarrhoea 14. The first
fatal case of cholera occurred to the wife of an iron puddKT, n«^ 30, at AhtTcannaid, on 24th Au^at ;
After tbib date deaths took place regularly, at the rate of out* or two a day, up to the middle of
October, wlien they suddenly ceascl, tlierc Ikmuj^ no other deaths until November, when a coa!
muicrr, aged 5 ly died on the 1st; and lastly tiie infant son of an enj^ine cleaner, on the 27th, in
Chapel-street. The greatest number of deaths that occurred in one locality was 10, at Caedraw.
In 1640 the deatlis from chclera vtere 4G2.
582; 3. Mertiitk TrnnL; Upper. Topubtion 27,47H. Cholera 72; I)iarrh(ra 4. Cholera
teoke out on 25th August, causing four deaths, two at Merthyr and two at Dowlais; but it was
not an til ^^cptemtwr tliat the epidemic reached its climax, there being 52 deaths recorded during
thpt month, the greater portion between the 1st and loth, it was fatal in 3G instances at Merthyr,
and I s* at Dowlais. Several deaths occurred in Quarry -row, Merthyr, at Sunny-bank, and in the
Boose of Refuge, ISrecon-road. Coal miners, labourers, and their families were the principal
soffer^r^. The last death was that of a metal weigher*s infant daughter, at Dowlais, on
lltb Noveiuber. In 1849 the deathb from cholera were 1,U05.
Air. Dyke, the Metlical (Officer of llealtli for Merthyr Tydfil, in his report to the I..ocal Board on
the Kinitary condition of the parish in 1800, states that in many towns (Llaneliy, Swansea, JSriton
Ferr>', AbC'rdare, and Cardill) with which the iuhabitants of Merthyr are in constant communication
epidemic cholera prevailed previously to the22d of August, ^% hen the first sickening under the disease
Eeciua to lijve taken place. With reganl to the first cases, Mr. Dyke says: *' It has been distiuctly
** proved to my thorough ccmvietiun, that no contact with anything infected, nor m ith any person
" aiTected, nor any conmmnication witli each other, could have taken place ;'* but in the fourth
ca«e, that nf an aged Iri^hwoman em])loyi-d at a nig store in picking and cleaning rags, ** it is
■* Tery po**ible that she may have come in contact witli clothiug brought fnim Al)crdare where
•* cholera then prevailed."' Mr. Dyke further confidently states, that no pollution of the water
aopply of ilerthyr with sewage occurred : ** The water used for all domestic purposes by all the
«* xubabitarits of the town ♦ * ♦ * is derived directly fnuu the lesser Taflf river, five miles
*' nonfa uf the town, discharged fnmi the main supply pii)e into two uncovered receivers at
** Peaybryn, thence it passe<l into uncovered filtering basins, and then into the covered reservoirs
*• iroiu which Merthyr aud Dowlais are supplied. It is true the portion of these open receivers
*' niid fiitt-ring beils on the slo])ing hill >lde ul>ove IVnydarren renders them liable to receive from
•' the winds that blow over them whatever of the seeds of disease may be conveyed through the
^' air; yet it is scarcely possible to imagine sucli shojild have been tlie ease in this ei)idemic, when
•• we rvnieiiiber the 8parbi>ness of the first cases, spread over a widely extended surface of hill
*• and daW."
Mr. Dyke subsequently states that ** in August a number of persons used water from wells which^
*• bvfing sipjated near old and deep cesspools, were contaminated by sewage. As to-the pernicious
*• iuAueuce of such a water Mr. Allday states that he was in attendance upon a tradesman who was
*^ offeoted wuh and died of cholera ; his wife aud son Mere also ill of the disease, but recovered.
^ This family used the water of a Mell whieli, upon impury at the time, Mr. Allday ascertained
** In-canie most offensive when kept for 24 lumrs.*'
The tem)>eraturc, both night and day, was higher tlian usual in the first three weeks of August,
acd the atmosphere was loaded with moisture. The c<melu ^ion an'ivi".l at by ^Ir. Dyke is, that the
(rernis of infection were communicated through the air: '* Arrived in the atmosphere of tlie town,
"■ the«e germs or seeds would find places where all the necewary elements abounded in which they
*• c<^uid propagate tliemselvcs in infinite multitudes, for everywhere hmnan excrements were to be
** seen or Kmelc.
•* lath % ; it sought
** aod the weak, an
•" and SdslIIx ceased in the elevcuih week from iis cjmmeiieemeul."
The epidemic was fatal in G'J dili'erent loeali'.ies, extendin;,' over au area of not less than eight
tquart mi'<..s, and between the 24th August and 9ih Novemlier 2178 per&ous had been attacked
ouc of a population of 53,48(i, aud 136 deaths had occurred. In 163 hou&es occupied by 824
people 34 deaths from cholera took place.
58254. MEUTnYRTviiFii.; .lArn/.m-. Topulation 34,4;VJ. Cholera 92 ; Diarrhoea 22. Cholera
vai fital to the son of a coal weigher, aged five years, atCwmbach, on 1st August. The deaths
*cre not very numerous until .September, when the disease spread rapidly, and was very fatal durin|p
lilt whole of the month, 60 deaths being rceoi-ded, principally among>t the miuing population. It
-wa* not until October that the epidemic began to decline, and the end of November was reached
before it was quite extinct, the last fatal ease being that of a labourer's daughter, aged four years.
It liinrain, on 30ih November. Dr. Davies, the Medical i >fticer of Health for Abcnlare, states that
fte water supplt was good from the AlK-nlare WatirwoiKs, but that the drainage was mdifferent.
In 1849 the deaths from cholera in the district of Meiihyr Tydfil were 1,C82; in IS54, 445; sad
in 1566, 230.
583 ; I. BRincE^tn; Maestcff. Population 8,562. Cholera 29 ; Diarrhcca 10. The first death
— cholera occorted to the wife of a collier, agetl 49, in Cross-street, on 25th Auguat ; thera
no other death until eth September, when three occurred, two in bhoemakcrVrow and one ia
a:ate tliemselvcs m inlmite mnltituaes, tor everywuere nmnan excremenis were 10 oc
it. The town infected by the epidemic infiuenee, cholera (piiokiy followed its usual
light out especially the til thy houses, all'ected prineipally the intemperate, the dirty,
k, and increasing the number of its victims uj) to the fourth week, gradually declined.
244 Notes on Cholera in Districts.
Jenkiii8*-Tow ; afler that date deaths took place at intrrvals of two or three days, ontil the middle
of November, when they ceased for a time, one more fatal case occurring on 5th December, to the
daughter of an iron puddler, at Duffryn-row, Maestcg. The greatest number of deaths in one street
was eight, in Bethania-street.
583; 3. Briiksewd; Cowhridge. Population 6,486. Cholera 2; Diarrhoea 0. On 15th Sep-
tember a female, aged 59, at Monknash, and an agricultural labourer, at Lantwit Major, on 2l8t
September.
583; 3. Bridgend; Bridgend. Population 11,417. Cholera 49; Diarrhoea 1. Cholera was
fatal to the wife of a tailor, aged 50, on 1 3th May, in Queen-street ; one other death occurred in
May, one in July, four in August, and 33 in September. The epidemic was most prevalent at New-
castle; six deaths occurred in the workhouse. The last death was that of a labourer's wife,
aged 30, at Aberkenfig, on 15lh November. The deaths from cholera in 1849 were 50.
584; I. Neath; Margam, Population 16,815. Cholera 123 ; Diarrhoea 21. The first death
from cholera occurred on 10th August, at Constant Margam ; it was not, however, until the begin-
ning of September that the disease became prevalent, causing 83 deaths during that month, the
greatest number occurring in one day being eight on the 9th, and the same number on the 18tb,
16 deaths were registered in October and six in November, the last being that of a coal miner,
aged 38, on the 22d, at Lower Michaelstone. A third of the deaths took place amongst coal miners,
their wives and families ; copper smelters also suffered considerably. The following are the prin-
cipal localities where the epidemic prevailed : Lower Michaelstone, 55 ; Aberavon, 38 ; and
Margam 25 deaths. In 1849 the deatlis from cholera were 241.
584; 2. Neath; NeaUi, Population 13,462. Cholera 94; Diarrhoea 16. One death from,
cholera occurred on 1 6th July at Briton Ferry ; the next case occurred on 5th August ; and the
epidemic reached its height in September. In October the deaths rapidly declined, the last case
being that of a mariner's widow, aged 26, at Briton Ferry, on 1st November. In llie parish of
Kea£b 47 deaths were recorded, and 49 in Briton Ferry, the remainder taking place at Ijantwit and
Higher Baglan.
S84 ; 3. Neath ; YstradoeUiey. Population 3,303. Cholera 49 ; Diarrhoea 8. The first death
ttom cholera occurred on 7th September to the wife of a labourer at Blaengwrach. Deaths took
place at intervals of two or three days during September, and then became of daily occurrence
up to 24th October, when they ceased for a time, there being no other death from cholera recorded
until the 31st ; between that date and 9th November it was ^tal to nine persons. Coal miners and
their families were the principal sufferers, and the epidemic raged most severely in the hamlet of
Upper Neath, where 36 of the deaths occurred. In 1849 the deaths from cholera were 38.
584; 4. Neato; Ystradgnnlaiii. Population 12,328. Cholera 163; Diarrhoea 15. Cholera
was first fatal on 3d August, to a tin Masher, aged 19, at Ystalyfera. The next death occurred on
9th August. The epidemic reached its height at the beginning of September, and continued very
fiital during the whole of that month. In October the mortality slowly declined ; but it was not
until November that the disease was finally extinguished, the last case being that of a haulier's wife,
aged 42, at Ystrad Village, Ystradgunlais, on 28th November. The following are some of the
localities that suffered severely: Graig-Aru, Cwmtwrch, Pant-teg, Wem, and Ystrad Village. The
deaths from cholera in 1849 were 107.
The following description of the local characteristics of Ystalyfera, where cholera was exceedingly*
fatal, is condensed from a sketch of the outbreak in this village, prepared by Mr. James Rogers,
M.R.C.S., of Swansea : —
The epidemic began eariy in August, and reached its climax on the 27th and 28th of that
month, 40 new cases occurring on each of those days. It seems to have subsided by the end
of September. Prior to the outbreak there had been a good deal of simple, painless diarrhoea
prevailing amongst the people engaged at the Ystalyfera works, but this soon gave place to the
more serious disorder.
The water supply was scanty in quantity, and very uncertain in quality, being " little better
than surface .water percolating through shale tips, and the drainage of coal and mine seama
and colliery workings ; so scarce was the water in the works thnt it was a common practice
with the men to drink largely of the canal water. This water received the surface drainage
0/ nearly all the houses in the village.''^ Drainage of a proper kind there was none; the village
occupying an abrupt hill-side, the cesspool contents of the higher parts percolated to the lower
levels, and the pavement of the back premises where the first case of cholera occurred during the
epidemic was 'squashy' from this cause. Cuhvrt'?, badly constructed, carried along close to the
back doors of the houses the excreta from the open privies; filthy ash heaps and 'stonds*
of putrid pig-wash were in dangerous proximity to doors and windows. Houses built with two
stories below the level of the r.)ad, and others close under the canal bank, but far below the
water level ; slaughter-houses, pigsties, cesspools, and we'.ls within a few feet of each other ; opea
gutters and trenches reeking with fuetid miasms ; an overcrowded graveyard, whose retaining walls
consist in some parts of the back walls of cottages ; the soil, rank with the decaying elements
of mortality, rising se^en or eight feet above the cottage floors— all these elements enter into the
local sanitary condition. The disease raged in nearly all the houses built close to and below the
canal bank (in some cases the water level was higher than the roof), and in underground tenements
generally ; in the locality of the noisome graveyard the virulence of the disease was rexoarkable*
Notes on Cholera in Districts. 245
•*'^hj'. in tbe name of common si-iisc/* says >rr. Honors, *• this pravc-yanl is not shut up I cannot
'* imagine." Of the O.'S fatal eases of ch<»leni, Mr. I{i);;iTs as-^eiis that all died of local circumstances
—the effect of avarice or ignorance, or iiejfli'ct of sanitary prt'caution : " in short, given a caw of
cholera in a foul dwellinjj;— JraM ; in a healthy dwellinfr — rt'Cunn/.'*
lu answer to inquiries Mr. JJogers has been p^ood. enough to communicate the following
infbrujatioo :
town. I believe the qiuUity is g<KKl ami tin* supply abundant, if it is made projierly available by
distribution.
•• As regards the outlying districts I think I may vi-uture to say tliat there is no system of
<irainage whatever. Wherever largr works arLTstaMi^lieil larg*' villages spring nj» totlie proportion
of tnwns in extent and number <ifpo]Mihit ion, and 4'xccj)tiiig Cvrnaron (in the parish of Michaelstone
I-owc-r, the works-owners make but us little pro\isi<,n as po'^siblc f<»r dwellings, and, as I think, very
!itfic or none ft»r the health and social eomlort of the peojile they mass together. The consequence
C'f This is iliat workmen inve*=t their >:»virigs iu l'.ou><* property; by this means and by the aid of
building societies a large mnnber of liouses are built ; and in consequence of there being no
authorized sup>ervi«ilon in their construction the most outrageous mistakes are made, leading to an
i&c^cukible amount of mischief, esj>eeially in localities wliere d(miestic and fiersonal cleanlineHS is
tbe trsccpiion and not the rule. The effect of this in tho works district with wliich I was connected
for 1 ^-ears (Ystalyfera) was very marked. Whatever th« nature of the epidemic it persistently
stuck to the place; scarlatina, mea>leN, whooping-cough, small-pox, each in their turn were governed
by tliat cause ; the last epidemic of small-pox, about three years since, lasted over 14 months,
psekixi^ out its victims amongst the unvaccinated, until I firmly bi'lieve all who were nf»t so protected
kid it. So Mrious are the consequences of neglect in the construction and regulation of the
vorkmea's dwellings that I feel quite sure it would K* attended with good as well as economical
revolts if the legislature would take action in tlie matter, retro8i>ective as well as prospective, and
compel owners of property to respect sanitary laws.
'• The water supply in these outlying <listncts in the neiglib<»;irhood of large works, and especially
of col\iierie«i and mines. Is very scanty ; the deep springs are drained by the colliery operations, and
the people have commonly to help tliemselves from surface \«ells ; in smnmer and in dry weather this
dwindles to a mere nothing, and I have seen crowds of women and children waiting for hours for
thar 'stem.' Since the cholera epidemic of 18C0 this ban to a great extent been remedied at
Ystaiyfera br the damming back of the drain of a disused colliery level, and the water conveyed
in pipes the length of the upjier half of the village with convenient delivery pipes attached.
■* Tbe population of the parish of Llanguiek, in one of the hamlets of which (Allt-y-grpg)
Tfttalyfera is situated, was estimatiHl in lHt)5 at S,(iOO ; the population of the village and immediate
neigbbourbood of Ystaiyfera is alwut 5,0U0."
584 ; 5. Xeath ; CmioTtvn, Population 7,52'J. Cholera r)4 ; T>iarrha?a 0. Cholera was fatal
to the wife of a coal miner, aged 21, on 1st August, at ISkewen, Cwdfrank, where the epidemic was
very fatal daring the whole of the mcmth among the families of coal miners and copper smelters.
In September the disease declined at Skewen, <nily six deaths occurring, against 25 in August, the
last fatal case being that of a tinplate worker's* scm, a^red 12, at Aberdulais, on IWh ifovember,
Neath Abbey also suflfered, principally iu •Sei)tem)ter.
584; 6. Neath ; Lltmitmht . l»oj.ulation .",10.3. Cholera 37; Diarrhopa 2. First death from
eholera on 0th August, at I'entre Cawr. The epidemic v. as chieHy prevalent in September,
Higber Lbnsamlet suflcring the Mt»rst. Xearly the whole of the nutrtality was among the
mSnin^r population, llie last death (K'curred on nUt ( )etober.
iSs^i I' Swansea; Uandihtahihont. Topnlaliim 5,114. Cholera 4.5 ; J)iarrluea *>. The first
2itai case of cholera was at Mynyddliach. on 2;Jd Jul_\. The next death occurred on 12lh August,
and between that date and the end of the month lour'persi»ns died. The epidemic prevailed clucily
in .September, and was most fatal at Clulach. 'i'he last death was that of a miller's daughter, at
LHw Mill, on 9th November.
5*5^; 2. SwA»E.i; Llauyafi'Uivh. Topulation 14,55:». Cholera lol ; Diarrluea 1. Cholera
ri« fatal on 27tli May to a sinker at Morrist on. Jn June there were 11 deaths; in July 8, in
Ausust 17, in September 84, iu Octoln-r 2i*, and in NovemlK-r 2 ; the last case being that of a
tanlier, aged 47, at Raven Hill, on 1 1th N<i\ ember. The epidemic was nmch more fatal to females
tlian makrs, and it prevailed princip.illy at Morriston. The miniu^' and metal-\*orking popuUtion
Tenr the most numerous sufferei's, several families l<»sing more than one meuilKT.
58Sff ; 3. SwA>-8EA; Swavsut. Population ni..i9.^. Cholera .M2r. ; Diarrhcea 1!>. Cholera
ftevailed principally in the months of Augu.-t and September, the death'J being 109 and 154
re?.p€ct5vely ; the greatest number occurring lu one day was 12, on 21st September, and on several
tors during August and September the cleaths reached 'J and 10 in numl>er. Cholera was
fcfit fotal to the wife of a haulier, aged 27, in Fleet street, on 14th ^lay : the next case was on
Sih Joly ; there were no other deaths from cholera utitil liMh July, arter which date they occurred
dafly throughout that month, increasing in number diu-ing August, the disetise attaining its height
Notet on Cholera in Districts^ 247
Drainage, — ** In 1857 the main drainage of the town was commenced, and np to July 18C6 thirteen
mileft of sewers had been constructed, principally in the town proper (town and franchise, and hamlet
of St. Thomas). The drainage of the new part of the town is pretty complete, but the drainage
of the upper part of the town (the Irish quarter before referred to) has only just been completed
(1667). The rapid growth of the town, which has increased for the last 17 years at the rate of
150 bouses annually, has been in advance of the action of the Board ; but, considering that all that
ha5 been done has been done since 1857, the drainage has been very satisfactory, and as rapid as
the machinery of municipal institutions would pennit.
** Water supply.—'The water supply of Swansea, before the completion of the last reservoir, was
oltuiied from, —
*' (a) Br^nmill rebervoir, the first which supplied water to Swansea, and which latterly only
applied a portion of the town just above the sea level. Its water was derived : 1. From a spring
jisisif; within half a mile of the reservoir, and conveyed into it l)y a covered watercourse, and giving
ziai\\ supply, in dry weather, of 32,000 gallons, and in winter of 104,000 gallons. 2. From three
ucorered streams running through cultivated (principally meadow) land, with houses thinly
eeatxtTed at a few points in the neighbourho(Kl of their course, free from sewage contamination as
br as known, but of course, like all oi)en streams, liable to wilful or accidental fouling. The
great objection to this supply was that af^er rain surface water from gardens and roads which the
ftreams flowed under was liable to get into the streams. Daily supply in dry weather, 109,000
galkms,. and as this supply was more than sufficient for the population of the district, the surveyor
of the Board, long before cholera was expected, had diverted stream No. 1. from the reservoir, and
bad taken it direct into the servicc-pipi' after leaving the reservoir.
In this may the mass of water in the reservoir was ouly used vcn/ (tccasionalfy to supplement the
supply from the spring if it fell short, and this reserve was never turned into the town in July 186G.
** (if) Cwmdonkin reser\'oir. The siqiply is derived from : 1. An uncovered stream which rises
in a market-garden about a quarter of a mile from the reservoir ; in dr^- weather affording a supply
of aboot 12,000 gallons daily, and in winter reaching 170,000 gallons. This supply pusses through
the garden of one other inliabited house. 2. A covered stream, rising in an abandoned coal level,
vhjch had been disused in consequence of the difficulty of getting rid of the water, and which was
free from the possibility of contamination, and is still used. Average daily supply in dry weuther,
4^,000 gallons.
'^ (c) The Velindre or new reservoir, commenced in 1862, and from which water was first brought
iDtXi i^whmek in 1863. It is formed by an embankment across the valley through which the river
nuppljing it runs. This river is fed by springs rising in a gathering ground of mountain about
],9uO acres in extent, and at a level of from 450 to 800 feet above the sea. The soil of the
gvhering ground is almost entirely uncultivated, affording pasturage to mountain sheep and a few
cattle. There are four or five sniuU holdings on the mountain tenanted by cotter farmers, who
besid€r« V.«eep\ng theep grow perhaps enough eom to supply their own households. This reservoir
for storage is about seven miles to the north of Swansea, the top water 408 feet aboTC mean-tide
le^el. Tne service resenoir is on the hill above Morri^ton (in the sub-district of Llangafelach),
^91 feet above tide level. Afler supplying that part of Alorriston lying within the borough boundar}',
k tnters the town of Swansea at its highest point, the north-eastern end, and supplying in its
couse this part of the town, pusses through it and empties itself into the Cwmdonkin {b) reservoir
at the western extremity of Swansea.
" It may be thought that as there was more than one water supply there might have been
a difference in purity ; the streams supplying the old reservoirs were for a great part of their course
iscovered and in the neighbourhood of inhabited hous<.'s, and as there was just a possibility
fiff sewage contamination, and as it was very important that the water supply of the town should
he above suspicion, the Hoard, at my suggestion, cut off entirely, on 28th July 1866, the water
nppl^ from the old sources, and thenci'fonranl it was wholly drawn fi'om the new reser\'oir,
vbich was absolutely free fVom the risk of sewage contamination.
•* 72}tf heavy mortality from cholera here in 1S66 — the total deaths from that disease within the
Vofoog-fa being 363 (172 of males and 191 of females) — was a grievous disappointment to myself and
to dM>t« who hoped that afler the improvement that had taken place in drainage and water supply
W ahoald bare fared better than in 1849.
" Undoabtedly our weak point was incomplete drainage ; but this reproach, as far as the town
V eciDoemedy is being rapidly removed.**
5S5& ; I. GrOWEB ; Eastern, Topulation 4,962. Cholera 26 ; Diarrhcpa 5. Cholera was fatal
tea bboarer on 19th ^lay ; the last case was that of a mariner's wife, aged 28, on 1 1th November.
Ifvis OM)6t iatal at Fenclawdd and Oystermouth, chiefly in the faiuilies of ]alK)urer3 and colliers.
585*; 2- Gowbr; Western, Fopulation 3,354. Cholera 3; Diarrhcra 2. The three deaths
fitMn cholera occurred at Buny's (ireen, Llangennith, and were those of a farmer on 12ih Sep-
*mber, his widow on the 15th, and a shipwright on the 16th.
Carmaiitiie:?5uire.
c86: 1. LtANELLT; Louyhor, Population 3,970. Cholera 21 ; Diarrhcea 3. Cholera was fhtal
k'g ntW^ and 15 females; the first case was that of a coal-miner, aged 21, at Llwynhendy, on
- Mtk Jnly 8 tbe last was that of a labourer's wife, aged 63, on 2d October at Fenygraig, Llanelly^
248 Notes on Cholera in Districts.
The epidemic was most fotal at Llwynhendy and Loogbor BorongH, and it prevailed chiefly in
July and September, there being but two deaths recorded in August.
586; 2. Llanelly; Llanelly, Population 14,619. Cholera 167; Diarrhoea 24. The first
death from cholera occurred on 8th July in Ann-street, Llanelly ; the last on 30th October at
Llwyncaefarthwch. The disease was chiefly prevalent in July (84 deaths) and August (65 deaths),
the deaths visibly declining in September ; the last three cases occurred respectively on 9th, 20thy
and 30th October ; 1 were recorded in the workhouse, 20 at Felinfoel, 11 at Wem, 10 at New
Dock, and 9 at Custom Ilouse Bank ; coal -miners, labourers, and their families were the principal
BuflTerers.
586; 3. Llanelly; Pembrey, Population 5,797. Cholera 32 ; Diarrhoea 22. On 15th July
a case of cholera proved fatal in 32 hours, at Penllech, Pembrey, to a coal -miner, aged 54 years;
the next death occurred on 18th July, and by the end of August seven more had occurred, chiefly
of miners, labourers, and their families. Diarrhoea was very fatal in September, 1 1 deaths occurring
from that disease, while only four cases of cholera were registered. In October the epidemic again
prevailed, and was fatal to 1 1 persons, in some instances to more than one member of the same
£imily ; the last death was that of a farmer, aged 46, on 18th November. In 1849 the deaths
from cholera were 16, diarrhoea one.
586 ; 4. Llakelly ; Lktnnon, Population 3,593. Cholera 8 ; Diarrhoea 0. The first death
from cholera occurred on 15th July at Llancch, the last on 7th December at Tynewydd; four were
recorded in September and one in each of the months of July, October, November, and December.
In every instance the deaths were uncertified by a medical practitioner.
Dr. Thomas, the Medical OflBcer of the Llanelly district, has obligmgly supplied the following
particulars :
^< The water supply in liOughor borough at the time of the cholera epidemic was from two wells,
one within a few yards of several privies, which must have in some measure drained into it, the
Other in close proximity to a burial ground.
" At Llwynhendy the water supply was also from two wells and a colliery pomp, in neither of
which could I find any source of impurity.
** At Pelin Foel the people obtained their water from the river in part, and partly from a well
and a small running stream. The two former were suspected of being contaminated.
" The Wem, New Dock, and the Custom Ilouse Bank were supplied from the town reservoir^
which is very insuflicient for the supply of the town, and open to pollution from four cottages with
22 inhabitants without a privy to either, but having a pigsty each, overhanging the little stream
that supplies the reservoir, as well as from a farmyard.
" In Pembrey parish the disease was very much scattered, Pembrey proper escapinff. The
water supply was chiefly from small wells, some of them open to grave suspicion of being
contaminated.
" At Morlais, where the complaint prevailed most severely in this district, the water was got
fr^m a small running stream largely polluted.
** In Llannon pansh the disease was also very much scattered, the village escaping. The water
supply here also was obtained from small wells, most of which would appear to be removed from
any source of impurity, except at Pontyberem where the water was had from the river and from
the canal, both of which sources were bad.
" There was a general scarcity of water through the district during the greater portion of the
time that cholera prevailed.
** The only special causes present in all the localities were decomposing animal and vegetable
matters, the evacuations of man and animals, polluting the air and the water too. To the neglect of
a systematic and thorough removal of these manures into the earth, particularly the excrements at
man, I am disposed to attribute the heavy epidemic of cholera that visited this pkice, and to the
same causes the common presence of typhoid fever over the whole district
" The river water was suspected as a cause in the attacks at Felin Foel, as well as at Pcnygar, a.
small place containing about 50 inhabitants, who also up to this time had used the river water ;
and to prevent the people using it several cart loads of lime were thrown into it above the village f
whether from this circumstance or not I cannot say, but the attacks sensibly decreased in number
and severity immediatelythereon."
589; f. Caiimaktiien ; Llangmdcirnc. Population 9,034. Cholera 27 ; DiarrhoBa 3. Cholera
was fatal to a labourer on the 26th August at Croesyceilog. The epidemic i)revailed throughout
Septemlier and October, and ceased on 1 4th November. Labourers and their fiimilies were the
principal suiferers, and the greatest number of deaths occurred in the parish of St. Ishmaels.
589 ; 2. Carmauthex ; St. C/eartt. Population 6,862. Cholera 30 ; Diarrhoea 2. Between
25th Aujrust and the end of the month cholera was fatal to 13 persons, or more than a third of the
whole mortality from that disease. It was principally fatal among labourers, fiirmere, and their
families. In September the deaths recorded were 15, in October one, and the last on 9th November.
The water supply is derived from open wells and rivulets. In 1849 the deaths from cholera
were 13.
580 ; 3. Carmautiien- ; Carmarthen. Population 12,583. Cholera 80; Diarrbcea 6. Cholem
-•as fetal on 28th Alareh to the wife of a mason, aged 29, at Blaenwain, Abergwilly ; no other
Notes on Cholera in Districts. 249
\gvAk occurred antO 17th Augv^t^when tliree piTi^nns died in Damc-fttrcet. The epidemic continued
rcrr Htal antil the end of November, and the last death was tliat of a labourer's son, in Grove-street,
on'^th December. It was most fatal anion;: IVniales, and in the following localities : Dame-street,
Laiujiias-}»treec and Village, Abergwilly. The deaths from cholera in 1849 Mere 102.
S&9 ; 4. C^vicMABTiiGX : Canwil. Population 8,1 OG. Cholera 6 ; Diarrhtea 0. With one excep-
tion, the deaths from cholera were those of persons above GO years of age. The first case was that
Af a female aged 74, on 24th Augu&t ; the lust was that of a t>hoemaker*s wife, aged 64, on
'.9th September.
rK.MUUOKKAIIIRK.
5^0} 5. Xakbkrtii ; Slebtrh. Population 3,171. Cliolera 2 ; Diarrha»a 0. Both the deaths
fttci cholera <iccurred at Old Mill. Narborth; a female, aged 47, died on 13th September, and a
labourer, aged CO, on the foUowing day.
yp; 6. 'Saumirtii ; Bi'iffUi/. Population 4,313 ; Cholera 14. Diarrhoea 2. Kxce])ting one
JMEli on 29th August, the whole of the eases occurred in ix'pteuiber, the last on the 2Gth. Cool-
vatn and their families were the princi|)al sutVerers.
sqi ; E. Pembrokk ; Tcnhtj. Population 0,219. Choh-ra .5; Diarrluea 3. First death from
chbfen occurred on 13th September, at Carew, to a liglitennan, aged 47, and the last on .5th October,
to the inftnt fik^n of a farm labourer, at Ilolyland Gate.
591 ; i. Pembroke ; Pcmhroke. Pt)pidation IC-'JriO. Cholera 33 ; Diarrha'a 13. Cholera was
tri fatal In thi« sub-district on 26th August, Mhen a messenger's wife, aged 43, died at Xew Pennar.
h was ven^ prevalent in September, ewpeeially at New Pennar, St. Mary, where the greater part of
Ihe dnu&s took place. The last case was that of a labourer's son, aged 14, at Pennar, on 7th October^
591 ; 3. pEMBROKB ; JiooMe. Population 3,225. Cholera 4 ; Uiarrhcca 4. Thn.*c of the deaths
ftvin cholera were those of a fisliennan, his wife, and son, who died at Langum FeiTy, Burton, the
IDB on the Sltft of September, the wife on the following day, and the father on the 24th ; not one of
ditae dcaih.< was certified by a medical practitioner. The last case was that of a railway porter,,
ijgtd \% at Neyland, Uanstadwcll, on 10th October.
^2', 1. Haverfordwest; MUfiu-d. Population 9,771. Cholera 15; Diarrh<ea 5. These
deiidw from cholera all occurred in September, the first on the 2d and the last on the 26th; it pre-
vaiM cZiiffly in the parishes of llubberston and Walwinscastle.
192 : 2. Haterfordwej*t ; I/avvrfon/wcst. Population 12,330. Cholera 24 ; Diarrha>a 8.
19 oif the deaths from cholera took place in September; it prevailed among the poorer class, and
vat part^GulaTly fatal among females, 20 of the deaths being recordeil an female.**, and only four of
naJeSw The lati fital case was that of a shoemaker's widow, aged 70, in Quay-street, on
»th October.
CARDiaAXeilIRE*
! 597; 3- ABERTS-nviTii ; Ahen/stwUh. Population 8,772. Cholera 12; Diarrhoea 1. Cholera
wtt&t&I on S8th October, to the wife of a luariner. age<l 30. In Mill-htreet-<.*ourt then^ was one
dMh in October, three in Novemlier, and seven in December. In Fountnin-courr there were
axdtttfas <>DC man, a labourer, losing his M-ife and two children, but he appears to have escaj^ed
^Mftctf. In High-street three deaths occurnil. Duriug the c])ideuiic of 1 8411 not a single fatal case
«f eholcxa occurred in Aberystwith.
Bunc-KNocKSiiiui:.
601; J. Okickiiowell ; JJamjunidcr. Population ;^504. Cholera 12; Diarrh<ra 1. ^Vith
94 exceptions, the deaths from cholera took [ilaec at Tafaunnmbach among coal and iron miners
wiiboT families. The first death occurred on 21>«t October, aud the lust on li^tli DeccnibiT. In
}M> the deaths fhym cholera were nine.
foi; 5- CatCKROWELr. ; IJanffattor/i. Popuhition .'i.T.'i'J. Cholera 2; Diarrhoea 9. On 7th
Sepcoaber cholera was fatal to the wife of a eoul miner, nged GG, at lleaufort llill, and on 15th
to the daughter of a coal miner at \Villi:inis-row, P>cauf(>rt. Of the niue deaths from
eight were of children under two years of :igr.
<oi ; 4. Cbickiiowell s Uancliy. Populrti»»n 0,GC)3. Cholera 3 ; Diarrhefa 8. Cholera was
heat to the son and daughter of a quarrii-r at Llanelly Connnou on 20th August, and to a coal
nineroa Bih September at Br}'nmawr.
44. Nnurii Walks.
i'LlNTSlIlKi:.
610; a. HoLTWELL; //o/yire//. Population 12. mo. Cholera 38 ; Diarrhoea 2. There was no
cholen until 3d October, when a eoul e;irter, ago<l 38, died at Penybal. There were
deaths in October, leren in November, and five in December, the last case being thai of a coal
Nates on Cholera in Districts. 251
Cio ; 4. Casvaxtoh \ Lbnidan, Population 3,313. Cholera 2 ; Diarrhoea 0. Both these
4aAm from eholerm oeenred at Brymhenkin, the first being that of a hibourer's wife, aged 36, od
SM I>eeember» and the other that of a labonrer^s widow, ag^ 75, on Christmas Day.
631; 2. Baii<k>x; Sanger, Fopnladon 14,043. Cholera 3; Diarrhoea 5. Two of the deatha
fwa eholerm o cc ur red in one fiunily at Kyffin-sqoare, where the wife of a joiner died on 22d Aognst^
and Us danghter on 2d September; the last case was that of a stonemason's wife, aged 67, on
71k December.
<ji ; 3. Bakgox; LlanUt^id, Population 9,127. Cholera 10; Diarrhoea 5. Tlie first fktal
CMS of dudeia occnrred on 1 5th September at Bethesda. There was no other death until 5th October^
vhm the ion of a shoemaker, aged 13, died at Alma- terrace, Llanfairfechan ; and on the 8th,
modicr aon, an infimt, died of choleraic diarrhoea. On 6th October the wife of a stonemason died
Jk tte same terrace, and on the 16th a daughter, after illnesses of 14 hours and 10 hours respectiyely,
BskxBg ftmr deaths in Alma-terrace in less than a fortnight The last two cases occurred on 21st
Dnmber at £liisenden, the widow (aged 21) and the daughter (aged one) of a schoolmaster haying
Ml &d from Aiiaric cholera on the same day.
A50LE8ET.
Ijj ; 6L ANOLE8ZT ; Holyhead. Population 9,235. Cholera 26 ; Diarrhoea 1. 22 of the
\ from cholera occurred in October, and four in Noyembcr, the first being that of a stoker on
a steam Tessd, who died at Swift-square on 8th October, and the three last on 6th November,
req>eetiTely those of a labourer and two children, not members of the same fiunily. The
■sjoiity of the deaths were registered as Asiatic cholera, and in those cases where the duration is
~ Bed death appears to have followed a few hours after first attack. In 1849 the deaths from
were 42, exteodmg from July until the end of October.
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Mettorolagy.
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. sjiK^s^K s9S^g?2 5s = 5i^~s sgasera ;
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ill
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SXSSJSfS SSSISSSS SEgSSS£& S
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iSS aisijS^SS 3S!S2335
iifi»i!
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siisi: &sssi:^s ssssahs gssssts :
PI
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m
'SS3^2S SSSE^EgS isi;3is$£S 8S3SS39 3
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lt|
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;slll!^ eilil^g Si^SSsi ISSSSSI p
'asaags sssaaisa aissaass aiiaiaas a
Quality of London Water Supply in 1866. 257
VIII.— PROFESSOR FRANKLAND'S REPORT ON THE QUALITY
OF THE LONDON WATER SUPPLY IN 1866.
I Xeprinted /rem the Begutrar Gauratt Anntml Sitmmaiy of the Weehfy Rtlunu of 1866.]
%^,'\^^t,*\* ^/^^^^<yv#•« w.-^^ w •^ti ^ w, ^ w ■'■w-
Ro^al College of Chemistry^
Jhb, Febrtiary 20M, 1 867.
I have the honour to lay beforo you a summary of the results obtained in my
- anafyftes of the metropolitan waters during the year 1866. These results are con-
tamed in the accompanying five tables, marked respectively A., B., C, D., and E.
Table A. records the amount of solid impurity left on evaporation and desiccation
' at l2Xf — 130** C, (248^—266** F.) of 100,000 parU hy weight of water. Table B.
the loss which this solid matter sulfered on incineration. Tabic C. the amount of
oxygen required to oxidize the organic matter contained in 100,000 parts of the
water ; and Table D. the degrees of hardness, or parts of carbonate of lime (or its
eqaivalent of other hardening salts) contained in the same weight of water. Thus
in January 1866 we find, on referring to Table A., that 100,000 lbs. of the water
delivered to consumers by the Chelsea company contained 30* 12 lbs. of solid
impurity, of which, as shown by Table B., 1 • 44 lb. was driven off by incineration.
From Table C. we learn that '11841b. of oxygen wa^ required to oxidize the
orgamc matter in 100,000 lbs. of the said Chelsea water ; whilst from Table D. we
£nd that 21 '4 lbs. out of the 30* 12 lbs. of total solid impurity consisted of cai'bonate
of lime or other soap-destroying material, which communicates to all the water
delivered in London its excessive hardness.
Table E. exhibits a comparison between the years I860 and 1866 as regainls the
compoeition and properties of the waters supplied to the metropolis. From this
table it will be seen that, with two exceptions, the New River and South Essex,
all the waters were harder, and contained more solid impurity in 1866 than in
I860. Tlie water delivered by the New River Company was softer, and contained
leas solid impurity, whilst the South Essex Company's water contained less solid
imparity but was harder in 1866 tlian in 1865. With one exception the organic
and other volatile matter was in every case markedly less in 1866 than in 1865.
The exception is the water of the New River Company, which cxliibits a very
alight excess of this matter in 1866 as compared with the previous year. The
amount of oxygen required to oxidize the organic matter contained in the waters
was also less in 1866 than in I860, with two exceptions, viz., in the New RiVor
and South Essex Company's waters. It must bo remarked, however, that in tlua
reaped the Kent, South Essex, and New River Company's waters are greatly
laperior to those of all the other companies in both years.
I have, &c.
The Registrar General, E. Frankland.
he. &C. &c.
r a
258
Quality of London Water Supply in 1866.
Table A.
Solid Matter in 100,000 parts of the Watebs.
NA1CE8
OT COMPAinES.
1866. 1
Jan.
Feb.
April.
Hsj.
June.
July.
Aug.
Sept.
Oct.
Nor.
Dec
Meau.
Thames.
Chelsea-
West Middlesex •
Bouthwark -
Gnnd Junction •
Lambeth
80^12
32^02
29^90
80^70
27^10
31^14
30^40
80^90
31^40
31^16
28'55
28*50
29*20
29 '60
27'98
2S'64
27'e9
29-49
29*38
28*62
26*78
26*85
27*83
27^06
27^13
25^25
2^1^82
24^74
21*82
26^63
2S^40
24^72
25^25
25- 14
25^25
21*89
28*62
23*66
25*00
25*51
24-68
24^ 15
24^09
25*21
25*00
27*54
26*88
28*18
28*97
28*68
30-46
80*01
80*71
80*74
80*84
81*72
29^90
81^18
80^74
8018
27-tt
^•4«
27-M
28-«
t7-M
OTHEE SOUBCES.
Kent - - -
New River -
Bast London
Booth Easex-
87^70
29^92
35^15
40^69
37^92
29^50
32^78
40'60
39'80
29*85
33'60
40'40
39*02
27*28
30*45
89*66
80^98
25^39
35^09
39^63
39^28
21^55
26^22
38 ^52
40^4fi
20*58
24*38
40*94
88*88
20*20
26*14
88-04
38*60
26*87
26*26
88*46
89-28
26-60
80*20
88*94
89*69
29*09
81-18
88*U
87-99
17-92
84^84
81^82
89^0ft
84-86
80*48
88-77
Colonins •
1
2
3
4
5
6
7
8
9
10
11
12
IS
Table B.
Obganic and other Volatile Matteb in 100,000 parts of the Watebs.
Najces
OV COUPAVIES.
1866. 1
Jan.
Feb.
March.
ApriL
May.
June.
July.
Aug.
Sept.
Oct.
Nov.
Dec
Mean.
Thames.
Chelsea-
West Middlesex -
Southwark •
Gnmd Junction •
Lambeth
1*44
1-^0
1^85
1^65
1^94
1-26
1^80
2-24
1^09
2^59
200
2*40
1*60
1*65
1*80
1*68
1*68
1*36
1*25
1*40
1*40
1*55
1*33
1*40
1*92
1-20
2-10
1^02
128
1^50
1-77
1^96
0^88
1^79
2-26
1*40
0*74
0*86
1*55
0-8-1
0*90
1*08
0*53
0*63
1*98
0*85
0*97
0*93
0*91
1*01
1*60
0*91
1*26
1*66
1^67
1^58
1*55
1^26
1^71
1^68
0-58
1^94
1-96
1^29
1^16
0*98
1^09
1-53
1^80
0^89
1^44
1^80
©•66
0*88
0*63
0*56
0*91
0^64
0^78
0^65
1^21
0^70
0-72
180
0^79
r70
1^40
071
1^25
0*98
1^82
1^82
l^OS
1^46
1^80
1^6S
0-71
0*96
1*00
I'OS
1*24
1*10
0*87
1*19
1-11
0^88
1^63
1^48
i-n
1*86
1*16
1*48
1*«4
1^06
i^4i
1-66
Oteeb SOUBCES.
Kent . - (
NowBiver -
East London
South Essex -
Columns •
1
2
8
4
6
6
7
8
9
10
11
12
18
Table C.
Amount of Oxtoen required to oxidize Obganic Matteb in 100,000 parts of the Waibbs.
Names
op comfavies.
1866. J
Jon.
Fob.
•0912
•0789
'0643
•0555
•0592
•oioi
•057«
•OHIW
•0086
March.
April.
May.
June.
July.
Aug.
Sept.
Oct.
Nov.
Dec i
Mean.
rVuXMES.
Chelsea-
West Middlesex -
Southwark -
Grand Junction -
Lambeth -
Otheb Soubces.
Kent -
New River -
Ea^t I^ndon
South Essox -
•1184
•0336
•0568
•0627
•1288
*009fl
*0152
* 021)1
*0(KW
•0561
•0684
•0406
•0184
•09U2
•0092
•0.'W2
•0548
•0108
•0608
•0404
•0628
•0620
•0518
•0070
•0308
•0621
•0070
•
•0372
•0344
•0600
•0404
•0452
•0072
■0280
•0^28
•0114
•0360
•0360
•ai20
•0368
•0124
•0076
•0252
•0264
•0080
•0504
•0516
•0596
•0548
•0560
•0007
•0212
•0311
•0120
•0344
•0304
'0336
*0368
*0368
•0084
•0133
•032S
•0108
-0840
•0873
•0315
•0823
•0467
•0073
•0128
•0262
•0587
•0884
•0730
•0670
•0761
•0604
•0062
•0258
•0125
•0098
•0589
•0748
•0866
•0790
•0760
•0110
•0228
•0657
•0083
•0543
•0599
•0629
•OMO
•0599
•0199
•0299 ,
•0987 '
•oui '
1
•0596
•0611
•0504
•083S
•0654
•0006
•0268
•0474
•01S8
Columns •
1 2
1
3
4
6
6
7
8
9
10
11
12 15 1
Qifa/i/j( of London Water Supply in 1866.
259
Table D.
DfGKEES of Hiju>an8ii (1 deg. >■
L part of carbonate of lime, or its
equivalent,)
in 100,000 parts of
the Waters.
XAsnn
1866.
1 €ff COHPAVIKS.
1
1
1
Jul
Feb.
Kutsh.
Ajnil.
M«j.
June.
July.
Auk.
Sept.
Oct.
! Nov.
Doc.
Mean.
«Jit*^
21*4
21 1
19-4
21*0
21*1
18*5
18*5
17*4
18*0
18*5
21*1
18-5
19*3
1 ViHlXiddlaMX -
21-4
19-8
19-7
21*4
21*7
18*2
16*2
16*2
17*2
19*1
21-4
19*1 1
19*1
19*3
■ fatfhwvk
20-S
10-7
21*0
22-8
21*4
13*7
16*5
16*2
16*8
20*0
21*4
19'4 ,
tl-1
22-2
20-7
22*8
20*8
18*2
17*1
18*8
18*0
20*2
21*7
19*1 !
19-7
^B IflBBKB
15-4
21-0
18 5
20*5
21-1
18-8
16*2
17*2
17-4
20-0
22*0
18*2
18*7
1
1
H
1^ ...
t8'6
27-4
27*7
28*5
29-7
25*4
24*5
2i-8
26*5
27*4
28*2
23*4
1 28*5
^B
Sev Bifvi -
»-7
22*0
22-5
22-7
21-4
18-7
13*4
13-7
14'
18*5
20*8
14*2
18*4
^P
kMLoodon
M-8 1
23-1
25*1
22*8
20*8
15*7
10*0
17*7
17*1
20*2
21*7
20*0
2i)'4
1
iMkBcMZ
25-7 1
20-5
27*4
27*4
28*5
28-1
23*4
22*2
iU*8
25*8
28-7
22*5
25*1
1
1 '
1
2
3
4
5
8
7
8
10
11
12
13
Table E.
CoMPARATiTE RESULTS in Years 1865 and 1866.
am CojoMsmL
Tear.
1
!
1
Total
Solid Impusitt.
OaoAiric aiid other
Volatile Matter.
OxYOBif required
to oiidizo
organic Matter.
HABD5BS8.
Max.
Min.
1
Moan.!
Max.
Min.
Mean.
1
1 Max.
Min. Meam
' Max.
Blin.
1 Blean.
Xkambs.
1
1
i
1
1
Odte •
•{
1885 '
1866
31*72
31*72
23-58
24*03
20*44
27*92 ,
3*05
2*60
•72
*70
1*60
1*21
•1M2
•1131
•0328
•0340
•0794
•0500
18^1
21*4
14*5
16*5
16*3
19*3
VMlCUhHi
{
1886 ;
1866
80*03
3202
22-42
23*62
26-43
27-42
3*07
2-00
*P6
•72
1^57
1*20
*1076
•0748
•0304
. '0304
•03S1
•0511
18*7
1 2r7
17*1
16*2
17*7
10*1
r. 1865
'X 1866
32*62
31*18
18*78
23*66
26*80 '
27-88 '
3*40
2*40
-81
*63
1*77
1*30
*m2
*U806
•0408
•0315
•0701
0564
18^9 ! 16-4
22*0 j W7
17^7
19-3
r 1865 :
t 1888 I
32*11
31*40
22*ai
24*82
26*97
28*23
2*72
1*77
•81
*fiO
1*5&
1*10
•1722
*07W)
•0352
•0323
•o«w '
•0M2
18*4
1
10*4
16*2
17*7
W7
IJBbelli •
( 1885
-: 'l868
31-36
31*18
22*76
25*25
26*41
27*82
2*70
1*W
*07
•90
1*61
1*43
*1050
*1&*8
•0302
•0308
•0818
•0654 ^
18*8
22*0
16*4
13*4
17^6
W7
Onon BouiCBS.
Bent -
■{
1885
1866 1
1
39*80
40*42
3i*92
37-70
37*79 i
3903 ;
2-66
1*80 1
1
•81
61
1*65
13ft
•0092
•0109
•0018
•0070
•0140
•0096
27*4
29*7
23*7
23*4
25^6
86^5
BtvRirer-
-{
1865 '
1866
3002
29-92
10-40 25*2i
20*20 ; £4*85
1
2*00 !
1*02
1
*5&
•53
•98
1*05
*040A
^0576
•0006
•0128
•0251
•0208 ;
21*1
23*7
17*2
13*4
19^S
18^4
-{
1865
1806
84*62
35' 16 j
22*17
24*33
27*9S :
30'4S ;
3*30
2*20
■R6
*55
1*62
1*42
•13H
•09S7 .
•0188
'0262
•0504
•0474
22*2
25*1
17*4
15-7
20-2
20^4
IntfcEMeE
-{
1885*
1880
«*36 ' 37-B8 '
40*91 j 31*32
40*28
3S77
2*70
2" 10 '
1
•81
*08
1*82
1*53
•0160
•0557
*0Oi8
•0070
*0I03
•0138
20*5
28-5
21*1
22*2
24-2
25-1
260
Water Supply of London.
IX.-WATER SI
1. The IV^ter Companies of Xrf>BdoB i their Sources of Supply, and the Paj
WATER
COMPANY.
[The Hampstead
OoamHUiy was
amalgamated with
the New Biyer
OoaniMuiy in 1866.]
Bast Lovdov •
Ohelsia
WSBT MlDDLBlEZ
BOUROB OF SUPPLY.
1850.
Chadwell Spring ;
River Lea, at a
point betwoenHert-
ford and Ware
21 miles aboye Lea
Brid^ ; Springs ;
4WenBatChe8huiit,
Amwell, and Hamp-
stead Road.
{,AX90 Thames btiow
SladifHars Bridge.'}
Riyer Lea at Lea
Bridge.
Thames at Battersea
Thames at Barnes,
B| miles below Tod-
dingtonLook.
1856.
Same as in 1849, with
addition of the
Hampstead Com-
pany's sources,
which consisted of
springs at Hamp-
stead and High-
gate, and one deep
chalk welL
The springs used
onbr for streof, sewer,
ana similar purposes.
\_AUo Thames oelofe
Bladifriars Bridge J}
Riyer Lea at Totten-
ham Mills, 2 miles
above Lea Bridge.
Thames at Seething
Wells, two miles
above Teddington
Lock. Water from
this source used
first in 1866. Works
at Chelsea disused
and connections
severed in 1856, the
land being sold to
Railway Companies.
Thames at Hampton,
6| miles above Ted-
dington Lock. First
used in 1806.
1866.
Same as in 1856,
including power
of draught firom
the Thames
below Blackfiriars
Bridge for sewer
and street pur-
poses, and one
additional deep
well.
Of the average
daily supply
about 18 mimon
gallons were
drawn flnom the
Lea; theremain-
ino: 4 million
gaUons flrom
other sources.
River Lea at
Higham Hill,
8 miles above
Lea Bridge; local
drainage being
excluded ftrom the
river as ftur as
Ponders End,
which is 6 miles
Arom Lea Bridge.
Same as in 1866
Same as in 186C
RESERA
1850.
2 at Cheshunt (18
acres); 2 at Stofte
Newington (42
acres) ; 1 at New
River Head (6
acres) J 1 in Hamp-
stead Road (200 feet
in diameter), built
with brick sides.
Six open reservoirs;
capacity 86 million
gallons, via., 2 at
Old Ford, 2 on east
side of River Lea,
1 at Lea Bridge,
and 1 at StamfOrd
Hill.
4 subsiding reser-
voirs (at Chelsea?)
(Si acres) ; 2 open
service reservoirs
for filtered water, 1
in Green Park (U
acres) and 1 in
HydoFsrkdaore).
2 subsiding reser-
voirs at Biumes (16
acres) ; 1 service re-
servoir at Ken-
sington, o^wcity
3.460.000 gallons,
elevation 111 feet;
1 service reservoir
at Barrow Hill,
capacity 4,762,000
gallcm^ elevation
1)
2 at Ch<
sidenoe
Newing
de&ce;
Head;
Read ;
Square
water),
holds »1
Ions; 2
Lane^
minion I
lat Bt<
ton. c
million
Theli
ing re
Stoke
werefoi
to lOd
but nov
I covere<
at Old
merly
•ores in
rin t1
of 1865
of He
neers
-the c
njin a
and St
are n(
out of I
2 subsi
voirs 1
Wells ;
j'eservo
Heath
170 t
Trinity
mark;
open re
an acre
of unfl
for po
and flu
2 subsi
voirs
and se
voirs M
Water Supply of London.
LONDON.
WoBKS for Stoimire md nitratloii« in ISSO, ISS69 and 1S66.
1866.
PILTEATION.
1850.
1856.
at
■^^ Hom aeyj
NtrHind; al-
ff about 70
WMactiamp-
■i Higfaeato
re-
lit Clarcnwnt
. Maidea Lone,
t^andHamp-
|Kfe oaiwcit J
None; subsidence only
ervoinatWal-
xmx capacity
Bongalkms.
iiawiwiffiri. ro-
I of 9aens at
d/ne of which
UyarttmtaUy
nNHi in U04^
M MM^ pre-
B the oomple-
' the above-
lid reservoirs
Wattbamstow
d naerroirot
das in 1896.
inlUiO -
None; subsidence only
Filter bc<l8 at Stoke
Nowiiiirton and Xuw
River llead.
The lUttiriiifc medium
iH 5fi!et in tbickneiM,
2 of which coii8i»t of
Hand and the rei»t of
fcravcl, iu layers in-
creaaiii^ in coaraenoHS
towards the bottom.
The supply of filtered
water to i>art of the
disthet was com-
meiiced at Christmas
1855.
Pipe Nupplyinp: unfll-
tered water flrom tank
at New River Head
retained for supply
during periods of
fhMt. The Board of
Health Renort states
that it would be more
satisfactory that this
means of supplying
imflltercd water
should be removed.
13 filter beds at Li>A
Briclge. 12 acres in
extent.
The fllteriiuc mediimi
is 3| feet or sand.
Filtered water flnft de-
livered in November
1855.
90.000 siiiKjrficial feet of 2 filter IkkIs at Seething
af re<iervolr«
es; service re-
8s in 1850.
filtering area at Chel
sea ; the medium
being gravel, shells,
and sand, 8 feet thick.
None ; subsidence only
Welbi, area 2 acres;
filtering medium as
bcfoie.
3 filter beds at Barnes ;
medhnn, saud and
gravel.
Filtered water fbrst
supplied in March
18M ; but connection
between main and
subsiding reservoirs
still maintained.
1866.
3 filter beds at
Homsev, 6 at
Stoke Newington,
and 3 at New
River Head; total
area 9i acres.
Aybraov Daily Quavtitt
Watib supflied.
1849.
1856.
Gallons. < Gallons.
14^76,783
Same as in 1866
83»,463
28,396,400
\^J»lfi^
Same as in 1856
5 filter beds at
Barnes; the con*
nectiou alluded
to in preceding
column lias been
severed.
8,940,730
18(
Galli
22,896
19,880
5,582,000
8,000.
3,3Si054
6,005,293
8,206,
262
fFater Supply of London^
The IVater Compaiiies of &oBdOB | their Bouroes of Sii|q^« and the Fam
WATEB
COMPANY.
Obaxd Jukctiok
BOVTnWABK AKD
Tavxhaix.
KSVT - - -
[The Pluxnstoad,
Woolwich, and
Charlton Company
vat established in
1864 for the supply
of water derived
fh>iu artesian wells
j funk in the chalk.
. and softcmed by
' Dr.Clark's process.
After the failure of
tiie Company the
works were pur-
chased by the Kent
Company in 1861.]
BOUBCE OP SUPPLY.
1850.
Thames at Kew,
6 miles below Ted-
dingtonliock.
Thames at Battersea
(Red House).
Thames at Lambeth
inear Hungerford
iridge).
Bavensboume
l>eptford.
at
1856.
1866.
Thames at Hampton.
6k miles aboreTcd-
dington Lock.
Same as in 1866 -
Thames atHampton.
b\ miles above
Teddington Lock.
Water from this
source first sup-
plied in 185S. Con-
nection with the
Biver at Battersea
not yet removed.
Thames at Long
Ditton (since 1852).
Same as in 1850
Same as in 1856
Same as in 1856
BESEBT(
1850.
Artesian wells at
Deptford, Charl-
ton, Plimistead.
Bromley, and
Crarfoni, sunk
in the chalk.
Depositing reser-
voirs at Kew
Bridge, caoacity
5 million gulous;
store reservoir at
Campden Hill (6
million gallons) ;
store reservoir at
Paddington, capa-
city 3,400,000 gal-
lons, elevation 89
feet.
2 depositing reser-
voirs at Battersea
(32 million gallons).
2 o|)en reservoirs at
Brixton (capacity
12 million gallons) ;
1 open reservoir at
Streatham (capa-
city 3,750,000 gal-
lons).
2 impounding reser-
voin at Deptford.
Service reservoirs
in Greenwich Park,
Woolwich Common,
and Woolwich.
ISl
Subsidsnoe
ToirsatK
service
at Ounp
Paddiniti
voiraboli
2 subsidix
voirs at '.
Depositin
voirs at B
2 covered
atBnxtor
veredatS
Same at In
The foregomg particulars have been chiefly derived from Returns supplied hj the London Water Con
to the Select Committee of the House of Commons on ** East London Water Bills (Session 1867)*' an<
the Report of Messrs. Austin, Ranger, and Dickens to the General Board of Health on the Metropolis
Supply, 1856 ; hut to ensure correctness of description the facts were submitted in proof to the severa
panies for revision before publication.
The Registrar General, desiring further to ascertain the state and nature of the works for water su]
the latest date, addressed the following inquiries to each of the London Water Companies, who have obli
and promptly furnished the information required : —
L — ^Resebyoirs. State, for each Reservoir : (I) its name or aitnation ; (2) whether for nnfilte
filtered water ; (3) whether covered or uncovered ; (4) its elevation above Trinity high-watei
or above intake ; (5) its superficial area and contents (rn gaJtont) when full ; (6) how of
contents are changed in the ordinary way ; (7) how often it is cleansed?
JfiUer Supply of London.
263
for
and VlttrmttoB, in &SSO, ISB69 and 1S««— ronfiniccc/.
PILTBATIOX.
ATXJuei Dailt Quavtxtt 01 1
Watu buppusd. 1
iiw
1850.
1856.
1866.
1849.
1856.
1866.
Gallons.
Gallons.
GaUooa.
■Mvvoir wX
ntcr bedi li Kew,
thrangh 4 ft. of mTd,
■hellg, ■nd Mnd.
Same at in 1860 •
:Sameatinl880 •
8,6a«.018
6,478,861
9^S17|066
18M * •
t filter beds at Bat-
tenea, &ifeet; river
■and and graToL
Filter beds at Batter-
sea; 8 feet additional
filtering medium, and
Hanrich sand chiefly
used.
Sameasinl866 -
6^018^716
lOiSSlAtt
11^609,000
ittH; with
lOHsatBei-
Entire aupply fllteiyjd
through 7 ft. of grarel
and sand.
Same as in 1860 •
Same as in 1860 •
8»077,£G0
6,801.000
8.960^000
mmdin at
1 filter beds at Beot-
ford; gravel, shoUs,
and sand.
Same as in 1860 •
Filters and deposit
reservoirs aban-
doned on change
of supply flrom
Bavensooume to
chalk springs.
1,079,111
^680,000
6^160^000
lal P*|Mdtj
Gifmwich
i Woolvich
.r— -FiLTKATiON. State for each filter-bed : (1) its name or situation ; (2) its elevation above intake ;
(8) ita anperficial area ; (4) its ftructnre ; (5) the number of gallons it will filter daily when in fhll
cypcration ; (6) how often cleansed ; (7) whether subject to obstruction from confcrrse or other
Gmosea?
.— WoBxuro. (1) How is the water* taken to the filter-beds ^-bj pumping, gravitationy in open
ehannels, or in pipes ; (2) how is it taken from the filter-beds and stored ; (3) how is it delivered
to the consumers — hy constant, intermittent, daily supply ; for what hours ; to each house ; or by
■tand-pipea?
(JFar BepUes to these Questions see following pages 264 to 271.)
f
264
Water Suppfy o/Londoiu
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266
Water Supply of London.
O
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Wider Supply of London.
267
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mi
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Wikt Suppfy of London.
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Water Stg>ply ofLondoH,
i
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1^
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fFater Suppfy of London,
271
I
Pi
1
Sk S
ill 1^
a
«i« ta 6 iS b ■•■
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I
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27S
W<a^rStq>ply of^LmdmL
a. Water Supply of London in each of the Three Yean 184^, 1866, and 1866.
Ateragb Daily Quajftitt supplied iw Gallons.
fTAXJSK \/UJi]fAAX.
1849*
I856.t
1866t.
New River . - - <
East London -
Chelsea
West Middlesex -
Gnuid Junction -
Southwark and Vauxhall •
Lambeth - - - .
Kent
Total
141(76,783
8329*462
8^940,730
8,334,054
8,532,013
6,013^716
8,077,260
1.079,111
28,896,400
14,662,684
6,632,000
6,008,993
6,478»361
. 10.881.122
6,891,000
2,680,000
22,898,769
19,880,789
8,000,000
8,208,168
9.817,065
12,508,000
8,950.000
6,150.000
, ■»
44,888,129
78,876>880
95,406,731
* See Report to General Board of Health on the Supply of Water to the Metropolis, 1850, p. 6.
t See Returns from Water Companies (Question 180 in Appendix No. 1. to Report of Select Committee of
the House of Common* on ** East London Water Bills, 1867."
3. London Water Companies. Amount of Capital and Rate of Dividend in the
Tears I860 and 1866. [See Appendix No, 5. to Report of Select Committee on East London
Water Sme, 1867, ;?.318.]
Watbb Compaay.
1850.
1866. j
Capital in Shares
or Stock.
Dividend
percent.
Capital in Shares
or Stock.
Dividend
percent.
New Bivcr (a)
East London (6) - - -
Chelsea
West Middlesex
Qrand Junction {Share Capital)
Southwark and Vauxhall {Shares) -
Tiambeth {Shares) - - - -
Kent
•
£
1,491,671
600,000
800,000
506,800
881,000
803,218
211.881
229.500
£
4*06
8-00
2-13
9*80
8-00 1
500 1
5-00
3-75
£
1,519,953
l,247/i60
616,600 (c)
79^367 (d)
646,000
64^000
8^280
877,870
126,600
125,160
632,130
428,946
£
6-11
6-81
6-50
9*40
8'50
7-60
4-00
6*50
6-00
4*50
0*00
6-00
3,878,570
6^402,870
(a) In 1854 the Company formed a reserve ftmd, by setting aside a portion of the half-yearly profits, in
order to guard against the result of accident to the extensive works carried out under the provisions of
the 1852 Act and subsequent Acts. In 1866 it was considered that time had consolidated these works,
and that the danger, to guard against which this fund was created, had in a great measure passed away.
Tlie directors, therefore, determined to restore to the proprietors a portion of the profits which in prenous
years had been withheld fh)m them, and a distribution of 1,4002. per share, or 61. 11*. 6f cf. per cent, upon
the capital, was made, which reduced the fiind to 21,417^. 98. 6d. It is to be observed, that the increase in
dividends in 1865 and 1866 is chiefly the result of the Company having ceased to make the usual additions
to this fimd.
(6) Three bonuses, of 1 per cent, each, on ordinary stock, were declared between 1860 and 1866.
(c) In addition to the capital of 615,600?. the Company have expended on pennanent works 170,0002.
(raised on existing bonds at interest), and 103,5002.. produced on sale of surplus lands.
(d) An addition of 4,2042. has been made to the capital since Christmas 1866.
fFater Suppfy tf London.
278
Water Oomyaiiles. Capital, Receipts, and Houses supplied by eacli
Gqxfaht in the Tear ia6€. [See Answera of Companies to Questions 2, 5, 6, cmd 14, 4
Afpemdix No, 1. to Beport of Select Committee on East London Water Bills, 1867.]
Watzb Compavt.
and
Loans.
BXCSIPTS.
Houses supplied a 1866.
....... •!
Gross.
Water Rents.
Number.
Rateable
Value.
•
Population.;'
Q.a.
Q.14.
Q.14
Q.6.
Q.6. .
1
Q.5.
£
£
£
£
XewSiver
2,009,418
281,380
232,607
112,964
4,054,400
800,000 '
Sast London - - .
1,400,000
155,554
129,818
91,975
1,870,760
67?,000
Cheiftea ....
78s,eoo
65^1
64,251
26,900
1,228,000
170,000
t
West Hiddleiex -
798,571
101,115
100,546
S6,500(a)
2,044,000(a)
255,500(a)
Grand Junction
850,000
112,695
75,675
26,902
1,918,780
24M18
1,100,440
192,734
80,311
73,980
1,418,640
468,540
Lvnbeth - • • •
736^246
72,755
72,343
37,203
1,240,822
225.000
Kent
489,240
62,789
44,585
88,864
675,329
287.068
8,769^4
1.044,282
799,636
440,288
14,445,581
8,070,226
jfoie.— The houses and population given in this Table will be found to differ slightly from those derived
firom another Return as given in the Table on the next page.
(a) Tbe total number of houses in the Company's district is stated at 39,500, their rateable value being
2,212,000{. and thebr inhabitants 276,500. The numbers in the Table refer only to the 36,500 houses actually
supplied by the Company, the rateable value and population being proportionately reduced.
S 2
274
Water Supply of London.
8. LONDON WATER COMPANIES.— l>UtrlbnUoii of Supply in 1866. (See Return in
Appendix 4. to Report of Select Committee on East London Water Bills, 1867, p. 31 7.)
Watbb Comfavt.
Avenge
Dsi]^
Quantity
supplied
for all
Purposes.
Quantity
for other
than
House
Supply.
Quantity
for
House
Supply.
Number
of
Houses.
•
Quantity
for
House
Supply
House.
Population
(Esti-
mated).
•
Quantity
for House
Supply
per Head
of Popu-
lation.
TOTAT. -
Total drawn firom the
Thames.
Total drawn from the Lea
and Welts of the New
River Company.
Total drawn fh)m the Wells
of the Kent Company.
Ghslssa (')--•
Wbbt Middlesbx 0>) -
Gbiitd JuKcnojr («)
Gallons.
95,406,731
46,977.223
42.279.508
6,150.000
Gallons.
16,997,378
7.269,408
9,361,965
366.000
Gallons.
78,409,358
39,707315
32,917,548
5,78^000
431,269
198,033
199,372
83,864
Gallons.
182
200
165
171
3,064,728
1;M9,090
1.468,670
237,068
Gallons.
26
29
28
24
8.000,000
S.208.168
0,S17,055(*)
12,602,000
8,950,000
1,193.000
556.000
1,192,696("»)
3,076.712
1,251.000
6,807.000
7,652.168
8,124,359
9.425.288
7.099,000
26,900
86.500
26,450
70,980
87,203
263
210
307
133
207
201.000
255.500
238,050
4i9,640
226,000
34
80
84
21
34
SOUTHWAKJL AAU VAUX*
HALL (•).
Lambeth (')•-•
New Eiybb («)
East Loitdon (')
Kbitt
22.898,709
19,880,739
4,361,905
5,000,000
18,536,804
14,380.739
109,198(^)
90,174
170
160
800,000
688,S70
28
22
6.150,000
366,000
5.784,000
33,864
171
287,068
24
* JV(o/0.— The houses and population given in the Retium from which this Table is derived differ sli|^ht]y
from those ffiven in the Returns from which the preceding Table is derived.
i*) CTuhea Compantf, The House supply includes stables. About one-fourth of the houses are of the
largest class. The population is based on the official returns.
0*) Wett MiddUtex Compang have no sufficient knowledge of the character and requirements of other
Water Companies' districts to enable them to account for any differences in the quantities of
water supplied per house or per head which may appear between their own returns and those
of the other Companies.
K*) Cfran'l Junction Company's district contains a large proportion of flrst-dass houses and many noble-
man's mansions, having a considerable number of waterdosets^ many fixed baths, heating
apparatus, &c
(<i) Includes 688,850 gallons used for sand washing, Qondensing, ftc at the Company's works.
^•) Southwark and VauxhaU Companp. In districts where a better dass of houses exists than in this
Company's district, large quantities of water are consumed for baths, hot-water apparatus,
watercloaets, kitchen boilers, and for general purposes.
»(') Lambeth Company supply about 6.000 houses in the countiy districts which take large quantities of
water for gardens, small fountains, &c.
<>) New Biver Company. The average rate of consumption may be higher in some districts than in others,
because of the generally larger size of the houses supplied, the prevalence of baths, kCn the
amount of trade demands, and the degree to which waste may go on unchecked.
C) Excluding trade and business premises and buildings.
0) Eatt London Company say that the retium they make is the best approximatioa in their power.
Water Supply of Paris. 275
X.-WATER SUPPLY OF PARIS.
bnFOBMATION BESPECTING THE WaTER SuPPLY OP PaSIS, FURNISHED BY THE
Inspector General to the Registrar General of England.
Water Carriers.
This branch of industry is gradually disappearing. Whereas in 1830 the only
means of distributing water to the houses of Pai'is was by water carriers, at the
present time not more than 2,237 cubic meters (or nearly 500,000 gallons) per
day is thas distributed. The carriers draw their supply from 30 fountains called
**' marchcmdes^ that is, where the water is purchased and is filtered, and from
60 public fountains in which the water is not previously filtered.
The daily supply of water in those houses supplied by the Paris Company is
as follows : —
Water of the Ourcq - - 66,000 cubic meters.
Water of the Seine, or springs - 40,000
» >?
Total . - 106,000 „ „ = 23,330,281 galls.
The quantity of water, therefore, supplied through the water carriers is quite
insignificant. Although the quantity of water supplied by this means is ascer-
tainable, because it is derived principally from the two sources above mentioned,
ft is quite impossible to estimate the number of the inhabitants of Paris who are
thas supplied. The figures in the final resume will show the rapid decrease in the
nuxxiber of water carriers between 1862 and the present time.
The System of the Water Supply of Paris.
The water supply of Paris is in the hands of a company, which bears the name of
the ** General Water Company." This company acts under the control of the
Director General of the Water Service, and in fact its duties consist in distributing
the water furnished by the city, and in collecting the water rates.
Formerly this company held a concession for the supply of water to the suburbs,
since annexed to Paris ; through an arrangement with the municipal government^
this concession has become the property of the city.
The company pays the whole of the receipts into the municipal treasury, which
reimburses in 12 payments the sum total of the net profit realized by the company
up to 31st December 1861, and 25 per cent, of the new rates, when the gross receipt
shall exceed 3,600,000 francs.
The company bears certain expenses of management which are gradually
decreasing, and will be extinguished in 1873.
Water Supply by means of Street Fountains (" Borne-fontaines ").
The city has established 131 street fountains (taps) where inhabitants can, at
will, draw water gratuitously at any hour of the day or night. There are, moreover,
580 other similar fountains where water may be gratuitously drawn during the
four hours of each day that they arc open for the purpose of sluicing the gutters.
Grenerally speaking it is the working classes who avail themselves of this gratuitous
distribution of water. The quantity of water thus consumed probably does not
exceed 4^000 cubic meters per day.
276 Water Supply of Paris.
Distribution of the Water to the Ratepayers of the Water Company.
From a subsequent table it appears that the number of inhabitants supplied by
the water company certainly exceeds 1,000,000 ; the quantity of water consumed
daily being 106,000,000 litres, or rather more than 100 litres (equal to 22 gallons)
per head.
The number of persons who obtain their water, either through the water carriers
or from the free fountains, is certainly less than 825,000 ; the amount of water
consumed by these persons is at most 6,000,000 litres a day, which gives a daily
consumption per head of only just over seven litres (about a gallon and a half), .
This enormous inequality in consumption is easily explained. The subscribers to
the water company belong for the most part to the well-to-do classes ; moreover, water
to them is cheap and does not cost so much as 15 centimes the cubic meter [l\d. a
ton], they therefore use it liberally ; those who employ the water carriers pay as high
a price as 5 francs the cubic meter [As, 2d. a ton] ; and those who draw their water frotn
the free fountains have the trouble of carrying the water home. The consumpUoa
is kept within the smallest limits on account either of the expense or of the labour.
Half of the population of Paris, therefore, is abundantly supplied ; the remainder,
on the contrary, consuming a minimum quantity, although the city is in a position
to furnish an abundant supply to all the inhabitants.
Three reasons prevent the supply of the company's water to the entire city. j-Hie
first is the size of the houses and the large number of occupiers in each house.
The tenant cannot get a separate supply inasmuch as the owner pays the water
rate for the whole house. Many house proprietors are unwilling to bear this expense,
although the water rate does not amoun^te one per cent, on the rent.
The cesspool system in Paris is opposed te the development of the water supply.
Cesspools are in almost general use, and the proprietors of houses seek to dis-
courage the use of water in order that these cesspools may not be filled too rapidly,
as the cost of emptying is from 7 to 8 francs per cubic meter.
But the principal reason which prevents a more universal use of the company's
water is the liberality of the city in allowing water to be drawn gratuitously in the
public streets. The proprietors of houses in the neighbourhoods principally occu-
pied by workmen take advantage of this liberality, and refusing to have the
company's water laid on, send their tenants to the free fountains.
Evidently, if the drawing of water in the public streets were forbidden, all the
houses would use the company's water, for the well water in Paiis is not drinkable.
Quality of the Water,
The 106,000 cubic meters of water daily consumed in Paris are derived fix)m the
following sources : —
River water / Ourcq . • . . 66,000 1 ^^ ^rvA u-
unfiltered. 1 Seine - ... 14;800 j ^^'^^ ^^^'^ °'®*^''^-
Wat^ from fSPfi^g^ ^^ ^^^^^ (ayerage) - 22,000"
cnrincrfl »» d'ArCUCll - - 1,000
anrfiltf red^ ^^^« ^* ^'•^^^"^ " " " ^ > 25,200 „
water 1 ^^^^^^^^ ^^ter from the " fon-
wa er. j^ taines marchandes " - - 1,600
Total - 106,000 „
»
The waters of the Ourcq and the Seine are not filtered, but in the course of
three years it is hoped that the Vanne and the Dhuis aqueducts will be completed,
when the daily amount of spring water will be increased to 140,000 cubic meters.
These waters do not require filtration as they are fresh and clear in all seasons, and
consequently pleasant to the taste.
The greater part of the ratepayers supplied from the Ourcq and Seine filter the
water in their own houses. The Seine water is drawn from above Paris, and when
^tered is better and more pleasant to drink than tbe water drawn fix>m the Thames
fFiUer Supply ofliirU, 277
iboTC London. I have kept for a time filtered Thames water, and it very soon
became undrinkable.* The water of the Seine, on the contrary, does not change.
There is, liowever, no doubt that in !a few years the water of the Seine will be com-
^k^Kkf wpo^ikmd'lbj the increase of the factories on its banks.
The Amount of Water consumed for all purposes.
The quantity of water consumed in Paris both for private and public service had
risen in 1867 to the following amount :—
River water rgl'^ - " ' ?ffi'?^
Spring water f Springs de la Dhuis - 7;904,699
' naturtlly' ./ ..^, . da Midi - - 945,269
UvpidL I p . dn Nord - 187,962
Artesian f Wells at Passy - - ay066,000
, wells.. .,. \ .„ Grenelle - - 241,775
/ cubic meters = to 16,742
,; Total . 76,068,671 \ nuUions of gaUops.
This gives ^n average of 208,000 cubic metres per day.
The largest, consumption took place in August^ and showed an average of
228,000 cubic ineters per day. It is estimated that the largest daily consuB^ption
in the summer was about 250,000 cubic meters.
The smallest monthly consumption was in February, and showed a daily mean
of 196,000 cubic meters.
In 1868 tl^e- daily quantity of water can be increased 80,000 cubic meters by
means of the-, hydraulic machines of Tribardon and Daisies •les-Meldeuses, and in
three years time another 90,000 cubic meters by the Vanno aqueduct, by which
time it is expected that 420,000 cubic metres per day may be distributed in the hot
weigher, equal to rather less than 100,000,000 gallons.
The XK>pn\ation of Pjuis being 1,825,000, the consumption of water for both
public and private purposes was at the rate of 1 14 litres (about 25 gallons) per
h.ead per day in 1867. During the hot weather of July and August this average
rose to 125, while in winter it did not exceed 107 per head.
It is ^mated that a daily distribution of 420,000 cubic meters will supply a
population of 2,000,000 at the liberal daily rate of 210 litres (46 gallons) per head.
Included with the water supplied for domestic purposes is the supply to 216 bath
establishments and 195 lavatories.
The public water service includes the supply of the parks of the J3ois-de-
Boulogne, of Vincennes, of Buttes Chaumont, of Monceaux, of 15 squares in different
pactA of the .Oity, of 61 monumental; fountains, the watering of the streets, the
sluicing of the gutters, the supply of 507 urinals, and all the public establishments
and pablic offices which receive a gratuitous daily supply of about 8,000 cubic
meters.
Hydraulic establishments of the City of Paris.
^e following is a list of the conduits and of the plant employed in the w^ter
MTvice of the city :-^
Canals and. iKiueducts : ■ •• -
The Ourcq canal . - - - 96,000 metres in length.
The river Ourcq (canalled) - - • 11,000 „ „
The Dhuis aqueduct . . - 131,044 „ „
That portion of the aqueduct from Arcueil * ^
to the fortilications - - - 10,506 „ h -
■ . , ' . .'
248,550 metres.
- - - II ■
* Thit was the case formerly, bat the water OBoally delivered by the London companies cantiov'
I keot miehanflred. — W.F.
be kept imdumged. — WJ*.
278 Water Supply of Paris.
MachineB for raising Water :
Hydraulic wheels. The establishment of St. Manr, 8 wheels
or turbines of - - - - - - 680 horse power.
Steam machines :
Two machines of 50 horse power ... 100 ,,
The Alfort houses (two machines) ... 100 „
Austerlitz ( » 3 " " - 240 „
ChaiUot ( » ) - - - 350 „
NeuilJy ( « ) " " " 65 „
The reserve machines at Yilleneuf, of the Place de I'Ourcq, and of Menilniontant
are not included, neither are those of Auteuil and of St. Ouen, which are going to
be suppressed.
During this year four hydraulic wheels, those of Tribardon and D'lsles-les-
Meldeuses will give an additional force of 200 horse power ; thus raising the total
horse power of those engines to 1,735.
The length of the water-mains ... 1,300,000 meters.*
(about 808 miles).
Monumental fountains ... . 61
Public ditto ... - 60
Fountains for the sale of water - - - 30 •
Street fountains " h, repoussoir *' - - - 131
Other street fountains .... 580
Tanks beneath the footway (?) (bouches sous trottoir) - 3,465
Hose for throwing water .... 3,228
Posts for watering purposes (stand-pipes) - - 84
Water urinals - - - - - 507
Water service of carriage stands - - - 69
All the street fountains and the tanks under the footway are constantly at the
disposal of the firemen, and are furnished with suitable apparatus in case of fire.
The foregoing explanations were necessary to a full comprehension of the follow-
ing replies to the questions relating to the water supply of Paris :—
\st. The number of water carriers.
At 30 fountains for the sale of water - 1 , ?5g " ^ " 1 q^
At 60 public fountains (carriers with a yoke) - 1868 (about) - 500
2nd. The daily amount of water distributed by water carriers.
At the fountains for the sale of water - { |^ J^g ". \^^ ^^^^^ ^^*^"-
At the public fountains - - in 1868 - 600 „
Zrd. Source of water distributed by water carriers.
The fountains for the sale of water are supplied from the Seine, and from springs;
of the public fountains, 10 in the higher parts of the city are supplied from the
Seine, and the other 50 in the lower parts of the city from the Ourcq.
4M. Price of water sold to the public by the water carriers.
At the average price of 10 centimes the 20 litres (about one penny for
four gallons), the daUy amount would be —
Water taken from the fountains for the sale / in 1862 - 10,000 francs.
of water ... .\ in 1868 - 8,125 „
Water from the public fountains - - in 1868 - 8,000 „
* This total is only an approximation, the length of pipes laid in 1867 not having been jet
lahied j to the end of 1866 the length was 1^18,018 meters.
Water Supply of Paris, 279
^tk. Net profit of water carriers.
Tbis profit arises from the difference in the price paid for the water and the
price chAFged to customers, making an allowance for the expense of carriage.
The price paid at the fountains is 10 centimes the hectolitre (100 litres, and
22 gidlons), and the water is resold at 10 centimes the 20 litres by the water
carriers. These carriers for the most part use a barrel and horse and cart. The
water carriers, with a yoke, who draw from the public fountains, do not pay for
their water.
66L 7^ (laiiy amount of waters furnished to ratepayers of the water company.
n ♦^i. / according to the terms of subscription - 33,118 cubic meters.
uurcq water - ^ actuaUy delivered - - - 66,000 „
Seine and spring f according to the terms of subscription - 26fi76 „ „
water. \ actually delivered - - - 40,000 „ „
This difference between the amount subscribed for and the quantity actually
confiomed arises from the fact that the whole of the Ourcq water is delivered from
open taps, and as regards the Seine water this mode of distribution is rapidly
increasing. The subscribers avail themselves of this liberality, and consume con-
siderably more water than they pay for.
The above figures do not include the quantity of water sold by the city of Paris
in the Department of the Seine, which is —
Subscribed for - - - 3,225 cubic meters.
Actually consumed - - 5,800 „
7fft. Number of houses with water laid on.
On 31st December 1867 the number in the city was 30,109, and those outside,
in the Department of the Seine, 2,476. The number of houses in Paris is about
60,000; therefore the number paying water rates to the City Water Company
scarcely exceeds one half.
Sih. The number of persons living in these ratepaying houses.
According to the census of January 1867 the population of Paris was 1,825,000.
Allowing an equal distribution of inhabitants in the 60,000 houses, the 30,109 houses
famished with the company's water would show 913,000 inhabitants ; but, in fact,
these houses which subscribe to the Company include ail the largest and those con-
taining most inhabitants. It must be estimated, therefore, that these subscribing
houses are inhabited by at least 1,000,000 persons.
9/A. The number of persons supplied with water in other ways.
The number of persons supplied either through water carriers or directly frova,
the street fountains is difficult to estimate, but is certainly less than 825,000.
The amount of water drawn directly from the Seine and from the canals is almost
nil. Two of the railway companies, however, draw from the Seine about 2,000
cubic meters per day.
Kara. — ^Dr. Vacher, in his interesting paper << Des Maladies popolaires," writing of the year 1866,
flays that the greater part of tiie lifdng-pumps on the Seine are below Paris ; and observes that
m 1865 the Yolome of water flowing down the Seine was reduced fh>m its normal flow of 130 cubio
metres to 26 cubic metres a second. Now the sewage of Paris, according to the estimate of
Professor Dumas, is one metre a second ; and consequendy one twenty-sixth part of the water supply
taken from the Seine then was sewage. One quarter of Paris obtained its water exdusiyely m>m
the Seine, and there precisely in that year the ravages of cholera were most severe. It was the
flme in Montmartre and Batignolles ; the mortality was high also at Clichy, Puteaux, and St Denis,
drinking the Seine water below Paris ; while on the Seine above Paris the deaths from cholera in
iUAnti Choisyy and Charenton were few. (Pages 79-^0).
280 Letter from Dr. Pettenkofer,
XI. -LETTER FROM DR. PETTENKOFER ON CHOLERA
IN BAVARIA.
/ W W%/V"V. ^ \/X^ \i
Miinchen, den lOten October 1867.
Mein theurer Dr. Farr,
Von einer Ferienreise zuriickgekehrt, finde ich Ihr sehr werthes Schreiben
vom 5 ten Septb. und beeile mich nun, es zu beantworten.
Miinchen hat verschiedene Wasserversorgung. Sie finden eine Studie hieiniber,
die Cholera 1854 betreffend, in meinem Buche " Verbreitungsart der Cholera," 1855,
Seite 50 bis 61. Dem dort Gesagten habe ich nichts wesentlich neues beizufugen,
nur meine Anschauung iiber den Einfluss der Isar auf den Stand der Brunnen
und Quellen am linken Ufer (Seite 50, Zcile 3, von untcn, " Die ersto M oglichkeit
ftnlangend," bis Seite 51, Zeile 18) habe ich geandert : meinc 13 jahrigen Beobach-
tungen ilires Standee haben mich gelehrt, dass sie viel unabhangiger davon sind,
al& ich damals dachte. Aus demselben Grunde kann ich den Satz Seite 65^ Zeile
17 bis 19 : Die Quellen des linken Isarufers liegen sammtlich im Bereich des
Wasserspiegels der Isar, wesshalb sie mit diesem steigen und falleUjj" nicht mehr
aufrecht erhalten. Ich hatte damals noch keine Idee von den Grundwusseirer-
haltnissen Miinchcns, und glaubte desshalb, was mir Ingenieure und Brunnenmeister
hieriiber sagten, was sich durch fortgesetzte genaue Beochachtung aber grossentheils
in*ig erwiesen hat.
Fiir den Schluss, den ich aus dem Verlauf der Cholera 1854 in Miinchen Im
Vergleich mit der Wasserversorgung gezogen habe, sprechen auch die Thatsacben
an vielen andern Orten ; es kommen die heftigsten Choleraepidemien ohne Einfluss
des Trinkwassers vor (z. b. Irrenanstalt in Devon, Pfrundneranstalt in Wiirzburg,
Irrenanstalt in Halle). Namentlich der letzte von Delbiiick veroffentlichte FaJU
ist hochst interressant, weil in derselben Anstalt bei gleichem Wassergenusso und
gleicher Kost auch das Wechselfieber vor mehreren Jahren nur die Bewohner
derjenigen Abtheilung ergiiflP, welche 1866 ausschliessUch von Cholem ergriffen
wurde.
Ich glaube nicht, dass der Einfluss des Grundwassers darin zu suchen sej, ob
dieses ^s Trinkwasser benutzt wird, oder nicht, d. i., ob der Cholerakeim (Choler^-
•stoff) einen langem oder kiirzem Weg zu machen hat, bis er von der OberflaeB^
indas Grund-(Trink) Wasser gelangt. Ich glaube iiberhaupt nicht, dass das Wassef
die Keimstiitte fur den eigentlichen lafectionsstoff sey — ^sondem ein feuchter Bodeff.
Wenn es anders ware und das Wasser fiir sich die Hauptgrundlage der Epidemien
bildete, konnten sie nicht so in den ortlichen und zeitlichen Granzen erscheinen,
welche sie thatsachlich und ofl in hochst auflallcnder Weise einhalten ; es konnte,
2. b., in Indien nicht die heisse und trockne Jahreszeit die Bluthezeit der Cholera
sejn, sondern die heisse und nasse, zu welcher Zeit es aber gerade die geringsie
Cholera-giebt.
Das Verhalten der Qholera in Ostlondon 1866 ist von grossem Interesse und ict
bin sehr gespannt auf die weitere Entwicklung der Forschung. Wenn auch die
Wasserleitung zur Verbreitung eines wesentlichen Momehtes gedient haf^ so liat
sich doch auch in diesem Falle der Localeinfluss (ortliche und zeitliche Dispd^tion)
in auffallender Weise geltend gemacht Ich bin iiberzeugt^ dass Ihre Formel uber
den Einfluss der Elevation auf den epidemisch ergriflenen Theil wieder ganz gut
passt. Warum andere niedrig gelegene Theile (z. b. Silvertown und Norihwoolwich)
nicht auch ergrlffen wurden, auf diese Frage steht die Antwort wieder in einetn
anderen Capitel.
Ich fiihle in mir die voUe Sicherheit, dass man in der Erkenntniss des Cholera
processes keine Fortschritte mehr machen kann, wenn man die Bodenverhaltnisse
nicht zugleich mit dem Cholera Keim, welchen der Verkehr verbreitet, ins Auge faast.
Letter from Dr. Pettenhojer. 281
and erfoTBcht^ wie diese beiden Faktoren zuBammenhangen. Hieriiber habe ich
allerdings nocJi gar keine bestimmte Idee. Kommt das x des Verkehrs zum y des
Bodens durch die Kloaken ? kommt das y aus dem Boden zum x in die Eloaken,
Oder begegnen sich x nnd y erst in uns, um das z zu erzeugcn, was uns Cholera-
anfalle machen kann ? Das ist Torlaofig uicht zu sagen.
Ich freue mich sehr auf femere giitige Mittheilungen. Mit aller Hochachtung
Ihr ergebenster,
Pettenkofeb.
Im letzten Hefit der 2^itschrift fur Biologie steht eine Arbeit yon Dr. Pfeiffer
iiber die Cholera 1866 in Thiiringeu, mit interessanten Resultaten.
XII.-CHOLERA IN ALBANO.
«^rf^^«^M/v^/^A^^tf^AA/^^^AMAMA/^A/\/^^^/>/^«
A!^n the meeting of the International Statistical Congress at Florence was over,
I proceeded in October to Rome, where I hoped to get some information about the
epidemie of cholera, which had been excessively fatal, and was then subsiding.
Bat I found that at that time nothing official had been published on the subject ;
«nd through an accident I was prevented from visiting Albano. It had been the
scene e£ m violent outbreak, and appeared to offer facilities, within a circum-
scribed area, for analjsing the phenomena. The medical men in Rome were most
willing to supply all the information in their power ; and Mr. H. Helj (himself
not A medical man, but in Albano at the time,) has given a faithful picture of the
fiital events which he witnessed or heard described, with such an account of the
circiimstances as leaves no doubt that the fatality was there, as it is in India, due
to the extraordinary diffusion of the cholera matter in water, air, and food. Since
Mr. Holy's paper was received the Marchese Ermenegildo de Cinque Quintili has
been good enough to supply not only the statistics but also a description of the
epidemic in the following interesting paper. — W. F.
Cholera m Albano in 1867.
AoeoufU of the Outbreak of Cholera in Albano by the Marchese Cinque
Quintili.
The little town of Albano is situated about 15 miles S.E. of Rome, at an
elevation of 381 metres above the level of the sea.
The most recent and authentic statistics (1853) give it a population of 6,265
inhabitants, to which we may add about 3,000 strangers, composed of the nobility
and Ae richer citizens of the capital, who spend the summer there.
This city is situated on the southern declivity of the Albau Hills, which are
portions of a cluster of lazuli mountains formed by volcanic eruptions ; they are
perfectly isolated in the Roman Campagna.
The Appian Way passes through the centre of the city.
The hi&s tae formed entirely of volcanic materials of recent aerial eruption.
Large beds of basaltine lava flow from their flanks in many places s some of these
reach as far as Rome, to the tomb of Cecilia Metella.
The greater part of these hills is composed of scoria, tufo or sandstone, peperino
and pebbles. The stratification observed in the Alban Hills is simply the result of
. the stratum of rain water and of volcanic ashes. Some materials, more or less
. aiiered by the influence of the air, must of course be found, but all are of a volcaoic
nature, and none proceed from fluviatile or marine agencies.
The peculiar materials are puzzolana or Roman cement, calcined stones, blac^
micd) granites, auphigima, &c. Black granites are found in abundance a iff
282 Cholera in AJbano.
miles further on towards Tusculum on the Hills of Grottaferrata. The waters flow
down their sides in several streams, some of them very ahundant, and supply the
Lakes of Albano, Castel Gandolfo, and Nemi. The water is of excellent quality,
but the inhabitants do not preserve the aqueducts in repair, so that the supply is
insufficient. The overflow canal of the lakes is not used to fill the cisterns.
These geological conditions are by no means favourable to the development
of contagious disease, because they produce ferruginous waters, and a rich
vegetation.
But to neutralize these gifts of nature every precaution for preserving the purity
of the air by public and private sewers has been entirely neglected, owing perhaps
to an excessive confidence in the mildness of the climate and the fertility of the
soil.
The historians of our city, principally desirous to record those events which
participate in the past grandeur of the Roman Empire, and to expatiate on the
remnants of antiquity, have neglected to register the suflferings of the unfortunate
people.
However it is a fact that Albano, although decorated at a remote period with
a suburban episcopal palace, in the midst of a most fertile soil, and in a position
which could easily be defended, for many centuries has had a population far inferior
to that of the neighbouring villages, which were also, like Albano, subject to
baronial sway. Thus in 1594, an epoch comparatively modern, it only counted
730 inhabitants. From this date to our days, the inhabitants have gradually
increased. In fact from the middle of the 17th century up to the approach of
the Asiatic cholera amongst us, the town was never visited by war or famine, or
any of those evils which counteract the increase of population. One meets, how-
ever, with indications of contagious diseases in the old chronicles of the principal
towns situated on the Latin and Alban Hills, as also in the erection of churches and
chapels dedicated to St. Sebastian or St. Roch, whom we Catholics venerate as
special intercessors against contagious diseases. Even in Albano there is a church
dedicated to God in honour of St. Koch.
The town of Albano was visited by the cholera in 1837, from the 5th of August
to the 16th of September, and there fell 170 victims.
From the latest and most exact statistics, which I send you at the end of this
paper, it appears that the cholera epidemic of 1867 lasted 39 days in Albano; viz.
from the 6th of August to the 13th of September, a period almost equal to that of
1837. Out of 677 who were attacked by the disease 443 died, which gives to 100
attacked of each sex, 67 deaths of males, 64 of females. This proportion is
increased if we reckon at least 50 individuals who died during their flight, or in the
neighbouring villages and towns where they had taken refuge. In Rome alone
the number amounted to 20. This number is considerable, if one remembers the
small number of the inhabitants, which after the third day of the epidemic hardly
amounted to 3,500 persons. The greatest proportion of deaths was amongst males,
although there was a greater number of females attacked by the epidemic.
With respect to age, the disease was most fatal to children and aged persons,
and the smallest number of deaths was amongst persons of from 15 to 25 years of
age ; their mortality was only at the rate of about 42 per cent. The greater number
of those attacked by the epidemic were between 35 and 45 years of age.
Although the greater number of deaths was amongst the middle and lower classes
of society, still the highest class had its many and iUustrioua victims.
One may, however, attribute this, perhaps, to the panic terror which seized upon
every one, especially in the very beginning, when during the short period of 48
hours the deaths amounted to 125. It is a recognized fact that terror has a most
powerful effect in almost every contagious disease.
There remains a weighty consideration concerning the chronological progress of
the cholera at Albano, namely, its having increased suddenly from 2 cases to 63.
One reasonable manner of explaining this singularity is, that there were several
well-known cases of cholera in various parts of the town (but principally in the
neighbourhood of St. Roch) as far back as the last week of July. These cases
were concealed hj the townspeople for fear of losing the profit which they drew
Cholera in Albano. 283
finom the very anasual number of persons who were spending the sununer there.
Another element to be taken into consideration is the miasma produced from the
cholera flux in a place where public and private sewers are perfectly unknown.
As also the evaporations of the stagnant waters employed in the tan pits situated
in the neighbourhood of St. Roch, from which there often resulted midignant and
dangerous fevers at the same season in preceding vears. To the foregoing may be
added the unusual lowering of the temperature of the air which took place at the
time, and the contempt of the commonest precautions as to food and cleanliness on
Ihe part of the inhabitants, in spite of the many warnings of the Government, as
they were only a few miles distant from Rome (where the epidemic was known to
have prevailed more or less for the last three months), and in continual contact
with its inhabitants.
The decrease of cholera in Albano is evidently coincident with the precautions
most prudently and energetically enforced by the Papal Government. In fact,
imxaediately after the lamented death of Cardinal Louis Altieri, who fell a
martyr to his zeal for the cai*e of his flock, the Roman prelate Monsignore
AchiUus Appoloni was sent to Albano, invested with full authority as Extraordinary
Delegate. In the first place, as prudence suggested, he set about completely
extinguishing the causes which favoured and extended the contagion. To attain
this object he superintended the necessary precautions in the burial of the dead,
causing the graves to be made separate, about 10 hands deep, with about three hands
high of earth above each grave, and also placing in immediate contact with the
corpse a sufficient quantity of quicklime.
He also caused the public sewers to be covered over, destroyed all the reservoirs
of putrid water and pernicious matter ; he transported the tan pits far from the
inhabited parts of the town, and caused the public wards and courtyards of the
houses to be thoroughly cleaned out. Besides this he caused both the one and
the other to be watered twice a day with sulphate of iron diluted in water. He
caused the interior of the houses to be well fumigated, and fires to be lighted at
sunset at the comers of the streets to purify the air.
To these general precautions the papal delegate joined the most diligent and
intelligent attendance on the sick, in which he was assisted by the medical body
and the difierent religious orders of the neighbourhood, who hastened to ofier their
service wherever it might be usefuL
He availed himself of this opportunity to ventilate some of the narrow streets of
the town, which were still built after the narrow fashion of the feudal times ;
throwing down houses and piercing openings towards the west so as to facilitate
ventilation. He also transferred the public cemetery to a more elevated position,
where it would be less prejudicial to the health of the city.
To face the expenses of these public and private improvements, as also to pro-
cure nourishment and remedies for the sick, he spent above 40,000 francs, of which
the Holy Father furnished 8000 from his private purse j the remainder was
furnished by the town.
According to the reports of the medical men, the symptoms of the disease in
Albano were pretty similar to those observed at the same moment in Rome.
The fury with which it broke out in Albano must therefore be attributed to the
causes above mentioned.
It is impossible to describe the cruelty engendered in mankind by the fear of
an impending and mysterious death, especially when there is little of that habit of
self-possession which usually results from a cultivated mind joined to a deep sense
of religion. The moment it was announced that the cholera had broken out in
Albano all the surrounding villages and towns {of their own authority) cut off
all communication with the persons and objects coming from the infected town ;
ihey even stationed anned guards to secure the observation of this precaution^
They cq)pointed commissioners ^ they drew sanitary cordons, and rigorously repulsed
all those who sought to penetrate their villages. In addition to all the recent
investigations about the contagious nature of the cholera, it may not be useless to
observe that these measures, joined also to other precautions, have efiectuaUjj
confined the influence of the cholera to the sole territory of Albano, thus ofieri||J
a fresh proof of the very evident efficacy of the system of isolation.
iH
Cholera tn ARtano.
• It has also been practised Trith succees on other occasions, espccUlt; in 1656
and 1657, when the Plague in Romo carried off above 14,000 victims in the sole
region of Tranatevere, whilst the remjiiiider of the city was entirely free from its
ravages. This result was principally owing to their having completely isolated the
infected region, by walling up the gates and bridges, and severely guarding the
necessary intercourse ; the penalty of death was incurred by crossing the boundaries.
So much rigour may seem excessive and even barbarous ia this age of milder
civilization, but the legislators of those days preferred the aalration of the greater
number of citizens to every other consideration.
' And they obtained wlwt they sought, since Rome had only to weep for the
desolation of a fourteenth portion of its population, whereas the most flourishing
cities of Italy remained almost deserted.
Such are the main precautions taken during this last disastrous epidemic The
adjoined statistical Tables wilt exhibit the particulars.
ErMEKEGILDO DI CinQUB QcDITlLI,
Scgretarw Generalo della Commustone degli Ospedali di Roma
Diretlore della Stat.islica presso la medenma CommUsiotie.
Soma, 20 Febbraio 1868.
Pboobess of (he Cuoleka Dbatus in Auuto in 1S67.
DiH.
DEATlia.
Date.
B..r
8.
DEiTilS.
Dkitus, 1
1
ll
i
1
1
1
j
1
D1.TS.
1
1
1
flAuBUit -
34
21
ID
11
a
1
so
M
i
JO
in August ■
17 ,.
19 .. -
an ..
!1 .. -
1
e
4
3
10
1
1*
to
M
11
28 August -
as ., -
1 Sept. -
1 ^
1 ;
« : Ti
Unoettalu - 3
Oat-doon - 1 7
'l
Tot«i -Issa
!»)|US
AoES of those who we
re Attacked, Clhed, and Died of Ciiolc&a, with the FaoFOBTio.f
of Deaths to lUO Attacks.
AOB.
A..CKK..
Cl-bed,
!>„.
Dbaths 1
TO 100 Attack*. 1
1
1
1
ill
i
1
1
1
1
i \ -a
1 : 1
ruder bYh
i to 10
10 to 15
•5 10 35
U
IS
«
33
53
13
«
81
M
IB
2S U
li ID
IS ^ 13
' 1 '^
. ' 2
«
40
z
31
'i
IB
81
15
10
IS
87
ST
1
M
H)
Si
SO
w
60
18
HS
47
67
79
7a
100
04
60
41
TO
66
77
87
100
Total
m
314
""
no 1 lu
"'
223
tut
««3
m
61
K
Cholera in Albano. 385
The following extracts are from Mr. Helj's paper.
Albano is a mile long from the ''Porta Roman a" to the Carmelite conircnt of
^La Stella." Castelgandolfo is on n hill a mile northward from Albano, Ariccia
half a mile south-east, passing over the bridge of arches, which is one of the
most magnificent specimens of architecture of our time. Palazzuola is a convent
inhabited bj Augustine hermits, also commanding the lake, and erected on part
of the site once occupied bj the city of Alba Longa, about two miles eastward ;
and the Albano Mount, or Monte Cave, due east, soars above the last-named spots, o
Albano itself is almost surrounded bj hills from north to south-east, and quite
exposed in front from south to west ; hence the coast of the Mediterranean is
seen for an extent of many leagues, and the winds that blow from those two points
and the intermediate naturally strike the town without the slightest impediment.
For a distance of about four miles from the town to the commencement of the
plain the land is cultivated with vineyards, fruit trees, corn, maize, <&c. ; but
immediate!/ dose under Albano are several kitchen gardens and orchards, in
which all kinds of herbs and vegetables are grown for the market.
Between the limits of the town and the said orchards up to the 20th of
August had been built several enormous cisterns, all supplied by the refuse of
the fountains, &c. One of these cisterns served for the purposes of the public
slaughter-house; two others were used to soak hides in, to prepare them for
tanning, the process of which was carried on in a building contiguous to the
habitations ; while others were first let out for washing dirty clothes and such
pnrposes, and after they had been full of these filthy stagnant waters for weeks
were emptied, and the mass of putrefaction they contained was used by the
proprietors of the above kitchen gardens for watering the vegetables and salads
eaten by the inhabitants of Albano. The stench, even at a distance, was positively
nauseous!
Towards the south-west, attached to the church of La Stella, at the farther
extremity of the town, and close to the tomb once thought to be that of the
Horatii and Curatii, but now recognized to be the sepulchre of Aruns, son of
Porsenna, lies the public cemetery in a very low situation beneath the above-men<-
tioned bridge of Ai'iccia, which, if it be a classical and silent spot for the dead, is
certainly not beneficial to the living.
There are but two public fountains supplied with water in the whole town ;
one of these is placed in the most central spot, but the other is almost useless,
being extremely inconveniently situated in one of the most elevated parts of
Albano, the square of " S. Paolo," and supplying a very scanty quantity of water.
In the terrace of the Capuchin convent there is a small fountain of excellent
water, which comes from the adjacent hills.
And in the yard of the same convent there is a capacious reservoir that receives
the rain which drains from the roofs, but up to many days after the arrival of the
commission sent from Home, while the cholera was raging, it had always been
kept closed, and was almost stagnant.
In the above-mentioned square, in front of the chm'ch and convent occupied by
missionary monks, are to be observed several stone covers embedded in the ground,
each of which encloses a supply of water belonging to the gentry and princely
proprietors in Albano and in its vicinities, by which the fountains of their private
WUas and gardens are provided ; but the public at large are excluded from the
use of them.
The consequences of this penury of water are several, curious, and sad. The
principal fountain already alluded to is a continual scene of laughter, strife, and
fighting ; in more than one instance stabbing, and even death, have occurred in
this shocking drama ; the fountain being always crowded with women, men, and
boys, who go there with large copper recipients called " concho," containing many
quarts of water, which they often knock or throw at one another's head ; while at
a &liort distance in the vicinity of ** Rocca-di-Papa," on the west side of Monte
Cave, there is an abundant flow of limpid water, whiah is allowed to go to
waste among the trees of the forest and the rocks and clifis of that picturesque
wilderness, while many overtures have been made for the purchase and conveyance
of it to Albano ; but ill-management and selfishness on the part of persons whoso^
386 Cholera in Albano.
duty it is to remedy such evils, and to remove the cause of the above exposed
flagrant scandals, by wisely providing for the urgent deficiency of a commodity of
first necessity to society and indispensable to health, have always frustrated
every attempt and every exertion made by the honest, benevolent, and con-
scientious few.
It has always been a source of regret and disgust to see how in some countries
one of the paramount means conducive to health and comfort is lost sight of.
For instance, in Albano the sewage is shockingly unheeded, and fearfully ill-
managed, and there is hardly a house that has proper conveniences ; but it is not
only Albano, but almost all the towns in the greater portion of central Italy (not
excepting Rome herself) that well deserve the severe epithet applied to her by
a recent writer in a work descriptive of his travels through Italy — " sentina
gentium."
When it was no longer possible to conceal the existence of the cholera i|^ Rome]
in the month of May, at the time of the concourse from every foreign ^^
the occasion of St. Peter's centenary, and it became evident that the disHf^had
positively manifested itself, thousands of persons escaped from the city.^Kibano
was chosen by many as an asylum, and the throng was so great that the houses
of that town were actually crammed.
In the morning of the 3d of August the town was much excited at the report
that a young maiden lately arrived from Rome had thrown herself out of the
window. The fact was, that during the night she died of cholera, and to conceal
the real cause of her death her body was found in the yard. Tuesday the
6th of the same month an old gardener and another person died of the same
disease in the evening ; but these two cases could not be concealed ; in con-
sequence, several hundreds of persons of every condition quitted the town the
next morning ; the most necessary shops were closed, and Albano soon became
more like a desert than a gay populous town.
It was given out, and foolishly believed, that a dark cloud, in the shape
of an enormous column, had appeared, and brought the cholera to Albano !
I must here inform the reader that on the Sunday previous a public enter-
tainment had been given at the small adjacent village of Ariccia, and the crowd
that fiocked thither was so thick that it resembled more a swollen river than a
concourse of human beings.
Moreover, it is to be observed that the people in general, but the " vUleggiatura "
particularly, who repaired to Albano on this melancholy occasion, indulged to
excess in quantity and inconsiderately in quality, at their repasts, both at table
and at parties and sumptuous picnics, rashly concluding they might with impunity
do at Albano what fear (if not prudence and temperance) had prevented at Rome ;
hence many who quitted that town on the manifestation of the disease, after
having changed the air of Rome, unhealthy at that season, for the more wholesome
air of Albano, died of cholera immediately on their arrival at the Eternal City.
The consequences of the above-stated concourse at Ariccia were also serious
and deplorable ; the throng of people, many of whom, as stated above, had just
repaired to Albano from Rome, where the disease already raged, added to the
intense heat of the atmosphere, and to the many causes of infection already
existing in the town itself, as has been above demonstrated, could not but produce
the unhappy efiects we are contemplating.
The whole population was thrown into the deepest consternation by the almost
incredible and sudden number of cases and deaths on the 7th, which increased
every day more and more, while few out of a hundred attacked survived. This
terrific scene of suffering and mortality continued for a week, when it abated
sensibly, but after a slight lowering of the atmospheric temperature it recom-
menced with still greater fierceness, and so continued for nearly a fortnight.
As soon as the disease appeared all the authorities and officials of the town
escaped or hid themselves ; some thousands, partly visitors and partly inhabitants,
also disappeared ; the canons of the cathedral and other priests shut themselves in
their houses or absconded ; the monks remained in their convents; ^while the poor
Capuchins only and three missionaries devoted themselves to the assistance and
Cholera in Rome.
S87
comfort of the aick and the dying. Some of the dead bodies i-omsined as long aa
six and eren eight days in the houses, until a small portion of the papal Zouaves
arrived from Rome, to the Bucoour of the desolate and distressed surviving. And
it may be recorded to their honour and real glory in this instance, that they gave
an example of chanty and dcTotednesa seldom to be found; but which, alas 1 forms a
melancholy contrast with • • • • Several " S<EurB-de-charit4o "*
alao flew to the boly work, and devoted themselves principally to the direction of
the hotipital and assistance of the infirm, with exemplary alacrity.
The Cardinal Altieri, Bishop of Albano, be it said in this instance to his per-
petnal encominm, manfully, and with Christian zeal, came to the comfort and to the
assiataoce of his afflicted flock ; but alas ! on his way ho met four priests, escaping
the horrid scene of death, in a carriage, whom he obliged to retrace their st«ps.
A few days after his arrival, shocked and grieved at finding the place thus forsaken,
ind likewise at the unseemly manner in which the dead were conducted to their
graves, he fdl a victim to his devotedness to bis ecclesiastical and paternal duties,
and died ot cholera, leaving his flock in still greater bilterness and dismay than be
had found it, lamented by the grateful, and deplored by the juet.
XIII.-CHOLERA IN ROME.
July 6th, 1868. I have just i-eccived a paper by Professor Scalzi, giving the
Gtatistics of the Roman epidemic. I had an opportunity of showing in Rome iho
evidence in proof of (he distribution of cholera matter by water in London, and
I rejoice to find that Professor Scalzi has opened the subject, which certainly
demands attention. Quarantine is of inSnitely less importance. lie describes and
gives analyses of the principal waters : (1) Aegaa Vergine, which takes its riaa at
Salone seven miles from the city ; and from its tiva castelU including that of Trevi,
the well-known Bottina di Piazza di Spogna, and others supplies the best water ;
(2) Acqua Felice, rising 22 miles from the city ; and (3) Acqua Paolo, Rpringing
from Ldigo di firacciano. The openings of the aqueduct, and the uso of wells and
pumps conceded to certain proprietors, he admits, put the purity of the waters,
even of the Trevi, in continual peril, as they receive through those openings
every kind of orduie. There can be no doubt that the waters of the Roman
■qneducta are contaminated either on the gathering grounds in their course or in
their distribution.
In the interest of tho population of this important city the erll should be inves-
tigated fully and remedied.
The subsequent Table is supplied by Professor Scalzi :
Attacks j
a Dkaths in TKn&B Epidbuics or Cboleili iv Boke.
YMiXM.
PoPULiTlOy.
.„™..
Cubed.
Died.
liy ClLOLEBA.
1
i
1
i
1
1
1
i
1
1
i
1
1
Tn inn To
lastM
iii.eia
70,817
_
1M,MT
11S.823
Zla.373
LEU
i,703
fll«
1,321
s.aTa
1,S0S
m
170
Mi
S,!81
BOS
1,030
711
WO
1,618
S,Wl
TO'SO
3W
fill
u jet publuhed for the Epidemic of IsaO-Qt.
288 Cholera in London, 1848-49.
XIV -CHOLERA IN LONDON^ 1848-49.
Extracts from Dr. Farr's Report to the Eegistrar-General
ON Cholera in England in 1848-49.
1. The Thames and the Water Supply op London.
The Thames collects the waters of 6160 square miles of country, extending from
the Cotswold Hills in Gloucestershire to the eastern coast ; and the great body of this
water flows and reflows through London in tides, which caiTy the matter below
London Bridge a mile and a half above Battersea Bridge twice a day, and ascend as
high as Teddington. The contents of the greater pait of the dirains, sinks, and
waterclosets of this vast city and of the 2,360,000 people on its sides are discharged
through the sewei-s into its waters, which, scarcely sullied by the primitive inhabitants
have now lost all their clearness and pmity. The dark, turbid, dirty waters
from half stagnant sewers ai'e agitated by the tides, but are not pmified imtil they
reach the sea.
The Thames presents a large evaporating surface which must be taken into
account, and it gives off vapours day and night in quantities which the phenomena
of a " London fog " reveal. The still air then condenses the matter which at other
times enters the atmosphere invisibly and escapes observation. The mean lowest night
temperature of the Thames from May 27th to September 15th, 1849, was 64° ; the
mean lowest night temperature of the air was 52** ; so that the wide simmering
waters were breathing incessantly into the vast sleeping city tainted vapours, which
the temperatm'c of the air at night would not sustain.
It is a fact well worthy of attention that after the temperatm*e of the Thames has
risen above 60°, diairhoca, summer cholera, and dysenteiy become prevalent, and dis-
appear as the temperature subsides. The cholera reached London in the new
epidemic form about October 1848 ; it prevailed through the winter and destroyed
94 lives in the second week of January, when the temperature of the Thames was
37° ; it declined rapidly through April and May ; the night temperature of the
Thames then rose to G2° in tlie week ending June 2d ; with some fluctuations it went
up to 68® in July, and remained above 60° until the middle of September (week
ending September loth). Tlie deaths from cholera registered dmung each of the
16 weeks were 9, 22, 42, 49, 124, 152, 339, 678, 783, 926, 823, 1230, 1272, 1663,
2026, 1682. The mean night temperature of the Thames fell to 56° ; the deaths
from cholera to 839 in the week September 16-22 ; the temperature gradually fell
to 38° on the last week of November, when there was only one death from cholera
registered.
The mortality from cholera increases generally in descending the river on the
south side ; in Wandsworth it was at the rate of 100 in 10,000 inhabitants, in
Lambeth 120, St. Saviour 153, St. Olave 181, Bennondsey 161, Rotherhithe 205,
where the water was perhaps most impure, Greenwich 75, where it had lost some of
its impurities.
On the north side, commcncinG: at the highest part of the river, the mortality from
cholera was, in Kensington 33, Chelsea 46, Belgravia28, Westminster 68, St. Martin-
in-the-Ficlds 37, Strand 35, West London (on the old Fleet Ditch) 96, London City
38, East London 45, WhiJcchapel 64, St. George-in-the-East 42, Stepney 47,
Poplar 71. The mortality from cholera in the three sub districts of Stepney,
adjoining the Thames, was t\Yico as great as in the two districts away from the
river. The result is here disturbed by elevation. No good analysis has been made
Cholera in London, 1848-49. 289
of tlie Thames water at difTerent points of its course ; but the matter in suspension
is perhape greatest between London Bridge and Limehouse Reach, against Rother-
Mthe.
The seven districts of London in which the mortality is highest from ordinary
causes are the West London District (between Smithfield and the Thames),
St. Saviour, Whitechapel, St. George-in-the-East, Chelsea^ St. Olave, and Rother-
bithe. The J all adjoin the Thames.
Mr. Glaisher, of the Royal Observatory, Greenwich, was requested to make
an estimate of the amount of vapour raised by evaporation from the Thames in
London, and favoured the Registrar General with the subjoined statement : —
" for some yean past I have made daily experiments upon the amount of T^ater evaporated from
a surfiaoe of water, and the amount exceeded 30 inches annually.
^ A depth of water of fully 30 inches must evaporate from the surface of the Thames annually ;
indeed the quantity must be larger than this from the circumstance of its relative high night tempe-
ratures Take it, however, at 30 inches, and we shall have —
2' 5 X 9 X 4840 » 108900 cubic feet evaporated in a year from an area of water of one acre.
108900
Q..gQ. = 678505 gallons of water evaporated in one year from an acre of water.
108900 X 2245 = 244,480,500 cubic feet of water evaporated from a surface of 2245 acres
of water in one year.
244480500 „ . . , .
Q .gQ, = 1,523,242,991 gallons of water evaporated m one year from a surface of
water of 2245 acres in extent, or more than 1523 millions of gallons. The salt water affects the
water at Woolwich ; it is usually what is termed brackish there. Lieut Sanders states that at
Greenwich, at high-water spring tides, the water is frequently brackish.
** The dirt and filth in solution must be very large. The * Dreadnought ' experiments are made
under my direction chiefly, and I can assure you that to read the instruments is a serious affair, owing
to the filth of the waters ; on first pulling them up they are covered with a slimy adhesive mud ;
they first have to be wiped, and if the wind is blowing strongly, this muddy water is blown about and
o^er the observer. A new trunk is now being made, with a perforated copper-bottom tumiog do'^^n-
wards upon hinges, so as to get rid of the enormous deposit.
Upon Mr. Glaisher's estimate, 678,505 gallons evaporate from an acre of water
in a year, which is at the rate of 1857*6 gallons daily. The bed of the Thames in
London is estimated approximately at 2245 acres ; consequently 4,170,000 gallons
are raised from the Thames on an average daily through the year. The quantity
evaporated at low water is, perhaps, much less than this ; on the other hand the
evaporation in summer is more active than in winter, and the proportion of decom-
posing organic matter in the water and on the banks exposed to evaporation is
greater at low than at high water. Hence it is probable that in summer four million
gallons, or about 18,000 tons of water, are raised from the polluted Thames daily
and discharged into the atmosphere which is breathed by the inhabitants of London.
It remains to determine how much of the organic matter in the water is raised with
the vapour at different temperatures.
London derives its supply of water for washing, cleansing, cooking, and drinking,
to a small extent from wells ; 18 disti*icts have supplies from the River Amwell and
£rom the Lea, a tidal tributaiy of the Thames ; two districts from the Ravensboume ;
and IS districts from the Thames, at five points of its coui'se. The water is
generally pumped by steam-power into water-butts or reservoirs in the houses, at
intervals of one, two, or three days. As the water is of very different degrees of
impurity, it will now be right to state the fatality of cholera in the severnJ water
districts of London, aiTanged under the companies by which the water is furnished.
Grand Junction Company, — The waters of the Thames at Kew chiefly supply
the aab-diatricts of Paddington, Hanover-square, and May Fair, and the greater part
of the district of St. James Westminster. The mortality from cholera was at the
rate of 8 in 10,000 inhabitants.
Weit Middlesex Company, — The waters of the Thames at Hammersmith supply
Marylebone and a small part of Hampstcad. The mortality from cholera was at the
rate of 17 in 10,000 inhabitants in Marylebone. In Hampstcad the mortality was 8
in 10,000.
Chelsea Water Company. — The waters of the TJiames at Battersea, much below
BaUeraea Bridge and below the Chelsea Hospital, supply the Belgrave sub-district of
St. Geca^e Hanover-square, and the districts of Chelsea and Westminster. Tha
t 2
290 Cholera in London^ 1848-49.
mortality from cholera was at the mean rate of 47 in 10,000 inhabitants ; in the
Belgi'ave sub-district the deaths from cholera were 28, in Chelsea 46, in Westminster
68 in 10,000 inhabitants.
Southwark Water Company, — ^The waters of the Thames at Battersea^ still
lower down the river, supply the districts of Wandsworth, St. Olave, and Bennond-
sey. The mortality from cholera was at the rate of 147 in 10,000. In Wandsworth
the mortality was 100, in St. Olave 181, in Bermondsey 161 in 10,000.
Lambeth Water Company and Southwark Water Company, — The waters of the
Thames between Waterloo Bridge and the Hungerford Suspension Bridge, supply
parts of the districts of Lambeth, St. Saviour, St. George Southwark, Newington,
and Camberwell ; the other parts of these distiicts being supplied from Battersea by
the Southwark Company. The mortality from cholera was at the rate of 136 in
10,000. In the district of Lambeth the mortality was 120, St. Saviour 153,
St. George Southwark 164, Newington 144, Camberwell 97 in 10,000.
Southwark and East Kent Water Companies, — Rotherhitho is supplied with
water partly by t/ie Thames at Battersea and by the Ravensbourne, and partly
from ditches aud wells, into some of which the drains and cesspools soak. The
mortality from cholera was at the rate of 205 in 10,000 inhabitants.
East London Water Company, — The Lea supplies the districts of Poplar,
Stepney, Bethnal Green, St. George-in-the-East, and Whitechapel with water. The
mortality from cholera was at the mte of 63 in 10,000 inhabitants ; and 71, 47, 90,
42, and 64 in each of the fiyQ districts.
New River Water Company, — The Amwell and the Lea supply Islington, St. Luke,
Clerkenwell, London City, West London, East London, Holborn, St. Giles, the
Strand, St. Martin-in-the-Fields. The mean mortality from cholera was at the rate
of 41 in 10,000 inhabitants ; the mortality was least in Clerkenwell (19), neai* the
head resei'voir ; greatest (96) in West London, on the edge of the Thames.
Kent Water Company, — The waters of the Ravensboume supply Gi^eenwich,
where the mortality from cholera was 75 in 10,000 inhabitants ; and parts of Lewis-
ham, where the cholera was at the rate of 30 in 10,000 inhabitants.
Two or more companies supply some districts. Tho district of St. James West-
minster is supplied by the Kew and the New River waters ; the mortality from cholera
was 16 in 10,000 inhabitants ; Kensington is supplied by the West Middlesex, the
Chelsea and the Grand Junction Companies ; the mortality from cholera was 33 in
10,000. St. Pancras is supplied by the New River, Hampstead, and the West
Middlesex Companies ; the mortality from cholera was 22 in 10,000. Shoreditch
and Hackney are supplied by the New River and the East London Companies ; the
mortality in the two districts from cholera was 76 and 25 in 10,000.
Arranging the groups of districts in tho order of mortality, it appears that the
mortality from cholera was lowest in districts which have their water chiefly from
the Thames so high in its course as Hammeramith and Kew. Upon the other hand
the mortality was greatest in the districts which derive their water from the Thames
so low down as Battei*sea and the Hungerford Bridge. The districts of the New
River occupy an intermediate station.
In the 6 districts which are supplied with water taken from the Thames at Kew
and Hammersmith, 15 in 10,000 inhabitants died from cholera ; and the mortality
ranged from 8 to 33.
In the 20 districts which are supplied with water from the Amwell, the Lea, and
the Ravensbourne, 48 in 10,000 inhabitants died of cholera ; and the mortality
ranged from 19 to 96.
In the 12 districts which are supplied with water taken fi'om the Thames between
Battersea and the Waterloo Bridge, 123 in 10,000 inhabitants died of cholera; and
the mortality ranged from 28 to 205.
In the second group of districts cholera was three times as fatal ; in the third
eight times as fatal as it was in the fii*st : 1, 3, and 8, express the relative virulence
of the epidemic in the three conditions. The density of the population was greatest
'n the central group, and nearly the same in the first and third group.
Cholera in London, 1848-49.
291
1 LONDON.
1 Group ov Dibtsicts.
Deaths from
Cholera to
10.000 Persons
Living.
Density of
Population
(Persons to an
Acre).
Elevation in
Feet above
High -water
Mark (Trinity).
Annual Value
of Houses
(Year ending
April Mb, 1S43).
1 6 I>i6trict8 sappUed with Water'
1 taken from the Thames above >
15
72
105
£
82
1 Battebbea - - - -
1 20 Districts sapplied with Water'
fit>m the New Riyeb, the Lea, *
and the Ratensboubkb
48
137
42
44
12 I^tricts rapplied with Water"
taken from the Thames, he- 1
1 tween Battebsea and Wa-
123
73
5
31
1 tertx>o Bbiikses - - V
Cholera Report^ 1848-9, jt?p. Iviii-lxi.
2, Theory of the Propagation of Cholera.
Jameson, in the last page of the vSupplement to his admirable '* Report on Cholera
in Bengal,'^ after noticing that some of the natives placed '* great faith in boiled
wafer as a preventive/' and that one of the principal native gentlemen of Calcutta
ascribed the '^ singular healthiness of his numerous household to his having taken
** the simple precaution of allowing no water to be drunk by them until it had been
" previously boiled," adds : " Bad water no doubt sometimes immediately induces
*' the disorder; but we must not suppose it is the sole cause of it."* This is borne
oat bj some observations in the Indian Reports, where, however, the sources of the
water supply are too seldom referred to, although a popular belief prevails in many
countries of India that it is the water which produces ague and remittent fever. f
Dr. Barnes, who had medical charge of the district of Jessore in Bengal from 1810
to 1822, but who was absent in part of the years 1816 and 1817 when the disease
assumed the epidemic character, stated in 1831 that he had there been intimately
acquainted with the disease as an endemic. He had considered it from the first
as a disease peculiar to that country and previously unknown, which had superseded
the periodical remittent fever formerly so prevalent. If the annual storms <^
violent thunder, lightning, wind, and rain commenced early in March, and recurred
at short intervala until the rainy season began, the hot season (April, May, June)
was, he says, comparatively healthy, and conversely : if the rains broke up at the
end of August, and the- waters sank rapidly during September, the cholera com-
menced its attack at the beginning of October, carrying death and desolation
among the inhabitants until the middle of December, when the disease in a short
time became apparently extinct. Instead of the usual rainy and dry season,
scarcely a week of 1816, in Jessore, was without rain ; the sun was constantly
obscured ; the atmosphere close, heavy, moist ; the thermometer from March to
November' ranging between 70° and 95°. The crowded, ill-ventilated native huts
are on mounds surrounded with pits, which are the receptacles of stagnant water
and of every kind of filth. Dr. Barnes asserts unhesitatingly that in these circum-
stances the Asiatic epidemic was generated from the exhalations arising from the
decomposition of animal and vegetable matter and the use of water in which this
process was continually going on. " These," he emphatically declares, " were the
sole cause of this disease "^
♦ Report on Cholera Morhus in Bengal, by James Jameson, p. 324, Supplement
t See Bishop Heber*8 Indian Journal, ed. 1843, chap, xvii., p. 253. In a previous page (251) is a
good description of the depressing and degrading effects of malaria on man.
t Letter addressed to Dr. Roupell, Dr. Babington, H. Field, Esq., and J. Ridout, Esq., members
of the London Board of Health, dated Nov. 12, 1831, published in M'Colioch aad Madaren oiy
Cholera, pp. 26*35, 1850.
292 Cholera in London, 1848-49.
" In the autumn of 1849, Dr. Brittain and Dr. Swayne, of Bristol, considered
" that they had discovered the cause of cholera in a minute fundus ; and Dr. W.
'^ Budd, of the same city, met with the supposed fungus in various specimens of
" water used as drink, in places where the cholera was very prevalent"* Upon
further investigation the supposed fungi were, by experienced microscopists, pro-
nounced to be other matters ; and after the able Report of the Committee of the
London College of Physicians, the hypothesis was generally abandoned.
Dr. Snow, in a paper dated Aug. 29, 1849, advanced a theory of the pathology
of cholera ; and it is in many respects the most important theory that has yet been
propounded. Dr. Snow, after endeavouring in a subsequent paper to show that
the disease is propagated by human intercourse, and that it is a local affection of
the alimentary canal, thus states his doctrine : —
'' The induction from these data is that the disease must be caused by some-
thing which passes from the mucous membrane of the alimentary canal of one
patient to that of the other, which it can only do by being swallowed ; and as the
disease grows in a community by what it feeds upon, attacking a few people in a
town first, and then becoming more prevalent, it is clear that the cholera poison
must mul^ply itself by a kind of growth, changing surrounding materials to its
own nature like any other morbid poison ; this increase is the cause of the nuUeries
morbi of cholera taning place in the alimentary canal.
*^ The instances in which minute quantities of the ejections and dejections of
cholera patients must be swallowed are sufficiently numerous to account for the
spread of the disease ; and on examination it is found to spread most where the
facilities for this mode of communication are greatest. Nothing has been found
to favour the extension of cholera more than want of personal cleanliness,
whether arising from habit or scarcity of water, although the circumstance
hitherto remained unexplained. The bed-linen nearly always becomes wetted by
the cholera evacuations, and as these are devoid of the usual colour and odour, the
hands of persons waiting on the patient become soiled, and unless these persons are
scrupulously cleanly in their habits, and wash their hands upon taking food, they
must accidentally swallow some of the excretion, and leave some on the food they
handle or prepare, which has to be eaten by the rest of the family, who, amongst
the working classes, often have to take their meals in the sick room. Hence the
thousands of instances in which, amongst this class of the population, a case of
cholera in one member of the family is followed by other cases ; whilst medical
men and others, who merely visit the patients, generally escape.
" With only the means of communication which we have been considering, the
cholera would be constrained to confine itself chiefly to poor and crowded dwellings,
and would be continually liable to die out accidentally in a place for want of the
opportunity to reach fresh victims ; but there is often a way open for it to extend
itself more widely, and that is by the mixture of the cholera evacuations with
the water used for drinking and culinary purposes, either by permeating the
ground and getting into wells, or by running along channels and sewers into the
rivers."t
Dr. lAoydf on Aug. 30, 1849, at a meeting of the South London Medical
Society, adduced instances of the great mortality from cholera, of people living in
Silver-street and Charlotte-place, Hotherhithe, who got their water from a well
and a ditch into which the privies discharged their contents. The disease was
much more fatal in the parts of Rotherhithe where ditch-water was used than it
was in places which had their supply from the waterworks. Dr. Snow has col-
lected examples in the South London districts where the water, being derived
from deep wells, few cases of cholera occurred ; and other instances of a great
fatality among people living in houses, such as those in Wandsworth-road,
wheie the contents of the waterclosets found their way into the water. He shows,
from a communication by Dr. Shapter, that in 1832 Exeter was supplied with
water taken from the streams of the Exe, into which the sewers emptied them-
• Dr. Snow on Cholera, paper read at the Epidemiological Society. 1851.
. f '* On the Pathology and Mode of Communication of Cholera," by John Snow, M.D. (Paper
■»riuted from the XiOndon Medical Gazette, pp. 2, 3).
Cholera in London, 1848-49. 293
selves ; and that subsequently waterworks were established on the river, two miles
above the toivn, and more than two miles above the tidal range. In three months
of 1832 cholera destroyed 347 lives in Exeter; in 1849 it was only fatal to 44
peraons, many of them strangers, who died within three days of their arrival. An
opposite instance is afforded by Hull, which in 1832 was scantily supplied with
water from springs at Anlaby, three miles distant. About seven years since
waterworks were established on the River Hull, two miles and three-quarters above
its confluence with the Humber, and afford the town a plentiful supply. But half
the sewage of the town is delivered into the waters of the River Hull, half into the
Humber ; the tide flows up the river many miles past the waterworks, and carries
with it the contaminated liquids of the sewers. In 1832 the cholera was confined
almost exclusively to the poor, and the deaths amounted to about 300 ; in 1849
the deaths were 1178, and occurred among all classes of persons.* Negative and
positive instances in other towns are cited by Dr. Snow ; and in their Reports to
the Board of Health by Dr. Sutherland and Mr. Grainger.
I>r. Snow's theory of the propagation of Asiatic cholera in London is very
simple. The cholera matter was brought to London by patients from Hamburgh ;
it was multiplied in the intestines of infected people until the disease spread in this
way all over the metropolis. It necessarily implies that the rice-water discharges
of the cholera patients may, under the present system of water-supply, be distri-
buted unchanged to nearly every house in London where water is used for drink,
ablution, and washing. Dr. Snow is unfortunately able to show that this exere-
mental dbtribution, sJmost too revolting and disgusting to write or read, is possible
to a very considerable extent.f The sewers of LK)ndon run into the Thames and
the Lea, from which a part of the water-supply is derived. The water, which th^
inhabitants of London have but the repulsive alternative to discuss in words or to
use in &ct, is, however, baled from the ditches only by the wretched inhabitants
of such parts as Jacob's Island. It is in one case, before distribution, pumped up
to a distant reservoir at Brixton ; in other cases it is taken higher up the rivers,
largely diluted, or beyond the reach of any but casual contamination ; filtration is
4£TQpVoyed $ chemical action, as the chemists on behnlf of their wealthy clients tell
us, is incessantly going on, and converting impurities into simple elements ; so that
it is only in some places, or in rare circumstances, that tlie organic waste can
reach and injure the people. Still, in this mitigated form, the risk is too tremendous
to be incurred by two millions and a half of the people, who require and can pbtain
an abundance of sweet water.
The supply of Paris is from various sources, but four-fifths of the water is from
the Canal de TOurque, which, by the decision of Napoleon, was also appropriated
to navigation. The water for some years, and in 1832, when the first e[)i(]emic
was so fatal, was drawn from the dirty basin in which the boats and barges of the
canals rested ; but is now drawn from the canal iHjforo it enters the basin. The
water in the Regent's Canal round London and i\\ trie Cumberland Basin, Roo'ent'fi-
park, present a pretty faithful image of the v/uters t' ^he Canal de rOurquo,'>vhich
iow from the fountains and supply the want of the Turisians. The water in the
Cumberland Basin is described by Dr. Milroy as " in a most offensive state, and
** indeed no better than that of a stagnant p.itrid ditch ; and a great deal ot
*' choleraic disease prevailed among the men who were eni^ 'eyed in the barges,
" and most of the families living in the houses on the whrirvc were more or less
" aflfected/'J The mortality of cholera in Paris was excessive, ; nd in 1832 varied
from 80 of 10,000 inhabitants in the elegant Chaussee d'Antin ar I in Montmartro
on the heights, to 530 and 520 in the low Quartiers of the Hotel Jo Ville and the
Cite.§ The experience of Paris then, as well as of many of our onn towns, lends
some countenance to Dr. Snow's theory.
Cholera Report^ 1848-9, j^P- Ixxvi — Ixxviii.
* Dr. Snovy pp. 7, 8. The numbers -..f denths in 1849 are from the present ret-irna.
* f •*On the coinmnnicalion of chf)K'!:i," by J. Snow, M.D., pp. 23-2G.
I Report of Guneral Boar-l of Health on ChoUra, ]•. 4S.
§ Etudes snr la Ville dc I'an^, p:ir Horace Say, pp. GS4-422, 4 SI, and maps. And Rapper du
Chol&a dans Paris, 1834.
294 Cholera in London, 1848-19.
3. The Zymotic Principle op Cholera.
It may, I think, be admitted that the disease Asiatic cholera is induced in man
"by a certain specific matter, and as it has been proposed to call the matter varioline
•which causes small-pox, so cliolrine may designate the zymotic principle of cholera.
A variety of that matter was produced in India in certain unfavourable circum-
stances; it had the property of propagating and multiplying itself in air, or water,
or food, and of destroying men by producing in successive attacks the series of
phenoraeoa which constitute Asiatic cholera.
That cholrine is an organic matter cannot, I think, bo doubted by those who
have studied the whole of its phenomena and the general laws of zymotic disease.
The great questions remain — Is cholrine produced in the human organization
alone and propagated by excreted matter ? Is it produced and propagated in dead
animal or vegetable matter or mixed infusions of excreta and other matter out of
the body ? Is it propagated through water, through air, through contact, or
through all these channels ?
Observations sufficiently exact to decide these questions definitively have yet to
be made and discussed on the principles of probability. The decisive facts cannot
be investigated by experiments in which human life may be exposed to risk. They
must be carefully looked for and noted by good observers. Conflicting theories
serve, among other purposes, to direct the attention of observers to important
points which they may otherwise neglect. Cholera Report, 1848-9, p. Ixxx.
4. Precautions against Cholera in regard to Water.
The precautions to take against cholera, in regard to watery are well stated
by Dr. Snow ; and they are of so simple a nature that, considering all the facts, no
person can prudently neglect them.*
(a.) Water into which sewers flow, or which is navigated by persons living in
boats, or which is any other way contaminated by the contents of drains or cess-
pools, should be entirely disused.
[To warn any class of men against the use of unclean excremental water, oven
filtered, may appear useless. But it is now known that it enters into the supply of
some of the principal cities of Europe and contaminates the eau sucree of Paris as
well as the house water of London. The disagreeable revolting nature of this
truth has probably been a cause of its suppression, and the consequent perpetuation
of an insufferable nuisance.]
(b,) Hand-basins and towels, with sufficient water, should always be in readiness
in the sick person's room, where everyone should observe strict cleanliness ; nurses
and other people should invariably wash their hands before touching food.
(c.) The healthy should be separated from the sick, and be removed to another
abode when they have no place but the sick-room in which to prepare and take
their meals.
{d.) Soiled linen should be immersed in water until it can be scalded and washed;
for if it should become dry the matter might be wafted about in the form of dust.
[The washing of the linen of cholera patients in the ordinary way is apparently
not unattended with danger.]
The sanitaiy value of pure water, as well as the danger of habitually using water
holding organic matter of any sort in solution, has been known from the earliest
period. Instinct and science hallow springs and streams of living water. It is a
difficult engineering task to place an adequate supply of fresh water within the
reach of every householder in the large towns ; but the task is of such vital import-
ance that it cannot be neglected, and the mission of bringing it within the range
of the municipal institutions of London, Paris, and every city, is too beneficent to
be overlooked by statesmen. Tlie quality of the best water is only to be discovered
by experience ; and may be learnt with sufficient accuracy from analyses of the
waters of the salubrious fields. Cholera Report^ 1848-9, pp. ci-cii.
♦ Slightly altered from Paper on Cholera, by J. Snow, M.D., p. 23 ; read May 5, June 2, 1851,
before the Epidemiological Society.
Cholera in London^ 1853-54. 295
XV.-CHOLERA IN LONDON^ 1853-54.
Extract fbom Dr. Farr's Letter to the Registrar General
ON THE Cholera Epidemic of 1853-54.
1. LiPUBE Water.
Xndependcntlj of an/ regard to theory, it appeared to be desirable to determine
the effects of the different waters on the population of London during the impending
cbolera epidemic ; accordingly the following circular was addressed by Mr. Mann
to the. Secretaries of the several Water Companies : —
Sir, General Register Office, 13th October 1853.
The Registrar Greneral will feel obliged if you will answer the accompanying inqoiiies for the
public infonnation.
I have the honour to be, Sir,
Tour obedient servant,
To the Secretary of Water Company. (Signed) T. Mann.
1. What is the source from which the Water Company obtains the water for the supply of the
London districts? If wholly or partly from a river or running stream, state at what point
the supply is taken.
3. Is it the same as it was in 1849 ?
3. Are the methods of filtration and purification the same as those in use in 1849 ?
4. Is the area ot supply the same ?
5. If any changes have been made in either of the above particulars, what are the date and nature*
oi those cluuiges ?
6. If any change is contemplated in the existing arrangements, what is its nature, and when is it
likely to come into operation ?
A detailed abstract of the answers of the secretaries was published in a supple-
ment to the Weekly Return, No. 47.> November 19th, 1853 ; and the general result
was thus sununed up : —
From the returns received from the Water Companies it appears that cholera finds London, as
regards water, in the situation in which it left it. Tliis holds true with reference to all except the
Lambeth Waterworks Company, who changed their source of supply nearly two years ago from
Lambeth to Thames Ditton ; and from a Table subjoined it will be seen that the results of the
present epidemic in the districts supplied by that company, as compared with some others, are rather
more satis&ctory than they were in 1649, an improvement which, it is hoped, in the further course
of events will be maintained. But new works undertaken by other companies in accordance with
recent legislation are in progress. The return of cholera at an earlier period than was anticipated
famishes a motive for increased activity in their operations. With capital, public spirit, and natural
advantages of locality, London may enjoy a pure and copious supply of this first necessary of life»
as well as country towns and villages, and more than some towns with municipal institutions where
the burgesses are too idle, or too busy, or too poor to bring it from surrounding springs to their
doors. Manchester has set a good example, and it is only necessary that the national intelligence
should be generally awakened to the question, for this great end — a good water supply — to be
accomplished both in town and countiy.
296
Cholera in London, 1853-54.
Water Companies.
Sources of Supply.
Aggregate of Districts supplied
chiefly by the
respective Water Companies.
Deaths to
100,000
Inha-
bitants.
Elevation
in feet
above
Trinity
High-water
Mark.
Population
enumerated
1861.
Deaths from
Cholera in
12 Weeks
ending
Nov. 12,
1853.
88
626
27
LONDON « • -
Hampstead and New
Ei?er.
New River ■ - -
Grand Junction -
Chelsea - - - -
Kent - • . -
West Middlesex - -
Bast London
Lambeth and South-
wark.
Southwark - - -
Southwark and Kent -
Springs at Hampstead and Ken-
wood, two artesian wells, and
New Eiver.
At Chadwell Springs in Hert-
fordshire, ftrom Biver Lee, and
four wells in Middlesex and
Herts.
The Thames, 860 yards above
Kew Bridge.
The Thames, at Battersea -
The Bavensboume, in Kent
The Thames, at Barnes
The Biver Lee, at Lee Bridge -
The Thames, at Thames Ditton
and at Battersea.
The Thames, at Battersea -
The Thames, at Battersea, the
Bavensboume in Kent, and
ditches and wells.
80
76
88
7
18
72
26
1
8
166,956
634^468
109,686
122,147
13i200
277,700
484.694
346,368
118.267
17306
6
14
22
27
72
124
198
100
18
4
8
13
18
20
26
29
56
85
101
It is believed that through nearly the whole of this Table the impurity of the waters with which
the inhabitants of the several districts are supplied is in nearly a direct proportion to the mortality
£rom cholera.
The water at St. Thomas's Hospital is thus described by Dr. B. Dundas Thomson, the Professor
of Chemistry : —
The water as delivered at the pipe in the Laboratory of St. Thomas's Hospital on the 11th No-
vember was quite turbid, as it usually is, and contained diffused through it 1* 16 grains of vegetable
matter, dried at a steam heat, consisting principally of silica, the chief constituent of the shields of
the lower class of plants. But as in its moist state it contained at least two thirds of its weight
of water, we cannot estimate the filth in the water, which could be removed by filtration, at less
than 3^ grains per gallon.
The influence of the water became more evident ; and was discussed in the
supplement to the Weekly Return (December 3d, 1853), from which the following
Table is taken : —
Cholera in London^ 1853-54.
297
MOSTAIXTT 7R0X ChOLERA IN DISTRICTS SUPPLIED BT DIFFERENT WaTER COMPANIES.
Water Compsnies.
Sonroes <rf 8ixiq)ljr.
A|;gregate of Districts supplied
chiefly by the
respective Water Companies.
Elevation
in feet
above
Trinity
High-water
Mark.
Population
enumerated
185L
Deaths finom
Cholera in
14 Weeks
ending
Nov. 26,
185S.
Deaths to
100,000
Inha-
bitants.
LOITDON
* (1) Hampstead and
(£) New Biver.
L
Grsnd Jnnetion
ChelMa •
Kent • •
WeaitMiddleMz
East London -
• (1> Lambeth and (2)
SoccUiwark.
Boothwaxk • • .
• (1) Soathwark and (2)
Kent.
SprinM at Hampstead and Ken-
wood, two artesian wells, and
New Biver.
At Chadwell Springs in Hert-
fordshire, fhmi Biver Lee, and
four wells in Middlesex, and
Herto.
The Thames, 860 yards above
Kew Bridge.
The Thames, at Battersea -
The Bavensboume, in Kent
The Thames, at Barnes
The Biver Lee, at Lee Bridge -
The Thames, at Thames Ditton
and at Battersea.
The Thames, at Battersea
The Thames, at Battersea, the
Bavensboume in Kent, and
ditches and wells.
98
80
76
88
7
18
72
26
1
8
2,862,286
166,966
68^468
109,636
122,147
184^200
277,700
484^694
846,868
118,267
17,805
744
82
8
66
16
22
81
89
162
220
121
19
6
9
15
18
23
82
87
64
102
107
* In three cases (marked with an asterisk) the same districts are supplied by two companies.
After correctiiiff the above Table and the tables of cholera 1848-49, for the effects of elevation,
it \B fotmd that a large residnal mortality remains, which is fairly referable to the impurity of the
water ; for it is leott where the water is known to be sweetest, greatest where the water is known to
be the most impure.
AAer the great lots of life in 1849, and the patient investigations of two able committees of the
Honse ot C^nmons, the preset water companies were left in the undisturbed possession of the
mofnopol^, which thiey enjoy, of selling the people of London water. In the present state of
engineenuig and sanatory science, purer waters from gathering grounds, or from springs, could pro-
batdy be procured, and be supplied at cheaper rates by new companies, or by the incorporated rate-
payers. But this would disturb the values of large masses of invested capital. To avoid such a
result, always undesirable, the supply is left in the hands of the existing companies ; but by Act of
FSariiament they are prolubited from obtaining supplies frx>m the tidal waters of the Thames and
liCe, after certain fixed dates.
It is enacted, that it shall not be lawful '^ after those dates " to distribute the pernicious waters
over London. It unfortunately happens that in the invasion of cholera with which we arc threatened
next year (1854), every parish, except those which the Lambeth Company supplies, may receive
waters m» bad as those of 1849 without a direct violation of the Act of Parliament.
^ But the Water Companies will do well to bear in mind that the dates in the Act are the extreme
limits of time beyond which they can supply London with impure water without a direct violation
of the law. They may complete the works in half the time. They can accelerate their progress.
And^ the retnmB which they have ftLmished will enable us to appreciate their zeal and spirit in the
public service under an extraordinary emergency.
Instead of the distant dates of 31st August 1855, 1856, and 1857, which were fixed when the
return of cholera was not contemplated, the companies should aim at supplying London with the water
which they are then bound to furnish, at a date not later than the first of July 1854. This would
probably be the means of saving thousands of lives, and entitle the directors to tiie public gratitude.
Bates after which it will not be " lawful " for the Water Companies to supply waters from the
same sources, or of the same quality, as at present (1853), to the inhabitants of London :
New River
Grand Junction
Chebea
West Middlesex
East London
Southwark
30th June 1857.
31st August 1855,
31st August 1856.
31st August 1855.
August 1856.
3 1st August 1855.
The Grand Junction and the Southwark Companies state that they propose to complete their
works in 1854, a year before the limit prescribed by the Legislature.
298 Cholera in London^ 1853-54.
The cholera broke out again in 1854 : the effects of the bad water were watched
during the epidemic ; and the general results of a special inquiry are thus described
in the Weekly Return (October 14th, 1854).
Influence of the Waters of London on the Mobtalitt of Choleka«
The present epidemic of cholera in London presents a faTourable opportunity for determining the
influence of waters of various degrees of impurity on the mortality of cholera.
The Lambeth Company, which in 1849 took up its supply from the Thames at the part where the
water is most impure, has since January 1 852 drawn its water from the Thames above the tidal flow,
and has thus afforded an opportunity for ascertaining the effects of this great improvement.
It was observed in the first eruption (1853) of the present epidemic that the mortality was dimin*
ished in districts which were partially supplied by that company.
On October 13th, 1853, a circular had been sent to the London Water Companies, and the replies
of all, except the Lambeth Company, showed that their new works and improvements had not then
been carried out, as they were only bound under the Act of Parliament to complete them in 1855,
1856, or 1857.* . .
The Southwark Company, which now supplies the most impure water stated, however, that though
the Act '* allowed three years from August 1852 for the execution of the new works, the contracts
for the whole having been made immediatelv after the passing of the Act, and being now [October]
in a rapid course offulfibnenty the works will be completed ana in operation one year within tlie time it
prescribes" that is in September 1854.
The hopes of the Company, notwithstanding their efforts on the approach of cholera, were defeated,
the officers informed Lord Palmerston, by a concurrence of various causes, and the impure water of
the Thames is still supplied by this Company.
Bermondsey, one of the south districts of London, is exclusively supplied with the impure water,
and the deaths by cholera are already more numerous than they were in 1849, while in the parish of
Lambeth, which is supplied partly by the Southwark Company, and partly by the Lam1;feth Company,
the mortality is much lower than it was in 1849.
Deaths from Cholera.
Districts. In the year 1849. In the 14 weeks ending 14th Oct 1854.
Bermondsey • - 734 .... S29
Lambeth - - 1,618 ... - 904
But the pipes of the two Companies which were once in active competition often run down the same
streets, and through the same sub-districts, so that alternate streets or houses in the same sub-districts
are supplied with the pure and the impure waters.
Dr. Snow, who has devoted much time to the investigation, having procured from this office the
addresses of the persons who died of cholera in Kennington and some other sub-districts, states, as
the result of an inquiry from house to house where the pipes of the Lambeth Water Company are
intimately mixed with those of the Southwark Company, ^at, in the 7 weeks ending August 26th, of
600 deaths from cholera, 475 have happened in houses supplied bv the Southwark Company ; 89 in
houses supplied by the Lambeth Company; 13 in houses supplied by pumps, wells, and springs;
8 in houses which derived their water directly from the Thames and from ditches.
The Registrars on the south side of London were instructed to inquire, in all cases of death by
cholera, whether the house in which the patient was attacked was supplied by the Southwark, the
Lambeth, or the Kent Companies, or with water from pumps, wells, ditches, or other sources. The
inquiry was attended with considerable difficulty, as the information could not be obtained from
hospitals or workhouses, and the informants and the householders themselves were often ignorant of
the source of supply, as the water rate in the worst districts is paid by the landlord. The informa-
tion was thus not obtained in 766 out of 3805 instances ; but it was stated that in 3039 instances
2284 deaths occurred in houses supplied with the impure Thames water, 294 in the houses supplied
by the Lambeth Company with the purer filtered Thames water. The disparity was observed week
after week in the progress of the epidemic.
The total number of houses supplied by the Southwark Company is stated to be 40,046 ; by the
Lambeth Company to be 26,107 ; consequently there were in 6 weeks 57 deaths in every 1000 houses
supplied with impure water, and 1 1 in every 1000 supplied with the less impure or comparatively
pure water.
• Tlie Secretary of tho East London Water C<3tapany in August 1854 wrote thus to Viscount Palmerston ^—
* lu reply to your Lordship's inquiry, what steps have been taken by the East London Waterworks Company
to effect a remedy in rcffard to the water supplied by them, I am instructed to state that the Company baa
already expended 150,000f. in effecting improvements ; the supply has, for two months past, been taken through
a newly constructed aqueduct, from a point in the valley of the Lee, nearly three miles higher up than
formerly : the sewage of the valley, so far as it can effect the purity of this Company's supply, has been
diverted by an interceptiug drain, and the whole of tho water delivered, is filtered. Further works 9x9 tim in
progress."
Cholera in London, 1853-54»
299
MoRTALiTT bj Cboubsa in the South Dutbicts of Lokdox during the Six Weeks—
August 28 to October 7, 1854.
Inhabited
Houses.
Population
enumerated
1861.
Deaths
from
Cholera.
Mortality to
every 100,000
Inhabitants.
Mortality to
every 1,000
Houses.
flouUi Districts of London
92,654
616,686
8,806
617
41
DxATHS by Cholbba in Six Wbekb in the Houses of the South Distbicts of London
supplied with Water frmn various Sources.
Weekending
Number of Houses supplied with Water by 1
The
Southwark
Company.
The
Kent
Company.
The
Lambeth
Company.
Pump«,"Wells,
and
other Sources.
Unascer-
tained
Sources.
Total.
Septembers • •
September 9 - -
September 16 -
September 28 •
SeptemberdO •
Octobcr7 - - -
899
580
624
483
228
121
88
45
48
28
19
10
46
72
66
72
25
14
72
62
4«
62
24
9
116
218
174
ISO
87
46
670
978
856
724
888
200
2,284
188
294
278
766
8,805
Ji^TLVEVCE of the Wateb Supply on the Mortality from CnoLEHA in the South Districts
of London during the Six Weeks from August 28th to October 7th, 1854.
Water Compsny.
Bouroe of Supply.
Houses
supplied.
Estimated
Population
of the
Houses
supplied.
Deaths
registered
by Cholera
in Houses.
MorUlity
to every
100,000
Inhabi-
tants.
Mortality
to every
1,000
Houses.
Southwark Company -
Lambeth Company -
Kent Company •
The Thames, at Bat-
tersea.
The Thame8,at Thames
Ditton.
The Bavcnsboumo -
40,016*
26,107
14,594
266,516
178,748
97,127
2,284
291
188
857
169
194
67
11
13
* There are, exclusive of this number, 634 consumers, vis., railwsys, distilleries, road watering, flres, flushinir
•ewers, and trades generally, averaging per day 2366 gallons. (See Parliamentary Return, " MetroiMlisWater,^*
dated 26th July 1854, No. 415.)
NoU.-^the sources of water supply was not ascertained in 766 instances. The water was said to bo derived
from pomps, wells, rivers* and other sources in 273 instances.
At the close of the epidemic the results of the observations on the water were
finallj summed up in the Weekly Return, December 9th, 1854.
The deaths of 26,088 people in London, out of two millions and a half^ living in 135 sub-districts
St elcTations rising from 3 feet below to 350 feet above the high-water mark of the Thames, have
shown how much more fatal the cholera is on low groimd tihan it is on ground of a moderate
deration.
It has been calculated that more than four million gallons of water evaporate daily from the
Thames in its course through London ; and besides the supply from wells, pumps, and streams, nine
water companies in their returns state that they pumped on an average 60,614,420 gallons of water
into 302,428 houses and a certain number of manufactories daily, during the year 1853. The water
that flows through the houses and streets daily is probably double the weight of the population. It
is pomped at intervals into reservoirs until it is withdrawn for cooking, for cleansing, for washing
Hnen, for ablution, and in some cases for drink by the people. It thus comes into contact with the
body in many ways and it gives off incessantly at its temperature, ranging from the freezing point to
rammer heat, vapors and eflBuvia into the atmosphere that is breathed in every room ; while the
lendue is discharged to carry the dirt of the houses and the town-guano of the waterclosets into the
and the Thames.
300 (Hiolera in London, 1853-54.
A certain portion of the water of London is drawn by the New River Company from distant
springs and wells in the basin of the Lee river, which is a tributary of the Thames ; bnt a large
quantity of the water of this company, as well as the whole of the water of the East London Com-
pany is drawn from the Lee lower down its channel. The Lambeth Company draws its water from
the Thames at Ditton above the tidal range, but the Grand Junction at Kew, the West Middlesex at
Hammersmith, and still lower down at Battersea, the Chelsea and the SonUiwark Companies draw
up their water fr^m a part where the Thames is now evidently contaminated by the sewers which
ducharge the dndnage of the population into the river. The temperature of the water of the
Thames ranged from 60^ to 7CK> during the cholera epidemics, and the chemical compondon and
chanees of the matters in its waters undoubtedly varied to a great extent ; bnt the microscope and
chemical anal3rsis have confirmed the evidence of the senses, in showing that the water which the
Chelsea and Uie Southwark Companies draw at Battersea contains the greatest quantity of oiganic
matter ; that it is the most impure ; and that fr-agments of the muBcular fibre m food exist in the
Southwark water. The other waters are of a better quality.
The mortality frt)m cholera in the sub-districts of London is shown under two aspects ; thus, the
mean mortality of the districts wholly or partially supplied by the New Biver Company in the two
epidemics was at the rate of 15, 28, 28, 46, and 70 in every 10,000 living on the successive terraces
of elevation ; and the mortality in the sub-districts that are supplied by other companies at corre-
sponding elevations is found to differ from this scale, some in excess, others in defect.
In the supply by all the companies extensive improvements are projected, and in some cases have
been partially carried out. The New River Company states in reply to an inquiry, that *^ works
have been since June in operation to prevent sewage from Waltham, Ponder*s-end, and Tottenham
running into the river Lea, which before affected the pumping station at Tottenham." On the terrace
of 60 to 80 feet elevation, containing Berwick street, the cholera was more fatal (30) in 1854 than it
was in 1849 when it was 25 ; but on the other elevations the mortality frt)m cholera was less than
it was before, in the proportion of 18, 42, 72, and 73, in 1849 ; and 11, 14, 19, and 67 in 1854, to
every 10,000 inhabitants, at the respective elevations, supplied with water by the New River. A
similar decrease is observed in the mortality of the sub-districts supplied by the East London Com*
pany, which has latterly drawn its water three miles higher up the River Lea, than it did in 1849.
The sub-districts that were supplied by the Grand Junction and by the West Middlesex Companies
suffered much less from cholera in 1849 than the sub-districts of the New River and the East London;
but in 1854 the mortality increased in the districts of the two former companies, and in all the dis-
tricts that derive their water from the Thames, which from Kew down to Battersea and Chelsea has
every year for the last five years received an increased quantity of town sewage.
The Lambeth Company has in the interval between the two epidemics clumged the source of its
supply from Hungerford Bridge to Thames Ditton, where the river is unpolluted by the London
sewage ; but the pipes of this company run into the same districts as those of the Southwark Com-
pany, against which it was at one time in active competition, so that a special method of inquiry
must be here resorted to. The Tables 1. and 2. only show that the sub-districts that were supplied
wholly or partially with the impurest Thames water experienced a high and extraordinary mortality
from cholera in 1849, and again in 1854.
The region of London south of the Thames is divided into 1 1 large districts, comprising 42 sub-
districts, which extend from Putney in the west to Woolwich in the east, — from the large tract of
low ground along the Thames to Uie heights of Norwood and Sydenham. Many houses in eTcry
district derive their water supply from weUs, pumps, and tidal ditches ; in addition to these sources
Bermondsey, St. Olave, and Wandsworth are supplied almost exclusively by the Southwark Com-
pany ; the Greenwich and the Lewisham districts chiefly by the Kent Company ; in the streets of the
other districts the pipes of the Lambeth and Southwark Company — the one supplying water compara-
tively pure, the other impure — are so intermingled that neither the informants nor the Registrars
knew in 823 cases out of 4,059 whether the house in which the death from cholera occurred obtained
its water from the Lambeth, Southwark, or the Kent Company. The officers of the latter company
themselves have stated that they experience almost insuperable difficulties in distinguishing the
houses which they supply in ever>' street. It is therefore evident, that in the general character of
the houses, the means of the householders, the density of the population, and the elevation of their
dwellings, the difference is not considerable. The water supply is the cliief element in which there
is an evident difference ; one class of houses is now supplied by water from Ditton, the other by
water which the Southwark Company draws from Battersea, where the Thames is contaminated by
the London sewage. And what is the result ?
In the 26,107 houses that derived the water from Ditton 313 deaths from cholera occurred in ten
weeks ; in the 40,046 houses that received the impure water from Battersea 2,443 persons it was
ascertained died from cholera in the same time. The deaths in the latter districts exceeded by
nearly 2000 the deaths that would have occurred if cholera had only been as fatal as it was in the
houses that derived their water from Ditton. The Registrars were probably in some cases misin-
formed, but there is reason to believe that no undue proportion of the deaths is referred to houses
that Ihe Southwark Company supplies.
The deaths are given in Table 3. as they were returned by the Registrars in the eleven districts ;
and it will be observed, that the balance of mortality is heaviest in every district against the impure
water, to an extent that leaves litUe room for doubt on the mind.
Thus in St. Saviour Southwark, 280 of the deaths by cholera were in houses supplied by the
Battersea Vfuter, 59 in houses supplied with the Ditton water. In the week ending September Sd th#
Cholera in London, 1853-54.
301
profmrtions were 58 to 11 ; in the week ending October 14th they were 9 to 1. In St. Olave, con-
tuning the hospitals, and in BermondMy, an undoe proportion is perhaps referred to Southwark, as
die Registrars notice no eases in houses that derlTcd water from wells and ditches. In 8t. Oeorge
Soothwark 254 persons died of cholera in houses that were supplied with water from Battersea, 79 in
lKWfB<»# that were supplied with water from Ditton ; the proportions were 303 to 47 in Newmgton,
349 to 95 in Lambeth, 206 to 6 in Wandsworth and Clapham, 167 to 24 in Camberwell ; and so the
propordons ran wedL after week. And it will be observed that in Bermondsey, which is not entered
bj the lAmbeth Company, 734 persons died by cholera in 1849, and 846 in 17 weeks of 1854 ;
while in Lambeth, which was wholly supplied with impure water in 1849, the deaths in that year by
cholera were 1618, while in 17 weeks of 1854, when it was partially supplied with a comparatiyely
porer water, the deaths by cholera were only 935 ; of which about four fifths were in houses that
receiTed impure water.
Woorks are now in progress for procuring better water for Southwark and for the rest of London ;
and the salutary effects of the changes that have been already wrought justify us in anticipating that
when X«ondon is well drained, and when the water compames supply London with the cool, pure,
refreshing water of the streams frtnn the high grounds of Middl^x, Hertford, and Surrey on the
system of constant supply, the health of the metropolis will be improved, and under wise medical
arrangements the devastations of cholera, if they recur, will be no longer terrible.
TxBLM of Deaths frxnn CHOLEnA in the Eleven Districts of LoTn)ON on the South Side of
the Thames, distinguishing the Deaths in Houses supplied with Water by Three Water
Companies, or by Wells, Pumps, &c.
DISTRICTS.
8.9
ill
Deaths
from
Cholbsa.
Of the Deaths from Cholera in 17 Weeks of 1854 it was found
by inquiry in 10 Weeks that the subjoined numbers
occurred in Houses of which the Water Supply was
inquired inta
Total
Deaths
inves*
tigated
in 1864
Deaths in Houses supplied with Water by~ 1
1849
(Year).
1864
(17
Weeks).
Southwark
Company.
Lambeth
Company.
Kent
Company.
Wells.
Pumps,
Rivera,
and other
Sources.
8ouroo
of Supply
unascer-
tained.
StJSavioar, Southwark
St. Olave, Southwark
Bermondaey
St. Oeorge, Southwaik
XewiDgton - -
JLtfunbeth - - -
Wandsworth -
Ounberweil
Botherhitbe -
Greenwich
Lewisham-
TOTAL -
8.L.
S.
8.
8.L.
S.L.
L.S.
8.
8.L.
8.
K.
K.
639
849
784
836
907
1618
484
604
852
718
96
491
818
846
643
694
936
421
649
283
663
81
841
209
655
886
625
684
825
352
180
441
61
280
186
655
254
303
349
206
167
139
4
69
"79
47
95
6
24
8
11
9
161
15
T
?
1
9
78
102
2
85
12
2
23
63
174
231
40
48
SO
191
81
7187
6719
4059
2443
313
106
284
823
The Southwark Water Company, which obtains its supply from the Thames at Battersea near
the Bed House, supplied 40,046 houses in 1853.
The Lambeth Water Company obtains its supply from the Thames at Thames Ditton, about
a mile and a half above Kingston, and three miles beyond the influence of the tide. This Company
supplied 26,107 houses in 1853.
The Kent Water Company obtains its supply from the Rayensboume below the T^ewisham Mills.
It supplied 14,594 houses in 1853.
The further inquiry to which reference has been made in the Weekly Heturns^
was undertaken at the instance of the Board of Health Committee for Scientific
Inquiries* ; and the general result, as stated in the lucid report of Mr. Simon, the
Medical Ofiicer of the Board of Health, is : "the population drinking dirty water
" accordingly appears to have sufiered 3^ times as much mortality as the popula-
" tion drinking other water."
The results of this conclusive investigation of the Board of Health complete
the inquiry.f
♦ The Committee consisted of Amott, Baly, Farr, Owen, and Simon.
t Report on the last two Cholera Epidemics as affected by the consumption of impure water*
By the Medical Officer of the Board, p. 6.
302
Cholera in London, 1853-54.
Synopsis of Results.
Death Bates per 1.000
!of
living Population
in
Two Epidemic Periods.
Cholera -
-{:
1848-9 -
853-4 -
Dlulkhcea-
r 1848-9 -
1 1853-4 -
In Houses enumerated
in 1864 as receiving
their Water Supply
r
firomthe
Lambeth
Company.
12-5
3-7
s
from the
SOUTHWABK
and
Vauxhall
Company.
2-9
2-1
11-8
13-0
2-7
3*3
N.B.— Between the two epidemic periods the Lamboth Water Company had changed its source of supply.
We have now learnt in England that the mortality of a settled population, or of
such moving bodies of men as ai*mies, in an epidemic of cholera, is reduced to an
insignificant fraction, — when they are lodged on places of some elevation — are
supplied with pure water — are kept in generally favourable hygienic conditions —
and obtain, when attacked by diarrhcea, immediate medical advice.
The practical importance of these results is evident, when we reflect that the
disease which they show us how to combat, destroyed within seven years, in two
epidemics, little less than a quarter of a million of the population of the United
Kingdom at home, where its visitations were less deadly than they were in our army
and navy abroad and among other nations.
It is right to state that Dr. Snow by his hypothesis*, by his researches, and by
his personal inquiries ; that the Registrar General, by procuring information and
by promoting inquiry ; as well as the Board of Health by their Report ; have all
contributed in various ways to establish the fact that the cholera matter or
cholrine, where it is most fatal, is largely diffused through watery as well as
through other channels.
Appe7idix to Registrar- GencraVs Seventeenth Annual Heport, pp. 91-99.
♦ The following is a very brief outline of Dr. SnoVs views as expressed in his last publication,
Cholera and the Water Supply in tlie Soutli Districts of London :
" The cholera commences as an affection of the alimentary canal, and not with general illness ;
there is no evidence of poisoning of the blood in this disease, except in some cases where
secondary fever occurs ; there is conclusive evidence that cholera may be communicated from
person to person, and it follows, therefore, that the morbid matter which produces the disease is
applied to the interior of the alimentary canal, where it increases and multiplies during the period
of so-called incubation, and passes off, during the attack, to cause fresh cases when suitable
opportunities occur. Various circumstances connected with the propagation of cholera seem in
accordance with the above view of its pathology. Thus, it was observed to pass frequently from
person to person in the crowded habitations of the poor, who eat, drink, cook, and sleep in the
same apartment, and pay little or no regard to cleanliness, who live, in fact, under circumstances
where the sudden and copious evacuations of cholera, soiling the bed and body linen, would not
lail to contaminate the hands of the patient and his attendants, and be thence transferred to any
Ibod they might touch. The absence of colour and odour in the evacuations could not help to
favour this result."
" It occurred to me, as soon as I began to entertain the above opinions, that if the cholera
excreta could reproduce the disease in the way just mentioned, they might also do so when diffused
in water taken as drink, and that, unless this were the case, the whole of the phenomena of cholera,
as an epidemic, could not be explained."
303
List of some of the Principal English Official and other
Publications relating to Cholera,
AcLAHB, Ds. ; On Cholera at Oxford.
Balt ahd Gull, Dim. ; Reports [to Hojal College of Fhyticians] on Epidemic Choleim
[of 1848-9J, published 1854.
BcALE, Dr. L. S. ; Microscopical Researches on Cholera in Medical Times and Gasette.
Bebo, Dr. ; Cholera in Sweden, 1850. (In Swedish.)
Briquet, M ; Rapport sur les ^^pidemies de Cholera-Morbos qui ont r^gnu de 1817 k 1850.
(In " Memoires de TAcad^mie Imperiale de Medecine.** — VoL 28, Part 1.)
Bbtaov, Dr. ; On the Infectious Origin and Propagation of Cholera (1851).
Bi7DD» Dr. W. ; On Asiatic Cholera in Bristol (In " British Medical Journal " of ISth April
1867.)
Chapmait, Dr. John ; Diarrhisa and Cholera.
CoxoRES IiTTBRNATioxAL DE Statistique ; Reuni ik Florence, Compte-rendu des traranx
de la yi« Session, 1867. Published in 1868 at Florence. This Taluable Report of
Dr. Maestri contains information and some important recommendations from the congress
on the subject of Water Supply.
liPiDRinou>oiCAL Society ; transactions of.
General Boards of Health ; On Oiolera in 1831-2.
Report on Epidemic Cholera of 1848-49.
Ai^ndix A. ; Report by Dr. Sutherland on Ditto.
Appendix B. ; Report by Mr. Grainger.
Appendix C. ; Abstract of Report by James Wynne, MD.,
on Epidemic Cholera in United States, 1849-50.
Report of the Medical Council on Epidemic Cholera in 1854.
Report of CommitUe for Scientific Inquiries in relation to
the Epidemic of 1854 (with Appendix).
Report on Cholera as affected by the Consumption of Impure
Water— by the Medical Officer of the Board (1856).
Report of Dr. Sutherland on Cholera in London, 1854.
Reports 1 and 2 on the Results of different Methods of
Treatment of Cholera (by Medical Council Committee).
Orsesinobr ; On Cholera, (/n Virchow'e Handbuch der SpecieOen Pathohgie und Tkerapie
—2 Band, 2 Abth.)
Grimaud de Caux ; Du Cholera, 1866.
GuKTHER, Dr. Rudolf ; Atlas zu die Indische Cholera in Sachsen im Jahre 1865.
Hallier, Dr. Ernest ; Das Cholera-Contagium, 1867.
Hauohton, Rev. Dr. j Papers on Cholera in Medical l^es and Gazette, 1867.
International Cholera Conference at Constantinople ; Despatch from Her M^esty'a
Ambassador at Constantinople, with Document) presented to both Houses of Parliament,
1868. (See also Paper by Dr. Goodeve, read before the Epidemiological Society in 1866.)
Ireland— Ha YDEN and Cruise ; C^iolera Epidemic of 1866 in Dublin.
Mapother, Dr.} Lectures on Public Health, 1867.
U
304
Jajcesok, James, ; Report on Epidemic Cholera in the Presidency of Bengal in 1817-19.
Johnson^ Db. Geosge; On Epidemic Diarrhoea and Cholera; their Pathology and Treat-
ment.
Notes on Cholera.
Klob, Dr. Julius ; Stodien iiher das vesen des Cholera Processes, 1867.
Maofhebson, Db. Johk ; Cholera in its Home, 1866.
Mabtin AiTD Johnson ; on Tropical Climates.
MuLLEB, Dr. E. H. ; Die Cholera-Epidemie zu Berlin, 1867.
Newcastls-upon-Ttne ; Report of Commission on Cholera Epidemic of 1853..
Obton, I On the Epidemic Cholera of India.
Pacini, M.; Da Cholera asiatique. Tradait par Janssens. Brozelles, 186fi.
{Note. — An earlier publication is out of print)
Delia Natura del Colera Asiatico (Firenze, 1866).
Pabkes, E. a. ; On Asiatic or Algide Cholera, 1847.
Pettenkofeb, Db,; Yerbreitungsart der Cholera (Munich, 1855).
Pbitt Council, Medical Officeb of ; Eighth Report
Ninth Report
Radcliffe, Mb. J. N. ; On the Sources and Development of Cholera in Europe (8th Report
Med. OflE:, Privy Council).
On Outbreak of Cholera at Theydon Bois (Ditto).
On Cholera in London (9th Report Med. Off., Privy Ckmncil).
Reoistbab-Genebal of England ; Report on Cholera in 1848-40, by Dr. Fanr.
The Cholera Epidemic of 1853-64. {Im Appendix to
Seventeenth Annual Report)
Report on the Cholera Epidemie of 1866.
Cholera in London. (See Weekhf Betunu for 1849,
1854, ancf 1866).
RiOHABDSON, Db. ; Theory of Propagation of Cholera. {In Drangactioni of Epidemiologieal
Society, Vol II., Part DL)
RoOEBS, S. ; Reports on Asiatic Cholera in Madras, 1848.
*
St. James, Westminsteb; Report on Cholera (1854).
Sanderson, Db. J. B. ; On Communicability of (Cholera (9th Report Med. OS., Privy
Council).
Scott, William ; on Epidemic Cholera in Presidency of Fort St Greorge, 1849-
Shafteb, Db. ; History of Cholera in Exeter.
Snow, Dr. John ; On the Mode of Communication of Cholera (1854).
Sutton, Dr. H. 6. ; On the Characters of the Cholera of 1866 (9Ui Report Med. Off.,
Privy Council).
Thomson, Dr. R. D. ; On Cholera. Transactions of Royal Medico-Chiruigical Society.
Vol. XXXIIL
Thudichum, Db. ; Chemistry of Cholera (9th Report Med. Off., Privy Coondl).
Weber, Db. Hermann ; On Pettenkofer's Theory of the Propagation of Cholera. (In TnaB-
actions of Epidemiological Society, Vol. II., Part U.)
Note. — ^A copious list of Works on Cholera irill be found in the British and Foreign
Medico-Chirurgical Review, Nos. Ixxv., Ixzvi., and budx.
INDEX.
Page
Age anp Sex; influence of, in Cholera ..... ... Ux
AoKS:
Deaths and Hate of Mortality from Cholera and Diarrhoea in 1849, 1854, and
1866 in England of Males and Females of different Ages (Table 8.) -« 19
Agf^regate Deaths from Cholera and Dlarrhcea of Males and Females of
different Ages during the Three Epidemics of 1849, 1854, and 1866 In
England (Table 9.) - ...... 80'
Aggregate Annnal Mortality from Cholera and Choleraic Diarrhoea of Males
and Females of different Ages in the Three Epidemics of 1849, 1854, and
1866 in England (Table 10.) - . ... - SO
Deaths registered from Cholera and Diarrhoea in the Tear 1866 of Males and
Females of different Ages in each of the Begistration Dirisions of England
(Table 1 1.) - - - - - - - - 81-22
Deaths registered from Cholera in England in the Year 1866 of Males
and Females at different Ages, with the Period of Duration of Attack
(Table 12.) ....... 23
Deaths registered from Diarrhoea in England in the Tear 1866 of Males
and Females at different Ages, with the Period of Duration of Attack
(Table 13.) - -24
Deaths registered from Cholera in London in the Year 1866 of Males
and Females at different Ages, with the Period of Duration of Attack
(Table 14.) - -25
Deaths registered from Diarrfaoea in London in the Tear 1866 of Males
and Females at different Ages, with the Period of Duration of Attack
(Table 15.) ...-.--- - 26
Occupations of Males dying at different Ages, of Cholera in England in the
Year 1866 (Table 16.) - - 27-33
Occupations of Females dying at different Ages of Cholera in England in
the Year 1866 (Table 17.) - - - - - - 84-36
Albano, Cholera in--- - - - - 281
ALConoL and Cholera matter --...• Ixix
AinrcAL Value op Pbopertt in each District of London (Tables 25 and 26) - 60-61
Abht ; Mortality from Cholera - - - . - - Izxxiii
Atmospheric Diffusion of (Hiolera - - - - - xvi, Izxix
Attack^ of Cholera - - - - - - bd
Atbton^ M.P., Mr. ; Report of Committee on East London Water Bills - - xii
Baw, Dr. ; Letter in reference to Eels in East London water pipes - - 129
Balfour, Dr. T. G. ; on Cholera in the Army - - - - - b aiii
BlATEXAN, J. F. ;. project for Supply of Water to London from Welsh Mountains - xli
Beyised estimates for new supply .... . xlv
Batlib, Dr. ; on CJholera ahd PreventiTe Measures at Birkenhead - - 228
U 2
306 Alphabetical Index to
Bazalgette, J. W. ; Letter in reference to Drainage of East London - - 117
Bbale, Dr. ; Microscopical researches - • - - Ixviiy Izriii, Izz
Beabdmobb, N. ; on pollution of the Lea . . • . • xxiii
on cnlnc contents of the Lea ... . Iziii
reply to inquiries relative to the Lea . • . • 126
Bishop of Loin>ON's letter to the Times in reference to Distress in East London - 89
Board ov Health. (5ee Health.)
BoASD OF Tbade and Water Supply of East London ... -102-108
Bombay ; Mortality from Cholera . « • • . • xc
Bbistol Cholera Field ^ - . - . • . . xlriil
Broad Street Pump - - • - • • xi, xxxix
Brtsox, Dr. ; on Cholera in the Navy - - - - - • Ixxxiv
Causes of Cholera ...... xiii
Cuarltom (Woolwich). Outbreak of Cholera .... 142,801-205
Chateau, M. ; researches on Cholera • • • . • Ixvii, Ixix
Cholera :
Its Four Visitations to this Country .... - ix
Preceded by Diarrhoea - - - • - «ix, x
Sir Thomas Watson on arrest of - - - - - ix
Views of Board of Health in 1850, in reference to - • . . x
Advantages of the Registration System in recording facts ... x
The Medical Council of the Board of Health - . . . xi
"The Committee for Scientific Liquiries on impure Water and Cholera • - xi
Dr. Snow*s water theory - - - . . - xi
Lessons of previous epidemics ..... - xi
Four public inquiries relative to the Epidemic of 1866 - - - xii
The Begistrar-General's charge against the East London Water - - xii
Approach of the Disease in 1865 * - . . . . xiii
Outbreak in East London .... . xiii
Cholrine ....... xiii, xiv
Causes of-- - . . - . xiii
Fungoid theory ........ xiii
Pettenkofer's Uieory ---.-- xiv
Experiments of Drs. Thiersch and Sanderson - - • - xiv
Dilutions of rice water evacuations in tubes ... . xiv
Communicability of--- ... • xiv
Vibrions >• - - - • --xv
Localization in East London .'. . . . -xv
Atmosperic diffusion - - ■ • . . . xvi
Sewage exhalations •-••.. xvi
East London Water Company*s Woriu .... xvii-xx
Old Ford water distributed from open reservoirs .... xvii
The opening of the sluice .... • . xvili
Proximity of covered reservoirs to tidal Lea .... xviii
The first Deaths --.. . . -xix
The Old Ford and Lea Bridge Water Distribution ...
The -eflects of the dose of Cholera matter administered . • •
Mortality in the several Water-fields - - - - - xx-xxii
Beport on Cholera m 1866, 307
Page
Cholera — continutd.
The example of South London • • • • • zxii
Pollution of the Lea « . ^ . . . zxiii
Inequalities of Mortality in different parts of the Waterildda ... xxiy-xxy
Some statistioal ftdlacies in reference to Choleraic diffusion
The doctrine of probabilities
Exceptions to water theory — North Wool'wich • - - • xxvi
•• City of London • • . xx^ii
Stamford HOI .... xxrii
Bow Common Workhouse and Limehouse School ^xxviii
Dr. Letheby's objections to water diffusion theory - • . xxriii, xxix
Cholera matter and arsenic -•-••. xxviii
Comparison between gas and water distribution .... xxriii
Alleged immunity of the London Hospital Staff • • •
The experience of other hospitals . • . . •
Derelopment Of the disease in indiyiduals and communities ...
Its detelopment in London in 1849, 1854, and 1866 ... xxxi
The decline of the epidemic in East London • • . . xxxii
In Newcastle-upon-Tyoc :
A parallel case - . - - • • • xxxiii
First cases, and progress of the disease in Newcastle ... xxxiy
The water supply suspected - - . - -
Pumpiug from the Tyne stopped ; decrease of deaths . . •
The Newcastle water supply - - - - - xxxvi
Comparison between the mortality in Newcastle and East London - xxxvii
Besults of two great experiments ; the parallel ccnnplete - - xxxyiii
Indirect difiusion of Cholera by water . - . • xxxix
In the seyeral fields throughout England . • • • . xlyii-li
In the ten great cities - - . - - - li
In the eleven divisions of England ------ lil
In the United Kingdom - - ■ - - - lii
Influence on mortality of elevation ------ lii
„ of distance - <• - - - Iv
„ of density of population - - - - ly
of sewerage _ . - - - Ivi
of wealth and poverty . - - - lyil
of occupation - - • - - Iviii
of sex and age - - - - - lix
Influence of Sex and Age in reference to attacks and &tality of the disease - Ixi
Duration of fetal cases- - ------ Ixii
Dispersion of Cholera Flux over large areas of water - - . - Ixlii.
Enormous number of corpuscles in the flux from Cholera cases • • Ixiii
Fatality of the disease on the several days of the week - - - - Ixir
Meteorological phenomena of the epidemic period • - - - Ixiy
Zymotic theory - ----- -- Ixr
Pasteur's researches' ----- - Ixy
Cholera Flux -------- Ixvi
Vibrions and vaccinads l*^|i
M. Chaveau's researches .--•-- Ixvii
Experiments on Zymotic diffusion • - - - - Ixviii
Alcohol, temperature, filtration ----- Ixix
Monads, Biads ^«
308 « Atphabetwal Index to
Page
QhxAenr^continued.
Mathematical theory * --*- • - - - Ixx
Pacini's inTcetigations - - . - - - • Ixx
. his pathological reiearches confinn the Zymotic Theory • Ixzi
fundamental eqoations ... - - Izxiii
collapse - . - - - - - - Ixxiv
- fiw^l equation --•-•• - Ixxv
symbols - - - - - - • ^**^
jelated phenomena of Cholera ^ . - - Ixxriii
Air, water, contact theories . - - - - - Ixxix
Spontaneous generation of Cholera - - - - - • bcxxi
£^cacy of preyentive personal measures - . • • • - Ixxrii
Popt Office 1*^^
Dr. Waller Lewis's "Sulphuric Orangeade" . - - Ixxxii
Customs . - - - - • - ^^"^
Ajmy .•-.---- Ixxxiii
Navy -.-..-- - Ixxxiv
PoUce - . - - - - - - - 1*^^
Quarantine ...---- - ]xx3ds
The practice of England - - • - - - Ixxxv
In the Mediterranean ."---- - Ixxxvi
Isolation impossible in great cities - - - - - Ixxxvii
Subordinate importance of quarantine ... - Ixxxviii
International conference at Constantinople ----- Ixxzriii
Eesponsibility of England in regard of Cholera • - - - Ixxxix
Sanitary progress in India ------- xc
Cholbra Cokfebbnce at Constantinople ------ Ixxxriii
Cholesa Flux ; its characteristics ------ Ixyi
Cholbine .----- • xid
Cities ; Cholera in the ten great - - - . - - li
Coal ; consumption and cost in the Metropolis - - - - xl
Contact Thbobt - - - - - - - Ixxx
Counties. Deaths registered from Cholera and Diarrhoea in each County in 1849,
1854, and 1866 (Table 3.)- - - - - - -3-4
Cbossness ; the Metropolitan Sewage Works - - - - 98
Custom House Ovficials ; Cholera among them in 1866 ... Izzxii
Daily Deaths :
Deaths from Cholera and Diarrhoea occurring in England on each Day of each
of the Twelve Months of 1866 (Table 19.) - - - - - 38
Deaths from Cholera and Diarrhoea occurring in London on each Day of each
of the Twelve Months of 1866 (Table 20.) ^ , - - 39
Death3 from Cholera and Diarrhoea occurring in the East Districts of London
and in the District of West Ham on each Day of each of the Twelve Months
of 1866 (Table 21.) "- - - - - - - 40
Deaths from Cliolera and Diarrhoea occurring in London, exclusive of the East
Districts, on each Day of each of the Twelve Months of 1866 (Table 22.) - 41
Deaths from Cholera occurring on each Day during Thirteen Weeks ending
29th September 1866 in the Water-fields of the several London Water
Ck)mpanies (Table 23.) . -. -. -. -, - - - 42-43
Report on C/wUra in 1866. 309
IHSiy Deaths — continued.
Deaths from Cholera occorriog on each Daj during Thirteen Weeks ending
S9th September 1866 in the seyeral Sub-districts of London, grouped ac-
cording to their Water-supply (Table 24.) - - . . 44-59
Diagram No.4. exhibiting the Deaths by Cholera and Diarrhoea, and the
Temperature and Rain-&11 in London on each Day of the Fiye Months
June to October 1866.
Diagram No. 5. exhibiting the Deaths by Cholera and Diarrhoea in London
on each Day of the Five Months June to October in the Years 1849, 1854,
and 1866.
Daily Bbtu]»8 ; when commenced and discontinued - ... 99
D^BWiif, CoABLES ; on the propagation of species .• . • • xv
Datdbs, Datid ; on Cholera and prerentiYe measures at Bristol - ^ . 224
Daytes, Sbettezeb ; on Cholera and Water-supply in Swansea - - 246
Days of thb Week --...... ixir
Dbath-ratb:
From Cholera and Diarrhoea in England, and in London, in each of the years
1838-^6 (Table 1.)----- . . i
From Cholera and Diarrhoea during the Years 1849, 1854, and 1866 in
the sereral Divisions of England (Table 4.) - - - . . 16
From Cholera in 1849, 1854, and 1866 in London and in certain Districts
of England in which the Epidemic of 1866 was most i^tal in proportion to
the Populati<Jta (Table 6.) -- - - - ..17
From Cholera in London and in the Districts of England which were chiefly
attacked in 1849, 1854, and 1866, arranged in the order of Mortality
(Table 7.) ------.-- 18
From Cholera and Diarrhoea in 1849, 1854, and 1866 in England of Males and
Femalesof different Ages (Table 8.) - - - - - 19
From Cholera and Choleraic Diarrhoea of Males and Females of different Ages
ID the Three Epidemics of 1849, 1854, and 1866 in England (Table 10.) . 20
From Cholera in 1866 among Males and Females of different Occupations
(Table 18.) -------. 37
From Cholera and Diarrhoea in 1849, 1853-54, and in 1866 in the several
Districts of Ix)ndon (Table 26.) {See also ^faps 1. and 2.) . . ei
From Cholera in 1849, 1853-4, and in 1866, in the several Sub-districts of
London (Table 27.) .-.--- . 62-75
From Cholera in 1849, 1853-4, and in 1866 in the several Sub-districts of
London, arranged in the order of Elevation (Table 28.) - - - 76-77
From Cholera in Eleven Groups of London Sub-districts at different Elevations
in Three Epidemics (Table 29.) ------ 73
From Cholera in 1866 in Sub districts of London grouped according to Eleva-
tion in the several Water-fields (Table 31.) - - - - 79-81
From Cholera in the London Sub-districts in 1849, 1853^54, grouped according
to their Elevation and Water Supply (Table 32.) - - - 82
From Cholera and Diarrhoea in 1849, 1854, and 1866, in the Fields of the
difflerent London Water Companies (Tables 33. and 34.) ... 83^84
Density, as an element in Cholera mortality - - . . - ^Iv
of Population in each District of London (Table 26.) - - - 61
in each of the London Water-fields (Tables 33 and 84.) - 83-84
Development of Cholera in individuals and communities ... xxx
in London in 1849, 1854, and 18C6 ... xxxi
^a mm * ' '
DiAGBAMs. (JSee Maps.)
Dickson, Dr. W. ; on.Cholera aiQong Custom House Officials - - • - buudi
310 Afyhabetical Index to
Page
DiFFVBiON of Cholera ..---••- xri
Inequalities of------* • ^mr
Statistical Fallacies in regard to - - " • - - xxv
Indirectly by water ..---.
Disinfectants ; the Medical Officers of Health on their nse - - - 178-198
Dr. Lethebyon • - - . - -199-200
Distance - - - - - -.Iv
Districts :
Deaths registered from Cholera and Dianhflsa in London and in Nine large
Town Districts of England in each of the Yean 1888-66 (Table 2.) - 2
Deaths registered from Cholera and Diarrhoea in each District *of England
during the Tears 1849, 1854, and 1866 (Table S.) - - - 5-16
Number of Districts in 1849, 1854, and 1866 in which no Deaths from
Cholera were recorded (Table 5.) - - • - 17
Mortality from Cholera in 1849, 1854, and 1866 in London and in certain
Districts of England in which the Epidemic of 1866 was most fiital in pro-
portion to the Population (Table 6.) - - - - - 17
Mortality from Cholera in London and in the Districts of England which
were chiefly attacked in 1849, 1854, and 1866, arranged in the <»der of
MortaUty (Table 7.) .... ---18
Water Companies supplying each District of London ; Area in Acres; Number
of inhabited Houses in 1861; annual Value of Property assessed in 1866
estimated Population, 1866; and Deaths registered from Cholera and
Diarrhcea in 1849, in 1853-4, and in 1866 (Table 25.) - • . 60
Water Companies supplying each District of London ; Eleration ; Persons to
an Acre ; Persons to a House ; annual Value of Property per Head of
Population ; average annual Valae of Houses ; Poor Belief; and Number
of Deaths to 10,000 Persons living from Cholera and Dianhoea in 1849,
in 1853-54, and in 1866 (Table 26.) - - ... 61
The London Medical Officers of Health on the Water Supply and Causes
of Cholera in their Districts .... . . 160-177
The London Medical Officers of Health on the Preventive and other Measures
adopted in their Districts --•... . 178-198
Notes on Cholera, in 1866, in the several Districts of England ... 206-251
Maps 1 and 2, showing the Mortality from Cholera in Loudon Districts in
1849 and 1866.
Divisions ; Cholera in the Eleven - - - • - . lii
Deaths registered from Cholera and Diarrhoea in each of the Registration
Divisions of England during the years 1849, 1854, and 1866 (Table 3.) - 3
Mortality from Cholera and Diarrhoea in each of the Divisions in 1849, 1854,
and 1866 (Table 4.) - 16
Deaths registered fVom Cholera and Diarrhoea In 1866 of Males and Females
at different Ages in each of the Divisions (Table 11.) • - - 21-22
Dote, Bathxtbst ; on Cholera in the London Hospital • • •
Dbainaob or Eut London ... . • - 131
DuBATioN or Patal Cases and Law of its connexion with Epidemic Mortality - Ixii
Duration of Attack :
Deaths registered fh>m Cholera in England m the Tear 1866 of Males and
Pemales at different Ages, with the Period of Duration of Attack
(Table 12.) - . . . ...23
Deaths registered firom Diarrhoea m England in the Year 1866 of Males
and Females at different Ages, with the Period of Duration of Attack
(Table 18.) --.•-. 24
Report OH Cholera in 1666. 311
Ffege
DimAion of Attack — eonHnutd.
Deaths registered from Cholera in London in the Year 1866 of Males
and Females at different Ages, with the Period of Duration of Attack
(Table 14.) - -25
Deaths registered from Diarrhflea in London in the Tear 1866 of Males
and Females at different Ages, with the Period of Duration of Attack
(Table 15.) - - - - ---26
Dtxs, T.J. ; on Cholera at MerthyrTjdfil - - - - 243
EastLoitdon:
Beport of Captain Tyler on Water Supply ----- xil
Beport of Mr. Ayrton*8 Committee on Water Supply • - - zii
BeportofMr. J.N. Raddiffe on Cholera Outbreak ... - xii
Charge of Registrar-General against Water Supply - - . xii
Outbreak of (Solera - - - ... xiii
Loealixation of Cholera .... . - xy
Distribution of impure Water ..... xvii
First Deaths of the Epidemic • . . • -
Mr. Baddiffe's Account of the first Cases - • • • •
Old Ford and Lea Bridge Water Distribution . . -
and New Biyer Water - - - • - - xxvii
Lnmunity of certain Places in the District . • • . xxyiii, xxix
Decline of the Epidemic - - - - • - xxxii
Parallel Outbreak of Newcastle-upon-Tyne • - - - xxxiii
Deaths from Cholera and Diarrhoea occurring in the East Districts of London
and in the District of West Ham on each Day of each of the TweWe
Monthsof 1866 (Table 21.) ..... - 40
Deaths from Cholera and Diarrhcoa occurrins in London, exchuive of the East
JDutrkU, on each Day of each of the Twelve Months of 1866 (Table 22.) - 41
Board of Trade and the Water Supply of the East Districts - - 102-108
Water Supply of -.-.----114
East London Wateb Compaht ; Besenroirs and Works - - - xvii
Professor Frankland*8 Beport on Works - 122-126
Ebls in East London Waterpipes - - - - - 129
ExxTEB Cholera Field . . . - . . . xlvii
Eletation .-.----lii
Water Companies supplying each London District; Elevation; Persons to
an Acre ; Persons to a House ; Annual Value of Property per Head of
Population ; Average Annual Value of Houses ; Poor Bielief ; and Number
of Deaths to 10,000 Persons living from Cholera and Diarrhoea in 1849, in
1853-54, and in 1866 (Table 26.) ... . - 61
Water Supply; Elevation; Area; Enumerated Population; Deaths; and
Annual Rate of Mor&lity from Cholera in 1849, 1854, and 1866— in London
Sub-districts (Table 27.) - 62-75
Mortality from Cholera in 1849, 1854, and 1866, in London Sub-districts,
arranged in the Order of Elevation (Table 28.) . - - - 76-77
Mortality from Cholera in Eleven Groups of London Sub-Districts at
difFereut Elevations (Table 29.) . . - ... 75
Population, Deaths, and Mortality from Cholera in 1866, in London Sub-
districts, grouped according to Elevation in the several Waterfields
(Table 81.) - 75-81
Mortality from Cholera in London Sub-Districts in 1849 and 185dj^-54,
grouped according to fheir Elevation and Water Supply (Table 32.) - 82
312
Alphabetical Index to
Eleration — continued.
Area; Enumerated Fopolation 1851 and 1861 ; Number of Deaths r^stered
from Cholera and IHarriioea in 1849, 1854, and 1866; Annual Mortality
from Cholera and Diarrhoea per 10,000 of Population in 1849, 1854, and
1866 ; Annual Bate of Increase per Cent of Population 1851-61 ; Density
of Population in 1866; and Elevation in Feet above Trinity High- water
Mark m the Fields of the different London Water Compuiies (Tables 83.
and 84.) - - - --•-
INLAND: - - •
Deaths and Hate of Mortality by Cholera and Diarrhosa in each of the Years
1838-66 (Table 1.) - - - - - .
Deaths registered from Cholera and Dlarrhosa in 1849, 1854, and 1866 (Table 3.)
Mortality firom Cholera and Diarrhoea in 1849, 1854, and 1866 (Table 4.)
Deaths and Rate of Mortality firom Cholera and Diarrhoea of Males and
Females at difBerent Ages, in 1849, 1854, and 1866 (Tkble 8.)
Aggregate Deaihs from Cholera, and Diarrhoea of J^es and Females of
different Ages during the Three Epidemics of 1849, 1854, and 1866
(Table 9.) - - - - - - ' -
Aggregate Annual Mortality from Cholera and C!holeraie DiarrhcBe of Males
and Females of different Ages in the Three Epidemics of 1849, 1854, and
1866 (Table 10.) - -
Deaths registered fh>m Cholera in the Tear 1866 of Males and Females at
different Ages, with the Period of Duration of Attack (Table 12.)
Deaths registered from Diarrhoea in the Year 1866 of Males and Females at
different Ages, with the Period of Duration of Attack (Table 13.)
Occupations of Males dying at different Age§ of Cholera in the Year 1866
(Table 16.) -
Occupations of Females dying at different Ages of Cholera in the Year 1866
(Table 17.)
Proportion of Deaths by Cholera in 1866 to 10,000 Persons living in 1861, <^
different Occupations (Table 18.) - - - . -
Deaths from Cholera and Diarrhoea occurring on each Day of each of the
Twelve Months of 1866 (Table 19.) - . - . -
Page
83-84
I
3
16
19
20
20
23
24
27-33
34-36
37
38
148
EuBOPBAN Cities; Mortality from Cholera - - - .
■'••■• • • «
Fare, Db. W.; Letter to the Registrar-General - - - . ^ii
Narrative of Proceetogs at General Register Office daring
Cholera Epidemic • - . . . 87-100
Leti^ers to Professor Frankland in reference to East London
Water '" - " - - - ' - . 88-94
FiLTBATioN and Cholera Matter - - * - ■ - * - - - Ixix
FiLTBATioN OF Wateb; Nature of Methods in use by the London Water Ck>m
panics ... - - - . 260-271
Fbankland, Pbofessor ; on Water Supply of London ... xUfi
Letter in reference to the Filtration of Water - - 116, 131
Analysis of East London Water - - - 116
Report on East London Company's Works - < 122-126
Analysis of Cholera Evacuations - - - 144
Effect of Temperature on organic Matter in Water - 145
Report on the Quantity and Quality of the London
Water Supply in 1866 - - - - 257-259
FuKGOiD Theory of Cholera -. - -. - - - - xiii
FuBGussoN, Mb. R. ; Letter to East End News in reference to Eels in East
London Waterpipes .----- - 129
• ■ - ■ ..
Gateshead. (5^ Nbwcastlb-upok-Ttite.)
Gladstone, Mbs. ; Letter to the Timet m reference to Cholera Orphanage - 90
Report on Cholera in 1866. 313
QjLUKOXB^ Mb. ; Reports to Board of H^th onX^holeia in Newcastle « - xudr
Qbeateb, Charles ; Statements as to Purity of East London Water - - zvii
Admissions as to nae of open Reservoirs ... xvii
Letter to the Times denying the Distribntion of onfiltered
Water by East London Company - - - 91
Extract from his ETidenoe before the Foliation of Rivers
(River Lea) Commission in reference to the Dlstribation
ofimpnre Water by the East London Company - - 100^101
GreekhiiXi Db. ; Communication of Cholera by bedding - - - - ISO
Gut's Hospital Cholera Cases - • - ... xxx
Hansasd, Rey. Septimus ; promote Local Inquiry • - - - 108
Hassall, Db. ; Obsenrations on Cholera Flux ..... z^
On Fungi and Yibrions - - - - - zvi
Microscopical Researches — Yibrions ' - - - • Ixri, Ixvii
Health, Genebal Boabd or ; Views in reference to Cholera in 1850 - . x
Medical Council • - ' - - zi
Committee for sdentifio Inquiries on impure
Water and Cholera ... - zi
Offioen* Reports .... leo, 198
Helt, Mb. H. ; on Cholera in Albano ... . . 285, 287
Holland, P. H. ; on Cholera at Iringhoe • . • • • 216
HosFiTALB A2fi> Cholbba ; the London • . • • . xziz
St. Bartholomew's ....
Middlesex
Guy's - - - ...
Hull Cholbba Field - - ..... xliz
Impube Wateb (from Dr. Farr's Letter to the Registrar-General on Cholera in
1853-54) ..-....-- 295-302
I5DIA ; the Source of Cholera ......
Sanitary Progress of- ------ xc
I3IEQUALITIES of Cholera Mortality within the different Parts of the Water-fields • xxiy
Iktebhational Cholbba Coivfebence at Constantinople ... Ixxxyiii
InTBODUcnoN to Cholera Report ...... ix-xii
Jackson, Db. ; on Cholera in the London Hospital .... xxx
KjfowLBS, H. ; on sanitary Condition of North Woolwich ... xxyi
La2vc£t Sanitabt CoHMifiSioii ; Extract ttom. its Report on the State of the East
London District .... . . •• i28
Lea Bbidoe and Old Ford Water Distribution - .... xx, xxii
Lea Riteb ; pollution of--- - - -- xxlii
Lethebt, Db. ; his Objections to Theory of difltasion of Cholera by Water - xxriii, xxix
Lewis, Db. Walleb ; on Cholera Preyentiye Measures at the General Post Office Ixxxii
LiDDLE, John ; Report on Cholera in Whitechapel .... xxvii
Lihehouse School ; its Immunity from Cholera .... xxriu
LiYBBPooL Choleba-Field • - ---.-..- • xlyiii
Localixation of Cholera in East London ... . - xv
Pap
314 Alphabetical Index to
Locujr, Dr.; on Cholera in the Army • • • • •
LOKDON:
Derelopmentof Cholera in 1849, 1854, and 1866 ....
Mortality by Cholera and DiarrhoBa in each of the Tears 1838-66 (Table 1.) * 1
Deaths registered from Cholera and Diarrhoea in London and in Nine large
Town Districts of England in each of the Years 1838-66 (Tkble 2.) - 2
Deaths registered frxMn Cholera in the Tear 1866 of Males and Females at
different Ages, with the Period of Duration of Attack CTable 14.) - 25
Deaths registered from Diarrhoea in the Tear 1866 of Males and Females at
difRerent Ages, with the Period of Doration of Attack (Table 15.) - 26
Deaths from Cholera and Diarrhoea occurring on each Day of each of the
Twelve Months of 1866 (Table 20.) - .... 39
Deaths frtmi Cholera and Diarrhoea occurring in the East Districts and in the
District of West Ham on each Day of each of the Twelye Months of 1866
(Table 21.) - - - - - - - - 40
Deaths from Cholera and Diarrhoea occurring in London, exdnsiTe of the
East Districts, on each Day of each of the Twelve Months of 1866
(Table 21) ....... . -41
Diagrams (No. 4.) exhibiUng the Deaths by Cholera and Diarrhoea, and the
Temperature and Rain-fidl in London on each Day of the Five M(mtha
June to October 1866.
Diagrams (No; 5.) exhibiting the Deaths by Cholera and Dianhdea in London
on each Day of the Five Months June to October in the Tears 1849, 1854,
and 1866.
Deaths from Cholera occurring on each Day during Thirteen Weeks ending
29th September 1866 in the Fields of the several Water Companies
(Table 23.) ----- - .- 42^3
Deaths from Cholera occurring on each Day during Thirteen Weeks ending
29th September 1866 in the several Sub-districts, grouped according to their
Water Supply (Table 24.) .... . . 44.59
Water Companies supplying each District ; Area in Acres ; Number of In*
habited Houses in 1861 ; Annual Value of Property assessed in 1866 ;
Estimated Population, 1866 ; and Deaths registered fttmi Cholera and
Diarrhoea in 1849, in 1853--4, and in 1866 (Table 25.) ... 60
Water Companies supplying each District; Elevation; Persons to an Acre;
Persons to a House ; Annual Value of Property per Head of Population ;
Average Annual Value of Houses ; Poor Belief ; and Number of Deaths to
10,000 Persons living from Cholera and Diarrhoea in 1849, in 1853-54,
and in 1866 (Table 26.) .... . - 61
Maps 1 and 2 showing the Mortality in Districts in 1849 and 1866.
Water Supply ; Elevation ; Area ; Enumerated Population ; Deaths ; and
Annual Kate of Mortality ftom Cholera in 1849, 1854, and 1866, in Sub-
districts (Table 27.) - - - . . . et-75
Mortality from Cholera in 1849, 1854, and 1866, in Sub-districts, arranged in
the Order of Elevation (Table 28.) - - - . . 76-77
Mortality of Cholera in Eleven Groups of Sub-districts at difl^rent Elevations
in Three Epidemics (Table 29.) - - - - .73
Population, Deaths, and Mortality from Cholera in 1866, in Sob-diatricts,
grouped according to Elevation in the several Water-fields (Table 31.) - 79-81
Mortality from Cholera in Sub-districts in 1849 and 1853^54, grouped
accorcUng to their Elevation and Water Supply (Table 32.) - - 82
Area ; Enumerated Population 1851 and 1861 ; Number of Deaths registered
from Cholera and Diarrhoea in 1849, 1854, and 1866 ; Annual Mortality
from Cholera and Diarrhoea per 10,000 of Population in 1849, 1854, and
1866 ; Annual Rate of Increase per Cent of Population, 1851-61 ; Density
of Population in 1866 ; and Elevation in Feet above Trimty High-water
Mark in the Fields of the different London Water Companies (Tables 33.
and 34.) ....... . 83-84
Narrative of Proceedings at Greneral Register Office during the (Hiolera Epi-
demic of 1866 ... . • • • 87.100
Report M Cholera in 1866.
315
I^oodoQ — continued.
Page
EJiiu
Mr. Greaves's Evideiice before the PollutioQ of Riyen Commistion in
reference to the Distribution of impore Water in Eaat London - - 100-101
The Board of Trade and the Water Supply of East London ... 102-108
Majp No. 3.y showing the Position of the BeieiTolrB of tiie East London Water
Company.
Cholera in London, 18B6 :
1. Extracts from the Registrar Qeneral's Wedd/ Retains daring the Coarse
of the Epidemic ....... 109-159
2. The Medical Officers of Health on the Wftter Sapply and Causes of
Cholera m their DistricU . . « . . . 160-177
3. The Medical Officers of Health on the Prerentive-and other Measures
. adopted in their Districts ... - . - ] 78-198
4. Dr. Letheby on Disinfectants . - . « . 199-200
5. Cholera at Charlton (Woolwich)' ..... 201-205
Meteorological Elements of the Period of Cholera Epidemic in London,
1866 ........ 252-256
Professor FrankUnd's Report on the Quality of the London Water Supply in
1866----- - - - 257-259
Water Supply of London :
1. The Water Companies of London ; their Sources of Supply, and the Par-
ticulars of their Works for Storage and Filtration in 1850» 1856, and
1866 - - - - • • .- - 260-271
2.-ATerage daily Quantity of Water supplied by each Company in 1849,
1856, and 1866 ....... 272
3. "Amount of Capital and Rate of Dividend paid by each Company in 1850
and 1866 272
4. Capital, Receipts, and Houses supplied by each Company in 1866 • 273
5. Distribution of Supply of each Company in 1866 ... 274
Cho\eni in London, 1848-49 :
1. The Thames aud the Water Supply of London
2. Theory of the Propagation of Cholera ...
3. The Zymotic Principle of Cholera ....
4. Precautions against Cholera in regard to Water
Cholera in London, 1853-54 :
1. Impure Water -.-•••-
- 288-291
- 291-293
294
294
LoNDOic Cholera Field .---..
LoifDON Hospital ; its alleged Immunity from Cholera . . -
London Water Supply. {See Water Sitpplt of London.)
Maclouoolin, Dr., on premonitory Diarrhcea ...
Main, D^ on Newcastle Water Supply - . . - -
Mansion^ House Cholera Relief Commutes ; its Operations during Cholera
Epidemic - - - - - ...
Maps and Diagrams:
1. Map showing the Mortality from Cholera in London Districts in"
- 1849 .......
2. Map showing the Mortality from Cholera in London Districts in
1866 ......
8. Map showing the Position of the Reservoirs of the East London
Water Company •..---
4. Diagrams exhibiting the Deaths by Cholera and Disrrhcn, and
the Temperature and Rain-fidl in London on each Day of the
' Five Months June to October 1866
5. Diagrams exhibiting the Deaths by Cholera and Diarrhflsa in
London on each Day of the Fire Months June to October in
the Years 1849, 1854, and 1866 . . .. •
295-302
xItU
91
Foliowing
Pagezo
of Report
S16 Alphabdieal hidkf to
Page
Habo/lte ; Outbreak of Cholera • • . . . 399
ifA»jmAT.T., J. G. ; on West Ham Drainage • - • . 'n\\\
Mathematical Theobt:
FaeinrB Inyestigationa .«.••,, Ixx
His pathological Besearchea - • . * • « It-h
Cholera Flax ... « « Izzii
Fundamental Equations • . . • . . izxiii
CoHapse -••..« . . Ixxiy
Final Equation « • • . • • . ixxv
Symbols •. • • • • ^ Ixxv
Belated Phenomena of Cholera - • • . Ixxriii
Kbdioal CouvciL of the Board of Health • • « • - xi
Medical OmcEBS OF Heath for the several Districts • • • - -155-157
On the Water Supply and Causes of Cholera in their Districts - - 160-1 77
On the Freventxre and other Measures adopted in tiielr Districts • - 178-198
Meteobolooical Elements of the Period of Cholera Epidemic in London,
1866 ----- - - , bdv; 252-256
Metbopolitan Belief Association ; its Operations daring Chdera Epidemic - 91
MiDDLEaBX Hospital Cholera Cases ... • .. xxx
MiDDLETONy A. B. ; on Cholera in Salisbury - • • - •218
Mobtalitt. ('See Death Bate.)
Nabbative of Fbocebdinqs at General Begister Office daring the Cholem
Epidemic of 1866 . - . . . . . 87-100
Nayt ; Mortality from Chdlera • . . . , Ixxxiv
Newcastle-upon-Ttne ^ Outbreak of 1853, a parallel Case to that in East
London in 1866 - . . . . • xxxiii
First Cases, and Progress of the Epidemic - - • • . xxxlv
The Water Supply suspected - . - . - ,
Pumping from the Tyne stopped ; Decrease of Deaths - • .
The Water Supply of the Town ------ xxxvi
Comparison of Mortality with that of East London • . • xxxvii
Besults of Two great Experiments ; the Parallel complete • • • xxxviii
New Bi¥EB and East London Water --.•.. xxrii
NoBTH Woolwich ; its Immonity from Cholera - - - • « xxri
Description of its sanitary Condition by Mr. Enowles •« xxvi
l^OTES ON Cholera in 1866 in the several Districts of England ... 206-251
Occupations and Mortality from Cholera .... . lyiu
Of Males dying at different Ages of Cholera in the Year 1866 (Table 16.) - 27-33
Of Females dying at different Ages of Cholera in the Year 1866 (Table 17.) - 34-36
Proportion of Deaths by Cholentin 1866 to 10,000 Persons living in 1861, of
difEierent Occupations (Table 18.) - - - - - 37
Old Fobd ; the '^ disused '' and covered Beseryoirs .... xvii
Water distributed fit)m open Beservoirs - - - - xviii
Proximity of covered Beservoirs to Tidal Lea - - • . . xviii
Old Fobd and Lea Bridge Water Distribution • . . • • xx-zxH
Obanoeade, SuLPHURia -»-.-«•• - boodi
Rqiwrt M Cholera fit 1866. 817
Page
PAcmr Obferrationiof Tibrioni • • • • • • zr
Estimate of sixe of Cholera corpuMlet ..... ix|ii
Bcaearchea on Cholera - - - • • • Izx
His Mathematical Theory ..... - Izx
Faihological Researches ....... ixzi
Fimdameatal Equations of the-Theory .... . Izziii
CoDapse --- . .... Izxiy
Final Equation - - * - - • • Izzr
Symbols --.-.••-. boDr
Faxib, Wateb Supply op----- - • 275-279
Faxkss, FnoFESSOB ; on Cholera at Southampton . . ., • X7i
Pasteur on the loflaence of Elevation upon Zymotic liatter - - • Ifii
His Researches into the Nature of Ferments . . • • Izr
The Zymotic Theory ,-^- - - - - -Ixt
Pbttehkopeb, Dr. ; Theory of Cholera .----• xiv
Letter on Cholera in Bavaria ..... • 280
PouGE,'M£TsopouTAif ; Mortality from Cholera - .... Izxxiv
Poor Relief in each DisMst of London (Table 26.) - - - • 61
Poplar; Diffusion of Cholera ih • - ' -" *- • - xxv
Deaths registered from Cholera and Diarrhoea in different Streets, &c.
(Table 35.) - -. - - -. - - - 85-86
Portsmouth Cholera Field - - - - ... zlvii
Post Orwum OwncikiM} Preventive Measores ad<^»ted .... Izxzii
Precautioks against Cholera in regard to Water (from Cho. Rep. 1849) - - 294
Przvo5Itort Diarrh<xa found to be a Symptom of Cholera in 1832 *• - iz
Dr. Sutton thereon - - - - . - x
Prevention of Cholera ; Efficacy of Personal Meatures ... Ixzxii
PHiPHAif, Charles ; On Cholera at Paignton .... 220
Problem ; Elimination of Cholera Matter - - - - - 136
Propagation of Cholera ; Theory of (from Cholera Report of 1849) - - 291-293
Quarantine ......... Izzziv
Queen, Her Majesty the ; Letter to the Bishop of London in reference to
Distress in East London ...... -go
Quintiu, The Marchesb Cinque ; On Cholera in Albano ... 281-284
Radcliffe, J. N., Report to Privy Council on the Outbreak in East London • xii
On ihe Orfgin of the Epidemic in East London - - - • ziz
Rainfall ; Diagram (t^o. 4.) showing the Temperature, Rainfidl, and Deaths by
Cholera and Diarrhoea in London on each Day of the Five Months June to
October 1866.
(See also " Meteorology.*')
^oiBTRAR General, Letter to, from Dr. Farr . - - - - vii
His Charge against the East London Water ... - xii
Reoist^tion ; its Advantages uTrecording Facts relating to Disease • . x
Rrssrtoirs of the London Water Companies ; their Situaticm and Site - 260^271
■'RiOB Water E^iACUATioNB ; dilutions m tabes . • « • • xhr
318 Alphabetical Lidex io
Page
fiiGHABSBOir, Dr. s theory of choleraic propagation ... . ^;i
Biters Pollution Coiaassioir ; inquiry into pollution of Birer Lea and Cholera
Outbreak in East London ••... --xii
BooBBS, Jjlmss ; On Cholera at Ystalyfera (Neath) • • • ^ 244
Boms, Cholera in- • • • • ... 287
BowB, Dr. T. J. On outbreak of Cholera at Margate - - <.. - 211
BuBBXLLy Mr. A. ; Letter to East End Newt in reference to £eLi in J!ast London
water pipes ------•.. 129
St. Babtholomew's Hospital Cholera cases . • • .
SAUNBKBSOir, Dr. ; experiments on Choleraic Propagation ... xiy
tScALzi, Pbofessob, on Cholera in Bome • « « - • 287
SdBKTiFio Elements of Cholbba • - - - • lii
SciENTino Inquibies CoMmTTEB (1854), on imparity of London water - xi
8bWAOB EXHAJFATIONS -- ...... XTI
SbwaqbIbbioation and Water Supply .... . xliv
Sbwbbaab - ---.-----Ivi
Sex:
Influence of in Cholera •--.... -lix
Deaths and Bate of Mortality from Cholera and Diarrhiea in 1849, 1854, and
1866 in England of Males and Females of different Ages (Table 8.) - 19
Aggregate Deaths from Cholera and DiarrluBa of Males and Females of dif-
ferent Ages during the Three Epidemics of 1849, 1854, and 1866 in England
(table 9.) 20
Aggregate Annual Mortality from Cholera and Choleraic Diarrfaoa of Males
and Females of different Ages in the Three Epidemics of 1849, 1854, and
1866 in Ei^gland (Table 10.) .--... 20
Deaths registered from Cholera and DiarrluBa in the Year 1866 of Males and
Females of different Ages in each of the Begistration Divisions of England
(Table 11.) -.--•-- 21-22
Deaths registered from Cholera in England in the Year 1866 of Males and
Females at different Ages, with the Period of Duration of Attack
(Table 12.) - -28
Deaths registered from DiarrhcBa in England in the Year 1866 of Males and
Females at different Ages, with uie Period of Duration of Attack
(Table 13.) -24
Deaths registered from Cholera in London in the Year 1866 of Males and
Females at different Ages, with the Period of Duration of Attack
(Table 14.) - - - - - - - 25
Deaths registered from Diairhcsa in London in the Year 1866 of Males and
Females at different Ages, with the Period of Duration of Attack
(Table 15.) - - - - - - - 26
Occupations of Males dying at different Ages of Cholera in England in the
Year 1866 (Table 16.) - - - . - . 27-33
Occupations of Females dying at different Ages of Cholera in England in the
Year 1866 (Table 17.) -- - 84-3S
Proportion of Deaths by Cholera in 1866 to 10,000 Males and Females living
in England in 1861, of different Occupations (Table 18.) - - - 37
SiLTEBTQWN; its immunity from Cholera • • • • • xxyi
Snow, Dr. ; on Cholera and impure water • • - xi, xiii, zzziii, zxxix, 302
B0UBCB8 of Scptlt of the London Water Companies « • • • 260-^71
Rejxn^ bn Cholera in 1866. 319
Page
SoiTTB London ; experiences of Cholera .... . xxH
Cholera and its Water Supply - r ... xxxix
Spontahbous Gkheration of Cholera ..... . Ixzxi
Stages of Cholera ; Deaths in the sereral stages of Asiatic Cholera (Table 30.) 78
SrATUTtCAL Fallacies in reference to Choleraic Diffusion - - - - xrr
8uB-Di8Tfticn:
Deaths from Cholera oectirring on each Day during Thirteen Weeks ending
29th September 1866 in the sereral Solndistriets of London, grouped ac-
cording to their Water Supply (Table 24.) .... 44^9
Water Supply ; Eleyation ; Area ; Enumerated Population ; Deaths ; and
Annual Kate of Mortality from Cholera in 1849, 1854, wad 1866, in London
Sub-districts (Table 27.) ....... 62-7
Mortality from Cholera in 1849, 18S4, and 1866, in London Sub-districts,
arranged in the order of Bleyation (Table 28.) .... 76-77
Mortality of Cholera in Eleven Ckoups of London Sub-districts at different
Eleyations in Three Epidemics (Table 29.) .... 7$
Population, Deaths, and Mortality ftom Cholera in 1866, in London Sub-
districts, grouped according to Elevation in the several Water-fields
(Table 31.) -.-- 79-81
Mortality from Cholera in London Sub-d&tricts In 1849 and 1853^-54,
grouped according to their Elevation and Water Supply (Table 82.) - 82
SuLPHUsio Oranosadx ...... Izxxii
Sutton, Dr. ; record of Cholera cases with and without premonitory Diarrhcea - x
Tbmfehature ; Diagram (Ko. 4.) showing the Temperature, Rainfall, and Deaths
by Cholera and Diarrhcea in London on each Day of the Five Months, June to
(jctober J 866.
{See alio Mbteoeologt).
Tempxeatuee and Cholera matter . .. ^ . . . ixix
Thxoeies of Cholbea:
Zymotic Theory - - - -.- - -- Ixv
Mathematical Theory -..--- - but
Air, Water, Contact— Theories .-.--. budx
Spontaneous Generation - . - - - - - Ixxxi
Thxobt of the Fbopaoation of Choleba (from Cholera Beport of 1849) - 291-293
Thomas, Dr. ; on Cholera and Water Supply in Llanelly - - - 248
Thomson, Dr. R. D. ; on the specific gravity of Cholera Flux - - - xv
microscopical researches ... . Uvi
Theee Epidemics ; Observations of^ in regard to Age and Sex ... ix
Town Distbicts. Deaths registered from Cholera and DiarrhdMt in Nine large
Town Districts in each of the years 1838-66 (Table 2.) - - - - 2
Tbench, Dr. ; Extracts from his Report on CSiolera at Liverpool - - 229
On Preventive Measures adopted at Liverpool - - - 231
Ttleb, Captain j Report on East London Water Supply - - xii 5 102-108
Ttnemouth Choleba Field ... - - - xlix
{See also Newcastle-upon-Ttne.)
United Kingdom, Mortality from Cholera in - - . • ' . ^
ViBBIONS .-•-- - -XT
ViEBORDT ; Estimate of number of globules in a litre of blood - - - bdii
X
Alphabetical Index to
PaM
:8 (South) Cholera Fisld ..... . xhx
ER, dispersion of Cholera Flax over large areas of - - - Iziii
TEB Closets, Introduction of • - - - - iTii
TEH Companies :
Deaths from Cholera occurring on each Day during Thirteen Weeks ending
29th September 1866 in the Water-fields of the several London Water
Companies (Table 23.) ..... . 42-43
Deaths from Cholera occurring on each Day during Thirteen Weeks endmg
29th September 1866 in the several Sub-districts of London, grouped
aocordmg to their Water Supply (Table 24.) .... 44-59
Water Companies supplying each London District ; Area in Acres j Number
of Inhabited Houses. in 1861 ; Annual Value of Property assessed 4n 1866 ;
Estimated Population, 1866 ; and Deaths registered firom Cholera and
Diarrhoea in 1849, in 1853-4, and in 1866 (Table 25.) - - • 60
Water Companies supplying each London District ; Elevation ; Persons to an
Acre ; Persons to a House ; Annual Value of Ftoperty per Head of Popu-
lation ; Average Annual Value of Houses*; Poor Relidf; and Number of
Deaths to 10,000 Persons living from Cholera and DiarrhoM in 1849, in
1853-54, and in 1866 (Table 26.) - - - - - 61
Water Supply ; Elevation ; Area ; Enumerated Population ; Deaths ; and
Annual Kate of Mortality frx>m Cholera in 1849, 1854, and 1866, in London
Sub-districts (Table 27.) ..... - 62-75
Population, Deaths, and Mortality from C!holera in 1866, in London Sub-
districts, grouped according to Elevation in the several Water-fields
(Table 81.) ... . . - . 79-81
Mortality from Cholera in London Sub-districts in 1 849 and 1853^54, grouped
according to their Elevation and Water Supply (Table 32.) ... 82
Area ; Enumerated Population 1851 and 1861 j Number of Deaths registered
from Cholera and Diarrhcea in 1849, 1854, and 1866 ; Annual Mortality
from Cholera and Diarrhoea per 10,000 of Population in 1849, 1854, and
1866 ; Annual Rate of Increase per Cent of Population 1851-61 ; Density
of Population in 1866 ; and Elevation in Feet above Trinity High-water
Mark, of the Fields of the different London Water Companies (Tables 33
and 34.) -.----. 83-84
Watbbfiblds :
Of London .-.- - .. -»
Mortality from Cholera therein .... . - x
Inequalities of Cholera Mortality in their different parts - • zi
Indirect Diffusion of Cholera in - - - - - xxi
Wateb Supply of London :
Its quantity and cost - - .....
Small cost of conveyance of water ... ...
Present sources of supply ......
Plnojects for new supply from Wales and Cumberland ...
Utilization of rain-fall . . . . -
Quantity and quality of water necessary for use
Soft and hard waters ... . . . -
The dangers of river water - - - . - . -
Fixity of zymotic molecules ....
Sewage irrigation .--...-
Mr. Bateman*B revised Estimates for Welsh supply ....
Financial considerations .......
Hr. Greaves's Evidence before Pollution of Rivers Commission in reference to
the Distribution of Impure Water in East London ...
Map (No. 3.) showing the Position of the Beservoirs of the East London
Water Company.
Beport an Cholera in 1866. 321
Page
Water Supply of London — continued.
The Board of Trade and the Sapply of East London ... 102-108
The Medical Officers of Health on the Water Sapply of their Districts - 1 60-1 77
Professor Frankland's Report on the Quality of the Water in 1866 - - 257-259
The Water Companies of London ; their Sources of Supply, and the par-
ticulars of their Works for Storage and Filtration in 1850, 1856, and 1866 - 260-271
Average daily quantity of Water supplied by each Company in 1849, 1856,
and 1866 ..---- . - 272
Amount of Capital and Rate of Dividend paid by each Company in 1850 and
1866 ---.-- -.-272
Capital, Receipts, and Houses supplied by each Company in 1866 - - 273
Distribution of Supply of each Company in 1866 ...» 274
The Thames and the Water Supply of London in 1848-9 - - • 288-291
The Water Supply of London in 1854 .... -295-302
Water Supply of Newcastle - - . ...
Wateb Supply of Pabis -.-•-- . 275-279
Water Diffusion Theory - - - . - - . Ixxx
Watson, Sib T. ; on Arrest of Cholera - ... - ix
Wealth and Poverty - - - - .--. lyii
Weekly Returns; Extracts from those published daring the ooime of the
Epidemic of 1866 ..... . . •109-159
West Ham - - - - - - - - - 95, 132
Whitechapel ; Mr. Liddle on Cholera therein .... xxvii
Williams, Jambs ; on Cholera at Holyw^ - - • - - 250
WOLVEBHAMPTON CHOLBBA FiBLD - • - • • . zlvili
Woolwich (Charlton), Outbreak of Cholera . . . « 142,201-205
WoBKHousES of City and East London ; Immunity from Cholera « - xxvii
Zymotic Molecules, fixity of- - - --.- xliv
Zymotic Pbinciple of Cholera (from Cholera Report of 1849) ... 294
Zymotic Theoby :
Pasteur's researches .... . • . i^y
Cholera flux - - - ....• ]zYi
Dr. Hassall and Dr. Thomson's researches • .... ixvi
Vibrions and vaccinads ...•-.. ]xvii
Dr. Beale and M Chaveau's researches • .... izvii
Experiments on zymotic diffusion ..... Ixviii
Alcohol, temperature, filtration ....•• l-g^x
Monads, biads ..•••• • . izz
LONDON:
Printed by Qbobob E. EtBs and William Spottiswoode,
Printers to the Queen'i most Excellent Migesty.
For Her Migesty's Stationery Office.
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