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Full text of "Annual report of the registrar-general of births, deaths, and marriages in England. v. 16, 1853"

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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. 



CUOLKUIC DlAXBBOU. „ 



yjif&m ^wkrm awrf Jtoftaa ml ^BrentAym i» lUgUtruHoH Divirioiu. SI 



M 



SS IS 



is ir 



a » a 8 n 3 



SI it 



ii »s a« 3. 



S§ (» 



« 8 S3 S S 



55 s» ss =t 



«r 



SS R« 



§g 3 3 



E8 53 



S5-=^ sgsa 



M 



lii! 



iS ^S »s Ss ==55 



llll 



II ;| %i%i ■'^ i% itli S3II 



llll 



III! llll llll llll ml 



km 



ii 



i 1 



u 



8 



1 1 I f I i 1 1 j I 



S8 DeathMfrom Ckotera and Diarrkaa at different Ages in Segitlrati&m Diouii 



s 



ll 



S^B 






u 



ggSJi 35^8 s;;;:? ns 



■•5 S1S8 6Sa« S?t:: 



»l >' == !» 5» 



feKatr S3"8 SSS" 



S 5 

TT 



"■•-« »,-»* iSSt 3-"* 



55 



•'it IBS? »'Sf. »»5! SS 



1== 1^ '« !S IS 



! 1 « SI 



88 88 S8SE 8 

II || II || II jl || II II I 



£i£ 3 b k£ 



II 



11 

1~ 



J| t t it si 



. DlMfAf fi'ttm Otabrm in EngUmit with Duration qfAltaeh. 



n 


i§ 


a 13 3* sj as 5J s? 81 ai »f- "= --i 


H 


*i c 


" " -V -- , . - , , , , 






a 


" * 


'' > ■' i> ■■ "* ■■ . 






« 


u « 


"*-. 1. .. ,- .. ". ". 1. ,, , 






a 


ss 








3 


at 


«; ., .. -. -^•.. .-. -, .. .. , 






s 


I j 


3j. .«..«.. ..-.....» ,. , 






, ' 


1 1 








i . 


»* 


*«t-K<Ba''«at^g2>>'*>B, u« ,« , 






» 


?f 


8^ "Z St St Sb S« s? it *? ■•■• , 






« 


SI 


6t -: -» s- a« -» =t =: -- -• . 






■ 


3« 


3S SS St SS m SS •« 35 '8 - ■» - 






4 


Si 


s« as "s sfta «jb! is as -■ , 






■ 


i; 






* 


3X 


jiSjas»ss-SBirs^ssse-s ,• 




- 


II 


S^ £1^ B« %^ S9 S* g« St St: S8 «e 




i 


II 


isisssssaiaf^ssi*?'!'"- 




s 


St 


i; si s« 88 S5 as ss se a; si ■> 




a 


M 


8| 3f 0? SS IJ S« SS ES S£ =S -• 




• 


ss 


j:t:ii,i>333S!a£cs£is:s> ,« 




• 


«« 






8 


i! 


15 ci Ss S« 5| l| S3 S5 15 SS" •' -■ 

li y ij y ii li ij y 1 li J if y 


i 


1 






j 


i! ^ ^ = i i i i i ^ = If 



M 








Z)«Uj 


fitm morrlma a Englmd, vnlh Duration tfjlmeh. 


1 


« 


d 
a 


fi 


1! 


Ij sa as S3 ss sa 2| g§ gj 55 5ft " 


\ 


31 


35 


^^ s. * «« «K «- "S "-T as as s? "• , 


4 


a 


;! ? 


Sfe,, ..-ir---""*-*, ,-«* ., , 


J 


s 


SE 


ii -• ■ ■ ..••.-•■• s 


1 


s 


if 


j5 ..,,-.„, .. -^ ^, a, B* -- . 


•» 


i 


3S 


jg ,, _. ,. -. ., .. 3; a^ a, .. , 


1 


s 


Bl 


3^ ,--,-•---.-« -S S'S -t -- . 




2 It 


»• ~ ■■ ■' "■ '■ -»---•- 


5 




sS 


S3---I .^ ,v«. ».».-.. -^-Vj 






§1 


^l""", .•'-■'-'-•*35a«5»*Si 




E< 


JS "•"'-•-•"-"' "~ " * 






II 




a 




BS 


H""--. »»---»•- a»3-s! -'* 


^ 


- 


fit 




9 


- 


ti 


3, — - "- - -■ --->" " -. . 


j 


- 


SI 


sa***. ." ,-'«-'-■'«*>*-*■■*»-'*, 


j 




ill 


3 S. 


S3 3* ," -* -" -*- -" *" -• -• -- , 


J 


^ 


s 


« s 


a*"" jVr-. ,., !*.-*«, ,1_ ,-, ^, , 


4 
J 


s 


s % 


as-** .• ,, ", -■-•"^""-'--•'-■«., 


'• 


b 8 


2 ?■=-.......*—,,-.-,-> . 




• 








li 

s 


II 
II 


jl ss ss cs ss = J SI II II 85 Ef" 

UlltJiliJlJtJlliJiiy! 


1 


II 


1 


3. 5 s s S S ! s s 1 5 • 




1 

a 


H ' S i S i i i i i il 



CSWbrs M Lmidom, with DurathH ofAttaekM, 



n 


it 


51 IS as SR =; jj s| cs sj =5 -« -•! 


ii 


w « 


-- - 






3 


-' 


- ■ ' ' 






a 


« * 


- - 








-- 










8» 


s. .. - - -> . 








*t 


3« -. ,,...,-.-.«. . . , , , 






















, . 


S3 


wan ii«»***n,^.„,w, ,, 






" 


«« 


>, „. .. .. „5 -5 ,„.... ,. , 






) • 


«R 


a5-.«-o,.,.c-e"-= .... . 






1 ■ 


S£ 


3ts---'="2"~;<---'--» '' ' 






1 . 


S| 


as se ---• a- stbc a-."" "" 








*S 










s? 


as ss -" ss 3S US ai as == -• •• 






IS 






M 


Si 


II as Sft SS 3f SS 5^ 35 S3 J!? ~ 






s 


15 


S, «5 tro « =. as j-« t; S *S =8 - .- ' 






i = 


S5 


ssssiss as3s f?, ssasse •-- 






a e 


il 


»S3»S5=C3SKt=t3?S*»-' ' 






o 


lit 








,1 
II 


IS 

ll 


It SI 21 SI St SS 83 8? =1 =s -t -■ 


l| 


1 


1 i :- s i : 3 S 1 s " ' 


i 

< 


i 


li; i s 5 s s s s s ; ! ji 



Deathi from Diarrhaa in Lundon, with Dvratiim ofAUadu, 



! 

! 


i 


It 
1 


S K 


1^ =s *■' «■- s~ St S8 BS 83 as *'- 


» i 


S 5 ' - ■ ' ' 




s 


' ; 


"S ■ ■ ' ' ■ - 


• ' " - ■ 




3 


St 


.- „ , , , , 


- ' • • - ■ 




S 


s s 


»S ' » ' ' ' 


'•-'-'-■-•-- 




+ 


ss 


81 ■ ' ' » ' 






s 


s s 


s» 






- 


5 5 


3 5 






. 


as 


3 ! 










- 


s; 


jS , . , , . 


■ • "• ' • 




« 


J f 


a s - • - ' - 


-' .-■.-..... 




" 


8 7 


SS - ■ ' ' ' 






« 


a« 


8 5"' ' ' ' 


1 > r- » n -» 






- 


sc 


S R "- ' - ' 


■ • ' • - ' 






- 


e> 


«»-•"' -- ■• ■■ -■ 


. , . , . 




- 


S i 


88-- ■' ■' '' '' '■ 


• - ■ • - 




m 


s s 


5 5"' 1 , , 


, , , . - ■ 


• , • , - 




I 


a 


-■ 


-- 




, . . ,. 




= 


n 5 


f A n > ■ < 1 


, , , , „. 


V 1 k < 1 




f 


., 


. . - , , , , 










' • - ' ■ ' ' 










li 

s 


tl 


ge sa -- «* SB se s« s? se sa •«' 

ll if 11 ll ll ll l| l| if ll ll 

^ is iS IS Is Is iJ Is sj Is li 


II 


5 


: : 3 3 : : s s 8 : a 


i 
% 


i 
3 


If - S 5 S S ! S 5 B : 



.OenfpctioM f^Makt ^ng Jrom Chokra. 



Tabu U^-ESTGLAND. 



'frff-' 



I i I I 



»-'.| 



«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- 


- 


„- 


.. 


»- 


as- 


«- 


M- 


«- 


76- 


8S- 


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 


ISIT 


771 


m 

1 


u 

1 


- 


- 


- 


- 


- 


- 


- 


- 


■ 




: 






j 

s 


1 

6 

1 

1 
'1 


i 

4 

i 

1 


a 
a 

1 
'1 

} 

1 


1 

1 


1 
1 


j 


'- 


! 

S 

3 

18 

Si 


^ 


l 


'l 


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"a 


'6 


'i 

'1 

I 

2 


'1 

h 

1 

s 


1 

i 

"1 

'l 

» 

] 


'l 


1 


: 


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7 
» 


: 


: 


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i 


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io 


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J 
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j 


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s 
1 

"1 


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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 


- 


- 


10- 


18- 


M- 


iW- 


«- 


"- 


ss- 


.-j.-:.l 


iiHi aW>. FKcin. oruum. 

AXUIALB, awl irfAtr prodilcf. 
\.InPitid,ai^PaH<,rm. 

LudAirrejor, iMOd ErtUe Asoat • 
Gudour <nD(IK)ai«Ue8«rvM>q - 


n 

T 
SB 


: 


: 




"s 


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13 




M 


11 
"2 


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'1 


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: 


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IS 


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1 

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: 


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~t 


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:' 


t 


:|;i; 

-*!:': 


Tomin DatraxcT. Kat'^hcr - - 

1. h B,«k*. 
tMa^^rnVaOnr .... 

Xuicil iDUnunnit-JUlier.Daacr . 

L £• n«U>/H-S|wr« Md Sow*. 
Toi-Mikar.SMlo . . . ■ 

g. /jlIMfB*. V*dri(,iMd DIM. 
P>l«n>Dai«Ber 


10 

4 

1 
1 

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= 




1 
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3 

1 
2 


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1 
1 

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1 


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, 1 






- 



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- 


M- 


1 


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 . - . . 


S 

D 

B7 

J 

* 
SI 

or 

« 
1 

47 

1 

1 

1 


= 


= 


"l 


7 

1 
10 

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'l 

s 

T 

I 

"l 


t 

1* 

"l 

a 

IS 

's 
w 

I 

10 

1 

I 


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11 

1 

i\ 

10 

1 
> 


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1 

i 

'l 


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1 


1 


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S 
V 
41 

i 


: 


- 


: 


'« 


't 


B 

"l 


^ 


•! 


1 
11 


t 


'- 


: 



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 : 


-!-ll'l 1 1 21- - - 


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» 


! i' " ' " ' " ' r ! i "i "' "' ■ " 


. il - ; . i . i . ■ - : , : - , - . . - ■ - 


r. BodB. Hlnna) Tttn.- 


l\\\ 


: 1 ".! !: S' V, ii -' "J \ : 




I ]' _l_:_--l..->,l.l 1 .,-1-1 


ssjffi^fsr'- 




' ' ; ■ ■ i 1 


-•fcas'''-"-'^- 








iDdlsr 




.-,.;-'- 1 }■ |, J 8 1 - 


- 




JMhT'Marra.MtfQKJRt. 


J 


. ■ .1 . ' . ' - 1 , ; / - ■ . 








7 


:!:::.: l i' s, S : 






: 


3. AA(r. 












<«>!r!£s.v.,.v..^; 


! 


: 


; 


;|:-;-;'!'>l2. 


- 




^J_ 



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 
» 

S 




- 


-: 


• 




1 

't 

t 

I 


'i 

1 
"i 

'! 

B 

1 


'l 

1 

1 


« 
1 


1 
~1 


: 


.": 


^^..i, :::::: 
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 


l 


: 


'* 

i 
I 


1 
IS 

"a 

s 

-' 


"l 
S 

I 
J 

- 
11 

"a 

B 

e 


4a 

B 

"l 

S 

1 

i 

1 


SB 

3 

1 

"l 
1 

1 


U 

1 
~B 

j 

"l 

I 




: 




&; ; ; ; i ; 

OHwrM 

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 


.11 


W 


IMS 


IIW 


» 


:«. 


«7S 




st 


s 






























> 






- 


- 


1 




- 


- 


I 




- 


- i 




1M4 




• 
an 


SOS 


no 

10 

in 


SO 


BU 




au 

MB 


Ml 
UO 


« 
IM 


a 
a 




r 


1 

« 
£1 


: 


: 


1 


'i 


10 

31 
'l 


> 

1 
11 


u 
u 

i 


"i 

1 

i 


I 
I 


B 


1 






,i 




: 




% 


"l 




i 


'i 


: 


1 


: 














1 

















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 

! 


: i "J ; 

- : 1 1 


• 


: 


7 4 


i ■ 
1 




. ' - i - 1 . 1 - : - ' - 1 - ' J . 


1 ■ . 


! . j 1 


1 
i 




l! 

1! - 

IS ; - 

I ] - 


- 


'i 




1 

'1 

'l 

1 

if 

* 


- 


11 




1 

" 1 ' 

- i - 

1 

■ 1 " 
:l : 

1 




; 


>':; 


: 


> 




:■ 


:■ 


-- 


: 



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 


- 






- 


- 


- 


- 


\ 




' 




- 


. 


» 


> 




' 


- 


-■ 


■ 


■J 

i 








1 


I 


- 


- 




- 


- 


- 


^ 


^ 




. 


, 


_ 


, 


1 


1 


1 


_ 


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 

s 

c 

s 


v 


5-1 


- 8 


' ' 






" ? 




ij 


SI 


' ' 


s JJ 


1 . 1 ^ 


a 


•3 5 


' ■? 




" s 


- tr 


'■ s 


" i 


s^ 


s s 


= • 


S 5 




i 3 


' tr 


' ' 




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' 8 


» S 


§^ 


91 


IS 


8 * 


=> B - : 


s 


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si 


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- ? 


" l- 


-* 5; 


n- 


2 S 


s s 


S !S 


S 5 - 5 


' 5 


' ? 


- ? 


' 5 


" « 




^? 


ss 


S f: 


7s a 


2 ? - S 


- 1 


' 8 




' 8 


" 8 


'■ ? 


sr 


S & 


sn 


E* 


s 3 « a 




il 


r- tr 


-^ t 




" 3 




" 3 


3? 


5 B 


S e 


e & 


S 8 - S 


IS 
II 




' 8 


^ 


" 8 


« 3 


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J_5 

2? 


2 R 

2 a 


as 


s s 


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- s- - s 


n 


15 


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S 2 


5 ?. 


a ^ 


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■" a 


* fr 


S^ 


S £ 


S s: 


s s 


S 8 - t 


8J 


- S 


■ t 


- a 


' 3 


B 5 


- c- 


« ? 


S3 


a& 


S 3 


= ? * ( 


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" S 


" i! 


»? 


K S. 


ae 


S 5 


2 8"! 


5 


33 


' ■? 


' B 




' 2- 


» 8 


" S 


g 3 


S J 


a 3 


S s 


S ? =t 


£: 


51 


" ■s 


" a 




■ S 


" S 


= ? 


S S 


S ^ 


2 * 


K S 


S S -! 


S 


S'5 


> ? 


• « 




' i 


- s 


« 8 


e fe 


> ? 




ss 


2 8 - * 


a 


IS 


'fr 


' s 




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- J 


' S 


4 S 




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' 5 


' 5 




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a « 


s ?. 


s 


19 


' 8 

' a 
' s 


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* s 


S f. 


s r 


"si" 


S Q 


s S' s a 


a 


5J 
55 


= s 


J' 5_ 


i 5 


8S 


S 8 - S 


" s 




' ? 


" fi- 


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6 ? 


S 9 * t 


' ? 


> e 




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* 8 


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s « 


5 s 


BI 


S £ 


S « - ) 


a. 


6! 


" 6- 


' 8 




- ? 


■= t 


' s 


3 t 


5f 


as 


S S 


3 K -1 


- 


Si 


- 8 


' S 




' a 


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" a 


a ti 


sr 


S? 


^s 


e ? * t 


"^ 


13 

3! 


' ff 


- £ 




' ■? 


" t 


" * 


S R, 


II 


s? 


83 


S 3. •« 


- £ 


- ! 




' 8 


" S 


" 8 


-S 


:;? 


s ^ 


S S 


S 8 - 1 


4 


15 


' 3 


" B 




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H 5 


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£ T 


g^ 


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' t 


- » 


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91 


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Da3g Deaths Jrom Cholera and Diarrhaa in London. 





a 


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lillJlflllliliiiliiilili 


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DaUy D«Uh$ from Cholera and Diarrliaa in £att DitlnOt. 



in 



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s 

s 
1 


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DaUy Dtalkt Jrma iSubra mid Diarrluta in Londox (fxeluding East DistricU). 41 



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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 

4 
5 
4 
8 



1 
6 

3 
3 

3 
2 
3 

4 
2 
4 
8 

6 
2 

3 
8 
2 
2 
2 



3 
3 
3 


3 
7 

3 
6 
1 
3 


7 
3 

6 


4 

4 
3 
7 

1 
7 
1 
5 
6 
3 
4 

2 

4 
3 
2 

4 

4 

1 
4 
3 
2 
3 
1 
3 



>^4 



3 

5 
4 
1 
1 
3 

5 

3 

1 
•> 

3 
3 
4 

ft 

G 

4 

3 
3 

5 
5 
4 
6 
3 
4 
4 

3 
6 
7 
4 




6 
11 
12 
9 
3 
6 
5 



u I 



2 

3 

4 



3 
1 



1 
1 
1 

1 
1 
1 



5 
3 
It 

a 
I 

2 

2 
8 



•I 

1 

1 

I 

1 I 

1 

I 

1 

4 

M 

3 I 
1 I 
2 



•2 



23 
20 
20 
ID 

2«; 

IS 
11 

21 
21 
17 
20 
l» 
7 
10 



»2 
40 
32 

3«; 






27 



Sft 

.'» 
33 
2.1 
32 
21 
2:1 



2j 



5-. 

a 
s 

1^ 

'.• 

yj 

tt 

ii 
it 
n 

') 
t 






■3 X 



39 



33 



35 



2S 



5 


22 


& 


22 


10 


27 


/'* 


27 


11 


ii 


IX 


23 


i:j 


23 


f't 


26 


10 


2*1 


/J 


28 


S 


21 


s" 


21 


11 


27 


r-» 


28 





22 


tt 


24 


13 


3<) 


t.l 


30 


14 


23 


/.J 


26 


9 


31 


V 


31 


11 


22 


it 


22 


6 


17 


6 


17 


7 


22 


"f 


23 





IS 


1 


IS 


8 


21 


/» 


24 


8 


21 


1 


27 


S 


2ft 


y 


23 


9 


2S 


to 


29 


* 


2:1 


i 


23 


6 






23 


7 


2ft 


/ 


2« 


3 


2a 


J 


26 


5 


2»'> 


« 


26 


4 


29 


J 


29 


5 


1ft 


J 


14 


4 


19 


« 

' 


20 


G 


1 21 


^' 


21 



ToUl . 148 



30 



229 



232 



382 



323 



3ft10 



4731 



.;;/5 



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 


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4 


B 


fl 


1 


1 


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10 


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 - - . . 


9 


u 
a 
1 

IS 
28 
M 

i 

1 

W 
SM 

-8 

u 

08 

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: 


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: 
















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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 


"," 


« 


M ' 11 


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 


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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 


1 




_ 

: 

- 

: 




I 




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; 




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: 




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i 


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' 


' 


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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 


» 


» 


u 


11 


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-t 


1 


1 


1 


1 




a 


- 


S 


4 


i 


i 


' 


* 


' 


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 - 

gS!:iS.- : : : : : 
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, 


Jl 


W 


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JB 


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w 


11 1 ±i 


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12 

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37.103 
S.ftlB 

ilSI 

21,«S« 

iS;S! 

SS.113 

zi.sas 
SI .910 

10,7B3 
1Z.BS9 
19,773 

isIba* 
zb'.bsz 

3«7«9 
22,«93 

3«:9Z7 
3«,913 
3Z,9«0 




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11,071 
29,371 
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19,692 

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17,00 9 

16,««8 

19,ZC9 
1B.60 

3o'.78 

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13.340 
0.481 

zo.Ba4 
ao.oay 

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» 


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. - .^ - ■ :: ■ -^ . ^ 


229 


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 

OS 

as 

78 
100 

7 

ad 
so 

M 




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: 




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- 




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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 


IB 


11 


to 


SI 


u 


a 


» 


U 


ta 


» 


B 


. .| 


tl 


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: 


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1 


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i 


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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 


« 


,. 


» 


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 


1 

i 


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i 


1 

i 

1 


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=" 






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n| .p^ 


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J 



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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ill 


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1 

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I 


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1 


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1 

1 


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a 


1 


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1 
1 


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1 

1 


1 


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S 


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! 

i 

1 


1 


a 


9 


6 S 


* 


3 


1 


« 


S 


6 




Z 


7 


3 


B 


I 


3 


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7 


1 

1 
1 


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: 
: 


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1 






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B 

\ 
1 

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1 


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1 


1 


a 

1 
1 


1 


: 


; 


8 


4 


8 

3 


^ 


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1 


1 
1 




; 


^ 


1 


J 


A 


• 


3 


J! 


« 


- 


D 1 3 


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 


* 
S 

1 


1 


i 


1 


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 


1 


■ 




1 


i 


1 


I 
i 




■ 


i 




i 

8 


i 

i 


i 

1 


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 


S 


a 


A 





i 


t 


s 




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1 


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1 


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1 








1 


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1 


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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 


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so 


.1 


S3 


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M 


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IS 


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i 

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1 


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1 




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: 


i 


1 

1 
1 


I 
1 




1 

1 


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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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i 

I 


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it 

23 

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13 

3 

13 

3 
9 
21 
15 

19 

3 
14 

2 

S 

J 

1 
« 

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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 


: 




^ 






1 


X 


i 


; 


r 






13S 
3B 

13 

39 


12,B37 
9,971 

IS;I!5 

3i,4at 






* 


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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 




: 




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1 


C 




: 










; 




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HLB-DlSTElO'tS. 


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■ 


* 


* 


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7 


. 





a 


■» 


But KDndan. 

8t.JohnSt.C«irp>in-ll,.:-E«»t W 


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9 
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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 


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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? 


\m 


]7.m 


M 




Dillo 




HtokpJi^iuKlon .'^- - - 


7e 




fljuw 


t.«H 






Ditto 




GoiWOlUtTNt - . - . 
Pcnlonylll^ 


Js 


is.'ta 








ID 


l.-f<r RiviT - 


80-M 


Bin.771 


a7.«i7 


(SU78 


17* 


s 


n 


„,„„ 


13J)-B 


1S,M7 


^ 





l>illa - - ' Iillnnton Kn«t . . ■ . 






7n,sm 




41> 




Ditto - - iHlLriKtoii W<-it . . - . 

1i:it.. Tfr.Klitil. f^.irlt - . - > 


jim 


ft'w 


la.i-ki 


GD^ 




• 


i/il10 ■ ■ iii:rmaii-iowu ----- 












M(.i.,.»J. 


ia.i,.-Hiii 


211787 


m«i 


ins 


4 














! 


1 


n.[>m 


oja« 


gL^d 


100 


171 


U11.I1.T S 


lMf.-> 


W,1W» 


o.iti 


ISH 


171 


, 


■•■iwt 


asai 


M,1WI 


«i 


M 


E.Lonil. h X.Itiv. tiliiidwcU 


7 


Iii'lT-J 


la^ar 


mas 


lit'. 


U8 




3-III 


■lYrkvi 


:am6 


OS.TM 


R.7 



















Envt I.nndoii - Linichotii.c 


"; 


2! 7-^2 


°716I 




ajH 


I» 


Uitlo - . ■ Ho* 






h'.iM7 








Ditlo - - ttatelilT .---■- 


3S 


ii!iii 


1.I.-71 


liJ-W 


an- 


IS 


iij-ai 


y'.iTi 


;y,7iia 


vi.nt 


il 17 


1« 
















)tl„ - - SI.3lBi7St.G«M«o-iH-liip-Kai!l - 


a; 


H.mi7 


Ivl 


■17.7M 


IW 


m 


.It" - -'Mt.HmISI,(;.-onn-iit-llio-Ka>l - 




Su.nm 




SD.T71 




H 


Ml.. - ■ MilpEn']«l.iT'wn£iul - • 








43,<ai 


3ll> 


T* 




»i 




ll.lW 




5a 


i7 




iii 


7;i*r>. 


^jwa 


KJMi 






Uti.. . . M 1. r .:..|.lTow»-\Vii(t - - 






ia,7W 


3tflU 




M 


E,T .1..1 .'. . ■ N..«h - - - 






U,1H 






a 


Ki'l l.i'iii. ■ -...i-T^wii - - - 


■■ui 


if;ir. 


18.801 


liSlW 


nu 


m 




a>i 




1B,T0I) 








K.ll-olil",', ■■.]'. > v:.'i. r. Miiiii'vl.niK.I '. - '. 




ic-s' 


wt 


il.iM) 




n 






au/iM 


HAM 


S1.67S 


"a 


A 


IJillu - . i;h.in'li.lMl.tuiUin™. - - 


S11 




SMSi 


^ik^ili 




U 


Ijitlu ■ - GRGn.UdhuulGruvu . - - 


3U 


^!^ 


nine 


M.M7 




Tt 




91- in 


ail I AW 


scj..'ih; 


awz-a 


,,». 


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 




Slim 




M 


IS 






























sa 


n„wi 


ir,ti" 


EO^II 


n 


7 




fliuntordeill 


*>-«o 


M.M3 


WijuT 


iHzn 


ni 


e> 




M 


a.!H9 


s-tna 


B,48S 


i ' i 




N-tW 


e,MB 


e.iea 


MM 


1 4 
































«thk. 


St.G«nm(^ml»rweU- - - 






!n;u.i 
























I 




BE: 


s 




















i^i}1i^SSSf'^h^: 


II 


U,ttU 


lawe 






















^thk.'t^h«h%t;hWpL^ - 








af.>«i 






















































8t.JafiQHonkTd<nn> - - - 
VBt<!rlDoBaadlBtPirt ■ ■ 
















t 








» 






[TiHlcra 


tM9^%t6 


M7,«0 


MS.TU 


iVi 




lOtllk. 


J 


IIIW 


njMU 




J, 


















































WM 








S "~""'" 












«,»« 












































3-10 


lSi,«17 


irajun 


IWIJM 


IM 


a 


Vdl. 


Puiner 


\l 


ei'iij 


IMWt 
B.U1 


1V.K> 
7,"W 


1 


i 




lo-a) 


U,§»1 


li»ar 


■ii,0l8 


IS 




Weill 


SI 


3a^» 


WW. 


■.;.,■«« 


4 




i»-4l) 


in.m 


i.i.-ai 


aaj«.3 


4 




mthk. 


Srizton ...... 


M 


lt,fllO 
14,11 lu 




i3,,71 


C 






40-ai 


aLs;! 


« 








103- 




i.-w 


_ 


_ 






T! 




10,«rf 










ffli^sn 


in,.Ufl ' 11^ 


«;«o 1 3 3 1 




1-f 


,^ 






s 


1 




















SD>:.,p«,l. 


8,i;s 1B.M7 


2a,Mfl 


B 


3 




Kent Oampg«r. 
















SLXicboluDnArurd ■ • • 






S.13» 










7 




l.,5US 






1. 




3-l« 


a,s9» 


w,*» 


**•»' 


100 


" 



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 


*"£ 


* s 


:: |53 


ii^" 


1° " 




JSiS^ 


-nW¥Tn»j«K»iai 


3fe5 


s is Hi 








vnw 


- 


& & 




. ^»-I«t'00H^*MJ^^ 


s s 


1 s s s 










nooi io w»H pmonY 








»:*« 




"^^ 








i 


•»-- • 






><A«I 




1 


II 


;:=h 


s S 


r. igj 


s-s 


s: 


! 3 




lli'li 


fcii 


I i 


- f <f f 

9 8 S S 


ilk 


k 


= S 




i 
















I 




ssa 


i S 


S lifei■ 


;ss 


_8S g 1 






1 












--rn 




1 


1 


f.«P 




= -2 2 


!— 






IB'H 


js=s 


= i 


S 


S B ■■ 


31 


is: 




1 






















2 2 


:i S 




-a 


sa = 






tq 


















1 




"• ^ 


- « 


-s 






,._ 




B'^ 
















'i 


1 


sss 


a s 


» d 


s s 


!ES 


s 


: s 








i 
























t a 


i bE£ 


S3 


igs 1 






1| 
1^ 


i 


gig 


^ S 


" *§| 


pa 


i 


in 




il^i 


|£l 


i s 


9 ^P 


I'l 


'ir~ 




1 


i§3 


S 3 


^ a|i 


jft5 






s 


sss 


3 g 


° a m 


3i:a 


IS* 




s 

f 


1 
















IS'I'^ 


sSii 


s S 


s a 11 


!=l 


SSS 




i 


§=s 


& : 


5 sia 


i=c 


Si = 




1 


iil 


fiS8 


2 E 


" s|5 


!=« 


16 s 


I 


P= 


s 6 


* l?J 


Wi 


l|£ 


1 


?«s 


fe s 


8 SjS 


ISj 


IP 


4 


» 


ri 




m 


E S 


i 6|S 


!ii 


8es 


i 


i 


3 
1 




iti 


a S 


= «.^S 


ES=i 


1 


1 


i 


Isl 


11 


li}i 


jSg 


ill 




•waToinm 


S u[»wv 


ill 


l3 


^ BIS 


Is! 


Bi! 


















? 




§ 






i'r 


mm: 




.4' 






8 




11 








1 - 


;l 




i 




III 


i 




i 


M 



Ifflp 

iS»sa £l 

"^ IP 

Hill F 

iiiii a 

Iflili! 



HRlllli 

lit 

llliiP 
i:|Si|iii 

mim 

mm 

ill 

Ppl 
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 


S 


9 


8 


3 






e 


s 


S 


s 


a 


■]U*3J3ll0»1 


WJ3UI ;d Jt>H l"u"Y 






'- 




" 


" 






j 














f. 


|| 


a 


a 


K 


3 






Mi'li 


z 


3 


t 


i 


t 


1 


1 














3 




R 


-i 


R 


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 


« 


s 


J 


n 




? 


1 


1 'JINI 














1 


i 


? 


i 


a 


1 


S 


g 


« 


a 


i 


3 


1 i 


i 


i 


§ 


s 


1 


ti 


1 


1 ili^S 


5 


1 


8 


1 


A 


i 




" 1 s 


i 


s 


S 


» 


^ 


s 


















2 


3 
1 


i 


1 


1 


1 


i 


1 


1 


% 


i 


1 


i 


i 


1 


i 




■hMOV Wms n? 1!WY 


1 


i 


1 


s 


i 


1 


S 
2 

g 
o 


Ij'ji 


■2 

a 

sl| 

f 




. 


r 
1. 

Ii 
1^ 


;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 



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■ir-.;:-L -^ -inn -^nraiE? an the premises 

~-~ i r'*=^-n 1^ -a»2 N5ew RItcf Companjr 



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,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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148 



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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 - - - - 

16 DvTcn Cities nnd'TowNS 
(including Amsterdam). 

Amstebdam . « • - 
7 Belgian Towns (including 
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 


3,037,991 

1,606,141 

416,931 
560,000 
484^837 
826,101 
262,601 
C3U14 
184^032 


6.548 

f 6^53 
I 1,812 

2,801 

2,875 

1.764 

8372 

1404 

11.771 

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. 





ExtracUfrom Weekly Rthtnu of \^M. 




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.ExtraeU from Weekly Rttamt of 1B66. 



U ibovlnc th* VAntm Cravixm nipplyln* & 
la Un, Fonru.Tiox' 1811, 1861, aid 1880, uid DBa 
ftu, C*rni, fttnn Crolbba. and from It 



1 Tv«nty.Uu«awe^ gndlng L 



it invABiTav Hod 



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DtATBCCTfl MipidlHi by the Tuinia Wateb 

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wi, and Chebica 

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e 1') by New Blrer, dnwins Its trilor 

8 m? aSTliOnd^u from Old Ford" 
al'fli)' NcirltiTer.kud by Ewl London 

tlally by BociuwUK and LaDDEtii 


. 

K,EI7 S7,9fil 
E,5S1 W,-«0 

5,132 27,338 


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1 'is^ MM 

L N. MSI. Weat London- . . - 

r E.» 'il. BtthnilOnen . ' - 
K.+ tU.MiliHMid Old Town - 
E.t S1.8taeotjo-lii-tbe.Eiiat . . 


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jjM ansa maraea iniu (BJ lUCIUIlO «im.T. 

3« •Hcral water oonipunlM an desiuHledliylelteTH: thus, llw Srw RIvit Cnuipinv hy X, t lie firimd Junction byJ-.O 
VC.WaatMliUlfKibr'WSUEiwtiuiMliiiiliyB, Huuimliwl by II_ Knutliwnrk by tl., lAuiiwth by L.. and Kent bf 
**>*wlin«aIKMrlct IsMippUadhy mora Uuui niu- cnniioiiiy, the Initinl tif the coiiiianr imjiiilyinK tlie greater |jsrt Ii 
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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SSTSicn nippliod bj (he TnABBB Watib 

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e (•] by XunKiviv. ilTSwinit ita vntcr 
Supper p.rt<rfL«.^vef (83 per 
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8 CLXf"' ^^^°" '"" '^''* ^""^ 

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DinBICra Buppliryd miunly by tlie Eekt 
CoMFAVT ftoHi Brteaian wi-lbi, and par- 
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6. 8t. Uartin-in-the-Fieldi - 
in. London City , - . - 
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y^^ntlUttiilMMn-Mmiflnt aeluly from Ihe niier.-oi« at Old Foni; -^ 1 ' 

araaiS^,''-^ «*«fW«oi*»HM in Hwpitiils. 

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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 






DEiTna 


BEiTns 


MORIAIJIT 






in S3 W-Lfki 
from 


from 


Pencils 
liviiii from 


Scn-DiarnicTS. 


MZDICAI. OFFICBia. 






1 


i 


1 


5 


j 


1 


"^r 








WEST DISTRICTS. 




















1. Kesbisotoit. 




















atljolSfpsildi^lto^ '. - 
















M 


1« 


Ki^tulxitton Town - - - 


i P.Oodrich.Jun. - , 
1 F.J.BuTBO - - 


HttO 


H 


SIO 


fiO-8 


a-7 


BE 






FiiUiam 


















a. CasUBx. 


















( 


Chijl«n South ... - 


[ Dr-Borctay . • 














B7 


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en 


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t. W EBTMIIBT*!. 


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KORTH DISTRICTS. 




















7. Martlibo^k. 
























































M 


H 


BectOTT Uuf lebone - ■ 
St KuT Uirrlabons - 

ChTtMchnreli1lliinlel)one - 


Dr. J. WTiltmore . 


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11. HiCIHBT. 

BUmlDrdBin- - • - 


J Dr. Bullard - - 


an 


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C8NTRAL DI3TRICTB. 
11. Ht. Gius. 


Dr.Tripo - - . 










n-J 


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le 


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St. GrorBeBiooaabury - ■ 
SE.GUa South - ■ - 


1 Br.BudiBiun - ■ 


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M 


70 


12B-0 


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St. GilM North . - - 














A- 


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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 


!Si 


rrom 


EEQiaiHASB' 


KiMEa OF 
JllDTCil OmCEBS. 






\ 


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i 




i 


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1 


1 


















1 






IS. BTBAm. 
















•t 


"{ 


81. AmicSoUo - . . - 
SI.Muj'-U'-Stnuid - - • 


1 Dr. Conwii)' Eiiiu - 


m 


ta 


u 


ni-a 


S'S 


&-0 




Et. Clement Dane - - - 


















li-tli-LBOlK 


















=•{ 


El. Genrep-the-Martjr - - 


• Dr.S.C.ibbou . • 














M 


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MT 


u 


BT 


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6-fl 


Hi 




BuffronHil! - . - - 


















10. CLIBlCHJtWlLL 






















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Pentoiivillf^ .... 


. Dr. Griffith - - 


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IS. LOSOOS ClTT. 


Dr. Lethtby - - 


an 


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1 


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.. London Cilj- Xortbi-Mt -J 


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EAST DISTRICTS. 










1 






fl. SUOHBllITCn. 
















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1 
















W 


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1 il. HKTiraiiaREEs. 








:| 


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I 












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'1 










IlfiloBndNoirToirn . . 






























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Aldgate 


• J, Llddlc - . - 




002 


1!0 «3-l 








1 33. ST.GEO)U}B-tN-TIlK*llST. 
















t 81.JolmS,.ti™.En,t - - 


t Dr. 9. Erpilc - . 












at 


low 


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TO SSI- 8 


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|> Sluulwpll 


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u 


1 !*4. 31iLHE:tDOLiiTow.i. 














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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 



- 


■nml, 


•inJ. 
















As>xal' 

BOKTillTT 
kuCADBES 


EEoiaiaxns' 
ScB-BJsraicTs. 


Xaxbsov 

itsmcii. OvricEaa. 


Deathb 

ineiWMka 

from 


Deaths 

to lO^H) living 

from 


1 


g 


1 


1 


1 


1 


'^sS' 


BO. 






East DisiHiCTB-con*. 
















ta 


»{ 


S3.; : : : ■- : 

SOUTH DISTBICTS. 


B.'k. Enu™ '• '.} 


nil 


m 


» 


ill-B 


«-l 


WB 




26. Br.BiViorBSotTiTWiUK. 




















StSsTknir .... 


} B.BisDdii . ■ 


391 


*r 


ST 


ior« 


7'* 


TO-I 


X 


»■ 


(7. St. Oum SouTuwiRK. 

BLOlne 

BtJohnHorsleydown . . 


}».>,.,.:. . . 


US 


ifl 




1^-9 


8-a 


.»■• 


2S 


"{ 


iBSP'-: ; 


X W.ParlBr. - - 


SB 


M 


-.s 


m-i 


E-* 


ir7 


30 


.{ 


i9. St. GEQnai SOITTHWAEC. 

Kent-rood . . , . 
Boruufh-roid .... 
lADdon^qsd . • . . 


X Dr-Batcwn - . 


<Ht 


«) 


^ 


UB-S 


T-O 


t« 


H 

U 




JO. NimsOTOH. 
Truiitj Nowinston • . . 
St. Peter Walwnrth - . 
SLMirrNcwingttin . - 

JI. L*«SBTO. 

Waterloo Road iSen nd . 
LunbethChurch First - ■ 

rr^T-r • ; 

SSTdi ; : : : 


1 Dr.lliff - . - 
Dr. Puttie . - . 


isa 




HO 


1M4 


6-5 


e-6 


n 


A 


SS. WAmwOBTB. 

ass,: : : : : 

Wudiworth - . - . 


J. MDonegh • -T 


MO 


41 


H 


».. 


ve 


8-7 






s* 


"[ 


Cunberwell .... 

Sl.GeorgeCsinborwdl - 


il>r.BHrtoTO - . 


AM 


IS 


*0 


ini'3 


B-e 


•-> 


w 


ts 


M. BOTBEBniTUB. 

Bothcrhlthe .... 


Dr. Murdock - . 


!8T 


M 


,.. 


99-8 


fi 


4-1 


n 


St 




-H.N. Pint . . 
No Medical Officer - 


1W8 


m 


Si 


IM-l 


WB 


B-a 


11 


u 


30. LEinsHAU. 

fJi!"r- ; : : : - 


Dr. Finch . - ." 

f SiS'oT : : 


«0d 

■ 


u 


. 


OS'S 


9-1 


»■«, 


Lewiriuni VlHngs - - . 





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 - 
St IMTa Gknrdi jaid 



1 4 

a 



KevfihwWkte 



Company • 
Oonpaoj 



grs. 



23 

25 

21 

21 

19 

22 

32 

25 

18 

14 

14 

20 

19 

22 

21 

21 

12 

13 

16 

15 

16 

14 

16 

15 

19 

16 

25 

21 

33 

17 

19 

18 

23 

21 

20 



•43 
•30 
•70 
•17 
•29 
•60 
•23 
•80 
•67 
•53 
•80 
•53 
•93 
•13 
•07 
•77 
•90 
•37 
•57 
•47 
•40 
•57 
•10 
•70 
•27 
•63 
•27 
•93 
•63 
•23 
•73 
•50 
•47 
•03 
•60 



III 



grs. 
I6^63 



24- 
16- 
25' 
12^ 
21 • 
33- 
19- 
26- 
23- 
13' 
16" 
17 
18- 
9' 
20- 
8 
4 
15 
10 
13- 
21 
10 
19 
30 
23 
29 
21 
37 
10 
14 
15 
19 
29 
15 



30 
17 
20 
80 
20 
54 
13 
20 
07 
73 
43 
33 
20 
43 
23 
65 
40 
53 
83 

eo 

90 
50 
50 
60 
97 
93 
70 
'84 
33 
14 
•20 
93 
17 
20 



'<0 



grs. 
13^17 



20 
15 
12 
19 
18 
22 



■70 
•47 
73 
11 
20 
43 



18^47 
11*17 
25-53 
10-87 



11 

13 

10 

6 

14 

4 

3 

7 

6 

17 

15 

9 

15 

13 

38 

13 

15 

22 

*• 

4 

13 

7 

12 

31 

9 



87 

03 

70 

70 

50 

30 

40 

■47 

50 

23 

87 

23 

73 

57 

60 

83 

46 

93 

•27 

70 

•70 

57 

•87 

•47 






grs. 
19-37 



24' 
16' 
13^ 
19- 
17^ 
16- 
12^ 

9- 
24- 
25- 
16- 
21' 
16" 

7" 
21' 

3 

2 
10 
12" 
15- 
30- 

6 
22 
15 
29 
•6 
29 
23 

6 
14 
13 
20 
38 
20 



20 
50 
60 
58 
33 
06 
87 
13 
27 
53 
57 
90 
23 
17 
33 
05 
76 
53 
27 
00 
50 
63 
63 
07 
13 
42 
00 
50 
03 
70 
33 
74 
36 
80 




grs. 
0^96 



I' 
0- 
0- 
I' 
I- 
I- 
I- 
1- 
0" 



12 
97 
97 
00 
10 
50 
00 
00 
93 



1^00 



03 
00 
20 
87 
87 
95 
60 
97 
76 
87 
93 
10 
30 
26 
07 
43 
I '23 
r33 
0-97 
1-30 
0-94 
1-13 
1-20 
1-10 




grs. 



4 

8 
4 

6' 

8" 

6 

9' 

5' 

4' 

6- 

5- 

7- 

5 

5" 

2 

7 

2 

2 

5 

3 

3 

5 

3 

5 

6 

5 

8 

6 

8 

4 

6 

4 

5 

8 

4 



87 

13 

56 

30 

22 

23 

07 

43 

93 

87 

10 

03 

60 

37 

56 

23 

•90 

•10 

33 

50 

50 

86 

27 

•44 

•90 

'53 

•27 

•63 

•34 

•37 

-83 

•93 

•63 

10 

10 



s 



I 



grs. 
77^43 



103 

75 

79 

80 

86 < 
114 

82 

71 

95 

71 

73 

77 

73 

47 

85 

32 

26 

56 

49 

66 

89 

46 

80 

86 
114 

85 

95 
127 

46 

70^40 

60*27 

83*37 
129-73 

71*27 



75 
37 
97 
00 
66 
83 
70 
10 
20 
03 
46 
79 
83 
80 
93 
75 
63 
40 
33 
00 
63 
83 
30 
67 
93 
17 
97 
57 
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