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  REPORTS
  RELATING TO
  THE SANITARY CONDITION
  OF THE
  CITY OF LONDON.

  BY
  JOHN SIMON, F.R.S.
  SURGEON TO ST. THOMAS’S HOSPITAL, AND
  OFFICER OF HEALTH TO THE CITY.

  LONDON:
  JOHN W. PARKER AND SON, WEST STRAND.
  MDCCCLIV.


  LONDON:
  SAVILL AND EDWARDS, PRINTERS, CHANDOS STREET,
  COVENT GARDEN.


  TO
  LOUIS MICHAEL SIMON,
  OF THE STOCK EXCHANGE, LONDON, AND OF
  THE PARAGON, BLACKHEATH,
  I DEDICATE THIS REPRINT OF MY REPORTS:
  LOOKING
  LESS TO WHAT LITTLE INTRINSIC MERIT THEY MAY HAVE,
  THAN TO THE YEARS OF ANXIOUS LABOUR THEY REPRESENT:
  DEEMING IT FIT TO ASSOCIATE
  MY FATHER’S NAME
  WITH A RECORD OF ENDEAVOURS TO DO MY DUTY:
  BECAUSE IN THIS HE HAS BEEN MY BEST EXAMPLE;
  AND
  BECAUSE I COUNT IT THE HAPPIEST INFLUENCE IN MY LOT,
  THAT, BOUND TO HIM BY EVERY TIE OF GRATEFUL AFFECTION,
  I HAVE LIKEWISE BEEN ABLE, FROM MY EARLIEST CHILDHOOD
  TILL NOW--THE EVENING OF HIS LIFE,
  TO REGARD HIM WITH UNQUALIFIED AND INCREASING RESPECT.




CONTENTS.


                                                            Page
  DEDICATION                                                 iii

  PREFACE                                                    vii

  FIRST ANNUAL REPORT                                          1

  FURTHER REMARKS ON WATER-SUPPLY                             72

  SECOND ANNUAL REPORT                                        77

  THIRD ANNUAL REPORT                                        177

  FOURTH ANNUAL REPORT                                       211

  FIFTH ANNUAL REPORT                                        213

  APPENDIX OF TABLES ILLUSTRATING THE SANITARY CONDITION OF
  THE CITY OF LONDON.                                        264

  REPORT ON CITY BURIAL-GROUNDS                              280

  REPORT ON EXTRAMURAL INTERMENTS                            285




PREFACE.


The following Reports, officially addressed to the Commissioners of
Sewers of the City of London, were originally printed only for the use
of the Corporation; and although, to my very great pleasure, they have
been extensively circulated through the medium of the daily press, there
has continued so frequent an application for separate copies that the
surplus-stock at Guildhall has long been exhausted. Under these
circumstances--believing the Reports may have some future interest, as
belonging to an important educational period in the matters to which
they refer, I have requested the Commission to allow their collective
reprint and publication; and this indulgence having been kindly accorded
me, I have gathered into the present volume all my Annual Reports,
together with a special Report suggesting arrangements for extramural
burial.

From the nature of the work, I have not considered myself at liberty to
make those extensive alterations of text which usually belong to a
second edition. I have restricted myself to a few verbal corrections,
and to rectifying or omitting some unimportant paragraph, here or there,
in case its matter has been more fully or more correctly stated in parts
of a subsequent Report. Frequently, where I have wished to explain or
qualify passages in the text, I have added foot-notes; but these are
distinguished as interpolations by the mark--J. S., 1854.

My Reports lay no claim to the merit of scientific discovery. Rather,
they deal with things already notorious to Science; and, in writing
them, my hopes have tended chiefly towards winning for such doctrines
more general and more practical reception. It has seemed to me no
unworthy object, that, confining myself often to almost indisputable
topics--to truths bordering on truism, I should labour to make trite
knowledge bear fruit in common application.

Nor in any degree do they profess to be cyclopædic in the subject of
Preventive Medicine; for it is but a small part of this science that
hitherto is recognised by the law; and that--so far as the metropolis is
concerned, scarcely beyond the confines of the City. It would have been
an idle sort of industry, to say much of places or of matters foreign to
the jurisdiction of those whom I officially addressed.

In re-publishing documents which proclaim extreme sanitary evils, as
affecting the City, I think it right to draw attention to the dates of
the several Reports, and to state that for the last five years many of
these evils have been undergoing progressive diminution, of late at a
rapid and increasing rate; while, at their worst, they represented only
what I fear must be considered the present average condition of our
urban population.

This national prevalence of sanitary neglect is a very grievous fact;
and though I pretend to no official concern in anything beyond the City
boundaries, I cannot forego the present opportunity of saying a few
words to bespeak for it the reader’s attention. I would beg any educated
person to consider what are the conditions in which alone animal life
can thrive; to learn, by personal inspection, how far these conditions
are realised for the masses of our population; and to form for himself a
conscientious judgment as to the need for great, if even almost
revolutionary, reforms. Let any such person devote an hour to visiting
some very poor neighbourhood in the metropolis, or in almost any of our
large towns. Let him breathe its air, taste its water, eat its bread.
Let him think of human life struggling there for years. Let him fancy
what it would be to himself to live there, in that beastly degradation
of stink, fed with such bread, drinking such water. Let him enter some
house there at hazard, and--heeding where he treads, follow the guidance
of his outraged nose, to the yard (if there be one) or the cellar. Let
him talk to the inmates: let him hear what is thought of the bone-boiler
next door, or the slaughter-house behind; what of the sewer-grating
before the door; what of the Irish basket-makers upstairs--twelve in a
room, who came in after the hopping, and got fever; what of the
artisan’s dead body, stretched on his widow’s one bed, beside her living
children.

Let him, if he have a heart for the duties of manhood and patriotism,
gravely reflect whether such sickening evils, as an hour’s inquiry will
have shown him, ought to be the habit of our labouring population:
whether the Legislature, which his voice helps to constitute, is doing
all that might be done to palliate these wrongs; whether it be not a
jarring discord in the civilisation we boast--a worse than pagan
savageness in the Christianity we profess, that such things continue, in
the midst of us, scandalously neglected; and that the interests of human
life, except against wilful violence, are almost uncared for by the law.

And let not the inquirer too easily admit what will be urged by less
earnest persons as their pretext for inaction--that such evils are
inalienable from poverty. Let him, in visiting those homes of our
labouring population, inquire into the actual rent paid for
them--dog-holes as they are; and studying the financial experience of
Model Dormitories and Model Lodgings, let him reckon what that rent can
purchase. He will soon have misgivings as to dirt being cheap in the
market, and cleanliness unattainably expensive.

Yet what if it be so? Shift the title of the grievance--is the fact less
insufferable? If there be citizens so destitute, that they can afford to
live only where they must straightway die--renting the twentieth
straw-heap in some lightless fever-bin, or squatting amid rotten
soakage, or breathing from the cesspool and the sewer; so destitute that
they can buy no water--that milk and bread must be impoverished to meet
their means of purchase--that the drugs sold them for sickness must be
rubbish or poison; surely no civilised community dare avert itself from
the care of this abject orphanage. And--_ruat cœlum_, let the principle
be followed whithersoever it may lead, that Christian society leaves
none of its children helpless. If such and such conditions of food or
dwelling are absolutely inconsistent with healthy life, what more final
test of pauperism can there be, or what clearer right to public succour,
than that the subject’s pecuniary means fall short of providing him
other conditions than those? It may be that competition has screwed
down the rate of wages below what will purchase indispensable food and
wholesome lodgment. Of this, as fact, I am no judge; but to its meaning,
if fact, I can speak. All labour below that mark is masked pauperism.
Whatever the employer saves is gained at the public expense. When, under
such circumstances, the labourer or his wife or child spends an
occasional month or two in the hospital, that some fever-infection may
work itself out, or that the impending loss of an eye or a limb may be
averted by animal[1] food; or when he gets various aid from his Board of
Guardians, in all sorts of preventable illness, and eventually for the
expenses of interment, it is the public that, too late for the man’s
health or independence, pays the arrears of wage which should have
hindered this suffering and sorrow.

  [1] Twenty years’ daily experience of hospital surgery enables me to
  say, from personal knowledge, that our wards and out-patient rooms are
  never free from painful illustrations of the effects of insufficient
  nutrition--cases, in fact, of chronic starvation-disease among the
  poor; such disease as Magendie imitated, in his celebrated
  experiments, by feeding animals on an exclusively non-azotised diet.

Probably on no point of political economy is there more general
concurrence of opinion, than against any legislative interference with
the price of labour. But I would venture to submit, for the
consideration of abler judges than myself, that before wages can safely
be left to find their own level in the struggles of an unrestricted
competition, the law should be rendered absolute and available in
safeguards for the ignorant poor--first, against those deteriorations of
staple food which enable the retailer to disguise starvation to his
customers by apparent cheapenings of bulk; secondly, against those
conditions of lodgment which are inconsistent with decency and health.

But if I have addressed myself to this objection, partly because--to the
very limited extent in which it starts from a true premiss, it deserves
reply; and partly because I wish emphatically to declare my conviction,
that such evils as I denounce are not the more to be tolerated for their
rising in unwilling Pauperism, rather than in willing Filth; yet I doubt
whether poverty be so important an element in the case as some people
imagine. And although I have referred especially to a poor
neighbourhood--because here it is that knowledge and personal refinement
will have least power to compensate for the insufficiencies of public
law; yet I have no hesitation in saying that sanitary mismanagement
spreads very appreciable evils high in the middle ranks of society; and
from some of the consequences, so far as I am aware, no station can call
itself exempt.

The fact is, as I have said, that, except against wilful violence, life
is practically very little cared for by the law. Fragments of
legislation there are, indeed, in all directions: enough to establish
precedents--enough to testify some half-conscious possession of a
principle; but, for usefulness, little beyond this. The statutes tell
that now and then, there has reached to high places the wail of physical
suffering. They tell that our law-makers, to the tether of a very scanty
knowledge, have, not unwillingly, moved to the redress of some clamorous
wrong. But--tested by any scientific standard of what should be the
completeness of sanitary legislation; or tested by any personal
endeavour to procure the legal correction of gross and glaring evils;
their insufficiencies, I do not hesitate to say, constitute a national
scandal, and, perhaps in respect of their consequences, something not
far removed from a national sin.

In respect of _houses_--here and there, under local Acts of Parliament,
exist sanitary powers, generally of a most defective kind; pretending
often to enforce amendments of drainage and water-supply; sometimes to
provide for