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    \ July 8, 1854.] THE LEADER. 641

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    *• Simon On Outt Sanitary Condition. Rep...

    glanced at them will be glad to give them a calm , steady examination ; those who missed them altogether , will l > e surprised at the interest with which style , mastery , and earnestness can invest matters apparently so unpromising as sewerage , water supply , burial , & c . The five Keports , with tables and appendix , and a Report on extramural interment are reprinted very much as they originally appeared , footnotes occasionally correcting or modifying the text . A preface full of important suggestion and written with a splendour of style , rare in all places , but especially rare in medical writings , fitly prepares the reflective reader for the lteports which succeed . It is , indeed , only of late years that the smallest degree of interest has been shown in sanitary matters ; and if one-third of the polemics , agitation , Exeter Hailization , and missionary ardour so superfluously and so fruitlessly bestowed on our souls , had been given to the more practicable , if less dignified , subject of our bodies , the complaints now loudly urged would have been less frequent ; for there can be no doubt that we are as singularly neglectful of our bodily condition as if we still believed in the approaching destruction of the world : —

    " This national prevalence of samtary 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 < i 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 uiie ui uic tcuui xjvi iiuu litus in ins inmates jet wiidt

    J s urac "' ^ . . : nun near is thought of the bone-boiler next door , or the- slaughter-house behind ; what of the sewergrating before the door ; -what of the Irish basket-makers up-stairs- —twelve in a room , who came in after the hopping , andgot 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 , onght to be the habit of our labouring population : whether the legislature ,, which his voice helps to constitute , is doing allthat might be done to palliate these wi'ongs ; 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 agajait 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 theft ; 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 —d 0 g-aoles 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 wliatif 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 dier ~ 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 watqt ~ that milk and bread must be impoverished to meet their means of purchase—that thedrpgs sold them for sickness must be rubbish or poison ; surely no civilised community dara ^ yert itself from the care of this abject orphanage . And—rtiat aelnvi , let the principle ' lJe 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 j 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 siicfi circumstances , the labourer or his wifp or child spends an occasional month or two in the hospital , that some fever-infection maj work itself out , or that the impending loss of an eye or a limb may be avcited by animal food ; or when he gets various aid from his Board of Guardians , in all sorts of preventable illness , and cyontiially 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 . 4 < Probably on no point of political economy is there more general concurrence of opinion

    than against any legislative interference with tho 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 , tho law should ba rendered absolute and available in safeguards for tho ignorant poor—first , against those deterioration * of staple food which enable the retailor to difiguiao starvation to his customers by npparont chcapenings of bulk ; secondly , against those conditionsollodgment which are inconsistent with decency nnd health . " But if I have- addressed myself to this objection , partly bocauso—to the very limited extent in which it starts from a truo premiss ; it deserves reply ; and partly because I wish emphatically to declaro rny conviction , thut such evils as 1 denounce are not the moro to bo tolerated for thoir rising in unwilling Punperism , ruther tluin in willing Filth ; yet I doubt whether poverty bo so important an element in tho case as some people imagine . And although I havo referred especially to a poor neighbourhood—becauao here it is that knowluugtj wiu lunncinunt win least

    . puiauwii nnyo power to compensate lor tlio insufficiencies ot public law ; yet I have no hesitation in saying that sanitary mismanagement spromls very appreciable evils high in tho middle ranks of society ; ami from somo of the consequences , so far as I « m aware , no station can call itself exempt . " M ' ho fact is , as I luuo said , that , oxoopt against wilful violence , life is practically very little wired for by tho law . Frnginuuts of legislation livery are , indeed , in all directions : enough to establish precedents— enough to twatify some liulf-consetaua possession of i \ princlpio ; but , for usel'ulucss , litllo beyond this . TlioBtntutcs toll thut , now and then them has reached to high places tho wail of physical suffrring . They ti-11 thai our luw-mukors , to tho tothor of a very scanty knowledge , have , not unwillingly , moved to tho redress ol some clmnoroua wrong . Hut—tea tod by any sciontiiio standard of what should bo tho cmnplotencaa of sanitary legislation , or tested by any personal endeavour to procure tho legal correction of gross and glaring evils—their iiibulnuumoioB , I do not hosituto to any , eoixuiiutu a national scandal , and , perhaps in respect ot tliuii continences , somolhlru' not liiv removed from a national sin . "

    Mr . Simon with eloquence ur « es tho necessity of n Minister of Public Health being appointed , a noo « AKity which id now becoming the conviction of hundreds of thoughtful men , although it has to combat tliu naturaljeulousy of Englishmen against legislative ) interference . But us Mi \ Simon , in tliu energetic vividness of hia style , truly Bays : — " If faotory children « ro ourod for , luitt thoy bo overworked ; ami minors , lout thoy be Dtultid ) ho , lor those who Ubour with coppm-, murcury , arsenic , and loud , IuL us care , lu . it they bo poisoned 1 for grinders , lost their lungs be Iroltod into consjiunialon I for nrntclinmkorfl , lost thoir jaws bo rotted from tlii'ia by phosphorus 1 " And further : — " Against adulteration a of fowl ., hero and tlioro , obsolete powers exist , for our ancestors Imdiui eye to thoso thui B ( but , practically , they are of ho avail . If wo , who aro educutod , imbituiiHy aubimt to h « vo copper in our prosorvoH , rud-load in our cuyonnc , alum in our

    bread , pigments in our tea , and ineffable nastinesses in our fish-sauce , what can we expect of the poor ? Can they use galactometers ? Can they test their pickles with ammonia ? Can they discover the tricks by which bread is made dropsical , or otherwise deteriorated in value , even faster than they can cheapen it in price ? Without entering on details of what might be the best organisation against such things , I may certainly assume it as greatly a desideratum , that local authorities should uniformly have power to deal with these frauds ( as , of course , with every sale of decayed and corrupted food ) , and that they should be enabled to employ skilled officers , for detecting at least every adulteration of bread and every poisonous admixture in condiments aud the like . " In some respects this sort of protection is even more necessary , aswell as more deficient , in regard to the Jxdsijkation of drugs . The College of Physicians and the Apothecaries ' Company are supposed to exercise supervision in tie matter : so that at least its necessitv is

    recognised by the law . Ihe security thus afforded is , in practice , null . It is notorious in my profession that there are not many simple drugs , and still fewer compound preparations , on the standard strength of which we can reckon . It is notorious that some important medicines are so often falsified in the market , and others so often mis-made in the laboratory , that we are robbed of all certainty in their employment . Iodide of potassium—an invaluable specific—may be shammed to half its weight with the carbonate of potash . Scammony , one of onr best purgatives , is rare without chalk or starch , weakening it , perhaps , to h , ilf the intention of the giver . Cod-liver oil may have come from seals or from , olives . The two or three drops of prussic acid that we would give for a dose may be nearly twice as strong at one chemist's as at another ' s . The quantity of laudanum equivalent to a gram of opiutn being , theoretically , 19 minims ; we may practically find this grain , it is said , in 4 . 5 minims , or in 34 . 5 . "

    We heartily concur with him in his belief that " our commanding need is that the general legislation of the country be imbued with deeper sympathies for life ; " and we concur with him when he says : — " Having said so much on the defects and the wrongs of our existing sanitary condition , perhaps I may venture to speak of the almost obvious remedy . l Almost obvious , ' I say v tor surely no one will doubt that this great subject should be dealt with by comprehensive and scientific legislation ; and I hardly see how otherwise , than that it should be submitted in its entirety to some single department of the execntive , as a sole charge ; that there should be some tangible head , responsible , not only for the enforcement of existing laws , such , as they are or may become , but likewise for their progress from time to time to the level oi contemporary science , for their completion where fragmentary , for their harmonisation where discordant .

    " If—as is rumoured—the approaching re-constitution of the General Board of Health is ( after the pattern of the Poor-law Board } to give it a parliamentary president , that member of the Government ought to be open to challenge in respect of every matter relating to health . What , for this purpose , might be the best subordinate arrangements of such a Board , it would take a volume to discuss . But at least as regards its constituted head , sitting in Parliament , hi 8 department should be , in the widest sense , to care for the physical necessities of human life . Whether skilled coadjutors be appointed for him or not ; engineers —lawyers—chemists— -pathologists ; whether he be , as it were , the foreman of this special jury , or , according to the more usual precedent of our public affairs , collect advice on his own responsibility , arid speak without quotation of other authority than himself , his voice unless tlie thing is to be a sham—must represent all these knowledges . " The people , through its representatives , must be able to arraign him wherever human life is insufficiently cared for . .

    " He must be able to justify or to exterminate adulterations of food ; to show that alum ought to be in o ^^ r loaves , or to banish it for ever ; to show that copper is wholesome for dessert , or to give us our olives and greengages without it ; to show that red-lead is an estimable condiment , or to divert it from our pepper-pots and curries . " Similarly with drugs and poisons—the alternatives of life and death—a Minister of Public Health would , I presume , be responsible for whatever evils arise in their unlicensed and unregulated sale . He would hardly dare to acquiesce in our present defencelessness against fraud-arid ignorance ; in doses being sold—critical doses , for the strength o £ which we , who prescribe them , cannot answer within a margin of cent , per cent . ; or in pennyworths of poison being handed across the counter as nonchalantly as cakes of soap , fcjurely , before he had been six months in office , he would have procured some enactment to remedy this long neglect of the legislature , by providing that the druggist ' s trade be exercised only after some test of fitness , and in subjection to certain regulations . " Nor in spite of opposition ( what is there not opposed ?) would there be wanting a firm phalanx of intelligent support : —

    " Thank God ! the number of persons capable of apprehending the cause , and ready to take interest in its promotion , is now dail y on the increase . If some Minister of Public Health could take his seat in the House of Commons—some Minister knowing his subject and feeling it—I believe he would find no lack of sympathy and co-operation . The world abounds with admirable wishes and intentions , that vaguely miscarry for want of guidance . How many men can get no farther in their psalm of lite than tho question , in quo corriget . To such—not masters of the subject , but willing and eager to be its servants , an official leader might bo everything : for in great causes like this , where the scandal of continued wrong burns in each man ' s conscience , the instincts of justice thirst for satisfaction . What can wo do or give—how shall we speak or vote , to lessen these dreadful miseries of sanitary neglect—is , « t this moment , I beliave , the fervent inquiry of innumerable minds , waiting , as it were , for tho word of command to act . " Wo have lingered so long at the threshold , that wo shall scarcely have time to do more than glance around us on entering , many as are the tempting " passages . " We urge the reader to wait for no guidance of ours but to enter by himself . As a hint of the many incidental topics of interest we will extract this on WATER , 1 IAK 1 > AND SOFT .

    " Is ^ yator tb . us . constitutcd in any degree detrimental to tho health of thoso who drink it ? It is not in a single word that this question can bo fairly answered . Almost insuperable ditliculty belongs to it from tho absence of any statistical method by which wo might isolate tho water-drinking portion of , our population , and might compare , them , in regard of the diseases to which they arc liable , with similar sections of population in softwator districts and in luirdor-wuter districts . Obviously , no other method of comparison can bo unolijectioiiablu ; and , in arguing tho subject from such materials aa I havo , I can protend to nothing more than a rational approximation to truth . " li . \ cept in tho comparativel y i ' aw instances wboro active medicinal agonta are naturally dissolved in a wut , < jr , its effects , if injurious , would bo so slow as to elude ordinary observation . If , ns is exceedingly probable , tho dame constitution of wator as impairs its solvency out of the body , tlo likewise opentte against it a being thu most eligible menstruum or dissolvent lor processes occurring within tlic body—tuioh processes 1 moiin as attoiul tho act of digestion ; if the liinu and otlior luu'deuiuK ingredionts which vvuuto soap in our laundries ,

    nnd toa m our parlours , do similarly waste within us thoso organic agoncius by whtah our food is dissolved nnd converted ; any result arising from this aim re o would bo of gradual oporation , would not easily admit of boing traced to its source , unu ( uxcepfc in susoopliblo por « ons ) would rarely pro . luco such symptoms aa might immediately draw uttontion to their cause . Tho ill etlocts ( whatever tliey may bo ) arising from tho uso of hard waters must bo loolwsd for in ohrouiu impairment of digestion , and in tlioso var ious derangements of nutrition in distant parts (" the slum ami teeth particularly ) wliich follow ns secondary results ou huo 1 > chronic disorder . It would bo ridiculous to look for tho operation of an illchosou wator , titter its habitual u . io during two centuries , au though , ono wore inquiring for tho nymplouiH of tin acute poison . Tho Mignn thut am to bo uttcortained among n population , If such signs exist , aro tlioso which woulU oviilenco « proimituro exhuuDtion or tho power of difjoiJtioiJ , and would tontify that Uio » j »« ot » ii » o on which wo dopond for that power had been oxposod to uimoeeatmry and avoidable fatigue . This , I believe , is tho utmost , which Medicine , proceeding from theoretical grounds , would vonturo to sny on tho subject . ' " ' 1 ' oj-hapn 1 nood not inform you that iinli / jostion , with all that follows from it , is so

    \ July 8, 1854.] The Leader. 641

    \ July 8 , 1854 . ] THE LEADER . 641

• Citation
  • Leader (1850-1860), July 8, 1854, page 17, in the Nineteenth-Century Serials Edition (2008; 2018) ncse-os.kdl.kcl.ac.uk/periodicals/l/issues/cld_08071854/page/17/