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Title: Dr. Southwood Smith: A Retrospect

Author: Gertrude Hill Lewes

Release date: May 14, 2019 [eBook #59510]
                Most recently updated: January 12, 2023

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                          Transcriber's Note:

This version of the text cannot represent certain typographical effects.
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bold face is delimited with the equals sign as =bold=.

Footnotes have been moved to follow the chapters in which they are
referenced.

                    Dr Southwood Smith, A Retrospect

[Illustration: Frontispiece]




                           DR SOUTHWOOD SMITH

                              A RETROSPECT


                                   BY

                           HIS GRANDDAUGHTER

                            MRS C. L. LEWES


                       WILLIAM BLACKWOOD AND SONS
                          EDINBURGH AND LONDON
                              MDCCCXCVIII

                                   TO

                               MY MOTHER,

                        CAROLINE SOUTHWOOD HILL,

                        _I DEDICATE THIS MEMOIR_

                                   OF

                              HER FATHER.

                                PREFACE.


It is now nearly forty years since the death of my grandfather, Dr
Southwood Smith, and with this distance of time lying between him and
us, it may not be uninteresting to this generation to look back upon the
origin of some of the great social reforms which have now reached such
wide proportions, and to see these reforms as gathered round the life of
a man who was in the forefront of the noble army which promoted them.

He, one of the first to seize a truth, one of the most indomitable to
persevere in the promulgation of it when perceived, went straight
forward until it prevailed, and thus became instrumental in conferring
some of the widest benefits which have come to us in this century.

From his great grief in early manhood he but emerged the stronger. The
force of his condensed sorrow produced an energy which carried all
before it, and resulted in the strength of his middle age and the
serenity of his latter years. In order that such a life--crowned by its
humility--might not pass away without some permanent record of its
nobleness, the following memoir has been written.

I must apologise for the frequent allusion, in the midst of grave public
questions, to my own recollections; but since all the early years of my
life were passed at my grandfather's side, it has been difficult to
avoid this.

Moreover, I have hoped that something picturesque and touching would be
found in the relation of the strong man and little child, who worked
together at various public causes, playing together in the bright
intervals, and that something of the reverent enthusiasm he inspired in
that child might pass, through her, to those who read these pages.

GERTRUDE LEWES.

                               CONTENTS.


INTRODUCTION.

RECOLLECTIONS OF MY GRANDFATHER 1


CHAPTER I.

EARLY LIFE, 1788-1820.

Education. Marriage. Death of his wife. Edinburgh University.
Publication of the 'Illustrations of the Divine Government.' Yeovil 7


CHAPTER II.

FIRST YEARS IN LONDON--DAWN OF THE SCIENCE OF MODERN HYGIENE, 1820-1834.

Appointment to Fever Hospital. 'Westminster Review' articles in 1825.
Laws of Epidemics. Principles laid the foundation of Sanitary Reform.
Its practical importance. Devotion of himself to the cause.
Parliamentary attention attracted to articles. Publication of the
'Treatise on Fever,' 1830. Its phenomena, treatment, and causes. Causes
the most important. Contagious and epidemic diseases. Universal origin
of epidemics stated to be bad sanitary conditions 16


CHAPTER III.

LONDON CONTINUED--LITERARY AND OTHER WORK, 1820-1834.

'Penny Encyclopedia.' The Medical Schools and dissection.
Body-snatching. Lectures--physiological, forensic, and popular. Lecture
over the remains of Bentham. Publication of the 'Philosophy of Health'
35


CHAPTER IV.

WORK ON THE FACTORY COMMISSION, 1833.

History of Factories. Laws previous to 1833. Apprenticeship system.
Appointed Commissioner. Description of state of factories in 1833.
Passing of the Factory Act. Subsequent additions to Act. Visits to see
result of its working 49


CHAPTER V.

RISE OF THE SANITARY MOVEMENT, 1837.

Outbreak of fever in London. Personal inspection of Bethnal Green and
Whitechapel. First Report to Poor Law Commissioners. Ventilation in
crowded districts. Overcrowding of children in workhouses. Second Report
of Poor Law Commissioners, 1839. Takes the Marquis of Normanby (Home
Secretary) to see spots reported on at Bethnal Green. Takes also Lord
Ashley. Press and public men take up the cause 60


CHAPTER VI.

PHILANTHROPIC AND MEDICAL WORK, 1840-1848.

Children's Employment Commission, Mines and Collieries. Improvement in
the condition of women working therein. Report on Trades and
Manufactures. Homes of eastern dispensary patients. "Sanatorium"
founded. Letters from Charles Dickens. First model dwellings founded.
Life at Highgate. My recollections of first "Health of Towns
Association" Meeting. Feeling of public men 72


CHAPTER VII.

THE TEN YEARS' STRUGGLE FOR SANITARY REFORM, 1838-1848.

Causes of delay. History of the sanitary movement at this time a series
of inquiries and defeated bills. "Health of Towns Association" founded
to spread knowledge and guide legislation. Address to the working
classes calling upon them to petition Parliament. Final passing of the
Public Health Act 102


CHAPTER VIII.

OFFICIAL LIFE--GENERAL BOARD OF HEALTH, 1848-1854.

Appointment to the General Board of Health. Letter to Lord Morpeth. Work
at Whitehall with Lord Ashley and Mr Chadwick. Cholera epidemic of
1848-49. System of "house-to-house visitation." Lord Brougham's comments
on it. Cholera Report. Quarantine Report. Interment Report. Attacks on
the Board in Parliament. Fear of centralisation. Triumph of the sanitary
principle, but to be carried out by local authorities. Lord Palmerston's
letter of thanks 127


CHAPTER IX.

RETIREMENT FROM PUBLIC LIFE--ST GEORGE'S HILL, WEYBRIDGE, 1854-1860.

"The Pines," Weybridge. Happiness in its beauty. Need of rest. Study of
modern physiology for new edition of the 'Philosophy of Health.'
Publication of 'Results of Sanitary Improvement.' Lectures in Edinburgh
on "Epidemics." Visit to Alnwick. Happiness in the work of his
granddaughters Miranda and Octavia Hill. Appreciation of former
fellow-labourers. "Recognition." His words of thanks. Joy in the success
of his great cause 139


CHAPTER X.

THE SUNSET OF LIFE--ITALY, 1861.

Visit to Milan. Death of his second wife at "The Pines." Florence.
Sunset from Ponte Vecchio. Last illness. Death. Porta Pinti. "A
Knight-Errant" 147


CHAPTER XI.

THE AFTERGLOW.

Spread of the social reforms Dr Southwood Smith originated. Improvement
in the public health and saving of life. Memorial bust in the National
Portrait Gallery. Lines upon it. A people's gratitude 153


APPENDICES.

I. LETTER FROM MR TAYLOR, ASSISTANT RETURNING OFFICER OF THE WHITECHAPEL
UNION 159

II. RECOGNITION OF THE PUBLIC SERVICES OF DR SOUTHWOOD SMITH 164

INDEX 167


ILLUSTRATIONS.


PORTRAIT OF DR SOUTHWOOD SMITH _Frontispiece_

(_From a chalk drawing by Miss Margaret Gillies._)

DR SOUTHWOOD SMITH AND HIS GRANDCHILD GERTRUDE 2

OLD WOMAN CARRYING COAL 72

CHILDREN AT WORK 74

WOMAN DRAWING TRUCK 74

CHARLES DICKENS'S LETTER _Facsimile_ 84

FIRST MEETING OF THE HEALTH OF TOWNS ASSOCIATION 106

(_From an old print._)

VIEW FROM PORTA PINTI, FLORENCE, 1861 152




                             INTRODUCTION.
                    RECOLLECTIONS OF MY GRANDFATHER.


My first recollection of my grandfather is of him in his study. As a
little child my bed stood in his room, and when he got up, as he used to
do in the early mornings, to write, he would take me in his arms, still
fast asleep, carry me down-stairs to his study with him, and lay me on
the sofa, wrapped in blankets which had been arranged for me overnight.

So when first I opened my eyes in the silent room I saw him there, a man
of some fifty years, bending over a table covered with papers, the light
of his shaded reading-lamp shining on his forehead and glancing down
upon the papers as he leant over his writing, and the firelight
flickering on the other parts of the room.

The silence and the earnestness seemed wonderful and beautiful. It was
strange to watch him when he did not know it. It seemed to me, then,
that he had been working so through the whole night, and that some great
good which I could only dimly understand was to come of it.

My lying quiet, however, did not last long, for I knew the loving merry
welcome I should have when, climbing--as I hoped and believed quite
unperceived--up the back of his arm-chair, I should throw myself down
into his lap with a loud cry of joy, and then we should have a famous
game, until either he persuaded me to go back to my blankets to await a
rational hour for getting up, or sent me up-stairs to be dressed. These
two things--the intent, absorbed purpose, and the power of putting it
aside to give himself up completely, with simple delight, to whatever he
loved, whether to a child or to the beauty of nature--are the two that
seem to me specially characteristic of him in all that later part of his
life which comes within my remembrance. [Illustration: Dr Southwood
Smith and his grandchild Gertrude.]

At this time we lived in Kentish Town, then field-surrounded, he going
daily to his consulting-rooms in Finsbury Square, returning late and
giving the early mornings and Sundays to public work. These hours were
at that period (1840 to 1842) chiefly devoted to the question of the
employment of children in coal-mines, the more deeply impressed on me
because the report which he was then writing had illustrations showing
the terrible condition of people working in mines.

I remember long bright Sunday mornings when he was at work endeavouring
to remedy these evils. He let me do what little I could, such as the
cutting out of extracts to be fastened on to the MS. report with
wafers--and very particular I was as to the colour of these wafers!
Sometimes all I could do to help was to be quiet--not the least hard
work! Yet I loved these still Sunday mornings, and would not willingly
have been shut out from them any more than from the afternoon ride which
came later, when, perched up in front of him on his own horse, in the
little railed saddle he had devised for me, we rode along the lanes
towards Highgate. I can see now the sunset light falling on the grass
and tree-stems of the Kentish Town fields as we went along.

Then came the day when the Act was brought into operation which was to
regulate the employment of children in mines, and I tied blue ribbons on
to his carriage horses and thought, with a child's hopefulness, that all
the suffering was at once and completely over. "Then, now, they are all
running over the green fields," I said.

My grandfather let me think it, and did not damp my enthusiasm by
letting me know that this happy state of things was not arrived at in
one day!

But although he often played merrily with me and entered into my
childish joys, my grandfather was endowed with a most earnest nature and
with a firmness of character which was very remarkable. He never swerved
from a purpose, never vacillated. One of his sayings was, "Life is not
long enough for us to reconsider our decisions."

It was probably this quiet determination, combined with his unfailing
gentleness, that made him inspire so much confidence in his patients. I
can fancy, in a house where illness was spreading anxiety and sorrow,
the restfulness there would be in his calm presence, and I can remember
the faces of those--often the very poor--who used to come up to him
wishing to thank him for the life of some wife, or son, or child which
they said he had saved. These things used to happen in the crowded city
streets or courts, and sometimes in parts of London far away from the
place where the illness had occurred. The fact that these faces were
generally forgotten by him, whilst _his_ was so well remembered, made a
still more beautiful mystery over it. It seemed to me that there was an
honour in belonging to one who was a help and support to so many. Such
experiences must be familiar to those who share his profession, still I
mention it as being my strong childish impression; and even now, looking
back upon his life, it appears to me that he did possess, in a very high
degree, not only the power of healing, but that of soothing mental
suffering.

It was, in fact, this deep sympathy, joined to his remarkable insight
into the relations between effects and their causes, which led him to
devote his life to the promotion of sanitary reform, when once it had
become obvious to him that all effort to improve the condition of the
people would be impossible until its principles were known and acted
upon.




                               CHAPTER I.
                         EARLY LIFE, 1788-1820.


Thomas Southwood Smith was born at Martock in Somersetshire in 1788, and
was intended by his family to become a minister in the body of
Calvinistic dissenters to which they belonged. He was educated with that
view at the Baptist College in Bristol, where he went in 1802, being
then fourteen years of age. A scholarship, entitled the "Broadmead
Benefaction," was granted to him, and he held it for nearly five years.

But in the course of his earnest reading on religious subjects he was
led to conclusions opposed in many ways to the doctrines he would be
expected to teach; and when, in the autumn of 1807, from conscientious
scruples, he felt bound to declare this to be the case, the benefaction
was withdrawn. If we consider his youth and his limited means, it is
clear that this avowal must have cost him no little anguish. He was at
this time only eighteen. It was an early age at which to have been able
to make up his mind on questions so momentous, to break away from early
and dear traditions, and to face the displeasure of the Principal of the
college, Dr Ryland, whom he ever revered. But honour demanded the
sacrifice, and it was made.

In consequence his family cast him off at once and for ever.

During his college career, however, he had visited much at the house of
Mr Read, a large manufacturer in Bristol, who was a man of noble
character, and at that time one of the leading supporters of the
college; and an attachment had sprung up between the young student and
Mr Read's daughter Anne. This lady seems to have possessed both great
personal beauty and much sweetness and strength of character; and though
she in nowise changed her own religious opinions, she yet sympathised
deeply with him in his earnest seeking after truth, and encouraged him
to risk all--position, friends, everything--rather than act against his
conscience.

Mr Read also upheld him through all his difficulties, and in the
following year sanctioned their marriage, which brought with it some few
very happy years. Two children were born--Caroline,[1] my mother, and a
year afterwards her sister Emily.[2]

His happiness was to be but of short duration, for in 1812 the young
wife died, and left him alone, at the age of only twenty-four, with two
little children. With what deep grief he mourned her death his early
writings show, but he met it with a noble courage and an undiminished
faith.

The course he took was a strong one. Deprived of the profession to which
he had looked forward, cut off from all intercourse with his family, and
having lost the wife he so devotedly loved, he resolved--leaving his two
children under the gentle care of their mother's relations--to apply
himself to the study of medicine. Thus he entered as a student at the
Edinburgh University in the year 1813.

At first he lived quite alone; but finding it more than he could bear,
he returned to England to fetch his eldest child, then four years old.

The father and child (my mother) went from Bristol to Edinburgh in a
small sailing vessel, and encountered a terrible storm, which lasted
many days. She tells me that she still remembers that storm of
eighty-five years ago, the thick darkness, the war of the winds, the
toss of the waves, the flash of the lightning illuminating her father's
face; but, most of all, she remembers the feeling of the strong arm
round her, giving the sense of safety.

His interest in religious matters at this period was greater than ever;
for the change in his opinions, in leading him to take a more loving
view of the Divine nature, had increased his ardour for the truth, and
his own personal sorrow had heightened his faith and made him wish to
carry its comfort to others. As well, therefore, as pursuing his medical
studies, he gathered round him in Edinburgh a little congregation for
service every Sunday. The sermons preached by him then, seem to have an
added depth of feeling when we know the circumstances in which they were
given; and the following words, written by him at this time, give some
insight into the calm sublime faith which upheld him, not only then, but
throughout life.

"Can there be a more exalted pleasure," he writes, "than that which the
mind experiences when, in moments of reflective solitude--in those
moments when it becomes tranquil and disposed to appreciate the real
value of objects--it dwells upon the thought that there is, seated on
the throne of the universe, a Being whose eye never slumbers nor sleeps,
and who is perfect in power, wisdom, and goodness? How little can the
storms of life assail _his_ soul who rests his happiness upon this Rock
of Ages! How little can death itself appal _his_ mind who feels that he
is conducted to the tomb by the hand of the Sovereign of the universe!
Yes! there is a reality in religion; and if that happiness, which is so
often sought, and so often sought in vain--that happiness which is
worthy of a rational being, and which at once satisfies and exalts
him--be ever tasted upon earth, it is by him who thus, in the solitude
of his heart, delights to contemplate the idea of a presiding Benignity,
the extent of whose dominion is without limit, and the duration of whose
kingdom is without end! It is a felicity which our Father sometimes
sends down to the heart that is worthy of it, to give it a foretaste of
its eternal portion."

Much interest was felt in the young pale student and his little girl.
For all this time my mother, the little Caroline, lived with him,
cheering his home-coming from the university to their rooms, and
drinking in from him at a very early age--as I, her daughter, was
destined to do many years after--lessons of self-devotion to great ends.

It was at this time of sorrow, and in the intervals of medical study,
that he wrote his 'Illustrations of the Divine Government,' the object
of which is to show how perfect is the Love that rules the world, in
spite of that which seems to clash,--pain, and sorrow, and wrong--all
that we call evil.

His medical studies only added to his impression of the great Whole as
one perfect scheme, for he felt an intimate connection between the field
of scientific research and those religious studies to which he had
formerly devoted himself exclusively. This is shown in his own words in
the preface to the fourth edition of the work, which was published in
1844.

"The contemplation," he writes, "of the wonderful processes which
constitute life,--the exquisite mechanism (as far as that mechanism can
be traced) by which they are performed--the surprising adjustments and
harmonies by which, in a creature like man, such diverse and opposite
actions are brought into relation with each other and made to work in
subserviency and co-operation;--and the divine object of all--the
communication of sensation and intelligence as the inlets and
instruments of happiness--afforded the highest satisfaction to my mind.
But this beautiful world, into whose workings my eye now searched,
presented itself to my view as a demonstration that the Creative Power
is infinite in goodness, and seemed to afford, as if from the essential
elements and profoundest depths of nature, a proof of His love."

This book came to be a help to many of all classes and creeds, and
passed through several editions.

He was often urged to reprint it in later life, but held it back,
wishing to modify it slightly. Not that his opinion of its main
principles had altered in the least degree, but that he thought he had
passed too lightly over the sea of misery and crime that there is in the
world; he thought there was rather too much of the bright hopefulness of
youth about it. Sorrow he had known, certainly, in the loss of his wife;
but the sorrow that comes from the loss of one who was noble and good,
and who has been taken from us by death, is of quite a different kind
from that which comes from a closer acquaintance with the mass of sin
and misery which exists. He did not change his view that, even this,
rightly understood, is consistent with the divine benevolence; but he
wished to recognise more fully its existence, and to enter more largely
into the subject.

Having completed his medical studies and obtained his degree, the young
physician determined to take a practice in Yeovil. The following extract
from a letter, dated August 5, 1816, addressed by him to a friend in
Rome,[3] shows with what views as to his future profession he quitted
Scotland.

"I leave Edinburgh this week," he writes; "I leave it with much regret,
for I have found friends here whom I shall ever remember with respect,
affection, and gratitude. I go to Yeovil, a little town in the west of
England, where it is my intention to take charge of a congregation and
at the same time to practise medicine. This double capacity of physician
to body and soul does not appear to me to be incompatible, but how the
plan will succeed can be determined only by the test of experience.

"My expectations are not very sanguine, but neither are my desires
ambitious."

"The test of experience" proved that he was admirably qualified for the
double office he had taken upon himself, and for some years he pursued
faithfully the plan he had made.

But this quiet country life was not to be his always. It was decreed
that he should come up to London and enter into its teeming life, to
think, and write, and labour, until he had done his part towards
lessening its mass of misery.

Footnote 1:

  Caroline Southwood Smith, married, 1835, Mr James Hill.

  _Children of this marriage_: Miranda Hill, Gertrude Hill (Mrs Charles
  Lewes), Octavia Hill, Emily S. Hill (Mrs C. E. Maurice), Florence
  Hill.

Footnote 2:

  Emily Southwood Smith, born 1810, died 1872.

Footnote 3:

  The Hon. D. G. Halliburton.




                              CHAPTER II.
FIRST YEARS IN LONDON-DAWN OF THE SCIENCE OF MODERN HYGIENE, 1820-1834.


On first arriving in London in 1820, my grandfather, who whilst still at
Yeovil had married for the second time (Mary, daughter of Mr John
Christie of Hackney),[4] settled in Trinity Square, near the Tower. He
soon formed a considerable private practice, and was appointed physician
to the London Fever Hospital, and he was thus led to give very special
attention to the subject of fever. He also held the offices of physician
to the Eastern Dispensary and to the Jews' Hospital, situated in the
very heart of Whitechapel. And while his experience in the wards of the
fever hospital taught him by what means that disease can most frequently
be _cured_, his acquaintance with it in the homes of his East-end
patients taught him more--how it might be _prevented_.

Almost the first writings bearing on what came to be afterwards called
the "Sanitary Question" are to be found in the pages of the 'Westminster
Review.' In the two first numbers of that Review, published in the year
1825, there appeared some articles on "Contagion and Sanitary Laws."
These articles, published anonymously, were written by Dr Southwood
Smith. It must be noted that the word "sanitary" had not then the
meaning it has in these days: sanitary science was unknown, and the
words "Sanitary Laws" had a no wider signification than that of the
regulations of a quarantine code.

But from that time these words acquired a new meaning.

In the articles above referred to, facts were brought together which had
been collected from the writings of men who had devoted years to the
study of pestilences in Spain, in various ports of the Mediterranean, in
Constantinople, and in the West Indies. They had gone where epidemics
were raging, had risked their lives that they might increase the store
of knowledge about these fearful scourges, and might, if possible, learn
on what they depend. Amongst these men, one of the most distinguished
was apparently a Dr Maclean, of whom the article tells us that "when he
was in Spain in 1821 yellow fever attacked Barcelona, and that with his
wonted zeal he hastened to the spot in order that he might fully
investigate its nature." Dr Maclean is spoken of as "one of those
extraordinary men who is capable of concentrating all the faculties of
his mind, and of devoting the best years of his life, to the
accomplishment of one great and benevolent object." We are told how, "in
order to demonstrate what epidemic diseases really are, and what they
are not, and to put an end to errors which have so long and so
universally prevailed on this subject, errors which he believes to be
the source of incalculable misery and of certain death to millions of
the human race, Dr Maclean, with an energy scarcely to be paralleled,
has devoted thirty years--a large portion of the active life of man. In
this cause he has repeatedly risked that life, and for its sake he has
encountered all sorts of suspicion and abuse."[5]

Generalising, then, from the facts which such men had collected and from
others observed by himself, Dr Southwood Smith endeavours to establish
the laws of epidemic disease. In the first place, he labours to prove
that _epidemic_ diseases are not, in the strict sense of the word,
_contagious_, and that the laws which epidemic diseases observe offer a
complete contrast to those which regulate contagious diseases.

"It was proved," he thought, to use his own words, "that the symptoms of
epidemic diseases are not determinate and uniform. They vary in
different countries and different seasons--even in the same country and
the same season, and do not succeed each other in any determinate order.

"That epidemics observe certain seasons--the periods at which they
commence, decline, and cease, hardly vary. For instance, the plague in
Egypt begins in March or April, and ends in June or July. All epidemics
in Great Britain, of which we have any record, have raged in the autumn.

"That epidemic diseases prevail most in certain countries, in certain
districts, in certain towns, and in certain parts of the same town. They
prevail most in those countries which are the least cultivated; in those
districts which are the most woody, the most exposed to particular winds
and to inundations; in those towns which are placed in low and damp
situations, and which are unprotected from certain winds; in those
streets and houses, and even in those apartments of the same house,
which are the most low and damp, the worst built, and the least
sheltered.

"That epidemics commence, spread, and cease in a manner perfectly
peculiar. They arise, for example, in some particular quarter of a town,
and do not attack the other districts which happen to be nearest it in
regular succession, but break out suddenly in the most distant and most
opposite directions. People are attacked, _not in proportion as the
inhabitants of the affected mix with the inhabitants of the unaffected
places, but in proportion as the inhabitants of the unaffected expose
themselves to the air of the affected places_.

"That the termination of epidemics is peculiar, since they cease
suddenly at the exact period when the greatest number of persons is
affected by them, and when the greatest mortality prevails. This fact is
inexplicable under the supposition that epidemics owe their spread from
person to person. To suppose that a disease which is propagated by
contagion can rapidly decline and even suddenly cease, just when most
persons are affected and the mortality is greatest--that is, when the
contagious matter is proved to be in its most active and malignant
state--is utterly absurd.

"That epidemics attack the same person more than once, and that relapses
are frequent amongst those suffering from them, whereas contagious
diseases seldom affect the same individual a second time, and relapses
are most uncommon."

From all this it will be clear that the object of these articles was to
prove that all epidemics have their origin in the bad sanitary
conditions (as we now say) of the places in which they arise.

It happened then, as very frequently happens in all sciences when the
time is ripe for a discovery, that those working in different fields of
observation noticed, at the same period, the same facts--some, as for
example Dr Maclean, in their posts of observation during the epidemics
in distant countries; Dr Southwood Smith in the fever-haunts of London.
But it remained for him, collecting together all the experience and
generalising from it, to announce the law on which they depend.

Those who thus arrived at the great principle of the connection between
defective sanitary conditions and disease, laid the foundation of
Sanitary Reform. That connection is an old truth now,--one of those
about which it is difficult to realise that it could ever have been
unknown to the world; but in those days it was unknown and unrecognised,
and amongst the few who began to recognise it, there were scarcely any
who saw to what wide practical results such truths ought to lead.

My grandfather, however, saw that if the principle were once
established, not only would the quarantine laws, at that time absurd and
inefficacious, be modified; not only would our merchant ships be
released from spending long weary months in unhealthy ports, while their
crews were perhaps contracting, from their confinement, the very
diseases which they were supposed to have brought with them from foreign
lands; not only would the poor sufferers from plague and yellow fever
cease to be imprisoned in the poisoned districts whose air had just
given them the pestilence;--not only would these _false_ precautions
cease, but the true ones would be taken: the _causes_ of disease would
be removed; and thus, wherever a knowledge of this law spread and was
acted on, disease and death would diminish.

Might not, he thought, something practical be done _now_ and _here_ if
these facts were once generally known? Epidemics throughout follow the
same laws. Were not the very causes which produce plague in Egypt
operating now to produce typhus fever in Bethnal Green and Whitechapel?
We might not be able to stop the pestilential, moisture-laden wind that
came down to Cairo each year at the time of the inundation of the Nile,
but could we not do something towards purifying that which crept into
the rooms of our own poor from undrained courts and stagnant pools?
Could we not, if people once believed and acted on their belief, banish
the yearly epidemic fever from the back-streets of our large towns?

Dr Southwood Smith believed that this great result would follow from the
general acceptance of the truth of the principle he had announced. He
gave his life to spreading the knowledge of it.

By the articles in the 'Westminster Review' something was done towards
enlightening the public mind, for I find that they attracted the
attention of leading men in and out of Parliament, and were often
referred to in the debates in both Houses.

Five years more of daily experience and constant thought passed before
his 'Treatise on Fever' was published.[6] It entered fully into all the
phenomena of the disease and into the question of its treatment. It
added largely to the knowledge of fever existing at that time, and was
welcomed by the medical profession. 'The Medico-Chirurgical Review,' the
highest authority of that day, pronounced it to be "the best work on
Fever that ever flowed from the pen of physician in any age or country."
It was for a long time the standard work on the subject with which it
dealt. The most important part of the work, however, as might be
expected, is that which relates, not to the treatment of disease (which
has since his time much changed) but to its _causes_. And here we find
an elaboration of the principles laid down five years before in his
articles in the 'Westminster Review.' Those articles had been the result
of a rapid glance which had gone to the very root of things, though when
they were written their writer had held his position at the Fever
Hospital for one year only, and had therefore not acquired the large
experience of fever which he subsequently attained. But the five years
that had passed since they were written could not change--could only
strengthen--his conviction of the truth of the principles which he had
previously expounded.

In the 'Treatise on Fever,' as in the articles just quoted, it is
enforced upon us, that since epidemics are everywhere the same, when
they reach our own country we must expect to find conditions similar to
those which produce pestilence in foreign countries. He writes as
follows:--

"_The room of a fever patient, in a small and heated apartment of
London, with no perflation of fresh air, is perfectly analogous to a
stagnant pool in Ethiopia full of the bodies of dead locusts. The poison
generated in both cases is the same; the difference is merely in the
degree of its potency. Nature with her burning sun, her stilled and
pent-up wind, her stagnant and teeming marsh, manufactures plague on a
large and fearful scale. Poverty in her hut, covered with her rags,
surrounded by her filth, striving with all her might to keep out the
pure air and to increase the heat, imitates Nature but too successfully;
the process and the product are the same, the only difference is in the
magnitude of the result. Penury and ignorance can thus, at any time and
in any place, create a mortal plague._"[7]

Dr Southwood Smith has been accused of ignoring the fact that those
suffering from fever can communicate the disease to others--of
"infection," as it is called. But he did not. He shows, on the contrary,
that the atmosphere of a room such as that spoken of in the passage just
quoted must have the power of inducing fever in others besides the
patient. He even says that "the poison formed by the exhalations given
off from the living bodies of those affected by fever is by far the most
potent febrile poison derived from animal origin."

Then, it might be asked, of what consequence is it to insist on the
disease being non-contagious? If fever-patients can give fever to
others, it is a mere matter of words whether you choose to call it
"contagious" or "infectious."

It is, however, of the utmost consequence to fix the attention on the
difference; because, if that is done, the real seat of the danger will
be clearly seen, and those whose duty it is to enter the rooms of the
sick will know that their danger rarely lies in touching the patient,
and may be prevented by abundance of fresh air and scrupulous
cleanliness.

In order to emphasise this side of the truth my grandfather wrote as
follows (and, though it may seem to require qualification, the _general_
truth of his remark will be admitted by all): "No fever produced by
contamination of the air can be communicated to others in a pure
air--there never was an instance of such communication."

The form of poison given off from a fever patient is, besides, not so
much to be feared as other forms of that poison, because, though it is
potent, it has not a wide range; when let out into the fresh air, it is
so far diluted that its power is reduced to a minimum.

An epidemic, he asserts, can only arise from some cause sufficient to
affect a whole district. Continually we are brought back to observe this
universal cause of fevers; to see that, whether in the sudden falling
off of an army to half its numbers, or in the prostration of a whole
ship's crew on approaching shore, or in the plague devastating Cairo,
this one source may be traced as the true one. Bad air comes from the
marsh near which the army is stationed; bad air, poisoned by decaying
vegetation, comes off shore to the ship; bad air enters the houses of
Cairo. We are shown that Cairo is the birthplace of the plague, because
it is a city crowded with a poor population; because it is built with
close and narrow streets; because it is situated in the midst of a sandy
plain at the foot of a mountain, which keeps off the wind, and is
therefore exposed to stifling heat; and, above all, because it has a
great canal which, though filled with water at the inundation of the
Nile, becomes dry as the river gets lower, and thus emits an intolerable
smell from the mud and from the offensive matter that is thrown into it.

Besides being thus shown that, in all places in which epidemics appear,
some sanitary defect may be found, we are shown that they come back and
back to the same places, and that, if these defects are removed, the
epidemics will not return. So we are led on to the great idea that they
are _preventible_.

The facts advanced to prove these principles have not, of course, the
wide range, the distinct statistical exactness, of those which the
further progress of sanitary science has now enabled people to bring
forward; but it is very interesting to see how all further advance has
been but a development of the principles brought forward in this
'Treatise on Fever,' just as it was itself but a development of those
brought forward five years before. Hardly any investigations had yet
been made, but the results which research would bring to light are here
foreshadowed. Even the direction which such research would take is
indicated, for we are told, at the end of the chapter which treats of
the "Causes of Fever," that--

"Further inquiries are necessary--such as, whether the vegetable and
animal poisons we have been considering be the _only_ true, exciting
cause of fever;[8] by what means its general diffusion is effected; on
what conditions its propagation depends; by what measures its extension
may be checked and its power diminished or destroyed; what circumstances
in the modes of life, in the habits of society, in the structure of
houses, in the condition of the public streets and common sewers, in the
state of the soil over large districts of the country as influenced by
the mode of agriculture, drainage, and so on, favour or check the origin
and propagation of this great curse of civilised, no less than of
uncivilised, man."

Not a mere article or book contained the result of such inquiries. They
occupied the greater part of his life, and that of many others. Their
outcome is the present state of sanitary knowledge.

If some people think there was nothing new in the view of epidemics
insisted on in this Treatise, they have only to see what was the common
opinion at that time amongst medical men. A few shared the writer's
opinions, but the majority of English physicians then certainly took
quite the opposite view. When Asiatic cholera first broke out in 1831,
it was of no avail that the physicians of Bengal had declared
unanimously that "the attempt to prevent the introduction of cholera by
a rigorous quarantine had always and utterly failed"; it was of no avail
that the articles on "Quarantine Laws" had, six years before, urged the
same truth; the London College of Physicians issued, notwithstanding, a
notification that, wherever cholera appeared, the sick should be
collected together in houses, which should be marked conspicuously
_Sick_; and that, even after the sufferers had been removed, and the
houses purified, _Caution_ should be marked on them. That the dead from
cholera should be buried in separate ground; that food to be delivered
at a house where any one was sick should be placed outside, and only
taken in when the person who brought it had gone away; and that no one
who had communicated with a cholera patient should, during twenty days
after, communicate with the healthy.

If cholera resisted all these precautions, and became fatal in the
terrific way it had done in other countries, the authorities announced
"that it might become necessary to draw a strong body of troops or
police round the affected places."

This proclamation of the physicians of 1831 was published throughout the
land in the form of an Order of the King in Council. It might have been
more to the purpose to have cleansed the affected town.

"But," says Mr Howell,[9] "the strong good sense of the public averted
many of the mischiefs which these scientific advisers would have
produced had their counsels been carried into execution. The preventive
measures, which were eventually adopted by them, consisted in
prohibiting intercourse between one town and another by sea, and
permitting it by land: thus communication between London and Edinburgh
by stage-coach was perfectly free and uninterrupted, while communication
between those capitals by sea was prohibited with such rigour that no
interest, however powerful, could procure an exemption! Francis
Jeffrey--at this time holding the high office of Lord Advocate of
Scotland, and whose influence from his personal and official connections
was very great--was unable to obtain permission for his faithful
servant, in the last stage of dropsy, to go from London to Leith by
water, lest he should carry with him to his native country by that mode
of conveyance, not the dropsy which he had, but the cholera which he had
not.

"'You will be sorry,' writes Jeffrey to Miss Cockburn, 'to hear that
poor old Fergus is so ill that I fear he will die very soon. I have made
great efforts to get him shipped off to Scotland, where he wishes much
to go; but the _quarantine regulations are so absurdly severe that, in
spite of all my influence with the Privy Council, I have not been able
to get a passage for him, and he is quite unable to travel by land_....
He has decided water in the chest and swelling in all his limbs. The
doctors say he may die any day, and that it is scarcely possible he can
recover.'"[10]

Mr Howell adds that these examples are not adduced for the purpose of
casting obloquy on the eminent physicians of that day, who vainly
endeavoured to reduce to practice in the nineteenth century the
standard, but obsolete, doctrines taught almost universally in the
medical schools, but solely for the purpose of displaying the state of
the science of Public Health in the year 1831-32, as far as the
physicians of highest reputation and largest practice may be taken as
its exponents.

It need hardly be said that it is with this purpose only that these
facts are again cited here.

Footnote 4:

  _Children of this marriage_: Herman Southwood Smith, born 1819, died
  1897; Spencer, Christina, both died in childhood.

Footnote 5:

  Westminster Review, 1825, p. 519.

Footnote 6:

  Longmans, 1830.

Footnote 7:

  Treatise on Fever, p. 324.

Footnote 8:

  Modern investigations have proved, for instance, that contaminated
  water or milk will produce an epidemic as well as contaminated _air_.
  But all these poisons arise from bad sanitary conditions.--G. L.

Footnote 9:

  Origin and Progress of Sanitary Reform. T. Jones Howell.

Footnote 10:

  Cockburn's Life of Jeffrey, ii. 247.




                              CHAPTER III.
         LONDON CONTINUED--LITERARY AND OTHER WORK, 1820-1834.


The 'Treatise on Fever' held an important place in the development of
that sanitary ideal to the realisation of which my grandfather
afterwards devoted himself almost exclusively; but in the course of the
years which are treated of in this chapter, he wrote much on other
subjects.

During this time severe money losses had necessitated the breaking up of
the establishment in Trinity Square; retrenchment became a duty; Mrs
Southwood Smith went abroad with the three children of the second
marriage[11] to carry on their education; and (his two elder daughters,
Caroline and Emily, being engaged in teaching away from home) my
grandfather once more retired to a strictly studious and professional
life at his consulting-rooms in New Broad Street, giving much time to
literary work, including the writing of a large number of physiological
articles for the 'Penny Encyclopædia.'

Dr Southwood Smith at this period assisted in founding the 'Westminster
Review.' This Review, supported as it was by men of great ability and
earnest thought, took, as is well known, a leading place in the
promotion of the political and social reforms of the day.

His own contributions to it were many. Besides the articles on
"Quarantine and Sanitary Laws" already mentioned, the one on
"Education," which appeared in the first number, may be specially
referred to.

There was also one calling attention to the horrors arising from there
being no proper provision for supplying the anatomical schools with the
means of dissection, which led to very practical results.

"Body-snatching" is now an extinct crime. Such was the name given to the
practice of robbing graves of the bodies of the dead in order to sell
them for the purpose of dissection. Such practices were an outrage
against all the feelings which render the resting-places of the dead
hallowed spots. One can imagine the horror which the friends of the
newly interred must have experienced in finding that their graves had
been violated during the night; and worse still were the midnight scenes
when the work was interrupted by the police, and struggles ensued.

The men who carried on this trade were called "resurrection-men": they
were a depraved and dangerous class, and if the state of things then
existing had caused no other evil than that of educating such a class,
it would still have been worth much effort to get it remedied.

Without bodies for dissection medical education was impossible, and at
that time there was only one legal means by which they could be
obtained: those of executed criminals were made over to the medical
profession for the purpose of dissection. But this source was, happily,
even then a scanty one. Until, therefore, some other provision was made,
the employment of "resurrection-men," though against the law, and in
itself revolting to the professors of anatomy, was a necessity.

The difficulty was an increasing one. The wretched men whose trade it
was to supply the medical schools were punished with imprisonment and
heavy fines, and were, not unnaturally, regarded with abhorrence by the
mob--such abhorrence that it was often difficult to protect them from
its fury when arrested. In Scotland, especially, this popular feeling
was so strong that disgraceful outrages were committed against those
even _suspected_ of being concerned in exhumation; the churchyards were
watched, and the obstacles in obtaining subjects for the schools had
become so many that the students were fast deserting them. Indeed
throughout Great Britain it appeared as if there would soon be a general
desertion of all the native schools, and that students would go to Paris
for the education they could not get at home.

In the article by Dr Southwood Smith which first called public attention
to these evils, he points out, in a very striking manner, the paramount
necessity of a supply of subjects. He reminds his readers of the wild
theories of former times when anatomical knowledge was not possessed,
and enforces on their attention the fact that this knowledge can only be
acquired, with any degree of perfection, by means of dissection. He
further reminds them that no operation can be performed without torture
to the living, and danger to life itself, by the hand of a surgeon
unpractised in dissection; and no clear judgment formed by the physician
on the diseases of the human frame--diseases generally seated in organs
hidden from the eye--without a study of the internal structure.

After shortly passing over the evils of the system then prevailing,
which have just been pointed out--evils which were then very generally
known--he suggests the remedy,--a very simple one. It was, to cease to
give the bodies of executed criminals for anatomical purposes, and thus
in a measure to take off the stigma on dissection; and then to
appropriate to that purpose the bodies of all those who die in hospitals
and workhouses _unclaimed by relatives_.

Nothing was done for some time, till in 1828, three years after this
paper was written, there came the horrible discovery that the difficulty
of obtaining subjects from the churchyards had become so great that two
men, Burke and Hare, had resorted to murder to supply the need--the
temptation having been the large price to be obtained for bodies.

When things had come to this climax, legislative attention was aroused.
At this time the article which had appeared in the 'Westminster Review'
was reprinted as a pamphlet, under the title of 'The Use of the Dead to
the Living.' In this form it went through several editions, a copy being
presented to members of both Houses of Parliament.

The measures recommended in it were mainly adopted by the Legislature,
and have proved completely successful.

There is something at first sight sad in a plan which lets anything that
is painful in the thought of such an appropriation of the bodies of the
dead fall exclusively on the poor. This did not fail to suggest itself
to my grandfather's mind. But it is to the survivors alone that such
pain comes, and these friendless ones would have none left to shrink
from this use of their remains. Such were to be chosen for the necessary
purpose, not because they were "poor," but because they were
"unclaimed." Neither was any pain arising from this arrangement to be
compared with that springing from the forcible seizure of bodies in the
old times. Out of _that_ arose, necessarily, scenes of horror revolting
to all sense of the respect due to the dead; while their quiet removal
from the hospital to the anatomical school, to be followed, after the
necessary dissection, by their burial, is widely different. It seemed,
moreover, that the interest of the poor specially demanded a widespread
anatomical knowledge in medical men, since they, more than all others,
suffered when the means of gaining it were limited. "Poverty, it is
true," my grandfather writes, "is a misfortune; poverty, it is true, has
terror and pain enough in itself. No legislature ought by any act to
increase its wretchedness; but the measure here proposed is pregnant
with good to the poor, and would tend, more than can be estimated, to
lessen the misery of their condition. For it would give knowledge to the
lowest practitioners of the medical art--that is, to persons who are at
present lamentably deficient, and into whose hands the great bulk of the
poor fall. And, after all, the true question is, whether the surgeon
shall be allowed to gain knowledge by operating on the bodies of the
dead, or driven to obtain it by practising on the bodies of the living.
If the dead bodies of the poor are not appropriated to this use, their
living bodies must be, and will be. The rich will always have it in
their power to select, for the performance of an operation, the surgeon
who has signalised himself by success; but that surgeon, if he has not
obtained the dexterity which ensures success by dissecting and operating
on the bodies of the dead, must have acquired it by making them on the
living bodies of the poor."

It was said at the time by objectors that the measure in question would
deter patients from entering the hospitals, and add terrors to
workhouses, but experience has proved that my grandfather was right: the
adoption of his plan has not been found to have the slightest effect of
the kind.

In considering the work of this period of my grandfather's life, I ought
not to omit to mention his lectures, which were full of the same
earnestness and originality that characterised all he did. He was
lecturer at the Webb Street School of Anatomy, where he gave a course on
"Forensic Medicine," which made much impression at the time. He gave
also courses of popular lectures on physiology at the London Institution
and elsewhere. To those at the London Institution ladies were
admitted--a permission unusual in those times.

One lecture, delivered on a very remarkable occasion, must be mentioned
here. My grandfather was the friend and physician of Jeremy Bentham, and
was called upon, after his death, to perform a duty which he had
solemnly undertaken. The venerable philosopher died in 1832 at the age
of eighty-five, and by will desired that his body should be used for the
purposes of dissection. He intrusted to Dr Southwood Smith, in
conjunction with two other friends, the task of seeing this disposition
properly fulfilled, trusting that they would not be deterred by
opposition or obloquy.

This disposition of his body was not a recent act. By a will, dated as
far back as 1769, it was left, for the same purpose, to his friend Dr
Fordyce. The reason at that time assigned for this is expressed by
Bentham in the following remarkable words:--

"This my will and special request I make, not out of affectation of
singularity, but to the intent and with the desire that mankind may reap
some small benefit by my decease, having hitherto had small
opportunities to contribute thereto while living."

By a memorandum affixed to this document it is clear that it had
undergone revision as lately as two months before his death, and that
this part of it, originally made when he was twenty-one, was again
deliberately and solemnly confirmed by him at eighty-five.

In thus appropriating his remains to the service of mankind, Bentham
carried out, to the last moment of his life, and even after his death,
his principle of "Utility."

The subject of dissection was agitating the public mind: the "Anatomy
Bill" was not yet passed, and the idea might well present itself to a
benevolent mind such as his, that to show a thorough absence of horror
or dislike to the idea of being dissected after death would be a means
of lessening the prejudice which existed against it.

Whatever may be thought of the "greatest happiness principle" of this
philosopher, it did not cause him to lead a selfish or epicurean life.
The long calm expanse of eighty-five years was filled with simple
pleasures, with hard work, and contained many sacrifices to the cause of
truth.

My grandfather bears his testimony to the wonderful energy and
self-devotion of Bentham during his life in these words:--

"Bentham's object was no less a one than to construct an
all-comprehensive system of morals and an all-comprehensive code of
laws. For the accomplishment of a work so prodigious he put forth an
energy commensurate to the end. The extent of mental labour required for
this undertaking, and actually brought to it, is truly extraordinary.
Every day for nearly half a century did he devote to it never less than
eight hours, often ten, and sometimes twelve."

And now, when this busy life was stilled, my grandfather was bound to
carry out as fully as possible Bentham's wish that in death too he might
be useful. He delivered the oration over the body, in the Webb Street
School of Anatomy, on the evening of the 9th of June 1832. One who was
there thus writes of it:--

"None who were present can ever forget that impressive scene. The room
is small and circular, with no windows, but a central skylight, and was
filled, with the exception of a class of medical students and some
eminent members of that profession, by friends, disciples, and admirers
of the deceased philosopher, comprising many men celebrated for literary
talent, scientific research, and political activity. The corpse was on
the table in the centre of the room, directly under the light, clothed
in a night-dress, with only the head and hands exposed. There was no
rigidity in the features, but an expression of placid dignity and
benevolence. This was at times rendered almost vital by the reflection
of the lightning playing over them; for a storm arose just as the
lecturer commenced, and the profound silence in which he was listened to
was broken, and only broken, by loud peals of thunder, which continued
to roll at intervals throughout the delivery of his most appropriate and
often affecting address. With the feelings which touch the heart in the
contemplation of departed greatness, and in the presence of death, there
mingled a sense of the power which that lifeless body seemed to be
exercising in the conquest of prejudice for the public good, thus
cooperating with the triumphs of the spirit by which it had been
animated. It was a worthy close of the personal career of the great
philosopher and philanthropist. Never did corpse of hero on the
battle-field, with his martial cloak around him, or funeral obsequies
chanted by stoled and mitred priests in Gothic aisles, excite such
emotions as the stern simplicity of that hour in which the principle of
utility triumphed over the imagination and the heart."

In the year 1834 my grandfather published his book entitled 'The
Philosophy of Health,'[12] the preparation of which had been a work of
great care, and had occupied much time for several years before. This
book, which was, perhaps, the first attempt to bring the truths of human
physiology within the comprehension of the general reader, achieved a
marked success. It was full of the clearness and force which
characterised all the writings of its author. The strides of modern
science have now, of course, left its physiological teaching far behind,
but at the time it did original educational work and added lustre to his
name.

His life in chambers must have been an arduous one--first at 36 New
Broad Street, afterwards at 38 Finsbury Square,--his days given up to
his ever-increasing practice, his mornings and evenings to writing: the
amount achieved was prodigious, and he allowed himself but little
relaxation.

I may mention that it was at this time that my grandfather first visited
at the house of old Mr Gillies, a city merchant of refined literary
tastes and the father of the two distinguished women, Mary and Margaret
Gillies (author and artist), who afterwards became the friends for life
of himself, his wife, and daughters, and in whose home he--and I with
him--had rooms in Kentish Town and afterwards at Highgate, though he
occupied for professional purposes the rooms in the city to which I have
before referred.

Footnote 11:

  Herman Southwood, born 1820, died 1897; Christina and Spencer, died in
  childhood.

Footnote 12:

  Longmans, 1834.




                              CHAPTER IV.
                 WORK ON THE FACTORY COMMISSION, 1833.


In the year 1833 it became clear that some legal interference was
necessary with regard to Factories.

In order to understand the abuses which existed in factories in 1833, we
must revert to the system of employment at the end of the last century
and trace its gradual development.

At that period all the spinning and weaving of the country was domestic,
the spinning being carried on in farmhouses and scattered cottages in
rural places by the mothers and daughters of the families, and the
weaving by men working in their own homes in towns and villages. This
peaceful state of things did not last beyond the beginning of the
present century. The "spinning-jenny" and "power-loom" were invented,
and changes occurred. Large buildings were now needed to carry on the
work, and mills and factories sprang up beside the streams of
Nottinghamshire, Derbyshire, and Lancashire, these places being chosen
because water was required to turn the new machinery. The water-wheel
now did much of the work which had formerly needed the strong arms of
men, but the small and nimble fingers of children were henceforth called
into play, as they were found to be specially fitted for much of that
which remained to be done by hand. Thus it came about that children's
labour, in consequence of its greater cheapness, was substituted for
that of grown people.

In order to get a sufficient supply of children, which the scanty
population near the mills could not afford, manufacturers applied to the
managers of the workhouses in London and other large towns, for pauper
children to be taken as apprentices. Hundreds, it is said even
thousands, of children were thus taken away from even the slight
protection which the tender mercies of the workhouse authorities of that
day might afford, and placed entirely in the power of the master
manufacturer, or, worse still, of his overseer.

The evils that resulted from this apprenticeship system resembled those
springing from slavery. One writer[13] says:--

"There is abundant evidence on record, and preserved in the recollection
of some who still live, to show that, in many of the manufacturing
districts, cruelties the most heartrending were practised upon the
unoffending and friendless creatures who were thus consigned to the care
of the master manufacturers; that they were harassed to the brink of
death by excess of labour, that they were flogged, fettered, and
tortured to the most exquisite refinements of cruelty; that they were in
many cases starved to the bone whilst flogged to their work; and that,
in some instances, they were driven to commit suicide to evade the
cruelties of a world where, though born into it so recently, their
happiest moments had been passed in the garb and in the coercion of a
workhouse. The beautiful and romantic valleys of Derbyshire, Lancashire,
and Nottinghamshire, secluded from the public eye, became the dismal
solitudes of torture and of many a murder."

The Legislature interfered, and in 1802 passed an Act for regulating
factories and protecting the apprentices employed in them. This Act was
brought in and carried by Sir Robert Peel, the father of the statesman
who repealed the Corn Laws, and himself a large manufacturer.

A further change in the history of manufacture, however, occurred. The
steam-engine was invented, and when its power was applied to
manufacture, it was no longer necessary to build factories where
water-power was at hand; they were henceforth principally established in
towns. Apprentices were now but little employed; free, paid
child-labour, here to be obtained in abundance, was preferred by the
mill-owners. They had never wished for apprentices; the charge of them
had always entailed considerable trouble; the responsibility was felt
heavily by conscientious masters, whilst the legal restrictions of Sir
Robert Peel's Act prevented the avaricious and hard-hearted from
profiting by the abuses of the system. Apprenticeship therefore died a
natural death.

It might be thought that children employed under the new plan, receiving
wages and living at home under the protection of their parents, would
suffer no hardships calling for legal restraint; but representations
having been made to the Government that abuses had crept in, a Royal
Commission of inquiry was determined upon in 1833.

On this occasion Dr Southwood Smith was appointed by the Government a
member of this Commission, conjointly with Mr Tooke and Mr Edwin
Chadwick.[14]

Their first work was to send district commissioners into the
manufacturing regions to collect evidence, and the results of those
inquiries were embodied in the general Report. My grandfather took a
deep interest in the subject, for the evils disclosed by the inspection,
if not so great as they had been under the apprenticeship system, were
still sufficiently appalling: children, some of them not more than five
years old, were obliged to work the same number of hours as the adult
operatives--twelve, fourteen, or sixteen hours a-day--sometimes the
whole night; their health was thus often ruined for life; neither time
nor strength remained for education; they were growing up totally
ignorant; and they were, besides, often unkindly treated.

It is sad to see in the Report such words as these, quoted from the
children's lips: "I am sick tired, especially in the winter nights." "So
tired when I leave the mill that I can do nothing." "I feel so tired
when I gang home that I throw myself down, no caring what I does." "So
tired I am not able to set one foot by the other." "Many a time I have
been so fatigued I could hardly take off my clothes at night, or put
them on in the morning. My mother would be raging at me, because when I
sat down I could not get up again through the house."

As to their ruined health, such sentences as these foretell it: "Many
nights I do not get a wink of sleep from the pain." "My knees failed
from the work." Or, "Severe pains would come on, particularly in the
morning."

The evidence of the overseers and managers is scarcely less strong than
that of the little sufferers themselves.

One manager says: "I have known the children hide themselves in the wool
so that they could not go home when the work was over. I have seen six
or eight fetched out of the stove and beat out of the mill."

Another says: "After the children from eight to twelve years old had
worked eight or nine hours, they were nearly ready to faint: only kept
to their work by being spoken to, or by a little chastisement to make
them jump up. I was sometimes obliged to chastise them when they were
almost fainting, and it hurt my feelings; then they would spring up and
work pretty well for another hour; but the last two or three hours were
my hardest work, for they then got so exhausted."

And a third manager says: "I have seen them fall asleep, and they were
performing their work with their hands, while they were asleep, after
the 'billy' had stopped and their work was over."

Two great objections were made to any legislative limitation of the
number of hours of children's labour. One was, that it was impossible to
shorten their hours of work without also shortening those of the adults,
who could not go on without them; the other, that it was wrong to
restrict the liberty of the subject.

The first of these was, truly, a difficulty; but if the evil was so very
great, it appeared to my grandfather and those acting with him that some
change _must_ be made in the mode of working, rather than overtax the
children to this extent. Relays of children must be obtained, or
grown-up workers must be substituted as assistants.

With regard to the second objection--that it would be restricting the
liberty of private individuals if the law interfered--the Report shows
that children, at the age at which they suffered these injuries, were
not free agents, but were let out to hire by their parents, by whom
their wages were appropriated, and who were easily rendered callous to
their children's wrongs by a threat of dismissal, or a bribe of an
additional penny an hour of wage. If the law did not step in to protect
these unfortunate little ones from parents whose selfishness and
ignorance was allowing them to grow up diseased and benighted, where,
argues the Report, was their help to come from?

The question as to whether it is right in any instance for the
Government to intervene between parent and child, is now practically
settled by the many laws and enactments which regulate children's
education and hours of labour. But in those days the idea of any
restriction of a parent's right over his child excited much opposition.
It was regarded by many people as both impracticable and undesirable.

The reformers, however, carried their point and achieved success. That
very year the Factory Act passed, and the recommendations of the Report
were nearly all embodied in it. No child was allowed to be employed at
all under eight years old; children between eight and thirteen were only
allowed to work six and a half hours a-day; and all those employed were
obliged to attend school for three hours a-day. Inspectors were
appointed to see that the provisions of the Act were fully carried out.

Of course there was considerable indignation on the part of the
millowners, but many of those who at first objected to the restrictions
were afterwards convinced of their utility, and as time passed on this
conviction spread amongst all classes and gathered strength.

The only modifications of the Act of 1833 which have been made since,
have been mere extensions of its principles. The regulations, which at
first applied to cotton, cloth, and silk mills only, have been extended
by subsequent Acts to bleaching and dyeing works. Powers have also been
given to compel the fencing of machinery, and to enforce other
safeguards against injury to the workpeople.

Even after the Factory Commission had finished its work, and had ceased
to exist, my grandfather continued to watch with interest the results of
what had been done. Five years afterwards, the House of Commons having
ordered a Return showing the working of the educational provisions of
the Act, he went down himself to various mills, and I find his copy of
the Return thickly pencilled with marginal notes like the following:--

"I visited this mill myself with a view to examine the school." "The
whole neighbourhood was opposed to the direction of the mill. They now
consider it a great blessing." "The children of the higher class of
people are anxious to get employment in the mills."

It must have given him great delight to feel that, as was said by a
writer eleven years later--

"The present Act has led to an amelioration of the treatment, and an
improvement in the physical and moral character, of the vast juvenile
population, such as was never before effected by an Act of Parliament;
while the benefits resulting from it to all parties, the employers no
less than the employed, are not only rapidly multiplying and extending,
but are becoming more and more the subjects of general acknowledgment
and gratulation. There is reason to believe that the total number
employed in factory labour in the United Kingdom is little short of
1,000,000.[15] In one district, not by any means one of the largest, the
number of children attending school was increased from 200 to 2316."

Footnote 13:

  M. Fielden, M.P., 'The Curse of the Factory System.'

Footnote 14:

  This Commission, for considering the employment of children in
  _factories_, preceded by eleven years the one relating to their
  employment in _mines_ alluded to in the Introduction.

Footnote 15:

  This was in 1844.




                               CHAPTER V.
                  RISE OF THE SANITARY MOVEMENT, 1837.


Perhaps the most necessary and the most tried quality in a reformer is
Patience. Notwithstanding the publication of the 'Treatise on Fever' in
1830, and the tribute paid by the scientific world to its masterly
exposition of the treatment and causes of the disease, notwithstanding
the constant and ardent endeavours of the author to propagate his views,
yet seven long years passed away before he was able to awaken the apathy
of the public and the authorities.

Year after year went by, and the wards of the Fever Hospital continued
to be supplied from the same districts, from the same courts and
lanes--even from the very same house--as before. The preventible
suffering, thus daily brought before my grandfather's eyes, was a daily
reminder of the urgent need for help--of the necessity for taking
practical steps to diminish it.

In 1837 the opportunity came for pressing forward in the cause. That
year a frightful epidemic fever broke out in London, arousing general
alarm, and demanding special inquiry. The pressure on the poor-rates
became excessive, and my grandfather was appointed by the Poor Law
Commissioners to report on the eastern districts of London, Drs Arnott
and Kay being appointed to other districts.

The title of the Report presented by him is at once striking. He called
it, "Report on the Physical Causes of Sickness and Mortality to which
the Poor are particularly exposed, _and which are capable of prevention
by Sanitary Measures_." Its opening words are,--

"Some of the severest evils at present incident to the condition of
poverty, which have a large share in inducing its high rate of sickness
and mortality, are the consequences of improvidence. Such evils are
capable of being remedied only by bringing the poor under the influence
of the inducements to forethought and prudence.

"But there are evils of another class, more general and powerful in
their operation, which can be avoided by no prudence, and removed by no
exertion, on the part of the poor. Among the gravest, and at the same
time the most remediable, of these latter evils, is the exposure to
certain noxious agents generated and accumulated in the localities in
which the poor are obliged to take up their abode, and to the pernicious
influence of which they are constantly, and for the most part
unconsciously, subjected.

"It is the object of the present Report to direct attention to the
nature and extent of this evil, and to show how important it is that its
mitigation, and, as far as may be found practicable, its entire removal,
should form a part of every exertion that is made for improving the
physical condition of the poor."

These words would seem to strike the key-note of Sanitary Reform.

In order to make the Report more full and impressive, Dr Southwood Smith
writes an exact account of what he saw. He went personally over the
greater part of the Bethnal Green and Whitechapel districts. "I
traversed," he says, "a circle of from six to seven miles in extent. I
wrote the account of the places I am about to notice on the spot; I
entered many of the houses and examined their condition as to
cleanliness, ventilation, as well as the state of the people themselves,
who were at the time labouring under fever."

The descriptions that follow are too dreadful to be dwelt upon in detail
here. We are shown individually the houses of Whitechapel: they are
piled storey above storey, and are teeming with people; the streets,
courts, and alleys are so built that all current of air is blocked out,
and no measures whatever are taken to secure cleanliness. We are shown
Bethnal Green, flat, low, damp, wasted. Here the houses are not so
closely packed--there are open spaces; but these are for the most part
undrained marshes, and the air coming across them is poisonous rather
than life-giving. Straggling rows of rickety cottages look out upon
stagnant swamps; their miserable gardens are scattered over with
uncleared dust and refuse of all kinds, and are surrounded with black
and overflowing ditches, to cross which you must pass over rotting
planks used as bridges: there are houses which contain only two rooms,
the larger being 9 feet by 7 and 7 feet high, the smaller not able to
contain an ordinary-sized bed.

If the house has more rooms, it probably contains many families, and a
state of overcrowding is produced nearly as fatal as that which prevails
in the parts of London where the houses stand more thickly.

The picture comes vividly before us of the dismal homes, with their
melancholy gardens where the pale children play by the black ditches;
their green damp walls; the rags stuffed into the broken windows to keep
out the tainted outside air; and the crowds huddled together breathing
the suffocating air within doors. It is easy to realise the hopeless
efforts of the poor inhabitants to fight against the dirt and disease
which all those efforts are powerless to overcome!

No wonder then, that, in the words of his Report, we are told that "in
many parts of both these districts fever of a malignant kind and fatal
character is always more or less prevalent; that in some streets it has
recently prevailed in _almost every house_; in some in _every house_;
and, in some few instances, in _every room of every house_. Cases are
recorded in which every member of a family has been attacked in
succession, of whom, in every such case, several have died: some whole
families have been swept away. Instances are detailed in which there
have been found, in one small room, six persons lying ill of fever
together: I have myself seen this--four in one bed and two in another."

He once more enforces the preventibleness of this dreadful state of
things--how entirely it was within the power of man to change it by wise
attention to the laws of health. He points out parts of the districts
which had always remained comparatively healthy, and some, formerly
haunts of fever, where during the last epidemic no single case had
occurred, owing to sanitary improvements.

The necessity for providing in some way for the airing of streets and
courts in densely populated neighbourhoods, by the knocking down of
houses or other expedients, is insisted upon. Its difficulty is
admitted, but still it is urged.

"Though it might seem a hopeless task," he says, "to set about
ventilating such districts as Bethnal Green and Whitechapel, yet, if the
importance of the principle be duly appreciated and the object be kept
steadily in view, much may be accomplished. In some of the worst
localities in these districts, at moderate expense, means might be taken
to introduce free currents of air, where at present the air is perfectly
stagnant and stifling. Some of the improvements recently made in the
City of London show to what extent it is possible to introduce good
ventilation into the heart of the most densely populated part of the
Metropolis."

In this Report my grandfather also draws attention to the state of the
Workhouses. He was writing to the Poor Law Commissioners, and so he
could efficiently bring under their notice the state of those buildings.

"From what I have observed I am satisfied," he says, "that many existing
workhouses are extremely deficient in space, ventilation, and drainage."

The overcrowding in the dormitories is especially pointed out. He
writes:--

"In going over the Whitechapel Workhouse I was struck with the statement
of the fact that, out of 104 children (girls) resident in that house, 89
have recently been attacked with fever. On examining the dormitory in
which these children sleep, my wonder ceased. In a room 88 feet long,
16-1/2 wide, and 7 feet high, with a sloping roof rising to 10 feet, all
these 104 children, together with four women who have the charge of
them, sleep. The beds are close to each other; in all the beds there are
never less than four children, in many five; the ventilation of the room
is most imperfect. Under such circumstances the breaking out of fever is
inevitable.

"I was likewise struck with the pale and unhealthy appearance of a
number of children in the Whitechapel Workhouse, in a room called the
'Infant Nursery.' These children appear to be from two to three years of
age; they are 23 in number, they all sleep in one room, and they seldom
or never go out of this room either for air or exercise. Several
attempts have been made to send these infants into the country, but a
majority of the Board of Guardians has hitherto succeeded in resisting
the proposition.

"In the Whitechapel Workhouse there are two fever-wards: in the lower
ward the beds are much too close; two fever patients are placed in each
bed; the ventilation is most imperfect, and the room is so close as to
be dangerous to all who enter it, as well as most injurious to the
sick."

The Report mentions, in contrast, the case of the Jews' Hospital, where
he had been physician. In that hospital, though at one time there had
been a yearly outbreak of fever, since the number of beds in the
dormitories had been reduced, and several large ventilators had been put
in, the evil had entirely ceased. At the time he wrote eight years had
passed since the improvements, and fever had not once returned as an
epidemic.

                  *       *       *       *       *

After finishing this Report, my grandfather set to work to obtain exact
statistics as to fever in other parts of London; and by the next year
(1839) tables had been compiled, which proved, by a wider range of
experience, the truths he had again and again brought forward. Once more
he wrote a Report to the Poor Law Commissioners--of whom Mr (afterwards
Sir Edwin) Chadwick was one--pointing out the facts which were proved by
these figures and the duty of acting on them.[16]

Such accounts as those given by the three physicians appointed by the
Poor Law Board to inquire, could not pass unnoticed. The press, not only
in London but in all parts of England, took up the subject. Public men
began to be roused.

At first the facts were doubted. It was difficult to believe that such a
dreadful state of things _could_ exist; but attention was awakened, and
inquiry followed.

The Marquis of Normanby, then Secretary of State for the Home
Department, was much impressed with what he had read, but he could
hardly conquer a belief that there must have been some exaggeration. My
grandfather took him to see some of the places in Bethnal Green and
Whitechapel which the Report had described. Lord Normanby was deeply
moved, as every one must have been who was brought to realise the kind
of dwellings which were all that these people had for homes. "So far,"
he said, "from any exaggeration having crept into the descriptions which
had been given, they had not conveyed to my mind an adequate idea of the
truth."

Lord Ashley, too, always in the forefront to relieve the sufferings of
the poor, was taken by my grandfather on two occasions to see these
regions personally; and from that time forth he became one of the most
ardent supporters of the Sanitary Cause, working strenuously for it both
in and out of Parliament.[17] In a letter to a friend my grandfather
writes:--

    "FINSBURY SQUARE, 1841.

    "I have just returned from Whitechapel and Bethnal Green, over which
    I have been taking Lord Ashley and his brother, and I think they
    have received an impression which will be lasting, and which will
    stimulate them to exert themselves for the removal of some of the
    evils which they have witnessed."

The Bishop of London had the honour of being the first to bring the
question before Parliament. In an earnest and eloquent speech made in
the House of Lords during the session of 1839, he moved for an extension
of such inquiries as the Poor Law Board had caused to be made in London,
to other towns in the United Kingdom.

It must have seemed to my grandfather a glorious moment when the
principles he had so long advocated were for the first time
recognised--when the country began to hear with surprise and shame of
the existing state of things--and when the suffering, which he felt so
deeply, seemed about to be relieved.

The movement had now begun. Surely it would go quickly, since the saving
of thousands of lives each year depended on its progress?

Footnote 16:

  Report on the Prevalence of Fever in Twenty Metropolitan Unions in
  1838.

Footnote 17:

  For the account of what was shown to Lord Ashley on these occasions
  see Appendix I., p. 159.




                              CHAPTER VI.
               PHILANTHROPIC AND MEDICAL WORK, 1840-1848.


I have now arrived at the period of my grandfather's life which comes
within my own memory, and which begins with the days described in the
Introduction when I used to watch him as he sat at his writing in the
early mornings. He had taken me to live with him at three years old, and
from that time I was with him throughout his life. If, in this chapter
or elsewhere, I dwell on his care and tenderness towards myself, it is
only that it may indicate the love he invariably showed to all near and
dear to him.

My grandfather, though losing no opportunity of promoting the cause he
had chiefly at heart--the great sanitary cause--did not limit his public
work to it alone: he was at this time engaged in reforming the state of
coal-mines, being a member of a Royal Commission--the "Children's
Employment Commission"--the chief object of whose labours was to secure
the abolition of child-labour in mines. It has been mentioned that the
Report presented to Parliament by this Commission had pictures: they
were drawn on the spot at my grandfather's instigation, and I believe I
am right in saying it was the only parliamentary report so issued. The
state of things in the mines was sufficiently appalling. Children of
tender years were employed in opening and shutting little gates in
narrow passages of coal. They were untaught, and seldom breathed the
fresh air. They were sometimes as young as five years old (parents have
been known to send them even at four years old); they sat in small
niches, scooped out of the coal, for twelve hours at a time, to watch
the doors, and they were alone and in the dark except when a "hurrier"
with a candle fastened to his forehead passed along, on hands and knees,
dragging a truck.

[Illustration: Old woman carrying coal.]

The suffering was not confined to children; it was found that young
girls, married women, and aged and decrepit women were exposed to
bearing upon their backs burdens of coal weighing from three-quarters of
a cwt. to 3 cwt.; often to carry these whilst wading in water up to the
ankles, sometimes up to the knees, or to carry them from the bottom of
the mine to the bank up steep ladders; to go through the hard work of
hewing coal by the side of the men; to drag trucks on all fours
harnessed by chains; and that the nature of their work, when hewing
coal, constantly obliged them to dispense with most of their clothing.

[Illustration: Children at work.]

The illustrations in the Report brought all this before my childish
imagination very vividly. Perhaps they also, as the Commissioners hoped
they might do, caught the attention of busy members of Parliament and
learned lords who might not have waded through a lengthy "blue-book" to
find the facts which these pictures showed at a glance. The object of
the Commissioners was to put the facts strikingly, and in this they
succeeded.

[Illustration: Woman drawing truck.]

Lord Ashley's Bill, based on this Report, encountered great opposition,
especially in the House of Lords, many members of which were large
proprietors of mines, and in the course of its passage through
Parliament it was much mutilated. Lord Ashley had hoped to prevent any
boy under thirteen from working in the mines, but the age of exemption
was lowered to ten years old; and his attempt to prohibit the employment
of boys and old men in the work of lowering the miners into the pit by
means of ropes was also defeated.

Still, the main points were gained; for by Lord Ashley's Bill, which
passed in 1844 and was founded on the labours of this and the Factory
Commission, not only was it enacted that all _children_ under ten should
henceforth be prohibited from working in mines, but that such labour
should also be illegal for girls of all ages and for women.

It may be worth noticing that the change in the law did not at first
give satisfaction to the miners. The men considered it a great hardship
to be deprived of the earnings of their wives and children, and the
women themselves complained sorely of being deprived of their work. But
time has proved the great benefits of the new system. The men now earn
nearly as much as a man and his wife used to do, the presence of the
wife in the home causes it to be better cared for, and the children are
free to attend school.

The "Children's Employment Commission" instituted a further inquiry into
the state of young people employed in branches of trade not as yet
brought under regulation. This second Report of the Commission, on
"Trades and Manufactures," related to the state of apprentices in the
South Staffordshire ironworks, and of young workers in such trades as
earthenware-making, calico-printing, paper-making, &c.; and although
nothing could be done for them at the time, the regulations recommended
in the Report have since been adopted.

These Inquiries--important and interesting as they were--occupied only
the hours which my grandfather could spare from his professional work as
one of the chief consultants in cases of fever, and a leading London
physician.

He went daily from our home in Kentish Town to his rooms in the City,
and often used to take me with him as a little child. We usually stopped
first at the Fever Hospital, which was then near King's Cross. The Great
Northern Railway Station stands now on its site, where I used to sit in
the carriage at its gate. His connection with that Hospital was never
broken (at his death he had been one of its physicians for nearly forty
years), and he was, of course, much interested in its re-erection when
it was removed to its present position in Liverpool Road, Islington. The
new building was made with wards having no upper storeys; each ward had
three outer walls and a very high ceiling, thus ensuring perfect
ventilation; and there were many other advantages of arrangement.

But even the original hospital at King's Cross was very carefully
managed as to fresh air, and my grandfather's implicit belief in his own
doctrine of non-contagion was proved by his more than once taking me
into the fever-wards, though, when I was a child and therefore
peculiarly susceptible, he never would let me breathe the tainted air of
the courts and lanes of which he fearlessly encountered the danger, not
only in his capacity as a physician, but when making his early sanitary
investigations.

Three times in the course of his life he had been stricken down with
fever. In one of these attacks his life had been despaired of, but
medical skill, aided by most careful nursing and by his naturally strong
constitution, at length conquered the disease.

After the visit to the hospital we went on into the City to his
consulting-rooms, which were first at 36 New Broad Street, and
afterwards at 38 Finsbury Square; and then came the morning hours during
which he saw patients there, and I amused myself until he was ready for
the afternoon round. Then outdoor work again. Generally the visits led
us through crowded streets where the carriage got blocked in amongst
great waggons or hemmed in near high warehouses; but at times there came
long drives to some patient living more in the country at Hackney,
Dalston, Stoke Newington, or farther off still; and then what a happy
time I had with him, sitting on his knee and asking endless questions!
It was worth many hours of waiting in the carriage, outside doors, to
have the times that came between.

Then there was the Eastern Dispensary and Jews' Hospital practice, in
connection with which he daily went to see patients in their own poor
homes. How well I remember being left in the carriage at the end of
streets too narrow for it to drive down. I used to amuse myself with
looking out at the people passing to and fro--children without hats and
bonnets; old-clothesmen with their bags; orange-girls;--many dark faces
amongst the passers-by--Jews, as I was afterwards told. I used to wonder
at it all, and make up stories about the people and guess on what
errands they were bent when entering their little shops and doorways;
and when tired of all this--for I was still too small to see without
kneeling up on the seat to look out at the window--I seated myself on
the floor of the carriage and was soon deeply engrossed in some book of
pictures or fairy tales, which my grandfather, in the midst of all else,
had thoughtfully put into the pocket of the carriage for me to "find."

Then I would climb up again and watch for him. At last he would come!
Down the dark, narrow street, looking very grave, the reflection of
some scene just left still resting on his face. Out of such
thoughts--produced by such places--came his afterwork.

When he came to me, however, the sad thoughts passed away, and he was
ready to let his happy nature come through to cheer his little girl. He
would practically work to relieve such misery as he had seen--day and
night--at all cost--through all opposition,--but he would also play
merrily with his little grandchild, to make joyous for her the homeward
drive through the evening air.

My grandfather was much interested at this time in another effort of
which I have not yet spoken. It was the institution of a "Home in
Sickness" in London for those of the middle classes who might be far
from their own families, or who, from some other cause, could not secure
favourable surroundings in times of illness. The position of such people
struck him as very desolate. There were many with homes far
away--clerks, students, young men engaged in various professions,
governesses, and other ladies of limited income--who might be seized
with illness under circumstances when a return to their family was
impossible; others who had no family to which to return. It seemed to
him that chambers or lodgings which might be tolerably convenient for
people in health, were utterly unsuited to give the requisite comforts
when illness came: the poorer classes had the hospitals, but for this
intermediate class there was no provision.

His plan was, therefore, to found an institution into which, by
subscribing a small sum annually, members could secure a right to be
received when they were suffering from disease. They would each have a
separate room where an equal temperature could be secured, well prepared
diet, superior nursing, the advantage of a medical officer in the house
who could be called in at any moment, and the daily advice of skilled
physicians and surgeons specially appointed; or should the patients
prefer it, of their own medical advisers. For this they were to pay two
guineas a-week during their residence, or less, should it be found that
such an establishment could be self-supporting at a lower rate: that it
should be self-supporting was, he thought, essential.

Such an institution was founded in 1840 under very good auspices, and
opened under the name of "The Sanatorium" at Devonshire House, York
Gate, Regent's Park, in 1842. My grandfather freely gave it his medical
services, as well as his influence and supervision, for some years.

The house stood in a garden in which there were tall trees (with rooks
in them), making a cool green shade and shutting out all other houses;
whilst within doors the soft carpets and general feeling of quiet and
order gave a sense of peace. The contrast on turning into that garden
from the "New Road"[18] was striking. Quiet, indeed, was one of the
chief boons which the Sanatorium could offer.

Charles Dickens, one of its earliest supporters, speaks forcibly of this
contrast in a speech made in behalf of the Institution. He speaks of the
noise of crowded streets and busy thoroughfares as--

"That never-ceasing restlessness, that incessant tread of feet wearing
the rough stones smooth and glossy." "Is it not a wonder," he says,--"is
it not a wonder, how the dwellers in narrow ways can bear it? Think of a
sick man in such a place as St Martins Court, listening to the
footsteps, and in the midst of pain and weariness obliged, despite
himself (as though it were a task he must perform), to detect the
child's step from the man's; the slipshod beggar from the hooded
exquisite; the lounging from the busy. Think of the hum and noise always
present to his senses, and of the stream of life that will not stop,
pouring on, on, on, through all his restless dreams, as if he were
condemned to lie dead, but conscious, in a noisy churchyard, and had no
hope of rest for centuries to come."

After some time it was found that a building specially constructed,
which should contain many small separate rooms, would be more suitable
and less expensive than Devonshire House. To erect this it was necessary
to raise a building fund. By this time the Institution was supported by
a powerful list of patrons, with Prince Albert at their head; many large
banking-houses and City firms had subscribed to it for the sake of their
clerks and others; and more than a hundred members of the medical
profession had visited it, and had signed a statement expressing their
belief in the need of such an establishment, adding that the Sanatorium
had supplied this need most satisfactorily, though on a small scale.

Charles Dickens then lived nearly opposite to Devonshire House, and when
the building fund was opened, he and several other literary men and
artists came forward and gave for its benefit the first of those amateur
performances which they repeated at a later period. They acted Ben
Jonson's "Every Man in his Humour," at St James's Theatre, on November
15, 1845, both audience and actors being brilliant. Charles Dickens,
Douglas Jerrold, John Foster, Mark Lemon, Frank Stone, and others took
part. I remember seeing them, as I peeped down from a side-box.

The Sanatorium did not, from a money point of view, succeed; but it was,
nevertheless, the forerunner of all those "Home Hospitals" and "Nursing
Homes" which have since proved so great a boon to the public. So that in
this, also, my grandfather was a pioneer.

As the name of Dickens has been mentioned, it may be interesting to
refer here to some of the letters which show the early and keen interest
he felt in the removal of the evils with which my grandfather was
contending, and his readiness to give his aid to the cause of the poor.
Here is the first letter, alluding both to the Sanatorium and to the
Children's Employment Commission:--

[Illustration: Letter from Charles Dickens] [Illustration: Letter from
Charles Dickens] [Illustration: Letter from Charles Dickens]

    1 DEVONSHIRE TERRACE, YORK GATE,

    _Fifteenth December 1840_.

    MY DEAR SIR,--I am greatly obliged to you for your kind note and
    inclosure of to-day. I had never seen the Sanatorium pamphlet, and
    have been greatly pleased with it. The reasons for such an
    Institution, and the advantages likely to result from it, could not
    have been more forcibly or eloquently put. I have read it twice with
    extreme satisfaction.

    You have given me hardly less pleasure by sending me the
    Instructions of the Children's Employment Commission, which seem to
    me to have been devised in a most worthy spirit, and to comprehend
    every point on which humanity and forethought could have desired to
    lay stress. The little book reaches me very opportunely; for Lord
    Ashley sent me his speech on moving the Commission only the day
    before yesterday; and I could not forbear, in writing to him in
    acknowledgment of its receipt, cursing the present system and its
    fatal effects in keeping down thousands upon thousands of God's
    images, with all my heart and soul.

    It must be a great comfort and happiness to you to be instrumental
    in bringing about so much good. I am proud to be remembered by one
    who is pursuing such ends, and heartily hope that we shall know each
    other better.--My dear Sir, faithfully yours,

    CHARLES DICKENS.

    Dr SOUTHWOOD SMITH.

Another characteristic and genial letter, dated half a-year later,
appears to refer to some proposed expedition, in the course of which
Dickens was to see on the spot some place where children were at work in
a coal-mine:--

    DEVONSHIRE TERRACE,
    _Wednesday, June the Second, 1841_.

    MY DEAR DR SMITH,--I find it can't be done. The artists, engravers,
    printers, and every one engaged have so depended on my promises, and
    so fashioned their engagements by them, that I cannot with any
    regard to their comfort or convenience leave town before the
    nineteenth. At any other time I would have gone with you to
    John-o'-Groat's for such a purpose; and I don't thank you the less
    heartily for not being able to go now.

    If you should see one place which you would like me to behold of all
    others, and should find that I could get easy access to it, tell me
    when you come back, and I'll see it on my way to Scotland, please
    God.

    I will send your papers home by hand tomorrow.--In haste, believe me
    with true regards, faithfully yours,

    CHARLES DICKENS.

    Dr SOUTHWOOD SMITH.

The following year, Dickens, being about to proceed to Cornwall, wrote
to my grandfather asking his advice as follows:--

    DEVONSHIRE TERRACE,

    _Saturday, October Twenty-second, 1842_.

    MY DEAR SIR,--I have an expedition afoot in which I think you can
    assist me.

    I want to see the very dreariest and most desolate portion of the
    sea-coast of Cornwall; and start next Thursday, with a couple of
    friends, for St Michael's Mount. Can you tell me of your own
    knowledge, or through the information of any of the Mining
    Sub-Commissioners, what is the next best bleak and barren part? And
    can you, furthermore, while I am in those regions, help me down a
    mine?

    I ought to make many apologies for troubling you, but somehow or
    other I don't--which is your fault and not mine.--Always believe me
    faithfully your friend,

    CHARLES DICKENS.

    Dr SOUTHWOOD SMITH.

My grandfather's feeling about the Cornish coast is given in his
answer:--

    36 NEW BROAD STREET, _October 25, 1842_.

    MY DEAR SIR,--I do not think you will find St Michael's Mount
    particularly desolate, but it is nevertheless a very remarkable and
    interesting place. The coast about Land's End, I am told, is
    incomparably more dreary and presents a fine specimen of wrecken
    scenery. But the place above all others for dreariness is Tintagel
    (King Arthur's) Castle, near Camelford. There shall you see nothing
    but bleak-looking rocks and an everlastingly boisterous sea, both in
    much the same state as when good King Arthur reigned.[19] You must
    go through Truro to get to either place. Your best plan will be to
    call on Dr Charles Barham. He is the physician of those parts and a
    most intelligent man, thoroughly acquainted with every nook in
    Cornwall and known to every mine. He was one of our best
    Sub-Commissioners; and he will tell you where best to go for your
    immediate object, and will take you with the least loss of time to
    the best specimen of a mine. But pray do not forget that a Cornish
    mine is quite different from a coal-mine: while much less
    disagreeable to the senses, far more fatal in its effects upon the
    men and boys (they have no women).

    I send you herewith a letter of introduction to Dr Barham, whom you
    will find both able and willing to give you all the information and
    assistance you may require.--Faithfully yours,

    SOUTHWOOD SMITH.

The following merry letter from Dickens, on his return, winds up the
little correspondence:--

    1 DEVONSHIRE TERRACE,

    YORK GATE, _Eighth November 1842_.

    MY DEAR SIR,--I have just come home from Cornwall. I did not, after
    all, deliver your letter. Having Stanfield and Maclise and another
    friend with me, I determined not to do so, unless I found it
    absolutely necessary; lest the unfortunate Doctor should consider
    himself in a state of siege.

    I saw all I wanted to see, and a noble coast it is. I have sent your
    letter to Dr Barham with a line or two from myself; and am as much
    obliged to you as though I had driven him wild with trouble.--Always
    faithfully yours,

    CHARLES DICKENS.

    Dr SOUTHWOOD SMITH.

Before leaving this subject, I will give two more of Charles Dickens's
letters, which show that the interest he had manifested in the first
beginning of the inquiry into the state of the children in coal-pits did
not wane, but that, when the Report came before him in 1843, he was
deeply moved, and prepared himself at once to take up arms in defence of
the children. The first letter runs thus:--

    DEVONSHIRE TERRACE, _Sixth March 1843_.

    MY DEAR DR SMITH,--I sent a message across the way to-day, urging
    you, in case you should come to the Sanatorium, to call on me if
    convenient. My reason was this:

    I am so perfectly stricken down by the blue-book you have sent me,
    that I think (as soon as I shall have done my month's work) of
    writing and bringing out a very cheap pamphlet called "An Appeal to
    the People of England on behalf of the Poor Man's Child," with my
    name attached, of course.

    I should be very glad to take counsel with you in the matter, and to
    receive any suggestions from you in reference to it. Suppose I were
    to call on you one evening in the course of ten days or so? What
    would be the most likely hour to find you at home?--In haste, always
    faithfully your friend,

    CHARLES DICKENS.

    Dr SOUTHWOOD SMITH.

The next promises a "sledge-hammer" in lieu of the pamphlet.

    DEVONSHIRE TERRACE, _Tenth March 1843_.

    MY DEAR DR SMITH,--Don't be frightened when I tell you that, since I
    wrote to you last, reasons have presented themselves for deferring
    the production of that pamphlet until the end of the year. I am not
    at liberty to explain them further just now; but _rest assured_ that
    when you know them, and see what I do, and where and how, you will
    certainly feel that a sledge-hammer has come down with twenty times
    the force--twenty thousand times the force I could exert by
    following out my first idea. Even so recently as when I wrote to you
    the other day I had not contemplated the means I shall now, please
    God, use. But they have been suggested to me; and I have girded
    myself for their seizure--as you shall see in due time.

    If you will allow our _tête-à-tête_ and projected conversation on
    the subject still to come off, I will write to you as soon as I see
    my way to the end of my month's work.--Always faithfully yours,

    CHARLES DICKENS.

    Dr SOUTHWOOD SMITH.

I now turn to another subject. It was during these years that my
grandfather conceived the idea that houses might be built from which
fever could be banished even amongst the classes and in the districts in
which up to that time disease had most fatally prevailed. If the
experiment succeeded, and the amount of sickness and death were found to
be markedly diminished, he felt that a very valuable practical
illustration would be afforded of the truth of the principles he was
advocating--of the law which connects bad sanitary conditions with
disease. He also hoped it would be proved that money expended on the
building of such dwellings would bring in a fair return of interest, so
that it would be seen to be a wise as well as a benevolent expenditure
of capital, and healthy dwellings might be multiplied.

To accomplish this purpose he gathered together the men who formed the
original directors of "The Metropolitan Association for Improving the
Dwellings of the Industrious Classes" in 1843.

As this was before the days of "limited liability," it was necessary to
obtain through the Prime Minister a Royal Charter to secure those who
should furnish money for the experiment against serious loss if it
failed, and a deputation (who chose my grandfather as spokesman) waited
on Sir Robert Peel on January 23, 1844, to ask him for this charter,
which was eventually cordially granted.

The course the promoters took resulted in the building of the block of,
so-called, "Model Dwellings" in Old St Pancras Road, on a site nearly
opposite the Fever Hospital.

Thus a first step was taken towards providing healthy and cheap homes
for the poor, and the results realised the fullest hopes of the
originators.

                  *       *       *       *       *

In 1844 we removed from Kentish Town to our Highgate home. It was very
beautifully situated, the slopes of the West Hill lying at the back, and
the front looking over Caen Wood. When we went there, not even the
present open park paling divided us from the park: there were only a few
moss-grown and picturesque hurdles bordering the road between us and it,
and our lane was as quiet as if it had been far in the real country. The
life was, indeed, like that of the country, and full of pleasure to a
child. We had cows; and my longed-for and much-enjoyed pony in the
field; and chickens, and dogs, and a goat, and pigs; a perfect orchard
of wonderful apple-trees, and a wealth of roses that I have never seen
equalled. In the summer came hay-making of our own, and all this so near
London that half an hour's drive of our fast horse Ariel took us to its
centre. It was indeed inwardly and outwardly a beautiful home, and it is
_the_ one of my childhood which is fullest of recollections of my
grandfather.

During all my early years he had, as it were, _two_ works going on--the
profession which occupied his days, and the work for the various
reforms, which occupied the early mornings and the quiet Sundays alluded
to in the Introduction. But now, as the "ten years' struggle" advanced,
the necessity of attending committees and of having interviews with
public men, whom he was interesting and bringing together, made itself
felt; and thus not only were the early mornings, as hitherto, given up,
but, as the public health cause advanced, many hours were given out of
his professional time, and he compressed that given to his practice as
much as possible. He worked enthusiastically, and with unfailing energy,
beginning to write at four or five (sometimes even at three) o'clock in
the morning, and only returning home to dinner about eight o'clock in
the evening.

Our "Hillside" was a peaceful and lovely spot for him to come to after
the day's work in London, and he made the most of the hours spent at
home. It was his wish, and our habit, during all possible weather to
breakfast out in the summer-house, which stood at the top of that piece
of Lord Mansfield's park which was our field, so that he might carry the
memory of its pretty view, and the feeling of its fresh morning air,
into town with him. We dined in the garden in a tent under trees and
surrounded by flower-beds, and had dessert in the field, where the view
of the wooded slopes in the light of the setting sun gave much delight,
not only to ourselves, but to many of the distinguished friends who
frequently joined us on those happy evenings. These hours were indeed
happy ones, whether in summer, spent in the field out in the starlight,
or in winter, round his hospitable fire; for he liked to have, and
helped to make, happiness around him.

Sometimes he used to let me tell him the story of my day--the wonderful
doings of pony, dog, or newly-hatched little yellow chickens. And then
he would tell us of his own work. Each time that some onward step of
importance had been taken he told us about it, but when things were
uncertain, or depressing, he seldom mentioned them. So that an advance
for the cause came generally with the pleasure of a sudden surprise, but
a defeat we only surmised by seeing him unusually grave. He was
naturally extremely reserved; but as he advanced in years his desire for
sympathy overcame this reticence in some degree, so that he became ready
to share his thoughts on all deep subjects with others. He rarely spoke
of things merely personal, and there was an absence of all littleness in
his conversation which was striking. A mixture of high thought with
simplicity of expression was characteristic of him. I listened to all
that passed, and with a strange, vague, but gradually-increasing
understanding, I learned to watch for the success of his different
efforts.

The days were over when the height of the carriage-windows had been an
obstacle to my view out into the streets of Whitechapel in our daily
drives, but I was still a child at the time of the first public meeting
of the "Health of Towns Association." To this day the look of everything
at that meeting is distinctly impressed upon me: the platform; the empty
chairs upon it; the table and bottle of water; the crowd round us, which
were all new to me, are remembered as vivid first impressions are. And
when, after waiting some time, a number of men came in--many of them of
great importance--and I saw my grandfather amongst them, how proud and
glad I felt that his efforts to interest others had been successful, and
that he now had all this strength on his side.

I did not understand all that passed, but I knew when the speakers
praised him; and when his speech came, towards the end of the meeting, I
felt the thrill of his voice, and liked all those other people to hear
it too--I liked them to feel _what_ he was.

But stronger even than the pride in him was the belief that people must
be moved by the truth that was being brought forward; for, even more
than himself, I loved his cause. He lost himself in it, and I caught
from him the desire, above all else, for the progress of the thing
itself.

It is pleasant to me now to see the words, only partly understood then,
in which the public men with whom he worked expressed the feeling with
which he inspired them. "Benevolent," "earnest," "indefatigable,"--this
is what they call him when mentioning his name. Again and again he was
thanked in the House of Commons and House of Lords for what he had done.

"The country was indebted to Dr Southwood Smith and Mr Slaney," says Sir
Robert Harry Inglis, M.P., "for its first knowledge of the real
condition of the poorer classes. Their unwearied labours for the
instruction of the Legislature and the public on these subjects were
unrewarded by emolument or fame; though the value of their services was
beginning to be appreciated, and they would be more highly estimated by
posterity than in their own day."

And Mr Slaney himself says that "for the powerful manner in which he had
first described the actual condition of the poor in their present
dwellings; for the clearness with which he had shown that their most
grievous sufferings were adventitious and removable; and for the
untiring zeal with which he had continued to press these truths on the
attention of the Legislature and the public, Dr Southwood Smith deserved
the gratitude of his country."

In bringing in the first sanitary measure in 1841, Lord Normanby speaks
of what Dr Southwood Smith had "taught" him; and in 1847 the same tone
is still used.

In bringing in the Health of Towns Bill in 1848, Lord Morpeth, then Home
Secretary, gracefully disclaims his own share in the work, and alludes
to my grandfather, amongst others, when saying,--

"Several persons of very great accomplishment, and, what is more to the
purpose, of most ardent benevolence, both in and out of this House, have
taken great pains, in a way which does them infinite credit, to inform
and excite the public mind on this subject; and now, mainly by the
accident of my position, I find myself at the last hour (as I trust it
may prove to be) entering upon the fruit of their labours and gleaning
from their stores."

All they could say of his devotion to the cause of the people and the
saving of life was true. Silently, almost unconsciously, and as the most
natural thing he could do, he pursued his point. As far as unceasing
labour could enable him, he carried on both his professional and his
public work; but when it became a question between private fortune and
public good he never hesitated--he steadily and persistently chose the
latter.

Footnote 18:

  Now Marylebone Road.

Footnote 19:

  It is somewhat curious to note that a similar enthusiasm for Tintagel
  animated the mind of his granddaughter, Octavia Hill: she became
  instrumental, through the National Trust, in preserving its wonderful
  cliff intact for the nation for ever. It was bought in 1896.




                              CHAPTER VII.
        THE TEN YEARS' STRUGGLE FOR SANITARY REFORM, 1838-1848.


It is not easy to convince a whole nation of the truth of new
principles, however closely they may in reality affect its welfare; not
easy to produce a degree of conviction that shall lead to practical,
tangible results. The early workers in the public movements, such as
that for Sanitary Reform, have first to spread such a knowledge of
existing evils as shall create a general feeling of the need for
improvement. They have to educate the public until it believes in that
need. And when the _vis inertia_ of ignorance and indifference is
overcome, they have to encounter the active opposition of those whose
interests are bound up with the old abuses, and whose property would be
affected were the evil swept away. Even when it is decided that
something must be done they have to bear a long time of waiting until it
is settled what that something is to be, for decision is not easy when
questions arise which closely affect the property of a powerful class.

From these causes arose the long delay which occurred before any
mitigation of the suffering took place, and hence it was that the great
feature of the period was a succession of "Inquiries" and of bills
brought before Parliament and defeated.

The first step in the House of Commons was made in 1840, the year
following that which has just been spoken of as the one from which dates
the public beginning of the Sanitary movement, when Mr Slaney, M.P. (one
of the most earnest and energetic of the early labourers in the cause)
obtained a Committee of the House to "inquire into the sanitary state of
large towns in England." Mr Slaney wished not only to extend the
investigation, but to bring the striking results already obtained
directly before Parliament.

My grandfather was the first witness examined by the Committee, and
nearly the whole of his evidence was transferred to its minutes. Some of
his words were--

"_These miseries will continue till the Government will pass measures
which shall remove the sources of poison and disease from these places.
All this suffering might be averted. These poor people are victims that
are sacrificed. The effect is the same as if twenty or thirty thousand
of them were annually taken out of their wretched homes and put to
death; the only difference being that they are left in them to die._"

And how long was it before any measure to stop this could be carried
through Parliament? Dating from the time when he first examined Bethnal
Green and Whitechapel, _ten years_. Not long, perhaps, in reality,
considering the difficulties in the way, but very long to one who not
only believed, but most deeply felt and realised, the truth of such
words as those quoted above.

The history of events was this. In 1841 Lord Normanby brought in a
"Drainage of Buildings Bill." It was by no means a perfect one. My
grandfather wrote of it many years afterwards in the following words:--

"Subsequent discussion and inquiry greatly improved both the principles
and the details of sanitary legislation as compared with the proposals
in this bill. Still, honour to the House of Lords who carried it with a
cordial and noble spirit through their own House and sent it down to the
Commons!"

The session, however, came to an end before any discussion could there
be held on it.

Next year, 1842, was presented Mr Edwin Chadwick's Report on the
Sanitary Condition of the Labouring Population of Great Britain. He was
Secretary to the Poor Law Board, and this Report was, in fact, a Return
to the Bishop of London's motion of 1839. It confirmed and extended the
results of previous inquiries, and greatly helped to prepare the way for
legislation.

In 1843 Lord Normanby made a second attempt. It was again defeated. The
Administration of which he was a member was broken up before much
progress had been made with the new and improved bill which he had
introduced.

Now came another Inquiry. Sir Robert Peel's Government, soon after
coming into office, appointed a Royal Commission,[20] of which the Duke
of Buccleuch was chairman, "to inquire into the state of large towns and
populous districts." My grandfather was again the first witness
examined. Their report was presented in June 1844; but during this
session no bill bearing on sanitary subjects was even introduced.

My grandfather, however, who was brought daily face to face with the
preventible suffering, was not likely to forget it, nor to relax his
efforts. With the calm, persistent earnestness which was characteristic
of him, he worked on and on. The more defeats, the more necessity for
strenuous exertion.

Seeing the difficulty of obtaining any practical result from all the
labour that had been devoted to the improvement of the health of the
people, he now determined to try to bring together the distinguished men
who had taken an interest in the cause, and who had exerted themselves
to promote it. He hoped that, thus united, they would have more power in
spreading the information which had been acquired, and in forcing it on
the attention of the public and the Legislature; and he also thought
that a body of men acquainted with the subject would be useful in
suggesting and discussing remedies, and in proposing legislative
measures.

He succeeded in this effort. He founded the "Health of Towns
Association" already referred to, which, numbering amongst its members
Lord Normanby, Lord Ashley, Lord Morpeth, Lord Robert Grosvenor, Lord
Ebrington, Mr Slaney, M.P., and many other influential men both in and
out of Parliament, proved a highly useful instrument in carrying forward
the work of Sanitary Reform up to the time of the passing of the Public
Health Act.

[Illustration: Meeting of Health of Towns Association.]

Its first meeting was held in December 1844, and the facts which the
various speakers eloquently brought out are chiefly summed up in the
petition which, in accordance with one of the resolutions then passed,
was presented to Parliament.

Those to whom sanitary truths are familiar will have little interest in
this repetition of what they already know, except as showing what the
early sanitary work was before a public opinion had been formed. But it
is somewhat curious to look back upon a time when it was necessary to
state what now appear self-evident truths. My grandfather gives it as
the opinion of the meeting, that--

"From the neglect of sewerage, drainage, a due supply of water, air, and
light to the interior of houses, and an efficient system of house and
street cleansing, a poisonous atmosphere is engendered, particularly in
the districts occupied by the poor, which endangers the health and life
of the whole community, but which is particularly injurious to the
industrious classes.

"That it appears from indubitable evidence that the amount of deaths
attributable to these causes is, in England alone, upwards of 40,000
annually.[21]

"That the great majority of the persons who thus prematurely perish are
between the ages of twenty and forty, the period when they ought to be
most capable of labour and are heads of families; and that it appears
from official returns that in some districts nearly one-third of the
poor-rates are expended in the maintenance of destitute widows and
orphans rendered destitute by the premature death of adult males: that
the number of widows receiving out-relief was, in the year 1844, 86,000;
that these widows had dependent upon them 111,000 orphan children; and
that there were, besides, receiving relief in the Union houses, 18,000
orphan children.

"That the expense thus constantly incurred for the maintenance of the
destitute would in many cases defray the cost of putting the district
into a good sanitary condition, and thus prevent the recurrence of these
dreadful evils.

"That this poisonous atmosphere, even when not sufficient to destroy
life, undermines the strength, deteriorates the constitution, and
renders the labourer in a great degree unable to work; and that there is
every reason to believe that his healthy life and working ability is
abridged in many districts to the extent of twelve years. And lastly--

"That the moral and religious improvement of the industrious classes is
incompatible with such a degree of physical degradation as is actually
prevalent in numerous instances; and that until the dwellings of the
poor are rendered capable of affording the comforts of a home, the
earnest and best directed efforts of the schoolmaster and clergyman must
in a great degree be in vain."

In 1845 the Government Commission issued their second Report. Another
bill, founded on this and their former Report, was brought forward; but
it was so late in the year that it could not be passed that session.

Lord Lincoln, who brought it in, avowed that his principal motive was
that it might be considered during the recess. "The Health of Towns
Association" was here very useful in publishing a report (addressed in
the first instance to its own members) criticising the provisions of
this bill. My grandfather wrote this report, assisted by the notes and
suggestions of various members, and by Mr Chadwick, who, though not
connected with the Association, helped greatly on this and other
occasions.

Lord Lincoln's bill was not again introduced, and the only sign of
progress in these matters during 1846 was to be found in the criticisms
offered on that abortive measure.

It was at this juncture that it was thought well to strengthen the hands
of the Government by bringing the force of Petition to bear upon the
Legislature. It thus became important to arouse the attention of the
working classes to the subject.

My grandfather, as one move in this direction, wrote the following
address, which I give in full. It was written from his heart, and, with
all its calm, philosophical mode of expression, burns underneath with
the white heat of that earnestness which made this sanitary cause--this
saving of life and of suffering--with him almost a crusade.

    AN ADDRESS TO THE WORKING CLASSES OF THE UNITED KINGDOM ON THEIR
    DUTY IN THE PRESENT STATE OF THE SANITARY QUESTION.

    MY FELLOW-COUNTRYMEN,

    The artificial distinctions by which the people of a country are
    divided into different classes have no relation to the capacities
    and endowments of our common nature. No class is higher or better
    than another in the sense of having more or different sentient,
    intellectual, moral, and religious faculties. Every property by
    which the human being is distinguished from the other creatures of
    the earth is possessed alike by rich and poor. Wealth can give to
    the rich man no additional powers of this kind, nor can poverty
    deprive the poor man of one of them. Before these glorious gifts
    with which our common nature is endowed, with which all human beings
    without distinction are enriched, and which can be neither added to
    nor taken away, the little distinctions of man's creation sink into
    absolute insignificance.

    It is the universal possession of these noble faculties by the human
    race that makes the gift of human life alike a boon to all. It is
    the exercise of these noble faculties on objects appropriate to
    them, and worthy of them, that _makes_ life a boon. It is because
    these faculties, when duly exercised and properly directed,
    strengthen and enlarge with time, that the value of life increases
    with its duration. In the mere possession of the full number of the
    years that make up the natural term of life there is a larger and
    higher boon than is apparent at first view. What the natural term of
    human life may be is indeed altogether unknown; because, although
    one of the characteristics by which man is distinguished from other
    animals is, that he is capable of understanding the conditions of
    his existence, and of exerting, within a certain limit, a control
    over them, so as to be able materially to shorten or to prolong the
    actual duration of his life,--yet these conditions have hitherto
    been so little regarded that there is not a single example on record
    of a community in which the conditions favourable to life have been
    present and constant, and in which the conditions unfavourable to it
    have been excluded, in as complete a degree as is obviously
    practicable. History is full of instances in which the successive
    generations of a people have been swept away with extraordinary
    rapidity; but on no page is there to be found the notice of a single
    nation, in ancient or modern times, the great mass of the population
    of which has attained a higher longevity; yet it is certain that a
    degree of longevity never yet witnessed has always been attainable,
    because such longevity depends on conditions which are now
    known--conditions entirely within human control.

    I have said that there is involved in the mere length of life a
    larger and higher boon than is apparent without reflection. First,
    because length of life is in general a tolerably accurate measure of
    the amount of health, without a good share of which life is
    comparatively worthless. The instances are rare in which a person
    attains to old age who has not enjoyed at least a moderate share of
    daily health and vigour.

    Secondly, because length of life is a perfectly accurate measure of
    the amount of enjoyment. Long life is incompatible with a condition
    of constant privation and wretchedness. It is one of the
    beneficences of the constitution of our nature that when the balance
    of happiness is against us, a limit is fixed to our misery by its
    rapid termination in the insensibility of death. In the very brevity
    of its existence, therefore, a human being indicates his own history
    for evil; the shortness of his life is the sure and correct index of
    the amount of his suffering, physical and mental: it is the result,
    the sum-total, the aggregate expression, of the ills endured.

    Thirdly, because length of life is the protraction of that portion
    of life, and only of that portion of it, in which the human being is
    capable of the greatest degree of usefulness. I have elsewhere shown
    that every year by which the term of human life is extended is
    really added to the period of mature age; the period when the organs
    of the body have attained their full growth and put forth their full
    strength; when the physical organisation has acquired its utmost
    perfection; when the senses, the feelings, the emotions, the
    passions, the affections are in the highest degree acute, intense,
    and varied; when the intellectual faculties, completely unfolded and
    developed, carry on their operations with the greatest vigour,
    soundness, and continuity: in a word, when the individual is capable
    of communicating, as well as of receiving, the largest amount of the
    highest kind of happiness.

    These considerations give peculiar interest to the results of the
    inquiries recently made into the actual duration of life at the
    present time in our cities, towns, and villages. From these
    inquiries it appears not only that the rate of mortality in the
    whole of England at the present day is deplorably high, but that
    there is an extraordinary excess of mortality over and above what is
    natural, supposing the term at present attainable to be the natural
    term of human life. The statement of this excess presents to the
    mind an appalling picture. From accurate calculations, based on the
    observation of carefully recorded facts, it is rendered certain that
    the annual slaughter in England alone by causes that are
    preventible, by causes that produce only one disease--namely, typhus
    fever--is more than double the loss sustained by the allied armies
    in the battle of Waterloo; that 136 persons perish every day in
    England alone whose lives might be saved; that in one single
    city--namely, Manchester--thirteen thousand three hundred and
    sixty-two children have perished in seven years over and above the
    mortality natural to mankind.

    It appears, moreover, that the field in which this annual slaughter
    takes place is always and everywhere the locality in which you
    reside, and that it is you and your wives and children who are the
    victims. In some instances in the streets, courts, and alleys in
    which you live, the mortality which afflicts you is nearly double,
    and in others it is quite double, that of the inhabitants of other
    streets in the same district, and in adjoining districts. While the
    average age at death of the gentry and of professional persons and
    their families is forty-four, the average age at death attained by
    you and your families in many instances is only twenty-two, just
    one-half,--that is to say, comparing your condition with that of the
    professional persons, you and your families are deprived of one-half
    of your natural term of life.

    Though the causes by which you and your children are thus immolated
    are well known; though they have been constantly proclaimed to the
    public and the Government for nearly ten years past; though their
    truth is universally admitted; and though it is further admitted
    that the causes in question are removable,--yet not only has nothing
    whatever been done to remove them, but their operation during this
    very year has been far more fatal than at any period since we have
    had the means of making accurate observations on the subject. Thus
    we are informed by the Registrar-General, that in the summer quarter
    of the present year Ten Thousand Lives have been destroyed, in a
    part only of England, by causes which there is every reason to
    believe may be removed; that in the succeeding quarter--namely, the
    quarter ending the 30th of September--the number of deaths exceeded
    the number in the corresponding quarter of last year by Fifteen
    Thousand Two Hundred and Twenty-seven; that is to say, in the very
    last quarter upwards of 15,000 persons perished, in a part only of
    England, beyond the mortality of the corresponding quarter of last
    year.

    From this same report it appears, further, that in many of our large
    towns and populous districts--that is, in the places in which you in
    great numbers carry on your daily toil--the mortality has nearly
    doubled; in some it has quite doubled, and in others it has actually
    more than doubled; that this is the case among other places in
    Sheffield and Birmingham; that in Sheffield, for example, the number
    of deaths in the last quarter are double those in the corresponding
    quarter of last year and 149 over; while in Birmingham they are
    double and 239 over.

    "The causes of this high mortality," says the Registrar-General,
    "have been traced to crowded lodgings, dirty dwellings, personal
    uncleanliness, and the concentration of unhealthy emanations from
    narrow streets without fresh air, water, or sewerage."

    We are further told by the Registrar-General that "the returns of
    the past quarter prove that nothing effectual has been done to put a
    stop to the disease, suffering, and death in which so many thousands
    perish; that the improvements, chiefly of a showy, superficial,
    outside character, have not reached the homes and habits of the
    people; and that the consequence is that thousands, not only of the
    children, but of the men and women themselves, perish of the
    diseases formerly so fatal, for the same reason, in barracks, camps,
    gaols, and ships."

    For every one of the lives of these 15,000 persons who have thus
    perished during the last quarter, and who might have been saved by
    human agency, those are responsible whose proper office it is to
    interfere and endeavour to stay the calamity--who have the power to
    save, but who will not use it. But their apathy is an additional
    reason why you should rouse yourselves, and show that you will
    submit to this dreadful state of things no longer. Let a voice come
    from your streets, lanes, alleys, courts, workshops, and houses that
    shall startle the ear of the public and command the attention of the
    Legislature. The time is auspicious for the effort; it is a case in
    which it is right that you should take a part, in which you are
    bound to take a part, in which your own interests and the wellbeing
    of those most dear to you require you to take a part. The Government
    is disposed to espouse your cause; but narrow, selfish,
    short-sighted interests will be banded against you. Petition both
    Houses of Parliament. Call upon the instructed and benevolent men in
    the legislative body to sustain your just claim to protection and
    assistance. Petition Parliament to give you sewers; petition
    Parliament to secure to you constant and abundant supplies of
    water--supplies adequate to the unintermitting and effectual
    cleansing both of your sewers and streets; petition Parliament to
    remove--for it is in the power of Parliament universally and
    completely to remove--the sources of poison that surround your
    dwellings, and that carry disease, suffering, and death into your
    homes. Tell them of the parish of St Margaret, in Leicester, with a
    population of 22,000 persons, almost all of whom are artisans, and
    where the average age of death in the whole parish was during the
    year 1846 only eighteen years; tell them that on taking the ages of
    death in the different _streets_ in this parish, it was found that
    in those streets that were drained (and there was not a single
    street in the place properly drained) the average age of death was
    twenty-three and a-half years; that in the streets that were
    partially drained it was seventeen and a-half years; while in the
    streets that were entirely undrained it was only thirteen and a-half
    years.

    You cannot disclose to them the suffering you have endured on your
    beds of sickness, and by which your wives and children have been
    hurried to their early graves--there is no column in the tables of
    the Registrar-General which can show that; but you can tell them
    that you know, and you can remind them that they admit, that by
    proper sanitary regulations the same duration of life may be
    extended to you and your families that is at present enjoyed by
    professional persons, and that it is possible to obtain for the
    whole of a town population at least such an average duration of life
    as is already experienced in some parts of it. In your workshops, in
    your clubs, in your institutes, obtain signatures to your petitions:
    get every labourer, every artisan, every tradesman whom you can
    influence, to sign petitions. Other things must also be done before
    your condition can be rendered prosperous; but this must precede
    every real improvement: the sources of the poison that infects the
    atmosphere you breathe must be dried up before you can be healthy,
    and uncleanliness must be removed from the exterior of your
    dwellings before you can find or make a Home.--I am your friend and
    servant,

    SOUTHWOOD SMITH.

    _1st January 1847._

In this same year 1847 a Royal Commission--"Metropolitan Sanitary
Commission" (of which my grandfather was a member)--was appointed to
inquire "whether any, and what, sanitary measures were required for
London."

To the country at large, however, it seemed as if perhaps there had been
enough "inquiring." The thing _had_ been considered. Surely something
might be _done_; and Lord Morpeth now brought forward a Government
measure for "improving the health of towns in England."

In bringing in the bill, Lord Morpeth first gives a history of the
principal stages of the various inquiries and commissions which had been
helped on by all parties, and by successive Governments. He states that
he has nothing new to bring forward, and can but repeat the information
gained by others. He goes on to show by elaborate statistics the waste
of life in large towns.

"Thus the inhabitants of London," he sums up, "compared with England at
large, lose eight years of their lives, of Liverpool nineteen. The
population of the large towns in England being 4,000,000, the annual
loss is between 21,000 and 22,000."[22]

But all places are not equally unhealthy, as further statistics
strikingly show. Where do we find the greatest number of deaths? Is it
where wages are lowest and the people poorest? What did Lord Morpeth
tell the House?

"Let it not be said," he urges, "that the greater rate of mortality in
certain districts is owing to extreme poverty and the want of the
necessaries of life. The condition of the labourers of the west, the
lowness of their wages and the consequent scantiness of their food and
clothing, have been the subject of public animadversion. The mortality
of the south-western district, which includes Cornwall, Devon, Somerset,
Dorset, and Wilts, is only 1 in 52--not 2 per cent; while that of the
north-western, including Cheshire and Lancashire, is 1 in 37. With the
exception of the Cornish miners the condition of labourers throughout
the western counties is nearly the same, yet in Wiltshire, the county of
lowest wages, the deaths are 1 in 49, in Lancashire 1 in 36. The average
age at death in Wiltshire was thirty-five, in Lancashire twenty-two. The
Wiltshire labourer's average age was thirty-five, that of the Liverpool
operative fifteen. At Manchester, in 1836, the average consumption per
head of the population was 105 lb. of butcher's meat--about 2 lb. a-week
(exclusive of bacon, pork, fish, and poultry); the average age at death
was twenty years." He then brings forward evidence of the
preventibleness of most of the premature deaths.

Having proved the extent of the evil, Lord Morpeth proceeded to show how
it was proposed to meet it,--by what machinery of central board,
inspectors, &c; and, lastly, he entered into the money-saving that would
be effected were thorough sanitary measures carried out. He cites Dr
Playfair's estimates, which give the money loss, through unnecessary
sickness and death, at £11,000,000 for England and Wales, and at
£20,000,000 for the United Kingdom. This loss arises from many causes:
the expenses of direct attendance on the sick; the loss of what they
would have earned; the loss caused by the premature death of productive
contributors to the national wealth; and the expenses of premature
funerals.

But the measure which was framed to relieve this sum of misery, though
well and carefully prepared, was again to be thrown out!

It was weary work. The years were passing away, and nothing was being
done. My grandfather used to come home saddened by each new defeat. He
was sad at the delay, but he was not disheartened; he knew that the
thing would be done in time, and that the progress must be slow. He
could wait calmly in that belief and enjoy fully the beauty of the
sunset light during the summer evenings passed in our beautiful field,
overlooking the green slopes and large trees of Caen Wood, Highgate.
There our friends used to come to us, amongst others Professor Owen,
Robert Browning, William and Mary Howitt, and Hans Christian Andersen;
and we spent evenings that I can never forget, staying out constantly
till the moon rose or the stars came out. How he loved nature and all
happy things!

His faith did not err. The work of urging had not been in vain; the
movement could not be stopped; the time was ripe.

The bill had been thrown out in 1847, but in 1848 the first sanitary
law, the Public Health Act, passed!

Footnote 20:

  "The Health of Towns Commission."

Footnote 21:

  The statements as to the saving of life which would be effected if
  proper sanitary measures were carried out were necessarily various,
  since the difference which could be made in the death-rate was a
  matter of opinion, and had yet to be proved by experiment. If, instead
  of one death annually in every 46 inhabitants throughout England and
  Wales (the then proportion), there should be an improvement sufficient
  to secure there being one death in every 50, upwards of 25,000 lives
  would be saved. Whilst, if the sanitary state of towns could be raised
  to that of healthy counties, there would be a saving of 49,000 lives.
  The Association seems to have chosen something between the least
  probable and the highest probable saving of life.--G. L.

Footnote 22:

  Lord Morpeth speaks here of the saving of life in large towns only.




                             CHAPTER VIII.
           OFFICIAL LIFE--GENERAL BOARD OF HEALTH, 1848-1854.


Immediately after the passing of the Public Health Act, Lord Morpeth
wrote to my grandfather that the changes made in the bill during its
passage through Parliament had prevented the creation of any post which
could be offered to him. Lord Morpeth said, however, that if Dr
Southwood Smith would give the department the advantage both of his
presence and counsel by accepting a seat on the Board, he hoped to
provide for him a permanent post, by means of a supplementary Act, "The
Diseases Prevention Act," which the Government expected to pass shortly.
In answer to this my grandfather wrote as follows:--

    38 FINSBURY SQUARE, _Sept. 12, 1848_.

    MY DEAR LORD MORPETH,--I thank you very sincerely for your kind
    communication.... Thanks to your Lordship's indefatigable exertions,
    a position is now gained from which it is possible to attack, with
    some hope of success, the sources of excessive sickness and of
    premature mortality. You have at last laid the foundation of
    Practical Sanitary Improvement; but the structure is still to be
    raised, and if, as your Lordship intimates, both you and the
    Government are desirous that I should assist you in this labour, no
    one will apply himself with a deeper feeling of responsibility, or
    with greater earnestness, to what her Majesty justly calls "this
    beneficent work."

    Your Lordship will remember how earnest I was in December last, on
    the publication of the Bishop of London's Pastoral Letter, that we
    should at once avail ourselves of the power of the Contagious
    Diseases Act; as well to make immediate preparation against the
    threatened visitation of cholera, as to check the progress of our
    own native epidemics, then and still so frightfully prevalent;
    diseases manifestly dependent on conditions within our control, and
    highly favourable to the spread of the pestilence then menacing, and
    now still more nearly menacing us. The Bishop of London had called
    earnestly upon the clergymen of his diocese to co-operate with the
    medical profession in this object; and being desirous of
    ascertaining the state of intelligence and feeling of this natural
    class of co-operators in such a work, I visited privately every
    clergyman in the Eastern District of London and discussed the
    subject with them.

    Without a single exception, I found them impressed with a sense of
    the necessity of doing something, and with a conviction that they
    might materially help the medical profession in carrying out any
    plan of operation proposed by authority. The necessity of some such
    general plan is greater now than it was then, on account of the
    continual prevalence in their severest forms of our own epidemics,
    and of the nearer approach of cholera. The new "Contagious Diseases
    Act," the "Public Health Act," and the new "Metropolitan Sewers
    Act," taken together, afford greater facilities for meeting this
    necessity than ever before existed; and certainly it is now in the
    power of the Government to do more for securing the public health,
    and improving the physical condition of the population, than has
    ever yet been attempted in any age or nation,--a power which, if
    wisely and successfully exerted, will reflect the highest honour on
    the Government and the country.

    My intimate relation with the origin and progress of this work, and
    my deep conviction that it is one of the most useful to which
    experience and science can be applied, would render it a
    satisfaction to me to spend the remainder of my life in assisting to
    complete it.--I am, my Lord, with much esteem and regard, very
    faithfully yours,

    SOUTHWOOD SMITH.

The dates given at the head of this chapter (1848 to 1854) cover the
period when the Sanitary cause was completely successful, and when my
grandfather found himself one of the heads of a Government department
devoted to the furtherance of sanitary measures throughout the
kingdom--a department which was called the General Board of Health.
Here, at offices in Whitehall, in daily conference with Lord Ashley
(afterwards the Earl of Shaftesbury) and Mr Edwin Chadwick, he could
propagate knowledge on questions relating to the public health, and
carry out sanitary measures, as from a powerful centre, having the
authority of a Government department.

This power of carrying out his convictions to practical issues was an
immense satisfaction to my grandfather's mind, and many were the
congratulations which he received on this public appointment. The
following, from a Portsmouth physician, is interesting:--

    _October 8, 1848._

    SIR,--Though personally a stranger, permit me to offer my sincere
    congratulations on your appointment by her Majesty's Government to
    the Board of Health, where the talents you have so long displayed
    will have scope for the full share of utility.

    I have traced and followed you in the various publications issued by
    the Government and the Health of Towns Association for several years
    past, and having myself, though in a much more confined area,
    mingled with public life, I know the heart-burnings, the
    disappointments and annoyances, to which in such a course a man is
    necessarily exposed; but if reward come at last--though the delay
    has almost made the heart sick--one is then amply repaid, especially
    in a case like yours, when a whole kingdom will applaud the
    appointment.

    Permit me again, sir, to beg your acceptance of my
    congratulations.--I am, sir, your obedient servant,

    To Dr SOUTHWOOD SMITH, Whitehall.

Almost the first work which the Board of Health had to do was to take
measures to resist an epidemic of Asiatic cholera. This it did by
sending down inspectors from London to instruct and aid the local
authorities in organising plans for systematic cleansing, and for the
removal of the sick. The Board also issued "Notifications" for the
purpose of instructing the public as to what precautions were necessary
to avert an attack. But above all, it organised, at my grandfather's
instance, what was called the "system of house-to-house visitation." My
grandfather was of opinion that in every instance an attack of cholera
is preceded by a period of a few days (sometimes only of a few hours) of
premonitory symptoms, which, since they are painless, escape notice; and
that, unless a specially appointed medical visitor goes round to the
houses of the less educated to inquire, and almost to cross-question, as
to the existence of these symptoms, and to treat the disease _at once_,
this stage rapidly passes on into developed cholera, when recovery
becomes all but hopeless. These facts and experiences are brought out in
the General Board of Health's Report on the Cholera Epidemic of 1848-49,
presented to Parliament in 1850.

In relation to this, Lord Brougham thus wrote to my grandfather:--

    "I also proclaimed[23] your important statement of the _preventive
    cure_ of cholera, bearing further testimony to the soundness of your
    views from Sir J. Mordaunt's account given to me in the Malta case.

    "I availed myself of the opportunity to give you just praise, and to
    note your many valuable services to the country. Lord Lansdowne
    amply concurred in the statement by his cheers. But such things are
    never reported. Had you given a vote or an opinion on a contested
    party matter, all the papers would have chronicled your merits and
    our eulogies of you.--Ever yours truly,

    "H. BROUGHAM."

Another of the subjects which the Board of Health took up was that of
quarantine. Their first report on that subject, issued in 1850, was
considered of sufficient importance to be translated into various
foreign languages, and was ordered to be presented to the Parliaments of
France and Italy. I think that, even if recent discoveries have modified
some of the opinions there advanced, all the progress which has been
made in the prevention of disease by quarantine regulations has been in
the direction there indicated--that is, in plans for cleanliness, for
the letting in of light and air, and for the isolation of infected
persons in pure air, thus diluting the poison--rather than in plans for
shutting them into confined quarters as was formerly done, thereby
concentrating the poison.

The question of putting a stop to burials in overcrowded churchyards was
also taken up by the Board. Their report on "A General Scheme for
Extra-mural Sepulture" was published also in the same year (1850), and
proved very clearly the evils arising from the crowded state of
churchyards at that time.

The Board proposed that a Government department should be established
which should be intrusted with the care of the whole question of the
burial of the dead; that, in future, interment should take place only in
ground remote from large towns; and that everything should be arranged
decorously and reverently. My grandfather, personally, was much
interested in adding an element of beauty in the form of exquisite and
appropriate cemetery churches and chapels. But only the preventive part
of the scheme was carried out. What was actually achieved was the
closing of the overcrowded churchyards; the provision of other grounds
has been left for private enterprise.

Thus, for six years, earnest men, at the head of a Health Department,
spread information and gave advice. The newspapers of the period
contained many notices of the various practical measures devised by this
department, together with comments and leading articles on its reports
on such large and pressing questions as cholera, quarantine, extra-mural
sepulture, and water-supply. The newspapers, indeed, began to devote
much space to the discussion of health questions in all forms, so that
at last a widespread interest was aroused.

Then came a time when the chief question was, _not_ as to the
principles, but as to what machinery could best be employed to carry out
those principles.

The fear of "centralisation," and the desire for local self-government,
which is strong in the English people, caused opposition in Parliament
to the continuance of any Government department having such large
control over the expenditure of public money on local objects; so that
in 1854 the original Board of Health ceased to exist, but did not cease
till sanitary principles and sanitary science, once unknown or despised,
were acknowledged throughout the country, and recognised as one of the
fundamental needs lying at the root of all efforts to benefit the
community.

With the ending of this department my grandfather's official life came
to a close. From a personal point of view this cessation of his public
work was somewhat softened by the following letter, written at the
desire of the Prime Minister:--

    WHITEHALL, _12th August, 1854_.

    SIR--I am directed by Viscount Palmerston to inform you that he
    cannot allow you to quit the Board which this day ceases to exist by
    the expiration of the Act of Parliament by which it was constituted,
    without conveying to you the full approbation of her Majesty's
    Government of the zealous, able, and indefatigable manner in which
    you have performed the important duties which have belonged to your
    official situation; and his Lordship desires me to express to you
    the great regret which he feels, that an adverse decision of the
    House of Commons as to an arrangement which his Lordship had
    proposed for the reconstruction of the Board of Health has led to so
    abrupt a cessation of your employment.--I am, sir, your obedient
    servant,

    HENRY FITZROY.

    Dr SOUTHWOOD SMITH.

According to the rules of the service, my grandfather was not entitled
to a retiring allowance, because so much of the work he had done had
been unpaid. A few years afterwards, however, a Government pension was
awarded him in consideration of the services which he had rendered to
the country.

Footnote 23:

  In the House of Lords.




                              CHAPTER IX.
  RETIREMENT FROM PUBLIC LIFE--ST GEORGE'S HILL, WEYBRIDGE, 1854-1860.


When his official life came to a close, my grandfather retired to a
house on Weybridge Heath, and he met the sudden cessation of his eager
public life with the same calm courage with which he had met all the
other crises in his career.

This house had been built on a beautiful spot as a gathering-place for
his much-loved and somewhat scattered family, and the beauty of its
position came to be a great comfort to him when he turned his quiet days
to the prosecution of literary work in his little study, which, opening
on to a sunny terraced walk, overlooked, through vistas of dark-green
pines and yellow birch-trees, the miles of blue distance which stretched
out southwards to the Surrey and Hampshire hills. Through the kindness
of Lord Ellesmere, whose property adjoined, there was a small private
gate leading from our own little firwood on to St George's Hill itself;
and, in the intervals of his writing, frequent strolls on to its
beautiful slopes were a great source of pleasure during that first
autumn and in all the ensuing years. The heather banks and wooded dells
brought him much joy; for, as always, it was in the presence of nature
and in the stillness of the country that he gathered strength. The
strain of the last few months had been great, and it was well that the
closing of the year brought with it the much-needed rest.

He now gave a good deal of time to physiological study, turning to his
old subjects with the vigour of a younger man, and entering with the
deepest interest into the discoveries of later science. He did this with
a view of bringing his early book, 'The Philosophy of Health,' which at
the time of its publication had made so much mark, up to the standard of
modern knowledge; and though he did not live to complete this task, the
reading for it gave a living interest to those years of quiet country
life.

He had also much satisfaction in writing and publishing a pamphlet
called 'Results of Sanitary Improvement,' based mainly on the experience
obtained in the "Model Dwellings" for the working classes, of which he
had been the originator. This pamphlet, coming as it did before many
influential men throughout the country, spread the good news of progress
far and wide.

A further instance of the fruit of his labours was afforded him by his
visit to Edinburgh, in November 1855, when he lectured on his own
subject, "Epidemics," at the Philosophical Institution, where a
brilliant reception and distinguished audience awaited him.[24]

I have a vivid recollection of his pleasure in the beauty of Alnwick as
we journeyed north--of its old castle's warm grey walls, its lovely
woods and clear running streams, during a sunny Sunday which we passed
there,--the gold and russet tints of autumn shining out against a
perfectly blue sky; and I also remember the satisfaction he had in
hearing from the Mayor, who took us round the town, of the pure water
and good drainage lately introduced. Alnwick was, I believe, one of the
first places which adopted the sanitary measures advised by the General
Board of Health, so that here he had the gratification of seeing some of
the great reforms practically carried out.

As I am recalling the various sources of comfort which came to my
grandfather during these years at Weybridge, I must mention the great
happiness which arose from the opening out of the lives of two of his
granddaughters, Miranda and Octavia Hill; for it was at this time that
they--at the ages of nineteen and sixteen--took the responsibilities of
their lives upon themselves, and began the great and good works which
they have since carried to such wide issues.

In his retirement, letters of appreciation and sympathy reached him from
many of the public men with whom he had worked, expressing in various
ways that which Lord Shaftesbury, who knew him as well as any, gives as
his own feeling when writing to a mutual friend:--

"I have known Dr Southwood Smith well, having sat with him during four
years and in very trying times at the Board of Health. A more able,
diligent, zealous, and benevolent man does not exist. No work ever
seemed too much for him if it were to do good. His great services will
not, I fear, be appreciated in this generation."

Such words as these cannot but have been gratifying to my grandfather;
but in 1858 those who shared these sentiments resolved to make a clearer
and more public demonstration of their sense of the value of the
services which he had rendered to the country. At a preliminary meeting
held on the 7th May 1856 it was agreed that this recognition should take
the form, primarily, of a memorial bust, to be presented to a suitable
public institution. This intention was communicated to Dr Southwood
Smith at the final meeting held at the house of Lord Shaftesbury, 24
Grosvenor Square, on the 6th of December 1858, and was accompanied by a
short address.

I give his own words of thanks, as they show not only the pleasure this
recognition afforded him, but also--what is so characteristic of
him--his joy in the progress of his cause, quite apart from his personal
share in it:--

    "My Lord, I need not say how deeply I feel the kindness that
    prompted the proceeding which has led to this meeting. If anything
    could increase the intensity of that feeling, it would be the words
    in which you have given expression to your sentiments in this
    matter, and to those of the rest of the subscribers to this
    recognition.

    "The labourers in the work of sanitary reform have been many; and it
    is by the united efforts of some of the most enlightened,
    disinterested, and learned men that shed lustre on this century,
    that this great work has been placed in its present position.

    "That such names as those which grace this Tablet[25] should have
    united to express their sense of the value of any part which I may
    have taken in this work, will ever be to me a source, I do not say
    of happiness only, but of that rare and pure happiness which results
    not alone from the inward consciousness of devotion to duty through
    encouragement and discouragement, through evil and through good
    report, but also from the knowledge that such judges of the matter
    justify that consciousness, and in my own individual case have so
    placed their judgment on record, that it may be present to me to the
    latest day of my life and to my children and my children's children.

    "I will only add that the honourable names on this Record give me
    this further delight, that they are to me a pledge that Sanitary
    Improvement will go on. They thus bear their testimony to their
    sense of its importance, and they, from their position and
    character, can ensure its progress. The first labourers in this work
    may not be permitted to complete it,--they seldom are in any great
    work; but, whoever may have the satisfaction of completing it, that
    work--whatever obstacles may retard, whatever short-sighted and
    short-lived interests may oppose it, however it may seem for a while
    not to advance--_that work will be done_; and the time will come
    when not only the professional man and the educator, but the
    legislator, the statesman, the general, the minister of religion--in
    a word, every one to whom is entrusted the care, the guidance, and
    the control of numbers, will feel ashamed to be ignorant, and indeed
    will be accounted unfit for his office if he be ignorant, of the
    laws of human health and life."

Yes! That his work had lived and would live, this was what he cared for.
This it was that kept him uniformly brave and bright, and made him say
to me one evening in tones of grateful joy--we were sitting on the wide
balcony watching the moon rise over the fir-tree tops, his hand in mine
as of old,--

"I have indeed succeeded! I have lived to see seven millions of the
public money expended on this great cause. If any one had told me, when
I began, that this would be, I should have considered it absolutely
incredible."

Footnote 24:

  Epidemics considered with relation to their Common Nature and to
  Climate and Civilisation. Published by Edmonston & Douglas, Edinburgh,
  1856.

Footnote 25:

  See Appendix II., p. 164.




                               CHAPTER X.
                    THE SUNSET OF LIFE--ITALY, 1861.


My grandfather had travelled abroad but little during his strenuous
life. He had, it is true, been to Paris in 1850, accompanied by Mr
Charles Macaulay, Dr John Sutherland, and Mr (afterwards Sir Henry)
Rawlinson, on business connected with the General Board of Health scheme
for extra-mural sepulture, but, except on that occasion, he had not left
England.

So that when in 1857 he was asked to join a party of three proceeding to
Milan for the purpose of examining the irrigation works of that city, he
gladly undertook the journey, which was to lead them _viâ_ Marseilles
and along the Cornice Road, then traversed by carriage only. The beauty
of Italy thus came before him with full freshness at the age of seventy,
and he returned strengthened and invigorated.

The following year my grandfather lost his wife. She died at The Pines,
at Weybridge, after a short illness, in the summer of 1858.

Two years later he was able to carry out his cherished hope of returning
to Italy, and we went to Florence, where his daughter Emily had been
living for some years. She welcomed us to the rooms she had secured in
an old palace beyond the Arno--to the artistic Italian surroundings of
which she had added something of the atmosphere of an English home.

His delight in the art and nature of Florence and its environs was
intense, and the beauty of land and sky seems to make a fitting setting
for the end of such a life as his.

He stood on the old jeweller's bridge, one autumn evening late in
November, and watched the sun go down behind the western hill of the
rushing Arno; and the sunset of his own life came soon after. Perhaps he
had lingered too long gazing at this beautiful scene; for a chill,
producing rapid bronchitis, took him from us on the 10th December 1861.

Towards the end, when he knew he was passing away, after other gentle
loving words, almost his last were--with a sweet triumphant smile--"Draw
up the blind and let me see the stars; for I still love the beauty."

                  *       *       *       *       *

[Illustration: Porta Pinti.]

At the cemetery at Porta Pinti are some sombre gates with, over them,
the words "Ils se reposent de leurs travaux, et leurs oeuvres les
suivent." Those black gates opened one sunny December morning and showed
a sloping avenue of marble tombs, tangles of pink and of white China
roses in full flower falling over them, and at the end a tall white
cross shining in the sunlight against the blue Italian sky,--fit type of
the black gates of death, which had rolled back to let him pass into the
Eternal Light beyond.

There we left him in completest trust, our "Knight Errant," after his
life's warfare.

                  *       *       *       *       *

For there is a poem by Adelaide Procter (on whom written I know not)
which seems to give, with the full force of poetical presentation, the
spirit of the Life I have tried to depict. It even seems to follow the
very order of the periods of that life--_our_ hero following the course
of _hers_; and thus fulfilling Mrs Browning's words when she says--

    "Ingemisco, ingemisco!
    Is ever a lament begun
    By any mourner under sun
    Which, ere it endeth, suits but one?"

In my extract-book the following lines have lain away for the nearly
forty years which have passed since he went from us, and they still
remain, to me, the best expression of what he was. I find, in pencil,
against the verses the place or date which they symbolise.

If those who have read these pages see their aptness, they will learn
from them, more than from any words of mine, what measure of man he was.

A KNIGHT ERRANT.

    "Though he lived and died amongst us,
      Yet his name may be enrolled
    With the knights whose deeds of daring
      Ancient chronicles have told.

    Still a stripling he encountered
      Poverty, and suffered long,
    Gathering force from every effort
      Till he knew his arm was strong.

    Then his heart and life he offered
      To his radiant mistress--Truth.
    Never thought or dream of faltering
      Marred the promise of his youth.

    So he rode forth to defend her,
      And her peerless worth proclaim;
    Challenging each recreant doubter
      Who aspersed her spotless name.

    First upon his path stood _Ignorance_,
      Hideous in his brutal might;
    Hard the blows and long the battle
       Ere the monster took to flight.

    Then, with light and fearless spirit,
      _Prejudice_ he dared to brave,
    Hunting back the lying craven
      To her black sulphureous cave.

    Followed by his servile minions,
      _Custom_, the old Giant, rose;
    Yet he, too, at last was conquered
      By the good Knight's weighty blows.

    Once again he rose a conqueror,
      And, though wounded in the fight,
    With a dying smile of triumph
      Saw that Truth had gained her right.

    On his failing ear re-echoing
      Came the shouting round her throne;
    Little cared he that no future
      With her name would link his own.

    Spent with many a hard-fought battle
      Slowly ebbed his life away,
    And the crowd that flocked to greet her
      Trampled on him where he lay.

    Gathering all his strength he saw her
      Crowned and reigning in her pride,
    Looked his last upon her beauty,
      Raised his eyes to God--and died."

    --A. A. PROCTER.




                              CHAPTER XI.
                             THE AFTERGLOW.


It was at this time that the Prince Consort died, and England was full
of mourning. Lord Shaftesbury speaks, in his diary of December 16, 1861,
of that national loss, and then alludes to the death of my grandfather
in these words:--

"I hear, too, that my valued friend and coadjutor in efforts for the
sanitary improvement of England is gone--the learned, warm-hearted,
highly-gifted Southwood Smith."

But the work he had set on foot and the principles he had established
did not end with his life. They have gone on with an ever-increasing
vitality to this day.

The efforts he made for the non-employment of women and young children
in mines have resulted in the entire cessation of the practice; while
his work for the provision of proper schooling for factory children has
culminated now in a whole system of workhouse and factory supervision
and in the school-board system throughout the land.

Intramural burial is virtually at an end. And the "Home Hospitals" and
"Nursing Homes," which are established in all our large towns, are the
successors of that "Sanatorium, or Home in Sickness," which he devised,
and for which Charles Dickens pleaded in its early days.

The marshy Bethnal Green and Spitalfields, where he first visited the
individual homes, and which he took Lord Normanby and Lord Ashley to
see, are now comparatively healthy places. He found them without water;
there is now water laid on to every house. He found them without
drainage; now a complete and scientific system of drainage exists
throughout the metropolis. The "£7,000,000 of public money spent on
sanitary reform," over which he rejoiced so greatly, is, since he spoke
in 1857, increased by all the millions spent on such works in the last
forty years.

His first set of "Model Dwellings," in the St Pancras Road, is now
multiplied by the countless blocks of such in all the large towns of
England. Sanitary Law and Sanitary Inspection everywhere prevail, and
the thousands of lives annually saved--the lowered death-rate both in
town and country--attests the power of the laws he was one of the first
to perceive and proclaim.

To show the saving of life in London alone, the death-rate in the early
"forties" was 26 in the thousand, it is now 19; whilst in the Model
Dwellings the improvement is even more striking, since there it is not
more than half that of London at large. To show how completely the
experiment he made to prove the possible healthfulness of such dwellings
has answered, it is only necessary to quote the figures given in the
report just issued for this fifty-third year of the Society which he
founded.

"The rate of mortality," we learn, "in the Dwellings of the Association,
was 9·64 per 1000, including 12 deaths which occurred in hospitals,
infirmaries, &c. In the entire metropolis the rate was 18·2 per 1000. As
regards infant mortality, the deaths under one year of age were at the
rate of 79 in every 1000 births; and in the entire metropolis, at the
rate of 161 per 1000 births."

Allusion has been made to the bust which was executed as a tribute to
the public services of my grandfather by those whom we have called the
Pioneers of Sanitary Reform--Lord Normanby, Lord Shaftesbury, Lord
Carlisle (formerly Lord Morpeth), Charles Dickens, Mr Slaney, and
others. This bust is now in the National Portrait Gallery, and
accompanying it are the following lines by Leigh Hunt, which proclaim
the services of his life in the cause of the poor to wider circles
still:--

    "Ages shall honour, in their hearts enshrined,
    Thee, Southwood Smith, Physician of Mankind;
    Bringer of Air, Light, Health into the Home
    Of the rich Poor of happier times to come!"




                                APPENDIX




                              APPENDIX I.


    LETTER FROM MR TAYLOR, ASSISTANT RETURNING OFFICER OF THE
    WHITECHAPEL UNION, TO DR SOUTHWOOD SMITH; written at the request of
    the latter, for Lord Ashley's use, after their personal inspection
    of Bethnal Green and Whitechapel.

    289 BETHNAL GREEN ROAD, _Feb. 5, 1842_.

    MY DEAR DOCTOR,--Lord Ashley, the Honorable Mr Ashley, and yourself
    visited the following places with me. I have arranged them in the
    form of a table: in one column is the name of the street, and,
    opposite, a brief notice of its condition, with an occasional remark
    by which his Lordship may recognise it.

    Apologising for the length of time that has elapsed since I promised
    to forward this account to you, I remain, dear Doctor, Your Obedient
    Servant,

    T. TAYLOR.


_First Visit._


Back of Chester Place. Open ditch and several pigsties.

Pitt Street. A wretched road, no drainage. Hon. Mr Ashley spoke to one
of the inhabitants respecting the state of the road.

Burnham Square. Houses built on undrained ground.

Grosvenor Street, Bonner Street. Undrained houses on one side not
supplied with water (all the houses on this estate, to the amount of
about 200 or more, in the same condition, the inhabitants having to go
to a distant pump or beg of their neighbours, who have had it laid on at
their own expense, and who for giving it are liable to punishment).
Bonner Street has an open ditch in front of part of it.

Pleasant Place. Road a perfect quagmire.

Green Street. Stagnant water on southern side and also on part of the
northern.

Baker Street, Digby Street. Houses back to back, consisting of two
rooms, each one above the other. Privies close to windows of lower
rooms. Baker's night-yard is in this street.

James Street. Another night-yard.

Bethnal Green Road (eastern end). No drainage, many of the houses having
10 inches to 2 feet of water in the cellars, which are from 3 feet to 3
feet 8 inches only below the level of the road.

Sanderson's Gardens. Houses on each side below the level of the pathway,
which has a gutter in the middle. (Lord Ashley spoke to one of the
inhabitants of this place.)

Pitt Street, Bethnal Green Road. A narrow street with only surface
drainage. (Fever was very prevalent here.)

Cambden Gardens. Houses built on the soil, many of them not being larger
than an 8-feet cube, are inhabited.

Lamb's Fields. An acre at least of complete marsh and three open
ditches--one on the north, another in the middle, and the third to the
eastern side close to the backs of the houses in North Street.

London Street. Undrained.

Rupia Lane. Two open ditches.

Ann's Place. Open sewer in front of some of the houses.

Houses at the back of Ann's Place. The open sewer from Ann's Place
passes beneath one of the houses and then is again open to the houses at
the back, but is boarded in so that Lord Ashley had to mount a boundary
stone to obtain the view of it.

A group of streets to the north of Slacky Road. All the houses stained
with damp to a height varying from 1 to 2 or more feet.

Warmer Place. An open sewer in front of the houses giving off bubbles of
gas very freely.

Wellington Pond. A large piece of water into which the above sewer
drains--gives off constantly innumerable bubbles of gas, and the stench
is sometimes abominable. Persons who have accidentally fallen into it,
though taken out immediately, have all died.

A thoroughfare leading from bottom of Pollards Row to Wellington Row.
The lucifer match manufactory faces this road, into which we all went.
An open ditch in the most filthy condition.

Squirries Street. Green stagnant water on each side.

Wellington Row. Lower rooms all damp. An open ditch in front. Western
end soft mud, into which the wheels of a waggon sank 14 or 15 inches as
it passed.

North Street and some of the houses at the back. Lord Ashley saw the
landlord of some of them.

Waterloo Town (several streets). All undrained, but part of Manchester
Street and Albion Street. Many variations of level of several feet at a
distance of a few yards only, as Manchester Place, Derbyshire Street,
Sale Street. Many of the houses back to back and consisting of five
ground-floor rooms only.


_Second Visit._


George Street. A centre gutter full of stagnant water.

Old Bethnal Green Road. Has had a sewer made recently, but houses do not
communicate with it.

Clare Street, Felix Street, Centre Street, Cambridge Circus, Minerva
Street, Matilda Street, Hope Street, Temple Street, Charles Street,
Charlotte Street, Durham Street. All built on undrained ground, and the
houses affected with damp.

Court opposite to Cambridge Road. One privy to several houses, and
mosses growing on the damp brick of the houses to the height of 4 or 5
feet from the ground.

Nova Scotia Gardens. Several feet below the road in many parts, the
drainage of which it receives. (Here lived the burkers of the Italian
boy.)

Virginia Row, York Street, and the streets to the east. Undrained,
having stagnant water in them.

Rose Court. Most wretched hovels.

Typen Street. (Where the child was burnt.)

Satchwell Rents. The privies form part of the ground-floor of these
houses. Lord Ashley inspected the first house; _no_ yards.

Mount Street. Level of the houses very uneven; many below the level of
the road. The undrained portion of this street suffered from fever to an
awful extent, while the high and drained part had scarcely a case.

Courts out of Mount Street. Dung-heap in one. Lord Ashley saw the
landlord of another and spoke to him.

Collingwood Street. Houses on one side much lower than on the other;
very badly drained, and not a healthy-looking person or child in the
street.




                              APPENDIX II.


RECOGNITION OF THE PUBLIC SERVICES OF DR SOUTHWOOD SMITH.

At a Meeting held at the residence of the Earl of Shaftesbury on the 7th
of May 1856

    IT WAS RESOLVED

    That this Meeting, deeply impressed with the untiring and successful
    labours of Dr Southwood Smith in the cause of social amelioration,
    and specially recognising the value of these labours in the great
    cause of

    SANITARY IMPROVEMENT,

    are anxious to tender him some mark of their personal esteem. That
    accordingly a bust of Dr Southwood Smith be executed in marble, and
    presented to some suitable institution, as an enduring memorial of
    his eminent services in the promotion of the Public Health.

_The following is a List of the Subscribers_:--

    Viscount Palmerston, K.G., G.C.B., First Lord of the Treasury.

    The Earl of Carlisle, K.G., Lord Lieutenant of Ireland.

    The Earl of Harrowby, Chancellor of the Duchy of Lancaster.

    The Marquis of Lansdowne, K.G.

    The Marquis of Normanby, K.G., G.C.B., Ambassador at Florence.

    The Right Honourable W. F. Cowper, M.P., President of the Board of
    Health.

    Thomas Graham, Esq., F.R.S., Master of the Mint.

    The Duke of Buccleuch.

    The Duke of Newcastle.

    The Earl of Ellesmere.

    The Earl Fortescue, K.G.

    The Earl of St Germans.

    The Earl of Harrington.

    The Earl of Shaftesbury.

    The Lord Bishop of London.

    The Lord Bishop of St Asaph.

    The Lord Bishop of Ripon.

    The Lord Brougham and Vaux.

    The Viscount Ebrington, M.P.

    The Viscount Goderich, M.P.

    The Lord Robert Grosvenor, M.P.

    The Lord Claude Hamilton, M.P.

    The Lord Stanley of Bickerstaffe, M.P.

    The Honourable A. Kinnaird, M.P.

    Sir Edward Borough, Bart.

    Sir E. N. Buxton, Bart.

    The Rev. Sir H. Dukinfield, Bart.

    Sir John Easthope, Bart.

    Sir Ralph Howard, Bart.

    Sir Samuel Morton Peto, Bart.

    Sir John Ramsden, Bart.

    Sir Erskine Perry, Q.C., M.P.

    The Lord Mayor.

    The Dean of Ely.

    Henry Austin, Esq.

    B. G. Babington, Esq., M.D.

    Thomas Baker, Esq.

    Joseph Bateman, Esq., LL.D.

    John Batten, Esq.

    G. Beaman, Esq., M.D.

    Thomas Bell, Esq., F.R.S.

    Joseph Brotherton, Esq., M.P.

    Alexander Browne, Esq., M.D.

    A. Collyer, Esq.

    The Rev. J. Cumming, D.D.

    The Rev. R. S. Daniell, M.A.

    Charles Dickens, Esq.

    John Dillon, Esq.

    William Farr, Esq., M.D.

    Arthur Farre, Esq., M.D.

    John Finlaison, Esq.

    C. Gatliff, Esq.

    F. D. Goldsmid, Esq.

    R. D. Grainger, Esq., F.R.S.

    Samuel Gurney, Esq.

    J. F. Hart, Esq.

    A. Hassall, Esq., M.D.

    James Heywood, Esq., M.P.

    Rowland Hill, Esq.

    M. D. Hill, Esq., Q.C.

    F. Hill, Esq.

    A. Hill, Esq.

    E. Hill, Esq.

    Gurney Hoare, Esq.

    P. H. Holland, Esq.

    T. Jones Howell, Esq.

    The Rev. Charles Hume, M.A.

    R. W. Kennard, Esq.

    Duncan M'Laren, Esq.

    J. Leslie, Esq.

    Waller Lewis, Esq., M.B., F.G.S.

    C. Z. Macaulay, Esq.

    J. J. Mechi, Esq.

    R. Monckton Milnes, Esq., M.P.

    Gavin Milroy, Esq., M.D.

    James Morrison, Esq.

    Professor Owen, F.R.S.

    Tucker Radford, Esq., M.D.

    Robert Rawlinson, Esq.

    J. A. Roebuck, Esq., M.P.

    W. Rogers, Esq.

    S. S. Scriven, Esq.

    R. A. Slaney, Esq., M.P.

    J. J. Smith, Esq.

    James Startin, Esq.

    John Sutherland, Esq., M.D.

    Thomas Thornely, Esq., M.P.

    John Thwaites, Esq.

    J. W. Tottie, Esq.

    Thomas Tooke, Esq., F.R.S.

    E. Westall, Esq.

It will be seen that a very large number of the names on this list are
those of men who had personally worked with my grandfather or had
watched and helped as labourers in the Sanitary cause from the
beginning.--G. L.




                                 INDEX.


 Ashley, Lord, visits Bethnal Green and Whitechapel with Dr Southwood
    Smith, 70--
   his Bill relating to child labour in mines passed, 75.


 Bentham, Jeremy, death of, 43--
   Dr Southwood Smith delivers oration on, 45.

 "Body-snatching," agitation in connection with, 36.

 Bristol, Dr Southwood Smith educated at Baptist College in, 7.

 "Broadmead Benefaction," Dr Southwood Smith holds the, 7.

 Brougham, Lord, letter from, 133.


 Chadwick, Mr Edwin, member of Factory Commission, 53--
   reports on the sanitary condition of the labouring population, 105.

 Children, employment of, in factories, 49 _et seq._

 "Children's Employment Commission," Dr Southwood Smith a member of,
    73--
   report by, _ib._--
   report on "Trades and Manufactures," 76.

 Cholera, house-to-house visitation as a preventive cure of, 132, 133.

 Christie, Miss Mary, marriage of Dr Southwood Smith to, 16.


 Dickens, Charles, speech by, 82--
   joins in performance for the benefit of "The Sanatorium," 84--
   letters from, 85, 86, 87, 89, 90, 91--
   letter to, 88.


 Edinburgh, Dr Southwood Smith enters University as medical student, 9--
   lectures in Philosophical Institution, 141.

 Education, article on, 36.

 "Epidemics," lecture on, 141.


 Factories, need for reform in, 49 _et seq._--
   Factory Commission appointed, 53--
   report by, 54 _et seq._--
   Factory Act, 1833, passed, 57--
   return showing working of educational provisions of Act, 58.

 'Factory System, The Curse of the,' by M. Fielden, M.P., quoted, 51.


 "General Board of Health," Dr Southwood Smith appointed to, 127--
   work on, 132 _et seq._--
   report on "A General Scheme for Extramural Sepulture," 133--
   Board discontinued, 136.

 Gillies, Mr, Dr Southwood Smith becomes acquainted with, 48.


 Haliburton, Hon. D. G., letter to, 15

 "Health of Towns Association," 98--
   founding of, 107.

 "Health of Towns Commission," 105.

 Highgate, Dr Southwood Smith's home at, 94 _et seq._


 'Illustrations of the Divine Government,' publication of, 12--
   fourth edition of, 13--
   quotation from preface to, _ib._

 Inglis, Sir Robert Harry, M. P., quoted, 99.

 Italy, travels in, 147, 148.


 Jeffrey, Lord, quoted, 33.


 Kentish Town, life at, 3 _et seq._

 Lincoln, Lord, introduces a Sanitary Reform Bill, 110.

 London, Bishop of, moves in House of Lords for extension of Poor Law
    Board inquiries, 71.

 London, Dr Southwood Smith removes to, 16--
   report on eastern districts of, 61 _et seq._


 Maclean, Dr, referred to, 18.

 Martock, Dr Southwood Smith born at, 7.

 "Metropolitan Association for Improving the Dwellings of the
    Industrious Classes," founding of, 93.

 "Metropolitan Sanitary Commission" appointed, 122.

 Mines, child labour in, 73.

 "Model Dwellings," building of first, 94.

 Morpeth, Lord, quoted, 100--
   brings forward Bill for "Improving the Health of Towns in England,"
      122 _et seq._--
   letter to, 128.


 Normanby, Marquis of, visits Bethnal Green and Whitechapel with Dr
    Southwood Smith, 69--
   referred to, 100--
   his "Drainage of Buildings Bill," 104.


 'Origin and Progress of Sanitary Reform,' by T. Jones Howell, quoted,
    32.


 Palmerston, Viscount, letter from, 137.

 'Penny Encyclopædia,' Dr Southwood Smith contributes to, 36.

 'Philosophy of Health, The,' 47--
   revision of, 140.

 Procter, Adelaide, quotation from, 150.

 Public Health Act, 1848, passed, 126.


 "Quarantine Laws," articles on, 31.


 Read, Miss Anne, attachment of Dr Southwood Smith to, 8--
   marriage of, 9--
   death of, _ib._

 Recognition of public services of Dr Southwood Smith, 143, 162.

 "Report on the Physical Causes of Sickness and Mortality," &c., 61--
   extracts from, _ib._ _et seq._

 "Report on the Prevalence of Fever in Twenty Metropolitan Unions in
    1838," 68.

 'Results of Sanitary Improvement,' publication of, 141.

 Ryland, Dr, reference to, 8.


 Sanatorium, founding of the, 81.

 Sanitary Reform, Dr Southwood Smith's first writings on, 17--
   beginning of the movement for, 60 _et seq._--
   struggle for, 102 _et seq._--
   Parliamentary Committee appointed, 103--
   Mr Chadwick's report, 105--
   "Health of Towns Commission," _ib._--
   "Public Health Act, 1848," passed, 126.

 Shaftesbury, Lord, letter from, 142--
   quotation from diary of, 153.

 Slaney, Mr, M.P., quoted, 99--
   obtains committee to inquire into sanitary state of large towns in
      England, 103.

 Smith, Caroline Southwood, 9.

 Smith, Emily Southwood, 9.

 Smith, Dr Thomas Southwood, author's recollections of, 1 _et seq._--
   birth and early years, 7--
   his education and preparation for the ministry, _ib._--
   cast off by his family on account of religious views, 8--
   attachment to Miss Anne Read, _ib._--
   marriage, 9--
   death of his wife, _ib._--
   decides to study medicine and enters Edinburgh University, _ib._--
   conducts religious services in Edinburgh, 10--
   writes his 'Illustrations of the Divine Government,' 12--
   starts practice at Yeovil, 14--
   removes to London, 16--
   second marriage, _ib._--
   appointed physician to the London Fever Hospital, the Eastern
      Dispensary, and the Jews' Hospital, _ib._--
   his first writings on the "Sanitary Question," 17--
   publishes his 'Treatise on Fever,' 24--
   house at Trinity Square broken up, 35--
   contributes to the 'Penny Encyclopædia,' 36--
   assists in founding the 'Westminster Review,' _ib._--
   publishes pamphlet on 'The Use of the Dead to the Living,' 40--
   lectures at Webb Street School of Anatomy, 42--
   delivers popular lectures at London Institution and elsewhere, 43--
   his oration on Jeremy Bentham, 46--
   publishes 'The Philosophy of Health,' 47--
   appointed to the Factory Commission, 53--
   reports to the Poor Law Commissioners on eastern districts of London,
      61--
   member of "Children's Employment Commission," 73--
   assists in founding "The Sanatorium," 81--
   correspondence with Charles Dickens, 85 _et seq._--
   forms the "Metropolitan Association for Improving the Dwellings of
      the Industrious Classes," 93--
   removes to Highgate, 94--
   founds the "Health of Towns Association," 98, 107--
   his efforts on behalf of Sanitary Reform, 102 _et seq._--
   issues an "Address to the Working Classes," 111--
   is appointed member of the "Metropolitan Sanitary Commission," 122--
   appointed to General Board of Health, 127--
   letter to Lord Morpeth, 128--
   retires from public life, 139--
   revises 'The Philosophy of Health,' 140--
   writes pamphlet on 'Results of Sanitary Improvement,' 141--
   lectures on "Epidemics" at Edinburgh, _ib._--
   receives public recognition of his services, 143--
   travels in Italy, 147--
   death of his wife, 148--
   returns to Italy, _ib._--
   death, _ib._


 Taylor, Mr, letter from, 157.

 Tooke, Mr, member of Factory Commission, 53.

 'Treatise on Fever,' publication of, 24--
   opinion of 'The Medico-Chirurgical Review' on, _ib._--
   quotations from, 25 _et seq._, 30.


 'Use of the Dead to the Living, The,' 40.


 'Westminster Review,' Dr Southwood Smith's contributions to, 17--
   founding of, 36.

 Workhouses, Dr Southwood Smith draws attention to state of, 66.


 Yeovil, Dr Southwood Smith begins practice and takes charge of
    congregation at, 14--
   leaves for London, 16.

PRINTED BY WILLIAM BLACKWOOD AND SONS.




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