Transcribed from the [1850?] Charles Gilpin edition by David Price.  Many thanks to the British Library for making their copy available.

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THE CHOLERA:

THE CLAIMS OF THE POOR UPON THE RICH.

BY THOMAS BEGGS,

LATE SECRETARY OF THE HEALTH OF TOWNS ASSOCIATION.

Author of “Enquiry into the Extent and Causes of Juvenile Depravity,” &c., &c.

LONDON: CHARLES GILPIN, 5, BISHOPSGATE WITHOUT.

In 1831 the Asiatic Cholera first made its appearance in this country.  It spread consternation wherever it went.  This pestilence, however, had its mission.  It had previously swept over the fairest portions of the earth, and had destroyed no less than fifty millions of human beings.  Its birth-place was among the swamps and jungles of India.  True to its origin, it principally revelled in the crowded and neglected districts of our large towns, and gathered its victims from the homes of the poor and indigent.  It sought out the abodes of filth and fever—it flew from one reeking nest of disease to another.  The public authorities were startled into exertion; whitewash and soap were in requisition—a visitation of the alleys and lanes commenced—and, in many instances, the accumulated filth and rubbish of years were removed.  A great many temporary expedients, all excellent in their way, were adopted.  One unquestionable good was the result of these extraordinary measures—the higher classes obtained a glimpse of the condition of their poorer brethren.

p. 2The cholera at length passed away, and our exertions died with it.  The stern teacher went to other lands, and we relapsed into our wonted carelessness, our usual indifference—we became easy and comfortable again.  It is true we have had several official inquiries, and through their means much information has been elicited and diffused.  Some improvements have been effected, and others are in progress, but nothing has been done commensurate to the requirements of the case.  Our towns exhibit the same grievous defects.  There is, as yet, no complete system of drainage and sewerage—our dwellings are in the same condition as to air and light, and other conveniences—and a supply of water is still a desideratum.  The old fever-nests remain.  We have a vast number of abominations in every direction inviting pestilence, and scattering abroad the seeds of disease, misery, and demoralisation.  It is true we have obtained a Health Bill, but it is quite clear that the establishment of a central authority can do little, without the sympathy and co-operation of the public at large.

In this state of things, we have another visitation of the Asiatic cholera.  We are again admonished as to our duties as men and Christians.  Once more we are awakened to a full knowledge of the fact, that thousands of our fellow creatures are perishing annually, victims to public neglect.  The great bulk of our working classes are placed in a condition unfavourable to health—a condition that forbids the preservation of the ordinary decencies and moralities of life.  There is a responsibility rests upon all who have influence or power—a responsibility which cannot be shaken off.  The work of reform is not accomplished because we have got a legislative enactment and a Board of Health.  Every town-council and all parish authorities must see to it that the present warning is not neglected, and that it is not permitted to pass away unimproved.  It is a question involving many others of great moment; and experience has p. 3shown that they cannot be neglected without serious loss, nor without entailing upon us great physical and moral evils.

The history of the present visitation will be familiar to all readers.  The general statements are absolutely appalling.  In Albion Terrace, Wandsworth Road, seventeen persons died within a fortnight, in ten houses, of cholera.  In one house no less than six persons died.  This house was occupied by the Rev. Mr. Harrison, a dissenting minister: he had two relatives staying with him,—Mrs. Roscoe and Mrs. Edwards.  Mrs. Roscoe was first attacked, and died; Mrs. Edwards, who attended upon her, was next seized; and on Mr. Harrison returning from the funeral of Mrs. Roscoe, he found his wife attacked by the same disease, and that lady expired the next morning.  Mr. Harrison, overwhelmed by this terrible calamity, fled to Hampstead.  On the morning of his departure Mrs. Edwards died, and the cook was attacked and died the same evening.  On the following day the three bodies were interred at Kensall Green; and on the return of the mourners they found the nurse who had attended Mrs. Edwards dead, and a note informed them that Mr. Harrison had been attacked at Hampstead, and had died the same day.  It is important to look at some of the facts brought out before the coroner’s jury.  Mr. Harrison had stated before his death that he believed the attack had arisen from bad drainage and from bad water.  Dr. Milroy stated, in his report, that in the house in which the epidemic had first broken out in that neighbourhood,—“The cellars were swarming with filth and maggots, amounting altogether to some cart-loads.”  The verdict of the jury declared that the disease had first broken out “in a house where the drainage was very defective, and the water bad.”

In other places we find the same causes actively at work, producing cholera.  The seizures have been mainly in the districts notorious for bad sanitary arrangements.  In every case we find that the track of cholera has been p. 4identical with that of fever.  In a report just published by the Board of Health ample evidence is supplied that the seats of fever are also the seats of cholera.

The first decided case in London occurred in a court that had been specially pointed out to the Sanitary Commissioners.  In the town of Uxbridge four cases occurred last October, marked by the unequivocal characteristics of Asiatic cholera.  One of the persons lived in a house notoriously insalubrious, and in which some cases of malignant fever had proved fatal.  In relation to it the medical man had said, that if ever cholera visited Uxbridge, he believed the first case would be in that house.  The conditions upon which cholera extends are everywhere the same.  They establish most clearly the connection between a low sanitary condition and disease,—between filth and fever; and show that the two diseases, although rarely, if ever, found in the same district together, are twins from the same parent stock.  They have, no doubt, a common origin.

One word on the attacks of typhus.  How is it that we are stirred into activity by an invasion of cholera? that we feel so much alarm?  It is proved that the mortality from attacks of cholera, during its visitation in 1831–2, was not greater altogether than the average annual mortality occasioned by typhus.  The effects of the latter disease are still more serious than those of cholera.  And yet we sit down with the latter, and become reconciled to its existence, because it is common and always with us.  If the sanitary evils which have been proved to exist almost universally were removed, cholera and typhus would scarcely be known amongst us; and yet “the annual slaughter in England and Wales, from preventable causes of typhus, which attacks persons in the vigour of life, appears to be double the amount of what was suffered by the allied armies in the battle of Waterloo.”  Every day, disease and death arise from the presence of p. 5filth, from bad water, or overcrowding.  They are put down in the bills of mortality as deaths by typhus, scarlatina, consumption, &c.—the true report would be, poisoned by bad air, killed by public neglect.  It would not be too much to say that they are sacrificed to the indolence, incapacity, or waywardness of the public authorities.

To justify this view of the case, I may quote, from the report just referred to, a passage in relation to Dumfries.  This town had suffered most severely in 1832.  I believe at that time the cholera attacked one-eleventh of the entire population, and destroyed one-seventeenth.

“Knowing,” say the Commissioners, “that little sanitary improvement had been effected in the interval, and consequently that the inhabitants must be in as great danger as before, we called the attention of the authorities to the special regulations of the Board.  To our recommendations the parochial board paid no regard.  The disease, meantime, went on committing its former ravages.  Thus, within the first twenty-nine days after its outbreak, there occurred 269 deaths out of a population of 10,000.  No efforts being made on the part of the local authorities to check this great mortality, it appeared to us that this was a case requiring a stringent enforcement of the regulations of the Board, and we sent one of our medical inspectors (Dr. Sutherland) to organise a plan of house-to-house visitation, to open dispensaries for affording medical assistance by night as well as by day, and to provide houses of refuge for the temporary reception of persons living in filthy and overcrowded rooms, where the disease was prevailing, and who, though not yet attacked, were likely to be the next victims.  The result of the adoption of these measures was, that, on the second day after they were brought into operation, the attacks fell from 27, 38, and 23 daily, to 11; on the fifth day they diminished to eight; on the ninth day no new case occurred, and in another week the disease nearly disappeared.”

p. 6Surely, there was great want of knowledge or culpable neglect, on the part of the local authorities, in this case.  In other cases similar conduct has been displayed.  It appears we have yet to learn that the care of the public health is a branch of social economics; that it involves more than mere pecuniary considerations.  We have not summed up the evils of this immense pressure of disease when we have estimated the number of those attacked, or the number of those who die.  The money cost, though heavy, is a mere trifle to the various afflictions that follow in the dark train.  Neither does the bodily suffering—the physical pain—complete the amount of evil.  The more we look at it, the more intense does the feeling of awe and sorrow become.  We find, as we look abroad on the face of society, a fearful retribution for sins of neglect, and for opportunities unemployed.  We find ample proof that the ordinations of Divine Providence cannot be violated with impunity:—if we sever the links of duty and of kindness which unite us to our fellow-men, we cannot separate ourselves from the guilt, the suffering, and the loss, such alienation may induce.

I must present some of these evils in detail.  I begin with the lowest—the pecuniary loss.  We have to estimate the unnecessary deaths, the unnecessary sickness, the number of funerals, the burthens upon every charity, and that upon the poor-rate.  The fever-tax is the heaviest of all taxes.  And yet a much larger sum is annually spent in sustaining a number of palliative expedients, than would suffice to support a machinery of prevention.  It is laid upon us, sometimes by the neglect, sometimes by the false economy of local authorities.  They have only one object—to keep down the rates.  However obvious the improvement, it is met by the question—“How much will it cost?”  Short-sighted economy!  The question ought to be—“How much suffering and sickness will it prevent?”  The largest sum that could by possibility be required to carry out all the p. 7needful schemes of sanitary improvement, are far exceeded by the sums now expended in various ways, and which are entailed upon us by the presence of disease, and the poverty it produces.

The moral evils far exceed any pecuniary loss, and outweigh any amount of physical suffering.  The various epidemic diseases generally attack persons in the vigour of life.  This is, especially, the case with typhus, which is, as Dr. Guy terms it, our “pet epidemic,” and which we nurse “with as much care as if we loved it.”  How many widows and orphans are thus thrown destitute upon the world?  How many thousands of poor children are cast, homeless and friendless, upon the streets, furnishing supplies for that great fund of juvenile depravity of which we have lately heard so much?  These wretched children crowd our thoroughfares, miserable and abject.  They soon acquire the irregular habits of the class among whom they are thrown.  Let the candid mind calculate the cost.  How much in poor-rates? how much in alms? how much to public institutions?  And then let us ask how many of them become depredators and thieves—punishing society for its neglect—punishing, by preying upon its property—punishing, by spreading abroad the contagion of disease and of vice—and punishing, by the cost of prisons, police, bridewells, penitentiaries, and all the other appliances to repress crime?  The reports from some places are of the most painful description, as respects the great number of orphans made by the present visitation of cholera.  If this applies to an occasional visit of cholera, it applies with ten-fold force to typhus.  I know, at this moment, three different families suffering under this affliction.  In two of the cases, the mother is left to struggle with a large family; in the other case, both parents were taken off by fever within a fortnight of each other.  The children are in the workhouse.

Look at it in another light, as depriving the poor man of p. 8the ability to toil.  Health is the working man’s all—his capital—his stock-in-trade.  Deprived of it, his means of subsistence are gone—his independence is destroyed.  His sole possessions are his skill and industry.  It is considered unjust to deprive him of free markets and fair play.  Is it not cruel to surround him by such circumstances as greatly increase the chances of sickness?  Have we never known a sober, industrious man stricken down by an attack of fever, and rising from his bed of sickness to look upon a prospect of poverty and want?  His means have become exhausted—he has run into debt, and that debt clogs his future energies.  Perhaps the fever leaves him in broken health and infirmity.  He struggles awhile with all these adverse circumstances; seeks parish relief, and declines into pauper habits.  The workman has a right, by every law divine and human, to eat his daily bread by his daily toil.  Is it not a mockery to allow him this, if the conditions of health are withheld?  Is it not worse?  Is it not injustice to leave him in a condition inferior to the criminal?  The man who has offended the laws can enjoy all the luxuries of good air, good water, and live in a palace, as compared with the wretched hovels in which thousands of our working men, with their wives and families, are placed.  Are we always to go on discussing plans of prison discipline, and the efficacy of various kinds of treatment for paupers?  Are we never to learn that the true philosophy is to inquire by what means we can prevent those who are not yet paupers or criminals from becoming so?  Sanitary reform is only one means, but it is one of primary importance.  How can we expect to cultivate habits of temperance and industry—how can we hope to diffuse the blessings of education, so indispensable to the elevation of the people in morals and happiness, so long as they are left physically degraded and wretched?  The soil is unfavourable to the reception of religious counsel and consolation.  This lesson must be learnt before we can hope to legislate wisely.  All p. 9practical remedies must begin by a due care for the material wants of the population.

It is not possible, in the compass of a tract, to enter into detail on all the evils of our present condition.  They are too general to have escaped the attention of any careful observer.  With regard to drainage and sewerage, every town in the kingdom is defective.  Nearly all are equally so with regard to supplies of water; and the overcrowding in wretchedly constructed dwellings has become matter of universal complaint.  The people have no control over the construction of their dwellings, little or none over the selection, as they must be near their place of work.  They have to pay a high price for the most wretched accommodation.  The state of living is utterly at variance with cleanliness, order, or the cultivation of decent habits.  Labouring under these disadvantages, they have a right to demand of the higher classes a complete system of drainage and sewerage, an efficient water supply, and a thorough cleansing of streets—no penny wise and pound foolish policy ought to stand in the way.  They have a right to demand such reforms as will make their homes the abode of comfort to their families.  It is injustice, it is cruelty to withhold them.  How is it that, in the active discussion of public and private rights, at present going on, there are so few to vindicate the poor man’s claims to pure air and good water?

I would remind those who are in affluence and comfort of the duties of their station.  Many of them can go away from the crowded streets, and spend the greater part of their time in a suburban residence; not so the poor man.  The rich man can command many comforts beyond the reach of the poor man.  He has to work, perhaps, in a heated, crowded workshop, and to retire to a room wretchedly small, and unwholesome.  Need we wonder that he should sometimes prefer the gin-shop, or the beer-house, to his own dim, close, and dirty apartment?  I make no p. 10apology for his excesses.  I do not wish to excuse his faults.  But I ask whether many of the errors, so conspicuous in the character of the poorer population, may not have arisen from the neglect of those who had the power to stimulate them to higher and better things?  Before we reproach them with the neglect of their duties, let us see that our own are faithfully discharged.  If we want to raise them up, we must begin by doing them justice.  Remove the acknowledged evils that press so heavily upon their condition, and the assurance awaits us that the Almighty, who rewards all cheerful and honest labour, will bless the effort to the good of those who give and to those who may receive.

All delay is dangerous, and not only so, it is criminal.  The evils of which we complain have been allowed to remain from a general ignorance of the laws of health.  Up to a recent period, there was a want of knowledge amongst even the educated classes on these vital subjects.  We cannot offer that plea now, to excuse our indifference or neglect.  The evils have been fully explored, and most clearly exposed.  The connexion between filth and disease—the suffering and vice flowing from them, have been exhibited in so striking a manner as to leave no room for mistake or misapprehension.  The knowledge creates a solemn responsibility, and makes us really chargeable with the consequences.  The knowledge gives us the power to arrest the progress of a class of diseases which strike down so many of our fellow-creatures in the years of their strength and usefulness.  Every day of supineness is so much opportunity wasted.  Every delay carries death to thousands.  The admonition now read to us must not be suffered to pass with our usual heedlessness, or we may perchance be aroused by still more fearful means.

The poor man is now sufficiently instructed to feel that many of the evils of which he complains admit of removal, and that the wealthier classes have the power to effect a p. 11change that would surround his condition with many comforts.  Is there no danger in leaving such a feeling to grow and develop itself among the working classes?  The security of the State depends upon the feelings of the people at large.  What hold can there be upon their sympathies or affections, if they are left to themselves; to all the misery of their present lot, and with the knowledge, too, that those who have the power to help, though witnesses of their suffering and sorrow, like the priest and the Levite, turn away, and pass on the other side.  We can expect no other fruit than alienation and disaffection.  We shall see it manifested in contempt of the laws; in bitterness of feeling to the property classes; in an increasing disregard to the invitations of religion; in still greater recklessness of conduct, and still more irregular habits.  Have the revolutions of 1848 been read to us in vain?  What was there behind these mighty convulsions?  Simply this:—The people had been little regarded; their appeals had met with no attention; their wants were neglected; their wrongs were left unredressed; government did not seem to secure or care for their prosperity and happiness.  Tumult and disorder were the inevitable results.  It is a law of God that men shall reap as they have sown.  In this land we have, under Providence, secured some of the blessings of good government, and in consequence a hardy and industrious race has sprung up.  It is in the power of the richer classes to gather round the institutions of the country the affections of the people at large.  They may do much to banish the grim forms of disease and want which now threaten the poor man’s home.  They can carry light to his darkened abode, and dispense comfort and joy upon his gloomy hearth.  By timely effort they may raise up a young generation, who will cherish the home attachments, pay ready obedience to the laws, and, by habits of sobriety and cheerful industry, give strength and stability to the State.  They may, by a proper discharge of the duties of their p. 12stewardship, in a few years, cover the land with smiling homes and a contented population.  And then, again, there is the converse of this.  They may, by neglect and indifference, by leaving the people in their present condition, prepare the way for a state of things that every generous mind would tremble to contemplate.  Who is there so blind as not to see in one course security and happiness; in the other, wretchedness and peril?  I hope there is no need to urge the propriety, the necessity of the former course.  I trust that all classes will unite to secure the true glory of England—that of raising up a healthy and happy population.  Science can have no higher aim; government no loftier purpose; philanthropy no holier pursuit.  It is not less our interest than a duty enjoined upon us by the principles of our holy religion, to administer to the necessities of the lowly and distressed.  Let us, while it is yet day, “break off our sins by righteousness, and our iniquities by showing mercy to the poor, if it may be a lengthening of our tranquillity.”

Note.—The following extract is from the Report of Mr. Phillips, Surveyor Metropolitan Sewers Commission:—“At the last census, in 1841, there were 270,859 houses in the metropolis.  It is known that there is scarcely a house without a cesspool under it, and that a large number have two, three, four, and more under them, so that the number of such receptacles in the metropolis may be taken at 300,000.  The exposed surface of each cesspool measures, on an average, 9 feet, and the mean depth of the whole is about 6½ feet; so that each contains 58½ cubic feet of fermenting filth, of the most poisonous, noisome, and disgusting nature.  The exhaling surface of all the cesspools (300,000 × 9) = 2,700,000 feet, or equal to 62 acres nearly: and the total quantity of foul matter contained within them (300,000 × 58½) = 17,550,000 cubic feet, or equal to one enormous elongated stagnant cesspool, 50 feet in width, 6 feet 6 in. in depth, and extending through London, from the Broadway at Hammersmith to Bow-bridge, a length of ten miles.”

“This,” say the Metropolitan Sanitary Commissioners, “there is reason to believe, is an under estimate.  The cesspool, however, in general, forms but one-fourth of the evaporating surface—the house-drain forms half or two-fourths, and the sewer one; but, connected as the sewers and house drains mutually are, and acted upon by the winds and barometric conditions, the miasma from the house-drains and sewers of one district may be carried up to another.”