What is the condition of the children born or kept in courts or places of the condition you describe, with badly cleansed drains, with privies, and without water or conveniences for cleansing introduced into their habitations?—The children are, for the most part, of delicate or weak frame, and subject to struma. The health of children depends partly whether they were born in such places or not, whether their parents on each side are Londoners, as there appears to be a gradual decline in physical power by a long continuance in a vitiated atmosphere, which passes from parent to progeny, and partly also in a family where one part of the children have been born and brought up in the country and the other in town; those born in the country, and not coming into London until they are five years of age, will have comparatively strong frames, and will resist such influences, whilst those born in town will be comparatively of delicate frame, weakly and strumous, liable to glandular disease, and diseased affections of the joints and the spine. Generally they are shorter in stature, sometimes they are taller, but then they are slender and very delicate, in which case they are likely to have bending of the limbs.
What is the condition of females born under such circumstances?—I have observed that the females are less depressed than the males, and are reared with less difficulty.
Why is this so?—I have not been able to determine. It may be that the male requires more extensive and powerful exercise, and that in pure air, than the female, and consequently that the female suffers less from the want of it.
What are the moral characteristics of the population brought up under these depressing physical circumstances?—They have decided unwillingness to labour. They are not so strenuous as the more healthy people from the country. They are more apt to resort to subterfuge to gain their ends without labour. Light employments they do not object to, and do comparatively well in. But it is difficult to keep a native of London, either male or female to heavy work; they will avoid it if they can. The cause is in most cases physical from the deficiency of ability to labour. The greatest part of them are mentally irritable and impatient under moral restraint.
Is any similar difference marked on the condition of the children of tradespeople between those children of tradespeople brought up in London and those born in the country?—Yes, there is a similar difference perceptible, but less in degree. Amongst tradesmen, too, it is the extensive practice of the parents to send their children out of town to school or on visits, which may powerfully affect them beneficially. In the tradesman’s family they have better sleeping rooms, and greater cleanliness in person, and in bed and body linen, and also a better regulated dietary.
What is the effect of such atmospheric impurities as those described in the chances of recovery from attacks of disease?—It lessens the chances of recovery and greatly impedes convalescence. Indeed, in many instances, very little progress can be made until the patient is sent out into the country. In a case of fever which occurred to a strong healthy man, aged 24, a carman, in a close neighbourhood, the house being without drains and ill ventilated; no progress could be effected until he was removed into the country, although the fever had decidedly subsided. I believe that in this case something else would have supervened, had he not been removed. I frequently remove patients in a respectable condition, finding no chance of recovery without it. Many of the better conditioned houses being badly adapted for the treatment of fevers, having low ceilings and insufficient ventilation.
What will be the difference in respect to the time of cure or convalescence between a well and an ill-cleansed neighbourhood?—A difference of perhaps one-half.
Suppose the rooms of each house supplied with water, the privies and cesspools removed, drains from the houses to sewers, and the sewers so constructed as to be cleansed, and to convey away daily such refuse as that which is allowed to remain decomposing in the close courts during weeks. Supposing the surfaces of the streets cleansed as frequently after the manner in use in Philadelphia and other towns where they are cleansed with water daily, to what extent do you conceive disease would be reduced?—Of fevers two-thirds certainly, and other diseases would be considerably lessened.