An impression is often prevalent that a heavy mortality is an unavoidable condition of all large towns, and of a town population in general. It has, however, been shown that, groups of cottages on a high hill, exposed to the most, salubrious breezes when cleanliness is neglected, are often the nests of fever and disease, as intense as the most crowded districts. The mortuary returns of particular districts (in the essentials of drainage, cleansing, and ventilation, to which it is practicable to make other districts approximate, and that too with reductions of existing charges), prove that a high degree of mortality does not invariably belong to the population of all towns, and probably not necessarily to any, even where the population is engaged in manufactures. The proportion of deaths appears in some of the suburbs of the metropolis (as at Hackney), and of Manchester and Leeds, to be lower than amongst the highest classes in two of the agricultural counties.
It appears from the report of Dr. d’Espine, one of the members of the Council of Health of Geneva, who has examined the records of the mortality prevalent amongst the population extra muros, as well as that in the city (which will hereafter be submitted to special notice), that the deaths were in the rural districts 1 in 39·3; whilst in the city they were 1 in 44·7 of the whole of the population in the year 1838. In the poorest and worst conditioned of the rural districts the proportions of the deaths were the greatest. In the year 1837 the deaths were in the poorest of the rural districts 1 in 38·6; in the intermediate district, 1 in 40·8; in the richest district, 1 in 53·2.
In comparison with the very high state of the chances of life in the county of Wilts, the city of Bath presents an example confirmatory of this view. The Rev. Whitwell Elwin has supplied the following return of the chances of life amongst the different classes in that city. Out of 616 cases of death in 1840, the results were as follow:—
| No. of Deaths. | Average Age of Deceased. | |
|---|---|---|
| 146 | Gentlemen, professional persons, and their families | 55 years. |
| 244 | Tradesmen and their families | 37 |
| 896 | Mechanics, labourers, and their families | 25 |
The very high average chances of life amongst the middle classes, which is nearly the same as that of the farmers, &c. of the agricultural districts, is the fact adduced as most strongly proving the salubrity of the place.
“In making these returns,” says Mr. Elwin, “I have thrown out all visitors and occasional residents, and my knowledge of the locality, with the assistance of the clerk of the union, has enabled me to attain complete accuracy with respect to the gentry, and a close approximation to it in the remaining cases. The difference in the ages of these several classes presents to my mind a tolerably exact scale of the difference of their abodes. The large houses, the broad streets, looking almost invariably on one side or other upon parks or gardens or open country, the spacious squares, the crescents built upon the brows of the hills without a single obstruction to the pure air of heaven, give the gentry of Bath that superiority over other grades and other cities which their longevity indicates. And herein, it appears to me, consists the value of the return. It shows that the congregation of men is not of necessity unhealthy; nay, that towns, possessing as they do superior medical skill and readier access to advice, may, under favourable circumstances, have an advantage over the country. The situation of the tradesmen of Bath, inferior as it is to that of the gentry, is better than that of their own station in other places. The streets they chiefly inhabit, though with many exceptions, are wide, and swept by free currents of air, with houses large and well ventilated. The condition of the poor is worse than would be anticipated from the other portions of the town. They are chiefly located in low districts at the bottom of the valley, and narrow alleys and confined courts are very numerous. Yet even here we have an unquestionable advantage over most large towns. It was only yesterday that I was expressing my horror to a medical gentleman at some portions of the habitations of the poor, when he replied, that it excited little attention, because they were so much better than what was to be seen in other parts of the kingdom.
“Whatever influence occupation and other circumstances may have upon mortality, no one can inspect the registers without being struck by the deteriorated value of life in inferior localities, even where the inhabitants were the same in condition with those who lived longer in better situations. The average age of death among the gentlemen was as high as 60, till I came, at the conclusion, to a small but damp district, in which numerous cases of fever brought down the average to 54. So again with the shopkeepers, the average was reduced two by the returns from streets which, though inhabited by respectable men, were narrow in front and shut in at the back. The average among the labourers was greatly diminished by the returns from some notorious courts, and raised again in a still higher proportion by districts which appertained rather to the country than the town. Of three cases of centenarians, one of whom had attained the vast age of 106, two belonged to this favoured situation. Not but that great ages were to be found in the worst parts as in the best, or that particular streets did not in a measure run counter to the rule. Still, wherever I brought into opposition districts of considerable extent, I found the law more or less to obtain. Bath is a favourable town to institute the comparison, from presenting such marked contrasts in its houses, and the inquiry being little complicated by the presence of noxious trades, which in some towns would necessarily disturb every calculation of the kind. Even here a colony of shoemakers would bring down the average of its healthiest spot to the age of childhood. My attention was called to this circumstance by the clerk incidentally remarking that more shoemakers were married at his office, and were uniformly more dirty and ill-dressed, than any other class of persons. The proneness to marriage or concubinage in proportion to the degradation of the parties is notorious, and I anticipated from the fact an abundant offspring, afterwards to be carried off by premature disease. Accordingly I went with this view through several of the registers, and the result was, that while the average of death amongst the families of labourers and artisans in general was 24 and 25, that of shoemakers was only 14. Had the shoemakers been excluded from the former average, as for the purpose of this comparison they should have been, the disproportion would be some years greater.
“The deaths from fever and contagious diseases I found to be almost exclusively confined to the worst parts of the town. An epidemic small-pox raged at the end of the year 1837, and carried off upwards of 300 persons; yet of all this number I do not think there was a single gentleman, and not above two or three tradesmen. The residences of the labouring classes were pretty equally visited, disease showing here and there a predilection for particular spots, and settling with full virulence in Avon-street and its offsets. I went through the registers from the commencement, and observed that, whatever contagious or epidemic diseases prevailed,—fever, small-pox, influenza,—this was the scene of its principal ravages; and it is the very place of which every person acquainted with Bath would have predicted this result. Everything vile and offensive is congregated there. All the scum of Bath—its low prostitutes, its thieves, its beggars—are piled up in the dens rather than houses of which the street consists. Its population is the most disproportioned to the accommodation of any I have ever heard; and to aggravate the mischief, the refuse is commonly thrown under the staircase; and water more scarce than in any quarter of the town. It would hardly be an hyperbole to say that there is less water consumed than beer; and altogether it would be more difficult to exaggerate the description of this dreadful spot than to convey an adequate notion to those who have never seen it. A prominent feature in the midst of this mass of physical and moral evils is the extraordinary number of illegitimate children; the offspring of persons who in all respects live together as man and wife. Without the slightest objection to the legal obligation, the moral degradation is such that marriage is accounted a superfluous ceremony, not worth the payment of the necessary fees; and on one occasion, when it was given out that these would be dispensed with, upwards of 50 persons from Avon-street, who had lived together for years, voluntarily came forward to enter into a union. And thus it invariably happens in crowded haunts of sin and filth, where principle is obliterated, and where public opinion, which so often operates in the place of principle, is never heard; where, to say truth, virtue is treated with the scorn which in better society is accorded to vice. I have been rendered familiar with these places by holding a curacy in the midst of them for upwards of a year, and my duty as chaplain to the union, in visiting the friends of paupers or discharged paupers themselves, keep up the knowledge I then contracted.
“I think these facts supply us with important conclusions. Whether we compare one part of Bath with another or Bath with other towns, we find health rising in proportion to the improvement of the residences; we find morality, in at least a great measure, following the same law, and both these inestimable blessings within the reach of the legislature to secure. When viewed in this light, these investigations, so often distressing and disgusting, acquire dignity and importance.”
The suffering and expense of life prevalent in differently situated districts observed in this country, are consistent with the experience of the continent.