London (Ancient and Modern) from the Sanitary and Medical Point of View

by George Vivian Poore

There are certain facts which make me seriously doubt the permanence of the present state of health in London.

The first of these is the fact that some of our hygienic measures have tended to produce overcrowding of houses, which is infinitely the greatest of all sanitary evils. Formerly the sanitary arrangements of houses were such that without some garden or back premises they would have been uninhabitable, and a reference to Aggas’s map, or Norden’s map, or Newcourt’s map, will show that in Old London a large proportion of the houses had gardens or back premises large enough to be shown on a map. These maps also show that in Charles II.’s time, just before the plague, the overcrowding of houses in London was much more marked than in the days of Elizabeth. When every drop of water and all the fuel used had to be carried to the upper storeys by hand, there were practical inconveniences attending upon very high houses which prevented them from being built to any great extent. Now all is changed. Our system of sewerage has made it possible to build houses with no curtilage whatever, and with no outlet but a hole, and the possession of a high pressure of water (the result of steam power) and the modern system of gas has made it possible to have houses of any height, without any great inconvenience to the occupants. “Five hundred rooms, passenger and luggage lifts to every floor, 1,000 electric lights, hot and cold water laid on to every room, bath-rooms on every floor,” is the kind of advertisement put forward by an eight-storeyed hotel without an inch of curtilage. Without steam power, without water under pressure, and without water-carried sewage, such Yankee monstrosities were not possible, whereas nowadays the loftier the hotel so much the greater is the profit, because extra storeys do not increase the ground-rent.

On the other hand, the fact that houses can be and are allowed to be built without curtilage has given an altogether fictitious value to land, the price of which varies in this country (according to situation) from about £200,000 to £10 per acre. It is not surprising that the bias of landlords and builders is very much in favour of our present system of Sanitation. Sanitary authorities are also in favour of it because, having borrowed enormous sums of money, which have to be paid out of the rates, they are naturally quite regardless of hygiene if they can increase the rateable value of the district, and so make the burden of rate-collection lighter. “Black care (in the form of rates) sits behind the councillor.” Everywhere throughout the metropolitan area houses are being pulled down and replaced by others twice as high; extra storeys are being added to old houses, and back-yards and gardens are fetching enormous prices for building purposes, so that the buildings in the centre of London have doubled their height and have lost all their curtilage.

Huge thoroughfares have been driven through London in all directions, but as the ultimate increase in the height of the buildings has been proportionately greater than the increase in the width of the street, locomotion has become more difficult, our traffic has become more in need of police regulations, and it has become an acknowledged rule in the City that if you want to keep an appointment it is dangerous to take a cab, because one can thread one’s way with more certainty on foot.

And yet the overcrowding in London does not appear in official documents. Thus the City of London, on an area of 668 acres, in 1871 had 9,415 inhabited houses, and 3,222 uninhabited, and a population just short of 76,000; whereas in 1881 the inhabited houses had fallen to 6,562, the uninhabited had risen to 4,770, and the population had fallen to 51,439. Some historian of the future may draw the conclusion that the decay of London set in acutely about the year 1871, unless he should perchance discover that within the same period the rateable value had risen from £2,500,000 to £3,500,000; that the day population had risen from 170,000 to 260,000, and that the number of persons entering the City daily for business had risen from 657,000 to 739,000. This population is one mainly of adult males, and since, if they get ill in the City they don’t die in it, the death-rate keeps down, and we like to think it is a wholesome place for a young man to work in. The 50,000 people who have to live night and day on this square mile of ground have not a very cheerful time in this wealthy city, where nature has been most effectually obliterated by the brute force of the almighty dollar. What chance have they of any fresh air with a radius of houses extending to five miles all round them? At one time the Thames served as a recreation ground, but that was in the days before the tide rolled in charged with the excrements of 4,000,000 people, and when it was possible to fish and boat, and perhaps catch a salmon, without the danger of being sunk by some headlong steam-tug. Until a few years ago there was a little green spot called Drapers’ Gardens, but now Drapers’ Gardens is occupied by Throgmorton Avenue, where dwell 322 different firms of stockbrokers and others, and the nearest recreation ground is St. James’s Park, three miles off.

I have lately seen a young man, aged 21, with signs of incipient consumption. He is a fine young fellow, and three years ago entered one of the large City warehouses connected with the drapery trade, in the centre of the City. At first he was employed mainly in the basement, where gas was burning all day. During times of extra pressure he often worked from eight in the morning to past midnight, and when he retired to rest he had to share a bedroom with other men, the windows being shut. I believe this is no uncommon case, and I commend it most heartily to the attention of the “Sweating Committee.” Occasionally on a Saturday afternoon he got a game of football, his very slender resources being severely taxed to pay the railway fare to the spot where the games are contested.

What has occurred in the City has occurred elsewhere in London.

I need hardly say that the crowding of houses means loss of liberty, and increases competition—that competition is the cause of “sweating” and other miseries. Having wilfully produced these evils, I for one do not believe that they are to be removed even by the best intentioned efforts of city missionaries, nor by young men’s Christian associations, nor even by music halls, though tea be the beverage and hymn tunes the melodies.

We have to bear in mind the fact that all writers on sanitary matters are agreed that of all dangers to health, overcrowding is the greatest, and that the death-rate rises in proportion to the density of population. When, therefore, we allow building to go practically unchecked, and move the poor out of two-storeyed dwellings into six-storeyed barracks, we must remember the possible drawbacks of such a system.

The death-rate of Paris is higher than that of London (it was nearly 26 per 1,000 in 1881), but the density of population in Paris is twice that of London, being 117 to the acre, as against 50 in London. Some parts of Paris are very much more crowded than any parts of London, and no parts of it have a density of population so slight as Fulham, Hampstead, Wandsworth, Woolwich, or Lewisham. The effect of overcrowding on death-rate is seen very markedly in the city of New York, which has a population of 1,337,000, which has an almost unlimited water-supply, and the sewage of which is discharged direct into the sea. According to the writer in the “Encyclopædia Britannica,” there is an excessive crowding of the inhabitants into tenement houses, and the houses are to a great extent without back entrances. As a consequence, the death-rate was 26·47 in 1880, 31·08 in 1881, and 29·64 in 1882.