The Sanitary Evolution of London

by Henry Jephson

In 1902 the Midwives Act was passed. It provided for the constitution of a Central Midwives Board with power to frame rules for the registration of midwives and for regulating and supervising the practice of midwives. After the 1st of April, 1905, no person might use the title of midwife without being certified under the Act. The London County Council was constituted the local supervising authority for London, and under its supervision much good has already been done.

Also in 1902 the Cremation Act, which empowered burial authorities to provide and maintain crematoria, and empowered the Secretary of State to make regulations as to the conditions under which cremation might take place.

And to complete the tale of sanitary legislation since 1900, a few reforms were secured by sections in the annual General Powers Acts which the London County Council obtained from Parliament. Among these was one rather important one.

In 1894 the duty of supervising and regulating the common lodging-houses in London, which hitherto had been performed by the Commissioner of Police, was transferred to the London County Council. In that year 654 such houses were on the register, and the authorised number of lodgers was close upon 30,000 persons. In 1902 the Council obtained powers for the annual licensing of such houses. These larger powers enabled the Council to improve the sanitary condition of many of these houses. The supervision of these houses has been most satisfactorily carried out, and has been of immense value in securing sanitary abodes for the miserable people who frequent them, and in diminishing what would otherwise doubtless often be a source of infection to the community.

The sanitary evolution of London having begun a little before the middle of the nineteenth century, the figures of the censuses of 1851 and 1901 afford the means for measuring many of the great changes which have taken place in the intervening period.

And a comparison of the state of those things which most affect the public health at these two dates enables a reliable deduction to be drawn as to whether there has been evolution to a higher level of public health, or a retrogression; and, if the former, the progress which that evolution has made.

In 1851 the population of London was 2,362,236. In 1901 it had reached 4,536,541. And when to this is added the fact that all through the intervening years so enormous a mass of people has been cooped up in an area of 117 square miles, and that at the present time there are over 4,500,000 within that small area, the multiplicity of the matters decisively influencing their health and physical well being, and the vastness of the issues at stake, come into vivid light.

As has been often said, the very basis or foundation of the sanitation of a city is an efficient system of drainage. Without it sanitation is impossible.

What the main drainage of London was up to 1858 has been described in the earlier chapters of this book. In effect, nothing less than an entire system had then to be designed and constructed to provide London with this first essential. This was done, and the result was of immediate and enormous benefit to London, and ever since then the maintenance and extension and improvement of this work has received the solicitous attention of the Central Authority. Originally designed for 3,500,000 people, it had, as London grew, to be considerably enlarged and extended, and as some of the districts outside the boundaries of London were allowed by Parliament to drain into the London sewers, still larger works had to be constructed. And now the system serves a resident population of, in round figures, 5,500,000 people spread over an area of about 140 square miles. It comprises close upon 90 miles of great intercepting and outfall sewers, 176 miles of main sewers, and 26 miles of large relief sewers, constructed for the special purpose of conveying storm-water away.