From the nature of the work, I have not considered myself at liberty to make those extensive alterations of text which usually belong to a second edition. I have restricted myself to a few verbal corrections, and to rectifying or omitting some unimportant paragraph, here or there, in case its matter has been more fully or more correctly stated in parts of a subsequent Report. Frequently, where I have wished to explain or qualify passages in the text, I have added foot-notes; but these are distinguished as interpolations by the mark—J. S., 1854.
My Reports lay no claim to the merit of scientific discovery. Rather, they deal with things already notorious to Science; and, in writing them, my hopes have tended chiefly towards winning for such doctrines more general and more practical reception. It has seemed to me no unworthy object, that, confining myself often to almost indisputable topics—to truths bordering on truism, I should labour to make trite knowledge bear fruit in common application.
Nor in any degree do they profess to be cyclopædic in the subject of Preventive Medicine; for it is but a small part of this science that hitherto is recognised by the law; and that—so far as the metropolis is concerned, scarcely beyond the confines of the City. It would have been an idle sort of industry, to say much of places or of matters foreign to the jurisdiction of those whom I officially addressed.
In re-publishing documents which proclaim extreme sanitary evils, as affecting the City, I think it right to draw attention to the dates of the several Reports, and to state that for the last five years many of these evils have been undergoing progressive diminution, of late at a rapid and increasing rate; while, at their worst, they represented only what I fear must be considered the present average condition of our urban population.
This national prevalence of sanitary neglect is a very grievous fact; and though I pretend to no official concern in anything beyond the City boundaries, I cannot forego the present opportunity of saying a few words to bespeak for it the reader’s attention. I would beg any educated person to consider what are the conditions in which alone animal life can thrive; to learn, by personal inspection, how far these conditions are realised for the masses of our population; and to form for himself a conscientious judgment as to the need for great, if even almost revolutionary, reforms. Let any such person devote an hour to visiting some very poor neighbourhood in the metropolis, or in almost any of our large towns. Let him breathe its air, taste its water, eat its bread. Let him think of human life struggling there for years. Let him fancy what it would be to himself to live there, in that beastly degradation of stink, fed with such bread, drinking such water. Let him enter some house there at hazard, and—heeding where he treads, follow the guidance of his outraged nose, to the yard (if there be one) or the cellar. Let him talk to the inmates: let him hear what is thought of the bone-boiler next door, or the slaughter-house behind; what of the sewer-grating before the door; what of the Irish basket-makers upstairs—twelve in a room, who came in after the hopping, and got fever; what of the artisan’s dead body, stretched on his widow’s one bed, beside her living children.
Let him, if he have a heart for the duties of manhood and patriotism, gravely reflect whether such sickening evils, as an hour’s inquiry will have shown him, ought to be the habit of our labouring population: whether the Legislature, which his voice helps to constitute, is doing all that might be done to palliate these wrongs; whether it be not a jarring discord in the civilisation we boast—a worse than pagan savageness in the Christianity we profess, that such things continue, in the midst of us, scandalously neglected; and that the interests of human life, except against wilful violence, are almost uncared for by the law.
And let not the inquirer too easily admit what will be urged by less earnest persons as their pretext for inaction—that such evils are inalienable from poverty. Let him, in visiting those homes of our labouring population, inquire into the actual rent paid for them—dog-holes as they are; and studying the financial experience of Model Dormitories and Model Lodgings, let him reckon what that rent can purchase. He will soon have misgivings as to dirt being cheap in the market, and cleanliness unattainably expensive.
Yet what if it be so? Shift the title of the grievance—is the fact less insufferable? If there be citizens so destitute, that they can afford to live only where they must straightway die—renting the twentieth straw-heap in some lightless fever-bin, or squatting amid rotten soakage, or breathing from the cesspool and the sewer; so destitute that they can buy no water—that milk and bread must be impoverished to meet their means of purchase—that the drugs sold them for sickness must be rubbish or poison; surely no civilised community dare avert itself from the care of this abject orphanage. And—ruat cœlum, let the principle be followed whithersoever it may lead, that Christian society leaves none of its children helpless. If such and such conditions of food or dwelling are absolutely inconsistent with healthy life, what more final test of pauperism can there be, or what clearer right to public succour, than that the subject’s pecuniary means fall short of providing him other conditions than those? It may be that competition has screwed down the rate of wages below what will purchase indispensable food and wholesome lodgment. Of this, as fact, I am no judge; but to its meaning, if fact, I can speak. All labour below that mark is masked pauperism. Whatever the employer saves is gained at the public expense. When, under such circumstances, the labourer or his wife or child spends an occasional month or two in the hospital, that some fever-infection may work itself out, or that the impending loss of an eye or a limb may be averted by animal[1] food; or when he gets various aid from his Board of Guardians, in all sorts of preventable illness, and eventually for the expenses of interment, it is the public that, too late for the man’s health or independence, pays the arrears of wage which should have hindered this suffering and sorrow.
[1] Twenty years’ daily experience of hospital surgery enables me to say, from personal knowledge, that our wards and out-patient rooms are never free from painful illustrations of the effects of insufficient nutrition—cases, in fact, of chronic starvation-disease among the poor; such disease as Magendie imitated, in his celebrated experiments, by feeding animals on an exclusively non-azotised diet.
Probably on no point of political economy is there more general concurrence of opinion, than against any legislative interference with the price of labour. But I would venture to submit, for the consideration of abler judges than myself, that before wages can safely be left to find their own level in the struggles of an unrestricted competition, the law should be rendered absolute and available in safeguards for the ignorant poor—first, against those deteriorations of staple food which enable the retailer to disguise starvation to his customers by apparent cheapenings of bulk; secondly, against those conditions of lodgment which are inconsistent with decency and health.