Reports Relating to the Sanitary Condition of the City of London

by John Simon

[50] It has been alleged that, by the use of soft water, the saving in soap would probably be equivalent to the whole of the money at present expended on water-supply; and that in the article of tea, the economy would amount to about one-third of the tea now consumed in the metropolis. It strikes me as possible that, in forming these estimates, the argument may have proceeded too much from a consideration of the hardness of London waters in their unboiled state; and that sufficient allowance may not have been made for the change which boiling produces. If boiling were prolonged for some hours before culinary or detergent use of the water, the results (for tea or soap) would be identical with those produced under the employment of soft water. Notoriously this precaution is not taken: but to avoid disputable ground, I confine myself to the fact of considerable pecuniary loss, arising from the cause in question, and I avoid any attempt to determine its exact amount.

The chemical constitution of these waters occasions another inconvenience. Their carbonate of lime is held in solution (in the chemical form of bicarbonate) by an excess of carbonic acid: under the influence of heat this excess is gradually disengaged and driven off; consequently, as they approach the boiling point, they begin to precipitate the earthy salt which that gas was instrumental in dissolving. Each gallon of water under these circumstances would deposit from ten to fifteen grains of earthy matter on the interior of whatever vessel might contain it, or on the surface of whatever solid—linen or mutton, might be contained in the boiler. Hence arises the well-known furring of vessels in which such waters have habitually been boiled.

I refrain from dwelling on the economical considerations which arise in these points of the subject, as very obvious inferences from the result of chemical analysis; and I pass to other matters more strictly within my own province of observation.

Is water thus constituted in any degree detrimental to the health of those who drink it? It is not in a single word that this question can be fairly answered. Almost insuperable difficulty belongs to it, from the absence of any statistical method by which we might isolate the water-drinking portion of our population, and might compare them, in regard of the diseases to which they are liable, with similar sections of population in soft-water districts and in harder-water districts. Obviously, no other method of comparison can be unobjectionable; and, in arguing the subject from such materials as I have, I can pretend to nothing more than a rational approximation to truth.

Except in the comparatively few instances where active medicinal agents are naturally dissolved in a water, its effects, if injurious, would be so slow as to elude ordinary observation. If, as is exceedingly probable, the same constitution of water as impairs its solvency out of the body, do likewise operate against its being the most eligible menstruum or dissolvent for processes occurring within the body—such processes I mean as attend the act of digestion; if the lime and other hardening ingredients which waste soap in our laundries, and tea in our parlours, do similarly waste within us those organic agencies by which our food is dissolved and converted; any result arising from this source would be of gradual operation, would not easily admit of being traced to its source, and (except in susceptible persons) would rarely produce such symptoms as might immediately draw attention to their cause. The ill effects (whatever they may be) arising from the use of hard waters must be looked for in chronic impairment of digestion, and in those various derangements of nutrition in distant parts (the skin and teeth particularly) which follow as secondary results on such chronic disorder. It would be ridiculous to look for the operation of an ill-chosen water, after its habitual use during two centuries, as though one were inquiring for the symptoms of an acute poison. The signs that are to be ascertained among a population, if such signs exist, are those which would evidence a premature exhaustion of the power of digestion, and would testify that the machine on which we depend for that power had been exposed to unnecessary and avoidable fatigue. This, I believe, is the utmost which Medicine, proceeding from theoretical grounds, would venture to say on the subject.

Perhaps I need not inform you that indigestion, with all that follows from it, is so frequent in the metropolis, in persons after the first strength of youth, that, for large classes of society, a perfect discharge of the natural process of digestion (such a discharge of it as a lecturer would describe to be the exact type and intention of Nature), is exceptional and rare. Unquestionably, in large numbers of cases, wine and beer and spirits, rather than water, have to do with this effect. Unquestionably, other influences of metropolitan life—and, not least, the mental wear and tear which belong to its large excitement, contribute immensely to this chronic derangement of health; but there are reasons likewise for believing, that the quality of water consumed is not a matter of indifference to the result. We cannot but give it an important place among those influences of health or unhealth which we consider local; and we cannot refuse to recognise the fact, that in recommending our patients (as we do often recommend them) to try ‘change of air’ for complaints which baffle us by their obstinacy, so long as the subject of them remains in London, the course on which we rely for success implies ‘change of water,’ equally with that other change to which more popular importance is attached.

In illustration of this view, I may quote to you the experience of two other towns. Dr. Sutherland stated, in evidence before the General Board of Health, that having lived for a number of years at Liverpool (where the water is said to be of about the same degree of hardness as ours), he had long entertained a conviction that ‘the hard water, in a certain class of constitutions, tends to produce visceral obstructions; that it diminishes the natural secretions, produces a constipated or irregular state of the bowels, and consequently deranges the health. He had repeatedly known these complaints to vanish on leaving the town, and to re-appear immediately on returning to it, and it was such repeated occurrences which fixed his attention on the hard selenitic water of the new red sandstone as the probable cause, as he believed it to be, of these affections.’ (Rep. p. 51). And Dr. Leach, of Glasgow, stated before the same Board, as the result in that town of two years’ experience of a substitution of soft for hard drinking-water, that in his opinion, ‘dyspeptic complaints had become diminished in number;’ and that it had ‘been observed, since this change, urinary diseases have become less frequent, especially those attended by the deposition of gravel.’

Inferences useful for ourselves cannot be drawn from statements like the above, on the fullest assumption of their accuracy, without comparing the waters referred to with our own, more completely than is done by the one characteristic of ‘hardness;’ and there may likewise be other qualifications requisite for an application of the analogy. But those disorders of health which are specified by the gentlemen quoted, as produced by the use and diminished by the disuse of hard waters, are such as might very probably stand in the relation of effect to their alleged cause; results, namely, primary and secondary, of disordered digestion.

Practically, I may tell you, that there are many individuals whose stomachs are extremely sensitive to the impression of hard water, who derive immediate inconvenience from its use, and who refuse to drink it without artificial reduction of its objectionable quality. I may likewise inform you that a physician, recently deceased, whose knowledge of indigestion and its chronic effects (especially in relation to the skin and urinary organs) was most profound and accurate, and whose consulting practice in such disorders was for many years almost a monopoly (I mean Dr. Prout) was in the habit of enjoining on his patients the use of distilled water. He evidently considered that the consumption of such waters as are habitually drunk in the metropolis was detrimental, at least to an enfeebled digestion. This is an opinion which, I have reason to believe, is generally entertained by medical practitioners in London.

It may not be irrelevant to mention to you (since the influence of imagination or of artificial habits can have little to do with this result) that horses are liable to be much inconvenienced by hard water, if unaccustomed to its use; and it is, I believe, notorious that grooms in charge of racers habitually take the trouble of conveying with them, to their temporary racing stables, a supply of the accustomed water. Veterinary surgeons say that under the continued use of hard water, which horses will avoid if possible, their coats become rough and staring;—an effect, I may observe, analogous to those skin-disorders of the human subject which are apt to occur from impairment of the digestive functions.