These conditions, indeed, are in obvious mutual relation. To human life there has been affixed a normal range of duration; and when it prematurely fails—when children perish in the cradle, or adults amid the glow of manhood, the exception in every case is a thing to be investigated and explained. Of the 15,597 persons who have died within your jurisdiction, not an eighth part had reached the traditional ‘threescore years and ten;’ while nearly three-eighths died in the first five years of life. In proportion as facts like these appear in the death-tables of a particular district, in the same proportion we can trace the local prevalence of particular diseases, to explain the abridgment of life; and passing from such a locality to other districts, where the natural term of existence is more nearly attained, invariably we find that these diseases have fallen into comparative inertness. Finally, in grouping the fatal results of such diseases in their proportionate geographical allotment, invariably we find that their prevalence or non-prevalence, here or there, has been associated with demonstrable physical differences; that life has not capriciously been long in one place and short in another, but that, where short, it has been shortened; that its untimely extinction has depended on the direct operation of local and preventable causes.
In this recognition of cause and effect, which the experience of late years has rendered vivid and precise; and in that higher appreciation of human life, which belongs to civilized nations in peaceful times; and in that deeper sympathy for the suffering poor, which should be at the heart of every Christian government, sanitary legislation had its origin in this country; and it has been the good fortune of the City of London (in respect of your two Acts of Parliament) to precede the rest of the metropolis in acquiring and exercising authority for the mitigation of preventable disease.
Nearly five years have now passed over your tenure of this very grave responsibility; and although in many respects the period must be regarded as one of apprenticeship to a new and difficult career—although you have hardly yet arrived at what may permanently represent your method of action—although important changes which you have determined to adopt are not yet in actual working—although the far greatest evils still remain for correction—yet I rejoice to inform you that sensible improvement has already shown itself in the sanitary state of your population. My comparison of the past five years with any considerable previous period cannot be as precise as I would wish, owing to the absence of circumstantial records for the time anterior to my appointment; but, judging from such information as I can consult on the subject, I am induced to believe that the deaths, for equal numbers of population, are about four per cent. fewer than before your Acts of Parliament came into operation, and that the disproportionate mortality of children is decidedly lessened.
On this first improvement—the beginning, I would fain hope, of a long series of similar steps for regaining the allotted duration of human life, I beg to offer my respectful congratulations to your Hon. Court, under whose auspices it has been effected. Further impetus in the same direction will shortly be given by the removal of sanitary evils, already in fact or in principle condemned. The approaching institution of your extramural cemetery, and, I venture to hope, the translation of all slaughtering establishments to the site of your new Smithfield, will be important contributions to this effect. I therefore make bold to speak with some sanguineness of the slight change of death-rate already noticed; though, while so much remains to be accomplished, I doubt not you will welcome the amelioration rather as an encouragement to proceed, than as the final reward of a completed task.
Here, Gentlemen, terminates all that I have to submit for your consideration in respect of your past and present record of deaths. The greater extension which, during the last two years, I have given to my habitual Weekly Reports, and to sundry occasional statements which it has been my duty to lay before you, may seem, at least generally, to render it superfluous for my Annual Report to contain anything beyond such statistical particulars as I have now brought under your notice. But, however this may generally be, there exist exceptional circumstances at the present time which induce me to trouble you at somewhat greater length.
II. Two years ago—adverting to the non-completion of metropolitan sanitary works, on which the health of entire London is vitally dependent, I could not but comment[77] on the utter unpreparedness with which the metropolis was awaiting any sudden return of Asiatic cholera. It was indeed impossible to foresee how soon, or how late, that dreadful visitation might recur to desolate our homes—whether it might return at once, or never. But typhus—averaging in fifteen years double the fatality of that rarer epidemic—was adding day by day to its list of preventable deaths; and other endemic diseases were co-operating with it, demonstrably, uninterruptedly, to decimate, impoverish, and abase the people.
[77] [Third Annual Report], [p. 206].
Whatever doubts might have existed as to a return of the foreign pestilence were soon solved: whatever hasty conclusions had been formed, as to its again remaining absent during half a generation, were soon disappointed and reversed. Even while I was addressing you on the subject, the plague had again kindled its smouldering fire, and was widening its circle of destruction. Perhaps from the eastern centres of its habitual dominion—from the alluvial swamps and malarious jungles of Asia, where it was first engendered amid miles of vaporous poison, and still broods over wasted nations as the agent of innumerable deaths; or perhaps from the congenial flats of Eastern Europe, where it may have lingered latent and acclimatised; the subtle ferment was spreading its new infection to all kindred soils. Repelled again from the dry and airy acclivities of the earth, and their hardier population, it filtered along the blending-line of land and water—the shore, the river-bank, and the marsh. Conducted by the Oder and Vistula from the swamps of Poland to the ports of the Baltic, it raged east and west, from St. Petersburg to Copenhagen, with frightful severity, and, obedient to old precedents, let us witness its arrival at Hamburg.
Twice in the European history of cholera, had this town seemed the immediate channel of epidemic communication to our island; the disease having on each occasion commenced in our north-eastern sea-ports within a very short time of its outburst there. A third time, not unexpectedly, has this dreadful guest, following the line of former visitation, touched upon the banks of the Tyne; where[78] a worse than beastly condition of the crowded poor, and sewage-water diluted through the people’s drink, had prepared it an appropriate welcome.