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    glanced at them will be glad to g ive them a calm , steady examination ; those ¦ who missed them altogether , will be surprised at the interest with which style , mastery , and earnestness can invest matters apparently so unpromising as sewerage , water supply , burial , &c . The five Reports , with tables and appendix , and a . Report on extramural interment are repr inted very much as they originally appeared , footnotes occasionally correcting or modifying the text . A preface full of important suggestion and written with a splendour of style , rare in all places , but especially . .. rare in medical writings , fitly prepares the reflective reader for the Reports which succeed . It is , indeed , only of late years that the smallest degree of interest has been shown in sanitary matters ; and if one-third of the polemics , agitation , Exeter Hallization , and missionary ardour so superfluously and so fruitlessly bestowed on our souls , had been given to the more practicable , if less dignified , subject of our bodies , the complaints now loudly urged would have been less frequent ; for there can be no doubt that we are as singularly neglectful of our bodily condition as if we still believed in the approaching destruction of the world : —

    " 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 oegany 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 r tf 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 sewergrating before the door ; what of the Irish basket-makers up-stairs— -twelve in a room , who came id after the hopping , and got fever ; what of the artisan ' s dead body , stretched on his ¦ w idow ' s one bed , beside her living children .

    " Let him , if he have a heart for the duties of . manhood and patriotism , gravely reflect ¦ w hether 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 he 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 , stud y ing 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 mar-ker , 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 liglitless 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—iiutt ccelum , 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 ciin 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 . Whenunder

    , 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 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 . " Probably on wo point of political economy is there more general concurrence of opinion than against any legislative interference with tho price of labour . But I would venture to submit , for the consideration of abler judges than myself , that before wages can safely be loft to find their own level in the struggles of an unrestricted competition , the law should bo rendered absolute and available in safeguards for tho ignorant poor—first , against those deteriorations of staple food which enable the retailer to disguise starvation to his customers by apparent choapenings of bulk ; secondly , against those conditions of lodgment which are inconsistent with decency and health .

    *• But if I have addressed myself to this objection , partly bocause—to tho very limited extent in which it starts from a true premiss , it deserves reply ; and partly because I wish emphatically to declare my conviction , that such evils as I denounce are not the more to bo tolerated for their rising in unwilling Pauperism , rather than in willing Filth ; yet I doubt whether poverty be so important an element in tho case as soino people imagine . And although I have referred especially to a poor neighbourhood—bocauso here it is that , knowlodge and personal rcrinoinent will have least power to compensate for tho insufficiencies of public law ; yot I haves no hesitation in saying that sanitary Mismanagement spreads very appreciable evils high in tho piddle ranks of society ; and from some of tho consequences , ho far as I am awuro , no station can cull itself oxompt .

    " I he tact is , as I have said , that , except ugninut wilful violence , life is practically very little cured for by tho huv . Fragments of legislation there aro , indeed , in all directions : enough to establish precedents—enough to tastily some half-conscious possession of a principle ; but , for usefulness , little beyond this . The statutes tolLthat , now and then , thoro has reached to liigh places the wail of physical suffering . They tell that our law-makers , to tho tether of « . vory scanty knowledge , huvo , not unwillingly , moved to tho redress of Bomo clamorous wrong . Hut— tested by any acicntiiio standard of what should bo tlio completeness of minitnry legislation , or tested by any ^ personal endeavour to procure the lega l correction of gross and glaring evils—their iusiUHuionoios , I do not hesitate to say , constitute a national scandal , and , perhaps in respect oi their consequences , something not Jar removed from a nutional sin . "

    Mr . Simon wiLh _ eloquence ur ^ os the . necessity a Minister Public Health being appointed , a necessity which id now becoming the conviction of hundreds of thoughtful men , although it has to combat tUe natural jealousy of Englishmen uguinst legislative interference . But n . t > Mr . Simon , in the energetic vividness of hia style , truly Bays : — " If factory children aro oared for , lost they bo overworked ; avud minors , Icat they bo stifled ; ho , for those who labour with copper , mercury , arsenic , and loud " , lot uo euro , lost . they bo poisoned ! for grindom , lest their hiiiya bo I retted into consumption ! lor mutoliniMkora , lost their jiiwu bo rotted from them by phosphorus 1 " And further : — " Against adulterations of food , here and there , obsolete poworn exist , for our ancestors l i if" V ? ' . i things > but > practically , ( . hoy are of no avail . If wo , who aro educated , Jmbitunlly submit to havo captor in our prosorvea , rod-lend in our cayenne , nliun in our

    bread , pigments in our tea , and ineffable nastinesses in oar fish-sauce , what can -we expect of the poor ? Can they use galactometers ? Can they test their pickles with ammonia ? Can they discover the tricks by which bread is made dropsical , or otherwise deteriorated in value , even faster than they can cheapen it in price ? Without entering on details of what might be the best organisation against such things , I may certainly assume it as greatly a desideratum , that local authorities should uniformly have power to deal with these frauds ( as , of coarse , with every sale of decayed and corrupted food ) , and that they should be enabled to employ skilled officers , for detecting at least every adulteration of bread and every poisonous admixture in condiments and the like . " In Borne respects this sort of protection is even more necessary , as well as more deficient , in regard to the falsification of drugs . The College of Physicians and the Apothecaries ' Company are supposed to exercise supervision in the matter ; so that at least its necessitv is

    recognised by the law . The security thus afforded is , in practice , null . It is notorious in my profession that there are not many simple drugs , and still fewer compound preparations , on the standard strength of which we can reckon . It is notorious that some important medicines are so often falsified in the market , and others so often mis-made in the laboratory , that we are robbed of all certainty in their employment . Iodide of potassium- —an invaluable specific—may be shammed to half its weight with , the carbonate of potash . Scammony , one of our best purgatives , is rare without chalk or starch , weakening it , perhaps , to half the intention of the giver . Cod-liver oil may have come from seals or from olives . The two or three drops of prussic acid that we would give for a dose may be nearly twice as strong at one chemist's as at another ' s . The quantity of laudanum equivalent to a grain of opium being , theoretically , 19 minims ; we may practically find this grain , it is said , in 4 . 5 minims , or in 34 . 5 . "

    We heartily concur -with him . in his belief that " our commanding need is that the general legislation of the country be imbued with deeper sympathies for life ; " and we concur with him when he says s" Having said so much on the defects and the wrongs of our existing sanitary condition , perhaps I may venture , to speak of the almost obvious remedy . i Almost obvious , ' I say ; for surely no one will doubt that this great subject should be dealt with by comprehensive and scientific legislation ; and I hardly see bow otherwise , than that it should be submitted in its entirety to some single department of the executive , as a sols charge ; that there should be some tangible head , responsible , not only for the enforcement of existing laws , such as they are or may become , but likewise for their progress from time to time to the level of contemporary science , for their completion where fragmentary , for their harmonisation where discordant . . ¦

    " If—as is rumoured—the approaching re-constitution of the General Board of Health is ( after the pattern of the Poor-law Board ) to give it a parliamentary president , that member of the Government ought to be open to challenge in respect of every matter relating to health . What , for this purpose , might be the best subordinate arrangements of such a Board , it would take a volume to discuss . But at least as regards its constituted head , sitting in Parliament , his department , should be , in the widest sense , to care for the physical necessities of human life . Whether skilled coadjutors beappo 5 tte « i . for him or not ; engineers — -lawyers—¦ chemists—pathologists ; whether he be , as it were , the foreman of this special jury , or , according to trie more usual precedent of our public affairs , Collect advice on bis own responsibility , and speak without quotation of other authority than himself , his voiceunless t lie thing is to be a sbam—must represent all these knowledges . " Tlie people , through its representatives , must bo able to arraign him wherever human life is insufficiently cared for .

    " He must be able to justify or to exterminate adulterations of food ; to show that alum ought to be in our loaves , or to banish it for ever ; to show that copper" is wholesome for dessert , or to give us our olives and greengages without it ; to show that red-lead is an estimable condiment , or to divert it from our pepper-pots and curries . " Similarly with drugs and poisons—the alternatives of life and death—a Minister , of Public Health would , 1 presume , be responsible for whatever evils arise in their unlicensed and unregulated sale . He would hardly dare to acquiesce in . our present defencelessnesa against fraud and ignorance ; in doses being sold—critical doses , for the strength of which we , who prescribe them , cannot answer within a margin of cant , per cent . ; or in pennyworths of poison being ) landed across tho counter as nonchalantly as cakes of soap . Surely , before he had been six months in office , he would have procured some enactment to remedy this long neglect of the legislature , b y providing that the druggist ' s trade be exercised only after some test of fitness , and in subjection to certain regulations . "

    Nor in spite of opposition ( what is there not opposed ?) would there be wanting a firm phalanx of intelligent support : — " Thank God I the , number of persons capable of apprehending the catise j and ready to take interest in its promotion , is now daily on the increase . If some Minister of Public Health could take his scat in'the House of Commons—some Minister knowing his subject and feeling it—I believe he would find no lack of sympathy and co-operation . The world abouMTWrtrsdmirable wishes and intentions , that vaguely miscarry for want of guidance . How many men can get no farther in thoir psalm of life than the question , in quo corriget . To s « cli—not masters of the subject , but willing and eager to be its servants , " an official leader might be everything : for in great causes like this , where the scandal of continued wrong burns in each man ' s conscience , tho instincts of justice thirst for satisfaction . What can we do or give—how shall we speak or vote , to lessen these dreadful miseries of sanitary neglect—is , at this moment , I believe , the fervent inquiry of innumerable minds , waiting , as it were , for the word of command to act . "

    We have lingered so long at tlie threshold , that we shall scarcely have time to do more than glance around us on entering , many as are the tempting passages . " We urge the reader to wait for no guidance of ours but to enter by himself . As a hint of the many incidental topics of interest wo will extract this on

    WATER , HARD AND SOFT . " Is water thus constituted in any degree detrimental to tho health of those who drink it ? It is not in a single word that this question can bo fairly answered . Almost insuperable difficulty belongs to it { from tlie absence of any statistical method by which wo might Isolate the water-drinking portion of our population , and might compare them , in regard of tho diseases to which they aro liable , with similar suctions of population in aoftwator districts and in harder-water districts . Obviously , no other method of comparison can be unobjectionable ; mid , in arguing tho subject from su « h materials as I have , I can protend to nothing more than a rational approximation to truth . " Kxcopt in tho comparatively few instances where active medicinal agents are naturally dissolved in a water , its effects , if injurious , would bo so alow us to elude ordinary observation . If . as is exceedingly probable , tlie aamo constitution of water as impairs its solvency out of the body , do , likewise oporato ' ngainst its being tho most oligiblo menstruum or dissolvent for processes occurring within tlwi body—such procossos I mean as attend tho not of dims I ion : if tho lime and other hardening ingredients which waste soap in our laundries .

    and tea in our parlours , do similarly waste within us thoao organic agencies by which our foud is dissolved and converted ; any result arising from this aourco would be of gradual operation , would not cosily admit of boing traced to its source , and ( oxcopfc in suacoptiblw persons ) would raroly |> roiluco such symptoms ns might immediately draw attention to their cause . The ill efiocts ( whatever tliey may bo ) arising from the uso of hard waters must bo looked for in clironio impainnont of digestion , and in thoso various derangements of nutrition in diatiuit parts ( tho skin and teeth particularly ") which follow as secondary rosulls on such chronic disorder . It would be ridiculous to l » ok for tho operation of an illohoson water , after its habitual uso during two centuries , as though ono wore inquiring for tlio nymptoms of nn ucnto poison . Tlui signs that aro to l > o ascertained among a . population , if Much signs exist , are those wliioh would evidence u promuturo exhaustion of tho pmvor of digestion , " »» d would testify that the machine on wliioh wo depend for that powor had been exposed to unnccomtary and avoidable fatigue . This , I believe , is tho utmost which Medicine-, proceeding from theoretical ground *) , would venture to say on tho subject . " Perhaps I need not , inform you Unit indigestion , with all thAt follows from it , is so

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    Jujly 8 , 1854 . ] THE LEADER . 641

• Citation
  • Leader (1850-1860), July 8, 1854, page 641, in the Nineteenth-Century Serials Edition (2008; 2018) ncse.ac.uk/periodicals/l/issues/vm2-ncseproduct2046/page/17/