Chapter III: Preface: To the Second Edition (3)

Whether the impurities of the water were derived from the sewers, the drains, or the cesspools, of which latter there are a number in the neighbourhood, I cannot tell. I have been informed by an eminent engineer, that whilst a cesspool in a clay soil requires to be emptied every six or eight months, one sunk in the gravel will often go for twenty years without being emptied, owing to the soluble matters passing away into the land-springs by percolation. As there had been deaths from cholera just before the great outbreak not far from this pump-well, and in a situation elevated a few feet above it, the evacuations from the patients might of course be amongst the impurities finding their way into the water, and judging the matter by the light derived from other facts and considerations previously detailed, we must conclude that such was the case. A very important point in respect to this pump-well is that the water passed with almost everybody as being perfectly pure, and it did in fact contain a less quantity of impurity than the water of some other pumps in the same parish, which had no share in the propagation of cholera. We must conclude from this outbreak that the quantity of morbid matter which is sufficient to produce cholera is inconceivably small, and that the shallow pump-wells in a town cannot be looked on with too much suspicion, whatever their local reputation may be.

[Sidenote: PUMP-WELL, BROAD ST., GOLDEN SQ.]

Whilst the presumed contamination of the water of the Broad Street pump with the evacuations of cholera patients, affords an exact explanation of the fearful outbreak of cholera in St. James’s parish, there is no other circumstance which offers any explanation at all, whatever hypothesis of the nature and cause of the malady be adopted. Many persons were inclined to attribute the severity of the malady in this locality to the very circumstance to which some people attribute the comparative immunity of the city of London from the same disease, viz., to the drains in the neighbourhood having been disturbed and put in order about half a year previously. Mr. Bazelgette, however, pointed out, in a report to the commissioners, that the streets in which the new sewers had been made suffered less than the others; and a reference to the map will show that this is correct, for I recollect that the streets in which the sewers were repaired about February last, were Brewer Street, Little Pulteney Street, and Dean Street, Soho. Many of the non-medical public were disposed to attribute the outbreak of cholera to the supposed existence of a pit in which persons dying of the plague had been buried about two centuries ago; and, if the alleged plague-pit had been nearer to Broad Street, they would no doubt still cling to the idea. The situation of the supposed pit is, however, said to be Little Marlborough Street, just out of the area in which the chief mortality occurred. With regard to effluvia from the sewers passing into the streets and houses, that is a fault common to most parts of London and other towns. There is nothing peculiar in the sewers or drainage of the limited spot in which this outbreak occurred; and Saffron Hill and other localities, which suffer much more from ill odours, have been very lightly visited by cholera.

[Sidenote: IRRUPTION OF CHOLERA AT DEPTFORD.]

Just at the time when the great outbreak of cholera occurred in the neighbourhood of Broad Street, Golden Square, there was an equally violent irruption in Deptford, but of a more limited extent. About ninety deaths took place in a few days, amongst two or three score of small houses, in the north end of New Street and an adjoining row called French’s Fields. Deptford is supplied with very good water from the river Ravensbourne by the Kent Water Works, and until this outbreak there was but little cholera in the town, except amongst some poor people, who had no water except what they got by pailsful from Deptford Creek—an inlet of the Thames. There had, however, been a few cases in and near New Street, just before the great outbreak. On going to the spot on September 12th and making inquiry, I found that the houses in which the deaths had occurred were supplied by the Kent Water Works, and the inhabitants never used any other water. The people informed me, however, that for some few weeks the water had been extremely offensive when first turned on; they said it smelt like a cesspool, and frothed like soap suds. They were in the habit of throwing away a few pailsful of that which first came in, and collecting some for use after it became clear. On inquiring in the surrounding streets, to which this outbreak of cholera did not extend, viz., Wellington Street, Old King Street, and Hughes’s Fields, I found that there had been no alteration in the water. I concluded, therefore, that a leakage had taken place into the pipes supplying the places where the outbreak occurred, during the intervals when the water was not turned on. Gas is known to get into the water-pipes occasionally in this manner, when they are partially empty, and to impart its taste to the water. There are no sewers in New Street or French’s Fields, and the refuse of all kinds consequently saturates the ground in which the pipes are laid. I found that the water collected by the people, after throwing away the first portion, still contained more organic matter than that supplied to the adjoining streets. On adding nitrate of silver and exposing the specimens to the light, a deeper tint of brown was developed in the former than in the latter.

All the instances of communication of cholera through the medium of water, above related, have resulted from the contamination of a pump-well, or some other limited supply of water; and the outbreaks of cholera connected with the contamination, though sudden and intense, have been limited also; but when the water of a river becomes infected with the cholera evacuations emptied from on board ship, or passing down drains and sewers, the communication of the disease, though generally less sudden and violent, is much more widely extended; more especially when the river water is distributed by the steam engine and pipes connected with waterworks. Cholera may linger in the courts and alleys crowded with the poor, for reasons previously pointed out, but I know of no instance in which it has been generally spread through a town or neighbourhood, amongst all classes of the community, in which the drinking water has not been the medium of its diffusion. Each epidemic of cholera in London has borne a strict relation to the nature of the water supply of its different districts, being modified only by poverty, and the crowding and want of cleanliness which always attend it.

[Sidenote: THE EPIDEMIC OF 1832.]

The following table shows the number of deaths from cholera in the various districts of London in 1832, together with the nature of the water supply at that period. (See next page.)[11]

This table shows that in the greater part of Southwark, which was supplied with worse water than any other part of the metropolis, the mortality from cholera was also much higher than anywhere else. The other south districts, supplied with water obtained at points higher up the Thames, and containing consequently less impurity, were less affected. On the north of the Thames, the east districts, supplied, in 1832, with water from the river Lea, at Old Ford, where it contained the sewage of a large population, suffered more than other parts on the north side of London. Whitechapel suffered more than the other east districts; probably not more from the poverty and crowded state of the population, than from the great number of mariners, coalheavers, and others, living there, who were employed on the Thames, and got their water, whilst at work, direct from the river. There were one hundred and thirty-nine deaths from cholera amongst persons afloat on the Thames. The cholera passed very lightly over most of the districts supplied by the New River Company. St. Giles’ was an exception, owing to the overcrowding of the common lodging-houses in the part of the parish called the Rookery. The City of London also suffered severely in 1832. Now when the engine at Broken Wharf was employed to draw water from the Thames, this water was supplied more particularly to the City, and not at all to the higher districts supplied by the New River Company. This would offer an explanation of the high mortality from cholera in the City at that time, supposing the engine were actually used during 1832; but I have not yet been able to ascertain that circumstance with certainty. I know, however, that it was still used occasionally some years later.

=TABLE II.=

┌────────────────────┬───────────┬────────┬───────────┬──────────────────────┐ │ │ │ Deaths │Deaths from│ │ │ Districts. │Population.│ from │Cholera in │ Water Supply. │ │ │ │Cholera.│ 10,000 │ │ │ │ │ │ living. │ │ ├────────────────────┼───────────┼────────┼─────┬─────┼──────────────────────┤ │ │ │ │ │ │Southwark Water Works,│ │St. George the │ │ │ │ │ from Thames at │ │ Martyr, Southwark}│ 77,796│ 856│ 110│ │ London Bridge. No │ │ │ │ │ │ │ filter or settling │ │ │ │ │ │ │ reservoir. │ │St. Olave’s, │ „ │ „ │ „ │ │ „ │ │ Southwark} │ │ │ │ │ │ │St. Saviour’s, │ „ │ „ │ „ │ │ „ │ │ Southwark} │ │ │ │ │ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chiefly by Lambeth │ │ │ │ │ │ │ Water Works, from │ │Christchurch, │ 13,705│ 35│ 25}│ │ Thames opposite │ │ Southwark │ │ │ │ │ Hungerford Market. │ │ │ │ │ │ │ No filter or │ │ │ │ │ │ │ settling reservoir. │ │Lambeth │ 87,856│ 337│ 38}│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chiefly by South │ │ │ │ │ │ │ London Water Works, │ │Newington │ 44,526│ 200│ 45}│ │ from Thames at │ │ │ │ │ │ │ Vauxhall Bridge. │ │ │ │ │ │ │ Reservoirs. No │ │ │ │ │ │ │ filter. │ │Camberwell │ 28,231│ 107│ 37}│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │South London Water │ │Bermondsey │ 29,741│ 210│ 70}│ │ Works, & Tidal │ │ │ │ │ │ │ Ditches. │ │Rotherhithe │ 12,875│ 19│ 14}│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │East London │ │Bethnal Green │ 62,018│ 170│ 27}│ 42{ │ Waterworks, from │ │ │ │ │ │ │ tidal part of river │ │ │ │ │ │ │ Lea at Old Ford. │ │St. │ 38,505│ 123│ 31}│ „ │ „ │ │ George-in-the-East│ │ │ │ │ │ │Poplar │ 25,066│ 107│ 42}│ „ │ „ │ │Stepney │ 78,826│ 225│ 28}│ „ │ „ │ │Whitechapel[12] │ 52,848│ 470│ 88}│ „ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │New River Company, │ │ │ │ │ │ │ from various │ │ │ │ │ │ │ springs, and river │ │ │ │ │ │ │ Lea in │ │Clerkenwell │ 47,634│ 65│ 13}│ 34{ │ Hertfordshire; and │ │ │ │ │ │ │ occasionally from │ │ │ │ │ │ │ Thames at Broken │ │ │ │ │ │ │ Wharf, near │ │ │ │ │ │ │ Blackfriar’s Bridge.│ │St. Giles │ 52,907│ 280│ 52}│ „ │ „ │ │Holborn │ 27,334│ 46│ 16}│ „ │ „ │ │Islington │ 37,316│ 39│ 10}│ „ │ „ │ │London City │ 55,798│ 359│ 64}│ „ │ „ │ │East and West London│ No return.│ │ }│ „ │ „ │ │St. Luke’s │ 46,642│ 118│ 25}│ „ │ „ │ │Strand │ 9,937│ 37│ 37}│ „ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │New River and East │ │Hackney │ 7,326│ 8│ 10 }│ │ London Water │ │ │ │ │ │ │ Companies. │ │Shoreditch │ 68,564│ 57│ 8 }│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chelsea Water Works, │ │Westminster │ 124,585│ 325│ 26│ │ from Thames at │ │ │ │ │ │ │ Chelsea. Reservoirs │ │ │ │ │ │ │ and filters. │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chelsea Water Works │ │ │ │ │ │ │ and Grand Junction │ │St. George, Hanover │ │ │ │ │ Water Works, also │ │ Sq. │ 58,209│ 74│ 12}│ 15{ │ supplying water from│ │ │ │ │ │ │ Thames at Chelsea, │ │ │ │ │ │ │ and having settling │ │ │ │ │ │ │ reservoirs. │ │Kensington │ 75,130│ 134│ 17}│ „ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │West Middlesex Water │ │St. Marylebone │ 122,206│ 224│ 20│ │ Works, from Thames │ │ │ │ │ │ │ at Hammersmith. │ │ │ │ │ │ │ Settling reservoirs.│ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │West Middlesex, New │ │St. Pancras │ 103,548│ 111│ 10│ │ River, and Hampstead│ │ │ │ │ │ │ Water Works. │ └────────────────────┴───────────┴────────┴─────┴─────┴──────────────────────┘

[Sidenote: THE EPIDEMIC OF 1849.]

Westminster suffered more in 1832 than St. George, Hanover Square, and Kensington, which at that time had the same water. This arose from the poor and crowded state of part of its population. The number of cases of cholera communicated by the water would be the same in one district as in the other; but in one district the disease would spread also from person to person more than in the others.

Between 1832 and 1849 many changes took place in the water supply of London. The Southwark Water Company united with the South London Water Company, to form a new Company under the name of the Southwark and Vauxhall Company. The water works at London Bridge were abolished, and the united company derived their supply from the Thames at Battersea Fields, about half a mile above Vauxhall Bridge. The Lambeth Water Company continued to obtain their supply opposite to Hungerford Market; but they had established a small reservoir at Brixton.

But whilst these changes had been made by the water companies, changes still greater had taken place in the river, partly from the increase of population, but much more from the abolition of cesspools and the almost universal adoption of waterclosets in their stead. The Thames in 1849 was more impure at Battersea Fields than it had been in 1832 at London Bridge. A clause which prevented the South London Water Company from laying their pipes within two miles of the Lambeth Water Works was repealed in 1834, and the two Companies were in active competition for many years, the result of which is, that the pipes of the Lambeth Water Company and those of the Southwark and Vauxhall Company pass together down all the streets of several of the south districts. As the water of both these Companies was nearly equal in its impurity in 1849, this circumstance was of but little consequence at that time; but it will be shown further on that it afterwards led to very important results.

On the north side of the Thames the Water Companies and their districts remained the same, but some alterations were made in the sources of supply. The East London Water Company ceased to obtain water at Old Ford, and got it from the river Lea, above Lea Bridge, out of the influence of the tide and free from sewage, except that from some part of Upper Clapton. The Grand Junction Company removed their works from Chelsea to Brentford, where they formed large settling reservoirs. The New River Company entirely ceased to employ the steam engine for obtaining water from the Thames. The supply of the other Water Companies remained the same as in 1832.

The accompanying table (No. 3), shows the mortality from cholera in the various registration districts of London in 1849, together with the water supply. The annual value of house and shop-room for each person is also shown, as a criterion, to a great extent, of the state of overcrowding or the reverse. The deaths from cholera and the value of house room, are taken from the “Report on the Cholera of 1849,” by Dr. Farr, of the General Register Office. The water supply is indicated merely by the name of the Companies. After the explanation given above of the source of supply, this will be sufficient. It is only necessary to add, that the Kent Water Company derive their supply from the river Ravensbourne, and the Hampstead Company from springs and reservoirs at Hampstead.

=TABLE III,=

Showing the mortality from Cholera, and the Water Supply, in the
Districts of London, in 1849. The Districts are arranged in the order of
their Mortality from Cholera.

┌─────────────┬──────────┬────────┬─────────┬──────┬─────────────────────────┐ │ │ │ │ │Annual│ │ │ │ │ │ │value │ │ │ │ │ │ │ of │ │ │ │Population│ Deaths │Deaths by│House │ │ │ District. │ in the │ from │ Cholera │& Shop│ Water Supply. │ │ │middle of │Cholera.│to 10,000│ room │ │ │ │ 1849. │ │inhabits.│ to │ │ │ │ │ │ │ each │ │ │ │ │ │ │person│ │ │ │ │ │ │in £. │ │ ├─────────────┼──────────┼────────┼─────────┼──────┼─────────────────────────┤ │ │ │ │ │ │Southwark and Vauxhall │ │Rotherhithe │ 17,208│ 352│ 205│ 4.238│ Water Works, Kent Water│ │ │ │ │ │ │ Works, & Tidal Ditches.│ │St. Olave, │ 19,278│ 349│ 181│ 4.559│Southwark and Vauxhall. │ │ Southwark │ │ │ │ │ │ │St. George, │ 50,900│ 836│ 164│ 3.518│Southwark and Vauxhall, │ │ Southwark │ │ │ │ │ Lambeth. │ │Bermondsey │ 45,500│ 734│ 161│ 3.077│Southwark and Vauxhall. │ │St. Saviour, │ 35,227│ 539│ 153│ 5.291│Southwark and Vauxhall. │ │ Southwark │ │ │ │ │ │ │Newington │ 63,074│ 907│ 144│ 3.788│Southwark and Vauxhall, │ │ │ │ │ │ │ Lambeth. │ │Lambeth │ 134,768│ 1618│ 120│ 4.389│Southwark and Vauxhall, │ │ │ │ │ │ │ Lambeth. │ │Wandsworth │ 48,446│ 484│ 100│ 4.839│Pump-wells, Southwark and│ │ │ │ │ │ │ Vauxhall, river Wandle.│ │Camberwell │ 51,714│ 504│ 97│ 4.508│Southwark and Vauxhall, │ │ │ │ │ │ │ Lambeth. │ │West London │ 28,829│ 429│ 96│ 7.454│New River. │ │Bethnal Green│ 87,263│ 789│ 90│ 1.480│East London. │ │Shoreditch │ 104,122│ 789│ 76│ 3.103│New River, East London. │ │Greenwich │ 95,954│ 718│ 75│ 3.379│Kent. │ │Poplar │ 44,103│ 313│ 71│ 7.360│East London. │ │Westminster │ 64,109│ 437│ 68│ 4.189│Chelsea. │ │Whitechapel │ 78,590│ 506│ 64│ 3.388│East London. │ │St. Giles │ 54,062│ 285│ 53│ 5.635│New River. │ │Stepney │ 106,988│ 501│ 47│ 3.319│East London. │ │Chelsea │ 53,379│ 247│ 46│ 4.210│Chelsea. │ │East London │ 43,495│ 182│ 45│ 4.823│New River. │ │St. George’s,│ 47,334│ 199│ 42│ 4.753│East London. │ │ East │ │ │ │ │ │ │London City │ 55,816│ 207│ 38│17.676│New River. │ │St. Martin │ 24,557│ 91│ 37│11.844│New River. │ │Strand │ 44,254│ 156│ 35│ 7.374│New River. │ │Holborn │ 46,134│ 161│ 35│ 5.883│New River. │ │St. Luke │ 53,234│ 183│ 34│ 3.731│New River. │ │Kensington │ │ │ │ │West Middlesex, Chelsea, │ │ (except │ 110,491│ 260│ 33│ 5.070│ Grand Junction. │ │ Paddington)│ │ │ │ │ │ │Lewisham │ 32,299│ 96│ 30│ 4.824│Kent. │ │Belgrave │ 37,918│ 105│ 28│ 8.875│Chelsea. │ │Hackney │ 55,152│ 139│ 25│ 4.397│New River, East London. │ │Islington │ 87,761│ 187│ 22│ 5.494│New River. │ │St. Pancras │ 160,122│ 360│ 22│ 4.871│New River, Hampstead, │ │ │ │ │ │ │ West Middlesex. │ │Clerkenwell │ 63,499│ 121│ 19│ 4.138│New River. │ │Marylebone │ 153,960│ 261│ 17│ 7.586│West Middlesex. │ │St. James, │ 36,426│ 57│ 16│12.669│Grand Junction, New │ │ Westminster│ │ │ │ │ River. │ │Paddington │ 41,267│ 35│ 8│ 9.349│Grand Junction. │ │Hampstead │ 11,572│ 9│ 8│ 5.804│Hampstead, West │ │ │ │ │ │ │ Middlesex. │ │Hanover Sq. &│ 33,196│ 26│ 8│16.754│Grand Junction. │ │ May Fair │ │ │ │ │ │ ├─────────────┼──────────┼────────┼─────────┼──────┼─────────────────────────┤ │London │ 2,280,282│ 14137│ 62│ │ │ └─────────────┴──────────┴────────┴─────────┴──────┴─────────────────────────┘

A glance at the table shows that in every district to which the supply of the Southwark and Vauxhall, or the Lambeth Water Company extends, the cholera was more fatal than in any other district whatever. The only other water company deriving a supply from the Thames, in a situation where it is much contaminated with the contents of the sewers, was the Chelsea Company. But this company, which supplies some of the most fashionable parts of London, took great pains to filter the water before its distribution, and in so doing no doubt separated, amongst other matters, the greater portion of that which causes cholera. On the other hand, although the Southwark and Vauxhall and the Lambeth Water Companies professed to filter the water, they supplied it in a most impure condition. Even in the following year, when Dr. Hassall made an examination of it, he found in it the hairs of animals and numerous substances which had passed through the alimentary canal. Speaking of the water supply of London generally, Dr. Hassall says:—

“It will be observed, that the water of the companies on the Surrey side of London, viz., the Southwark, Vauxhall, and Lambeth, is by far the worst of all those who take their supply from the Thames.”[13]

In the north districts of London, which suffered much less from cholera than the south districts, the mortality was chiefly influenced by the poverty and crowding of the population. The New River Company having entirely left off the use of their engine in the city, their water, being entirely free from sewage, could have had no share in the propagation of cholera. It is probable also, that the water of the East London Company, obtained above Lea Bridge, had no share in propagating the malady; and that this is true also of the West Middlesex Company, obtaining their supply from the Thames at Hammersmith; and of the Grand Junction Company, obtaining their supply at Brentford. All these Water Companies have large settling reservoirs. It is probable also, as I stated above, that the Chelsea Company in 1849, by careful filtration and by detaining the water in their reservoirs, rendered it in a great degree innocuous.

Some parts of London suffered by the contamination of the pump-wells in 1849, and the cholera in the districts near the river was increased by the practice, amongst those who are occupied on the Thames, of obtaining water to drink by dipping a pail into it. It will be shown further on, that persons occupied on the river suffered more from cholera than others. Dr. Baly makes the following inquiry in his Report to the College of Physicians.[14]

“How did it happen, if the character of the water has a great influence on the mortality from cholera, that in the Belgrave district only 28 persons in 10,000 died, and in the Westminster district, also supplied by the Chelsea Company, 68 persons in 10,000; and, again, that in the Wandsworth district the mortality was only 100, and in the district of St. Olave 181 in 10,000 inhabitants—both these districts receiving their supply from the Southwark Company?”

The water of the Chelsea Company has been alluded to above, but whether this water had any share in the propagation of cholera or not, it is perfectly in accordance with the mode of communication of the disease which I am advocating, that it should spread more in the crowded habitations of the poor, in Westminster, than in the commodious houses of the Belgrave district. In examining the effect of polluted water as a medium of the cholera poison, it is necessary to bear constantly in mind the more direct way in which the poison is also swallowed, as I explained in the commencement of this work. As regards St. Olave’s and Wandsworth, Dr. Baly was apparently not aware that, whilst almost every house in the first of these districts is supplied by the water company, and has no other supply, the pipes of the company extend to only a part of the Wandsworth district, a large part of it having only pump-wells.

The epidemic of 1849 was a continuance or revival of that which commenced in the autumn of 1848, and there are some circumstances connected with the first cases which are very remarkable, and well worthy of notice. It has been already stated (page 3) that the first case of decided Asiatic cholera in London, in the autumn of 1848, was that of a seaman from Hamburgh, and that the next case occurred in the very room in which the first patient died. These cases occurred in Horsleydown, close to the Thames. In the evening of the day on which the second case occurred in Horsleydown, a man was taken ill in Lower Fore Street, Lambeth, and died on the following morning. At the same time that this case occurred in Lambeth, the first of a series of cases occurred in White Hart Court, Duke Street, Chelsea, near the river. A day or two afterwards, there was a case at 3, Harp Court, Fleet Street. The next case occurred on October 2nd, on board the hulk _Justitia_, lying off Woolwich; and the next to this in Lower Fore Street, Lambeth, three doors from where a previous case had occurred. The first thirteen cases were all situated in the localities just mentioned; and on October 5th there were two cases in Spitalfields.

Now, the people in Lower Fore Street, Lambeth, obtained their water by dipping a pail into the Thames, there being no other supply in the street. In White Hart Court, Chelsea, the inhabitants obtained water for all purposes in a similar way. A well was afterwards sunk in the court; but at the time these cases occurred the people had no other means of obtaining water, as I ascertained by inquiry on the spot. The inhabitants of Harp Court, Fleet Street, were in the habit, at that time, of procuring water from St. Bride’s pump, which was afterwards closed on the representation of Mr. Hutchinson, surgeon, of Farringdon Street, in consequence of its having been found that the well had a communication with the Fleet Ditch sewer, up which the tide flows from the Thames. I was informed by Mr. Dabbs, that the hulk _Justitia_ was supplied with spring water from the Woolwich Arsenal; but it is not improbable that water was occasionally taken from the Thames alongside, as was constantly the practice in some of the other hulks, and amongst the shipping generally.

When the epidemic revived again in the summer of 1849, the first case in the sub-district “Lambeth; Church, 1st part,” was in Lower Fore Street, on June 27th; and on the commencement of the epidemic of the present year, the first case of cholera in any part of Lambeth, and one of the earliest in London, occurred at 52, Upper Fore Street, where also the people had no water except what they obtained from the Thames with a pail, as I ascertained by calling at the house. Many of the earlier cases this year occurred in persons employed amongst the shipping in the river, and the earliest cases in Wandsworth and Battersea have generally been amongst persons getting water direct from the Thames, or from streams up which the Thames flows with the tide. It is quite in accordance with what might be expected from the propagation of cholera through the medium of the Thames water, that it should generally affect those who draw it directly from the river somewhat sooner than those who receive it by the more circuitous route of the pipes of a water company.

[Sidenote: THE EPIDEMIC OF 1853, IN LONDON.]

London was without cholera from the latter part of 1849 to August 1853. During this interval an important change had taken place in the water supply of several of the south districts of London. The Lambeth Company removed their water works, in 1852, from opposite Hungerford Market to Thames Ditton; thus obtaining a supply of water quite free from the sewage of London. The districts supplied by the Lambeth Company are, however, also supplied, to a certain extent, by the Southwark and Vauxhall Company, the pipes of both companies going down every street, in the places where the supply is mixed, as was previously stated. In consequence of this intermixing of the water supply, the effect of the alteration made by the Lambeth Company on the progress of cholera was not so evident, to a cursory observer, as it would otherwise have been. It attracted the attention, however, of the Registrar-General, who published a table in the “Weekly Return of Births and Deaths” for 26th November 1853, of which the following is an abstract, containing as much as applies to the south districts of London.

=TABLE IV.=

┌─────────────┬─────────────────────┬───────────────────────────┬────────────┐ │ Water │ Sources of Supply. │ Aggregate of Districts │ Deaths in │ │ Companies. │ │ supplied chiefly by the │ 100,000 │ │ │ │ respective Companies. │inhabitants.│ ├─────────────┼─────────────────────┼────────────┬──────────────┼────────────┤ │ „ │ „ │ │ Deaths by │ │ │ │ │ │Cholera in 13 │ │ │ │ │ │ wks. ending │ │ │ │ │Population. │ Nov. 19. │ „ │ ├─────────────┼─────────────────────┼────────────┼──────────────┼────────────┤ │(1) Lambeth │Thames, at Thames │ │ │ │ │ and (2) │ Ditton and at │ │ │ │ │ Southwark │ Battersea │ │ │ │ │ and │ │ │ │ │ │ Vauxhall │ │ 346,363│ 211│ 61│ │ │ │ │ │ │ │Southwark and│Thames, at Battersea │ │ │ │ │ Vauxhall │ │ 118,267│ 111│ 94│ │ │ │ │ │ │ │(1) Southwark│Thames, at Battersea;│ │ │ │ │ and │ the Ravensbourne, │ │ │ │ │ Vauxhall, │ in Kent, & ditches │ │ │ │ │ (2) Kent │ and wells │ 17,805│ 19│ 107│ └─────────────┴─────────────────────┴────────────┴──────────────┴────────────┘

It thus appears that the districts partially supplied with the improved water suffered much less than the others, although, in 1849, when the Lambeth Company obtained their supply opposite Hungerford Market, these same districts suffered quite as much as those supplied entirely by the Southwark and Vauxhall Company, as was shown in table III, p. 62. The Lambeth water extends to only a small portion of some of the districts necessarily included in the group supplied by both Companies; and when the division is made a little more in detail, by taking sub-districts instead of districts, the effect of the new water supply is shown to be greater than appears in the above table. The Kent Water Company was introduced into the table by the Registrar-General on account of its supplying a small part of Rotherhithe. The following interesting remarks appeared, respecting this portion of Rotherhithe, in the “Weekly Return” of December 10, 1853:—

[Sidenote: THE EPIDEMIC OF 1853.]

“_London Water Supply._—The following is an extract from a letter which the Registrar-General has received from Mr. Pitt, the Registrar of Rotherhithe:—

“‘I consider Mr. Morris’s description of the part of the parish through which the pipes of the Kent Water Company were laid in 1849, is in the main correct; for though the Company had entered the parish, the water was but partially taken by the inhabitants up to the time of the fearful visitation in the above year.

“‘With respect to the deaths in 1849, they were certainly more numerous in the district now generally supplied by the Kent Company than in any other part of the parish. I only need mention Charlotte Row, Ram Alley, and Silver Street,—places where the scourge fell with tremendous severity.

“‘Among the recent cases of cholera, not one has occurred in the district supplied by the Kent Water Company.

“‘The parish of Rotherhithe has been badly supplied with water for many ages past. The people drank from old wells, old pumps, open ditches, and the muddy stream of the Thames.’

“In 1848–9 the mortality from cholera in Rotherhithe was higher than it was in any other district of London. This is quite in conformity with the general rule, that when cholera prevails, it is most fatal where the waters are most impure.”

The following table (which, with a little alteration in the arrangement, is taken from the “Weekly Return of Births and Deaths” for 31st December 1853) shows the mortality from cholera, in the epidemic of 1853, down to a period when the disease had almost disappeared.

The districts are arranged in the order of their mortality from Cholera.

=TABLE V.=

┌──────────────────────┬──────────┬──────┬───────┬───────────────────────────┐ │ │ │Deaths│ │ │ │ │ │ by │ │ │ │ │ │Chol. │Deaths │ │ │ │Population│in 17 │ by │ │ │ Districts. │ in 1853 │wks., │Cholera│ Water Supply. │ │ │ (estim.) │ Aug. │ to │ │ │ │ │21 to │100,000│ │ │ │ │ Dec. │living.│ │ │ │ │ 17, │ │ │ │ │ │1853. │ │ │ ├──────────────────────┼──────────┼──────┼───────┼───────────────────────────┤ │Bermondsey │ 48,128│ 73│ 150│Southwark & Vauxhall. │ │S. Saviour, Southwark │ 35,731│ 52│ 146│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │S. George, Southwark │ 51,824│ 74│ 143│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │St. Olave │ 19,375│ 26│ 134│Southwark & Vauxhall. │ │Rotherhithe │ 17,805│ 20│ 112│South. & Vaux., Kent. │ │Whitechapel │ 79,759│ 78│ 95│East London. │ │Newington │ 64,816│ 37│ 57│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │Kensington,—except │ 73,699│ 40│ 53│West Middlesex, Chelsea, │ │ Paddington │ │ │ │ Grand Junction. │ │Wandsworth │ 50,764│ 26│ 51│South. & Vaux., Pump-wells,│ │ │ │ │ │ River Wandle. │ │St. George (East) │ 48,376│ 21│ 43│East London. │ │Camberwell │ 54,667│ 22│ 40│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │Stepney │ 110,775│ 40│ 34│East London. │ │Lambeth │ 139,325│ 48│ 34│Lambeth, Sou. & Vaux. │ │Greenwich │ 99,365│ 32│ 31│Kent. │ │Marylebone │ 157,696│ 48│ 30│West Middlesex. │ │Westminster │ 65,609│ 19│ 27│Chelsea. │ │St. James, Westminster│ 36,406│ 9│ 25│Grand Junction, New River. │ │Hackney │ 58,429│ 13│ 22│New Riv., East London. │ │Paddington │ 46,305│ 10│ 22│Grand Junction. │ │Shoreditch │ 109,257│ 23│ 21│New Riv., East London. │ │Bethnal Green │ 90,193│ 18│ 20│East London. │ │Poplar │ 47,162│ 9│ 17│East London. │ │West London │ 28,840│ 4│ 14│New River. │ │Hanover Square and May│ 33,196│ 5│ 12│Grand Junction. │ │ Fair │ │ │ │ │ │Islington │ 95,329│ 12│ 12│New River. │ │Chelsea │ 56,538│ 6│ 11│Chelsea. │ │East London │ 44,406│ 4│ 9│New River. │ │London City │ 55,932│ 5│ 9│New River. │ │Clerkenwell │ 64,778│ 5│ 8│New River. │ │Belgrave │ 40,034│ 3│ 7│Chelsea. │ │St. │ 24,640│ 1│ 5│New River. │ │ Martin-in-the-Fields│ │ │ │ │ │St. Pancras │ 166,956│ 8│ 5│New River, Hampstead, West │ │ │ │ │ │ Middlesex. │ │St. Luke │ 54,055│ 2│ 4│New River. │ │Lewisham │ 34,835│ 1│ 3│Kent. │ │Holborn │ 46,571│ 1│ 2│New River. │ │St. Giles │ 54,214│ 1│ 2│New River. │ │Strand │ 44,460│ │ │New River. │ │Hampstead │ 11,986│ │ │Hampst., West Mid’sex. │ ├──────────────────────┼──────────┼──────┼───────┼───────────────────────────┤ │ │ 2,362,236│ 796│ │ │ └──────────────────────┴──────────┴──────┴───────┴───────────────────────────┘

[Sidenote: THE EPIDEMIC OF 1853, IN LONDON.]

It will be observed that Lambeth, which is supplied with water in a great measure by the Lambeth Company, occupies a lower position in the above table than it did in the previous table showing the mortality in 1849. Rotherhithe also has been removed from the first to the fifth place; owing, no doubt, to the portion of the district supplied with water from the Kent Water Works, instead of the ditches, being altogether free from the disease, as was noticed above.

As the Registrar-General published a list of all the deaths from cholera which occurred in London in 1853, from the commencement of the epidemic in August to its conclusion in January 1854, I have been able to add up the number which occurred in the various sub-districts on the south side of the Thames, to which the water supply of the Southwark and Vauxhall, and the Lambeth Companies, extends. I have presented them in the table opposite, arranged in three groups.

=TABLE VI.=

┌───────────────┬──────────────┬──────────────┬──────────────┬───────────────┐ │ │ │ Deaths from │ Deaths by │ │ │Sub-Districts. │Population in │ Cholera in │ Cholera in │ Water Supply. │ │ │ 1851. │ 1853. │ each 100,000 │ │ │ │ │ │ living. │ │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │ │ │ │ │Southwark and │ │St. Saviour, │19,709 │45 │227 │ Vauxhall │ │ Southwark │ │ │ │ Water Company│ │ │ │ │ │ only. │ │St. Olave │8,015 │19 │237 │ „ │ │St. John, │11,360 │7 │61 │ „ │ │ Horsleydown │ │ │ │ │ │St. James, │18,899 │21 │111 │ „ │ │ Bermondsey │ │ │ │ │ │St. Mary │13,934 │27 │193 │ „ │ │ Magdalen │ │ │ │ │ │Leather Market │15,295 │23 │153 │ „ │ │Rotherhithe[15]│17,805 │20 │112 │ „ │ │Wandsworth │9,611 │3 │31 │ „ │ │Battersea │10,560 │11 │104 │ „ │ │Putney │5,280 │ │ │ „ │ │Camberwell │17,742 │9 │50 │ „ │ │Peckham │19,444 │7 │36 │ „ │ │ │ │ │ │ │ │ │ │ │ │Lambeth Water │ │Christchurch, │ │ │ │ Company, and │ │ Southwk. │16,022 │7 │43 │ Southwark and│ │ │ │ │ │ Vauxhall │ │ │ │ │ │ Company │ │Kent Road │18,126 │37 │204 │ „ │ │Borough Road │15,862 │26 │163 │ „ │ │London Road │17,836 │9 │50 │ „ │ │Trinity, │20,922 │11 │52 │ „ │ │ Newington │ │ │ │ │ │St. Peter, │29,861 │23 │77 │ „ │ │ Walworth │ │ │ │ │ │St. Mary, │14,033 │5 │35 │ „ │ │ Newington │ │ │ │ │ │Waterloo (1st │14,088 │1 │7 │ „ │ │ part) │ │ │ │ │ │Waterloo (2nd │18,348 │7 │38 │ „ │ │ part) │ │ │ │ │ │Lambeth Church │18,409 │9 │48 │ „ │ │ (1st part) │ │ │ │ │ │Lambeth Church │26,784 │11 │41 │ „ │ │ (2nd part) │ │ │ │ │ │Kennington (1st│24,261 │12 │49 │ „ │ │ part) │ │ │ │ │ │Kennington (2nd│18,848 │6 │31 │ „ │ │ part) │ │ │ │ │ │Brixton │14,610 │2 │13 │ „ │ │Clapham │16,290 │10 │61 │ „ │ │St. George, │15,849 │6 │37 │ „ │ │ Camberwell │ │ │ │ │ │ │ │ │ │ │ │Norwood │3,977 │ │ │Lambeth Water │ │ │ │ │ │ Company only.│ │Streatham │9,023 │ │ │ „ │ │Dulwich │1,632 │ │ │ „ │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │First 12 │167,654 │192 │114 │Southwk. & │ │ sub-districts│ │ │ │ Vaux. │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │Next 16 │301,149 │182 │60 │Both Companies │ │ sub-districts│ │ │ │ │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │Last 3 │14,632 │ │ │Lambeth Comp. │ │ sub-districts│ │ │ │ │ └───────────────┴──────────────┴──────────────┴──────────────┴───────────────┘

Besides the general result shown in the table, there are some particular facts well worthy of consideration. In 1849, when the water of the Lambeth Company was quite as impure as that of the Southwark and Vauxhall Company, the parish of Christchurch suffered a rather higher rate of mortality from cholera than the adjoining parish of St. Saviour; but in 1853, whilst the mortality in St. Saviour’s was at the rate of two hundred and twenty-seven to one hundred thousand living, that of Christchurch was only at the rate of forty-three. Now St. Saviour’s is supplied with water entirely by the Southwark and Vauxhall Company, and Christchurch is chiefly supplied by the Lambeth Company. The pipes and other property of the Lambeth Company, in the parish of Christchurch, are rated at about £316, whilst the property of the Southwark and Vauxhall Company in this parish is only rated at about £108. Waterloo Road, 1st part, suffered almost as much as St. Saviour’s in 1849, and had but a single death in 1853; it is supplied almost exclusively by the Lambeth Company. The sub-districts of Kent Road and Borough Road, which suffered severely from cholera, are supplied, through a great part of their extent, exclusively by the Southwark and Vauxhall Company; the supply of the Lambeth Company being intermingled with that of the other only in a part of these districts, as may be seen by consulting the accompanying map (No. 2). The rural districts of Wandsworth and Peckham contain a number of pump-wells, and are only partially supplied by the Water Company; on this account they suffered a lower mortality than the other sub-districts supplied with the water from Battersea Fields. In the three sub-districts to which this water does not extend, there was no death from cholera in 1853.

[Sidenote: THE NEW WATER SUPPLY OF THE LAMBETH COMPANY.]

Although the facts shown in the above table afford very strong evidence of the powerful influence which the drinking of water containing the sewage of a town exerts over the spread of cholera, when that disease is present, yet the question does not end here; for the intermixing of the water supply of the Southwark and Vauxhall Company with that of the Lambeth Company, over an extensive part of London, admitted of the subject being sifted in such a way as to yield the most incontrovertible proof on one side or the other. In the sub-districts enumerated in the above table as being supplied by both Companies, the mixing of the supply is of the most intimate kind. The pipes of each Company go down all the streets, and into nearly all the courts and alleys. A few houses are supplied by one Company and a few by the other, according to the decision of the owner or occupier at that time when the Water Companies were in active competition. In many cases a single house has a supply different from that on either side. Each Company supplies both rich and poor, both large houses and small; there is no difference either in the condition or occupation of the persons receiving the water of the different Companies. Now it must be evident that, if the diminution of cholera, in the districts partly supplied with the improved water, depended on this supply, the houses receiving it would be the houses enjoying the whole benefit of the diminution of the malady, whilst the houses supplied with the water from Battersea Fields would suffer the same mortality as they would if the improved supply did not exist at all. As there is no difference whatever, either in the houses or the people receiving the supply of the two Water Companies, or in any of the physical conditions with which they are surrounded, it is obvious that no experiment could have been devised which would more thoroughly test the effect of water supply on the progress of cholera than this, which circumstances placed ready made before the observer.

The experiment, too, was on the grandest scale. No fewer than three hundred thousand people of both sexes, of every age and occupation, and of every rank and station, from gentlefolks down to the very poor, were divided into two groups without their choice, and, in most cases, without their knowledge; one group being supplied with water containing the sewage of London, and, amongst it, whatever might have come from the cholera patients, the other group having water quite free from such impurity.

[Sidenote: EPIDEMIC OF 1854, IN THE SOUTH DISTRICTS OF LONDON.]

To turn this grand experiment to account, all that was required was to learn the supply of water to each individual house where a fatal attack of cholera might occur. I regret that, in the short days at the latter part of last year, I could not spare the time to make the inquiry; and, indeed, I was not fully aware, at that time, of the very intimate mixture of the supply of the two Water Companies, and the consequently important nature of the desired inquiry.

When the cholera returned to London in July of the present year, however, I resolved to spare no exertion which might be necessary to ascertain the exact effect of the water supply on the progress of the epidemic, in the places where all the circumstances were so happily adapted for the inquiry. I was desirous of making the investigation myself, in order that I might have the most satisfactory proof of the truth or fallacy of the doctrine which I had been advocating for five years. I had no reason to doubt the correctness of the conclusions I had drawn from the great number of facts already in my possession, but I felt that the circumstance of the cholera poison passing down the sewers into a great river, and being distributed through miles of pipes, and yet producing its specific effects, was a fact of so startling a nature, and of so vast importance to the community, that it could not be too rigidly examined, or established on too firm a basis.

I accordingly asked permission at the General Register Office to be supplied with the addresses of persons dying of cholera, in those districts where the supply of the two Companies is intermingled in the manner I have stated above. Some of these addresses were published in the “Weekly Returns,” and I was kindly permitted to take a copy of others. I commenced my inquiry about the middle of August with two sub-districts of Lambeth, called Kennington, first part, and Kennington, second part. There were forty-four deaths in these sub-districts down to 12th August, and I found that thirty-eight of the houses in which these deaths occurred were supplied with water by the Southwark and Vauxhall Company, four houses were supplied by the Lambeth Company, and two had pump-wells on the premises and no supply from either of the Companies.

As soon as I had ascertained these particulars I communicated them to Dr. Farr, who was much struck with the result, and at his suggestion the Registrars of all the south districts of London were requested to make a return of the water supply of the house in which the attack took place, in all cases of death from cholera. This order was to take place after the 26th August, and I resolved to carry my inquiry down to that date, so that the facts might be ascertained for the whole course of the epidemic. I pursued my inquiry over the various other sub-districts of Lambeth, Southwark, and Newington, where the supply of the two Water Companies is intermixed, with a result very similar to that already given, as will be seen further on. In cases where persons had been removed to a workhouse or any other place, after the attack of cholera had commenced, I inquired the water supply of the house where the individuals were living when the attack took place.

The inquiry was necessarily attended with a good deal of trouble. There were very few instances in which I could at once get the information I required. Even when the water-rates are paid by the residents, they can seldom remember the name of the Water Company till they have looked for the receipt. In the case of working people who pay weekly rents, the rates are invariably paid by the landlord or his agent, who often lives at a distance, and the residents know nothing about the matter. It would, indeed, have been almost impossible for me to complete the inquiry, if I had not found that I could distinguish the water of the two companies with perfect certainty by a chemical test. The test I employed was founded on the great difference in the quantity of chloride of sodium contained in the two kinds of water, at the time I made the inquiry. On adding solution of nitrate of silver to a gallon of the water of the Lambeth Company, obtained at Thames Ditton, beyond the reach of the sewage of London, only 2·28 grains of chloride of silver were obtained, indicating the presence of ·95 grains of chloride of sodium in the water. On treating the water of the Southwark and Vauxhall Company in the same manner, 91 grains of chloride of silver were obtained, showing the presence of 37·9 grains of common salt per gallon. Indeed, the difference in appearance on adding nitrate of silver to the two kinds of water was so great, that they could be at once distinguished without any further trouble. Therefore when the resident could not give clear and conclusive evidence about the Water Company, I obtained some of the water in a small phial, and wrote the address on the cover, when I could examine it after coming home. The mere appearance of the water generally afforded a very good indication of its source, especially if it was observed as it came in, before it had entered the water-butt or cistern; and the time of its coming in also afforded some evidence of the kind of water, after I had ascertained the hours when the turncocks of both Companies visited any street. These points were, however, not relied on, except as corroborating more decisive proof, such as the chemical test, or the Company’s receipt for the rates.

A return had been made to Parliament of the entire number of houses supplied with water by each of the Water Companies, but as the number of houses which they supplied in particular districts was not stated, I found that it would be necessary to carry my inquiry into all the districts to which the supply of either Company extends, in order to show the full bearing of the facts brought out in those districts where the supply is intermingled. I inquired myself respecting every death from cholera in the districts to which the supply of the Lambeth Company extends, and I was fortunate enough to obtain the assistance of a medical man, Mr. John Joseph Whiting, L.A.C., to make inquiry in Bermondsey, Rotherhithe, Wandsworth, and certain other districts, which are supplied only by the Southwark and Vauxhall Company. Mr. Whiting took great pains with his part of the inquiry, which was to ascertain whether the houses in which the fatal attacks took place were supplied with the Company’s water, or from a pump-well, or some other source.

Mr. Whiting’s part of the investigation extended over the first four weeks of the epidemic, from 8th July to 5th August; and as inquiry was made respecting every death from cholera during this part of the epidemic, in all the districts to which the supply of either of the Water Companies extends, it may be well to consider this period first. There were three hundred and thirty-four deaths from cholera in these four weeks, in the districts to which the water supply of the Southwark and Vauxhall and the Lambeth Company extends. Of these it was ascertained, that in two hundred and eighty-six cases the house where the fatal attack of cholera took place was supplied with water by the Southwark and Vauxhall Company, and in only fourteen cases was the house supplied with the Lambeth Company’s water; in twenty-two cases the water was obtained by dipping a pail directly into the Thames, in four instances it was obtained from pump-wells, in four instances from ditches, and in four cases the source of supply was not ascertained, owing to the person being taken ill whilst travelling, or from some similar cause. The particulars of all the deaths which were caused by cholera in the first four weeks of the late epidemic, were published by the Registrar-General in the “Weekly Returns of Births and Deaths in London,” and I have had the three hundred and thirty-four above enumerated reprinted in an appendix to this edition, as a guarantee that the water supply was inquired into, and to afford any person who wishes it an opportunity of verifying the result. Any one who should make the inquiry must be careful to find the house where the attack took place, for in many streets there are several houses having the same number.

According to a return which was made to Parliament, the Southwark and Vauxhall Company supplied 40,046 houses from January 1st to December 31st, 1853, and the Lambeth Company supplied 26,107 houses during the same period; consequently, as 286 fatal attacks of cholera took place, in the first four weeks of the epidemic, in houses supplied by the former Company, and only 14 in houses supplied by the latter, the proportion of fatal attacks to each 10,000 houses was as follows. Southwark and Vauxhall 71. Lambeth 5. The cholera was therefore fourteen times as fatal at this period, amongst persons having the impure water of the Southwark and Vauxhall Company, as amongst those having the purer water from Thames Ditton.

It is extremely worthy of remark, that whilst only five hundred and sixty-three deaths from cholera occurred in the whole of the metropolis, in the four weeks ending 5th August, more than one half of them took place amongst the customers of the Southwark and Vauxhall Company, and a great portion of the remaining deaths were those of mariners and persons employed amongst the shipping in the Thames, who almost invariably draw their drinking water direct from the river.