TABLE IX.
TABLE IX.
TABLE IX.
The mortality in the houses supplied by the Southwark and Vauxhall Company was therefore between eight and nine times as great as in the houses supplied by the Lambeth Company; and it will be remarked that the customers of the Lambeth Company continued to enjoy an immunity from cholera greater than the rest of London which is not mixed up as they are with the houses supplied by the Southwark and Vauxhall Company.
As regards the period of the epidemic subsequent to the 26th August to which my inquiry extended, I have stated that the Registrar-General requested the District Registrars to make a return of the water supply of the house of attack in all cases of death from cholera. Owing to difficulties such as I explained that I had met with in the beginning of my inquiry, the Registrars could not make the return in all cases, and as they could not be expected to seek out the landlord or his agent, or to apply chemical tests to the water as I had done, the water supply remained unascertained in a number of cases, butthe numbers may undoubtedly be considered to show the correct proportions as far as they extend, and they agree entirely with the results of my inquiry respecting the earlier part of the epidemic given above.
The Registrar-General published the returns of the water supply, which he had obtained from the District Registrars, down to 14th October, in a table which is subjoined. As the whole of the south districts of London were included in the inquiry of the Registrar-General, the deaths in the Greenwich and Lewisham districts, which are supplied by the Kent Water Company, and did not enter into my inquiry, are included in the table, but they do not in the least affect the numbers connected with the other companies.
TABLE X.
TABLE X.
TABLE X.
Now 2,353 deaths in 40,046 houses, the number supplied by the Southwark and Vauxhall Company, are 537 deaths to each 10,000 houses; and 302 deaths to 26,107, the number of houses supplied by the Lambeth Company, are 115 deaths to each 10,000 houses; consequently, inthe second seven weeks of the epidemic, the population supplied by the Southwark and Vauxhall Company continued to suffer nearly five times the mortality of that supplied with water by the Lambeth Company. If the 795 deaths in which the water supply was not ascertained be distributed equally over the other sources of supply in the above table (No.X), the deaths in houses supplied by the Southwark and Vauxhall Company would be 2,830, and in houses supplied by the Lambeth Company would be 363. By adding the number of deaths which occurred in the first seven weeks of the epidemic, we get the numbers in the subjoined table (No.XI), where the population of the houses supplied by the two water companies is that estimated by the Registrar-General.[16]
TABLE XI.
TABLE XI.
TABLE XI.
We see by the above table that the houses supplied with the water from Thames Ditton, by the LambethCompany, continued throughout the epidemic to enjoy an immunity from cholera, not only greater than London at large, but greater than every group of districts, except the north and central groups.
In the next table (No.XII), the mortality from cholera in 1849 is shown side by side with that of 1854, in the various sub-districts to which the supply of the two water companies with which we are particularly interested extends. The mortality of 1854 is down to October 21, and is extracted from a table published in the “Weekly Return of Births and Deaths” of October 28; that of 1849 is from the “Report on Cholera” by Dr. Farr, previously quoted. The sub-districts are arranged in three groups as before, the first group being supplied only by the Southwark and Vauxhall Company, the second group by this Company and the Lambeth, and the third group by the Lambeth Company only. It is necessary to observe, however, that the supply of the Lambeth Company has been extended to Streatham, Norwood, and Sydenham, since 1849, in which year these places were not supplied by any water company. The situation and extent of the various sub-districts are shown, together with the nature of the water supply, in Map 2, which accompanies this work.
TABLE XII.
TABLE XII.
TABLE XII.
THE CHOLERA OF 1849 COMPARED WITH THAT OF 1854.
The table exhibits an increase of mortality in 1854 as compared with 1849, in the sub-districts supplied by the Southwark and Vauxhall Company only, whilst there is a considerable diminution of mortality in the sub-districts partly supplied by the Lambeth Company. In certain sub-districts, where I know that the supply of the Lambeth Water Company is more general than elsewhere, as Christchurch, London Road, Waterloo Road 1st, and Lambeth Church 1st, the decrease of mortality in 1854 as compared with 1849 is greatest, as might be expected. Waterloo Road 1st, which suffered but little from cholera in the present year, is chiefly composed of very dirty narrow streets, in the neighbourhood of Cornwall Road and the New Cut, inhabited by very poor people; and Lambeth Church 1st, which suffered still less, contains a number of skinyards and other factories, between Lambeth Palace and Vauxhall Bridge, which have often been inveighed against as promoting the cholera. The high mortality of the Streatham district in 1849 was caused by the outbreak of cholera in Drouett’s Asylum for pauper children, previously mentioned.
Whilst making inquiries in the south districts of London, I learned some circumstances with respect to the workhouses which deserve to be noticed. In Newington Workhouse, containing 650 inmates, and supplied with the water from Thames Ditton, there had been but two deaths from cholera amongst the inmates down to 21st September, when the epidemic had already greatly declined. In Lambeth Workhouse, containing, if I remember rightly, nearly 1,000 inmates, and supplied with the same water, there had been but one death amongst the inmates when I was there in the first week of September. In St. Saviour’s workhouse, which is situated in the parish of Christchurch, and is supplied with water by the Lambeth Company, no inmate died of cholera before I called in the first week of September. On the other hand, in the workhouse of St. George, Southwark, supplied with the water of the Southwark and Vauxhall Company, six inmates died out of about 600 before the 26th August, when the epidemic had only run one-third of its course. The mortality was also high amongst the inmates of St. Olave’s Workhouse, supplied with water by the Southwark and Vauxhall Company, but I do not know the number who died. I trust, however, that the Registrar
HORSEMONGER LANE GAOL.
General, in giving an account of the recent epidemic, will make a return of the deaths amongst the inmates of the various workhouses and other institutions on the south side of the Thames, together with the water supply of the buildings. Bethlehem Hospital, the Queen’s Prison, Horsemonger Lane Gaol, and some other institutions, having deep wells on the premises, scarcely suffered at all from cholera in 1849, and there was no death in any of them during the part of the recent epidemic to which my inquiry extended.
DISTRICT OF CHELSEA WATER COMPANY.
On the north side of the Thames the mortality during the recent epidemic seems to have been influenced more by the relative crowding and want of cleanly habits of the people, and by the accidental contamination of the pump-wells, than by the supply of the water companies. The water of the New River Company could have no share in the propagation of cholera, as I explained when treating of the epidemic of 1849; and the extensive districts supplied by this company have been very slightly visited by the disease, except in certain spots which were influenced by the causes above mentioned. The water of the East London Company is also free from the contents of sewers, unless it be those from the neighbourhood of Upper Clapton, where there has been very little cholera. The districts supplied by this company have been lightly visited, except such as lie near the Thames, and are inhabited by mariners, coal and ballast-heavers, and others, who are employed on the river. Even Bethnal Green and Spitalfields, so notorious for their poverty and squalor, have suffered a mortality much below the average of the metropolis. The Grand Junction Company obtain their supply at Brentford, within the reach of the tide and near a large population, but they detain the water in large reservoirs, and their officers tell me they filter it; at allevents, they supply it in as pure a state as that of the Lambeth Company obtained at Thames Ditton, and their districts have suffered very little from cholera except at the spot where the irruption occurred from the contamination of the pump-well in Broad Street, Golden Square. The West Middlesex Company, obtaining their supply from the Thames at Hammersmith, have also very large reservoirs, and the districts they supply have suffered but little from cholera, except the Kensington brick fields, Starch Green, and certain other spots, crowded with poor people, chiefly Irish.
CHOLERA IN THE DISTRICT OF THE CHELSEA WATER COMPANY.
The districts supplied by the Chelsea Company have suffered a much greater mortality, during the recent epidemic, than the average of the whole metropolis, as the subjoined table (No.XIII) shows. But the mortality in these districts is only half as great as in the houses supplied by the Southwark and Vauxhall Company, who obtain their supply from the Thames just opposite the spot where the Chelsea Company obtain theirs. The latter company, however, by detaining the water in their reservoirs, and by filtering it, are enabled to distribute it in a state of comparative purity; but I had ample opportunities of observing, in August and September last, that this was far from being the state of the water supplied by the Southwark and Vauxhall Company. Many of the people receiving this latter supply were in the habit of tying a piece of linen or some other fabric over the tap by which the water entered the butt or cistern, and in two hours, as the water came in, about a tablespoon of dirt was collected, all in motion with a variety of water insects, whilst the strained water was far from being clear. The contents of the strainer were shown to me in scores of instances. I do not, of course, attribute the cholera either to the insects or the visible dirt; but it is extremely probable that the measures adopted by the Chelsea Companyto free the water from these repulsive ingredients, either separated or caused the destruction of the morbid matter of cholera. It is very likely that the detention of the water in the company’s reservoirs permitted the decomposition of the cholera poison, and was more beneficial than the filtering, for the following reasons. The water used in Millbank Prison, obtained from the Thames at Millbank, was filtered through sand and charcoal till it looked as clear as that of the Chelsea Company; yet, in every epidemic, the inmates of this prison suffered much more from cholera than the inhabitants of the neighbouring streets and those of Tothill Fields Prison, supplied by that company.[18]In the early part of August last, the use of the Thames water was entirely discontinued in Millbank Prison, and water from the Artesian well in Trafalgar Square was used instead, on the recommendation of Dr. Baly, the physician to the prison. In three or four days after this change, the cholera, which was prevailing to an alarming extent, entirely ceased.
TABLE XIII.
TABLE XIII.
TABLE XIII.
The quantity of impurity in the Thames was greatly increased during the late autumn, by the long course of dry weather. From 5th August to 12th September, a period of more than five weeks, only 0·29 of an inch of rain fell at Greenwich, as appears by the report of the Astronomer Royal. The stream of the Thames above the reach of the tide became so slender, that it was difficult to navigate barges above Richmond. The Thames in London is a very large body of water, and if the whole of it flowed away into the sea every day, the liquid which flows down the sewers in twelve hours would form but a very small part of it; but it must be remembered that the quantity of water which passes out to sea, with the ebb of every tide, is only equal to that which flows over Teddington Lock, and from a few small tributary streams. In hot dry weather this quantity is moreover greatly diminished by the evaporation taking place from the immense surface of water exposed between Richmond and Gravesend, so that the river becomes a kind of prolonged lake, the same water passing twice a day to and fro through London, and receiving the excrement of its two millions and more of inhabitants, which keeps accumulating till there is a fall of rain. In time of cholera, the evacuations of the patients keep accumulating in the river along with the other impurities; and it is probably in this way that the dry weather with a high barometer aids in promoting cholera, as it has often been observed to do.
IMPURITY OF THE THAMES.
I thought at first that the quantity of common salt, previouslymentioned as being present in the water of the Southwark and Vauxhall Company, consisted entirely of the salt which had passed down the sewers into the river, for I had no idea that any admixture of sea water reached as high as Battersea Fields. Mr. Quick, the engineer of the above Company, informed me, however, that an impregnation of salt water does extend as far after a long course of dry weather. It is obvious that a dry season, whilst it increases the quantity of impurity in the Thames, must also cause the sea water to flow further inland than at other times. I did not examine the water of the Thames in August or September, but I have done so now, at the latter part of November, and I am inclined to think that even yet a slight admixture of sea water may reach to Battersea Fields with every tide. I found 5·8 grains of chloride of sodium per gallon in water obtained at Hungerford Market, at half-flow of the tide, on 19th November, and 19·1 grains per gallon, in water obtained at the same place, on 27th November, at an hour and a half before high water; whilst water obtained at London Bridge, on 28th November, at high water, contained 63·3 grains per gallon.
A specimen of water obtained on 21st November, from a house supplied by the Southwark and Vauxhall Company, contained 28·8 grains of common salt per gallon, or about three-quarters as much as it contained in September, when the quantity was 37·9 grains. It is very obvious from the above analyses, that the Water Company obtain their supply from the Thames at high water, or nearly so, although this is the time of the tide when the water contains the greatest amount of impurity. It is quite certain that the sea water cannot reach to Thames Ditton, any more than the contents of the London sewers, and therefore, whatever may be its source, thequantity of chloride of sodium in the water is quite conclusive as regards the purpose for which I examined into it, viz., to distinguish between the water of the two Companies.
When the water of the Southwark and Vauxhall Company was examined by Messrs. Graham, Miller, and Hofmann, at the latter part of January 1851, it contained only 1·99 grains of chloride of sodium, or about one-twentieth as much as it contained last September, and one-fifteenth as much as on 21st November 1854.[19]
ALLEGED EFFECT OF LEVEL.
Dr. Farr discovered a remarkable coincidence between the mortality from cholera in the different districts of London in 1849, and the elevation of the ground; the connection being of an inverse kind, the higher districts suffering least, and the lowest suffering most from this malady. Dr. Farr was inclined to think that the level of the soil had some direct influence over the prevalence of cholera, but the fact of the most elevated towns in this kingdom, as Wolverhampton, Dowlais, Merthyr Tydvil, and Newcastle-upon-Tyne, having suffered excessively from this disease on several occasions, is opposed to this view, as is also the circumstance of Bethlehem Hospital, the Queen’s Prison, Horsemonger Lane Gaol, and several other large buildings, which are supplied with water from deep wells on the premises, having nearly or altogether escaped cholera, though situated on a very low level, and surrounded by the disease. The fact of Brixton, at an elevation fifty-six feet above Trinity high-water mark, having suffered a mortality of 55 in 10,000, whilst many districts on the north of the Thames, at less than half theelevation, did not suffer one-third as much, also points to the same conclusion.
I expressed the opinion in 1849,[20]that the increased prevalence of cholera in the low-lying districts of London depended entirely on the greater contamination of the water in these districts, and the comparative immunity from this disease of the population receiving the improved water from Thames Ditton, during the epidemics of last year and the present, as shown in the previous pages, entirely confirms this view of the subject; for the great bulk of this population live in the lowest districts of the metropolis.
The prevalence of cholera has been very much under the influence of the water supply in other towns besides London. The cholera has prevailed to a considerable extent in the crowded habitations of the poor in Liverpool and some other towns, where the general supply of water was not in fault, but I know of no instance in which it has spread through all classes of the community, except where the general supply of water has been contaminated with the contents of the drains and sewers; and all the towns with which I am acquainted that have enjoyed an almost complete immunity from this disease, have a water supply quite free from any chance of contamination. Birmingham, Bath, Cheltenham, and Leicester have nearly escaped the cholera in every epidemic. The few cases that have occurred being chiefly those of persons newly arrived from places where the disease was prevailing, and a few others who came in communication with them. All these towns have a supply of water quite free from connection with the drains and sewers, and the small rivers which flow through them are so impure that it would beimpossible to drink the water. Leicester is crowded with a poor population, and has hardly any physical advantage except its water supply.
CHOLERA IN EXETER.
The first cases of cholera in Exeter in 1832, were three in the same day, besides one in St. Thomas’s, a suburb of Exeter, in a gentleman just arrived from London, where the disease was prevailing. The other three were a woman and her two children; the former, with one of her children, had returned from Plymouth the previous day, where she had been nursing a child that had died of the cholera. Within five days from this time, there were seven fresh cases in as many different parts of the town, amongst persons having no intercourse with each other or the first cases. The disease soon became very prevalent, and in three months there were 1,135 cases, and 345 deaths. Exeter is situated on ground which rises from the edge of the river to an elevation of one hundred and fifty feet. In 1832 the inhabitants were chiefly supplied with river water by water-carriers, who conveyed it in carts and pails. Dr. Shapter, from whose work[21]the above particulars are obtained, kindly furnished me with information concerning the sewers, and with maps of their position. The water-carriers, by whom Exeter was very greatly supplied, obtained their water almost exclusively from certain streams of water, diverted from the river in order to turn water-mills; and one of the chief sewers of the town, which receives such sewage as might come from North Street, in which the first cases of cholera occurred, empties itself into the branch from the river which divides into the two mill-streams just mentioned. It must be remarked that the parish of St. Edmund, in which these streams of water were situated, had a lower mortality from cholera than other parts of thetown like it, densely populated and on low ground near the river. Dr. Shapter attributes this lower rate of mortality, and I believe rightly, to St. Edmund’s being freely intersected by running streams of water. The people would probably not drink more of the water than in parts of the town where it was less plentiful, and had to be paid for, but they would have much better opportunities for personal cleanliness: so that whilst they would be exposed to only the same number of scattered cases, they would be less likely to have the malady spreading through families, and by personal intercourse. After the cholera of 1832, measures were taken to afford a better supply of water to Exeter; not, so far as I can find by Dr. Shapter’s work, that its impurity was complained of, but because of its scarcity and cost. Waterworks were established on the river Exe, two miles above the town, and more than two miles above the influence of the tide. Exeter has since been very plentifully supplied with this water, and Dr. Shapter informed me that in 1849 there were only about twenty cases of cholera, nearly half of which occurred in strangers coming into the town, and dying within two or three days after their arrival. This last summer there was only one death from cholera in Exeter.
CHOLERA IN HULL.
We will now consider the town of Hull, in which, together with other sanitary measures adopted since 1832, there has been a new and more plentiful supply of water, but with a far different result to that at Exeter. In 1832 Hull was scantily supplied with water conveyed in pipes from springs at Anlaby, three miles from the town. About 1844, new waterworks were established to afford a more plentiful supply. These works were situated on the river Hull, at Stoneferry, two miles and three quarters from the confluence of that river with the Humber. About half the sewage of the town is delivered into theriver of the same name, the rest being discharged into the Humber, as appears from information and a map kindly furnished me in 1849 by Dr. Horner of Hull, who was making great efforts to have better water obtained for the town. The tide flows up the river many miles past the waterworks, carrying up with it the filth from the sewers. The supply of water was, to be sure, obtained when the tide was down, but as the banks of the river are clothed with sedges in many parts, and its bottom deep with mud, the water can never be free from sewage. Moreover, there are some parts of the river above Stoneferry much deeper than the rest, and where the deeper water is, according to the testimony of boatmen, nearly stagnant; thus allowing the water carried up by the tide to remain and gradually mix with that afterwards flowing down. There are also boats, with families on board, passing up the river to the extent of five thousand voyages in the year. The water when taken from the river was allowed to settle in the reservoir for twenty-four hours, and was then said to be filtered before being sent to the town. In 1832 the cholera was confined almost exclusively to the poor, and the deaths amounted to three hundred.
In 1849 the deaths in Hull (including the suburb of Sculcoates) were 1834, although 8,000 or 10,000 left the town, it is said, to avoid the ravages of the disease. Dr. Horner informed me that the deaths occurred amongst all classes of the community, and that the town was much better drained in 1849 than in 1832.
CHOLERA IN YORK.
When the cholera made its appearance at York, about the middle of July 1849, it was at first chiefly prevalent in some narrow streets near the river, called the Water Lanes. The inhabitants of this spot had been in the habit, from time immemorial, of fetching their water from the river at a place near which one of the chief sewers ofthe town empties itself; and recently a public necessary had been built, the contents of which were washed every morning into the river just above the spot at which they got the water. In a short time from twenty to thirty deaths occurred in this locality; but the medical men considering the impure water injurious, the people were supplied from the waterworks, with water obtained from the river at a point some distance above the town, and the cholera soon ceased nearly altogether in this part of the city, but continued to spread in some other parts. The cholera having thus abated in the Water Lanes, the gratuitous supply of water was cut off, and the people went to the river as before. There were still cases of cholera in the town, and it soon broke out again in this locality, and in the first few days of September eight deaths occurred among the persons who used water obtained direct from the river. The tap for general use was again opened, and the river water interdicted, and the cholera again ceased, and did not recur. These circumstances were communicated to me by a friend on whose accuracy I can rely.
The inhabitants of Dumfries drink the water of the river Nith, which flows through the town, and into which the sewers discharge their contents, which float afterwards to and fro with the tide. In 1832 there were 418 deaths from cholera out of a population of 11,606, being at the rate of 360 in 10,000, or 1 in every 28 of the inhabitants. The cholera again visited Dumfries at the close of 1848, and carried off 431 persons, or 1 in every 32, out of a population now numbering 14,000; so that the mortality was excessive on both occasions.
Preston and Oldham, in Lancashire, are supplied with water from surface drainage on the neighbouring hills, and there was scarcely any cholera at either of theseplaces in 1849. The greater part of the town of Paisley is supplied in a similar way; and I was informed that the cases of cholera which occurred there in 1849 were confined to a quarter of the town to which this supply of water does not extend. Nottingham is supplied with filtered water obtained from the river Trent, some distance above the town. In 1832 this supply did not extend to all the inhabitants, and the cholera was somewhat prevalent amongst the poor, of whom it carried off 289; the population of the town being 53,000. After that time the water was extended copiously to all the inhabitants, and there were but thirteen deaths from the epidemic in 1849. The local Sanitary Committee placed the supply of water amongst the chief causes of this immunity from cholera, and I believe justly. There were but seven deaths from cholera in Nottingham last summer.
CHOLERA IN GLASGOW.
Glasgow has been supplied, since the early part of the present century, with the water of the Clyde, obtained a little way above the town, but within the influence of the tide, and consequently mixed with the contents of the sewers. It is imperfectly filtered through sand. In 1847, however, the parish of Gorbals, which forms the south part of Glasgow, was furnished with a supply of water collected on the neighbouring hills; and Dr. Leech, of Glasgow, speaks as follows respecting the influence of this water on the prevalence of cholera: “During the late cholera there was a remarkable circumstance, which deserves notice as compared with the epidemic of 1832. Since the former period, the population of Glasgow, south of the Clyde, has nearly doubled; and with this exception, and the introduction of the soft-water supply, the circumstances might be considered as the same at both periods. In one district, the parish of Gorbals, the attack in 1832 was fearful; while Glasgow, north of the Clyde,also suffered severely. During the late epidemic [that of 1848–49], Gorbals parish furnished comparatively a small number of cases; while the epidemic in other parts of Glasgow was very severe. The unanimous opinion of the Medical Society was, that this comparative immunity was to be attributed to the soft-water supply.”[22]
CHOLERA IN NEWCASTLE.
I was informed that when the cholera was prevalent in Glasgow last winter, the parish of Gorbals again enjoyed a similar immunity from the disease.
The following passage respecting the water supply of Paris is from Dr. Farr’s “Report to the Registrar-General on the Cholera of 1848–49”:—“The supply of Paris is from various sources, but four-fifths of the water is from the Canal de l’Ourque, which, by the decision of Napoleon, was also appropriated to navigation. The water for some years, and in 1832, when the epidemic was so fatal, was drawn from the dirty basin in which the boats and barges of the canals rested; but is now drawn from the canal before it enters the basin.... The mortality of cholera in Paris was excessive, and in 1832 varied from 80, of 10,000 inhabitants, in the elegant Chaussée d’Antin and in Montmartre on the heights, to 530 and 520 in the low quartiers of the Hôtel de Ville and the Cité.” (p. lxxviii.)
The town of Newcastle-upon-Tyne affords a remarkable instance of the influence of the water supply on the prevalence of cholera. In 1831–32 there were no waterworks at Newcastle; it was supplied, in an insufficient manner, with spring water, which generally had to be carried some distance to the houses from “pants” in the streets. The epidemic was pretty severe at this time. From November 1831 to November 1832 there were 801 deaths from cholera out of a population of 42,760. The disease prevailedchiefly amongst the poor, and was worst in the least elevated parts of the town, near the river. Subsequently to 1832, waterworks were established on the river Tyne, a little above the town; but these were abandoned, in 1848, in favour of a supply from a rivulet and springs at Whittle Dean, about ten miles distant. In 1849, there were but 295 deaths from cholera in a population then increased to 71,847. In the beginning of July 1853, two months before the reappearance of cholera in England, the Whittle Dean Water Company found their proper sources insufficient for the demands of the population and the various factories, and they made use of the former waterworks, mentioned above, to obtain water from the Tyne. The point at which they obtained water from the river, is scarcely a mile above Newcastle, and the tide flows for six miles above the town, carrying the contents of the sewers with it. There are also villages, containing several thousands of colliers and ironfounders, on the banks of the Tyne, above the waterworks. The water from the Tyne was mixed, without filtration, with that from Whittle Dean, to the extent of one-third; and the mixed water, so supplied, was discoloured, and contained the large quantity of 7·1 grains of organic matter per gallon.
In the autumn of 1853, the cholera was prevailing extensively at Hamburgh, and in nearly all the ports of the Baltic, whence a number of ships were arriving every day in the Tyne. The first cases of cholera commenced, with diarrhœa, on the 27th and 28th August, at Bell Quay, on the banks of the Tyne, three miles below Newcastle. One of the patients from Bell Quay was taken worse whilst on a visit to her mother at Newcastle: she died on 2nd September. Her mother was taken ill the same evening, and died on the following day. Other cases occurred in Newcastle on the 1st and 2nd of September, having noconnexion with these. A ship from Bremen was lying at Bell Quay, opposite the house where the first cases occurred; but there had been no illness on board this ship, and the precise way in which the cholera was introduced on this occasion, is not known.
The disease soon spread to an extent almost unprecedented in this country: by the 15th of September the deaths exceeded a hundred a day. In nine weeks there were 1,533 deaths from cholera in a population of 86,114, being 178 to each 10,000 inhabitants; but the greater number of these deaths occurred in a few days, as 1001 took place from the 13th to the 23rd Sept. inclusive.[23]
Gateshead, which is situated opposite to Newcastle, on the other side of the Tyne, is supplied with the same water; and in 1849 it shared with that town a comparative immunity from cholera, whilst in the autumn of 1853, 433 persons died of that disease out of a population of 26,000, or thereabouts, being 166 to each 10,000 inhabitants.
The lowest streets in Newcastle and Gateshead are about five feet above high-water mark; and only a few streets are situated at this level, for the banks rise very abruptly, at a little distance from the river, on both sides. A great portion of each town is elevated nearly 200 feet above the river, and some parts are nearly 300 feet high; yet the Water Company supplies all these districts, and all were severely visited by the cholera, which on this occasion spared no class of the community. In the districts which are most crowded, the mortality was greatest, the deaths being much more numerous in the parishes which contained a great number of tenements consisting of a single room, than in those which consisted chiefly of housesoccupied by one family.[24]This, however, is quite in accordance with the principles which I am throughout endeavouring to explain. A great deal of stress is laid, very properly, by the Commissioners who have reported respecting this outbreak, on the ill-arranged buildings, the defective drainage, and want of privy accommodation, in Newcastle; but it must be remembered that all these evils existed in 1849, when Newcastle escaped with less cholera than most towns,—to a greater extent than they did in 1853, for many improvements had taken place in the meantime.
In consequence of a great outcry on the part of the public, who naturally connected the great fatality of cholera in some measure with the turbidity and offensive smell of the drinking water, the Company entirely ceased to draw water from the Tyne on the 15th September; and although the Tyne water was not entirely out of the pipes for a day or two, the deaths, which had been rapidly increasing, began to diminish on the 17th, and were lessened considerably by the 20th. The following is the course of the mortality in Newcastle, in the most fatal part of the epidemic; and it began to decline at exactly the same time in Gateshead:
The late General Board of Health directed one of their medical inspectors, Dr. Waller Lewis, to make minute inquiry as to the relative effects produced by the use of pure spring water, and that of the Water Company, during the epidemic of cholera in Newcastle; and it is much to be regretted that the inquiry was not carried out. To have conducted the inquiry through the whole of Newcastleand Gateshead would not have entailed a quarter as much labour as my investigations in Lambeth, Newington, and the Borough. Dr. Lewis called on Mr. Main, the secretary of the Water Company, and they made an inquiry in certain houses, taken at random, through three streets, and also in Greenhow Terrace, where a severe outbreak of cholera had occurred, although it was not supplied by the Company, but had what was reported to be good spring water. Dr. Lewis gave up the inquiry because he could not find two places exactly alike in all their physical conditions,—one place supplied with spring water, the other by the Company. He made no report of what he had done; but Mr. Main sent a paper on the subject of this commenced inquiry to the Pathological Society of Newcastle, an abstract of which appeared in the “Medical Times and Gazette”.
By adding Greenhow Terrace to the streets partly supplied by the Company, and by including cases of cholera, fatal or otherwise, with those of mere diarrhœa, Mr. Main was able to show a result apparently in favour of the Company’s water. He was good enough, however, to send me a copy of his paper, which contains the details of the inquiry as far as it extended; and I found, on perusing it, that, leaving out Greenhow Terrace, which is not supplied by the Company at all, there was no case of cholera, either fatal or otherwise, and no case, even of approaching cholera, in any house which was not supplied with the Company’s water. All the deaths and all the cholera occurred in the houses having this water, whilst in the houses having only pump-water, there was simply diarrhœa. In the workhouse, supplied by the Water Company, and having five hundred and forty inmates, there were twelve cases of cholera, or approaching cholera, and seven deaths; whilst in the military barracks, supplied fromwells on the premises, and having five hundred and nineteen inmates, although there was a good deal of harmless diarrhæa, there was no cholera, nor any case of approaching cholera.