(7) CONFERENCE ON MONDAY, JUNE 9TH, 1884. 66 I. The Domestic Sanitary Arrangements of the Metropolitan Poor." 2. "The Improvement of the Sanitary Arrangements of Metropolitan Houses." By ERNEST TURNER, F.R.I.B.A. Chairman: T. ORME DUDFIELD, Esq., M.D. Chairman of the Conference Joint-Committee; President of the Society of Medical Officers of Health; Medical Officer of Health for Kensington, &c. It was THE CHAIRMAN, in opening the proceedings, stated that the Conference had been organised, at the request of the Executive Council of the Health Exhibition, by the Parkes Museum of Hygiene, the Sanitary Institute of Great Britain, and the Society of Medical Officers of Health. intended, originally, that each society should have a Conference of its own, managed by its own council, but it appearing probable that the subjects to be dealt with by the three societies-which were all working on similar lines-might overlap, it was thought desirable, by the Executive Council, that the societies should amalgamate for the purpose of holding a Conference in common. A Joint-Committee, therefore, had been appointed to make the necessary arrangements, and he ventured to hope that the programme drawn up, and which was in the hands of most of those present, would be found sufficiently interesting, embracing as it did many subjects of considerable importance to sanitarians and to the public generally, whether in town or country. After briefly referring to the subjects of the papers to be read on the six days over which the Conference would be continued, and to the special qualifications of Dr. Tripe and Mr. Ernest Turner to deal with the subject assigned to them, and with which they would deal, the one from the medical and the other from the architectural point of view, the Chairman called upon Dr. Tripe to read his paper. THE DOMESTIC SANITARY ARRANGEMENTS OF THE POOR. METROPOLITAN By JOHN W. TRIPE, M.D., M.R.C.P., Ed., &c. WHEN I was requested to read a brief Paper on this wellworn subject in conjunction with Mr. Ernest Turner, the first question which suggested itself to me was, Who are the poor concerning whom I have to address you? The word embraces a very great variety, I may say not only of persons but of classes; not merely the two great classes of the deserving and the undeserving poor, that is to say, (a) those who are poor from the force of circumstances over which they have no control, and (b) those who are poor from indulgence in vice, and even crime, but also a multitude of others who obtain an honest living as hawkers, costermongers, needle-women, matchbox makers, workers in manufactories, and others. I do not, however, propose to mention the domestic arrangements of any particular class, but to take the word "poor" in its broadest sense as including all those who live in very small houses containing two or three rooms, or in tenement houses when they occupy perhaps only one, it may be two, or at the most three rooms, according to the size of their families. The houses in which many of them live are those to which "Regulations," made under the 35th Section of the Sanitary Act will apply, and differ very much in various parts of London, some being very old with low ceilings, imperfect means of ventilation, rotten floors and staircases; and are also dirty, dark, and generally dilapidated. The sanitary arrangements usually correspond with the houses; the water-closets being dark, foul smelling; the water supply apparatus frequently defective, the supply generally insufficient; the cisterns dirty, being rarely cleaned out; the dustbins frequently broken and full, containing offensive refuse, even excrement, so that it is dangerous to empty them. Houses in this state are frequently occupied by the residuum, many of whom are disgustingly filthy and destructive in their habits. I have seen fairly good sanitary waterclosets so misused as to convert them in a very short time into the most filthy places it is possible to conceive. Persons of this class can scarcely be said to have any domestic sanitary arrangements whatever; they inhabit certain streets and courts forming colonies, and can scarcely be reformed, except by breaking up and dispersing them amongst a better class, and by repeated appeals being made to their feelings by district visitors and others. The word "residuum" is now generally used to distinguish the lowest classes who have no definite occupation by which to obtain a livelihood. There is another kind of house, with better sanitary arrangements, much occupied by the poor, viz., that containing five or six rooms, in which two or more families dwell, with rather low ceilings, fairly good sanitary appliances, although generally more or less dirty, but rarely, except when occupied by the residuum, so dirty and dilapidated as the others. To houses such as these the enforcement of the Regulations are of great service, as there is comparatively little difficulty in getting the rooms and passages whitewashed and coloured once a year, and in obtaining fairly good water-closet accommodation, paving and drainage of the yards, and in keeping the water-supply apparatus in good order. The inhabitants of houses of this class, however, often keep poultry, rabbits, &c., in their yards, which is undoubtedly an insanitary arrangement, and should always be prevented if possible. As very many persons may not understand the powers given to the Local Sanitary Authorities or the subjects on which Regulations may be made, I will state that by the provisions of the Sanitary Act, 1866, Section 35, the Local Government Board is empowered, on the application of a Nuisance Authority, by notice to be published in the London Gazette, to "declare the following Enactments to be in force in the district of such Nuisance Authority, and from and after the publication of such notice the Nuisance Authority shall be empowered to make Regulations for the following matters-that is to say, "1. For fixing the Number of Persons who may occupy a House, or Part of a House, which is Let in Lodgings, or occupied by Members of more than One Family. "2.-For the Registration of Houses thus let or occupied in Lodgings. "3. For the Inspection of such Houses, and the keeping of the same in a cleanly and wholesome state. 4-For enforcing therein the provision of Privy Accommodation and other appliances and means of cleanliness, in proportion to the number of Lodgings and Occupiers, and the cleansing and ventilation of the Common Passages and Stair cases. "5.-For the cleansing and lime-whiting at stated times of such premises." The Sanitary Law Amendment Act, 1874, Section 47, enables Regulations made under the 35th Section of The Sanitary Act, 1866, to extend to "Ventilation of rooms, "Paving and drainage of premises, "The separation of the sexes, and to "Notices to be given, and precautions to be taken in case of any dangerously infectious or contagious disease, under the powers of this Act, or of the principal Act, or of the Acts therein mentioned." The Nuisance Authority (ie. the Vestries and District Boards) may provide for the enforcement of the Regulations by penalties. There is considerable doubt in my mind as to the extent to which the Regulations should be enforced in providing and keeping the sanitary arrangements of the poor in an efficient state, as if frequent inspections are made, and the owners or rent-collectors are put to comparatively a large expense, the ordinary rent, which could with difficulty be paid, is increased, and if the additional rent be not paid the tenants are ejected, to carry a bad example elsewhere. In some instances in Hackney occupied by the residuum a whole street has been closed before the required repairs were done; the rents were raised, and the streets occupied by a better class of poor, when the destructive poor do not return to it. On the other hand, if due regard be not paid to the sanitary arrangements, including periodical cleansing, repair, &c., disease may arise in the streets and spread to the adjoining neighbourhood. Due care must therefore be taken by the inspector that whilst too much zeal is not displayed, yet nuisances injurious to health are not allowed to remain. The position of the landlord or middle-man is often by no means an enviable one, as it is most disheartening for him to find dust-bins broken, the water-supply apparatus damaged, the walls defaced, and his property injured almost immediately after it has been put into good order. If these houses are kept in a good sanitary condition no reasonable rent will pay the cost, so that either the inhabitants must remain for an uncertain |