SANITARY NOTES. SANITARY Statistics have, for many years past, formed a portion of the labours of medical and other scientific men; and a vast amount of useful information of this description has been collected; insomuch, indeed, that, of many towns and districts of the kingdom, a map might be drawn out, with sanitary lines upon it, showing the varying health-conditions of the several parts, in the same manner that lines of altitude show the varying levels of the earth's surface. But if it be asked what works have been executed for the sanitary improvement of our thickset towns during the last 15 years, in which attention has been repeatedly drawn to the subject, there is but one fearful answerscarcely anything.

That epidemic diseases vary in their intensity according to the degree of salubrity of the localities they visit, could never be doubted by intelligent observers; but the fact has been powerfully illustrated during the course of the present plague. It will be found, on examination, that in Berlin and Paris, which are but slightly altered from their condition in 1832, the cholera has not exceeded its former violence. In Hamburgha town which has undergone, since the great fire in 1842, a renovation almost equal to that of London after 1666-the visitation has been less severe than in 1832;-while in London, which has been allowed to extend to an unprecedented degree without sanitary regulations of any kind, and which may, therefore, be justly said to be in a worse condition than in 1832, the number of vic

tims to the fearful scourge of cholera has, during the last ten weeks, exceeded the total number in the whole country, in an equal length of time, on the former occasion. Thirteen thousand victims have fallen under a disease, the violence of which is to a great extent attributable to our own neglect and carelessness. In other towns and places the disease has been equally fatal. The long

line of docks at Liverpool, filled with stagnant water, and receiving the refuse of a thousand ships of every size and every country, has proved, in the recent peculiar state of the atmosphere, as fatal a neighbour to human life in crowded streets and cellars, as the tanks filled with putrid water under the wretched huts of the village of Mevagissey to the hardy labourers of the deep-sea fisheries.

There are two physical conditions under which all sanitary requisites may be classed, viz :--Ventilation and Cleanliness.

It is strange that a nation so sensitively alive as Englishmen are to any infringement of their civil rights, should passively submit to the most fearful encroachments on their physical rights; yet it is a fact that they have thought but lightly of the deprivation of that pure air which God has given them, and the substitution of a deadly poison, which destroys their health and consumes their powers. This evil, however, has reached a point at which human forbearance must cease, and when it has become a duty on every man to exert his utmost powers to counteract its effects and procure its abolition. It is time that Englishmen should take as much pride in repelling a secret and insidious enemy, that threatens their every home with sorrow, as in resistance to an open and visible one; it is time that more honour should be bestowed on those whose labour, health, and even life itself, has been given to save their fellow-beings from sickness, misery, and death, than on those whose profession exists by the destruction of life and happiness. There is not in the wide world a purer and more elevated chivalry

than is exhibited in the labours of those who, in spite of danger the most deadly, and of scorn and insult the most dishearten

ing, wage unflinching war upon the filth and misery of crowded populations, and exert

the talents which a most beneficent Provi

dence has bestowed upon them to procure for their fellow-thousands the requisites of health and happiness.

pulsory regulations for the admission of air It would be premature to make cominto the crowded dwellings of the poor, until that air is freed from the poisons which it holds in solution to a fearful amount.

First

In entering on this particular subject I am fully aware of the odium and obloquy which I am sure to incur from those whose interest it is to keep matters as they are, and rather to impede the progress of medical science than promote that which would tend to decrease their sources of gain, though it might be productive of the greatest benefit; and it is undoubtedly from some such cause that the public has so long been misled into a belief that our hospitals, being perfect and requiring no reformation cr change, it is quite needless to bestow any attention on them, considering it utterly impossible that they can be improved.

With the view of proving, on the contrary, that they are now so far from what they ought to be as to compel me to express the greatest doubt whether they are a public benefit or a public injury, I lay before my readers as minute a statement of the circumstances and peculiarities of each as my space will admit of, and leave them to judge of the truth and merits of my observations.

In establishing a hospital for the recovery of the sick and diseased, surely the consideration of the first importance is the healthiness of the situation: it is of far greater value than any medicine or medical aid in all cases not purely surgical, and in many that

are.

Of what avail is medicine in the wards of a crowded hospital, situated amid a dense population, surrounded on all sides by smoke, and contaminated by the effluvia of decomposing vegetable and animal matters?

The reply is too plain.

When the older metropolitan hospitals were founded, there is every reason to believe that their positions, as to circumjacent evils, were very different from what they now are, and that they were free from the overwhelming nuisances with which they now abound; but, even if they were not, there is no reason, because they were established in places which are totally unfit, and have ever since continued so, that they should, in this enlightened age, be allowed to remain in them, objectionable as they are even for the habitations of the healthy. Whether they were so circumstanced on their first establishment, or whether nuisances and evils have since gathered around them, matters not; they do exist to so frightful an extent, that not to adopt a remedy without loss of time is, on the part of those who have the authority and power, a scandalous and unpardonable dereliction of duty, alike injurious to the healthy and to the sick.

The extent of the evil and the mischievous effects it entails on society are only to be justly appreciated by a brief review of the

peculiarities of situation to which each hospital is exposed, and this it will be my object to give, resting fully satisfied that my labors in bringing before the public a subject of such grave and serious meditation will not be in vain.

It is my unalterable conviction that no public hospital ought to be situated where it is surrounded by houses; in short, it ought to be out of town, and not in it; first, because the air in such a locality is not congenial with the means used to restore health; and, secondly, because it is equally unfit that a number of persons afflicted with all kinds of diseases should be congregated among the habitations of those who are in health, and these dangerous and disgusting evils are the fate of al! the inhabitants of London, from its centre to its circumference, as I shall now establish by individual detail, commencing with

ST. BARTHOLOMEW'S HOSPITAL, which, if at the period of its institution it was surrounded by a tenth part of the nuisances and abominations which now exist, its location near Smithfield was quite worthy of the age of martyrdom and barbarity; but I strongly suspect that it was comparatively free from the number of pestilential contaminations with which it now, on all sides, abounds.

It is in the very centre of filth; on its north side it has Smithfield-market, with its disgusting scenes and collection of decomposing animal matter; a dense population of the most wretched and abject poor in Cow-cross, abounding in horse-slaughterers; Saffron and Mutton hills, and Long-lane, with their dirt and filth; on its western side it has Giltspur-street, Hosier-lane, Snowhill, and that part of Field-lane through which runs the Fleet-ditch, uncovered; besides the crowded and poor population in the vicinity of Green Harbor-court, and the low precincts of the Old Bailey. On its south side it is even worse circumstanced, for, besides the air being greatly excluded by the high building of Christ's Hospital, with the volumes of smoke it pours down on it, there is Newgate-market, with its contiguous slaughter-houses, giving out, especially in hot weather, effluvia enough to contaminate the whole of London. On its eastern side, it is bounded by the crowded neighbourhood of Little Britain and Aldersgate-street, and subject to all the evils inseparable from such localities.

These are not, perhaps, the whole of the evils, but they are enough; and it has been stated lately that this hospital is more unhealthily placed than any similar establish

ment in London, if it is possible, considering the account we have to give of

GUY'S AND ST. THOMAS'S HOSPITALS, situate in the borough of Southwark. It is probable that when these were first founded the state of the neighbourhood was very different from what it now is, which is such as would induce us to believe that their founders were fit subjects for a commission of lunacy. They stand almost below ground, close to the banks of the Thames, at a part where all the sewers from the immense district of Bermondsey, Tooley-street, &c., pour forth their filth to decompose on the sides at low water, and diffuse their pestiferous vapors among the inhabitants; in addition to which they are surrounded by the Borough-market, with its never-ceasing animal and vegetable decompositions-by breweries, distilleries, &c., with their dense volumes of smoke-by the skin-market and by tan-yards, in the midst of a district abounding in the hovels of the abject poor, in courts from which air is quite excluded. I leave it to my readers to comment on such a site for two large hospitals, in which are hundreds of sick beds, mostly occupied, and now proceed to notice

THE LONDON HOSPITAL, which, in consequence of the filth besetting it on every side has lately attracted the notice of the authorities, who seem, in their “zeal not according to knowledge" to have no idea that their establishment itself is a nuisance both physically and morally, of no common order, as I shall now prove to the fullest satisfaction and utter disgust of the community, and to the surprise, if not to the credit, of those by whom it is permitted to exist.

This receptacle for the sick is in the Whitechapel-road, and it has lately been proved that more than nine of the most offensive manufactories are carried on in its immediate vicinity-these are Patent Manure Companies, horse-slaughterers and boilers, soap-makers, distillers, sugar-refiners, &c. It has also the slaughter-houses in Whitechapel on one side, and Spitalfields market on the other; amidst a population of the very lowest kind, where poverty exists in its most frightful forms, and where from that and bad habits, consequent on ignorance and vice, cholera has made more than its usual havoc. It is merely necessary to state in conclusion, that it is in the immediate contiguity of Brick-lane and Wentworth-street, with their courts and alleys of abject and squalid misery and wretchedness, to give an idea of the position of this hospital.

And now I proceed to relate what concerns the hospital itself, which, with this one excep tion, is perhaps as well managed as any other; this exception is a violation of the best feelings of humanity, and even a profanation of a solemn religious rite. Its medical officers are equal to any in talent and humanity, and some are authors of works I have often reviewed with great pleasure and satisfaction, yet have they by some oversight, or by extreme occupation, allowed the following loathsome, barbarous, and dangerous piece of mockery to exist in the face of every passenger, and even of the poor afflicted inmates.

It is well known that by the Anatomy Act, obtained by Mr. Warburton, the bodies of persons dying in hospitals and poorhouses, and not claimed by friends, are given for dissection, and the remains are afterwards put into coffins and buried with the curtailed rites usually performed over the poor. In observance of this regulation, the authorities of the London Hospital have chosen a place at the rear of the institution, and quite within the sight of the patients; whether this ground is consecrated or not is of more importance to the Bishop of London than to us, or as viewed in connection with the facts I am about to record.

In this piece of ground is dug a large hole, and when as many bodies have been dissected as will fill coffins sufficient to lay within two or three feet of the surface, a clergyman comes at about nine o'clock in the morning-somewhat ashamed, doubtless, to meet the numbers which at a later hour might congregate-and performs the ceremony; but whether he is committing "dear brothers or sisters," or a due admixture of both "to the ground," I leave to those who have the job of making up these packingcases of human flesh.

So vile an abomination, and so flagrant an outrage on the best feelings of human nature, would be a disgrace to any country but one degree removed from barbarism; and is made the more revolting by being committed under the very eyes of those who are doomed, in addition to their own afflictions, which need no increase, to witness the lowering into the earth of the flesh, after being dissected, probably of those who occupied the next beds of death, and who must soon follow their mangled fellow-sufferers, now for ever hidden from human sight, and with whom, while writhing in agony or sinking in deliquium, they have often exchanged those "pious drops the closing eye requires," and are doomed to endure the sight of the horrid atrocity in the silence of terror and abhor

rence.

Gladly do we pass from these frightful details to the peculiarities as to situations of

THE SMALL-POX AND FEVER HOSPITALS.

These seem, indeed, to have been chosen, as it were, to propagate and not to cure those diseases; they are most delusive abortions; their locality and internal constructions are equally in harmony. They are placed in the low swamps of King's-cross, near the stagnant basin of the canal, surrounded on all sides by horse-slaughterers and boilers, varnish-makers, dust-yards, and other nuisances; the latter has, of late, been doomed to removal to Islington, leaving the former in sole possession of the benefits it so long enjoyed, and carrying its not very congenial or desirable influence to its new locality. The change is, however, on the whole, for the better, yet does it evince so partial and trivial an improvement as to display gross ignorance as to the real object; but I will leave it to make my observations on

THE MIDDLESEX HOSPITAL.

This is situated at the northern extremity of Berners-street, and has, certainly, less nuisances than those already made the subject of remark; yet its position is by no means suited for a house intended for the cure of the sick, and to show the utter want of knowledge and perfect disregard as to a proper selection of a spot, a new and capacious wing has lately been added; but this sinks into perfect insignificance when compared

with the site chosen for the new

KING'S COLLEGE HOSPITAL, now about to be erected in the neighborhood of Portugal-street, Lincoln's-inn-fields. This hospital will, like its temporary building, be in the midst of the crowded vicinity of St. Clement's, with Clare-market and the close and confined courts, redolent of filth and stench, in its immediate proximity and actual contact. Looking into the churchyard, now ordered to be closed, which is conspicuous for the disgusting scenes which have been disclosed within it, as well as for being the resting-place of the original Joe Miller, who, it alive, would certainly jest at such a selection for the foundation of an hospital, but, at present, we must merely notice it, and proceed to give a brief account of

UNIVERSITY COLLEGE HOSPITAL, at the north end of Gower-street. The situation of this institution is not such as to call for any further remarks, than that, as a general principle, no such establishment ought to be in a large and crowded locality; we, therefore, proceed to notice

ST. GEORGE'S HOSPITAL, AT HYDE-PARKCORNER.

which, although not badly situated as regards the institution itself, and the health of its inmates, ought not to be within two or three miles of its site. It is difficult to conceive how any rational being could have selected such a spot as that chosen for

CHARING-CROSS HOSPITAL.

evils: the neighborhood is dense and crowded; It is surrounded by many objectionable houses surround it in every direction, consequently it must be far from healthy, and must be uncongenial to the recovery of the sick. I now come to

THE NEW

HOSPITAL FOR CONSUMPTION
AT BROMPTON.

It is said that this is the healthiest situation in London. Be it so. I ask, is it the most healthy place that can be found out of it? and there, alone, should a hospital, especially for such a complaint as tubercular phthysis, be erected? I greatly fear that -11 who go in with real consumption are carried out by the undertaker. Medical aid, without the best air, is a perfect farce, and with Some it, I fear, very little to be relied on. physicians, thinking to acquire notoriety by blishing such an Institution, may find it a getting a number of subscribers and estasure and speedy way of obtaining practice. A carriage seen rolling down every morning naturally creates enquiry as to who are the medical attendants, and what the wonderworking results of their skill? Certain, however, it is, that it is much more likely to prove a source of benefit to the physician than to the patients.

For my own part, I am satisfied that it would be far more advantageously located in the country, and, although it would be further from physic, it would receive an immeasurably more valuable remedial agentpure air; and arrangements as to the former are easily practicable, as I shall prove when I present my readers and the public with the result of my attention to, and reflections on the subject of hospitals during a long course of years. I shall, therefore, give but one more brief sketch, that of

THE FREE HOSPITAL IN THE GRAY'S

INN-ROAD.

This, without doubt, is one of the most benevolent and philanthropical institutions in the metropolis. It receives, without any letter of authority, the poor who are the subjects of any disease-poverty and sickness are the only recommendations necessary for admission. So far I have no inclination,