supplied at an adequate pressure to reach the top story of the highest house, provided it was required by the owners or occupiers, and paid for accordingly. Lastly, the parochial authorities were empowered to compel owners and occupiers of houses without water to have it laid on at their own expense.

The very next Act in the Statute-book is one by which Parliament for the first time attempted to deal on a great scale with the difficult subject of intramural interment by the 'Act to amend the Laws concerning the Burial of the Dead in the Metropolis.' The main features of that Act, notwithstanding minor additions and alterations, have from that time been uniformly adhered to and maintained. The Secretary of State has authority to order, for the protection of the public health,' that any particular burial-ground shall be closed, and any parish has power to take certain simple steps for procuring a new cemetery.

Embarrassments have, no doubt, arisen in various places in the working of the Burial Acts, but they are due to the inherent difficulty of preserving vested rights when wide reforms are in operation, and have never been such as to throw a doubt on the wisdom of the general system. In fact, few great alterations were ever adopted with a more general or more intelligent assent.

The same year, 1853, saw the passing of an Act 'to make compulsory the practice of Vaccination,' which has been extended and amended in several recent sessions and the general superintendence of the subject vested in the Privy Council; but, as these enactments relate to a specific disease only, we shall not further discuss them. But we have not yet done with the legislation of this fertile period. It comprehended an Act to abate the Smoke Nuisance. Here it may, perhaps, be asked whether this be entitled to rank as a sanitary measure. Some persons are, we believe, inclined to contend that the bad effect of smoke on the respiratory organs is counterbalanced by the tendency of the particles of carbon to arrest noxious matters in the atmosphere and prevent the spread of infection. We are not disposed wholly to repudiate this view, but we think that any great excess of smoke in the air of a town has prejudicial effects both of a direct and indirect kind. Its direct result is to weaken the power of the solar ray, to which modern science is daily coming to attach a greater and greater importance as a vivifying agent; and the indirect result cannot be better exemplified than by a short anecdote, for the truth of which we can vouch. A lady, visiting a poor but most respectable couple, whose apartment was an underground kitchen in London, ventured to suggest that the ventilation would be much improved by the homely process of

opening

opening the window. Well, ma'am,' was the reply, we did open it last summer, but the blacks came in so, we have kept it fastened ever since.' And so they had!-nailed up, and with list carefully placed round every crevice. There is hardly a close and unsavoury room in this metropolis (and they are legion) which does not owe some of its unhealthiness to the tenant's dread of the blacks.'

We have now reached the period of the last great visitation of cholera-a visitation which, though less destructive on the whole than that of 1849, was full of useful lessons in regard to scientific precaution. The virulence with which it raged in certain limited areas induced the most casual observer to acquiesce in the theory of predisposing causes. At the same time it rendered the inquiry after such causes more easy and manageable. The Golden-square district was specially notorious as one in which the cholera prevailed to an alarming extent, though neighbouring districts were comparatively free. While public attention was directed to the subject, elaborate investigations were made on the spot, both under the directions of the Board of Health and by other competent authorities.

Dr. Lankester, in a paper read before the Social Science Association, in 1860, does not scruple to say, 'The fatal outbreak of cholera in the Golden-square district was traced to a pump in Broad-street, which communicated with a cesspool.' And, no doubt, enough appeared both in this and other cases as to the effects of polluted water, to justify the strictest vigilance of local authorities for the future, as well as to enhance the value of the Act respecting the water supply from the Thames.

The Registrar-General has shown (says Professor Parkes) that the districts supplied in 1853 by the Lambeth Company with a pure water, and part by the Southwark Company with an impure water, suffered much less than the districts supplied by the latter Company alone (the proportion was 61 and 94 cases respectively to 100,000 of population); and Dr. Snow has shown, by a most elaborate inquiry, that in the districts partly supplied with pure water by the Lambeth Company, and partly with impure water by the Southwark,† the attacks of cholera were chiefly in the houses supplied by the latter water.' +

* Prof. Parkes says, 'In 1854 occurred the celebrated instance of the Broadstreet Pump in London, which was investigated by a Committee, whose Report, drawn up by Mr. John Marshall, of University College, with great logical power, contains the most convincing evidence that, in that instance at any rate, the poison of cholera found its way into the body through the drinking-water.'

† Our readers should bear in mind that the Metropolis Water Act of 1852 had not yet come into full operation. See Dr. Sutherland's Report to the Board of Health, 1855,' p. 40.

Practical Hygiene,' p. 58.

But

But the Report of the Board of Health takes broader ground. It asserts that the results of the inquiry show that most of the evils against which sanitary reformers had been fulminating for years, were more or less operative. It says, in fact, This new outbreak is after all only a fresh version of the old story. If you ask what is to be done in future, we reply, just what we have been insisting upon all along-let cesspools be filled up; let there be a compulsory and more perfect system of house drainage, with proper water supply; let dustbins be frequently emptied, and never constructed within an inhabited house; let the gullies be trapped; and slaughter-houses and noxious trades removed as far as may be from human dwellings.*

Under the full influence of the fresh interest thus given to the subject, Parliament came to the consideration of the sanitary clauses intended to form part of the Bill which has since passed into law as 'The Metropolis Local Management Act, 1855.' By this measure the constitution of the vestries was remodelled, and the Metropolis Board of Works created. To the latter body was assigned the charge of the arterial sewers, and the responsibility for the drainage of London considered as a whole. To the former belongs the construction and repair of all sewers of less magnitude situate within their respective parishes, together with the supervision of house drainage. The old Commissions of Sewers were from henceforth abolished. Miscellaneous clauses of a most useful character were inserted in this Act, partly derived from local acts previously in force in other parts of the country, partly framed de novo, and as an experiment. These were augmented and improved by the Amendment Act of 1862, and constitute altogether no mean contribution to sanitary legislation. They confer upon the vestries power to withhold permission to a builder to commence a house until he has provided for adequate drainage; power to require the prompt and effectual repair of drains in existing houses when in bad order (including sufficient water supply and apparatus); and power to object before the magistrates against the licensing of slaughterhouses and cowhouses (which are to be illegal, unless so licensed). Moreover underground rooms are forbidden to be used as dwellings, unless they comply with certain requirements as to ventilation, and other matters essential to health. At the same time

* See the Cholera Report of the Board of Health,' 1855 passim. + The Metropolis Board of Works (as most of our readers no doubt know) is composed of representatives chosen by the several Vestries, these latter consisting of vestrymen elected on a uniform system by the ratepayers.

Legislation on this point at first took a course which would seem to show that the draftsman must have been from the sister isle. The definition of a 'dwelling'

time the vestries were made the local authorities' in their respective parishes for the purpose of carrying out the Nuisances' Removal Acts, which of itself gave them large and general powers. But amongst the most important changes now introduced, must be reckoned the provision that every vestry should forthwith appoint a Medical Officer of Health' and an 'Inspector of Nuisances.' The former officer (who must be a legally qualified medical practitioner of skill and experience) is directed

To inspect and report periodically upon the sanitary condition of the parish or district, to ascertain the existence of diseases, more especially epidemics increasing the rate of mortality, and to point out the existence of any nuisance or other local causes which are likely to originate and maintain such diseases, and injuriously affect the health of the inhabitants, and to take cognisance of the fact of the existence of any contagious or epidemic diseases, and to point out the most efficacious mode of checking or preventing the spread of such diseases, and also to point out the most efficient modes for the ventilation of churches, chapels, schools, lodging-houses, and other public edifices within the parish or district, and to perform any other duties of a like nature which may be required of him.'

The mere fact that, since the passing of this Act, a gentleman of skill and intelligence is to be found in every London parish, charged with such duties, is of itself an incalculable benefit. The particular method in which his duties are discharged, varies somewhat in different places. In some instances, he makes his report directly to the vestry † from time to time, who thereupon give their sanction to such of his recommendations as they may deem expedient. In other parishes, a standing committee is appointed for the management of sanitary questions, which advises with the medical officer as to the details of the necessary measures, and co-operates with him both in their preparation and execution.

'dwelling' by the Act was a room or cellar where any person passes the night;' and for the purpose of ascertaining this fact, power of entry was given to the authorities between nine in the morning and six in the evening!'

Of course it was out of the question to get by this means such direct legal evidence as would justify a conviction. The mistake, which bordered on the ludicrous, was remedied by the Act of 1862. That Act provides that 'such evidence as may give rise to a probable presumption that some person passes the night in such room or cellar shall be evidence, until the contrary be made to appear, that such has been the case.'

It still remains as a desideratum that the Inspectors of Nuisances should be directly charged with the administration of this clause. At present the only officers whose express duty it is to look to it, are the District Surveyors, whose ordinary occupations are not of a sanitary nature.

*The most useful of these Acts was passed in this same year.

Throughout this paper we have used the term Vestry for the sake of simplicity. But where two parishes are united, as is sometimes the case, the governing body is styled a District Board. The powers are the same.

But

But the best account of the working of the system will be found in a paper read before the Social Science Association, in 1862, by Dr. Ballard, the Medical Officer of Health for the parish of Islington.

After stating that the schedules of the district registrars of births and deaths, and the books of the various hospitals and dispensaries and workhouses are habitually consulted by the officers of health, in order that they may learn the existence of disease or mortality exceeding the average in the districts under their charge, he continues:

'The mode in which all this information is utilised may be illustrated by my own method of proceeding in Islington, which I believe does not differ greatly from that of other health officers in other parishes. On receiving the mortuary schedules, I take out from them a list of houses where deaths from zymotic diseases of an epidemic character have occurred, and these houses are visited either by the Inspector of Nuisances, or by myself, and the conditions of drainage, ventilation, water-supply, crowding, &c., are noted down upon a form provided for the purpose: corresponding to this is another form on which I enter the recommendation for improvements that it is necessary should be carried out. The same thing is done in respect of houses where cases of epidemic sickness are ascertained to be existent. And as these deaths and cases of illness could not possibly be all attended to, those houses are preferred for immediate inquiry which are situated in the poorest localities, or where the diseases referred to are manifesting a disposition to spread. These recommendations are laid before a Committee of the vestry, which sanctions the issue of the requisite orders. Thus much for immediate action. But, in addition, I keep a list of all the streets, courts, and alleys in my parish, on which every week I enter the particular house in which a death has occurred, specifying the character of the disease, whether it is of a child or adult, and also record the occurrence of a death from certain specific diseases. Where two deaths are thus found to occur in any house within the year, that house is put upon the list for inspection; and, at the close of the year, a list of streets is made out in which the mortality has been the highest, and especially in which the infant deaths have been most numerous, and these streets are inspected house by house in the course of the next year. Dividing my parish also into minor districts, I am enabled by the aid of my street list to ascertain what neighbourhoods have especially suffered during the year, and to these again my own attention and that of the Inspector is particularly directed in the succeeding year.'

*

If we ask, what are the actual results of all this machinery, Dr. Ballard will again come to our aid. From the annual

* Proceedings of the National Association for the Promotion of Social Science, 1862,' p. 658.

reports