Читать книгу Reports Relating to the Sanitary Condition of the City of London - John Simon - Страница 4

[9] There are many instances in my mind, some already adverted to, where the existence of a standing jury for scientific—especially for sanitary, purposes might be of great utility. It is an organisation which prevails extensively in France, under the name of Conseils de Salubrité; forming, in most of the large towns there, a constant board of reference for the municipality, in respect of sanitary regulations. Mutatis mutandis, it might become invaluable as an English institution, in respect of many matters touched upon in this sketch; and perhaps with some division of duties, into such as would best belong to a General Board of the kind, and such as might properly be vested in Local Boards. To determine the indispensable conditions of healthy lodgment; to examine the influence of trades and occupations, and to devise the regulations they may require, for the neighbourhood’s sake, or for their operatives’; to supervise the sale of food and drugs; to be cognisant of medical matters; would seem, either locally or generally, to require the co-operations of several skilled persons. But, though I have spoken of such, as indispensable jurors for these subjects, I do not forget that other interests than those of life may need to be consulted. For the fair representation of these, the lay faculty of educated common-sense will fulfil an inestimable usefulness, if it may be there to mediate between science, which is sometimes crotchety, and trade, which is sometimes selfish.

Organisations against epidemic diseases—questions of quarantine—laws for vaccination, and the like, would obviously lie within his province; and thither, perhaps, also his colleagues might be glad to transfer many of those medical questions which now belong to other departments of the executive—the sanitary regulation of emigrant ships, the ventilation of mines, the medical inspection of factories and prisons, the insecurities of railway traffic, et hoc genus omne.

There is another subject respecting which I should reluctantly forego the present opportunity of saying something. To the philosopher, perhaps, any partial sanitary legislation—even for a metropolis, may seem of low importance, as compared with our commanding need that the general legislation of the country be imbued with deeper sympathies for life. Yet London is almost a nation in itself; and the good which might be effected by its sanitary regeneration would, even as example, be of universal influence. Now, at this moment, there seems a chance—such a chance as may not soon recur—for gaining a first step towards this consummation. The re-construction of the Metropolitan Commission of Sewers, on the principle of local representation, affords extraordinary facilities for providing London, at length, with an efficient sanitary government. For, while any administration for this purpose would require to be entrusted with very extensive and very stringent powers, it seems probable that such authority might by the public be willingly conceded to a body constituted, in great part, of persons representing local interests. The jurisdiction required would be substantially such as is already vested in the City Commissioners of Sewers, for the sanitary control of the city; the concession of which—because to a representative body—was never any matter of municipal dispute. In so vast a government as that of the metropolis, Local Boards of Health for its various sections would seem indispensable; it is presumed that these boards[10] would be represented in the general Commission; which, in conjunction with them, and including certain skilled assessors, might constitute a complete sanitary organisation, consultative and executive.

[10] It would seem premature to discuss what might be the best constitution of such Local Boards for the metropolis; but it will appear to the reader, on a moment’s reflection, that there would be no difficulty in finding materials for their organisation. If, according to suggestions lately ventilated, municipal institutions should be given to the parts of London hitherto without them; these new corporations would probably have sanitary functions allotted them, and might readily become Local Boards of Health under such a constitution as I have sketched. If, on the other hand, our present non-municipal system were to be continued, probably our several Boards of Guardians might seem specially proper to act as Local Boards of Health; first, as being elected representative bodies, already invested with certain authority of the kind—as, for instance, under the Nuisances Removal Act; secondly, because various of their officers would be almost indispensable parts of any sanitary machinery. Indeed, my experience of such matters suggests it to me as not unimportant, that, under any arrangement which may be made, the jurisdiction of Local Boards of Health should, at least in area, be conterminous with Poor Law Unions; so that those who administer sanitary affairs—affairs which are always chiefly relative to the poor—may, as far as possible, in their several districts, come into relation with single sets of Poor Law officers.

I have one word more to say about the Reports. They have been received by the public with such remarkable indulgence and favour, that I feel some anxiety lest I may seem to have plumed myself with other feathers than my own. Let me, therefore, at least in part, confess my debts.

Before my first enlistment in the service of public health, others had fought this great cause with rare courage and devotion; establishing its main principles in a manner to require no corroboration, and to admit little immediate increase. The true patriarchs of the cause in this country are the present working members of the General Board of Health. The constitution of my city appointment is quite independent of this Board; but I should be acting an unworthy part if I refrained from acknowledging, that, in innumerable instances, I have gathered most valuable knowledge from the Board’s official publications, and that, in personal intercourse with its members and officers, I have had abundant reason to be grateful for information invariably given with that frank kindness which belongs to brotherhood in science, and to sympathy for common objects.

I must likewise acknowledge constant obligations to the courtesy of the Registrar-General, and express with how much pleasure and instruction I have studied the works of his inestimable office. Especially I would offer my tribute of respect to Dr. Farr’s learning and industry, as well as to that capacity for generalisation which the world has long recognised in his eloquent and thoughtful writings.

And, though this be not the place to boast of private friendships, I may venture to say that there are few topics relating to sanitary medicine that I have not enjoyed the advantage of discussing with men who have given genius, inquiry, and reflection to their development.

Thank God! the number of persons capable of apprehending the cause, and ready to take interest in its promotion, is now daily on the increase. If some minister of Public Health could take his seat in the House of Commons—some minister knowing his subject and feeling it, I believe he would find no lack of sympathy and co-operation. The world abounds with admirable wishes and intentions, that vaguely miscarry for want of guidance. How many men can get no farther in their psalm of life than the question, in quo corriget. To such—not masters of the subject, but willing and eager to be its servants, an official leader might be everything: for in great causes like this, where the scandal of continued wrong burns in each man’s conscience, the instincts of justice thirst for satisfaction. What can we do or give—how shall we speak or vote, to lessen these dreadful miseries of sanitary neglect—is, at this moment, I believe, the fervent inquiry of innumerable minds, waiting, as it were for the word of command, to act.

How much of this generous earnestness towards the cause exists in society—how much desire to grasp any reasonable opportunity of good has lately happened to fall under my notice. Last winter, when the signs of the times were making us fear that Cholera would presently again be epidemic in London, it was remembered that, in the greater part of the metropolis, nothing whatever had been done since the last invasion to give immunity against the returning disease. It was remembered—too late, how indescribably dreadful a thing is the epidemic prevalence of sudden death. And the poor were thought of—in their unprotectedness, their filth, their ignorance. Among the persons thus aroused, was a gentleman whom I reluctantly leave unnamed; saying of him only, that, from a distinguished position in official life, he had retired to literary enjoyments, amid which he bears the imputation of many unacknowledged writings which charm and instruct the public. When the rumours of the pestilence began, he too heard and read and became aghast. The notion that ‘in a skilful, helpful, Christian country nothing should be done’ against these impending dangers—that the poor should be left ‘defenceless, huddled together in some dismal district, not more helpful than women’—was felt by him, he wrote, ‘deeply as a disgrace;’ and he pleaded that, ‘on a great and pressing occasion, it remains for the thoughtful, the rich, and the benevolent, to try and do these needful things for the people.’[11] Let us, he urged, endeavour to meet this shameful reproach; let us combine voluntary charitable assistance for extemporaneous sanitary measures, rapid, though partial; let us get a hundred thousand pounds and do what we can in aid of local authorities in the poorest districts—in Bethnal Green, in Shoreditch. Eventually this plan was abandoned, at least for the time. There was argued against it, that prompt legislation might do more good, with less exoneration of local responsibility. Whether rightly or wrongly, the latter view was acted on; and in accordance with it, the gentleman first adverted to (waving his own hopes and wishes in the matter) took active part in framing suggestions,[12] which Lord Palmerston had expressed himself willing to accept, for modifying the laws of Nuisance and Disease-Prevention to a form more suitable for the apprehended emergency. But, in the meantime, what had happened? The author of the plan, as it were at a moment’s notice, had seemed to draw round himself half the intellectual and moral strength of the metropolis. Himself setting aside the literary ambition of his life, he found others ready to meet him with their several self-sacrifices. Over-worked men of science and of business, who afford no time to relaxation; favourites of society, who might have been suspected of mere shuddering at distasteful subjects; men of high laborious rank in Church and State; poets; heads of professions; minds that guide the tastes and morals of the country, or feed its imagination; not least, the invalid from his distant wintering-place; men, in short, immersed in all kinds and grades of occupation, were either bodily present at the deliberations referred to, or were writing about the plan in terms of warm interest, anxious to promote whatever usefulness could be shown them. About the means there was discussion—about the object, none; nor lukewarmness. All were competing, by gifts of time and labour, to snatch some opportunity of serving this neglected cause.

[11] I quote from a pamphlet printed by him for private circulation. It was entitled ‘Health-Fund for London; some Thoughts for next Summer: by Friends in Council.’

[12] These have since been laid before the House of Lords, on the motion, I think, of Lord Harrowby, who took much interest in the subject.

Such—to return to my text—such, I am deeply assured, would be the spirit which a minister of Public Health would find abundantly on his side in Parliamentary discussion, and in the Press. There is no attachment to the incongruities I have sketched as belonging to our abortion of a sanitary system. Still less is there any want of feeling for the poor—any reluctance to raise their state and better their circumstances—any unconsciousness that these things are great solemn duties. On the contrary, everywhere there is the conviction that something must be done; everywhere a waiting for authority to say what. But, the trumpet giving an uncertain sound, who can prepare himself to battle? Knowledge, and method, and comprehensiveness, are wanted—the precise, definite, categorical impulses of a Parliamentary leader, who can recognise principles and stick to them.

And for such a minister, what a career! It would be idleness to speak of the blessings he could diffuse, the anguish he could relieve, the gratitude and glory he could earn. A heathen can tell him this. Homines enim ad Deos nullâ re propius accedunt quam salutem hominibus dando. Nihil habet nec fortuna tua majus quam ut possis, nec natura tua melius quam ut velis, conservare quam plurimos.

Upper Grosvenor Street,

May 15th, 1854.

REPORTS

RELATING TO

THE SANITARY CONDITION

OF THE

CITY OF LONDON.