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 [-254-]

A MEDICAL OPINION 

Dr. Conway Evans's Reports on the Strand District, London. 1858.

    The manner in which parts of the district are crammed with people is one of the greatest of its evils which have to be mitigated. The importance of this matter was dwelt upon in my first annual report, in which it was shown that in one of the parishes of this district at least 581 persons are packed upon every acre of its surface.*

[* St. Clement Danes]

 The evil consequences of this overcrowding are manifold; into a discussion of all of them the limits of this report do not permit me to enter: some of them, however, must be briefly adverted to. 
    By this state of overcrowding the duration of life generally is shortened and health impaired; and these effects, though manifest when looked for, as will be presently shown, in persons of adult age, are far more readily discoverable in the case of infants and young children, to the high death-rate of which class your attention was directed on a former occasion. But it is not merely that so many of the children born in the district die at an early age--66 infants of the age of one year and under, having died out of every 10,000 persons residing in the district during the past year--but it is that very many of those children, who do not speedily fall victims to the circumstances by which they are surrounded, grow up weakly and scrofulous, and sooner or later throng the out-patient rooms of the public hospitals and dispensaries, or come under the care of the private medical practitioner, or the parochial [-255-] surgeon, suffering from one or other forms of tubercular disease. The loss of health thus induced is in the case of adults in some respects more costly to the community at large than that resulting from fever, as it sooner or later involves, not a temporary, but permanent inability to labour, until at length death steps in and relieves the public of the expense thus thrown upon it. 
    But the evil consequences of overcrowding are not limited to the impairment of health, or even to the destruction of life, either in the manner referred to or by favouring the occurrence and spread of disease; but by its action not only are the bodily powers prostrated and sapped, but the moral life is also degraded and debased; and ignorance, indecency, immorality, intemperance, prostitution, and crime, are directly or indirectly fostered and induced. The mode in which prostitution originates in overcrowding is but too frequently illustrated in this densely peopled district; indeed, cases occasionally come under my observation in which this vice cannot but be regarded as the necessary and inevitable result of the indiscriminate manner in which the sexes are huddled together. 
    To this subject of overcrowding your earnest attention is solicited, for it is without doubt the most important, and at the same time the most difficult, with which you are called upon to deal; and sooner or later it must be dealt with. Houses and streets may be drained most perfectly; the district may be paved and lighted in such a manner as to excite the jealous envy of other local authorities; new thoroughfares may be constructed, and every house in the district furnished with a constant supply of pure water; the Thames may be embanked, 
[-256-] and all entrance of sewage into that river intercepted; but so long as twenty, thirty, or even forty individuals are permitted--it might almost be said compelled- to reside in houses originally built for the accommodation of a single family or at most of two families, so long will the evils pointed out in regard of health, of ignorance, of indecency, immorality, intemperance, prostitution, and crime continue to exist unchecked. So long as no kind of privacy whatever can be obtained even by the individual members of a single family; so long as brothers and sisters, as well children as adults, are obliged to live, sleep, and perform the offices of nature in the same room with their parents, and it may be with other relatives, or possibly with strangers; and so long as the amount of air*

[*In the Pentonville Prison the inmate of each cell is supplied with between 800 and 900 cubic feet of air, and means are employed for renewing this every sixteen or twenty minutes. The minimum amount of space in barracks allowed to each soldier by the Ordnance Rules of 1851 is 450 cubic feet. In the rooms of the crowded courts and alleys of the Strand district, the amount of breathing-space to each person frequently falls much below the Ordnance minimum. In one court, in which I caused measurements to be made of four rooms (taken without selection), the following were the results:

which each person has to breathe is less than half or even one-third the quantity which nature requires: so long will the pious zeal and virtuous [-257-] indignation of public declaimers against prostitution be a libellous satire upon themselves, and so long will all efforts at improving the health and elevating the social condition of the poorer classes of the district be comparatively unavailing.