LONDON SANITARY IMPROVEMENTS. 321 



much larger suburban area was, in all probability, the most power- 

 ful of the various sanitary causes which led to the great diminution 

 of mortality, both general and from the zymotic diseases. 1 



Another very important agency, at about the same time, was the 

 great change in the popular diet that then occurred the change from 

 bread, beer, and salted meat or fish to potatoes, tea or coffee, and 

 fresh meat. Dr. Poore tells us that potatoes were first used in hos- 

 pital diet in 1767. 2 They steadily grew in favor, and in the early 

 part of this century had become so common that they almost com- 

 pletely abolished scurvy, the prevalence of which had no doubt ren- 

 dered other diseases more fatal. At the same time tea became a 

 common beverage. The consumption of tea in England in 1775 was 

 5,648,000 pounds, and in 1801, 23,730,000 pounds a more than four- 

 fold increase; a rate which has never been approached in any subse- 

 quent twenty-five years. With tea came the more general use of 

 milk and sugar; and it was this, perhaps, that helped to cause the 

 exceptionally rapid decrease of infant mortality. Again, in the same 

 period, the disuse of the city churchyards for interments became 

 general; cemeteries were formed in various parts of the suburbs, till 

 such interments in any part of London were forbidden in 1845, thus 

 removing one more, and not an unimportant, source of disease from 

 the more crowded areas. 



Now, the various classes of improvements here briefly indicated 

 those in the city itself, in wider, cleaner, and less obstructed streets, 

 the construction of sewers, and better water supply; the more whole- 

 some food, especially in the use of potatoes and other vegetables, 

 and tea, with its accompanying milk and sugar, becoming common 



1 1 have already repeatedly referred to the vital importance of space, air, and 

 light for healthy living. A few more illustrations may be here given. In his work, 

 already quoted, Dr. Poore gives a table of the mortality by measles and whooping- 

 cough of children under five, for the years 1871-80, in the different districts of 

 London, according to density of population. It gives the following results: 



DEATHS PER 100,000 LIVING. 



Six districts, having more than 150 persons per acre, . . 1157 



Seven " " from 100 to 150 " "... 1077 



Seven " " " 50 to 100 "... 968 



Eight " " less than 50 "... 743 



The general death-rate follows the same law. In Lewisham, Wandsworth, and 

 Hampstead, with densities under 35 per acre, the death-rates are under 15 per thou- 

 sand; while in Shoreditch, Whitechapel, SI,. George-in-the-East, and St. Saviour, 

 Southwark, with densities from 185 to 208 per acre, the death-rates are from 20 to 

 24 per thousand, according to the latest returns of the Registrar-General. 



3 " London from a Sanitary and Medical Point of View." 1889. 



