542 OF RESPIRATION. 



arising from overcrowding, in its effect upon the spread of Cholera, is that pro- 

 duced by the diffusion of the effluvia of drains, sewers, slaughter-houses, manure- 

 manufactories, &c., which correspond closely in their nature and effects with the 

 putrescent emanations from the living human body. So remarkably was the 

 localization of the disease connected with this condition, that the knowledge of 

 the existence of the latter rendered it quite safe to predict the former, such pre- 

 dictions being scarcely ever falsified by the result. As a characteristic illustra- 

 tion of the operation of this cause, the outbreak of Cholera at Albion Terrace, 

 Wandsworth-road, may be specially referred to. This place consisted of 17 

 houses, having the appearance of commodious comfortable dwellings ; the popu- 

 lation does not seem to have averaged more than 7 individuals per house, so that 

 there was no overcrowding ; yet out of the total 119 or 120, no fewer than 42 

 persons were attacked with cholera, of whom 30 (or 25 percent.) died. It was 

 not difficult to account for this fearful result, when the circumstances of the case 

 were inquired into. About 200 yards in the rear of the terrace was an open 

 sewer, whose effluvia were most offensive at the backs of these houses, whenever 

 the wind wafted them in that direction ; and the drainage of the houses them- 

 selves was so bad, that a stench was continually perceived to arise from differ- 

 ent parts of the kitchen floor, and more especially from the back-kitchen. 

 'Moreover, in the house in which the first case of cholera occurred, there was 

 an enormous accumulation of most offensive rubbish, exhaling a putrid effluvium. 

 And there was also reason to believe that the water supplied to some of the 

 houses accidentally became contaminated with the contents of a sewer and cess- 

 pool. 1 The accumulation of night-soil and other rubbish in a triangular space 

 of about three acres in Witham, a suburb of Hull, had been represented to the 

 local authorities as almost certain to induce a severe outbreak of cholera in the 

 neighborhood ; the prediction was disregarded ', but it was most fearfully verified 

 by the occurrence of no fewer than 91 deaths in its immediate neighborhood. 2 

 Numerous examples of the same kind might be cited ; but the following shows 

 the efficacy of preventive measures. The Coldbath-fields House of Correction, 

 situated in the neighborhood of some of the most overcrowded and ill-drained 

 parts of the metropolis, had suffered severely from Cholera in the epidemic of 

 1832-3 j for out of 1148 prisioners, 207 were attacked with Cholera, of whom 

 45 died, and 319 more suffered from diarrhoea. At that time, however, it was 

 discovered that the whole drainage of the prison was in a most defective state, 

 and steps were taken to have it completely and effectually renewed ; at the same 

 time the diet was somewhat improved, and more attention paid to temperature 

 and ventilation. In the epidemic of 1848-9, with 1100 prisoners, there was 

 not a single case of cholera in this prison, although the disease was raging in 

 its vicinity ; and the cases of diarrhoea were few in number, and were mild in 

 their character. 3 



581. Now although the Cholera-epidemics have been here referred to, as 

 affording the most remarkable examples of the influence of a contaminated 

 atmosphere in predisposing the individuals habitually living in it to the invasion 

 of Zymotic disease, yet the evidence is not less strong in regard to the uniform 

 prevalence of ordinary Fevers, &c., in the same localities ; the places in which 

 Cholera was the most severe having been almost invariably known as " fever- 

 nests," at other periods, and being distinguished by a very high rate of mortality. 

 Thus the average age of all persons who die in Witham is only 18 years; whilst 

 the average age at death in the town of Hull (itself distinguished by an unusual 

 brevity of life) is 23 years. In the "Potteries," at Kensington, a locality in 

 which filth and overcrowding prevail to an almost unequalled degree, the inor- 



1 "Report of the General Board of Health on the Epidemic Cholera of 1848-9," p. 43. 



2 Op. cit., p. 45. 3 Op. cit., App. B, p. 68. 



