350 THE AIR OF TOWNS. 



of disease, yet we see nothing of them. The death roll of all our bat- 

 tlefields probably does not number so many victims as that of contam- 

 inated water. What is the result? An unlimited quantity of pure 

 water is regarded as the first essential to health. We go far afield for 

 it. Manchester, at a cost of £3,000,000, drinks the water from the 

 rivulets of Cumberland. Liverpool pays a high price for the water of 

 the Welsh hills. 



As regards the air we breathe, we stand much in the same relation 

 as Mohammed to the mountain. As we can not bring pure air to the 

 town, we go and seek it in the country or by the sea ; that is, those of 

 us who can afford it. 



But there are many Mohammeds who never see the mountain. How 

 many there are may be judged from this fact, that according to the 

 registrar-general's report, out of a population in England and Wales 

 of 29,001,018 on April 5, 1891, 20,802,770 persons were urban and 

 8,198,248 were rural, i. e., nearly three-quarters live in towns as against 

 about one quarter resident in the country. 



What is the effect of this town air upon the urban population? 



Where changes are occurring which are imperceptibly affecting indi- 

 viduals, and to the cause of which we therefore can not definitely point, 

 it is possible by coordinating a large number of observations to so 

 multiply the effect that we can arrive at a very probable estimate of it 

 and lay our finger on the cause. 



By means of statistics from the health returns of medical officers we 

 can compare the health of the town with that of the country. Dr. 

 Tatham, medical officer for Manchester, in a life table compiled for 

 Manchester, has shown that "if we take three periods, under 25 years 

 of age to represent youth, the period between 25 and 65 to repre- 

 sent maturity, and ages above 65 to represent old age, it will be found 

 that males in Manchester are young for 94 -per cent, mature for 87 per 

 cent, and old for 46 per cent as long as in England and Wales. We 

 are almost forced to the conclusion that in Manchester men grow old 

 sooner than in the country as a whole." 



What may be said of Manchester may also be said of Leeds and 

 other industrial towns. This, of course, might be put down to the 

 strain and worry of business life; but if we compare the diseases from 

 which people die in town and in the country, those who have examined 

 the medical returns -must have been struck by the number of deaths in 

 towns from diseases of the respiratory organs, pneumonia, phthisis, 

 etc. My friend and colleague, Mr. Wager, of the Yorkshire College, 

 took some trouble to obtain statistics on these points in regard to 

 Leeds, and found that the percentage of deaths from diseases of these 

 organs was considerably greater in the town than in the surrounding 

 districts. As I prepared this lecture, the quarterly return from the 

 medical officer for Manchester arrived for the quarter ending Septem- 

 ber, 1893, and here I found that out of 400 deaths between the ages of 



