1865.] On the Predisposing Causes of Pestilence. 391 



same air over and over again ! What a favourable condition of ex- 

 istence for the cultivation of the higher, or even the lower moral facul- 

 ties ! Again we say, it is enough to make one shudder to read of such 

 scenes, chronically existing in the very midst of our boasted civilization. 



But there are still worse cases. In No. 27, Chisenhale Street, 

 Michael Lonergan occupied a house, one room of which, 802 cubic 

 feet in measurement, served as the abode of three persons. Mary 

 Koach, 19, Brick Street, rented three rooms, together about 2,700 to 

 3,000 feet, sheltering seventeen persons ! Sarah Goughran, No. 21, in 

 the same street, had also three rooms, containing the same number of 

 persons, and in these rooms, there was literally no furniture whatever ; 

 men, women, and children lying together promiscuously on straw, or on 

 the bare boards ! * 



We recommend these cases to the consideration of all pious per- 

 sons, whose philanthropy finds its issues in public speeches in favour 

 of African missions, or in the propagation of the gospel among the 

 Jews, or in foreign parts ! 



And now as regards the absence of cleanliness, the nature of the 

 subject compels us to be still more brief. " Any history," says Dr. 

 Trench, under the unsavoury heading of ' Filth,' f " any history of 

 the causes favouring the extension or diffusion of typhus, would be 

 incomplete which did not include the filth, foul smells, and vitiated 

 air within rooms ; or the noxious exhalations from open middens and 

 heaps of decomposing vegetable and animal refuse in the immediate 

 neighbourhood of houses. It would indeed be difficult to overrate the 

 force of such auxiliary and predisponent influences, which are only 



* Since this article was written, official reports have described even more un- 

 healthy and immoral scenes of overcrowding in country districts than any here 

 noticed as existing in our large towns ; and if any further evidence were needed to 

 establish the causes of typhus and other epidemics, it is to be found in the Eeport 

 of the Government Inspector, from which we make the following extract : — 



" To sum up : — Destitution, dirt, and intemperance, with overcrowding and bad 

 ventilation of streets and houses, are the conditions that keep up the disease steadily 

 from year to year. The reasons why typhus has become epidemic are not so clear. 

 The only positive conditions that have been ascertained appear to be these — slight 

 but steady increase in overcrowding, some increase of immigration and of distress 

 at the end of 1861, some increase of vagrancy, and with these some influence in 

 each autumnal season. But these causes are not sufficient to account for the 

 epidemic. Typhus, like other contagious diseases, fluctuates in its amount at dif- 

 ferent periods ; at one time occurring in scattered cases only, at another time 

 extending widely over the community. What determines it to assume the epidemic 

 form can sometimes be made out — an exceptional intensity of the conditions that 

 foster it in ordinary times. But sometimes its prevalence as an epidemic cannot be 

 thus explained. Like other diseases of its class, with predisposing conditions 

 apparently constant, it has times of subsidence and times of prevalence that medical 

 science cannot yet explain. 



" The negative conclusion at which this report arrives concerning the causes of 

 the present epidemic may appear at first sight unsatisfactory. But it is not without 

 its value if it shows that efforts for preventing epidemics of typhus must be applied 

 not chiefly at the times of the epidemic itself, but to the improvement of certain 

 habitual conditions that can be recognized as fostering the disease in ordinary 

 times. Some of these conditions are within the range of public sanitary measures, 

 others are connected with social circumstances over which no direct public control 

 can be exercised." (The italics are ours.) 



t ' Report of 1864,' p. 35. 



