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Title: On the mode of communication of cholera

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Author: John Snow

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Release date: February 7, 2024 [eBook #72894]

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Language: English

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Original publication: London: John Churchill, 1855

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Other information and formats: www.gutenberg.org/ebooks/72894

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Credits: Richard Tonsing, MWS, (Maps provided by The UCLA Fielding School of Public Health Website), and the Online Distributed Proofreading Team at https://www.pgdp.net (This book was produced from scanned images of public domain material from the Google Books project.)

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*** START OF THE PROJECT GUTENBERG EBOOK ON THE MODE OF COMMUNICATION OF CHOLERA ***

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ON THE MODE OF COMMUNICATION OF CHOLERA.

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BY

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JOHN SNOW, M.D.,

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MEMBER OF THE ROYAL COLLEGE OF PHYSICIANS, FELLOW OF THE ROYAL MED. AND CHIR. SOCIETY, FELLOW AND VICE-PRESIDENT OF THE MEDICAL SOCIETY OF LONDON.

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Second Edition, much Enlarged.

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LONDON: JOHN CHURCHILL, NEW BURLINGTON STREET.

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M.DCCC.LV.

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LONDON:

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T. RICHARDS, 37 GREAT QUEEN STREET.

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PREFACE TO THE SECOND EDITION.

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The first edition of this work, which was published in August 1849, was only a slender pamphlet. I have, since that time, written various papers on the same subject, which have been read at the Medical Societies, and published in the medical journals. The present edition contains the substance of all these articles, together with much new matter, the greater part of which is derived from my own recent inquiries.

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I take this opportunity of expressing my thanks to the Registrar-General for the facilities afforded me in making these inquiries.

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I feel every confidence that my present labours will receive the same kind consideration from the Medical Profession which has been accorded to my former endeavours to ascertain the causes of cholera.

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Sackville Street, Piccadilly, 11 December, 1854.

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CONTENTS.

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PAGE

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Outline of the history of cholera 1

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Cases proving its communication from person to person 3

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Cholera not communicated by means of effluvia 9

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The pathology of cholera indicates the manner in which it is communicated 10

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Analysis of the blood and evacuations in cholera 11 and 14

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Cholera is propagated by the morbid poison entering the alimentary canal 15

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Evidence of this mode of communication in the crowded habitations of the poor 17

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—— amongst the mining population 19

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Instances of the communication of cholera through the medium of polluted water, in Horsleydown 23

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—— at Albion Terrace, Wandsworth Road 25

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—— at Ilford and near Bath 32

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—— at Newburn on the Tyne 33

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—— at Cunnatore 35

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—— in the Black Sea Fleet 36

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—— in the neighbourhood of Broad St., Golden Sq. 38

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—— at Hampstead West End (the water being carried from Broad Street) 44

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Explanation of the Map showing the situation of the deaths in and around Broad Street, Golden Square 45

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Table of attacks and deaths near Golden Square 49

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Outbreak of cholera at Deptford caused by polluted water 55

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Communication of cholera by means of the water of rivers which receive the contents of the sewers 56

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Influence of the water supply on the epidemic of 1832, in London 57

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Table showing the mortality from cholera, and the water supply 58

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Influence of the water supply on the epidemic of 1849, in London 60

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Table showing this influence 62

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Communication of cholera by Thames water in the autumn of 1848 66

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New water supply of the Lambeth Company 68

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Effect of this new supply in the epidemic of autumn 1853 69

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Tables showing this effect 71 and 73

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Intimate mixture of the water supply of the Lambeth with that of the Southwark and Vauxhall Company 74

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Opportunity thus afforded of gaining conclusive evidence of the effect of the water supply on the mortality from cholera 75

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Account of inquiry for obtaining this evidence 77

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Result of the inquiry as regards the first four weeks of the epidemic of 1854 79

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—— the first seven weeks of the same epidemic 82

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Tables illustrating these results 84, 85

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Inquiry of the Registrar-General respecting the effect of the water supply of the above-mentioned Companies during the later period of the epidemic 87

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Comparison of the mortality of 1849 and 1854, in the districts supplied by the above-named Companies 89

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Effect of the water supply on the mortality from cholera amongst the inmates of workhouses and prisons 91

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Cholera in the district of the Chelsea Water Company 93

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Effect of dry weather to increase the impurity of the Thames 95

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Relation between the greater or less mortality from cholera in London and the less or greater elevation of the ground 97

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This relation shown to depend on the difference of water supply at different elevations _ib._

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Effect of water supply on the mortality of cholera in Birmingham, Leicester, etc. 98

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—— in Exeter 99

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—— in Hull 100

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—— in York 101

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—— in Dumfries, etc. 102

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—— in Nottingham and Glasgow 103

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—— in Paris and Newcastle-upon-Tyne 104

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Limited inquiry respecting the effect of the water supply at Newcastle 107

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Assent of the medical profession to the influence of polluted water on the mortality from cholera 109

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True explanation of this influence 110

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Answers to certain objections 111

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Circumstances connected with the history of cholera explained by the principles advocated in this treatise, as,—

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The duration of the epidemic in each place usually bears a direct relation to the number of the population 115

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The effect of season on the prevalence of cholera 117

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Proportion of the sexes who die of cholera at different periods of an epidemic, and under different circumstances 119

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Proportion of deaths from cholera in certain occupations 121

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Evidence that plague, yellow fever, dysentery, and typhoid fever are communicated in the same way as cholera 125

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Instances in which ague was caused by impure water 129

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Measures required for the prevention of cholera and other diseases which are communicated in the same way 133

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Appendix, containing a list of the deaths from cholera which were registered in the four weeks ending 5th August 1854, together with the water supply of the houses in which the fatal attacks took place, in all the sub-districts to which the supply of either the Southwark and Vauxhall or the Lambeth Water Company extends 138

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MAPS.

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Map 1. Showing the deaths from cholera in Broad Street, Golden Square, and the neighbourhood, from 19th August to 30th September 1854. A black mark or bar for each death is placed in the situation of the house in which the fatal attack took place. The situation of the Broad Street Pump is also indicated, as well as that of all the surrounding Pumps to which the public had access.

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Map 2. Showing the boundaries of the Registrar-General’s districts on the south side of the Thames in London, and also the water supply of those districts.

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ON THE MODE OF COMMUNICATION OF CHOLERA.

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The existence of Asiatic Cholera cannot be distinctly traced back further than the year 1769. Previous to that time the greater part of India was unknown to European medical men; and this is probably the reason why the history of cholera does not extend to a more remote period. It has been proved by various documents, quoted by Mr. Scot,[1] that cholera was prevalent at Madras in the year above mentioned, and that it carried off many thousands of persons in the peninsula of India from that time to 1790. From this period we have very little account of the disease till 1814, although, of course, it might exist in many parts of Asia without coming under the notice of Europeans.

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In June 1814, the cholera appeared with great severity in the 1st bat. 9th regt. N.I., on its march from Jaulnah to Trichinopoly; while another battalion, which accompanied it, did not suffer, although it had been exposed to exactly the same circumstances, with one exception. Mr. Cruikshanks, who attended the cases, made a report, which will be alluded to further on.

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[Sidenote: ON THE MODE OF COMMUNICATION OF CHOLERA.]

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In 1817, the cholera prevailed with unusual virulence at several places in the Delta of the Ganges; and, as it had not been previously seen by the medical men practising in that part of India, it was thought by them to be a new disease. At this time the cholera began to spread to an extent not before known; and, in the course of seven years, it reached, eastward, to China and the Philippine Islands; southward, to the Mauritius and Bourbon; and to the north-west, as far as Persia and Turkey. Its approach towards our own country, after it entered Europe, was watched with more intense anxiety than its progress in other directions. It would occupy a long time to give an account of the progress of cholera over different parts of the world, with the devastation it has caused in some places, whilst it has passed lightly over others, or left them untouched; and unless this account could be accompanied with a description of the physical condition of the places, and the habits of the people, which I am unable to give, it would be of little use.

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There are certain circumstances, however, connected with the progress of cholera, which may be stated in a general way. It travels along the great tracks of human intercourse, never going faster than people travel, and generally much more slowly. In extending to a fresh island or continent, it always appears first at a sea-port. It never attacks the crews of ships going from a country free from cholera, to one where the disease is prevailing, till they have entered a port, or had intercourse with the shore. Its exact progress from town to town cannot always be traced; but it has never appeared except where there has been ample opportunity for it to be conveyed by human intercourse.

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There are also innumerable instances which prove the communication of cholera, by individual cases of the disease, in the most convincing manner. Instances such as the following seem free from every source of fallacy.

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I called lately to inquire respecting the death of Mrs. Gore, the wife of a labourer, from cholera, at New Leigham Road, Streatham. I found that a son of the deceased had been living and working at Chelsea. He came home ill with a bowel complaint, of which he died in a day or two. His death took place on August 18th. His mother, who attended on him, was taken ill on the next day, and died the day following (August 20th). There were no other deaths from cholera registered in any of the metropolitan districts, down to the 26th August, within two or three miles of the above place; the nearest being at Brixton, Norwood, or Lower Tooting.

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The first case of decided Asiatic cholera in London, in the autumn of 1848, was that of a seaman named John Harnold, who had newly arrived by the _Elbe_ steamer from Hamburgh, where the disease was prevailing. He left the vessel, and went to live at No. 8, New Lane, Gainsford Street, Horsleydown. He was seized with cholera on the 22nd of September, and died in a few hours. Dr. Parkes, who made an inquiry into the early cases of cholera, on behalf of the then Board of Health, considered this as the first undoubted case of cholera.

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Now the next case of cholera, in London, occurred in the very room in which the above patient died. A man named Blenkinsopp came to lodge in the same room. He was attacked with cholera on the 30th September, and was attended by Mr. Russell of Thornton Street, Horsleydown, who had attended John Harnold. Mr. Russell informed me that, in the case of Blenkinsopp, there were rice-water evacuations; and, amongst other decided symptoms of cholera, complete suppression of urine from Saturday till Tuesday morning; and after this the patient had consecutive fever. Mr. Russell had seen a great deal of cholera in 1832, and considered this a genuine case of the disease; and the history of it leaves no room for doubt.

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The following instances are quoted from an interesting work by Dr. Simpson of York, entitled “Observations on Asiatic Cholera”:—“The first cases in the series occurred at Moor Monkton, a healthy agricultural village, situated to the north-west of York, and distant six miles from that place. At the time when the first case occurred, the malady was not known to be prevailing anywhere in the neighbourhood, nor, indeed, at any place within a distance of thirty miles.

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“John Barnes, aged 39, an agricultural labourer, became severely indisposed on the 28th of December 1832; he had been suffering from diarrhœa and cramps for two days previously. He was visited by Mr. George Hopps, a respectable surgeon at Redhouse, who, finding him sinking into collapse, requested an interview with his brother, Mr. J. Hopps, of York. This experienced practitioner at once recognised the case as one of Asiatic cholera; and, having bestowed considerable attention on the investigation of that disease, immediately enquired for some probable source of contagion, but in vain: no such source could be discovered. When he repeated his visit on the day following, the patient was dead; but Mrs. Barnes (the wife), Matthew Metcalfe, and Benjamin Muscroft, two persons who had visited Barnes on the preceding day, were all labouring under the disease, but recovered. John Foster, Ann Dunn, and widow Creyke, all of whom had communicated with the patients above named, were attacked by premonitory indisposition, which was however arrested. Whilst the surgeons were vainly endeavouring to discover whence the disease could possibly have arisen, the mystery was all at once, and most unexpectedly, unravelled by the arrival in the village of the son of the deceased John Barnes. This young man was apprentice to his uncle, a shoemaker, living at Leeds. He informed the surgeons that his uncle’s wife (his father’s sister) had died of cholera a fortnight before that time, and that, as she had no children, her wearing apparel had been sent to Monkton by a common carrier. The clothes had not been washed; Barnes had opened the box in the evening; on the next day he had fallen sick of the disease.

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“During the illness of Mrs. Barnes, her mother, who was living at Tockwith, a healthy village five miles distant from Moor Monkton, was requested to attend her. She went to Monkton accordingly, remained with her daughter for two days, washed hey daughter’s linen, and set out on her return home, apparently in good health. Whilst in the act of walking home she was seized with the malady, and fell down in collapse on the road. She was conveyed home to her cottage, and placed by the side of her bedridden husband. He, and also the daughter who resided with them, took the malady. All the three died within two days. Only one other case occurred in the village of Tockwith, and it was not a fatal case.” (p. 136.)

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“A man came from Hull (where cholera was prevailing), by trade a painter; his name and age are unknown. He lodged at the house of Samuel Wride, at Pocklington; was attacked on his arrival on the 8th of September, and died on the 9th. Samuel Wride himself was attacked on the 11th of September, and died shortly afterwards. These comprise the first cases.

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“The next was that of a person named Kneeshaw, who had been at Wride’s house. But as this forms one of a series connected with the former, furnished by Dr. Laycock, who has very obligingly taken the trouble to verify the dates and facts of the latter part of the series, it will be best to give the notes of these cases in that gentleman’s own words.

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“‘My dear Dr. Simpson,—Mrs. Kneeshaw was attacked with cholera on Monday, September 9th, and her son William on the 10th. He died on Saturday the 15th; she lived three weeks; they lived at Pocklington. On Sunday, September 16th, Mr. and Mrs. Flint, and Mr. and Mrs. Giles Kneeshaw, and two children, went to Pocklington to see Mrs. Kneeshaw. Mrs. Flint was her daughter. They all returned the same day, except Mr. M. G. Kneeshaw, who stayed at Pocklington, until Monday, September 24th, when he returned to York. At three o’clock on the same day, he was attacked with cholera, and died Tuesday, September 25th, at three o’clock in the morning. [There had been no cholera in York for some time.] On Thursday, September 27th, Mrs. Flint was attacked, but recovered. On Saturday, September 29th, her sister, Mrs. Stead, came from Pocklington to York, to attend upon her; was attacked on Monday, October the 1st, and died October the 6th.

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“‘Mrs. Hardcastle, of No. 10, Lord Mayor’s Walk, York, was attacked with cholera on October 3rd, and died the same day. Miss Agar, residing with her, died of cholera on October 7th. Miss Robinson, who had come from Hull to take care of the house, after the death of Mrs. Hardcastle and Miss Agar, was attacked, and died on October 11th. Mr. C. Agar, of Stonegate, York, went to see Mrs. Hardcastle on October 3rd, was attacked next day, and died October 6th, early in the morning. On Monday, October 8th, Mrs. Agar, the mother of Mr. C. Agar, was attacked, and on the same day, one of the servants; both recovered. They had lived with Mr. Agar. All the above dates and facts I have verified.

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“‘I am, dear Dr. Simpson, yours very truly, “‘T. LAYCOCK.

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“‘Lendal, December 1st, 1849.’” (p. 160.)

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Several other instances of the communication of cholera, quite as striking as the above, are related in Dr. Simpson’s work.

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The following account of the propagation of cholera has been published, along with several other histories of the same kind, in a pamphlet by Dr. Bryson.[2]

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“Mr. Greene, of Fraserburgh, gives the following account of the introduction of cholera into two villages in Scotland. Two boats, one belonging to Cairnbulgh and the other to Inveralochy, met at Montrose, and their crews on several occasions strolled through the town in company, although aware that it was at that time infected with cholera. On their passage homeward, they were obliged to put into Gourdon, where one man belonging to the Cairnbulgh boat died on the 22nd of September, after an illness of fourteen hours, with all the symptoms of cholera. Several of the men of both boats were at the same time attacked with serous diarrhœa, of which three of them had not recovered when they reached their respective homes; nor indeed until the first cases of the epidemic broke out in the villages.

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“In Inveralochy the first case appeared on the 28th of September, three or four days after the arrival of the boat; the sufferer, the father of one of the crew, had been engaged in removing the cargo along with other members of his family. Two other cases occurred in this family; one on the 30th of September, and one on the 1st of October.

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“In Cairnbulgh, the first cases appeared on the 29th and 30th of September respectively, and both patients had also been engaged in removing the cargo of the boat (shell-fish) belonging to that village. No other cases appeared until the 3rd of October; so that from the 28th of September to the 3rd of October none were attacked in either village, but those who had come in contact with the suspected boats, or their crews.

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“The subsequent cases were chiefly among relatives of those first attacked; and the order of their propagation was as follows. In Inveralochy, the first case was the father of a family; the second, his wife; the third, a daughter living with her parents; the fourth, a daughter who was married and lived in a different house, but who attended her father and mother during their illness; the fifth, the husband of the latter; and the sixth, his mother. Other cases occurred at the same time, although they were not known to have communicated with the former. One of them was the father of a family; the second his son, who was seized the day after his father, and a daughter the next day.”

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The following instances of communication of cholera are taken from amongst many others in the “Report on Epidemic Cholera to the Royal College of Physicians”, by Dr. Baly.

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“Stockport. (Dr. Rayner and Mr. J. Rayner, reporters). Sarah Dixon went to Liverpool, September 1st, to bury her sister, who had died of cholera there; returned to Stockport on September 3rd; was attacked with cholera on the 4th; was taken home by her mother to her mother’s house, a quarter of a mile distant; was in collapse, but recovered. Her mother was attacked on the 11th, and died. The brother, James Dixon, came from High Water to see his mother, and was attacked on the 14th.

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“Liverpool. (Mr. Henry Taylor, reporter.) A nurse attended a patient in Great Howard Street (at the lower part of the town), and on her return home, near Everton (the higher part of the town), was seized, and died. The nurse who attended her was also seized, and died. No other case had occurred previously in that neighbourhood, and none followed for about a fortnight.

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“Hedon. (Dr. Sandwith, reporter.) Mrs. N. went from Paul, a village close to the Humber, to Hedon, two miles off, to nurse her brother in cholera; the next day, after his death, went to nurse Mrs. B., also at Hedon; within two days was attacked herself; was removed to a lodging-house; the son of the lodging-house keeper was attacked the next day, and died. Mrs. N.’s son removed her back to Paul; was himself attacked two days afterwards, and died.”

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It would be easy, by going through the medical journals and works which have been published on cholera, to quote as many cases similar to the above as would fill a large volume. But the above instances are quite sufficient to show that cholera can be communicated from the sick to the healthy; for it is quite impossible that even a tenth part of these cases of consecutive illness could have followed each other by mere coincidence, without being connected as cause and effect.

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Besides the facts above mentioned, which prove that cholera is communicated from person to person, there are others which show, first, that being present in the same room with a patient, and attending on him, do not necessarily expose a person to the morbid poison; and, secondly, that it is not always requisite that a person should be very near a cholera patient in order to take the disease, as the morbid matter producing it may be transmitted to a distance. It used to be generally assumed, that if cholera were a catching or communicable disease, it must spread by effluvia given off from the patient into the surrounding air, and inhaled by others into the lungs. This assumption led to very conflicting opinions respecting the disease. A little reflection shews, however, that we have no right thus to limit the way in which a disease may be propagated, for the communicable diseases of which we have a correct knowledge spread in very different manners. The itch, and certain other diseases of the skin, are propagated in one way; syphilis, in another way; and intestinal worms in a third way, quite distinct from either of the others.

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A consideration of the pathology of cholera is capable of indicating to us the manner in which the disease is communicated. If it were ushered in by fever, or any other general constitutional disorder, then we should be furnished with no clue to the way in which the morbid poison enters the system; whether, for instance, by the alimentary canal, by the lungs, or in some other manner, but should be left to determine this point by circumstances unconnected with the pathology of the disease. But from all that I have been able to learn of cholera, both from my own observations and the descriptions of others, I conclude that cholera invariably commences with the affection of the alimentary canal. The disease often proceeds with so little feeling of general illness, that the patient does not consider himself in danger, or even apply for advice, till the malady is far advanced. In a few cases, indeed, there are dizziness, faintness, and a feeling of sinking, before discharges from the stomach or bowels actually take place; but there can be no doubt that these symptoms depend on the exudation from the mucous membrane, which is soon afterwards copiously evacuated. This is only what occurs in certain cases of hæmorrhage into the alimentary canal, where all the symptoms of loss of blood are present before that fluid shows itself in the evacuations. In those rare cases, called “cholera sicca,” in which no purging takes place, the intestines have been found distended with the excretion peculiar to the disease, whenever an examination of the body has taken place after death. In all the cases of cholera that I have attended, the loss of fluid from the stomach and bowels has been sufficient to account for the collapse, when the previous condition of the patient was taken into account, together with the suddenness of the loss, and the circumstance that the process of absorption appears to be suspended.

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The symptoms which follow the affection of the alimentary canal in cholera are exactly those which this affection is adequate, and, indeed, could not fail to produce. The analyses which have been made of the blood of cholera patients, show that the watery fluid effused into the stomach and bowels is not replaced by absorption, or is replaced only to a small extent. The analyses of Dr. O’Shaughnessy and others, during the cholera of 1831–32, show that the amount of water in the blood was very much diminished in proportion to the solid constituents, and that the salts of the blood were also diminished. The analyses of Dr. Garrod and Dr. Parkes, in the spring of 1849, were more numerous and exact.[3] The amount of water in the blood of healthy persons is on the average 785 parts in 1000; whereas, in the average of the analyses performed by Drs. Garrod and Parkes, it was only 733 parts, while the amount of solid constituents of the blood, relatively to the water, was increased from 215—the healthy standard—to 267. The globules, together with the albumen and other organic constituents of the serum, amount in the healthy state to 208 parts in 1000, while in the blood of cholera patients they amounted to 256 parts. The saline constituents in 1000 parts of blood are somewhat increased, on account of the great diminution of water; but, when estimated in relation to the other solid ingredients, or to the whole quantity existing in the healthy body, the amount is diminished. Dr. Garrod is of the opinion that a chemical analysis will determine whether or not a specimen of blood has been derived from a cholera patient.

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The stools and vomited matters in cholera consist of water, containing a small quantity of the salts of the blood, and a very little albuminous substance. The change in the blood is precisely that which the loss by the alimentary canal ought to produce; and, indeed, it is physically impossible that the alteration in the blood can be caused in any other way. The sweating which takes place in an advanced stage of the disease may increase the density of the blood to a trifling extent; but it does not come on till the blood is already altered, and it is only a consequence of the diminished force of the circulation, like the sweating met with in collapse from hæmorrhage or severe injuries, and in faintness from venesection.

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The loss of water from the blood causes it to assume the thick tarry appearance, so well known to all who have opened a vein in cholera. The diminished volume of the blood causes many of the symptoms of a true hæmorrhage, as debility, faintness, and coldness; while these effects are much increased by its thick and tenacious condition, which impedes its passage through the pulmonary capillaries, thereby reducing the contents of the arteries throughout the system to the smallest possible amount, as indicated by the small thready pulse. The interruption to the pulmonary circulation occasioned by the want of fluidity of the blood, is the cause of the distressing feeling of want of breath. Proofs of the obstructed circulation through the lungs generally remain after death, in the distended state of the pulmonary arteries and right cavities of the heart. The deficient supply of blood to the various organs, and its unfitness to pass through the capillaries, are the cause of the suppression of the renal, biliary, and other secretions. The cramps appear to consist chiefly of reflex action, caused by the irritation, and probably the distension, of the bowels.

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If any further proof were wanting than those above stated, that all the symptoms attending cholera, except those connected with the alimentary canal, depend simply on the physical alteration of the blood, and not on any cholera poison circulating in the system, it would only be necessary to allude to the effects of a weak saline solution injected into the veins in the stage of collapse. The shrunken skin becomes filled out, and loses its coldness and lividity; the countenance assumes a natural aspect; the patient is able to sit up, and for a time seems well. If the symptoms were caused by a poison circulating in the blood, and depressing the action of the heart, it is impossible that they should thus be suspended by an injection of warm water, holding a little carbonate of soda in solution.

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It has often been contended that the collapse of cholera cannot be the mere result of the purging and vomiting, because, in some of the most rapid and malignant cases, the amount of the stools and vomited fluid is less than in milder and more protracted ones, or even in some cases in which the patients recover. But, in the most rapid and malignant cases, there is sufficient loss of aqueous fluid by the alimentary canal to alter the blood into the thick tenacious state peculiar to this disease; and the fact of more purging occurring in other cases which are more protracted, only proves that, in these latter, absorption from the stomach and intestines has not been altogether arrested, or that the stools have been diluted with fluids drank by the patient. The loss of fluid in every case of fully developed cholera must be sufficient to cause the thickened state of the blood, which is the cause of the algide symptoms; and the amount of malignancy of the case must depend chiefly on the extent to which the function of absorption is impaired.

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If absorption were altogether arrested in every case of cholera from the beginning, the amount of discharge from the alimentary canal would not equal that of a fatal hæmorrhage, for the thickened blood which remains is certainly not able to maintain life so well as the same quantity of healthy blood. Indeed, it is easy to calculate the amount of fluid separated from the blood, by means of the analyses previously quoted, and others which have been made of the cholera stools. In some analyses of these evacuations made by Dr. Parkes,[4] the average composition in 1,000 parts was found to be 982.4 water and 17.6 solids; consequently, the problem is merely to find how much of such a fluid requires to be subtracted from blood consisting of water 785 and solids 215, in 1000 parts, in order to reduce it to blood consisting of water 733 and solids 267. The answer to this problem is that 208.5 parts would require to be subtracted from 1000 parts of blood. M. Valentin has estimated the average amount of blood in the human adult at thirty pounds; and, therefore, the whole quantity of fluid that requires to be effused into the stomach and bowels, in order to reduce the blood of a healthy adult individual to the condition in which it is met with in the collapse of cholera is, on the average, 100 ounces, or five imperial pints. This calculation may be useful as indicating the amount of fluid which ought not to be exceeded in the injection of the blood vessels.

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Diseases which are communicated from person to person are caused by some material which passes from the sick to the healthy, and which has the property of increasing and multiplying in the systems of the persons it attacks. In syphilis, small-pox, and vaccinia, we have physical proof of the increase of the morbid material, and in other communicable diseases the evidence of this increase, derived from the fact of their extension, is equally conclusive. As cholera commences with an affection of the alimentary canal, and as we have seen that the blood is not under the influence of any poison in the early stages of this disease,[5] it follows that the morbid material producing cholera must be introduced into the alimentary canal—must, in fact, be swallowed accidentally, for persons would not take it intentionally; and the increase of the morbid material, or cholera poison, must take place in the interior of the stomach and bowels. It would seem that the cholera poison, when reproduced in sufficient quantity, acts as an irritant on the surface of the stomach and intestines, or, what is still more probable, it withdraws fluid from the blood circulating in the capillaries, by a power analogous to that by which the epithelial cells of the various organs abstract the different secretions in the healthy body. For the morbid matter of cholera having the property of reproducing its own kind, must necessarily have some sort of structure, most likely that of a cell. It is no objection to this view that the structure of the cholera poison cannot be recognised by the microscope, for the matter of small-pox and of chancre can only be recognised by their effects, and not by their physical properties.

PG72894.B00130
The period which intervenes between the time when a morbid poison enters the system, and the commencement of the illness which follows, is called the period of incubation. It is, in reality, a period of reproduction, as regards the morbid matter; and the disease is due to the crop or progeny resulting from the small quantity of poison first introduced. In cholera, this period of incubation or reproduction is much shorter than in most other epidemic or communicable diseases. From the cases previously detailed, it is shown to be in general only from twenty-four to forty-eight hours. It is owing to this shortness of the period of incubation, and to the quantity of the morbid poison thrown off in the evacuations, that cholera sometimes spreads with a rapidity unknown in other diseases.

PG72894.B00131
The mode of communication of cholera might have been the same as it is, even if it had been a disease of the blood; for there is a good deal of evidence to show that plague, typhoid fever, and yellow fever, diseases in which the blood is affected, are propagated in the same way as cholera. There is sufficient evidence also, I believe, in the following pages, to prove the mode of communication of cholera here explained, independently of the pathology of the disease; but it was from considerations of its pathology that the mode of communication was first explained, and, if the views here propounded are correct, we had a knowledge of cholera, before it had been twenty years in Europe, more correct than that of most of the older epidemics; a knowledge which, indeed, promises to throw much light on the mode of propagation of many diseases which have been present here for centuries.

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The instances in which minute quantities of the ejections and dejections of cholera patients must be swallowed are sufficiently numerous to account for the spread of the disease; and on examination it is found to spread most where the facilities for this mode of communication are greatest. Nothing has been found to favour the extension of cholera more than want of personal cleanliness, whether arising from habit or scarcity of water, although the circumstance till lately remained unexplained. The bed linen nearly always becomes wetted by the cholera evacuations, and as these are devoid of the usual colour and odour, the hands of persons waiting on the patient become soiled without their knowing it; and unless these persons are scrupulously cleanly in their habits, and wash their hands before taking food, they must accidentally swallow some of the excretion, and leave some on the food they handle or prepare, which has to be eaten by the rest of the family, who, amongst the working classes, often have to take their meals in the sick room: hence the thousands of instances in which, amongst this class of the population, a case of cholera in one member of the family is followed by other cases; whilst medical men and others, who merely visit the patients, generally escape. The _post mortem_ inspection of the bodies of cholera patients has hardly ever been followed by the disease that I am aware, this being a duty that is necessarily followed by careful washing of the hands; and it is not the habit of medical men to be taking food on such an occasion. On the other hand, the duties performed about the body, such as laying it out, when done by women of the working class, who make the occasion one of eating and drinking, are often followed by an attack of cholera; and persons who merely attend the funeral, and have no connexion with the body, frequently contract the disease, in consequence, apparently, of partaking of food which has been prepared or handled by those having duties about the cholera patient, or his linen and bedding.

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[Sidenote: PREVALENCE OF CHOLERA IN THE MINING DISTRICTS.]

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Deficiency of light is a great obstacle to cleanliness, as it prevents dirt from being seen, and it must aid very much the contamination of the food with the cholera evacuations. Now the want of light, in some of the dwellings of the poor, in large towns, is one of the circumstances that has often been commented on as increasing the prevalence of cholera.

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The involuntary passage of the evacuations in most bad cases of cholera, must also aid in spreading the disease. Mr. Baker, of Staines, who attended two hundred and sixty cases of cholera and diarrhœa in 1849, chiefly among the poor, informed me, in a letter with which he favoured me in December of that year, that “when the patients passed their stools involuntarily the disease evidently spread.” It is amongst the poor, where a whole family live, sleep, cook, eat, and wash in a single room, that cholera has been found to spread when once introduced, and still more in those places termed common lodging-houses, in which several families were crowded into a single room. It was amongst the vagrant class, who lived in this crowded state, that cholera was most fatal in 1832; but the Act of Parliament for the regulation of common lodging-houses, has caused the disease to be much less fatal amongst these people in the late epidemics. When, on the other hand, cholera is introduced into the better kind of houses, as it often is, by means that will be afterwards pointed out, it hardly ever spreads from one member of the family to another. The constant use of the hand-basin and towel, and the fact of the apartments for cooking and eating being distinct from the sick room, are the cause of this.

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The great prevalence of cholera in institutions for pauper children and pauper lunatics, whenever it has gained access to these buildings, meets with a satisfactory explanation according to the principles here laid down. In the asylum for pauper children at Tooting, one hundred and forty deaths from cholera occurred amongst a thousand inmates, and the disease did not cease till the remaining children had been removed. The children were placed two or three in a bed, and vomited over each other when they had the cholera. Under these circumstances, and when it is remembered that children get their hands into everything, and are constantly putting their fingers in their mouths, it is not surprising that the malady spread in this manner, although I believe as much attention was paid to cleanliness as is possible in a building crowded with children. Pauper lunatics are generally a good deal crowded together, especially in their sleeping wards, and as the greater number of them are in a state of imbecility, they are no more careful than children in the use of their hands. It is with the greatest difficulty that they can be kept even moderately clean. As might be expected, according to the views here explained, the lunatic patients generally suffered in a much greater proportion than the keepers and other attendants.

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The mining population of Great Britain has suffered more from cholera than persons in any other occupation,—a circumstance which I believe can only be explained by the mode of communication of the malady above pointed out. Pitmen are differently situated from every other class of workmen in many important particulars. There are no privies in the coal-pits, or, as I believe, in other mines. The workmen stay so long in the mines that they are obliged to take a supply of food with them, which they eat invariably with unwashed hands, and without knife and fork. The following is a reply which I received from a relative of mine connected with a colliery near Leeds, in answer to an inquiry I made:—

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“Our colliers descend at five o’clock in the morning, to be ready for work at six, and leave the pit from one to half-past three. The average time spent in the pit is eight to nine hours. The pitmen all take down with them a supply of food, which consists of cake, with the addition, in some cases, of meat; and all have a bottle, containing about a quart of ‘drink’. I fear that our colliers are no better than others as regards cleanliness. The pit is one huge privy, and of course the men always take their victuals with unwashed hands.”

PG72894.B00139
It is very evident that, when a pitman is attacked with cholera whilst at work, the disease has facilities for spreading among his fellow-labourers such as occur in no other occupation. That the men are occasionally attacked whilst at work I know, from having seen them brought up from some of the coal-pits in Northumberland, in the winter of 1831–2, after having had profuse discharges from the stomach and bowels, and when fast approaching to a state of collapse.

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Dr. Baly, who has done me the honour of giving a very full and impartial account of my views in his “Report on Cholera to the College of Physicians”, makes the objection to what I have said about the colliers, that the women and children who do not work in the mines, were attacked in as large numbers as the men. I believe, however, that this is only what ought to occur from the propagation of the cholera in the crowded dwellings of the pitmen, in the manner previously explained. The only effect of its communication in the pits would be, that the men and boys in a family would have the cholera a day or two earlier than the women and children; and if a special inquiry were made on this point, this would probably be found to be the case. It has often been said that, if cholera were a communicable disease, women ought to suffer in much greater numbers than the men, as they are employed in nursing the sick. I leave this objection and Dr. Baly’s to combat each other.

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It is very probable that, when cholera occurs amongst people who are employed in the preparation or vending of provisions, the disease may be spread by this means, although from the nature of the subject it is hardly to be expected that the fact would be discovered. The following cases, perhaps, afford as decisive proof of this variety of communication of cholera as can be expected. In the beginning of 1850, a letter appeared in the _Provincial Medical and Surgical Journal_, from Mr. John C. Bloxam, in the Isle of Wight, being an answer to the inquiry on cholera by Mr. Hunt. Among other interesting information, Mr. Bloxam stated, that the only cases of cholera that occurred in the village of Carisbrook, happened in persons who ate of some stale cow-heels, which had been the property of a man who died in Newport, after a short and violent attack of cholera. Mr. Bloxam kindly made additional personal inquiries into the case, in consequence of questions I put to him, and the following is a summary of the information contained in his letter:—

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[Sidenote: COMMUNICATION OF CHOLERA BY POLLUTED WATER.]

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The man from whose house the cow-heels were sent for sale died on Monday, the 20th of August. It was the custom in the house to boil these articles on Monday, Wednesday, and Friday; and the cow-heels under consideration were taken to Carisbrook, which is a mile from Newport, ready boiled, on Tuesday the 21st. Eleven persons in all partook of this food, seven of whom ate it without any additional cooking. Six of these were taken ill within twenty-four hours after eating it, five of whom died, and one recovered. The seventh individual, a child, who ate but a small quantity of the cow-heels, was unaffected by it. Four persons partook of the food after additional cooking. In one case the cow-heels were fried, and the person who ate them was taken ill of cholera within twenty-four hours afterwards, and died. Some of the food was made into broth, of which three persons partook while it was warm; two of them remained well, but the third person partook again of the broth next day, when cold, and, within twenty-four hours after this latter meal, she was taken ill with cholera, of which she died. It may be proper to mention, although it is no unusual circumstance for animal food to be eaten in hot weather when not quite fresh, that some of the persons perceived the cow-heels to be not so fresh as they ought to have been at the time they were eaten, and part of them had to be thrown away a day or two afterwards, in consequence of being quite putrid.

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It is not unlikely that some of the cases of cholera which spring up without any apparent connection with previous cases, may be communicated through articles of diet. It is the practice of the poor people, who gain a living by selling fruit and other articles in the streets, to keep their stock in the very crowded rooms in which they live, and, when visiting the out-patients of a medical charity a few years ago, I often saw baskets of fruit pushed under the beds of sick patients, in close proximity with the chamber utensils. I need hardly say that if cases of disease were propagated in this way, it would be quite impossible to trace them.

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If the cholera had no other means of communication than those which we have been considering, it would be constrained to confine itself chiefly to the crowded dwellings of the poor, and would be continually liable to die out accidentally in a place, for want of the opportunity to reach fresh victims; but there is often a way open for it to extend itself more widely, and to reach the well-to-do classes of the community; I allude to the mixture of the cholera evacuations with the water used for drinking and culinary purposes, either by permeating the ground, and getting into wells, or by running along channels and sewers into the rivers from which entire towns are sometimes supplied with water.

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In 1849 there were in Thomas Street, Horsleydown, two courts close together, consisting of a number of small houses or cottages, inhabited by poor people. The houses occupied one side of each court or alley—the south side of Trusscott’s Court, and the north side of the other, which was called Surrey Buildings, being placed back to back, with an intervening space, divided into small back areas, in which were situated the privies of both the courts, communicating with the same drain, and there was an open sewer which passed the further end of both courts. Now, in Surrey Buildings the cholera committed fearful devastation, whilst in the adjoining court there was but one fatal case, and another case that ended in recovery. In the former court, the slops of dirty water, poured down by the inhabitants into a channel in front of the houses, got into the well from which they obtained their water; this being the only difference that Mr. Grant, the Assistant-Surveyor for the Commissioners of Sewers, could find between the circumstances of the two courts, as he stated in a report that he made to the Commissioners. The well in question was supplied from the pipes of the Southwark and Vauxhall Waterworks, and was covered in on a level with the adjoining ground; and the inhabitants obtained the water by a pump placed over the well. The channel mentioned above commenced close by the pump. Owing to something being out of order, the water had for some time occasionally burst out at the top of the well, and overflowed into the gutter or channel, afterwards flowing back again mixed with the impurities; and crevices were left in the ground or pavement, allowing part of the contents of the gutter to flow at all times into the well; and when it was afterwards emptied, a large quantity of black and highly offensive deposit was found.

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The first case of cholera in this court occurred on July 20th, in a little girl, who had been labouring under diarrhœa for four days. This case ended favourably. On the 21st July, the next day, an elderly female was attacked with the disease, and was in a state of collapse at ten o’clock the same night. This patient partially recovered, but died of some consecutive affection on August 1. Mr. Vinen, of Tooley Street, who attended these cases, states that the evacuations were passed into the beds, and that the water in which the foul linen was washed would inevitably be emptied into the channel mentioned above. Mr. Russell, of Thornton Street, Horsleydown, who attended many of the subsequent cases in the court, and who, along with another medical gentleman, was the first to call the attention of the authorities to the state of the well, says that such water was invariably emptied there, and the people admit the circumstance. About a week after the above two cases commenced, a number of patients were taken ill nearly together: four on Saturday, July 28th, seven or eight on the 29th, and several on the day following. The deaths in the cases that were fatal took place as follows:—one on the 29th, four on the 30th, and one on the 31st July; two on August 1st, and one on August the 2nd, 5th, and 10th respectively, making eleven in all. They occurred in seven out of the fourteen small houses situated in the court.

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The two first cases on the 20th and 21st were probably caused by the cholera evacuations contained in the Thames water, as it came from the waterworks, and they may be considered to represent about the average amount of cases for the neighbourhood, there having been just that number in the adjoining court, about the same time. But in a few days, when the dejections of these patients must have become mixed with the water the people drank, a number of additional cases commenced nearly together. The patients were all women and children, the men living in the court not having been attacked; they may have been out at work all day and not have drank the water, but as the surviving inhabitants nearly all left the place immediately after the above mortality occurred, I was not able to ascertain whether this was so or not.

PG72894.B00149
In Albion Terrace, Wandsworth Road, there was an extraordinary mortality from cholera in 1849, which was the more striking as there were no other cases at the time in the immediate neighbourhood; the houses opposite to, behind, and in the same line, at each end of those in which the disease prevailed, having been free from it. The row of houses in which the cholera prevailed to an extent probably at that time quite unprecedented in this country, constituted the genteel suburban dwellings of a number of professional and tradespeople, and are most of them detached a few feet from each other. They were supplied with water on the same plan. In this instance the water got contaminated by the contents of the house-drains and cesspools. The cholera extended to nearly all the houses in which the water was thus tainted, and to no others.

PG72894.B00150
[Sidenote: THE OUTBREAK OF CHOLERA AT ALBION TERRACE.]

PG72894.B00151
These houses were numbered from 1 to 17, in Albion Terrace, and were supplied with water from a copious spring in the road in front of the terrace, the water of which was conducted, by a brick barrel-drain between Nos. 7 and 8, to the back of the houses, and then flowed right and left, to supply tanks in the ground behind each house, the tanks being made of brickwork and cement, covered with a flat stone, and connected with each other by stoneware pipes six inches in diameter. A leaden pipe conveyed water from each tank to a pump situated in the back kitchen. There was a cesspool behind each house, under the privy, and situated four feet from the water-tank. The ground was opened behind the houses No. 1 and No. 7, and the drains examined under the superintendence of Mr. Grant, the Assistant-Surveyor to the Commissioners of Sewers. The cesspools at both these places were quite full, and the overflow-drain from that at No. 1 choked up. At this house the respective levels of the cesspool and the water-tank were measured, and the top of the overflow-drain from the cesspool was found to be fifteen inches above the top of the tank, and the intervening ground was very wet. The overflow-drain mentioned above had no bottom, or one so soft that it could be penetrated with a stick; and it crossed, at right angles, above the earthenware pipe of the water-tank, the joints of which were leaky, and allowed the water to escape. Behind No. 7, Mr. Grant found a pipe for bringing surplus water from the tanks, communicating with a drain from the cesspool; and he found a flat brick drain laid over the barrel-drain before mentioned, which brought the water from the spring. It appears, from a plan of the property, that this drain, which was continued in a direction towards the sewer in Battersea Fields, brought surface-drainage from the road, and received the drains from the cesspools, the house-drains from the sinks in the back kitchens, and the surplus water, or some of it, from the tanks. There was every reason to believe that this drain was stopped up, but that was not ascertained: at all events it was unable to convey the water flowing into it during the storm on July 26th, as it burst near the house No. 8, and inundated the lower premises of that and the adjoining house, No. 9, with fœtid water; and it was from this time that the water, which had occasionally been complained of before, was found by most of the people in these seventeen houses to be more or less impure or disagreeable. The water broke out of the drain again at No. 8, and overflowed the kitchens, during a heavy rain on August 2nd. It should be particularly remarked, that the tanks were placed on the same level, so that pumping from one would draw water from the others, and that any impurity getting into one tank would consequently be imparted to the rest.

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The first case of cholera occurred at No. 13, on July 28th (two days after the bursting of the drain), in a lady who had had premonitory symptoms for three or four days. It was fatal in fourteen hours. There was an accumulation of rubbish in the cellar of this house, which was said to be offensive by the person who removed it; but the proprietor of the house denied this. A lady at No. 8 was attacked with choleraic diarrhœa on July 30th: she recovered. On August 1st, a lady, aged eighty-one, at No. 6, who had had some diarrhœa eight or ten days before, which had yielded to her own treatment, was attacked with cholera: she died on the 4th with congested brain. Diarrhœa commenced on August 1st in a lady aged 60, at No. 3; collapse took place on the 5th, and death on the 6th. On August 3rd, there were three or four cases, in different parts of the row of houses, and two of them terminated fatally on the same day. The attacks were numerous during the following three or four days, and after that time they diminished in number. More than half the inhabitants of the part of the terrace in which the cholera prevailed, were attacked with it, and upwards of half the cases were fatal. The deaths occurred as follows; but as some of the patients lingered a few days, and died in the consecutive fever, the deaths are less closely grouped than the seizures. There was one death on July 28th, two on August 3rd, four on the 4th, two on the 6th, two on the 7th, four on the 8th, three on the 9th, one on the 11th, and one on the 13th. These make twenty fatal cases; and there were four or five deaths besides amongst those who were attacked after flying from the place.

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The fatal cases were distributed over ten out of the seventeen houses; and Mr. Mimpriss of Wandsworth Road, who attended many of the cases, and to whose kindness I am indebted for several of these particulars, stated that cases occurred in the other seven houses, with the exception of one or two that were empty, or nearly so. There were five deaths in the house No. 6; and one of a gentleman the day after he left it, and went to Hampstead Heath. The entire household, consisting of seven individuals, had the cholera, and six of them died.

PG72894.B00154
There is no data for showing how the disease was communicated to the first patient, at No. 13, on July 28th; but it was two or three days afterwards, when the evacuations from this patient must have entered the drains having a communication with the water supplied to all the houses, that other persons were attacked, and in two days more the disease prevailed to an alarming extent.

PG72894.B00155
I had an opportunity of examining some of the water removed by Mr. Grant from the tanks behind the houses No. 1 and No. 7, and also some of the deposit which lay in the tanks to the depth of from six to nine inches. The water was offensive, and the deposit possessed the odour of privy soil very distinctly. I found in it various substances which had passed through the alimentary canal, having escaped digestion, as the stones and husks of currants and grapes, and portions of the thin epidermis of other fruits and vegetables.

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Many of the patients attributed their illness to the water. This is here mentioned to show that they had drank of it, and at the same time found that it was impure. As explaining how persons might drink of such water before finding out its impurity, it may be stated that the grosser part of the material from drains and cesspools has a tendency, when mixed with water, to settle rapidly to the bottom. The only houses supplied with the same water, after passing the tanks in Albion Terrace, were four in Albion Street; but three of these had been empty for months, and the fourth was inhabited by a gentleman who always suspected the water, and would not drink it. There were two or three persons attacked with cholera amongst those who came to nurse the patients after the water was condemned, and who, consequently, did not drink it; but these persons were liable, in waiting on the patient, to get a small portion of the evacuations into the stomach in the way first pointed out; and there might be food in the houses, previously prepared with the tainted water. It is not here implied that every one of the cases in Albion Terrace was communicated by the water, but that far the greater portion of them were; that, in short, it was the circumstance of the cholera evacuations getting into the water, which caused the disease to spread so much beyond its ordinary extent.

PG72894.B00157
[Sidenote: IRRUPTIONS OF CHOLERA IN ROTHERHITHE.]

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The mortality in Albion Terrace was attributed by Dr. Milroy, in a published report to the General Board of Health, chiefly to three causes: first, to an open sewer in Battersea Fields, which is four hundred feet to the north of the terrace, and from which the inhabitants perceived a disagreeable odour when the wind was in certain directions; secondly, to a disagreeable odour from the sinks in the back kitchens of the houses, which was worse after the storm of July 26; and lastly, to the accumulation in the house No. 13, before alluded to. With respect to the open sewer, there are several streets and lines of houses as much exposed to any emanations there might be from it, as those in which the cholera prevailed; and yet they were quite free from the malady, as were also nineteen houses situated between the sewer and Albion Terrace. As regards the bad smells from the sinks in the kitchen, their existence is of such every day and almost universal prevalence, that they do not help to explain an irruption of cholera like that under consideration; indeed, offensive odours were created in thousands of houses in London by the same storm of rain on July 26th; and the two houses in which the offensive smell was greatest, viz. Nos. 8 and 9—those which were flooded with the contents of the drain—were less severely visited with cholera than the rest; the inhabitants having only had diarrhœa, or mild attacks of cholera. The accumulation in the house No. 13 could not affect the houses at a distance from it. It remains evident then, that the only special and peculiar cause connected with the great calamity which befel the inhabitants of these houses, was the state of the water, which was followed by the cholera in almost every house to which it extended, whilst all the surrounding houses were quite free from the disease. Indeed, the General Board of Health attributed the mortality at this place to the contamination of the water, in a manifesto which they published not long after Dr. Milroy’s report.[6]

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Dr. Lloyd mentioned some instances of the effects of impure water at the South London Medical Society, on August 30th, 1849.[7] In Silver Street, Rotherhithe, there were eighty cases, and thirty-eight deaths, in the course of a fortnight early in July of that year, at a time when there was very little cholera in any other part of Rotherhithe. The contents of all the privies in this street ran into a drain which had once had a communication with the Thames; and the people got their supply of water from a well situated very near the end of the drain, with the contents of which the water got contaminated. Dr. Lloyd informed me that the fetid water from the drain could be seen dribbling through the side of the well, above the surface of the water. Amongst other sanitary measures recommended by Dr. Lloyd was the filling up of the well; and the cholera ceased in Silver Street as soon as the people gave over using the water. Another instance alluded to by Dr. Lloyd, was Charlotte Place, in Rotherhithe, consisting of seven houses, the inhabitants of which, excepting those of one house, obtained their water from a ditch communicating with the Thames, and receiving the contents of the privies of all the seven houses. In these houses there were twenty-five cases of cholera, and fourteen deaths; one of the houses had a pump railed off, to which the inhabitants of the other houses had no access, and there was but one case in that house.

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The following instance, as well as some others of a similar kind, is related in the “Report of the General Board of Health on the Cholera of 1848 and 1849.”

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“In Manchester, a sudden and violent outbreak of cholera occurred in Hope Street, Salford. The inhabitants used water from a particular pump-well. This well had been repaired, and a sewer which passes within nine inches of the edge of it became accidentally stopped up, and leaked into the well. The inhabitants of thirty houses used the water from this well; among them there occurred nineteen cases of diarrhœa, twenty-six cases of cholera, and twenty-five deaths. The inhabitants of sixty houses in the same immediate neighbourhood used other water; among these there occurred eleven cases of diarrhœa, but not a single case of cholera, nor one death. It is remarkable, that, in this instance, out of the twenty-six persons attacked with cholera, the whole perished except one.”—Page 62.

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[Sidenote: THE OUTBREAK OF CHOLERA AT NEWBURN, ON THE TYNE.]

PG72894.B00163
Dr. Thomas King Chambers informed me, that at Ilford, in Essex, in the summer of 1849, the cholera prevailed very severely in a row of houses a little way from the main part of the town. It had visited every house in the row but one. The refuse which overflowed from the privies and a pigsty could be seen running into the well over the surface of the ground, and the water was very fetid; yet it was used by the people in all the houses except that which had escaped cholera. That house was inhabited by a woman who took linen to wash, and she, finding that the water gave the linen an offensive smell, paid a person to fetch water for her from the pump in the town, and this water she used for culinary purposes, as well as for washing.

PG72894.B00164
The following circumstance was related to me, at the time it occurred, by a gentleman well acquainted with all the particulars. The drainage from the cesspools found its way into the well attached to some houses at Locksbrook, near Bath, and the cholera making its appearance there in the autumn of 1849, became very fatal. The people complained of the water to the gentleman belonging to the property, who lived at Weston, in Bath, and he sent a surveyor, who reported that nothing was the matter. The tenants still complaining, the owner went himself, and on looking at the water and smelling it, he said that he could perceive nothing the matter with it. He was asked if he would taste it, and he drank a glass of it. This occurred on a Wednesday; he went home, was taken ill with the cholera, and died on the Saturday following, there being no cholera in his own neighbourhood at the time.

PG72894.B00165
There is no spot in this country in which the cholera was more fatal during the epidemic of 1832 than the village of Newburn, near Newcastle-upon-Tyne. We are informed, in an excellent paper on the subject by Dr. David Craigie,[8] that exactly one-tenth of the population died. The number of the inhabitants was five hundred and fifty; of these, three hundred and twenty suffered from the epidemic, either in the form of diarrhœa or the more confirmed disease, and the deaths amounted to fifty-five. Being aware of this mortality, I wrote, about the beginning of the year 1849, to a friend in Newcastle—Dr. Embleton—to make inquiries respecting the water used at Newburn, and he kindly procured me some information from the Rev. John Reed, of Newburn Vicarage, which I received in February, as well as an answer from Mr. Davison, surgeon, of Newburn, to whom I had written in the meantime. I learnt from these communications that the people were supplied with water in 1832, as they still were, from three wells, two of which were very little used, and that the water in the third well was derived from the workings of an old coal-mine near the village. The water of this well, as I was informed, although generally good when first drawn, became putrid after being kept two days. It was considered that the evacuations of the people could not get into any of the wells; but the vicar thought that the water of a little brook which runs past the village, and falls into the Tyne immediately afterwards, might find its way into that well which is chiefly resorted to. Putrefaction, on being kept a day or two, is so much the character of water containing animal matter, that, after receiving confirmation of my views respecting the communication of cholera by water from many other places, I wrote to Mr. Davison again on the subject, and he kindly took a great deal of trouble to investigate the matter further. He informed me that the brook was principally formed by water which was constantly pumped from coal-pits in the neighbourhood. About half a mile before reaching Newburn it received the refuse of a small village, and between that village and Newburn it ran through a privy used by the workmen of a steel factory. In Newburn this brook received the contents of the open drains or gutters from the houses. The drain which conveyed water from a coal mine or drift not worked for a great number of years, to the well mentioned above, passed underneath the brook at one part of its course, and from that point ran alongside of the brook to the well,—a distance of about three hundred yards. Mr. Davison said that it was disputed whether there was any communication between the drain and the brook, but that it was highly probable that there might be; and that an occurrence which took place a few months previously seemed to prove that there was. Some gas-water from the steel manufactory mentioned above got by accident into the brook, and some of the people affirmed that the water in the well was strongly impregnated with it.

PG72894.B00166
The first case of cholera in Newburn was that of a young man living close to the brook, about a hundred yards above the place at which it passes the well. He was taken ill on the 29th December, 1831, and died, in the stage of consecutive fever, on January 4th, 1832. There were some cases of diarrhœa in the village, but no new cases of cholera till the night of January the 9th, during which night and the following morning thirteen persons were taken ill. During the night of the 12th four persons were attacked; by the 15th there were fourteen new cases, and on this day the late vicar died—the Rev. John Edmonston. By the next day at noon there were at least fifty new cases. A few days after this the disease began to subside, and by the 2nd of February had almost disappeared. As several days elapsed between the first case of cholera and the great outbreak, it is probable that the water in which the soiled linen must have been washed, and which would necessarily run into the brook, was the means of communicating the disease to the thirteen persons taken ill on the night between the 9th and 10th of January; unless, indeed, the intermediate cases of diarrhœa could transmit the disease.

PG72894.B00167
The following passage is from the report of Mr. Cruikshanks on the outbreak of cholera in 1814, previously alluded to as occurring in a battalion on its march from Jaulnah to Trichinopoly.

PG72894.B00168
“It was the belief of the natives, strenuously fostered and inculcated by their spiritual guides, that the epidemic was the immediate consequence of the wrath of Heaven, outraged and insulted by the pollution of certain sacred tanks, situated at the village of Cunnatore, in which sepoys of low caste and camp followers had indiscriminately bathed. Such we may not regard as affording a very satisfactory solution of the difficulty; yet it leads, I think, directly to the true point of inquiry. At Cunnatore, the force was so encamped, that while the 5th Native Infantry on the right had their supplies of water from wells, the puckallies of the 9th Native Infantry procured water for that battalion from tanks situated on low ground on the left of the line. The fact, that the disease first broke forth in a day or two after passing Cunnatore; the prevailing opinion of the natives, that it originated there, and that somehow it was connected with the tanks; a desire to discover some one cause confined in its influence and operation to one out of the two battalions; lastly, the difficulty or impossibility of lighting on any other; all these led to inquiry, and to ascertaining with a considerable degree of certainty, that each battalion was supplied with water from a source distinct from the other.”[9] The cholera was said not to be at Cunnatore at the time the infantry were encamped there, but this was probably a mistake.

PG72894.B00169
[Sidenote: CHOLERA IN THE BLACK SEA FLEET.]

PG72894.B00170
The following quotation is from a letter by a medical officer in the Black Sea fleet, dated Baljik, August 23, 1854, and published in the _Medical Times and Gazette_ of September 30th.

PG72894.B00171
“A week after the return of the fleet to Baljik, on the 7th of August, about four thousand French troops encamped on the heights abreast our anchorage. These were part of the first division of the army that had marched to Kostenje, about ten days before. By it the first blood had been drawn on the part of the allied army. The loss in battle was small, but they had encountered an enemy more terrible than the Russians. The cholera had broken out among them, and attacking four hundred on the first night had destroyed sixty. The total loss had been something incredible. It was said, that out of eleven thousand men, not less than five thousand had perished in a few days. This dreadful calamity was attributed to drinking water from wells that had been poisoned by throwing in putrid carcases.

PG72894.B00172
“Putting aside the question of intentional poisoning, which always presents itself as the most ready way of accounting for such destruction, perhaps some support to the theory, that water is the medium by which cholera poison is conveyed, may be found in this circumstance, and in another of which I was witness. These soldiers, wearied by marching from a focus of cholera infection, were seen, many of them, washing their persons and clothing in the stream from which all the French ships of war, and the majority of the English fleet, obtained their supply of water. This was going on on the 7th and 8th, and, on the nights of the 9th and 10th, the disease burst out with great violence among the crews of several ships.

PG72894.B00173
“Some English ships were the first to suffer, on the night of the 9th, and they proceeded to sea next morning. On the night of the 10th, other English ships, and some of the French, began to suffer; and the latter in an almost unparalleled manner.

PG72894.B00174
“The two admirals’ ships, _Montebello_ and _Ville de Paris_, were terribly affected. On the previous day they had been in as healthy a state as usual; and in the night the cholera attacked, in the former, two hundred men, of whom forty lay dead in the morning; and in the _Ville de Paris_ there were also many deaths. The French fleet sailed on the afternoon of the 11th; and the following morning saw the English ships also at sea.

PG72894.B00175
“On this day (the 14th), about noon, the _Britannia_, which had left port in a favourable condition, was attacked suddenly, and in twenty hours upwards of fifty of her crew had expired. We knew nothing of the calamity that had overwhelmed our leader until the following morning, when ‘reports of the sick’ were sent from each ship to the admiral. By this time (the evening of the 16th), eighty had died, and more than two hundred remained in greater or less danger.

PG72894.B00176
“The night of the 16th must have been one of great consternation on board her. The epidemic went on with unchecked violence; the officers were voluntarily attending on the sick; and the very few of the crew who had not been attacked, or who were not assisting their unfortunate messmates, were found quite insufficient to perform the duties of a ship when under sail; and the admiral, therefore, determined to return to Baljik, taking with him the _Trafalgar_ and _Albion_, also badly affected.

PG72894.B00177
“The crew of the _Britannia_ were at once sent away from the ship, in small parties, into the numerous transports that remained idle; and it appears that, by this procedure, the epidemic influences operating among them have been greatly moderated, if not extirpated.”

PG72894.B00178
[Sidenote: THE CHOLERA NEAR GOLDEN SQUARE.]

PG72894.B00179
The most terrible outbreak of cholera which ever occurred in this kingdom, is probably that which took place in Broad Street, Golden Square, and the adjoining streets, a few weeks ago. Within two hundred and fifty yards of the spot where Cambridge Street joins Broad Street, there were upwards of five hundred fatal attacks of cholera in ten days. The mortality in this limited area probably equals any that was ever caused in this country, even by the plague; and it was much more sudden, as the greater number of cases terminated in a few hours. The mortality would undoubtedly have been much greater had it not been for the flight of the population. Persons in furnished lodgings left first, then other lodgers went away, leaving their furniture to be sent for when they could meet with a place to put it in. Many houses were closed altogether, owing to the death of the proprietors; and, in a great number of instances, the tradesmen who remained had sent away their families: so that in less than six days from the commencement of the outbreak, the most afflicted streets were deserted by more than three-quarters of their inhabitants.

PG72894.B00180
There were a few cases of cholera in the neighbourhood of Broad Street, Golden Square, in the latter part of August; and the so-called outbreak, which commenced in the night between the 31st August and the 1st September, was, as in all similar instances, only a violent increase of the malady. As soon as I became acquainted with the situation and extent of this irruption of cholera, I suspected some contamination of the water of the much-frequented street pump in Broad Street, near the end of Cambridge Street; but on examining the water, on the evening of the 3rd September, I found so little impurity in it of an organic nature, that I hesitated to come to a conclusion. Further inquiry, however, showed me that there was no other circumstance or agent common to the circumscribed locality in which this sudden increase of cholera occurred, and not extending beyond it, except the water of the above mentioned pump. I found, moreover, that the water varied, during the next two days, in the amount of organic impurity, visible to the naked eye, on close inspection, in the form of small white, flocculent particles; and I concluded that, at the commencement of the outbreak, it might possibly have been still more impure. I requested permission, therefore, to take a list, at the General Register Office, of the deaths from cholera, registered during the week ending 2nd September, in the sub-districts of Golden Square, Berwick Street, and St. Ann’s, Soho, which was kindly granted. Eighty-nine deaths from cholera were registered, during the week, in the three sub-districts. Of these, only six occurred in the four first days of the week; four occurred on Thursday, the 31st August; and the remaining seventy-nine on Friday and Saturday. I considered, therefore, that the outbreak commenced on the Thursday; and I made inquiry, in detail, respecting the eighty-three deaths registered as having taken place during the last three days of the week.

PG72894.B00181
On proceeding to the spot, I found that nearly all the deaths had taken place within a short distance of the pump. There were only ten deaths in houses situated decidedly nearer to another street pump. In five of these cases the families of the deceased persons informed me that they always sent to the pump in Broad Street, as they preferred the water to that of the pump which was nearer. In three other cases, the deceased were children who went to school near the pump in Broad Street. Two of them were known to drink the water; and the parents of the third think it probable that it did so. The other two deaths, beyond the district which this pump supplies, represent only the amount of mortality from cholera that was occurring before the irruption took place.

PG72894.B00182
With regard to the deaths occurring in the locality belonging to the pump, there were sixty-one instances in which I was informed that the deceased persons used to drink the pump-water from Broad Street, either constantly or occasionally. In six instances I could get no information, owing to the death or departure of every one connected with the deceased individuals; and in six cases I was informed that the deceased persons did not drink the pump-water before their illness.

PG72894.B00183
The result of the inquiry then was, that there had been no particular outbreak or increase of cholera, in this part of London, except among the persons who were in the habit of drinking the water of the above-mentioned pump-well.

PG72894.B00184
I had an interview with the Board of Guardians of St. James’s parish, on the evening of Thursday, 7th September, and represented the above circumstances to them. In consequence of what I said, the handle of the pump was removed on the following day.

PG72894.B00185
Besides the eighty-three deaths mentioned above as occurring on the three last days of the week ending September 2nd, and being registered during that week in the sub-districts in which the attacks occurred, a number of persons died in Middlesex and other hospitals, and a great number of deaths which took place in the locality during the last two days of the week, were not registered till the week following. The deaths altogether, on the 1st and 2nd of September, which have been ascertained to belong to this outbreak of cholera, were one hundred and ninety-seven; and many persons who were attacked about the same time as these, died afterwards. I should have been glad to inquire respecting the use of the water from Broad Street pump in all these instances, but was engaged at the time in an inquiry in the south districts of London, which will be alluded to afterwards; and when I began to make fresh inquiries in the neighbourhood of Golden Square, after two or three weeks had elapsed, I found that there had been such a distribution of the remaining population that it would be impossible to arrive at a complete account of the circumstances. There is no reason to suppose, however, that a more extended inquiry would have yielded a different result from that which was obtained respecting the eighty-three deaths which happened to be registered within the district of the outbreak before the end of the week in which it occurred.

PG72894.B00186
The additional facts that I have been able to ascertain are in accordance with those above related; and as regards the small number of those attacked, who were believed not to have drank the water from Broad Street pump, it must be obvious that there are various ways in which the deceased persons may have taken it without the knowledge of their friends. The water was used for mixing with spirits in all the public houses around. It was used likewise at dining-rooms and coffee-shops. The keeper of a coffee-shop in the neighbourhood, which was frequented by mechanics, and where the pump-water was supplied at dinner time, informed me (on 6th September) that she was already aware of nine of her customers who were dead. The pump-water was also sold in various little shops, with a teaspoonful of effervescing powder in it, under the name of sherbet; and it may have been distributed in various other ways with which I am unacquainted. The pump was frequented much more than is usual, even for a London pump in a populous neighbourhood.

PG72894.B00187
There are certain circumstances bearing on the subject of this outbreak of cholera which require to be mentioned. The Workhouse in Poland Street is more than three-fourths surrounded by houses in which deaths from cholera occurred, yet out of five hundred and thirty-five inmates only five died of cholera, the other deaths which took place being those of persons admitted after they were attacked. The workhouse has a pump-well on the premises, in addition to the supply from the Grand Junction Water Works, and the inmates never sent to Broad Street for water. If the mortality in the workhouse had been equal to that in the streets immediately surrounding it on three sides, upwards of one hundred persons would have died.

PG72894.B00188
There is a Brewery in Broad Street, near to the pump, and on perceiving that no brewer’s men were registered as having died of cholera, I called on Mr. Huggins, the proprietor. He informed me that there were above seventy workmen employed in the brewery, and that none of them had suffered from cholera,—at least in a severe form,—only two having been indisposed, and that not seriously, at the time the disease prevailed. The men are allowed a certain quantity of malt liquor, and Mr. Huggins believes they do not drink water at all; and he is quite certain that the workmen never obtained water from the pump in the street. There is a deep well in the brewery, in addition to the New River water.

PG72894.B00189
At the percussion-cap manufactory, 37 Broad Street, where, I understand, about two hundred workpeople were employed, two tubs were kept on the premises always supplied with water from the pump in the street, for those to drink who wished; and eighteen of these workpeople died of cholera at their own homes, sixteen men and two women.

PG72894.B00190
Mr. Marshall, surgeon, of Greek Street, was kind enough to inquire respecting seven workmen who had been employed in the manufactory of dentists’ materials, at Nos. 8 and 9 Broad Street, and who died at their own homes. He learned that they were all in the habit of drinking water from the pump, generally drinking about half-a-pint once or twice a day; while two persons who reside constantly on the premises, but do not drink the pump-water, only had diarrhœa. Mr. Marshall also informed me of the case of an officer in the army, who lived at St. John’s Wood, but came to dine in Wardour Street, where he drank the water from Broad Street pump at his dinner. He was attacked with cholera, and died in a few hours.

PG72894.B00191
I am indebted to Mr. Marshall for the following cases, which are interesting as showing the period of incubation, which in these three cases was from thirty-six to forty-eight hours. Mrs. ——, of 13 Bentinck Street, Berwick Street, aged 28, in the eighth month of pregnancy, went herself (although they were not usually water drinkers), on Sunday, 3rd September, to Broad Street pump for water. The family removed to Gravesend on the following day; and she was attacked with cholera on Tuesday morning at seven o’clock, and died of consecutive fever on 15th September, having been delivered. Two of her children drank also of the water, and were attacked on the same day as the mother, but recovered.

PG72894.B00192
Dr. Fraser, of Oakley Square, kindly informed me of the following circumstance. A gentleman in delicate health was sent for from Brighton to see his brother at 6 Poland Street, who was attacked with cholera and died in twelve hours, on 1st September. The gentleman arrived after his brother’s death, and did not see the body. He only stayed about twenty minutes in the house, where he took a hasty and scanty luncheon of rumpsteak, taking with it a small tumbler of brandy and water, the water being from Broad Street pump. He went to Pentonville, and was attacked with cholera on the evening of the following day, 2nd September, and died the next evening.

PG72894.B00193
Dr. Fraser also first called my attention to the following circumstances, which are perhaps the most conclusive of all in proving the connexion between the Broad Street pump and the outbreak of cholera. In the “Weekly Return of Births and Deaths” of September 9th, the following death is recorded as occurring in the Hampstead district: “At West End, on 2nd September, the widow of a percussion-cap maker, aged 59 years, diarrhœa two hours, cholera epidemica sixteen hours.”

PG72894.B00194
I was informed by this lady’s son that she had not been in the neighbourhood of Broad Street for many months. A cart went from Broad Street to West End every day, and it was the custom to take out a large bottle of the water from the pump in Broad Street, as she preferred it. The water was taken on Thursday, 31st August, and she drank of it in the evening, and also on Friday. She was seized with cholera on the evening of the latter day, and died on Saturday, as the above quotation from the register shows. A niece, who was on a visit to this lady, also drank of the water; she returned to her residence, in a high and healthy part of Islington, was attacked with cholera, and died also. There was no cholera at the time, either at West End or in the neighbourhood where the niece died. Besides these two persons, only one servant partook of the water at Hampstead West End, and she did not suffer, or, at least, not severely. There were many persons who drank the water from Broad Street pump about the time of the outbreak, without being attacked with cholera; but this does not diminish the evidence respecting the influence of the water, for reasons that will be fully stated in another part of this work.

PG72894.B00195
[Illustration: _MAP 1._]

PG72894.B00196
The deaths which occurred during this fatal outbreak of cholera are indicated in the accompanying map, as far as I could ascertain them. There are necessarily some deficiencies, for in a few of the instances of persons who died in the hospitals after their removal from the neighbourhood of Broad Street, the number of the house from which they had been removed was not registered. The address of those who died after their removal to St. James’s Workhouse was not registered; and I was only able to obtain it, in a part of the cases, on application at the Master’s Office, for many of the persons were too ill, when admitted, to give any account of themselves. In the case also of some of the workpeople and others who contracted the cholera in this neighbourhood, and died in different parts of London, the precise house from which they had removed is not stated in the return of deaths. I have heard of some persons who died in the country shortly after removing from the neighbourhood of Broad Street; and there must, no doubt, be several cases of this kind that I have not heard of. Indeed, the full extent of the calamity will probably never be known. The deficiencies I have mentioned, however, probably do not detract from the correctness of the map as a diagram of the topography of the outbreak; for, if the locality of the few additional cases could be ascertained, they would probably be distributed over the district of the outbreak in the same proportion as the large number which are known.

PG72894.B00197
The dotted line on the map surrounds the sub-districts of Golden Square, St. James’s, and Berwick Street, St. James’s, together with the adjoining portion of the sub-district of St. Anne, Soho, extending from Wardour Street to Dean Street, and a small part of the sub-district of St. James’s Square enclosed by Marylebone Street, Titchfield Street, Great Windmill Street, and Brewer Street. All the deaths from cholera which were registered in the six weeks from 19th August to 30th September within this locality, as well as those of persons removed into Middlesex Hospital, are shown in the map[10] by a black line in the situation of the house in which it occurred, or in which the fatal attack was contracted.

PG72894.B00198
In addition to these the deaths of persons removed to University College Hospital, to Charing Cross Hospital, and to various parts of London, are indicated in the map, where the exact address was given in the “Weekly Return of Deaths,” or, when I could learn it by private inquiry.

PG72894.B00199
The pump in Broad Street is indicated on the map, as well as all the surrounding pumps to which the public had access at the time. It requires to be stated that the water of the pump in Marlborough Street, at the end of Carnaby Street, was so impure that many people avoided using it. And I found that the persons who died near this pump in the beginning of September, had water from the Broad Street pump. With regard to the pump in Rupert Street, it will be noticed that some streets which are near to it on the map, are in fact a good way removed, on account of the circuitous road to it. These circumstances being taken into account, it will be observed that the deaths either very much diminished, or ceased altogether, at every point where it becomes decidedly nearer to send to another pump than to the one in Broad Street. It may also be noticed that the deaths are most numerous near to the pump where the water could be more readily obtained. The wide open street in which the pump is situated suffered most, and next the streets branching from it, and especially those parts of them which are nearest to Broad Street. If there have been fewer deaths in the south half of Poland Street than in some other streets leading from Broad Street, it is no doubt because this street is less densely inhabited.

PG72894.B00200
In some of the instances, where the deaths are scattered a little further from the rest on the map, the malady was probably contracted at a nearer point to the pump. A cabinet-maker, who was removed from Philip’s Court, Noel Street, to Middlesex Hospital, worked in Broad Street. A boy also who died in Noel Street, went to the National school at the end of Broad Street, and having to pass the pump, probably drank of the water. A tailor, who died at 6, Heddon Court, Regent Street, spent most of his time in Broad Street. A woman, removed to the hospital from 10, Heddon Court, had been nursing a person who died of cholera in Marshall Street. A little girl, who died in Ham Yard, and another who died in Angel Court, Great Windmill Street, went to the school in Dufour’s Place, Broad Street, and were in the habit of drinking the pump-water, as were also a child from Naylor’s Yard, and several others, who went to this and other schools near the pump in Broad Street. A woman who died at 2, Great Chapel Street, Oxford Street, had been occupied for two days preceding her illness at the public washhouses near the pump, and used to drink a good deal of water whilst at her work; the water drank there being sometimes from the pump and sometimes from the cistern.

PG72894.B00201
The limited district in which this outbreak of cholera occurred, contains a great variety in the quality of the streets and houses; Poland Street and Great Pulteney Street consisting in a great measure of private houses occupied by one family, whilst Husband Street and Peter Street are occupied chiefly by the poor Irish. The remaining streets are intermediate in point of respectability. The mortality appears to have fallen pretty equally amongst all classes, in proportion to their numbers. Masters are not distinguished from journeymen in the registration returns of this district, but, judging from my own observation, I consider that out of rather more than six hundred deaths, there were about one hundred in the families of tradesmen and other resident householders. One hundred and five persons who had been removed from this district died in Middlesex, University College, and other hospitals, and two hundred and six persons were buried at the expense of St. James’s parish; the latter number includes many of those who died in the hospitals, and a great number who were far from being paupers, and would on any other occasion have been buried by their friends, who, at this time, were either not aware of the calamity or were themselves overwhelmed by it. The greatest portion of the persons who died were tailors and other operatives, who worked for the shops about Bond Street and Regent Street, and the wives and children of these operatives. They were living chiefly in rooms which they rented by the week.

PG72894.B00202
The following table exhibits the chronological features of this terrible outbreak of cholera.

PG72894.B00203
=TABLE I.=

PG72894.B00204
Date. No. of Fatal Attacks. Deaths. August 19 1 1 „ 20 1 0 „ 21 1 2 „ 22 0 0 „ 23 1 0 „ 24 1 2 „ 25 0 0 „ 26 1 0 „ 27 1 1 „ 28 1 0 „ 29 1 1 „ 30 8 2 „ 31 56 3 September 1 143 70 „ 2 116 127 „ 3 54 76 „ 4 46 71 „ 5 36 45 „ 6 20 37 „ 7 28 32 „ 8 12 30 „ 9 11 24 „ 10 5 18 „ 11 5 15 „ 12 1 6 „ 13 3 13 „ 14 0 6 „ 15 1 8 „ 16 4 6 „ 17 2 5 „ 18 3 2 „ 19 0 3 „ 20 0 0 „ 21 2 0 „ 22 1 2 „ 23 1 3 „ 24 1 0 „ 25 1 0 „ 26 1 2 „ 27 1 0 „ 28 0 2 „ 29 0 1 „ 30 0 0 Date unknown 45 0 ——— ——— Total 616 616

PG72894.B00205
The deaths in the above table are compiled from the sources mentioned above in describing the map; but some deaths which were omitted from the map on account of the number of the house not being known, are included in the table. As regards the date of attack, I was able to obtain it with great precision, through the kindness of Mr. Sibley, in upwards of eighty deaths which occurred in Middlesex Hospital; for the hour of admission was entered in the hospital books, as well as the previous duration of the illness. In a few other cases also I had exact information of the hour of attack, and in the remainder I have calculated it by subtracting the duration of the illness from the date of death. Where the illness did not exceed twelve hours, the attack was considered to have commenced the same day; where the illness exceeded twelve, and did not exceed thirty-six hours, the attack was put down to the previous day, and so on. Where the illness exceeded forty-eight hours, its duration is generally given in days, which were subtracted from the date of the attack. Although this plan does not always give the precise date of attack, it reaches within a few hours of it, and is as valuable perhaps as if the exact day were given, unless the hour as well as the day could be introduced into the table. Where premonitory diarrhœa is stated to have existed, the period of its duration is deducted from the date of death, and, in fact, the time of attack is fixed at the first commencement of indisposition, except in two or three instances in which the patient was labouring under another disease, as phthisis or typhus fever. There are forty-five cases in which the duration of the illness was not certified, or entered in the books of the registrars, and the time of attack in these cases is consequently unknown. These persons nearly all died in the first days of September, in the height of the calamity, and it is almost certain that they were cut off very quickly, like the others who died at this time.

PG72894.B00206
It is pretty certain that very few of the fifty-six attacks placed in the table to the 31st August occurred till late in the evening of that day. The irruption was extremely sudden, as I learn from the medical men living in the midst of the district, and commenced in the night between the 31st August and 1st September. There was hardly any premonitory diarrhœa in the cases which occurred during the first three days of the outbreak; and I have been informed by several medical men, that very few of the cases which they attended on those days ended in recovery.

PG72894.B00207
The greatest number of attacks in any one day occurred on the 1st of September, immediately after the outbreak commenced. The following day the attacks fell from one hundred and forty-three to one hundred and sixteen, and the day afterwards to fifty-four. A glance at the above table will show that the fresh attacks continued to become less numerous every day. On September the 8th—the day when the handle of the pump was removed—there were twelve attacks; on the 9th, eleven; on the 10th, five; on the 11th, five; on the 12th, only one; and after this time, there were never more than four attacks on one day. During the decline of the epidemic the deaths were more numerous than the attacks, owing to the decease of many persons who had lingered for several days in consecutive fever.

PG72894.B00208
[Sidenote: THE PUMP-WELL IN BROAD STREET, GOLDEN SQUARE.]

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There is no doubt that the mortality was much diminished, as I said before, by the flight of the population, which commenced soon after the outbreak; but the attacks had so far diminished before the use of the water was stopped, that it is impossible to decide whether the well still contained the cholera poison in an active state, or whether, from some cause, the water had become free from it. The pump-well has been opened, and I was informed by Mr. Farrell, the superintendent of the works, that there was no hole or crevice in the brickwork of the well, by which any impurity might enter; consequently in this respect the contamination of the water is not made out by the kind of physical evidence detailed in some of the instances previously related. I understand that the well is from twenty-eight to thirty feet in depth, and goes through the gravel to the surface of the clay beneath. The sewer, which passes within a few yards of the well, is twenty-two feet below the surface. The water at the time of the cholera contained impurities of an organic nature, in the form of minute whitish flocculi, visible on close inspection to the naked eye, as I before stated. Dr. Hassall, who was good enough to examine some of this water with the microscope, informed me that these particles had no organised structure, and that he thought they probably resulted from decomposition of other matter. He found a great number of very minute oval animalcules in the water, which are of no importance, except as an additional proof that the water contained organic matter on which they lived. The water also contained a large quantity of chlorides, indicating, no doubt, the impure sources from which the spring is supplied. Mr. Eley, the percussion-cap manufacturer of 37 Broad Street, informed me that he had long noticed that the water became offensive, both to the smell and taste, after it had been kept about two days. This, as I noticed before, is a character of water contaminated with sewage. Another person had noticed for months that a film formed on the surface of the water when it had been kept a few hours.

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I inquired of many persons whether they had observed any change in the character of the water, about the time of the outbreak of cholera, and was answered in the negative. I afterwards, however, met with the following important information on this point. Mr. Gould, the eminent ornithologist, lives near the pump in Broad Street, and was in the habit of drinking the water. He was out of town at the commencement of the outbreak of cholera, but came home on Saturday morning, 2nd September, and sent for some of the water almost immediately, when he was much surprised to find that it had an offensive smell, although perfectly transparent and fresh from the pump. He did not drink any of it. Mr. Gould’s assistant, Mr. Prince, had his attention drawn to the water, and perceived its offensive smell. A servant of Mr. Gould who drank the pump-water daily, and drank a good deal of it on August 31st, was seized with cholera at an early hour on September 1st. She ultimately recovered.

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Whether the impurities of the water were derived from the sewers, the drains, or the cesspools, of which latter there are a number in the neighbourhood, I cannot tell. I have been informed by an eminent engineer, that whilst a cesspool in a clay soil requires to be emptied every six or eight months, one sunk in the gravel will often go for twenty years without being emptied, owing to the soluble matters passing away into the land-springs by percolation. As there had been deaths from cholera just before the great outbreak not far from this pump-well, and in a situation elevated a few feet above it, the evacuations from the patients might of course be amongst the impurities finding their way into the water, and judging the matter by the light derived from other facts and considerations previously detailed, we must conclude that such was the case. A very important point in respect to this pump-well is that the water passed with almost everybody as being perfectly pure, and it did in fact contain a less quantity of impurity than the water of some other pumps in the same parish, which had no share in the propagation of cholera. We must conclude from this outbreak that the quantity of morbid matter which is sufficient to produce cholera is inconceivably small, and that the shallow pump-wells in a town cannot be looked on with too much suspicion, whatever their local reputation may be.

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[Sidenote: PUMP-WELL, BROAD ST., GOLDEN SQ.]

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Whilst the presumed contamination of the water of the Broad Street pump with the evacuations of cholera patients, affords an exact explanation of the fearful outbreak of cholera in St. James’s parish, there is no other circumstance which offers any explanation at all, whatever hypothesis of the nature and cause of the malady be adopted. Many persons were inclined to attribute the severity of the malady in this locality to the very circumstance to which some people attribute the comparative immunity of the city of London from the same disease, viz., to the drains in the neighbourhood having been disturbed and put in order about half a year previously. Mr. Bazelgette, however, pointed out, in a report to the commissioners, that the streets in which the new sewers had been made suffered less than the others; and a reference to the map will show that this is correct, for I recollect that the streets in which the sewers were repaired about February last, were Brewer Street, Little Pulteney Street, and Dean Street, Soho. Many of the non-medical public were disposed to attribute the outbreak of cholera to the supposed existence of a pit in which persons dying of the plague had been buried about two centuries ago; and, if the alleged plague-pit had been nearer to Broad Street, they would no doubt still cling to the idea. The situation of the supposed pit is, however, said to be Little Marlborough Street, just out of the area in which the chief mortality occurred. With regard to effluvia from the sewers passing into the streets and houses, that is a fault common to most parts of London and other towns. There is nothing peculiar in the sewers or drainage of the limited spot in which this outbreak occurred; and Saffron Hill and other localities, which suffer much more from ill odours, have been very lightly visited by cholera.

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[Sidenote: IRRUPTION OF CHOLERA AT DEPTFORD.]

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Just at the time when the great outbreak of cholera occurred in the neighbourhood of Broad Street, Golden Square, there was an equally violent irruption in Deptford, but of a more limited extent. About ninety deaths took place in a few days, amongst two or three score of small houses, in the north end of New Street and an adjoining row called French’s Fields. Deptford is supplied with very good water from the river Ravensbourne by the Kent Water Works, and until this outbreak there was but little cholera in the town, except amongst some poor people, who had no water except what they got by pailsful from Deptford Creek—an inlet of the Thames. There had, however, been a few cases in and near New Street, just before the great outbreak. On going to the spot on September 12th and making inquiry, I found that the houses in which the deaths had occurred were supplied by the Kent Water Works, and the inhabitants never used any other water. The people informed me, however, that for some few weeks the water had been extremely offensive when first turned on; they said it smelt like a cesspool, and frothed like soap suds. They were in the habit of throwing away a few pailsful of that which first came in, and collecting some for use after it became clear. On inquiring in the surrounding streets, to which this outbreak of cholera did not extend, viz., Wellington Street, Old King Street, and Hughes’s Fields, I found that there had been no alteration in the water. I concluded, therefore, that a leakage had taken place into the pipes supplying the places where the outbreak occurred, during the intervals when the water was not turned on. Gas is known to get into the water-pipes occasionally in this manner, when they are partially empty, and to impart its taste to the water. There are no sewers in New Street or French’s Fields, and the refuse of all kinds consequently saturates the ground in which the pipes are laid. I found that the water collected by the people, after throwing away the first portion, still contained more organic matter than that supplied to the adjoining streets. On adding nitrate of silver and exposing the specimens to the light, a deeper tint of brown was developed in the former than in the latter.

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All the instances of communication of cholera through the medium of water, above related, have resulted from the contamination of a pump-well, or some other limited supply of water; and the outbreaks of cholera connected with the contamination, though sudden and intense, have been limited also; but when the water of a river becomes infected with the cholera evacuations emptied from on board ship, or passing down drains and sewers, the communication of the disease, though generally less sudden and violent, is much more widely extended; more especially when the river water is distributed by the steam engine and pipes connected with waterworks. Cholera may linger in the courts and alleys crowded with the poor, for reasons previously pointed out, but I know of no instance in which it has been generally spread through a town or neighbourhood, amongst all classes of the community, in which the drinking water has not been the medium of its diffusion. Each epidemic of cholera in London has borne a strict relation to the nature of the water supply of its different districts, being modified only by poverty, and the crowding and want of cleanliness which always attend it.

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[Sidenote: THE EPIDEMIC OF 1832.]

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The following table shows the number of deaths from cholera in the various districts of London in 1832, together with the nature of the water supply at that period. (See next page.)[11]

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This table shows that in the greater part of Southwark, which was supplied with worse water than any other part of the metropolis, the mortality from cholera was also much higher than anywhere else. The other south districts, supplied with water obtained at points higher up the Thames, and containing consequently less impurity, were less affected. On the north of the Thames, the east districts, supplied, in 1832, with water from the river Lea, at Old Ford, where it contained the sewage of a large population, suffered more than other parts on the north side of London. Whitechapel suffered more than the other east districts; probably not more from the poverty and crowded state of the population, than from the great number of mariners, coalheavers, and others, living there, who were employed on the Thames, and got their water, whilst at work, direct from the river. There were one hundred and thirty-nine deaths from cholera amongst persons afloat on the Thames. The cholera passed very lightly over most of the districts supplied by the New River Company. St. Giles’ was an exception, owing to the overcrowding of the common lodging-houses in the part of the parish called the Rookery. The City of London also suffered severely in 1832. Now when the engine at Broken Wharf was employed to draw water from the Thames, this water was supplied more particularly to the City, and not at all to the higher districts supplied by the New River Company. This would offer an explanation of the high mortality from cholera in the City at that time, supposing the engine were actually used during 1832; but I have not yet been able to ascertain that circumstance with certainty. I know, however, that it was still used occasionally some years later.

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=TABLE II.=

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┌────────────────────┬───────────┬────────┬───────────┬──────────────────────┐ │ │ │ Deaths │Deaths from│ │ │ Districts. │Population.│ from │Cholera in │ Water Supply. │ │ │ │Cholera.│ 10,000 │ │ │ │ │ │ living. │ │ ├────────────────────┼───────────┼────────┼─────┬─────┼──────────────────────┤ │ │ │ │ │ │Southwark Water Works,│ │St. George the │ │ │ │ │ from Thames at │ │ Martyr, Southwark}│ 77,796│ 856│ 110│ │ London Bridge. No │ │ │ │ │ │ │ filter or settling │ │ │ │ │ │ │ reservoir. │ │St. Olave’s, │ „ │ „ │ „ │ │ „ │ │ Southwark} │ │ │ │ │ │ │St. Saviour’s, │ „ │ „ │ „ │ │ „ │ │ Southwark} │ │ │ │ │ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chiefly by Lambeth │ │ │ │ │ │ │ Water Works, from │ │Christchurch, │ 13,705│ 35│ 25}│ │ Thames opposite │ │ Southwark │ │ │ │ │ Hungerford Market. │ │ │ │ │ │ │ No filter or │ │ │ │ │ │ │ settling reservoir. │ │Lambeth │ 87,856│ 337│ 38}│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chiefly by South │ │ │ │ │ │ │ London Water Works, │ │Newington │ 44,526│ 200│ 45}│ │ from Thames at │ │ │ │ │ │ │ Vauxhall Bridge. │ │ │ │ │ │ │ Reservoirs. No │ │ │ │ │ │ │ filter. │ │Camberwell │ 28,231│ 107│ 37}│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │South London Water │ │Bermondsey │ 29,741│ 210│ 70}│ │ Works, & Tidal │ │ │ │ │ │ │ Ditches. │ │Rotherhithe │ 12,875│ 19│ 14}│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │East London │ │Bethnal Green │ 62,018│ 170│ 27}│ 42{ │ Waterworks, from │ │ │ │ │ │ │ tidal part of river │ │ │ │ │ │ │ Lea at Old Ford. │ │St. │ 38,505│ 123│ 31}│ „ │ „ │ │ George-in-the-East│ │ │ │ │ │ │Poplar │ 25,066│ 107│ 42}│ „ │ „ │ │Stepney │ 78,826│ 225│ 28}│ „ │ „ │ │Whitechapel[12] │ 52,848│ 470│ 88}│ „ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │New River Company, │ │ │ │ │ │ │ from various │ │ │ │ │ │ │ springs, and river │ │ │ │ │ │ │ Lea in │ │Clerkenwell │ 47,634│ 65│ 13}│ 34{ │ Hertfordshire; and │ │ │ │ │ │ │ occasionally from │ │ │ │ │ │ │ Thames at Broken │ │ │ │ │ │ │ Wharf, near │ │ │ │ │ │ │ Blackfriar’s Bridge.│ │St. Giles │ 52,907│ 280│ 52}│ „ │ „ │ │Holborn │ 27,334│ 46│ 16}│ „ │ „ │ │Islington │ 37,316│ 39│ 10}│ „ │ „ │ │London City │ 55,798│ 359│ 64}│ „ │ „ │ │East and West London│ No return.│ │ }│ „ │ „ │ │St. Luke’s │ 46,642│ 118│ 25}│ „ │ „ │ │Strand │ 9,937│ 37│ 37}│ „ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │New River and East │ │Hackney │ 7,326│ 8│ 10 }│ │ London Water │ │ │ │ │ │ │ Companies. │ │Shoreditch │ 68,564│ 57│ 8 }│ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chelsea Water Works, │ │Westminster │ 124,585│ 325│ 26│ │ from Thames at │ │ │ │ │ │ │ Chelsea. Reservoirs │ │ │ │ │ │ │ and filters. │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │Chelsea Water Works │ │ │ │ │ │ │ and Grand Junction │ │St. George, Hanover │ │ │ │ │ Water Works, also │ │ Sq. │ 58,209│ 74│ 12}│ 15{ │ supplying water from│ │ │ │ │ │ │ Thames at Chelsea, │ │ │ │ │ │ │ and having settling │ │ │ │ │ │ │ reservoirs. │ │Kensington │ 75,130│ 134│ 17}│ „ │ „ │ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │West Middlesex Water │ │St. Marylebone │ 122,206│ 224│ 20│ │ Works, from Thames │ │ │ │ │ │ │ at Hammersmith. │ │ │ │ │ │ │ Settling reservoirs.│ ├────────────────────┼───────────┼────────┼─────┼─────┼──────────────────────┤ │ │ │ │ │ │West Middlesex, New │ │St. Pancras │ 103,548│ 111│ 10│ │ River, and Hampstead│ │ │ │ │ │ │ Water Works. │ └────────────────────┴───────────┴────────┴─────┴─────┴──────────────────────┘

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[Sidenote: THE EPIDEMIC OF 1849.]

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Westminster suffered more in 1832 than St. George, Hanover Square, and Kensington, which at that time had the same water. This arose from the poor and crowded state of part of its population. The number of cases of cholera communicated by the water would be the same in one district as in the other; but in one district the disease would spread also from person to person more than in the others.

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Between 1832 and 1849 many changes took place in the water supply of London. The Southwark Water Company united with the South London Water Company, to form a new Company under the name of the Southwark and Vauxhall Company. The water works at London Bridge were abolished, and the united company derived their supply from the Thames at Battersea Fields, about half a mile above Vauxhall Bridge. The Lambeth Water Company continued to obtain their supply opposite to Hungerford Market; but they had established a small reservoir at Brixton.

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But whilst these changes had been made by the water companies, changes still greater had taken place in the river, partly from the increase of population, but much more from the abolition of cesspools and the almost universal adoption of waterclosets in their stead. The Thames in 1849 was more impure at Battersea Fields than it had been in 1832 at London Bridge. A clause which prevented the South London Water Company from laying their pipes within two miles of the Lambeth Water Works was repealed in 1834, and the two Companies were in active competition for many years, the result of which is, that the pipes of the Lambeth Water Company and those of the Southwark and Vauxhall Company pass together down all the streets of several of the south districts. As the water of both these Companies was nearly equal in its impurity in 1849, this circumstance was of but little consequence at that time; but it will be shown further on that it afterwards led to very important results.

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On the north side of the Thames the Water Companies and their districts remained the same, but some alterations were made in the sources of supply. The East London Water Company ceased to obtain water at Old Ford, and got it from the river Lea, above Lea Bridge, out of the influence of the tide and free from sewage, except that from some part of Upper Clapton. The Grand Junction Company removed their works from Chelsea to Brentford, where they formed large settling reservoirs. The New River Company entirely ceased to employ the steam engine for obtaining water from the Thames. The supply of the other Water Companies remained the same as in 1832.

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The accompanying table (No. 3), shows the mortality from cholera in the various registration districts of London in 1849, together with the water supply. The annual value of house and shop-room for each person is also shown, as a criterion, to a great extent, of the state of overcrowding or the reverse. The deaths from cholera and the value of house room, are taken from the “Report on the Cholera of 1849,” by Dr. Farr, of the General Register Office. The water supply is indicated merely by the name of the Companies. After the explanation given above of the source of supply, this will be sufficient. It is only necessary to add, that the Kent Water Company derive their supply from the river Ravensbourne, and the Hampstead Company from springs and reservoirs at Hampstead.

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=TABLE III,=

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Showing the mortality from Cholera, and the Water Supply, in the Districts of London, in 1849. The Districts are arranged in the order of their Mortality from Cholera.

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┌─────────────┬──────────┬────────┬─────────┬──────┬─────────────────────────┐ │ │ │ │ │Annual│ │ │ │ │ │ │value │ │ │ │ │ │ │ of │ │ │ │Population│ Deaths │Deaths by│House │ │ │ District. │ in the │ from │ Cholera │& Shop│ Water Supply. │ │ │middle of │Cholera.│to 10,000│ room │ │ │ │ 1849. │ │inhabits.│ to │ │ │ │ │ │ │ each │ │ │ │ │ │ │person│ │ │ │ │ │ │in £. │ │ ├─────────────┼──────────┼────────┼─────────┼──────┼─────────────────────────┤ │ │ │ │ │ │Southwark and Vauxhall │ │Rotherhithe │ 17,208│ 352│ 205│ 4.238│ Water Works, Kent Water│ │ │ │ │ │ │ Works, & Tidal Ditches.│ │St. Olave, │ 19,278│ 349│ 181│ 4.559│Southwark and Vauxhall. │ │ Southwark │ │ │ │ │ │ │St. George, │ 50,900│ 836│ 164│ 3.518│Southwark and Vauxhall, │ │ Southwark │ │ │ │ │ Lambeth. │ │Bermondsey │ 45,500│ 734│ 161│ 3.077│Southwark and Vauxhall. │ │St. Saviour, │ 35,227│ 539│ 153│ 5.291│Southwark and Vauxhall. │ │ Southwark │ │ │ │ │ │ │Newington │ 63,074│ 907│ 144│ 3.788│Southwark and Vauxhall, │ │ │ │ │ │ │ Lambeth. │ │Lambeth │ 134,768│ 1618│ 120│ 4.389│Southwark and Vauxhall, │ │ │ │ │ │ │ Lambeth. │ │Wandsworth │ 48,446│ 484│ 100│ 4.839│Pump-wells, Southwark and│ │ │ │ │ │ │ Vauxhall, river Wandle.│ │Camberwell │ 51,714│ 504│ 97│ 4.508│Southwark and Vauxhall, │ │ │ │ │ │ │ Lambeth. │ │West London │ 28,829│ 429│ 96│ 7.454│New River. │ │Bethnal Green│ 87,263│ 789│ 90│ 1.480│East London. │ │Shoreditch │ 104,122│ 789│ 76│ 3.103│New River, East London. │ │Greenwich │ 95,954│ 718│ 75│ 3.379│Kent. │ │Poplar │ 44,103│ 313│ 71│ 7.360│East London. │ │Westminster │ 64,109│ 437│ 68│ 4.189│Chelsea. │ │Whitechapel │ 78,590│ 506│ 64│ 3.388│East London. │ │St. Giles │ 54,062│ 285│ 53│ 5.635│New River. │ │Stepney │ 106,988│ 501│ 47│ 3.319│East London. │ │Chelsea │ 53,379│ 247│ 46│ 4.210│Chelsea. │ │East London │ 43,495│ 182│ 45│ 4.823│New River. │ │St. George’s,│ 47,334│ 199│ 42│ 4.753│East London. │ │ East │ │ │ │ │ │ │London City │ 55,816│ 207│ 38│17.676│New River. │ │St. Martin │ 24,557│ 91│ 37│11.844│New River. │ │Strand │ 44,254│ 156│ 35│ 7.374│New River. │ │Holborn │ 46,134│ 161│ 35│ 5.883│New River. │ │St. Luke │ 53,234│ 183│ 34│ 3.731│New River. │ │Kensington │ │ │ │ │West Middlesex, Chelsea, │ │ (except │ 110,491│ 260│ 33│ 5.070│ Grand Junction. │ │ Paddington)│ │ │ │ │ │ │Lewisham │ 32,299│ 96│ 30│ 4.824│Kent. │ │Belgrave │ 37,918│ 105│ 28│ 8.875│Chelsea. │ │Hackney │ 55,152│ 139│ 25│ 4.397│New River, East London. │ │Islington │ 87,761│ 187│ 22│ 5.494│New River. │ │St. Pancras │ 160,122│ 360│ 22│ 4.871│New River, Hampstead, │ │ │ │ │ │ │ West Middlesex. │ │Clerkenwell │ 63,499│ 121│ 19│ 4.138│New River. │ │Marylebone │ 153,960│ 261│ 17│ 7.586│West Middlesex. │ │St. James, │ 36,426│ 57│ 16│12.669│Grand Junction, New │ │ Westminster│ │ │ │ │ River. │ │Paddington │ 41,267│ 35│ 8│ 9.349│Grand Junction. │ │Hampstead │ 11,572│ 9│ 8│ 5.804│Hampstead, West │ │ │ │ │ │ │ Middlesex. │ │Hanover Sq. &│ 33,196│ 26│ 8│16.754│Grand Junction. │ │ May Fair │ │ │ │ │ │ ├─────────────┼──────────┼────────┼─────────┼──────┼─────────────────────────┤ │London │ 2,280,282│ 14137│ 62│ │ │ └─────────────┴──────────┴────────┴─────────┴──────┴─────────────────────────┘

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A glance at the table shows that in every district to which the supply of the Southwark and Vauxhall, or the Lambeth Water Company extends, the cholera was more fatal than in any other district whatever. The only other water company deriving a supply from the Thames, in a situation where it is much contaminated with the contents of the sewers, was the Chelsea Company. But this company, which supplies some of the most fashionable parts of London, took great pains to filter the water before its distribution, and in so doing no doubt separated, amongst other matters, the greater portion of that which causes cholera. On the other hand, although the Southwark and Vauxhall and the Lambeth Water Companies professed to filter the water, they supplied it in a most impure condition. Even in the following year, when Dr. Hassall made an examination of it, he found in it the hairs of animals and numerous substances which had passed through the alimentary canal. Speaking of the water supply of London generally, Dr. Hassall says:—

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“It will be observed, that the water of the companies on the Surrey side of London, viz., the Southwark, Vauxhall, and Lambeth, is by far the worst of all those who take their supply from the Thames.”[13]

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In the north districts of London, which suffered much less from cholera than the south districts, the mortality was chiefly influenced by the poverty and crowding of the population. The New River Company having entirely left off the use of their engine in the city, their water, being entirely free from sewage, could have had no share in the propagation of cholera. It is probable also, that the water of the East London Company, obtained above Lea Bridge, had no share in propagating the malady; and that this is true also of the West Middlesex Company, obtaining their supply from the Thames at Hammersmith; and of the Grand Junction Company, obtaining their supply at Brentford. All these Water Companies have large settling reservoirs. It is probable also, as I stated above, that the Chelsea Company in 1849, by careful filtration and by detaining the water in their reservoirs, rendered it in a great degree innocuous.

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Some parts of London suffered by the contamination of the pump-wells in 1849, and the cholera in the districts near the river was increased by the practice, amongst those who are occupied on the Thames, of obtaining water to drink by dipping a pail into it. It will be shown further on, that persons occupied on the river suffered more from cholera than others. Dr. Baly makes the following inquiry in his Report to the College of Physicians.[14]

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“How did it happen, if the character of the water has a great influence on the mortality from cholera, that in the Belgrave district only 28 persons in 10,000 died, and in the Westminster district, also supplied by the Chelsea Company, 68 persons in 10,000; and, again, that in the Wandsworth district the mortality was only 100, and in the district of St. Olave 181 in 10,000 inhabitants—both these districts receiving their supply from the Southwark Company?”

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The water of the Chelsea Company has been alluded to above, but whether this water had any share in the propagation of cholera or not, it is perfectly in accordance with the mode of communication of the disease which I am advocating, that it should spread more in the crowded habitations of the poor, in Westminster, than in the commodious houses of the Belgrave district. In examining the effect of polluted water as a medium of the cholera poison, it is necessary to bear constantly in mind the more direct way in which the poison is also swallowed, as I explained in the commencement of this work. As regards St. Olave’s and Wandsworth, Dr. Baly was apparently not aware that, whilst almost every house in the first of these districts is supplied by the water company, and has no other supply, the pipes of the company extend to only a part of the Wandsworth district, a large part of it having only pump-wells.

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The epidemic of 1849 was a continuance or revival of that which commenced in the autumn of 1848, and there are some circumstances connected with the first cases which are very remarkable, and well worthy of notice. It has been already stated (page 3) that the first case of decided Asiatic cholera in London, in the autumn of 1848, was that of a seaman from Hamburgh, and that the next case occurred in the very room in which the first patient died. These cases occurred in Horsleydown, close to the Thames. In the evening of the day on which the second case occurred in Horsleydown, a man was taken ill in Lower Fore Street, Lambeth, and died on the following morning. At the same time that this case occurred in Lambeth, the first of a series of cases occurred in White Hart Court, Duke Street, Chelsea, near the river. A day or two afterwards, there was a case at 3, Harp Court, Fleet Street. The next case occurred on October 2nd, on board the hulk _Justitia_, lying off Woolwich; and the next to this in Lower Fore Street, Lambeth, three doors from where a previous case had occurred. The first thirteen cases were all situated in the localities just mentioned; and on October 5th there were two cases in Spitalfields.

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Now, the people in Lower Fore Street, Lambeth, obtained their water by dipping a pail into the Thames, there being no other supply in the street. In White Hart Court, Chelsea, the inhabitants obtained water for all purposes in a similar way. A well was afterwards sunk in the court; but at the time these cases occurred the people had no other means of obtaining water, as I ascertained by inquiry on the spot. The inhabitants of Harp Court, Fleet Street, were in the habit, at that time, of procuring water from St. Bride’s pump, which was afterwards closed on the representation of Mr. Hutchinson, surgeon, of Farringdon Street, in consequence of its having been found that the well had a communication with the Fleet Ditch sewer, up which the tide flows from the Thames. I was informed by Mr. Dabbs, that the hulk _Justitia_ was supplied with spring water from the Woolwich Arsenal; but it is not improbable that water was occasionally taken from the Thames alongside, as was constantly the practice in some of the other hulks, and amongst the shipping generally.

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When the epidemic revived again in the summer of 1849, the first case in the sub-district “Lambeth; Church, 1st part,” was in Lower Fore Street, on June 27th; and on the commencement of the epidemic of the present year, the first case of cholera in any part of Lambeth, and one of the earliest in London, occurred at 52, Upper Fore Street, where also the people had no water except what they obtained from the Thames with a pail, as I ascertained by calling at the house. Many of the earlier cases this year occurred in persons employed amongst the shipping in the river, and the earliest cases in Wandsworth and Battersea have generally been amongst persons getting water direct from the Thames, or from streams up which the Thames flows with the tide. It is quite in accordance with what might be expected from the propagation of cholera through the medium of the Thames water, that it should generally affect those who draw it directly from the river somewhat sooner than those who receive it by the more circuitous route of the pipes of a water company.

PG72894.B00240
[Sidenote: THE EPIDEMIC OF 1853, IN LONDON.]

PG72894.B00241
London was without cholera from the latter part of 1849 to August 1853. During this interval an important change had taken place in the water supply of several of the south districts of London. The Lambeth Company removed their water works, in 1852, from opposite Hungerford Market to Thames Ditton; thus obtaining a supply of water quite free from the sewage of London. The districts supplied by the Lambeth Company are, however, also supplied, to a certain extent, by the Southwark and Vauxhall Company, the pipes of both companies going down every street, in the places where the supply is mixed, as was previously stated. In consequence of this intermixing of the water supply, the effect of the alteration made by the Lambeth Company on the progress of cholera was not so evident, to a cursory observer, as it would otherwise have been. It attracted the attention, however, of the Registrar-General, who published a table in the “Weekly Return of Births and Deaths” for 26th November 1853, of which the following is an abstract, containing as much as applies to the south districts of London.

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=TABLE IV.=

PG72894.B00243
┌─────────────┬─────────────────────┬───────────────────────────┬────────────┐ │ Water │ Sources of Supply. │ Aggregate of Districts │ Deaths in │ │ Companies. │ │ supplied chiefly by the │ 100,000 │ │ │ │ respective Companies. │inhabitants.│ ├─────────────┼─────────────────────┼────────────┬──────────────┼────────────┤ │ „ │ „ │ │ Deaths by │ │ │ │ │ │Cholera in 13 │ │ │ │ │ │ wks. ending │ │ │ │ │Population. │ Nov. 19. │ „ │ ├─────────────┼─────────────────────┼────────────┼──────────────┼────────────┤ │(1) Lambeth │Thames, at Thames │ │ │ │ │ and (2) │ Ditton and at │ │ │ │ │ Southwark │ Battersea │ │ │ │ │ and │ │ │ │ │ │ Vauxhall │ │ 346,363│ 211│ 61│ │ │ │ │ │ │ │Southwark and│Thames, at Battersea │ │ │ │ │ Vauxhall │ │ 118,267│ 111│ 94│ │ │ │ │ │ │ │(1) Southwark│Thames, at Battersea;│ │ │ │ │ and │ the Ravensbourne, │ │ │ │ │ Vauxhall, │ in Kent, & ditches │ │ │ │ │ (2) Kent │ and wells │ 17,805│ 19│ 107│ └─────────────┴─────────────────────┴────────────┴──────────────┴────────────┘

PG72894.B00244
It thus appears that the districts partially supplied with the improved water suffered much less than the others, although, in 1849, when the Lambeth Company obtained their supply opposite Hungerford Market, these same districts suffered quite as much as those supplied entirely by the Southwark and Vauxhall Company, as was shown in table III, p. 62. The Lambeth water extends to only a small portion of some of the districts necessarily included in the group supplied by both Companies; and when the division is made a little more in detail, by taking sub-districts instead of districts, the effect of the new water supply is shown to be greater than appears in the above table. The Kent Water Company was introduced into the table by the Registrar-General on account of its supplying a small part of Rotherhithe. The following interesting remarks appeared, respecting this portion of Rotherhithe, in the “Weekly Return” of December 10, 1853:—

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[Sidenote: THE EPIDEMIC OF 1853.]

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“_London Water Supply._—The following is an extract from a letter which the Registrar-General has received from Mr. Pitt, the Registrar of Rotherhithe:—

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“‘I consider Mr. Morris’s description of the part of the parish through which the pipes of the Kent Water Company were laid in 1849, is in the main correct; for though the Company had entered the parish, the water was but partially taken by the inhabitants up to the time of the fearful visitation in the above year.

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“‘With respect to the deaths in 1849, they were certainly more numerous in the district now generally supplied by the Kent Company than in any other part of the parish. I only need mention Charlotte Row, Ram Alley, and Silver Street,—places where the scourge fell with tremendous severity.

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“‘Among the recent cases of cholera, not one has occurred in the district supplied by the Kent Water Company.

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“‘The parish of Rotherhithe has been badly supplied with water for many ages past. The people drank from old wells, old pumps, open ditches, and the muddy stream of the Thames.’

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“In 1848–9 the mortality from cholera in Rotherhithe was higher than it was in any other district of London. This is quite in conformity with the general rule, that when cholera prevails, it is most fatal where the waters are most impure.”

PG72894.B00252
The following table (which, with a little alteration in the arrangement, is taken from the “Weekly Return of Births and Deaths” for 31st December 1853) shows the mortality from cholera, in the epidemic of 1853, down to a period when the disease had almost disappeared.

PG72894.B00253
The districts are arranged in the order of their mortality from Cholera.

PG72894.B00254
=TABLE V.=

PG72894.B00255
┌──────────────────────┬──────────┬──────┬───────┬───────────────────────────┐ │ │ │Deaths│ │ │ │ │ │ by │ │ │ │ │ │Chol. │Deaths │ │ │ │Population│in 17 │ by │ │ │ Districts. │ in 1853 │wks., │Cholera│ Water Supply. │ │ │ (estim.) │ Aug. │ to │ │ │ │ │21 to │100,000│ │ │ │ │ Dec. │living.│ │ │ │ │ 17, │ │ │ │ │ │1853. │ │ │ ├──────────────────────┼──────────┼──────┼───────┼───────────────────────────┤ │Bermondsey │ 48,128│ 73│ 150│Southwark & Vauxhall. │ │S. Saviour, Southwark │ 35,731│ 52│ 146│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │S. George, Southwark │ 51,824│ 74│ 143│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │St. Olave │ 19,375│ 26│ 134│Southwark & Vauxhall. │ │Rotherhithe │ 17,805│ 20│ 112│South. & Vaux., Kent. │ │Whitechapel │ 79,759│ 78│ 95│East London. │ │Newington │ 64,816│ 37│ 57│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │Kensington,—except │ 73,699│ 40│ 53│West Middlesex, Chelsea, │ │ Paddington │ │ │ │ Grand Junction. │ │Wandsworth │ 50,764│ 26│ 51│South. & Vaux., Pump-wells,│ │ │ │ │ │ River Wandle. │ │St. George (East) │ 48,376│ 21│ 43│East London. │ │Camberwell │ 54,667│ 22│ 40│Southwark and Vauxhall, │ │ │ │ │ │ Lambeth. │ │Stepney │ 110,775│ 40│ 34│East London. │ │Lambeth │ 139,325│ 48│ 34│Lambeth, Sou. & Vaux. │ │Greenwich │ 99,365│ 32│ 31│Kent. │ │Marylebone │ 157,696│ 48│ 30│West Middlesex. │ │Westminster │ 65,609│ 19│ 27│Chelsea. │ │St. James, Westminster│ 36,406│ 9│ 25│Grand Junction, New River. │ │Hackney │ 58,429│ 13│ 22│New Riv., East London. │ │Paddington │ 46,305│ 10│ 22│Grand Junction. │ │Shoreditch │ 109,257│ 23│ 21│New Riv., East London. │ │Bethnal Green │ 90,193│ 18│ 20│East London. │ │Poplar │ 47,162│ 9│ 17│East London. │ │West London │ 28,840│ 4│ 14│New River. │ │Hanover Square and May│ 33,196│ 5│ 12│Grand Junction. │ │ Fair │ │ │ │ │ │Islington │ 95,329│ 12│ 12│New River. │ │Chelsea │ 56,538│ 6│ 11│Chelsea. │ │East London │ 44,406│ 4│ 9│New River. │ │London City │ 55,932│ 5│ 9│New River. │ │Clerkenwell │ 64,778│ 5│ 8│New River. │ │Belgrave │ 40,034│ 3│ 7│Chelsea. │ │St. │ 24,640│ 1│ 5│New River. │ │ Martin-in-the-Fields│ │ │ │ │ │St. Pancras │ 166,956│ 8│ 5│New River, Hampstead, West │ │ │ │ │ │ Middlesex. │ │St. Luke │ 54,055│ 2│ 4│New River. │ │Lewisham │ 34,835│ 1│ 3│Kent. │ │Holborn │ 46,571│ 1│ 2│New River. │ │St. Giles │ 54,214│ 1│ 2│New River. │ │Strand │ 44,460│ │ │New River. │ │Hampstead │ 11,986│ │ │Hampst., West Mid’sex. │ ├──────────────────────┼──────────┼──────┼───────┼───────────────────────────┤ │ │ 2,362,236│ 796│ │ │ └──────────────────────┴──────────┴──────┴───────┴───────────────────────────┘

PG72894.B00256
[Sidenote: THE EPIDEMIC OF 1853, IN LONDON.]

PG72894.B00257
It will be observed that Lambeth, which is supplied with water in a great measure by the Lambeth Company, occupies a lower position in the above table than it did in the previous table showing the mortality in 1849. Rotherhithe also has been removed from the first to the fifth place; owing, no doubt, to the portion of the district supplied with water from the Kent Water Works, instead of the ditches, being altogether free from the disease, as was noticed above.

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As the Registrar-General published a list of all the deaths from cholera which occurred in London in 1853, from the commencement of the epidemic in August to its conclusion in January 1854, I have been able to add up the number which occurred in the various sub-districts on the south side of the Thames, to which the water supply of the Southwark and Vauxhall, and the Lambeth Companies, extends. I have presented them in the table opposite, arranged in three groups.

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=TABLE VI.=

PG72894.B00260
┌───────────────┬──────────────┬──────────────┬──────────────┬───────────────┐ │ │ │ Deaths from │ Deaths by │ │ │Sub-Districts. │Population in │ Cholera in │ Cholera in │ Water Supply. │ │ │ 1851. │ 1853. │ each 100,000 │ │ │ │ │ │ living. │ │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │ │ │ │ │Southwark and │ │St. Saviour, │19,709 │45 │227 │ Vauxhall │ │ Southwark │ │ │ │ Water Company│ │ │ │ │ │ only. │ │St. Olave │8,015 │19 │237 │ „ │ │St. John, │11,360 │7 │61 │ „ │ │ Horsleydown │ │ │ │ │ │St. James, │18,899 │21 │111 │ „ │ │ Bermondsey │ │ │ │ │ │St. Mary │13,934 │27 │193 │ „ │ │ Magdalen │ │ │ │ │ │Leather Market │15,295 │23 │153 │ „ │ │Rotherhithe[15]│17,805 │20 │112 │ „ │ │Wandsworth │9,611 │3 │31 │ „ │ │Battersea │10,560 │11 │104 │ „ │ │Putney │5,280 │ │ │ „ │ │Camberwell │17,742 │9 │50 │ „ │ │Peckham │19,444 │7 │36 │ „ │ │ │ │ │ │ │ │ │ │ │ │Lambeth Water │ │Christchurch, │ │ │ │ Company, and │ │ Southwk. │16,022 │7 │43 │ Southwark and│ │ │ │ │ │ Vauxhall │ │ │ │ │ │ Company │ │Kent Road │18,126 │37 │204 │ „ │ │Borough Road │15,862 │26 │163 │ „ │ │London Road │17,836 │9 │50 │ „ │ │Trinity, │20,922 │11 │52 │ „ │ │ Newington │ │ │ │ │ │St. Peter, │29,861 │23 │77 │ „ │ │ Walworth │ │ │ │ │ │St. Mary, │14,033 │5 │35 │ „ │ │ Newington │ │ │ │ │ │Waterloo (1st │14,088 │1 │7 │ „ │ │ part) │ │ │ │ │ │Waterloo (2nd │18,348 │7 │38 │ „ │ │ part) │ │ │ │ │ │Lambeth Church │18,409 │9 │48 │ „ │ │ (1st part) │ │ │ │ │ │Lambeth Church │26,784 │11 │41 │ „ │ │ (2nd part) │ │ │ │ │ │Kennington (1st│24,261 │12 │49 │ „ │ │ part) │ │ │ │ │ │Kennington (2nd│18,848 │6 │31 │ „ │ │ part) │ │ │ │ │ │Brixton │14,610 │2 │13 │ „ │ │Clapham │16,290 │10 │61 │ „ │ │St. George, │15,849 │6 │37 │ „ │ │ Camberwell │ │ │ │ │ │ │ │ │ │ │ │Norwood │3,977 │ │ │Lambeth Water │ │ │ │ │ │ Company only.│ │Streatham │9,023 │ │ │ „ │ │Dulwich │1,632 │ │ │ „ │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │First 12 │167,654 │192 │114 │Southwk. & │ │ sub-districts│ │ │ │ Vaux. │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │Next 16 │301,149 │182 │60 │Both Companies │ │ sub-districts│ │ │ │ │ ├───────────────┼──────────────┼──────────────┼──────────────┼───────────────┤ │Last 3 │14,632 │ │ │Lambeth Comp. │ │ sub-districts│ │ │ │ │ └───────────────┴──────────────┴──────────────┴──────────────┴───────────────┘

PG72894.B00261
Besides the general result shown in the table, there are some particular facts well worthy of consideration. In 1849, when the water of the Lambeth Company was quite as impure as that of the Southwark and Vauxhall Company, the parish of Christchurch suffered a rather higher rate of mortality from cholera than the adjoining parish of St. Saviour; but in 1853, whilst the mortality in St. Saviour’s was at the rate of two hundred and twenty-seven to one hundred thousand living, that of Christchurch was only at the rate of forty-three. Now St. Saviour’s is supplied with water entirely by the Southwark and Vauxhall Company, and Christchurch is chiefly supplied by the Lambeth Company. The pipes and other property of the Lambeth Company, in the parish of Christchurch, are rated at about £316, whilst the property of the Southwark and Vauxhall Company in this parish is only rated at about £108. Waterloo Road, 1st part, suffered almost as much as St. Saviour’s in 1849, and had but a single death in 1853; it is supplied almost exclusively by the Lambeth Company. The sub-districts of Kent Road and Borough Road, which suffered severely from cholera, are supplied, through a great part of their extent, exclusively by the Southwark and Vauxhall Company; the supply of the Lambeth Company being intermingled with that of the other only in a part of these districts, as may be seen by consulting the accompanying map (No. 2). The rural districts of Wandsworth and Peckham contain a number of pump-wells, and are only partially supplied by the Water Company; on this account they suffered a lower mortality than the other sub-districts supplied with the water from Battersea Fields. In the three sub-districts to which this water does not extend, there was no death from cholera in 1853.

PG72894.B00262
[Illustration: MAP 2.]

PG72894.B00263
[Sidenote: THE NEW WATER SUPPLY OF THE LAMBETH COMPANY.]

PG72894.B00264
Although the facts shown in the above table afford very strong evidence of the powerful influence which the drinking of water containing the sewage of a town exerts over the spread of cholera, when that disease is present, yet the question does not end here; for the intermixing of the water supply of the Southwark and Vauxhall Company with that of the Lambeth Company, over an extensive part of London, admitted of the subject being sifted in such a way as to yield the most incontrovertible proof on one side or the other. In the sub-districts enumerated in the above table as being supplied by both Companies, the mixing of the supply is of the most intimate kind. The pipes of each Company go down all the streets, and into nearly all the courts and alleys. A few houses are supplied by one Company and a few by the other, according to the decision of the owner or occupier at that time when the Water Companies were in active competition. In many cases a single house has a supply different from that on either side. Each Company supplies both rich and poor, both large houses and small; there is no difference either in the condition or occupation of the persons receiving the water of the different Companies. Now it must be evident that, if the diminution of cholera, in the districts partly supplied with the improved water, depended on this supply, the houses receiving it would be the houses enjoying the whole benefit of the diminution of the malady, whilst the houses supplied with the water from Battersea Fields would suffer the same mortality as they would if the improved supply did not exist at all. As there is no difference whatever, either in the houses or the people receiving the supply of the two Water Companies, or in any of the physical conditions with which they are surrounded, it is obvious that no experiment could have been devised which would more thoroughly test the effect of water supply on the progress of cholera than this, which circumstances placed ready made before the observer.

PG72894.B00265
The experiment, too, was on the grandest scale. No fewer than three hundred thousand people of both sexes, of every age and occupation, and of every rank and station, from gentlefolks down to the very poor, were divided into two groups without their choice, and, in most cases, without their knowledge; one group being supplied with water containing the sewage of London, and, amongst it, whatever might have come from the cholera patients, the other group having water quite free from such impurity.

PG72894.B00266
[Sidenote: EPIDEMIC OF 1854, IN THE SOUTH DISTRICTS OF LONDON.]

PG72894.B00267
To turn this grand experiment to account, all that was required was to learn the supply of water to each individual house where a fatal attack of cholera might occur. I regret that, in the short days at the latter part of last year, I could not spare the time to make the inquiry; and, indeed, I was not fully aware, at that time, of the very intimate mixture of the supply of the two Water Companies, and the consequently important nature of the desired inquiry.

PG72894.B00268
When the cholera returned to London in July of the present year, however, I resolved to spare no exertion which might be necessary to ascertain the exact effect of the water supply on the progress of the epidemic, in the places where all the circumstances were so happily adapted for the inquiry. I was desirous of making the investigation myself, in order that I might have the most satisfactory proof of the truth or fallacy of the doctrine which I had been advocating for five years. I had no reason to doubt the correctness of the conclusions I had drawn from the great number of facts already in my possession, but I felt that the circumstance of the cholera poison passing down the sewers into a great river, and being distributed through miles of pipes, and yet producing its specific effects, was a fact of so startling a nature, and of so vast importance to the community, that it could not be too rigidly examined, or established on too firm a basis.

PG72894.B00269
I accordingly asked permission at the General Register Office to be supplied with the addresses of persons dying of cholera, in those districts where the supply of the two Companies is intermingled in the manner I have stated above. Some of these addresses were published in the “Weekly Returns,” and I was kindly permitted to take a copy of others. I commenced my inquiry about the middle of August with two sub-districts of Lambeth, called Kennington, first part, and Kennington, second part. There were forty-four deaths in these sub-districts down to 12th August, and I found that thirty-eight of the houses in which these deaths occurred were supplied with water by the Southwark and Vauxhall Company, four houses were supplied by the Lambeth Company, and two had pump-wells on the premises and no supply from either of the Companies.

PG72894.B00270
As soon as I had ascertained these particulars I communicated them to Dr. Farr, who was much struck with the result, and at his suggestion the Registrars of all the south districts of London were requested to make a return of the water supply of the house in which the attack took place, in all cases of death from cholera. This order was to take place after the 26th August, and I resolved to carry my inquiry down to that date, so that the facts might be ascertained for the whole course of the epidemic. I pursued my inquiry over the various other sub-districts of Lambeth, Southwark, and Newington, where the supply of the two Water Companies is intermixed, with a result very similar to that already given, as will be seen further on. In cases where persons had been removed to a workhouse or any other place, after the attack of cholera had commenced, I inquired the water supply of the house where the individuals were living when the attack took place.

PG72894.B00271
The inquiry was necessarily attended with a good deal of trouble. There were very few instances in which I could at once get the information I required. Even when the water-rates are paid by the residents, they can seldom remember the name of the Water Company till they have looked for the receipt. In the case of working people who pay weekly rents, the rates are invariably paid by the landlord or his agent, who often lives at a distance, and the residents know nothing about the matter. It would, indeed, have been almost impossible for me to complete the inquiry, if I had not found that I could distinguish the water of the two companies with perfect certainty by a chemical test. The test I employed was founded on the great difference in the quantity of chloride of sodium contained in the two kinds of water, at the time I made the inquiry. On adding solution of nitrate of silver to a gallon of the water of the Lambeth Company, obtained at Thames Ditton, beyond the reach of the sewage of London, only 2·28 grains of chloride of silver were obtained, indicating the presence of ·95 grains of chloride of sodium in the water. On treating the water of the Southwark and Vauxhall Company in the same manner, 91 grains of chloride of silver were obtained, showing the presence of 37·9 grains of common salt per gallon. Indeed, the difference in appearance on adding nitrate of silver to the two kinds of water was so great, that they could be at once distinguished without any further trouble. Therefore when the resident could not give clear and conclusive evidence about the Water Company, I obtained some of the water in a small phial, and wrote the address on the cover, when I could examine it after coming home. The mere appearance of the water generally afforded a very good indication of its source, especially if it was observed as it came in, before it had entered the water-butt or cistern; and the time of its coming in also afforded some evidence of the kind of water, after I had ascertained the hours when the turncocks of both Companies visited any street. These points were, however, not relied on, except as corroborating more decisive proof, such as the chemical test, or the Company’s receipt for the rates.

PG72894.B00272
A return had been made to Parliament of the entire number of houses supplied with water by each of the Water Companies, but as the number of houses which they supplied in particular districts was not stated, I found that it would be necessary to carry my inquiry into all the districts to which the supply of either Company extends, in order to show the full bearing of the facts brought out in those districts where the supply is intermingled. I inquired myself respecting every death from cholera in the districts to which the supply of the Lambeth Company extends, and I was fortunate enough to obtain the assistance of a medical man, Mr. John Joseph Whiting, L.A.C., to make inquiry in Bermondsey, Rotherhithe, Wandsworth, and certain other districts, which are supplied only by the Southwark and Vauxhall Company. Mr. Whiting took great pains with his part of the inquiry, which was to ascertain whether the houses in which the fatal attacks took place were supplied with the Company’s water, or from a pump-well, or some other source.

PG72894.B00273
Mr. Whiting’s part of the investigation extended over the first four weeks of the epidemic, from 8th July to 5th August; and as inquiry was made respecting every death from cholera during this part of the epidemic, in all the districts to which the supply of either of the Water Companies extends, it may be well to consider this period first. There were three hundred and thirty-four deaths from cholera in these four weeks, in the districts to which the water supply of the Southwark and Vauxhall and the Lambeth Company extends. Of these it was ascertained, that in two hundred and eighty-six cases the house where the fatal attack of cholera took place was supplied with water by the Southwark and Vauxhall Company, and in only fourteen cases was the house supplied with the Lambeth Company’s water; in twenty-two cases the water was obtained by dipping a pail directly into the Thames, in four instances it was obtained from pump-wells, in four instances from ditches, and in four cases the source of supply was not ascertained, owing to the person being taken ill whilst travelling, or from some similar cause. The particulars of all the deaths which were caused by cholera in the first four weeks of the late epidemic, were published by the Registrar-General in the “Weekly Returns of Births and Deaths in London,” and I have had the three hundred and thirty-four above enumerated reprinted in an appendix to this edition, as a guarantee that the water supply was inquired into, and to afford any person who wishes it an opportunity of verifying the result. Any one who should make the inquiry must be careful to find the house where the attack took place, for in many streets there are several houses having the same number.

PG72894.B00274
According to a return which was made to Parliament, the Southwark and Vauxhall Company supplied 40,046 houses from January 1st to December 31st, 1853, and the Lambeth Company supplied 26,107 houses during the same period; consequently, as 286 fatal attacks of cholera took place, in the first four weeks of the epidemic, in houses supplied by the former Company, and only 14 in houses supplied by the latter, the proportion of fatal attacks to each 10,000 houses was as follows. Southwark and Vauxhall 71. Lambeth 5. The cholera was therefore fourteen times as fatal at this period, amongst persons having the impure water of the Southwark and Vauxhall Company, as amongst those having the purer water from Thames Ditton.

PG72894.B00275
It is extremely worthy of remark, that whilst only five hundred and sixty-three deaths from cholera occurred in the whole of the metropolis, in the four weeks ending 5th August, more than one half of them took place amongst the customers of the Southwark and Vauxhall Company, and a great portion of the remaining deaths were those of mariners and persons employed amongst the shipping in the Thames, who almost invariably draw their drinking water direct from the river.

PG72894.B00276
It may, indeed, be confidently asserted, that if the Southwark and Vauxhall Water Company had been able to use the same expedition as the Lambeth Company in completing their new works, and obtaining water free from the contents of sewers, the late epidemic of cholera would have been confined in a great measure to persons employed among the shipping, and to poor people who get water by pailsful direct from the Thames or tidal ditches.

PG72894.B00277
The number of houses in London at the time of the last census was 327,391. If the houses supplied with water by the Southwark and Vauxhall Company, and the deaths from cholera occurring in these houses, be deducted, we shall have in the remainder of London 287,345 houses, in which 277 deaths from cholera took place in the first four weeks of the epidemic. This is at the rate of nine deaths to each 10,000. But the houses supplied with water by the Lambeth Company only suffered a mortality of five in each 10,000 at this period; it follows, therefore, that these houses, although intimately mixed with those of the Southwark and Vauxhall Company, in which so great a proportional mortality occurred, did not suffer even so much as the rest of London which was not so situated.

PG72894.B00278
In the beginning of the late epidemic of cholera in London, the Thames water seems to have been the great means of its diffusion, either through the pipes of the Southwark and Vauxhall Company, or more directly by dipping a pail in the river. Cholera was prevailing in the Baltic Fleet in the early part of summer, and the following passage from the “Weekly Returns” of the Registrar-General shows that the disease was probably imported thence to the Thames.

PG72894.B00279
“Bermondsey, St. James. At 10, Marine Street, on 25th July, a mate mariner, aged 34 years, Asiatic cholera 101 hours, after premonitory diarrhœa 16¹⁄₂ hours. The medical attendant states: ‘This patient was the chief mate to a steam-vessel taking stores to and bringing home invalids from the Baltic Fleet. Three weeks ago he brought home in his cabin the soiled linen of an officer who had been ill. The linen was washed and returned.’”

PG72894.B00280
The time when this steam-vessel arrived in the Thames with the soiled linen on board, was a few days before the first cases of cholera appeared in London, and these first cases were chiefly amongst persons connected with the shipping in the river. It is not improbable therefore that a few simple precautions, with respect to the communications with the Baltic Fleet, might have saved London from the cholera this year, or at all events greatly retarded its appearance.

PG72894.B00281
As the epidemic advanced, the disproportion between the number of cases in houses supplied by the Southwark and Vauxhall Company and those supplied by the Lambeth Company, became not quite so great, although it continued very striking. In the beginning of the epidemic the cases appear to have been almost altogether produced through the agency of the Thames water obtained amongst the sewers; and the small number of cases occurring in houses not so supplied, might be accounted for by the fact of persons not keeping always at home and taking all their meals in the houses in which they live; but as the epidemic advanced it would necessarily spread amongst the customers of the Lambeth Company, as in parts of London where the water was not in fault, by all the usual means of its communication. The two subjoined tables, VII and VIII, show the number of fatal attacks in houses supplied respectively by the two Companies, in all the sub-districts to which their water extends. The cases in table VII, are again included in the larger number which appear in the next table. The sub-districts are arranged in three groups, as they were in table VI, illustrating the epidemic of 1853.

PG72894.B00282
In table VIII, showing the mortality in the first seven weeks of the epidemic, the water supply is the result of my own personal inquiry, in every case, in all the sub-districts to which the supply of the Lambeth Company extends; but in some of the sub-districts supplied only by the Southwark and Vauxhall Company, the inquiry of Mr. Whiting having extended only to 5th August, the water supply of the last three weeks is calculated to have been in the same proportion by the Company, or by pump wells, etc., as in the first four weeks,—a calculation which is perfectly fair, and must be very near the truth. The sub-districts in which the supply is partly founded on computation, are marked with an asterisk.

PG72894.B00283
The numbers in table VIII differ a very little from those of the table I communicated to the _Medical Times and Gazette_ of 7th October, on account of the water supply having since been ascertained in some cases in which I did not then know it. The small number of instances in which the water supply remains unascertained are chiefly those of persons taken into a workhouse without their address being known.

PG72894.B00284
=TABLE VII.=

PG72894.B00285
The mortality from Cholera in the four weeks ending 5th August.

PG72894.B00286
┌──────────────┬──────────┬───────┐ │ │ │Deaths │ │ │ │from in│ │ │ │ the │ │Sub-Districts.│Population│ four │ │ │ in 1851. │ weeks │ │ │ │ending │ │ │ │ 5th │ │ │ │August.│ ├──────────────┼──────────┼───────┤ │ │ │ │ │ „ │ „ │ „ │ │ │ │ │ │ │ │ │ ├──────────────┼──────────┼───────┤ │St. Saviour, │ 19,709│ 26│ │ Southwark │ │ │ │St. Olave, │ 8,015│ 19│ │ Southwark │ │ │ │St. John, │ 11,360│ 18│ │ Horsleydown │ │ │ │St. James, │ 18,899│ 29│ │ Bermondsey │ │ │ │St. Mary │ 13,934│ 20│ │ Magdalen │ │ │ │Leather Market│ 15,295│ 23│ │Rotherhithe │ 17,805│ 26│ │Battersea │ 10,560│ 13│ │Wandsworth │ 9,611│ 2│ │Putney │ 5,280│ 1│ │Camberwell │ 17,742│ 19│ │Peckham │ 19,444│ 4│ │ │ │ │ │Christchurch, │ 16,022│ 3│ │ Southwk. │ │ │ │Kent Road │ 18,126│ 8│ │Borough Road │ 15,862│ 21│ │London Road │ 17,836│ 9│ │Trinity, │ 20,922│ 14│ │ Newington │ │ │ │St. Peter, │ 29,861│ 20│ │ Walworth │ │ │ │St. Mary, │ 14,033│ 5│ │ Newington │ │ │ │Waterloo Road │ 14,088│ 5│ │ (1st) │ │ │ │Waterloo Road │ 18,348│ 5│ │ (2nd) │ │ │ │Lambeth Church│ 18,409│ 5│ │ (1st) │ │ │ │Lambeth Church│ 26,784│ 10│ │ (2nd) │ │ │ │Kennington │ 24,261│ 11│ │ (1st) │ │ │ │Kennington │ 18,848│ 3│ │ (2nd) │ │ │ │Brixton │ 14,610│ 1│ │Clapham │ 16,290│ 5│ │St. George, │ 15,849│ 9│ │ Camberwell │ │ │ │ │ │ │ │Norwood │ 3,977│ │ │Streatham │ 9,023│ │ │Dulwich │ 1,632│ │ │Sydenham │ 4,501│ │ ├──────────────┼──────────┼───────┤ │ │ 486,936│ 334│ └──────────────┴──────────┴───────┘

PG72894.B00287
┌──────────────┬──────────────────────────────────────────────────────┐ │ │ │ │ │ │ │ │ │ │Sub-Districts.│ Water Supply. │ │ │ │ │ │ │ │ │ │ │ │ │ ├──────────────┼─────────┬────────┬───────────┬────────┬──────────────┤ │ │Southwark│ │ │ River │ │ │ „ │ & │Lambeth.│Pump-wells.│Thames, │Unascertained.│ │ │Vauxhall.│ │ │ditches,│ │ │ │ │ │ │ etc. │ │ ├──────────────┼─────────┼────────┼───────────┼────────┼──────────────┤ │St. Saviour, │ 24│ │ │ 2│ │ │ Southwark │ │ │ │ │ │ │St. Olave, │ 15│ │ │ 2│ 2│ │ Southwark │ │ │ │ │ │ │St. John, │ 17│ │ │ 1│ │ │ Horsleydown │ │ │ │ │ │ │St. James, │ 23│ │ │ 6│ │ │ Bermondsey │ │ │ │ │ │ │St. Mary │ 19│ │ │ 1│ │ │ Magdalen │ │ │ │ │ │ │Leather Market│ 23│ │ │ │ │ │Rotherhithe │ 17│ │ │ 9│ │ │Battersea │ 10│ │ 1│ 2│ │ │Wandsworth │ │ │ │ 2│ │ │Putney │ │ │ 1│ │ │ │Camberwell │ 19│ │ │ │ │ │Peckham │ 4│ │ │ │ │ │ │ │ │ │ │ │ │Christchurch, │ 2│ 1│ │ │ │ │ Southwk. │ │ │ │ │ │ │Kent Road │ 7│ 1│ │ │ │ │Borough Road │ 20│ 1│ │ │ │ │London Road │ 5│ 4│ │ │ │ │Trinity, │ 14│ │ │ │ │ │ Newington │ │ │ │ │ │ │St. Peter, │ 20│ │ │ │ │ │ Walworth │ │ │ │ │ │ │St. Mary, │ 5│ │ │ │ │ │ Newington │ │ │ │ │ │ │Waterloo Road │ 5│ │ │ │ │ │ (1st) │ │ │ │ │ │ │Waterloo Road │ 5│ │ │ │ │ │ (2nd) │ │ │ │ │ │ │Lambeth Church│ 2│ 1│ │ 1│ 1│ │ (1st) │ │ │ │ │ │ │Lambeth Church│ 7│ 2│ │ │ 1│ │ (2nd) │ │ │ │ │ │ │Kennington │ 9│ 1│ 1│ │ │ │ (1st) │ │ │ │ │ │ │Kennington │ 3│ │ │ │ │ │ (2nd) │ │ │ │ │ │ │Brixton │ │ 1│ │ │ │ │Clapham │ 4│ │ 1│ │ │ │St. George, │ 7│ 2│ │ │ │ │ Camberwell │ │ │ │ │ │ │ │ │ │ │ │ │ │Norwood │ │ │ │ │ │ │Streatham │ │ │ │ │ │ │Dulwich │ │ │ │ │ │ │Sydenham │ │ │ │ │ │ ├──────────────┼─────────┼────────┼───────────┼────────┼──────────────┤ │ │ 286│ 14│ 4│ 26│ 4│ └──────────────┴─────────┴────────┴───────────┴────────┴──────────────┘

PG72894.B00288
=TABLE VIII.=

PG72894.B00289
Mortality from Cholera in the seven weeks ending 26th August.

PG72894.B00290
┌──────────────┬──────────┬───────┐ │ │ │Deaths │ │ │ │ from │ │ │ │Cholera│ │ │Population│in the │ │Sub-Districts.│ in 1851. │ seven │ │ │ │ weeks │ │ │ │ending │ │ │ │ 26th │ │ │ │August.│ ├──────────────┼──────────┼───────┤ │ │ │ │ │ „ │ „ │ „ │ │ │ │ │ │ │ │ │ ├──────────────┼──────────┼───────┤ │*St. Saviour, │ 19,709│ 125│ │ Southwark │ │ │ │*St. Olave, │ 8,015│ 53│ │ Southwark │ │ │ │*St. John, │ 11,360│ 51│ │ Horsleydown │ │ │ │*St. James, │ 18,899│ 123│ │ Bermondsey │ │ │ │*St. Mary │ 13,934│ 87│ │ Magdalen │ │ │ │*Leather │ 15,295│ 81│ │ Market │ │ │ │*Rotherhithe │ 17,805│ 103│ │*Battersea │ 10,560│ 54│ │Wandsworth │ 9,611│ 11│ │Putney │ 5,280│ 1│ │*Camberwell │ 17,742│ 96│ │*Peckham │ 19,444│ 59│ │ │ │ │ │Christchurch, │ 16,022│ 25│ │ Southwk. │ │ │ │Kent Road │ 18,126│ 57│ │Borough Road │ 15,862│ 71│ │London Road │ 17,836│ 29│ │Trinity, │ 20,922│ 58│ │ Newington │ │ │ │St. Peter, │ 29,861│ 90│ │ Walworth │ │ │ │St. Mary, │ 14,033│ 21│ │ Newington │ │ │ │Waterloo Road │ 14,088│ 10│ │ (1st) │ │ │ │Waterloo Road │ 18,348│ 36│ │ (2nd) │ │ │ │Lambeth Church│ 18,409│ 18│ │ (1st) │ │ │ │Lambeth Church│ 26,748│ 53│ │ (2nd) │ │ │ │Kennington │ 24,261│ 71│ │ (1st) │ │ │ │Kennington │ 18,848│ 38│ │ (2nd) │ │ │ │Brixton │ 14,610│ 9│ │*Clapham │ 16,290│ 24│ │St. George, │ 15,849│ 42│ │ Camberwell │ │ │ │ │ │ │ │Norwood │ 3,977│ 8│ │Streatham │ 9,023│ 6│ │Dulwich │ 1,632│ │ │Sydenham │ 4,501│ 4│ ├──────────────┼──────────┼───────┤ │ │ 486,936│ 1514│ └──────────────┴──────────┴───────┘

PG72894.B00291
┌──────────────┬──────────────────────────────────────────────────────┐ │ │ │ │ │ │ │ │ │ │ │ │ │Sub-Districts.│ Water Supply. │ │ │ │ │ │ │ │ │ │ │ │ │ ├──────────────┼─────────┬────────┬───────────┬────────┬──────────────┤ │ │Southwark│ │ │ River │ │ │ „ │ & │Lambeth.│Pump-wells.│Thames, │Unascertained.│ │ │Vauxhall.│ │ │ditches,│ │ │ │ │ │ │ etc. │ │ ├──────────────┼─────────┼────────┼───────────┼────────┼──────────────┤ │*St. Saviour, │ 115│ │ │ 10│ │ │ Southwark │ │ │ │ │ │ │*St. Olave, │ 43│ │ │ 5│ 5│ │ Southwark │ │ │ │ │ │ │*St. John, │ 48│ │ │ 3│ │ │ Horsleydown │ │ │ │ │ │ │*St. James, │ 102│ │ │ 21│ │ │ Bermondsey │ │ │ │ │ │ │*St. Mary │ 83│ │ │ 4│ │ │ Magdalen │ │ │ │ │ │ │*Leather │ 81│ │ │ │ │ │ Market │ │ │ │ │ │ │*Rotherhithe │ 68│ │ │ 35│ │ │*Battersea │ 42│ │ 4│ 8│ │ │Wandsworth │ 1│ │ 2│ 8│ │ │Putney │ │ │ 1│ │ │ │*Camberwell │ 96│ │ │ │ │ │*Peckham │ 59│ │ │ │ │ │ │ │ │ │ │ │ │Christchurch, │ 11│ 13│ │ │ 1│ │ Southwk. │ │ │ │ │ │ │Kent Road │ 52│ 5│ │ │ │ │Borough Road │ 61│ 7│ │ │ 3│ │London Road │ 21│ 8│ │ │ │ │Trinity, │ 52│ 6│ │ │ │ │ Newington │ │ │ │ │ │ │St. Peter, │ 84│ 4│ │ │ 2│ │ Walworth │ │ │ │ │ │ │St. Mary, │ 19│ 1│ 1│ │ │ │ Newington │ │ │ │ │ │ │Waterloo Road │ 9│ 1│ │ │ │ │ (1st) │ │ │ │ │ │ │Waterloo Road │ 25│ 8│ 1│ 2│ │ │ (2nd) │ │ │ │ │ │ │Lambeth Church│ 6│ 9│ │ 1│ 2│ │ (1st) │ │ │ │ │ │ │Lambeth Church│ 34│ 13│ 1│ │ 5│ │ (2nd) │ │ │ │ │ │ │Kennington │ 63│ 5│ 3│ │ │ │ (1st) │ │ │ │ │ │ │Kennington │ 34│ 3│ 1│ │ │ │ (2nd) │ │ │ │ │ │ │Brixton │ 5│ 2│ │ │ 2│ │*Clapham │ 19│ │ 5│ │ │ │St. George, │ 30│ 9│ 2│ │ 1│ │ Camberwell │ │ │ │ │ │ │ │ │ │ │ │ │ │Norwood │ │ 2│ 1│ 5│ │ │Streatham │ │ 1│ 5│ │ │ │Dulwich │ │ │ │ │ │ │Sydenham │ │ 1│ 2│ │ 1│ ├──────────────┼─────────┼────────┼───────────┼────────┼──────────────┤ │ │ 1263│ 98│ 29│ 102│ 22│ └──────────────┴─────────┴────────┴───────────┴────────┴──────────────┘

PG72894.B00292
The following is the proportion of deaths to 10,000 houses, during the first seven weeks of the epidemic, in the population supplied by the Southwark and Vauxhall Company, in that supplied by the Lambeth Company, and in the rest of London.

PG72894.B00293
=TABLE IX.=

PG72894.B00294
┌──────────────────────────────┬────────────┬────────────┬────────────┐ │ │ Number of │Deaths from │ Deaths in │ │ │ houses. │ Cholera. │each 10,000 │ │ │ │ │ houses. │ ├──────────────────────────────┼────────────┼────────────┼────────────┤ │Southwark and Vauxhall Company│ 40,046│ 1,263│ 315│ │Lambeth Company │ 26,107│ 98│ 37│ │Rest of London │ 256,423│ 1,422│ 59│ └──────────────────────────────┴────────────┴────────────┴────────────┘

PG72894.B00295
The mortality in the houses supplied by the Southwark and Vauxhall Company was therefore between eight and nine times as great as in the houses supplied by the Lambeth Company; and it will be remarked that the customers of the Lambeth Company continued to enjoy an immunity from cholera greater than the rest of London which is not mixed up as they are with the houses supplied by the Southwark and Vauxhall Company.

PG72894.B00296
As regards the period of the epidemic subsequent to the 26th August to which my inquiry extended, I have stated that the Registrar-General requested the District Registrars to make a return of the water supply of the house of attack in all cases of death from cholera. Owing to difficulties such as I explained that I had met with in the beginning of my inquiry, the Registrars could not make the return in all cases, and as they could not be expected to seek out the landlord or his agent, or to apply chemical tests to the water as I had done, the water supply remained unascertained in a number of cases, but the numbers may undoubtedly be considered to show the correct proportions as far as they extend, and they agree entirely with the results of my inquiry respecting the earlier part of the epidemic given above.

PG72894.B00297
The Registrar-General published the returns of the water supply, which he had obtained from the District Registrars, down to 14th October, in a table which is subjoined. As the whole of the south districts of London were included in the inquiry of the Registrar-General, the deaths in the Greenwich and Lewisham districts, which are supplied by the Kent Water Company, and did not enter into my inquiry, are included in the table, but they do not in the least affect the numbers connected with the other companies.

PG72894.B00298
=TABLE X.=

PG72894.B00299
┌────────────┬─────────┬────────────────────────────────────────────────────┐ │ │ Deaths │ │ │Week ending.│ from │ Water Supply. │ │ │Cholera. │ │ ├────────────┼─────────┼─────────┬─────────┬─────────┬─────────┬────────────┤ │ │ │Southwk. │ │ Kent │ Pumps, │ Not │ │ „ │ „ │ and │Lambeth. │Company. │and other│ascertained.│ │ │ │Vauxhall.│ │ │sources. │ │ ├────────────┼─────────┼─────────┼─────────┼─────────┼─────────┼────────────┤ │September 2.│ 670│ 399│ 45│ 38│ 72│ 116│ │ „ 9.│ 972│ 580│ 72│ 45│ 62│ 213│ │ „ 16.│ 856│ 524│ 66│ 48│ 44│ 174│ │ „ 23.│ 724│ 432│ 72│ 28│ 62│ 130│ │ „ 30.│ 383│ 228│ 25│ 19│ 24│ 87│ │October 7.│ 200│ 121│ 14│ 10│ 9│ 46│ │ „ 14.│ 115│ 69│ 8│ 3│ 6│ 29│ ├────────────┼─────────┼─────────┼─────────┼─────────┼─────────┼────────────┤ │ │ 3920│ 2353│ 302│ 191│ 279│ 795│ └────────────┴─────────┴─────────┴─────────┴─────────┴─────────┴────────────┘

PG72894.B00300
Now 2,353 deaths in 40,046 houses, the number supplied by the Southwark and Vauxhall Company, are 537 deaths to each 10,000 houses; and 302 deaths to 26,107, the number of houses supplied by the Lambeth Company, are 115 deaths to each 10,000 houses; consequently, in the second seven weeks of the epidemic, the population supplied by the Southwark and Vauxhall Company continued to suffer nearly five times the mortality of that supplied with water by the Lambeth Company. If the 795 deaths in which the water supply was not ascertained be distributed equally over the other sources of supply in the above table (No. X), the deaths in houses supplied by the Southwark and Vauxhall Company would be 2,830, and in houses supplied by the Lambeth Company would be 363. By adding the number of deaths which occurred in the first seven weeks of the epidemic, we get the numbers in the subjoined table (No. XI), where the population of the houses supplied by the two water companies is that estimated by the Registrar-General.[16]

PG72894.B00301
=TABLE XI.=

PG72894.B00302
┌─────────────────┬────────────────┬─────────────────┬────────────────┐ │ │ Population in │Deaths by Cholera│Deaths in 10,000│ │ │ 1851. │in 14 wks. ending│ living. │ │ │ │ Oct 14. │ │ ├─────────────────┼────────────────┼─────────────────┼────────────────┤ │London │ 2,362,236│ 10,367│ 43│ │ │ │ │ │ │West Districts │ 376,427│ 1,992│ 53│ │North Districts │ 490,396│ 735│ 14│ │Central Districts│ 393,256│ 612│ 15│ │East Districts │ 485,522│ 1,461│ 30│ │South Districts │ 616,635│ 5,567│ 90│ │ │ │ │ │ │Houses supplied │ │ │ │ │ by Southwark │ 266,516│ 4,093│ 153│ │ and Vauxhall │ │ │ │ │ Company │ │ │ │ │Houses supplied │ │ │ │ │ by Lambeth │ 173,748│ 461│ 26│ │ Company │ │ │ │ └─────────────────┴────────────────┴─────────────────┴────────────────┘

PG72894.B00303
We see by the above table that the houses supplied with the water from Thames Ditton, by the Lambeth Company, continued throughout the epidemic to enjoy an immunity from cholera, not only greater than London at large, but greater than every group of districts, except the north and central groups.

PG72894.B00304
In the next table (No. XII), the mortality from cholera in 1849 is shown side by side with that of 1854, in the various sub-districts to which the supply of the two water companies with which we are particularly interested extends. The mortality of 1854 is down to October 21, and is extracted from a table published in the “Weekly Return of Births and Deaths” of October 28; that of 1849 is from the “Report on Cholera” by Dr. Farr, previously quoted. The sub-districts are arranged in three groups as before, the first group being supplied only by the Southwark and Vauxhall Company, the second group by this Company and the Lambeth, and the third group by the Lambeth Company only. It is necessary to observe, however, that the supply of the Lambeth Company has been extended to Streatham, Norwood, and Sydenham, since 1849, in which year these places were not supplied by any water company. The situation and extent of the various sub-districts are shown, together with the nature of the water supply, in Map 2, which accompanies this work.

PG72894.B00305
=TABLE XII.=

PG72894.B00306
┌─────────────────┬─────────────────┬─────────────────┬─────────────────┐ │ Sub-Districts. │ Deaths from │ Deaths from │ Water Supply. │ │ │Cholera in 1849. │Cholera in 1854. │ │ ├─────────────────┼─────────────────┼─────────────────┼─────────────────┤ │St. Saviour, │ │ │Southwark & │ │ Southwark │ 283│ 371│ Vauxhall │ │ │ │ │ Company only. │ │St. Olave │ 157│ 161│ „ │ │St. John, │ 192│ 148│ „ │ │ Horsleydown │ │ │ │ │St. James, │ 249│ 362│ „ │ │ Bermondsey │ │ │ │ │St. Mary Magdalen│ 259│ 244│ „ │ │Leather Market │ 226│ 237│ „ │ │Rotherhithe[17] │ 352│ 282│ „ │ │Wandsworth │ 97│ 59│ „ │ │Battersea │ 111│ 171│ „ │ │Putney │ 8│ 9│ „ │ │Camberwell │ 235│ 240│ „ │ │Peckham │ 92│ 174│ „ │ │ │ │ │ │ │ │ │ │Lambeth Company, │ │Christchurch, │ 256│ 113│ and Southwark │ │ Southwark │ │ │ and Vauxhall │ │ │ │ │ Compy. │ │Kent Road │ 267│ 174│ „ │ │Borough Road │ 312│ 270│ „ │ │London Road │ 257│ 93│ „ │ │Trinity, │ 318│ 210│ „ │ │ Newington │ │ │ │ │St. Peter, │ 446│ 388│ „ │ │ Walworth │ │ │ │ │St. Mary, │ 143│ 92│ „ │ │ Newington │ │ │ │ │Waterloo Road │ 193│ 58│ „ │ │ (1st) │ │ │ │ │Waterloo Road │ 243│ 117│ „ │ │ (2nd) │ │ │ │ │Lambeth Church │ 215│ 49│ „ │ │ (1st) │ │ │ │ │Lambeth Church │ 544│ 193│ „ │ │ (2nd) │ │ │ │ │Kennington (1st) │ 187│ 303│ „ │ │Kennington (2nd) │ 153│ 142│ „ │ │Brixton │ 81│ 48│ „ │ │Clapham │ 114│ 165│ „ │ │St. George, │ 176│ 132│ „ │ │ Camberwell │ │ │ │ │ │ │ │ │ │Norwood │ 2│ 10│Lambeth Company │ │ │ │ │ only. │ │Streatham │ 154│ 15│ „ │ │Dulwich │ 1│ │ „ │ │Sydenham │ 5│ 12│ „ │ ├─────────────────┼─────────────────┼─────────────────┼─────────────────┤ │First 12 │ 2261│ 2458│Southwk. & │ │ sub-districts │ │ │ Vauxhall. │ ├─────────────────┼─────────────────┼─────────────────┼─────────────────┤ │Next 16 │ 3905│ 2547│Both Companies. │ │ sub-districts │ │ │ │ ├─────────────────┼─────────────────┼─────────────────┼─────────────────┤ │Last 4 │ 162│ 37│Lambeth Company. │ │ sub-districts │ │ │ │ └─────────────────┴─────────────────┴─────────────────┴─────────────────┘

PG72894.B00307
[Sidenote: THE CHOLERA OF 1849 COMPARED WITH THAT OF 1854.]

PG72894.B00308
The table exhibits an increase of mortality in 1854 as compared with 1849, in the sub-districts supplied by the Southwark and Vauxhall Company only, whilst there is a considerable diminution of mortality in the sub-districts partly supplied by the Lambeth Company. In certain sub-districts, where I know that the supply of the Lambeth Water Company is more general than elsewhere, as Christchurch, London Road, Waterloo Road 1st, and Lambeth Church 1st, the decrease of mortality in 1854 as compared with 1849 is greatest, as might be expected. Waterloo Road 1st, which suffered but little from cholera in the present year, is chiefly composed of very dirty narrow streets, in the neighbourhood of Cornwall Road and the New Cut, inhabited by very poor people; and Lambeth Church 1st, which suffered still less, contains a number of skinyards and other factories, between Lambeth Palace and Vauxhall Bridge, which have often been inveighed against as promoting the cholera. The high mortality of the Streatham district in 1849 was caused by the outbreak of cholera in Drouett’s Asylum for pauper children, previously mentioned.

PG72894.B00309
Whilst making inquiries in the south districts of London, I learned some circumstances with respect to the workhouses which deserve to be noticed. In Newington Workhouse, containing 650 inmates, and supplied with the water from Thames Ditton, there had been but two deaths from cholera amongst the inmates down to 21st September, when the epidemic had already greatly declined. In Lambeth Workhouse, containing, if I remember rightly, nearly 1,000 inmates, and supplied with the same water, there had been but one death amongst the inmates when I was there in the first week of September. In St. Saviour’s workhouse, which is situated in the parish of Christchurch, and is supplied with water by the Lambeth Company, no inmate died of cholera before I called in the first week of September. On the other hand, in the workhouse of St. George, Southwark, supplied with the water of the Southwark and Vauxhall Company, six inmates died out of about 600 before the 26th August, when the epidemic had only run one-third of its course. The mortality was also high amongst the inmates of St. Olave’s Workhouse, supplied with water by the Southwark and Vauxhall Company, but I do not know the number who died. I trust, however, that the Registrar

PG72894.B00310
[Sidenote: HORSEMONGER LANE GAOL.]

PG72894.B00311
General, in giving an account of the recent epidemic, will make a return of the deaths amongst the inmates of the various workhouses and other institutions on the south side of the Thames, together with the water supply of the buildings. Bethlehem Hospital, the Queen’s Prison, Horsemonger Lane Gaol, and some other institutions, having deep wells on the premises, scarcely suffered at all from cholera in 1849, and there was no death in any of them during the part of the recent epidemic to which my inquiry extended.

PG72894.B00312
[Sidenote: DISTRICT OF CHELSEA WATER COMPANY.]

PG72894.B00313
On the north side of the Thames the mortality during the recent epidemic seems to have been influenced more by the relative crowding and want of cleanly habits of the people, and by the accidental contamination of the pump-wells, than by the supply of the water companies. The water of the New River Company could have no share in the propagation of cholera, as I explained when treating of the epidemic of 1849; and the extensive districts supplied by this company have been very slightly visited by the disease, except in certain spots which were influenced by the causes above mentioned. The water of the East London Company is also free from the contents of sewers, unless it be those from the neighbourhood of Upper Clapton, where there has been very little cholera. The districts supplied by this company have been lightly visited, except such as lie near the Thames, and are inhabited by mariners, coal and ballast-heavers, and others, who are employed on the river. Even Bethnal Green and Spitalfields, so notorious for their poverty and squalor, have suffered a mortality much below the average of the metropolis. The Grand Junction Company obtain their supply at Brentford, within the reach of the tide and near a large population, but they detain the water in large reservoirs, and their officers tell me they filter it; at all events, they supply it in as pure a state as that of the Lambeth Company obtained at Thames Ditton, and their districts have suffered very little from cholera except at the spot where the irruption occurred from the contamination of the pump-well in Broad Street, Golden Square. The West Middlesex Company, obtaining their supply from the Thames at Hammersmith, have also very large reservoirs, and the districts they supply have suffered but little from cholera, except the Kensington brick fields, Starch Green, and certain other spots, crowded with poor people, chiefly Irish.

PG72894.B00314
[Sidenote: CHOLERA IN THE DISTRICT OF THE CHELSEA WATER COMPANY.]

PG72894.B00315
The districts supplied by the Chelsea Company have suffered a much greater mortality, during the recent epidemic, than the average of the whole metropolis, as the subjoined table (No. XIII) shows. But the mortality in these districts is only half as great as in the houses supplied by the Southwark and Vauxhall Company, who obtain their supply from the Thames just opposite the spot where the Chelsea Company obtain theirs. The latter company, however, by detaining the water in their reservoirs, and by filtering it, are enabled to distribute it in a state of comparative purity; but I had ample opportunities of observing, in August and September last, that this was far from being the state of the water supplied by the Southwark and Vauxhall Company. Many of the people receiving this latter supply were in the habit of tying a piece of linen or some other fabric over the tap by which the water entered the butt or cistern, and in two hours, as the water came in, about a tablespoon of dirt was collected, all in motion with a variety of water insects, whilst the strained water was far from being clear. The contents of the strainer were shown to me in scores of instances. I do not, of course, attribute the cholera either to the insects or the visible dirt; but it is extremely probable that the measures adopted by the Chelsea Company to free the water from these repulsive ingredients, either separated or caused the destruction of the morbid matter of cholera. It is very likely that the detention of the water in the company’s reservoirs permitted the decomposition of the cholera poison, and was more beneficial than the filtering, for the following reasons. The water used in Millbank Prison, obtained from the Thames at Millbank, was filtered through sand and charcoal till it looked as clear as that of the Chelsea Company; yet, in every epidemic, the inmates of this prison suffered much more from cholera than the inhabitants of the neighbouring streets and those of Tothill Fields Prison, supplied by that company.[18] In the early part of August last, the use of the Thames water was entirely discontinued in Millbank Prison, and water from the Artesian well in Trafalgar Square was used instead, on the recommendation of Dr. Baly, the physician to the prison. In three or four days after this change, the cholera, which was prevailing to an alarming extent, entirely ceased.

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=TABLE XIII.=

PG72894.B00317
┌────────────────────────────────────┬──────────┬─────────────────────┐ │ │Population│ Deaths by Cholera │ │ │ in 1851. │ │ ├────────────────────────────────────┼──────────┼──────────┬──────────┤ │ │ │In 15 wks.│ To every │ │ „ │ „ │ ending │ 10,000 │ │ │ │ October │ living. │ │ │ │ 21. │ │ ├────────────────────────────────────┼──────────┼──────────┼──────────┤ │Chelsea, south │ 19,050│ 122│ 64│ │Chelsea, north-west │ 17,669│ 99│ 56│ │Chelsea, north-east │ 19,819│ 71│ 36│ │Belgrave │ 40,034│ 238│ 59│ │St. John, Westminster │ 34,295│ 173│ 50│ │St. Margaret, Westminster │ 31,314│ 238│ 76│ ├────────────────────────────────────┼──────────┼──────────┼──────────┤ │Total of districts supplied by the │ 162,181│ 941│ 56│ │ Chelsea Water Company │ │ │ │ │Houses supplied by the Southwark and│ 266,516│ 2,900│ 108│ │ Vauxhall Company │ │ │ │ │LONDON │ 2,362,236│ 10,530│ 45│ │London, except the houses supplied │ │ │ │ │ by the Chelsea Company, and by the│ 1,933,539│ 6,689│ 34│ │ Southwark & Vauxhall Compy. │ │ │ │ └────────────────────────────────────┴──────────┴──────────┴──────────┘

PG72894.B00318
The quantity of impurity in the Thames was greatly increased during the late autumn, by the long course of dry weather. From 5th August to 12th September, a period of more than five weeks, only 0·29 of an inch of rain fell at Greenwich, as appears by the report of the Astronomer Royal. The stream of the Thames above the reach of the tide became so slender, that it was difficult to navigate barges above Richmond. The Thames in London is a very large body of water, and if the whole of it flowed away into the sea every day, the liquid which flows down the sewers in twelve hours would form but a very small part of it; but it must be remembered that the quantity of water which passes out to sea, with the ebb of every tide, is only equal to that which flows over Teddington Lock, and from a few small tributary streams. In hot dry weather this quantity is moreover greatly diminished by the evaporation taking place from the immense surface of water exposed between Richmond and Gravesend, so that the river becomes a kind of prolonged lake, the same water passing twice a day to and fro through London, and receiving the excrement of its two millions and more of inhabitants, which keeps accumulating till there is a fall of rain. In time of cholera, the evacuations of the patients keep accumulating in the river along with the other impurities; and it is probably in this way that the dry weather with a high barometer aids in promoting cholera, as it has often been observed to do.

PG72894.B00319
[Sidenote: IMPURITY OF THE THAMES.]

PG72894.B00320
I thought at first that the quantity of common salt, previously mentioned as being present in the water of the Southwark and Vauxhall Company, consisted entirely of the salt which had passed down the sewers into the river, for I had no idea that any admixture of sea water reached as high as Battersea Fields. Mr. Quick, the engineer of the above Company, informed me, however, that an impregnation of salt water does extend as far after a long course of dry weather. It is obvious that a dry season, whilst it increases the quantity of impurity in the Thames, must also cause the sea water to flow further inland than at other times. I did not examine the water of the Thames in August or September, but I have done so now, at the latter part of November, and I am inclined to think that even yet a slight admixture of sea water may reach to Battersea Fields with every tide. I found 5·8 grains of chloride of sodium per gallon in water obtained at Hungerford Market, at half-flow of the tide, on 19th November, and 19·1 grains per gallon, in water obtained at the same place, on 27th November, at an hour and a half before high water; whilst water obtained at London Bridge, on 28th November, at high water, contained 63·3 grains per gallon.

PG72894.B00321
A specimen of water obtained on 21st November, from a house supplied by the Southwark and Vauxhall Company, contained 28·8 grains of common salt per gallon, or about three-quarters as much as it contained in September, when the quantity was 37·9 grains. It is very obvious from the above analyses, that the Water Company obtain their supply from the Thames at high water, or nearly so, although this is the time of the tide when the water contains the greatest amount of impurity. It is quite certain that the sea water cannot reach to Thames Ditton, any more than the contents of the London sewers, and therefore, whatever may be its source, the quantity of chloride of sodium in the water is quite conclusive as regards the purpose for which I examined into it, viz., to distinguish between the water of the two Companies.

PG72894.B00322
When the water of the Southwark and Vauxhall Company was examined by Messrs. Graham, Miller, and Hofmann, at the latter part of January 1851, it contained only 1·99 grains of chloride of sodium, or about one-twentieth as much as it contained last September, and one-fifteenth as much as on 21st November 1854.[19]

PG72894.B00323
[Sidenote: ALLEGED EFFECT OF LEVEL.]

PG72894.B00324
Dr. Farr discovered a remarkable coincidence between the mortality from cholera in the different districts of London in 1849, and the elevation of the ground; the connection being of an inverse kind, the higher districts suffering least, and the lowest suffering most from this malady. Dr. Farr was inclined to think that the level of the soil had some direct influence over the prevalence of cholera, but the fact of the most elevated towns in this kingdom, as Wolverhampton, Dowlais, Merthyr Tydvil, and Newcastle-upon-Tyne, having suffered excessively from this disease on several occasions, is opposed to this view, as is also the circumstance of Bethlehem Hospital, the Queen’s Prison, Horsemonger Lane Gaol, and several other large buildings, which are supplied with water from deep wells on the premises, having nearly or altogether escaped cholera, though situated on a very low level, and surrounded by the disease. The fact of Brixton, at an elevation fifty-six feet above Trinity high-water mark, having suffered a mortality of 55 in 10,000, whilst many districts on the north of the Thames, at less than half the elevation, did not suffer one-third as much, also points to the same conclusion.

PG72894.B00325
I expressed the opinion in 1849,[20] that the increased prevalence of cholera in the low-lying districts of London depended entirely on the greater contamination of the water in these districts, and the comparative immunity from this disease of the population receiving the improved water from Thames Ditton, during the epidemics of last year and the present, as shown in the previous pages, entirely confirms this view of the subject; for the great bulk of this population live in the lowest districts of the metropolis.

PG72894.B00326
The prevalence of cholera has been very much under the influence of the water supply in other towns besides London. The cholera has prevailed to a considerable extent in the crowded habitations of the poor in Liverpool and some other towns, where the general supply of water was not in fault, but I know of no instance in which it has spread through all classes of the community, except where the general supply of water has been contaminated with the contents of the drains and sewers; and all the towns with which I am acquainted that have enjoyed an almost complete immunity from this disease, have a water supply quite free from any chance of contamination. Birmingham, Bath, Cheltenham, and Leicester have nearly escaped the cholera in every epidemic. The few cases that have occurred being chiefly those of persons newly arrived from places where the disease was prevailing, and a few others who came in communication with them. All these towns have a supply of water quite free from connection with the drains and sewers, and the small rivers which flow through them are so impure that it would be impossible to drink the water. Leicester is crowded with a poor population, and has hardly any physical advantage except its water supply.

PG72894.B00327
[Sidenote: CHOLERA IN EXETER.]

PG72894.B00328
The first cases of cholera in Exeter in 1832, were three in the same day, besides one in St. Thomas’s, a suburb of Exeter, in a gentleman just arrived from London, where the disease was prevailing. The other three were a woman and her two children; the former, with one of her children, had returned from Plymouth the previous day, where she had been nursing a child that had died of the cholera. Within five days from this time, there were seven fresh cases in as many different parts of the town, amongst persons having no intercourse with each other or the first cases. The disease soon became very prevalent, and in three months there were 1,135 cases, and 345 deaths. Exeter is situated on ground which rises from the edge of the river to an elevation of one hundred and fifty feet. In 1832 the inhabitants were chiefly supplied with river water by water-carriers, who conveyed it in carts and pails. Dr. Shapter, from whose work[21] the above particulars are obtained, kindly furnished me with information concerning the sewers, and with maps of their position. The water-carriers, by whom Exeter was very greatly supplied, obtained their water almost exclusively from certain streams of water, diverted from the river in order to turn water-mills; and one of the chief sewers of the town, which receives such sewage as might come from North Street, in which the first cases of cholera occurred, empties itself into the branch from the river which divides into the two mill-streams just mentioned. It must be remarked that the parish of St. Edmund, in which these streams of water were situated, had a lower mortality from cholera than other parts of the town like it, densely populated and on low ground near the river. Dr. Shapter attributes this lower rate of mortality, and I believe rightly, to St. Edmund’s being freely intersected by running streams of water. The people would probably not drink more of the water than in parts of the town where it was less plentiful, and had to be paid for, but they would have much better opportunities for personal cleanliness: so that whilst they would be exposed to only the same number of scattered cases, they would be less likely to have the malady spreading through families, and by personal intercourse. After the cholera of 1832, measures were taken to afford a better supply of water to Exeter; not, so far as I can find by Dr. Shapter’s work, that its impurity was complained of, but because of its scarcity and cost. Waterworks were established on the river Exe, two miles above the town, and more than two miles above the influence of the tide. Exeter has since been very plentifully supplied with this water, and Dr. Shapter informed me that in 1849 there were only about twenty cases of cholera, nearly half of which occurred in strangers coming into the town, and dying within two or three days after their arrival. This last summer there was only one death from cholera in Exeter.

PG72894.B00329
[Sidenote: CHOLERA IN HULL.]

PG72894.B00330
We will now consider the town of Hull, in which, together with other sanitary measures adopted since 1832, there has been a new and more plentiful supply of water, but with a far different result to that at Exeter. In 1832 Hull was scantily supplied with water conveyed in pipes from springs at Anlaby, three miles from the town. About 1844, new waterworks were established to afford a more plentiful supply. These works were situated on the river Hull, at Stoneferry, two miles and three quarters from the confluence of that river with the Humber. About half the sewage of the town is delivered into the river of the same name, the rest being discharged into the Humber, as appears from information and a map kindly furnished me in 1849 by Dr. Horner of Hull, who was making great efforts to have better water obtained for the town. The tide flows up the river many miles past the waterworks, carrying up with it the filth from the sewers. The supply of water was, to be sure, obtained when the tide was down, but as the banks of the river are clothed with sedges in many parts, and its bottom deep with mud, the water can never be free from sewage. Moreover, there are some parts of the river above Stoneferry much deeper than the rest, and where the deeper water is, according to the testimony of boatmen, nearly stagnant; thus allowing the water carried up by the tide to remain and gradually mix with that afterwards flowing down. There are also boats, with families on board, passing up the river to the extent of five thousand voyages in the year. The water when taken from the river was allowed to settle in the reservoir for twenty-four hours, and was then said to be filtered before being sent to the town. In 1832 the cholera was confined almost exclusively to the poor, and the deaths amounted to three hundred.

PG72894.B00331
In 1849 the deaths in Hull (including the suburb of Sculcoates) were 1834, although 8,000 or 10,000 left the town, it is said, to avoid the ravages of the disease. Dr. Horner informed me that the deaths occurred amongst all classes of the community, and that the town was much better drained in 1849 than in 1832.

PG72894.B00332
[Sidenote: CHOLERA IN YORK.]

PG72894.B00333
When the cholera made its appearance at York, about the middle of July 1849, it was at first chiefly prevalent in some narrow streets near the river, called the Water Lanes. The inhabitants of this spot had been in the habit, from time immemorial, of fetching their water from the river at a place near which one of the chief sewers of the town empties itself; and recently a public necessary had been built, the contents of which were washed every morning into the river just above the spot at which they got the water. In a short time from twenty to thirty deaths occurred in this locality; but the medical men considering the impure water injurious, the people were supplied from the waterworks, with water obtained from the river at a point some distance above the town, and the cholera soon ceased nearly altogether in this part of the city, but continued to spread in some other parts. The cholera having thus abated in the Water Lanes, the gratuitous supply of water was cut off, and the people went to the river as before. There were still cases of cholera in the town, and it soon broke out again in this locality, and in the first few days of September eight deaths occurred among the persons who used water obtained direct from the river. The tap for general use was again opened, and the river water interdicted, and the cholera again ceased, and did not recur. These circumstances were communicated to me by a friend on whose accuracy I can rely.

PG72894.B00334
The inhabitants of Dumfries drink the water of the river Nith, which flows through the town, and into which the sewers discharge their contents, which float afterwards to and fro with the tide. In 1832 there were 418 deaths from cholera out of a population of 11,606, being at the rate of 360 in 10,000, or 1 in every 28 of the inhabitants. The cholera again visited Dumfries at the close of 1848, and carried off 431 persons, or 1 in every 32, out of a population now numbering 14,000; so that the mortality was excessive on both occasions.

PG72894.B00335
Preston and Oldham, in Lancashire, are supplied with water from surface drainage on the neighbouring hills, and there was scarcely any cholera at either of these places in 1849. The greater part of the town of Paisley is supplied in a similar way; and I was informed that the cases of cholera which occurred there in 1849 were confined to a quarter of the town to which this supply of water does not extend. Nottingham is supplied with filtered water obtained from the river Trent, some distance above the town. In 1832 this supply did not extend to all the inhabitants, and the cholera was somewhat prevalent amongst the poor, of whom it carried off 289; the population of the town being 53,000. After that time the water was extended copiously to all the inhabitants, and there were but thirteen deaths from the epidemic in 1849. The local Sanitary Committee placed the supply of water amongst the chief causes of this immunity from cholera, and I believe justly. There were but seven deaths from cholera in Nottingham last summer.

PG72894.B00336
[Sidenote: CHOLERA IN GLASGOW.]

PG72894.B00337
Glasgow has been supplied, since the early part of the present century, with the water of the Clyde, obtained a little way above the town, but within the influence of the tide, and consequently mixed with the contents of the sewers. It is imperfectly filtered through sand. In 1847, however, the parish of Gorbals, which forms the south part of Glasgow, was furnished with a supply of water collected on the neighbouring hills; and Dr. Leech, of Glasgow, speaks as follows respecting the influence of this water on the prevalence of cholera: “During the late cholera there was a remarkable circumstance, which deserves notice as compared with the epidemic of 1832. Since the former period, the population of Glasgow, south of the Clyde, has nearly doubled; and with this exception, and the introduction of the soft-water supply, the circumstances might be considered as the same at both periods. In one district, the parish of Gorbals, the attack in 1832 was fearful; while Glasgow, north of the Clyde, also suffered severely. During the late epidemic [that of 1848–49], Gorbals parish furnished comparatively a small number of cases; while the epidemic in other parts of Glasgow was very severe. The unanimous opinion of the Medical Society was, that this comparative immunity was to be attributed to the soft-water supply.”[22]

PG72894.B00338
[Sidenote: CHOLERA IN NEWCASTLE.]

PG72894.B00339
I was informed that when the cholera was prevalent in Glasgow last winter, the parish of Gorbals again enjoyed a similar immunity from the disease.

PG72894.B00340
The following passage respecting the water supply of Paris is from Dr. Farr’s “Report to the Registrar-General on the Cholera of 1848–49”:—“The supply of Paris is from various sources, but four-fifths of the water is from the Canal de l’Ourque, which, by the decision of Napoleon, was also appropriated to navigation. The water for some years, and in 1832, when the epidemic was so fatal, was drawn from the dirty basin in which the boats and barges of the canals rested; but is now drawn from the canal before it enters the basin.... The mortality of cholera in Paris was excessive, and in 1832 varied from 80, of 10,000 inhabitants, in the elegant Chaussée d’Antin and in Montmartre on the heights, to 530 and 520 in the low quartiers of the Hôtel de Ville and the Cité.” (p. lxxviii.)

PG72894.B00341
The town of Newcastle-upon-Tyne affords a remarkable instance of the influence of the water supply on the prevalence of cholera. In 1831–32 there were no waterworks at Newcastle; it was supplied, in an insufficient manner, with spring water, which generally had to be carried some distance to the houses from “pants” in the streets. The epidemic was pretty severe at this time. From November 1831 to November 1832 there were 801 deaths from cholera out of a population of 42,760. The disease prevailed chiefly amongst the poor, and was worst in the least elevated parts of the town, near the river. Subsequently to 1832, waterworks were established on the river Tyne, a little above the town; but these were abandoned, in 1848, in favour of a supply from a rivulet and springs at Whittle Dean, about ten miles distant. In 1849, there were but 295 deaths from cholera in a population then increased to 71,847. In the beginning of July 1853, two months before the reappearance of cholera in England, the Whittle Dean Water Company found their proper sources insufficient for the demands of the population and the various factories, and they made use of the former waterworks, mentioned above, to obtain water from the Tyne. The point at which they obtained water from the river, is scarcely a mile above Newcastle, and the tide flows for six miles above the town, carrying the contents of the sewers with it. There are also villages, containing several thousands of colliers and ironfounders, on the banks of the Tyne, above the waterworks. The water from the Tyne was mixed, without filtration, with that from Whittle Dean, to the extent of one-third; and the mixed water, so supplied, was discoloured, and contained the large quantity of 7·1 grains of organic matter per gallon.

PG72894.B00342
In the autumn of 1853, the cholera was prevailing extensively at Hamburgh, and in nearly all the ports of the Baltic, whence a number of ships were arriving every day in the Tyne. The first cases of cholera commenced, with diarrhœa, on the 27th and 28th August, at Bell Quay, on the banks of the Tyne, three miles below Newcastle. One of the patients from Bell Quay was taken worse whilst on a visit to her mother at Newcastle: she died on 2nd September. Her mother was taken ill the same evening, and died on the following day. Other cases occurred in Newcastle on the 1st and 2nd of September, having no connexion with these. A ship from Bremen was lying at Bell Quay, opposite the house where the first cases occurred; but there had been no illness on board this ship, and the precise way in which the cholera was introduced on this occasion, is not known.

PG72894.B00343
The disease soon spread to an extent almost unprecedented in this country: by the 15th of September the deaths exceeded a hundred a day. In nine weeks there were 1,533 deaths from cholera in a population of 86,114, being 178 to each 10,000 inhabitants; but the greater number of these deaths occurred in a few days, as 1001 took place from the 13th to the 23rd Sept. inclusive.[23]

PG72894.B00344
Gateshead, which is situated opposite to Newcastle, on the other side of the Tyne, is supplied with the same water; and in 1849 it shared with that town a comparative immunity from cholera, whilst in the autumn of 1853, 433 persons died of that disease out of a population of 26,000, or thereabouts, being 166 to each 10,000 inhabitants.

PG72894.B00345
The lowest streets in Newcastle and Gateshead are about five feet above high-water mark; and only a few streets are situated at this level, for the banks rise very abruptly, at a little distance from the river, on both sides. A great portion of each town is elevated nearly 200 feet above the river, and some parts are nearly 300 feet high; yet the Water Company supplies all these districts, and all were severely visited by the cholera, which on this occasion spared no class of the community. In the districts which are most crowded, the mortality was greatest, the deaths being much more numerous in the parishes which contained a great number of tenements consisting of a single room, than in those which consisted chiefly of houses occupied by one family.[24] This, however, is quite in accordance with the principles which I am throughout endeavouring to explain. A great deal of stress is laid, very properly, by the Commissioners who have reported respecting this outbreak, on the ill-arranged buildings, the defective drainage, and want of privy accommodation, in Newcastle; but it must be remembered that all these evils existed in 1849, when Newcastle escaped with less cholera than most towns,—to a greater extent than they did in 1853, for many improvements had taken place in the meantime.

PG72894.B00346
In consequence of a great outcry on the part of the public, who naturally connected the great fatality of cholera in some measure with the turbidity and offensive smell of the drinking water, the Company entirely ceased to draw water from the Tyne on the 15th September; and although the Tyne water was not entirely out of the pipes for a day or two, the deaths, which had been rapidly increasing, began to diminish on the 17th, and were lessened considerably by the 20th. The following is the course of the mortality in Newcastle, in the most fatal part of the epidemic; and it began to decline at exactly the same time in Gateshead:

PG72894.B00347
September 12 13 14 15 16 17 18 19 20 21 22 23 DEATHS 38 59 90 106 114 103 103 111 85 68 82 60.

PG72894.B00348
The late General Board of Health directed one of their medical inspectors, Dr. Waller Lewis, to make minute inquiry as to the relative effects produced by the use of pure spring water, and that of the Water Company, during the epidemic of cholera in Newcastle; and it is much to be regretted that the inquiry was not carried out. To have conducted the inquiry through the whole of Newcastle and Gateshead would not have entailed a quarter as much labour as my investigations in Lambeth, Newington, and the Borough. Dr. Lewis called on Mr. Main, the secretary of the Water Company, and they made an inquiry in certain houses, taken at random, through three streets, and also in Greenhow Terrace, where a severe outbreak of cholera had occurred, although it was not supplied by the Company, but had what was reported to be good spring water. Dr. Lewis gave up the inquiry because he could not find two places exactly alike in all their physical conditions,—one place supplied with spring water, the other by the Company. He made no report of what he had done; but Mr. Main sent a paper on the subject of this commenced inquiry to the Pathological Society of Newcastle, an abstract of which appeared in the “Medical Times and Gazette”.

PG72894.B00349
By adding Greenhow Terrace to the streets partly supplied by the Company, and by including cases of cholera, fatal or otherwise, with those of mere diarrhœa, Mr. Main was able to show a result apparently in favour of the Company’s water. He was good enough, however, to send me a copy of his paper, which contains the details of the inquiry as far as it extended; and I found, on perusing it, that, leaving out Greenhow Terrace, which is not supplied by the Company at all, there was no case of cholera, either fatal or otherwise, and no case, even of approaching cholera, in any house which was not supplied with the Company’s water. All the deaths and all the cholera occurred in the houses having this water, whilst in the houses having only pump-water, there was simply diarrhœa. In the workhouse, supplied by the Water Company, and having five hundred and forty inmates, there were twelve cases of cholera, or approaching cholera, and seven deaths; whilst in the military barracks, supplied from wells on the premises, and having five hundred and nineteen inmates, although there was a good deal of harmless diarrhæa, there was no cholera, nor any case of approaching cholera.

PG72894.B00350
[Sidenote: CHOLERA AT MOSCOW.]

PG72894.B00351
The communication of cholera by means of the water is well illustrated by the instance of Moscow, which was severely visited by that disease in 1830; but much less severely in the second epidemic. Subsequently to 1830 the greater part of the town, which is situated to the north of the Moscow river, obtained a supply of excellent water, conducted in pipes from springs at a distance; and the cholera in 1847 was chiefly confined to those parts of the town which lie to the south of the river, to which the new supply of water did not extend, and where the people had still only impure river water to drink.[25]

PG72894.B00352
The above instances are probably sufficient to illustrate the widely-spread influence which the pollution of the drinking water exerts in the propagation of cholera.

PG72894.B00353
[Sidenote: DIFFUSION OF THE CHOLERA POISON IN WATER.]

PG72894.B00354
After the Registrar-General alluded, in the “Weekly Return” of 14th October last, to the very conclusive investigation of the effects of polluted water in the south districts of London, there was a leading article, in nearly all the medical periodicals,[26] fully admitting the influence of the water on the mortality from cholera. It may therefore be safely concluded that this influence is pretty generally admitted by the profession. It must not be disguised, however, that medical men are not yet generally convinced that the disease is actually communicated from person to person by the morbid matter being swallowed in the drinking water, or otherwise. It used to be the custom of medical authors to speak of three kinds of causes of a disease, viz. predisposing, exciting, and proximate causes. The proximate causes have been given up, as being the diseases themselves; but authors still divide causes into predisposing and exciting ones. It may be remarked, however, that in treating of certain communicable diseases, the cause of which is thoroughly understood, as syphilis and the itch, predisposing causes are never mentioned; and that they are rarely alluded to in treating of small-pox, measles, and scarlet fever, whilst they continue to be appealed to in explanation of the various continued fevers.[27] Now many medical men, whilst they admit the influence of polluted water on the prevalence of cholera, believe that it acts by predisposing or preparing the system to be acted on by some unknown cause of the disease existing in the atmosphere or elsewhere. The following amongst other reasons prove, however, that opinion cannot long halt here, and that, if the effect of contaminated water be admitted, it must lead to the conclusion that it acts by containing the true and specific cause of the malady.

PG72894.B00355
In my inquiries in the south districts of London I met with several instances in which persons, especially maidservants and young men, died of cholera within a few days after coming from the country to a house supplied with water by the Southwark and Vauxhall Company. The Registrar of Waterloo Road (2nd) remarked as follows on this point, on 26th August last:—“This is the third successive case of fatal cholera, where the patients have recently come from the country. Similar instances have frequently attracted the Registrar’s notice.” I found that the houses in which these cases occurred were supplied by the above-named Company. The outbreak of cholera in the Baltic fleet, related at page 36, occurred within forty-eight hours after the polluted water had been taken on board. And lastly, if the contaminated water merely acted by predisposing or preparing the system to be affected by some other cause, it would be impossible to explain why nearly all the persons drinking it should be attacked together, in cases where a pump-well or some other limited supply is polluted, while the population around experience no increase of the malady.

PG72894.B00356
All the evidence proving the communication of cholera through the medium of water, confirms that with which I set out, of its communication in the crowded habitations of the poor, in coal-mines and other places, by the hands getting soiled with the evacuations of the patients, and by small quantities of these evacuations being swallowed with the food, as paint is swallowed by house painters of uncleanly habits, who contract lead-colic in this way.

PG72894.B00357
There are one or two objections to the mode of communication of cholera which I am endeavouring to establish, that deserve to be noticed. Messrs. Pearse and Marston state, in their account of the cases of cholera treated at the Newcastle Dispensary in 1853, that one of the dispensers drank by mistake some rice-water evacuation without any effect whatever.[28] In rejoinder to this negative incident, it may be remarked, that several conditions may be requisite to the communication of cholera with which we are as yet unacquainted. Certain conditions we know to be requisite to the communication of other diseases. Syphilis we know is only communicable in its primary stage, and vaccine lymph must be removed at a particular time to produce its proper effects. In the incident above mentioned, the large quantity of the evacuation taken might even prevent its action. It must be remembered that the effects of a morbid poison are never due to what first enters the system, but to the crop or progeny produced from this during a period of reproduction, termed the period of incubation; and if a whole sack of grain, or seed of any kind, were put into a hole in the ground, it is very doubtful whether any crop whatever would be produced.

PG72894.B00358
[Sidenote: EXPERIMENTS OF DR. THIERSCH ANSWERS TO CERTAIN OBJECTIONS.]

PG72894.B00359
Dr. Thiersch is of opinion, as appears by a discussion which has recently taken place at Munich, that the cholera evacuations are not at first capable of generating the disease; but that a decomposition takes place in them, and that in from six to nine days they become in a state to induce cholera. He founds this opinion on experiments which he performed by giving small quantities of the cholera evacuations to white mice. Although it is not contrary to all analogy that some change or development should take place in the cholera poison in the interval between its leaving one person and entering another, it is most probable that the fatal bowel complaint produced in white mice by Dr. Thiersch was not a specific disease, but the ordinary effect of putrifying ingesta. Many of the best attested instances of the communication of cholera are those, such as were related at the commencement of this work, where the patient is attacked in from twenty-four to forty-eight hours after first being near another patient, and although an interval of a week or so, often elapses between one case of the disease and those which follow, it is extremely probable that, in these instances, the evacuations remain the greater part of this time in a dry state on the soiled linen, without undergoing any change.

PG72894.B00360
An objection that has repeatedly been made to the propagation of cholera through the medium of water, is, that every one who drinks of the water ought to have the disease at once. This objection arises from mistaking the department of science to which the communication of cholera belongs, and looking on it as a question of chemistry, instead of one of natural history, as it undoubtedly is. It cannot be supposed that a morbid poison, which has the property, under suitable circumstances, of reproducing its kind, should be capable of being diluted indefinitely in water, like a chemical salt; and therefore it is not to be presumed that the cholera poison would be equally diffused through every particle of the water. The eggs of the tape-worm must undoubtedly pass down the sewers into the Thames, but it by no means follows that everybody who drinks a glass of the water should swallow one of the eggs. As regards the morbid matter of cholera, many other circumstances, besides the quantity of it which is present in a river at different periods of the epidemic, must influence the chances of its being swallowed, such as its remaining in a butt or other vessel till it is decomposed or devoured by animalcules, or its merely settling to the bottom and remaining there. In the case of the pump-well in Broad Street, Golden Square, if the cholera poison was contained in the minute whitish flocculi, visible on close inspection to the naked eye, some persons might drink of the water without taking any, as they soon settled to the bottom of the vessel.

PG72894.B00361
[Sidenote: THEORIES OF THE CAUSE OF CHOLERA.]

PG72894.B00362
It is not necessary to oppose any other theories in order to establish the principles I am endeavouring to explain, for the field I have entered on was almost unoccupied. The best attempt at explaining the phenomena of cholera, which previously existed, was probably that which supposed that the disease was communicated by effluvia given off from the patient into the surrounding air, and inhaled by others into the lungs; but this view required its advocates to draw very largely on what is called predisposition, in order to account for the numbers who approach near to the patient without being affected, whilst others acquire the disease without any near approach. It also failed entirely to account for the sudden and violent outbreaks of the disease, such as that which occurred in the neighbourhood of Golden Square.

PG72894.B00363
Another view having a certain number of advocates is, that cholera depends on an unknown something in the atmosphere which becomes localized, and has its effects increased by the gases given off from decomposing animal and vegetable matters. This hypothesis is, however, rendered impossible by the motion of the atmosphere, and, even in the absence of wind, by the laws which govern the diffusion of aeriform bodies; moreover, the connection between cholera and offensive effluvia is by no means such as to indicate cause and effect; even in London, as was before mentioned, many places where offensive effluvia are very abundant have been visited very lightly by cholera, whilst the comparatively open and cleanly districts of Kennington and Clapham have suffered severely. If inquiry were made, a far closer connection would be found to exist between offensive effluvia and the itch, than between these effluvia and cholera; yet as the cause of itch is well known, we are quite aware that this connection is not one of cause and effect.

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Mr. John Lea, of Cincinnati, has advanced what he calls a geological theory of cholera.[29] He supposes that the cholera poison, which he believes to exist in the air about the sick, requires the existence of calcareous or magnesian salts in the drinking water to give it effect. This view is not consistent with what we know of cholera, but there are certain circumstances related by Mr. Lea which deserve attention. He says that, in the western districts of the United States, the cholera passed round the arenacious, and spent its fury on the calcareous regions; and that it attacked with deadly effect those who used the calcareous water, while it passed by those who used sandstone or soft water. He gives many instances of towns suffering severely when river water was used, whilst others, having only soft spring water or rain water, escaped almost entirely; and he states that there has been scarcely a case of cholera in families who used only rain water. The rivers, it is evident, might be contaminated with the evacuations, whilst it is equally evident that the rain water could not be so polluted. As regards sand and all sandstone formations, they are well known to have the effect of oxidizing and thus destroying organic matters; whilst the limestone might not have that effect, although I have no experience on that point. The connection which Mr. Lea has observed between cholera and the water is highly interesting, although it probably admits of a very different explanation from the one he has given.

PG72894.B00365
[Sidenote: DURATION OF CHOLERA IN DIFFERENT PLACES.]

PG72894.B00366
There are certain circumstances connected with the history of cholera which admit of a satisfactory explanation according to the principles explained above, and consequently tend to confirm those principles. The first point I shall notice, viz., the period of duration of the epidemic in different places, refers merely to the communicability of the disease, without regard to the mode of communication. The duration of cholera in a place is usually in a direct proportion to the number of the population. The disease remains but two or three weeks in a village, two or three months in a good-sized town, whilst in a great metropolis it often remains a whole year or longer. I find from an analysis which I made in 1849 of the valuable table of Dr. Wm. Merriman, of the cholera in England in 1832,[30] that fifty-two places are enumerated in which the disease continued less than fifty days, and that the average population of these places is 6,624. Forty-three places are likewise down in which the cholera lasted fifty days, but less than one hundred; the average population of these is 12,624. And there are, without including London, thirty-three places in which the epidemic continued one hundred days and upwards, the average population of which is 38,123; or if London be included, thirty-four places, with an average of 78,823. The following short table will show these figures in a more convenient form:—

PG72894.B00367
No. of Places. Duration in Days. Average Population. 52 0 to 50 6,624 43 50 to 100000 12,624 33} 100 and upwards { 38,123 34} „ { 78,823

PG72894.B00368
There was a similar relation in 1849 between the duration of the cholera and the population of the places which it visited; a relation which points clearly to the propagation of the disease from patient to patient; for if each case were not connected with a previous one, but depended on some unknown atmospheric or telluric condition, there is no reason why the twenty cases which occur in a village should not be distributed over as long a period as the twenty hundred cases which occur in a large town.

PG72894.B00369
Even the duration of the cholera in a street, when compared to its duration in the individual houses, points to the same conclusion. A table has been published[31] in the report of the late discussion on cholera at Munich, which shows that whilst the epidemic remained three or four weeks in a street, it only remained six or seven days in houses where several people were attacked. Dr. Pettenkofer remarks, that “if the proximate cause of the disease had been generally diffused over a certain number of streets or a certain district, and its invasion had been opposed by individual disposition alone, one might have expected that both the cases of disease and the instances of death would have occurred in single houses, where many such appeared together, at similar periods of time throughout the whole street; but, supposing that the proximate cause of the disease was not general, but local, then it would act in such a manner that the period of time within which the disease would show itself in single houses would be very different from that which was applicable to the entire street.” The local cause in a house we know to be the illness of some individual, who, in many cases, has newly arrived from some place where the disease was prevailing.

PG72894.B00370
[Sidenote: EFFECT OF SEASON ON THE PREVALENCE OF CHOLERA.]

PG72894.B00371
Each time when cholera has been introduced into England in the autumn, it has made but little progress, and has lingered rather than flourished during the winter and spring, to increase gradually during the following summer, reach its climax at the latter part of summer, and decline somewhat rapidly as the cool days of autumn set in. In most parts of Scotland, on the contrary, cholera has each time run through its course in the winter immediately following its introduction. I have now to offer what I consider an explanation, to a great extent, of these peculiarities in the progress of cholera. The English people, as a general rule, do not drink much unboiled water, except in warm weather. They generally take tea, coffee, malt liquor, or some other artificial beverage at their meals, and do not require to drink between meals, except when the weather is warm. In summer, however, a much greater quantity of drink is required, and it is much more usual to drink water at that season than in cold weather. Consequently, whilst the cholera is chiefly confined in winter to the crowded families of the poor, and to the mining population, who, as was before explained, eat each other’s excrement at all times, it gains access as summer advances to the population of the towns, where there is a river which receives the sewers and supplies the drinking water at the same time; and, where pump-wells and other limited supplies of water happen to be contaminated with the contents of the drains and cesspools, there is a greater opportunity for the disease to spread at a time when unboiled water is more freely used.

PG72894.B00372
In Scotland, on the other hand, unboiled water is somewhat freely used at all times to mix with spirits; I am told that when two or three people enter a tavern in Scotland and ask for a gill of whiskey, a jug of water and tumbler-glasses are brought with it. Malt liquors are only consumed to a limited extent in Scotland, and when persons drink spirit without water, as they often do, it occasions thirst and obliges them to drink water afterwards.

PG72894.B00373
There may be other causes besides the above which tend to assist the propagation of cholera in warm, more than in cold weather. It is not unlikely that insects, especially the common house-flies, aid in spreading the disease. An ingenious friend of mine has informed me that, when infusion of quassia has been placed in the room for the purpose of poisoning flies, he has more than once perceived the taste of it on his bread and butter.

PG72894.B00374
Dr. Farr gives the following very important information respecting the sex of persons who died of cholera at different periods of the epidemic.[32]

PG72894.B00375
“It is worthy of remark, that at the beginning of the epidemic, the deaths of males exceeded the deaths of females very considerably; the numbers in the months of October, November, and December, 1848, were,—males 612, females 493; or in the proportion of 100 to 80....

PG72894.B00376
“As a general rule, when the mortality from cholera attained a very high rate, the number of deaths among females exceeded the deaths among males.

PG72894.B00377
“In London a remarkable change was observed in the proportion of the sexes affected in the course of the epidemic. In four weeks of October 1848, the deaths of 80 males and of 42 females by cholera were registered; in the thirteen last weeks of the year the deaths of 258 males and 210 females were registered; and there was an excess of males at all ages, but particularly in the ten years of age 15–25. In the quarter ending March 1849, the deaths of males amounted to 250, of females to 266: at the age of 25 and upwards the excess of deaths among females was considerable. In June, at the commencement of the great outbreak, the males again furnished the most numerous victims. At the close of July the females died in greater numbers than the males, and continued to do so to the end. In the week that the mortality was highest, the deaths of 895 males and of 1131 females were returned. In the September quarter the deaths of males under the age of 25 exceeded the deaths of females; but after that age the proportions were reversed.”

PG72894.B00378
[Sidenote: PROPORTION OF THE SEXES WHO DIE OF CHOLERA.]

PG72894.B00379
The greater part of the female population remain almost constantly at home, and take their meals at home, whilst a considerable number of the men move about in following their occupations, and take both food and drink at a variety of places; consequently, in the early part of an epidemic, when the disease only exists in a few spots, the male part of the population is most liable to come within the operation of the morbid poison; but at a later period of the epidemic, when the cholera is more generally diffused, it may reach those who stay at home as readily as those who move about; and in addition to the risk which the women share with the men, they have the additional one of being engaged in attending on the sick.

PG72894.B00380
It is a confirmation of this view of the matter that, when the cholera poison is distributed through the pipes of a Water Company, the above rule does not hold good, but a contrary one prevails, owing, probably, to females being less in the habit of drinking beer than men, and being therefore more likely to drink water. Of the 334 deaths detailed in the Appendix to this work (286 of them amongst the customers of the Southwark and Vauxhall Water Company), only 147 were males, whilst 187 were females. The deaths occurred in the first four weeks of the recent epidemic. On the other hand, out of the 229 deaths from cholera which occurred in all the rest of London during this period, 140 were males and only 89 females. When the mortality of the whole of the metropolis during this period is taken together, there is a slight preponderance on the part of the males; the numbers being,—males 287, females 276: total 563.

PG72894.B00381
The deaths from cholera in England in 1849 were 53,293; of those, 14,718, or 27 per cent. of the whole, occurred in children under 15 years of age. Of the 334 deaths which are recorded in the Appendix to this work, 127, or 38 per cent., are those of children under 15, whilst of the remaining 229 which occurred in the rest of London during the first four weeks of the epidemic, only 61, or 26 per cent., took place before the age of 15,—a proportion nearly the same as in the whole of England in 1849. The higher proportion of deaths amongst children in the houses supplied with the impure water from the Thames at Battersea Fields, probably arose from the circumstance that children are very fond of drinking water in warm weather. I often heard such remarks as the following, in making my inquiries in the south districts of London:—“My children like water better than tea or anything else, I cannot keep them away from the water-butt;” or, “the child that is dead used to drink a great deal of that water, she was big enough to reach to the butt herself.”

PG72894.B00382
Dr. Guy, physician to King’s College Hospital, made a table showing the occupations of 4,312 males, of fifteen years of age and upwards, who died of cholera in London in the epidemic of 1848–49; together with the ratio which the deaths bear to the living, as well as it could be ascertained from the census of 1841. I have not room for the whole table, but have selected the occupations which suffered most, and those which suffered least. The following abstract of Dr. Guy’s table contains all the occupations where the deaths from cholera equalled one-fiftieth of the number living, and all those in which the deaths did not exceed one in two hundred and fifty living.

PG72894.B00383
[Sidenote: PROPORTION OF DEATHS IN DIFFERENT OCCUPATIONS.]

PG72894.B00384
In some of the occupations which show a high relative mortality, the number of living is too small to allow of any reliable statistical result, and the relative mortality is probably due to accidental circumstances quite unconnected with the occupation. In other cases, however, the numbers are so considerable as to indicate something more than accident. The 299 sailors, for instance, constituted one twenty-fourth of the whole estimated number in that occupation. The 7 ballast-heavers form just the same proportion of the whole in that occupation, and the 53 coalporters and coalheavers constituted one in 32 of those so employed. Now all those persons lived or were employed on the river, where it is the habit to drink water drawn by pailfuls from the side of the ship. The 67 hawkers are one in 22 of the whole number. These persons are constantly moving about, and are in the habit of living in crowded lodging-houses, and consequently must be extremely liable to contract any communicable disease. Tanners nearly all live in Bermondsey and Lambeth, supplied in 1849 with none but very impure water, as was previously explained. The weavers probably suffered the high rate of mortality from the crowding of their apartments in Spitalfields, and the uncleanness of their habits.

PG72894.B00385
The persons who suffered less from cholera than any other part of the male population, are footmen and men-servants; and it is impossible to conceive a class less exposed to the disease. They live in the best parts of London, and go from home much less than their masters. The low rate of mortality amongst medical men and undertakers is worthy of notice. If cholera were propagated by effluvia given off from the patient, or the dead body, as used to be the opinion of those who believed in its communicability; or, if it depended on effluvia lurking about what are by others called infected localities, in either case medical men and undertakers would be peculiarly liable to the disease; but, according to the principles explained in this treatise, there is no reason why these callings should particularly expose persons to the malady.

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=TABLE XIV.=

PG72894.B00387
┌───────────────────────────────────────────────────┬────────┬────────┐ │ │ No. of │ Ratio. │ │ │Deaths. │ │ ├───────────────────────────────────────────────────┼────────┼────────┤ │Agents │ 12│1 in 49 │ │Bricklayers and builders │ 14│1 „ 39 │ │Cowkeepers, dairymen, and milkmen │ 8│1 „ 20 │ │Egg merchants │ 5│1 „ 6 │ │Fishmongers │ 11│1 „ 20 │ │Fruiterers and greengrocers │ 12│1 „ 28 │ │Jobmasters, livery-stable keepers │ 5│1 „ 37 │ │Oilmen │ 13│1 „ 46 │ │Paper-makers │ 2│1 „ 15 │ │Poulterers │ 3│1 „ 32 │ │Sail-makers │ 2│1 „ 30 │ │Turners │ 2│1 „ 50 │ │Ballast-heavers │ 7│1 „ 24 │ │Coal-porters and coalheavers │ 53│1 „ 32 │ │Dustmen and scavengers │ 6│1 „ 39 │ │Founders │ 10│1 „ 12 │ │Hawkers, etc. │ 67│1 „ 22 │ │Lithographers │ 3│1 „ 48 │ │Modellers │ 3│1 „ 41 │ │Polishers │ 4│1 „ 36 │ │Sailors, including Greenwich pensioners │ 299│1 „ 24 │ │Tanners │ 22│1 „ 39 │ │Weavers │ 102│1 „ 36 │ │ │ │ │ │Physicians, surgeons, & general practitioners │ 16│1 „ 265 │ │Magistrates, barristers, conveyancers, and │ 13│1 „ 375 │ │ attorneys │ │ │ │Merchants │ 11│1 „ 348 │ │Auctioneers │ 1│1 „ 266 │ │Saddlers │ 1│1 „ 250 │ │Brass-finishers │ 3│1 „ 318 │ │Coach-makers │ 16│1 „ 262 │ │Cork-cutters │ 2│1 „ 279 │ │Footmen and men-servants │ 25│1 „ 1572│ │Jewellers, goldsmiths, and silversmiths │ 6│1 „ 583 │ │Millwrights │ 2│1 „ 266 │ │Tallow-chandlers │ 2│1 „ 430 │ │Type-founders │ 1│1 „ 390 │ │Undertakers │ 2│1 „ 325 │ │Warehousemen │ 8│1 „ 472 │ │Watchmakers │ 11│1 „ 364 │ │Wheelwrights │ 8│1 „ 294 │ └───────────────────────────────────────────────────┴────────┴────────┘

PG72894.B00388
[Sidenote: ABSENCE OF DRAINAGE INCREASES CHOLERA.]

PG72894.B00389
There is one remarkable circumstance connected with Dr. Guy’s table. One master-brewer died of cholera, being 1 in 160 of the trade; but no brewer’s man or brewer’s servant is mentioned as having died of this malady, although these men must constitute a very numerous body in London. There must be a few thousands of them. I have, indeed, met with the deaths of two or three of these persons, in looking over the returns of some of the most fatal weeks in 1849; but the brewers’ men seem to have suffered very slightly both in that and the more recent epidemics. The reason of this probably is, that they never drink water, and are therefore exempted from imbibing the cholera poison in that vehicle.

PG72894.B00390
The great prevalence of cholera along the course of rivers has been well known for a quarter of a century; and it meets with a satisfactory explanation from the mode of communication of the disease which I am inculcating. Rivers always receive the refuse of those living on the banks, and they nearly always supply, at the same time, the drinking water of the community so situated. It has sometimes been objected to the propagation of the disease by the water of rivers, that the epidemic travels as often against the stream as with it. The reply to this is, that people travel both against the stream and with it, and thus convey the malady from village to village and from town to town on the banks, whilst the water serves as a medium to propagate the disease amongst those living at each spot, and thus prevents it from dying out through not reaching fresh victims.

PG72894.B00391
The principles I have laid down afford a satisfactory explanation of the circumstances, that absence of drainage promotes the prevalence of cholera, and that it flourishes better on a clay soil than on primitive rocks, sandstone, or gravel. Without drainage, the refuse of the population permeates the ground, and gains access to the pump-wells. Merthyr Tydvil, with 52,863 inhabitants, is entirely without drainage, and the people derive their supply of water from pump-wells. This place has suffered severely from cholera in every epidemic. In 1849 there were 1,682 deaths from this disease, being 234 to each 10,000 inhabitants,—a rate of mortality as high as in Hull and certain of the south districts of London, where the morbid poison of cholera was distributed by the steam-engines of the water companies. The primitive rocks, sandstone, and gravel, generally cause the purification of the water by the separation or oxidation of organic matters, whilst clay does not exert this salutary influence to the same extent.

PG72894.B00392
Since the latter part of 1848, when I first arrived at my present conclusions respecting the mode of communication of cholera, I have become more and more convinced that many other diseases are propagated in the same way.

PG72894.B00393
When the plague visited this country, it was most fatal in London, York, Winchester, and certain other towns having a river of fresh water passing through them. It resembled cholera also in being twice as fatal in the districts on the south of the Thames as in those on the north. The following passage from Stow’s “Survey”, published in 1633, shows the way in which Southwark was supplied with water about the time of the great visitations of plague: “Southwark useth chiefly the water of the Thames, that falls into a great pond at St. Mary Overies, that drives a mill called St. Saviour’s Mill, the owner whereof is one Mr. Gulston. The revenue thereof is supposed by some to be worth 1,300_l._ a year.”

PG72894.B00394
[Sidenote: MODE OF PROPAGATION OF THE PLAGUE.]

PG72894.B00395
Although some of the lower parts of the City were supplied with water from the Thames, at the latter part of the sixteenth and throughout the seventeenth century, yet the greater part of London north of the Thames was supplied by fountains and conduits, conveying spring water from a distance. The following quaint but poetic account of the conduits of London cannot fail to be interesting: “As nature, by veins and arteries, some great and some small, placed up and down all parts of the body, ministereth blood to every part thereof; so was that wholesome water, which was necessary for the good of London, as blood is for the good and health of the body, conveyed by pipes, wooden or metalline, as by veins, to every part of this famous city.... They were lovely streams indeed that did refresh that noble city, one of which was always at work pouring out itself when the rest lay still. Methinks these several conduits of London stood like so many little but strong forts, to confront and give check to that great enemy, fire, as occasion should be. There, methinks, the water was intrenched and in-garrisoned. The several pipes and vehicles of water that were within these conduits, all of them charged with water, till by turning of the cock they were discharged again, were as so many soldiers within these forts, with their musketry charged, ready to keep and defend these places. And look how enemies are wont to deal with these castles, which they take to be impregnable, and despair of every getting by them,—that is, by attempting to storm them by a close siege: so went the fire to work with these little castles of stone, which were not easy for it to burn down (witness their standing to this day); spoiled them, or almost spoiled them, it hath for the present, by cutting off those supplies of water which had vent to flow to them, melting those leaden channels by which it had been conveyed, and thereby, as it were, starving those garrisons which it could not take by storm. As if the fire had been angry with the poor old tankard-bearers, both men and women, for propagating that element which was contrary to it, and carrying it upon their shoulders, as it were, in state and triumph, it hath even destroyed their trade, and threatens to make them perish by fire who had wont to live by water.”[33]

PG72894.B00396
Dr. Farr makes the following remarks on the plague, in his report on the cholera of 1848–9: “It is endemic in the Delta of the Nile, and periodically decimates the population of Cairo and Alexandria.... It grows gradually less fatal up the Nile, and is less frequent and destructive in Upper than in Lower Egypt, in the high lands and in the desert, than on the low lands on the shores of the Mediterranean.” Speaking of Cairo, he says: “Through the midst of it passes the Great Canal, into which the sewers are discharged over carrion, excretion, and mud. At the yearly overflow of the Nile, its waters, filling this canal, are distributed over the city, and drunk by its wretched inhabitants.”

PG72894.B00397
The plague resembles cholera in being much promoted by crowding and want of personal cleanliness. The natives of Gurhwal, a province in the north-west of British India, in which the plague has been present for the last thirty years, believe that it may be transmitted from one place to another in articles of diet, such as a jar of ghee.[34]

PG72894.B00398
[Sidenote: MODE OF PROPAGATION OF YELLOW FEVER.]

PG72894.B00399
Yellow fever, which has been clearly proved by Dr. M’William and others to be a communicable disease, resembles cholera and the plague in flourishing best, as a general rule, on low alluvial soil, and also in spreading greatly where there is a want of personal cleanliness. This disease has more than once appeared in ships sailing up the river Plate, before they have had any communication with the shore. The most probable cause of this circumstance is, that the fresh water of this river, taken up from alongside the ship, contained the evacuations of patients with yellow fever in La Plata or other towns.

PG72894.B00400
It was long ago observed, that dysentery was apparently propagated by the drinking of water containing excrementitious matters.[35] The frequent appearance of this disease in Millbank prison, when the Thames water was used, is a confirmation of this; and Dr. Bryson has lately related a number of instances where both dysentery and fever seemed to be occasioned by the water of the Yangtse-Kiang, the Canton river, and other rivers of China.[36] What very much confirms this view of the case, is, that nearly all the patients were afflicted with great numbers of intestinal worms (_lumbrici_); for it cannot be supposed that the worms could proceed from malaria, miasmata, or any of the causes which are frequently believed to occasion dysentery and fever. The eggs of the lumbrici were no doubt contained in great numbers in the water of the densely populated Chinese rivers.

PG72894.B00401
There are many facts which indicate that one at least of the continued fevers—the typhoid fever with ulceration of the small intestines—is also propagated in the same way as cholera. Dr. Jenner called my attention some time ago to an instance occurring at the village of North Boston, Erie County, N.Y., in which typhoid fever was probably communicated to a number of families by the contamination of the water of a well which they used.[37] The epidemic which prevailed so extensively at Croydon two years ago was of this character, as was verified by a Committee of the Epidemiological Society, of which Drs. Sankey, Jenner, and A. P. Stewart were members. Mr. Carpenter, of Croydon, has lately shown very ably that this epidemic was connected with the pollution of the pump-wells of the town, owing to the disturbance of the ground, and of many old cesspools during the drainage operations of the Local Board of Health.[38] The Board had supplied the town with good water from a deep well in the chalk, but the population had a prejudice against it and persisted in resorting to the water of the shallow pump-wells. In the autumn of last year diarrhœa was very prevalent in Croydon, and Mr. Carpenter found that this also was caused by the impure water of the pump-wells. Nine-tenths of the people of Croydon were drinking the new water supplied by the Board of Health, but, out of thirty-two patients with diarrhœa who came under the notice of Mr. Carpenter, twenty-five were drinking well-water entirely, five drank water from both sources, and the other two could not decidedly say that they had not drank well-water.

PG72894.B00402
Intermittent fevers are so fixed to particular places that they have deservedly obtained the name of endemics. They spread occasionally, however, much beyond their ordinary localities, and become epidemic. Intermittent fevers are undoubtedly often connected with a marshy state of the soil; for draining the land frequently causes their disappearance. They sometimes, however, exist as endemics, where there is no marshy land or stagnant water within scores of miles. Towards the end of the seventeenth century, intermittent fevers were, for the first time, attributed by Lancisi to noxious effluvia arising from marshes. These supposed effluvia, or marsh miasmata, as they were afterwards called, were thought to arise from decomposing vegetable and animal matter; but, as intermittent fevers have prevailed in many places where there was no decomposing vegetable or animal matter, this opinion has been given up in a great measure; still the belief in miasmata or malaria of some kind, as a cause of intermittents, is very general. It must be acknowledged, however, that there is no direct proof of the existence of malaria or miasmata, much less of their nature.

PG72894.B00403
[Sidenote: CAUSE OF INTERMITTENT FEVERS.]

PG72894.B00404
That preventive of ague, draining the land, must affect the water of a district quite as much as it affects the air, and there is direct evidence to prove that intermittent fever has, at all events in some cases, been caused by drinking the water of marshes. In the “General Report of the Poor Law Commissioners on the Sanitary Condition of Great Britain,”[39] Mr. Wm. Blower, surgeon, of Bedford, states that typhus and ague, which had long infested the village of Wootton, near Bedford, had been much diminished by digging a few wells, and obtaining good water. He also states that, in the neighbouring parish of Houghton, almost the only family which escaped ague, at one time, was that of a respectable farmer who used well-water, whilst all the other families had only ditch water.

PG72894.B00405
M. Boudin[40] relates a very marked instance in which intermittent, and apparently also remittent, fever were caused by drinking marsh water. It is as follows:—

PG72894.B00406
“In July 1834, 800 soldiers, all in good health, embarked on the same day in three transports at Bona, in Algeria, and arrived together at Marseilles; they were exposed to the same atmospheric influences, and were, with one essential difference, supplied with the same food, and subjected to the same discipline. On board one of the vessels were 120 soldiers: of these, 13 died on the passage, from a destructive fever, and 98 more were taken to the military hospital of the lazaretto at Marseilles, presenting all the pathological characters proper to marshy localities. On seeing the physiognomy of these patients, altogether so unusual for Marseilles, one would have said that the Gulf of Mexico, the Delta of the Ganges, and the marshes of Senegal and of Holland, had supplied passengers to this ship. In short, by the side of a simple intermittent, there was a pernicious fever. On an inquiry being instituted, it was ascertained that on board the affected ship the water supplied for the soldiers, owing to the haste of the embarkation, had been taken from a marshy place near Bona; whilst the crew, not one of whom was attacked, were supplied with wholesome water. It further appeared that the nine soldiers who had escaped had purchased water of the crew, and had consequently not drunk the marsh water. Not a single soldier or sailor of the other two transports, who were supplied with pure water, suffered.”

PG72894.B00407
Mr. Grainger, who quotes the above circumstance in his Appendix to the Report on Cholera, also says:[41] “Dr. Evans, of Bedford, related to me an equally well-marked instance. A few years ago, he was staying at Versailles, with his lady, when they both became affected with the ague, and, on inquiry, the following facts were disclosed. The town of Versailles is supplied with water for domestic purposes from the Seine, at Marli. At the time in question, a large tank, supplying one particular quarter, was damaged, and the mayor, without consulting the medical authorities, provided a supply of water, consisting of the surface-drainage of the surrounding country, which is of a marshy character. The regular inhabitants would not use this polluted water; but Dr. and Mrs. Evans, who were at an hotel, drank of it unwittingly, and it was also used by a regiment of cavalry. The result was, that those who drank the water suffered from intermittent fever of so severe a type, that seven or eight of the soldiers, fine young men, died on one day, Sept. 1, 1845. On a careful investigation it was ascertained that those only of the troops who had drunk the marsh water were attacked; all the others, though breathing the same atmosphere, having escaped, as did also the townspeople.”

PG72894.B00408
In all the instances I have just quoted, the cause of ague, whatever it may be, was swallowed with the water, not inhaled with the air; and on questioning two patients, ill with this complaint, in St. George’s Hospital, after harvesting in Kent, they told me that they had often been obliged to drink water from the ditches. The disease of the liver and spleen, to which persons are subject after attacks of intermittent fever, also confirms the view that its material cause enters the system by the alimentary canal, and not by the lungs; and it is of importance to remark, that Hippocrates observed, that drinking stagnating waters caused hard swellings of the spleen.[42]

PG72894.B00409
Whether the unknown cause of ague has been produced in the system of a previous patient, like the pus of small-pox and the eggs of tape-worm, or whether it has been produced externally, there is, at present, no sufficient evidence to show. In the case first supposed, the disease would be a communicable one, in the second it would not.

PG72894.B00410
There is one circumstance which seems to indicate that the specific cause of intermittent fevers undergoes a development or multiplication within the system of the patient,—it is, that a period of dormancy, or incubation, has been observed, in many cases, between the visit to the unhealthy locality and the illness which followed; for, as I have already remarked, every poisonous or injurious substance causes symptoms as soon as it has been absorbed in sufficient quantity.

PG72894.B00411
The communication of ague from person to person has not been observed, and supposing this disease to be communicable, it may be so only indirectly, for the _materies morbi_ eliminated from one patient may require to undergo a process of development or procreation out of the body before it enters another patient, like certain flukes infesting some of the lower animals, and procreating by alternate generations.

PG72894.B00412
The measures which are required for the prevention of cholera, and all diseases which are communicated in the same way as cholera, are of a very simple kind. They may be divided into those which may be carried out in the presence of an epidemic, and those which, as they require time, should be taken beforehand.

PG72894.B00413
The measures which should be adopted during the presence of cholera may be enumerated as follows:—

PG72894.B00414
1st. The strictest cleanliness should be observed by those about the sick. There should be a hand-basin, water, and towel, in every room where there is a cholera patient, and care should be taken that they are frequently used by the nurse and other attendants, more particularly before touching any food.

PG72894.B00415
2nd. The soiled bed linen and body linen of the patient should be immersed in water as soon as they are removed, until such time as they can be washed, lest the evacuations should become dry, and be wafted about as a fine dust. Articles of bedding and clothing which cannot be washed, should be exposed for some time to a temperature of 212° or upwards.

PG72894.B00416
[Sidenote: MEASURES REQUIRED FOR THE PREVENTION OF CHOLERA.]

PG72894.B00417
3rd. Care should be taken that the water employed for drinking and preparing food (whether it come from a pump-well, or be conveyed in pipes) is not contaminated with the contents of cesspools, house-drains, or sewers; or, in the event that water free from suspicion cannot be obtained, it should be well boiled, and, if possible, also filtered.

PG72894.B00418
Works are in progress for supplying a great part of London with water from the Thames, obtained, like that of the Lambeth Company, above Teddington Lock. Although this is not the best possible source for supplying a large town, it is a great improvement on the practice of many of the water companies; and the water, owing to filtration, and especially to its detention in large reservoirs, will probably be quite salubrious: at all events it will be much safer than that of the shallow pump-wells of London, which are fed from very polluted sources. It is very desirable that the handles of nearly all the street-pumps of London and other large towns should be fastened up, and the water used only for such purposes as watering the streets. A proper supply of water for the shipping in the Thames is much wanted. Water acquires a flat taste by being boiled; but if it is filtered after it becomes cold, it gets re-aerated, and the flat or vapid taste is entirely removed.

PG72894.B00419
4th. When cholera prevails very much in the neighbourhood, all the provisions which are brought into the house should be well washed with clean water, and exposed to a temperature of 212° Fahr.; or at least they should undergo one of these processes, and be purified either by water or by fire. By being careful to wash the hands, and taking due precautions with regard to food, I consider that a person may spend his time amongst cholera patients without exposing himself to any danger.

PG72894.B00420
5th. When a case of cholera or other communicable disease appears among persons living in a crowded room, the healthy should be removed to another apartment, where it is practicable, leaving only those who are useful to wait on the sick.

PG72894.B00421
6th. As it would be impossible to clean out coal-pits, and establish privies and lavatories in them, or even to provide the means of eating a meal with anything like common decency, the time of working should be divided into periods of four hours instead of eight, so that the pitmen might go home to their meals, and be prevented from taking food into the mines.

PG72894.B00422
7th. The communicability of cholera ought not to be disguised from the people, under the idea that the knowledge of it would cause a panic, or occasion the sick to be deserted.

PG72894.B00423
British people would not desert their friends or relatives in illness, though they should incur danger by attending to them; but the truth is, that to look on cholera as a “catching” disease, which one may avoid by a few simple precautions, is a much less discouraging doctrine than that which supposes it to depend on some mysterious state of the atmosphere in which we are all of us immersed and obliged to breathe.

PG72894.B00424
The measures which can be taken beforehand to provide against cholera and other epidemic diseases, which are communicated in a similar way, are—

PG72894.B00425
8th. To effect good and perfect drainage.

PG72894.B00426
9th. To provide an ample supply of water quite free from contamination with the contents of sewers, cesspools, and house-drains, or the refuse of people who navigate the rivers.

PG72894.B00427
10th. To provide model lodging-houses for the vagrant class, and sufficient house room for the poor generally.

PG72894.B00428
The great benefit of the model lodging-houses arises from the circumstance that the apartments for cooking, eating, and sleeping, are distinct, and that all the proper offices which cleanliness and decency require are provided. The very poor who choose to avail themselves of these institutions, suffer a rate of mortality as low as that of the most opulent classes. The public washhouses, which enable poor persons to wash the soiled linen of the sick or the healthy, without doing it in the midst of the plates and dishes and provisions of the family, are well calculated to prevent the spread of disease.

PG72894.B00429
11th. To inculcate habits of personal and domestic cleanliness among the people everywhere.

PG72894.B00430
12th. Some attention should undoubtedly be directed to persons, and especially ships, arriving from infected places, in order to segregate the sick from the healthy. In the instance of cholera, the supervision would generally not require to be of long duration.

PG72894.B00431
In the autumn of 1853, certain German emigrants, on their way to America, who had crossed the sea from Hamburgh and Rotterdam, where cholera was prevailing, to the port of Hull, and had gone thence, by rail, to Liverpool, were seized with cholera (some of them fatally) in the latter town; and it is most likely to the well-regulated Emigrant’s Home, in which these cases occurred, that the town of Liverpool owed its freedom from the epidemic at that time. And a little medical supervision, and the detention of some of the emigrants for a short time in Liverpool, before their embarcation, would probably have prevented the great mortality which occurred in some of the emigrant ships during their passage to America.

PG72894.B00432
The measures which are intended to prevent disease should be founded on a correct knowledge of its causes. For want of this knowledge, the efforts which have been made to oppose cholera have often had a contrary effect. In 1849, for instance, the sewers of London were frequently flushed with water,—a measure which was calculated to increase the disease in two ways: first, by driving the cholera evacuations into the river before there was time for the poison to be rendered inert by decomposition; and second, by making increased calls on the various companies for water to flush the sewers with,—so that the water which they sent to their customers remained for a shorter time in the reservoirs before being distributed. It should be remarked, also, that the contents of the sewers were driven into the Thames by the flushing, at low water, and remained flowing up the stream for four or five hours afterwards. Flushing the sewers was not repeated during the recent epidemic, but increased quantities of water were distributed by some of the Companies, and at more frequent intervals, causing the water-butts to overflow for hours together into the drains, and producing nearly the same effect as flushing the sewers; in addition to which, the water in the butts of the Southwark and Vauxhall Company’s customers was prevented from settling, as it might have done if less frequently disturbed.

PG72894.B00433
I feel confident, however, that by attending to the above-mentioned precautions, which I consider to be based on a correct knowledge of the cause of cholera, this disease may be rendered extremely rare, if indeed it may not be altogether banished from civilized countries. And the diminution of mortality ought not to stop with cholera. The deaths registered under the name of typhus consist chiefly of the typhoid fever mentioned above. Its victims are composed chiefly of persons of adult age, who are taken away from their families and connections. In 1847 upwards of 20,000 deaths were registered in England from typhus, and in 1848 upwards of 30,000 deaths. It is probable that seven times as many deaths have taken place from typhus as from cholera, since the latter disease first visited England in 1831; and there is great reason to hope that this mortality may in future be prevented by proper precautions, resulting from a correct knowledge of the mode of communication of the malady.

PG72894.B00434
APPENDIX,

PG72894.B00435
Containing the number of deaths from cholera registered in the four weeks ending 5th August, 1854, together with the supply of water in the houses in which the fatal attacks took place, in all the sub-districts to which the water supply of either the Southwark and Vauxhall or the Lambeth Company extends. (See Table VII, page 84.) The registers of deaths are copied from the Weekly Returns of the Registrar-General.

PG72894.B00436
ST. SAVIOUR, SOUTHWARK. _Christchurch._

PG72894.B00437
At 34, Charlotte Street, on 29th July, a stock-maker, aged 29, “Asiatic cholera 18 hours”

PG72894.B00438
_Lambeth._

PG72894.B00439
At 45, Gravel Lane, on 1st August, the widow of a farmer, aged 48, “cholera 12 hours”

PG72894.B00440
_Southwark & Vauxhall._

PG72894.B00441
At 1, Alpha Place, on 1st August, a barrister’s clerk, aged 57, “cholera 24 hours”

PG72894.B00442
_Southwark and Vauxhall._

PG72894.B00443
ST. SAVIOUR, SOUTHWARK. _St. Saviour._

PG72894.B00444
At 1, Park Street, on 25th July, the wife of a labourer, aged 35, “Asiatic cholera 14¹⁄₂ hours”

PG72894.B00445
_Southwark & Vauxhall._

PG72894.B00446
At 40, Bankside, on 25th July, the son of a locksmith, aged 5 years, “cholera 12 hours”

PG72894.B00447
_Southwark and Vauxhall._

PG72894.B00448
At same house, on 26th July, the daughter of a locksmith, aged 9 yrs., “cholera 12 hours”

PG72894.B00449
_Southwark and Vauxhall._

PG72894.B00450
At same house, on 28th July, the daughter of a locksmith, aged 13 yrs., “cholera 12 hours”

PG72894.B00451
_Southwark and Vauxhall._

PG72894.B00452
At 97, Bridge Road, on 28th July, a hatter, aged 36, “Asiatic cholera 24 hours”

PG72894.B00453
_Southwark and Vauxhall._

PG72894.B00454
At 49, Great Guildford Street, on 29th July, a coal-porter, aged 44, “cholera 12 hours”

PG72894.B00455
_Southwark and Vauxhall._

PG72894.B00456
At 20, Zoar Street, on 31st July, a female, formerly a domestic servant, aged 79, “diarrhœa 2 days, cholera 12 hours”

PG72894.B00457
_Southwark and Vauxhall._

PG72894.B00458
At 22, America Street, on Aug. 1, the wife of an engine-driver, aged 38, “cholera 12 hours”

PG72894.B00459
_Southwark and Vauxhall._

PG72894.B00460
At 5, Pleasant Place, August 1, the daughter of a coal-porter, aged 5 years, “Asiatic cholera 13 hours”

PG72894.B00461
_Southwark and Vauxhall._

PG72894.B00462
At 10, Castle Street, on 1st August, the son of an engineer, aged 7 years, “cholera 12 hours”

PG72894.B00463
_Southwark and Vauxhall._

PG72894.B00464
At 36, New Park Street, on 1st August, the son of an artist, aged 2 years, “Asiatic cholera 10¹⁄₂ hours”

PG72894.B00465
_Thames water from the tank of a saw-mill._

PG72894.B00466
At 54¹⁄₂, Great Guildford St., on 2nd Aug., a labourer aged 51, “Asiatic cholera 47 hours”

PG72894.B00467
_Southwark and Vauxhall._

PG72894.B00468
At the same house, same day, the wife of a labourer, aged 48, “Asiatic cholera 12¹⁄₂ hours”

PG72894.B00469
_Southwark and Vauxhall._

PG72894.B00470
At 2, Emerson Place, on 3rd August, the wife of an engineer, aged 30, “cholera 2 days”

PG72894.B00471
_Southwark and Vauxhall._

PG72894.B00472
At 29, Norfolk St., on 2d Aug., the son of a labourer, aged 3 years, “Asiatic cholera 12¹⁄₂ hours”

PG72894.B00473
_Southwark and Vauxhall._

PG72894.B00474
At 68, Great Guildford St., on 3rd Aug., the widow of a labourer, aged 40, “cholera 19 hours”

PG72894.B00475
_Southwark and Vauxhall._

PG72894.B00476
At 10, Castle Street, on 3rd August, the daughter of a labourer, aged 4 years, “cholera 12 hours”

PG72894.B00477
_Southwark and Vauxhall._

PG72894.B00478
At White Hart Inn Yard, on 3rd August, the wife of a porter, aged 49, “cholera 14 hours”

PG72894.B00479
_Southwark and Vauxhall._

PG72894.B00480
At 22, America Street, on 3rd August, an engine-driver, aged 35, “cholera 9 hours”

PG72894.B00481
_Southwark and Vauxhall._

PG72894.B00482
At 15, Essex Street, on 4th August, a packer, aged 65, “diarrhœa 4 days, cholera 11 hours”

PG72894.B00483
_Southwark and Vauxhall._

PG72894.B00484
At 17, Southwark Square, on 3rd August, the wife of an engineer, aged 31, “diarrhœa 1 day, cholera 3 days”

PG72894.B00485
_Southwark and Vauxhall._

PG72894.B00486
At 31, York Place, 5th Aug., the daughter of a labourer, aged 5 yrs. “Asiatic cholera, 11¹⁄₂ hours”

PG72894.B00487
_Southwark & Vauxhall._

PG72894.B00488
At 50, Great Guildford Street, on 4th August, a baker’s shopwoman, aged 21, “Asiatic cholera”

PG72894.B00489
_Southwark & Vauxhall._

PG72894.B00490
At 10, Russell Place, on 5th August, the widow of a steam-boat stoker, aged 38, “diarrhœa 4 weeks, Asiatic cholera 20 hours”

PG72894.B00491
_Southwark and Vauxhall._

PG72894.B00492
At 14, Keppel St., 31st July, the daughter of a cooper, aged 4 years, “Asiatic cholera 12 hours”

PG72894.B00493
_Southwark & Vauxhall._

PG72894.B00494
At 3, Bank End, on 2nd August, a widow of a coach-trimmer, aged 73, “Asiatic cholera 14 hours”

PG72894.B00495
_Thames water from tank at Messrs. Barclay & Perkins._

PG72894.B00496
ST. OLAVE, SOUTHWARK. _St. Olave._

PG72894.B00497
At St. Thomas’s Hospital (from Grey Eagle Street, Spitalfields), on 27th July, a labourer, aged 32, “rheumatism, cholera 20 hours”. This patient, named John Moull, was admitted with rheumatism on 25th July. Water supply of hospital

PG72894.B00498
_Southwark and Vauxhall and pump-wells on the premises._

PG72894.B00499
At 5, Marble Court, July 28, the son of a basket maker, aged 4 years, “malignant cholera 12 hours”

PG72894.B00500
_Southwark and Vauxhall._

PG72894.B00501
At the same house, July 30, a stonemason’s daughter, aged 2 yrs., “choleraic diarrhœa 2 days”

PG72894.B00502
_Southwark & Vauxhall._

PG72894.B00503
At 3, Gimber’s Rents, July 31, a labourer’s daughter, 13 months, “Asiatic cholera 7 hours”

PG72894.B00504
_Southwark and Vauxhall._

PG72894.B00505
At Guy’s Hospital, July 30, a dressmaker, aged 19, “cholera”; admitted with cholera from 2, Port Place, Walworth Common

PG72894.B00506
_Southwark and Vauxhall._

PG72894.B00507
At 3, Gimber’s Rents, Aug. 1, a labourer’s daughter, 3 years, “Asiatic cholera 48 hours”

PG72894.B00508
_Southwark & Vauxhall._

PG72894.B00509
On board the “Prince Cobourg”, Cotton’s Wharf, on August 2nd, a seaman, aged 38, “Asiatic cholera 14 hours”

PG72894.B00510
_Most likely Thames water._

PG72894.B00511
At 5, Marble Court, August 1, the daughter of a basket maker, aged 1 year and 4 months, “cholera, congestion of brain”

PG72894.B00512
_Southwark and Vauxhall._

PG72894.B00513
At 6, Darley’s Buildings, August 2, the daughter of a labourer, 2 yrs., “Asiatic cholera 14 hrs.”

PG72894.B00514
_Southwk. & Vauxhall._

PG72894.B00515
At Guy’s Hospital, on August 1st, a sailor, aged 16, “cholera”; admitted with cholera from a ship in the Thames

PG72894.B00516
_Most likely Thames water._

PG72894.B00517
At Guy’s Hospital, on 2nd August, a bookbinder, aged 30, “cholera”; was taken ill in the train on his way from Portsmouth

PG72894.B00518
_Water supply not ascertained._

PG72894.B00519
At Guy’s Hospital, on 3rd August, the daughter of a block-turner, aged 11 yrs., “cholera”; admitted with cholera from 7, Mint Street, Southwark.

PG72894.B00520
_Southwark and Vauxhall._

PG72894.B00521
At St. Thomas’s Hospital, supposed from Red Cross Street, Southwark, on 31st July, a charwoman, aged 50, “cholera”

PG72894.B00522
_Water supply not ascertained._

PG72894.B00523
At St. Thomas’s Hospital, from (28) Cole Street, Dover Road, on 2nd August, a cab-driver, aged 40, “cholera”; admitted with cholera

PG72894.B00524
_Southwark and Vauxhall._

PG72894.B00525
At St. Thomas’s Hospital, from (1 Star Place) Star Corner, Bermondsey, on 3rd August, a baker, aged 27, “cholera”; admitted with cholera.

PG72894.B00526
_Southwark and Vauxhall._

PG72894.B00527
At 10, Tattle Court, on 4th August, a labourer, aged 46, “Asiatic cholera 12 hours”

PG72894.B00528
_Southwark and Vauxhall._

PG72894.B00529
At 11, Green Bank, on 4th August, the daughter of a pavior, aged 3 years, “Asiatic cholera 18 hours.”

PG72894.B00530
_Southwark & Vauxhall._

PG72894.B00531
At 24, Mellor Street, on 3rd August, a butcher, aged 73, “cholera 18 hours”

PG72894.B00532
_Southwark and Vauxhall._

PG72894.B00533
At 194, Tooley Street, Aug. 5th, the son of a railway porter, aged 16 months, “cholera”

PG72894.B00534
_Southwark and Vauxhall._

PG72894.B00535
ST. OLAVE, SOUTHWARK. _St. John, Horsleydown._

PG72894.B00536
At 8, Charles Street, July 20, a carman, aged 42, “diarrhœa 3 days, Asiatic cholera 22 hours”

PG72894.B00537
_Southwark & Vauxhall._

PG72894.B00538
At 19, Bermondsey St., July 26, a labourer’s daughter, aged 5 yrs., “cholera Asiatica 4¹⁄₂ hours”

PG72894.B00539
_Southwark & Vauxhall._

PG72894.B00540
At 4, Abdy Street, on 29th July, a corn-turner, aged 60, “Asiatic cholera, with premonitory diarrhœa, 18 hours”

PG72894.B00541
_Southwark and Vauxhall._

PG72894.B00542
At 12, Bermondsey Street, July 29, a railway porter, aged 34, “malignant cholera 12 hours”

PG72894.B00543
_Southwark & Vauxhall._

PG72894.B00544
At 5, Gibbon’s Rents, July 29, wife of a railway porter, aged 39, “malignant cholera 16 hours”

PG72894.B00545
_Southwark & Vauxhall._

PG72894.B00546
At 18, Parish Street, July 29, a carpenter’s labourer, aged 19, “diarrhœa 4 days, cholera 3 days”

PG72894.B00547
_Southwark & Vauxhall._

PG72894.B00548
At the Union Workhouse, on 30th July, a labourer, aged 40, “Asiatic cholera 24 hours”; admitted with cholera from 4, Bethel Place, Vine Yard

PG72894.B00549
_Southwark and Vauxhall._

PG72894.B00550
At the Union Workhouse, on 31st July, an apprentice to the sea, aged 16, “Asiatic cholera 36 hours”; admitted with cholera from on board ship

PG72894.B00551
_Most likely Thames water._

PG72894.B00552
At 5, Bethel Place, July 30, the wife of a corn-turner, aged 35, “Asiatic cholera 4 hours”

PG72894.B00553
_Southwark and Vauxhall._

PG72894.B00554
At the same house, Aug. 1, daughter of a corn-turner, aged 1 year, “Asiatic cholera 3 days”

PG72894.B00555
_Southwark and Vauxhall._

PG72894.B00556
At 8, Gibbon’s Rents, Aug. 1, the wife of a carpenter, aged 32, “Asiatic cholera 12 hours”

PG72894.B00557
_Southwark and Vauxhall._

PG72894.B00558
At 6, Gordon Terrace, on 1st August, the daughter of a coal-porter, aged 2 years and 7 months, “Asiatic cholera 4 hours”

PG72894.B00559
_Southwark and Vauxhall._

PG72894.B00560
At the Union Workhouse, on 1st August, a slater, aged 56, “Asiatic cholera 24 hours”; admitted with cholera from 4, Magdalen Court, Tooley Street

PG72894.B00561
_Southwark & Vauxhall._

PG72894.B00562
At the Union Workhouse, on 3rd August, the wife of a labourer, aged 30, “Asiatic cholera 4 days”; admitted with cholera from 4, Bethel Pl., Vine Yd.

PG72894.B00563
_Southwark & Vauxhall._

PG72894.B00564
At 22, Magdalen Street, Aug. 1, a single woman, aged 53, “cholera 24 hours”

PG72894.B00565
_Southwark and Vauxhall._

PG72894.B00566
At 3, Freeman’s Lane, on 2nd August, a labourer, aged 25, “premonitory diarrhœa, with sickness, 24 hours; Asiatic cholera 9 hours”

PG72894.B00567
_Southwark and Vauxhall._

PG72894.B00568
At 2, Charles Street, July 30, the widow of a hatter, aged 62, “cholera 11 hours”

PG72894.B00569
_Southwark and Vauxhall._

PG72894.B00570
At 4, Charles Street, Aug. 4, a female, aged 45, “diarrhœa 7 days, English cholera 12 hours”

PG72894.B00571
_Southwark & Vauxhall._

PG72894.B00572
BERMONDSEY. _St. James._

PG72894.B00573
On board the ship “Ouse”, off Bermondsey, July 9, a mariner, aged 50, “cholera 16 hours”

PG72894.B00574
_Most likely Thames water._

PG72894.B00575
At 5, Gibson’s Cottages, on 18th July, the son of a chair-marker, aged 5 years, “choleraic diarrhœa 2 days, collapse 1 day”

PG72894.B00576
_Southwark and Vauxhall._

PG72894.B00577
At 4, Bermondsey Wall, on 23rd July, the daughter of a bookseller, aged 4 years, “cholera 9 hours”

PG72894.B00578
_Thames water, by dipping a pail in the river._

PG72894.B00579
At 4, Bermondsey Wall, July 24, a sawyer’s daughter, aged 3 yrs., “cholera 20 hours”

PG72894.B00580
_Thames water, by dipping a pail._

PG72894.B00581
At 9, Pleasant Row, July 25th, the wife of a labourer, aged 55, “chronic disease of liver 2 years, choleraic diarrhœa 16 hours”

PG72894.B00582
_Southwark and Vauxhall._

PG72894.B00583
At 10, Marine Street, on 24th July, a mate, mariner, aged 34, “Asiatic cholera 101 hours, after choleraic diarrhœa 16¹⁄₂ hours”

PG72894.B00584
_Southwark and Vauxhall._

PG72894.B00585
At 10, Marine Street, on 24th July, a mariner, aged 27, “Asiatic cholera 13 hours, after premonitory diarrhœa 2¹⁄₂ hours”

PG72894.B00586
_Southwark and Vauxhall._

PG72894.B00587
At 4, Bermondsey Wall, July 27, a sawyer, aged 62, “cholera 32 hours”

PG72894.B00588
_Thames water, by dipping a pail._

PG72894.B00589
At 6, Perseverance Court, on 28th July, the wife of a hawker, aged 30, “cholera 24 hours, no premonitory symptoms”

PG72894.B00590
_Southwark and Vauxhall._

PG72894.B00591
At 8, Foxlow Street, on 29th July, the daughter of a labourer, aged 18 years, “diarrhœa some days, cholera 13 hours”

PG72894.B00592
_Southwark and Vauxhall._

PG72894.B00593
At 14, Gedling Terrace, Aug. 2, a carman’s daughter, aged 2 years, “cholera maligna 4 days”

PG72894.B00594
_Southwark & Vauxhall._

PG72894.B00595
At 22, George Row, August 3, a stonemason, aged 30, “cholera maligna 10 hours”

PG72894.B00596
_Southwark and Vauxhall._

PG72894.B00597
At Bermondsey Wall, on 3rd August, the wife of a publican, aged 34, “Asiatic cholera 19 hours”

PG72894.B00598
_Thames water, by dipping a pail._

PG72894.B00599
At 6, Pleasant Row, on 3rd August, the daughter of a currier deceased, aged 5 years, “Asiatic cholera 7 hours”

PG72894.B00600
_Southwark and Vauxhall._

PG72894.B00601
At 3, Parker’s Terrace, on 3rd August, the son of an oil-cooper, aged 1 year, “diarrhœa 10 days, cholera 2 days”

PG72894.B00602
_Southwark and Vauxhall._

PG72894.B00603
At 36, Ernest Street, on 4th August, the wife of an engineer, aged 37, “premonitory diarrhœa 24 hours, cholera 41 hours”

PG72894.B00604
_Southwark and Vauxhall._

PG72894.B00605
At 1, Bermondsey Wall, on 4th August, the son of a mariner, aged 2 years, “diarrhœa 10 days, cholera 2 days”

PG72894.B00606
_Thames water, by dipping a pail._

PG72894.B00607
At 5, George Row, Aug. 2, the son of a lighterman, aged 3 yrs., “choleraic diarrhœa 3¹⁄₂ days”

PG72894.B00608
_Southwark and Vauxhall._

PG72894.B00609
At Water Lane, on 29th July, a domestic servant, aged 23, “cholera 10¹⁄₂ hours”

PG72894.B00610
_Southwark and Vauxhall._

PG72894.B00611
At 16, Marine Street, on 30th July, the daughter of a labourer, aged 9 yrs., “cholera 11 hrs.”

PG72894.B00612
_Southwark & Vauxhall._

PG72894.B00613
At 8, Printer’s Place, July 30, the widow of a publican, aged 70, “Asiatic cholera 15 hours”

PG72894.B00614
_Southwark & Vauxhall._

PG72894.B00615
At 4, Green Walk, on Aug. 1, the wife of a hoop-bender, aged 47, “Asiatic cholera 7 days”

PG72894.B00616
_Southwark and Vauxhall._

PG72894.B00617
At 5, John Place, on 1st August, a leather-dresser, aged 54, “Asiatic cholera 22 hours”

PG72894.B00618
_Southwark and Vauxhall._

PG72894.B00619
At 16, Marine Street, on 2nd August, the wife of a labourer, aged 51, “cholera 30 hours”

PG72894.B00620
_Southwark and Vauxhall._

PG72894.B00621
At 2, Metcalf Court, on 1st August, the son of a labourer, aged 2 years and 6 months, “measles 14 days, diarrhœa 1 week, cholera 2 days”

PG72894.B00622
_Beg Southwark and Vauxhall water from neighbours._

PG72894.B00623
At 3, Frederick Place, on 2nd August, a cooper, aged 40 years, “Asiatic cholera”

PG72894.B00624
_Southwark and Vauxhall._

PG72894.B00625
At 5, Somerset Place, on 2nd August, the daughter of a labourer, aged 3 years, “diarrhœa 18 hours, cholera 12 hours”

PG72894.B00626
_Southwark and Vauxhall._

PG72894.B00627
At Mill Street, on 3rd August, the wife of a master tin-plate worker, aged 27 years, “diarrhœa 4 hours, cholera 16 hours”

PG72894.B00628
_Southwark and Vauxhall._

PG72894.B00629
At 14, Gedlin Terrace, 31st July, the son of a carman, aged 4 yrs., “malignant cholera 13 hours”

PG72894.B00630
_Southwark & Vauxhall._

PG72894.B00631
BERMONDSEY. _St. Mary Magdalen._

PG72894.B00632
At 13, Abbey Street South, July 25, a trotter-cleaner, aged 18 years, “cholera 16 hours”

PG72894.B00633
_Southwark and Vauxhall._

PG72894.B00634
At 2, Long Walk, on 26th July, the son of a labourer, aged 2 yrs., “diarrhœa choleraic 15 hours”

PG72894.B00635
_Southwark & Vauxhall._

PG72894.B00636
At 2, Providence Place, on 28th July, the wife of a leather-dresser, aged 56, “diarrhœa 4 hours, cholera 20 hours”

PG72894.B00637
_Southwark and Vauxhall._

PG72894.B00638
At 3, Providence Place, on 28th July, the wife of a currier, aged 58, “diarrhœa 3 hours, cholera 18 hours”

PG72894.B00639
_Southwark and Vauxhall._

PG72894.B00640
At 13, Willow St., on 2nd Aug., the daughter of a warehouseman, aged 4 yrs., “cholera morbus”

PG72894.B00641
_Southwark & Vauxhall._

PG72894.B00642
At 14, Fendall St., Aug. 4, the son of a leather-dresser, aged 5 yrs., “Asiatic cholera 10 hours”

PG72894.B00643
_Southwark & Vauxhall._

PG72894.B00644
At 2, Finimore’s Court, on 3rd August, a labourer, aged 74, “Asiatic cholera”

PG72894.B00645
_Southwark and Vauxhall._

PG72894.B00646
At 54, Little George St., Aug. 4, son of a labourer, aged 2 yrs., “cholera maligna, 40 hrs”

PG72894.B00647
_Southwark & Vauxhall._

PG72894.B00648
At the Workhouse, on July 29, the son of a pen-cutter, aged 9 yrs., “Asiatic cholera 19 hours. Died 7 hours after admission.” From 12, Minto Street.

PG72894.B00649
_Southwark and Vauxhall._

PG72894.B00650
At 25, Maltby Street, July 28, the widow of a solicitor’s clerk, aged 65, “Asiatic cholera”.

PG72894.B00651
_Southwark and Vauxhall._

PG72894.B00652
At the Workhouse, on 31st July, a shoemaker, aged 46, “Asiatic cholera 11 hours after admission in state of collapse”. From 99, Russell Street.

PG72894.B00653
_Southwark and Vauxhall._

PG72894.B00654
At 19, Grange Walk, on 31st July, a blacksmith, aged 21, “cholera 15 hours”

PG72894.B00655
_Southwark and Vauxhall._

PG72894.B00656
At 36, Abbey Street, on 30th July, the daughter of a labourer, aged 2 years, “cholera 3 days, congestion of brain, convulsions 12 hours”

PG72894.B00657
_Southwark and Vauxhall._

PG72894.B00658
At 13, Abbey Street, on 29th July, the daughter of a labourer, aged 2 years, “cholera 56 hours, diarrhœa 2 days”

PG72894.B00659
_Southwark and Vauxhall._

PG72894.B00660
At 5, Russell Street, on 1st August, a porter, aged 64, “Asiatic cholera”

PG72894.B00661
_Southwark and Vauxhall._

PG72894.B00662
At the Workhouse, on 2nd August, a sailor, aged 32, “Asiatic cholera, 21 hours after admission in a state of collapse”. From ship “Malvern”

PG72894.B00663
_Most likely Thames water._

PG72894.B00664
At 3, Long Walk, on 30th July, the son of a carpenter, aged 2 years, “cholera 2 days, secondary fever 2 days”

PG72894.B00665
_Southwark and Vauxhall._

PG72894.B00666
At 49, Page’s Walk, on 1st August, the wife of a deal-porter, aged 31, “cholera maligna 10 hours, diarrhœa 4 hours”

PG72894.B00667
_Southwark and Vauxhall._

PG72894.B00668
At the Workhouse, on 2nd August, the daughter of a labourer, aged 7 years, “Asiatic cholera (30 hours) after admission in a state of collapse”. From 7, Chapel Place, Long Lane

PG72894.B00669
_Southwark and Vauxhall._

PG72894.B00670
At 41, Brunswick Court, on 3rd August, a servant, aged 28, “cholera 48 hours”

PG72894.B00671
_Southwark and Vauxhall._

PG72894.B00672
BERMONDSEY. _Leather Market._

PG72894.B00673
At 4, Princes Place, Crosby Row, on 19th July, the daughter of a journeyman cordwainer, aged 4 years, “English cholera, 12 hours”

PG72894.B00674
_Southwark and Vauxhall._

PG72894.B00675
At 17, King’s Place, Crosby Row, on 28th July, the wife of a labourer, aged 29 years, “Asiatic cholera 24 hours”

PG72894.B00676
_Southwark and Vauxhall._

PG72894.B00677
At 25, Smith’s Buildings, 30th July, the daughter of a labourer, aged 3 yrs., “cholera 19 hours”

PG72894.B00678
_Southwark & Vauxhall._

PG72894.B00679
At 15, Brook Street, on 31st July, the son of a journeyman tanner, aged 20 months, “cholera 15 hours”.

PG72894.B00680
_Southwark and Vauxhall._

PG72894.B00681
At 27, Nelson Street, July 31, the wife of a labourer, aged 35, “Asiatic cholera 18 hours”

PG72894.B00682
_Southwark and Vauxhall._

PG72894.B00683
At 5, Richardson Street, on 30th July, the son of a journeyman leather-dresser, aged 18 years, “diarrhœa 7 days, Asiatic cholera 15 hours”

PG72894.B00684
_Southwark and Vauxhall._

PG72894.B00685
At 2, Staple Street, on 2nd August, the daughter of a journeyman cordwainer, aged 6 years, “cholera 11 hours”

PG72894.B00686
_Southwark and Vauxhall._

PG72894.B00687
At 185, Long Lane, on 3rd August, the wife of a journeyman tanner, aged 26 years, “cholera biliosa 12 hours”

PG72894.B00688
_Southwark and Vauxhall._

PG72894.B00689
At 1, Elizabeth Place, Baalzephon Street, on 2nd Aug., the son of a journeyman cordwainer, aged 1 year, “diarrhœa 1 day, Asiatic cholera 1 day”

PG72894.B00690
_Southwark and Vauxhall._

PG72894.B00691
At 3, Alfred Place, Nelson Street, on 2nd August, the daughter of a cordwainer, aged 17 years, “Asiatic cholera 12 hours”

PG72894.B00692
_Southwark and Vauxhall._

PG72894.B00693
At 101, Snow’s Fields, Aug. 3, a journeyman carpenter, aged 63, “Asiatic cholera 12 hours”

PG72894.B00694
_Southwark and Vauxhall._

PG72894.B00695
At 2, Staple Street, on 3rd August, the son of a journeymen cordwainer, aged 4 years, “cholera 48 hours, premonitory diarrhœa 3 days”

PG72894.B00696
_Southwark and Vauxhall._

PG72894.B00697
At 7, Little Charlotte Row, Nelson Street, on 1st August, the son of a carman, aged 1¹⁄₂ years, “cholera 12 hours”

PG72894.B00698
_Southwark and Vauxhall._

PG72894.B00699
At the same house, on the same day, the son of a carman, aged 3 yrs., “cholera 12 hours”

PG72894.B00700
_Southwark & Vauxhall._

PG72894.B00701
At 8, Minto Street, on 2nd August, the son of a journeyman tanner, aged 3 yrs., “diarrhœa 3 days, cholera 24 hours, secondary fever 2 days”

PG72894.B00702
_Southwark and Vauxhall._

PG72894.B00703
At 23, Baalzephon Street, on 4th August, the son of a journeyman wire-weaver, aged 1¹⁄₂ years, “diarrhœa 2 days, Asiatic cholera 36 hours”

PG72894.B00704
_Southwark and Vauxhall._

PG72894.B00705
At 53, Long Lane, on 3rd August, a stay-maker, aged 52, “diarrhœa, Asiatic cholera”

PG72894.B00706
_Southwark and Vauxhall._

PG72894.B00707
At 4, Grange Road, on 4th August, the son of a journeyman tanner, aged 4 years, “Asiatic cholera 11 hours”

PG72894.B00708
_Southwark and Vauxhall._

PG72894.B00709
At 1, Wood’s Place, Grange Road, on 4th August, a labourer, aged 24, “cholera 12 hours, premonitory diarrhœa 3 hours”

PG72894.B00710
_Southwark and Vauxhall._

PG72894.B00711
At 16, Alfred Place, Nelson Street, on 3rd August, the daughter of a journeyman bricklayer, aged 1 year, “dentition, diarrhœa, cholera, convulsions”

PG72894.B00712
_Southwark & Vauxhall._

PG72894.B00713
At 15, Wyld’s Rents, on 15th August, the wife of a journeyman baker, aged 27, “cholera Asiatica 17 hours, collapse, premonitory diarrhœa 8 hours”

PG72894.B00714
_Southwark & Vauxhall._

PG72894.B00715
At 7, Alfred Street, on 5th Aug., a journeyman tanner, aged 63, “cholera, collapse 62 hours, premonitory diarrhœa 12 hours, consecutive fever 12 hours”

PG72894.B00716
_Southwark & Vauxhall._

PG72894.B00717
At 7, Brook Street, on 3rd Aug., a journeyman tanner, aged 40, “cholera, collapse 12 hours, premonitory diarrhœa 7 hours”

PG72894.B00718
_Southwark and Vauxhall._

PG72894.B00719
ST. GEORGE, SOUTHWARK. _Kent Road._

PG72894.B00720
At 7, Layton’s Buildings, July 29, a tailor, aged 20, “cholera 17 hours”

PG72894.B00721
_Southwark and Vauxhall._

PG72894.B00722
At 2, Dobb’s Cross, July 30, the son of a shop-keeper, aged 10 yrs., “cholera Asiatic 24 hours”

PG72894.B00723
_Southwark & Vauxhall._

PG72894.B00724
At 81, Ann Street, July 29, the son of a labourer, aged 12 years, “cholera 8 hours”

PG72894.B00725
_Southwark and Vauxhall._

PG72894.B00726
At 28, Wickham Pl., Aug. 2, son of a brush-mkr., aged 2¹⁄₂ yrs., “choleraic diarrhœa 24 hours.”

PG72894.B00727
_Southwark & Vauxhall._

PG72894.B00728
At 2, Russell Place, Aug. 2, the widow of a labourer, aged 55, “Asiatic cholera 21 hours”

PG72894.B00729
_Southwark and Vauxhall._

PG72894.B00730
At 9, Tennis Place, 3rd of August, the widow of a sawyer, aged 67 years, “diarrhœa 36 hours, cholera 14 hours”

PG72894.B00731
_Southwark and Vauxhall._

PG72894.B00732
At 13, George St., Aug. 2, the wife of a shoemkr., aged 35, “diarrhœa, cholera, convulsions”

PG72894.B00733
_Southwark and Vauxhall._

PG72894.B00734
At 7, Noel Street, Aug. 4, the widow of a porter, aged 65 years, “Asiatic cholera 39 hours”

PG72894.B00735
_Lambeth._

PG72894.B00736
ST. GEORGE, SOUTHWARK. _Borough Road._

PG72894.B00737
At the Workhouse, from Savage’s lodging-house, Mint Street, 29th of July, a female servant, aged 28 years, “cholera”

PG72894.B00738
_Southwark and Vauxhall._

PG72894.B00739
At 6, Ebden Court, Pearl Row, 27th of July, the daughter of a butcher, aged 3 years, “Asiatic cholera 10 hours”

PG72894.B00740
_Southwark and Vauxhall._

PG72894.B00741
At 24, Gun St., July 23, the wife of a bookbinder, aged 36, “Asiatic cholera 24 hours”

PG72894.B00742
_Southwark and Vauxhall._

PG72894.B00743
At 5, Nelson Pl., July 28, the son of a butcher, aged 5 weeks, “choleraic diarrhœa 3 days”

PG72894.B00744
_Southwark & Vauxhall._

PG72894.B00745
At the Workhouse, July 29, a hawker, aged 44, “cholera (very bad)”; an inmate

PG72894.B00746
_Southwark and Vauxhall._

PG72894.B00747
At 2, Union Street, July 27, the widow of a master shoemaker, aged 73, “diarrhœa 7 days, cholera Asiatica 8 hours”

PG72894.B00748
_Lambeth._

PG72894.B00749
At 10, Lombard Street, July 29, the daughter of a labourer, aged 2 years, “diarrhœa 4 hours, cholera maligna, 24 hours”

PG72894.B00750
_Southwark and Vauxhall._

PG72894.B00751
At the same house, August 1, the daughter of a labourer, aged 4 years, sister of above, “cholera maligna 12 hours”

PG72894.B00752
_Southwark and Vauxhall._

PG72894.B00753
At 1, Burton’s Buildings, Friar Street, August 2, the daughter of a coppersmith, aged 9 years, “cholera 3 days, fever 2 days”

PG72894.B00754
_Southwark and Vauxhall._

PG72894.B00755
At the Workhouse, from Hooper’s lodging-house, 9, Angel Place, July 30, a labourer, aged 36, “cholera Asiatica”

PG72894.B00756
_Southwark and Vauxhall._

PG72894.B00757
At the Workhouse, brought in from 29, Wilmot’s Buildings, August 1, a labourer, aged 29, “cholera Asiatic about 12 hours”

PG72894.B00758
_Southwark and Vauxhall._

PG72894.B00759
At 35, Green Street, 31st of July, the wife of a horse-slaughterman, aged 64, “hepatitis 14 days, gall stones, Asiatica cholera 24 hours”

PG72894.B00760
_Southwark and Vauxhall._

PG72894.B00761
At the Workhouse, Aug. 3, a widow, aged 70, “cholera Asiatica about 12 hours”; inmate

PG72894.B00762
_Southwark & Vauxhall._

PG72894.B00763
At the Workhouse, from King’s lodging-house, Mint Street, 3rd August, a hawker, aged 45 years, “cholera Asiatica”

PG72894.B00764
_Southwark and Vauxhall._

PG72894.B00765
At the Workhouse, Aug. 3, a coppersmith, aged 52, “cholera Asiatica 2 days”, from 15, John St., Suffolk Street

PG72894.B00766
_Southwark and Vauxhall._

PG72894.B00767
At 30, Hill St., Aug. 1, the daughter of an engineer, aged 2 years, “cholera 12 hours”

PG72894.B00768
_Southwark and Vauxhall._

PG72894.B00769
At 83, Southwark Bridge Rd., Aug. 1, solicitor’s clerk, aged 21, “cholera 19 hours”

PG72894.B00770
_Southwark and Vauxhall._

PG72894.B00771
At 23, George St., Aug. 3, the wife of a labourer, aged 19, “cholera maligna 15 hours”

PG72894.B00772
_Southwark and Vauxhall._

PG72894.B00773
At the Workhouse, brought in by the police from the station-house at Stones End, Aug. 4, a servant, aged 50, “cholera Asiatica”

PG72894.B00774
_Not ascertained._

PG72894.B00775
At 1, Little Suffolk Street, Aug. 4, the daughter of a hammerman, aged 3 years, “remittent fever 7 days, cholera 20 hours”

PG72894.B00776
_Southwark and Vauxhall._

PG72894.B00777
At 5, Bean Street, Aug. 5, a female servant, aged 28, “diarrhœa 24 hours, cholera 30 hours”

PG72894.B00778
_Southwark & Vauxhall._

PG72894.B00779
ST. GEORGE, SOUTHWARK. _London Road._

PG72894.B00780
At 60, Tower Street, July 16, the wife of a butcher, aged 26, “Asiatic cholera 13 hours”

PG72894.B00781
_Southwark and Vauxhall._

PG72894.B00782
At 12, East Pl., West Sq., July 29, an ostler, aged 42, “diarrhœa 6 days, cholera maligna 14 hours”

PG72894.B00783
_Lambeth._

PG72894.B00784
At 32, Duke Street, Aug. 1, the son of a smith, aged 5 years, “Asiatic cholera 36 hours”

PG72894.B00785
_Lambeth._

PG72894.B00786
At 11, London Road, July 31st, a servant, aged 17, “Asiatic cholera 24 hours”

PG72894.B00787
_Southwark and Vauxhall._

PG72894.B00788
At Spiller’s Ct., Webber Row, Aug. 1, the daughter of a charwoman, aged 18 months, “chronic diarrhœa 2 months, cholera 24 hours”

PG72894.B00789
_Southwark and Vauxhall._

PG72894.B00790
At 2, Short St., Tower St., Aug. 2, a coal-porter, aged 32, “cholera 3 days”

PG72894.B00791
_Lambeth._

PG72894.B00792
At 8, Princes Court, Princes Street, on the 3rd of August, the son of a butcher, aged 5¹⁄₂ years, “cholera 8 hours”

PG72894.B00793
_Southwark and Vauxhall._

PG72894.B00794
At 105, Blackfriars Road, Aug. 1, a compositor, aged 32, “diarrhœa, cholera 14 hours”

PG72894.B00795
_Southwark and Vauxhall._

PG72894.B00796
At 3, Duke Street, Tower Street, August 4th, the son of a civil engineer (deceased), “consumption 9 months, cholera 8 hours”

PG72894.B00797
_Lambeth._

PG72894.B00798
NEWINGTON. _Trinity._

PG72894.B00799
At 58, Brandon Street, July 26, a house-painter, aged 24, “Asiatic cholera 40 hours”

PG72894.B00800
_Southwark and Vauxhall._

PG72894.B00801
At 3, Winter Terrace, July 31, the wife of an engineer, aged 27, “cholera 26 hours”

PG72894.B00802
_Southwark and Vauxhall._

PG72894.B00803
At 16, Swan St., Aug. 1, the son of a carpenter, aged 8 years, “cholera maligna 14 hours”

PG72894.B00804
_Southwark & Vauxhall._

PG72894.B00805
At 6, St. Andrew’s Rd., Aug. 1, a waiter, aged 35, “diarrhœa 3 days, cholera maligna 12 hours”

PG72894.B00806
_Southwark & Vauxhall._

PG72894.B00807
At 175, Kent St., Aug. 2, the son of a clothier, aged 7 years, “malignant cholera 23 hours”

PG72894.B00808
_Southwark & Vauxhall._

PG72894.B00809
At 66, Brunswick St., Aug. 3, the wife of an engineer, aged 35, “cholera 1 week, exhaustion”

PG72894.B00810
_Southwark & Vauxhall._

PG72894.B00811
At 64, Trinity Square, August 2, a milliner, aged 32, “cholera maligna 30 hours”

PG72894.B00812
_Southwark and Vauxhall._

PG72894.B00813
At 3, Etham Place, Aug. 3, a paperhanger, aged 42, “cholera Asiatica 6¹⁄₂ hours”

PG72894.B00814
_Southwark and Vauxhall._

PG72894.B00815
At 54, Great Dover Rd., Aug. 3, the widow of a wine merchant, aged 64, “English cholera 23 hours, collapse 12 hours”

PG72894.B00816
_Southwark and Vauxhall._

PG72894.B00817
At 182, Kent Street, August 4th, a labourer, aged 23 years, “diarrhœa 17 hours, cholera Asiatica 8 hours, collapse”

PG72894.B00818
_Southwark and Vauxhall._

PG72894.B00819
At 99, Uxbridge Street, Aug. 4, the son of a jeweller, aged 3 years, “diarrhœa 27 hours, Asiatic cholera 24 hours, collapse”

PG72894.B00820
_Southwark and Vauxhall._

PG72894.B00821
At the same house, on the same day, the daughter of a jeweller, aged 1 year, “Asiatic cholera 28 hours, collapse”

PG72894.B00822
_Southwark and Vauxhall._

PG72894.B00823
At 11, Swan Street, August 5, the wife of a collecting clerk, aged 42, “chronic bronchitis 5 years, English cholera 3 days, collapse 18 hours”

PG72894.B00824
_Southwark and Vauxhall._

PG72894.B00825
At 58, Brandon St., Aug. 4, the widow of a house-painter, aged 26, “Asiatic cholera 4 days”

PG72894.B00826
_Southwark and Vauxhall._

PG72894.B00827
NEWINGTON. _St. Peter, Walworth._

PG72894.B00828
At 7, Berkeley Terrace, the 25th of July, the wife of a mercantile clerk, aged 35 years, “Asiatic cholera 14 hours”

PG72894.B00829
_Southwark and Vauxhall._

PG72894.B00830
At 8, Townley Place, on the 29th of July, the son of a journeyman shoemaker, aged 6¹⁄₂ years, “cholera 19 hours”

PG72894.B00831
_Southwark and Vauxhall._

PG72894.B00832
At 8, Richmond Street, July 28th, the daughter of a labourer, aged 5 years, “choleraic diarrhœa 3 days, cerebral effusion 2 days”

PG72894.B00833
_Southwark and Vauxhall._

PG72894.B00834
At 6, John Street, East Street, July 29th, the widow of a carman, aged 83, “cholera Anglica 27 hours, old age”

PG72894.B00835
_Southwark and Vauxhall._

PG72894.B00836
At 29, Pilgrim Street, on the 1st of August, the daughter of an ostler, aged 18 months, “Asiatic cholera 8 hours”

PG72894.B00837
_Southwark and Vauxhall._

PG72894.B00838
At 8, Townley Place, August 1st, the daughter of a journeyman shoemaker, aged 8 years, “cholera Asiatica about 16 hours”

PG72894.B00839
_Southwark and Vauxhall._

PG72894.B00840
At 29, Beckford Row, Aug. 1, the wife of a greengrocer, aged 46 years, “cholera Asiatica 16 hours, collapse 11 hours”

PG72894.B00841
_Southwark and Vauxhall._

PG72894.B00842
At 15, Smith Street, Aug. 3, the wife of a baker, aged 20, “Asiatic cholera 8 hours”

PG72894.B00843
_Southwark and Vauxhall._

PG72894.B00844
At 1, John Street, Walworth Common, August 2, the wife of a glue-maker, aged 54, “diarrhœa 2 days, cholera 22 hours”

PG72894.B00845
_Southwark and Vauxhall._

PG72894.B00846
At 2, Milk Street, on the 2nd of August, the daughter of a journeyman shoemaker, aged 6 years, “Asiatic cholera 30 hours”

PG72894.B00847
_Southwark and Vauxhall._

PG72894.B00848
At 7, Blucher St., Aug. 2, a gentleman, aged 36, “cholera Asiatica 20 hours, collapse”

PG72894.B00849
_Southwark and Vauxhall._

PG72894.B00850
At 28, Bronti Place, August 2nd, the wife of a letter carrier, aged 46, “cholera Asiatica 28 hours, collapse 24 hours”

PG72894.B00851
_Southwark and Vauxhall._

PG72894.B00852
At 2, Totham Place, Boundary Lane, August 2nd, the widow of a journeyman bricklayer, aged 63, “Asiatic cholera 18 hours”

PG72894.B00853
_Southwark and Vauxhall._

PG72894.B00854
At 2, Sarah Terrace, Hill Street, August 2nd, the son of a clerk in the Post Office, aged 5¹⁄₂ years, “epidemic cholera 7 hours”

PG72894.B00855
_Southwark and Vauxhall._

PG72894.B00856
At 99, Hill Street, on the 3rd of August, the daughter of a traveller, aged 1 year and 10 months, “malignant cholera 9 hours”

PG72894.B00857
_Southwark and Vauxhall._

PG72894.B00858
At 18, West Street, Aug. 4, a needlewoman, aged 22, “cholera maligna 12 hours”

PG72894.B00859
_Southwark and Vauxhall._

PG72894.B00860
At 26, Penton Row, Aug. 1, an auctioneer, aged 39, “diarrhœa 52 hours, cholera 9 hours”.

PG72894.B00861
_Southwark & Vauxhall._

PG72894.B00862
At 21, Park Road, August 5th, an iron-planer, aged 43, “cholera 4 days”

PG72894.B00863
_Southwark and Vauxhall._

PG72894.B00864
At 19, James Place, Hill Street, Aug. 5, a gentleman, aged 89, “choleraic diarrhœa 6 days”

PG72894.B00865
_Southwark & Vauxhall._

PG72894.B00866
At the same house, same day, the wife of the above, aged 50, “Asiatic cholera 12 hours”

PG72894.B00867
_Southwark & Vauxhall._

PG72894.B00868
NEWINGTON. _St. Mary._

PG72894.B00869
At 4, Parsonage Row, July 30, a gentlewoman, aged 40, “Asiatic cholera 16 hours”

PG72894.B00870
_Southwark and Vauxhall._

PG72894.B00871
At 31, Weymouth Street, July 28, the wife of a chairmaker, aged 34, “Asiatic cholera 12 hrs.”

PG72894.B00872
_Southwark & Vauxhall._

PG72894.B00873
At 8, Church St., July 30, the daughter of a chairmaker, aged 17 months, “cholera 10 hours”

PG72894.B00874
_Southwark and Vauxhall._

PG72894.B00875
At 8, Peacock Sq., July 31, the widow of a seaman, aged 59, “cholera 12 hours, typhus 4 days”

PG72894.B00876
_Southwark & Vauxhall._

PG72894.B00877
At 19, Waterloo Pl., Aug. 2, the son of a shoemaker, aged 8 years, “cholera 12 hours”

PG72894.B00878
_Southwark and Vauxhall._

PG72894.B00879
LAMBETH. _Waterloo (First Part)._

PG72894.B00880
At Curtis Hatch, on 29th July, a Baptist minister, aged 52, “diarrhœa 3 days, Asiatic cholera and collapse 18 hours”. The informant stated that deceased, whom he had long known, called at his house about seven in the morning before his death; he was then very ill. He lived at 7, Lower Anne Street, Waterloo Road, where the supply was

PG72894.B00881
_Southwark and Vauxhall._

PG72894.B00882
At 4, Hammond’s Place, on 30th July, the wife of a labourer, aged 72, “diarrhœa 24 hours, malignant cholera 12 hours”

PG72894.B00883
_Southwark and Vauxhall._

PG72894.B00884
At 4, Queen Street, July 31st, late a brewer’s servant, aged 76, “cholera 1 day”

PG72894.B00885
_Southwark and Vauxhall._

PG72894.B00886
At 41, Brad Street, August 1st, the wife of a printer, aged 51, “cholera 26 hours”

PG72894.B00887
_Southwark and Vauxhall._

PG72894.B00888
At 3, Hammond’s Place, on August 5th, the daughter of a smith, aged 6 years, “diarrhœa and malignant cholera 12 hours”

PG72894.B00889
_Southwark and Vauxhall._

PG72894.B00890
LAMBETH. _Waterloo (Second Part)._

PG72894.B00891
At 23, Howley Place, July 29, the wife of a carman, aged 58, “cholera about 11 hours”

PG72894.B00892
_Southwark and Vauxhall._

PG72894.B00893
At 18, Vine Terrace, on 31st July, a butcher, aged 19, “Asiatic cholera 18 hours”

PG72894.B00894
_Southwark and Vauxhall._

PG72894.B00895
At 36, Isabella St., July 30, a hammerman at a factory, aged 39, “Asiatic cholera 68 hours”

PG72894.B00896
_Southwark & Vauxhall._

PG72894.B00897
At 12, Harriet Street, on 2nd August, a miller, aged 17, “cholera Asiatica 17 hours”

PG72894.B00898
_Southwark and Vauxhall._

PG72894.B00899
At 9, Griffin Street, Aug. 4, the wife of a bricklayer, aged 75, “Asiatic cholera 48 hours”

PG72894.B00900
_Southwark and Vauxhall._

PG72894.B00901
LAMBETH. _Lambeth Church (First Part)._

PG72894.B00902
At 52, Upper Fore Street, on July 20th, the wife of a bricklayer’s labourer, aged 23, “cholera 12 hours”

PG72894.B00903
_Thames water, by dipping a pail._

PG72894.B00904
At 6, Newport Street, on 30th July, the wife of a porter, aged 37, “cholera 8 hours”

PG72894.B00905
_Lambeth._

PG72894.B00906
At 32, South St., July 31, a timber-merchant’s widow, aged 67, “Asiatic cholera 15 hours”

PG72894.B00907
_Southwark and Vauxhall._

PG72894.B00908
At 3, Mount Place, Kennington Road, on 31st July, a wine merchant, aged 35, “Asiatic cholera 16 hours”; address not found

PG72894.B00909
_Not ascertained._

PG72894.B00910
At 7, Vauxhall Row, Aug. 2, the son of a bricklayer, aged 4 years, “cholera 16 hours”

PG72894.B00911
_Southwark and Vauxhall._

PG72894.B00912
LAMBETH. _Lambeth Church (Second Part)._

PG72894.B00913
At 26, New St., July 28, the wife of a labourer, aged 29, “diarrhœa 3 days, cholera 12 hours”

PG72894.B00914
_Southwark and Vauxhall._

PG72894.B00915
At 29, Park Street, July 29, an eating-house keeper, aged 39, “cholera 9¹⁄₂ hours”

PG72894.B00916
_Southwark and Vauxhall._

PG72894.B00917
At 79, Wickham Street, August 1, the daughter of an engineer, aged 1 year, “choleraic diarrhœa, exhaustion”

PG72894.B00918
_Lambeth._

PG72894.B00919
At 24, Caroline Street, on 31st July, the son of a labourer, aged 14 years, “cholera 11 hours”

PG72894.B00920
_Lambeth._

PG72894.B00921
At the Workhouse, on 2nd August, a washerwoman, aged 23, “Asiatic cholera”; admitted in a dying state; address not known

PG72894.B00922
_Not ascertained._

PG72894.B00923
At 60, Park Street, on 2nd August, the wife of a lathrender, aged 31, “cholera 2 days, consecutive fever 5 days”

PG72894.B00924
_Southwark and Vauxhall._

PG72894.B00925
At 4, High St., Vauxhall, Aug. 3, a musician, aged 35, “malignant cholera after 2 days diarrhœa, 6 days secondary fever, with cerebral congestion.”

PG72894.B00926
_Southwark and Vauxhall._

PG72894.B00927
At Vauxhall Gardens, on 2nd August, a widow, aged 56, “cholera 16 hours”

PG72894.B00928
_Southwark and Vauxhall._

PG72894.B00929
At 33, East Street, on 3rd Aug., a carpenter, aged 40, “diarrhœa 7 days, cholera 3 days”

PG72894.B00930
_Southwark and Vauxhall._

PG72894.B00931
At 19, Bennett’s Buildings, on 4th August, the daughter of a carpenter, aged 2 years, “cholera Asiatica 12 hours”

PG72894.B00932
_Southwark and Vauxhall._

PG72894.B00933
LAMBETH. _Kennington (First Part)._

PG72894.B00934
At 6, William Street, Clapham Road, on 26th July, the son of a carpenter, aged 2 years, “Asiatic cholera 12 hours”

PG72894.B00935
_Lambeth._

PG72894.B00936
At 3, Dudley Place, Clapham Road, on 24th July, the wife of a bookseller, aged 42, “sero-spasmodic cholera 15 hours”

PG72894.B00937
_Southwark and Vauxhall._

PG72894.B00938
At 7, Henry Street, Dorset Street, Clapham Road, on 28th July, the daughter of a butcher, aged 4 years, “cholera sero-spasmodica 15 hours”

PG72894.B00939
_Pump-well._

PG72894.B00940
At 23, Cambridge Terrace, Clapham Road, on 30th July, the daughter of a commercial traveller, aged 20, “choleraic diarrhœa 24 hours”

PG72894.B00941
_Southwark and Vauxhall._

PG72894.B00942
At 3, Belmont Place, Wandsworth Road, on 29th July, the daughter of a railway-guard, aged 8 years, “cholera 10¹⁄₂ hours”

PG72894.B00943
_Southwark and Vauxhall._

PG72894.B00944
At 9, Regency Place, White Hart Street, on 31st July, the widow of a brass-worker, aged 44, “cholera 30 hours”

PG72894.B00945
_Southwark and Vauxhall._

PG72894.B00946
At 1, Bowling Green Mews, on 28th July, the daughter of a chairmaker, aged 8 years, “cholera 13 hours”

PG72894.B00947
_Southwark and Vauxhall._

PG72894.B00948
At 61, Prince’s Square, July 31, widow of a linen-agent, aged 42, “Asiatic cholera 15 hours”

PG72894.B00949
_Southwark and Vauxhall._

PG72894.B00950
At 4, Southville, Wandsworth Road, on 2nd August, a paperhanger, aged 26, “Asiatic cholera, premonitory diarrhœa 24 hours, collapse 24 hours”

PG72894.B00951
_Southwark & Vauxhall._

PG72894.B00952
At 5, South Lambeth, Aug. 4, the wife of an equestrian, aged 39, “cholera Asiatica 36 hours”

PG72894.B00953
_Southwark & Vauxhall._

PG72894.B00954
At 19, Mansion House Street, Kennington, on 3rd August, formerly a dressmaker, aged 36, “cholera Asiatica 6 hours, premonitory diarrhœa 2 days”

PG72894.B00955
_Southwark & Vauxhall._

PG72894.B00956
LAMBETH. _Kennington (2nd Part)._

PG72894.B00957
At 14, Robertson Place, Stockwell, on 3rd August, the wife of a carpenter, aged 35, “Asiatic cholera 5 hours”

PG72894.B00958
_Southwark and Vauxhall._

PG72894.B00959
At 2, James Street, on 5th August, the son of a bricklayer, aged 7 yrs., “cholera 7 hours”

PG72894.B00960
_Southwark and Vauxhall._

PG72894.B00961
At 1, Somerset Place, Aug. 3, a gentleman, aged 56, “spasmodic cholera 12 hours”

PG72894.B00962
_Southwark and Vauxhall._

PG72894.B00963
LAMBETH. _Brixton._

PG72894.B00964
At 2, Sussex Road, July 14th, the widow of a coachman, aged 53, “diarrhœa 6 days, English cholera 3 days”

PG72894.B00965
_Lambeth._

PG72894.B00966
LAMBETH. _Norwood._—No death from cholera.

PG72894.B00967
WANDSWORTH. _Clapham._

PG72894.B00968
At 5, Cook’s Buildings, Park Road, on 29th July, the daughter of a sawyer, aged 3 years, “cholera 12 hours, diarrhœa 3 days”

PG72894.B00969
_Southwark and Vauxhall._

PG72894.B00970
At 4, Howard Street, Wandsworth Road, July 30, a labourer, aged 74, “cholera 52 hours”

PG72894.B00971
_Southwark & Vauxhall._

PG72894.B00972
At 1, Waterloo Retreat, Bromell’s Road, July 29, a gardener, aged 46, “cholera 12 hours”

PG72894.B00973
_Pump-well._

PG72894.B00974
At High Street, July 31, a domestic servant, aged 28, “cholera 52 hours”

PG72894.B00975
_Southwark and Vauxhall._

PG72894.B00976
At 13, Prospect Place, Wandsworth Road, on 2nd August, a Government clerk, aged 50, “malignant cholera 4 days, diarrhœa 48 hours, collapse”.

PG72894.B00977
_Southwark and Vauxhall, and pump-well._

PG72894.B00978
WANDSWORTH. _Battersea._

PG72894.B00979
At 6, Church Road, July 19, the wife of a house-agent, aged 48, “Asiatic cholera 48 hours”

PG72894.B00980
_Southwark and Vauxhall._

PG72894.B00981
At Nine Elms, on 26th July, the widow of a cooper, aged 79, “cholera 18 hours”

PG72894.B00982
_Southwark and Vauxhall._

PG72894.B00983
At Albert Villas, on 27th July, the son of a clerk in the Customs, aged 2 years, “premonitory diarrhœa a month, Asiatic cholera 16 hours, consecutive fever 30 hours, convulsions 2 hours”

PG72894.B00984
_Southwark and Vauxhall._

PG72894.B00985
At Lavender Hill, on 25th July, the wife of a gentleman, aged 46, “premonitory diarrhœa 20 hours, cholera 16 hours”

PG72894.B00986
_Pump-well._

PG72894.B00987
At 25, Little Europa Place, on 30th July, the wife of a gardener, aged 50 years, “Asiatic cholera 33 hours”

PG72894.B00988
_Southwark and Vauxhall._

PG72894.B00989
At York Road, on 31st July, the daughter of a gardener, aged 12 years, premonitory diarrhœa neglected 8 hours, “Asiatic cholera, 11 hours”

PG72894.B00990
_Southwark and Vauxhall._

PG72894.B00991
At 18, York Street, Battersea Fields, on 29th July, the son of a boiler-maker, aged 1 year and 7 months, “cholera 10 hours”

PG72894.B00992
_Thames water supplied by a cart._

PG72894.B00993
At Canterbury Place, York Road, on 2nd August, the wife of a bricklayer, aged 35, “diarrhœa unattended 2 days, Asiatic cholera 12 hours”

PG72894.B00994
_Southwark and Vauxhall._

PG72894.B00995
At 33, Little Europa Place, on 2nd August, a labourer, aged 48, “premonitory diarrhœa 4 hours, cholera 16 hours”

PG72894.B00996
_Southwark and Vauxhall._

PG72894.B00997
At Falcon Lane, on 3rd August, the daughter of a chemist deceased, aged 14 years, “premonitory diarrhœa 4 hours, cholera 24 hours”

PG72894.B00998
_Water from a ditch into which the cesspools empty themselves._

PG72894.B00999
At Lavender Road, on 3rd August, a clockmaker, aged 47, “Asiatic cholera”

PG72894.B01000
_Southwark and Vauxhall._

PG72894.B01001
At York Road, August 4, the daughter of a gardener, aged 21, “cholera maligna 11 hours”

PG72894.B01002
_Southwark and Vauxhall._

PG72894.B01003
At 30, Ægis Terrace, Battersea Fields, on 2nd August, the son of a horse-dealer, aged 12 years, “cholera 15 hours”

PG72894.B01004
_Southwark and Vauxhall._

PG72894.B01005
WANDSWORTH. _Wandsworth._

PG72894.B01006
At Armoury Yard, on 3rd August, the daughter of a labourer, aged 4 years, “measles 6 days, cholera 6 hours”

PG72894.B01007
_Thames water fetched in pails._

PG72894.B01008
At Apothecaries’ Row, 5th Aug., the son of a sawyer, aged 10, “cholera 12 hours”

PG72894.B01009
_Thames water and pump-well._

PG72894.B01010
WANDSWORTH. _Putney._

PG72894.B01011
At Cooper’s Arms Lane, on 5th August, a bricklayer’s labourer, aged 38, “premonitory diarrhœa 9 hours, cholera 15 hours”

PG72894.B01012
_Pump-well._

PG72894.B01013
WANDSWORTH. _Streatham._ No death from cholera.

PG72894.B01014
CAMBERWELL. _Dulwich._ No death from cholera.

PG72894.B01015
CAMBERWELL. _Camberwell._

PG72894.B01016
At 1, Rose Cottages, Waterloo Street, on 23rd July, the daughter of a proctor’s clerk, aged 8 years, “cholera Asiatica 15 hours”

PG72894.B01017
_Southwark and Vauxhall._

PG72894.B01018
At the same house, on same day, the sister of the above, aged 1 year, “cholera Asiatica 9 hours”

PG72894.B01019
_Southwark & Vauxhall._

PG72894.B01020
At Garden Cottage, Harris Street, on 22nd July, a carman, aged 49, “cholera 16 hours”

PG72894.B01021
_Southwark and Vauxhall._

PG72894.B01022
At 17, James Street, on 26th February, the daughter of a single woman, aged 14 days, “natural exhaustion from choleraic diarrhœa” (Inquest.)

PG72894.B01023
_Southwark and Vauxhall._

PG72894.B01024
At Ann’s Place, George Street, on 2nd August, the daughter of a coachman, aged 4 years, “cholera 8 hours”

PG72894.B01025
_Southwark and Vauxhall._

PG72894.B01026
At 9, Martha Street, on 3rd August, a fish-hawker, aged 62, “cholera 24 hours”

PG72894.B01027
_Southwark and Vauxhall._

PG72894.B01028
At 8, Cork Street, on 4th August, the wife of a labourer, aged 33, “cholera 32 hours”

PG72894.B01029
_Southwark and Vauxhall._

PG72894.B01030
At the Workhouse, on 29th July, a nurse, aged 60 years, “cholera 24 hours”. From 5, Martin’s Road, Peckham

PG72894.B01031
_Southwark and Vauxhall._

PG72894.B01032
At 57, James Street, on 5th August, the wife of a waiter, aged 33, “cholera 17 hours”

PG72894.B01033
_Southwark and Vauxhall._

PG72894.B01034
At Camberwell House, on 1st August, a male, aged 69 years, “exhaustion from mania 3 months, cholera 24 hours”

PG72894.B01035
_Southwark and Vauxhall._

PG72894.B01036
At Camberwell House, on 1st August, a mariner, aged 53 years, “general paralysis 11 months, cholera 17 hours”

PG72894.B01037
_Southwark and Vauxhall._

PG72894.B01038
At 13, Waterloo Street, on 30th July, the son of a labourer, aged 4 yrs., “cholera 7 hours”

PG72894.B01039
_Southwark and Vauxhall._

PG72894.B01040
At 3, Caroline Place, Wyndham Road, on 31st July, the daughter of a brewer’s servant, aged 1 year, “cholera 9 hours”

PG72894.B01041
_Southwark and Vauxhall._

PG72894.B01042
At Camberwell House, Lunatic Asylum, on 28th July, a male, aged 32, “epilepsy 7 years, cholera 8 hours”

PG72894.B01043
_Southwark and Vauxhall._

PG72894.B01044
At Camberwell House, Lunatic Asylum, on 29th July, a labourer, aged 43, “general paralysis 2 years, cholera 18 hours”

PG72894.B01045
_Southwark and Vauxhall._

PG72894.B01046
At Camberwell House, on 29th July, a servant, aged 47, “cholera 26 hours”

PG72894.B01047
_Southwark and Vauxhall._

PG72894.B01048
At 30, Clarendon Street, on 30th July, a grocer, aged 56, “Asiatic cholera 9 hours”

PG72894.B01049
_Southwark and Vauxhall._

PG72894.B01050
At 1, Absolom Place, South Street, on 2nd August, a girl, aged 21 months, “diarrhœa 48 hours, cholera 21 hours”

PG72894.B01051
_Southwark and Vauxhall._

PG72894.B01052
At 17, Cork Street, on 1st August, the son of a painter, aged 1 year, “diarrhœa 2 days, cholera 1 day”

PG72894.B01053
_Southwark and Vauxhall._

PG72894.B01054
CAMBERWELL. _Peckham._

PG72894.B01055
At 5, Martin’s Road, July 27th, the wife of a labourer, aged 40, “cholera maligna 16 hours”

PG72894.B01056
_Southwark and Vauxhall._

PG72894.B01057
At the same house, on 29th July, the daughter of a labourer, aged 2 yrs., “cholera 28 hours”

PG72894.B01058
_Southwark & Vauxhall._

PG72894.B01059
At 33, Rye Lane, on 30th July, a domestic servant, aged 23, “cholera 5¹⁄₂ hours”

PG72894.B01060
_Southwark and Vauxhall._

PG72894.B01061
At 2, Nun Green, Nunhead, on August 4, the daughter of a potter’s labourer, aged 4 years, “cholera 48 hours”

PG72894.B01062
_Southwark & Vauxhall._

PG72894.B01063
CAMBERWELL. _St. George._

PG72894.B01064
At Binfield House, Windmill Lane, July 28, the son of a labourer, aged 4 years, “cholera 16 hours”

PG72894.B01065
_Southwark and Vauxhall._

PG72894.B01066
At 2, Waterloo Place, Coburg Road, July 31, a girl, aged 3 months, “cholera 20 hours”

PG72894.B01067
_Lambeth._

PG72894.B01068
At 1, Oakley Ter., Old Kent Rd., July 29, the wife of an oilman, aged 30, “Asiatic cholera”

PG72894.B01069
_Southwark & Vauxhall._

PG72894.B01070
At the same house, Aug. 1, the son of an oilman, aged 8 weeks, “cholera maligna 3 days”

PG72894.B01071
_Southwark and Vauxhall._

PG72894.B01072
At 6, Brown’s Terrace, Wyndham Road, Aug. 3, the son of a labourer, aged 3 months, “infantile cholera 6 days”

PG72894.B01073
_Southwark and Vauxhall._

PG72894.B01074
At 27, Thomas Street, Wyndham Road, Aug. 4, the widow of a labourer, aged 68, “diarrhœa 6 days, cholera 4 days”

PG72894.B01075
_Southwark and Vauxhall._

PG72894.B01076
At 7, Rosemary Terrace, Southampton Street, Aug. 5, the son of a labourer, aged 7 years, “Asiatic cholera 15 hours”

PG72894.B01077
_Southwark and Vauxhall._

PG72894.B01078
At 5, Chatham Place, Windmill Lane, August 3rd, a plumber, aged 60, “diarrhœa 2 days, cholera 2 days”

PG72894.B01079
_Southwark and Vauxhall._

PG72894.B01080
At 7, Gloucester Pl., Old Kent Rd., Aug. 4, a carman, aged 19, “Asiatic cholera 15 hours”

PG72894.B01081
_Lambeth._

PG72894.B01082
ROTHERHITHE. _Rotherhithe._

PG72894.B01083
At 2, Albert Place, Union Road, July 8, the wife of a coffee-shopkeeper, aged 32, “cholera 30 hours”

PG72894.B01084
_Southwark and Vauxhall._

PG72894.B01085
At 7, Spread Eagle Court, July 22nd, the wife of a labourer, aged 25, “cholera 12 hours”

PG72894.B01086
_Southwark & Vauxhall._

PG72894.B01087
At 19, Spread Eagle Court, July 24th, the daughter of a labourer, aged 1 year and 9 months, “cholera 20 hours”

PG72894.B01088
_Southwark and Vauxhall._

PG72894.B01089
At 4, John’s Place, July 25th, a blacksmith, aged 41, “cholera 10 hours”

PG72894.B01090
_Water pumped from beneath the Thames Tunnel, by the Engine of the Thames Tunnel Company._

PG72894.B01091
At 1, John’s Place, July 27th, the wife of a biscuit baker, aged 45, “cholera 26 hours”

PG72894.B01092
_Same as above._

PG72894.B01093
At 5, John’s Place, July 25, the son of a baker, aged 4 years, “cholera 24 hours”

PG72894.B01094
_Same as above._

PG72894.B01095
At 89, Adam Street, on the 28th July, the widow of a blacksmith, aged 36 years, “diarrhœa 24 hours, cholera 16 hours”

PG72894.B01096
_Southwark and Vauxhall._

PG72894.B01097
At 5, King St., July 29th, the wife of a labourer, aged 40, “cholera 2¹⁄₂ days”

PG72894.B01098
_Southwark and Vauxhall._

PG72894.B01099
At Charlotte Place, Charlotte Row, July 29, the son of a barge-builder, aged 3 years, “cholera 3 days”

PG72894.B01100
_Tidal ditch._

PG72894.B01101
At 5, Slater’s Alley, July 29, a labourer, aged 33, “cholera 3¹⁄₂ days”

PG72894.B01102
_Thames Tunnel water, fetched from John’s Place._

PG72894.B01103
At 18, Upper Queen Street, Aug. 2, the daughter of a labourer, aged 7 years, “cholera 2 days, typhoid fever 7 days”

PG72894.B01104
_Southwark and Vauxhall._

PG72894.B01105
At 1, Thetford Place, August 1, the son of a labourer, aged 7 years, “cholera 7 hours”

PG72894.B01106
_Southwark and Vauxhall._

PG72894.B01107
On board ship in the Surrey Canal Dock, August 2, a mariner, aged 65, “Asiatic cholera 18 hours”

PG72894.B01108
_Most likely Thames Water._

PG72894.B01109
On board the brig “Borcas”, of Sunderland, in the river Thames, Aug. 2, the wife of a master mariner, aged 38, “cholera 13¹⁄₂ hours”

PG72894.B01110
_Most likely Thames Water._

PG72894.B01111
At 20, Spread Eagle Court, Aug. 1, a labourer, aged 28, “cholera 16 hours”

PG72894.B01112
_Southwark and Vauxhall._

PG72894.B01113
At 7, Midway Pl., Aug. 1, the daughter of a domestic servant, aged 3 years, “measles 14 days, Asiatic cholera 18 hours”

PG72894.B01114
_Southwark and Vauxhall._

PG72894.B01115
At 12, St. Helena Pl., Aug. 1, the wife of a carpenter, aged 31, “morbus cordis 5 years, Asiatic cholera 24 hours”

PG72894.B01116
_Southwark and Vauxhall._

PG72894.B01117
At 18, Stanley Terrace, August 1, the son of a mercantile clerk, aged 2 years, “premonitory diarrhœa 3 hours, Asiatic cholera 5 hours”

PG72894.B01118
_Southwark and Vauxhall._

PG72894.B01119
At York St., near Swan Lane, Aug. 1, the son of a carpenter, aged 3 yrs., “cholera 12 hours”

PG72894.B01120
_Southwark & Vauxhall._

PG72894.B01121
At York Street, near Swan Lane, on 3rd August, a carpenter, aged 38, “cholera 8 hours”

PG72894.B01122
_Southwark and Vauxhall._

PG72894.B01123
At 8, Norfolk Place, August 4, the son of a labourer, aged 5 years, “cholera 8 hours”

PG72894.B01124
_Southwark & Vauxhall._

PG72894.B01125
At 16, Charlotte Row, Aug. 3, the wife of a waterman, aged 57, “cholera 20 hours”

PG72894.B01126
_Tidal ditch._

PG72894.B01127
At 3, Plough Bridge, Aug. 3, the daughter of a warehouseman, aged 12, “Asiatic cholera 12 hours”

PG72894.B01128
_Surrey Canal._

PG72894.B01129
At 53, Clarence Street, Aug. 4, the wife of a labourer, aged 48, “cholera 14 hours”

PG72894.B01130
_Southwark & Vauxhall._

PG72894.B01131
At York St., near Swan Lane, Aug. 5, the son of a carpenter, aged 1 year, “cholera 3 days”

PG72894.B01132
_Southwark & Vauxhall._

PG72894.B01133
At 9, New St., Neptune St., Aug. 5, the wife of a brushmaker, aged 57, “cholera 3 days”

PG72894.B01134
_Southwark & Vauxhall._

PG72894.B01135
LEWISHAM. _Sydenham._—No death from cholera.

PG72894.B01136
THE END.

PG72894.B01137
T. RICHARDS, 37 GREAT QUEEN STREET.

PG72894.B01138
-----

PG72894.B01139
Footnote 1:

PG72894.B01140
Report on the Epidemic Cholera, 1824, p. 5.

PG72894.B01141
Footnote 2:

PG72894.B01142
On the Infectious Origin and Propagation of Cholera.

PG72894.B01143
Footnote 3:

PG72894.B01144
See “London Journal of Medicine,” May, 1849.

PG72894.B01145
Footnote 4:

PG72894.B01146
London Journal of Medicine, loc. cit.

PG72894.B01147
Footnote 5:

PG72894.B01148
In the so-called secondary fever there is toxicohæmia, arising from suppressed excretion by the kidneys.

PG72894.B01149
Footnote 6:

PG72894.B01150
See “London Gazette”, 18th Sept. 1849.

PG72894.B01151
Footnote 7:

PG72894.B01152
See Report in “Med. Gaz.”, vol. ii, 1849, p. 429.

PG72894.B01153
Footnote 8:

PG72894.B01154
Edin. Med. and Sur. Jour., vol. xxxvii.

PG72894.B01155
Footnote 9:

PG72894.B01156
Scot, “Report on the Epidemic Cholera”, p. 237.

PG72894.B01157
Footnote 10:

PG72894.B01158
The particulars of each death connected with this outbreak were published in the “Weekly Returns” of the Registrar-General to 16th September, and I procured the remainder through the kindness of the Registrar-General and the District Registrars.

PG72894.B01159
Footnote 11:

PG72894.B01160
The deaths are obtained from the “First Report of the Metropolitan Sanitary Commission”, 1847; and the water supply, chiefly from a work entitled “Hydraulia”, by William Matthews, 1835.

PG72894.B01161
Footnote 12:

PG72894.B01162
A small part of the Whitechapel District is supplied with New River water.

PG72894.B01163
Footnote 13:

PG72894.B01164
A Microscopic Examination of the Water supplied to London. London: 1850.

PG72894.B01165
Footnote 14:

PG72894.B01166
P. 207. In the table at page 206, Dr. Baly has fallen into the mistake of supposing that the Lambeth Water Company obtained their supply from Thames Ditton in 1849. It was not till 1852 that their works were removed to that place. Dr. Baly has also mistaken the name and identity of all the three Companies which supply the south districts of London with water.

PG72894.B01167
Footnote 15:

PG72894.B01168
A part of Rotherhithe was supplied by the Kent Water Company; but there was no cholera in this part.

PG72894.B01169
Footnote 16:

PG72894.B01170
Weekly Return, Oct. 14, p. 433.

PG72894.B01171
Footnote 17:

PG72894.B01172
A small part of Rotherhithe is now supplied by the Kent Water Company.

PG72894.B01173
Footnote 18:

PG72894.B01174
In 1849, there were forty-eight deaths from cholera in Millbank prison, amounting to 4·3 per cent. of the average number of prisoners. In Tothill Fields prison there were thirteen deaths among eight hundred prisoners, or 1·6 per cent. The other prisons on the north side of the Thames are supplied either by the New River Company, or from pump-wells, and there was but one death from cholera in all of them; that death took place in Newgate.

PG72894.B01175
Footnote 19:

PG72894.B01176
Report by the Government Commission on the Chemical Quality of the Supply of Water to the Metropolis. (177.)

PG72894.B01177
Footnote 20:

PG72894.B01178
Medical Gazette, vol. xliv, p. 749.

PG72894.B01179
Footnote 21:

PG72894.B01180
History of the Cholera in Exeter in 1832.

PG72894.B01181
Footnote 22:

PG72894.B01182
Report of the General Board of Health on the Supply of Water to the Metropolis, 1850, p. 55.

PG72894.B01183
Footnote 23:

PG72894.B01184
See Report of Commissioners on the Cholera at Newcastle, etc., p. 474.

PG72894.B01185
Footnote 24:

PG72894.B01186
Opus cit., p. xxv.

PG72894.B01187
Footnote 25:

PG72894.B01188
Report of Swedish Commissioners, quoted in the Second Report of the Metropolitan Sanitary Commission, 1848.

PG72894.B01189
Footnote 26:

PG72894.B01190
Medical Times and Gazette, Lancet, and Association Journal.

PG72894.B01191
Footnote 27:

PG72894.B01192
Various conditions are requisite for the production of a disease, as they are for the production of a crop of wheat or turnips; but it is not necessary to dignify these conditions with the name of causes.

PG72894.B01193
Footnote 28:

PG72894.B01194
Medical Times and Gazette, 1854, vol. i, p. 182.

PG72894.B01195
Footnote 29:

PG72894.B01196
Cholera, with Reference to the Geological Theory. Cincinnati, 1850.

PG72894.B01197
Footnote 30:

PG72894.B01198
Trans. of Roy. Med. and Chir. Soc., 1844.

PG72894.B01199
Footnote 31:

PG72894.B01200
Med. Times and Gazette, Nov. 25th, 1854.

PG72894.B01201
Footnote 32:

PG72894.B01202
Report on the Cholera of 1848–49, p. xl.

PG72894.B01203
Footnote 33:

PG72894.B01204
Rolle’s Account of the Burning of London in 1666.

PG72894.B01205
Footnote 34:

PG72894.B01206
Official Reports on the Province of Kumaon, by J. H. Batten, Esq., C.E. Agra, 1851.

PG72894.B01207
Footnote 35:

PG72894.B01208
Dr. Cheyne on Dysentery, Dublin Hospital Reports, vol. iii.

PG72894.B01209
Footnote 36:

PG72894.B01210
Statistical Reports on the Health of the Navy. Part II. 1853.

PG72894.B01211
Footnote 37:

PG72894.B01212
See Clinical Reports of Continued Fever, by Austin Flint, M.D.: Buffalo, 1852, p. 380. Also Med. Times and Gazette, March 12, 1853, p. 261.

PG72894.B01213
Footnote 38:

PG72894.B01214
Association Journal, October 6, 1854.

PG72894.B01215
Footnote 39:

PG72894.B01216
8vo., 1842, p. 66.

PG72894.B01217
Footnote 40:

PG72894.B01218
Essai de Géographie Médicale, p. 52.

PG72894.B01219
Footnote 41:

PG72894.B01220
Page 94.

PG72894.B01221
Footnote 42:

PG72894.B01222
De Aere, Aquis, et Locis.

PG72894.B01223
------------------------------------------------------------------------

PG72894.B01224
_London, New Burlington Street, February, 1855._

PG72894.B01225
MR. CHURCHILL’S

PG72894.B01226
Publications,

PG72894.B01227
IN

PG72894.B01228
MEDICINE, SURGERY,

PG72894.B01229
AND

PG72894.B01230
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PG72894.B01231
[Illustration: [Logo]]

PG72894.B01232
“It would be unjust to conclude this notice without saying a few words in favour of Mr. Churchill, from whom the profession is receiving, it may be truly said, the most beautiful series of Illustrated Medical Works which has ever been published.”—_Lancet._

PG72894.B01233
“All the publications of Mr. Churchill are prepared with so much taste and neatness, that it is superfluous to speak of them in terms of commendation.”—_Edinburgh Medical and Surgical Journal._

PG72894.B01234
“No one is more distinguished for the elegance and _recherché_ style of his publications than Mr. Churchill.”—_Provincial Medical Journal._

PG72894.B01235
“Mr. Churchill’s publications are very handsomely got up: the engravings are remarkably well executed.”—_Dublin Medical Press._

PG72894.B01236
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PG72894.B01237
“Mr. Churchill’s illustrated works are among the best that emanate from the Medical Press.”—_Medical Times._

PG72894.B01238
“We have before called the attention of both students and practitioners to the great advantage which Mr. Churchill has conferred on the profession, in the issue, at such a moderate cost, of works so highly creditable in point of artistic execution and scientific merit.”—_Dublin Quarterly Journal._

PG72894.B01239
MR. CHURCHILL is the Publisher of the following Periodicals, offering to Authors a wide extent of Literary Announcement, and a Medium of Advertisement, addressed to all Classes of the Profession. COMMUNICATIONS, BOOKS for REVIEW, addressed to the respective Editors, are received and duly forwarded by Mr. Churchill.

PG72894.B01240
THE BRITISH AND FOREIGN MEDICO-CHIRURGICAL REVIEW;

PG72894.B01241
OR,

PG72894.B01242
QUARTERLY JOURNAL OF PRACTICAL MEDICINE.

PG72894.B01243
Price Six Shillings. Nos. 1 to 29.

PG72894.B01244
THE MEDICAL TIMES AND GAZETTE.

PG72894.B01245
Published Weekly, price Sevenpence, or Stamped, Eightpence.

PG72894.B01246
Annual Subscription, £1. 10_s._, or Stamped, £1. 14_s._ 8_d._ and regularly forwarded to all parts of the Kingdom.

PG72894.B01247
The MEDICAL TIMES AND GAZETTE is favoured with an amount of Literary and Scientific support which enables it to reflect fully the progress of Medical Science, and insure for it a character, an influence, and a circulation possessed at the present time by no Medical Periodical.

PG72894.B01248
THE HALF-YEARLY ABSTRACT OF THE MEDICAL SCIENCES.

PG72894.B01249
Being a Digest of the Contents of the principal British and Continental Medical Works; together with a Critical Report of the Progress of Medicine and the Collateral Sciences. Edited by W. H. RANKING, M.D., Cantab., and C. B. RADCLIFFE, M.D., Lond. Post 8vo. cloth, 6_s._ 6_d._ Vols. 1 to 20.

PG72894.B01250
THE JOURNAL OF PSYCHOLOGICAL MEDICINE AND MENTAL PATHOLOGY.

PG72894.B01251
Being a Quarterly Review of Medical Jurisprudence and Insanity. Edited by FORBES WINSLOW, M.D. Price 3_s._ 6_d._ Nos. 1 to 29.

PG72894.B01252
THE PHARMACEUTICAL JOURNAL.

PG72894.B01253
EDITED BY JACOB BELL, F.L.S., M.R.I.

PG72894.B01254
Published Monthly, price One Shilling.

PG72894.B01255
Under the sanction of the PHARMACEUTICAL SOCIETY, whose TRANSACTIONS form a distinct portion of each Number.

PG72894.B01256
⁂ Vols. 1 to 13, bound in cloth, price 12_s._ 6_d._ each.

PG72894.B01257
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PG72894.B01258
Published Weekly, Stamped, price Sixpence, free to any part of the Empire.

PG72894.B01259
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PG72894.B01260
Published Annually. 12mo. cloth, 7_s._ 6_d._

PG72894.B01261
MR. ACTON, M.R.C.S.

PG72894.B01262
A PRACTICAL TREATISE ON DISEASES OF THE URINARY AND GENERATIVE ORGANS OF BOTH SEXES, INCLUDING SYPHILIS. Second Edition. 8vo. cloth, 20_s._

PG72894.B01263
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PG72894.B01264
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PG72894.B01265
“We cannot too highly recommend this treatise; it should be found wherever Surgery is practised throughout the British Empire.”—_Provincial Medical Journal._

PG72894.B01266
DR. WILLIAM ADDISON, F.R.S., F.L.S.

PG72894.B01267
ON HEALTHY AND DISEASED STRUCTURE, AND THE TRUE PRINCIPLES OF TREATMENT FOR THE CURE OF DISEASE, ESPECIALLY CONSUMPTION AND SCROFULA, founded on MICROSCOPICAL ANALYSIS. 8vo. cloth, 12_s._

PG72894.B01268
“A work deserving the perusal of every one interested in the late rapid advance of physiology and pathology.”—_Medico-Chirurgical Review._

PG72894.B01269
MR. ANDERSON, F.R.C.S.

PG72894.B01270
I.

PG72894.B01271
HYSTERICAL, HYPOCHONDRIACAL, EPILEPTIC, AND OTHER NERVOUS AFFECTIONS; their Causes, Symptoms, and Treatment. 8vo. cloth, 5_s._

PG72894.B01272
II.

PG72894.B01273
THE SYMPTOMS AND TREATMENT OF THE DISEASES OF PREGNANCY. Post 8vo. 4_s._ 6_d._

PG72894.B01274
DR. JAMES ARNOTT.

PG72894.B01275
I.

PG72894.B01276
ON THE REMEDIAL AGENCY OF A LOCAL ANÆSTHENIC OR BENUMBING TEMPERATURE, in various painful and inflammatory Diseases. 8vo. cloth, 4_s._ 6_d._

PG72894.B01277
II.

PG72894.B01278
ON INDIGESTION; its Pathology and its Treatment, by the Local Application of Uniform and Continuous Heat and Moisture. With an Account of an improved Mode of applying Heat and Moisture in Irritative and Inflammatory Diseases. With a Plate. 8vo. 5_s._

PG72894.B01279
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PG72894.B01280
PRACTICAL ILLUSTRATIONS OF THE TREATMENT OF OBSTRUCTIONS IN THE URETHRA, AND OTHER CANALS, BY THE DILATATION OF FLUID PRESSURE. 8vo. boards, 3_s._

PG72894.B01281
MR. F. A. ABEL, F.C.S.,

PG72894.B01282
PROFESSOR OF CHEMISTRY AT THE ROYAL MILITARY ACADEMY, WOOLWICH; AND

PG72894.B01283
MR. C. L. BLOXAM,

PG72894.B01284
DEMONSTRATOR OF PRACTICAL CHEMISTRY IN KING’S COLLEGE.

PG72894.B01285
HANDBOOK OF CHEMISTRY: THEORETICAL, PRACTICAL, AND TECHNICAL. 8vo. cloth, 15_s._

PG72894.B01286
MR. T. J. ASHTON,

PG72894.B01287
SURGEON TO THE BLENHEIM-STREET DISPENSARY.

PG72894.B01288
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PG72894.B01289
ON THE DISEASES, INJURIES, AND MALFORMATIONS OF THE RECTUM AND ANUS. 8vo. cloth, 8_s._

PG72894.B01290
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PG72894.B01291
“It is the most complete of all the works at present under consideration.”—_New York Journal of Medicine._

PG72894.B01292
II.

PG72894.B01293
A TREATISE ON CORNS AND BUNIONS, AND IN-GROWING OF THE TOE-NAIL: their Causes and Treatment. Post 8vo. cloth, 3_s._ 6_d._

PG72894.B01294
MR. ATKINSON.

PG72894.B01295
MEDICAL BIBLIOGRAPHY. Vol. I. Royal 8vo. 16_s._

PG72894.B01296
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PG72894.B01297
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PG72894.B01298
ROYAL COLLEGE OF PHYSICIANS.

PG72894.B01299
DR. WILLIAM BALY, F.R.S.,

PG72894.B01300
ASSISTANT PHYSICIAN TO ST. BARTHOLOMEW’S HOSPITAL; AND

PG72894.B01301
DR. WILLIAM W. GULL,

PG72894.B01302
ASSISTANT PHYSICIAN TO GUY’S HOSPITAL.

PG72894.B01303
REPORTS ON EPIDEMIC CHOLERA, its Cause and Mode of Diffusion, Morbid Anatomy, Pathology and Treatment. Drawn up at the desire of the Cholera Committee. With Maps, 8vo. cloth, 16_s._

PG72894.B01304
MR. RICHARD BARWELL, F.R.C.S.,

PG72894.B01305
DEMONSTRATOR OF ANATOMY AT ST. THOMAS’S HOSPITAL.

PG72894.B01306
ASIATIC CHOLERA; its Symptoms, Pathology, and Treatment. Post 8vo. cloth, 4_s._ 6_d._

PG72894.B01307
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PG72894.B01308
DR. BASCOME.

PG72894.B01309
A HISTORY OF EPIDEMIC PESTILENCES, FROM THE EARLIEST AGES. 8vo. cloth, 8_s._

PG72894.B01310
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PG72894.B01311
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PG72894.B01312
MR. BATEMAN.

PG72894.B01313
MAGNACOPIA: A Practical Library of Profitable Knowledge, communicating the general Minutiæ of Chemical and Pharmaceutic Routine, together with the generality of Secret Forms of Preparations; including Concentrated Solutions of Camphor and Copaiba in Water, Mineral Succedaneum, Marmoratum, Silicia, Terro-Metallicum, Pharmaceutic Condensions, Prismatic Crystallization, Crystallized Aromatic Salt of Vinegar, Spa Waters; newly-invented Writing Fluids; Etching on Steel or Iron; with an extensive Variety of _et cætera_. Third Edition. 18mo. 6_s._

PG72894.B01314
MR. LIONEL J. BEALE, M.R.C.S.

PG72894.B01315
THE LAW OF HEALTH IN THEIR RELATIONS TO MIND AND BODY. A Series of Letters from an Old Practitioner to a Patient. Post 8vo. cloth, 7_s._ 6_d._

PG72894.B01316
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PG72894.B01317
“Although addressed to the public, a vast variety of excellent practical matter is contained in it, which is calculated to interest the practitioner. It conveys in an agreeable and epistolary style most of the important truths connected with preventive medicine, and their practical application on the development and maturity of mind and body. Mr. Beale’s volume is calculated to make a favourable impression on the minds of all intelligent readers.”—_Dublin Quarterly Journal._

PG72894.B01318
MR. BEASLEY.

PG72894.B01319
I.

PG72894.B01320
THE BOOK OF PRESCRIPTIONS; containing 2900 Prescriptions. Collected from the Practice of the most eminent Physicians and Surgeons, English and Foreign. 24mo. cloth, 6_s._

PG72894.B01321
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PG72894.B01322
THE DRUGGISTS’ GENERAL RECEIPT-BOOK; comprising a copious Veterinary Formulary and Table of Veterinary Materia Medica; Patent and Proprietary Medicines, Druggists’ Nostrums, &c.; Perfumery, Skin Cosmetics, Hair Cosmetics, and Teeth Cosmetics; Beverages, Dietetic Articles, and Condiments; Trade Chemicals, Miscellaneous Preparations and Compounds used in the Arts, &c.; with useful Memoranda and Tables. Third Edition. 24mo. cloth, 6_s._

PG72894.B01323
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PG72894.B01324
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PG72894.B01325
THE POCKET FORMULARY AND SYNOPSIS OF THE BRITISH AND FOREIGN PHARMACOPŒIAS; comprising standard and approved Formulæ for the Preparations and Compounds employed in Medical Practice. Fifth Edition, corrected and enlarged. 24mo. cloth, 6_s._

PG72894.B01326
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PG72894.B01327
DR. O’B. BELLINGHAM.

PG72894.B01328
ON ANEURISM, AND ITS TREATMENT BY COMPRESSION. 12mo. cloth, 4_s._

PG72894.B01329
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PG72894.B01330
DR. HENRY BENNET,

PG72894.B01331
OBSTETRIC PHYSICIAN TO THE WESTERN DISPENSARY.

PG72894.B01332
A PRACTICAL TREATISE ON INFLAMMATION AND OTHER DISEASES OF THE UTERUS. Third Edition, revised, with additions. 8vo. cloth, 12_s._ 6_d._

PG72894.B01333
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PG72894.B01334
MR. P. HINCKES BIRD, F.R.C.S.

PG72894.B01335
PRACTICAL TREATISE ON THE DISEASES OF CHILDREN AND INFANTS AT THE BREAST. Translated from the French of M. BOUCHUT, with Notes and Additions. 8vo. cloth. 20_s._

PG72894.B01336
DR. GOLDING BIRD, F.R.S.

PG72894.B01337
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PG72894.B01338
URINARY DEPOSITS; THEIR DIAGNOSIS, PATHOLOGY, AND THERAPEUTICAL INDICATIONS. With Engravings on Wood. Fourth Edition. Post 8vo. cloth, 10_s._ 6_d._

PG72894.B01339
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PG72894.B01340
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PG72894.B01341
DR. BLAKISTON, F.R.S.,

PG72894.B01342
LATE PHYSICIAN TO THE BIRMINGHAM GENERAL HOSPITAL.

PG72894.B01343
PRACTICAL OBSERVATIONS ON CERTAIN DISEASES OF THE CHEST; and on the Principles of Auscultation. 8vo. cloth, 12_s._

PG72894.B01344
“Dr. Blakiston’s production not only gives him a place in the rather thin ranks of sound and accomplished physicians, possessed of a true notion of the importance of their science, and of the means by which it should be cultivated,—but adds to English Medical Literature one of the few really inductive works by which it is adorned.”—_Medico-Chirurgical Review._

PG72894.B01345
DR. JOHN W. F. BLUNDELL.

PG72894.B01346
MEDICINA MECHANICA; or, the Theory and Practice of Active and Passive Exercises and Manipulations in the Cure of Chronic Disease. Post 8vo. cloth, 6_s._

PG72894.B01347
MR. JOHN E. BOWMAN,

PG72894.B01348
PROFESSOR OF PRACTICAL CHEMISTRY IN KING’S COLLEGE, LONDON.

PG72894.B01349
I.

PG72894.B01350
PRACTICAL CHEMISTRY, including Analysis. With numerous Illustrations on Wood. Second Edition. Foolscap 8vo. cloth, 6_s._ 6_d._

PG72894.B01351
“One of the most complete manuals that has for a long time been given to the chemical student. Every process is indicated with clearness, and the manipulatory details are assisted by an extensive series of woodcuts.”—_Athenæum._

PG72894.B01352
II.

PG72894.B01353
MEDICAL CHEMISTRY; with Illustrations on Wood. Second Edition. Fcap. 8vo. cloth, 6_s._ 6_d._

PG72894.B01354
“We have examined this treatise, and we can recommend it to the student as a useful elementary guide. The illustrations are numerous and accurate, and well calculated to aid diagnosis.”—_Medical Gazette._

PG72894.B01355
DR. JAMES BRIGHT.

PG72894.B01356
ON DISEASES OF THE CHEST AND AIR PASSAGES; with a Review of the several Climates recommended in these Affections. Second Edition. Post 8vo. cloth, 7_s._ 6_d._

PG72894.B01357
MR. ISAAC BAKER BROWN, F.R.C.S.,

PG72894.B01358
SURGEON ACCOUCHEUR TO ST. MARY’S HOSPITAL.

PG72894.B01359
ON SOME DISEASES OF WOMEN ADMITTING OF SURGICAL TREATMENT. With Plates, 8vo. cloth, 10_s._ 6_d._

PG72894.B01360
“The most valuable chapter in the book is that on Ruptured Perinæum. It is in the treatment of this distressing accident, which has long held a prominent place amongst the opprobria of Surgery, that Mr. Brown has, in our opinion, shown the greatest amount of originality, and in which his efforts have been rewarded with the greatest success.”—_The Lancet._

PG72894.B01361
“We can recommend Mr. Brown’s work most strongly to all those who are called upon to treat the Diseases peculiar to Women, as a book in which they will find a great deal of really valuable practical information.”—_Medical Times and Gazette._

PG72894.B01362
DR. BUDD, F.R.S.,

PG72894.B01363
PROFESSOR OF MEDICINE IN KING’S COLLEGE, LONDON.

PG72894.B01364
ON DISEASES OF THE LIVER. Illustrated with Coloured Plates and Engravings on Wood. Second Edition. 8vo. cloth, 16_s._

PG72894.B01365
“In Dr. Budd’s work the practitioner will find abundant instructions upon symptoms and treatment. We hope the specimen we have exhibited will induce many to search the work for themselves.”—_Lancet._

PG72894.B01366
DR. WILLOUGHBY BURSLEM,

PG72894.B01367
SENIOR PHYSICIAN TO THE BLENHEIM-STREET DISPENSARY.

PG72894.B01368
PULMONARY CONSUMPTION AND ITS TREATMENT. Post 8vo. cloth, 5_s._

PG72894.B01369
“We find a series of original and important observations on the state of the periodical functions of the female in relation to the development and treatment of phthisis, and a commentary on the various phenomena of the disease, which impress us with the conviction that the author is as painstaking in his literary pursuit of knowledge as he is evidently a practical physician.”—_Lancet._

PG72894.B01370
DR. CARPENTER, F.R.S.

PG72894.B01371
I.

PG72894.B01372
PRINCIPLES OF HUMAN PHYSIOLOGY. With numerous Illustrations on Steel and Wood. Fourth Edition. 8vo. cloth, 28_s._

PG72894.B01373
II.

PG72894.B01374
PRINCIPLES OF COMPARATIVE PHYSIOLOGY. Illustrated with 300 Engravings on Wood. Fourth Edition. 8vo. cloth, 24_s._

PG72894.B01375
⁂“The whole work has been most carefully revised; and the Author ventures to think that the present Edition more completely represents the state of the Science at the period of its publication than any of its predecessors have done. He can honestly say, that he has spared no time or labour in its preparation which it has been in his power to bestow.”—_Extract from Preface._

PG72894.B01376
III.

PG72894.B01377
A MANUAL OF PHYSIOLOGY. With numerous Illustrations on Steel and Wood. Second Edition. Fcap. 8vo. cloth, 12_s._ 6_d._

PG72894.B01378
“Dr. Carpenter has brought up his Manual, in this new and beautiful edition, to the present state of physiological science. The work is complete. We recommend it as an admirable text-book.”—_London Journal of Medicine._

PG72894.B01379
“We can strongly recommend this volume to the student. This second edition contains the latest additions to physiological science.”—_Medical Gazette._

PG72894.B01380
MR. ROBERT B. CARTER, M.R.C.S.

PG72894.B01381
THE PATHOLOGY AND TREATMENT OF HYSTERIA. 8vo. cloth, 4_s._ 6_d._

PG72894.B01382
MR. H. T. CHAPMAN, F.R.C.S.

PG72894.B01383
THE TREATMENT OF OBSTINATE ULCERS AND CUTANEOUS ERUPTIONS OF THE LEG WITHOUT CONFINEMENT. Second Edition. Post 8vo. cloth, 3_s._ 6_d._

PG72894.B01384
“Mr. Chapman has done much by directing the attention of the profession to the advantages of this combined treatment. We have read his work with much pleasure, and have used the compress, straps of linen, and roller, as directed, and have found them to answer admirably well.”—_Dublin Quarterly Medical Journal._

PG72894.B01385
DR. G. C. CHILD.

PG72894.B01386
ON INDIGESTION, AND CERTAIN BILIOUS DISORDERS OFTEN CONJOINED WITH IT. Second Edition. 8vo. cloth, 6_s._

PG72894.B01387
SIR JAMES CLARK, M.D., BART.,

PG72894.B01388
PHYSICIAN TO THE QUEEN.

PG72894.B01389
THE SANATIVE INFLUENCE OF CLIMATE. With an Account of the Principal Places resorted to by Invalids in England, South of Europe, the Colonies, &c. Fourth Edition, revised. Post 8vo. cloth, 10_s._ 6_d._

PG72894.B01390
MR. J. PATERSON CLARK, M.A.,

PG72894.B01391
DENTIST EXTRAORDINARY TO HIS ROYAL HIGHNESS PRINCE ALBERT.

PG72894.B01392
THE ODONTALGIST; OR, HOW TO PRESERVE THE TEETH, CURE TOOTHACHE, AND REGULATE DENTITION FROM INFANCY TO AGE. With plates. Post 8vo. cloth, 5_s._

PG72894.B01393
DR. CONOLLY.

PG72894.B01394
THE CONSTRUCTION AND GOVERNMENT OF LUNATIC ASYLUMS AND HOSPITALS FOR THE INSANE. With Plans. Post 8vo. cloth, 6_s._

PG72894.B01395
MR. BRANSBY B. COOPER, F.R.S.,

PG72894.B01396
LECTURES ON THE PRINCIPLES AND PRACTICE OF SURGERY. 8vo. cloth, 21_s._

PG72894.B01397
“Mr. Cooper’s book has reminded us, in its easy style and copious detail, more of Watson’s Lectures, and we should not be surprised to see it occupy a similar position to that well-known work in professional estimation.”—_Medical Times._

PG72894.B01398
MR. W. WHITE COOPER,

PG72894.B01399
OPHTHALMIC SURGEON TO ST. MARY’S HOSPITAL.

PG72894.B01400
ON NEAR SIGHT, AGED SIGHT, IMPAIRED VISION, AND THE MEANS OF ASSISTING SIGHT. With 31 Illustrations on Wood. Second Edition. Fcap. 8vo. cloth, 7_s._ 6_d._

PG72894.B01401
MR. COOPER,

PG72894.B01402
LATE PROFESSOR OF SURGERY IN THE UNIVERSITY COLLEGE, LONDON.

PG72894.B01403
A DICTIONARY OF PRACTICAL SURGERY; comprehending all the most interesting Improvements, from the Earliest Times down to the Present Period. Seventh Edition. One very thick volume, 8vo., 1_l._ 10_s._

PG72894.B01404
MR. COOLEY.

PG72894.B01405
COMPREHENSIVE SUPPLEMENT TO THE PHARMACOPŒIAS.

PG72894.B01406
THE CYCLOPÆDIA OF PRACTICAL RECEIPTS, AND COLLATERAL INFORMATION IN THE ARTS, MANUFACTURES, AND TRADES, INCLUDING MEDICINE, PHARMACY, AND DOMESTIC ECONOMY; designed as a Compendious Book of Reference for the Manufacturer, Tradesman, Amateur, and Heads of Families. Third Edition. _In the Press._

PG72894.B01407
SIR ASTLEY COOPER, BART., F.R.S.

PG72894.B01408
ON THE STRUCTURE AND DISEASES OF THE TESTIS. Illustrated with 24 highly-finished Coloured Plates. Second Edition. Royal 4to. _Reduced from £3. 3s. to £1. 10s._

PG72894.B01409
DR. COTTON,

PG72894.B01410
ASSISTANT PHYSICIAN TO THE HOSPITAL FOR CONSUMPTION, BROMPTON.

PG72894.B01411
I.

PG72894.B01412
ON CONSUMPTION: Its Nature, Symptoms, and Treatment. To which Essay was awarded the Fothergillian Gold Medal of the Medical Society of London. 8vo. cloth, 8_s._

PG72894.B01413
“Notwithstanding the hackneyed nature of the subject, and the multitude of works which have appeared upon phthisis, the present work is of very considerable interest, from the clear and simple manner in which it is arranged, and from the use made by the author of the ample materials placed at his disposal at the Brompton Hospital.”—_Medical Times._

PG72894.B01414
II.

PG72894.B01415
PHTHISIS AND THE STETHOSCOPE: a concise Practical Guide to the Physical Diagnosis of Consumption. Foolscap 8vo. cloth, 3_s._ 6_d._

PG72894.B01416
MR. COULSON,

PG72894.B01417
SURGEON TO ST. MARY’S HOSPITAL.

PG72894.B01418
I.

PG72894.B01419
ON DISEASES OF THE BLADDER AND PROSTATE GLAND. The Fourth Edition, revised and enlarged. 8vo. cloth, 10_s._ 6_d._

PG72894.B01420
“Mr. Coulson’s work may be stated to be full and practical, to fill a vacant space in Medical Literature, and to be highly valuable to both students and practitioners.”—_Medical Times._

PG72894.B01421
“The practical and comprehensive character of Mr. Coulson’s volume claims for it a place in the library of every surgeon who desires to be on a level with modern improvements.”—_London Journal of Medicine._

PG72894.B01422
II.

PG72894.B01423
ON LITHOTRITY AND LITHOTOMY; with Engravings on Wood. 8vo. cloth, 8_s._

PG72894.B01424
DR. JOHN GREEN CROSSE, F.R.S.

PG72894.B01425
CASES IN MIDWIFERY, arranged, with an Introduction and Remarks by EDWARD COPEMAN, M.D., F.R.C.S. 8vo. cloth, 7_s._ 6_d._

PG72894.B01426
MR. T. BLIZARD CURLING, F.R.S.,

PG72894.B01427
SURGEON TO THE LONDON HOSPITAL.

PG72894.B01428
A PRACTICAL TREATISE ON DISEASES OF THE TESTIS, SPERMATIC CORD, AND SCROTUM. Second Edition, with Additions. 8vo. cloth. _Just ready._

PG72894.B01429
MR. JOHN DALRYMPLE, F.R.S., F.R.C.S.

PG72894.B01430
PATHOLOGY OF THE HUMAN EYE. Complete in Nine Fasciculi: imperial 4to., 20_s._ each; half-bound morocco, gilt tops, 9_l._ 15_s._

PG72894.B01431
“A work reflecting credit on the profession has been brought to a successful conclusion. Had Mr. Dalrymple’s life been spared but a few short months longer, the chorus of praise which now greets the completion of this great work would have fallen gratefully on his ear. The Publisher may well be proud of having issued such a work.”—_London Journal of Medicine._

PG72894.B01432
“The satisfaction with which we should have announced the completion of this unrivalled work is overclouded by the regret which we feel, in common with all who were acquainted with its distinguished and estimable author, at his early decease. The value of this work can scarcely be over-estimated: it realizes all that we believe it possible for art to effect in the imitation of nature.”—_British and Foreign Medico-Chirurgical Review._

PG72894.B01433
DR. DAVEY,

PG72894.B01434
FORMERLY OF THE COUNTY OF MIDDLESEX LUNATIC ASYLUMS AT HANWELL AND COLNEY HATCH.

PG72894.B01435
ON THE NATURE AND PROXIMATE CAUSE OF INSANITY. Post 8vo. cloth, 3_s._

PG72894.B01436
“It gives us much pleasure to state that the method of treatment inculcated in this little Essay is most judicious, and that the general statements which pervade the work are such as do honour to the head and heart of the writer.”—_Psychological Journal._

PG72894.B01437
DR. HERBERT DAVIES,

PG72894.B01438
SENIOR PHYSICIAN TO THE ROYAL INFIRMARY FOR DISEASES OF THE CHEST.

PG72894.B01439
ON THE PHYSICAL DIAGNOSIS OF DISEASES OF THE LUNGS AND HEART. Second Edition. Post 8vo. cloth, 8_s._

PG72894.B01440
DR. TOOGOOD DOWNING.

PG72894.B01441
NEURALGIA: its various Forms, Pathology, and Treatment. THE JACKSONIAN PRIZE ESSAY FOR 1850. 8vo. cloth, 10_s._ 6_d._

PG72894.B01442
DR. DRUITT, F.R.C.S.

PG72894.B01443
THE SURGEON’S VADE-MECUM; with numerous Engravings on Wood. Sixth Edition. Foolscap 8vo. cloth, 12_s._ 6_d._

PG72894.B01444
“Without any of the adventitious aids to which most publications of the present day owe their success—the previous heralding and subsequent puffing which are usually in requisition at a literary début—without the prestige of rank or official distinction on the part of its author—the ‘Vade-Mecum’ has secured an extraordinary popularity in Great Britain, and the most flattering commendations of medical critics; such testimony to its intrinsic merits has encouraged its republication here.”—_Preface to the American Edition._

PG72894.B01445
DR. DUNDAS,

PG72894.B01446
PHYSICIAN TO THE NORTHERN HOSPITAL, LIVERPOOL, ETC.

PG72894.B01447
SKETCHES OF BRAZIL; including New Views on Tropical and European Fever; with Remarks on a Premature Decay of the System, incident to Europeans on their Return from Hot Climates. Post 8vo. cloth, 9_s._

PG72894.B01448
DR. JAMES F. DUNCAN.

PG72894.B01449
POPULAR ERRORS ON THE SUBJECT OF INSANITY EXAMINED AND EXPOSED. Foolscap 8vo. cloth, 4_s._ 6_d._

PG72894.B01450
DR. JOHN C. EGAN,

PG72894.B01451
FORMERLY SURGEON TO THE WESTMORELAND LOCK HOSPITAL.

PG72894.B01452
SYPHILITIC DISEASES: THEIR PATHOLOGY, DIAGNOSIS, AND TREATMENT: including Experimental Researches on Inoculation, as a Differential Agent in Testing the Character of these Affections. 8vo. cloth, 9_s._

PG72894.B01453
“This is an interesting practical work, and as such it is worthy of the attention of the profession.”—_Lancet._

PG72894.B01454
SIR JAMES EYRE, M.D.

PG72894.B01455
I.

PG72894.B01456
THE STOMACH AND ITS DIFFICULTIES. Second Edition. Post 8vo. cloth, 5_s._

PG72894.B01457
II.

PG72894.B01458
PRACTICAL REMARKS ON SOME EXHAUSTING DISEASES. Second Edition. Post 8vo. cloth, 4_s._ 6_d._

PG72894.B01459
MR. FERGUSSON, F.R.S.,

PG72894.B01460
PROFESSOR OF SURGERY IN KING’S COLLEGE, LONDON.

PG72894.B01461
A SYSTEM OF PRACTICAL SURGERY; with numerous Illustrations on Wood. Third Edition. Fcap. 8vo. cloth, 12_s._ 6_d._

PG72894.B01462
DR. ERNEST VON FEUCHTERSLEBEN.

PG72894.B01463
DIETETICS OF THE SOUL. Translated from the Seventh German Edition. Foolscap 8vo. cloth, 5_s._

PG72894.B01464
DR. D. J. T. FRANCIS.

PG72894.B01465
CHANGE OF CLIMATE; considered as a Remedy in Dyspeptic, Pulmonary, and other Chronic Affections; with an Account of the most Eligible Places of Residence for Invalids in Spain, Portugal, Algeria, &c., at different Seasons of the Year; and an Appendix on the Mineral Springs of the Pyrenees, Vichy, and Aix les Bains. Post 8vo. cloth, 8_s._ 6_d._

PG72894.B01466
“Proceeds from the pen of a well informed practitioner and an accomplished gentleman, well acquainted with the subject upon which he treats.”—_The Lancet._

PG72894.B01467
“A very meritorious production.”—_Medical Times and Gazette._

PG72894.B01468
C. REMIQIUS FRESENIUS.

PG72894.B01469
ELEMENTARY INSTRUCTION IN CHEMICAL ANALYSIS, AS PRACTISED IN THE LABORATORY OF GIESSEN. Edited by LLOYD BULLOCK, late Student at Giessen.

PG72894.B01470
QUALITATIVE; Third Edition. 8vo. cloth, 9_s._

PG72894.B01471
QUANTITATIVE. Second Edition. 8vo. cloth, 15_s._

PG72894.B01472
“I can confidently recommend this work, from my own personal experience, to all who are desirous of obtaining instruction in analysis, for its simplicity and usefulness, and the facility with which it may be apprehended.”—_Baron Liebig._

PG72894.B01473
MR. FRENCH, F.R.C.S.,

PG72894.B01474
SURGEON TO THE INFIRMARY OF ST. JAMES’S, WESTMINSTER.

PG72894.B01475
THE NATURE OF CHOLERA INVESTIGATED. Second Edition. 8vo. cloth, 4_s._

PG72894.B01476
“This is one of the best treatises on cholera which we have lately read. His theory of the nature of cholera is ingenious, and is argued with acuteness.”—_Medical Times and Gazette._

PG72894.B01477
MR. FOWNES, PH.D., F.R.S.

PG72894.B01478
I.

PG72894.B01479
A MANUAL OF CHEMISTRY; with numerous Illustrations on Wood. Fifth Edition. Fcap. 8vo. cloth, 12_s._ 6_d._

PG72894.B01480
Edited by H. BENCE JONES, M.D., F.R.S., and A. W. HOFMANN, PH.D., F.R.S.

PG72894.B01481
“An admirable exposition of the present state of chemical science, simply and clearly written, and displaying a thorough practical knowledge of its details, as well as a profound acquaintance with its principles. The illustrations, and the whole getting-up of the book, merit our highest praise.”—_British and Foreign Medical Review._

PG72894.B01482
II.

PG72894.B01483
CHEMISTRY, AS EXEMPLIFYING THE WISDOM AND BENEFICENCE OF GOD. Second Edition. Fcap. 8vo. cloth, 4_s._ 6_d._

PG72894.B01484
III.

PG72894.B01485
INTRODUCTION TO QUALITATIVE ANALYSIS. Post 8vo. cloth, 2_s._

PG72894.B01486
IV.

PG72894.B01487
CHEMICAL TABLES. Folio, price 2_s._ 6_d._

PG72894.B01488
DR. FULLER,

PG72894.B01489
ASSISTANT PHYSICIAN TO ST. GEORGE’S HOSPITAL.

PG72894.B01490
ON RHEUMATISM, RHEUMATIC GOUT, AND SCIATICA: their Pathology, Symptoms, and Treatment. 8vo. cloth, 12_s._ 6_d._

PG72894.B01491
“We have been much pleased by the perusal of Dr. Fuller’s interesting volume. The views it enforces are sound and judicious, and are based upon that foundation on which all doctrines in medicine ought to rest—namely, clinical experience.”—_Medical Times and Gazette._

PG72894.B01492
“We would particularly recommend a careful perusal of Dr. Fuller’s pages, for in them will be found much sound and practical information, drawn from a large field of observation and experience.”—_Lancet._

PG72894.B01493
DR. GAIRDNER.

PG72894.B01494
ON GOUT; its History, its Causes, and its Cure. Third Edition. Post 8vo. cloth, 8_s._ 6_d._

PG72894.B01495
“No one can rise from the perusal of Dr. Gairdner’s treatise without the conviction that it contains a trustworthy history of the disease,—that it conveys sound directions for treatment,—and that it is the work of a physician who, amid the wearying toil of a large and successful practice, keeps himself thoroughly conversant with all the recent advances in physiological science, both at home and abroad.”—_Medical Times._

PG72894.B01496
MR. GALLOWAY,

PG72894.B01497
I.

PG72894.B01498
THE FIRST STEP IN CHEMISTRY. Post 8vo. cloth, 3_s._

PG72894.B01499
“We heartily commend this unpretending and useful work to the heads of scholastic establishments, and to others who are anxious to initiate their pupils into the principles of a most fascinating and most useful branch of human knowledge.”—_London Journal of Medicine._

PG72894.B01500
II.

PG72894.B01501
A MANUAL OF QUALITATIVE ANALYSIS. Post 8vo. cloth, 4_s._

PG72894.B01502
“This is really a valuable little book. We have not for a long time met with an introductory Manual which so completely fulfils its intention.”—_Athenæum._

PG72894.B01503
MR. ROBERT GARNER,

PG72894.B01504
SURGEON TO THE NORTH STAFFORDSHIRE INFIRMARY, ETC.

PG72894.B01505
EUTHERAPEIA; or, AN EXAMINATION OF THE PRINCIPLES OF MEDICAL SCIENCE, including Researches on the Nervous System. Illustrated with 9 Engravings on Copper, and Engravings on Wood. 8vo. cloth, 8_s._

PG72894.B01506
DR. GAVIN.

PG72894.B01507
ON FEIGNED AND FACTITIOUS DISEASES, chiefly of Soldiers and Seamen; on the means used to simulate or produce them, and on the best Modes of discovering Impostors; being the Prize Essay in the Class of Military Surgery in the University of Edinburgh. 8vo. cloth, 9_s._

PG72894.B01508
DR. GLOVER.

PG72894.B01509
ON THE PATHOLOGY AND TREATMENT OF SCROFULA; being the Forthergillian Prize Essay for 1846. With Plates. 8vo. cloth, 10_s._ 6_d._

PG72894.B01510
DR. GRANVILLE, F.R.S.

PG72894.B01511
ON SUDDEN DEATH. Post 8vo. cloth, 7_s._

PG72894.B01512
“Abounding in illustrations, which are often striking and appropriate.”—_Medical Times and Gazette._

PG72894.B01513
“The entire question is considered by the author in a philosophic style, and the facts contained presented in eloquent language; indeed, we have been charmed with Dr. Granville’s book.”—_Dublin Quarterly Journal._

PG72894.B01514
MR. GRAY, M.R.C.S.

PG72894.B01515
PRESERVATION OF THE TEETH indispensable to Comfort and Appearance, Health, and Longevity. 18mo. cloth, 3_s._

PG72894.B01516
“This small volume will be found interesting and useful to every medical practitioner, the heads of families, and those who have the care of children; while persons who have lost teeth will be made aware of the cause, and enabled to judge for themselves of the rationale of the principles pointed out for their replacement, and preservation of the remainder.”

PG72894.B01517
MR. GRIFFITHS.

PG72894.B01518
CHEMISTRY OF THE FOUR SEASONS—Spring, Summer, Autumn, Winter. Illustrated with Engravings on Wood. Second Edition. Foolscap 8vo. cloth, 7_s._ 6_d._

PG72894.B01519
“This volume combines, in an eminent degree, amusement with instruction. The laws and properties of those wonderful and mysterious agents—heat, light, electricity, galvanism, and magnetism, are appropriately discussed, and their influence on vegetation noticed. We would especially recommend it to youths commencing the study of medicine, both as an incentive to their natural curiosity, and an introduction to several of those branches of science which will necessarily soon occupy their attention.”—_British and Foreign Medical Review._

PG72894.B01520
DR. GULLY.

PG72894.B01521
I.

PG72894.B01522
THE WATER CURE IN CHRONIC DISEASE: an Exposition of the Causes, Progress, and Terminations of various Chronic Diseases of the Viscera, Nervous System, and Limbs, and of their Treatment by Water and other Hygienic Means. Fourth Edition. Foolscap 8vo. sewed, 2_s._ 6_d._

PG72894.B01523
II.

PG72894.B01524
THE SIMPLE TREATMENT OF DISEASE; deduced from the Methods of Expectancy and Revulsion. 18mo. cloth, 4_s._

PG72894.B01525
DR. GUY,

PG72894.B01526
PHYSICIAN TO KING’S COLLEGE HOSPITAL.

PG72894.B01527
HOOPER’S PHYSICIAN’S VADE-MECUM; OR, MANUAL OF THE PRINCIPLES AND PRACTICE OF PHYSIC. New Edition, considerably enlarged, and re-written. Foolscap 8vo. cloth, 12_s._ 6_d._

PG72894.B01528
DR. MARSHALL HALL, F.R.S.

PG72894.B01529
PRACTICAL OBSERVATIONS AND SUGGESTIONS IN MEDICINE. Post 8vo. cloth, 8_s._ 6_d._

PG72894.B01530
DITTO. Second Series. Post 8vo. cloth, 8_s._ 6_d._

PG72894.B01531
“The work affords fruits of the mental energy of an observer who is anything but content to follow the beaten path where more successful roads lie open before him. It is not a work of speculative dreamy philosophy, but of sound practical common sense, and as such will recommend itself to the judicious practitioner.”—_Northern Journal of Medicine._

PG72894.B01532
MR. HARE, M.R.C.S.

PG72894.B01533
PRACTICAL OBSERVATIONS ON THE PREVENTION, CAUSES, AND TREATMENT OF CURVATURES OF THE SPINE; with Engravings. Third Edition. 8vo. cloth, 6_s._

PG72894.B01534
MR. HARRISON, F.R.C.S.

PG72894.B01535
THE PATHOLOGY AND TREATMENT OF STRICTURE OF THE URETHRA. 8vo. cloth, 7_s._ 6_d._

PG72894.B01536
MR. JAMES B. HARRISON, F.R.C.S.

PG72894.B01537
ON THE CONTAMINATION OF WATER BY THE POISON OF LEAD, and its Effects on the Human Body. Foolscap 8vo. cloth, 3_s._ 6_d._

PG72894.B01538
MR. HIGGINBOTTOM, F.R.C.S.

PG72894.B01539
I.

PG72894.B01540
ADDITIONAL OBSERVATIONS ON THE NITRATE OF SILVER; with full Directions for its Use as a Therapeutic Agent. 8vo. 2_s._ 6_d._

PG72894.B01541
II.

PG72894.B01542
AN ESSAY ON THE USE OF THE NITRATE OF SILVER IN THE CURE OF INFLAMMATION, WOUNDS, AND ULCERS. Second Edition. Price 5_s._

PG72894.B01543
MR. F. W. HEADLAND. B.A., M.R.C.S.

PG72894.B01544
ON THE ACTION OE MEDICINES. Being the Prize Essay to which the Medical Society of London awarded the Fothergillian Gold Medal for 1852. Second Edition. _In the Press._

PG72894.B01545
MR. JOHN HILTON, F.R.S.,

PG72894.B01546
SURGEON TO GUY’S HOSPITAL.

PG72894.B01547
ON THE DEVELOPMENT AND DESIGN OF CERTAIN PORTIONS OF THE CRANIUM. Illustrated with Plates in Lithography. 8vo. cloth, 6_s._

PG72894.B01548
DR. HINDS.

PG72894.B01549
THE HARMONIES OF PHYSICAL SCIENCE IN RELATION TO THE HIGHER SENTIMENTS; with Observations on Medical Studies, and on the Moral and Scientific Relations of Medical Life. Post 8vo., cloth, 5_s._

PG72894.B01550
MR. C. HOLTHOUSE,

PG72894.B01551
ASSISTANT SURGEON AND LECTURER ON ANATOMY TO THE WESTMINSTER HOSPITAL.

PG72894.B01552
LECTURES ON STRABISMUS, delivered at the Westminster Hospital. 8vo. cloth, 4_s._

PG72894.B01553
“We have perused Mr. Holthouse’s lectures with much pleasure. They contain not only an accurate exposition of the principles upon which the treatment of the disorder should be conducted, but also various original suggestions, which will prove useful to the oculist or surgeon in performing the operation; for, with all its improvements, it has not hitherto proved so invariably satisfactory as might be desired.”—_Edinburgh Monthly Journal._

PG72894.B01554
DR. W. CHARLES HOOD,

PG72894.B01555
RESIDENT PHYSICIAN AND SUPERINTENDENT OF BETHLEM HOSPITAL.

PG72894.B01556
SUGGESTIONS FOR THE FUTURE PROVISION OF CRIMINAL LUNATICS. 8vo. cloth, 5_s._ 6_d._

PG72894.B01557
DR. HENRY HUNT,

PG72894.B01558
MEMBER OF THE ROYAL COLLEGE OF PHYSICIANS, LONDON.

PG72894.B01559
ON HEARTBURN AND INDIGESTION. 8vo. cloth, 5_s._

PG72894.B01560
MR. THOMAS HUNT, M.R.C.S.

PG72894.B01561
THE PATHOLOGY AND TREATMENT OF CERTAIN DISEASES OF THE SKIN, generally pronounced Intractable. Illustrated by upwards of Forty Cases. 8vo. cloth, 6_s._

PG72894.B01562
“We have found Mr. Hunt’s practice exceedingly successful in severe obstinate cases.”—_Braithwaite’s Retrospect of Medicine._

PG72894.B01563
“The facts and views he brings forward eminently merit attention.”—_British and Foreign Medical Review._

PG72894.B01564
DR. ARTHUR JACOB, F.R.C.S,

PG72894.B01565
PROFESSOR OF ANATOMY AND PHYSIOLOGY IN THE ROYAL COLLEGE OF SURGEONS IN IRELAND.

PG72894.B01566
A TREATISE ON THE INFLAMMATIONS OF THE EYE-BALL. Foolscap 8vo. cloth, 5_s._

PG72894.B01567
It includes the Description and Treatment of the Idiopathic, Scrofulous, Rheumatic, Arthritic, Syphilitic, Gonorrhœal, Post-febrile, and Neuralgic Species; as well as the circumscribed Inflammations of the Cornea, Membrane of the Aqueous Humour, Choroid, Crystalline Lens and Retina; and also Inflammation from Injury, with the Sympathetic and Phlebitic varieties.

PG72894.B01568
DR. HANDFIELD JONES, F.R.S., & DR. EDWARD H. SIEVEKING.

PG72894.B01569
A MANUAL OF PATHOLOGICAL ANATOMY. Illustrated with numerous Engravings on Wood. Foolscap 8vo. cloth, 12_s._ 6_d._

PG72894.B01570
⁂ Mr. Churchill is happy to announce this additional volume to his Manuals, and believes it will be found fully to sustain the high reputation which the Series has attained.

PG72894.B01571
MR. WHARTON JONES, F.R.S.,

PG72894.B01572
PROFESSOR OF OPHTHALMIC MEDICINE AND SURGERY IN UNIVERSITY COLLEGE.

PG72894.B01573
I.

PG72894.B01574
A MANUAL OF THE PRINCIPLES AND PRACTICE OF OPHTHALMIC MEDICINE AND SURGERY; illustrated with 102 Engravings, plain and coloured. Foolscap 8vo. cloth, 12_s._ 6_d._

PG72894.B01575
“We can assure students that they cannot meet with a hand-book on this subject that is more ably or more carefully written.”—_Medical Gazette._

PG72894.B01576
“We entertain little doubt that this work will become a manual for daily reference and consultation by the student and general practitioner.”—_British and Foreign Medical Review._

PG72894.B01577
II.

PG72894.B01578
THE WISDOM AND BENEFICENCE OF THE ALMIGHTY, AS DISPLAYED IN THE SENSE OF VISION; being the Actonian Prize Essay for 1851. With Illustrations on Steel and Wood. Foolscap 8vo. cloth, 4_s._ 6_d._

PG72894.B01579
“A fit sequel to the Bridgewater Treatises: it is philosophically and admirably written.”—_Literary Gazette._

PG72894.B01580
“This treatise resembles in style of treatment the famous Bridgewater Treatises.”—_Athenæum._

PG72894.B01581
DR. BENCE JONES, F.R.S.

PG72894.B01582
ON ANIMAL CHEMISTRY, in its relation to STOMACH and RENAL DISEASES. 8vo. cloth, 6_s._

PG72894.B01583
“The work of Dr. Bence Jones is one of the most philosophical and practical which has issued from the press for many years past.”—_Lancet._

PG72894.B01584
“Dr. Bence Jones is already favourably known as the author of works and papers on animal chemistry, and this contribution to his favourite science is calculated to extend his reputation as an able chemist and sound physician.”—_Monthly Medical Journal._

PG72894.B01585
MR. KNAGGS.

PG72894.B01586
UNSOUNDNESS OF MIND CONSIDERED IN RELATION TO THE QUESTION OF RESPONSIBILITY IN CRIMINAL CASES. 8vo. cloth, 4_s._ 6_d._

PG72894.B01587
MR. LAWRENCE, F.R.S.

PG72894.B01588
A TREATISE ON RUPTURES. The Fifth Edition, considerably enlarged. 8vo. cloth, 16_s._

PG72894.B01589
“It must be superfluous to express our opinion of its value to the surgical practitioner. As a treatise on hernia, presenting a complete view of the literature of the subject, it stands in the first rank.”—_Edinburgh Medical and Surgical Journal._

PG72894.B01590
MR. LAWRENCE, M.R.C.S.

PG72894.B01591
THE DIAGNOSIS OF SURGICAL CANCER. The Liston Prize Essay for 1854. Plates, 8vo. cloth, 4_s._ 6_d._

PG72894.B01592
DR. HUNTER LANE, F.L.S.

PG72894.B01593
A COMPENDIUM OF MATERIA MEDICA AND PHARMACY; adapted to the London Pharmacopœia, 1851, embodying all the new French, American, and Indian Medicines, and also comprising a Summary of Practical Toxicology. Second Edition. 24mo. cloth, 5_s._ 6_d._

PG72894.B01594
MR. EDWIN LEE.

PG72894.B01595
I.

PG72894.B01596
THE WATERING PLACES OF ENGLAND, CONSIDERED with Reference to their Medical Topography. Third Edition. Foolscap 8vo. cloth, 5_s._ 6_d._

PG72894.B01597
II.

PG72894.B01598
THE BATHS OF FRANCE, CENTRAL GERMANY, &c. Third Edition. Post 8vo. cloth, 6_s._ 6_d._

PG72894.B01599
III.

PG72894.B01600
THE BATHS OF RHENISH GERMANY. Post 8vo. 3_s._

PG72894.B01601
MR. HENRY LEE, F.R.C.S.,

PG72894.B01602
SURGEON TO THE LOCK HOSPITAL.

PG72894.B01603
PATHOLOGICAL AND SURGICAL OBSERVATIONS; including an Essay on the Surgical Treatment of Hemorrhoidal Tumors. 8vo. cloth, 7_s._ 6_d._

PG72894.B01604
DR. ROBERT LEE, F.R.S.

PG72894.B01605
I.

PG72894.B01606
CLINICAL REPORTS OF OVARIAN AND UTERINE DISEASES, with Commentaries. Foolscap 8vo. cloth, 6_s._ 6_d._

PG72894.B01607
II.

PG72894.B01608
CLINICAL MIDWIFERY; comprising the Histories of 545 Cases of Difficult, Preternatural, and Complicated Labour, with Commentaries. Second Edition. Foolscap 8vo. cloth, 5_s._

PG72894.B01609
“More instructive to the juvenile practitioner than a score of systematic works.”—_Lancet._

PG72894.B01610
“Will be consulted by every accoucheur who practises his art with the zeal which it merits.”—_Medical Gazette._

PG72894.B01611
“A storehouse of valuable facts and precedents.”—_American Journal of the Medical Sciences._

PG72894.B01612
III.

PG72894.B01613
PRACTICAL OBSERVATIONS ON DISEASES OF THE UTERUS. With coloured Plates. Two Parts. Imperial 4to., 7_s._ 6_d._ each Part.

PG72894.B01614
MR. LISTON, F.R.S.

PG72894.B01615
PRACTICAL SURGERY. Fourth Edition. 8vo. cloth, 22_s._

PG72894.B01616
LONDON MEDICAL SOCIETY OF OBSERVATION.

PG72894.B01617
WHAT TO OBSERVE AT THE BED-SIDE, AND AFTER DEATH. Published by Authority. Second Edition. Foolscap 8vo. cloth, 4_s._ 6_d._

PG72894.B01618
MR. EDWARD F. LONSDALE,

PG72894.B01619
SURGEON TO THE ROYAL ORTHOPÆDIC HOSPITAL.

PG72894.B01620
OBSERVATIONS ON THE TREATMENT OF LATERAL CURVATURE OF THE SPINE. Second Edition. 8vo. cloth, 6_s._

PG72894.B01621
“We would wish that this treatise on lateral curvature of the spine were generally read, since much ignorance prevails concerning the subject, and, consequently, it presents an ample field for the quack, and an opprobrium to the profession.”—_Lancet._

PG72894.B01622
M. LUGOL.

PG72894.B01623
ON SCROFULOUS DISEASES. Translated from the French, with Additions by W. H. RANKING, M.D., Physician to the Suffolk General Hospital. 8vo. cloth, 10_s._ 6_d._

PG72894.B01624
MR. JOSEPH MACLISE, F.R.C.S.

PG72894.B01625
SURGICAL ANATOMY. A Series of Dissections, illustrating the Principal Regions of the Human-Body.

PG72894.B01626
The singular success of this Work exhausted the First Edition of 1000 Copies within six months of its completion.

PG72894.B01627
The Second Edition, now in course of publication, Fasciculi I. to VIII. Imperial folio, 5_s._ each.

PG72894.B01628
MR. MACILWAIN,

PG72894.B01629
ON TUMOURS, THEIR GENERAL NATURE AND TREATMENT. 8vo. cloth, 5_s._

PG72894.B01630
DR. MAYNE.

PG72894.B01631
AN EXPOSITORY LEXICON OF THE TERMS, ANCIENT AND MODERN, IN MEDICAL AND GENERAL SCIENCE, including a complete MEDICAL AND MEDICO-LEGAL VOCABULARY, and presenting the correct Pronunciation, Derivation, Definition, and Explanation of the Names, Analogues, Synonymes, and Phrases (in English, Latin, Greek, French, and German) employed in Science and connected with Medicine. Parts I. to IV., price 5_s._ each.

PG72894.B01632
DR. WM. H. MADDEN.

PG72894.B01633
THOUGHTS ON PULMONARY CONSUMPTION; with an Appendix on the Climate of Torquay. Post 8vo. cloth, 5_s._

PG72894.B01634
“This work is the product of a mind, sensible alike to the value of carefully observed facts, and of philosophical reasoning. We cordially recommend our readers to peruse this instructive treatise; the views brought forward are such as to merit careful attention from every candid pathological inquirer.”—_London Journal of Medicine._

PG72894.B01635
DR. MARTIN.

PG72894.B01636
THE UNDERCLIFF, ISLE OF WIGHT: its Climate, History, and Natural Productions. Post 8vo. cloth, 10_s._ 6_d._

PG72894.B01637
“Dr. Martin has rendered good service to patients and practitioners by the publication of this work.”—_Medical Gazette._

PG72894.B01638
“A great variety of information, collected with much labour, and so agreeably placed before the general and professional reader, speak highly for the seal and ability of the author.”—_Lancet._

PG72894.B01639
DR. MASON,

PG72894.B01640
INVENTOR OF MASON’S HYDROMETER.

PG72894.B01641
ON THE CLIMATE AND METEOROLOGY OF MADEIRA: Edited by JAMES SHERIDAN KNOWLES; to which are attached a Review of the State of Agriculture and of the Tenure of Land, by GEORGE PEACOCK, D.D., F.R.S.; and an Historical and Descriptive Account of the Island, and Guide to Visitors, by JOHN DRIVER, Consul for Greece, Madeira. 8vo. cloth, 18_s._; royal 8vo. £1. 11_s._ 6_d._

PG72894.B01642
DR. MASSY,

PG72894.B01643
4TH LIGHT DRAGOONS.

PG72894.B01644
ON THE EXAMINATION OF RECRUITS; intended for the Use of Young Medical Officers on Entering the Army. 8vo. cloth, 5_s._

PG72894.B01645
DR. CHARLES D. MEIGS,

PG72894.B01646
PROFESSOR OF MIDWIFERY AND THE DISEASES OF WOMEN AND CHILDREN IN JEFFERSON MEDICAL COLLEGE, U.S.

PG72894.B01647
A TREATISE ON ACUTE AND CHRONIC DISEASES OF THE NECK OF THE UTERUS. With numerous Plates, coloured and plain, 8vo. cloth, 25_s._

PG72894.B01648
MR. JOHN L. MILTON, M.R.C.S.

PG72894.B01649
PRACTICAL OBSERVATIONS ON A NEW WAY OF TREATING GONORRHŒA. With some Remarks on the Cure of Inveterate Cases. 8vo. cloth, 5_s._

PG72894.B01650
DR. MONRO,

PG72894.B01651
FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS.

PG72894.B01652
I.

PG72894.B01653
REMARKS ON INSANITY: its Nature and Treatment. 8vo. cloth, 6_s._

PG72894.B01654
“We see throughout its pages evidences of a highly cultivated mind without any assumption, and an honest spirit of inquiry marked by great seal and an earnest desire to afford a helping hand to benefit the condition of the insane.”—_Dublin Quarterly Journal._

PG72894.B01655
II.

PG72894.B01656
AN ESSAY ON STAMMERING. 8vo. 2_s._ 6_d._

PG72894.B01657
III.

PG72894.B01658
REFORM IN PRIVATE LUNATIC ASYLUMS. 8vo. cloth, 4_s._

PG72894.B01659
DR. MILLINGEN.

PG72894.B01660
ON THE TREATMENT AND MANAGEMENT OF THE INSANE; with Considerations on Public and Private Lunatic Asylums. 18mo. cloth, 4_s._ 6_d._

PG72894.B01661
“Dr. Millingen, in one small pocket volume, has compressed more real solid matter than could be gleaned out of any dosen of octavos on the same subject. We recommend this vade-mecum as the best thing of the kind we ever perused.”—_Dr. Johnson’s Review._

PG72894.B01662
DR. NOBLE.

PG72894.B01663
I.

PG72894.B01664
ELEMENTS OF PSYCHOLOGICAL MEDICINE: AN INTRODUCTION TO THE PRACTICAL STUDY OF INSANITY. Post 8vo. cloth, 7_s._ 6_d._

PG72894.B01665
II.

PG72894.B01666
THE BRAIN AND ITS PHYSIOLOGY. Post 8vo. cloth, 6_s._

PG72894.B01667
DR. J. NOTTINGHAM,

PG72894.B01668
SURGEON TO THE ST. ANNE’S EYE AND EAR INSTITUTION, LIVERPOOL.

PG72894.B01669
PRACTICAL OBSERVATIONS ON CONICAL CORNEA, AND on the Short Sight, and other Defects of Vision connected with it. 8vo. cloth, 6_s._

PG72894.B01670
MR. NOURSE, M.R.C.S.

PG72894.B01671
TABLES FOR STUDENTS. Price One Shilling.

PG72894.B01672
1. Divisions and Classes of the Animal Kingdom.

PG72894.B01673
2. Classes and Orders of the Vertebrate Sub-kingdom.

PG72894.B01674
3. Classes of the Vegetable Kingdom, according to the Natural and Artificial Systems.

PG72894.B01675
4. Table of the Elements, with their Chemical Equivalents and Symbols.

PG72894.B01676
MR. NUNNELEY.

PG72894.B01677
A TREATISE ON THE NATURE, CAUSES, AND TREATMENT OF ERYSIPELAS. 8vo. cloth, 10_s._ 6_d._

PG72894.B01678
=Orford Editions.=—Edited by DR. GREENHILL.

PG72894.B01679
I. ADDRESS TO A MEDICAL STUDENT. Second Edition, 18mo. cloth, 2_s._ 6_d._

PG72894.B01680
II. PRAYERS FOR THE USE OF THE MEDICAL PROFESSION. Second Edition, cloth, 1_s._ 6_d._

PG72894.B01681
III. LIFE OF SIR JAMES STONHOUSE, BART., M.D. Cloth, 4_s._ 6_d._

PG72894.B01682
IV. ANECDOTA SYDENHAMIANA. Second Edition, 18mo. 2_s._

PG72894.B01683
V. LIFE OF THOMAS HARRISON BURDER, M.D. 18mo. cloth, 4_s._

PG72894.B01684
VI. BURDER’S LETTERS FROM A SENIOR TO A JUNIOR PHYSICIAN, ON PROMOTING THE RELIGIOUS WELFARE OF HIS PATIENTS. 18mo. sewed, 6_d._

PG72894.B01685
VII. LIFE OF GEORGE CHEYNE, M.D. 18mo. sewed, 2_s._ 6_d._

PG72894.B01686
VIII. HUFELAND ON THE RELATIONS OF THE PHYSICIAN TO THE SICK, TO THE PUBLIC, AND TO HIS COLLEAGUES. 18mo. sewed, 9_d._

PG72894.B01687
IX. GISBORNE ON THE DUTIES OF PHYSICIANS. 18mo. sewed, 1_s._

PG72894.B01688
X. LIFE OF CHARLES BRANDON TRYE. 18mo. sewed, 1_s._

PG72894.B01689
XI. PERCIVAL’S MEDICAL ETHICS. Third Edition, 18mo. cloth, 3_s._

PG72894.B01690
XII. CODE OF ETHICS OF THE AMERICAN MEDICAL ASSOCIATION. 8_d._

PG72894.B01691
XIII. WARE ON THE DUTIES AND QUALIFICATIONS OF PHYSICIANS. 8_d._

PG72894.B01692
XIV. MAURICE ON THE RESPONSIBILITIES OF MEDICAL STUDENTS. 9_d._

PG72894.B01693
XV. FRASER’S QUERIES IN MEDICAL ETHICS. 9_d._

PG72894.B01694
MR. PAGET,

PG72894.B01695
LECTURER ON PHYSIOLOGY AT ST. BARTHOLOMEW’S HOSPITAL.

PG72894.B01696
A DESCRIPTIVE CATALOGUE OF THE ANATOMICAL MUSEUM OF ST. BARTHOLOMEW’S HOSPITAL. VOL. I. Morbid Anatomy. 8vo. cloth, 5_s._

PG72894.B01697
DITTO. VOL. II. Natural and Congenitally Malformed Structures, and Lists of the Models, Casts, Drawings, and Diagrams. 5_s._

PG72894.B01698
MR. LANGSTON PARKER,

PG72894.B01699
SURGEON TO QUEEN’S HOSPITAL, BIRMINGHAM.

PG72894.B01700
THE MODERN TREATMENT OF SYPHILITIC DISEASES, both Primary and Secondary; comprising the Treatment of Constitutional and Confirmed Syphilis, by a safe and successful Method. Third Edition, 8vo. cloth, 10_s._

PG72894.B01701
DR. THOMAS B. PEACOCK, M.D.,

PG72894.B01702
ASSISTANT PHYSICIAN TO ST. THOMAS’S HOSPITAL, ETC.

PG72894.B01703
ON THE INFLUENZA, OR EPIDEMIC CATARRHAL FEVER OF 1847–8. 8vo. cloth, 5_s._ 6_d._

PG72894.B01704
“We know of no work which contains a more complete description of the disease, and its complications.”—_Lancet._

PG72894.B01705
DR. PEREIRA, F.R.S.

PG72894.B01706
SELECTA E PRÆSCRIPTIS. Twelfth Edition. 24mo. cloth, 5_s._

PG72894.B01707
MR. PETTIGREW, F.R.S.

PG72894.B01708
ON SUPERSTITIONS connected with the History and Practice of Medicine and Surgery. 8vo. cloth, 7_s._

PG72894.B01709
“The anecdotal character of this work cannot fail to render it generally acceptable; while the good sense that pervades it, as distant from empty declamation as from absurd credulity, stamps it with true historic value.”—_Gentleman’s Magazine._

PG72894.B01710
MR. PIRRIE, F.R.S.E.,

PG72894.B01711
REGIUS PROFESSOR OF SURGERY IN THE UNIVERSITY OF ABERDEEN.

PG72894.B01712
THE PRINCIPLES AND PRACTICE OF SURGERY. With numerous Engravings on Wood. 8vo. cloth, 21_s._

PG72894.B01713
“Professor Pirrie has produced a work which is equally worthy of praise as an admirable text-book for surgical pupils, and as a book of reference for experienced practitioners. We rejoice to find that the chair of surgery is so ably filled in Aberdeen.... Professor Pirrie’s work is clear and trustworthy. All recent improvements, real or pretended, are judiciously and candidly discussed.”—_London Journal of Medicine._

PG72894.B01714
PHARMACOPŒIA COLLEGII REGALIS MEDICORUM LONDINENSIS. 8vo. cloth, 9_s._; or 24mo. 5_s._

PG72894.B01715
IMPRIMATUR.

PG72894.B01716
Hic liber, cui titulus, PHARMACOPŒIA COLLEGII REGALIS MEDICORUM LONDINENSIS. Datum ex Ædibus Collegii in comitiis censoriis, Novembris Mensis 14^{to} 1850.

PG72894.B01717
JOHANNES AYRTON PARIS. _Præses._

PG72894.B01718
PROFESSORS PLATTNER & MUSPRATT.

PG72894.B01719
THE USE OF THE BLOWPIPE IN THE EXAMINATION OF MINERALS, ORES, AND OTHER METALLIC COMBINATIONS. Illustrated by numerous Engravings on Wood. Third Edition. 8vo. cloth, 10_s._ 6_d._

PG72894.B01720
⁂ This Edition has been most carefully revised by Professor MUSPRATT, and received from him considerable additions.

PG72894.B01721
THE PRESCRIBER’S PHARMACOPŒIA; containing all the Medicines in the London Pharmacopœia, arranged in Classes according to their Action, with their Composition and Doses. By a Practising Physician. Fourth Edition. 32mo. cloth, 2_s._ 6_d._; roan tuck (for the pocket), 3_s._ 6_d._

PG72894.B01722
“Never was half-a-crown better spent than in the purchase of this ‘_Thesaurus Medicaminum_.’ This little work, with our visiting-book and stethoscope, are our daily companions in the carriage.”—_Dr. Johnson’s Review._

PG72894.B01723
SIR WM. PYM, K.C.H.,

PG72894.B01724
INSPECTOR-GENERAL OF ARMY HOSPITALS.

PG72894.B01725
OBSERVATIONS UPON YELLOW FEVER, with a Review of “A Report upon the Diseases of the African Coast, by Sir WM. BURNETT and Dr. BRYSON,” proving its highly Contagious Powers. Post 8vo. 6_s._

PG72894.B01726
DR. RADCLIFFE,

PG72894.B01727
ASSISTANT PHYSICIAN TO THE WESTMINSTER HOSPITAL.

PG72894.B01728
I.

PG72894.B01729
EPILEPSY, AND OTHER AFFECTIONS OF THE NERVOUS SYSTEM which are marked by Tremor, Convulsion, or Spasm: their Pathology and Treatment. 8vo. cloth, 5_s._

PG72894.B01730
“This sketch will serve to make our readers aware of the important nature of the book under notice. Sufficient has been said to show the grounds upon which Dr. Radcliffe hopes to effect a complete revolution in all matters relating to the pathology and treatment of epilepsy and the cognate disorders, and to stimulate inquirers to read the book itself.”—_The Lancet._

PG72894.B01731
II.

PG72894.B01732
PROTEUS; OR, THE LAW OF NATURE. 8vo. cloth, 6_s._

PG72894.B01733
III.

PG72894.B01734
THE PHILOSOPHY OF VITAL MOTION. 8vo. cloth, 6_s._

PG72894.B01735
DR. F. H. RAMSBOTHAM,

PG72894.B01736
PHYSICIAN TO THE ROYAL MATERNITY CHARITY, ETC.

PG72894.B01737
THE PRINCIPLES AND PRACTICE OF OBSTETRIC MEDICINE AND SURGERY. Illustrated with One Hundred and Twenty Plates on Steel and Wood; forming one thick handsome volume. Third Edition. 8vo. cloth, 22_s._

PG72894.B01738
“Dr. Ramsbotham’s work is so well known, and so highly approved by the profession as a work of reference and authority in obstetric medicine and surgery, that we need do little more than direct the attention of our readers to the publication of a third edition. With regard to the engravings, they are so numerous, so well executed, and so instructive, that they are in themselves worth the whole cost of the book.”—_Medical Gazette._

PG72894.B01739
DR. RAMSBOTHAM,

PG72894.B01740
CONSULTING PHYSICIAN TO THE ROYAL MATERNITY CHARITY.

PG72894.B01741
PRACTICAL OBSERVATIONS ON MIDWIFERY, with a Selection of Cases. Second Edition. 8vo. cloth, 12_s._

PG72894.B01742
DR. RANKING & DR. RADCLIFFE.

PG72894.B01743
HALF-YEARLY ABSTRACT OF THE MEDICAL SCIENCES; being a Practical and Analytical Digest of the Contents of the Principal British and Continental Medical Works published in the preceding Half-Year; together with a Critical Report of the Progress of Medicine and the Collateral Sciences during the same period.

PG72894.B01744
Volumes I. to XX., 6_s._ 6_d._ each.

PG72894.B01745
“The sifting which the journals and other medical works undergo, and the judicious selection from their pages of points of practical interest, and of discoveries of importance in the collateral sciences, form an important part of the duty of the editor; and, after a careful examination of Dr. Ranking’s volumes, we are bound to state that the duty has been most ably performed.”—_Provincial Medical Journal._

PG72894.B01746
DR. DU BOIS REYMOND.

PG72894.B01747
ANIMAL ELECTRICITY; Edited by H. BENCE JONES, M.D., F.R.S. With Fifty Engravings on Wood. Foolscap 8vo. cloth, 6_s._

PG72894.B01748
“This small volume is a valuable addition to our scientific literature. Those who read with attention will learn many most important facts from this work, but it demands such attention.”—_Athenæum._

PG72894.B01749
“The name of M. Du Bois Reymond is probably known to most of our readers, as that of a zealous investigator into Animal Electricity. We have now had the opportunity of witnessing some of the most interesting of these experiments. We beg to tender our thanks to Dr. Bence Jones for this very seasonable publication, and for the very efficient mode in which he has performed the task.”—_Medico-Chirurgical Review._

PG72894.B01750
MR. EVANS RIADORE, F.R.C.S, F.L.S.

PG72894.B01751
I.

PG72894.B01752
ON SPINAL IRRITATION, THE SOURCE OF NERVOUSNESS, INDIGESTION, AND FUNCTIONAL DERANGEMENTS OF THE PRINCIPAL ORGANS OF THE BODY; with Cases, illustrating the Importance of attending to the peculiar Temperature of the Patient, and the most successful Mode of Treatment, and on the legitimate Remedial Use of Water. Post 8vo. cloth, 5_s._ 6_d._

PG72894.B01753
II.

PG72894.B01754
THE REMEDIAL INFLUENCE OF OXYGEN, NITROUS OXYDE, AND OTHER GASES, ELECTRICITY, AND GALVANISM. Post 8vo. cloth, 5_s._ 6_d._

PG72894.B01755
MR. ROBERTON,

PG72894.B01756
FORMERLY SENIOR SURGEON TO THE MANCHESTER AND SALFORD LYING-IN HOSPITAL.

PG72894.B01757
ON THE PHYSIOLOGY AND DISEASES OF WOMEN, AND ON PRACTICAL MIDWIFERY. 8vo. cloth, 12_s._

PG72894.B01758
“We honestly recommend this work to our readers as one calculated to interest them in the highest degree.”—_Provincial Medical and Surgical Journal._

PG72894.B01759
“We recommend this work very strongly to all engaged in obstetric practice, or interested in ethnological studies. It possesses practical utility and physiological interest, combined with the fruits of a large experience, great power of observation, and an extensive and varied erudition.”—_Medical Gazette._

PG72894.B01760
DR. W. H. ROBERTSON,

PG72894.B01761
PHYSICIAN TO THE BUXTON BATH CHARITY.

PG72894.B01762
I.

PG72894.B01763
THE NATURE AND TREATMENT OF GOUT. 8vo. cloth, 10_s._ 6_d._

PG72894.B01764
“We cannot conclude this notice of Dr. Robertson’s treatise without cordially recommending it as a sound and practical work, fitted for reference, both as a work of information on the subject and as a guide to practice.”—_Provincial Medical Journal._

PG72894.B01765
II.

PG72894.B01766
A TREATISE ON DIET AND REGIMEN. Fourth Edition. 2 vols. post 8vo. cloth, 12_s._

PG72894.B01767
“It is scarcely necessary that we should add our hearty recommendation of Dr. Robertson’s treatise, not merely to our medical readers, but to the public, over whom they have an influence. It is one of the few books which is legitimately adapted, both in subject and manner of treatment, to both classes.”—_British and Foreign Medico-Chirurgical Review._

PG72894.B01768
DR. ROTH.

PG72894.B01769
ON MOVEMENTS. An Exposition of their Principles and Practice, for the Correction of the Tendencies to Disease in Infancy, Childhood, and Youth, and for the Cure of many Morbid Affections in Adults. Illustrated with numerous Engravings on Wood. 8vo. cloth, 10_s._

PG72894.B01770
DR. ROWE, F.S.A.

PG72894.B01771
NERVOUS DISEASES, LIVER AND STOMACH COMPLAINTS, LOW SPIRITS, INDIGESTION, GOUT, ASTHMA, AND DISORDERS PRODUCED BY TROPICAL CLIMATES. With Cases. Thirteenth Edition. 8vo. 5_s._ 6_d._

PG72894.B01772
“Dr. Rowe, the first edition of whose work appeared in 1820, claims, with justice, a priority of authorship over many other writers in this field of inquiry.”—_Lancet._

PG72894.B01773
DR. ROYLE, F.R.S.

PG72894.B01774
A MANUAL OF MATERIA MEDICA AND THERAPEUTICS. With numerous Engravings on Wood. Second Edition. Fcap. 8vo. cloth, 12_s._ 6_d._

PG72894.B01775
“This is another of that beautiful and cheap series of Manuals published by Mr. Churchill. The execution of the woodcuts of plants, flowers, and fruits is admirable. The work is indeed a most valuable one.”—_British and Foreign Medical Review._

PG72894.B01776
DR. SHAPTER.

PG72894.B01777
I.

PG72894.B01778
THE CLIMATE OF THE SOUTH OF DEVON, AND ITS INFLUENCE UPON HEALTH. With short Accounts of Exeter, Torquay, Teignmouth, Dawlish, Exmouth, Sidmouth, &c. Illustrated with a Map geologically coloured. Post 8vo. cloth, 7_s._ 6_d._

PG72894.B01779
“This volume is far more than a guide-book. It contains much statistical information, with very minute local details, that may be advantageously consulted by the medical man before he recommends any specific residence in Devonshire to his patient.”—_Athenæum._

PG72894.B01780
II.

PG72894.B01781
THE HISTORY OF THE CHOLERA IN EXETER IN 1832. Illustrated with Map and Woodcuts. 8vo. cloth, 12_s._

PG72894.B01782
MR. SAVORY,

PG72894.B01783
MEMBER OF THE SOCIETY OF APOTHECARIES.

PG72894.B01784
A COMPENDIUM OF DOMESTIC MEDICINE, AND COMPANION TO THE MEDICINE CHEST; comprising Plain Directions for the Employment of Medicines, with their Properties and Doses, and Brief Descriptions of the Symptoms and Treatment of Diseases, and of the Disorders incidental to Infants and Children, with a Selection of the most efficacious Prescriptions. Intended as a Source of Easy Reference for Clergymen, and for Families residing at a Distance from Professional Assistance. Fourth Edition. 12mo. cloth, 5_s._

PG72894.B01785
MR. SHAW.

PG72894.B01786
THE MEDICAL REMEMBRANCER; OR, BOOK OF EMERGENCIES: in which are concisely pointed out the Immediate Remedies to be adopted in the First Moments of Danger from Poisoning, Drowning, Apoplexy, Burns, and other Accidents; with the Tests for the Principal Poisons, and other useful Information. Third Edition. 32mo. cloth, 2_s._ 6_d._

PG72894.B01787
“The plan of this little book is well conceived, and the execution corresponds thereunto. It costs little money, and will occupy little room; and we think no practitioner will regret being the possessor of what cannot fail, sooner or later, to be useful to him.”—_British and Foreign Medical Review._

PG72894.B01788
MR. SKEY, F.R.S.

PG72894.B01789
OPERATIVE SURGERY; with Illustrations engraved on Wood. 8vo. cloth, 18_s._

PG72894.B01790
“Mr. Skey’s work is a perfect model for the operating surgeon, who will learn from it not only when and how to operate, but some more noble and exalted lessons, which cannot fail to improve him as a moral and social agent.”—_Edinburgh Medical and Surgical Journal._

PG72894.B01791
“We pronounce Mr. Skey’s ‘Operative Surgery’ to be a work of the very highest importance—a work by itself. The correctness of our opinion we trustfully leave to the judgment of the profession.”—_Medical Gazette._

PG72894.B01792
DR. SPURGIN.

PG72894.B01793
LECTURES ON MATERIA MEDICA, AND ITS RELATIONS TO THE ANIMAL ECONOMY. Delivered before the Royal College of Physicians. 8vo. cloth, 5_s._ 6_d._

PG72894.B01794
“Dr. Spurgin has evidently devoted much time and labour to the composition of these lectures; and the result is, that he has produced one of the most philosophical essays on the subject of “Materia Medica” existing in the English language.”—_Psychological Journal._

PG72894.B01795
DR. W. TYLER SMITH,

PG72894.B01796
PHYSICIAN-ACCOUCHEUR TO ST. MARY’S HOSPITAL.

PG72894.B01797
I.

PG72894.B01798
THE PATHOLOGY AND TREATMENT OF LEUCORRHŒA. With Engravings on Wood. 8vo. cloth, 6_s._ 6_d._

PG72894.B01799
II.

PG72894.B01800
THE PERIODOSCOPE, a new Instrument for determining the Date of Labour, and other Obstetric Calculations, with an Explanation of its Uses, and an Essay on the Periodic Phenomena attending Pregnancy and Parturition. 8vo. cloth, 4_s._

PG72894.B01801
“We anticipate for the work that which it deserves for its novelty, ingenuity, and utility—a wide circulation. It should be in the hands of all medical men who practise midwifery.”—_Medical Gazette._

PG72894.B01802
DR. SNOW.

PG72894.B01803
ON THE MODE OF COMMUNICATION OF CHOLERA. Second Edition, much Enlarged, and Illustrated with Maps. 8vo. cloth, 7_s._

PG72894.B01804
MR. SQUIRE,

PG72894.B01805
CHEMIST ON HER MAJESTY’S ESTABLISHMENT.

PG72894.B01806
THE PHARMACOPŒIA, (LONDON, EDINBURGH, AND DUBLIN) arranged in a convenient TABULAR FORM, both to suit the Prescriber for comparison, and the Dispenser for compounding the formulæ; with Notes, Tests, and Tables. 8vo. cloth, 12_s._

PG72894.B01807
“Mr. Squire has rendered good service to all who either prescribe or dispense medicines by this work. He has succeeded in bringing together the similar formulæ for ready comparison and reference. The work offers a striking comment on the necessity of uniformity in the strength and preparation of all medicines which are used in the United Kingdom.”—_Lancet._

PG72894.B01808
“A very valuable work. Mr. Squire’s volume combines the formulæ of the three Pharmacopœias, and at one glance shows the difference of the official preparations of the three kingdoms.”—_Medical Times._

PG72894.B01809
“A most convenient and well-arranged work; it will be found of very great utility, both to the prescriber and to the dispenser.”—_Medical Gazette._

PG72894.B01810
J. STEPHENSON, M.D, & J. M. CHURCHILL, F.L.S.

PG72894.B01811
MEDICAL BOTANY; OR, ILLUSTRATIONS AND DESCRIPTIONS OF THE MEDICINAL PLANTS OF THE PHARMACOPŒIAS; comprising a popular and scientific Account of Poisonous Vegetables indigenous to Great Britain. Edited by GILBERT BURNETT, F.L.S., Professor of Botany in King’s College.

PG72894.B01812
In three handsome royal 8vo. volumes, illustrated by Two Hundred Engravings, beautifully drawn and coloured from nature, cloth lettered.

PG72894.B01813
_Reduced from £6. 6s. to £4._

PG72894.B01814
“The most complete and comprehensive work on Medical Botany.”—_Pharmaceutical Journal._

PG72894.B01815
“So high is our opinion of this work, that we recommend every student at college, and every surgeon who goes abroad, to have a copy, as one of the essential constituents of his library.”—_Dr. Johnson’s Medico-Chirurgical Review._

PG72894.B01816
DR. STEGGALL.

PG72894.B01817
STUDENTS’ BOOKS FOR EXAMINATION.

PG72894.B01818
I.

PG72894.B01819
A MEDICAL MANUAL FOR APOTHECARIES’ HALL AND OTHER MEDICAL BOARDS. Eleventh Edition. 12mo. cloth, 10_s._

PG72894.B01820
II.

PG72894.B01821
A MANUAL FOR THE COLLEGE OF SURGEONS; intended for the Use of Candidates for Examination and Practitioners. Second Edition. 12mo. cloth, 10_s._

PG72894.B01822
III.

PG72894.B01823
GREGORY’S CONSPECTUS MEDICINÆ THEORETICÆ. The First Part, containing the Original Text, with an Ordo Verborum, and Literal Translation. 12mo. cloth, 10_s._

PG72894.B01824
IV.

PG72894.B01825
THE FIRST FOUR BOOKS OF CELSUS; containing the Text, Ordo Verborum, and Translation. Second Edition. 12mo. cloth, 8_s._

PG72894.B01826
⁂ The above two works comprise the entire Latin Classics required for Examination at Apothecaries’ Hall.

PG72894.B01827
V.

PG72894.B01828
A TEXT-BOOK OF MATERIA-MEDICA AND THERAPEUTICS. 12mo. cloth, 7_s._

PG72894.B01829
VI.

PG72894.B01830
FIRST LINES FOR CHEMISTS AND DRUGGISTS PREPARING FOR EXAMINATION AT THE PHARMACEUTICAL SOCIETY. 18mo. cloth, 3_s._ 6_d._

PG72894.B01831
DR. ALFRED TAYLOR, F.R.S.,

PG72894.B01832
LECTURER ON MEDICAL JURISPRUDENCE AND CHEMISTRY AT GUY’S HOSPITAL.

PG72894.B01833
I.

PG72894.B01834
A MANUAL OF MEDICAL JURISPRUDENCE. Fifth Edition. Fcap. 8vo. cloth, 12_s._ 6_d._

PG72894.B01835
“We recommend Dr. Taylor’s work as the ablest, most comprehensive, and, above all, the most practical useful book which exists on the subject of legal medicine. Any man of sound judgment, who has mastered the contents of Taylor’s ‘Medical Jurisprudence,’ may go into a Court of Law with the most perfect confidence of being able to acquit himself creditably.”—_Medico-Chirurgical Review._

PG72894.B01836
“Dr. Taylor possesses the happy art of expressing himself on a scientific topic in intelligible language. The size of his Manual fits it to be a circuit companion.”—_Law Times._

PG72894.B01837
II.

PG72894.B01838
ON POISONS, in relation to MEDICAL JURISPRUDENCE AND MEDICINE. Fcap. 8vo. cloth, 12_s._ 6_d._

PG72894.B01839
“An excellent and valuable manual. We predict for it a very favourable reception by the profession. It contains all that kind of information which a medical man will be glad to have access to when he has the prospect of appearing in the witness-box.”—_Edinburgh Medical Journal._

PG72894.B01840
MR. TAMPLIN, F.R.C.S.E.,

PG72894.B01841
SURGEON TO, AND LECTURER ON DEFORMITIES AT, THE ROYAL ORTHOPÆDIC HOSPITAL.

PG72894.B01842
LATERAL CURVATURE OF THE SPINE: its Causes, Nature, and Treatment. 8vo. cloth, 4_s._

PG72894.B01843
DR. THEOPHILUS THOMPSON, F.R.S.,

PG72894.B01844
PHYSICIAN TO THE BROMPTON HOSPITAL FOR CONSUMPTION AND DISEASES OF THE CHEST.

PG72894.B01845
CLINICAL LECTURES ON PULMONARY CONSUMPTION. With Plates. 8vo. cloth, 7_s._ 6_d._

PG72894.B01846
“The extracts we have already made are sufficient to show the practical character of Dr. Thompson’s work. The volume abounds in useful and instructive matter, and displays Dr. Thompson’s talents in a very favourable light.”—_Dublin Medical Press._

PG72894.B01847
HENRY THOMPSON, M.B. LOND., F.R.C.S.,

PG72894.B01848
SURGEON TO THE MARYLEBONE AND TO THE BLENHEIM DISPENSARIES.

PG72894.B01849
STRICTURE OF THE URETHRA; its Pathology and Treatment. The last Jacksonian Treatise of the Royal College of Surgeons. With Plates. 8vo. cloth, 10_s._

PG72894.B01850
DR. TILT.

PG72894.B01851
I.

PG72894.B01852
ON DISEASES OF WOMEN AND OVARIAN INFLAMMATION IN RELATION TO MORBID MENSTRUATION, STERILITY, PELVIC TUMOURS, AND AFFECTIONS OF THE WOMB. Second Edition. 8vo. cloth, 9_s._

PG72894.B01853
“We rejoice to see that physicians of weight and authority are beginning to look beyond the os and cervix uteri for the causes of disease in these parts. Already a reformation somewhat analogous to what Abernethy effected for surgical diseases has commenced, and we feel assured that Dr. Tilt’s work will powerfully co-operate in helping it forward, and in placing the pathology and therapeutics of diseases of the female generative organs upon a sound and permanent basis.”—_Dublin Quarterly Review._

PG72894.B01854
II.

PG72894.B01855
ON THE PRESERVATION OF THE HEALTH OF WOMEN AT THE CRITICAL PERIODS OF LIFE. Foolscap 8vo. cloth, 4_s._ 6_d._

PG72894.B01856
MR. TOD, M.R.C.S.

PG72894.B01857
A DISQUISITION ON CERTAIN PARTS AND PROPERTIES of the BLOOD. With Illustrative Woodcuts. 8vo., 10_s._ 6_d._

PG72894.B01858
DR. ROBERT B. TODD, F.R.S.,

PG72894.B01859
PHYSICIAN TO KING’S COLLEGE HOSPITAL.

PG72894.B01860
CLINICAL LECTURES ON PARALYSIS, DISEASES OF THE BRAIN, and other AFFECTIONS of the NERVOUS SYSTEM. Foolscap 8vo. cloth, 6_s._

PG72894.B01861
“The work will soon be in the hands of every practitioner who desires to be informed of the present state of knowledge in regard to diseases of the nervous system. It is exceedingly easy reading, and replete with just such information as the scientific practitioner requires.”—_Medical Times and Gazette._

PG72894.B01862
MR. TUKE.

PG72894.B01863
DR. JACOBI ON THE CONSTRUCTION AND MANAGEMENT OF HOSPITALS FOR THE INSANE. Translated from the German. With Introductory Observations by the Editor. With Plates. 8vo. cloth, 9_s._

PG72894.B01864
DR. TURNBULL,

PG72894.B01865
PHYSICIAN TO THE LIVERPOOL NORTHERN HOSPITAL.

PG72894.B01866
I.

PG72894.B01867
A TABULAR VIEW AND SYNOPSIS OF THE PHYSICAL SIGNS AND DIAGNOSIS OF THE DISEASES OF THE LUNGS. With Woodcuts, mounted on cloth, 5_s._ boards.

PG72894.B01868
“This tabular view, affording a coup d’œil of the various auscultatory &c. phenomena discoverable in health and disease, will prove useful to many practitioners, as well as students, in their investigation of thoracic maladies.”—_Medico-Chirurgical Review._

PG72894.B01869
II.

PG72894.B01870
AN INQUIRY HOW FAR CONSUMPTION IS CURABLE; WITH OBSERVATIONS ON THE TREATMENT AND ON THE USE OF COD-LIVER OIL AND OTHER REMEDIES. Second Edition. 8vo. cloth, 4_s._

PG72894.B01871
DR. UNDERWOOD.

PG72894.B01872
TREATISE ON THE DISEASES OF CHILDREN. Tenth Edition, with Additions and Corrections by HENRY DAVIES, M.D. 8vo. cloth, 15_s._

PG72894.B01873
VESTIGES OF THE NATURAL HISTORY OF CREATION. Tenth Edition. Illustrated with 100 Engravings on Wood. 8vo. cloth, 12_s._ 6_d._

PG72894.B01874
BY THE SAME AUTHOR.

PG72894.B01875
EXPLANATIONS: A SEQUEL TO “VESTIGES.” Second Edition. Post 8vo. cloth, 5_s._

PG72894.B01876
DR. VAN OVEN.

PG72894.B01877
ON THE DECLINE OF LIFE IN HEALTH AND DISEASE; being an Attempt to Investigate the Causes of LONGEVITY, and the Best Means of Attaining a Healthful Old Age. 8vo. cloth, 10_s._ 6_d._

PG72894.B01878
DR. WAGSTAFF.

PG72894.B01879
ON DISEASES OF THE MUCOUS MEMBRANE OF THE THROAT, and their Treatment by Topical Medication. Post 8vo. cloth, 4_s._ 6_d._

PG72894.B01880
MR. WADE, F.R.C.S.,

PG72894.B01881
SENIOR SURGEON TO THE WESTMINSTER DISPENSARY.

PG72894.B01882
STRICTURE OF THE URETHRA; its Complications and Effects. With Practical Observations on its Causes, Symptoms, and Treatment; and on a Safe and Efficient Mode of Treating its more Intractable Forms. 8vo. cloth, 5_s._

PG72894.B01883
“Mr. Wade is well known to have paid great attention to the subject of stricture for many years past, and is deservedly looked upon as an authority on this matter.”—_Medical Times and Gazette._

PG72894.B01884
DR. WALLER,

PG72894.B01885
LECTURER ON MIDWIFERY AT ST. THOMAS’S HOSPITAL.

PG72894.B01886
ELEMENTS OF PRACTICAL MIDWIFERY; OR, COMPANION TO THE LYING-IN ROOM. With Plates. Third Edition. 18mo. cloth, 3_s._ 6_d._

PG72894.B01887
“Students and practitioners in midwifery will find it an invaluable pocket companion.”—_Medical Times and Gazette._

PG72894.B01888
MR. HAYNES WALTON, F.R.C.S.,

PG72894.B01889
SURGEON TO THE CENTRAL LONDON OPHTHALMIC HOSPITAL.

PG72894.B01890
OPERATIVE OPHTHALMIC SURGERY. With Engravings on Wood. 8vo. cloth, 18_s._

PG72894.B01891
“We have carefully examined the book, and can consistently say, that it is eminently a practical work, evincing in its author great research, a thorough knowledge of his subject, and an accurate and most observing mind.”—_Dublin Quarterly Journal._

PG72894.B01892
DR. WARDROP.

PG72894.B01893
ON DISEASES OF THE HEART. 8vo. cloth, 12_s._

PG72894.B01894
DR. EBEN. WATSON, A.M.,

PG72894.B01895
LECTURER ON THE INSTITUTES OF MEDICINE IN THE ANDERSONIAN UNIVERSITY, GLASGOW.

PG72894.B01896
ON THE TOPICAL MEDICATION OF THE LARYNX IN CERTAIN DISEASES OF THE RESPIRATORY AND VOCAL ORGANS. 8vo. cloth, 5_s._

PG72894.B01897
DR. WEGG.

PG72894.B01898
OBSERVATIONS RELATING TO THE SCIENCE AND ART OF MEDICINE. 8vo. cloth, 8_s._

PG72894.B01899
“We have much pleasure in stating, that the work is highly instructive, and proclaims its author to be a sober, sound, and able physician.”—_London Journal of Medicine._

PG72894.B01900
MR. T. SPENCER WELLS, F.R.C.S.,

PG72894.B01901
LATE ASSISTANT SURGEON IN MALTA HOSPITAL.

PG72894.B01902
PRACTICAL OBSERVATIONS ON GOUT AND ITS COMPLICATIONS, and on the Treatment of Joints Stiffened by Gouty Deposits. Foolscap 8vo. cloth, 5_s._

PG72894.B01903
DR. WHITEHEAD, F.R.C.S.,

PG72894.B01904
SURGEON TO THE MANCHESTER AND SALFORD LYING-IN HOSPITAL.

PG72894.B01905
I.

PG72894.B01906
ON THE TRANSMISSION FROM PARENT TO OFFSPRING OF SOME FORMS OF DISEASE, AND OF MORBID TAINTS AND TENDENCIES. 8vo. cloth, 10_s._ 6_d._

PG72894.B01907
II.

PG72894.B01908
THE CAUSES AND TREATMENT OF ABORTION AND STERILITY: being the result of an extended Practical Inquiry into the Physiological and Morbid Conditions of the Uterus, with reference especially to Leucorrhœal Affections, and the Diseases of Menstruation. 8vo. cloth, 12_s._

PG72894.B01909
“The work is valuable and instructive, and one that reflects much credit alike on the industry and practical skill of the author.”—_Medico-Chirurgical Review._

PG72894.B01910
MR. WILLIAM R. WILDE, F.R.C.S.I.

PG72894.B01911
AURAL SURGERY, AND THE NATURE AND TREATMENT OF DISEASES OF THE EAR. 8vo. cloth, 12_s._ 6_d._

PG72894.B01912
“We have no hesitation in expressing our opinion that the book is by far the best treatise on Aural Surgery which has yet appeared in any language.”—_Medical Times and Gazette._

PG72894.B01913
DR. JOHN CALTHROP WILLIAMS,

PG72894.B01914
LATE PHYSICIAN TO THE GENERAL HOSPITAL, NOTTINGHAM.

PG72894.B01915
PRACTICAL OBSERVATIONS ON NERVOUS AND SYMPATHETIC PALPITATION OF THE HEART, as well as on Palpitation the Result of Organic Disease. Second Edition, 8vo. cloth, 6_s._

PG72894.B01916
“From the extracts we have given, our readers will see that Dr. Williams’s treatise is both able and practical.”—_Medical Times._

PG72894.B01917
“The work is calculated to add to the author’s reputation, and it is creditable to the provincial practitioners of England that so useful a treatise should have emanated from one of their body.”—_Dublin Medical Press._

PG72894.B01918
DR. J. WILLIAMS.

PG72894.B01919
I.

PG72894.B01920
INSANITY: its Causes, Prevention, and Cure; including Apoplexy, Epilepsy, and Congestion of the Brain. Second Edition. Post 8vo. cloth, 10_s._ 6_d._

PG72894.B01921
II.

PG72894.B01922
ON THE ANATOMY, PHYSIOLOGY, AND PATHOLOGY OF THE EAR; being the Prize Essay in the University of Edinburgh. With Plates. 8vo. cloth, 10_s._ 6_d._

PG72894.B01923
DR. JAMES WILSON.

PG72894.B01924
THE PRINCIPLES AND PRACTICE OF THE WATER CURE, and HOUSEHOLD MEDICAL SCIENCE, in Conversations on Physiology, on Pathology, or the Nature of Disease, and on Digestion, Nutrition, Regimen, and Diet. 8vo. cloth, 10_s._ 6_d._

PG72894.B01925
DR. G. C. WITTSTEIN.

PG72894.B01926
PRACTICAL PHARMACEUTICAL CHEMISTRY: An Explanation of Chemical and Pharmaceutical Processes, with the Methods of Testing the Purity of the Preparations, deduced from Original Experiments. Translated from the Second German Edition, by STEPHEN DARBY. 18mo. cloth, 6_s._

PG72894.B01927
MR. ERASMUS WILSON, F.R.S.

PG72894.B01928
I.

PG72894.B01929
THE ANATOMIST’S VADE-MECUM: A SYSTEM OF HUMAN ANATOMY. With numerous Illustrations on Wood. Sixth Edition. Foolscap 8vo. cloth, 12_s._ 6_d._

PG72894.B01930
“As a satisfactory proof that the praise we bestowed on the first edition of this work was not unmerited, we may observe it has been equally well thought of in foreign countries, having been reprinted in the United States and in Germany. In every respect, this work, as an anatomical guide for the student and the practitioner, merits our warmest and most decided praise.”—_Medical Gazette._

PG72894.B01931
II.

PG72894.B01932
DISEASES OF THE SKIN: A Practical and Theoretical Treatise on the DIAGNOSIS, PATHOLOGY, and TREATMENT OF CUTANEOUS DISEASES. Third Edition. 8vo. cloth, 12_s._

PG72894.B01933
THE SAME WORK; illustrated with finely-executed Engravings on Steel, accurately coloured. 8vo. cloth, 30_s._

PG72894.B01934
“The work is very considerably improved in the present edition. Of the plates it is impossible to speak too highly. The representations of the various forms of cutaneous disease are singularly accurate, and the colouring exceeds almost anything we have met with in point of delicacy and finish.”—_British and Foreign Medical Review._

PG72894.B01935
III.

PG72894.B01936
HEALTHY SKIN: A Treatise on the Management of the Skin and Hair in relation to Health. Fifth Edition. Foolscap 8vo. 2_s._ 6_d._

PG72894.B01937
“The student will be delighted to find his labours so much facilitated; and a few hours of agreeable society with a most pleasantly-written book will do more to make him acquainted with a class of obscure diseases than all that has been previously written on the subject.”—_Lancet._

PG72894.B01938
IV.

PG72894.B01939
PORTRAITS OF DISEASES OF THE SKIN. Folio. Fasciculi I. to XI. Containing Four highly-finished Coloured Plates. 20_s._ each.

PG72894.B01940
“May be truly designated a splendid performance, surpassing, in the artistic beauty of its delineations, and fully equalling in their fidelity to nature, any thing which has yet been brought out in this country or on the continent. We can scarcely speak too strongly of the merits of this work.”—_British and Foreign Medical Review._

PG72894.B01941
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