new remedies, come from whatever quarter they may; and faith is put in certificates, which perhaps have been forged. Many, very many, are thus drugged to death, either by the blind guides of their own uninformed minds, or the unfounded pretensions of others. The object of this measure is to diffuse, among all classes of people, more enlightened views of life, health and disease. In this way it is believed numerous lives might be saved, a great amount of sickness prevented, and a corresponding amount of suffering avoided. Is not this a useful purpose?

III. It should be approved because it is AN ECONOMICAL

MEASURE.

The expense of preventive sanitary measures is the most common argument brought against their adoption. Epidemics are considered by the ignorant as evils which it is useless to attempt to prevent; and among the better informed, a false idea of economy, which has sometimes led to the most fatal results, has been the ground of resistance to measures which were necessary to save life. It should, however, be known that public expenditures cannot be avoided during the prevalence of an epidemic disease. Money must be spent, either in saving life, or in the maintenance of pauperism, widowhood, and orphanage. In this case economy is on the side of humanity, and the most expensive of all things is-to do nothing.

Debility, sickness, and premature deaths, are expensive matters. They are inseparably connected with pauperism; and whenever they occur they must, directly or indirectly, be paid for. The city or town must pay for the sick man's supportfor his food and clothing, for medical attendance on him during life, and for the support of his widow and children (if he leave any) after his death. A town in which life is precarious pays more taxes than its neighbors of a different sanitary character. An individual who is unable to perform a large amount of labor or no labor at all, is a less profitable member of society than one who can do whatever vigorous health allows.

"It is for the interest of the public at large, no less than for the happiness of the few immediately interested in each human being, that the life once breathed should, if possible, be pre

served, until it is released by the natural wearing away of its earthly tabernacle. We all know that, in the common

sense of the term, a short-lived population is generally a surplus population,-not only because those who are reckless of preserving life, will be careless of all its obligations, and will be poor and vicious, but because the tendency of early deaths is chiefly to shorten the existence of those who produce more than they consume, and to increase the number of those who must be dependent on the charity of others. 'A cholera widow' is a significant expression occasionally used by the Board of Health, to indicate one who has been thrown on the parish by the death of that husband who, if he had not been prematurely cut off, might have supported her for years, and left his children old enough to earn bread for themselves. Many communities are now thus paying, in alarmingly swollen poor-rates, for the short-sighted selfishness which made them. grudge the cost of precautionary arrangements." 1

As an illustration, the proportion of deaths by cholera, in two parishes in England-Hampstead and Rotherhithe-have been stated. In the latter, 225 persons died of the disease in every 10,000 inhabitants, while in the former 8 only died. At Rotherhithe, out of 225 persons, 217 died of preventable causes. "There were in that place, 28 times the proportional number of deaths that there were at Hampstead, 28 times the cases of sickness, 28 times the number and cost of funerals, 28 times the doctors' bills, and 28 times the proportional number of widows and helpless children to be supported by somebody." 2

As a further illustration we present the following extract from a speech delivered by Lord Ashley, at a meeting held Feb. 5th, 1850, to take into consideration the sanitary condition of the metropolis :

"At least one third of the pauperism of the country arose from the defective sanitary condition of large multitudes of the people; and he had no hesitation in saying, upon the authority of experienced persons, that if the population of their great towns were placed under proper sanitary regulations, in less

1 Edinburgh Review, Vol. XCI, January, 1850, p. 212. 2 Do. for April, 1850, p. 389.

than ten years the poor rates would be reduced £2,000,000 annually. What had been the effect produced upon the parish of Lambeth by the ravages of the cholera, a large proportion of which might have been prevented by suitable sanitary meastures? He had the official return of the number of persons becoming chargeable to the parish in consequence of deaths from cholera between the 16th of June and the 16th of October, 1849. There were-orphans 310, widows 74; total 384 persons. There was a village in Wiltshire with a population of 510; in this village four widows and 16 orphans, making a total of 20 persons, had become permanently chargeable. A still more remarkable instance occurred in another village, containing 54 inhabitants. Of these, 19 had been carried off by cholera, and their families had become chargeable upon the rates. Let it be observed, that if the attack of cholera in London had been in proportion to the attack in that village, 500,000 persons would have been carried off; but he quoted these instances of the ravages of the epidemic to show that what cholera did rapidly and by fits and starts, typhus and other fatal diseases were doing slowly day by day. If the cholera had sent 1,000 orphans and widows to the poor-house in a few weeks, typhus was permanently sending hundreds and thousands there, to become chargeable upon the rates payable by those parties who, if they had been wise and humane in time, might have obviated all fatal consequences and been the means of preserving the existence of many worthy and honorable citizens. Of all the agencies which predisposed the human body to disease, none were so fatal as over-crowding in small dwellings. There had been remarkable instances wherein localities ill drained, badly ventilated, and exposed to noxious influences, had continued without a visitation from the cholera, whilst a building where the inmates were well fed, well clothed, and had every appliance to keep them in health, with the single exception of over-crowding, presented a mortality greater in proportion than the awful mortality among the pauper children at Tooting. Under such circumstances it was impossible any particular class could insure immunity from disease. The deaths from cholera in London amounted to 16,696. Of these

72 per cent. occurred among the poorer classes, 16 per cent. among the middle, and 3 per cent. among the upper classes; but he reminded the middle and the upper classes that the expenses inflicted upon the community in the metropolis, during the late epidemic, amounted to no less than £1,060,096, including the cost of funerals, medical attendance, and the loss of reproductive labor. It might be asked, was this instructing the people? He did not say it was; but what they were doing in bringing such facts before the public was an indispensable preliminary to their moral and spiritual welfare.”

The expenses and losses entailed by a neglect of sanitary measures may be classed under the following heads:-1. Expenses imposed upon the poor, by loss of work or of situations, for medical attendance and medicine, for nursing, for funerals, for the support of widows and orphans, and for other purposes. 2. Expenses imposed upon the tax-payers, for the support of those who are unable to support themselves, besides their own increased expenses arising from a bad sanitary condition. 3. Burdens imposed upon the charitable, for the support of hospitals, dispensaries, and for other more general or special charities. 4. A loss sustained by the state, in consequence of the diminished physical power and general liability to disease. Expenses imposed upon the community, by the crimes arising from the unfavorable physical circumstances by which the laboring poor are surrounded, and which lead with certainty to their moral degradation. Various estimates have been made of these expenses, some of which, as stated by Lord Morpeth, we have already noticed, (p. 44.)1

5.

We extract from the Report on the Condition of Large Towns, the following illustra tive passage from the testimony of Dr. Taylor, an intelligent surgeon of London:-"Amongst others was the family of a policeman whom I attended. When he applied for relief, the observation which occurred was, 'You have, as a policeman, 20s. a week regular wages, and other advantages; you are never out of work, and cannot be considered a proper object of relief from the funds of a dispensary intended for the poorest class ?? His reply was, that he paid for his miserable one room, divided into two, 5s. a week; that he had is. &d. weekly to pay for keeping up his clothes, which reduced the money he had for his family of four children and his wife to 13s. 4d.; that he had had all his children ill, and lost two; that he had during three years paid six doctors' bills, principally for medicine, at the rate of 2s. 6d. a bottle, amounting to between £30 and £40; that two of the children had died, the funerals of which, performed in the cheapest manner he could get it done, had cost him £7: the wife and his four children were now ill. They were so depressed and debilitated, as to render them very great objects for the dispensary and the Samaritan Fund. All this misery was traceable to preventable causes. Take another case in the list before me. A porter, in regular employment, at wages producing £1 a week: he paid 3s. 6d. for a most miserable and unwholesome room, in which himself and six other people, four children and three adults, slept; the children were shoeless, extremely filthy, and 'badly clad; the wife ill in bed of a

Attempts have been made to show the pecuniary advantages which would result to Massachusetts by the adoption of an efficient sanitary system. The subjoined is given as an estimate, which we believe would fall far below the reality. The number of unnecessary deaths the past year, has been estimated (p. 245) at 6,000, and of cases of unnecessary sickness at 12,000. This is a direct pecuniary loss to the State. If each of these 6,000 persons had been saved, and had lived 18 years, which may be taken as the average length of the labor-period of life; or if the whole 18,000 persons who died in the State, could have lived, on the average, six years longer than they did, (and who will say that they might not more than that period?) then we have 108,000 years of lost labor on their account, which may fairly be estimated at $50 each per annum. The cost of 12,000 years of unnecessary sickness may be estimated at $50 each, and the lost labor of the sick at $100 each.

diseased knee, for which I attended her; two children had been still-born, and he had lost three others; the sickness of one of these children, which had died at fourteen of consumption, had cost him in doctors' bills 16 guineas; the sickness of the one which died eleven months old, of water on the brain, had cost him £6; the third had died fourteen days old. The expenses in the three cases had so impoverished him, that he was compelled to apply to the parish for aid for their burial. I will submit a third case-that of a cook, in receipt of 255. per week regular wages. He was living with his wife and three children in a small, close, illconditioned room, for which he paid 5s. per week rent. He complained that the water was always 'thick,' and very disagreeable to the taste, and the smells from the sewers and the drains in the house were very bad: he had five children, of whom two had died; that he had paid doctors' bills for his wife's confinements £5 each; and for one child which died of scarlet fever, at four years of age, the doctor's bill was £4 18s. ; the one which died of debility, at the age of ten weeks, cost him £1, 10s. the funeral of the eldest child cost him £3; and the one at ten weeks, £1, 10s. He showed that the expenses of confinements, the doctors' bills, and the undertakers' bills, and the illness of his wife, arising from five miscarriages, had so impoverished him, that having now two children ill with scrofula, he was obliged, though reluctantly, to apply to the dispensary for relief. The last case I will submit to the commissioners is that of a shoemaker, a good workman, who earns 20s. a week: he pays 5s. a week for one small, miserable room, in a narrow court; he has had seven children, of whom he has lost five, for which he has paid in doctors' bills between £2 and £3 each; the expense of his wife's confinements amounted to £3, 15s, each; the expenses of the funerals of the five children were between £3 and £4 each: his wife's age was thirty-two, his own age thirty-seven, and at this age of thirty-seven he continually suffered from nervous depres Sion; and having one of his two other children with a lingering disease-a scrofulous affection of the hip-he was compelled to come to the dispensary: he complained that the water of his house was never clear, and never sweet. A man in receipt of 30s. per week's wages, considering his amount of rent which was 5s. 6d. for one room, for himself, wife, and three children; having had four deaths after lingering consumptions, and a wife and children never well, I felt that he also was a proper object of the charity. At the time I visited these 100 families, no less than 212 of the members were suffering under disease manifest in various stages. They had already had no less than 251 deaths and funerals, and a corresponding amount of sickness. It was only in a late stage of my investigations that I began to see the very serious amount of miscarriages they have had, and which in many instances exceed the deaths. Three hundred and fifty of the members of these 100 families were dependent children, whose average age was little more than ten years."

Henry Austin, Esq., in his Report on the Sanitary Condition of Worcester, (p. 40,) says the attacks of fever appear to commit the greatest ravages among those in the vigor of life; and to one fatal case there is at least 10 attacks. "An insurance charge for the mitigalion of the effects of sickness and premature mortality for an average family, is more than three times the annual cost of the outlay for the whole of the intended works at Worcester," sufficient to place the city in a good sanitary condition.