By Edwin Chadwick Esq., Barrister at Law and secretary to the Board of Poor Law Commissioners

Contents (This is work in progress)

General Prevelence of Epidemic, Endemic and Contagious Diseases

Return of the number of deaths in 1838, in each county, from epidemic, endemic, and other diseases, most powerfully affected by the physical state of a districy

p 2

Extent of evils which are the subject of inquiry



in Tiverton union, Cornwall


In Truro, Cornwall


In Cerne union, Dorset


In Axbridge union, Somerset


In Chippenham union, Wilts


In Bedford union, Bedford


In Woburn union, Bedford


In Ampthill union, Bedford


In Bishop Stortford union, Hertford


In Witham union, Essex


In Windsor, Berks


In Epping union, Essex


In West Ham union, Essex


In Bromley union, Kent


In Bilston, Leicester


In Stafford (town of), Stafford


In Macclesfield union, Chester


In Heaton Norris, Stockport union, Chester


In West Derby union, Lancaster


In Wigan union, Lancaster


In Durham (city of), Durham


In Barnard Castle, Durham


In Carlisle, Cumberland


In Gateshead, Durham


Condition of the Border peasantry


In Loclunaben, Scotland


In Glasgow and Edinburgh




Town drainage of streets and houses. Instances of the effects on the public health of the neglect of town drainage

  • At Derby  26
  • At Stockport  28

Comparative mortality in two similar towns, one drained, the other undrained

At Beccles and Bungay, Suffolk 28

State of town cleansing at Leeds  29, At Tamworth  30, At Edinburgh 33, At Traneut and Ayr 33, At Stirling 34, At Clitheroe, Lancashire  35

Street and road cleansing—road pavements.

Defective from want of skill or proper combination of means .                     36

Different influence on the public health of paved and unpaved streets, instance of, in Portsmouth 37

Instance of the effect on the public health of street cleansing in Macclesfield 37

Instances of the neglect of street cleansing— In Manchester 38, In Leeds39

Instances of the consequences on the public health of the neglect of road cleansing in rural districts in England and in Scotland  42

Discipline in respect to cleanliness of the army superior to the civic economy of the towns

house cleansing as connected with street cleansing and sewerage.

Instances of the sanitary condition of houses in the metropolis where the cesspools do not communicate with the drains

Small value of refuse in London, in consequence of the expense of cartage 46

Effects on the health of the accumulation of refuse near the residences of the labouring classes : examples in Greenock, Leeds

Cleansing by means of water-closets applicable to the poorer districts as being the most economical 38

Instance of the removal of the refuse of the city of Edinburgh by sewerage, and of its application to agriculture by irrigation 43

Objections by the citizens of Edinburgh to irrigation by sewers in the immediate vicinity of the city    49

Value of the refuse of London, on the scale of value of the refuse of Edinburgh

Modifications of the mode of sewerage of Edinburgh, to make a system of cleansing innoxious and profitable, and extend it to the residences of the poorer classes

Expense of street cleansing in Manchester  53

Defects of the prevalent mode of removing the refuse of houses by cartage, or otherwise than by sewerage  54

Instances of defective construction of sewers  55

Evidence on the action of improved modes of sewerage 55

Effects of different descriptions of streets upon the public health 59

Proposed mode of cleansing streets by sweeping the refuse into the sewers 60

Similar mode proposed of cleansing Paris 61

Supplies of water

Necessity of improved supplies of wafer for house and street cleansing . 63

Instances of the want of water in the houses, and of the effect on the personal and domestic habits of the lower classes of the population in towns 63

In :Manchester, 64; in Truro union, 65; in Audley district of Newcastle­under-Lyne union, 65 ; in Dunmow union, 65 ; in Bishops Stortford union, 65; in Lexden and Winstree union, 65; in Wootton, Bedford, 66 ; in Edinburgh, 66; in Glasgow, 66; in Aberdeen, 67; in Stirling, 67; in Dundee, 67; in Greenock, 67; in Ayr, 67; •in Arbroath, 67; in Renfrew, 68; in Dunfermline, 68; in Tain, 68; in Tranent.

Inapplicability of the supplies of water to be obtained by fetching from the public wells

The supplies of water in Landoll by machinery and pipes, and in Paris by cartage and hand carriage, compared

Cost of laying on water in labourers’ tenements and the economy of supply in such a mode

Supplies of water by private companies, not applicable to rural districts of small population 72

Complaints against the modes of supplies of water by private companies  72

Private companies do not ensure the best practicable supplies to the public 73

Instance of supplies of water obtained by the public without private companies.74

Necessity of general provisions of supplies of water  77

Unwholesome effects of bad water.. 77

Sanitary drect of land drainage.

General land drainage, effects of, on the health of the population, instances of in The Isle of Ely, 80; the Newhaven union, Si ; the Ongar union, 81; the Gravesend and Milton union, 81; the Eastry union, 81 and 82 ; the Dumnow union, 82; the Epping union

Instances of— of the effect of land drainage upon the health of cattle Scotland

Instance of the effects of land floods and deficient land drainage in The Langport union,85; the Chesterfield union, 87 ; the Dore union, 87; the Bicester union, 88; the Leighton Buzzard union, 88 ; the Foleshill union, 89; the Mahon union, 89; Lochmaben, Scotland       90

Foreign illustrations of the effect of drainage upon the health of the popu lation ..        90

Interests opposed to the cleansing of Paris .  93

Collateral benefit of more effectual cleansing of towns in diminishing degrading employments


Various effects of overcrowding places of work, as shown in the case of one class of workmen

Comparative ease and economy of measures of prevention rather than of relief

Sanitary effects of ventilation on workpeople at Glasgow

Effects of defective ventilation on the health of milliners and dressmakers in the metropolis

Instances of the effects of defective ventilation of sleeping rooms of the working classes

Effects of the defective economy of lodging-houses and places of repose exemplified in the duration of life of one class of workmen112

Instances of errors in respect to the sanitary effects of particular occupations 113

Injurious effects of deficient ventilation in schools  119

Bad ventilation and overcrowding private houses.

Great apparent increase in the proportionate number of houses according to the last census attributable to a different mode of making the return. 120

Instances of great overcrowding in cottages in Greenock, 121 ; Trauent, 121 ; Sleaford union 122

The want of separate apartments and overcrowding of private dwellings.

Effects of the overcrowding of private dwellings on the morals of the population, instances of, in– The Ampthill union, 122 ; the Leighton Buzzard union, 123; the Bicester union, 123 ; the Romsey union, 123; among the border peasantry, 124; in Manchester, Liverpool, Ashton-under-Lyne, and Hull, 124 ; in Leeds, 126 ; in Nottingham, 126; in Clitheroe ..  125

Instances of the injurious influences of bad tenements upon the personal condition and moral habits of the inmates 128

Effects of noxious agencies in preventing frugality and promoting intemperance 129

in preventing the influence of education ….  132

Force of habits of intemperance in the use of spirituous liquors against all habits of decency, or frugality, or morality.. 133

Misconceptions as to casualties occurring among the indigent or profligate 134

Intemperance the cause of fever  136

Domestic mismanagement a predisposing cause of disease.

Mismanagement of earnings obstructive to the domestic improvement of the sanitary condition of the labouring classes. Instances of in— Derby, 137; Birmingham 138 ; Manchester, 139; Preston union, 140; Ayr, 141 ; Tranent, 141 ; Dundee 142

Attacks of fever most frequent on workmen in full employment and ordinary health                             145, 147

Irrelevancy of controversy on the generation of fever, in respect to practical means of prevention    148

Concurrence of medical opinions as to the most efficient means of preventing fever                150


Instances of the comparative chances of life amongst the gentry, trades­men, and working men—

In Truro, 14; in Derby, 155; in Manchester, 157; in Rutland, 157 ; in the Bolton union, 158; in Bethnal Green, 159 ; in Leeds Borough, 159 ; in Liverpool, 159; in the 1Vhitechapel union, 160; in the Strand union, 160; in the Kensington union, 161; in Wiltshire 161; in the Kendal union .

Tabular views of the ages at which deaths have occurred in different classes of society . .

Comparative mortality of differently circumstanced districts of the metropolis

Comparative prevalence of fever in different districts of Leith

Comparative mortality in three classes of the community at Bath

Corroborative experience from Paris as to the influence of local circumstances on mortality

Improvements in the health of large towns chiefly confined to improved districts

Instance of progressive improvement in the social condition of the population concurrently with its increase in numbers    175

Prevalence of disease no evidence of the pressure of population on food 177

Variations of the proportion of deaths and births in different districts of the same town  178

Proportion of births to the population greatest where there is the greatestmortality …  179

Proof that pestilence or excessive mortality does not diminish population 182

Numbers merely not the test of strength or prosperity of a community . 185

Deterioration of the strength of the population by disease without diminishing its numbers

Increase of food or production concurrently with the increase of population 188


Cost of remedies for sickness and of mortality which is preventible . . Average ages of death of the heads of families of widows and orphans chargeable to the Manchester, Whitechapel, Bethnal Green, Strand,Oakham and Uppingham, Alston with Garrigill, and Bath unions . . 190

Table of the number of widows and dependent orphans chargeable in eight unions…..

Table of the chief cause of death producing widowhood and orphanage in eight unions

Detailed instances of the causes of widowhood and orphanage in Alston with Garrigill .  193

Examples of the sanitary effects of superior care in the residences and the places of work of labourers—in the Reeth union, North York, 196; in Gwennap, Mogan, and Camborne, Cornwall, 198; in Great Bradford and Horton, West York .

Comparison of a young population under favourable and a mature popula tion under unfavourable circumstances. 200

Effects of noxious physical agencies on the moral and intellectual condition of the working classes  202

Jurisprudential measures for the prevention of deaths from accidents . 205

Cost of disease as compared with cost of prevention, instances of in Glasgow and Dundee


Former health of gaols as compared with the present state   . 211

Effects of sanitary measures of prevention on the health of prisoners  214

Comparison of the experience of sickness amongst different classes of people …  216

Amount of sickness experienced by the labouring classes  217

Defects of Insurance tables  218

Effects of sanitary measures in the prevention of disease in the army and navy          219

Cost to tenants and owners of the public measures for drainage, cleansing, and the supplies of water, as compared with the cost of sickness:—

Cost of measures of prevention as compared with the cost of sickness and Means of payment for improved accommodation

Impolicy of exemptions of tenements from proper charges Injurious effects of exemptions of labourers’ tenements

Inability of workmen to improve their own condition

Necessity of extrinsic aid for the improvement of the condition of the working classes

Employers’ influence on the health of workpeople, by means of improved habitations:

Advantages to labourers of holding tenements in connexion with their em ployments

Instance of a superior moral and sanitary  condition enjoyed by workers  in a cotton factory

Elevation of a manufacturing population by improvements in the condition of their dwellings .    Most advantageous construction of manufactories for the   health of the workpeople

The employers’ influence on the health of workpeople—

By modes of payment which do not lead to temptations to intem perance 245

By the promotion of personal cleanliness 253

By the ventilation of the places of work and the prevention of noxious fumes, dust, &c. 256

By promoting respectability in dress.261

Employers’ or owners’ influence in the improvement of habitations and sanitary arrangements for the protection of the labouring classes in therural districts .  261 Instances of in the Bedford Union, 262 ; Stafford Union, 263; in Norfolkand Suffolk, 264 ; at Harlaxton, Lincolnshire, 266; at the Earl of Rosebery’s estate, Scotland, 266 ; at CIoseburn, Dumfries, 266 ; Turtonand Bollington, Lancashire, 267; Birmingham  267

Instances of the influence of the materials used in building upon the health of the inmates in Cheshire, Lancashire, Buckingham and Berkshire  267

Instances of efficient improvements in the detail of labourers’ dwellings in Scotland  270

Improvements proposed for the construction of the dwellings of the lower classes in towns  272

Effects of public walks and gardens on the health and morals of the lower classes of the population  275


Necessity of legislative interference for the protection of’ the health of the population.. 279

Spread of old evils in unprotected new districts by inefficient legislation                280 .

Dangers of increased charges. for inefficient sanitary measures shifting without. improving the population . .  282

Expulsion of labourers front old tenements without providing appropriate new ones, not invariably beneficial  286

Advantages in the regulation of the sites of dwellings  ‘287

General state of the law for the protection of the public health :—

Medical police in Germany. 288

Existing laws for the protection of the public health in England  289

Early state of the law for the protection of the public health 291

State of the special authorities for reclaiming the execution of the laws for the protection of the public health:—

General desuetude of the laws for the protection of the public health .    296

State of the administration of the laws for the protection of the public health, by court leets and local trusts 299

State of the local executive authorities for the erection and maintenance of drains and other works for the protection of the public health :—

State of the obstructions to land drainage and works of private profit redounding to the public health302

Injuries to private properly as well as to the public health, occasioned by defective administration 305

Continuance of the causes of disease in the face of representations of their effects on the population  307

Areas of jurisdiction for drainage inconsistent with efficient operations                          309

Prevalent misconceptions as to the objects and state of management of existing sewerage.. 311

Objections made to the existing local administration of the sewers’ rate 315

Securities requisite to obviate opposition to new expenditure for sewerage . 316

Necessity of the subordinate drainage of private tenements being comprehended as part of one system  319

Disturbing local interests opposed to efficient management of expenditure in new districts 324

Obstacles arising from defective, local arrangements ‘inefficient expenditure in local public works  323

Inconveniences of legislation on details, and the want of scientific and trustworthy direction 328

High rates of charges, by revs, for superintendence of imperfect structural arrangements  329

Extent of waste in expenditure on local public works, and on separate collections    333

Public facilities for private land drainage afforded by consolidation . ……  337

Grounds of unpopularity and distrust of new local expenditure      339

Boards of Health or public officers for the prevention of disease:—

Inefficiency of Boards of Health, as ordinarily constituted      340

Failure of Boards of Health in Ireland  342

Importance of the functions of medical officers in connexion with the executive authority  343

Means and economy of skilled services for the prevention of diseases .  348

Administrative measures for the prevention of disease amongst the labouring classes  349

Administrative means for promoting the extension of medical science 352


State of the common lodging-houses in the Barnet union, 357; in Birmingham, 357; in Brighton, 358; in Manchester, 358; in the Stockport union, 360; in the Maccksfield union, 360; in Durham, 361 ; in the Teesdale union, 361 ; in the Tynemouth union, 361 ; in Newcastle-on­Tyne, 362; in Tranent, Haddingtonshire, 362; in Tain, Ross-shire, 302; in the borough of Warwick, 363; in Chelmsford 364

Grounds for subjecting common lodging-houses to the responsibilities of public-houses and beer-shops    364

Practical illustration of the regulations of common lodging-houses..       366


Recapitulation of the chief conclusions deduced on the information obtained in the course of the inquiry  369

Conclusions as to the available means of prevention 370

Grounds for uniformity of legislation . 372


  1.  Evidence of Mr. John Roe, civil engineer, on the practical improvement in sewerage and drainage tried in the Holborn and Finsbury divisions of the metropolis
  2. Evidence of Mr. John Dance, contractor for cleansing, as to the obstacles to cleansing, and the conversion of the refuse of the metropolis to productive uses  379
  3. Evidence of Mr. John Treble, contractor for cleansing, as to the obstacles to cleansing, and the conversion of the refuse of the metropolis to productive use 380
  4. Extract from the report of Fourcroy and others, showing the calculation of, the extent of pollution of the Seine from the discharge of the refuse of the streets of Paris  381
  5. Communication from Captain Vetch, of the Royal Engineers, on the structural arrangements of new buildings, and protection of the public health 382
  6. Evidence of Mr. George Gutch, district surveyor, on shifting and building inferior tenements in the suburbs, to avoid the provisions of the Metropolis Building Act…394
  7. Estimnte by Mr. Howell, of the cost of structural arrangements of sewerage, drainage, water-tank, and means of house cleansing for labourers’ tenements in the metropolis . . …… .394
  8. Description of specification of Mr. London’s agriculturists’ model cottage • 305
  9. . Statement of the requisites of cottage architecture, by Mr. Loudon. . . 396
  10. Specification of the cost of erection, weekly rents, interest on the capital invested, and the numbers of the tenements and cottages occupied by the poor and labourers ; taken from returns made by the relieving officers of their respective districts in 24 unions in the counties of Chester, Stafford, Derby, and Lancaster       400
  11. Tables of the expense of building cottages and repairs, in England and Scotland    401
  12. Examination of the Rev. Thomas Whateley, Cookham, Berks, on cottage allotments and the keeping of pigs by cottagers  403
  13. Arrangement of public walks in towns : plan of the arboretum at Derby, laid out by Mr. Loudon  405
  14. Boards of Health : report on the labours of the “Conseil de Salubrite,” of Paris, from 1829 to 1839, by M. Trebuchet ..  409
  15. (missing in original)
  16. Qualifications of officers of public health : statement by M. Duchatelet 423
  17. Instance by MM. Duchiltelet and D’Arcet, of the erroneous medical inferences as to the insalubrity of particular trades . 424
  18. On the habitations of the lower orders of Paris .  426
  19. On the habitations and lodgings of the lower orders in Paris  428
  20. Extract from the report of the commission appointed by the Central Board of Public Health, to ascertain the condition of the dwellings of the working classes in Brussels, and to suggest means for their improvement 429
  21. Principles of sanitary police in Germany: extracts from Professor Mold  431
  22. A report on the statements of Dr. Mauthner, regarding the sanitary condition of the operatives in the new cotton manufactures, Vienna, given at the monthly meeting on the 2nd of November, 1841. By Herr L. M. Von Pacher 432
  23. Typhus fever, the vast amount of, produced amongst the poor of Liverpool, from Want of ventilation and cleanliness: extract from Dr. Currie’s medical reports
  24. Extract from Dr. Ferriar’s “Advice to the Labouring Classes in Manchester,” given in 1800              941
  25. Principles of jurisprudence and responsibility for accidents: extract from the First Report of the Commissioners of Inquiry into the Labour of Children in Factories. 442
  26. Extract from the report of Mr. John L. Kennedy, barrister-at-law, to the Commissioners for inquiring into the Labour of Young Persons in Mines and Manufactories .  445
  27. Tables of Sickness in prisons  449
  28. Tables of Sickness in the wynds of Edinburgh 452
  29. Suggested form of notification to owners or occupiers, for the distribution of the expense of permanent alterations and the avoidance of overcharges on persons enjoying only portions of the benefit .453
  30. Extracts from evidence as to the moral and physical evils that may be created by defective arrangements for hiring and paying workpeople . 454


  1. Map, exhibiting the track of fever and cholera, and the badly-cleansed portions of the town of Leeds 460
  2. Map, exhibiting the numbers and places of death from epidemic and other diseases affected by locality, in the parish of Bethnal Green, during one year 460
  3. Linear representation of the comparative numbers and progress of deaths from consumption, from epidemics, and other classes of disease, in the metropolis, during the two years ended the 1st of January, 1842 167
  4. Plans and views of habitations for the labouring classes 266
  5. Group of Northumberland cottages, copied from a view given by Dr. Gilly, canon of Durham ;—Group of cottages at Harlaxton, erected by Gregory Gregory, Esq. ;—Plans and elevations of cottages, erected by the Rev. Benyon de Beauvoir, at Culford, Suffolk ;—Plans of labourers’ cottages, erected by the Earl of Leicester, at Holkham; by the Earl of Rosebery, in Scotland; —Plan of a new form of labourers’ cottages, erected by Sir Stewart Monteath, at Closeburn ;—Plan of labourers’ cottages, erected by Messrs. H. and E. Ashworth, at Turton ; by S. Greg, Esq., at Bollington.
  6. Plan, by Mr. Sydney Smirke, of lodging-houses for workmen in towns . 274
  7. Section of the chief forms of sewers used in the metropolis . 378
  8. Plan of the arrangement of the future increment of towns for the protection of the sanitary condition and convenience of the population, by Captain Vetch, of the Royal Engineers  384
  9. General plan of house and street sewerage, and of the construction of streets favourable to cleansing and dryness, by Captain Vetch  389
  10. Isometrical view of a model agricultural labourer’s cottage, by Mr. Loudon 390
  11. Isometrical view of a mechanic’s model double cottage, by Mr. Loudon   398
  12. Furniture of cottages : plans of construction of beds and windows 399
  13. Plans and elevations of labourers’ cottages erected by the Messrs. H. and E. Ashworth ;—Plans and elevations of houses in Birmingham ..  402
  14. Plan for the arrangement of public walks in restricted space in towns, as shown in the arrangement of the Arboretum, in Derby, by Mr. Loudon