rose higher in 1863 than it had been in any
year since 1854, when cholera raged in the
metropolis." He warns all who have the
control of sanitary matters that, unless great
care be taken, the ground that has been gained
will be lost. We would draw particular
attention to his warning, for his fears are founded
on facts which cannot be explained away.
In '64, the deaths in London nearly equalled
those of '63; and in the year which has just
passed away the deaths exceeded those of 63.
Thus, during the first half of the decennial
period, from 1860 to 1870, the health of London
is not more favourable than it was during the
previous twenty years; and the "unnatural"
or preventable deaths are at the rate of no less
than seven a year among each thousand of its
dwellers. During the present year there are
no signs of improvement, for in its first quarter
the deaths have been at the rate of twenty-six
a year among each thousand inhabitants.

It will happen occasionally that there will be
an exceptionally healthy season, when, owing to
favourable meteorological conditions and to
unusual national prosperity, fevers and all diseases
of low type will be less frequent. This lull in the
violence of death will be taken by many persons
who have not studied sanitary matters as proof
positive that the condition of London is satisfactory.
Such a lull, however, is not to be trusted,
and is often followed by a storm of disease.

Our large cities are still wofully undefended
against the encroachments of disease even in
ordinary times, and in unhealthy seasons they
are nearly defenceless. We escaped the ravages
of cholera last year, yet that fact does not prove
that we are cholera-proof, and that this scourge
may not visit us again as in the years 1849 and
1854. Even the knowledge that it has lately
touched our shores, though it did not stay here,
ought to make us the more careful, and the more
eager to take every preventive measure.

Although, in the other large towns to which
we have alluded, there has been a slight decrease
in the mortality during the last decennial period
—with the exception of Birmingham, which
presents a slight increase instead—Salford yet gave
as many as nine unnatural deaths among each
thousand of its inhabitants, Birmingham gave
ten, Leeds and Bristol each gave eleven,
Manchester fourteen, and Liverpool sixteen!

It is sad to know that, despite every measure
hitherto taken to improve the public health, the
rate of mortality in England and Wales abated
"not a jot" during the ten years ending in 1860.
During the decade commencing in the year 1841,
and ending in '50, the average yearly number of
deaths was twenty-two among each thousand
inhabitants; during the ten years ending in '60
the average annual death-table remained the
same. Twenty-two! Sad news this, truly. Yet
this fact ought not to make us desponding.
Ought it not rather to stimulate us to work
zealously, in preventing this cruel waste of
English life? That the evil admits of remedy
there can be no doubt, as there can be no doubt
that the one great cause of this wasting of life is
the over-crowding in our large cities and towns.
But over-crowding may exist too—often does
exist—in the smallest villages, in hamlets where
the number of inhabitants exceeds the
house-accommodation, so that human beings are too
closely packed during some portion of every
twenty-four hours, and are subjected to the evil
influences of imperfect ventilation, and other
unnatural sanitary conditions. Then diseases of
the most virulent type spring up, and spread
with as much rapidity among the cottagers, and
cause as many deaths in proportion to their
numbers, as are caused by the same diseases in
the most densely populated portions of our
largest cities.

It is the greatest public question, how far the
present sanitary machinery answers its purpose.
If it were thought well and wise to appoint a
public commission to inquire into the cattle
plague, how much more necessary would it seem
to inquire with the most searching care into
the all-important subject of the economising
and protecting of human life. Comprehensive
measures must be adopted sooner or later
towards this end. Whether it would be well for
government to do thoroughly and with
uniformity that which charity is now doing by
patches and in miniature—to buy up
over-crowded and disease-saturated districts of
London, to pull down low-storied and cellar-habited
houses, and to build squares of taller houses in
their places, converting the area saved, into
public play-grounds; whether it would be well
to order a general sanitary survey of that "ring
of life" growing rapidly around the metropolis,
with the view of organising a system of more
complete governmental control over the erection
of houses, so that larger open spaces should be
left, and a check imposed on the present practice
of building upon every available piece of
ground, to the detriment of public health; these
are subjects requiring the greatest freedom of
discussion; but it is certain that some determined
action must be taken, and that by the executive.
Measures must be adopted towards the saving
of many thousands of lives, and towards the
strengthening of the entire populations. It is
a subject requiring the calmest thought, and the
most decided action. It ought not to be
considered in a time of panic, when some disease,
during one year or during one season, is
particularly destructive; nor ought it to be shelved
for smaller and more ephemeral national
questions, even although during one year or one
season the death-tables of England generally, or of
London and the large cities specially, have been
unusually low. To believe that the low mortality
of one year is a sign of great improvement in
national health, and of permanent increase of
national safety, and thus to bury among the leaves
of the blue-book of the single year the statesmanlike
view of the subject, is to do what the
ostrich does, when he buries his foolish head in
the sand.

On the other hand, to hesitate about grappling
with this national difficulty because of its gigantic
proportions and its complexities, is still worse: