The most obvious source of water remained the Thames. John Stow in his monumental Survey of London explained how water was conveyed through lead pipes straight into peoples’ houses from a pumping device located under an arch of London Bridge. This clever device involved a waterwheel and came into use in 1582, not being decommissioned until 1822. The Thames water was of course filthy and full of disease-bearing organisms.
The first major scheme to tap into water supplies that were distant from London was the well-known project developed by Sir Hugh Myddelton, completed in 1613. This brought clean water from springs and streams in Hertfordshire to a reservoir at New River Head in the Islington district just north of the City. For a substantial fee of at least 5s per annum, the householder could be connected to the mains, which were made of wood, by a lead pipe called a ‘quill’. Since the supplies to individual houses only operated a few days a week, it was advisable to install a storage tank in the cellar, probably of lead. Wooden pipes absorbed pollutants, even from this relatively clean source. Lead of course contains various toxins. Constant exposure to these toxins over long periods could be fatal.
During the rebuilding of London after the Great Fire of 1666, owners of new houses were given the opportunity of being supplied with water from either the New River Water Company or the London Bridge Waterworks. This gave them the choice of water that was relatively pure, or water that was close-to-hand but likely to be polluted and to look, smell and taste foul. They often chose the latter because it was considerably cheaper.
The quality of its water supplies deteriorated as the population of London and its environs grew. The Thames and the various tributaries that flowed into it in the vicinity of London became progressively filthier. These streams were used as convenient receptacles for every sort of refuse – animal, vegetable or mineral. If this ordure was tipped into the street, it stank and got in the way. Throwing it into the nearest watercourse meant that there was some chance that it would be washed away from the immediate vicinity. Perhaps the most notorious of the tributaries was the Fleet which became a festering open sewer, flowing – perhaps we should say oozing – through the western fringes of the City in an area densely occupied by housing and industrial premises. Like virtually all of the streams that made their way into the Thames in the area we now think of as central London, the Fleet was eventually covered over. Only then did these streams cease to be quite so filthy and germ-ridden. Just how awful the ordure and other pollutants that were contained in these streams could be was shown in 1846 when gases produced by the material in the Fleet caused it to explode and a tsunami of excrement coursed down its shallow valley and demolished three Poor Law workhouses in Clerkenwell, drowning some of their occupants.
Lining the banks of streams like the Fleet were knackers’ yards, tanneries, glue factories, slaughterhouses, tar-works and other working premises. These not only emitted their own offensive smells but deposited their effluents and refuse in the nearest convenient stream. These tributaries took on a colour compounded of all the noxious substances they received and also deposited a repulsive, stinking, viscous slime along their courses. This was visible at low tide both in the tributaries and in the Thames itself around the outflows. In hot, humid weather the stench given off by the water and the mud was simply indescribable. In wet weather, with heavier flows of water, the smell from this repulsive detritus would be somewhat diminished.
Jonathan Swift (1667–1745) gives a sense of the disgusting nature of the City’s open water-courses in his ‘Description of a City Shower’ (1711):
Now from all parts the swelling kennels* flow,
And bear their trophies with them as they go:
Filth of all hues and odours seem to tell
What street they sail’d from, by their sight and smell …
Drown’d puppies, stinking sprats, all drench’d in mud,
Dead cats and turnip-tops, come tumbling down the flood.
*Kennels are drains or gutters.
As late as the second half of the nineteenth century, the various private companies that supplied water to London’s citizens did so largely through wooden pipes and, using the excuse that those pipes could not stand up to constant pressure, seriously restricted the times at which water was available from standpipes. Their subscribers were therefore tempted to draw water from alternative sources at other times, which were often polluted and occasionally lethal.
Waste disposal has always posed formidable problems for Londoners. In the fourteenth century it became illegal to discharge sewage into watercourses and cesspits were provided as receptacles for this purpose. However, Londoners ignored official decrees and continued to throw human excrement and all sorts of other waste matter into the nearest convenient stream, simply because it was easy to do so. If it flowed away it became someone else’s problem.
The state of the cesspits and the frequency (or otherwise) with which they were emptied provided a topic for Londoners to carp and gripe about. Men called ‘rakers’ or ‘gong-fermors’ emptied the cesspits. This job carried little status but was comparatively well paid because of its intrinsically unpleasant nature and the anti-social working-hours – it was normally performed at night. Perhaps it also attracted an element of danger money: in 1326 the unfortunate ‘Richard the Raker’ fell into a cesspit and was described somewhat unsympathetically as having drowned ‘monstrously in his own excrement’. Samuel Pepys had cause for grievance with the inadequacies of his neighbour’s cesspit when he wrote grumpily in his diary on 20 October 1660: ‘Going down to my cellar … I put my feet into a great heap of turds by which I find that Mr Turner’s house of office is full and comes into my cellar.’
Before the nineteenth century there was no modern germ theory of disease. Londoners, however, had worked out empirically that there was a connection between dirt, unpleasant smells and various kinds of illness. The agent that most people thought was responsible for transmitting illness was ‘miasma’ (something smelly and poisonous in the air or in water). Even before the invention of powerful microscopes and the knowledge this brought of minute disease-bearing organisms, the feeling developed in the 1820s that the use of water from the Thames was undesirable and that alternative sources needed to be found. A Parliamentary Select Committee was set up at the end of the 1820s and the distinguished civil engineer Thomas Telford (1757–1834) was asked to make suggestions for finding new supplies of clean water for the metropolis. He laboured in vain as there was no action on his recommendations.
The private companies supplying water to London had a vested interest in attempting to staunch growing public concerns about the dubious quality of, and the dangers posed by, the existing water supplies. Their spin-doctors got to work. According to one ‘expert’, there was ‘probably not a spring, with the exception of Malvern, and one or two more, which is so pure as Thames water’. For sheer mendacious effrontery such an official statement would take some beating – even today.
The Thames continued to be the major source of London’s water supplies. Some improvement in its cleanliness seems to have been effected by a process of filtering the water through beds of sand before it was piped to the consumers. As late as 1816 salmon were still taken in the river in some numbers but evidence that the Thames was getting progressively dirtier is suggested by the fact that the last record of a salmon being caught was in 1833. Salmon do not like badly-polluted water.
By the 1840s serious concerns were being expressed about many of the social effects of the twin processes of industrialisation and urbanisation, not only in London but throughout Britain. It was evident that a heavy human price was being paid in terms of the blighted environment, the poor and overcrowded housing, the epidemic diseases, the hazardous working conditions and the short and miserable lives of much of the urban industrial workforce. The prevailing philosophy of laissez-faire argued that it was not the job of governments to intervene extensively in the economic and social life of the nation. ‘Market forces’ should be allowed t
he greatest possible freedom. Although laissez-faire policies were never applied absolutely, the concept obviously did not sit easily with the idea that the government should accept any responsibility for the health of the nation. The largely untrammelled pursuit of wealth-production and private profit was clearly having dire social and environmental consequences.
The horrors that the Industrial Revolution brought could not be entirely ignored by those in power. The issue of public health forced itself onto the political agenda. What was known as the ‘Sanitary Movement’ developed in the 1840s and owed much to the tireless efforts of Sir Edwin Chadwick (1800–1890). Chadwick was a bumptious busybody who had played a key role in the highly unpopular reforms of the Poor Law in 1834. His experience with the Poor Law had convinced him that the distress accompanying the emergence of an industrial society had considerable financial and human costs both of which could be reduced by the development of preventative public health measures.
In 1842 Chadwick produced a voluminous and far-reaching report on the sanitary conditions of the working classes. It shocked the nation. In it Chadwick demonstrated the close connection between unsanitary living conditions and endemic/epidemic disease. He showed how disease carried away breadwinners and forced their families into what is now called the ‘dependency culture’, having to be paid for out of the Poor Rates. In Bethnal Green in the East End, the average age of death among labourers was an appalling sixteen years. For the better-off in London, it was forty-five. Chadwick argued that misery and despair among the industrial working class led to crime, drunkenness and immoral behaviour which also had damaging financial implications. Finally, Chadwick urged reforms to tackle the appalling state of affairs he had identified in the sphere of public health.
Chadwick was widely disliked not only personally but because of the mare’s nest of neglect and vested interests that his report highlighted. He was extremely persistent and his report highlighted many deficiencies in London’s drainage and sewage systems which he believed were responsible for much preventable death. These systems were the responsibility of the kind of self-perpetuating, uncoordinated and inefficient cliques that he hated so much. The man has to be given credit for placing the issue of public health at the forefront of the political agenda and his efforts were at least partly responsible for the passing of the keynote Public Health Act of 1848. This Act created a breach in the dam of self-serving interest, complacency, indifference, obfuscation, ignorance and dislike of state intervention behind which effective ways of dealing with avoidable death had been hidden for too long.
Further widespread legislative action was to follow over the next decades, the effect of which was a cleaner, healthier environment as responsibility was assumed by the agencies of national and local government. Combined with great advances in scientific knowledge and in surgery and clinical practice the scene was set for dramatic reductions in preventable death in London and throughout the United Kingdom. Meanwhile London was in danger of being overwhelmed by a flood of human excrement. Action was needed, and quickly!
How often is it that an invention which unquestionably brought great benefits to mankind over time has had disastrous consequences in the short term? Such was the impact of the flushing water-closet.
Various flushing devices had been made from the sixteenth century onwards but it was probably the ingenious Joseph Bramah (1748–1814) who invented, manufactured and marketed the first popular flushing water-closet. These devices were eagerly bought up by the well-to-do as much because they were fashion items as for their ostensible practical purpose. By 1800 Bramah was producing hundreds of flushing water-closets each year. A crisis was about to occur!
The problem was that flushing closets used huge quantities of water compared with cesspools and pits. Not only did those houses fitted with water-closets now require far more water but the greatly enlarged discharge that resulted put a huge burden on the already inadequate drains, sewers and cesspits, one which they were frequently unable to deal with. Much of this water eventually made its way into the Thames, still a major source of London’s water, but not before it had sometimes flowed through sources of contamination such as burial grounds.
In 1801 the population of London was nearly 1 million. By 1861 the population had increased about fourfold but both the amount of water used and the quantity of liquid waste had increased out of all proportion. This put large numbers of Londoners, more or less irrespective of class, at risk of disease or death from waterborne infection. Many people took their water supplies from a tap shared by several families or they scooped water by the bucketful out of the nearest river. It was all too common for such sources to contain dangerous, sometimes lethal, invisible disease-bearing organisms.
The archetype of potentially-lethal diseases that are transmitted in contaminated water is cholera. This arrived in England for the first time in 1831 and spread across the country with terrifying speed. It is an acute intestinal disease caused by the bacterium Vibrio cholerae which is ingested through polluted water. Its most obvious symptom is chronic diarrhoea bringing on severe dehydration, agonising muscular cramps and culminating in the worst cases with circulatory collapse before death. Cholera outbreaks in 1831–2, 1848–9, 1853–4 and 1866 killed more than 36,000 Londoners. Most of the victims would have suffered such agonies that death must have provided welcome relief.
Officialdom and the medical world were virtually powerless; society at large panicky and confused. ‘Conspiracy-theorists’ argued that the scare around cholera had been created deliberately by the government to divert attention away from the ferment of debate and unrest around the Reform Bill. Some people thought that doctors and druggists were growing rich as a result of the extra work that the cholera entailed and that they had a vested interest in keeping the disease prevalent as long as possible. In reality the medical profession could do little to reduce mortality rates.
There was widespread fear of entering hospital. This was because the Anatomy Act of 1832 permitted the use of the bodies of paupers for medical dissection. Rumours circulated that indigent cholera victims would be hospitalised compulsorily then murdered and sold to the anatomists. Rapid burials were used by the authorities as a measure intended to slow the spread of the disease. This offended the working-class tradition of accompanying the send-off of the deceased with good old-fashioned junketing. Funerals traditionally took place on Sundays so that friends and relatives did not have to take time off work. Now the official requirement that funerals must take place on other days, as soon as possible after death, prevented some mourners from taking part. This was strongly resented. Rapid interments raised fears about premature burial too. Opium and laudanum were often used to treat cholera victims and they could produce a state of coma difficult to distinguish from death itself. No one wanted to wake up inside a coffin!
The apparently random manner in which cholera struck, killing all classes and ages but with equal unpredictability allowing some to survive, led many people to question basic religious assumptions. What kind of a God permitted the deaths of the supposedly innocent? Assurances that the innocent died to assuage the sins of those still alive cut little ice with the bereaved. It was cold comfort to be assured that those who had died would find their rewards in the hereafter. Repentance was put forward as the surest way of avoiding the fatal consequences of cholera but it was noted that many of those who had tried to shrive their sins still died from the scourge. Some self-righteous individuals claimed that cholera was the reward for the ‘sin’ of drunkenness. Certainly prolonged alcohol abuse can damage chemicals in the stomach which act as a barrier to infection. The malnutrition so common among London’s poor would have had much the same effect.
The cholera visitation of 1832 came and went and few lessons were learnt. The next, and more serious pandemic was in 1848. Now it is a pleasure to introduce one of London’s rather unsung heroes. In 1849 John Snow, a general practitioner in Soho, published a paper called On the mode of communication of chole
ra. In this he produced a cogent argument to the effect that whatever caused cholera was transmitted via contaminated water and was not ‘something in the air’ or a harmful smell or ‘miasma’, as most people believed. Snow drew a map identifying where 500 cholera deaths had occurred in Soho during a ten-day period in September 1854. Those who had succumbed were concentrated in houses in which the water supply was drawn from the Broad Street pump. Snow believed that this water had been contaminated by seepage from a leaking cesspool or drain. He had the handle of the pump removed. Local residents had to draw their supplies from elsewhere. The incidence of cholera in the district fell immediately.
Snow had made an effective case but he was a somewhat retiring man unable to take on doubters very forcefully. In 1866 another outbreak followed killing 6,000 in London alone and it was left to Robert Koch, a German researcher, about twenty years later to establish conclusively that cholera was transmitted in water containing a dangerous micro-organism and that it thrived in dirty and unsanitary conditions.
Typhoid fever is caused by a member of the Salmonella family, Salmonella typhi. Typhoid is marked by prolonged bouts of diarrhoea – or occasionally, strangely enough, by constipation – severe abdominal pain, raging fever, excruciating headaches and exhaustion. Complications which may be fatal include pneumonia, intestinal perforation, haemorrhaging and coma. In the nineteenth century mortality rates were between 10 and 20 per cent. Typhoid killed nearly 1,500 Londoners every year from 1850 to 1870.
In technical terms, typhoid fever is described as faecal-orally spread. This simply means that the causative organism moves from the gut of the infected individual into the mouth of its next victim. This can happen when water supplies are polluted with faecal matter. The bacteria can also travel from person to person via the unwashed hands of someone, for example, preparing food for others. Flies are effective carriers of typhoid, landing first on faecal material and then on food or someone’s face. Typhoid is typically a disease of poor sanitation. Its enemies are effective sewers, clean water and attention to personal hygiene. London at this time provided typhoid with the optimum conditions for its spread.
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