Edwin Chadwick: Report on Sanitation (1842)

After as careful an examination of the evidence collected as I have been enabled to make, I beg leave to recapitulate the chief conclusions which that evidence appears to me to establish.

First, as to the extent and operation of the evils wich are the subject of this inquiry:--

         That the various forms of epidemic, endemic, and other disease caused, or aggravated, or propagated chiefly amongst the labouring classes by atmospheric impurities produced by decomposing animal and vegetable substances, by damp and filth, and close and overcrowded dwellings prevail amongst the population in every part of the kingdom, whether dwelling in separate houses, in rural villages, in small towns, in the larger towns--as they have been found to prevail in the lowest districts of the metropolis.

         That such disease, wherever its attacks are frequent, is always found in connexion with the physical circumstances above specified, and that where those circumstances are removed by drainage, proper cleansing, better ventilation, and other means of diminishing atmospheric impurity, the frequency and intensity of such disease is abated; and where the removal of the noxious agencies appears to be complete, such disease almost entirely disappears.

         The high prosperity in respect to employment and wages, and various and abundant food, have afforded to the labouring classes no exemptions from attacks of epidemic disease, which have been as frequent and as fatal in periods of commercial and manufacturing prosperity as in any others.

         That the formation of all habits of cleanliness is obstructed by defective supplies of water.

         That the annual loss of life from filth and bad ventilation are greater than the loss from death or wounds in any wars in which the country has been engaged in modern times. . . .

         That, measuring the loss of working ability amongst large classes by the instances of gain, even from incomplete arrangements for the removal of noxious influences from places of work or from abodes, that this loss cannot be less than eight or ten years. . . .

         That the population so exposed is less susceptible of moral influences, and the effects of education are more transient than with a healthy population.

         That these adverse circumstances tend to produce an adult population short-lived, improvident, reckless, and intemperate, and with habitual avidity for sensual gratifications.

         That these habits lead to the abandonment of all the conveniences and decencies of life, and especially lead to the overcrowding of their homes, which is destructive to the morality as well as the health of large classes of both sexes.

         That defective town cleansing fosters habits of the most abject degradation and tends to the demoralization of large numbers of human beings, who subsist by means of what they find amidst the noxious filth accumulated in neglected streets and bye-places.

         That the expenses of local public works are in general unequally and unfairly assessed, oppressively and uneconomically collected, by separate collections, wastefully expended in separate and inefficient operations by unskilled and practically irresponsible officers. , , ,

Secondly. As to the means by which the present sanitary condition of the labouring classes may be improved:--

         The primary and most important measures, and at the same time the most practicable, and within the recognized province of public administration, are drainage, the removal of all refuse of habitations, streets, and roads, and the improvement of the supplies of water.

         That the chief obstacles to the immediate removal of decomposing refuse of towns and habitations have been the expense and annoyance of the hand labour and cartage requisite for the purpose.

         That this expense may be reduced to one-twentieth or to one-thirtieth, or rendered inconsiderable, by the use of water and self-acting means of removal by improved and cheaper sewers and drains. . . .

         That for all these purposes, as well as for domestic use, better supplies of water are absolutely necessary. . . .

         That the expense of public drainage, of supplies of water laid on in houses, and of means of improved cleansing would be a pecuniary gain, by diminishing the existing charges attendant on sickness and premature mortality.

         That for the protection of the labouring classes and of the ratepayers against inefficiency and waste in all new structural arrangements for the protection of the public health, and to ensure public confidence that the expenditure will be beneficial, securities should be taken that all new local public works are devised and conducted by responsible officers qualified by the possession of the science and skill of civil engineers. . . .

         That by appropriate arrangements, 10 or 15 per cent. on the ordinary outlay for drainage might be saved, which on an estimate of the expense of the necessary structural alterations of one-third only of the existing tenements would be a saving of one million and a half sterling, besides the reduction of the future expenses of management.

         That for the prevention of the disease occasioned by defective ventilation and other causes of impurity in places of work and other places where large numbers are assembled, and for the general promotion of the means necessary to prevent disease, that it would be good economy to appoint a district medical officer independent of private practice, and with the securities of special qualifications and responsibilities to initiate sanitary measures and reclaim the execution of the law. . . .

         And that the removal of noxious physical circumstances, and the promotion of civic, household, and personal cleanliness, are necessary to the improvement of the moral condition of the population; for that sound morality and refinement in manners and health are not long found co-existent with filthy habits amongst any class of the community.

Question:  How does Chadwick turn a medical argument into a moral and social one?