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LONDON
[PUBLIC HEALTH


  Average
 1895–1904. 
 1905. 
 Leicester 16.7 13.3
 Brussels 16.7 14.5
 Bristol 16.9 14.6
 Bradford 17.7 15.2
 Leeds 19.1 15.2
London 18.2 15.6
 Birmingham 20.2 16.2
 Nottingham 18.4 16.5
 Newcastle 20.9 16.8
 Sheffield 19.6 17.0
 Berlin 17.8 17.2
 Paris 19.2 17.4
 Manchester 22.6 18.0
 New York 20.2 18.3
 Vienna 20.0 19.0
 Liverpool 23.2 19.6
 Rome 19.1 20.6
 St Petersburg  25.9 25.3

In 1905 the lowest death-rates among the metropolitan boroughs were returned by Hampstead (9.3), Lewisham (11.7), Wandsworth (12.6), Woolwich (12.8), Stoke Newington (12.9), and the highest by Shoreditch (19.7), Finsbury (19.0), Bermondsey (18.7), Bethnal Green (18.6) and Southwark (18.5). A return of the percentage of inhabitants dwelling in over-crowded tenements shows 2.7 for Lewisham, 4.5 for Wandsworth, 5.5 for Stoke Newington, and 6.4 for Hampstead, against 35.2 for Finsbury and 29.9 for Shoreditch.

Sanitation.—As regards sanitation London is under special regulations. When the statutes relating to public health were consolidated and amended in 1875 London was excluded; and the law applicable to it was specially consolidated and amended in 1891. The London County Council is a central sanitary authority; the City and metropolitan boroughs are sanitary districts, and the Corporation and borough councils are local sanitary authorities. The County Council deals directly with matters where uniformity of administration is essential, e.g. main drainage, housing of working classes, infant life protection, common lodging-houses and shelters, and contagious diseases of animals. With a further view to uniformity it has certain powers of supervision and control over local authorities, and can make by-laws respecting construction of local sewers, sanitary conveniences, offensive trades, slaughter-houses and dairies, and prevention of nuisances outside the jurisdiction of local authorities. A medical officer of health for the whole county is appointed by the Council, which also pays half the salaries of local medical officers and sanitary inspectors. The Council may also act in cases of default by the local authorities, or may make representations to the Local Government Board respecting such default, whereupon the Board may direct the Council to withhold payment due to the local authority under the Equalization of Rates Act 1894.

The first act providing for a commission of sewers in London dates from 1531. Various works of a more or less imperfect character were carried out, such as the bridging over in 1637 of the river Fleet, which as early as 1307 had become inaccessible Drainage. to shipping through the accumulation of filth. Scavengers were employed in early times, and sewage was received into wells and pumped into the kennels of the streets. A system of main drainage was inaugurated by the Commissioners of Sewers in 1849, but their work proceeded very slowly. It was carried on more effectively by the Metropolitan Board of Works (1856–1888) which expended over six-and-a-half millions sterling on the work. The London County Council maintained, completed and improved the system. The length of sewers in the main system is about 288 m., and their construction has cost about eight millions. The system covers the county of London, West Ham, Penge, Tottenham, Wood Green, and parts of Beckenham, Hornsey, Croydon, Willesden, East Ham and Acton. There are actually two distinct systems, north and south of the Thames, having separate outfall works on the north and south banks of the river, at Barking and Crossness. The clear effluent flows into the Thames, and the sludge is taken 50 m. out to sea. The annual cost of maintenance of the system exceeds £250,000. The sanitary authorities are concerned only with the supervision of house drainage, and the construction and maintenance of local sewers discharging into the main system. The Thames and the Lea Conservancies have powers to guard against the pollution of the rivers.

Hospitals.—The Metropolitan Asylums Board, though established in 1867 purely as a poor-law authority for the relief of the sick, insane and infirm paupers, has become a central hospital authority for infectious diseases, with power to receive into Metropolitan Asylums Board. its hospitals persons, who are not paupers, suffering from fever, smallpox or diphtheria. Both the Board and the County Council have certain powers and duties of sanitary authority for the purpose of epidemic regulations. The local sanitary authorities carry out the provisions of the Infectious Diseases (Notification and Prevention) Acts, which for London are embodied in the Public Health (London) Act 1891. The Board has asylums for the insane at Tooting Bec (Wandsworth), Ealing (for children); King’s Langley, Hertfordshire; Caterham, Surrey; and Darenth, Kent. There are twelve fever hospitals, including northern and southern convalescent hospitals. For smallpox the Board maintains hospital ships moored in the Thames at Dartford, and a land establishment at the same place. There are land and river ambulance services.

There are three regular funds in London for the support of hospitals. (1) King Edward’s Hospital Fund (1897) founded by King Edward VII. as Prince of Wales in commemoration of the Diamond Jubilee of Queen Victoria. The League of Mercy, under royal charter, operates in conjunction with the Fund in the collection of small subscriptions. The Order of Mercy was instituted by the King as a reward for distinguished personal service. (2) The Metropolitan Hospital Sunday Fund, founded in 1873, draws the greater part of its revenue from collections in churches on stated occasions. (3) The Metropolitan Hospital Saturday Fund was founded in 1873, and is made up chiefly of small sums collected in places of business, &c. The following is a list of the principal London hospitals, with dates of foundation:—

  1. General Hospitals with Medical Schools (all of which, with the exception of that of the Seamen’s Hospital, are schools of London University):—

  Charing Cross; Agar Street, Strand (1820).
  Guy’s; St Thomas Street, Southwark (1724).
  King’s College; Lincoln’s Inn Fields (1839).
  London; Whitechapel (1740).
  Middlesex; Mortimer Street, Marylebone (1745).
  North London, or University College; Gower Street (1833).
  Royal Free; Gray’s Inn Road (1828; on present site, 1842).
    London School of Medicine for Women.
  St Bartholomew’s; Smithfield (1123; refounded 1547).
  St George’s; Hyde Park Corner (1733).
  St Mary’s; Paddington (1845).
  St Thomas’; Lambeth (1213; on present site, 1871).
  Seamen’s Hospital Society; Greenwich (1821).
  Westminster, facing the Abbey. (1720; on present site, 1834).

2. General Hospitals without Schools:—
  Great Northern Central; Islington (1856; on present site, 1887).
  Metropolitan; Hackney (1836).
  Poplar Hospital for Accidents (1854).
  West London; Hammersmith Road (1856).

3. Hospitals for Special Purposes:—
  Brompton Consumption Hospital (1841).
  Cancer Hospital; Brompton (1851).
  City of London Hospital for diseases of the chest; Bethnal Green (1848).
  East London Hospital for Children and Dispensary for Women; Shadwell (1868).
  Hospital for Sick Children; Bloomsbury (1852).
  London Fever Hospital; Islington (1802).
  National Hospital for Paralysed and Epileptics; Bloomsbury (1859).
  Royal Hospital for Incurables; Putney (1854).
  Royal London Ophthalmic Hospital; City Road (1804; on present site, 1899).

(See also separate articles on boroughs.)

Water Supply.—In the 12th century London was supplied with water from local streams and wells, of which Holy Well, Clerk’s Well (Clerkenwell) and St Clement’s Well, near St Clement’s Inn, were examples. In 1236 the magistrates purchased the liberty to convey the waters of the Tyburn from Paddington to the City by leaden pipes, and a great conduit was erected in West Cheap in 1285. Other conduits were subsequently built (cf. Conduit Street off Bond Street, Lamb’s Conduit Street, Bloomsbury); and water was also supplied by the company of water-bearers in leathern panniers borne by horses. In 1582 Peter Moris, a Dutchman, erected a “forcier” on an arch of London Bridge, which he rented for 10s. per annum for 500 years. His works succeeded and increased, and continued in his family till 1701, when a company took over the lease. Other forciers had been set up, and in 1609, on an act of 1605, Sir Hugh Myddelton undertook the task of supplying reservoirs at Clerkenwell through the New river from springs near Ware, Hertfordshire; and these were opened in 1613. In 1630 a scheme to bring water from Hoddesdon on the Lea was promoted by aid of a lottery licensed by Charles I. The Chelsea Water Company opened its supply from the Thames in 1721; the Lambeth waterworks were erected in 1783; the Vauxhall Company was established in 1805, the West Middlesex, near Hammersmith, and the East London on the river Lea in 1806, the Kent on the Ravensbourne (Deptford) in 1810, the Grand Junction in 1811, and the Southwark (which amalgamated with the Vauxhall) in 1822.

For many years proposals to amalgamate the working of the companies and displace them by a central public authority were put forward from time to time. The difficulty of administration lay in the fact that of the area of 620 sq. m. constituting what is known as “Water London” (see map in London Statistics, vol. xix., issued by the L.C.C., 1909) the London County Council has authority over little more than one-third, and therefore when the Council proposed