CHAPTER V. RISE OF THE SANITARY MOVEMENT, 1837. Perhaps the most necessary and the most tried quality in a reformer is Patience. Notwithstanding the publication of the 'Treatise on Fever' in 1830, and the tribute paid by the scientific world to its masterly exposition of the treatment and causes of the disease, notwithstanding the constant and ardent endeavours of the author to propagate his views, yet seven long years passed away before he was able to awaken the apathy of the public and the authorities. Year after year went by, and the wards of the Fever Hospital continued to be supplied from the same districts, from the same courts and lanes--even from the very same house--as before. The preventible suffering, thus daily brought before my grandfather's eyes, was a daily reminder of the urgent need for help--of the necessity for taking practical steps to diminish it. In 1837 the opportunity came for pressing forward in the cause. That year a frightful epidemic fever broke out in London, arousing general alarm, and demanding special inquiry. The pressure on the poor-rates became excessive, and my grandfather was appointed by the Poor Law Commissioners to report on the eastern districts of London, Drs Arnott and Kay being appointed to other districts. The title of the Report presented by him is at once striking. He called it, "Report on the Physical Causes of Sickness and Mortality to which the Poor are particularly exposed, _and which are capable of prevention by Sanitary Measures_." Its opening words are,-- "Some of the severest evils at present incident to the condition of poverty, which have a large share in inducing its high rate of sickness and mortality, are the consequences of improvidence. Such evils are capable of being remedied only by bringing the poor under the influence of the inducements to forethought and prudence. "But there are evils of another class, more general and powerful in their operation, which can be avoided by no prudence, and removed by no exertion, on the part of the poor. Among the gravest, and at the same time the most remediable, of these latter evils, is the exposure to certain noxious agents generated and accumulated in the localities in which the poor are obliged to take up their abode, and to the pernicious influence of which they are constantly, and for the most part unconsciously, subjected. "It is the object of the present Report to direct attention to the nature and extent of this evil, and to show how important it is that its mitigation, and, as far as may be found practicable, its entire removal, should form a part of every exertion that is made for improving the physical condition of the poor." These words would seem to strike the key-note of Sanitary Reform.