“That the filthy and disgraceful state of many of the streets in these densely populated and neglected parts of the town where the indigent poor chiefly reside cannot fail to exercise a most baneful influence over their health is an inference which experience has fully proved to be well founded; and no fact is better established than that a large proportion of the causes of fever which occur in Manchester originate in these situations. Of the 182 patients admitted into the temporary fever hospital in Balloon-street, 135 at least came from unpaved or otherwise filthy streets, or from confined and dirty courts and alleys. Many of the streets in which cases of fever are common are so deep in mire, or so full of hollows and heaps of refuse that the vehicle used for conveying the patients to the House of Recovery often cannot be driven along them, and the patients are obliged to be carried to it from considerable distances. Whole streets in these quarters are unpaved and without drains or main-sewers, are worn into deep ruts and holes, in which water constantly stagnates, and are so covered with refuse and excrementitious matter as to be almost impassable from depth of mud, and intolerable from stench. In the narrow lanes, confined courts and alleys, leading from these, similar nuisances exist, if possible, to a still greater extent; and as ventilation is here more obstructed, their effects are still more pernicious. In many of these places are to be seen privies in the most disgusting state of filth, open cesspools, obstructed drains, ditches full of stagnant water, dunghills, pigsties, &c., from which the most abominable odours are emitted. But dwellings perhaps are still more insalubrious in those cottages situated at the backs of the houses fronting the street, the only entrance to which is through some nameless narrow passage, converted generally, as if by common consent, into a receptacle for ordure and the most offensive kinds of filth. The doors of these hovels very commonly open upon the uncovered cesspool, which receives the contents of the privy belonging to the front house, and all the refuse cast out from it, as if it had been designedly contrived to render them as loathsome and unhealthy as possible. Surrounded on all sides by high walls, no current of air can gain access to disperse or dilute the noxious effluvia, or disturb the reeking atmosphere of these areas. Where there happens to be less crowding, and any ground remains unbuilt upon, it is generally undrained, contains pools of stagnant water, and is made a depôt for dunghills and all kinds of filth.” Of 687 streets, inspected by a voluntary association in that town, 248 were reported as being unpaved, 112 ill ventilated, 352 as containing stagnant pools, heaps of refuse, ordure, &c.