All things considered, by the end of the first five years of the working of the new local constitution conferred upon the metropolis, a real beginning had been made in the sanitary evolution of the great city. Some of the grossest evils had been attacked, and a start made in lifting London out of the depths of the appalling slough of abominable filth in which it had become submerged. In some of the vitally important matters progress was material. The improvement in the water supply was considerable, the main drainage works had been started; the construction of many new sewers, the abolition of great numbers of cesspools, and the better drainage of houses, were all events of a decidedly satisfactory character. And the death-rate of London as a whole showed a slight decrease--from 23·38 per 1,000 in 1851 to 23·18 in 1861. In some districts there was an increase--in the majority, however, there was a decrease. But most encouraging of all was the direct evidence afforded by experience as to the effects of sanitary improvements. Thus, in Whitechapel, the Medical Officer of Health, in reporting that the cases of fever had diminished from 1,929 in 1856 to 190 in 1860, said:-- "This diminution may be fairly attributed to the additions made to the sewerage of the district, the improvements effected in the drainage of 2,172 houses, the abolition of 3,002 cesspools, the better paving of many of the courts, the systematic inspection, &c., of houses where fever occurred, the removal of 37,607 nuisances, and to the abolition of several offensive trade nuisances." And the Medical Officer of Health for Shoreditch wrote, in 1861:-- "That the diminished mortality and the lesser frequency of epidemic diseases are really due in great measure to sanitary works and inspection is proved by the diminution and even disappearance of certain forms of sickness from streets, courts, and districts where sewers have been constructed, ventilation provided, and other improvements effected; whilst, on the other hand, the districts still requiring those necessary reforms furnish far more than their proportion of the epidemic sickness and mortality." Philanthropic individuals were increasing their efforts for the improvement of the people; and societies, working on a self-supporting basis, were taking more active interest in the housing problem, and erecting model lodging-houses and more healthy habitations.[80] Public opinion was more interested than before in sanitary matters, and it was thought that the working classes had also in some degree awakened to the care of their own health. "Altogether," wrote the Registrar General, in his report on the health of London after the census figures of 1861 were known, "there is abundant proof of that increased regard for human life that attends civilisation." FOOTNOTES: [54] 18 and 19 Vic. cap. 120. [55] 18 and 19 Vic. cap. 121. [56] 18 and 19 Vic. cap. 122. [57] Section 103 of Metropolis Local Management Act.