"The apathy of the public in matters of health is truly lamentable." Nor was all the apparent progress as genuine as appeared on the surface. The Medical Officer of Health for St. Mary, Newington, in his report of 1874 disclosed this material fact. Writing of some Returns which he had prepared of sickness in seventeen years, he said:-- "In the period we have seen the end of many fever haunts. We have seen hundreds and hundreds of the old tenements removed and new abodes raised in their stead; but with it, alas! we have seen all the defects of new buildings, all the defects of badly laid drains, all the evils of work ill done, its dangers too often not capable of recognition until sickness and death forced the discovery. We have seen too often in the new houses defects of ventilation, of construction, of drainage, and of overcrowding: we have seen many an evil allowed by law, and over which we cannot extend our sanitary rules. We have also to contend with the indifference, the carelessness, the blindness of the people themselves--intemperance and crime stand in our way...." But in 1881 he wrote: "Sanitary work has borne fruit." The progress of sanitation is almost necessarily slow. "There is not," wrote one of the Medical Officers of Health, "a more difficult task than that of carrying out sanitary reform, for although every one agrees that sanitary laws should be put in force, they are greatly objected to when they interfere with one's self." And another wrote:-- "Nuisances crop up, are removed, and re-appear. _It is a continuous warfare due to many causes_, such as carelessness and wilfulness on the one hand, and accidental circumstances on the other." And another:-- "The sanitary labours of your officers increase year by year as the population becomes denser, and the need for sanitary precautions grows more urgent." And underneath all was the view expressed by the Medical Officer of Health for Islington (1881):-- "I fear the public have not even yet learned to regard health as a matter of infinitely greater moment than rates and taxes." How far-reaching were the effects of disease was admirably set forth by Dr. Simon:-- "I do not pretend to give any exact statement of the total influence which preventable diseases exert against the efficiency and happiness of our population, for it is only so far as such diseases kill, and even thus far but very imperfectly, that the effect can be reported in numbers. Of the incalculable amount of physical suffering and disablement which they occasion, and of the sorrows, and anxieties, the permanent darkening of life, the straitened means of such subsistence, the very frequent destitution and pauperism which attend or follow such suffering, death statistics testify only in sample or by suggestion."[148] Few people realise the infinite importance of health to a great community. As one of the Medical Officers of Health truly wrote:--