The industrial classes realised to a greater extent than ever before the disastrous results to themselves and their families of sickness and ill-health; the prolonged suffering, the loss of work and wages, the ensuing hardships. And it was upon them more than on others that the effects of disease fell most heavily. In most matters the interests of the various parts of London, and of the various classes, are one and the same, but in none to anything like the same extent as in the vital matter of public health. Here they are one and indivisible. But neither Parliament nor the Government had got so far as to recognise that yet, and London--the great metropolis--with its four-and-a-half millions of people, was left for its protection against disease to a number of semi-independent local sanitary authorities who had no authority beyond their own area, and who could take no action for the safety of London as a whole. One thing was absolutely certain--and that was that the civic life of London had within the decade been lifted to altogether a higher plane. The publicity of the proceedings of the central representative authority--whether of its meetings in the Council Chamber, or of its constant applications to Parliament for legislation embodying far-reaching civic reforms in London--the triennial elections, when the area of discussion was shifted from the Council Chamber to the constituencies, quickened the interest and awoke the dormant masses of the people to the importance of civic administration and of civic laws. In this remarkable change the subject of the public health strode to the front. Men began to realise how it entered into every branch or part of their own lives and of their families, how its ramifications invaded every part of their existence, how much their welfare and comfort and even their existence depended upon it. And the people had a great load lifted off them--the load of despair begotten by the hopelessness of any amelioration of the conditions of life which so long had weighed them down. They felt now that there was some one to whom they could complain, some public authority who would see that things would be righted, if they could be righted, and hope was born in their lives. In 1899 another change was made in the system of local government in London. The Act of 1888, while dealing with the central government of London, had practically not touched the local areas. The work was felt to be incomplete, and in 1893 Commissioners were appointed "to consider the proper conditions under which the amalgamation of the City and the County of London can be effected, and to make specific and practical proposals for that purpose." They reported in August, 1894. Their general conclusion was contained in the following paragraph.[183]