Deaths from cholera took place in the very same streets, and houses, and rooms, which had been again and again visited by fever; and rooms were pointed out where some of the poor people had recovered from fever in the spring to fall victims to cholera in the summer. As it was tersely summed up by one of the most active and capable medical officers of the Board of Health:-- "We find but one cause of so much sickness, suffering and death--the prolific parent of all this diversified offspring--'filth.' "It is in filth, in decomposing organic matter, that the main causes of epidemic diseases are to be sought out--filthy alleys, filthy houses, filthy air, filthy water, and filthy persons." What the General Board of Health could do, it did, as was indeed to be expected from such sanitary enthusiasts as Lord Ashley, Dr. Southwood Smith, and Mr. Edwin Chadwick, but the local authorities were dilatory, lukewarm, or actually hostile, and their proceedings, where anything was done, were altogether inadequate for insuring those prompt, comprehensive, and vigorous measures so urgently demanded in the presence of a great and destructive epidemic such as malignant cholera. The system of house-to-house visitation was essential for the discovery and checking of the disease, but, wrote the Board, "nothing effective was done or attempted in the metropolis. We repeatedly and earnestly urged upon the Boards of Guardians the importance to the saving of life of making immediate arrangements for special measures of prevention, but our representations were made in vain. "The local authorities could not be induced to carry into effect the preventive measures we proposed." Several unions and parishes, among whom were some of the most wealthy and populous, positively refused to comply with the directions of the Board. In the case of Bethnal Green, just described, the Board issued a "Special Order." But even under these urgent circumstances "the Board of Guardians appointed no medical officer for five days, they provided no nurses, they established no hospital, they opened no dispensary, they appointed one inspector of nuisances instead of two, and they made no provision for extensive and effectual lime-washing."