The result was a fearful mortality--an awful waste of human life. "Death," wrote one of the Medical Officers of Health, "finds easy victims in filthy habits, overcrowded rooms, impure air, and insufficient and ineffective water supply." The consequences were inevitable. "Wherever there are crowded apartments, imperfect or no drainage, offensive cesspools, dung-heaps resting against houses or close to inhabited rooms--wherever ventilation is impeded by the narrowness of courts and alleys, and wherever the inhabitants living under these unfavourable circumstances lose their self-respect, pay no regard to personal cleanliness, and consider a state of filth and offensiveness as their natural lot--there we find zymotic diseases in full force and frequency. Those attacked do not simply recover or die. I shall not be exaggerating when I say that all recovering from these complaints are permanently injured."[66] It is impossible to apportion the respective shares which these various causes of insanitation had in bringing about these dire results, but overcrowding was undoubtedly one of the principal. As to its disastrous effects the Medical Officers of Health were of one opinion. There was no single exception to the strong-voiced insistence upon this fact. "The main cause," wrote the Medical Officer of Health for the Strand (1856), "to which we must attribute the high mortality is the close packing and overcrowding which exists throughout the district.... Overcrowding and disease mutually act and react upon each other. "There is one circumstance of general prevalence throughout the district which, so to speak, almost paralyses these efforts of sanitary improvement--overcrowding--the overcrowding of parts of it with courts and alleys, the overcrowding of these courts and alleys with houses, the overcrowding of these houses with human beings" (1859). "The overcrowding of dwellings," wrote another,[67] "is one of the most frequent sources of sickness and decay at all ages." "Perhaps," wrote a third,[68] "there is no single influence to which a human being is exposed more prejudicial to his health than overcrowding in rooms the air of which cannot be perpetually and rapidly changed." "No axiom," wrote another,[69] "can be more positive than the connection of epidemic diseases with defects of drainage and ventilation ... the overcrowded localities being especially scourged by disease." The consequences were not confined to epidemic disease; other fatal diseases were begotten by it. "All medical writers," wrote the Medical Officer of Health for St. James' (1858), "are agreed that impure air from want of ventilation is the most potent of all causes of consumption." Not merely directly did overcrowding bring about fatal results. Indirectly it also led thither. It was recognised as a cause of intemperance and of the evils, moral as well as physical, which ensued from intemperance.