"One of the greatest barriers to the practical efficiency of sanitary arrangements is the ignorance and carelessness of the public. It is frequently seen that where infectious illness occurs, little or no attention is paid to its infective character, and an unscrupulous intercourse is carried on between the members of infected families, not only amongst themselves, but amongst their neighbours, and thus these diseases are propagated in spite of every warning and precaution." "I regret," wrote the Medical Officer of Health for Whitechapel, "that the powers of your Board are not at present sufficient to compel the owners of small house property to provide an adequate supply of water for their tenants." The Medical Officer of Health for Westminster wrote:-- "Few of the objects of sanitary improvement can be fairly attained without intrenching upon private interests to an extent which would appear harsh and oppressive. One great obstacle consists in the habits of a great portion of the poor--generally deficient in cleanliness or order; they consider any endeavour to improve their dwelling as an interference, and throw every obstacle in the way. On the other hand, a large number are most grateful for what has been effected." But in many matters the local authorities would not take action. In only four parishes or districts in London had public baths and wash-houses been established under the Act of 1846, though where they were in existence "the benefits were immense by promoting habits of cleanliness." In Poplar in 1858-9 nearly 40,000 men, and 3,000 women, and 400 children availed themselves of the baths. In St. Pancras (1856-7) the laundry department, erected by the "Society for Establishing Public Baths and Wash-houses," was of great value in affording the poor housewife an opportunity of washing and drying her linen away from her one room, in which the family had to live night and day. "I have frequently seen a small room of this kind with from four to eight or even ten inmates rendered doubly unhealthy by these laundry operations, which produce a damp and almost malarious atmosphere." The Medical Officer of Health for Lambeth had pleaded for such an establishment in his district, but "the idea of erecting them seems quite abandoned by the Vestry." "I know nothing more objectionable in a sanitary point of view than the washing of foul clothes in the dwellings of the poor, and still worse the drying of them in courts and rooms already deficient of free circulation of air and light." Nothing, however, was done. But inaction far greater in gravity and infinitely more reprehensible was that relating to the housing of the people. The Medical Officer of Health for Whitechapel drew attention, in his report of 1857, to their power in this respect:--