Alida Baxter

Renowned London journalist and author

 

View from Soho

A Healthy Place to Live

What it is to live in a healthy area! There used to be some buildings around the back of Berwick Market which were known locally as Healthy Homes back in the nineteen fifties, but I suspect this was typical irony on the part of the natives. We do irony, we've had to, when it comes to living (and dying) conditions.

The slightest acquaintance with the history of Soho has you reaching for your Wet Wipes before you pick up a coffee, but I assure you it's all right now. The present is incredibly clean and wholesome it's just the past that's a bit alarming.

Let's start with something good, though, and something you can actually go and look at. The best of our previous centuries' health record is commemorated in Broadwick Street, where there's not only a pub named for the remarkable John Snow, but a memorial to him a replica of the pump from which he removed the handle in 1854. A pioneering anaesthetist who worked to relieve the agony of surgery and childbirth (it was he who gave Queen Victoria chloroform, to help her during the birth of the last two of her nine children), he was also an epidemiologist, and became convinced that cholera was a water-borne infection, when the general belief was that it resulted from a miasma a foulness in the air.

Soho was suffering an appalling cholera outbreak, and John Snow's meticulous investigation and mapping established that the source was contaminated water being drawn from the pump in what was then called Broad Street (many of the area's streets have had their names altered, even in recent decades). He found that in sixtyone cases of death, the victims had been used to drinking from the Broad Street pump, and took the draconian action of removing the pump handle. But whatever protests this loss of supply caused (and remember that the population relied on pumps for what was not to be had in their homes) were silenced when the epidemic was stopped in its tracks. Later it was discovered that the well for the pump water had been dug only three feet from a cesspit!

It's hard for us, to-day, to comprehend how ignorant people were about the dangers of locating cesspits near to sources to drinking water and cesspits were the norm for the disposal of sewage. They were everywhere, beneath houses, and the next time you watch a brilliant television adaptation of a Dickens' novel, remind yourself that no matter how accurately the dirt of the poor is depicted, what the screen can't show you is the all-pervading stench. In many areas it must have been almost as much a part of life as in Tudor times, when the rich carried pomanders to sweeten the foetid air around them.

I've walked past alpine meadows after muck-spreading, and gagged till I've got out of range. The idea of walking streets where the houses over cesspits must have reeked from basement to cellar is horrendous this was where people ate and slept, with their children. And strangely enough children weren't just the victims of this particular Soho cholera epidemic it was a baby who innocently caused it. An infant who'd contracted cholera elsewhere had its nappy washed into the general waste, and from there the contagion entered the water supply through a leaking cesspit.

So distasteful was all this to the government authorities in that prissy era that as soon as the epidemic had subsided they rejected Snow's evidence, and restored the pump handle. There's a well-worn tendency for brilliant pioneers to be disregarded and criticised by their contemporaries, and John Snow was incredibly out of step with his pain-racked, disease-ridden age. He was to die only four years later, following a stroke, but he is remembered to this day, and as recently as 2003 a poll of British doctors named him the greatest physician of all time.

Those authorities who swept John Snow's findings off their desks weren't just criminally narrow-minded; their view was the general one. And they preferred any amount of paper-shuffling to the cost that a safe, clean system of sewers would entail. It wasn't till the Great Stink of 1858, when not just the poor but the powerful were affected, that something was finally done. The smell of the raw sewage in the Thames that summer was so horrendous that the curtains of the Commons had to be soaked in chloride of lime (although even that didn't help the choking MPs), and a Bill was rushed through in eighteen days, allocating money for what would become Joseph Bazalgette's masterwork a vast, wonderfully efficient system of sewers.

But even when that enormous project was under way, and despite all that John Snow had proved years before, there was still an astonishing and almost stubborn ignorance when it came to the causes of infection. Florence Nightingale, the heroine of the Crimean War, was incredibly a believer in the miasma theory when it came to cholera. And this despite the discovery that the water supply for the greater part of the hospital at Scutari, with its monstrous death toll, was passing through the decaying carcase of a dead horse! Of course she wanted cleanliness, but she firmly believed that foul air was the problem, and held to her belief while the men died around her, together with more than one of her best nurses. To her credit, she castigated herself in later life for not having understood the true cause of the water-borne infection.

We should also remember how dangerous and disease-filled hospitals (and not just military ones) were in those days, and how hard she tried to change that. In her book Notes on Hospitals, she actually stated as a first requirement that these institutions should do the sick no harm, and at the time her view that the huge numbers of fatalities could be prevented was regarded as revolutionary. Yet she was only echoing Hippocrates: Make a habit of two things: to help; or at least to do no harm.

Women in particular were vulnerable they dreaded having their babies in hospital, because the death rate from childbirth fever was so high there. This was due to the surgeons and medical students going to examine their female patients straight from having dissected corpses in the morgue, without washing their hands between one activity and the next! In 1843 an American physician named Oliver Wendell Holmes recommended that hands be washed between procedures, and most famously, in 1847, a Hungarian doctor named Ignaz Semmelweiss actually insisted that this be done, using carbolic, reducing the death rate from puerperal fever in his hospital from 18% to as low as barely 1%.

These were the beginnings. Visionary doctors, an understanding of the need for cleanliness, vaccination: all these slowly began to contribute to a better life expectancy. Bazalgette's sewage system was completed in 1865, but the mortality rate in London didn't improve for another six years it was just one part of the jigsaw that became a healthier picture. It would be a long time before housing conditions were tackled, and even while the sewers were under construction, people were suffering and dying simply because of the way they earned their living.

Most of us know that the Mad Hatter was no figure of fantasy, created by either Lewis Carroll or Johnny Depp, but a real and suffering human being drawn from life. Hatters used mercury during the process of turning fur into felt, and were poisoned by it, right up into the twentieth century. Neurological damage, mental disorders, shaking all endured so that a gentleman could wear a fashionable hat.

It doesn't bear thinking about, does it? Any more than the terrible state of the girls who worked with white phosphorus, making matches, and contracted phossy jaw. The vapour of the phosphorus created a build-up in their jaw bones, where, after initial toothaches and swelling gums, abscesses would become so bad that the only solution was the removal of the bone itself. If this wasn't done they would die, usually of organ failure. Have half your face cut away, or die? A nice choice, and how many manufacturers gave it a thought, as they lit their cigars?

We have come a long way, but it has taken us a long time. As late as the nineteen sixties the old flats which had no bathrooms and only communal lavatories and water supplies were being widely replaced, yet these flats were in the majority, in Soho , and complete modernisation took decades.

I can remember the discovery of a plague pit, when one large building was demolished and new, deeper foundations dug, but this shouldn't have surprised me. I'm living around the corner from what was once called Pesthouse Close!

Records show that in 1665 part of the Marshall Street area was hired by the Earl of Craven as a site for what was described as a pestfield. The Earl stayed in London throughout the Great Plague, when the majority of the rich and titled fled to the country in the hope of safety, and he obviously gave much thought as to how to deal with the emergency; he was a member of the commission appointed to find a way of preventing the epidemic's spread. The usual desperate, brutal practice of shutting victims up in their homes with their whole families, and then burying all the dead in overwhelmed, ever-swelling parish churchyards, was doing nothing to control the magnitude of the plague.

He came up with the idea of confinement in pesthouses and disposal in plague pits, and put this into practice in Soho . Here the ground he hired was surrounded by a brick wall, and accommodation provided not only for the sick but also for an attendant physician and surgeon. The development was subsequently described as thirtysix small houses for the reception of poor and miserable objects afflicted with a direful pestilence. Near it, approximately at the southern end of Marshall Street , where it meets Beak Street , was a pit where some thousands of bodies were buried. Thousands, in that pit alone!

But thankfully the horror passed. The plague burned itself out (without help, contrary to popular belief, from the Great Fire of London it was already on the wane before that). No more poor and miserable objects came to the lazaretto as a special hospital for the diseased poor, usually lepers, was called. In 1671 the Earl purchased the freehold of the land he'd hired, which was by then known as Pesthouse Close, and although the plague-free decades went by and what was there utterly changed , the name stuck. By 1736 what was still called Pesthouse Close was almost entirely built over with houses, market buildings and shops!

That's the thing about Soho : its resilience. Plague, cholera look at what's been thrown at it, yet it just seems to dust itself down and become even more popular.

More astonishing still, internationally famous Carnaby Street , constantly crammed with tourists, is right by the site of the old lazaretto, and alongside the ground where a plague pit received its thousands!

I hope it'll always be like this: surviving whatever happens, and welcoming newcomers in. As I told you, the present is incredibly clean and wholesome: it's got its face washed and it's ready for visitors. And I'm so proud of it.

© Alida Baxter

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