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January 16, 1904


JAMA. 1904;XLII(3):175-176. doi:10.1001/jama.1904.02490480037005

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The most striking victories of sanitary reform have been those won in and over the slums of the great English and Continental cities, and the call to arms has usually come through the medical profession, for although these reeking nests of unwashed humanity have shocked the moral sense of the public as nurseries of crime and physical degeneracy, yet their most powerful appeal for vigorous action has ever been through becoming the starting point of some deadly epidemic. Disease is the revenge which the submerged tenth takes on the careless selfishness of the upper social strata. As long ago as 1838 a serious outbreak of disease in London, beginning in the east end, inspired an extensive investigation into the conditions of life in certain districts, the report of which came like a revelation to the rest of the city. Nearly 1,500 families were found living in 2,200 rooms and with

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