London is and always has been a tale of two cities: London and Westminster, the river and the shore, town and country, rich and poor.  The contrasts can be remarkable.  If Tiger Woods were to stand at the east end of pristine, polished Threadneedle Street where millions are traded every day and hit a golf towards Whitechapel, that ball would fly over at least one boarded-up pub, a handful of derelict buildings, a trendy club, local authority flats, 26 Big Issue sellers and some corner shops where all the biscuits are out of date.

Two hundred years ago, poverty and sickness were an ever-present spectre for many families and particularly the day-labourers, who supported wives and families from one sunrise to the next with the strength of their backs.  They skirted the abyss, never more than a few days away from losing their footing.  This morning I was flicking through a facsimile of an old miscellany from the British Library.  Lots of it is random and undated, but one letter, originally submitted to the Gentleman's Magazine in 1780 really got under my skin.  In December of 1780, Mr Lettsom left his front door with the intention of taking a morning walk.  He was 'accosted' by a tall, thin man who was 'a picture of distress'.  Lettsom enquired as to the man's situation and informed that the man's name was Foy, and that he had recently recovered from a sickness.  He sought work, to support his family in Little Greenwich, Aldersgate Street.

Lettsom handed over some money, and Mr Foy burst into tears and went on to try and find work.  Lettsom set out on his walk, but was troubled by the idea of the man and his family.  His steps turned towards Aldersgate Street and without much trouble, he discovered Foy's 'miserable habitation': 'a little chamber furnished with one bedstead; an old box was the only article that answered the purpose of a chair'.  However, it wasn't the furniture that shocked Lettsom, but the occupants: in the bed was a woman suffering from a putrid fever, her lips and gums black.  At her feet was a girl of around five years old, naked apart from a poultice bound to the blisters on her back, held on by strings across her chest.  Beneath the arm of the mother lay a naked boy of toddling age.  On the floor was a girl of about twelve, covering herself with a petticoat, moaning that she would 'die of thirst'.  All were fevered, apart from a four year old girl in a 'fragment of petticoat', who stood barefoot near them, providing water.  The twelve year old, no doubt relieved to see another adult, begged Lettsom to look at 'her mother's side', where a huge 'mortification', or skin infection spread from her thigh to stomach, 'and nothing to stop its progress had been applied'. 

Mr Lettsom 'procured medical assistance immediately' and paid a neighbour to nurse the family.  Not long afterwards, he had 'the pleasure the conclude this relation of their unspeakable distress by communicating their total delivery from it'.

This is a tale of London itself, the ever-present gulf and how it is often breached by small acts of kindness rarely remembered.  For Lettsom, the incident bore one crucial lesson and one that is a relevant today as it was in 1780: