Part 1

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THE CITY THAT WAS

THE CITY THAT WAS

By STEPHEN SMITH, A. M., M. D., LL. D.

COMMISSIONER OF THE METROPOLITAN BOARD OF HEALTH, 1868–1870; COMMISSIONER OF THE BOARD OF HEALTH OF NEW YORK, 1870–1875

PUBLISHED BY FRANK ALLABEN NUMBER THREE WEST FORTY-SECOND STREET, NEW YORK

COPYRIGHT, 1911, BY FRANK ALLABEN

To the Memory of Dorman Bridgman Eaton

My thanks are due especially to Mr. Frank Allaben and my son, Mr. Sidney Smith, for their service in carrying this book through the press.

STEPHEN SMITH.

NOTE BY THE PUBLISHER

The story of a great life-saving social revolution, the mightiest in the nineteenth century and one of the most momentous in the history of civilization, is told here for the first time. It is told from the standpoint of the transformation of the City of New York, by a chief actor in the event.

Only by forcing ourselves into a receptive mood can we of the present credit the half of what is set before us concerning The City That Was. The shocked imagination rebels. It seeks relief in assuming that even a trained expert, a contemporaneous witness and investigator of the conditions described, in writing after they have passed away, unconsciously yields to the historian’s temptation to throw the past into dramatic relief by starting exaggerations.

Dr. Smith, however, leaves us no room for doubt. The appalling chapter in which he lays bare the New York of 1864 is a contemporaneous document. It is a physician’s report of a systematic medical inspection of New York in that year, as delivered before a Legislative Committee a few months later by the very physician who had directed the inspection.

Nevertheless, The City That Was is not New York alone. She is but a type. Her condition, with variations, may be multiplied, during the early years of the nineteenth century, by the total of the cities, towns, and villages in the world. In the work of regeneration some of these anticipated her. Others, including all throughout the territory of the United States, were aroused through her agitation and inspired by her example.

As a student of local history, the writer thought himself familiar with the many phases of the growth of New York; but the condition of the City as late as the period of our Civil War, as here depicted, startled him as might a revelation. He believes that no seriously minded man or woman can afford to ignore this volume. We owe it to ourselves and to one another fully to face its lesson.

We shall be shocked; we shall be filled with horror; but accepting the city that now is, great as her faults may be, with a new gratitude, we shall turn with anointed sympathy and understanding to any earnest voice that pleads for the city that should be. And, indeed, other volumes which Dr. Smith himself has in preparation, as suggestive and as interesting as this one, may help us on in this direction.

FRANK ALLABEN

CONTENTS

A BLIND METROPOLIS AND HER DYING CHILDREN

Healthy or Unhealthy: Which?--Two Centuries and a Half Unhealthy--A Plague-Stricken Town--Enormous Sacrifice of Life

A GREAT AWAKENING IN ENGLAND

The Scourge of 1849--A Town That Was Immune--The Word Fitly Spoken

III

THE AWAKENING IN AMERICA

Apathy in the United States--An Incident That Counted--A Fever Nest--The Unknown Owner--Fear of Publicity--Agitation for Reform--The Citizens Association--A Health Bill--Sanitary Inspection of New York--An Anomaly in Law--Introduction of an Epoch-Making Bill

NEW YORK, THE UNCLEAN

Alarm of Medical Men--A Systematic Investigation--A House-to-House Inspection--The Medical Experts--Plan of Inspection--Each Room Examined--Period of the Inspection--Distribution of Population--Tenant-House Packing--Avoidable and Inevitable Disease--Filthy Streets--Street Filth and Disease--Dead Animals--Filthy Courts and Alleys--Cesspool Abominations-- Unbelievable Vileness--Special Nuisances--Cellar Population: Dens of Death--496 Persons Under Ground--A Visit to the Cave-Dwellers--Tenant-House Population--Cat Alley--Rag Pickers Row--Tenant-House Degeneration--The Rioters-- Tenant-House Rot--Tenant-House Cachexy--Prevailing Diseases-- Seeds of Disease Uncontrolled--Where Disease Flourishes-- Smallpox--Smallpox in Tailored Garments--Typhus Fever-- Intestinal Affections--Living at a Sewer’s Mouth--The Normal Death-Rate--Death-Rate of New York--New York, London, and Liverpool Compared--Constant Sickness--Where the Death Pressure Is Greatest--Some Scapegoats: Foreign Immigration--The Floating Population--Can the Causes of Disease Be Removed?-- Improvements During the Inspection--How to Improve the People-- Can Diseases Be Prevented?--Can Populous Towns Be Improved?-- Cleanliness Preserves from Epidemics--Importance of Sanitary Government--The Entire Country Concerned--Smallpox in a Hotel Bedroom--New York Inoculates the Nation--Inefficiency of Health Organizations--Without Sanitary Government--The City Inspector’s Department--Sanitary Inspection--Inspection Must Be Thorough--The Remedy--An Efficient Health Board