Part 13

The struggle and final triumph of the people of New York, in their efforts to secure adequate health protection, were national in their influence. And this influence was emphasized by the first acts of the Metropolitan Board. Scarcely had it organized when cholera made its appearance in New York. There was the usual alarm among the people, and large numbers left the city. But the new health laws and ordinances, administered by an intelligent, scientific authority, demonstrated the raison d’être of their existence.

The first case of cholera was promptly isolated, the house and its surroundings cleansed and disinfected, and rigid supervision established. The second case, which appeared in another part of the city, was treated in a similar manner and with the same results. A third, fourth, fifth, and finally many cases appeared in different parts of the city during the season, apparently brought from localities in the vicinity where the epidemic prevailed with its usual severity; but in New York no two cases occurred in the same place, so effectually was each case treated.

Within one month public confidence in the power of the board to control the spread of the disease was firmly established; people who had fled returned to their homes; business in commercial districts, which was at first suspended, was resumed; and the health department became the most popular branch of the city government, a position which it has maintained uninterruptedly for nearly half a century.

This popular triumph of sanitation is largely due to the perfection of the original Metropolitan Law, which has been declared, officially and judicially, to be the most complete piece of health legislation ever placed on the statute books. From that fountain of legal lore the whole country has been supplied with both the principles and the details of sanitary legislation.

The agitation in New York rapidly extended over the entire country, and other cities secured the necessary authority, the Metropolitan Law being the basis of such health legislation. Within a decade nearly every municipality in the land had its health laws and sanitary ordinances and a competent authority to enforce them.

The enormous influence which this reform has had upon the health and domestic life of the people can never be estimated. A reference to the former and present sickness and death-rates of New York enables us to approximate the vast saving of life and consequent prevention of sickness and human misery that has resulted from health laws founded on the Metropolitan Law and intelligently but rightly enforced. Before the passage of that law the annual death-rate of the city fluctuated between 28 and 40 per 1,000 population; since that law went into effect it has steadily fallen until it has reached the low figure of fifteen to the thousand, or a saving of more than twenty thousand lives annually when the population of New York was only about one million, and of nearly 10,000 lives of the present population. If we extend this estimate to the whole country, of ninety-five million people, we may gain a faint conception of the inestimable benefits which the application of sanitary knowledge to the daily life of a people can accomplish.

THE LEGAL WORK OF DORMAN BRIDGEMAN EATON

The following chapter consists of the address delivered by Dr. Stephen Smith on the occasion of the memorial service of Hon. Dorman B. Eaton, January 21, 1899. We have inserted it immediately following his historic review of the events which led up to the great public health reform of 1865–1866, not only because it is a fitting tribute to the memory of one to whom the citizens of New York are indebted for many improvements in the administration of the municipal government, but because it brings together in one compact perspective the legal and sanitary requirements of modern preventive medicine.--F. A.

The progress of the race is largely affected in each generation by a few pioneers who, with toil and sacrifice, prepare the way for the advance. Of these pioneers some blaze the future course in the unexplored and trackless forest; others remove the obstructions which impede the builders; while a few expert engineers bridge the rivers, tunnel the mountains and lay broad and deep the foundations of the great highway along which humanity passes to a higher civilization. Unfortunately these pioneers are not always known to public fame, and far too often, though benefactors of their race, pass away without a proper recognition of their services.

This apparent neglect is not due to a lack of appreciation of their work by the people, but rather to the fact that their labors are performed in obscurity, and hence are unknown. Far in the wilderness, or deep in the tunnel, or in the mire of the caisson, they toil all unseen by their generation, sacrificing health and often life while searching for the true pathway or laying its foundations. When the bridges are builded, the tunnels completed, and the broad highway is thrown open for travel and traffic, few or none of the passing throng give a moment’s thought to the labors and sacrifices of the builders, or the tribute of a sigh to the memory of those who perished at their work.

Impressed with a sense of public obligation and of a duty to the memory of a citizen with whose labors and sacrifices in the interests of this city I had great opportunities to become familiar, it has been a grateful task to place on record some of the incidents in the life of Hon. Dorman B. Eaton as they came under my personal observation. He was by nature, education, and association a reformer of the civil administration. Born and bred in the rural communities of Vermont, educated at Harvard, a partner of the famous Judge Kent, of this city, and an associate of men of the type of William Curtis Noyes, Charles O’Conor, and others of equal reputation, Mr. Eaton was admirably equipped for the great work to which he devoted so much of his life and energies.

Nor was he a reformer whose methods were simply destructive of what he regarded as wrong or evil in the municipal government; on the contrary, his mind was eminently constructive, and consequently he sought to remedy defects by substituting the new and best for the old and worst with as little friction and disturbance as possible. Thus he quietly and without observation, as a master builder, laid foundations and reared the massive superstructures of four of the best-organized and most efficient departments of our city government--viz., the Department of Health, the Fire Department, the Department of Docks, the Police Judiciary.

My personal acquaintance with Mr. Eaton began in the year 1864, when we became associated in an effort to secure reforms in the sanitary government of the City of New York. Although prior to this date there had been periods of agitation in favor of a more efficient health organization, especially when epidemics, like cholera, visited the city and the utter worthlessness of our health officials became apparent, yet there had been no such organized effort as that of 1864. Previous agitation had, however, been very useful in preparing the way for the final struggle, by creating a popular interest in these reforms and in rendering the public mind both sympathetic and receptive.

In 1855 the Academy of Medicine applied to the Legislature for relief from the evils of an insufficient health organization, and as a result a committee of that body investigated the sanitary condition of the city. It appeared that there were four separate departments devoted to the conservation of the public health. First, was the Board of Health, composed of the Aldermen and Mayor. When this body was organized as a Board of Health it had supreme power, both in the abatement of nuisances and the expenditure of money. So much and so justly was this board feared, that Fernando Wood, while Mayor, refused to call it into existence during an epidemic of cholera, declaring that the Board of Health was more to be feared than the pestilence.

Second, was the Commissioners of Health, composed of the Mayor and the Recorder, the City Inspector, the Health Commissioner, the Resident Physician, and the Port Health Officer. This body had no adequate power and was perfectly useless both for good and evil.

Third, was the Resident Physician, whose duties were limited to visiting the sick poor.

Fourth, was the City Inspector, a most formidable official politically, for he had the right to expend annually $1,000,000 without “let or hindrance.” His jurisdiction extended to the cleaning of the street, gathering vital statistics, and preserving the public health by the appointment of health wardens for each ward.

The investigation showed that this department, the only one which actually exercised public health functions, was permeated with corruption, ignorance, and venality. The City Inspector was the lowest type of ward politician, the vital statistics were crude and unreliable, there was no pretense of cleaning the streets, and the health wardens were for the most part keepers of saloons. It was shown in the evidence that no health warden ever dared to visit a house where there was a case of contagious disease. One, who was asked the best method of preventing smallpox, replied: “Burn sulphur in the room.” Another, asked to define the term “hygiene,” said: “It is a mist rising from wet grounds.”

The report of this committee created a profound sensation and gave the first impetus to a reform movement. A number of prominent physicians and influential citizens became deeply interested in the subject and determined to secure proper legislation. Health bills were annually prepared and sent to the Legislature only to be rejected under the direction of the City Inspector, whose $1,000,000 was expended freely in the lobby at Albany. But the agitation increased in force with successive defeats, a large and still larger number of people were added to the ranks of the reformers of the Citizens’ Association in 1864, with Peter Cooper as President and upwards of a hundred of the leading citizens as members.

The moving spirit in organizing and managing this powerful body was Mr. Nathaniel Sands, an ardent and enthusiastic sanitarian. Two departments were created in the Association, through which the principal work was to be done; viz., a Council of Law and a Council of Hygiene. Mr. Eaton was an active member of the former, and I was for a considerable time Secretary of the latter. Thus we were brought into frequent consultation over a public health law, which the Association had determined to have prepared for the next Legislature.

It was decided that the Council of Hygiene should make a first draft of the bill in which should be incorporated the necessary sanitary provisions. This draft was then to be submitted to the Legal Council for completion in legislative form. As secretary of the Council of Hygiene I had to prepare the first draft of the bill, which was done along the lines of former bills and seemed to the members to be a very perfect piece of work. When, however, the bill came from the Legal Council, scarcely a shred of the original draft was recognizable.

Though the Legal Council was composed of the leading lawyers of the city at that time, the revision and completion of the health law was committed to Mr. Eaton, a junior member. This selection proved to be of immense importance to the immediate sanitary interests of this city, and secondarily to the creation and administration of the health laws of the United States. The field of sanitary legislation was entirely uncultivated in this country at that time, and the principles on which health laws should be based were unrecognized, except by the more advanced students.

Mr. Eaton fortunately proved to be one of the few citizens who had kept pace with the progress of sanitary reforms in England, and entered fully into the spirit of the great movement that for a quarter of a century had agitated the people of that country. Alarmed by the high death-rate annually reported by the Registrar-General, and informed that the larger part was due to preventable diseases, the public demanded adequate remedial measures of the government. The contest was long and most exciting, the issues often being carried into the arena of politics. The Prime Minister once declared that there was such a craze about sanitation that the rallying cry of an election campaign might well be “Sanitas sanitatum, et omnia sanitas.”

The triumph of the reformers was finally complete, and England adopted a code of health laws that are models of excellence, and which, in their enforcement, have made its cities and towns the healthiest in the world.

When our health bill came from the hands of Mr. Eaton it was evident in every line that he had made an exhaustive study of the English health code and had become thoroughly imbued with its spirit. The language was not altogether familiar, and in the involved sentences there were intimations of extraordinary powers quite unknown to our jurisprudence. When he brought the completed bill before the Legal and Medical councils for adoption it was subjected to a most searching criticism. While most of its sections were clear and readily understood, there were portions which were so obscure, owing to the methods of expression employed, that the legal members were in doubt as to the proper construction to be put upon them, while the medical members were altogether at a loss as to their meaning.

Mr. Eaton explained the theory of modern health legislation as illustrated by the English laws, and contended that a thoroughly organized and efficient board of health must have extraordinary powers, and must not be subordinated to any other branch of the civil service, not even to the courts. What it declared to be a nuisance--dangerous to life and detrimental to health--no one should call in question. When it ordered a nuisance to be abated within a given fixed time no mandate should avail to stay its action or the enforcement of its decree.

A board of health, in his opinion, should make its own laws, execute its own laws, and sit in judgment on its own acts. It must be an imperium in imperio. England, the foremost country in the world in the cultivation of sanitary science and in the application of its principles to practice, had by its legislation for a quarter of a century established a precedent which it was right and safe for us to follow.

He predicted that if this bill became a law its operations would be so beneficial that it would not only become very popular in this city, but that it would be the basis of future health legislation in this country. He believed, however, that no legislature would pass a bill containing such powers if these powers were made a prominent feature of the bill. For that reason he had adopted that involved expression peculiar to English law which required a judicial interpretation to determine the precise meaning. The bill was approved in the form presented by Mr. Eaton, and preparation was made to secure its passage.