Part 4

The epidemic of 1849 came and went with its apparent usual great disturbances of the people. “Flight” and “fasting and prayers” had their natural results, the former being effectual when undertaken in time, and the latter without sensible influence over the mortuary records.

Then the net results of this visitation of cholera were officially determined by the Registrar-General, one fact attracted wide attention and created a profound and lasting impression on the minds of the common people. A town in the interior of England reported no case of cholera, though the epidemic had prevailed with great virulence in the communities surrounding it.

On inquiry as to the cause of this remarkable feature of a pestilence that hitherto had shown no respect for persons or localities, it was learned that certain citizens of this town were deeply impressed with the reasonableness of the Prime Minister’s suggestions, and had organized and taken action accordingly. Volunteer committees composed of the leading men and women were selected. One was to secure thorough cleaning of the streets and public places; another was to cause an inspection of every residence and its surroundings and secure complete cleanliness; a third was to obtain reports of all cases of sickness and require immediate isolation and treatment when there was the slightest symptom of cholera.

This town had its “fastings and prayers,” but not until its citizens had done works meet for repentance; and then it asked the divine blessing on its efforts to protect itself--and its prayers were abundantly answered.

But there was another phase of this place’s experience not less impressive than its escape from cholera. There was a great diminution of such diseases as diphtheria, typhoid, erysipelas, scarlet fever, measles, and other low forms of sickness, so fatal in the homes of the poor, during the period that the citizens exercised so much care in securing cleanliness.

“A word fitly spoken is like apples of gold in pictures of silver.” A word fitly spoken broke the spell of centuries, and completely revolutionized human history. That word was spoken, not at the suggestion of science, nor by a scientist, but, at the dictation of common sense, by a layman who happened to be in authority. It was a plain, simple word, which was understood by the people and which appealed to their common sense.

A new era now dawned upon the domestic life of the English people. Every household learned that cleanliness had not only saved a town from a visitation of cholera, but had reduced the contagious and infectious diseases always present in their homes. The Health Officer of England gave tremendous force to the revelation that had been made by officially characterizing and classifying cholera and the whole brood of domestic scourges as “filth diseases.” This was a most happy term, because it suggested not only the source of these diseases, but the simple and effectual remedy that every householder could apply. It became popular in the sanitary literature of the period, and thus permeated all classes, until the most humble family knew its import and complied with its suggestion.

The next visitation of cholera to England was met by the simple remedy of domestic and civic cleanliness; and so manifestly effectual was this measure that the pestilence lost its former terrors. But the great and lasting gain to the people, which grew out of the original proclamation of the Prime Minister that cleanliness of the home and its surroundings was the best preventive of cholera, was the discovery of the fact that nearly all diseases which afflict the individual family, and in a larger sense the whole community, have their origin in or are intensified by decomposing waste matter, the “filth” of the sanitarian, in and around their homes.

So profoundly impressed with this fact were the laboring classes, and so earnest did they become in their zeal for sanitation, that sanitary measures entered into the political campaign. On one occasion a prominent candidate was so disturbed by the numerous inquiries which the audience made as to his views in relation to current questions of local sanitation, that he cried out in despair, “Sanitas sanitatum, et omnia sanitas!”

III

THE AWAKENING IN AMERICA

During the score of years that the great awakening of the people of England to the value of cleanliness of the individual, the home, and the municipality, as the true remedial measure against foreign as well as domestic pestilences was in progress, extending from 1846 to 1866, the people of the United States remained profoundly apathetic in relation to all questions of improvement of the public health and the prevention of epidemics. Cholera ravaged their cities in 1849, and again in 1854, without meeting other obstruction than the occasional fumes of sulphur. Days of fasting and prayer were religiously observed; but, for the most part, the terror-stricken people fled to the country to escape what they believed to be inevitable death if they remained in their town homes.

The object lesson which the people of England had learned from the experience of one town, and had so successfully applied in several visitations of epidemics, was known to a few students of sanitary science and administration in different parts of this country and efforts had been made by them, from time to time, to awaken public interest in sanitation of the home and the municipality, but very little progress was made. A few cities had health organizations which, for the most part, were devoted to political schemes and purposes, with no pretense to knowledge of the objects or methods of sanitation.

As the simple suggestion of the Prime Minister, that cleanliness of the home and its surroundings was the best measure of protection against cholera, contained the germ of practical sanitary reform in England, so an incident in the writer’s experience became the potential force that gave to New York a most complete system of health laws and ordinances, and an efficient administrative department of health. In a larger sense it may, with justice, be claimed that this incident contained the germ of health reform that has given to this entire country the most perfect system of municipal, state, and national health administration in the civilized world.

The incident referred to occurred in the fifties of the last century. New York was in the grip of the deadly typhus. This was sometimes called the “Spotted Fever,” from the dark spots which appeared on the body of its victims, and also “Emigrant Fever,” because it was brought to this country by the immigrants, especially by those who came from Ireland. Indeed, the Irish immigrants suffered so generally and severely that the disease was sometimes called the “Irish Fever.” Immigration from Ireland was at that time at its flood and the typhus was so prevalent among these poverty-stricken people that the hospitals were overcrowded by them and large numbers were treated in tents, both on Blackwell’s Island and at the quarantine grounds on Staten Island.

Having completed a two years’ term of service on the interne medical staff of Bellevue Hospital, where large numbers of typhus cases were treated, I was placed in charge of the tents on Blackwell’s Island by the Commissioner of Charities. Soon after entering upon the service, I noticed that patients were continually admitted from a single building in East Twenty-second Street.

Impressed with the importance of closing this fever-nest, I visited the tenement and was not surprised at the large number of cases of fever which it furnished our hospital. It is difficult to describe the scene that the interior of the house presented to the visitor. The building was in an extreme state of dilapidation generally; the doors and windows were broken; the cellar was partly filled with filthy sewage; the floors were littered with decomposing straw, which the occupants used for bedding; every available place, from cellar to garret, was crowded with immigrants--men, women, and children. The whole establishment was reeking with filth, and the atmosphere was heavy with the sickening odor of the deadly typhus, which reigned supreme in every room.

The necessity of immediately closing this house to further occupation by immigrants, until it was thoroughly cleansed and made decently habitable, was imperative, and I made inquiries for the responsible owner. I found that the house was never visited by anyone who claimed to be either agent or owner; but that it was the resort of vagrants, especially of the most recent and destitute immigrants; that they came and went without let or hindrance, generally remaining until attacked by the prevailing epidemic of fever, when they were removed to the fever hospital.

After considerable inquiry in the neighborhood I found a person who was the real agent of the landlord; but no other information could be obtained than that the owner took no interest in the property, and that the agent was under instructions not to reveal the owner’s name. A suggestion to this agent, to have the house vacated and put in good condition for tenants, was refused with a contemptuous remark as to the absurdity of furnishing such vagrants and immigrants better quarters in which to live.

As there was no Health Department to which an appeal could be made, the Metropolitan Police Department was visited and the matter laid before its president, Mr. Acton. He directed the secretary, Mr. Hawley, a lawyer, to examine the health laws and ordinances to determine what measures were in the power of the police to enforce. A search was made, and the result was that neither law nor ordinance under which the police could take action was found. Mr. Acton advised that the tax lists be examined, to find who paid taxes on the property, and thus discover the responsible party to its ownership, and then that appeal be made directly to him to authorize the necessary improvements. An examination of the tax list revealed that the owner was a wealthy man, living in an aristocratic neighborhood, a member of one of the most popular churches of the city.

The condition of his tenement house was brought to his attention, and its menace to the public health as a fruitful fever nest was explained. He was very angry at what he declared was an interference with the management of his property, and asserted, in the most emphatic manner, that as the house yielded him no rent, he would not expend a dollar for the benefit of the miserable creatures who had so wrecked the building.

With the failure of this appeal to the owner, I had exhausted, apparently, every legal and moral means of abating a nuisance dangerous to life and detrimental to health.

In this extremity I visited the office of the Evening Post and explained the matter to Mr. William Cullen Bryant, then editor of that newspaper. He was at once interested in the failure of the power of the City Government to remedy such a flagrant evil. In the absence of laws and ordinances, Mr. Bryant proposed to make the case public in all of its details, and for that purpose suggested that the police should cause the arrest of the delinquent owner, and he would send a reporter to make notes of the case. A charge was made against the landlord, and he was required to appear at the Jefferson Market Court. On entering the court he was confronted by the reporter, pad and pencil in hand, who pressed him with questions as to his tenement house.

Greatly alarmed at his situation, the owner inquired as to the purpose of the reporter, and was informed that Mr. Bryant intended to publish the proceedings of the court in the Evening Post, and to expose his maintenance of a fever nest of the worst description. He begged that no further proceedings be taken, and promised the court that he would immediately make all necessary improvements. He promptly vacated the house, and made such a thorough reconstruction of the entire establishment that it became one of the most attractive tenements in that East Side district. For many years that house continued to be entirely free from the ordinary contagious diseases of the tenement houses of the city. It is an interesting fact that the landlord subsequently thanked the writer for having compelled him to improve his tenement house; for he had secured first-class tenants who paid him high rents.

This incident came to the attention of several prominent citizens, physicians, lawyers, and clergymen, who became profoundly impressed with the revelation that there were no laws under which such a glaring violation of the simplest principles of health, and even of common decency, could be at once corrected.

For many years there had been a growing sentiment in favor of a reform of our health regulations, stimulated by the writings of Dr. John H. Griscom, Dr. Joseph M. Smith, Dr. Elisha Harris, and others, and the Academy of Medicine had occasionally passed resolutions favoring adequate health laws; but no results had been secured.

It was now resolved to organize a society devoted expressly to sanitary reform, and the “Sanitary Association” came into existence. For several years this body annually introduced a health bill into the Legislature, but the measure was regularly defeated through the active opposition of the City Inspector, whose office would be abolished if the bill became a law.

In the early sixties the famous “Citizens Association” was organized, with Peter Cooper as President, and a membership of one hundred of the most prominent citizens. This was in the days of the Tweed régime, and at a period when the City Government was most completely in his power. The objects of the Association were reform in all branches of the Municipal Government, the promotion of wise legislation, and the defeat of all attempts to subordinate the city to the schemes for control by Tweed and the coterie of politicians who were under his directions.