Part 6

The plan of inspection adopted by the Council was as follows: The city was divided into thirty-one districts and an Inspector selected for each, care being taken to assign to each inspector a district with which he was most familiar. The Inspector was directed to commence his inspection by first traversing the whole district, to learn its general and topographical peculiarities. He was then to take up the squares in detail, examining them consecutively as they lie in belts.

Commencing at a given corner of his district, he was first to go around the square and note: 1. Nature of the ground. 2. Drainage and sewerage. 3. Number of houses in the square. 4. Vacant lots and their sanitary condition. 5. Courts and alleys. 6. Rear buildings. 7. Number of tenement houses. 11. Drinking shops, brothels, gambling saloons, etc. 12. Stores and markets. 13. Factories, schools, crowded buildings. 14. Slaughter-houses (describe particularly). 15. Bone and offal nuisances. 16. Stables, etc. 17. Churches and school edifices.

Returning to the point of starting, he was to commence a detailed inspection of each building, noting: a. Condition and material of buildings. b. Number of stories and their height. c. Number of families intended to be accommodated, and space allotted to each. d. Water supply and house drainage. e. Location and character of water-closets. f. Disposal of garbage and house slops. g. Ventilation, external and internal. h. Cellars and basements, and their population. i. Conditions of halls and passages. j. Frontage on street, court, alley--N., E., S. or W. 18. Prevailing character of the population. 19. Prevailing sickness and mortality. 20. Sources of preventible disease and mortality. 21. Condition of streets and pavements. 22. Miscellaneous information.

He entered each room, examined its means of ventilation and its contents, noted the number of occupants by day and by night, and carefully estimated the cubical area to each person. Whenever any contagious or infectious disease was discovered, as fever, smallpox, measles, scarlatina, the Inspector made a special report upon the dwelling. This report embodied specific answers to a series of questions, furnished in a blank form, requiring him 1. To trace and record the medical history of the sick person. 2. To ascertain and record facts relating to the family and other persons exposed to the patients and to the causes of the malady. 3. To report the sanitary condition of the domicil. 4. To report the statistics and sanitary condition of the population of that domicil. 5. To report upon the sanitary condition of the locality or neighborhood and its population. 6. To preserve and make returns of these records. 7. To prepare on the spot the necessary outlines or data for the sketching of a map or descriptive chart of the domicil, block, or locality.

Each Inspector was supplied with a notebook and a permanent record-book; in the first he constantly made notes as his examination proceeded, and in the latter these notes were expanded and put on permanent record. These permanent record-books are the property of the Association and embrace for the most part minute details concerning every building and tenement occupied by the laboring classes, as also, grog-shops, stables, vacant lots, slaughter-houses, etc.

Each Inspector was furnished with materials for drawing, and was directed to make accurate drawings of the squares in his district, locating each building, vacant lot, etc., and distinguishing the character and condition of each by an appropriate color. Many of these drafts of districts are beautiful specimens of art, and as sanitary charts enable the observer to locate infectious and contagious diseases, and with the aid of the permanent records, to determine the internal and external domiciliary conditions under which they occur.

I have been thus minute in specifying the details of the plan of inspection, the qualifications of the Inspectors, and the means employed, in order that the character of the work and the value of the results obtained may be properly appreciated.

Early in the month of May the work of thoroughly inspecting the insalubrious quarters, where fever and other pestilential diseases prevail, had been commenced, and the fact was soon ascertained that smallpox and typhus fever were existing and spreading in almost every crowded locality of the city. It was not until about the middle of July that the entire corps of Inspectors was engaged. The work was then prosecuted with vigor and without interruption to the middle of November, when it was completed. The Inspectors met regularly every Saturday evening to report to a committee on the part of the Council the progress of their work, and to receive advice and instruction in regard to all questions of a doubtful character.

On the completion of the inspection each Inspector was required to prepare a final report embodying the general results of his labors. These reports have all been properly collated, under the direction of the Association, and are now passing through the press. They will soon appear in an octavo volume of about 400 pages, largely illustrated, with maps and diagrams. It will be the first interior view of the sanitary and social condition of the population of New York, and will abundantly demonstrate the fact that, though a great and prosperous commercial centre, she does not afford happy homes to hundreds of thousands.

Before proceeding to an analysis of this work, it will be necessary to notice the topographical peculiarities of our city, and the distribution of its population. New York is an island having an area of about thirty-four square miles, inclusive of its parks. Unlike Philadelphia, London, and most other large cities, which have a background of hundreds of square miles upon which to extend according to the exigencies of the population or of business, New York is limited in its power of expansion, and must accommodate itself to its given area. While it is true that a large business population will gather upon the adjacent shores, it is equally true that these non-residents will be of the better class. The laboring population will, for the most part, remain upon the island, and must be accommodated in the city proper, as they are compelled to live near their work.

New York has, thus far, grown without any control or supervision, until its population is estimated at 1,000,000 of persons. Of this number, at least one-half are of the laboring and dependant classes, compelled to live under such conditions as they find in their homes, without any power, either to change or improve them. Following the natural law which governs the movements of such a population, the wealthier or independent class spreads itself with its business arrangements over the larger proportion of the area, and the poorer or dependent class is crowded into the smallest possible space.

Already New York has covered about 8 of its 34 square miles with the dwellings of a population not far from 1,000,000, and all its commercial and manufacturing establishments. And the result is, as might have been anticipated, the dependent class, numbering fully one-half of the people, is crowded into tenant-houses which occupy an area of not more than two square miles. Such crowding amounts literally to packing.

For example, it is estimated that there are three contiguous blocks of tenant-houses which contain a larger population than Fifth Avenue; or, again, if Fifth Avenue had front and rear tenant-houses as densely packed as tenant-houses generally are, there would be a population of 100,000 on that single avenue. A single tenant-court in the Fourth Ward is arranged for the packing of 1,000 persons.

Arranged for the Packing of 1,000 Persons]

A resident of the same Ward reports that: “On a piece of ground 240 feet by 150, there are 20 tenant-houses, occupied by 111 families, 5 stables, a large soap and candle factory, and a tan-yard, the receptacle of green hides. The filth and stench of this locality are beyond any power of description.” In general, it may be stated that the average number of families to a house among the poor is 7, or about 35 persons.

It is necessary also to make a single explanation, to render more apparent the bearing of the facts developed. For the purposes of sanitary inquiry, the causes of disease are divided into those which are inevitable, and those which are avoidable or removable, and hence it follows that diseases and deaths are divided into those which are inevitable and those which are preventable. For example: Of unavoidable causes of disease, we have vicissitudes of weather, accidents, old age, physical degenerations, etc.

Of avoidable or removable causes of disease we have those conditions around or within our dwellings or places of business or resort, errors in our mode of living, etc., which vitiate health, or rather tend to diseases, and yet which can be removed or changed by human agency. For example, a country residence may be most favorably located for health, and yet decaying vegetable matter in the cellar, or a cesspool so situated as to allow the gaseous emanations to be diffused through the house, will expose all the inmates to fevers, diarrhoea and dysentery.

These would be preventable diseases, and all the deaths therefrom would be preventable, and hence unnecessary deaths. In like manner in cities, all diseases and deaths due to causes which human agencies can remove are preventable. And it is a melancholy fact that fifty per cent of the mortality of cities is estimated to be due to such causes, and is hence unnecessary.

In reviewing the result of this inspection, I shall call your attention only to the more patent causes of disease found existing, and to the preventable diseases discovered, and their relation to these causes. In this evidence you will find ample proof that radical reforms are required in the health organizations of New York.

I will first notice the causes of disease which exist external to our dwellings, and which are the most readily susceptible of remedy. The first that attracts attention in New York is the condition of the streets. No one can doubt that if the streets in a thickly populated part of a town are made the common receptacle of the refuse of families, that in its rapid decomposition a vast amount of poisonous gases must escape, which will impregnate the entire district, penetrate the dwellings, and render the atmosphere in the neighborhood in a high degree injurious to the public health. In confirmation of this statement, I will quote the City Inspector, who, in a former communication to the Common Council, says:

“As an evidence of the effect of this state of things upon the health of the community, I would state that the mortality of the city, from the first of March, has been largely on the increase, until it has now reached a point of fearful magnitude. For the week ending April 27th, there were reported to this department one hundred and forty more deaths than occurred during the same week of the previous year. Were this increase of mortality the result of an existing pestilence or epidemic among us, the public would become justly alarmed as to the future; but although no actual pestilence, as such, exists, it is by no means certain that we are not preparing the way for some fatal scourge by the no longer to be endured filthy condition of our city.”

The universal testimony of the sanitary inspectors is that in all portions of the city occupied by the poorer classes, the streets are in the same filthy condition as that described by the City Inspector, and, that street filth is one of the most fruitful causes of disease.

Says the Inspector of the Eighth Ward: “Laurens, Wooster, Clark, and Sullivan are in a most filthy condition, giving off insalubrious emanations on which depend the many cases of fever, cholera infantum, dysentery, and pulmonary diseases. I have observed that near where other streets cross the above-named streets there is a greater proportionate amount of sickness; and this fact I have shown by special reports of typhus and typhoid fever in Grand and Broome, and dysentery in Spring.”

The Inspector of the Sixth Ward says: “Domestic garbage and filth of every kind is thrown into the streets, covering their surface, filling the gutters, obstructing the sewer culverts, and sending forth perennial emanations which must generate pestiferous disease. In winter the filth and garbage, etc., accumulate in the streets, to the depth sometimes of two or three feet. The garbage boxes are a perpetual source of nuisance in the streets, filth and offal being thrown all around them, pools of filthy water in many instances remaining in the gutters, and having their source in the garbage boxes.”

The Inspector of the Seventh Ward says: “The whole most easterly portion of the district, the streets and gutters are very filthy with mud, ashes, garbage, etc.”

The Inspector of the Thirteenth Ward says: “The streets are generally in a filthy and unwholesome condition; especially in front of the tenant-houses, from which the garbage and slops are, to a great extent, thrown into the streets, where they putrefy, rendering the air offensive to the smell and deleterious to health. The refuse of the bedrooms of those sick with typhoid and scarlet fevers and smallpox is frequently thrown into the streets, there to contaminate the air, and, no doubt, aid in the spread of those pestilential diseases.”

Says the Inspector of the Ninth Ward: “The effect of dirty streets upon the public health is too well known, and too often insisted upon, to need any exposition in this report. The largest number of cases of cholera infantum, cholera morbus, and kindred disease, is always found in localities where the streets are dirtiest.”

The Inspector of the Seventeenth Ward writes: “The two following localities present the appearance of dung-hills rather than the thoroughfares in a civilized city, viz.: Sixth Street, between Bowery and Second Avenue, and Eleventh Street, between First and Second Avenues.”