Part 3
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.
[Sidenote: Period of the Inspection]
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.
[Sidenote: Distribution of Population]
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.
[Sidenote: Tenant-House Packing]
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.
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.
[Sidenote: Avoidable and Inevitable Disease]
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.
[Sidenote: Filthy Streets]
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.
[Sidenote: Street Filth and 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.”
[Sidenote: Animals Dead]
The Inspector of the Eleventh Ward says: “As a rule, the streets are extremely dirty and offensive, and the gutters obstructed with filth. The filth of the streets is composed of house-slops, refuse vegetables, decayed fruit, store and shop sweepings, ashes, dead animals, and even human excrements. These putrifying organic substances are ground together by the constantly passing vehicles. When dried by the summer’s heat, they are driven by the wind in every direction in the form of dust. When remaining moist or liquid in the form of “slush,” they emit deleterious and very offensive exhalations. The reeking stench of the gutters, the street filth, and domestic garbage of this quarter of the city, constantly imperil the health of its inhabitants. It is a well-recognized cause of diarrhoeal diseases and fevers.”
The Inspector of the Eighteenth Ward reports: “The streets in the eastern part of the district, east of First Avenue especially, have, for the past six months, been in a most inexcusably filthy condition. The pavement here is uneven, there are deep gutters at either side of the streets, filled with foul slops, in which float or are sunk every form of decaying animal and vegetable matter. Occasionally, at remote and irregular intervals, carts come round, these stagnant pools are dredged, so to speak, and their black and decayed solid contents raked out. If there be anything on earth that is ‘rank and smells to heaven,’ these gutters do on such occasions, especially in the summer months. The streets in this part of the city are the principal depositories of garbage. In some instances heaped up at the sides of the streets, in others thrown about promiscuously, the event in either case is the same, if it be allowed to remain day after day, as it usually is. After having passed through every stage of decay, after having corrupted the surrounding air with its pestilential smell, it gradually becomes dessicated and converted into dust by the summer sun and the constantly passing vehicles. And now every horse that passes stirs it up, every vehicle leaves a cloud of it behind; it is lifted into the air with every wind and carried in every direction.
“Those who are directly responsible for this state of things suffer no more than the cleanly and thrifty who are so unfortunate as to live anywhere the wind, blowing from this quarter, reaches them. And what a _pulvis compositum_ is it to breathe into the lungs! As we pass by, our mouths become full of it, we draw it in with our breath. It is swallowed into the stomach, it penetrates our dress and clings until it has covered our perspiring skin. Surely no dumping-ground, no sewer, no vault, contains more filth or in greater variety than did the air in certain parts of our city during the long season of drought the past summer. And wherever the wind blows, the foul corruption is carried; by a process as sure and universal as the diffusion of gases, is it conveyed throughout the city. Such, often, is the air drawn into the lungs with every respiration, of the poor sufferer stifled with consumption or burning with fever. No barrier can shut it out, no social distinction can save us from it; no domestic cleanliness, no private sanitary measures can substitute a pure atmosphere for a foul one.”
But I need not multiply these quotations. It will suffice to state that during the week ending August 5th, a special inspection of all the streets was made and they were found to be reeking, and, indeed, almost impassable, with filth. And to-day they are in, if possible, a still worse condition than ever before.
[Sidenote: Filthy Courts and Alleys]
Closely allied to the streets are courts and alleys. These cul-de-sacs leading to, and adjoining the close and unventilated homes of the poor, are almost universally in a more filthy condition than the adjacent street. They are the receptacles of much of the waste of the house, and are rarely cleaned. The air of these places during the summer is often the most stifling and irrespirable, and yet as it descends it enters the closely packed tenant-house and furnishes to the inmates the elements of disease and death. Says the Inspector of the Fourth Ward:
“Slops from rear buildings of such premises are usually emptied into a shallow gutter cut in the flagging and extending from the yard, or space between front and rear buildings, to the street. This is often clogged up by semi-fluid filth, so that the alley and those parts of the yard through which it runs are not infrequently overflown and submerged to the depth of several inches. There are more than four hundred families in this district whose homes can only be reached by wading through a disgusting deposit of filthy refuse. In some instances, a staging of plank, elevated a few inches above the surface, is constructed through the alleys.”
[Sidenote: Cesspool Abominations]
In the court is found generally that most pestiferous of all the sources of civic uncleanliness and unhealthiness--the privy and cesspool. These receptacles are rarely drained into the sewers, and consequently require for their cleanliness the frequent and faithful attention of the scavenger. The reports of the sanitary inspectors prove that this work is most irregularly and imperfectly done. Hundreds of places were found where these nuisances existed within, under or beside large tenant-houses, creating a vast amount of disease and death. Numerous instances of this kind are detailed in these reports, which are almost too revolting to be believed. I will quote but one or two illustrations:
“The privies (two in one) of Nos. -- and -- West Twenty-fourth Street need instant cleaning. They are overflowing the yard, and are very offensive. The privy No. -- Seventh Avenue, as in the preceding two adjoining houses, is in the yard, and adjoins the house, and is on a line with the southerly wall of house No. -- (the adjacent house), which has a back area; the wall of said area being part of the foundation of the privy. At times the fluid portion of the privy oozes through its own and the area wall.
“The privy of the rear tenant-house No. -- West Twenty-second Street is used by 42 persons; it has five subdivisions, one for every two families. The compartments are so small that a person can scarcely turn round in them, and so dark that they have to be entered with an artificial light. The cellar itself, as has been stated, is damp, dark, and without ventilation. Under such circumstances the emanations of the excrementious matter of 42 persons can find no escape; thus this privy-cellar is worse than a Stygian pit.”
The Inspector of the Fifth Ward says: “Very few tenements have water-closets in the house; they have privies in the yards, which, as a rule, are insufficient for the accommodation of the numbers crowded into the houses; many are not connected with the sewers; are seldom cleaned, being allowed to overflow in some cases, rendering the neighborhood offensive with insalubrious emanations.”
The Inspector of the Fourteenth Ward states that: “The water-closets are nearly all in the yards--but few being in the houses--and connecting with the sewers. The greater number of these sewers are in a filthy condition, being but seldom emptied. Many of those which communicate with the privies are choked up by all sorts of offal being thrown into them, thereby producing a very bad condition.”
[Sidenote: Unbelievable Vileness]
The Inspector of the Seventeenth Ward reports: “The privies of East Eleventh Street, rear, are beneath the floored alley-way leading to the building. Large holes in this floor allow ocular inspection from above, and admit rain and dirt. These nuisances are almost always overflowing, and the passage leading to them is full of fæcal matter. It would seem impossible for human beings to create or endure such vileness. The cellar is used by children and others as a privy; the foul air there seems never to change.”
The Inspector of the Sixteenth Ward says: “The privies form one end of the chief features of insalubrity. Nearly all of them are too small in size and too few in number, and without ventilation or seat-covers. About twelve were found locked securely, and on procuring the key and inspecting the privy, such masses of human excrements were found on the seats and floors as would justify the locking of the door to protect unwary persons from injury. Occupants of rear buildings are the principal sufferers from this insalubrity. The proximity of privies is in some cases eight feet from the windows of rear houses; the odor in these is, especially at night, intolerable. Instances of the kind are to be found at Nos. --, -- and -- West Seventeenth Street, and others. They are also too few in number; for example, No. -- West Nineteenth Street, where in the front and rear buildings more than one hundred persons live who have one common privy, with a single partition dividing it, and but four seats in all. Twenty-five persons are expected to use one seat-opening.”
The Inspector of the Twentieth Ward says: “During my inspection I reported a number which were filled, and at the same time in such need of repair as to hazard the lives of those who entered them. The proximity of these places to the houses in many cases is a fact to which I would call your attention. One instance of this kind I may state: At a house in Fortieth Street, between Broadway and Seventh Avenue, the privy is situated about 10 feet from the door, and there is another on a line 10 feet from the first, and still another within 10 feet of the last mentioned, making three privies within 30 feet, and two of these belong to houses fronting on Broadway. The offensive odor arising from these places contaminates the air of the houses in the vicinity. This house, in Fortieth Street, is actually unfit to live in. At the time of my inspection the noxious gases from these privies were strongly perceptible in every part of the house.”
The Inspector of the Seventeenth Ward reports: “The privies are in most cases in the rear court-yard. In about two-thirds of the houses the privies are connected with the sewer. Overflowing privies are frequently found. Sometimes they are located in a dark place, which in all cases must be considered an evil. Such is the case in some houses in Rivington, Stanton, Ninth and Eldridge streets. All these places are filthy, and exceedingly offensive and dangerous to the whole neighborhood; in some places the foundation of the privies being rotten and broken, and fæcal matter runs into the cellar, as in No. -- ‘Extra Place,’ where diseases and deaths have occurred. The contents of a privy in a court at No. -- Fifth Street have, from a similar cause, saturated the yard of premises on the Bowery, where several children died during the summer.”
[Sidenote: Special Nuisances]