United States from 1846 to 1866, the people of the United States remained profoundly apathetic5 in relation to all questions of improvement of the public health and the prevention of epidemics7. Cholera9 ravaged10 their cities in 1849, and again in 1854, without meeting other obstruction11 than the occasional fumes12 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 inevitable13 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 applied14 in several34 visitations of epidemics, was known to a few students of sanitary15 science and administration in different parts of this country and efforts had been made by them, from time to time, to awaken1 public interest in sanitation16 of the home and the municipality, but very little progress was made. A few cities had health organizations which, for the most part, were devoted17 to political schemes and purposes, with no pretense18 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 An Incident
That Counted became the potential force that gave to New York a most complete system of health laws and ordinances20, and an efficient administrative21 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 civilized22 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 called35 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 severely23 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 Commissioner24 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 tenement25 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 A Fever
Nest of the house presented to the visitor. The building was in an extreme state of dilapidation36 generally; the doors and windows were broken; the cellar was partly filled with filthy27 sewage; the floors were littered with decomposing28 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 reeking29 with filth26, and the atmosphere was heavy with the sickening odor of the deadly typhus, which reigned30 supreme31 in every room.
The necessity of immediately closing this house to further occupation by immigrants, until it was thoroughly32 cleansed33 and made decently habitable, was imperative34, and I made inquiries35 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 vagrants36, especially of the most recent and destitute37 immigrants; that they came and went without let or hindrance38, generally remaining until attacked by the prevailing39 epidemic8 of fever, when they were removed to the fever hospital.
After considerable inquiry40 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 The Unknown
Owner was under instructions not to reveal the owner’s37 name. A suggestion to this agent, to have the house vacated and put in good condition for tenants41, was refused with a contemptuous remark as to the absurdity42 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 Metropolitan43 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 ordinance19 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 authorize44 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 his38 property, and asserted, in the most emphatic45 manner, that as the house yielded him no rent, he would not expend46 a dollar for the benefit of the miserable47 creatures who had so wrecked48 the building.
With the failure of this appeal to the owner, I had exhausted49, apparently50, every legal and moral means of abating51 a nuisance dangerous to life and detrimental52 to health.
In this extremity53 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 Fear of
Publicity54 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 delinquent55 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 publish39 the proceedings56 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 promptly57 vacated the house, and made such a thorough reconstruction58 of the entire establishment that it became one of the most attractive tenements59 in that East Side district. For many years that house continued to be entirely60 free from the ordinary contagious61 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 violation62 of the simplest principles of health, and Agitation63 for
Reform even of common decency64, could be at once corrected.
For many years there had been a growing sentiment in favor of a reform of our health regulations, stimulated65 by the writings of Dr. John H. Griscom, Dr. Joseph M. Smith, Dr. Elisha Harris, and others, and the Academy of40 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 annually66 introduced a health bill into the Legislature, but the measure was regularly defeated through the active opposition67 of the City Inspector68, 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 The Citizens
Association most completely in his power. The objects of the Association were reform in all branches of the Municipal Government, the promotion69 of wise legislation, and the defeat of all attempts to subordinate the city to the schemes for control by Tweed and the coterie70 of politicians who were under his directions.
The friends of sanitary reform decided71 to attempt to secure proper legislation through the Citizens Association. The application, by a delegation72, for the aid of this Association was well received and a plan of procedure adopted. The41 secretary of the Citizens Association, Mr. Nathaniel Sands, had been a member of the Sanitary Association, and as an enthusiastic sanitarian had been disappointed at its repeated failure to secure legislation. At his suggestion, it was decided to create two committees, one on health and another on law, and through these agencies to have the Citizens Association accomplish its work. The first committee eventually came under my direction, while the second was directed by Dorman B. Eaton, Esq.
In the Committee on Public Health were many of the more prominent medical men of that period, as Dr. Valentine Mott, Dr. Joseph M. Smith, Dr. James R. Wood, Prof. John W. Draper, Dr. Willard Parker, Dr. Isaac E. Taylor. The Committee on Law was equally distinguished73 for its membership, having on its list the names of William M. Evarts, Charles Tracy, D. B. Silliman.
It was determined74, as a preliminary step, to prepare a “Health Bill” and introduce it into the Legislature, which was that of 1864, and thus learn the obstacles to be met; for efforts had repeatedly been made to pass health bills A Health
Bill without success. The bill was drawn75 along the lines of previous bills, and was altogether inadequate76 in its provisions to effect the required reforms. The effort, however, developed the fact42 that the real opposition to health legislation was the City Inspector’s Department. As that department exercised all of the health powers, any proper health bill would abolish it altogether.
The City Inspector, at that time, was a grossly ignorant politician, but as he had upwards77 of one million of dollars at his disposal, he had a prevailing influence in the Legislature when any bill affected78 his interests. At the hearing on the Association’s bill, the City Inspector’s agents denied every allegation as to the unsanitary condition of the city, and as the Association had no definite information as to the facts asserted, the bill failed, as had all the bills of the Sanitary Association during the previous ten years.
In conference it was now decided to make a thorough sanitary inspection79 of the city by a corps80 of competent physicians, draft a new and much more comprehensive measure, and thus be prepared to confront the City Inspector with reliable facts in Sanitary Inspection
of New York regard to the actual condition of the city. The Citizens’ Association consented to bear the expense of the undertaking81.
Under the auspices82 of the Association, and in the absence of the secretary of the Committee on Health, Dr. Elisha Harris, who was at that43 time in the service of the United States Sanitary Association, I organized and supervised the inspection. The corps of inspectors83 consisted of young physicians, each assigned to one of the districts into which the city was divided. The work was completed during the summer months of 1864, and the original reports of the inspectors were bound in seventeen large folio volumes. These reports were afterwards edited by the secretary, Dr. Elisha Harris, and published by the Association in a volume of over 500 pages. The total cost to the Association of this inspection and publication was $22,000; but it richly repaid the Association, for it accomplished84 the object for which it was undertaken.
This volunteer sanitary inspection of a great city was regarded by European health authorities as the most remarkable85 and creditable in the history of municipal reform. Too much credit can not be given to the President of the Association, Peter Cooper, and to the Secretary, Nathaniel Sands, for the constant support which they gave the Committee on Health in the prosecution86 of this great undertaking.
Meantime the Committee on Law perfected a bill to be introduced at the coming session of the Legislature, 1865. It was the joint87 product of the Medical and Law Committees, and was made the subject of extensive study and research, in order to embody88 in it every provision essential to its practical operations.
44 At the request of the Committees I made the first draft for the purpose of embodying89 the sanitary features as the basis of the bill. Former health bills were restricted in their operations to the city of New York, and the officers were appointed by the Mayor. As the government of the city was dominated in all of its departments by Tweed, it was decided to place the proposed new health organization under the control of the State, by making a Metropolitan Health District, the area of which should be co-extensive with that of the Metropolitan Police District. This feature of the bill was also important because the protection of the city from contagious diseases in outlying districts required that the jurisdiction90 of the Board should extend to contiguous populations.
The original draft having been approved by the Committee on Health, Mr. Eaton was requested to perfect the bill by adding the legal provisions. As he had recently made a study of the English health laws, he incorporated many items especially relating to the powers of the Board which were quite novel in this country.
One feature of the bill deserves mention; for it is an anomaly in legislation and apparently violates the most sacred principle of justice; viz., the power of the courts to review the proceedings of a health board. The Committees An Anomaly
in Law concluded that a board which was authorized45 to abate91 nuisances “dangerous to life and detrimental to health” should not be subjected to the possible liability of being interrupted in its efforts to abate them by an injunction that would delay its action. Accordingly the law as so drawn that the Metropolitan Board was empowered to create ordinances, to execute them in its own time and manner, and to sit in judgment92 on its own acts, without the possibility of being interrupted by review proceedings or injunctions by any court.
Its power was made autocratic. The language of that portion of the bill conveying these powers was purposely made very technical, in order that only a legal mind could interpret its full meaning, it being believed that the ordinary legislator would not favor the measure if he understood its entire import. It is an interesting fact that the first case brought into court under the law was an effort to prove the unconstitutionality of this feature; but it was carried to the Court of Appeals, and its constitutionality was sustained by a majority of one.
On the assembling of the Legislature of 1865 the Metropolitan Health Bill was formally introduced into both houses, and preparations made to secure its passage. Mr. Eaton was selected by the Citizens’ Association to advocate Introduction of an
Epoch-Making Bill the legal provisions of the bill at the hearings46 before the committees of the Legislature, and I was delegated to explain the sanitary requirements of the measure. The first hearing occurred on the thirteenth of February, before a joint committee of both houses, Hon. Andrew D. White, senator, presiding. A large audience was present, including the City Inspector and the usual retinue93 of office holders94 in his department. The Citizens Association was represented by Rev6. Henry W. Bellows95, Dr. James R. Wood, Dr. Willard Parker, Prof. John W. Draper, and several other prominent citizens, in addition to Mr. Eaton and myself.
Mr. Eaton first addressed the committee, and made an admirable presentation of the legal features of the bill. He eloquently96 appealed for its enactment97 into law, in order to create in New York a competent health authority, with power to relieve the city of its gross sanitary evils and adopt and enforce measures for the promotion of the public health.
I followed him, my task being to show, from the existing condition of the city, the imperative need of such legislation. My remarks on the occasion were published in The New York Times of March 16, 1865.
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awaken
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| vi.醒，觉醒；vt.唤醒，使觉醒，唤起，激起 | |
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awakening
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| n.觉醒，醒悟 adj.觉醒中的；唤醒的 | |
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pestilences
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| n.瘟疫， （尤指）腺鼠疫( pestilence的名词复数 ) | |
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apathy
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| n.漠不关心，无动于衷；冷淡 | |
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apathetic
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| adj.冷漠的，无动于衷的 | |
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rev
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| v.发动机旋转，加快速度 | |
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epidemics
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| n．流行病 | |
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epidemic
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| n.流行病；盛行；adj.流行性的，流传极广的 | |
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cholera
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| n.霍乱 | |
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ravaged
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| 毁坏( ravage的过去式和过去分词 )； 蹂躏； 劫掠； 抢劫 | |
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obstruction
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| n.阻塞，堵塞；障碍物 | |
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fumes
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| n.(强烈而刺激的)气味，气体 | |
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inevitable
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| adj.不可避免的，必然发生的 | |
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applied
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| adj.应用的；v.应用，适用 | |
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sanitary
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| adj.卫生方面的，卫生的，清洁的，卫生的 | |
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sanitation
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| n.公共卫生，环境卫生，卫生设备 | |
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devoted
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| adj.忠诚的，忠实的，热心的，献身于...的 | |
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pretense
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| n.矫饰，做作，借口 | |
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ordinance
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| n.法令；条令；条例 | |
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ordinances
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| n.条例，法令( ordinance的名词复数 ) | |
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administrative
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| adj.行政的，管理的 | |
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civilized
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| a.有教养的，文雅的 | |
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severely
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| adv.严格地；严厉地；非常恶劣地 | |
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commissioner
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| n.（政府厅、局、处等部门）专员，长官，委员 | |
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tenement
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| n.公寓；房屋 | |
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filth
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| n.肮脏，污物，污秽；淫猥 | |
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filthy
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| adj.卑劣的；恶劣的，肮脏的 | |
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decomposing
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| 腐烂( decompose的现在分词 )； （使）分解； 分解（某物质、光线等） | |
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reeking
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| v.发出浓烈的臭气( reek的现在分词 )；散发臭气；发出难闻的气味 (of sth)；明显带有（令人不快或生疑的跡象） | |
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reigned
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| vi.当政，统治（reign的过去式形式） | |
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supreme
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| adj.极度的，最重要的；至高的，最高的 | |
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thoroughly
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| adv.完全地，彻底地，十足地 | |
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cleansed
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| 弄干净，清洗( cleanse的过去式和过去分词 ) | |
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imperative
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| n.命令，需要；规则；祈使语气；adj.强制的；紧急的 | |
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inquiries
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| n.调查( inquiry的名词复数 )；疑问；探究；打听 | |
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vagrants
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| 流浪者( vagrant的名词复数 )； 无业游民； 乞丐； 无赖 | |
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destitute
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| adj.缺乏的；穷困的 | |
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hindrance
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| n.妨碍，障碍 | |
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prevailing
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| adj.盛行的；占优势的；主要的 | |
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inquiry
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| n.打听，询问，调查，查问 | |
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tenants
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| n.房客( tenant的名词复数 )；佃户；占用者；占有者 | |
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absurdity
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| n.荒谬，愚蠢；谬论 | |
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metropolitan
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| adj.大城市的，大都会的 | |
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authorize
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| v.授权，委任；批准，认可 | |
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emphatic
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| adj.强调的，着重的；无可置疑的，明显的 | |
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expend
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| vt.花费，消费，消耗 | |
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miserable
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| adj.悲惨的，痛苦的；可怜的，糟糕的 | |
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wrecked
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| adj.失事的，遇难的 | |
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exhausted
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| adj.极其疲惫的，精疲力尽的 | |
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apparently
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| adv.显然地；表面上，似乎 | |
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abating
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| 减少( abate的现在分词 )； 减去； 降价； 撤消（诉讼） | |
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detrimental
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| adj.损害的，造成伤害的 | |
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extremity
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| n.末端，尽头；尽力；终极；极度 | |
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publicity
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| n.众所周知，闻名；宣传，广告 | |
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delinquent
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| adj.犯法的，有过失的；n.违法者 | |
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proceedings
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| n.进程，过程，议程；诉讼(程序)；公报 | |
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promptly
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| adv.及时地，敏捷地 | |
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reconstruction
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| n.重建，再现，复原 | |
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tenements
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| n.房屋，住户，租房子( tenement的名词复数 ) | |
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entirely
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| ad.全部地，完整地；完全地，彻底地 | |
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contagious
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| adj.传染性的，有感染力的 | |
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violation
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| n.违反(行为)，违背(行为)，侵犯 | |
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agitation
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| n.搅动；搅拌；鼓动，煽动 | |
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decency
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| n.体面，得体，合宜，正派，庄重 | |
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stimulated
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| a.刺激的 | |
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annually
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| adv.一年一次，每年 | |
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opposition
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| n.反对，敌对 | |
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inspector
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| n.检查员，监察员，视察员 | |
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promotion
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| n.提升，晋级；促销，宣传 | |
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coterie
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| n.(有共同兴趣的)小团体，小圈子 | |
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decided
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| adj.决定了的，坚决的；明显的，明确的 | |
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delegation
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| n.代表团；派遣 | |
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distinguished
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| adj.卓越的，杰出的，著名的 | |
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determined
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| adj.坚定的；有决心的 | |
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drawn
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| v.拖，拉，拔出；adj.憔悴的，紧张的 | |
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inadequate
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| adj.(for,to)不充足的，不适当的 | |
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77
upwards
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| adv.向上，在更高处...以上 | |
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affected
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| adj.不自然的，假装的 | |
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inspection
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| n.检查，审查，检阅 | |
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80
corps
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| n.(通信等兵种的)部队；(同类作的)一组 | |
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81
undertaking
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| n.保证，许诺，事业 | |
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auspices
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| n.资助，赞助 | |
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83
inspectors
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| n.检查员( inspector的名词复数 )；（英国公共汽车或火车上的）查票员；（警察）巡官；检阅官 | |
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84
accomplished
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| adj.有才艺的；有造诣的；达到了的 | |
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85
remarkable
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| adj.显著的，异常的，非凡的，值得注意的 | |
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86
prosecution
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| n.起诉，告发，检举，执行，经营 | |
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87
joint
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| adj.联合的，共同的；n.关节，接合处；v.连接，贴合 | |
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embody
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| vt.具体表达，使具体化；包含，收录 | |
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embodying
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| v.表现( embody的现在分词 )；象征；包括；包含 | |
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jurisdiction
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| n.司法权，审判权，管辖权，控制权 | |
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abate
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| vi.(风势，疼痛等)减弱，减轻，减退 | |
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judgment
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| n.审判；判断力，识别力，看法，意见 | |
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retinue
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| n.侍从；随员 | |
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holders
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| 支持物( holder的名词复数 )； 持有者； （支票等）持有人； 支托（或握持）…之物 | |
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bellows
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| n.风箱；发出吼叫声，咆哮（尤指因痛苦）( bellow的名词复数 )；（愤怒地）说出（某事），大叫v.发出吼叫声，咆哮（尤指因痛苦）( bellow的第三人称单数 )；（愤怒地）说出（某事），大叫 | |
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eloquently
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| adv. 雄辩地(有口才地, 富于表情地) | |
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enactment
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| n.演出，担任…角色；制订，通过 | |
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