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THE HEALTH QUESTION.
From the body of evidence produced by the labours of skilled physicians, acting as medical inspectors, and from a mass of testimony arrayed during the last few years before legislative committees, the public must have become familiar with the sanitary wants of our city. They have learned that numberless abodes of human beings in our midst are the nurseries of disease, as well as the centres of misery. They know that we have alleys, lanes, and streets, in which sickness is ever present— that there are dwellings which can be fitly described only by the suggestive title of "fevernests ;" and that there is a process of moral and physical decay among our poorer population which can only be classified as "tenant-house rot." Facts of the most stubborn kind demonstrate the existence in our community of a barbarism which shames civilization, and of degradation that accuses Christianity. We have learned that our preventible deaths are numbered by tens of thousands; that fevers have become endemics within a hundred precincts; that multitudes are poisoned by putrid effluvia; that squalor, filth, and physical sufferings are the daily concomitants of half our social life.
Medical theorists may dispute as to the contagious principle of our common low, nervous, and bilious fevers. We need not enter into entangling discussions regarding the comparative prevalence of typhus, synochus, or other more arbitrary distinctions of febris. It is enough to realize that, in our city, we can trace a deathtrail of Something—call it by whatever name you please —which prostrates as quickly, and overcomes as surely, as any malignant type of spotted pestilence. Passing from individual to individual, from tenement to tenement, alternately afflicting every member of a family, and every family residing under the same roof; we can identify its characteristics, whether we classify it or not. We shall never fail to remark its appearance where circumstances lead to its introduction; and we must inevitably chronicle its establishment wherever those circumstances concur to afford it proper nidus and support. It is observed by naturalists that, where all things tend to the disclosure and sustenance of any production, in that place—no matter how the germen may be conveyed—we are sure to find developed the peculiar species, which, by habit and sympathy, accords with the local surroundings. The same, undoubtedly, is true of disease. If abject poverty, scanty food and clothing, filthy habitation, dejection of mind, and debility of body, be latent causes that engender contagious or infectious diseases in one district, we may be certain that " like will beget like" in other districts, however remote.
It is sufficiently frightful to contemplate the ravages of a pestilence from some safe scien
tific stand-point of observation. It becomes more alarming when the visitation depopulates a neighbourhood of ours, and when the deathrates of a city in which we reside reveal the presence of fatal infection on every side of us. But what will the community, as yet unawakened to peril, reply to our assertion, based on medical statistics, that fevers comparatively light among the poorer classes wax to malignant fatality when introduced to the quarters of luxury and refinement? Typhus, for instance, comparatively mild in its attacks upon. the lower strata of society, becomes virulent when transferred to the mansions of wealth and apparent exclusiveness. Originating in the same specific contagion, and developed through the same malarious influences, as an endemic, it no sooner becomes liberated upon the wings of ammonia than it assumes directly a mortal character, changing, as it were, its very essence, as it passes from poor to rich. Among the habitants of gregarious localities, abandoned to filth and neglect, and becoming actual purvey ors of disease, the mortality in cases of fever will be found to average less than one in thirty ; but among the affluent and comfortable the deaths are as one to five cases. So, then, the chances to survive, attacked by typhus or other local fever—apart from putrid hospital types—are against our " better classes" in the proportion of six to one, as compared with the poorer. A poor denizen of the crowded tenant-house, attacked by low typhus in his dark abode, may be prostrated, and speedily recover; while the
dweller in Square, after succumbing to
sequent symptoms of stupor, headache, convulsions, muscular contractions, and deliriums, may perish miserably, at last, under the true, malignant typhus.
The labours of Hercules, as recited in classic story, were types, it has been said, of successive reforms or ameliorations introduced by wise monarchs into ancient society. However that may be, it is certain that we have in modern communities the equivalents of many such monsters as were destroyed by Alcmena's son. Not to apply the threadbare simile of Augean stable to London back-streets, we may aptly liken the tenant-house nuisance to that other embodiment of malarious poison which the strong man encountered in Lernean morasses. We have, in fact, a domestic Lernean marsh in the filthy and feculent "back-slums" of our city, and a local hydra in the many-headed evils of that horrible excrescence—the tenanthouse.
To recognize this abominable packing-box arrangement as a dwelling-system for human beings is to scandalize civilization. To declare it a "laboratory of poisons"—whose emanations vitiate health and morals, whose agencies corrupt body and soul—is to utter only simple truth. To assert that its endemic influences add forty per cent, to our bills of mortality, sixty per cent, to our pauperism, seventy per cent, to our local crime, would be but the iteration of truisms. To describe it as a gangrene of the social membrane, as a "goitte" (so to speak) upon our community's body, would be but a suggestion of superficial venom and hideousness. For our tenant-house cancer is liot merely protrusive; in fact, it does not protrude enough, therefore we lose sight of it; but it is a polypus, secretly and constantly renewing its virus—fatally expansive for mischief, and accretive of all mischievous elements. "It doth make the meat it feeds on."
We do not propose to deal rhetorically with our tenant-house, its incubations, or its progenies. Here it is, in our midst, quite equal to the task of telling its own story eloquently, in mortality-bills, crime-dockets, and the records of pauperism. We are content to marshal facts and array statistics, letting them fight their own battle against prejudice or indifference. Beginning at the social base, we encounter thousands of dwellers in cellars six feet or more underground—cellars that are not simply dark, impure abodes, but clammy, mouldy, obscene abysses, invaded periodically by tide-water, or submerged by drainage of the soil. Life rots in them: seventy per cent, of children born in their gloom perish within five years; many of the residue survive only as victims to future typhoid, rheumatism, hip, or bowel affections. These cellar-born children have pallid skins rickety limbs, watery blood. Hygrometric scrutiny of the boles they inhabit shows a condition of atmosphere actively destructive by night and by day—day, indeed, with its aircurrents and sunshine, is unknown to our city troglodytes. Crawling out of their burrows, into narrow lanes, close-pent by high walls, they may catch occasional glimpses of the blue sky, just as the cretins and cagots of sunless Alpine chasms may get sight of a heaven far above them. Indeed, our cellar-dwellers have much in common with the cretins. They are not afflicted with goitre or elephantiasis; they do not transmit leprosy and idiocy; but they exhibit the incipient effects of the same destitution of sunlight and proper air which engenders cretinism and its revolting monstrosities. Darkness, moisture, and squalor in our suhterrene tenements are constantly operative, producing scrofula, rickets, ophthalmia and erysipelas. We need no subtler agent of disease than darkness alone. All foul or loathsome forms of life or decay multiply under its curtain. Where heaven's sunbeams enter not, health cannot survive. Epidemics are sure to fasten, with deadliest gripe, on the inhabitants of dark, close localities. The sunny side of a street has been known to escape a pestilential visitation which decimated the population opposite. As we find the negro and Indian drinking strength from the solar rays which they delight to bask in, so surely may
we discover our cellar-dwellers emasculated by the dank and putrid emanations of their living tombs.
A traveller visiting Lyons, in France, will notice long lines of stumps bordering on the river; remains of giant trees, which formerly adorned the landscape. Their naked, blasted appearance might indicate the locality of a great conflagration, or the scene of conflict during wir. But on inquiry it was found that the fumes of a neighbouring vitriol factory have silently, stealthily, but with deadly influence, destroyed the trees, as effectually as if a cannonade hid levelled them to the ground.
Within the limits of our city there exist factories of poison more malignant than the fumti of vitriol, and their tendency, nay, their constant effect is to dwarf, stunt, and kill—not trees, but human beings; more actively destructive than the Lyons laboratory, and operating every hour, both of day and night.
In many localities it appears as if no supervision were ever contemplated. Entire streets seem to be given over to the dominion of dirt, "Fever-nests," where typhoid infection is bred by miasmatic sewers, and "small-pox circles," where loathsome contagion riots on foul house gases and decomposed garbage, horrify the explorer in these quarters. Filth destroyseach year its thousands of men, women, and children in our city, as surely as vitriol killed those trees in Lyons. Thirty per cent, of our whole mortality rises from preventible disease. What army, even in an open country and well fed, would not be ravaged by disease under such conditions? But we have numberless aggravations of the packing process. All descriptions of noxious surroundings besiege our tenant-bouse population. Slaughter-houses, fat-boiling concerns, and similar nuisances, are scattered in toe vicinity of populous neighbourhoods. Vegetable decay, animal putrefaction, quite as deleterious as vitriol exhalations, are heaped in dust-bins through many of our streets and back-areas. There are no vigilant police to remove them: no officer of the day responsible for their extirpation. We have no Sanitary Department in the city at all commensurate with what the name implies.
We are, with good reason, alarmed at the occasional encroachments upon local health m comfort by the erection of chemical works, furnaces, glue-factories, and kindred nuisances near our private dwellings. We feel properly aggrieved when one of the slaughter-houses distributed through densely populated neighbourhoods casts forth its noisome stenches " betwixt the wind and our nobility." We can trace" fatal connection between the slow fever wbicn robbed us of a darling child or a dear wife, ana that sickening effluvium of which our beloved one had so often complained, as invading »• windows. We have a right to complain of toe official neglect which allows compost grounds, brickfields, &c, &c, &c, to be permanent located within a few hundred yards of ovt decent and respectable dwellings. But thongn all these nuisances are intolerable, and, in their measure, deadly foes to public health, they cannot be compared, for a moment, with the incessantly-active, ever-malignant forces of death that are ejected constantly from those "laboratories of poison," the tenant-houses. Not isolated, like factories, but agglomerated in certain districts, these building-anomalies not only compress, torture,- and murder their wretched inmates, but actually have power to make those inmates the involuntary murderers of their innocent fellow-citizens who dwell elsewhere. Through the potent chemistry of stagnant air, darkness, damp, and filth, these terrible structures are able to create miasmatic poisons that beleaguer both the daily and nightly existence of their unhappy occupants. Entering every pore, fastening on every sense, clinging to every tissue, these tenant-house poisons, thus chemically combined, become prolific agents of disease ; developing whatsoever morbific germs may already lurk in the human system. The germs, in their turn, become a portion of the local poison. Disease multiplies its agencies. Corruption, decay, mortality, give out their atoms. All these forces concentrating under tenanthouse roofs, working latently within the precincts of narrow dens, which the sun enters not, where the air cannot circulate—constituting in their combination a battery of subtile gases—does it require a scientific disquisition to demonstrate what must be their natural effects upon all surroundings f Let our local epidemics, our chronic diseases answer.
It is a fact, that long and bloody national conflicts are usually precursors of virulent and fatal visitation of disease. Epidemics encamp behind armies. Pestilence is the rearguard of war. In the pages of Thucydides we find harrowing pictures of that dread infection which clung to the skirts of Athens during her Peloponnesian war, fulfilling the oracular prediction that
"A Doric war shall fall,
Calvisius writes in Latin of a terrible plague that scourged the Roman world for fifteen years, about the period when Gallus reigned; a period marked by savage intestinal conflicts, resulting in the elevation, successively, of fifty usurpers to the imperial throne. Still later, Procopius describes a pestilential visitation which traversed the Eastern Empire, just after the Persian war of Justinian, and the sanguinary popular quarrels of Red and Green factions in Byzantium—an epidemic so fatal that ten thousand deaths are reported to have occurred daily in Constantinople alone. Following the Roman invasion of Britain, a plague broke out, in Vortigern's reign, of so fierce a type as to sweep off more victims than the survivors could bury. In 1347 began the "six year plague"—known through the pages of Boccaccio as the "Plague of Florence"—which "so wasted Europe," says Calvisius, "that not the third part of the men were left alive. One
church-yard alone, in London, received more than fifty thousand bodies in twelve months of the disease. Boccaccio ascribes its origin to India; but like other epidemics we find it following a previous great conflict. Bloody civil wars in France and Italy ,a fierce struggle in Flanders, the battle of Crecy, the siege of Calais, were all immediate forerunners of the great plague. And nearly two centuries after this, in the middle of the Thirty-years' War, another plague arose. Still another succeeded the wars of the Fronde, in France. Then came the great plague of 1664, when there perished, in London and its parishes, 68,000 between April and October. This awful infliction followed the English civil war, which had been ended by the Restoration.
And the cholera! how closely its shrouded form glided after revolution! how its ghastly death-dance attended the red carnival of war! Its birth may have been Asiatic, but its funeral foot-prints traced the map of European battlefields—from Jemappes to Moscow. Are these facts only curious coincidences, or is there an appalling connection between war and pestilence? Is there a mysterious lex ta/ionis in Nature, revisiting on man the plagues which he inflicts upon earth through his bloody contentions r Are battle-plains, with their reeking dead, hospitals, with their fecund exhalations, camps, and their contagions, so many voltaic piles, charged with the subtle fluid of latent pestilence? Do wasted fields, abandoned of husbandry, nurse the germs of a future corruption, which floods shall liberate and winds disseminate broadcast over the land? We care not to speculate concerning agencies like these; but if they exist, are we secure against the innoculation of their deadly principle?
It is an inquiry fraught with vital significance. At this very hour, the " cloud no bigger than a man's hand" may be densifying over some aceldama of carnage, or some fever-den of war; the cloud which, imbosoming malarious infection, shall hereafter launch its viewless bolts into the reservoirs of carbonic-acid gas; the storehouses of sulphureted hydrogen; the magazines of putrescent exuviae, that, in crowded cities, await but a communicating virus, to become death-dealing batteries of pestilence.
Here — at the commercial gate of the nation, a point to which converge the most diverse business-highways, and from which radiate the most extended lines of human intercourse—here must pestilence, should it arise, find pivot and fulcrum. We have built up here our warehouses, and piled them with flour and meats; but we have here, likewise, constructed our tenant-houses, and stored them with pabulum for death. We fill our public squares with gay equipages, and our walks with refined and brilliant strangers and citizens; but we crowd our narrow lanes and hidden courts with diseased, stifled, and stunted outcasts. We appropriate miles of palaces to luxurious occupancy, but we confine thousands of souls under ground in cellars, and in airless dens and sunless rooms—there to sin, there to suf-1 fer, there to rot, and there to die, unregarded.
In the city of York, the cholera of 1832 broke out in a crowded court, known as the "Hagworm's Nest." In that locality raged the plague of 1664. In the same court first appeared the pestilence of 1551. During nearly three centuries, that horrid "nest" had kept intact its eggs of pest. Generation after generation dwelt around it, heedlessly, as we dwell around our "fever-nests" of the metropolis.
In following the track of pestilence through different climes and ages, we encounter coincidences which establish the fact that epidemics have an affinity for endemics; or, rather, that the former usurp the dominion of the latter, claiming the localities wherein they flourished, and the subjects which they swayed. Thus, in the passage of the great plague of 1346 over Europe, and in subsequent visitations of similar diseases, the small town of Aigne Morte, in Languedoc, was repeatedly made a centre, or point d'appui, whence the distemper radiated to surrounding districts. This town has always been noted for its local disorders, arising from the malaria which overhangs, and the stagnant water that encompasses it. Milan and the healthful mountain-ranges were notably as exempt from this plague as the coasts and marsh-lands of Italy were ravaged by it. And, as in plague, so in cholera and typhus, the crowded purlieus of great cities have ever been the seats of infection.
When low fevers and their concomitants become naturalized in certain localities, they serve as nuclei for the sporadic propagation of kindred diseases, whenever season and material combine to feed it. The distinctive type of the endemic may merge and be lost in its more virulent successor, but it will have performed its mission; it will have absorbed and given out the principle of poison which constitutes its affinity with plague or cholera. "It appears," says Dr. Southwood Smith, "that in many parts of Bethnal-green and Whitechapel fever of a malignant and fatal character is always more or less prevalent. In some streets it has prevailed in almost every house; in some courts, in every house; and in some few instances, in every room in every house. Cases are recorded in which every member of a family has been attacked in succession, of whom, in every such case, several have died. Some whole families have been swept away. Six persons have been found lying ill of fever in one small room."
Here we have the point d'appui of a pestilence movement. It was said that early plagues might be traced to fcetid exhalations from dead locusts; and Dr. Smith, above quoted, says that "the room of a fever-patient in a small, heated apartment in London, with no perflation of fresh air, is perfectly analagous to a standing pool in Ethiopia full of bodies of dead locusts. The poison generated in both cases is the same; the difference is merely in the degree of its potency. Nature, with her burning sun, her stilled and pent-up wind, her stagnant and
teeming marsh, manufactures plague on a large and fearful scale. Poverty, in her hut, covered with rags, surrounded with her filth, striving with all her might to keep out the pure air and to increase the heat, imitates nature but too successfully; the process and the product are the same; the only difference is in the magnitude of results."
To this testimony, a hundred authorities add weight. Another English medical man says that he has encountered localities from which fever is seldom absent. "We find spots where spasmodic cholera located itself are also the chosen resorts of continued fever." "In damp, dark, and chilly cellars of our city, fevers, rheumatism, contagious and inflammatory disorders, affections of the lungs, skin, and eyes, too often successfully combat the skill of the physicians." Again: "The degraded habits of life, the degenerate morals, the confined and crowded apartments, and insufficient food, of those who live in more elevated rooms, comparatively beyond the reach of the exhalations of the soil, engender a different train of diseases, sufficiently distressing to contemplate; but the addition to all these causes of the foul influence of the incessant moisture and more confined air of underground rooms, is productive of evils which humanity cannot regard without shuddering."
How would our "fever-nests" and "choleraholes" be quarantined, should the "pestilence that walketh at noon-day" fling his yellowshadow over this great metropolis? What charmed circle around the "tenant-house" neighbourhood shall taboo its deadly gases, its subtle infections, from contact with the palaces of luxury?
Here, under our nostrils, the virus of smallpox continually eats into society. It is at this time fearfully on the increase, and its dreadful emanations penetrate to the rural districts. They cling to waggons and steamboats; they are dispensed through personal contagion; they lie-in-wait among second-hand garments sold in our slop-shops; they nestle in bed-clothes so plenty after periodical epidemics. But smallpox is only one of the myriad agencies of death in our midst.
Now, it is better for us, as Christians and good citizens, to hear sober truth occasionally, though it be unpalatable, than to listen always to "the voice of the charmer, charm be ever so wisely." We may ignore the fact of there being latent and horrible evils in our midst, or we may, to a season, shirk our responsibility regarding them; but, sooner or later, we shall invoke, and must abide, the consequences of their protracted existence. There is an oriental story, which relates that a certain tyrant used to clothe his fierce soldiers in the skins of tigers, wolves, and other wild beasts, and set them to hunting pw people out of their beds at night, and dnvinR them into the highways and fields, to worry a"° tear them, while the old king rode behind, enjoying the sport. But in punishment of tni» cruelty, as the legend runs, the disguised soldiera were suddenly changed into real wi beasts, and made to turn on the wicked monarcn