D During the score of years that the great awakening of the people of England to the value of cleanliness of the individual, the home, and the municipality, as the true remedial measure against foreign as well as domestic pestilences was in progress, extending Apathy in the The object lesson which the people of England had learned from the experience of one town, and had so successfully applied in several 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 The incident referred to occurred in the fifties of the last century. New York was in the grip of the deadly typhus. This was sometimes called Having completed a two years’ term of service on the interne medical staff of Bellevue Hospital, where large numbers of typhus cases were treated, I was placed in charge of the tents on Blackwell’s Island by the Commissioner of Charities. Soon after entering upon the service, I noticed that patients were continually admitted from a single building in East Twenty-second Street. Impressed with the importance of closing this fever-nest, I visited the tenement and was not surprised at the large number of cases of fever which it furnished our hospital. It is difficult to describe the scene that the interior A Fever The necessity of immediately closing this house to further occupation by immigrants, until it was thoroughly cleansed and made decently habitable, was imperative, and I made inquiries for the responsible owner. I found that the house was never visited by anyone who claimed to be either agent or owner; but that it was the resort of vagrants, especially of the most recent and destitute immigrants; that they came and went without let or hindrance, generally remaining until attacked by the prevailing epidemic of fever, when they were removed to the fever hospital. After considerable inquiry in the neighborhood I found a person who was the real agent of the landlord; but no other information could be obtained than that the owner took no interest in the property, and that the agent The Unknown As there was no Health Department to which an appeal could be made, the Metropolitan Police Department was visited and the matter laid before its president, Mr. Acton. He directed the secretary, Mr. Hawley, a lawyer, to examine the health laws and ordinances to determine what measures were in the power of the police to enforce. A search was made, and the result was that neither law nor ordinance under which the police could take action was found. Mr. Acton advised that the tax lists be examined, to find who paid taxes on the property, and thus discover the responsible party to its ownership, and then that appeal be made directly to him to authorize the necessary improvements. An examination of the tax list revealed that the owner was a wealthy man, living in an aristocratic neighborhood, a member of one of the most popular churches of the city. The condition of his tenement house was brought to his attention, and its menace to the public health as a fruitful fever nest was explained. He was very angry at what he declared was an interference with the management of his With the failure of this appeal to the owner, I had exhausted, apparently, every legal and moral means of abating a nuisance dangerous to life and detrimental to health. In this extremity I visited the office of the Evening Post and explained the matter to Mr. William Cullen Bryant, then editor of that newspaper. He was at once interested in the failure of the power of the City Government to Fear of Greatly alarmed at his situation, the owner inquired as to the purpose of the reporter, and was informed that Mr. Bryant intended to publish This incident came to the attention of several prominent citizens, physicians, lawyers, and clergymen, who became profoundly impressed with the revelation that there were no laws under which such a glaring violation of the simplest principles of health, and Agitation for For many years there had been a growing sentiment in favor of a reform of our health regulations, stimulated by the writings of Dr. John H. Griscom, Dr. Joseph M. Smith, Dr. Elisha Harris, and others, and the Academy of It was now resolved to organize a society devoted expressly to sanitary reform, and the “Sanitary Association” came into existence. For several years this body annually introduced a health bill into the Legislature, but the measure was regularly defeated through the active opposition of the City Inspector, whose office would be abolished if the bill became a law. In the early sixties the famous “Citizens Association” was organized, with Peter Cooper as President, and a membership of one hundred of the most prominent citizens. This was in the days of the Tweed rÉgime, and at a period when the City Government was The Citizens The friends of sanitary reform decided to attempt to secure proper legislation through the Citizens Association. The application, by a delegation, for the aid of this Association was well received and a plan of procedure adopted. The 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 distinguished for its membership, having on its list the names of William M. Evarts, Charles Tracy, D.B. Silliman. It was determined, 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 The City Inspector, at that time, was a grossly ignorant politician, but as he had upwards of one million of dollars at his disposal, he had a prevailing influence in the Legislature when any bill affected 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 inspection of the city by a corps 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 Under the auspices of the Association, and in the absence of the secretary of the Committee on Health, Dr. Elisha Harris, who was at that This volunteer sanitary inspection of a great city was regarded by European health authorities as the most remarkable 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 prosecution 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 joint product of the Medical and Law Committees, and was made the subject of extensive study and research, in order to embody in it every provision essential to its practical operations. 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 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 Mr. Eaton first addressed the committee, and made an admirable presentation of the legal features of the bill. He eloquently appealed for its enactment 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. |