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A •K38 I 1 <3^ REPORT TO THX HEALTH COMMITTEE RECOMUEKDINa THB ie-m0b«Un0 of t%e §ealt% iepartmfnt, WITH An Account of the Recent Visit of the Delegation Appointed to Visit New York and Boston IN August last, 3Y i WILLIAM KENNEDY, Chairman Health Coiimittek. ' ♦ ' Printed by The Lovell Printing & Publishing Co. 1874. HEALTH COMMITTEE, Thursday, 29th October ir?^ HEALTH COMMITTEE. Ai-DERMAN Alexander, << Kav, '« ROLLAND, Alderman Kennedy, Chairman, Alderman Debmarteac, «« M0LLIN, «« McCord. MAHEIAGES, BIRTHS AND TEATHS, For the Year, 1873. .1,435. .6,086. Marriages Births The number of Births is probably considerably greater than here mentioned as this nun>ber is compiled from the returns of baptism only and therefore the number of those who are not baptised m m- fancy, (either through the religious views or neglect of their parents) does not appear. Deaths, over five years of age ^'^^S- (( , . .2,986. «< under 4,954. These numbers are probably incorrect. From the imperfect system oi registration and the number of those buried in our cemeteries, .vho have died outside the City Limits a perfect statement cannot be obtained under the present system. Jj H03O REPORT. Montreal, Octv^bor 28, 1^74. To THE Health Committee. (Gentlemen: — On tbo 11th Aiignnt Inst tho Council ap- pointed your Cliuirraan, and Aldornion McCord, Stophons, Rivard and David as a dolei::ation to visit Ibo principal cities in the United States, tho dutios of your chairman and Alderman McCord bein^ more particuliarly to enquire into the working of their Health Dtipnrtraonts, I believe that a groat bonotit would result to tho health of tho city if the system of Abattoirs, so long under consi- deration, is adopted by the Council. Tho fat rendering establishments in tho city h:ive become such a nuisance, that complaints against them are made to this department almost daily. The present by-laws provide for the punish- ment of such nuisances (by a $20 fine) but to put tho law in force would subject respectable citizens to fines every day, Wo have a remedy, however, in tho erection of public Abattoirs, and this work should bo proceeded with at once. In my Report to the Market Committee reference was made to the Ottal Ducks in Now York. These Docks are situated on tho river side and are enclosed on three sides by a high wooden fence, the whole covering an area of 200 square feet. A small shed has been erected for tlie accom- modation of tho policeman in charge and emplo^'ees. Tho offal is removed from tho slaughter houses every day, and taken in barrels by a schooner to Barren Island ever}- second day. From the policeman in charge I learned that this offal was made into manure, and then reshipjied for the use of 6 farmers. Tho Animal Dock is soparnto from tho Offal Dock. A groat nuiny liorbc-i dio in New York daily (I saw two myself while passing through tho city.) Those animals are put into a scow and towed by a steamer to Barren Island. No men are allowed on the scow, until it has arrived at its destination. Offal Docks appear to bo necessary in New York but I would not recommend tho sycjiem here. GARBAGE. I was informed that the department in Now York had been more or loss used for supporting political friends than lor doing tho work assigned to it, and it was therefore transferred to tho charge of the police. From personal observation, I noticed that a number of loading streets wore kept clean, but in others, especially in the more crowded parts of tho city, there appeared to bo groat no 'ect. Tho garbage and ash box for such purposes were kept in front of tho chain stono, on the footpath, with tho lid on a bevel so that it could not be used as a'l easy seat. These should bo cleaned every day, but from appearances many showed several days neglect. By moans of these boxes tho closets wore kept in order and tho obstruction of drainage prevented. When tho garbage is removed it is placed in scows and used for filling in flat parts near shore where tho city is extending. EPIDEMICS. The Now York smalUpox hospital is built at tho end of an island. Through the kindness of tho Health Physician wo received much information. A special chart of tho city showed where small-pox had been, the special localities being particularly noted. The mixture of so many nationrlities and the connexion between New York and tho world is no doubt the cause why small-pox still exists. A great work lies before the Health Department, but from the energy and activity we observed there is no doubt they are doing all they can to conquer their difficulties. 7 BOSTON. From New York wo proceodod to Boston. From observa- tioii this appoarrt to l)c a very clean city. Having had con- ."jidorablo conversation with tho physician, Dr. Green, and the olUcers of the Health Department, wo return them many thanks for kindness shown, and for many very valuable (locnraonts. VACCINATION. They s'accinate chiefly from the ciglit day lymph. Com- pulsory vaccination had not been adopted, but Dr. Green believed it soon would be. A great many difficulties hud to bo contended with among the population. The French and the negroes were opposed to vaccination, the Irish were ob- stinate, and the Portuguese were a very bad class to der.l with. The plan followed by the Health Department waste call at the manufactories where a largo number of people were employed, and induce manufacturers to employ only those who had been vaccinated. The clergy were also reasoned with and took up the matter satisfactorily. Three doctors canvassed the city thoroughly. The Irish called at the office and would not bo satisfied unless they wore well marked. Some foreigners were stubborn, but on the whole tho intelligent submitted and those who did not suffered. THE SiMALL-POX HOSPITAL OF BOSTON. HOW IT WAS ESTABLISHED. Many of tho Aldermen were pledged not to vote for a Small-Pox hospital, but such pressure was brought to bear upon them by the citizens that they were forced to establish a Board of Health, which was composed of m. nbers of the Council and citizens, and of which one member retired every year subject to re-election. This Board went immediately to work and bought a large building, sending the account into the city for payment. Many proprietors petitioned against the Hospital being near their property, but to no 8 purpose. The death rate was at that time very high but through the energies displayed by the Board it was gradu- ally reduced till it was almost extinct, only onf/ or two cases coming under their attention in a month. For the last six months they have not had one case. Dr. Green's opinion is that vaccination is good but it is not the only moans of stamping out small pox. The gi'eat- est success is attained by isolation. To this moans Boston to-day owes its freedom from the loathsome disease. The expenses are comparatively light, being only for the Doctor,. Steward, and a small stafi' of assistants. HEALTH TEPAHTMENT. This department removes garbage and ashes, and attends to ^watering, and sweeping and cleaning the streets. It has its own stables, horsea, carts, &c. The horses number 160. Alderman McCord and myself visited the main stable at 6.30, a.m. in order to witness their arrangements. We found it to contain 100 horses, and to bo provided with horse shoers, a wheelwright, and all the materials necessary to repair and make new carts. The horses were of a large size, something like those of the " B " Battery, which was stationed here. The sight was a very interesting one and showed how much could be done under a proper system, and with what little trouble. (The man in charge of the horse and waggon knows his work, and with his help, a broom, shovel and tilting stick, and a small box of sundries in case of accident, each waggon is a self-acting department.) The first waggons go out at six o'clock, and call at hotels, &c. Second lot goes out at seven o'clock, the men in charge seeing that the brass buckles in the harness of the horses are cleaned and everything m order. Waggons then go out in regular order, each waggon being an institution of itself and each driver being responsible for any neglect. The garbage is gathered three times and the ashes twice a week. The hotels are visited every day. The streets are well cleaned and watered. The men by constant employ- ment know their duty and perform it with ease. 9 In conversation with a Pullman boy (as they call them- selves) I was told that a nuiaber of themhad a feast in their boarding rooms, and during the evening threw the rind of a melon into the street. It was not long before the landlady carne in saying she had picked up the rind, and requesting them not to throw any more as if the road inspector found it out she could be fined. The people here are taught to be clean. In Montreal we must begin to inculcate the same doctrine. PUBLIC BATHS. There are sixteen or eighteen Public Bathing places in Boston. Of these six are for ladies, Avho generally drive down to them in carriages. The bathing here is very bene- ficial, having the salt refreshing (pialities which cannot be ob- tained in a fresh water bath. I will describe one of the men's baths. It is a large floating dock something similar to the one which has for so many j-ears been owned in our own harbor by Mr. Kilgallin. A man has charge of it, who receives a small remuneration for the use of towels, and this makes the bath self supporting, after cost of erection. There is no charge for admission. Wo noticed a few of the rules : Each bath is under the supervision of one of the City Aldermen. The person in charge has full power to expel any one violating the rules. No swearing and no boisterous language is permitted. In all there are some eighteen rules, which are strictly adhered to. PUBLIC UEINALS. In New York Ave only came across them in public squares and parks. They are all placed off the main walk, and with elevated grass plots. There are two or three in each square. In Central Park there is a very handsome Public Urinal. It is an iron octagon building resembling wicker work, tastefully got up. The man in charge had a neat grass plot adjoining with swings for boys and girls. The few cents 10 he earned from tliis source were his renumeratioii. Wo also saw a neat builJinfj in an isolated part ofl' tlie main walk. It was fitted up with pan closets complete. One side was I'or women the other for men. There are also baths attached kept in very good order. In Boston, there was but one Public Urinal besides those in the parks and squares. Xear the flagstaff on Boston Common, there is a building fitted with closets and urinals, with a man in charge. The place Avas very cleanly kept. Odorless excavating ajiparatus for emptying vaults, sinks, cesspools, sewers, &c., are used in New York to great advan- tage. Alderman McCord, Avho visited Baltimore where these are made and in general use, gave me a pamphlet containing a description of them. They are quite different from those which were made for the Guano Company here. They are so complete in the pumps the valves of which are made of gutta pcrcha, These valves being made in the shape of a bottle, allow for obstacles, which cut-off pumps do not. Montreal should have one of these machines. They could not be used in frosty weather, but during eight months of the year would prove very beneficial. INSPECTION OF MILK. For the past 14 years there have been annual reports on the inspection of milk in Boston. We were informed by the Inspector that they were baffled by law in proving the adul- teration of milk, from quirks as to how cattle were fed, &c. As to the mode of convicting, the Inspector secures the milk and proves its quality by a lactometer. If it shows beyond proof to him, he gets it analyzed, resulting in all cases of certain conviction. 11 RECOMMENDATIOx\S FOR |iie-ax[fflbi£liin:g 11$ Si^pairlaowKl <5 ^ This Committee luxs a very important work before it, and j no time should be lost in taking it in hand and instituting a I complete reform. When the Health Department was fh-st j organized the city had but a small population, now it has at least six times the number, and the Department does not meet the requirements of the day. I beg to lay before you a few suggestions, which I hope you will carefully consider, /' ^ntl the Council will aid and adopt. For some time past, in signing the warrants I have been I . convinced that the city does not receive the benefit that it I has a right to expect from the amount of money expended. I am thoroughly convinced that many of the employees would be more useful if the Department was better organized. Instead of the two doctors who occasionally call to see if the Health Office is still near Nelson's Monument while attend- ing to their own professional calls, I would recommend that we should have but one doctor, who would devote his whole time to the Department, be responsible to the Committee, and receive such salary as would fairly compensate him for his services. Our citizens feel grieved at the present large death rate, and it is our duty therefore to at once take action. A few months ago Public Vaccinators were appointed. Though little has been done, I do not blame them, for the very good reason that " too many cooks spoil the broth," and the fee of 25 cents is too small, bringing the profession, in my opi-niou, to a very low standard. I ivould not recommend the ap- 12 pointment of Public Vaccinators as heretofore, but would ask that the law be so amended that, instead of dividing the city into disti-icts, the Health Committee have the power to appoint vaccinators from time to time for such districts as they may deem necessary. By such an alteration the Doctor in charge would secure the eight day lymph, and the Department would become more efficient. AVhon found necessary, assistant doctors could bo employed, and a thorough house-to-house visitation made. These doctors would have to make full returns, and be properly paid for their services. I would recommend the appointment of an efficient mana- ger, whose duty it would be to make out the city returns, receive all complaints and register them, and then assist the Committee in making such by-laws as would meet cases ior which the law docs not now provide. His further duty would be to see the proper working of the department, and in all cases of complaints where the Health Inspectors do not fulfil their duty, to personally examine and record the facts. SANITAEY DEPARTiMENr. I would recommend instead of the present out-door staff of Inspectors but fom* men, and the division of the city into East and West. This department I think wants im- ])roving. The men at the dump and deposit grounds will, from circumstances, regulate themselves. Gentlemen, believe me 1 would not recommend this Com- mittee to enter into any more contracts to do the city san- itary cleaning. By this I do not mean the cleaning of soil pits but the collection of all waste and garbage, and everything of that nature that chokes up our sinks and drains. This cannot be done effectually without constantly watching the city, and no contractor will perform the work required to the satisfaction of the Department and to the requirements of perfect sanitary reform. I would also recommend the erection of city stables, and 13 that land be purchased at onco, and Ktablos built, with sheds and other necessary buildings. An out-door overseer should bu apj)ointod who should have a horse and light vehicle. (This is so essential for the super- vision of the city and general out-door management that it cannot be dispensed with.) I would also recommend the purchase of seven horses with waggons made with covered lids, to hold twice the quantity of our present carts. One of the horses might bo used for the meat inspector's wag- gon, and one of the carts with ratchet windlass and oil skin covering for the removal of dead horses and animals ; the remaining horses and carts to bo employed in the cleaning of our markets and scavcngering. The men in charge to bo furnished with a uniform, suitable and clean for their work. The expense to the city would be much less, and tJie work better done than by our present system. MILK INSPECTION. Our attention has been drawn time and again to the state of our infantile death rate, especially by our city physicians; the adulteration of milk, which is the sole nourishment of the infant, being the more direct cause. We should not neglect this important article of food, but at once initiate measures to give us fuller powers than we now possess. I would recommend tliat a Milk Inspector be appointed whose duty should be to visit all places, keep a strict watch- fulness where cattle are fed and supplied with food for dairy purposes, analyse with a lactometer and keop adaily record. By this means a general supervision would be exercised. In cases of prosecution, a chemist eould be employed to ana- lyse the milk. Sub-Chief Flynn, from his long and faithful services with this department, would, I think, make an efficient Inspector of i\'^ilk. This department is i^reparod to give all necessary infor- mation, and our City Attorneys should see that the neces- sary protection is given for the efficient carrying out of the Law. 14 MEAT INSPECTION. Tlio progress of our Moat Inspection since the appointment of tlie second Inspector has been slow and unsatisfactory. The Inspectors do not feel their responsibility to the public, and neglect their duty by arguing the merits of the law with those they have to deal with, instead of sending to the Chairman a written doci ment, stating the omissions and defects they meet with in carrying out the present Law, or seeking the assistance and counsel of the City Attorneys. In many cases they have not shewn sufficient respect for them- selves or their position, but too often have acted as scaven- gers. I am sorry to state "^hat a great many scabby and unhealthy cattle have been slaughtered this summer. Many have had ulcers, and many were loan and sickly. These facts I am prepared to prove. If our Meat Inspectors have no law for this, it is high time they should suggest the difficulties to this committee. As they are now in office I hope they will see the importance and responsibility of their position. These facts show more clearly the need of Abattoirs. SMALL-POX HOSPITAL. Shall Montreal have this blessing or not ? I Avould earnestly recommend but one. Our neighboring cities have a larger pojjulation, and one is all they find necessary. I hope all differences will cease on this question, and that we will all Join in establishing an hospital on the land adjoining the Hotel Dieu. If we allow the appropria- tion for this Hospital to be subdivided, wo will bring with it all those ill feelings and discords which should be as much as possible avoided. Further, the spread of small-pox in our midst, and the many influential citizens that are dying, should urge us to call upon the Board of Health to take the matter up at once, for it has become an epidemic. The law is plain. Let us get a temporary building in the meantime, and proceed with the erection of a city hospital. 15 CEMETERIES. I would hero bring under your notice a cubtom of burial in the Roman Catholic Comotory which this Committee should request the Council or the Board of Health to bring before the R. C. Bishop ; it is that a corpse coming after ten o'clock a.m. remains in the chapel till the following morning; the epide- mic cases remaining among others. The friends of all kneel during the service of the dead, and after leaving the chapel go into the cabs and city railways, thus endangering the lives of our citizens. If his Lordship would give such instructions as would give immediate burial to all corpses, where death has resulted from epidemic diseases, he would confer a great boon on the citizens. Both Protestants and Roman Catholics should, in Winter and Summer, insist on the immediate burial of all epidemic cases; The inside decorations of our city hearses should be re- moved and replaced with plate glass. On every occasion when the hearse is used it should be properly fumigated. Our city cars and omnibuses are at present very unclean, arising from the many foul stomachs and expectorations of those who ride in them. They should be daily washed and slightly sprinkled with camphor or some other disinfectant. There has been a great improvement in the removal of cushions, &c., but there is still a necessity of more fi-equent cleansing. Special by-laws should be made to meet the requirements of each case. WATEIi CLOSETS. I am surprised to find intelligent citizens giving such little care to the water closets in their dwellings and public offices. The nuisance arising from their neglect, from the confined space, and want of ventilation is one of the many causes why we have so much typhoid fever now in the city. I would recommend every householder to become his own Sanitarian. 16 Let ^thc soil pipe bo clear from tlniiii to diflcliar^o. It fihould enter the kitchen flue in the attic and if not practi- cable from its position to do so it should pass throuijh tho roof. Connect with this main soil pipe your bonds and traps keeping always a clear pipe, and never lot your bend sit on tho top of the pipe. This will be found an improvement on the present sysfom. DOG TAX. I am somewhat at a loss to know wh}'" tho sanitay police should bo hunting after dogs, and to what part of the duty of tho Health Department this belongs. On this question I find a great deal of time is lost in the Recorder's Court and in many cases the wages wo pay our men amount to more than three times the fines received. There should be a spe- cial time appointed for prosecuting this oft'ence and not allow so many of our men to waste thoir time at the city's expense. By searching for unlicenced dogs their usefulness is impaired and their special duty interfered with. PUBLIC BATHS. Sometime last year three of our Aldermen were appoint- ed a Special Committee to report to the Council on Public Baths. I was Chairman, the other two were members from the Water Committee. We mot for business, but one mem- ber isaid that he thought the baths would interfere with the water supply of the city, and, finally.lost himself in a pond at Point St. Charles. The other argued that owing to the swiftnessof the current opposite St. Helens Island it could not be placed there, and to go further down would bo too far for the citizens. Your Chairman feels confident the public would support the inauguration of Public Baths. Ho is of opinion that during next summer two inclosuros for this purpose should be erected on the south-east side of the Island, one for males and one for females. They could be cheaply erected, and bo removed during tho winter season. I would ask this Committee how, when in many teneraentB n thoro ftro thr^e or four persons bleeping and occupying the same apartments, it is possible they can ever wamli or clean themselves ? If I am allowed to answer I would say I be- lieve many never have been washed since their childhood. Look around us and see the factories and the many who work in them day after day, but the water of the St. Law- ence never reaches them. Many cases of drowning occur every spring and summer an unusual large number having occurred during the past eeason. I feel certain thaL by the inauguration of public beihs these melancholy accidents would be ilmost entirely averted, both by the opportunity they would afford every one to learn to swim, and also by removing the neceosity so many now find of bathing in the river. I would strongly recommend two city free baths, one oast and one west, heated in winter by steam. The cost would not be more than 814,000, including ground, building baths, and steam apparatus. After cost they could be made self-sup- porting, to meet expenses of supervision and care. Will the city be without this boon when thousands of dollarsa re being voted for parks, &c. CRAIG STEEET TUNNEL. During this summer I have heard complaints of dibagrea- ble odors and sickly smells in several partq of the City. I have endevoured, on many special occasions, to trace their source, and I have traced them to this cause, that the outlet through to the river opposite the Custom House is so low that the drainage is in the water, thus forming a stench trap at the outlet. This drain falls from St Urbain Street, part running down and part running up the stream. Thus the gasses and foul air are accumulated, and forced into the cel- lers and btsements of our dwellings. By this means the foul air passes through the traps, and enters into the offices, and dwellings, not only in the lower part of the City, but into a great many on higher elevations. I have felt greived when I have been told that the fault lies at our door, and 18 that the doutli and sickiioHS of many childron in duo to the Crftig Stroot Tunnol. But what can 1 do ? I attoudod a moot- ing of tho financo committoo and thoy authorized theoxpon- dituro of 618,000, out of the 600,000 to bo borrowed from our city loan to commenco this woric Bomo tiiree months fiince. Why 't stands in oboyenco, I cannot say. The amount, fur this Bpecial purpose, was phicod to thu credit of the Road Department. CITY LIMITS. I would draw your attention to the City limits, compris- ing the various municipalities. From the overcrowding of dwellings, principally tenements, the want of drainage, and tho making of false c'rains where there is no outlet, a good deal of sickness, small pox and t^'phoid fever have resulted, extending to the City itself. As there is no sanitary law enforced in the districts outside the City Limits, the stron- gest appeal should be made through the Board of Health and tho Council to Parliament, that some action and prompt measures should be at once taken, otherwise the city will constantlv be under the threats of epidemic diseases. I would also draw your attention to the fact, that many of our newly constructed tenements in the City are not much better than in former years. A By-law should bo made to remedy the evil. I would mention a custom practiced in Montreal a few years b.ck, that is, of excavating a soil pit, and when ano- ther IS wanted, of excavating it alongside the one already full. The result is that the surrounding ground of some of the City Proi:)erty is nothing more than a quagmire of soil, only fit to convey disease. All pits should be properly built of hard brick or Ftone cemented. I hoi)e the committee will see the advisability of supporting a By-Law on this point. PUBLIC URIJSALS. In establisliing these some regard should be observed as to where they are placed. The one in Craig street should l^e removed inside the fence, the background lowered and 19 ornnmentod with croopint? vinoH, &c., wliilo tho approachoft should bo from tho walk iiiHido, and tatjtofully laid out. This Cominittoo should HUggOHt to thoso having charge of the Court IIouho tho advisihility of improving the grounds fronting it. Nothing looks more dosolato than a lot of trees without a blado of grass or herbage of any kind surround- ing them. Two })ublic urinals are very much required on this ground for tho use of the many strangers and others daily " frequenting the Court House on business. Those might bo placed at tho corners of tho two wings, under tho supervision of tho caretaker of tho Court House. I would suggest to this Committee tliat whatever sanitary measures are inaugurated or institutions established that they must bo placed under tho strictest surveillance; other- wise they will become a public nuisance instead of a benefit. INFANTILE DEATH. Tho question of infantile death should at once be taken u]) by tho Corjjoration Physicians. Why are there so many of these deaths? It is not wise to be beat about the bush in this matter. Would it not bo better to have a law passed l)y Parliament providing that every illegitimate child should bo nursed by its unnatural mother for at least two months before it is allowed to be handed over to the care of any of tho city institutions. A more sti-ingent law might bo enacted com- pelling tho father, whenever known, and able to meet tho expense, to support tlic mother and child ; and in cases where this cannot be done Goverment should provide for tho wants of tlio mother during this period. This I think w(-iild tend to much decrease tho present large number of infantile deaths. VACCINATION. In this matter very little has been done in the great work lying before us. I feel I would be neglecting my duty if I here omitted to mention the strong opposition we have met with in our work from Drs. Coderro, Gariepy, and others, the many obstacles they have thrown in our way, and their endeavor to trample under foot tho great medical provonta- 20 tivo for small-pox, and to i/^noro the ncionco of Dr. Jonnor, to whom tho world owoh a dobt of gratitude. Our thanks ftro duo to tlioHo j^ontlemcn who camo forward and oxpowed tho fraud of tho truiniMvl up ]»hotograph, which tho above namei doctorn had tho audueity to asHort was taken from nature, tlnis docoiving Lho uninformed and materially in* creabing tho opposition to our work. GABBAGE. Ceasing to remove tho g 'hago of tho city on the Slwt of Octohor, in a miMtako, an ' ' hope tluH Committee will awk the Council for a small appropriation to continuo tho work until a now and gonoral plan is introduced. Tho garbage during this season has boon much bettor col- lected than in previous years. The amount is steadily in- creasing, and the amount of good done .n this way cannot bo calculated. Tho Committee have to return thanks to tho Council for ado]4ing tho system recommended in the opening of the season, and although much good has boon done, still a great- er improvement is much desired. I have to thank Mr. Lamb, who was appointed by this Committee to see that the Bcavongcring wa^: done, for his untiring exertions. I have found him from early morning always attending to his duty, but the men accompanying tho carts have not been wliat could bo desired. There is great necessity of adopting a new and more perfect system. SANITARY CODE. I have to request that during this fall you will take up tho Sanitary Code and have it so revised and amended under the Statutes and Ordinances that the doijartment may be placed in proper working order. I would also ask that our City Attorneys be called upon to give their serious attention to tijis matter. The whole "ospectfully submitted, William Kennedy, Chairman of Health Committee,