UNIVERSITY OF CALIFORNIA 
 AT LOS ANGELES
 
 of 
 
 AT
 
 THE HEALTH OF THE CITY
 
 THE HEALTH OF 
 THE CITY 
 
 BY 
 
 HOLLIS GODFREY 
 
 Sc.D., ENG.D., LL.D., D.C.L., F.R.G.S., ETC. 
 
 President of Drexel Institute, Philadelphia; Commissioner of the 
 
 Advisory Commission of the Council of National Defense, in 
 
 charge of the Section of Engineering and Education 
 
 BOSTON AND NEW YOEK 
 
 HOUGHTON MIFFLIN COMPANY 
 
 (OEfte ffitontfibe ptcsj-f Cambribge 
 
 135406
 
 COPYRIGHT, 1910, BY HOLLIS GODFREY 
 ALL RIGHTS RESERVED 
 
 Published May iqio
 
 PREFACE 
 
 THE ten descriptive chapters of this volume, 
 eight of which have been published in a more 
 or less abbreviated form in the "Atlantic 
 Monthly," represent four years of personal in- 
 J? vestigation of the health problems of the city- 
 ^ dweller. During that period many other duties 
 A\ have demanded attention, but scarcely a week 
 has passed without some advance in the work 
 on city health. And each advance has shown 
 more clearly the complexity of the municipal 
 * problems involved, each has defined more 
 ^ sharply the fact that only through the work 
 of many men advancing along many lines can 
 the questions at issue be fully treated. I make 
 no claim to comprehensive treatment here. 
 
 My effort has been to record in non-tech- 
 nical English what is known of the actual 
 harm or harmlessness to the people of the city 
 of such every-day affairs as air, water, wastes, 
 food, housing, and noise, to give some account 
 of certain civic conditions which are working 
 evil, and to tell of some of the organized move- 
 ments which are striving for the welfare of the
 
 viii PREFACE 
 
 people of the crowded streets. I have tried most 
 of all to show the wonderful advances that sani- 
 tary science has made in the work of cleans- 
 ing the city, and, through the account of some 
 researches undertaken for the public good, to 
 impress upon the citizen the necessity of a 
 greater reliance on the deductions of modern 
 science. 
 
 Many students have noted the migration of 
 the last decades which has taken so many 
 thousands from the life of the individual farm, 
 where each householder controlled his own 
 supplies, to the present community life, where 
 no man controls the sources of the necessities 
 which enter his household. With that passing 
 has come the recognition of the fact that the 
 municipality, since its citizens can no longer 
 properly guard themselves or their families, 
 must have public servants who can guard each 
 individual by their guardianship of the whole. 
 Many American cities which have accepted 
 this theory have failed when they have tried 
 to put it into execution. They have not shown 
 sufficient care in their selection of public ser- 
 vants. They have not given the men they 
 have chosen the necessary freedom from politi- 
 cal control. They have been slow in passing
 
 PREFACE ix 
 
 new protective laws. They have not provided 
 appropriations to enforce laws already passed. 
 It is not too much to ask that the men who are 
 to guard the health of the community should be 
 trained for that work, that they should be free 
 from political control, and that they should be 
 supported by carefully framed laws, enforced 
 and made available by sufficient appropria- 
 tions. It is the great task of the coming years 
 to educate the people of the cities to the point 
 where they will demand not only health for 
 themselves but for their brothers, not only 
 life for their own child but for every child. 
 
 The printed sources from which statements 
 given here have been obtained are indicated 
 in many instances in the text. A final chapter 
 contains a brief and selected bibliography, 
 designed to give an outline of sources and to 
 be of actual working use. The list of refer- 
 ences therein given contains those books which 
 have proved of the most value in the work, 
 and gives the genesis of much of the material 
 secured from the printed page. Those results 
 which have been obtained by personal investi- 
 gation can, of course, trace no direct connec- 
 tion with any previous publication. 
 
 Any student of this subject must recognize
 
 x PREFACE 
 
 the difficulty of obtaining accurate generaliza- 
 tions from the statistics furnished by some 
 American cities. For example, take the mortal- 
 ity of children under five years of age. The 
 improvement in standards of living, combined 
 with the work of some of the pure milk cru- 
 sades, gives wholly different figures in 1910, 
 in a selected group of cities, than 1900 fur- 
 nished. A still greater obstacle to this special 
 investigation is the lax methods employed by 
 some municipalities in the recording of such 
 matters as total births. In still other cases, as 
 especially in the housing of the people, statis- 
 tics have been gathered chiefly by private or 
 semi-public associations, and no effective effort 
 has been made by the public authorities to col- 
 lect accurate information concerning existent 
 conditions. I shall be glad at any time to know 
 of changing conditions along any of the lines 
 considered in this volume. 
 
 I have gained much of my data from books. 
 I have gained more from personal visits of in- 
 spection made in the cities of this country and 
 of Europe. I have gained most of all from 
 men. During the course of the investigation 
 I have talked and corresponded with men of 
 every type, with street-cleaners, garbage men,
 
 PREFACE 
 
 xi 
 
 and market men, business men, doctors, and 
 engineers, with any one, in short, who could 
 shed any light on the things I wished to know. 
 State and municipal authorities of England, 
 Germany, and the United States, members 
 of private and public associations engaged in 
 various welfare movements, officials of cor- 
 porations and universities, have given me 
 assistance. It is impossible to name the many 
 individuals who have done so much for me in 
 so many ways. Here and now, I wish to offer 
 my sincere appreciation of the many courte- 
 sies I have received. 
 
 The entire proof has been read from the 
 standpoint of the economist by Professor Henry 
 C. Metcalf of Tufts College, from the stand- 
 point of the physician by Doctor Lincoln F. 
 Sise, of Medford, Massachusetts, from the 
 standpoint of the sanitary engineer by E. C. 
 Howe of the Massachusetts Institute of Tech- 
 nology. The advice and assistance of each of 
 these readers has been of great value. 
 
 I believe the names of the two men who 
 have most influenced me in my scientific work, 
 Professor John Sterling Kingsley of Tufts 
 College and Professor William T. Sedgwick of 
 the Massachusetts Institute of Technology,
 
 xii PREFACE 
 
 should also appear in this Preface. I am glad 
 to have this opportunity of declaring the debt 
 I owe to them. 
 
 HOLLIS GODFREY.
 
 CONTENTS 
 
 I. AIR 
 
 The smoke nuisance. Its prevention and control. Dust 
 and the germ theory of disease. The micro-organic 
 life of the city streets. Dust and tuberculosis. Pave- 
 ments and cleansing processes. The air of subways. 
 Light, cleanliness, and the prevention of disease . . 1 
 
 II. THE MILK-SUPPLY 
 
 Milk and infantile mortality. Pure milk. Dirty milk. 
 Milk as a medium for the spreading of disease. Milk 
 frauds and dangers. What a dairy farm should be. 
 Methods of improving the city milk-supply. Sterili- 
 zation and pasteurization. The milk-supply of institu- 
 tions. New uses for lactic acid bacteria. Certified 
 milk and inspection 30 
 
 HI. THE CITY'S FOOD 
 
 Food as a factor in the struggle for commercial suprem- 
 acy. The natural and unnatural dangers to which food 
 is exposed. The garden of the air and the molds, yeasts, 
 and bacteria that live therein. The preservation of 
 foods. The sale of impure foods. Federal food laws 
 and their limitations. State and municipal regulation 
 of food. Markets. How they may serve the city best. 
 Abattoirs and their control. Bakeries and the regula- 
 tions which should govern them 68 
 
 IV. THE FOOD OF THE INDIVIDUAL 
 The composition of the human mechanism. Proteids, car- 
 bohydrates and fats, mineral salts and water. The ser-
 
 xiv CONTENTS 
 
 vice of the nutrients. What some experts have said of 
 the amount of meat required for daily fare. The work 
 of Chittenden, and of some other students of food 
 values. Nitrogenous equilibrium. Over- and under- 
 feeding. The fallacy of specialized foods. The eco- 
 nomic value of a knowledge of marketing and cooking. 
 Vocational training, welfare work, and factory lunch- 
 eons. Some old and new experimental work along 
 these lines 92 
 
 V. CITY WATER AND CITY WASTE 
 Guarding the water-supply. Water-borne disease. 
 Ground-water and surface-water. Natural filtration. 
 Storage as a purifying factor. Continuous filtration. 
 Mechanical filtration. Household filters. Sewage as 
 the source of the infection of water-supplies. Dilution 
 and separation of wastes. The sewage farm. Different 
 methods of filtration used to purify sewage. The con- 
 tact bed. The sprinkling filter. Chemical disinfecting 
 of water. The septic tank. The household filter . . 127 
 
 VI. ICE 
 
 Natural and artificial ice. Crystallization. Upper layer 
 ice. Snow ice. The joining of ice cakes. Impurities in 
 natural and in artificial ice. The elimination of bacteria 
 from ice. Some researches to determine the effect of 
 freezing upon bacterial life. The reproduction of nat- 
 ural conditions in the laboratory. Storage of ice. The 
 danger of contamination from handling. How the mu- 
 nicipality can regulate the ice-supply for the public 
 good 158 
 
 VII. SEWER-GAS AND PLUMBING 
 The common fear of sewer-gas. Two theories of its harm- 
 fulness. City disposal of sewage. Comparing the air 
 of the street and the air of the sewer. Some charac-
 
 CONTENTS xv 
 
 teristic bacteria found in sewage. The different stand- 
 points of Britain, Germany, and the United States on 
 sewer-gas problems. Early experiments and later 
 researches on sewer air. Vital resistance and predis- 
 position to disease. The present status of sewer-gas 
 problems 194 
 
 VIII. THE CITY'S NOISE 
 
 The noise habit. The influence of noise upon disease. 
 Whistling. Signaling by the eye instead of the ear. 
 Attempts to minimize the evil. The noises of the city. 
 The crusade against noise. What that crusade has 
 accomplished. The work of Mrs. Isaac L. Rice and of 
 the Society for the Suppression of Unnecessary Noise 231 
 
 IX. CITY HOUSING ABROAD 
 The lack of proper housing. Overcrowding and the 
 slums. The slum disease and the death-rate of the 
 crowded streets. The cost of sun, air, and water in the 
 slum. German theories of housing. Town planning. 
 Building of model tenements. Cooperative Societies 
 and housing. The demolition of the slum. "Zone 
 Systems." Gardens and garden allotments. English 
 Housing Acts. Garden Cities. The work of Miss Oc- 
 tavia Hill. The influence on housing in Belgium of 
 the policy of the Belgian railways 263 
 
 X. CITY HOUSING IN AMERICA 
 The slum as a culture medium of disease. The econo- 
 mic cost to tax-payer and rent-payer of the existing 
 congestion. Actual conditions in a group of American 
 cities. Local conditions which affect the problem. The 
 necessity that housing plans should consider the 
 personal equation of each city. The danger of fire in 
 the tenements. Housing commissions and housing 
 departments. The relation between rapid transit and 
 housing. General problems of housing control . . . 302
 
 xvi CONTENTS 
 
 XI. A SELECTED BIBLIOGRAPHY 
 Journals, Bacteriology, Hygiene and Sanitation, Air, 
 Milk, Food) Water, Sewage, Ice, Plumbing, Noise, 
 Housing, Tuberculosis 346 
 
 INDEX ,..,.. 359
 
 THE HEALTH OF THE CITY
 
 THE 
 HEALTH OF THE CITY 
 
 AIR 
 
 WHEN, on that long-past burning August day, 
 the wide-mouthed crater of Vesuvius poured 
 down an overwhelming cloud on little Hercu- 
 laneum and greater Pompeii, the daily life of 
 rich and poor was choked out suddenly by that 
 terrific burial in dust. As we escape from some 
 fierce dust-storm in our cities, gasping and 
 coughing with the load of dirt which has envel- 
 oped us, as we behold dark wreaths of heavy 
 smoke pouring from soft-coal fires on every 
 side, the thought must sometimes come that our 
 communities to-day endure a peril far too much 
 like that which, in that distant time, engulfed 
 city and town about the Bay of Naples. 
 
 What does the air of the city hold? How does 
 it differ from pure mountain air ? Wherein lie 
 its dangers? What can be found to rem- 
 edy its perils? All these are questions whose
 
 2 THE HEALTH OF THE CITY 
 
 answer immediately concerns every dweller in 
 community centres. We know, chemically 
 speaking, that air in its normal state is com- 
 posed chiefly of oxygen and nitrogen, approxi- 
 mately one fifth oxygen to four fifths nitrogen. 
 Besides these it contains some carbon diox- 
 ide, a little water-vapor, a few inert elementary 
 gases, and small traces of compounds formed 
 from nitrogen. How much do we know of 
 the burdens which the air carries, or of the 
 wealth of life which the atmosphere holds? 
 Day after day we go trudging to and fro along 
 our various paths, at the bottom of a gaseous 
 ocean which surrounds us, eating and sleeping, 
 working with hand and brain, yet giving 
 scarce a thought to the essential part which 
 the air plays in our common life. 
 
 Of all the engines cunningly devised by man, 
 not one can equal that masterpiece of construc- 
 tion, the engine of the human frame. To run 
 that engine, air is the first necessity. Construct 
 it how you will, the greater part of the energy 
 which feeds a power-plant is lost before it 
 reaches the applying machine. The body only 
 has the power of using energy really economi- 
 cally and efficiently. Its food is its fuel. To be 
 available, all the constituents of that food must
 
 AIR 3 
 
 be burned, producing heat and power. For 
 that burning the oxygen of the air is essential. 
 The quality of the air we breathe must have 
 an immediate effect upon the human frame. 
 
 Farther and farther outward stretch the 
 high city walls of brick and stone, engulfing 
 tree and shrub, laying bare grassy knoll and 
 living green. Higher and higher rise the chim- 
 neys, and with their rise increases daily the 
 great outpouring of solids, rushing into the 
 air from the fuel burning in the fires below. 
 Set a factory chimney in the midst of a grassy 
 plain, or send forth huge volumes of hot gases 
 from a steamer in mid-ocean, and the additions 
 to the air are of but little consequence. The 
 wind scatters them to infinite dilution. The 
 air of the city rising from hundreds of chim- 
 neys and confining walls has no such chance. 
 The task is too heavy for even the sweeping 
 winds to accomplish. 
 
 With the outpouring of the city's chimneys 
 has come a serious problem in these later days, 
 a cloud which shadows all our cities, covering 
 with its blackness wall and pavement, entering 
 house and factory alike, the city's smoke. 
 Life in the soft-coal cities comes to be exist- 
 ence in a gray, blackened world. Whiteness
 
 4 THE HEALTH OF THE CITY 
 
 of cloth, cleanliness of face or hands, becomes 
 a shadowy hope, not a reality. 
 
 The reason for these conditions is by no 
 means hard to find. Soft coal differs from hard 
 coal most of all in this: when burned, its car- 
 bon, turning but in part to oxide, leaves a 
 cloud of soft black soot, that carbon uncom- 
 bined which soots the study -lamp or rises from 
 the snuff ed-out candle. The coating which such 
 soot casts on the lining of the lungs is one of 
 the hardships of the city-dweller, despite the 
 fact that our breathing-organs possess a most 
 extraordinary power of taking care of foreign 
 bodies which invade their midst. Of all the 
 particles that enter, no small portion returns, 
 coughed back from the mouth or else ejected 
 from the nose, where tiny filters held these 
 solids as they entered. Those which persist 
 and lodge in windpipe or in bronchial tubes 
 find there a horde of soldiers placed to drive 
 the invader back, the cilia. These sentinels 
 are shaped like tiny fingers. They stand at 
 this entrance to the body and swing unceas- 
 ingly through life. As they swing, they bear 
 invading solids, carried in the mucous stream, 
 backward and upward toward the mouth. 
 
 Besides the cilia, the phagocytes, those sani-
 
 AIR 5 
 
 tary engineers of the blood, stand ready to 
 seize, encompass, and destroy harmful sub- 
 stances that may enter. 
 
 Yet through all these defenses solids can 
 enter, and many do enter. Once in the lungs, 
 they settle on the walls where passes out car- 
 bonic acid from the blood, where enters air 
 carrying life-giving oxygen to the fires within. 
 Where they fall, they clog the way. In city 
 life, the fresh pink of a normal person's lung 
 is streaked and spotted with black lines which 
 chart the blocked-up roads where breath of 
 life once entered, where burned-out wastes 
 once passed. In reason this may do no serious 
 harm, because of the tremendous space through 
 which the boundary walls extend. The trouble 
 is that we have long since passed the stage of 
 reason in many of our cities. The flood pours 
 on unceasingly. Every hour of every day the 
 black smoke pours from the furnaces below. 
 Scarcely a minute of the long year goes by 
 without some addition to the total burden. 
 
 In smoky cities the proper ventilation of 
 houses, one of the greatest essentials in stamp- 
 ing out tuberculosis, becomes more difficult. 
 The doors and windows of the tenements are 
 closed, and the stifled air within hastens dis-
 
 6 THE HEALTH OF THE CITY 
 
 ease and death. On humid days the smoke 
 which fills the streets unites with the water- 
 vapor of the air to form the fogs which over- 
 hang the city. Fogs can exist only when the 
 gaseous water of the air is liquefied upon solid 
 particles. The bits of carbon floating through 
 the ways give such foundation, and the water 
 condensing on them forms a mist. Probably 
 without direct injurious effect, a fog depresses, 
 renders resistance to disease more difficult, sets 
 up a barrier to the cleansing, life-giving sun. 
 The pity is that most of the evils which come 
 from smoke are preventable. Smoke-consumers 
 exist which have shown their worth. Due care 
 in running fires will do much. The fuel re- 
 quired under careful management to produce 
 combustion which shall be practically smoke- 
 less need show but slight, if any, increase. It 
 is a matter of community supervision, of laws 
 rightly framed and fearlessly administered. 
 Fortunately, inspection is no difficult matter. 
 One city, for example, handles that problem 
 by means of a chart holding six pictures of 
 a chimney above a factory, the first of which 
 shows the chimney with no smoke, the second 
 with a light smoke issuing, the other four 
 showing greater and blacker volumes. The
 
 AIR 7 
 
 first conditions are passable. The last are dan- 
 gerous. The inspector takes a photograph of 
 any questionable chimney and compares it with 
 the standard pictures. The comparison tells the 
 story. The factory is pronounced "passed," 
 or the owner is warned to conform immedi- 
 ately to the regulations, under penalty of the 
 law. 
 
 The West shows two cases which may aid 
 the East in abatement of the smoke nuisance. 
 In St. Paul, some years ago, the work was given 
 over to the department of health, whose first 
 act was to lay the following question before the 
 local and national unions of steam engineers 
 and firemen : " Can the smoke nuisance as it 
 exists to-day be reasonably prevented without 
 injury to trade and manufacturing interests?" 
 This question was unanimously answered in 
 the affirmative by the members of both unions. 
 Notice was taken of all dubious cases, and fines 
 were imposed when necessary : a minimum fine 
 of twenty-five dollars for the first offense, 
 doubled for each succeeding one. The work 
 has been most successful, and besides an abate- 
 ment of smoke, a saving of fuel is reported. 
 
 In Milwaukee an ordinance which has been 
 in force for a considerable number of years,
 
 8 THE HEALTH OF THE CITY 
 
 has been successful in clearing the air of that 
 city. About half the city at the time of a 
 recent report used smoke-consuming devices; 
 about one fourth used hard coal or smokeless 
 fuel. The general condition of the city was 
 admirable. So admirable, indeed, that the title 
 of the ordinance passed by the Common Coun- 
 cil is worth quoting in full as an epitome of 
 what such an ordinance should be. 
 
 " An Ordinance declaring it to be a nuisance 
 to cause or permit dense black smoke to be 
 emitted from the chimneys or smoke-stacks of 
 furnaces, boilers, heating, power or manufac- 
 turing plants, boats, vessels, tugs, dredges, 
 stationary or locomotive engines, and creating 
 the office of smoke-inspector, fixing his salary 
 and prescribing his duties, and creating a board 
 for the suppression of smoke." 
 
 Close as is the relation between the pro- 
 ducts of combustion and the public health, 
 there is a yet closer one between the other 
 burden which the atmosphere carries dust 
 and disease. For many centuries the world 
 believed that air was a vehicle of disease, 
 and many a historian of pestilential years told
 
 AIR 9 
 
 of foul and heavy vapors which hung daily 
 over doomed cities and seemed to carry death 
 as they spread. From stage to stage passed the 
 beliefs in the causation of epidemic disease, 
 but with ever-recurring persistence they re- 
 turned in one way or another to some belief 
 in the transmission agency of the gases of the 
 air. Only in that clarifying time when Schwann 
 and Pasteur, Lister and Tyndall worked, was 
 it made evident that the disease properties of 
 the atmosphere came not from the air itself, 
 but from the burden of living organisms which 
 it bore. From that great demonstration came 
 the germ theory of disease. 
 
 In the rush of modern scientific research the 
 work done a generation ago is likely to be lost 
 to sight. It is well worth a moment's pause, 
 however, to recall the brilliant research by 
 which John Tyndall, in 1868, proved the pre- 
 sence of organic matter in the air. Like many 
 another experimenter, Tyndall found what he 
 did not seek. He sought knowledge on the 
 decomposition of vapors by light. He found 
 the relation between dust and disease. The 
 sunlight passing through a chink in the shut- 
 ters reveals its path by the motes dancing in 
 its ray. To obtain the results he wished, it was
 
 10 THE HEALTH OF THE CITY 
 
 necessary for Tyndall to remove all floating 
 matter from the air of his tubes. He at- 
 tempted to do this in various ways, finally 
 passing his air over the flame of a lamp. To 
 his surprise the floating matter disappeared. 
 It had been burned by the flame. His mind 
 instantly leaped to the conclusion that it was 
 organic matter, though practically every scien- 
 tist had hitherto believed that the floating 
 matter of the air was wholly inorganic and 
 non-combustible. Tyndall created a living 
 world at a bound, the world wherein moves 
 the living matter of the air. He pushed his 
 inquiry farther. He placed a lamp in a beam 
 of light. Strange wreaths of blackness rose, 
 blacker, as he says, " than the blackest smoke 
 ever seen issuing from the funnel of a steamer." 
 Carrying the inquiry on, he tried the same ex- 
 periment with red-hot iron, to preclude any pos- 
 sibility that the blackness might be smoke from 
 a flame. " The same whirling masses of dark- 
 ness rose, smoke was out of the question." 
 One conclusion remained. The darkness was 
 that of stellar space, of the night which holds 
 between the far-hung stars. The heat had 
 burned the organic matter of the air, the 
 inorganic had settled, no material substance
 
 AIR 11 
 
 remained to reflect light. Dust was in part 
 organic. Nay, more. Dust was made up of two 
 parts: the inorganic, matter like the rolling 
 sands of the sea; the organic, largely germ 
 masses of living organisms, each infinitesimal, 
 yet each unit complete in itself. 
 
 These micro-organisms of the air were soon 
 proved capable of many things. Among other 
 powers, they were proved to be carriers of dis- 
 ease. The surgeon's scalpel laid on a dusty 
 shelf had time after time introduced the germs 
 of evil into the wound it was meant to cure. 
 An operation was a dread event where death 
 was almost as likely as recovery. Lister's dis- 
 covery of the possibilities of bacteriological 
 cleanliness meant exclusion of germ-life from 
 the surgeon's hand as well as from wound, 
 instrument, and dressing. It brought life to 
 thousands. Swiftly the new theory made its 
 way. Germ -life which could cause disease 
 existed in the atmosphere. Methods arose 
 to combat the various forms of ill which it 
 brought. Knowledge grew as to the specific 
 germs of evil and their brothers of good. 
 
 The marvelous life of the earth, the teeming 
 billions of micro-organisms which inhabit the 
 soil, will be considered in a later chapter. It is
 
 12 THE HEALTH OF THE CITY 
 
 sufficient to recall here that by far the greater 
 part of the earth's surface contains a vigorous 
 microscopic life which serves many important 
 purposes in the economy of nature. When 
 earth is dried and driven by the wind about 
 the streets, various types of micro-organisms 
 rise with the dust, clinging to sand or splinter, 
 or floating by themselves. Of these forms, the 
 bacteria interest us the most. The great service 
 which they perform lies in the power which 
 many of them possess of taking worn out or 
 exhausted organic material and turning it into 
 harmless inorganic form. That service is turned 
 to account in every modern sewage plant. The 
 great injury which they may cause comes from 
 a few forms in which lie the beginnings of dis- 
 ease. Growing with intense rapidity, these tiny 
 plants, shaped like balls, rods, or spirals, spread 
 wherever they may fall. Moist surfaces hold 
 the germs, and besides the soil, they abound 
 in manure and all decaying organic bodies, 
 while those which find suitable homes in the 
 human body multiply there with serious re- 
 sults. They appear in dust in billions piled 
 on billions, when the dried earth, sweeping 
 into the air with the varying impulse of the 
 breeze, carries with it dried masses of bacteria.
 
 AIR 13 
 
 The city street is a great centre of bacterial 
 life. The concourse of the mart, the moving 
 to and fro of many people, the constant throw- 
 ing forth of human sputum, the dirt brought 
 by the passing of many horses and domes- 
 tic animals confined within a comparatively 
 meagre space, all tend to furnish a constant 
 supply of bacteria to the soil of the streets. 
 When the soil has once been dried, the pound- 
 ing of heavy wagons and the suction of the 
 great wheels of motor-cars form a fine pulver- 
 ized surface powder on the road surface, ready 
 to rise in clouds with every wandering breeze. 
 The healthiest period which exists in city air 
 is that during or just after a rain or snow. 
 Moisture brings the germ content of street air 
 most teeming with bacterial life to figures low 
 in the extreme. It is true that the great ma- 
 jority of the micro-organisms found in dust die 
 after a brief exposure to air and sunshine. It 
 is equally true that the traffic which fills the 
 streets is constantly providing new hosts to 
 take the places of the fallen. 
 
 To oppose the entry of any surviving germs 
 stands that same chain of defenses which 
 the respiratory tract raises against invad- 
 ing coal-dust, and, as well, that continuity
 
 14 THE HEALTH OF THE CITY 
 
 of armor which the body holds. Cased in the 
 air-tight coverings of the skin without, lined 
 with the barrier of the epithelia within, the 
 human frame is well equipped by nature for 
 the war against disease. Those coverings must 
 be penetrated before disease can enter. A 
 ragged sliver in the hand or foot often pro- 
 duces injuries far from proportional to its size. 
 Why ? because the poisoned arrow of the 
 Malay, though swifter, carries no more toxic 
 poison than may come from a splinter of the 
 streets. The danger of the dust lies, beyond 
 all else, in the fact that every dust-storm, bear- 
 ing thousands of small sharp grains of sand, 
 tiny splinters of wood, and bits of stone, is a 
 flight of poisoned arrows driven against the 
 body covering of the passer-by. The poison 
 which they bear may or may not come from 
 the dried organic matter of the street. It may 
 be lying at the point of entrance where the 
 germs growing in the warm moisture of the 
 respiratory tract lurk within the body, like 
 bandits beneath a fortress wall. In whatever 
 way they come, it is most difficult for bacteria 
 to pass through the body armor except when 
 sharp particles such as those of dust make 
 wounds or lesions in the inner walls. Once
 
 AIR 15 
 
 such openings are made, dangerous micro- 
 organisms are but too ready to avail themselves 
 of the opportunity. When they are within, 
 disease of major or minor type may show its 
 presence. 
 
 Within the walls of dwelling, hall, or office- 
 building, the direct dust-storm penetrates less 
 easily, but only too often comes another 
 danger from the difficulty of removing the 
 fine cloud of dust which enters by every door 
 and window from the streets, coating the fur- 
 niture, hanging to curtain and rug, and cling- 
 ing there with a persistence which renders 
 many a city home a veritable storehouse of 
 ancient micro-organic life. Especially is this 
 true where hangings of cloth, upholstered 
 furniture, and heavy carpets furnish excel- 
 lent abiding-places for the germs. Few sani- 
 tary reforms have meant more than modern 
 hardwood floors, light upholstered furniture, 
 vacuum cleaning, and washable curtains. 
 
 One question must inevitably rise with any 
 discussion of these points. " If such dangers 
 exist about us in the city air which we all 
 breathe, how can any escape ? " It is easy to 
 understand the freedom of individuals from 
 specific contagion such as comes from impure
 
 16 THE HEALTH OF THE CITY 
 
 water or impure milk. Disease from such 
 causes can strike only in isolated spots or sep- 
 arate communities. It is far more difficult to 
 understand the immunity which is afforded 
 the individual in the smoke and dust-laden 
 air of thousands of American cities. Yet there 
 is no question that great numbers show no 
 signs of harm. Their vital resistance is so 
 great as to make them triumphant over any 
 form of disease. On the other hand, since 
 there are thousands in any community who 
 are susceptible to these attacks, it is the duty 
 of the whole community to shield those thou- 
 sands. 
 
 One germ found in dust needs especial 
 mention. Tuberculosis, which may be classed 
 among the dust diseases, ravages our country 
 beyond all other plagues to-day. The con- 
 sumptive sheds hundreds and thousands of 
 living tubercle bacilli every time he sends 
 forth sputum where it can mix with the dust 
 of street or room. Once mixed with that dust, 
 deposited on sand or other cutting particle, the 
 poisoned weapon flies upward, ready to cut 
 through and enter the body through the lesion 
 formed in the lungs. And remember that 
 every careless sufferer from tuberculosis is a
 
 AIR 17 
 
 constant centre of infection. Grant that a large 
 portion of the countless billions of tubercle 
 bacilli die in light and air, grant that organ- 
 ized warfare against the evil is making a per- 
 ceptible impression, and still the appalling roll 
 of deaths from this cause will show how many 
 infected mortals must walk the city streets 
 and sleep in the city's rooms. In case after 
 case we find in the lungs of perfectly healthy 
 persons small tubercular lesions which have 
 healed, showing that they were able to com- 
 bat the poison when attacked. But how about 
 the time of low resistance ? How can the citi- 
 zen tell when that time may come to him or to 
 his family ? The magnificent crusade against 
 tuberculosis is doing much to convince the 
 individual of the necessity of care against 
 scattering contagion. The municipality can do 
 one part toward the stamping out of the plague 
 by a steady constant struggle to achieve the 
 cleanest possible street. That ideal street will 
 fail in its purpose, if its construction does not 
 first of all prevent mechanical wounds to the 
 passers-by through the agency of winged par- 
 ticles of harsh dust. 
 
 In the dirt of the assembly hall, of the the- 
 atre, of the hotel and the railway-car we find
 
 18 THE HEALTH OF THE CITY 
 
 conditions in which the difficulties which exist 
 in the private house are fourfold multiplied. 
 For hours the crowds of people in such places 
 sit breathing the accumulated dust brought 
 from the streets, which, rising from the floor, 
 floats in clouds into the air and settles heavily 
 on the antiquated plush still in high favor for 
 such places. It is but a year or two ago that 
 the newspapers considered briefly the dangers 
 of that bacterial paradise, the Pullman sleep- 
 ing-car. A brief spasm of remonstrance passed 
 over the country, and disappeared as suddenly 
 as it came. The peril from such sources was, 
 however, recognized two decades ago, by more 
 than one, and these words of Dr. Mitchell 
 Prudden, concerning the presence of tuber- 
 culosis in such places, written almost as long 
 ago, are no less true to-day : 
 
 " Sleeping-cars and the staterooms of steam- 
 ships and hotel bedrooms are almost always 
 liable to contain infectious material, if they 
 have been recently used by uncleanly consump- 
 tives or those ignorant of the danger of their 
 expectoration. When the infectious nature of 
 consumption becomes generally appreciated, 
 hotels and transportation companies over long 
 routes will be compelled to provide special
 
 AIR 19 
 
 accommodations for such persons as are known 
 to be thus affected." 
 
 Tuberculosis is but one of the contagious 
 diseases which can be spread in this way, and 
 its outdoor treatment is coming more and more 
 to be recognized as consisting primarily of 
 three things. First, that the patient shall 
 have an ample supply of good nourishing 
 food. Second, that the patient shall have 
 an abundance of oxygen-laden air. Third, 
 that that air shall be as free as possible 
 from all impurities. Climate and environ- 
 ment, important as they may be in many 
 cases, both seem to be secondary to these re- 
 quirements, and the spread of outdoor treat- 
 ment from its original field of tuberculosis to 
 that of other respiratory diseases, such as 
 grippe and pneumonia, is along the same line. 
 
 First of all steps to be taken in freeing the 
 city from dust, is the laying of proper pave- 
 ments. Most of our present pavements are little 
 better than those of common country roads 
 piled high in time of drought with shifting 
 sands. So long as dry and unstable earth caps 
 the broken stone of many a city street, so long 
 the dust-clouds will send many a patient to the 
 doctors and the hospitals. The increasing use
 
 20 THE HEALTH OF THE CITY 
 
 of the automobile will inevitably make proper 
 street-cleansing easier. To-day the roads torn 
 up by the suction of the huge machines show 
 little promise of advance, but the future should 
 tell a different tale. Continuous pavements like 
 those of asphalt are ideal, because of their 
 smoothness for motor carriage, and when the 
 horse passes from the city, streets so paved 
 will be wholly available. There can be little 
 doubt that the horse in time will have to go, 
 as almost all the other wild and domestic beasts 
 have disappeared from community centres. An 
 anachronism in himself, the filth which follows 
 him acts as a shelter for the micro-organisms 
 of disease. With proper pavements, with the 
 dirt of animals excluded, street-cleansing can 
 be properly performed. 
 
 Within the house the vacuum-cleansing pro- 
 cesses are sweeping out and completely remov- 
 ing from many a dwelling and public building 
 the accumulated dust of years. In the vastly 
 greater extension of such devices, in such in- 
 crease of service as shall bring them within 
 the constant use of every household, lies the 
 great possibility here. City rooms will no 
 longer be considered rightly ventilated by the 
 dusty air of the sidewalk driven in by fans
 
 AIR 21 
 
 blowing through open windows. Satisfactory 
 air-filters will take their place, filters not left 
 to the intermittent, semi-annual care of a jani- 
 tor. One watchword of the model city of the 
 future will be " Freedom from Dust." 
 
 As the centres of population become more 
 and more crowded, as the distance between the 
 workrooms and the bedrooms of the city grows 
 greater, more of our population burrow be- 
 neath the earth on their daily passing to and 
 fro. The condition of the air in the subways of 
 the cities has been a moot point since their first 
 establishment. Few subways have undergone 
 more criticism in this respect than has the long 
 winding tunnel which lies beneath New York. 
 The trouble began with the first opening of 
 the subway, while its stifling heat during the 
 terrific summer of 1905 is a matter of painful 
 memory to thousands. That heat was made 
 yet more intolerable by the peculiar " subway 
 smell." From those causes grave questions in- 
 evitably arose as to the healthf ulness of the 
 air within the subway. Those queries have now 
 been answered in large part by an investiga- 
 tion made by Dr. George Soper, which consid- 
 ered temperature, humidity, odor, bacteria, and 
 dust. The first two of these divisions, impor-
 
 22 THE HEALTH OF THE CITY 
 
 tant as they are, have comparatively little 
 relation to our theme, but the last three are 
 pertinent. 
 
 The belief in the injurious effects of the 
 odor of the subway was a relic from the period 
 when certain forms of illness were supposed 
 to be directly connected with evil smells. With 
 the exception of the ill effects which certain 
 gaseous compounds of sulphur and carbon 
 produce, there seems to be scarcely any ground 
 for relating disease and evil odor. Constant 
 exposure to any smell, be it bad or good, is 
 likely to produce nervous irritation and ex- 
 haustion. On the great rose-farms of southern 
 France, for example, the stranger, wandering 
 among the fragrant fields, soon feels the same 
 heavy headache which a persistently objection- 
 able odor like that of a soap factory is likely 
 to produce. A lowering of energy from any 
 type of odor may put the individual into a con- 
 dition to invite disease, but is little likely to 
 be the direct cause of contagion. In the case 
 of the subway, the odor came chiefly from the 
 smell of the trap-rock employed in the stone 
 ballast of the road-bed, mingled with lubricat- 
 ing oil and gear grease, and combined with 
 occasional slight infusions of human odor. Dis-
 
 AIR 23 
 
 agreeable as it might be when long inhaled, 
 there was no reason to believe it dangerous. 
 
 The dust of the subway was quite another 
 matter. It was very distinct from the dust of 
 the streets, blacker, more clinging. As a horse- 
 shoe magnet was brought near a heap of dust, 
 the powdery mass sprang into magnetic curves. 
 Following this line, two magnets of similar size 
 were hung, one in the subway and one in an 
 iron foundry; and the first showed clusters 
 of black magnetic stuff far heavier than the 
 second. Analysis after analysis showed almost 
 half as much dust again by weight in the sub- 
 way as was found outside. Over sixty per cent 
 of that dust was iron. A passenger traveling 
 for half an hour inhaled on an average some 
 .42 of a milligram of the dust, a very appre- 
 ciable amount, and received into his lungs a 
 goodly number of iron missiles. Add to them 
 the tuberculosis germs forever floating in the 
 cars, and you have a very dangerous combi- 
 nation. The iron came from the wearing down 
 of the brake-shoes on the wheels, and it is com- 
 puted that the huge figure of twenty-five tons 
 of iron and steel is ground into powder in the 
 New York subway in the course of a month. 
 Here is a type of dust too little regarded up
 
 24 THE HEALTH OF THE CITY 
 
 to the present time, which means much to the 
 tuberculosis campaigns of the future. 
 
 The bacteria found in the subway were com- 
 monly less in number than those found outside, 
 but amounted to the fairly high figure of some 
 five hundred thousand per gram of dust, some- 
 times running as high as two million. The pas- 
 senger waiting for the train, however, seems 
 engaged in no more harmful occupation, so 
 far as danger from the number of bacteria 
 present is concerned, than he would be if he 
 was waiting for a car on the street outside. 
 
 In summing up the situation, the engineer 
 in charge states : " My own conclusion was 
 that the general air (of the subway), although 
 disagreeable was not actually harmful, except, 
 possibly, for the presence of iron dust." Re- 
 cent investigations of iron dust, particularly 
 from the standpoint of those exposed to iron 
 and steel dust, makes one believe that the word 
 "possibly" in the quotation just made might 
 well be stricken out. 
 
 One other point concerning subway air 
 should be mentioned. The constant renewing 
 of the atmosphere by the motion of the trains 
 keeps the carbon dioxide in the tunnel so little 
 more than that on the surface that, so far
 
 AIR 25 
 
 as that index shows, few more harmful pro- 
 perties exist in the subway than in the streets. 
 
 Closely allied with the problems which the 
 air of the city brings are the difficulties in- 
 volved in the city's light. Despite the many 
 theorists who have offered papers on the in- 
 jurious effects of sunlight, we must believe 
 from the long history of the race that we are 
 made to be sun animals. The dwarfed frame 
 of the poor cellar dweller, the stunted body of 
 the child of the dark city room may be largely 
 due to malnutrition, close air, and the other 
 evil surroundings of the slum. There is small 
 reason to think that lack of sunlight does 
 not play its part in producing the total 
 effect. 
 
 Over and over again in the succeeding 
 chapters we shall be brought to realize that 
 the germs of disease flourish in dirt and in 
 darkness. Were there no other reason for 
 letting in the light, the fact that the impulse 
 to cleanliness comes with illumination would 
 be enough. Take an apartment of five rooms, 
 two of which have inside windows and three 
 of which are the typical dark interior cells 
 of so many tenement houses. The two light 
 rooms will regularly show a large percentage
 
 26 THE HEALTH OF THE CITY 
 
 of improvement in cleanliness over the other 
 three. 
 
 In no part of the house are the good 
 effects of light regulation more perceptibly 
 necessary than in the kitchen, where the ma- 
 terials which offer the greatest possibilities of 
 decomposition and the best lodging-places for 
 micro-organic life are concentrated. Recent 
 investigations concerning the bacteria present 
 in poorly washed dishes and in refuse spilled 
 in the kitchen show the possibilities of germ- 
 life inherent in dark kitchens. That room is 
 the common living-room of the whole family 
 in thousands of cases. The possibilities for the 
 spread of disease which it offers are enormous. 
 
 Of no disease is the preceding statement 
 truer than of tuberculosis, whose bacillus dies 
 swiftly in cleanliness, light, and air. With this 
 micro-organism, as with the other germs of 
 disease, it is the dark room which furnishes 
 the filth which holds the germ as well as the 
 darkness which favors its growth. It is in the 
 dark rooms of the slums that poverty forces 
 the greatest amount of overcrowding. The 
 air from such abodes may well be laden with 
 the seed of the white plague. We know that 
 men are affected by the combination of good
 
 AIR 27 
 
 or bad air, space, food, and light. How heav- 
 ily the factor of light may weigh in the total, 
 we can hardly tell definitely as yet. It seems 
 reasonable to believe that it bears no small 
 part of the whole burden. 
 
 Germany has done far more to insure satis- 
 factory lighting than has been even attempted 
 in this country. In Saxony no building may be 
 erected behind any other building for dwell- 
 ing purposes unless a supply of light at an 
 angle of at least 45 is secured for all the win- 
 dows. At Ulm and Frankfort, when the muni- 
 cipality took up the work of housing, a supply 
 of light was made one of the first requirements. 
 To insure the carrying out of these needs, the 
 width of streets, areas of front and rear gar- 
 dens, and proximity of squares and boulevards 
 were all taken into consideration. The " Zone " 
 system of building, mentioned later, which 
 limits the number of stories of houses in dif- 
 ferent districts of the town, has accomplished 
 the same result in Cologne. There is more 
 than one reason for such enactments. 
 
 One thing cannot be forgotten. The light 
 furnished to houses must come from the sun. 
 It is never sufficient to offer artificial light 
 as illumination for any room of any habita-
 
 28 THE HEALTH OF THE CITY 
 
 tion. The shop or factory will furnish arti- 
 ficial light where it is needed far more readily 
 than it can ever be supplied to the rooms of 
 the great majority of homes. The employer 
 knows that he must furnish light if his work 
 is to be done. The woman in the home 
 knows that every minute that her lights may 
 run means money which must come from the 
 weekly wage. She is unlikely to give suffi- 
 cient light to any room where it is not fur- 
 nished free by windows. 
 
 First of all necessities in the betterment 
 of city air comes cleanliness outside and in. 
 Crime, dirt, and disease are all rank growths 
 of the dark. Light is a powerful factor of 
 reform. No municipality is doing its duty to 
 its citizens which neglects to enforce laws to 
 provide light in every room of the habitations 
 of men. How far some of our cities fail of 
 that condition, we shall see later. 
 
 For the smoke nuisance, the dust evil, and 
 the dark dwelling, the city can provide reme- 
 dies. Laws passed, and enforced, requiring 
 smoke-consumers and proper firing will do 
 away with the smoke nuisance. Proper pave- 
 ments, with good street-cleaning, will reduce 
 germ-laden dust to a minimum. The city
 
 AIR 29 
 
 which desires to give light to its inhabitants, 
 has only to refuse to allow the occupancy of 
 any new house whose rooms do not possess 
 sufficient window space through which sun- 
 light can pass at a proper angle. 
 
 It is all in the city's hands. Community 
 life is apparently the inevitable sequence of 
 our modern age. The fortunate who can, the 
 intelligent who know, will turn more and more 
 for their hours of recreation and of sleep to 
 wide stretches of heath and hill, or to the 
 comparative cleanliness of the suburbs. But 
 for the thousands of the narrow streets, the 
 cleansing of the city air is a necessity. To 
 every pallid weary worker should come the 
 rushing breath of purifying winds, the free 
 and open air of heaven.
 
 n 
 
 THE MILK-SUPPLY 
 
 IF the death angel, Azrael of the flaming 
 sword, stood before the gates of the city cry- 
 ing, " Open ye ! For every street within your 
 portals must yield to me one babe in ten," 
 what wailing and what lamentation would 
 run quicker than thought through palace 
 and through hovel ! But decimation does not 
 suffice the death angel to-day. Two babes of 
 every ten die in our great cities, and the world, 
 filled with the rush of our modern age, scarce 
 gives a thought to this fearful winnowing. 
 
 Nor is such a statement in any way an ex- 
 aggeration. There can be little doubt that of 
 one thousand children born, the fifth year will 
 find more than one fifth blotted out. And 
 the majority of these have come from the nar- 
 row ways of the city. From under two hun- 
 dred in those cities which do most, to over 
 three hundred in those which do least, rises 
 the five-year death roll. Many an empire- 
 making struggle has passed with far less loss.
 
 THE MILK-SUPPLY 31 
 
 Read on the tattered banners of historic Brit- 
 ish regiments the golden scroll of battles, from 
 Malplaquet to Pretoria. How few of them 
 show any such list of slain as do these records 
 of the tiny victims of disease in peace. 
 
 Study the rows of figures further, and cer- 
 tain definite facts stand forth in the light. 
 June, July, and August are the months of 
 greatest infant mortality^Diseases of the di- 
 gestive system cause forty per cent of the 
 deaths in many cities. Not only that, but deaths 
 from other causes are rated as complicated by 
 diseases of this class. No small number of these 
 might well be added to the direct column 
 wherein occur the greatest percentage of mor- 
 tality. That points to one thing as a source 
 of danger the food-supply. Cow's milk is 
 the exclusive food of a great majority of our 
 children up to the time they are one year old. 
 It is the chief food of practically all children 
 from the age of one through the age of five. 
 The inference is obvious. 
 
 Strange to say, the narrow street of the 
 Azores, or the mountain village of northern 
 Italy, feeds its children better than we can 
 feed our own. Smelling to heaven though these 
 little towns may be, with gutters running with
 
 32 THE HEALTH OF THE CITY 
 
 sewage, with .walls and barns falling in dirty 
 picturesque decay, their common milk-supply 
 is superior to that furnished even to the bet- 
 ter class of our American cities. Twice a day, 
 morning and evening, the herdsman leads his 
 goats through pathway, street, and rocky alley. 
 Patiently the herd stands for its milking be- 
 side the clustering children, and the warm 
 milk, fresh from the animal, goes directly to 
 the child. The rising generation there gets 
 pure, whole milk from a clean, healthy ani- 
 mal. Such milk is practically sterile, and if it 
 be transferred to the consumer in that state, 
 it is safe. But the danger from milk increases 
 with every hour after it leaves the creature 
 which produces it, unless precautions are taken 
 to turn it over to the consumer in the same 
 state in which it comes from the healthy ani- 
 mal. Therefore, since we can solve the prob- 
 lem in no such fashion as can the herdsman 
 of the foreign streets, we must first understand 
 the peculiar dangers which surround our city 
 milk-supply and then find the means of over- 
 coming them. 
 
 Our common necessities of life, such as air, 
 water, and milk, are taken so much for granted, 
 that many of their ordinary properties escape
 
 THE MILK-SUPPLY 33 
 
 our observation. The widespread course of 
 milk, coming as it does to every family table, 
 makes it a means for spreading disease, once 
 pathogenic conditions have been introduced, 
 second to no other medium, barring water. In 
 one respect it is more dangerous than water, 
 since a plague of typhoid or Asiatic cholera 
 startles the community from its customary 
 phlegm and causes immediate regulation of 
 the single source of supply. But the death of 
 children from stomach trouble or analogous dis- 
 ease makes no deep impression upon the people 
 as a whole, and a hundred separate milkmen 
 in a city are infinitely harder to regulate than 
 is a common service of water. Other factors 
 for comparison may be found in the inherent 
 properties of the two liquids. The transpar- 
 ency of water causes its instant rejection when 
 it bears visible sediment. The whiteness and 
 opaqueness of milk serve as covering and shel- 
 ter for insoluble substances. Dirt and filth, the 
 carriers of disease, are easily hidden therein. 
 A report from Germany, the home of syste- 
 matic inspection, well shows the possibilities 
 inherent here. Berlin, with its great system of 
 vital statistics, reports that its inhabitants con- 
 sume daily three hundred pounds of barnyard
 
 34 THE HEALTH OF THE CITY 
 
 refuse in their milk-supply. If that is true of 
 Berlin, a city of extraordinary cleanliness, what 
 must happen in our cities here? 
 
 Still more important than the mere carriage 
 of dirt or filth stands the power of milk to 
 give lodgment and nutrition to the bacterial 
 hosts. These bodies are about us everywhere, 
 lurking in the dust on the window-sill, float- 
 ing in the sunshine, lying on the ground ; they 
 exist in such countless hordes that words like 
 billion or quintillion utterly fail of significance 
 when the number in an area of any size is to 
 be considered. These invisible myriads of the 
 air, moreover, increase with tremendous rapid- 
 ity once they encounter favorable conditions 
 for growth, such as moisture, warmth, and 
 food. All these are furnished by milk. Raise 
 barnyard dust near an open milk-pail, and the 
 whirling masses which have been lying in the 
 refuse of the barnyard floor pour down upon 
 the liquid as the destroying Huns of Attila 
 poured down upon Europe. 
 
 But it must not be thought that all of the 
 bacteria are evil. Suppose we try to separate 
 the sheep from the goats. Roughly speaking, 
 we may say that three great classes of bacteria 
 may be present in milk, the acid-producing
 
 THE MILK-SUPPLY 35 
 
 bacteria, the putrefactive bacteria, and the dis- 
 ease-germs proper. The souring of milk is an 
 every-day phenomenon, and every housewife 
 knows that high temperature sours milk and 
 low temperature keeps it sweet. Translated 
 into scientific terms, the souring of milk means 
 that lactic acid bacteria, the bacteria of the 
 first class, have been busily working on some 
 of the constituents, and have changed a part 
 of them over into lactic acid, which in turn 
 has acidified the milk. This type of bacillus 
 is commonly harmless, indeed it may have an 
 absolutely beneficial effect ; but the souring of 
 the milk has been well called a placing of red 
 lanterns to warn of danger, since the growth 
 of these acidifying germs under ordinary con- 
 ditions shows the growth of other types, which 
 are productive of disease. 
 
 The putrefactive bacteria do not as a class 
 belong in milk, but to be present must be 
 introduced there from filth or outside refuse. 
 This is the class of bacteria most dangerous 
 to the child, since certain members of the 
 group are the immediate cause of many of the 
 serious digestive troubles of children. Danger- 
 ous, indeed, such troubles often are to adults, 
 but far more dangerous when they assail the
 
 36 THE HEALTH OF THE CITY 
 
 delicate system of the child. Once entered 
 into the intestines, they produce putrefaction 
 there, with grave accompanying disturbances. 
 Cholera infantum, for example, long recog- 
 nized as an acute milk-poisoning, comes from 
 these dangerous visitors, and its symptoms re- 
 semble those of poisoning by white arsenic, a 
 violent gastro-intestinal irritant. 
 
 Putrefactive bacteria, moreover, breaking 
 up the constituents of the milk, may produce 
 dangerous end-products. These classes of bac- 
 teria by their growth change the composition 
 of the milk, so that an infected or dirty milk, 
 twenty-four hours old, may actually bring a 
 poison to the child. And these infinitesimal 
 bodies increase like wildfire. If two samples 
 be taken, one from the milk of the night be- 
 fore, and the other from that of the morning 
 of an examination, over one hundred thousand 
 more bacteria per cubic centimetre will com- 
 monly be found to have sprung up over night 
 in the uncooled evening's milk, than are found 
 in the fresh supply. 
 
 The third class, the pathogenic or disease- 
 germs proper, come in a way which is entirely 
 preventable. They are the germs of contagious 
 disease, the bacilli which cause typhoid, diph-
 
 THE MILK-SUPPLY 37 
 
 theria, and cholera, and they get into milk 
 through milkers or handlers who are suffering 
 from mild forms of disease, from persons who 
 have been in contact with sufferers from such 
 troubles, or else from deliberate or careless 
 adulteration with a disease-infected water- 
 supply. 
 
 Responsible as man may be for carelessness 
 which allows the growth of dangerous bacteria, 
 he is even more directly responsible when he 
 deliberately adds water for purposes of gain, or 
 skims off cream from milk which is to be sold 
 as whole milk. In either case the percentage of 
 fat is cut down, and a constituent is removed 
 which is needed, not only for purposes of nu- 
 trition, but also for the energy which keeps our 
 body-engine running. Thence comes a direct 
 weakening of the resistant power and of the 
 capacity of assimilation. The milk business, 
 with its billions of gallons of milk, hundreds 
 of millions of pounds of butter, and millions 
 of pounds of cheese, is one of the great indus- 
 tries of the United States. With any such vol- 
 ume of business comes the tendency toward 
 unrighteous gain. How great this evil is has 
 been shown in St. Louis, where it was esti- 
 mated in one year that over sixteen hundred 
 
 o r 1 f\ 
 O u 3
 
 38 THE HEALTH OF THE CITY 
 
 gallons of cream were removed each day, a 
 loss of $900,000 a year to consumers, and 
 one which bears most heavily upon the scanty 
 purses of the poor. In New York the frauds 
 committed by the milkmen were said some 
 time ago to amount to about $10,000 per day, 
 a gain to a few individuals, which bears in its 
 train two dangers, the transmission of disease 
 and the lessening of bodily resistance because 
 of diminished food-value. 
 
 There are, then, two factors to be con- 
 sidered in the control of milk. First, bacte- 
 rial cleanliness, and second, the necessity for 
 whole unadulterated milk. To fully recognize 
 the necessity for proper bacterial conditions, 
 we must trace the milk back to its source, 
 consider the dairy farm, and what such a farm 
 should be. 
 
 Dr. James K. Wardwell divides dairy farms 
 as follows : 
 
 "First, what might be called 'model farms ' 
 places conducted as nearly as possible in an 
 ideal manner and buying no milk from others. 
 Second, good clean places some old, some 
 new managed by careful men who are trying 
 to do the best they can with what they have. 
 Some of them buy from one or two neighbors
 
 THE MILK-SUPPLY 39 
 
 who are also careful and are watched pretty 
 closely by the man to whom they sell. Third, 
 all the rest." 
 
 No matter how thoroughly imbued city men 
 may be with city life and city ways, nothing 
 touches most of them more closely than does the 
 thought of country life. Typical of all whole- 
 some outdoor joys is the mind-picture of the 
 old-fashioned barn. The wide doors swinging 
 open to vistas of clover-scented meadow, the 
 lofts laden with generous overhanging masses 
 of hay, above which wheel the darting swal- 
 lows, the cows and horses in their darkened 
 stalls, and the broad bands of sunshine pierc- 
 ing the dusty windows, to broaden out into a 
 full golden river before the open door, all give 
 a setting for the imagination which completely 
 fills the rural foreground of the average urban 
 dweller. While that remains the conception of 
 a dairy farm, the actual conditions are likely 
 to be hidden completely from view. It is true 
 that the old unswept barn where dust and 
 refuse filled the air had evident difficulties, 
 but it is also true that it had certain redeem- 
 ing features. Our forefathers had a liking for 
 " sightly spots," as they expressed it, and no 
 one traversing the east to-day can fail to note
 
 40 THE HEALTH OF THE CITY 
 
 how often a great red or white barn crowns 
 some noble eminence. Those heights meant 
 good drainage, good air, and free ventilation. 
 The milk produced there, once it left the 
 barn, was the especial province of the good 
 housewife, and the spotless purity of her cool 
 milk-room with its border of shining milkpans 
 was her pride and joy. Not only that, but 
 the short time which intervened before the 
 warm milk reached its users left comparatively 
 little chance for injury. Then, indeed, the 
 foaming draught from the healthy pasture-fed 
 cows might well bear health and strength. 
 
 No such conditions exist to-day in the ma- 
 jority of dairy farms. The milk-supply of the 
 city, if it comes from afar, must pass through 
 hours of waiting by cross-road, by station, and 
 in train, ere it reaches the urban terminal ; 
 and when it reaches the door it is likely to 
 be anywhere from sixteen to forty hours old. 
 Only when the greatest care has been taken 
 in starting the milk clean, and keeping it 
 throughout at a low temperature, can it arrive 
 without accompanying millions of bacteria. If 
 the milk comes from near at hand, the increas- 
 ing value of real estate about a city only too 
 often places the dairy farm in some damp,
 
 THE MILK-SUPPLY 41 
 
 undrained spot. In either case the doctrines 
 of fresh air, cleanliness, and sunshine spread 
 slowly through the consciousness of the hired 
 milker, an employee not uncommonly taken 
 from some batch of immigrants just entering 
 upon their first occupation in a new land. So 
 seldom is any cleansing attempted in some of 
 these barns that every movement of the milk- 
 ers plants the seeds of numerous colonies of 
 bacteria. An almost historic experiment of 
 Freeman's shows this clearly. Three culture- 
 plates, shallow dishes containing jelly-like 
 masses ready to give lodging and food to 
 errant bacteria, were set for three minutes in 
 separate places, one in the free open air, 
 one just outside a barn, and the third in- 
 side, in front of a cow and beside a milk-pail 
 when milking was going on. These jellies 
 were afterward developed, that is, were put 
 under conditions favorable to bacterial growth, 
 and the first plate showed six, the second, one 
 hundred and eleven, and the third, eighteen 
 hundred, colonies of bacteria. No result could 
 more strikingly illustrate the possibilities of 
 the dirty barn. Not only the floor but the 
 cow herself is an immediate provider of such 
 bodies, for the sides and udders of the animal,
 
 42 THE HEALTH OF THE CITY 
 
 lying in the filth of the stall, carry many pu- 
 trefactive germs. Then, too, those common 
 carriers of disease, the swarming flies, may 
 easily carry infection from a considerable dis- 
 tance. 
 
 The food of the herd must be good and 
 ample if the milk produced is to be up to the 
 standard. Where tower the walls of brewery or 
 distillery the daily wayfarer may note streams 
 of farm wagons which enter the big gates 
 empty and come out full of dark spent grains. 
 The farmer who buys those cheap grains is 
 injuring the composition of his milk, and his 
 wagon is bearing an improper food to the 
 farm. That is only one of the dangers which 
 come to the herd when greed of gain or 
 ignorance holds sway instead of a wise pro- 
 gression. The milk of cows suffering from 
 tuberculosis and other complaints is another 
 example. Concerning this, one thing we may 
 say. Bovine tuberculosis is probably trans- 
 missible to man. In any case, the secondary 
 products of toxine reactions in tuberculous 
 cows, or the impure milk which comes from 
 any diseased cow, may fill the milk with inju- 
 rious ingredients. But all these things are less 
 likely to occur than is the ever-present trouble
 
 THE MILK-SUPPLY 43 
 
 of unclean milkers, unwashed dishes, and 
 unswept floors. In cleanliness, in spotlessness, 
 lies the great solution. One more point should 
 be mentioned. Look out for sounds in the 
 early morning hours which mean that milk is 
 being bottled on the street in the wagon, in- 
 stead of at the farm in the milk-house. The 
 milk-house may well be in a far from perfect 
 condition, but milk bottled there is far less 
 liable to serious contamination than when it 
 is taken from the farm in cans and bottled at 
 the consumer's door. On the street the possi- 
 bility of contamination from dust, flies, and 
 dirty bottles rises to a practical certainty. 
 
 The number of proper dairy farms is grow- 
 ing year by year. Those breeze-swept sunny 
 heights which called instinctively to the farmer 
 of an older day, call because of their good 
 drainage and ventilation to the modern farmer. 
 His long, low barn, clean-swept, with floors 
 where every form of filth may be easily and 
 swiftly removed, his open stalls and stanchions, 
 his separate hay-barn, all show thought, care, 
 and cleanliness. On such a farm the milk- 
 house is properly separate from the barn and 
 deserves a word for itself. There come the 
 clean-handed, white-clad milkers, with their
 
 44 THE HEALTH OF THE CITY 
 
 covered pails whose contents have been drawn 
 from clean cows. No milker enters the milk- 
 house, but each pours his milk from an outside 
 passage directly into the aerator or cooler. 
 This piece of apparatus takes the warm milk 
 fresh from the cow, and cools it immediately 
 to 40 or 50 F., passing it from a tank over 
 a large expanse of cylindrical pipe, whose in- 
 terior is cooled by coils through which flows 
 running water. From the cooler, the milk is 
 run direct into sterile bottles. These are capped 
 and placed on ice, where they remain, both on 
 the farm and in the wagon, until the consumer 
 is reached. Such a farm has, as a matter of 
 course, a pure and sufficient water-supply and 
 clean and jointless milk-utensils. 
 
 With all the difficulties which bar the way, 
 it must seem an Augean task to cleanse the 
 city milk, to force the farmer to have proper 
 conditions in his barn. Yet after all it is not 
 so hard when one knows that there are definite 
 ways to go about a cure, that dairy farms exist 
 where pure milk is being produced, and that 
 in some cities the milk-supply is excellent. 
 Since it has been proved that a satisfactory 
 milk-supply can be secured, the natural se- 
 quence is the arousing of the community to
 
 THE MILK-SUPPLY 45 
 
 such a point that it will require every farmer who 
 supplies it to have a proper farm, every dealer 
 to keep and deliver his milk whole and clean. 
 
 The necessity for those standards which 
 oblige the milk to have a certain content of 
 fat and solids, that is, to contain the amount 
 of nutriment which should exist in milk from 
 a healthy cow, is fairly recognized. The diffi- 
 culty in this respect has come less from a lack 
 of city ordinances than from the appointment 
 of incompetent or untrustworthy officials ; or 
 else from insufficient appropriations, which too 
 often keep good milk-officials from covering 
 any reasonable portion of the supply, to say 
 nothing of taking care of the whole. The 
 automatic law, which will work without ample 
 appropriations, though long sought, is yet to 
 be found. 
 
 The newer standard, which requires that 
 milk shall be free from injurious bacteria and 
 germs, or that a fixed quantity of milk shall 
 not contain more than a certain limited num- 
 ber of bacteria, is the one which chiefly needs 
 our attention. For this standard a tiny mass 
 of liquid, the cubic centimetre, about the thir- 
 tieth part of a liquid ounce, is taken. A small 
 portion only can be used effectively, since even
 
 46 THE HEALTH OF THE CITY 
 
 here the number of bacteria present may range 
 from a meagre hundred to a host of ten million. 
 But counting the bacterial inhabitants in a 
 cubic centimetre is quite as effective a way of 
 telling the condition of the milk as counting 
 the bacteria in a quart would be. It is known 
 that the greater the number of bacteria pre- 
 sent, the greater the chance for evil growths. 
 We may, therefore, obtain a standard from 
 the total number present, and decide that for 
 practical purposes the purest milk is that milk 
 which contains the smallest number of bacte- 
 rial forms. 
 
 So the bacteriologist, bending over his mi- 
 croscope and culture-tube in the quiet labora- 
 tory, stands between death and the children. 
 No unworthy follower of St. George, the 
 dragon-fighter of old, is this follower of sci- 
 ence, fighting the modern dragons of disease 
 and death. To him may safely be left the 
 task of guarding the city, provided we have a 
 law which will require a proper limit to the 
 number of bacteria present, and inspectors to 
 enforce the law. In his laboratory the samples 
 received from the wagons and the farm are 
 each carefully labeled, properly diluted, and 
 poured on plates which hold sterile solutions
 
 THE MILK-SUPPLY 47 
 
 calculated to give the best results in the way 
 of bacterial growth when placed in warm, moist 
 air. After a few hours under these conditions 
 the plates begin to show small spots, which 
 steadily grow larger and larger. These are the 
 colonies from the individual micro-organisms, 
 whose progeny have increased at the rate of 
 hundreds, almost of thousands, an hour. Each 
 colony means a single living organism at the 
 start, and from the total of colonies the num- 
 ber of individuals present may be determined. 
 Their kind also may be ascertained, be it 
 harmless lactic-acid form, dangerous putre- 
 factive type, or in many cases disease-germ 
 direct. Such bacteriological care insures the 
 safest and healthiest supply that a community 
 _can possibly obtain. 
 
 The safeguarding of the city's milk by ster- 
 ilization and pasteurization has been so often 
 considered that some reference to their action 
 is essential. While heat up to 100 F. tends 
 to increase bacteria rapidly, yet high tempera- 
 ture kills them, and the problem of the effect 
 of temperature upon milk is no simple one. 
 Whenever the housewife scalds her milk to 
 keep it from souring, she employs sterilization. 
 Her real object in the process is to kill the
 
 48 THE HEALTH OF THE CITY 
 
 lactic-acid bacteria and prevent them from 
 doing their work. In fact, practically all the 
 living organisms of milk are destroyed by keep- 
 ing it at 212, the boiling temperature, for ten 
 minutes. But with this destruction come a 
 series of changes which affect seriously the 
 composition of the liquid. The gases, aromat- 
 ics, and several of the watery constituents are 
 lost, while some of the other constituents are 
 modified. In consequence, the digestibility of 
 the milk is affected, and serious intestinal ill- 
 ness has been attributed to a constant use of 
 such milk by infants. The process is a some- 
 what difficult one to perform properly ; more- 
 over, the appearance and taste, as well as the 
 composition, of the sterilized milk are injured. 
 In consequence, comparatively little of it is 
 used in American cities, though it is com- 
 monly found in continental Europe. 
 
 Pasteurization is the simple process of sub- 
 jecting milk for twenty minutes to a tempera- 
 ture of not under 155, not over 159. This 
 method, while it does not kill all bacteria, de- 
 stroys the.more dangerous of them, kills many 
 putrefactive and disease-germs, and commonly 
 reduces the number per cubic centimetre from 
 thousands and tens of thousands of bacteria
 
 THE MILK-SUPPLY 49 
 
 to less than a hundred. Here is a possible 
 safeguard for the individual family unable to 
 obtain sanitary milk. The composition and ap- 
 pearance of the milk are less changed than by 
 sterilization, yet decided results are obtained. 
 The destruction of the souring bacteria is in 
 itself no minor matter, since milk which either 
 has turned, or is on the point of turning, may 
 be given accidentally to infants, with serious 
 digestive troubles as a result. But far more im- 
 portant than this is the fact that the destruc- 
 tion of the germs of tuberculosis, typhoid, and 
 diphtheria is practically certain. Pasteurization 
 is inexpensive, simple, and easy to perform, 
 does not require complex apparatus, but does 
 demand care. Yet any process which heats 
 milk above blood heat can never be wholly 
 satisfactory, and pasteurization is by no means 
 perfect. Nevertheless, it surely seems wiser for 
 the individual consumer to have recourse to it 
 than to chance the use of milk from a ques- 
 tionable supply. 
 
 Commercial pasteurization, however, is a 
 very different matter from individual pasteuri- 
 zation. On this subject we can hardly do better 
 than to quote from Professor James 0. Jordan 
 of the Boston Board of Health, as follows:
 
 50 THE HEALTH OF THE CITY 
 
 " Commercial pasteurization serves a pur- 
 pose, but it is not true pasteurization. Un- 
 doubtedly nearly all of the souring bacteria 
 are destroyed under this treatment, but the 
 more deleterious bacteria are not killed, and 
 these may produce harmful changes in the 
 milk while it still appears sweet and palatable. 
 Oftentimes this pasteurization means that 
 filthy milk which would, under ordinary con- 
 ditions, be unsalable, because of souring, is 
 given a new lease of life and becomes a 
 marketable commodity." 
 
 Higher and higher loom the huge caravan- 
 saries where flock the city-dwellers. Greater 
 and greater wax the numbers of hospitals 
 and institutions. With the increase of centres 
 where hundreds and thousands may be fed 
 from a single source of supply, has come a 
 different problem from that which meets the 
 individual consumer. At least one record ex- 
 ists which tells how milk received pure may 
 be kept pure, even when distributed in many 
 different directions. 
 
 Down beyond the North End of Boston, 
 where the harbor air first begins to hold its 
 own against the city smells, lies the Floating 
 Hospital, a noble philanthropy nobly carried
 
 THE MILK-SUPPLY 51 
 
 on. Some time ago, when a new hospital ship 
 was equipped for its use, it was determined 
 that pasteurization and sterilization should 
 not be employed. That meant that bacterial 
 growths must be practically excluded from the 
 supply, for the cases which enter the hospital 
 are largely those of children suffering from 
 digestive disease. No satisfactory apparatus 
 by which institutions could keep milk down 
 to a minimum of bacteria had been evolved, 
 and the search to find a way to accomplish 
 this fell upon the director of the food-labora- 
 tory of the hospital, Mr. Frederic W. Howe. 
 He took up the task, and designed a labora- 
 tory which sends out milk day by day with a 
 smaller bacterial content than has been re- 
 corded from many institutions. The Boston 
 Board of Health requires a standard of not 
 more than five hundred thousand bacteria per 
 cubic centimetre. The food-laboratory of the 
 Floating Hospital sends out milk to all its 
 wards with a bacterial content of from one to 
 two hundred. How is this possible of accom- 
 plishment? It is done by means of a series 
 of devices that insure absolute cleanliness in 
 every process. That means a chance for the 
 children, a decrease in infant mortality, which
 
 52 THE HEALTH OF THE CITY 
 
 is one of the noteworthy accomplishments of 
 the day. 
 
 The cramped space of a ship leaves little 
 room for useless experimentation, so the sunny 
 laboratory is a multum in parvo of four small 
 rooms, cut off from the rest of the hospital, 
 and having communication by door only with 
 the deck, by windows only with the corridors. 
 The first room is the cleansing-room, where 
 the nursing-bottles back from the wards are 
 washed by motor-driven brushes in tanks filled 
 with hot cleansing solutions. From there the 
 bottles are taken to the great sterilizer, a 
 rack-lined, copper-floored room, where hun- 
 dreds of bottles may be placed. The doors of 
 the sterilizer are hermetically closed, and live 
 steam, perhaps the greatest cleansing agent 
 known, is turned on to fill every cranny of 
 the room and of its contents. Then comes the 
 modifier room, where the whole milk is modi- 
 fied to meet the needs of each individual 
 patient. This room beyond the sterilizer is 
 the essential part of the whole process. Any 
 institutional apparatus must be of a sort to 
 require a minimum of time and care. with a 
 maximum of efficiency. That is what is ac- 
 complished here. The modifier, a great square
 
 THE MILK-SUPPLY 53 
 
 tank filled with cooling brine, holds a series 
 of cylindrical tanks, which supply the various 
 liquids required for the milk-mixtures used 
 in the laboratory. The turning of a tap 
 gives the milk. By a single connection of the 
 hose each can is connected with a live-steam 
 pipe which cleanses and sterilizes it perfectly. 
 Every can, once filled, is sealed save for its 
 single delivery tube, and the bacteria, instead 
 of being killed, are excluded. Last of all in 
 the series, but first in actual use, comes the 
 huge refrigerator, where the clean milk from 
 a model dairy farm is delivered at one side 
 and taken into the modifier room on the other. 
 Day after day and meal after meal pure milk- 
 mixtures are furnished to the children, and 
 the percentage of cases gained, and the num- 
 ber of children who pull through despite the 
 handicap of the slum, is the best certificate 
 of success. There is no institution or hospital 
 but can profit by such experimental success as 
 this. 
 
 One more record of modern research before 
 we close ; and this is another chapter of that 
 great theory which shows the possibility of 
 destroying germs of evil within the body by 
 means of their enemies, the germs of good.
 
 54 THE HEALTH OF THE CITY 
 
 It has long been known that certain health- 
 giving properties belong to buttermilk, but 
 the scientific value of this fact has only re- 
 cently been recognized. It was found that in 
 certain cases this liquid was extremely suc- 
 cessful in curing digestive difficulties. That 
 gave a clue to start the development of the 
 theory. If buttermilk, stripped of much of its 
 value in the butter-making, and dirty from 
 the process, would do this, could not clean 
 milk be so treated as to make it of greater 
 value ? Experiment after experiment along 
 this line has been tried. In the most success- 
 ful of these a pure culture of lactic-acid bac- 
 teria is added to clean milk to acidify it. 
 Sufficient of these bacteria are introduced to 
 produce a maximum of seven tenths of one 
 per cent of lactic acid, a quantity which cur- 
 dles the milk but gives in the soluble part a 
 goodly growth of bacteria. These tiny war- 
 riors are the deadly enemies of putrefaction ; 
 once within the body, they struggle with the 
 bacteria of evil which have taken lodgment 
 there, fighting on until they destroy them. 
 Though a different type of action from the 
 antitoxine in diphtheria which destroys the poi- 
 sons brought by that germ-disease into the sys-
 
 THE MILK-SUPPLY 55 
 
 tern, it is another step toward the prevention 
 of disease by neutralization. No slight possi- 
 bility for the future is such safeguarding of 
 food by use of good bacteria to fight the bad. 
 Among the many attempts tending toward the 
 stamping out of disease, this discovery may 
 stand as a precursor of great and noble deeds. 
 Probably the best results obtained to-day 
 have come from the union of private enter- 
 prise with the physicians of the city and with 
 the lay allies of reform. The encouragement 
 of such united action may well become a pub- 
 lic duty. Wherever wagons upon the street 
 bear the sign "Certified Milk," two things 
 are likely to be true, that the farm from 
 which the wagon comes furnishes good milk, 
 and that the dealer selling the milk has little 
 difficulty in procuring customers. The sign 
 is a valuable advertising asset. Certified milk 
 means, first, that a certificate has been issued 
 to a dairy farm by a committee of physicians, 
 and implies that the farm has been inspected 
 and is in every way what it should be. It 
 means, second, that the milk is delivered to 
 the customer in some thoroughly satisfactory 
 way. It is entirely possible that some features 
 of any system like that of certification may
 
 56 THE HEALTH OF THE CITY 
 
 not be practical for certain individual cities ; 
 but one feature, personal investigation of the 
 conditions of the farm, should be a part of 
 every milk inspection. In Vancouver, B. C., 
 for example, the city milk-seller cannot obtain 
 a license unless the farmer from whom he 
 obtains his milk agrees to inspection. If the 
 result of such supervision is not satisfactory, 
 the trouble is removed by taking away the 
 license. 
 
 And now, to summarize : First, the modern 
 study of milk tends to the exclusion of bacteria 
 by cleanliness and cold, not their destruction 
 by heat. In general it considers pasteuriza- 
 tion a fairly satisfactory substitute in emer- 
 gencies where pure milk cannot be obtained. 
 Second, mortality statistics tend to prove that 
 exclusion is necessary for the child and for the 
 nation. It may be that at the present moment 
 we are a little weary of reform. The pendulum 
 of warning may have gone too far in some di- 
 rections, but in one it has not gone far enough. 
 The lives of the city children hang in the bal- 
 ance to-day. If there is any means by which 
 we can bring back ruddy cheeks and healthy 
 bodies to children unjustly deprived of them, 
 if there is any way in which we can lower our
 
 THE MILK-SUPPLY 57 
 
 present fearful death-rate, who of the commu- 
 nity can refuse to lend interest, or give aid ? 
 The trumpet-call that summons should rouse 
 each deadened ear, quicken each dulled soul. 
 It is the call to a new, all-embracing, all- 
 powerful children's crusade.
 
 Ill 
 
 THE CITY'S FOOD 
 
 OUT of the gray dawn, from smoky stations 
 where grimy engines pant and heave, by lighted 
 subways in swift, silent trains, or through the 
 barren shuttered streets in clanging car, pour 
 the great hosts who do the city's work. That 
 restless river springing from the morn bears 
 in its flood the total of the city's wealth. From 
 its requirements rise the varied activities of 
 the city, whose total economic power is built 
 by massing the single units of the moving 
 throng. The energy of this human river gath- 
 ers the resources of sea and earth, and turns 
 the wealth it gains to the use and the service 
 of man. On the preservation of that energy, 
 therefore, depends the effective work of the 
 city. Higher and better living for all would 
 come from its general increase. 
 
 To gain energy, the individual has but one 
 means at his command, his food. Just as surely 
 as the red flame of any coal-fed fire dies down, 
 left unreplenished, so man dies, once his food-
 
 THE CITY'S FOOD 59 
 
 supply is stopped. That is so evident, so per- 
 sonal, that it is remembered. It is equally true, 
 but less commonly remembered, that as a fur- 
 nace with dead ashes about the walls yields 
 little heat despite the fire within, so insuffi- 
 cient or wrong foods, poisoning or dulling the 
 worker, give him little energy for his tasks, 
 little strength to bear his part in the world's 
 struggle. 
 
 Stated in its simplest form, the problem of 
 the city's food-supply resolves itself to this: 
 how can we provide the consumer with health- 
 ful food which shall be in a normal condition 
 when it reaches the table? If we can solve that 
 problem, we can furnish the army who are 
 attacking the work of the world with a proper 
 commissary, and so supply it with a require- 
 ment second to no other. If Napoleon's fa- 
 mous remark, that an army travels on its 
 stomach, applied a century ago to the invin- 
 cible legions that so long dominated Europe, it 
 is quite as true to-day that in our desperate 
 struggle for commerical supremacy that nation 
 which is best fed, that city which pays the 
 most attention to the food of the workers 
 within its walls, stands the greatest chance of 
 ultimate victory.
 
 60 THE HEALTH OF THE CITY 
 
 Visualizing to our entire satisfaction the 
 vegetable garden of the farm, or the white 
 butcher' s-cart of the village, as the basis of 
 our food-supply, we, as a nation, have long 
 been inclined to neglect the widespread sources 
 from which we draw our bodily energy. As in 
 so many other civic conditions, the tradition 
 of the immediate plenty of the American farm 
 has overcome the actual reality. What the city- 
 dweller should visualize are the thousands upon 
 thousands of tons of perishable food-material 
 which are brought yearly into the city; for 
 these, on their way to our homes, must pass 
 through a cordon of attacking foes. The 
 armored trains which carried provisions from 
 place to place in the Boer war, and the forts 
 in which those provisions were received, have 
 no distant parallel in the refrigerator cars and 
 the cold-storage warehouses of the city. Like 
 supplies hastened to beleaguered fortresses, 
 our foods are exposed to destructive agencies 
 from the time they leave their place of origin 
 to the time they reach their final destination. 
 The foes that the foods encounter are of two 
 classes, the natural and the unnatural, the 
 forces of nature and those of greedy or igno- 
 rant men. Both types of evil can be avoided
 
 THE CITY'S FOOD 61 
 
 by the community, if it will raise against them 
 certain well-recognized guards. To raise those 
 guards, some definite knowledge of the dangers 
 which surround the food-supply is imperative. 
 In common parlance we say that an orange 
 which has turned soft, or a piece of meat which 
 becomes tainted, is spoiled. The housekeeper 
 looking over the contents of the ice-chest says, 
 " This must be eaten to-day, for it will not 
 keep until to-morrow." In such expressions we 
 instinctively recognize the existence of destruc- 
 tive agencies. It is comparatively seldom that 
 we fully realize that what we call the spoil- 
 ing of food is one of the great movements 
 of natural order in the world, that it is the 
 attempt of nature to do one of two things: 
 either to encourage new life at the expense of 
 a substance which has lived its allotted time, 
 or to destroy and clear away matter which has 
 served its purpose and is ready for removal. 
 Food-materials, left under conditions where 
 plant-life can exist, become fertile soil. Decom- 
 position of food-materials is produced by micro- 
 organic life growing in that soil, life which is 
 attempting to clear away organic wastes from 
 the face of the earth, and return the substances 
 which have composed those wastes into such
 
 62 THE HEALTH OF THE CITY 
 
 elemental form that they can serve once more 
 as food for plant-life. 
 
 All round us, in library and kitchen, in 
 office and laboratory, on hill and valley, 
 through winter cold and summer heat, flour- 
 ishes the garden of the air, a garden rilled 
 with countless myriads of tiny plants. There 
 may be found threadlike moulds such as form 
 on bread or cheese; wild yeasts, such as fer- 
 ment fruit juices and change sweet cider to 
 hard cider; and bacteria like the mother of 
 vinegar, which turns hard cider into vinegar, 
 or like those other types of the same group 
 of tiny plants which, by decomposition, break 
 down the organic structure of the foods in 
 many fashions. 
 
 The moulds, the yeasts, and the bacteria, 
 all of which may be grouped as micro-organ- 
 isms, share certain general peculiarities. All 
 three belong to the great general group of 
 fungi, a group of plants which take their 
 nourishment from the soil on which they rest ; 
 and, like their relatives of this group, these 
 organisms, as they grow and take in food, 
 break down the organic matter which affords 
 them lodging and nourishment. All three of 
 these plant-types thrive best under conditions
 
 THE CITY'S FOOD 63 
 
 of darkness, warmth, and moisture. All three 
 flourish in dirt, and dirt is laden heavily with 
 these tiny bodies. Cleanliness and cold are two 
 great guards by which we can protect food 
 against the attack of decomposing micro-or- 
 ganic life. The clean, cool ice-chest preserves 
 food in the home. The hot, moist kitchen 
 destroys it. The first, by cleanliness and low 
 temperature, tends to retard micro-organic 
 growth. The second, by the increased oppor- 
 tunity for dirt and dust and by a higher tem- 
 perature, fosters the plant-life of the air. 
 
 The normal tendency of leaf, stem, flower, 
 and fruit is to turn at last to the cellulose 
 and lignin of the tree-trunk. In the action of 
 organisms which attack the fallen forest tree 
 and, decomposing it, return its elements to 
 the ground from which they sprang, may be 
 seen the agencies through which old life is 
 constantly exchanged for new. Were it not 
 for such action, the fresh and living plants 
 which give us food might, ere this, have be- 
 come locked fast in harsh, unyielding, woody 
 fibre, which offers nutrients to neither man 
 nor beast. Nor does such action show the only 
 value of micro-organic life. A modern sew- 
 age-plant will be referred to later as a pile of
 
 64 THE HEALTH OF THE CITY 
 
 rocks on which bacterial films gather. The 
 bacteria of those films are fulfilling their ac- 
 tion as earth's scavengers when they break 
 down the sewage flowing over them, and turn 
 the objectionable organic wastes to simple in- 
 organic forms. 
 
 A few short phrases sum up conditions. 
 The natural enemies of food-preservation are 
 micro-organic plants, which flourish the world 
 over, ever ready for their tasks of decomposi- 
 tion. With foods as a common habitat, these 
 organisms in their process of growth break 
 down the structure of the foods into forms un- 
 palatable and often directly injurious to man. 
 Yet the growth of such micro-organic life is 
 a necessity of nature. Man can oppose it only 
 in some part. He can, however, control it, 
 in so far as necessity requires, by cleanliness 
 and a cool temperature. The preservation of 
 the city's food by dryness, a third protection 
 against the decomposing organisms, is im- 
 practicable for many of the foods because of 
 their normal content of water. 
 
 The incoming of the city's foods is of it- 
 self a splendid pageant. Wheat trains, rush- 
 ing from the wide horizon of the West ; fish- 
 ing schooners, tacking up from off the Banks;
 
 THE CITY'S FOOD 65 
 
 refrigerator cars, hastening across the conti- 
 nent, laden with the spoils of a thousand 
 herds; high-topped wagons hauled by sturdy 
 Percherons, looming in over the country roads 
 in the freshness of the earliest dawn ; crates 
 filled with golden oranges, with luscious 
 peaches, with heavy hanging grapes, hasten- 
 ing upon their city way; huge mo tor- vans, 
 piled high with dainties, speeding through the 
 bustling streets; all such inrushing, converg- 
 ing evidence of natural plenty offers a wide 
 breadth of thought, a feeling of greatness, a 
 sense of pride in this rich and glorious coun- 
 try in which we live. 
 
 But there is a dark reverse to this splendid 
 shifting curtain. Down on the East Side lives 
 a Russian Jew, a vender of fruit, who finds 
 a hand-barrow quite large enough for all his 
 meagre stock in trade. A weary day has gone, 
 whose long rounds have been profitless. Back 
 comes the wretched stock to the home in the 
 hot tenement, to go out again, already well on 
 in the process of putrefaction, to be offered 
 for sale the next morning in the sweltering 
 streets. The fruit-peddler's action in selling 
 his damaged goods may be deliberate or igno- 
 rant; whichever it is, matters little as regards
 
 66 THE HEALTH OF THE CITY 
 
 results. Nature makes no allowances. Her laws 
 are inexorable. Food such as this, uninspected 
 and uncondemned, ravages the weakened 
 frames of the city's poor, and the exhausted 
 doctors, those warriors of the high-walled 
 streets, report after such a sale, "Another 
 epidemic caused by rotten food." One great 
 necessity for inspection is laid bare by such 
 conditions. 
 
 While ignorance, while deep need (for the 
 loss of one day's stock may mean starvation 
 to the seller), while greed, can control the ac- 
 tions of the small provider of food to the ranks 
 of the poor, the city must guard its children. 
 Go into the slums of your city, and enter the 
 small grocery and the butcher-shop /frC7ean7i- 
 ness and cool temperature I gave as the two 
 great guards against the decomposing action 
 of the micro-organisms. See how the shops of 
 the tenement streets provide those guards, and 
 then read the general death-rate from intes- 
 tinal disease in the summer. Put milk in a 
 separate category, for that is a still greater 
 problem, and, even with that omission, you will 
 have much to ponder over. 
 
 The men who use adulteratives, the sellers 
 of " embalmed beef," and the venders of other
 
 THE CITY'S FOOD 67 
 
 substances which have been treated with inju- 
 rious types of preservatives, can hardly plead 
 ignorance as an excuse for the continuance of 
 their methods. The discussion of pure foods 
 which has gone on in recent years, the pure- 
 food laws which have been passed by federal 
 and state authorities, have been sufficient to 
 enlighten any manufacturer as to the neces- 
 sities of the situation. But so long as crime 
 is committed for the sake of gain, the public 
 must be protected against the deliberate at- 
 tempt of unscrupulous manufacturers and 
 dealers in foodstuffs, who work injury in the 
 pursuit of their own profit. 
 
 Indeed, it may hardly be too general to say 
 that the evil done to the city's food by its un- 
 natural foes may be divided into three classes. 
 These may be stated as follows : First, men 
 may deliberately offer for sale food which has 
 begun the process of decomposition. Second, 
 they may treat food with preservatives which, 
 while they destroy or prevent the action of 
 micro-organisms, are injurious to the human 
 frame. Third, they may adulterate, or substi- 
 tute, cheaper, poorer foods for better, more 
 nutritious foods. 
 
 " But," the reader will very possibly cry in
 
 68 THE HEALTH OF THE CITY 
 
 surprise at this point, " I thought all that had 
 been settled. How about the pure-food laws 
 that have been passed? How about the work 
 of the Boards of Health? How about the 
 crusade of the last four years, mentioned a 
 moment ago? We may not be able to control 
 the natural foes of food, but surely there are 
 laws to control the unnatural ones." 
 
 It is almost a national fallacy to believe that 
 once a law has been placed upon the statute- 
 books safety has been secured, even though 
 such a law has been passed without sufficient 
 enforcing power, or sufficient money to pro- 
 vide for proper enforcement. Much has been 
 done; no inconsiderable beginning has been 
 made; but large bodies move slowly, and the 
 impetus necessary to arouse general feeling to 
 the point where the American people will re- 
 quire proper inspection and control of all food- 
 supplies is still far from attainment. Without 
 attempting to enumerate the merits or defects 
 of all the statutes which have been passed 
 for our protection, suppose we consider for 
 a moment certain difficulties which surround 
 the most general law of them all. 
 
 Whatever the local condition around him, 
 the citizen who thinks of the matter puts his
 
 THE CITY'S FOOD 69 
 
 trust chiefly in the Food and Drugs Act, 
 passed by Congress on June 30, 1906. Three 
 analogous pieces of work accomplished by the 
 national government : the law just cited, with 
 its regulations, alterations, and amendments; 
 the work done on standards of purity ; and 
 the so-called " Meat-Inspection Amendment," 
 which regulated the meat-control of the De- 
 partment of Agriculture, contain much that 
 is admirable. From the very nature of the re- 
 lation between the federal and state authori- 
 ties, there are many things that the nation 
 cannot do. Two brief quotations from the 
 Food and Drugs Act may serve to make this 
 clear. 
 
 This is " An Act for preventing the manu- 
 facture, sale, or transportation of adulterated 
 or misbranded or poisonous or deleterious 
 foods, drugs, medicines, and liquors, and for 
 regulating traffic therein, and for other pur- 
 poses." Section 1 provides, " That it shall be 
 unlawful for any person to manufacture within 
 any Territory or the District of Columbia, 
 any article of food or drug which is adulter- 
 ated or misbranded, within the meaning of this 
 Act." Section 2 provides, " That the intro- 
 duction into any State or Territory or the
 
 70 THE HEALTH OF THE CITY 
 
 District of Columbia, or from any foreign 
 country, or shipment to any foreign country, 
 of any article of food or drug which is adul- 
 terated or misbranded within the meaning of 
 this Act, is hereby prohibited." 
 
 These brief quotations show the limitations 
 of federal law. The Territories and the Dis- 
 trict of Columbia are under the direction of 
 Congress. The shipments of foods from state 
 to state, like export and import, can be con- 
 trolled by officers of the national government ; 
 but the traffic in food-supplies which goes on 
 within the borders of any state must be regu- 
 lated by the government of the individual 
 state. Each of these bodies politic presents a 
 different solution of the question. Certain 
 states have met the problem bravely, have en- 
 deavored to solve it by the aid of expert opin- 
 ion and without reference to the clamors of 
 special interests. Some few (a most essential 
 point) have endeavored to back up their laws 
 by boards of control, with inspectors to carry 
 out their mandates. In other cases, the cry of 
 selfish interests still dominates the assemblies. 
 Laws, if passed at all, are passed without suf- 
 ficient reference to expert advice, and by their 
 verbiage are practically nullified. The thou-
 
 THE CITY'S FOOD 71 
 
 sand demands for money which the long-estab- 
 lished departments of our commonwealths 
 bring forward, leave little to spare for the 
 newer sanitary inspection, necessary as such 
 a department is for the health of the citizen. 
 
 Multiply the difficulties of the nation by 
 fifty, more or less, and you have the difficulties 
 which confront proper food-regulations in the 
 states. Multiply the fifty of the states by hun- 
 dreds reaching into thousands, and you have 
 the difficulties which are before the munici- 
 palities when they desire properly to control 
 the food of the individual citizen. Yet, as 
 we get down to the intra-mural conditions of 
 the municipality, some balancing conditions 
 appear. These we shall consider in a moment. 
 
 That crowded concourse, the modern city, 
 which has left behind the possibilities of indi- 
 vidualistic control, has been forced, step by 
 step, to a collective control of its prime neces- 
 sities. The paving of the streets, the protection 
 of the houses from fire and theft, the educa- 
 tion of the children, have long been wisely 
 placed under the municipal government. De- 
 fective administration of these departments 
 calls for swift correction. Is the insurance of 
 the healthfulness of food, that vital question
 
 72 THE HEALTH OF THE CITY 
 
 which so intimately touches the welfare of each 
 individual, of less importance than these? 
 The body in which the control of food is 
 vested is commonly the Board of Health. 
 Have you seen headlines in your morning- 
 paper within the last year or two, referring to 
 the holding up of an appointment to that body, 
 or to the rejection of a candidate because of 
 political beliefs? How many cities have reached 
 the point of making a man trained in scientific 
 methods, especially a sanitarian, a member of 
 such a board? The medical men of such bodies 
 are doing an invaluable service. How many 
 of the problems which confront them could 
 be solved by men with the training of the en- 
 gineer? The state can do little in regulating 
 the affairs of all the municipalities within its 
 lines. The adjustment of home conditions 
 must depend upon the men whom you elect in 
 your cities. Once more, bring the matter to 
 the argumentum ad hominem : what do you 
 personally know about the health-control of 
 your own city ? 
 
 Fortunately, our instinctive training of cen- 
 turies past does much for us in the way of pro- 
 tection. The table of our earliest forbears was 
 limited in the extreme, and its variety could
 
 THE CITY'S FOOD 73 
 
 be enlarged only by experiment. A tempting 
 cluster of berries on some shrub in the neo- 
 lithic forest might be a delicious dessert, or it 
 might be a violent poison. Brave experiment 
 alone could determine which. It was a hard 
 predicament. If the early-research man guessed 
 right, he had a valuable addition to his diet. 
 If he guessed wrong, he died. Blunted as our 
 senses are by centuries of civilization, the in- 
 stinctive training which primeval man received 
 in the choice of good and bad food has per- 
 sisted to this very day. The evidence of the 
 senses is no mean aid to assist the buyer of 
 the household's food-supplies to ward off evil. 
 But the senses are an insufficient guard at 
 best. Two factors in the city are constantly 
 arrayed against them. First, the resources of 
 the man who deliberately doctors his damaged 
 goods in such a way as to disguise their real 
 condition, the seller who renders impure 
 goods savory to the taste and pleasant to the 
 eye ; and second, the desperate need of the 
 poor. And after all, defective conditions in the 
 city always bear most heavily on that class, on 
 the ones who can endure them least easily. 
 The poor suffer most from bad air, bad water, 
 and wretched food. In few respects are they
 
 74 THE HEALTH OF THE CITY 
 
 more heavily handicapped than in their choice 
 of food. The lesser cost of damaged goods is 
 a fearful temptation to the slender purse of 
 the ignorant woman of the tenements ; the 
 stores where she buys her food-supplies offer 
 but little choice for well or ill. Few more im- 
 mediate duties confront the municipality to-day 
 than the guardianship of the food of its poor. 
 
 We cannot better conditions by not recog- 
 nizing them. While money rules the world, 
 men will sell impure or damaged food-supplies 
 ignorantly or wickedly ; and since the national 
 law cannot affect the sale of goods of this sort 
 within the boundaries of the state, we must 
 pass state and municipal laws for our own pro- 
 tection. To make them effective, they must be 
 intrusted for enforcement to competent men, 
 backed by ample supplies of money. Obtain- 
 ing a maximum of control with a minimum of 
 money is a theme inseparably connected with 
 the centres of sale of food-supplies, the mar- 
 kets, abattoirs, and bakeries. That brings us 
 directly to those important considerations. 
 
 The Old World shows the market in its first 
 stage and in its last. The New World, save 
 here and there in scattered foreign quarters or 
 in the great marts of trade, shows stages in
 
 THE CITY'S FOOD 75 
 
 between. Rise early any morning in the little 
 German town, and stroll along the cobbled 
 streets to the square where the church so often 
 forms the background of the market-place. 
 There you will find the direct successor of the 
 ayopa of the Greek, the forum of the Roman. 
 The market-woman under her broad umbrella ; 
 the picturesque peasant with his rude country- 
 cart filled with fresh produce ; the frocked 
 butcher weighing a piece of meat in his niche 
 in the wall : each is selling his wares under 
 practically the same conditions that prevailed 
 two thousand years or more ago. Such mar- 
 kets offer an example of the most primitive 
 type of trade, direct barter between the pro- 
 ducer and the consumer ; a barter carried on, 
 in some German towns at least, under strict 
 surveillance of the health authorities. In more 
 than one market of that type I have seen a 
 cleanliness and an order foreign to far better 
 theoretical conditions in American cities. 
 
 Paris offered to the world the first great 
 example of the modern market, built and 
 controlled by the government. Napoleon the 
 First, warrior, statesman, jurist, and sanitary 
 engineer, found time among his many labors 
 to accomplish many salient municipal and gov-
 
 76 THE HEALTH OF THE CITY 
 
 ernmental reforms. The great " Halles Cen- 
 trales" of Paris, those iron-pillared, zinc- 
 roofed pavilions through which run covered 
 streets, were planned under his direction, and 
 Begun in 1811, in his reign. These markets 
 are said to cover not far from twenty acres, 
 and their pavilions are subdivided into numer- 
 ous tiny stalls. The early example of the Halles 
 Centrales has been carried on since by simi- 
 lar markets built in other parts of Paris, and 
 the profits which the municipality has realized 
 from these sources have been large. 
 
 London, Berlin, Vienna, and other European 
 cities soon followed Paris in the work of regu- 
 lating the food-supply, and have raised mar- 
 kets on an almost monumental scale during 
 the last half-century. The American markets 
 cannot be compared with those found abroad, 
 in size, completeness of equipment, and ease of 
 control. To particularize, such markets as the 
 Fulton or Washington in New York, or the 
 Faneuil Hall Market in Boston, are not in 
 the same class with the great modern markets 
 of the European capitals. 
 
 While the single market in the town square 
 sufficed temporarily for the small segregated 
 town, the gradual spread of population soon
 
 THE CITY'S FOOD 77 
 
 carried with it separation of the centres of 
 food-supply, so that grocery and butcher-shops 
 sprang up in every little sub-centre of popula- 
 tion. The opening of such scattered shops has 
 greatly increased the difficulty of bringing 
 food in its best condition to the consumer. 
 Berlin, with its fifteen great markets, can 
 control each one by an individual corps of 
 attached inspectors, and do this at a minimum 
 of expense. To secure thorough inspection of 
 the widely scattered food-shops of New York 
 and Chicago is vastly more expensive and 
 trying. 
 
 If we assume two premises, that a proper 
 control and inspection of food-supplies makes 
 for the good of the city, and that such con- 
 trol and inspection should be carried out at a 
 minimum of expense, four questions confront 
 the interested citizen with regard to the mar- 
 kets of the community. What are the advan- 
 tages of centralized markets as opposed to our 
 present separated ones ? What should be the 
 general location of such markets? What should 
 be the general internal construction of the 
 buildings? Should the ownership of the mar- 
 kets be vested in the public, or should they be 
 under private control ?
 
 78 THE HEALTH OF THE CITY 
 
 City reservoirs have long taken the place 
 of the garden well ; and city water, because of 
 its distribution from a main source of supply, 
 can be readily inspected for its purity. The 
 furnishing of food-supplies must always re- 
 main a problem strongly distinct from the fur- 
 nishing of the first-named great necessity ; 
 yet city water, entering at a single point and 
 radiating out through different streets to indi- 
 vidual houses, may furnish us with a valuable 
 analogy. By a system of centralization com- 
 parable to that already employed with water, 
 the establishment of centralized markets will 
 do away with a large part of the difficulty of 
 control. Such movements have proved direct 
 magnets to trade. Such markets have become 
 the centre of the food-movement of the city. 
 Centralization has shown other merits besides 
 the primary one of control. In the smaller 
 city a single market may be used for whole- 
 sale trade in the early morning hours, and 
 for retail trade during the day. In the greater 
 city a division into parts, with a great whole- 
 sale market as a main source of supply, and 
 a radial series of retail markets placed at sub- 
 centres of population and fed by the central 
 market, would seem to be the ideal arrange-
 
 THE CITY'S FOOD 79 
 
 ment. Such a hub-and-spokes arrangement 
 should prove particularly effective when we 
 consider its possibilities with regard to build- 
 ing markets for the poor, a matter to be con- 
 sidered in some detail a moment later. 
 
 The general location of the markets should 
 be determined chiefly by the conditions of 
 transportation. With vegetables and fruits, 
 as with milk, it is essential to their purity to 
 transmit them to the consumer in the shortest 
 possible space after their preparation. Those 
 markets accomplish the swiftest transfer of 
 goods to the receiver where cold-storage cars 
 can deliver directly to the doors, where the 
 laden wagons from the adjacent country-side 
 can most readily bring their fresh-gathered 
 goods, or where inland waterways or ocean 
 docks are close at hand. Every such central 
 market should have its cold-storage warehouse, 
 and its devices for supplying cold storage to 
 the tenants who rent the stalls. Convergence 
 
 O 
 
 of transportation to a single point is one 
 of the best safeguards of food. Swiftness of 
 delivery and continuance of low temperature 
 oppose the decomposing action of the plants 
 of the garden of the air. The location of the 
 sub-markets in a radial system must, of course,
 
 80 THE HEALTH OF THE CITY 
 
 be controlled by the position of the centres of 
 population. In these days of motor-wagons 
 and tube-systems of delivery, the problem of 
 transportation from a central point to the 
 minor marts becomes a by no means difficult 
 matter. 
 
 Not the least argument in favor of central- 
 ization may be found in the increased facili- 
 ties afforded as regards garbage removal. The 
 need for a satisfactory service of this kind 
 may be readily recognized when two state- 
 ments are placed side by side. The natural 
 enemies of pure food flourish almost beyond 
 belief in the organic wastes cleared from the 
 food-shop. Some of our better ordered muni- 
 cipalities think it sufficient, even in midsum- 
 mer, to collect garbage but once a day. Other 
 less progressive cities believe their duty done 
 when the accumulated wastes are removed 
 twice a week. 
 
 The construction of markets is, in its detail, 
 a matter for architect and engineer; but 
 since laymen must use the finished work, the 
 simple details laid down by William Paul 
 Gerhard, in his excellent work on the " Sani- 
 tation of Markets and Abattoirs," may be 
 quoted :
 
 THE CITY'S FOOD 81 
 
 " The chief constructional requirements [of 
 markets] are the following : 
 
 " 1. The halls must have ample light. 
 
 "2. They must not be draughty, yet be 
 well ventilated. 
 
 " 3. They must afford plenty of floor space 
 and storage room. 
 
 "4. They must have plenty of exits and 
 passageways, also driveways for the unload- 
 ing and loading of wagons. 
 
 " 5. They must be well and substantially 
 constructed." 
 
 Those five sentences sum up the require- 
 ments well. 
 
 Now for the answer to the last of the four 
 questions, public versus private control. If 
 the modern theory is correct, which assumes 
 that it is a part of the duty of the munici- 
 pality to care for the health of its citizens, it 
 is surely a legitimate function of the muni- 
 cipal government to undertake the building 
 and ownership of public markets. The trades- 
 man who rents the stall from the municipality 
 comes, by that act, directly under the rules 
 which may be laid down for the control of the 
 market. The inspector who condemns goods 
 in accordance with such rules has no mean
 
 82 THE HEALTH OF THE CITY 
 
 moral support behind him. In consequence, 
 the customer who buys his household supplies 
 from the centralized municipal market has a 
 better chance of protection than in buildings 
 where private companies, seeking the largest 
 dividends possible, may be in conflict with the 
 officers of health. Nor need such a venture 
 be an altruistic one. The ownership of public 
 markets has proved no losing venture for many 
 cities. Yet the municipality, if the movement 
 is to prove of its utmost value, should not 
 look toward making dividends, for the ultimate 
 purpose of such ownership is not the imme- 
 diate pecuniary gain, but rather that more 
 general gain that results from the better health 
 and greater energy of a well-nourished people. 
 Beyond all else, markets so built and so con- 
 trolled should result in advantage to the class 
 which needs them most, the city's poor. 
 
 Few luxuries are more expensive than the 
 five cents' worth of the poor. The cost of 
 lodging and food, two of the absolute neces- 
 sities of community life, is a tremendous prob- 
 lem to the great majority of the city-dwellers. 
 To the poor the margin by which these are 
 secured at all is scant indeed. It is the more 
 pitiful, therefore, that only in the luxurious
 
 THE CITY'S FOOD 83 
 
 shops of the rich do foods cost as much as 
 among the tenements. The small quantities 
 consumed, the meagre variety, the hand-to- 
 mouth method of buying, all combine to 
 make the nourishment obtained far less than 
 it should be for the money expended. 
 
 Municipal markets placed less to accommo- 
 date, the rich or well-to-do than to reach the 
 buyers of the tenement district, markets whose 
 stalls offer the variety desired by the many 
 races who make up our cosmopolitan whole, 
 are a most immediate necessity. The Italian 
 emigrant woman, bewildered for years by a 
 new land and by strange customs, will seek 
 the dirty Italian shop in the back street, if 
 there are no stalls in the public building where 
 she can chaffer in her own tongue. The ex- 
 tortion of the small shop cannot continue 
 where the entering buyer passes a hundred 
 stalls offering the same quality of goods. 
 Once more let us reiterate a salient point. The 
 cost of stalls in such markets, the necessary 
 running expenses for keeping up the busi- 
 ness, should be distinctively lower than those 
 charged by the tenement landlord outside. 
 The municipality cannot afford to have its 
 markets too profitable an investment. Sick-
 
 84 THE HEALTH OF THE CITY 
 
 ness from poor food, lack of energy from in- 
 sufficient nourishment, are fearful drains on 
 a city's total resources. The proper control of 
 markets is a step along the lines of preventive 
 medicine. 
 
 The meat-stall of the market must buy its 
 goods from the slaughter-house or abattoir. 
 No other part of the providing of the city's 
 food has come to the attention of the public 
 as has this single trade. Mr. Upton Sinclair's 
 novel " The Jungle " ; the report of the commis- 
 sion named by President Roosevelt to consider 
 conditions in the abattoirs ; the work of the 
 illustrated weeklies and the daily newspapers, 
 all have combined to stir the public deeply. 
 The past is a matter of history, and the former 
 conditions of many of the slaughter-houses 
 have proved to be wretched beyond belief. 
 The reforms accomplished have already been 
 considerable, a result due largely to the fact 
 that most of the abattoirs are engaged in 
 interstate commerce, which fact places them 
 under the control of the national government. 
 Numerous smaller abattoirs catering to local 
 trade still exist, however, and the same general 
 statements that apply to the public ownership 
 and control of markets may well apply to these.
 
 THE CITY'S FOOD 85 
 
 Certain characteristics of the work of the 
 abattoirs differentiate their problems from 
 those of the markets. The very nature of their 
 business is of a more filthy and disagreeable 
 sort, and demands especial precautions with 
 regard to cleanliness and the preservation of 
 the products. The wholesale nature of the 
 trade allows the abattoir and the stockyards, 
 which normally are adjacent to it, to stand in a 
 location outside the centres of population. Not 
 only the unpleasant features of the slaughter- 
 ing business, but also the odors due to utili- 
 zation of the by-products, such as the making 
 of soap and the handling of hides, horns, and 
 hoofs, make it extremely inadvisable to locate 
 abattoirs in residential sections of any class. 
 
 One model abattoir erected recently in New 
 York has commonly been referred to of late 
 as presenting an excellent example of what 
 a plant of this type should be. Abattoirs may 
 be divided into two general classes : those but 
 a single story high and extending over a con- 
 siderable ground area, and those which are 
 several stories high and extend over a com- 
 paratively limited area. The abattoir of the 
 New York Butchers' Dressed Meat Company 
 is of the second type.
 
 86 THE HEALTH OF THE CITY 
 
 In this slaughter-house the cattle coming 
 from the cars at the gates follow two white 
 bell-wethers up long graded inclines, rising 
 story after story, till the roof is reached, where 
 the pens for the steers are located. Below 
 the beef -pens are pens for calves, sheep, and 
 lambs. All of these are open to the air. From 
 the roof the operations of the abattoir go on 
 in regular order downward from floor to floor. 
 The floor below the roof holds the slaughter- 
 ing-room, where all slaughtering is done in 
 " kosher " fashion . Below are the refrigerating 
 rooms, which are kept at a constant tempera- 
 ture of two degrees above freezing. Below 
 these are rooms for the utilization of the vari- 
 ous by-products of the slaughtering. Every 
 part of the animal is used for one purpose 
 or another, and cleanliness is the law of the 
 establishment from start to finish. 
 
 The market stands before our eyes : the 
 abattoir carries on its work beyond our vision. 
 Yet the same need exists for both, control 
 brought into being and sustained by a firm 
 public spirit, a reliant public opinion. 
 
 The bakery, a third general distributor 
 of food-supplies, needs the same protection 
 against the enemies of food as that claimed by
 
 THE CITY'S FOOD 87 
 
 the market and the abattoir ; centralized mu- 
 nicipal ownership is hardly practical in this 
 case, but the need of civic regulation is a vital 
 one, which presses more urgently year by 
 year. 
 
 The disappearance of the art and practice 
 of cooking in the homes of the city is one of 
 the noteworthy signs of the age. The girl in 
 employment, whether she gains her wage by 
 labor in the mill, the department-store, or the 
 office, has had little chance or inclination to 
 take up the household sciences before marriage. 
 Her mother, though of the generation before, 
 is likely to have had much the same experience 
 as the daughter, can offer but slight knowledge, 
 and has little skill as a teacher. As an inev- 
 itable result, thousands of families fall back 
 on the baker to make up in some part the defi- 
 ciency in home training. City after city uses 
 baker's loaves to the number of tens and hun- 
 dreds of thousands. The enormous increase in 
 the production of cooked food in the city is 
 pregnant with matter for careful consideration. 
 
 Stand waiting for your car beside a corner 
 bake-shop, when the mills are pouring out their 
 living stream at night. Watch the long line 
 entering the bakery, standing at the corner,
 
 88 THE HEALTH OF THE CITY 
 
 receiving the evening loaf or leaving the doors 
 laden with pastry and cake. Much of the hake- 
 shop's wares offer a soil as fertile for bacterial 
 hosts as the goods of the market can afford. 
 The market's goods are commonly uncooked. 
 They must pass through the antiseptic pro- 
 cesses of cooking. The bake-shop's viands are 
 cooked and ready to be eaten. Note the cloy- 
 ing, sickish smell about the ordinary bake-shop 
 on a summer's day, and observe the swarms of 
 flies striving for entrance. Flies are notorious 
 carriers of disease. The bake-shop, the source 
 of most of the cooked food of the community, 
 offers a problem distinct from, but no less 
 important than, that of the market or the 
 abattoir. 
 
 The salesroom of the bakery may or may 
 not be attractive, but the real crux of the prob- 
 lem does not lie there. You will find that in 
 the bake-room, commonly a close room situated 
 behind the shop, or perhaps below it, in a dim 
 cellar. Strange to say, the condition of the 
 bakeries, with their possibilities of the direct 
 transmission of disease, has been largely over- 
 looked in the crusade that has gone on dur- 
 ing the last few years. Grave possibilities of 
 danger inhere in unclean bake-houses, heavy
 
 THE CITY'S FOOD 89 
 
 with fetid air, hot with the constant radiation 
 of the ovens, and fouled by the burning of 
 gas-jets that strive against the dusk at mid- 
 day. Massachusetts has done good work in 
 clearing up the wretched bakeries of the slums, 
 and for this the Commonwealth should be 
 given credit. Here are two quotations from 
 the state law on the subject which are aimed 
 directly against certain of the chief evils which 
 exist in this trade. 
 
 Chapter 75 of the Revised Laws of Massa- 
 chusetts provides in Section 20 : " All build* 
 ings which are occupied as biscuit, bread or 
 cake-bakeries shall be provided with a proper 
 wash-room and water-closets, having ventila- 
 tion apart from the bake-room or rooms ; and 
 no water-closet, earth-closet, privy, or ash-pit 
 shall be in, or communicate directly with, the 
 bake-room of any bakery." Section 29 says : 
 " Furniture and utensils in bake-rooms shall 
 be so arranged that they and the floor may at 
 all times be kept clean and in good sanitary 
 condition." 
 
 Space is precious in the tenements. Air and 
 light are costly. The salesroom shows. The 
 bake-room is hidden. Only through municipal 
 or state control and proper inspection can we
 
 90 THE HEALTH OF THE CITY 
 
 be sure that the evils of the bake-shops are 
 avoided. Nor should this subject be closed 
 without reference to the individual public spirit 
 of some of the men engaged in the bakery 
 business on a large scale. Some of them have 
 done excellent work in this regard, and their 
 efforts should receive a greater support from 
 the community. With the exception of the 
 large biscuit or cracker bakeries, the national 
 laws in general have nothing to do with these 
 food-producers. Their trade is commonly car- 
 ried on within the confines of the city which 
 they serve. 
 
 The sinister threads which mark the path- 
 way of the pathogenic organisms, of the germs 
 of disease, run blackly through all the discus- 
 sions of those common necessities of mankind, 
 air, water, and food. Ever at the gates, 
 they watch for the chance opening which shall 
 give them entrance. Control of the diseased 
 employee, the tuberculous patient, should not 
 be confined to his relation to air, water, and 
 milk : every man who hancllss food-supplies in 
 market or abattoir, every worker in the bake- 
 shops, should undergo constant and vigilant 
 inspection. The danger of food injured by 
 decomposition may be somewhat less in the
 
 THE CITY'S FOOD 91 
 
 bakery than in the market or abattoir, but the 
 danger to the public from adulteration, substi- 
 tution, or the transmission of disease is quite 
 as great. 
 
 Back through the hurrying, home-bound 
 crowds, into the dusk where the lamps are 
 gleaming, returns the city worker at the close 
 of day. Whether the weariness of the night 
 gives place to rest and power in the morning 
 depends largely upon the food that the home 
 table provides ; and the healthfulness of that 
 food, gathered as it is from many different 
 sources, must be controlled by the individual 
 citizen, in the end. Only by the deterrence of 
 the knowing criminal who furnishes impure 
 food, and by the teaching of the ignorant, 
 can general safety be secured. Nor is it enough 
 to insure our own safety only. This complex 
 latter-day organism, the city, when injured in 
 one fibre, transmits the hurt throughout its 
 frame. Whether we wish it or no, to keep our- 
 selves, we must be our brother's keeper. Only 
 when we strive to guard our neighbors as our- 
 selves are our own walls secure.
 
 IV 
 
 THE FOOD OF THE INDIVIDUAL 
 
 POWER is the text of half the industrial ser- 
 mons preached to-day. It is the factor which 
 demands the conservation of our forests, our 
 rivers, and our other national resources. It is 
 the strenuously sought goal of mechanical en- 
 gineer and of electrical engineer, of student 
 of hydraulics and of aeronautics. Scarcely 
 a month goes by without scientific journals 
 placing upon record the development of new 
 water powers, and all this change of poten- 
 tial energy into kinetic energy has to do with 
 the inanimate matter of nature ; with coal 
 burned to generate steam ; with water turning 
 busy mill-wheels; or with gases exploding in 
 cylinders and driving forward pistons. How 
 many manufacturers, watching the long stream 
 of operatives pouring from the mills at night, 
 have ever considered that the problem of in- 
 creasing the total efficiency of that hurrying 
 crowd by the in crease of the efficiency of each 
 individual might have a personal application ?
 
 THE FOOD OF THE INDIVIDUAL 93 
 
 Many an employer thinks thousands a year 
 well spent in buying good fuel instead of bad, 
 in keeping his machines at the maximum de- 
 gree of efficiency by repair and replacement. 
 Many such a man has never realized that 
 like care, as regards the substance that fur- 
 nishes both fuel and repair to his workman, 
 might bring an efficiency to his factory, an 
 increase of power to his force, which would 
 make his other saving seem trifling by com- 
 parison. 
 
 The study of food in its relation to the effi- 
 ciency of man as an individual has long been 
 recognized by the occasional student. With 
 one remarkable exception, the consideration of 
 food in its relation to masses of people, to the 
 general upbuilding of the state, is of compara- 
 tively recent growth. And to-day, much of the 
 discussion along this line is based on results 
 rather than upon causes. The body is an or- 
 ganization of many chemical compounds sub- 
 ject to nature's immutable laws. The foods 
 which repair lost tissue or provide heat and 
 power are chemical compounds as well. Since 
 all food problems concern both body and foods, 
 some mention of the composition of the foods 
 and some review of what has been happily
 
 94 THE HEALTH OF THE CITY 
 
 termed "the human mechanism" may not be 
 amiss. We shall turn from that review to con- 
 sider certain problems of food which closely 
 affect the city-dweller. 
 
 The wide discussion of diet which has 
 sprung up in recent years is by no means set- 
 tled. Specialized regimes, guaranteed to pro- 
 cure immediate efficiency, have been brought 
 forth by the score. Some have persisted. 
 Many have died. It is well to pause a little 
 and consider some of the results already ob- 
 tained, to see if investigation has given us 
 any clue as to the kind of diet which will do 
 most for man. 
 
 We may state our first problem thus : Can 
 science propose any diet which will offer 
 greater efficiency than a varied three meals a 
 day? There can be little doubt in the mind 
 of one who knows anything of the kitchens 
 of the tenement houses, that it is hard indeed 
 to insure proper home food for the workman, 
 his wife, and his child. The second problem 
 before us, therefore, is : What can be done to 
 stop the tremendous waste of personal effi- 
 ciency caused by the poor food provided in 
 the home? The third problem must deal with 
 the possibility of collective instead of indi-
 
 THE FOOD OF THE INDIVIDUAL 95 
 
 vidual effort. It may be stated thus : Can cor- 
 porations or associations, dealing with masses 
 instead of individuals, give impetus to the 
 movement for proper food? 
 
 On the shelves of one of our museums re- 
 posed for years a series of cubes and cylin- 
 ders supposed to represent the proportions in 
 which the various elements occur in the body 
 of a human being of average size. I can feel 
 to-day the strange and somewhat awful fasci- 
 nation by which those longer cubes, marked 
 Ditrogen, oxygen, carbon, and hydrogen, those 
 shorter cubes, marked phosphorus, sulphur, 
 chlorine, iodine, sodium, potassium, calcium, 
 magnesium, and iron, dragged one small boy's 
 footsteps to their solemn shelf despite the 
 attractions of full-rigged models of Chinese 
 junks and armored Indian warriors. Those 
 cubes showed the essential parts of the body's 
 frame, the lifeless elements which, by the magic 
 of living processes, build up the sentient organ- 
 ism, man. Since man is compounded of these 
 elements, his food, from which alone can come 
 the structure of the body, must be made up 
 of these same substances. 
 
 The meal which provided power for your 
 morning labor or evening pleasure, however
 
 96 THE HEALTH OF THE CITY 
 
 apparently diversified it may have seemed, 
 was wholly composed of five simple classes of 
 nutrients, or substances which nourish the 
 body. These nutrients are built up from the 
 elements just given. Though some students 
 divide the foods into more divisions, the five 
 classes of nutrients which we shall consider are 
 proteids, carbohydrates, fats, inorganic salts, 
 and water. Each does its special part, some 
 by producing tissue or a form of energy, some 
 by aiding the processes by which other mem- 
 bers of the nutrients are made available. Stat- 
 ing a few of the common foods in rough per- 
 centages of these nutrients, we find that bread 
 has 37% of water, 8% of proteid, 50% of car- 
 bohydrates, 1% of fats, and 2% of salts ; milk 
 has 86% of water, 4% of proteid, 5% of car- 
 bohydrates, 4% of fat, and 0.8% of salts ; lean 
 beef contains 72% of water, 19% of proteid, 
 3% of fats, and 1% of salts ; while peas con- 
 tain 15% of water, 23% of proteid, 57% of 
 carbohydrates, 2% of fats, and 2% of salts. 
 Whether found in bread or cheese, meat or 
 lettuce, each individual of these classes acts 
 on the body in very much the same way, and 
 the relation of food to the efficiency of the 
 individual must be considered in terms of
 
 THE FOOD OF THE INDIVIDUAL 97 
 
 these basic groups rather than in terms of the 
 foods made up by them. If we eat meat, fish, 
 or eggs, we are increasing our proteid ration. 
 If we eat bread, cereals, vegetables, or fruit, 
 we are increasing our carbohydrates. If we 
 increase our amounts of butter or olive-oil, we 
 are adding fats. 
 
 Like most important modern businesses, the 
 body is a well-equipped manufacturing plant, 
 and many factors enter into its life. Every 
 productive factory must be kept in efficient 
 condition by repair. Proteids supply repair- 
 stuff to the body. In the factory a power-plant 
 must supply the energy which runs the ma- 
 chines, and a heating-plant is needed to warm 
 the rooms and give heat for various processes. 
 Carbohydrates and fats, burning in the oxygen 
 drawn in through the lungs, supply the body 
 with such energy and heat, while a part of the 
 proteids, not used for repair, does some share 
 of this work. A thorough supply of water for 
 washing, cleansing, and preparing the mate- 
 rials used is commonly required in both busi- 
 nesses. A large up-to-date establishment would 
 certainly have an interior railway to carry 
 fuel, raw materials, and completed products 
 from one point to another. The circulating
 
 98 THE HEALTH OF THE CITY 
 
 blood serves as an interior railroad, which car- 
 ries fuel, waste-supplies, and finished goods 
 through the whole human plant. In our study 
 of the nutrients, water and mineral salts, essen- 
 tial as they are, need but 1 little consideration. 
 It is the three other classes that demand our 
 attention. 
 
 The carbohydrates and the fats have a mis- 
 sion besides their chief one of the provision 
 of energy. They are the storehouse employees. 
 It is a part of their duty to see that reserve 
 supplies of food are put away in the body- 
 storehouses, in sufficient quantity to carry the 
 body along when food is scarce or when the 
 machinery is temporarily out of order and in- 
 capable of use. The exhaustion of those sup- 
 plies during illness, as exhibited in the shrunken 
 frame of the convalescent, is a common testi- 
 mony to this employment. When more of the 
 combustible compounds of this class are taken 
 than are needed for immediate use, a part of 
 the surplus is turned into fat and stored away 
 in the body against time of need. Essential 
 as such storage was when prehistoric man, 
 having breakfasted, knew not where his din- 
 ner roamed the forest, to-day that overworked 
 machinery of supply too often produces the
 
 THE FOOD OF THE INDIVIDUAL 99 
 
 disease of the well-filled table and the seden- 
 tary life, obesity. 
 
 The proteids belong to the repair staff. They 
 are those nutrients which serve to repair the 
 living moving portions of our body ; like mus- 
 cles and glands. It is this repairing power 
 which differentiates them from the more strictly 
 fuel-foods. Every part of the living tissue 
 which composes our mechanisms is made up 
 of cells, living masses of various size, each of 
 which is complete in itself. These cells are 
 themselves of proteid structure, and the nutri- 
 ent proteids are the chosen foods to which are 
 intrusted the important task of caring for the 
 cells, of building them up and keeping them 
 in condition. Two elements found in the cell, 
 nitrogen and sulphur, are found only in, and 
 can be supplied only by, proteid. No part of 
 the problem is more important to us than a 
 knowledge of proteid demands. Life is a con- 
 stant change of form, an incessant building 
 up and breaking down, and the disintegration 
 of the cell, the loss of proteid in the human 
 body, never ceases. In sickness and in health, 
 sleeping or waking, working or resting, the 
 nitrogen and sulphur of the cells is breaking 
 down and changing from living active sub-
 
 100 THE HEALTH OF THE CITY 
 
 stances to dead wastes ready for removal. A 
 constant supply of proteid in one form or an- 
 other must be received, or life stops as surely as 
 the mill shuts down when its worn-out wheels 
 and pulleys, left unrepaired, slow down for the 
 last time and stop, incapable of longer trans- 
 mitting power. 
 
 From the facts already stated we must be- 
 lieve that some proteid is necessary to life. We 
 have by no means settled how much proteid 
 is required for man's greatest efficiency. That 
 problem has long been a vexing one. The whole 
 question of how often meat and fish shall 
 appear in the diet is involved in its answer. 
 It divides into the perils of too much and too 
 little, and the man who wishes to learn what 
 to eat himself, or what to advise for others, is 
 bound to be perplexed. Carl Voit and his fol- 
 lowers form the school which believes in a com- 
 paratively large proportion of proteid or nitro- 
 genous food. This is the diet which most nearly 
 corresponds to that of the average person. 
 These students believe in general that a man 
 should take from 110 to 130 grammes of pro- 
 teid a day, a fairly generous meat diet. Re- 
 membering that all such figures are merely ap- 
 proximations, and that physical condition, age,
 
 THE FOOD OF THE INDIVIDUAL 101 
 
 occupation, and sex are all factors which affect 
 quantity in diet, we may try to translate that 
 requirement into terms of two or three foods. 
 If a man bought about a pound and a half of 
 lamb, of sirloin steak, or of halibut, ate the 
 edible portions, and took nothing else contain- 
 ing proteid all day, he would approach Voit's 
 ratio. Sirloin steak contains 16.5% of proteid. 
 Leg of lamb contains 15.9%. Halibut con- 
 tains 15.3%. Of course, in practice much of 
 the proteid taken in by any individual comes 
 from the bread, milk, vegetables, etc., of the 
 diet. It is almost never provided wholly by the 
 meat. A middle course as regards proteid is 
 held by Armand Gautier and others, who would 
 cut our meat diet by perhaps a third, and limit 
 us to 80 grammes. Probably the lowest diet 
 in point of nitrogen of those not strictly vege- 
 tarian is that proposed by Professor Chittenden 
 of Yale in the historic experiments published 
 in his book on the " Physiological Economy 
 of Nutrition." A brief resume of that research 
 follows. 
 
 Professor Chittenden divided the subjects 
 of his experiments into three general divisions. 
 The first was made up of five men of varying 
 ages connected with Yale University as pro-
 
 102 THE HEALTH OF THE CITY 
 
 fessors and instructors. These teachers repre- 
 sented the man of somewhat sedentary life, 
 the brain-worker rather than the physical 
 worker. The second group was a squad of 
 thirteen men from the Hospital Corps of the 
 army, who took moderate daily exercise in 
 the gymnasium and represented the man who 
 combines both physical and mental labor, 
 the skilled worker, for example. The third 
 division was composed of students, all Yale 
 athletes, who represented the man taking se- 
 vere and prolonged physical labor. 
 
 Each of the groups lived for some months 
 under constant observation. Each passed from 
 the common meat diet of an ordinary man, 
 110 to 130 grammes of proteid per day, to an 
 extremely low meat diet, generally less than 
 half the usual amount ; and each was not only 
 able to do a full quota of labor on the limited 
 amount of proteid which he consumed, but 
 was even able to accomplish more work and 
 keep in better health than had formerly been 
 the case. The long research ended with a firm 
 conviction in the mind of the experimenter 
 that the subjects of the experiment came into 
 "nitrogenous equilibrium" (we shall consider 
 that phrase later), and maintained a thor-
 
 THE FOOD OF THE INDIVIDUAL 103 
 
 oughly healthy condition of body and mind, 
 with about one half the proteid that the ordi- 
 nary individual uses in his diet. Professor 
 Chittenden believes that on this lower diet 
 the body increases in efficiency and undergoes 
 less strain, while a very large saving in the 
 amount of money spent for food is possible. 
 
 Remarkable as were the results of that 
 distinguished believer in a greatly reduced 
 intake of proteid, with its greatly lessened 
 diet of meat, the great hosts of individuals 
 who form the race have, through centuries o/ 
 experimental evidence, gained an experience 
 and formed a research on a vastly greater 
 scale, where the inaccuracies of observation 
 seem more than counterbalanced by the mil- 
 lions who have performed the experiment. 
 Occidental man has always taken a moder- 
 ate meat diet when he could get it ; and 
 the change from a narrower vegetarian to a 
 broader meat diet has always been a change 
 accompanying a higher standard of living. 
 The limited proteid of the peasant has never 
 seemed to give greater mental or physical 
 vigor than the larger proteid diet of his lord. 
 One point stands saliently forth throughout 
 every experiment along this line. Whatever
 
 104 THE HEALTH OF THE CITY 
 
 may be our judgment of the advisability of 
 high or low proteid, some proteid is neces- 
 sary. In the balanced ration lies safety, in the 
 proper mixing of meat and bread and vege- 
 tables, in the acquiring of sufficient proteid 
 to support "nitrogenous equilibrium." The 
 nitrogen balance is one of the keynotes of 
 modern scientific feeding. Generally speak- 
 ing, this nitrogen balance means that the 
 amount of nitrogen taken in as proteid in 
 food equals the amount of nitrogen given off 
 as waste. According to this theory, a man at 
 full labor and in good health, neither gaining 
 nor losing in weight, breaks down on an aver- 
 age as much of the nitrogen-bearing proteid 
 of his cells, in doing his work, as he puts in 
 in the form of the proteid of his food. A man 
 must take a sufficient amount of proteid to 
 take care of his repair-work, or he will be 
 infringing on his body-capital. The fats and 
 carbohydrates consumed do not balance as 
 does the proteid, since, as we have seen, that 
 part of these nutrients which is not used im- 
 mediately for heat and power is largely stored 
 in the shape of fat. 
 
 In the necessity for a nitrogen balance we 
 find man once more coming under the con-
 
 THE FOOD OF THE INDIVIDUAL 105 
 
 trol of one of those mighty laws that under- 
 lie the universe and all its manifestations, the 
 law of the conservation of energy. When man 
 absorbs sufficient nitrogen for the nitrogen 
 balance, when he preserves the ratio of other 
 foods which will support that nitrogen and 
 keep the body organs in action, he possesses 
 the necessary energy for his labors. If he 
 takes too little proteid, he uses the very sub- 
 stance of his body in carrying out his daily 
 tasks. If he takes too much, the elimination 
 of the wastes, which increase as his proteid 
 increases, becomes more than his body can 
 handle, and he overloads his machine, break- 
 ing down the organs. 
 
 The relation of this last statement to our 
 modern city life is close. As the individualis- 
 tic city home fades further and further from 
 our ken, the tribe of hotel-dwellers develops 
 more and more digestive difficulties due to 
 overloaded organs. The American who eats 
 eggs or chops for breakfast, steak at noon, 
 and fish, meat, or game at night often stores 
 up trouble for himself. Carbohydrates, whose 
 removal from the body is comparatively sim- 
 ple, contain carbon and hydrogen, which burn 
 to the gases, carbon dioxide, and water. The
 
 106 THE HEALTH OF THE CITY 
 
 body mechanism can safely carry no great 
 excess of these ; but the proteids are worse, 
 for they break down into probably delete- 
 rious compounds, whose elimination is much 
 more difficult. The average business man and 
 his wife are over-fond of proteid foods, from 
 whose elimination may come serious diges- 
 tive difficulties. The school which follows 
 Mr. Fletcher in his belief that extremely com- 
 plete and thorough mastication is one way out 
 of the difficulty, may owe no small portion 
 of the success they have attained to the fact 
 that, owing to the limitations of time, its 
 members are unable to consume an excessive 
 amount of proteid in a given period. In a bal- 
 anced ration, which provides sufficient fat and 
 carbohydrate for heat and power and suffi- 
 cient proteid for repair, lies the only safety. 
 
 Excepting among the poor, the average man 
 is more in danger of over-feeding proteids 
 than carbohydrates, but there is one instance 
 of the latter condition which should not be 
 overlooked. This danger comes from the per- 
 sistent crusade in favor of cereal products. It 
 illustrates the harm which may come from a 
 one-sided food wrongly advertised. If you 
 turn over the pages of the first advertising
 
 THE FOOD OF THE INDIVIDUAL 107 
 
 section which reaches your hand, you will see 
 that a large percentage of the foods advertised 
 there are cereals. Cereals are excellent and 
 valuable foods. It is entirely right and proper 
 to advertise them. Their advertisement be- 
 comes questionable only when the greater part 
 of the effort made is to impress on the buying 
 public the idea that these foods, and these 
 foods only, provide the ideal diet. A break- 
 fast from some of them is claimed to contain 
 exactly the ingredients needed for strength 
 and energy, while a saucer or two at luncheon 
 and a pudding made of the same substance 
 for dinner will, they consider, produce a har- 
 mony of effort of body and brain unattainable 
 in any other way. 
 
 The follower of those glowing statements 
 takes for his medical counselor and guide the 
 press-agent of the advertised food, the man 
 who is employed to sell as much as possible 
 of the product he is pushing. The man who 
 blindly follows the press agent's directions is 
 taking a grave chance. If our present beliefs in 
 dietetics point to one thing more than to an- 
 other, it is to the necessity of keeping up nitro- 
 genous equilibrium. If that is not kept at a 
 level by the feeding of proteids, the body must
 
 108 THE HEALTH OF THE CITY 
 
 draw upon its own structure to do its daily 
 tasks, an action which weakens its frame. 
 The cereals are chiefly carbohydrates. Their 
 proportion of proteid is practically never suf- 
 ficiently high to give a balanced ration. All of 
 them contain some proteid; but in order to 
 obtain this in sufficient amount for daily use, 
 the eater of cereals is obliged to overload his 
 digestive organs with so great a percentage 
 of other nutrients that he passes beyond the 
 safety-point and fills himself to repletion. 
 The steel bridge which bears a load beyond 
 its power will no more surely break than will 
 the delicate organs of the human mechanism 
 when overloads of any single type of food are 
 constantly inflicted upon them. 
 
 In the preceding discussion may be found 
 some explanation of the thousand questions 
 of diet raised in the present day. It is worse 
 than the "Battle of the Books." On the one 
 hand vegetarianism, on the other meat diet. 
 The sides of the electric car beseech us to buy 
 food to nourish brain, to produce greater 
 powers of memory, of concentration, of initia- 
 tive, or of thought. The magazines are filled 
 with pictures of magnificently formed athletes 
 accomplishing marvelous results by their in-
 
 THE FOOD OF THE INDIVIDUAL 109 
 
 dulgence in certain picked foods. It is no 
 wonder that the weary brain-worker of the 
 city, hoping for greater force, turns to foods 
 which promise immediate and special results, 
 that he tries "brain foods" or "muscle 
 nutrients." 
 
 Such search is vain. Thorough as has been 
 the study of foods in the last few years, and 
 carefully as the question has been considered, 
 there is no established ground for belief that 
 any particular food can be found which will 
 have any special effect on any part of the 
 body. So far as we can tell, the interior rail- 
 way of the human factory, the blood, takes 
 the same raw materials to the cells of the brain 
 and the cells of the hand. This statement must 
 not be taken to mean, however, that a diet 
 limited to but a few types of nutrients is as 
 good a body-builder as one which gives a 
 wider choice. The comparatively recent work 
 of Osborne and Abderhalden has shown what 
 wide differences can exist with regard to the 
 different forms of proteid found in various 
 nitrogenous foods. 
 
 Reviewing the whole body of evidence, the 
 present writer is forced to the conclusion that 
 there is no convincing proof that the average
 
 110 THE HEALTH OF THE CITY 
 
 diet of centuries past should be radically 
 changed. Most of the topics treated in this 
 book are the results of unnatural conditions. 
 Overcrowding, bad air and food are the pro- 
 ducts of the congestive rush to the cities. 
 Many, perhaps most, of the city's problems are 
 products of recent date. The period of experi- 
 mentation with these problems has been com- 
 paratively short. The period of man's experi- 
 mentation with food reaches back to the 
 cloudiest vistas of time. In most of the evil 
 conditions of the city we can see the evil forces 
 actively at work. Here we are forced to turn 
 somewhat to speculative philosophy. Some 
 things have been established. It has been 
 reasonably established that efficiency cannot 
 be obtained by any royal road of overloading 
 or of underfeeding. The rich, or those in more 
 moderate circumstances, may overload. The 
 poor, with the present prohibitive prices, are 
 but too likely to underfeed. No accepted evi- 
 dence exists that any specialized diet can give 
 any more power to muscle than to brain, or to 
 brain than to muscle. After a violent agitation 
 of the pendulum in different directions, we are 
 coming back to a greater belief in unspoiled 
 appetite than ever before. We are coming to
 
 THE FOOD OF THE INDIVIDUAL 111 
 
 recognize that the reasonable variation of the 
 ordinary table, which provides its due amount 
 of proteid, carbohydrate, and fat, is not far 
 from right. There is good experimental evi- 
 dence to show that a diet which gains its neces- 
 sary nitrogen from fish, flesh, and fowl, is wise. 
 
 Starting our next division of the subject 
 with the hypothesis that a varied, reasonably 
 plentiful diet is the one which will produce 
 the greatest efficiency, the hardest question is 
 before us. How can we supply the great mass 
 of the city-dwellers with such a diet, especially 
 with such a diet properly cooked ? Is there any- 
 thing which can be done to provide, not only 
 the food itself, but also the training which 
 shall make the provision of such food a con- 
 stantly increasing factor in the total increase 
 of efficiency of the city? There is no small 
 amount of sociology involved in the answer. 
 
 The working-man's choice of food in these 
 days when prices climb skyward is difficult in 
 the extreme. It is made much worse by the 
 tradition of the American table. The work- 
 man of a hundred years ago generally had his 
 isolated house and garden. His primary occu- 
 pation was likely to be husbandry, his second- 
 ary, manufacturing. As Whittier's father, in
 
 112 THE HEALTH OF THE CITY 
 
 the long winter evenings, is said to have sat 
 making shoes in his own house, surrounded and 
 assisted by his family, so the average workman 
 of that time preserved, like him, individualism 
 and self-respecting freedom in his industry. 
 The small garden of the worker supplied vege- 
 tables to the family from soil tilled by the 
 owner's hands; and even yet such a mixture 
 of farmer and artisan exists in many a coun- 
 try manufacturing town. To these people the 
 wealth given back by the soil and the com- 
 paratively low cost of the meats that were 
 brought by the butcher's white cart to the 
 door, resulted in a lavish table. When walls 
 of brick prisoned the worker and laid waste 
 his garden, the tradition of the earlier table 
 persisted. In whatever way the family stinted 
 themselves, the table was the last thing to be 
 affected. If the keeping up of an expensive 
 table was the only way for a family to obtain 
 sufficient nutrition, no question could be raised. 
 But it is not. Knowledge of food-values and 
 proper methods of cooking could provide quite 
 as great nutrition at far less cost. To many 
 a worker's wife a proper table long meant, and 
 in far too many cases means to-day, expensive 
 meats, prepared cereals, and even out-of-season
 
 THE FOOD OF THE INDIVIDUAL 113 
 
 delicacies. Sometimes the money for the meal 
 is almost wholly spent on meat, with all the 
 accompanying ills of an unbalanced diet. To 
 correct that especial evil there is one remedy, 
 training in marketing. 
 
 Even where the raw food is clean and 
 nourishing, cooking can ruin its potentialities 
 of good. The wife of the mill-worker is ex- 
 tremely likely to have been a mill-worker her- 
 self. The brief schooling of her youth ended 
 when she reached the minimum age of exemp- 
 tion from school. Sometimes it scarcely began, 
 for child-labor still eats the strength and sinew 
 from the republic. Too often the mill-girl 
 leaves the mill to be married, returns there till 
 her child is born, and then, despite the best 
 intentions in the world, becomes a mockery to 
 the name of home-keeper. As she is utterly 
 untrained in the science of buying food, the 
 household supplies are poorly chosen, and cost 
 far more than her husband's scanty purse can 
 afford. As she is wholly unacquainted with 
 cooking, the food which she provides too often 
 swims in grease, or is left half -raw. Cooking 
 is one of the essential steps in the provision 
 and utilization of the body-fuel. The organs 
 of digestion will not act upon many of the
 
 114 THE HEALTH OF THE CITY 
 
 foods except when they are cooked. Many a 
 man starts to work in the morning in a state 
 of actual starvation, because he has been un- 
 able to assimilate the food which his untrained 
 wife has prepared for him. 
 
 The worker in such a condition may read- 
 ily prove more of a loss to his employer than 
 would be occasioned by his mere personal loss 
 of efficiency. The average workman to-day is 
 employed in doing a minor detail of some 
 expensive operation. He cares for one single 
 action of a complicated machine. He lays the 
 single rail that bears the train. There is a 
 grave possibility that the bodily ills, which fol- 
 low insufficient nutriment, may cost money 
 and lives. The tendency to drunkenness among 
 the proletariat comes in many a case from a 
 desire to obtain quick energy not supplied by 
 proper food, or from a wish to deaden the 
 pangs of that frightful disease, the indigestion 
 of the poor. 
 
 More than one factor determines the effi- 
 ciency of the workman, the living mint of the 
 city. Some of these have been stated elsewhere. 
 One we may state here. Back of campaigns of 
 education or socialistic propaganda stands the 
 necessity of training the wife of the worker
 
 THE FOOD OF THE INDIVIDUAL 115 
 
 in choice of foods and in cooking. The train- 
 ing of schoolgirl or woman in household arts 
 is more than an uplift to the immediate pre- 
 sent : it is the way of safeguarding the future. 
 The workman's wife, untrained herself, can- 
 not educate her daughter. 
 
 We can go far beyond any single class. The 
 women of America of the present generation 
 are, as a whole, untrained in the one vocation 
 by which they can give the greatest efficiency, 
 the vocation of home-keeping. They are 
 especially deficient in the most important art 
 in that vocation, the art of cookery. We are 
 escaping from that well-worn myth which still 
 declares that the only place to train the man is 
 in the workshop, to train the woman is in the 
 home. Half a century ago we were a nation of 
 individual homes, and could show great num- 
 bers even of city housewives skilled in house- 
 hold arts. To-day it is the exceptional city 
 girl who has the opportunity at home to ob- 
 tain more than a fragmentary training in the 
 one profession above all others which she is- 
 likely to pursue. The new vocational school, 
 which trains girls to cook, to understand the 
 choice of foods, and to unravel some of the 
 thousand problems of household economics,
 
 116 THE HEALTH OF THE CITY 
 
 is doing a work heretofore omitted, at a tre- 
 mendous cost, from the scheme of education. 
 Conferences on the industrial training of 
 woman, the establishment of new industrial 
 schools, the enlargement of old curriculums to 
 include instruction of an industrial character, 
 all show a striving unrest which will inevitably 
 pierce the clouds which hang over any new ed- 
 ucational movement. As some one has wisely 
 said : " Systems of education, conceived hun- 
 dreds of years ago by celibate monks for the 
 training of men, will not suffice for the training 
 of the wives and mothers of the twentieth cen- 
 tury." In that Utopian day when the city recog- 
 nizes that money spent in teaching its girls the 
 arts of the home brings back direct dividends 
 in the efficiency of the men who are its work- 
 ers, we shall find a whole series of schools, 
 fitted to occupy certain definite places in the up- 
 lifting forces of the community. Each of these 
 may be found, at least in its beginnings, to-day. 
 Some of the women's colleges are already train- 
 ing teachers and social workers, who are to be 
 missionaries in the field of true domestic re- 
 form. Here and there may be found secondary 
 schools which are teaching womankind to bring 
 homes into being where skill of brain joined to
 
 THE FOOD OF THE INDIVIDUAL 117 
 
 skill of hand may send forth well-nourished, 
 efficient men and women into the battle of life. 
 Occasional trade-schools are meeting the needs 
 of those girls who must earn, and whose fami- 
 lies are unable to support them through sec- 
 ondary schools. Few of the trade schools pro- 
 per limit themselves to training for a definite 
 trade. In most of them the girl has such in- 
 struction in domestic matters as enables her to 
 care for her own home and cook her own food, 
 great aids to healthy, pleasurable existence. 
 Such education gives permanent assets to 
 every pupil, for these arts are of value to any 
 woman, both during her wage-earning life and 
 when she is laying the foundations for happy 
 family relations after her direct wage-earning 
 existence is over. 
 
 One great hope of those who look for the 
 endurance and success of our republic lies in 
 the power of the nation to assimilate vast 
 hordes of immigrants by means of conscious 
 and unconscious education. What type of con- 
 scious education could do more than voca- 
 tional schools to train the immigrating, illit- 
 erate woman in the possibility of using the 
 opportunities about her? Our modern hurry 
 tends to break down the women quite as much
 
 118 THE HEALTH OF THE CITY 
 
 as the men for whose domestic welfare they 
 are responsible. The woman-worker who, be- 
 cause of her ignorance, subsists on tea and 
 toast, who becomes as much a slave to her 
 coffee as any man to his dram, as well as the 
 woman who, because of ignorance, lives in 
 constant terror of her servant's departure, will 
 disappear before the oncoming knowledge of 
 the new training. Amazing as are the num- 
 bers of women employed in a thousand varied 
 occupations, those employed as keepers of 
 the house and of the home far outshadow and, 
 so far as human foresight can foresee, must 
 always outshadow, all the rest. The efficiency 
 which the foods of the city can give, must 
 spring, in the last analysis, from the power of 
 woman. 
 
 The municipality may do much in provid- 
 ing a training for women which shall raise 
 the home-standards of food ; but that, at best, 
 is a long process. It is entirely possible that 
 employers of labor can do more immediate 
 good of the kind that produces immediate 
 returns, by considering the opportunities for 
 increased efficiency that are open to commu- 
 nity-kitchens. The provision of model factory- 
 luncheons is a very different matter from the
 
 THE FOOD OF THE INDIVIDUAL 119 
 
 provision of corporation-owned houses. The 
 factory-luncheon is an open competitive busi- 
 ness, which attracts only because it gives 
 greater value for the same money than the 
 employee can get elsewhere. It may be made 
 of great value both as a source of energy and as 
 a model. It is a very serious matter for a man 
 to lose his home and his employment simulta- 
 neously. It is of no great importance for him 
 to lose his luncheon with his job. It is a very 
 costly affair for employers to house their work- 
 men. It is a minor expense for them to pro- 
 vide excellent luncheons at cost price. A word 
 of an experiment made along this line by one 
 of the earliest and greatest of American scien- 
 tists may be well worth consideration. 
 
 To find the genesis of reform in the prob- 
 lem of the food of the community, we must 
 turn back more than one hundred years, to 
 that North Woburn 'prentice-boy who became 
 soldier and philosopher, diplomatist and privy 
 councilor, and who, at the height of his ca- 
 reer, ruled the Kingdom of Bavaria, Count 
 Rumf ord. A possessor of autocratic power, he 
 was able to carry out one of the most sweep- 
 ing experiments in practical philanthropy ever 
 attempted. On January 1, 1790, by the use
 
 120 THE HEALTH OF THE CITY 
 
 of both civil and military power, Rumford 
 gathered in one mass the whole body of beg- 
 gars about the capital of the kingdom, sweep- 
 ing them together like a school of fishes in 
 a net. Having brought them together, he de- 
 termined to reform them, and decided to do 
 this, as he says, " Not as in the usual method 
 of philanthropy, making people virtuous and 
 then happy, but rather happy and then virtu- 
 ous " ; and this because " it is most undoubt- 
 edly much easier to contribute to the happi- 
 ness and comfort of persons in a state of 
 poverty and misery than by admonitions and 
 punishments to improve their morals." 
 
 Of Rumford's various steps to accomplish 
 that end, the one which most concerns us here 
 was the success of his community-kitchen. He 
 changed his beggars in six years from being 
 a drain on the state, amounting to thousands 
 on thousands of florins annually, to an asset 
 which produced a considerable net profit after 
 expenses of every kind had been deducted. 
 The chief element in Rumford's success was 
 undoubtedly his development of industrious 
 habits where before had existed habits quite 
 the opposite ; but next in importance to that he 
 himself placed the triumph of the commissa-
 
 THE FOOD OF THE INDIVIDUAL 121 
 
 riat. By careful experimentation, he was able 
 to feed his beggars with wholesome, attractive, 
 and satisfying fare at a low general cost. 
 
 Rumf ord worked in the dawn of scientific 
 discovery, peering ahead into unknown land 
 where no explorer's feet had trod. To-day we 
 find but slowly gaining ground the recognition 
 of the employer that his well-fed, well-housed, 
 happy workman is a source of direct profit. 
 Eleven decades have passed between Rum- 
 ford's practical recognition that the well-fed 
 man produces most, and the welfare better- 
 ment work of the great factories of the present 
 day : a century filled with endless experiments 
 along moral and charitable lines, with but 
 little recognition of one basic fact, that the 
 worker can be made far more productive by 
 improving his environment. 
 
 The model factory of the present day should 
 attack the question of community-food by the 
 aid of all the data at command. Its welfare 
 work should be a recognized department, en- 
 titled to support as much as its selling depart- 
 ment ; and whatever else the social workers do, 
 the problem of food should not be forgotten. 
 The old noon-lunch taken from a tin pail, 
 containing cold coffee, white-livered pie, and
 
 122 THE HEALTH OF THE CITY 
 
 hunks of ill-baked bread, persists in most of 
 our factories, but here and there can be found 
 one where the noon hour means long white 
 tables and hot, nutritious food, at a minimum 
 price. The daily lunch of such a factory does 
 far more than supply that single meal : it sets 
 a new standard for the home. The workman 
 who finds good food at the luncheon-table is 
 very likely to desire it for his other meals ; and 
 the follow-up system of the factory's welfare 
 department should meet that desire by cooking 
 and housekeeping lessons for the wives and 
 daughters of the workers, which may be given 
 in classes and in the homes. The eagerness to 
 learn on the part of many is pathetic, and the 
 good influence of a single factory luncheon- 
 table may spread over a whole community. 
 
 That lunch-rooms for employees can be 
 made practical under varying conditions has 
 already been shown by no small number of 
 employers. The Waltham Watch Company 
 of Waltham, the Westinghouse Companies of 
 Pittsburg, the Curtis Publishing Company of 
 Philadelphia, and many others have done much 
 experimental work of value. The manufac- 
 turer who recognizes the difficulty of the 
 problem and yet desires to solve it will find
 
 THE FOOD OF THE INDIVIDUAL 123 
 
 value in the five questions formulated by the 
 National Civic Federation in its Conference 
 in Welfare Work held some time ago. These 
 follow. 
 
 " In establishing lunch opportunities 
 
 " 1. What is the first practical step ? 
 
 " 2. Should the company take the initiative 
 or encourage and await suggestions from the 
 employees? 
 
 "3. Once established, should the lunch 
 facilities be carried on by employer or em- 
 ployees, by both, or by an outsider ? 
 
 "4. Should employees pay for all lunch- 
 eons? 
 
 " 5. To what have the many failures been 
 due?" 
 
 If the individual employer uses those ques- 
 tions and makes the matter personal by 
 amending that last question to read 
 
 " What can the failures of others show me 
 as to methods I should avoid and other 
 methods I should pursue ? " 
 he will at least have a groundwork on which 
 to build. 
 
 So many urgent interests engage the atten- 
 tion of our agencies for social reform, that 
 careful determination of the food problems of
 
 124 THE HEALTH OF THE CITY 
 
 the city, followed by systematic instruction in 
 the methods best suited to individual cases, is 
 rarely found. One personal episode showed me 
 a possibility of greater accomplishment than I 
 had ever seen before. I had spent the evening 
 among the varied activities of St. George's 
 Parish in New York, and my conversation with 
 some of the workers was nearly ended. The 
 old question of fitting the instruction to the 
 individual arose. One turned to another. " How 
 about your new idea in that direction ? " We 
 turned to hear the reply : " I am trying to 
 work out a course which will give the girls the 
 most nutritious, least expensive, and most easily 
 prepared meals that can be cooked over a 
 single gas-light in a hall bedroom." There you 
 have it epitomized. Thousands of girls living 
 in New York on the barest living wage ; morn- 
 ing and evening meals that must be had ; the 
 gas-burner as the only means of heat. There 
 were the factors. The problem must be solved 
 by their use. 
 
 The community - kitchen, in theoretical 
 rather than in practical form, still remains a 
 burning question in our households. The ser- 
 vant class is diminishing in quantity and in 
 quality. The influx to the crowded city con-
 
 THE FOOD OF THE INDIVIDUAL 125 
 
 stantly increases. The number of tired house- 
 wives chained to the weary routine of seem- 
 ingly endless tasks seems all too great. Why 
 has not the community-kitchen proved the 
 way out ? One reason may be that many such 
 experiments have begun at the wrong end. 
 Most of the community-kitchens which have 
 lived and failed have been started among 
 the comparatively well-to-do, who had a con- 
 siderable privilege of choice. There seems to 
 be no apparent reason why the tremendously 
 overburdened factory-worker's wife should not 
 receive such a kitchen with quite as much wel- 
 come as her richer sister. From the successes 
 which the welfare workers of the factories have 
 gained in their attempts to initiate food cru- 
 sades, the opening of community-kitchens for 
 the operatives' families of some of the great 
 manufacturing plants should not be Utopian. 
 One thing is sure : Count Rumford's concep- 
 tion seems plausible. It is difficult to amuse, 
 reform, and educate the man with an empty 
 stomach. It is easier to do it with the well-fed 
 individual. 
 
 The making of food aU that it should be 
 involves many complex problems of sociology 
 and natural science. One of these problems
 
 126 THE HEALTH OF THE CITY 
 
 seems solvable to-day by specialized education, 
 by the training of the women of the great city 
 and of the village, of rich and of poor, in 
 household arts. The solution of the rest of 
 the problem must depend primarily on two 
 groups of workers, on the investigators in 
 the laboratory, whose untiring researches are 
 gradually reducing dietetics to a science, and 
 on the public spirit of societies and corpora- 
 tions which stand ready to make this further 
 effort, to take this next step in the better- 
 ment of life to the individual. From all these 
 agencies may come, in time, the realization of 
 our purpose, increase of the total efficiency 
 through the individual's gain in power.
 
 CITY WATER AND CITY WASTE 
 
 ON the Campagna, still dominating the soft 
 Italian landscape, stand the great aqueducts 
 by which water was brought to the imperial 
 city. In the time of the Roman engineers, 
 the necessity of an adequate supply of water 
 was recognized ; yet even to the present day, 
 quantity of water has been the first step, and 
 quality, when considered at all, the second. In 
 no place has this condition been more apparent 
 than in the United States. England, by her 
 wide-reaching systems of great reservoirs fed 
 by the waters of small streams ; France and 
 Austria, by their mountain-spring supplies, 
 necessitating hundreds of miles of aqueducts, 
 trailing their way from the upper slopes 
 through meadows and vineyards to the towns 
 and cities; Germany, with her enormous purifi- 
 cation plants for treating polluted river waters, 
 all have taken more national interest in the 
 problems of public water-supply than has the 
 United States. In this country there are many
 
 128 THE HEALTH OF THE CITY 
 
 excellent water-supplies, but there are many 
 others still existing in a most imperfect state, 
 furnishing with every gallon of water the pos- 
 sibilities of disease. 
 
 Great bodies of men have concentrated in 
 the cities during the last half century. With 
 this concentration centres of population have 
 emerged from the condition where every man's 
 water-supply was his well, his sewage-plant 
 the cesspool in his own yard ; and, with many 
 another collective change, we have come to 
 a common source of water and a common dis- 
 posal of sewage. To guard the purity of the 
 common water and to insure safe methods 
 of sewage disposal is a great task, for without 
 such guardianship, grave and deadly danger is 
 at the city's side. A single failure of this sort 
 may well recall the gravity of the problem. 
 
 In April, 1885, the town of Plymouth, 
 Pennsylvania, contained some eight thousand 
 men, women, and children. The general health 
 was excellent, and the water-supply, from a 
 clear mountain spring far above the town, 
 seemed unusually good. Like a whirlwind came 
 the plague. Out of that eight thousand, eleven 
 hundred and four contracted typhoid fever, 
 and one hundred and fourteen died. Rich and
 
 CITY WATER AND CITY WASTE 129 
 
 poor alike were taken, and through every part 
 of the town, highlands as well as lowlands, 
 the fever raged. And this terror came from 
 a single case of typhoid, brought back from 
 a great city whose polluted waters caused the 
 fever. This case existed in one of the only two 
 houses that could contaminate the water-sys- 
 tem. From this source came the decimation of 
 the little town far below. The story of such 
 water-borne epidemics as this, and the solution 
 of the problem of prevention by the sanitary 
 engineer, form one of the most fascinating 
 chapters in the never-ending war against dis- 
 ease. 
 
 Disease is ordinarily caused by preexist- 
 ing disease in man or another animal. Here 
 is a bold statement that is often forgotten. 
 Typhoid fever and Asiatic cholera from the 
 intestinal germs of former cases, scarlet fever 
 and measles from the skin-excretions of con- 
 valescing patients ; yellow fever and malaria 
 through the mosquito in which the disease-germs 
 pass a portion of their life, case after case of 
 the truth of this theory might be cited. More- 
 over, if we accept the germ theory of disease, 
 we must believe that many classes of ailments 
 owe their origin to certain definite micro-or-
 
 130 THE HEALTH OF THE CITY 
 
 ganisms, each of which belongs specifically to 
 a separate disease. It is well known that these 
 bacteria, entering the body in sufficient num- 
 ber, find there a comfortable lodging-place 
 where they may grow and multiply. A pecul- 
 iarly favorable ground for the cultivation of 
 certain of these micro-organisms is furnished 
 by the alimentary canal. Water is the chief 
 substance to pass through this channel. Ty- 
 phoid fever and Asiatic cholera are water- 
 borne. Water, pouring from the hillside down 
 to the lake or river, has no selective power by 
 which it can avoid carrying on disease-germs 
 in its path. Evidently, it is of vital importance 
 for us to know the possibilities of disease in 
 water, and how prevention may be secured. 
 
 Of all possible sources of bacterial infection 
 of water, sewage stands easily first. Sewage, 
 the collected organic wastes of community 
 life, is the home of myriads upon myriads of 
 bacteria. With the necessity for a common 
 sewer has come the problem of such a disposi- 
 tion of sewage that there shall be no possibil- 
 ity of admixture with the water-supply. The 
 coast cities can use the sea for such disposal, 
 but the great mass of our population is inland. 
 Large towns and cities must depend on large
 
 CITY WATER AND CITY WASTE 131 
 
 bodies of water for their water-supply. The 
 danger that these waters may contain pollu- 
 tion from sewage is one which should be 
 avoided at any cost. 
 
 Each pipe and faucet bringing water into 
 the private home or public fountain is a gate 
 by which disease may enter, if proper safe- 
 guards are not placed in the way. Let us con- 
 sider what barriers, natural and artificial, may 
 be raised against such entrance. 
 
 Two classes of water are recognized by the 
 sanitary engineer. Ground-water is the first, 
 in which class ultimately belongs the great 
 body of atmospheric water falling to the soil. 
 This water directly penetrates the interstices 
 of the surface-earth, and sinks to a greater 
 or less distance. Surface-water, on the other 
 hand, is that water which strikes non-perme- 
 able soil, and rolls from rocks or flows from 
 clayey earths directly into streams or ponds. 
 These larger bodies, as well as their visible 
 supplies, are also called surface-water, although 
 they are fed to a large degree by ground- 
 waters from below. It is in the water on the 
 surface of the earth that one finds the chief 
 source of peril. The rushing stream or quiet 
 brook gathers the various impurities along its
 
 132 THE HEALTH OF THE CITY 
 
 road and disseminates them as it passes on, 
 while, to add to the difficulty, other pollution 
 may come from industrial and organic wastes 
 sent forth from factory and town along the 
 shore. 
 
 Ground-water, as it passes into the earth, 
 receives a natural filtration marvelously thor- 
 ough in its action. In this straining and cleans- 
 ing of the water entering the soil we find 
 the first of the natural barriers placed against 
 the foe. A porous earth is a storehouse of bac- 
 teria ; the richer the soil, the more fertile 
 and open the ground, the greater will be the 
 multitudes of bacilli spread to an indefinite 
 extent throughout its masses, since here are 
 found all the advantages to foster the life of 
 the germ, darkness, moisture, and food. As 
 the water passes down through layers rich in 
 micro-organisms, some filtration proper un- 
 doubtedly .takes place. Important for purifi- 
 cation as well is the fact that the bacteria 
 in its path rob the traveling liquid of its or- 
 ganic matters, the food of the germs. This 
 action is so effective as soon to make bacte- 
 rial existence impossible. In consequence, the 
 purity of the ground-waters is marked ; and 
 when taken from deep cavities, by means of
 
 CITY WATER AND CITY WASTE 133 
 
 driven wells, they make a serviceable type of 
 water-supply. A possible hardness from dis- 
 solved inorganic matters, and a tendency to 
 develop vegetable growths under the action of 
 light, are two difficulties with such a source. 
 Far more serious, however, is the fact that 
 such a supply in most cases is small in amount, 
 owing to the slight extent of the natural res- 
 ervoirs. 
 
 The limited supply of ground-water has 
 forced the great mass of communities to the 
 use of surface-water. With this source the first 
 point of defense must be the control of that 
 territory from which the supply comes. No 
 point in the chain of defense against the 
 invading germ is of more importance than 
 complete control and proper supervision here. 
 The results of overlooking this necessity have 
 already been noted in the case of the town 
 of Plymouth ; and widespread epidemics have 
 often come from a single source of infection 
 on the watershed. In Germany, England, and 
 America it has repeatedly happened that in 
 towns with two sources of supply, one pure and 
 the other impure, those who used pure water 
 have escaped, while those who used the pol- 
 luted liquid have perished. More thoroughly
 
 134 THE HEALTH OF THE CITY 
 
 to safeguard the Metropolitan Water-Works 
 System in Boston, for instance, neighboring 
 towns and cities, whose drainage might even 
 remotely affect the water furnished by the 
 system, have been obliged to install sewage- 
 disposal plants. 
 
 Geological conditions and the natural slopes 
 of the land prevent many cities from using still 
 waters collected in reservoirs or impounding 
 basins, and they are forced to resort to more 
 or less polluted lakes and rivers. Even under 
 this necessity, how has it come about that so 
 many water-supplies are taken directly from 
 polluted sources, without a single cleansing of 
 the raw water? The answer in many cases must 
 be that such systems were installed during the 
 prevalence of the theory that " running water 
 purifies itself." This theory was based on the 
 fact that fouled running water soon became 
 bright and clear. The chemical analysis showed 
 that less organic matter was present at the lower 
 than at the higher point where wastes had 
 entered. Moreover, the slight knowledge of 
 bacterial water examination of that day was in- 
 sufficient to show that the germs of disease had 
 not disappeared between the two points to the 
 same extent as had the other organic matter.
 
 CITY WATER AND CITY WASTE 135 
 
 On the contrary, it is now known that stor- 
 age water-systems which keep potable water 
 for periods of time in lake or reservoir have a 
 purifying tendency. This purification is due 
 to the fact that parasitic bacteria in the low 
 temperature, the sunlight, and the scant food- 
 supply of a reservoir or lake where organic 
 matter is practically absent, have at best a 
 struggle for existence. Many must succumb, 
 since disease bacteria of the water-borne varie- 
 ties are adapted to the warmth and moisture 
 of the alimentary canal. Such germs as these, 
 accustomed as they are to an easy existence, 
 die when brought into conditions where hardier 
 organisms might survive. 
 
 Storage is sometimes impossible to attain. 
 Communities must occasionally depend on river 
 waters at their doors. Yet no town placed on 
 a river-bank and unable to obtain long stor- 
 age need be forced to use polluted water or lie 
 defenseless against the bacterial assault. One 
 safeguard stands preeminent to-day : the filtra- 
 tion of water under conditions which remove 
 not only its turbidity and color, but even much 
 of its bacterial life as well. Water-filtration 
 proper, as opposed to sewage-filtration, is a 
 mechanical operation, a straining out, not only
 
 136 THE HEALTH OF THE CITY 
 
 of dust and dirt, but also of the infinitely small 
 inhabitants of the liquid, these inhabitants 
 being such tiny living organisms that tens and 
 hundreds of thousands of them may float un- 
 seen in a teaspoonful of water. Let us journey 
 through the chain of fortifications used in the 
 treatment of water by a system of continuous 
 filtration. 
 
 To remove any grosser forms of residue, 
 such as gravel and waste, the raw incoming 
 water, known as the affluent, is turned into a 
 great reservoir with massive sides, called the 
 settling or sedimentation basin. Here the li- 
 quid is allowed to remain until the impurities 
 which would clog the filter have settled. When 
 this has occurred, the upper layers of the water 
 are drawn off into the filter proper, a great 
 basin made of masonry or concrete, under- 
 drained, and with an exit pipe at the bottom. 
 This basin is filled with fine sand above a gravel 
 layer, which in turn is supported by rock un- 
 derdrains. The sand acts in a double capacity. 
 The spaces between separate grains of sand are 
 ordinarily less than 5 | 7 of an inch in diameter, 
 so that the passage of all but the finest par- 
 ticles is prohibited. The bacteria would pass 
 even through here, were it not for a second ser-
 
 CITY WATER AND CITY WASTE 137 
 
 vice of sand, which acts in a most remarkable 
 way as a support for a true bacterial filter. As 
 the affluent passes through the upper layers, 
 the sand stops the coarser materials left in the 
 liquid and held in suspension there. Soon 
 there forms above the original surface a filter 
 composed of the smaller sediments, a layer so 
 fine that even the infinitely small micro-organ- 
 isms cannot pass. Many of them are probably 
 held by the sheer adhesion of the sand. Add 
 this adhesion to the filtering powers of the 
 sediment layer, and you have erected a strong 
 barrier. Here is a fortress placed across the 
 pathway of the invading germ, a barrier so 
 effectual that water from sources polluted with 
 disease-germs has been safely furnished to 
 thousands after such filtration. 
 
 The sediment-filter is, of course, constantly 
 increasing in thickness, and as it increases, 
 more and more pressure is necessary to drive 
 water through the interstices. When the point 
 is reached where the pressure required to force 
 the water through is too great to be practica- 
 ble, the surface of the filter is scraped. Since 
 during this scraping the filter has to be out 
 of commission, filter-plants are generally built 
 up from a series of small filters, in order that
 
 138 THE HEALTH OF THE CITY 
 
 one or more may be out of use at any time for 
 repairs. Filters may be either open or roofed, 
 the covering of the filter-beds depending to 
 some degree upon geographical location. The 
 North requires covered filters, while the South 
 gets along very well with open ones, the chief 
 difficulty being due to ice-formation. 
 
 Besides the continuous filter described above, 
 one other form of filtration is commonly em- 
 ployed to-day, the mechanical filter. For the 
 last ten years the growth in number of plants 
 of this type has been most remarkable. The 
 mechanical filter differs greatly from the con- 
 tinuous filter. It delivers from fifty to one 
 hundred times the quantity of water, and is 
 correspondingly reduced in size. A single con- 
 tinuous filter may occupy an acre, while half 
 a dozen mechanical filters may be installed in 
 less than a quarter of that space. The former 
 device recognizes as a cardinal principle the 
 keeping intact of the surface of the filter 
 where the bacterial life is strained out in the 
 close upper layers. The latter accomplishes 
 its work by the addition of a chemical, whose 
 action on meeting the water is such as to 
 engulf all matters held in suspension, includ- 
 ing bacteria, thus forming comparatively large
 
 CITY WATER AND CITY WASTE 139 
 
 masses, which can be filtered without difficulty. 
 The chemical commonly employed in the me- 
 chanical filter is sulphate of alumina, which, 
 when added to water, separates into sulphuric 
 acid and alumina, the latter being a floccu- 
 lent cloudy precipitate which spreads out over 
 the water. The heavy precipitate thus formed 
 settles down upon the sand, and, acting like 
 a sediment-layer in the continuous filter, re- 
 moves the germs. As with these large masses 
 the clogging tends to stop the flow, the sand 
 at brief periods is washed and stirred, with 
 removal of the former residues. 
 
 Now as to household filters. What can we 
 do in the private home to stop the entrance of 
 the disease-germ, provided we believe danger 
 exists ? The sanitary experts say that no small 
 filter which allows a good stream of water to 
 pass removes bacteria. In the sale of such 
 filters and the belief in their efficiency lies 
 peril to the public, who so often believe that a 
 couple of inches of sand or charcoal preserves 
 them from all harm. As a matter of fact, 
 expert engineers are practically agreed that 
 eighteen inches of sand above drains, and 
 that well covered with the sediment-filter, are 
 necessary to obtain efficiency. Some of the
 
 140 THE HEALTH OF THE CITY 
 
 larger household filters are efficient when filled 
 with fine filtering matters, such as sandstone 
 and infusorial earth, which only allow water 
 to pass drop by drop. These are usually either 
 provided with storage-reservoirs, or joined in 
 a series of filters so that a quantity may be 
 obtained at once despite the slow rate of fil- 
 tration. One simple safeguard is always at 
 hand, and should never be forgotten, the 
 boiling of the drinking-water. No precau- 
 tion is better in time of epidemics. One point 
 should be made clear, individual protection 
 can never possess a fraction of the value that 
 belongs to municipal control, any more than 
 the individual fire extinguisher can compete 
 with the city fire department. 
 
 The teeming thousands in the narrow ways 
 receive one common food, the city water. We 
 have already considered the way in which it 
 may be delivered to all, pure and free from 
 dangerous burdens. We must now consider the 
 other side, the outgo of the city. Every organ- 
 ism, as a condition of its existence, must be 
 forever building up and breaking down. Life 
 depends upon the proper balance of the con- 
 structive and destructive forces of nature.
 
 CITY WATER AND CITY WASTE 141 
 
 From the decomposition of the organic foods 
 and various materials used in our complex 
 life, from the sweepings of the streets and the 
 discharges from houses, factories, and shops, 
 comes the outgo of the city, its sewage. 
 
 The sewer is the abiding-place of good and 
 bad bacteria, five million or more of which 
 may make their home in a single thimbleful 
 of liquid. In the sewer they find darkness, 
 moisture, and food. There they thrive and 
 multiply. Possibly as important as the number 
 of evil micro-organisms found there is the cer- 
 tainty of the presence of deleterious organic 
 matters which, in their present state, and in 
 their changed form after decomposition, are 
 products dangerous in themselves and noxious 
 to all around. We have hitherto considered 
 chiefly the removal of bacteria of disease ; but 
 we must here consider as of primary impor- 
 tance the elimination of the harmful elements 
 of the city wastes. 
 
 The realization that sewage, unless properly 
 purified, might be a danger to the community 
 is a matter of comparatively recent growth. 
 In 1815 London used her sewers only for rain- 
 water, and disposition of other matters therein 
 was forbidden. Here and there in isolated
 
 142 THE HEALTH OF THE CITY 
 
 cases might be found early attempts at some 
 method of disposal, as in the case of the little 
 town of Bunzlau in Prussia, which iii 1559 
 had a piped water-supply and a system of sew- 
 age-farming. These attempts at scientific solu- 
 tion of the problem were at best sporadic 
 until the year 1844, which marks the opening 
 of an era that recognized the necessity for 
 proper waste-disposal. This era began with the 
 remarkable " Report of the Health of Towns 
 Commission in Great Britain," which for the 
 first time revealed the dangers which might 
 come from improper waste-disposal and the 
 accumulation of sewage. As a result of that 
 report arose the " Filth Theory of Disease," 
 which, since it is not yet eradicated from the 
 popular mind, and since under it was accom- 
 plished some of the best sanitary work of the 
 century, needs at least a passing mention here. 
 According to this belief, disease was bred in 
 masses of decomposing filth; it originated 
 there, and was in some way a product of the 
 reactions therein contained. We now know 
 that the main part of this theory is false, and 
 that disease cannot originate in filth, although 
 it does find there a convenient carrier. 
 
 This "Filth Theory of Disease" swept
 
 CITY WATER AND CITY WASTE 143 
 
 through the scientific world with the most sur- 
 prising rapidity. The problem of sewage-dis- 
 posal became urgent in a moment, and soon 
 the modern method of sewage-carriage, dilu- 
 tion with water, was evolved ; and the problem 
 became that of handling a mass of wastes 
 enormously diluted with water, a dilution so 
 great that in America there exists but one part 
 of solid in one thousand of water. Disposal by 
 dilution is in some special cases possible. It is 
 true that where not more than one part of 
 diluted sewage is sent into fifty of water, the 
 oxygen of the water may be sufficient to take 
 care of the wastes; but this proportion of water 
 to sewage is so large that, save on the sea, on 
 great lakes, or on rivers the size of the Missis- 
 sippi, any such disposal is unsafe in the extreme, 
 and any use of water from such a source must 
 be a constant menace. 
 
 The first step in any handling of sewage is 
 such a separation of the wastes that the differ- 
 ent parts may be handled to the best advan- 
 tage. The first treatment consists in screening 
 the large floating objects which have entered 
 the sewer in various ways, and removing all 
 rags, bits of wood, and the like, which may be 
 
 ' ' V 
 
 in the liquid. In Germany this treatment has
 
 144 THE HEALTH OF THE CITY 
 
 been brought to a high degree of efficiency by 
 the use of very fine screens mechanically op- 
 erated. There will still remain in suspension 
 a large amount of gravel and other matters of 
 that type, which have been washed in from 
 the sewer-openings in the streets. This may 
 be removed by checking the rate of flow, and 
 so allowing a settling-out to take place. That 
 leaves as the crux of the problem the disposi- 
 tion of the organic matter which is left. Puri- 
 fication by chemical precipitants, such as are 
 used in the purification of water in mechani- 
 cal filters, has been tried in the past and has 
 proved unsatisfactory. 
 
 Before passing to the consideration of par- 
 ticular details, let us turn for a moment to 
 consider by what method this cleansing may 
 be brought about. Sewage must either putrefy 
 or nitrify. That is, it must either decompose 
 (with results unfavorable in the extreme), or 
 such chemical action must take place as will 
 change the harmful organic ingredients to 
 simple inorganic matters, a result really ef- 
 fected through bringing them into contact 
 with the air, the oxygen of which will produce 
 the change. These organic city wastes, while 
 most complex, and differing greatly in their
 
 CITY WATER AND CITY WASTE 145 
 
 individual structure, are yet composed chiefly 
 of but four elements, carbon, hydrogen, nitro- 
 gen, and oxygen. The oxidation or nitrifica- 
 tion of such wastes consists in so combining 
 the nitrogen with the free oxygen of the air 
 as to form nitrates. This is the reaction, which 
 is of importance to the city's health, though at 
 the same time the hydrogen is oxidized to water, 
 and the carbon to carbon dioxide. 
 
 The problem before us, then, really resolves 
 itself into this: How may we so oxidize or 
 nitrify sewage as to change the noxious or- 
 ganic matter into harmless mineral substances? 
 To do this, the sanitary engineer reverses one 
 of his processes for cleansing water. Instead 
 of removing the germs, as in water-filtration, 
 he cultivates myriads of helpful bacteria. 
 Whether we consider such sewage-disposal as 
 carried on by natural or by artificial means, 
 on the irrigated farm or the trickling filter, we 
 find this startling and remarkable fact : the 
 oxidizing of the sewage is done by millions of 
 living organisms. These tiny particles take in 
 the organic wastes and turn them into safe 
 and harmless inorganic matters. To cultivate 
 such bacteria, and to use their destructive 
 powers on dangerous elements, has been the
 
 146 THE HEALTH OF THE CITY 
 
 effort of all recent sewage researches. How 
 they are accomplishing this task may be told 
 briefly here. 
 
 The oldest form of sewage-disposal is the 
 disposal on land for use as a fertilizer. For 
 more than four centuries the sewage-farm has 
 been an attractive conception to students of 
 possible economies of the state. Berlin and 
 Paris have both had farms of this kind for 
 years, and many other experiments along this 
 line have been made here and abroad. 
 
 On soils even moderately fertile the sewage- 
 farm seldom pays, costing, despite returns, 
 more for its maintenance than other types 
 of disposal-systems. It is on soils like those 
 of the West, where the water carrying the 
 organic matter is of value for irrigation, that 
 sewage-farming has been made to pay; and 
 there is every reason to believe that in such 
 a region it could be made a most profitable 
 municipal investment. 
 
 The fertility of any soil is greatly affected 
 by the bacterial action which goes on in its 
 upper layers. The bacteria on the soil of sew- 
 age-farms are the oxidizing agents, taking in 
 the organic, and sending forth inorganic, mat- 
 ters at the end of the reaction. As the fertility
 
 CITY WATER AND CITY WASTE 147 
 
 of the soil increases, the effectiveness of the 
 plant to nitrify the sewage increases as well, 
 but one precaution must be taken in any use 
 of sewage for fertilizer. No crop should be 
 raised which is to be eaten raw, and preferably 
 no crop intended for human consumption. A 
 notable example of successful Western sew- 
 age-farming is shown by Pasadena, Califor- 
 nia, where walnuts, a crop safe from bacterial 
 infection because of their shell, and free from 
 all clogging of the porous soil, have been 
 grown with profitable results. A substantial 
 profit has been made year by year, and from 
 the surplus the original cost of the land is 
 rapidly being paid off. 
 
 Leaving this natural process, we come to 
 the processes evolved by science. By 1865 it 
 was recognized that the essential factor in the 
 purification of sewage by means of land was 
 the bacterial action upon the organic wastes. 
 Early investigators had some inkling of the 
 fact, and had proposed a system by which, 
 through the special cultivation of the destruc- 
 tive germs, a rapid purification might take 
 place. By passing the organic wastes of a 
 community, with their accompanying micro- 
 organisms, through great masses of destruc-
 
 148 THE HEALTH OF THE CITY 
 
 tive bacteria of the proper type, these waste 
 products might be broken down, the living 
 organisms destroyed, and the harmful ele- 
 ments removed. A tremendous conception, this 
 enlisting of armies of good microbes to fight 
 the hosts of evil ! This theory has directed 
 the scientific attack on the problem for the last 
 thirty years. Given the possibility of such 
 action, what method could best carry it out ? 
 
 In 1887 conditions in Massachusetts had 
 become so serious that there was instituted by 
 the State Board of Health an experiment sta- 
 tion at Lawrence for the study of sewage-dis- 
 posal and water-supply. It was put under the 
 charge of Mr. H. F. Mills, with the coopera- 
 tion of Professors Sedgwick and Drown of the 
 Massachusetts Institute of Technology. At 
 that station were carried out the classic Law- 
 rence experiments. 
 
 In these researches ten different filtering 
 materials, such as gravel, sand, loam, and the 
 like, were placed in ten experimental tanks, 
 and the same sewage was passed through each. 
 Continuous and intermittent filtration was 
 tried, and the number of bacteria present be- 
 fore and after filtration was most carefully 
 determined. As a result, the great principle
 
 CITY WATER AND CITY WASTE 149 
 
 was established that purification is an oxidiz- 
 ing process carried out by bacteria living in 
 the filter, and (a most important result) that 
 a rich supply of oxygen is necessary for their 
 activity. The process of action with oxygen is 
 known as the " breathing of the filters." It 
 was early found that in sewage-filters, like the 
 continuous water-filters, there was not suffi- 
 cient opportunity for the bacilli to obtain 
 enough oxygen to oxidize the organic matter 
 passing over. In consequence it soon became 
 evident that maximum efficiency would be ob- 
 tained only when the filters having been 
 once filled with sewage the bacteria should 
 be allowed to act upon it with free access 
 to the oxygen of the air. This intermittent 
 action, the addition of the sewage followed by 
 the addition of supplies of oxygen, is a battle 
 in which the foe is met by a defending army 
 whose ammunition is constantly renewed. 
 
 The principle of the intermittent filter is 
 found in the other modern devices by which 
 bacteria meet bacteria in deadly battle. The 
 contact-bed system, used in England, is found 
 but rarely here. In this system, the liquid, 
 instead of passing through the filter of sand, 
 is let into a great tank filled with coke or some
 
 150 THE HEALTH OF THE CITY 
 
 hard, smooth material ; this is then filled with 
 sewage and closed. The sewage is allowed to 
 remain there for two hours or more. During 
 this time the bacterial films upon the rocks 
 absorb organic matter and bacteria, and at the 
 end the remaining liquid is discharged. Oxy- 
 gen is thereby allowed entrance to the films, 
 and the bacteria do their appointed work as 
 scavengers. By careful regulation as to the 
 time necessary to accomplish the results, it has 
 been claimed that satisfactory purification may 
 be obtained ; but extreme care has to be taken 
 in the control. Some decomposing action also 
 proceeds during the period in which the sew- 
 age is in the tank. Action of this type will be 
 considered later in a paragraph on the septic 
 tank, and need not be considered here. 
 
 The third type of disposal is still simpler 
 in principle. In early experiments with inter- 
 mittent filtration, air was forced in from below 
 to allow for the breathing of the filters. Soon 
 the necessity for more air, for increased sup- 
 plies of oxygen, made further experiments 
 along the line of intermittent filtration neces- 
 sary. In the trickling or sprinkling filter it 
 was first made possible to treat sewage with 
 a continuous supply of air. In this process, by
 
 CITY WATER AND CITY WASTE 151 
 
 one means or another, the tipping of small 
 buckets or splashing from sprinklers, the 
 sewage is constantly passing into a filter filled 
 with coarse gravel. As it trickles down be- 
 tween the openings, it carries with it air for 
 its own destruction. Oxygen is also obtained 
 from the open construction of the filter, which 
 allows constant air-communication between 
 the interstices. The bacterial films upon the 
 stones absorb the organic matters and new 
 bacterial life, as in the case of the contact-bed ; 
 and through the constant breathing of the fil- 
 ters the oxygen necessary for the burning up 
 or oxidization of the wastes is secured. 
 
 The action of the intermittent filter and the 
 possibilities of its use can be expressed in no 
 way better than by quoting the brilliant end- 
 ing of Mr. Winslow's article on this subject : 
 " The trickling bed appears to be the ideal 
 method of solving the essential problem of sew- 
 age-disposal, the oxidation of organic matter. 
 It exhibits the simplicity of all scientific appli- 
 cations which are merely intelligent intensifi- 
 cations of natural processes. A pile of stones 
 on which bacterial growth may gather, and 
 a regulated supply of sewage, are the only 
 desiderata. We meet the conditions resulting
 
 152 THE HEALTH OF THE CITY 
 
 from an abnormal aggregation of human life 
 in the city by setting up a second city of 
 microbes. The dangerous organic waste-mate- 
 rial produced in the city of human habitations 
 is carried out to the city of microbes on their 
 hills of rock, and we rely on them to turn it 
 over into a harmless mineral form." 
 
 To produce a still greater bacterial cleans- 
 ing, the effluent, or outcoming liquid, produced 
 by these processes may be rapidly filtered 
 through a second filter of sand, or may be 
 sterilized by the use of the chlorine of bleach- 
 ing powder. The development of this latter 
 chemical process for the purifying of water 
 has proved one of the most interesting devel- 
 opments of recent years. It has been shown 
 that the chemical disinfecting of water gives 
 a very high degree of bacterial purification 
 at a very low cost. In fact, the entire water-sup- 
 ply of Jersey City, N. J., has been treated in 
 this way for over a year. Properly controlled, 
 there seems to be no evidence that the addition 
 of the bleaching powder in any way injures 
 the water. 
 
 Such a process should be excellent for high- 
 grade supplies, where it is desired to remove 
 even traces of impurities. It should be espe-
 
 CITY WATER AND CITY WASTE 153 
 
 cially satisfactory with good unfiltered water 
 from protected watersheds. It has scarcely 
 been definitely proven as yet that it provides an 
 unfailing method of purifying polluted waters. 
 
 The processes of nature have much to do 
 with any water-supply, and the rain falls in 
 greatly varying quantities at unexpected sea- 
 sons. A sudden rush of rain washes in quan- 
 tities of solids and produces a largely increased 
 bacterial content in any water-supply. Where 
 there is any possibility of sewage reaching the 
 water, pollution will be far greater in wet than 
 in dry times. An amount of bleaching powder 
 which would be quite sufficient to cleanse 
 water on, for example, 363 days in the year, 
 might prove wholly inadequate on the 364th 
 or 365th. Unless a great excess of the puri- 
 fying agent is added constantly, there will 
 be unusual days which might prove times of 
 peril. Under no circumstances should any 
 community be obliged intentionally to drink 
 sewage. A water-supply which has been puri- 
 fied by the best methods known to-day is the 
 right of every citizen. 
 
 One last method of bacterial destruction of 
 sewage must be considered here the septic 
 tank, the successor of the individual cesspool.
 
 154 THE HEALTH OF THE CITY 
 
 While impracticable for final disposition, it 
 has a decided value as a preliminary step 
 in the treatment of certain concentrated sew- 
 ages. The principle of the ordinary cesspool 
 depends upon the fact that a large part of the 
 solid organic wastes are acted upon in the 
 closed dark receptacles, without access of air, 
 by bacterial ferments, and are turned into li- 
 quids which may be drained off, or into gases 
 which may escape. Such solid portions as are 
 unaffected by this change may be removed a 
 couple of times a year. In the modern form 
 of septic tank the wastes, instead of being left 
 to be acted on for a long period without the 
 use of oxygen, are run into a close tank, where 
 they are left for about twenty-four hours. 
 During this time, the chief decomposition has 
 taken place, after which the residues are 
 pumped to the filters or contact-beds, where 
 the final oxidation may occur by means of the 
 oxygen of the air. The septic process does not 
 produce a pure effluent, and it does not effect 
 bacterial reduction to any important degree. It 
 is simply a method of reducing solids as a 
 preliminary to some form of biological puri- 
 fication. It is, however, a useful device in its 
 proper place.
 
 CITY WATER AND CITY WASTE 155 
 
 We have already considered the use of the 
 household filter in some detail; but the gen- 
 eral problem of good water and safe sewage 
 appeals to every owner of a country house, 
 and a few words on this subject should be in- 
 serted here. The best soil for these purposes 
 is a sandy one, and wherever a rocky or clayey 
 soil gives possibility of a fissure which might 
 connect water and drainage, expert examina- 
 tion should be called in. The individual plant 
 for water and sewage may often be a well and a 
 cesspool the cesspool, once a bogy to sanita- 
 rians, being now justified by the septic tank and 
 the sand-filter, both of which principles are 
 employed in its construction. Two points must 
 be recognized here. First, such a covering of 
 the well that the grave danger of surface pol- 
 lution may be avoided, for it is most essential 
 that no pollution should be washed through 
 covering boards. Second, care with regard to 
 the direction of drainage. This is generally 
 toward the nearest water-course, and must be 
 such that the water-supply may not be below 
 the point of sewage-disposal. With these 
 simple precautions of investigation of soil, 
 covering of well, and proper location of the 
 direction of drainage water and the source of
 
 156 THE HEALTH OF THE CITY 
 
 drainage, the isolated country house-owner 
 may feel secure. 
 
 As we look over the whole field of effort, 
 the striking factors of present-day progress 
 in bacteria-removal and sewage-disposal seem 
 to be taking on definite specialized form. The 
 engineer is tending to use one method for 
 water the removal of evil bacteria by filtra- 
 tion. He is using largely a different method 
 for sewage the cultivation of good bacte- 
 ria which may render safe the city by their 
 removal of its dangerous organic wastes. 
 Removal of the evil and cultivation of the 
 good ! The most highly specialized forms of 
 water and sewage-filters show this best. The 
 mechanical water-filter has chemicals to sepa- 
 rate out the bacteria, pneumatic arrangements 
 to wash out the sand, and casings of concrete 
 for protection from the air. The sewage-filter, 
 on the other hand, is, in its essentials, nothing 
 more than a pile of rock on which the good 
 bacteria may grow. The future advance of 
 sanitary science seems likely to be along these 
 lines. More and more dependence is placed 
 upon research, and the real importance of the 
 problem seems daily more manifest. The care- 
 ful experiments at the Columbus Experiment
 
 CITY WATER AND CITY WASTE 157 
 
 Station in Ohio, as well as the noteworthy 
 results obtained by the Sanitary Research 
 Laboratory which has been established by the 
 Massachusetts Institute of Technology, show 
 the trend of progress. 
 
 To make the city habitable, to increase the 
 efficiency of the state through the better health 
 of its citizens what task is higher than this 
 great labor for the common good? On the 
 man in control of the water-system or the sew- 
 age-plant rests the success or failure of many 
 measures planned for the public weal. In the 
 solution of that great problem in applied sci- 
 ence, the government of the city, no man 
 must bear a greater responsibility than the 
 sanitary engineer. 
 
 Such civic interest should be awakened in 
 every community as will demand that the 
 guardians of our public health shall be rightly 
 trained, wise, and free. Above all free since 
 freedom from political control, from jealousies 
 and narrowness, must be secured in order that 
 full power may be given to the guardians of 
 the public health to keep up the fight until 
 the day when final conquest comes.
 
 VI 
 
 ICE 
 
 STRAIGHT from the north sweeps down the 
 icy blast, cresting the snowy mountain-top, 
 clearing its rugged barriers, and swaying to 
 rhythmic pulsations the pines along the bor- 
 ders of the lake. Day after day the winds bear 
 down increasing burdens of cold. Hour after 
 hour the ice-crystals sink deeper and deeper 
 into the depths below. Then, when the leaden 
 skies are bordered with dull northern gold, 
 figures of men advance upon this natural stage, 
 whose background is the majestic mountain, 
 whose wings are forested with white-capped 
 green. The stillness ends as workers, in gay 
 blanket-coats or heavy corduroys, harvest their 
 winter store, cut out huge squares upon the 
 surface of the lake, trace and retrace their 
 steps, moving like living chessmen in steps of 
 knight or queen. The cold wind of the open 
 north congeals the ice. Hot, dust-filled city 
 winds return it to its liquid state once more. 
 Whatever the purity of the source, the sum-
 
 ICE 159 
 
 mer days, when the ice-cars reach the city, see 
 this common food thrust out on dirty platforms 
 through dirty chutes, thrown into wagons 
 which stand open and exposed to the dust of 
 the city street. Nor does delivery at the door 
 end the possibility of contamination. Solid 
 water may turn to liquid water in unclean re- 
 frigerators, cool the refreshing drink of car, 
 of office, or of street, in positively filthy water- 
 tanks, or become infected by the hand of its 
 server. Make a personal experiment : look at 
 your own refrigerator after a hundred pounds 
 of ice have melted, and see whether or not the 
 compartment is clean. 
 
 Few of the topics considered in this book 
 belong more exclusively to the city than this of 
 ice. Food, air, and milk vary the conditions 
 of their supply by the different requirements 
 of the crowded street and the isolated farm. 
 Ice, on the other hand, to-day as always, finds 
 its chief use in the city. The cold cellar or 
 the well still serves the refrigeration purposes 
 of a large portion of rural America. Where 
 ice is used on the farm, it is commonly taken 
 directly from the individual ice-house, where 
 it has had all the benefits which come from 
 storage and few of the disadvantages which
 
 160 THE HEALTH OF THE CITY 
 
 come from handling. Farm food, moreover, 
 is not only fresher and in less need of cold 
 storage than the city's supply, but it may well 
 be possible that the freer life of the country 
 breeds less desire for cooling foods and drinks 
 than does the far greater confinement of our 
 brick-walled existence. Certainly, the city's 
 necessity for refrigeration and for ice is beyond 
 question. Its food, brought from long dis- 
 tances and often unnaturally preserved by stor- 
 age methods, must be chilled to be healthful. 
 Its children, wearied by the nervous exhaus- 
 tion of the streets, have a real need of the 
 tinge of attractiveness which cooled viands 
 provide, to obtain a sufficient nourishment. 
 
 No other nation can compare with the United 
 States in the consumption of ice. Its use in 
 the Orient is limited chiefly to the foreign 
 settlements and the selected upper classes; 
 while in Europe, though it is used for cold 
 storage, its service as a food is relatively small. 
 Even where modern custom and the inroads 
 of American travelers have made its presence 
 an every-day affair abroad, the cooling drink 
 is offered the diner, but not forced upon him. 
 The waiter presents the glass bowl of cracked 
 ice for acceptance or rejection. In America
 
 ICE 161 
 
 we have no choice. If the carafe is not full 
 of water frozen in its place, the glass of ice- 
 water is surely present at your elbow. Slight 
 indeed is the probability that we can diminish 
 the city's call for ice, however loud the annual 
 outcry against its use. Granting that the 
 demand is unlikely to subside materially, let 
 us, in order to determine what the situation 
 really is, consider, first, how the purity of ice 
 is affected by its formation, second, the pos- 
 sibilities of its contamination during harvest- 
 ing, sale, and use, and, third, the way in which 
 the present-day conditions of the ice trade con- 
 cern the dwellers of the city. 
 
 City ice comes from one of two sources: it 
 may be produced naturally in river, lake, or 
 pond, or it may be manufactured artificially 
 by what, for want of a better name, we may 
 call cold-storage methods. The formation of 
 natural ice is, in itself, one of the strangest 
 of the thousand disregarded phenomena of 
 natural life. The basic causes of that exam- 
 ple of the craftsmanship of nature known as 
 crystallization, of that property of matter by 
 which solids group themselves in the fairy 
 traceries of the snow, the gleaming facets of 
 rock crystal, or the huge pillars of the salt
 
 162 THE HEALTH OF THE CITY 
 
 mines, lie deeply hidden. The effects of that 
 craftsmanship we know, and of those effects 
 few are stranger than the selective process 
 which goes on in crystalline formations. Those 
 tiny particles which make up the regularly 
 formed crystals are able to pick and choose 
 their associates, and refuse to accept for the 
 structure of their walls substances unlike 
 themselves. This is a general rule which gov- 
 erns many forms besides the special one under 
 consideration. Crystalline bodies in solution 
 in the foulest liquids crystallize out in a state 
 of purity so great that analytical chemistry 
 constantly takes advantage of this principle 
 to obtain strictly pure materials. Ice-crystals, 
 forming, will build nothing into the icicles 
 save water. The effect of this natural selective 
 power has a close bearing upon our subject. 
 
 Every lake or pond is a great bowl holding 
 in solution and suspension many solid particles, 
 such as the tiny bacterial plants which inhabit 
 its depths, the refuse of the shores, and por- 
 tions of the solid matter of the bottom. When 
 the falling mercury plunges below the freez- 
 ing-point, the contents of these huge bowls 
 suffer a sudden change. Tiny six-sided crystals 
 shoot forth upon the surface, join side by
 
 ICE 163 
 
 side, and take up so much more space than 
 the water from which they come, that the ex- 
 panded ice is often thrust up upon the banks. 
 If substances like straw, chips, or refuse are 
 floating on or near the surface of the water 
 when the change takes place, such solid bodies 
 will be imbedded, mechanically caught, be- 
 tween the crystals, in the same fashion that 
 a ball is caught between two clasping hands. 
 There is the first possibility of ice-contamina- 
 tion. A considerable amount of light straw 
 and refuse is likely to be floating upon or near 
 the surface. The greater part of this, good 
 and bad, pure and impure, is entangled in this 
 upper sheet. 
 
 Below the surface of the liquid quite an- 
 other condition holds good. The ground at 
 the sides and bottom is a non-conductor of 
 heat. In consequence, ice can form only at 
 the top, and the solid mass must grow verti- 
 cally downward from the surface. As the cold 
 increases, the tiny crystals, forcing their way 
 through the water, shoot towards the bottom 
 like icicles on the eaves of a house. Each 
 pointing icy finger, as it pushes its way down- 
 ward, constantly rejects all other substances 
 besides water, forces floating bacteria and other
 
 solids steadily back, builds water and only 
 water into its structure. Since the whole mass 
 is made up of millions of individual crystals, 
 those solids, and only those solids, which are 
 mechanically entangled between these indi- 
 vidual crystals appear in the final cake of ice. 
 Such impurities are comparatively few below 
 the topmost crust. In consequence, the greater 
 part of the ice is cleansed by this process. 
 The old theory that "frozen water purifies 
 itself " is true so far as crystallization below 
 the surface (notice those three words) is con- 
 cerned. 
 
 Crystallization is not the only mechanical 
 factor which tends to clear ice from impurities. 
 Once the cold lake is covered with its glitter- 
 ing shield, the water below is no longer ruffled 
 by the wind, and is practically undisturbed by 
 the changes in weight due to expansion and 
 contraction. Under such circumstances a lake 
 or pond tends to become a still pool in which 
 all floating matter which is heavier than the 
 liquid in which it rests is persistently pulled 
 downward, is constantly sinking toward the 
 bottom. To state it in a different form : once 
 the water's surface is chained in place, the 
 never-resting force of gravity, then unopposed
 
 ICE 165 
 
 by many resisting forces, such as wind and 
 wave, goes steadily to work to pull the solid 
 matter in suspension away from the upper 
 layers of the liquid into which the ice is ex- 
 tending. The tiny micro-organisms which are 
 responsible for water-borne disease are slightly 
 heavier than water. They are borne down also. 
 The force of gravity, which drags them down, 
 works with crystallization to free the lower 
 portions of natural ice from its impurities. 
 
 The floating matter of the surface makes 
 but one portion of trouble. Men and horses, 
 passing over the ice in harvesting, track in no 
 small amount of dirt of various kinds. If the 
 ice is harvested from ponds below the snow- 
 line, dust-filled winds from neighboring streets 
 may cover it. If it comes from lakes near 
 manufactories, refuse from the plant may be 
 blown out upon it. If snowfalls and slight 
 thaws come, the snow and ice, melting to- 
 gether, produce snow-ice, the white opaque 
 form known to all. Snow is by no means a 
 welcome addition. It holds readily all solids 
 which fall upon it, and, crystalline as it is, 
 falling snow serves as a filter to the air, en- 
 tangling and enmeshing bacteria and dust as 
 it falls from the heavens to the earth. Snow-
 
 166 THE HEALTH OF THE CITY 
 
 ice is to be avoided. The upper crust of ice is 
 dangerous for use. 
 
 The conditions mentioned heretofore have 
 been produced by comparatively normal con- 
 ditions of ice-formation and of harvesting. 
 The ice- dealer has little share in producing 
 them. The dealer, however, can make trouble 
 for the consumer who desires purity by joining 
 thin sheets to form thick cakes. In mild win- 
 ters, when the ponds where ice is generally 
 cut do not freeze to a sufficient depth to give a 
 satisfactory cake, narrow sheets are sometimes 
 cut and packed together in such a fashion as 
 to give a doubled cake. Under such circum- 
 stances, two upper layers with their impurities 
 often come together in the centre of the cake, 
 and give out their combined dirt when the ice 
 melts. 
 
 From filth produced or preserved in some 
 such fashion as those mentioned above comes 
 a large part of the mud which fouls your ice- 
 compartment, or leaves a line of black scum 
 in your glass of water. Difficult though it is 
 to bring a direct charge of typhoid infection 
 against these sources, there is a perfectly rea- 
 sonable probability that many cases of intes- 
 tinal diseases have originated in such dirty
 
 ICE 167 
 
 masses. And cleanliness in this respect is di- 
 rectly within the control of the health authori- 
 ties of the community. Since individual con- 
 sumers of ice are unlikely to be able to stop 
 the selling of upper-layer, snow, and doubled- 
 layer ice, the city should keep such ice from 
 reaching the homes of its citizens. Demand 
 that this slight layer, which contains the dirt, 
 be planed off ; let the sale of dirty ice be for- 
 bidden by enforced official act ; and conditions 
 will rapidly improve. Every consumer recog- 
 nizes clear ice at a glance. Inspection is no 
 difficult matter. 
 
 When we look over our data thus far ob- 
 tained, we find many hopeful signs. It is true 
 that the free ice of the north may become con- 
 taminated by the foreign matter of its crust, 
 or by the burden of snow-ice; but it is equally 
 true that two cleansing agencies are unceas- 
 ingly at work, crystallization and the force of 
 gravity. It is within the power of man to use 
 a third, the planing of the ice. The artificial 
 ice of the factory has been much heralded as 
 an advance upon nature. Before passing to a 
 relation of the researches and discoveries which 
 bear upon our problem, suppose we compare 
 the two.
 
 168 
 
 If the ingenious Yankee who first conceived 
 the possibility of sending Wenham ice to trop- 
 ical lands could return to view the results of 
 his handiwork, he would be amazed indeed to 
 observe the results of the trade begun so many 
 years ago. Once the torrid zone had tasted ice, 
 the development of the artificial supply was 
 inevitable. To-day, the ice-machine, its bene- 
 fits long since extended far beyond the bound- 
 aries of the tropics, is used the world over 
 where any deficiency in the supply of natural 
 ice exists. As the problems of artificial ice are 
 closely connected with the processes of manu- 
 facture, a word concerning these processes 
 may be of service here. 
 
 One point should be noted here before going 
 farther. Ammonia is much used in the produc- 
 tion of artificial ice. The ammonia referred 
 to in the following paragraph is not the com- 
 mon household ammonia. It is the liquefied 
 anhydrous ammonia gas of the cold-storage 
 plant. With that point clarified, we may turn 
 to our description. 
 
 The making of artificial ice depends on the 
 fact that certain liquids, like ammonia, turn 
 to gases at low temperatures, absorbing heat 
 from everything around. If you had a stop-
 
 ICE 169 
 
 pered bottle of liquid ammonia in a pail of 
 water, and suddenly released the stopper, the 
 liquid would turn to a gas, and the absorption 
 of heat in the process would so chill the sur- 
 rounding water as to turn it to ice. This is 
 one variety of the many natural changes which 
 absorb heat and, in so doing, chill surround- 
 ing bodies. The commonest change of this 
 kind that we know takes place when the ice 
 and salt of the ice-cream freezer take heat from 
 the liquid in the can and chill it to solid ice- 
 cream. In the case under consideration here, 
 if you have brine around the inner bottle, when 
 the liquid ammonia changes to gas, instead 
 of water, the brine remains liquid, but is so 
 chilled that it would freeze a glass of water 
 placed within its bounds. This second indirect 
 method of freezing, that is, chilling brine by 
 the ammonia or some like process, and allowing 
 the cooling solution to freeze water, is the one 
 employed in making artificial ice. The water 
 to be frozen may be placed in tanks in the 
 cold brine, or may be allowed to run continu- 
 ously down a trough, bordered on each side 
 by tubes of cold solution. In the first case, the 
 ice freezes solidly in blocks. In the second, 
 ice is continually formed at the sides, but the
 
 170 THE HEALTH OF THE CITY 
 
 liquid never solidifies to the centre. There is 
 always a stream of water flowing between the 
 cakes of ice. One point more : when the cold 
 brine is pumped through pipes to refrigera- 
 tors and warehouses, a cold-storage system 
 is formed. 
 
 Our special interest in the artificial process 
 has mainly to do with its cleanliness, or lack 
 of cleanliness, as related to the methods used 
 by nature. In general, forced freezing com- 
 pares unfavorably with the natural processes 
 already mentioned. If the water used in such 
 manufacture is ordinary city water, the excel- 
 lence of the ice will be in direct proportion to 
 the excellence of the water. And the excellence 
 of the water-supply should be strongly insisted 
 upon, for the forces that cleanse natural ice 
 can do but little to free artificial ice from its 
 impurities. Where water is frozen from a con- 
 tinuous stream, gravity has little chance to 
 purify the ice. Where water is frozen in blocks, 
 crystallization does nothing to make the solid 
 better than the liquid. Artificial ice, frozen 
 in a solid block, freezes from the outside in, 
 and remains liquid in the centre to the last. 
 Because of this, any solids present are driven 
 back towards the centre. In the case of natu-
 
 ICE 171 
 
 ral ice, the impurities, driven downward, sink 
 into the water below. In the case of artificial 
 ice, after they have reached the centre, they 
 are frozen solidly into the block. Moreover, 
 this natural freezing inward gathers all the 
 impurities into the centre of the block, thereby 
 making possible all the dangers which come 
 from concentration as opposed to dilution. 
 Several methods have been employed to do 
 away with this difficulty where the water-sup- 
 ply is questionable. One needs special mention, 
 the tapping of the cakes (just after the final 
 solid freezing) in order to remove polluted 
 water. Reliance cannot be placed on any such 
 alternative as this. 
 
 Artificial ice made from impure water must 
 always be of dubious purity. Even where dis- 
 tilled water, probably the safest alternative, 
 is used, one precaution should be taken. The 
 stills should not contain lead pipe. The danger 
 of lead-poisoning in ice is quite as great as 
 the peril of similar poisoning in water. One 
 and only one way provides safety, freez- 
 ing pure water delivered through pipes unaf- 
 fected by water's dissolving powers. A former 
 custom, now fortunately somewhat gone by, 
 of serving raw oysters in hollowed, melting
 
 172 THE HEALTH OF THE CITY 
 
 blocks of ice, succeeded, when the artificial 
 form was used, in laying the food at the one 
 point where whatever infectious material might 
 be present was chiefly gathered. 
 
 Closely related to the production of artificial 
 ice is the growing use of cold storage, probably 
 the best method of refrigeration yet discov- 
 ered. The large markets of our cities depend 
 almost exclusively upon systems which pump 
 chilled brine through stall after stall and 
 shop after shop. In these, the former custom 
 of placing food-supplies in immediate contact 
 with ice is rapidly changing. A number of 
 the new apartment houses have recently pro- 
 vided refrigerators for their tenants, which 
 are cooled by cold-storage systems running 
 out from small central plants ; and there would 
 seem to be no reason why the extension of 
 such advantages to whole blocks and streets 
 in crowded quarters might not be practicable. 
 It is a possibility well worth consideration. 
 
 Somewhat reversing the normal sequence, 
 we have so far considered ice the final product. 
 We can scarcely pass to the second stage of 
 our argument without a word concerning 
 water, the source from which the product
 
 ICE 173 
 
 springs. It can hardly be repeated too often 
 that the city's problem, as it has to do with 
 water, concerns not the liquid itself, but the 
 tiny plants which live within its depths ; that 
 the possibility of water-borne disease arises 
 from floating micro-organic forms. Bacterial 
 life is lived under widely varying conditions. 
 Even with a common environment, great di- 
 versity appears ; and the investigator of bac- 
 terial populations often finds wide variations 
 in the numbers present in a given area, even 
 where the surrounding conditions seem appar- 
 ently much the same. Thickly clustered, liv- 
 ing masses of organisms may appear in one 
 part of a lake where other portions show only 
 widely scattered individuals and minute colo- 
 nies. So men may be found crowding together 
 in the masses of London's huddled slums, 
 and living the widely scattered individualistic 
 life of the African desert. And as human 
 criminals are found far from the haunts of 
 men and in the city street, so the micro-organ- 
 isms of disease may be found wherever man 
 may spread infection. Yet disease caused by 
 dangerous organisms must always come chiefly 
 from dense micro-organic growths and heavily 
 infected liquids.
 
 174 THE HEALTH OF THE CITY 
 
 Natural ice offers no very favorable oppor- 
 tunity for the continued life of even crowded 
 bacterial communities. In another chapter I 
 have spoken of three things favorable to bac- 
 terial existence, warmth, nourishment, and 
 darkness. Not one of these is present in pond, 
 river, or pool when ice is forming. Light 
 streams through the glasslike coating into 
 the depths beneath. Bitter cold tends to shrivel 
 and destroy plant-life. Nourishment is scant 
 in winter waters. The environment in which 
 these tiny bits of animate creation must carry 
 on their struggle for existence seems forbidding 
 in the extreme. Their life must be difficult 
 enough in the cold liquid. How much more 
 difficult it would seem to be when the fragile 
 plants freeze into hard unyielding ice whose ex- 
 pansive force rends iron shells apart and splits 
 the granite rock. No tale of life in Arctic snows 
 could be more fascinating than the story of that 
 microscopic struggle for survival in the bitter 
 chill, observing that struggle simply from the 
 standpoint of the ordinary observer. But its 
 relation has an interest far more immediately 
 personal than this, and one which concerns di- 
 rectly our immediate question. " Is city ice safe 
 for use? If not, what can be done toward its
 
 ICE 175 
 
 betterment?" We have already answered some 
 portion of that question in our discussion of 
 ice-formation. The rest of the answer must 
 depend upon the scientific labors of the hand- 
 ful of men who have attacked this problem 
 from its bacteriological standpoint. 
 
 In this day of hurrying clamor for reform, 
 when journals leap into the arena thirsting 
 for the blood of modern dragons of corruption 
 one evening, and forget the next morning 
 that such strange monsters ever existed ; when 
 every conceivable form of legislative regula- 
 tion is gravely and soberly proposed ; it is well 
 to consider what touchstone may be found to 
 give us some foundation for our beliefs, to en- 
 able us to act wisely and justly ; for wisdom 
 and justice are sometimes difficult to obtain 
 even by legislative decree. It is fortunate 
 that, in our work for the health of the city, 
 we may settle many disputed points once for 
 all by an appeal to the laws of nature as they 
 are demonstrated in the laboratory. Any dis- 
 cussion for or against present-day ice condi- 
 tions, for example, should rest either upon 
 the records of past researches or the under- 
 taking of new. The results of careful research 
 should form the basis for the formulation of
 
 176 THE HEALTH OF THE CITY 
 
 laws or regulations intended for the better- 
 ment of conditions. We cannot afford the time 
 to-day for discussion not based upon experi- 
 mentation. 
 
 An advertising scheme, widely heralded in 
 recent time, portrays the manner in which 
 much of the experimentation on ice has been 
 carried on. Some ingenious press-agent, de- 
 siring to show the indifference of his particular 
 watches to heat and cold, froze timepieces in 
 blocks of artificial ice. The result of his efforts 
 is evident to any passer-by who notices an 
 eager group pressing their noses against the 
 jeweler's window and watching hour-hand and 
 minute-hand moving over the white dials quite 
 without regard to their unaccustomed frozen 
 environment. The watch-manufacturer freezes 
 watches in blocks of ice. The bacteriologists 
 have frozen the bacteria which inhabit water 
 in tubes of ice, or, reproducing nature in the 
 laboratory, have frozen purposely-infected 
 waters from the top downward. 
 
 Less than forty years reach between the 
 two extremes of the quest. The beginning of 
 the work was marked by the publications of 
 two men : of Dr. Nichols, who reported the 
 first recognized ice-epidemic, and of Burdon-
 
 ICE 177 
 
 Sanderson, who discovered that melted ice or 
 snow contained living micro-organic growths. 
 The end may be said to have been reached in 
 the comparatively recent work of Park of New 
 York, of Hill of the Boston Board of Health, 
 and of Sedgwick and Winslow. From first to 
 last, nearly a hundred students have published 
 papers on the kindred subjects of the epide- 
 miology of ice and the life of the bacteria at 
 low temperatures. Cycle by cycle, those indi- 
 vidual researches fall into a series of groups. 
 The early work of Burdon-Sanderson, of 
 Cohn, of Leidy, of Pohl, and of Hey roth, like 
 that of several other pioneers, had a single 
 aim, to determine whether or not bacteria 
 could exist in naturally frozen water. In every 
 case, these investigators inoculated sterile me- 
 dia (nourishing liquids or solids which were 
 wholly free from micro-organic life) with natu- 
 ral snow and ice, and then observed the sub- 
 sequent growth of bacteria. Pohl studied ice 
 from the Neva. Heyroth investigated the sup- 
 ply of Berlin. The Massachusetts State Board 
 of Health in 1889 analyzed two hundred and 
 thirty-eight samples of natural ice; and the 
 supplies of London, of Paris, of Vienna, and 
 of other cities received attention. Bacteria
 
 178 THE HEALTH OF THE CITY 
 
 were found in every case. Scofone, on a sci- 
 entific expedition to Monte Rosa, even found 
 small quantities of bacteria at heights more 
 than seven thousand feet above the surface 
 of the sea. This preliminary cycle of investi- 
 gation developed the first part of the general 
 thesis. It proved that naturally frozen water 
 could contain living micro-organisms. It did 
 not test results by the essential touchstone of 
 quantitative methods. Knowledge of the num- 
 ber of bacteria before and after freezing is the 
 only thing which will give definite answers 
 regarding the persistence of germ-life or the 
 resulting danger from these forms. This in- 
 formation, could not be obtained by any single 
 counting of bacteria. Only by many countings 
 of the number present before freezing, and of 
 the numbers left after various periods of time 
 spent in the frozen state, could really valuable 
 and decisive results be obtained. 
 
 The group of experimenters who took up 
 the work in what might be termed the second 
 cycle did not obtain this necessary numerical 
 knowledge, but, despite this, were able to 
 carry the investigation some distance forward. 
 Instead of working with natural snow and 
 ice, they froze solutions filled with bacteria,
 
 ICE 179 
 
 and submitted them, not only to freezing 
 temperatures, but to degrees of cold far below 
 that of ice. Von Frisch, Pictet and Young, 
 D'Arsonval, Charrin, Ravenel, Janowsky, and 
 others studied the problem by exposing cul- 
 tures of bacteria to temperatures ranging from 
 10 to 400 Fahrenheit below the freezing- 
 point of water. All proved that bacterial life 
 could exist even when seemingly hardier or- 
 ganisms perished, but each secured his results 
 by the use of bacteria living in rich and nour- 
 ishing media, a condition vastly different from 
 the normal life of micro-organisms imbedded 
 in ice. This fact, that bacteria lived in severe 
 cold when supplied with ample nourishment, 
 told only part of the story. Not only that, 
 but the results of the second cycle of inves- 
 tigation, from which came a more or less 
 general belief that frozen water did nothing 
 to free itself from impurities, were incomplete 
 and unsatisfactory for another vital reason. 
 Strangely enough, this body of investigators 
 had not yet reached the point of testing their 
 results by quantitative numerical work : they 
 still relied on qualitative tests. 
 
 Few things are more essential to the city 
 than for its citizens to acquire some measure
 
 180 THE HEALTH OF THE CITY 
 
 of the modern scientist's reliance upon quanti- 
 tative methods ; for despite the fact that in the 
 differentiation between qualitative and quan- 
 titative we find a distinction old as the race it- 
 self, the average person pays little attention to 
 quantitative results. Qualitative experiment is 
 like aboriginal cooking, where quantities are 
 unconsidered and the prepared food may vary 
 through all degrees from bad to good. Quanti- 
 tative experiment, with its possibilities of good 
 results, has existed since that moment in the 
 dawn of civilization when primeval woman first 
 measured out her breadstuffs in a stone cup, 
 and, trying different quantities, finally reached 
 a definite amount which would serve her as 
 a standard for her later production of good 
 bread. Progress has always passed through 
 what happens to how much happens ; from 
 gathering crops at random to the computation 
 of bushels per acre ; from the stifling heat 
 and foul air of the old school-rooms to the 
 proper number of cubic feet of fresh air per 
 individual in the new ; from the general fact 
 that cold will not kill entire bacterial popula- 
 tions to the exact numerical part which the cold 
 of ice plays in limiting or partially cutting 
 off the numbers of the micro-organisms present.
 
 ICE 181 
 
 Such a change from qualitative to quanti- 
 tative methods characterizes the third cycle of 
 the researches on ice. Frankland, Pengra, 
 Frankel, and others had made isolated efforts 
 at obtaining numerical results ; but it was left 
 to Dr. Prudden of New York to consider the 
 problem for the first time by the use of care- 
 ful quantitative methods, used with relation 
 to certain specific micro-organisms of disease. 
 Using an analogy with the study of men, 
 we may say that Prudden's work marked the 
 point where this research passed from general 
 anthropology to specific criminology. For the 
 first time the purpose of an investigator bore 
 directly upon those germs which are respon- 
 sible for water-borne disease. Using definite 
 counted numbers of bacteria, and observing 
 their endurance, their period of life, under 
 frozen conditions, Prudden determined that 
 many bacteria were killed by freezing, that 
 different species are very differently affected 
 by the cold, that alternate freezing and thaw- 
 ing are likely to be fatal, and that the number 
 killed increases as the length of time in a 
 frozen condition is prolonged. 
 
 Prudden's results, excellent as they were, 
 left much to be desired. There were various
 
 182 THE HEALTH OF THE CITY 
 
 possibilities of error in 1887, when this work 
 was done. Methods of bacteriological work 
 had not reached the degree of excellence after- 
 wards obtained, and the general knowledge 
 of sanitary science had increased enormously 
 during the twelve years which elapsed before 
 Sedgwick and Winslow began their research 
 in the biological laboratories of the Massachu- 
 setts Institute of Technology with regard to 
 the " effect of freezing and other low temper- 
 atures upon the viability [the capacity of liv- 
 ing] of the bacillus of typhoid fever, with 
 considerations regarding ice as a vehicle of 
 infectious disease." 
 
 In this investigation, for the first time, bac- 
 teriological research on ice was concentrated 
 in such a way as to apply directly to the im- 
 mediate service of man. Although Prudden 
 had used pathogenic germs (the micro-organ- 
 isms which cause disease), his labors had 
 been confined largely to comparisons of vari- 
 ous bacilli. Now, as a student of the criminal 
 classes might specialize on a single branch of 
 his subject, such as forgery, so the present 
 consideration narrowed down to the one chief 
 water-borne disease of the temperate zone, 
 typhoid fever.
 
 ICE 183 
 
 Three striking results appeared as the ex- 
 periment progressed. First, as regards the per 
 cent of micro-organisms which perished as the 
 time of endurance of cold continued. Fifty per 
 cent of the total number died in half an hour. 
 Less than one per cent of the total number 
 survived after fourteen days. Beyond that 
 time-limit, a slow, steady reduction continued 
 until either every micro-organism perished, or 
 the numbers of the bacilli were diminished to 
 an apparently irreducible minimum. 
 
 In duration of time, then, in the stor- 
 age that ice receives in the ice-house, to put it 
 more practically, is to be found one of the 
 greatest factors in the elimination of what 
 might be called the internal organic life of ice. 
 We have already considered how crystallization 
 and gravity work towards that end. We shall 
 see in a moment how this research brought 
 the conclusions on that subject to a laboratory 
 basis. Here we have figures which relate di- 
 rectly to the storage factor, to the length of 
 time ice must be stored before its dangerous 
 bacteria die. Practically all the natural ice 
 which comes to the city is stored for weeks or 
 months before use. Time is a great factor in 
 stamping out the micro-organisms of disease.
 
 184 THE HEALTH OF THE CITY 
 
 Able as many are to endure low tempera- 
 tures for brief spaces of time, tbe greater part 
 of them die under long exposure to the cold. 
 A second fact appeared upon investigation. 
 Prudden had already noted that the number 
 of bacteria killed by freezing varied with the 
 species, that such tiny organisms as the ironi- 
 cally named Bacillus pro digiosus lived their 
 life in their icy world in a different way from 
 the Bacillus typhi. Now came the conclusion, 
 not only that different species of bacteria 
 were differently affected by the same condi- 
 tions of cold, but also that within the limits of 
 a single species existed distinct races marked by 
 strongly variant powers of resistance. Four sep- 
 arate races which the experimenters named 
 A, B, C, D were considered. All were pre- 
 sumably of the same typhoid type. Striking 
 differences, however, appeared between them. 
 Race C succumbed to the cold far more readily 
 than Race B. Races A and D were neither as 
 weak as Race C, nor as strong as B. Similar 
 variations showed in the growth of each indi- 
 vidual race ; and the conclusion was finally 
 reached that in different races of a single bac- 
 terial species the number killed varies with the 
 race. As in the case of man, we can observe the
 
 ICE 185 
 
 varied resistance which Northerner and South- 
 erner offer against the invasion of cold and 
 heat ; as we see the Negro living and flour- 
 ishing in climates which destroy the white 
 man ; so we may see that one alien bacterial 
 stock dies out in an unaccustomed clime where 
 another persists. 
 
 Important as are the conclusions arrived at 
 concerning the purifying effect of storage, 
 another part of the research bears peculiarly 
 closely upon the public health that which 
 regards the " effects of sedimentation and crys- 
 tallization during the freezing of typhoid-fever 
 bacilli in water." The work of every early 
 investigator was marked by a common error, 
 the conditions under which the bacteria 
 were frozen were not the same as those which 
 obtained in the formation of natural ice. The 
 culture-tubes were frozen in a solid block, 
 a way in which natural ice never freezes. In 
 this case an attempt was made to copy the 
 work of nature rather than to follow that of 
 previous experimenters along the same line. 
 Heretofore, the purification of the free ice of 
 the lake solidifying under the winter sky had 
 received but little attention from the men who 
 observed bacterial life in the ice-tubes of the
 
 186 
 
 laboratory. Make one exception, the pre- 
 sence in natural water of multitudes of hostile 
 infusoria, tiniest of scavengers, who may de- 
 vour forests of microscopic plants which grav- 
 ity is drawing towards the bottom, and all 
 the natural circumstances surrounding ice-for- 
 mation were reproduced in this research. 
 
 This portion of the investigation offers an 
 excellent demonstration of the hypothesis that, 
 if natural phenomena are to be subjected to lab- 
 oratory examination, natural conditions must 
 be duplicated. Certainly, no reference to the 
 necessity for exact duplication of nature's pro- 
 cesses appears in the fairly extensive literature 
 collected for this chapter up to the time that 
 the Sedgwick and Winslow research is reached. 
 The way in which the inherent difficulties of 
 this problem were overcome was most ingenious. 
 Placing about ten gallons of sterile water in a 
 caref ully jacketed wine cask, the experimenters 
 inoculated the liquid with typhoid bacilli and 
 exposed the cask to temperatures below the 
 freezing-point. The jacketing of the sides 
 and bottom of the cask produced a condition 
 similar to that of a natural pond. Cold could 
 enter only at the top. The ice could grow in 
 but one direction, downward. Natural condi-
 
 ICE 187 
 
 tions were reproduced, and it was found that 
 the ice contained about one tenth as many 
 bacteria as inhabited the water below. The 
 tendency of natural ice to purify itself by 
 the aid of gravity and crystallization had been 
 demonstrated under laboratory conditions. 
 
 Three conclusions may be drawn from this 
 research. First, one race of a certain pathogenic 
 germ may persist where another dies. Second, 
 whatever the persistence of any race, exposure 
 to long-continued cold, such as takes place in 
 the natural storage of ice, cuts the numbers 
 of the bacteria to a very low quantity. Third, 
 crystallization reduces the numbers in nearly 
 as great a proportion as storage. Since crys- 
 tallization and gravity exclude 90% of the 
 organisms present in any germ-body of water, 
 cold and storage combined exclude almost 99%. 
 When these factors are added together, as 
 they ordinarily are, we may reasonably con- 
 clude that ice so formed is safe, provided we 
 hold to our original criticism of the topmost 
 layer. There the number of micro-organisms 
 may be so great as to defy the destructive 
 agencies. The common belief that disease- 
 germs may live for months in ordinary clear 
 natural ice seems unfounded, and the empha-
 
 188 THE HEALTH OF THE CITY 
 
 sis is placed on a new point, the possibility of 
 the contamination of ice through human car- 
 riers and unclean resting-places. 
 
 Scarcely another article of human con- 
 sumption receives so much direct handling 
 just before its use as does this food. Milk and 
 water, tea and coffee, are poured. Bread, meat, 
 and butter are cut. Bread, probably handled 
 more than any other food on the list, has a 
 hard crust, which offers a rather unfavorable 
 lodging-place for germ-life. Ice, on the con- 
 trary, washes the hands of every person who 
 handles it, and affords an ever-ready liquid 
 medium for the immediate absorption of the 
 hosts of bacteria which hands may carry. The 
 carelessness of the handlers of ice, their utter 
 disregard of the resting-places where it may 
 receive infection, may be due partly to their 
 lack of realization that ice is a food, as real 
 a food as meat. Whatever the cause, few 
 substances which pass through the digestive 
 processes of man receive such treatment. Its 
 surface contaminated by the passage of men 
 and horses in the cutting, its sides and base 
 fouled by muddied platforms and dirty straw, 
 covered with the filth of black ice-cars and 
 dust-swept freight stations, your cake of ice
 
 ICE 189 
 
 commonly receives its only cleaning just be- 
 fore it enters the ice-chest. So far as the ice- 
 man is concerned, this is generally a hasty 
 brush with a time-worn whisk-broom, well 
 filled with the dust of the street and blackened 
 with constant use. According to the personal 
 testimony of various ice-men, not even the pre- 
 caution of a momentary washing beneath the 
 faucet is ordinarily taken. Add to this lack 
 of cleanly control the immediate contamination 
 of the server's hand who prepares the ice just 
 before meal-time, and you have excellent 
 opportunity for infection. And this infec- 
 tion, contrary to the conditions which prevail 
 with water and milk, will be normally a producer 
 of isolated disease rather than of epidemics. 
 The proper management of house-conditions 
 rests upon the consumer, but there is much 
 that can be done before ice reaches the house. 
 Few of the city's necessities possess such 
 possibilities of regulation as the one considered 
 here. Water, springing from a thousand rills, 
 is the bearer in solution and suspension of 
 a great portion of the matter which it meets 
 upon its travels. Only by extraordinary pre- 
 cautions, by complete control of miles of water- 
 shed, or by carefully constructed filters, can
 
 190 THE HEALTH OF THE CITY 
 
 it be cleansed. From the moment of its incep- 
 tion to that of its actual use, water must be 
 kept pure and free. Milk, produced in hun- 
 dreds of isolated dairy farms, small and large, 
 enters the city in a flood, daily renewed, and 
 requiring daily, almost hourly, inspection. 
 Vegetables and other provisions come in by 
 every thoroughfare. 
 
 Sharply contrasted with these are the condi- 
 tions of the city's ice. Harvested in great bulk, 
 since small ponds no longer produce paying 
 quantities, a glance at any large-scale topo- 
 graphical map will show the sources of supply. 
 Inspection of sources in consequence becomes 
 a matter of long jumps from point to point. 
 Entering the city through centralized freight 
 stations, ice from a distance could invariably 
 be discharged (as it commonly is) at a few 
 distributing points, where single inspectors at 
 each terminal could determine its condition. 
 In the cases where ice comes in by wagon, 
 it must originate in bodies of water close at 
 hand. These are few at best and easy of cen- 
 tralized control. Concealment of unfortunate 
 conditions in a pond open to the eye of every 
 wayfarer is far more difficult than similar 
 concealment inside four walls, just as immu-
 
 ICE 191 
 
 nity from the consequences of assault and 
 robbery is a much greater problem in the 
 public square than it is in the back alley. The 
 ice-dealer who attempted to overflow his ice, 
 or to join thin cakes in violation of law, would 
 have no easy task to do it unconvicted. Even 
 if regulation did not extend to the control of 
 the sources, an enforced law requiring the 
 planing off of the topmost layer would do 
 much. Artificial ice-control is made simple 
 because of the fact that the manufacturer 
 must produce his product in accessible central 
 locations, and each city will support but few 
 plants of this type. 
 
 Municipal or state control of the ice busi- 
 ness is more than practical, then. It is inex- 
 pensive. The comparatively small number of 
 individual and corporate ice-dealers in each 
 city makes the issuance of licenses a very 
 much less complicated matter than the present 
 issuances of permits to peddlers, to milk-men, 
 and to other purveyors of the city's foods. 
 Inspection of most food-supplies must occur 
 almost hourly. Inspection of ice need be little 
 more than semi-annual. Visual examination 
 of the pond, the ice-house, and the methods 
 of transportation, bacteriological examination
 
 192 THE HEALTH OF THE CITY 
 
 of samples at harvesting and shipping times, 
 regulations against the use of snow and over- 
 flowed ice, or proper provision for planing, con- 
 trol of artificial ice-factories in respect both to 
 water-supply and to construction, all these 
 matters could be governed with a minimum 
 of cost as compared with the possible results 
 obtained. 
 
 That great example of the individualistic 
 life, our old friend Robinson Crusoe, before 
 he took up a community existence with Friday, 
 drew up, as you will remember, two parallel 
 columns of bad and good. The critic of the 
 city's health, striving to adjust a balance, may 
 set down the results of his reasoning some- 
 what as follows : 
 
 All the bacteria of disease are not killed, 
 even by temperatures far below the freezing- 
 point of water. 
 
 But when the bacteria have to live for long 
 periods in ice, as they commonly do in ice- 
 house storage, the greater part of them perish. 
 
 Snow-ice and upper ice may be filled with 
 surface impurities. It is the top layer which 
 needs cleansing. 
 
 This layer can be planed off.
 
 ICE 193 
 
 There is grave danger of contamination 
 from handling. 
 
 That is true and hard to combat. But the 
 remedy for it lies in the awakening of indi- 
 vidual interest. 
 
 There is pressing need for proper general 
 control of both the natural and the artificial 
 ice-supply. 
 
 But there are unusual possibilities of com- 
 plete control in the dawning recognition of 
 the fact that the citizen must guard himself 
 and his family by the advice and service of 
 trained experts. Many as are the ways in which 
 the state can protect her children, her greatest 
 reliance must always be the education of the 
 individual citizen, the formation of standards 
 of life, and of approachable ideals.
 
 VII 
 
 SEWER-GAS AND PLUMBING 
 
 THE chapter which follows is frankly and un- 
 reservedly a tale of research. It is an attempt 
 to tell the city householder what is actually 
 known about sewer-gas, and to explain some 
 of the studies made in recent years on house- 
 drainage and plumbing with regard to their 
 bearing on the public health. It gives the 
 story of a notable public action on the part of 
 a craft. It includes a brief discussion of actual 
 plumbing conditions, and of the regulations 
 made to avoid the dangers which have been 
 believed to come from wastes which leave our 
 homes. Since the plumbing of our houses is the 
 barrier between us and substances which might 
 rise from the sewer's stream, it is a matter of 
 immediate importance to every city-dweller to 
 know the relation between sewer-air, house- 
 drains, and the health of the inmates of each 
 home. 
 
 Few of the sanitary theories of the city 
 worker are more firmly fixed than his belief
 
 SEWER-GAS AND PLUMBING 195 
 
 in the dread effect of sewer-gas. He may have 
 no hesitation in drinking water whose source 
 offers every possibility of pollution from 
 typhoid-germs, and may fear no danger in 
 the milk which feeds his child. He is, however, 
 generally strong on drains. What is more, 
 there are probably few sanitary matters on 
 which there seems to be more personal evi- 
 dence. So many people can refer you to some 
 house where there have been cases of diph- 
 theria, pneumonia, dysentery, or typhoid, and 
 in which broken drains or leaky drain-pipes 
 have been discovered. Trace those cases down, 
 compare them with the total amount of re- 
 ported sickness from these specific diseases, 
 and you begin to become skeptical. No epi- 
 demic of disease has been reported where reli- 
 able statistical evidence exists of causation 
 by sewer-gas. There are undoubtedly well- 
 authenticated reports of sporadic illness where 
 sewer difficulties have existed. We can hardly 
 make generalizations from these reports, how- 
 ever, for the simple reason that there are leak- 
 ing drains on every hand without disease. 
 Epidemiology, however, is filled with reports 
 of disease whose causation has been definitely 
 traced to water or to milk. Is it not possible
 
 196 THE HEALTH OF THE CITY 
 
 that the danger from this special source has 
 been exaggerated, and that in attributing 
 much trouble to this cause we have been led 
 to neglect the greater dangers of poor water, 
 poor food, overcrowding, and bad air? There 
 are plenty of real evils in the city. We have 
 no time to fi^ht with chimaeras. 
 
 O 
 
 Two theories of the harmf ulness of sewer- 
 gas hold the stage to-day. The first and less 
 common is not yet definitely proved or dis- 
 proved. It concerns the possibility that sewer- 
 gas may predispose to disease, may create a 
 state of lowered vitality in the human frame 
 in which that tendency to immunity from dis- 
 ease which the healthy body holds is weak- 
 ened. Of the relation which that theory bears 
 to the public health we shall speak later. The 
 second is the common theory that the germs 
 of disease rise directly from the sewer. This 
 chapter tells of the researches which have 
 proven this popular belief to be untenable. 
 
 Before we turn to the story of the search 
 for the truth or falsity of the charges made 
 against sewer-gas, let us pause briefly to con- 
 sider some of the facts on which that search 
 was forced to depend. According to the Cen- 
 tury Dictionary, sewer-gas is "the contami-
 
 SEWER-GAS AND PLUMBING 197 
 
 nated air of sewers." Assume that to be the 
 common definition, and expand it. The air of 
 a sewer, in its chemical composition, can be 
 little different from the air of a street. The 
 chemical elements and compounds which com- 
 pose the great body of the atmosphere are 
 the same in either case. If sewer-air is con- 
 taminated, that contamination can arise only 
 from one of two causes, either from the addi- 
 tion of poisonous gases which are produced 
 by the decomposition of the organic wastes 
 which sewage contains, or from the rise into 
 it of dangerous micro-organisms present in the 
 liquid which flows through the sewer-pipes. 
 
 The amount of poisonous gases likely to be 
 evolved from sewage is small. Sewage is made 
 up from the washings from sinks, from water- 
 closets, from a hundred processes involving 
 the use of water, from rain and melted snow. 
 It runs to its ultimate destination in a greatly 
 diluted flood, which seldom contains more 
 than one part in one thousand of organic 
 matter. That amount could furnish but little 
 gas under any circumstances. Add the fact 
 that the evolution of gases is dependent upon 
 decomposition and that sewage is rapidly hur- 
 ried on to its place of disposal : it is evident
 
 198 THE HEALTH OF THE CITY 
 
 that it can seldom advance to the point where 
 there is any material amount of decomposition. 
 In this connection it is especially worthy of 
 note that, according to Richards and Wood- 
 man, ill-smelling gases are given off only when 
 sewage is about eighteen hours old. It is true 
 that sewage, standing in the septic tank, may 
 produce much gas. Such evolution of gases 
 occurs, however, only under anaerobic con- 
 ditions, conditions where air is excluded. It 
 occurs when comparatively concentrated sew- 
 age is stored for shorter or longer periods of 
 time. To-day sewage is swiftly removed from 
 the well-sewered city, and the danger of large 
 amounts of gases rising from the sewer, in 
 which the liquids are carried to their point of 
 final disposal, is slight indeed. The house- 
 drain, the broken pipe from which sewage 
 seeps into the soil, the ill-constructed waste- 
 pipe, the cesspool where stagnant liquid stands, 
 might provide more. 
 
 Rightly enough, the possibility of direct 
 germ-infection from the sewer has attracted 
 the most attention. We may learn from any 
 analysis that there are great quantities of the 
 germs which cause disease in the fresh liquid 
 sewage of any city. It is a matter of very real
 
 SEWER-GAS AND PLUMBING 199 
 
 importance for us to know whether or not 
 these micro-organisms are likely to fly upward, 
 escape into the air above, and infect the house- 
 hold. Speculation on this point is wholly val- 
 ueless. Once more we have one plain way 
 before us a quantitative and qualitative ex- 
 amination of sewer-air, to determine whether 
 or not it is more dangerous than the every-day 
 air that we breathe throughout the twenty- 
 four hours of the day. Many people breathe 
 the most dust-laden atmosphere without a 
 thought of harm, who believe sewer-gas a 
 deadly miasma. Here is a chance for a com- 
 parative study. Let an investigator take equal 
 quantities of street-air and sewer-air and ex- 
 amine each sample, under the rigorous laws 
 of the laboratory, to determine how many 
 bacteria are present and what kind they are. 
 If rightly carried on, that will tell the story, 
 furnish the proof. If the air of the sewer is 
 heavily laden with bacteria and contains the 
 germs peculiar to sewage, while the air of the 
 street does not contain these germs, the case 
 against sewer-gas would seem well on its way 
 to be proven. If, on the other hand, sewer-air 
 contains practically no more bacteria than 
 street-air holds ; if it is free from the danger-
 
 200 THE HEALTH OF THE CITY 
 
 ous organisms found in liquid sewage, it would 
 look as if we had been falsely alarmed con- 
 cerning the possibility of direct infection from 
 this source. 
 
 As has been mentioned before, it is not 
 enough to investigate natural phenomena 
 under one set of conditions or with limited 
 amounts. Truth is always difficult to attain. 
 Only by repeated investigations, made under 
 the closest possible approximation to natural 
 conditions, can the truth be found in the lab- 
 oratory. The air of the sewer may be inert, 
 stagnant. It may vary in velocity from a gentle 
 breeze to a rushing wind. The swifter the 
 wind, the greater the possibility of its raising 
 germs from the surface of the liquid below. 
 Sewage normally flows in a quiet, steady 
 stream. But water falling into it goes down 
 in a cascading spray filled with bubbles of 
 air. Gases, generated in its depths, may rise 
 to its surface. Both the quiet liquid and the 
 bursting bubble should be investigated. The 
 research to determine whether or not danger- 
 ous germ-enemies of man exist in sewer-air 
 should be carried on under conditions which 
 actually occur. 
 
 There are some peculiarities of certain mem-
 
 SEWER-GAS AND PLUMBING 201 
 
 bers of the bacterial family which should be 
 mentioned here. Two of the bacteria most 
 closely connected with the problem before us 
 are the Bacillus coli and the Bacillus typho- 
 sus. Constantly found in the intestines of 
 man and of many of the higher animals, the 
 colon bacillus is especially characteristic of 
 sewage, where it is found in enormous quanti- 
 ties ; while the typhoid bacillus is the micro- 
 organism which, beyond all others, causes 
 water-borne disease in temperate climes. These 
 two bacteria are closely related. Their pre- 
 vailing form is that of a plump, straight rod, 
 with rounded ends, which is approximately one 
 twenty-five-thousandth of an inch in length. 
 Similar as they are, they can be clearly dis- 
 tinguished by bacteriological methods. Both 
 of these tiny germs have perceptible weight, 
 and swiftly settle out of the air. Following 
 the general rule of the bacteria, they flourish 
 in dirt, darkness, and moisture, all of which 
 conditions are found in sewage. There is no 
 condition known in which they tend of them- 
 selves to leave any quiet liquid media for the 
 air. As we shall see, these characteristics play 
 their part in the story which follows. 
 
 The three countries most interested in san-
 
 202 THE HEALTH OF THE CITY 
 
 itary reform, Germany, England, and America, 
 each offered their share of investigators, to 
 the end that more light might be shed upon 
 this question of direct infection from the 
 germs of the sewer. The experimental results 
 reached in every country were similar, and 
 have convinced the great body of experts in 
 Germany and the United States. They have 
 not been sufficient to overcome the conserva- 
 tism of some British sanitarians, who have 
 been more affected by the reports of local 
 authorities, who have attributed typhoid and 
 other epidemics to poor drains, than they have 
 been by the carefully controlled work of the 
 laboratory. France and Italy, in the work of 
 Miquel and D'Alessi, have furnished two of 
 the most noteworthy researches of the series. 
 Mention of the first of these will be made in 
 the immediately following paragraphs. Refer- 
 ence to the second must be postponed till the 
 consideration of the second half of our topic 
 predisposition. 
 
 Britain's contribution to the subject may 
 be said to commence with the work of Sir 
 Edward Frankland, who, like Pumpelly in 
 America, made a careful investigation of the 
 bacterial life existent in air above quiet liquid
 
 SEWER-GAS AND PLUMBING 203 
 
 sewage, and in air above sewage from which 
 bubbles of gas, generated by the decomposing 
 organic matter, were rising. Both Frankland 
 and Pumpelly decided that, under ordinary 
 circumstances, germs could be thrown off only 
 by the bursting of bubbles, that they did not 
 rise from the quiet liquid. Carnally and Hal- 
 dane, in a long and careful study of English 
 and Scottish cities, found in practically every 
 street a greater bacterial population per given 
 quantity of air than was found in the sewers 
 beneath the street. The kinds of bacteria oc- 
 curring in street and sewer were the same, 
 and wherever, for any reason, the number of 
 the micro-organisms increased in the street, 
 they increased proportionally in the sewer. 
 Laws and Andrewes, in a similar investigation, 
 carried the matter yet further. They deter- 
 mined that moulds and micro-cocci, both 
 especially characteristic forms of street-air, 
 were most abundant in sewer-air. Even more 
 important in some ways was the discovery of 
 these investigators that the Bacillus coli, the 
 most typical bacterial form of sewage, was not 
 found in any sample investigated. 
 
 The German results include numerous in- 
 vestigations, from those of Nageli, who con-
 
 204 THE HEALTH OF THE CITY 
 
 eluded in 1877 that " infectious materials, in 
 general, pass into the air only after drying, 
 and then in the form of dust," through the 
 work of Uffelmann, Flugge, Petri, and Ficker. 
 Discussing the whole matter in 1895, Kirch- 
 ner and Lindley, in a paper read before the 
 German Society of Public Health, came to 
 the following conclusions : 
 
 " 1. The assumption of the spread of epi- 
 demic diseases, such as Typhoid, Cholera, and 
 Diphtheria, by sewer-gas does not harmonize 
 with our present knowledge of the nature of 
 the causative agents of these diseases. 
 
 " 2. On the other hand, the gaseous products 
 of decomposition arising in sewers and house- 
 drains may be harmful, indirectly if not directly, 
 to those exposed to them for a considerable 
 time; they may produce nausea and may lower 
 the general tone of the body, including its 
 resistance against disease." 
 
 One of the most interesting investigations 
 of the whole series is the comparative study 
 made every year for sixteen years by Miquel, 
 who annually, for that whole period, counted 
 comparative numbers of the bacteria found 
 under similar conditions in Paris streets, in 
 the French countryside at Montsouris, and in
 
 SEWER-GAS AND PLUMBING 205 
 
 Paris sewers. Some amazing results as regards 
 numbers were secured. If we average four 
 years of the series, we find approximately one 
 bacterium in country air to fourteen in the 
 sewers and thirty in the street, the exact re- 
 sults being Ito 13.817 to 29.976. According 
 to Miquel, in these years there were about 
 half as many micro-organisms in the sewer 
 as in the street. 
 
 In America, besides Pumpelly already men- 
 tioned, Abbott, Hazen and Ruttan, Whipple 
 and Harrington, came to similar conclusions, 
 that the danger of infection from germs rising 
 from the sewer was practically negligible, and 
 that bacteria rose only when they reached 
 the sewer in spray, or were thrown from it 
 on bursting bubbles of gas. 
 
 In 1905 affairs rested on the basis of the ex- 
 periments just described. German and Amer- 
 ican sanitary authorities in general did not 
 believe that direct infection from the germs 
 of the sewer was at all probable. One section 
 of the body of British sanitarians thought dif- 
 ferently. A large proportion, if not a majority, 
 of the general public were convinced that 
 typhoid, diphtheria, and other similar diseases 
 rose directly from the sewer when there was
 
 206 THE HEALTH OF THE CITY 
 
 any drain trouble in the house. Then, in 1905, 
 occurred an event, which seems to the writer 
 one of the most notable recorded in this book, 
 the determination of a craft to take up 
 officially a scientific investigation, through the 
 employment of trained investigators, who were 
 to conduct a research in one portion of their 
 field of labor. The National Association of 
 Master Plumbers of the United States, acting 
 upon the suggestions offered by their Sanitary 
 Committee, authorized that committee to make 
 plans for an investigation, to determine, in 
 the words of the report, "how much sewer- 
 gas was to blame for the carriage of disease, 
 and if so, to what extent." 
 
 It is a remarkable tribute to the grad- 
 ually spreading belief in the touchstone of the 
 laboratory that this committee, finding no 
 place in the world where investigation of the 
 questions which they desired to have settled 
 was being carried on, started upon a research 
 of their own. Most corporations have already 
 learned that a chemist may save them thou- 
 sands of dollars. Many business interests have 
 come to recognize that research which involves 
 utilization of by-products, or produces meth- 
 ods for shortening processes, means greater
 
 SEWER-GAS AND PLUMBING 207 
 
 profits. It is certainly rare, if not unique, to 
 find a national association of a craft commenc- 
 ing such an undertaking for the public health, 
 spending money for an enterprise which did 
 not immediately affect the pocket-books of the 
 members. 
 
 There was, fortunately, one place where 
 problems of sewage-disposal had been espe- 
 cially considered for some years. Since 1903 
 the Massachusetts Institute of Technology has 
 maintained a Sanitary-Research Laboratory 
 and Sewage-Experiment Station, designed, in 
 the words of the catalogue, for "the investi- 
 gation of problems relating particularly to the 
 purification of the sewage of large cities, for 
 the demonstration of sanitary methods and 
 appliances, and ultimately for the advance- 
 ment of popular education in public-health 
 subjects." The Sanitary Committee of the 
 Master Plumbers, consisting of David Craig, 
 chairman, and Messrs. Balme, Decker, Morgan, 
 and Highlands, arranged with the Institute 
 of Technology to erect needed experimental 
 apparatus in the laboratory of the sewer- 
 station, and intrusted the work to Professor 
 C-E. A. Winslow of the faculty. 
 
 The investigations which preceded the one
 
 208 THE HEALTH OF THE CITY 
 
 now under consideration had been concerned 
 chiefly with sewer-air proper, that is, with 
 the air in sewer-pipes, not with the air of 
 house-drains. It had been reasonably estab- 
 lished that sewer-air was freer from germ-life 
 than the air of the street. It had not been 
 proven that, assuming the ordinary conditions 
 of the discharge of water from a water-closet 
 or a sink in a house, germs from a broken drain, 
 a cesspool, an unsealed trap, or a badly placed 
 vent might not make their way into the air 
 of rooms. It was just this question of the 
 possibility of danger from house-plumbing 
 that this research undertook to solve. 
 
 Plumbing is terra incognita to so many 
 of us that a word about the means employed 
 to remove wastes from the household may not 
 be amiss. In his " Municipal Engineering and 
 Sanitation," Baker writes that the essentials 
 of sanitary plumbing are simplicity, durability, 
 accessibility, and air-tightness. To these re- 
 quirements, Harrington, in his " Practical 
 Hygiene," added thorough ventilation and 
 plentiful water-supply. Open plumbing, by its 
 simplification of repair and construction, has 
 done much to accomplish those ideals. The 
 necessity for sound materials has brought
 
 SEWER-GAS AND PLUMBING 209 
 
 about a general use of cast iron, instead of 
 lead, for soil-pipes, a notable change for the 
 better, as iron is lighter, stiffer, and more 
 durable; its stiffness prevents the sagging 
 and pocketing possible with lead. The soil- 
 pipe furnishes the means of exit to the wastes. 
 With it, as with all the removal apparatus, a 
 first essential is such construction that there 
 shall be no possibility of leakage for solid, 
 liquid, or gas. The soil-pipe, however, does 
 nothing more than provide a road for removal. 
 Protection against the return of sewage or the 
 influx of sewer-gases is centred in the trap 
 and the vent. 
 
 A trap is a device for providing a water-seal 
 to the plumbing of a house, by causing some 
 of the passing liquid to lodge in a pocket 
 or depression. It may be manufactured in 
 many forms and shapes, but the simplest one 
 of all is the running trap shaped like a U- The 
 wastes enter this trap at A and leave at B. 
 No matter how much water passes through, 
 C should be left filled with liquid. This liquid 
 seal prevents the passage of air from the sewer 
 to the house. A vent or air-pipe, D, the round 
 iron pipe which you may see rising through 
 the roof of your neighbor's house, leading to
 
 210 
 
 THE HEALTH OF THE CITY 
 
 the outer air, is placed on the outflowing 
 side of the trap to provide ventilation for 
 any gases which, accumulating in the pipes, 
 
 might force sewage back into the bowl. It 
 has been believed that the vent does away with 
 any possible siphoning or emptying of traps 
 because of the sudden rush of water through 
 them. 
 
 In actual practice there are three possibili- 
 ties of sewer-air or sewer-gases rising into a 
 house through a trap. The level of water in the 
 U of the pipe may fall so low as to leave the
 
 SEWER-GAS AND PLUMBING 211 
 
 trap only partially sealed. The liquid, through 
 some flaw, may disappear altogether. Gases 
 generated on the sewer side may exert sufficient 
 pressure on the liquid in the water-seal to force 
 their way through to the soil-pipe. It is possible, 
 moreover, though hardly probable, that germs 
 might rise from the wetted interior surface of 
 a soil-pipe. We have already seen that bacteria 
 have a perceptible weight, and tend to settle 
 rather than to rise. Even with an open trap, the 
 only possibility of getting them into the house 
 would be when they were borne on a strong 
 air-current. 
 
 We have briefly reviewed the plumbing con- 
 ditions which were to be investigated. Now, 
 strangely enough, as we turn back to research, 
 we find a comparative quiescence of some 
 years changing to an active interest in the 
 matter of sewer-air. There began at this time 
 a series of rival investigations, attaining differ- 
 ent ends and forming a striking story of a 
 struggle to wrest truth from the laboratory. 
 A first research carried on by Professor Wins- 
 low was met by a research which reached 
 almost diametrically opposite results, carried on 
 by Major W. H. Horrocks of the British Army. 
 The Horrocks conclusions were startling in
 
 212 THE HEALTH OF THE CITY 
 
 the extreme, for they seemed to show that the 
 greater part of the results already accomplished 
 were false, and that disease-germs could rise 
 from the sewer. A second research conducted 
 by Professor Winslow followed the work of 
 Horrocks step by step, showed the fallacies of 
 the conclusions which he reached, and proved 
 that we may be freed from one of the fears 
 of sewer-gas which has long loomed over us. 
 How that laboratory struggle was carried on, 
 the next division of this chapter shows. 
 
 The necessity for reproducing actual condi- 
 tions in researches concerning the public health 
 has been mentioned more than once in this 
 book. It is interesting to note how closely that 
 rule was followed in the investigation author- 
 ized by the Master Plumbers. Stock plumbing 
 materials, of the same sort that would be put 
 into your house, were used. A four-inch cast- 
 iron soil-pipe, fifteen feet long, was connected 
 at the bottom with an ordinary running trap. 
 Currents of air, varying in velocity from four 
 hundred and ninety feet to seven hundred and 
 ninety feet a minute, were driven through trap 
 and pipe. No normal conditions would ever see 
 an air-current of even five hundred feet a min- 
 ute passing through a trap. The air in the soil-
 
 SEWER-GAS AND PLUMBING 213 
 
 pipe was examined at different levels, with the 
 trap sealed with sewage, partially sealed, and 
 unsealed, and with the pipe dried and wetted. 
 Under no circumstances were any large num- 
 ber of bacteria found in the air. Only when the 
 air-current was rushing through at its higher 
 velocities were any bacteria dislodged at all. 
 The conclusions of Professor Winslow fol- 
 low : 
 
 "On the whole, it appears that germs are 
 carried into the air of a house-drainage system 
 from its traps or wetted surfaces only by suc- 
 tion corresponding to an air-current of six hun- 
 dred feet per minute. It is scarcely conceivable 
 that such a force could be exerted under any 
 practical conditions. The friction in a four-inch 
 pipe is so great that a fairly hot fire inside it 
 could hardly produce such a draft as this, and 
 wind, blowing across the top of such a pipe and 
 directly into its fresh-air inlet at the bottom, 
 could cause so strong an up-current only under 
 exceptional conditions. It seems, therefore, that 
 the carriage of disease-germs from the air of a 
 house-drainage system is an improbable con- 
 tingency." 
 
 In the same year (1907) that the investiga- 
 tion just mentioned was completed, Major W.
 
 214 THE HEALTH OF THE CITY 
 
 H. Horrocks of the Royal Medical Corps re- 
 ported to the Royal Society the results of a 
 series of experiments made at the Fortress of 
 Gibraltar, especially at the Military Hospital. 
 How widely the conclusions reached by this 
 investigator diverged from those just related, 
 the following paragraph will show. 
 
 The results obtained by Major Horrocks, 
 followed by the confirming report of Dr. 
 Andrewes, startled the world of sanitarians. 
 Making a frothing soap-solution strongly in- 
 fected with a test bacterium, the Bacillus 
 prodigiosus, Horrocks investigated the air in 
 drains, in pipes, and in various parts of sewers, 
 by placing open dishes, containing sterile nu- 
 trients, at points above the infected solution. 
 The plates one and all showed the charac- 
 teristic red colonies of Bacillus prodigiosus. 
 Experiments made with the typhoid bacillus 
 under similar conditions showed cultures of 
 this organism. The investigator concluded that 
 "Specific bacteria present in sewage may be 
 ejected into the air of ventilation-pipes, inspec- 
 tion-chambers, drains, and sewers, by (a) the 
 bursting of bubbles at the surface of the sew- 
 age, (&) the separation of dried particles from 
 the walls of pipes, chambers, and sewers, and
 
 SEWER-GAS AND PLUMBING 215 
 
 probably (c) the ejection of minute droplets 
 from flowing sewage." 
 
 Results so contrary to the previous work ac- 
 complished naturally provoked much criticism. 
 On their publication the Sanitary Committee 
 of the Master Plumbers' Association took up 
 the problem anew, and commissioned Professor 
 Winslow to carry on a second series of experi- 
 ments to check the results obtained by Horrocks, 
 and to carry them further if possible. This was 
 especially necessary, as the Horrocks experi- 
 ments had been made in a somewhat different 
 fashion from any hitherto attempted. Soapy 
 water was used. The method of leaving plates 
 containing nutrients freely exposed to the 
 air for considerable periods of time, commonly 
 for twenty-four hours, left great possibilities 
 of contamination. Such contamination might 
 proceed, not only from a worker lowering the 
 plates to place, but also from the more prob- 
 able cause of infection by dust and flies. Most 
 of the Horrocks tests were qualitative not 
 quantitative, as the plates examined were sim- 
 ply exposed for various periods of time to 
 unmeasured volumes of air. 
 
 The isolated fact that harmful bacteria are 
 found in any place is not necessarily a sign of
 
 216 THE HEALTH OF THE CITY 
 
 danger. They are so plentiful that we can 
 scarcely escape them, and their growth is so 
 rapid as to be almost beyond our comprehension. 
 These micro-organisms grow by division, and 
 some of the species grow so rapidly as to divide 
 twice every hour. One at the beginning of an 
 hour, therefore, means four at the end, if all 
 survive. The rapidity of this type of multipli- 
 cation is extraordinary. In a day, if nothing 
 stopped the growth, H. W. Conn has figured 
 that one bacterium would have 16,500,000 
 offspring, so to speak. Two days would produce 
 281,500,000,000, which would form a solid pint 
 of bacteria, weighing about a pound. Three 
 days, still assuming that nothing stepped in the 
 way of the growth, would produce forty-seven 
 thousand billions, which would weigh about 
 sixteen million pounds. These figures are of 
 course wholly theoretical, for the simple reason 
 that something always does step in the way. 
 Before the descendants of the bacteria reached 
 even to the millions, lack of food, overcrowd- 
 ing, and the accumulation of their own life- 
 processes would stop their further growth. But 
 the essential point remains, that bacteria 
 multiply with a swiftness almost beyond our 
 ken. A thimbleful of milk may contain hun-
 
 SEWER-GAS AND PLUMBING 217 
 
 dreds of thousands of these organisms. Its 
 content may easily reach to the millions. The 
 milk is unusually pure if it contains less than 
 ten thousand in this slight volume. A quart of 
 infected milk may easily contain billions of 
 these tiny bodies. 
 
 It must be evident from the preceding para- 
 graph that the mere presence of bacterial life 
 is not a sign of danger. If it were, we should 
 never be free from peril. Major Horrocks's re- 
 sults showed the presence of some indicator- 
 germs (germs intentionally used to test con- 
 ditions) like Bacillus Coli in sewer-air. The 
 essential problem which he left unsolved 
 and which the next research answered is this, 
 Does the presence of comparatively few 
 indicator-germs mean any real probability of 
 getting any disease-germs at all? New York 
 City water, a surface-water of good quality, will 
 almost always contain one hundred bacteria 
 of the sewage type to a quart of water. Such 
 a bacterial content indicates a slight degree 
 of pollution which would be better done away 
 with, yet New York water is drunk without 
 serious harm by hundreds of thousands of city- 
 dwellers. A quart of water is a small amount 
 for use during a day. If we breathe in no
 
 218 THE HEALTH OF THE CITY 
 
 more harmful germs than that amount con- 
 tains, we shall probably suffer n9 injury from 
 specific infection caused by the germs of sewer- 
 gas. 
 
 The second part of Winslow's work on this 
 subject was devoted to a careful imitation of 
 the Horrocks methods and a still more ex- 
 tended examination of the air in plumbing 
 systems actually in use in residences, hospitals, 
 offices, and hotels. The report of the Sanitary 
 Committee of the Master Plumbers for 1909 
 gives the full story of this search. It contains 
 the answer to our original comparison of equal 
 quantities of street-air and sewer-air. It in- 
 volves three of the most interesting appli- 
 cations of the possibility of joining actual 
 conditions to laboratory methods that have 
 been recorded. 
 
 Entering the Boston sewer in a boat-cham- 
 ber, the investigators placed dishes containing 
 sterile nutrients beside the eddying stream of 
 sewage, and on various steps leading to the 
 street. The colon bacillus characteristic of ani- 
 mal wastes was found on every plate, but the 
 numbers of these bacilli were smallest near- 
 est the sewer, greatest nearest the street, and 
 the increase from sewer to street was constant.
 
 SEWER-GAS AND PLUMBING 219 
 
 Remember the point made earlier, that these 
 organisms, tiny as they are, have a perceptible 
 weight and settle swiftly, and you will see 
 that these results indicate one thing, that 
 the bacteria found in sewer-air come chiefly 
 from street dust infected by such agencies as 
 manure, not from the sewer. 
 
 A soapy solution, like that used in the Hor- 
 rocks experiments, was next tried. Qualita- 
 tively, without reference to numbers, it ap- 
 peared that bacteria could be drawn into the 
 air from heavily infected solutions. In eight 
 careful investigations it was shown that but 
 seven test bacteria (Bacillus prodigiosus] ap- 
 peared in air above foaming liquids containing 
 over fifteen billions of this specific organism. 
 Dilution such as this can harm no one. Wins- 
 low carried the matter still further. Setting up 
 an ordinary water-closet, and reproducing the 
 natural splashing of water passing through it, 
 he examined forty-four samples of air to see 
 if infection could take place under these con- 
 ditions. One case of contamination, and only 
 one, occurred. One plate, and only one, was 
 apparently infected by a single drop. Again 
 quantitative methods showed that the possi- 
 bility of disease from the germs of an ordinary
 
 220 THE HEALTH OF THE CITY 
 
 house-system were too slight to be considered. 
 The investigation of nineteen plumbing sys- 
 tems in actual use showed the general air of 
 house drainage-systems to be amazingly free 
 from sewage organisms, far freer, in fact, than 
 the air of the street or the common water-sup- 
 ply of many cities. 
 
 According to this investigation, therefore, 
 a man in an ordinary room would have to 
 breathe undiluted sewer-air for twenty-four 
 hours on a stretch to take into the system as 
 many sewage bacteria as a pint of New York 
 water contains. Only at those points where 
 sewage splashes into spray does the bacterial 
 content increase above this ratio, and then 
 only for a few moments. Suppose we sum the 
 matter up with the closing sentence of Pro- 
 fessor Winslow's report : " I believe, however, 
 that my results, in the light of all previous 
 evidence, warrant the conclusion that the 
 chance of direct bacterial infection through 
 the air of drains and sewers is so slight as to 
 be practically negligible." 
 
 The results obtained by Horrocks failed in 
 two respects. His use of heavily infected, foam- 
 ing emulsions to represent sewage did not 
 actually represent the conditions which exist in
 
 SEWER-GAS AND PLUMBING 221 
 
 a common house drain-pipe or in the sewer. 
 His reliance on qualitative measures did not 
 give sufficient information as to actual every- 
 day conditions. Bacterial life is so widespread, 
 so nearly omnipresent, that the mere presence 
 of various organisms in air is not enough to 
 condemn the air. There is a possibility of the 
 presence of harmful micro-organisms, but it 
 is slight. Were we to consider all such risks, 
 we should live under a never-lifting cloud of 
 fear. Man must take some chances, and in 
 comparison with graver dangers we may con- 
 sider the possibilities of harm from this source 
 negligible. 
 
 In the preceding portion of this chapter I 
 have considered the grounds on which sanita- 
 rians base their disbelief of the common the- 
 ory of the carriage of infectious disease by 
 germs in sewer-air. There remains, however, 
 a second possibility which has received com- 
 paratively little consideration. One chance of 
 deleterious action on the part of sewer-gas 
 remains : the general predisposition to disease 
 which may be caused by the constant inhala- 
 tion of odors, or of such gases as ammonium 
 sulphide, carbon monoxide, and hydrogen sul- 
 phide, all of which possess poisonous properties,
 
 222 THE HEALTH OF THE CITY 
 
 and all of which may be generated during 
 the decomposition of organic matter. Records 
 are in existence which tell of deaths caused 
 by accumulation of heavy gases in cesspools 
 and in dead ends of sewers. Such deaths were 
 caused by suffocation or by direct gas poison- 
 ing. They are few in number, and the testi- 
 mony of vital statistics shows that sewer-work- 
 ers are unusually strong, with a high mean 
 age at death and a low death-rate. 
 
 Vital resistance, the varying powers of dif- 
 ferent persons to resist disease, is no slight 
 factor in sickness. It is entirely possible that 
 the odors of sewer-gas, interfering with appe- 
 tite and digestion, might weaken the general 
 condition. There has been one, and, so far 
 as the writer knows, only one investigation 
 into the problem of predisposition to disease 
 resulting from exposure to sewage. This was 
 the research conducted some years ago by Dr. 
 Alessi of the University of Rome. The results 
 of that investigation indicated that animal 
 life, when exposed to the effect of gases pro- 
 duced by decomposition in sewage, lost its 
 power of resistance to certain specific germ- 
 diseases. Notable as these results were, their 
 lack of confirmation and their comparatively
 
 223 
 
 limited extent enjoin caution before they can 
 be accepted as wholly authoritative. 
 
 Roechling, the author of the important work 
 " Sewer-Gas and its Influence on Health," 
 believes that the action of sewer-gas may pre- 
 dispose the individual to the attacks of disease ; 
 and no small number, especially of British 
 sanitarians, as has been said, agree with him. 
 It is an interesting commentary on the other 
 side of the question that, of six American 
 books on the causation of disease, taken at 
 random from the shelf, the indexes of one 
 half show no reference to odors or to sewer- 
 gas. 
 
 A quotation from Dr. William Budd, given 
 in Sedgwick's " Sanitary Science and the Pub- 
 lic Health," is so peculiarly pertinent to the 
 matter in hand that a part of it will bear repe- 
 tition here. "The need of some radical mod- 
 ification in the view commonly taken of the 
 relation which subsists between typhoid fever 
 and sewage was placed in a very striking light 
 by the state of the public health in London 
 during the hot months of 1858 and 1859, 
 when the Thames stank so badly. 
 
 "Never before had nature laid down the 
 data for the solution of a problem of this kind
 
 224 THE HEALTH OF THE CITY 
 
 in terms so large, or wrought them out to s& 
 decisive an issue. 
 
 " An extreme case, a gigantic scale in the 
 phenomena, and perfect accuracy in the regis- 
 tration of the results three of the best of 
 all the guarantees against fallacy were com- 
 bined to make the induction sure. For the 
 first time in the history of man, the sewage 
 of nearly three million people had been brought 
 to seethe and ferment under a burning sun, 
 in one vast open cloaca lying in their midst. 
 
 " The result we all know. Stench so foul, 
 we may well believe, had never before ascended 
 to pollute this lower air. Never before, at 
 least, had a stink risen to the height of a his- 
 toric event. Even ancient fable failed to fur- 
 nish figures adequate to convey a conception 
 of its vile Augean baseness. For many weeks 
 the atmosphere of Parliamentary committee- 
 rooms was only rendered barely tolerable by 
 the suspension before every window of blinds 
 saturated with chloride of lime, and by the 
 lavish use of this and other disinfectants. 
 More than once, in spite of similar precautions, 
 the law courts were suddenly broken up by 
 an insupportable invasion of the noxious vapor. 
 The river steamers lost their accustomed traf-
 
 SEWER-GAS AND PLUMBING 225 
 
 fic, and travelers pressed for time often made 
 a circuit of many miles rather than cross one 
 of the city bridges. 
 
 "Members of Parliament and noble lords, 
 dabblers in sanitary science, vied with profes- 
 sional sanitarians in predicting pestilence. If 
 London should happily be spared the cholera, 
 decimation by fever was, at least, a certainty. 
 The occurrence of a case of malignant cholera 
 in the person of a Thames waterman early in 
 the summer was more than once cited to give 
 point to these warnings, and as foreshadowing 
 what was to come. Meanwhile, the hot weather 
 passed away, the returns of sickness and mor- 
 tality were made up, and, strange to relate, 
 the result showed, not only a death-rate below 
 the average, but, as the leading peculiarity 
 of the season, a remarkable diminution in the 
 prevalence of fever, diarrhoea, and the other 
 forms of disease commonly ascribed to putrid 
 emanations. 
 
 " The testimony of Dr. Me William, as med- 
 ical supervisor of the waterguard and water- 
 side custom-house officers, is still more to the 
 point. The former, to the number of more 
 than eight hundred, may be said to live on 
 the river, or in the docks, in ships, or in open
 
 226 THE HEALTH OF THE CITY 
 
 boats; and the latter, numbering upward of 
 five hundred, are employed during the day 
 in the docks, or at various wharves of the 
 bonded warehouses on each side of the river. 
 After stating that the amount of general sick- 
 ness among these men was below the average 
 of the three preceding years, and considerably 
 below that of the forms of disease (including 
 diarrhoea, choleraic diarrhoea, dysentery, etc.) 
 which, in this country, noxious exhalations 
 are commonly supposed to originate, we find 
 the additions during the four hot months of 
 the year from this class of complaints 26.3 
 per cent below the average of the correspond- 
 ing period of the three previous years, and 
 73 per cent less than those of 1857. In an- 
 other passage this distinguished physician says, 
 'It is nowhere sustained by evidence that the 
 stench from the river and docks, however 
 noisome, was in any way productive of dis- 
 ease. On the contrary, there was less disease 
 of that form to which foul emanations are 
 supposed to give rise than usual.' 
 
 "Before these inexorable figures the illu- 
 sions of half a century vanish in a moment." 
 
 One nearby possibility of infection from 
 the bath-room has been too much neglected in
 
 SEWER^GAS AND PLUMBING 227 
 
 the consideration of the comparatively remote 
 possibility of more distant germ-infection, 
 the spilling of slops poured down the hopper 
 by careless servants. That this provides a con- 
 siderable possibility of infection through vari- 
 ous carrying agencies, such as flies, fingers, 
 and the like, few can question. Fortunately, 
 the cure is directly in the housekeeper's hands. 
 Here, as in so many other places, the woman in 
 the home can do more than man in the seat of 
 government to better affairs through clean- 
 liness. There is every possibility, moreover, 
 that unclean, ill-ventilated house-plumbing 
 will give off stronger, more immediate, and 
 more persistent odors than any sewer. Odors 
 from bath-tubs and set bowls, for example, are 
 due commonly to decomposing soap in the 
 overflow pipe. 
 
 An analysis made some years ago of the 
 status of the plumbing laws indicated a wide 
 divergence of requirements made by states 
 and municipalities. At that time only nine- 
 teen states, the District of Columbia, and 
 Porto Rico had laws with regard to plumb- 
 ing; but the large cities of most of the states 
 had laid down individual regulations. Most of 
 these ordinances require master plumbers to
 
 228 THE HEALTH OF THE CITY 
 
 have licenses. About a third require master 
 plumbers to furnish bonds ranging in amount 
 from two hundred to five thousand dollars. 
 The majority require extra heavy cast-iron soil- 
 pipes, running traps, and fresh-air inlets. Vent- 
 pipes in general must be of cast iron or of 
 galvanized wrought iron, and must extend 
 from one to three feet above the roof. 
 
 Plumbing regulations, like many other or- 
 dinances intended for the city's health, are 
 cursed with certain typical evils. They are 
 indefinite, stating, for example, that cer- 
 tain parts of the plumbing shall be " suitable," 
 "adequate," "properly installed." They are 
 by no means uniform. They are stated in too 
 complex a fashion, and they vary from the 
 extremes of excessive caution to those of 
 excessive laxness. They are not firmly based 
 on the broad foundation of the body of scien- 
 tific fact already acquired. 
 
 The case of the people versus sewer-gas, as 
 originally entered, contained two charges, a 
 major and a minor. On the evidence submitted 
 I believe we may fairly acquit the defendant 
 on the major charge, and declare that sewer- 
 gas cannot produce infectious disease, through 
 rising germs. On the minor charge, that ex-
 
 SEWER-GAS AND PLUMBING 229 
 
 posure to the gases of the sewer may produce 
 predisposition to disease, the evidence submit- 
 ted is still inconclusive. We can scarcely do 
 more than register a Scotch verdict of "Not 
 proven." 
 
 The results so far obtained, however, show 
 us one truth of no slight importance. Where 
 infectious disease exists, we must look else- 
 where than in the sewer for its causation. 
 That fact renders it no less our duty to insure 
 proper sewers and a proper disposal of wastes. 
 And this, not alone from common decency, 
 but from the very real dangers which sewage 
 holds. Instead of striking at a point where the 
 enemy has made a feint, we should attack his 
 main force at those weak points of his chain 
 of defenses which our scouts have laid bare. 
 
 The change of attitude on sewage is one of the 
 interesting developments of reversal brought 
 about by an increase of knowledge. Where 
 sanitarians formerly believed that sewer-gas, 
 if not the root of all evils, was certainly the 
 root of many of them, experts to-day consider 
 sewer-gas a comparatively harmless substance, 
 but pay the greatest attention to liquid sew- 
 age as a means of infection, a substance 
 whose noxious qualities are much less consid-
 
 230 THE HEALTH OF THE CITY 
 
 ered by the average layman. Filled with the 
 possibilities of infectious disease, liquid sew- 
 age needs the greatest care in its handling and 
 disposal. Some of the modern methods of dis- 
 posal have already been considered in another 
 place. Streams of sewage emitting evil odors 
 and offensive to the senses cannot directly 
 produce disease, yet it is most essential that it 
 should be safely, accurately, and thoroughly 
 disposed of. It is only the barbarian who does 
 not remove sewage from the sight and smell 
 of his community.
 
 VIII 
 
 THE CITY'S NOISE 
 
 Now loud, now low, now sounding in musical, 
 humming rhythm, now clanging in sharp stac- 
 cato or rising in plangent, shrieking chords, 
 the song of the city comes to the listening ear. 
 The low, beating throb of the midnight hours, 
 broken by the abrupt sounds of early morning, 
 changes, as morning turns to afternoon, through 
 the various measures of a full-throated chorus 
 whose instruments are those of trade: the 
 whistle, the rushing car, the noise of commerce. 
 The theme passes, with the fall of night, into 
 the hurrying allegro of returning thousands, 
 threads to its web through the clatter of the 
 evening hours, and returns at last to the low 
 throb of twenty-four hours before. Never does 
 it cease. 
 
 Stimulus to the morning toiler entering the 
 city gates, the city's noise may be. To the 
 strong, it seems the call of battle-trumpets 
 summoning to the rush and hurry of the busy 
 morning. As the long day wears on, inevitable
 
 232 THE HEALTH OF THE CITY 
 
 reaction sets in, the wearing grind of city-labor 
 bears heavily on hand and brain ; and the noise, 
 growing more and more an irritant, beats at 
 last on the wearied ear with whips of strident 
 steel. Another factor has been added to in- 
 crease the nerve-exhaustion which is drawing 
 so heavily on the forces of the city. A constant, 
 if unperceived, drain upon the strong, the 
 noise of the city may be an almost intolerable 
 torture to the weak. 
 
 Quixotic tilting against windmills will do 
 little more in a noise-crusade than it will else- 
 where. No city can be carried on without a 
 very considerable amount of necessary noise. 
 A really silent city is impossible. But the 
 unnecessary noise of recent years, the escapa- 
 ble noise, so to speak, has increased to a point 
 beyond all reasonable tolerance. It is just 
 this part of the whole that we wish to stop. 
 Muirhead once said : " Among the most search- 
 ing tests of the state of civilization reached by 
 any country are the character of its roads, its 
 minimizing of noise, and the position of its 
 women. If the United States does not stand 
 very high on the application of the first two 
 tests, its name assuredly leads all the rest in 
 the third." It is well worth our while to see
 
 THE CITY'S NOISE 233 
 
 what we can do toward obtaining a higher per- 
 centage on the second test. 
 
 Of all the manifestations of the world about 
 us, which our senses can perceive, many can be 
 escaped. Sound is inescapable. The eyelids 
 can shut out light from the eyes, the lips keep 
 taste from the tongue, and the hand may be 
 voluntarily withheld from touching. The ear 
 remains open day and night to receive what- 
 ever impressions, be they pleasant or unpleas- 
 ant, the outer world may send to it. Where 
 Mother Nature has failed to protect her chil- 
 dren, man must step in to aid. 
 
 In his consideration of the physiological ef- 
 fects of noise, Dr. Richard Olding Beard once 
 made the statement that " Noise is fast becom- 
 ing a neurotic habit with the American people." 
 Speaking of the separation of sound-waves into 
 two great classes, " noises and musical sounds, 
 the one class characterized by the absence, the 
 other by the presence, of the quality of rhythm," 
 he went on to explain that the one is an irri- 
 tant, the other a solace to the normal ear ; and 
 remarked that these different types of vibration 
 not only act differently upon the ear, but ac- 
 tually act upon different parts of the ear's mech- 
 anism. Noise, acting upon the nervous system
 
 234 THE HEALTH OF THE CITY 
 
 of the nervously worn city-dweller, produces so 
 real and constant an irritation that quiet be- 
 comes an abnormal state, to which exhausted 
 nerves find great difficulty in responding. 
 
 A personal experience first showed the writer 
 the possibility of a state of affairs where the 
 habit of noise could become as fixed as the 
 habit of a drug. Waking one night in the 
 quiet of a country-house far from other habi- 
 tations, I suddenly heard the starting of the 
 hot-air engine which pumped the water, chug- 
 chug-chug-chug. I lay listening to its monoto- 
 nous vibrations, and wondering at the unusual 
 hour for pumping, until I fell asleep. The next 
 night the sound was repeated. On my men- 
 tioning the matter to my host, he confessed 
 that he could not sleep in the quiet of the coun- 
 try, that the sudden change from the roar of 
 a great city to the silence of the woods was so 
 great as to cause him real suffering. As his only 
 way to rest, he would leave the house in the 
 middle of the night, start up the pump, and, 
 lying down in a nearby hammock, find sleep 
 brought him by the lullaby of the hot-air engine. 
 That man recognized that he had the noise- 
 habit, and finally conquered it. How about the 
 many who are never far enough away from the
 
 THE CITY'S NOISE 235 
 
 incessant tumult to know that the habit has 
 formed? The incessant din of hammer upon 
 iron in the boiler-shop creates a disease of the 
 ear among the workers, known as "boiler- 
 maker's ear." Little by little their finely at- 
 tuned sensory nerves become dull and indiffer- 
 ent to ah 1 sound. Far more continuous than the 
 clamor of the boiler-shop, the noise of the city 
 is, at times, almost as deafening. The boiler- 
 maker commonly resides far from his scene of 
 labor, and may have thirteen or fourteen hours 
 of rest from the sounds of his vocation. The 
 city-dweller is never free from the surrounding 
 din. The passage to his ear is open, sleeping 
 and waking. More than one expert believes 
 that a dulling of the ear to the finer gradations 
 of sound must result in time from life spent in 
 the midst of such surroundings. The aggregate 
 of city noise has increased so greatly in recent 
 years that we have hardly, as yet, sufficient 
 data to prove this theorem. It is, at least, 
 extremely probable. 
 
 When we come to consider the effect of 
 noise in the sick-room, the records of the doc- 
 tors appear in report after report, testimonial 
 after testimonial. Officers of hospitals for the 
 insane consider the increasing noise of the city
 
 236 THE HEALTH OF THE CITY 
 
 a potent factor in the recent increase of insan- 
 ity, citing case after case where their attempts 
 to cure these unfortunates have been hampered 
 or nullified by sudden or continued noises. Dr. 
 Hyslop of London says, in his monograph on 
 " Noise in its Sanitary Aspect": "There is in 
 city life no factor more apt to produce brain 
 unrest, and its sequel of neurotism, than the 
 incessant stimulation of the brain through the 
 auditory organs." 
 
 Dr. Gregory of Bellevue Hospital, in a state- 
 ment made at the time of the first struggle 
 in New York to suppress unnecessary steam- 
 whistling on the rivers, wrote in part : " Many 
 patients suffering from typhoid, meningitis, 
 and other serious illness, will become annoyed 
 by the least noise or disturbance. To these, 
 restful sleep is of paramount importance, and 
 frequently such disturbances may cause a 
 relapse or turn the scale against them. In 
 many delirious patients an hour's rest or sleep 
 may mean life. You can readily imagine the dis- 
 appointment of the doctor and nurse, who 
 have struggled to bring about the much-desired 
 quiet and sleep, when suddenly all their efforts 
 are frustrated as a result of the disturbing 
 whistles."
 
 THE CITY'S NOISE 237 
 
 In the quotation just cited, Dr. Gregory 
 spoke especially of the steam whistle. In any 
 catalogue of the causes of noise, that type 
 must stand preeminent. Sudden, discordant, 
 terrific in its intensity, few are the ears that 
 can bear its sudden attack unmoved. As used 
 in cities, it is an outworn relic of a former 
 time, of the day when every crossing bore 
 upon its pointing finger the inscription, " Look 
 out for the engine when the bell rings"; when 
 watches and clocks were high in price or low 
 in accuracy ; when such modern substitutes 
 for the voice as the electric bell were generally 
 quite unknown. Of the whistle of the steam- 
 boats we shall have occasion to speak later, 
 in our discussion of conditions in New York. 
 It is sufficient here to bring up those twin 
 banes of the city, the factory and the train 
 whistle, specialized forms of noise which have 
 been fought valiantly for years by Professor 
 Edward S. Morse of Salem. No statement of 
 this subject would be complete without refer- 
 ence to his labors. 
 
 A few decades ago, the locomotive whistle 
 had its undoubted use in signaling, and in 
 the warning of travelers on roads crossed at 
 grade. To-day, on country roads it may still
 
 238 THE HEALTH OF THE CITY 
 
 serve a purpose. Its city use is ended. Com- 
 pulsory gates are now placed at important 
 city-crossings. The tendency toward compell- 
 ing crossings to be above or below grade is 
 growing rapidly. Block-systems of control and 
 automatic methods of signaling have come 
 into being. Every city-crossing is guarded. 
 But the whistling continues, the strength of 
 the noise has increased as engines have grown 
 more modern in other ways, and the delight 
 of employees in the use of the whistle seldom 
 fails. Here and there, cities and towns have 
 passed ordinances aimed at this annoyance. 
 Some have been successful in carrying them 
 through. In the majority of places, however, 
 through lack of concerted action, the trains 
 passing gated crossings at midnight wake 
 every light sleeper, and every sick and weary 
 soul, for long distances around, by their con- 
 tinued blasts. 
 
 The use of the locomotive whistle in sig- 
 naling train-crews, in switching and shunting, 
 makes life in the vicinity of a station-yard a 
 twenty-four-hour nightmare, three hundred 
 and sixty-five days in the year. I shall not 
 soon forget my first sight of a European 
 freight-yard, where all the signals were given
 
 THE CITY'S NOISE 239 
 
 by bugle calls, whose clear musical notes gov- 
 erned the easily moving trains and minimized 
 the attendant noise. If the American railroad 
 man scorns the use of a bugle, there is still 
 the megaphone and the boatswain's whistle. 
 Much could be done by signals read by the 
 eye. If the engineer can back his engine to 
 the required point on the signal of the brake- 
 man's waving arm or lantern, is there any 
 reason why he should not respond in turn by 
 arm or light instead of by use of the whistle ? 
 While railroad men with whom I have talked 
 are not all agreed on this point, no small 
 number believe that the continual whistling 
 of the yards confuses the men at work, renders 
 their labors more difficult, and increases the 
 awful yearly total of maimed and injured rail- 
 road employees. 
 
 Whatever excuse the locomotive whistle 
 may yet have for a curtailed existence, the 
 right of the factory whistle to continue has 
 ceased. In the old days when workmen of 
 city factories lived grouped around their in- 
 dividual places of employment, it may have 
 been necessary to summon workmen by a 
 whistle. To-day, with the multiplication of 
 timepieces of all sorts, with the nightly de-
 
 240 THE HEALTH OF THE CITY 
 
 parture of many city workmen to homes far 
 from the factory section, that need is disap- 
 pearing. The land about city factories is too 
 valuable for workmen's houses. The modern 
 corporation has no use for the man who can- 
 not get to his work on time. The six-o'clock 
 whistle can no longer rouse its workmen, for 
 they, as a mass, no longer live within its call ; 
 and the workman who is at the factory on 
 time will enter no more rapidly on the call 
 of a seven-o'clock whistle than he will on 
 that of an electric gong. As a matter of fact, 
 the moment of starting work is determined 
 by the starting of the machinery in the vast 
 majority of factories, those which run only in 
 the day. Since tens and hundreds of thousands 
 of the workmen's children reach school on the 
 stroke of nine on every school-day in the year, 
 since they are able to enter on the call of 
 an electric gong and pass from room to room 
 on the pulsation of electric bells, is there any 
 reason why their fathers should be unable to 
 do as much? Factory after factory has abol- 
 ished its whistle with complete success, yet 
 custom holds good with thousands of others 
 whose shrill cry brings torment to the innocent 
 victims around.
 
 THE CITY'S NOISE 241 
 
 The whole problem of whistling has been 
 dealt with in a systematic manner by the city 
 of Cleveland. So brief and simple are the pro- 
 visions of its law, made some years ago and still 
 in force, that I venture to quote them : 
 
 ORDINANCE OF THE CITY OF CLEVELAND. 
 Sub-Division, No. 1. 
 
 Section 841. Engine Whistle. No whistles con- 
 nected with any railway engine shall be sounded 
 within the limits of the city of Cleveland except as 
 a signal to apply the brakes in case of immediate 
 or impending danger. 
 
 /Section 842. Vessel Whistles. No person shall 
 blow or cause to be blown the steam whistle of 
 any vessel propelled by steam, while lying at any 
 wharf in the city of Cleveland, or when approach- 
 ing or leaving such wharf or navigating the Cuya- 
 hoga River in said city, except when absolutely 
 necessary as a signal of danger, or in cases and 
 under the circumstances prescribed by the rules 
 of navigation or the laws and regulations of the 
 United States requiring the use of such whistles. 
 
 Section 843. Stationary Engines. No person 
 shall blow or cause to be blown within the limits 
 of the city of Cleveland the steam whistle of any 
 stationary engine as a signal for commencing, or 
 suspending work, or for any other purpose except 
 as specified in the following section. 
 
 Section 844. Nothing in this sub-division con-
 
 242 THE HEALTH OF THE CITY 
 
 tained shall be construed as forbidding the use of 
 steam whistles as alarm signals in case of fire or 
 collision, or other imminent danger, nor for the 
 necessary signals by the steam engines of the fire 
 department of the city. 
 
 Section 845. Any person violating or failing 
 to comply with any of the provisions of the sub- 
 divisions shall be fined not less than ten dollars, 
 nor more than fifty dollars. 
 
 A section also prescribes the signals that 
 shall be sounded for steam-tugs. 
 
 The construction of the pavements of a 
 city, important from the side of the cleanliness 
 of the air, needs serious consideration from 
 the standpoint of noise. Stop in Times Square, 
 New York, some evening when the rush of 
 theatre traffic is crossing the pavement, and 
 listen to the sound. The asphalt gives back 
 comparatively little reverberation from the 
 rolling wheels, whose sound is continuous, 
 regular, and rhythmical. Separate the sound 
 of horses' hoofs from tbe general clatter. 
 First in steady clicks like clock-beats, now it 
 slows, now hastens, now stops, now quickens. 
 Ever changing, the broken series of sounds 
 comes at irregular intervals and produces a 
 particularly trying type of sound-injury. The
 
 THE CITY'S NOISE 243 
 
 reason for such differences in speed becomes 
 evident as we turn and walk down Broadway. 
 On a clear space of sidewalk our pace becomes 
 regular, moving with precision ; when a crowd 
 blocks the way, our movement is checked ; if 
 a crossing intervenes, it stops. Corners, car- 
 tracks, and blockades are constantly chang- 
 ing the speed of even a single horse crossing 
 the city pavements, thereby producing noise 
 instead of regularity of sound. Add to the 
 noise of a single horse, passing on the asphalt, 
 the many sounds of different horses passing at 
 various speeds, and you have a tumult. Stone- 
 block pavements, with their irregular junctions 
 and broken edges, are much worse than asphalt. 
 Macadam is comparatively quiet. Wooden 
 blocks, such as are found on the London streets, 
 are the best from a standpoint of noiseless- 
 ness. Cobblestones are the worst of all. 
 
 Horse-transportation is but one factor in 
 the total passing of the city. Cable and trol- 
 ley-cars rattle from side to side ; motors, with 
 their fiendish variation of whistles, thread 
 their way in and out; while the overhead 
 trolley-wires, like the strings of some huge, 
 discordant violin, never cease their vibrations. 
 Thoreau speaks of the sounding of the tele-
 
 244 THE HEALTH OF THE CITY 
 
 graph-wires, "that winter harmony of the 
 open road and snow-clad field." Grateful as 
 that song may be in the quiet of the country, 
 in the city the noise of the racked trolley-wire 
 above adds a peculiarly trying factor to the 
 pounding from the rocking cars below. When 
 corporate officials desire to economize on trac- 
 tion lines, they not uncommonly equip the 
 service with poor rails and wheels. The rails 
 soon wear away. The wheels assume the shape 
 of polygons instead of circles, and, as they 
 turn, strike flattened angles against the irreg- 
 ularities of the iron rail. This is a particu- 
 larly effective method of adding to the total 
 noise. Fortunately, there is one way of relief 
 in sight. Few devices in transportation have 
 done more for the quiet of the city than has 
 the increasing use of subways. Though the 
 reverberation within the subway proper may be 
 greatly increased, the relief on the street is 
 marked. Only in our greater cities and along 
 main trunk-lines, however, does the subway 
 yet exist. The elevated, so far as noise is con- 
 cerned, gives practically little advantage over 
 the surface-car, save for the intermittence 
 of stopping and starting, and the absence of 
 the sound of the bell.
 
 THE CITY'S NOISE 245 
 
 Pleasant as is the mental picture of chiming 
 bells pealing out from the spire of quiet, 
 white-walled church or Gothic tower, many 
 of our church bells are quite out of place in 
 the crowded concourse of men. No longer 
 limiting its service to the brief call to prayers 
 on the quietest day of the week, the resonant 
 metal sends forth its summons each day and 
 night throughout the year. Chimes tell the 
 quarter, long peals mark each passing hour; 
 periods of tolling ring the requiem, not only 
 of the dead of the individual church, but of 
 each notable man who passes away. The last 
 necessity of the clock's telling the time audibly 
 disappeared with the coming of the illuminated 
 dial. The tolling of one bell among the many 
 in a great city ceases to have significance in 
 its honor of the dead. Yet with the multipli- 
 cation of church bells, each hour brings a 
 dozen chimes, mingling, prolonging, clashing, 
 as they send forth their voices from their 
 lofty spires. Intended as messengers of the doc- 
 trine of mercy, they are merciless indeed to 
 the weak and sick within sound of their voices. 
 
 The sounding of a general fire-alarm by the 
 use of whistles or bells serves as another re- 
 minder of a tradition quite outworn. The wild
 
 246 THE HEALTH OF THE CITY 
 
 clang of the village bell, which summons every 
 able-bodied man within reach to fight the 
 flames, is still a necessity of the country. City 
 fires, on the other hand, are fought by highly 
 trained specialists, who have no use for ama- 
 teur help. The silent electric fire-alarm an- 
 swers every purpose of the fire-fighters. The 
 telephone can notify the individuals especially 
 interested. A general alarm from bells and 
 whistles, which calls a horde of curious gazers, 
 is a decidedly mixed blessing as regards the 
 fire. It is an unmixed evil in its increase of 
 the general noise. 
 
 The barking of stray dogs and the howl- 
 ing of wandering cats furnish another proof 
 of the finding of good things in the wrong 
 place. No real lover of animals can feel any- 
 thing but pity for most of the ranging dogs 
 and cats of the city alleys and back-yards, 
 starved, pitiable spectacles as they are. A false 
 humanity has kept these companions of man 
 in an environment wholly unsuited to their 
 nature, and the wrong which men have done 
 in prisoning these creatures of the open in 
 the brick-walled city has produced its appro- 
 priate punishment to mankind in the resulting 
 annoyance from their cries.
 
 THE CITY'S NOISE 247 
 
 For real malignant power, none of the 
 individual offenders against repose surpasses 
 the milkman. Others raise their voices in the 
 midst of an awakened city. He assumes the role 
 of the wakener of the early morning. Surely 
 there must be few of us who have not been 
 aroused by the rumbling of the milk-wagon, 
 the running feet of the milkman, the pecul- 
 iarly sharp clatter of the exchange of the 
 empty bottles for the full, the lengthy and 
 animated discussions of drivers meeting in the 
 early morning. Some of the largest milk com- 
 panies in New York have taken up this prob- 
 lem with gratifying results. Rubber-tires and 
 rubber-shod horses, instructions to drivers to 
 avoid unnecessary disturbance, and inspection 
 to see that these instructions are carried out, 
 has been more than a public-spirited move. It 
 has been a commercial success. The average 
 citizen much prefers his own milk delivered 
 by a noiseless milkman, other things being 
 equal. 
 
 It is hard indeed utterly to condemn the 
 music of hurdy-gurdy and barrel-organ, of 
 street-band, and of itinerant musician. The 
 little dancing feet of the children of the poor 
 are too seldom stirred by melody to shut this
 
 248 THE HEALTH OF THE CITY 
 
 solace wholly from their lives. Stop for a 
 space and follow the music up the crowded 
 slum street, and you will see an eagerness of 
 appreciation such as symphonies do not receive. 
 There are some quarters of the city where the 
 organ-grinder is welcome. There are others 
 where his coming spells torture to every mu- 
 sical ear. He is certainly out of place near 
 hospitals or schools. A limitation of street- 
 music to certain definite areas has proved 
 possible. It would seem as if even more than 
 this might be done. There are music commis- 
 sioners in many cities. Why not turn the 
 licensing of street-music over to them, with 
 the requirement that with the license shall go 
 some inspection of the quality of the music. 
 It is said, though of this I have no definite 
 proof, that the experiment has already been 
 tried under the direction of a city department 
 of police. If this elevation of the police to a 
 censorship of the Muses continues, we may yet 
 achieve marvels of harmony. On the whole, 
 however, I cannot but think the music com- 
 mission might prove more satisfactory. 
 
 Last, but not least, in our catalogue of 
 noises comes the call of the street-peddler. 
 " Street cries." That phrase, like certain chords
 
 THE CITY'S NOISE 249 
 
 of music, certain fragrances of flowers, brings 
 up a medley of delightful reminiscences. Early 
 morning in the " Quartier," where one lis- 
 tened drowsily to the ancient calls of charcoal- 
 seller and baker, of venders of merchandise 
 who cried their wares with the very intonation 
 of their ancestors of decades, even of centu- 
 ries, ago. Afternoons in dingy London streets, 
 hunting down the rare prints of the brilliantly 
 colored "Street Cries of London." The roar- 
 ing tide of Whitechapel, and an old church 
 with its vivid oasis of green where we turned 
 to the quiet of the Thames. Always the pleas- 
 ant memories are of foreign lands; never of 
 America. In their attempt to overcome the 
 general din, our own itinerant merchants have 
 taken to every possible means of making their 
 presence known. Bugle calls, rattles, bells, and 
 horns ; even, in the case of one ingenious soul, 
 the mounting upon his cart of a monster 
 phonograph which declared in doggerel the 
 virtues of his wares. Each strives to outdo 
 the other, producing a general level of sound, 
 in whose presence, as in the presence of a 
 shouting mob, no individual voice can be 
 perceived. In the interest of the huckster, as 
 well as of the community, a reform already
 
 250 THE HEALTH OF THE CITY 
 
 suggested should be gladly received. It has 
 been proposed that the principle of the com- 
 mon ice placard be greatly extended. The ice- 
 man comes at the call of the card. There is 
 no reason why all other sellers of the street 
 should not be summoned by the same sign. 
 Differently colored cards are proposed for every 
 trade, and the housewife, should her commu- 
 nity establish such an ordinance, may call her 
 butcher, baker, and candlestick-maker by the 
 use of signal cards which represent an exten- 
 sion of one of the underlying principles of 
 noise-reform, the use of the eye instead of the 
 ear. 
 
 Arverne-by-the-Sea has put into execution 
 a successful plan for doing away with the ex- 
 traneous noise of hucksters. In this case, an 
 ordinance was passed which charged junkmen 
 a license fee of five dollars unless the licensee 
 cry, shout, or employ one or more bells or other 
 noisy devices. If such devices are employed, 
 the fee is fifty dollars. Five dollars each is 
 charged other types of wagon, two dollars each 
 to pack, hand-cart, or basket-peddler, if they 
 are quiet. If they shout or use noisy devices, 
 the fee is trebled. If you enter Arverne by any 
 route, you may pass hucksters beside the road,
 
 THE CITY'S NOISE 251 
 
 busily engaged in removing the bells from 
 their carts. The appeal to the pocket-book has 
 been successful. 
 
 Newark attacked the problem by means of 
 a direct law, which forbade the use of bells, 
 gongs, horns, whistles, or similar noise-makers, 
 and went on to regulate the phonograph, a 
 source of noise which few municipalities have 
 been so hardy as to assail. This section of the 
 ordinance follows : 
 
 " Section 3. It shall be unlawful for any 
 person, persons, company, corporation or other 
 body of individuals, to permit or cause any 
 sound such as that emitted by phonographs 
 and other similar sound-producing instru- 
 ments to be directed through open doors or 
 windows into the streets or other public 
 places within the corporate limits of the city 
 of Newark, or permit or cause such sounds 
 to be produced so as to be diffused in public 
 places, within the corporate limits of the city." 
 
 Many as are the sources of noise, the gen- 
 eral movement against the evil was slow in 
 starting. Recognition of the necessity of gen- 
 eral cleanliness in the city, of control of food- 
 supplies and water-supply, began much earlier 
 and progressed more rapidly. Citizens could
 
 252 THE HEALTH OF THE CITY 
 
 recognize that deaths resulted from lack of 
 cleanliness. They were far slower in realizing 
 that constant drains upon the city's forces 
 caused by unnecessary noise might prove a 
 serious handicap to the total efficiency of a 
 community. Many men, hardened to noise, 
 scornfully repudiated the conception that it 
 could be in any way harmful, considered ob- 
 jectors weak sentimentalists, refused to believe 
 that noise could be in any way harmful to the 
 sick, and even gloried in the increasing tumult 
 of the city as a sign of material growth. Here 
 and there an individual sufferer complained. 
 Now and then some man, wiser than his genera- 
 tion, protested publicly. In recent years several 
 men, Hyslop, Kempster, Lederle, Girdner, and 
 Morse, among others, published papers and did 
 valiant work. The American's habit of inertia 
 in the presence of an evil suffered by all his 
 neighbors equally with himself, hindered con- 
 certed action. Only in the last few years has 
 the movement, which originated in New York, 
 risen to large proportions. 
 
 Hemmed in by the North and East rivers, 
 the long narrow strip of land which holds the 
 crowded buildings of New York suffered from 
 the continual torment of resounding whistles
 
 THE CITY'S NOISE 253 
 
 which came from tugs and steam-craft of every 
 type. If you were a riparian New Yorker, it 
 mattered little whether you lived in a palatial 
 residence on Riverside Drive, or in a crowded 
 tenement on the East Side : in either case, you 
 were haunted day and night by the continual 
 shrieking. So confusing was the din that it 
 was difficult for boats to make proper use of 
 signals for meeting and passing. Tugs coming 
 to wharves to take scows up or down the river 
 would begin whistling two miles and more 
 away, in order to waken sleepy watchmen on 
 the docks. Boats sounded their screaming call 
 for half hours, to call their crews from river- 
 bank saloons. Pilots on river-steamers ex- 
 changed greetings with their friends on other 
 boats by means of the whistle's cord, or gave 
 salutes in honor of the servant girls in apart- 
 ment houses that front the Drive. It was a 
 saturnalia of sound. 
 
 Such a tyranny of noise on the New York 
 rivers made Riverside Drive a natural place 
 for the beginnings of the league against noise. 
 To one who suffered from that frenzied tumult 
 it was a natural step to think of other sufferers, 
 especially of the long lines of sick in hospital, 
 helpless before its fury. From those conditions
 
 254 THE HEALTH OF THE CITY 
 
 arose a leader whose single-minded devotion 
 to the cause and singular abililty of organiza- 
 tion have produced far-reaching results. That 
 leader is Mrs. Isaac L. Rice. 
 
 Mrs. Rice began her campaign some years 
 ago, with an investigation of the relation be- 
 tween health and noise, as exemplified by the 
 conditions in the New York hospitals. From 
 preliminary queries, sent to the officials of those 
 institutions, the almost universal response came 
 back that noise was injurious to patients suf- 
 fering with many different types of disease. 
 Her data once obtained, Mrs. Rice started a 
 systematic campaign through bureau and com- 
 mission, council and legislature, aimed at the 
 abolition of the evil of unnecessary noise. 
 
 From the Department of Health to the Dock 
 Commissioners, from the Wardens of the Port 
 to the United States Local Steamboat In- 
 spectors, from the Collector's Office to the Law 
 Division, from the Police Department back to 
 the Department of Health again, through all 
 the mazes of the Municipal Circumlocution 
 Office, Mrs. Rice traveled over and over again. 
 Each and all, like their famous protemporaries, 
 finally " gave it up," deciding that the reason 
 why they did so was because the Hudson was
 
 THE CITY'S NOISE 255 
 
 a Federal waterway. Its noise could not be 
 controlled by the municipality. 
 
 If genius is tbe capacity for "eternally 
 pegging away at a thing," genius was surely 
 shown in this case. Undaunted by her experi- 
 ences, Mrs. Rice took her case to the Federal 
 government: first to the Department of the 
 Treasury, thence to the Department of Com- 
 merce and Labor, thence to the Board of 
 Supervising Inspectors of Steam Vessels. The 
 workings of the Federal Circumlocution Office 
 seemed as devious as those of the municipal 
 office. One by one, those officials "gave it up." 
 They decided that there was no law under 
 which the Federal government could act. For- 
 tunately, however, even if circumlocution offices 
 were labyrinths which ended where they began, 
 multitudes in the world outside were becoming 
 interested in the success of the cause. Unable 
 though Mrs. Rice had been to secure the ces- 
 sation of the noise by governmental action, 
 private individuals by the hundreds, a great 
 body of the press, the owners of steamboat 
 lines, the American Association of Masters, 
 Mates, and Pilots, had expressed their sympathy 
 with the work and offered their aid. Influenced 
 to some degree by this exhibition of public
 
 256 THE HEALTH OF THE CITY 
 
 sentiment, the whistling stopped in part. It 
 was but a temporary cessation. Soon it was 
 on the increase once more. 
 
 Here, as elsewhere, legislation proved the 
 only permanent safeguard. There was no law 
 which governed steamboat whistling, and the 
 only way to reach it was by a congressional 
 bill. Congressman William S. Bennett of New 
 York brought forward and secured the pas- 
 sage of a bill giving to the supervising inspec- 
 tors of steamboats the right to regulate the 
 whistling done by boats on water under their 
 jurisdiction. This was the first bill ever passed 
 by Congress having for its ultimate object 
 the suppression of noise. The bill once passed, 
 interpretation was secured, and eighty-five per 
 cent of the unnecessary noise due to this cause 
 was eliminated. 
 
 The passage of the Bennett bill marked a 
 decisive victory. Partial legislation had been 
 secured, and the way was open to a continu- 
 ance. But there was an ever-present necessity 
 that enforcement follow legislation, and that 
 a strong public sentiment back up enforce- 
 ment, if the statutes against noise were to 
 become effective, and not a part of the dead, 
 useless lumber that crowds our statute-books.
 
 THE CITY'S NOISE 257 
 
 Legislation, enforcement, public opinion, these 
 are three links of a chain that breaks if any 
 one of the three be severed. To sustain all 
 three, "to awaken public sentiment in favor 
 of our cause, and to aid our hospitals by di- 
 minishing unnecessary noises in their immedi- 
 ate vicinity," the " Society for the Suppression 
 of Unnecessary Noise " was formed. Mrs. Rice 
 was made president, and many distinguished 
 Americans offered their services to the advi- 
 sory board. Most important of all, fifty-nine 
 hospitals, representing eighteen thousand and 
 eighteen beds, had representatives on the di- 
 rectorate. The work of this society on the 
 " Quiet Zone " ordinance and the " Children's 
 Hospital Branch" deserves the imitation of 
 other cities. 
 
 The " Quiet Zone " law in particular marked 
 a great advance. For years an old law of New 
 York had forbidden organ-grinders to ply 
 their trade or hucksters to cry their wares 
 within one block of church, hospital, or school, 
 between the hours of nine and four. That 
 law had been a dead letter almost from the 
 day of its passage. It failed lamentably at 
 three points. It was effective only in school 
 and church hours, leaving the hospitals during
 
 258 THE HEALTH OF THE CITY 
 
 the many other hours of the day at the mercy 
 of the passers-by. It did not mark off in any 
 public way the space which was to represent 
 the vicinity, thereby making enforcement at 
 any time extremely difficult. It did not include 
 the manifold unnecessary noises of transpor- 
 tation. The new " Quiet Zone " ordinance, 
 passed last year by the Board of Aldermen, 
 includes all noises caused by transportation, 
 whether from horse-drawn or motor vehicles 
 (this latter a most important point), requires 
 the placing of conspicuous signs of " Hospital 
 Zone," or " Hospital Street," one block away 
 from the hospitals on all approaching streets, 
 and enables the police to arrest any persons 
 making unnecessary noise near a hospital. 
 
 If there is one quality of which most of us 
 who are striving for the city's welfare need 
 to be long, and of which we are likely to be 
 short, it is never-failing tact. How many of 
 us have no occasion to cry mea culpa ! when 
 charged with its lack? There seems to be so 
 much to be done, so little time in which to 
 do it. It is all the more refreshing on that 
 account to relate the happy manner in which 
 the difficult problem of the noise of playing 
 children about the hospitals a serious evil
 
 THE CITY'S NOISE 259 
 
 because of the unfortunate fascination which 
 ambulance cases have for the city child was 
 attacked. Watch the craning of necks and 
 scampering of feet among the children as the 
 ambulance hurries by, and you will under- 
 stand that hospitals readily become gather- 
 ing-places for all the children within reach. 
 Arrest, imprisonment, or fine, even restriction 
 of their brief rights in the playground of the 
 streets, is a crime against the city child's 
 starved nature, save in cases of real extremity. 
 Recognizing this, and recognizing at the same 
 time the need of the sick, Mrs. Rice, with 
 the help of Mark Twain and the New York 
 Board of Education, started the Children's 
 Hospital Branch in the schools of New York. 
 
 From room to room, from building to build- 
 ing, Mrs. Rice pursued her quest, asking the 
 children not only to be quiet themselves near 
 the hospitals, but to use their influence to 
 keep others quiet. In thousands they re- 
 sponded. I quote from Mrs. Rice's own story 
 of the founding of the Branch a few of the 
 children's pledges, each written in the child's 
 own words: 
 
 "I offer up this sacrifice, so as to comfort 
 the sick near hospital and any place I know
 
 260 THE HEALTH OF THE CITY 
 
 where sick persons are, and to prevent all 
 sorts of noises that are not necessary." 
 
 " I promise just the way a president pro- 
 mises to be true to his country, to stop other 
 people from making a noise, and I also will 
 not make a noise in front of a hospital." 
 
 " My dear Miss Rice, I promise that I will 
 never make a noise near a hospital. Positively 
 know." 
 
 " I promise not to play near or around any 
 hospital. When I Do pass I will keep my 
 mouth shut tight, because there are many 
 invalids there. Nor will I make myself a per- 
 fect NUISANCE." 
 
 " With all my heart I promise you, 
 Just what you advised us to do, 
 I am willing to obey your plan, 
 To make the least noise as I can, 
 Before a hospital." 
 
 It would be hardly right to close this article 
 without at least a word concerning the day 
 which marks the culmination of the year's 
 burden of noise. The Fourth of July, like the 
 more local festivals similarly celebrated, has 
 stood declared in recent years as a Moloch 
 which claims its yearly toll of maimed and 
 dying human sacrifice. Its sins lie open and
 
 THE CITY'S NOISE 261 
 
 declared. It has been shown again and again 
 that the change from the red cracker of the 
 day before to the smoke and noise of the Fourth 
 itself produces lists of killed and wounded 
 greater than those of many battles. Those 
 sorrowful lists tell but a part of the story. If 
 we could estimate the death and suffering 
 from the noise of that day, who doubts that 
 they would stretch to appalling proportions ? 
 Three hundred and sixty-odd days in the year 
 we shield our population from the use of dan- 
 gerous weapons by rigorous laws. On two or 
 three days we allow not only men and women, 
 but even little children, to buy explosives 
 of known and deadly violence without let or 
 hindrance. The critics who call the United 
 States " the land of inconsistencies " can 
 scarcely point to a more notable example 
 than this. 
 
 It is written that among the various schools 
 of Grecian philosophy existed one known as 
 "The Academy of Silence," composed of one 
 hundred men, each member pledged to the 
 purpose of the school. To them came one 
 seeking admission. Their list of membership 
 was closed, and their head, calling the would- 
 be neophyte before the assembled audience,
 
 262 THE HEALTH OF THE CITY 
 
 showed him without a word an urn so filled 
 with water that not a single drop could be 
 added. The neophyte, reading the message, 
 bowed silently, started to withdraw, but hesi- 
 tated and returned. Picking a petal from a 
 flower, he dropped it on the brimming bowl 
 so dexterously that it floated without dislodg- 
 ing the slightest particle of the liquid. The 
 membership of the Academy of Silence be- 
 came one hundred and one. 
 
 Like that ancient member of the Society 
 for the Suppression of Unnecessary Noise, 
 we, who wish to give quiet and rest to the 
 sick in crowded ward and sick-room, to little 
 children and wearied workers, must work 
 tactfully, steadily, effectively. Then will quiet 
 come.
 
 IX 
 
 CITY HOUSING ABROAD 
 
 FROM the long columns of dusty departmen- 
 tal reports I garnered the text which follows. 
 Eleven thousand men in Manchester, England, 
 tried to enlist in the army. Eight thousand 
 were rejected, two thousand were accepted for 
 the militia, and one thousand were taken for 
 the army. With that record, and with the pos- 
 sibility of German invasion ever before her 
 eyes, is it any marvel that Britain sees the 
 shambling hooligan in her streets with a grow- 
 ing foreboding of the future? From recruit- 
 ing-officers of the army, the workshop, the 
 factory, and the forge come like tales of re- 
 jection and distrust. A remedy is needed, and 
 that right speedily. As one part of that remedy, 
 European leaders of both the peaceful and the 
 militant armies are striving to better the house 
 in which a man is born, in which he lives 
 and dies, in a belief that environment may 
 be closely connected with personal efficiency. 
 They have sought the cause which has pro-
 
 264 THE HEALTH OF THE CITY 
 
 duced the defective man behind the gun or 
 machine. They have found that housing has 
 a direct connection with the welfare of every 
 individual in the state. 
 
 Hardly a city but reports a desperate lack 
 of proper housing, hardly a city ward but 
 shows that marvelous upspringing of indus- 
 tries which the last half century has seen. 
 There is a close relation between these things. 
 I stood with a German on a height crowned by 
 an ancient castle, and looked out over the plain 
 below, clotted with tall chimneys. " The old 
 and the new," he said, pointing backward and 
 forward. "It is the same the empire over. 
 Every year sees thousands more of those spires 
 that mean industrial dominance to us." That 
 little label, " Made in Germany," on the ware 
 they send to us is but one battle-cry of modern 
 Germany. Every one of those chimneys means 
 that many hands are busily at work beneath, 
 that many a head must find some lodging for 
 the night. And good lodging is by no means 
 as easily secured as good chimneys. Fires 
 will not burn without good, well-built chim- 
 neys, but men and women can exist in rotting 
 hovels. 
 
 The building of houses has by no means
 
 CITY HOUSING ABROAD 265 
 
 kept pace with building of chimneys. From 
 every side rises the cry of the worker : 
 " Where can we find decent housing within 
 the bounds of our wage?" Driven by sheer 
 lack of quarters to the slum, many a man, 
 against his will, adds another family to the 
 rabbit-warrens of the tenements, crowding 
 yet more what was already overcrowded almost 
 beyond endurance. For it is the slum only 
 which is elastic. The houses of the well-to-do 
 are not the ones which expand to take in the 
 increase of population. It is the family in 
 two rooms, which, driven by necessity, gives 
 up one, or, even when crowded into one, takes 
 lodgers in those narrow quarters to help pay 
 the rent. Thousands of slum-rooms do double 
 duty, night and day. No sooner are the night- 
 sleepers on their way to work than the night- 
 workers enter, and their places are filled with 
 sleepers once again. "Overcrowding" is al- 
 most synonymous with "slum." 
 
 Were this crowding into narrow quarters 
 temporary, it might be better borne, but the 
 slum has the tentacles of a devilfish. Once it 
 receives its prey within its walls, it is loath to 
 let them go. Suppose a laborer, sickened with 
 the fetid air and seeing his wife and children
 
 266 THE HEALTH OF THE CITY 
 
 pine before his eyes, wishes to escape; what 
 opportunities has he to better his condition? 
 Even if his wage allows him better quarters, 
 landlords and agents of better buildings often 
 look askance at new-comers from the slums. 
 And small indeed is the percentage whose 
 wages allow them to spend more than the 
 minimum for rent. From one end of Europe 
 to the other, permanency of occupation for 
 unskilled labor is difficult to obtain. The cry 
 of the unemployed is heard on every hand. 
 For many years a minimum of expenditure 
 for shelter could be found only in the slum. 
 It is one of the master achievements of the 
 twentieth century that here and there doors 
 of escape are opening even for the men with 
 the lowest wage. 
 
 It has been often proved that the various 
 barriers by which the slum holds its people 
 are not long necessary. By imperceptible but 
 rapid degrees its denizens sink into apathy, 
 and develop that strange malady of the great 
 modern city, the slum-disease. This is an in- 
 fection productive of infections, a contagion 
 which, as it spreads through the slum, creates 
 new slum-dwellers as it passes, leaving its vic- 
 tims stricken with inertia, slothf ulness, drunk-
 
 CITY HOUSING ABROAD 267 
 
 enness, criminality. Marvelous it is, and worthy 
 of high praise, that so many of the poor escape 
 these characteristics. Let them escape or not, 
 one and all suffer equally in their lack of re- 
 sistance to disease. Malnutrition, bad air, and 
 overcrowding swell the columns which tell of 
 tuberculosis, pneumonia, diphtheria, and every 
 kindred disease. The slum is the great culture- 
 medium of civilization, wherein huge cultures 
 of disease are growing, ready when ripe to rise 
 and sweep the city streets. 
 
 Some twenty years ago Dr. Russell of Glas- 
 gow presented figures on the relation of the 
 death-rate and overcrowding, whose brevity 
 and clarity have scarcely been surpassed 
 since. He divided all the families of the whole 
 city of Glasgow into three classes. In families 
 occupying one and two room houses, 27.74 
 died out of every 1000 ; in families occupying 
 three and four room houses, 19.45 died out 
 of every 1000; in families living in houses 
 of five rooms and over, 11.23 died out of 
 every 1000. Broadly speaking, these figures 
 mean this : that for every two mortals who 
 died in a Glasgow house open to sun and air 
 and in which overcrowding did not exist, five 
 died in the slums. Life is hard for the slum-
 
 268 THE HEALTH OF THE CITY 
 
 dwellers, but our modern cities make it easy 
 for them to die. 
 
 Conditions are hard for the adult; they 
 are much harder for the child. St. Mary's, in 
 Birmingham, is less than four miles from 
 Bourneville. Three hundred and thirty-one 
 infants die out of every thousand born in the 
 crowded city ward. Sixty-five die out of every 
 thousand born in the model village of Bourne- 
 ville. Every child who comes into the world 
 in that favored village has more than five 
 times the chance of life that the wretched 
 scraps of humanity of crowded St. Mary's 
 possess. 
 
 Lack of fresh air is by no means the least 
 evil. According to many authorities we require 
 as a minimum from eight hundred to a thou- 
 sand cubic feet of fresh air per hour to keep 
 the body-machine in efficient working order. A 
 room twelve and a half, by ten, by nine and a 
 half, is a good-sized room for a slum-quarter. 
 Yet the number of cubic feet of air which it 
 contains is less than twice the amount required 
 for health by the average person, even if there 
 is not a stick of furniture on the floor. Add 
 the ordinary amount of furniture, every piece 
 of which subtracts cubic feet from the total air-
 
 CITY HOUSING ABROAD 269 
 
 space, and put four people in the room instead 
 of two. How much chance does each have of 
 getting the minimum amount of fresh air, even 
 provided the air can be completely changed 
 every hour? 
 
 As a matter of fact, the average slum-house 
 abroad is so constructed that such change ia 
 quite impossible. Any one who has struggled 
 with the windows in provincial continental 
 houses knows that they are not made to open 
 and shut. They are there for light, or for deco- 
 rative purposes. They are certainly not there 
 for ventilation. Not only are they difficult to 
 open and shut, not only are the families of the 
 slums afraid of fresh air by tradition and pre- 
 cedent, but the very buildings of the crowded 
 quarters shut off the possibility of proper ven- 
 tilation. Make a personal experiment the next 
 time you walk down a narrow city street on 
 a warm day, and notice the window-shades. 
 Those on the top floor may be fluttering 
 bravely, while those at the bottom are still. 
 Fortunately for England, many of her slums 
 are still composed of buildings which are from 
 one to three stories in height ; but the tall bar- 
 rack-buildings of the continent, which are more 
 like our tenement houses, are in many cases as
 
 270 THE HEALTH OF THE CITY 
 
 bad as anything New York's streets can show. 
 Ventilation on the first floor, in truth, is no 
 simple matter in the slum. There the open 
 window means an open entrance to the filth 
 of the street, which is the common dumping- 
 ground of the householders along the way. 
 
 Few external things, indeed, have been more 
 discouraging to the workers in the slum than 
 that same habit of dumping. And yet if the 
 tenants of the crowded street scatter garbage, 
 they do so chiefly because they have no proper 
 means of garbage-disposal. Their rooms con- 
 tain mixtures of food, of clothes, and of refuse ; 
 the one thing that cannot be found in them is 
 closets for storage. Their sanitary habits are 
 outrageous, and no small number of English 
 courts and German alleys provide one privy 
 for seven or more families. Their dishes and 
 persons are unclean. Often one faucet will sup- 
 ply a whole court, or in tall barrack-buildings 
 water will be piped only to the first floor. A 
 long trip for water tends to discourage the 
 morning tub, and darkened rooms where sun- 
 light never falls give little impetus to cleanli- 
 ness. 
 
 Barred from sun, air, and water, those three 
 good gifts to man, how can the people of the
 
 CITY HOUSING ABROAD 271 
 
 slum produce men and women capable of car- 
 rying on the race? For years, light, air, and 
 water have formed the stock example of free 
 goods for the economist. They are no longer 
 free in the slum. The narrow streets keep their 
 denizens in the shadow. The high walls bar 
 the air. Water becomes a luxury difficult of 
 attainment. One by one the legislatures of the 
 great states of Europe have come to under- 
 stand the necessity for action. This chapter con- 
 siders particularly the work of Germany and 
 England. 
 
 Judging of causes by results, one is forced 
 to the conclusion that the welfare of the indi- 
 vidual German citizen is the immediate con- 
 cern of the empire. The coming greatness of 
 Germany, so devoutly foreseen by every pa- 
 triotic German, seems to be the well-spring 
 of that stupendous mass of regulations which 
 tends to the advancement of the condition of 
 the German unit. That is not a startlingly 
 new doctrine, but the German attitude toward 
 carrying out those beliefs shows many inter- 
 esting applications. The German workman 
 who is ill receives medical treatment, his fam- 
 ily receive all necessary aid. He is obliged 
 to carry insurance. He receives his old-age
 
 272 THE HEALTH OF THE CITY 
 
 pension when he can no longer work. All these 
 steps, taken for the welfare of the state, tend 
 toward the improvement of the efficiency of 
 the individual. It is another step in this di- 
 rection for the German municipality or the 
 German state to buy land and build houses 
 for the workmen within its borders, and to 
 house the poor at rates which they can pay. 
 To create a healthy proletariat, the govern- 
 ment recognizes that it must eradicate the 
 slum. Since it fully realizes that in this civic 
 disease, as in cancer, the roots lie deep, it is 
 ready where necessary to bring the full weight 
 of its authority to the aid of better housing. 
 The theory that the municipality or the 
 state should own land or buildings, and receive 
 revenue therefrom, is older than feudalism. 
 The lands about the castle belonged to the 
 castle's lord. The free cities held lands and 
 houses, but their burghers merely stood in 
 the place of prince or baron, and received 
 the rents from town-property as a part of the 
 normal income of the municipality. Many a 
 city of continental Europe and no small num- 
 ber of English boroughs unhesitatingly drew 
 blood-money from foul tenements within a 
 few years. It is only in recent time that those
 
 CITY HOUSING ABROAD 273 
 
 stains have begun to be washed from those 
 Augean stables by the waters of a new Alpheus 
 and a new Peneus. 
 
 That there was need of action, a few figures 
 from reports made about the time the move- 
 ment began, in 1891, will show. In that year 
 Berlin had three hundred and sixty-seven thou- 
 sand families in twenty-one thousand buildings, 
 an average of seventeen families to each roof. 
 Scarcely one family in six hundred had a house 
 of its own. Of the total population of Berlin, 
 117,702 individuals, or seven and two thirds 
 per cent, lived in cellars. Hamburg was nearly 
 as badly off in this respect. Breslau, Dresden, 
 and Magdeburg each had nearly one half of 
 its population in dwellings containing but 
 one room, if we exclude the closet called the 
 zubehor, which is tiny in size, has no means 
 of heating, and small opportunity for ven- 
 tilation. German families in general were 
 housed in the so-called barrack-buildings, 
 four or more stories in height, which corre- 
 sponded fairly closely to our tenement houses. 
 The common barrack-house of that period 
 was wretchedly deficient in water-supply, its 
 sanitary accommodations were foul and inade- 
 quate, and the possibilities of decent family
 
 274 THE HEALTH OF THE CITY 
 
 life within its walls were at a minimum. De- 
 spite all these things, the cost of rent was 
 great, often averaging as high as one third 
 the total wage received. 
 
 Recognizing that the immediate necessity 
 was to prevent the growth of new slums, the 
 German authorities who first took up the cru- 
 sade began work by passing stringent ordi- 
 nances to govern the erection of new buildings. 
 They were aided in the successful carrying 
 out of these measures by the great police 
 powers possessed by the government. Strin- 
 gent requirements for strength were followed 
 by equally stringent requirements for fire-pro- 
 tection. Believing that the solid building-up 
 of areas causes most unhealthy conditions, 
 some of the governments allowed only two 
 thirds of any building-lot in certain sections 
 to be occupied by buildings. That regulation 
 gave the children of the poor some chance to 
 play, and gave both adults and children far 
 greater chance for air and light. The dark 
 interior room was forbidden. A sufficient 
 number of cubic feet for change of air was 
 demanded for every room. Water-supply, re- 
 ceptacles for garbage and ashes, storage for 
 food and clothes, were brought under control
 
 CITY HOUSING ABROAD 275 
 
 by various ordinances. But all the require- 
 ments in the world would not provide fit 
 houses for the poor. At best such laws serve 
 mainly to guard against the building of new 
 unfit houses. Mere ownership of municipal 
 land and some funds to use in connection 
 with the work were not sufficient. There was 
 need of aggressive tactics. 
 
 The plans of campaign pursued by the pro- 
 gressive German towns may be summarized 
 under four heads : first, town planning, the use 
 of foresight in determining the inevitable de- 
 velopment of the cities ; second, the building 
 of model tenements that should take care of 
 deficiencies in housing, serve as models, sup- 
 ply needed balance-wheels to speculation, or 
 stimulate activity in private building; third, 
 the encouragement of private builders and of 
 cooperative building societies; and fourth, 
 the demolition of the slum, either by destroy- 
 ing old buildings and replacing them by new 
 model tenements, business offices, or parks, 
 or else by such repairs of existing dwellings 
 as would make the old houses fit for sanitary 
 use. 
 
 Town planning is by no means a new con- 
 ception, much as we have heard of it in recent
 
 276 THE HEALTH OF THE CITY 
 
 years. As far back as 1668, just after the great 
 fire, Sir Christopher Wren proposed a town 
 plan for London. In its provision of means of 
 communication and in general excellence many 
 of the details of his general scheme are not ex- 
 celled to-day. He proposed that " all trades that 
 use great fires or yield noisome smells be placed 
 out of the town." The modern scheme sets 
 down such removal as a primary necessity. 
 Means of communication, by the Wren plan, 
 were to be considered of the greatest impor- 
 tance, and there were provisions for streets of 
 three different widths, all yielding easy access 
 to the centre of the city where stood the Ex- 
 change. The modern plans lay great stress on 
 rapid transit to and from the centre of the city, 
 believing in general that the place where work- 
 men should live is in garden suburbs encircling 
 a town containing manufactories, stores, and 
 warehouses. Wren differentiated his roads by 
 separating them into traffic ways and residential 
 streets. The first were to be wide, costly, and 
 strongly built to stand heavy wear and tear, 
 the second, narrower, less costly, and built for 
 less arduous service. The new methods divide 
 the streets into three classes: first, the wide 
 expensive street through which traffic is to pass ;
 
 CITY HOUSING ABROAD 277 
 
 second, the narrow and comparatively inexpen- 
 sive street ; and third, what may be called the 
 undetermined street, which may in time become 
 a traffic-route, but which is intended prima- 
 rily to be used for residences. This third type 
 of street may be built inexpensively, may be of 
 narrow width, and can be enlarged at a mini- 
 mum of expense because of the foresight shown 
 in its construction. Streets of this class are 
 laid out with gardens in front of all houses. 
 The garden-space can be added to widen the 
 thoroughfare to the proper width, whenever 
 it becomes necessary to expand. Compare this 
 method with the costly American habit of 
 building up narrow streets, with the enforced 
 result of buying both buildings and land 
 when residential streets are turned to traffic 
 purposes. 
 
 Nowhere does Wren's foresight seem more 
 prophetic than in his plans for redistricting his 
 ideal city. Even two centuries and a half ago, 
 men were able to understand that the close re- 
 lation between cost of land and cost of rent per 
 room of any building on that land, made it in- 
 evitable that dwellings, where offices should be, 
 would call for office-rents. The European work- 
 man is housed to-day in many cities on land
 
 278 THE HEALTH OF THE CITY 
 
 worth from twenty thousand to eighty thousand 
 dollars an acre. Only by building on every pos- 
 sible foot of such land, only by crowding hu- 
 man beings into every available inch of space, 
 can tenements for the poor pay on such pro- 
 perty. It is the general experience of foreign 
 cities that it is wiser to replace the demolished 
 slums by model tenements on less expensive 
 land outside the business or manufacturing 
 section. That this seems advisable, not only 
 from financial but from hygienic grounds, it is 
 hardly necessary to question. 
 
 Few things are more wastefully expensive 
 or more naturally disorderly than a large pro- 
 portion of the great cities. Huddled together 
 without rhyme or reason are shop and factory, 
 hovel, barrack-house, and mansion. The Eu- 
 ropean custom of living above the shop has 
 exerted no small influence on this conglomer- 
 ation. By various plans the Germans are trying 
 to sift out their dwellings from the chaotic mass, 
 sending them into the suburbs and leaving the 
 industries grouped in the centre of the town. 
 That is the principle behind the plans for the 
 encircling garden-suburb, and such ideas, to be 
 developed by building laws, exist in the " Zone 
 System." In this system the height of houses
 
 CITY HOUSING ABROAD 279 
 
 and the proportion of the lot which may be oc- 
 cupied by a building in any section is limited 
 by its distance from the centre of the town. The 
 farther a zone is from the centre, the smaller the 
 number of houses to an acre, the smaller the num- 
 ber of stories allowed to a house. These zones are 
 not mathematical circles: a zone may be simply 
 an area set apart. Such regulations naturally 
 tend to group the factories. In Cologne, for 
 example, buildings in the centre of the city may 
 be five stories in height with a mansard. In 
 outer portions of the city delimited by law, no 
 building may rise over three stories in height, 
 or occupy more than forty per cent of its lot. 
 Saxony made such a scheme compulsory for all 
 towns in 1900 ; and Prussia, before that time, 
 by a suggested plan which was not completely 
 carried out, endeavored to limit the height and 
 number of houses in the line of the prevailing 
 winds which blow over Berlin, in the endeavor 
 to obtain fresh air for every part of the city. 
 Various German communities which have taken 
 up such schemes have developed especially the 
 placing of houses in such a way as to obtain a 
 maximum amount of sunshine, and have made 
 sure that space should be left for parks, for 
 playgrounds, and especially for "the garden
 
 280 THE HEALTH .OF THE CITY 
 
 which helps to pay the rent," as one of the 
 housing pamphlets puts it. 
 
 Few minor reforms have done more for 
 the general health than such encouragement 
 of gardens. Dumps and waste land have been 
 reclaimed by the allotment system, which is, 
 in general, the parceling out of small lots 
 on the edge of the city to artisans who will 
 promise to cultivate them. Prizes for the best 
 gardens have been productive of good results. 
 Instruction in practical gardening has inter- 
 ested many city-bred men and women who 
 were ready to work, but did not know how to 
 begin. The allotment system of distributing 
 gardens is by no means the ideal one, however. 
 It is the little garden behind the house which 
 does the most, which engages the father's spare 
 time before and after work, and provides 
 healthful occupation for mother and child. 
 
 Summarizing the most enlightened general 
 regulations of Germany which have to do di- 
 rectly with building operations, we may say 
 that their general trend is to do away with 
 speculation, rigidly to control the builder 
 who is building for investment, and to give the 
 greatest possible freedom to the individual 
 who desires to build for himself. The author-
 
 CITY HOUSING ABROAD 281 
 
 ities desire to encourage individuality and 
 resourcefulness. They step in to guard the 
 community when it is a question of building 
 in the mass. The limitation of dividends on 
 municipal money loaned for house-building ; 
 the leasing of lands for periods of years with 
 the proviso that the buildings to be erected 
 thereon shall become town property at the 
 expiration of the lease-period ; the reservation 
 of power of repurchase and of power to break 
 leases in cases of necessity, have all shown 
 enlightened progress. Most of these projects 
 have already shown fruit in model tenements 
 containing happier and healthier citizens. 
 
 All these things cost time and money. Do 
 they pay in human lives? Is the efficiency 
 sought, obtained? For answer take the death- 
 rate of one city, Offenbach am Main, which 
 has done much for the housing of its citizens. 
 In the ten years from 1870 to 1880 the city 
 death-rate was 23.6 per thousand. From 1880 
 to 1890 it was 20.8. From 1890 to 1900 it 
 was 18.5. In 1908 it was 14.1. Every year of 
 the last decade has shown increased activity. 
 Every year has seen the death-rate a little 
 lower. In that one German city modern meth- 
 ods, not only of housing but of general im-
 
 282 THE HEALTH OF THE CITY 
 
 provement in standards of living, are saving 
 from nine to ten more human beings out of 
 every thousand to-day than were saved thirty 
 years ago, while the gain in efficiency, in the 
 possibilities of life, which those figures denote, 
 is quite immeasurable. 
 
 No nation more than Germany has recog- 
 nized that the bleakness and the barrenness 
 of the tenements form one point in a vicious 
 circle which includes drunkenness, immorality, 
 and gambling, which makes for disease and 
 death. None have done more in fighting the 
 depressing effect of slum-life by the potent 
 aids of pleasant surroundings, of gardens, 
 music, and incentives to out-of-door life. None 
 have understood so completely that good hous- 
 ing affects each member of a family, down to 
 the tiniest babe, while remission of direct 
 taxes, or state aid of many other sorts given 
 to the poor, is but too likely to result in 
 assistance to the one member of the family 
 who needs it least, to the head of the family, 
 alone. 
 
 Much of the work of England has pro- 
 gressed along lines parallel to those followed 
 by Germany. Part One of the English Hous- 
 ing Act (an act which applies also to Scotland
 
 CITY HOUSING ABROAD 283 
 
 and Ireland) provides for wholesale clearance 
 of slums and the erection of model municipal 
 dwellings in their place, either on the same 
 spot, or in cheaper land in the suburbs. Part 
 Two of this Act provides for the compulsory 
 setting in order of unfit habitations at the 
 owner's cost, and for the demolishing of houses 
 where the owners refuse to act. Houses are 
 seldom demolished under this provision. The 
 owners almost invariably become much inter- 
 ested in better housing before their time-limit 
 expires. Part Three of the act gives power to 
 English local authorities to buy land, erect 
 houses, lay out open spaces for gardens, play- 
 grounds, and parks, in much the same way as 
 is now being done by the municipalities of 
 Germany. 
 
 According to figures given by Nettlefold 
 in his "Practical Housing," the cost per head 
 of rehousing under Part One of this Housing 
 Act varies from two hundred to one thousand 
 dollars, averaging three hundred and seventy- 
 five dollars. His lowest average, taken for 
 purposes of comparison, is given as two hun- 
 dred and fifty dollars. Against this is placed 
 the cost of work done under Part Two by 
 Liverpool and Birmingham, cities which paid
 
 284 THE HEALTH OF THE CITY 
 
 less than seven dollars per head for satisfac- 
 tory rehousing. The average cost given for 
 purposes of comparison is taken as fifteen dol- 
 lars. Part One can provide better houses for 
 a small number of people. Part Two can pro- 
 vide fair houses for a vastly greater number. 
 Many of the believers in Part Two consider 
 it safe to state that at least fifteen persons 
 can be healthfully housed by the use of this 
 scheme to one that can be so housed by the 
 use of Part One. 
 
 At the very time that the Lords estranged 
 the Commons by their revolutionary refusal 
 of the Budget, they passed a new housing act 
 which they had previously practically rejected. 
 This new law involves sanitary changes of 
 great interest. Every county council appoints 
 a medical officer of health, who is to have 
 general charge of the health of the county. 
 This officer cares especially for houses unfit 
 for human habitation. As a most important 
 adjunct to this executive, provision is made 
 for a committee on health and housing con- 
 ditions which hears all matters of this sort 
 coming; before the councils. 
 
 o 
 
 Far greater powers have been given by 
 this bill to all officials dealing with housing
 
 CITY HOUSING ABROAD 285 
 
 questions, and tens, almost hundreds, of thou- 
 sands of additional houses have been brought 
 under the law which provides that all con- 
 tracts for houses at low rents shall imply that 
 they be reasonably fit for human habitation 
 at the beginning and through the term of 
 their occupancy. In case houses of this type 
 are found to be unfit, the authorities may 
 make them fit and recover all costs from the 
 landlord. 
 
 Cellar dwellings and back-to-back houses 
 are forbidden. Town-planning schemes of 
 magnitude are provided. Powers of radical 
 action on the part of the authorities are greatly 
 enlarged, and many additional schemes for 
 the betterment of the housing of the people 
 are laid down. 
 
 Sometimes, across the riot of the street 
 comes the call of Pan. Then heath and hill- 
 top, dawn across the snow and the long twilight 
 of the summer solstice, pull at the heartstrings 
 of the city-dweller. What if a land could be 
 where every city was a garden where children, 
 as one poor waif once told me, "could see 
 the whole sky," learn the world of bird and 
 flower, and come to manhood and womanhood 
 free from the sordid handicaps of city ways?
 
 286 THE HEALTH OF THE CITY 
 
 For those who long for " the whole sky " and 
 trust in its beneficence, it is a pleasant duty 
 to record some few details which deal with 
 " Garden Cities" which have sprung up outside 
 the smoke and grime of English towns. Under- 
 lying these various projects are basic ideas 
 worthy of citizens of Altruria. They require 
 that the property be highly restricted, that 
 the number of houses built on each acre be 
 limited sufficiently to give each householder 
 pleasant and healthful surroundings, and that 
 these houses shall be placed among green- 
 swards where children may play and old people 
 dream. They demand that all the services 
 necessary to community life shall be rationally 
 and wisely developed, that all building and 
 planning shall consider both the hygienic and 
 the aesthetic possibilities, and that the joys of 
 country life shall be combined with the advan- 
 tages of the city. Baling, Bourneville, Port 
 Sunlight, the Letch worth Garden City, Har- 
 borne, Hampstead, '-each of these settlements 
 contains many of the elements of the ideal 
 garden city. Of this list two, Bourneville and 
 Port Sunlight, owe their existence to the 
 public spirit of two men, Bourneville to Mr. 
 George Cadbury, Port Sunlight to Mr. W. H.
 
 CITY HOUSING ABROAD 287 
 
 Lever. Rivals in a worthy strife, the cottages 
 at both Port Sunlight and Bourneville are 
 models of architecture and sanitation. Plenty 
 of sun, air, and water, gardens and garden- 
 allotments, gymnasia, children's playgrounds, 
 swimming-baths, social clubs, good schools, 
 and neat, well-ordered shops, make both these 
 villages of great interest to any student of 
 the housing problem. 
 
 In 1909 the outlay on Port Sunlight was 
 stated to have been something more than two 
 million and a half dollars. It would have been 
 no slight task, with that enormous expense, 
 to make the village a self-supporting financial 
 success; but this has not been attempted. As 
 the houses are intended to supply homes for 
 the workers in the Lever Brothers Company, 
 rents have been fixed simply to cover taxes, 
 repairs, and upkeep. The annual cost to the 
 firm of the maintenance of the village is many 
 thousands of dollars a year ; but it is the strong 
 belief of the employers that their expenditures 
 here are returned manifold in the better con- 
 ditions of the employees, the permanency of 
 the staff, and the attraction of many excellent, 
 workers to the plant because of the possibili- 
 ties of life in the town.
 
 288 THE HEALTH OF THE CITY 
 
 Bourneville, made over to a board of trustees 
 as an absolute gift, by Mr. Cadbury, is increas- 
 ing the scope of its original work by means 
 of the surplus revenue in the trustees' hands. 
 Open to workers outside the Cadbury Cocoa 
 Works, Bourneville has, for considerably more 
 than half its householders, men who work in 
 other places, and who are entirely independent 
 of the cocoa factory. From six shillings and 
 sixpence a week to seven shillings and sixpence 
 will house a worker well. Detached houses can 
 be obtained at rentals ranging from thirty to 
 forty pounds, and every tenant is a landed 
 man, for every cottage has a private garden. 
 This is all planted before it is turned over to 
 a tenant, and two expert gardeners, with a 
 staff of employees, care for the general garden- 
 work of the village and stand ready to advise 
 each individual householder. Is it any wonder 
 that no tenant leaves unless he is obliged to 
 do so, and that there is a permanent waiting- 
 list large enough to occupy every house, were 
 all suddenly vacated? Mr. Cadbury himself 
 says that the great work of the future must 
 be to enable the poor " to remove from the 
 squalor and temptations of city life and settle 
 amid the wholesome, helpful sights and sounds
 
 CITY HOUSING ABROAD 289 
 
 of country life. In a word, the people must be 
 brought back to the land." 
 
 Translate the word "land " into " suburbs," 
 carry your people of the slum away from the 
 pavement into the light and air on the outskirts 
 of the town, and these sentences show the 
 solution of the housing problem in which I 
 most believe. 
 
 The Lever Brothers' policy of building 
 houses for their employees, to be rented at 
 practically nominal rents, attractive as it is in 
 many ways, is open to serious objections. In 
 this particular case some of these objections 
 are met by Mr. Lever's partnership schemes. 
 Others are basic. We have seen, in no very 
 distant time, newspapers filled with accounts of 
 homeless men, women, and children driven into 
 the winter cold by general eviction from cor- 
 poration-owned houses. One of the evils which 
 has stirred England most of recent years has 
 been the complaint of agricultural laborers: 
 " Lose work, you lose your house." Few things 
 make more for self-respecting independence 
 than for a man to own his own domicile. When 
 his home is owned by his employer, when the 
 same period sees the loss of work and of home, 
 the impetus to such independence loses heavily.
 
 290 THE HEALTH OF THE CITY 
 
 The action of Mr. Cadbury, who has insisted 
 from the first on making his houses produce 
 a fair return in rentals, who has released all 
 personal claims to Bourneville, turned the 
 houses over to a board of trustees, and opened 
 the estate to all who wish to come, is far to be 
 preferred. If corporations are to enter upon 
 the building of houses to better the condition 
 of their employees, they can scarcely do more 
 wisely than to follow the Bourneville plan. If 
 they cannot follow the great philanthropy of 
 Mr. Cadbury, let them invest their money in 
 sanitary houses, rented at such rates as will 
 bring them in a fair return, and then give 
 the control of the houses over to an absolutely 
 disinterested board of trustees. They will 
 thereby gain the primary object the im- 
 provement of the condition of the workers 
 without leaving open the possibility of strife 
 which may otherwise occur. 
 
 One thing more should be mentioned in 
 this connection. There seems to be a tendency 
 to-day towards centralization of industries, a 
 movement by which many great capitalistic 
 enterprises, gradually closing their scattered 
 plants, are striving to save money and effort 
 by concentrating in single spots. Such a move-
 
 CITY HOUSING ABROAD 291 
 
 ment is likely to bring about a dangerous 
 condition for the employee who owns his own 
 home. With the consequent shifting of pop- 
 ulation, the skilled worker, forced to move with 
 the industry and owning his own house, is left 
 with his property tied up in a form difficult 
 of ready realization. No small number of soci- 
 ologists are, therefore, advising such workmen 
 to invest their savings elsewhere. To-day it is 
 at least questionable if this danger is so great 
 that we can spare the impetus to betterment 
 of life which comes from ownership of the land 
 one lives upon. What ten or twenty years more 
 will show, we cannot tell. Here as elsewhere 
 in the city we may have to run some future 
 danger for present good. It is possible, how- 
 ever, that many of the good effects of individ- 
 ual ownership may be secured by such modified 
 cooperation as is shown by some of the European 
 cooperative societies, such as the Berlin Savings 
 and Buildings Society, which operates in and 
 around Berlin, and the Baling Tenants Lim- 
 ited, now a part of the Co-Partnership Tenants 
 Societies, at Ealing, just outside of London. 
 The magnificent buildings of the Berlin 
 society, though of the city-block type, possess 
 many striking advantages. Sheltering in their
 
 292 THE HEALTH OF THE CITY 
 
 Hasler Street buildings as many as a thousand 
 families, each family can obtain three large 
 rooms for one hundred dollars a year. (The 
 Rixdorf tenements just outside Berlin provide 
 four model rooms for one hundred and twenty 
 dollars a year.) In these buildings the problem 
 of keeping the children off the street is solved 
 by the expedient of providing sunny inner 
 courtyards and playgrounds. Ornamental gar- 
 dens were first planned, but the authorities in 
 control soon decided that a garden of children 
 was better worth cultivating than a garden of 
 flowers, and the whole space was turned over 
 for play purposes. Flowers are not neglected, 
 however: the balconies are full of them and 
 the whole side of the building is gay with 
 bloom. One more point in this connection. 
 The Germans know far more than we do con- 
 cerning possible economies of space. Take the 
 roof of a model tenement, for example. It may 
 hold baths, lockers, laundries, playgrounds, 
 drying-rooms, and many of the more general 
 offices of the house. 
 
 If on some sunny London morning you 
 should roll down through Marylebone to Pad- 
 din gton station and start due west from the 
 great city, you would be headed for the most
 
 CITY HOUSING ABROAD 293 
 
 famous of the cooperative settlements of Eng- 
 land Baling. Draw a line from Harrow on 
 the Hill to the point where the Thames makes 
 one of its snakiest twists at Kew, place your 
 pencil two thirds of the way down the line, 
 and you have located it again ; the point of 
 all this geographical labor being to show the 
 first necessity of a suburban community 
 proximity to the metropolis. 
 
 The Baling Tenants Limited is a concrete 
 expression of a belief in cooperative ownership 
 and administration. First shares in the under- 
 taking may be bought by incoming members 
 at ten pounds each, and every tenant-member 
 must take in the end not less than five shares, 
 an equivalent to the cost of the land on which 
 his house is placed. It is evident that, if co- 
 operative housing is to do good to the people 
 who need it most, money must be brought in 
 from outside. The society, therefore, divides 
 its capital into two parts, the shares just men- 
 tioned and the loan-stock which the society 
 has power to issue. How this scheme .has re- 
 sulted is evinced by the fact that five per cent 
 has been paid on shares and four per cent on 
 loan-stock from the very beginning of active 
 operation. Nor is that all. The company has
 
 294 THE HEALTH OF THE CITY 
 
 been able, in addition, to accumulate an un- 
 divided surplus to care for unexpected losses 
 and repairs. The ideal of this community, 
 like that of the other associations making up 
 the Co-Partnership Tenants Societies, is to 
 have the tenants say, "This estate is ours," 
 not, "This house is mine." In other words, 
 they desire to have a general ownership of the 
 whole plant by rent-paying tenants as a body, 
 instead of having each individual family hold 
 the title to its own house. 
 
 The purposes of the Co-Partnership Socie- 
 ties which follow are well worth quoting spe- 
 cifically. "To secure suitable sites; to build 
 suitable houses ; to let the houses at moderate 
 rents ; to pay a moderate rate of interest on 
 the capital invested; to divide the surplus 
 profits among the tenant members in proportion 
 to the rents paid by them after such charges 
 as maintenance, depreciation, and repairs have 
 been met; to have every tenant-member's 
 profits paid to him. in shares until the total 
 so paid is equal in value to the value of the 
 house in which he resides ; to pay the total 
 amount to him in cash when such equalization 
 is secured." It would prove hard to draw up 
 a broader or sounder programme.
 
 CITY HOUSING ABROAD 295 
 
 Since the great mass of surplus profits is 
 held as a part of the capital, such a system 
 makes for the safety of capital and for regu- 
 larity of dividends. Since, by the wholesale 
 buying of building supplies, as high as twenty 
 per cent of the total cost has been secured, 
 the system makes for radical reductions in 
 cost as well. As the cost of interior repairs 
 is chargeable against the individual tenant's 
 profits, such repairs are kept at a minimum. 
 Since the profit to every tenant depends on 
 the general profit of the whole, each member 
 becomes an ardent agent for the property. 
 Since rents in Baling are below market-value 
 and the tenants enjoy many of the advantages 
 of the garden city, the task of the amateur 
 real-estate agents is not difficult. Best of all, 
 every member of the society is getting returns 
 from something which costs him time, energy, 
 and a moderate amount of money, all of 
 which things make him value the opportunity 
 presented to him far more than any tenant 
 can value purely philanthropic aid. 
 
 One word of caution should be spoken be- 
 fore we leave the topic of cooperative effort 
 in its various forms. The word " cooperation," 
 as used commonly in housing literature and
 
 296 THE HEALTH OF THE CITY 
 
 as transferred to these pages, is a rather loosely 
 defined term. It is, at best, a modification of 
 the broader principle of genuine cooperation, 
 which still remains a somewhat altruistic ideal. 
 
 In housing, as elsewhere in municipal re- 
 form, we are but too likely to forget the per- 
 sonal side. The reducing of flesh and blood 
 to statistics and generalizations too often 
 withers that full course of sympathy necessary 
 in affairs which deal with human lives. The 
 understanding of human nature which shines 
 through the record of the achievements of 
 Miss Octavia Hill is of especial value to the 
 man or woman who wishes to give personal 
 aid. 
 
 From small beginnings Miss Hill's work has 
 spread from house to house and district to 
 district, until thousands of dwellings owned 
 by many different corporations and individuals 
 have now passed into her governing hand. 
 Invariably those houses have produced satis- 
 factory financial returns and have provided 
 good homes for the tenants. As an educational 
 policy the system is almost unrivaled. Briefly 
 stated, it follows. 
 
 The slum houses which pass under Miss 
 Hill's control are first carefully inspected to
 
 CITY HOUSING ABROAD 297 
 
 determine whether or not it is possible to put 
 them in a fit condition for use. When a scheme 
 for renovation has been decided upon, certain 
 portions of the most necessary repairs, such 
 as the mending of roofs and the bettering 
 of the water-supply and drainage, are carried 
 out. The tenants are then given an opportu- 
 nity to use the benefits thus conferred, with 
 the understanding that those who use them 
 well will be given more, while those who use 
 them ill will be obliged to leave. The allure- 
 ment of struggling for a prize never wholly 
 dulls to any of us. When such personal bene- 
 fits are aided by a bonus for prompt payment 
 of rent and a tactful though persistent cam- 
 paign of education, a swift reformation is 
 likely to result. Thereupon the work of chang- 
 ing wretched dwellings into thoroughly com- 
 fortable houses is hurried forward as rapidly 
 as funds will admit. The money for such re- 
 pairs is obtained by an equalization of the 
 rights of landlord and tenant. Five per cent 
 income only is paid to the owner, no matter 
 what the return on the investment may be. 
 At least four per cent has been steadily re- 
 turned up to the present time. All money 
 received above this sum, after charges for in-
 
 298 THE HEALTH OF THE CITY 
 
 surance, taxes, and maintenance have been 
 met, is applied to the betterment of the houses. 
 The tenant, therefore, has every interest in 
 keeping up with his rent and reducing unne- 
 cessary repairs. 
 
 To obtain such results elsewhere, it might 
 prove necessary to build up a system of 
 control similar to that established by Miss 
 Hill. Her collectors and inspectors are trained 
 women, who are required to use that some- 
 what rare sixth or common sense, and who 
 have developed an extraordinary amount of 
 tact in dealing with their difficult task of 
 training the tenants to help themselves. 
 
 Successful as are many plans for improv- 
 ing houses in the centre of the city, there can 
 be little question that the great possibilities 
 of the future lie in the development of the 
 suburbs. No general misconception has been 
 more insistent or unfortunate than the old 
 one that the workman must live beside his 
 work. Of a great part this is true, but of 
 thousands of city workers it is untrue. The 
 chief obstacle to suburban development is now, 
 and will remain, the lack of a cheap and 
 rapid transit which provides a seat for every 
 passenger. Belgium by its development of
 
 CITY HOUSING ABROAD 299 
 
 a complete system of inexpensive workmen's 
 trains has already shown the way in which 
 such cheap and rapid transit can build up a 
 whole countryside. The progression of this 
 kingdom on the theory that the provision of 
 workmen's trains is as necessary a part of the 
 functions of a railroad as the carrying on of 
 a freight department, has produced a remark- 
 able exodus to the country from the city. A 
 workman's round-trip weekly ticket (twelve 
 rides) for a six-mile trip on the Belgian rail- 
 roads can be obtained for less than a quarter. 
 Thirty cents a week will buy such a ticket to 
 and from a station twelve miles out. Fifty 
 cents will take a man back and forth every 
 day for a week from a station thirty miles out. 
 As a result of this policy, ten years' compara- 
 tive record showed an increase of the number 
 of these tickets sold from about 1,200,000 
 to about 4,400,000. Belgian villages by the 
 score act as bedrooms for the workers of the 
 city ; and thus the high wages of the city are 
 combined with the economic advantages of 
 the country. Speaking of the work already 
 accomplished, Professor Emile Vanderwelder 
 wrote as follows some time ago, in an article 
 in " Soziale Praxis " :
 
 300 THE HEALTH OF THE CITY 
 
 " Enter Hesbaye or Flanders from whatever 
 side one may, the country is everywhere thickly 
 strewn with white red-roofed houses, some of 
 them standing alone, others lying close to- 
 gether in populous villages. If, however, one 
 spends a day in one of the villages, I mean 
 one of those in which there is no local indus- 
 try, one hardly sees a grown-up workman 
 in the place, and almost believes that the pop- 
 ulation consists almost entirely of old people 
 and children. But in the evening quite a dif- 
 ferent picture is seen. We find ourselves, for 
 example, some twelve or thirteen miles from 
 Brussels at a small railway station in Brabant, 
 say Bixensast, Genval, or La Hulpe. A train of 
 inordinate length, consisting almost entirely 
 of third-class carriages, runs in. From the 
 rapidly opened doors stream crowds of work- 
 men in dusty, dirty clothes, who cover all the 
 platform as they rush to the doors, apparently 
 in feverish eagerness to be the first to reach 
 home where supper awaits them. And every 
 quarter of an hour, from the beginning of 
 dusk till well into the night, trains follow 
 
 O ' 
 
 trains, discharge part of their human freight, 
 and at all the villages along the line set down 
 troops of workmen masons, plasterers, pav-
 
 CITY HOUSING ABROAD 301 
 
 iors, carpenters with their tool-bags on their 
 backs." 
 
 Gather the skeins together, follow each clue 
 to its end, and the investigator is forced to 
 the conclusion that the housing hope of the 
 future lies outside the city walls. The vision 
 of the time to come shows suburbs circling 
 massed workshops, homes set in green trees 
 and surrounded by playgrounds and fertile 
 gardens. Costly land is used for business. 
 Cheap land is held for dwellings. Nor is that 
 vision so remote and fanciful that we must 
 consign it with a sigh to a longed-for distant 
 day. There is a pressing problem to be solved, 
 one that reaches up to you as you walk along 
 the street, work at your desk or bench, or 
 sleep in your home, the providing of health- 
 ful homes for every citizen of the community. 
 There is no fallacy more abominable than the 
 one which declares that " that which is must 
 be." Because the slum exists is no reason for 
 its continuance. Let in the light of scientific 
 fact upon the problem, and the waste places 
 shall be filled and the children lift up their 
 hands to the sunshine of a coming day.
 
 CITY HOUSING IN AMERICA 
 
 IN the war-office of the modern city, head-quar- 
 ters of the fight for health, for housing, and 
 for like reform, hang party-colored campaign 
 maps, whose tints expose the strongholds 
 of the foe. Study one of them for a space. 
 On streets beneath that bar of crimson rages 
 a fell disease. There, below that spot of blue, 
 another holds its sway. That smear of yellow 
 covers a district where the victims of a third 
 are dying by the score. There is but little color 
 in the suburbs. There the white background 
 of the map shows many a district clear. Look 
 towards the centre of the city. As your eye 
 runs inward, note how the stains group closer 
 and closer together. They are deep upon the 
 slum. 
 
 The close connection between the slum 
 and disease is too patent for question. Some 
 of the tuberculosis exhibits show an intermit- 
 tent incandescent light burning upon the wall. 
 Twice every minute, one hundred and twenty
 
 CITY HOUSING IN AMERICA 303 
 
 times every hour, it flames and fades. Above 
 it a placard reads : " A human being dies from 
 tuberculosis each time this light goes out." 
 Watch that changing filament for a brief 
 space and project its burning through each 
 hour of the day, each day of the year. You 
 may suddenly remember that tuberculosis is 
 but one of the diseases that flourish rankly 
 in the slum. 
 
 I have spoken previously of the slum as 
 a culture-medium of disease. To how slight 
 an extent that is a figure of speech, the re- 
 cords given above may partly show. Take the 
 crusade against tuberculosis, for example. No 
 campaign was ever fought more bitterly, 
 and yet authorities tell us that this disease 
 can never be stamped out until we disinte- 
 grate the crowded masses of the city. The 
 prison of the state and the prison of the slum 
 are our two most overcrowded centres to-day. 
 According to Dr. Knopf, mortality from tu- 
 berculosis among prisoners is three times as 
 high as it is among the general population. 
 Next to the prisons in providing fertile soil 
 for the growth of this disease comes the chief 
 home of the American workman, the tenement 
 house.
 
 304 THE HEALTH OF THE CITY 
 
 The old crone in the doorway, peering 
 through the watching group, exclaimed, " Sev- 
 enteen ! " as the coffin came down the steps 
 into more sunlight than its occupant had ever 
 seen in its former, dark, unclean ill-ventilated 
 home. "Eight families and this the seven- 
 teenth brought out from that door. God be 
 good to us, but it's a haunted house!" She 
 crossed herself as I passed on, noting the 
 number and street. The woman spoke the 
 truth. One after another, seventeen had died 
 in that one dwelling from tuberculosis. Nine- 
 teen in a like space was the record of an- 
 other. Two hundred and four cases of the 
 same disease occurred in twelve New York 
 houses in eight years. And these were direct 
 cases only. How many others were infected 
 from the poor wretches, dying in those narrow 
 quarters, who can tell. 
 
 " Where the sun does not enter the doctor 
 does," say the Italians. We know to-day that 
 the micro-organisms responsible for tubercu- 
 losis die in a few hours in cleanliness and in 
 direct sunlight. They perish in a few days 
 in cleanliness and ordinary diffused window- 
 light in a light room. They will live long 
 in darkness, damp, and filth. We know in
 
 CITY HOUSING IN AMERICA 305 
 
 addition that tuberculosis is a contagious dis- 
 ease, whose spread is greatly assisted by over- 
 crowding and bad air. The reason why houses 
 are haunted by the dread plague lie open to 
 all who know the lack of space, air, and light 
 in the slum. Poor is the air of those streets. 
 Poor as it is, the windows are stuffed with 
 rags and paper to keep it out, through all 
 the winter months. Small is the amount of 
 sun which reaches over the high roofs of the 
 tenement houses and falls upon the cloudy 
 panes. Slight as that is, many are the rooms 
 where sunlight never penetrates. New York 
 alone has over one hundred thousand dark 
 living-rooms, absolutely without windows; 
 the same proud city has a little less than 
 three hundred thousand without sufficient 
 light or sunshine, while over twenty-five thou- 
 sand New York families live in cellars. Those 
 facts are so horrible that comment becomes 
 superfluous. 
 
 Our foreign critics have a habit of referring 
 to us as a nation whose methods of appeal 
 lie through the pocket-book. Whether that 
 charge is true or not, there is no question 
 that he who can show a saving to the tax- 
 payer offers one of the strongest arguments
 
 306 THE HEALTH OF THE CITY 
 
 that can be advanced in favor of any reform. 
 The Committee on Congestion of Population 
 in New York, in the course of its investiga- 
 tions, has been taking up an analysis of the 
 budget of the city in an attempt to ascertain 
 definitely the economic cost to tax-payer and 
 rent-payer of such congestion as now exists, 
 and of the lack of a city plan. The ten parts 
 into which the committee divides its research 
 consider the economic waste from preventable 
 disease, the cost of hospitals, orphanages, and 
 similar institutions, and the expense to the 
 individual citizen of the city's failure to pro- 
 vide playgrounds, means of transit, and traffic- 
 ways at times when they could be cheaply 
 obtained. The first of these ten investigations, 
 the economic waste from certain preventable 
 diseases, has been completed and published. 
 Some of its conclusions follow. 
 
 Preventable disease has cost New York from 
 thirty-seven to forty-one millions of dollars a 
 year for the last four years. $166,248,408.24 
 is the total estimate of the wealth poured out 
 in these four years for wasteful pain and suf- 
 fering. For millions of that great total the 
 tenement house is directly responsible. If we 
 could only have that money for playgrounds,
 
 CITY HOUSING IN AMERICA 307 
 
 for the renewing of the city ! Remember that 
 those millions represent a steady drain on the 
 community as a whole, that your prosperity 
 depends on the prosperity of your own city 
 and of other cities, and that such constant 
 leakage must affect you individually. Nor 
 need it necessarily affect you indirectly. The 
 child who sickens after a ride in the cars, the 
 skilled employee whose illness means delay 
 and loss to your business, the fellow worker 
 whose labors must be added to your own while 
 he is ill, the employer whose death means a 
 reorganization that sends you searching for 
 another position, the business associate whose 
 loss sets back the clock of your progress, 
 each and all are woven into the threads of 
 your life. The disease which affects them af- 
 fects you. If housing reform cuts down the 
 total of disease, it safeguards you. 
 
 The golden dreams of the immigrant turn- 
 ing for freedom and help to our shore, to 
 that great " Melting-Pot " of which Mr, Zang- 
 will has written, must, one fears, be doomed 
 to some disappointment. Too often, however, 
 disappointment turns to a tragic certainty. 
 Suppose a little band of immigrants, leaving 
 some continental village, starts on the ever
 
 308 THE HEALTH OF THE CITY 
 
 new discovery of the west. The entrance to 
 this country must raise their hopes. If they 
 come on one of the newer steamers, thanks to 
 federal law, more space, light, and air, more 
 healthful surroundings, are granted to the 
 incomer on shipboard than the municipality 
 will assure him when he reaches land. The 
 incoming human wave which breaks upon our 
 shores sends its scattered spray to many cities. 
 Too little reaches the country. Too much 
 stays in the city-slum. It is entirely natural 
 that this should be the case, and that the enter- 
 ing foreigner should seek a dwelling in some 
 locality where his own tongue sounds kindly 
 to his ears. So the Italian, at whatever port 
 he lands, hastens to Little Italy, the Russian 
 seeks Little Russia, and the Hungarian finds 
 lodging in Little Hungary. 
 
 Division of this sort makes housing prob- 
 lems in the United States more complex than 
 those which many European cities show. Model 
 tenements here cannot receive tenants chosen 
 at random in the same fashion as can Berlin 
 or London. Difference of race and type, even 
 difference of locality forbids, for the Italian 
 from the North must have his quarters sepa- 
 rated from the Italian of the South, and one
 
 CITY HOUSING IN AMERICA 309 
 
 tribe from that strange mixture of races called 
 Russia may be the ancient enemy of another. 
 Evidently, our attack on this problem must 
 include some selective processes. Before we 
 can consider general or special methods, how- 
 ever, we must know something of the condi- 
 tions which surround us. 
 
 Laying aside for a time the vexing questions 
 raised by such a conglomeration of types as 
 inhabit our slums, let us see what quarters 
 the little band of immigrants is apt to find if, 
 as might well happen, each unit of the group 
 is bound to some one of our great cities. 
 Tracing the steps of each wandering family, 
 we find that one stops at the gateway, in New 
 York, one turns to Boston, one to Buffalo, 
 three others south to Philadelphia, Baltimore, 
 and Washington, while the rest push onward 
 to the west, to Cleveland, Chicago, and St. 
 Louis. Their separation will indicate the con- 
 ditions now existing in a selected group of 
 the cities of the eastern half of the United 
 States. 
 
 The family which stopped first, in New 
 York, stands the least chance of a happy and 
 healthy life. In 1905 the state census reported 
 one hundred and twenty-two blocks of that
 
 310 THE HEALTH OF THE CITY 
 
 city with a density of seven hundred and fifty 
 per acre or over, and thirty blocks with a 
 density of one thousand or over, spread over 
 the whole of Manhattan. Since 1905 hundreds 
 of those houses have been raised from one to 
 four stories in height, and the total number 
 per acre has risen in some cases to sixteen 
 and seventeen hundred. The somewhat un- 
 common density of one thousand to the acre, 
 of 1905, has become a common occurrence. 
 What does a density of one thousand per acre 
 mean to you reading this article in your own 
 home? Assume that you are in a suburban 
 house, with a lot sixty by seventy-two feet. 
 That means ten houses to the acre. Think of 
 the ten houses immediately around you and 
 see whether they will average more than six 
 persons to each house. If not, there is a den- 
 sity of sixty to an acre. If you are reading 
 this in a four-story apartment house standing 
 on a lot whose total area is three thousand 
 feet and in which every apartment contains an 
 average of five persons, you are taking your 
 part in producing a density of population of 
 about two hundred and ninety to the acre. 
 In both these cases density is figured exclusive 
 of streets and open spaces. When these are
 
 CITY HOUSING IN AMERICA 311 
 
 included, conditions become worse. Even the 
 last conditions cited are too crowded. What 
 is the result when you place a thousand or 
 fifteen hundred people where there is scarcely 
 room for three hundred? To-day in New York 
 there is acre after acre on which thirteen hun- 
 dred persons live their crowded lives; where 
 there are ten persons to every seven rooms; 
 where, instead of the minimum of eight hun- 
 dred and eighty feet, there is but four hundred 
 cubic feet of air for each adult and but two hun- 
 dred for a child; where only one room out of 
 four receives direct sunlight. The immigrant 
 who stops in New York stands but little chance 
 of length of days under such conditions. 
 
 In its crowded districts New York presents 
 one more example of that unfortunate state 
 of affairs where the poor man, living on land 
 which is far too expensive for dwellings, is 
 forced into narrow quarters from the compel- 
 ling exigency of a narrow purse. Over and 
 over again one truism appears. House your 
 laborer on expensive land, and you will have 
 overcrowding because his wage will pay for 
 but a little space. House him on cheap land, 
 and the money which bought four walls be- 
 fore will buy a home. The dumb-bell tene-
 
 312 THE HEALTH OF THE CITY 
 
 ment (sometimes called the double-decker), 
 into whose darkened doorway our immigrant 
 is likely to pass, is unsurpassed for wretched- 
 ness in any great city of the world. Strange 
 to say, it is an example of ill-directed reform. 
 In December, 1878, after a spasm of housing 
 interest in New York, prizes were offered for 
 plans of the best model tenement house that 
 could be secured. To the horror of thousands 
 at that time, and of hundreds of thousands 
 since, the dumb-bell tenement was awarded 
 the first prize. From 1879 to 1901 city block 
 after city block was filled solidly with these 
 buildings. Mistakenly advised as a model plan 
 to builders who knew no better, f ulfilling every 
 purpose of the man who was ready to exploit 
 human lives for money, the dumb-bell tene- 
 ment is responsible for an appalling roll of 
 deaths, and for an extraordinary waste of effi- 
 ciency. Its name is derived from the fact that 
 it narrows in the centre and expands at the 
 ends like a huge dumb-bell, and its expansion 
 fills the street both front and rear. Its narrowed 
 centre gives room for that misnamed feature, 
 the air-shaft. That shaft has been variously 
 called a garbage-hole, a dirt-trap, an ash-bin, 
 and a destroyer of privacy. It has never proved
 
 CITY HOUSING IN AMERICA 313 
 
 its right to the name of air-shaft. Without 
 an intake at the bottom, how long would any 
 chimney draw ? The air-shaft is like a chimney 
 without an intake. It is but one of the evils 
 of the dumb-bell. Seven stories high, with 
 four rooms in the front apartment; three 
 rooms in the back ; with one room of the front 
 apartment open to the street and one room of 
 the rear apartment opening on twenty feet or 
 so of back yard; with inside rooms facing on 
 an air-shaft whose wall is less than five feet 
 away from the windows of the next house, 
 these are some of the characteristics of the 
 habitations which house a large portion of the 
 citizens of the greatest city of the Western 
 Hemisphere. 
 
 The building of the dumb-bell tenement 
 was stopped in 1901, and regulations provid- 
 ing for the erection of new-law tenements, 
 with large courts designed to provide natural 
 light and ventilation for every room in the 
 house, were made. No window was to open 
 within twelve feet of any other window. The 
 practical results of this law have hardly equaled 
 its theoretical possibilities. In October, 1908, 
 the Committee of One Hundred held a Citi- 
 zens' Exhibit showing conditions in New York
 
 314 THE HEALTH OF THE CITY 
 
 under Tammany. One of the placards on the 
 wall read as follows : 
 
 THERE ARE IN NEW YORK APPROXIMATELY 
 300,000 LIVING-ROOMS WITHOUT ADEQUATE 
 LIGHT AND VENTILATION. ONLY ONE IN 
 FOUR OF THE ROOMS IN THE NEW-LAW TENE- 
 MENTS HAS ADEQUATE SUNSHINE. ON MAY 
 1, 1909, THERE WERE 16,006 OLD BUILDING VIOLA- 
 TIONS SLEEPING IN THE CORPORATION COUN- 
 SEL'S OFFICE. 1563 CASES WERE OVER 4 YEARS 
 OLD. 2283 CASES HAD BEEN NEGLECTED ONE 
 YEAR. 4578 CASES HAD BEEN NEGLECTED OVER 
 6 MONTHS. THERE WERE 35,000 VIOLATIONS OF 
 THE TENEMENT-HOUSE LAW ON THE BOOKS OF 
 THE TENEMENT-HOUSE DEPARTMENT. BLAME 
 TAMMANY FOR THESE CONDITIONS. AND FOR 
 YOUR HEALTH'S SAKE 
 
 VOTE TAMMANY OUT! 
 
 That placard is but one more example of the 
 oft-told tale that regulation without appropria- 
 tion and enforcement does not regulate. 
 
 No part of our group of immigrants is likely 
 to suffer so greatly as the family that stopped 
 at New York. The new-comers who came to 
 Boston have a wider choice, but they may find 
 lodging in certain quarters of the city where con- 
 ditions are fully as bad as any in the greater com- 
 munity. There is more opportunity for proper 
 housing, should American surroundings so 
 improve the family's financial condition as to
 
 CITY HOUSING IN AMERICA 315 
 
 enable them to move into the far more acces- 
 sible suburbs. Those who live in the centre of 
 the city must crowd into houses with but little 
 more light and air than they would get in the 
 dumb-bells of New York. The bbvine street 
 superintendents who are said to have first laid 
 out Boston's thoroughfares did a poor enough 
 piece of work in the business quarters of the 
 city. They did their worst in the old North 
 End, whence once the finest residences of the 
 city overlooked the bay ; where now are slums, 
 whose narrow winding alleys cut off whatever 
 advantage of light and air the houses, lower 
 by two or three stories than those of New 
 York, possess. Nor is overcrowding any better 
 in lower houses than in higher ones. There are 
 1672 persons on an acre in five and six story 
 houses in New York. There are 1143 persons 
 on an acre in three and four story houses in 
 the North End of Boston. 
 
 If one could imagine the head of a family, 
 which goes west, studying the figures which 
 tell of congestion of population, Chicago, 
 with its average density of only 21.09 to the 
 acre, would seem a free and open city for him 
 to choose. These figures, however, are most 
 misleading. The city of Chicago contains
 
 316 THE HEALTH OF THE CITY 
 
 122,011 acres within its limits. Thousands of 
 these acres are but sparsely settled. Tens, 
 almost hundreds, of them in the centre of 
 population are either overcrowded or on the 
 edge of overcrowding. Congestion in Chicago 
 is developing with amazing rapidity. In an 
 investigation of six selected blocks, one half 
 had three persons to a room, one fourth had 
 two persons to every room. That means that, 
 if two rooms are occupied by four people, all 
 four are commonly in the bedroom at night. 
 Such overcrowding is not all. Add to it the 
 tendency to cover eighty or ninety per cent of 
 the whole lot with dwellings, and the chance 
 of air and light grows small indeed. 
 
 Lot-covering is not peculiar to Chicago : 
 it exists in all great cities. Profitable to the 
 purse of the landlord, it is wasteful of the life 
 of the tenant. Every built-up yard drives chil- 
 dren to the street, cuts off light, and obstructs 
 the current of air. According to many experts 
 there is no central city lot on which dwellings 
 should cover more than from sixty-five to 
 seventy per cent of the total area. More open 
 space may be advisable, depending on local 
 conditions. Less open space does harm to the 
 city.
 
 CITY HOUSING IN AMERICA 317 
 
 St. Louis gives no great promise to the new- 
 comer. In an investigation recently carried 
 on by the Civic League of that city, one half 
 the houses in the negro quarter were declared 
 unfit for human habitation. The Polish quar- 
 ter had an average of thirteen persons to four 
 rooms, and a number of lots were found which 
 were wholly covered by buildings. Cleveland 
 reports that one third of all the buildings 
 in one of its slum-districts should not be 
 permitted to exist. Philadelphia, the vaunted 
 " City of Homes," specializes in one-room 
 "housekeeping apartments," where whole fam- 
 ilies, often containing from four to seven 
 members, eat, sleep, cook, and live in a single 
 room. Buifalo presents a Polish quarter, whose 
 buildings are chiefly small, individual, wooden 
 houses seldom more than two and a half stories 
 high. This city offers an interesting proof of 
 the fact that overcrowding is not synonymous 
 with high brick tenements. In its frame houses 
 live thousands of Poles, who crowd together 
 like bees in a hive. Two, three, four, five, even 
 six and seven families gather under the same 
 roof in small houses whose space is no more 
 than sufficient for a single family. Such build- 
 ings, however, have one great advantage over
 
 318 THE HEALTH OF THE CITY 
 
 the ordinary tenement. They are open to the 
 air. 
 
 In both Baltimore and Washington the 
 alley-problem is the most pressing evil which 
 needs reform. Alley-house and rear tenement 
 alike offer one great barrier to correction : they 
 are out of the public eye. Sanitary reform is 
 difficult behind a sheltering screen, and it has 
 no more active agent than publicity. So long 
 as noisome alleys and rotting rear tenements 
 exist, so long will vice and crime find a home 
 and a citadel whence they may sally forth. 
 Either of these conditions can find but one 
 remedy, demolition. They cannot be cured by 
 halfway measures. Centres of decay, the knife 
 is the only way of cleansing the body politic 
 from the corruption which they engender. 
 
 The various characteristics of the slums, 
 high death-rate and premature old age, moral 
 degradation, drunkenness, and thriftlessness, 
 difficulty of family life and utter lack of com- 
 munity spirit, are produced by a mixture of 
 causes. The tenement house and its allies are 
 not alone responsible for all these things. 
 Poor food, water, and air, drunkenness and 
 gambling, each of these plays its part ; but 
 overcrowding is a powerful factor which is
 
 CITY HOUSING IN AMERICA 319 
 
 the genesis of many other evils. So long as the 
 slum exists, the piers of our city structures 
 must rest on quicksand. 
 
 How largely topographical conditions in- 
 fluence the making of a slum is hard to tell. 
 Manhattan's long tongue of land, fenced in 
 by its limiting rivers, is very probably respon- 
 sible for some part of the overcrowding of New 
 York. It is hardly fair, however, to throw the 
 whole onus of blame on topography alone, 
 when such serious conditions obtain in other 
 cities. Mr. Lawrence Veiller considers that a 
 large part of the trouble came originally from 
 the short-sighted policy of the authorities, 
 who utterly neglected to provide dwellings 
 for the horde of immigrants who have poured 
 through the open gates of the continent for 
 so many decades. Enforced regulations have 
 long been lacking. Slipshod methods have en- 
 abled evils to gain the upper hand, and have 
 produced their ill results in housing, as in 
 other city needs. So long as man is allowed 
 unchecked to wring exorbitant profits from 
 the scanty pittance of the poor, so long will 
 men be found to do it. 
 
 Much of the necessary body of building 
 regulation has been outlined by American
 
 320 THE HEALTH OF THE CITY 
 
 and foreign experiment. It seems an absurdly 
 evident proposition that the area of air-shafts 
 and courts should increase in proportion to 
 the height of the building. Even a child, 
 building a play-house in a pasture, will en- 
 large its area as the rock wall goes higher. 
 Even a child has wisdom enough to see that 
 the higher wall will cut off sunshine from the 
 ground within, if the space be narrow, and 
 that his room will be damp and cold in con- 
 sequence. The child in carrying out his build- 
 ing operations shows more intelligence than 
 the combined wisdom of many municipal de- 
 partments displays. They have not yet awak- 
 ened to the fact that every additional story 
 of a building, rising into the air, necessitates 
 larger open spaces on the ground. Back-to- 
 back tenements, which quite forbid thorough 
 ventilation, may still be built in many cities ; 
 lots may be wholly covered with buildings ; 
 rear tenements may be placed behind front 
 tenements ; and when, as in the case of New 
 York, houses are built originally at the back 
 of a lot, with a front garden, the march of 
 building movement may fill such garden- 
 spaces with brick and mortar. 
 
 There is no great difference in the need
 
 CITY HOUSING IN AMERICA 321 
 
 of light, of air, or of water in the case of a 
 tenant who lives in Chicago, in Pittsburg, in 
 Washington, or in Boston. General sanitary 
 regulations for general needs may be made 
 which can cover any city ; yet local conditions, 
 topographical and sociological, must determine 
 local laws. The twenty-five foot lot binds New 
 York to a definite procedure. The desire of 
 tenants in many quarters to have one room 
 open on the street makes impracticable in this 
 country some of the inner-courtyard plans 
 which have been successful abroad. The long- 
 ing for street windows is probably due to the 
 fascinations of the unfailing picture-show of 
 the city street, which seems never to weary the 
 observers who, with elbows crossed upon the 
 sills, crowd their casements for hours. Give 
 them far greater measure of convenience in 
 other ways, give them double window-space, 
 opening on a courtyard, and they will still long 
 for the sights and sounds of the street. More- 
 over, the intangible chains of social procedure 
 are powerful in the tenements. In many dis- 
 tricts the occupant of a rear tenement which 
 does not look out upon the street is considered 
 the social inferior of the occupant of a precisely 
 similar apartment with street frontage and situ-
 
 322 THE HEALTH OF THE CITY 
 
 ated on the same floor. Ridiculous! Yes! But 
 is it any more ridiculous than some of the rules 
 of precedence nearer the top of the social lad- 
 der? Since such conditions exist, it behooves 
 the reformer at least to recognize strong bar- 
 riers of social prejudice, which may be easily 
 evaded but hardly surmounted. 
 
 Among the more general housing regula- 
 tions, there are two for which the city is es- 
 pecially responsible, the service of municipal 
 water and the protection against fire. That such 
 primary necessities of existence as water-closets 
 should be used in common by whole tenement 
 houses is one of the burning shames of our 
 community life. There are numerous tenement 
 houses to-day where water has never been put 
 in above the first floor. Imagine shopping with- 
 out an elevator, and then think of the weari- 
 ness of those long flights to tired women and 
 little children ! Even where water is piped to 
 every floor, a common water-closet and a com- 
 mon sink often supply the needs of four apart- 
 ments, which may house from eight to twelve 
 whole families, to say nothing of lodgers. In 
 the slums, as too often in apartment houses far 
 from the slum-classes, the water-closet venti- 
 lates on an air-shaft used also to ventilate bed-
 
 CITY HOUSING IN AMERICA 323 
 
 rooms. In still other cases the water-closet is 
 placed directly in the bedroom. Manchester, 
 England, requires that every room used for such 
 purposes must have a window opening on the 
 outside air, with an area of at least one foot by 
 two. Detroit requires that the water-closet com- 
 partment be open to the outer air, or be venti- 
 lated by a shaft which is not used for ventilat- 
 ing any habitable room. Several cities demand 
 that no water-closet shall be placed in the yard 
 or the cellar. Some of the most enlightened 
 have reached the point of requiring one for 
 each family or each separate apartment. In 
 general, the infamous " school sinks " and other 
 cheap substitutes for modern plumbing are for- 
 bidden. Violations of these ordinances, how- 
 ever, like those of many other laws made for 
 the protection of the city's health, are far too 
 common. 
 
 That cleanliness is not a necessity of existence 
 has been proven by the slums for many years. 
 It is a forbidden luxury to most of them. That 
 it is necessary for healthful life, few will deny. 
 The way to provide opportunities for cleanli- 
 ness in the houses of the poor is by no means 
 settled, but the great mass of opinion is on the 
 side of the individual set tub. Nor need the
 
 324 THE HEALTH OF THE CITY 
 
 tubs be confined to clothes-washing alone. A 
 movable partition and stout supports improvise 
 a bath-tub which, though scarcely as convenient 
 as a porcelain one, is by no means to be de- 
 spised where space and cost must be considered. 
 If clothes are to be washed, it is practically a 
 choice between the cooperative laundry, to be 
 used in common by all tenants, and the indi- 
 vidual set tub ; and the cooperative method has 
 shown one interesting example of failure which 
 hardly encourages its adoption. 
 
 The cooperative laundry built by the Lon- 
 don County Council for their Boundary Street 
 buildings, at an expense of over fifty thousand 
 dollars, has never from the first proved a suc- 
 cess. The tenants of those buildings would not 
 wash in public where their neighbors could see 
 and criticise the quantity, quality, and appear- 
 ance of their clothes. There appeared to be no 
 objection to hanging out the clothes to dry in 
 a common space after they were washed, but 
 the preliminaries must be done in private. 
 
 I have seen one tenement-house fire : I 
 hope I may never see another. It was an ob- 
 ject lesson which makes the heading, "An- 
 other Tenement-House Fire. Two Lives Lost," 
 a real and vital thing which overshadows even
 
 CITY HOUSING IN AMERICA 325 
 
 politics and the financial page. That is such 
 a common heading, too ! How common was 
 shown vividly by the investigation of Hugh 
 Bonner and Lawrence Veiller a few years 
 ago on the relation between tenement houses 
 and fire. All the records of fires which oc- 
 curred throughout the city during a period 
 of two years and a half were examined, to 
 determine the type of buildings in which 
 most of the fires occurred. Sixty thousand 
 records were searched to determine the general 
 method of the spread of fires in tenement 
 houses. Nearly one half of the total fires, 
 during the period chosen, occurred in tene- 
 ment houses, although this type of house 
 composed but thirty-seven per cent of the 
 total buildings of the city. Forty-two per cent 
 of all the buildings of the city at that time 
 were dwellings holding not more than two 
 families, yet such dwellings furnished only 
 fourteen per cent of the total fires. The tene- 
 ment house is more than a centre of infection : 
 it is a fire-centre as well. The way in which 
 the flames spread in the cases of serious tene- 
 ment-house fires shows how much destruction 
 and loss of life is due to construction. Twenty- 
 six per cent of all such fires spread through
 
 326 THE HEALTH OF THE CITY 
 
 the air-shaft; five per cent through the air- 
 shaft combined with the halls and stairs ; 
 twenty-four per cent through flooring or par- 
 titions; twenty per cent through halls and 
 stairs ; one fourth of all the fires started in 
 the cellar. From those figures, taken in New 
 York, we may obtain an indication of the 
 lines which should be taken in freeing the 
 tenements from this scourge. 
 
 Fireproofing throughout is, of course, the 
 ideal solution of the fire-problem. It is very 
 doubtful if it is practical in the tenements. 
 Construction of this sort is so expensive that 
 its general application would mean a rise in 
 rents and a consequent diminishing of other 
 necessities which would make conditions worse 
 than they have been. The analysis of Bonner 
 and Veiller just cited shows three points 
 which need especial protection stairs, hall- 
 ways, and shafts. If those natural chimneys 
 can be safeguarded, if we can obtain fireproof 
 floors and fireproof partitions between cellars 
 and first floors, we shall have eliminated no 
 small portion of the probable difficulty. 
 
 After all those changes have been made, 
 however, enough has not been done. Interior 
 egress is not sufficient ; exterior egress should
 
 CITY HOUSING IN AMERICA 327 
 
 also be provided. In only too many cities, 
 the laws which require adequate fire-escapes 
 have been systematically ignored ; only too 
 often when escapes have been raised, they 
 have been wholly inadequate for their pur- 
 pose. At the time of the investigation just 
 cited, there were approximately two thousand 
 persons in one New York ward living in tene- 
 ment houses wholly without fire-escapes. In 
 the same district were many fire-escape balco- 
 nies constructed of wood, which would burn 
 out at the first blast of flame. Household 
 goods and flower-pots blocked sudden egress 
 in case of sudden fire. Many of the escapes 
 were vertical ladders. A vertical ladder is safe 
 enough for an active powerful man, but the 
 great majority of the population of any given 
 tenement house is never composed of such 
 men. How much chance do women and chil- 
 dren have of gaining the ground in safety 
 and in good order by such means? Talk with 
 the firemen and they will tell you that a ver- 
 tical ladder fire-escape generally means that 
 they must carry the women and children to 
 the ground while the conquest of the fire 
 must be delayed. Sometimes the battle is lost 
 because of that delay. Fire-escapes made
 
 328 THE HEALTH OF THE CITY 
 
 wholly of metal, with stairs bordered by hand- 
 railing, provide the only safe method of 
 escape from the crowded dwellings of the 
 slums. It is no less than a city's duty to de- 
 mand them. Nor should fire-escapes on the 
 larger tenement houses be limited to the 
 
 O 
 
 rear. Kitchens, commonly placed in the fear 
 of an apartment, are favorite starting-places 
 for fires, whose flame may easily envelop a 
 rear escape as well as the stairs. Under such 
 circumstances, the only safety comes from 
 the possession of escapes both front and 
 rear. 
 
 The initiative in the movement for reform 
 may come from single or collective forces. 
 Private citizens can do much to aid. The won- 
 derful work of the tuberculosis exhibits can 
 be duplicated by good housing exhibitions 
 prepared by societies interested in civic re- 
 form. Cooperative societies have fully as great 
 a chance to build model houses here as in 
 England, where so much has been accom- 
 plished. Capitalists, who desire to aid the 
 poor by methods of self-help, may find work 
 ready for their hands. Labor unions, which 
 have done no small part of the whole work so 
 far accomplished, can do much more. The
 
 CITY HOUSING IN AMERICA 329 
 
 greatest necessity of all is for a constant per- 
 sistent campaign of education. 
 
 After all the general work has been done, 
 however, each individual city must find the 
 values of the many unknown x's of the housing 
 problem by the use of the known factors, the 
 a's and 6's, of its personal equation. The initi- 
 ators of such movement have a large field to 
 cover. Only when all the facts and figures 
 furnished by local and general conditions 
 have been secured, only when all the data 
 obtainable with respect to the work already 
 performed is at hand, can we hope to find 
 firm foundation for our arguments. It is en- 
 tirely probable that the best way for munici- 
 palities or associations to take up this ques- 
 tion is by means of a temporary committee 
 or commission, whose membership should be 
 made up in the way pointed out by the best 
 foreign examples. Some of the governments 
 abroad have obtained the services of experts 
 in the six lines of work most closely connected 
 with the housing problem. Their commissions 
 include a doctor, an engineer, an architect, 
 a real-estate expert, a builder, and a social 
 worker. There are too many problems of dis- 
 ease, too many problems of construction, too
 
 330 THE HEALTH OF THE CITY 
 
 many problems of finance, and too many per- 
 sonal problems, for any of those experts to 
 be safely omitted. 
 
 Such a board would, of course, proceed im- 
 mediately after its appointment to obtain the 
 necessary facts and figures for its labors. A 
 house-to-house canvass should be immediately 
 begun, not only for the purpose of determin- 
 ing to what extent evil conditions exist, but 
 also to find out what deficiency of housing 
 exists in the city. While this canvass proceeds, 
 a general investigation of the land in the slums 
 and around the city should be undertaken, to 
 determine what localities exist where inexpen- 
 sive and easy means of transit make access to 
 work comparatively simple, and where land 
 can be bought cheaply. The collection of data 
 from American and foreign states, cities, and 
 private enterprises is important. Its arrange- 
 ment and cataloguing in such shape as to make 
 access easy is quite as necessary. Each of the 
 specialists on the commission should report in- 
 dividually on his own line of work, and bear 
 his part in the general statement to be issued 
 by the whole commission. Experts should add 
 to this such a digest of existing law as to make 
 it evident, at the close of the house-to-house
 
 CITY HOUSING IN AMERICA 331 
 
 canvass, just what the law is and just how 
 completely it has been enforced. 
 
 The assessors' books provide a starting- 
 point for housing investigations, since they are 
 the register of house property of every kind 
 situated within the city limits. From these 
 books may be learned what land is too costly 
 for dwellings and what land is cheap enough 
 to be used for this purpose. That point can 
 scarcely receive too great emphasis. If houses 
 are to be available for the poor, rents must be 
 so regulated as to meet the lowest average wage. 
 To know the practicable rents for any city, the 
 wage-statistics of that individual city, not the 
 general statistics of a country, must be obtained. 
 In no civic problem does the personal equation 
 of a city affect the result more. A second point 
 follows naturally here. The regulations imposed 
 on persons desiring to build must not be too 
 costly. They must always seek to give the max- 
 imum health-protection at the minimum cost. 
 The desire for harmonious artistic development 
 is most laudable. If it can be secured without 
 hygienic loss, well and good ; but when the beau- 
 tiful and the healthful conflict, it is the aesthetic 
 side which should suffer. There is no finer or- 
 nament to a city than healthy boys and girls.
 
 332 THE HEALTH OF THE CITY 
 
 One must hesitate a long time, however, be- 
 fore advocating the policies of Germany and 
 Great Britain in the United States. Municipal 
 ownership of dwellings, which may be to some 
 degree successful under the autocratic rule of 
 the first nation or the parliamentary control 
 of the second, may be of dubious value here. 
 The average municipal officer would be too 
 hesitant in applying sufficiently rigorous meth- 
 ods of control to a tenant of city property who 
 had helped in his election. The possibility of 
 colonization in municipally-owned dwellings 
 would be too great. The danger that a man's 
 home would be used as a club to control his 
 vote would not be small. Most of all, our lack 
 of those distinctive classes which make houses 
 exclusively for the poorer classes possible 
 abroad, makes houses for any class impossible 
 here. However contented with his former lot 
 the immigrant may have been, the air of this 
 country soon leads him to hope and dream of 
 advancement for his children, if not for him- 
 self. 
 
 Municipal housing considers but one phase 
 of the question at best. There are many other 
 ways in which municipalities can do much to 
 encourage the building of good and inexpen-
 
 CITY HOUSING IN AMERICA 333 
 
 sive dwellings by individual citizens, and by 
 cooperative societies or associations. 
 
 The common practice of remitting taxes to 
 manufacturers, who are willing to increase 
 the prosperity of a town by bringing new 
 business within its limits, is a precedent for 
 similar action to builders willing to put up 
 model houses at low rents. The heavy cost of 
 betterments, of sewer-opening, and of street- 
 making might be waived in the case of con- 
 tractors willing to supply housing deficien- 
 cies under strict regulations. Such remissions 
 should be charged to the builder, and waived 
 only during his performance of the necessary 
 conditions. On violation of the regulations, 
 or on the raising of rents above the stipulated 
 sums, such charges should become automati- 
 cally due. In the present competition of town 
 with town, boards of trade are sending ad- 
 vertising matter all over the country in their 
 efforts to attract citizens and manufacturers. 
 Could a board of trade offer a better drawing 
 card than a good town plan ? Could they fur- 
 nish many greater incentives to a manufac- 
 turer than would be provided by well-planned 
 houses for employees ? No organization could 
 work more effectively in obtaining the back-
 
 334 THE HEALTH OF THE CITY 
 
 ing of public-spirited citizens ready to further 
 housing schemes. 
 
 Of the close relation between rapid transit 
 and housing, Charles H. Cooley wrote some 
 years ago in one of the papers of the Ameri- 
 can Economic Association : 
 
 " We must recognize in the system of urban 
 transportation a definite social organ, having 
 for its function the distribution of population 
 about industrial centres. It is an industrial 
 necessity that men shall work in dense aggre- 
 gates. Humanity requires that they shall not 
 live in dense aggregates. The conditions of 
 industrial life are such that the number of 
 aggregated workers necessarily increases re- 
 latively to the number of scattered workers. 
 There is, then, a conflict between the indus- 
 trial tendency to aggregation, and the needs 
 of humanity. The function of city railways is 
 to reconcile these conflicting requirements of 
 the social organism." 
 
 To bridge the gap between the workshops 
 of the centres and the homes of the suburbs, 
 cheap and rapid transit must be provided. 
 That transit, if it is to be of use to those who 
 need it most, must especially consider the 
 length of time which the worker will spend
 
 CITY HOUSING IN AMERICA 335 
 
 in passing to and from his labor. Suppose we 
 start with the assumption that a trip of half an 
 hour each way, an hour a day given over to 
 travel, is the most that the average workman 
 will give to travel to and from his work. That 
 hour is not a fixed period based on statistical 
 information. It is rather a general statement 
 made to serve as a reasonable standard for 
 the development of a theory. The half hour 
 of the single trip should include the time 
 taken to go from his home to the cars, from 
 the cars to the factory, and necessary waits 
 for the cars. Surely it does not seem excessive 
 to say that the average workman will be 
 obliged to spend ten minutes of his half hour 
 waiting and getting to and from his means of 
 transportation. That leaves twenty minutes 
 to be spent on board the cars. On an electric 
 surface car, at the hour at which he travels, 
 that will scarcely take him, at best, more than 
 four miles from his labors. With the block- 
 ades of the streets it is likely to carry him a 
 much shorter distance in the given time. The 
 great city has tried the surface car (still avail- 
 able for the small city) and found that it will 
 not give the rapid transit that its citizens 
 must have. Under the best conditions such
 
 336 THE HEALTH OF THE CITY 
 
 railways will not take the workman outside 
 the crowded quarters in the time that he can 
 spare. 
 
 An elevated system will do far more. A 
 two-track system, however, at the rush hours, 
 has its cars crowded to the doors and is 
 forced to comparatively frequent stops. It 
 will not open an area of sufficient size to pro- 
 vide space for the people of the crowded cen- 
 tres. Four-track elevated systems in the narrow 
 streets of many of our larger cities are an im- 
 possibility. The only spaces left for railway 
 locations in the centres are underground or 
 above the high roofs of the sky scrapers. Air- 
 ships are hardly practicable for workingmen's 
 transit as yet, and the four-track subway with 
 two tracks for accommodation trains and two 
 for express trains seems to be the best means 
 of traveling back and forth. Only by swift 
 expresses can we open an area sufficient for 
 modern city needs. 
 
 We are sometimes likely to forget how close 
 is the relation between the rapidity of transit 
 and the area available for buildings. It is even 
 more difficult to realize how swiftly that area 
 grows as the speed of the trains increases. 
 Estimating the average rate of speed of the
 
 CITY HOUSING IN AMERICA 337 
 
 different types of city railways, for purposes 
 of comparison, as ten miles an hour for sur- 
 face, twenty for a two-track elevated system, 
 and thirty for a four-track subway, will give 
 us some light on the relation between the two 
 factors. Consider the unit which we proposed, 
 the possibility of the workman spending twenty 
 minutes on the train, and you will see that the 
 surface railway will carry him three and a third 
 miles in that time, the two-track system six 
 and two thirds miles, and the elevated ten 
 miles. If we could obtain radial systems run- 
 ning into circular zones about the city, we 
 should find that the area in square miles would 
 develop amazingly as we increased the rate of 
 speed. The surface railways would serve an 
 area of about thirty-five square miles. The 
 two-track an area of about one hundred and 
 forty square miles. The four-track, with its 
 express trains, an area of about three hundred 
 and fourteen square miles. And this progres- 
 sion in size would be due to the geometrical 
 fact that the areas of two circles are to each 
 other as the squares of their radii. 
 
 The steam railways can do much in distrib- 
 uting the population, but their general use 
 is limited in three ways : first, their compara--
 
 338 THE HEALTH OF THE CITY 
 
 tively small number, second, their inadequate 
 terminals, which commonly require a long walk 
 after the workman reaches the city, and, third, 
 their fares graded on distance. The number 
 of the steam roads around the towns does not 
 seem likely to be greatly increased. The steam 
 railroad, in America, is essentially a long dis- 
 tance line. Its suburban traffic moves along 
 the long path of the road's journey to its final 
 destination. The short branch lines which 
 serve suburban populations are largely projects 
 of a former day. It is to the electric road that 
 we must look for the development of our sub- 
 urbs. Steam roads are likely to have poorly 
 placed terminals for the development of work- 
 ingmen's traffic, and the difficulty of passing 
 from one terminal to the different parts of 
 the working quarters or to the terminals of 
 other roads is often great. In this respect we 
 might well take advantage of the example of 
 Berlin, whose four-track belt line, encircling 
 the city, joins terminals and leaves passen- 
 gers near their destination. Of the problem of 
 the graded fare, the third limitation, we shall 
 speak in another paragraph. 
 
 Cost of transit is no less important than 
 rapidity. Rapidity of transportation will do
 
 CITY HOUSING IN AMERICA 339 
 
 little for the city, if its expense prevents its 
 general use by those who need it most. The 
 steady expenditure required by the movement 
 to and from work, even at a five-cent fare, is 
 a serious steady drain on the workman's purse. 
 In these days of the high cost of living, 
 the weekly sixty cents means much to a man 
 with a limited wage. Speaking of this topic, 
 A. F. Weber, at the close of his work on the 
 " Growth of Cities," gives, " Four goals which 
 are of fundamental importance. (1) a shorter 
 working day, which will permit the working- 
 man to live at a distance from the factory; 
 (2) associations for promoting the ownership 
 of suburban homes by workingmen ; (3) cheap 
 transit; (4) rapid transit." Of the third of those 
 goals, Cooley has said, " The lower the fare, 
 the wider the area open to the man with the 
 light purse." 
 
 It is worth noting that the London County 
 Council, in its Millbank buildings, provides 
 transportation with a seat for every workman 
 at a rate of two cents per trip. Contrast that 
 with the average condition here. The waste 
 of opportunity in our granting of franchises 
 has been great in many directions. In none 
 is it more apparent than in the neglect of
 
 340 THE HEALTH OF THE CITY 
 
 American cities to impose such conditions 
 upon petitioning corporations as shall provide 
 opportunities for workmen's dwellings in the 
 suburbs. Railroads and trolley-lines should be 
 required by charter restrictions to run work- 
 ingmen's trains and cars at reduced prices at 
 convenient times. 
 
 It may be that our freedom from class con- 
 ditions makes it impracticable to run trains 
 for any given class. If so, is it too much to 
 ask that at workingmen's hours, trains at re- 
 duced prices shall run, which are open to all 
 classes ? The majority who use them will be 
 the ones who need them most. There will be 
 slight probability of empty seats, and the as- 
 surance of full trains should make it possible 
 to base fares on actual running expenses. If 
 reduced prices are to be granted, however, 
 they must be based, so far as possible, on a 
 uniform fare. Urban railroad fares, graded 
 on the distance traveled, have not found great 
 favor in this country. They offer a serious 
 obstacle to sending of the workman far from 
 his work into healthful surroundings, for they 
 set up a series of artificial barriers at the limits 
 of each payment. A limit, beyond which an 
 extra fare is required, is difficult for the slen-
 
 CITY HOUSING IN AMERICA 341 
 
 der purse to surmount. It offers too great an 
 inducement for the traveler to stop at a point 
 which can be reached by one of the lower 
 fares from which he proceeds no farther. 
 
 Projected lines should insure that possibili- 
 ties of housing be not neglected. This second 
 requirement can be fairly imposed only by 
 such an expert commission as that mentioned, 
 which can examine proposed routes with rela- 
 tion to their housing possibilities. 
 
 Surveys of general conditions, and recom- 
 mendations of definite laws, may do much; 
 but to make such work lasting, some perma- 
 nent body must be provided which shall deal 
 with housing as a permanent city department. 
 The construction of such a department, and 
 the regulations under which it should act, 
 
 O ' 
 
 should depend upon the information obtained 
 by the preliminary body. A single depart- 
 ment having in charge this one branch of civic 
 life should be instituted in every city where a 
 bureau of this type does not exist. Such gov- 
 ernment as the slum has so far received has 
 shown the disadvantages of a multiplicity of 
 controllers, all too engrossed in their immedi- 
 
 ' O 
 
 ate affairs to pay much attention to this side- 
 issue. The police, the fire department, and
 
 342 THE HEALTH OF THE CITY 
 
 the department of health have each had a 
 share of the control. Between them all, little 
 has been done. The tenement-house bureau of 
 New York, ineffective as it has been under 
 Tammany, is yet far better than the older 
 methods which divided responsibility. But a 
 housing department, if it is to have any value, 
 must be backed by sufficient appropriations. 
 The spirit of the people must be behind the 
 movement. New York's experience, as evi- 
 denced by the placard cited near the begin- 
 ning of this chapter, has shown of what limited 
 value legislation can be when these things are 
 wanting. The city must guard against nulli- 
 fying such reform by legal intricacies or ver- 
 bosities. The first necessity of the laws or 
 ordinances under which such a department is 
 to work is simplicity. The wording should be 
 intelligible, not only to architect and builder, 
 but also to any intelligent layman. Owner 
 and tenant alike should be able to understand 
 each and every paragraph. Fortunately, more- 
 over, if. we grant the postulate of a rightly 
 constituted department, with sufficient appro- 
 priations, we shall find ample possibility of 
 enforcement in the city's hands. If the hous- 
 ing authorities refuse to allow tenants to oc-
 
 CITY HOUSING IN AMERICA 343 
 
 cupy a new house until all the necessary 
 regulations have been met, builders become 
 extremely anxious to meet requirements. The 
 closing of a few houses which are unfit for 
 human habitation and the refusal of permits 
 to occupy them until they have been properly 
 renovated bring about rapid repairs. Oppo- 
 sition to public control of private property is 
 inevitable, yet the swiftness with which so 
 great a movement for the city's health has 
 prevailed seems sometimes incredible. Every 
 attempt which has been made to secure pro- 
 tection for tenants has been opposed by two 
 classes of hostile building interests, the hon- 
 est builder and the reckless speculator. Many 
 of the first class, who have been sufficiently 
 public spirited to accept changes which are for 
 the good of their fellows, have been brought 
 to see that properly built tenements are a 
 better investment than poorly built ones, be- 
 cause of the permanency of the tenants and 
 the minimizing of repairs. The speculator who 
 throws up a jerry-built house for the sole 
 purpose of unloading it on some confiding 
 investor at the first possible moment, needs 
 no protection. The community needs protec- 
 tion against him as against any other sharper.
 
 344 THE HEALTH OF THE CITY 
 
 To the honest landlord who objects to the 
 apparently arbitrary control of his property, 
 there is but one reply: he must endure that 
 control for the good of the community. In 
 like case, more than one honest milkman has 
 objected to a board of health which required 
 inspection of all his milk-supplies. His good 
 milk must be inspected with the bad. The 
 individual has no right to market wares that 
 injure the health of the community. No land- 
 lord can hold property without assuming lia- 
 bility for such betterment assessments as the 
 city may think it wise to make : his possession 
 of property implies his assumption of liability 
 to protective governmental measures. Fortu- 
 nately, the final tribunal of this country, the 
 Supreme Court of the United States, has al- 
 ready determined the right of a state to say 
 to its citizens : " You shall build in accordance 
 with our laws and in no other way." When 
 the Massachusetts legislature divided Boston 
 into certain divisions and limited the height 
 of the buildings in those divisions, buildings 
 in the residential quarter were required to be 
 less in height than those in the business dis- 
 trict. A citizen desiring to erect a building 
 of a greater height than that allowed for cer-
 
 CITY HOUSING IN AMERICA 345 
 
 tain sections of the city decided to test his 
 rights, and appealed his cause from court to 
 court. He lost his case. This affirmation of the 
 right of a city to protect its citizens by its con- 
 trol of the building of their habitations makes 
 this a decision of the greatest importance. 
 
 The great books whereon are blazened the 
 achievements of our American cities are still 
 in the making. Turning the pages slowly, 
 one finds many an illumined scroll, many a 
 fair full line. Side by side with those noble 
 records stand blotted paragraphs where shame 
 has ruthlessly despoiled the workman's careful 
 task. Here and there a sentence well begun has 
 trailed off into vague traceries which carry no 
 message to the eager searcher. Turn to the 
 page on which the American city's contribu- 
 tion to this great world-problem of housing 
 should be entered and you will find it scarce 
 begun. The filling of that page will be forced 
 upon us, on you and me, in the coming years. 
 
 NOTE. At the close of these two chapters on housing I 
 feel that I should express my appreciation of the information 
 along these lines given me by Mr. Edward Hartman, Secre- 
 tary of the Massachusetts Civic League; by Mr. Benjamin 
 Marsh, Secretary of the Committee on Congestion of Popula- 
 tion in New York ; and by Mr. Ernst Parsons, of Somes and 
 Parsons, Architects, Boston, Mass.
 
 XI 
 
 A SELECTED BIBLIOGRAPHY 
 
 THE bibliography which follows is designed 
 to be, as far as possible, a bibliography of 
 accessible books rather than of articles which 
 might be difficult for the reader to obtain. 
 It is wholly an English list. It represents, as 
 has been stated in the Preface, the genesis of 
 much of the material used in this book. In 
 the consideration of three subjects, noise, ice, 
 and sewer-gas, the general rule, given above, 
 has been broken because of the limited num- 
 ber of books on these subjects and because 
 of the fact that these are stories of individual 
 effort. The journals which have been chiefly 
 used in the preparation of the matter are in- 
 cluded in the first list given. The Depart- 
 ments of the United States at Washington 
 have furnished a great number of pamphlets 
 on many different subjects. Most of these can 
 be obtained by any citizen upon application 
 to the Superintendent of Documents, Wash- 
 ington, D. C. Their titles are not generally
 
 BIBLIOGRAPHY 347 
 
 included here, as they can be obtained, upon 
 request, from the proper officials. The regis- 
 try departments and departments of health of 
 various cities have supplied much information. 
 Other material has been drawn from the 
 twelfth census, from the "Bevolkingsstatis- 
 tiek" of Amsterdam, published by the Bureau 
 Municipal de Statistique of Amsterdam, and 
 from Newsholme's "Vital Statistics," pub- 
 lished by Swan, Sonnenschein and Co. of 
 London. The Society for the Suppression of 
 Unnecessary Noise furnished a considerable 
 part of the material on noise. The bibliography 
 on ice, included in the Memoirs of the Amer- 
 ican Academy of Arts and Sciences, vol. xii, 
 No. 5, is of especial value to the student of 
 this subject. Richards and Woodman have an 
 excellent brief bibliography relating to the 
 subjects of their work in their volume on Air, 
 Water, and Food, mentioned later in this 
 chapter. 
 
 JOURNALS 
 
 American Journal of Public Hygiene. 
 American Journal of Medical Sciences. 
 Journal of the American Medical Association. 
 Engineering News. 
 American Academy of Medicine.
 
 348 THE HEALTH OF THE CITY 
 
 Technology Quarterly. 
 
 Science. 
 
 Municipal Affairs. 
 
 BACTERIOLOGY 
 
 Conn, The Story of Germ Life. D. Appleton and 
 
 Co. 1897. 
 Conn, Bacteria, Yeasts and Molds in the Home. 
 
 Ginn and Co. 1903. 
 Fischer, Structure and Function of Bacteria. 
 
 Trans. Coppen Jones. Clarendon Press, Oxford. 
 
 1900. 
 Frankland, Mrs. Percy, Bacteria in Daily Life. 
 
 Longmans, Green and Co. 1903. 
 Lipman, Bacteria in Relation to Country Life. 
 
 Macmillan Co. 1908. 
 
 Muir and Ritchie, Manual of Bacteriology. Mac- 
 millan Co. 1907. 
 Prescott and Winslow, Water Bacteriology. Wiley 
 
 and Sons. 1908. 
 Report of the Merchants Assoc. of N. Y., Typhoid 
 
 Fever. March, 1908. 
 W hippie, Typhoid Fever. Wiley and Sons. 
 
 1908. 
 Winslow, Systematic Relationship of the Cocca- 
 
 ceae. Wiley and Sons. 1908. 
 
 HYGIENE AND SANITATION 
 
 Abbott, Hygiene of Transmissible Diseases. 
 W. B. Saunders Co. 1899.
 
 BIBLIOGRAPHY 349 
 
 Baker, Municipal Engineering and Sanitation. 
 
 MacmillanCo. 1906. 
 Bergey, The Principles of Hygiene. W. B. Saun- 
 
 ders Co. 1909. 
 Chapin, Municipal Sanitation in the United States. 
 
 Snow. Providence, 1906. 
 
 Fisher, Bulletin of the Committee of One Hun- 
 dred on the Conservation of Vital Resources. 
 
 Title Guarantee and Trust Co. New York, 1909. 
 Fitz, Physiology and Hygiene. Henry Holt and 
 
 Co. 1908. 
 Gerhard, Sanitation of Public Buildings. Wiley 
 
 and Sons. 1907. 
 Harrington, Practical Hygiene. Lea Bros, and Co. 
 
 1902. 
 Hough and Sedgwick, The Human Mechanism. 
 
 Ginn and Co. 1906. 
 Pyle, Personal Hygiene. W. B. Saunders Co. 
 
 1900. 
 Sedgwick, Principles of Sanitary Science. Mac- 
 
 millan Co. 1902. 
 
 Shaw, School Hygiene. Macmillan Co. 1901. 
 Sternberg, Infection and Immunity. Putnam. 
 
 1903. 
 
 Vernon-Harcourt, Sanitary Engineering. Long- 
 mans, Green and Co. 1907. 
 
 AIR 
 
 Booth and Kershaw, Smoke Prevention and Fuel 
 Economy. Henley. 1905.
 
 350 THE HEALTH OF THE CITY 
 
 Cohen, The Air of Towns. Government Printing 
 Office. 1896. 
 
 De Varigny, Air and Life. Government Printing 
 Office. 1896. 
 
 Nicholson, Practical Smoke Prevention. Sanitary 
 Publishing Co. London, 1902. 
 
 Prudden, Dust and its Dangers. G. P. Putnam 
 and Sous. 1907. 
 
 Randall and Weeks, The Smokeless Combustion 
 of Coal in Boiler Plants. U. S. G. S. No. 23. 
 1909. 
 
 Richards and Woodman, Air, Water, and Food. 
 Wiley and Sons. 1906. 
 
 Russell, The Atmosphere in Relation to Human 
 Life and Health. Smithsonian Institute. Wash- 
 ington, 1896. 
 
 Soper, Air and Ventilation of Subways. Wiley 
 and Sons. 1908. 
 
 Soper, Modern Methods of Street-Cleaning. En- 
 gineering News Pub. Co. 1909. 
 
 Tyndall, Essays on the Floating Matter in the Air 
 in Relation to Putrefaction and Infection. Long- 
 mans, Green and Co. 1883. 
 
 MILK 
 
 Belcher, Clean Milk. Hardy Publishing Co. 
 1903. 
 
 Bulletin No. 56 of the Hygiene Laboratory, De- 
 partment of Treasury. Milk and its Relation to 
 the Public Health. 1909.
 
 BIBLIOGRAPHY 351 
 
 Chapin, Theory and Practice of Infant Feeding. 
 Wm. Wood and Co. 1909. 
 
 Conn, Practical Dairy Bacteriology. Orange Judd 
 Co. 1907. 
 
 Conn, Bacteria in Milk and its Products. P. Blak- 
 istou's Son and Co. 1903. 
 
 Jensen, Essentials of Milk Hygiene. Trans. Pear- 
 son. J. B. Lippincott. 1909. 
 
 Kober, Milk in Relation to the Public Health. 
 Senate Document. 1902. 
 
 Rotch, Pediatrics, J. B. Lippincott. 1909. 
 
 Spargo, The Common Sense of the Milk Ques- 
 tion. Macmillan Co. 1908. 
 
 Wardwell, Practical Milk Inspection by a District 
 Medical Society. Annals of Gynecology and 
 Pediatry, vol. xxi. 1908. 
 
 Wardwell, Some Things that a Physician ought 
 to know about Milk. Annals of Gynecology and 
 Pediatry, vol. xxi. 1908. 
 
 FOOD 
 
 Blyth, Foods, their Composition and Analysis. 
 Charles Griffin and Co. 1903. 
 
 Chittenden, Physiological Economy in Nutrition. 
 Stokes. 1904. 
 
 Chittenden, The Nutrition of Man. Stokes. 1907. 
 
 Fletcher, The A. B.-Z. of Our Own Nutrition. 
 Stokes. 1906. 
 
 Friedenwald and Ruhrah, Diet in Health and Dis- 
 ease. Saunders Co. 1909.
 
 352 THE HEALTH OF THE CITY 
 
 Hutchison, Food and the Principles of Dietetics. 
 Wm. Wood and Co. 1903. 
 
 Langworthy, The Nutrition Investigations of the 
 Office of Experiment Stations and their Results. 
 Annual Report of the Office of Experiment Sta- 
 tions. 1906. 
 
 Leach, Food Inspection and Analysis. Wiley and 
 Sons. 1907. 
 
 Richards, The Cost of Food : A Study in Dietaries. 
 Wiley and Sons. 1901. 
 
 Richards, Food Materials and their Adulteration. 
 Whitcomb and Barrows. 1886. 
 
 Richards, Dietary Computer. Wiley and Sons. 
 1902. 
 
 Richards, Dietary Studies. Wiley and Sons. 1903. 
 
 Sunderland (Editor), System of Diet and Dieta- 
 ries. Oxford Medical Publications. 1908. 
 
 Thompson, Practical Dietetics with Special Refer- 
 ence to Diet in Disease. D. Appleton and Co. 
 1899. 
 
 Townshend, The Relation of Food to Health. Witt 
 Publishing Co. St. Louis, 1897. 
 
 Wiley, Foods and their Adulteration. P. Blakis- 
 ton's Son and Co. 1907. 
 
 WATER 
 
 Frankland, G. and P., Micro-Organisms in Water. 
 
 Longmans, Green and Co. 1894. 
 Gerhard, Water Supply, Sewerage and Plumbing of 
 
 Modern City Buildings. Wiley and Sons. 1910.
 
 BIBLIOGRAPHY 353 
 
 Gerhard, Sanitation, Water Supply and Sewage 
 
 Disposal of Country Houses. J. B. Lippincott. 
 
 1909. 
 Hazen, Clean Water and How to Get It. Wiley 
 
 and Sons. 1907. 
 Hazen, Filtration of Public Water Supplies. Wiley 
 
 and Sons. 1903. 
 
 Mason, Water Supply. Wiley and Sons. 1896. 
 Whipple, Value of Pure Water. Wiley and Sons. 
 
 1907. 
 
 SEWAGE 
 
 Baker, Sewerage and Sewage Purification. Van 
 Nostrand. 1896. 
 
 Cosgrove, Sewage Purification and Disposal. Stand- 
 ard Sanitary Manufacturing Co., Pittsburg. 
 1909. 
 
 Dunbar, Principles of Sewage Treatment. Trans. 
 Calvert. Charles Griffin and Co. London, 
 1908. 
 
 Fowler, Some Principles underlying the Design of 
 Small Sewage Installations. Wiley and Sons. 
 1907. 
 
 Gerhard, The Disposal of Household Wastes. Van 
 Nostrand Co. 1904. 
 
 Kinnicutt, Winslow and Pratt, Sewage Disposal. 
 Wiley and Sons. (In press.) 
 
 Raikes, The Design, Construction and Mainte- 
 nance of Sewage Disposal Works. Constable, 
 1908. 
 
 Winslow and Phelps, Investigations on the Purifi-
 
 354 THE HEALTH OF THE CITY 
 
 cation of Boston Sewage. Geological Survey, 
 1906. 
 
 ICE 
 
 Character and Quality of the Ice Supply of Lon- 
 don. Lancet, vol. Ixxi, 1893, ii. 
 
 Hill, An Investigation of the Boston Ice Supply. 
 Boston Medical and Surgical Journal, vol. cxlv, 
 pages 557-561. 
 
 Leidy, Organisms in Ice. Proc. Acad. Nat. Sci. 
 Philadelphia, 1884. 
 
 Nichols, Report on an Outbreak of Intestinal Dis- 
 order attributable to the Contamination of Drink- 
 ing Water by Means of Impure Ice. Seventh 
 Annual Report, State Board of Health, Massa- 
 chusetts. 1876. 
 
 Park, Duration of Life of Typhoid Bacilli, derived 
 from Twenty Different Sources, in Ice. Journal 
 of the Boston Society of Medical Sciences, vol. v. 
 
 Pengra, Purification of Water by Freezing. 
 Twelfth Annual Report State Board of Health, 
 Michigan. 1884. 
 
 Prudden, On Bacteria in Ice and their Relations 
 to Disease, with Special Reference to the Ice 
 Supply of New York City. The Medical Record, 
 March 26 and April 2, 1887. 
 
 Ravenel, The Resistance of Bacteria to Cold. Med- 
 ical News, Philadelphia, June 10, 1899. 
 
 Report upon the Pollution of Ice Supplies. 
 Twenty-first Annual Report, State Board of 
 Health, Massachusetts. 1889.
 
 BIBLIOGRAPHY 355 
 
 Sedgwick and Winslow, Experiments upon the 
 Effect of Freezing and other Low Temperatures 
 upon the Viability of the Bacillus of Typhoid 
 Fever, with Considerations Regarding Ice as a 
 Vehicle of Infectious Disease. Memoirs of the 
 American Academy of Arts and Sciences, vol. 
 xii,No. 5. 1902. 
 
 PLUMBING 
 
 Andrewes, Reports on the Micro-Organisms Pre- 
 sent in Sewer Air and in the Air of Drains. 
 Local Government Board. Thirty-sixth and 
 Thirty-seventh Annual Reports, 1906-07, 1907- 
 08. 
 
 Carnelley and Haldane, Air of Sewers. Royal So- 
 ciety of London, vol. xlii. 1887. 
 
 Cosgrove, Principles and Practice of Plumbing. 
 Standard Sanitary Manufacturing Co. Pitts- 
 burg, 1906. 
 
 D'Alessi, Translation of account of his Ex- 
 periment. Journal of Sanitary Institute, vol. 
 xvi. 
 
 Frankland, Transport of Solid and Liquid Parti- 
 cles in Sewer Gas. Royal Society of London, 
 vol. xxv. 1876-77. 
 
 Horrocks, Specific Bacteria derived from Sewage 
 which may be Present in the Air of Ventilator 
 Pipes, Drains, Inspection Chambers and Sewers. 
 Royal Society, February 7, 1907, vol. Ixxix, 
 No. B, 531.
 
 356 THE HEALTH OF THE CITY 
 
 London County Council, Report of Sewer Air 
 Investigation, 1893, No. 126, and 1898, No. 189. 
 
 Pumpelly, Relation of Soils to Health. National 
 Board of Health Report, 1881. 
 
 Reports of the Sanitary Committee, National Asso- 
 ciation of Master Plumbers of United States, 
 1907-08-09. 
 
 Roechling, Sewer Gas and its Influence on Health. 
 Biggs and Co. London, 1898. 
 
 NOISE 
 
 Beard, Physiological Effects of Noise. Century 
 Magazine, 1908. 
 
 First, Second, and Third Annual Reports of the 
 Society for the Suppression of Unnecessary 
 Noise. New York City, 1908-09-10. 
 
 Morse, The Steam Whistle a Menace to Public 
 Health. 1905. Read before the Massachusetts 
 Association Boards of Health. Published pri- 
 vately. 
 
 Rice, Hoodlumism in Holiday Observance. Fo- 
 rum, 1909. 
 
 Rice, An Effort to Suppress Noise. Forum, 1906. 
 
 Rice, Our Most Abused Sense, the Sense of Hear- 
 ing. Forum, 1907. 
 
 Rice, The Children's Hospital Branch of the So- 
 ciety for the Suppression of Unnecessary Noise. 
 Forum, 1908. 
 
 Rice, Our Barbarous Fourth. Century Magazine, 
 1908.
 
 BIBLIOGRAPHY 357 
 
 HOUSING 
 
 Alden and Hayward, Housing. Headley Bros. 
 London, 1907. 
 
 DeForest and Veiller, The Tenement House Prob- 
 lem, vols. i and ii. Macmillan Co. 1903. 
 
 Garden Suburbs, Villages, and Homes. Garden 
 City Press, 1906. 
 
 Harris, The Garden City Movement. Garden City 
 Press, 1905. 
 
 Horsfall, Improvement of Dwellings. University 
 Press, Manchester, England. 1905. 
 
 Hunter, Tenement Conditions in Chicago. City 
 Homes Association. Chicago, 1901. 
 
 Marr, Housing Conditions in Manchester and Sal- 
 ford. Sherratt and Hughes 1904. 
 
 Merchants Association of New York. Passenger 
 Transportation Service in the City of New York. 
 1903. 
 
 Nettlefold, Practical Housing. Garden City Press, 
 1908. 
 
 Nettlefold, A Housing Policy. Cornish Bros. Bir- 
 mingham, 1905. 
 
 Report of the Housing Committee of Birmingham. 
 Published by the City. 1906. 
 
 Report of the Royal Commission, Housing of 
 Working Classes. British Blue Book, 1885. 
 
 Reynolds, Housing of the Poor in American Cities. 
 Published in the publications of the American 
 Economic Association, vol. viii, Nos. 2, 3. 
 
 Special Report on the Housing of Working Classes 
 Amendment Act. British Blue Book, 1906.
 
 358 BIBLIOGRAPHY 
 
 Sykes, Public Health and Housing. P. S. King 
 
 and Son. 1901. 
 Thompson, Housing Handbook. H. K. Aldrich. 
 
 London, 1903. 
 Weber, The Growth of Cities in the Nineteenth 
 
 Century. Macmillan Co. 1899. 
 
 TUBERCULOSIS 
 
 List obtained from the National Association for 
 the Study and Prevention of Tuberculosis : 
 
 Flick, Tuberculosis : A Curable and Preventable 
 Disease. J. C. Winston Co. 1910. 
 
 Flick, The Crusade against Tuberculosis: Con- 
 sumption a Curable and Preventable Disease: 
 What a Layman should know about it. McKay. 
 1903. 
 
 Knopf, Tuberculosis as a Disease of the Masses 
 and how to Combat it. The Survey. New York, 
 1908. 
 
 Knopf, Tuberculosis : A Preventable and Curable 
 Disease: Modern Methods for the Solution of 
 the Tuberculosis Problem. Moifat, Yard and 
 Co. 1909. 
 
 Otis, The Great White Plague Tuberculosis. 
 T. Y. Crowell and Co. 1909.
 
 INDEX
 
 INDEX OF NAMES 
 
 (EXCLUDING THE BIBLIOGRAPHY) 
 
 Abbott, on bacteria in sewage, 
 
 205. 
 Abderhalden, work on proteids, 
 
 109. 
 Andrewes, work on bacteria in 
 
 air, 203, 214. 
 
 Baker, on plumbing, 208. 
 Balrae, member of Sanitary 
 
 Comm. of Master Plumbers, 
 
 207. 
 
 Beard, on effects of noise, 233. 
 Bennett, U. S. bill regulating 
 
 noise, 256. 
 Bonner, investigations of fires, 
 
 325, 326. 
 Budd, on odors from the 
 
 Thames, 223. 
 Burdon-Sanderson, work on ice, 
 
 177. 
 
 Cadbury, founder of Bournville, 
 286. 
 
 Caruelley, study of bacteria in 
 air, 203. 
 
 Charrin, on bacteria in ice, 
 179. 
 
 Chittenden, experiments on nu- 
 trition, 101 et seq. 
 
 Cohn, research on ice, 177. 
 
 Cooley, on rapid transit and 
 housing, 334. 
 
 Craig, Chairman of Sanitary 
 Committee of Master Plumb- 
 ers, 207. 
 
 D'Alessi, on relation of sewer- 
 gas and disease, 202. 
 
 D'Arsonval, on bacteria in ice, 
 179. 
 
 Decker, member of Sanitary 
 Comm. of Master Plumbers, 
 207. 
 
 Drown, work on sewage-disposal 
 and water-supply, 148. 
 
 Ficker, work on bacteria in air, 
 
 204. 
 
 Fletcher, School of Diet, 106. 
 Fliigge, work on bacteria in air, 
 
 204. 
 
 Frankel, work on ice, 181. 
 Frankland, work on ice, 181 ; on 
 
 sewer-gas, 202. 
 Freeman, on bacteria in milk, 41. 
 
 Gautier, on diet, 101. 
 
 Gerhard, on sanitation of mar- 
 kets and abattoirs, 80. 
 
 Girdner, work for suppression of 
 noise, 252. 
 
 Gregory, on noise, 236. 
 
 Haldane, study of bacteria in 
 
 air, 203. 
 Harrington, on plumbing and 
 
 sewage, 205, 208. 
 Hazen, on bacteria from sewage, 
 
 205. 
 Heyroth, on bacteria in frozen 
 
 water, 177. 
 Highlands, member of Sanitary 
 
 Comm. of Master Plumbers, 
 
 207. 
 Hill, Miss Octajia, work on 
 
 housing, 296, 298. 
 Hill, on sewage, 177. 
 Horrocks, investigations of 
 
 plumbing, 211 et seq., 220 et 
 
 seq.
 
 362 
 
 INDEX 
 
 Howe, P. W., care of milk in 
 Boston Floating Hospital, 51. 
 Hyslop, on noise, 236. 
 
 Janowsky, on bacteria in frozen 
 water, "179. 
 
 Jordan, on commercial pasteur- 
 ization, 49. 
 
 Kempster, work against noise, 
 252. 
 
 Kirchner, on sewer-gas, 204. 
 
 Knopf, on mortality from tu- 
 berculosis, 303. 
 
 Laws, study of bacteria in air, 
 203. 
 
 Lederle, work for suppression 
 of noise, 252. 
 
 Leidy, on bacteria in frozen wa- 
 ter, 179. 
 
 Lever Bros. Co., houses for 
 workmen, 287, 289. 
 
 Lever, founder of Port Sun- 
 light, 286. 
 
 Lindley, on sewer-gas, 204. 
 
 Lister, work on the germ the- 
 ory of disease, 9, 11. 
 
 Me William, on odors from 
 Thames, 225. 
 
 Mills, on study of sewage-dis- 
 posal and water-supply, 148. 
 
 Miqnel, on bacteria in street and 
 sewer, 148. 
 
 Morgan, member of Sanitary 
 Comm. of Master Plumbers, 
 207. 
 
 Morse, work against noise, 237, 
 252. 
 
 Muirhead, on noise, 232. 
 
 Nageli, on bacteria in air, 203. 
 Napoleon I, work on markets, 75. 
 Nettlefold, work on housing, 
 
 283. 
 Nichols, on ice epidemic, 176. 
 
 Osborne, work on proteids, 109. 
 
 Park, on bacteria in ice, 177. 
 
 Pasteur, on disease - germs in 
 air, 9. 
 
 Pengra, research work on ice, 
 181. 
 
 Petri, work on bacteria in air, 
 204. 
 
 Pictet, on bacteria in frozen wa- 
 ter, 179. 
 
 Pohl, on bacteria in frozen 
 water, 179. 
 
 Prudden, on dust and tuberculo- 
 sis, 18; on ice, 181, 182, 184. 
 
 Pumpelly, work on sewer-gas, 
 202, 205. 
 
 Ravenel, on bacteria in freezing 
 water, 179. 
 
 Rice, Mrs. I. L., campaign against 
 noise, 254 et seq. 
 
 Richards, on sewer-gas, 198. 
 
 Roechling, on "Sewer Qas and 
 its Influence on Health," 223. 
 
 Roosevelt, appointment of board 
 to consider conditions of abat- 
 toirs, 84. 
 
 Rumford, Count, philanthropic 
 reforms, 119, 125. 
 
 Russell, on overcrowding in 
 Glasgow, 267. 
 
 Kut tan, on bacteria from sew- 
 age, 205. 
 
 Schwann, on disease-germs in 
 air, 9. 
 
 Scofone, research on bacteria, 
 178. 
 
 Sedgwick, work on sewage-dis- 
 posal and water-supply, 148, 
 223; on bacteria in ice, 177, 
 182, 186. 
 
 Sinclair, effect of " The Jungle," 
 84. 
 
 Soper, on air in subways, 21. 
 
 Twain, Mark, work on Children's 
 Hospital Branch in N. Y., 259. 
 
 Tyndall, on germ theory of dis- 
 ease, 9, 10.
 
 INDEX 
 
 363 
 
 Uffelmann, work on bacteria in 
 air, 204. 
 
 Vanderwelder, on housing in 
 Belgium, 299. 
 
 Veiller, on housing of immi- 
 grants in N. Y., 319 ; investi- 
 gations of fires, 325, 326. 
 
 Voit, dietaries of, 100. 
 
 Von Frisch, work on bacteria in 
 ice, 179. 
 
 Wardwell, on dairy farms, 38. 
 
 Weber, A. F., on transit and 
 housing, 276. 
 
 Whipple, on bacteria from sew- 
 age, 205. 
 
 Winslow, work on ice, 177, 182, 
 186; on intermittent filter, 
 151 ; work on sewer-gas, 207, 
 211, 218. 
 
 Woodman, on sewer-gas, 198. 
 
 Wren, town plan of London, 
 276. 
 
 Young, on bacteria in ice, 179.
 
 INDEX OF SUBJECTS 
 
 (EXCLUDING THB BIBLIOGRAPHY) 
 
 Abattoirs, conditions in, 84, 85 ; 
 model, 85. 
 
 Agriculture, Department of, 69. 
 
 Air, 1, 159; believed to be a 
 carrier of disease, 9; chemi- 
 cal composition of, 2; in 
 drains and sewers, 208, 218 ; 
 of street, 208, 220, 305 ; light 
 and water as the free goods 
 of economist, 271 ; of sewer, 
 197, 198, 208 ; of subways, 21 ; 
 organic matter in, 10 ; shaft, 
 312, 320, 326; volume re- 
 quired per hour in living and 
 sleeping rooms, 268. 
 
 America, air of cities in, 16; 
 city milk-supply in, 32 ; dilu- 
 tion of sewage in, 143 ; epi- 
 demics from infection of 
 water-sheds in, 133; experi- 
 ments in housing in, 319. 
 
 American sanitarians' beliefs re- 
 garding sewage, 205; street 
 cries, 249. 
 
 Ammonia in cold-storage plants, 
 168. 
 
 August, infant mortality in, 31. 
 
 Arverne-by-the-Sea, ordinance 
 concerning noise, 250. 
 
 Austria, water-supply of, 127. 
 
 Azores, food for children in, 31. 
 
 Bacillus, coli, 201, 203, 217 ; pro- 
 digiosus, 184 ; typhi or typho- 
 sus, 184, 201. 
 
 Bacteria, acid producing, 34; 
 action in soil, 146 ; armor of 
 body against, 14 ; exclusion of, 
 56; floating in water, 163, 
 165; from handling of ice, 
 
 188, 193; good against bad, 
 53, 156; growth (general), 216 ; 
 growth of, in air, 12 ; growth 
 of, in cold and ice, 174, 177, 
 181, 187 ; growth of, in milk, 
 34, 36; in sewage, 201; in 
 snow, 165, 177 ; in subway, 
 21 ; life in ice, 192 ; of city 
 streets, 13; of sewage-plant, 
 63 ; parasitic, 135 ; putrefac- 
 tive, 35. See also Micro-organ- 
 isms. 
 
 Bacteriologist, 176. 
 
 Bacteriologist's work with milk. 
 46. 
 
 Bakery, danger to public in 
 wrong conditions in, 90, 91 ; 
 inspection of employees, 90; 
 laws of Mass., 89 ; regulations, 
 86. 
 
 Bake-room, conditions of, 88. 
 
 Baltimore, alley problem of, 
 318. 
 
 Barns, location and sanitation of 
 dairy, 39, 40. 
 
 Belgian railways and housing, 
 298 et seq. 
 
 Berlin, housing of, 273, 308 ; im- 
 purities in milk of, 33 ; mar- 
 kets of, 76, 77 ; Savings and 
 Building Societies, 291 ; sew- 
 age farms of, 146. 
 
 Birmingham, infant mortality in 
 ward of, 268 ; housing of, 283. 
 
 Bixensast, housing in, 300. 
 
 Boards of health, pure food lawa 
 and, 68 ; control of food, 72. 
 
 Body, chemical composition of 
 human, 93. 
 
 Boiler-maker's ear, 235.
 
 366 
 
 INDEX 
 
 Boston, Board of Health, stand- 
 ard for milk, 30, 51 ; division 
 of city by building regula- 
 tions, 344 ; housing in North 
 End, 315 ; investigation in 
 sewer of, 218 ; needs of tenant 
 in, 321 ; overcrowding in, 315. 
 
 Boundary St. buildings, 324. 
 
 Bournville, infant mortality of, 
 268 ; housing in, 283. 
 
 Brabant, housing in, 300. 
 
 Breslau, housing in, 273. 
 
 Britain, housing policies in, 332. 
 
 British sanitarians on bacteria 
 from sewage, 205, 223. 
 
 Brussels and rapid transit, 300. 
 
 Buffalo, housing in Polish quar- 
 ter of, 317. 
 
 Bunzlau, ancient water and sew- 
 age system of, 142. 
 
 Buttermilk, 54. 
 
 Cellulose, 63. 
 
 Chicago, congestion of popula- 
 tion in, 315 ; inspection of 
 markets, 77. 
 
 Children's Hospital Branch of 
 S. S. U. N., 259. 
 
 Chimneys and dwellings, 264; 
 inspection of, 6. 
 
 Cholera, Asiatic, 33, 129. 
 
 Cholera Infantum, 35, 37. 
 
 Cilia, 4. 
 
 City, and its food-supply, 59, 64, 
 67, 110, 190; bakeries, 87 et 
 seq. ; control of ice, 167, 190 ; 
 dust, 16, 23, 28; gardens, 280; 
 granting of franchises, 339; 
 health maps of, 302 ; housing, 
 82, 263, 272, 282, 308; hous- 
 ing commission, composition 
 and duties of, 329, 341; ice- 
 supply of, 159 ; infant mor- 
 tality, 30, 57; light, 25, 28, 
 279, 304 ; markets, 75 et seq. ; 
 milk, cleansing of, 44 et seq. ; 
 need of refrigeration, 160, 198 ; 
 overcrowding in, 110, 267,278; 
 pavements and dust, 19, 71; 
 
 and noise, 242 et seq. ; play- 
 grounds, 306 ; preventable 
 disease in, 306 ; reliance on 
 qualitative and quantitative 
 tests, 180, 199 ; reservoirs, 78 ; 
 smoke in, 3 et seq., 16, 28; 
 traffic, 242 et seq., 306; 
 transit, 276, 298, 306, 334, 338 ; 
 value of land in, 277 et seq., 
 301 ; wages and housing, 299. 
 
 Cleaning by vacuum processes, 
 20. 
 
 Cleanliness and light, 25, 28; 
 bacteriological, 11 ; necessity 
 of, 323; of artificial ice, 170; 
 of natural ice, 167. 
 
 Cleveland city ordinance con- 
 cerning whistles, etc., 241. 
 
 Coal, hard and soft, 4. 
 
 Cold, effects on bacteria, 187. 
 
 Cold storage, systems of, 160, 
 170, 172. 
 
 Cologne, Zone System of, 27, 279. 
 
 Columbia, District of, pure food 
 laws in, 69; laws on plumb- 
 ing, 227. 
 
 Columbus, Ohio, Experiment Sta- 
 tion work on water-supply and 
 sewage, 156. 
 
 Committee of One Hundred and 
 Housing, 313. 
 
 Community kitchens, 118, 124. 
 
 Construction, problems of house, 
 329. 
 
 Consumption. See Tuberculosis. 
 
 Cooperation, definition of, 295. 
 
 Co-Partnership Tenants Soci- 
 ety, 291, 294. 
 
 Courtyards and housing, 292, 
 o21. 
 
 Cows, food of, 42. 
 
 Crystallization, 161, 162, 167, 
 170, 187. 
 
 Curtis Pub. Co., lunch-rooms of, 
 122. 
 
 Deaths from suffocation and gas- 
 poisoning in sewers, 222. 
 Density of population, 310.
 
 INDEX 
 
 367 
 
 Diet, discussion of, 94 et seq. ; of 
 average American, 105, 111. 
 
 Diphtheria, 36, 49, 195, 267. 
 
 Disease, carriers of, 33, 42 ; 
 causes of preventable, 306 ; 
 causes of, in tenements, 280 ; 
 cost of preventable, 306 ; 
 Filth Theory of, 142 ; germs, 
 25, 36, 90; intestinal, 31, 35, 
 66, 166; ordinary causes of, 
 129; problem, 329; spread 
 of, 26, 205, 267 ; water-borne, 
 135, 165, 173, 181. 
 
 Dresden, housing in, 273. 
 
 Dust, and disease, 9 ; and house- 
 hold furniture, 15 ; composi- 
 tion of , 1 1 ; in air, 8 ; in houses, 
 15; iron, 23; of street, 159, 
 165; storms of cities, 1, 14; 
 subway, 21, 23. 
 
 Dysentery, 195. 
 
 Baling, 286, 293. 
 
 Education, vocational, 125. 
 
 Efficiency, increase and preser- 
 vation of, 58, 92, 126, 272; 
 value of food in producing or 
 diminishing, 93, 114. 
 
 Engine, human frame as, 2. 
 
 Engineer, Sanitary, 157. 
 
 England, contact bed system in, 
 149 ; Cooperative Societies in, 
 328 ; hooligans in, 263 ; water- 
 supply of, 127. 
 
 English courts, sanitation of, 
 270; Garden Cities, 286; Hous- 
 ing Act, 282 ; investigations 
 of sanitary reforms, 202 ; slum 
 buildings, 269. 
 
 Epidemics, caused by decayed 
 food, 66 ; from air, belief in, 9 ; 
 from sewer-gas, belief in, 195. 
 
 Epidemiology, of ice, 177. 
 
 Europe, housing in continental, 
 272, 277, 278, 308 ; unskilled 
 labor in, 266 ; use of sterilized 
 milk in, 48. 
 
 European froight yard signals, 
 
 200 
 Do. 
 
 Factory luncheons, 118, 121. 
 
 Farm, dairy, 38, 43. 
 
 Farm, food, 160 ; use of ice, 159. 
 
 Federal control of noise, 255. 
 
 Feudalism and housing, 272. 
 
 Fever, scarlet, 129 ; typhoid, 
 182 ; yellow, 129. 
 
 Filtration of sewage, continuous 
 methods of, 148, 149; gen- 
 eral, 148 et seq. ; intermit- 
 tent methods of, 148, 150 ; sand 
 filter, 152, 155 ; trickling filter 
 for, 150, 151. 
 
 Filtration of water, continuous, 
 136; general, 135 et seq.; 
 household filters for, 139 ; me- 
 chanical filters for, 138, 156 ; 
 sediment layers for, 137, 139. 
 
 Fire protection, 322. 
 
 Fires in tenement houses, 324, 
 325, 326. 
 
 Food, over and under-feeding, 
 1 10 ; perishable, 60 ; preserva- 
 tion, 64, 66 ; sources of supply 
 of, 59. 
 
 Foods, adulteratives of, 66 ; ad- 
 vertised, 107 ; and Drugs Act, 
 69 ; as a source of energy, 58 ; 
 as fuel, 2 ; cereals, 106 ; cook- 
 ing of, 1 13 ; cost of, 111; de- 
 composition of, 60, 61 ; ele- 
 ments in, 95 ; inspection and 
 control, 68, 71, 74; laws, 67, 
 70 ; nutrients in, 96, 97 ; of in- 
 dividual, 71, 92; of the city, 
 59 et seq. ; of the poor, 73. 
 
 Fourth of July, celebration of, 
 260. 
 
 France, water-supply of, 127. 
 
 Frankfort, light for dwellings 
 in, 27. 
 
 Fungi, 62. 
 
 " Garden Cities," purpose and 
 
 maintenance of, 286. 
 Gardens, allotment system of, 
 
 280 ; encouragement of, 280. 
 Genval, housing in, 300. 
 Germ life, 11, 178.
 
 368 
 
 INDEX 
 
 German, alleys, sanitation of, 
 270 ; building requirements, 
 274 ; citizen's welfare a mat- 
 ter of state action, 271 ; hous- 
 ing 273, 279, 332; improve- 
 ments in standards of living, 
 281 ; investigations of sewer 
 conditions, 202 ; light require- 
 ments, 27 ; location of dwell- 
 ings, 278 ; milk inspection, 33 ; 
 sanitarians, their theories of 
 sewer-gas, 205 ; town markets, 
 75 ; treatment of sewage, 143 ; 
 water-supply, 127, 133. 
 
 Gibraltar, investigations of Ma- 
 jor Horrocks at, 214. 
 
 Glasgow, housing conditions of, 
 267. 
 
 Gravity, force of, and its influ- 
 ence in cleansing ice, 164, 167, 
 187. 
 
 Grippe, outdoor treatment of, 
 19. 
 
 Hamburg, housing in, 273. 
 
 Hampstead, housing in, 286. 
 
 Harborne, housing in, 286. 
 
 Health of Towns Commission in 
 Great Britain, 142. 
 
 Health, public and scientific in- 
 vestigations, 185. 
 
 Heat absorption in cold-storage 
 processes, 109; of subway, 
 21. 
 
 Height of buildings in slums, 
 269. 
 
 Hisbaye, village life in, 300. 
 
 Horse, an anachronism in the 
 city, 20. 
 
 Hospital, Boston Floating, 50. 
 
 Housing, abroad, 263 ; and feu- 
 dalism, 272 ; artistic devel- 
 opment in, 331 ; by private 
 enterprise, 275, 333 ; city de- 
 partment of, 341, 342; com- 
 missions, composition and 
 duties of, 329, 330; decision 
 of Supreme Court of United 
 States, 334 ; for employees of 
 
 corporations, 119, 289 et seq., 
 328; improvement in city, 
 298 ; in back to back houses, 
 320 ; in barrack houses, 273, 
 274 ; in cellar dwellings, 285 ; 
 initiative in movement for re- 
 form in, 328 ; in suburb, one 
 solution of problem, 289, 301 ; 
 in United States, 308, 332 ; 
 lack of decent, 265 ; loca- 
 tion of dwellings, 277, 311, 
 331 ; Massachusetts legisla- 
 tion concerning, 344 ; munici- 
 pal, 272, 332; needs, 263; 
 on office sites, 277, 311, 331; 
 personal side of, 296, 330; 
 possibilities along railroad 
 routes, 341 ; regulations con- 
 cerning municipal water, 
 322; regulations, 327, 331, 
 333, 341, 343 ; repairs, 275 ; 
 speculation, 275, 280 ; use of 
 courtyard plans, 321 ; work 
 of English Health Council, 
 284 ; work of individual cities, 
 329. See also Tenements, 
 Slums, and names of individ- 
 ual cities and towns, as Lon- 
 don and Bournville. 
 Humidity of subway, 21. 
 
 Ice, 158 ; artificial manufacture 
 of, 168 et seq. ; cars, 159 ; 
 consumption of, 160 ; control, 
 191 ; crystals, 158, 162; dealer, 
 166, 191; demand for, 161; 
 dirt in, 165 ; epidemics from, 
 176 ; impurities of, 164, 171 ; 
 infected by handling, 159, 
 188, 193 ; natural formation 
 of, 161 et seq. ; sources of, 
 161,190; use in America, 160; 
 use in city, 159, 160; use 
 of, abroad, 160; water, 159, 
 160. 
 
 Immigrants and housing, 309, 
 332 ; possibilities of vocational 
 schools for, 117; settlements 
 of, 308.
 
 INDEX 
 
 369 
 
 Immunity of individual from 
 
 disease, 15. 
 Indicator germs, 217. 
 Industries, centralization of, 290. 
 Infusoria, action on bacteria in 
 
 water, 186. 
 Insurance, obligatory, 271. 
 
 Jersey City, water-supply of, 
 
 152. 
 
 July, infant mortality of, 31. 
 June, infant mortality of, 31. 
 
 Labor unions, their work in 
 housing, 328. 
 
 Laboratory, reliance on, 186. 
 
 La Hulpe, housing in, 300. 
 
 Land, cost of, for housing, 301. 
 
 Laundry, cooperative, 324. 
 
 Lead-poisoning, 171. 
 
 Letchworth, Garden City, 286. 
 
 Light, and germs of tuberculo- 
 sis, 26, 304 ; as impulse to 
 cleanliness, 25, 26, 28 ; effects 
 of sun, 25 ; lack of, in tene- 
 ments and slum, 25, 270. 
 
 Lighting, of dark living-rooms 
 in New York, 305 ; of fac- 
 tory, home, and shop, 28 ; re- 
 quirementsy 27, 29 ; sun vs. 
 artificial, 27. 
 
 Lignum, 63. 
 
 Liverpool, cost of housing in, 
 283. 
 
 London Cooperative Laundry, 
 324 ; County Council-and hous- 
 ing, 324, 339 ; housing in, 308 ; 
 markets of, 76 ; pavements of, 
 243; public health in 1858, 
 223 ; street cries of, 249 ; use 
 of sewers 1815, 141. 
 
 Lords' action on Housing Bill, 
 284. 
 
 Lot covering and housing, 316. 
 
 Lunch-rooms, questions on, Na- 
 tional Civic Federation, 123. 
 
 Magdeburg, housing in, 273. 
 Malaria, 129. 
 
 Manchester (Eng.) requirements 
 on ventilation of water-closets, 
 323. 
 
 Manhattan, density of buildings 
 in, 310. 
 
 Markets, American, 76 ; central- 
 ization of, 77 ; control and 
 inspection of, 77 ; location and 
 construction of, 79, 80 ; pub- 
 lic ownership of, 81. 
 
 Mass. Institute of Technology, 
 157, 182, 207 ; State Board of 
 Health, analyses of natural ice, 
 177 ; State Board of Health, 
 work on sewage-disposal and 
 water at Lawrence, 148. 
 
 Masters, Mates, and Pilots, 
 American Assoc. of, 255. 
 
 Measles, 129. 
 
 Meat inspection amendment to 
 Pure Food Law, 69 ; diet, 100 
 et seq. 
 
 Metropolitan Water Works Sys- 
 tem in Boston, sewage-dispo- 
 sal plants of, 134. 
 
 Micro-organisms, decomposing 
 action of, 63, 64, 66 ; destruc- 
 tion by cold of, 183 ; in air, 9, 
 11 ; in alimentary canal, 130 ; 
 in kitchen, 26 ; in sewage, 
 147 ; in soil, 11 ; in water, 
 165, 173, 177, 181. See also 
 Bacteria. 
 
 Milk, adulteration of, 37; as a 
 food for children, 31 ; as a 
 medium for the spread of dis- 
 ease, 33 ; bacteria in, 41 ; bac- 
 terial life in, 34, 46 ; bottled, 
 43 ; certified, 55 ; cleanliness 
 of, 43 ; difficulties in the in- 
 spection of, 33 ; distribution of, 
 50 ; frauds in, 38 ; inspection 
 by milk officials, 45 ; souring 
 of, 35 ; standards, 45 ; supply, 
 30; tests for, 41, 45 et seq.; 
 the hired milker, 41. 
 
 Milwaukee ordinance on smoke 
 nuisance, 7. 
 
 Monte Rosa, bacteria on, 178.
 
 370 
 
 INDEX 
 
 Mortality, infant, 30. 
 Moulds, characteristics of, 62. 
 
 Natural conditions reproduced 
 in laboratory, 175. 
 
 New York, bacteria in water of, 
 217, 220; cellar dwellings of, 
 305 ; Citizens' Exhibit of con- 
 ditions under Tammany, 313; 
 Committee on Congestion of 
 population in, 306 ; cost of 
 preventable disease in, 306 ; 
 dark living-rooms in, 305 ; 
 efforts to suppress unneces- 
 sary noise, 2i~>2 et seq. ; fires, 
 326 ; lack of fire-escapes, 327 ; 
 model abattoir, 85 ; model 
 tenements in, 312 ; overcrowd- 
 ing in, 315, 319, 320, 321 ; 
 " Quiet Zone " ordinance, 258 ; 
 slum streets in, 270 ; subway 
 air, 21, 23; tenement house 
 bureau, 342. 
 
 Newark law to regulate noise, 
 251. 
 
 Nitrogenous equilibrium, 104. 
 
 Noise, a cause of nervous ex- 
 haustion, 232, 233; and its 
 effect in sick room, 235 et seq.; 
 campaign against unnecessary, 
 254 et seq. ; diminished by 
 subway, 2*44 ; Federal control 
 of, 255 ; habit, 234 ; necessary, 
 232; of cats and dogs, 246; 
 of church bells, 245 ; of elec- 
 tric bells as better than that 
 of whistles, 240 ; of fire alarms, 
 245 ; of hurdy-gurdy, 247, 257 ; 
 of milkmen, 247; of railroad 
 signaling, 239 ; of street cries, 
 248, 257; of traffic, 242 et 
 seq. ; of transportation, 237, 
 243, 244, 253; of whistles, 
 230, 236, 237, 253; remedies, 
 250 ; stimulus of, 231 ; unne- 
 cessary, 232. 
 
 Offenbach-am-Main, reduction 
 of death-rate in, 281. 
 
 Old age pensions in Germany, 
 
 271. 
 Overcrowding, 26, 265. See also 
 
 Slums and Tenements. 
 Oysters in ice, 171. 
 
 Paris, first modern market in, 
 75; ice-supply of , 177 ; sewage 
 farms of, 146. 
 
 Pasadena, Cal., sewage farm of, 
 147. 
 
 Pasteurization of milk, 47, 49 
 et seq. 
 
 Pathogenic germs, 36, 90, 187 ; 
 definition of, 182. 
 
 Pavements and cleanliness, 19, 
 28 ; and noise, 242. 
 
 Phagocytes, 4. 
 
 Philadelphia, housing in, 317. 
 
 Playgrounds, 292, 321. 
 
 Plumbers, National Assoc. of 
 Master, 206 ; Sanitary Com- 
 mittee of Master, 207, 215, 
 218. 
 
 Plumbing, 194; effects of poor, 
 227; essentials of, 208; in 
 tenement houses, 323 ; re- 
 quirements of states, 227 ; 
 U-trap, vents in, 209. See also 
 Sewage. 
 
 Plymouth, Penn., typhoid epi- 
 demic in, 128. 
 
 Pneumonia, modern treatment 
 of, 195, 267. 
 
 Port Sunlight, housing in, 
 286. 
 
 Property, limitations on owner- 
 ship of real, 344. 
 
 Prussia, building plans of, 279. 
 
 Pullman car and the bacteria of 
 disease, 18. 
 
 Quartier, street cries of, 249. 
 " Quiet Zone " law, 257. 
 
 Races of bacteria, 184. 
 
 Railways and housing, 234, 299 ; 
 elevated system, 336; rates, 
 graded on distance, 338, 340;
 
 INDEX 
 
 371 
 
 steam, distribution of popula- 
 tion, 337; subway, 336; sur- 
 face, 335. See also Transit. 
 
 Refrigerators, 159. 
 
 Rent, expenditure for, 266, 298, 
 331. 
 
 Resistance, vital, 16, 222. 
 
 Sanitary reform, difficulties of, 
 318. 
 
 Saxony, lighting regulations, 27 ; 
 building regulations, 279. 
 
 Sewage as fertilizer, 146; com- 
 position of gases from, 197 ; 
 danger from, 141 ; diluted 
 with water, 143 ; disposal of, 
 128; effluent, 152; filtration 
 of, 135, 156; flow of, 200; 
 germ infection from, 198 ; of 
 country house, 155 ; oxidation 
 of, 145 ; pollution from, 131 ; 
 putrefaction and nitrification 
 of, 144 ; separation of wastes, 
 143 ; sources of, 197 ; the 
 home of bacteria, 130 ; use of 
 septic tank, 153, 198. 
 
 Sewer air, examination of, 199. 
 
 Sewer-gas, 194 ; belief in bad 
 effect of, 194 ; definition of, j 
 196 ; does it predispose to dis- ! 
 ease ? 196, 220 ; germs rising 
 from, 196, 210, 218 ; research, 
 211 et seq. 
 
 Signals, used in place of whistle, 
 239. 
 
 Slum, as a culture medium of 
 disease, 303 ; characteristics, ] 
 318 ; clearance in England, ! 
 283; disease, 266; dumping, 
 270; eradication in Germany, i 
 272 ; government, 341 ; hold I 
 upon inhabitants of, 265, 266 ; i 
 influence of topography on, j 
 319 ; reason of continuance 
 of. 301 ; rents, 278 ; sanitary j 
 habits, 270. See also Tene- ! 
 ments, Overcrowding, and j 
 Housing. 
 
 Smoke, and ventilation, 5 ; con- ' 
 
 snmers, 6, 8, 28 ; effect on 
 city, 3 et seq. ; inspection of 
 factory, 6, 7 ; inspector, 8 ; 
 nuisance, 7, 8, 28 ; nuisance 
 and the opinions of unions of 
 firemen and engineers, 7. 
 
 Smoke ordinances, 7. 
 
 Snow ice, 165, 192. 
 
 Societies, building, 275 ; cooper - 
 ative, 291, 293, 294, 328. 
 
 Society for the Suppression of 
 Unnecessary Noise, 257. 
 
 Solids in the lungs, 5. 
 
 Sterilization of milk, 47. 
 
 St. George's Parish, N. Y., wel- 
 fare work, 124. 
 
 St. Louis, housing in, 317. 
 
 St. Paul, smoke nuisance, 7. 
 
 Storage, effects on ice of, 185. 
 
 Street cleaning, 20. 
 
 Street plans in model city, 276. 
 
 Suburbs, development of, 289, 
 298, 338. 
 
 Subway and housing, 336 et 
 seq. ; and abatement of noise, 
 244 ; smells, 21 ; temperature 
 of, 21. 
 
 Tammany, housing conditions 
 under, 314. 
 
 Taxes and housing plans, 333. 
 
 Tenement, dumb-bell, 311 ; fire- 
 escapes, 327 ; model, 275, 
 278 ; roof possibilities, 292. 
 
 Tenements as fire centres, 325. 
 See also Slum, Overcrowding, 
 and Housing. 
 
 Thames, historic smell of, 223. 
 
 Town planning, England, 285 ; 
 Germany, 275. 
 
 Town plans, 333. 
 
 Trade, boards of, 333. 
 
 Traffic routes and housing, 276. 
 
 Transit, and area for buildings, 
 336; and housing, 337; cost 
 of, 338 ; to and from suburbs, 
 298, 300, 334; workingmen's 
 trains, 299, 340. See also Rail- 
 ways.
 
 372 
 
 INDEX 
 
 Treatment, medical, for German 
 workmen, 271. 
 
 Tuberculosis, and dust, 5, 16, 17, 
 18, 26 ; bovine, 42 ; deaths in 
 slums from, 17, 302, 304 ; ex- 
 hibits, 302 ; germs of, 23, 26, 
 49, 304; in slums, 267, 303; 
 in tenement houses, 303 ; out- 
 door treatment of, 19 ; spread 
 of, 305. 
 
 Tubes, culture, 185. 
 
 Tubs, in model tenements, 323. 
 
 Typhoid infection, 33, 36, 49, 
 129, 166, 195. 
 
 Ulm, lighting regulations of, 27. 
 
 Vancouver, B. C., control of 
 milk in, 56. 
 
 Ventilation and air filters, 20 ; 
 in slums, 269 ; of tenements, 
 313 ; of water-closets, 322 et 
 seq. 
 
 Viability of typhoid bacillus, ! 
 182. 
 
 Vienna, ice-supply of, 177 ; mar- 
 kets of, 76. 
 
 Vocation of home-keeping, 113. 
 
 130 ; as a luxury of the slum, 
 271 ; bacterial infection of, 
 130, 173 ; chemical analysis of, 
 134 ; chemical cleansing of, 
 152 ; continuous filter, 136, 
 148 ; control of sources, 189 ; 
 filtration, 135 et seq. ; from 
 polluted sources, 134 ; from 
 rains, 153 ; ground, 131 ; 
 ground and natural filtration 
 of, 132 ; increase of bacteria 
 in, by washings from rains, 
 153 ; infection of, 173 ; me- 
 chanical filter, 136, 148; of 
 country house, 155 ; reservoirs, 
 134 ; storage systems, 135 ; 
 supply and ice, 170, 172 ; sup- 
 ply and typhoid in Plymouth, 
 Penn., 1885, 129, 133 ; supply 
 for tenements, 322 ; supply, 
 guarding purity of the, 1 28 ; 
 supply of U. S., 127 ; supplies, 
 source of, 127, 189 ; surface, 
 181. 
 
 Westinghouse Co., lunch-rooma 
 of, 122. 
 
 Women, industrial training of, 
 115, 116. 
 
 Workmen's savings and housing 
 investment, 328. 
 
 Wage and housing, 331. 
 Waltham Watch Co., lunch-room 
 
 of, 122. 
 Washington, alley problem of, 
 
 318; infant mortality, 30; 
 
 needs of tenant In, 321. 
 Water, as a carrier of disease, ! Zone System, 278. 
 
 Yale University experiments iu 
 
 dieting, 101. 
 Yeasts, 62.
 
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