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 MEDICAL 
 
 
 GIFT OF THE 
 
 SAN FRANCISCO COUNTY 
 
 MEDICAL SOCIETY 
 
EEPOET 
 
 ON THB 
 
 IMPORTANCE AND ECONOMY 
 
 to 
 
 BY JOHN \BELL, M.D., 
 
 OF PHILADELPHIA. 
 
 BOARD OF 
 
 November 28, 1859. 
 
 DOCUMENT JTo. 2O. 
 
 I860 
 
 NEW YOKK: 
 
 EDMUND JONES & CO , PRINTERS TO BOARD OF COUNCILMEN, 
 
 No. 26 JOH\ STKKKT. 
 
 I860. 
 
01 
 
 NOVEMBER 
 
 128, 1859. j 
 
 The following report, on the Internal Higiene of Cities, was 
 received, laid over, and subsequently adopted, November 28, 
 1859, and ordered printed in document form. 
 
 C. T. McCLENACHAN, 
 
 Clerk. 
 
CONTENTS. 
 
 PAGE. 
 
 Ancient Egyptian Hygiene, . . .<.... . 6 
 
 Carthaginian Hygiene, . g 
 
 Public Hygiene of Ancient Borne, ... 7 
 
 The Cloacae, 
 
 o 
 
 Pestilential Fevers, 10 
 
 The Aqueducts, ..... n 
 
 Agrippa, . . . . . . . . ; | f 13 
 
 Barbarism and Civilization, .... 15 
 
 Causes of Pestilence, . 20 
 
 Venice, .' ....-'" 22 
 
 Amsterdam, .... 23 
 
 St. Petersburgh, .... 25 
 
 Neglect of Sanitary Legislation, .... 27 
 
 Community of Interests, . . . 82 
 
 Paving, ..... 34 
 
 Cleansing of Streets, '..... 37 
 
 Economy of Street Cleaning, . 37 
 
 Sewered and Unsewered Districts compared, . 38 
 Sewerage and Sewer Gases, .. 
 
 The Remedy for the Sewer Miasms, ... 57 
 System of Sewers, 
 
 Disposal of Sewage, 
 
 Ventilation, 
 
 /. : . . 79 
 
 Defective Ventilation Crowded Streets and Habitations, . 81 
 
 Predilection of Cholera for Old Haunts of Disease, . 91 
 
 Public Lodging-Houses, .... 93 
 
 General Want of Ventilation, ... 94 
 
 In Schools, 
 
 . yy 
 
 In Hospitals, . , , , -. 100 
 
 In Work-Shops and Factories, % . 102 
 Seamstresses, 
 
 iUo 
 
 72329 
 
CONTENTS. 
 
 PACK. 
 
 Printing-offices 103 
 
 Pulmonary Diseases from Defective Ventilation, . 104 
 
 Defect of Light, . ... . . ''*.*.. . . . . .' . 104 
 
 The Kemedies, ... . N . . ' . .... . . 107 
 
 Model Houses, . . . : . .' f;^ : \ . . 110 
 
 Model Lodging-Houses, . . . . ... Ill 
 
 Means of Ventilation, 112 
 
 Different Modes, . . . . . . . . 114 
 
 Chemical Ventilation, . . . . . ... 121 
 
 Ventilation of Schools, ,127 
 
 Ventilation of Hospitals, 128 
 
 Factory Ventilation, . ..... 132 
 
 Ventilation of Sewers, 134 
 
 Supply of Water, . , 135 
 
 "Water in Leaden Cisterns and Pipes, '. . . . . 138 
 
 Effects of Bad Water for Drink, ....... 139 
 
 Intemperance, . . . . ... . . . . 146 
 
 Preventable Diseases and Mortality, . . . . . 150 
 
 Sanitary Improvements, .... . . . . 160 
 
 Pulmonary and Cutaneous Purification, ..... 164 
 
 Public Squares and Parks, ...... 165 
 
 V 
 
 Gymnasia and Museums, ....... 166 
 
 Ablution and Bathing, . . . . ... . 167 
 
 Public Wash-Houses, 170 
 
 Nuisances, . ..... . . . . . . . 171 
 
 Slaughter-Houses, . . . . . . . . 174 
 
 Cow-Houses, 177 
 
 Interments in Cities, . 180 
 
REPORT. 
 
 This is one of the subjects to which the Committee on 
 the Internal Hygiene of Cities has been specially instruct- 
 ed to direct its attention. It is that on which, in the divi- 
 sion of labor, I am required to be the reporter. The mate- 
 rials for the purpose are ample, and it only requires the 
 labor of selection and arrangement to make them available 
 for immediate instruction and guidance in the work of sani- 
 tary reform. History, notwithstanding its imperfect no- 
 tices of the real condition of the people of the different 
 countries whose progress it professes to narrate, furnishes, 
 when read and studied in a proper sense, large contribu- 
 tions More especially is this true with regard to contem- 
 porary records, which, while they manifest awakened at- 
 tention to existing evils, point out at the same time the 
 means of amelioration and improvement. In the use to be 
 made of the knowledge obtainable from so many sources, 
 and to be brought to bear in aid of sanitary reform, it will 
 be safer to incur the charge of iteration rather than of fail- 
 ure to impress the public mind with the vast importance 
 of the questions involved in the discussion, and with the 
 pertinency and force of the facts adduced in elucidation of 
 principles. We must not imagine that a knowledge of 
 sanitary matters, possessed by a small number of intelligent 
 and inquiring minds, is at all indicative either of the 
 knowledge or the zeal of the public at large. Our reform, 
 like every other that has been successful, requires itera- 
 tion, and again iteration. / 
 
 Ancient Egyptian Hygiene. The mere mention of ancient 
 Egypt suggests to the minds of all readers her pyramids and 
 obelisks, with their hieroglyphics, the splendor of Thebes and 
 
6 
 
 Memphis, the superstitious observances of her people in 
 their alleged worship of animals, and of their embalming the 
 dead, both of their own and the brute kind. The annually- 
 overflowing and fertilizing Nile, with its innumerable canals 
 for irrigation, is also a theme for admiration. But the 
 wise sanitary measures which secured health to the inhabit- 
 ants, and their protection from pestilence, by a system of 
 irrigation and methodical distribution of the waters of the 
 great river, and the practice of embalming the dead, under 
 religious sanction, are scarcely deemed to be worthy of 
 notice by the historian; certainly they are not impressed 
 on the minds of the youthful student in such a manner 
 as is called for, both by the importance of the facts them- 
 selves, and as suggestive of theduty of a government to 
 exercise unceasing vigilance in all matters that relate to 
 public hygiene. Unless the process of converting the dead 
 bodies, not only of men but of animals also, into mum- 
 mies, had been in a great measure universal, it would have 
 been difficult to prevent putrefactive exhalations from con- 
 tinually filling and poisoning the air, owing to the difficulty, 
 not to say impossibility, of securing deep and permanent burial 
 for the dead in a land like that of Egypt, the soil of which is 
 undergoing continual changes of surface by the annual overflow 
 and washing of the Nile. With a similarly wise provision of 
 means best calculated to preserve the public health, one, if not 
 more of the ancient kings, made those great artificial excava- 
 tions, the lakes of Mceris, the effect of which was protection 
 against the impetuous flow of the Nile at its rise, or the too 
 persistent delay of its waters at its fall ; and, in either case, 
 to diminish, if not entirely prevent, an exposed marshy surface 
 with its deleterious exhalations. 
 
 Carthaginian Hygiene. We are all familiar with the 
 memorable incidents of the wars growing out of the rivalry 
 between the Homans and the Carthaginians ; but few are 
 
aware that paving the streets was first practised in Car- 
 thage, and that the example was followed by the Romans, 
 or that a copious supply of water for the use of the inhabit- 
 ants of that city, was brought, after immense labor and ex- 
 pense, by an aqueduct more than fifty miles in length, and 
 of such dimensions that a man could stand erect in it. The 
 cisterns for the reception and distribution of the water 
 through the city were of corresponding magnitude ; and even 
 now in rowing along the beach, the mouths of common 
 sewers are frequently discovered. In a like spirit of regard 
 for the public health, the Carthaginians set apart ground for a 
 public cemetery, beyond the suburbs of the city, which became 
 a true Necropolis, a city of the dead, of which notice will be 
 taken when we come to treat of the evils of intramural inter- 
 ments. 
 
 Public Hygiene of Ancient Rome. Favorable as 
 the site of ancient Eome, extending over her seven hills, 
 might at first appear for early habitation and defense, it 
 may be safely said that we should never have heard of 
 the eternal city, never would she have become mistress of 
 the world, if her rulers and people had not early felt the 
 importance of sanitary measures, and carried them out with 
 a persistence and an ability which should serve as models 
 for all succeeding ages. Much of the ground between the hills 
 was little better than a swamp, owing to the trickling down of 
 the small springs from above, and to the frequent overflowing 
 of the Tiber. Unless, therefore, the ground could have been 
 thoroughly drained, it must have remained, in a great measure, 
 uninhabitable ; and the seven hills would have continued to 
 be the seat of merely so many separate villages, the abode and 
 refuge of a half-shepherd, half-robber population, who had the 
 Capitoline hill for their citadel , and Eome would have barely 
 acquired the rank of an inferior Latin city, under the rule of 
 her neighbor and subsequent nval Alba Longa. 
 
8 
 
 The CloacoB. With not only an intentness to meet existing 
 wants, but with apparently a prescience of the future greatness 
 and dominion of Rome, the work of drainage and sewerage was 
 begun by her kings and continued during the republic on a 
 scale of such magnitude, and in a manner so enduring, as to 
 be unsurpassed and rarely equaled by any subsequent labor 
 of the same kind in other countries. The Cloaca Maxima 
 which carried off the waters of the Veldbrum, at the time a 
 marsh between the Tiber in one direction, and the Capitoline, 
 Palatine, and Aventine hills in another, rivals the largest ' of 
 the pyramids in solidity and amount of material, arid exceeds 
 them all in unquestionable utility. The inner diameter of this 
 river-like trimural sewer was more than thirteen feet, and 
 such as to allow it to receive other large affluxes. "Earth- 
 quakes, the pressure of buildings, the neglect of fifteen hun- 
 dred years, have not," writes Niebuhr, "moved a stone out 
 of its place ; and for ten thousand years to come, these vaults 
 will stand uninjured as at this day." The Minor Velabrum 
 was continuous with the marshy districts, known afterwards 
 as the Forum and the Suburra, which were drained by appro- 
 priate tunnels opening into the main trunk. In the centre of 
 the Minor Velabnim was a bog or swamp called lake Curtius, 
 which was long an unabated and unmanageable nuisance. 
 The myth of Marcus Curtius sacrificing himself for the good 
 of his country, by plunging, mounted and armed, into this 
 yawning abyss, which was henceforth closed forever, would, 
 if clothed in the language of sober reality, probably read as 
 follows, in the style of an obituary notice: " Marcus Curtius, 
 edile, while superintending day after day, the drainage and 
 filling up of the unsightly and insalubrious Minor Velabrum, 
 and being exposed all the time to the fervid rays of an 
 autumnal sun, contracted a pestilential fever, under which he 
 sank, a martyr to his love for Rome, to whose welfare he gave 
 his life as a sacrifice. Peace to his manes ! Eternal honor 
 to his memory." 
 
9 
 
 All these reclaimed marshes became memorable in the his- 
 tory of Rome, as sites for many of her most useful and orna- 
 mental buildings and streets. In the Velabrum were con- 
 structed the cattle and fish markets, Forum, Boarium and 
 Forum Piscatorium, the temples of Fortune and Vesta, the 
 Arcus Quadrifrons and the Circus 3faximus. The Forum^ 
 long known by that simple designation, and afterwards called 
 Forum Romanum, was a place for public meetings, and also 
 a market-place ; it was surrounded by buildings of various 
 descriptions, both useful and ornamental ; shops, arcades, 
 columns, triumphal arches, and temples. This is not the time 
 to speak of the historical associations of the Roman Forum, 
 where the Comitia were held, where Cicero harangued, and 
 where the triumphal processions passed. The once remote 
 and marshy suburban village, the Suburra, became after its 
 drainage and the desiccation of the soil, the site of the amphi- 
 theatre of Titus Vespasian, more generally known as the 
 Coliseum, and the triumphal arch of Titus. 
 
 But, notwithstanding all the pains and expense lavished on 
 the vast subterranean drains (cloacce), it was always a matter 
 of extreme difficulty to keep the ground of the Velabrum and 
 the Suburra sufficiently dry to be healthy ; and hence these 
 quarters were the residence of the plebs or commonalty. Julius 
 Csesar, in the early part of his career, occupied an humble 
 house in the Suburra. Of a similar marshy nature was the 
 plain lying between the Tiber and the Pincian, Quirinal, and 
 Capitoline hills, on which a good part of modern Rome has 
 been built. Part of this plain, in an early period of ancient 
 Rome, was cleared of trees, and made a field for gymnastic 
 exercises and feats of mimic war (Campus Jlfartius). Large 
 groves were, however, retained, among which Augustus 
 erected the Mausoleum called after him ; and behind it beau- 
 tiful walks were laid out. Another part of the plain was 
 covered wiih, innumerable palaces, wooded gardens, three 
 
10 
 
 theatres, an amphitheatre, and magnificent temples, con- 
 tiguous one to another. To have drained this district, as a 
 necessary preliminary for such various and splendid construc- 
 tions, must have been a work of considerable labor and time, 
 as we have an opportunity of learning from the experimental 
 observations of an eminent Italian savant (Brocchi). He 
 shows that, at any spot over the whole plain, water is readily 
 procured at the depth of a few feet from the surface, and in 
 such quantity as to furnish, were it necessary, an adequate 
 supply to the whole city, by means of wells, and without hav- 
 ing recourse to the aqueducts. With a knowledge of the 
 buildings which bordered the Campus Martius on three sides, 
 and the still more numerous and imposing ones in the Forum 
 and the Suburra, previously noticed, we see the necessity for 
 completing the simple yet extensive underground construc- 
 tions in the way of sewers, before a firm foundation could be 
 procured for the more various, massive, lofty, and ornamental 
 edifices erected on the surface. The lesson is a fruitful one, 
 and ought never to be lost sight of in the founding and laying 
 out of new towns. In many of these a proper system of 
 drainage arid sewerage is an after-thought, and hence when 
 executed, it is at an immense cost, and often after much sick- 
 ness, suffering, and mortality among the first inhabitants. 
 
 Pestilential Fevers. Paving, the necessary accompaniment 
 of sewerage, and without which the latter must always be im- 
 perfect, was not begun in E-ome until an advanced period of the 
 republic, when the practice was said to have been adopted from 
 the example of the Carthaginians. The early deficiency in this 
 respect, and the inadequate supply of water for washing out 
 the sewers, allowed of the extrication and escape of effluvia, 
 which, added to the exhalations from an exposed and wet 
 surface, still in part subjected to overflow of the Tiber, gave 
 rise to those epidemic and aggravated periodical fevers, which 
 
11 
 
 under the vague name of plague (pestis) ravaged the city and 
 the Ager Romanus, now the Campagna di Roma, at dif- 
 ferent times, and carried off large numbers of their inhabitants. 
 The state of war in which the Romans were, with the excep- 
 tion of short intervals, so constantly engaged, must have com- 
 plicated the features and augmented the violence and fatality 
 of these pestilences. Without professing to have made anti- 
 quarian or much historical research, it seems to us that these 
 visitations were not so destructive in the latter years of the 
 republic, and under the first emperors, notwithstanding the 
 greatly increased population of the city, as they had been 
 under the kings and in the first centuries of the republic. 
 The difference in these respects must be traced to the extended 
 system of paving and of sewerage, and the abundant supply 
 of water brought by the aqueducts. Brennus at the head of 
 his victorious Gauls, after having held possession of the city 
 for six or seven months, during which period he laid close 
 siege to the Capitoline hill, on whose summit the surviving 
 citizens had taken their last stand, was finally obliged to 
 retire, owing to the sickness that destroyed so many of his 
 soldiers, much more than to the gold with which it was said 
 he was bought off. The Grauls encamped around the Capito- 
 line hill, in the Forum and the region of the Yelabrum, were 
 unavoidably exposed to the causes of fever growing out of this 
 low and unhealthy situation, acted on by the fervid rays of a 
 summer and autumnal sun. Reference has been already 
 made to the ground in this region being sometimes overflowed 
 by the Tiber ; and we may now add, that, even as late as the 
 time of Augustus, it was, on such occasions, impossible to 
 pass from the Palatine to the Aventine mount without the aid 
 of a boat, for which each passenger paid a quadrans, or 
 about a cent of our money. 
 
 The Aqueducts. On an equally large and magnificent 
 scale with the subterranean conduits and galleries for the 
 
12 
 
 purpose of sewerage, were the numerous aqueducts which 
 traversed Rome ill all directions. They were nine in number, 
 and conveyed into the city, at distances varying from seven 
 to sixty miles, a supply of water adequate for both public 
 and private uses cleansing the cloaques, supplying the 
 numerous baths, and naumachise, and the houses for all 
 domestic purposes. One of these aqueducts, the Martian, 
 conveyed the waters of three separate streams in as many chan- 
 nels. The first aqueduct, made in the fifth century from the 
 foundation of Rome, was almost entirely subterranean. In 
 such cases, openings to the external air were made at inter- 
 vals of 241 feet, for the purposes of ventilation. With the 
 growth of* the city, and the extension and multiplication of 
 the sewers, it became more than ever an object to keep these 
 underground passages free from obstructions, and hence 
 whether Rome was at war or at peace with the neighboring 
 states, the government, both in the time of the republic and 
 in that of the empire, exercised unceasing vigilance, not only 
 in these important matters, but in every thing that bore rela- 
 tion to the public health. The comprehensive jurisdiction of 
 the ediles indicated the supervision, as well of public build- 
 ings temples, theatres, &c. as of private edifices, to such 
 an extent that they should neither endanger nor incommode 
 passengers on the streets, but also of baths, aqueducts, com- 
 mon sewers, and control of the markets and houses of 
 public resort taverns and hotels, as we should call them at 
 the present day. The ediles took care that the health of the 
 people should not suffer by bad provisions, which they threw 
 into the Tiber, nor their morals by bad women, whom they 
 had authority to banish from the city. Officers were also 
 specially appointed to take care of the aqueducts. These 
 Cur at ores Aquarum were invested with considerable author- 
 ity ; being attended, when they went out of the city, by an 
 architect, secretaries, two lictors, three public slaves, &c. 
 
13 
 
 After reading the account given by Strabo of the quantity 
 of water introduced into the city being so great that whole 
 rivers seemed to flow through the streets and sewers, what a 
 contrast is offered to our minds when we turn over the pages 
 of the Parliamentary reports made a few years ago, showing 
 the lamentable deficiency in this respect both in London and 
 many of the great and even small towns of England. To 
 such an extent did this prevail, that hundreds of thousands 
 were deprived not only of an adequate supply for washing 
 their clothes, and for purposes of personal cleanliness, but 
 also for drink itself. The only fountains to which they 
 had access were those of liquid poison ; the only edifices 
 to rejoice their eyes, and to which they might claim 
 entrance, by spending the pittance earned by their daily 
 toil, were gin-palaces. In most of our cities on this side of 
 the Atlantic, provision has been made for an abundant supply 
 of water for the use of their inhabitants ; and our municipal 
 authorities might, with propriety, repeat the language of 
 Augustus, who, in reply to a popular clamor about the dear- 
 ness and scarcity of wine, reminded the people of Rome, "that 
 no man could reasonably complain of thirst, since the aque- 
 ducts of Agrippa had introduced into the city so many copious 
 streams of pure and salubrious water." There is reason to 
 fear that this appeal in favor of the unsophisticated appetite 
 for water, as contrasted with the acquired relish for alcoholic 
 stimulants, would be received with as little favor in the 
 Christian capitals of Europe and America, as it was in 
 pagan Rome. 
 
 Agrippa. There is no name in Roman history and records 
 so eminent for his numerous and extensive additions to the chief 
 means of promoting the health, as Agrippa, the son-in-law and 
 most trusted counselor of Augustus. He increased the number 
 of the public sewers, and exercised a continual and careful super- 
 
14 
 
 vision over all of them. So numerous were these subterranean 
 galleries, that the entire city might be said, in the language 
 afterwards used by Pliny, to be suspended over innumerable 
 arches (urbs pensilis). Agrippa contrived, in addition to other 
 means, to collect several minor streams into a larger one, and 
 to divert the entire current into the sewers, so as, in a 
 measure, to flush them, as we would say nowadays, and 
 thus to drive before it all refuse and fetid accumulations. He 
 carried his supervision so far as to see in person to the clean- 
 ing out of the sewers, for which purpose he used to enter 
 some of them in a boat. . The civil authorities of Rome dis- 
 played continued watchfulness, in order to prevent the waste of 
 water brought by the aqueducts ; and, among other laws to 
 this effect, there was one which prohibited the diverting of the 
 water, that flowed over the castella or reservoirs at the ter- 
 mination of the aqueducts, to private purposes, to the detri- 
 ment of the health of the city, by thus preventing the washing 
 out of the sewers. By the like attention to drainage and cul- 
 tivation of suburban districts, and indeed of all Latium, the 
 country was rendered in a great measure healthy, and became 
 the favorite retreat of the wealthy Romans during the hot 
 season. These delightful villas could not, even if they were 
 yet entire, be now inhabited, on account of the altered condi- 
 tion of the soil, and its alleged consequent extrication of the 
 pervading and destructive malaria. 
 
 Following the construction of the aqueducts, and the intro- 
 duction of so great a body of water as was conveyed by them 
 into Rome, was that of the Public Baths, some of which, as 
 those of Diocletian, were almost small towns, comprising, as 
 they did, every kind of structure for bodily exercise, religious 
 worship, reading, and recreation, in addition to the vast 
 lavacra, and other appliances for bathing in water, vapor, or 
 hot air, as taste or the bodily health might require. Some 
 reference will again be made to these establishments, towards 
 the close of this report. 
 
15 
 
 Barbarism and Civilisation. History tells us of the 
 immense population of ancient Rome at the height of her 
 power, and the villas which overspread the surrounding 
 country ; both town and country preserving and maintain- 
 ing a vigorous and unremitting observance of the laws 
 enacted for the public health. From the same source we 
 learn the melancholy and contrasted picture of Rome, fallen, 
 depopulated, and rendered almost desolate by her barbarian 
 invaders, and the consequent entire neglect of all sanitary 
 legislation. Such was the wide-spread ruin which followed 
 the repeated irruptions of barbarian conquerors and despoilers, 
 Goths, Huns, Vandals, and Lombards, that, in the eighth 
 century, as we read in the pages of the learned and accurate 
 Muratori, a considerable part of Italy was covered with forests 
 and marshes of great extent, and infested with wolves and 
 other wild beasts. The same state of desolation prevailed in 
 other countries of Europe. Rome herself, fallen from her 
 high estate, exhibited the melancholy spectacle of a great city 
 in ruins ; the adjacent country a gloomy solitude, and disease 
 reigning supreme over the surviving inhabitants. Plundered 
 first by Alaric, and spared by the ferocious Attila, who had 
 laid waste the whole empire, her greatest sufferings were 
 caused by Totila, who besieged Rome, and cut the aqueducts, 
 in order to facilitate the capture of the city. By this means 
 the country around was overflowed, ponds and quagmires 
 were formed, and the air became in consequence poisoned. 
 The Lombards exceeded, if possible, those who had gone 
 before them in the work of destruction, in which we must 
 include that of drains, dikes, and sewers. Even if these had 
 not been destroyed or closed up by foreign enemies, there 
 were not inhabitants left in sufficient number to keep them 
 entire and to cleanse them. With progressive barbarism and 
 decay of all the useful arts, a knowledge of the very exist- 
 ence, and, consequently, of the direction of most of the sewers, 
 
16 
 
 was lost. There was no longer any police, nor tne commonest 
 attention to public hygiene. Frequent references were made, 
 in successive centuries of the dark or middle ages, to the 
 stagnant 'waters in the vicinity of Rome, and their retention 
 in the vaults and the ruined buildings of the city, as a con- 
 stant cause of taint of the incumbent air. During the 
 twelfth and thirteenth centuries, few of the inhabitants of 
 Rome reached the fortieth year of life, and a very small 
 number survived the sixtieth year. On the advance of the 
 Emperor Frederic Barbarossa on Rome, it was asserted by a 
 writer at the time, that its pestilential air offered a better 
 means than its soldiers, of protection to the city against an 
 enemy. When the Popes returned to Rome, after an absence 
 of seventy years (1306 to 1376) in Avignon, the city only 
 contained thirty thousand inhabitants. This return became 
 the sigAal for setting about the work of restoration and im- 
 provement, and among the measures of this nature most con- 
 tributive to the public health, was the construction of new and 
 the repairing and opening some of the old sewers. Noticeable 
 evidences of improvement in the sanitary condition of Rome, 
 effected by drainage, were presented in the changes wrought 
 in the quarter of the Vatican, and in that corresponding with 
 the ancient Campus Martius. The first, in the time of Tacitus, 
 was eminently unhealthy, owing to the marshy nature of the 
 ground ; but it was so much improved in this particular by 
 the Popes, as to be made the site for the Church of St. Peter 
 and the Palace of the Vatican. In fact, many of the largest 
 churches and finest palaces in modern Rome are so many 
 evidences of conquests over marshy ground, in order to give 
 space and stable foundation for their erection, and also, to 
 render access and occupation easy and safe. Modern Rome, 
 through the Popes, has in part imitated and in part turned to 
 direct account the construction of the ancient aqueducts, so 
 that by means of three of these art-directed rivers, the city is 
 
17 
 
 amply supplied with water, not only for the domestic and per- 
 sonal wants of the inhabitants, but for the purposes of cleans- 
 ing the streets and supplying numerous fountains. The 
 gushing streams and jets sent out from these last, diffuse, a 
 grateful coolness through the surrounding air, during the rag- 
 ing and oppressive heats of summer. The most rigid Protest- 
 ant, in going the rounds of sight-seeing during the dog-days, 
 must feel his odium theologicum oozing out at every pore as 
 he approaches the magnificent fountains of Termini, of Trevi, 
 and of the Piazza N^avone, formerly the Circus Agonalis, 
 or sees a river foaming like a cataract at the Pauline. 
 
 The calamities which followed the irruption of the German 
 and Scythian nations into the Roman empire, lasted for four 
 centuries ; and during this period it were vain to talk of public 
 hygiene. No longer were ediles and questors to be found, 
 nor were similar officers created by the barbarian conquerors. 
 Even after the outlines of a new order of things were visible, 
 and modern history began its records, a long time elapsed 
 before any pains whatever were taken to preserve the health 
 of communities by sanitary regulations. The cultivators of 
 the soil, herding rather than dwelling together round the 
 castle of their lord and tyrant, were badly fed and worse 
 lodged ; and both in town and country the purifying aid of 
 the bath ceased to be sought for, and in fact was no longer 
 procurable. The first memorable step towards a better social 
 and political organization of the people who overran and sub- 
 jugated the Roman empire, was their collection into commer- 
 cial communities. Ingenuity, enterprise, and taste were 
 rapidly developed ; and with the increase of the wealth of the 
 state there ensued greater individual comfort and enjoyments 
 better means, in fine, of procuring health, and avoiding 
 disease. To huts, and dark and unwholesome habitations, 
 succeeded spacious, if not always well-aired and well-lighted 
 mansions ; and avenues obstructed by mud and filth were re- 
 
18 
 
 placed by paved streets ; while here and there a fountain gave 
 evidence of a recognition of the virtues of running water, and 
 rendered it probable that abundance for use was secured be- 
 fore indulgence in ornament was allowed. This ameliorating 
 process was chiefly observable in the free cities of Germany 
 and Italy ; and it was after a much longer period that even 
 the capitals of powerful kingdoms, such as London and Paris, 
 were wanting in most of the essentials for the preservation of 
 the public health. The streets were narrow and unpaved, 
 and with their own mud were mixed up all kinds of garbage 
 and offal ; the houses were for the most part small, damp, and 
 badly ventilated ; water for both public and private wants, 
 household and personal, was deficient in quantity ; and when 
 procured often tainted with impurities. The supply of food 
 was irregular, and never in the variety required for the pur- 
 poses of health. In all the cities of Europe, in the middle 
 ages, the population was excessive, owing to the insecurity of 
 persons and property outside the walls during their frequent 
 and almost continual wars, and to the consequent flight of 
 large numbers from the country, who sought refuge in the 
 city from the sudden fury of a barbarous enemy. It mattered 
 but little whether the town were large or small ; there was 
 always a disproportion between the number of its inhabit- 
 ants and the space for habitation and change of air Hence 
 we cannot be surprised that any noticeable deviation from the 
 customary states of the atmosphere, or, still more, inter- 
 ruption to the regular supply of food, should have been fol- 
 lowed in city, town, and hamlet, with pestilence in its most 
 appalling and deadly forms. Even if we were ignorant 
 of all the particulars of bad medical police, or of its entire 
 neglect, and of the mode of living during this period, we still 
 could not fail to see in these melancholy chapters of the de- 
 vastations from epidemic diseases, a want of adequate public 
 hygiene, if not a total ignorance of its principles. In propor- 
 
19 
 
 tion, on the other hand, to more conformity with, and a better 
 appreciation of, these latter, was there an abatement, if not 
 entire disappearance of these scourges of mankind. Sani- 
 tary measures, methodically carried out, were followed by 
 improved public health and increased duration of the life of 
 the individual. ' 
 
 Vital statistics enable us to speak with confidence of the 
 progressive ameliorations, in these respects, which accompanied 
 advancing civilization. The mortality in Paris in the early 
 part of the fourteenth century has been estimated from a manu- 
 script document to be 1 in 20 ; whereas the average mor- 
 tality of the inhabitants of that city, in the very poorest 
 arrondissement or ward, as we might term it, in which poverty 
 and destitution are extreme, was 1 in 24, in the first third of 
 the present century. The average deaths in all Paris at the 
 same date (1830) was 1 in 32, and among the more wealthy 
 inhabitants, 1 in 42 ; and hence we are safe in saying that 
 the mechanic of the present day, who resides in the French 
 capital, is better off on the score of air and the appliances tor 
 supporting life, than the rich inhabitant at the opening of the 
 thirteenth century, notwithstanding that the population is more 
 than 300 times greater now than it was then. The difference in 
 the vital statistics of the two periods thus compared is easily 
 explained by the entire neglect of public hygiene in the former, 
 and the careful attention which it receives in the latter. Al- 
 though paving of the streets of Paris had been begun in the 
 twelfth century, under Philip Augustus, yet it was of very 
 limited extent at the beginning of the fourteenth, when Philip 
 the Fair was king. At that time the streets of Paris gave out 
 abominable stenches, so obstructed where they with mud, 
 dung, and other excrementitial substances and offal of.all kinds. 
 Even towards the close of the century things were no better, if 
 we may judge from a proclamation of Charles VI., which speaks 
 of the pavement being so broken up into ruts, that it was dan- 
 
20 
 
 gerous in many places to ride either on horse Dack or in a 
 carriage ; and that, owing to the accumulation of refuse of all 
 kinds, grave diseases and death were common. With few 
 exceptions, the houses were little better than hovels. Even 
 down to the early period of the reign of Louis XIV., the 
 greater number of the streets were still unpaved, or paved 
 only on one side and at certain distances ; they were obstruct- 
 ed also by the same kind of abominations already mentioned. 
 'Historians remark that, after the paving of Dijon, the ancient 
 capital of Burgundy, in the middle of the fourteenth century, 
 dysentery, spotted fever, and other diseases became of less 
 frequent occurrence in that city. A still more striking example 
 of the effect of improved sanitary legislation in increasing the 
 average duration of human life, is exhibited in the registration 
 of the births and deaths, and of the population of the city of Ge- 
 neva, during the last three centuries. M. Marc d'Espine, in a 
 late work on " Comparative Mortuary Statistics, "shows, that 
 the proba ble life at Geneva in the sixteenth century was rather 
 less than 5 years ; in the seventeenth century 11 years ; at 
 the beginning of the eighteenth 27 years ; at the end of the 
 century 32 years ; and now it is 44 ^ears. M. Mallet had 
 previously ascertained from the same documents, that the mean 
 duration of life in Geneva, in 1833, was nearly the double (or 
 as 40 years 5 months to 21 years 2 months) of that reached 
 rather more than two centuries before. 
 
 Causes of Pestilence. Nearly all the great cities of the 
 world have been founded on the banks and at the confluence 
 of rivers, or on the sea-shore, where the ground is low, flat, 
 and often marshy, and liable to be in part flooded by heavy 
 rains, or the overflow of adjoining rivers. In localities like 
 these, almost invariably at particular seasons, and under cer- 
 tain regularly recurring atmospherical influences, fevers of a 
 periodical kind afflict the first inhabitants. It was so, as we 
 
21 
 
 have already stated, at Kornp ; and in the cities and' small 
 towns, too, of modern Europe, as well as those in America, 
 the same unfavorable localities have produced the same effect, 
 until the industry and art of the inhabitants have been exerted 
 to alter the surface of the ground by firm pavements and judi- 
 cious draining, so that the water coming from the houses, and 
 that falling in the streets in the shape of rain, shall readily flow 
 into the sewers beneath, in place of being allowed to stagnate 
 in ruts, hollows, and pools, and afterwards, with the aid of 
 heat, to bring about a putrefactive fermentation of all the refuse 
 accumulated, in the shape of vegetable and animal offal, and 
 other matters which are thrown or otherwise find their way 
 into the streets. A compost thus formed of all kinds of abomi- 
 nations, in union with the filth retained in most of the houses 
 of Europe during the middle ages, was a perpetually sustain- 
 ing cause, not only of periodical fevers, but of plague itself. 
 The meterials of wood, and lath, and plaster, of which the 
 houses were chiefly built, by retaining moisture and yielding 
 to decay, must have greatly contributed to the evolution of 
 foul and unwholesome air, which was added to the permanent 
 supply in the streets. Fire in some instances came oppor- 
 tunely to purify the air, while it destroyed the dwellings in 
 a city. The great fire of London in 1665, which followed the 
 great plague, destroyed thirteen thousand houses and eighty- 
 nine churches, in four hundred streets ; but it left the English 
 capital free, ever after, from the plague. The benefits would 
 have been much more complete if the streets had been laid out 
 after a general and uniform plan, instead of preserving the old 
 lines, although many of them were made wider. To this last 
 circumstance, and the better construction of the houses, both 
 as regards the material, brick, and the larger access of light 
 and air, was the new city indebted for a higher sanitary stan- 
 dard than it had ever attained before. But the imperfect 
 paving and drainage of London still left it open to intermittent 
 
22 
 
 And dysentry, "both of which prevailed every year. It 
 will surprise many persons, general readers too, when they are 
 told that the mortality from the former cause alone, in a popu- 
 lation at the time not greater than that of Philadelphia, was 
 from one to two thousand persons annually. Now, it scarcely 
 figures on the mortuary list, owing to the great sanitary im- 
 provements in the metropolis, especially under the heads just 
 mentioned. In former times, it appears that Walbrook, Sher- 
 bourne, Longbourne, and Oldbourne, were really brooks, often 
 closed up by filth, and in some places the currents so much 
 obstructed as to form pools. A large portion of the country 
 also, around London, was a marsh, and indeed the banks of the 
 Thames, from Lambeth to Woolwich, was one continued 
 swamp. All these parts, however, have been underdrained, 
 extensive sewers formed, the ditches filled up, the river banked 
 out, and the site generally rendered so dry, that London is 
 now unquestionably not only the most healthy capital in 
 Europe, but on the score of salubrity, is scarcely rivaled by 
 any city in the world. 
 
 Venice. We have been accustomed to read and to speak 
 of the wonderful and almost miraculous progress of Rome, 
 from a small and insignificant beginning to universal empire, 
 and to expatiate on the firmness, courage, and martial spirit 
 of her people, which bore them up under the most trying and 
 adverse circumstances. Viewed under another, and hygienic 
 aspect, her career must excite our surprise and admiration to a 
 still geater extent, when we reflect on the eminently unfavora- 
 ble geographical situation of the city, as every way adverse to 
 health, and to the growth in numbers, wealth, and splendor 
 which she ultimately attained. It would indeed be difficult to 
 adduce a stronger and more convincing proof of the importance 
 of sanitary measures, not only for the prosperity, but for the 
 existence of a city, than was exhibited in the history of Rome. 
 But in more modern times the same instructive lessons have 
 
23 
 
 been taught, witfi even greater force and point, by the founda- 
 tion and growth of the three great cities of Venice, Amsterdam, 
 and St. Petersburg. Had the refugees from the mainland, 
 who fled, before Attila and his Huns, to the small islands in 
 the lagunes of the Adriatic, hesitated to procure a stable and 
 permanent abiding-place for themselves amid the waters, and 
 to set about laying at once the foundations of a mart for com- 
 merce, they might, perhaps, have had a line in history, telling 
 of their love of freedom and of their success as fishermen and 
 buccaneers, but never would the world have heard of the name 
 of Venice, or of its extensive trade and political power. Never 
 would the spectacle have been exhibited of a great city rising 
 as it were out of the sea, and resplendent with marble palaces, 
 and churches, and piazzas, and with rich tessellated pavements, 
 and houses, many of them, palatial in size and architectural 
 decorations, and nearly all of these edifices, both public and 
 private, built on piers. There was pavement-foundation of a 
 new kind, and upon a large and costly scale; but how fully was 
 the expense repaid ! Where canals take, in most cases, the 
 place of streets, these are necessarily small, if not insignifi- 
 cant ; but their pavements required a heavier outlay than that 
 of many of the broad avenues of other cities. What shall 
 be said of the engineering skill in making the canals, and in 
 preserving their requisite levels, as well as of the labor in pre- 
 venting undue accumulations of offal and refuse of all kinds 
 cast into them. The entire exemption of the inhabitants of 
 Venice from periodical fevers, is well calculated to excite sur- 
 prise under any view which may be taken of the peculiar to- 
 pographical features of the city. During the summer months 
 the lagunes give out very unpleasant odors. 
 
 Amsterdam had as small and unpropitious beginning 
 as the Queen of the Adriatic, and like that of the latter, 
 it was a maritime one. Its founders were, first, a few fish- 
 
24 
 
 ermen, and then a few traders, whose early efforts were direct- 
 ed to prevent them from sinking in the morasses on which they 
 had erected their humble dwellings, and from having these 
 swept away by the sudden rising of the stormy Zuyder Zee. 
 Drainage by canals gave them something like terra Jirma in 
 their marshes, while dykes sheltered them from the capricious 
 fury of the ocean. Industry and enterprise thus early exer- 
 cised were not long in being directed into the channels of an 
 extensive and lucrative commerce, which brought the inhabi- 
 tants wealth and a mercantile marine. Its tonnage constituted 
 a large part of that of the Seven United Provinces, and this, 
 at the close of the seventeenth century, was nearly equal to 
 the tonnage of all the rest of Europe. Amsterdam presents 
 the spectacle of a flourishing and handsomely-built city, of 
 more than two hundred thousand inhabitants, with well-paved 
 and clean streets, which sometimes run parallel to, and some- 
 times are intersected by, numerous canals, and with public 
 and private edifices evincing durability, taste, and wealth. 
 The whole of them rest on piles ; and hence the common re- 
 mark, assuming the tone of complaint, that a house costs as 
 much below as above the ground. It should be remembered, 
 however, that a house is worth little above-ground anywhere, 
 as a residence, unless the under-ground be well kept, and rest 
 on a dry and properly-drained soil. Notwithstanding, how- 
 ever, all the pains taken to keep the canals of Amsterdam 
 clear of accumulations of filth or other obstruction, the depth 
 of water is often insufficient to prevent offensive and injurious 
 exhalations, which affect the health and lessen the mean dura- 
 tion of the life of the inhabitants. What is here said of Am- 
 sterdam applies to nearly all Holland. The people of that 
 country, inhabiting a barren soil, alternately marsh and sand, 
 and almost submerged by water, and breathing an atmosphere 
 the most unfriendly to human comfort, so far from retiring be- 
 fore the encroachments of the ocean, erect barriers to restrain 
 
25 
 
 its fury, give new channels to their sluggish waves, drain by 
 numerous canals their marshes and morasses, and convert, as 
 it were, the elements which seemed to be the means of de- 
 struction, into so many sources of wealth and power. 
 
 /St. Petersburg, the capital of the Russian empire, rests, like 
 Venice and Amsterdam, on made ground, once an area of 
 marsh and bog, near the mouth of the Neva. Its foundation, 
 unlike, however, that of the free cities just named, was owing 
 to the despotic will of one man, Peter the Great, who tri- 
 umphed over nature, but at an enormous sacrifice of human 
 life. History tells of forty thousand men having been em- 
 ployed at one time in the preliminary work of draining of the 
 soil, and filling up pools and quagmires ; and of three hundred 
 thousand men having lost their lives before the work was com- 
 pleted. Now, we look at a magnificent capital, containing a 
 population of half a million of souls, with its wide and long 
 streets, its grand stone quays extending for three miles on 
 each side of the Neva, its apparently endless lines of imposing 
 houses in a uniform style of architecture for entire blocks and 
 even streets, interspersed with churches and palaces and gov- 
 ernment edifices. All this has been created within the period 
 that has elapsed since the foundation and first settlement of 
 Philadelphia. Well might it be said, after a study of the rise 
 and growth of all the great capitals and celebrated cities of 
 the world, that the first and the most important chapter in the 
 history of civilization is that of drainage. If there be exceptions, 
 they will be found, for the most part, to strengthen and en- 
 force the general practice, by showing the inconveniences and 
 loss caused by its neglect. 
 
 JBerlin.A& a part of the contrasted picture of neglect of 
 the most important measures of sanitary legislation in cities, 
 we may adduce the instance of Berlin, the capital of Prussia. 
 For the first half of the seventeenth century, its streets were 
 
26 
 
 not entirely paved ; and at the beginning of the century they 
 were never swept. The new market was paved as late as 
 1679. How different the state of things in the commercial 
 and free city of Augsburg, the paving of which was begun in 
 the early part of the fifteenth century ; and in the earliest pe- 
 riods it had subterranean passages or sewers. In Berlin, on 
 the other hand, in the latter part of the seventeenth century t 
 (1671), every countryman who came to the market was re- 
 quired to carry away with him a load of dirt. Hog-styes were 
 erected on the streets, sometimes under the windows. Berlin 
 had no regular sewers or underground drains at as recent a 
 date as 1846. A sluggish but considerable river, the Spree, 
 almost stagnates in the town. ' It might be made a grand 
 cloaque, connecting with the other drains when covered, and 
 the whole of them, as well as the streets, could be washed by 
 water raised by engines, at a cost not greater than that now 
 incurred for stucco work, and other outside decorations for the 
 houses. Large puddles of filth are allowed to collect before 
 the doors even of the best houses, which, especially in the last 
 months of summer, diffuse a most horrible stench. It must 
 be admitted, however, that the low situation of the town ren- 
 ders drainage a matter of great difficulty. Laing, the traveler, 
 speaking of Berlin as he found it 1841', says : " It is a fine 
 city, very like the age she represents very fine, and very 
 nasty. The streets are spacious and straight, with broad mar- 
 gins on each side for foot-passengers ; and a band of broad 
 flag-stones on their margins, make them much more walkable 
 than the streets of most continental towns. But these mar- 
 gins are divided from the spacious carriage-way in the middle 
 by open kennels, telling the most unutterable things. These 
 open kennels are boarded over only at the gateways of the pal- 
 aces, to let the carriages cross them, and must be particularly 
 convenient to the inhabitants, for they are not at all particu- 
 larly agreeable." " If bronze and marble could smell, Bluch- 
 
27 
 
 er and Bulow, Schwerin and Ziethen, and duck-winged angels, 
 and two-headed eagles innumerable, would be found on their 
 pedestals, holding their noses instead of grasping [as in the 
 case of the generals] their swords." Berlin is still so far be- 
 hindhand in the comforts of life, as not to have water conveyed 
 in pipes into the city and the houses. " Three hundred thou- 
 sand people have taste enough to be in dreamy ecstasies at 
 the singing of Madame Pasta, or the dancing of Taglioni, and 
 have not taste enough to appreciate or feel the want of a sup- 
 ply of water in their kitchens, sculleries, drains, sewers, and 
 water-closets." No surprise need be felt that Berlin was 
 scourged with the cholera in 1831, and again with still great- 
 er severity in 1837. Putting aside drainage, the Prussian 
 capital is, in the width and general arrangements of the streets, 
 and the better ventilation of the houses, superior to the French ; 
 but yet the proportionate mortality from Cholera was much 
 greater, or at the rate of nearly 2J to 1 in 1831, in the former 
 than in the latter city which, as commonly described, was 
 so great a sufferer. In the second attack (in 1837), the mor- 
 tality was still heavier in Berlin, or, as the difference between 
 1426 and 2174 deaths. There, as in nearly every city in 
 which the Cholera made its attack, the greater number of 
 cases, and the chief mortality, were found in dark, narrow 
 streets, inaccessible to the rays of the sun and to winds, and 
 in low, damp habitations, especially near the water. 
 
 Neglect of Sanitary Legislation. During the last two 
 centuries, colonization and incidental conquest have exerted a 
 powerful influence on the political and social relations of the 
 different countries in both hemispheres, from which neither 
 Hindoo nor Chinese, Turk nor Tartar, Indian nor Negro are 
 exempt. Consequent upon the vast extension and the open- 
 ings of new channels of commerce, have been the foundation 
 and growth of many cities, the inhabitants of which, in their 
 
28 
 
 eagerness for gain, have hardly allowed themselves, until 
 recently, time to attend to the obvious requirements of public 
 hygiene. Looking too much at the surface, they have often 
 neglected proper draining and sewerage, and the means of pro- 
 curing an adequate supply of water ; and, more surprising still, 
 a renewal of fresh air by suitable ventilation. The conse- 
 quences of this neglect have been the production of febrile 
 and other diseases, which have not only destroyed life to a 
 fearful extent, but retarded industry and greatly interfered 
 with social progress and educational amelioration. These evils 
 are not confined to Calcutta and New Orleans, to Cairo and 
 Constantinople ; they are but too apparent in Liverpool and 
 Manchester, and Glasgow, and New York ; and, although 
 in less degree, in Boston, Philadelphia, and Baltimore, not to 
 speak of our great inland towns on the Mississippi and its 
 tributaries, and on our great Lakes. Little admonished by 
 the history of former ages, the people of Europe and America 
 have paid but scant attention to the best measures for pre- 
 venting diseases, and for preserving health among the masses. 
 The poor, and the destitute, and the degraded, have been too 
 long allowed to remain in their ignorance, to grovel in their 
 filth, and while suffering acutely themselves, to spread around 
 them the contamination and contagion of the diseases of body 
 and of mind, which inevitably result from their neglected con- 
 dition. The philanthropic few have, from time to time, re- 
 monstrated : they have also recommended, and as far.7as 
 their limited efforts would allow, have carried out improve- 
 ments ; but the former have never obtained a full public 
 hearing, and the latter were too partial in their nature to 
 prune, still less to eradicate, the wide-spread and constantly 
 growing evils. The Plague of Asia and Africa, the Yellow 
 Fever of America, the Typhus Fever in Europe, and the 
 Cholera in all quarters of the world, have spread fright and 
 death, have elicited many legislative and municipal enact- 
 
29 
 
 ments, and given rise to acts of heroic devotion for the relief of 
 suffering and humanity ; but until a recent period they have 
 failed, notwithstanding their frequent and dreaded visits, to 
 fix the attention of the several communities, among which 
 they have been most rife, on their real, and as far as could be 
 ascertained, their preventible causes. It is under these cir- 
 cumstances that Hygeia may be invoked, not merely as the 
 handmaid of Medicine, but as the potent divinity saving her 
 tens of thousands of lives, while the latter can only hope to 
 rescue her hundreds, after incredible efforts and expense on 
 the part of her immediate votaries. 
 
 Concurrently with the increase, and both as an effect, and, 
 in turn, a cause of commerce, have been the vast extension 
 and multiplication of manufactures within the past century, 
 and the concentration of human beings, in consequence, far 
 beyond what would be allowable on any principle of hygiene. 
 Deprived, as so many tens of thousands are, in the great 
 manufacturing cities and towns of Great Britain and France, 
 of the common air and common light, pent up in close and 
 damp, often underground lodgings by night, and forced to ex- 
 traordinary and yet partial bodily efforts by day, receiving an 
 inadequate supply of food, and tempted by their overpower- 
 ing feelings of exhaustion and depression to seek for tempo- 
 rary renovation and excitement in the use of ardent spirits, 
 or fermented and drugged, erst called malt liquors, what 
 wonder that they are invaded by disease in every shape 
 fevers, pulmonary consumption, scrofula, and all that can 
 disfigure and deform? The picture is a gloomy one, and 
 suggestive of fearful forebodings ; it has long enlisted the 
 sympathies of the benevolent, and has at last startled the self- 
 ish and the avaricious, who feel a well-grounded alarm at 
 the probability of the continued sufferings and degradation of 
 a neglected, if not despised, class of their fellow-beings di- 
 minishing their own gains. But we must not scrutinize 
 
30 
 
 motives too closely, if the acts be of an ameliorating and 
 kindly nature. Enlightened public spirit is urging those 
 who have the power, to make the requisite reforms, and in 
 legislative snactments, as well as in voluntary associations 
 and individual liberality, satisfactory proofs are given of a 
 new and better state of things. Recurrence will soon be 
 made to this subject. In some of the towns of England, of 
 late years, public baths have been opened, and public wash- 
 houses erected, so as to insure to the poorer classes cleanliness 
 of person and clothing, two great means of preserving health, 
 and, indirectly, of aiding the cause of morals ; the mind re- 
 ceiving from the body's purity a secret sympathetic aid. 
 
 The burden of sanitary legislation is protection of the 
 public health, compatibly with the rights of person and pro- 
 perty, and the pursuits of industry. The common right 
 of all is entire enjoyment of the material conditions for 
 healthy life. This right is seldom obtained in its full 
 latitude. It is too often neglected by those who might, 
 with care, enjoy it ; and, still oftener, it is withheld 
 or violated by force or selfishness in such a way that 
 the people in mass find it difficult to obtain justice. The con- 
 test between cupidity and sanitary rights is sometimes un- 
 avoidable, but more frequently it arises from the ignorance 
 on the part of the opponents of reform. So soon as people 
 are congregated in cities and other marts of business, they dis- 
 cover, on coming to a common understanding, the necessity 
 of giving up the indulgence of individual will when it conflicts 
 with the public good. Hence municipal laws for regulating 
 thoroughfare, and for the introduction and export of various arti- 
 cles of commerce, especially the products of agriculture. Eve- 
 ry citizen is insured the right of way through all the streets, 
 in the pursuit of business or pleasure; and he is protected by 
 stringent laws from the dishonesty of those who would sell 
 him tainted meat, or provisions at short weight. It is not 
 
31 
 
 in any view of sentimental philanthrophy or of ascetic re- 
 striction, but in the name of humanity and justice, that so 
 many of our fellow-citizens, in all the walks of life, are urgent 
 for similar prohibitions against the retail trade in liquid poison, 
 the product of alcoholic distillation the original noxious effects 
 of which on the animal economy are still further increased by 
 the addition of some of the most subtle and active poisons de- 
 rived from other sources. 
 
 Individual caprice and heedlessness are checked in acts 
 which conflict with the rights of the majority, in fact, of the 
 public at large, as when a person would extend the front of 
 his house beyond the regular line, or pile up goods or wares 
 in the middle of the street. It would be well that some limit- 
 ation should be put also to the height of the house, in order 
 that a whole neighborhood and the passers-by may not be put 
 in jeopardy, or suffer from the loss of limb and life itself by the 
 fall of these lofty structures, which are neither dedicated to 
 religion nor to any public use, but which seem to be merely 
 monuments of the silly vanity of individuals. The exclusion of 
 the cheerful and genial sunlight from the street, and the re- 
 stricted ventilation produced by such lofty piles, might count 
 for something, even though questions of this nature do not 
 enter into the calculations of cost and profit by the first 
 owners. Paving and draining and sewerage are also recognized 
 parts of city police and sanitary legislation, to which all hold- 
 ers of property are made to contribute, for the public good as 
 well as for their own personal benefit. Public convenience 
 and public health are subserved by these means, the perform- 
 ance or which is insured by regularly appointed agents, and 
 boards of health. Few will be found in the large cities of 
 Europe and America to contest the propriety and wisdom of 
 all these measures of public hygiene, to which must be added 
 the procuring a suitable supply of pure water, although, in 
 many smaller places, they may be, at first, thought to be un- 
 
32 
 
 called for, and to involve an expenditure of money beyond the 
 good to be obtained. It is seldom, however, that experience 
 does not show the groundless nature of these objections, both 
 in a sanitary and economical point of view. There are not 
 wanting, indeed, persons in every country, Christian or Mo- 
 hammedan, who claim, as one of their reserved rights, the 
 privilege of having their senses of sight and smell assailed by 
 emanations from all kinds of offal and -garbage, and the stag- 
 nant water of gutters, as if to mark the difference between 
 town and country, and, at the same time, their freedom from 
 restrictive laws. There are also not a few who, with tastes 
 akin to those of the preceding class, claim that their house is 
 their castle, and that they have a right to exclude the air from 
 it as carefully as if they were in a state of siege, and had been 
 obliged to close every aperture through which an enemy's mis- 
 Bile might find entrance. 
 
 Community of Interests. State policy, isself, however 
 little affinity it may seem to have to philanthropy and philo- 
 sophy, is deeply concerned in the inculcation and enforcement 
 of the true principles of public hygiene. The power of a state 
 depends on the population, wealth, and productive industry, 
 and on the cultivated intelligence of its people ; trammels on 
 all of which are created by whatever deteriorates the physical 
 strength and the health of any portion of them. Perma- 
 nent injury to the public health exerts, at the same time, an 
 unfavorable influence on the social state ; and hence poverty, 
 with its frequent concomitants of hunger and the daily alter- 
 nations of eager expectation of relief and of depression of the 
 feelings, has ever been a promoter of secret and political dis- 
 organization. While philanthropy incites to more extended 
 efforts for the relief and prevention of sufferings which are the 
 result of a breach of the natural laws or those of health, ex- 
 panded philosophy teaches that, although some classes in every 
 city pay the heaviest penalties, yet there is no one class ex- 
 
33 
 
 empt from similar inflictions. The rich man, in his spacious 
 mansion, has a direct personal interest in the health and do- 
 mestic comfort of his poor neighbor ; and the more secluded 
 and shut out from the world, in a dark court or alley, is this 
 neighbor, the greater is this interest. His open windows will 
 give entrance, not only to the refreshing breeze, but also to 
 the poisoned air emanating from congregated beings in the 
 confined lodgings, and from the unremoved refuse or offal ad- 
 jacent. It is thus that Typhus Fever, beginning in the hovels 
 of the poor, finds its way into the luxurious abodes of the rich. 
 'YV'ere it necessary to continue in this line of argument, we might 
 point to the importance of sanitary legislation for the em- 
 ployer or master manufacturer, as well as for the operatives and 
 workmen. His real interest will not consist in obtaining 
 from them the greatest possible amount of work from day to 
 day, without reference to their having a due proportion of 
 time for sleep, and of moderate recreation in the open air. 
 Nor will it be good economy to stint these persons in the 
 quantity of wholesome food which is necessary not merely 
 to remove the cravings of hunger, but to renovate the body 
 weakened by labor. The landlord who desires to have his 
 houses always occupied by good paying tenants, will not be neg- 
 ligent of either their health or their morals. He will not 
 speculate on the powers of endurance of human beings, when 
 deprived of fresh air by residence in close, damp, and badly- 
 ventilated rooms, and who are compelled to inhale an impure 
 and vitiated air, the product of their own respiration, and the 
 exhalations from the accumulated filth of cess-pools, and of 
 yards choked up by offal. The inmates of such habitations 
 are, necessarily, less fitted for labor and active employment 
 of every kind ; lose more time by sickness, and are carried 
 off in larger proportion by death than those in more favorable 
 hygienic conditions. Their nervous system is weakened in 
 
 the functions of the senses and of the brain ; and, even if in- 
 3 
 
34 
 
 temperance should not add its baneful influence to their 
 distress, they are more susceptible to the causes of moral 
 disorders and the temptations to evil doing. Men, thus 
 wearied and worn, depressed in body and in mind, and 
 deprived of all the genial excitement from fresh air and light, 
 and shut out from all the objects which might remind them of 
 nature, under her more pleasing aspects, become careless of 
 themselves, indifferent to the wants of their families, and 
 regardless of the obligations contracted with employer and 
 landlord, or with the administrators of the laws. They are 
 unfitted for prolonged and regular labor. They are bad work- 
 men, bad tenants, and unsafe neighbors. We shall conclude 
 what is to be said of the benefits of a good sanitary system, 
 both to the rich and the poor, by repeating that right royal 
 sentiment of Prince Albert, on the occasion of his taking the 
 chair at a meeting of the " Society for improving the Condition 
 of the Working Classes." u Depend upon it," said the 
 princely chairman, " that the interests of the often-contrasted 
 classes are identical, and it is only ignorance which prevents 
 their uniting to the advantage of each other." 
 
 Paving. The sanitary reforms which have been carried 
 out within the last ten or fifteen years in Great Britain, and 
 those which are still in progress, following as they do a care- 
 ful investigation of the evils and abuses to be corrected, 
 enable us to speak with additional confidence of the import- 
 ance and economy of sanitary measures to cities, and to 
 adduce a large body of facts alike pertinent and convincing. 
 Your reporter will content himself with introducing at this 
 time some statements taken from a mass of evidence which 
 he had previously collected for other purposes. To begin 
 wtih paving ) it might be sufficient to say that the evils from 
 neglect of it are pointed out in most of the reports on the 
 health of towns, but we cannot forbear from again adverting 
 to the effects witnessed in London. Before the streets of that 
 
35 
 
 metropolis were paved, the inhabitants were as great sufferers 
 'from periodical fevers as those of the worst situated rural 
 districts in our own country, and until underground drainage 
 had been adopted to some extent, dysentery was common and 
 .* largely fatal. Drawing on home experience, it has been found 
 that in Philadelphia, the exemption of the inhabitants from 
 intermittent and bilious remittent fevers has, with great uni- 
 formity, followed the paving of the streets. The space now 
 called Dock street was, in the early days of the history of 
 Philadelphia, a miry swamp, traversed by the sluggish stream 
 Dock creek, on either side of which periodical fevers, of 
 all grades, prevailed with a violence equal to those met with 
 in the most sickly districts in distant States. The exposed 
 surface having been paved, and the creek partly filled up and 
 covered over, and made the line of a great culvert, no person 
 residing there now has any apprehension of fevers, such as 
 those that affected the former dwellers there. A like change 
 from the operation of a similar cause has been wrought in the 
 districts of Southwark, Kensington, aud Richmond. The 
 change in the sanitary condition of Southwark is the more 
 obviously due to paving and subsequent attention to scaven- 
 gering, as the greater part of the drainage is on the surface, 
 owing to the limited extent of sewers. 
 
 A.n important lesson is deduced from the history of the 
 foundation of new cities, or the extension of the streets of old 
 ones, viz. : that paving ought to precede the erection of 
 houses, and drainage follow habitation at a very early period. 
 A neglect of these two preliminary conditions for public 
 health has been productive, in all ages, of a fearful waste of 
 life ; we say waste, because the deaths were readily prevent- 
 able. Actually at this time the pavement of the seventy 
 miles of streets in Boston furnishes a cheap protection to 
 the inhabitants against the evils arising out of the constant 
 presence and accumulation of town mud and filth, and other 
 
36 
 
 abominations which it would be impossible to remove from 
 any ground not coated in this way. This is the more evi- 
 dent when we learn that for the length of seventy miles of 
 streets, there are but twenty-five miles of sewers, many 
 of which were some years ago one third to one half filled 
 with mud. Baltimore is mainly indebted to street pavement 
 for the drainage which is done at the surface, as the aggre- 
 gate length of all the sewers ten years ago did not exceed 
 two miles. One of the most remarkable examples of the 
 beneficial change in the health of a city produced by paving 
 its streets, is furnished in the history of Louisville, Kentucky, 
 which from being called the grave-yard of the West, is now 
 regarded as one of the most healthy cities of that extensive 
 region. Intermittent fever was, as we learn from Dr. L. P. 
 Yandell, a regular annual visitor, and occasionally a form of 
 bilious fever prevailed, rivaling Yellow Fever in malignity, 
 and threatening to depopulate the town. The citizens, 
 awakened, after the fever of 1822, to a sense of their condi- 
 tion and to the means of mending it, set about a system of 
 improvement, the chief feature of which was paving of the 
 streets and filling up of the ponds. The change in the sani- 
 tary character of Louisville is the more noticeable, as it was 
 brought about without the aid of subsoil drainage by sewers. 
 It has been truly said that fever loves the banks of rivers, 
 the borders of marshes, the edges of stagnant pools ; it makes 
 itself at home in the neighborhood of cess-pools and badly con- 
 structed drains, and takes especial delight in the incense of 
 gully-holes. It should be added at the same time, that fever, 
 at least of the periodical kind, will be prevented from show- 
 ing itself by its favorite haunts being covered with a good 
 pavement, so as to separate at once and permanently from the 
 sun and air, the bed of moist putrefactive materials which 
 ferment and give rise to the continual evolution of noxious 
 gases. But the guardians of the public health must not relax 
 
37 
 
 their vigilance after the construction of suitable street pave- 
 ments, for, unless there be enforcement of a regular system of 
 scavengering, their surface will soon be covered with semi- 
 fluid mud, and offal, and vegetable and animal refuse, which 
 will represent too faithfully and fatally the banks of rivers, a 
 marsh, or the edge of ponds, and the contents of cess-pools 
 and gullies. 
 
 Cleansing of the Streets. Cleansing of the streets, by a 
 proper system of scavengering, is called for, both by the re- 
 quirements of health and of comfort. The streets have been 
 said, with justice, to be the reservoirs whence we are supplied 
 with fresh air, and if it be impure in them, it is impure every- 
 where. It is not endugh to prevent the access of foul air from 
 untrapped and unwashed drains, but also from surface filth, 
 and the remains of any kind accumulated in the streets. 
 Further, continues the writer who makes these remarks, Mr. 
 P. H. Holland, of Manchester, dirty streets cause dirty 
 houses, dirty clothes, dirty persons ; every one walking in 
 them in wet weather carries into his house some portion of 
 dirt, to increase the difficulty of domestic cleanliness. In 
 dry weather the same effect is perhaps more powerfully pro- 
 duced by constant clouds of dust. 
 
 Economy of Street Cleaning. The great obstacle to in- 
 creased cleanliness of the streets, is the expense of frequent 
 scavengering. Mechanical ingenuity has, within a few years 
 past, obviated, in a considerable degree, this objection. Mr. 
 Whitworth, the celebtated mechanic of Manchester, has per- 
 fected a sweeping machine, by means of which he is enabled 
 to sweep. the streets of that town three times as often as they 
 used to be by hand, and at the same cost. In Birmingham, 
 Leeds, London, and several other places, this machine has 
 likewise been worked with success. In Liverpool, from some 
 unexplained cause, it has not given equal satisfaction- 
 
38 
 
 The expense of cleaning the streets and ash-bins, &c., is 
 balanced by the sale of ashes and dust by the parishes of 
 London. The experience of Edinburgh shows that, under 
 proper officers, the daily cleaning of the city, and of its 
 numerous courts and closes, is attainable at the moderate 
 expense of ten thousand dollars a year. In Aberdeen, the 
 work is done daily, at a profit to the city of a sum equal to 
 three thousand dollars. In Hull, they have discovered that 
 they can readily dispose of to small farmers who find it their 
 interest to collect it the refuse from the houses, even in the 
 courts and alleys, which are inaccessible to carts. Small 
 streets, as well as courts and alleys, are apt to be neglected 
 by the scavengers, and if any of these be unpaved, stagnant 
 puddles are the consequence, and the atmosphere, necessarily 
 close and confined in such spots, becomes still further deteri- 
 orated by the accumulations of refuse and filth, not to speak 
 of the presence of open privies. 
 
 Sewered and Unsewered Districts compared. In con- 
 trasting the effects on the health of the inhabitants of sewered 
 with unsewered districts in the same town, we are met by the 
 remarkable example of Ashton-under-Lyne in England, in 
 which the duration of life is six years more in the former than 
 in the latter portions. Equally marked results have been ob- 
 tained from the sanitary records of Chorlton, a township of 
 Manchester. While the mortality in the undrained streets 
 amounts to four per cent., in the drained districts it is 
 only two per cent. ; and that we do not overrate the influence 
 of drainage, is proved by the fact that some streets containing 
 3500 inhabitants, and exhibiting a mortality of 1 in 32 of 
 the population, were elevated immediately after having ob- 
 tained the benefit of sewerage to such a scale of health, that 
 the deaths decreased to 1 in 50, or in other words, the deaths 
 were diminished 20 a year out of every 110, even as a first 
 effect of putting the streets in a proper condition as to sewer- 
 
39 
 
 age. Other districts of Manchester give the same instructive 
 lesson. In Liverpool it was ascertained that although the 
 high mortality of 5.4 per cent, occurred in both sets of courts 
 in that city, yet that more than 22 persons in every 100 of 
 the undrained courts had serious cases of illness, while only 
 10 in 100 suffered in the same way in the drained districts. 
 The sanitary history of every city contains evidence of the 
 improvement of the public health following a good system of 
 sewerage. Proof is also furnished in the contrast offered be- 
 tween the preferred and fashionable streets as we now find 
 them, and the same spots before they had the benefit of pav- 
 ing and sewerage. In London, the west end of the city, and 
 Westminster, the seats of the residences of the nobility, and 
 where are found the courts of law and the two hous.es of Par- 
 liament, were once extensive marshes, nearly uninhabitable 
 on account of the fevers which annually prevailed there. In 
 Paris a regular system of sewerage has converted sickly and 
 almost abandoned districts into those now known as the 
 Faubourg Montmartre, the Chausse d'Antin, and the 
 Faubourg St. Honore, which are remarkable for the busi- 
 ness transacted in them, and the wealth of their inhabitants. 
 Rotherhithe, a district of London, on the south bank of the 
 Thames, has been the favorite haunt of the cholera in suc- 
 cessive periods of appearance of that disease from 1831-2 to 
 1854. Its sewerage was deplorably defective, being by open 
 sewers connected with the river. Malignant cholera spread 
 to a much greater extent on the line of open sewers than in 
 the other poor and densely inhabited places. In other dis- 
 tricts, we are told that the line of habitations, badly cleansed 
 and suffering from defective drainage, formed the line of 
 cholera cases in 1831-2. The reports of the medical in- 
 spectors, appointed by the Board of Health in London, in 
 1854, concur in showing that wherever cholera has become 
 localized, it was found to be connected with obvious remov- 
 
40 
 
 able causes. Of these, the principal were the open ditches 
 used in most instances as sewers, or receptacles of all descrip- 
 tions of filth, and receiving the drainage of numerous privies. 
 Generally speaking, the mortality from cholera was greatest 
 in the- lowest levels, owing, as may readily be supposed, to 
 their imperfect drainage, and consequently to the greater 
 humidity and impurity of the air of such places. The ad- 
 vantages that might be expected from greater elevation are 
 lost however, by defective or inefficient drainage, as in the in* 
 stance of the district of Kensal, in the parish of Chelsea, near 
 London, if not now an integral part of the metropolis. This dis- 
 trict, with the advantage of having at least 50 feet higher eleva- 
 tion than the rest of the parish, and an open airy situation, had 
 a death-rate from epidemic disease, principally diarrhoea, nearly 
 double that of any other district in the parish ; although if we 
 exclude epidemic disease, it is actually the healthiest of the 
 Chelsea districts. The defective sanitary arrangement, on 
 which this state of things depends, is described by Dr. 
 Barclay, Medical Officer of Health for Chelsea, to be inefficient 
 drainage, fecal fermentation, and the impregnation of the at- 
 mosphere with unwholesome emanations from foul drains, 
 ditches, and cess-pools. It has been said that the course of 
 Typhoid Fever in a town may be tracked by that of neglectod 
 sewerage. In Croydon, a town not far from London, in con- 
 sequence of a new but badly constructed system of drainage, 
 there occurred "an alarming outbreak of Fever, (Typhoid), 
 Diarrhoea, and Dysentery." And the relator, Dr. Letheby, 
 adds, that Dr. Carpenter, of that town, informed him "that 
 even now he can tell where the pipes are stopped, by the oc- 
 currence of Diarrhoea or Fever in the houses through which 
 the foul gases are forced." Typhoid Fever has been repre- 
 presented to be a better test than even Diarrhoea of the 
 sanitary state of a town. 
 
 The unhealthiness of an urban or suburban district, and its 
 
41 
 
 liability to visitations of Fevers and Cholera, depend in no small 
 degree on its low situation and its proximity to river-banks, 
 or to stagnant water, and too commonly still on its imperfect 
 drainage. It was said, in reference to the intimate rela- 
 tions between the activity of the disease, and the proximity 
 of the river Thames, that two causes are at work in such a 
 locality. First, increased humidity, and, secondly, and more 
 especially, the large evaporating surface of foul water, by 
 which noxious effluvia are continually given off, and poison, 
 to a certain extent, the atmosphere through which they are 
 diffused. On this point, the language held by Dr. Grainger, 
 will properly find a place on the present occasion: " It is almost 
 needless to point out," writes this gentleman, "that when the 
 numerous sewers of a city reach the stream, one part of their 
 contents widely mingling with a large body of water, under- 
 goes solution, and thus presents a physical condition favorable 
 to their subsequent escape into the atmosphere in the form of 
 mephitic gases ; whilst other portions, owing to the diminish- 
 ed velocity, sink to the bottom, near the edge of the river, 
 and thus become deposited on the banks of putrid mud, which 
 will at the next tide, being laid bare to the action of the sun and 
 air, exhale poisonous effluvia." This writer adds, that some 
 facts came to his knowledge, showing that it is precisely in 
 those spots at the stream, which receive the principal body of 
 sewerage, that Cholera especially ravages the population. We 
 may add that it was so at Hamburg and at Berlin, in the 
 latter of which cities open drains emptying their contents into 
 the sluggish Spree, would be productive of still greater mis- 
 chief. In Paris, the evils from this cause have been felt, and 
 suggestions were made some years ago, and h#ve been in a 
 measure carried out, to construct two great tunnel sewers, one 
 on each side of the Seine, to receive and transmit to some dis- 
 tance below the city all the sewerage of the different branch- 
 sewers. A similar project is now discussed in London, so 
 
42 
 
 that the Thames may cease to Tbe, as it has been for a long 
 time past, the great common and open sewer of the metropolis. 
 In Philadelphia and New York, reforms are called for in this 
 matter, so that the mouths of the sewers, which discharge 
 their contents into the rivers of these two cities, shall not be 
 exposed at low tide, and give out poisonous effluvia, 'which 
 either directly generate malignant Fevers, or serve as exciting 
 causes on organisms predisposed by atmospherical extremes, 
 such as high heat and humidity. Without involving ourselves 
 in doctrinal questions as to the origin of Yellow Fever, we are 
 sure of receiving, from all quarters, the admission of the gene- 
 ral sameness of the localities of this disease, and that these are 
 distinguished by their consisting, for the most part, of alluvial 
 and made soil, and by their being deficient in suitable drainage 
 and analogous means of preserving the surface dry and clear of 
 accumulations of filth and the like decomposed organic re- 
 mains What is said of the Yellow Fever in New Orleans 
 will apply to other places in which it has committed its worst 
 ravages, viz., that it attacks, generally, at first, the most sus- 
 ceptible, who live in the filthiest, worst-drained and paved, 
 and worst-ventilated, and most crowded portions of the city. 
 In Philadelphia, invariably from the first visitation of the 
 Yellow Fever in 1699, to the last slight one in 1853, the his- 
 tory of the origin of the first appearance of the Fever is told in 
 nearly the same language, viz., in Dock street, near the draw- 
 bridge, the former mouth of Dock Creek, in different parts of 
 Water street, or at the water-side, or on one of the wharves, 
 between Kensington on the north, and Southwark on the south 
 end of the city. In 1699 it broke out in the vicinity of the dock 
 at the end of Spruce street ; and in 1853 on or near the wharf 
 at the Delaware corner of South street the two spots being less 
 than three hundred yards apart. Near the latter of the two, 
 the mouth of a large sewer was exposed at low tide, and the 
 emanations from its imperfectly discharged contents left to 
 
43 . 
 
 poison the air around. In New York, a still worse state of 
 things prevails, not only from the same cause, but from the 
 slips and docks, especially on the East River, being made the 
 receptacles for all kinds of offal and refuse, thrown into them 
 from the wharves and the vessels. 
 
 SEWAGE AND SEWER GASES. The virulent and actively 
 poisonous nature of the emanations from sewage, whether at 
 the terminations of the sewers left exposed in the manner 
 now described, or in the course of its passage under the 
 streets of a city, from gully-holes or leaks in the public sewers, 
 as well as in the private drains leading into these latter, have 
 been investigated with considerable care of late years both in 
 London and Paris. In the British metropolis, Drs. Barker 
 and Letheby, the first in a paper in the Sanitary Review and 
 Journal of Public Health, Vol. IV., the second in a Report 
 to the Commissioners of Sewers of the City of London, 
 have entered very fully and ably into the subject. Dr. Bar- 
 ker instituted a number of experiments on animals, with a 
 view of showing the toxical effects of the chief gases in 
 sewer emanations, viz., carbonic acid, sulphuretted hydrogen, 
 and ammonia, or rather sulphide of ammonium. A mouse, 
 exposed in a cage to the air of a cess-pool, within three inches 
 of the surface, although it was well fed at intervals, died on 
 the fifth day. Dogs thus exposed suffered from vomiting, 
 diarrhoea, and febrile symptoms, rigors, restlessness, thirst, 
 and loss of appetite. The gases above named were then ex- 
 perimented with separately. A puppy, exposed to less than 
 two per cent, of sulpheretted hydrogen in the common air, 
 was destroyed in two minutes and a half, without a struggle, 
 and so small a proportion as 0.428 per cent, killed another 
 in an hour. A dog, exposed to 0.205 per cent, of this gas, 
 was affected within a minute by tremors, and fell on his side. 
 The action of the heart became irregular, and within four 
 
44 
 
 minutes the respiration had apparently ceased, but after 
 awhile was renewed. After one hour and thirty-eight minutes 
 the dog was removed from the box containing air mixed with 
 sulpheretted hydrogen as above. The respirations, which had, 
 previously, at one time three quarters of an hour from the 
 beginning of the experiment been 112 and even 120 in a 
 minute, became suddently stertorous, as in apoplexy. On 
 the removal of the dog the respirations were stertorous, the 
 limbs rigid, and the head was drawn backwards : the animal 
 died nine hours and thirty-eight minutes after the commence- 
 ment of the experiment. A second dog, similarly exposed, 
 suffered at first, but soon revived, and at the end of five 
 hours, was removed without exhibiting any morbid effect. 
 Another was attacked with tremblings and diarrhoea after 
 breathing the gas ; a fourth with all the appearances of in- 
 toxication. Ammonia and its salts produced what Dr. 
 Richardson, in his Essay on the Causes and Coagulation of 
 the Blood, considers to be unmistakably typhoid symptoms. 
 The minute quantity of 0.056 per cent, or 56 parts of sul- 
 phuretted hydrogen in a thousand of common air, is sufficient 
 to produce serious symptoms eructations, tremors, rapid and 
 irregular respiration, extraordinary rapidity of the pulse, and 
 diarrhoea. The inhalation of carbonic acid in small propor- 
 tions was followed by diarrhoea. Dr. Barker arrived at the 
 following conclusions, which may be received as a fair expres- 
 sion of the facts : 
 
 " The symptoms which have been noticed as resulting 
 from the inhalation of sulpheretted hydrogen, sulphide of am- 
 monium, and carbonic acid, are sufficient to account for the 
 effects arising from cess-pool effluvia, without seeking for any 
 further product from such emanations. Comparing the expe- 
 riments with cess-pool air with those in which separate gases 
 were employed, the inference seems clear to my mind, that 
 the symptoms arising from the inhalation of cess-pool atmo- 
 
45 
 
 sphere were due mainly to the presence of a small amount of 
 sulpheretted hydrogen, which gas was always present. If the 
 experiments with the cess-pool air be placed side by side with 
 those in which sulpheretted hydrogen, in the proportion of 
 0.056 per cent, was administered by inhalation, the analogy 
 between the two sets of results will be sufficiently un- 
 mistakable." 
 
 Before inquiring into the nature, and the effects on the animal 
 economy of sewage gases, Dr. Letheby examines the nature 
 of sewage itself as far as observed by this writer, in reference 
 to what is met with in England. The matters to be dealt 
 with in the public sewers of every town and city are very com- 
 plex, for they are composed not only of the solid and liquid 
 ejecta of the population, but also of the fluid refuse of every 
 branch of industry. They consist of the filth of kitchens, 
 laundries, and dye-houses; the drainings from stables, slaughter- 
 houses, and the public markets ; the various liquid impurities 
 of trade and manufactories ; and the washings of the streets 
 and alleys ; all of which, with the ejecta of the inhabitants 
 and a large quantity of water, compose the sewage of towns. 
 In Paris and the French towns generally, and in our Ameri- 
 can ones, a difference prevails in their sewage from that of 
 London and other towns in England, in the circumstance of 
 the small quantity of human ejecta which is conveyed by 
 private sewers into the public ones in France and the United 
 States. Altogether, it may be said, that the ejecta of the 
 inhabitants of London and the washings of the streets daily, 
 furnish about 233 tons of solid matter to the sewage, of 
 which 152.6 tons are of dry matter, and 293.6 of moist, and 
 these with the trade refuse, are diluted with about 84f 
 million gallons of water. It has been estimated, as data for 
 part of the preceding calculations, that 2 to 2^ ounces of dry- 
 solid matter are contained in the excrements per diem of 
 each member of the population. Another mode of estimat- 
 
46 
 
 ing the composition of sewerage is founded on the analys 
 tical results of its examination at different times and 
 places. These show that the sewage discharge by day 
 is richer in solid material than the night sewage is ; and 
 that there are considerable differences in this respect 
 between the contents of sewers situated in different quar- 
 ters of the city. " Taking the average of all the results 
 obtained in the examination of the metropolitan sewers, it 
 may be concluded that the -sewage which flows into .the 
 Thames contains about 90^- grains of solid matter in the gal- 
 lon ; of which about 29f are suspended, and 60^ dissolved: 
 there being about 15 grains of organic matter in each of these 
 constituents." " The mineral constituents of sewer-water are 
 chiefly carbonate of lime and common salt, with small pro- 
 portions of the alkaline sulphates and phosphates. They are 
 derived from urine and from the water supply. The mineral 
 part of the insoluble matter consists almost entirely of the 
 debris of the streets, and detritus of wheels and horse-shoes. 
 Their amount is about 15 grains per gallon; which, in the 
 aggregate, is as near as possible 81 tons per day for the 
 whole of the metropolis, or 19 for the city." "Then, of the 
 total amount of 485.5 tons of solid matter contained in the 
 sewage of one day, about 152.60 tons are the ejecta of the 
 inhabitants ; 81.08 tons the pulverized granite and iron on 
 the roads ; 102.04 the, saline matter contained in the water 
 supply; and the residue, 152.78 tons, is from trade and 
 manufactures. The total amount of organic matter in all 
 this is about 215.14 tons ; of which half is in a state of solu- 
 tion, and the rest is suspended. 
 
 " The physical properties of the sewage are peculiar, for 
 when it is examined under the microscope, it is found that 
 the clear supernatant part contains a large quantity of amor- 
 phus organic matter, with the filaments of various fungi. It 
 swarms with animal life, as beaded spirulina, vibriones, and 
 
47 
 
 monads ; and soon after exposure to air the higher forms of 
 infusoria appear, as paramecium, vorticella, rotifera, &c. 
 Besides which it contains small particles of animal and 
 vegetable tissues, as the fibres of cotton, wool, &c." " The 
 mineral part is composed of the debris of the streets, as 
 particles of granite, flint, and carbonate of lime, with a large 
 quantity of the black sulphuret of iron. When the sewage 
 has a very unpleasant odor, and is charged with sulphureted 
 hydrogen, it never exhibits much sign of animal or vegetable 
 life, notwithstanding that it contains an abundance of decay- 
 ing organic matter. This is the case with the foul contents 
 of the nearly stagnant sewers." 
 
 The putrefactive decomposition of sewage is noticed by 
 Dr. Letheby. Looking at the enormous quantity of organic 
 matters contained in sewage, and its minute subdivision, 
 proportion of water, and temperature, it is not surprising that 
 its decomposition should be attended with the evolution of a 
 large amount of noxious gas, or that it should at once take 
 on the putrefactive change, and begin to evolve foul gases, 
 before it enters the sewers. " Under ordinary circumstances, 
 the solid excrements do not ferment in less than three or four 
 days, but here the catalytic influences are so strong, that 
 putrefaction begins at once, and it is always of the same kind 
 as that already in progress in the old sewer matter. This 
 tendency to accelerate and direct the decomposition is very 
 remarkable. Its power lasts for weeks after the sewage has 
 ceased to ferment, or it will operate immediately in all kinds 
 of organic substances. Blood, sugar, feces, urine, and other 
 fermentable bodies are rapidly changed by it ; and they 
 evolve compounds of a most offensive character. Common 
 sugar, instead of being fermented into alcohol, is converted 
 into lactic acid, which smells like putrid pig's-wash ; then it 
 passes into butyric acid, and gives hydrogen and carbonic 
 acid, with the odor of rancid butter and human perspiration." 
 
48 
 
 Dr. Letheby points out the important part which the oxygen 
 of the atmospheric air performs in the sewers, by giving birth 
 to mineral products, as water, carbonic acid, the sulphates, 
 phosphates, and nitrates, which are the final products of 
 decay. " Its influence, therefore, is most salutary, and ought 
 not to be disregarded. Experiment has also shown that the 
 oxydizing power of the air is promoted by water, by porous 
 substances, and by the fixed alkalies." Dr. Jj. ascertained 
 that it is the solid part of the sewerage which continues to 
 ferment and keep up the putrefactive action for months, evolv- 
 ing large quantities of ammonia, sulphuretted hydrogen, marsh 
 gas, and carbonic acid. It is the sedimentary matter which 
 is the chief cause of the effluvium, and to this the writer after- 
 wards directs attention. 
 
 The Nature of the Sewer Gases. Dr. Letheby judiciously 
 precedes his observations on this subject by the observation, 
 that little can be really done in the way of providing a 
 remedy for the sewer miasms, until something is definitely 
 known of their nature and composition. He has endeavored 
 to procure the knowledge wanted, by three sets of investiga- 
 tions, viz. : "1. From inquiries into the composition of the 
 gases dissolved in sewage; 2. From an analysis of the 
 gases evolved during its putrefaction ; and 3. From an ex- 
 amination of the sewer air itself." The clear liquid of 
 sewage, when heated, evolves all the gases which were held 
 in solution. These consist of carbonic acid, sulphuretted hy- 
 drogen, ammonia, marsh gas (carburetted hydrogen), and nitro- 
 gen. Their quantity varies from about 32 to 76 cubic inches per 
 gallon ; and the proportion of carbonic acid varies from 36 to 
 72 per cent. ; the sulphuretted hydrogen from 0.9 to 3.1. A 
 fact, full of significance, in relation to the condition of that 
 river in its course through London, is stated here. It is, that 
 Thames water, near to the shore at low tide, contains the same 
 
49 
 
 > v,arly the same proportion. It was observed that these 
 gase.5* ire abundantly evolved wherever the sewerage becomes 
 stagnant, or nearly so. From the thick slushy matter in one 
 sewer (that of Catharine-wheel alley) the carburetted hydro- 
 gen, among other gases, bubbled up in such quantities that 
 it could be ignited with ease, and would thus set fire to the 
 neighboring bubbles and produce a sheet o flame that would 
 extend for some distance along the surface of the sewage. 
 " The gas contained G3 per cent, of inflammable air ; 17.6 of 
 carbonic acid ; 14.1 of nitrogen, and 0.2 of sulphuretted hydro- 
 gen. The amount of ammonia contained in the liquid of sew- 
 age is also considerable. It ranges from 3 to 15 grains in 
 the gallon of ordinary sewage, and from 15 to 41 in that of 
 nearly stagnant sewers. In addition to all these, there are 
 other volalilc compound3 which have not yet been isolated 
 compounds which give to the sewage its peculiar odor, and 
 which Dr. Leihcby surmises may also cause its poisonous ac- 
 tion. Looking at the experiments of Dr. Baker, previously 
 noticed, we may doubt the necessity of searching for other 
 and unknown toxical agents to give rise to morbid phenome- 
 na winch are already strictly ascribable to known gases. The 
 English writer made experiments similar to those performed 
 thirty years ago in Paris by Gaultier de Claubry, which show 
 the great diminution of oxygen, the increase of nitrogen, 
 and the evolution of sulphuretted hydrogen in sewer air. He 
 was able to condense the organic vapor which rose from the 
 sewer air, as had been done by the French commissioner ap- 
 pointed to report on the cleaning and purifying of the public 
 sewers of Paris, at the time just mentioned, and of which Pa- 
 rent-Duchatelet was a member. The liquid thus obtained 
 had a very disagreeable and putrid and ammoniacal odor, like 
 that of bad sewage. 
 
 On the subject of the properties of the sewage gases and 
 their ejects on the animal system, we gather some interesting 
 
50 
 
 facts from Dr. Letheby's Report. He begins with sulphuret- 
 ted hydrogen, which experiments, performed many years ago 
 by Dupuytren and Thenard, show to be eminently poisonous, 
 even in very 'minute quantities. Horses are killed by an at- 
 mosphere containing one part of it in 250 of the air ; but 
 much less is hurtful if it be breathed for any length of time. 
 It is on record, |hat the men who were engaged in cutting 
 through the bed of the river, for the construction of the 
 Thames tunnel, suffered severely from the effects of the gas, 
 although the proportion of it in the air was hardly to be dis- 
 covered by lead paper, and could not, therefore, have exceed- 
 ed one part in 100,000. It is true that it sometimes came in 
 gushes from the fissures of the mud, but the quantity was 
 rarely sufficient to be recognizable by its odor. Strong and 
 robust men were, however, reduced to a state of extreme ex- 
 haustion by breathing it for a few months, and several of them 
 died from this cause. The symptoms with which they were 
 affected were giddiness, nausea or actual sickness of stomach, 
 and great debility. The men became emaciated, lost their 
 appetites, and fell into a state of low fever, from which, in 
 several instances, they did not recover. Chloride of lime and 
 other prophylactics were used, but the evil did not entirely 
 cease until the tunnel was opened from end to end, and free 
 ventilation established. Dr. Taylor mentions another remark- 
 able instance of the same kind of poisoning, which occurred 
 in the summer of 1857, at Clayton Moor, near Whitehaven, 
 where there is a row of small cottages built on the refuse slag 
 of some neighboring iron furnaces. In the course of two 
 days, in the month of June, thirty of the inhabitants, all of 
 whom had been for some time previously annoyed by an of- 
 fensive smell, were made seriously ill by it. In a family of 
 seven persons, consisting of a husband and wife, and five 
 children, who had retired to rest in their usual health, two 
 were found dead the next morning, and the others were in a 
 
state of insensibility. "Before the day was over, another of 
 them died, and in the course of the week a fourth. In the se- 
 cond case, a strong, healthy man came home from his night- 
 work, and went to bed ; but an hour had hardly elapsed when 
 he also was found dead. And in a sixth instance, a child 
 was taken ill in the morning and was a corpse at night." In 
 an inquiry instituted on the occasion, in order to discover the 
 cause of the mischief, Dr. Taylor came to the conclusion that 
 it was the sulphuretted hydrogen, generated by the action of 
 water on the refuse slag upon which the houses were built. 
 If the explanation be a correct one, the case is a remarkable 
 instance of the poisonous action of this gas, for the. test of lead 
 paper failed to show the presence of the poison except in mere 
 traces, that is, in quantities which could not have been great- 
 er than one part in 100,000 of the air. " These experiments 
 and observations show that sulphuretted hydrogen gas is a 
 powerful narcotic poison ; that in a concentrated state it kills 
 immediately, as with the energy of prussic acid. In a more 
 dilute form, it causes death by lingering stupor, and when 
 more diluted still, so as hardly to be discovered by the odor, 
 it prostrates the vital powers, and produces a low 'fever, which 
 may end fatally." 
 
 " Carbonic acid is also produced by the decay of organic 
 matters. It is found in the air of sewers to the extent of 0.5 
 to 2.3 per cent., and the gases evolved from the sewage itself 
 contain about 19 per cent, of it. If the gas has been produced 
 at the expense of the oxygen of the air, as happens in sewers 
 and crowded rooms, the effects are more strongly marked, for 
 under these circumstances as little as three per cent, will 
 quickly destroy life, and even the proportion of from 1.5 to 2 
 per cent, will cause almost immediate distress and feelings of 
 suffocation, with often giddiness and headache, and a sense of 
 weight and throbbing of the temples. This is sometimes fol- 
 lowed by a slight delirium, and then by an irresistible desire 
 to sleep, the stupor of which passes slowly into coma." 
 
52 
 
 Ammonia is anotner constituent of the sewer air, and is a 
 product of putrefaction. It is known by its peculiar odor 
 and alkaline reaction. It is lighter than the common air in the 
 proportion of 590 to 1000. " When ammonia is inhaled in 
 a concentrated state, it produces immediate asphyxia ; when 
 it is somewhat diluted with air, its action is chiefly on the 
 lungs ; and when it is more diluted still, and is breathed for 
 a considerable time, it liquefies the corpuscles of the blood, 
 and produces the symptoms of typhoid fever." These ob- 
 servations are confirmed by Dr. Barker's experiments. Dr. 
 Richardson, already quoted, in the same sense, finds, from 
 experiment, that the continued action of ammoniacal gas, 
 even when it is largely diluted with air, is peculiarly injuri- 
 to the animal economy : the tongue becomes dry and dark, 
 there is an involuntary action of the muscles, varying from 
 mere twitching to violent convulsions ; there are insensibility, 
 extreme sensitiveness to sound, obscurity of sight, and ulti- 
 mately, if matters are pushed far enough, death by coma. 
 The state of the organs after death tends to the same conclu- 
 sion. The blood is dark and fluid ; the serous membranes 
 show petechial spots, and the tissues are softened. " But, ;T 
 adds Dr. Letheby, " there is another property of ammonia 
 which is more dangerous still r it is that of conveying the less 
 volatile products of putrefaction into the air. In all proba- 
 bility it is the purveyor of the miasms of infected districts, 
 as it is known to have the fetid compounds of animal and 
 vegetable decomposition. It wsu the. agent which gave valid- 
 ity to the putridities of the Thames during the hot weather, 
 and it is the medium by which the more offensive matters of 
 coal gas are held in suspension. Nor is it less powerful by 
 by diffusing the sweet odors of plants and the subtle constitu- 
 ents of many perfumes. It may, therefore, act for good as 
 well as for evil. 
 
 " The volatile compounds of ammonia, with carbonic acid 
 
53 
 
 and sulphuretted hydrogen, are also injurious. The first act 
 like the alkali itself, and the second like sulphuretted hydro- 
 gen. I have found that one part of hyposulphate of ammonia 
 in 1000 of air will kill birds almost instantly, and one in 
 500 will kill rabbits." 
 
 ' Light carburetted hydrogen, or marsh gas, is also found 
 in the atmo3pliere of sewers, but it rarely occurs in such pro- 
 portion as to be dangerous ; now and then, however, it accu- 
 mulates, as it does in coal mines, and becomes ' explosive." 
 Miners are often obliged to work in an atmosphere containing 
 from 8 to 10 per cent, of the gas, but they experience no ill 
 effects from it, until the proportion rises to about 20 per cent., 
 and then they feel giddy, with a sense of weight upon -the 
 forehead 
 
 " Coal gas is likewise present in the sewers; it is not 
 found there, but escapes from the street mains. The quan- 
 tity which is let loose in this manner is enormous Gas con- 
 sumers say that from 12 to 35 per cent, of all the gas manu- 
 factured in London is lost. Now supposing that of this, the 
 leakage amounts to five per cent., which my friend, Mr. 
 Wright, informs me is about the quantity, then as much as 
 386,400,000 cubic feet of gas escape into the public ways of 
 the metropolis every year, or rather more than a million cubic 
 feet every day ; and in the city it amounts to about 25,000,000 
 cubic feet per annum, or nearly 70,000 cubic feet per day. 
 Most of this must find its way into the sewers, and therefore 
 is a matter of some importance. The chief constituents of 
 coal gas are hydrogen, and light carburetted hydrogen. The 
 former amounts to about 40 per cent, of the gas, and the latter 
 to 45. The other constituents are about 7 per cent, of car- 
 bonic oxide, 2 of nitrogen, 1 of carbonic acid, and 5 of the 
 condensable hydrocarbons, besides which, there are always 
 traces of ammonia, bisulphuret of carbon, and coal tar. The 
 principal danger from this gas is its inflammability, and ita 
 
 
54 
 
 property of forming an explosive mixture with atmospheric 
 air." " Dr. Taylor has attested the record of seven cases of 
 death from the action of coal gas, and it is probable that the 
 air was not charged with more than 8 or 9 per cent, of it in 
 any one of them." 
 
 Dr. Letheby cannot speak with certainty of the organic 
 vapor which is contained in sewer gases, " except that it is a 
 matter in a state of active decomposition ; and experience has 
 long since decided that matter in this condition has power to 
 disturb the equilibrium "of other organic molecules, and to 
 propagate to them its own state of decay. When this occurs 
 in the living animal body, it is productive of the most terrible 
 consequences. Our ignorance of the nature of this organic 
 vapor is not surprising, when we^onsider that we are equally 
 uninformed of the composition of the subtle miasms and pu- 
 tridities which abound in the air of infected districts, and in 
 the vapors of organic decomposition." " Sometimes these 
 miasms are colorless, but in the case of the sewer gases, it is 
 the organic vapor which gives them their peculiar smell, for 
 when the sulpheretted hydrogen is entirely removed, there are 
 still the characteristic stinks which have been so accurately 
 described by Parent- Duchatelet." 
 
 * What are the dangers of the Complex Sewer Gases 
 themselves f Experience has shown that they are of two 
 kinds, namely -. the dangers which are incidental to the poi- 
 sonous action of the gases ; and those which arise from their 
 explosive property." Observation has proved that these 
 gases are among the most active poisons. Passing over a 
 description of the acute forms of poisoning by them when in- 
 haled in their undiluted state, it, may be stated, as most ger- 
 man to the present inquiry, that when these gases are much 
 diluted with atmospheric air, they produce a general prostra- 
 tion of the vital powers. " The appetite fails ; the bowels 
 become disturbed ; diarrhoea of a chronic character sets in ; 
 
55 
 
 and the sufferer is either worn out by exhaustion, or he falls 
 into a state of low fever, from which it is difficult to raise 
 him." 
 
 Dr. Letheby gives additional point to this part of the sub- 
 ject by mentioning a few cases of chronic poisoning in which 
 the effects were produced by the inhalation of very small quan 
 tities of sewer miasm. We cannot forbear from repeating his 
 narrative, under a belief of their extreme appositeness to the 
 immediate purposes of this report, and for the lessons of cau- 
 tion which they furnish. One of the most remarkable instances 
 of this is recorded by M. D'Arcet. He states that there was 
 a small lodging in Paris, consisting of a bed-room and ante- 
 room, which had been successively tenanted by three vigor- 
 ous young men, each of whom died within a few months of 
 his occupying the place. D'Arcet was requested to exam- 
 ine the rooms, and ascertain the cause of the evil. He found 
 that a pipe from a privy in the upper floor ran down by the 
 side of the wall near to the head of the bed where the inmates 
 slept. The pipe was unsound, and the wall was damp from 
 leakage of the soil into it ; but there was no perceptible smell 
 in the room when D'Arcet examined it ; nevertheless he 
 had no doubt that the deaths of the former occupants 
 were referable to the emanations from the wall. The 
 pipe was therefore repaired, and from that time the un- 
 wholesomeness of the place was cured. Again, in August, 
 1831, twenty-two boys living at a boarding-school in Clap- 
 ham, near London, were suddenly seized with alarming 
 symptoms of irritation of the stomach and bowels, with 
 twitchings of the muscles of the arms and excessive prostra- 
 tion of strength. Another boy had been similarly attacked 
 three days before, and he died in twenty-five hours ; one of 
 the others died in twenty-three hours. A suspicion of acci- 
 dental poisoning naturally arose, and the various utensils and 
 articles of food used by the family were examined, but nothing 
 
56 
 
 of a deleterious nature was found. The only circumstance 
 which appeared to explain the accident was, that two days 
 before the first child was taken ill, a foul cess-pool had been 
 opened, and the matter of it diffused over a garden adjoining 
 to the children's play-ground. This was considered to be the 
 cause of the disease, and the opinion was formed not only by 
 the medical attendants, but also by Drs. Latham, Chambers, 
 and Pearson, who personally examined the whole of the par- 
 ticulars. The third instance to which I shall refer is of more 
 recent date, and has been a subject of considerable discussion. 
 In the month of August, 1852, an attempt was made to drain 
 the town of Croydon by means of small stoneware pipes, 
 which were not only of insufficient size, but were imperfectly 
 cemented together. The consequence was, that a large quan- 
 tity of the sewage escaped into the earth, and drained away 
 to the neighboring ditches. This became a subject of great 
 annoyance, and in a short time it produced an alarming out- 
 break of Fever, Diarrhoea, and Dysentry. In the report from 
 the Poor Law Commissioners on the sanitary condition of the 
 laboring population of Great Britain, there are many examples 
 of the morbific action of sewer and cess-pool gases. There is 
 one case which is remarkable for its significance. " On the 
 north side of a street in Derby there are fifty-four houses, all 
 of the same description, and inhabited by the same class of 
 persons. Six of these houses in the very centre of the row 
 became the abodes of fever, and of sixteen persons attacked 
 with the disease, five died. The fever was nowhere ebe in 
 the row, and on inquiry it was found that these, and these 
 only, were exposed to the action of sewer gases, and the miasms 
 from cess-pool matter which had soaked into the soil." 
 
 It is impossible to carry the observations and experiments 
 of Drs. Barker and Letheby in our minds without our com- 
 prehending the noxious agencies by which obstinate and often 
 fatal diseases of the digestive organs, and low fevers, are pro- 
 
duced in those parts of a town where the inhabitants are 
 continually exposed to the operation of the gases above 
 mentioned. These arise from vegetable and animal matter in 
 decay and decomposition, from obstructed gutters, open drains, 
 or from cess-pools, and the mouths and gully-holes of sewers r 
 and accidental openings in these latter. Even when not di- 
 rectly poisoned by the continued inhalation of a corrupt 
 atmosphere always charged with these gaseous poisons, the 
 people thus exposed acquire such a predisposition have their 
 vital 'energies so much reduced are primed as it were that 
 a slight change in the ordinary conditions of the atmosphere, 
 or diminution of their accustomed food, serves as a spark to 
 ignite into febrile fire their weakened and susceptible frames. 
 On the means of remedying the sewer miasms, or of pre- 
 venting the offensive and toxical effects of the emanations 
 from sewers, we cannot do better than introduce that portion 
 of Dr. Lelheby's report, the title* of which was furnished in a 
 preceding page. His manner of treating the subject gives it a 
 freshness and value that cannot fail to be acceptable even 
 after the interesting report of Dr. Van Bibber. At any rate, 
 coming directly in our line of practical precept in all that re- 
 lates to sewerage and sewage, we have not hesitated to apply 
 it to our own purposes. 
 
 "THE REMEDY FOR THE SEWER MIASMS. This is the great 
 question which you have submitted to me for consideration, and 
 the preceding facts show clearly enough that it is an important 
 question. I am far from thinking, with your engineer, that the 
 mischief occasioned by sewer gases is not of such magnitude as to 
 be worth a remedy that may cost sixpence a head to the popula- 
 tion ; nor do I believe that if you had temporized with the matter, 
 and had yielded to the demand on the part of the public, to close 
 up the ventilating gratings, which are' now so offensive, and had 
 thus turned the foul gases into the house-drains, the nuisance would 
 have been regarded simply as a domestic evil, for which the cure 
 
58 
 
 was to be sought privately and individually by those who felt the 
 annoyance ; in fact, such a proceeding would have been unworthy 
 of the trust which is reposed in you as the custodians of the public 
 health, for it would have been a matter of life or death to- the 
 great bulk of the community. 
 
 " At all times attempts have been made to destroy or neutralize 
 the offensive products of decomposition ; and the simplest way of 
 doing it has been by the use of another secret a perfume of vola- 
 tile oil, which would cover or mask the offensive body. These 
 were the correctives employed in religious worship. They entered 
 into the composition of the ointments of the high priest and the in- 
 cense of the altar, and to this day they have enjoyed a reputation 
 and general popularity which they have not deserved, for their 
 action is not on the putrid product, but merely on the sense of 
 smell, which they blunt to the action of the offensive vapor. In the 
 middle ages, when the plague, the black death, and sweating sick- 
 ness, and pestilential fever desolated the cities of Europe, immense 
 importance was attached to th$ use of perfumes ; fumigations, with 
 costly spice and rich-smelling Oriental drugs, were largely used in 
 the houses of the rich, but with no good effect. The ancients also 
 knew the value of fire as a disinfectant ; and they also made use of 
 the fumes of burning sulphur. 
 
 "But the right knowledge of the action of disinfectants and 
 deodorizers dates from a very recent period, for so late as the year 
 1773, Guyton Morveau, one of the best- chemists of France, thought 
 that the vapors of muriatic acid were the most powerful of dis- 
 infectants; and later still, in the year 1803, Dr. Carmichael Smith 
 obtained a grant of 5000 from Parliament, for a suggestion which 
 is nearly valueless, namely, the employment of the fumes of nitrous 
 acid. Chlorine gas was discovered by Scheele in 1774, and soon 
 afterwards its disinfecting properties were noticed by Berthollet, 
 but its use cannot be dated farther back than the present century, 
 when Guyton Morveau and Dupuytren first pointed out the great 
 value of it as a disinfectant ; and even then it was not generally 
 employed; in fact, its present popularity dates only from the time 
 that chloride of lime has been largely manufactured for bleaching 
 purposes. Within the last twenty years almost all the refuse 
 
59 
 
 products of the arts, and a great number of special compounds, have 
 been recommended for the deodorization of sewage, &c. They all 
 act in one of two ways ; they either give stability to the organic 
 matter, and so check its tendency to decay, or they operate on the 
 putrid vapors, and destroy their offensive properties. This they 
 do, either by fixing the effluvium, and forming compounds which 
 are inert, or by breaking up the putrid molecule and changing its 
 nature, or by expediting the process of decay, and hurrying it on 
 to the last stage of oxydation. 
 
 " Those substances which give stability to organic matter are 
 properly called anti-septics or anti-putrescents. They have always 
 been more popular than any of the second class of deodorizers, be- 
 cause of their importance in the arts. Salt, sugar, vinegar, 
 creosote, and the empyreumatic oils of wood, peat, coal, &c., are 
 examples of this class. So also are chloride of zinc, sulphate of 
 copper, and corrosive sublimate, substances which have been re- 
 spectively patented by Sir William Burnett, Mr. Margary, and 
 Mr. Kyan. Alum and the astringent matter of many vegetables 
 have likewise been used for ages as the means of preserving gela- 
 tinous tissues in the form of leather. None of these, however, 
 except the chloride of zinc, is applicable to the case before us, and 
 that operates more as a deodorizer than an anti-putrescent. In 
 fact, as I have already stated, the matters of sewage are always in a 
 state of decomposition, and cannot, therefore, be treated with much 
 advantage, unless the anti-septics are applied to them before they 
 enter the sewers ; and this, I need not say. is altogether impracti- 
 cable. Even in Paris, where there are special contrivances for 
 such a purpose, it fails, because of its utter impracticability. 
 
 " Of the second class of substances, namely, the deodorizers and 
 disinfectants, there are many which deserve notice. 
 
 " Those which combine with the putrid gases and fix them into 
 involatile form, are the metallic oxyds and their salts, as chloride 
 and sulphate of zinc; acetate and nitrate of lea<J; sulphate, 
 muriate and pyrolignate of iron ; impure muriate of manganese ; 
 the refuse of bleaching works ; common alum ; the fixed alkalies ; 
 and the salts of lime and magnesia. Most of these compounds 
 unite with sulpheretted hydrogen and ammonia of sewage, and so 
 
60 
 
 far, therefore, they remove the unpleasant smell of it, but they do 
 not touch the organic vapors. Besides which, they arc difficult to 
 apply, and are very costly. In fact, putting aside all the working 
 expenses that would attend their use, the mere cost of the deodor- 
 izers alone would range from 20,000 to upwards of 1,000,000 
 per annum for the city sewage, and from 1,000,000 sterling to 
 48,000,000 for the sewage of the whole of London. This, 
 together with the insufficiency of their power as deodorizers, and 
 the difficulty of applying them while the sewage is within the 
 sewer, deprives them of all practical utility. That power which 
 they possess, namely, the power of coagulating a great part of the 
 soluble matter of sewage, and favoring the precipitation of the in- 
 soluble, can only be applied with any chance of success after the 
 sewage has left the sewers ; and, even then, there are but two of 
 them, namely, lime and the superphosphate of lime with magnesia, 
 that can be used with advantage. 
 
 " Of the second class of disinfectants, those which act chemi- 
 cally on the volatile matter, and break them up, so as to form new 
 compounds, which are inert, the most important are chlorine, 
 chloride of lime, hypochlorous acid, sulphurous acid, and nitrous 
 acid. The first three of these, namely, chlorine and its oxy-com- 
 pounds, operate by abstracting hydrogen from the putrid vapors, 
 and perhaps, also, by decomposing water, and . setting the oxygen 
 free to destroy the miasm. The power is remarkably great, as may 
 be seen by the action of chlorine or chloride of lime on ordinary 
 sewage. Eight grains of chloride of lime, or less than an ounce of 
 the solution of chlorine, will completely deodorize a gallon of 
 sewage ; and the diffusion of a little chlorine through the worst 
 kind of sewer gases, is sufficient instantly to deprive them of their 
 offensive odor. Nevertheless chloride of lime is a costly agent. 
 If it be used in the proportion of only eight grains to the gallon, 
 it will cost nearly 57,000 a year for the deodorization of the city 
 sewage, andrfiearly 237,000 for the sewage of all London. As 
 for the gas itself, it is almost impossible go to apportion and manage 
 the diffusion of it in the sewers as not to have the chlorine or the 
 sewer gases in excess. 
 
 " Sulphurous acid and nitrous acid are still less manageable, and 
 
61 
 
 besides that they are costly, and not nearly as powerful in their 
 action as chlorine. Like chlorine, however, they disorganize the 
 putrid molecules and decompoie the hydrosulphuric compounds, and 
 fix ammonia ; but like it also they are powerful irritants, and could 
 scarcely be let lodse into the sewers without danger to the workmen. 
 " The last of the disinfectants are those which expedite the pro- 
 cess of decay, to combine with oxygen, and to become inert. Of 
 this class there are two members, namely, those which act chemi- 
 cally, and supply oxygen, of themselves, to the offensive compounds, 
 and those which merely facilitate oxydation by their physical pro- 
 perties. The manganatcs and permanganates of potash are the 
 best examples of the first class, and contain a large proportion of 
 oxygen, which they freely give the putrid organic matter, and so 
 destroy it. These compounds have been patented by Mr. Condy, 
 of Battcrsca, and he supplies them in a state of solution of various 
 strengths. That which I have used in my experiments contained 
 nearly six per cent, of the permanganate, and could be supplied at 
 a shilling a gallon. One hundred and fifty drops of it were suffi- 
 cient to deodorize a gallon of ordinaiy sewage; but the disad- 
 vantage of it is, that it has no power to destroy the foul gases which 
 have already escaped into the sewer air. Besides this, the cost of 
 the material, even if it were used in proportion of 150 grains to 
 the gallon, would be about 753,000 a year for the city sewage, or 
 more than three millions per annum for that of the whole metro- 
 polis. Looking, however, merely at the chemistry of the subject, 
 it must be admitted that Mr. Condy's solution is a powerful and 
 valuable disinfectant. 
 
 " The second of this class of disinfectants are the agents which 
 promote oxydation by a physical property, that is by bringing the 
 putrid matters into contact with atmospheric oxygen. There are 
 three of them, namely, fire, water, and porous solids. The first 
 effects the change by active combustion, and the others by the 
 slower process of oxydation, which is called eremacausis or slow 
 burning. All of them, however, are complete in their action, 
 and are under different circumstances more or less manageable 
 and useful. 
 
 " The value of fire as a disinfectant was known and has been 
 
recognized since the remotest time. The sacrificial altars of early 
 nations were the rude methods by which the agent was employed ; 
 and so fully did the ancients believfe in its salutary action, that in 
 times of pestilence it was often resorted to as the only effective 
 means of purifying the atmosphere. In the popular mind there 
 has always been a notion that the plague of London was extermi- 
 nated by the great fire. Powerful, however, as the agent is, it does 
 not appear to be applicable to the destruction of the sewer gases, 
 notwithstanding that the use of it for such a purpose has always 
 been a favorite idea with every new commission to sewers, and is 
 the basis of most of the amateur schemes of the present day. Mr. 
 Bazalgette has stated, in his evidence before the House of Com- 
 mons, that putting aside all the difficulties for controlling the course 
 of the air, in the main channel of the sewers, and stopping the 
 leakage from the thousands of openings in the street closets and 
 drains, the mere cost of fuel for the furnaces would not be less 
 than 80,000 a year, and perhaps it might reach to upwards of 
 200,000. 
 
 " The destruction of the sewer miasms by the agency of water is 
 not quite so unmanageable, and has therefore received attention from 
 many of the leading engineers of the present day. Mr. Bazalgette 
 says of it, that it is the best and the only available means of purify- 
 ing the sewers. As to its salutary action there can be no doubt, 
 for its power as a disinfectant in the presence of atmospheric air is 
 manifested in every river in the kingdom. Wheresoever the putrid 
 refuse of a town mixes with a large volume of fresh water, there 
 the process of oxydation is quickly carried out, and the offensive 
 matters are rendered innocuous. Even the river Thames, except 
 at a peculiarly dry and hot season, finds within itself a means of 
 purification which is quite equal to the contaminating influence of 
 the soluble organic matter that flows into it. This is effected by 
 the physical power which water possesses of transferring oxygen 
 from the atmosphere to the putrid products, and this is so great that 
 it will even destroy the soluble organic constituents of ordinary sew- 
 age without further dilution with water. I cannot inform you 
 very accurately what quantity of water is necessary for the purpose 
 of disinfection. Already there is a daily supply of about thirty-one 
 
63 
 
 gallons to each of the inhabitants of this metropolis. But this is 
 evidently not sufficient to cleanse the sewers, for, independently of 
 the existence of a putrid atmosphere, there is the stronger evidence 
 of their foulness and the condition of the sewage which is discharged 
 after a heavy fall of rain. And even if it could be determined pre- 
 cisely what amount of water would effect the purpose, there is still 
 the difficulty of distributing it so as to scour out all the channels ; 
 for this could not be accomplished without special contrivances for 
 delivering the water at the head of every drain. I do not therefore 
 see much prospect of success in this mode of dealing with the sub- 
 ject. 
 
 "The last means of destroying the offensive matter is by the 
 agency of porous solids ; and this may be applied either to the sew- 
 age itself, or to the gases which are evolved from it. The best 
 examples of such an agent are common clay and charcoal. Both 
 of them operate in the same way, namely, by condensing the putrid 
 vapors within their pores and upon the surface, so as to cause them 
 to unite with atmospheric oxygen, and produce in fact a species of 
 slow combustion, by which the miasms are gradully consumed. To 
 effect this, however, there must be a free access of atmospheric air. 
 Hence it is these substances have but a limited power of deoxyda- 
 tion where they are mixed with a liquid sewage, or are so over- 
 charged with water as to be incapable of absorbing oxygen. 
 
 " Every one is familiar with the deodorizing power of common 
 earth ; in fact, the grave-yards of every city testify to the enormous 
 quantities of organic matter that can be disposed of through its 
 agency, and no one who has witnessed the rapid deodorizing power 
 of clay when sewage or night-soil is distributed upon the land, can 
 doubt its efficacy. The Chinese have long taken advantage of this 
 power, for they mix night-soil with one third of its weight of fat 
 marl, and knead it into cakes, which are common articles of com- 
 merce. In practice also, it is found that a ton of clay will deodorize 
 about three tons of the solid matter of sewage. But, powerful as 
 is this action, it is not applicable to liquid sewage. Even in the 
 case of charcoal, which is a much more energetic deodorizer than 
 common clay, the power is speedily lost when it is mixed with fluid 
 refuse. Dr. Hofman found that four cubic feet of charcoal began 
 
64 
 
 to lose their power of dcodoriza,tion>when about seventy-eight gal- 
 lons, or rather more than three times their bulk, of the sewage had 
 passed through them. Mr. Blythe's experiments are to the same 
 effect. To this I may add that the cost of this mode of deodoriza- 
 tion would be upwards of 230,000 a year fur the city sewage. The 
 remedy would be but imperfect, to say nothing of the fact that it 
 would contribute largely to the solid matter already in the sewers. 
 " The most effective way of using charcoal as a deodorizer, is to 
 take advantage of its power of absorbing the putrid miasms when 
 they are in a vaporous condition. This power is remarkably great. 
 It was noticed by Sausure as far back as 1814, that charcoal took 
 from 75.90 times its bulk of various gases. Count Morozzo had 
 also observed the same fact, and had directed attention to it ; and later 
 still, Messrs. Allen and Pepys found that different kinds of charcoal 
 had different powers of absorption ; and yet it is only very recently 
 that we have been well informed in this matter, and we owe our 
 knowledge of it to the researches of Dr. Stenhouse, who in 1853 
 had his attention directed to the fact, that when dead bodies of large 
 animals are covered with a layer of charc6al, they putrefy without 
 evolving any unpleasant odor, notwithstanding that they are kept 
 for many months. 
 
 " 
 " Charcoal as an Air-Filter. These results suggested the use of 
 
 charcoal as a respirator and an air-filter, and soon after Dr. Sten- 
 house proposed it as a purifier of the foul gases which escape 
 from the street gullies, the sewers, ventilators, and the drains of 
 private houses. One of his air-filters is in action in the justice-room 
 of the Mansion House, and another is in the justice-room oi Guild- 
 hall, and Dr. Stenhouse reports that their operations have been 
 successful and continuous for a long time. I have myself repeated 
 some of Dr. Stenhouse' s experiments during the last twelve months, 
 and have ascertained that the offensive gases from a close cess-pool 
 are completely deodorized by passing them through a small box con- 
 taining about thirty-six cubic inches of coarsely powdered peat 
 charcoal. I have had this in continual action for three months j 
 and although the charcoal has not been renewed, yet it does not 
 show any sign of derangement or loss of power. 
 
65 
 
 * All kinds of charcoal are not however, equally valuable for the 
 purpose. Dr. Stenhouse found that wood charcoal and peat char- 
 coal are the most effective. Mr. Blythe's experiments at the Board 
 of Health, and the inquiries made in my own laboratory by Mr. 
 Fewrell, are to the same effect. The cause of this superiority is 
 doubtless due to the great porosity of vegetable charcoal. Liebig 
 states that the pores in a cubic inch of beech-wood charcoal must, 
 at the lowest computation, be equal to the surface of one hundred 
 square feet, and several other chemists have estimated it at more 
 than double this amount. Hence the extraordinary physical power 
 of wood charcoal in condensing gases and vapors within its pores ; 
 so that when it is exposed to an atmosphere containing the putrid 
 products of decomposition, it absorbs and oxydizes them by a spe- 
 cies of combustion that is as effectual as if they were passed through 
 the ignited coals of a furnace. 
 
 " Now in making a practical application to these facts, it is mani- 
 fest that we have in common wood charcoal a powerful means of 
 destroying foul gases of sewers. How it is to be applied is fortu- 
 nately a question of but little embarrassment, for let the sewers be 
 ventilated as they may, either by open gratings in the street or by the 
 rain-water pipes of the houses, or by pillars of the gas-lamps, or by 
 tubes carried up at the landlord's expense from the drains of every 
 house, or by especial shafts of the public street in fact, let the 
 gases go out of the sewers how they will and where they will, you 
 have but to place a small box containing a few pennies' worth of 
 charcoal in the course of a draft, and the purification of the air will 
 be complete." 
 
 SYSTEM OF SEWERS. To procure the most efficient system 
 of sewerage, by a well-connected system of sewers, and to 
 determine their proper level, and the degree of declination of 
 which they are capable, according to the situation and nature 
 of the soil of the place, as well as to ascertain what are the 
 best materials for their construction, and the diameters best 
 adapted to give them proper powers of transmission, are ques- 
 tions which, although they must Tbe investigated and deter- 
 5 
 
66 
 
 mined by the civil engineer, are still of lively interest to the 
 professional sanitarian. Thus, for instance, he will tell us 
 that the very large sized sewers, such as the Cloaca Maxima, 
 unless intended for trunk sewers running the entire length of 
 the city, are not serviceable. Egg-shaped culverts of a 
 moderate sfee, and, preferably still, circular pipes of small 
 diameter, and perfectly smooth and glazed, are superior, by 
 far, to the sewer with upright sides and flattened segmental 
 invert. It would be difficult to estimate the great amount 
 that might be saved not only by a judicious system of sewer- 
 age, but even by a proper form of sewers, unless from data 
 such as those furnished some years ago by Mr. Williams in 
 his examination before Commissioners of whom we have pre- 
 cedingly spoken. In the Westminster district of London, in 
 forty miles of covered drains built during a period of ten years, 
 a loss of a sum equal to 333,348 dollars was incurred by 
 faulty construction. In the whole metropolis, which includes 
 the city of London, Westminster, the Holbom and Fins- 
 bury districts, and the Tower Hamlets, also the Surrey and 
 Kent portions, which include the borough of Southwark, it 
 appears that, during a period often years, about 220 miles of 
 sewers were built. The difference between the expense ac- 
 tually incurred in this work by the construction of upright 
 sided sewers with man-holes, and that which would have been 
 required by egg-shaped or arched sewers, with a flushing ap- 
 paratus, was a quarter of a million of pounds sterling, or about 
 one million and two hundred and fifty thousand dollars. 
 There is much less friction and risk of detention of sewage 
 when the conveying duct is egg-shaped or circular. Even 
 the opening of gully-holes, or the introduction of a gully- 
 neck in the crown of the arch to admit the surface-water of 
 the street into the sewer, produces accumulations. The plan 
 so common in London of forming the opening of private or 
 house-drains at right angles to the sewers, and, to aggravate 
 
67 
 
 the difficulty, of having them to approach the culvert at an 
 elevation of eighteen inches or two feet above the latter, com- 
 bines both objections ; that of flattened invert and the junc- 
 tion of two sewers at right angles to each other. When 
 sewers meet at right angles, there is a diminution of velocity, 
 and eddies are formed, as well as injurious accumulations of 
 deposit above the point of meeting ; the rectangular mode of 
 junction of the sewers increasing the resistance more than 
 200 per cent. It is of great importance that the internal 
 surface of the sewer should be perfectly smooth, and in order 
 to retain this property, that it should be built of indestructible 
 materials, in part for reasons already assigned, and also to 
 prevent inequalities and cavities from being formed, and the 
 risk of falling of the entire wall by its becoming a burrow for 
 rats, which have a great partiality for public sewers. Of 
 equal necessity is a suitable declination in the line of the 
 sewer, from its upper end, or in the heart of the city, to its 
 termination in a river, or in a reservoir for the purpose. Mr. 
 Hosking, whose calculations were made on certain low situ- 
 ations in Westminster, assumes that a fall of two inches the 
 hundred feet, with a good back-water from a river, at equal 
 intervals, would be sufficient. 
 
 So imperfect was the public drainage, not many years ago, 
 in even the best parts of London, as in Regent street and 
 Portland place, that, according to the testimony of Mr. Guth- 
 rie, before the Health of Towns Commissioners, there was 
 not, at the time he made his observations in those streets, one 
 gully clean in twenty that were not greatly choked up, and 
 this even during heavy falls of rain. An idea may be had of 
 the little interest felt in a system of progressive sewerage, from 
 the fact, that in some large towns of England, as Wigan, 
 Rochdale, and Bolton, there was not, some years since, the 
 slightest knowledge of the plans of the sewers already made. 
 Neglect of this kind should serve as a warning to the munici- 
 pal governments in the United States to avoid similar faults. 
 
68 
 
 The escape of deleterious emanations from sewers is pre- 
 vented by traps or valves at the opening in the upper part, 
 and the termination of the other end under water ; and, if the 
 opening at this end is exposed at low tides, by closing it with 
 a gate. In London, Liverpool, and Glasgow, and in Paris and 
 Hamburg, as well as in Boston, New York, and Philadelphia, 
 the mouths of the sewers are exposed at low tide, and constitute 
 an offense to the nostrils, and a probable source of disease. Of 
 the ventilation of sewers we shall speak after awhile. Unless 
 there be an abundant supply of water for keeping the lower 
 and branch drains free from obstruction and accumulation, 
 they will prove a source of annoyance and disease. To give 
 effect to these means, a general and systematic survey of the 
 different levels of a town should be made, and a uniform plan 
 of sewerage adopted. Much trouble, expense, and sickness 
 will be saved in its subsequent history, if these measures be 
 adopted in the beginning of every new town. The rise of 
 such is common enough in our widely extended country, in 
 which the direct wants and necessities of trade, and emulous 
 speculation are continually urging its people to new schemes 
 the foundation of a second Tyre or Alexandria, of another 
 Persepolis, or Carthage, or Rome. As a general rule, each 
 house-drain at least ought to be provided with a trap or valve 
 to prevent the escape of emanations from the drain into the 
 house. Especially is this necessary where the supply of 
 water is not enough to keep the drain clean. Mr. Simpson, 
 advocate of Edinburgh, urges strongly the advantage of a 
 separation of sewers proper from surface-drains ; the first 
 holding sewerage proper, the second giving passage to rain 
 and melted snow. He recommends the entire abandonment 
 of built sewers, and the substitution of close pipes or tubes in 
 their room. 
 
 The entire separation of sewerage from rain-fall is strenu- 
 ously urged by Mr. F. O. Ward, in a letter to William Cun- 
 
69 
 
 ingham, Esq., Member of Parliament, in relation to the puri- 
 fication of the river Thames. Mr. Ward's cardinal proposition 
 is, " that the whole of the rain-fall is due to the river, the 
 whole of the sewage to the soil." And again, "that just as 
 on the one hand, the sewage proper should be carefully di- 
 verted from the Thames, just so, on the other hand, should 
 the rain-fall be directed to the Thames, to aid its scour which 
 suffers from every drop withdrawn. To divert a rain-brook is 
 to mutilata a river." Both sewage and rain-falls are rendered 
 useless by admixture. 
 
 The proportions of the two, apart from economical consider- 
 ations connected with the disposal and utilization of sewage, 
 forbid recourse to the same system of conduits for their con- 
 veyance. The average weight of the residuum (excluding 
 moisture) yielded to the sewage by each man, woman, and 
 child in London, is about two ounces per diem, and by the 
 entire population, 139 tons in this period.* This is an insig- 
 nificant quantity, if delivered as fast as produced. "But in- 
 stead of taking measures to secure to London this regular de- 
 cimal evacuation, we keep, on the most moderate estimate, at 
 least twelve moaths' excretS constantly stagnating under 
 ground, as deposit in the cess-pools and sewers. The mass of 
 putridity thus constantly 'retained in subterranean London ac- 
 tually equals one day's evacuation of the whole population of 
 Europe and Asia, numbering eight hundred millions." 
 
 The rain-fall on the London drainages, Mr. Ward thinks, 
 may yield to the sewage some eighty or ninety millions of 
 tons annually a total about equivalent to the annual total of 
 sewage. Were the *fall of rain equally distributed through- 
 out the year, it could, like the sewage, be easily disposed of. 
 
 * Dr. Letheby, as will have been seen in a preceding page, estimates the 
 dry solid excreta of each inhabitant of the metropolis, to amount to from 2 
 to 2 ounces, and the entire amount of solid matter contained in the sewage 
 of one day, to be about 152.60 tons. 
 
70 
 
 But so far from this being the case, the whole of the rain-falls 
 on one hundred and fifty-two days of the year, and of the an- 
 nual twenty-four inches, sixteen fall on forty-four days or 
 two thirds of the rain in about one eighth of the days. The 
 disproportion between sewage and rain-fall is such, that, in 
 one day in twelve, the former is to the latter as one to four 
 and three quarters; in ten days in the year, as one to nine and 
 a half; and on some few occasions, annually it is as one to 
 nineteen, and upwards. Nor is the rain-fall assigned to each 
 rain-day diffused over twenty-four hours of time ; R) that, for 
 example, seven millions of tons of rain, equal to more than a 
 month's sewage, sometimes fall on London in a single hour. 
 " The mixed streams of rain-fall and sewage, liable to be 
 thus suddenly swollen, exceed the capacity of any tunnels that 
 can be built for their diversion from the river, and would over- 
 flow in any mechanism at our disposal for their distribution 
 upon the soil." 
 
 Let us, with Mr. Ward, consider the effect of a sudden rain- 
 storm falling on London, and pouring through the over- 
 charged subterranean receptacles in the shape of sewers par- 
 tially banked up with the accumulated sewage. Suppose it 
 were to sweep into the river nine or ten days' accumulation of 
 filth ; this would be enough to discolor the tidal river, and in 
 hot weather render its waters putrescent for several days. 
 The money-loss on every such occasion would be, in ammonia 
 only, without reckoning phosphorus, nearly sixteen thousand 
 pounds sterling $80,000. 
 
 Up to the point of meeting of the two streamlets, the one 
 of the rain from roof and area, and the other of the sewage, 
 from closet and sink, we are free to apply each of them to its 
 proper use. " We can send the unpolluted rain-fall to scour 
 the river, and the undiluted sewage to fertilize the land. But 
 directly this junction-point is passed, directly the rivulet of 
 cistern-water, rich with its freight of ammonia and phospho- 
 
71 
 
 rus, meets and mingles with the casual rain-fall, the two 
 waters become, as we have seen, a worthless, unmanageable 
 mixture, equally unfit for agricultural and urban use. Not 
 only do they cease to be our property, and pass beyond the 
 control of art, but they revert to the domain of nature, spoiled 
 even for her simple service. For this error we are punished 
 by pestilence." 
 
 Mr. Ward speaks in terms of gratification at his having, 
 with his friends, succeeded in establishing the tubular drainage 
 of houses and streets, after a ten years' struggle with the 
 engineers. The tubular sewers "are now working successfully 
 by hundreds of miles, not only in provincial towns, but in 
 the metropolis itself." The writer is confident "that this tubular 
 purification of the Thames, will* ultimately supersede the 
 monstrous tunnel process, which, if adopted, would cost us 
 many millions, and turn out a gigantic failure after all." 
 
 Dr. Huxley proposes to combine the embankment of the 
 Thames on both sides, throughout the metropolis, with the 
 formation of main sewer canals, the contents of which shall be 
 subject to a tidal flushing towards the mouth of the river 
 twice daily from flood to two thirds ebb. The fall in the canals 
 should be only that of the river itself. At certain intervals, 
 the canals would leave the river edge (the embankments to 
 cease), and take a subterranean course by tunnels five in 
 number, and in length twenty miles on the north side, and 
 three in number, and seventeen miles in length on the south 
 side of the river. By means of the upper divergings from the 
 river, the port of London would be left untouched, while the 
 lower tunnels would obviate sharp bends in the river, which 
 would offer obstacles if followed in the course of the canals. 
 
 The depth of the canals should be three feet below the 
 lowest ebb of the stream ; their height, four feet below the 
 soil and pavement of the embankment. Taking the rise of 
 the Thames at London Bridge at twenty feet, the canals would 
 
72 
 
 thus be twenty-five feet in depth, and the top of the embank- 
 ment six feet above high water. The breadth of the canals 
 might be determined according to the area required say 
 twenty feet, which would give a sectional area of five hundred 
 square feet. All London surface-water, as well as sewage, 
 should be allowed to enter the canals, both as an assistance to 
 the movements of their contents, and a means of frequently 
 lessening the amount of the river-water abstracted from the 
 canals for the purposes of navigation. 
 
 If the saving of the sewage for the purposes of agriculture 
 be a settled question, the required accessibility might be ob- 
 tained at those points on the canals where it is proposed to 
 make them open to the air (Rainham Creek,* Gray's 
 Thurrock, and Plumstead ]\f arshes). 
 
 " Greatness of the cost is," Dr. Huxley thinks, " about 
 the last consideration which ought to deter from any scheme 
 embracing the power really to do the work. If five millions 
 sterling were required and spent, five per cent thereon would 
 not exceed two shillings per head per annum on the popula- 
 tion of London."* 
 
 The editor of the Sanitary ^Review, Dr. Benjamin W. 
 Richardson, in some remarks and suggestions on this subject 
 (No. xlv.), while noticing the exaggerations respecting the 
 existing evil, admits the necessity of cleansing the Thames, 
 and that such arrangements should be made as shall at once 
 lead to the constant and ready removal of the sewage with 
 which the water is loaded. " Among the temporary plans for 
 relieving the river of its dirty burden, the one most likely to 
 answer the purpose for the present, and it may be for the 
 future, consists in adopting for the direct removal of sewage, 
 a system resembling the present water-conveyance system. 
 A series of pipes laid down on the river-side to receive the 
 sewage flow, and convey it towards the sea from the city, 
 
 * Sanitary Review^ No. xiii. 
 
73 
 
 would at once meet the emergency," as in the plan proposed 
 by Mr. Austin, and in that as described, on a grand scale, by 
 Dr. Huxley, just now placed before our readers. 
 
 "There is yet," writes Dr. Richardson, "another idea 
 which has occurred to us, and which deserves at least as much 
 consideration as the majority of the schemes which have been 
 brought before the public. This idea suggests that floating 
 reservoirs might be constructed for the reception of the sewer 
 flow. We see no reason why the contents of a sewer might 
 not be intercepted by a floating reservoir, through which the 
 water part of the sewage might filter, and which, when charged 
 with the solid and valuable sewage matter, might be lugged 
 away for its contents, to be disembarked elsewhere, and dis- 
 posed of for agricultural purposes. We doubt not, that with 
 this arrangement rendered practicable, all the cost of sewage 
 removal would be undertaken by private enterprise. The 
 lading of sewage vessels with valuable cargoes, indeed intro- 
 duces merely a new business for the river sailor." 
 
 In London, as we learn from the instructive " Eeport on 
 the Results of Examinations made in relation to Sewerage in 
 several European cities," by E. S. Chesbrough, Chief En- 
 gineer of the Board of Sewerage Commissioners, Chicago, 
 there were, in a grand total of 934 miles of covered and 400 
 of open sewers, 126 of pipes, in 1855. The first pipe sewer 
 was laid in 1848. The greatest length of any one is two and 
 a half miles. Mr. Hay wood, Engineer of the city of London, 
 has always laid circular pipes ; none smaller than nine inches, 
 nor larger than fifteen inches diameter ; the joints are put 
 together sometimes with puddled clay, sometimes with cement. 
 
 The return of reflux odors, one of the greatest objections to 
 house-drains, is prevented by three modes pointed out by Mr. 
 Simpson : " First, the water pan in and the sigmatic curve 
 under the water-closet and sink ; next, another sigmatic 
 curve, if the descent will make it safe, where the pipe joins 
 
74 
 
 
 
 the main street-drain ; and thirdly, a delicately hung flap 
 valve of galvanized iron at the extreme end of the tube, where 
 it discharges into the main drain. The valve will always be 
 shut, except when opened by a flow from the house." In 
 the severe winters of our climate, obstructions to the easy 
 working of these contrivances will not unfrequently occur, 
 owing to the water freezing in the supply-pipe. For his 
 sewers, Mr. S. rightly asserts that water in unstinted propor- 
 tion is indispensable, but especially for a system of tubular 
 sewers, which cannot be cleansed by any other method. 
 * For drains, earthenware pipes, glazed, are preferable to brick 
 conduits, which sometimes allow of exudation of their contents. 
 The size of a pipe for a drain will depend on the number of 
 houses. In one instance, in London, an 18-inch drain was 
 carried 400 feet at the back of forty houses, where there was 
 a good supply of water, and it was kept clean. 
 
 Eobert L. Viele, Esq., Civil and Topographical Engineer, in 
 a statement in the Senate Committee Report, expresses un- 
 hesitatingly his opinion, that one of the chief causes of mor- 
 tality of the city of New York, "is to be found in the 
 defective drainage of certain districts of the city, and further- 
 more, that this is an evil which is increasing as the city extends 
 itself towards the northern portion of the island, and that the 
 main elements by which this evil is increased, are the so-called 
 city improvements, or grading of streets or avenues which are 
 now being carried forward." 
 
 Mr. , Viele then describes the intricate topography of the 
 island of New York : " Abrupt ledges of rock, deep and nar- 
 row valleys, sudden upheavals and contortions of the geographi- 
 cal formations," with a surface varying in elevation from 5 to 
 150 feet above high-water mark. " Winding along this varied 
 surface in every direction, are the original drainage streams, 
 one of them of such an extent that it was formerly used for 
 mill purposes." No attention having been paid to the original 
 
75 
 
 topography of the island, in the arrangement of streets and 
 avenues, deep ditch excavations and high embankments have 
 been made, so that these latter cross the old valleys of drain- 
 age, and become so many drains for the collection of water all 
 over the island, which in summer are converted into " stag- 
 gant pools, breeding pestilence and disease." The earth 
 dumped in to absorb the water, when it is desired to improve 
 these lots, soon becomes saturated, and forms a sort of sponge 
 through which the water ascends, and continues to be a per- 
 manent source of humid and noxious exhalations. No system 
 of sewerage in which the sewers are only ten or twelve feet 
 below the grade of the streets, can remedy this evil, when in 
 some instances the underground streams are forty feet below 
 the grade of the streets, " being thirty feet between the bottom 
 of the sewer and the water of drainage." Melancholy evidence 
 of the evils arising from habitation of a made soil, thus impro- 
 perly drained, is afforded in the sacrifice of lives among the 
 wretched victims sent to the present "Halls of Justice," or 
 the " Tombs," as they are appropriately called, which are 
 built on the site of the old Collect Pond, seventy feet deep 
 it was here that Fitch launched his first steamboat. The pond 
 was connected with the Hudson River, by a stream running 
 through what is now Centre and Canal streets ; in this section 
 of the city it is impossible to have dry cellars. 
 
 In giving farther currency to Mr. Yiele's statement of the 
 actual impediments to a complete system of drainage of the 
 city of New York, and of his remedy, which we subjoin, our 
 design is, as in the cases of hygienic deficiencies in other cities, 
 not merely to incite to a reform in thejn, but also to furnish 
 warning to new cities, or those in embryo, against the com- 
 mission of similar mistakes and omissions in their incipient 
 plans for civic improvement. Mr. Viele describes his remedial 
 measures as follows : 
 
 " The remedy to be applied in the lower part of the city is 
 
76 
 
 to widen the narrow streets, and to raise the grade where the 
 streets pass through the original depression of the surface. 
 Narrow streets, under any circumstances, are a curse to a city. 
 They are too generally the abodes of vice and crime. In 
 them an ordinary sickness spreads into a pestilence, and a 
 fire into a conflagration. They are always filthy in summer, 
 and frequently blocked up with snow in winter. They are 
 not fit for business purposes, for they stifle commerce ; nor for 
 residences, for they breed disease. Wide streets, on the con- 
 trary, are more healthful and cheerful for residences, and more 
 useful and valuable for business purposes. There is less danger 
 from fire, as the flames cannot spread across the street. They 
 are cleaner in summer, and are never impassable in winter. 
 By constructing lateral drains along the slope of the depres- 
 sions in the lower part of the city, and 'connecting them with 
 the sewers, they will intercept the water in its descent, and 
 prevent its accumulation in the original basins; and then rais- 
 ing the grade as is proposed in the accompanying profile of 
 Worth street, at the same time widening the streets and per- 
 haps discontinuing some of the short and insignificant streets 
 in the 6th Ward, the health of the city will be improved one 
 hundred per cent. So far as regards the upper part of the 
 city, it is absolutely necessary that some system should be 
 adopted for the free flow of water along the channels of the 
 original drainage stream. This can be done by building more 
 substantial culverts beneath the streets, and by the construc- 
 tion of permanent drains, so built as to admit of the percolation 
 of water through the interstices of the covering. These drains 
 should be excavated to a firm substratum, and every property 
 owner should be compelled to construct, of a uniform charac- 
 ter, tha portion of each drain which may pass through his 
 property." ^^ 
 
 Disposal of Sewage. The subject of the application of 
 sewage for agricultural purposes has been freely discussed of 
 
77 
 
 late years, especially in connection with its deodorization, and 
 subsequently the free and more general use of it than could be 
 obtained in its unaltered and offensive state. The practice of 
 the Chinese, the most economical cultivators of the soil, is quoted 
 at the same time, and their practice of uniting clay with fecal 
 collections, and selling the compound for manure, referred to. 
 Objections have been made to the deodorizing of sewage by 
 chemical agents, on the ground of their neutralizing the am- 
 monia, and destroying one of the most active of the exciters 
 to vegetable growth. It has been computed, that if the whole 
 drainage of London could be employed for manurial purposes 
 at a sufficient distance from the city, the animal increase in 
 the value of the land t<*wliich it would be applied, would ex- 
 ceed half a million of pounds sterling, or about two millions 
 five hundred thousand dollars. An estimate by Mr. Smith, 
 a distinguished agriculturist, places this question in a strong 
 light. It rates the annual average value of the excreta of 
 each individual at five dollars ; so that, taking the whole 
 population of Great Britain and Ireland at twenty-eight mil- 
 lions, we are positively, says this writer, throwing away 
 every year that which is equivalent to twenty-eight millions 
 sterling, or 140 millions of dollars. The actual salable value 
 of the excreta in Belgium is thirty-seven shillings, and at 
 this rate, continues the English writer just named, we may 
 be said to be depositing the worth of fifty-one millions ster- 
 ling in the ocean that washes our shores. 
 
 According to Dr. Lyon Playfair, a pound of urine is capable 
 of increasing the production of grain by an equal weight ; so 
 that even allowing for some exaggeration in this estimate, 
 the human urine wasted in the British kingdom would serve 
 to produce more than all the grain required for the consump- 
 tion of their entire population, besides affording through its 
 fertilizing influence on lands at present imperfectly tilled, or 
 not tilled at all, a source of employment to a superabundant 
 laboring population. 
 
78 
 
 Mr. Campbell, in an address on the utilization of sewage, 
 says : " The chief element of the manurial value of town 
 sewage is the excremental material, and this, in the instance 
 of London, with a population of 2,600,000, amounts annually 
 to 53,393 tons of dry solid,* which, as I have already shown, 
 contains ingredients which give it a value of fifteen pounds 
 sterling ($75) per ton, at least. 
 The quantity of ammonia which this contains, 
 
 or is capable of producing, is 11,440 tons. 
 
 The phosphoric acid, 1,839 " 
 
 And the potash, &c., 1,331 " 
 
 These three items make up a money value of about 
 836,834 pounds sterling, equal to 4p!84,170 dollars. 
 
 The number of methods that have been proposed for obtain- 
 ing manure from town sewage may be considered, Mr. Camp- 
 bell thinks, under three heads. 
 
 1. Filtration through various media, and after the addition 
 of chemical substances. 
 
 2. Precipitation by means of various re-agents. 
 
 3. Irrigation. 
 
 Reviewing the three modes here named, Mr. Campbell in- 
 clines to that by irrigation, and concludes, that by no process 
 of chemistry hitherto known, can a highly valuable solid ma- 
 terial be procured from town sewage alone. 
 
 Mr. Ward, in his letter to Mr. Cunningham, of which we 
 have already made large use (p. 509), says on the present 
 theme : " In the first place I would remind you, that to throw 
 away the ammonia and the phosphorus of the London sewage, 
 is virtually to throw away bread. Town sewage, which many 
 engineers look upon as refuse to be discharged, I regard as 
 property to be administered. The proper outfall for the Lon- 
 don sewage is not this or that point of the river or of the sea, 
 
 * There must be some mistake in this estimate, which is not made more 
 than a third of that made by Dr. Letheby. 
 
79 
 
 "but a suitable tract of land growing exhausting crops. Fifty 
 farms of a thousand acres each might be raised in value at 
 least ten pounds per acre per annum, equivalent to five per 
 cent, to ten millions of capital. This ought not to be thrown 
 into the sea." 
 
 VENTILATION. Two great requisites for the healthy 
 existence of human beings, are due supplies of pure 
 air and of pure water. Without these, the most abundant 
 food and all the appliances furnished by science and art will 
 be of little avail ; and yet, by a singular inconsistency in 
 human conduct, there would seem to be a fixed determination 
 on the part of the majority of mankind to deprive themselves 
 of these essential elements of health. Air, in an especial 
 manner, is shut out from habitations by all kinds of con- 
 trivances, or, when allowed ingress, it is deteriorated by ad- 
 mixture with emanations from decayed organic matter, or 
 from living bodies brought together in large numbers, to meet 
 the wants of what is called civilization. 
 
 The atmosphere by which we are surrounded and from 
 which, by means of respiration, our bodies derive the oxygen, 
 or vital element of the air that necessary for the support of 
 life is at the same time the great reservoir into which flow 
 all the exhalations from the bodies of men and animals, and 
 those resulting from the animal and vegetable decay which 
 takes place on the surface of the soil. If not carried into 
 space in the upper air by winds, tbey would prove 
 a destructive poison to all the people congregated in cities 
 and towns. The process by which these exhalations are re- 
 moved is ventilation ; and the more complete it is, the 
 healthier are the inhabitants ; as, on the other hand, its irrifr 
 perfection and neglect are productive of diseases of the worst 
 kind. Streets are so many channels for conveying the requi- 
 site air to the inhabitants of the houses on either side of them; 
 
80 
 
 and the wider and more numerous are these channels, the 
 more completely is their object, in this respect, attained. Pro- 
 portions ought to be preserved between the breadth of a street 
 and the height of the houses in it. If the latter be very high, 
 and the former narrow, both the air and sun are prevented 
 from reaching the street, and lower portion of the houses. 
 Still greater detriment, in this respect, is experienced by the 
 occupants of narrow alleys and small courts, in which unfortu- 
 nately the crowd of inhabitants is greatest, and the supply of 
 fresh air and suitable ventilation the least. Every sanitary 
 investigation, down to the last made in New York, goes to 
 show the magnitude of the injury done to the public health by 
 this last-mentioned state of things. The ills thence resulting 
 are on the increase, since they follow, too generally, in certain 
 but not well-defined proportions, the growth of the cities 
 themselves. No excuse, therefore, will be offered for dwelling 
 on this subject, first by presenting the darker and repulsive 
 features, and then under its remedial and preventive aspect. 
 
 Few pause, says Dr. D. B. Reid, to consider the necessary 
 consequence of 20 respirations per minute, 1200 per hour, or 
 28,800 in a single day and night for every adult human being, 
 and of his abstracting, during this period of twenty-four hours, 
 from the atmospheric magazine, his portion of air, amounting 
 to fifty-seven hogsheads, of which he retains vital oxygen to 
 the amount of about twenty pounds, that enters into his blood, 
 and there serves to maintain the activity of all the functions 
 of life, corporeal as well as mental. It has been estimated 
 that about one fourth of all the air drawn into the lungs by 
 inspiration is altered in these organs, and is no longer fitted 
 for respiration. The alteration consists, first, in the abstrac- 
 ion of the vitalizing element of oxygen ; and secondly, in the 
 addition of the deleterious and poisonous gas carbonic acid 
 which, together with volatilized animal matter, is given out 
 by expiration, and passes into the outer and common atmo- 
 
81 
 
 sphere. But if, instead of a free inhalation of pure atmo- 
 spheric air, there takes place that of a noxious or impure air, 
 from which the exhaled carbonic acid has not been carried 
 away, two results ensue : first, the individual fails to receive 
 his proper proportion of oxygen, while he suffers from the in- 
 halation of the noxious carbonic acid gas ; and secondly, the 
 lungs are unable to eliminate from the blood with their usual 
 freedom the noxious products, including this very carbonic 
 acid, or its base, carbon, the retention of which, together with 
 the animal matter (previously mentioned) in the system, is 
 productive of serious disorder in itself, and predisposes to the 
 attacks of current diseases. This abnormal condition of 
 things will continue, with aggravation, on to a fatal termination, 
 if the same air be breathed over and over again, without its 
 being displaced by a purer air ; that is, without ventilation 
 being carried on. Bad ventilation, as well said by Dr, Reid, 
 is also injurious to the mind as to the body ; and, where it is 
 utterly neglected, not only produces headache and apoplexy, 
 but, conjoined with other circumstances, is prone to favor that 
 depression which leads at times to low spirits, and even to 
 suicide. 
 
 Defective Yentilation Crowded Streets and Habi- 
 tations. Taking into account the physiological data just 
 mentioned in connection with the facts previously de- 
 scribed, of the noxious effluvium of the gases result- 
 ing from the putrefaction of animal and vegetable matter, 
 we find a ready explanation of the great amount of sick- 
 ness and high death-rates among the crowded courts and 
 cellar population in Liverpool, Birmingham, New York, and 
 other cities. In Liverpool, in 1841, there were 2,398 courts 
 containing 68,365 persons. In the parish of Birmingham, the 
 older and more densely inhabited parts of the town, there were 
 2000 courts, containing 50,000 inhabitants. In Liverpool 
 it was not enough, for outraging humanity and common-sense, 
 
82 
 
 that, gloomy and badly ventilated as the houses themselves 
 were in the courts, there were found cellars under more than 
 one half of them, or 1272 in number, occupied by 6290 
 persons. The whole number of cellars in Liverpool was 
 7892, containing a population of nearly 40,000 persons, or 
 five persons on an average to each cellar Aware, as we are, 
 of the impossibility of a ventilation of these courts and cellars, 
 and the continued deterioration of the air by exhalations from 
 them and their inmates, we need not wonder at the bad emi- 
 nence which that city, after the registration act had gone into full 
 operation, unexpectedly acquired, on the score of disease, and 
 the short average duration of life of its inhabitants, taking them 
 in the aggregate. Reference has been made in a previous part' 
 of this report to the greater amount of sickness and mortality in 
 the undrained than in the drained cellar districts of Liver- 
 pool. The concomitant evils attending this crowded popula- 
 tion are tersely described by Dr. Reid, in speaking of the 
 8000 houses in Nottingham, built back to back and side to 
 side, and with no other outlet than the street-door. " Suffice 
 it to say, that in such quarters it is hardly possible that a 
 family can. preserve for any term of years, either decency, 
 morals, or health." Worse, if possible, than the scenes ex- 
 hibited in some English towns, is the condition of the poor 
 in the chief cities of Scotland. Dr. Arnot, among other 
 details, relates that in some of the wynds of Edinburgh and 
 Glasgow, there were no sewers or drains, and the dung-heaps 
 received all the filth which the swarm of wretched inhabitants 
 could give: he learned that a considerable part of the 
 rent of the houses was paid by the produce of the dung-heaps. 
 The interior of these houses, and ^eir inmates, corresponded 
 with their exterior. "We saw half-starved wretches crowd- 
 ing together to be warm, and in one bed ; although in the 
 middle of the day, several women were imprisoned under a 
 blanket, because as many others, who had on their backs all 
 
83 
 
 the articles of dress that belonged to the party, were then 
 out of doors in the streets." 
 
 The pictures drawn some years back by Dr. J. H. Griscom, 
 of the diseases and mortality caused by residence "in the damp, 
 dark, and chilly cellars" of New York, and of " the degraded 
 habits of life, the filth, the degenerate morals, the confined 
 and crowded apartments, and insufficient food of those who 
 live in more elevated soil, engendering a different train of 
 diseases, failed to arrest the attention of the authorities. The 
 evils have been allowed to go on increasing, until at last their 
 alarming excess has led to official investigations, the results 
 of which fully confirm all that Dr. Griscom, and other sani- 
 tarians on the spot, had previously proclaimed. They are 
 embraced in a " Report of the Select Committee appointed 
 to investigate the Health Department of the City of New 
 York," which, together with a large amount of appended docu- 
 ments, in the shape of medical and other testimony, and 
 tabular matter, was transmitted to the Legislature, February 
 3, 1859. A startling fact which tells in a few figures the 
 deplorable state of the public health in the city of New York, 
 is its gradual deterioration, with some interruptions and short 
 rises, during the last forty-six years. Thus, we learn that 
 in 1810, with a population of 96,713, the deaths were 1 in 
 46.6; whereas, in 1857, with a population of probably 
 700,000, the deaths were 1 in 27.15. The testimony of Dr. 
 Griscom, in Committee, is full of instructive details, direct 
 and comparative, on the subject of the causes of the increase 
 of death-rates in New York. He shows that if the mortality 
 of London bore the same ratio as that of New York to popu- 
 lation, it would have been 92,784, in place of 56,786, which 
 was its actual mortality. Dr. G. quoted from the Report of 
 a Committee of the Association for Improving the Condition of 
 the Laboring Classes in the City of New York, in which the 
 dwellings in many parts of the city are thus characterized : 
 
84 
 
 " Crazy old buildings ; crowded rear tenements in filthy yards, 
 dark, damp basements, leaky garrets, shops, out-houses, and 
 stables, converted into dwellings, though scarcely fit to shelter 
 brutes, are the habitation of thousands of our fellow-beings 
 
 7 o 
 
 in this wealthy, Christian city." " In Oliver street, Fourth 
 Ward, for example, is a miserable rear building, 16 feet by 30, 
 two stories and garret, three rooms to each of the first and 
 second floors, and four in the attic; in all, ten small apart- 
 ments, which contain fourteen families. The entrance is 
 through a narrow, dirty alley, and the yard and appendages 
 of the filthiest kind." In Cherry street, is a " tenement- 
 house," in two lots, extending back from the street about 150 
 feet, five stories above the basement, so arranged as to contain 
 120 families, or more than 500 persons. " But the most 
 objectionable habitations in this district are the cellars, in 
 some instances six feet under ground, which have to be bailed 
 out after every rain-storm, and are so damp as to destroy 
 health, so dark as to prevent industry, and so low that ven- 
 tilation is impossible. Though utterly unavailable for every 
 other use, they are rented, at rates which ought to procure 
 comfortable dwellings, to persons who have become as debased 
 in character, as the condition is degrading, in which they 
 live." Many of the poor of the Sixth Ward " are in a con- 
 dition incomparably worse than the hovel-dwellers, where fa- 
 ther, mother, children, and swine live and lodge together." 
 In the Eighth Ward, " Kotten Row," so unlike the fashiona- 
 ble locality in London thus called, " consists of eight houses 
 on either side of the street, fronting each other, with as many 
 more in the rear, containing, in all, about two hundred and 
 fifty families, and not less than one thousand two hundred and 
 fifty persons, in a space of about one hundred and eighty f jet, 
 by, perhaps, a depth of fifty feet on each side. The pestifer- 
 ous stench and filth of these pent-up tenements exceed descrip- 
 tion. In one room, says a visitor, six people are living, with 
 
85 
 
 hens scratching about on the bed. Every corner of these 
 buildings is occupied cellars and garrets." The cellar popu- 
 lation of New York is believed to be twenty-five thousand. 
 What makes the case worse with the occupants of these tene- 
 ments and cellars, is, the circumstance of many of them being 
 emigrants from Europe, particularly from Ireland and Ger- 
 many, who, during their voyage, had suffered from defective 
 ventilation, in their being crowded between decks, and com- 
 pelled to breathe much of their time a damp and impure air. 
 Among the diseases arising from, or singularly multiplied and 
 aggravated by, what Dr. Griscom terms '' internal domiciliary 
 causes," are Cholera Infantum, Diarrhoea, and Erysipelas, 
 which have been increased in a high proportion since 1820. 
 
 Dr. Samuel Rotton, in his testimony before the Committee, 
 repeating, in a summary manner, what had been said by Dr. 
 Griscom, and, to a certain extent, also by Dr. McNulty, af- 
 firms the chief causes of the mortality in New York to arise 
 from a great number of the inhabitants living " with the 
 smallest amount of air that is necessary to keep life in them, 
 and the smallest possible quantity of light with which they 
 can possibly see and get along with ; and these causes have 
 been proven by Dr. Griscom to produce much greater mortali- 
 ty than bad food or bad clothing, because, the people who 
 have lived in the same way, with the same food and clothing, 
 in better localities, have been seventy-five per centum better 
 with regard to mortality than those who lived in cellars and 
 other dark, unventilated, and miserable places." During the 
 cholera season of 1849, in New York, Dr. Rotton noted the 
 fact of the great mortality from the disease among the occu- 
 pants of cellars, and hence, it became his invariable practice 
 to have such persons, when attacked, immediately removed. 
 He does not know of a single case of recovery of those who 
 were not removed. "The reason is obvious," continues Dr. 
 R. " In many of them I was obliged to wade my way upon 
 
86 
 
 bricks, "before I could stand upon the floors, for the water 
 would cover my feet." In the same year, Dr. Rotton attend- 
 ed a great many patients who were attacked with Typhus or 
 Ship Fever, and with results similar to those just noticed in 
 regard to Cholera. All whom he could not remove from the 
 cellars, died whereas, those who were situated in well-venti- 
 lated places fared much better. He mentions the cases of 
 two men lying sick with Typhus Fever, "in a back alley- 
 way." His constant recommendation, at every visit, to admit 
 fresh air, was as constantly disregarded, and on his return, each 
 day, he found the windows again closed, the door closed, and a 
 number of persons living in the same room with the sick. At 
 last, Dr. Rotton, becoming exasperated, broke out eveiy pane 
 of glass in the upper portion of the windows. His patients 
 gradually improved, and recovered. Dr. D. Meredith Reese, 
 in his testimony before the Committee, lays down the propo- 
 sition, that " The true criterion and best index of atmospheric 
 impurity, in any city, or other locality, is manifested in young 
 children, whose greater susceptibility to morbid causes, by 
 reason of their greater delicacy of structure, renders them the 
 earliest victims of atmospheric poisons. Hence the fearful 
 aggregate of infant mortality in New York, which authentic 
 statistics disclose, is at once the fruit and the proof of the con- 
 taminated air they breathe, in the wretched habitations of the 
 poor, where confined and ill-ventilated apartments render 
 healthy respiration impossible." Dr. Reese assigns other 
 causes for infant mortality, which do not come under our pre- 
 sent head, but which are suggestive of the importance and 
 necessity of sanitary reform, not only in New York, but in 
 most other cities. His views on the exceedingly interesting 
 topic of infant mortality in large cities, have been embodied 
 in a Report to the American Medical Association, which he 
 offered as part of his testimony before the New York Com- 
 mittee, 
 
87 
 
 The morbid effects of crowding and deficient ventilation 
 are well illustrated by comparison with an opposite condition 
 of things, as set forth by Dr. Eichard S. Kissam. The com- 
 parison is of the state of health of two wards in New York, 
 the most healthful and the least healthful. In the Sixth Ward 
 there were twenty-five thousand inhabitants in 1856, having 
 one thousand four hundred dwellings, and the deaths were one 
 thousand and eighty-nine. In the Fifteenth Ward the popu- 
 lation was twenty-four thousand and forty-six, who occupied 
 two thousand four hundred and forty-five dwellings, and the 
 deaths among whom were four hundred and thirty-six. The 
 proportion of deaths in the Fifteenth Ward is one in fifty-five, 
 and in the Sixth Ward one in twenty-three. The contrast, 
 as set forth in the Report itself, between the Fifteenth and the 
 First Wards in 1857, was still greater. The proportions 
 were 1 in 69.68 in the former, and 1 in 21.96 in the latter. 
 Dr. Kissam states the difference between New York and Phil- 
 adelphia, on the score of public health, to be, that almost 
 every family in the latter city has a tenement in itself; the 
 members of it are well provided and comfortable. " The city, 
 of course, has a larger number of houses in proportion than 
 our own. It is very seldom that there is more than one family 
 in a house ; but here, as has been stated, there are twenty or 
 thirty families in one house." To the question, " Then 
 you regard ventilation as a great principle connected with 
 the preservation of health?" Dr. Kissam replies: "Most 
 assuredly, even in higher walks than among the poor. Our 
 Academy of Medicine will sit, night after night, being poison- 
 ed, so that those who are sensitive on this point, invariably 
 have a headache the next day. The Historical Rooms, the new 
 building, is very badly ventilated. The subject of ventila- 
 tion is one that seems to escape the attention of builders as 
 well as of officers." 
 
 Examples of the connection of overcrowding with the de- 
 
88 
 
 velopment of Typhus, Scarlatina, and Cholera, are numerous. 
 Some striking cases of this nature are recorded by Mr. Cox, 
 in the Sanitary Review , April, 1858. In the limits of two 
 streets, in the village of Bromley, fifty-three cases of fever oc- 
 curred. The disease did not extend to the rest of the village, 
 neither did it break out elsewhere within the district. The 
 evident cause of this local fever, and its mortality, was the 
 " awful" overcrowding. Each house consisted of four rooms, 
 about twelve feet square. " An entire family lived and slept 
 in each chamber. In one, Mr. Cox counted seven human 
 beings, who occupied the same filthy couch a father, 
 mother, three adult daughters, and two younger children. 
 In a second room, six persons slept, viz., a widow, her two 
 grown-up daughters, an adult son, and two young children.'' 
 It is unnecessary to say that the rooms were indescribably 
 foul, fetid, close, and disgusting. " In the above instance," 
 continues Mr. Cox, "we can have no hesitation in ascribing 
 the concentration and severity of the fever-poison (if not in- 
 deed its actual development) to the vitiated atmosphere pro- 
 duced by the overcrowding." He made every inquiry, but 
 was quite unable to trace the origin of the disease to any other 
 sources. Dr. Duncan, of Liverpool, described, some years 
 ago, a filthy, pent-up court, one of the thousands in that city, 
 with an area of only one hundred and fifty square yards, occu- 
 pied by one hundred and eighteen inhabitants, or about one 
 and a quarter square yards to each. This average breathing 
 room is only one half of what it ought to be at night. In this 
 court, fifty cases of fever, or nearly one half the population, 
 were attended by the Dispensary in a single year. Some of 
 the most frightful ravages of Cholera on record were owing to 
 the direct pulmonary poisoning by impure air and animal efflu- 
 vium, accumulated for want of suitable ventilation. Exam- 
 ples of this nature have been furnished in all parts of the 
 civilized world in the East Indies, at Karrachee, among the 
 
troops, at Juggernaut, among the native population, also in 
 tlie crowded and ill-ventilated barracks ; in England, among 
 the brickmakers at Southal, the hop-pickers at East Farleigh, 
 the pauper children at Tooting, the lunatics in the Wakefield 
 Asylum, the convicts at the Wakefield Old Prison, the in- 
 mates of the Millbank Penitentiary, and of the Taunton 
 Work-house. At a time when no case of Cholera had occurred 
 in the neighborhood of Tooting, and when, indeed, even Dia- 
 rhoea was not at all prevalent in the village, three hundred of 
 the inmates of the establishment were smitten with the secret 
 pestilence, and of these no less than one hundred and eighty 
 died. The girls, whose dormitories were the most overcrowded 
 and the worst ventilated, suffered more severely than the boys. 
 The essential cause of all this mortality was declared to be 
 "the inordinate crowding of the establishment." The num- 
 bers crowded together into the dormitories were so great, that 
 each boy had only one hundred and fifty cubic feet, and each 
 girl one hundred and thirty-three cubic feet of air allowed for 
 respiration, and some of the apartments were, at the same 
 time, so faultily constructed there being windows on one 
 side only that no effective ventilation could possibly be kept 
 up. 
 
 How far this scant supply of the pabulum vitce falls 
 short of the requirements of health, may be inferred from the 
 recommendation of the inspectors of prisons in England, 
 some years ago, that every prisoner should have one thousand 
 cubic feet of air, and from the estimates which have been made 
 in other quarters, that health and strength cannot be main- 
 tained in a space of less than seven hundred to eight hundred 
 cubic feet ; and that to live and sleep in a space less than four 
 hundred to five hundred cubic feet for each individual, is not 
 compatible with safety to life, even where there is no extrinsic 
 or superadded cause of atmospheric impurity. And let it not 
 be supposed that even the first-named spaces would be suffi- 
 
90 
 
 cient in a hermetically-closed box or chamber, for life would 
 become extinct long before the oxygen had been consumed.* 
 In Philadelphia, we have had some sad reminders of the per- 
 nicious effects of overcrowding and want of ventilation in the 
 mortality, and preceding horrors in the old Arch Street Prison, 
 during the cholera season of 1832, and in the Blockley Alms- 
 house in the epidemic of 1849. We may note also similar 
 catastrophes in the Bucks County Poorhouse, and the 
 Baltimore Almshouse. Although Philadelphia, Boston, and 
 Baltimore compare advantageously with New York in their 
 annual death-rates, yet they have also their dark spots, 
 their bad districts, in which physical is associated with 
 moral degradation and impurity, and Cholera claims its 
 largest proportion of victims. Whatever effects may be at- 
 tributed to bad or defective supply of food in the production 
 of this disease, it has been said, with no doubt much truth, 
 that the state of health, as well as the proclivity to disease, is 
 influenced much more by the condition of the air that is 
 breathed than of the food that is eaten. The foul and fetid 
 atmosphere, continues the English writer, f of our Whitechap- 
 els, and Bermondseys aided often by intemperance has 
 more to do with the haggard looks and earthy complexion of 
 these denizens than even penury or want. Dr. Letheby, in 
 visiting some of the rooms tenanted by poverty-stricken beings 
 crowded together, found the atmosphere so close and unwhole- 
 some, and infected with that peculiar fainty and sickening 
 smell so characteristic of the filthy haunts of poverty, that he 
 endeavored to discover the special offending element. He as- 
 certained that the contaminated and reduced air was not only 
 deficient in due proportion of oxygen, but that it contained 
 three times the usual amount of carbonic acid, besides a quan- 
 tity of alkaline matter that stank abominably, doubtless the 
 
 * Brit, and For. Med.-Chir. Review, vol. vii., 1851. 
 f Ibid. 
 
* 
 
 91 
 
 product *of putrefaction of the various fetid and stagnant ex- 
 halations that are given off from the unclean "body, and a 
 pestilential scourge of disease, the consequence of heaping hu- 
 man beings into such contracted localities. 
 
 Observations have been made, and to such an extent as to 
 justify the. belief, that the intensity and mortality of Scarlet 
 Fever are greatly increased by overcrowding. Mr. Cox, al- 
 ready quoted, describes an outbreak of this Fever with fearful 
 and uncontrollable malignity in a dismal court at the back of 
 Covent Garden, London. There were altogether nineteen 
 cases in the three houses, whereof ten terminated fatally. Mr. 
 Cox "can confidently attribute this fearful mortality to the 
 overcrowding ; as, although the disease prevailed extensively 
 in the neighboring streets, it did not assume the same malig- 
 nity of type, and yielded to remedial measures." Both Mr. 
 Cox and a friend who accompanied him, and shared the pro- 
 fessional duties with him on his visits to this forbidding spot, 
 contracted the disease, and narrowly escaped with their lives. 
 Measles have nearly double the mortality in the crowded 
 north-western districts, that they have in comparatively thinly 
 peopled south and south-east ones of England. Even though 
 we must attribute a good deal to the ready transmission of 
 contagious disease among a thickly planted population, we 
 can hardly doubt, as suggested by Mr. Simon, that a general 
 weakness of constitution, conjoined with defective sanitary 
 arrangements, greatly aggravates the fatality of the contagious 
 diseases in question. 
 
 Predilection of Cholera for Old Haunts of Disease. 
 Dr. Laycock, in his highly interesting report to the Health of 
 Towns Commissioners, on the Epidemics of York, tells us, 
 that the first steps of the plague which used to ravage that 
 ancient city in the middle ages, down to the early part of 
 the seventeenth century, seem to have been very similar to 
 those of the cholera in 1831, marking the badly-drained dis- 
 
triets by its course, as did the latter. "It is a* singular 
 coincidence," remarks Dr. Laycock, "that while the cholera 
 commenced in the Hay-market, near the traditional spot of 
 the plague under consideration (in 1604), and probably near 
 to that of 1551, the first death from cholera took place also in 
 the parish of St. Michael, Spurriengall, and on June 5th." It 
 was in this parish, and on June 4th, 1604, that the first death 
 from plague occurred. The first case that occurred in the 
 town of Leith (Edinburgh), in 1848, took place in the same 
 house, and within a very few feet of the same spot where the 
 epidemic of 1832 commenced its course. On its re-appear- 
 ance in the town of Pollockshaws, it snatched its first victim 
 from the very same room and the very bed in which it had 
 broken out in 1832. Its first appearance in Bermondsey was 
 close to the same ditch in which the earlier fatal cases occurred 
 in 1839. At Oxford, in 1839 as in 1832, the first case 
 occurred in the county jail. This return to its former haunts 
 has been observed in several other places, and the experience 
 in foreign countries has been similar. At Groningen, in Hol- 
 land, the disease in 1832 attacked, in the better part of the 
 city, only two houses, and the epidemic broke out in these 
 two identical houses on the visitation of 1848. But it was 
 observed, that while in both epidemics, those of 1832 and 1848 
 -9, the disease was localized in precisely the same districts, 
 several of them have changed places in the relative degree in 
 which they have suffered The earliest case of cholera in 
 Chelsea (near London), in 1848, is said to have been in 
 Whitehall Court, and there it continued to exist until the end 
 of the epidemic in 1849. The first case in 1854 was in the 
 same place, perhaps also in the same house, in both visita- 
 tions. A very similar fact is presented by Augusta Court, in 
 which the three earliest fatal cases of cholera, in Chelsea, oc- 
 curred in February, 1832 ; and which being revisited in 1854, 
 continued to furnish victims to the pestilence throughout the 
 
early duration of the outbreak. Kent and Mew streets, 
 South work (on the south side of the Thames), which were 
 severely visited at an early period of the last epidemic, were 
 also among the first seats of cholera in 1832. Dr. Acland 
 relates that, with one exception, every yard and every street 
 in St. Thomas's parish, Oxford, which had been attacked by 
 cholera in 1832 and 1849, was revisited in 1854. 
 
 It is evident, from these and many more analogous facts, 
 that, although we are unable to explain all the conditions for 
 the development of cholera, it is impossible for us to deny 
 the great influence of locality on its production. 
 
 Public Lodging-Houses. To speak of overcrowding is at 
 once suggestive of public lodging-houses, long a recognized 
 and prolific source of disease and vice. They are in all large 
 cities the nightly resorts, not only of the migrating laborer 
 and traveling artisan, but, also, of the lower mendicants, 
 thieves, and prostitutes. It was no uncommon thing, as Dr. 
 Duncan related, when writing on the sanitary state of Liver- 
 pool, for the keepers of lodging-houses, in that city, to cover 
 the floor with straw, and to allow as many human beings as 
 could manage to pack themselves together, to take up their 
 quarters for the night, at the charge of a penny (a little over 
 two cents) each. The havoc made by the cholera in the 
 lodging-houses of Manchester was terrible. In some of them 
 as many six or eight bodies were contained in a single room, 
 which was crowded promiscuously with men, women, and 
 children. Dr. Howard, after showing the lamentable extent 
 to which they become hot-beds of febrile diseases of the most 
 violent and fatal character, owing mainly to their filthy and 
 unveritilated condition, thus describes the morals of their 
 frequenters, and their malign influence in this way on the 
 young and inexperienced : " They serve as open receptacles 
 of crime, vice, and profligacy, and as nurseries in which the 
 
94 
 
 young and yet uninitiated become familiar with every species 
 of immorality. They are the haunts of the most depraved 
 and abandoned characters, as well as the most miserable and 
 suffering objects of the town (Manchester), and constitute one 
 of the most influential causes of the physical and moral 
 degradation of our laboring population." In Glasgow, where 
 the same evils prevailed to an alarming degree, the lodging- 
 houses have been subjected to regular municipal supervision 
 and ordinance, and, as we are told, with excellent effects. 
 Partial inquiries made in our large American cities, reveal a 
 state of things approaching to the evils just pointed out as so 
 common in those of Great Britain, and which call imperatively 
 for the ameliorating and reforming influences introduced with 
 success of late years in different parts of this kingdom. To 
 these we shall soon advert. 
 
 General Want of Ventilation. But the evil consequences 
 of crowding and defective ventilation are not confined to 
 the poor and the destitute. Wherever people are brought 
 together for religious worship, for amusement or recreation, 
 in the halls of legislation and of law, in school-rooms, 
 hospitals almshouses, and prisons, the neglect of sani- 
 tary measures, and especially of ventilation, is the rule. 
 Attention to this paramount means of preserving health is 
 the exception. JSTor are the mansions of the rich and tasteful 
 exempt from the penalty of infraction of one of the chief if not 
 the very first of the natural laws. This stricture is still more 
 applicable to modern than to old houses. 
 
 In modern houses, the neglect of ventilation is extreme, as 
 far as regards recourse to any other means of obtaining it than 
 the windows of the rooms. All the fire-places, as they used to 
 be called, are hermetically sealed by slabs of marble, and 
 when the register of the flue, by which warm air is introduced, 
 is closed, as at night, or when the room becomes too warm in 
 
95 
 
 the day, there is no aperture, either for the admission of fresh 
 air from without, or for the escape of foul air from within. 
 During the night, the windows and doors are closed, and the 
 supply of air fitted for respiration becomes exhausted long be- 
 fore morning, especially if, as is so commonly the case, there be 
 several persons sleeping in the same room. Headaches, rest- 
 less slumbers, nervousness of various kinds, palpitations, op- 
 pressed breathing, and loss of appetite, are no unusual effects 
 of defective ventilation in the houses of the wealthy, who, at 
 the very time, may be commiserating the poor for their small 
 and close apartments. It is indeed time that architects should 
 wake up, and think of constructing houses in which the in- 
 mates can live without a continued infraction of the laws, by 
 compliance with which alone they can enjoy health and seren- 
 ity of mind. Benevolent individuals and societies have taken 
 the state of the defective lodgings of the poor into considera- 
 tion, and have set about, in some instances with entire success, 
 the devising and execution of the needful remedies. Let us 
 hope that the rich will, in due time, come in for a share of 
 this well-directed philanthropy. 
 
 We hear much of applied science, but the community has 
 yet to learn its direction towards a better system of either pub- 
 lic or private hygiene. Both proprietors and builders of 
 houses are, for the most part, quite innocent of the desired 
 knowledge of this subject. Division of rooms for business or 
 family wants in the interior, and decorations externally after 
 some order, Greek or Gothic, or a barbarous blending of both, 
 are the only things thought of in relation to modern structures. 
 How the inmates are to procure an adequate and continued 
 supply of fresh air, and how to get clear of that which is im- 
 pure, are not even secondary matters : they are sometimes 
 discussed as curious questions of philosophy, but seldom with 
 a view to their direct bearing on health. Wearied, oppressed, 
 and giddy, and with palpitating hearts and hurried breathing, 
 
96 
 
 how many, after leaving a church, have mistaken their really dis- 
 turbed states of the physical man for those which result from 
 the workings of the Spirit ; and have retired to their homes, 
 fiill of terrors for the state of their soul, when, in reality, they 
 were suffering from a disorder of their corporeal functions, in- 
 duced by the impure and half-poisoned blood circulating 
 through their veins ? We are familiar with the " blue Mon- 
 day" of dissipated and drunken workmen and laborers, who 
 pay the penalty of a recognized gross infraction of natural laws 
 on the preceding Sunday, but we are not often aware of the 
 well-defined u blue Monday," as exhibited in feelings of lan- 
 guor, depression of spirits, and unevenness of temper in those 
 who have sinned against these same natural laws, albeit in a 
 different manner, by their three goings to church, including an 
 evening service on the Sabbath, and breathing all the while 
 an impure air. Dr. D. B. Reid, who visited numerous church- 
 es in hot weather, to observe the effects of bad air on the con- 
 gregations, gives the result in a very graphic sketch, which we 
 regret not having room to insert. We would refer to his work, 
 entitled Illustrations of the Theory and Practice of Venti- 
 lation, with remarks on Warm Air, Exclusive Lighting, 
 and the Communication of Sound, for much valuable infor- 
 mation on the entire subject embraced in our present notice. 
 
 The same author has favored the public with a more recent 
 treatise on Ventilation in American Dwellings, with a 
 series of illustrative diagrams ; and to this eminently practical 
 work, Dr. Elisha Harris has contributed an Introductory 
 Outline of the Progress of Improvement in Ventilation. 
 The volume is replete with instruction on a most interesting, 
 we might say vital topic. 
 
 Dr. E. Harris, after stating "the imperative necessity of giv- 
 ing prompt and efficient attention to the removable sources of 
 danger and disease which exist in our communities," presents 
 the subject in a very lucid manner in the shape of the follow- 
 ing propositions : 
 
97 
 
 " First. We would refer to the fact that more than one half 
 the entire population of the city of New York reside in crowd- 
 ed tenement-houses, and that there is no statute or municipal 
 law regulating the construction, ventilation, or the space al- 
 lowed to specified numbers of residents therein. Hence 
 crowding such structures to their utmost capacity has become 
 the rule rather than the exception. And it may here be stated, 
 that our city has an underground or cellar population of more 
 than twenty-five thousand persons. 
 
 "In the 17th Ward alone, there are 1257 tenement- 
 houses, having 20,917 rooms, which are occupied by 10,123 
 families, embracing a total number of 51,172 persons ; thus 
 giving an average of about four persons to each suit of two 
 apartments, one only of which is usually occupied as a dormi- 
 tory, and that one often a dark, close room, of a capacity only 
 of from 500 to 800 cubic feet. Now, in a close apartment of 
 only 600 cubic feet, a single person cannot spend six consecu- 
 tive hours, in air of ordinary temperature, without impair- 
 ment to health. 
 
 " Dr. Reid's estimate of ten cubic feet of pure air per min- 
 ute, for the respiration of an adult person, .is certainly quite 
 low enough for an average of comfort and safety, and with 
 such an allowance, the air in such an apartment would become 
 too much vitiated for healthy respiration at the expiration of 
 sixty minutes or one hour ; and allowing that the air is par- 
 tially replenished during that brief period, the atmosphere 
 would be decidedly unwholesome at the expiration of two or 
 three hours. Or, taking the lowest estimate within the limits 
 of safety, as given by Dr. Neill Arnott, viz., about three 
 cubic feet per minute, such an apartment could not be consid- 
 ered a healthy sleeping-room for a single person, much less 
 a safe dormitory for a whole family. 
 
 4 In some of the lower wards of the city, the tenement- 
 houses are much more densely crowded than in those just 
 
98 
 
 mentioned. In one of them, containing from 120 to 150 fam- 
 ilies of three to ten persons each, there are but about forty 
 feet of frontage and sunlight. In two of the smallest of those 
 apartments, eight cases of malignant typhus have been seen 
 at one time. And at the last visitation of cholera, the first 
 cases of that malady occurred in that pent-up and overcrowd- 
 ed locality. 
 
 " Second, Small-pox, typhus fever, and every other pesti- 
 lence find a genial and prolific soil in such crowded, 'unventi- 
 lated structures as the habitations of the poor in our city, and 
 from them the germs of fatal diseases are continually conveyed 
 to the dwellings of the more favored classes. 
 
 <c Third, The fashionable and gregarious custom of crowd- 
 ing our hotels and boarding-houses is becoming a hazardous 
 practice, unless more attention is given to the hygienic condi- 
 tion and wants of such establishments very few of which 
 have hitherto been provided with any thing like systematic and 
 efficient ventilation, or perfect drainage. The recent fearful 
 endemic at the National Hotel, in the city of "Washington, 
 should teach an important practical lesson on this subject. 
 
 " Fourth, The drainage or sewerage, and the necessary 
 measures for securing general cleanliness and a pure atmo- 
 sphere, are not yet suitably provided for by law. 
 
 " Fifth, Architecture, in its applications to private resi- 
 dences as well as to public edifices, has not yet had primary 
 or suitable reference to man's hygienic interests. Adaptations 
 for a sufficient supply of pure air and sunlight have been sa- 
 crificed to architectural effect on the one hand, and to a mis- 
 taken economy on the other. 
 
 " The vital importance of a correct understanding and esti- 
 mation of such considerations as the foregoing, must be man- 
 ifest to all who intelligently investigate such subjects ; and to 
 the political economist, the merchant, and the moralist, these 
 
99 
 
 
 topics are invested with relations quite as interesting as those 
 that lead the physician and the philanthropist to study them." 
 Dr. Eeid was one of the Commissioners appointed by 
 Queen Victoria for inquiry into the state of large towns and 
 populous Districts ; and his opinions are founded on large ex- 
 perience 
 
 In /Schools. The greatest sufferers from the general ignor- 
 ance of elementary physiology and hygiene among architects, 
 controllers and teachers, are children in schools, both public 
 and private ; the latter just now probably the more punished 
 of the two. We need not repeat from the report of the Com- 
 missioners just mentioned, the distressing particulars of the 
 wretched state of the cottage schools in the different parts of 
 England, nor of the dame and public schools of Liverpool and 
 Manchester some years ago. Abundant matter for comment 
 and stricture is offered to observation in the schools of th.e 
 United States. The fate of the school children of poor or im- 
 provident parents, who reside in narrow streets, courts, or al- 
 leys, is peculiarly hard ; for, after suffering from partial suffo- 
 cation during the night and a part of the day in their own 
 wretched homes, they are subjected to a similar, if not more 
 injurious process in their school-rooms, into which they may 
 be said to be entrapped, and thus cruelly treated under the 
 show of kindness and regard for their welfare. 
 
 Of all the various edifices in which a number of persons are 
 gathered together, and for whose protection and benefit an effi- 
 cient system of ventilation is needful, none are of such para- 
 mount importance as school-houses, and none have been so 
 generally, and we might add so cruelly neglected. The child- 
 ren who sit in them for many hours daily, require, above all 
 other members of the community, a continued supply of fresh 
 air for their healthy growth, and to allow of their tender 
 brains being tasked without detriment and continual danger 
 
. iff 
 
 r VV Li i 1 
 
 100 
 
 to their intellects, and a depression of spirits and languor so 
 opposed to their instinctive feelings' and tendencies. The 
 originally indolent boy becomes at school a hater of lessons 
 and books, associating as he does with it all that is wearisome 
 and dull ; while the boy desirous to learn, and emulous of dis- 
 tinction, becomes exhausted by his brain-work, and*his nerv- 
 ous system acquires a morbid sensibility which remains with 
 him during all his after-life. The unrenewed air of a school- 
 room soon becomes charged with the noxious exhalations both 
 from the lungs and the skin. The latter organ, in a vast ma- 
 jority of the poorer children, and in not a few of the wealthier 
 class, becomes, for want of due attention, almost coated 
 with perspirable and other matters, and is a source of contin- 
 ual poisoning of the air of an ill-ventilated room. The archi- 
 tectural arrangement of nearly all the schools in England, as 
 far as they were examined some years ago, was, with few ex- 
 ceptions, deplorably defective, especially where the scholars 
 slept in the building. Among many instances of the same 
 kind, we may state that, in Manchester, the blue-coat boys 
 suffered from scurvy, which was removed in a great measure 
 by an amended diet, and by ventilation of the dormitories 
 after a fixed method. But it is not necessary to look abroad 
 to find a general neglect of school hygiene, evidenced even in 
 what all call first-class seminaries, as well as in those of less 
 pretension and with humbler inmates. 
 
 In Hospitals. All medical men must be aware, at the pre- 
 sent time, how much the mortality is increased in hospitals 
 and asylums of every kind by a confined air, rendered nox- 
 ious by want of ventilation. The greatest skill on the part 
 of the professional corps, the most attentive administration of 
 well-selected medicines by intelligent and humane nurses, are 
 nullified by the inmates of a hospital breathing an air not con- 
 tinually renewed, and which, if allowed to remain stationary, 
 even for a very short period, becomes charged with einana- 
 
101 
 
 tions, gaseous and animal, of the most deleterious kind. It is 
 not too strong language to say, that a renewal of the air in 
 hospitals, which implies adequate ventilation, is a question of 
 life or death : every hospital in which the atmospheric air re- 
 mains vitiated, so far from being a "benefit to the poorer class- 
 es, becomes a, public calamity. Better that its inmates should 
 remain in their own wretched tenements, deprived of all med- 
 ical attendance, than to be subjected to the concentrated poi- 
 son of the large wards of a hospital. Many years ago, during 
 a season of epidemic visitation of small-pox in Philadelphia, it 
 was found that the mortality from this disease was greater 
 among the inmates of the hospital at Bush Hill, of which your 
 reporter was at the time the chief medical attendant, than 
 among the sick in the city, many of them living in confined 
 courts and dirty alleys, who came under his care as dispensary- 
 patients. As illustrative of the contrasted effects of crowding 
 and bad ventilation on the one hand, and of improved ventila- 
 tion on the other, reference may be made to the Lying-in Hos- 
 pital, Dublin, in which there died 2,944 children out of 7,650 ; 
 but after ventilation, the deaths, in the same period of time, 
 and in a like number of children, amounted only to 279. 
 The quantity and poisonous nature of the exhalations 
 continually given out in the wards of a hospital occu- 
 pied by the sick, are strikingly shown by Montfalcon and 
 Poliniere in a treatise on the Health of Great Cities,* when 
 speaking of the Hotel Dieu, the great hospital at Lyons. 
 The large fever wards of this building represent a cross, at 
 the centre of which is a vestibule surmounted by a dome and 
 a cupola ; in it is placed an altar of marble, over which is a 
 smaller dome. From the wards thus communicating with the 
 vestibule, the impure air and exhalations escape into the dome 
 and cupola, which act as so many funnels, and thence through 
 suitable openings they find exit into the outer air. The 
 
 * Trait6 de la Salubrite dans lea Grandes Villes, suivie de 1'Hygiene de Lyon. 
 
102 
 
 amount of mephitic air accumulated in the dome and cupola, 
 and afterwards expelled, is incredible, as no one could form 
 the least idea of it when visiting the wards and "breathing an 
 air exempt from all bad smell in them. But if workmen at 
 this very time ascend to the cupola, especially near its top, 
 they will suffer so much from the close and foul air which has 
 risen from below, as to be unable to continue their work, at 
 the longest, for more than half an hour. Sometimes even 
 after half an hour's delay in this infectious medium, they come 
 away pale and oppressed, and so disordered that sometimes 
 they sink down in a state of syncope. Many workmen are 
 obliged to succeed one another, to perform the work of a single 
 man. 
 
 In Work-shops and Factories. The work-shops of persons 
 engaged in various mechanical employments are for the most 
 part exceedingly deficient on the score of ventilation, and their 
 inmates in consequence encounter much suffering and disease. 
 Dr. Southwood Smith relates many distressing details of thia 
 nature, which came under his own observation. There was 
 a room in London, sixteen or eighteen yards long, and seven 
 or eight yards wide, in which eighty working tailors sat, and 
 so closely to each other, as to be nearly knee to knee ; one 
 witness told of his having known young men, tailors from the 
 country, faint away in the shop from the excessive heat and 
 closeness. It was of frequent occurrence in such work-shops, 
 that suits of clothes of a light color were spoiled from the 
 perspiration of the hand, and the dust and flue which arose 
 during the work. In winter, these places are still more un- 
 healthy, as the- heat from the candles it may now be said 
 gas and the closeness are much greater. The entrance of 
 fresh air through an open window is objected to by those 
 nearest to it on account of the draught, and generally they pre- 
 vail in keeping out the cold that is, the fresh air. The 
 effects of continued exposure to this impure and deleterious 
 
103 
 
 air, were to drive away many before their labors were over, 
 and to take away the appetite of those unaccustomed to the 
 place. " The natural effect of the depression," continues the 
 witness before the Commissioners, "was that we had recourse 
 to drink as a stimulant ; gin being taken instead of food. I 
 should say the greater part of the habit of drinking was pro- 
 duced by the state of the place of work, because when men 
 work by themselves, or only two or three together, in cooler 
 and less close places, there is scarcely any drinking between 
 them." 
 
 Seamstresses, &c. What has been said of the journeymen 
 tailors, applies with too much force to the individuals of the 
 other sex, who work in milliner and dressmaker shops, with 
 the additional aggravation of their being sometimes kept up 
 late at night to finish the dress promised by the employer for 
 the next day. Even when working alone in their small and 
 close rooms, from morn to night, in a half-bent posture, they 
 are objects of deserved pity, as victims to the sin of a neglect 
 of hygiene. 
 
 Printing Offices, in which germinate so many young 
 Franklins, do not exhibit, if we may judge from the indiffer- 
 ence of those who work within them, the shrewdness of their 
 professed model, in either devising or availing themselves of 
 known measures for the promotion of health, foremost of which 
 is attention to the respiratory function. If it be true, as 
 alleged, that pressmen are less liable than compositors to pul- 
 monary consumption, we have additional confirmation of the 
 fact, pointed out by Dr. Guy, of the greater frequency of this 
 disease among those who are habitually exposed to a close 
 and impure air, and especially if, at the same time, they are 
 deprived of all exercise. The saving nature of this last is 
 evinced under the circumstances just stated. 
 
 Nautical hygiene shows that outbreaks of cholera have 
 occurred aboard ship from defective ventilation. 
 
104 
 
 Pulmonary Diseases from Defective Ventilation. It has 
 been observed that, as a general rule, the frequency of pulmo- 
 nary diseases in England is greater among the males than 
 among the females, in the proportion of 100 to 94 as regards 
 the country generally ; but that in particular districts and 
 towns, the greatest death-rates from these causes are on the 
 side of the females. The difference is attributable to the con- 
 finement in factories or in shops, and even in their own 
 houses, of this part of the population, while engaged in mak- 
 ing textile or other fabrics. ~n three of the registration dis- 
 ricts in which this difference prevails, a good proportion of 
 the adult females are engaged in industrial manufacturing 
 pursuits these being chiefly conducted at their own homes. 
 Exceptions, not yet explained, occur in this matter in some 
 counties in England. We are, after all, safe in adopting the 
 opinion expressed by Mr. Simon, namely : " In proportion as 
 the male and female populations are severally attracted to 
 indoor^branches of industry, in such proportion, other things 
 being equal, their respective death-rates by phthisis are in- 
 creased." In the lace-making districts, the female death- 
 loss seems always to exceed the male. " The pulmonary 
 death-rate is usually excessive in towns where both males and 
 females are largely employed in the manufacture of textile 
 fabrics ; but the difference in the mortality of the sexes is 
 rarely great." So in Manchester, which, as one of the cotton 
 manufacturing districts, has a high pulmonary mortality, the 
 difference in the death-rates of males and females is slight ; 
 both being largely engaged in the industrial occupations of the 
 place. In comparing this state of things with what occurs in 
 Liverpool, we find that city, with a higher mortality still, 
 does not show it so much in its female population, who are 
 not engaged in any special employment. 
 
 Defect of Light. Next to the apparent determination to 
 exclude fresh air from the habitations of man, and from all the 
 
105 
 
 places in which people assemble for the purposes of .religious 
 worship, business, and pleasure, is the apparent determination 
 to prevent full access of light to the human body. The para- 
 mount importance of light to vegetation, so that through it 
 plants acquire not only their verdure but the variegated colors 
 which we admire in their flowers, as well as their requisite 
 firmness of texture and the distinctive flavor of their juices, 
 seems to have received only a passing application, suggestive 
 of its producing analogous effects on animals. The bleaching 
 and sickly character of vegetables, which follow the privation 
 of solar light, and their sleep during the night, showing great- 
 ly diminished vital activity, find their parallels in the influence 
 of the same cause on the animal economy. Comparative phy- 
 siology furnishes additional proof in the same line of argu- 
 ment. When the eggs of a frog are put in water, in a vase 
 with opaque sides and top, so^as to exclude the light, they 
 evince no change ; whereas, eggs in water of the same quan- 
 tity and temperature, exposed to the light, undergo a gradual 
 development, and exhibit in due time young tadpoles. The 
 subsequent transformation of these beings is not prevented, 
 but it is retarded by their being kept in darkness Edwards, 
 who made these experiments, thought that in countries in 
 which nudity was allowed by the nature of the climate, expo- 
 sure of the whole surface of the body to light, or to inso- 
 lation, as we may term it, was very favorable to good bodily 
 conformation. Humbolt sesms to incline to the same opinion. 
 He asserted that deformity and deviations from the natural 
 standard of symmetry are very rare in certain races of men, 
 especially among those with a highly-tinted dermoid system. 
 The sinister effects of want of the sun's light in underground 
 apartments, and in houses, narrow alleys, and in deep courts, 
 almost ^blocked out from its genial access, ought to share 
 largely with humidity and impure air in the production of 
 scrofula and scurvy, and must count its full share in* the 
 
106 
 
 etiology of anaemia and chlorosis, and of the pallid and earthy- 
 colored skin of miners, and the tenants of prisons, as also of 
 those persons who lead a sedentary life in ill-lighted habita- 
 tions. Dr. Brown, of Chatham, near London, calls attention 
 (Sanitary Review, April, 1858) to the injurious effects of 
 underground kitchens. He would have large room for com- 
 ment in some of our cities, especially New York, in which 
 there are not only underground kitchens, but where also it is 
 quite common to meet with dining, and sometimes sleeping- 
 rooms thus situated. This vicious architectural arrangement 
 is too common also in Philadelphia. Dampness is generally 
 associated with the want of light, and performs a not unim- 
 portant part in causing disease, by withdrawing from the body, 
 as Dr. Brown supposes, "its normal proportion of electricity, 
 and thus occasions disorders that depend upon diminished 
 nerve force. These are ague, neuralgia, certain forms of rheu- 
 matism, epilepsy, chorea, and asthma, with some other affec- 
 tions, such as dyspepsia." The servant girls of London ex- 
 emplify, in their etiolated condition, and their breathlessness, 
 as well as the anaemia under which they suffer, the evil effects 
 of dampness and of deprivation of the solar rays. The func- 
 tions peculiar to their sex are carried on imperfectly, or are 
 absolutely suspended ; hence the headache, the pains in the 
 side, the palpitation, and the dropsical ankles so frequently 
 witnessed in this class. Organic disease of the heart is origin- 
 ated by these causes in some instances. Another considera- 
 tion stated by Dr. Brown, but not bearing on our present 
 theme, is the exhaustion attendant on the frequent ascent 
 and descent of stairs. 
 
 Dr. Elisha Hams, in his replies to the New York Commit- 
 tee, lays great stress on the privation of sunlight to a vast 
 proportion of the population of the city, " not only in work- 
 shops, in warehouses, in counting-rooms, and in basements ; 
 but in the modern tenement-houses, the hotels, the school- 
 
107 
 
 rooms, the churches, and the private dwellings." He adds, 
 and with becoming warmth of language : "So important is 
 light to human health, that it should be made a legal offense 
 for any party to deprive a neighboring dwelling of light." He 
 repeats an observation of Sir John Wylie, for many years 
 physician to the Emperors Alexander and Nicholas, of Russia, 
 viz. : that in a certain barrack at St. Petersburg, the mor- 
 tality on the dark side, that from which sunlight was always 
 excluded, was two hundred times greater than on that side on 
 which the sun shone, and penetrated into the windows and 
 doors of the apartments. 
 
 THE REMEDIES. After a tolerably full notice of the 
 impurity, and, still worse, the virulent properties and ef- 
 fects of the air, caused by overcrowding and defective 
 ventilation, we are the better prepared to inquire into 
 the means of the cure, and still better, because acting on 
 a larger scale, the prevention of the evils described. The 
 measures for meeting this object must be undertaken and 
 carried out on a scale commensurate with the extent of 
 the obstructions to be overcome. They require for their 
 successful performance, discreet but firm legislation. First 
 should be carried into effect the recommendation of the Eng- 
 lish commissioners already noticed, viz. : to empower the local 
 and municipal administrative bodies, to raise money for the 
 purchase of property, with a view of opening thoroughfares 
 and widening streets, courts, and alleys, so as to improve the 
 ventilation of the densely-crowded districts of towns, as well 
 as to increase the general convenience of traffic. Practical 
 suggestions in this line occur to us on learning the steps taken 
 by the present Emperor of France, for the improvement and 
 embellishment of Paris. There may be a difference of opinion 
 respecting the motives which influence the French ruler in the 
 great changes which have been brought about, and others still 
 in progress and projected, in the interior of the capital ; but 
 
108 
 
 of one thing we may be well assured, that tfce public health 
 will gain immensely, and this through the external ventila- 
 tion procured by the new wide and magnificent streets, which 
 intersect, and, in degree, break up the crowded dens of miser- 
 able tenements, in dark and narrow streets, occupied by a pop- 
 ulation ready at any hour to engage in scenes of public revo- 
 lution or of local outbreak and bloodshed. With a view of 
 securing better ventilation, the Commissioners farther recom- 
 mended, that courts and alleys be not built of a less width 
 than twenty feet, to be open at both ends ; and that they have 
 an opening of not less than ten feet from the ground upwards, 
 at each end ; the width of the court being in proportion to the 
 height of the houses. Streets are not to be of less width than 
 thirty feet. 
 
 Local acts, as authorized by acts of Parliament, have al- 
 ready been passed in Liverpool, Leeds, and London, and 
 doubtless in other cities and towns, since our attention was 
 last directed to this point, prohibiting the use of cellars in 
 dwellings, unless they are so constructed as to provide pro- 
 tection against the existence of the evils which we have just 
 pointed out. The Commissioners farther recommended that, 
 after a limited period, the use of cellars as dwellings be pro- 
 hibited, unless the rooms are of certain dimensions, and are 
 provided with a fire-place, and window of sufficient size, made 
 to open, and that said dwelling have an open space in front ; 
 and also, that the foundation be properly drained. Prohibi- 
 tions have been suggested, if not laid down by actual enact- 
 ment, against building houses back to back a vicious practice, 
 which effectually prevents both a deep supply of light, and 
 any adequate ventilation by a through current of air through 
 each house. 
 
 "The French Government has appropriated 10,000,000 
 francs to encourage the building of workmen's dwellings. 
 Many model cottages are now being erected in the neighbor- 
 
109 
 
 hood of Paris ; each is designed for four families, and each 
 containing four rooms, is to be let at 150 francs a year. They 
 are to be exclusively for laboring men and their families, and 
 to be supplied with water and gas. One hundred and fifty 
 more of these chalets are to be erected in and about Paris ; 
 and already 15,000 applications have been made for them to 
 the Administration. 
 
 "At Mulhouse, a society had expended, up to the close of 
 1855, 900,000 francs, for a like object; the Government 
 having contributed 150,000 francs. 
 
 "At Genoa, where the municipality expended 12,500,000 
 francs, during the last invasion of the Cholera, chiefly for the 
 relief of those living in defective, unhealthy dwellings, a com- 
 pany has been formed to erect houses for workmen, in which 
 the King of Sardinia has taken 150 shares. 
 
 " At Berlin, there is a Building Society, under the patron- 
 age of the Prince of Prussia, with a capital of 200,000 thalers, 
 which yields 4 per cent, on the investment. It has now 202 
 occupied dwellings, and 27 work-shops. 
 
 " In Tuscany, the Grand Duke, in October, 1844, issued a 
 decree, empowering all municipal magistrates within his terri- 
 tory, who may deem it expedient, to form a commission for 
 providing the means of cleansing and rendering wholesome the 
 dwellings actually let or occupied by any other person than 
 the proprietor, which are in such a state as to be dangerous to 
 the health of the occupants or community. 
 
 "There are also societies to improve the dwellings of the 
 working men at Parma, Dresden, Brandenburg, Bremen, 
 Chemnitz, Locle in Switzerland, and many other places. 
 
 " The houses erected are incomparably better than the ordi- 
 nary dwellings for the same class ; the rents are lower, with 
 
the privilege generally to the tenants of becoming propri- 
 etors."* 
 
 Model Houses. After State and municipal governments 
 shall have done their duty, by wise and liberal enactments, 
 and providing means for giving them effect, a large field will 
 still be left for the exercise of individual benevolence, or of 
 voluntary associated effort, to carry on a series of auxiliary 
 measures, which are necessary to the completion of those of a 
 public and administrative nature. Among these it is pleasant 
 to be able to announce, not merely the inception of plausible 
 plans but their already successful execution, as in the erection 
 of model-houses in town, and model-cottages in the country, 
 for the use of the working classes in England. The new 
 buildings, though small, are on a footing of comfort and sanitary 
 arrangements, as to a due supply of water, warming, and ven- 
 tilation, equal, if not superior, to larger mansions inhabited by 
 the wealthy. The trials so far verify a remark made by the Rev. 
 Mr. Girdlestone, who has taken an active and praiseworthy 
 part in sanitary reform : " that one of the most efficacious 
 means of elevating the condition of the laboring classes is the 
 improvement of their dwellings." At Birkenhead, opposite 
 Liverpool, dwellings have been erected in a style so neat as to 
 approach to elegance, by the Dock Company, for the accom- 
 modation of the workmen employed in the construction of the 
 docks and warehouses of that new and flourishing town. 
 Tenements have also been erected at the same place by Mr. 
 William Laird, called " Morpeth Buildings," and others by 
 Mr. Robert Hughes ; the former consisting of sixty-four, the 
 latter of seventy dwellings. The first is built on the Scotch 
 plan, in flats, or suites of rooms on a floor, and constitute eight 
 blocks, each block consisting of eight dwellings. The blocks 
 
 * The Fourteenth Annual Report of the New York Association for Im- 
 proving the Condition of the Poor, for the year 1857. 
 
Ill 
 
 are four stories high, with no yard or cellar, and each flat is 
 divided into two dwellings. Each dwelling consists of three 
 rooms kitchen, parlor, and bed-room, or two bed-rooms. Th$ 
 kitchen is provided with a range and oven. Separated from 
 the kitchen, by a well-fitting door, is a water-closet, with an 
 abundant supply of water for this and all other purposes. 
 Through the centre of each block, from top to bottom, runs a 
 square shaft, containing the water and gas-pipes belonging to 
 the eight dwellings. A small iron door, about ten inches 
 square, is fixed to one corner ot a recess, close to the ground, 
 through which all the dust and dirt are swept ; the dust-shaft 
 receives the dust from all the eight dwellings by eight similar 
 openings, and* decends to a very large dust cellar beneath the 
 level of the house,' from which it is removed at stated periods. 
 Each house is ventilated by two air-bricks that is, a space 
 equal to the size of a brick is left open for the admission of 
 ah, covered within and without by an iron grating, and capa- 
 ble of being closed by an iron shutter, if necessary. One of 
 these openings is placed near the ceiling, for the escape of 
 vitiated or heated air. There is only one appliance, external 
 to the person, wanting in these houses, viz. : the bath. In 
 New York, tenements of this description have been con- 
 structed ; and, where ground is so valuable, and the popula- 
 tion so dense, in some of the worst districts, they must be 
 regarded with favor, although they may allow of but compar- 
 atively limited external ventilation. 
 
 Model lodging-houses have likewise been built in London 
 and other places with the most satisfactory results. The * 
 houseless, the destitute, and the very poor are comfortably 
 lodged, at the same time that they escape the contamination 
 both of disease and vice, for a very small sum, but which is 
 remunerative to the proprietor. At a meeting, some years 
 back, of the " Society for Improving the Condition of the 
 Working Classes" Prince Albert presiding, it was stated by 
 
112 
 
 Lord Ashley, that the new lodging-houses gave nightly lodg- 
 ing, with every accommodation for cleanliness and decency, at 
 Jhe rate of four pence (eight cents) a night ; so entire was the 
 success and so remunerative was the profit obtained, that 
 upon a sum of about 13,000 or 14,000 pounds sterling 
 (65,000 to 70,000 dollars) expended on these lodging-houses, 
 they were now receiving an income of very nearly 1500 
 pounds, or (7500 dollars) a year. Great improvements have 
 been brought about in common lodging-houses throughout the 
 kingdom by Lord Graftenbury's act, as it is called. 
 
 With such examples of successful sanitary reform before 
 them, the people of the city of New York need not hesitate 
 day before entering on a similar course, and thus regain * 
 high health-rate which it once enjoyed, realizing the benefits 
 due to its naturally favorable situation, and to certain hygienic 
 measures which have been completed on a large scale at great 
 cost. In the words of the Committee of Investigation of the 
 health department of the city of New York, we can say : "A 
 healthful river flows beneath its streets and avenues, supply- 
 ing every habitation with sufficient water to allay thirst, to 
 prepare food, and to promote cleanliness. The island on 
 which it stands is laved by two noble rivers, whose tides uplift 
 and cleanse the respective streams. Its sewerage is advancing 
 with rapid stretches from street to street, and the fresh breezes 
 from the ocean temper the coldness and moderate the heat of 
 its climate." 
 
 MEANS OF VENTILATION. When persons speak of the 
 necessity of fresh air for health, they are not always aware of 
 the various purposes which it serves in the animal economy. 
 It is a " thing," a substance to be weighed and measured as 
 we would water. It is a food, the introduction of which into 
 the lungs is more necessary than that of the substances com- 
 monly reckoned as food which are introduced into the stomach. 
 The call for the aerial food is incessant, allows of no pause , 
 
113 
 
 that for the solid and liquid food is periodical and allows of 
 postponement for many hours. Using the terse language of 
 a recent writer, when speaking of the air: "It affords 
 mechanical support ; it is a heat-modifying medium ; it swal- 
 lows all gases exposed to it ; it supplies a food to man, out of 
 which he is in part built up ; it feeds him with the active 
 principle by which the warmth of his body is sustained. The 
 chief sustaining element of the air inspired in breathing, is 
 the oxygen, which forms a fifth part of the whole of the 
 atmospheric sea." The minute terminations of the branches of 
 the bronchia, themselves ramifying from the windpipe, and 
 called air-cells, amount to about six hundred millions. The 
 air in these cells, and chiefly its oxygenous portion, permea- 
 tes their sides and enters those of the minute blood-vessels, 
 which are ramified over them, and thus finds entrance into 
 the blood with which it mixes, and which it so changes as to 
 fit this vital fluid for the nutrition and building up of the 
 new and assisting to remove the old materials of the organs. 
 While the blood is thus changed by the introduction of oxy- 
 gen, it gives off, 'at the same time, its gaseous refuse in the 
 form of carbonic acid and animal exhalations. There is no 
 tampering with the respiratory wants : the lungs must have 
 their due supply of pure air, or the entire animal organism 
 suffers the lungs suffer, the heart suffers, the brain suffers, 
 and the mind works slowly ; the stomach is weakened in its 
 functions ; muscular movement is enfeebled ; the senses are 
 dull ; the natural color of health is replaced by pallor. The 
 movements of inspiration and expiration, which make up re- 
 spiration, constitute the natural ventilation of the living frame. 
 This living ventilation is carried on unceasingly from birth to 
 death, by the infant as well as by the adult, by the profoundest 
 philosopher as well as the solitary artisan in his close polluted 
 atmosphere, or by the sailor nursed amid storms, in a pure and 
 invigorating air. Whether the circumambient air be pure or 
 
pestilential, we drink of it twenty times a minute ; if of the 
 latter kind, we look old in our youth ; if of the former, we 
 maintain the appearance of youth in old age. The average 
 chance of living to the proverbial age of threescore years and 
 ten may be considered the measure of the purity of the air we 
 breathe.* 
 
 Different Modes. All the different modes for ventilation 
 are reducible to three heads : 1. To ventilate by heat, or by 
 a chemical process. 2. By pumping, or a mechanical process. 
 3. By the pressure and movements of the atmosphere 
 without let or hindrance, f Dr. Reid, both in his work before 
 mentioned and in his Report to the Commissioners on the 
 Northern Coal Mine Districts, enters fully into this interesting 
 question, which he presents under the following aspect : 
 "Ventilation depends essentially on three conditions: the 
 quality of the external air ; the quantity that can be made to 
 flow through it in a given time, including the mode of distri- 
 bution and the regulation of which it is susceptible, whether 
 in regard to the temperature communicated tp it, or the force 
 with' which it impinges on the system ; and its freedom from 
 any noxious ingredients that may be developed by lamps, 
 candles, fire-places, or by any other special cause. Where 
 sanitary measures have secured the purity of the external 
 atmosphere by effective drainage, cleansing, and prevention of 
 nuisances, one-half of the remedy may be secured, and with- 
 out such measures no system of ventilation can be successful." 
 "Were it generally known," writes Dr. Reid, "that the 
 movement from an ascending current from lamps is always 
 accompanied in non-ventilated apartments by a proportionate 
 descent of vitiated air, which may have previously supported 
 combustion, and that the descent, though limited at first, 
 
 * Dr. Hutchinson. Jour, of Pub. Health, vol i. 
 f Sanitary Review, rol. iL p. 208. 
 
115 
 
 may suddenly reach the floor, greater anxiety would be mani- 
 fested to give vent to such products by a superior aperture." 
 Dr. Guy very justly remarks that no system of ventilation 
 can come into general use which does not prevent draughts, 
 which is not cheap, and which interferes to any great extent 
 with existing structural arrangements. 
 
 The great number of plans for ventilation would imply that 
 an easy and efficient system is not yet reached. They 
 are, however, encouraging, as they afford evidence of an in- 
 creasing desire to become acquainted with the subject, and to 
 give it a practical bearing. The extension to which this 
 report has already unexpectedly reached, will forbid my enter- 
 ing into deiails, or even repeating the outlines of all the dif- 
 ferent plans which I gave some years back (1850), in a report 
 on Public Hygiene, read before the College of Physicians of 
 Philadelphia. 
 
 Beginning with the third head of the plans of ventilation, 
 which looks to the natural movements of the air by a simple 
 interchange between that of the interior of a house or other 
 building, and the external atmosphere, Dr. Iveid thinks, that 
 a well-constructed window, capable of being opened above 
 and below, realizes, when the fire-place is well arranged, all 
 the essential conditions for effective ventilation, in the apart- 
 ments or tenements occupied by the poorer classes* This, as 
 he admits, however, will only answer when the weather is not 
 severe. It also assumes, what in our towns now is becoming 
 a rare thing, viz. : an open fire-place. This last is replaced by 
 a stove, or more generally still, by a register for the admission 
 of warm air from the air-chamber heated by the furnace below. 
 
 One of the simplest, and at the same time a most gentle 
 and efficient mode of ventilation, is the admission of external 
 air through a perforated zinc plate, or fine wire gauze, which 
 is to replace a pane of glass in a window of the room toi>e 
 ventilated. The plate is perforated with 290 holes to the 
 
116 
 
 square inch. It, or the gauze wire, is generally introduced 
 in the upper part of the window, and in the place of the cor- 
 ner pane the farthest from the fire-place. Instead of the 
 contrivances just mentioned, the pane of glass might itself be 
 perforated. The fine orifices prevent the air from coming in 
 with a rush, which would occasion discomfort, and they tend 
 to diffuse the air equally and gently through the apartment. 
 No draught is felt unless a person be seated immediately 
 under tke window. But the benefit is not limited to the in- 
 troduction of pure atmospheric air into the room. There is, 
 all the time, an interchange between it and the internal heated 
 and impure air, which thus finds vent and is carried off. The 
 interchange takes place on the same principle with the diffu- 
 sion of vapors and gases, even though they differ from each 
 other in temperature and specific gravity. It is in this way that 
 Jeffray's respirator acts, by mitigating the coldness of the 
 external air in its admixture with the warm internal air, just 
 escaping from the lungs in respiration. The plan of ventila- 
 tion now described is recommended by its simplicity and its 
 cheapness. It is applicable to ordinary sleeping and sitting- 
 rooms, in a private house, as well as to shops, in which, owing 
 to the general absence of an open chimney, or any other 
 means of permanent communication with the external air, it 
 is more urgently required. During the first winter in which 
 your reporter had charge of the men's wards of the Com- 
 mercial Hospital at Cincinnati, he caused gauze wire to be 
 substituted for a pane of glass, in every other window, and 
 the effects were immediate and perceptible, both in a diminu- 
 tion, if not entire exclusion, of the unpleasant odors which 
 pervaded the wards, the ceilings of which were very low, and 
 which were heated by large coal stoves in the centre of each 
 ward. On the following winter, the gauze wire was substi- 
 tuted for the pane of glass in the other windows f f the large 
 ward, and with the best effects. At the conclusion of his first 
 
117 
 
 tour of duty in the spring, his colleagues in the Ohio Medical 
 College were pleased to compliment him on what they termed 
 his successful practice in the Hospital. As statistical returns 
 were wanting, one could not attach much importance to this 
 favorable opinion ; "but if the patients could have spoken, they 
 would have expressed themselves in very decided terms of 
 commendation of the plan Iby which they could breathe with 
 some comfort, especially during the night, and obtain, at the 
 same time, alleviation from the excitement and pains of fever 
 and inflammation. 
 
 Another plan of ventilation still, based on the natural 
 movements of the air, without the aid either of mechanical 
 or chemical means, is by an opening in the wall or ceiling 
 which leads to the external air, and which is protected by a 
 shield or disk, say two inches larger than the aperture. The 
 external air, in impinging against the side of this shield, is 
 split up into a thin circular radiating sheet, and at a short 
 distance below, not more than two feet, a person cannot feel 
 cold entering, nor can the hand detect a draught at eight or 
 ten inches distance from the edge of the disk. The sheet of 
 air may be modified according to the distance of the shield 
 from the aperture. A still farther precaution has been used 
 by Dr. Guy, who adopted this practice for admitting air, 
 through a window-pane of glass. It is to have the sides of a 
 close-fitting shield perforated, and thus to have the air broken 
 into jets. The plan of ventilation through openings with 
 shields or disks before them, has been modified by Mr. Leather, 
 of Sheffield. He introduced it for supplying the day and bed- 
 rooms of the Eccleshall Bierlow Union Poor House with fresh 
 air, and, as lie said, in his evidence before the English Com- 
 missioners for Inquiry, &c., so often referred to in this report, 
 it answers the purpose admirably. An opening is to be 
 made in the outer wall, and a flue carried from it between the 
 floor timbers, to the middle of the ceiling, where the air passes 
 
118 
 
 into the room ; in order to prevent the current of air from 
 rushing downwards, the aperture in the ceiling is masked "by 
 a large circular iron plate. The purpose of this has been 
 already explained. It is fixed on a screw passing through its 
 centre, and by turning th plate round, the aperture may be 
 closed or opened, little or much, and the supply of air regulated 
 at pleasure. Mr. Hosking, in his valuable work on the 
 " Proper Regulation of Buildings in Towns," suggests 
 different plans for ventilation. One of the simplest, and 
 which comes under our present head, is by means of " oppo- 
 site air-flues, or flues opening to the same apartment, in 
 opposite walls, the flue on one side giving vent to the spent 
 air at the highest level the room affords, and that on the 
 other side delivering fresh air at the same high level." This 
 plan will go far to fulfill the indications previously stated by 
 Mr. H., viz. : the expulsion of foul air from apartments by 
 processes which act independently, and which cannot operate 
 offensively, as by cold draughts ; and such processes must be 
 moreover inexpensive, to give them any chance of being 
 largely adopted. The plan just offered will be more complete 
 where there is a fire, whose place is arranged, and whose com- 
 bustion is fed with air, in a manner previously described by 
 Mr. Hosking, so as to insure its own immunity from ignorant 
 interference, while it requires no manipulation that a child 
 may not supply. For the details of his plan, by which the 
 fresh air from without is introduced behind and about the 
 range or stove, and made to do the double duty of feeding the 
 fire and supplying the room for the purposes of respiration, I 
 must refer those curious on the subject to the work itself. 
 The plan is very analogous to the one recommended long 
 before by Franklin. The air-syphon ventilator originating 
 with Dr. Chowne, is recommended by its simplicity ^and easy 
 use, and its adaptation to the general ventilation of buildings, 
 of ships, and of mines ; and if a little care were taken in pro- 
 
119 
 
 viding for its application in architectural designs, many useful 
 results, both in regard to artistic display and hygienic com- 
 forts, would be realized. The general principle of the air- 
 syphon ventilator rests on the curious fact, that if a tube of 
 the syphon shape be placed in a room with the long end 
 uppermost, a current of air will immediately play through it, 
 in the downward direction of the short, and in the upward 
 direction of the long, leg of the tube. Another and still more 
 simple process of ventilation is that recommended by Dr. 
 Corwan. It consists in simply bisecting all tubes or outlets 
 by which a current of air is desirable. The bisecting consists 
 in the introduction of a second tube within the first, so as to 
 allow space between the two. If smoke is to ascend, it will 
 be drawn up in a steady and rapid stream on one or other side 
 of the septum, and a downward current more or less active 
 will be established in the other. " Smoky chimneys, for 
 example, with their legionary train of evils and inconveniences, 
 would be impossible, were their spaces properly subdivided ; 
 for no disproportion in the relative strength of either upward 
 or downward currents would prevent their independent estab- 
 lishment. The short and ever-smoking chimneys of small 
 tenements and upper chambers might thus be made efficient ; 
 and in cases where bisecting the tube was impracticable, sus- 
 pending a central tube would probably succeed. The pipings 
 of stoves, if so constructed, would be far more certain in their 
 action, while the downward draught could be easily converted 
 into an efficient bellows for the fire." Mr. McKennell, of 
 Glasgow, has constructed his patent ventilator on this system. 
 "It consists mainly of air-tubes arranged concentrically, the 
 inner discharging the vitiated air, while the fresh supply flows 
 down the outer tube. It is almost automatic in its action, 
 requiring little or no attention in ordinary circumstances. It 
 removes the air as it is vitiated, and supplies its place with 
 pure air in the exact amount required, in currents so gentle as 
 to be scarcely perceptible." 
 
120 
 
 Mr. Roberton describes the mode of ventilation of the hos- 
 pital at Bordeaux, which is on the same principle as that advo- 
 cated by Mr. Hosking. It consists in having isolated wards, 
 and these open to the air, from side to side and from end to 
 end, by means of long windows, so that a current of air is 
 always passing through, in correspondence with the natural 
 laws of the atmosphere. In carrying out this, the natural plan 
 of ventilation, the perforated zinc or glass plates are most 
 useful. 
 
 Under the head of mechanical or physical means of ventila- 
 tion, come wind-sails, chiefly used on board ship, the bellows 
 or pump, the fan and the screw. The fanner and screw may 
 be looked upon as modifications of the same instrument. All 
 these mechanical plans are described by Dr. Hutchinson, in 
 the Journal of Public Health, vol. ii. In this connection, 
 reference may be made to Dr. Arnott's single ventilating 
 pump, his gasometer ventilating machine in fact, an air- 
 pump also his double-current warming ventilation. In the 
 Niger expedition, the steamers were ventilated after a plan 
 proposed by Dr. Reid, which rested in the plenum and vacuum 
 principles. A fanner or ventilating machine was put in mo- 
 tion either by the machinery of the steam-engine, or by the 
 " kroomen," or when in the rivers, the paddles being discon- 
 nected from the engine, by the paddles themselves, which 
 acted as water-wheels. From the ventilator a series of tubes 
 extended to all the compartments of the vessel. When the 
 fanner worked on the " vacuum principle" the vitiated air 
 was drawn by it from the various compartments, and was dis- 
 charged at an opening in the circumference of the fan-box. 
 When the " plenum principle" was resorted to, the fresh ex- 
 ternal air was connected with the centre, and blown into the 
 distribution tubes to the several compartments. By these 
 means it was hoped that, under any circumstances, fresh air 
 might be infused into, or vitiated air extracted from, the hold, 
 
 
121 
 
 or any part of the vessel. At some periods of the voyage, the 
 air was drawn through a medicator, with the intention of 
 
 removing carbonic acid, and of evolving chlorine. 
 
 
 
 Chemical Ventilation. For nearly all useful purposes, 
 and as an agejit, in some sort, always present, and readily 
 brought into play, heat is the most efficient agent, and it is 
 that which gives rise to chemical ventilation. In fatt, the 
 questions of warming and ventilating apartments are closely 
 related and interwoven one with another. There can be no 
 ventilation where there is no movement of air, and this move- 
 ment, apart from some mechanical contrivances of very limited 
 use and power, is always imparted by heat ; one portion of air 
 rarefied by heat, rising and being replaced by a cooler one, 
 and so on. As long as we have a fire we have a ventilator ; 
 and when the difference between the temperature of a room or 
 hall of any description, and that of the outer air, is not enough 
 to cause an active movement of the air, or where this is mixed 
 with much watery vapor or gases, it is necessary to procure 
 the aid of artificial heat, or a fire, in order to give the requisite 
 movement to the air, and thus insure ventilation. With this 
 view a fire is made in the upper part of the tower of a building 
 to be ventilated, and flues are constructed to establish a com- 
 munication between the room or hall in which persons are 
 assembled, and the chimney of the fire-place, or a common 
 central flue contiguous to and heated by this fire. A few 
 large gas-burners will answer the purpose of this last, and 
 with less trouble to the attendants, and less risk to the build- 
 ing. The impure air is by this means drawn, as it were, from 
 the various rooms below, through the prepared apertures at the 
 upper part, or near the ceiling, and passes along the flues 
 which converge at the central flue, whence it finds its way 
 into the open air, at such a height, and with such a rapidity 
 of movement, as to insure its diffusion through the atmo- 
 
122 
 
 sphere, without its exerting any injurious effects on the people 
 out of doors, or, in fact, without the possibility of its reaching 
 them. By methods of this kind, we could ventilate all places 
 in which people congregate for any length of time, as churches, 
 schools, and lecture-rooms, courts of justice, concert, and danc- 
 ing-rooms, and theatres, or in which a number of persons are 
 confined from infirmity or sickness, as in hospitals and other 
 asylums, or for crimes, as in prisons. The ingress air, or that 
 from without, is to be introduced in quantity bearing a rela- 
 tion to the number of persons assembled, and to the quantity 
 of egress air through the discharging flues. When, however, 
 it is necessary to procure artificial warmth for the comfort of 
 the parties assembled, in any of the ways just mentioned, 
 then the heating apparatus will rarefy the air sufficiently to 
 insure, after it has been used in respiration, its rising and 
 being earned off by exit flues opening into the external atmo- 
 sphere. These flues for egress air should be somewhat of a 
 valvular form, because air, except under a powerful and quick 
 motion, will, from any cause, regurgitate into the apartment 
 or hall. By the internal valve for egress air, we must be 
 understood to mean some valvular machine opening into a 
 heated chimney-flue, which may pass up the side of the 
 chamber. The internal valve is, therefore, chiefly applicable 
 to private rooms or buildings constructed on a similar system. 
 More than sixty years ago, Franklin spoke of the advantage- 
 ous system of making a communication into a smoke-flue 
 near the ceiling of the wards of the Pennsylvania Hospital, 
 and that such an opening, together with another in each door 
 of the ward, made them all "perfectly sweet." 
 
 The ventilating valve of Dr. Arnott has got into extensive 
 use, and when correctly fitted up, works well. It is placed 
 in an opening made for the purpose from the room into the 
 chimney-flue, near the ceiling, by which all the noxious air, 
 caused by the breathing of persons in the room, the combus- 
 
123 
 
 tion of gas or other bodies for lighting, &c., is allowed at 
 once, in obedience to the chimney draught, to pass away ; 
 but through which no air or smoke can return. The valve is 
 a metallic flap to close the opening, balanced by a weight on an 
 arm behind the hinge. The weight may be screwed on its 
 arm to such a distance from the axis, or centre of motion, 
 that it shall exactly counterpoise the flap ; but if a little far- 
 ther off, if will just preponderate, and keep the flap, when not 
 acted on by entering air, very softly in the closed position. 
 Although the valve, therefore, be heavy and durable, a breath 
 of air suffices to remove it ; which, if from the room, opens 
 it, and if from the chimney closes it, and when no such force 
 interferes, it shuts. The valve is so regulated originally, as 
 to settle always in the closed position. An important part of 
 the arrangement is the wire, which descends like a bell-wire, 
 from a valve to a screw or peg fixed in the wall within the reach 
 of a person's hand, by acting on which the valve may be 
 either entirely closed, or left free to open in any desired degree. 
 In cold weather, or with few persons in the room, the valve, 
 when only opened a little, allows as much air to pass as is 
 requisite. A flap of thirty-six square inches area is large 
 enough where there is a good chimney draught, for a full- 
 sized sitting-room with company. It is essential for the suc- 
 cessful working of this ventilating valve, that the chimney 
 draught be uniform and good, so that no more air shall enter 
 at the chimney-flue over the fire, than can escape at the chim- 
 ney-pot above. Where the room is warmed by a stove or by 
 furnace, there is less probability of any obstacle of this kind 
 to the chimney taking in air at the ventilating valve. 
 
 Mr. Ewart has constructed a more simple, and it is alleged, 
 effective valve, than Dr. Arnott, for the small cost of a sum 
 not exceeding a dollar. The valve is composed of oiled silk, 
 on a frame, on which are six large openings, admitting the 
 egress of air with great freedom. Very similar to this con- 
 
124 
 
 trivance, is one also suggested by Dr. Arnott. It consists of 
 a square iron tube of from three to six inches in diameter, 
 and so long that the outer orifice shall be flush with the wall 
 of the apartment, and the inner one enter the chimney. These 
 tubes are usually from four to six inches in length. At the 
 orifice entering the room, there is either a plate of perforated zinc 
 or a piece of fine wire-work, from the upper and back part of 
 which hangs a piece of ordinary or oiled silk, which acts as a 
 valve, so as to allow the warm and vitiated air to pass up the 
 chimney, and to prevent any smoke from entering the room. 
 The annoyance of a smoky chimney is removed by this 
 mechanism. When it is found necessary to close up the valve, 
 either upon lighting the fire, or in cold weather, or when a 
 room is first inhabited, or finally, if the chimney should be on 
 fire, a slide connected with the tube can be drawn up and 
 cover the whole aperture. 
 
 In constructing a house, Dr. Ilutchinson recommends the 
 introduction of a sufficient flue for air. All chambers should 
 receive the air below the level of the head of the inhabitant 1 , 
 and this air should be carried away at the highest point of 
 the chamber, in the ceiling or immediately below it. This 
 direction is not applicable to the flues through which heated 
 ingress air from furnaces, or analogous heating apparatus by 
 steam or hot water below, finds its entrance into a room. Its 
 diffusion takes place without difficulty. Supposing, as is the 
 case in summer, that no movement is communicated to the 
 air by internal heat, and no external supply is obtained by 
 heated air which had just come from the external atmosphere, 
 then must the ingress air be low down ; and while entering it 
 should be dispersed or broken up into small streams or thin 
 sheets, as previously recommended, so that no draught can be 
 felt by the inmate of the chamber. It is necessary that the 
 air should be admitted imperceptibly, and thus receive the 
 natural radiant heat of the chamber as quickly as possible. 
 
125 
 
 Perforated floors were adopted by Dr. Eeid, in the House of 
 Commons ; this again being covered by hair cloth, so that 
 the supply of air be broken up into small currents. The ob- 
 jections to this arrangement were found to be, that the air not 
 only brought with it all the dust and dirt and taint from the 
 feet, but it was likewise directed upon this part of the body, 
 thus increasing the discomfort of " cold feet," from which 
 many persons suffer. In large buildings, as churches, where 
 there is generally underground convenience for directing the 
 air through some favorable quarter below the floor, into the 
 body of the building, and that in particular spots, not near the 
 feet, as in the aisle, this system of perforated floors may be 
 found to answer. In private rooms, there remains only the 
 side-wall for ingress air, and the place recommended in prefer- 
 ence, is the top of the skirting board which surrounds the 
 room. But even here some of the objections occur which in- 
 tervene with the plan of perforated floors, viz., the escape of 
 dust which would adhere to the borders of the slit, if not par- 
 tially obstruct it, and be impelled at other times into the 
 room by the draught of the ingress air. This latter may be 
 broken into a sheet-like form by other means, which have 
 been already mentioned. Corresponding with the passage 
 round the lower part of the room for ingress air, and free from 
 the objections brought against this, is another passage for the 
 egress air made by openings just below the cornice, which 
 communicate with the external air, and are wide enough to 
 answer the desired purpose without interfering with the orna- 
 mental character of the cornice, or the general style of the 
 finest apartment. 
 
 Among the latest and most valuable for efficiency and gene- 
 ral applicability, is the plan of ventilation of dwellings and 
 other edifices, suggested and put in execution by Dr. J. H. Gris- 
 com, of New York. It pertains to the " chemical method," 
 the motive power of the air being heat, but requiring no ex- 
 
126 
 
 tra expenditure of fuel, the heat used for the purpose being 
 only the waste heat of the furnace by which the house is 
 warmed. The arrangement consists in the construction of 
 independent ventilating flues in the walls of the house, in 
 proximity to the hot-air tubes, so that the two may be con- 
 nected together by means of a lateral or branch tube, by 
 which a current of hot air may, at any desired moment, be 
 transmitted from the hot-air tube to the ventilating flue. By 
 this means the ventilating flues, which terminate in the open 
 air like an ordinary chimney, will be warmed by the hot air 
 from the furnace, when the ordinary hot-air register is closed, 
 as at night in a dwelling, or in a school-house after school 
 hours. 
 
 If properly constructed, of brick, or smooth stone, the walls 
 of a flue will, after a current of hot air has passed through it 
 a short time, become sufficiently heated to rarefy the air with- 
 in, thus giving the flue a good ventilating power, even after 
 the current of hot air has been withdrawn. For example, if 
 the hot-air register of a parlor be closed at ten o'clock at night, 
 and the heat, instead of- being thrown back into the furnace, 
 is allowed to pass through the lateral tube into the ventilating 
 flue, and so continue till six the next morning, it is evident 
 that, during those eight hours, the interior of the ventilating 
 flue must become thoroughly heated, so that the next day, 
 when the current of hot air is restored to the parlor, the heated 
 sides of the ventilating flue will continue to rarefy the air 
 within them for many hours, and perhaps even days, after- 
 wards. 
 
 There being no danger of a reaction of the air of the flue 
 through the ventilating register (as is the case when ventilating 
 openings are made in ordinary fire-flues), connections with 
 the apartment to be ventilated may be made at any point, and 
 even carried to the opposite side .of the house, between the 
 beams of the ceiling, to ventilate distant apartments. Dr. 
 
127 
 
 Griscom's method has the advantage of being applicable to 
 all edifices warmed by hot-air furnaces of any description, 
 which, in general, are those most needing ventilation. This 
 arrangement may be introduced into many houses already 
 erected, by connecting the hot-air tubes wtih such of the 
 ordinary chimney-flues as are not used with fire. 
 
 One of the principal advantages appertaining to this plan, 
 is the capability of having a large number of ventilating flues 
 put in connection with the furnace. In fact, the number may 
 correspond with the number of hot-air registers, and thus any 
 desirable amount and extent of ventilation be obtained. 
 
 Ventilation of /Schools. Happily we can now speak of a 
 marked reform in this matter, which began in Boston, and prom- 
 ises to spread to other and remote places. A committee, consist- 
 ing of Dr. Henry G. Clark, E. G. Loring, Esq., and the Rev. 
 Charles Brooks, under an appointment of the School Committee 
 of Boston, to inquire into the subject of the ventilation of school- 
 houses, and to indicate the means of remedying defects, re- 
 ported, after the successful performance of their task, that the 
 grammar school-houses were then in a better condition, in re- 
 spect to their ventilation, than any other public schools in the 
 world. The first-named gentleman of the Committee, who is 
 our colleague on the present occasion, was mainly instrumental 
 by his ingenuity and perseverance, in bringing about these 
 improvements. In Philadelphia and other cities, many of the 
 public schools received the benefit of the visits and reforma- 
 tory suggestions of the Boston Committee. Statues have 
 been reared, and other honors conferred, for much less services 
 than were rendered by these gentlemen. They ought to have 
 received at least an ovation from the grateful children and 
 teachers in the public schools. Commendatory reference may 
 be made at this time to the very useful volume of Mr. Henry 
 Barnard on School Architecture in the United States. From 
 
128 
 
 page 142 to page 165, 2d edition, the reader will find instruct- 
 ive details on the subject of warming and -ventilating schools 
 and other public buildings. Among the apparatus for the 
 purpose, Chilson's furnace and ventilating stove, and also 
 Emerson's ejecting and injecting ventilators, are noticed in 
 terms of commendation, such as had been previously bestowed 
 on them by the Committee. Mr. Emerson very properly in- 
 sists on the admission of warm air into a school-room, as in- 
 dispensable to its proper ventilation ; and he enforces his 
 views on this point, by refusing to allow his ventilators to be 
 put up in any school-house that is not, by some means, sup- 
 plied with fresh wanned air. He objects, like most people 
 who have attended to the subject, to the use of all such stoves 
 and furnaces as emit their heat through and from red-hot iron ; 
 and he recommends what large experience sanctions, that 
 when anthracite coal is used, the stove or furnace in which it 
 is burned be lined with brick or stone. 
 
 The great and crying neglect of external ventilation in 
 nearly all the schools, both public and private, in cities, tells 
 heavily on the health of their inmates. No adequate, and in 
 most cases, no space at all is allowed for the children to ob- 
 tain fresh air, and to engage in healthful exercise and sports 
 during the hours of recess from study. Not only are out-door 
 exercises imperatively demanded for the purposes of full re- 
 spiratory effect by expansion of the chest, but also of allowing 
 the body to receive its erect posture, and the limbs their free 
 play, all of which is prevented when the children are seated, 
 and leaning over a table or desk. 
 
 Ventilation of Hospitals. It has been well remarked 
 by the French authors (MM. Montfalcon and Poliniere) of 
 a work already cited a Treatise on the Health of Great 
 Cities that the more numerous and diversified are the 
 causes of vitiated air in a hospital, the greater is the neces- 
 
129 
 
 sity for vigilance in obviating its occurrence. Every patient 
 ought, these gentlemen think, to have at least three hundred 
 cubic inches of pure air per hour at his disposal ; and every 
 ward of a hospital so well ventilated, that the most delicate 
 sense of smell could not detect any unpleasant odor j and 
 finally, the temperature should be always kept at 60 F. 
 Ameliorating influences, to the extent, in some instances, of 
 entire reform of old abuses, are now at work in the ventilation 
 of hospitals and benevolent and charitable asylums of all kinds. 
 This is more particularly observable in the asylums for the in- 
 sane, some valuable suggestions and improvements in the in- 
 terior economy of which have been made of late years by 
 their medical superintendents. At their meeting in Utica, in 
 1849, they declared it to be their unanimous opinion, ''that 
 the experiments recently made in various institutions in this 
 country and elsewhere, prove that the best means of supply- 
 ing warmth in winter, at present known to them, consist in 
 passing fresh air from the external atmosphere over pipes or 
 plates, containing steam at a low pressure, or water, the tem- 
 perature of which in the boiler does not exceed 212 F., and 
 placed in large air-chambers in the basement or cellar of the 
 building to be heated." These gentlemen also declared " that 
 a complete system of fixed ventilation was absolutely indis- 
 pensable in every institution, like hospitals, for the ordinary 
 sick or insane, and where all possible benefits are sought to 
 be derived from these arrangements ; and, " that no expense 
 that is required to effect these objects thoroughly, can be 
 deemed either misplaced or injudicious." 
 
 The union of mechanical with chemical means of ventila- 
 tion of hospitals has been recommended. A small power 
 would be sufficient to abstract the air rendered heavy by the 
 carbonic acid, which is accidentally diffused in consequence 
 of being condensed before it arrives at the ventilating tubes. 
 This might be done by means of a ventilator on the bellows 
 9 
 
130 
 
 plan, similar to that adopted by Hales, or the still more sim 
 pie one, the exhausting air-pump of John Taylor, for the 
 ventilation of coal mines, which is worked by a regulated 
 power on the principle of clock-work, and with the addition of 
 an apparatus for opening the valves. " The expense of labor 
 to raise a weight every day to keep it in constant action, 
 would be," Tredgold thinks, "much less than the expense of 
 fuel and attention to produce the same effect by fire, the action 
 being more certain. To produce the effect we desire, the best 
 plan seems to be to have open gratings in various parts of the 
 passages, with tubes from each to the place of the ventilator ; 
 and the gratings might be provided with slides, so that the 
 action might be confined more to particular parts, as occasion 
 might require." Another important part of the ventilation of 
 hospitals is that of the water-closets. An effectual plan for 
 attaining this end is to connect a flue at one end with the de- 
 scending pipe of the basin, or with the well below, and at 
 another end with the chimney of a fire that is constantly kept 
 up. Even where the water-closet pipe empties into a cess-pool 
 privy below, this arrangement is, as we know from actual ex- 
 perience during a period of seventeen years, quite successful ; 
 even in a case in which, although water is introduced by a 
 pipe and stop-cock into the basin of the water-closet, yet there 
 is no addition of a trap or syphon. It is necessary for the 
 proper effect of this plan, that the lids of the privy below be 
 kept down, otherwise there will be an upward and offensive 
 current of air from the cess-pool, interfering with the draft from 
 this into the chimney, as just described 
 
 At this present time two novel systems of warming and ven- 
 tilation seem to divide scientific opinion and support in Paris. 
 The one is by M. Duvoir, the advantages of which are said 
 to be: 1st. That it insures free ventilation; 2d. That it warms 
 and ventilates at the same time ; 3d. That it is cleanly and 
 inexpensive ; 4th. That in hospital wards, where the emana- 
 
131 
 
 tions from the sick are offensive and pernicious, such ema- 
 nations can be borne away, directly from above downwards, 
 by having the upper opening in the ventilating shafts in 
 each ward closed, and the lower one open. The wards are 
 thus constantly swept clean of all hurtful gaseous products. 
 Among other public buildings is the " Hospital de Lariboi- 
 siere" to which the system of M. Duvoir has been applied. 
 Strong testimony is borne by distinguished judges of the value 
 of its action and of its successful application.* The second 
 apparatus for warming and ventilation, is that contrived 
 by Van Hecke. The apparatus lor heating the men's 
 wards at the Neckar Hospital, consists of three furnaces in a 
 cellar, which heat air that is distributed by flues to the hos- 
 pital. The quantity of air heated is considerable, and hence 
 it need not be raised to a high temperature : this, when enter- 
 ing the wards, is not more than 86 to 95 Fah. It acquires 
 the proper humidity by passing over contiguous reservoirs of 
 water. The ventilation is procured by the agency of a small 
 steam-engine placed in the cellar, but its boiler in a suitable 
 place outside the building, which sets in motion a ventilator, 
 that derives its pure air from the garden, and injects it into a 
 strong suction-pipe placed under ground, and running the 
 length of the entire building. This chief pipe is divided into 
 secondary ones, which convey the air to the furnaces, and 
 thence into the wards situated on different stories. The air 
 enters into the wards in large sections, and without producing 
 sensible currents. The impure and vitiated air escapes by 
 flues, wliich convey it out above the roof. This system may 
 be denned to be, warming the hospital wards by means of 
 three furnaces ; mechanical ventilation by propulsion ; com- 
 plete appropria' ion of the steam vapor, which, after doing its 
 first duty in the engine, is employed to meet the necessary 
 wants of the patients, such as baths and washing. The ven- 
 
 * Sanitary Review, vol. L pp. 423-4. 
 
132 
 
 apparatus propels from sixty to one hundred and twen- 
 ty cubic inches of pure air hourly for each bed. Kegisters 
 allow of the diminution of the amount of warm air brought 
 by the different flues. 
 
 Factory Ventilation. Were we to speak of the bodily ills 
 from factory labor, as arising in part from defective ventila- 
 tion, we should be met by the counter opinions of Drs. Ure, 
 Thackrah, and W. Cooke Taylor, in England, and MM. Vil- 
 lenne, and Benoisten-Chateauneuf, in France. Dr. Ure con- 
 tends that, from the very nature of the machinery used in 
 cotton mills,, it is impossible to crowd the operatives, and 
 especially those, nine-tenths of them children, who tend 
 the open-spurred mules. As respects the growth and de- 
 velopment of persons engaged in factory employments, Sir 
 David Barry, in his Factory Commission Report, relates, as the 
 results of personal observation, that many of the girls were 
 beautifully formed, who had been from ten years to maturity 
 in the mills. On the subject of ventilation, M. Villerme' 
 states distinctly, after a careful calculation of data, that the 
 great body of those employed in the cotton mills have a better 
 supply of air at their work than at their homes, and better, 
 also, than great numbers of other classes of work-people. Dr. 
 W. Cooke Taylor says : "I would be very well contented to 
 have as large a proportion of room and air in my own study, 
 as a cotton spinner in any of the mills in Lancashire ! " We 
 must look then, it would seem, for the causes of the greater 
 proportionate mortality among the manufacturing than among 
 the agricultural population, to the confined lodgings and 
 crowding in the parts of the town in which the former sleep 
 and spend the time not given to work, and to the want of 
 abundant nutriment, and also in a large number, to habits of 
 intemperance. There are, however, some facts recorded 
 which might serve to qualify the favorable opinions of factory 
 life. Thus, for instance, fewer recruits of the proper strength 
 
133 
 
 and stature for military service are obtainable now than here- 
 tofore from Manchester. Again: a corps levied from the 
 agricultural districts in Wales, or the northern counties of 
 England, will last longer than one recruited from the manu- 
 facturing towns, as from Birmingham and Manchester, or near 
 the metropolis. 
 
 All classes might turn to useful account, for the purposes 
 of ventilating both the rooms in their own houses and the 
 larger ones in public buildings, the presence of artificial lights, 
 especially those furnished by gas. A truncated cone of zinc, 
 the upper part of which is narrower than that of an ordinary 
 gas-shade, and resting, like the latter, over the burner, will be 
 perforated near its upper border by one end of a tube of zinc, 
 which will at the other end be carried through the outer wall, 
 or else into a chimney, and thus be a conductor for the air of 
 the room rendered impure by the combustion of the gas and 
 the breathing of persons in the room. This mode of ventila- 
 tion is particularly called for in small rooms or shops in which 
 the air soon becomes contaminated, and exerts a noxious 
 effect on those employed in them. There is one instance of 
 an exit tube for gas, so elegant that it would grace any 
 drawing-room, applicable for the lights over the mantel-piece 
 at each side of the looking-glass, introduced by Prof. Faraday. 
 
 Dr. Hutchinson makes an observation which will be con- 
 soling to those of us who encroach on the midnight hour 
 while engaged in the labors of the desk. " It is an error," 
 he tells us, " to suppose that gas is more injurious to the con- 
 stitution than candles ; scientifically the common means of 
 lighting, whether by candles, oil, or camphene, are all gas- 
 lights. The work of a gas company is to take from the coal 
 a certain product, and send it to our houses for combustion ; 
 when we burn the candle, &c., &c., we do in the sitting-room 
 the work of the gas company, taking from the material the 
 same product which the gas company sends to us in pipes ; 
 
,134 
 
 therefore, if there is any difference, it is in favor of gas- 
 lights." 
 
 Ventilation of Sewers. This is done, first, by air-shafts, 
 and gratings over them, at certain distances from each other, 
 which permit the escape of the emanations from the sewer 
 below into the atmosphere ; 2d, by establishing a communi- 
 cation between the sewers and the rain-water spouts of the 
 houses ; but it is necessary to trap these latter, for, otherwise, 
 they might allow of the escape of the foul air into the windows 
 of sleeping-rooms. A common method in Paris is to allow of 
 the escape of the foul air of the sewer through lofty shafts or 
 chimneys, so that it shall be disseminated at a height which 
 would prevent its annoying the people in the streets, and the 
 inhabitants of houses of ordinary elevation. These shafts are 
 placed, as much as possible, in the least frequented parts of 
 the city; but even then the air escaping from them is a 
 source of more or less annoyance. Sometimes fires are made 
 in these chimneys, and thus a strong upward draft is pro- 
 cured, and a large amount of gases extracted. A simpler and 
 more economical plan, is to connect the sewers with the fur- 
 naces or chimneys in large manufactories. The only drawback 
 to a measure of this kind is the occasional risk of sewer gases 
 exploding when subjected to flame. 
 
 As ventilation is a means of purification of sewers, a remark 
 may be here made opportunely, that water is the best purifier, 
 by its diluting the sewage and accelerating its onward pro- 
 gress; and hence the freer and bolder the flushing, and the 
 more frequently water is introduced into the sewer, the less 
 occasion will there be for ventilation. In Paris the gutters and 
 sewers are flushed daily with water from the hydrants, 2-J- 
 hours in the morning, and the same length of time in the after- 
 noon. With an adequate supply of water, and the impetus 
 derived from the height of the reservoirs of supply, there is no 
 
135 
 
 necessity for this system of flushing, if the water which passes 
 through each house as waste be turned into drains, both pri- 
 vate and public. Mr. G. Gurney reported, four years ago, to 
 the Office of Works in London, a successful experiment which 
 he had made for removing or destroying the effluvia of sewers. 
 He accomplished this object by means of the steam jet, which 
 produces a current through the sewer and conveyed with it the 
 noxious exhalations which are then decomposed and rendered 
 harmless by their being made to pass through a coke fire as 
 they are drawn off. The objection to the frequent use of the 
 steam jet in the same sewer would be the disintegration of the 
 mortar, and action on the surface of the bricks on the inside of 
 the culvert. 
 
 SUPPLY OF WATER. One can hardly overrate the import- 
 ance of a full supply of pure water to meet the requirements 
 of health, whether we look to the individual or to the congre- 
 gated numbers in cities and populous districts. Water, in an 
 average state of purity, is indispensable for digestion and the 
 elaboration of good blood, as, on the contrary, if it be hard, 
 and contaminated with vegetable or animal matters, it perpet- 
 ually disorders digestion, and gives rise to the innumerable 
 secondary affections of the kidneys, skin, and nervous system, 
 and an impairment of bodily strength and activity. Next to 
 its importance as a drink is its use for culinary purposes; and, 
 after this, bathing and preserving due personal cleanliness, 
 and thus enabling the skin to perform its important functions, 
 which are so necessary to the feeling and the possession of 
 health. Closely, almost inseparably, connected with its use- 
 fulness in this way, is its paramount office in the washing of 
 our garments and household linen. In the house itself it is 
 impossible to remove, without the aid of water, the deposit of 
 dust and fine ashes that arise from smoke, and the air and 
 gases given out in respiration. As a means of preserving pub- 
 lic health, which is but a collective term for that of the indi- 
 
136 
 
 viduals who constitute the public, water ranks next to air. 
 Unless it be obtained in abundance, there cannot be clean 
 streets, nor can either scavenging, by removal of surface-refuse, 
 or sewerage, by carrying off through underground conduits 
 this refuse and exuviae of all kinds, be properly performed. 
 
 The Eeport of the Commissioners on the Health of Towns, 
 made about fifteen years ago, revealed a sad deficiency of 
 water supply in nearly all the cities angl burghs of England. 
 Only twenty-six out of the fifty towns in which their inves- 
 tigations extended, were supplied with water, under the provi-. 
 sions of any act of Parliament. Even in these the supply was 
 very deficient, and in many of them it only extended to a part 
 of the town ; the poorest and most populous portions receiving 
 from it little or no benefit. At Birmingham, only 8,OOG out 
 of 40,000 houses are stated to have been separately supplied ; 
 and at Newcastle-upon-Tyne, where the Cholera made its first 
 attack in 1831, it was stated that the company supplied about 
 one-twelfth of the dwelling-houses, and that very few of these 
 had either tanks or tubs. In Bristol, containing, with Clifton, 
 upwards of 100,000 inhabitants, not more than 5,000 per- 
 sons, constituting the most wealthy families, are supplied 
 with water by pipes laid into their houses ; the remainder 
 were dependent on public and private wells. 
 
 In contrast with these deficiencies, and extravagant prices 
 the poor pay for water in many places, is its abundance in 
 other towns, as Nottingham and Preston, for example. In the 
 former, the supply amounts to 40 gallons per diem to each 
 family ; and in the latter, to 45 gallons. The intermittent sup- 
 ply of water at certain points in a city is reprehensible, both 
 on the score of time and morals, not to speak of the confusion 
 and quarreling in the crowd of persons collected round the 
 water-stands. It cannot be said of our chief cities, Boston, 
 New York, Philadelphia, &c., as it was by the Commissioners 
 when speaking of the defective supply of water to the poor in- 
 
137 
 
 habitants of so many of the English towns : " The present dif- 
 ficulty, and the labor, after a hard day's work, of obtaining 
 water, have a very great effect on their economy, their habits, 
 and their health. The obstacles to the maintenance of domes- 
 tic or personal cleanliness soon produce habits of personal care- 
 lessness, which rapidly lower both the moral and physical con- 
 dition of the whole population." 
 
 The following is an estimate of the average consumption of 
 water, per head, in some of the chief cities, including not only 
 what is drunk, but what is consumed per diem in domestic 
 and manufacturing purposes, also for baths, stables, gardens, 
 washing the streets, extinguishing fires, &c. By an inhabit- 
 ant of Paris, 2^ gallons; of London, 20; of Philadelphia, 30; 
 of New York, 40; of Boston, 43; of Edinburgh, 19; of Glas- 
 gow, 27 ; of Vienna, Constantinople, and Montpelier, in 
 France, 15 ; in all France, 5 gallons. 
 
 Various means, on a large scale, have been adopted to cor- 
 rect the impurities of water destined for the supply of great 
 cities. These consist chiefly in filtration through gravel, sand, 
 and charcoal. Boiling the water, by destroying the animal and 
 vegetable matter which river and rain-water so generally con- 
 tain, destroys the taste and odor dependent on this cause; 
 but recourse to such a process cannot form a part of public, 
 however useful it may be in private, hygiene. Boiling also 
 precipitates some of the earths which were united with carbo- 
 nic acid ; but the neutral saline contents of the water still re- 
 main; and hence it retains the peculiar flavor which was 
 owing to this cause. 
 
 The saving, in the less wear and tear of clothes, and in the ar- 
 ticles of soap and soda, by the use of soft water in the place of 
 hard, is very great. In London, for example, the cost of soap 
 used per annum is estimated at upwards of five millions of 
 dollars. 
 
138 
 
 Water in Leaden Cisterns and Pipes. A common cause 
 of the deterioration of the purity of water arises from the mode 
 of transmitting it from the reservoirs and main pipes to dwell- 
 ing-houses in leaden pipes, for the purposes of domestic econo- 
 my. It sounds paradoxical to say, and yet the assertion is 
 quite true, that the purer the water, as respects its freedom 
 from saline impregnation, the greater is the danger of its acting 
 on the lead, and converting a portion of it into a salt which is 
 there held in solution. When we speak of pure water, we sup- 
 pose it to contain carbonic acid, by which its solvent power is 
 greatly increased. Hence rain-water readily acquires an im- 
 pregnation of lead from roofs, gutters, cisterns, or pipes made 
 of this metal. The saline substances, on the other hand, found 
 in spring and river water, impair the corrosive action of 
 water and air, and thus exert a protecting power. Of these, 
 the carbonates and sulphates are the most powerful ; the 
 chlorides or muriates the least so. Dr. Taylor believes that if 
 the sulphate of lime forms only the five-thousandth part of 
 water, no carbonate of lead is formed ; and this salt dissolved 
 in the above, or in larger proportion, in distilled water, will 
 still confer in it the properties possessed by river water. 
 
 Dr. Dana, who doubts the protecting property of the salts 
 of lime, suggests that the changes in the lead is produced by 
 a galvanic action between it and iron, which may be developed 
 by very slight difference in the state of the lead, as where the 
 soldering is with the usual mixture of this latter and the more 
 fusible metals. Dr. Dana proposes, as substitutes for leaden 
 pipes in the conveying of water : "1. Wood wherever it can be 
 used ; 2. Cast iron or wrought iron tubes ; 3. Copper, pro- 
 tected by pure tin. The use of all other metals, or alloys of 
 these, in the present state of our knowledge and experience in 
 these objects, ought forthwith to be abandoned." Dr. Christi- 
 son speaks of an " effectual remedy " which has been lately in- 
 troduced by a patent invention for covering lead pipes, both 
 
139 
 
 externally and internally, with a thin coating of tin. Little in- 
 convenience can result from the use of leaden pipes where the 
 water flows through them by hydraulic pressure, as they can 
 be speedily emptied before using the water which comes from 
 the larger iron pipes beyond them. It is only in cases of slow 
 entrance, and retention for some time of water in leaden pipes 
 and cisterns, that the question just discussed becomes a prac- 
 tical one, affecting the public health, 
 
 EFFECTS OF BAD WATER FOR DRINK. Favored, as the in- 
 habitants of most of our large cities are, in an abundant supply 
 of pure water furnished to them, they are beginning to forget 
 that they ever drank that which was bad, and cannot realize 
 fully the disastrous consequences of the habitual use of such a 
 fluid. Generally, however, people are more easily led to be- 
 lieve, even if they are not themselves fully sensible of the fact, 
 that bad water is injurious to the health than that the air 
 which they often breathe over and over again is a poison. 
 One of the first sanitary measures of a growing and thriving 
 population is to procure for themselves a suitable supply of 
 good water. All the people of antiquity were alive to this fact. 
 The means on a large scale adopted for the purpose both in 
 Rome and Carthage have been referred to in this report. It is 
 not necessary for me to enlarge on this point, and I proceed to 
 mention, as a warning to all young cities, the evils from using 
 bad water, and as an incentive for them to take measures to pro- 
 cure that which is good. When this, our natural beverage, is 
 impure, it proves to be a cause of protracted ailments in ordi- 
 nary seasons, and in those of epidemic visitations it acts as a di- 
 rectly exciting cause of disease and death. In marshy regions, 
 in which periodical fevers abound, water is deemed by some, 
 on good evidence, to be as actively a contributing cause as the 
 bad air itself. But its malignancy has been particularly con- 
 spicuous in the production of Cholera. Dr. Lankester, in de- 
 scribing the three kinds of water drunk by the inhabitants 
 
140 
 
 of London, viz. : 1, that of the Thames and New Kiver ; 2, 
 that of deep wells, 150 feet for example, below the surface ; 
 and 3dly, the surface well-waters, points out the fact that 
 these last contain organic matters " of precisely the same na- 
 ture as those found in rivers, which are the receptacles of house 
 sewerage and saline matters, common salt, ammonia, the phos- 
 phates, nitric acid, &c., all indicative of animal excretion. 
 Carbonic acid is largely present in these surface-waters, and 
 from the pleasant drinking qualities it imparts to them, actu- 
 ally makes the more impure waters the most popular, and the 
 most dangerous." Dr. Liddle, Officer of Health to the White 
 Chapel District, relates the following incidents : " In a street 
 at Salford, containing ninety houses, 25 deaths from Cholera 
 occurred in thirty of these houses, the inhabitants of which 
 drank water from a well into which a sewer had leaked ; in 
 the remaining sixty houses, where pure water was drunk, there 
 were 11 cases of diarrhoea only, and no deaths."* 
 
 A gigantic experiment, as Mr. Simon calls it, was made in- 
 voluntarily and in ignorance by the parties who so largely suf- 
 fered under it, in its progress during two epidemics in the 
 southern districts of London. It is related as follows : 
 
 " These districts (comprising nearly a fifth of the population of 
 the Metropolis) have been notorious for the great severity with which 
 
 Cholera has visited them Throughout these districts, during the 
 
 epidemics of 1853-4, there were distributed two different qualities 
 of water ; so that one large population was drinking a tolerably 
 good water, another large population an exceedingly foul water ; 
 while in all other respects these two populations (being intermixed 
 in the same districts, and even in the same streets of these districts) 
 were living under precisely similar social and sanitary circumstances. 
 And when, at the end of the epidemic period, the death-rates of 
 these populations were compared, it was found that the Cholera mor- 
 tality in the houses supplied by the bad water had been three and 
 a half times as great as in the houses supplied by the better water. 
 
 * British and Foreign Med.-Chir. Rev., Jan. i859. 
 
141 
 
 Phis proof of the fatal influence of foul water was rendered 
 still stronger by reference to what had occurred in the epidemic of 
 1848-9. For on that occasion the circumstances of the two popu- 
 lations were to some extent reversed. That company which, during 
 the later epidemic, gave the better water, had given, during the 
 earlier epidemic, even a worse water than its rival's ; and the popu- 
 lation supplied by it had at that time suffered a proportionate 
 cholera mortality. So that the consequence of an improvement 
 made by this water-company in the interval between the two 
 epidemics was, that whereas, in the epidemic of 1848-9 there had 
 died 1925 of their tenants, there died in the epidemic of 1853-4 
 only 611 ; while among the tenants of the rival company (whose 
 supply between the two epidemics had been worse instead of better), 
 the deaths which in 1848-9 were 2880, had in 1853-4 increased 
 to 3476. And when these numbers are made proportionate to the 
 populations or tenantries concerned in the two periods respectively, 
 it is found that the cholera death-rates per 10,000 tenants of the 
 companies were about as follows: for those who in 1848-9 drank 
 the worse water, 125 ; for their neighbors, who in the same epi- 
 demic drank a water somewhat less impure, l\S ; for those who in 
 1853-4 drank the worst water which had been supplied, 130 ; for 
 those who in this epidemic drank a comparatively clear water, 37. 
 The quality of water which (as is illustrated in the first three of 
 these numbers) has produced such fatal results in the metropolis, 
 causing two-thirds of the cholera deaths in those parts of London 
 which have most severely suffered from the disease, has been river- 
 water polluted by town drainage water pumped from the Thames 
 within range of the sewage of London water which, according to 
 the concurrent testimony of chemical and microscopical observers, 
 was abundantly charged with matters in course of putrefactive 
 change." (Mr. Simon's " Report," p. 14.) 
 
 Dr. Sutherland, in his report to the General Board of 
 Health en the cholera epidemic of 1849, says, that the injurious 
 effects of unwholesome water had been manifest in nearly 
 every affected place ; and adds, that a number of most severe 
 and fatal outbursts of Cholera were referable to no other cause 
 
142 
 
 except the state of the water-supply, and this especially where 
 it had been obtained from wells into which the contents of 
 sewers, privies, or the drainage of grave-yards had escaped. 
 Since that time much additional evidence of a confirmatory 
 character has been collected. Two examples are recorded by 
 Dr. Acland, in his valuable and interesting " Memoir on the 
 Cholera in Oxford " the parish of St. Clements, which suf- 
 fered a large mortality in 1832, when the inhabitants had 
 filthy water from a sewer-receiving stream, and an insignificant 
 mortality in 1849 and 1854, when the water was derived 
 from a purer source. The other case is that of the county 
 jail, in which cases have occurred in every epidemic, whilst 
 the city jail, which is not far from the other, has uniformly 
 escaped. The only apparent difference between the two estab- 
 lishments in 1854, seems to have been that the supply of 
 water for the use of the county jail, and of which the soup 
 and gruel were made, was pumped from a filthy well-pool, 
 within ten feet of one of the prison drains. No sooner were 
 the supply-pipes disconnected with this impure source, than 
 Cholera and Diarrhoea ceased. It appears from an elaborate 
 inquiry by the General Board of Health, at the close of the 
 cholera epidemic of 1854, that the contrasted effects of the 
 disease on the people of two large sections of the population, 
 are only explicable by the fact that one division, comprising 
 a population of about 268,171 persons, drank impure water; 
 whilst the other, numbering about 166,906 persons, used a 
 clearer, and comparatively pure water. The two classes 
 resided in the same localities, breathed the same atmosphere, 
 comprehended the same classes, and averaging the same 
 habits of life ; in short, placed in circumstances nearly iden- 
 tical, saving the difference in the source whence they obtained 
 their water for drink. The mortality from Cholera among the 
 drinkers of impure water of water impregnated with the 
 sewage of the metropolis, and containing in solution a large 
 
143 
 
 quantity of saline matter, derived from the intermixture of 
 sea-water being at the rate of 130 to every 10,000 ; that of 
 the drinkers of the pure water being only at the rate of 37 to 
 every 10,000 persons living.* 
 
 In the report on Epidemic Cholera in London, in 1854, by 
 Dr. Sutherland, much interesting information is afforded on 
 the influence of water upon the spread of the disease. The 
 deduction from the microscopical and chemical examination of 
 the water used in the houses and neighborhoods where the 
 disease was most prevalent, by Dr. Hassall, was : " That 
 there is no water supplied to the metropolis that does not 
 contain dead and living organic matter, animal and vegetable. 
 But the Thames Ditton water, supplied by the Lambeth 
 Company, is by much the purest of the waters, while the 
 Southwark and Vauxhall water is one of the worst, and the 
 waters of the other companies might be arrayed in a series 
 between these two." From an inquiry instituted by the 
 Registrar-General, the following results appear : " In 26,107 
 houses that derived the water from Ditton, 313 deaths from 
 Cholera occurred in ten weeks. In the 40,046 houses that 
 received the impure water from Battersea, 2445 persons, it 
 was ascertained, died from Cholera in the same time. The 
 deaths in the latter districts exceeded by nearly 2000 the 
 deaths that would have occurred if Cholera had only been as 
 fatal as it was in the houses that derived their water from 
 Ditton." Dr. Sutherland makes the following remarks upon 
 these results : " When it is considered that the sanitary con- 
 dition of -the population does not materially differ, except in 
 the quality of the water supplied by the two companies, it is 
 difficult to resist this statistical evidence of the predisposing 
 effect of the Battersea water, and of the loss of life which has 
 arisen from its use.f 
 
 * British and Foreign Med.-Chir. Rev., January, 1857. 
 f Ibid. July, 1855. 
 
144 
 
 The deleterious effects of impure water are not seen in 
 cities or large towns alone ; they occur in small villages, some- 
 times in the solitary farm-house any place, in fine, in which 
 the pump or draw-well is in the midst of a farm-yard or filthy 
 court ; receiving the surface-drainage of heaps of stable ma- 
 nure, pig-sties, &c. How often do we notice, says Dr. W. J. 
 Cox, green, slimy, stagnant pools, in the close vicinity, and 
 affording the sole water-supply, of cottages. Such a state of 
 things does not often occur in this country ; but in too many 
 instances there is a neglect to obtain an adequate supply of 
 pure water, the penalty is paid in the frequent occurrence of 
 bowel-complaint, and the sudden inroads of epidemic cholera, 
 which makes its attacks without any other apparent provoca- 
 tion. In the new settlements of the West, the enterprising 
 pioneer and his family often pay a tax in the shape of disease, 
 and not seldom of life itself, from the use of bad water or its 
 imperfect supply ; and in new towns other schemes of improve- 
 ment are tried, before sanitary measures, both for present and 
 future protection, such as paving, drainage, and a supply of 
 good potable water, are thought of. 
 
 Dr. Cox tells us, that water tainted with various organic 
 matters, whether gaseous, as carbide or sulphide of hydrogen, 
 or solid, as putrescent vegetable fibre, or vitalized, as algse, 
 confervas, hydrae, fungi, infusoria, &c. is a very frequent 
 cause of severe visitations of bowel complaints during the 
 summer months. Several instances came under his own ob- 
 servation, in 1853 and 1854, of the aggravation of epidemic 
 diarrhoea from this cause. " That water falling on a growing 
 soil, and running off to lie in stagnant pools, is sure to become 
 tainted with animal and vegetable life, is well known ; and 
 when to this is supperadded the circumstances of the said soil 
 being highly charged with effete organic products, the water 
 thus collected must necessarily be highly impure, and most 
 unfit for human consumption. Yet very often it forms the 
 
145 
 
 only available source of supply." Dr. Cox alludes to epi- 
 demic scarlatina simplex showing itself in a small agricultu- 
 ral village in the west of England, in August, 1856. There 
 occurred in all thirty-eight cases, chiefly among the peasant- 
 ry, whereof three proved fatal. Two of these were in one 
 house, the residence of a wealthy farmer. Here the disease 
 changed its character, assuming the worst asthenic type, with 
 intense throat-affection, and, as is so frequently the case, de- 
 fying all treatment. The persons attacked were a servant 
 girl and three children, the two oldest of the latter of whom 
 died. The younger child and the servant girl recovered with 
 some difficulty. The probable cause of the malignity and fa- 
 tality of the disease in this family was its bad water-supply. 
 It was derived from a shallow draw-well in the back-yard, 
 imperfectly covered, surrounded by heaps of decomposing 
 manure and cow-sheds, the black drainings from which were 
 constantly flowing over the soil. Dr. Cox examined the 
 water from this well on two occasions, before and after heavy 
 rains. The first analysis showed sixty grains of solid matter 
 (chiefly nitrates) in the gallon, of which five grains were un- 
 decomposed organic matter. The second analysis (after the 
 rain) gave the enormous amount of between seven and eight 
 grains of organic matter. The rest of the village derived its 
 chief supply of water from a good public well, situated at a 
 little distance in a large field, and properly covered from the 
 weather. 
 
 Water tainted with putrid contents sends into the air a 
 much larger quantity of noxious organic matter than it re- 
 ceives from the air. If we take the Thames river, for an 
 example, where it flows through London, it has been calcu- 
 lated that 4,000,000 of gallons of water rise daily, in the form 
 of vapor, from the surface of the river within the city limits, 
 carrying with it into the atmosphere some portion of the 
 
 putrid contents of the river. 
 10 
 
146 
 
 INTEMPERANCE. The transition is easy from one noxious 
 drink to another from bad water (nature perverted) to alco- 
 holic liquors (art perverted) viewed as the cause of so much 
 intemperance and disease, un,der a great variety of aspects. 
 As a question of public health it comes necessarily under our 
 notice, and as such alone it can be studied here. We are not 
 called upon to arbitrate between the two doctrinal extremes 
 in regard to the dietetic usage of this class of drinks, but sim- 
 ply to look at things as we find them, and, as in the case of 
 any other form of physical evil afflicting a fellow-creature, 
 either standing by itself, or implicating at the same time the 
 moral and intellectual faculties, to limit, if possible, its diffu- 
 sion, and to find means for its prevention. The first of these 
 objects aimed at, is done by legislative enactmsnts, enforced 
 by suitable penalties ; the second, or preventive, is more 
 certainly brought about by individual will, aided by, and at 
 the same time aiding, voluntary association with others. 
 Everywhere drunkards, or, ajf they are usually called, the in- 
 temperate, which is the more correct term of designation, are 
 among the first victims of epidemic, and also contagious febrile 
 diseases. They are more readily attacked, and more readily 
 sink under disease, than any other class of persons. " The 
 pernicious effects of intemperance, in predisposing to the dis- 
 ease [cholera], have been recognized by all writers, in the 
 East Indies as well as the different countries of Europe. 
 What, then, must have been the mischief done by this debas- 
 ing and life-destroying sin in a country like ours [England], 
 where it has been computed that upwards of twenty millions 
 of sterling are annually spent upon ardent spirits alone ?"* 
 
 The value of temperate habits among the poor, in prolong- 
 ing life and diminishing sickness, has been exhibited in the 
 comparison of temperance provident societies with other 
 societies.- The Teetotal Society in Preston (of which how- 
 
 * Brit, and For. Med.-Chir. Rev., vol. vii. p. 33. 
 
147 
 
 ever, the numbers are rather small for the purpose of any 
 general deduction), presents, as we learn from the sanitary- 
 report of the Rev. Mr. Clay, not merely the smallest propor- 
 tion of sick, but it also suffers the shortest average duration 
 of illness. The annual mortality in the Temperance Provi- 
 dent Society (of London), during seven years, has averaged 
 only 4 in 1,000. In agricultural laborers, in the prime of 
 life, the most highly-favored of the working-classes, it is 8 per 
 1,000. Among healthy persons, generally, it is rated at 10 
 per 1,000. Among clerks, at the same age, it is no less than 
 23 per 1,000. 
 
 It will naturally be asked whether sanitary measures, 
 which are admitted to be both necessary and praiseworthy, 
 or preventing the noxious effects of bad air, generated by 
 street and household refuse arid impurities, or by a neglect of 
 paving and sewerage, as well as for arresting the sale of taint- 
 ed meat and spoiled provisions generally, should not also be 
 , brought to bear against the abuse, if not the use, of so active 
 a poison as alcohol, especially in its stronger forms of combi- 
 nation. In some countries in Europe the apothecary is for- 
 bidden to sell a poison without an express prescription or 
 order from a physician ; and in every country he would be 
 looked upon as open to prosecution, if he passed across his 
 counter a poison, with a knowledge that the purchaser intend- 
 ed to make use of it at the peril, if not the cost, of his life. 
 Ought a man or a woman for the sex is not always ashamed 
 to be seen engaged in such a calling behind a bar, be allow- 
 ed privileges not granted to an educated and careful apothe- 
 cary ? But, while we condemn the apothecary for selling a 
 small vial of laudanum, the contents of which, if swallowed, 
 cause insensibility and other alarming symptoms, if not death 
 itself, we can not only tolerate, but give, as voters, and legis- 
 lators, and judges, our countenance to the bar-tender, whose 
 customer is allowed to drink his bottle of distilled liquor, with 
 
148 
 
 a similar risk of being made dead-drunk insensible, and 
 sometimes ending his life in this state of insensibility. No 
 terms of censure and condemnation are thought to be too 
 severe on the person who is administering, at stated intervals, 
 a slow but certain poison, with intent to kill ; but men gen- 
 erally have little to allege against the person who also admin- 
 isters, across his bar, a certain poison, under the plea of his 
 ignorance of, it may be his indifference to, the consequences. 
 The more violent and acute paroxysmal disturbances, induced 
 by alcoholic drinks, sometimes excite alarm, but the popular 
 mind has not attained to a full knowledge of the subject, as 
 far as relates to its chemical and physiological relations ; and 
 until it is enlightened on these points, we must be slow to 
 censure those who still foster, directly or indirectly, the habit 
 of intemperance, by refusing to sanction, or themselves to set 
 the example of, the avoidance of a practice which so soon and 
 so often becomes a habit, and a dangerous habit too. 
 
 One important effect of alcoholic drinks, which pervades the 
 entire organism, while it seems at first confined to the function " 
 of respiration, is to diminish the amount of carbonic acid eli- 
 minated from the lungs and skin. Valentin, Prout, Fyfe, and 
 Vierordt, certify to this fact. Dr. E. Smith speaks of brandy 
 and beer as greatly decreasing the respiration, and the quantity 
 of carbonic acid exhaled. Dr. Bocker found, from his experi- 
 ments on his own person, that those beverages diminished by 
 at least one-fifth the amount of carbonic acid exhaled. In 
 1854, Mr. W. J. Cox, from whose paper* we are now borrow- 
 ing, performed the experiment of collecting the carbonic acid 
 evolved from the lungs of two healthy individuals during one 
 hour, both before and after administering a dose of alcohol, 
 in the shape of whisky. In the first case, the quantity of 
 gas evolved, previously to taking the alcohol, was twelve hun- 
 
 * Epidemics and their Every-day Causes, in Sanitary Review, vol. iv. p. 
 259-60. 
 
149 
 
 dred cubic inches ; after it, nine hundred and fifty only. In 
 the case of the other person, the quantities were respectively 
 nine hundred, and six hundred and twenty cubic inches. 
 These facts show, continues Mr. Cox, that the presence of 
 alcohol in the circulating current is always associated with a 
 diminished percentage of carbonic acid in the air expired, 
 and in the exhalation from the cutaneous surface. The blood 
 becomes thereby loaded with effete carbon. An analysis was 
 made by Mr. C. in 1850, of the blood of two delirium tre- 
 mens patients. It was, in both instances, attenuated and defi- 
 cient in plastic material ; containing a great excess, or from six 
 to eight times more than common, of fatty matters. Lecanu found 
 in one case of a sot, the still higher proportion of one hundred and 
 seventeen parts in one thousand. Now, any agent which checks 
 the depuration of blood in the lungs, and retains in them 
 the effete products of the circulation, as is done in the case of 
 the blood of a drunkard, must be eminently deleterious. It 
 yet remains to be determined whether the blood of a moderate 
 habitual drinker is pro tanto in a similar state. Were we to 
 draw conclusions from the prompt effects in the experiments 
 by Mr. Cox, we should answer in the affirmative. This 
 writer has, however, no hesitation in urging "the following 
 fact, which has received overwhelming proof, that the least 
 habitual excess beyond a very moderate indulgence in fer- 
 mented beverages lowers the vital properties of the blood ; 
 destroys the normal tone of the nervous centres ; and as a 
 constant sequela most powerfully predisposes the frame to the 
 absorption of epidemic virus of whatever kind. Pure 
 aerated blood affords the best safeguard against the attack of 
 any epidemic. But the more perfect system of house ven- 
 tilation, cleanliness, &c., will fail to secure this, if by the 
 constant imbibition of alcohol in excess, the functions of the 
 lungs and skin are interfered with, their healthy relations de- 
 . stroyed, and their waste products retained within the current." 
 
150 
 
 We have the encouraging reflection in nearly all the efforts 
 and plans of hygienic reform, that as one evil often gives 
 strength to another, so does the abatement of one evil aid in 
 bringing about a similar change in regard to another ; and 
 hence, as living in filth, breathing a close and impure air, and 
 want of nutritious food, and of adequate hours of sleep, pre- 
 dispose to intemperance in the use of alcoholic drinks, so will 
 cleanliness, light, fresh air, proper food, and diminished toil, 
 do much to prevent the habit being formed, or to cure it if it 
 has been formed. Judicious sanitary reform is therefore fa- 
 vorable to temperance, as e converso, temperance is an indis- 
 pensable auxiliary to sanitary reform if only by its inspiring 
 the individuals who are to be its subjects with a desire, and, 
 at the same time, the requisite bodily vigor, to engage in in- 
 dustrial pursuits. Everybody must, by this time, be familiar 
 with the fact of the pecuniary loss to his family by the idle- 
 ness of the inebriate, and the cost to the public treasury for 
 his ultimate support in the last stage of destitution ; to say 
 nothing of the expense of measures of repression and punish- 
 ment called for by the breaches of peace and crimes commit- 
 ted by the intemperate. 
 
 PREVENTABLE DISEASES AND MORTALITY. Having ex- 
 hibited one view of the importance of sanitary measures for 
 cities, viz., that arising from the attention at all times given 
 to them as a necessary condition for growth and prosperity, 
 and the punishment in various ways, and often on a large 
 scale, when the subject has been neglected, we shall next take 
 a more pleasing and encouraging one, and which contrasts 
 strongly with the first. But before noticing some of the be- 
 neficial changes in the physical well-being and comfort, and 
 even an improved moral tone, which have resulted from sani- 
 tary reform, we have yet to say something on losses of life 
 and money incurred in many places, by the persistence in old 
 
151 
 
 abuses, owing more to ignorance of hygienic laws, than to 
 purposed wrong-doing or want of humanity. 
 
 Dr. Lyon Playfair, taking the single county of Lancashire, 
 in England, which includes indeed the large cities of Liver- 
 pool and Manchester in its bounds, showed some years ago, 
 by tabular statements, that there are every year in Lancashire 
 14,000 deaths, and 398,000 cases of sickness which might be 
 prevented, and that 11,000 of the deaths consists of adults 
 engaged in productive labor. They farther show, continues 
 Dr. Playfair, that every individual in Lancashire lives 19 
 years, or only one-half of the proper term of his life, and 
 that every adult loses more than ten years of life, and from pre- 
 mature old age and sickness much more than that period of 
 working ability. Without taking into consideration the dim- 
 inution of the physical and moral energies of the survivors 
 from sickness and other depressing causes ; without estimating 
 the losses from the substitution of young and inexperienced 
 labor for that which is skillful and productive ; without in- 
 cluding the heavy burdens incident to the large amount of 
 preventable widowhood and orphanage ; calculating the loss 
 from the excess of births resulting from the excess of deaths, 
 or the cost of the maintenance of an infantile population, near- 
 ly one-half of which is swept off before it attains two years 
 of age, and about 59 per cent, of which never become adult 
 productive laborers ; and with data in every case much below 
 the truth, Dr. Playfair estimates the actual pecuniary burdens 
 borne by the community in the support of removable disease 
 and death in Lancashire alone, at the annual sum of five mil- 
 lions of pounds sterling twenty-five millions of dollars. 
 He would draw attention to the columns respecting the num- 
 ber of preventable cases of death and sickness in Liverpool 
 and Manchester, or in any other of the large towns, to show 
 the immense amount of money which might be saved by 
 proper sanitary arrangements. 
 
152 
 
 Another view of the subject of preventable diseases and 
 deaths is presented in the following guise : Taking the least 
 unfavorable sanitary conditions of a certain number of people 
 living in sixty-four districts, in various parts of England, as a 
 standard, we may call the difference between this and the 
 general mortality as preventable, and make our estimates ac- 
 cordingly. The people now referred to dwell in sixty-four dis- 
 tricts, extending over 4, 797, 31 5 square miles, and their number 
 at the last census was 973,070, or nearly a million of souls. Al- 
 though living undoubtedly Tinder many favorable sanitary con- 
 ditions, yet investigations will lead to the detection of many 
 sources of insalubrity, such as small, close, and crowded bed- 
 rooms, and a neglect of cleanliness of person, and in the surroun- 
 ings. And yet after all, " the annual mortality per 1000 of this 
 million of men, women, and children, year after year, does not 
 exceed 17. Is it not evident, that under more favorable auspi- 
 ces, the death-rate would be still lighter ? Under such sanitary 
 conditions as are known, and with all the appliances existing, 
 can we not imagine a community living a healthier life than 
 those isolated people ?"* Setting out, however, from this stan- 
 dard, we are safe in affirming that deaths in a people exceed- 
 ing 17 in 1000 annually, are unnatural deaths. " If the peo- 
 ple were shot, drowned, burnt, poisoned by strychnine, their 
 deaths would not be more unnatural than the deaths wrought 
 clandestinely by disease in excess of the quota of natural 
 death; that is, an excess of seventeen deaths in 1000 living." 
 
 It may be alleged that an excess of deaths over the stan- 
 dard is inevitable in large cities, but, as justly remarked by 
 the Review, whose train of argument we are now following, 
 we lack the measure-line between the attainable and the inev- 
 itable loss. " In London, during the sixteenth century, the 
 population lived about twenty years on an average, and 50 
 died out of 1000 living ; consequently the excess over 17 was 
 
 * Sanitary Review, vol. iv pp. 87-8. 
 
153 
 
 33. That this excess was .not inevitable is now demonstrated; 
 for, with a great increase in number, the population now lives 
 about 37 years, and the mortality has fallen to 25 in 1000. 
 Is the excess of 8 deaths a year among every 1000 living, in- 
 evitable ? This cannot be admitted for a moment, if we regard 
 only the imperfect state of the sanitary arrangements which 
 the public authorities of London have within their power. 
 Nor can it be admitted that the excess of 5 deaths or 22 
 deaths instead of 17 a year, on every thousand living, is inev- 
 itable in England and Wales, with evidence before our eyes 
 of the same violations of nature in every district." Of the 
 420,019 persons who died in England in 1857, about 328,163 
 would have died had the mortality not exceeded the standard 
 of 17. deaths in 1000 living. Of the difference, 91,856, or 
 what may be called the unnatural deaths, 18,328 happened in 
 the country, or in the village districts, and 73,528 in the town 
 districts. To extend the argument. Within the shores of 
 the islands of Great Britain and Ireland dwell nearly eight 
 millions of people who " do not live out half their days ; a hun- 
 dred and forty thousand of them die every year unnatural 
 deaths ; two hundred and eighty thousand are constantly suf- 
 fering from actual diseases, which do not prevail in healthy 
 places ; their strength is impaired in a thousand ways ; their 
 affections and intellects are disturbed, deranged, and dimin- 
 ished by the same agencies." 
 
 Dr. Hutchinson sums up the loss to the city of London, 
 growing out of the preventable deaths, 10,000 in number, and 
 of the preventable cases of sickness, 20,000 in number, annu- 
 ally, to be, for funerals, medical attendance, loss of wages, and 
 expense of widows and orphans, 500,000, or $2,500,000. 
 In addition to this, he estimates the loss to the community at 
 1,000,000, or $5,000,000. He charges to the same account 
 the sums that might be saved by the consolidation of existing 
 boards and companies, improved water-supply, suppression of 
 
154 
 
 smoke-nuisance, and revenue from sewer-water, amounting to 
 more than another million of pounds, or five millions of dol- 
 lars. This gives a sum of nearly three millions of pounds, or 
 fifteen millions of dollars, lost by preventable disease and 
 death, and otherwise bad sanitary economy, to the city of Lon- 
 don. Mr. Banfield's estimate of loss to the United Kingdom, 
 from these causes, amounts to fifty-five millions of pounds, 
 or two hundred and seventy-five millions of dollars, per 
 annum. 
 
 In the single State of Massachusetts an estimate exhibits 
 an annual loss to the commonwealth of $62,000,000 to 
 $93,000,000 by the premature death of persons over 15 years 
 of age. 
 
 Of the preventable mortality a large proportion occurs in 
 the early or infantile period. Parents, on the spot, would be 
 startled at the announcement that the probabilities are against 
 their child reaching its second year ; and yet in Manchester, 
 Mr. Roberton assures us, in his account of the statistics of 
 mortality in that town, that for every 100 infants born (in the 
 township), upwards of 33 males and 26 females die within the 
 year ; whereas in Dorsetshire, the proportions are less than 
 half .these numbers. For the next period of life (from one to 
 two years), the percentage of male deaths is 18, and of female 
 deaths upwards of 16 ; but in Dorsetshire the proportions are 
 less than one fourth of this amount. 
 
 In Liverpool, the low sanitary state of which has been 
 already mentioned, the proportion of deaths to the whole popu- 
 lation is as low as 1 in 28.75, and the average duration of life 
 is only 20 years. Some have thought that the large emigrant 
 floating population of Liverpool, chiefly Irish, contributed 
 much to the increased mortality and low average of life in that 
 city ; but this is a fallacy, exposed by Dr. Playfair, who shows 
 that in both of these particulars they have greatly the advan- 
 tage of the fixed resident population. 
 
155 
 
 Not only is the mortality much increased by the preventable 
 causes of disease, but the physical vigor of the survivors is dimi- 
 nished by the same causes. The recruiting officers in the 
 county of Lancaster, which used to furnish the best soldiers 
 in the country, complained to Dr. Playfair that the sons are 
 less tall than the fathers, and that the difficulty is constantly 
 increasing of obtaining tall and able-bodied men. 
 
 Diseases of the respiratory organs, including phthisis, exist, 
 according to Dr. Playfair, in the great manufacturing districts 
 of Lancaster and Cheshire, to a greater extent than in any 
 other part of the kingdom. 
 
 It has been estimated that the mortality among the poorer 
 classes in England might be reduced 20 per cent, by means 
 within administrative control, to say nothing of the abatement 
 or removal of other causes depending on their personal habits, 
 which are intimately associated with those of the first-men- 
 tioned class. 
 
 In the town of Preston, we learn, from the full and exceed- 
 ingly interesting report of the Rev. J. Clay, that, while the 
 deaths in the whole town are one in every 29 persons, yet in 
 streets which are described by him, where there is a neglect of 
 sanitary measures, and the inhabitants of which are equally 
 negligent, the proportion is one death in every 19 persons. 
 
 The large proportion of infant mortality in Preston, among 
 the working classes those least favored on the score of sani- 
 tary protection is an evident melancholy fact, bearing on the 
 same argument. With the gentry, the loss is only 17-j per 
 cent, of infant life (children under five years of age), while 
 the operatives' loss is 55.5 per cent. For the whole of Eng- 
 land and Wales the percentage of deaths is 39.1. 
 
 The average age of deaths, including children, of the dif- 
 ferent classes in Preston, is still further confirmatory of the 
 position laid down. For " gentlemen," it is 47 years ; for 
 "tradesmen," 32 years ; and for "laborers," 18 years. 
 
156 
 
 In our own country the subject of infant mortality is one of 
 the highest interest, especially in towns. We would again 
 refer to a valuable paper on this very important subject, by 
 Dr. D. M. Reese. 
 
 This gentleman, in his evidence before the New York Senate 
 Committee, asserts, and as we believe on good grounds, that : 
 " Infant mortality in large cities in a great multitude of ex- 
 amples," &c., ending, " and life." (See the Senate Com- 
 mittee, Rep. p. 99.) 
 
 On this subject, which is one of such vital importance to 
 the public health in all cities, instructive reference can be made 
 to Mr. Hartley's " Essay on Milk, as an article of Human 
 Sustenance." The writer takes equally strong ground with 
 that assumed by Dr. Reese, and in confirmation of his view, 
 he adduces a certificate, signed by fifty-eight physicians of the 
 city of New York, men of professional eminence and worth, 
 affirming their belief, that the milk of cows, fed chiefly on 
 distillery slops, is " extremely detrimental to the health, es- 
 pecially of young children, as it not only contains no little 
 nutriment for the purposes of food, but appears to possess un- 
 healthy and injurious properties, owing in part, probably, to 
 the confinement of the cows, and the bad air which they con- 
 sequently have to breathe, as well as the unnatural and perni- 
 cious nature of the slop on which they are fed." Dr. Charles 
 A. Lee, in two letters to Mr. Hartley, adduces his personal ob- 
 servations and experience to the same purport.* 
 
 Under the operation of improved sanitary measures in the 
 city of New York, the Committee of Investigation believe that 
 the amount of thirteen millions of dollars, the estimated cost 
 of avoidable sickness and death, and the unnecessary loss of 
 five thousand lives per annum, might be prevented, with an 
 effect upon the happiness and morals of the people which can 
 neither be reckoned in figures nor expressed in words. 
 
 * Eleventh Annual Report of the New York Association for Improving the 
 Condition of the Poor, for the year 1854. 
 
157 
 
 The following is a statement of the number of the indigent 
 sick who were gratuitously provided for by the public institu- 
 tions of the city of New York, in the year 1853 : 
 
 " New York Dispensary. . . 46,338 
 
 Eastern " 19,706 
 
 Northern " 14,075 
 
 Demilt " 9,006 
 
 North-Western " 4,964 
 
 New York Hospital 3,526 
 
 Bellevue Hospital 4,836 
 
 Blackwell's Island Hospital 3,034 
 
 Ward's Island Hospital 10,794 
 
 Marine Hospital 4,938 
 
 Total 121,217 
 
 " Startling as are the above figures, they doubtless fall far 
 short of the reality. To this list of 121,000 sick, who are 
 chiefly unskilled laborers, of the most destitute class, should 
 be added multitudes of the same class that are relieved by 
 private benevolence, and the numerous organized charities in 
 the city ; also those cared for by the different churches and 
 beneficial societies ; and last, but not least, the great body of 
 operative artisans, builders, &c., in humble life, whose occupa- 
 tions sometimes, but more frequently their unhealthy dwell- 
 ings, induce debility, sickness, and incapacity for labor." 
 
 " Infant mortality, in large cities, in a great multitude of 
 examples, which no man can number, is caused by the impure 
 and adulterated milk, and other unwholesome articles of food, 
 which are among the necessaries of life. Our profession has 
 ever and anon sought to arouse public attention to this im- 
 portant subject, but in vain. Distilleries in or near large 
 cities would be an intolerable nuisance and curse, apart from 
 the mischiefs of their manufacture of alcoholic drinks, in view 
 qf the single fact that, wherever they exist, their slops will 
 
I 
 
 158 
 
 furnish the cheapest food for cows, the milk from which is 
 more pernicious and fatal to infant health and life than alcohol 
 itself to adults ; poisoning the very fountains of life. So long as 
 distilleries are tolerated in cities, cow-stables will be their 
 appendages, and the milk, fraught with sickness and death, 
 will still perpetuate mortality, especially among the children 
 of the poor. All the artificial adulterations of milk, as by 
 water or chalk, &c., are harmless nay, laudable, compared 
 with the poisonous supply obtained from cows fed on distillery 
 slops, for to this poison chemistry itself affords no antidote, 
 since it defies all analysis or synthesis a poison sui generis, 
 utterly destructive both of health and life." 
 
 The deaths from pulmonary consumption in England and 
 Wales are represented to amount annually to 36,000, of which 
 one half are said to occur in London. Dr. Guy attributes the 
 great mortality from this disease to be owing to " defective 
 ventilation of houses, shops, and places of work. Next to 
 this, in point of importance, is the inhalation of dust, metallic 
 particles, and irritating fumes. One cause, over which the 
 poor themselves can exercise control, is the abuse of spirituous 
 liquors, a frightful source of consumption." The death-rates 
 of consumption are susceptible of being much diminished. 
 
 Mention was made, under the head of Ventilation, of the 
 sufferings, from neglect of this matter, incurred by tailors. 
 The economy of a better sanitary system with them is set forth 
 as follows : "If the employers and the men had been aware 
 of the effects of vitiated atmosphere on the constitution and 
 general strength, and of the means of ventilation, the practi- 
 cable gain of money from the gain of labor by that sanitary 
 measure could not have been less, in one large shop, employ- 
 ing two hundred men, than 100,000 ($500,000). Inde- 
 pendently of subscription of the whole trade, it would diminish 
 their working period of life, and have been sufficient, with the 
 enjoyment of greater health and comfort by every workman 
 
159 
 
 during the time of work, to have purchased for him an annuity 
 of 1 ($5) per week for his comfortable and respectable self- 
 support during a period of superannuation, commencing soon 
 after fifty years of age." 
 
 When speaking of the greatly increased cost of sewers, 
 owing to defective arrangements in their first construction, the 
 amount lost in this way should be put under the head of 
 money that might have been saved by judicious sanitary 
 measures. 
 
 In comparing the mortality of the town of Salford, in 
 which thirty-one persons per thousand die annually, and of 
 Manchester, which is still greater, with the neighboring town 
 of Broughton, where only fourteen persons in a thousand die 
 annually, Mr. Chadwick enters into some instructive calcula- 
 tions, which go to show that there are 700 deaths annually 
 from preventable causes alone ; hence to remove these causes 
 might insure an annual saving of a sum of money exceeding 
 40,000, or $200,000. To effect this saving, the main thing 
 required is that the working classes should understand what 
 are the sanitary requirements to secure health and comfort to 
 their homes. The above sum is based on the estimate that 
 there are twenty-five cases (Dr. Play fair says 28) of illness, 
 on an average, to one death. Each death costs, on an aver- 
 age, 60, or $300, including funeral expenses, medical attend- 
 once, loss of labor, and the like. The reference to the neces- 
 sity of awakening the intelligence of the working classes to a 
 correct view of preventive hygiene, reminds us of the advice 
 so forcibly expressed by Dr. Kissam, as to the means of 
 abating the evils of poverty, so as to reduce the mortality 
 among the inhabitants of certain districts in the city of New 
 York. Dr. Kissam says, with much torce: " The poor must 
 have good dwellings to live in, and they must have medical 
 missionaries to teach them how to live. They are taught upon 
 almost every other subject than about how to live. They do 
 
160 
 
 not know how to cook their food ; they do not know that 
 they are poisoned when four or five of them sleep in a room 
 without ventilation." 
 
 SANITARY IMPROVEMENTS. The importance and economy 
 of sanitary measures for cities are evinced in the great benefits 
 derived from sanitary improvements. Hamburg suffered se- 
 verely from the cholera in 1832. In 1842 occurred a grievous 
 calamity, as it was thought at the time, in a fire which de- 
 stroyed nearly a third of the city. The rebuilt portion shows 
 that in it due attention has been paid to drainage and other 
 requirements ; and the effect was tested in its having enjoyed 
 an exemption from the cholera of 1848, alike remarkable and 
 important. A comparison of the state of the poor, living in 
 the rebuilt parts of the town, with those living in the old 
 parts, showed that not more than one of the former had been 
 attacked with cholera for ten of the latter. Exeter, in Eng- 
 land, affords another remarkable illustration of the benefit ob- 
 tained by the adoption of improved hygienic measures. These 
 consisted in improved drainage, an ample supply of good 
 water in every part, pulling down of old houses, the removal 
 of nuisances, and greater general attention to the sanitary 
 condition of the poor. In 1832, before these reforms were 
 even thought of, the deaths from cholera were 402, and a vast 
 amount of suffering, as well as heavy expenditures, inflicted 
 on the town. In 1849 not more than ninety-nine cases in all 
 occurred in Exeter, and one half of these took place in the 
 single parish of St. Edmund, in a low, unwholesome district, 
 near the accumulations of a main drain from the city, im- 
 mersed in putrid exhalations. A still more instructive ex- 
 ample is afforded by Nottingham. Upwards of 1000 cases 
 of cholera, of which nearly 500 were fatal, occurred there in 
 1832. At that time Nottingham, like Exeter, was badly sup- 
 plied with water, besides its being ill-drained, extremely filthy, 
 and very densely populated. The ravages of the pestilence 
 
161 
 
 were confined in a great measure, to the worst localities, the 
 higher and better-conditioned district escaping almost entire- 
 ly. Since then very much has been done for the improvement 
 of the town. It now enjoys an almost unlimited supply of 
 wholesome filtered water. Nuisances were removed, and the 
 condition of the dwellings of the poor improved. The result 
 was, that in the autumn of 1848, although a filthy village 
 within five miles of Nottingham was severely attacked, yet 
 the town remained entirely exempt, nor did a single case oc- 
 cur there until December in the following year, although there 
 had been much diarrhoea during the season a clear proof that 
 the epidemic influence had been felt when five fatal cases oc- 
 curred. In the same line of encouraging results from in- 
 creased attention to hygienic reforms occurs the example of 
 Tynemouth, eight miles below Newcastle and Gateshead, in 
 the north of England. This town, like the last two mention- 
 ed, suffered severely from cholera in 1848-49, losing 463 out 
 of its population of 64,248. Thus warned, active sanitary 
 measures were adopted, and when in 1852 cholera was again 
 epidemic, those exertions were redoubled ; and, as a conse- 
 quence, 1852 saw Newcastle and Gateshead suffering "from 
 the most terrible outbreak of cholera yet experienced in Eng- 
 land, whilst Tynemouth, only eight miles lower down the 
 river, was exempt, all hough numerous cases of diarrhoea plain- 
 ly showed that over it the choleraic influence extended, but 
 found no congenial soil." Evidence to the same purport was 
 furnished in different cities of the United States during the 
 cholera outbreak of 1849 ; as, for instance, in Boston and 
 Philadelphia alt hough the sanitary measures adopted did 
 not imply organic changes, but were mainly confined to the 
 removal or abatement of certain nuisances, domestic and 
 otherwise, cleansing the streets, &c. 
 
 As justly remarked by the British and Foreign Medico- 
 Chirurgical Review,* to which we are continually indebted 
 
 11 * Vol. vi. pp. 36-87 
 
162 
 
 for so much in all that relates to British sanitary progress : 
 " But far more gratifying, in every point of view, is the clear 
 testimony which the late epidemic afforded of the strikingly 
 beneficial results of substantial structural improvements in 
 averting the fatal effects of choleraic disease. From a large 
 mass of evidence we select the following facts as illustrative 
 of this most important subject : The three model lodging- 
 houses in the metropolis two of them situated in a most un- 
 healthy district, and where there were numerous fatal cases 
 around escaped almost entirely. There were a few cases of 
 diarrhoea among the inmates (210 in number,) and only one 
 case of cholera, which occurred in an old man intemperate and 
 ill-fed. The complete immunity of the ' Metropolitan Build- 
 ings' in Old Pancras Road, containing upwards of 500 in- 
 mates, was equally striking, although within a few hundred 
 yards the epidemic was so severe that three deaths occurred in 
 one house, and the whole neighborhood was severely af- 
 flicted with diarrhoea. Of the metropolitan prisons, two suf- 
 fered severely, while the seven others remained nearly exempt. 
 In the model prison at Pentonville, whose sanitary arrange- 
 ments are good, there was no cholera, and very little diarrhoea 
 among 465 inmates. Giltspur and Newgate prisons enjoyed, the 
 former a complete, and the latter an all but complete exemption, 
 although the district around suffered with extraordinary severity. 
 The case of the House of Correction, in Cold Bath Fields, is, 
 perhaps, the most instructive of all. In 1832, when the num- 
 ber of prisoners was 1148, there occurred 319 cases of diar- 
 rhoea, 207 of cholera, and 45 deaths. At that time the drainage 
 of the prison was most faulty, the sewers having in places 
 fallen in and become choked with soil. Subsequently the 
 whole sewerage was rebuilt, and on examination previous to 
 the late epidemic it was found to be in good order. The ven- 
 tilation, also, of the cells had been improved, and a small 
 open fire was placed in each of the day-rooms. Out of 1100 
 
163 
 
 prisoners there was not a single instance of cholera, and only 
 a few cases of diarrhoea, which speedily yielded to prompt 
 treatment. Bridewell prison afforded equally satisfactory re- 
 sults. In 1832 it was in a most filthy state, and the prison- 
 ers were much crowded. Sixteen cases, four fatal, occurred 
 in the epidemic of that year. The sanitary arrangements of 
 the prison have since that period "been rectified ; and while 
 the pestilence raged on all sides of it, in houses separated only 
 "by a narrow wall, no case of cholera took place, though fresh 
 prisoners of the very lowest class were daily brought in. 
 There was only one case of the malignant form of the disease 
 in Horsemonger Lane Jail, which is situated in a district that 
 suffered most severely. The two public metropolitan lunatic 
 asylums of Bethlehem and Hanwell escaped without loss of 
 life, although cholera prevailed extensively and severely within 
 a hundred yards of the former, and the latter was visited with 
 a rather sharp attack of diarrhoea, showing clearly that the 
 morbific influence was there." To these remarkable proofs of 
 the exemption from a fatal epidemic enjoyed by good internal 
 hygienic arrangement, we may add the case of the jail at 
 Taunton, a town with a population of 16,000, during the pre- 
 valence of the cholera in 1849. Not a solitary case even of 
 diarrhoaa occurred among the prisoners in tlie jail ; which of- 
 fers a remarkable contrast with the state of things at that 
 period in the work-house, the inmates of which lost by death 
 from cholera 22 per cent, of their number, or 60 out of 276. 
 This last building was low, badly drained, and most imper- 
 fectly ventilated ; there were numerous nuisances within the 
 walls ; the people had insufficient space allowed them, and 
 personal cleanliness was very much neglected. The space al- 
 lowed for each inmate was not above two thirds of what was 
 requisite for safety. The stress of the attack was in the girls' 
 school-room, in which the greatest degree of over-crowding ex- 
 isted. The prisoners in the jail were much better cared for 
 than the poor inmates of the Union Work-house. Each cell 
 
164 
 
 contained from 800 to 900 feet and upwards of air, besides 
 being systematically ventilated and warmed, to maintain an 
 even temperature throughout the twenty-four hours. More- 
 over, each prisoner had the means of personal cleanliness, and 
 attention to this was strictly enforced throughout the building. 
 The result was that the health of the prisoners remained 
 throughout perfectly good. 
 
 A similar exemption from cholera in 1849 was enjoyed by 
 the Eastern Penitentiary of Pennsylvania in Philadelphia. 
 
 PULMONARY AND CUTANEOUS PURIFICATION. The consen- 
 taneous, and in a measure identical action of the lungs and 
 skin, is not so generally known or attended to as is demanded 
 by the interests of both public and personal hygiene. The 
 lungs and the skin are both of them engaged in the same offices, 
 viz., 1, to evolve gaseous and animal matters, the retention of 
 which would be injurious to the organism ; and, 2, to intro- 
 duce into the blood the vitalizing element, or the oxygen of 
 the atmosphere ; and hence both organs, the pulmonary and 
 the cutaneous, require a supply of fresh air. Both of them 
 require also the additional purifying aid of water. The lungs 
 receive their share in the shape of ordinary atmospheric mois- 
 ture, and how they rejoice in this is seen in the rosy cheeks, 
 implying active pulmonary circulation and respiration, of the 
 inhabitants of the moist climates of England and Holland. 
 The skin receives its share more commonly in the shape 
 of water, directly applied to its surface, as in the process 
 of ordinaiy ablution, and of bathing; and in some coun- 
 tries, on a large scale by vapor baths. Both the lungs and 
 the skin exact as a condition for the healthy discharge of their 
 functions, that they shall have their air-bath for transpiration, 
 and their water-bath either as simple aqueous fluid or as vapor, 
 to deterge the respiratory and cutaneous surfaces, and to 
 enable them to cast off, in the first case, mucus, and in the 
 
165 
 
 second, the perspirable and oily matters. Cleanliness, in its 
 true comprehensive meaning, cannot be carried out so as to 
 meet the wants of the animal economy, unless we attend to 
 these requirements. Our senses revolt at the mere offer of dirty 
 water for drink ; but nature displays equal repugnance when 
 dirty, that is, impure air is offered for breathing ; and no less 
 injustice is done to the lungs by the inhalation of foul air, in 
 which are floating, at the same time, particles of fine dust, rising 
 from different substances in manufacture, than would be to the 
 skin, if first, ditch or gutter-water, and then sand and dirt, were 
 sprinkled over it. The very idea of swallowing or even tast- 
 ing the fluid substances ejected as excreta, or thrown off by 
 disease, from the body of another person, or even from our own, 
 is abhorrent to all ; and yet how few scruple about receiving 
 into their lungs, by respiration, the impure exhalations from 
 the lungs of everybody in the same room with themselves. But 
 they are doing more at this time ; they are inhaling not only 
 the foul air which escapes from the lungs, but also that and 
 the kindred cutaneous emanations of all those present on such 
 an occasion. 
 
 Public Squares and Parks. We make these remarks as 
 introductory to, and with a view of enforcing, not merely the 
 desirableness on the score of pleasurable bodily sensations, 
 but also the necessity on that of health, of out-door exercise 
 in a fresh and pure air, and of regular bathing in pure water, 
 whether it be fresh or saline. Attention to these things is a 
 duty which every individual owes to him or to herself, but 
 unless it be regarded at the same time as part of public hy- 
 giene, and carried into effect by proper sanitary measures, the 
 inhabitants of cities cannot meet the requirements of the case, 
 and must suffer if they are not aided by judicious municipal 
 legislation. The opportunities afforded for ventilation are 
 availed of to a certain and too often to a very limited extent 
 in the house ; tliey are more effective in the street ; but they 
 
166 
 
 can only be said to have received their full, or in a measure 
 their satisfactory development in public gardens, squares, and 
 parks, in which the delicate and the valetudinarian adults 
 more especially, and all those of tender age, may find com- 
 pensation for their inability to visit the suburban districts, 
 to breathe fresh air, and to been livened by the sight of herb- 
 age, flowers, and trees, in their habitual and ever-pleas- 
 ing livery. These advantages are all easily attained in the 
 spots of the kind just designated, which on this account can 
 never be too highly prized, nor too greatly multiplied. But 
 there is yet another and a large class, namely, the artisans 
 and mechanics, whose engagements are such as to keep them 
 within the narrowest city limits, and who, fatigued and jaded 
 with their prolonged toil, are too often prompted to fly for 
 present excitement and relief to the drinking-shop, or tavern, 
 in place of drawing on the stimulants which nature affords in 
 the cordial of a full measure of oxygen of the pure air of these 
 open and ornamented places. Here they would experience, in 
 addition, the grateful excitement of the senses in admiring 
 the grass-plots, and the rich parterres, with their shrubs and 
 flowers, while seated under the shade of the spreading trees, 
 and refreshed by listening to the falling water of a fountain, 
 while watching at the same time its feathery spray. It is 
 in such places that town rivals the country, and that nature 
 and art join together to promote the public health, and incite to 
 innocent gayety and enjoyment. 
 
 Gymnasia and Museums. But something more is re- 
 quired for the youth, and the industrious mechanics and work- 
 ing men generally, of a city, than space for walking for 
 themselves and their families, important as this confessedly 
 is. Grounds ought to be set apart for gymnastic exercises 
 and various manly sports, under the supervision of competent 
 instructors. 
 
167 
 
 Connected with these^ grounds there might be instituted 
 museums of natural history, models of machinery, and even 
 specimens of the fine arts ; thus creating in the minds of all 
 who would visit these places, associations of the most pleasing 
 and instructive kind. If we suggest these things as measures 
 of health, others might strengthen our suggestion by urging 
 them as an affair of morals. 
 
 Until within the last few years, it was thought that there 
 was something in the Anglo-Saxon disposition and character 
 which unfitted the people of Great Britain and the United 
 States for a due appreciation of the benefits and pleasures of 
 public walks and gardens, and of museums and galleries of 
 art ; and that if these places were thrown open to the public, 
 they would be injured, if not destroyed, by the Vandal multi- 
 tude. Trials made on a large scale, as for instance by throw- 
 ing open the British Museum, in London, and the grounds 
 and the palace, including the collection of paintings, at Hamp- 
 ton Court, to the public of all classes, have dispelled this 
 notion. The following carries with it instruction. On the 
 occasion of a projected chartist meeting at Manchester, which 
 greatly alarmed the municipal magistrates, Sir Charles Shaw, 
 the Chief Commissioner of Police, induced the Mayor to get 
 the Botanical Garden, the Zoological Garden, and the Museum 
 of that town thrown open to the public. The effect was, that 
 not more than 200 or 300 attended the .political meeting, 
 which entirely failed ; and scarcely a dollar's worth of damage 
 was done to the gardens or to the public institutions by the 
 working people, who were pleased with their share of the 
 entertainment. A farther effect produced, was, that the 
 charges before the police, of drunkenness and riot, were on 
 that day less than the average of that on ordinary days. 
 
 Ablution and Bathing. As relates to cutaneous purifi- 
 cation^ personal cleanliness ought to be regarded in the light 
 
168 
 
 of a sanitary measure of the first importance, and to come 
 within the category of the cleansing of streets and houses. It 
 does not engage attention to the extent that its importance 
 demands, whether we look to health or comfort. The neglect 
 of cleanliness by the colliers of Lancashire, as recorded by 
 Mr. Chadwick in his Report, is, we fear, not without a 
 parallel, either among the same classes elsewhere, or among 
 many others in better circumstances, but whose skin does not 
 tell the tale to the eye so forcibly as if it were blackened by 
 coal-dust. Neither the men nor the girls employed in the 
 coal-mines ever washed their bodies. " Their legs and their 
 bodies, said a witness, are as black as your hat." One 
 laborer remembered t\isit a particular event took place, because 
 it was then he washed his feet. The effects of these habits 
 are seen in the work-house, in almost every pauper admitted. 
 When it is necessary to wash them on their admission, they 
 usually manifest an extreme reluctance to the process. Their 
 common feeling was expressed by one of them, when he de- 
 clared it " e.qual to robbing him of a great-coat which he had 
 had for many years." 
 
 How many of those who walk our streets, in gay attire too, 
 wear a garment of this kind over their skins ? If the exter- 
 nal surface of insects be covered with oil, so as to stop up 
 their spiracles, and the skin of animals of a higher grade be 
 covered by a layer of some impermeable substance, death re- 
 sults. It needs little physiological knowledge to make us 
 aware of the injury done to the functions of a human body, 
 by the skin being coated for years with the secreted, oily, and 
 perspirable matter. The lungs, to which the skin is auxilia- 
 ry, must be overtasked in consequence, and rendered more 
 liable to disease. That distressing, and too often unmanage- 
 able affection, albuminuria, or Bright's disease, is not unfre- 
 quently traceable to the imperfect performance of the func- 
 tions of the skin. 
 
169 
 
 " It might savor of caricature," says Mr. Martin, one of 
 the Commissioners on the Health of Towns, &c., " were it 
 asserted that in regard to the laboring poor, it is only when 
 the infant enters upon breathing existence, and when the man 
 has ceased to breathe, at the minute of birth, and at the hour 
 of death, that he is really washed ; yet such a statement 
 would not be so far removed from the truth as it may at first 
 appear. To the great mass of the people, and from dawn to 
 the term of life, the bath, as an article of comfort, luxury, 
 and health, is hardly known, even in name. In the chief 
 cities of the United States a better, and in some of them an 
 abundant supply of water, allows of the inhabitants having 
 bath-rooms in their houses, for the purpose of cold-bathing ; 
 and within these few years past, the increase of kitchen ranges 
 and boilers attached, allows of the use of a warm-bath. But 
 the multitude, the masses of our population, both in town and 
 country, are still wanting in these means of promoting health 
 and enjoyment ; and we have ample cause for imitating, by 
 our own municipal governments, those in England, which, 
 aided by the benevolence of individuals, have set about 
 the erection of public baths. These, if not actually allowed 
 to be used by all applicants gratuitously, are accessible on 
 the payment of a very small sum. 
 
 As yet, the people of Christendom are behind the ancients, 
 particularly the Romans, and even the semi-civilized inhabit- 
 ants of different countries at the present time, in the general 
 resort to the bath, and the readiness of access to this comfort 
 and solace by the people at large. Your reporter would ven- 
 ture to refer to a work of his (on Baths, &c.), for a variety of 
 details on the subject of bathing, as a part of public hygiene. 
 Warm as well as cold water should be introduced into all 
 bath-houses, both for the purpose of more complete ablution and 
 detersion of the skin of all adhering impurities, and on account 
 of the differences in individual sensibility and vigor of frame, 
 
170 
 
 either constant or connected with temporary indisposition and 
 weakness, short of actual disease. Warm baths might be sup- 
 plied to the working-classes, Mr. Hawkesby thinks, at the 
 low rate of about six cents each, if taken by 200 or 300 daily. 
 By Sir Henry Dunkerfield's Act, the Parliamentary standard 
 charge, for a warm-bath, is fixed at two pence (four cents), 
 and when the bathers are in reasonable numbers, this sum is 
 represented to be quite sufficient to give a profit beyond ex- 
 penses. Dr. Reid, in his report to the Commissioners, in 
 which he describes the means of ventilating different kinds of 
 buildings, mentions the advantage of a limited supply of water 
 being procured, " during the progress of the steam-bath, ren- 
 dering cleansing, and the use of the flesh-brush, much more 
 convenient than in the ordinary water or vapor-baths." 
 
 It has been calculated that the waste-water of a steam- 
 engine of 500 horse-power would, at an average temperature 
 of 70 to 75 deg. K, suffice to bathe 26,000 persons. A new 
 source of an abundant supply of water, of a somewhat elevated 
 temperature, adapted to personal and domestic wants, has 
 been opened of late years in Artesian wells. The most re- 
 markable of these is the one at Grenelle, near Paris, which, 
 from a depth of nearly 2000 feet, sends up a volume of water 
 equal to 132,000 gallons every twenty-four hours, at a tem- 
 perature of 82 deg. F. Its softness and temperature adapt it 
 admirably to the purposes of a bath and of washing clothes, 
 for both of which it is largely used. 
 
 Public Wash-houses. One of the marked improvements 
 in public hygiene of late years, and which bears evidence that 
 the spirit of philanthropy is abroad and active, is the establish- 
 ment of Public Wash-houses, to which women of the poorer 
 classes can go, and have the use of rooms, and all the appliances 
 for washing and drying their clothes and those of their families, 
 on the payment of a very small sum. The trials so far, made 
 
171 
 
 in England and different cities of this country, have been 
 quite successful, and promotive of much good and comfort to 
 the parties for whom these houses are opened. Incidental 
 but very decided benefit to the women who make use of the 
 conveniences thus offered, is enjoyed in the avoidance of the 
 dirt and litter, and confusion and disturbance to the whole 
 family, on a washing day, in their own small and confined 
 rooms. 
 
 An improvement, or rather an exceedingly useful addition, 
 has been made to the original plan, by the procuring of large, 
 airy rooms in which the infant children of the wash-women 
 who come to wash their clothes, stay, and are watched and 
 nursed by a person employed for the purpose. And yet a 
 step farther has been taken in the way of present as well as 
 future good to these juveniles. It is teaching them the simple 
 elements of learning and morality. 
 
 NUISANCES. A few words may be said on the present occa- 
 sion in regard to nuisances, a term which in the minds of 
 many has an entirely too limited meaning for the cause of pub- 
 lic health, while, on the other hand, some of the more sensi- 
 tive and exacting would extend the list to an almost indefinite 
 extent. Under the general head of Nuisances are included 
 special obstructions to the public health, such as accumula- 
 tions of dung and offal, pig-sties, open privies, obstructed 
 drains, pools of stagnant water, noxious smoke and other mat- 
 ters coming from manufactories, and especially the animal re- 
 fuse invariably found in the vicinity of slaughter-houses, aU 
 of which act with so much power in the midst of a dense popu- 
 lation. By an Act of Parliament, passed some years ago, 
 aggrieved parties can, by an easy course, procure a removal of 
 evils, when duly specified. The Nuisance Removal and Dis- 
 ease Prevention Act, passed in 1848, with the Amended Sta- 
 tute enacted the following year, are great steps in the way of 
 sanitary reform. They constitute, together with the Public 
 
172 
 
 Health Act and the Interment Act, a good beginning in a 
 course of wise sanitary legislation, which has already done 
 much toward an amelioration of the great and many abuses by 
 which the public health in England had suffered so much. 
 
 French sanitary legislation is more precise, and at the same 
 time* comprehensive, on the subject of nuisances. It distrib- 
 utes into three classes all establishments which are adverse to 
 the comfort, health, and safety of the inhabitants ; and it 
 describes in what manner each is unhealthy and annoying. 
 
 Establishments of the first class cannot be allowed in the 
 vicinity of private dwellings, and their erection is only permit- 
 ted by a decree of the sovereign council. To this category be- 
 long the manufacture of. sulphuric, hydrochloric, and nitric 
 acids, as well as that of various chemical products, melting 
 establishments of fat on open fires, work-shops for the prepara- 
 tion of taffety, leather, and varnished tissues, also of knackers, 
 tripe-men, and cat-gut manufacturers, and of those in which 
 are prepared animal black, glue, Prussian blue, blood-manure, 
 aiselle (a kind of dye), and starch, factories of fire-works, luci- 
 fer matches, and fulminating compounds. The reasons ior 
 placing these together, as the most dangerous class, are vitia- 
 tion of the air by the disengagement of emanations inimical to 
 health, the risk of fire, and the intolerable odors which they 
 emit. Hence, if allowed at all, it is only within a radius of 
 three thousand feet, after long and multiplied formalities, which 
 want of time prevents us from introducing in this place. 
 
 The second class of establishments of the manufacturing 
 kind include those the removal of which from an inhabited dis- 
 trict is not absolutely necessary, but which it is fit should only 
 be permitted after a suitable inquiry to show that they are not 
 nuisances. To this category belong lime or plaster kilns, 
 when they are in constant operation, high-pressure steam- 
 engines, gas-works, currieries, tanneries, hat factories, foun- 
 dries, manufactories of sulphate of iron and zinc, of sulphate of 
 
173 
 
 soda in close vessels, phosphorus, imitation jewelry, bitumin- 
 ous matter, chandleries of tallow and of stearine, and work- 
 shops for the scraping and cleaning of copper vessels. 
 
 None of these can be called actually unhealthy to those in 
 their vicinity, but many of them are disagreeable, and seri- 
 ously annoy others by their smoke, their noise, the danger of 
 fire, or by their offensive smell. 
 
 The third class comprises all those establishments which 
 may be in operation in the vicinity of dwelling-houses without 
 inconvenience, but which must nevertheless be submitted to 
 the inspection of the Prefect of the Department, for his autho- 
 rization. They are, lime and plaster kilns, used not more 
 than a month in the year, brick-yards, potteries, and tile 
 works, manufactories of gelatine and isinglass, crucible foun- 
 dries, dye-works, &c. 
 
 There is nothing absolute in this classification, inasmuch as 
 that a particular manufactory, the processes of which are im- 
 proved, may pass from one category to another. 
 
 Considering the excessive annoyances from the smoke, 
 especially from the burning of bituminous coal, in large cities, 
 such as London, and some of our own on this side of the Atlan- 
 tic, it becomes a measure of the first importance, as a question 
 of public health, connected with its effects on the lungs, by its 
 being constantly breathed, and on the skin, in relation to per- 
 sonal cleanliness, and to the interiors of houses, on the score 
 of domestic cleanliness, to discover the means by which the 
 evil can be materially abated, if not entirely neutralized. Ex- 
 periments with more or less success have been made with this 
 view, the precise results of which, or their relative value, need 
 not be introduced here. Too much importance has been 
 attached to the mere effect of lofty chimneys in removing to a 
 distance and diluting the heavy smoke and noxious fumes 
 which are evolved from many manufactories. In themselves 
 
174 
 
 they in no way destroy the emanations which are conveyed 
 into them ; these are discharged as much as before into the 
 external atmosphere ; and experience has proved that even 
 very lofty chimneys, on which large sums have been expend- 
 ed, do not necessarily insure that amount of admixture with 
 the common air which is essential to prevent the most inju- 
 rious consequences of their deposit, even at very considerable 
 distances. The extent to which nauseous, acrid, and other 
 noxious fumes from manufactories often destroy the atmo- 
 sphere of numerous dwellings, and sometimes of whole streets, 
 is abundantly explained in the reports of the Commissioners. 
 
 Slaughter-Houses. These nuisances, of the worst class, 
 were clung to in England and elsewhere, with a tenacity such 
 as might imply a thorough conviction of the use of them 
 being a time-honored privilege, interwoven with the dearest 
 rights of the people. The last and decisive battle of old 
 prejudices against the clearest evidences of hygiene, was 
 fought in the matter of the Smithfield Market and its 
 shambles, in the very heart of London. We cannot introduce 
 the subject better than by giving the following portion of Ab- 
 stract of Evidence before the Select Committee of the House 
 of Commons on Smithfield Market, May, 1847. 
 
 Dr. Jordan Roche Lynch had lived and practised for the 
 last fifteen years in the neighborhood of Smithfield, the 
 sanitary state of which was most defective. The slaughter- 
 houses have a most injurious influence upon the district ; 
 they generate fever, and render the most simple diseases ma- 
 lignant, and shorten the duration of life. In Bear alley, a 
 lane running from Farringdon street to the old wall of Lon- 
 don, called Breakneck Steps, there is a slaughter-house 
 behind six or seven houses, which are inhabited by the hum- 
 blest classes of society. The stench is intolerable, arising 
 from the slaughtering of the cattle, and the removal of the 
 fecal matters, the guts, the blood, and the skins of the animals. 
 
175 
 
 When they clean the guts, the matter is turned out ; some of 
 the heavier parts of the manure are preserved to be carted 
 away, but a great deal of it is carried into the sewers, which 
 have gully-holes ; and in the summer months, the heat acting 
 upon the fecal matter causes its decomposition ; and carburet- 
 ted and sulphuretted hydrogen gas, and carbonic acid gas, 
 all of which are fatal to animal life, are disengaged, and rush 
 out of the gully-holes, so that a blind man's nose will enable 
 him to avoid approaching these outlets. Whenever he goes 
 into places or houses contiguous to the slaughter-houses, he 
 is compelled to hold his nose all the time he is there, the 
 stench is so great. Dr. Lynch has patients in all these 
 houses. They are never free from the effects of this stench, 
 and when the people there are dangerously ill, he is without 
 the hope, by any exercise of skill, of restoring them to health. 
 He invariably makes it a rule to entreat them to conquer their 
 repugnance to go into the Work-house, in order that they may 
 have better air ; and if they accede, the medicines that would 
 have failed in the noxious atmosphere before, restore them, in 
 most instances, to health. 
 
 The people where such smells are, drink ; it is a kind of 
 instinct ; they fly to it ; they fancy that the stimulus resists 
 the noxious agency of the foul air they are breathing. 
 Malaria, such as is generated in these slaughter-houses, is a 
 narcotic poison; it oppresses both body and mind; and 
 under the influence of this physical and mental depression, 
 they instinctively resort to the gin-shop, which aggravates 
 their distresses, by extracting from them the means *rf living 
 perhaps better than they do, and it might have been added, 
 also, by the addition, in this way, of one poison to another.* 
 Mr. Dunliill, civil engineer, who made the abstract from 
 which we have been borrowing, relates also, that in Newgate 
 and Leadenhall markets, the slaughtering was carried on in 
 
 * Journal of Public Health, vol. i., p. 244. 
 
176 
 
 cellars, where there was a total absence of natural light, ven- 
 tilation, or drainage ; the blood and dung being sometimes 
 allowed to accumulate therein for months together, or until 
 the pestiferous effluvia caused sufficient alarm and sensation in 
 the neighborhood to originate an indictment. The water 
 supply was utterly inadequate, and was obtained, from the 
 most impure sources, while the machinery was of the most 
 primitive and imperfect character. In Aldgate (better known 
 as Whitechapel) Market, the open kennels and water-tables 
 of the wood-way are to be seen almost daily streaming to over- 
 flow with blood and ordure. Immense quantities of skins, 
 offal, and dung, were also exposed on the public highway, 
 where thousands of pedestrians were continually passing to 
 and fro. 
 
 We have spoken of these nuisances in the past tense, under 
 a belief that they have been abated, if not entirely removed. 
 Smithfield Market has been finally closed. 
 
 Some of the witnesses before the Commons Committee, 
 spoke in high terms, from personal observation, of the 
 French abattoirs, which form a striking contrast to the Eng- 
 lish slaughter-houses. Mr. Dunhill, on this point, remarks : 
 " In Paris, the influence of cleanliness, supervision, and facili- 
 ties for performance of the duties of the slaughtermen, was 
 very interesting to observe. Their demeanor was character- 
 ized by none of that brutality, apparent relish for cruelty, and 
 indifference to the dirt, filth, and disgusting scenes, which 
 those of our own country witness and participate in every 
 day of their lives. Not the least important feature in the 
 establishment of outlying abattoirs is, that bone-boiling and 
 crushing, skin-dressing, glue, gut, horn, and manure-manufac- 
 turing, with numerous other noxious crafts in connection with 
 the offal and refuse of slaughter-houses, highly prejudicial to 
 the public health, and intolerable nuisances in the crowded 
 districts, where they are now carried on, would very soon 
 
177 
 
 find their location outside the town, in the neighborhood of 
 the depots of the materiel which they require." 
 
 When the public abattoirs in Paris were completed, they 
 were handed over to the use of the butchers, and all private 
 slaughter-houses were suppressed. Two indispensable con- 
 ditions have been laid down for making use of an abattoir 
 first, a copious supply of good water ; and secondly, com- 
 plete arrangements for its being carried away after having been 
 used in the various processes of slaughtering the animals, and 
 in the washing and manipulations of their several parts. 
 Where the water cannot be brought by hand, it must be 
 pumped up by steam-engines. It has been computed that a 
 single abattoir in Paris requires about 45,000 gallons of water 
 daily. The sewers for the carrying off the waste and impure 
 water, are either special, and open directly into the Seine, or 
 communicate with public sewers, which have a uniform fall 
 towards the river. Trials were made, but unsuccessfully, of 
 large pits filled with calcareous stones, for the reception of the 
 waters coming from an abattoir, and also of open drains to 
 convey the waters to the Seine. Finally, an absorbing 
 Artesian well, 570 feet deep, was bored, and in this opening 
 all the bloody and saline water of the abattoir was allowed to 
 flow. The absorption went on at a uniform rate, and without 
 the escape of a single drop of the inflowing water, or of any 
 odor, either inside or external to the establishment. 
 
 In the public abattoirs, a supervision can be, and is exer- 
 cised over the health of the cattle that are brought to be 
 slaughtered. None are allowed to be killed in them which 
 are laboring under contagious disease ; nor can the animals 
 affected with other diseases be slaughtered without the con- 
 sent of the inspectors of the abattoir. 
 
 Cow-Houses. These have become of late years regular 
 establishments in nearly all large cities. Though not directly 
 
178 
 
 nor necessarily coming under the head of nuisances, yet inci- 
 dentally and too frequently they are made such. The sub- 
 ject is doubly important first, as it relates to the contamina- 
 tion of the surrounding air, by a failure to remove the excre- 
 mental matters from the stables, and to keep them clean ; and 
 secondly, by the bad milk obtained from cows pent up in 
 stables in which ventilation is not attended to. Of the dele- 
 terious food given to these animals when kept in stables in 
 a city, and of the consequent bad health and diseases, 
 especially among the infantile portion of the inhabitants of a 
 city, we have already spoken. 
 
 Cow-keeping did not elude the vigilance of the French 
 government. The regulations which exist have for their 
 object, to prevent overcrowding of the animals, to insure 
 cleanliness, and a sufficient ventilation of the stables. It 
 appears, from a report of the Metropolitan Medical Officers of 
 Health on London cow-houses, that there are in that metropo- 
 lis 846 of these establishments, containing 11,818 cows. The 
 Committee, in conclusion, offer the following rules for the regu- 
 lation of cow-houses : 
 
 1. Every cow-house shall be paved with flag-paving or 
 other non-absorbent material, set and bedded in cement, with 
 a proper inclination to the foot of the stalls, so as to drain 
 into a channel leading, by a fall of not less than one and a half 
 inches, or ten feet in a trapped gully. 
 
 2. Every cow-house will be provided with a proper trapped 
 drain, to convey fluid matter alone into the sewers. 
 
 3. Every cow-house shall be furnished with an adequate 
 supply of water, and be washed thoroughly at least once a day. 
 
 4. All solid manure and refuse shall be carefully swept up 
 twice a day, be kept under cover, and be carted away every 
 morning by seven o'clock from Lady-day to ]\lichaelmas, and 
 by eight o'clock from Michaelmas to Lady-day. 
 
179 
 
 5. Every cow-house shall be kept in proper condition, and 
 the walls be lime-washed at least four times a year, within 
 fourteen days after the quarter. 
 
 6. Every cow-house shall have at least 8 feet by 4 feet for 
 each cow (when the cows are kept in separate stalls), or of 8 
 feet by 7 feet for every two cows (where the stalls are con- 
 structed to hold pairs), with a cubic capacity, in either case, 
 of at least 1000 feet to each cow; shall be properly lighted 
 and ventilated, and when the state of the neighborhood re- 
 quires it, shall be provided with tight roofs and ventilating 
 shafts, so as to convey the noxious exhalations above the level 
 of the adjacent houses. 
 
 7. Every yard in which a cow-house is situated, shall be 
 well paved with stone, or other impervious material (the joints 
 of the paving to be run with grout), with such a slope towards 
 the channels and trapped gully, as to permit the rapid escape 
 of all fluids into the sewer, and shall be washed at least once 
 a day. 
 
 8. The grain-bins and receptacles for wash, shall be kept 
 properly cleaned, and under cover. 
 
 9. No underground cellar, and no part of a dwelling-house, 
 shall be used as cow-sheds. 
 
 Among the most grievous nuisances to which many neigh* 
 borhoods have been subjected in London and other large 
 towns, is burial-grounds not adequate for complete sepulture. 
 Indeed, the practice of intra-mural interment, that is, of bu- 
 rial of the dead in a densely populated part of a city, must 
 altogether be regarded in the light of a nuisance. It is not 
 necessary to enlarge on this subject, as it has been made one 
 of S3parafe investigation by your reporter, and as such it is 
 now oTered to the Convention as the completion of his labors 
 at this time. 
 
180 
 
 INTERMENTS IN CITIES. 
 
 There yet remains one important branch of sanitary reform, 
 bearing on the public health, to which attention must now 
 be directed. It is interment of the dead in city limits. 
 Turning to present account the materials which, as chairman 
 of a committee appointed for the purpose by the Philadelphia 
 County Medical Society, your reporter collected and presented 
 to that body, he now offers this document, with some addi- 
 tions, as a contribution, on the part of the Committee on the 
 Internal Hygiene of Cities, to the Quarantine and Sanitary 
 Convention. 
 
 The practice of intra-mural interments, or of those within 
 the limits of a city or town, and especially in those parts of it 
 in which people are congregated in numbers for fixed habita- 
 tion, is always dangerous to the public health. It has caused, 
 in numerous instances, sudden death ; and to a still greater 
 extent, it has been productive either of fatal disease, or of a 
 slow decay of the powers of life, and a breaking down of the 
 constitution. Enlightened legislation, from the earliest times, 
 has endevored to prevent, or if this could not be done, to 
 mitigate the evils attendant on interments in cities and towns. 
 Sometimes a religious sanction was given as the means best 
 adapted to attain these objects. This was the case in ancient 
 Egypt, in which, owing to the nature of the soil and the 
 annual overflow of the valley of the Nile, inhumation could 
 not be performed in a proper manner ; and hence the universal 
 resort to embalming the dead, which came to be regarded both 
 as a religious and a hygienic measure. The bodies thus pre- 
 pared were afterwards deposited in grottos and in chambers 
 excavated from the rocks, the walls of which were covered 
 with bas-reliefs and fresco paintings, descriptive of the trades 
 and other occupations of the deceased. The Etruscans, to 
 whom Rome was indebted for her ritual, her %st sanitary 
 regulations, and the construction of the great cloaque, took 
 
181 
 
 wise precautions against the dead being a cause of disease and 
 of terror to the living, by arrangements for sepulture on such 
 a scale, that in their excavated cities of the dead, the traveler, 
 at the present time, sees sepulchral chambers so ample and 
 decorated,- as to persuade him that he is actually in the houses 
 of the former inhabitants 
 
 In the primitive ages of Greece, the inhabitants buried their 
 dead in depositaries prepared for the purpose in their own 
 houses ; and vaults in temples were sometimes used in this 
 way. But with the progress of refinement and better know- 
 ledge, the custom afterwards prevailed of carrying the dead 
 without the cities, and interring them chiefly by the highways. 
 Lycurgus, in this, as in most of his institutions, differed from 
 the rest of the Greek lawgivers, for he allowed the Lacedemo- 
 nians not only to bury their dead in the city, but also around 
 their temples. His object was to remove from the minds of 
 the youth the fear of a dead body, as well as to destroy the 
 superstitious dread, that treading on a grave or touching a 
 dead body would defile. Burning the bodies of the dead 
 became general among the Greeks, from whom the Romans 
 afterwards borrowed the custom. 
 
 The ancient Jewish cemeteries were commonly situated 
 beyond the limits of cities and villages. It was, indeed, the 
 custom among other nations of the East as well as among 
 the Hebrews, to bury out of the city, except in the case of 
 kings and very distinguished men. The Hebrews generally 
 exhibited a preference for burying in gardens, and beneath 
 shady trees. Large subterranean places of interment were 
 frequently to be found in Palestine : in some instances they 
 were the work of nature ; in some they were merely artificial 
 excavations of the earth, and in others were cut out from 
 rocks. Numerous sepulchres of this kind are still found in 
 Syria and also in Egypt. Examples of these subterranean 
 quarries, used probably for the same purpose, are seen at 
 
182 
 
 Marsala (the ancient Lilybseum) in Sicily, Syracuse, Salerno, 
 Malta, and, in the north at Maestricht, &c.; and perhaps, 
 adds Mr. Burton, * the celebrated labyrinth in the island 
 of Crete was formed originally by excavations of the kind. 
 But by far the most remarkable are those discovered of late 
 years by Laborde, in the remains of the large and wealthy 
 city of Petra, the ancient Edom. They are of incredible 
 number and extent, and of various forms and dimensions. 
 Some of them are houses and palaces ; but the greater num- 
 ber are tombs and the like sepulchral monuments. They not 
 only occupy the foot of the entire mountain by which the 
 valley is encompassed, but fhe ravines and recesses which 
 branch out from the inclosed area. Ranged in regular order, 
 like houses of a well-built city, they would extend, we are 
 told by the Rev. Dr. Olin, who visited the place, not less 
 than five or six miles in length. The facades of many of 
 these rock tombs are decorated with great architectural and 
 sculptural beauty ; the more striking on account of the utter 
 solitude and desolation in which they are found. 
 
 The Carthaginians buried their dead at some distance from 
 the city. The Necropolis was situated beyond the suburbs, 
 or the new town, Megara, as it was called, which, itself, 
 was made up chiefly of gardens intersected by canals for the 
 purpose of irrigation. 
 
 In the brightest or the republican period of the history of 
 Rome, down to the time of Sylla, the ordinary method of 
 inhumation was practised in either public or private places. 
 The private were in fields and gardens, often on the sides of 
 the most frequented roads, so as to attract the notice of those 
 that passed, and it may have been also to remind them of 
 their mortality. ' Hence the frequent inscriptions on the 
 tombs: Stop, Traveler; Behold, Traveler, &c. (SESTE 
 VIATOR ; ARPICE VIATOR), seen on the Appian, the Aurelian, 
 
 * Description of the Antiquities and other Curiosities of Rome 
 
183 
 
 the Flaminian, and other roads. Public places, such as the 
 Campus Esquilinus outside the Esquiline gate, were granted 
 by the Senate for poor people. The vast accumulation of 
 the dead at this spot rendered the neighborhood so unhealthy, 
 that Augustus, with the consent of the Senate, gave part of it 
 to his favorite Maecenas, who built on it a magnificent house, 
 and surrounded it by extensive gardens. The Roman law 
 was very decided in its prohibition of the burial of the dead 
 within the city ; and only in a tew exceptional cases was any 
 relaxation permitted. The vestal virgins and some illustrious 
 men were favored in this way. The right of sepulture for 
 himself within the poemarium, or open space left both within 
 and outside of the walls, was decreed to Julius Csesar, as an 
 unusual privilege. By the emperors the original law was 
 enforced with a severity which was rendered the more neces- 
 sary by its frequent infractions on the part of the people, who 
 believed the worship of their household gods and the manes of 
 their ancestors to be more acceptable in the vicinity of the 
 dead. Adrian decreed the confiscation of the land on which 
 a tomb was reared within the city limits, and the exhumation 
 of the body which had been buried. 
 
 Burning the bodies of the dead, of which mention is made 
 in the laws of Numa and of the Twelve Tables, did not be- 
 come general until towards the end of the republic. Under 
 the emperors the custom was almost universal, but it after- 
 wards gradually declined on the introduction of Christianity, 
 and fell into disuse about the end of the fourth century. The 
 Romans prohibited both the burning and the burial of the 
 dead in the city ; in the former case in order that houses 
 might not be endangered by the frequency of funeral fires, 
 and the air contaminated by the stench arising from them. 
 The Senate House, contiguous to the Forum, was burned by 
 the flames extending from the funeral pile of Clodius. 
 
 The canons of the Christian Church, in imitation of the; 
 
184 
 
 civil law, were opposed to interments in cities, and also in 
 their churches, but with indifferent success. The pernicious 
 examples set by the Emperor Constantine, who, in pursuance 
 of his expressed wish, was buried in the vestibule of the 
 Basilica ot the Holy Apostles at Constantinople, and by 
 Honorius, who found a sepulchre in the portico of the Church 
 of St. Peter's, at Rome, soon had numerous imitators among 
 the patricians and great officers of the state. Vainly did suc- 
 ceeding emperors forbid intra-mural interments, and endeavor 
 to restrict the privilege to martyrs alone. Mistaken piety, 
 superstition, and the vanity of the rich and the powerful, pre- 
 vailed over imperial edicts, and before the sixth century there 
 were not only numerous interments in towns, but the practice 
 of sepulture in churches was also on the increase. The monks 
 obtained permission to be buried in the cloisters of their con- 
 vents, and the founders of churches procured for themselves 
 the same privilege. Charlemagne, toward the close of" the 
 eighth century, seconding the wise reform of these abuses be- 
 gun by Theodolphus, bishop of Orleans, prohibited the burial 
 of the laity in churches, and eventually of all persons what- 
 ever. But the evil was not arrested, although attempts were 
 made with this view by numerous great councils of the Cath- 
 olic Church, held in different parts of Europe, from the begin- 
 ning of the ninth to the latter part of the sixteenth century. 
 Why prohibitions, enjoined under such solemnity, were so 
 long and so extensively disregarded, may be understood 
 for the reasons already assigned. To these should be added 
 another and constantly nullifying cause, viz. : the cupidity of 
 the clergy, who derived large fees for the permission which 
 they granted to bury in churches or contiguous porticos ; and 
 this often in despite of positive enactments by some of the 
 councils against such abuses. Even somewhat less than a 
 century ago, or in 1765, the Parliament of Paris, disregarding 
 the remonstrances of the physicians, who had called the atten- 
 , tion of the government to the danger of intra-mural burials, 
 
185 
 
 continued the permission to the clergy to be interred in the 
 churches. It was not long, however, before the clerical body, 
 animated by a more enlightened spirit, gave up privileges 
 which were productive of so much danger to the public health ; 
 and at the present time the traveler has an opportunity of ad- 
 miring the numerous and tastefully-arranged suburban and 
 rural cemeteries in France, Italy, and Germany, which have 
 replaced the crowded and often closely body-packed and 
 noisome grave-yards and church-vaults in the central parts of 
 the cities. 
 
 The practice by the first Christians of interring their dead 
 in the city of Rome, grew out of the peculiar circumstances in 
 which they were placed as a persecuted sect. As such they 
 were compelled to hold their religious meetings and to celebrate 
 their rites at night, and in retired and obscure spots ; and for 
 this purpose no places were better fitted than the subterranean 
 caves and passages known ever since as the Catacombs. There 
 they met to worship, there they baptized their children and 
 neophytes ; and in many instances they deposited their dead in 
 excavations made in the sides of these numerous^galleries and 
 avenues. These excavations were originally begun, and must 
 have been carried on to a great extent for the purpose of pro- 
 curing building materials. How far they were increased by 
 the primitive Christians in Rome, is a matter of doubt. The 
 length of these subterranean streets, in different directions, and 
 taken altogether, has been estimated by late investigators at 
 about nine hundred miles. According to Father Marchi, the 
 Roman Catacombs may be believed to contain the prodigious 
 number of nearly seven millions of graves. When Christiani- 
 ty came to be tolerated so as to admit of freedom of worship 
 in the open day, grants of pieces of ground for the burial of 
 the dead were made by converted publicans and Roman lead- 
 ers, and thus were begun the intra-mural cemeteries, with 
 their chapels, which, in process of time, became parish 
 
186 
 
 churches. Some of the cemeteries of the rural parishes were 
 after a time comprised in the limits of the city by its subse- 
 quent extension. The history of the quarries in the tufa hills, 
 near Naples, is similar to those of Rome : both of them sup- 
 plied building materials, and both were converted into cata- 
 combs for Christian worship and burial. In the first centuries 
 after the Christian era, so far was interment in churches from 
 being allowed, that the presence of a solitary tomb was deem- 
 ed to be sufficient cause for preventing the erection of a house 
 of worship. The cemeteries, however, were soon placed, prob- 
 ably by the terms of their original grants, under ecclesiastical 
 jurisdiction, and continued to be so during the middle ages, 
 and as low down as the middle of the sixteenth century. It 
 was owing to this circumstance that sanitary reforms, which 
 seemed to be of a purly mundane valve, were so slow in being 
 brought about. In modern times, the subject of the control 
 of cemeteries is properly viewed as a municipal affair, and as 
 such it ought to be studied and regulated with an eye solely 
 to the public good. 
 
 It is not necessary to enlarge on the terrible penalties which 
 result from a neglect of the natural laws, established on an 
 unchangeable basis, by the Deity himself, nor to present in 
 detail the loss of life, and in other respects wide-spread injury 
 to the public health, caused by an infraction of these laws in 
 the long-continued custom of interments in churches and in 
 grave-yards within city limits. Medical men have never 
 ceased to protest against it, and to point out the evils, some- 
 times amounting to frightful catastrophes, from its continu- 
 ance. In some instances these results were caused by the 
 escape of pestiferous air from recently-opened vaults in 
 churches ; in others by its extrication on a larger scale, and 
 with more concentrated virulence, from the earth of old bury- 
 ing-grounds, which had been turned up with a view to their 
 being occupied for other purposes. The efforts of Navier to 
 
187 
 
 enlighten the people of the government of France on the sub- 
 ject were so far successful, that a royal decree was issued in 
 the following year (1776) limiting the privilege of sepulture in 
 churches to some of the higher dignitaries in church and state. 
 In a small tract written a few years (in 1768) before this time, 
 the author anticipated many of the views and suggestions put 
 forward of late years by Mr. Chadwick. Vicq d'Azyr ten 
 years later, yielding to the solicitations of his friend D'Alem- 
 bert, snatched time from his profound studies and experimental 
 observations in anatomy and physiology, to translate a volume 
 from the Italian of Scipio Patioli, on the subject of the selec- 
 tion of proper places for interment, and the dangers resulting 
 from a neglect of the observances required on the occasion 
 
 Within the last few years the attention of the people of 
 Great Britain has been thoroughly aroused to the enormities 
 of intramural interments, especially as witnessed in London, 
 by the labors of Walker and Chadwick. One cannot read 
 without feelings of sickening and disgust, the details of the 
 state of some of the grave-yards of the metropolis; and 
 it must be a matter of surprise to every reflecting mind, 
 that such scenes as kre exhibited in the pages of these 
 writers should have been so long tolerated by any people 
 pretending to civilization, or possessed of ordinary sen- 
 sibility and intelligence. In a report on extramural 
 sepulture by the General Board of Health, it was stated 
 that " there could not be less than two hundred, and probably 
 more, burial-grounds in London, situated at various distances 
 from each other, and each differing in extent. These consti- 
 tute two hundred centres of more or less pollution, each 
 pouring out unceasingly, day and night, its respective contri- 
 bution of decaying matter, but the whole together, reckoning 
 only the gas from decomposing human remains, amounting, as 
 we have seen, in one year, to upwards of two million and a 
 half of cubic feet. Whatever portion of these gases is not ab- 
 
188 
 
 sorbet by the earth earth already surcharged with the accu- 
 mulation of centuries and whatever part does not mix with 
 and contaminate the water, must be emitted into the atmo- 
 sphere, bearing with them, as we know, putrescent matters 
 perceptible to sense. That these emanations do act injuriously 
 on the health of the people resident in the immediate neigh- 
 borhood of the places from which they issue, appears to us, by 
 the evidence that has been adduced, to be indubitably estab- 
 lished. From the law of diffusion of gases, they must be 
 rapidly spread through the whole of the atmosphere that sur- 
 rounds the metropolis, and though they thereby become di- 
 luted, and are thus rendered proportionally innocuous, yet that 
 they do materially contribute to the contamination of the air 
 breathed by two millions of the people, cannot, we think, ad- 
 mit of reasonable doubt. We submit, therefore, that a case 
 is made out for the total prohibition of interments within the 
 metropolis, on account of the injury resulting from the practice 
 to public health." The argument of the General Board of 
 Health was a convincing one, and it led to the Interment Act 
 of 1850, the passage of which was probably facilitated by the 
 favoring influence of the clergy of the Established Church, 
 headed by the Bishop of London. Evidence was adduced by 
 the Board of Health, to show that severe complaints in the 
 vicinity of some of the church-yards, almost invariably prove 
 fatal ; and also, that the pestilential atmosphere thus formed 
 became a fit radius for the poison of cholera during the fatal 
 year of 1849. 
 
 But the exhalations into the atmosphere are not the only 
 evils. Mr. George A. Walker had shown, years before, 
 that the fluid portions of the decomposing body pass into the 
 earth, and together with resulting gases, percolate through the 
 walls of houses and drains, and find their way into gully-holes, 
 and thence into the air of the streets. It is not improbable 
 that legislative action was quickened (in the case of the Inter-- 
 
189 
 
 ment Act) by the annoyance to which the members of the 
 House of Commons were exposed from a stench exhaling from 
 gully-holes in the neighborhood. M. Gallo, the surveyor, 
 declared it' to be produced by the percolation of gases and ani- 
 mal compounds from the over-charged church-yard of St. 
 Margaret's, immediately opposite. Mr. Walker, in a letter 
 to the " editor of the Journal of Public Health" in which 
 he had stated this fact, writes, in addition : "I have fre- 
 quently demonstrated that a single inspiration of the pro- 
 ducts of human putrefaction has, in innumerable individual 
 and collective instances, instantly destroyed life ; in others 
 produced lingering consumption, typhus, scarlet fever, &c., 
 &c., whilst in other cases ruined health, and crippled useful- 
 ness have been the clearly traceable consequences resulting 
 from exposure to human remains in a state of decomposition." 
 A case related by Mr. Chadwick, and which came under his 
 own observation, may be related here, as serving to point the 
 moral of a longer history in the same vein. In one of his 
 walks with Professor Owen, he met with a butcher, who, in 
 reply to some inquiries about his health, stated the following 
 particulars. This man had lived a long time in Bear yard, 
 near Clare market, where he was exposed to two deleterious 
 influences shambles on one side and a tripe-house on the 
 other. His attention to his own impaired health, under such 
 circumstances, was quickened by observing that it was im- 
 possible for him to keep birds, of which he was extremely 
 fond, in this place. " You may hang up a cage," said he, 
 " in any window of the corn-houses round Bear yard, and not 
 a bird will live out the week." What most annoyed them 
 among the congregation of odors, was the vapor rising from 
 the fat in the process of preparing the tripe. Some time be- 
 fore this, he had occupied a room in Portugal street, overlook- 
 ing a crowded church-yard, from which he often saw a dense 
 vapor rise, that had a very offensive odor. The butcher's 
 
190 
 
 birds died there in "brief time, and the good man found that 
 he could only preserve new purchases by removing his quar- 
 ters to Vere street, beyond the range of deleterious emana- 
 tions. 
 
 Among the many wise laws enacted for the benefit of the 
 people by the government of the republic, after the subversion 
 of the monarchy in France, were those relating to interments. 
 By a decree of the 23d prairial, in the year XII. of the Ke- 
 public (12th June, 1804), burial in churches, temples, syna- 
 gogues, and all other edifices devoted to religious worship, or 
 in the limits of any city, town, or village, was prohibited: 
 and, at the same time, provision was directed to be made for 
 interring the dead in cemeteries beyond town limits. It 
 was decreed in 1808, under the empire, that there should 
 be no dwelling built, or well dug, within 125 yards of the 
 new cemeleries. In Prussia, the distance of cemeteries from 
 towns varies from 100 to 1000 yards. Some English 
 writers recommend an interval of six to seven hundred yards 
 between the two. The French law requires that five years 
 must elapse before the same grave can be opened for a second 
 interment, so that time may be allowed for the decom- 
 position of the body first inserted, before another is deposited 
 in its place. In the case of the city of Marseilles, with a 
 population of one hundred thousand inhabitants, and an an- 
 nual mortality of three thousand persons, it has been estimated 
 that six thousand square metres, or about six thousand five 
 hundred square yards of ground, would be required for the 
 purpose of interment during a single year ; assuming that to 
 each body, separately, to be buried, there ought to be allowed 
 a space of two square metres, or six and a half square feet. 
 But as five years must elapse between successive interments 
 iu the same spot, the entire extent of ground necessary for 
 the burial wants of a population of one hundred thousand 
 persons, is thirty thousand square metres, or about thirty-two 
 
191 
 
 thousand five hundred square yards. Various estimates have 
 been made of the time that must elapse "before the entire de- 
 composition and destruction of the body, leaving only the 
 skeleton or the bones entire. Some, like Gmelin, make the 
 period thirty to forty years ; others, with Walker, at seven 
 years ; Orfila, again, found, by actual experiments instituted 
 for the purpose, that a body, even when inclosed in a coffin, 
 would, after interment, be reduced to the state of a skeleton 
 in a period varying from fourteen to eighteen months. Much, 
 in all these calculations, must depend on the nature of the 
 soil in which interments take place. The legislation on the 
 subject of the time that should intervene between the deposit 
 of dead bodies in the same grave also varies. In Hesse 
 Darmstadt, and in Prussia, an interval of thirty years is ex- 
 acted ; in the city of Leipsic, fifteen years ; in Milan, ten 
 years ; in Munich, the capital of Bavaria, nine years. The 
 law in France, as above stated, may be considered as meet- 
 ing the exigencies of the case. Much less difference occurs 
 in the enactments prescribing the depth of the grave opened 
 for the reception of a dead body. In most countries, in- 
 cluding Russia, this is somewhat more than six feet ; in 
 Frankfort on the Main, it is four feet seven inches ; and in 
 Lindon, the bishop used to direct a depth of between four and 
 five feet. 
 
 Danger to the public health does not end with the perma- 
 nent closure of a cemetery, and by the discontinuance of 
 burial within its limits. Years must elapse before the soil 
 can be broken up for other purposes, such as the construction 
 of houses or the digging out of trenches or drains. It has 
 been found that the soil of a burying-ground, in which a suc- 
 cession of bodies in large numbers has been laid, becomes in 
 process of time, unfitted to bring about the putrefactive changes 
 in bodies of more recent deposit, so as to render them, in a 
 great degree, innocuous. The soil, under such circumstances, 
 
192 
 
 becomes saturated, to adopt language of recent introduction, 
 as applied to this subject, and animalized to such a degree, 
 that it cannot be disturbed without exhaling poisonous vapors 
 and gases, which, in many instances, have proved suddenly 
 fatal to those who inhaled them. Vicq d'Azyr tells of the 
 breaking up of the soil of an old cemetery in the heart of the 
 town of Riom, in Auvergne, with a design to public improve- 
 ment, which was followed, soon after, by an endemic disease, 
 that carried off a large number of the inhabitants, particularly 
 of the poorer classes ; and it was noticed that the mortality 
 was greatest in the neighborhood of the cemetery. A similar 
 calamity, from the same cause, had occurred six years before, 
 in a small town called Ambert, also in Auvergne. The spot 
 on which had stood a convent of the Daughters of St. Gene- 
 vieve, at Paris, was eventually appropriated for the erection 
 on it of several shops. All the first occupants of these new 
 shops, and especially young persons, suffered from diseases 
 nearly of the same kind effects attributed, with good reason, 
 to the exhalations from the bodies of those who had been buried 
 in this ground. M. Tardieu, to whose work a Dictionary of 
 Public Hygiene,* &c. we are indebted for the preceding de- 
 tails, writes, that he has heard many of the old inhabitants 
 who occupied houses near the church of St. Severus, in Paris, 
 say, that when the weather was mild and damp, there arose 
 from the ground, which had been used for so many centuries 
 as a place of interment, a dense vapor, of such a sickening 
 nature as to force them to close the windows, in order to escape 
 serious consequences. Another incident to the same purport, 
 which occurred also in Paris, is worthy of notice. After the 
 memorable three days of July, 1830, great difficulty was ex- 
 perienced in procuring immediate sepulture for those who had 
 fallen in the fight. A provisional inhumation of a certain 
 number was directed to take place in the ground of the Market 
 
 * Dictionnaire d'Hygiene Publique et de Salubrite. 3 vols. Paris, 1854. 
 
193 
 
 of the Innocents, the spot anciently occupied as a cemetery, 
 in long use. A trench was accordingly dug, of about twelve 
 feet in length, by seven in width, and ten deep. When the 
 pavement was taken up, and a layer of sand of about six 
 inches in depth removed, a dark and greasy earth was exposed 
 to view, mixed with bones and remains of coffins, which it 
 was necessary to break up. The exhalations arising, in con- 
 sequence, were so fetid and poisonous as to suffocate immedi- 
 ately one of the workmen. 
 
 Taking into consideration the alarming and often fatal ef- 
 fects following the disturbance of the soil of old cemeteries, 
 the first republican government of France enacted as one of 
 the clauses of the law respecting interments, of which we have 
 previously spoken, that no cemetery after its final closure, 
 should be appropriated to any other purpose short of a period 
 of ten years. Grass or grain might be sown in it, and trees 
 planted, but no deep digging, or foundation for buildings 
 should be begun, ^ntil permission was regularly granted for 
 the purpose. Eeference being had to the different opinions 
 held respecting 'the time required for the entire decomposition 
 of a body after its inhumation, it may be readily supposed 
 that there would be corresponding differences in the legislative 
 enactments in different countries, in regard to the period that 
 ought to elapse before a cemetery, finally closed, could be used 
 for any other than its original purpose. 
 
 If we appeal to chemistry for aid in detecting the deleterious 
 gases given out from grave-yards, and more particularly from 
 the soil after it has been dug, as in opening a grave, or from 
 vaults in which the dead had been deposited, we learn that 
 the gas most largely extricated is carbonic acid, and also 
 carbonate and sulphydrate of ammonia. Dr. Reid states, 
 that in some church-yards he has "noticed the ground 
 to be absolutely saturated with carbonic acid gas, so that 
 
 whenever a deep grave was dug, it was filled in some 
 13 
 
194 
 
 hours afterwards with such an amount of carbonic acid 
 gas, that the. workmen could not descend without danger. 
 Deaths have, indeed, occurred in some church-yards from this 
 cause." But chemistry still fails to enlighten us fully respect- 
 ing the nature or composition of those subtle poisons called 
 miasms, which under so many circumstances generate wide- 
 spreading and fatal disease. The vitiation of the air of the 
 hospitals, dormitories in barracks, and in crowded assemblies, 
 is, to a certain extent, made explicable by a minute increase 
 of carbonic acid in these places. As evincing the great pene- 
 trativeness of these miasms, Dr. Reid tells us that he has 
 detected their escape from graves more than twenty feet deep. 
 
 The extent of the facts now collected respecting the evils 
 attending the practice of interments in cities in different parts 
 of the world, and the almost uniform course of legislation, both 
 civil and canonical, prohibiting the practice, can hardly fail of 
 being applicable to the actual condition of things in our own 
 country. Looking at the large and increasing population of 
 our chief cities, the dearness of ground, and the economy of 
 building-space, now so carefully studied, every question relat- 
 ing to the public health becomes of more and more importance. 
 All preventable causes which diminish the purity of the air, 
 or vitiate it by the addition of deleterious gases and miasms, 
 ought to be, -as far as possible, withdrawn. The increase of 
 rural or suburban cemeteries for the burial of the dead, has 
 doubtless had a share in abating the mischief which universal 
 experience shows to be the frequently incidental, if not con- 
 stant effect of interments in its more crowded districts. It is 
 desirable now to take a farther and final step, and to ask that 
 the growing partiality for extra-urban cemeteries should be- 
 come not only a common, but a universal custom, sustained 
 and enforced by formal municipal enactment. 
 
 Several years since, the Sanitary Committee of the Board 
 of Health of Philadelphia, made a report on this subject, 
 
195 
 
 and offered a resolution, that in the opinion of the Board, 
 interments of the dead within the densely populated parts 
 of the city of Philadelphia and adjoining districts, ought 
 to Tbe discouraged. A carefully drawn bill, accompanying 
 the resolutions of the Board, was sent to Harrisburgh for 
 legislative action, but without effect. The period which has 
 intervened between that and the present time has not dimin- 
 ished the evils complained of, nor rendered a reform less ne- 
 cessary ; for the relief afforded by the voluntary extraurban 
 interments has not kept pace with the increase of population. 
 The following language of the Sanitary Committee, just 
 referred to, is as full of warning and monition to other cities 
 as it is to the people and the municipal authorities of Phila- 
 delphia : " Your Committee are convinced that the grounds 
 of our own metropolis are even now sources of danger to the 
 health of our citizens, and that every year the danger result- 
 ing from these must augment. Scattered as they are over 
 every neighborhood, surrounded by a dense and constantly- 
 increasing population, and many of them already compara- 
 tively crowded with dead bodies, which are carelessly, and in 
 many instances superficially interred, some of the grounds, 
 particularly those belonging to the colored congregations, are, 
 even now, decided nuisances, injurious to the health of the 
 neighborhood in which they are located." Dr. Wilson Jewell, 
 who has given much attention to public hygiene, does 
 not hesitate to declare, after careful personal inspection and 
 inquiry, that there is not a burial-ground in the thickly 
 populated parts of Philadelphia, which has been in use 
 during a period of fifteen to twenty years, which does not 
 contain twice the number of bodies that the ground is capa- 
 ble of allowing to be decomposed ; in other words, that it has 
 passed its point of saturation. In some cemeteries in this 
 city, it is no common thing to deposit three, tour, and even 
 five, bodies in one grave, until their decomposing remains 
 reach within eighteen inches, and even a foot, of the surface. 
 
196 
 
 There are grave-yards in the city, of modern date, which al- 
 ready show marks of being crowded with the dead ; and al- 
 though when first opened, they were on the borders of the 
 city, and almost rural, they are now surrounded -by streets, 
 regularly built, which, ere many years have passed, will be- 
 come densely inhabited. One of the cemeteries thus situated, 
 and the first we believe laid out as a private speculation, a 
 little more than thirty years ago, has received during this 
 period, as Dr. Jewell was informed, upwards of 11,000 
 bodies. It occupies a space equal to one of our Philadelphia 
 squares. Mr. White, some years ago City Inspector of New 
 York, in his report for 1850, speaks pointedly of the nui- 
 sances of many of the grave-yards of that city. He had some of 
 them closed during the prevalence of the Cholera in 1849. 
 Under such circumstances, a sudden addition to 'the number 
 of interments in these places, as in times of epidemic diseases, 
 would not be without danger, and might give rise to catas- 
 trophes on a large scale, analogous to those which occurred in 
 foreign lands, and some of which have been recorded in the 
 present report. 
 
 Not having been required to invesigate the whole subject 
 of interments, we do not deem it necessary to specify the kinds 
 of soil most favorable for the purpose of accelerating the desired 
 changes in the decomposition of the body buried, nor have 
 we inquired into the sanitary influence of plantations of trees 
 in cemeteries, with a view to the purification of the air of these 
 spots. We must not omit, however, referring to a plan re- 
 cently suggested, and in some places carried into effect, in 
 England. It is, to surround the bodies of the dead, before 
 they are finally inclosed, with a layer some four inches thick 
 of finely powdered wood or peat charcoal. By this means the 
 decay of the animal textures would go on rapidly, and without 
 giving rise to dangerous exhalations. In the burial of the 
 poor this plan merits a favorable consideration, and it must in- 
 
,197 
 
 ^ deed commend itself as worthy of adoption by all classes. 
 The experiments of Dr. Stenhouse place the subject of the 
 operation of vegetable charcoal on dead bodies in a new and 
 instructive light, by showing, contrary to popular belief, that, 
 although a deodorizing and disinfecting agent, it is not an anti- 
 septic proper, which gives stability to organic matter, and pre- 
 vents its decomposition. Charcoal, and, in less degree, clay, 
 produce a species of slow combustion, by which the miasms 
 are gradually consumed. 
 
 Without being called upon to look at the subject of intra- 
 mural interments under its purely moral and religious aspects, 
 we are nevertheless free to allude to the depressing, and in 
 such times morbid influence, exerted on the community by its 
 being compelled to witness the frequent, and in visitations of 
 certain fearful epidemics, the almost continual succession of 
 funeral processions. This is a matter of public health, in dis- 
 cussing which, medical testimony cannot be overlooked. 
 Were it necessary, clerical experience could also be invoked in 
 favor of suburban burials in preference to those in the city, 
 whether regard be had to the desirableness of the uninterrupt- 
 ed solemnities of the burial service, the avoidance of whatever 
 would grate on the already harrowed feelings of attending 
 relatives and friends, and the preserving unbroken the associa- 
 tions of an elevated and religious character, with the sight of 
 the memorials to the dead and of the spot where their bodies 
 rest. * * * * 
 
 There are yet other matters worthy of notice which might 
 serve to show still further the importance and economy of 
 sanitary measures to cities, and of which it would be 
 desirable to treat. A topic of considerable moment in all 
 commercial cities is the structure of the wharves, so 
 that there shall be nothing in the materials of which 
 they are made, susceptible of decay and decomposition. 
 So also of quays in every town on the banks of a river, 
 
198 
 
 and their construction so as to narrow the channel and dimin-^ 
 ish the exposed surface at low water on both of the sides of 
 the river. One measure in the internal hygiene of cities ought to 
 be a careful supervision of all stables, cow-houses, and pigger- 
 ies, and vigilance in the removal of heaps of manure, accumu- 
 lated under no matter what excuse. Ascending the scale of 
 the duties of sanitary supervision, would come that of manu- 
 factories and of work-shops, which may be termed public, by 
 their extent and the number of persons employed ; also of all 
 buildings in which people assemble in numbers at stated 
 times. Minute inquiries are made into the structure and ar- 
 rangement of the rooms, and the number and plan of fire-places, 
 furnaces, and stoves, before an insurance against fire can be 
 effected. Why then should there be any hesitation about a 
 similarly careful investigation by the sanitary authorities, with 
 a view to insurance against preventable diseases among the 
 inmates of a house ? 
 
 In concluding this report, its author must express his re- 
 gret at not having had the time to treat in a rigidly methodi- 
 cal manner the various topics which have come under notice. 
 He submits, however, that, while adhering with some close- 
 ness to the terms of his instructions, he has made out a case 
 showing the paramount necessity for a methodical and liberal, 
 yet prudent, system of sanitary legislation, and the wisdom of 
 adopting such a code as the Metropolitan Sanitary one, which 
 will be presented to the Convention by one of our Committee. 
 The time, we may hope, is not remote when the writer on sani- 
 tary subjects, especially if he desires exactness of detail, and 
 comparisons and results of an authentic kind, set forth nume- 
 rically, will not be obliged, as he now is, to procure most of 
 his arguments and enforcements of reform from abroad, owing 
 to the deficiency of statistical knowledge and the underrating its 
 value here at home, so that he is deprived of the requisite data 
 either to show with accuracy the extent of existing evils, or 
 
; 199 
 
 
 
 to point out the means for their removal. One measure of the 
 highest importance, and without which nothing trustworthy 
 can be learned of vital statistics, direct or comparative, is a 
 system of births, deaths, and marriages, regularly carried out 
 in every State of the Union. 
 
D R ^. F T 
 
 OP A 
 
 SANITARY CODE FOR CITIES, 
 
 (Reported to the Committee on Internal Hygiene.) 
 
 BY HENRY G. CLARK, M.D., OF BOSTON, 
 
CONTENTS. 
 
 PAGE. 
 
 PUBLIC HEALTH ACT, ......... 205 
 
 SANITARY CODE FOR CITIES, 207 
 
 Sanitary Survey, , ' 209 
 
 Sewerage, . . . . . . . . 211 
 
 Cleansing, . .... . . '.v - . . . 215 
 
 Slaughter-Houses, ' 218 
 
 Markets, . . . 218 
 
 Dram-Shops and Drinking-Houses, . . . . 221 
 
 Lodging-Houses, . . ' . . . ... 221 
 
 Cellars, *v . . . . . . . . - 222 
 
 New Streets and Houses, .... . . 223 
 
 Supply of Water, . . ,' .. . .' . . 224 
 
 Ventilation, . - \ 225 
 
 Pleasure-Grounds, . . . . . . . 226 
 
 Epidemic and Contagious Diseases, .. . . . 226 
 
 Vaccination, . \ , ' . . .* . 227 
 
 Interment of the Dead, 227 
 
 General Provisions, . . . . . . . 230 
 
 APPENDIX, 233 
 
205 
 
 DRAFT 
 
 OF AN ACT FOR ESTABLISHING GENERAL AND LOCAL BOARDS 
 OF HEALTH, AND FOR OTHER SANITARY PURPOSES.* 
 
 AN ACT, in addition to existing Acts, for promoting the 
 Public Health. 
 
 WHEREAS it is expedient that further and more effectual 
 provision should be made for improving the sanitary condition 
 of populous places : Be it therefore enacted by the Senate 
 and House of Representatives in General Court assembled, 
 and by the authority of the same, as follows ; that is to 
 say: 
 
 I. This act may be cited for all purposes as " Tl^e Public 
 Health Act, 1860." 
 
 II. The Governor of the Commonwealth, with the advice 
 and consent of the Council, shall appoint five discreet and 
 suitable persons, three at least of whom shall be Doctors of 
 Medicine, who, together with the Secretary of State for the 
 time being, and the Governor, ex-officiis, shall together be 
 and constitute a Board, to be called " The General Board 
 of Health;" and shall have and execute all the powers and 
 duties necessary for superintending and promoting the 
 general sanitary affairs of the State. 
 
 III. They shall hold their offices for five years, or until 
 others are appointed in their place; and they shall be 
 sworn to the faithful performance of their duty. 
 
 IV. They shall meet at such convenient times as they 
 deem expedient, and their necessary official expenses shall 
 be paid out of the Treasury of the State ; but they shall 
 receive no other compensation for their services. 
 
 V. They shall appoint a competent person, who may also 
 be the Register-General, to be the Secretary or Actuary of 
 
 * For the debate on this Keport, see pp. 86, et seq., and pp. 226, et seq., of 
 the Proceedings. 
 
206 
 
 the Board, who shall receive such a salary, not exceeding 
 
 dollars per annum, as the 
 
 Board shall determine. They shall also appoint, if need be, 
 a competent physician, who shall be styled a Medical 
 Health Officer, and another competent person for Surveyor, 
 who shall be removable at their pleasure, and who shall 
 receive such fees or other compensation as the Board may, 
 from time to time, determine. 
 
 They may also appoint and employ such other persons 
 as may be necessary to carry into effect the sanitary laws 
 of the State, and delegate to them the necessary powers, 
 subject to the approval of the local Boards of Health, here- 
 inafter provided for. 
 
 VI. They shall consider and decide upon sanitary ques- 
 tions submitted to them by the State, cities, towns, or 
 local Boards of Health. 
 
 VII. They shall, by reports or otherwise, diffuse infor- 
 mation to the inhabitants of the State on sanitary matters ; 
 and shall aid, by regulations, suggestions, and by furnish- 
 ing blanks, &c., the various local Boards of Health. 
 
 VIII. The corporate authorities of the various cities and 
 towns of this Commonwealth are hereby authorized and em- 
 powered to establish local Boards of Health, and to enact 
 and enforce, generally and severally, such laws, ordinances, 
 and regulations, as they may deem expedient or necessary 
 for promoting the sanitary condition of the said cities and 
 towns, and* as are not inconsistent with the Constitution 
 and laws of the State. 
 
 IX. And the said authorities are also authorized to dele- 
 gate to the said local Boards of Health, or other agents, all 
 the powers necessary for the convenient execution of said 
 law^s, ordinances, and regulations. 
 
 X. All acts, and parts of acts, incompatible with this 
 act, are hereby repealed. 
 
207 
 
 DRAFT 
 
 OF AN ORDINANCE FOR PROMOTING THE HEALTH OF TOWNS. 
 
 SANITARY CODE FOR CITIES. 
 
 Whereas, by an Act of the Legislature, in the year 1860, en- 
 titled " The Public Health Act" this Corporation has been 
 duly authorized and empowered to make all needful rules and 
 regulations for the preservation of the health of its inhabitants : 
 
 Be it therefore ordained by the Councils of the Town of- , 
 
 and by authority thereof, as follows, to wit : 
 
 I. This Ordinance shall be cited for all purposes as 
 " The Sanitary Code for Cities." , 
 
 II. The duty of executing and enforcing the provisions 
 of this " Code" is hereby vested in a Board of Health, at 
 least one-third of the members of which shall be Doctors 
 of Medicine, to be chosen by the Councils, or in such other 
 way as the legal voters may determine ; and they are 
 hereby constituted the local Board of Health, with all the 
 powers and privileges usually invested in Boards of Health, 
 and with such further especial powers as may be conferred 
 by the provisions of this Ordinance. 
 
 III. And said local Board, or its authorized agents, shall 
 have the right at all times to enter into or upon any 
 premises for the purposes of this Ordinance, and also to 
 call upon any of the officers or of the police, to aid them 
 in the execution of its provisions. 
 
 IV. In the construction, and for the purposes of this 
 Ordinance, the following words and expressions shall have 
 the meanings hereinafter assigned to them ; that is to say : 
 
 The term "person," and words applying to any individ- 
 ual, shall apply to, and include corporations, aggregate or 
 sole. 
 
 The term " owner" shall mean the person for the time 
 being entitled to the rent of the land or premises in con- 
 
208 
 
 nection with which the term is used, wnether on his own 
 account, or as trustee or agent for any other person. 
 
 The expression, " Improvement Commissioners," shall 
 mean the commissioners, trustees, or other persons, in- 
 trusted by any local act with powers of cleansing, paving, 
 or otherwise improving any town. 
 
 The term " town " shall also include "cities," or any 
 other municipal corporation. 
 
 The term " land " shall include messuages, buildings, 
 lands, and hereditaments of every tenure ; also rivers, 
 streams, wells, and waters of every description ; also ease- 
 ments of any description in respect of the foregoing par- 
 ticulars. 
 
 The term " waste-pipe" shall mean the pipe which dis- 
 charges the waste-water from within any house into the 
 drain. 
 
 The term " drain" shall mean any drain of, and used for 
 the drainage of one building only, or premises within the 
 same curtilage, and made merely for the purpose of com- 
 municating therefrom with a cess-pool or other like recep- 
 tacle for drainage, or with a sewer, into which the drain- 
 age, of two or more buildings or premises, occupied by 
 different persons, is conveyed. 
 
 The term " sewer " shall mean and include sewers and 
 drains of every description, except drains to which the 
 word " drain," interpreted as aforesaid, applies. 
 
 The term, " slaughter-house," shall mean and include 
 the buildings and places commonly called slaughter-houses 
 and knackers' yards, and any building or place used for 
 slaughtering cattle, horses, or animals of any description. 
 
 The term " district " shall mean the entire area, places, or 
 parts of places, comprised within the limits of any district 
 to which this " Code," or any part thereof, shall be applied. 
 
 The term " street " shall include a square, circus, cres- 
 
209 
 
 cent, terrace, place, row, mews, alley, court, passage, or 
 or other like place in which the houses are continuous, or 
 separated only by small intervals of space. 
 
 The word " house " shall include schools, factories, and 
 other buildings, in which more than twenty persons are 
 assembled at one time. 
 
 SANITARY SURVEY. 
 
 V. There shall be made, annually, a thorough sanitary 
 survey of the town or district, as the case may be ; and at 
 any other time, when it shall appear from the returns to 
 the Registrar that the number of 'deaths shall exceed, an- 
 nually, that of twenty-five to a thousand of the population 
 of such place. 
 
 And the Board of Health may, if in their discretion they 
 think fit, direct the Medical Health Officer to cause public 
 inquiry to be made as to the following matters and things, 
 or any of them ; that is to say : 
 
 As to the sewerage, drainage, and water-supply ; 
 
 As to the number and sanitary condition of the inhab- 
 itants ; 
 
 As to the accumulation of filth ; 
 
 As to any other matter of which the Board may require 
 to be informed. 
 
 VI. The said survey shall be made in the manner follow- 
 ing, to wit : 
 
 The Medical Health Officer shall have the right to call 
 upon the Chief of Police, who shall detail for this service a 
 sufficient number of the regular patrol force, who shall act 
 as inspecting health officers. But during an epidemic sea- 
 son, or when .any medical facts are to be obtained, the in- 
 spectors shall be Doctors or Students of Medicine. 
 
 Upon receiving his instructions, each officer will com- 
 mence and diligently prosecute his inquiries ; carefully no- 
 14 
 
210 
 
 ticing the state of the streets, lanes, courts, passages, com- 
 mon stairs, houses, rooms, cellars, yards, or vacant lots in 
 his assigned district ; reporting in detail, and in writing, all 
 accumulations of filth; all cases where the Waste-pipes, 
 drains, or water-closets are foul or obstructed ; all cases of 
 prevailing sickness, especially where there is great over- 
 crowding, or unusual destitution; also all cases of dead 
 bodies found in single-living rooms. 
 
 The reports may be made in the manner of the blank 
 forms hereto annexed. (See Appendix A.) 
 
 VII. When any nuisance or other source of disease is 
 discovered, notice, in the proper form (see Appendix B), is 
 to be served upon the owners or occupants, forthwith to 
 abate the same, and in case of refusal or neglect for a 
 period of hours, the Medical Health Officer is author- 
 
 ized and directed to cause the same to be abated or re- 
 moved in the most summary manner ; and he is hereby 
 authorized to call upon the Chief of Police, the Engineer, 
 the Registrar, and the Superintendents of Health, of 
 Streets, and of Drains, to aid him in such removal. 
 
 The expense of such removals or abatements of nuis- 
 ances (of which an accurate account is to be kept), shall 
 be chargeable to the owners or occupants of the premises. 
 
 These measures shall be so continuously pursued as to 
 prevent, as far as possible, any reaccumulation of the 
 causes of disease sought to be removed, and each officer 
 shall be held strictly responsible for the sanitary condition 
 of his assigned district. 
 
 All persons, acting under and by the authority of this 
 order, may be authorized to enter upon and into any prem- 
 ises which it may be necessary to visit, in compliance with 
 its provisions ; but their object in so doing must be first 
 stated to the occupants, and all unnecessary annoyance to 
 them most carefully avoided. 
 
211 
 
 SEWEKAGE. 
 
 VIII. The said Board of Health may, if they shall think 
 fit, cause to be prepared, or procure a map, exhibiting a 
 system of sewerage for effectually draining their district 
 for the purpose of this Ordinance, upon a scale to be pre- 
 scribed by the General Board of Health ; and every such 
 map shall be kept at the office .of the said Board, and shall, 
 at all reasonable times, be open to the inspection of the 
 tax-payers of the district to which it applies. 
 
 IX. All sewers, drains, or waste-pipes, whether at pres- 
 ent existing, or which shall be hereafter constructed, shall 
 be entirely under the management and control of the Board 
 of Health. 
 
 X. The Board of Health shall cause their district to be 
 effectually drained upon the plan recommended by the 
 General Board of Health of Great Britain ; and they shall 
 have power within such district from time to time to do 
 any of the following things : 
 
 (1.) To repair, arch over, enlarge, lessen, or otherwise alter, 
 any existing sewer or drain. 
 
 (2.) To construct any new sewer or drain, with a like 
 power of repairing and altering the same. 
 
 (3.) To discontinue, close up, or destroy any sew r er or drain, 
 
 (4.) To carry any sewrer, drain,' or pipe, for the distribution 
 of sewage, through, across, or under any turnpike 
 or other road, or county bridge, or any street, or place 
 laid out as, or intended for a street, or under any 
 cellar or vault which may be under the pavement or 
 carriage-way of any street or intended street, upon 
 condition of making good all damage done by them ; 
 or if it is deemed necessary by the Surveyor of the 
 Board, into, under, or through any lands whatever, 
 upon making due compensation for the same : 
 
212 
 
 Subject, nevertheless, to the restrictions hereinafter 
 mentioned ; that is to say 
 
 (1.) All waste-pipes, sewers, and drains shall be so con- 
 structed and kept as not to create a nuisance, or be 
 injurious to health. 
 
 (2) If, by the exercise of any of the above powers, any 
 person is deprived of the lawful use of any sewer or 
 drain, the Board shall provide for his use some other 
 sewer or drain equally convenient. 
 
 XI. The Board of Health are hereby empowered, upon 
 making due compensation, to do the following things ; that 
 is to say : 
 
 (1.) To construct, either above or under ground, such 
 reservoirs and other works as may be necessary for 
 holding the sewage flowing from the sewers of their 
 district, or to provide outfalls for the same. 
 
 (2.)^ To cause the sewers to empty into such reservoirs or 
 outfalls, by means of connecting sewers, or such other 
 means as they think fit. 
 
 (3.) To contract with any company or person for the sale 
 of such sewage, or for the distribution of it over any 
 land ; and any such company for these purposes shall 
 have the same privileges, and be subject to the same 
 conditions, as would the local Board. 
 
 (4.) To contract for, purchase, or take on lease any build- 
 ings, engines, materials, or apparatus for the pur- 
 pose of receiving, storing, disinfecting, or distribut- 
 ing any such sewage, and to" lease or assign such 
 buildings, engines, materials, 'or apparatus to any 
 company or person with whom the said Board of 
 Health may contract as aforesaid. 
 
213 
 
 (5.) To purchase or take on lease any land where such 
 purchase or leasing is necessary for carrying into 
 execution the above objects. 
 
 XII. No person shall, without the consent of the Board 
 of Health, do the following things, or any of them : 
 
 (1.) Cause any waste-pipe, sewer, or drain, to communi- 
 cate with, or be emptied into any sewer of the Board 
 of Health. 
 
 (2.) Cause any vault, arch, or cellar, to be newly built or 
 constructed under any public street ; and if any 
 sewer, drain, vault, arch, or cellar is made, in con- 
 travention of this Ordinance, the Board of Health 
 may cause the same to be pulled down, if they shall 
 think fit, and the expenses incurred by them in so 
 doing shall be repaid to them by the offender, and 
 be recoverable from him in a summary manner. 
 
 XIII. Any owner or occupier of premises adjoining any 
 district, may, with the consent of the Board of Health, 
 cause any sewer or drain from such premises to communi- 
 cate with any sewer of the Board, upon such conditions as 
 they shall mutually agree. 
 
 XIV. Whenever it appears to the Board of Health that 
 any house or other building, already built, is without any 
 waste-pipe, drain, or water-closet, or that they do not 
 empty into such place as is efficient for effectual drainage, 
 the Board may by notice require the owner of such house 
 or building, within a reasonable time therein specified, to 
 make a sufficient drain, of a construction approved by the 
 Board of Health, emptying as follows : that is to say, if 
 the sea, or a sewer of the Board of Health, or any sewer 
 which they are entitled to use, is within one hundred feet 
 of the site of such house or dwelling, emptying, as the 
 Board may direct, either into the sea or such sewer ; but 
 
214 
 
 if no such means of drainage are within that distance, then 
 emptying into such covered cess-pool, or other place, not 
 being under any house, and not being within such distance 
 from any house, as the Board of Health direct ; and if the 
 person, on whom such notice is served, fail to comply 
 with the same, the Board may themselves do the work 
 required, and assess the expenses to the owner or occupant 
 aforesaid. 
 
 XV. The following rules shall be observed with regard 
 to drains of houses not already built : 
 
 (1.) The drains of every such new house or building as 
 aforesaid, shall be covered in, and be of such size and 
 materials, at such level, and with such fall, as may 
 be effectual, in the opinion of the Surveyor or Engi- 
 neer of the Board, to secure a proper drainage of 
 such house or building, and its appurtenances. 
 
 (2.) If the sea, or a sewer of the Board of Health, or a sewer 
 which they are entitled to use, is within one hun- 
 dred feet of any part of the site of such new house 
 or building, the drains so to be constructed shall 
 communicate with such one of those means of drain- 
 age as the Board direct. 
 
 (3.) If no such means of drainage are within that distance, 
 then the last-mentioned drains shall communicate 
 with, and be emptied into such covered cess-pool or 
 other place, not being under any house, and not being 
 within such distance from any house, as the Board 
 of Health direct. 
 
 (4.) The Board shall have the power of enforcing and 
 directing the construction of " dry privies," vaults, 
 or cess-pools, wherever the nature of the ground, the 
 building materials in use, the imperfect supply of 
 water, or any other circumstances, shall render this 
 
215 
 
 necessary for the public health, especially for the 
 preservation of the purity of streams, springs, or 
 other sources of fresh water. 
 
 But : a. These privies or vaults shall be so constructed 
 that their contents can be periodically, conveniently, 
 and safely removed for agricultural or other pur- 
 poses, b. And they shall be effectually deodorized 
 by some proper and sufficient drying or deodorizing 
 agent, so that they will not be dangerous or offen- 
 sive, either while undisturbed or during the process 
 of removal. 
 
 (5.) Any house or building which, during the process of 
 repairs, shall be pulled down to the ground floor, 
 shall be subject to the same regulations as if it 
 were a new house or building. 
 
 XVI. If any house or building is built or re-built, or any 
 drain or vault constructed contrary to the foregoing provi- 
 sions, the owner of such house or building shall be subject 
 to the following liabilities ; that is to say : 
 
 (1.) He shall incur such a penalty for each offense as the 
 
 Board may determine ; or, 
 (2.) The Board of Health, after due notice, and his failure 
 
 to comply therewith, may thereupon proceed to 
 
 do the work required, and assess the expenses 
 
 upon said owner. 
 
 CLEANSING. 
 
 XVII. The following works shall be done in respect to 
 scavenging : 
 
 (1.) All public streets, together with the foot-pavements 
 thereof, shall be properly cleansed arid watered ; 
 all roads shall be properly cleansed, and the whole 
 or any part of such roads may, in the discretion 
 of the Board of Health, be watered. 
 
216 
 
 (2,) All dust, ashes, and rubbish shall be carried away 
 from the premises of the inhabitants. 
 
 (3.) All privies and cess-pools shall be, from time to time, 
 emptied and cleansed ; but their contents shall 
 first be deodorized. And the Board of Health may 
 themselves undertake, or contract with any person 
 to undertake the aforesaid works, or any of them. 
 
 XVIII. No person, except by direct authority of the 
 Board, shall undertake to remove any of the substances 
 mentioned in the preceding section, or obstruct the Board 
 or its agents in so doing. 
 
 XIX. In cases where the Board of Health do not them- 
 selves undertake, or contract with any person to undertake, 
 the works heretofore named, they may make by-laws im- 
 posing on the occupier of any premises any or all of the 
 duties of cleansing. They may affix reasonable penalties 
 for the breach of said by-laws. 
 
 XX. Whenever the Board of Health shall be satisfied 
 that the number of persons occupying any tenement or 
 building is so great as to be the cause of nuisance, or sick- 
 ness, or a source of filth ; or that any tenements or build- 
 ings are not furnished with vaults constructed according to 
 the pr6visions of this Ordinance ; or with a sufficient 
 number of privies or water-closets, with underground 
 drains ; with proper ash-pits, or with a proper water-sup- 
 ply ; or that, from any cause, they are in a condition which 
 is prejudicial or dangerous to the public health, or to the 
 health of the occupants themselves they may thereupon 
 issue notice in writing to such persons, or any of them 
 that is to say, the owner, agent, or occupant, or either of 
 them to cause either or all of these deficiencies to be sup- 
 plied, and the premises put into a cleanly and proper condi- 
 tion, within such reasonable time as they shall appoint ; and 
 in case of neglect or refusal to obey such notice, they may 
 
217 
 
 themselves cause the alterations and cleansings to be done 
 forthwith, and the expense of it shall be paid by such own- 
 er, agent, occupant, or other person. Or they may, if they 
 think fit, issue notice to the persons inhabiting such tene- 
 ment, or to the owner or agent, requiring them to remove 
 from, and quit the premises, within such time as the Board 
 may deem reasonable ; and if the person or persons so no- 
 tified, or any of them, shall neglect or refuse to remove 
 from said tenement or building, the Board of Health are 
 hereby fully authorized and empowered thereupon forcibly 
 to remove the same. 
 
 XXI. The Board of Health may make and issue by-laws 
 for the prevention of nuisances arising from filth, dust, 
 ashes, and rubbish, or from the keeping of animals, and 
 may annex reasonable penalties for the breach of said by- 
 laws. 
 
 XXII. The business of a blood-boiler, bone-boiler, bone- 
 burner, fell-monger, slaughterer of animals of any descrip- 
 tion not fit for human food, soap-boiler, tallow-melter, 
 tripe-boiler, or other noxious or offensive business, trade or 
 manufacture, shall not, without the consent of the Board, 
 be established within the district ; and the Board may 
 make such regulations in regard to these occupations as 
 they may deem expedient. 
 
 XXIII. When the contents of any sewer, or any accu- 
 mulations of filth, are discharged into any river or stream, 
 in the bed of which the quantity of water is so much 
 diminished, either by drought during the summer, or by 
 any other cause, as to be insufficient to keep the channel 
 clear, the Board of Health may, by excavations or other 
 operations, so deepen the channel as that the flow of water 
 will be accelerated, and the contents of said sewers or 
 drains be thereby prevented from accumulating and stag- 
 nating in parts thereof, to the injury of the health, and the 
 annoyance of the surrounding population. 
 
218 
 
 XXIY. No person, without the license of the Board of 
 Health, shall throw into, or leave in, or upon any street, 
 square, or vacant lot, or into any pond or body of water, 
 within the limits of this town or district, any dead animal, 
 dirt, saw-dust, soot, ashes, cinders, shavings, hair, manure, 
 oyster, clam, or lobster shells, waste water, rubbish, or filth 
 of any kind, or any refuse, animal, or vegetable whatso- 
 ever. Nor shall any person throw into, or leave in or 
 upon any dock, flats, or tide- water, within the jurisdiction 
 of this district, any dead animal or other foul or offensive 
 matter, except as above provided. 
 
 XXV. The owners and occupants of livery and other 
 stables, within the limits of the town or district, as the 
 case may be, shall not wash or clean their carriages or 
 horses, or cause them to be washed or cleaned, in the 
 streets, nor otherwise encumber the same ; they shall keep 
 their stables and yards clean, and shall not permit more 
 than four cart-loads of manure to accumulate in or near the 
 same, at any one time between the first day of May and 
 the first day of November ; nor within that period suffer 
 the same to be removed, except between the hour of twelve 
 at night and two hours after sunrise. 
 
 XXVI. Swine shall not be kept within the limits of the 
 town without a permit from the Board of Health. 
 
 SLAUGHTER-HOUSES. 
 
 XXVII. No place shall be used or occupied as a slaugh- 
 ter-house except by permission of the Board of Health ; 
 and they may make by-laws with respect to their manage- 
 ment, and for keeping the same in a wholesome state. 
 
 THE MARKETS. 
 
 XXVIII. The Medical Health Officer, or either of the 
 Inspectors or Agents of the Board of Health, may, at all 
 
219 
 
 reasonable times, enter into and inspect any shop, build 
 ing, stall, or place kept or used for the sale of butchers' 
 meat, poultry, or fish, or as a slaughter-house ; and to ex 
 amine any animal, carcass, meat, poultry, game, flesh, or 
 fish, which may be therein ; and in case either of them, 
 being intended for the food of man, shall appear to be unfit 
 for such food, the same may be seized; and if it prove to be 
 unwholesome, he shall order the same to be destroyed, or 
 be so disposed of as to "prevent its being again exposed for 
 sale. 
 
 XXIX. No person shall be permitted to bring into town 
 for sale, or sell, or offer for sale, any fresh fish, until the same 
 shall have been cleansed of their entrails and refuse parts ; 
 and such entrails and parts shall be thrown overboard below 
 low- water mark ; and shall never be kept beyond the flowing 
 of the next tide ; and until so thrown overboard, they shall 
 be kept in a close and safe manner on board the vessels or 
 boats on which the fish are brought. And no person shall 
 sell, or offer for sale, fish of any kind, unless the same be 
 kept in covered stalls, fish-boxes, or other houses, which shall 
 always be clean and in good order ; or, in clean covered 
 carts, or boxes, well secured from the rays of the sun. 
 
 XXX. No person shall have in his possession for sale, or 
 shall sell, or offer for sale, within the limits of the town, any 
 vegetables whatever, excepting green peas in the pod, and 
 green corn in the inner husks, which have not previously 
 been divested of such parts or appendages as are not com- 
 monly used for food. 
 
 XXXI. No person shall land on any wharf or other place, 
 or shall bring into town, any decayed or damaged grains, 
 vegetables, or fruit, without a permit from an officer of the 
 Board of Health, and in such manner as he may direct. 
 
 XXXII. No person shall sell any adulterated or unwhole- 
 some food or drink ; and if, upon being notified by the Board 
 
220 
 
 to discontinue such practice, he shall neglect or refuse to 
 obey such order, he may be ejected from the precincts of 
 the market, and such articles of food or drink may be 
 seized and destroyed. 
 
 XXXIII. If any person shall falsify any milk, by adultera- 
 tion with water or otherwise, or by the abstraction of its 
 cream, or any other substance originally belonging to it; or, if 
 any person having reason to believe it so falsified, shall sell the 
 same, or cause it to be sold, he shall be liable to have it seized 
 and destroyed, and to fine and imprisonment, and to have 
 placards, stating his offense and the sentence imposed, posted 
 up at his place of business or elsewhere, as the Board may 
 determine. This shall also apply to milk from diseased cows. 
 
 XXXIV. All bread, ^except as specially provided to the 
 contrary in this section, shall be sold by weight. 
 
 A loaf of bread shall be two pounds in weight ; and bread 
 may be baked and sold in whole, half, three-quarter and 
 quarter loaves, but not otherwise, except in bread composed 
 in chief part of rye or maize. 
 
 Small rolls and fancy bread, weighing less than one 
 quarter of a pound each, may be baked and sold without 
 regard to weight. 
 
 In every shop or place where bread is sold by retail, and 
 in each front window thereof, there shall be conspicuously 
 placed a card, on which shall be legibly printed a list of 
 the different kinds and qualities of loaves sold there, with 
 the price of each per loaf, and half, three-quarter, and 
 quarter loaf. 
 
 All bread, except small rolls and fancy bread of less than 
 a quarter of a pound each, sold in any shop or place, shall 
 be weighed in the presence of the buyer, and if found de- 
 ficient in weight, bread shall be added to make up the 
 weight required by law. 
 
221 
 
 Any person, who shall violate any of the provisions of 
 this act, shall forfeit for each offense the sum of 
 dollars, and he shall also be liable to the penalties provided 
 in Section XXXIII. 
 
 XXXV. And the Board of Health is also hereby author- 
 ized to make, promulgate, and enforce such by-laws for the 
 government of the market-houses and the sale of provisions 
 as they may think expedient. 
 
 DRAM-SHOPS AND DRINKING-HOUSES. 
 
 XXXVI. All unlicensed dram-shops and drinking- 
 houses for the sale of intoxicating drinks, are hereby de- 
 clared to be nuisances, and may be abated as such, by the 
 Board of Health. 
 
 COMMON LODGING-HOUSES. 
 
 XXXVII. No person shall keep a common lodging-house 
 without a license from the Board of Health, after inspec- 
 tion by the Medical Health Officer of the Board. And a 
 register shall be kept, in which shall be entered the name 
 of every person applying to register any common lodging- 
 house kept by him, and the situation of every such house ; 
 and the said Board shall, from time to time, make by-laws 
 for fixing the number of lodgers who may be received into 
 each house so registered ; for promoting cleanliness and 
 ventilation therein ; and with respect to the inspection 
 thereof, and the conditions and restrictions under which 
 such inspection may be made ; and the person keeping 
 any such lodging-house shall give access to the same, when 
 required by any person who shall produce the written 
 authority of the Board, for the purpose of inspecting the 
 same, or for introducing or using therein any disinfecting 
 process ; and the expenses incurred by the said Board in 
 such process shall be assessed and collected from the 
 keeper of said house ; and if any such keeper of such lodg- 
 
222 
 
 ing-house shall neglect or refuse to obey the directions of 
 the Board of Health, he shall forfeit his license. 
 
 CELLARS. 
 
 XXXYlLL. No cellar or underground room shall be let 
 or occupied separately as a dwelling, without being regis- 
 tered and licensed by the Board, and unless it possess the 
 following requisites ; that is to say: 
 
 (1.) Unless the same is in every part thereof at least seven 
 feet in height, measured from floor to ceiling there- 
 of; nor, 
 
 (2.) Unless the same is at least one foot of its height above 
 the surface of the street or ground adjoining, or 
 nearest to the same ; nor, 
 
 (3.) Unless there is outside of, and adjoining such cellar or 
 room, and extending along the entire frontage there- 
 of, and upwards, from six inches below the level of 
 the floor thereof, up to the surface of the said street 
 or ground, an open area of at least three feet wide 
 in every part ; nor, 
 
 (4.) Unless the same is well and effectually drained, and 
 secured against the rise of effluvia from any sewer 
 or drain ; nor, 
 
 (5.) Unless there is appurtenant to such cellar or room the 
 use of a water-closet or privy, as the Board may 
 require ; and of an ash-pit, furnished with proper 
 doors and coverings ; nor, 
 
 (6.) Unless the same has a fire-place, with a proper chim- 
 ney, or other ventilating flue ; nor, 
 
 (7.) Unless the same has an external window of at least 
 nine superficial feet in area, clear of the sash-frame, 
 and made to open in such manner as is approved by 
 the Surveyor of the Board. 
 
223 
 
 And whosoever lets, occupies, or continues to let, or 
 knowingly suffers to be occupied, any cellar or under- 
 ground room, contrary to this section, shall be liable to for- 
 feit his license, and shall be subject, if he persist, to such 
 other penalty as the Board may determine : and every cel- 
 lar or underground room, in which any person passes the 
 night, shall .be deemed to be occupied as a dwelling within 
 the meaning of this Ordinance ; but the above rule shall 
 be qualified in respect to areas as follows : 
 
 (1.) In any area adjoining a cellar or underground room, 
 there may be placed steps necessary for access to 
 such cellar or room, if the same are so placed as not 
 to be over or across the said external window. 
 
 (2.) Over or across any such area there may be steps 
 necessary for access -to any building above the cellar 
 or room to which such area adjoins, if the same be 
 so placed as not to be over or across any such external 
 window. 
 
 NEW STREETS AND HOUSES. 
 
 XXXIX. The Board, with the consent of the town 
 councils, and with the advice and aid of the Engineer or 
 Surveyor, shall fix and determine the following matters ; 
 that is to say: 
 
 (1.) With respect to the level and width of new streets, and 
 the provisions for the sewerage and paving thereof. 
 
 (2.) With respect to the structure of walls of new buildings, 
 in reference to stability and the prevention of fires. 
 
 (3.) With respect to the sufficiency of the space in connec- 
 tion with buildings, to secure a free circulation of 
 air, and the ventilation of buildings. 
 
224 
 
 (4.) With reference to the drainage of buildings, to water- 
 closets, privies, and cess-pools in connection with 
 buildings, and to the closing and prohibition of build- 
 ings or parts of buildings unfit for human habitation. 
 
 The regulations of this Section and of Sections XX., 
 XXXVII., and XXXVIII, shall be considered also as par- 
 ticularly applicable, and may be enforced in regard to 
 Model Houses, and to houses already built or occupied. 
 
 They may annex such penalties, and further provide for 
 the observance of these regulations by such by-laws as they 
 think necessary , and may alter or pull down any work 
 begun or done in contravention of such by-laws : Provided, 
 however, that no person shall be deprived by any by-law 
 of such right of appeal as is hereinafter given in respect of 
 by-laws. 
 
 SUPPLY OF WATER. 
 
 XL. The following provisions shall be observed with 
 respect to the supply of water : 
 
 (1.) All public wells, pumps, conduits, or other works 
 used for the gratuitous supply of water to the inhab- 
 itants shall vest in, and be under the control of, a 
 Board of Improvement Commissioners, or such per- 
 sons as may be chosen for that purpose by the town 
 councils, with the approbation of the Board of Health, 
 who shall have the right to direct the use of the 
 water for any sanitary purpose. 
 
 (2.) A sufficient quantity shall be supplied for domestic 
 purposes, the takers paying such fixed rates therefor 
 as may be determined ; and, 
 
 (3.) May be supplied to any public baths or wash-houses, 
 or for manufacturing purposes, on such terms and 
 conditions as may be mutually agreed upon. 
 
225 
 
 (4.) A sufficient quantity shall be provided for flushing 
 sewers and drains, for putting out fires, for cleaning 
 and watering the streets, and for other public purposes. 
 
 (5.) The expense of providing a supply of water for the 
 foregoing purposes, over what shall be paid by the 
 takers, shall be assessed on the inhabitants, or paid 
 in such other way as the councils shall determine. 
 
 XLI. Any person who willfully wastes or fouls the 
 water, or injures any of the works for its supply, shall be 
 liable to such penalties as the Board or the Commissioners 
 shall determine, and shall be also liable to a suit for dam- 
 age at common law. 
 
 XLII. When it shall appear that any house or tenement 
 let to other persons than the owners thereof is not in any 
 way supplied with water, the owners of such house or tene- 
 ment shall be notified by the Board of Health to supply 
 the same ; and in case of refusal, or neglect to do so within 
 a reasonable time, the Board may supply the same at the 
 expense of the owner, or, at its option, vacate the premises. 
 
 VENTILATION. 
 
 XLIII. No cellar, lodging-house, or other "house," in- 
 tended for the constant occupation of not less than ten 
 persons, or for the occasional assemblage of large numbers 
 of persons, shall be used or occupied, except under the 
 following conditions ; that is to say : 
 
 (1.) Unless the same shall be provided with some effectual 
 ventilation, as follows : 
 
 a. By ventiducts for supplying fresh air of a suita- 
 ble temperature, which shall have a capacity of not 
 less than one hundred square inches for every twenty- 
 
 15 
 
226 
 
 five persons, and in the same proportion for any 
 greater or less number ; or, 
 
 b: By some other mode capable of supplying pure 
 air to each person at the rate of four cubic feet per 
 minute. 
 
 c. By discharging- ventiducts, which open directly 
 into heated flues, or which are conducted into the 
 outer air above the roof, and then terminated by a 
 suitable cowl or cap, and which shall have a capacity 
 of not less than two-thirds of that of the admitting 
 ventiducts j or. 
 
 d. By an open fire-place ; an Arnott's valve ; an 
 opening into some other ventilated apartment ; or, 
 
 e. By some other effectual method of expelling the 
 foul air. 
 
 (2.) Or unless the drains, vaults, and water-closets are se- 
 curely trapped and effectually ventilated : 
 
 a. By connecting them with the rain-water spouts ; or, 
 
 b. If within the house, as in the case of water- 
 closets, by a ventilating flue opening above the roof, 
 or which is connected with a heated flue. 
 
 PLEASURE-GROUNDS. 
 
 XLIV. The Board of Health may, with the approval of 
 the Town Council, hold, purchase by agreement, take on 
 lease, maintain, lay out, plant, and improve land for the pur- 
 pose of being laid out as public walks or pleasure-grounds, 
 and support or contribute towards any premises provided 
 for such purposes by any person whomsoever. 
 
 EPIDEMIC AND CONTAGIOUS DISEASES. 
 
 XLV. When any epidemic, endemic, or contagious disease 
 shall threaten the town, or affect any part of the same, in 
 
227 
 
 order that measures of precaution may be taken with 
 promptitude, according to the exigency of the case, the 
 Board of Health may issue such directions and regulations 
 as they may think fit ; and they shall provide for the fre- 
 quent cleansing of streets and public ways, and for the 
 cleaning, purifying, ventilating, and disinfecting of houses 
 by the owners or agents ; for the removal of nuisances ; to 
 provide for the sick by establishing and opening temporary 
 hospitals, and for the speedy interment of the dead ; and, 
 generally, for preventing or mitigating such malignant dis- 
 eases, in such manner as to the said Board seems expedient. 
 And if any vessel, having any contagious or other malig- 
 nant disease on board, or having come from ports where 
 such diseases are prevailing, shall arrive at either of the 
 wharves, or come to anchor near them, she shall be ordered 
 by the Health Officer to proceed to Quarantine, there to 
 report herself to the Quarantine Physician. 
 
 PUBLIC VACCINATION. 
 
 XL VI. In order to prevent the spread of small-pox, and 
 to diffuse the benefits of vaccination, it is hereby ordained 
 that there shall be provided a suitable apartment for the 
 Medical Officer of the Board, at which place he shall attend 
 at such times as the Board may direct ; and he shall vaccin- 
 ate without charge any inhabitant of this town, not pre- 
 viously vaccinated, who may apply for that purpose. And 
 he shall give certificates of said vaccination, without which 
 no child shall be admitted to the public schools. And he 
 shall also always have on hand, as far as practicable, a suf- 
 ficient quantity of vaccine lymph to supply the physicians 
 of the public institutions, 
 
 INTERMENT OF THE DEAD. 
 
 XL VII. The Board of Health, with the consent of the 
 councils, shall, from time to time, provide, in such places 
 
228 
 
 as, having regard to the public health, may appear to them 
 expedient, and within or without the limits of the district, 
 burial-grounds of sufficient extent for the decent interment 
 of the bodies of all persons dying within the district ; and 
 it shall be lawful for the said Board, in case it appears to 
 them necessary or expedient so to do, to enlarge any burial- 
 ground provided by them under this Ordinance, and to 
 make any road to such ground, or to enlarge or improve 
 any existing road for facilitating the approach to such 
 burial-ground ; and for providing any such burial-ground, 
 or improving it, they may purchase any lands which it may 
 appear to them expedient to purchase for that purpose. 
 
 XL VIII. They may inclose and lay out the burial-grounds 
 thus provided, and build therein suitable chapels for the 
 performance of the burial service, and such other buildings 
 and works as may appear to them fitting and propel. 
 
 XLIX. When the said Board shall be of opinion that in- 
 terment (otherwise than in the burial-grounds provided in 
 this Ordinance) should be discontinued, wholly, or subject 
 to any exception or exceptions, in any part or parts of the 
 town, they shall, after due notice, order their discontinu- 
 ance ; and the grounds so discontinued shall be closed or 
 fenced up in such a manner as to protect the public health, 
 and secure proper respect to the bodies interred therein. 
 And this section shall also be considered as applying to vaults 
 under churches and chapels, as well as to the open burial- 
 grounds. 
 
 L. No burial shall take place, or be permitted in any of 
 the so-closed grounds, or under, or in any churches or cha- 
 pels to which this order shall have been applied, except in 
 the cases following ; that is to say : 
 
 (1.) In case of long previously-existing private rights of 
 sepulture, the Board may, in their discretion, give a 
 
229 
 
 license, under such restrictions as may seem to them 
 proper. 
 
 (2.) Or if, on representations properly made to them, they 
 may deem the permission, if granted in exceptional 
 cases, not prejudicial to the public health. 
 
 LI. But any and all persons who may have, by any such 
 discontinuance or closure of any burial-ground, as provided 
 for in section XLIX, been deprived of any rights of sepul- 
 ture, shall have in the newly-consecrated ground the same 
 rights as they respectively would have had in the burial- 
 places thus closed and discontinued ; or they shall be other- 
 wise equitably compensated therefor. 
 
 LIT. The relatives of any deceased person, with the con- 
 sent of the Registrar, or other person having charge of the 
 closed ground in which the body of the deceased has been 
 interred, and subject to the regulations of the Board, may 
 cause such body to be removed to, and re-interred in any 
 burial-ground provided under this Ordinance. 
 
 LIU. The Board, from time to time, may make regulations 
 as to the depth and formation of the graves and places of 
 interment, the nature of the coffins to be received in the burial- 
 grounds thus provided, the time and mode of removing bodies, 
 and generally, as to all matters connected with the good order 
 of such burial-grounds, and as to the conduct of funeral pro- 
 cessions, and the convenient exercise of the rights of interment 
 therein : and such regulations shall be printed and published, 
 and shall be fixed and continued on some conspicuous part 
 of every such burial-ground. 
 
 LIV. All burials shall be registered in books to be kept 
 for the purpose, in the manner directed, and by the officer 
 whose duty it shall be made by the Board of Health. 
 
 LV. No burial shall take place, except upon the written 
 permit of the Registrar or Coroner, who, before issuing said 
 
230 
 
 permit, shall require to be furnished with the name, sex, age, 
 rank, profession or occupation, and the residence at the time 
 of death, of said person ; nor shall such permit be then issued, 
 except the cause of the death of said deceased person shall be 
 fully certified to the Registrar or other permitting officer, by 
 some regularly-licensed or competent physician or surgeon. 
 
 LVL The Board may, at any time after the passage of this 
 Ordinance, build, or otherwise pro vide, in suitable and conve- 
 nient locations, houses for the reception and care of the 
 bodies of the dead, previously to, and until interment, and 
 make arrangements for the reception and care of such bodies 
 therein, and appoint fit officers for such houses of reception ; 
 and they may also appoint or provide medical or other officers, 
 who, in cases where the friends of the deceased so desire, may 
 cause the body of the deceased to be decently removed to one 
 of the houses of reception provided for under this section. 
 
 LVII. " Wakes" shall not be permitted, without the special 
 leave, in writing, of the Board, or of its authorized agent : 
 nor then, if the death has been occasioned by any malignant 
 or epidemic disease ; or if from any cause the health of those 
 who would be there present, or of others with whom they 
 would be in contact, would be thereby endangered. 
 
 LVIIL The Board may, from time to time, fix, according 
 to a just and regular scale of charges, the rates in classes, 
 varying according to circumstances, of prices for the conduct 
 of funerals ; but so that in respect of the lowest of such classes, 
 the funeral may be conducted with decency and solemnity. 
 
 GENERAL PROVISIONS. 
 
 LIX. There shall be elected or appointed annually, or at 
 such times as shall be determined by the town councils, for 
 the purposes of this Ordinance, the following officers, who 
 
231 
 
 shall receive such compensation, and perform such specific 
 duties as shall from time to time be determined ; that is to say : 
 
 (1.) A Eegistrar, who shall be a Doctor of Medicine, whose 
 duty it shall be to record the births, deaths, and mar 
 riages, and to regulate all funerals, and the proceed- 
 ings thereunto appurtenant. 
 
 (2.) A Medical Health Officer who shall be the principal 
 physician-in-ordinary to the Board of Health who 
 shall superintend, under the direction of the Board 
 of Health, all the sanitary measures ordered by the 
 Board ; and who shall advise them generally as to all 
 matter relating to the public health. 
 
 (3.) A Board of Consulting Physicians, who shall be 
 
 elected annually, and whose duty it shall be, in case 
 of an alarm of any contagious or other dangerous dis- 
 ease occurring in the district, to give the Board of 
 Health all such professional advice and information 
 as they may request, with a view to the prevention 
 of such disease, and at all convenient times, when 
 requested, to aid and assist them with their counsel 
 and advice in all matters that relate to the preserva- 
 tion of the health of the inhabitants. 
 
 (4.) An Engineer, or Surveyor, whose duty it shall be to 
 furnish all plans required for the use of the Board ; 
 to advise in relation to the construction and grade of 
 the streets ; the structure of the drains ; the water- 
 supply ; and, generally, with regard to all plans for 
 improving the surface and substratum of the district. 
 
 (5.) Superintendents of Streets, of Health (or Cleaning), of 
 Drains, and of Burials ; whose duty it shall be to 
 supervise, and direct, and execute the details of the 
 various departments to which they shall be assigned, 
 
232 
 
 under the direction of the Board, of the Health 
 Officer, or of such other persons as the Board of 
 Health may direct. 
 
 (6.) Such other officers as the councils may from time to 
 time determine. 
 
 LX. Any person who shall violate the provisions of this 
 Ordinance, or any of them ; or who shall obstruct the 
 Board, or any of its authorized agents, in the performance 
 of their lawful duties ; or who shall do any act or acts by 
 which the public health is endangered shall be fined there- 
 for not less than . dollars, nor more than dollars, 
 for each and every offense, and he shall be subjected to such 
 other penalty as the Board of Health, with the approval of 
 the councils, may fix and determine, and which are not re- 
 pugnant to the Constitution, and laws of the State, or in 
 violation of the regulations of the General Board of Health. 
 
 LXI. If any person feel aggrieved by any order of the 
 Board of Health, or by the orders or acts of any of its 
 accredited officers or agents, he shall always have the right 
 of appeal to the Board of Health ; or, if he so elect, he 
 may prosecute such appeal in the courts of law, in accord- 
 ance with the Bill of Rights, as in such cases made and 
 provided ; but no such appeal shall be entertained by the 
 Board of Health, unless said appeal is made within four 
 months next after making such order, or the doing of such 
 act, nor unless ten days' notice, in writing, is given to the 
 party against whom the appeal is brought, stating the na- 
 ture and grounds thereof; nor then, unless the appellant 
 enter into sureties duly to abide the decision of the Board, 
 or to prosecute his appeal in the proper Court. 
 
 LXH. All Ordinances and parts of Ordinances heretofore 
 passed, inconsistent with this Ordinance, are hereby repealed. 
 
233 
 
 - 
 APPENDIX A. 
 
 FORM OF RETURN. 
 
 The Health Officer, or Inspector, after ascertaining the 
 condition of his district, shall make his report in the fol- 
 lowing manner, viz. : 
 
 " Health Officer, A. B. , District , reports the 
 
 condition of premises No. , street, to he as follows : 
 
 1. PREVALENT SICKNESS. 
 
 (Under this head state what the disease is, and how many- 
 are affected.) 
 
 2. OVERCROWDING. 
 
 (State in figures the numher of persons occupying the 
 the rooms or houses in badly situated localities.) 
 
 3. VENTILATION. 
 
 (State if there is any ; and, if so, whether it is hy doors, 
 windows, or fire-places ; especially when the apartments are 
 closed at night.) 
 
 4. DRAINAGE. 
 
 (State simply if there is any, and whether it is "good" or 
 11 bad: 1 
 
 6. FILTH AND RUBBISH. 
 
 (State the kind, quantity (hy estimate), and its specific 
 locality.) 
 
 6. WATER SUPPLY. 
 
 (State if there is a supply of water for cooking, washing, 
 or bathing, and of what kind.) 
 
 T. DEAD BODIES IN SINGLE LIVING ROOMS. 
 
 (State the cause of death, and the general condition of the 
 apartment and its inhabitants.) 
 
 He shall also make a record, in a book to be furnished 
 him for that purpose, of the same facts in tabular form, 
 
234 
 APPENDIX B. 
 
 FORM OF NOTICE TO ABATE NUISANCES. 
 
 (To be served by any Officer competent to serve a civil process.) 
 
 CITY OF 
 OFFICE OF BOARD OF HEALTH, 18 
 
 To No. St. 
 
 SIR : Your premises having been examined, and ascertained 
 to be in a condition which is, in my opinion, prejudicial to the 
 public health, by reason of 
 
 you are hereby required, in conformity with the provisions of 
 an Order of the Board of Health, passed to 
 
 within hours. 
 
 Health Officer. 
 
 Approved. 
 
 Chairman Committee of Board of Health. 
 
 EXTRACT FROM THE ORDER. 
 
 " Ordered, That the Medical Health Officer, with the concur- 
 rence of the Committee of the Board, be and he is 
 hereby authorized to take such measures in regard to causes or 
 occasions of danger to the public health of the city, as he may 
 deem necessary and proper for its preservation." 
 
EEP O E T 
 
 UPON 
 
 SEWERAGE, WATER SUPPLY, AND OFFAL. 
 
 EY JOHN H. GRISCOM, M.D., OF NEW YORK. 
 
237 
 
 EEPOKT. 
 
 IN his artificial condition of civilization, there are two 
 classes of circumstances which effect the health of man : 1st, 
 Those which are found exclusively within his domocile ; and 
 2d, Those which are more particularly operative without his 
 dwelling. To the former class belong the various impurities 
 of the atmosphere derived from respiration, combustion, and 
 exuberant moisture, the quality of food, the clothing, and 
 personal cleanliness. Included in the latter, or extra-domi- 
 ciliary causes of disease are terrestrial emanations, meteoric 
 changes, and the influence of those matters, which, having 
 been cast out from the dwelling, are suffered to undergo 
 decomposition in its vicinity. 
 
 To me has been assigned the duty of reporting upon 
 "the importance of an ample supply of water, an edequate 
 sewerage, and the proper disposal of offal." 
 
 The first of these objects of inquiry water belongs to 
 both classes of circumstances, i. e., the internal and external 
 domiciliary. Used as a beverage, for cooking, for bathing, for 
 washing, and cleansing generally, it pertains to the internal 
 affairs of the household ; as a means of cooling the atmos- 
 phere, of absorbing free gases, of cleansing the ways, and 
 of removing filth, its applications are chiefly external, and 
 in this direction, though more extensive as regards area, 
 they are less important than in their indoor relations. 
 
 Of the vast importance of an ample supply of water for 
 family use, an impression may perhaps be best formed by ima- 
 gining the horrors of a drought, in contrast with the comforts 
 of an abundance of this element furnished unstintedly ; and 
 
238 
 
 the measure of the comfort and health of a people, or even 
 of a single household, may be judged by the approach to 
 one or the other of these extremes, of the water afforded 
 to, and used by them. There is nothing extravagant in the 
 conjecture, that, in many of the very crowded portions of 
 cities, where dwellings rise to the height of five or six stories, 
 up to which it is impossible, by hand labor, to carry an 
 ample supply of water, that there, suffering and sickness 
 from the deficiency, are marked and decided, while nearer 
 the ground, the inhabitants, being better able to observe 
 rules of cleanliness, and to use it more freely in every way, 
 are on this account less prone to evils of many kinds. 
 
 Water should be second only to air in abundance and 
 accessibility ; as the poorest has no excuse for self-privation 
 of air, nature pressing it upon him with the force of fifteen 
 pounds to the square inch, and he having only to expand 
 his chest to receive it, so should water be accessible to every 
 one, the poorest more especially, simply by the opening of 
 a valve, that there might be no excuse for its neglect. 
 Stephen Girard and John Jacob Astor could have made no 
 better disposition of their wealth, than to have given the 
 waters of the Schuylkill and the Croton to their fellow- 
 citizens without price. 
 
 Passing to the subject of sewerage, we have to observe that 
 terrene exhalations in rural localities are a well-known cause 
 of various diseases, which need not be here enumerated. 
 From this cause every city should and can be, made almost 
 wholly free. However vicious may be the soil upon which a 
 city stands, a thorough system of paving and sewerage will 
 prevent the natural exhalations, and obviate the diseases 
 which will otherwise flow from them. But however well paved 
 and sewered a city may be, whereby its natural exhalations 
 are obviated, the formation of artificial marshes above 
 the stones of the pavement, and beyond the reach of the 
 
239 
 
 sewers, by the accumulation of the offal of men and ani- 
 mals is equally bad, if not worse. The marsh miasm of new 
 countries which produces intermittent, remittent, and 
 bilious fevers, the scourges of uncultivated regions, is the 
 result of vegetable decomposition only ; but if to this there 
 be added a large proportion of animal matter, and the ex-* 
 halations of the combined decomposition are suffered to in- 
 vade our dwellings and surround us continually, the intensity 
 of the malarious poison is redoubled, and in addition to the 
 diseases just mentioned, we have Diarrhoea, Dysentery, 
 Cholera, Typhus Fever, and a general depression of the 
 vital powers, which renders every other disorder more 
 dangerous. Of such a character is the. miasm of a city of 
 uncleaned and unwashed streets, where the debris of the 
 kitchens and manufactories are allowed to accumulate on 
 the surface, exposed to the decomposing influences of the 
 air, the sun, and the rains, and where the fecal emanations 
 of the inhabitants are preserved in sinks and cess-pools. 
 
 If even the tidal waters of such a magnificent sewer as 
 the river Thames are insufficient to relieve the city of Lon- 
 don of the pernicious effects of its vast amount of animal and 
 vegetable debris and exhalation, how clean soever its surface 
 may be kept, how much more offensive and deleterious 
 must be the compound animal and vegetable malaria from 
 these same materials, stagnant upon the surface. They 
 fo^rn artificial marshes more dangerous than the Pontine. 
 
 " The sewerage of large towns and cities consists of refuse 
 animal matters, of the excrementitial discharges of the in- 
 habitants and myriads of the lower animals, of the blood 
 and animal fluids from slaughter-houses, knackers' yards, 
 and tan-pits, of the foul and contaminated waters from 
 gas-works, factories, and other establishments, and of refuse 
 vegetable matters in a state of decomposition from public 
 
240 
 
 markets and other places."* The combined amount of these 
 matters is estimated at seven cubic feet (about fifty gal- 
 lons) per diem, for each individual, which for the city of 
 New York, with a population of 700,000, rises to the daily 
 average of 35,000,000 gallons, and, annually, to the as- 
 tounding quantity of twelve billions seven hundred and 
 seventy-five millions of gallons (12,775,000,000). 
 
 To descant upon the necessity of the immediate and 
 thorough removal of this prodigious mass of waste ani- 
 mal, vegetable, mineral, and gaseous matter, which, were 
 it possible to concentrate it daily, in separate deposits, 
 would require for each day, a reservoir fifty per cent, larger 
 than the Croton distributing reservoir on Murray Hill, New 
 York City ; to descant upon the absolute necessity of an 
 immediate removal of these immense masses of poisonous 
 matter far away from the precincts of human lungs; to 
 discuss the fearful results which would follow their reten- 
 tion would seem to be a work of supererogation ; and yet 
 we find even intelligent citizens and legislators, almost 
 everywhere, doubting, hesitating, and procrastinating. 
 
 To all such we commend earnestly, and in the pure 
 spirit of patriotism, the following passages from the recent 
 able work on Hygiene, before quoted. The remarks there 
 made, though written for the metropolis of Great Britain, 
 are equally applicable to New York, Philadelphia, or any 
 other large and crowded city. 
 
 "In all large cities and towns there are plague-spots 
 where fever of the intermittent, remittent, or continued form 
 always prevails in greater or less intensity. There are dis- 
 tricts and localties in our modern Babylon which are ever re- 
 mitting the poison which generates Typhus Fever ; there 
 
 Hygiene, by Dr. Pickford. 
 
241 
 
 are certain squares and streets, nay, particular houses, 
 the inmates of which, family after family, for a long series 
 of years have been the victims of Typhus Fever, though 
 the districts in which they are situated are airy, and the soil 
 
 dry. 
 
 " Open and imperfect sewers, faulty, superficial, choked 
 up and overflowing drains, imperfect traps of cess-pools and 
 water-closets, a filthy condition of the earth's surface, toge- 
 ther with intramural burying-grounds, slaughter-houses, 
 and slaughtering-cellars, and the conversion of tidal rivers 
 into cloacae maximae, are the fruitful sources of fevers, 
 diarrhoea, and dysentery, in all congregations, and on any 
 one spot, of great multitudes of human beings. 
 
 " There is probably no subject so complex, so incalculably 
 difficult to grapple with, especially if it be how to apply a 
 remedy, as the drainage and sewerage of large overgrown 
 cities. Yet, we must perceive, that unless this be efficiently 
 done, an ultimate limit is set by the hand of man himself to dynas- 
 ties, to peoples, and to nations. The air we breathe, loaded 
 with carbonaceous matter, sulphurous and sulphuric acid, 
 sulphate of ammonia, and sulphurretted hydrogen, is de- 
 prived, by the absence of vegetation, of the revivifying prin- 
 ciple, oxygen, and is hence less fitted for the necessary changes 
 of the blood effected during respiration. The earth which we 
 tread under our feet, loaded with the ashes of our forefathers, 
 and rich with the remains of animal and vegetable matter of 
 ages long gone by, saturated with the putrefying contents of 
 myriads of cess-pools and leaking sewers of our own day, 
 emits at certain seasons of the year the poisonous emanations 
 which generate Typhus, Diarrhoea, Dysentery, and Cholera ; 
 whilst the waters of our principal tidal rivers, converted 
 into open common sewers, teem with pestiferous exhala- 
 1G 
 
242 
 
 tions, charged with the germ of disease, or the messenger of 
 death, If, under these favoring conditions, a pestilential epi- 
 demic invade our shores, it finds us an unprepared and easy 
 prey. 
 
 " The government of every state and nation would do 
 wisely to appoint a minister of public health, whose duty 
 it should be to superintend and watch over the health of 
 the community at large, to see that due ventilation is ob- 
 served in all large and public buildings, and in the dwellings 
 of the poor ; to ascertain that the water is pure, and its 
 supply ample ; to prevent all noxious and unwholesome 
 trades and manufactures being carried on within a given 
 distance from towns and dwellings ; to prohibit intramural 
 burial-grounds, slaughter-houses, and slaughtering-cellars ; 
 but, above all, to lay down, and carry out an effectual, effi- 
 cient, complete, and common-sense plan of drainage and 
 sewerage for every town and city. 
 
 "Were the fearful consequences which result from the 
 reprehensible practice of converting our rivers into open 
 common sewers but thoroughly understood, and properly 
 understood, arid properly estimated by the public, no ex- 
 penditure of time or money would be deemed too great to 
 put an end, by penal enactment, to a system so disgusting, so 
 revolting, and so destructive to the health and lives of the 
 community at large ; but more especially of those whose 
 avocations necessitate their daily and hourly exposure to, 
 and residence in the midst of its pernicious influence. 
 
 " Unless this montrous and suicidal evil be staid, London 
 will ultimately become the hot-bed of plague and pestilence, 
 and will, as a consequence, be depopulated and deserted, and 
 numbered with the cities of the world which have been. 
 Then, perhaps, may be fulfilled the prophetic visions of Vol- 
 ney, of Walpole, of Shelley, of Macaulay: * when London shall 
 be an habitation of bitterns ; when St. Paul's and Westminster 
 
243 
 
 Abbey shall stand shapeless and nameless ruins, in the midst of 
 an unpeopled marsh; when the piers of Westminster Bridge 
 shall become the nuclei of islets of reeds and osiers, and cast 
 the shadows of their broken arches on the solitary stream ;' 
 or with Macaulay : ' when travelers from distant regions shall 
 in vain labor to decipher on some mouldering pedestal the 
 name of our proudest chief; shall hear savage hymns chanted 
 to some misshapen idol over the ruined dome of our proudest 
 temple, and shall see a single naked fishermaij wash his 
 nets in the river of the ten thousand masts.' " 
 
This book is due on last date given below. A fine of 
 5c will be charged for each day the book u kept overtime. 
 
 Date Due 
 
 L. B. CAT. NO. 1197 
 
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