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decrees of Providence. Thousands die annually before their time, and tens of thousands waste much of their lives on beds of sickness, not by the inscrutable purposes of their Creator, but because the noisome atmosphere of uncleanliness, disease, and death has been allowed to gather and float about them, till the lamp of life has gone out.
Sanitary improvement is now generally recognized in Europe as one of the great reform movements of the day. It has attained this position more on account of its intrinsic importance, than from the exertions of its friends. It is much indebted to the efforts of a few persevering and philanthropic men, like Mr. Chadwick and Mr. Southwood Smith ; but it has chiefly commended itself to public notice through the magnitude of the interests which it affects. In Europe, and particularly in France, Germany, and England, it has attracted considerable attention and accomplished much good. It is regarded, not merely as an auxiliary, but as an indispensable prerequisite, to any attempt for the general and permanent elevation of the poorer classes. In this country the sanitary movement is less known. Our readers are doubtless familiar with its name, though it has not yet assumed before the community the importance which rightfully belongs to it. We trust, however, that the Report of the Sanitary Commission of Massachusetts will do much towards creating a more enlightened public sentiment upon the subject.
We do not propose at the present time to give a history of the sanitary movement, or even an exposition of the principles upon which it is founded. Our object is to present, as briefly as possible, a few of the most important facts, which form at once the basis of sanitary science, and the most urgent reasons for sanitary reform.
Pure air, exercise, and cleanliness, have been recognized since the days of Hippocrates as indispensable to soundness of body and length of years. But until very lately, there have been no data by which to estimate, with any degree of exactness, the enormous waste of life and health, which result from the privation and insufficient supply of these essential conditions of physical existence. The labors of the Registrar-General in England, and of the Bureaus of Health in France and Germany, have at length supplied this defect, so far as those countries are concerned. Their Registration
Reports do not contain merely a barren enumeration of each year's births, marriages, and deaths. They present accuratelyrecorded observations, in every case, of the date and cause of death, and also of the occupation, age, sex, habitation, and locality of those who have died. It is from these Reports, which contain the actual sanitary history, not of a single community, but of millions of individuals, and which now embrace a series of years, that we are enabled to ascertain the comparative healthiness of different classes and occupations in society, and to compare the mortality of different cities with each other, and with that of the country. With these Reports before us, it is easy to eliminate the unnecessary, from the inevitable, causes of disease and death; and thus to show how sickness may be avoided and human life prolonged.
Let us look at some of the facts with regard to this matter. In the first place, there is an annual, needless sacrifice of human life in this country and in Europe, which is great enough to stagger belief. The English Registration Reports show that two per cent., or one death to every fifty inhabitants, is the annual average mortality for the healthy districts of England. In a large proportion of the districts, (nearly one half of the whole number, the average rate is somewhat less than this. These districts do not exhibit this low ratio of mortality merely because they are rural. They contain towns and cities, whose population varies from ten to forty thousand inhabitants. Even in Birmingham, a manufacturing town with a population of 140,000, the average mortality, according to the authority of an intelligent writer in the British and Foreign Medical Review for January, 1848, is less than two
Thus it appears from actual observation, that in nearly one half of England, in towns as well as in the country, the rate of mortality is two per cent., or less. In the other parts of England, which, in a sanitary point of view, differ from these only in circumstances that are removable, the ratio is much greater. According to the writer just quoted, the annual mortality in Birmingham is one in 50.63 of the population, or less than two per cent. In London, it is one in 39.10, in Sheffield, one in 29.28; in Liverpool, one in 34.92; in Leeds, one in 35.14; in Manchester, one in 39.93. In the whole of England, it is one in 45.8, or 2.18 per cent. A glance at these figures is enough to show
an appalling waste of human life. There is no reason why these last named towns should have a sanitary condition inferior to that of Birmingham; and, a fortiori, the mortality of the United Kingdom ought not to be greater. It has, in fact, been proved that the rate of mortality for the whole kingdom might be reduced, by proper sanitary regulations, to less than two per cent., — the rate of Birmingham and of nearly half
the districts of England. If this were the case, there would be a saving of the excess above that rate, which would amount annually to more than 50,000 lives in Great Britain alone. Surely, such a sacrifice of life should arouse the attention of every philanthropist.
The Registration Reports of Massachusetts, imperfect as they are, show that the amount of unnecessary sickness and the waste of life are proportionally as great in New England, as among our Transatlantic brethren. We learn from the Report of the Sanitary Commission, that the average rate of mortality, during a period of ten years, in three country towns of New England, was one in 67 of the inhabitants, or 1.49
This agrees very nearly with the healthiest English district. In Boston, according to the City Registrar's Report, the average rate for the ten years ending with 1850 inclusive was one in 41, or 2.43 per cent. 1849, when the cholera prevailed, it was as high as one in 26, or 3.84 per cent. For the last half of this decade, the rate was one in 34, or 2.94 per cent. This is nearly one per cent. greater than the mortality of Birmingham with all its smoke, and dirt, and manufactories; and but little less than the average mortality of Liverpool, one of the unhealthiest cities in England. Observation has shown, as we have stated, that the average rate of mortality in any community need not exceed two per cent. If the number of deaths in Boston had been kept at this standard for the last ten years, by proper sanitary regulations, there would have been in this city a saving of more than 1,100 lives annually. What an amount of anguish and grief might have been averted, how many hearts might have been saved from desolation, and families from gloom, and homes, how often, from poverty and misery, if the hand of the destroying angel had been so often stayed !
The waste of life in our large towns may be seen in a still
For the year
more striking manner, by comparing different sections of the same city with each other. For this purpose, let us make a comparison of three different sections of Boston. We are enabled to do this with considerable exactness through the kindness of Mr. Simonds, the City Registrar. Compare, for example, the mortality of the population for the year 1850, on Beacon Hill, with that of the inhabitants of what is called “the Back Bay," and of those who dwell along the wharves, in Broad, Sea, and Cove Streets. We give the population of these sections as set down in the city census report for the same year.
The first section which we have selected comprises the portion between Beacon and Pinckney Streets inclusive, extending from the State House to Charles Street. Belknap and West Cedar Streets were not included. This section of the city is all high land and thoroughly drained by nature. The houses are large and well ventilated. The inhabitants belong to the upper classes of society, and in England would be denominated the “gentry.” The population of this district is 2615. Of this number, 2054 are Americans, and 561 foreigners. Most of the latter class are probably domestics in the families of the former. The number of deaths in this section for 1850 was only 35; this is one in 74.7 of the inhabitants, or 1.3 per cent. In Herefordshire, one of the healthiest districts of England, the rate of mortality is about one in 68.49. In the country towns of New England, cited above, it is one in 67. Thus the Beacon Hill district of Boston exhibits a more favorable rate of mortality than either of these rural localities. We should be careful, however, not to draw a too hasty conclusion from this statement. The year 1850 was one of unusual health in Boston. Moreover, many of the inhabitants of this district spend a considerable portion of each year out of the city, and doubtless several deaths occurred, during their absence, which are not included in the enumeration. It would therefore be a nearer approximation to the actual mortality to assume one in 67, or the rate of the country towns, just cited, as the rate of the Beacon Hill district. Even this is much more favorable than the standard of two per cent., or one in 50, to which sanitary science has shown the mortality of every community may be reduced. VOL. LXXIII.-NO. 152.
The next section is that upon “the Back Bay.” It contains the district which is included between Pleasant Street and the marsh, and extends from the Providence Railroad station to West Orange Street. It is composed entirely of newly made land. The streets are narrow,
and drainage are imperfect. The houses are small, and built around alleys as well as upon streets. The population is 5121. Of this number, 1348 are foreigners, and 3773 Americans. The native inhabitants are mostly tradespeople and mechanics. They are intelligent, and are as attentive to the known laws of hygiene as the average of any community. Here the mortality was one in 52.7 of the inhabitants, or 1.9
This rate is much higher than that of the first district, and nearly equal to the mortality of Birmingham. It is not, however, a large mortality, and is a close approximation to the standard of two per cent. If the year had been sickly, the rate would have been considerably increased.
Let us now look at the last district selected for comparison. It comprises Broad, Cove, and Sea Streets. These streets are situated near the wharves. They are built principally upon made land, and have numerous blind alleys, or cul-desacs, leading from them. The streets and alleys are badly drained, and crowded with an overflowing population. A large number of the houses have no means of sewerage
whata ever, and all their refuse of every description stagnates about the yards, spreading on every side poisonous exhalations, laden with disease and death. A majority of the houses contain several families, and some of them have no less than nine or ten. Even the cellars of the houses are often inhabited. In some instances, one cellar leads to another, and this to a third, a sort of dungeon, all inhabited by human beings of both sexes and every age. The population of these three streets was 2813, of whom 2738 were foreigners, and only 75 Americans. The mortality was one in 17.6 of the population, or 5.65 per cent., and this in a year remarkable for its healthiness. What it would have been in a sickly year, we dare not conjecture. There are but few instances on record of a mortality like this, in any community, except during the visitation of a pestilence or an epidemic. Doubtless, the habits of the people, their excesses and inattention to personal cleanliness, or rather fondness for filth, contributed