The City That Was

by Stephen Smith

To give practical effect to their efforts, it was determined in May last to undertake a systematic investigation of the sanitary condition of the city. For this purpose a central organization was formed, and when I mention the names of its leading members, I A Systematic
Investigation give you the best assurance that the work was undertaken in the interests of science and humanity. The president was Dr. Joseph M. Smith, one of the ablest writers on sanitary science in this country, and among its members were Drs. Valentine Mott, James Anderson, Willard Parker, Alonzo Clark, Gurdon Buck, James R. Wood, Charles Henschel, Alfred C. Post, Isaac E. Taylor, John W. Draper, R. Ogden Doremus, Henry Goulden, Henry D. Bulkley, and Elisha Harris.

In prosecuting this inquiry the Association was guided by the experience of similar organizations in Great Britain, where sanitary science is now cultivated with the greatest zeal, and is yielding the richest fruits. As a preliminary step to the introduction of sanitary reforms, many of the populous towns of England made a more or less complete inspection of the homes of the people to determine their condition, and to enable them to arrive at correct conclusions as to the required remedial measures. The English Government undertook a similar investigation through its “Commissioners for Inquiring into the State of Large Towns and Populous Districts,” and the voluminous and exhaustive reports of that Commission laid the foundation of the admirable sanitary system of that country.

The first object of sanitary organization was apparently, therefore, to obtain detailed information as to the existing causes of disease and the mortality of the population, and as to the special incidence of that mortality upon each sex, and each age, on separate places, on various occupations; in fact, to present a detailed account of what may be called, in commercial phrase, our transactions in human life.

Evidently the best method of arriving at such knowledge was by a systematic inspection. And that inspection must be a house-to-house visitation, in which the course of inquiry not only developed all the facts relating to the sanitary, but A House-to-House
Inspection equally to the social condition of the people. It must necessarily be required of the inspector that he visit every house, and every family in the house, and learn by personal examination, inquiry, and observation, every circumstance, external and internal to the domicile, bearing upon the health of the individual.

To perform such service satisfactorily, skilled labor must be employed. No student of general science, much less a common artisan, was qualified to undertake this investigation into the causes of disease; however patent these causes might be, he had no power to appreciate their real significance. Minds trained by education, and long experience in observing and treating the diseases of the laboring classes, could alone thoroughly and properly accomplish the work proposed.

Happily, experts were at hand and prepared to enter upon the task, viz.: the dispensary physicians. The daily duties of these practitioners have been for years to practice among the poor, and study minutely their diseases; and thus they have gained an The Medical
Experts extensive and accurate knowledge of the sanitary and social condition of the mass of the people. Many of these practitioners have been engaged in dispensary service, and in a single district, for ten to twenty years. They have thus become so familiar with the poor of their district, though often numbering 40,000 to 50,000, that they know the peculiarities of each house, the class of disease prevalent each month of the year, and to a large extent the habits, character, etc., of the families which occupy them.

From this class of medical men the Council selected, as far as possible, its corps of Inspectors. As a body, they represent the best medical talent of the junior portion of the profession of New York. Many occupy high social positions, and all were men of refinement, education, and devotion to duty. They entered upon the work with the utmost enthusiasm; engaging in it as a purely scientific study.

Everywhere the people welcomed the Inspectors, invited them to examine their homes, and gave them the most ample details.

The plan of inspection adopted by the Council was as follows: The city was divided into thirty-one districts and an Inspector selected for each, care being taken to assign to each inspector a district with which he was most familiar. Plan of
Inspection The Inspector was directed to commence his inspection by first traversing the whole district, to learn its general and topographical peculiarities. He was then to take up the squares in detail, examining them consecutively as they lie in belts.

Commencing at a given corner of his district, he was first to go around the square and note: 1. Nature of the ground. 2. Drainage and sewerage. 3. Number of houses in the square. 4. Vacant lots and their sanitary condition. 5. Courts and alleys. 6. Rear buildings. 7. Number of tenement houses. 11. Drinking shops, brothels, gambling saloons, etc. 12. Stores and markets. 13. Factories, schools, crowded buildings. 14. Slaughter-houses (describe particularly). 15. Bone and offal nuisances. 16. Stables, etc. 17. Churches and school edifices.