A considerable part of this mortality, it may be feared, is unavoidable. Our climatic influences are permanent factors, and must always count in the bills of mortality. But there are certain agencies which we can, to a great extent, control. We can and do submit the dwellings of our citizens to inspection and sanitary regulation; we can and shall provide our city with proper drainage; we can and do inspect the food in our market, and condemn it if unfit for use; we can and must secure for our citizens the influences of unroofed and unwalled Nature,—air, light, space for exercise and recreation, the natural birthright of mankind.
Of the uses of these larger breathing-spaces, which we call parks,—for the relief of the imprisoned dwellers in crowded streets, for the recreation of poor and rich alike, for the health of mind and body which they offer to all,—it seems almost needless to speak from the medical point of view; for all know what cities would be without open areas, where children can play in the shade, and old people warm themselves in the sun. I wish to call your attention to a single point intimately connected with the alarming fact of the excessive death-rate of which I have spoken. That point is the influence of the air they breathe on the health of children, with the bearing of this on the question before us.
If a child is found to have been starved to death in a cellar or an attic, a cry of horror is raised over it. If two or three wandering boys, as it happened the other day at Lowell, come upon some noxious roots, and, in obedience to their omnivorous instinct, devour them, and pay the forfeit, the whole country hears of it. If a family or two get hold of some ill-conditioned meat, and suffer for it, the groans of their colics are echoed all over the land. If a milkman misrepresents his honest cows by falsifying their product, the chemist detects him, and the press puts him in the pillory. If the Cochituate or Mystic water is too much like an obsolete chowder, up go all noses, and out come all manner of newspaper paragraphs from "Senex," "Tax-payer," and the rest. But air-poisoning kills a hundred where food-poisoning kills one. Let me relate a circumstance which happened in Ireland, to which circumstance, in all probability, I owe the pleasure of being listened to at this moment by some among our hard-working, adopted citizens who are before me.
When I say to you, meaning to speak the words of sober truth, that a single physician, by a single and simple measure, saved more lives than were lost at Waterloo by the British army and all its allies, leaving out the Prussians, you will suspect me of exaggeration, not very uncommon in public speakers. I will therefore intrench myself behind certain details which I have often before cited, but not in the presence of a gathering of this kind.
Dr. Robert Collins was Master, as it is called, of the great Dublin Lying-in Hospital, where the annual rate of births was between two and three thousand, from the year 1826 to 1833. A work of his, containing the results of his practice during his seven years of service, was published in Boston in 1841, by order of the Massachusetts Medical Society, for the use of its members. I consider him vouched for as authority, therefore, by men in whom you can put confidence. Dr. Collins makes the following statement:—
When his predecessor, Dr. Joseph Clarke, was in office, in the year 1784, he found that seventeen children in the hundred, nearly one in six, died within the first fortnight after birth, nineteen-twentieths of these of one particular disease peculiar to very early infancy. Looking for the cause of this frightful mortality, he thought he found it in a foul and vitiated state of the air of the hospital. So he had some openings of considerable size made in the ceiling of each ward, and three holes, of an inch in diameter, through each window at top: the doors, too, were perforated with numerous holes. In this way, a free circulation was secured, and so arranged, that the nurses could not control it; for some of the old-fashioned nurses would not have opened a window in the Black Hole at Calcutta, for fear the inmates should catch a cold.
What was the result of this simple proceeding? Why, the mortality fell, from seventeen in a hundred, down to between five and six; and Dr. Collins gives us the result up to his time in these words, "Thus, by his valuable suggestions, 16,371 lives have been saved, as, had the mortality of infants continued one in six to this day (1833), the number of children dying of the 131,227 (which is the total number born in the hospital) would be 21,871, as the hospital registry now shows." In the battle of Waterloo, the British and their allies lost 16,186 men; that is, 185 less than the great army of very light infantry saved from death by letting out the smoke of the battle of life, and letting in the sweet air of heaven, through the walls of the Dublin hospital.
So much for what air alone can do for children. Now, it is not the "nine-day fits" of that hospital in its unventilated condition which kills our poor children in the hot months, but that other disease of infancy, which to name is like sounding a funeral knell in the ears of many a parent. This one malady, more than any other, gives Boston its place on the black list of unhealthy towns. All parents having young children leave the city during the worst part of the sickly season, if they have the means of so doing. Our best streets look as Defoe tells us London streets looked during the Great Plague. But thousands of families must remain; and we are bound to do what we can for them in their dearest interests,—the lives of their children.
With regard to cholera-infantum,—the deadly scourge of which I have spoken,—the testimony of experience shows that change of air, even temporary, often effects the cure of which the apothecary, who "pestles a poisoned poison behind his crimson lights," cannot bring about with his drugs, though the wisest of physicians had written the prescription. This point is so important, and bears so directly, not only on the necessity of park-spaces, but upon their distribution so as to bring them within reach of all the crowded and unhealthy districts as far as possible, that I shall borrow a few sentences, enforcing it, from writers recognized as authorities on the diseases of children.
"Even in cases in which a removal to a healthy and airy situation in the country is impracticable," says Dr. Condie of Philadelphia, long and well known by his writings, "much benefit may be derived from carrying the patient frequently into the open air in a carriage, or in the arms, or, when its residence is near a large river, sailing it daily in an open boat." And Dr. John Bell of the same city says, "The restorative effects of fresh air in cholera-infantum are strikingly evinced in the relief procured by many hundreds of children every summer in Philadelphia, by their simply crossing and recrossing the River Delaware in steamboats once or twice a day. New life is restored to the little beings, who, on leaving their homes in the city, seemed almost exanimate, and in the last stage of incurable exhaustion." Dr. James Stewart of New York, in his treatise on the diseases of children, and our own honored patriarch of the profession, the late Dr. James Jackson, in his letters to a young physician, speak in similar terms of the great advantage of change of place and of air. The "aquatic jaunts" recommended by Dr. Stewart, and spoken of as so efficacious by Dr. Bell, are among the advantages to be secured by the plan proposed by our Park Commissioners. I wish twenty tons of little children could be shipped every fine summer day for a good sail.