Consider what has been done for poor children alone. Recently I stood in one of the fifty-five diet-kitchens maintained by the city. A poor woman of the neighborhood entered, carrying in her arms a sickly baby. Evidently familiar with the proper course of procedure, she said to the nurse in charge, “I have given him castor-oil and barley gruel; now what shall I do?” This incident is remarkable because the woman never before had come within the reach of the Health Department. In the danger that menaced the child, she had learned to take the first essential steps not through experience or instruction, but merely through neighborhood gossip.
CONDITION OF NEW YORK HALF A CENTURY AGO
TEN years ago such a thing would have been impossible in New York or in any other large city. The tremendous agencies that now exist for the medical enlightenment of the masses were then unheard of. A generation ago New York was in a condition of almost primeval darkness concerning questions of public health. Canton or Constantinople is to-day little worse off than was America’s chief city then.
In 1866 the public health conditions of New York were in so low a state that the average length of life of the inhabitants was thirty years. In 1912 these conditions had been improved so that the average length of life was sixty-six years. Thus the value of human life, reckoned in terms of time alone, had more than doubled in less than half a century.
Let us go back to the year following the Civil War. The only paving in New York then was of cobblestones, and many streets were unpaved. All were in filthy condition, being irregularly cleaned by contractors, who shirked their work. There was no general system for the removal of ashes and garbage, and these were thrown loosely upon the streets. In three quarters of the city, cellars were in foul condition, often flooded with water and undrained. At that time, incredible as it may seem to the modern New Yorker, few houses were connected with sewers. Offensive trades, such as the boiling of bones, offal, and fat, were carried on without hindrance. There were numerous cesspools and cisterns overflowing with filth. Much of the city’s milk was obtained from cows kept in dark, crowded, ill-ventilated stables and fed upon swill from distilleries. The animals were diseased, and the milk was unclean, unwholesome, and frequently was watered.
In alleyways and back yards great quantities of manure were allowed to accumulate. Farmers sometimes bought it and carted it off for fertilizing; but if no farmer happened to come along, the stuff stayed there indefinitely. Outhouses were neglected, and never were properly cared for by the scavengers, who worked for grafting contractors. The practice of keeping swine in the built-up portions of the city was common. The slaughterhouses were in horrible condition, and the offal from these could not be properly cared for because of defective sewers.
Tenement-house conditions were as bad as they have ever been anywhere. No space was left unoccupied. Sheds, basements, and even cellars were rented to families and lodgers. The vast numbers of immigrants pouring in, and the constricted space on Manhattan Island, made rents so high that even a corner in a cellar brought an exorbitant price. Single rooms were divided by partitions, and whole families occupied each section.
In 1866 it was estimated that 20,000 People were then living in cellars in New York. Ten years before that period many of the city houses had been shaky from quick building; after the war, figuratively speaking, they had fallen into the cellars. At that time New York could hardly claim distinction as a great city. Travelers referred to it as an overgrown village, into which had been shoveled slovenly hordes of European immigrants. The annual death-rate was thirty-four per thousand, while that of London was about twenty-three per thousand. And it must be remembered that New York’s new population was composed of vigorous men and women, the cream of other localities, with what should have been healthy offspring, who had quickly centered here, ambitious and active; whereas London was an ancient city, bearing the ills of its own age. It must be remembered also that at that time the medical profession knew little of bacteriology; antitoxins were unknown; people lived like ostriches, with their heads in the sand concerning questions of sex hygiene and child hygiene; and the science of sociology had yet to be discovered.
Cities had always existed, it is true, but they had to be constantly replenished by fresh blood from the country, and most of them had space to spread out into the country, and thus absorb naturally some of the health that comes from fresh air. But here was a city that had little chance to spread. It was confined to a narrow, rocky island, and was growing more rapidly than any other city in the history of the world. “Bounded on one side by a bluff and on the other side by a sound,” it was burrowing into the earth and climbing constantly into the air to make room for its fast-growing population. It was the center of the fiercest contest for money and power, yet it failed to hold long those who came there. The men that made money went to Europe to spend it, and those that fell in the fight went to the West to recuperate. Immigrants that arrived there with money went on to the West or the South; those without money stayed.
The result was that New York did not primarily become a city of residence, but the resort of those who either through the necessity of poverty or the necessity of ambition sojourned there. Of all American cities it became the most artificial; there life came to be lived at its highest tension; there the struggle for existence became fiercest.