PREPARATION OF THE CITY OF 
BROOKLYN FOR THE ANTICI- 
PATED EPIDEMIC OF CHOL- 
ERA IN 1884 AND 1885. 
By Joseph H. Raymond, M.D., 
Ex-Commisioner of Health. 
Reprinted from 
The Brooklyn Medical Journal, 
(Special Edition.) 
September io, 1892. 
New York: 
M. J. Rooney, Printer and Stationer, 
1329 Broadway. PREPARATION OF THE CITY OF BROOKLYN 
FOR THE ANTICIPATED EPIDEMIC OF 
CHOLERA IN 1884 AND 1885. 
BY JOSEPH H. RAYMOND, M.D., 
Ex-Commissioner of Health. 
In June, 1883, cholera was announced in Egypt, at Damietta 
on one of the mouths of the Nile and spread to other cities in 
Egypt. 
In the same month the disease appeared at Toulon, Mar- 
seilles and Paris in France and later in Italy. It is stated by 
Wendt that the epidemic cost France and Italy 40,000 or 50,000 
lives and many hundreds of millions of money. Later it pre- 
vailed in Spain, attacking thirty-three provinces. There were 
reported 273,549 cases of which 101,346 proved fatal. 
The widespread prevalence of cholera in Europe in 1883 
and 1884 and the history of previous epidemics alarmed the 
sanitarians of the United States and it was the general opinion 
that we could not escape a visitation. A conference of State 
and Municipal Boards of Health was called to meet in Wash- 
ington, D. C., December 10, 1884, to consider the subject of 
cholera with reference to its threatened appearance in the 
United States in 1885, and to adopt measures to prevent its 
entrance if possible ; or should these be unsuccessful, to reduce 
its ravages to a minimum. 
Health officers were requested to present reports stating 
what had been done in their respective localities to prepare 
for its probable advent. In accordance with this request the 
writer reported what had been done in Brooklyn and offered 
certain recommendations which embodied the principles on 
which the Brooklyn Department had acted, and it is flattering 
to Brooklyn to know that these recommendations were sub- 
sequently adopted by the Conference and promulgated as 
guides to all municipal authorities. 
In order that the history of the actual and threatened inva- 
sions of Brooklyn by cholera may be complete, President 
Emery has requested me to state what measures were taken 
by the Department of Health in Brooklyn in the years 1884 
and 1885. 
The principles which guided the department and which 
formed the recommendation referred to and the work which it 
djd are herewith submitted. 2 
JOSEPH H. RAYMOND, M.D. 
FIRST.- That all surface wells should be closed at the earliest 
possible moment; and that great care should be taken that the 
water supply of all cities, towns and villages shall be of un- 
doubted purity. 
For some time the efforts of the Department of Health had 
been directed to closing up the wells of the city which at the 
outset of the undertaking numbered three hundred and sixteen, 
varying in depth from fifteen to one hundred feet. An analy- 
sis of the water of these wells showed that of the whole num- 
ber but seventeen furnished water fit for consumption. These 
were, of course, liable at any time to become contaminated. 
As a result of these efforts all the wells, but one, were closed. 
As the water supply of Brooklyn came from the country 
at a distance of twenty miles from the city, and as there was 
danger of contamination from stables, slaughter houses and 
privies along the bank of the stream special inspection was 
made of these sources of danger, and the nuisance, wherever 
found, abated. 
SECOND.- That all privy vaults be abolished wherever 
water-closets can be supplied; and that zvherever the existence 
of such vaults is necessary that they should be rendered water- 
tight in such manner as to prevent saturation, not only of the 
ground surrounding them, but ajso of the materials of which 
they are built; and that the contents of such vaults should be 
kept constantly disinfected, and removed to a proper place at 
frequent intervals. 
A census of the privy vaults in Brooklyn was made in 
1878, showing that at that time there were 25,000 of these 
abominations within the city limits. Of this number 14,000 
were not water-tight, but were built of stones loosely placed 
together without cement. Thousands of these had been done 
away with during the interval between 1878 and 1884, and all 
that were in lots adjacent to sewers were under orders for 
their abolition. There were, however, 11,000 additional 
privies which were built of brick and in accordance with city 
ordinances. Experience had shown that these structures were 
intolerable nuisances, the human excrement accumulating and 
decomposing in them, giving off offensive odors and saturat- 
ing the porous brick of which they were composed. Nothing 
but the abolition of all privies would abate the nuisance, and 
an amendment to the ordinances was asked for to compel this 
in all cases where sewers existed and to require the substitu- 
tion of water-closets, and where there were no sewers, such 
vaults were to be filled after their contents had been disin- 
fected and removed, and new vaults constructed so as to 
minimize the danger as much as possible. Special police 
force was obtained to make repeated examinations of the 
existing vaults, the exact location of which by street and PREPARA TION OF BROOKL YN FOR EPIDEMIC OF CHOLERA. 
3 
number was known. The disinfecting officers of the Health 
Department attended to the disinfection of all vaults reported 
as offensive. The necessity for this work will be readily 
appreciated when it is stated that in the years 1884 and 1885 
notwithstanding the abolition of thousands of vaults, 586,202 
cubic feet of night soil were removed from the vaults of the 
city. 
The old-fashioned method of emptying privies had been 
prohibited and the so-called "odorless" was the only one 
permitted. The night soil was removed to farms and utilized 
as fertilizer, but arrangements were made by which, had 
cholera come, this would have been discontinued and the 
material would have been carried to sea in boats. This latter 
method of disposal was adopted in August, 1885. 
Third.- That all stagnant ponds should be disinfected, and 
when possible the water removed by drainage or ptimping, and 
the further accumulation prevented by filling with fresh earth or 
other material free from garbage or other filth. 
The epidemic of cholera which visited Brooklyn in 1866 
was especially marked in the 12th Ward. Dr. J. T. Conk- 
ling reported that in June, 1866, and the early part of July, 
cases simulating cholera occurred, but the first reported 
case happened July 8th. Its increase at first was not rapid 
and mostly confined to places where there was the greatest 
amount of filth, especially in the southwest 12th Ward, 
which had many depressed lots and ponds of foul, stagnant 
water. Some of the houses were built on piles in sunken 
places filled with garbage and other foul stuff. Of the 816 cases 
which occurred in the city, 288, or more than one-third 
occurred in that ward. To this part of the city attention was 
therefore naturally directed. This section is to a great ex- 
tent composed of filled-in ground, being originally covered 
by salt water, with marshes and islands interspersed. In its 
improvement streets were constructed in such manner as to 
leave between them ponds of water, which being stagnant, 
soon became offensive. During the season of 1884 and 1885, 
twenty-three of the ponds in this ward were drained and 
filled; in the whole city there were fifty-nine filled at an ex- 
pense of $35,108.85. The material employed for this filling 
was in every case fresh earth or clean ashes, no garbage or 
other decomposable matter being used in a single instance. 
FOURTH.- That great care should be exercised to keep at all 
times clear and free from obstruction all sewers into which 
passes the refuse from dwellings, factories and other buildings; 
and that such examinations should be made as will detect im- 
perfect plumbing in all buildings and the defects immediately 
corrected. 4 
JOSEPH H. RA YMOND, M.D. 
The efficient Superintendent of Sewers had thorough and re- 
peated examinations of the sewers made, and the plumbing 
inspectors of the Health Department were constantly on duty 
in the examination of dwellings and factories. 
During the two years the inspectors made 11,622 inspec- 
tions of the plumbing in old houses. 
The large sewer on Third Avenue, seven feet in diameter, 
which for so many years had been depositing its filth on the 
low land at the foot of Twenty-eighth Street was completed in 
the summer of 1885. To remove as much of this deposit as 
could be reached, a dredging machine was put to work and 
did valuable service. 
Fifth.- That extraordinary care should be exercised in 
reference to all tenement houses, lodging-houses, and in general 
all places where large numbers of human beings congregate; 
that no accumulation of garbage or other filth be permitted in 
cellars or yards; and that frequent and thorough cleaning and 
whitewashing of such structures be required; and that house- 
holders should frequently and thoroughly examine their yards, 
cellars, closets and other out of the way places, to see that no 
filth of any kind has been deposited there. 
As sailors coming to the city were liable to find their way 
first to the lodging-houses, special attention was directed to 
these. Nine of them with 532 beds existed in the city. These 
were thoroughly examined from cellar to attic, and when de- 
fects of plumbing, ventilation or overcrowding were found 
these were corrected. The disinfecting corps disinfected 
them thoroughly, and it was made a part of the inspectors' 
duties to visit them often. The proprietors were summoned 
to the Health Office and instructed as to the necessity of 
cleanliness and of prompt notification to the Health Officer of 
all cases of sickness. 
The frequency with which disease has been spread by 
rags made it important to have these under surveillance. 
A census showed that there were 279 places in which rags 
were stored. In order to have the necessary control over 
them, the following ordinance was passed. "Section 188. 
No person engaged in buying, selling or storing skins, hides, 
rags, bones or similar articles, or who has become possessed 
by purchase or otherwise of skins, hides, rags, bones or simi- 
lar articles, for the purpose of selling the same, shall store or 
keep any of said above mentioned articles within the limits of 
the city of Brooklyn without first obtaining a written permit 
so to do from the Commissioner of Health of said city, the 
terms and conditions of which permit shall be strictly com- 
plied with by the person obtaining the same." Of the 279 
places, 113 were permitted to continue, the others were 
ordered closed as being unfit places for the business. PREPARATION OF BROOKLYN FOR EPIDEMIC OF CHOLERA. 
5 
Sixth.- That the food supply he vigorously watched to ex- 
clude from the market all unwholesome meat; all milk adulter- 
ated or from diseased animals ; and all unripe fruits and vege- 
tables; and that cow stables be kept, at all times, clean, well 
whitewashed and free from all excremental accumulations. 
It is conceded that the food supply during the time of a 
cholera epidemic is an important agent in the predisposition 
of individuals to attacks of the disease, the liability of con- 
tracting it being greater when, for any cause the alimentary 
canal is in an abnormal condition. It is also known that the 
ability to withstand disease is greater in those who are well 
nourished than in those who are debilitated. My experience 
leads me to the opinion that a very much greater proportion of 
diseased animals is killed at slaughterhouses than is generally 
believed. No inspection of meat is complete unless it occur at 
the slaughter houses and before the viscera are removed. 
Many cases of tuberculosis were detected by the meat inspec- 
tors because they were able to examine the viscera at the 
slaughter houses which would never have been recognized had 
an examination of the carcasses alone been relied on. During 
the year 1884 and 1885, 436,669 animals were slaughtered in 
the city and the amount of meat condemned as unfit for food at 
slaughter houses and butcher shops was 169,956 pounds. 
During this period 139,470 quarts of milk were examined by 
the milk inspectors, of which 6,433 were either watered or 
skimmed. There were 5,593 inspections were made of cow 
stables. 
SEVENTH.- That all garbage, kitchen and household refuse 
should be promptly removed from dwellings, stores and other 
buildings to a proper place where it may be destroyed by fire or 
otherwise disposed of in such manner as to occasion no nuisance. 
EIGHTH.- That such material should never be used in the 
filling of lots or disposed of by throwing the same in streets or 
vacant property where it may decompose and exhale offensive 
and deleterious gases. 
Vacant lots have always proved a standing invitation to 
householders and others who have filth to dispose of. To 
keep such spots in an inoffensive condition a force of thirty-two 
men with eighteen carts was kept employed from May 15 to 
December I, 1885, in removing such filth wherever deposited, 
in streets, vacant lots or yards. Three thousand nine hundred 
and sixty-two loads of such material were removed by boat 
to sea. The cost of this service was $9,128.89. 
Ninth.- That in view of the practical results reported by 
that eminent sanitarian, Edwin Chadwick, F.sq., C. B., the 
authorities of all public institutions, and individuals as well, 
have their attention drawn to the great importance of the per- 6 
•JOSEPH II RA YMOND, M.D. 
sonal cleanliness of the persons committed to their charge, as one 
of the most efficient means of warding off an attack of cholera, 
and of reducing its force when once it has appeared. 
Sir Edwin stated at a meeting of the members of the Asso- 
ciation of Public Sanitary Inspectors that "Whilst much pre- 
ventive service rqay be effected by cleansing of places, very 
extensive prevention may be effected by active measures for 
the cleansing of persons. At the last epidemic visitation of 
cholera, which fell severely upon Limehouse, the children of 
the pauper half-time school there were distinguished by their 
entire exemption from any choleraic attack. The distinction 
was due to the careful head-to-foot washing with tepid water. 
The like distinction of immunity was presented in other half- 
time district schools in the metropolis. Indeed, we had ex- 
periences of its efficiency in ordinary times, which enables me 
to predict it as a factor of at least one-third in sanitation." 
He further says " That the most efficient preventives of chol- 
era are the effectual cleansing of places and of persons." 
The American Public Health Association at its meeting in 
St. Louis, October 1884, appointed a committee to examine 
the subject of disinfectants, antiseptics and germicides, in 
their relations to preventive medicine and sanitation, and di- 
rected them to formulate a table of these agents for the infor- 
mation of those interested, the agents to be classified, so far 
as may be deemed advisable, according to their specific vir- 
tues, facility of application and economy of use. This com- 
mittee began its work at once, and although its final report 
was not made until November, 1887, yet preliminary reports 
were made in December, 1884, and in 1885, at the request of 
the State boards of health. The recommendations therein 
contained were made the basis of the circulars of disinfection 
issued by most of the official bodies throughout the United 
States. The Brooklyn department thoroughly revised its 
methods in this respect, and issued the pamphlet entitled 
" Restriction and Prevention of Diphtheria, Scarlet Fever, 
Measles, Cholera and other Contagious or Infectious Diseases," 
which has been in use in the department since that time. 
I might also add that during the summer of 1885 the Health 
Office was kept open day and night for the reception of reports 
of suspicious cases, should any such occur. 
In reference to the provision of hospitals I will say that 
while such acommodations would doubtless have been neces- 
sary in case the disease had appeared, for there would be 
many who would be inmates of lodging or other houses where 
they could not be properly treated, still the removal of the sick 
should for their sakes be avoided as much as possible, and as 
recommended by the English College of Physicians, " Hospitals 
should be numerous rather than large, and so distributed as 
to make it unnecessary to convey to any great distance those PRE PA RA TION OF BROOKL YN FOR EPIDEMIC OF CHOLERA. 
7 
who are stricken with disease." Those stricken with pestilen- 
tial disease have rights as well as those who may escape, and 
it is an absurd contradiction for us to recommend that a 
patient should at once be placed on his back and kept abso- 
lutely quiet, and at the same time insist upon removing him to 
a hospital which may be at a considerable distance from his 
home. Such a practice unless there are grave reasons requir- 
ing it is, to say the least, inhuman. The transportation down 
flights of stairs and over rough pavements has undoubtedly 
caused death in many cases. So far as possible patients 
should be left at home, and the well removed, and the house 
regarded as an infected place to be kept constantly disin- 
fected. Of course this is an individual opinion, and the 
subject is one on which differences of opinion may well exist. 
On this point Sir Edwjn Chadwick says "that the fatality of 
pronounced attacks is aggravated by removal to large hos- 
pitals." 
The total amount of money expended by the Health De- 
partment in anticipation of cholera over and above the regular 
salaries and expenses was $56,735.83. 
I would not have it understood that the sanitary work here 
recited was confined to the years 1884 and 1885. While this 
is true of much of it, it is not true of it all. This report 
includes so much of the usual work of the department as in 
my judgment had a direct bearing on the preparation of the city 
and its inhabitants for the advent of cholera. None of it was 
work which should not be constantly done by a department 
of health, and I am inclined to believe that although it called 
for a greatly increased expenditure of money, yet that the 
results in the increased cleanliness of the city were so evident 
to the eye and so gratifying, that a department that should 
adopt such a course as it would pursue in times of threatened 
invasion of epidemic disease, as a part of its usual and ordi- 
nary routine, would be sustained by public opinion.