FIRST REPORT 
OF THE 
COMMITTEE ON PUBLIC HYGIENE 
OF THE 
AMERICAN MEDICAL ASSOCIATION. 
READ AT THE ANNUAL MEETING, HELD IN BOSTON, MAY, 1849, 
WITH AN APPENDIX, 
CONTAINING 
SKETCHES OF THE SANITARY CONDITION 
OF THE 
CITIES OF CONCORD, PORTLAND, NEW YORK, PHILADELPHIA, 
BOSTON, LOWELL, BALTIMORE, CHARLESTON, NEW 
ORLEANS, LOUISVILLE, AND CINCINNATI. 
Extracted from the Transactions of the American Medical Association, Vol. II. 
PHILADELPHIA: 
T. K. AND P. Gr. COLLINS, PRINTERS. 
1849. H. 
FIRST REPORT OF THE COMMITTEE ON PUBLIC HY- 
GIENE OF THE AMERICAN MEDICAL ASSOCIATION. 
The Committee on Public Hygiene, would respectfully report:— 
That immediately upon their organization, its members determined 
to devote themselves to specific hygienic inquiries, connected with 
their various residences, in order that they might be embodied in 
one collection, and thus furnish authentic data for future research 
on the highly important subject about to occupy their attention. 
In order to obtain greater definiteness, the chairman of the commit- 
tee was directed to indicate to each member such subjects as it was 
thought most advisable to elucidate at this time, and likewise, to 
prepare a series of questions for distribution. This course became 
absolutely necessary, from the peculiarity of the information sought 
by the committee, which differed materially from that required by 
any other committee of the Association. To them, the vast field of 
medical literature was open, and it became their duty to gather 
valuable materials from this abundant harvest. The facts required 
by the Committee on Hygiene, on the contrary, were as yet, for the 
most part, unrecorded; books were silent on the subject; and the 
data which they sought to possess themselves of, were to flow from 
careful personal observations. How far the committee has suc- 
ceeded in answering the ends for which it was created, and in placing 
on record these new contributions to science, it leaves for the Asso- 
ciation to determine. 
The principal inquiries of the committee have been directed to 
the effect produced on the inhabitants by residence in large towns, 
the results of which are to be found embodied in the several accom- 
panying reports of its members. In all towns, however, whether 
large or small, which fell under the observation of the members of the 
oommittee, certain causes were invariably found to be in operation, 
to a greater or less extent, tending to the destruction of human life, 
and producing a greater mortality than in the adjacent country dis- 432 
trict. Among these, deficient drainage, street cleaning, supply of 
water, and ventilation; together with improperly constructed houses, 
and the various kinds of nuisances incident to populous places, occupy 
prominent positions. 
DRAINAGE. 
One of the most important duties devolving upon the authorities 
of populous towns, is to devise means of effectually getting rid of the 
filth, which necessarily and rapidly accumulates, in and about the 
dwellings of its inhabitants; and for this purpose sewers unquestion- 
ably present the most efficient means at their disposal. The com- 
mittee would here remark, that nothing is more detrimental to pub- 
lic health than the error, not unfrequently entertained by municipal 
authorities, that, where the surface drainage is good, it supersedes 
the necessity for under-ground drainage* The main purpose of sur- 
face drainage, is to remove moisture, and not refuse animal and vege- 
table matter, for which purpose scavenging and sewers are required. 
Sewers bear an intimate relation to the streets of a city under which 
they are usually built, and receive from the houses along their sides, 
by branch drains, not only the Water that collects within them, and 
would otherwise become stagnant, but likewise those unhealthy ema- 
nations, and refuse materials, which, if not thus disposed of, wmuld 
inevitably become sources of disease. They are subterranean canals, 
traversed by water, holding various unhealthy substances in solu- 
tion, and possess an atmosphere peculiar to themselves: usually 
highly charged with ammoniacal and sulphuretted hydrogen gases. 
When properly constructed, they are among the most efficient agents 
within our reach for promoting health, but when improperly built 
or neglected, they are in the highest degree insalubrious. It is 
not alone necessary, therefore, that subterranean passages should be 
built, to carry off the refuse matter of a populous place, in order to 
insure its healthiness, but that they should be constructed in such a 
manner, as to perform their duty efficiently at first, and afterwards 
be constantly kept under the watchful vigilance of proper officers. 
To answer this end, a system of sewerage must be adopted, which 
will collect the water that falls in the form of rain, and that derived 
from springs, from the entire area of the towTn, to be drained; for, 
it is by means of the flow of water, that the sewers are enabled 
to carry off the decomposing materials, which find their way into 
them. It need hardly be said that educated engineers are the only 433 
persons competent to direct the execution of these important works. 
If uniformity be observed in the inclinations given to the entire 
drained district, but a very slight current is required to prevent the 
accumulation of deposits within the sewers; more especially if, as is 
generally the case in sewers, many small currents unite to form a 
larger one; because the united currents obtain a greater impe- 
tuosity over the same inclination, and sweep away the deposits with 
greater certainty than where they flow through separate channels. 
The deposits will be much more efficiently removed if the flow of 
water be over an inverted arch, than a flat bottom. It is highly im- 
portant to prevent the formation of a deposit in the bottom of a 
sewer; when this does occur, it very soon becomes hardened to such 
a degree as to exclude the hope of its removal without extraordinary 
means. The dam thus made aids in the collection of fresh accu- 
mulations of those matters, which seek the most depending part of the 
current until not only the sewer in which the stoppage occurs, but 
those leading into it, are loaded with offensive accumulations, or en- 
tirely choked up. This difficulty is much more likely to occur in a 
flat-bottomed sewer, where the force of the current is diffused, than 
in one with an inverted arch, where its power is concentrated. Pri- 
vate drains from houses are often constructed of brick with little 
mortar at their bottom, in order to allow the water of the soil around 
them to penetrate their interior. In drains of this sort, the water is 
as likely to flow out as in; and, consequently, however well they 
may be built in other respects, it is impossible to maintain a current 
through them. The solid matters soon accumulate, and in a short time 
they become choked up. The committee are desirous of calling the 
attention of the Association to the necessity of maintaining currents 
of water within sewers, because they are of the impression that the 
entire filth of a town, under an extended system of sewerage, is de- 
pendent upon an adequate supply of water for its removal; and that, 
whenever this supply is deficient, accumulations must necessarily 
occur within the sewers. 
Upon no subject within their jurisdiction have the municipal 
authorities of our populous places differed more widely from each 
other than in their plans of drainage; as well in the character of 
the wrorks constructed by them as in their extent. The aggregate 
sewerage in Boston is about twenty-five miles; in Philadelphia, 
about eleven and three-fourths miles; while in Baltimore, it is 
but little more than one mile. New Orleans, which is remarkably 
situated, fifteen feet below the Mississippi river, is entirely de- 
vol. ii.—28 434 
pendent upon surface drainage, as well as Louisville, Cincinnati, 
and indeed most of the towns of the United States. The bills of 
mortality of these different places, have not heretofore been kept 
in such a manner as to enable comparisons to be made between 
sewered districts and those which are without them. Could such 
results be obtained, the committee are well assured that they would 
present' such facts, in relation to the high mortality of non-sewered 
districts, as would startle the legislators of our cities from their 
slumbers, and induce the rapid extension of these works to every 
portion of their respective towns. It is to be hoped that the day is 
not far distant, when a town without sewerage will be unknown in 
the United States. 
STREET CLEANSING. 
It is of the first importance to a city, that its streets should be 
laid out in such a manner, and paved with such materials, as to 
facilitate the discharge of its surface water; and this becomes the 
more imperious, where surface drainage is the only one in use. It 
is well known, that more malarial disease prevails in the suburbs of 
a town than in the town itself, or the adjacent country. This is 
doubtless due in a great measure to the innumerable pools of wTater, 
which a defectively drained surface allows to accumulate. The 
pavement for streets in almost general use in the United States, is 
laid with round paving stones, usually found in abundance in their 
immediate vicinity. Although this pavement is greatly inferior to 
cubical blocks of granite, yet, under the improved system of laying 
the stones now in use, it furnishes an excellent substitute for them. 
The necessity for the removal of the refuse which is constantly 
accumulating in streets is so obvious, and so generally admitted, 
that no argument appears to be necessary to establish its claim to 
public favour. But while the authorities of every town in the United 
States, however inconsiderable its size, profess to rank this among 
their most important duties; but few places can boast of a thorough 
and efficient system of scavenging. The facts developed by the 
special reports of the members of the committee, show that, in our 
largest cities, the principal streets are not cleaned oftener than twice 
each week, and frequently but once. The smaller streets, although 
frequently inhabited by a denser population, are seldom visited by 
the street cleaners oftener than once or twice a month; and the 
courts are seldom or never cleaned, except when reported as nui- 435 
sances. The mode of cleansing is likewise exceedingly superficial, 
and consists in removing the loose particles upon the surface. For 
the want of proper economy in the disposition of the street manure, 
this defective system is kept up at a considerable expense; and all 
arguments in favour of the introduction of a more efficient one, are 
met by the disinclination to increase this already heavy tax. Now, 
in those cities in Europe, where great attention is paid to cleaning 
the streets, experience has demonstrated that the more effectual its 
scavenging, the less is the city charged with its expense. Edin- 
burgh, whose streets, including the narrow alleys and courts, are 
thoroughly swept daily, is made to bear but a trifling portion of the 
expense. 
In most towns, laws are enacted to prevent the inhabitants 
from depositing the refuse from their houses in the streets; but 
where no other means is offered to them to get rid of the offal, 
it must eventually find its way into them. This offal consists of 
decaying vegetable and animal matter, wdiich, under the influence 
of exposure to the sun, is constantly sending forth, to unite with air 
breathed by the inhabitants, the most deleterious gases, which are 
not only offensive to the smell, but prejudicial to health. Of all the 
causes of disease in cities, there is none more extensive in its opera- 
tions, or more fatal in its results, than the poisonous emanations 
arising from the decomposing refuse of articles used as food, and 
employed in the arts, which collect in large quantities, not only in 
the streets, but within the very habitations of the inhabitants of 
populous places. 
Here are sources of disease clearly indicated, which are in opera- 
tion in all of our towns, affecting the health and physical condition 
of their entire populations, but wasting their greatest fury upon the 
labouring classes, who are doomed to make their abode in the most 
unhealthy quarters. Much has been said in favour of disinfect- 
ants, and great reliance is placed on them in the prevention of epi- 
demics, but there is no disinfectant for filth except its removal. So 
long as badly drained and filthy quarters are permitted to exist in 
a city, so long will it be scourged by fevers, and liable to the inva- 
sions of epidemics. The fuel is always ready gathered, and it requires 
but the application of the torch to set the fabric into a blaze. Me- 
dical men who are conversant with a city, can, with unerring cer- 
tainty, point out the localities of fever, by their uncleanliness; and 
it is a fact, established by the history of every epidemic, including 
the late visitation of the cholera, that it usually makes its appear- 436 
ance, and commits its greatest ravages, in those uncleanly quarters, 
which are notoriously the permanent abodes of fever. In order to 
prevent this decomposition, the streets should be swept daily, includ- 
ing the narrow alleys and courts, which, indeed, demand greater 
attention than the more open thoroughfares; in addition to which, 
every facility should be offered to the inhabitants to get rid of the 
collections of the kitchen. Where none of these measures are taken, 
and where, in addition to the close, offensive air generated by the 
street collections, it is still further tainted by pig pens, overrunning 
privies, and stagnant water, it is scarcely a matter of surprise, that 
disease should be ever present, producing the degree of mortality 
revealed by our reports of interments. 
WATER. 
Pure water, like pure air, is so essential a requisite, that its 
presence is absolutely necessary to preserve human life. Indeed, 
its influence over the human organization is even greater than that 
of the atmosphere; for it has been abundantly proved, by too many 
examples, in our large cities, that life is enabled to maintain itself, 
while surrounded by a noxious and deleterious atmosphere; but it 
has yet to be shown that the same poisonous properties can be in- 
fused into water without immediately inducing serious disease. 
But it is not only necessary that its quality should be good, but 
that its supply should be abundant in cities; where it is required for 
numberless purposes, other than an aliment; which could not be dis- 
pensed with, without great detriment to the comfort and morality 
of their inhabitants; among which may be enumerated domestic pur_ 
poses, baths, washing streets, cleaning sewers, manufactories, and 
extinguishing fires. 
Waiving the subject of an abundant supply of water for domestic 
purposes, as a question too self-evident to be discussed, the com- 
mittee would call attention to the remarks already advanced in re- 
lation to sewers, and again urge the necessity for active currents of 
water through them, in order to avoid deposits. It must be con- 
stantly kept in mind that an absolute prerequisite for effectual 
drainage, both for the surface and sewers, is a copious supply of 
water, without which the best arranged structures would fail to 
effect this object. 
Whenever the quantity of water furnished to a town is deficient, 
the heaviest burden of the evil must, from necessity, fall upon the 437 
poor. If there are any parts of a town which possess an unenviable 
reputation on account of bad drainage, consequent accumulations of 
filth, and excessive disease, they are invariably inhabited by the 
poor. The result of much observation on this subject has convinced 
the committee, that many of the evils, and much of the disease 
incident to poverty, may be relieved by copious and never-failing 
supplies of pure water. It would be a great mistake to imagine 
that the poor are incapable of estimating the advantages of pure 
water, or would not avail themselves of it. The experience of New 
York and Philadelphia, which are more abundantly supplied with 
water than any of the other cities in the United States, has estab- 
lished this point beyond controversy. The introduction of an 
abundant supply of water is so intimately connected with the health 
of a city, that the municipal authorities should rank this among the 
most important of their public duties. In connection with this mat- 
ter, the committee are deeply impressed with the importance of con- 
fining the execution and management of such great works, as a 
supply of water, gas, and drainage, to the city authorities. The 
public welfare is too deeply interested in their faithful performance, 
safely to permit them to pass into the hands of incorporated com- 
panies; who, however high-minded they may be, look to them as 
sources of revenue, and not as objects of public good. 
BUILDING AND VENTILATION. 
The lungs of each individual are constantly penetrated by an 
atmosphere which momentarily exercises a healthy or unhealthy in- 
fluence over the entire organization. The object of respiration, 
which is constant, is to introduce into the lungs, with a certain 
degree of force, a large quantity of air, which loses a portion of its 
oxygen, and receives in return a certain amount of carbonic acid gas. 
Now, when a large number of persons occupy an apartment the air 
of which undergoes but little change, the simple act of respiration 
converts the healthy into an unhealthy atmosphere. But it is not 
the change induced by respiration alone which vitiates the atmos- 
phere. The body is always giving off other emanations, in the form 
of insensible perspiration and animal heat, whose effect on the air is 
Strikingly prejudicial. 
The insalubrity of the atmosphere of populous places, is dependent, 
however, upon much more powerful causes of vitiation, than those 
induced by respiration alone. Organic substances in a state of 438 
putrefaction, offensive odours from pig-sties, and uncovered inlets to 
sewers, humidity, and such an arrangement of the buildings as to 
prevent a change, of air, and effectually cut off ventilation, are here 
the powerful promoters of its impurity. Those parts of a town, 
therefore, which are built up with innumerable courts and tortuous 
or narrow alleys, are permanent abodes of infection, and are con- 
stantly giving forth those noxious emanations, which not only poison 
the atmosphere in their immediate vicinity, but extend to a consider- 
able distance into the better built and ventilated parts of the town. 
These emanations are the cause of much of the disease which is inci- 
dent to poverty. Their immediate action is to induce febrile and 
asthenic affections; hence consumption, scrofula, and rheumatic and 
gastric affections, are their constant attendants. 
If evils of such great magnitude are the necessary consequence 
of inattention to ventilation and building, it becomes one of the 
highest duties of city authorities to regulate the erection of houses 
with an eye to their prevention. Streets should be of a certain 
width, proportioned to the height of the houses, and always laid out 
at right angles, or at least so as to secure a free circulation of air 
through them. If the streets are narrow and the houses high, they 
will be damp, and, if too wide, liable to inconvenience from the heat 
of the sun. The houses upon their sides should be regulated so as 
to prevent an over crowding of population, which is very likely to 
occur where the proximity to business renders the ground valuable. 
The ventilation of public schools is a subject of much importance, 
which is usually neglected, and which earnestly addresses itself to 
those having charge of them. For various facts connected with this 
subject, the committee would refer to special reports of its members. 
The necessity for public squares, tastefully ornamented and 
planted with trees, cannot be too strongly urged upon public atten- 
tion, as one of the most powerful correctives to a vitiated air within 
the reach of the inhabitants of a populous place. 
NUISANCES. 
Those nuisances which owe their origin to the subjects before enu- 
merated, and which may be summed up in defective draining and 
cleaning, are unquestionably the most extensive in their operation; 
but there are others more confined in their character, and less pal- 
pable in their effects, which yet require a brief consideration. These 
consist in the various kinds of manufactories, butcheries, and public 439 
works, incident to towns, and almost always found in their midst. 
These may, by the discharge of noxious and acrid gases, be directly 
prejudicial to health ; or, from the evolution of large quantities of 
black smoke and unpleasant odours discommode, without exercising 
a direct influence in the production of disease; hence, it has been 
customary to rank them in different classes, dependent upon their 
deleterious action. 
Those establishments which are found to be most unhealthy, are 
the manufactories of the different kinds of powerful acids, as nitric, 
sulphuric, and hydrochloric. But a slight remove from these, are the 
manufactories of brass, chemicals, compounds of lead, and copper 
smelting works. All of these operate by loading the air with ema- 
nations eminently prejudicial to health, and not unfrequently to 
vegetation. In order to render them innoxious, chimneys of great 
height have often been erected, but without materially lessening 
their deleterious effects on the inhabitants surrounding them. 
Next to these, stand gas works, butcheries, soap and candle fac- 
tories, dyeing establishments, manufactories of the sulphates of zinc 
and iron, phosphorus, friction matches, and an innumerable number 
of others; some of which are injurious on account of the unhealthy 
gases they emit, while others are rather sources of discomfort than 
of immediate disease. Great diversity of opinion exists concerning 
the unhealthiness of gas works. It is admitted that, in the manu- 
facture of gas, as well as in the refuse material left after its produc- 
tion, large quantities of sulphuretted hydrogen, and ammoniacal gases, 
are given off to the surrounding atmosphere, which are known to be 
eminent sources of disease. The theory has of late been agitated, 
and very ably advocated by Professor Gardner, of Ilampden-Sydney 
College, that sulphuretted hydrogen gas is the cause of autumnal 
fever. It is no argument in favour of the healthiness of a manu- 
factory, that the workmen enjoy an immunity from its evil conse- 
quences ; because the fact is well established, that the human body 
can become accustomed to the effects of the most deleterious agen- 
cies, without apparent injury. The question is not whether the 
workmen immediately engaged are affected or not, but what are the 
causes of the high rates of mortality, which the large cities of the 
United States, in common with those of the rest of the world, ex- 
hibit. If the neighbourhood of manufactories are found to be more 
unhealthy than other places, it becomes the duty of every municipal 
body to interdict them in populous parts of the town, and this fur- 
nishes a very strong argument in favour of the corporate authority 440 
of a city immediately furnishing to its inhabitants a supply of gas, 
without the intervention of an incorporated company. The com- 
mittee would earnestly urge the establishment of one general butch- 
ery, at a convenient distance from each town, as one of the most 
important sanitary measures it can adopt; 
DISINFECTANTS. 
Great reliance is placed by corporate authorities on the preventive 
power of certain substances to arrest the spread of diseases, which 
are now known to be more or less intimately connected with the 
presence of nuisances ; hence, on the appearance of an epidemic, it is 
customary for them to recommend the free use of a class of agents 
termed disinfectants, as chloride of lime, fumes of nitrous acid, &c. 
The facts in our possession, in relation to the value of disinfectants, 
are exceedingly vague and unsatisfactory, and by no means warrant 
the reliance placed in them, over evils of such vast extent as the 
impurities of a populous place. The great source of infection is 
'putrefaction; by preventing putrefaction, we are enabled to arrest 
infection; but no agent has yet been discovered sufficiently general 
in its operations to reach the putrefactive process eliminated from 
the numberless sources ever present in towns. Air, heat, and water, 
which are necessary to produce putrefaction, are nevertheless, in the 
laboratory of nature, the principal agents she employs as disin- 
fectants. Chemical agents, on which most reliance is placed, are con- 
fined in their efficacy to a very small extent of surface, and are very 
uncertain in their operations. It is obvious that, in order to reach 
an evil, we must ascertain something of its nature. Now, in what 
consists the infection of typhus or yellow fever, or cholera ? Is it 
a gas? If so, why does it confine itself to a particular locality of 
very limited extent, frequently being intercepted by a very narrow 
street? and if not a gaseous product, which is the generally re- 
ceived opinion, where is the evidence of its assuming any other form ? 
But although disinfectants are not capable of arresting epidemic 
diseases, they are not altogether useless; confined within proper 
limits, their use is highly advantageous, not only in destroying fetid 
odours, but in some degree in restoring purity to the air. Their 
operation is necessarily confined, and their advantages consequently 
limited. The wards of hospitals, dwelling-houses, and privies, may 
derive advantage from #their use, but surely no one would be 
visionary enough to think of disinfecting the unwholesome atmo- 441 
sphere of a populous city, by means of any chemical agency, how- 
ever extensive, within his reach. 
Among the various substances of this class which have of late 
obtained considerable celebrity, the solutions of chloride of zinc and 
nitrate of lead occupy a prominent position. A solution of the 
nitrate of lead, known as Ledoyen’s disinfecting fluid, to be found 
in most of our towns, has probably a higher reputation than any 
other in use at this moment, although other combinations of nitric 
acid, as those with zinc and wood fibre, are advocated as possessing 
peculiar merits. The principal advantage of Ledoyen’s fluid over 
others, is its power of removing an offensive smell, without substi- 
tuting another in its stead. The committee, however, have not 
learned of any case in which the application of any agent of this 
class has done more than to arrest putrefaction temporarily. So 
long as the cause exists, so long will disease be generated; and while 
the committee do not hesitate to recommend the use of disinfectants, 
they would at the same time caution the public authorities and in- 
habitants of populous towns against placing reliance on them to the 
exclusion of the strictest measures for removing the sources of dis- 
ease, which are found to reside in uncleanliness, and impurity of 
the atmosphere. If they usurp the place of these sanitary measures, 
which can alone render a town salubrious, so far from being advan- 
tageous their use will be eminently injurious. 
CONCLUDING REMARKS. 
With these general observations your committee will introduce the 
special reports from individual members, embracing an account of 
the sanitary condition of the cities of Portland, Concord, Boston, 
Lowell, New York, Philadelphia, Baltimore, Charleston, New Or- 
leans, and Louisville, so far as it may be developed by answers to 
the questions propounded in the circular issued by them. 
They are aware, however, that the investigation into this interest- 
ing and almost unexplored region of medical inquiry, has but just 
commenced; and that their labours have accomplished little more 
than to open the way for its farther, and, as they hope, more suc- 
cessful prosecution. The subject they conceive to be one eminently 
congenial with the purposes of the Association, inasmuch as it has 
for its object the preservation of human life, and the removal of 
those causes of disease and death which it is in the power of legisla- 
tion to eradicate, and to which the public mind must be directed by 
vol. ii.—29 442 
those medical bodies, whose philanthropic and honourable duty it is 
to preside like sentinels over the avenues by which human misery is 
admitted, and warn those whose scope of vision is less extended, of 
the approach of the evil, before it is too late to avoid it. 
That the efforts of physicians, when directed to such objects, are 
not always abortive, is shown from the events which are now oc- 
curring around us. During the deliberations of this Association, 
the Commonwealth, in whose capital we are assembled, has mani- 
fested a regard for her citizens, and for the voice of her medical men, 
which is worthy of the imitation of her sister States, by the passage 
of a law for a sanitary survey of the State; and has thus obtained 
the high distinction of being the first State in the Union, to direct 
her legislation to a source so intimately connected with the welfare 
and happiness of mankind. 
JAMES WYNNE, 
ISAAC PARRISH, 
L. P. YANDELL, 
J. P. HARRISON, 
E. H. BARTON, 
P. C. GAILLARD, 
JOSIAH CURTIS, 
JOHN H. ORIS COM, 
ALBERT SMITH, 
CHARLES P. GAGE, 
E. D. FENNER, 
JOHN M. THOMAS. H.—1. 
American Medical Association, Committee on Public Hygiene. 
At the Annual Convention of the American Medical Association, 
held in Baltimore, in May, 1848, the following gentlemen were ap- 
pointed a Committee on Public Hygiene:— 
Drs. James Wynne, Baltimore, 
Charles P. Gage, Concord, N. H., 
John M. Thomas, Washington, B. C. 
Isaac Parrish, Philadelphia, 
P. C. Gaillard, Charleston, S. C., 
L. P. Yandell, Louisville, Ky., 
J. P. Harrison, Cincinnati, Ohio, 
Albert Smith. Peterborough, N. H., 
Josiah Curtis, Lowell, Mass., 
Edward H. Barton, New Orleans, 
John H. Griscom, New York, 
E. D. Fenner, New Orleans. 
It is the purpose of this committee to make a sanitary report, 
embracing the principal cities in the United States; and with a view 
of facilitating their inquiries, you will greatly oblige by furnishing 
the member of the committee who requests the information of you, 
with answers to the following questions :— 
1. What is the population of the town, and its position in relation 
to the surrounding country; what the geological formation of the 
country, the nature of its surface and subsoil, and the means of, or 
impediments to drainage, more especially within the town limits ? 
2. What is the character of the town in reference to health ? What 
is the condition of its most unhealthy and crowded parts, where 
disease is supposed to be most prevalent; and to what causes are 
such diseases mainly attributable ? 
3. What are the arrangements for drainage ? Is there a public 
survey of levels ? Are the streets and alleys paved and laid out with. 444 
a proper inclination for surface drainage; or are they defective in 
these particulars ? Is the drainage effected by sewers or surface 
drainage, and is the mode adopted effective ? 
4. What is the mode and expense of cleansing the streets ? Are 
the courts and alleys occupied by the poor cleaned, and how often? 
Where is the refuse from the houses deposited; and where is the 
street manure kept, and how disposed of? 
5. What is the condition of the more densely populated parts of 
the town in respect to ventilation ? Are the streets wide or narrow ? 
Are courts and alleys built up, and closed at the end, and what is 
the character of the houses of the poor ? What number of families 
occupy one house; how many persons live in one room, and what 
provision for ventilation ? How are the houses warmed in winter ? 
6. What is the system of public schools, and its influence on 
health ? At what ages are children received into them ? What is 
the size of room, the number of occupants, time allotted to instruc- 
tion, means afforded for exercise in the open air, and length of sum- 
mer vacation ? 
7. What hospitals and dispensaries ? How are the public build- 
ings ventilated, as churches, &c.; and what provision for public 
grounds or squares ? 
8. From what source is the town supplied with water ? What are 
its qualities, and is it abundant ? 
9. Are the municipal regulations on the above subjects effective 
or not ? 
By order of the committee. 
JAMES WYNNE, Chairman. 
Baltimore, May, 1848. H.—2 
Sanitary Report of Concord, N. H. By Charles P. Gage, M.D. 
1. Concord, the capital of New Hampshire, with a population 
of eight thousand, and an area of forty thousand acres, lies on both 
sides of the Merrimack River, in N. lat. 43° 12' 29", and W. Ion. 
71° 29', forty miles inland from Portsmouth, and seventy N. N. W. 
from Boston, Mass. By railroad, it communicates with the chief 
seaboard towns in New England, and, with a rich and extensive 
agricultural interior, abounding in mineral and manufacturing re- 
sources. 
The country may be considered as divided into three parts: 1. 
The rich river alluvion, one mile in width, and extending from north 
to south eight miles, dividing the town into two nearly equal parts. 
2. The diluvial deposit of granitic sand, forming level plains, wooded 
with low pines, and comprising nearly one-third of the area of the 
town. On this portion, there are but few inhabitants. 3. The oak 
land or hilly portion, rising into numerous swells of rich land, occu- 
pied by a temperate, industrious, and independent yeomanry. 
Its geological formation is granite, covered with a diluvial detritus 
of granitic sand, in depth varying from ten to one hundred feet, 
through which a white, fine-grained granite shows itself, forming, 
in some localities, low ridges, in others, hills of considerable eleva- 
tion. Granite Hill, one hundred feet in height and three miles in 
circumference, is a solid mass of as pure granite as can be found on 
the globe. 
The soil on the river is a rich alluvium; on the plains it is a thin, 
gravelly loam, with a subsoil of sand. On the upland, the soil is a 
yellow loam, with a hard, gravelly subsoil. 
2. The village extends a distance of two miles along the river, 
and is about one mile in width. Good natural facilities for drain- 
age are afforded to nearly every part of the town, the highest point 
being one hundred and forty feet above the intervale. On the 
southwest margin of the town is a wet hollow, fed by springs, which 446 
may be kept dry by proper drains. There has been no public sur- 
vey of levels; consequently, regard has not been had, in all in- 
stances, to proper inclination for surface drainage. The streets are 
not paved. There are no alleys. Drainage is effected partly by 
sewers, but mostly by surface drains, and is tolerably effective. 
The streets are very wide and straight, crossing each other at right 
angles, affording good ventilation. 
3. The streets are cleansed at the expense of the persons living 
on them, and by the farmers in the vicinity. The refuse from the 
houses is generally deposited on the gardens, one being connected 
with almost every house. 
There is, in a thickly settled part of the town, a slaughter-house, 
the stench from which, in summer, is so intolerable, as to compel 
the inhabitants in the neighborhood to keep their doors and windows 
closed for weeks together. It is now under indictment as a nui- 
sance. 
4. An abundant supply of good water is obtained from wells and 
springs in the town, and its immediate vicinity. 
5. The houses are mostly of wood, two stories high, and designed 
for one family only. The houses are warmed by close stoves. The 
sleeping rooms are, as a general thing, too small. The public build- 
ings, as well as private dwellings, are deficient in means of ventilation 
—doors and windows being the only arrangement for that purpose. 
The town is well provided with public squares. 
6. Children are admitted into schools at four years of age. The 
sexes are never separated. In most districts, all are taught in the 
same room, by a single teacher. The rooms are about twenty-five 
feet by thirty feet, and nine feet high, with an average of thirty 
scholars in winter, and twenty-five in summer, in each. In the vil- 
lage, the school-rooms are larger, and more crowded. In one in- 
stance, a room 45 x 56 x 11 feet, has seats for one hundred and 
eighty scholars, and sometimes they are all filled. In no instance 
is there any other mode of ventilation than the imperfect one of 
doors and windows. The scholars are taught in three different de- 
partments—reading and spelling in the first; reading, writing, arith- 
metic, and geography in the second; and all the higher English 
branches in the third. 
During each of the secular days in the week, the school is taught 
three hours each forenoon, and three on each of the afternoons, ex- 
cept those of Wednesday and Saturday. The children have ample 
means for exercise in the open air. The summer vacation is from 447 
two to three weeks. The system is as little injurious as any, where 
the children are admitted so young, and where so little attention is 
paid to ventilation. 
7. The town may he considered one of the healthiest in New 
England. By reference to Table I., it will be seen that, for the last 
ten years, the proportion of deaths has ranged from 1 in 101, to 1 
in 50 of the whole population, and that the average of age is 29.71 
years. It will be seen, too, that more than one-third of all the 
deaths are of children under ten years of age. This may be ac- 
counted for, in part, perhaps, by the fact that many mothers are 
obliged to wean their children very early, sometimes within the 
month, on account of a sore mouth peculiar to nursing women. 
The poor are well housed, and supplied with the actual neces- 
saries of life; through the charitable societies, they are in sickness 
well cared for, and supplied with many little conveniences and 
luxuries. 
There is an asylum for the insane, and also an almshouse. There 
is no dispensary but the one connected with the State prison. 
The effect of confinement and discipline in the N. H. State pri- 
son is salutary, partly from the compulsory abandonment of irregu- 
lar and intemperate habits, and partly from the forced observance 
of strict hygienic rules. The inmates suffer from all prevailing dis- 
eases equally with the people in town, but all affections are more 
under the control of the physician, and treated with better success, 
on account of the habits of the patient, and his perfect submission. 
Masturbation is the prisoner’s besetting sin, and often produces 
death. 
Each prisoner eats and sleeps in a cell by himself. Each cell is 
constructed for one man only, with a grate in the upper part of the 
door to admit the fresh air, and an opening in the wall opposite, 
communicating with a flue leading to the outer air. This mode of 
ventilation is very defective, especially in summer, when the pri- 
soners are kept in the cells from sunset until sunrise. It is regard- 
ed by them as their greatest punishment. The prisoners work in 
the large yard connected with the prison, or in large, well venti- 
lated shops, from fifteen to thirty in each room. 
The fact that the rate of mortality for thirty-six years, is only 1 
to 79.21 of the whole number, shows that the prisoner enjoys an 
advantage over his more fortunate brethren without. 
“ What is the influence likely to be produced by the extensive 
introduction of tea and coffee into the diet of persons under the age 
of puberty ?” 448 
Injurious; causing undue excitement of the vascular and nervous 
systems, and functional derangement of the digestive organs, par- 
ticularly the liver. Tea acts more directly on the nervous system 
than coffee, partly, because almost all the tea in the market is poi- 
soned by deleterious agents used in its preparation. Coffee has an 
almost immediate injurious effect on the liver; and, as that organ 
in the child is relatively larger than in the adult, it may be held 
that, the younger the child, the more pernicious the use of the arti- 
cle. Both tea and coffee tend to enervate and derange the whole 
system, and to produce an effeminate race. 
“What is the influence of the substitution of the luxuries, tea and 
coffee, as a food, upon the health of the labouring classses?” 
Injurious. They act as slow poisons. The effect is more per- 
ceptible, and more easily traced to the cause, than in the fashion- 
able devotee, for its consequences are not modified by other delete- 
rious agents and practices. 
Table II. is a meteorological table kept by Abial Chandler, Esq., 
of Concord, and has been prepared with great care. 
TABLE I. 
Showing the number of deaths, ages, fc., in the town of Concord, 
N. II., for nine successive gears, as drawn from records kept by 
Rev. Nathaniel Bouton, pastor of the First Church, in said town. 
Mr. Bouton has kept a record of deaths annually, in Concord, for 
the last 24 years; from which a table may be constructed showing 
the number who have deceased, time of death, age, proportion to 
the population, consumptives, inebriates, and those who have died 
by casualties. 
Total 
00 GO GO OO GO GO GO CO GO GO 
00^}050i^Wt3MOCD 
Years. 
•-» i-» H- 
Wm CO 
Under 1 year. 
184 
COtOWOiOtOOGOMQO 
Between 1 and 
10. 
62 
MOOCOCOClOiCOCOW 
10 and 20. 
104 
c«o-vio^o^<ja>cD<i 
20 and 30. 
79 
tDOoSoffl&J 
30 and 40 
58 
-JO<35-4b3Cn~Ji^.OlCH 
40 and 50. 
62 
WOCO^GOGOOlCJOOM 
50 and 60. 
60 
60 and 70. 
83 
COWWOOOr-^OinCO 
70 and 80. 
CO 
GO 
CJxOiCOC^tOKJtOOi^CO 
80 and 90. 
OW-WWOOHOCO 
90 and 100. 
CO 
— h-OOOOOOO — 
Over 100. 
917 
H-‘tOK>CD*-GOO'<-5<lC} 
COCOOCOWCOM w WOl 
Total. 
GO *vj O O Oi OI Oi Ot 
OOOOOOOOOOi 
oooooooooo 
Estimated 
population. 
66.56 
O-O^-Om^CD^v} 
co * bi * * * © © 
Proportion to 
population. 
29.71 
tOCOtOCOKOtOCOCOCObO 
05^w00i-sl0l0tt»0 
■oi b *—»1*3 b bo 
Average of 
all. 
153 
W WGiG0 
Consumptives. 449 
TABLE II. 
Meteorological Tables for Concord, N. H.,for the years 1843, 1844, 
and 1845. Lat. 43° 12' 29". Long. 71° 29'. 
1 1843. 
Thermometer. 
Barometer. 
Maxi- 
Mini- 
Mean 
Maxi- 
Mini- 
vailing 
wind. 
Remarks. 
, Months. 
mum. 
mum. 
Range. 
temp. 
mum. 
mum. 
Range. 
January 
50 
— 20 
70 
28.48 
N. W. 
The tables are made 
February 
40 
— 13 
53 
18.20 
30.13 
28.52 
1.61 
N. W. 
up from two daily 
'March 
45 
3 
42 
25.80 
30.05 
28.90 
1.15 
N. W. 
observations, taken 
April 
65 
6 
59 
42.00 
29.97 
29.00 
.97 
N.E. 
at about 15 minutes 
'May 
80 
34 
46 
53.30 
30.10 
29.30 
.80 
N. W. 
before sunrise, and at 
(June 
91 
33 
58 
61.30 
30.02 
29.25 
.77 
N. W. 
2 o’clock P. M. 
July 
90 
42 
48 
65.20 
30.11 
29.40 
.71 
N. W. 
The thermometer 
; August 
85 
49 
36 
67.20 
30.18 
29.49 
.69 
N. W. 
is on the N. N. E. side 
Septem. 
85 
34 
51 
58.80 
30.13 
29.44 
.69 
N. W. 
of a dwelling-house, 
October 
65 
26 
39 
44.50 
29.93 
29.20 
.73 
N. W. 
about four feet from 
;Novem. 
48 
11 
37 
33.40 
30.16 
29.22 
.94 
N. W. 
the ground ; it is lia- 
Decem. 
43 
1 
42 
28.4 
30.20 
29.06 
1.14 
N. W. 
ble to reflected heat 
Year 
1.66 
91 
1 
o 
111 
43.88 
30.18 
28.52 
N. W. 
till 9 or 10 o’clock, 
but after that time it 
1 1844. 
January 
40 
— 15 
55 
15.2 
30.01 
28.68 
1.33 
N. W. 
is entirely free from 
February 
48 
— 9 
57 
23.5 
29 97 
29.20 
.77 
N. W. 
jMarch 
56 
10 
46 
33.4 
30.13 
29.12 
1.01 
N. W. 
hangs in a room with- 
out a fire at any time 
of year. It is of the 
! April 
72 
7 
65 
47.8 
30.46 
29.43 
1.03 
E. 
'May 
77 
31 
46 
55.9 
30.03 
29.18 
.85 
N. W. 
'June 
88 
40 
48 
63.5 
30.07 
29.46 
.61 
N. VV. 
July 
84 
40 
44 
65.8 
29.92 
29.36 
.56 
N. W. 
;August 
81 
51 
30 
64.0 
29.94 
29.32 
.62 
N. W. 
(Septem. 
84 
32 
52 
58.0 
30.14 
29.01 
1.13 
N. W. 
'October 
70 
26 
44 
47.9 
30.21 
29.15 
1.06 
N. W. 
iNovem. 
52 
12 
40 
37.1 
29.90 
29.04 
.86 
N. W. 
(Decem. 
48 
— 5 
53 
28.4 
30.20 
28.75 
1.45 
N. W. 
tube .24 inch. There 
88 
— 15 
103 
have been nocorrec- 
Year 
45.04 
30.46 
28.68 
1.78 
N. W. 
tions applied to the 
observations of it. 
1845. 
January 
46 
0 
46 
24.1 
30.10 
29.02 
1.18 
N. W 
February 
48 
— 8 
56 
25.0 
30.20 
28.58 
1.62 
N. W. 
'March 
61 
0 
61 
34.4 
30.03 
29.02 
1.01 
N.W. 
! April 
76 
22 
54 
44.1 
30.03 
29.12 
.91 
N. W. 
'May 
90 
32 
58 
56.5 
30.08 
29.23 
.85 
N. W. 
iJune 
90 
42 
48 
64.7 
29.85 
29.36 
.49 
N.W. 
(July 
92 
50 
42 
68.0 
29.82 
29.30 
.52 
N.W. 
(August 
91 
46 
45 
67.6 
30.01 
29.33 
.68 
N.W. 
Septem. 
80 
31 
49 
55.4 
30.01 
29.09 
.92 
N.W. 
'October 
73 
16 
57 
47.1 
30.15 
29.36 
.79 
N.W. 
INovem. 
63 
10 
53 
39.6 
30.20 
28 49 
1.71 
N. W. 
Decem. 
38 
— 8 
46 
20.4 
30.13 
28.95 
1.18 
N.W. 
Year 
1 
92 
— 8 
100 
45.57 
30.20 
28.49 
1.71 
N. W. H.—3. 
Replies to Circular Letter. By Dr. J. T. Gilman, of Portland, 
Maine. 
Query lsf.—1. Portland, with a population of about twenty 
thousand, is situated on a peninsula at the western extremity of 
Casco Bay, and composes an area of about twenty-two hundred acres. 
It has railroad and water communication with an extensive interior, 
rich in agricultural, mineral, and manufacturing resources, to which 
it furnishes the nearest seaboard market. 
2. Its geological formation is metamorphic, consisting of talcose 
or mica slate, with occasional beds charged with minute crystals of 
hornblende and laminae of iron pyrites. 
3. The soil is a yellow loam, with a subsoil principally of gravel. 
4. The land, on which the town is built, rising gradually from 
the water sides, furnishes natural facilities, almost unequalled, for 
drainage. 
Query 2d.—1. The town is, and has always been, unusually 
healthy. 
2. There are no crowded or unhealthy parts, where disease is 
particularly prevalent. 
Query 3d.—1. There are no arrangements for drainage by public 
authority. 
2. There is a public survey of levels, or grade of the streets, as 
we term it, which is sufficient, in all cases, to carry off the surface 
water freely, in most cases briskly. 
3. The streets are not generally paved: some of those most ex- 
posed to injury, from the rapid motion of surface water, in heavy 
showers, are paved. Alleys, we have none. Inclination for surface 
drainage answered in No. 2. 
4. The cellars are generally drained beneath the surface by pri- 
vate drains or sewers, which carry off, also, the water from sinks; 
the private drains communicating with some main trunk, which is 
to be found in almost every street, built at the expense of indi- 452 
viduals or neighborhoods, and which empties into the dock. This 
mode is effective so far as adopted. 
Query 4th.—1. There is no municipal provision for cleansing the 
streets; the natural facilities for surface drainage, before referred 
to, cause them to be washed by every shower. 
2. There are hut very few courts occupied by the poor, and those 
are spacious and clean. Alleys, there are none. 
3. The refuse from the houses, not carried off by sewers, is taken 
away by the “ city cart,” which passes through all the streets, 
several times a week, for that purpose. 
4. The street manure, where retained, is gathered up from time 
to time by inmates of the almshouse, and deposited upon the grounds 
of the farm connected with that establishment. 
Query 5th.—1. The most densely populated parts of the town 
have the advantage of free ventilation. 
2. The streets are generally Avide. 
3. Courts and alleys answered in query 4th, No. 2. The houses 
of the native poor are, for the most part, comfortable, healthfully 
situated, and not over-croAvded; those of the Irish, are as well 
situated, but almost invariably over-ciwded, filthy, and very im- 
perfectly ventilated. 
4. The houses are Avarmed by wood or coal close-stoves. 
Query 6th.—1. Children of both sexes are taught in our pri- 
mary schools; they are admitted at four years of age, and remain 
until they can read and spell fluently, and cypher in long-division 
readily, AAThen they are admitted into the grammar schools. Here 
the sexes are separated, the girls and boys attending schools held in 
different buildings. The influence of our system upon the health of 
the pupils is not prejudicial, so far as I knoAV. 
2. The rooms vary in size, according to location, and the pro- 
bable number of pupils to be accommodated. Those in our principal 
school-houses are from tAvelve to sixteen feet high, Avith correspond- 
ing proportions, and carefully ventilated. The number of pupils 
varies from fifty to one hundred and fifty, in each room ; each 
pupil, however, having sufficient space both for moving and breath- 
ing. Instruction is given six hours a day, except Wednesday and 
Saturday, to Avhich three hours each are allotted. An intermission of 
tAventy minutes is allowed, forenoon and afternoon, for exercise in 
the open air. There are two summer vacations, of one week and 
tAvo weeks. 453 
Query 'Jth.—1. There is a marine hospital—no dispensary but 
the one connected with the almshouse. 
2. The public edifices, of recent construction, have been built 
with due regard to ventilation. The high grounds, at the eastern 
and western extremities of the town, are appropriated for public 
promenades, and afford a highly invigorating air, and a prospect, 
both of land and water, unsurpassed in richness, variety, and extent. 
Query 8th.—Good water, and an abundant supply, is furnished 
by wells and springs. Rain water, subjected to the process of fil- 
tration, is usual, and preferred in many families. 
Query 9th.—The municipal regulations in the above subjects 
are generally effective. H.—4. 
COMMITTEE ON PUBLIC HYGIENE. 
Hygiene of New York City. Reported by John H. Griscom, M.D. 
Query 1. The population of the city of New York may now be 
estimated at 400,000. 
Its position in relation to the surrounding country is highly salu- 
brious, being on an island, of triangular shape, all sides of which are 
washed by broad and deep rivers, with rapid currents of salt water, 
which run in both directions as the tide rises and falls, and are 
never at rest. The rise and fall of the water average about six 
feet. 
The base upon which the island rests is supposed to be a basin of 
rock, pushed up at some points of its edge, and forming a hollow in 
the centre, which is believed by some to contribute to a certain 
degree of dampness of subsoil; but in the more thickly settled por- 
tions of the city there have not thus far been discovered any serious 
impediments to sewerage, as far as it has been tried. The basin 
alluded to, if it does exist, is too far beneath the surface to present 
any obstruction to drainage by sewers. 
2. With reference to health, the character of the city of New 
York is by no means what it might be, if its natural facilities for 
maintaining cleanliness, and enforcing other sanitary measures, were 
properly regarded and diligently embraced. 
Its ratio of mortality is believed to be above the average of large 
cities, and when its great natural advantages are taken into con- 
sideration, and a comparison instituted between it and less favoured 
places, we must necessarily look to its sanitary regulations for the 
cause of this. 
A large deduction is, however, to be made from the bills of mor- 
tality on account of the numbers of foreigners who die here, of 
diseases contracted in other places, and who, on arrival, had health 
permitted, would not have remained in the city. 456 
Its most populous parts are exceedingly crowded, and in very 
many instances, no regard whatever is paid to the numbers inhabit- 
ing any particular house or section. 
There is no law to regulate the number of inhabitants to any given 
space; and such a law as is now in force respecting the number of 
passengers in ships, would confer very great benefits upon the poorer 
classes of this city. Diseases of asthenic character are very preva- 
lent among them; arising, doubtless, from the impurities of the air 
they breathe, in their low, rotten, and crowded tenements, and the 
abundant filth with which they are surrounded and encased. 
3. The arrangements for drainage are good and improving. 
Surveys of levels are made, and new sewers rapidly projected. 
In most parts there is good inclination for drainage, though in some 
places the surface is quite level, and stagnant water is by no means 
uncommon. The streets and alleys are almost universally paved, 
in the most thickly inhabited parts of the city. 
4. The mode of cleansing the streets has varied in past years. 
Formerly, an ordinance required each house occupant to sweep up 
the dirt in front of his own residence, two or three times a week, 
which was then to be removed by public carts. On account of the 
number of distinct families occupying single houses (all of whom 
could not be made responsible for the work), and other causes, ren- 
dering the enforcement of that law difficult and almost impossible, 
the mode was changed, and a municipal department created for the 
purpose, and the streets were swept by labourers employed by the 
corporation. This continued several years. Subsequently, the 
sweeping of the streets was let out on contract, first to one con- 
tractor, afterwards to several, the city being divided into districts 
for the purpose. 
All plans have failed to insure thorough cleanliness. Street- 
sweeping machines have not been permitted, it is believed, for the 
principal reason, that they cannot exercise any political influence— 
they cannot vote—the street sweepers forming a strong and im- 
portant corps of voters, who cast their suffrages as they are 
required by the party in power. 
The expense of cleaning streets, including the removal of coal 
ashes, garbage, &c. &c., amounted, in 1848, to $145,844 95 ; the 
receipts for sale of manure, &c., being $18,592 32, leaving a net 
cost to the city of $127,252 63. 
5. In the more densely populated parts, the ventilation is exceed- 
ingly imperfect; the internal ventilation is about as bad as it can be. 457 
Most of the streets cannot be termed narrow, when compared with 
the old cities of Europe; most of the narrowest are mere alleys, and 
many of these are closed at the end. There are, however, fewer of 
these closed alleys or courts than in the city of Philadelphia. The 
dwellings of the people inhabiting these parts are of the worst pos- 
sible description; old, dilapidated, and filthy, and crowded with 
people to an extent scarcely to be believed. As many as twelve to 
fifteen have been known to occupy one room; sixty may be the 
entire number in one house. One exception, however, stands out 
prominently above all others, a curiosity in the way of human habi- 
tations, known as the old Brewery, at the Five Points, which has 
often been known to hold 300 dwellers. 
The average number of people in each room, in the poorest parts 
of the city, is probably six. The ventilation, as before remarked, is 
as bad as it possibly can be, the atmosphere being rendered worse in 
winter, by the methods adopted for warming; small stoves for burn- 
ing anthracite coal being universally used. Other parts of the city, 
which may be characterized as densely inhabited, are occupied by 
mechanics and artizans, who, with their families, occupy an entire 
floor; a suit of two or three rooms taking the place of the single 
room already referred to; twenty to twenty-five persons thus living 
in one house. 
6. There are, in all, one hundred and seven public schools in New 
York; eighty-three of them under the care of a charitable society 
established in 1805; and twenty-four under the control of the pub- 
lic authorities. Children are received at all ages; for the youngest, 
there are sixty-five of these schools, denominated primary schools. 
It is difficult to say, precisely, what effect these schools exercise 
on the health of the children. Whatever bad effects are produced, 
must be attributed to the great numbers in them, and to the absence 
of a scientific method of ventilation. The rooms are usually quite 
filled, often over-crowded; recitation-rooms, of smaller dimensions 
than the main room, are often found in the buildings, to which 
classes of the more advanced pupils frequently retire, and thus, per- 
haps, are in a measure relieved from the evils of constantly breath- 
ing the air of a large and crowded room, though this relief cannot 
amount to much, all the rooms being under one roof, and between 
the same walls. 
The mode of ventilation, generally, consists in nothing beyond 
flues, which open into the rooms, and into which, in winter, stove- 
pipes are introduced. There are some exceptions to this deficiency, 
YOL. II.—30 458 
however, some of the elegant buildings recently erected being ven- 
tilated upon the plan introduced by Joseph Curtis, while the method 
of warming by hot-air furnaces, causing an influx of warm fresh air, 
in winter, though imperfectly carried out, is getting more in vogue. 
The time allotted to instruction is from nine o’clock till twelve, 
with a short intermission during that period, in the morning, and 
from two to five in the afternoon, in summer; in winter, from nine 
to three, with appropriate short intervals. On Saturday of each 
week, there is a release from school duty, and a vacation of from 
three to five weeks in summer. 
7. There are three dispensaries affording medical aid and medi- 
cine gratuitously to 50,000 patients annually; which, with the City 
Hospital, which has about 300 beds; the Bellevue Hospital, with 800 
beds; a Lying-in-Asylum, capable of accommodating about fifty 
patients; with an Infirmary for diseases of the eye and ear, consti- 
tute the medical charities of the city. 
There is no general system adopted for ventilating public build- 
ings. Most of the older churches have no arrangement whatever 
for this object, and some of the more recently built edifices have 
nothing more than an opening in the ceiling. 
Some of the open squares are remarkable for their beauty, and 
the taste displayed in their arrangement. Four of them have foun- 
tains of very large size, which throw the water to a great height. 
These squares are by no means so numerous as they should be in so 
large a city. In the newly built sections, however, ample provision 
has been made for them. 
8. The city is supplied with water from the Croton River, and is 
brought a distance of forty miles by means of an aqueduct, which 
empties into a receiving reservoir, covering thirty-five acres of 
ground; it is thence conveyed to a distributing reservoir, into which 
it flows without the aid of any hydraulic machinery. The elevation 
of the latter reservoir enables the water to be received in any part 
of the city, eighty feet from the ground. It is abundant, and of very 
excellent quality. 
9. The municipal regulations have hitherto been quite inefficient; 
they have, however, been improving for the last few years, and the 
new charter which the city has recently obtained, will, it is generally 
thought, add much to their efficiency. H— 5. 
Report on the Sanitary Condition of Philadelphia. By Isaac 
Parrish, M. D. 
“Wiiat is the population of the town, and its position in relation 
to the surrounding country; what the geological formation of the 
country, the nature of its surface and subsoil, and the means of or 
impediments to drainage, more especially within the town limits?” 
Topography, <fc.—The city of Philadelphia, in lat. 39° 57' north, 
and long. 1° 54' east of Washington, is situated on the western 
shore of the river Delaware, on moderately elevated ground, extend- 
ing westward, about two miles to the river Schuylkill, which unites 
with the Delaware, three miles to the south. The Delaware is a 
mile wide opposite the city, and admits ships of heavy burthen to 
come to its wharves, which are strung along an extent of nearly five 
miles. The water of the river continues fresh for about thirty 
miles below the city, or nearly one-third the entire distance to the 
Atlantic Ocean, by the natural course of the river and bay. In a 
direct line eastward, across the State of New Jersey, the distance to 
the sea is about forty-eight miles. 
The river Schuylkill, opposite the western side of the city, is about 
200 yards wide, where it admits sea vessels of moderate draught. 
The portion of the isthmus formed between the Delaware and 
Schuylkill on which Philadelphia stands, is of the modern tertiary 
formation, consisting below of sand and gravel, overlaid with a thick 
bed of clay, the whole resting on a primitive basis, which shows 
itself on the surface, in some of the north-western districts. Fresh 
water is easily obtained, by digging, in every part of the city and 
suburbs, at depths varying from ten to thirty feet. This was for- 
merly soft and excellent, before the contamination incident to the 
extension of the city, and the usual infiltrations. The water now 
used is supplied in the greatest abundance from the water-works 
erected on the Schuylkill, north-westward of the city. The whole 460 
district over which the population of Philadelphia is spread, as well 
as the adjacent country, wrhich is generally of the primitive forma- 
tion, admits of the most perfect drainage. 
The plot of the city proper, forms a parallelogram of a mile in 
width, from north to south, and about two miles from east to west, 
or from river to river. But the town has so far overrun the original 
lines surveyed by Wm. Penn, that by far the larger portion of the 
population reside in the adjacent districts, which constitute, as it 
were, so many distinct wards. 
According to a calculation made by Dr. G. Emerson, for this 
Report, the population of the city and liberties at the present time 
may be computed at 320,000, including only those sections of the 
county making returns of births and deaths to the Health Office, 
and subject to the regulations of the Board of Health. This esti- 
mate is founded upon the supposition, that the ratio of increase con- 
tinues the same as between the census of 1830 and that of 1840, 
viz., about three and a-half per cent, per annum. The births and 
mortality per annum, as well as for the several months, are given 
in detail, in a highly valuable paper, published in the American 
Journal of Medical Sciences for July, 1848, by Dr. Emerson, under 
the head of “Vital Statistics of Philadelphia,” together with the 
proportion of white and coloured inhabitants, &c. This, with other 
papers in former numbers, by the same author, embracing a period 
of twenty-four years, will be found exceedingly interesting to those 
who desire to pursue the subject. 
“ Query 2. What is the character of Philadelphia in reference to 
health? What is the condition of its most unhealthy and crowded 
parts, where disease is supposed to be most prevalent, and to what 
causes are such diseases mainly attributable?” 
Ans. The general character of Philadelphia for health, is perhaps 
equal to that of any large city in the world; and had the designs of 
the illustrious founder been fully carried out, it is probable, that a 
still greater immunity from disease than now exists would have 
been enjoyed. The rectangular arrangement of the streets, extend- 
ing for the whole breadth of the city North and South, and East 
and West between the twro rivers; their ample wTidth, and convenient 
level for drainage; the natural advantages of surface and soil; the 
ample supply of pure water, with wholesome regulations to preserve 
cleanliness, might wTell give to Philadelphia a high range of health. 
But in the rapid progress of population which marks all the cities 
of the NewT World, and in wrhich this has largely participated, features 461 
have been engrafted upon the original plan which have added 
greatly to the sources of disease, and have marred the beauty of the 
primitive design. Amongst these, may be mentioned the building 
up of the river front of the city with massive structures, which cut 
off the air and the view of the river; and the construction of a nar- 
row street surrounded by high buildings between the river and the 
natural bank which rose up from its shore. This bank is described, 
by the early pioneers in the settlement of the city, as a beautiful, 
elevated hill, which skirted the shore along the front of the city, and 
upon its top was laid out the broad and spacious street called Front 
street, now one of its great business thoroughfares. It was the 
design of Penn, that the space between Front street and the river 
should be kept open, and that the bank should be laid out as a shaded 
promenade, along the whole line of the city, to be used as he ex- 
presses it, “as a common exchange or walk,” with wharves opening 
on the river below, thus forming a beautiful quay for the securing of 
vessels, the unlading of merchandize, &c., but that no buildings 
should be erected on the east side of Front street. It was not long, 
however, before the holders of lots on Front street, began to urge 
their claim to build vaults or store-houses in the bank against their 
respective lots; these applications were at first firmly resisted by 
Penn, who allowed them the right of building stairs to the top of the 
bank, but not to encroach in any way upon the public promenade. 
As early, however, as 1690, grants to build on the wharves and in 
the bank were made to some few special friends; and on William 
Penn’s second arrival in the colony, in 1699, after an absence of some 
years, he found, to his great regret, that serious encroachments upon 
his plan had been permitted by his agents, and that a permanent de- 
formity had been inflicted on the city. Buildings in the bank, and 
on the wharves proceeded, and, as early as 1705, they had progressed 
so far that the owners were called upon to regulate a street between 
these buildings; and, following out the same selfish policy which had 
induced the first departure from the proprietor’s plan, they laid out the 
present unsightly thoroughfare, called Water street. The eastern 
front of Philadelphia was thus intersected by a confined, irregularly 
built, and narrow avenue, which has since served as a focus for 
disease and pestilence, instead of presenting a beautiful, open 
promenade, which would have diffused health and salubrity to the 
inhabitants. 
As an evidence of the fatal error which was thus early committed, 
it may be mentioned that the several yellow fever epidemics which 462 
have scourged Philadelphia, have commenced their ravages in this 
section of the city; and that other infectious disorders are very apt 
to spread from this point. Houses built upon the side of a natural 
bank cannot of course have a back outlet, and hence the tenements 
on the west side of Water street, which are occupied as the resi- 
dences of the poor, or as taverns for the accommodation of sailors, 
emigrants, &c., are without yards, privies, or any means of venti- 
lation, while they are generally overcrowded by a population pecu- 
liarly liable, from their habits, to disease. Under these circum- 
stances, it is not surprising that, when an alarm of an infectious 
disorder prevails, the attention of the citizens should be involun- 
tarily turned to the condition of Water street, and of the river front. 
So great an evil has this been regarded, that it has more than 
once been seriously urged by public-spirited citizens, to restore the 
plan of Penn, so far at least, as to tear down the buildings along 
the bank side of Water street, opposite the most densely built por- 
tions of the city proper, and to open a shaded promenade in their 
place. 
This proposition was urged by a committee of distinguished phy- 
sicians, who presided over the sanitary condition of the city during 
the cholera epidemic of 1832 ; and they presented an able memorial 
to the city councils, setting forth its advantages to the future health 
and prosperity of the inhabitants. The immense expense attendant 
on such a measure, was, however, considered as an insuperable bar- 
rier to its accomplishment, and the project was therefore never 
seriously entertained. 
The unhealthy condition of this portion of the city, was also a 
subject of serious thought to the late Stephen Girard; and he has 
added greatly to its improvement, by a munificent bequest of half a 
million of dollars, the interest of which is appropriated under the 
direction of the city authorities to the widening of Water street, and 
to the laying out of a spacious street along the river front, now 
known as Delaware Avenue. 
These improvements, together with the substitution of store-houses 
for human habitations, which is gradually progressing along this 
line, will remove many of the nuisances, which have long existed 
in this section of Philadelphia, and render the eastern front more 
salubrious and inviting; thus diminishing our regrets that the wise 
counsels of Penn did not prevail. 
Another source of insalubrity in the river front, is the mode 463 
adopted of constructing the wharves with timber instead of stone, 
which prevails in Philadelphia. 
The constant wearing of the water against the wood causes in- 
filtration and decay, and thus cavities are formed which give lodg- 
ment to vegetable and animal refuse floating in the river, and keep 
up a degree of moisture, which, at certain seasons, may generate 
disease. 
Extending our inquiries into the interior of the city, we may trace 
a large amount of disease, which prevails in certain localities, to a 
still further departure from the primitive design of the sagacious 
founder. 
In the original city plot, no provision was made for the small 
streets, alleys, and courts, which are now so numerous. The design 
of Penn was to divide the city into squares, or blocks, with the houses 
fronting upon the four sides ; the interior of the square being kept 
open for garden plots, outbuildings, &c., with perhaps an occasional 
narrow avenue or private alley, for the accommodation of the pro- 
perty owners in the neighbourhood. 
But, with the increase of population and trade, and the enhanced 
value of ground, these spaces were soon encroached upon by build- 
ings, the private alleys began to be built upon, and were, in pro- 
cess of time, dedicated to public use, while new ones were projected, 
and lined with small buildings for the accommodation of an humbler 
class of citizens, whose means would not enable them to live upon 
the principal streets. 
Thus commenced the system of building up courts, alleys, and 
lanes, which has since proceeded unchecked, and has multiplied the 
causes of disease to an extent which calls loudly for reform. 
It was scarcely to be anticipated that no innovations upon the 
original plan would occur, especially as the size of the squares was 
more ample than the necessities, or even the comfort of the inhabi- 
tants required; but it is unfortunate for the health and beauty of 
the city, that no effort wrns made at an early period to regulate, by 
law, the mode of building, and to adapt it, as far as possible, to the 
admirable intentions of the founder. 
Had the squares, for instance, been intersected by wide open 
streets running at right angles, upon which small and neat build- 
ings, with moderate sized garden plots could have been erected, thus 
securing to each house a free ventilation, no serious evil would have 
accrued; while a large number of inhabitants, of moderate means, 
would have been accommodated. 464 
Unhappily, however, private cupidity was allowed to operate un- 
checked, and owners of property, eager to realize the largest income 
from their estates, were permitted to build upon these open spaces 
in a mode detrimental to the public health. Narrow alleys, and 
closed courts were projected and compactly built up with small houses, 
oftentimes without yard room, or back outlet of any kind, and under 
the private control of the owner. 
Alleys of twenty feet wide and upwards, running through the 
square, and open at both ends, are, of course, less objectionable than 
closed courts. 
These alleys, or small streets, are paved, curbed, and lighted by 
authority of the city, and are under its control. The houses upon 
them are furnished with yards, which, though often confined and 
filthy, still furnish sufficient space for privies, hydrants, &c.; and 
allow of a circulation of air through the house, and of the access of 
sun light by back windows opening upon them. In the closed 
courts, and in some of the smaller alleys, on the other hand, these 
arrangements do not exist. These courts are usually laid out upon 
deep lots, fronting upon a small street or alley, and wTell adapted to 
several buildings, with ample yard room back; but such buildings 
wrould yield a much smaller income, than that derived from a row 
upon each side of the lot, extending backward through its whole 
depth. A lot, for instance, of forty feet front, by one hundred feet 
deep, encompassed by a high wall upon each side, and fronting upon 
a narrow street, would accommodate three small houses with large 
back yards ; but the same premises, laid out as a court, -would give 
place to seven or eight houses upon each side, with a common outlet 
of eight or ten feet wide, upon the alley. In such a court, the 
houses are, of course, built against a dead wall, and unprovided 
with any means for the access of air or light in the rear; they are 
without privies, or hydrants, and from the height of the surrounding 
wralls, and the confined situation of the street on which the court 
has an outlet, it is often deprived of currents of air through it, and 
from the access of sun light, except during a small portion of the 
day. 
At the upper end of such courts, a hydrant, to be used in common 
by the occupants, is placed, and near by a range of privies; which, 
in wrarm weather, infect the atmosphere with a sickening effluvium ; 
while, in some instances, the privy is even placed in the cellar of 
each house, which is still worse. 
There is another description of court quite common in Philadel- 465 
phia, even more confined than this. A row of small tenements is 
built upon the rear of a lot of ordinary dimensions, upon which is 
erected a substantial wide building, fronting on the street. 
The space which is ordinarily appropriated to back buildings, and 
to a garden plot, is filled up by a compactly built row of houses, the 
only entrance to which is through a four feet wide alley, opening 
out upon the street along side of the front building. In this con- 
fined space, a number of families are housed with a dead wall in 
front of them, and no outlet back; without the luxury of sun light, 
and a very deficient supply of fresh air. Many such pent up courts 
are to be found in the thickly settled portions of Philadelphia, the 
existence of which is, perhaps, unknown to the great mass of the 
citizens. While they fill the coffers of the greedy proprietor, they 
inflict disease and discomfort upon their needy occupants. 
That confined courts and alleys should be numerous in the thickly 
settled parts of the city, where the high value of ground holds out a 
strong inducement to appropriate it in this way is, perhaps, not sur- 
prising ; but the evil also prevails, and is increasing in the recently 
built portions of the city and districts, where property is compara- 
tively cheap. The beautiful section of the liberties called Spring 
Garden, in which are some of the most tasteful private residences 
and public buildings to be found in Philadelphia, most of which 
are of modern construction, is already defaced by this system of 
building courts and alleys, and will probably be still further spoiled, 
if some legal check is not placed upon it. 
The same irrational system of building houses against dead walls, 
without back windows, yard room, hydrants, or privies, prevails here, 
and for the same reason, viz.: because, in certain localities, such a 
plan will yield to the property owner a larger income than by pur- 
suing the ordinary method. 
To illustrate the extent to which this system prevails in the city 
proper, we may mention a fact, elicited by a slight survey of a 
chart of the city, in the office of the city surveyor. 
In two blocks, not far distant from the centre of business, and 
selected without reference to any pre-eminence in this respect, it 
was found that, in one, six compactly built alleys, and Jive closed 
courts existed, and in the other, four alleys and seven courts. 
The front buildings on the four sides of these squares, were for 
the most part neat and substantial private residences, and some of 
them conspicuous for these qualities, while the interior of the squares 466 
were thus compactly built up, and densely crowded with popu- 
lation. 
Your reporter made some effort to ascertain the number, dimen- 
sions, population, &c., of these confined courts and alleys, within 
the city limits, but found the inquiry too extensive to be prosecuted 
at present. 
The attention of the Sanitary Committee of the Select and Com- 
mon Councils, and of the Board of Health was, however, solicited 
to it; and partial returns from several districts were presented 
through the collectors of vaccine cases, as will be found, in the in- 
teresting report herewith presented, of the Joint Special Committee 
of the Councils, to whom was referred the circular letter of our 
committee.* 
The subject of the construction of houses for the poor in large 
cities, is one of great importance in its relations to the public health. 
In these habitations children are reared, and during their infan- 
tile years, they are confined very much to them. The crowding 
together of a large number of families in confined courts, such as 
we have described; the accumulation of filth and offal, which must 
inevitably take place in those localities; the excessive heat and close- 
ness of the atmosphere in summer, and the over-heating of the houses 
by coal stoves in the winter; the foul smell from privies, and the 
absence of hydrants to each house for the promotion of cleanliness, 
are so many causes of disease. 
We hazard nothing in saying that the seeds of scrofula and con- 
sumption are sown here; and that the more acute diseases, which 
are distinctly traceable to a deficiency in the supply of the natural 
elements for sustaining and developing the frame, must prevail in 
these confined situations. Happily, the instincts of childhood lead 
the young being beyond the narrow confines of his cheerless home, 
and, when his strength will permit, he is prompted to active sports 
in the open air, which counteract, in part, the deleterious influences 
by which he is surrounded in doors; so that, in spite of these, his 
constitution, if naturally good, may become established on a firm 
basis; but still, many perish before they are capable of seeking for 
* By this report, we observe that in the north-east district of the city, embracing the 
squares from the south side of Vine street to north side of Chestnut, and from east side 
of Ninth street to Delaware avenue, upwards of fifty courts and alleys are reported; in 
most of which there is no ventilation, and in the rest, it is stated to be very defective. 
In many instances, two or three families live in one house, and the premises are reported 
as filthy. In the south-east district, embracing the same extent of surface, forty courts 
and alleys are noted; and these numbers are believed to be below the truth. 467 
themselves the air and light of heaven, and of establishing their 
claim to these natural gifts. 
The amount of infant mortality, in Philadelphia, believed to be 
traceable to a combination of heat, moisture, and impure air, in con- 
fined situations, is sufficient to excite anxious inquiry. Cholera in- 
fantum, and other chronic bowel diseases, which annually carry off 
such a large number of children during the heat of summer, are 
known to be greatly influenced in their origin and progress by these 
causes. The cause of a large portion of these cases is as obvious 
as though it were tangible, and the cure often depends simply upon 
the removal of the patient from the crowded court or alley, to the 
pure air of the country. During a period of ten years, from 1838 
to 1847 inclusive, 2,936 deaths are reported as having occurred from 
cholera infantum, and 119 deaths from teething, in the districts re- 
porting to the Board of Health. How many of these deaths came 
from the closed courts, crowded alleys, and illy ventilated abodes of 
the poor ? We imagine, without any means of accurate information, 
except a somewhat extended personal observation, that a large pro- 
portion could be traced to these situations; and, hence, that they 
were, in a great measure, dependent upon removable causes. 
During the same period, there were reported 2,450 deaths from 
convulsions, in children under two years of age. May not many of 
these be fairly attributable to the same influences ? 
In addition to the infantile diseases, these localities form foci for 
infectious disorders, during those epidemic visitations, which occa- 
sionally afflict large cities, or which are transported from other 
places; small-pox, ship or typhus fever, and other like disorders, 
originate and spread here, with a rapidity and a fatality not observed 
in more open situations. Several typhus fever epidemics which have 
visited Philadelphia within the past few years, have originated and 
been almost entirely limited to a crowded and filthy section of the 
district of Moyamensing, amongst a class of depraved inhabitants, 
who live in confined courts and cellars, exposed to the inclemencies 
of the weather. Small-pox may also be traced to the same districts ; 
and were it not for the rigid municipal regulations, which require 
the immediate removal of patients affected with these diseases to 
hospitals, and the evacuation and cleansing of the infected district, 
there would, no doubt, be a frequent extension of these disorders to 
other sections of the city.* The sanitary condition of some of the 
* The influence of these confined habitations upon the health of the neighbouring 
city of New York, has been ably investigated by Dr. John H. Griscom, of that city. He 468 
large cities of Great Britain, is known to be greatly influenced by 
the evil of which we complain, with the additional cause now ope- 
rating of a deficient supply of food, which is, unhappily, experienced 
by many of the poor who live in these wretched habitations. In 
some of the cities and large towns of that country, the mortality 
from diseases induced by causes, which, in a more favoured state of 
society, do not exist, is frightful, and furnishes a sad commentary 
upon the civilization and philanthropy of the age. 
It is, however, gratifying to perceive that the condition of these 
unhappy sufferers is attracting the attention, and arousing the 
efforts of some of the first statesmen and philanthropists of that 
nation, and that a thorough investigation into the sanitary condi- 
tion of towns, and into the removable causes of disease, is now in 
progress. Health of towns’ associations are formed, parliamentary 
committees are appointed, and the sanitary question has taken its 
rank amongst the leading topics of public concern. 
In the United States, we are more favourably situated, in these 
respects, than in the older cities of Great Britain and the continent. 
Our cities are comparatively new, and most of them are in the pro- 
gress of rapid growth; so that now is the time to guard against 
errors of construction, and a system of over-crowding, which have 
inflicted such heavy, and, it is to be feared, irremediable calamities 
upon the towns of the old world. It is the opinion of the writer, as 
well as that of the committee with which he is associated, that the 
construction of dwellings should be, to some extent, under legal 
control; so far, at least, as to prevent the building up of confined 
courts and alleys, or of houses without provision for privies, hy- 
drants, and a certain amount of open space in their rear. Surely, 
the protection of human life is one of the highest and noblest ends 
of government; and if a sordid self-interest interferes with the 
public good, by depriving any portion of the honest and industrious 
poor, of those natural elements, essential to the preservation of 
has ascertained, that the females living in these situations, suffer much more from 
disease than the males, whose occupations lead them more into the open air, while the 
women are confined to this polluted atmosphere during the greater portion of the time. 
“It will be seen,” says Dr. G., “ upon examining the dispensary returns, that in some 
years the proportion of females to males prescribed for at the dispensary, has been as 
12 to in others, 12 to 8J, and, in one instance, as 19 to 11. This comparison is 
rendered more striking, when we take into account the greater amount of intemperance 
among the males.” “See Sanitary Condition of the Labouring Population of New York, 
with Suggestions for its Improvement,” &c. By John H. Griscom, M. D. New York, 
Harper & Brothers, 1845. 469 
health, it should be within the province of the State to interpose its 
authority to prevent it. This principle is recognized in the powers 
given to Boards of Health, and other municipal bodies, to remove nui- 
sances, &c., and should, we think, be extended much farther than is 
now generally regarded as essential. If, for instance, it can be shown 
that the method of building to which we have referred gives origin 
to a multitude of diseases which might be avoided under a more 
rational system, and that a large amount of mortality is distinctly 
traceable to it as a cause, it is certainly the duty of the legislature 
to pass laws which shall effectually prevent this unnecessary expo- 
sure of human life. The law regulates the laying out and grading 
of streets; it fixes lines and defines the limits of estates; it declares 
even that no frame buildings shall be erected, within the city limits, 
for fear of fire, which may endanger the surrounding property; why 
may it not, with still greater propriety, control the construction of 
houses, so far as to secure to their inhabitants a due supply of the 
elements so bountifully furnished by nature for the sustenance and 
strength of man ? Nowhere is such legislation more imperatively 
demanded than in the cities of the New World. The climate of our 
temperate regions is subject to greater extremes than are experi- 
enced in the central portions of Europe, while the hot weather of 
our summers superinduces many diseases almost unknown in those 
countries, thus tending to aggravate the miseries of confined and 
over-crowded localities. If, therefore, the municipal authorities do 
not move in this matter, it is greatly to be feared that the large and 
flourishing cities, which are now rapidly rising up in different sec- 
tions of the Union, some of which will, ere long, vie with the largest 
towns of the Old World, in wealth and population, will be perma- 
nently defaced, and their facilities for diffusing health and comfort 
for ever impaired, for want of such timely interference. For while 
taste and elegance may adorn the mansions of the rich, and in- 
creasing splendour may mark the structures which public munifi- 
cence or private enterprise rears to charity and science; yet, if the 
dwellings of the poor are neglected, if the light and air of heaven 
are shut out from their abodes, and avarice is allowed to feed and 
fatten upon their helplessness, we shall fail in establishing cities 
worthy of that high destiny to which our country aspires. It is the 
boast of the Republic to regard with an equal eye the happiness and 
interests of all classes, and especially to throw the aegis of its pro- 
tection around those who, from adverse circumstances, may be 
exposed to privation and suffering, at the hands of their more 470 
favoured fellow-citizens; let our legislators, then, he inspired with 
the genius of our institutions, and act upon this principle, and the 
work which we advocate would he speedily accomplished. 
Your committee would therefore respectfully urge upon the atten- 
tion of the authorities of the large towns and cities of the United 
States, the subject of the construction of houses, and of the proper 
arrangement of streets, avenues, &c., within the town limits, as one 
intimately connected with the health and civilization of their re- 
spective communities, and eminently worthy of their regard.* 
There are other causes of disease existing in Philadelphia, which 
will be more appropriately noticed under other heads of this report. 
We would briefly refer here to the prevalence of malarial fevers in 
the thinly settled districts lying between Broad street and the river 
Schuylkill, and in the low, flat lands to the south of the city, 
situated between the Delaware and Schuylkill, familiarly called the 
“Neck.” There were formerly many brick ponds, or other smaller 
collections of stagnant water scattered over this portion of the 
commons of the city, which were the fruitful source of autumnal 
fevers, generally of the intermittent type; these, however, are gra- 
dually disappearing, as pavements and buildings are extended in 
this direction—so that many localities which, a few years ago, were 
subject to these fevers, are now entirely clear. There has been, 
however, during late seasons, a prevalence of this class of disorders 
in the southwestern and northwestern suburbs, bordering on the 
Schuylkill, as well as some cases of dysentery which appeared to be 
dependent on the same causes. It is confidently believed, however, 
that, in the progress of building, these diseases will entirely disap- 
pear, as no case of intermittent or remittent fever is known to have 
primarily originated within the compactly built portions of the city. 
In the “Neck,” and along the banks of the Schuylkill in the 
vicinity of Philadelphia, it is probable that malarial fevers will con- 
tinue to prevail at certain seasons, although there is an unaccount- 
able irregularity in their visitations. For a series of years, fevers 
were so prevalent that many beautiful country seats were abandoned 
by their proprietors, and sold out at very low prices, while an ex- 
* As a preparatory measure to proper legal enactments on this subject, the institution 
of sanitary surveys, under the direction of the municipal authorities, would become 
necessary. These surveys would include an accurate investigation into the condition of 
confined and crowded localities, with a chart of the town or city, which should reveal 
at a glance its interior arrangement, and thus enable the proper officers to act under- 
standing^. 471 
emption for a few succeeding years partially restored confidence, 
and caused them to be re-occupied, to be again deserted by their 
new owners, at the occurrence of another epidemic. 
It is believed by many that the construction of the dam on the 
Schuylkill, at Fairmount, has contributed largely to render these 
suburbs unhealthy; and there is, perhaps, no doubt of the fact; 
though during some seasons, as, for instance, in the autumn of 1847, 
there were many cases of fever along the banks of the river below 
the dam, and in the sections of the city before alluded to. 
Drainage, $c.—Philadelphia enjoys great advantages in the facility 
with which a system of drainage may be carried out. It has the natural 
advantages of surface and soil, together with a careful regulation of 
lines and heights in all the streets, lanes, and courts, embraced in the 
limits of the city and districts, which proves amply sufficient for this 
purpose. The water is carried off by means of common sewers, at 
the corners of the principal streets, which are generally sufficient, 
though the opinion is expressed by Marine T. Chandler, assistant 
city surveyor, that an increase in the amount of sub-drainage would 
be advantageous. (See letter of M. T. Chandler. Report of Joint 
Committee of Select and Common Councils, on Public Hygiene, fc., 
p/12.) The public sewers vary in size from three to ten feet in 
diameter in the clear, and with their branches, amount in the aggre- 
gate, at the present time, to eleven and three-quarter miles, more 
than four and a half miles of which are discharged through the 
Dock street sewer into the river Delaware; it is in contemplation to 
construct another sewer at Walnut street, to take off a portion of 
this drainage, and to accommodate additional branches which the 
increasing accumulation of water may require. In the surrounding 
districts, the sewerage amounts to fifteen and three-quarter miles. 
The cesspools at the inlet of the sewers are apt to become filled up 
with putrid filth, thus impeding the course of the water, and some- 
times during heavy rains causing a temporary overflow of the gutters; 
to prevent this, these inlets are frequently cleaned out, by raising 
up the mud which collects in them and depositing it on the pavement; 
a practice which, in hot weather, causes the surrounding atmosphere 
to be charged with a sickening effluvium. If some other plan of 
cleansing these inlets could be devised, it would no doubt add to the 
health and cleanliness of the city. (See letter of Samuel Haines, 
City Surveyor, pp. 17 and 18. Report on Public Hygiene.) 472 
The plan of flushing, by copious effusions of water into the sewer, 
so advantageously adopted in Great Britain, might be introduced 
into our cities with great benefit. The trapping of the sewers, for 
the purpose of preventing the emission of noxious gases from the 
inlets, has been partially attempted in Philadelphia, but with results 
altogether inadequate for the purpose. As this has, however, been 
well accomplished elsewhere, it is presumed that further experience 
will perfect it here. The great mass of the drainage of the city and 
districts is necessarily surface drainage, inasmuch as the densely 
built area of the town occupies but five square miles, while the total 
amount of sewers is but twenty-seven miles in extent. 
The drainage by these arrangements would be amply sufficient, 
were the municipal regulations to enforce cleanliness strictly adhered 
to. It often happens, however, that obstructions occur from the 
collection of offal in the gutters deposited in violation of the law, 
thereby adding to the causes of ill health. Another impediment to 
a perfect system of drainage, consists in the mode of paving the 
streets and carriage ways of the city with rounded pebble stones, 
the interstices between which furnish a lodgment for dirt and water, 
much of which percolates into the stratum below. The substi- 
tution of cubical blocks for the present method of paving would in 
a great measure remedy this difficulty. If sub-soil drainage of the 
pavements, where practicable, were resorted to, the effluvium and 
moisture arising from them would be further diminished, and their 
durability and level more perfectly maintained. 
There is, also, in certain portions of the districts recently settled, 
and in some of the courts and alleys in these localities, an entire 
deficiency of pavement, and consequently of adequate drainage; and 
even in some of the old portions of the town, especially in Moya- 
mensing, a few alleys are still unpaved. As the spirit of improve- 
ment progresses, and new buildings are erected, this difficulty is 
rapidly disappearing. 
Cleansing, £c.—The streets are cleansed by contract, with some 
exceptions, once a week; the contract in some instances being given 
to the highest bidder, the value of the street dirt being held, not 
only as an equivalent, but as a source of revenue to the contractors. 
The mode adopted is as follows. 
The streets are first watered in dry seasons, and then by the 
application of large birch brooms, aided by iron scrapers for the 
gutters, the dirt is gathered into heaps, on either side of the street, 473 
taken up by carts, and deposited on vacant lots, subjacent to the 
outskirts of every district appropriated for the same by the several 
municipal authorities. From thence it is sold to the neighbouring 
farmers as manure. The kitchen offal and slops from houses, are 
generally collected by covered water-tight carts, sent round on par- 
ticular days through the week, taken out of the city, and the most 
of it converted into swill for hogs, while the dry refuse, from houses, 
is collected in the same manner and sold for filling in lots and streets 
in the new and outer precincts of the city and liberties. [See Com- 
munication of Board of Health to Committee on Public Hygiene,— 
herewith presented.) 
Some streets are cleansed by the above method twice in each 
week, and others once a week; and all the paved courts, lanes, and 
alleys within the city limits are included in the contracts. Unpaved 
avenues are not so cleansed, and complaints are often made that the 
confined courts and alleys receive less attention than the larger and 
better ventilated streets. (See Communication of Board of Health.) 
The contractors further engage to remove the kitchen offal which 
may be placed by housekeepers in some convenient place, daily, 
from the first day of June to the first day of October, three times a 
week during the months of May and October, and twice a week 
during the other months of the year; and also completely to cleanse 
and wash the market-houses, twice in each week, from the first of 
May to the first of October. 
The efficacy of the above regulations depends both upon the 
fidelity of the contractors, and upon the carefulness of housekeepers. 
Lapses of duty in the former can generally be detected, and re- 
medied by the proper authorities; while carelessness in the latter is 
not so easily reached. Upon this latter point, we are impelled to 
quote the following remarks of Charles A. Poulson, Esq., the Chair- 
man of the Committee of Councils, to whose report we have so fre- 
quently had reference. “ But the deficiency in cleanliness most to be 
dreaded,” say the committee, “ exists even in our midst, from a care- 
less or culpable want of this virtue in private residences. It must 
not be concealed, that this grievous evil does not obtain solely in the 
habitations of the poor and destitute, in lanes, in courts, and in 
alleys; but actually exists also on the premises of persons whose 
means are adequate to procure a better state of things; where 
there are cellars, vaults, sinks, privies, and other secret and hidden 
depositories of filth to be found, in some cases we may, perhaps, 
charitably hope unknown to those most immediately interested— 
YOL. II.—31 474 
heads of families.” Another source of insalubrity arises from several 
open drains, or natural water-courses in the districts (but not in the 
city proper, where they also existed in former times, but have been 
converted into sewers). These are gradually undergoing the same 
process, and in the progress of improvements will, no doubt, be soon 
obliterated. The numerous piggeries within the limits of the city 
and districts, furnish a source of insalubrity, which is much com- 
plained of. In some of the narrow alleys and courts, inhabited by 
the poor, large numbers of pig-sties are to be found, sending forth 
their noxious gases, and thereby adding another to the already 
accumulated causes of disease in those confined situations; while 
the existence of large piggeries, in the open lots around the city, 
sometimes infects the atmosphere of the whole neighbourhood. 
Ventilation of Public Buildings.—Most of the public buildings 
of Philadelphia, including court-houses, school-rooms, places of 
public worship, lecture-rooms, halls devoted to scientific purposes, 
hospitals, prisons, &c., are provided with no means of ventilation, 
except by casual opening of the windows and doors. A few are 
provided with the additional contrivance of one or more openings in 
the ceiling, sometimes connected wfith louvers in the roof, which 
afford partial, though by no means free ventilation. A small num- 
ber of houses of worship and school-houses, have recently resorted 
to forced ventilation, by means of fires in lofty flues or chimneys, 
but in no instance, that we know of, has this plan been perfected so 
as to secure a pure atmosphere at all times and seasons. 
The west wing of the Pennsylvania Hospital, devoted to the female 
patients, is believed to be the best ventilated building in Philadel- 
phia, and is scarcely equalled by any similar institution in the 
Union; the apparatus for warming and ventilating are combined, so 
as to render the atmosphere comparatively pure, and well-tempered 
during the cool seasons. 
Ventilation in the prisons of Philadelphia, is especially faulty; 
and the want of it is believed to be a fruitful source of disease in 
these establishments. The absence of a sufficient supply of pure 
air, is particularly felt in prisons conducted on the plan of separate 
confinement, as in Pennsylvania; inasmuch as the convicts are con- 
fined to their cells both day and night, and have no opportunity for 
exercise in the open air; except during an hour each day, in a small 
yard attached to the cell. In the congregate prisons, on the other 
hand, where the ventilation of the cells is equally bad, the prisoners 475 
spend the day either in working in the open air, or in spacious 
workshops, and are exposed to the confined air of the cell only dur- 
ing the night. 
The school-houses are also generally badly ventilated, though in 
some, recently built, greater attention has been bestowed upon this 
subject. The evils of defective ventilation in these institutions are 
especially worthy of regard. In them, children, whose constitutions 
are in the process of formation, spend some five or six hours during 
the day, engaged in mental labour, and subjected to the necessary 
discipline of a school. It often happens too, that the school-rooms 
arer over-crowded, and during cold weather the windows are kept 
tight, and they are heated by red-hot coal stoves, or by furnaces in 
the cellar, a combination of circumstances eminently injurious to 
health, at an age when the constitution has need of a full supply of 
the agents which nature has furnished for its development and 
support. 
Since the introduction of anthracite coal, the ventilation, both of 
public and private buildings, is more defective than formerly, when 
houses were chiefly heated by wood in open fire places, although the 
degree of warmth and comfort is greater than by the old method. 
The introduction of furnaces in lieu of the open grates, is also 
believed to have diminished the purity of the atmosphere, by intro- 
ducing air into the room at too low a dew point, and charged with 
dust. 
The heated air is also apt to be impure by containing a portion of 
the gases resulting from the combustion of the coal, and from the 
decomposition of the dust, which is always floating in the atmo- 
sphere ; where open fires are employed as auxiliary to the furnace, 
as is now done in many private dwellings, the ventilation is improved 
so far as the quantity of air is coneerned, though the quality remains 
the same. As furnaces are now generally constructed, their influ- 
ence upoi\ life and health must be more or less prejudicial; and it is 
greatly to be desired, that a reformation in this mode of heating 
should be speedily effected. 
The ventilation and heating of the houses of the poorer classes, 
is also intimately connected with the public health. In many of 
the sleeping apartments of these houses, especially those built in 
confined situations, there are no flues, chimneys, or other apertures 
for the passage of air, and in these rooms four or five persons often 
sleep. Other small houses are supplied with flues or small chim- 
neys, which are closed up in winter, and the rooms heated by close 476 
coal-stoves. In either case, the deprivation of air must be exceed- 
ingly injurious, especially to young children. 
Public Squares.—Philadelphia is justly celebrated for her beauti- 
ful public squares. Four of these, occupying positions intermediate 
between the river Delaware and Broad street, and between this 
street and the Schuylkill, and originally known as the north-east 
and south-east, and north-west and south-west squares, were laid 
out in the first settlement of the city, by Penn himself, and devised 
to the city, to be for ever kept open as public grounds, and used as 
Moorefields, in London, for a free circulation of air and recreation. 
Each of these squares contains eight acres of ground ; they are 
beautified by handsome shade trees, and are kept in order by the 
city. 
Besides these, Wm. Penn laid out a plot of ten acres, near the 
centre of the city, and on the main thoroughfare between the two 
rivers, which he intended as a site for the public buildings, when 
the city should become large and populous. 
This was called the Centre Square, and, like the others, w~as de- 
vised to the city, to be kept open as a public ground. In the early 
settlement of Philadelphia, this spot was a beautiful piece of woods, 
in the midst of which stood a Friends’ meeting-house, and subse- 
quently it became the site of a handsome edifice, which was a re- 
ceiving fountain for the first water-works on the Schuylkill, erected 
in 1799. After the erection of the Fairmount works, this structure 
■was demolished, and the square became again a public common. 
Unfortunately, however, it was not allowed to remain open, as 
originally intended, but was intersected by two wide streets, and 
surrounded by another, thus seriously curtailing its original dimen- 
sions, and dividing the remainder into four small open spaces, which 
have recently been dedicated to public use, and are but partially 
improved. 
A project is now on foot, to cover these desirable open grounds 
with four huge buildings, to be used as depots for the railroads which 
meet at this point, and the mercantile interest is clamorous for this 
further encroachment on the original design of the founder. If 
public health and salubrity are to be considered paramount to mo- 
neyed interest, some other spot will be selected for this purpose, and 
Philadelphia will be spared this additional infliction upon her fair 
proportions. 
Another beautiful square, not included in the original plot of the 477 
city, lias since been added, namely, Independence Square, upon which 
are located the public buildings, so celebrated in the history of our 
country. This ground originally belonged to the State, of whom it 
was purchased by the city corporation, to be appropriated as a pub- 
lic square. It is planted with magnificent shade trees, and is, in 
common with the other squares enumerated, greatly admired for 
the neatness and taste with which it is kept. 
In addition to these open grounds within the city limits, the cor- 
poration has wisely appropriated the grounds at Fairmount to pub- 
lic use, and has ornamented them with a degree of taste and ele- 
gance highly creditable to the city. This beautiful spot, easily 
accessible by omnibuses from all parts of the city, is the resort of 
thousands of the inhabitants, and is admirably adapted for healthful 
recreation. 
In the districts of Philadelphia, including a much larger space 
than the city proper, and crowded in many parts with population, 
no provision has yet been made for public squares. 
This is the more to be regretted, from the fact, that ground is 
now comparatively cheap in many portions of these districts, and 
that many spaces, now open, would furnish admirable situations for 
public squares. In the districts of Spring Garden, and of Penn, 
situated to the north-west of the city proper, there are many beau- 
tiful hills overlooking the city, now open commons, which, at a 
moderate cost, might be secured to these corporations, and ap- 
propriated to public use; whereas, if the matter is allowed to rest 
for a few years longer, the march of improvement, which is rapidly 
extending in this direction, will level down these commanding emi- 
nences, and busy thoroughfares will take their place. 
The importance of public open grounds, in the midst of a crowded 
city, to* the health of the inhabitants, was fully appreciated by the 
founder of Philadelphia, in his first plan, and his foresight has se- 
cured to the inhabitants those which they now possess. He looked, 
not only to the immediate necessities of his own times, but to the 
welfare of future generations. A more contracted policy seems now 
to prevail; and the future healthfulness and beauty of the extensive 
districts which have grown up around the city, and which vie with 
it in wealth and population, is now in danger for want of a spirit of 
liberality, which would disregard an immediate outlay, where a 
great future benefit was to be attained. 
Supply of Water.—Amongst the sources of health and salubrity 478 
with which Philadelphia is favoured, is an abundant supply of excel- 
lent water. This is derived from the river Schuylkill, through the 
admirable works located at Fairmount. The water is pumped by 
machinery into reservoirs built at the top of the mount, and from 
thence is distributed through the city. 
The main trunks, proceeding from these reservoirs, are so arranged 
as to admit of the subsidence of any sediment, which may exist in 
the water, previous to its passage into the smaller pipes which carry 
it onward; and, except after great freshets in the river, when the 
water is apt to be turbid for several days, it is drawn from the hy- 
drants in a very pure state. It is estimated, by the Superintendent 
of the Water Works, that the average number of days in the year, 
in which this impurity exists, is about twenty. “ The water is con- 
ducted into the city by two principal iron mains of twenty inches 
diameter; from these are carried lateral mains, varying in size from 
three to sixteen inches diameter, and extending, in the city proper 
alone, nearly seventy-five miles.”* 
The water is carried into all the main streets of the city, and into 
almost all the public lanes and alleys east of Broad street, but be- 
tween that street and the Schuylkill, the distribution is not so com- 
plete; this being regulated chiefly by the number of houses in the 
street. It is not known what proportion of houses in the city are 
furnished with hydrants ; but it is supposed that at least 3,500 fami- 
lies obtain their supply of water from the public hydrant pumps, 
which are placed along the principal streets. 
The districts of the Northern Liberties, Spring Garden, and Ken- 
sington, lying north of the city proper, are supplied with water by 
a distinct set of works, under the control of these corporations ; and 
since their opening, the distribution in this direction has been greatly 
increased. 
The number of baths in private houses, receiving their supply 
from Fairmount, was estimated in 1847 at 3,521; while the number 
of tenants who paid for a supply of water during the same year was 
15,205 in the city proper. From this, it appears that the number 
of baths bears a small proportion to the private hydrants existing 
on the premises of the inhabitants; a fact which would seem to in- 
dicate that the practice of bathing was confined to a comparatively 
small number. 
* Letter of Frederick Graff, Superintendent of Fairmount Water Works. Report of 
Joint Special Committee of Select and Common Councils of Philadelphia, on Public 
Hygiene. 479 
A rapid improvement is, however, manifest in this respect; and 
in most of the houses recently erected on the main streets, or now 
in progress, conveniences for bathing are furnished—and a bath- 
house is considered indispensable to domestic comfort. There is, 
however, a general absence of bathing apparatus, and even of hy- 
drants, in the houses of the poorer classes, and especially in the 
confined courts and alleys in the populous districts of the city. This 
is a great evil, and calls loudly for public interference. A regula- 
tion, enforcing the introduction of water into every house, would, 
it seems to us, fall within the powers of municipal bodies. Upon 
this point, in reply to ninth query of the committee, touching the 
effective administration of existing ordinances, in regard to health, 
the Sanitary Committee of the Board of Health remark : “ The 
agents of municipal bodies execute the orders of the body they re- 
present ; but it is believed that a very short-sighted, circumscribed 
policy obtains too generally in the administration of local ordinances, 
with reference to public health in the free use of water, which it 
should be made obligatory to have introduced into every house 
erected, however small. By facilitating the means of frequent bath- 
ing in families—particularly the poor and labouring classes—the 
effect would soon be apparent, by removing a prominent cause of 
disease, and contribute to the moral, as well as physical improve- 
ment of the lower classes of society.” 
But five public baths exist within the city limits, and one in the 
district of Spring Garden; and the entrance to these is at a cost 
which excludes a large proportion of the inhabitants who are with- 
out the facilities of bathing at their own houses. Could the system 
of model bathing-houses and cheap baths, be introduced here as in 
some of the cities of Europe, it would add greatly to the public 
convenience, and be promotive of health. By this plan, the means 
of bathing, at least once a week, would be furnished to the labouring 
population, while the private interest of no one would suffer. 
A benevolent institution, recently established in the district of 
Moyamensing, for the purpose of furnishing employment to the poor, 
have connected within their building a range of baths, supplied 
with hot and cold water, to which access is had by tickets, furnished 
at the rate of three cents each, or by its equivalent in labour. Such 
an arrangement is highly commendable, and has, probably, been the 
means, in this instance, of furnishing baths to many poor creatures 
in this section of Philadelphia, who have never before enjoyed that 
luxury ; and who, from their filthy condition, are peculiarly in want 480 
of it. The multiplication of such establishments, especially in parts 
of the city inhabited chiefly by the poorer classes, and open at a 
mere nominal cost, would be an excellent practical measure of be- 
nevolence ; and would, we believe, diminish the liabilities to disease 
amongst a large class, who are now much exposed. 
The quality of Schuylkill water is excellent, both for drinking 
and for domestic purposes; but four or five grains of foreign mat- 
ter are contained in a gallon ; and of this, one-half is carbonate of 
lime, obtained in its passage through the limestone region in the 
vicinity of the city. 
The supply furnished to the city is ample, and the means of in- 
creasing it, when necessary, easy. 
At present, it is estimated that each tenant receives, on an aver- 
age, 179 gallons per day; and, allowing six persons to a family, 30 
gallons daily to each individual.* 
In order to secure the water from contamination by manufactories, 
sewers, &c., located above the dam, the city corporation have re- 
cently purchased the ground, skirting the river for some distance 
above the water works, which it now holds as public property. 
The conversion of this attractive spot, once occupied as a country 
seat by the late Henry Pratt, and celebrated for its beautiful gar- 
dens, into a public square or park, which should be thrown open to 
the citizens, and be connected with the grounds at Fairmount, would 
add additional attraction to this favorite place of resort, and consti- 
tute an important link in that chain of influences which counteract 
the deleterious effects upon health induced by the evils of a crowded 
population to which we have referred. 
Prison Discipline in Philadelphia.—A resolution passed by the 
Association, at its last meeting, directs the attention of the Com- 
mittee on Public Hygiene to “the effects of confinement in prisons 
and penitentiaries; and of the discipline in general, in those institu- 
tions, on the health of their inmates.” Without entering into an 
extended inquiry upon this important subject, the undersigned would 
simply present a few facts and conclusions, derived from the official 
records of the Eastern State Penitentiary and of the Moyamensing 
or County Prison, both located in the vicinity of Philadelphia. 
These prisons, as is generally known, are conducted upon the 
plan of separate confinement, which originated in Pennsylvania, and 
* See Letter of F.Graff, Esq., in Report of Committee on Public Hygiene, to Councils. 481 
have been in operation for a sufficient length of time to enable us to 
arrive at important results as to the influence of this system upon 
health. 
From the last Annual Report of the Eastern Penitentiary, we 
learn that since its opening in 1829, to the close of the year 1848, 
2421 prisoners have been confined there, of whom 214 have died, 
being a mortality of nearly ten per cent. 
In the County Prison, from its opening in Tenth mo. (October), 
1835, to the close of the year 1848, 2818 prisoners were admitted 
to hard labour, of whom 155 have died, being an average mortality 
of 5.50. (See Second Annual Report of Inspectors of Philadelphia 
County Prison, p. 21.) 
This disproportion between the two institutions is believed to be, 
in a great measure, attributable to the difference in the length of 
sentences of their inmates. 
In the State Prison, persons convicted of the higher crimes are 
confined, their sentences varying from one to twenty-one years, and 
averaging at least three years; while in the County Prison, the 
period of confinement for less grave offences is much shorter, many 
being confined under six months, and a large majority not over a 
year. Thus, in the year 1848, of 160 prisoners sentenced to hard 
labour, 67 were sentenced for under six months, 40 over six months, 
39 for one year and over, 11 for two years and over, and 3 for 
three years and over. 
The mortality in both institutions is sufficiently high to excite 
anxious inquiry, and to create doubts as to the favourable influence 
of their discipline upon health. When it is remembered that the 
inmates of prisons are composed chiefly of young and middle-aged 
men, about three-fourths of the whole number being between twenty 
and forty years of age, and that prisons upon the separate plan are 
usually exempt from the epidemic and infectious disorders which 
prevail in crowded communities, this amount of mortality is the 
more striking. 
It is estimated that in 1840, when the last census was taken, the 
deaths occurring in Philadelphia between the tenth and twentieth 
year, were only one in about 260 of the inhabitants at that period 
of life. Those between the twentieth and thirtieth years of age, 
were 1 in about 102; between the thirtieth and fiftieth years, 1 
in about 57. This estimate includes the coloured population, 
whose general average of mortality, when taken separately, is 482 
higher than the whites.* It would appear, therefore, that there is 
a wide difference between the deaths of the inmates of prisons and 
of persons of the same age out of prison. Allowance must be 
made, of course, for the vicious and irregular habits of convicts, 
and for their defective health on admission, but, even with this 
abatement, there is still a large mortality to be attributed to other 
causes.f 
In examining into the circumstances which may be supposed to 
influence these results, several points present themselves as deserv- 
ing of especial attention. 
First. Prisoners in separate prisons, are confined both by day 
and night to small, illy-ventilated cells, which are shut out from the 
direct rays of the sun, and are consequently damp and gloomy. To 
these cells, yards are attached, in which the convicts are allowed to 
exercise an hour each day; but the walls enclosing these spaces are 
so high as to cut off a free circulation of air, and to prevent the 
access of the sunlight, except for a short time each day. To this 
cell and yard the prisoner is constantly restricted, and his trade or 
occupation is carried on in the same narrow apartment in which he 
eats and sleeps. He has, by this arrangement, no opportunity for 
exercise or employment in the open air, and is breathing, for the 
most part, a vitiated atmosphere, without the relief of a change of 
position and scene to a workshop, or of a walk to and from his 
daily labour. 
Second. The occupations supposed to be best adapted to sepa- 
rate prisons are sedentary and unhealthy; weaving and shoemaking 
being the principal trades in these institutions. 
Third. The length of sentences to which prisoners are subjected 
is a fruitful source of disease and death; and, in separate prisons, 
operates with more intensity than in the congregate prisons, in 
which the confinement is less rigid, and the occupations more health- 
ful. Close confinement, which might be borne with impunity for 
six months or a year, becomes prejudicial when carried beyond this 
period; and if prolonged to four or five years, often breaks down 
the health of body and mind, if it does not destroy life. 
Fourth. The most prominent cause of the large mortality in 
* Emerson on Vital Statistics of Philadelphia, Amer. Journ. of Med. Sciences, July 
1848, p. 19. 
t In 1846, there were 13 deaths, of whom 9 entered the institution in imperfect 
health; in 1847, 9 deaths, of whom 3 entered in imperfect health; in 1848,16 deaths, of 
whom 11 entered in imperfect health. 483 
the prisons of Philadelphia, is to be found in the intolerance of the 
coloured prisoners of this method of confinement, and their com- 
parative good health under the milder system of associated labour. 
This peculiarity of the coloured race was noticed very soon after 
the opening of the Eastern State Penitentiary at Philadelphia, and 
was made the subject of an able paper by Dr. Benj. H. Coates, of 
this city, which was read before the American Philosophical Society, 
in the year 1843, and has since been published. 
Ample experience since that time has confirmed the views then 
expressed by Dr. Coates, and the subject is now claiming renewed 
attention at the hands of the Prison Discipline Society of Phila- 
delphia. 
It appears that of the whole number of 1631 white prisoners 
received to the close of the year 1848, at the Eastern Penitentiary, 
73 have died; and of the whole number of 790 coloured prisoners, 
141 have died! (See Note to Physician’s Report, in Twentieth An- 
nual Report, p. 1.) 
At the County Prison, a nearly equal disproportion exists. Of 
1526 whites received to the close of the year 1848, 37 have died; 
while of 1392 blacks, admitted up to the same period, 118 have 
died! (See Second Annual Report of the Inspectors of Phila- 
delphia County Prison, made February, 1849.) 
The proportional mortality amongst the coloured population in 
the community at large, has been supposed by some to account for 
this wide difference in prisons; but this is found entirely inadequate 
to explain it. 
The average mortality of the white inhabitants of Philadelphia 
during the decennial period from 1830 to 1840, has been estimated 
at 1 in 43; while the general average of the coloured population 
for the same period was 1 in 31, and in the year 1840 it was as 
low as 1 in 38f *. 
It is proper to remark, that another cause for this increased 
mortality amongst the coloured prisoners, arises from the fact that 
the average length of their sentences for the same class of crimes is 
higher than that of the white prisoners; and that they seldom par- 
take of executive clemency. Out of 278 pardons, granted since 
the opening of the Eastern State Penitentiary, but 25 have been 
bestowed upon this unfortunate class, notwithstanding the propor- 
tion which they bear to the whole number of inmates. 
The causes above indicated predispose to the development of 
* See Emerson on Vital Statistics of Philadelphia, pp. 18 and 19. 484 
scrofula and consumption, and it is found that the large proportion 
of the deaths occurring in our prisons are from these diseases. 
The development of insanity in penal institutions, with reference 
especially to the two systems of confinement known as the separate 
and congregate, is, at this time, exciting a deep interest both here and 
abroad. It is generally admitted that a larger ratio of insane to the 
sane, will be found in all prisons, than in the community at large ; 
while many believe that there is a striking connection between in- 
sanity and crime, and a strong proclivity to the commission of out- 
rages against the laws, even on the part of those hereditarily predis- 
posed to mental disease. Some interesting inquiries upon this point 
have been made by Dr. Given, the present resident physician of the 
Eastern State Penitentiary, which will be found embodied in the 
seventeenth annual report from that institution. 
It is believed by Dr. Given, that 9.09 per cent, of the prisoners 
committed there are insane to a greater or less degree, and that 
20.20° of them have insane relatives bearing to them different de- 
grees of consanguinity. 
If this observation be true in reference to convicts generally, it is 
not surprising that there should be more insanity in a prison popula- 
tion than amongst other classes. The question for us to consider, 
however, is, How far does the discipline of a prison tend to the 
development of the disease; or in what proportion of the convicts 
who enter with sound minds, is it induced ? 
Upon this point, it is to be regretted that we are not furnished 
with the same accurate and detailed information as is contained in 
the admirable tables of physical health before referred to. We have 
tables, however, from both the prisons of Philadelphia, which present 
the actual amount of insanity occurring in each year in these insti- 
tutions, and from the county prison a table showing all the cases which 
have been under treatment there, from the opening of the institution 
in 1835, to the close of the year 1848, with the age, sex, colour, date 
of sentence, period of attack, &c., of each patient. From this we learn 
that, in the county prison, twenty-three insane prisoners have been 
under treatment, out of 2,818 who have been in confinement. Of 
these, 14 are reported as having been insane on admission leaving 
but 9 cases originating in the prison. 
We have no similar table from the Eastern State Penitentiary, but, 
by reference to the annual tables of insanity (which of late years 
have been very full and complete), we can ascertain the number re- 485 
ported for any given period. With a view of presenting the present 
condition of that establishment, we will refer to the statistics for the 
past three- years, as found in the eighteenth, nineteenth, and twenti- 
eth annual reports; premising that only the new cases, originating 
in the prison, are put down in these tables. 
In 1846, 8 cases of insanity are reported, in a population of 
308 prisoners in confinement at the close of the year. In 1847, 
9 new cases are reported from 294 inmates, and in 1848, 10 cases 
from 292 inmates. All of these 27 cases are supposed to have been 
of sound mind on admission; 9 were ascertained to have had insane 
relatives in different degrees of consanguinity; from 7, no informa- 
tion could be obtained on this point, and in the other 11 no such 
tendency existed. 15 are recorded as entering the institution in 
good health, and 12 in imperfect health. 1* 
The large disproportion here manifest between the two institutions, 
is probably attributable in a great measure to the same causes which 
influence the mortality, as before referred to, and also to the fact that 
the offences for which convicts are confined in the county prison, are 
of a less grave character, and not so likely to produce mental dis- 
tress. Another cause may be, that the seclusion in the county 
prison is much less rigid than in the State institution, prisoners 
communicating with great ease, and being generally aware of what 
is going on around them. 
It must be confessed, that the large amount of insanity and mor- 
tality revealed by the reports of both these institutions, has created 
in many candid and humane minds, strong doubts as to the safety 
of the discipline adopted therein. Many believe, however, that these 
results are not fairly attributable to the system of separate confine- 
ment, but that they might be greatly diminished by a more strict 
regard to hygienic laws, than has heretofore been observed. Such 
appears to be the opinion of the present efficient medical officer of 
the State Penitentiary; who thus expresses himself in his report for 
1847. 
“ When speaking of the physical health, I stated my belief that, 
by proper sanitary regulations, the mortality could be reduced very 
greatly, without the slightest encroachment on the principles of sepa- 
ration ; and now, as regards the mental health, I repeat the same 
conviction, with even greater confidence in its truth, and, if possible, 
a more earnest desire to see the necessary measures put in immediate 
operation.” And again, speaking of the insane prisoners in 1848, 
he remarks: “As regards those who become insane during their im- 486 
prisonment, some efforts ought certainly to be made to have them 
placed under more suitable influences for their restoration to health, 
than has heretofore been the case.” 
Whatever may be thought of the practicability of the Penn- 
sylvania system, and of the superiority of the principle upon which 
it is based in a moral point of view, it is evident that, unless the 
results which have thus far attended it can be altered by an admi- 
nistration more consonant with the laws of mental and physical 
health, this great experiment in penal discipline, for which Penn- 
sylvania has become so distinguished, must fail of its humane pur- 
poses. 
In the, preceding sketch of the public hygiene of Philadelphia, 
your reporter has confined himself mainly to the topics suggested 
in the circular letter of the committee ; he has aimed rather to point 
out defects and growing evils, than to bring to view the varied beau- 
ties and advantages, which have given to this city a high reputation, 
as one of the most healthful and attractive which is to be found in 
either hemisphere. 
Should the labours of this and subsequent committees of the Asso- 
ciation be instrumental in directing public attention to abuses in our 
large cities, and in bringing about salutary reforms, a noble work will 
have been accomplished; and we may reasonably cherish the hope, 
that these flourishing seats of intelligence, learning, and enterprise, 
will become also the abodes of health and salubrity. 
In concluding this Report, the undersigned must acknowledge his 
obligations for the valuable aid furnished in its preparation by Gr. 
Washington Smith, Esq., and Dr. Emerson, both well known for the 
zeal and ability with which they have prosecuted inquiries into the 
subject of public hygiene, and to Charles A. Poulson, Esq., a mem- 
ber of the Common Council of Philadelphia, and Drs. Elkinton 
and Jewell, of the Board of Health, for their influence in obtaining 
prompt replies to the circular of the committee addressed to these 
bodies. 
ISAAC PARRISH. 
To Dr. James Wynne, Chairman of Committee on Public Hygiene, of the Na- 
tional Medical Association. H.—6. 
Public Hygiene of Massachusetts; but more particularly of the 
Cities of Boston and Lowell. By J. Curtis, M. D. 
The Commonwealth of Massachusetts sustains a prominent posi- 
tion among the States of the Union in the adoption of measures for 
improving public health. For a long time, its statutes have provided 
for the registration of births, marriages, and deaths, occurring upon 
its territory. Its earlier systems, however, subsided into a state of 
comparative uselessness from their great inefficiency. 
In 1842, the Massachusetts Medical Society, the American Aca- 
demy of Arts and Sciences, and others, memorialized the legis- 
lature for a more perfect and operative law on this subject. These 
memorials resulted in the Act of March 3, 1842, which was super- 
seded by the more effectual one of March 16, 1844. This last act 
was again revised and materially modified so as to augment its 
utility, in the act which passed yesterday (May 2, 1849). Yester- 
day, also, our General Court complied with the petitions of the 
State Medical Society, the American Statistical Association, and 
others, by passing a resolve which authorizes the governor to ap- 
point three commissioners, to report to the next legislature a plan 
for a sanitary survey of the State. This is much in advance of 
anything that has before been done in this country. 
In compliance with the registration laws, seven annual reports 
have been made by the Secretary of the Commonwealth.* These 
reports, though quite imperfect, from defective modes of registration 
in many parts of the State, have nevertheless presented much im- 
portant information, especially the 2d and 4th, which were enriched 
with letters from Lemuel Shattuck, Esq., of Boston. Each year 
has made an advance towards accuracy and completeness of return, 
showing that the system is becoming better understood, and enlist- 
* These annual reports embrace the twelve months ending on the 30th of April, in 
the year of their date. The city of Boston made no returns to the Secretary of the State, 
hence the county of Suffolk is not included. 488 
ing an interest in proportion to the increasing knowledge of its 
great utility. During the last five years, nearly 80,000 births, 
25,000 marriages, and 50,000 deaths, have been recorded. The 
record of deaths states the date, age, sex, disease, late residence and 
occupation. From such tables (a summary of which are appended 
to this Report), especially wThen they shall be nearer perfect under 
the late act, computations and comparisons of the highest value may 
be drawn with different localities in our own country, and other parts 
of the globe. The influences of climate, season, condition, place- 
ment, and occupation, upon human life, may be more or less clearly 
seen, as well as, also, topical influences upon particular diseases, and 
the proportional degree with which mortality presses upon different 
ages. 
In the seaboard counties of the State, even after excluding Suffolk 
county, which embraces the city of Boston, the rate of mortality 
among children under five years of age, is four per cent, higher 
than in the western counties. In one of the interior counties 
(Franklin co.), in the valley of the Connecticut River, the average 
duration of life was thirty-eight years ten months and twenty-four 
days; while in the county of Middlesex, vdiich includes the city of 
Lowell, it was only twenty-eight years two months and tAventy-two 
days. A still greater difference obtains when we compare country 
districts with cities. In Franklin county, as before stated, the 
average age was nearly thirty-nine years, while in the city of Bos- 
ton, it was a little less than 22.75 years, giving an addition of 
about 16.25 years, or over seventy per cent, in favour of the coun- 
try district. Again, when we notice the condition of different 
classes, we find that, although the average age of all dying in Boston 
was only 22.75 years, the average age of those of them who were 
buried in the Catholic burying-grounds was but 13.5 years, or about 
one-third the average life in Franklin county. 
In 1846, twenty-eight per cent, of all the deaths in the State 
were from diseases of the organs of respiration. The mortality from 
this class of diseases advanced, in 1847 and 1848, to near thirty per 
cent. Last year, of the 11,203 deaths recorded, 9954 Avere from 
specified causes; of these, 2937 were from lung diseases, most of 
which were consumption; 1202, or twelve per cent., Avere from 
typhus,* and 1074, or 10.8 per cent., from dysentery; making 52.3 
per cent., or more than half of the total mortality of the State, from 
* Typhus also embraces “typhoid fever.” 489 
these three causes alone. This shows that death has of late visited 
our people through consumption, typhus, and dysentery, much more 
frequently than through any other agents. The mortuary tables 
show that that most fruitful source of death—consumption—is much 
influenced by age, very little by season ; while the congeners typhus 
and dysentery are affected both by age and season, as is exhibited 
by the subjoined abstracts. The period embraced is three years, 
viz., from 1846 to 1848 inclusive:— 
TABLE I. 
Ages. 
Deaths from Consumption. 
Deaths from Typhus Fever. 
Deaths from Dysentery. 
Males. 
Females. 
Total. 
In 10,000. 
Males. 
Females. 
Total. 
In 10,000. 
Males. 
| Females. 
Total. 
In 10,000. 
Under 1 
107 
97 
204 
296 
48 
27 
75 
265 
148 
122 
270 
1681 
1 to 2 
71 
51 
122 
177 
54 
33 
87 
308 
198 
143 
341 
2123 
2 to 5 
56 
64 
120 
174 
80 
85 
165 
584 
185 
159 
344 
2142 
5 to 10 
47 
69 
116 
169 
87 
96 
183 
647 
65 
49 
114 
710 
10 to 20 
190 
539 
729 
1058 
234 
301 
535 
1893 
37 
41 
78 
486 
20 to 30 
564 
1108 
1672 
2427 
392 
308 
700 
2477 
37 
57 
94 
585 
30 to 40 
446 
727 
1173 
1703 
200 
157 
357 
1263 
21 
42 
63 
392 
40 to 50 
329 
468 
797 
1157 
91 
95 
186 
658 
28 
42 
70 
436 
50 to 60 
248 
352 
600 
871 
90 
86 
176 
623 
32 
40 
72 
448 
60 to 70 
268 
325 
593 
861 
70 
74 
144 
510 
21 
30 
51 
318 
70 to 80 
233 
367 
500 
726 
77 
55 
130 
460 
20 
38 
58 
361 
80 to 90 
62 
90 
152 
221 
22 
19 
41 
145 
11 
20 
31 
193 
Over 90 
2 
6 
8 
12 
1 
2 
3 
11 
3 
3 
6 
38 
Unknown 
46 
56 
102 
148 
22 
22 
44 
156 
8 
6 
14 
87 
Totals 
2669 
4219 
6888 
10,000 
1466 
1360 
2826 
10,000 
814 
792 
1606 
10,000 
TABLE II. 
Months. 
Deaths from Consumption. 
Deaths from Typhus Fever. 
Deaths from Dysentery. 
Males. 
Females. 
Total. 
In 10,000. 
Males. 
Females. 
Total. 
In 10,000. 
Males. 
Females. 
Total. 
In 10,000. 
May 
210 
360 
570 
828 
65 
53 
118 
417 
7 
3 
10 
62 
June 
213 
331 
544 
790 
98 
73 
171 
605 
6 
9 
15 
93 
July 
239 
322 
561 
814 
112 
82 
194 
686 
60 
63 
123 
766 
August 
224 
367 
591 
858 
152 
154 
306 
1083 
233 
239 
472 
2939 
September 
241 
376 
617 
896 
231 
219 
450 
1592 
310 
300 
610 
3798 
October 
208 
369 
577 
838 
225 
205 
430 
1522 
135 
134 
269 
1675 
November 
203 
313 
516 
749 
158 
144 
302 
1069 
25 
20 
45 
280 
December 
215 
348 
563 
817 
112 
118 
230 
814 
9 
7 
16 
100 
January 
217 
346 
563 
817 
70 
84 
154 
545 
10 
7 
17 
106 
February 
210 
346 
556 
807 
80 
80 
160 
566 
3 
4 
7 
44 
March 
244 
367 
611 
887 
88 
77 
165 
584 
6 
5 
11 
68i 
April 
245 
374 
619 
899 
75 
71 
146 
517 
10 
1 
11 
68J 
Totals 
2669 
4219 
6888 
10,000 
1466 
1360 
2826 
10,000 
814 
792 
1606 
10,000 
YOL. II.—32 490 
The preceding tables show that consumption and typhus press 
upon the period between twenty and thirty with a force of mortality 
greater than at any other age; while more than one-half of the 
deaths from dysentery occur prior to the end of the fifth year of 
life. Again, we observe that typhus and dysentery, like other dis- 
eases of the zymotic* class, are by far the most fatal in the latter 
part of summer and early part of autumn, being the severest in 
September; while consumption exhibits much uniformity through 
the entire year. 
Our life records are not sufficiently minute, to show how much the 
various occupations of life are influenced by the seasons; but the 
following table will serve to illustrate their effect on longevity, by 
exhibiting the average ages at death, in some of the more common 
pursuits, during the five years last past. 
TABLE III. 
Number of deaths in 
The average ages were in 
Classes. 
1844 
1844 
to 
to 
1844. 
1845. 
1846. 
1847. 1848. 
1848. 
1844. 
1845. 
1846. 
1847. 
1848. 
1848. 
Agriculturists 
663 
645 
679 
741 
739 
3467 
64.02 
61.81 
66.63 
64.14 
65.41 
64.40 
Labourers 
182 
219 
216 
262 
424 
1303 
51.18 
48.81 
49.44 
46.73 
43.49 
47.93 
Mechanics 
452 
477 
538 
651 
649 
2767 
45.63 
46.96 
45.75 
46.45 
46.06 
46.17 
Merchants 
75 
90 
81 
102 
93 
441 
54.08 
48.92 
53.04 
49.20 
51.92 
51.42 
Paupers 
35 
5 
37 
47 
32 
156 
70.91 
81.60 
69.48 
57.62 
65.00 
68.92 
Professional men 
82 
62 
54 
74 
64 
336 
43.28 
43.93 
52.72 
51.15 
49.87 
48.19 
Public officers 
25 
35 
34 
42 
45 
181 
40.68 
44.11 
41.06 
45.00 
40.04 
42.18 
Seamen 
162 
145 
119 
214 
188 
828 
40.12 
42.80 
48.72 
43.04 
43.50 
43.64 
Totals 
1676 
1678 
1758 
2133 
2234 
9479 
51.23 
52.37 
53.35 
50.42 
50.66 
51.61 
Since 1840, the subject of improving public health has been more 
or less agitated; and many writers have urged, with some effect, the 
claims of hygiene upon the citizens of the State. The excellent little 
treatise on the “Preservation of Health,” by Prof. J. C. Warren, 
has passed through many editions, and had an extensive circulation. 
“The Factory System in its Hygienic Relations,” being the annual 
address before the State Medical Society in 1844, by Dr. J. 0. 
Green, has been perused by the profession with interest. The last 
annual address, before the same body, on “Ventilation,” by Dr. L. 
V. Bell, is a very elaborate and valuable contribution. The well- 
timed lecture, before a benevolent fraternity in Boston, on the “ Cir- 
cumstances affecting Individual and Public Health,” by Dr. C. E. 
* Zymotic—epidemic, endemic, and contagious. See page 504. 491 
Buckingham, contains many important topical facts, and ought to 
have a salutary influence. The works on “Physiology for Schools,” 
by Drs. Cutter, Jarvis, and others, are effecting much good. But, 
without enumerating here all the useful publications on this subject, 
we would allude to the following, which deserves more than a pass- 
ing notice. One of the most useful documents bearing on this point, 
is the very able Report of the Hon. Horace Mann, as Secretary of 
the Board of Education in 1843. At that time, of the 150,000 
scholars in our public schools, only 416 were pursuing the study of 
human physiology; while 2,333 were studying the less important 
branch of algebra. The Hon. Secretary says: “The study of the 
laws of life and hygiene, or the rules and observances by which 
health can be preserved and promoted, has claims so superior to 
every other; and, at the same time, so little regarded or understood 
by the community, that I shall ask the indulgence of the board, 
while I endeavour to vindicate its title to the first rank in our 
schools, after the elementary branches;” and this he does in a very 
eloquent and convincing manner. Here he aims at a most important 
principle, that of teaching our children and youth those essential 
matters, which, if observed, will prevent much sickness, enlarge ca- 
pacities for happiness and usefulness, and prolong life. When Cati- 
line would subvert the liberties of Rome, he commences by corrupt- 
ing the minds of its youth; so, also, the most efficient mode of 
working any great reform is to instruct, properly, the rising gene- 
ration. The cardinal reason why the laws of health and life are so 
little regarded at present, is found in the great prevalence of an ig- 
norance of them throughout the community, or, as the writer above 
quoted has it: “ Sheer ignorance of facts and principles, which every 
parent, by virtue of his 'parental relation, is as much bound to know, 
as a judge is bound to know the civil or criminal law which he under- 
takes to administer; or a juror, in a case of life and death, is bound 
to understand the evidence on which his verdict is to be rendered.” 
“Even educated men,” he continues, “who are not physicians, are 
rare exceptions. The graduates of colleges and theological semi- 
naries, who would be ashamed if they did not know that Alexander’s 
horse was named Bucephalus, or had not read Middleton’s octavo 
volume on the Greek Article, are often profoundly ignorant of the 
great laws which God has impressed on their physical frame, and 
which, under penalty of forfeiting life and usefulness, He has com- 
manded them to know and obey.” It is this that allows eminent 
divines, and others of high, general intelligence, to give their re- 492 
commendations to vague nostrums, and lend their influence to vain 
pretenders, thus occupying a position where they cast a most baneful 
shadow upon the vital interests of their fellow-men. 
Now, until knowledge on any subject, however practical or 
important, is disseminated, but little is to be expected; for, unfor- 
tunately, men seldom act as well as they know—never better. 
Knowing that a great change had taken place in the pursuit of life- 
knowledge in the State, within the last few years, and deeming some- 
thing definite on the point highly desirable, I inquired of what will 
be universally acknowledged the best authority, and received the 
following reply:— 
“Dr. J. Curtis— 
“Washington, April 12th, 1849. 
“Dear Sir: Your letter has just been forwarded to me at this 
place. The information to which you refer was obtained, in 1843, 
by inserting a question in the blank of the form of school return, 
which was sent to the committees. 
“No such information has been obtained since. Of course, it is 
impossible to answer your question with precision. The number 
given must be conjectural. But a vast change has taken place in 
the public mind since that time, perhaps on no other subject a greater. 
All the teachers just out from our normal schools are well grounded 
in the elements of human physiology. They introduce it wherever 
they go. It has been prominent at all our teachers’ institutes. I 
have lectured upon it hundreds of times to teachers and school 
associations. My estimate is, that not less than 15,000 of the 
170,000 children in our public-schools attend to this subject. But 
this, as I before said, is conjectural. 
“Very truly, yours, &c., 
“HORACE MANN.” 
It gives me great pleasure to comply ■with the strong request of 
Mr. Mann in another letter, by still urging increased attention to 
this most important subject, in the public schools of our common- 
wealth; for the sad results of violated physical law hereinafter to 
he noticed, are not so surprising to those who are aware of the 
general, almost universal lack of proper information.* 
* “ I will only add that, respecting the laws of health and life, it may be said—though 
the remark may seem so extraordinary as apparently to amount to a libel on human 
nature—on no other subject connected with the interests, happiness, or longevity of man, 493 
Although something has been done in this State, when compared 
with other States in the confederacy, insomuch that those interested 
in sanitary improvement, both at home and abroad, have pointed to 
Massachusetts as having set an example worthy the imitation of her 
sister States, yet we are far, very far, in the rear of what we ought 
to be, when the great and vital importance of the subject is duly 
considered. We have legislated, usque ad nauseam, on almost every- 
thing but that which concerns us most, namely, the surest sources of 
health and life, and consequent happiness and prosperity. By legis- 
lation, we have protected the beasts of the field, the fowls of the air, 
and the fish of the sea; by legislation, we have encouraged the arts 
and sciences, except those which would most directly enable us to 
live long, useful, and happy; by legislation, we have granted privi- 
leges to the manufacturer, developed the resources of the agricul- 
turist, and directly or indirectly offered rewards* for the best cattle, 
the fleetest horses, and the fattest hogs; have extended inducements 
for the best buildings, greatest crops, and most improved implements, 
all of which is most praiseworthy; but we have neglected to use the 
means for securing attainable longevity and exalted happiness as 
well as some of the most prolific sources of State wealth. 
The City of Boston kept a record of baptisms, marriages, and 
deaths for the seventy years immediately preceding the American 
Revolution, which is still extant. Since 1810, the superintendent 
of burials has kept a record of deaths. Abstracts of these bills of 
mortality have been printed by the city, and all but two or three of 
the earliest are still in existence. These statements, as annually 
made by the officer, since the date of the city charter in 1821, have 
been consulted, and the whole divided into quinquennial periods, the 
last being incomplete as to time, embracing only three years. The 
diseases have been classified according to the plan of Mr. Farr, the 
English Registrar-General, as modified by Mr. Shattuck, of Boston, 
and recommended by the American Medical Association, in 1847. 
is the darkness of ignorance so profound and universal.”—Sanitary Condition of the La- 
bouring Population of New York. By H. Griscom, M. D. New York, 1845: pp. 58. 
* The State has paid, through Agricultural Societies alone, 
From 1792 to 1845 $115,816 00 
In 1846 3,440 00 
In 1847 6,631 20 
In 1848 7,102 00 
Total $132,989 20 
Mem. Mass. Med. Soc., House Doc., No. 66, 1849. 494 
For the convenience of ready comparison, I have also calculated the 
per cent, which the mortality from each disease bears to the total 
from specific causes in each period.* Approaching accuracy in these 
records is manifested in the fact, that the unspecified causes of death 
have been reduced from 18.5 per cent, in the first period to less than 
one per cent, in the last period. 
The statistics for the State embrace no period in the tables for 
Boston, unless it is the last; and typhus and dysentery have pre- 
vailed as epidemics so extensively in the State during the last year, 
as to preclude the propriety of considering the zymotics of this 
period a fair index of this class of diseases generally; hence, the 
justice of comparison between the State and its capital, in these dis- 
eases at least, is lost. 
In 1818 and 1819, typhus fever proved quite fatal. It prevailed 
again in 1835, though not so severely. Since 1846, however, it has 
been one of the most fatal diseases in Boston. In the year 1847, 
it caused 673 deaths. Dysentery has also prevailed extensively, 
and been very fatal, not only in Boston, but throughout most parts 
of New England, during the last two years. The number of deaths 
in Boston from it was 222 in 1847, and 278 in 1848. It has never 
been above sixty-five in any year before since 1810. All “diseases 
of the bowels” have likewise very much increased of late. During 
the last three years, 1079 deaths have been recorded as having been 
caused by what it was intended to have this vague term express; 781 
being the whole number recorded under this head for the thirty-five 
years previous, 123 of which were in 1845. 
The measles appeared as a very fatal epidemic so long ago as 
1713. In 1730 it was very extensive, but less fatal. It appeared 
again in 1757 and 1772. It has been much more frequent of late. 
In the period comprised in the tables, 1821, ’25, ’29, ’32, ’35, and 
’46 wTere the most fatal. In the last named year, it caused 150 
deaths, and only fifteen and sixteen, respectively, in 1847 and ’48. 
Scarlet fever is said to have been first noticed in 1735 and ’36, 
when it was quite general and very fatal throughout New England. 
It is stated that 4000 were sick with it in Boston, and one in thirty- 
five of them died. At this date, the town contained only 9000 in- 
habitants. In one of the neighbouring country towns, where nine 
* We take the calculations for the period 1841 to 1845 inclusive (with some trans- 
positions), as made out by Lemuel Shattuck, Esq., of Boston. We here also take plea- 
sure in acknowledging our indebtedness to him for many important hints and points of 
information. 495 
or ten was the usual annual number of deaths, it swelled the bills of 
mortality to 102, and an equal increase of deaths occurred in other 
places. We find but few deaths from the disease after this, till 
1832, when it was quite fatal, as it also was in 1839, ’42, and ’44. 
Of late, it has attacked the younger members of some of the most 
healthy families in this city and in Lowell, and been very rapid in 
its progress, frequently terminating fatally in twenty-four or forty- 
eight hours. 
The small-pox, so fatal previous to Jenner’s discovery of vaccina- 
tion, is on the increase. In 1836, the law which required all patients 
of this disease to be removed to the hospital, was repealed. During 
the last ten years, there have been 496 deaths from this disease in 
this city; there were but fifty-three for the thirty years previous. 
Within the last two weeks, our General Court have refused to revive 
the wholesome law that was repealed in 1836, although Boston has 
not been free from this loathsome disease since its repeal. 
Boston was afflicted with epidemics of small-pox in 1649, 1666, 
1678, and 1690. In 1698, Mather writes, “The small-pox has four 
times been a great plague among us.”—“Often had one hundred 
bills, desiring prayers for the sick, been read in one day, in one of 
our assemblies. In one twelvemonth, about one thousand of our 
neighbours have been carried to their long home.” In 1702, 4.4 
per cent, of the inhabitants died with it. The most violent epi- 
demic was in 1721, when 6006, being 54.6 per cent, of the popu- 
lation, had it; of whom 14.3 per cent. died. It was during the 
severity of the disease at this date, that the Rev. Dr. Mather called 
the attention of the faculty to an article on inoculation in a foreign 
journal. Dr. Boylston took the hint, and in opposition to the in- 
fluence of his professional brethren, introduced inoculation into this 
country, commencing with his own son. Of those who were inocu- 
lated, one in forty-two died; of those who “took it in the natural 
way,” as it was called, one in seven died. Notwithstanding these 
results, the opposition was so great that Dr. Boylston found it un- 
safe to leave his dwelling in the evening.* The prejudice appears 
to have been equally great in other countries.-}* The cry, some- 
times heard at the present day in such cases,J was raised, that it 
was an impious interference with the judgments with which God was 
* Blake’s Blog. Diet. Chambers’ Inform, for the People, et alia. 
f See Lady Montagu’s Letter from Adrianople, April, 1717, &c. 
J See Prof. Simpson on Anaesthesia. 496 
pleased to scourge his chosen people! The following table from 
Mr. Shattuck* furnishes a view of the prevalence and results of 
this disease during the eighteenth century:— 
TABLE IV. 
Years. 
Cases. 
Deaths. 
Per cent of pop. 
Natural. 
Inoculated. 
Cases. 
Deaths. 
Cases. 
Deaths. 
Per cent. 
Cases. 
Deaths. 
Per cent. 
1721 
6006 
850 
54.6 
7.7 
5759 
844 
14.8 
247 
6 
2.4 
1730 
4000 
500 
26.6 
3.3 
3600 
488 
13.5 
400 
12 
3.0 
1752 
7669 
569 
48.9 
3.6 
5545 
539 
9.7 
2124 
30 
1.4 
1764 
5646 
170 
36.4 
1.1 
669 
124 
18.5 
4977 
46 
0.9 
1776 
5292 
47 
44.1 
1.0 
304 
29 
9.5 
49S8 
18 
0.5 
1778 
2243 
71 
16.6 
0.4 
122 
42 
34.4 
2121 
29 
0.9 
1792 
8346 
198 
46. 
1.0 
232 
33 
14.2 
8114 
165 
1.8 
From Mr. Shattuck we also learn that the proportional mortality 
between the white and coloured population, during two epidemics, 
was as follows :— 
TABLE V. 
Natural. 
Inoculated. 
1752. 
Cases. 
Deaths. 
Per cent. 
Cases. 
Deaths. 
Per cent. 
5060 
470 
9.2 
1985 
24 
1.2 
Whites 
Coloured 
485 
69 
14.2 
139 
6 
4.3 
Total 
5545 
539 
9.7 
2124 
30 
1.4 
1792. 
Whites 
214 
27 
12.5 
8808 
157 
1.7 
Coloured 
18 
6 
33.3 
348 
7 
2.0 
Total 
232 
33 
14.1 
9152 
164 
1.8 
Vaccination was introduced in 1799, after which, this repulsive 
disease was nearly annihilated until within the last ten years, when 
it has prevailed epidemically in 1840, and the winter of 1845-6. 
Diseases of uncertain or general location have varied only 1.5 
per cent, prior to 1840. Had the periods embraced ten years each, 
viz., 1821 to ’30, 1831 to ’40, and 1841 to ’48, they would have 
stood 7.31, 7.50, and 7.56 per cent, respectively. Atrophy has con- 
siderably increased, while dropsy has decreased. “ Sudden deaths” 
have also decreased, owing, no doubt, as in some other cases, to 
more accurate returns by physicians. 
Diseases of the nervous system have maintained a higher per 
* “Census of Boston,” page 144. 497 
cent, than the same class in the State. Those which more especially 
afflict children, as convulsions, hydrocephalus, &c., have generally 
increased. 
The organs of respiration furnish a high ratio for a class of dis- 
eases no larger than this. The tables show increased accuracy in 
returns, and indicate that consumption has somewhat diminished. 
Tubercular diatheses, effected by the debilitating influences of city 
life, have, doubtless, sent off some to typhus and dysentery. 
Diseases of the digestive organs have increased from 5.38 to 
15.01 per cent. There is a great tendency to bowel complaints, 
both those of a zymotic and a sporadic character, among city inha- 
bitants, especially the younger portion, and during the summer and 
autumn months. 
Class V., and Classes VII. to X. inclusive, are quite small, and pro- 
duce an aggregate of only 3.85, or an average of .77 per cent, of 
deaths. 
I have ranked the indefinite terms “ infantile” and “old age” 
together. Justifiable reasons for this, I think, will appear obvious 
to vital statists. 
The seasons are acknowledged to exert great influence on health 
and mortality. By reference to Table XXVII., it will be seen that 
September was the most fatal month previous to 1840, and August 
since that time. This change has been quite gradual; and Mr. 
Shattuck has shown that the greatest number of deaths took place 
in October before 1820. He has also shown that the seasons do 
not affect all ages equally. We quote from him the annexed table, 
embracing five years, viz., 1841 to 1845 inclusive:— 
Months. 
Number of deaths. 
In each 10,000 deaths, ihere were 
Under 15 
15 to 60 
Over 60 
Total. 
Under 15 
15 to 60 
Over 60 
Total. 
January 
433 
292 
96 
826 
421 
280 
92 
793 
February 
431 
315 
84 
830 
414 
302 
80 
796 
March 
373 
306 
87 
766 
358 
294 
83 
735 
April 
421 
322 
100 
843 
404 
309 
96 
809 
May 
425 
330 
101 
856 
408 
316 
97 
821 
June 
356 
291 
82 
729 
341 
279 
79 
699 
July 
475 
296 
75 
846 
456 
285 
71 
812 
August 
698 
335 
64 
1097 
670 
322 
61 
1053 
September 
671 
327 
88 
1086 
644 
314 
84 
1042 
October 
449 
339 
77 
865 
431 
325 
74 
830 
November 
377 
351 
80 
808 
362 
337 
76 
775 
December 
429 
337 
104 
870 
412 
323 
100 
835 
Total 
5543 
3841 
1038 
10,422 
5321 
3686 
993 
10,000 
TABLE VI. 498 
“These deductions,” he says, “show the interesting fact, that 
August, September, and October, which are most unhealthy to per- 
sons under 15 years of age, are the most healthy to those over 60; 
and that the winter months affect the health of old people most un- 
favourably ; and that in the productive ages—15 to 60, the seasons 
have little or no influence in increasing or diminishing the number 
of deaths. 
“ If the published annual abstracts of the deaths had exhibited, 
as they should have done, the number of deaths by each disease, at 
each age, in each month, they would show, it is believed, that the 
principal increase of deaths in the unhealthy months is from dis- 
eases of the digestive organs, which prevail among children.” 
As we turn our attention to the ages at death, we approach a 
most interesting and important point in our investigations. It is 
a point which seldom receives merited examination, and to make 
it as clearly understood as its importance demands, would compel 
us to transcend the proper limits of this report. This, however, has 
been done to a considerable extent, and with much labour by Mr. 
Shattuck, the zealous advocate of hygiene, to the published results 
of whose investigations we must content ourselves to refer.* 
The city of Boston contains not far from sixty-five miles of streets, 
and I learn, in a letter from C. B. Wells, Esq., the Superintendent 
of Sewers, that “ The city has about twenty-five miles of common 
sewers under its control, varying from sixteen inches to five feet in 
the clear. Much complaint is made,” he adds, “on the ‘South 
Cove,’ so called, of imperfect drainage, in consequence of the drains 
being constructed upon almost a dead level, and with no chance to 
remove the sediment which remains in tire common sewer, and gra- 
dually fills it up. The same remarks will apply to certain sections 
of the southerly part of the city which drains the 4 Back Bay,’ so 
called.” Here, then, we find only twenty-five miles of sewerage to 
sixty-five miles of streets, and even the sewers which do exist are 
very imperfect in their action, and becoming still more so from 
various causes. Mr. George H. Bailey, the Engineer to the Water 
Commissioners, informs me that, in laying pipe for water, in some 
places they have interfered very much with the sewers, occasionally 
so nearly obliterating them as to abridge their utility very essen- 
tially. In many places, also, in crossing streets, the water-pipes 
pass directly through the sewers only a few inches from their lowest 
part, thus assisting in the work of obstruction, not only by their own 
* “ Census of Boston,” et passim. 499 
presence, but also by staying substances on their tardy progress to 
the outlet. In answer to some inquiries, we received a letter from 
Dr. C. E. Buckingham, one of the physicians to the Boston Dispen- 
sary, from which we extract:— 
“ My Dear Sir: The soil of Boston rests directly upon granite. 
The surface is mostly imposed matter, a very large portion of which 
is filled -with organic substances in a state of partial decomposition. 
Much of the city is new land, built of mud from the fiats, and re- 
fuse from the houses in the older parts. 
“ The city is but partially drained. Such parts as are in the best 
condition are partly furnished with brick sewers of a sufficient size. 
Many of these, however, at this time, are from one-half to two- 
thirds filled with mud. There are no real impediments to drainage 
in the older town; but much of the newer is so low, that the drains 
must be lower than high water mark; and there is no possibility of 
getting sufficient descent to flush them.* 
“ There is a Superintendent of Sewers, whose sole duty it is to 
oversee the building and cleansing of main sewers, drains, &c., but 
he is under the direction of the Board of Aldermen, who cannot be 
perfectly informed upon this subject, owing to the nature of their 
occupations. He is, of course, hampered by the want of power to 
flush and clear out at discretion. The city does not drain any alleys 
or streets that are less than thirty feet wide. There are many such, 
and they are drained or not, according as real estate owners see fit. 
“ The mode of street cleaning is by manual labour. The courts 
and alleys are, with few exceptions, occupied by the poor, and, ge- 
nerally speaking, are not cleaned even. The refuse from the houses 
(dry dirt) is placed in barrels, and taken away by the city carts to 
build new land with : such part of the remainder as is fit for pigs, 
is taken to the city stalls for that purpose. Almost all the houses 
are provided with privies into which chamber slops are thrown. 
There are some houses, however, unprovided with these buildings ; 
“Boston, Bee. 7, 1848. 
* In another place, Dr. B. remarks : “ Speculation has built up houses and streets long 
before the new ground has become solid, and at such slight elevation, that waste water 
can run off only with the tide’s fall; and, on its return, the water is, in some places, to 
be heard under the houses, and instances are not unknown where the water regularly 
comes up so as to be seen from the rooms below. I have seen the tide pouring into a 
back yard, from all four sides, to the depth of a foot; and have known men to sail around 
their kitchens in pursuit of their dinners, and coast along the shores of their cellars in 
tubs for their winter’s wood!”—Lecture on Individual and Public Health, p. 19 : Boston, 
1848. 500 
in such cases, as well as some others, excrement is thrown into the 
yard, and even under the lower floor of the houses. The dwellings 
of the poor are mostly filthy, often from neglect on the part of 
the occupants, as often from neglect on the part of the landlords, 
who get large rents, and do not provide suitable drains, privies, 
yards, &c. 
“The number of families in a house varies with the number of 
rooms. I have found from six to forty or more in one house of two 
stories, eleven and more in one room constantly, and eight in one 
bed (men and women). This latter was in a physician’s house! 
“The municipal regulations are far from effective. We need a 
health commissioner, who, in this matter, should be dictator, with 
power to order drains, privies, and fresh water where needed, and 
to turn out any excess of population from houses and streets. 
“I have thus given you a very imperfect answer to your ques- 
tions. My investigations of late have been less than I could wish; 
but every new visit shows me so much that is new and disgusting, 
that my knowledge of the city hygiene of a year since seems 
nothing. 
“I remain, my dear sir, 
“Very respectfully yours, &c., 
“CHAS. E. BUCKINGHAM. 
“ Josiah Curtis, M. D., 
“Lowell 
The subject of ventilation is scarcely regarded. No public build- 
ings are adequately ventilated. Some of the public schools have 
been supplied with very imperfect ventilation, on an old plan re- 
cently revived by Mr. Emerson.* 
The water commissioners state that, prior to March 9th, 1849, 
the sum of $3,448,974 85 had been expended for the introduction 
of water. Their engineer informs me that fifty-eight miles of pipe 
(exclusive of service-pipe) have already been laid, and over 7500 
buildings are now using Cochituate water. These pipes vary from 
four to thirty-six inches calibre. Here are provisions for the esti- 
mated want of about 7,000,000 gallons of water daily, to be impured 
* The pride of Boston consists largely in its Latin school, twenty grammar schools, and 
165 primary schools, employing 330 teachers, with an aggregate salary of -$167,550 75, 
annually. Of this, the amount above the demands of the law, which may be considered 
a voluntary contribution, exceeds the sum expended in the whole of Great Britain. It 
is a little strange that all this should be done, and some of the obvious principles of 
hygiene so little thought of. 501 
by use and carried off by the scanty and ill-conditioned drains and 
sewers of the city. 
Lowell.—Scarce a quarter of a century lias elapsed since the 
site of the present city of Lowell was a wilderness. What of im- 
portance it lacks in age, when compared with other places, is more 
than counterbalanced by the character and occupation of its in- 
habitants. If not the oldest, it is much the largest manufacturing 
community in our country. 
The first factory here commenced operations in 1823; the second 
in 1825 ; two more commenced in 1828, &c. Lowell now has twelve 
large incorporated companies, which run about fifty mills, 310,000 
spindles, 9359 looms; and employ near 10,000 females, over 4000 
males; and possess a capital stock of $12,110,000. Besides, there 
are many smaller companies. 
By reference to Table XXXV., it will be noticed that our popu- 
lation possesses several important characteristics. First, it has in- 
creased very rapidly. This is owing to an influx from other places 
to meet the demand for labourers in our various manufacturing 
establishments. Secondly, it will be observed that a large prepon- 
derance, amounting to nearly two-thirds of our community, are 
females; and thirdly, that a larger proportion than in almost any 
other community—in the Atlantic States, at least—are embraced 
between the ages of ten and thirty. These characteristics are not 
altogether favourable to permanency of residence in our city, espe- 
cially to those of somewhat feeble health, whose friends are mostly 
back in the country. If, in the census of 1830, we take the num- 
ber 999, who were under ten years of age, and follow them in the 
census of 1840, they will be found between ten and twenty. But 
here are 4833, leaving an excess of 3834 between those ages who 
were not here in 1830, but since that time have taken up their resi- 
dence here for a longer or shorter period, and were still here in 
1840. Besides these, a very large number have sojourned among 
us for some time during the period bounded by the dates of the 
censuses, but had left before that period terminated. Again, there 
were 1587 in 1830, between the ages of ten and twenty, and in 
1840 we find the number between twenty and thirty increased to 
7711, showing that 6124 were added to this class during the same 
ten years; and here, as in the former case, just about seventy-five 
per cent, of this increment were females. When we advance another 
step, we discover a diminution instead of an augmentation to the 502 
class. For the purpose of completeness on this point, the following 
abstract is given—the population of 1830 being placed ten years 
in advance:— 
TABLE VII. 
Males. 
1840 
1830 
10 to 20 
20 to 30 | 30 to 40 
1 
40 to 50 50 to 60 
Over 60 
Total. 
1,369 
495 
2,143 
405 
1,128 
958 
520 
358 
224 
111 
92 
58 
7,341 
2,392 
Difference. 
874 
1,738 j 170 
162 
113 
34 
4,949 
Females. 
1840 
1830 
3,464 
504 
5,568 
1,182 
1,605 
1,792 
650 
353 
318 
164 
170 
86 
13,640 
4,085 
Difference. 
2,960 
4,386 | —187 
297 
154 
84 
9,555 
Totals. 
1840 
1830 
4,833 
999 
7,711 
1,587 
2,733 
2,750 
1,170 
711 
542 
275 
262 
144 
20,981 
6,477 
Difference- 
3,S34 
6,124 
—17 
459 
267 
118 
14,504 
It has been estimated, from somewhat extensive researches, that 
“ the average time during which the female operatives work in the 
mills, is between four and five years many observers, however, 
have placed the time considerably shorter. These peculiarities 
should be borne in mind, when our mortuary tables are compared 
with those of other localities. 
The Rev. Mr. Allen states the number of deaths in the town of 
Chelmsford, of which Lowell was a part till 1826, to have been on 
an average of sixteen annually, for the seventy years previous to 
1825.f There were forty-one deaths in 1825. No report was made 
in 1826. In fact, much obscurity envelopes the bills of mortality 
for the next succeeding ten years. The following table is the result 
of an examination of all reliable reports extant, previous to 1836:— 
* “ Lowell as it Was, and as it Is,” p. 194. 
f Chelmsford, Phoenix, Jan. 6th, 1826. 503 
Months. 
1827. 
1829. 
1830. 
1831. 
1832. 
1833. 
1834. 
1835. 
January 
3 
5 
9 
19 
12 
February 
3 
4 
5 
7 
11 
March 
3 
5 
20 
6 
19 
April 
7 
8 
11 
8 
14 
May 
4 
3 
5 
6 
7 
June 
2 
3 
4 
7 
14 
July 
2 
4 
4 
13 
10 
August 
9 
5 
6 
12 
22 
September 
7 
11 
11 
11 
14 
October 
8 
3 
11 
10 
12 
November 
1 
6 
13 
8 
25 
December 
1 
5 
15 
17 
24 
Unknown 
4 
Total 
50 
66 
114 
124 
184 
223 
225 
236 
Still-born in- 
eluded. 
Unkn’n 
Unkn’n 
11 
7 
6 
TABLE VIII. 
The deaths in 1828 were stated by Dr. Elisha Bartlett, at the 
time, to have been thirty-two. “Among the 1500 females em- 
ployed in the mills,” he adds, “ there did not occur, during the year, 
a single death.”* 
The bills of mortality since 1836, as returned by the Board of 
Health, and the superintendent of burials, have all been printed, 
and been filed in the city clerk’s office; but they are very crude and 
meagre in point of important facts, though they are very accurate 
so far as they go. Indeed, Lowell is doubtless as accurate in mor- 
tuary records as any place in the country.f These abstracts, pub- 
lished by the city, have all been consulted with great care, and clas- 
sified; and the ratio of mortality from each disease calculated in 
quinquennial periods, since the date of the city charter in 1836, 
forming Table XXXI., accompanying this report. 
By reference to this table, we find that the causes of 5,718 of the 
6,437 deaths that have occurred during the last thirteen years, have 
been stated. The deaths from causes not specified in the periods 
from 1836 to ’40, 1841 to ’45, and 1846 to ’48, have been respect- 
ively, 245, 141, and 64; exhibiting increasing accuracy on this im- 
portant point. 
In consulting the tables, and examining the various causes of 
death, as classified, and comparing them with the similar tables for 
* Lowell Courier, January 1829. 
f “ It is not pretended that the bills of mortality are absolutely correct; but the daily 
record of deaths is faithfully kept, and it is believed to be more accurate than that of any 
other city of its size in the country.”—Report of City Physicians for 1848. 504 
the State and the city of Boston, we discover some remarkable dif- 
ferences. The first which we notice is the higher proportional rate 
of mortality which obtains among epidemic, endemic, and contagious 
diseases, under the general term of zymotics. Says an earnest 
writer on public health, already frequently referred to, “ It is the 
property of zymotic diseases to prevail more at one season than at 
another, or more in one locality than another; and to become epi- 
demic, endemic, or contagious, under certain circumstances. The 
best index to public health,” he justly observes, “ may be deduced 
from the proportion in which these diseases prevail.” The propor- 
tion which this class sustained to all the deaths from specified causes 
in the State during the last five years, and in the cities of Boston 
and Lowell, during the last eight years, was respectively, 27.98, 
29.46, and 42.15 per cent. In Lowell, 20.66 per cent., or nearly 
one-half of these were from typhus and dysentery. In Boston, 
there has been no quinquennial period covered by the tables, when 
the per cent, of deaths from this class of diseases has been as high 
as thirty; while in our city, in no such period has it fallen as low as 
thirty-five. This, certainly, should arrest attention, and lead to an 
investigation of the causes of such results; and the causes should 
be removed; but, unfortunately, they are still at work, and on the 
increase! The following abstract exhibits a comparative view of 
deaths from zymotic diseases. 
Places. 
1836 to 1840. 
1841 to 1845. 
1846 to 1848. 
Deaths. 
Per cent. 
Deaths. 
Per cent. 
Deaths. 
Per cent. 
State 
Boston 
2,122 
26.51 
2,892 
28.36 
7,524 
3,147 
29.18 
29.96 
Lowell 
555 
37.94 
658 
35.47 
1,172 
48.83 
TABLE IX. 
In Lowell, the deaths from different causes were as follows:— 
TABLE X. 
Number of deaths 
In each 10,000 
Classes. 
1836 to '40 
1841 to ’45 
1846 to !49 
1836 to ’40 
1841 to ’45 
1846 to ’48 
Zymotics 
Sporadics 
555 
65S 
1,172 
3,794 
3,547 
4,883 
719 
980 
1,005 
4,918 
5,284 
4,188 
Age and exter- 
nal causes 
189 
217 
223 
1,288 
1,169 
929 
Total. 
1,463 
1,855 
2,400 
10,000 
10,000 
10,000 505 
It is well known that from 1841 to 1845 inclusive, was a remark- 
ably healthy period; and we accordingly find in it the lowest per 
cent, of deaths from zymotics. This corroborates the opinion just 
quoted from Mr. Shattuck, that the proportion of this class is gene- 
rally a correct index to the health of any locality. The annual 
average of deaths during this period was less than 400. In the 
next and last-mentioned period, it was a little over 821. 
Typhus, and dysentery, have prevailed as epidemics since 1846. 
The deaths from them were as follows:— 
1846. 
1847. 
1848. 
Total. 
Typhus, 
103 
147 
72 
322 
Dysentery, 
23 
206 
152 
381 
In the epidemic dysentery of 184T, about one in twelve of our 
population was sick with it; and not far from one in twelve of those 
who had it died. Of the deaths by this disease, July furnished 25 ; 
August, 93; September, 63, and October 15; other months, 10. 
Croup has gradually increased, and scarlet fever has decreased until 
quite lately, there having been no very extensive epidemic of this 
much dreaded malady. 
Sporadics were the lowest in the last of the three periods. The 
first division, embracing those under the head of uncertain or general 
location, are characterized by much uniformity—deviating not far 
from 4 per cent. This is as might have been anticipated in accu- 
rate returns, as the laws which govern them are nearly constant. 
Diseases of the nervous system have caused nearly one-twelfth of 
all the deaths. The most fatal of this class were hydrocephalus and 
convulsions among the young, and inflammation of the brain among 
adults. One death, ranked in this class, was from that frightful 
disease—hydrophobia. * 
The fatality from diseases of the respiratory organs, claim for 
this class a rank next in importance to the zymotics. A little less 
than one-fourth of all the deaths have occurred from this class of 
diseases; and all but about one and a half per cent, of these were 
of consumption and inflammation of the lungs. In our climate, 
tubercular consumption proves most fatal among the agents of death. 
It insidiously encroaches upon the most delicate and interesting of 
the population. No class of our citizens, no sex or age, locality, or 
season, is exempt from its mortal ravages. It has been constantly 
* The particulars of this case with autopsic observations, by “ J. C.” will be found in 
the American Journal of the Medical Sciences, Philadelphia, April, 1849. 
vol. ii.—33 506 
among us, and every third day chronicles one of its unfortunate 
victims in our city! 
The next class embraces the small family of diseases of the or- 
gans of circulation, which, though few in number, have somewhat 
increased. 
Sporadics of the digestives embrace a large, but less important 
class of diseases than those zymotics which involve these organs. 
Inflammations of the stomach and bowels have proved most fatal 
with adults, and teething with children. 
The organs of urination are subject to but few diseases, as also 
those devoted to the propagation of our kind, and the latter have 
decreased in fatal affections. Diseases of the bones, muscles, and 
skin, comprise the next two classes, and their number is very small. 
Many otherwise undefined causes of death in the extremes of life— 
the infant and the antiquated—have next been classed together. 
Nearly nine-tenths of this class were removed by death in early 
life. 
The heterogeneous group under the class of external causes have 
been gradually decreasing. Fatal accidents in various ways are not 
unfrequent in a place like Lowell; and, it is not surprising that 
these should have somewhat increased. 
The number of deaths from each sex will be found in Table 
XXXII. In each year, with the single exception of 1841, has the 
mortality of females exceeded that of males; but the proportion of 
the deaths among females to the living of that sex, has been less 
than the analogous ratio among males. In the years when the 
censuses were taken, the following proportions to the living ex- 
isted :— 
1S36. 
1S40. 
1S44. 
1846. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Total. 
Population 
6345 
11,288 
17,643 
7341 
13,640 
20,981 
9432 
15,697 
25,129 
29,127 
Deaths 
113 
140 
253 
186 
199 
407* 
163 
196 
362* 
690 
1 death in 
56.16 
80.63 
69.70 
39.47 
68.20 
51.55 
57.93 
80.87 
69.00 
42.21 
In 100 
1.79 
1.23 
1.43 
2.53 
1.47 
1.94 
1.73 
1.24 
1.44 
2.37 
TABLE XI. 
The above table shows the remarkable result, that, among the 
male population in the years of 1836, ’40, ancl ’44, there died one 
* In the total of deaths for 1840, there are 22 whose sex was not stated. In the year 
1844, there were also 3 whose Sex was not stated. 507 
in 56, 39.5, and 58 : while among the other sex, in those years, the 
deaths were one in 81, 68, and 81 respectively. 
Lest these isolated years, for some cause, should not prove a 
fair index, in their unexpected results, I have calculated the average 
population for the periods from 1836 to 1840, and from 1841 to 
1845. Also, the average number of deaths for the same periods, 
and deduced therefrom the following results:— 
TABLE XII. 
1836 to 1840. 
1841 to 1845. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Population 
Deaths 
One death in .... 
i In 100 
6,843 
159.8 
42.83 
2.332 
12,464 
177.4 
70.26 
1.423 
19,307 
341.6 
56.52 
1.804 
10,329 
186.4 
55.31 
1.808 
18,814 
209.0 
90.19 
1.108 
29,143 
399.2 
73.03 
1.369 
These figures corroborate the results in the former table, and sub- 
stantiate the general truth that, in Lowell, the agents of death press 
with much greater force on the male than on the female sex. One 
reason for this, doubtless, arises from the fact that so large a portion 
of our female population are sojourners here for a few years, and 
when they discover declining health, they retire to their homes in 
the interior country towns, to enjoy the invigorating and recupe- 
rative influences which are not found in a dense city, or to spend 
their final days among kindred and friends. 
It is conceded that the seasons exert much influence on health 
and life, especially in cities. Table XXXVII. will exhibit the 
range of the temperature of the air, and show some of our climate- 
rial changes. 
By consulting Table XXXIII. in the proportional mortality for 
the months, June will be found to have been the most healthy 
month in the aggregate, while August has universally been the 
most fatal. The seasons appear thus, for the thirteen years from 
1836 to 1848 inclusive:— 
No. of deaths. 
In 10,000 
January, February, March 
1245 
2056 
April, May, June 
1252 
2034 
July, August, September 
2271 
3616 
October, November, December, .... 
1400 
2294 
Total 
6168 
10,000 508 
This shows the summer months to have been by far the most 
fatal; although, at this season, large numbers of our citizens resort 
to the country for comfort or health. This is the time, too, when 
many a loom is silent, and many a spindle still—the operatives em- 
bracing this sickly season to be released from their labours, and 
enjoy a visit at their rural homes. Notwithstanding all this, there 
is a much greater difference in the health of Lowell at different 
seasons, than there is in the health of Boston. Of the deaths in 
Boston, from 1821 to 1848 inclusive, the months of 
January, February, and March furnished 23.14 per cent. 
April, May, and June “ 22.19 “ 
July, August, and September “ 28.64 “ 
October, November, and Dec’r “ 26.03 “ 
The difference between the highest and lowest rate as above, is 
only 6.45 per cent., while the difference between the highest and 
lowest in Lowell is 15.82 per cent. In Boston, it was shown (Table 
YI. p. 497) that the high rate of mortality in that city during the 
summer season fell almost entirely on the younger part of the com- 
munity. In 1845, 22.5 per cent, of their population wmre under 
ten years of age, and in 1844 only 19.2 per cent, of our population 
were under that age. Now, had we the necessary data at our 
command, it would be exceedingly interesting to ascertain if all of 
the greatly increased rate of mortality during the summer, in Lowell, 
was inflicted upon the diminished proportional number of the young; 
but, unfortunately, we have not the means. 
The ages at death furnish a point of great importance in our 
investigations, as has been already remarked. The first thing we 
notice in Table XXXIY. is the high per cent, of deaths in early life. 
More than one-fifth of all the persons who have died in Lowell since 
1836, were under one year old; and nearly one-half were under 
five. In the State, during the last five years, those who met death 
before they had lived five years, constituted 34.06 per cent, of all 
deaths. In Boston, during the last quarter of a century, the per 
cent, was 42.26; and in Lowell, during the last thirteen years, it 
was 46.46. This confirms the universally received opinion that 
cities are peculiarly unfavourable to viability; and gives definiteness 
to the fact. The philanthropic inquiry arises, cannot some means 
be put into operation which will avert, at least a part of this heavy 
fatal force which is pressing upon those of tender age in city com- 
munities ? If, as Jefferson stated, “ great cities are great sores on 
100.00 509 
the body politic,” in a political sense, they are not less so in a 
physical sense. After the age of ten, the Tables seem to indicate 
that the proportion diminishes till we arrive at the age of twenty, 
when it takes a sudden rise during the succeeding decennial period, 
from which it falls gradatim to extreme senility. Before deciding, 
however, at what age individuals are most liable to die, we must 
introduce another element of information. Let us institute another 
mode of inquiry, by comparing the deaths at different ages with the 
living at the same ages. The subjoined tables will show this. 
TABLE XIII. 
Under 10 10 to 20 
20 to 30 
30 to 40 
40 to 50 
50 to 60 
Over 60 
Total. 
Average population, 
1836 to 1840 
3369 
4469 
7300 
2497 
1009 
454 
209 
19,307 
Average deaths 
175.2 
37.4 
50.6 
31.4 
19.0 
14.4 
12.0 
341.6 
Being 1 death in 
19.23 
119.49 
144.27 
79.53 
53.10 
31.53 
17.42 
56.52 
In 100 
5.200 
.837 
.693 
1.258 
1.883 
3.172 
5.741 
1.804 
Av. population, 
1841 to 1845 
5181 
6713 
10,711 
3796 
1625 
753 
364 
29,143 
Av. deaths . 
211.2 
37.0 
55.6 
39.8 
21.6 
15.2 
16.4 
399.2 
Being 1 death in 
24.53 
181.43 
292.64 
95.38 
75.23 
49.54 
22.20 
73.03 
In 100 
4.077 
.529 
.342 
1.048 
1.329 
2.018 
4.504 
1.369 
These calculations show the probabilities of living to be the 
greatest at the period of life between twenty and thirty; and the 
next greatest between ten and twenty; then they follow between 
forty and fifty; fifty and sixty; under ten, and the least over sixty. 
In the city of Boston, we find similar results; the greatest probabi- 
lities of living, however, are one decade earlier. They run thus: 
Greatest probabilities of surviving the present period, between ten 
and twenty; the next greatest between five and ten; they then 
follow, between twenty and thirty; thirty and forty; forty and 
fifty; fifty and sixty; sixty and seventy; under five; between seventy 
and eighty; eighty and ninety; and the least over ninety. In that 
city, there has been a gradual and constant proportional increase 
of mortality among children under five years of age. The deduc- 
tions for Lowell, from 1841 to 1845, it will be observed, are more 
favourable in all ages than those during the next preceding quin- 
quennial period. But it has already been shown that the former 
was a very healthy period. The results of our investigations on 
other points warrant us in the statement that, had we the necessary 
data to examine and compare the mortuary bills for the three years 
last past, we should find in them the rate of mortality considerably 510 
advanced. It is to be regretted that no means exist, by which we 
can ascertain, even with any reliable approximate accuracy, what 
the results would show. 
The following table will exhibit the force with which some of the 
most fatal diseases have pressed upon different ages as well as sexes, 
during the last three years. 
TABLE XIV. 
Con- 
sump- 
tion. 
Dysen- 
tery. 
Typhus. 
Hydro- 
cepha- 
lus. 
Croup. 
Cholera 
Infant. 
Teeth- 
ing. 
Infan- 
tile. 
Totals. 
Males. 
137 
166 
146 
52 
48 
68 
13 
92 
722 
Females. 
218 
215 
176 
53 
38 
59 
14 
39 
812 
Total. 
355 
381 
322 
105 
86 
127 
27 
131 
1534 
Under 1 
6 
41 
35 
17 
78 
13 
131 
321 
1 to 2 
8 
82 
4 
35 
19 
41 
14 
203 
2 to 5 
7 
78 
15 
20 
42 
8 
170 
5 to 10 
5 
27 
15 
8 
8 
63 
10 to 20 
54 
33 
89 
4 
180 
20 to 30 
114 
49 
128 
2 
293 
30 to 40 
64 
21 
30 
1 
116 
40 to 50 
44 
16 
24 
84 
50 to 60 
25 
12 
11 
48 
60 to 70 
21 
13 
5 
39 
Over 70 
7 
9 
1 
17 
Total. 
355 
381 
322 
105 
86 
127 
27 
131 
1534 
The city of Lowell presents a very extensive field, by embracing 
the subject of manufacturing, as it influences health. This topic, 
howrever, is not sufficiently limited to receive a full investigation in 
our brief remarks. It must satisfy our present purpose, therefore, 
to allude to some of its more prominent features. 
A subject of so grave a character, has not remained to the pre- 
sent day without discussion. Unfortunately for the true merits of 
the question, however, it has hitherto been handled principally by 
politicians and partialists. Antagonistic parties have made state- 
ments and counter-statements, and too often, such only as would 
best make capital in favouring the views of each. It is a most im- 
portant subject, and should be approached, even for brief statements, 
with the utmost candour and strictest impartiality. There appears 
generally, not only a willingness, but a desire, on the part of the 
high-minded and humane gentlemen who have the charge of these 
manufacturing establishments, to have the matter fairly treated and 
the exact truth made known. The general public feel equally inte- 
rested and anxious to obtain unbiassed facts. 511 
So many elements of information, and these of such a nature, 
are called into requisition, that, to give it the critical and plenary 
consideration it so richly merits, would be to surmount insuperable 
difficulties. Some of these obstacles will manifest themselves as we 
progress. 
Our population now numbers not far from 33,000. Near one-half 
of these are directly connected with manufacturing, of whom three- 
fourths or four-fifths, are probably employed by the twelve principal 
corporations. These twelve companies manufacture annually, some 
hundred million yards of cotton; one million one hundred and fifty 
thousand yards of woollen; and three hundred and fifty thousand 
yards of carpeting. They also print some twenty million yards of 
calico; bleach four millions five hundred thousand pounds; and dye 
one million five hundred thousand yards. This requires some thirty- 
five millions of pounds of cotton; and two millions four hundred 
thousand pounds of wool. They consume twenty-five thousand five 
hundred tons of anthracite coal; thirty-six thousand five hundred 
bushels of charcoal; eighty thousand gallons of oil, and thirty-five 
thousand of lard. The amount of wages paid monthly is over two 
hundred thousand dollars, or near two millions five hundred thousand 
dollars per annum. The mills are all warmed by steam, and run 
the same hours, as follows:— , 
TABLE XV. 
Months. 
H. 
M. 
Months. 
H. 
M. 
Months. 
H. 
M. 
Months. 
H. 
M. 
January, 
11 
09 
April, 
13 
16 
July, 
12 
30 
October, 
11 
55 
February, 
11 
45 
May, 
12 
30 
August, 
12 
30 
November, 
11 
41 
March, 
11 
37 
June, 
12 
30 
September, 
12 
08 
December, 
11 
09 
Daily average for the year, twelve hours and thirty-three minutes.* 
Let us now confine our attention to a single corporation, and ex 
uno disce omnes. The Merrimack is the oldest in Lowell, the largest, 
and probably as favourable a specimen of cotton manufactories, as 
can be selected in New England. This establishment has extended 
every desired facility to me for accurate investigation. They employ 
between 1300 and 1400 females, and about 350 males, whose aggre- 
gate wages vary but a trifle from $1000 per diem, at the present 
* Twelve hours and thirty-three minutes embrace the average time of running the 
mills. Many of the operatives are not actually at work all this time. The mills ran an 
average of twelve hours and forty-eight minutes, prior to May 1st, 1847. 512 
time; previous to the reduction of wages in November last, it 
amounted to $1,200 per diem. I take the following abstracts from 
their books, covering the last nine years. 
TABLE XVI. 
Female Operatives. 
Whole number employed. 
Whole number left. 
Average 
No. of 
Years. 
Monthly 
average. 
Maximum. 
Minimum. 
Monthly 
Maximum. 
Minimum. 
months 
they re- 
Month 
No. 
Month. 
No. 
Month. 
No. 
Month. 
No. 
this Cor- 
poration. 
1840 
1355 
June 
1511 
Oct. 
1191 
175 
Aug. 
265 
Jan. 
96 
7.74 
1841 
1343 
May 
1465 
Sept. 
1223! 
152 
Aug. 
245 
Jan. 
93 
8.84 
1842 
1330 
Jan. 
1359 
Sept. 
12771 
152 
Aug. 
240 
April 
92 
8.75 
1843 
1277 
Jan. 
1304 
Aug. 
1166 
139 
July 
205 
Feb. 
89 
8.12 
1844 
1261 
June 
1356 
Jan. 
1226 
125 
Sept. 
186 
March 
66 
10.09 
1845 
1255 
June 
1362 
March 
1201 
132 
Sept. 
213 
Jan. 
68 
9.51 
1846 
1248 
May 
1442 
Jan. 
1217 
121 
Aug. 
197 
March 
69 
10.31 
1847 
1264 
May 
1367 
Sept. 
1121 
141 
Aug. 
241 
Dec. 
87 
8.96 
1848 
1438 
Oct. 
1741 
Jan. 
1205 
175 
Oct. 
248 
Feb. 
62 
8.21 
Annual 
averages. 
1308 
146 
8.95 
Male Operatives. 
Years. 
Monthly 
average. 
Maximum. * 
Minimum. 
Months 
No. 
Months. 
No. 
Number of yards 
manufactured. 
1S40 
224 
October 
245 
January 
205 
12,254,286 
1841 
259 
July 
308 
January 
226 
12,495,393 
1842 
232 
July 
257 
February 
212 
12,681,697 
1S43 
217 
October 
240 
March 
1S7 
12,064,690 
1844 
218 
September 
232 
March 
210 
12,809,424 
1845 
296 
September 
444 
January 
196 
13,313,594 
1846 
443 
August 
622 
January 
276 
13,024,020 
1847 
387 
May 
455 
March 
314 
12,918,921 
1S48 
347 
September 
369 
February 
317 
15,382,103 
Annual 
averages. 
* V 
287 
12,993,792 
This company has five mills,* each having five halls or rooms, 
151.7 feet long, 40.6 feet wide, and 10.5 feet high, giving 64,670 
cubic feet to a room. They own 178 houses, 35 of Avhich are de- 
voted to female boarders, and 10 to males; the remainder are occu- 
pied as tenements by the families of the married men among their 
* A sixth mill, of larger dimensions, has recently gone into operation; but the number 
of persons to work in it is correspondingly increased. In essential hygienic particulars, 
therefore, it does not differ from the others. 513 
employed. A part of these boarding-houses have been recently 
constructed, and are a superior class of buildings. Forty-five 
minutes are allowed for their meals, during which time they put 
on their extra clothing, go a few hundred yards to their boarding- 
houses, eat, and return to their work. During the six months inter- 
vening July 24th, 1848, and January 24th, 1849, among the 1438 
female operatives, 68 were known to be sick so as to require medical 
attendance, 4 of whom, or 1 in IT died. During the same period 
about 490 deaths occurred in the whole city. The attacks of sick- 
ness were, in July, 5; in August, 23; in September, 11; in October, 
12; in November, 3; in December, 9; and in January, 4. The 
deaths were in August, 2; in September, 2. 
The above data, as far as they go, very fairly indicate the hygienic 
state of cotton factories in Lowell, and present points worthy of 
notice. In the first place, we perceive the instability of our ope- 
rative population. While there are a very few who have remained 
some twelve or fifteen years or more, the average length of time of 
remaining on the Merrimack corporation for the last nine years, has 
been only nine months.* It is believed, that the entire population 
of other corporations changes a little oftener than this. Some go 
from one corporation to another in the city, to do the same or some 
other kind of work; some to other manufacturing places; some, either 
temporarily or permanently, return to their country homes; and 
some—are married. The causes are still more varied than the 
nature of these changes. We are not able to say how many leave 
on account of ill health, nor how many of these become ill while 
connected with the mills, nor how many of these can trace the cause 
of declining health to influences concomitant with their employment.f 
The very fact of their having exchanged the salubrious breezes which 
sweep the hills and valleys of country districts for a city 
“ Sated with exhalations rank and fell, 
Which rouse the heart to every fever’s rage,” 
has some influence, and should he taken into the account, as well 
as the various places of evening amusements and candy-shops, which 
tempt the unwary. The accidentals should not be confounded with 
* Due allowance should be made for those who make a temporary visit of but a few 
weeks among their friends, and then return. 
f In May, 1845, the following questions among others, were put to 1424 girls while 
at work, in eight different mills on as many different corporations : “Do you enjoy better 
health than before working in the mill? Do you enjoy as good health? Do you not 514 
the essentials of factory life. Generally speaking, their labour is 
light, but constant. Their hours of labour, and rest, and meals are 
regular, and this is highly conducive to health. Nature loves regu- 
larity as it abhors a vacuum. 
It has been said, that “ the rooms in which they work are kept 
of a uniform temperature, and are lofty and well ventilated.”* It 
will be seen in Table XYI. page 512, that on the Merrimack Corpo- 
ration (and this is supposed to be a fair specimen) there has been an 
average of about 1600 males and females. We will make a liberal 
deduction, and assume 1350 only, as actually in the mills, and 250 
employed in other places about the works. This gives 270 for each 
mill, and 55 for each room, containing only 64,670 cubic feet, in- 
clusive of the space occupied by machinery. Some rooms have 
more operatives in them than others, and there are more at some 
seasons than at others, but we have taken the average. Here, then, 
we find a certain number for a definite time in a limited space, 
without any ventilation whatever, except that of an accidental 
nature, at the doors of entrance in winter, and the same with 
open windows in summer, and this, too, with the thermometer rang- 
ing from 65° to 85° through the winter months! This certainly 
demands attention, and calls loudly for reform. From the character 
and variety of the ailments that solicit relief at the hands of our 
profession in Lowell, we look upon this topic as the most prolific 
source of deteriorated health in the adjuncts of factory labor among 
us, and in our neighboring manufacturing towns. Happily, this is 
an evil which admits of a remedy, and, though hitherto almost, or 
quite totally neglected, we cannot but look, with high confidence, 
enjoy so good health'?” Just four years before, in 1841, similar queries were made 
of 2611 girls. The results were as follows:— 
1841. 
1845. 
No. 
Per cent. 
No. 
Per cent. 
Health better 
170 
6.51 
154 
10.82 
Health as good .... 
1563 
59.87 
827 
58.08 
Health not so good . . . 
878 
33.62 
443 
31.10 
Whole number interrogated 
2611 
100.00 
1424 
100.00 
See “ Lowell as it Was, and as it Is,” pp. 164, et seq. By Rev. H. A. Miles, 1845; and 
“Vindication of the Character and Condition of the Females employed in the Lowell 
Mills,” p. 11. By Elisha Bartlett, M. D., 1841. 
* The Factory System in its Hygienic Relations,” by J. 0. Green, M. D., M. M., S. S. 515 
for a great change in this particular, when it becomes a little better 
understood. “ In the cotton mills, ventilation is very sparingly in- 
troduced, whereas, it ought to be most abundant in a place kept at 
an elevated temperature. The additional quantity of fuel this de- 
gree of ventilation (in the cold season) would require, cannot be 
withheld by any person endowed with either honesty or humanity. 
Pure and wholesome air is as necessary to the well-being of man, 
as pure and wholesome food; and he that would knowingly com- 
pel his work-people to live in an impure atmosphere, is equally as 
criminal as the adulterator of bread.”* An able writerf in our 
neighbourhood recently said: “ A few men of giant energies, of 
boundless faith, of far-seeing calculation, sit down in the counting- 
rooms of this city [Boston] with a surveyor’s sketch and a few 
engineer’s levels. They decide that a town shall be built—a 
manufacturing city erected. Straightway, and almost like the fall- 
ing, opening, raising, changing scenes of the theatre, huge brick 
palaces arise, streets in long perspective of shops, schools, houses, 
sidewalks, begin to stretch themselves out from a thousand nuclei, 
to meet the new-formed elements in exact symmetry, like the points 
of ossification in the growing embryo. Churches point their spires 
to the skies, in all the beauty of Gothic tracery, or plant their firm 
columns of stone in all the solidity of Grecian art. In short, what 
the conquerors of the world have been lives and centuries in design- 
ing and accomplishing, is called into existence by our merchant 
princes, almost with the wave of Prospero’s wand !” 
Would that the same prophetic and far-seeing vision, which pierces 
so clearly into the distant future as to warrant these unbounded out- 
lays ; which boldly cuts down hills and fills up valleys to accommodate 
the hundred thousand inhabitants, presenting themselves in the misty 
future, while the grass is still green in the projected avenues—would 
that it could, at the same time, foresee and prevent, the disease, the 
death, the misery; the moral, social, as well as political ills, which 
appear, upon the best of evidence, to go hand in hand with plain 
sanitary precautions—and realize the illustrations unnumbered from 
experience past, which tell, with demonstrative certainty, that moral 
and social degradation are indissolubly linked with disobedience of 
nature’s laws. 
* Principles of Warming and Ventilating Public Buildings. Manufactories, &c., by T. 
Tredgold, London, 1836 ; Art. Cotton Mills, pages 173, 4. 
fL. V. Bell, M. D., L.L. D. 516 
I blame not these founders of cities, that they have paid but little 
regard to hygienic and sanitary measures. It is glory enough to 
build cities—it is too much to expect the same minds which can 
grasp all the elements essential to these great undertakings, in a 
commercial point of view, should comprehend all the mysteries of 
typhus, struma, or contagion, and the relation of these to ventila- 
tion, sewerage, and water supply. It is for our profession to step 
in at this point, and to guard the rights of generations yet unborn, 
in these respects; and the wise interest, the sagacious foresight, the 
honourable ambition for unmixed success, will guarantee the co- 
operation of the builders of cities, whenever they are convinced of 
the reality of the evils, and that they are susceptible of prevention 
and relief. 
The “ghastly bills of mortality,” as they have been termed by 
an English statistician (under some overlooked or mistaken modify- 
ing circumstances, perhaps), “of one of our new cities [Lowell], the 
prevailing impression of the unhealthfulness already of our lately 
populated manufacturing towns, call aloud to the medical profession 
to look at the growing evils of hygienic neglect, full in the face, and 
if they require a plenary and decided remedy, however costly, it 
will not be long in being found.” 
“The very fact,” says the same eloquent writer, “that a half of 
the machinery of the human body, measured either by its capacity 
or its complexity, is devoted to the function of ventilating the blood, 
by processes essentially mechanical and chemical, demonstrates the 
rdle which the air plays in the support of life, and can hardly be 
over estimated.” The amount of air received at each inspiration, 
has been variously estimated,* and differs in different individuals at 
different seasons, times of the day, &c. We respire at least a thou- 
sand times each hour, and deoxygenize a volume of air equal to five 
times the amount of oxygen required in the animal economy. This 
is but a single source of atmospheric vitiation. Besides the polluting 
* The number of cubic inches of air taken into an ordinary pair of lungs at each 
inspiration, has been estimated by different experimenters as follows: Abildgaard, 3; 
Murzer and Lametherie, 8 to 10; Keutsch, 6 to 12; Abernethy, 12; Goodwin, 3 to 14; 
Lavoisier and Seguin, 13; Hutchinson, 7 to 17; Sir H. Davy, 13 to 17; Allen and Pepys, 
16.5; Kite, 17; Herbert, 16 to 25; Jurin, 20; Herdolt, 25 to 29; Barelle, 15 to 40; Dal- 
ton, 30; Fontana, 35; Richerand, Folland, Gordon, and Cavallo, 30 to 40; Hales, Sua- 
vages, Haller, Ellis, Soemmering, Thompson, Sperengel, Bostock, Bell, Monro, Blumen- 
bach, 40; Menzies, 42 to 46 ; Reil, 42 to 100. 517 
exhalations from our entire superficies,* we generate by the lungs a 
poisonous compound equal to the loss of oxygen. 
The volume of pure air to be supplied to each person has also 
been estimated.! This, too, varies in different circumstances. If 
we assume ten cubic feet each minute to each person, as the proper 
standard, and this is the minimum of the more recent investigations, 
we find the fifty-five operatives in a room requiring 550 cubic feet 
per minute, 33,000 per hour, and not less than 450,000 during each 
day’s period of labour; whereas we have shown that they have but 
about 60,000, making some abatement for space occupied by ma- 
chinery ! In winter, moreover, for four months, when the windows 
are closed and generally double, each room has fifty solar lamps 
burning morning and evening, which assist not only in impuring the 
confined air, but also in raising the temperature frequently to 90° F. 
before closing work at night. In all kinds of weather, the opera- 
tives, with a hastily adjusted dress, emerge from this atmosphere to 
their boarding places, partake of a plain but substantial dinner, and 
return to resume their labour in the space of forty-five minutes. 
The air in these rooms, which ought to undergo an entire change 
hourly, remains day after day, and even month after month, with 
only the precarious change which open doors occasionally give! 
There being no ventilation at night, the imprisoned condition of 
many of the rooms in the morning is stifling and almost intolerable 
to unaccustomed lungs. After the day’s work is ended, two hours’ 
release is enjoyed, a part of which is frequently spent in a crowded 
lecture-room, and then they retire to dormitories scarcely better 
ventilated than the mills. From four to six and sometimes even 
eight are confined during the night in a single room of moderate 
dimensions. It is but just to say, that this remark will apply with 
more force to other corporations throughout the city, than to the 
Merrimack at the present time. The condition of these sleeping 
apartments probably would not be endured so passively, did not 
their occupants first become habituated to unwholesome air in the 
* Estimated at an average of 32 ounces every 24 hours. 
f Dr. Arnott considers 2 or 3 cubic feet per minute, as all that need be furnished each 
person; Mr. Tredgold fixes his average at 4 cubic feet per minute; Mr. Hood, 3.5 to 5 ; 
Mr. Toynbee, F. R. S., 10. Dr. Reid, ventilator of the new House of Parliament, says 
that 10 cubic feet to each person proved to be a minimum which was generally recog- 
nized as below the natural wants of the system, and declares his determination to intro- 
duce not less than from 20 to 60 cubic feet per minute. In the late French Chamber of 
Peers, 12 cubic feet were furnished; at the Pentonville Model Prison, there are arrange- 
ments for supplying from 30 to 45 cubic feet. Dr. L. V. Bell considers from 10 to 20 
cubic feet as not, perhaps, an unsafe estimate. 518 
mills. In the latter, efficient ventilation might be economically fur- 
nished by appropriating a modicum of power to that purpose. 
It has been supposed that the motion of the machinery, in some 
degree, affords a substitute for ventilation; but it only agitates the 
confined air, and thus assists in the chemical admixture of the noxi- 
ous gases and the mechanical suspension of the dust particles and 
flue, thus proving a positive injury, so far as it is to be taken into 
the account. Who can calculate the amount of injury which such a 
fluid, thus frieghted, has upon the estimated 20,000 square inches of 
membranous surface investing the delicately constructed air-passages, 
and the 1,744,000,000 of infinitesimal air-cells, in an ordinary pair 
of lungs, and through the medium of the blood, upon the general 
system? Is this alone not enough to cause those debilities which 
give insipid pallor to countenances to which we naturally look for 
something interesting? Is it not enough to develope some of the 
protean forms of scrofula or other insidious diseases in the predis- 
posed, and to deteriorate general health and produce menstrual and 
other derangements?* The machinery in humanly organized beings 
can no more move with vigor and health, with a scanty supply of 
pure air, than the less complex machinery of the mills can move, 
with strength and efficiency, with a deficiency of water. The laws 
of nature are as precise and imperative in the one case as in the 
other. The blood has just the admixture of the proper components 
requisite, and the atmosphere has the definite proportions of the 
specific elements; both are in contact with the proper intervening 
septum to accomplish the necessary object in the best possible man- 
ner. Any variation must be a defect—a permanent deviation must 
be an irreparable injury. 
That we may not too far transcend our limits, we must omit many 
other important considerations incident to cotton manufactories, be- 
sides bleaching, dyeing, calico printing, &c.f The summation of 
* Vitiated air is also the proper pabulum for zymotics, whether in the stenchdoms of the 
filthy, the emigrant ship, or the cotton mill. Its effects “ are strikingly illustrated in an 
account given by Dr. N. Fanning, of Gilboa, N. Y., of a fever that made its appearance 
in that village during the last winter. Of 123 operatives employed in a cotton mill, it 
appears that, in the course of two months, nearly one-fourth were seized with typhoid 
fever. And, from the history of the disease, which is given with remarkable precision 
and clearness, there can be very little doubt that its origin may be justly traced to a gross 
neglect with regard to ventilation.” 
t M. Villerme, of France, has made many interesting investigations on some of these 
points. 519 
our investigations (united with some personal observations for a 
number of years in Lowell), respecting the hygiene of our manufac- 
turing population, as affected by the essentials of their employment, 
is embodied in the following conclusions. 
1. The peculiarity of Lowell, as embracing the leading manufac- 
turing community in America, renders the investigations of health 
and longevity among us, worthy the most impartial and anxious 
scrutiny. 
2. The fluctuating character of our operative population renders 
it exceedingly difficult to arrive at accuracy in points of public health 
among them. 
3. The limited investigations hitherto adopted can furnish no cor- 
rect idea of their comparative health, nor of the comparative health 
of Lowell. 
4. Though many points demand attention, yet, to imperfect ven- 
tilation, or rather to an absence of ventilation, more than to any 
other one cause, can we trace the origin of impaired health. 
5. The operatives are more comfortable and healthy than several 
other classes of our citizens; and as healthy, perhaps, as the aggre- 
gate of all other classes. 
6. Much might be done at a trifling cost, compared with the value 
of results, to elevate their physical condition; and it is earnestly 
hoped that some hygienic changes will be adopted. 
In turning our attention to Lowell at large, we find much more 
than we can ever allude to, which deserves serious attention. The 
city is supplied with water from wells, though a project for bringing 
water for domestic purposes, from the Merrimack river, has been pro- 
posed. Sewerage and drainage are in a very imperfect condition 
in many parts of the city, and many lanes and alleys are without 
either; the house-slops and other refuse remaining on the surface, 
especially in wet weather. Filth accumulates in various places, and 
tells the hygienist where zymotic diseases prevail. Typhus and 
dysentery especially, which we have seen to be so fatal of late, 
spring up around these fomites. Various memorials and petitions 
have gone to our city government from the physicians as a body, 
through the Middlesex District Medical Society. They probably 
were read, but nothing was ever known of their subsequent history. 
Means have recently been used for very imperfectly ventilating our 
school-houses, and some other public buildings, on the plan adopted 
in Boston. 
The rapid influx, especially of foreign population, has placed 520 
small tenements and cellars in high demand, and crowded them 
infinitely beyond a healthful condition. At this date (April, 1849), 
in a central district, bounded by Shattuck, Market, Central, and 
Merrimack streets (the two latter being our principal streets), we find 
the City Hall, and the offices of mayor, city clerk, treasurer, and 
engineer, and twelve physicians; the post-office, city library, two 
churches, three banks, one grammar and three primary schools 
(embracing an aggregate of eight hundred and thirteen pupils, 
during the last year), ninety stores (many of our first class), 
two smithies, several machine shops, a foundry, coal and wood yard, 
three livery stables, and two hundred and fifty-four tenements, in- 
habited by one thousand four hundred and forty-five individuals. 
This district, by the survey of the city engineer, embraces only one- 
fifteen thousandth of a square mile ! Statements like this engender 
their own comments. From an article in the Lowell Courier, of 
September, 1847, over the signature of J. C., we extract the follow- 
ing : “ Few cities are so crowded as Lowell. Various obvious 
reasons have promoted an influx of labouring population, filling 
every habitable tenement to an unhealthfully dense degree. We 
need a health officer, whose only duty should be to see that the laws 
of public health were complied with. He should visit cellars and 
hovels, now crammed with filth, and degradation, and disease, which 
are so numerous in our city. The faithful report of such an officer 
would astonish the public, for very few are aware of the hundreds 
of places now inhabited by a horde in a horrid condition. One 
week ago, I entered a house in a central location, and found it oc- 
cupied by one store, and twenty-five different families, embracing 
one hundred and twenty persons, more than half of whom were 
adults! In one of the rooms, which was inhabited by two families, 
I found one of the families to consist of a man, his wife, and eight 
children (four of whom were over fifteen years of age), and four 
adult hoarders! It is criminal to permit such an ill-conditioned 
ulcer so near the heart of our city, without proper remedial appli- 
cations. This, by no means, furnishes the worst case of pest germs 
in Lowell. Indeed, so numerous are the places equally crowded, 
that one would suppose that the following, which we quote from 
the London News, for June 1, 1847, was describing Lowell instead 
of London. ‘ And to crown the sum of misery, Irish paupers are 
trooping and gathering, in their rags and wretchedness, precisely to 
those spots where rags and wretchedness, with their concomitant 
curses of filth and fever, are already huddled together so close that 521 
every fresh arrival steals the air necessary to save other life. 
These Irish hordes bring -with them not only personal nastiness, 
with filthy and improvident habits, but the seeds of typhus and 
dysentery.’ If we examine the habitations of large numbers in our 
city, we shall find a woful lack of the necessaries to health, and 
impure air impregnated with animal effluvia and stenchful exhala- 
tions instead. Some three months ago, I had occasion to enter a 
room, occupied by a sick person by day, and the same, with the ad- 
dition of a well person, by night. It contained only three hundred 
and forty-two cubic feet of air! About the same time, it became 
necessary to visit another room, in the night, which contained only 
five hundred and thirty-seven cubic feet, and no means for ventila- 
tion. For many hours, night after night, it contained no less than 
six individuals, three of whom were adults.* Although they were 
induced to leave this hole, and occupy a more airy situation, yet 
every one of them soon had the ‘ ship fever,’ and from them it was 
evidently communicated to others. Both of these cases are within 
ten rods of the post office, though in opposite directions, and are 
fair specimens of numerous others in our city. Ought not the occu- 
pancy of such places to be forbidden ? It seems as much a duty to 
use means for preventing evils, as it is to devise appliances for 
remedying them.” Only one of the above cases, and that the most 
favourable one, was in the “central district,” previously alluded to. 
The following letter is from the Rev. Mr. Wood, “ minister at 
large,” in Lowell, whose holy duties and humane disposition call 
him to a surfeiting knowledge of what he says. 
“ Dear Sir : In answer to the questions you have addressed 
me, please accept the following imperfect statements. I find a 
gross violation of the laws of health and life among the poor. This 
might be expected of those ignorant of these laws, and trained to 
little reflection. The nature and quantity of food most conducive 
to strength and freedom from disease, are not understood. There is 
much imprudent exposure to the weather, bringing on colds and 
sickness, entirely unnecessary, if a little knowledge and thought 
were brought to bear. Labour is often excessive and ill-timed, 
breaking down noble constitutions; intemperance is the ruin of 
many. 
* The head of this recently emigrated family was quite intelligent, having taught 
one of the parish schools in Ireland for the last fourteen years. 
YOL. II.—34 522 
“ There is one infraction of the laws of life and health among the 
poor, which, I think, should be brought more prominently before the 
public. This is in connection with their habitations. Their rooms 
are generally not ventilated at all. From six to ten persons fre- 
quently sleep in a single room, and sometimes in one bed. This is 
particularly the case among our foreign population. The air is 
stagnant, soon becomes poisonous, and exceedingly offensive. Often 
every room in the house has from four to twelve inmates, in a nar- 
row lane, perhaps, crowded close with tenements; the little uncov- 
ered ground the receptacle of dirty water, rubbish, and corrupt 
vegetable matter; and numerous outhouses of necessity near to the 
windows, sometimes filling every room, and the whole neighbour- 
hood with noxious exhalations. Cellars are occupied in very damp 
locations, where water frequently stands in drops on the walls, and 
in wet times can be wrung from the sheets of the bed. Two-thirds 
of the inhabitants of the city, probably, would not deposit their 
vegetables where not a few families reside, and pay from $150 to 
$2 per month for rent. There are many cellars under ground, with 
only one or two half windows, and a few panes of glass, where the 
poor are urged to locate themselves, at a little cheaper rate—urged 
to gratify avarice, though they take to themselves fevers, rheuma- 
tisms, and consumption. I know of one case, where, in two connect- 
ed rooms in a cellar—and lighted by only three small panes of green 
glass covered with cobwebs, and where, on entering, I stumbled 
over the beds, because I could not see them—four families, amount- 
ing to twenty-two souls, wrere living ! 
“ Looking at this subject in only one light, can we suppose that 
God meant that his creatures should breathe over and over again 
this noxious and confined air, when abroad, all over the earth, He 
is continually stirring and filtrating it by wind and rain, that it may 
be breathed in purity ? Sometimes it is almost impossible, after 
breathing the out-door air, to inhale the air of these rooms. It is 
well known that this bad air infuses itself into all the clothes hung 
up and worn in these rooms, and this, connected with the exhala- 
tions of a body whose cleanliness is of course almost entirely neg- 
lected, attaches to one an effluvia which it must be very unhealthy 
for the bearer to breathe,* and which clings to him, though he walk 
against a strong north-wester a whole day; for let him, at the close 
* “ Of all known poisons, that produced by the concentrated effluvia from a crowd of 
human beings confined within a small space, and neglectful of cleanliness, is one of the 
worst.” Dr. A. Combe’s letter to the London Times, Sept. 17, 1847. 523 
of it, enter your room, and he will perceptibly poison the air you are 
breathing. Shall such a fact be alone an offence to us ? Have we 
no humanity to pity, enlighten, and remove? and more, when we con- 
sider the effects of the air breathed ! To this, more than to the want 
of food, I think, may be attributed pale faces, sallow complexions, 
torpor, and various sicknesses among the poor. May not the sickly 
appearance of infants in the abodes of poverty, and their early mor- 
tality, be often traced to this as a cause ? Do we doubt that many 
pains and distempers and deaths among adults also arise from this ? 
Are not ill health and death, too, among the causes of pauperism, and 
pauperism more and more dependent and degraded ? And it has 
well been asked, is it not true that many of those morbid appetites 
and unnatural desires that seek to assuage their longings by indulg- 
ence and excess, have their origin in the action of a distempered 
body upon the mind, rather than of the mind upon the body ?* 
“ This subject assumes a high importance in an intelligent com- 
munity, and an ascending one with the advance of intelligence. 
The intelligent philanthropist cannot rest easy. God will not 
allow him to rest, while no more attention is paid to it. 
“ I believe that it is the duty of the government of this city to 
feel a care of this matter, and to exert its authority more than it does. 
Why should not our city authorities do something to prevent tene- 
ments, or cellars of tenements, from being occupied, when there is 
positive proof that they are, and must be, destructive of health and 
life ? Why should not our government prevent, by law, houses from 
being jammed together in such unhealthy contiguity as they fre- 
quently are, by the cupidity of selfishness ? Why, it has been sug- 
gested, should government care so much for unusual k»mortality, 
and unusual sickness, and so little for the usual, in the aggregate 
affecting so much more, the prosperity, comfort, and highest inte- 
rest of the body politic ? Something more effectual still may be 
done by the instruction, in all our schools, of the plain and essential 
laws of health and life. With our schools, and the young generally, 
are the power and hope of reformation. The knowledge of these 
* Mr. Wood here alludes to an important point. In corroboration, we cite from Dr. 
Southwood Smith’s testimony before the Parliamentary Commission: “The poison gene- 
rated in these neglected districts, and to which these persons are habitually exposed, 
is a sedative poison, among the most distinctive characters of which are depressing ef- 
fects produced by it both on mind and body. This is one of the main causes, not only 
of the mental apathy of which I have already spoken, but also of that physical listless- 
ness which makes them incapable of any great exertion. I am satisfied that this feeling 
of depression is one of the chief inducements to the use of stimulants.” 524 
laws thoroughly instilled in early days, advanced to manhood, the 
children would not live in the manner, with the habits and in the 
localities, of their parents. In this way, too, would be raised up a 
host of missionaries of light. 
“ With great regard, yours, &c. 
“To Josiah Curtis, M.D. 
“Lowell, April, 1849.” 
“H. WOOD.” 
The above conveys a general idea of some of the worst places in 
the city which demand attention. We cannot leave this matter, 
however, without an allusion to another, and, probably, the worst 
district, known as “ The Acre.” It is inhabited, I believe, exclu- 
sively by foreigners, and contains two Roman Catholic churches, but 
in other particulars, it beggars all description!* 
Had we the necessary means of ascertainment, it would be highly 
interesting to learn the amount of sickness suffered by the com- 
munity. It is exceedingly difficult, if not absolutely impossible, to 
obtain the requisite items of information in society at large. The 
best approximation to the truth is derived by comparing the deaths 
to the sick in our hospitals, dispensaries, and other institutions for 
the benefit of the sick. The Massachusetts General Hospital went 
into operation in 1821, and the following table covers the informa- 
tion derived from a file of their Reports:— 
TABLE XVII.f 
Periods. 
Admitted. 
Discharged. 
Whole No. 
Unfit. 
| Eloped. 
Dead. 
Not relieved. 
Relieved. 
Much re- 
lieved. 
Well. 
insane. 
By request. 
Misconduct. 
Remained. 
1821 to 1825 
1077 
1031 
1077 
6 
13 
87 
31 
268 
96 
458 
3 
56 
9 
44 
1826 to 1830 
2483 
2482 
2528 
16 
11 
142 
288 
323 
477 
1206 
14 
54 
1831 to 1835 
2396 
2394 
2450 
18 
23 
192 
250 
314 
403 
1179 
6 
4 
2 
52 
1836 to 1840 
2036 
2034 
2088 
21 
11 
152 
240 
298 
427 
874 
57 
1841 to 1845 
2003 
2046 
2061 
42 
6 
193 
231 
293 
378 
796 
55 
1846 to 1848 
1937 
1886 
1991 
12 
6 
196 
136 
243 
258 
951 
2 
2 
111 
Total 
11,932 
11,873 
11,932 
115 
70 
962 
1176 
1739 
2039 
5464 
11 
76 
11 
Cases of Typhus Fever, 1846 to 1848, included above 
1846 to 1848 
203 
1 
203 
1 
14 
1 
3 
6| 
186 
2| 
1 
* The foregoing is, of course, 
intended only 
in a 
hygienic sense. We trust no one 
will construe the text here, or elsewhere, as 
offensive to 
any 
class 
of citizens. 
In all 
moral points, we prefer to cherish the spirit of Him 
“ who came not to condemn the 
world.” 
t The above table, though from official documents, exhibits some slight inaccuracies. 525 
Here, it will be perceived that, of the 11,932 cases treated, 962 
died, being one in 12.4, or 8.06 per cent. The different diseases, 
and the mortality therefrom, are not specified, excepting the cases of 
fever during the years 1846 to 1848 inclusive, which are appended 
above. The mortality from this disease was one in 14.5, being 6.9 
per cent. 
The McLean Asylum for the Lnsane, connected with this esta- 
blishment, is located two miles from the city, at Somerville. The 
condition of this department, since it came under the professional 
superintendence of its present incumbent in 1836, is shown in the 
subjoined table:— 
TABLE XVIII. 
Periods. 
Admitted. 
Discharged. 
Whole No. 
Dead. 
Improved 
Not do. 
and unfit. 
Well. 
Remain. 
1837 to 1840 
545 
491 
616 
43 
158 
290 
125 
1841 to 1845 
690 
665 
815 
76 
225 
360 
151 
1846 to 1848 
461 
451 
612 
65 
152 
234 
155 
Total 
1696 
1607 
184 
535 
884 
155 
For the sake of completeness and comparison, respecting this un- 
fortunate class of our citizens, we here annex some statistics of 
the State Lunatic Hospital located at Worcester. They are ab- 
stracted from the annual reports of that institution to the legisla- 
ture. 
TABLE XIX. 
Periods. 
Admitted. 
Recovered. 
Improved. 
Not improved. 
Died. 
Eloped. 
1833 to 1835 
385 
141 
52 
50 
20 
3 
1836 to 1840 
811 
365 
120 
136 
70 
1 
1841 to 1845 
1110 
532 
158 
210 
85 
1846 to 1848 
778 
393 
86 
152 
98 
2 
Total 
3084 
1431 
416 
548 
273 
6 526 
TABLE XX. 
Showing some of the Causes of Insanity as affecting persons pur- 
suing different avocations. 
Vocations. 
Intemperance. 
111 health. 
Masturbation. 
Domestic 
affliction. 
Religion. 
Property. 
Disappointed 
affection. 
Epilepsy. 
Jealousy. 
Total. 
Farmers 
65 
18 
29 
27 
27 
29 
4 
9 
3 
211 
Labourers . 
88 
10 
15 
8 
10 
9 
1 
6 
2 
149 
Seamen 
34 
5 
7 
3 
7 
6 
1 
3 
66 
Merchants . 
14 
5 
32 
5 
4 
20 
1 
3 
84 
Carpenters . 
17 
7 
9 
2 
10 
6 
3 
2 
56 
Shoemakers 
9 
7 
27 
5 
10 
6 
2 
1 
67 
Blacksmiths 
4 
1 
1 
1 
2 
4 
3 
16 
Students 
3 
22 
2 
2 
1 
30 
Clergymen . 
1 
2 
4 
1 
1 
1 
10 
Lawyers 
2 
2 
1 
1 
6 
Physicians . 
2 
1 
1 
4 
Painters 
1 
11 
2 
1 
1 
1 
1 
18 
Manufacturers . 
9 
3 
4 
1 
4 
4 
1 
26 
Totals 
246 
61 
163 
57 
78 
88 
19 
23 
8 
743 
The Boston Dispensary has now been established more than half 
a century. This charity employs eleven physicians and three apothe- 
caries. The following table, compiled by Mr. Shattuck, shows the 
character and results of their gratuitous labours for the years 1841 
to 1845 inclusive. 
TABLE XXI. 
Results. 
1841. 
1842. 
1843. 
1844. 
1845. 
Total. 
Recovered 
1861 
1524 
2115 
1796 
1540 
8836 
Died 
88 
87 
79 
87 
71 
412 
Relieved 
185 
136 
199 
193 
300 
1013 
Not relieved 
20 
16 
31 
19 
65 
151 
Removed 
130 
115 
90 
83 
166 
584 
Remained 
85 
61 
98 
83 
78 
405 
Not stated 
14 
18 
48 
56 
62 
198 
Total No. of cases 
2383 
1957 
2660 
2317 
2282 
11,599 
Places of birth. 
Boston 
272 
86 
119 
96 
100 
673 
American 
613 
302 
486 
428 
388 
2217 
Hibernico-American 
611 
514 
629 
752 
671 
3177 
Ireland 
771 
823 
1269 
926 
911 
4700 
British 
86 
47 
77 
78 
129 
417 
Others 
30 
49 
78 
37 
82 
276 
Habits. 
Temperate 
1879 
1827 
2124 
1979 
1604 
9431 
Intemperate 
Children of intempe- 
313 
127 
164 
74 
96 
774 
rate parents 
70 
3 
25 
61 
159 527 
We have not the reports of the “ City Hospital for the Poor,” at 
S. Boston; “ The Deer Island Pauper Hospital;” “ The Home for 
the Destitute,” &c. 
The Lowell Hospital commenced operations in May, 1840. It 
has never made any report, save in a few newspaper paragraphs* 
We learn the facts embraced in the following table from a paper 
recently read by its physician, before the Middlesex Dist. Med. 
Society, and from the Secretary of the Board of Trustees.* 
* It is proper here to remark, that this is a private institution, intended to benefit those 
engaged in the mills. But a small proportion, however, of our sick operatives find their 
way to the hospital. Some are too ill to be removed from their boarding-houses to the 
hospital before it is known to the officers of that institution ; others improperly attach a 
certain degree of odium to the idea of being sick in a “ hospitaland others, again, very 
properly prefer to select their own medical attendant, when sick. The corporations 
own the boarding-houses, and let them to various individuals, subject to certain regula- 
tions, and require, with few exceptions, their operatives to board in them. Within the 
last twelve months, the agents of the several manufacturing companies, who constitute 
the Board of Trustees to the Hospital, issued a circular to each boarding-house, for the 
purpose of inducing and urging, to use no stronger term, the sick among their employed 
to resort to the hospital. This circular terminates with the following sentence : “ It is 
requested that all boarding-house keepers will use all proper means to induce the sick 
among their boarders to avail themselves of its privileges; and notice is hereby given, 
that a neglect or refusal, on the part of the occupant of any boarding-house, to carry out 
this request, will be considered sufficient cause for terminating the occupancy of said 
house.” 
It is not to be supposed from this, however, that the hospital will hereafter furnish 
an index of the sickness among the operatives. 528 
Totals 
1840- 
1841- 
1842- 
1843- 
1844- 
1845- 
1846- 
1847- 
1848- 
Ox 
4^ 
w 
May. 
Cases of Typhoid Fever. 
CO 
t—*0505000x^004^- 
June. 
05 
tS 
tO 
C0tD0xOt34^0xC£>t0 
July. 
— *-»*-» to ‘-‘to 
-JIOOOx*—*4^0x0500x 
August. 
129 
to — to 
■*4!'—‘**4t0-4Ox-*3OxG0 
September. 
t3 
05 
to to >— »— •-*>-* 
040*-05000^0 
October. 
-3 
CO 
November. 
05 
t3000t04^0xw0x<l 
December. 
►&> 
Ox 
CO Ox GO Ox *-* Ox 
January. 
00 
t3C0CD-4^Ji-*-4EC505 
February. 
4*. 
Ox 
>-4^GOC©4».^3^*COt3 
March. 
to 
05 
C0C0O5OxC0t3t0t0 
April. 
827 
*J04^WC005*40iJ^ 
Total of typhoid 
fever. 
4^ 
MoaaHtctn&ioj 
Deaths of do. 
1627 
tO >-» tO t3 —» fcs «-* 
►— 0xC0 
00 00-4f00x0 
Total of all dis- 
eases. 
-4 
05 
K-- 60 
t3000t30505*4i^ 
Deaths of do. 
1444 
cooxooototototo — 
G0t0 WM 
Recovered. 
00 
CO 
t3C0C0t3^J0x05tS-4 
Relieved. 
00 
>—* 4** CO tO *—*►—* 05 
Not relieved. 
16.10 
11.54 
13.90 
12. 
11.67 
14.50 
16. 
Average days for 
each patient. 
-3 00 4*. 4*. Ox 00 Ox 
05 CO 05 05 
-4 O O Ox 00 CO 4^- 
Average popula- 
tion for year. 
20.16 
CO1—‘tOtOGOtOt—‘tO^—* 
bx be bo 05' * oo co 
O O CO 05 O O CO 
Of typhoid fever, 
there died one in 
21.40 
to CO 05 * * * * CO 
O CO *4 CO 
Of all, there died 
one in 
Exhibiting Statistics of the Lowell Hospital since its Organization in May, 1840. 
TABLE XXII. 529 
The foregoing table exhibits the remarkable fact, that, of the 
1,627 patients, 827 had the typhoid fever. Of these cases, there was 
one death in 20.16, or 4.96 per cent.; of other cases, there was one 
death in 22.86, or 4.37 per cent.; of the whole, one in 21.4, or 4.67 
per cent. These favourable results are, in part, accounted for in the 
following manner: we quote from the MS. paper of the physician 
before alluded to. “ It is to the advantage of the Lowell Hospital, 
no doubt, that its patients are taken from a class of individuals bet- 
ter able to withstand disease than those who ordinarily find their way 
into a similar city institution. The operative population of Lowell 
are young, robust, and generally free of constitutional infirmities. 
Indeed, it is just such a class as we should suppose would pass through 
sickness in the shortest time, and with the least danger. Such 
circumstances, I say, are obviously in favour of our Lowell popula- 
tion.”* 
The Lowell Dispensary received its charter from our legislature 
in 1836. It appoints three physicians, who render gratuitous ser- 
vices. No reports have ever been made. 
The intention and character of our hospitals are such as to pre- 
clude the general applications of their results to the whole commu- 
nity, as indicative of the ratio which the sick bear to the deaths. 
The Boston Dispensary, which is an entirely eleemosynary institu- 
tion, furnishes the fairest comparison. It was shown in Table XXI., 
page 526, that there was a little over 28 cases of sickness to one 
death, (11,599 + 412 = 28.15.) During the four preceding years, the 
results were nearly the same, (10,730 + 379=28.31.) This coincides 
with results found by some eminent English statists, who have given 
this point greater attention. Dr. Lyon Playfair, in his very able 
* The following extract is also worthy of record. “ From the statements here fur- 
nished, it appears quite obvious that typhoid fever is not only a very constant, but also 
the most important, disease among our operative population. It gives no evidence of the 
proportion it bears to the same disease, as it occurs with the rest of our adult popula- 
tion. Nevertheless, I think it must have been impressed upon the conviction of every 
physician of several years’ standing in our city, that our operatives, as a class, have suf- 
fered from it to a much greater degree than the citizens at large. If such is the fact, it 
becomes a matter of interest to inquire why it is so; and then, again, to ascertain if it 
is an evil which admits of a remedy, and if so, what it is. * * * * My own opin- 
ion, however, is, that imperfect ventilation, in our cotton-mills, particularly, may have a 
very important bearing upon the question of causes of fever among our operative popu- 
lation. * * * * Air thus confined for the space of several months, in rooms occu- 
pied by some fifty persons, for twelve hours every day, except Sundays, must, sooner or 
later, make an impression upon the constitution, and thus indirectly, at least, become the 
means of inducing disease.” 530 
report to the Health of Towns Commission, on the sanitary condi- 
tion of large towns in Lancashire, (which embraces Liverpool, Man- 
chester, &c.,) states that, “ out of 324,041 cases (excluding slight 
accidents), admitted into the Manchester medical institutions during 
twelve years, there have been 11,587 deaths, that is, about twenty- 
eight cases of sickness to one death.” But some writers have sup- 
posed this too high for a general estimate.* If we assume that there 
are only twenty attacks of sickness to one death in a community, it 
would give 89,000 cases of sickness, of longer or shorter duration, 
in Lowell, since 1840; of which 49,000 occurred during the last 
three years, being an annual average of over 16,000! In the city 
of Boston, on this hypothesis, there have been no less than 457,000 
cases of sickness since 1840; of which, 229,700, or 76,566 annu- 
ally, occurred since 1846. 
If we advance another step, and start the inquiry, how much of 
this sickness might have been prevented, and how much of this death 
might have been postponed, we enter upon the most impressive cha- 
racteristic in the province of our report. We see degradation, dis- 
ease, and death inflicted upon the disobedient public as the direct 
penalty of violated law. Physical laws are as sacred and obligatory 
as the Decalogue. Indeed, so imperative are they, that they have 
been inwrought into the very texture of our frames. The Divine 
Architect has inscribed upon every one of the scores of bones, every 
one of the hundreds of muscles, the thousands of blood-vessels, the 
millions of nerves, with their myriads of filaments, just what each 
can perform. The chemist, in his laboratory, with the control of 
elementary atoms, discovers aflinitives and repulsives with no nicer 
delicacy than obtains in the pulmonic alembic, where the blood re- 
cognizes a distinction between zotics and azotics; or the gastric cru- 
cible, where the crude viands of the table are fitted for conversion 
into living tissue—the mysterious mutation from death unto life! 
Nothing is more certain than that we hold the capacities of happi- 
ness,f health, and life itself, on certain conditions, and forfeit them, 
without the right of redemption, by non-compliance. Every infrac- 
tion is sinning on credit where there is no atonement. 
The diseases which are the most fatal among us, are those that 
are the most easily prevented by hygienic prophylactics; yet they 
* Med.-Chirurg. Review, vol. i., No. 1, p. 21. 
| “ A sound mind in a sound body constitutes a short but full description of a happy 
state in this world.”—Locke. 531 
are increasing, and so subtracting from the valuation of human life 
in our midst, that, in our State, our cities, and villages, longevity is 
taking the inverse ratio of their increasing density in population.* 
In this particular, we are falling in the rear of other nations.f The 
dwellings of the masses, and the factories of the few, seem less 
cared for than our Municipal authorities dictate the mode 
of building for the protection of property, but not for the protec- 
tion of life. Typhus, dysentery, and struma visit the offending, 
* Dr. E. Jarvis, an eminent hygienist, has demonstrated this. We quote from him, 
with some additions: (Petition of the American Statistical Association to the Legislature of 
Massachusetts for a Sanitary Survey of the State.—House Doc. No. 16, 1848, and 66, 1849.) 
“ The average of all whose deaths are recorded, was in 
Massachusetts. 
1842, 34 years 9 months. 
1843, 33 “ 10 “ 
1844, 33 “ 9 “ 
1845, 30 “ 9 “ 
CONCORB. 
1779 to 1808, 39 “ 7 “ 
1809 to 1842, 36 “ 0 “ 
Dorchester. 
1817 to 1829, 33 “ 11 months. 
1830 to 1843, 31 years 2 “ 
Boston. 
1811 to 1820, 27 « 3 “ 
1821 to 1830, 25 “ 11 “ 
1831 to 1840, 22 “ 9 “ 
1841 to 1845, 21 “ 5 “ 
Lowell. 
1836 to 1840, 17 “ lj “ 1841 to 1845, 17 “ 0 “ 
t We give but a single instance from many that might be adduced. 
“ Geneva (Switzerland) has arrived at a high state of civilization, and this wonder- 
ful improvement is attributed, among other things by M. Mallet, to the information ob- 
tained under their system of registration, rendering the science of public health better 
known and understood.” This city has kept a faithful registration for three centuries. 
Longevity appears as follows :— 
Period. 
Years. 
Months. 
Days. 
Rate of increase- 
1550 to 1600 
8 
7 
26 
100 
1600 “ 1700 
13 
3 
16 
153 
1701 “ 1750 
27 
9 
13 
321 
1751 “ 1800 
31 
3 
5 
361 
1801 “ 1813 
40 
8 
10 
470 
1814 “ 1833 
45 
0 
29 
521 
“ Showing that the mean duration of life has increased more than five times during 
these periods.” (Ibid.) 
J Says Finlayson, of the National Debt Office, Eng., “A Benefit Society, (as life or 
health insurance,) founding its calculations on the scale of prison mortality, would fail 
in three years.” There is not a State’s Prison, or House of Correction, in New England, 
where the hours of labour are so long, the hours for meals so short, or the ventilation so 
much neglected, as in all the cotton-mills with which I am acquainted. See also page 
517, note. 532 
especially in dense, urban localities.* Harpy-like, they prey upon 
personal filth. They make their deadly visitations not only among 
the 40,000 who dwell in cellars in Liverpool, the 18,000 who live 
below the level of the ground in Manchester, and the similar class 
in Glasgow, Leeds, and London; but also the occupiers of darkf 
nurseries of pestilence in Boston and Lowell, and other places. The 
germs of malignant disease, incubated in these nests, extend their 
infectious toils to those who visit to counsel and succour, as well as 
spread over juxtaposite localities. Among the former, the ministers 
of Gospel consolation, and the administerers of medical relief, suffer 
most.J Between the last two annual meetings of the medical so- 
ciety of this State, seven of its members died in this city, (Boston.) 
Four of these died of fever, contracted while on professional duty. 
The best of testimony informs us that near 4,000 deaths, and over 
75,000 cases of sickness, might have been avoided in Boston within 
the last three years! and that over 800 deaths, and 16,000 attacks 
of sickness might have been prevented in Lowell, within the same 
time! When we take into account the mental and physical strength 
lost to the community, in time and labour, the cost of sickness, ex- 
pense of funerals, &c., no arithmetic can calculate the detriment 
sustained unnecessarily by preventable disease and death, even in a 
pecuniary view. Had such a tax upon the public resources, and 
such a waste of human life been sacrificed in war, it would have re- 
ceived greater attention.§ 
* The Registrar-General (an officer unknown on the Continent of America), divides 
London into three groups, each having ten districts. The first contains 202 square yards 
to each person, and the mortality is one in 49; the second affords 102 square yards to 
each person, and the mortality is one in 41; the third allows 32 square yards to each 
individual, and the deaths are one in 36. Rev. Mr. Clay, of Preston, makes four classes 
of streets in that place, and the well-conditioned have a mortality, among children under 
one year old, of 15 in 100; the moderately-conditioned, 21 in 100; the ill-conditioned, 
38 in 100 ; the worst-conditioned, 44 in 100 ; or nearly three times as great as the first! 
Instances of the kind might be given ad libitum. 
f “ Where the sun does not come, the physician must.”—Neapolitan Proverb. 
J Says the editor of the London Journal of Health, “ Some idea of this calamity may 
be obtained, from the fact that, out of twenty-five medical officers engaged in the relief 
of the parish poor of Liverpool, twenty have had the fever.” “ Within the last few 
months,” he continues, “ no fewer than twenty-three (Catholic) priests have perished by 
fever ; of these, ten died in Liverpool, and five in Leeds.” “ In Canada, twenty Catho- 
lic priests, including one bishop, have recently died of fever.” 
§ “ The awful results of war are not confined to the bloody scenes of the battle-field; 
but disease—slow, consuming disease—more than any of the instruments of war, scat- 
ters death among those engaged in the trying fatigues and exposures of military duty. 
Of those who have died in active service in Mexico, the proportion of those cut down 533 
In England, where they have paid large attention to these evils 
by investigations, and the application of remedies,* we find results 
so ghastly, as to be incredible, were they not susceptible of mathe- 
matical demonstration. Says Dr. Southwood Smith, “ It is no ex- 
aggeration to state that the annual slaughter in England and Wales, 
from preventable causes of typhus, which attacks persons in the 
vigour of life, is double the amount that was suffered by the allied 
armies in the battle of Waterloo!” Lord Morpeth (now Earl of 
Carlisle), remarked, in the British Parliament, in a speech of April 
30th, 1847, that, in the various large towns in England, there were 
annually “ above 700,000 cases of unnecessary sickness,” and in the 
metropolis alone, “ there were 250,000 cases of unnecessary sick- 
ness, and 10,000 deaths that might have been saved!” “ There are 
items of expense,” he observes, such as “direct attendance on the 
sick; loss of what they would have earned ; premature death of pro- 
ductive contributors to the national wealth, and expense of prema- 
ture funerals.” Dr. Playfair estimates this loss for Manchester at 
nearly <£1,000,000, and for the whole of the county of Lancaster 
at £4,800,995; Mr. Hawkesley calculates the loss for Nottingham 
at £300,000; Mr. Clay estimates the loss for Ashton-under-Lyne 
at £235,000; and Dr. Playfair considers the loss of London to be 
above £2,500,000; and that of England and Wales to be little short 
of £11,000,000; and of the United Kingdom, £20,000,000, or 
nearly $100,000,000! And this an annual loss! 
Like causes produce like effects. The laws of health and of zy- 
motics, which prevail in Old England, also are operative in New 
by disease to those who fell on the battle-field, is about five to one!"—General Taylor’s 
Address to the Volunteers returned from Mexico. While the number of the “ killed and 
wounded” has been carefully preserved, the above has fallen almost lifeless from the 
lips of the “ hero of many battles.” 
* Within a few months after the Sanitary Act went into force, Liverpool closed 7,840 
cellars, and condemned 1,616 filthy houses. In Manchester, the sanitary officers go round 
daily, and inspect every lodging-house, and make returns to the chief constable, of the 
names of the owners and occupiers, the number and size of the rooms, the number of 
inmates in each room, the condition as to ventilation, furniture, beds, state of the walls, 
floors, &c., and all nuisances existing near. By the 86th section of the Manchester Police 
Act, the occupier of every house or dwelling is required to whitewash, purify, and 
cleanse the same, on receiving notice so to do, under a penalty of 5s. for each day’s de- 
lay. On their first visit, the inspectors serve notices, where circumstances call for them. 
Night soil and other filth are forthwith reported to the Nuisance Committee. On their 
second visit, the inspectors are accompanied by three men, one of whom carries a bucket 
of whitewash, and the other two, in any house not whitewashed in the interval follow- 
ing the notice, proceed at once to whitewash and cleanse every room. 534 
England. The experiments of Thenard and Dupuytren proved for 
both trans-atlantic and cis-atlantic regions, that birds perish when 
the vapours of sulphuretted hydrogen and ammonia exist in the 
atmosphere to the extent of a fifteen-thousandth part; that dogs are 
deprived of life when the air contains a thousandth part; and that 
man cannot live when the air he breathes is impregnated with a 
three-hundredth part; and suffers in a corresponding degree, when 
there is a less proportion of this poisonous gas, produced from the 
decomposition of feculent matter which we leave in our streets, and 
suffer to diffuse itself from overflowing privies and urinaries, to pol- 
lute the atmosphere inhaled, and waters imbibed.* If the losses 
from evident neglect in hygienic precautions in our cities could be 
accurately estimated, the statements would be astounding. To them 
would be applicable the language of a foreign writer, “ Halve or 
quarter every item, if they appear exaggerated, and there would still 
remain the most remarkable exposS ever yet made of municipal and 
national extravagance. One broad principle,” he adds, “ may be 
enunciated in sanitary economies—that it costs more money to cre- 
ate disease than to prevent it.” 
This subject, in its moral, domestic, physical, and pecuniary bear- 
ings, commends itself to the clergyman, the philanthropist, the phy- 
sician, and the statesman. 
Dr. Guy, of King’s College, London, &c., says, “I do not fear 
the charge of exaggeration, when I claim for the sanitary question, 
the right to be regarded the great question of the day. Look at it 
as a question of humanity, and it will not suffer by comparison with 
the highest efforts of the philanthropist; regard it as a great act of 
justice, and here, too, you will acknowledge it prefers peculiar claims 
to consideration; measure it by the rule of economy, and I hesitate 
not to affirm that it stands without a rival; or view it in its moral 
relations and reactions, and I know not whether even the great ques- 
tion of education will take rank before it.” 
All look to our profession, as the guardians of public health, for 
the light of information. Be it ours to furnish a full supply. It is 
the most pleasant, as well as the most important, duty of the mem- 
bers of this Association, to point out and illustrate facts and prin- 
ciples, which, if observed, will prevent disease, promote attainable 
* The compounds of Ellerman, Ledoyen, Sir Wm. Burnett, and others, have stronger 
claims to the epithet deodorants than disinfectants; though the metallic salts, (sulphates 
of iron and copper, the nitrate of lead, and chloride of manganese, &c.,) of which some 
of them are composed, possess the latter property. 535 
longevity, and thus add to the great world-stock of human happiness 
and human usefulness. To exhibit remedial agents to the sick, like 
the execution of criminal law upon the offending, is a necessary evil 
to overcome a greater one still existing. It is the opprobrium artis 
to the physician. In this matter, then, a responsibility, hard to be 
over-estimated, rests upon the profession. Who has not felt the 
high responsibility of our vocation, when called upon to render some 
sacred service—perhaps to enter within the precincts of the pene- 
tralia, with a grasp of the hand and a look which seem to say, “ I 
confide to your skill and knowledge my all of earth. Fail not, I be- 
seech you, to summon all your powers; I conjure you to command 
all your skill to relieve distress, to abridge agony, to augment hap- 
piness, and prolong life, and you shall have your reward!” May 
this be typical of our action on this subject! May the echo, as if 
from the spirit of Hygeia, fall with lingering reverberations on the 
heart—“ Fail not to do all in your power to diminish distress, aug- 
ment happiness, and prolong human life; and you shall have a rich 
reward.” 
Lowell, April 30th, 1849. 
TABLE XXIII. 
Shoiving the Mortality from different Diseases in Massachusetts for 
five years, viz., from 1844 to 1848 inclusive. 
DISEASES. 
1844. 
Mumbe 
1845. 
r of de 
1846. 
aths in 
1847. 
1848. 
In 
1844. 
each It 
1845. 
,000 de 
svere ii 
1846. 
aths tht 
1847. 
ire 
1848. 
I. Zymotics. 
Cholera 
28 
45 
40 
92 
46 
40 
56 
46 
89 
46 
Cholera infantum 
87 
in 
258 
224 
172 
123 
138 
294 
217 
173 
Croup 
122 
261 
218 
277 
265 
172 
323 
250 
268 
267 
Diarrhoea 
30 
24 
55 
271 
245 
42 
30 
63 
263 
246 
Dysentery 
120 
200 
122 
410 
1074 
170 
248 
140 
397 
1079 
Erysipelas 
104 
111 
84 
53 
60 
147 
137 
96 
51 
60 
Fever, intermittent 
3 
5 
2 
3 
4 
6 
2 
3 
Fever, remittent 
2 
6 
12 
6 
9 
3 
7 
14 
6 
9 
Fever, typhus 
634 
772 
614 
944 
1202 
896 
957 
703 
915 
1208 
Hooping-cough 
60 
68 
100 
104 
77 
85 
84 
114 
101 
77 
Influenza 
68 
16 
16 
28 
27 
96 
20 
18 
27 
27 
Measles 
32 
44 
46 
136 
43 
45 
54 
53 
132 
43 
Scarlatina 
328 
538 
516 
418 
176 
463 
667 
590 
405 
177 
Small-pox 
11 
5 
32 
12 
21 
16 
6 
37 
12 
21 
Syphilis 
3 
1 
1 
1 
4 
1 
1 
1 
Thrush 
1 
1 
2 
4 
1 
1 
2 
4 
Totals 
1627 
2208 
2121 
2982 
3421 
2299 
2736 
2427 
2890 
3437 
II. Sporadics. 
Abscess 
9 
3 
13 
10 
14 
13 
4 
15 
10 
14 
Atrophy 
50 
18 
13 
38 
40 
71 
22 
15 
37 
40 
Cancer 
94 
99 
113 
118 
114 
133 
123 
129 
114 
114 536 
In each 10,000 deaths, there 
DISEASES. 
Numbe 
r of de 
iths in 
were in 
1844. 
1845. 
1846. 
1847. 
1848. 
1844. 
1845. 
1846. 
1847. 
1848. 
Debility 
21 
15 
13 
37 
29 
35 
19 
15 
36 
29 
Dropsy 
163 
181 
235 
277 
250 
230 
224 
269 
268 
252 
Gout 
2 
5 
5 
3 
3 
6 
6 
3 
Hemorrhage 
20 
28 
30 
25 
40 
28 
35 
34 
24 
40 
Inflammation 
35 
6 
31 
27 
31 
49 
7 
35 
26 
31 
Malformation 
4 
4 
4 
8 
5 
6 
5 
5 
8 
5 
Mortification 
25 
26 
24 
44 
186 
35 
32 
27 
43 
187 
Scrofula 
27 
42 
31 
41 
27 
38 
52 
35 
40 
27 
Sudden 
27 
19 
27 
24 
38 
22 
26 
24 
Tumour 
6 
12 
12 
19 
23 
9 
15 
14 
18 
23 
Totals 
487 
439 
543 
674 
783 
688 
544 
621 
653 
787 
III. Of the Nervous 
System. 
Apoplexy 
82 
82 
69 
90 
78 
116 
101 
79 
87 
' 78 
Cephalitis 
92 
94 
38 
54 
130 
116 
44 
52 
Chorea 
3 
2 
2 
2 
1 
4 
3 
2 
2 
1 
Convulsions 
130 
204 
146 
237 
245 
184 
254 
167 
230 
246 
Delirium tremens 
13 
17 
24 
21 
16 
19 
23 
21 
Epilepsy 
15 
7 
13 
14 
6 
22 
9 
15 
13 
6 
Hydrocephalus 
129 
189 
231 
233 
197 
182 
234 
264 
226 
198 
Insanity 
10 
12 
9 
24 
35 
14 
15 
10 
23 
35 
Paralysis 
111 
117 
177 
164 
138 
157 
145 
203 
159 
139 
Tetanus 
3 
5 
3 
9 
13 
4 
6 
3 
9 
13 
Diseases of organs 
56 
69 
64 
79 
118 
79 
85 
74 
77 
119 
Totals 
631 
794 
769 
930 
852 
892 
984 
880 
901 
856 
IV. Of the Respiratory 
System. 
Asthma 
4 
9 
6 
12 
9 
6 
11 
7 
12 
9 
Bronchitis 
15 
12 
12 
19 
22 
21 
15 
14 
18 
22 
Consumption 
1634 
2072 
2104 
2397 
2387 
2309 
2567 
2407 
2324 
2399 
Hydrothorax 
16 
49 
18 
16 
15 
23 
61 
20 
15 
15 
Laryngitis 
2 
5 
1 
5 
3 
3 
6 
1 
5 
3 
Pleuritis 
25 
20 
33 
47 
37 
36 
25 
38 
46 
37 
Pneumonia 
337 
350 
235 
501 
432 
476 
434 
269 
486 
434 
Quinsy 
3 
11 
9 
14 
6 
4 
14 
10 
13 
6 
Diseases of organs 
14 
29 
31 
26 
17 
33 
30 
26 
Totals 
2036 
2542 
2447 
5032 
2937 
2878 
3150 
2799 
2949 
2951 
V. Of the Circulatory 
System. 
Aneurism 
2 
3 
3 
3 
3 
4 
4 
3 
Pericarditis 
13 
1 
2 
3 
16 
1 
2 
3 
Diseases of organs 
139 
120 
147 
202 
225 
196 
148 
167 
196 
226 
Totals 
141 
136 
151 
207 
228 
199 
168 
172 
201 
229 
VI. Of the Digestive 
System. 
Ascites 
Colic 
15 
34 
12 
16 
22 
21 
42 
14 
15 
22 
Dentition 
24 
31 
30 
61 
69 
34 
38 
34 
60 
69 
Dyspepsia 
6 
12 
8 
12 
8 
8 
15 
9 
12 
8 
Enteritis 
116 
145 
132 
118 
107 
165 
179 
151 
114 
108 
Gastritis 
16 
11 
4 
19 
13 
22 
13 
4 
18 
13 
Hepatitis 
4 
6 
Hernia 
19 
9 
12 
7 
28 
10 
12 
7 
Intussusception 
17 
5 
5 
2 
1 
24 
6 
6 
2 
1 
Jaundice 
7 
12 
14 
24 
18 
10 
15 
16 
23 
18 
Peritonitis 
16 
12 
5 
7 
2 
23 
15 
6 
7 
2 
Ulceration 
23 
32 537 
DISEASES. 
Numbe 
r of de 
aths in 
were in 
• 
1844. 
1845. 
1846. 
1847. 
1848. 
1844. 
1845. 
1846. 
1847. 
1848. 
Worms 
4 
10 
7 
14 
6 
6 
12 
8 
13 
6 
Diseases of liver 
27 
51 
49 
63 
57 
37 
63 
56 
61 
57 
“ spleen 
<£ organs 
139 
194 
53 
45 
39 
196 
243 
61 
44 
39 
Totals 
433 
517 
328 
393 
349 
612 
641 
375 
381 
350 
VII. Of the Urinative 
System. 
Cystitis 
5 
5 
3 
4 
3 
7 
6 
3 
4 
3 
Diabetes 
7 
7 
15 
16 
14 
10 
9 
17 
15 
14 
Gravel 
11 
9 
9 
10 
15 
15 
11 
10 
10 
15 
Nephritis 
9 
3 
5 
1 
13 
4 
5 
i 
Diseases of organs 
8 
9 
13 
24 
10 
11 
13 
24 
Totals 
32 
32 
36 
48 
57 
45 
40 
41 
47 
57 
VIII. Of the Generative 
System. 
Childbirth 
30 
52 
45 
69 
69 
42 
65 
52 
67 
69 
Paramenia 
1 
1 
Puerperal fever 
33 
35 
30 
25 
33 
47 
43 
34 
24 
33 
Diseases of organs 
4 
8 
5 
13 
2 
6 
10 
6 
13 
2 
Totals 
6S 
95 
80 
107 
104 
96 
118 
92 
104 
104 
IX. Of the Locomotive 
System. 
Rheumatism 
14 
17 
13 
21 
15 
20 
21 
15 
20 
15 
Diseases of hip 
1 
2 
3 
8 
4 
1 
3 
3 
8 
4 
Diseases of joints 
1 
2 
5 
1 
1 
2 
5 
1 
Diseases of spine 
19 
14 
21 
20 
30 
27 
17 
25 
19 
30 
Totals 
34 
34 
39 
54 
50 
48 
42 
45 
52 
50 
X. Of the Integumentive 
System. 
Fistula 
1 
1 
1 
1 
Purpura 
3 
4 
4 
2 
4 
5 
4 
2 
Ulcer 
8 
10 
9 
11 
7 
12 
12 
11 
10 
7 
Diseases of organs 
1 
2 
1 
4 
1 
1 
3 
1 
4 
1 
Totals 
12 
17 
10 
20 
10 
17 
21 
12 
19 
10 
XI. Of Age. 
Infantile 
663 
450 
1187 
708 
183 
937 
558 
1358 
686 
184 
Senile 
631 
504 
688 
733 
633 
892 
624 
787 
711 
636 
Totals 
1294 
954 
1875 
1441 
816 
1829 
1182 
2145 
1397 
820 
XII. Of External Causes. 
Accident 
86 
87 
131 
133 
142 
122 
108 
150 
129 
143 
Burns and scalds 
22 
33 
36 
27 
27 
31 
41 
41 
26 
27 
Drowned 
88 
114 
115 
178 
100 
124 
141 
131 
172 
101 
Executed 
Frozen 
1 
1 
1 
1 
Heat 
4 
4 
Intemperance 
40 
23 
19 
30 
27 
57 
29 
22 
29 
27 
Lightning 
1 
1 
Malpractice 
1 
1 
! Murdered 
5 
2 
2 
7 
2 
2 
Poisoned 
6 
10 
5 
4 
7 
9 
12 
6 
4 
7 
Suffocated 
6 
5 
3 
4 
7 
6 
3 
4 
| Suicide 
32 
29 
31 
36 
38 
45 
36 
35 
35 
38 
Totals 
281 
302 
342 
419 
347 
397 
374 
391 
406 
349 
vol. ii.—35 538 
RECAPITULATION OF TABLE XXIII. 
Number of deaths in 
In each 10,000 deaths, there were in 
CLASSES OF DISEASES. 
1844 
1844 
to 
to 
1844 
1845 
1846 
1847 
1848 
1848 
1844 
1845 
1846 
1847 
1848 
1848 
I. Zymotics 
1627 
2208 
2121 
2982 
3421 
12,359 
2299 
2736 
2427 
2890 
3437 
2798 
Sporadics 
II. Of General Location 
487 
439 
543 
674 
783 
2926 
688 
544 
621 
653 
787 
663 
III. Of Nervous System 
631 
794 
769 
930 
852 
3976 
892 
984 
880 
901 
856 
900 
IV. Of Respirative Sys- 
tem 
2036 
2542 
2447 
3042 
2937 
13,004 
2878 
3150 
2799 
2994 
2951 
2944 
V. Of Circulative Sys- 
tem 
141 
136 
151 
207 
228 
863 
199 
168 
172 
201 
229 
196 
VI. Of Digestive System 
433 
517 
328 
393 
349 
2020 
612 
641 
375 
381 
350 
458 
VII. Of Urinative Sys- 
tem 
32 
32 
36 
48 
57 
205 
45 
40 
41 
47 
57 
47 
VIII. Of Generative Sys- 
tem 
68 
95 
80 
107 
104 
454 
96 
118 
92 
104 
104 
103 
IX. Of Locomotive Sys- 
tem 
34 
34 
39 
54 
50 
211 
48 
42 
45 
52 
50 
48 
X. Of Integumentive 
System 
12 
17 
10 
20 
10 
69 
17 
21 
12 
19 
10 
16 
XI. Of Age 
1294 
954 
1875 
1441 
816 
6380 
1829 
1182 
2145 
1397 
820 
1444 
XII. Of External Causes 
281 
302 
342 
419 
347 
1691 
397 
374 
391 
406 
349 
383 
Total of specified 
7076 
8070 
8741 
10.317 
9954 
44,158 
10,000 
10,000 
10,000 
10,000 
10,000 
10,000 
Not specified causes 
1262 
572 
470 
499 
1249 
4052 
Stillborn 
49 
73 
109 
149 
143 
523 
Grand total 
8387 
8715 
9320 
10,965 
11,346 
48,733 
TABLE XXIV. 
Illustrating the Influence of Season on Longevity in Massachusetts, 
from 1844 to 1848, inclusive. 
Whole number of deaths in 
To 
Number of 
deaths 
1844 to 1848. 
tal 
In 10,000, 
there were 
1844 to 1848. 
1844 
1845 
1846 
1847 
1848 
May 
602 
571 
728 
722 
746 
3379 
693 
June 
548 
507 
653 
722 
728 
3158 
648 
July 
600 
715 
677 
895 
943 
3830 
785 
August 
831 
936 
1018 
1339 
1362 
5486 
1126 
September 
940 
952 
985 
1396 
1611 
5874 
1206 
October 
769 
845 
820 
1066 
1114 
4614 
947 
November 
649 
653 
652 
791 
780 
3525 
723 
December 
725 
677 
718 
800 
731 
3651 
749 
January 
650 
687 
695 
754 
819 
3595 
738 
February 
642 
696 
744 
784 
844 
3710 
761 
March 
655 
767 
826 
867 
865 
3980 
817 
April 
590 
709 
814 
814 
803 
3730 
766 
Unknown 
186 
15 
201 
41 
Total 
8387 
8715 
9320 
10,965 
11,346 
48,733 
10,000 539 
TABLE XXV. 
Blustrating the Influence of Age on Longevity in Massachusetts 
from 1844 to 1848, inclusive. 
Total 
1844 
1845 
1846 
1847 
1848 
Number of 
deaths 
1844 to 1848. 
In 10,000, 
there were 
1844 to 1848. 
Under 1 
1313 
1551 
1695 
1946 
1945 
8450 
1734 
1 to 2 
551 
697 
676 
1000 
976 
3900 
800 
2 “ 5 
566 
739 
682 
879 
944 
3810 
782 
Under 5 
2430 
2987 
3053 
3825 
3865 
16160 
3406 
5 to 10 
334 
354 
461 
494 
453 
2096 
430 
10 “ 20 
536 
592 
675 
707 
743 
3253 
668 
20 “ 30 
858 
995 
1041 
1251 
1422 
5567 
1142 
30 “ 40 
671 
704 
752 
890 
975 
3992 
819 
40 “ 50 
485 
508 
573 
717 
737 
3020 
620 
50 “ 60 
437 
500 
480 
613 
671 
2707 
554 
60 “ 70 
602 
541 
609 
691 
674 
3117 
640 
70 “ 80 
751 
705 
735 
826 
823 
3840 
788 
80 “ 90 
578 
462 
611 
677 
620 
2948 
605 
90 “ 100 
137 
107 
150 
156 
132 
682 
140 
Over 100 
4 
6 
6 
9 
9 
34 
7 
Unknown 
564 
254 
174 
109 
222 
1323 
271 
Total 
8387 
8715 
9320 
10,965 
11,346 
48,733 
10,000 
Showing the Mortality from different Diseases in Boston, since the 
date of the Qity Charter, viz., from 1821 to 1848, inclusive. 
TABLE XXVI. 
In each 10,000 deaths, there 
Number of deaths in 
were in 
DISEASES. 
1821 
1826 
1831 
1836 
1841 
1846 
1821 
1826 
1831 
1836 
1841 
1846 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
1825 
1830 
1835 
1840 
1845 
1848 
1825 
1830 
1835 
1840 
1845 
1848 
I. Zymotics. 
Cholera 
34 
26 
124 
40 
33 
33 
69 
56 
172 
50 
32 
31 
Cholera infantum 
43 
46 
70 
228 
223 
190 
87 
100 
99 
285 
219 
181 
Croup 
94 
151 
211 
204 
319 
290 
191 
326 
298 
255 
313 
276 
Diarrhoea 
58 
8 
15 
37 
48 
154 
118 
17 
22 
46 
47 
147 
Dysentery 
221 
142 
172 
218 
126 
552 
450 
307 
243 
273 
124 
526 
Erysipelas 
1 
11 
28 
46 
101 
42 
2 
24 
39 
57 
99 
40 
Fever, intermittent 
1 
4 
7 
6 
6 
1 
2 
9 
10 
7 
6 
1 
“ remittent 
4 
2 
8 
4 
“ typhus 
297 
294 
418 
385 
498 
1093 
603 
635 
591 
481 
488 
1041 
Hooping-cough 
88 
96 
158 
168 
201 
107 
179 
208 
223 
210 
197 
102 
Influenza 
7 
53 
19 
34 
18 
14 
82 
24 
33 
17 
Measles 
231 
101 
263 
78 
197 
181 
470 
218 
372 
97 
193 
172 
Scarlatina 
12 
36 
487 
485 
812 
342 
24 
78 
689 
606 
796 
325 
Small-pox 
2 
6 
17 
197 
185 
136 
4 
13 
24 
246 
182 
129 
Syphilis 
10 
7 
9 
8 
10 
6 
20 
15 
13 
10 
10 
6 
Thrush 
1 
3 
3 
99 
2 
2 
6 
4 
97 
2 
Totals 
1104 
933 
2032 
2122 
2892 
3147 
2243 
2016 
2877 
2651 
2836 
2996 
II. Sporadics. 
Abscess 
23 
14 
20 
20 
27 
18 
47 
30 
28 
25 
26 
17 
Atrophy 
36 
43 
168 
214 
225 
73 
61 
210 
210 
214 
Cancer 
34 
24 
46 
57 
72 
54 
69 
52 
65 
71 
71 
52 
Debility 
34 
48 
89 
43 
151 
76 
69 
104 
126 
54 
148 
72 
Dropsy 
133 
104 
155 
166 
197 
157 
270 
225 
219 
207 
193 
149 540 
In each 10,000 deaths, there 
Number of deaths in 
were in 
DISEASES. 
1821 
1826 
1831 
1836 
1841 
1846 
1821 
1826 
1831 
1836 
1841 
1846 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
1825 
1830 
1835 
1840 
1845 
1848 
1825 
1830 
1835 
1640 
1845 
1848 
Gout 
6 
2 
2 
2 
1 
12 
4 
3 
2 
1 
Hemorrhage 
3 
7 
21 
34 
25 
6 
15 
26 
33 
24 
Inflammation 
3 
23 
9 
26 
5 
6 
50 
13 
33 
5 
Malformation 
2 
2 
Mortification 
40 
37 
41 
24 
15 
17 
81 
80 
58 
30 
15 
16 
Scrofula 
18 
17 
31 
41 
62 
23 
37 
37 
44 
51 
61 
31 
Sudden 
62 
21 
35 
61 
62 
26 
126 
45 
50 
76 
61 
25 
Tumour 
4 
8 
18 
18 
51 
40 
8 
17 
25 
22 
50 
38 
Totals 
396 
305 
489 
649 
891 
671 
804 
659 
692 
809 
874 
638 
III. Of the Nervous 
System. 
Apoplexy 
45 
62 
73 
115 
99 
67 
91 
134 
103 
144 
97 
64 
Cephalitis 
51 
22 
21 
77 
57 
104 
104 
47 
30 
96 
56 
99 
Chorea 
1 
1 
Convulsions 
139 
170 
215 
264 
263 
250 
282 
368 
304 
330 
258 
237 
Delirium tremens 
23 
15 
24 
48 
27 
25 
47 
32 
34 
60 
26 
24 
Epilepsy 
6 
6 
5 
5 
13 
3 
12 
13 
7 
6 
13 
3 
Hydrocephalus 
89 
181 
248 
306 
429 
361 
180 
392 
351 
381 
421 
344 
Insanity 
8 
14 
12 
8 
16 
1 
16 
30 
17 
10 
16 
1 
Paralysis 
63 
50 
74 
58 
92 
78 
128 
108 
104 
72 
90 
74 
Tetanus 
3 
3 
3 
6 
5 
5 
6 
6 
4 
8 
5 
5 
Diseases of organs 
3 
27 
59 
96 
66 
63 
6 
58 
83 
120 
65 
60 
Totals 
430 
550 
734 
983 
1067 
958 
872 
1188 
1037 
1227 
1047 
912 
IV. Of the Respirative 
System. 
Asthma 
8 
5 
9 
20 
7 
8 
16 
11 
13 
25 
7 
8 
Bronchitis 
3 
3 
25 
23 
4 
4 
24 
22 
Consumption 
1032 
1022 
1143 
1163 
1543 
1608 
2096 
2207 
1616 
1454 
1513 
1531 
Hydrothorax 
24 
23 
18 
29 
19 
21 
49 
50 
25 
36 
19 
20 
Laryngitis 
10 
10 
Pleuritis 
22 
18 
39 
51 
57 
82 
45 
39 
55 
64 
56 
78 
Pneumonia 
254 
326 
511 
561 
753 
617 
516 
704 
721 
701 
738 
587 
Quinsy 
28 
15 
22 
13 
22 
8 
57 
32 
31 
16 
22 
8 
Diseases of organs 
15 
10 
9 
17 
8 
16 
30 
22 
13 
21 
8 
15 
Totals 
1383 
1419 
1754 
1857 
2444 
2383 
2809 
3065 
2478 
2321 
2397 
2269 
V. Of the Circulaiive 
System. 
Aneurism 
1 
4 
1 
2 
5 
1 
Pericarditis 
7 
1 
5 
14 
2 
6 
Diseases of organs 
30 
51 
83 
123 
192 
168 
61 
110 
118 
154 
188 
160 
Totals 
38 
52 
83 
132 
192 
169 
77 
112 
118 
165 
188 
161 
VI. Of the Digestive 
System. 
Ascites 
Colic 
13 
14 
13 
19 
7 
6 
26 
30 
19 
24 
7 
6 
Dentition 
27 
56 
121 
159 
209 
124 
55 
121 
171 
199 
205 
118 
Dyspepsia 
13 
2 
6 
7 
7 
3 
26 
4 
9 
9 
7 
3 
Enteritis 
68 
94 
140 
220 
322 
146 
130 
203 
198 
275 
316 
139 
Gastritis 
4 
5 
2 
13 
27 
19 
8 
11 
3 
16 
26 
18 
Hepatitis 
16 
2 
1 
33 
4 
1 
Hernia 
7 
5 
1 
4 
6 
8 
14 
11 
1 
5 
6 
8 
Intussusception 
1 
1 
1 
1 
Jaundice 
23 
11 
12 
14 
19 
22 
47 
24 
17 
17 
19 
21 
Peritonitis 
0 
10 
Ulceration 
105 
100 
Worms 
13 
13 
28 
2S 
30 
18 
26 
28 
40 
35 
29 
17 541 
In each 10.000 deaths, there 
Number of deaths in 
were in 
DISEASES. 
1S21 
1826 
1831 
1836 
1841 
1846 
1821 
1826 
1831 
1836 
1841 
1846 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
1825 
1830 
1835 
1840 
1845 
1848 
1825 
1830 
1835 
1840 
1845 
184S 
Diseases ofliver 
11 
59 
65 
47 
80 
46 
22 
127 
92 
59 
78 
44 
Diseases of spleen 
1 
1 
1 
2 
2 
1 
Diseases of organs 
64 
118 
170 
166 
260 
1080 
1 130 
255 
240 
207 
255 
1027 
Totals 
265 
380 
559 
678 
969 
1577 
I 538 
820 
791 
847 
950 
1501 
VII. Of the Urinative 
System. 
Cystitis 
1 
1 
2 
1 
Diabetes 
3 
1 
4 
6 
6 
6 
1 
5 
6 
6 
Gravel 
10 
11 
3 
4 
9 
9 
20 
24 
4 
5 
9 
9 
Nephritis 
Diseases of organs 
4 
1 
6 
4 
18 
19 
8 
2 
9 
5 
17 
18 
Totals 
15 
15 
10 
12 
33 
35 
30 
32 
14 
15 
32 
33 
VIII. Of the Generative 
System. 
Childbirth 
17 
67 
88 
99 
178 
139 
35 
145 
125 
124 
174 
132 
Paramenia 
Puerperal fever 
34 
3 
10 
69 
6 
12 
Diseases of organs 
6 
5 
2 
15 
7 
5 
12 
11 
3 
19 
7 
5 
Totals 
57 
75 
90 
124 
185 
144 
j 116 
162 
128 
155 
181 
137 
IX. Of the Locomotive 
System. 
Rheumatism 
25 
15 
20 
26 
32 
18 
1 51 
32 
28 
32 
31 
17 
Diseases ofhip 
13 
12 
Diseases of joints 
10 
11 
15 
15 
19 
2 
1 20 
24 
22 
19 
19 
2 
Diseases of spine 
23 
22 
Totals 
35 
26 
35 
41 
51 
56 
71 
56 
50 
51 
50 
53 
X. Of the lntegumentive 
System. 
Fistula 
7 
1 
15 
1 
Purpura 
1 
1 
Ulcer 
2 
16 
7 
15 
IS 
4 
23 
9 
15 
17 
Diseases of organs 
4 
4 
5 
2 
13 
lj 
8 
9 
7 
2 
13 
1 
Totals 
4 
13 
21 
9 
28 
21 
8 
28 
30 
11 
28 
20 
XI. Of Age. 
Infantile 
657 
226 
432 
551 
687 
723 
1334 
488 
611 
688 
674 
688 
Senile 
177 
243 
312 
333 
326 
214 
360 
525 
441 
415 
320 
204 
Totals 
834 
469 
744 
00 
00 
1013 
937 
1694 
1013 
1052 
1103 
994 
892 
XII. Of External Causes. 
Accidents 
74 
65 
101 
115 
128 
160 
150 
141 
143 
144 
126 
152 
Burns and scalds 
41 
45 
53 
70 
43 
28 
83 
97 
75 
87 
42 
27 
Drowned 
95 
93 
88 
109 
99 
83 
193 
201 
125 
136 
97 
79 
Executed 
1 
7 
2 
2 
10 
2 
Frozen 
1 
3 
2 
2 
6 
3 
Heat 
8 
2 
3 
5 
3 
5 
16 
4 
4 
6 
3 
5 
Intemperance 
111 
146 
19S 
147 
109 
76 
226 
316 
2S0 
184 
107 
72 
Lightning 
Malpractice 
Murdered 
8 
1 
4 
4 
9 
16 
1 
5 
4 
9 
Poisoned 
1 
5 
5 
11 
4 
61 
2 
11 
7 
14 
4 
6 
Suffocated 
5 
2 
6 
2 
6 
5 
10 
4 
9 
2 
6 
5 
Suicide 
19 
31 
54 
52 
35 
36' 
39 
67 
76 
65 
34 
33 
Totals 
363 
393 
518 
517 
431 
408 
737 
849 
733 
645 
423 
388 542 
BECAMTULATIOX OF TABLE XXVI. 
Number of deaths in 
In each 10,000 deaths, there were in 
CLASSES OF DISEASES. 
1821 
1826 
1831 
1836 
1841 
1846 
1821 
1826 
1831 
1836 
1841 
1846 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
to 
1825 
1830 
1835 
1840 
1845 
1848 
1825 
1830 
1835 
1840 
1S45 
1848 
I. Zymotics 
1104 
933 
2032 
2122 
2892 
3147 
2243 
2016 
2377 
2651 
2836 
2996 
Sporadics 
II. Of General Location 
396 
305 
489 
649 
891 
671 
804 
659 
692 
809 
874 
638 
III. Of Nervous System 
430 
550 
734 
983 
1067 
958 
872 
1188 
1037 
1227 
1047 
912 
IV. Of Respirative Sys- 
tem 
1383 
1419 
1754 
1857 
2444 
2383 
2809 
3065 
2478 
2321 
2397 
2269 
V. Of Circulative Sys- 
tem 
38 
52 
83 
132 
192 
169 
77 
112 
118 
165 
188 
161 
VI. Of Diprestive System 
265 
380 
559 
678 
909 
1577 
538 
820 
791 
847 
950 
1501 
VII. Of Urinative Sys- 
tem 
15 
15 
10 
12 
33 
35 
30 
32 
14 
15 
32 
33 
VIII. Of Generative Sys- 
tem 
57 
75 
90 
124 
185 
144 
116 
162 
128 
155 
181 
137 
IX. Of Locomotive Sys- 
tem 
35 
26 
35 
41 
51 
56 
71 
56 
50 
51 
50 
53 
X. Of Integumentive 
System 
4 
13 
21 
9 
23 
21 
£ 
28 
3C 
11 
28 
20 
XI. Of Age 
834 
469 
744 
884 
1013 
937 
1694 
1013 
1052 
1103 
994 
892 
XII. Of External Causes 
363 
393 
518 
517 
431 
408 
737 
849 
733 
645 
423 
388 
Total of specified 
4924 
4630 
7069 
8008 
10,196 
10,506 
10,000 
10,000 
10,000 
10,000 
10,000 
10,000 
Not specified causes 
1100 
816 
592 
745 
249 
99 
Stillborn 
500 
409 
468 
615 
923 
880 
Grand total 
6524 
5855 
8129 
9367 
11,368 
11,485 543 
Illustrating the Influence of Season on the Longevity of the Sexes in Boston, since the date of the City Charter, viz., from 
1821 to 1848, inclusive. 
1821 to 1825. 
1826 to 1830. 
1831 to 1835. 
1836 to 1840. 
1841 to 1845. 
1846 to 1848. 
Months. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Jan’y 
221 
225 
446 
228 
252 
480 
294 
298 
592 
390 
363 
753 
396 
431 
827 
386 
312 
698 
Feb’y 
183 
198 
381 
209 
192 
401 
271 
263 
534 
357 
352 
709 
412 
418 
830 
333 
336 
669 
March 
244 
208 
452 
234 
205 
439 
272 
290 
562 
364 
357 
721 
332 
435 
767 
369 
309 
678 
April 
250 
203 
453 
231 
223 
454 
286 
282 
568 
344 
314 
658 
419 
425 
844 
416 
378 
794 
May 
244 
206 
450 
247 
205 
452 
252 
255 
507 
300 
305 
605 
449 
409 
858 
444 
402 
846 
June 
217 
186 
403 
206 
155 
361 
255 
235 
490 
298 
273 
571 
388 
348 
736 
461 
349 
810 
July 
262 
245 
507 
239 
195 
434 
269 
250 
519 
354 
319 
673 
448 
402 
850 
522 
476 
998 
August 
295 
304 
599 
281 
251 
532 
365 
343 
708 
476 
449 
925 
575 
523 
1098 
764 
683 
1447 
Sept’r 
353 
321 
674 
308 
264 
572 
434 
387 
S21 
475 
467 
942 
566 
522 
1088 
604 
588 
1192 
Oct’r 
307 
299 
606 
258 
245 
503 
411 
363 
774 
385 
399 
784 
442 
424 
866 
510 
395 
905 
Nov’r 
245 
267 
512 
212 
203 
415 
417 
363 
780 
351 
360 
711 
412 
396 
808 
397 
397 
794 
Dec’r 
273 
268 
541 
200 
203 
403 
425 
381 
806 
363 
338 
701 
418 
455 
873 
400 
372 
772 
Total 
3094 
2930 
6024 
5853 
2593 
5446 
3951 
3710 
7661 
4457 
4296 
8753 
5257 
5188 
10,445 
5606 
4997 
10,603 
TABLE XXVII. 544 
Illustrating the Influence of Age on the Longevity of the Sexes in Boston, since the date of the City Charter, viz., from 
1821 to 1848, inclusive. 
1S21 to 1825. 
1826 to 1830. 
1831 to 1835. 
1836 to 1940. 
1841 to 1845. 
1846 to 1348. 
Years. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Males. 
Females. 
Total. 
Under 1 
530 
411 
941 
599 
422 
1021 
806 
629 
1435 
1196 
972 
2168 
1004 
812 
1816 
1159 
1033 
2192 
1 to 2 
237 
330 
667 
243 
310 
553 
424 
481 
905 
722 
682 
1404 
539 
580 
1119 
704 
651 
1355 
2 to 5 
219 
175 
396 
209 
190 
399 
462 
401 
863 
690 
597 
1287 
478 
419 
897 
608 
507 
1115 
Under 5 
1086 
916 
2002 
1051 
922 
1973 
1692 
1511 
3203 
2608 
2251 
4859 
2021 
1811 
3832 
2471 
2191 
4662 
5 to 10 
120 
91 
211 
113 
82 
195 
169 
151 
320 
245 
220 
465 
212 
159 
371 
269 
236 
505 
10 to 20 
113 
149 
262 
121 
150 
271 
144 
244 
388 
231 
320 
551 
175 
276 
451 
269 
294 
562 
20 to 30 
306 
356 
662 
365 
377 
742 
485 
492 
977 
510 
710 
1220 
478 
596 
1074 
741 
690 
1431 
30 to 40 
348 
315 
663 
402 
327 
729 
529 
398 
927 
526 
529 
1055 
504 
454 
958 
687 
555 
1242 
40 to 50 
330 
237 
567 
293 
229 
522 
342 
266 
608 
433 
293 
726 
391 
295 
686 
457 
330 
787 
50 to 60 
200 
183 
383 
189 
148 
337 
240 
198 
438 
251 
257 
508 
285 
214 
499 
284 
237 
521 
60 to 70 
106 
152 
258 
127 
135 
262 
158 
187 
345 
208 
228 
436 
179 
195 
374 
229 
197 
426 
70 to 80 
93 
133 
226 
88 
115 
203 
108 
154 
262 
155 
230 
385 
116 
171 
287 
122 
166 
288 
80 to 90 
41 
71 
112 
48 
66 
114 
46 
75 
121 
65 
122 
187 
54 
83 
137 
54 
81 
135 
90 to 100 
6 
15 
21 
5 
11 
16 
11 
17 
28 
10 
20 
30 
6 
22 
28 
14 
19 
33 
Unknown 
345 
312 
657 
51 
31 
82 
27 
17 
44 
15 
8 
23 
36 
! 
20 
56 
9 
1 
10 
Total 
3094 
2930 
6024 
2853 
2593 
5446 
3951 
3710 
7661 
4457 
4296 
8753 
; 5257 
5188 
10,445 
5606 
4997 
10,603 
TABLE XXVIII. 545 
TABLE XXIX. 
Showing the Population of Boston at different Periods. 
Total 
Males 
Females 
Continued 
Total 
Males 
Females 
1845 
Total 
Males 
Females 
1 1840 
Total 
Males 
Females 
1830 
Totals 
Males 
Females 
oc 
CO 
Ox 
Totals 
Males 
Females 
1825 
Totals 
Males 
Females 
1820 
Totals 
Males 
Females 
1810 
17,502 
8636 
8866 
12,515 
6206 
6309 
10,682 
5283 
5399 
8826 
4430 
4396 
Under 10. 
6190 
3117 
3073 
40 to 45. 
3144 
1626 
1518 
Under 1. 
11,269 
5711 
5558 
7822 
381S 
4004 
Under 5. 
3839 
1874 
1965 
45 to 50. 
2626 
1361 
1265 
1 to 2. 
8711 
4246 
4465 
5919 
2941 
2978 
5 to 10. 
7932 
3743 
4189 
6677 
3061 
3616 
5381 
2416 
2965 
3960 
1869 
2091 
10 to 16. 
2983 
1337 
1646 
50 to 55. 
CO 
05 
CD 
1459 
1709 
2 to 3. 
6921 
CO §C 
Cl 
w 
05 
2469 
2847 
10 to 15. 
1777 
CO 00 
to § 
55 to 60. 
to 
<1 
**1 
1423 
1354 
3 to 4. 
8855 
to CO 
05 
s 
3165 
3544 
15 to 20. 
19,753 
9633 
10,120 
15,211 
7622 
7589 
00 
O 
00 
3564 
4544 
7692 
3679 
4013 
16 to 26. 
1630 
714 
916 
60 to 65. 
| 2733 
1365 
1368 
4 to 5. 
8 
CD 
S 
15,612 
11,242 
15,6871 
7729 
7958 
20 to 30. 
1 
348 
490 
65 to 70. 
14,449 
7234 
7214 
Under 5. 
15,970 
9404 
6566 
00 
u5 
CO 
4132 
4661 
30 to 40. 
j 23,860 
12,483 
11,377 
16,193 
-O 00 
-3 
CO Ox 
Ox 00 
j 13,318 
7345 
5973 
8582 
4408 
4174 
26 to 45. 
Cl 
§ 
202 
387 
70 to 75. 
11,358 
5690 
5668 
5 to 10. 
6542 
3056 
3492 
4866 
2168 
2698 
40 to 50. 
7799 
3327 
4472 
5764 
CO to 
to Ox 
O 05 
o 
4069 
1500 
2569 
3259 
1363 
1896 
Over 45. 
CO 
o 
113 
191 
75 to 80. 
9636 
■4708 
14928 
10 to 15 
3396 
1476 
1920 
2490 
1077 
1413 
50 to 60. 
05 
to 
56 
106 
80 to 85. 
1826 
§3 
to 
15 to 16. 
1557 
CO C5 
Cl O 
1276 
CD 4* 
O -J 
i— Cl 
60 to 70. 
76,846 
37,822 
39,024 
56,360 
27,907 
28,453 
41,558 
20,108 
21,450 
32,319 
15,749 
16,570 
o 
Sj 
Cl 
CO 
to 
85 to 90. 
9123 
4325 
4798 
16 to 20. 
C5 
— 
Cl 
»t»to 
§ s 
o* 
CO 
CO 
to C5 
Cl rfs. 
70 to 80. 
CO 
00 
90 to 95. 
15,377 
7612 
7765 
20 to 25. 
8 
O 
32 
© 
H* CO 
CO 
Over 80. 
1757 
788 
969 
1917 
974 
943 
1740 
CO 00 
CO o 
H-* CO 
Coloured 
1468 
Not White. 
00 
95 to 100. 
14,218 
7397 
6821 
25 to 30. 
j 90,956 
147,844 
■ 43,112 
59,517 
28,171 
31,346 
Total. 
(-* 
Over 100. 
11,828 
6129 
5699 
30 to 35. 
2427 
1399 
1028 
1875 
865 
1010 
Coloured. 
78,603 
Ox 
CO 
'to 
-3 
43,298 
33,787 
Total. 
114,366 
Cl Cl 
'J^gd 
CO 
o o 
Total. 
8153 
4326 
3827 
35 to 40. 
93,383 
61,362 
Total. 546 
TABLE XXX. 
Showing the Condition of Dwellings in Boston, in 1845. 
Wards. 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
11 
12 
Total. 
Brick • . 
406 
221 
572 
503 
764 
652 
535 
342 
620 
793 
763 
82 
6253 
Wood . . 
511 
325 
335 
462 
295 
281 
97 
104 
204 
319 
650 
976 
4559 
Total inhab. 
917 
546 
907 
965 
1059 
933 
632 
446 
824 
1112 
1413 
1058 
10,812 
Inhab. in part 
42 
116 
88 
140 
43 
37 
110 
110 
48 
98 
74 
40 
946 
“ by 1 family 
201 
41 
120 
281 
274 
255 
197 
82 
280 
227 
286 
281 
2525 
cc cc 2 « 
75 
16 
35 
58 
91 
58 
3 
10 
25 
69 
124 
97 
661 
cc cc 3 cc 
16 
4 
5 
26 
10 
7 
1 
2 
5 
8 
14 
19 
117 
cc cc 4 cc 
2 
6 
1 
6 
2 
3 
5 
5 
5 
2 
37 
CC CC 5 cc 
1 
1 
1 
2 
1 
2 
2 
1 
11 
cc cc g cc 
1 
1 
1 
3 
6 
CC CC 7 cc 
1 
1 
1 
1 
4 
These are 
owned by an 
inhabitant 
296 
67 
162 
372 
377 
325 
202 
96 
315 
313 
433 
403 
3361 
Inhabited 
by 1 family 
272 
159 
312 
345 
371 
264 
318 
112 
266 
430 
524 
370 
3743 
2 “ 
206 
123 
248 
138 
223 
185 
54 
56 
139 
178 
357 
203 
2110 
3 “ 
85 
52 
108 
89 
60 
73 
26 
33 
45 
99 
66 
49 
785 
4 “ 
35 
54 
50 
16 
21 
51 
14 
19 
37 
47 
21 
17 
382 
5 « 
6 
26 
16 
4 
4 
26 
14 
29 
13 
14 
4 
7 
163 
6 “ 
11 
25 
9 
1 
2 
3 
2 
20 
4 
14 
3 
5 
99 
7 “ 
1 
15 
1 
1 
3 
2 
28 
1 
7 
3 
1 
63 
8 “ 
4 
10 
1 
1 
29 
1 
6 
1 
53 
9 « 
1 
6 
1 
11 
1 
2 
22 
10 “ 
2 
6 
2 
1 
2 
14 
10 to 30 
7 
7 
2 
1 
17 
Not owned by 
an inhabitant 
621 
479 
745 
593 
682 
608 
430 
350 
509 
799 
980 
655 
7451 
No. families 
in 
1635 
1542 
1695 
1482 
1614 
1667 
871 
1461 
1325 
2006 
2223 
1654 
19,175 
to each house 
1.78 
2.82 
1.86 
1.53 
1.52 
1.78 
1.37 
3.27 
1.60 
1.80 
1.57 
1.56 
1.77 
No. persons 
to do. 
9.12 
17.79 
11.08 
11.20 
8.04 
8.75 
10.55 
19.15 
10.39 
11.37 
8.68 
9.47 
10.57 
“ to family 
5.11 
6.30 
5.93 
7.29 
5.27 
4.90 
7.66 
5.84 
6.46 
6.30 
5.51 
6.05 
5.96 547 
Showing the Mortality from different Diseases in Lowell, since the 
date of the City Charter, viz., from 1836 to 1848, inclusive. 
TABLE XXXI. 
In each 10,000 deaths, 
there 
Number of 
deaths 
n 
were in 
DISEASES. 
1836 
1841 
1846 
1836 
1836 
1841 
1846 
1836 
to 
to 
to 
to 
to 
to 
to 
to 
1840 
1845 
1848 
1848 
1840 
1845 
1848 
1848 
I. Zymotics. 
Cholera 
6 
13 
9 
28 
41 
70 
37 
49 
Cholera infantum 
80 
148 
127 
355 
547 
798 
529 
620 
Croup 
38 
50 
86 
174 
260 
270 
358 
305 
Diarrhoea 
48 
44 
30 
122 
328 
237 
125 
214 
Dysentery 
54 
48 
381 
483 
369 
259 
1588 
844 
Erysipelas 
7 
14 
14 
35 
48 
75 
58 
59 
Fever, intermittent 
1 
1 
2 
7 
4 
4 
“ remittent 
“ typhus 
168 
175 
322 
665 
1148 
943 
1342 
1162 
Hooping-cough 
21 
36 
21 
78 
144 
194 
87 
136 
Influenza 
1 
1 
5 
2 
Measles 
25 
30 
46 
101 
171 
162 
192 
177 
Scarlatina 
97 
96 
113 
306 
663 
518 
471 
535 
Small-pox 
9 
2 
22 
33 
61 
11 
92 
58 
Syphilis 
1 
1 
5 
2 
Thrush 
1 
1 
7 
2 
Totals 
555 
658 
1172 
2385 
3794 
3547 
4883 
4169 
II. Sporadics. 
Abscess 
3 
4 
5 
12 
21 
22 
21 
21 
Atrophy 
23 
13 
34 
70 
157 
70 
142 
123 
Cancer 
2 
8 
13 
23 
14 
43 
54 
40 
Debility 
Dropsy 
15 
9 
13 
37 
102 
49 
54 
65 
Gout 
Hemorrhage 
4 
11 
8 
23 
27 
59 
33 
40 
Inflammation 
Malformation 
8 
14 
4 
26 
55 
75 
17 
46 
Mortification 
4 
6 
12 
22 
27 
32 
50 
39 
Scrofula 
2 
10 
6 
18 
14 
54 
25 
32 
Sudden 
Tumour 
1 
1 
7 
2 
Totals 
62 
75 
95 
233 
424 
404 
396 
408 
III. Of the Nervous System. 
Apoplexy 
15 
21 
26 
62 
102 
113 
108 
107 
Cephalitis 
66 
32 
27 
125 
451 
172 
113 
220 
Chorea 
Convulsions 
31 
54 
40 
125 
212 
291 
167 
220 
Delirium tremens 
16 
14 
8 
38 
110 
75 
33 
66 
Epilepsy 
2 
4 
2 
8 
14 
22 
8 
14 
Hydrocephalus 
30 
110 
106 
246 
205 
593 
442 
429 
Hydrophobia 
1 
1 
4 
2 
Insanity 
1 
1 
5 
2 
Paralysis 
1 
3 
2 
6 
7 
16 
8 
11 
Tetanus 
1 
1 
4 
2 
Disease of organs 
13 
11 
38 
62 
89 
59 
159 
107 
Totals 
174 
250 
251 
675 
1190 
1346 
1046 
1180 
IV. Of the Respirative System. 
Asthma 
1 
5 
6 
5 
21 
11 
Bronchitis 
13 
23 
13 
49 
89 
124 
54 
85 
Consumption 
229 
345 
355 
929 
1565 
1860 
1479 
1624 
Hydrothorax 
2 
4 
5 
11 
14 
22 
21 
19 548 
In each 10.000 deaths 
there 
Number of deaths in 
wer 
e in 
DISEASES. 
1836 
1841 
1846 
1836 
1836 
1841 
1846 
1836 
to 
to 
to 
to 
to 
to 
to 
to 
1840 
1845 
1848 
1848 
1840 
1845 
1848 
1848 
Laryngitis 
2 
2 
14 
4 
Pleuritis 
11 
6 
5 
22 
75 
32 
21 
38 
Pneumonia 
97 
114 
113 
324 
663 
615 
471 
566 
Quinsy 
Diseases of organs 
3 
3 
6 
21 
16 
11 
Totals 
357 
496 
496 
1349 
2441 
2674 
2069 
2358 
Y. Of the Circulative System. 
Aneurism 
2 
1 
3 
14 
5 
5 
Pericarditis 
5 
9 
2 
16 
34 
49 
8 
28 
Diseases of organs 
15 
20 
40 
75 
102 
108 
167 
132 
Totals 
22 
30 
42 
94 
150 
162 
175 
165 
VI. Of the Digestive System. 
Ascites 
1 
1 
5 
2 
Colic 
1 
1 
7 
2 
Dentition 
1 
7 
27 
35 
7 
38 
113 
61 
Dyspepsia 
1 
1 
5 
2 
Enteritis 
23 
25 
19 
67 
156 
135 
7 
117 
Gastritis 
12 
15 
6 
33 
82 
81 
25 
58 
Hepatitis 
3 
2 
5 
21 
11 
9 
Hernia 
2 
1 
1 
4 
14 
5 
4 
7 
Intussusception 
5 
2 
7 
34 
11 
12 
Jaundice 
4 
3 
5 
12 
27 
16 
21 
21 
Peritonitis 
11 
16 
27 
75 
86 
47 
Ulceration 
1 
5 
6 
7 
21 
11 
Worms 
2 
1 
3 
14 
4 
5 
Disease of liver 
5 
7 
12 
27 
29 
21 
“ spleen 
1 
1 
7 
2 
“ organs 
1 
6 
7 
14 
7 
33 
29 
24 
Total 
67 
84 
78 
229 
458 
457 
325 
401 
VII. Of the Urinative System. 
Cystitis 
1 
1 
7 
2 
Diabetes 
Gravel 
3 
3 
16 
5 
Nephritis 
Diseases of organs 
1 
5 
4 
10 
7 
27 
17 
17 
Totals 
2 
8 
4 
14 
14 
43 
17 
24 
VIII. Of the Generative Syst. 
Childbirth 
Paramenia 
4 
5 
9 
27 
27 
16 
Puerperal fever 
19 
21 
26 
66 
129 
113 
108 
115 
Diseases of organs 
5 
6 
1 
12 
34 
32 
4 
21 
Totals 
28 
32 
27 
87 
190 
172 
112 
152 
IX. Of the Locomotive System. 
Rheumatism 
Disease of hip 
“ joints 
1 
5 
6 
5 
21 
11 
1 
1 
2 
7 
5 
4 
“ spine 
1 
3 
6 
10 
7 
16 
25 
17 
Totals 
2 
5 
11 
18 
14 
26 
46 
32 
X. Of the Integumentive Syst. 
Fistula 
Purpura 
4 
1 
5 
27 
4 
9 549 
In each 10,000 deaths. 
there 
Nu 
mber of deaths in 
were in 
DISEASES. 
1836 
1841 
1846 
1836 
1836 
1841 
1846 
1836 
to 
to 
to 
to 
to 
to 
to 
to 
1840 
1845 
1848 
1848 
1840 
1845 
1848 
1848 
Ulcer 
Diseases of organs 
1 
1 
7 
2 
Totals 
5 
1 
6 
34 
4 
11 
XI. Of Age. 
Infantile 
91 
128 
131 
350 
622 
690 
546 
612 
Senile 
11 
7 
22 
40 
75 
38 
91 
70 
Totals 
102 
135 
153 
390 
697 
728 
637 
682 
XII. Of External Causes. 
Accidents 
17 
28 
52 
97 
116 
149 
217 
169 
Burns and scalds 
16 
9 
25 ! 
109 
49 
44 
Drowned 
36 
20 
11 
67 
246 
108 
46 
117 
Executed 
Frozen 
Heat 
2 
2 
4 
14 
8 
7 
Intemperance 
1 
5 
1 
7 
7 
27 
4 
12 
Lightning 
1 
1 
5 
2 
Malpractice 
Murdered 
Poisoned 
2 
5 
7 
14 
27 
12 
Suffocated 
4 
2 
6 
27 
11 
11 
Suicide 
9 
12 
4 
25 
61 
65 
17 
44 
Totals 
87 
82 
70 
239 
594 
441 
292 
418 
RECAPITULATION OF TABLE XXXI. 
Number of deaths in 
In each 10,000 deaths, there were in 
CLASSES OF DISEASE. 
1836 
1841 
1846 
1836 
1836 
1841 
1846 
1836 
to 
to 
to 
to 
to 
to 
to 
to 
1840 
1845 
1848 
1848 
1840 
1S45 
1848 
1848 
I. Zymotics 
555 
658 
1172 
2385 
3794 
3547 
4883 
4169 
Sporadics 
II. Of General Location 
62 
75 
95 
233 
424 
404 
396 
408 
III. Of Nervous System 
174 
250 
251 
675 
1190 
1346 
1046 
1180 
IV. Of Respirative System 
357 
496 
496 
1349 
2441 
2674 
2069 
2358 
V. Of Circulative System 
22 
30 
42 
94 
150 
162 
175 
165 
VI. Of Digestive System 
67 
84 
78 
229 
458 
457 
325 
401 
VII. Of Urinative System 
2 
8 
4 
14 
14 
43 
17 
24 
VIII. Of Generative System 
28 
32 
27 
87 
190 
172 
112 
152 
IX. Of Locomotive System 
2 
5 
11 
18 
14 
26 
46 
32 
X. Of Integumentive System 
5 
1 
6 
34 
4 
11 
XI. Of Age 
102 
135 
153 
390 
697 
728 
637 
682 
XII. Of External Causes 
87 
82 
70 
239 
594 
441 
292 
418 
Total of specified causes 
1463 
1855 
2400 
5718 
10,000 
10,000 
10,000 
10,000 
Not specified causes 
245 
141 
64 
450 
Still-born 
131 
138 
269 
Grand total 
1839 
2134 
2464 
6437 550 
TABLE XXXII. 
Illustrating the Influence of Sex on Longevity in Lowell, since the 
date of the City Charter, viz., from 1836 to 1848, inclusive. 
Years. 
Males. 
Females. 
Unknown. 
Total. 
Years. 
Males. 
Females. 
Unknown. 
Total. 
1836 
113 
140 
253 
1844 
163 
196 
3 
362 
1837 
140 
161 
301 
1845 
171 
192 
363 
1838 
203 
204 
407 
1846 
331 
359 
690 
1839 
157 
183 
340 
1847 
442 
507 
949 
1840 
186 
199 
22 
407 
1848 
398 
427 
825 
1841 
214 
209 
11 
434 
1842 
230 
239 
4 
473 
Total 
2902 
3225 
41 
6168 
1843 
154 
209 
1 
364 
TABLE XXIII. 
Illustrating the Influence of Season on Longevity in Lowell, since 
the date of the City Charter, viz., from 1836 to 1848, inclusive. 
* 
Number of deaths in 
In each 10,000 deaths, there were in 
1830 
1841 
1846 
1836 
ia36 
1841 
1846 
1836 
to 
to 
to 
to 
to 
to 
to 
to 
1840 
1845 
1848 
1848 
1840 
1845 
1848 
1848 
January 
_ 
- 
126 
138 
120 
384 
737 
691 
487 
638 
February 
- 
- 
126 
141 
150 
417 
737 
706 
609 
684 
March - 
- 
- 
144 
148 
152 
444 
843 
742 
617 
734 
April 
- 
. 
132 
145 
157 
434 
773 
726 
637 
712 
May 
- 
- 
122 
155 
143 
420 
714 
777 
580 
690 
June 
- 
- 
87 
133 
178 
398 
509 
666 
722 
632 
July 
- 
- 
121 
177 
263 
561 
708 
887 
1068 
888 
August - 
- 
- 
227 
289 
431 
947 
1329 
1448 
1749 
1509 
September 
- 
- 
190 
232 
341 
763 
1112 
1162 
1384 
1219 
October 
- 
- 
159 
158 
222 
539 
931 
792 
901 
875 
November 
- 
- 
125 
132 
168 
425 
732 
661 
682 
692 
December 
- 
- 
149 
148 
139 
436 
875 
742 
564 
727 
Total 
- 
- 
1708 
1996 
2464 
6168 
10,000 
10,000 
10,000 
10,000 
Mean 
- 
- 
142.33 
166.33 
205.33 
514.00 
833.33 
833.33 
833.33 
833.33 551 
TABLE XXXIV. 
Illustrating the Influence of Age on Longevity, in Lowell, since the 
date of the Qity Charter, viz., from 1836 to 1848, inclusive. 
Number of deaths in 
In each 10,000 deaths, there were in 
Years. 
1836 
1841 
1846 
1836 
1836 
1841 
1846 
1836 
to 
to 
to 
to 
to 
to 
to 
to 
1840 
1845 
1848 
1848 
1840 
1845 
1848 
1848 
Under 1 
368 
488 
458 
1314 
2153 
2448 
1859 
2153 
1 to 2 
261 
260 
311 
832 
1527 
1302 
1262 
1364 
2 to 5 
168 
216 
326 
710 
983 
1082 
1323 
1129 
Under 5 
797 
964 
1095 
2856 
4663 
4832 
4444 
4646 
5 to 10 
79 
92 
131 
302 
464 
461 
532 
486 
10 to 15 
52 
48 
54 
154 
305 
240 
219 
255 
15 to 20 
135 
137 
196 
468 
790 
686 
795 
757 
20 to 30 
253 
278 
417 
948 
1480 
1392 
1692 
1521 
30 to 40 
157 
199 
214 
570 
919 
997 
869 
928 
40 to 50 
95 
108 
134 
337 
556 
541 
544 
547 
50 to 60 
72 
76 
94 
242 
424 
380 
382 
395 
60 to 70 
33 
40 
73 
146 
193 
200 
296 
230 
70 to 80 
18 
32 
35 
85 
106 
160 
142 
136 
80 to 90 
8 
9 
20 
37 
47 
46 
81 
58 
90 to 100 
1 
1 
1 
3 
6 
5 
4 
5 
Unknown 
8 
12 
20 
47 
60 
36 
Totals 
1708 
1996 
2464 
6168 
10,000 
10,000 
10,000 
10,000 552 
TABLE XXXV. 
Shotving the Population of Lowell at different Periods. 
Under 10 
10 to 20 
20 to 30 
30 to 40 
40 to 50 
50 to 60 
Over 60 
Totals. 
1820 
Total 
about 200 
Coloured includ. 
1828 
Males 
Females 
1,342 
2,190 
Totals 
3,532 
1830 
Males 
Females 
495 
504 
405 
1,182 
958 
1,792 
358 
353 
111 
164 
37 
57 
21 
29 
2,392 
4,085 
7 
4 
Totals 
999 
1,587 
2,750 
711 
275 
94 
50 
6,477 
11 
1833 
Males 
Females 
905 
968 
813 
2,998 
1,638 
2,914 
792 
675 
202 
132 
64 
159 
23 
80 
4,437 
7,926 
Totals » 
1,873 
3,811 
4,552 
1,467 
334 
223 
103 
12,363 
33 
1836 
Males 
Females 
1,489 
1,520 
1,114 
2,990 
2,200 
4,689 
966 
1,296 
372 
475 
144 
222 
60 
96 
6,345 
11,288 
22 
22 
Totals 
3,009 
4,104 
6,889 
2,262 
847 
366 
156 
17,633 
44 
1840 
Males 
Females 
1,865 
1,865 
1,369 
3,464 
2,143 
5,568 
1,128 
1,605 
520 
650 
224 
318 
92 
170 
7,341 
13,640 
Totals 
3,730 
4,833 
7,711 
2,733 
1,170 
542 
262 
20,981 
58 
1844 
Males 
Females 
2,441 
2,391 
1,621 
3,642 
2,565 
5,945 
1,559 
2,098 
773 
946 
320 
431 
153 
244 
9,432 
15,697 
17 
27 
Totals 
4,832 
5,263 
8,510 
3,657 
1,719 
751 
397 
25,129 
44 
Penobscot Indians 
34 
Total 
25,163 
1846 
Total 
29,127 553 
TABLE XXXVI. 
Showing the Temperature of the Air in Boston, as indicated by the 
Thermometer. 
1846. 
1847. 
1843. 
Mean. 
Max. 
Min. 
Mean. 
Max. 
Min. 
Mean. 
Max. 
Min. 
January 
30*02 
49° 
1* | 
29*33 
54° 
5° 
31*85 
59* 
5° 
I1 ebruary 
24.68 
47 
2 
29.07 
49 
5 
28.21 
46 
1 
March 
39.17 
61 
9 
32.70 
51 
17 
34.70 
66 
8 
April 
50.25 
83 
31 
44.11 
83 
17 
46.79 
74 
30 
May 
56.17 
79 
43 
53.45 
81 
37 
58.47 
88 
June 
64.92 
88 
54 
56.43 
92 
49 
65.90 
91 
43 
| July 
71.61 
96 
57 
72.57 
96 
54 
70.04 
93 
54 
August 
71.26 
93 
55 
68.81 
92 
54 
69.72 
92 
50 
September 
67.12 
96 
47 
61.40 
85 
45 
60.02 
82 
36 
October 
50.45 
80 
26 
49.70 
73 
22 
50.77 
71 
34 
November 
44.19 
64 
21 
44.78 
67 
8 
37.92 
56 
15 
December 
29.66 
68 
11 
36.96 
65 
4 
36.70 
58 
9 
TABLE XXXVII. 
Showing the Temperature of the Air in Lowell, as indicated by the 
Thermometer. 
1846. 
1847. 
1848. 
Mean. 
Max. 
Min. 
Mean. 
Max. 
Min. 
I Mean. 
Max. 
Min. 
Morn. 
2PM 
Morn. 
2 P.M. 
iMorn. 
2 P.M. 
January 
19°83 
32°94 
48° 
—4° 
19°00 
31°39 
46° 
— 1° 
!19°50 
33°31 
58° 
—10° 
February 
10.40 
30.08 
42 
—10 
19.04 
32.71 
50 
—2 
17.16 
34.24 
46 
— 2 
March 
26.76 
45.94 
63 
1 
22.27 
41.11 
52 
8 
33.81 
39.67 
66 
2 
April 
37.25 
61.09 
83 
23 
32.20 
52.92 
90 
10 
36.00 
55.67 
76 
24 
May 
48.07 
66.42 
83 
32 
45.00 
64.58 
85 
32 
51.15 
68.93 
92 
33 
June 
57.80 
79.96 
96 
43 
56.58 
77.28 
100 
48 
57.00 
74.96 
95 
41 
July 
62.68 
83.73 
101 
50 
62.81 
85.77 
99 
50 
62.37 
81.65 
94 
50 
August 
61.50 
83.80 
98 
49 
58.96 
80.24 
91 
50 
60.92 
82.44 
93 
49 
September 
57.19 
77.77 
99 
40 
54.34 
68.69 
89 
40 
50.26 
69.27 
84 
32 
October 
41.22 
57.85 
83 
23 
38.73 
56.35 
72 
19 
41.00 
56.19 
72 
28 
November 
38.16 
47.91 
59 
26 
37.08 
49.88 
70 
5 
27.32 
42.23 
54 
12 
December 
21.77 
32.11 
46 
7 
29.74 
' 
40.15 
64 
—3 
28.67 
36.81 
60 
0 
No available systematic barometric observations have ever been 
made in Lowell. 
YOL. II.—36 554 
TABLE XXXVIII. 
Showing the Temperature of the Water, and the Amount of Water 
which fell in the forms of Rain and Snow in Lowell. 
1846. 
1847. 
1848. 
Inch’s 
Inch’s 
Inch’s 
Mean. 
Max. 
Min. 
water 
Mean. 
Max. 
Min. 
water 
Mean. 
Max. 
Min. 
water 
fell. 
fell. 
fell. 
January 
32° 
32° 
32° 
2.44 
32° 
32° 
32° 
5.42 
32° 
32° 
32° 
2.83 
February 
32 
32 
32 
1.82 
32 
32 
32 
3.14 
32 
32 
32 
2.10 
March 
33.22 
42 
32 
3.27 
32 
32 
32 
3.46 
33.41 
40 
32 
3.54 
April 
49.54 
58 
41 
1.31 
39.34 
46 
32 
2.26 
48.29 
54 
41 
1.60 
May 
60.23 
65 
56 
4.21 
54.73 
63 
44 
2.15 
58.63 
67 
51 
7.41 
June 
69.92 
76 
60 
2.40 
65.48 
75 
60 
6.75 
66.69 
74 
59 
4.01 
July 
76.27 
81 
72 
3.56 
78.81 
82 
73 
3.01 
74.12 
79 
69 
2.16 
August 
77.54 
81 
71 
2.79 
74.77 
78 
73 
3.81 
74.41 
80 
68 
3.15 
September 
72.61 
82 
64 
.64 
66.44 
76 
59 
4.85 
64.58 
74 
55 
4.06 
October 
55.00 
64 
45 
1.61 
52.15 
58 
42 
3.01 
51.11 
57 
46 
5.00 
November 
43.50 
47 
34 
2.70 
43.88 
48 
36 
3.70 
38.76 
48 
34 
2.68 
December 
32.15 
33 
32 
1.25 
35.92 
44 
32 
4.70 
35.12 
37 
32 
3.75 
Total 
28.03 
46.26 
42.29 
i H.—7. 
Sanitary Report of Baltimore. By James Wynne, M.D. 
Baltimore is a compactly built commercial town, lying on the 
north bank of the Patapsco river; a short, but bold and wide stream, 
nine miles above its entrance into Chesapeake Bay, and two hundred 
miles inland from the Atlantic Ocean. It is partially divided by an 
inlet, which extends into the town about one and a half miles. On 
the north side of this inlet, that portion of the city devoted to com- 
merce and shipping is mainly built; but the populous part of the 
city is gradually extending around the basin at the head of the inlet 
to its southern bank, which is the eastern termination of the Balti- 
more and Ohio Railroad, a work intended to connect the Atlantic 
coast with the great valley of the Mississippi, as well as the outlet 
for the coal trade of the Alleghany coal basin. From this inlet, 
which forms a characteristic feature in the scenery of Baltimore, the 
surface rises toward the north and west into a range of gentle ele- 
vations, which extend beyond the town into a series of beautiful and 
highly picturesque heights, and finally terminate in an undulating 
country of great salubrity dotted by the country-seats, occupied by 
the more opulent inhabitants of the city as their summer residences. 
Baltimore is nominally divided into four districts, materially dif- 
fering from each other in general character and population. 1st. 
The Point, so called because the inlet here diverges from the main 
stream, is the most easterly portion of the city, and commands the 
greatest depth of water. The greater part of the ship-building and 
manufactures are carried on here. In addition to the population 
engaged in these avocations, it is the favourite resort for seamen and 
newly arrived emigrants, especially the German. 2d. Old Town 
lies between the Point and the city proper, and is principally occu- 
pied by mechanics and labourers. 8d. The City, so styled, which 
extends over the undulating surface already described, is the centre 
of trade, and the residence of the more opulent classes. 4th. The 
Spring Carden District reaches from the head of the inlet to the 
Patapsco River, including the south side of the basin. It is occu- 
pied by mechanics, labourers, and a coloured population. Both the 556 
Point and Old Town have a gentle inclination towards the wTater, 
but without a rapid descent. The city, howTever, which is divided 
from Old Towm by a rapid stream, possesses a very undulating 
surface, and may truly be said to have been built “ over hill and 
dale.” The Spring Garden District, on the contrary, is level and 
low, as indeed is the whole bank of the river at that point, and is 
liable, in common with the opposite bank, to remittent and inter- 
mittent diseases. From the clay of this district bricks are manu- 
factured, of unsurpassed excellence, in vast quantities, not only for 
the use of the city, but for exportation, wdiich, by the exposure of a 
newly denuded surface, and the collection of pools of water, serves 
greatly to increase the tendency to febrile diseases. 
G-eological Formation.—The soil on which Baltimore is located 
consists of clay and sand-hills, covered in many places with a thick 
coat of gravel. These hills have a north-east and south-west direc- 
tion, and the adjacent country is marked by short spurs to the south- 
east with rounded summits, between which its drainage is effected. 
The soil, with an admixture of lime and plaster, is made quite pro- 
ductive. That consisting of coarse granitic aggregates is ranked as 
best. It lies upon the upper limits of the great Atlantic arenaceous 
and argillaceous deposits, resting upon the chain of primary rocks. 
Drainage.—From what has already been said, it will be seen 
that the town, with the exception of the Spring Garden suburb, is 
admirably adapted, by nature, for surface drainage. Its peculiar 
facilities consist not only in the undulating nature of its surface, but 
likewise in the sand and gravel beds which lie beneath, and admit 
a free percolation of fluid particles. It is traversed by several 
valleys, coursing in a south-east direction toward the inlet. The 
outlet for the north-western portion of the city is through Liberty 
and Hanover streets; but the most extensive valley is that which 
bounds the City and Old Town, in whose bed flows a rapid, turbulent, 
and highly useful stream, called “Jones’ Falls,” which fulfils the 
purpose of an open sewer to a considerable part of both these sec- 
tions of the town. Harford Run, a more sluggish stream, flows in a 
similar direction, and empties itself into the river between the Point 
and Old Town. 
The drainage of the town is under the control of the city com- 
missioners, who are not at liberty, however, to project new works 
without the direction and assent of the common council. There 
being no public survey of levels, the grades are far from regular. 
The principal inconvenience arising from this source at present, is 557 
not the inability of the surface drains to carry off the water, but 
the unnecessary, and frequently injurious accumulations of it in 
certain localities during violent showers. It is the opinion of those 
best informed on this subject, that a general survey of levels would 
not have attained the object more effectively, but more conveniently 
than at present. The grades of the streets are extremely variable, the 
lowest being one inch, and the highest fourteen inches, in ten feet. 
All the streets are paved, and supplied with gutters on either side, at 
the cost of the property holders. As the improvements advance, they 
are anticipated by grading and paving the streets, with an especial 
eye to surface drainage; and as in a greater part of the town this 
is the only mode of draining, an inability to perform that office 
would be looked upon as a nuisance, and redressed. The grades 
are regulated by the city surveyor, and it is presumed no new streets 
are laid out, wThere every advantage the nature of the surface will 
admit of, is not taken to effect this object. 
The arrangements for under-ground drainage are very meagre, the 
aggregate of all the sewers not exceeding two miles in length. They 
are usually constructed near the streams in which the outlet for sur- 
face drainage is sought, to overcome some slight rise of surface; and 
as the distance is short, and the flow of water usually abundant, a 
very defective structure is frequently found to answer the purpose. 
The sewers usually have an arched roof of mason work, but a flat 
bottom, frequently made of timber instead of masonry. It is mani- 
fest that a sewer thus defective could not be made efficient, except 
under the most favourable circumstances, and their success is rather 
an argument in support of the favourable position of the town for 
drainage than an evidence of their excellence. It is a singular fact 
that the most defectively drained district skirts along Jones’ Falls, 
where the facilities for drainage are very great; and a stranger pass- 
ing from the clean and well-washed streets in the upper part of the 
city, into this district, loaded with filth, and giving off the most offen- 
sive exhalations, would hardly believe himself in a district under the 
same municipal regulations. Harrison and Frederick streets, and 
the lower part of Saratoga, are examples of the correctness of this 
assertion. 
Floods.—Jones’ Falls has, on three different occasions, overflowed 
its hanks, inundating the first stories of the houses in its vicinity, 
and in two instances reaching to the second, doing great damage 
to life and property. It was supposed that the abutments of the 
numerous bridges which crossed it, by checking the floating matter- 
carried down by the mad current, and thus forming dams, increased 558 
the volume of the stream to such an extent as to cause its overflow. 
These abutments have since been removed, and the bridges now 
span the stream by a single lofty arch. No flood, fortunately, has 
since occurred to test the reliance to be placed on this measure. It 
appears, however, adequate to the end proposed. 
Street Cleansing and Nuisances.—The scavenging of the city is 
placed under the control of the Board of Health, a portion of whose 
duty it is to see that the streets are kept in a proper condition. 
At present, the town is divided into five districts, let out to separate 
contractors, each of whom is bound by a penalty to keep his district 
clean. The aggregate amount paid by the city for this duty is be- 
tween six and seven thousand dollars, and the street refuse, -which 
is looked upon as the most valuable part of the remuneration. There 
is no fixed time for cleansing the streets, and they receive attention 
in proportion to their tendency to accumulate filth, but never more 
than twice a week, more frequently once in two weeks. The narrow 
lanes, inhabited by the poor, although more liable to become filthy, 
receive less attention than the more public thoroughfares, and are 
always in a more dirty condition. It may be proper to remark that 
the refuse of the streets is not collected together by brooms, but is 
gathered into heaps by hoes, and carted away. The most effectual 
scavenger is a copious shower, which, from the rapid descent of the 
streets, sweeps away with it an incredible amount of street washings. 
These showers are very frequent during the summer months, and 
are always hailed by me as a great blessing, on account of the man- 
ner in which they purify the streets. There are no regular depots 
for the street manure, but each contractor deposits the manure from 
his district on such vacant lots as he can obtain in the outskirts of 
the town, until disposed of to the surrounding country people, or 
carried away in boats. 
The courts are under the jurisdiction of the police, who require 
the owners to keep them clean; but as there is no regular system 
adopted, they frequently become not only offensive, but foci of dis- 
ease. They may be reported to the Board of Health as nuisances, 
when in this condition; but when it is considered hoAV unwholesome 
an atmosphere the inhabitants of a populous town will bring them- 
selves to tolerate, it is not a matter of surprise that they frequently 
freight the air with unhealthy emanations for months together before 
becoming a source of complaint. I remember being called to visit 
a poor female, under the charge of a midwife, in an extremely diffi- 
cult case of labour, in a narrow court, very near to my own resi- 
dence, and immediately behind the residences of several of the most 559 
fashionable families of the city. The only ingress for air into the 
court, which was surrounded by the high houses on the outer side 
of the square, was by means of a narrow entrance, immediately ad- 
joining which was a large piggery, constantly emitting the most 
offensive exhalations. The air of the whole court was close and 
oppressive, and although I had the good fortune to leave my patient 
safely delivered, I predicted in my own mind the death of her in- 
fant, from the want of wholesome atmosphere, which event was 
realized a few weeks after. I had occasion to observe, that out of 
a population of about fifty persons inhabiting this court, several 
deaths took place within a few weeks. The most surprising feature 
of this case is, that the wealthy inhabitants, surrounding the square, 
should be so little conversant with the actual condition in which they 
lived as to be content to inhale the noxious emanations from this 
confined court. 
My decided conviction is, that the superficial street cleansing to 
which the city is now subjected, does not reach the evil it aims to 
overthrow; and that nothing short of a careful sweeping of every 
part each day, including the narrow courts and alleys where it is 
most needed, will accomplish this object. 
Public Nuisances.—An important nuisance is found in the refuse 
animal and vegetable matter, deposited by the inhabitants of the 
small courts and alleys in them during the night. There is a city 
ordinance against thus disposing of the refuse of the kitchen ; but 
those who pass through the lanes of the town have abundant testi- 
mony to prove its disregard. This refuse, when not eaten by the 
swine, which are fortunately permitted to perambulate them at their 
pleasure, remain subject to the influences of decomposition until the 
streets are again cleansed; and as these lanes are never entered by 
the scavengers more than once a week, it is not unusual for de- 
composing matter to remain in them for several days—sufficiently 
long to generate all its noxious properties, and vitiate the atmo- 
sphere of the whole neighbourhood in which it is situated. The 
remedy for the removal of this important nuisance is sufficiently 
obvious, and consists : 1st. In sending carts into every part of the 
city once each day, to collect the refuse brought to them from the 
houses; and 2d. In submitting the streets to a thorough sweeping 
once every day. 
Each house, however humble, is provided with a privy supplied 
with a pit, enclosed with a brick wall in hydraulic cement. These 
pits are cleansed whenever they require it by the night-men, who dis- 
pose of their contents for manure. In the better class of houses 560 
the patent water-closets are in very general use. In these, the 
excrementitious matter is carried by a jet of water through a soil-pipe, 
but finally finds its way into the pit, and yet remains undisposed of. 
I have recommended to several architects to carry these soil-pipes 
beneath the ground for some distance until they meet a bed of 
gravel, freely traversed by a subterranean stream of water, which 
can always be found beneath the city, and thus permit it to be dif- 
fused. The practicability is admitted, but, owing to the additional 
expenditure, it has never been carried into operation.* 
Slaughter-Houses.—No new slaughter-house is allowed within the 
limits of the city, and those already erected are usually associated 
with each other. I am strongly of the opinion that the city should 
possess one slaughter-house under its immediate supervision, situated 
some distance from the populous parts of the town, and subjected to 
a rigid surveillance, where everything exposed for sale by the butch- 
ers in the market should be killed. The offensive matters might, 
by this means, be judiciously disposed of, and, at the same time, a 
scrutiny exercised to ascertain that no animal was killed, whose 
meat was not in a proper condition to be eaten. 
Manufactures.—The smoke and offensive fumes from different 
manufactories in various parts of the town, may likewise be in- 
cluded among the nuisances. Of these, the glue and poudrette 
manufactories stand foremost. In addition to these, soap establish- 
ments, and gas, chemical, and white-lead works, are prominent. 
Burial-Grounds.—There are numerous burial-grounds within the 
populous part of the city; but the number of recent interments in 
them is comparatively trivial. Green Mount Cemetery, situated 
about two miles from the centre of the town, and comprising a space 
of upwards of one hundred and fifty acres, rendered extremely pic- 
turesque by nature, and highly improved by art, is now the great 
receptacle for the dead of the better classes, and Potter’s Field for 
those in a more humble condition. It is difficult to induce the in- 
habitants of an increasing town to look very far beyond their pre- 
sent wants, and distant as Green Mount Cemetery now appears to he 
from the populous part of the town, it is easy to foresee that not 
many years will elapse before it will be surrounded by a dense popu- 
lation. 
* Since writing the above, I have seen several successful attempts made to carry off 
the soil in the manner indicated. Water has usually been reached at a depth of about 
twenty feet. 561 
Want of Sewers.—The absence of a complete system of under- 
ground seAverage, constitutes an important nuisance operating in 
all parts of the town, but most severely in the low, level, and 
uncleanly portions occupied by the poor. The appropriations for 
the present year for building sewers, have been more extensive than 
any previous one, and should a registration-bill pass the council, 
pointing out which are the unhealthy parts of the city, I make no 
doubt but that this much neglected subject would receive the atten- 
tion it merits. Harford Bun, which receives an immense amount of 
animal and vegetable deposit, and which has too sluggish a stream 
to carry it into the river, is a fruitful source of fever. An ordinance 
for tunneling this stream passed the city council at its last session. 
Water.—Baltimore is supplied with water in part by an incor- 
porated company, called the Baltimore Water Company, and in part 
by pumps and public fountains. The pumps and public springs are 
under the control of the city commissioners, who erect a new pump 
at the expense of the property holders, whenever eight of them re- 
siding in the vicinity of the proposed pump join in a petition for 
that purpose. There are several public fountains enclosed in small 
public squares, and tastefully ornamented in various sections of the 
town, supplied by springs. The pump water is offensive to the 
taste, and extremely hard, with a few exceptions. It is, therefore, 
seldom made use of by those who can supply themselves with the 
water company’s water. 
This company was chartered in 1808, and obtains its supply of 
water from Jones’ Falls, some distance above the town. This stream 
derives its origin from innumerable springs, taking their rise in the 
elevated slate region, north of the town, and passes with a very 
rapid descent over a rocky bed through an exceedingly romantic 
limestone valley. This water, which is pure and soft, is not only 
agreeable to the taste, but is well adapted to all household purposes. 
As an evidence of its purity, the dyers find no difficulty in fixing 
the most delicate colours with it. 
The company have two reservoirs. One, fed by the flow of the 
stream ; and the other, by pumps. The lower reservoir, or that fed 
by the flow of the stream, was built in 1846, and is capable of hold- 
ing fifteen millions of gallons. This reservoir is intended to supply 
the lower portion of the city on all occasions; and, at the same 
time, when the necessity occurs, to give a portion of its contents 
to the upper reservoir. The upper reservoir was built in 1888, and 
holds three millions of gallons. The water is raised into this reser- 
voir ninety-five feet, by means of two pumps, of twelve and three- 562 
fourth inches bore, and six feet stroke, and worked by one water- 
wheel of sixteen feet diameter. It requires the waste of eleven gal- 
lons of water to raise one into the reservoir; and, in order to pro- 
vide against a scarcity, an engine is at hand to work the pumps. 
The mains are laid down in about one-half of the populated portion 
of the city, and are being extended daily to such sections as will pay 
an interest on the expenditure. The mains at the reservoir are 
eighteen inches in diameter, and decrease as they recede to sixteen, 
twelve, ten, eight, six, four, and three inches. These mains were form- 
erly of wood, hut since 1820 they have been made exclusively of iron. 
The service-pipes are exclusively of lead, which metal has been 
in use by the company since 1820. About five thousand houses 
are supplied with hydrants, and the use of the water is unlimited. 
The daily consumption in summer varies from five hundred thousand 
to one million gallons, but is considerably diminished in winter. 
For the prevention of fires, there are one hundred and fifty fire 
plugs, and a full head of water is kept on in all the mains, so that 
it can be obtained as soon as the hose is attached. The city pro- 
vides no free hydrants for the poor. 
The company conceives its ability undoubted to supply an entire 
city, twice as large as Baltimore, with an unlimited quantity of 
water. Should, however, its resources, in time to come, not be 
equal to the wants of the population, the city has, in its vicinity— 
Gwynn’s Falls—a stream whose capacity in the dry season would 
enable it to furnish upwards of ten millions of gallons in twenty- 
four hours, flowing from the same region, and possessed of the same 
qualities, which can be diverted into a reservoir by the natural flow 
of the stream on the heights overlooking the town, at an elevation of 
135 feet above tide water, at an estimated expense of not more than 
half a million of dollars.* 
It may be proper, in looking to the prospective demand for an 
additional supply of water for the city, to mention that very exten- 
sive and accurate surveys were conducted by John Randel, Jr., 
Esq., of all the eligible streams in the neighbourhood of the town 
in 1835, under the direction, and at the cost of the city government. 
In Mr. Handel’s report, laid before the councils, April 21st, 
1836, he gives a decided preference to the Great Gunpowder Falls, 
which, according to an accurate gauge made by him in the driest 
season, is capable of yielding sixty-four millions, ninety-three thous- 
and and ninety-one wine gallons of water every twenty-four hours. 
* Report of the Water Committee to the City Council in 1829. The increased value 
of mill-seats on this stream in twenty years would probably now double the estimate of 
the committee. 563 
Across this stream, which was to be directed into the city, from a 
distance of twelve or thirteen miles, “A dam is to be built,” says 
this report, “near Tyson’s (formerly Jessup’s) mills, and another 
dam across the western run, near the York turnpike. These dams 
are to be connected by an aqueduct, and this aqueduct is to be con- 
tinued across the valley of the Beaver dam, to the high ground or 
hill of limestone rock, lying between a branch of Jones’ Falls south 
of Timonium, and a branch of Beaver Dam, near Cockey’s. This 
hill or rock is to be cut down to such a depth, as will permit the 
water to be carried by an aqueduct from a point from ten to twenty 
feet below the level of the top of this dam, on a descent of about 
one foot per mile to and through that deep cut, and thence along the 
west slope of Jones’ Falls Creek to an ample reservoir, to be pro- 
vided in the vicinity of the city of Baltimore.” This reservoir 
would have been three hundred feet above tide water. Although 
this work would have exceeded that of Gwynn’s Falls in cost, by 
at least half a million of dollars, it is probable that it might have 
been constructed, but unfortunately a difference ensued between Mr. 
Randel and the city government, which resulted in his withdrawing 
his surveys, and their abandonment of the project. 
The following prices are demanded by the company for the use 
of its water:— 
“ Charges for Hydrant Water.—Private family, $10 per annum, 
payable half yearly in advance; private family, in houses less 
than seventeen feet front, $8; boarding-houses, $10 to $50, do.; 
steam engines, $10 per horse power, do.; baths, $3 per annum, pay- 
able in advance; horses, $1 50 do.; carriages, $2 do.; water-closets, 
$3 do. Hotels, factories, and others, as per agreement with the 
company. 
“All persons using the hydrant water for any of the above pur- 
poses, without the knowledge of the company, or permitting their 
neighbours to use the water, without a written permit from the com- 
pany, will be charged double the above rates, and the water discon- 
tinued. No person will be permitted to introduce the hydrant 
water for any of the above uses without a written permit from the 
company; in case of discovery, the water will be stopped, and the 
connection cut off.” 
Lead Pipes.—The subject of lead pipes has lately attracted 
much attention in Boston, where the matter was fully investigated 
previous to their adoption, in distributing the Cochituate water, re- 
cently introduced into that city. The result of the investigations, 
conducted under the superintendence of Professor Ilosford, has re- 564 
cently been published in the Report of the Water Commissioners, 
and sets the question, in my opinion, finally at rest. From this 
report, it appears that no evidence of disease from lead has yet been 
detected in the cities of London and Paris from the use of the hy- 
drant water, although that material is in universal use in both of 
these cities as service pipes. 
Professor Hare, of Philadelphia, Professor McNaughton, of Al- 
bany, and Dr. Brinsmade of Troy, New York, all bear testimony to 
the same fact, although the lead for service pipes has long been used 
in each of these towns. Professor Hubbard, of Dartmouth College, 
states that the village has been supplied for twenty-six years with 
water conveyed two miles in lead pipes, and that he has never heard 
of a case of lead poisoning from its use. 
Dr. Dana, in an appendix to his translation of the work of M. 
Tanquerel, on lead diseases, recently published, has furnished a very 
strong argument against the use of lead pipe, which, in the absence 
of the positive testimony furnished by the Boston Water Commis- 
sioner’s Report might go far towards banishing it from use. In his 
remarks on the specimens of Baltimore and James River pipes, ex- 
amined by him, he says that he observed slight cribriform erosion, 
and adds : “ But this is evidence that so slight an action could not 
have been sufficient to produce erosion in a few days. It may be 
inferred to have gone on for years.” Since the appearance of Dr. 
Dana’s work, I have examined numerous specimens of lead pipe, 
which had been long in use in Baltimore, some, upwards of twenty- 
five years ; and, although I have anxiously sought for some evidence 
of the slight erosion mentioned in Dr. Dana’s Avork, I have not, in 
any instance, been able to detect it. I therefore, conclude that 
the erosion, in the specimen examined by him, was due rather to 
some original defect in the texture of the metal, than in the action 
of the water upon it. The interior of the pipe was always found 
thickly coated with an earthy deposit, which adhered with such 
tenacity as to require considerable force, and much washing to re- 
move it; and, in my judgment, formed a considerable protection to the 
water against the action of the lead, admitting its capacity to unite 
with the water, which did not appear, from any evidence furnished 
by the pipe itself. 
I have met with several cases of disease from lead among work- 
men engaged in its manufacture since my residence here; but have 
never observed any lead disease which might be attributable to the 
use of the hydrant water. Within a few weeks, the pipe of the 
hydrant attached to my own residence was removed, and its place 
supplied by a new one at least sixty feet in length, and although 565 
the water was used soon after, I could not learn that any member of 
my family experienced the slightest injury from it. 
Fires.—From the report of the joint committee of the Common 
Council, it appears that the organization of the fire department is 
purely volunteer, that there are seventeen fire companies, embracing 
in all about four hundred members. No compensation is allowed 
them for this service; nor exemption from the duties incumbent on 
all citizens. The city, however, appropriates a small sum annually 
to enable each of the fire companies to keep its apparatus in order. 
The number of fires which have occurred for a few years past are 
as follows:— 
Alarms. 
False. 
Chimneys. 
Fires. 
In 1841 - 
- - 258 
84 
36 
138 
“ 1842 - 
- - 297 
86 
51 
160 
“ 1843 - 
- - 302 
82 
66 
154 
“ 1844 - 
- - 232 
84 
22 
126 
“ 1846* - 
- - 238 
76 
33 
129 
“ 1847 - 
- - 385 
76 
51 
258 
“ 1848 - 
- - 410 
146 
41 
223 
Building and Ventilation.—The municipal authorities are vested 
with power to regulate the erection of new buildings, which must 
conform, in materials at least, to the existing city ordinances. The 
object of these ordinances being to protect from fire, and to pre- 
vent the closure of open thoroughfares, they do not attempt to in- 
terfere with the peculiar tastes of the landlords who erect them. 
The houses occupied by the labouring classes usually have a front 
of sixteen, and a depth of thirty feet, are two or three stories in 
height, and invariably built of brick. Behind the main build- 
ing, in most instances, is a back building of the same height, and a 
yard with a privy and hydrant. These houses are for the most 
part occupied by one family; but they are sometimes under-let in 
rooms to poor persons. The system of a number of families occu- 
pying the same house, does not prevail to the same extent in Balti- 
more as in some other places, and is confined to the very poor. 
Whole streets, however, in the worst parts of the town, are occu- 
pied by a wretched population, crowded together in the most un- 
seemly and unhealthy manner. 
Stoves for warming are in almost universal use among the 
labouring population, and the one known by the name of “ ten 
plate stove” which answers for cooking as well as warming, appears 
* No report was kept in 1845. 566 
to be in greatest demand. The fuel consumed by the poor is princi- 
pally wood. As the winters are usually mild, and liberal provision is 
made for the gratuitous distribution of fuel to the poor during the 
cold season, the want of it is not severely felt. 
The streets are generally laid out in such a manner as to inter- 
sect each other at right angles, and are from thirty to seventy feet 
in width. There are numerous courts and alleys, however, built up 
within the squares less than fifteen feet in width, which are very im- 
perfectly ventilated. These narrow alleys, which are unfortunate- 
ly frequently densely populated with the most improvident and 
miserable inhabitants, are, in some instances, shut out effectu- 
ally from ventilation by the erection of a building across the outlet 
of the alley. There are certain portions of the town, built at an 
early day for other purposes, which do not answer to the description 
already given. As an example, in that part bounded by Light and 
South streets, and extending from the Pratt street basin several 
squares backwards upon a marshy soil, the streets are very narrow 
and irregular, and the dilapidated houses, inhabited by numerous 
families, are filthy and offensive in the highest degree. Fortunately, 
such localities are not numerous. But why allow them to exist at 
all ? The cupidity of landlords should never be able, in a well- 
regulated town, to furnish the means of generating pestilence and 
death; cellars are scarcely ever occupied as sleeping-rooms, and few 
families live in them altogether. 
Ventilation.—But little attention is paid to ventilation, either in 
private buildings or public edifices, although occasionally instances 
occur among the recently erected residences of the more wealthy, 
which are deservedly admired for their beauty, where all the re- 
quirements for complete ventilation are present. Every one is 
aware that constant breathing is necessary to sustain life ; but few re- 
flect that nearly thirty thousand respirations take place every twenty- 
four hours, requiring six hundred cubic feet of air. One of the most 
prolific sources of mortality in cities, is the vitiation of the atmo- 
sphere by crowding large masses of human beings together. Sir 
James Clark observes, that “ If an infant, born in perfect health, 
and of the healthiest parents, be kept in close rooms in which 
free ventilation and cleanliness are neglected, a few months will 
often suffice to induce tuberculous cachexia.” It is precisely in 
those places where destitution is greatest, and mortality highest, 
that defective ventilation prevails. In addition to exhalations from 
drains and decomposing refuse, which contaminate the air from 
without, the poor, in their economy of warmth, close up all the 567 
avenues in their power by which its ingress or egress is effected. 
In proportion, also, as the body becomes enfeebled by disease, is it 
rendered sensitive to currents of air; and hence those whose circum- 
stances enable them to command comforts, are fain to dispense with 
a sufficient supply of wholesome atmosphere to preserve the integrity 
of the system. With the view of furnishing a perfect change of 
atmosphere to sleeping apartments, I have invented a stove, which 
contains a chamber for heating air, brought from without, and pipes 
to diffuse it through the apartment. By means of this apparatus, 
which is exceedingly simple and economical, for introducing air, 
and a valve to allow the impure air to escape into the flue, at the 
upper part of the room, the apartment can be kept perfectly 
ventilated. To a consumptive patient, who requires a fixed tempe- 
rature, and, at the same time, a change of atmosphere, such an 
apparatus appears to me invaluable. 
Public Squares.—There are several public fountains in different 
parts of the town, within inclosures of three or four acres in extent; 
hut, with these exceptions, Baltimore is destitute of public squares, 
nor do the public authorities yet appear to appreciate the advan- 
tages incident to their establishment in a large and increasing town. 
Several holders of vacant lands within the city limits, with a view 
to enhance the value of their property, have offered public squares 
to the city. Two of these, Franklin and Union Squares have, after 
much difficulty on the part of the city authorities, been accepted. 
In order to demonstrate the little value in which public squares have 
always been held by the city government, I have but to mention that 
immediately after the completion of Washington’s Monument, which 
occupies a position in one of the most elevated and fashionable parts 
of the city, the proprietor of the adjacent lands, which were then 
vacant, offered the city a public reservation of one hundred acres 
surrounding the monument in all directions, to be beautified as a 
public park for a mere nominal sum, which it declined accepting, 
seeing no advantage that could possibly result from such an appro- 
priation of land within its limits; and this exquisite contribution to 
architecture, now rears its beautiful and lofty proportions amid a mass 
of houses instead of the waving elms and towering oaks that once 
adorned the summit which it crowns, and which would have fur- 
nished such an agreeable relief to the monument itself, and have 
been productive of such vast advantages to the morals and health of 
the inhabitants of the city. 
It is to be hoped that the day is not far distant when Baltimore 
will appreciate the immense advantages to be derived from public 568 
parks, and will make provision for their creation and maintenance, on 
a scale of magnificence commensurate to the wants of its inhabitants. 
The evil does not reside in the tastes of its population, especially 
its lower classes, who seek recreation of this sort with avidity when- 
ever it is offered to them. Green Mount Cemetery became so 
favourite a resort for the citizens of the town, that the proprietors 
felt themselves obliged (whether wisely or not, I do not pretend to 
say) to shut their gates against those who sought recreation from 
their confinement and labours, in the midst of its rich foliage and 
pleasant shady walks. 
Surely those whom Providence has consigned to wearisome labour, 
in wretched homes, over which disease and mortality hang like a 
pestilential vapour, have a right to some consideration at the hands 
of municipal authorities; and with the facts Avhich our tables of 
mortality present, that one-half of our population die before they 
have reached their fifth year ; and that within the last year, the num- 
ber of deaths to the living was as one to thirty-six, a mortality almost 
equal to the most unhealthy manufacturing districts in Europe; it 
would be idle to say that every necessary thing had been done to 
alleviate the wants of that helpless, but interesting portion of the 
community. If the fearful miseries entailed by excessive mortality 
were irreclaimable, it might be prudent to bow our heads to the 
storm wdiich is wasting its fury upon our poorer population ; but it 
is an indisputable fact, which recent inquiries have fully demon- 
strated, that these evils are susceptible of almost entire removal, by 
an expenditure of less money than their existence entails upon the 
community. The amount contributed to the improvement of general 
health, and public morals, however large it may be, is only so much 
taken from the fund which would otherwise be expended in the 
maintenance of pauperism. 
Public Baths and Laundries.—The subject of baths for the poor 
has not attracted attention in Baltimore, and there are no public 
establishments of this sort. That they would be of advantage here, 
as elsewhere, is very evident; indeed, an appendage to a fashionable 
house is invariably a bath-room; and I am extremely cautious in 
advising those families, whose professional adviser I am, wherever the 
means are at hand, to bathe frequently, as one of the most powerful 
promoters of health. If frequent ablutions are of such importance to 
those who are surrounded by the appliances of luxury, of how much 
greater value do they become, to those less favoured in their con- 
dition ? The labourer or poor mechanic is unable to pay a large sum 
for a bath, and yet would gladly avail himself of one for himself 569 
and family, if brought within his reach. The beneficial result of 
ablutions is strikingly manifested in the practice of lead establish- 
ments, where the proprietors require their workmen to wash their 
hands and face carefully before leaving the workshop. By this sim- 
ple precaution, they are enabled to make an unhealthy occupation 
comparatively healthy. That uncleanliness and mental degradation 
are intimately associated with each other, is now generally admitted ; 
hence, in proportion as the body is kept cleanly, are the moral 
faculties elevated, and the tendency to commit crime diminished. 
Public Schools.—The public schools are placed under the super- 
vision of a board of school commissioners. The number of schools 
in operation, during the year 1848, appears, by the report of the 
commissioners, to have been twenty-five, of which eleven were male, 
and fourteen female schools. One of the male and two of the female 
are devoted to the higher branches of public instruction, and are 
termed high schools; the remainder are appropriated to the instruc- 
tion of the elements, and are termed primary schools. The build- 
ings occupied as public schools usually consist of a main story, and 
a basement beneath, either on a level with the ground, or more or 
less sunk beneath the surface. Both of these stories are occupied 
as school-rooms. The number of scholars in attendance last year 
was six thousand six hundred and ninety-nine, being about two 
hundred and sixty pupils to each school. The rooms occupied by 
these two hundred and sixty pupils, are about forty-five feet long, 
thirty-five feet wide, and from twelve to fifteen feet in height. They 
are, with the single exception of the male high school, defective in ven- 
tilation, and are universally heated by stoves. In some of the schools, 
no attempt, whatever, has been paid to improve their ventilation; 
in others, an effort has been made to remedy the evil by a few holes 
perforated in the ceiling ; but in no instance that I am aware of, has 
a building been provided with properly constructed flues for the 
escape of the foul air, and the introduction of pure atmosphere in 
its stead. The consequence is, that the air, in a very short time, 
becomes insupportable, and the teachers are obliged to lower the 
upper sashes of several of the windows, in order to procure a partial 
relief. It is obvious to any one at all acquainted with the principles 
of ventilation, that, whilst the currents of cold air, from the win- 
dows, expose those near them to disease, they signally fail to effect 
a change in the atmosphere of the apartment. It may be proper 
here to remark, that whenever a large quantity of cold air is intro- 
YOL. II.—37 570 
duced into an apartment bearing an elevated temperature, by means 
of a window, its tendency is to assume a local movement, which 
prevents its extensive diffusion, unless broken by some mechanical 
obstruction, which it is the great object of ventilation to promote. 
I have paid repeated visits to a number of the public schools, and 
invariably found them loaded with an atmosphere so unpleasant as 
not only to be sensible to myself, but painfully manifest to the 
teachers, who universally complained of headache, after two or three 
hours’ confinement. Now, when it is taken into view that an atmo- 
sphere, fresh at the commencement, and deteriorated slowly, may 
not be sensible to the persons confined in it, and that, therefore, the 
unwholesomeness manifest to the senses of a person newly entered, 
may not be perceptible to the teacher, it will readily be admitted, 
that the amount of impurity complained of was neither light nor 
trifling. From the number of persons crowded together in one 
apartment, the age of the pupils, and the length of time spent in 
them, there are no places more liable to a vitiated atmosphere than 
public schools; and for the reasons just mentioned, there are no 
places where greater care should be taken to prevent the operations 
of a cause, which impedes the functions of respiration, relaxes the 
body, and enervates the mind, so as to render the slightest exertion, 
either corporeal or mental, tiresome and irksome in the highest 
degree. 
In addition to the schools under the care of the commissioners, 
the Brothers of the Christian Schools, the Brotherhood of St. 
Patrick, and McKim’s free school, give schooling to about two thou- 
sand pupils. The remarks applicable to the public schools will 
generally apply to them. 
Vital Statistics.—In presenting the accompanying tabular state- 
ments, I have to remark that the hills of mortality are issued by the 
Board of Health, and are made upon a weekly inspection of the regis- 
ters kept by the sextons of the different graveyards. These registers, 
which contain all the information at the disposal of the Board of 
Health, are made of such information as the sextons can most readily 
command, and are, therefore, far from being reliable sources, so far 
as the particular diseases are concerned. The number of inter- 
ments is probably accurately stated, and an approximation to age 
obtained; but beyond this, very much uncertainty prevails. 
Table B presents the actual mortality which has taken place in 
each of the last thirteen years, and exhibits a fluctuation from the 571 
exceedingly favourable standard of less than one in fifty (1840), to 
an extremely unfavourable one of one in nearly every thirty-six in- 
habitants (1848). The table, showing the causes of deaths, exhibits 
the greatest fluctuation in these years in scarlet fever; the number 
in 1840 being only 71; and in 1848, 407. An examination of the 
table, exhibiting the ages at which deaths have taken place, would 
appear to confirm the correctness of the table of diseases, by show- 
ing that the infantile period on which scarlet fever makes its heaviest 
demands, was really freer from mortality in 1840 than in the years 
preceding or succeeding it. It would be unsafe, however, to reason 
upon causes of disease, which were not attested by the medical men 
in attendance; but even were I to assume the correctness of the 
causes of death as manifested in table D, there would still be want- 
ing very important elements, in order to make this information prac- 
tically useful. 
From my own observation, independent of the bills of mortality, 
I am enabled to state, that during the latter part of the year 
1847, and the first part of 1848, scarlet fever was not only more 
prevalent in Baltimore than for a number of years previous, but 
was marked by a great fatality. Epidemic scarlatina commenced 
about August 1847, and subsided about May 1848 ; after that period 
the number of cases not only diminished very rapidly, but those 
wdiich did occur, for the most part, yielded easily to medical treat- 
ment. In July and August of 1848, cholera infantum, a disease 
much more dependent upon a vitiation of the atmosphere than is 
generally supposed, and which is always a terrible disease in our 
large cities, especially among the poor, appeared to me to be more 
than usually fatal, and prevailed more extensively among the chil- 
dren of the better class of inhabitants, than I had hitherto ob- 
served it. 
These tables furnish evidence, however, that Baltimore, in com- 
mon with the other large cities of the United States, is subject to a 
much higher rate of mortality than the surrounding country. The 
reason for this increased mortality becomes, in this connection, a 
very important sanitary inquiry. That meagreness of diet occa- 
sionally induces unhealthiness and mortality in individual instances 
in our cities may be true; but I apprehend that, as a general rule, 
while the labouring classes in town perform less severe labour than 
those in the country, they are supplied with an equal, if not greater, 
amount of substantial food. One prominent and just cause assigned 
for this disparity, is the extreme vitiation of the air in cities from a 572 
great variety of causes. In the performance of the act of respira- 
tion, by man and the animals congregated for his use, an immense 
amount of impurity is constantly being given out to the atmosphere, 
in addition to which, the products of the innumerable fires and gas- 
eous effluvia from manufactories, seem still further to increase this 
evil; besides which, even where cleanliness is not entirely overlooked, 
a large amount of decaying vegetable and animal matter must ne- 
cessarily be present, loading the air with its noxious gases, so pre- 
judicial to health. Where, by a dense accumulation of improvident 
persons, such as occurs in the most humble quarters of a populous 
town, these evils are increased by uncleanliness, and an almost entire 
want of ventilation, typhoid fever and other diseases are rapidly 
generated; which not only scourge the quarters in which they 
emanate, but frequently extend with alarming rapidity from these 
wretched purlieus of misery to the more wholesome and better ven- 
tilated portions of the town. The system of sewerage, for the pur- 
pose of removing the refuse of the houses, is unknown in Baltimore. 
Carts are not sent around for this purpose, and the streets from 
necessity become the depositaries for much of the offensive matter 
from the kitchens. The consequence is, that in many of the nar- 
row courts and alleys, rarely visited by the scavengers, the atmo- 
sphere is constantly surcharged with the most unpleasant, and not 
unfrequently noxious effluvia. 
Another important element in the production of disease, is a con- 
centration of population among the poor. This can never take 
place without proportionally increasing the rates of mortality, and 
it has invariably been found to hold good in those places where the 
bills of mortality are so kept as to elucidate this inquiry, that high 
mortality and over-crowded population go hand in hand. Our bills 
of mortality furnish no means of designating the healthy from the 
unhealthy parts of the town. But it is no matter of surprise, 
where buildings and courts, with defective ventilation, surrounded 
by the effluvia of decomposing matter without sewerage, and crowded 
by a population subjected to the evils of poverty, exist, that the air 
should be freighted with pestilence, and life wither prematurely away 
under these destfuctive influences. 573 
Population of Baltimore, showing the Sex, Age, and Colour of the 
Inhabitants, as exhibited by the United States Census of 1840. 
table a. 
Total 
Free blacks. Males 
Slaves. Males 
Total 
sr 
0> 
3 £- 
§5 
CLASS OF 
POPULATION. 
2451 
2170 
231 
Under 10 
years. 
12,570 
© © 
to CO 
© © 
Under 5 
years. 
62 
CO 
g 
CD 
CO 
to 
Ol CD 
8 8 
10 to 24. 
9121 
4498 
4623 
5 to 10. 
to C5 
CO o 
24 to 36. 
to 
4a. 
to 
4*- CO 
CO © 
K- tO 
© © 
10 to 15. 
4* 
O 
o 
i-- to 
H* CD 
CO -vj 
36 to 55. 
9384 
Cn 
i-* to 
— 
to to 
15 to 20. 
4* 
O 
369 
35 
55 to 100. 
18,001 
8536 
9465 
20 to 30. 
CO 
4*- CO 
100 and 
upwards. 
11,265 
5721 
5544 
30 to 40. 
Fem. 
to 
•— 
© 
2961 
3279 
40 to 50. 
2618 
to 
CO to 
© Oi 
4* 4- 
Under 10 
years. 
8 
to 
© 
1552 
2068 
50 to 60. 
4S* 
8 
CD 
CO 
CO © 
4- CO 
© to 
10 to 24. 
s 
to 
© <? 
© © 
CD «£■* 
60 to 70. 
CO 
CD 
4^ 
27 11 
453 
24 to 36. 
© 
<- 
co to 
f CO 
© CD 
70 to 80. 
to 
3 
<t 
to co 
© © 
© i— 
36 to 55. 
<1 
CD 
© 
CD © 
80 to 90. 
© 
CO 
738 
61 
55 to 100 
to 
CD 
CD © 
90 to 100. 
CO 
o 
CO 
© 
100 and 
upwards. 
© 
© CO 
100 and 
upwards. 
102,513 
17,980 
3,212 
80,311 
Total pop- 
ulation. 
TABLE B. 
Baltimore.—Deaths, Population, and rate per cent, of Mortality 
for thirteen years, 1886—1848, inclusive.* 
Year. 
Population. 
Annual 
mortality. 
Mortality, 
one to every 
Per centage of 
mortality. 
1836 
93,919 
2192 
42.75 
2.33 
1837 
95,266 
2518 
37.80 
2.64 
1838 
97,547 
2476 
39.39 
2.53 
1839 
99,985 
2260 
44.23 
2.26 
1840 
102,513 
2045 
50.12 
1.99 
1841 
105,087 
2247 
46.76 
2.14 
1842 
108,233 
2477 
43.29 
2.31 
1843 
112,021 
2333 
48.01 
2.08 
1844 
116,501 
2665 
43.71 
2.28 
1845 
121,161 
2896 
41.81 
2.38 
1846 
127,219 
2996 
42.45 
2.35 
1847 
133,579 
3414 
39.12 
2.58 
1848 
140,457 
3861 
36.19 
2.76 
TABLE C. 
Baltimore.—Deaths, Population, and Mortality of Coloured 
Population for nine years, 1840—1848, inclusive.* 
Year. 
Population. 
Annual 
mortality. 
Mortality, 
one to every 
Per eentage of 
mortality. 
1840 
21,192 
480 
44.15 
2.26 
1841 
21,615 
583 
37.07 
2.69 
1842 
22,047 
641 
34.39 
2.90 
1843 
22,487 
562 
40.01 
2.49 
1844 
22,936 
590 
38.87 
2.59 
1845 
23,394 
676 
34.39 
2.90 
1846 
23,861 
699 
34.02 
2.93 
1847 
24,338 
694 
35.34 
2.82 
1848 
25,068 
840 
30.00 
3.33 
* Exclusive of stillborn. 574 
TABLE D. 
Baltimore.—Statement of the Causes of Deaths for thirteen years, 
1836—1848, inclusive.* 
1836. 
1837. 
1838 
1839. 
1840. 
1841. 
1842. 
1843. 
1844. 
1845. 
1846. 
1847. 
1848. 
Abscess - 
Affection of the 
- 
2 
4 
1 
2 
4 
2 
4 
1 
1 
1 
4 
2 
nerves 
2 
1 
- 
1 
Amputation - 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
1 
1 
Aneurism 
- 
1 
- 
- 
- 
1 
- 
1 
- 
- 
- 
- 
- 
- 
Apoplexy 
produced 
by 
22 
20 
25 
29 
25 
19 
22 
17 
23 
15 
28 
22 
19 
violence 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- ' 
Arthritis 
1 
2 
Asthma - 
- 
16 
4 
6 
6 
8 
6 
1 
1 
12 
2 
3 
3 
2 
Bite of a spider 
- 
1 
- 
- 
- 
- 
- 
1 
- 
1 
1 
- 
- 
- 
dog 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
- 
- 
Bronchitis 
- 
- 
- 
1 
- 
2 
5 
4 
5 
6 
5 
11 
8 
8 
Burn 
- 
11 
11 
16 
11 
14 
9 
7 
7 
9 
13 
8 
12 
17 
Cancer - 
- 
9 
9 
11 
7 
10 
8 
9 
12 
17 
12 
20 
17 
10 
Carbuncle 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
Carditis - 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
. 
Catarrh - 
- 
- 
- 
- 
- 
1 
- 
_ 
- 
- 
- 
- 
- 
- 
Casualty- 
- 
31 
28 
33 
24 
20 
27 
55 
21 
27 
37 
37 
34 
39 
Chicken-pox - 
- 
- 
4 
2 
1 
3 
1 
- 
- 
- 
- 
1 
1 
- 
Child-bed 
- 
18 
29 
28 
21 
20 
31 
14 
21 
29 
34 
36 
35 
62 
Cholera - 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
Cholera infantum 
- 
191 
131 
199 
125 
114 
194 
198 
159 
129 
113 
139 
249 
244 
morbus - 
- 
2 
- 
2 
2 
1 
- 
9 
8 
7 
7 
4 
9 
9 
Cholic - 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
cramp - 
- 
6 
9 
4 
3 
7 
4 
4 
10 
4 
12 
8 
4 
6 
bilious - 
- 
3 
8 
3 
4 
4 
4 
1 
2 
- 
5 
3 
1 
6 
painter’s 
Concussion of the 
1 
- 
- 
- 
1 
2 
" 
- 
“ 
" 
- 
brain - - - 
Congestion of the 
1 
" 
“ 
1 
- 
“ 
1 
2 
brain - 
3 
1 
3 
- 
1 
3 
2 
1 
lungs - 
- 
- 
- 
- 
- 
- 
1 
- 
1 
- 
1 
- 
- 
2 
bowels - 
- 
- 
- 
- 
1 
- 
- 
- 
- 
1 
- 
- 
- 
- 
Constipation - 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
Consumption - 
- 
316 
396 
410 
397 
359 
454 
480 
483 
510 
523 
548 
590 
620 
Contusion 
- 
2 
1 
2 
1 
- 
- 
- 
- 
1 
- 
- 
- 
- 
Convulsions - 
- 
86 
85 
89 
65 
55 
84 
83 
57 
73 
81 
73 
81 
106 
Coup de soleil 
- 
- 
- 
3 
- 
- 
2 
- 
- 
- 
1 
1 
1 
2 
Croup 
- 
47 
59 
45 
51 
31 
26 
42 
71 
56 
80 
91 
127 
165 
Death from blows 
- 
2 
6 
1 
- 
1 
3 
1 
2 
1 
1 
6 
- 
- 
by lightning 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
1 
- 
- 
from stabs 
- 
- 
5 
1 
- 
1 
- 
- 
2 
2 
- 
3 
- 
- 
violence 
- 
- 
- 
- 
i 
2 
1 
1 
1 
2 
- 
- 
2 
2 
Delirium tremens 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
Diarrhoea 
Disease of the pros- 
2 
- 
i 
" 
- 
2 
- 
1 
“ 
7 
15 
tate gland - 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
spine 
- 
1 
3 
3 
2 
8 
3 
3 
9 
3 
10 
8 
3 
5 
throat - 
- 
- 
- 
- 
- 
- 
- 
- 
- 
3 
- 
- 
4 
1 
womb - 
- 
- 
- 
- 
- 
- 
1 
1 
- 
- 
1 
3 
2 
1 
Dropsy - 
- 
50 
50 
63 
60 
57 
49 
44 
42 
58 
44 
62 
72 
79 
in the head 
- 
34 
34 
43 
26 
63 
64 
47 
55 
50 
46 
39 
- 
- 
Drowned 
- 
25 
39 
23 
35 
22 
27 
26 
24 
27 
34 
40 
34 
31 
Dysentery 
- 
25 
39 
25 
16 
27 
22 
25 
22 
11 
13 
7 
42 
46 
bilious - 
- 
- 
- 
- 
- 
- 
- 
- 
- 
2 
- 
- 
- 
- 
Dysmenorrhcea 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
Dyspepsia 
4 
1 
3 
4 
3 
2 
1 
3 
1 
6 
9 
5 
Erysipelas 
- 
- 
- 
1 
4 
- 
3 
5 
- 
4 
14 
9 
10 
Epilepsy 
- 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
* The classification is 
that of the Board of Health, and highly objectionable. 575 
Exposure to cold 
1836. 
5 
1837. 
2 
1838. 
3 
1839. 
3 
1840. 
3 
1841. 
1 
1842. 
2 
1843. 
4 
1S44. 
1 
1845. 
3 
1846. 
1 
1847 
5 
1848. 
1 
to heat, and 
drinking cold 
water - 
1 
28 
2 
1 
5 
9 
1 
Fever, bilious - 
- 
83 
32 
37 
46 
49 
38 
68 
38 
43 
53 
70 
44 
52 
catarrhal 
- 
77 
74 
67 
70 
44 
99 
117 
110 
75 
89 
104 
132 
144 
congestive 
- 
3 
2 
6 
4 
7 
10 
7 
11 
4 
4 
7 
1 
- 
gastric - 
- 
- 
3 
5 
8 
10 
7 
12 
17 
22 
36 
25 
29 
20 
inflammatory 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
- 
intermittent 
- 
3 
14 
3 
1 
2 
4 
14 
5 
3 
3 
2 
3 
2 
nervous 
1 
2 
2 
- 
- 
4 
remittent 
- 
2 
1 
3 
- 
- 
1 
scarlet - 
- 
30 
134 
141 
112 
71 
74 
27 
56 
370 
288 
132 
166 
407 
typhus - 
- 
41 
14 
33 
20 
13 
18 
19 
8 
19 
17 
20 
29 
76 
ship 
106 
7 
Fracture 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
Gout 
- 
- 
2 
- 
- 
- 
2 
2 
2 
1 
1 
2 
1 
- 
Gravel - 
- 
1 
2 
3 
4 
3 
1 
3 
2 
3 
5 
1 
- 
- 
Hemorrhage - 
- 
9 
4 
10 
5 
13 
11 
4 
14 
6 
8 
10 
8 
14 
Hernia - 
1 
- 
1 
1 
3 
Hip complaint 
- 
- 
- 
1 
1 
- 
1 
2 
- 
- 
1 
- 
- 
1 
Hives 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
Hooping-cough 
- 
43 
69 
18 
75 
9 
35 
63 
20 
59 
62 
26 
104 
59 
Hydrarthosis - 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
Hydrocephalus 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
21 
70 
79 
Hydrophobia - 
- 
1 
2 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
2 
Hysteritis 
- 
- 
- 
- 
2 
- 
- 
- 
- 
- 
- 
Inflammation - 
- 
3 
1 
2 
- 
1 
1 
1 
- 
- 
- 
- 
1 
3 
of the bladder 
1 
1 
- 
1 
- 
1 
- 
- 
- 
1 
1 
4 
- 
bowels - 
- 
15 
10 
14 
20 
21 
23 
36 
46 
37 
34 
51 
60 
67 
brain 
- 
19 
38 
25 
35 
IS 
27 
23 
34 
34 
46 
64 
89 
83 
breast - 
1 
10 
3 
2 
- 
- 
kidneys - 
- 
1 
2 
~ 
2 
- 
1 
2 
1 
- 
1 
1 
2 
2 
liver 
- 
- 
1 
- 
- 
- 
- 
1 
2 
2 
- 
- 
18 
s 
lungs 
- 
8 
8 
9 
10 
9 
7 
10 
14 
21 
11 
S 
20 
22 
stomach 
- 
3 
3 
3 
2 
1 
1 
3 
4 
6 
2 
- 
3 
2 
throat - 
- 
3 
- 
2 
3 
1 
2 
- 
1 
- 
5 
1 
4 
2 
uterus - 
- 
- 
- 
- 
_ 
- 
- 
- 
- 
- 
1 
- 
- 
- 
Infanticide 
- 
1 
- 
2 
1 
- 
1 
1 
2 
4 
3 
2 
1 
1 
Influenza 
- 
- 
- 
- 
- 
- 
- 
- 
9 
- 
1 
- 
- 
- 
Intemperance 
- 
50 
35 
47 
30 
35 
29 
18 
15 
10 
20 
16 
16 
23 
Jaundice 
- 
6 
2 
3 
2 
1 
1 
4 
3 
5 
- 
1 
1 
5 
Liver complaint 
- 
18 
13 
13 
10 
11 
7 
13 
6 
13 
13 
16 
- 
- 
Lock-jaw 
- 
4 
3 
2 
3 
1 
1 
5 
4 
3 
1 
3 
- 
- 
Mania - 
- 
3 
7 
6 
- 
5 
3 
6 
8 
9 
2 
12 
15 
9 
h. potu - 
3 
3 
4 
6 
Marasmus 
- 
27 
32 
30 
18 
3 
5 
5 
2 
- 
1 
- 
- 
- 
Measles- 
- 
1 
141 
4 
57 
32 
6 
103 
4 
1 
20 
114 
7 
74 
Mortification - 
- 
3 
10 
3 
5 
3 
6 
2 
8 
5 
3 
7 
5 
6 
Mumps - 
- 
- 
- 
1 
- 
- 
2 
- 
- 
- 
- 
1 
- 
1 
Murder - 
- 
- 
- 
1 
- 
- 
- 
- 
- 
1 
1 
- 
- 
- 
Neuralgia 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
3 
1 
Old age - 
- 
137 
93 
94 
118 
96 
94 
98 
120 
93 
97 
129 
144 
156 
Ophthalmia - 
- 
- 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
Organic disease of 
the heart 
6 
7 
4 
5 
20 
17 
27 
19 
30 
39 
47 
30 
29 
Palsy 
- 
13 
12 
18 
12 
24 
13 
1 
21 
21 
17 
10 
35 
34 
Paralysis 
11 
6 
- 
- 
Piles 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
Phthisic - 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
2 
- 
- 
- 
Pleurisy- 
- 
74 
66 
50 
55 
47 
38 
66 
86 
54 
26 
18 
32 
50 
bilious - 
1 
8 
23 
17 
- 
- 
Poison - 
- 
2 
1 
- 
1 
2 
- 
2 
4 
- 
3 
4 
2 
1 
Pneumonia 
1 
- 
2 
1 
31 
39 
Quinsy - 
- 
1 
7 
5 
1 
1 
1 
1 
2 
1 
2 
- 
- 
- 
Rheumatism - 
- 
- 
5 
2 
4 
7 
6 
9 
3 
6 
- 
- 
5 
4 
inflammatory 
2 
- 
3 
2 
2 
- 
1 
4 
1 
6 
4 
2 
1 576 
1836. 
1837 
1838. 
1839 
1840. 
1841. 
1842. 
1843. 
1844. 
1845. 
1846 
1847. 
1849 
Rupture- 
- 
2 
- 
- 
- 
2 
1 
2 
1 
- 
- 
- 
- 
- 
Scald 
- 
3 
4 
- 
1 
2 
1 
- 
1 
1 
- 
- 
- 
Scirrhus of the 
mach - 
sto- 
1 
. 
. 
. 
. 
_ 
m 
. 
_ 
Scrofula- 
- 
2 
12 
11 
3 
8 
5 
4 
3 
2 
5 
3 
3 
S 
Small-pox 
- 
1 
52 
71 
2 
9 
1 
1 
- 
- 
110 
115 
1 
5 
Spasms - 
- 
6 
0 
- 
3 
- 
- 
1 
1 
- 
- 
- 
- 
- 
Spleen - 
- 
- 
- 
- 
- 
2 
- 
- 
1 
- 
- 
- 
- 
- 
Stillborn 
- 
181 
196 
215 
171 
191 
201 
178 
187 
214 
211 
257 
381 
372 
Sting of a wasp 
- 
- 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
Stone 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
Strangulation - 
2 
1 
- 
- 
- 
1 
St. Vitus’ dance 
- 
- 
1 
- 
1 
- 
1 
- 
- 
- 
- 
- 
- 
Sudden - 
- 
32 
22 
21 
26 
27 
25 
14 
19 
13 
1 
6 
17 
20 
Suicide - 
- 
10 
5 
6 
3 
7 
3 
5 
1 
5 
6 
4 
3 
5 
Syphilis - 
- 
1 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
i 
Teething 
- 
16 
28 
21 
15 
21 
28 
29 
29 
16 
19 
42 
69 
92 
Thrush - 
- 
3 
6 
6 
5 
3 
6 
4 
6 
2 
- 
5 
7 
7 
Tic douloureux 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
Tumour - 
- 
2 
- 
4 
1 
5 
1 
2 
3 
8 
3 
9 
1 
8 
fungous - 
- 
- 
1 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
-i 
Ulcer 
- 
1 
- 
- 
2 
- 
1 
- 
- 
1 
- 
- 
- 
Ulcerated sore throat 
1 
1 
5 
3 
7 
1 
1 
2 
1 
1 
4 
2 
1 
Ulceration of 
bowels 
the 
1 
1 
Unknown, adult 
16 
13 
30 
20 
46 
29 
25 
47 
82 
85 
87 
96 
178 
infantile 
47S 
516 
535 
515 
468 
487 
490 
446 
466 
575 
533 
587 
489 
Varioloid 
- 
- 
1 
1 
- 
2 
- 
- 
- 
- 
- 
- 
1 
1 
White swelling 
- 
- 
- 
- 
- 
- 
- 
- 
- 
1 
- 
- 
- 
- 
Worms - 
13 
18 
20 
15 
4 
8 
3 
5 
7 
7 
12 
6 
14 
TABLE E. 
Baltimore.— The Ages at which Death has taken place for thirteen 
years, 1886—1848, inclusive (<Stillborn not enumerated). 
Year. 
Under 1 
year. 
1 to 2. 
2 to 5. 
5 to 10. 
10 to 21. 
21 to 30. 
© 
TJ< 
o 
o 
CO 
40 to 50. 
50 to 60. 
60 to 70. 
© 
00 
O 
o 
O 
© 
o 
o 
00 
90 to 100. 
Over 100. 
Total. 
1836 
584 
180 
208 
78 
109 
203 
227 
191 
147 
124 
81 
41 
11 
8 
2192 
1837 
630 
275 
324 
148 
172 
217 
250 
162 
103 
115 
80 
35 
6 
1 
2518 
1838 
655 
256 
246 
125 
154 
238 
276 
188 
124 
98 
61 
44 
8 
3 
2376 
1839 
612 
257 
266 
99 
112 
189 
220 
148 
116 
97 
88 
45 
9 
2 
2260 
1840 
532 
182 
183 
93 
123 
205 
226 
166 
126 
82 
76 
44 
5 
2 
2045 
1841 
651 
217 
208 
82 
123 
214 
231 
165 
120 
107 
73 
45 
8 
3 
2448 
1842 
666 
315 
263 
106 
157 
225 
121 
191 
109 
93 
46 
49 
10 
6 
2454 
1843 
682 
229 
153 
91 
138 
251 
234 
166 
112 
132 
94 
42 
9 
0 
2333 
1844 
630 
285 
363 
158 
161 
212 
262 
222 
126 
110 
72 
42 
13 
9 
2665 
1845 
830 
208 
351 
149 
155 
282 
305 
228 
144 
115 
71 
37 
14 
6 
2896 
1846 
786 
287 
320 
167 
200 
263 
305 
232 
135 
129 
94 
59 
15 
3 
2994 
1847 
866 
420 
376 
173 
151 
320 
343 
259 
176 
124 
133 
57 
12 
4 
3414 
1848 
959 
471 
508 
220 
207 
352 
349 
261 
174 
152 
128 
57 
17 
6 
3861 H.—8. 
Report on the Sanitary Condition of Charleston, South Carolina. 
By P. C. Gaillard, M. D. 
Dr. James Wynne, 
Chairman of Hygiene Committee of American Medical Association, 
Sir : As a member of the Committee on Hygiene, it is my duty 
to furnish such information as I have been able to collect, relative 
to the city of Charleston. The materials for a report on the hy- 
giene of this city are, however, by no means abundant; and much 
of the information, with which I have been furnished, is deficient 
in detail, and lacks precision. Under the direction of our city 
council, measures are now in progress for gathering up all the im- 
portant statistics relating to the population, health, mortality, trade, 
&c., of the city; and should the results be made known sufficiently 
early to be of service to you in preparing your general report, they 
shall be forwarded to you. I will now proceed to reply to the inter- 
rogatories contained in your circular of May 1848, in the order in 
which they there occur. 
“ 1. What is the population of the town, and its position in rela- 
tion to the surrounding country, the nature of its surface and subsoil, 
the means of, or impediments to drainage, more especially within 
the town limits ?” 
In 1840, by the census of the United States, Charleston contained 
a population of 29,261, of which 14,788 were white, 14,478 black 
and coloured. The suburbs contained at the same time a population 
of 11,876; but as these are not within the corporate limits, are not 
governed by the city laws, keep no bills of mortality, and have little 
or no medical police, they will not be included in this report. 
The city is situated on a narrow neck or tongue of land, between 
Cooper River on the east, and Ashley River on the west, in lat. 32° 
46', long. 79° 57'. Cooper River is rather more than a mile wide, 
and beyond it are extensive salt marshes, over which every tide 
flows, and which are covered with a luxuriant growth of salt-marsh 
grass—the spartina glabra. Ashley River, on the west, is not so 578 
wide, and the marshes, on its further shore, are less deep. Along 
its margins, on the city side, considerable salt marshes still exist— 
there are none such along the margins of Cooper River within the 
city limits. The two rivers unite at the point of the peninsula on 
which the city is situated, and below, widen out to form the bay. 
They discharge their waters into the ocean, seven miles below their 
point of confluence. Towards the north, the city is directly contigu- 
ous to the suburbs; and beyond the latter, the country is flat and 
sandy. 
A great part of the city has been built upon reclaimed marshes, 
and the beds of creeks and ponds, which have been filled up. 
The geological structure of the soil is alluvial. The surface con- 
sists of yellow or gray sand, resting on a stratum of red, ochrous 
clay, under which white or gray sands again occur. The depth of 
this alluvium is about twenty feet, and the water of our wells is de- 
rived from it. Under the alluvium, blue mud and sand are found, 
containing the characteristic shells of the post pliocene formation, 
the newest of the tertiary; and below the post pliocene, the eocene 
or lower tertiary beds are met with of great thickness, and composed 
principally of marl. The influence of this arrangement on the 
drainage of the city, is explained in the following extract from a 
very interesting monograph, on the Geology of Charleston, by Mr. 
F. S. Holmes, to which I am indebted also for the information given 
above. 
“ The natural drainage of the city, as affected by its geological 
structure, is next worthy of our notice. The waters percolating 
from the surface, I have already said, are obstructed in their down- 
ward course by the blue mud of the post pliocene bed; while their 
escape, in a lateral direction, is prevented by the clay deposited 
along the sides of the above-described creeks. In rainy seasons, all 
the water that is not carried off by the surface drains, is retained to 
the depth of about eighteen feet, and the earth becomes completely 
saturated by it; the present sewers admitting little or no water, 
except through the gratings from the streets. Hence, it appears 
that the wells of the city are its principal vents or drains, and that 
the quantity of water consumed daily by the citizens from these 
wells, will be the measure of the drainage.” 
“2. What is the character of the town in reference to health? 
What is the condition of its most unhealthy and crowded parts 
where disease is supposed to be most prevalent, and to what causes 
are such diseases mainly attributable?” 579 
The character of Charleston in reference to health is very fair. 
From a report, by the City Register, of the interments for the 
eighteen years from 1828 to 1846, it appears that the annual pro- 
portionate mortality averaged 1 in 44.11; whereas, for the last 
eight years, the average has been but 1 in 52. The causes of this 
difference are obvious. In 1836, epidemic cholera prevailed here, 
and carried off 392 persons, increasing the mortality that year to 1 
in 25.84. In 1838, in the month of May, a dreadful conflagration 
laid one-third of the city in ashes. By this, vaults and cellars con- 
taining offensive and decomposing matters, were exposed to the rays 
of the summer sun; and yellow fever, the most severe which we have 
had during the present century, made its appearance, victims being 
abundantly furnished for its ravages in the numerous Irish and other 
labourers who flocked here to aid in rebuilding the burnt district. 
The disease also prevailed to a less extent in 1839. The mortality 
for 1838 was 1 in 25.05; and in 1839, 1 in 35.38. These disas- 
trous years of course increased the ratio of deaths for the series of 
years to which we are at present alluding. “But since the rebuild- 
ing of the city,” says the City Register, in a letter to me, “we have 
had no epidemic of yellow fever (a period of eight years), and the 
average mortality has been 1 in 52. By the efficient system of 
drainage now existing, and the activity of the Board of Health in 
reporting all nuisances likely to injure the public health, I am satis- 
fied that our city does, and will continue to enjoy as great a share 
of health as any other maritime city in our widely extended Union.” 
The most beneficial effects appear, indeed, to have resulted from 
the system of grading and draining the streets which has been 
adopted. Many of the practitioners of our city are also impressed 
with the belief that the shells with which many of our streets have 
been covered, have contributed something to the improvement of the 
health of those quarters; and, when we reflect on the influence 
which lime is said to possess as a disinfectant; when we remember 
that a considerable portion of country about Leith is said to have 
been rendered salubrious, and fevers of a malarious nature to have 
been extirpated by the use of lime, we can readily allow some influ- 
ence to this cause. Our exemption from yellow fever of late years 
is not, however, to be taken as a positive proof of this. In the his- 
tory of this disease in our city, the following curious facts have been 
observed, and are recorded in the books of the Medical Society of 
S. C. In the year 1791, yellow fever reappeared in the city, after 
an absence of thirty-seven years, or from 1755, and prevailed more 580 
or less violently almost every year after until 1807. From 1807 to 
1817 there was no epidemic yellow fever in Charleston. But in 1817 
it again appeared, and was very severe, and again it prevailed in 1819, 
’24, ’27, ’28, ’34, ’35, ’38, and ’39, since which, as already stated, 
with the exception of a few cases in 1840, and one or two in 1843, 
our city has been entirely exempt from the disease. That the health 
of the city has been improved by the system of drainage, &c., 
adopted, and by the general vigilance of the proper authorities, I 
entertain no doubt, but sufficient time has not yet elapsed to enable 
me to state it as a proved fact. 
The most crowded parts of the city are Market street and neigh- 
bourhood, State street, Elliott street, and the eastern end of Tradd 
street, all the streets enumerated being on the eastern, or commer- 
cial side of the city. In these situations, the houses are generally 
built in blocks, and have very small yards, which are the most filthy 
of the city. These are the localities of sailors’ boarding-houses, 
and their concomitant houses of prostitution, and of the lodging- 
houses for the poorer classes generally. It is here, therefore, that 
we should expect to find all the elements of disease, and accordingly 
it is here that yellow fever first appears, and rages most violently. 
It may be asserted that with us yellow fever has constituted the 
test of the healthiness of the different quarters of the city proper, 
as typhus does of more northern sites. As just remarked, yellow 
fever invariably appears in the city first, in or near one of the loca- 
lities mentioned, and to whatever cause the origin of the disease may 
be attributed, it there continues to rage with most violence. “ Dur- 
ing all epidemics of yellow fever,” says the City Register, in the 
letter already quoted, “the large majority of patients were from 
Elliott, Tradd, Market, and State streets, which streets are the most 
closely built up, and worst ventilated of any in the city. But at 
the same time, these streets are occupied almost exclusively by that 
class of people most liable to the disease, viz., sailors, and strangers 
of the lower orders, given to drunkenness, &c. In ordinary years, 
these streets are as free from disease as any others in the city. 
Upon the whole, I would say that there is no one locality of the city 
more liable to disease than another, except the above-mentioned 
streets, and they only when yellow fever prevails as an epidemic.” 
You will have remarked that the localities just spoken of are not 
only the most crowded, most badly ventilated and filthy, but are also 
the chief, almost the only resort of sailors. This leads me here, to 
consider your suggestion regarding quarantine laws, in relation to 581 
diseases peculiar to our geographical position. The only disease 
which can come up in this connection, is that of which I have al- 
ready spoken—yellow fever. The question has often been agitated 
here, as to whether the disease may not sometimes be imported, and 
afterwards spread among the unacclimated inhabitants. With us, 
as elsewhere, this has been the subject of much controversy; the 
opinion of the profession generally, however, is very decided against 
the idea of importation, which would involve in some measure the 
idea of contagion. Others, although few in number, have not been 
wanting, who have maintained the opposite ground. Among these 
I may mention, Prof. Dickson, late of the Medical College of South 
Carolina, now of the University of New York, and Dr. B. B. Stro- 
bel. The latter has published a volume to prove the transmissibility 
of yellow fever, in which he contends that, when the atmosphere of 
a place is in a state to produce some form of febrile disease, the 
arrival of a vessel from a port where yellow fever is prevailing, may 
so infect the atmosphere, as to generate that peculiar form of fever; 
this peculiar state of the atmosphere being wanting, the poison will 
be harmless. To sustain this point, many facts in the history of 
yellow fever, familiar to the profession, are adduced; and Dr. S. 
endeavours further to prove that the fever which prevailed in this 
city in 1839, was imported by vessels from the West Indies. This 
he does by showing that the first cases occurred in the immediate 
neighbourhood of such vessels, that the disease was carried into 
lodging-houses in Market street, and subsequently extended among 
persons in that neighbourhood. 
The recent case of the Eclair steamer, and the appearance of yel- 
low fever at Boa-Vista, is so strong and positive, that, when added 
to that of the ship Baum, and the importation into, and spread of 
the disease, in the island of Ascension; the communication of the 
disease by the French ship Palinure to her English prize, the Carna- 
tion; and from their French prizes to the British ships Thetis and 
Hussar, there is little doubt that infected vessels may transmit the 
disease to other persons and localities, under peculiar circumstances. 
What these circumstances are precisely, it is impossible to say; but 
the previous existence of a high range of the thermometer, combined 
with unfavourable hygienic conditions, such as those stated to exist 
in the part of our city where the disease first appears, and rages 
most violently, are probably the most important. The inference I 
would deduce from these remarks, in relation to quarantine, is clear, 
viz., that, during the great heats of summer, vessels from ports where 582 
yellow fever is prevailing, especially if they have, or have had 
cases of the disease on board, should be subjected to quarantine, be 
thoroughly cleansed, ventilated, and whitewashed; that the cargo 
and effects of passengers and crew be opened, aired, &c., and that 
no case of the disease be introduced into the city. By proper hy- 
gienic precautions, however, within the city, by removing the states 
which favour the spread of the disease, and which are antecedents 
necessary to its extension, its importation may be prevented and its 
course arrested. 
The malarial fevers (intermittent and remittent) are by no means 
as common in Charleston as they formerly were. I here speak in 
reference to the city proper—they still prevail in the suburbs. Re- 
mittent fever, generally of a mild form, is sometimes observed to 
originate in the city; intermittents are more rare. The cases of 
death recorded in our bills of mortality from these fevers are, almost 
without exception, of persons who contracted them in the neighbour- 
ing country; and hence, they are often reported as country fever, 
from the place where they were contracted. The salt marshes along 
the western border of the city, do not seem to have any deleterious 
agency in giving rise to these forms of disease. It is worthy of re- 
mark, that in the years when yellow fever prevailed, there was no 
uniform increase in the deaths by the malarious fevers. But the 
reports of the City Register show that there was a remarkable in- 
crease in the number of deaths by typhus in the years 1838, ’39, 
and ’40; years in which yellow fever prevailed, in the two former 
extensively. The mortality from this cause, for the two years im- 
mediately preceding 1838, was eight for each year; whereas, in ’38, 
it was twenty-four; in ’39, twenty-five; and in ’40, twenty-one; and 
since the last date, there has been a gradual diminution in the num- 
ber of deaths by typhus; so that in ’46 there were but ten, and in 
’47, but seven deaths from this cause. It was, for some time, 
thought that typhus and typhoid fevers were taking the place of the 
malarious fevers among us. If, however, such a tendency did for a 
time exist, it has passed away; and, although there has of late been 
no remarkable increase in the number of cases of remittent and in- 
termittent fevers, their antagonistic diseases have certainly not 
shown any tendency to increase. 
The bills of mortality are made up principally from the returns of 
the sextons of the different burial-grounds ; who are required, before 
interring a body, to have the certificate of the physician who at- 
tended, stating the name, age, and disease of the deceased. The 583 
accuracy of the bills is not altogether to be relied on. In looking 
over them, one cannot avoid being struck with the great faultiness 
of the nomenclature which they exhibit. It is to be hoped that the 
nomenclature of diseases, recommended by the Association, will 
hereafter be adopted not only here but throughout the United 
States. A few examples will suffice to show the defect alluded to. 
Under the head of fever, we find, among others, the following : 
bilious, country, strangers’, remittent, intermittent, and congestive. 
I do not doubt, that persons at a distance are sorely perplexed 
with some of these names. Now, one name, remittent, would have 
sufficed for bilious, remittent, and country, for they are the same; 
the last being so called because contracted in the country. Again, 
strangers’ fever means yellow fever, and this name is given because 
strangers are the subjects it attacks. Many other defects might 
be noticed, but most of them have already been pointed out in the 
Report of the Committee on a Nomenclature of Diseases, &c., pre- 
sented to the Convention in 1847. 
“ 3. What are the arrangements for drainage ? Is there a public 
survey of levels ? Are the streets and alleys laid out with a proper 
inclination for surface drainage, or are they defective in these par- 
ticulars ? Is the drainage effected by sewers or surface drainage ? 
And is the mode adopted effective?” 
Most of these points will be answered by the following extract, 
from a letter addressed to me by his Honour the Mayor of the 
city: “The city is drained by means of subsoil brick drains, run- 
ning through the centre of the streets from river to river. In 
those streets that are graded (convex in the middle, and either 
macadamized, paved with round stones, or unpaved), there are sur- 
face drains running parallel with the side walks, with grate open- 
ings, which communicate with small brick diagonal drains running 
to the main central drain. From the lots on either side of the 
streets, small subterranean drains likewise connect with the central 
drains, thus draining both streets and yards. This system of drain- 
age has been adopted within the last twelve years, with marked 
improvement to the health of the city. The mode is effective. 
Many parts of the city are still imperfectly drained.” 
The mode of drainage, described in the above extract, is doubt- 
less efficient, so far as it has been carried out; but, unfortunately, 
one-half of the streets are still in a bad state as regards drainage. 
These have also central drains, but the streets are concave, have no 
surface drains at the sides ; and the water which falls, in part finds 584 
its way into the drains through grates at long intervals in the centre 
of the streets, and in part, owing to the inequalities of the surface, 
lies for days on the surface until it is evaporated, or is absorbed by 
the soil. This state of things is, however, gradually being corrected; 
and, within the last few years, attention having been more especially 
directed to the subject of hygiene, more progress has been made 
than for a much longer term of years previously. 
“4. What is the mode and expense of cleansing the streets? Are 
the courts and alleys occupied by the poor cleaned, and how often ? 
Where is the refuse from the houses deposited, and where is the 
street manure kept, and how disposed of?” 
This will also be sufficiently answered by the following extract 
from the letter just quoted: “ Residents are required by law to 
sweep their yards and in front of their houses daily (Sundays ex- 
cepted), and to deposit the sweepings and offal near the curb-stone, 
in front of their dwellings, before 9 o’clock A. M., from whence they 
are removed by carts employed by the Superintendent of Streets 
daily, the work to be done throughout the city at or before 1 o’clock 
P. M. The offal is deposited, during the summer months, at some 
point remote from habitation ; and in winter, it is used for filling up 
low streets and marsh lands owned by the city, to be afterwards 
covered with earth. 
“ The city is divided into two divisions, the upper and lower; for 
each of which there is a superintendent, who is bound to provide six 
carts, horses, and labourers, and who is responsible for keeping clean 
the streets, under the direction of the mayor. Each superintendent 
is elected by the City Council, and each receives a salary of $2800 
per annum.” 
It may be stated further, that, in order to insure the removal of 
offal, and to keep yards, &c., in a proper state, the Board of Health 
have the power to make domiciliary visits, and to order any offen- 
sive matters removed. They may, also, when necessary for insuring 
the proper drainage of lots, direct those which are so low as to hold 
water to be filled up, and proper drains constructed for carrying off 
the water. Should the owners of such lots fail to comply with these 
directions within a specified time, the work is done by the city, and 
the cost charged to them (the owners of lots). In this manner, when 
the Board is active, as they always are on the approach of summer, 
or when the visitation of such an affection as cholera is apprehended, 
a thorough cleansing of all the lots of the city is insured. 
5. The condition of the more densely populated parts of the city 585 
has already been mentioned. The streets are generally of sufficient 
width, and there are few alleys, and still fewer courts built up and 
closed at the end. The houses of the poor are either small wooden 
buildings, occupied by but one family, or they inhabit larger houses 
in the vicinity of East Bay, in which case many families reside in 
one house. Recently, ranges of comfortable two story tenements 
have been constructed of brick in different parts of the city, and 
many families of the poor reside in such ; each family occupying a 
tenement consisting of a room below and one above stairs. These 
are the best residences for the poorest classes which we have. The 
houses are ventilated by means of windows, and generally there is 
no deficiency in this respect, except in the cases alluded to in the 
earlier part of this Report. The houses are warmed by wood or coal 
fires, generally in open fireplaces. Stoves are comparatively rare. 
6. In relation to public schools, the chairman of the commis- 
sioners, the Rev. C. Hanckel, has kindly furnished the following in- 
formation : “ The system of our free schools in the city is like that 
of our private schools, with the exception that the instruction of the 
pupils is confined to a simple elementary English education, embrac- 
ing spelling, reading, writing, arithmetic, history, geography, gram- 
mar, and natural history; and that our schools are held morning 
and evening (afternoon), with the usual interval of recreation from 
12 to 3 o’clock. 
“ Its influence on the health of the children is, doubtless, bene- 
ficial; the confinement being too short to fatigue, and sufficiently 
long to restrain them from exposure by strolling through the streets, 
or loitering about places dangerous to health or morals. 
“ Children are admitted at all ages; but principally between six 
and nine years, and remain in the schools from one to fourteen 
years—upon an average, about five years. 
“ The school-rooms are of a moderate size (being hired by the 
teachers at their own expense), barely sufficient to accommodate the 
pupils, the number of whom in each school is about one hundred. 
The legislature has, at its last session, authorized the commissioners 
to raise a fund out of the general taxes for the purpose of erecting 
suitable school-rooms. 
“ Time allotted to instruction six hours (from 8 to 12 M., and 
from 3 to 5 P. M.) a day—Saturdays and Sundays excepted. For 
exercise in the open air—the intervals between school hours. 
“ Vacations—two weeks in April and December. Holidays— 
Fourth of July and Thanksgiving days.” 
vol. ii.—38 586 
7. There are two hospitals—the Marine and the Almshouse Hos- 
pitals—the former, confined to sailors; the latter, open to all indi- 
gent sick white persons. The latter is defective in many respects, 
and a good general hospital is much needed here. There is, also, a 
dispensary, with two physicians, who visit such of the poor at their 
domicils as require medical aid. 
8. Water.—The supply of water for drinking is from cisterns, of 
which there are a few large public ones; hut private residences are 
often provided with them. In some localities, the well or pump 
water is potable; but it is generally used only for cooking, wash- 
ing, &c. 
From the geological structure of the country, it is thought that 
pure water may be obtained from the stratum of sand, underlying 
the tertiary strata, by means of Artesian wells. The corporation 
have, in consequence, employed a competent person for the purpose 
of boring an Artesian well, and the work is now in progress with 
every prospect of success. A depth of 481 feet has been reached, 
and the water already rises to within one foot of the surface. The 
water-bearing stratum is supposed by Mr. Tuomey, late' State Geo- 
logist, to lie under the burr-stone formation of the tertiary, at a depth 
of about 650 feet. 
I have thus, to the best of my power and knowledge, given the 
information required by the committee, and only regret that it is 
not more satisfactory. I would conclude with the following brief 
summary:— 
1. From its almost insulated position, Charleston is little liable to 
the malarious diseases which prevail in the neighbourhood, and in 
all the lower part of South Carolina—the pine ridges excepted. 
2. That the character of the city for health is very fair, and has 
improved much of late years. That this improvement is to be at- 
tributed mainly to the improved condition of the streets, to their 
being paved (and possibly to the lime of the shells with which some 
of them are covered) and well drained, and to the greater atten- 
tion to the cleanliness of lots, yards, &c. That the most filthy and 
crowded parts are the most unhealthy, and that it is there that yellow 
fever first occurs, when it occurs at all, and prevails most severely. 
That there has been no epidemic of this disease for eight years; that 
its cause is somewhat uncertain—it being by some regarded as al- 
ways of endemic origin, and by others, as sometimes introduced from 
abroad. 587 
3. That the drainage of the city is as yet very imperfect—many 
parts being in this respect in a bad state. So far as the system now 
pursued has been carried, it has proved very effective, and it is being 
every day extended. This system consists of subterranean drains 
in the centre, and surface drains at the sides of the streets, the 
latter communicating with the former by small subterranean drains, 
the streets being convex. 
4. The streets are cleaned daily, and the offal from the houses is 
removed every day. 
The other points are answered so briefly, that it is needless to 
give a summary of them; and I will now submit this very imperfect 
report to your kind indulgence and consideration. 
I remain, very respectfully, 
P. C. GAILLARD, M.D. 
Chahlestojj-, S. C., January 1849. 
I herewith send a letter from the chairman of the Board of 
Health relative to the medical police of the city, which has just 
been received—too late to be introduced into the body of the report. 
P. C. G. 
January 27th. 
Charleston, January 2oth, 1849. 
To Dr. P. C. Gaillard. 
My Dear Doctor : You addressed to me certain inquiries of 
the Committee on Hygiene (of the United States Medical Associa- 
tion), of which you are a member, especially as regards the system 
of medical police. Our system, as of all other well-regulated cities, 
is twofold: one, external; the other, internal. 
1. Of the external. It is required of the pilots at all seasons of the 
year, if sickness is on board (and they are under heavy penalty for 
neglect), to bring the vessel to quarantine ground to be examined by 
the port physician. The object of this is to prevent the introduc- 
tion of small-pox. In some instances, cases have occurred which 
were well on arrival, but broke out afterwards in the city. Of this, 
the port physician has been informed by the physician attending on 
the person where the patient resides. The patient is, if practicable, 
removed to the Lazaretto, or all available means used to isolate him, 
and prevent the extension of the disease. An inspection of our 
bills of mortality, and general diseases, as reported by the City 
Kegister, will show how long we have been exempt from small-pox 588 
from this system, for it must be understood that every winter there 
are cases of small-pox at the Lazaretto. In summer, all vessels 
coming from more southern latitudes and the West India Islands, are 
brought to quarantine and inspected. At any season of the year, 
when an epidemic of a supposed contagious disease occurs, all ves- 
sels from the port where the epidemic prevails are subjected to quar- 
antine. Thus far, then, for external medical police. I do not enter 
into the long agitated disputations concerning the contagious or 
non-contagious character of certain diseases. We act in all these 
cases where there is a doubt, exactly as if they were contagious. 
2. I will now proceed to the internal medical police. The Board of 
Health consists of eighteen members elected by the City Council, and 
a medical committee composed of medical officers of the city insti- 
tutions and port physician, a State officer, of which the .City Re- 
gister is ex officio chairman, and the two elect a chairman of the 
whole Board. The duties of the members elect of the Board are, 
to inspect the various lots, and direct that all nuisances be removed 
therefrom. But in cases where cellars or lots which contain water 
require to be made water-tight or drained, then a Board of Inspec- 
tion is convened, which consists of the mayor of the city and four 
members of the Board of Health, whose decision is confirmed al- 
ways by council, and promptly put into execution. It is the duty of 
the Medical Committee to be the medical advisers of the Board; and 
of the City Register, who is chairman ex officio and clerk of the 
General Board, to keep the meteorological observations, the bills of 
mortality, births, and marriages, as far as practicable, and see that 
nuisances are removed from premises. The system of our Board 
of Health, which has been thoroughly organized since 1840, has 
worked so well as to have enabled that body to act with energy 
and efficiency in removing everything deemed likely to produce or 
aggravate epidemic disease ; and our annual bills of mortality will 
show the diminution of mortality, and likewise, that we have not 
had yellow fever prevailing among us since 1839. In 1838 and 
’39, there were abundant causes for the existence and prevalence of 
yellow' fever. One-third of the city was burnt in the spring of 1838, 
causing the exposure of an immense surface, leaving cellars and vast 
masses of burnt up materials exposed to the rain and sun, and which 
could not easily be removed; add to this, a great number of arti- 
sans, from the North and elsewhere, came to Charleston (as labourers 
of that kind were in demand) to rebuild the city ; and these, from 
■want of houses, crowded together, and badly accommodated. From 589 
the statement, it will be perceived that it would have been wonder- 
ful, with these predisposing and exciting causes, should yellow fever 
not have occurred in these years. A circumstance worthy of consi- 
deration is that, in 1838, of 354 cases of yellow fever, 340 were 
strangers, and only 14 natives, under 14 years of age. In 1839, of 
134 cases, 124 were strangers and only 8 children under 14— 
strongly evincing how the acclimated are protected, and the real 
causes of the disease in 1838 and ’39. 
I will now give you a statement of the plan of internal medical 
police. 1st. Cellars are required to be filled up or kept perfectly 
dry. This we regard as of great importance in our damp and low 
locality; and no cellars are allowed in houses to be built. 2d. All 
lots, except tide-lots, where the salt water ebbs and flows, are required 
to be thoroughly drained, or, if too low to be drained, then to be filled 
up. 3d. Our streets generally have subterraneous drains, into which 
the smaller drains from the various lots open; and in the main-drain, 
grates in the centre of the streets wrere placed. Much evil was occa- 
sioned by this arrangement, for much of the earth of the streets was 
thus thrown into the drains, choking them up and causing the water 
after heavy rains to remain in the street, and likewise regurgitating 
upon the lots, they not having free vent, and, above all, an accu- 
mulation of filth in the drains which caused much expense to cleanse, 
and exposed an immense mass of foul material, stagnant in the 
drains, to the external surface. A new system since 1840, from 
whence we date the improvement of Charleston, has taken place, 
viz., to convex the streets either with stone or some other hard 
materials, and to construct drains at either side of the streets, by 
which a rush of wrnter passes into the main drains without solid 
refuse, cleansing and purifying them; this system is progressively 
advancing. 4th. All offals are daily removed, by the superintendent 
of streets, from the respective residences. Efforts have been made 
to induce the citizens to have their cemeteries beyond the city; but 
the strong associations connected with the family burial-grounds in 
the churches rendered it impracticable to use any than recom- 
mendatory measures, which have proved unavailing. But an ordi- 
nance was passed by council in 1836, forbidding burial-grounds 
hereafter to be established in our city. The Second Baptist Church, 
in contravention of this law, buried some dead in the yard connected 
with their church; it became a matter of litigation, the discussion of 
which is still pending. 
We have regarded these measures as highly important in medical 590 
police, and the plan will, doubtless, bo progressively prosecuted, and 
I really think it has much to do with the continuance for years of 
health in our city. The authorities are attending, as you know, to 
another point—a plentiful supply of pure water, so important to the 
health of the city. I have thus, my dear doctor, given you a suc- 
cinct view of our medical police; you being in possession of our 
official documents. 
I am, with much esteem, 
THOMAS Y. SIMONS, M.D., 
Chairman of Board of Health and Port Physician. H.—9. 
Sanitary Report ofNeiv Orleans, La. By Edward II. Barton, M. D. 
New Orleans is situated in latitude 29° 57' 30" N., and lono-i- 
tude 13° 9' W. from Washington, on the alluvion hanks of the 
Mississippi (the longest and swiftest river, susceptible of more exten- 
sive navigation, and draining a larger surface of country, than any 
on earth), and about one hundred and ten miles from its mouth, by 
the meandering course of the stream, and about ninety in a geogra- 
phical line. It is protected from inundation by the great stream 
that glides by its front, at the rate of four and a half miles per hour 
in the thread of the current, during high water, and four and a 
quarter miles at low water, by a levee or embankment, about nine 
feet higher than it is a few squares back; and the city descends by a 
gentle slope to the swamps and draining canals in the rear, com- 
mencing about distant from the levee, where the surface of 
the swamp is feet below high water mark; but which is 
now kept several feet (four to five) above water mark, by the Drain- 
ing Company; all of which will clearly appear by reference to the 
line of levels annexed (vide Appendix A), from the river through 
the centre of the city to the Bayou St. John. 
The geological formation of the soil .on which the city is built, is 
alluvial; the surface and subsoil, to a great extent, being composed 
of the deposits of the river. In some places, beds of pure white 
sand occur, at a depth of six to ten feet, showing the former posi- 
tions occupied by the waters of the gulf. The height of the ground 
on the river bank is about fourteen feet above the level of ordinary 
wrater in the gulf. The river usually commences its rise about the 
last of November, attains its maximum elevation in March, remain- 
ing thus until the latter part of May, then falls more rapidly than 
it arose, till about the latter part of September, and remains sta- 
tionary until the autumnal rise. 
The city occupies a front on the river of about five miles, by an 
average breadth of about three-quarters of a mile. It is bounded 592 
on the north by a cypress swamp, of about five miles in breadth, 
where it reaches Lake Pontchartrain, a large body of water extending 
due north about twenty-five miles, and east and west from its centre 
about twenty miles. The Mississippi River runs south of east from New 
Orleans about twelve miles, and the balance of its course south-east 
to the Balize. It is bounded to the east by plantations and swamps 
covered with forest, to Lake Borgne, an arm of the sea fifteen miles 
distant, of about fifteen miles of irregular diameter. On the south, 
it is bounded by the Mississippi River, across which are cleared land, 
and swamps covered with forest growth, to Lake Ouacha (a body of 
water, about five miles wide, and eighteen long, extending to the 
south-west, and thence to the sea, it is forty to fifty miles); and it is 
bounded due west by the meanderings of the river, fine cultivated 
estates, and forest growth for about eighty miles. 
The prevailing winds, during ivinter, are, according to respective 
prevalence, from E., N., andN.W.; during spring, from E., S., S.E.; 
during summer, from S.E., E., and S.; and during autumn, N., E., 
and N.E. A perfectly calm atmosphere is very rarely noted; result- 
ing, no doubt, from our alternations of land and water, and the rapid 
current of the Mississippi before so large a surface of the city. It 
has been remarked as a fact, pregnant with great consequence to us, 
that, as the forest is cleared back towards, and covering the swamps, 
and to the lake, there is more air stirring, and less disposition to 
stagnation ; and with the drainage there is less moisture, and the land 
rises. The ventilation of the city is not at all defective; the streets 
are nearly all at right angles (there are few or no blind alleys), of 
the average width of betAveen thirty to forty feet; four or five of 
them being upwards of one hundred feet, and most of these planted 
with trees. There are six public squares, most appropriately 
termed the “lungs of large cities,” and all the streets would be in 
some measure entitled to the same beneficent appellation, were they 
planted with forest growth. Owing to the warmth of the climate, 
the houses are extremely well ventilated, even those of the poor, 
with but few exceptions in and about the centre, and near the mar- 
kets, occupied by small traders and emigrants, mostly foreigners; 
but in general, the labouring population is comfortably provided 
for, if at all provident; for, such is the facility of acquiring here the 
necessaries, and even comforts, nay, luxuries of life, and in a few 
years, a competency, that nearly all provident, temperate people 
find little difficulty in doing so; the wages of labour, and particu- 593 
larly mechanical labour, are in great demand, very high, and sup- 
port not costly. 
The average annual quantity of RAIN, falling in this city, is about 
fifty-two inches ; and although there is no proper rainy season—for, 
some years, there is just as much falling during one-half of the year 
as the other—yet in a long series of years (say ten, that I have over- 
looked my meteorological register for), there was a larger quantity 
falling in the winter, the next was in the summer, the next was dur- 
ing the spring, and the driest season wras clearly and palpably the 
autumn. But, as the hygrometric condition of the atmosphere is 
but poorly estimated by the quantity of rain that falls from it, for 
sometimes it is directly the reverse, I have constructed a chart, ex- 
hibiting these often opposite conditions (vide Appendix C), where 
this is seen at a glance, and also the thermometric and barometric 
variations, with their respective relations to each other. 
The average temperature of our winter months is 53.TT; of the 
spring, 67.76; of the summer, 79.27; and of the autumn, 67.51; 
making an annual average of 67.07, almost that perfect temperature 
thought to be most agreeable and salubrious to man. The thermo- 
meter rarely reaches 90° in a fair exposure, during the summer, and 
during the winter seldom descends below 30°. The average daily 
range, throughout the year, is near 10°. In more southern tropical 
regions, where these variations of temperature are unknown, the 
constitutions of the natives are rendered delicate and most sensitive, 
by a uniforn continuance of a high atmospheric temperature, and if 
a fall of the thermometer of from 2° to 5° is experienced, serious 
consequences to comfort, and even health, are experienced. These 
changes are essential to vigour of constitution, and it would be a 
great blessing were they much greater. The nights are cool and 
pleasant; and with more attention to the construction of our houses, 
to adapt them to our climate, the sleeping rooms in summer facing 
the southern quarters, whence there is almost every night a body of 
air stirring; and planting trees in the principal streets, the heat 
would be much less, radiation from the brick buildings would be 
arrested, the air purified, and the great extreme at midday and 
towards night, almost thoroughly controlled. 
The effects of planting trees in the streets, and of the multiplication 
of public squares, are wmll-established facts, of which there is now 
no dispute; experience here is too strong even for theory. A state- 
ment was published here some years ago, by one of our most respect- 
able journals (The New Orleans Delta), and said “to be derived 594 
from one of the old respectable inhabitants, and one of the chief 
magistrates of the city,” that there had rarely “ occurred a death 
on the Place d’Armes, in twenty-five years.” This is the most beau- 
tiful public square in the city, and on two of its sides has a dense 
population. The influence of luxuriant foliage and abundant shade 
in the public squares and streets of large cities, and particularly 
southern ones, is susceptible of very easy explanation; they absorb 
deleterious gases, and receive or prevent that reflected heat from 
brick houses, which is so oppressive to those who cannot otherwise 
escape their influence; and they hence assist in likening a city to 
the country, between which there is so great a discrepancy in 
mortality, and the difference is mainly in ventilation, shade, and 
foliage. 
Truly, this may be considered a “ sunny climate,” for of a series 
of observations, extending into many years, in reference to “ clear,” 
“cloudy,” and “ rainy,” from my meteorological journal, more than 
two hundred and forty days were registered “clear,” seventy odd 
“ cloudy,” and about thirty “rainy” (of the three hundred and fifty 
noted). And from consulting a register kept here more than forty 
years ago, the “clear” days have greatly increased since that 
period; there is much less moisture in the atmosphere, less rain fall- 
ing, and fewer storms; the winds diminished in strength, and more 
regular, the heat sensibly less, and the climate, in many respects, 
greatly ameliorated. All this has resulted, doubtless, from cutting 
down the forest growth of the neighbourhood, clearing, cultivating, 
and “subduing” the land to the purposes of man, and instituting 
that system of drainage that is destined to give this country all the 
advantages of an elevated champaign country, together with its own, 
of incomparable fertility, as much moisture as is needed for the pur- 
poses of agriculture and health, with the assurance of ample ventila- 
tion. For more particular reference to the meteorology of New 
Orleans, I refer to Appendix B and C, embracing an average of 
three years (anterior to 1843), containing a pretty fair estimate of 
the climate. 
From all the exhibits, then, in relation to ventilation, it is ap- 
parent that the mortality of the climate arises from no noxious 
principle derived from stagnation of air, and that we are located in 
that happy medium, removed from the violence of the winds of the 
tropics, where the natives seem to dread it more than almost any- 
thing else, from their greatly enhanced susceptibility of nervous 
system, and the frequent stagnation of temperate regions. Here,r 595 
then, there is nothing stagnant, neither the elements nor man; 
though the latter is too “ go-ahead” for his interests or his health. 
The city is now drained from its surface, which is extremely im- 
perfect, and in this climate highly objectionable. The gutters are 
cleared by rains; by letting in water from the river at particular 
points at certain stages of elevation; by a steam engine in the First 
Municipality, for the streets appertaining to it and running perpen- 
dicular to the river; and very partially by the Water Works Co., 
and all most imperfectly done. The mode of removing ordinary street 
accumulations, from constant filling up of the gutters, and the mud 
pressed up from a most imperfect system of paving, with large irregu- 
lar pebbles, on a moist mud substratum, is, to throw or scrape it up 
from the gutters, and about the surface into the streets, in heaps, for 
its more fluid parts to drain off, and then, after abundant exposure 
to the sun, it is carried off in uncovered carts, from time to time 
to the rear, to fill it up, at great expense to the city, and at some 
offence to our olfactories. The law now requires all offal from the 
houses to be thrown into the river, instead of the back lots, which 
it aided in filling up, at no expense of health to the vicinage, but 
sometimes offensive to smell. It is all most imperfectly carried out. 
Time does not permit me to go into a system of drainage and 
sewerage, that is demonstrable, from effects already produced on 
the swamps in the neighbourhood, can make this city as dry, and, 
with the water power and convenience unparalleled, always at com- 
mand, and at small expense, as clean as need be. It is my duty to 
allude to it, however briefly. It will be seen, from Appendix A, 
of a profile line of levels, that the river, at high water, is about 
fourteen feet above the level of the swamps, and that the Draining 
Co. has actually drained five feet below this. So we have here up- 
wards of fifteen feet from the level of some of our principal streets, 
in a distance of half a mile to a mile, for the most perfect system 
of drainage and sewerage that need be required. And it is a fact 
well known to us all, that boggy swamps that could not be passed 
through a very few years ago, by man, and scarcely by beast, and 
only inhabited by amphibious reptiles, are now high, dry, cultivated, 
and prepared for the residence of man, not only without consequences 
injurious to health, by the exposure of such a surface to the light of 
day and the winds of heaven, but greatly ameliorated by this increased 
ventilation. The moisture has sensibly diminished, and the ground 
has evidently risen (one of our oldest surveyors, who has been per- 
sonally conversant with it for more than forty years, thinks) more 596 
than ten inches. This invaluable company, which has accomplished 
so much, and can accomplish so much more for this city, was incor- 
porated in 1835, and has been steadily pursuing its great destined 
object since, under numerous difficulties, with an intelligent engineer 
corps and directory. It has drained the First, Third, and part of 
the Second Municipalities, by digging extensive canals and ditches, 
to lead the water to their reservoirs, where are located their steam- 
engines, embracing in their range a certain section of ground, which 
is first levelled to prevent back water from the lake to reach it by the 
natural drains; the water is now pumped out of these sections, from 
these reservoirs, into these natural drains, and thence flows to the 
lake. These extensive sections, embracing an area of over two 
miles in diameter, are now free from water, even soon after the 
heaviest rains; and most of it is cleared and much built upon; and 
with its proposed labours of drainage, and clearing the forest growth 
to the lake, will accomplish more for the comfort and salubrity of 
New Orleans than all other improvements combined, not excepting 
paving. 
Most of the principal business streets, to six or seven blocks hack 
from the river, are paved, and some of those perpendicular to the 
river much farther back ; it is done mostly with round stones, which, 
on such a subsoil, require constant expensive repairs in moist 
weather. The balance, or half the city, is unpaved, and is easily 
and soon cut up, in wet weather, by ordinary usage. Now the 
sewerage and drainage, properly conducted, would dry the subsoil, 
remove all offensive smells and sights, keep the lots and surface dry, 
and take off a very large proportion of the expense in cleansing and 
repairing the streets. It has already had so much effect on the 
burial-grounds in the rear of the city, that the dead can he placed 
under ground, where formerly you could not dig six inches from the 
surface without coming to water; and, consequently, the dead had 
to he buried in brick tombs (or the coffins sunk below the surface of 
the water by boring holes in them), which, in this climate, in a few 
years give way, impairing the purity of the atmosphere. It would 
also make the climate more dry, and prevent all the consequences 
injurious to health, merchandise, business, or pleasure, from being 
in excess. 
These wonderful results are destined to be carried out to their 
utmost extent, by our successors, by those who shall have grown 
wiser by our omissions, who shall be warned by the catacombs of 
victims our negligence (not poverty—not ignorance) has caused, 597 
and who shall properly appreciate the inestimable position of New 
Orleans. It is notorious that all the large cities of America are 
underdrained, and also in England, and on the Continent of Europe, 
and so vitally important has it proved to be to health by most valua- 
ble experience, that it is notorious in many cities, where these drains 
exist, the inhabitants are almost exempt from fever, and where they 
exist not, there is fever ! The towns along the river Po, the fens of 
England, and the low grounds of Holland, are all situated as New 
Orleans is, where the source of the water, and to which it is to be 
elevated, are all above the surface to be drained. If the indefati- 
gable Hollander has seized from the ravages of the ocean, and the 
others converted swamps into rich fields, and appropriated them to 
the use of man, in comparatively inhospitable climes, and under 
governments where the rights of man are comparatively in their 
infancy, how much greater reason have we to appropriate from the 
“father of waters” a portion of the otherwise waste swamp—now, 
or but lately, a hotbed of disease, of the richest soil and finest cli- 
mate in America, and under civil institutions, where man is blessed 
with every privilege he can enjoy. 
The city is supplied by water, for potable purposes, by a com- 
pany which was incorporated by the legislature in 1833, and began 
to furnish water to the city in 1837. It now has its pipes extended 
through various parts of the city, to the extent of thirty-seven and 
three-quarter miles. The engine by which the water is pumped from 
the river, is situated, with the reservoir, in the upper part of the 
city; the mound on which the basin is built is two squares back 
from the river, twenty-five feet above the adjoining streets; its area 
is 320 feet square, is divided into four compartments, each one suc- 
cessively supplying the city, while the sediment is being deposited 
from the others; it is capable of holding four millions of gallons of 
water, and the engine can pump up from the river daily, six millions 
of gallons of water. The cost has been upwards of a million of 
dollars. 
There are yet but few manufacturing establishments here: one 
for cotton, several for spirit gas, one paper mill, extensive forges, 
and on the opposite side of the river several ship-yards, and floating 
dry-docks. 
The city is well lighted with gas, and the pipes extend near thirty- 
four miles, at an original cost of $800,000, and an annual expense 
of about $100,000. 
Probably no city is more bountifully supplied with aid for the sick 598 
during epidemics; associations for their relief are extended with a 
true Samaritan spirit all over the city, and thousands upon thousands 
are distributed with no stinting hand. The large Charity Hospital 
is at all times open to those asking its eleemosynary assistance, and 
on an average of the last three years, near 9000 beneficiaries per 
annum have there found an asylum, with every appliance that hu- 
manity or science could desire, or charity ask for; and at an annual 
expense of about $56,000 per annum, derived most appropriately, 
principally from a tax on passengers, balls, and places of public 
amusement. There are three private hospitals for the accommoda- 
tion of the sick, besides an elegant U. S. Marine Hospital on the 
opposite side of the river, intended for the commercial marine. 
There are two canals connecting the city with Lake Pontchartrain, 
the avenues of an extensive inland or coast commerce; and two rail- 
roads, one to Lake Pontchartrain, and the other to Carrolton, a town 
of about 1200 inhabitants, distant by the river about twelve miles; on 
the trajdt of this road (about four miles) are fine seats for our wealthy 
citizens, and the country in the vicinage has numerous country resi- 
dences for ease, health, and pleasure. The roads or drives in the 
neighbourhood of the city, during dry weather, are numerous and 
fine, and conduce much to health. 
There are few subjects more cherished here than that primary one 
of education; receiving its impetus about eight years since, from 
the enlightened, intelligent zeal of Alderman Peters, and Recorder 
Baldwin, assisted by an intelligent municipal council, and public- 
spirited citizens. The holy feeling was ere long caught by our 
neighbours below—of the 1st, 2d, and 3d municipalities; and now the 
whole south of the city is, or may be, taught at the public schools, 
at the public expense. The system now works well; the rich and 
poor all receive together, the inestimable blessing of education; and 
here first imbibe that valuable practical political axiom of equality, 
as at the altar of their God. Commencing with a few scholars in 
1841, there are now over 5000 in the primary, intermediate, and 
high schools; there are probably 1000 in private schools, and about 
500 taught at their homes by private teachers. It may be seen how 
the value of this boon is estimated, when, according to the returned 
assessment, there were but about 10,000 of the proper age (between 
six and sixteen), in the school limits; it is then truly esteemed here 
a public blessing, and considered a sacred public duty to foster it; 
and, as such, it has been incorporated into the State Constitution. 
It may be mentioned, to the high honour of this young State, where 599 
the easy accumulation of property is so constantly seducing one to 
mammon by its alluring temptations, that more money has been 
spent in attempts to foster the interests of education, in proportion 
to its white population, than any other in the Union. The revenue 
for their support is derived from a tax of one mill on every dollar 
of the cash value of property on the rolls, besides a poll tax; and 
there is spent in this city, for these purposes, about $185,000 per 
annum. Libraries are being formed, attached to them, to foster and 
encourage a taste for reading, that admirable asylum, refuge, and 
protection against improper company; that of the 2d municipality 
already reaching upwards of 8000 volumes. 
The vital statistics of New Orleans constitute a problem, and a 
very important one, that never has been solved; and I approach the 
subject with great humility and unaffected diffidence, statements hav- 
ing been made in relation to them, at variance with the now (I be- 
lieve) ascertained facts; the true data have been heretofore want- 
ing—the primary bases of all calculation, viz., the number of the 
living, and the number of the dead. 
Of the first, we have to presume the U. States census for 1830 to 
be correct; that of 1840 [the cause of all the errors), we now know 
was not; a census was made in 1847;* it was partially correct only; 
the entire population almost certainly was not given; and then there 
were no details of ages, &c., and of course no basis for calculating 
the average age of the living; so I have taken these for 1830 as my 
basis, and calculated it at twenty-four years one month. In the 
census for 1847, none but strict family residents were taken; the thou- 
* This is presumed to be as near correctness as we could acquire under the circum- 
stances; by the U. States census of 1840, the population was stated to be 102,204; the 
over-estimate was supposed to have arisen from some vile political, or pecuniary purposes, 
and all the calculations in relation to the health, since, have been based upon it. To 
see how far this census differed from or corresponded with that of 1830, to find out where 
was the source of error (my only resource left), I calculated the average age of the liv- 
ing, according to it, to compare it with that of 1830, and found it differed but a few 
months, that of 1830 being as above, 24 years and 1 month, and this 24 years 10 months. 
It particularly becomes me to expose this vile fraud, because I have been made the in- 
nocent victim of propagating errors, in relation to the sanitary condition here, to the 
public, based on it, on which some reliance may have been placed, and I seize the first 
opportunity to wash my hands of the imposition. Nevertheless, error or not, New Or- 
leans has been more rapidly on the increase than any large city in America, New York 
excepted, for, on the lowest estimate, it has been at the rate of 5.32 per cent, annu- 
ally, since 1830; (the American portion, the 2d Municipality, more than doubling itself 
in twelve years !) while between 1830 and 1840, by the U. S. census, from the calculation 
of a friend, Philadelphia has increased 3.67 per cent., Boston 3.45, Baltimore 2.69, 
and New York but 5.81. 600 
sands that count New Orleans their homes, and are occasionally ab- 
sent, were left out entirely; such, we know, was not the case elsewhere. 
I have, accordingly, on the best advice, added only 5000 for this 
large population, to enable me to make my ratios as correct as pos- 
sible. 
But there is a large class, the floating population, not enume- 
rated in the census, that furnishes a very large per centage of our 
annual mortality, estimated, by those best entitled to judge, to 
amount to between 20,000 and 30,000, adding probably about one- 
fifth to our mortality, as is proved by the returns from the Charity 
Hospital for the last eight years, constituting one-fifth of the entire 
mortality, those from Louisiana forming from one to three per cent, 
of the admissions; besides this, there is a large number of strangers 
who die here, that our cemetery records do not specify as “ non-re- 
sidents.” By reference to Appendix D, it will he seen that I have 
merely corrected the census of that year by adding the small num- 
ber of 5000, making it 100,028, and the mortality the average of 
eight years, 5177, or one in 19.32, embracing all the yellow fever 
cases I could ascertain, viz., 5910! embracing also some of the 
sickliest years that the city has known ; to show how this varies, the 
mortality in 1845 was one in 33.07. I have added in that table va- 
rious comparative data of other cities, which will not be found with- 
out their interest. 
A still greater difficulty remains in relation to the dead. I have 
laboured many years to acquire something like truth and certainty 
on this subject, and I think I am entitled to the credit of rescuing 
from oblivion some ten or fifteen years of the records of mortality 
which had been surreptitiously made way with. I have collected 
now the mortality for about forty years; but then there is wranting 
those valuable details of special diseases, ages, and periods of resi- 
dence, &c., which should give it its greatest value; to be sure, I have 
some of these, and must make the best use of them I can: but it is 
impossible, without procuring the requisite materials, to give that 
accurate estimate of the “expectation of life,” or its “value,” or 
such a view of the true sanitary aspect of the climate, which is so much 
needed by the statistician, the insurer on lives, or him who wishes 
to know the risks he runs in coming here before he ventures, nor 
does time permit me to use, in a proper manner, all the materials 
I have collected. 
The vital statistics of this great city in embryo, and of course 
what may ameliorate it, are of the last importance to the citizen, the 601 
patriot, and the philanthropist. I do not wish to dodge what may 
and must be considered a large mortality: but it is due to truth, to 
science, and to the place; to all those great interests involved—and 
not merely the local ones, to those who live here themselves, and 
expect to raise their families here, or those whose property is here, 
on whose proceeds they are luxuriating in other climes—but to 
more than half this great confederacy, who are deeply interested in 
this great entrepot, for which there can be no substitute—to make 
such explanations as to put fairly before the eyes of the public, and 
their servants and agents (the public authorities), to amend errors, 
correct defects, and to make such improvements as the country re- 
quires, and the climate (if bad) is susceptible of. Is this climate, 
then, lethale per se? does it belong to its position? and is it irreme- 
diable? Or, does it spring, in any measure, from habits and customs 
that are incompatible with the climate? These are questions of the 
last importance to us, to the American people, and to science. I 
enter into the very limited discussion of these great questions with 
a deep conviction that the facts demonstrating the convictions I feel 
are correct. I have fruitlessly sought everything bearing upon this 
subject for years, and though I have gathered sufficient to satisfy 
my own mind, and, I think, most that are open to the truth and un- 
prejudiced; yet there are some gaps in my investigations, that may 
fail to produce on other minds that conviction arising from demon- 
stration. 
That diseases, or what may be called unhealthy years, occur in 
cycles of irregular return, is well known in the historical records of 
nations, in our country, as well as in others, and even among na- 
tions whose condition may be considered stationary; in many, they 
are doubtless much influenced by the agency of man; that various 
parts of our own country are being, and have been, constantly in- 
fluenced by these means, is doubtless true: it is within my own re- 
collection, and thousands now living, of various parts of our own 
State, where the mortality is now much less than half of what it was 
when passing through what may be termed its transition state, or 
that from its primeval, or forest state, to that fit for the purposes of 
man, and arrived at it, and made so by clearing, draining, and cul- 
tivating the land, is unquestionable. It is a general fact, that, as a 
country becomes cleared of its forest growth, and exposed to the in- 
fluence of the sun, there is a diminished annual fall of rain; how it 
has been for the last four or five years here, I cannot say, from my 
own observations, as I have been absent—travelling,—but, upon a 
vol. ii.—39 602 
comparison of journals kept here some forty years ago, and the 
recollection of the older inhabitants, compared ■with my own observa- 
tions up to 1844, there is no doubt that this is true here also. Such 
experience is applicable to the whole of our western country, within 
the knowledge of the present generation, and that all our new States 
to this date, have been the graves of unnumbered thousands; nor is 
it to be now told, for the first time, that the pioneers of civilization 
are to be made the first victims to the numberless blessings to be 
inherited from their toils. Such, too, is the actual fact in relation 
to cities; old cities are wealthier, cseteris jiaribus, than new, and 
new parts of old cities are more unhealthy, generally speaking, than 
the old; new ships are often less favourable to health than those 
more old. Why, during this “transition state,” there should arise 
a condition unfavourable to health, is difficult to say; numberless 
theories have been invented by the ingenuity of man to account for 
it; most of the hypotheses of the miasmatists have had their origin 
here; it is so much easier and more soothing to one’s pride, if not 
conscience, to ascribe to some unknown, invisible agent, the cause of 
our diseases and afflictions, than to find fault with our own dear 
habits; that the various changes in all our various modes of life and 
our habits, the disrupture and vicissitudes to which all are thus sub- 
ject, tending to destroy that balance and equilibrium on which a 
continuance of health so essentially depends, is much more proba- 
ble, I have no doubt; for it would be almost impious to refer the 
greatly increased mortality to obeying one of the plainest of God’s 
commands, that “of subduing the earth,” and subjecting it to the 
purposes of man as a cause of disease! rather than to breaking his 
laws, and obeying our own passions and vicious inclinations. 
That there is a peculiar air hanging over and through cities, or 
all great aggregations of human beings, is probable enough; in- 
deed, every page of recorded time shows it; asthmatics feel it; the 
most sensible of our race feel it; children, delicate females, or those 
in delicate health: nay, who is insensible to the difference between 
country and city air ? Let any one leave a city, and go a few hun- 
dred yards, on land or water, and particularly the latter, to sea, and 
he will be immediately sensible of it. This is independent of 
mere ventilation. I have myself often experienced it, and particu- 
larly during my heavy duties at Vera Cruz, when surgeon of the 
U. S. Army at that place during the summer of 1847, when, in 
attendance on the shipping off and near the harbour—immaterial 
which way the wind blew, from sea or shore—the peculiar feeling of 603 
the stomach was not experienced until we reached some hundred 
yards from shore. There is an atmosphere about cities that is, in 
a great measure, very much independent of perflation, for an epi- 
demic will commence and be continued during, and in spite of, a rapid 
wind blowing all the time; that this is not from simple putrefaction, 
is apparent; that it is independent of, in the very face of winds that 
should directly blow it away, and which seems to be constantly chang- 
ing the atmosphere of the place; it does not exist most where all 
kinds of putrefaction most abound, as in barn-yards, cat-gut, and other 
manufactories, where animal and vegetable substances are constantly 
going through this process; in butcheries, swamps, &c. &c.; it ex- 
ists concentrated in filthy hospitals, where many diseases originate; 
others can scarcely be cured for it; it is eminently rife in blind 
alleys, cellars, and dirty houses, where there is a stagnant air: it 
prevails to a great extent wherever there is a defect of domestic and 
personal cleanliness, and probably more from the latter, than the 
former. Now it is evident the nearer we make the condition of a 
city approach the condition of the country, the more likely it will 
be to enjoy that salubrity which it enjoys over the city. 
To apply the results of this well-established principle to this 
city, it is but fair and just, that, until its neighbourhood shall be 
cleared, drained, and cultivated ; the sub-soil kept dry by sewerage; 
the streets properly paved with flat stones; the glare of the sun or 
reflected caloric controlled by planting trees, and particularly in the 
wider and less business streets; wide sheds built over our great 
thoroughfare (the levee, where the mass of the business is done, and, 
in a great measure, by people unaccustomed to the climate); the 
refreshing current established in our gutters, with an efficient police, 
with 'proper habits in the people, a large mortality will inevitably 
ensue, together with such an occasional epidemic, with its devastat- 
ing horrors, as will cast a lasting stigma on the salubrity of the place, 
and retard its permanent advancement to a prosperous and stable 
condition. When these improvements shall have been effected, I 
do not doubt its being made the healthiest large city in the Union, 
and, withal, one of the pleasantest places of residence. As yet, 
hygienic observances have done little for New Orleans. 
The actual mortality of this city by ratios (now only correctly 
stated), as compared with other cities (in appendix D), is certainly 
very large ;* but then it is evident, from the ages of those who die, 
* “ The exposure of the mortality of New Orleans, if made years ago, might have 
had the same influence as a similar discovery made through statistical records in Eng- 604 
and from their short residence here, and from their course of life— 
not at all adapted to the climate—it is perfectly evident that the 
climate per se has less to do with it than other conditions. That man 
must mould his habits of living to the climate—or the climate to 
them—is as palpably evident as any proposition in Euclid; or that 
the same course of life is not equally adapted to all climates. Now, 
as it is somewhat difficult to accomplish the latter, he had better 
pursue the part of wdsdom and discretion, and adapt himself to the 
former. “Mould to its manners his obsequious frame, and mitigate 
the ills he cannot shun.” Man, in fact, is the only animal that can 
adapt himself to all climates, and he does it by the exercise of that 
intelligence with which the Great Father of all has endowed him, 
by: 1st, exercising that great principle of temperance in all things, 
characterized in the Holy Book as of such vital importance; and 
then, 2d, adopting the rational habits of the natives of the dif- 
ferent climes to which he proposes to adapt himself. Now, with the 
native, or well acclimated population, the mortality is very small; 
to the two extremes of infantile life and advanced age, it is extreme- 
ly kind; to middle life, the male sex, and the over-free, hard, and 
rapid liver, it is obnoxious. That all these are undeniable facts, the 
records will show. 
To prove that this large mortality does not proceed from the cli- 
mate necessarily, we have a most unanswerable argument derived 
from three sources. The first I shall mention, is to show the in- 
fluence of temperance on it: “ Civilization, which has done so much 
to mitigate the physical, as well as moral ills of life, and prolong 
existence, can hardly be debited, with but one exception to its in- 
numerable blessings. The modern art of distilling spirituous liquors, 
which has put such an unfortunate facility in the hands of the 
mass, who have so little control of themselves, may, by 
Eking from each infirmity that brings 
Untimely age on us,’ 
be that exception. The public exposure of the evil, by the publica- 
tion of the statistics of these societies, will open the eyes of the 
public to its magnitude, and force it to correct the evil.” 
I have received, on application, an official document from G. W. 
land and Massachusetts, by their invaluable registration laws, where situations supposed 
to be healthy (and who lives in a sickly place!!) were only found, by the corrected 
returns of the mortuary records, to be eminently the reverse, and by an examination 
into the causes and removal, a healthy condition may be restored.” 605 
Powell, Esq., Gr. W. P. of the Sons of Temperance in this city, ex- 
hibiting the mortality among the members of that body during the 
two last most fatal years known to this city, when it has been 
scourged by the combined influence of yellow fever and cholera, 
with an acknowledged mortality from them, during the period which 
this document embraces, of 5653! Of the 2427 members, there 
have died in two years, to the 1st of April (that is, from their com 
mencement to that date), but 29—or 1 in 83.41! This most valu- 
able report goes on further to state in detail, that, of this mortality, 
8 died of yellow fever, and 2 only of cholera—that about one-third 
of these deaths were of transient brethren visiting here for their 
health ! And, moreover, that nine-tenths of all these members were 
of that very age (between twenty and forty) most subject to the sup- 
posed malign influences of this climate ! 
It is said that figures cannot lie. There is no need of it here, for 
this I consider but a fair exponent of the effect of the clime on 
those who live according to the dictates of reason and prudence (in 
other wmrds, according to the rules of temperance). 
The second proof I shall mention bearing upon this subject, is 
the influence of the climate upon that sex who are proverbially tem- 
perate everywhere. Of the large mortality by yellow fever during 
the last eight years, but about one-seventh were females ! In rela- 
tion to other classes of fever, &c., in this country, my own expe- 
rience is equally expressive. Here, then, is another great proof, not 
only of the value of the principle, but a corroborating proof that 
the climate is not fatal per se. 
3d. But there is still another. It is now a well-established fact 
that incarceration in prison most fully protects the inmates from 
the yellow fever. Insulation can act only in one way; it protects 
from disease by controlling the habits of the individual, subjecting 
him to that course of regimen prescribed by the rules of the place, 
utterly incompatible with any kind of intemperance. 
“ In Mexico, the same immunity occurred with those incarcerated 
during the prevalence of cholera ; and, from the same cause, scarcely 
a case occurred among the temperate in its present visitation in New 
Orleans.” 
In all these cases, then, the same air is breathed by all, and they 
constitute a very fair test of the influence of the climate upon indi- 
viduals who live regular, prudent, and temperate lives. I believe 
such is its actual influence on the mass of those here who pursue 
such rules as a guide of life. I consider that document furnishes 606 
one of the most unanswerable arguments in favour of temperance and 
the climate that was ever published in this country, and is all that 
was wanting to put both upon their proper footing before the public. 
Temperance is a common virtue in nearly all tropical countries; 
stimulants of various kinds are used, but they are not of the diffusi- 
ble character of alcoholic drinks, being mostly of the class of condi- 
ments, supporting the action they excite. Mortality too soon follows 
in the footsteps of the inebriate for the natives of hot countries not 
to see the graves they would be thus digging for themselves : it is 
then mostly confined to the emigrants from northern nations who 
come to this country with the additional vigour of a more rigorous 
climate, who are alone able to stand it long; and with them, the 
mortality is greatly increased thereby. It is in vain to say—by 
those fond of indulging themselves—in the face of all these facts, 
that the free liver does not hasten his end. Thirty years’ ex- 
perience here, and in other more tropical regions, convinces me of 
its truth. All records go to prove it. My cotemporaries know full 
well, though this kind of life gives an appearance of fine ruddy 
health, that these appearances are deceptive; that they do not last 
many years; that ere long the system shows unequivocal signs of 
sinking, either by the occurrence of some form of stomach or bowel- 
complaint—by apoplexy, palsy, or some congenerous ailment, indi- 
cating the wearing out before their time of the organs essential to 
life. 
These are unpalatable and unpopular truths; but to my profes- 
sion belongs the important, though disagreeable task, as sentinels 
on the watch-tower of health, not only to point out the mode of curing, 
but often the more important one to communities, to indicate, for the 
sake of avoidance, the source of danger. To my personal knowledge, 
the medical profession here for the last thirty years has done its 
duty, and done it at every hazard to fame, to life, and to profit; 
and if their advice had been followed, New Orleans this day would 
be nearly as long ahead of its present destiny. It was the opinion 
of our distinguished countryman, Dr. Rush, that the medical pro- 
fession was about twenty to thirty years ahead of the public, in in- 
formation in relation to health; in that time, the public usually 
becomes sufficiently enlightened to estimate the value of hygienic 
laws, observances, and improvements, from time to time recom- 
mended by the profession. If a present outlay of a few thousands 
is more valued than human life, that outlay will be more than tenfold 
repaid by the increased value of property, by increased population, >5 J* J 
. . . 
of the levels of the high and low Traders in they Mississippi and. Bayou St John, which leads from they backport of the City 
to UikvBonbhartrcun and profile of the mclmmioas and, rise of lands front the I eves to fheJBtvyatu. 
New Orleans 3 February 1S40 (haslesseps. 
(ralvcz Street 
Terre des Lepraur Ridge 
Levee of the. drcwun <j Co. 
Levee Street 
Chartres „ 
Royal „ 
Bourbon .. 
DaapJun „ 
Burgundy „ 
Bempart ' „ 
Sic Claude .. 
Trane „ 
Marais „ 
ViUere' „ 
Robertson ,, 
'Claiborne 
Broad Street 
s 
S 
Hulk. water of 
they 
MssissippvBzv. 
er 
herelclLever SL 
Hurricane 1831. 
Hurrucuh '1ST. 
High water of 
Bayou 
Low water of the 
Baycu . 
Lowest water 
mark. 
Vertical Scale IP Feet to an- Inch 
Satie of lengths 1500Ieet to an Inch. 607 
and by a vast addition to our comforts.* If eternal vigilance is tbe 
price of liberty, why should it not be of health? I am fully aware 
that this country can never be entirely healthy, whatever may be 
its changes in its physical condition, unless the habits of the people 
are entirely adapted to it. I am not so Utopian as to believe that 
man will enjoy perpetual health, or live to extreme old age, anywhere; 
but the history of our species in all quarters of the globe, and at all 
times, will serve to show to the unprejudiced observer, that that 
great blessing is rather the reward of his adherence to the laws of 
hygiene than of external conditions, though these are of great im- 
portance, and essential to enable him to carry out, and put in execu- 
tion, some of the most important laws of hygiene, and especially 
in relation to dryness and moisture, ventilation, and exercise. 
* These important truths now find universal acceptation. “Whatever preserves 
health, serves society; for sickness, besides its vexation, occasions a loss of property and 
a loss of time, and often it involves both the property and the time of others.”—Ensor, 
London, 1818. 608 
THERMOMETER. 
4 observations per diem. 
BAROMETER. 
4 observations per diem. 
HYGROMETER. 
Once a day—at | 
midday. 
x\SPECT OF THE 
WEATHER. 
3 observations per 
diem. 
WINDS. 
3 observations per diem. 
MONTH. 
Average at 
sunrise. 
Average at 
miridav. 
U 
bo 
cS £ 
ii 
Average at 
10 o’clock 
at night. 
Highest. 
Lowest. 
Mean for 
! the month. 
General 
range. 
Average 
daily do. 
Average at 
sunrise. 
Average at 
midday. 
Average at 
sunset. 
Average at 
10 o’clock 
at night. 
Highest. 
1 
Lowest. 
Mean for 
the month. 
Monthly 
range. 
Highest. 
Lowest. 
Mean for 
the month. 
Range. 
Clear. 
3 
O 
5 
Rainy. 
Quantity 
of rain. 
* 
j N.E. 
W 
H 
(fj 
m 
| S.W. 
£ 
j N.W. 
Jan. 
53.04 
57.70 
53.53 
52.18 
74.33 
33. 
53.28 
41. 
10.59 
30.193 
30.113 
30.123 
30 103 
30 460 
29.790 
30.117 
.63 
68.21 
20.32 
49.66 
41.89 
16* 
7* 
5 
10.820 
7 
4* 
7* 
2* 
5* 
3* 
i* 
2 
Feb. 
53.57 
63.16 
59.44 
55.22 
74.33 
37.33 
57.93 
37. 
10.S9 
30.140 
30.143 
29.823 
30.127 
30.456 
29.860 
30.146 
.66 
69.42 
29 51 
50.92 
38 91 
17* 
8* 
2* 
6.890 
3* 
1* 
9* 
2* 
3* 
3 
i* 
3* 
Mar. 
60.12 
71.14 
65. 1 
62.92 
78.66 
51. 
65.00 
27.66 
8.68 
30.096 
30.040 
29.916 
29.956 
30.326 
29.823 
29.996 
60 
72.57 
32.03 
59.13 
35.54 
19* 
9* 
2* 
3.966 
4 
2* 
7* 
3* 
6* 
4 
i* 
1* 
April 
61.76 
76.25 
70.34 
68.54 
82.66 
57.33 
69.17 
25.33 
10 27 
30.110 
29.943 
30.090 
30.066 
30.273 
29.933 
30 040 
.35 
74.77 
48.92 
67.67 
29.18 
21 
3* 
1* 
4.918 
2*3 
8* 
4* 
6 
2* 
2 
2 
May 
69.30 
80.47 
73.82 
72.37 
84. 
59. 
74.23 
28. 
8.29 
30.110 
29.910 
30 093 
30.113 
30.326 
29.900 
30.096 
.43 
75.92 
53.67 
67.83 
22.58 
27 
3* 
1* 
2.963 
3*3 
7* 
2* 
4* 
4* 
1* 
3 
June 
74.37 
83.76 
7S.66 
73.78 
87.66 
10. 
77.82 
17.66 
9.98 
30.146 
30.060 
29.936 
30.113 
30.240 
29.800 
30.100 
.44 
78.57 
64.67 
73.78 
13.69 
23* 
3* 
3* 
3.954 
1*2 
7* 
3 
5* 
8* 
1* 
* 
July 
77.89 
83.90 
79.06 
79.02 
89.33 
72.66 
79.80 
16.66 
7 44 
30.143 
30.090 
30.136 
30.146 
30.226 
30 036 
30.143 
.19 
80.28 
72.33 
75.77 
7.95 
16* 
6* 
2* 
5.900 
3* 1* 
5* 
5 
8 
5* 
4* 
1 
Aug. 
75.20 
84.35 
79.30 
77.33 
87.66 
69. 
78.82 
19. 
8.80 
30.100 
30.113 
30.133 
30.116 
30 266 
30.020 
30 093 
.24 
78.9S 
60.99 
74 59 
11.99 
21 
4 
3* 
5.813 
4 
3 
6 
3 
2* 
5 
2* 
1* 
Sept. 
72.22 
80.70 
76.17 
74.61 
88. 
63.66 
75.92 
21. 
9.41 
30.150 
29.670 
30.086 
29.983 
30.190 
29 930 
30.006 
.25 
78.07 
59.92 
73.47 
1848 
17* 
8* 
2* 
3.930 
4*6 
11* 
2* 
2* 
1* 
1 
1 
Oct. 
62.98 
74.06 
68.03 
66.61 
80.66 
47. 
67.64 
34.35 
10.82 
30.110 
2 yrs. 
30.086 
30.123 
2 yrs. 
30.113 
2 yrs. 
30.376 
29.923 
30.113 
.48 
76.20 
44.69 
61 53 
34.98 
24 
4* 
2* 
2.840 
8*,4* 
11* 
1* 
0* 
0* 
1* 
2* 
Nov. 
51.10 
62.95 
56.26 
53.87 
75.66 
34. 
55.22 
41.66 
11.99 
30.100 
30.100 
30.205 
30.190 
30.443 
29.796 
30.200 
647 
70.73 
31.16 
52.04 
39.58 
22 
6 
2* 
2.370 
7*4* 
7 
1* 
2* 
2 
1 * 
3 
Dec. 
46.50 
57.95 
51.42 
47 62 
73 66 
34.33 
51.91 
40. 
11.60 
30.195 
30.183 
30.185 
30.160 
30.443 
29.986 
30.190 
.487 
62.26 
31.34 
46.54 
30.92 
19 
8* 
3* 
4.690 
8* 
3* 
6* 
2 
2* 
1 
2* 
3* 
67.22 
29.10 
9.93 
30.072 
.433 
245 
72 
29 
58.654 
APPENDIX B. M E TE OR O L O V,Y O' F YEW OBJ - E AN S. 
The Black lines indicate the Barometric Movement 
„ Blue v n n Tli eronome trie „ 
„ Yellow „ , „ Hygrometric „ or He wpoint taken oncea day ml'-.midday 
„ Bed * „ „ the monthly c/uemitty of Bain in lines orll//u'of inches. 
Haul 
The/no- Hygrometer by lines 
Barometer or 
msJw Dewpoint K^indus 
Inches. 
30.70# .96 SO 11.00 
05 . SO 
r M 04 .80 
jl S3 . 70 
S3 S3 . So 
600 SI .50 
SO SO .40 
89 . 30 
88 88 .so 
87 . 10 
5oo 88 88 io.oo 
85 . so 
84 84- .80 
83 . 70 
82. 82 .60 
400 81 . 50 
80 80 .40 
. 7S . 30 
78 78 .20 
77 . 10 
. 300 76 76 S. 00 
75 . SO 
74 74 .SO 
. 73 . 70 
72 72 . 6o 
200 71 . 50 
70 70 . 40 j 
69 . 3o 
68 68 .20 
67 .70 
-.700 66 66 S.00 
. 65 .90 
„ . 64 64 .80 
63 . 70 
62 68 . 6o 
-.30000 61 .50 
__5a. 60 60 40 
52 . 30 
58 58 .20 
_____ 57 JO 
900 56 56 7- 00 
55 . 90 
54 54 . So 
53 . 70 
52 52 . 6o 
800 51 . 50 
50 5o . 40 
49 .30 
48 48 .20 
47 . 70 
700 . 46 46 6.00 
45 . So 
44 44 . 80 
43 . 70 
42 42 .60 
600 47 . 50 
40 40 .40 
32 . 30 
_ 38 38 .20 
37 . io 
500 36 36 5.00 
_ 35 .90 
34 53 .80 
33 . 70 
32 32 .60 
—4oo 31 ____ .50 
30 30 .40 
29 . 30 
28 28 .20 
27 . 10 
300 '26 26 4 00 
25 .20 
24 24 . SO 
23 . 70 
22 22 . 60 
—200 21 . 50 
20 20 40 
79 . 30 
78 78 .20 
17 io 
79.760 16 76 3.00 
90 
U 74 .80 
. 70 
12 12 . 60 
29000 L_ . 5o 
10 70 . Io 
30 
8 8 .20 
. 10 
6 6 Z.oo 
ofthree yea nr J 
January. February. March. April. May. June July Any1 Septr Orlr JVovr Dec r 
* 609 
APPENDIX D. 
CITY. 
Popu- 
lation. 
| Year. 
Average 
age of the 
living. 
| Year. 
Ratio of 
deaths to 
popula- 
tion. 
Year. 
Average 
age at 
death. 
Year. 
Average 
annual 
deaths. 
For 
No. of 
years. 
years mo. 
yrs. mo. 
Boston 
114,366 
1845 
23 5 
1845 
1 in 48.87 
1845 
20 3 
1845 
1.919 
10 yrs. 
New York 
421.791 
1846 
23 1 
1840 
27.83 
Dr. Stevens 
18 
1846 
11.069 
lyr.’46 
Phil ad a. 
101,345 
1845 
24 1 
1840 
48.92 
1845 
19 11 
1845 
5.881 
’45-’46 
Whites 
’35—’45 
Baltimore 
124,331 
1848 
23 1 
1840 
29.37 
1848 
19 9 
1848 
3 253 
10 yrs. 
Whites 
Whites 
’35—’45 
Charleston 
29 261 
1640 
24 3 
1840 
4S.36 
1840 
35 lli 
1848 
.739 
10 yrs. 
Whites 
Whites 
’41—’41 
N. Orleans 
100.028 
1847 
24 1 
1830 
19.32 
1841—1848 
26 
'41-’48 
5.177 
8 yrs. 
Whites 
’36—’46 
Havana 
162.508 
1841 
28 
35.87 
1841 
4.568 
10 yrs. 
Vera Cruz 
5,500 
24 6 
1846 
Mexico 
170,000 
27.76 
1844 
6.122 
1844 
U. States 
22 2 
N. B.—In some of the cities, the population is estimated by adding 
the ratios of increase, where known. Of Yera Cruz and Mexico, I 
have seen no publication of the census; I was then told what I here 
state. 
The calculations have been made in great haste, and under many 
disadvantages. Mr. B. W. Cohen, of this city, has much aided in 
those relative to this place; and a kind friend, who would blush to 
see his name in print, has lent me much aid with the others. 
I have tried to make them correct. In the haste necessarily 
attendant on the entire preparation of this report, during a severe 
epidemic, I could only fill up its details by snatches of anxious 
moments, and it is thrown upon the charitable indulgence of my 
compeers. 610 
Statement of the Winds, in New Orleans, by Months and Seasons. 
APPENDIX E. 
AVERAGE NUMBER OF DAYS BLOWING FROM THE RESPECTIVE POINTS OF THE COMPASS, 
N. 
N.E. 
E. 
S.E. 
8. 
s.w. 
w. 
N.W. 
BY MONTHS. 
— 
— 
January 
6 
3f 
6* 
3* 
3 
2* 
2* 
2* 
February 
3* 
2 
5* 
3i 
2 
3* 
1* 
4* 
March 
3f 
2 
6* 
3* 
6* 
2f 
If 
2f 
April 
11 
2* 
7 
4} 
6* 
2* 
n 
3f 
May 
June 
July 
August 
2i 
H 
2* 
3| 
2f 
If 
If 
3* 
6 
5* 
5 
4f 
4* 
4f 
6 
4i 
5* 
4* 
6 
3* 
4* 
6* 
4* 
4 
H 
2f 
3* 
21 
2f 
If 
If 
2 
Being on an average of 8 
> years, viz., from 1835 to 
1842, inclusive. 
September 
5* 
5| 
6f 
2* 
2i 
H 
If 
2 
October 
6} 
5* 
6t 
H 
1 
Of 
H 
3* 
November 
8 
3 
4f 
3i 
2* 
If 
H 
3f 
December 
7* 
3f 
6 
2f 
2* 
If 
2* 
■4i 
J 
BY SEASONS. 
Winter 
Spring 
Summer 
6 
3 
2* 
3 
2f 
2f 
6 
6* 
5 
3 
4* 
5 
2* 
6* 
4* 
2* 
3f 
5f 
2 
H 
3 
4 
3 
2 
Average number of day’s- 
>> winds each month of the 
Autumn 
6f 
4f 
5f 
2 
H 
2* 
3 
J 
Winter 
m 
9* 
17* 
9* 
7i 
Of 
8* 
1U 
" 
Spring 
7} 
Of 
19i 
16 
18* 
9* 
41 
8* 
.Total number of day’s- 
Summer 
7t 
6f 
14* 
15i 
141 
141 
8* 
5* 
r winds each season. 
Autumn 
19f 
14 
17* 
7 
5| 
3f 
4* 
8* 
J 
Winter 
2d 
5 th 
1st 
4th 
6 th 
7th 
8th 
3d 
Spring 
6th 
7th 
1st 
3d 
2d 
4th 
8th 
5th 
Relative frequency of each 
Summer 
6th 
7th 
2d 
1st 
3d 
4th 
5 th 
8th 
( wind during each season. 
Autumn 
1st 
3d 
2d 
5th 
6th 
8th 
7th 
4th 
BY THE YEAR. 
2d 
5th 
1st 
3d 
4th 
6th 
8th 
7th 
Relative frequency of each 
Actual No. 
51* 
36* 
69i 
47i 
451 
34f 
24 f 
34 
wind during the year. 
Total number of day 
s noted having been 342*. 
Comparative Statement showing the Proportionate number at each 
interval of Ages, in every 10,000 Living, in Louisiana, America, 
and England. 
APPENDIX F. 
AGES. 
United 
States. 
Louisi- 
ana. 
New 
Orleans. 
England 
and 
Wales. 
United 
States. 
Louisi- 
ana. 
New 
Orleans. 
Engl and 
and 
Wales. 
Under 5 years 
1744 
1933 
1239 
1324 
5 and under 10 
1417 
1476 
1205 
1197 
10 
CC 
15 
1210 
1217 
940 
1089 
15 
cc 
20 
1001 
1032 
949 
997 
20 
cc 
30 
1816 
1882 
2158 
1780 
) 
30 
CC 
40 
1160 
1215 
1756 
1289 
> 3708 
3753 
4924 
4028 
40 
CC 
50 
732 
656 
1010 
959 
) 
50 
cc 
60 
436 
347 
433 
645 
60 
cc 
70 
245 
169 
192 
440 
70 
cc 
80 
113 
54 
81 
216 
80 
cc 
90 
32 
14 
27 
59 
90 and upwards 
4 
4 
8 
5 
100 and upwards 
1 
2 
10,000 
10,000 
10,000 
10,000 H.—10. 
Letter on the Sanitary Condition of Louisville, Ky. 
By L. P. Yandell, M. D. 
Dear Sir : I avail myself of my earliest leisure to reply to the 
questions proposed to me in your circular letter. In doing so, I 
shall not have it in my power to submit as many statistics as I could 
have wished to lay before the Association; but some of the facts 
which I shall be able to present have an important bearing upon 
public hygiene, and will not, I trust, prove wholly uninteresting to 
the profession. 
Louisville, in Kentucky, is situated on the south bank of the Ohio 
River, at the Falls, lat. 38° 3' N., long. 8° 45'W. from Washington 
City, on a beautiful plain, seventy feet above low water-mark, 
stretching back, and gently declining from the river. The plateau 
is constituted of sand and river gravel, intermingled with a tenacious 
clay, and reposes upon a friable shale, analogous in character to the 
Genesee, State of New York. The disintegration of this slate has 
imposed upon the Louisville plain its peculiar features. Everywhere, 
this rock forms a surface remarkable for its evenness; and the soil 
which it produces, as it crumbles under the action of the air, frost, 
and water, is peculiarly retentive of moisture. Ponds and slashes 
are abundant, wherever the black slate constitutes the surface rock. 
The first houses erected at the Falls, were built in the midst of 
ponds. Entire squares of the city are now pointed out, which oc- 
cupy the ancient beds of ponds, large, and deep enough to float a 
steamboat. These have all been drained, and such collections of 
water are now nowhere to be seen within the city limits. But, south 
of the city, and extending twenty miles to the mouth of Salt River, is 
a district of country known by the ominous name of the “ Pond 
Settlement,” which is still but partially reclaimed. The traveller, as 
he pursues-the public road in the direction of Nashville, sees on 
either hand a continuous chain of shallow ponds, until he reaches 
another formation, beyond Salt River. 
Louisville, March 15, 1849. 612 
Louisville is a flourishing city. In 1780, it contained a popula- 
tion of only thirty souls; and in the next twenty years the number 
of its inhabitants had increased to but six hundred. In 1820, it had 
reached four thousand; in 1830, ten thousand; now it may be stated 
at fifty thousand souls. 
The bed of the river, at the Falls, is composed, of the uppermost 
strata, of the gray, or cliff limestone, which, as well as the slate 
superimposed upon it, belongs to the Devonian system. The gray 
limestone is a compact rock, and its hardness at this point is increased 
by the immense infusion of fossil remains, chiefly corals; and the 
result is, that it yields slowly to the abrading action of water. The 
black slate originally overlapped it here. It is of a soft structure, 
and is rapidly worn away by the stream. In these facts, we have an 
explanation of the Falls. The river has washed away the destruc- 
tible slate, and its current follows the dip of the resisting limestone. 
The coral reef, and the superposition of the slate at this point, may 
be stated as the cause of the Falls of the Ohio. 
The plateau, which forms the site of the city, having a gentle 
slope from the river, gives a slight current to the water, which falls 
upon the surface, and slowly drains the ponds. No rock is near the 
surface, and consequently ditching is effected with facility. It has 
been carried on to a considerable extent; but much in that important 
line remains to be done. 
Louisville, while it stood amid its ponds, was regarded as one of 
the most sickly towns in the valley of the Mississippi. It was com- 
monly called u the graveyard of the west.” It is now esteemed one 
of the most healthy. Intermittent fever was a regular annual visit- 
ant; and occasionally a form of bilious fever prevailed, rivalling 
yellow fever in malignity, and threatening to depopulate the town. 
The most fatal of these endemics broke out in the summer of 1822, 
after a hot, rainy season. The number of victims from it, out of a 
population less than five thousand, was 232.* In a family, consist- 
ing of twenty persons, nineteen were sick at one time, and in some 
families, every individual died.f At this time, only one street in 
Louisville was paved, and within its limits were at least eight ponds 
of greater or less dimensions, most of which, in the course of the 
autumn, were dried up, exposing foul bottoms to the sun.J 
* Dr. J. P. Harrison, Philad. Med. Journ., vol. viii. 
t Collins’ Kentucky, p. 364. 
J Dr. J. P. Harrison, op. citat. 613 
Ten years after this fever had prevailed with such fatality, cholera 
appeared in Louisville. From the severity with which it had been 
visited by fevers, the citizens expected the approach of this pesti- 
lence with painful forebodings. But cholera proved milder in Louis- 
ville than in any of the neighbouring cities. Indeed, it hardly at 
any time assumed an epidemic character. When at its height, the 
daily average number of deaths from it were only about seven, as 
reported by the Board of Health. In Cincinnati, three hundred and 
fifty-one fatal cases occurred in twenty-seven days. On one day, forty- 
two persons died, or one out of every six hundred inhabitants then 
in the city. In Lexington, the mortality was still greater. This 
town, with a population not exceeding six thousand, lost five hun- 
dred of its inhabitants with cholera. In a single day, sixty deaths 
occurred, which was one to every hundred of its population, and one 
to every fifty actually in town. These facts are striking. It is not 
pretended that they establish the superiority of Louisville over its 
neighbours in respect to health. In the progress of cholera a second 
time, to which we are looking forward, the fate of the three cities 
maybe reversed; but the statistics afforded by its former prevalence 
are worthy of being noted. 
No fever approaching in malignity to the endemic of 1822, has 
ever since appeared in the city, nor, indeed, had one ever before 
appeared of so fatal a character. The citizens were awakened by 
this visitation to the importance of taking some measures for the re- 
moval of the causes of disease, and not long afterwards a system of 
internal improvements was instituted, which has been in operation 
ever since. The ponds have all disappeared. The streets have 
generally been paved, and though the grading is defective, and can 
never be as effectual for drainage as it might be rendered on a less 
even surface, still it is such as to carry off the rains into the river, 
and the ditch south of the city. In most of the gutters, water stands 
for some time after a rain, and, becoming green in the summer time, 
presents a forbidding appearance. But the quantity which thus col- 
lects in any one place is small, and I am not aware that disease has 
ever been traced to this source. 
The only parts of Louisville obnoxious to the charge of unhealth- 
fulness are its suburbs. Beargrass, a small, sluggish stream, with 
alluvial banks, which empties into the river at the foot of Third 
Street, taints the air in its neighbourhood. The ponds send up their 
* Dr. Drake, Western Journ. Med., vol. vi. p. 67. 614 
effluvia from the south; and the extended rock of the Falls, laid 
bare by the retreating river in dry seasons, exhales the poison of 
intermittent fever. The inhabitants along Beargrass, and of Water 
Street, and of the scattered dwellings in the outskirts of the city, 
are sorely afflicted with this fever. Now and then, a season passes 
without its occurrence; but it is looked for by people in these quar- 
ters, as well as by the residents of the country in the neighbourhood, 
as a regular visitant in autumn. The cause, howrever, is giving 
way, year by year, and the time is probably not far distant when the 
Pond Settlement will be reclaimed, as Louisville has been, from the 
dominion of malaria. The infected circle is receding. In 1837, 
it was not deemed safe to reside nearer the limits of the city than 
Walnut Street. Now Chestnut Street is considered healthy. As 
we go from the suburbs towards the crowded parts, the chances for 
health increase; and as the new streets are built up, a barrier to the 
fever poison is thrown around the older neighbourhoods. Hence, up 
to the present time, the growth of the city has been tending con- 
tinually to increase its salubrity. 
The streets and alleys are cleansed by hand, and with nearly equal 
care; but, owing either to the imperfection of the system, or to the 
inadequacy of the force employed, it would certainly be difficult to find 
anywhere more uncleanly lanes and thoroughfares than Louisville 
exhibits. The refuse from the houses is deposited in the streets and 
alleys, and, with the filth produced by every other cause, is allowed 
to accumulate in heaps, until the period comes around for the cart- 
ers to haul it away. One of the first things that strikes the eye 
of the stranger is the neglected condition of our streets. He won- 
ders how Louisville can be healthy, with such masses of putrescent 
matter in its midst. It may be doubted whether, in this respect, 
Louisville does not compare disadvantageously with any city of equal 
size in the country. 
The streets of the city are wide, and cross each other at right 
angles, which secures the most perfect ventilation, and favours their 
drying fast after rains. Many of the alleys are closed at one end, 
and on some of these a number of poor families reside who experi- 
ence the evils of confined air, in addition to the discomforts arising 
from the filth that must accumulate around their crowded dwellings. 
The houses of the poor are generally bad; not only small and badly 
ventilated, but built, the first floor on, or near the ground, so that 
they are damp and unwholesome. In the poorer quarters of the 
city, a family is generally to be found occupying each apart- 615 
ment of a building, and from five to ten persons will often be met 
with in a room. The houses, though so constructed as to prevent 
a free circulation of air, are so open as to expose the inmates to 
cold in winter, and wiien fuel is dear much suffering is experienced 
from this cause. They are warmed, for the most part, by stoves; 
but the more improvident poor are not supplied with this comfort, 
and such use open fireplaces. 
The public schools, twenty-four in number, are open to children 
at the age of six years, and all are crowded. The system is one 
which calls for reform in several particulars. Too many scholars 
are congregated in a room, either for health, or for mental or moral 
improvement. In some, there are as many as 130 ; and in none, 
less than 60. The largest rooms are not forty feet square, and 
many are of much smaller size. The children are kept in them 
from three to four hours in the morning, and two and a half to three 
hours in the afternoon. The long vacation is in summer, and lasts 
six or seven weeks. The health of the children is good. The 
number of teachers in the several schools is too small. It is not 
possible for the children to take exercise in the small yards con- 
nected with the schools, and they are consequently forced into the 
streets to enjoy it. Louisville, by a fatal oversight, neglected to 
provide grounds, when she might, for the exercise and recreation of 
her children, and now the opportunity has passed away. Fortu- 
nately, her streets are so wide that, planted as they are with fine 
trees, this evil will not be so sorely felt as it would be in cities less 
happily constructed. Broadway, when graded and set with trees, 
according to the plan which has been commenced, will afford a pro- 
menade as beautiful as could be desired. 
The Louisville Marine Hospital is the only receptacle for the sick 
in the city. It is a well-constructed charity, under the control of 
the city council, where marines especially are received and attended 
to, and clinical instruction is given to the students of the medical 
school. The means for ventilation in it, as well as in the other 
public buildings of the city, are effectual. In all the churches, the 
upper window-sashes can be lowered, in a way to afford circulation 
of air without draughts upon the congregation. 
The city is supplied with wmter from wells, which are from forty 
to sixty feet deep. After passing through beds of sand and gravel, 
a layer of tough clay is reached, upon which the water rests. It is 
largely impregnated with the salts of lime, especially the carbonate; 
and, in some of the more ancient wells, gives evidence of an old and 616 
crowded settlement. There has been, for several years, a project 
entertained for supplying the city with river water. Abundant as 
is the present supply, and excellent as is the quality of the water in 
most parts of the city, it is clear that the time is approaching when 
we must look to another source, and we are admonished, by the 
deterioration of the water on the first settled streets, that it is near 
at hand. 
From the statements given, it will be seen that the only promi- 
nent source of disease in the vicinity of Louisville is the marshy 
surface formed by the black slate, and that this source is being gra- 
dually dried up. It will strike the observer writh interest that the 
health of the city has gone on improving, pari y>assw, with the 
draining of the country. No doubt it would be better if the streets 
were more thoroughly cleansed, if the drainage were better; if less 
water stood upon the surface and in the gutters; if the houses of 
the poor were better built, and better ventilated; if there were open 
squares for the exercise of old and young; if we were supplied with 
pure water from the river: but, as we have seen, Louisville has been 
visited with no malignant fever for more than a quarter of a cen- 
tury. Cholera came in a form less fatal than that in which it 
appeared at Cincinnati, and far less than that in which it prevailed 
at Lexington. Typhus and typhoid fevers, Avhich have been preva- 
lent in those cities, and in many parts of the country, continue up 
to this day comparatively strangers here; and cholera infantum car- 
ried off more children in St. Louis in a week, a few summers since, 
than it did in Louisville in a month. My experience enables me 
to compare this city with Lexington, and with Nashville and Mur- 
freesborough, in Tennessee ; and I have no hesitation in saying that, 
as a residence for children, it is preferable to either of those towns. 
It would be difficult, indeed, to find a city where a more numerous 
infant population is exhibited on the streets, or where the children, 
in their ruddy complexions and vivacious movements, give better 
proofs of high health. 
Some years since, I drew the attention of the profession to the 
fact that, in the spread of cholera over the western country in 1832, 
and 1833, it was particularly fatal in those places where a limestone 
rock is the prevailing formation.* I have already alluded to the 
fact in this communication, and will simply add, that I have not 
been able to learn that the pestilence was fatal in any locality where 
* Western Journal, vol. vii. (new series), p. 152. 617 
the surface rock is sandstone or slate. If, in its future progress, 
the disease should be found to conform to this law, the fact will 
acquire great importance. In casting his eye over the country, 
Louisville, with its flat marshy surface, is the spot upon which the 
etiologist would have fixed as the one where cholera would exhibit 
its highest virulence, while Lexington had every prospect of escap- 
ing the pestilence. Lexington and Cincinnati, Versailles, Nashville, 
and Shelbyville, Tennessee, are all upon the same limestone, and 
cholera was fatal in all. New Albany, four miles below Louisville, 
on the opposite side of the river, but on the same geological forma- 
tion, afforded only a few cases of the disease. 
Very respectfully, yours, 
L. P. YANDELL. 
Louisville, March 15th, 1849. 
VOL. ii.—40 H.—11. 
Letter on the Sanitary Condition of Cincinnati. 
By J. P. Harrison, M. D. 
James Wynne, M. D., 
Chairman of Committee on Public Hygiene of the American Medical Association. 
Dear Sir: In answer to the questions submitted in your circular 
of May last, I beg leave to return the following replies: 
Question 1.—Population 110,000; the city is situated on the 
northern bank of the Ohio River; on the south, it is bounded by 
steep hills of ancient fossiliferous rocks, and on the eastern and 
western boundaries the hills jut in, leaving a space of only about 
two hundred yards free, between them and the river. The city stands 
on two terraces, the lower of which is liable to be inundated in very 
high floods of the river. These terraces are composed of sand, gravel, 
and loam—the deposited materials of a long prior overflow of the 
river. The soil is alluvial; the sub-soil sandy and gravelly. The 
city is favourably placed for rapid drainage, the water escaping 
along the streets from the upper and lower terraces to the river. 
Question 2.—The character of the town in reference to health is 
very good. Near the White Water Canal, which runs through a part 
of the city, along the lower terrace at the west end, ague and fever 
is somewhat prevalent in autumn. There is but little bilious remit- 
tent fever seen within the limits of the town. In the more crowded 
parts, especially among our German population, cholera infantum is 
very fatal during the hot months. This fatality is attributable to 
two influences: crowded and ill-ventilated apartments, and indigest- 
ible aliment. 
Question 3.—The streets and alleys are laid out generally for 
surface drainage; there are hut few sewers; the drainage is not well 
accomplished in all parts of the city. 620 
Question 4.—The streets are cleansed by scavengers hired by the 
city authority; but the streets are not kept in as clean a state as 
they should be; the courts and alleys are cleansed whenever the 
streets are; the refuse from the houses, such as kitchen refuse and 
ashes, is thrown into the streets; the hogs devour what they will, 
or can, and the remainder is taken up by the scavenger carts about 
every three weeks. The street manure is thrown on the wharves to 
extend accommodation to the river landing. It is very rarely car- 
ried into the country, as the soil does not require any kind of manure. 
Question 5.—The streets are wide; the ventilation free. There 
are only two or three courts or alleys built up and closed at the end. 
The houses of the poor are generally good; but, as in all cities of 
any magnitude, too many persons among the poor occupy the same 
building. Among the Germans especially, eight or ten families are 
seen to occupy the same house—a family in each room. This is 
not common among the native portion of our population. The houses 
of the poor are warmed by stoves or grates, in which the bituminous 
coal of Pittsburgh and of other points below that city on the river is 
burnt. Wood is burnt by some few families in air-tight stoves. 
Among the more wealthy families, the stone coal is consumed in 
grates, or the houses are warmed by heated air from cellar furnaces. 
Question 6.—The system of public schools is founded on entire 
freedom, without any payment of fees, supported by a public tax. 
The teachers are efficient in every sense; the children well taught in 
the common elements of a sound English education. The children 
are allowed certain periods of the day for exercise, half an hour 
being given them, for that purpose, between the regular school hours. 
They are received from seven to fifteen years of age. The rooms 
are large, well aired, with good pitch of ceiling—in. brick buildings 
especially constructed for the accommodation of a large number in 
each edifice—four large rooms in each edifice. During July and 
August, vacation is allowed; perhaps during six, but I think, eight 
weeks. 
Question 7.—There is but one hospital, the Commercial Hospital, 
which receives the boatmen from our steamboats, and other river 
craft, as well as the sick poor of the city. There is an appendage 
to the hospital, called the Pest House, to which small-pox patients 
are taken; this building is in a distant spot, with no dwellings near 621 
it. The township trustees, who, by law, have the oversight of the 
hospital, appoint four physicians not attached to the hospital, who 
attend the poor at their houses. These physicians receive an an- 
nual remuneration from the township trustees. The public buildings 
are well ventilated. There is no provision for public grounds or 
squares. 
Question 8.—The town is supplied by hydrants from a large re- 
servoir, filled by steam-worked machinery; the Ohio River, above the 
city, supplies the water. It is liable to become turbid in winter, but 
is very clear during the summer; it is abundant and salubrious. 
Question 9.—Our municipal regulations are pretty good; neither 
very stringent, nor altogether void of effectiveness; on the whole, 
rather leaning to the side of laxity. 
Very respectfully, yours, &c. 
JOHN P. HARRISON. 
Cincinnati, Bee. Ath, 1848. H.—12. 
The Yellow Fever Quarantine at New Orleans. 
E. D. Fenner, M.D. 
James Wynne, M. D. 
Dear Sir: Your favour of the 20th of May last, informing me 
that I had been honoured by the American Medical Association with 
an appointment on the Committee of Public Hygiene, came duly to 
hand, and at once prompted the determination, on my part, to un- 
dertake the task. But, little did I then know what difficulties and 
interruptions I should have to contend with. Since that time, I have 
passed through an epidemic of yellow fever, and what might he 
called two epidemics of cholera, all which has so completely occupied 
my time as to render it impossible for me to comply with your 
request in a satisfactory manner. I regret this the more, as the 
occasion presented by the close of the Mexican war, and the return 
of about thirty thousand men from that country, afforded such 
an admirable opportunity to investigate the point to which you 
have invited my special attention, viz., the contagion of yelloiv fever. 
In view of the task before me, I made ample memoranda of the 
principal facts presented, hut am now under the disagreeable neces- 
sity of cutting you off with a few brief extracts from my journal, 
and adding some general remarks on the subject. A more full detail 
of such information as I have obtained will perhaps appear in our 
medical journal at a future time, or in a contemplated work on the 
yellow fever of New Orleans. 
You inform me that “the Sanitary Report of New Orleans is 
confided to Dr. Barton”—and request that I will “examine and 
report upon the subject of yellow fever, with the view of showing 
how far it may be affected by hygienic measures, and what advan- 
tages or disadvantages result from our present quarantine regula- 
tions.” 
I am pleased to learn that my worthy colleague has performed 
the task assigned him, and I doubt not his report will be read with 
interest. Dr. Barton has long been familiar with the topography 624 
and diseases of New Orleans and lower Louisiana, and ought to be 
as well qualified as any one in the State to make a report concerning 
them. 
A difference of opinion has ever existed respecting the nature and 
origin of yellow fever at this and the neighbouring places where it 
has prevailed for a little more than half a century past. Whilst some 
have contended that it is a specific disease, introduced from the West 
Indies into New Orleans towards the end of the last century, when 
Louisiana was a colony of Spain, others, comprising some of the 
ablest and most experienced observers, have been perfectly convinced 
that it is only one of the forms of endemic malarial fevers occurring 
at irregular intervals. One party contends that it may be spread 
or propagated by means of infection or contagion. This is unequivo- 
cally denied by the other. At the same time, there is a third party 
which entertains some of the opinions belonging to both. 
For some time past, I have been endeavouring to trace the history 
of yellow fever from the time it first made its appearance in New 
Orleans. I have not yet finished the investigation; but from the 
lights before me, I am inclined to believe that it never prevailed 
here previous to the year 1793. In some old historical records, there 
is a vague allusion to it at an earlier date; but our full and reliable 
accounts only extend back to the period mentioned. I have recently 
conversed with five most respectable, wealthy, and intelligent old 
gentlemen, who settled in this city about the beginning of the 
present century, that is, from 1797 to 1804. They all say the 
disease was spoken of familiarly when they first came here. One of 
them (Col. Manuel White, who came here in 1801) recollects well 
a prevailing opinion that yellow fever was a disease brought into 
New Orleans from the West Indies, not many years previously. 
Another (Mr. Joseph Saul, who came in December 1803, and es- 
tablished the first branch of the old United States Bank) says he 
was intimately acquainted with Dr. Robert Dow, an eminent Scotch 
physician, who had then been practising medicine in this city for fif- 
teen or twenty years, and he recollects distinctly having often heard 
Dr. Dow remark that, previous to the year 1793, he had never seen at 
this place any other than the ordinary intermittent and remittent 
bilious fevers of southern latitudes, and that they readily yielded to 
mild treatment; but that, in the year mentioned, being the same as that 
in which Philadelphia was so severely scourged, yellow fever made 
its appearance in New Orleans, and continued afterwards to do so 
at irregular intervals. Dr. Dow continued to practice here till 625 
about the year 1824, when he returned to Scotland, and there lived 
nearly twenty years longer. Mr. Beverly Chew came here in 1797. 
He recollects hearing much of the yellow fever in 1794 and 1796. 
He speaks in the highest terms of Dr. Dow. Mr. McDonough and 
Mr. Parkwood, who settled here before the purchase of Louisiana, 
have recently given in statements similar to the foregoing. All 
these intelligent old gentlemen, who have lived here so long and 
seen so much of the disease, had long since arrived at the conclusion 
that yellow fever originates in this place, and is not contagious. 
These opinions are maintained by all the early medical writers on 
the yellow fever of New Orleans, whose essays I have been able to 
find. Without going more minutely into the progress of the disease 
at this place, a subject on which I might greatly enlarge, let me pro- 
ceed at once to the consideration of hygienic measures and quaran- 
tine regulations. 
My worthy colleague, Dr. Barton, will doubtless lay before the 
Association all the information that may be desired respecting the 
topography and sanitary condition of New Orleans. He will pro- 
bably show that, although much has been incidentally done in the 
way of improvements, much more remains to be done before we can 
hope for any decided mitigation or expulsion of our city’s great 
scourge. In fact, hardly anything has ever been done expressly 
with the view to improve the health of the city. All the improve- 
ments that have been made within the last twenty-five years (and 
they have been both extensive and costly), were almost exclusively 
designed to facilitate commerce and business. But you wish to 
know of me “ how far yellow fever may be affected by hygienic 
measures?” When I look around me, and see a large number of 
people living but a short distance off, exposed to the same sun, winds, 
and rains, drinking the same water, eating nearly the same food, 
and yet exempt from yellow fever, I can but imagine that much 
might be effected. The inference is irresistible that there must be 
something icithin the city which gives rise to the morbific cause. 
Nor can I abandon the belief that what it is may, by diligent search, 
be discovered and removed. 
As for the old delusion, that yellow fever is brought into New 
Orleans from the West Indies, Vera Cruz, or any other place, and 
might be kept away by quarantines, I need only say that the expe- 
riment has long since been fairly tried, and it signally failed. It is 
but fair to admit, however, that we still have amongst us intelligent 
men, who believe in the efficacy of quarantines, and are anxious to 626 
see the experiment tried again. So recently as 1847, the legislature 
had the subject before it, and came near adopting the measure. 
Fortunately, it failed, and I trust the experience of the last two 
years will serve to explode the idea altogether. The following is a 
summary of the legislation in this State on the subject of quaran- 
tines, as far as I have been able to ascertain:— 
The first act is dated March 17th, 1818, and is entitled “An 
act to establish a Board of Health, and Health Office, and to pre- 
vent the introduction of malignant, pestilential, and infectious dis- 
ease into the city of New Orleans.” This act provides for the 
establishment of quarantine, a lazaretto, &c. 
The second act was passed on the 6th March, 1819 ; repeals the 
first act, and orders the sale of the lazaretto, and everything con- 
nected with the quarantine establishment. 
The third act was passed on the 17th February, 1821, and is 
entitled “An act to provide against the introduction of infectious 
diseases,” &c. This act again constitutes the Board of Health, and 
establishes a quarantine ground. 
The fourth act was passed on the 19th February, 1825; repeals 
the last act, but gives the City Council power to pass quarantine 
laws. 
So far as I have as yet ascertained, the City Council has never 
passed any laws on the subject; and thus quarantine regulations 
were permitted to sleep until the winter of 1847-8, when another 
ineffectual effort was made to revive them. It has been said that 
the quarantines of 1818 and 1821 were not rigidly enforced, and 
therefore did not afford a fair experiment. On the contrary, I have 
heard that they were most rigidly enforced, and only abandoned 
when they were found to be utterly useless. 
In connection with this, I may be permitted to give you some 
information respecting the operation of quarantines at Natchez and 
Vicksburg, two towns or cities on the Mississippi River, above New 
Orleans. There are two villages between Natchez and Vicksburg, 
viz., Rodney and Grand Gulf. The first epidemic of yellow fever 
that ever prevailed at Natchez occurred in 1817. Since then, it has 
prevailed at irregular intervals (one as long as twelve years), though 
“there have been a few cases almost every year,” according to the 
testimony of Dr. S. A. Cartwright, a distinguished practitioner of 
that place. 
The first epidemic that ever prevailed at Vicksburg occurred in 
1841. Since that time, there have been two or three epidemics, but 627 
so mild as to cause doubts amongst some of the physicians of the 
place as to their being true yellow fever. It is not denied, however, 
that, among the few that died each year, were several well-marked 
instances of black vomit. The village of Rodney was scourged by 
a severe epidemic of yellow fever, for the first time, in 1848, and 
by a milder one in 1847. Grand Gulf has, so far, been entirely 
exempt, excepting such cases as were brought there on steamboats, 
and these have occurred every year when the disease prevailed in 
New Orleans; but no instance is known of its having been communi- 
cated to the inhabitants of the place. 
I am informed that, about the time quarantine was first established 
at New Orleans, it was likewise established at Natchez, and in like 
manner abandoned, after a few years’ trial. In 1841, it was again 
established, and has continued in force, as occasion seemed to require, 
ever since; but I have the best authority for saying that, during 
the time (a period of eight years), scarcely a year has passed without 
presenting a few cases of yellow fever, and in some a considerable 
number. 
After the severe epidemic of 1841, quarantine was established at 
Vicksburg, and has been maintained ever since, with results very 
similar to those at Natchez. 
There has never been any quarantine either at Rodney or Grand 
Gulf. As before stated, yellow fever has prevailed at the former 
place, but never at the latter. 
Bayou Sara and St. Franeisville, two villages on the Mississippi 
River, about half way between New Orleans and Natchez, present 
some curious and interesting facts in relation to yellow fever. I 
cannot do better than give you the following extract from a letter 
I received from Dr. P. B. M’Kelvy, one of the oldest and most 
respectable physicians in that region. The letter is dated St. 
Franeisville, March 20th, 1849. The Dr. says:— 
“I recollect but one case of yellow fever before the autumn of 
1839, which was brought here from New Orleans, and died. No 
other cases occurred. In 1839, the fever prevailed to an alarming 
extent. How it originated, I cannot say; but the first recognized 
case was a man by the name of Banta, a resident of the place. 
This epidemic was confined to Bayou Sara. No case occurred on 
the Hill, or in St. Franeisville, three-fourths of a mile distant from 
the river bank. One case, however, died in St. Franeisville, having 
been brought from Bayou Sara. From that period until 1843, I 
do not remember having seen or heard of a case. In 1843, the 628 
epidemic seemed to be confined to tin's village (St. Francisville). 
No case occurred under the Hill or at Bayou Sara, that I know of. 
A remarkable peculiarity attended this epidemic: although there 
were many persons residing in the village but partially acclimated, 
no individual was attacked or died but those who were creoles of the 
parish or State, or had resided here for many years. I was not 
able at that time to trace the origin of the disease beyond the pre- 
cincts of the village. The same year they had the fever in Wood- 
ville (1844); we had four cases here, originating in that place; three 
recovered, one died; he had the black vomit when he arrived, and 
lived but a few hours. No other cases occurred. In 1846,1 recollect 
one case brought from New Orleans early in the season—that is, he 
was taken with the fever a week or ten days after his arrival; 
he died. Some five or six weeks subsequently, an epidemic of a very 
mild type broke out simultaneously here and at the Bayou—only 
two bad cases, one of which died. Neither of them had been in any 
way exposed to any other than local causes. 1848. One case origin- 
ated here—had not been out of the village or to the city for some 
months; unacclimated; died. No other cases. During the periods 
embraced in the above remarks, the intercourse between this place 
and Bayou Sara, on the river bank, and between that and New 
Orleans, was free and uninterrupted at all times.” 
For the information of the reader, I may state that the village of 
Bayou Sara extends from the water’s edge to a hill in the rear. 
St. Francisville is located on the high grounds directly back, not 
quite a mile distant. No quarantine has ever been established at 
these places. A semi-weekly line of packets runs constantly be- 
tween them and New Orleans, to say nothing of the immense num- 
ber of steamboats always running on the river. 
It is a well-known fact that, since steamboats first began to run 
on the Mississippi River (1812), thousands of instances have occurred 
in which persons who had contracted yellow fever in New Orleans, 
travelled away on these boats, and either died amongst the passen- 
gers, or at some of the various landings along the river as high as 
the mouth of the Ohio. Yet the first epidemic of this disease ever 
known above this city occurred at Natchez in 1817—the first at 
Vicksburg in 1841, and the first at Rodney in 1848. At the same 
time, it is not to be denied that a few remarkable instances have 
been presented, in which the disease broke out at small towns in the 
interior of Louisiana, commencing from the arrival of cases just 
from New Orleans. My time will not allow me at present to exam- 629 
ine the connection, whether dependent on consequence or coinci- 
dence. 
In 1844, there occurred an extraordinary epidemic of yellow fever 
at the little town of Woodville, situated in the interior and southern 
part of Mississippi, some forty or fifty miles from the river at Bayou 
Sara. In the first volume of the New Orleans Medical Journal, 
may he found full accounts of it from the hands of Dr. A. R. Kil- 
patrick and Dr. C. II. Stone. These gentlemen took antagonistic 
grounds as to the origin of the disease. The former contended that 
it was imported in the person of a transient Methodist preacher, 
who had recently arrived there from Galveston, Texas, passing 
through New Orleans, at both of which places yellow fever was pre- 
vailing to quite a moderate extent. On the other hand, the latter 
contended that it was evidently of local origin. To say the least, 
it would appear very strange that a disease could be transported a 
distance of five or six hundred miles by sea and land, in the person, 
or summer wardrobe, of a Methodist preacher, and thus propagate 
itself in a place where such a disease never prevailed before; whilst 
four cases went from Woodville to St. Francisville, where the disease 
had prevailed before, only about forty miles distant, and jet failed to 
spread amongst the inhabitants; as has just been shown by Dr. 
McKelvy. 
I have received from Dr. William McCraven, of Houston, Texas, 
some interesting information concerning the beginning and progress 
of yellow fever at that place; but am compelled to withhold it till 
a future time. 
Let me now return to New Orleans, and briefly allude to such facts 
bearing on the contagion or infection of yellow fever as have fallen 
under my own observation since the year 1841, in the latter part of 
which I came here to live. In this year, there was a memorable 
epidemic, and the few believers in the importation of yellow fever 
contended strenuously that the disease was brought from the West 
Indies on board the ship “ Talma.” I have not before me an ac- 
count of the attendant circumstances; but, on inquiry, I found that 
but few persons believed that the disease was introduced from abroad, 
whilst the great majority, as well physicians as intelligent citizens, 
entertained no doubt that the breaking out of yellow fever about the 
time the “Talma” arrived with sick on board, was a mere coincidence. 
It was just about the time the epidemics generally commence here. 
We had moderate epidemics in 1842, ’3, and ’4. I made it my 630 
special study, and noted carefully the facts attending the commence- 
ment of the disease each year. I am compelled to withhold them 
at present for want of time, hut I declare to you that I saw nothing 
calculated to sustain the position that the disease was imported in 
those years. 
In 1845, there was a complete exemption from yellow fever. 
There may have been a single case of doubtful character admitted 
into the Charity Hospital. 
In 1846, there were about one hundred and sixty deaths from 
yellow fever. The disease made its appearance very late in the 
season, and partook very much of a typhoid type—hemorrhages and 
black vomit, in some instances, occurring as late as the eleventh and 
fourteenth days. In the history of yellow fever, this year should 
be memorable as the first of the Mexican war, and on account of the 
extraordinary circumstances attending it. 
In the third volume of the New Orleans Medical and Surgical 
Journal, Nos. 2 and 3, you may find some memoranda of passing 
events, made at the time, to which I beg leave to refer you. It will 
there appear that, during that summer, which was remarkably wet 
and warm, about 15,000 men from the interior and upper country 
passed through this city on their way to the seat of war on the Rio 
Grande. Most of them were necessarily detained here about two 
weeks, commencing a camp life and exposed to very bad weather. 
In the month of August, about six thousand Louisiana volunteers, 
not one-fourth of whom, perhaps, had suffered yellow fever, were 
discharged, and sent back from Mexico. The city was a perfect 
thoroughfare for unacclimated persons; and notwithstanding all this, 
there was but little sickness. It fortunately happened to be one of 
our healthy years; otherwise the mortality must have been terrific. 
Intercourse with the West Indies, where yellow fever was pretty 
bad this year, was uninterrupted; but we had no access to Vera 
Cruz, and there was no yellow fever on the Rio Grande. So much 
for 1846. 
In 1847, we had one of the most extensive epidemics that ever 
scourged our city. In the fifth volume of the New Orleans Medical 
and Surgical Journal, No. 2, Sept. 1848, may be found a rude ac- 
count of this epidemic, to which I beg leave to refer you for parti- 
culars. In the month of March, the famous city of Vera Cruz, 
generally considered the favourite abode of yellow fever, succumbed 
to the victorious arms of our commander, General Scott, and was 631 
retained by us till the close of the war. The main body of our 
forces being directed to that line, which led on to the city of Mexico, 
Yera Cruz necessarily became almost as great a thoroughfare as 
New Orleans. The new levies were constantly pouring in that direc- 
tion, whilst the sick and discharged were likewise returning. Now 
the advocates of imported infection were confident of witnessing 
a brilliant illustration of their position; whilst the impartial seeker 
after truth was glad to have such an opportunity for investigation. 
I can only here briefly mention the result, having carefully noted all 
the first cases that occurred in this city. Notwithstanding the great 
and continued intercourse between Yera Cruz and New Orleans, 
yellow fever prevailing at the former place all the time, but few cases 
were brought over to this city, and the most careful inquiry I could 
make, did not bring to light one single instance in which it was com- 
municated directly to any person either in Neiv Orleans or Lafayette, 
a town joining us above. This position is fully sustained by our 
Board of Health in its published proceedings, as follows:— 
u Meeting of the Board of Health, Monday, July 12th, 1847.— 
****** Five deaths from yellow fever have occurred in the Charity 
Hospital, and two or three cases are still under treatment in that 
institution. They appear to have originated in the city, and no 
facts have come to light to prove any connection between these 
cases and the fever prevailing at Yera Cruz or other foreign ports. 
(Signed) “W. P. IIORT, Chairman. 
“A. Hester, Secretary.” 
I regret that my time will not allow me to report some of the 
interesting facts on which this opinion is based. 
I come now to the last year, 1848, which derives especial im- 
portance from the facts that in it the Mexican war was brought to 
a close, and that between the 1st of May and the middle of August, 
our whole army, numbering about thirty thousand men, returned 
home—the greater part passing through Vera Cruz, and nearly all 
coming directly to New Orleans, without affording a single instance 
in which yellow fever was communicated from one person to another. 
I do not hesitate to say, that I can bring the united testimony of 
the arrmy medical staff engaged here, to substantiate this assertion. 
I have full memoranda of the principal circumstances attending the 
return of our army and the sickness of the season, which I hope to 
publish in the July number of our Medical Journal. 632 
It may not be considered irrelevant to the subject under consider- 
ation to make some allusion to the various forms of fever which 
usually prevail at this place. In the New Orleans Medical and 
Surgical Journal, vol. v. No. 1 (July, 1848), may be found some 
statistics compiled from the books of the New Orleans Charity Hos- 
pital, showing the monthly and annual admissions of the different 
forms of fevers for a period of seven years, 1841 to 1848. From 
that paper I extract the following concluding remarks:— 
“From these tables, it appears there were admitted, of all kinds 
of fever, 19,445 cases—of which 9991 were marked ‘intermittent.’ 
Add to which 26 cases marked 1pernicious' and ‘malignant inter- 
mittent,’ and 257 marked ‘ congestive’ (which is a form of intermit- 
tent), and you will have 10,274 intermittent, or more than one-half 
of the whole amount by 1103. 
“ The following table will show the relative prevalence of what 
is marked ‘intermittent fever,’ at the different seasons of the same 
seven years:— 
Spring. 
Summer. 
Autumn. 
Winter. 
1841 
112 
403 
177 
92 
1842 
119 
453 
394 
135 
1843 
85 
208 
413 
137 
1844 
117 
469 
732 
231 
1845 
180 
358 
664 
206 
1846 
236 
569 
1045 
218 
1847 
391 
508 
691 
602 
Totals 
1240 
2963 
4116 
1621 
“Is it not curious to note the gradual increase and decline of 
intermittent fever at this hospital, and also the remarkable fact 
that this form of fever is never entirely absent? not even at the 
zenith of the worst epidemics of yellow fever ! In August, 184T, 
when there were admitted 1611 cases of yellow fever, there were 
also admitted 74 cases of intermittent. 
“ Two interesting questions here present themselves, viz., What 
portion of all this intermittent fever really originated in New Or- 
leans ? and in what part of the city did most of it occur ? 
“ The city of New Orleans is certainly a great thoroughfare* and 
has a larger transient or floating population perhaps than any other 
to be found. It is accessible by ships, steamboats, and land car- 633 
riage. It is surrounded by a low, level, and very fertile country, 
having a large number of free white labourers. This class is en- 
gaged in the country principally in draining wet land, and, to some 
extent, in the mechanic arts. About the city, it is also engaged 
in draining the suburbs, but perhaps to a greater extent in street 
labour, such as paving, draying, loading and unloading ships and 
steamboats on the levee. Their residences are chiefly in the newer 
and more retired parts of the city, where rents are cheapest; but 
they are also interspersed amongst those of the wealthier classes. 
“Now the Charity Hospital is opened gratuitously to all indigent 
invalids, male and female, white or coloured; and there is no ob- 
stacle to admission. This charity is only offered to the indigent; 
but pay wards are provided for those who are able to afford a mode- 
rate compensation. 
“ I believe it has been established that the poorer classes suffer 
everywhere more than any others from all kinds of fevers. Such 
is certainly the fact here, where the usual exciting causes, such as 
intemperance, exposure to the hot sun, &c., are very potent. The 
records of the Charity Hospital do not afford any precise informa- 
tion as to the length of residence in New Orleans. The question is 
asked, and the time stated; but the clerk informed me that he made 
no distinction between a residence in the city proper and the neigh- 
bouring country. The house surgeon and one of the clerks gave 
the opinion that most of the cases of intermittent fever occurred 
amongst the labourers in the suburbs and vicinity of the city. But 
the truth is, the labourers on the levee, streets, and canals furnish 
the greatest number of all kinds of fever at this place. My own 
opinion is, that those localities within the precincts of the city 
which afford the greatest amount of intermittent fever, also afford 
the greatest amount of remittent, bilious, and yellow fevers; more- 
over, that they are all closely allied affections. ****** 
****** “ One more reference to the statistics, and I have 
done. It appears that the total admissions of all diseases into the 
main building of the Charity Hospital, during the above stated 
period of seven years, was 45,713—of which 19,445 were for fevers; 
and of these last, 10,274 were for the different forms of intermit- 
tent fever." 
Here necessity compels me to close my report, leaving me to 
regret that I have not been able to perform the task assigned me 
with more satisfaction both to you and myself. Having attended 
VOL. II.—41 634 
the first National Medical Convention, which met in New York in 
1846, I have ever felt a deep interest in its proceedings, and would 
gladly contribute anything in my power towards the accomplish- 
ment of its great objects. 
I have the honour to be, with high regard, 
Your obedient servant, 
E. D. FENNER. 
To James Wynne, M. D., Chairman of the Committee 
on Public Hygiene, American Medical Association. 
New Oiileans, La., April 16, 1849. H.—13. 
On the Influence upon Health of the Introduction of Tea and 
Coffee in large proportion into the Dietary of Children and the, 
Labouring Classes. By Samuel Jackson, M.D., Professor of 
the Institutes of Medicine in the University of Pennsylvania. 
The attention of the Committee was directed to an investigation 
of the influences exerted by the extensive introduction of tea and 
coffee into the dietary of children; and also the effects produced on 
the health of the labouring classes by the substitution of those luxu- 
ries for food. 
In the above proposition, the facts assumed, it is believed, do not 
require the verification of statistical evidence, which could only be 
procured by considerable personal sacrifice and labour. They are 
matters of constant and familiar observation to every one, and are 
daily forced on the attention of medical practitioners. The large 
consumption of tea and coffee in this country tends to corroborate 
indirectly the statements asserted. In no other country, in propor- 
tion to population, is it as great as in the United States. 
It is well known to be the custom of our people, that, as soon as 
children are able to sit at meals, they are placed at the family table, 
and partake of the same food as adults. The food especially adapted 
to the digestive organs and the nutrition of children, when it is pro- 
vided as often occurs, is, however, the exception to the general rule. 
In the poorer classes, the evil of a common diet for all ages cannot 
probably be avoided. It is one of the causes productive of the greater 
mortality of the children of the poor. But this injurious practice, 
which with the poor is to be regarded as an inevitable misfortune, is 
followed by those who are placed in circumstances above the neces- 
sity of it. In them it is most condemnable, and can be excused only 
on the plea of ignorance and want of thought. 
It is a subject of not less notoriety that coffee and tea are em- 
ployed extensively, as articles of food, by various classes of our 636 
population. Tea, coffee, and bread are the breakfast and supper; 
and tea, bread, and potatoes, with occasionally a modicum of meat, 
are the dinner of thousands in every portion of our country. They 
are the food of children as of adults. 
The classes in which this kind of alimentation prevails are female 
teachers, seamstresses, factory women, weavers, tradesmen, small 
retailers, clerks with families, and others living on restricted means, 
and very generally farmers in the country. 
The inducement for its adoption is its economy, as to money, time, 
and fuel. A meal of coffee or tea, and bread, or the addition of pota- 
toes, for a small family, will not cost beyond a few cents, while it 
requires but little fuel and a very short time for its preparation. 
Tea and coffee are, besides, very palatable, produce temporary ex- 
hilaration and force, and abate hunger. Coffee, as will be shown, 
is not devoid of some nutritive properties. Ostensibly answering, 
in this manner, the purposes of food, tea and coffee have, from the 
considerations of cheapness and convenience, become the substitutes 
of more substantial diet. 
In this country and England, chiefly, tea and coffee are intro- 
duced into the daily meals as aliment. In China, tea is used as a 
refreshing and cordial beverage, presented to visitors, or drunk 
between meals; in the East, coffee is regarded in the same light, 
and employed in the same manner; on the Continent of Europe, coffee 
is extensively used, but more as a cordial drink, or to flavour cream 
and milk, than as aliment. 
In prosecuting this inquiry, with a view to the effects, on the 
economy, of tea and coffee, some preliminary matters require pre- 
vious examination. 
Every one knows that food is indispensable to life. But what is 
this connection between them ? How is it that food is an indispens- 
able condition of life ? The solution of these questions is necessary 
to the understanding of the nature and objects of food, to determine 
the value of any alimentary articles, and to settle the pretensions 
of any substance for a place in the category of food. 
Before examining the relation existing between food and life-action, 
it is important to obtain an accurate idea of what is life, or organic 
action. This term we limit to a single series or class of phenomena. 
These phenomena are the evolution or production of specific organ- 
izable matter and definite organic forms, from a primary, formless, 
organic substance. Albumen is that substance in man and the 637 
higher animals. All other phenomena are excluded. They are 
subordinate to, depend on, but are indispensable to maintain life- 
action. 
Organized tissues, and organs worked out by life-action, are the 
instruments of life. They differ widely from each other. Each has 
its special office. The phenomena of each are special in character 
and purposes. They are the same as similar phenomena in the 
exterior and inorganic world. They can be properly understood 
and studied only in their connection with those phenomena. Some 
are chemical, as the transformation of albumen, the processes of 
digestion, secretion, and the oxidation of carbon and hydrogen in 
the blood producing animal heat. Others are physical, as the capil- 
larity of tissues, imbibition, endosmose, atmospheric pressure, and 
Graham’s law of the diffusion of gases, in respiration; others are 
dynamic, as the excitor, motor, and other forces of the nervous sys- 
tem; others, again, are purely mechanical, as the actions of the 
muscular system. 
Not one of those is properly an organic or life-phenomenon. They 
are indispensable to maintain the condition of the existence of life, 
or organic action. They are chemical, physical, dynamic, and me- 
chanical actions, executed by organized and living apparatus and 
instruments, for the objects of life. 
The organizable matter and organic forms are the products, and, 
consequently, the expression of existing forces or causes of action. 
Forces, matter, and form are indissolubly connected with, and give 
rise to, phenomena or function; and, inversely, function and phe- 
nomena are the correlatives of force, matter, and form. Organized 
matter, from its nature, cannot be persistent. Under normal states, 
force, matter, form, and function or phenomena, are permanent; 
but the structural material itself is not permanent—it wastes, decays, 
disintegrates, and is reproduced in every act of life. Life-action is 
thus resolvable into two inseparable actions, or links of one action, 
a birth and a death, the formation and destruction of the organic 
material of our structure. 
"The supply of the primary organic substance for this incessant 
renewal and building up of the organized structure, and maintenance 
of organic forms, is derived from the blood. This fluid, in its natural 
state, is a concentrated solution of all the solids and products of the 
animal economy. The amount of azotized or albuminous compound 
matter destroyed in twenty-four hours by life, or organic action, may 638 
be taken, on an average, at two to three ounces.* The blood would 
rapidly become impoverished, and unfitted for life objects, unless its 
losses of albumen and its organic derivatives were constantly restored. 
The renewal of the organizable or plastic material of the blood, and 
its maintenance in its normal composition, for structural formation, 
is one of the offices of our food. Repeated analyses have demon- 
strated that, of the aliment that is adapted to healthy nutrition, 
one-eighth part only consists of albumen, or its protein compounds, 
or their derivative compounds; and, whatever is devoid of those 
substances—that is, the chemical combination of carbon, hydro- 
gen, nitrogen, and oxygen, in the proportion to constitute protein 
(C40A30N5012t) or albuminous compounds—cannot perform the office 
of food, or be fitted for nutrition. 
Another condition, not less indispensable to life-action than 
organizable or plastic matter in the blood, is a definite temperature. 
For man and the warm-blooded animals, the heat essential to healthy, 
vigorous life-action is 98° to 100° F. So important is heat to life, 
that nature has made provision for its constant disengagement in the 
economy. This is accomplished by the incessant oxidation of carbon 
and hydrogen in the blood. The temperature of this fluid is thus 
kept at an equable point in every part of the economy. Every 
organized molecule requires, for the exciting and sustaining of its 
life-action, the presence of plastic or organizable material, and a 
definite temperature. 
The blood furnishes both these indispensable conditions of life- 
action to each living molecule. 
The carbon and hydrogen oxidized in the blood, and in this man- 
ner generating animal heat, are obtained from the food. Nature 
has made most ample provision for the supplies of these chemical 
elements, by constituting them a large portion of the food of animals. 
Not less than from six-sevenths to seven-eighths of the alimentary 
substances of animals consist of non-azotized bodies. Fatty, starchy, 
and saccharine matters are of this character; they are not adapted 
to or intended for nutrition, but solely for the purpose of calorifica- 
tion, by their combustion or combination with oxygen introduced 
into the blood by the processes of respiration. This proposition is 
demonstrated in the composition of the alimentary portion of milk. 
* Dumas, Chimie Physiologique et Medical, p. 463. 
f Mulder. 639 
The caseine, or plastic matter for nutrition, averages 13 per cent., 
the calorifacient, or the cream and sugar of milk, 87 per cent. 
Temperature is required not only for life-action, but also for the 
dynamic forces, and mechanic power and actions seated in and per- 
formed by the muscular apparatus. 
The identity of heat and mechanic force has been established by 
M. Joule.* It is expressed in the following formula: the heat re- 
quired to raise one gramme (15 grains) of water one degree (cent.) 
is capable of raising 432 grammes (3700 grains) one metre, or 31- 
feet. 
According to the estimate of Dumas, the quantity of carbon con- 
sumed by a man in good health (valuing the hydrogen by an equiva- 
lent proportion of carbon), averages from seventeen to twenty-eight 
ounces per diem. The large amount of heat thus disengaged is the 
sum of the dynamic or excito-motor force of the nervous system. 
By the establishment of the above facts, we obtain precise ideas 
of the nature of food, its objects in the economy, and the modes of 
its operation. We are enabled to say with certainty what substances 
are or are not food; and to fix the relative value of each article of 
diet. 
From these investigations, it is ascertained that alimentary sub- 
stances form two distinct classes, differing from each other by the 
most striking diversities of nature, composition, and operation. 
The first class are the protein or albuminous compounds. They 
have nearly the same chemical composition as the tissues, are iso- 
meric with many of the immediate organizable materials of animal 
structure, and are exclusively destined to nutrition proper, or the 
reconstruction and repair of the solids. 
No substance in which this especial chemical composition, protein 
and its compounds, does not exist, can belong to this class, or can be 
employed in the economy for its nutrition. Some of the most emi- 
nent organic chemists and physiologists appear to suppose that any 
organic nitrogenized body may answer for nutrition. This is not 
so. Morphia, quinia, strychnia, urea, taurine, as well as theine 
and caffeine, are organic nitrogenized bodies, yet cannot be ranked 
as food. It is the possession of the specific combination of which 
protein is the base, that can alone entitle any substance to rank in 
this class. 
The second, or calorifacient, class of aliment comprehends those 
* Comptes Rendus, tome xxv. p. 209. 640 
special chemical compounds, hydro-carbons mostly, that are capable 
of prompt decomposition into carbon and hydrogen in the blood. 
No other organic substances, though rich in carbon and hydrogen, 
are capable of entering into this division of aliments. 
The normal substances of this kind are glucose and lactic acid, 
into which saccharine and amylaceous substances are converted by 
the process of salivary digestion; and fatty matters, modified and 
reduced to the finest and minutest particles possible, in the emulsion 
formed with them by the pancreatic and biliary secretions. 
This last class is the more immediately connected with the main- 
tenance of life. It is established by the experiments of Chossat,* 
that death from starvation does not occur from inanition, or the 
waste of the organs, but from the cooling of the blood, from the 
absence of the carbon and hydrogen requisite to carry on the pro- 
cess of combustion and the generation of caloric. 
With the preceding facts ascertained, we can now proceed to in- 
vestigate the claims of tea and coffee to be regarded as properly 
belonging to either of the above classes of food. 
Theine and caffeine, according to Liebig, are the essential ele- 
ments of tea and coffee. The two are identical as to chemical equiva- 
lents. The formula for each is C8HsN202. M. Payen, in a later and 
more elaborate examination, gives a somewhat different formula, 
but not such as to vary their properties to any extent. Liebig con- 
siders them as closely approximating to alloxan, C8H4N20j, a prin- 
ciple obtained from urea, by the action of concentrated nitric acid; 
and to taurine (C4H8NO10), a principle which may be obtained from 
ox bile, but not from human bile. 
In this view, tea and coffee must be excluded wholly from the 
classes of aliments, to which theine and caffeine can have no pre- 
tensions. 
But M. Payen, in 1846, in a communication to the Academie des 
Sciences,f presented a highly laboured and accurate examination of 
the proximate constituents of coffee, which unquestionably brings it, 
at least, into the category of aliments, as it contains the constituents 
of both classes. 
The following is his analysis of coffee :J 
* Recherches Experimentales sur l’lnanition, Paris, 1843. 
f Comptes Rendus, tomes xxii., xxiii., 1846. 
f Ibid., tome xxiii., f. 249. 641 
Cellulose ------- 34 
Fat substances 10 to 13 
Glucose, dextrine, and an indeterminate vege- 
table acid ------- 15.5 
Legumin, caseine (gluten) - - - - 10 
Chloroginate of caffeine and potassa - - 3.5 to 5 
Azotized organic matter ----- 3 
Free caffeine ------- 0.8 
Insoluble, concrete vegetable oil - - - 0.001 
Fluid, aromatic essence of sweet odour, and a 
less soluble acrid aroma - 0.002 
Mineral substances, potassa, lime, magnesia, 
phosphoric, sulphuric, silicic acids, and a 
trace of chlorine ------ 6.697 
"Water - 12. 
100 
From this composition of coffee, it is evident the grain is endued 
with nutrient or plastic and calorifacient elements, and, consequently, 
is an aliment; yet the proportion of these elements is not sufficient 
to place it in a high rank in either class, or to justify the substitu- 
tion of its infusion, as a chief material of food, by those who are 
engaged in active and laborious pursuits. 
But, when the quality of the weak infusion almost generally used 
as food, and the consequent very small proportions of the alimentary 
elements held in solution in it, are taken into consideration, the dis- 
parity between the waste of the blood, and the elements for its repa- 
ration contained in coffee, become strikingly displayed. The ordinary 
coffee of the labouring and industrious classes is little more than 
warm water coloured and aromatized by coffee. It contains but a 
very small portion, if any, of the nutritive and calorifacient ele- 
ments. It is impossible, with such diet, to maintain in the blood the 
two indispensable conditions of life-action and nerve-force, organ 
izable material and heat. 
Coffee, to be prepared as food, should be first but slightly roasted, 
merely browned and rendered crisp, so as to be easily reduced to a 
coarse powder. A concentrated infusion is then to be made by the 
process of displacement. There should be added to it an equal, or 
double its quantity of cream or good milk, and be sweetened with 
sugar. An alimentary drink is thus prepared, possessing all the 
requisites of good food, with the addition of a specific excitant action 642 
on the nervous system and brain that entitles coffee to the appel- 
lation bestowed on it by Rousseau, “boisson intellectuelle.” 
The ordinary miserable preparation of coffee so extensively used 
as food, deficient in proper alimentary principles, by taking away 
appetite, by distending the stomach with a warm liquid, and thus 
impairing its digestive power, and by its agreeable aroma corrupting 
the taste, rendering more nutritious food unpalatable, tends to the 
ultimate impoverishment of the blood. This fluid loses its proper 
character, that of a concentrated solution of all the organic elements 
and products of the economy. 
As a consequence of this condition of the blood, the waste of the 
tissues exceeds the repair; death-action is stronger than birth-action; 
disintegration of structure predominates over its re-formation. In 
time, this loss of balance tells: the organs are degraded from their 
primitive type; their functions are impaired, and the organism de- 
scends in the scale of development. There is an approach to inferior 
organisms, and to cold-blooded animals; or, rather, the system is 
kept permanently in what constitutes the cold stage, or tendency to 
collapse in febrile diseases. 
In this state, individuals suffer from a variety of vague, anomalous 
symptoms, characterizing no definite disease. They are always ailing, 
complaining, suffering, but not absolutely sick. They are miserable 
themselves, a plague to doctors, the prey and victims of quacks. 
In this condition of the economy, the temperature is low. Dy- 
namic force, which is identical with heat, is equally depressed; and, 
consequently, the mechanic or muscular power is at zero, and the 
offices of the economy depending on it are imperfectly performed. 
The circulation is feeble, digestive movements slow and defective; 
languor and exhaustion prevail. Exercise augments the evils by 
expending the forces more rapidly than produced, and the nervous 
functions are in a state of perturbation or depression. These dis- 
ordered states are the results of a slow inanition or starvation, not 
suspected, because food is taken to the full repletion of the stomach; 
yet still it is starvation, for the blood does not possess the elements 
for heat and nutrition adequate to the full energy and the consump- 
tion of life-action. These cases are not remediable by medicine; 
they can be relieved only by a restoration of the digestive functions, 
and a return to a wholesome and appropriate diet. 
Cases of this character have augmented, in our towns and cities, 
and it is believed in the country, particularly amongst women, and 
in the industrious and labouring classes, in the last ten or fifteen 643 
years, most rapidly. The neuroses, as gastralgia, different visce- 
ralgias, and other forms of neuralgia, are now quite as common 
amongst those classes, if not more so, than they were formerly 
amongst the luxurious and idle, to which they were almost exclu- 
sively confined. 
A suspicion has arisen that this circumstance is to be attributed 
to the perversion of the use, as food, of tea and coffee, from their 
proper employment as nervous excitants and cordials, which are 
their appropriate properties. On inquiry, it is almost uniformly 
found, at least in the observations of many medical practitioners, 
that the greatest sufferers from these disordered states are the incon- 
siderate consumers of tea and coffee, who substitute them largely 
for food. 
It would extend this inquiry too far to enforce the above views by 
relations of specific cases. A large number could be cited as strongly 
illustrating their correctness. 
The practice of giving tea and coffee to children at their meals 
cannot be too strongly reprehended and discountenanced. In the 
first periods of life, the most nutritive food, rich in plastic elements, 
and capable of favouring the highest organization, is that which is 
required for growth and development. In the first fifteen years, 
nature is employed in constructing and perfecting the mechanism of 
life, fitting it for the conflicts, the exertions, the labours it must 
encounter and undergo in the struggles and difficulties of the great 
arena of the world, as well as with exterior malignant influences 
hostile to its existence, to which it is incessantly exposed. Without 
good materials there cannot be produced a good fabric. 
Whatever tends to excite, to render irritable, or to develop un- 
duly the cerebral structure and functions in children, is of necessity 
injurious. The bills of mortality show the fearful ravages in the 
early years of life from cerebral disease; and the foundation of most 
of the neurotic diseases and of ill-health in adult life dates from the 
abortive efforts of nature to build up substantial organs from the 
paucity and poverty of the building materials, or the abnormal 
direction imparted to nutritive action by over-excitement, in the 
commencement of development. 
Tea and coffee being cerebral excitants cannot act otherwise than 
injuriously on children, in whom there exists no object for such arti- 
ficial stimulation. Indirectly, they are mischievous by taking the 
place of food that contains all the elements and constituents of the 
fluids and solids of the organs and their products. They should be 644 
abolished from the dietary of children in all well-regulated families, 
and by parents careful of their children’s welfare. 
The analysis of tea is not complete, like that of coffee, by M. 
Payen. As far as known, it contains no alimentary elements, and 
cannot be classed with food. It is a purely cerebral excitant. 
Though the grain of coffee has, amongst its constituents, alimentary 
elements, yet in the common slovenly process of torrefaction, the 
calorifacient principles are destroyed; and the plastic are also more 
or less decomposed. But when more carefully performed, and these 
principles are not materially injured, still a small portion only can 
be dissolved in the infusion or decoction made in the ordinary mode. 
The infusions of tea and coffee cannot, therefore, be used as food, 
and be made substitutes for nutritious aliment, without a serious 
detriment to the economy. They are cordial beverages, and as such 
are grateful and useful, especially to those engaged in mental pur- 
suits, and who lead sedentary lives. They must, at the same time, 
be combined with substantial nutriment, or the blood becomes im- 
poverished, and fails to contain the materials for organic structure, 
and evolution of nerve-force. 
In proportion to the degree of physical exertions, are the wear 
and tear of the solids, and the expenditure of the forces. The ele- 
ments to maintain these in their normal conditions must exist in the 
blood, and the blood obtains them from the aliment in which they 
exist, through the digestive apparatus. Tea and coffee, largely drunk 
at their meals by those engaged in active and laborious pursuits, by 
excluding a due quantity of substantial food, rich in the plastic and 
force-producing elements, are more injurious to these classes than to 
the sedentary. 
The inevitable consequences of this practice must be to undermine 
the constitution, to impair the health, to break down the forces, to 
cause various nervous sufferings, and finally to produce disability for 
labour. H.—14. 
Letter from Professor Walter K. Johnson, Corresponding Secre- 
tary of the National Institute, on the introduction of Witer and 
Gras into cities. 
Washington, March 31s£, 1849. 
Dr. James Wynne, 
Chairman of Committee on Public Hygiene, of the American Medical Association. 
Dear Sir : In your note of yesterday, you ask to be informed, 
whether, in my opinion, “the supply of water and gas to cities, as 
well as their drainage, should he under the direction of, and conducted 
by, chartered companies, or the city authorities; and the reasons 
which have inclined me to prefer the mode which I deem most 
advisable.” 
In reply to this inquiry, I would state that, in my opinion, all 
these important municipal matters ought unquestionably to be con- 
trolled directly by the city authorities, and in no case be allowed to 
be left in the hands of chartered companies. The reasons for this 
opinion may be briefly stated as follows:— 
1st. When managed by the municipal authorities, who are—in 
every case to which your inquiry relates—assumed to be elected by, 
and amenable to, the people of the town or city, the object kept in 
view by the authorities will be likely to be that which is the true 
legitimate aim of all municipal regulations, viz., the greatest good 
of the greatest number. 
2d. Under any trading corporation, however constituted or limited 
in its chartered privileges, the selfish motives of trade and specula- 
tion will inevitably find their way into the management and opera- 
tions of the works. This is not a mere matter of conjecture, but 
rests on the experience of many communities, and is a just inference 
from the experience of those cities which have tried both species of 
direction. 
3d. It is also deducible from the analogies of other great interests 646 
which are, by general consent, managed by the constituted autho- 
rities of the cities themselves, and not by corporate companies. 
Thus, the opening, maintaining, and cleansing of public highways, 
including the laying of pavements, and the construction of bridges, 
the maintaining of the public peace, the establishment and control 
of public market places, the support of public schools, the abatement 
of nuisances which would endanger public health, the establishment 
of public prisons, the management, in short, of every interest in 
which all, or a very great majority, of the citizens have a common 
concern, are cases directly in point. No one would think of intrust- 
ing these to corporate companies. 
4th. To illustrate my views in the case of water, I may refer to 
the experience of the city of Boston, where, in former years, a com- 
pany, deriving water from an inadequate source, undertook to supply 
the citizens with that indispensable material, and continued to re- 
ceive compensation for such supply long after it had ceased to be 
able to meet the demands of the public, or the necessities of its cus- 
tomers, until, at length, the urgent wants of the public rose to a 
pitch which compelled the city to resort to means for obtaining that 
supply not subject to the operations of a trading corporation. 
5th. I may refer to the corresponding experience of many towns 
in England, as exposed in the elaborate reports of the Royal British 
Commission on the health of towns, to prove that the community 
there, when supplied with water by corporate companies, especially 
where these companies enjoy monopolies, has, in almost every in- 
stance, been inordinately taxed for inadequate supplies. 
6th. But not only the individuals who pay water-rents are liable 
to be imposed upon both in price and quantity, as well as the quality 
of the water furnished, but thuse supplies are particularly liable to 
be inadequate which are afforded by corporate companies to the city 
authorities for 'public uses, such as the washing of streets and the 
extinction of fires. 
7th. On the contrary, we have the experience of those cities and 
towns of our own country, which have erected water-works under 
municipal direction, to prove the great utility of that species of 
management. Among these cities, Philadelphia has had the largest 
experience, having tried it about fifty years; New York about one- 
seventh of that time, and Boston for a few months only; and yet it 
would, I apprehend, be an exceedingly difficult task to persuade the 
inhabitants of either of these cities to abandon their present system, 647 
and again accept such supplies of water as chartered companies 
would afford. 
8th. To secure public health, the most abundant streams of water 
for cleansing streets and sewers, and for supplying private baths, 
ought to be at the command of every individual in a large and 
densely peopled city, and growing as rapidly as American cities 
now are. They cannot too early bethink themselves of this element 
of health, comfort, temperance, and purity. Public baths are no 
proper substitutes for the private bath-room in one’s own dwelling; 
any more than the public pump is a substitute for the private hy- 
drant, always ready to send forth its gushing stream at our own 
door. 
9th. If, for the purpose of preventing imposition by a monopolizing 
company, two or more corporations be established for supplying the 
same district, they must, of necessity, cross the direction of each 
other’s works, must come in collision, and excite at first a competi- 
tion ruinous to both parties, and end with a combination between 
themselves to keep up prices, not less oppressive to the water renters 
than those of a monopoly, the purchasers of water eventually paying 
the costs of all their conflicts and litigation. All these results have 
been repeatedly produced in foreign countries, if not in our own. 
10th. In managing water-works, gas-works, or sewerage, by cor- 
porate companies, not only will the pecuniary interests, but often 
the personal convenience, of the corporators be studied, to the neglect 
of the general safety and comfort of the citizens. When works 
which create nuisances, or any serious annoyance, are to be estab- 
lished in the heart of a large city, the plea of public utility will often 
be urged in favor of locating them on sites where the annoyance 
will be most seriously felt; on ground wdiich, perhaps, the company 
find it convenient to purchase, but which the municipal authorities 
would not have felt authorized to occupy for such a purpose. The 
effluvia of gas-works are well known to create great annoyance to 
the residents in the immediate vicinity. Yet they are not unfre- 
quently located in the very heart of a large city. 
11th. The systems of under-ground drainage, from the days of 
the ancient Romans to our own times, have been justly regarded as 
objects of municipal regulation. The “cloacse,” or sewers, in Rome, 
were of such magnitude, that a rider on horseback, or a broadly 
loaded vehicle, or a galley with its oars, could pass along their chan- 
nels. They were, in short, comparable to our modern canal or rail- 
way tunnels, and extended with many ramifications under all the 648 
principal streets. Appropriate officers were specially charged with 
the superintendence and management of these important public 
works. 
13th. Whatever may be thought of the supply of water and gas 
to cities, there cannot, it seems to me, be two opinions as to the pro- 
priety of placing the drainage entirely under the control of muni- 
cipal authorities. It is one of those things which is perfectly iden- 
tified with the whole physical character and social condition of the 
city, and no power short of that which controls all its other affairs 
ought to he allowed to regulate this. Now, if it be once admitted 
that under-ground drainage is necessary to a town, and that the 
public good requires it to be under the municipal rule, it follows, 
almost as a corollary, that every other operation requiring extensive 
under-ground operations, or the opening of fosses, ought, in like 
manner, to be subject to the same control. If one of these species 
of works belongs to the public, and another to individuals or compa- 
nies, it is evident that one may be liable to great injury from the 
operations of another, and gas pipes, water pipes, and sewers will 
be crossing each other’s paths. The prevailing inducement for ex- 
tending the works of either kind into any given part of the city will 
be, not the accommodation of the public, but the obtaining of a maxi- 
mum profit. 
14th. Another reason for preferring public management of those 
works which afford supplies of such objects of prime necessity as 
light and water, is that the public management will always, in the 
long run, afford the supply at a cheaper rate than the private corpo- 
ration. In the city of Philadelphia, where both water and gas-works 
are under municipal control, it is believed that water and gas are 
furnished to the consumer at lower rates than in any other city in 
the country. The works are so situated, and so constructed, as to 
create no serious annoyance in the streets or elsewhere. While the 
Philadelphia Gas Works were, during the first five years of their 
existence, under the control of stockholders, the cost of gas to the 
consumer was more than fifty per cent, higher, and the quality of the 
gas much lower than it is at this time, when they have changed 
owners, and are controlled even indirectly by the city government. 
A more direct management and still further reduction in price are 
loudly called for by the citizens. Even at the present price ($2 25 
per 1000 cubic feet), the works yield a large annual profit above the 
cost of making and disposing of the gas. In some other cities of 
the Union, it is true that corporate companies have succeeded in 649 
imposing two, three, and even more than four times this rate of 
charge on the consumers of gas. Under public control, and with 
proper management, the authorities of our large towns might erect 
gas works that would speedily relieve their citizens from these mon- 
strous impositions. Throughout the West and South-west, in par- 
ticular, where coals of the best quality for making gas are abundant 
and cheap, as well as iron for the establishment of works, there is 
no sufficient reason why abundant and cheap light should not be 
matters of universal enjoyment. 
I am, very respectfully, 
Your obedient servant, 
WALTER R. JOHNSON. 
YOL. II.—42 H.—15. 
Letter from Dr. Thomas Harris, Chief of the Bureau of Medicine 
and Surgery, Navy Department, on the Use of Disinfectants in 
the Navy. 
Navy Department, 1 
Bureau of Medicine and Surgery. | 
Sir : I have to acknowledge your communication of the 28th ult., 
requesting information as to the result of inquiries and experiments, 
instituted by this Bureau, for the purpose of testing the value of 
various disinfectants, as applicable to ships and hospitals. 
The only disinfectants which have received the special attention 
of this Department, are the nitrates of iron, zinc, and wood fibre, 
as prepared and applied by Mr. Robert Grant, and the “Disinfect- 
ing Fluid” of M. Le Doyen. 
The Bureau of Medicine and Surgery assumed cognizance of Mr. 
Grant’s operations on the 24th of June, 1848: prior to which date, 
he had been employed on board various vessels of the U. S. squadron, 
in the Gulf of Mexico, under the direction of the Bureau of Con- 
struction, Equipment, and Repairs. As the results there obtained 
had been imperfect and unsatisfactory, a board of medical officers, 
consisting of Surgeons Waters Smith, Thomas L. Smith, and Passed 
Assistant-Surgeon George Maulsby, were immediately detailed at 
the Navy Yard, New York, with orders to examine, and report upon, 
his whole theory and process of disinfection. The views of this 
board, as elicited by Mr. Grant’s propositions and experiments, and 
communicated in the following extracts from their report, dated 
October 23d, 1848, will explain the course of the Bureau in declin- 
ing, as it has done, all further connection with the operator. 
May 16th, 1849. 
Propositions of Mr. Grant. 
“ 1. He considers the prese. of hydrogen to be necessary to 
the propagation or spread of infectious diseases. 
“ 2. The matter of contagion or infection, whether the result of 
animal or vegetable decomposition, or of whatever causes, unites 652 
atom to atom with the hydrogen thus present, and is by it buoyed 
up and carried through the air; and produces disease by being 
inhaled into the lungs. 
“ 3. In the natural (proximate) decomposition of vegetable fibre, 
hydrogen is evolved, in the first instance. After the hydrogen has 
ceased to be evolved, ultimate decomposition takes place; the oils, 
&c. of the wood take up oxygen from the atmosphere, from water, 
&c., and give off carbonic oxide gas. This gas, passing into the 
atmosphere, absorbs another portion of the oxygen therefrom, form- 
ing carbonic acid; and, while taking up this second equivalent, it 
acts chemically upon the miasmatic bubble floating in the air, and 
uniting with it, neutralizes, or destroys it.” 
Preliminary Experiments, showing the Manufacture of Mr. Grant's 
- Disinfecting Agents. 
First.—Acid nitro-muriatic acid (in four parts of water) to vege- 
table fibre; sawdust being tbe material used. 
Formula.—The hydrogen of the wood is driven off, the acid uniting 
with the essential oils of the wood by a process of electric affinity. 
Second Experiment.—Add nitrous acid to iron or zinc, forming 
nitrate of zinc or iron. 
In this manufacture, a Woolfs apparatus is used to receive the 
nitrous fumes given off, that they may not be wasted. In conclu- 
sion, combine the wood and nitrate of iron or zinc. 
This is the disinfecting material used. 
The material thus prepared Mr. Grant proposes to scatter about 
in the holds of ships, and other foul or infected places; and in 
what has now been stated consists, as admitted by himself, his whole 
theory and practice of disinfection. 
His theory of the mode in which infection is disseminated is 
entirely hypothetical, and has the farther disadvantage of being 
neither original nor new. Some half a century since, Dr. Garnett, 
of Manchester, suggested that hydrogen gas was probably the vehicle 
by which the morbific matter of contagion was carried about, and, 
upon that supposition, explained the alleged efficacy of the acid 
fumigations in destroying it. 
The fumes disengaged from Mr. Grant’s prepared sawdust are 
neither more nor less than those of nitrous acid and chlorine; that 
is to say, precisely what has been proposed and extensively used by 
Carmichael, Smyth, Moreau, and others, at least as far back as 1780. 
The Board consider his process to be an unscientific mode of ar- 
riving at well-known chemical results; and that the active agents 653 
in his preparation are those which have been in use, long since, in 
our own and foreign navies, and which have been very generally 
laid aside, for reasons of some cogency. 
As a deodorizing agent for “ apartments crowded with sick, de- 
composing animal and vegetable substances, vaults, sewers, and other 
receptacles of noxious matters,” they believe it to be inferior to the 
chloride of zinc of Sir William Burnett, or the nitrate of lead of 
Le Doyen; these last have, at least, the advantage of not substituting 
one bad smell for another. 
Entertaining these views, they cannot recommend its “general 
adoption into the naval service.” 
The “Disinfecting Fluid,” or solution of nitrate of lead, of Le 
Doyen, was first submitted for experiment at naval hospitals in 
November, 1848, by order of this Bureau. The cases at these 
institutions have thus far afforded but few opportunities for its ap- 
plication ; but in such as have occurred, the results have been fa- 
vourable with regard to the deodorizing power of this material. 
Surgeon William F. Patton, in charge of the hospital near Nor- 
folk, Va., informs me that, in two instances of foul ulcers, in which 
the fluid had been employed, the odour was completely destroyed; 
and its effect was similar in the apartments occupied by the insane. 
Surgeon K. J. Dodd, at the Hospital of the Naval Asylum, 
Philadelphia, says, “ In several cases, it has been applied with benefit 
to ill-conditioned ulcers. Its efficacy in removing offensive odours 
is complete.” 
I subjoin, also, the opinion of Surgeon Waters Smith, as given 
in the following letter :— 
U. S. Naval Hospital, 
New York, January 3d, 1849. 
Sir : I have to acknowledge the receipt of your letter of the 15th 
ult., by the hands of Dr. Boyd, of Brooklyn. 
The small quantity of “Le Doyen’s Fluid,” furnished by order of 
the Bureau, is exhausted, and it is my intention to ask for a further 
supply in my requisition for the present quarter. 
Our opportunities for testing its properties, in this establishment, 
thus far, have not been great; but, such as they have been, they 
tend to confirm the results of the more extensive experiments made 
in England by Dr. Leeson and others. For instance, we had, at 
one time, nine small-pox patients secluded in two rooms of moderate 
dimensions, in which they were kept until the disease had run its 
course. A few ounces of the fluid, sprinkled occasionally in each 654 
apartment, kept them perfectly sweet, entirely destroying the pecu- 
liar and offensive odour connected with certain stages of that disease. 
We have had similar proof of its power in correcting the fetor of 
water-closets, night vessels, &c. 
Even with this slight experience, one may venture to pronounce 
it a valuable agent in the hands of the hospital surgeon; and that 
it must prove equally so on ship-board may be inferred from its 
chemical composition, viewed in connection with the gases most fre- 
quently and copiously generated in the holds of vessels. One 
marked advantage which it possesses over the rest of the class of 
(what is loosely called) “disinfectants,” is that it is in itself in- 
odorous. 
It is my purpose, whenever occasion offers, to try its efficacy in 
correcting certain morbid discharges, and as a local application in 
various surgical diseases. 
I am, with much respect, your obedient servant, 
WATERS SMITH, 
Surgeon. 
Dr. Thomas Harris, Chief of the Bureau of Medicine and Surgery, Washington. 
With a view to extend these investigations, and to test the opera- 
tion of this material in sea-going ships, a special circular was ad- 
dressed, on the 2d inst., to surgeons of navy yards, authorizing and 
advising its use at naval stations, and on board all classes of U. S. 
vessels. As a report of each medical officer’s experience will be 
required, it may be in my power at a future time to communicate 
more conclusive information. 
In closing this statement, however, I would observe that, while 
desirous of affording every facility for averting and controlling dis- 
ease, it has never been either the policy or wish of this Bureau to 
give to such agents any other than an accessory importance. By 
a rigid observance of that internal police which the principles of 
naval hygiene recognize as indispensable to the preservation of health 
on ship-board, it is believed that the necessity for recourse to “dis- 
infectants” would be almost entirely, if not wholly, averted. 
I am, with much respect, your obedient servant, 
THOMAS HARRIS. 
James Wynne, M. D., Chairman of Committee on Pultlic Hygiene, American 
Medical Association, Baltimore, Md.