You will not ask for rhetoric or eloquence in the few remarks upon a
vital subject to be offered you by a member of the silent profession.
What could be so eloquent as the hollow voice which announces the Boston
annual death-rate as being 26.18 against 23.7, that of the great paved
nation of London; against 19.3, that of Philadelphia; and approaching
that of our two unhealthiest cities, New York and New Orleans? This high
death-rate has been shown to be largely due to the excessive mortality
among infants and children under five years of age. The most fatal of
the diseases which assail them is that destruction which wasteth at
noonday, to which our American practitioners give the name of
cholera-infantum. And this disease prevails chiefly, almost entirely,
from June to October, the season when all out-of-door influences are
most tempting and most needed. The weekly record of August and September
is that of a pestilence. The destroying angel carries off the firstborn,
and, oftener still, the last-born, out of almost every household in
certain districts, as in the heaviest curse laid on Egypt. Thousands
have fled the city, as they deserted London in the season of the
plague; but thousands are left to follow in the funeral procession of
those who were the hope of their households.
A considerable part of this mortality, it may be feared, is unavoidable.
Our climatic influences are permanent factors, and must always count in
the bills of mortality. But there are certain agencies which we can, to
a great extent, control. We can and do submit the dwellings of our
citizens to inspection and sanitary regulation; we can and shall provide
our city with proper drainage; we can and do inspect the food in our
market, and condemn it if unfit for use; we can and must secure for our
citizens the influences of unroofed and unwalled Nature,--air, light,
space for exercise and recreation, the natural birthright of mankind.
Of the uses of these larger breathing-spaces, which we call parks,--for
the relief of the imprisoned dwellers in crowded streets, for the
recreation of poor and rich alike, for the health of mind and body which
they offer to all,--it seems almost needless to speak from the medical
point of view; for all know what cities would be without open areas,
where children can play in the shade, and old people warm themselves in
the sun. I wish to call your attention to a single point intimately
connected with the alarming fact of the excessive death-rate of which I
have spoken. That point is the influence of the air they breathe on the
health of children, with the bearing of this on the question before us.
If a child is found to have been starved to death in a cellar or an
attic, a cry of horror is raised over it. If two or three wandering
boys, as it happened the other day at Lowell, come upon some noxious
roots, and, in obedience to their omnivorous instinct, devour them, and
pay the forfeit, the whole country hears of it. If a family or two get
hold of some ill-conditioned meat, and suffer for it, the groans of
their colics are echoed all over the land. If a milkman misrepresents
his honest cows by falsifying their product, the chemist detects him,
and the press puts him in the pillory. If the Cochituate or Mystic water
is too much like an obsolete chowder, up go all noses, and out come all
manner of newspaper paragraphs from "Senex," "Tax-payer," and the rest.
But air-poisoning kills a hundred where food-poisoning kills one. Let me
relate a circumstance which happened in Ireland, to which circumstance,
in all probability, I owe the pleasure of being listened to at this
moment by some among our hard-working, adopted citizens who are before
me.
When I say to you, meaning to speak the words of sober truth, that a
single physician, by a single and simple measure, saved more lives than
were lost at Waterloo by the British army and all its allies, leaving
out the Prussians, you will suspect me of exaggeration, not very
uncommon in public speakers. I will therefore intrench myself behind
certain details which I have often before cited, but not in the presence
of a gathering of this kind.
Dr. ROBERT COLLINS was Master, as it is called, of the great Dublin
Lying-in Hospital, where the annual rate of births was between two and
three thousand, from the year 1826 to 1833. A work of his, containing
the results of his practice during his seven years of service, was
published in Boston in 1841, by order of the Massachusetts Medical
Society, for the use of its members. I consider him vouched for as
authority, therefore, by men in whom you can put confidence. Dr. COLLINS
makes the following statement:--
When his predecessor, Dr. JOSEPH CLARKE, was in office, in the year
1784, he found that seventeen children in the hundred, nearly one in
six, died within the first fortnight after birth, nineteen-twentieths of
these of one particular disease peculiar to very early infancy. Looking
for the cause of this frightful mortality, he thought he found it in a
foul and vitiated state of the air of the hospital. So he had some
openings of considerable size made in the ceiling of each ward, and
three holes, of an inch in diameter, through each window at top: the
doors, too, were perforated with numerous holes. In this way, a free
circulation was secured, and so arranged, that the nurses could not
control it; for some of the old-fashioned nurses would not have opened a
window in the Black Hole at Calcutta, for fear the inmates should catch
a cold.
What was the result of this simple proceeding? Why, the mortality fell,
from seventeen in a hundred, down to between five and six; and Dr.
Collins gives us the result up to his time in these words, "Thus, by his
valuable suggestions, 16,371 lives have been saved, as, had the
mortality of infants continued one in six to this day (1833), the number
of children dying of the 131,227 (which is the total number born in the
hospital) would be 21,871, as the hospital registry now shows." In the
battle of Waterloo, the British and their allies lost 16,186 men; that
is, 185 less than the great army of very light infantry saved from death
by letting out the smoke of the battle of life, and letting in the sweet
air of heaven, through the walls of the Dublin hospital.
So much for what air alone can do for children. Now, it is not the
"nine-day fits" of that hospital in its unventilated condition which
kills our poor children in the hot months, but that other disease of
infancy, which to name is like sounding a funeral knell in the ears of
many a parent. This one malady, more than any other, gives Boston its
place on the black list of unhealthy towns. All parents having young
children leave the city during the worst part of the sickly season, if
they have the means of so doing. Our best streets look as DEFOE tells us
London streets looked during the Great Plague. But thousands of families
must remain; and we are bound to do what we can for them in their
dearest interests,--the lives of their children.
With regard to cholera-infantum,--the deadly scourge of which I have
spoken,--the testimony of experience shows that change of air, even
temporary, often effects the cure of which the apothecary, who "pestles
a poisoned poison behind his crimson lights," cannot bring about with
his drugs, though the wisest of physicians had written the prescription.
This point is so important, and bears so directly, not only on the
necessity of park-spaces, but upon their distribution so as to bring
them within reach of all the crowded and unhealthy districts as far as
possible, that I shall borrow a few sentences, enforcing it, from
writers recognized as authorities on the diseases of children.
"Even in cases in which a removal to a healthy and airy situation in the
country is impracticable," says Dr. CONDIE of Philadelphia, long and
well known by his writings, "much benefit may be derived from carrying
the patient frequently into the open air in a carriage, or in the arms,
or, when its residence is near a large river, sailing it daily in an
open boat." And Dr. JOHN BELL of the same city says, "The restorative
effects of fresh air in cholera-infantum are strikingly evinced in the
relief procured by many hundreds of children every summer in
Philadelphia, by their simply crossing and recrossing the River Delaware
in steamboats once or twice a day. New life is restored to the little
beings, who, on leaving their homes in the city, seemed almost
exanimate, and in the last stage of incurable exhaustion." Dr. JAMES
STEWART of New York, in his treatise on the diseases of children, and
our own honored patriarch of the profession, the late Dr. JAMES JACKSON,
in his letters to a young physician, speak in similar terms of the great
advantage of change of place and of air. The "aquatic jaunts"
recommended by Dr. STEWART, and spoken of as so efficacious by Dr. BELL,
are among the advantages to be secured by the plan proposed by our Park
Commissioners. I wish twenty tons of little children could be shipped
every fine summer day for a good sail.
There is one particular region which I will mention as like to be
specially benefited by the plan referred to,--a region which would get
the advantages of the fresh air coming over the wide estuary of Charles
River without the expense and trouble of taking boats. The narrow and
crowded streets of the northern slope of Beacon Hill, and a wide region
extending northward from it, are inhabited by the very class most
exposed to cholera-infantum and diseases of that nature. Having lived
for many years in Charles Street, where I am no longer an owner, I had
occasion to learn the incomparable comfort and delight to be got in a
hot summer's day, when the wind is from the southwest, by turning the
corner of Charles and Cambridge Streets, and getting into the current of
air cooled by passing over the water. Some of the poor mothers with sick
children had found out where to bring them for relief; and I often
thought, if there were an open green filling up that corner, with shade
trees and seats, what a priceless _sanatorium_ it would be to all that
suffering quarter of the city! The proposed green margin, beginning at
Leverett Street, and extending along the river, will meet this very
want; and this is only one locality of many which will thus turn its
natural advantages to account.
I have preferred to insist on a single point rather than to expatiate on
a larger number. But I trust that the eloquence of others will enforce
and illustrate the innumerable advantages our city will derive from the
only chain she would submit to,--a chain of pleasure-grounds all around
her. The Bostonian has looked up at the gilded dome of the State House,
and down at the reflection of his own features in the Frog Pond, long
enough. Our city has always been a centre; and it must not act as if it
considered itself a mere feeder. We must provide ourselves with the
complete equipment, not of a village community, not of a thriving town,
but of a true metropolis, large enough for a citizen of the world to
live in without feeling himself provincialized, and not too large for
one honest mayor like our own to handle. The marrow-bones of the past
are pretty well cleared out, or will be before the Centennial year is
over, and we must not be content to live on them for another century.
The Old Elm got enough of it,--grew discontented, and started on its
travels for wider quarters, but, unfortunately, stumbled and fell. Let
us take the hint, and plant a thousand acres with young elms and all
other trees of the forest, where the hillsides are not already clad in
foliage; so that the children of coming generations may bless our
memory, not only for all the happiness they have had in their shadow,
but for saving more lives to the country than were lost in any one of
the battles which scarred and crippled their fathers. [Applause.]
THE PRESIDENT. Gentlemen, you have been addressed by two of the learned
professions. It follows, as a matter of course, that you will now be
addressed by one from the third, the most important and most respected
of all. I am happy to introduce to you the Rev. Dr. NEALE, the oldest
settled pastor of the city of Boston. [Applause.]