RELL M. WOODWARD
Surgeon United States Public Health Service
Travelers from almost all foreign countries describe the public
convenience stations of foreign cities. In London there are many places
where crooked streets converge, leaving perhaps an irregular open space
or plaza. These are not all occupied by statues, as the city has
attempted to provide comfort for the living as well as honor to the
dead. Two modest iron stairways with suitable signs lead to two rooms
below ground, one for women, the other for men, where toilets and
urinals are found.
On the continent the provisions are usually less complete and in many
instances in the eyes of Anglo-Saxon observers seem much too public. For
instance in Paris urinals for men are located at convenient points, but
some of them only cover the user from the breast to the knees. In
Antwerp and Brussels urinals are attached to posts at the edge of the
narrow sidewalk, and some of them have no screen at all. In Rotterdam at
frequent intervals scrolls of sheet iron shaped somewhat like a letter C
are located in the gutters of the sidewalks; the open side of the scroll
facing the street. They reach from a point above the head to about a
foot from the ground. In Italy there are places, notably Naples, where
two slabs of slate set in a wall at an angle serve the purpose of a
urinal. They are usually at the entrance to a small street or alley, and
are not screened. The custom of ages causes the natives to pass by these
without a glance, but to use them is embarrassing to the tourist.
It is not the intention to advocate such crude contrivances, but to
present a plea for the establishment at frequent intervals of
convenience stations designed for the use of both men and women, and
with such surroundings that one may enter and leave without feeling the
blush of shame.
Many American cities have provided a few such places, for instance in
parks, and some of these are admirable in conception and in structure;
but one cannot always remain near a park, and in winter when the kidneys
are most active, these stations are often closed. One of the most
practical stations of this kind that I have seen is in the Boston
Common. It is underground in a small hill, with a wide stairway leading
to it.
As one approaches it he sees that the room is lighted and is lined with
white tiling. There are urinals, closets, washstands, and a
shoe-blacking establishment. It has the appearance of a toilet room in a
hotel, and the place is well ventilated and kept clean. I do not recall
how it is heated, but such places could be heated with steam from
adjacent buildings or by stoves.
Cities must of course consider the economic side of any new enterprise.
I believe that such stations, outside of the cost of original
construction, could be made almost if not quite self-supporting, in the
following way. Lease the shoe-blacking privilege to an individual for a
good round fee, said individual to be subject to certain rigid rules and
regulations, and the place to be subject to periodical inspections. The
lessee should be required to keep the place in perfect sanitary
condition. In addition to his income from blacking shoes the lessee
might be allowed to rent a few closets, ordinarily kept locked, and
charge a small prescribed fee. If the patronage of the station in Boston
Common is a criterion it would seem to me that the city could demand a
fee from the lessee that would cover all ordinary running expenses.
A woman attendant in the ladies’ station could be allowed the privilege
of renting closets, and could also be provided with pins, buttons, and
other necessaries such as are kept in the ladies’ waiting rooms at
department stores.
As a public health measure the subject must be considered from two
standpoints, the health of the individual, and the health of the
community.
Physiology teaches us that the normal adult bladder, when fully
distended, holds twenty ounces, but that a discomfort begins when it
contains more than four ounces. As one advances in years prolonged
retention of urine causes ammoniacal decomposition, with consequent
irritation of the bladder. If the retention is frequent, disease of the
kidneys must follow.
At present in most American cities there are few convenience stations
available to the public outside of hotels and saloons. In nearly all
hotels one finds a sign stating that the toilet facilities are for the
exclusive use of the guests. This makes a stranger feel unwelcome.
Saloons are open to the public, but one dislikes to make use of the
sanitary privileges offered without purchasing something. To a man of
mature age, who is perhaps in the habit of taking an occasional drink,
this phase of the subject has little importance; but for a young man in
a strange city, driven for lack of comfort stations into a saloon the
question assumes a moral side. The only way to avoid the saloon is to
make use of an alley or other dark place, thereby breaking a city
ordinance and creating a nuisance which gives the offence a public
health aspect. The frequency with which this is done is evidenced by the
familiar sign “Commit No Nuisance.” In London I saw a sign that to my
mind was much less objectionable and equally effective; it read simply
“Decency Forbids.”
The establishment of comfort stations at convenient points would I think
contribute greatly to public health.