The progress of modern civilization is marked by increasing attention to
the sanitary condition of cities, towns and homes. Barbaric races are
comparatively puny and short lived. Very old men are seldom found among
savages, and the rate of mortality bears some proportion to the degree of
barbarism, while early deaths everywhere diminish as the art and science
of sanitation advance. The increase of knowledge and the influence of
Christianity have greatly lengthened human life. Science is constantly
showing how many diseases and deaths are preventable. These facts are
abundantly established by statistics in all the most educated nations,
and, more recently, by the careful investigations of life insurance
companies and public boards of health. There has been a far greater
advance in sanitary science during the last fifty years than in any
previous century. But the popular appreciation of this science, though
steadily advancing, has not kept pace with its discoveries. The pressing
demand now is the diffusion of the art of sanitation—the practical
application of its methods by the people at large. The public press, the
daily, weekly and monthly journals are doing much in this direction.
Some of the most widely circulated religious journals have a column
regularly devoted to this subject. Our schools are helping on this good
work, and here the art of promoting health and prolonging life should be
learned and then applied in the family. Such principles, though they seem
truisms to the scientist, should be taught to our youth, who should early
memorize mottoes like the following: “Health is the prime essential to
success.” “The first wealth is health.” “The health of the people is the
foundation upon which all their happiness and all their power depend.”
“The material precedes and conditions the intellectual.” The school
may do more to popularize sanitary science than any other one agency.
When this work is once done here, it will not long be true that a large
proportion of our people are still living in ignorance and violation of
so many of the essential laws of health. The _popular_ neglect of such
laws should not be overlooked in our gratification at their discovery.
Our wisest sanitarians affirm that more than one fourth of the diseases
which still afflict modern life are preventable. Great prominence has
recently been given to this subject in England and other European
countries. Dr. Simon, chief medical officer of the English Privy Council,
says that “the deaths which we in each year register in this country
(now about five hundred thousand) are fully a hundred and twenty-five
thousand more numerous than they would be, _if existing knowledge_ of
the chief causes of disease, as affecting masses of population, were
reasonably well applied throughout England.” With our larger population,
probably a still larger number of lives in America might be prolonged by
the more general observance of the laws of health. If 125,000 needless
deaths occur annually, that implies 3,500,000 needless sicknesses, there
being on an average twenty-eight cases of sickness to every death. Saying
nothing of the hopes thus blasted and the hearts and homes desolated, the
mere money value of the lives thus prematurely ended every year would
amount to many millions of dollars, often involving the abandonment of
lucrative enterprises, and inducing poverty if not pauperism. In this
lowest view, it costs to be sick and it costs to die.
Modern civilization relates specially to the homes and social life of the
people, to their health, comfort and thrift, their intellectual and moral
advancement. In earlier times and other lands men were counted in the
aggregate and valued as they helped to swell the revenues or retinues
of kings and nobles. The government was the unit, and each individual
only added one to the roll of serfs or soldiers. With us the individual
is the unit, and the government is _for_ the people, as well as by the
people. This interest in the people has been manifested in new laws for
protecting their health, and by the general organization of State and
local Boards of Health.
Their investigations have embraced not only the needs of cities, towns
and individual homes, but have revealed startling facts as to the
unsanitary condition, and consequently the peril, of certain summer
resorts. Cases of loss of life from the burning of hotels have led to
the enactment of laws requiring fire escapes. On account of disasters
by the explosion of steam boilers, all steamboats are required to get a
“bill of safety” from an official expert examiner. But the violations of
sanitary laws in boarding houses, hotels and summer resorts have produced
annually far more sickness and death than have such fires and explosions.
The circumstantial horrors connected with these sudden and terrible
disasters produce a deep and lasting impression, and prompt to stringent,
preventive laws, while the deaths from bad sanitary conditions, though
more numerous, are so isolated as to attract little notice. The patronage
of summer resorts is already so large, and is so rapidly increasing from
year to year, as to multiply their number and increase their attractions.
This summer migration from city to country is more than a fashion, and
is favored by such substantial reasons as to insure its permanence and
growth. Even city clerks have their fortnight’s vacation for rest and
refreshment by the seaside or among the hills and mountains. There is a
greater exodus of teachers and members of all professions during their
longer vacations—still more, families, and especially those having
young children, seek this escape from the heat, dust, and miasmatic
exhalations of the crowded city. Though their children may have attended
the kindergarten in the city, they find the best sort of kindergarten
in the open fields and varied objects of the country, with its wider
range for rambles and those freer sports that are so attractive to every
wide-awake boy, such as boating, fishing, hunting, watching turtles,
gathering bugs and butterflies, roaming in the woods, taking long
excursions on the lakes or rivers, climbing steep hills and rocky cliffs,
loving flowers, observing the properties of plants and trees, and the
names, habits, retreats and voices of the birds. Living much in the open
air, nature becomes the great educator, and for the summer at least, the
country proffers superior advantages for the physical, mental and moral
training of youth. The boy, for example, who observes the birds so as to
distinguish them by their beak, claws, form, plumage, song or flight has
gained an invaluable habit of accurate observation never acquired while
cooped up in a city.
The apprehension of cholera during the present summer is likely to
increase the patronage of rural resorts. The condition of some dense
centers of population invites this pest. Its most terrible ravages last
summer in Naples, Marseilles and Toulouse occurred in the squalid dens
so long the reproach of those cities. Our summer retreats should all
be health resorts in fact as well as in name. Yet many of them—little
villages in winter, with a population of a few scores or hundreds—are too
often ill-prepared to be suddenly expanded into cities with a population
of many thousands, during the hottest and most trying months of the year.
Several State Boards of Health, within a few years, have examined many
watering-places and have been reluctantly compelled to make startling
statements as to their unsanitary conditions.
In some cases these unwholesome and unwelcome discoveries, though a
surprise and regret to the owners, were accepted as facts, and the
needful remedies promptly applied. In other instances, such disagreeable
revelations awakened resentment and were treated as absurd alarms or
slanderous attacks, and ignorance and prejudice held their ground
undisturbed.
In regard to one famous resort the State Board of Health of Massachusetts
said six years ago: “The unsanitary grounds invite a pestilence. They
violate the plainest teachings of hygienic common sense. There is no
adequate provision for the removal of refuse, and the wells and privies
are everywhere in close proximity, and some of the latter are immense
and offensive affairs, emptied only once a year, in the absence of the
summer boarders. At a large boarding house the sink drain empties on the
ground within three feet of the well, and at another, the well is within
a foot of an open trough sink drain, so filled and obstructed that the
water sets back, and a filthy puddle surrounds the well.” These were
mostly driven wells, reaching water from eight to twenty feet below the
surface. The theory was, that the foulest water would be fully filtered
by the soil above and around a driven well. The peddlers of this patent,
with their boastful advertisements, are in a measure responsible for
this mischievous error, which I have met in many states. I found a large
hotel beyond the Missouri River, where, instead of even a cess-pool,
the kitchen drainage gathered in a surface pool close to the well. At
a bakery in another resort the sink drain and cess-pool are but twelve
feet from the well. Twenty-four privies and thirteen cess-pools are
within a radius of 140 feet of a well used by many families. When the
water from forty wells was analyzed, the chemical examination proved that
sixteen of them were bad and unsafe. The official State report for 1879
contains many pages of similar details. In fifteen days after the State
Board of Health called attention to the results of this investigation,
the citizens held a town meeting, at which it was _unanimously_ voted
that the Board of Health of this town should adopt all proper methods
to perfect and enforce stringent sanitary regulations, and promising
them their most cordial support in all reasonable efforts they may
make in the furtherance of this end. The Board of Health of another
well-known resort, after a careful examination of the sanitary condition
of Oak Bluffs and Martha’s Vineyard Camp-grounds, frankly said that
“unless proper remedial measures were carried out, the abandonment of
the place, as a residence for health, is but a question of time.” The
State Board subsequently commended this local board for adopting wise
sanitary regulations and carrying them out with such energy that the high
reputation of the place as a health resort might be preserved.
The same report says: “It must not be taken for granted that this
condition of things is confined to one place. Visits to various seaside
resorts of a similar character on both north and south shores show little
change for the better. Many individual cases are worse.”
The official inspection of many such summer resorts revealed sickening
details connected with the large hotels and boarding houses. One hundred
and fifty summer houses examined were, almost without exception,
objectionable, on the score of danger to health, due in part to foul air,
but more to contaminated well water. There is always a risk in the use
of such water, and the only safe rule is to make privies and cess-pools
absolutely tight, and frequently empty and disinfect them, so that they
_can not_ poison the water supply. Nearly every State health report
abounds in instances of the outbreak of typhoid fever due to bad well
water, and one affirms that the majority of wells in the rural districts
of that state are tainted.
As is my custom, in order to adapt my lectures on “Village Improvements”
to local needs, I made a cursory inspection of the streets and private
grounds in the town of ⸺, which revealed a prolific source of peril to
its citizens. Though I had heard nothing of the actual experience of the
place, I spoke in strong terms of the danger of an early outbreak of
typhoid fever and diphtheria, from the proximity of vaults and wells.
After the lecture I was informed that such a dire visitation had already
desolated many homes, but it was regarded as “a mysterious visitation
of Providence,” and nothing was done to abate the obvious cause of the
pestilence. I find it exceedingly difficult to convince men of any danger
from their water supply. They are apt to resent a disparagement of their
wells as they would of their children, and yet I seldom inspect a town
where there is not found urgent need of the warning, “LOOK CAREFULLY
TO YOUR WELLS.” Gross sanitary defects are often found even around the
homes of isolated farmers, with every natural advantage for drainage and
healthfulness. Hence I advise that securing “better sanitary conditions
in our homes and surroundings” be made prominent among the various
objects of the “Village Improvement Associations” organized in many
states, and now numbering nearly three hundred.
The unsanitary condition of Memphis invited the terrible scourge of
yellow fever in 1878. The occurrence of four thousand deaths in one
season compelled attention to the cause and remedy. If Memphis was then
the filthiest and sickliest city of the South, it now claims to be the
healthiest. The case demanded and received “heroic treatment.” Over
forty-two miles of sewers have been built, on the most approved plan,
with one hundred and ninety automatic flushing tanks, each discharging
one hundred and twelve gallons of water twice a day. While collecting
facts for a lecture there on “The Needs of Memphis,” I inspected the
city, and especially the “man-holes,” in company with the city engineer,
who had supervised their construction, and found in none of them any
offensive odor. These improvements were costly, but the recent rapid
growth of this city in population and wealth proves that these liberal
expenditures were wise investments. The “death-pool” of 1878 now justly
aspires to be a health resort. An excellent sewer system, with automatic
flushing tanks, is now in use in Denver, Colorado. I made a similar
examination of the man-holes there last October, with similar results,
and received the testimony of a prominent physician, to the marked
diminution of zymotic diseases since the completion of the new sewers.
Cumulative evidence on the danger of using tainted water might be given
to an indefinite extent, like the following: Thirty-one out of one
hundred inmates of a convent in Munich, affected with typhoid fever; the
outbreak of typhoid fever in Princeton, New Jersey, two years ago; the
fearful epidemic at Waupun, Wisconsin, in April last, and the terrible
pestilence now desolating Plymouth, Pa. are all attributed to infected
water. In Plymouth nearly one hundred persons have already died, and
over one thousand have been prostrated—in the opinion of the physicians,
poisoned by water pollution. Such facts should everywhere prompt to
sanitary precautions, and enforce the motto, “Eternal vigilance is the
price of public health.”
In a popular summer resort of Massachusetts there occurred eighty cases
of typhoid fever during 1881, out of a population of only 1,500. The
citizens were alarmed, and prompt and thorough investigation discovered
and removed the cause. The mischief had been done mainly by tainted
water. The remedies suggested by the board of health—clearing of
premises, securing of better drainage and plumbing, removing of all
decomposing matter, abolishing all cess-pools and leaching vaults,
draining marshes and pumping out and cleansing all wells and cisterns
that afforded chemical evidence of being tainted—were energetically
applied. The owners of these beautiful cottages and villas spared no
effort or expense to restore this attractive resort to its former
salubrity. If any community of its size was ever more earnest, prompt and
united in such a work of restoration, I should be glad to learn its name.
In the face of peculiar difficulties on this rocky peninsula, nearly
five miles of sewers were constructed. Hundreds of chemical analyses of
the drinking water were made. Of the wells and cisterns so examined,
nearly sixty per cent. contained water unfit for drinking or cooking. As
a result of this renovation, the local board of health is quoted in the
Massachusetts report for 1883 as saying: “These vigorous correctionary
measures completely checked the epidemic, and not a single case of the
fever has since appeared here that could not be traced to some other
locality for its origin.”
Another seaside city, much resorted to in summer, with a regular
population of over 3,000, after suffering severely from zymotic
diseases, especially typhoid fever, requested the State Board of Health
to investigate the cause of this excessive mortality. Nine tenths of
the population here are crowded in one village of small area, having
many narrow streets, with small house lots, necessitating a dangerous
proximity of cess-pools, privy vaults and wells. This danger is increased
by the nature of the soil, mostly sand or gravel, that facilitates
rapid percolation. The climate itself is pronounced more equable and
salubrious than that of any other part of the State, and therefore
specially attractive to the health-seeker. The mean winter temperature is
seven degrees warmer than that of Cambridge. The insular position of the
town, and the sensible proximity of the Gulf Stream lend their combined
influence to modify the extremes of temperature, such as exist in the
inland parts of the State. The summer temperature of the water upon its
shores renders sea-bathing recreative, invigorating and pleasurable, even
to the delicate invalid. With such rare natural advantages for salubrity,
the high death rate is traced to preventable causes. The water of eleven
wells showed, on chemical analysis, a great degree of pollution. The
remedial plans, prepared at the suggestion of the State Board of Health,
were submitted to the action of the town meeting held February, 1884,
and were favorably received. But at a subsequent meeting, this favorable
action was reconsidered, and since that time no action has been taken.
The last two reports of the State Board of Health of New Jersey contain
valuable accounts of the sanitary investigations of the health resorts
of that state. The following statements are abbreviated from these
volumes. Within thirty miles of New York City is to be found half the
population of the state of New Jersey. Of this number, according to the
judgment of engineers, chemists, physicians, and boards of health, not
one half are supplied with water fit to drink. As our risks from impure
water are even more than those from ordinary impure air, it behooves
all to guard against any contamination of potable water. If there is
a neglect of sanitary care, and especially of a good water supply, it
is too late to adopt the policy of concealment, or to point to a death
rate of from twenty-six to thirty as a justification, when so large a
city as London can point to a death rate of only twenty per thousand,
and many an English town of 30,000 inhabitants, to a death rate of only
sixteen or eighteen. The sea coast of New Jersey, more than that of
any other state, abounds in popular summer resorts. The State Board of
Health has carefully inspected these resorts, notified the proprietors
of existing defects, and reported them to the public when they were not
remedied. Their first visits were often occasions of protest, and even of
denunciation on the part of proprietors, many of whom, on sober second
thought, were convinced of the truth, and corrected the evils complained
of. The latest inspection says that the sanitary condition of most of
these places has been greatly improved. In 1883 it is said of ⸺, where
are six hotels and over one hundred cottages, “This locality shows no
improvement in its care of sanitary conditions. No skilled attention is
given to drainage. The water supply is mostly from driven wells, which
are generally surface wells. Privy vaults are of the crudest description.
Slop water is disposed of in cess-pools, often in close proximity to
wells. This sanitary lawlessness has not been without its deleterious
results.” The last report speaks of the same place as improving, but
there are still some sanitary defects.
One popular resort shows some marked improvements. While some of the
large hotels have still rows of cess-pools, they are kept in better
condition than formerly. Still it has not equaled expectation in its
efforts to provide a much needed system of sewerage. The hotels exhibit
some of the very best and some of the very worst methods for the disposal
of water-closet refuse. In one hotel enormous brick vaults had no modes
of ventilation, and nothing but the shortness of the season protects
the inmates. These New Jersey resorts are no worse than those in other
states, and as a rule are salubrious and most desirable retreats, but
the self-satisfied carelessness of some wealthy owners of hotel property
has made light of these defects, and they have been tardy in their
correction. Visitors in such hotels, before taking rooms, should have an
expert make a sanitary inspection in their behalf.
These facts from different states clearly show that the sanitary
condition of summer resorts is the question of first importance to all
who frequent them, and that a rural location, naturally salubrious,
has often proved a death-pool when made the home of a dense crowd in
the hottest months of the year. This frequent outbreak of preventable
diseases in large watering places proves the necessity of applied hygiene
in such resorts, where the management often betrays gross ignorance or
carelessness on this vital point.
In this respect the Assembly grounds at Chautauqua form a happy
exception. Some details may suggest the changes and plans needed
elsewhere. Last summer, while meeting lecture appointments there, I made
a cursory inspection of the grounds around each of the four hundred
and twenty-eight cottages in this “city in a forest,” including its
numerous boarding houses. The village is very compact, and the cottages
are sometimes too closely crowded together. But everywhere the sanitary
conditions are admirable. The three essentials—pure air, pure soil, and
pure water—are well assured. Special effort is made to guard these three
“Ps.” No old fashioned privies are _now_ allowed. The last two nuisances
of this sort were removed while I was on the grounds. Some ten public
vaults are located at convenient points, each built of stone or brick,
laid in cement, and thus made water tight. Each is _daily_ supplied with
disinfectants, and emptied every other night, and then well cleansed with
water. There are sixty-seven private vaults, made in like manner, water
tight, and frequently emptied. The water-closet pipes emptying into them
are said to be all carefully trapped. The waste is conveyed by night to
farms far away from the grounds.
Every family is required to provide a barrel for garbage, kitchen slops
and wash water, which is emptied _daily_. No soiled water may be thrown
on the grounds. The daily inspection detects any violation of this rule.
There are no alleys, lanes, back yards or dumping grounds where garbage
can be thrown and secreted. There is no filth-saturated soil, and the
atmosphere is not tainted with the gases of decay. The decaying leaves,
so abundant in this forest city, are removed or burned.
Numerous wells, carefully guarded from surface drainage, and eight
springs furnish pure water. Borings some thirty feet deep, near the
engine house by the lake, have opened three flowing springs, the water
in five-inch pipes rising seven feet above the lake. This proves to be
a mineral water (pronounced by Dr. Edwards, the lecturer on chemistry,
a wholesome chalybeate tonic), is forced into a large tank on the hill,
and thence distributed in pipes near the surface over the grounds free
to all. There was little to criticise in the sanitary condition of the
grounds, and the few suggestions which I made were promptly carried out
by the efficient superintendent.