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THE HEALTH OF
OF THE CITIES
F. C. WALSH. M. D.
UPPOSE little Johnny, your that it had never thought it necessary to sole son and heir, were taken have a medical man in charge of its desperately ill in the middle of health-office. Of course it would have the night.
been very much surprised indeed if a "Never mind, dear," you say, cigar-maker had been forced on its shoulto quiet the mother's alarm. "Don't be ders to occupy, say, the position of city frightened. I'll send across the street for attorney. That would have been a bitter Jones, the cigar-maker. He's a good pill,—or a “horse of another color," as fellow, a hard party worker, controls the the Cigar-Maker City Doctor might have Third Ward."
aptly said, for he was a "good-fellow,” Or suppose several members of your and as wise as the average of his kind. Befamily successively come down with fore he took office the death-rate was high; typhoid. With astonishing perspicacity after he entered on his professional duties you begin to suspect that sanitary con it continued to soar, with an alarming ditions are bad. Send for the amiable number of cases and deaths due especigar-maker again! Turn the situation cially to typhoid,—but still no one so over to him!
much as dreamed that anything was difIdiotic! Of course. But what no sane ferent from what it should be; everybody individual would dream of doing a city was used to it, and the city slept! No, of 50,000 presumably intelligent people one man was awake, though he has little actually did! They hired a cigar-maker to do with this story. In talking to me to see that they were protected from the about the situation, he told me he thought ravages of measles, diphtheria, typhoid, it was all due to some peculiar, local, small-pox and tuberculosis! Inevitably climatic influence! I don't know what the death-rate was needlessly and wick his condition was, but I will say right edly high. Hundreds of little children, here that Springfield's deplorable plight adult men and women in their prime, was largely due to the three most baneful were sacrificed to the common stupidity influences of American city life,-ignorand ignorance.
ance, self-satisfaction, and politics ! The city which put a cigar-maker in Springfield has come to its senses, but charge of its health department was its story is well worth following a little Springfield, capital of the great state of further as an illustration of what may Illinois.
and does occur in almost any one of our But Springfield's citizens were no more cities, from the metropolis down to the open to blame,—nor was the unfortunate remotest of villages. But to continue, cigar-maker, – than are thousands of Springfield was sleeping. And then, others who are living in a state of dan- somehow or other, by one of those rare gerous bliss in various cities scattered chances of fortune, a medical man hapthroughout our country. Those worthy pened to be appointed to look after the citizens of the Illinois city didn't know city's health. There was much to be done that anything was especially wrong; no besides mere drawing a salary; the situaone had taken the trouble to arouse them tion required a good deal of head-work to a knowledge of their plight, and the and the bringing to bear of expert knowlinstance is here used merely as a horrible edge. The appointive Power recognized example.
this by making the salary of its first and One main trouble with Springfield was only medical health-officer equal to that
THE HEALTH OF THE CITIES
of the police patrolman, who measured estimate, and that's an important point, up to his office by sheer weight in pounds for instead of seventy per cent using city avoirdupois, and the requisite height water, it was found that two-thirds of the when measured in his stocking feet! dwellings used water from wells on or
But this new health-officer, this man near their own premises, and instead of who made the story of Springfield worth sewage connections, it was learned that telling, went to work at once systematic- these two-thirds were making use of ally, not knowing, however, just what he obnoxious cess-pools. The taxpayers had was going to find, and he himself was the put in a system of water and sewage at first to awaken to the real truth of the a cost of $400,000, and only one-third of situation.
the population was profiting from this He first turned his attention to the outlay! But this is a health story, and city's water-supply, and found it good. we must come to the point. It was quickly There was no typhoid from that source. discovered that a large proportion of Then he did something which no one these cess-pools were contaminated with before had thought of, and certainly the typhoid, and, horrible fact, were draining cigar-maker would have required more into adjoining private wells ! than the inspiration of a good Havana if This condition had evidently existed he were ever to think of such a thing for years, unknown to any one, and With untiring patience he carefully Springfield was properly shocked when plotted out on a map the location and the facts became known. But the source source of water-supply of every house in of the high annual death-rate was exSpringfield, and then began to work on plained, and action was taken to remedy the resulting figures. The consequences
the malodorous conditions as quickly as were startling and of tremendous im- possible. portance to at least two-thirds of the But to their credit be it said, the people city's dwellers. City officials, and others of Springfield did not try. to hide this who were supposed to know, had long blot on their 'scutcheon; on the contrary, thought that
they a Cabout sev
knowledged enty per cent
Fold of Spring
gence, voted field's dwell
C to the thanks to the ings o b
man who retained their
vealed the paper water from
E, over D objection
7 inches the city's
able condisource of D square.
Insert supply, and
were glad to that about
know where be it under
double stood, — the
ness lay. As sa me per
A on to B
fold of C.
a consecent of
quence of houses were along the line
Fold B back.
ing from a D..... with the
open city's system
the deathof sewage.
rate has Fold the line
diminished they had D te
to a surprisbeen harbor
E... F. and there's
ing extent, ing this de
and the city lusion. But F on the line A.....C DRINKING CUP. has become the facts fell
alive to other wildly short How to MAKE A SANITARY DRINKING Cup.
health One of numerous helpful bulletins issued by Chicago's City Health Department.
of this vague
But no city appropriate a little bit more toward the should rest satisfied health fund, the average American prewith merely reduc fers to run the risk of contracting a ing the deaths due to contagious disease. But does he? Is not any one disease; all this rather perplexing question made preventable diseases more perplexing by that familiar monster, should be prevented rotten politics? Why else do the mayors in actual fact as well of our cities, in such a majority of
as in fine-spun the- instances, refuse sufficient appropriaory. In other words, there is no excuse tions? Is it because they are pledged by nowadays for a city's population being tradition to look after job-seekers, and by afflicted with epidemics like diphtheria or past customs in politics they are bound to typhoid. And yet Chicago, as an instance, find places on the pay rolls of the police had 792 deaths from diphtheria for the and fire departments for the friends of year 1911. Could these deaths have been influential henchmen? Perhaps no,— prevented? Undoubtedly, if antitoxin perhaps yes! At any rate, according to could have been administered on the first a bulletin recently issued by the governday of the disease. The effectiveness of ment, the appropriations for forty-seven this remedy was proven by the records cities were as follows: of the Philadelphia Hospital for Contagious Diseases from 1904 to 1910.
employed. appropriation. During that time antitoxin was admin- Firemen
4,899 $4,632,497 istered to 256 on the first day of the Policemen
4,822 4,262.322 disease. All recovered! Why can't Chi- Health Inspectors.. 247 842,842 cago, why cannot other cities, show These figures tell their own story, and results as brilliant as this Philadelphia show the relative importance the average record ?
city official places on property protection The obstacles are many. The people as compared with health protection. themselves are often to blame, either These figures are the total of forty-seven through ignorance or a lack of interest cities with a population of between 50,000 in their own welfare, or both. Then and 100,000 each. again, health-officers, even medical ones, In Chicago medical inspectors receive are occasionally incompetent, and some- $66.66 a month, while the salary of a times gain office through skill in politics, police patrolman is $1,320 a year. The while the funds at the disposal of the salaries of plumbing inspectors were worthy ones are far too often sadly in- recently raised from $1,440 to $1,716 a sufficient. We will pay for police protec- year. The hundred or more medical intion; we will perhaps more gladly pay spectors petitioned a short time ago for a for fire protection; but we—or is it our
raise from $66.66 to $88.88 a month, and neighbor-seem to have a natural aver a rumor got afloat that they would strike sion to pay for health protection. It if they did not receive the raise. This resolves itself into this: rather than pay rumor reached the ears of Mayor Harria little bit more, or urge the officials to son. "Let them strike," he is reported
THE HEALTH OF THE CITIES
to have said, "these positions were well and good, but let us be sensible created for medical students just starting about it and begin at the bottom of out. No one supposes that the positions things, for the shortest road to efficiency are high salaried ones, and no one sup is good health, and it is the duty of city poses that a doctor who can't make more and state to conserve that. than $66 a month is much of a physi To what extent are the cities making cian.” By the same token apprentices good in this respect? Let us take the should suffice for plumbing inspection! matter of pure food,—the subject is not But the mayor's remark would seem to yet a dead issue !
yet a dead issue! For in spite of the indicate that a city's health was not of protection which the pure food law is sufficient importance to pay more and supposed to exercise over the welfare of get better men. Perhaps that attitude of the people, conditions relating to it are mind explains the 792 deaths from diph- far from perfect. Many big companies theria in Chicago for the year 1911. The have been fined during the past year for fact is that an epidemic of diphtheria was comparatively slight offenses. But it is raging in Chicago at the time the alleged not always the big fellows who are the remark was made !
most guilty. The little fellow is harder And yet hundreds of thousands of lives to watch, and his offense is often more and millions of money could be saved serious. Sometimes he is able to evade every year by attacking disease on scien- the law. And so it follows, that if the tific principles. Millions of money! Just big fellow is a national problem, the so, for disease is expensive, not only to lesser one is more often than not a probthe individual, but to the city and state lem to be solved by the city itself. as well. We are compelled to take care As there were more violations of the of the sick and indigent after they have Federal food law in Illinois than in any become diseased and helpless; we are not other state during the past year, Illinois' unwilling to build hospitals and asylums chief city is therefore selected to illusfor the insane and incurable; but,- trate the smaller offender. Chicago constrange fact—we do not like to spend tains manufactories whose deplorable sufficient money to keep them out of condition is almost unbelievable, and these places by averting disease by proper there is plenty of authority for any public health precautions. We are liberal presentation of examples in this regard. enough after the horse is stolen, but too John B. Newman, assistant food comcheap by far to buy a lock before the missioner for Illinois, had the following deed is done. Health can be counted in to say in recently commenting on the dollars and cents, if it must be counted situation: “In the Greek district of
Chicago a dealer sells cotton-seed oil for Money still talks. Show a man how to olive oil. In the Greek language he calls save his health and he is apt to turn a it olive oil. In English deaf ear; show him how to save a dollar he labels it correctly, and watch him listen. Mr. Brandeis because his Greek cusrecently showed the railroads how they tomers cannot could save millions of dollars a day, and the world sat up and took notice; another man, in the name of that magic word, Efficiency, told us a short time ago how we could make one brick-layer do the work of two, and everybody but the brick-layer threw his hat in the air. But how are we going to make a man efficient if he is half-sick half of the time? Won't this half-time sickness just about discount his newly discovered double-effi
in that way.
A SERIES OF WARNINGS TO PARENTS.
Suggestive measures to prevent blindness, preserve health ciency? If we must have efficiency,
THE COMMON OSMOKING UP
and save lives.
corn meal, and the whole THERE'S DEATH IN THE DIRTY BOTTLE mess preserved with benzo
ate of soda. The dirt over Thousands of babies bave been killed through the use of dirty bottles
the entire floor of this factory was an inch and a half thick!
The city of Boston recently lost a case in the courts in which it was trying to enforce a very good ordinance in favor of pure milk. As a result of this adverse decision, Bostonian babes yet unborn will lose their lives through feeding on filthy milk, laden with tubercular and other death-dealing germs, while even adults will swell the death list as victims of typhoid. This is an instance in which flimsy laws often work against the greater good.
Corrupt political influence also shows its evil claws in this problem of the health of the cities. It has no respect
for such sacred matters as Pointers About The Baby's Bottle:
life and death. In St. Paul, First: Get the right kind of a bottle-one without a tube, one
for example, this ghoulish easily washed. The best kind is one with large opening at top, the influence has permitted removable rubber cap and nipple forming the top of the bottle.
dairies condemned by the Second: Keep the bottle and nipple very clean. After each
health department to confeeding remove the nipple and boil both bottle and nipple for tea minutes. Before using again rinse the bottle and nipple in boiled water tinue in business, unreabout a quart of water in which a teaspoonful of baking soda has been
strained and dissolved-or keep them in a pan of water containing a little soda
unmolested. when not in use
And in the same city this familiar disintegrating force
has more than once retarded PARENTS ARE BEGINNING TO HEED This HINT.
legislation which would have
secured for the people more read the language. Thus he complies favorable sanitary conditions. Not long with the law and fools the Greeks.” But ago an ordinance for bottled milk was the following is a far more serious agitated. The health of the city would offense. “We visited a mince-meat fac have gained by its passage. But the tory," he said, “and found that the only health of the many was permitted to coningredients were currants, apple-peelings tinue endangered by the interests of the and suet. The currants were kept in bins few,—namely, the milk-venders. In the alive with white worms. We asked the
We asked the opinion of the health-commissioner, the manufacturer how he got rid of the passage of the ordinance was hindered by worms. He said he soaked the currants unfavorable political influence. "Of in boiling water and that the worms came course,” he remarked, in speaking on the to the top and were skimmed off.” In subject, "bottling dirty milk does not another instance the inspectors went to a make it clean; but bottling clean milk tomato factory where catsup was made. does keep it clean and removes the great They found that the stuff was composed danger of contamination by handling of tomato pulp, apple-peelings and water, after it leaves the dairy, and even botthe bulk of which was soaked up with tling of filthy milk prevents it from