ATMOSPHERICAL INFLUENCES. 225 Here is a demonstration that the American cities have an advantage on the scale of longevity of 3.56 per cent. Is it objected that these results refer to the total deaths, and therefore afford no just criterion of the effects of climate on the infant constitution? In answer, we quote Prof. C. A. Lee, of New-York. "In proof of the general healthiness of this city (New-York), we would refer to the statistics of that most excellent institution, the House of Refuge for the Reformation of Juvenile Delinquents. This was founded in 1824; since which time there have been received into the institution 1670 children, of whom eighteen only have died, being a fraction over one per cent. Out of 919 children who have been received at the New-York Orphan Asylum since its establishment in 1806, there have been seventy-five deaths, of which eighteen occurred in the year 1834, making a total of 8.16 per cent., and deducting the deaths by cholera, 6 per cent. of the whole number. From 1814 to 1820 it is a singular fact that there was not a single death in the institution, though there were generally over a hundred inmates; and in 1832, during my attendance, there was but a single death among 120 children, of whom there were not more than ten that escaped an attack of cholera, thus proving that the most malignant diseases lose much of their fatality when met with prompt treatment and good nursing.' It is, therefore, leaping at a conclusion which is contradicted by facts, to refer the excess of infant mortality amongst us above what occurs in European cities to climate; for independent of the above considerations, if climate was the cause, then must its salubrity have been deteriorating for the last * Lee's Medical Statistics, Am. Med. Jour. Vol. XIX. p. 27. 226 ATMOSPHERICAL INFLUENCES. quarter of a century in the ratio of the increase of infant deaths-a position no one, we suppose, will undertake to defend. Neither can it be ascribed to the physical or moral condition of the population. In regard to healthiness of situation, construction, etc., as well as atmospherical salubrity, the cities of New-York, Philadelphia and Boston, will not suffer by comparison with those referred to, nor perhaps with any of equal size on earth. In some particulars affecting the general health, such as the drainage of marshes, the widening of streets, better regulations for the removal of impurities, etc., these cities have not only been greatly improved, but as is shown by the official returns, and contrary to what the increasing infant mortality would indicate, the standard of health is higher than formerly, and the total annual deaths, according to the population, have ratably diminished. The waste of infant life in European cities, where so many causes conspire to produce it, is not a strange, but a natural result. The agents in the work of destruction, are too palpable to be mistaken. The extreme poverty which there exists, must give rise to numerous fatal diseases, and make direful havoc of infant life. But in this country the same causes do not exist, at least not in the same form, or to a very limited degree. Not only do the necessaries but also the comforts of life here abound, and are within the reach of all. Besides, the provident intelligence of the people, the social, civil, and economical advantages enjoyed, are decidedly greater than in the densely crowded manufacturing towns of the old world, where large masses of the people are condemned to wear out their lives in fruitless struggles to ameliorate their wretchedness. In addition to this, intemperance in the consumption of intoxicating drinks has greatly di BREVITY OF INFANT LIFE. 227 minished amongst us, and, as the criminal statistics prove, with a proportionate decrease of the pauperism and vice, which are so generally the proximate causes of improvidence, disease, and premature death. The question again returns: What is the cause of this excessive infant mortality, and of the difference which in this respect exists between American and European cities? The alarming fact that more than half the total deaths occur among children who perish in their infancy, is one which not only concerns the medical profession, but also every parent and philanthropist, and political economist ; for if this frightful mortality is allowed to go on unchecked and increasing as for a few years past, the time is not distant when it will be a rare occurrence for a child born in our cities to survive the period of infant life. If the evil be unavoidable where large masses of people are crowded together, exertions to diminish it must prove unsuccessful, and it were a folly either to attempt impossibilities, or to complain of that which cannot be removed. But such is not the fact. Our records prove, that the present was not always the condition of our cities in this respect; while foreign statistics show, that the increase of this mortality, and the extent to which it now prevails amongst us is peculiar to our own country, and therefore not inseparable from the conditions of city life. No exertions therefore should be spared to discover, if possible, the cause or causes of this fatality, and the means which are competent to their removal. CHAPTER XXVI. INFLUENCE OF IMPURE MILK ON THE HEALTH OF CHILDREN IN CITIES. Effects of immigration on the bills of mortality.-Immigrants in foreign cities. Objections anticipated.-Excessive infant mortality chiefly owing to improper aliment.—Impure milk such aliment.— Objection considered.—Origin and progress of the evil.-Influence of other causes.-Extent of the evil.-Early extinction of infant life in cities not a design of Providence.-Certificate of physicians.-Duty in reference to the subject. THE extreme brevity of infant life has not escaped the observation of medical men, who have expressed various opinions upon the subject. Several concur in attributing it chiefly to the immense immigration of poor foreigners, who land in our cities destitute even of the necessaries of life, and being crowded together in narrow streets and imperfectly ventilated houses, engender diseases which prove fatal to infant existence. That the accumulation of foreigners (hitherto chiefly Irish) in our cities under these unfavorable circumstances, has greatly contributed to augment the aggregate of the annual deaths, none will dispute. Owing to the destitution, but more to the intemperate and consequently improvident and reckless habits of this class of population, it has been estimated that the average duration of life among adults after their arrival in this country, has not exceeded five years. But for this fatality among adults, it is evident, that the proportion of infant deaths, as compared with the total mortality, would be still greater than it now appears. Conceding, however, EFFECTS OF IMMIGRATION. 229 all that can be fairly claimed on the score of immigration, it presents, we apprehend, an insufficient reason for the extent and increase of infant deaths amongst us; for the condition of the British cities to which we have referred, in regard to this class of population is as bad, if not more deplorable than our own, whilst the proportion of infant mortality is greatly against us. The three principal ports through which immigrants enter Britian, are Bristol, Liverpool, and Glasgow. Liverpool, with a population of 185,000, is computed to contain 30,000 Irish; the population of Glasgow is 202,426, of whom 35,554 are Irish. In Manchester, Leeds, and many other manufacturing towns, the Irish, it is said, are proportionally numerous. Dr. Symonds, speaking of their circumstances on immigration, says, "we frequently found in Bristol a family of five or six adventurers, with one threadbare blanket between them. It is a common circumstance for a house to be tenanted by five or six families. We have found thirteen men, women, and children, living promiscuously in one garret of no very large dimensions. On one occasion, it happened to us to discover that thirty individuals had, on one night, slept in a room, the measurement of which did not exceed twenty-five by sixteen feet. The people thus congregated were Irish."* Dr. Walker, physician to the Huddersfield Infirmary observes: "The most irksome part of our duty is the visiting the vast number of Irish domiciled in the numerous lodging-houses; where we are never without some, and usually a large number of typhus cases. Last year it was very fatal. Two Catholic priests have fallen victims to it from attending these lodging-houses. We have now about forty or fifty * Trans. of the Prov. Med. and Surg. Assoc., Vol. II. pp. 167, 168. |