The fever-nest--West Thirty-third Street--is one of a row of tenant-houses five stories high, and contains 16 families. It was in a filthy condition, without Croton water, waste-pipes stopped, sinks overflowing and emitting offensive odors; fever had prevailed all winter, nearly every person in the house having had an attack, four having died. It was never inspected by a city official. The owner was induced to clean the house, and from that date not a case of fever has occurred. The inspector who reports this case very justly adds: “If, when the first case of fever occurred in this building, the owner had been compelled to put it in a good sanitary condition, six human lives would undoubtedly have been saved, besides a great amount of sickness.”
[Illustration: PLAN OF A REAR CUL-DE-SAC FEVER-NEST, 1865]
Cholera infantum and diarrhoeal affections are found in their greatest intensity where putrescible animal matter and domestic filth exist. Remove these causes, or remove the patients from the neighborhood, and these diseases generally disappear at once. Diphtheria is found to be most intense in the vicinity of unclean stables. It is, therefore, with great propriety, that the entire class of zymotic diseases are now called “filth and foul air” diseases by the English sanitary writers. Remove the filth and foul air, and these diseases disappear as effect follows cause.
[Sidenote: Can Populous Towns Be Improved?]
But while it is admitted that the streets of a town may be cleaned, the condition of the poor improved, and diseases, under the most favorable circumstances, prevented, it may be doubted whether the sanitary condition of populous towns can be materially changed, and the death-rate greatly reduced. Yet in England, where sanitary science is enthusiastically cultivated, there is not only no doubt that large towns can be thus improved, but that the mortality of London itself may be no greater than that of the country.
Already, indeed, the London _Times_ boasts “that the average of health throughout the City of London is higher than the average of health throughout all England, taking town and country together. The mortality in all England is at the rate of 22.8 in every 1,000 of the population; in the City of London it is at the rate of 22.3 for every 1,000 inhabitants! The improvement has been progressive; it has been slow, but steady and sure. Gradually the mortality has decreased, until the yearly death roll of 3,763 has been reduced to 2,904 within a period of nine years, during which the city has been under the rule of the Sanitary Commission. The deaths this year--22.3 per 1,000, or one in every forty-five of the inhabitants--are nine per cent below the general average, and represent a saving of 286 lives. And secondly, this gratifying result has been obtained in the face of obstacles which seemed to be almost insurmountable.”