Chapter XXXVI: Appendix (4)

“It is a monument of this last kind of which the council ventures to suggest the erection, in demanding a law to regulate the construction of towns, villages, and houses, under the double relation of public and private health; a monumental law, if ever there was one, since it will embrace France in its conceptions; all the citizens will enjoy its benefits with a perfect equality; and the poor man, even more than the rich, will find himself protected by it in his health, in his life, in his happiness; because health is life—it is more, it is happiness.

“A similar law has never existed among any ancient people, although we find among several of them no equivocal proofs of the solicitude of their legislators to introduce into the laws some precepts of health, applicable to the people they governed.

“We certainly find among the greater part of modern nations some ordinances, and regulations, relative to the salubrity of towns and houses; but their operation does not extend beyond the localities for which they were made, and little, or not at all, known out of these localities, they are still very imperfect, and altogether insufficient for the localities themselves.

“Nevertheless, can any one doubt the immense influence which the salubrity of towns, of villages, and of the dwelling, even when it is isolated in the midst of fields, exercises on the health and life of the people. All statistics, general and individual, attest this extreme influence; and there is no physician, a little observing, who has not had frequent occasions to verify it at the bed-side of his patients.

“We must be like the men, so well painted by the Psalmist, to reject such evidence—_eyes have they and see not_. How shall we explain, or rather, to what shall we attribute the difference that is remarked between the mortality of one quarter and that of another quarter of the same town; of one street and that of another street of the same quarter or of the same village; or, lastly, the difference that is observed in this respect between the houses of the same street, and those houses which are completely isolated. Misery, it is replied to us, is the cause. Yes, without doubt, misery is a powerful cause; but it is so especially when it is driven back into the most insalubrious quarters, streets, and houses; when it lives habitually in the midst of filth and dirt, that is to say, in the midst of an infected atmosphere; and when there is no misery, or when it exists in the same degree in the quarters, in the villages, in the streets, and in the houses with which the comparison is made, and, stronger still, when poverty is met with precisely there where there is the least mortality, in what is to be found the cause of this difference, if it is not in the insalubrity of the dwelling-places?

“If you had not seen yourself, Monsieur le Prefet, in one of the most beautiful streets of Paris, and in the vicinity of the most frequented promenade of the capital, the influence which the construction of the houses we inhabit has on the health, we would seek by some facts to convince you of this truth; but we are happy to need only to refer you to your own experience. This great fact, which naturally results from the comparison you have drawn, in a report addressed to the Minister of Commerce, the 31st of June, 1832, between the mortality of the quarter of the Hôtel-de-Ville, and that of the quarter of the Chaussée-d’Antin, has not escaped you. Yet, in the striking difference which is found between the mortality of these two quarters, you have not taken into account the poor who died in the hospitals, and who were, undeniably, more numerous from the quarter of the Hôtel-de-Ville than from that of the Chaussée-d’Antin. What calculation has demonstrated to you for one quarter of Paris exists in all in different degrees; and the same calculation applied to other localities, very distant from the capital, in which the condition, the habits, the mode of living, and the nature of the labour which the inhabitants perform are nearly the same, has given analogous results, presenting the same extremes, without the possibility of assigning any other cause than the insalubrity of the dwellings understood in its widest acceptation.

“The council might accumulate facts, calculations, and quotations, to support the opinion they have formed of the necessity of a law to regulate the construction of towns, villages, and houses, under the double relation of public and private health; but they have no need to be at this pains to induce you to share their conviction, and they are fully persuaded that, in proposing to you to promote a law so important, they are only anticipating your desire to co-operate for the well-being: of your fellow-citizens, and to aid the enlightened zeal of the Minister of the Interior for all that is great and useful.”

Under certain points of view, salubrity confounds itself with health; on another side, it governs health; because, without it no good rules of health can be established. Thus it has engaged the special attention of the council. We see them to shrink from no difficulty, from no mission, however painful, however dangerous even, it may be. Nothing escapes their vigilant attention, and the administration is always sure to have their aid in all the amendments that it wishes to introduce into this important branch of public service. It is thus that they pass in review all which appertains to the wholesomeness of sewers, to the improvement of the paving, to the establishment of street-fountains, to the flow of water for domestic or manufacturing purposes, to the cleansing of wells, and of waste-water wells. The construction of the receptacles of privies, those incessant causes of insalubrity and inconvenience, occupies them above all. Here is what they say upon this point:—

“The emptying of the privies in the city of Paris has become a very heavy expense to the proprietors, and the expense is always on the increase, in consequence of the modifications in the construction of the receptacles, and the more abundant use of water; a use rendered necessary by the actual form of the seats, and still more by the introduction of private baths.

“It is evident that the first condition for obtaining a result at once economical and salubrious, is to separate, on the spot, the solid matter from the liquid, to preserve what has an intrinsic value, and to reject what is only cumbersome.

“For more than half a century some men, animated by love for the public good, and several speculators, have directed their researches to discover a method of making this separation. At the head of these are Girard and Gourlier, Casaneuve, Sanson, Derosne, Chaumet, the authors of the article in the _Mémorial de l’Officier du Génie_, and, lastly, the architects Payen and Dalmont.

“The system of Gourlier is seducing: if it has not yet been submitted to all the trials it requires, we are able to predict before hand that it will succeed, and that it will be productive of advantage.

“The benefits of the project of Gourlier are found in a higher degree in that which has been adopted in barracks.[55]

“The system of movable receptacles has the sanction of time, is applicable everywhere, facilitates the removal of the contents, and enables it to be done without smell or dirt: it preserves the workmen from the dangers of asphyxy, prevents the decay of our houses, and contributes to augment the disposable mass of manure.

“To prevent the gravest consequences, it is essential not to conduct the liquid from the privies into waste-water wells, and put them in communication with the upper layer of the soil in which our wells are sunk. Prudence requires that the liquid should not be directed into the second layer, which in many parts of Paris furnishes very good water. If it is possible, without great inconvenience, to conduct it into channels altogether lower, it is still the opinion of many experienced persons that it ought not to be done under Paris for any very considerable quantities of water, and that it is necessary to reserve this resource for localities badly situated, and which are rarely met with.

“All the proofs show that the liquid of the privies may be discharged into the Seine without inconvenience. An investigation conducted formerly by Hallé and Fourcroy, on the sweepings of Paris, adds great weight to this opinion. The ancient and recent gaugings, as well as the daily observation of facts, demonstrate that the quantity of dirty water sent into the Seine would be so small compared to the water of the river, that it would always remain unperceived, and could in no way be injurious to health.

“To convey these waters to the Seine, the first idea which presents itself is to cast them into one of the three great sewers which surround Paris on the north.

“A mass of facts and observations prove that the discharge into the sewers of the liquid from the privies will not infect the sewers, nor cause danger to those who work in them; that this infection will be so much the less to be apprehended with the apparatus of Gourlier, with that which has been adopted in barracks, and with the movable receptacles, that, by these different methods, the separation taking place slowly and successively, the liquid carries along with it but very little of solid matter.

“Everything seems to show that by mixing the liquid from the privies with a sufficient quantity of water it might, without inconvenience, be thrown upon the public way, and got rid of in this manner; but prudence requires that before any innovations of this kind the project should be submitted to minute and multiplied experiments. These experiments are the more important, that the result would be to increase the revenues of the city by the sale of a considerable quantity of water which it has for disposal.

“If the drying of the solid contents of the privies has hitherto been considered as one of the most infectious and inconvenient trades, it may be affirmed that it can now be made one of the less disagreeable, a circumstance which we owe to the means of disinfection recently discovered, or which, formerly known, have not been put in practice till lately on a large scale.[56]

“To favour the employment of these means, and to arrive thereby at results of high importance, it is not sufficient for the administration to be animated by praiseworthy intentions. It must obtain, by its interposition with the supreme authority, a modification in the classification of the establishments in which the fecal substances are prepared, and, above all, must use the means at its disposal to disabuse the public of the prejudices it entertains against these sort of places. The administration will meet at first with very great obstacles, but, with time and perseverance, may rest confident of success.

“The changes proposed are of such importance, they will be attended by consequences so useful, and extensive, that they will be sufficient to render illustrious to future generations, and to recommend to their gratitude, the name of the ministers who shall effect them.”

Since their institution, the “Conseil de Salubrité” have been charged to visit all the parts of France in which epidemic sicknesses have appeared. Thus we find them in 1807 investigating the autumnal disorders which broke out at Créteil, at Maisons, at Charenton, &c., and proposing the creation of a travelling hospital to render aid to the country districts during the prevalence of epidemics. Some years later, in 1810, they went to Montreuil, to Montmartre, and other communes in which the small-pox had assumed an epidemic character; to Pantin where there reigned an epidemic fever; to Fontenay-sur-Bois, Rosny, &c., where some ravages had been made by the dysentery. In 1812 they set forth the causes of the epidemic maladies which had declared themselves in the communes of Charonne, and Clicky, and by this means prevented their recurrence. In 1818 they stopped the progress of an endemic fever in the commune of Chevilly, and of the croup in the commune of Montreuil. In 1825 the small-pox committed great ravages among the inhabitants of Paris, and of the rural communes of the department of the Seine. Brought by a mass of workmen who flocked from the country to partake of the high wages produced by a glut of employment, it was rapidly propagated among a population who, through carelessness, or prejudice, had rejected the blessing of vaccination. The small-pox, favoured in its development by the high temperature of the atmosphere, gave rise for a moment to a doubt of the preservative property of the vaccine. An eruptive malady, the _varioloïde_, confounded with the small-pox by people in general, and by inattentive and inexperienced medical men, originated this idea, which some cases—rare certainly, but distinctly marked—of small-pox in persons who had had the true cow-pox, appeared to confirm. It was then feared that the vaccine had lost with time the advantages which rendered it so precious; that, weakened in its nature, by passing from one individual to another through a long course of years, it was no more susceptible of modifying the organization in a manner to render it inaccessible to the small-pox. It became therefore important to examine with care this interesting point of practice. The difficult task was performed by the council, and the administration, enlightened by their reports, was able both to re-assure the people justly alarmed, and to take the proper measures to arrest an evil of which no one could foresee the consequences.

It is by such labours that the council prepared themselves for the noble and grand mission which was reserved for them by the appearance in the capital of the cholera morbus,—a mission which they fulfilled with so much courage and devotion. In the midst of this public calamity, the “Conseil de Salubrité,” we do not hesitate to say, surpassed all expectation. This same zeal was manifested in 1837, when the epidemic catarrh made some ravages in the capital. Since then, with the exception of local maladies of little importance, the “Conseil de Salubrité” have not been called upon to occupy themselves with epidemics.

The _épizooties_ are in many respects less serious than the epidemics. Nevertheless, as they often affect the animals which serve for the nutriment of man, and that, apart from this consideration, they may have grave consequences for the public health, they have constantly engaged the care of the council. In 1834 an _épizootie_ was reported to the administration, which prevailed among the cows of the communes round Paris, and which caused a great mortality. The researches of the council established that this _épizootie_ was only a chronic disease, a true pulmonary phthisis to which has been given the name of _pommeliere_, and by which the greater part of the cows had been attacked which fill the stables of the milkmen of Paris and its environs. According to the council, the principal cause of the evil was to be attributed to the vicious regimen to which this species of animal is subjected. “It is known that they pass a part of the year in stables perfectly closed, in which the space is not proportioned to the number of inmates, in which the vitiated air renews itself with extreme difficulty, and in which the heat is sometimes suffocating. It is known also that they pass suddenly from the food of the stable to pasture, and that in this change they go from the hot and humid atmosphere of the stable, to a sudden exposure to the continual variations of the external air. This alternation of food, and of heat and cold, operates as a powerful cause of disease. But as the evil does not announce itself in a violent manner, as its progress is not very rapid, as there is even a period in the disease in which the animal is disposed to get flesh, the cow-feeder, who knows to what point to keep her, sells her when she is ready to calve. It is in a radius of thirty leagues from the capital that cows of this kind are purchased by the jobbers who supply the milkmen of Paris. With these last they still hold out a certain number of years, if they are properly cared for; but in general they are kept in stables which are neither sufficiently large, nor sufficiently airy, where they are exposed to the same causes which gave birth to the malady. The phthisis arrives insensibly at its last stage, and carries off every year from Paris, and its neighbourhood, a great number of these cows.

“As to the question, whether the sale of the flesh of oxen that have died from the diseases just described should be allowed, the council have already shown that, from time immemorial, the meat of cows attacked by pulmonary phthisis in a slight degree, has been consumed at Paris as good cow-beef. Often even cows which have reached the last stage of this disease are consigned to the butcher, who offers their flesh for sale as meat of the second quality, after taking the precaution to cut away the lungs, the pericardium, the mediastin, and those parts of the sides and diaphragm, which present a state of disorganization more or less advanced. This commerce has always taken place in the environs of Paris, and in Paris itself before the establishment of the _abattoirs_; and if we are not able to affirm that food of this nature is not bad, there is at least no example of its use having given rise to accidents. It is to be presumed that in this case, as in many others, the cooking destroys the vicious properties of the flesh, and deprives it of all the qualities injurious to the health of the consumer.

“The council have, however, been far from drawing from all these facts the conclusion that it is unnecessary to watch over the sale of butchers’ meat. They think, on the contrary, that this superintendence cannot be too active, in order that the low price of such meat may not lead poor families to make it habitually their principal sustenance. It is known that a bad diet which is not injurious when used casually, may become, by its continual employment, a source of disease. Numerous observations have equally taught us, that the flesh of animals in which putrefaction had commenced, has produced in persons who touched it the most serious consequences. The council, building upon such data, believe that it is indispensable to watch with the greatest care the sale of meat, to have destroyed all the bad meat which is exposed in the shops, and to forbid the butchers to sell the flesh of any animal that has died from disease, or been killed in consequence of disease, unless a veterinary surgeon and physician, appointed by authority, have decided that the meat could be eaten without inconvenience.”

Some considerations of a kind still more general are developed in the important report made by the commission, charged in 1839 with the investigation of the disease called _cocotte_, which attacked the milking-cows, and deeply occupied the public attention.

We stated at the commencement of this article, that the number of reports made by the “Conseil de Salubrité,” during the years comprised in this account, amounts to 4431. This number greatly surpasses in its proportions that of the preceding years, that is to say, of the twenty years which form the first period of their labours, dating from their institution, and which only presents a total of 5008 reports. This arises from the fact that Paris for a long time has been only a city of produce, and that the labours of the council have necessarily increased with the progress of trade, and the character, altogether manufacturing, assumed by the department of the Seine since 1815. It is necessary, moreover, to remark that the provisions of the decree of 1810 on insalubrious establishments, by submitting certain classes of manufactories to special authorizations, rendered more frequent the intervention of the council, who were the first to demonstrate the necessity of these new measures. “It is a great satisfaction to the council,” say the reporters of their labours for the year 1810, “that every year the observations and reports lead to general measures which simplify your administration, by giving certain rules of which the application becomes every day more easy. The public health was long since compromised by the existence of certain manufactures, and in the general accounts we have rendered we have never ceased to demand the removal of insalubrious establishments. The National Institute, consulted on this important point, shared our opinion, and a regulatory law has just designated the manufactures which may be established in the interior of towns, and those which are not to be tolerated there.”

In the year 1811 we find 118 reports on classed establishments. This number increased in 1812, and so from year to year, till in 1813, 313 reports were made on establishments of this kind. The use of steam-engines increased the labours of the council. In 1813, for instance, there was but one report on these engines; in 1822, the number had risen already to fifteen. The examination of these machines led the council to examine their different systems, the dangers and inconveniences they presented to the public health or safety, and we foresee, in reading their important observations on this subject, all the improvements which experience introduced in the sequel into this new branch of industry. If we pass from the year 1822 to the year 1839, we find there has been read ninety-six reports on engines of this description: but they are no longer simple considerations on machines of which the use is not well understood; they are views of an elevated order, both on the application of these engines, and on their dangers and inconveniences. We see that the council have profoundly studied these important questions.

“We have united under one head,” says M. Busy, the reporter, “all the establishments on which reports have been made relative to steam-engines. Each of these establishments doubtless offers by itself some inconveniences inherent in the kind of trade carried on; but in general these inconveniences are trifling. The greater part of the manufactories about which there is a question are for the construction of engines, and other analogous things, which can only affect the neighbourhood by the noise and activity which reign there. Out of sixty-three reports made to the council on steam-engines, eleven were on sawing-machines, nine on shops for the construction of engines, six on fulminating powder-mills, four on factories for printing and preparing stuffs, three on mechanical printing presses. The other reports are divided in the following manner:

“On machines for flattening metal, for bruising colours, for pulverizing, for mixing mortar, for extracting stone, seven; for sugar refining, for the making of sugar of starch, three; for spinning, two; for turning, two; for optical glasses, two; for polishing steel, one; for cleaning grain, for the preservation of provisions, three; for perfumery, two: for soap-making, two; for bleaching, for making candles, hats, and delf-ware, for ironfounding, for scouring ashes, six; total 63.

“There has been made besides on simple steam-boilers 33 reports, divided among different trades in the following manner, viz:—

For printing and preparing of stuffs and woollens 12
Hat manufactories 7
Wax and tallow candle manufactories 3
The shops of mechanicians 2
Refining 2
Soap-making 2
Extraction of the colouring matter from dye-woods 2
Baths 2
Dyeing 1

“If we add these 33 reports to the 63 preceding, we have a total of 96 reports on steam-engines, or simple boilers. We join them together in consequence of the identity of the inconveniences to which these machines give rise. These inconveniences can only proceed from the chance of explosion of compressed steam, or from the chance of fire, and from the presence of smoke, which accompany the establishment of every furnace, whatever may be its use. It is true, however, that among the complaints or objections which have reached the council, several have turned upon the noise and shaking occasioned by the steam-engines, a shaking which is particularly felt in houses a little shut in, and connected with the neighbouring houses. This occurred with the printing presses, and some other mechanical applications of steam.

“But these results are altogether independent of the steam itself, are inherent in the imperfection of the mechanism employed, and would be produced with much greater intensity by substituting for steam a horse, a fall of water, the action of the wind, or any other mechanical motor.

“If we consider the steam-engines and boilers with respect to the explosions to which they may give birth, we see that no accident has happened during the current year from a total or partial explosion of an engine, and yet there is no complaint or opposition which is not swelled by the fear of these dangers. If the accidents of this nature may with justice, by their seriousness and sphere of action, provoke the fears of the neighbours, the wise measures prescribed by the rules are of a nature to render them impossible, when they are faithfully executed. Thus, Monsieur le Prefect, the council have always vigorously insisted on the maintenance of the precautions with which the law surrounds the steam-engines, not only to shield the responsibility of your administration, but also because they are persuaded that it is impossible in the actual state of things to neglect these prescriptions without exposing those who make use of steam-engines to eminent dangers.

“The true and the most serious inconvenience of steam-engines is the smoke. It is against this that most of the well-founded complaints are raised.

“This inconvenience is not only felt at the present moment, but it excites, above all, apprehensions for the future.

“When we consider that in the single year 1839, there have been granted 82 authorizations for steam-engines, and that we are yet but at the beginning of the applications of this mechanical agent,—when we follow the increasing progression of petitions addressed to the administration, we are not able to suppress a certain fear against the ulterior invasions of the smoke from these establishments.

“The council have applied themselves for a long time to the solution of this difficulty, which is met at every turn in the petitions addressed to you, not only for steam-engines, but for all the trades in which furnaces are employed.

“Various systems have been proposed: that which first presents itself is the use of smoke-consuming furnaces, which appears in fact the most rational and appropriate. Nevertheless, although it is very easy to assign the theoretical conditions for complete combustion of coal, the difficulties of application have not permitted this kind of furnace to become general. Hitherto the smoke-consuming furnaces require great precision in the execution, great regularity in the distribution of the fuel,—things difficult to realize in ordinary labour. On the other hand, the great excess of air necessary to obtain complete combustion often diminishes the efficacy of the coal, and renders these furnaces more expensive, in certain cases, than the ordinary furnaces, in spite of the loss of fuel which the latter involve.

“The mechanical distributors to regulate the supply of fuel, and the activity of the combustion, have been also proposed and employed with success; but they are a considerable expense at the outset, and can be but little adopted except in great concerns, and where there is a very constant application of steam.

“It remains to modify the nature of the fuel; and it is this which the council have generally done. They commonly prescribe the use of coke, or some variety of prepared coal, which gives no smoke—leaving it however to the proprietors to make use of whichever method suits them best, whether smoke-consuming furnaces, mechanical distributors, or fuel which yields no smoke.

“These regulations, Monsieur le Prefect, have been adopted in principle by the “Conseil de Salubrité,” and are, in the majority of cases, the condition to which they think it their duty to submit the authorizations they have the honour to propose to you.

“Doubtless their rigorous application may cramp certain establishments. The council are not ignorant that for some particular purposes the use of coke presents great obstacles, considering the construction of the furnaces; but the absence of smoke in the combustion of coal is not so very difficult to obtain, as to shake the intimate conviction of the council that this constriction will be but momentary, and that it will end by turning to the profit of the manufacturer.

“The problem of which the council seek the solution, is able to be resolved; it is so already in great part, but there yet remains one step to arrive at the goal, and they will reach it by persevering in the course they have adopted. In their efforts they have been sustained, we repeat, by the conviction that they labour not only for the advantage of the health and cleanliness of the capital, by seeking to guarantee its inhabitants from the nuisance of smoke, but also for the advantage of the manufacturer himself, by forcing him to a better employment of his fuel, and by putting him into such a condition that he may be able to select the localities which suit him, without being exposed to those continual complaints, to those recriminations, often well-founded, which have not always been foreseen, and which sometimes become the cause of the greatest embarrassments to the manufacturing establishments.

“An important progress in the path we indicate was made in 1839, by the contrivance of M. Beslay, a mechanician, for steam-boilers—a contrivance which has been pointed out in several reports on this subject, and which proposes to prevent explosions and avoid smoke by means of a general use of coke. It is only to be regretted that it has not yet been able to be applied to all the purposes for which steam-boilers are employed.”

The improvements introduced by the council into the different branches of industry with which they have had to deal, and on which their reports enter into details at once useful and interesting, are numerous. Thus the refining of gold and silver, the factories for fulminating powder, for gilding, for chemical products, for bitumen, for melting tallow, and a mass of other trades, owe to them notable improvements, both in the methods of fabrication, and in the conditions for public health and safety under which they are to be carried on. The white-lead manufactories have excited their earnest solicitude. It is known that the workmen who labour in these places are subject to serious and frequent maladies. In consulting the earlier labours of the council, we see them unceasingly occupied with this question; but the frequency of the accidents, and their seriousness, have more particularly attracted their attention in these latter times, and have engaged them to compile a set of instructions which set forth the best rules of health to be observed in these manufactories. (The rules have already been quoted.)

Later, the council have anew examined deeply this branch of trade. They have visited the manufactories of white-lead existing in the department of the Seine; they have obtained the experience of other departments, and they have shown the necessity of commissioning one of their members to follow the results of the rules quoted above. They have required, moreover, that the administration should furnish some statistics on the state of workers in white-lead admitted into the hospital. The administration has hastened to defer to this wish, and there is no doubt that there will result a sensible improvement in the health of the workmen.

(After giving several other minor instances of the labours of the Conseil, the report thus concludes:—)

And now that we have detailed the principal labours of the council, it would be a necessary supplement to this article to show the results that have followed from them,—the reforms they have introduced into the public service. But here we are no more dealing with the labours of the council, but with the labours of the administration. Thus independently of the decisions on classed establishments, and which amount to about 300 a-year, it would be necessary to describe the measures for the public health executed by the administration. But to confine ourselves only to acts which interest the generality of the citizens, we may cite the ordinances of police which relate to coloured sugar-plums; to horses attacked with the glanders, or contagious maladies; to vessels and utensils of copper; to the adulteration of salt; to the aid to be given to the drowned and asphyxied; to the depôts for refuse in the rural communes; to the dissection, modelling, and embalming of corpses; to the cleaning of wells and waste-water wells; to the adulteration and sale of fulminating powder; to the classification of new trades, the amphitheatres of anatomy, the establishments of pork-butchers, &c. &c.

Certainly there are few institutions that can show such results; there are few that receive an impulse so enlightened and constant. Bound in an intimate manner with the administration of which they form part, the “Conseil de Salubrité” has at all times, found in it a just appreciator of their labours. They know the credit accorded to their reports, and the duties imposed on them by a confidence so honourable for the administration that gives it, and so justly merited by the body that receives it.

16.—_Qualifications of Officers of Public Health: Statement by_ M.
DUCHÂTELET.

It is generally thought in the world that the medical knowledge acquired in the schools is all that is necessary to become a useful member of the council. The greater part of medical men themselves share this opinion; and on the strength of some precepts which they have collected from books on health and professions, they think themselves sufficiently instructed to decide on the instant the gravest questions, which can only be resolved by special studies.

A man may have exhausted medical literature; he may be an excellent practician at the sick-bed, a learned physician, a clever and eloquent professor; but all these acquirements, taken in themselves, are nearly useless in a Conseil de Salubrité like that of Paris; and if an occasion presents itself to make use of them, a very small number of persons suffice to apply them. To be really useful in the council, it is necessary to have an extended knowledge of natural philosophy, of the constitution of the soil on which Paris stands, and of the geology of neighbouring countries; it is necessary, above all, to know with exactness the action which trades may have on the health of those who exercise them, and the much more important action of manufactories of every species on plants, on men congregated in towns, and on animals. This knowledge, so important, of the action of manufactories and trades, is not to be acquired by ordinary study, or in the silence of the cabinet. It is not to be obtained without positive notions on the arts, and on the greater part of the processes peculiar to each trade. It requires habit and the frequenting of the places of work. In this particular, more even than with medicine, books are not a substitute for practice; and if there exist works on the subject, they are more likely to mislead than enlighten.

From what has been said, the necessity will be evident to introduce into the council those physicians who have made health, and particularly the public health, a special study; and to join with them chemists, and, above all, manufacturing chemists, because what would many of those persons, whose life has been passed in hospitals and the exclusive study of medicine, be before a steam engine? It is clear that they would often be deceived by those adroit and skilful manufacturers who would have an interest in concealing the truth.

17.—_Instance by_ MM. DUCHÂTELET _and_ D’ARCET _of the erroneous Medical
Inferences as to the insalubrity of particular Trades_.

Ramazzini is, as far as we know, the first who has treated professedly of the maladies produced by the fumes of tobacco. In his great work, _De Morbis Artificum_, he states that the workmen employed in the manufacture of tobacco are seized with great pains in the head, with vertigo, nausea, and perpetual sneezing; and that so great is the subtilty of this substance, that all the neighbourhood, particularly in summer, experience nausea. He adds, that those who work on tobacco lose their appetite, and that their breath is insupportable.

Fourcroy, after repeating in his translation of Ramazzini all the passages from this author, adds, in a note, several observations to prove the dangers of tobacco; such as, that a lady died from a cancer in the nose in consequence of taking too much snuff; another from a polypus in the œsophagus, which prevented her swallowing; another from frightful convulsions produced by sleeping in a room in which tobacco had been rasped. Fourcroy states, however, that there are some privileged persons who become accustomed to the action of tobacco, and experience no inconvenience from it.

Cadet-Gassicourt, in a memoir addressed to the prefect of police on the maladies incident to the trades carried on in Paris, says that the workmen occupied in the preparation of tobacco are subject to vomitings, colics, and acute and chronic affections of the chest; that they have often vertigo, bloody fluxes, and are addicted to drink.

Tourtelle, in his _Elémens d’Hygiène_, affirms that it is very dangerous to sleep in warehouses of tobacco; and he quotes a case, mentioned by Buchoz, of a young girl of five, who died in a short time from dreadful vomitings, occasioned by this sole cause.

Percy, in the article _Chapeau_, in the _Dictionnaire des Sciences Médicales_, mentions, that some soldiers, exercising in the _Champ-de-Mars_ in very warm weather, were overcome by syncope, which he attributes to some tobacco that these men had put in their caps.

In a new edition of Ramazzini and Fourcroy, by Patissier, we find the opinions of these authors without observation or comment. The editor is content to add, that those who have to do with tobacco are, in general, wasted, discoloured, yellow, and asthmatical.

Finally, Merat, in the article _Tabac_, in the _Dictionnaire des Sciences Médicales_, says, that men engaged in the preparation of this substance are wasted, discoloured, yellow, asthmatic, subject to colic, diarrhœa, the bloody flux, but, above all, to vertigo, cephalalgia, muscular tremor, to true narcotism, and to diseases, more or less acute, of the chest. “All these assertions,” he continues, “are the fruit of my observations in the hospitals of Paris. Tobacco causes not only evils without number, but even death to those who prepare it. It deranges the memory of all who inhale it, and renders it less clear and entire; it weakens the tissues, especially the nervous tissues; it causes trembling of the limbs; diminishes strength; it produces emaciation, and even consumption, particularly among females; and sometimes begets entire imbecility.”

“We might multiply these quotations. The just celebrity of the authors who have furnished them gives to their opinion a force which imposes belief, and makes us reject every species of doubt. Let us recall, however, the maxim of Descartes; let us cease to believe the words of a master; let us dare to doubt for an instant, and, observing for ourselves, let us learn to form an opinion, based on what our own senses and judgment have taught us.”

Acting in this spirit, Parent Duchâtelet and D’Arcet carried on a minute investigation, in a vast manufactory of tobacco at Paris, containing 1,054 workmen. Not content with the results afforded by a single establishment, they directed questions to the nine other great manufactories of tobacco which France contains, and the answers were prepared by the physicians, surgeons, and officers of each establishment in conjunction. “The observations,” say MM. Duchâtelet and D’Arcet, “which compose this memoir, have been collected from a sum total of 4518 workmen. They appear to us so much the more valuable and conclusive, that they have been made simultaneously in the most opposite parts of France, by men who had not, and could not have, any connexion. There is thus no possibility to suspect the influence of a preconceived opinion; and if those to whom our inquiries were addressed are unanimous in their replies, and if these replies agree with our own observations, we shall be sure that we have arrived at the truth.”

The conclusions which followed from these widely extended researches were—

1. That in the greater part of the factories there was never known an example of an individual who could not accustom himself to the emanations of tobacco, and that in the rare cases where it proved injurious, it was always in a particular part of the process, which merely obliged the workman to be transferred to another department of the factory.

2. That all which has been said on the frequency of nausea, of vomitings, of diarrhœa, of colic, and of haemorrhages, is pure supposition. That it is so no less with respect to the headaches, sneezings, loss of appetite, foulness of breath, acute and chronic affections of the chest, cancers, and other similar diseases. What the same authors say on the discolouration of the skin of the workmen engaged in the preparation of tobacco, on the yellow hue of their complexion, their leanness, and emaciation, proves that they have not observed for themselves, or have only seen the exceptions to the rule, or have not compared this class of people with other workmen of the same town, who were engaged in occupations of a totally different kind.

3. That tobacco, far from producing, in those who prepare it, death and narcotism, does not even influence their nervous system; and that vertigo, syncope, muscular tremor, convulsions, and other like evils, which have been charged against it, have never existed in the manufactories, though the men sleep in the midst of the most subtil preparations, or, at least, are not to be attributed to that cause.

4. Not only is the tobacco without any effect on the health during the first years devoted to its preparation, it has not the least ill consequences in more advanced life. Feebleness and great age, or causes altogether accidental, have been the sole ground for dismissing the workmen.

5. There are some professions which, without destroying health in an evident manner, abridge life; but a great number of those who work on tobacco reach, and even surpass, the ordinary limit of human existence.

6. It is proved by innumerable facts, that the manufactories of tobacco are not in anywise injurious to the men, animals, or plants, which may exist in their vicinity.

It thus turns out, upon examination, that this much maligned substance is perfectly innocuous. “Yet what practitioner,” say MM. Parent Duchâtelet and D’Arcet, “who had not had occasion to visit the workshops and study their influence, would not be forced into belief by the imposing authorities we have quoted above; who of them would hesitate to regard as demonstrated opinions on which Ramazzini, Fourcroy, Cadet Gassicourt, Tourtelle, Percy, Patissier, Merat and others are unanimous, without a single person having uttered a contrary assertion? There are found among these authorities two members of the Royal Academy of Medicine, three members of the Academy of Sciences, two professors of the Faculty of Medicine of Paris, one professor of the Faculty of Medicine of Strasbourg, two chemists, and two celebrated physicians—one French, the other Italian; in a word, six physicians and an apothecary, who held, and still hold, the most eminent places in the learned world. It is therefore evident that it is of the highest importance that trades and professions should be investigated differently from what they have hitherto been; and this importance daily increases, because of the progress and extension of arts and manufactures.”

18.—_On the Habitations of the Lower Orders of Paris._
No. 1.

The labouring classes are obliged to live in houses almost always dilapidated, insufficient, or unhealthy. Such is the lot of the poor man in all countries: the force of circumstances, the hard law of necessity, compel it. Yet, if it is impossible to remedy completely this state of things, may we not approximate to it, by building houses for every grade of the lower orders—not only of the honest poor, but of the debased and depraved? It appears to me that these houses would have a double advantage;—they would diminish the causes of public insalubrity, and offer to the honest and economical workman the means to procure a residence equal to his necessities, and capable of producing in him the taste for retirement and domestic peace so favourable to morals. It is especially in this last point of view that the amelioration of the dwellings of the poor and laborious class is to be ranked among the preservatives against vicious habits.

Rent being one of the most important and indispensable domestic expenses, the father of a family, pressed by other wants of the first necessity, naturally seeks the least costly habitation. Now, these habitations exist only in certain quarters, and in certain streets of those quarters: they are old, ruined, and filthy. The proprietors, in order to tenant them, let the lodgings very low, and thus attract the poorer families. If these lodgings were healthy, if they were sufficient for all the members of the family, there would be no room for censure; but they are foul, badly lighted, and neither air-tight nor water-tight. They are small, and as parents and children live and sleep in the same room, the overcrowding is both a cause of unhealthiness, and an offence against good morals. Moreover, the bad state and filth of the passages, privies, and sinks, give rise to infectious exhalations, which vitiate the air of these humble abodes, and affect the health of their inhabitants in a manner so much more mischievous that the greater part of them work all the day in crowded and ill-ventilated shops.

It would be worthy of a wise administration to remedy this dangerous complication. The task is doubtless difficult; but why not grapple with it boldly, instead of allowing to subsist in Paris, without any effort to destroy them, so many centres of infection which reduce to the level of the lowest animals the unfortunate beings who seek in them a retreat for the night.

Although the lodgings are not all repulsive, they are all alike open to criticism. Some offend by overcrowding, others by the mode of sleeping; others, lastly, by the absence of all ventilation, and even by a total want of air. Overcrowding is an evil which prevails in all the lodgings of the lowest class, and which aggravates the mischief resulting from the other inconveniences to which they are subject. The twenty-five or thirty thousand workmen employed in house-building, who flock to Paris every year from certain departments, congregate in chambers, and sleep there during the season. Many of these places are kept by countrymen of their own, who attract them by their known probity, and the kindness they entertain for them. These chambers abound principally in the quarter of the Hôtel-de-Ville for the masons, and in the Faubourg Saint-Martin for the carpenters. These excellent workmen, by an exception more peculiar to them than to any others, look only to economy. They bargain with the lodging-house keeper, so as to obtain for six francs a month, besides the room, the washing of a shirt a-week, and a mess of soup every day, for which they themselves provide the bread. All that is not devoted to their slender wants is laid by for the support of their family, or the increase of their little patrimony. The police unanimously testify to the order and concord which reign in their chambers, as well as to their good conduct abroad. Is it not mournful that these fine fellows should sleep thus piled up in little garrets? Accustomed to work in the open air, the smallness of their rooms is more trying to them than to any others. Thus typhus fever is common among them, and sometimes attacks a whole chamber.

The overcrowding and deficient ventilation are still more injurious to workmen employed in manufactures. They pass every day from an infected lodging into a shop which is usually as unwholesome, and they are thus predisposed to contract readily contagious maladies.

Of all the lower orders, the chiffonniers inhabit the most infected and disgusting lodgings. It is vain to expect to descend into the lowest ranks of society,—inequality always appears somewhere. Even the chiffonniers have their notables. There are some a little more economical, a little more raised than the mass, and who enjoy a certain comfort. Those the most elevated occupy one or two small rooms, which they hire for themselves and their families; others possess a pallet, which serves them to sleep on, in the chamber of which they are one occupant among many. But this possession is more often collective than personal; and although shared, it does not fail to excite the envy of the poor wretches who lie in a species of trough, on rags, or on handsful of straw, with which the room is strewed. The police charged with the surveillance of the lodgings inhabited by the chiffonniers give an incredible picture of them. Each occupant keeps by him his basket, sometimes full of filth—and what filth! These savages do not hesitate to comprise dead animals in their gleanings, and pass the night by the side of this stinking prey. When the police go to these places, they experience a suffocating feeling, bordering on asphyxy. They order the windows to be opened when they can be opened, and the severe representations they address to the lodging-house keepers on this horrible mixture of human beings with decayed animal matter does not move them. They answer, that their lodgers are accustomed to it as well as themselves. A trait of manners peculiar to the chiffonniers, and which might be called their pastime, consists in rat-catching in the courts of the houses which they frequent. They entice the rats by the aid of certain substances attached to the rags they gather in the streets. With this view they put heaps of rags near the holes in the walls, and when they think that the rats are buried in the rags, they let loose into the court dogs trained for the purpose, and, in the twinkling of an eye, they make themselves masters of the rats, of which they eat the flesh and sell the skin.

The lodgings which receive at night the scum of society are thorough pest-houses. Those even which are not frequented by chiffonniers become, by the crowding of the inhabitants and their filthy habits, dangerous centres of infection. There are some chambers which contain as many as nine beds, separated by small passages hardly wide enough to get through, and these beds are often occupied by two persons who do not know each other, and have never seen one another. Difference of sex is no obstacle to these nocturnal and fortuitous cohabitations, although the police neglect nothing to prevent disorders. Among the female apartments there is one which is famous for the picture of decrepitude and abjectness which it presents. The women who occupy it are old drunkards, of whom several are suspected of theft. The spectacle of these animated mummies has something sepulchral.

One must bring to social anatomy a serious spirit of investigation, to form a just idea of the population which lives in the concealed recesses of society. The imagination, however fertile and daring, could never reach, in this matter, to the height of the reality: there is a character, a physiognomy, a strangeness, which it is necessary to have seen in order to assume the responsibility of an historian. Let no one tax with romance the traits of manners nor the description of places contained in this chapter. However softened by the reserve I have imposed on myself, they are not less true at bottom. I have sacrificed the coarseness of the outline and colouring out of respect to decency. It is the only infidelity of which I accuse myself. It is impossible not to feel the necessity to provide an efficacious remedy for a state of things so contrary to the rights of humanity and civilization.[57]

19.—_On the Habitations and Lodgings of the Lower Orders of Paris._
No. 2.