The effect of this startling exhibition of the horrible sanitary condition of New York, both upon the joint committees and the large audience, was evidently very profound. And this effect was heightened by the early denials by the then City Inspector and Effect of the
Hearing his followers of the truth of the description of the condition of special localities, and the immediate exhibitions by the speaker of the sworn statements of the Physician-Inspectors of the Citizens’ Association, with photographic illustrations. Pressed by members of the committee to state when he last had these places inspected, he admitted that they had never been inspected by his Department.

Intense interest was manifested in the custom of wholesale dealers in clothing of having their goods manufactured in tenement houses; in the fact that Inspectors had often found such clothing thrown over the beds or cradles of children suffering from contagious diseases, as scarlet156 fever, measles, smallpox; and in the evidence that these diseases were distributed widely over the country by this infected clothing. Several of the committee seemed much disturbed, as did the audience, during a recital of cases, and when the hearing closed, one of the committee said to me, in an excited manner, “Why, I bought underwear at one of those stores a few days ago, and I believe I have got smallpox, for I begin to itch all over!”

Indeed, the effect of the discussion before the joint committees was so favorable, that several members declared that the bill would immediately pass both Houses without opposition. But the City Inspector secured delay by requesting another hearing, in order to investigate the facts presented in my quotations from the report of our inspection. This delay gave him the desired opportunity to defeat the bill, by means at his command and by methods familiar to that class of politicians.

But the public, and especially the medical profession, both of the city and the State, had become so interested in the measure that at the next election it became a prominent issue and led to the defeat of seventeen candidates for the Legislature of 1866 who had voted in opposition.

It is said that epidemics are the best promoters of sanitary reform, and very opportunely cholera made its dread appearance in Europe157 late in 1865, and from its rate of progress it Triumph
at Last seemed likely to visit our shores early next year. These favoring conditions led to the passage of the “Metropolitan Health Law” among the first measures of the Legislature in 1866.

The struggle and final triumph of the people of New York, in their efforts to secure adequate health protection, were national in their influence. And this influence was emphasized by the first acts of the Metropolitan Board. Scarcely had it organized when cholera made its appearance in New York. There was the usual alarm among the people, and large numbers left the city. But the new health laws and ordinances, administered by an intelligent, scientific authority, demonstrated the raison d’être of their existence.

The first case of cholera was promptly isolated, the house and its surroundings cleansed and disinfected, and rigid supervision established. The second case, which appeared in another part of the city, was treated in a similar manner and with the same results. A third, fourth, fifth, and finally many cases appeared in different parts of the city during the season, apparently brought from localities in the vicinity where the epidemic prevailed with its usual severity; but in New York no two cases occurred in the same place, so effectually was each case treated.

158 Within one month public confidence in the power of the board to control the spread of the disease was firmly established; people who had fled returned to their homes; business in commercial districts, which was at first suspended, was resumed; and the health department became the most popular branch of the city government, a position which it has maintained uninterruptedly for nearly half a century.

This popular triumph of sanitation is largely due to the perfection of the original Metropolitan Law, which has been declared, officially and judicially, to be the most complete piece of health legislation ever placed on the statute books. From that The Reform National
in Its Results fountain of legal lore the whole country has been supplied with both the principles and the details of sanitary legislation.

The agitation in New York rapidly extended over the entire country, and other cities secured the necessary authority, the Metropolitan Law being the basis of such health legislation. Within a decade nearly every municipality in the land had its health laws and sanitary ordinances and a competent authority to enforce them.

The enormous influence which this reform has had upon the health and domestic life of159 the people can never be estimated. A reference to the former and present sickness and death-rates of New York enables us to approximate the vast saving of life and consequent prevention of sickness and human misery that has resulted from health laws founded on the Metropolitan Law and intelligently but rightly enforced. Before the passage of that law the annual death-rate of the city fluctuated between 28 and 40 per 1,000 population; since that law went into effect it has steadily fallen until it has reached the low figure of fifteen to the thousand, or a saving of more than twenty thousand lives annually when the population of New York was only about one million, and of nearly 10,000 lives of the present population. If we extend this estimate to the whole country, of ninety-five million people, we may gain a faint conception of the inestimable benefits which the application of sanitary knowledge to the daily life of a people can accomplish.