410 [Assembly 



should find a larger proportion than this directly dependant upon for- 

 eigners. There is no doubt that 75 per cent, of them are cither im- 

 iiiigranls, or the children of such. Put these facts, then, side by side, 

 and we are confirmed in the conclusion that the domiciliary condition 

 of these poor beings, the confined spaces in which they dwell, the un- 

 wholesome air they breathe, and their filth and degradation, are pro- 

 lific sources of an immense amount of distress and sickness, which in 

 their turn, serve, by the loss of time, of wages and of strength, to 

 aggravate the miserableness of their condition, to increase the dan- 

 ger to the public health, and the burden of public and private charity. 



The evils thus resulting are occasionally exhibited in an endemic 

 form, i. e-, some disease of a marked character will break out and 

 attack a considerable number of persons in the same neighborhood, 

 the extent of its prevalence depending upon the extent of the cause, 

 or the facilities for its propagation. Thus a fever may commence in 

 a oertai.; place inhabited mostly by the destitute and filthy: — if the 

 adjoining tenements are occupied by the same class of persons, and 

 kept in the same dirty and ill-ventilated condition, the tenants of the 

 latter will be very liable to attacks of the same disorder. The dis- 

 ease v.ill often be observed to pass houses in better .condition, and 

 re-appear at a distance, where similar causes prevail. 



Frequently, too, the prevailing disorder, though perhaps covering 

 a large district, will be seen only in certain parts of houses, as the 

 cellars. Several instances of this have occurred in New York, one 

 of which was the memorable Banker (now Madison) street fever of 

 1820. 562 blacks inhabited the infected district, of whom 119 lived 

 in cellars; of these 119, 54 were sick of the prevailing fever, and 

 24 died. Of the remaining 443 who lived above ground, 101 were 

 sick, and 46 died. Out of 48 blacks in 10 cellars, 33 were sick, of 

 whom 14 died, while out of 120 whites, living immediately ove*r their 

 heads, in the same houses, not one even had the fever. Numerous 

 other instances have occurred, which have attracted less attention, 

 probably because of their frequency rendering there less notorious. 

 But there is, as is well known to the physicians who move among 

 these haunts of wretchedness, a silent agency continually at work, 

 destroying annually the health and lives of hundreds of our fellow 

 citizens, and entirel}' within the power of the city government to 

 control or subdue, but which, by a strange neglect, appears to have 

 been hitherto allowed to work out destruction unopposed. 



I am enabled, by the kindness of some of my medical friends, to 

 present a history of some of the endemic diseases which prevail in 



