THE CITIZENS’ ASSOCIATION OF NEW YORK was organized for purposes of public usefulness. The deep convictions of duty and necessity that led to the preparation of the plans upon which this Association has commenced its efforts, have met with hearty responses from all classes of philanthropic and learned men whose counsel and aid have been invoked in our voluntary work of municipal reform and public improvement. To its COUNCIL OF HYGIENE AND PUBLIC HEALTH, and to its Board of Legal Advisers, the Citizens’ Association, and the City of New York, have been placed under lasting obligations, for labors in which the greatest professional learning and skill, combined with noble and philanthropic purposes, and individual sacrifices of time and personal efforts, have been voluntarily contributed for the single object of promoting the welfare of the community, and benefiting all classes in the city.

The COUNCIL OF HYGIENE AND PUBLIC HEALTH now presents to this ASSOCIATION its first General Report upon the Sanitary Condition and Hygienic Wants of New York; and the CENTRAL COUNCIL of the ASSOCIATION has ordered it published and widely circulated, in order that the public may immediately have access to this valuable source of information and practical suggestion.

The organization and efforts of the Council of Hygiene were begun very soon after the general plan of the Citizens’ Association was announced. The advice and knowledge of leading hygienists and medical gentlemen of great familiarity with the social and sanitary necessities of the people of this City were sought, and, at the request of the Council of this Association, an effective organization for Sanitary Inquiry and Advice was instituted. The necessity that exists for the commencement of such voluntary labors has long been conceded by the managers of benevolent institutions in the city, and, from this and other circumstances, the members of this body were fully prepared to appreciate the practical value and bearings of such work. They have unhesitatingly acted upon the information and suggestions which their Council of Hygiene has rendered; and they desire to state that in all its labors, suggestions, and advice, that Council has manifestly been actuated by an earnest and fearless purpose to benefit mankind, and to contribute most directly to the physical and moral welfare of their fellow-citizens. Thus its plans have entirely harmonized with the great objects of the CITIZENS’ ASSOCIATION, and at the same time have furnished a perfect example of both the utility and the necessity of such voluntary effort.

The WORKS of the COUNCIL OF HYGIENE will best perpetuate the history of its organization; therefore we will simply put on record here the preliminary correspondence, in which, without any purpose of organized effort and cooperation, a large number of physicians, who are distinguished for learning and experience in hygiene, gave expression to the leading facts upon which the argument for Sanitary Reform is based by this ASSOCIATION.

Franklin’s aphorism that Public Health is Public Wealth, finds ample confirmation in the experience of all populous communities; and when our best medical men assure us that a vast proportion of the sickness in our city is produced by causes that are positively preventable, or that may be removed; and when they state the fact that the preventable waste of life and health, in the City of New York, may safely be estimated at sevem thousand lives, and more than two hundred thousand cases of sickness every year—shall not every citizen bestir himself to terminate such a waste of the richest physical blessings which the Creator has bestowed upon mankind?  "All that a man hath will he give for his life;" and yet, to society at large, the care and protection of life and health is a cumulative good, which confers benefits that multiply and extend like the good deeds of well-spent days. Sanitary improvements directly promote the material advancement of a people, while they bring into operation the most reliable and effectual agencies for social and moral elevation.

Their ultimate and highest results reach far beyond pecuniary advantage; they take deep hold upon the noblest sympathies and sentiments of all classes of society; they confer benefits upon all alike.

The relation of the health and vigorous life of a people to the State, or to commercial prosperity, requires no discussion in this statement. From Plato to the greatest of modern statesmen and economists, the sanitary welfare of a people has justly been deemed an essential element of social and commercial advancement; and so intimately related do we find the sanitary and the social wants of the population in the City of New York, that, from the outset of reformatory efforts, whether social and political or exclusively moral and religious, sanitary improvement is a work of paramount necessity. "There is," says the Edinburgh Review (vol. xci , 1850), "a most fatal connection between physical uncleanness and moral pollution. The condition of a population becomes invariably assimilated to that of their habitations. The indirect effects of sickness are far more hurtful, though less observable, than the direct effects of mortal disease; it lowers the tone, unstrings the nerves, and brings on physical languor and mental apathy."  But beyond the physical, the mental, and the economical losses resulting from prevailing ill-health, there are certain political and social aspects of the same agencies that ought to be studied by every intelligent citizen. The mobs that held fearful sway in our city during the memorable outbreak of violence in the month of July, 1863, were gathered in the overcrowded and neglected quarters of the city. As was stated by a leading journalist at that time:

    "The high brick blocks and closely-packed houses where the mobs originated seemed to be literally hives of sickness and vice. It was wonderful to see, and difficult to believe, that so much misery, disease, and wretchedness can be huddled together and hidden by high walls, unvisited and unthought of; so near our own abodes. Lewd but pale and sickly young women; scarcely decent in their ragged attire, were impudent and scattered everywhere in the crowd. But what numbers of these poorer classes are deformed! what numbers are made hideous by self-neglect and infirmity!
    "Alas! human faces look so hideous with hope and self-respect all gone! And female forms and features are made so frightful by sin, squalor and debasement! To walk the streets as we walked them, in those hours of conflagration and riot, was like witnessing the day of judgment, with every wicked thing revealed, every sin and sorrow blazingly glared upon, every hidden abom-ination laid before hell’s expectant fire…..
    “The elements of popular discord are gathered in those wretchedly-constructed tenant-houses, where poverty, dis-ease, and crime find an abode. Here disease in its most loathsome forms propagates itself. Unholy passions rule in the domestic circle. Every thing, within and without, tends to physical and moral degradation.”

In the Report of the Council of Hygiene will be found a body of evidence bearing upon the subject of Sanitary neglect as producing social degradation, which to readers and to legislators can scarcely be of less interest than the definite records and well-sustained conclusions therein contained respecting the existing sanitary condition and wants of the city, the preventable causes of disease, and the physical agencies and works required for the needed hygienic improvements.

It should be borne in mind that this preliminary labor of the Council of Hygiene and its corps of skilled and indefatigable Sanitary Inspectors, has been planned and performed voluntarily, and by gentlemen whose time and thoughts are burdened by their ordinary professional and official duties; and that none of the means or powers of the municipal government could be used in prosecuting the great work of inquiry and recording, which has, under peculiar disadvantages, but with marked success, been prosecuted by them.

The CITIZENS' ASSOCIATION asks the attention of the people of the City and the State of New York to the facts set forth in this Sanitary Report, and it also asks that the needed works of SANITARY IMPROVEMENT be immediately begun by competent minds and competent hands. The skilled labors and trustworthy advice of a Voluntary Council of Hygiene, have definitely determined when and how such works of improvement should be commenced. They have shown what is the nature, and what must be the preventive or cure of existing causes of needless sickness, mortality, and public peril from removable evils.

To the physicians who have thus contributed lasting benefits to the public welfare, their own fellow-citizens and society at large are placed under renewed obligations. And in thus requesting and obtaining from the Profession that is ever in the front ranks of all great enterprises for human improvement such labors and such practical results, the Association has simply done what the people in their legislative capacity are in duty bound to do. A popular writer has stated that “The State which founds its legislation on a knowledge of realities, which expects from the physical sciences information respecting human life collectively, considered in all its relations, has a right to demand from its physicians a gen-eral insight into the nature and causes of popular diseases.” [HECKER'S Epidemics of the Middle Ages; BABBINGTON’S EDITION.]

The Association cannot close this Introduction without expressing its grateful estimate of the arduous and self-denying labors of the medical gentlemen, the fruit of whose researches is embodied in the Report. An investigation so thorough, searching, and extensive, and directed by such genius and energy, has never before been attempted in our city or in this country. In pursuing their investigations they have not hesitated to sacrifice personal ease and comfort, and deny themselves many social enjoyments; they have exposed themselves to repulsive and nauseous scenes in the abodes of misery and want, and to the infectious localities and homes of disease and death, in order to be able to give an exact and complete survey of the sufferings, perils, and sanitary wants of the inhabitants of the crowded and insalubrious districts, and to secure the application of effective guarantees against future misery and death.

The Citizens’ Association having determined to initiate reformatory movements that shall produce permanently beneficial results, and having taken counsel with able advisers, presents to the public this Report of its Council of Hygiene and Public Health, believing that the various questions which are therein examined and elucidated are of vital importance to the sanitary, commercial, and social welfare of New York.

The Council of the Citizens' Association

NEW YORK, January, 1865. Click here to see the report on the Fourth Ward