USA > Illinois > Cook County > History of Cook County, Illinois : being a general survey of Cook County history, including a condensed history of Chicago and special account of districts outside the city limits : from the earliest settlement to the present time, volume II > Part 36
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According to Dr. N. S. Davis jaundice has several times pre- vailed as an epidemic in Chicago.
The fear of cholera operated to cause the town authorities to pass certain sanitary enactments, the first of which on November 7, 1833, made it unlawful to throw any carcass into the river "under a penalty of three dollars."-(Report of the Board of Health for 1867, 1868 and 1869, and a sanitary history of Chicago from 1833 to 1870. Chicago, 1871.) In June following the trustees directed
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the supervisor to abate all nuisances, and a vigilance committee was appointed at a meeting held at Hubbard and Company's store. Ac- cording to Governor Reynolds the first public expenditure by the new town was for an estray pen or pound, which ground cost the embryo city $12, and is a part of the square on which the courthouse now stands. Early in 1849 the city council directed the street com- missioners to notify the owners or occupants of any lots or premises to remove nuisances and keep the property clean. This was in , anticipation of the advent of cholera.
"This action," says Dr. John H. Rauch, "was not any too soon, as on April 29 cholera was brought here by the emigrant boat 'John Drew.' Her captain, John Pendleton, contracted the disease from immigrants who had come from New Orleans by way of the Mississippi and Illinois rivers and the canal, and died a few hours after his arrival. Others who came by the same boat also died. There being no quarantine regulations, the disease was further introduced and spread by immigrants arriving from Europe."
The city was fully aroused; lime to the extent of one hundred barrels was scattered on the streets; nuisances were abated; slaugh- ter houses were forbidden to be erected within certain limits; the construction of sewers was authorized, and on May 15 an appropri- ation was made for the construction of a cholera hospital for the poor who might be attacked with the disease. Notwithstanding the vigorous action of the Council and the Board of Health, the dis- ease continued to spread, and during the thirty-four days from July 25 to August 28 there were 1,000 cases of cholera and 314 deaths. The cholera hospital was closed September 24, but it had to be opened again in October on account of the reappearance of the disease among some newly arrived immigrants. One person in every thirty-six of the population, according to Dr. Rauch, died, the total cholera mortality being 678. Nor did the scourge die out with the year 1849, for it reappeared in July, 1850, and to Septem- ber carried off 420 persons. It is learned from the official record already quoted that during this epidemic the Board of Health met every day. In 1851 the mortality from cholera was 216, and in this year the Board of Water Commissioners was created. In 1852 there were 630 deaths from cholera, and a temporary cholera hos- pital was erected on the beach in the north division. City Physician recommended a more adequate supply of lake water and stated the necessity for better drainage. There was but a single death from cholera in 1853-July 30; but in 1854-July 10, twenty-six deaths from cholera were reported, it is believed that the disease had been in existence for several weeks previous, but had not been reported. The disease continued to spread and lasted until December, giving a total recorded mortality of 1,424, although the probability is that there were many deaths which were not recorded. Chicago was not alone in the suffering of that year, St. Louis losing the enormous
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number of 3,547 cases, and the blame of the introduction into the West of the cholera of that year is charged to the laxity of the quarantine regulations at New York and New Orleans. In 1855 the mortality from cholera was 147, but dysentery is reported as having caused 150 deaths, and no more is heard of cholera until August, 1863, when there were three deaths and one in September. In 1864 there was but one death from cholera. July 21, 1866, a case of cholera was reported, and although concealed under the name of cholera morbus, the disease continued to spread, until November, when the total number of cases had reached 1,561 and the deaths 990. In July, 1867, cholera was again present, but there were only 67 cases up to the last case October 3. The utmost exertions were made by Sanitary Superintendent John H. Rauch to prevent the spread of the disease by isolation of the cases and disinfection of the premises, with eminent success.
The introduction of the water of Lake Michigan, the improved sewerage and the unceasing vigilance of the sanitary authorities so improved the condition of the city that when cholera again made its appearance in Chicago, May 24, 1873, it did not spread, and when the second case occurred June 10 there were only eight re- sulting cases. This epidemic was very widespread and came from New Orleans. Every portion of the Mississippi valley was visited by the scourge, and Congress ordered a special report. This report was made very exhaustively by Jno. C. Peters, John M. Wood- worth, Ely McClellan, Jno. S. Billings and Frank W. Reilly.
From Doctor Peters's subsequent condensation in Wendt's vol- ume, the following is quoted :
"The cholera invasion of the State of Illinois dates from May 24, when a man who had been employed as a bridge builder on the Memphis and Paducah railroad died of cholera in Chicago. No other cases occurred in that city until June 10, when a cholera death occurred in a house occupied by several Danish families, and in which an immigrant lately arrived from New Orleans had been sick with what was supposed to be typhoid fever. From this case a local epidemic occurred, consisting of eight cases, all having an epidemic connection, and from them a circumscribed epidemic oc- curred, fed by occasional importation. That no serious epidemic occurred in the city of Chicago was due to the activity and vigilance of the health authorities."
The persistence with which cholera clung to Chicago in former years was without doubt due to the lack of sewerage, bad water sup- ply and filthy surroundings of tenements. Whenever the seed is again sown, under like conditions, we may expect to reap even more disastrous results, in proportion to the great increase of popu- lation. It is true that the marshes have been reclaimed and in that work the mighty energy of the great city was displayed. Few at the present day would imagine that by far the largest area of the
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business center of Chicago was raised from the marsh by filling. The streets were raised to a grade of from eight to twelve feet above their natural level, and then whole blocks of business houses were lifted by jackscrews to correspond to the new grade, and in this work the ever present fear of the reappearance of cholera with its attendant loss of life and business depression operated as the prin- cipal cause. The raising of the city grade was necessary in order to provide drainage and sewerage, and to prevent dampness, and this was the view constantly urged by the sanitary authorities. From the earliest appearance of cholera the people were thoroughly aroused to the necessity of active effort and as early as 1834 the town supervisor was given authority to order "every male person in said town over the age of twenty-one years" to work at street clean- ing or furnish a substitute, for a failure to obey the supervisor's order, a penalty of $5 was authorized to be assessed for every offense. When the scare was over, however, the penalty was re- duced to $1. The whole history shows that cholera and smallpox were the real mainsprings of sanitary action, and the Council was active or apathetic according to the presence or absence of one or the other of these diseases.
Vaccination has been practiced in the army as a regulation routine of the recruiting service for many years, and in consequence there is not found a single case of smallpox among the returns of dis- eases among the troops at Fort Dearborn at any time during its occupancy.
That there was a smallpox scare in 1848 and presumably cases of that disease in the city is apparent from the action of the Board of Health January 24 in appointing a city physician, although "with- out salary," and the further order of the board directing the city marshal "to call upon the other physicians of the city and ascertain who were willing to vaccinate persons unable to pay for the opera- tion; to publish the names of such physicians in English and Ger- man handbills, in connection with a call upon all persons who were not vaccinated to be vaccinated without delay."-(Rauch Sanitary History of Chicago, page 20.) Nothing more seems to have been done until February 12 when Dr. E. McArthur called the attention of the Council to the necessity of vaccination and Dr. Henry S. Huber and Doctor Bird sent a joint letter urging the necessity of vaccinating the poor on account of the prevalence of smallpox, but no statement is anywhere furnished of the number of cases in the city. Smallpox was reported in December, 1850, and was prob- ably present each winter, for Dr. Rauch informs that in 1851 "small- pox increasing, on February 5 the Council ordered the city physi- cian, Dr. Boone, to vaccinate, at the expense of the city, all persons who needed it, so as to prevent the spread of the disease." There were "several" cases reported this year but beyond vaccination in a desultory fashion no municipal action was taken. Two deaths
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from smallpox are on the mortality list, which was the first recorded ' list.
As early as 1834 Dr. William Clark and Dr. E. S. Kimberly were authorized to establish a hospital for cholera outside the town limits, and in an ordinance of 1837 there is a clause authorizing the establishment of one or more hospitals, but the first mention of smallpox hospital proper is found in 1853, where the smallpox hos- pital was ordered to be opened for the reception of some cases of "ship" or typhus fever, and on June 28 of the same year, when the hospital was ordered to be altered "so as to accommodate small- pox at one end and cholera at the other," a truly accommodating ar- rangement, but one based on entire misconception of the necessities of administration. The pest house was removed further from the city in 1853, and Doctor McArthur again called the attention of the City Council to the prevalence of smallpox and urged a general vac- cination. In 1854 a prize of $100 was offered for the best plan of a smallpox hospital. In 1855 the smallpox hospital was enlarged and the infected houses ordered to be placarded. This is the first rec- ord of a warning sign on any infected house. The Marine hospital, then located at Rush street bridge on part of the old Fort Dearborn reservation, had refused to receive cases of smallpox occurring among sailors, on account of the danger of infecting the hospital, and a claim was made against the government for the care of sailors treated in the pest house. In 1856 a new smallpox hospital was built on the north beach just below the cemetery (now Lincoln Park).
In 1862 the smallpox cases materially increased although only five deaths were recorded, and the rather long period of good health had induced the city authorities to discontinue the employment of a medical man as health officer, and the mayor delegated the duties of that office to a policeman. The smallpox, however, showed no particular respect for "the force" and the Council finally passed an ordinance reestablishing the office of city physician and placed under his charge the general supervision of the sanitary condition of the city, the superintendence of the contagious disease hospitals and attendance on the sick therein, and the attendance on the poor. For this extended duty the city physician was allowed by the same ordinance $600 a year in monthly payments. It was stated that there were 800 cases of smallpox in the city from September, 1862, to May, 1863, although the mortality returns only partially show it. The Chicago Medical society appointed a committee of which Dr. John Bartlett was chairman to inspect and report on the condition of the pest house. His report was to the effect that it was badly managed and inadequate for its purpose. In 1864 the increase of smallpox had grown alarming, and a new pest house was built, and additional policemen detailed to assist the health officer. There were 1,233 cases reported this year and 283 deaths. The next year
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the smallpox showed little abatement, there being 1,058 cases and 57 deaths; this year the city physician was authorized to remove any person suffering from smallpox in any building to the smallpox hospital if in his judgment it was safe. The number of cases was reduced to 155 in 1866 of which nine died.
With the appointment of the Board of Health in 1867, real effi- ciency was for the first time shown in sanitary administration. In July on motion of Dr. H. A. Johnson the Board took active measures to vaccinate the people, and it may be inferred what the previous condition of the smallpox hospital may have been when it is said the Board recommended that the Board of Public Works "be re- quested to make the necessary arrangements for supplying said hospital with lake water; also when water is supplied, that the necessary steps be taken to furnish bathing facilities, and that the better portion of the clothing be disinfected by boiling, hot air, and the vapors of sulphur or bromine under the direction of the city physician."
In this year on recommendation of the Board of Health children were forbidden to be received in the public schools without a cer- tificate of vaccination. The schools were visited by sanitary inspec- tors and free vaccination was performed. There were 968 cases re- ported during the year and Dr. Rauch states that about 30,000 per- sons were vaccinated and revaccinated. In the first four months of 1868 smallpox was very prevalent, and the large influx of immi- grants made an inspection of them a necessity. There were 1,286 cases reported, of which forty-eight were immigrants just arrived, and the next year the Board of Health sent a memorial to Con- gress requesting the vaccination of immigrants before they are received on shipboard for transportation to this country. This wise measure was not finally carried into effect until the passage of the Act of Congress February 15, 1893, more than twenty years later. In 1873 smallpox continuing, an attempt was made in Decem- ber of that year to eradicate the disease by house to house vaccina- tion. Twelve inspectors were appointed, four for each division of the city, and 50,134 persons and 3,000 families were inspected. The "Chicago Relief and Aid society" also aided very materially in the work. A new smallpox hospital was built and occupied in this year, and located on the grounds of the House of Correction, and the old Lake hospital was abandoned. This hospital was better equipped than any previous one, and private rooms were provided for the class of patients requiring them, in order that the objections urged against leaving a well furnished home might no longer obtain. More than 63,000 were vaccinated. The reports for the years 1870, 1871, 1872 and 1873 are consolidated and owing to the great fire of October, 1871, the reports are very imperfect. There were reported 2,382 cases of smallpox in 1872, and 1,766 in 1873. The good effects of the active work of vaccination, inspection and
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isolation were apparent, for the number of cases diminished to 343 in 1874 and to 39 in 1875. In the last half of 1875 there were no cases. The condition of the smallpox hospital was asserted by Sanitary Superintendent Ben. C. Miller to be excellent in all re- spects. Six months' immunity brought relaxation from vaccina- tion and the constant inflow of immigrants brought more cases, and from them the disease spread, the smallpox report in 1876 is made to the sanitary superintendent by Dr. J. Suydam Knox, who says: "The first case occurred February 14 and scattering cases in various parts of the city. August 11 the disease appeared in a tenement house in Milwaukee avenue and twenty cases were traced to this source. On September 21 at 22 Hinsch street five cases were dis- covered and twelve cases followed from this. November 6 six cases were found on Orchard street and fourteen cases resulted from them. November 12 the disease was reported in the sixth and seventh wards.
The measures taken for the suppression of the disease were: 1. Prompt removal of patient to the hospital. 2. Thorough disinfec- tion of infected premises. 3. Extensive and compulsory vaccina- tion."
Doctor Knox further says: "Of the 154 cases of smallpox during the year, 116 were removed to the hospital, of whom twenty-six, or 22.4 per cent, died. Thirty-eight were quarantined at home, of whom seventeen, or 45 per cent, died. In other words, the chances of a smallpox patient were improved 100 per cent by removal." It was not the severity of the disease that prevented removal to hos- pital, as might be inferred from these figures, for the doctor says the following were the conditions which prevented removal: 1. The suppurative stage of the disease. 2. The inability of mothers to accompany young or nursing children. 3. The ability to fully isolate the patient at home.
The Health Department this year reported 19,980 vaccinations. In the first half of the year 1878, 102 cases of smallpox were re- ported, and twenty-one deaths, but no cases after July 25. Eighty- eight of the 102 cases were treated in the smallpox hospital. Health Officer De Wolf advocated sulphur fumigation. He says: "The re- sults of this fumigation have given me great satisfaction. Houses are made as close as paste and paper can make them, and with the clothing, bedding, furniture, etc., are subjected for a period of eight hours to the action of this gas liberally supplied. With a single exception the disease has not recurred in any house thus treated."
In 1879 there was but a single death from smallpox, an immi- grant at the Hotel Denmark; but in 1880 there were 227 cases, of which 216 were treated in hospital and eleven quarantined at home. The Health Commissioner, Doctor De Wolf, attributed the new in- fection as due to the large number of unvaccinated immigrants, of whom 147,000 arrived at and were distributed from Chicago. In
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regard to the use of the hospital he says: "The added experience of each year teaches me more and more that, in the attempt to circum- scribe the ravages of this contagious disease, the only safety to the masses is in the early removal of the patient to hospital, particularly among the tenement house population, with ignorance, willfulness and constant intermingling of the inmates of these houses to con- tend against. I do not believe that isolation can ever be relied upon. Wherever I have been led to trust the experiment of leaving a patient in one of these homes, I have in the end invariably re- gretted having done so."
He refers to the wonderful protection afforded by vaccination and reverts to the fact that "in the preceding four years, in which period smallpox has twice become prevalent in all parts of the city, only two cases of the disease have been reported among the 57,000 children attending the public schools."
A conference of representatives of State Boards of Health was held June 30, 1881, at which nearly every State board in the United States was represented. Dr. De Wolf reported that there were then sixty-two cases of smallpox in the hospital, and that in the first twenty-three weeks of 1881 there had been 136 deaths, and after much discussion the conference attributed the cause of the con- tinuance of the epidemic to lack of vaccination of immigrants. Smallpox appeared in various places throughout the State and dur- ing the three years up to 1882 there was an aggregate of 8,856 cases and 2,978 deaths. Of these, 6,518 cases and 2,518 deaths were in Chicago alone.
The health commissioner said in his report for 1881-82: "Our citizens had been sufficiently protected by methodical house to house vaccination in the districts liable to general infection. Yet the daily arrival of immigrants- suffering from the disease, and large num- bers unprotected by vaccination and ready to receive the infection on exposure, filled our hospital until it became necessary in Febru- ary, 1882, to construct a larger building within the same enclosure. This new building was erected in ten days after contract, and in two weeks thereafter sheltered 150 strangers, not one of whom could speak our language."
In this year an interior immigrant inspection service was main- tained by the National Board of Health and under the supervision of Dr. John H. Rand. In June, 1882, the hospital was again placed in charge of the Catholic sisters. In the year 1887 ten cases of smallpox were brought into the city, but no epidemic resulted. The hospital was kept fully equipped and ambulances were in readiness even when there was no case in the city, but the precaution was like that against fire, always necessary.
The long immunity from severe epidemic naturally increased the number of those susceptible to the disease, by neglect of vaccina- tion ; and the great influx of strangers in 1893 in attendance on the
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world's fair, together with a large immigration, made the oppor- tunities greater than ever for sowing the smallpox infection. There were three centers of infection, according to the report of the chief sanitary inspector, Dr. Garrod, to Commissioner Reynolds. In this year there were 140 cases and twenty-three deaths. In 1894 the disease markedly increased during the first half of the year.
Scarlet fever and diphtheria have been almost constantly present for many years. The first case of diphtheria is reported to have occurred in March, 1885 .- (Epidemic Diseases of Illinois, R. C. Hamill, M. D., Transactions American Medical Association, Vol. 18). There were then many cases in several places throughout the State. The cause of diphtheria being unknown until a very recent period, and bacteriologic diagnoses wholly unknown, it is not sur- prising that there have been many failures in diagnosis, even after notification was ordered. It is well understood by medical statis- ticians that many cases of diphtheria have been returned as croup, and vice versa. This has almost made the statistics valueless, so far as mortality is concerned. From this time forward there will be no difficulty in securing accurate returns, as the health depart- ment of the city for many years has had a bacteriological laboratory wherein careful examinations are made of faucial scrapings and pharyngeal mucous.
Although the exact date of the first case of scarlet fever cannot be given, it is certain that it has prevailed as an epidemic of more or less severity for many years, and up to February, 1877, no re- ports of its presence were required, but the medical profession themselves took the matter in hand and at a conference held with Health Commissioner De Wolf the same system of notification was agreed upon as already existed with regard to smallpox. There were said to be more than 100 cases in January, 1877, and in Feb- ruary there were actually reported 481 cases, and for the eleven months of 1877 2,205 cases and 810 deaths, giving a percentage to the total mortality of 36.73. There has never been a hospital for the reception of diphtheria and scarlet fever patients, and doubtless for that reason no attempt has been made to limit the spread of these diseases beyond house disinfection, attempted isolation and house placards. Diphtheria, as will be seen by the table, has caused many more deaths than scarlet fever. There is a point bearing on the question of relative mortality which it is well to remember, and that is, that a relatively larger number of cases of scarlet fever die from delayed secondary infection, and the cause of death is put down to one of the sequelæ of scarlet fever rather than the disease itself. Taking into consideration this source of error in the statistics in respect to deaths from scarlet fever and errors of diagnosis in respect to diphtheria, it can readily be seen that the figures are surely much under the truth. Nor is it to be expected that much more accurate returns will be received until these cases shall be cared for as smallpox is now cared for.
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An epidemic of influenza was present in 1843, of which little is of record, and again in 1889 and 1890. The latter epidemic reached its height in Chicago in January of that year, and the commissioner of health, Dr. Swayne Wickersham, states that in his opinion there were over 100,000 sufferers from the disease at that time. The city mortality for the month of January, 1890, was 2,501, but the deaths directly attributed to la grippe were 112. However, the mortality list shows distinctly the epidemic influence, and the fact is well known that the pulmonary complications of la grippe carried off many who, although suffering from various respiratory and circulatory diseases, would otherwise have recovered.
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