_We shall be shocked; we shall be filled with horror; but accepting the city that now is, great as her faults may be, with a new gratitude, we shall turn with anointed sympathy and understanding to any earnest voice that pleads for the city that should be. And, indeed, other volumes which Dr. Smith himself has in preparation, as suggestive and as interesting as this one, may help us on in this direction._ _FRANK ALLABEN_ CONTENTS I A BLIND METROPOLIS AND HER DYING CHILDREN Healthy or Unhealthy: Which?--Two Centuries and a Half Unhealthy--A Plague-Stricken Town--Enormous Sacrifice of Life II A GREAT AWAKENING IN ENGLAND The Scourge of 1849--A Town That Was Immune--The Word Fitly Spoken III THE AWAKENING IN AMERICA Apathy in the United States--An Incident That Counted--A Fever Nest--The Unknown Owner--Fear of Publicity--Agitation for Reform--The Citizens Association--A Health Bill--Sanitary Inspection of New York--An Anomaly in Law--Introduction of an Epoch-Making Bill IV NEW YORK, THE UNCLEAN Alarm of Medical Men--A Systematic Investigation--A House-to-House Inspection--The Medical Experts--Plan of Inspection--Each Room Examined--Period of the Inspection--Distribution of Population--Tenant-House Packing--Avoidable and Inevitable Disease--Filthy Streets--Street Filth and Disease--Dead Animals--Filthy Courts and Alleys--Cesspool Abominations-- Unbelievable Vileness--Special Nuisances--Cellar Population: Dens of Death--496 Persons Under Ground--A Visit to the Cave-Dwellers--Tenant-House Population--Cat Alley--Rag Pickers Row--Tenant-House Degeneration--The Rioters-- Tenant-House Rot--Tenant-House Cachexy--Prevailing Diseases-- Seeds of Disease Uncontrolled--Where Disease Flourishes-- Smallpox--Smallpox in Tailored Garments--Typhus Fever-- Intestinal Affections--Living at a Sewer’s Mouth--The Normal Death-Rate--Death-Rate of New York--New York, London, and Liverpool Compared--Constant Sickness--Where the Death Pressure Is Greatest--Some Scapegoats: Foreign Immigration--The Floating Population--Can the Causes of Disease Be Removed?-- Improvements During the Inspection--How to Improve the People-- Can Diseases Be Prevented?--Can Populous Towns Be Improved?-- Cleanliness Preserves from Epidemics--Importance of Sanitary Government--The Entire Country Concerned--Smallpox in a Hotel Bedroom--New York Inoculates the Nation--Inefficiency of Health Organizations--Without Sanitary Government--The City Inspector’s Department--Sanitary Inspection--Inspection Must Be Thorough--The Remedy--An Efficient Health Board V VICTORY Effect of the Hearing--Triumph at Last--The Reform National in Its Results VI THE LEGAL WORK OF DORMAN BRIDGEMAN EATON