قراءة كتاب Hygeia, a City of Health
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The consulting rooms of the medical staff are comfortably fitted, the dispensary is thoroughly officered, and the order that prevails is so effective that a sick person, who is punctual to time, has never to wait.
The medical officers attached to the hospital in our model city are allowed to hold but one appointment at the same time, and that for a limited period. Thus every medical man in the city obtains the equal advantage of hospital practice, and the value of the best medical and surgical skill is fairly equalised through the whole community.
In addition to the hospital building is a separate block, furnished with wards, constructed in the same way as the general wards, for the reception of children suffering from any of the infectious diseases. These wards are so planned that the people, generally, send sick members of their own family into them for treatment, and pay for the privilege.
Supplementary to the hospital are certain other institutions of a kindred character. To check the terrible course of infantile mortality of other large cities,—the 76 in the 1,000 of mortality under five years of age, homes for little children are abundant. In these the destitute young are carefully tended by intelligent nurses; so that mothers, while following their daily callings, are enabled to leave their children under efficient care.
In a city from which that grand source of wild mirth, hopeless sorrow and confirmed madness, alcohol, has been expelled, it could hardly be expected that much insanity would be found. The few who are insane are placed in houses licensed as asylums, but not different in appearance to other houses in the city. Here the insane live, in small communities, under proper medical supervision, with their own gardens and pastimes.
The houses of the helpless and aged are, like the asylums, the same as the houses of the rest of the town. No large building of pretentious style uprears itself for the poor; no men badged and badgered as paupers walk the place. Those poor who are really, from physical causes, unable to work, are maintained in a manner showing that they possess yet the dignity of human kind; and that, being worth preservation, they are therefore worthy of respectful tenderness. The rest, those who can work, are employed in useful labours, which pay for their board. If they cannot find work, and are deserving, they may lodge in the house and earn their subsistence; or they may live from the house and receive pay for work done. If they will not work, they, as vagrants, find a home in prison, where they are compelled to share the common lot of mankind.
Our model city is of course well furnished with baths, swimming baths, Turkish baths, playgrounds, gymnasia, libraries, board schools, fine-art schools, lecture halls, and places of instructive amusement. In every board-school drill forms part of the programme. I need not dwell on these subjects, but must pass to the sanitary officers and offices.
There is in the city one principal sanitary officer, a duly qualified medical man elected by the Municipal Council, whose sole duty it is to watch over the sanitary welfare of the place. Under him, as sanitary officers, are all the medical men who form the poor law medical staff. To him these make their reports on vaccination and every matter of health pertaining to their respective districts; to him every registrar of births and deaths forwards copies of his registration returns; and to his office are sent, by the medical men generally, registered returns of the cases of sickness prevailing in the district. His inspectors likewise make careful returns of all the known prevailing diseases of the lower animals and of plants. To his office are forwarded, for examination and analysis, specimens of foods and drinks suspected to be adulterated, impure, or otherwise unfitted for use. For the conduction of these researches the sanitary superintendent is allowed a competent chemical staff. Thus, under this central supervision, every death, every disease of the living world in the district, and every assumable cause of disease, comes to light and is subjected, if need be, to inquiry.
At a distance from the town are the sanitary works, the sewage pumping works, the water and gas works, the slaughter-houses and the public laboratories. The sewage, which is brought from the town partly by its own flow and partly by pumping apparatus, is conveyed away to well-drained sewage farms belonging to, but at a distance from, the city where it is utilised.
The water supply, derived from a river which flows to the south-west of the city, is unpolluted by sewage or other refuse, is carefully filtered, is tested twice daily, and if found unsatisfactory is supplied through a reserve tank, after it has been made to undergo further purification. It is carried through the city everywhere by iron pipes. Leaden pipes are forbidden. In the sanitary establishment are disinfecting rooms, a mortuary, and ambulances for the conveyance of persons suffering from contagious disease. These are at all times open to the use of the public, subject to the few and simple rules of the management.
The gas, like the water, is submitted to regular analysis by the staff of the sanitary officer, and any fault which may be detected, and which indicates a departure from the standard of purity framed by the Municipal Council, is immediately remedied, both gas and water being exclusively under the control of the local authority.
The inspectors of the sanitary officer have under them a body of scavengers. These, each day, in the early morning, pass through the various districts allotted to them, and remove all refuse in closed vans. Every portion of manure from stables, streets, and yards is in this way removed daily, and transported to the city farms for utilisation.
Two additional conveniences are supplied by the scientific work of the sanitary establishment. From steam-works steam is condensed, and a large supply of distilled water is obtained and preserved in a separate tank. This distilled water is conveyed by a small main into the city, and is supplied at a moderate cost for those domestic purposes for which hard water is objectionable.
The second sanitary convenience is a large ozone generator. By this apparatus ozone is produced in any required quantity, and is made to play many useful purposes. It is passed through the drinking water in the reserve reservoir whenever the water shows excess of organic impurity, and it is conveyed into the city for diffusion into private houses, for purposes of disinfection.
The slaughter-houses of the city are all public, and are separated by a distance of a quarter of a mile from the city. They are easily removable edifices, and are under the supervision of the sanitary staff. The Jewish system of inspecting every carcase that is killed is rigorously carried out, with this improvement, that the inspector is a man of scientific knowledge.
All animals used for food,—cattle, fowls, swine, rabbits,—are subjected to examination in the slaughter-house, or in the market, if they be brought into the city from other depôts. The slaughter-houses are so constructed that the animals killed are relieved from the pain of death. They pass through a narcotic chamber, and are brought to the slaughterer oblivious of their fate. The slaughter-houses drain into the sewers of the city, and their complete purification daily, from all offal and refuse, is rigidly enforced.
The buildings, sheds, and styes for domestic food-producing animals are removed a short distance from the city, and are also under the supervision of the sanitary officer; the food and water supplied for these animals comes equally, with human food, under proper inspection.
One other subject only remains to be noticed in connection with the arrangements of our model city, and that is the mode of the disposal of the dead. The question of cremation and of burial in the earth has been considered, and there are some who advocate cremation. For various reasons the process