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How Street Car Overcrowding Spreads Disease “Pneumonia and Consumption Are Most Easily Contracted When You Are Squeezed Face to Face in the Moist, Warm Air of a Crowded Car Through the ‘Droplet’ or ‘Spray’ Infection,” Health Commissioner Goldwater Explains \ T HE Health Commissioner of New York, Dr. S. S. Goldwater, has attacked the evil of subway overcrowding from a new point of view. He declares that the overcrowding Is endan gering public health by spreading contagious ^Jfkdly disease germs and that It Is the duty of 'lie Health Department to stop It. Dr. Goldwater was requested by this news- ■iaper to explain Just how, in his opinion, the rapid transit corporations were cultivating and . disseminating pestilential germs, and how ' the evil could be remedied. In a lengthy interview he has dealt with every phase of this question, which concerns the health of every New Yorker so closely. “In the first place," said the Commissioner, . I want to Impress on the people of New York ,u iat the willful and unn^pessary overcrowding W the subway cars Is one of the most danger ous causes of disease and mortality that we have to face. The cars are erellberately over crowded for profit. It Is our belief that the vitality of persons who ride In overcrowded ind poorly ventilated cars Is Injuriously af- ected; that the breathing, coughing and sneez- ug of persons who are packed together result n the .transmission of diseases by means of he so-caJled ‘droplet’ Infection. 3ver-Crowding of Cars Willfully Caused. ' “I speak of the subway because It Is con venient to concentrate one’s attention on one line, but the Brooklyn Rapid Transit Is, if any thing, a worse offender, and there are others. .The overcrowding of the Fifty-ninth street crosstown line at theatre time is scandalous and entirely unnacessary. There Is no doubt that the cars are unnecessarily overcrowded, for Commissioner Maltble, one of the Public 8ervice Commission, that has charge of the comfort of railway passengers, makes this re port to me: ’’ 'Investigation of the subway service in non- •v^h hours, made at my request during the past few weeks, shows that cars were crowded when more trains could have been run, that the orders of the commission were constantly vio lated and that the numerous complaints re ’Heed regarding Inadequate service were jrgely Justified. During rush hours the Inter- inmgh company claims to be operating trains ji the maximum capacity of the lines, and no uore can he expected. But there is no ex- .'use for constant crowding of the cars at non- sh hours, and for continual failure to comply ith the orders of the commission. Under pres it conditions. passengers must be Indecently "oiV'lod certain hours, hut because they are ?customed to it is no reason why they should 4^ .impelled to hang on straps when It Is not M -pessary. * " 'A recent tally by the transportation de- 81:partment of the commission, taken at the uety-sixth street station on one Saturday gdg'il and Sunday morning between 11:20V>. jn. id 1:40 a. m„ shows that the northbound Nils had standing passdngers In every period w ’ weiity minutes except one. At another time loWre were standing passengers from 10:40 . born- to 1:40 a. m. Upon a recent Sunday nlgnt the rp was overloading from 9:20 p. m. to mid it. Another count showed congestion from R 'Pi to 6:20 p. m. on Sunday.’ ^These are not Isolated cases, and If the com- Sf; lission had a sufficient number of Inspectors j count the passengers at all hours for the ' -hole system similar conditions would doubt- - >ss be found at ether places and at other times, !’ .idglng from the complaints received." Measures to Be Taken Against the Evil, i "Just how do you propose to remedy the dis semination of disease through car overcrowd ing?” enquired the writer. "At present what we demand Is that the sub way should run enough cars to prevent over crowding at the hours when It is able to do so. As a matter of fact as soon as the rush lessens they reduce the number of cars so as to keep up the overcrowding. Their ambition Is to have as many straphangers as possible. One of my visitors the other day noted that the subway provided two straps for every seat, and that there were twenty-five passengers on the plat form. where there should have been none. Our | requirements amount practically to saying that the subway should run the largest possible num- ! her of trains of the maximum length all day long. This they certainly ought to do to mini mize a danger that Is causing a great loss of life In New York. ”1 am now waiting for the Public Service Commission to act, for it is obviously their duty to act Ural. If It fails, the Health Department will take energetic action. I should not hesi tate If necessary to take control of the offend ing roads and ftfree them to protect public health. It may he necessary to adopt an appro priate amendment,to the Sanitary Code to meet the emergency. "The Health Department has very great powers, but we realize that we cannot Interfere with popular convenience. We do not feel we can go down into the subway and say, ‘You may go into this car until there are just enough people to fill every seat, and not one more.’ That Is w.iat thoy do in Europe, but the Ameri can desire to get somewhere Is so strong that we mightwaise a riot. All we can flo is to de mand tils' the c.-ndition should be relieved when .i -5 .entirety practicable to do so. "It is not logical that the Health Department should pursue the individual citizen and forbid him to spit on the floor of a car when no public official raises his hand to prevent him spraying into his neighbor’s face at close range the very bacteria which are forbidden to be distributed on the floor of a car.” “Will you please explain simply, doctor. Just why the danger of disease Infection Is so much greater in an overcrowded car than in an ordi nary car?’’ "The reason is that the Infection carried in moist, warm breath from one person to another a few Inches away is Infinitely the most dan gerous kind of Infection," replied Commis sioner Goldwater. "That, of course, Is the kind . of Infection to which you are exposed when you are squeezed face to face with another person In the subway. This Is often called ’droplet’ or ’spray’ infection. "Professor Fluegge, of Breslau, In 1890 first showed that the great majority of cases of tuberculosis were duo to spray Infection com ing directly from the mouth of a diseased per son. The moist, warm spray coming from the mouth of a tuberculous person Is loaded with germs to an enormous degree and all in the highest slate of virulence. The closer you are lo a person the heavier is the load of infec tion, and therefore the greater the risk of in fection. Hence the extreme danget of being crowded against a tuberculous Bufferer in the subway. “Previously medical men laid much stress on the risk of infection from germs that fell to the ground and dried and were then blown about by the wind. But we have now found that many deadly^ germs lose their virulence and even die soon after they fall to the ground and dry up. Medical research has proved more and more that the most dangerous cause of infection in many diseases In by the spray method. That Is why the health department of every great city must consider overcrowding ■M fc 4 \Wi Health Commissioner S. S. Goldwater, of New York. do not show the full Infections to which you are exposed. We are pow remedying this omis sion, and the Department Is catching specimens of the most deadly germ streams In the cars. “Dr. George A. Soper, the civil engineer whom I just mentioned, published an Interesting work called 'Air and Ventilation of Subways,’ In which he gives the results of an exhaustive series of experiments in this subject. Dr. Soper publishes Interesting tables showing exactly how the proportion of carbon dioxide in the sub way varies with the amount of trafflo. His ob servations, however, were mostly made at the stations, doubtless on account of the difficulty of making them in cars. • "Dr. Soper does not specify the kinds of bac teria he found In subway air, but it Is evident that the pneumococcus was among them. He mentions special studies which he made of the length of life of the pneumococcus In the sub way.* The pneumococcus was found capable of retaining Its virulence In dried sputum In the subway for twenty-three hours. This Is in marked contrast to the findings of others who have reported that the pneumococcus was killed in sunlight in four Hours. "The average numbers of bacteria which set tled from the air in fifteen minutes were, In the subway, 600; outside, 1,157. "The average number of bacteria found by filtering the air was 3,200 per cubic meter in the subway and 6,600 on the streets. “Dr. Soper noted that the proprietary disin fectants used In the toilet rooms bad no germi cidal or deodorizing value. Furthermore, they produced counter odors of a peculiarly unpleas ant character. "In his summary of results he shows that the numbers of bacteria recovered from the dust of the subway averaged 500,000 per gram. Testing the Disease-Laden Cars of the New York Subway i. Interesting Diagrams Showing How the Amount of Poisonous Carbon Dioxide in the New York Sub way Varied with the Season and Amount of Traffic. Colonies of Bacteria, Including Disease Germs, Grown on a Plate Exposed to the Air for Fifteen Min- -utes at the Grand Central Subway Station Air Pump, Sand Filters and Other Apparatus used by ‘ Ana' Dr. Soper for Bacteriological Analysis of New York Subway Air. These Pictures Are from "The Air and Ventilation of Subways,” by George A. Soper, Ph.D. Published by John Wiley and Sons, New York. In cars as one of the moat serious forms of dis ease distribution.” "Can you prove that dangerouB germs are present In large quantities In subway air?” "Oh, yes,” said the commissioner with confi dence. "Examinations of the subway air con ducted by Dr. William H. Park, director of our bacteriological laboratories, and also by George Soper, the well-known engineer, have demonstrated the presence of vast quantities of germs, but we can measure the danger even better In other ways. / "The greatest danger of all lies In the dis semination of the pneumonia germ. Investiga tions by the Health Department have shown that the pneumonia germ, the pneumococcus, is present in the throats of 90 per cent of per sons of all classes, whether suffering from pneumonia or not. It is hardly necessary to say that this proportion is well represented among the citizens you meet In the subway. These figures show that nine out of every ten persons you find riding there have this germ in the mouths, noses or throats. When they breathe, cough or sneeze they spray out the "germs all about them. “The pneumococcus is the cause of many diseases besides pneumonia. It Is the cause of obstinate colds, meningitis, sinus abscesses of the nasal passages, abscesses that cause per foration of the eardrum, and other troubles. When the germ is blown Into the eye it some times produces an inflammation that may cause blindness. "Of course you know that this Is the season when pneumonia begins to Increase.” "Can you prove that subway overcrowding Is the cause of many cases of pneumonia?’’ asked the interviewer. "We can prove it very clearly on general grounds.” said Commissioner Goldwater. “It would not help much to prove that such and such a person traced his pneumonia to a ride In the subway, because that would not show the enormous number that get the disease In that way. 1 have shown that practically every body is spraying out the germs. The death rate from respiratory diseases is stationary. With our improvements In treatment in many directions it should show a decrease, and we must believe that such conditions as the sub way are responsible for keeping it nip. Lobar and bronchial pneumonia caused 10,000 out of 74,000 deaths In New York In the last recorded year. It stood higher as a cause of death than tuberculosis, which was responsible for 8,6b0 deaths.” “Has the Health Department taken specimens of subway air to prove the quantity and kind of dangerous disease germs that are present in it at various times?” "Yes,” said the commissioner, “our own laboratories and others have caught specimens of subway air and counted the germs In them, but they did not realize the practicability and importance of catching the spray of infection just as it flies from the mouth of a person These specimens have nearly all been taken at stations, or in more or less empty cars. They "The largest number of bacteria found by Dr. Soper in subway dust was 2,000,000 per gram. Still greater numbers, he believes, could have been found by collecting specimens of dust with this object. "His comparisons with numbers of bacteria found In other places are interesting. Dust In a Broadway theatre contained 270,000 bacteria per gram; in a new and fashionable notel, 360,000 bacteria; In a well-known Fifth avenue church 3-20,000 bacteria; in a tall office building, 860,000 bacteria, and in the attic of a country house one hundred and fifty years old, 110,000 bacteria. "Even this investigator, who was at one time retained by the Interborough Rapid Transit Company, says: ‘It is practioally cer tain when great crowds are packed together, as they often were In some stations and most cars, that dangerous bacteria are at least occasion ally transmitted from person .to person. An obvious feature of this danger lies in the fact that people talk, cough and sneeze Into one G. K. Chesterton Would Revise Socialism’s A leanii igless Speed 1 By G. K. Chesterton, The Distinguished English Essayist. I F the Socialists desire, as many of them do most sincerely desire, to cure some of the cruel unfairness of our social chaos, I beg them. I embrace their knees and Implore them, not to be such prigs. The war in which they ought to be engaged is a war about bread and blood and sleep and death—a war of mon osyllables. There will not be a crust more bread In a poor man's house, or a penny more In a poor man’s bank, or another vote given independ ently, or another blow struck for freedom so long as Socialists UBe expressions like "The international solidarity of the class-conscious proletariat." A literary style like that would have sent the stormers of the Bastile to sleep standing at their guns, and turned every cap of liberty into a nightcap. Nor does 'the ex pression express even awkwardly any reality of this earth. It is a cheap pretense of sci ence; but there is not even science inside It. Men who work with their hands hate each other, or love each other, or fear each other, or pity each other, or are indifferent ter each other. But standing still In the middle of the street and feeling internationally solid is a sensation as inconceivable to a workman as It Is to me. I do not mean that the workmen of one country could not applaud or even assist the workmen of another in some battle against oppression. I think it is very probable that they might, if these frost-bitten profes sors of polvsyllabism would only put the thing the right way. If the poor of one country thought about the poor of another they would think of them as people of that country. The International sym pathy would be a national Sympathy, and, therefore, not a cosmopolitan one. An English laborer would not say : "The proletarian prob lem Is very acute In Poland.” He would say: “I think it’s a great shame the way those poor Poles are treated.” He would not say: “The proletarian programme Is hopeful in the de partment of the Seine.” He would say: "X hope those French strikers will win.” He would not say: “The proletarian victory under the Prussian electoral system Is somewhat unex pected.” He would say: “Golly; there’s some thing In those German sausages, after all.” The working man thinks In terms of nation ality, being a healthy man. To prefer one’s own habits, home, tastes and memories to widely different ones; to be surprised, agree ably or otherwise, at the sight of widely dif ferent ones; to prefer the familiar, even if you admire the unfamiliar—this Is as much one of the Rights of Man as bread Itself. You will never get any strong or simple men anywhere to see that a man is a voter before they see that he is a Chinaman; or to recognize a man as a delegate before they recognize him as a nigger. You will never persuade men close to such a reality as manual labor to think only of the ticket In a man’s pocket, and never of the hat on his head, or the boots on his feet, or the hair on his face, or the tongue In his mouth. You certainly cannot do it by using one material metaphor Which is manifestly contrary to the facts, and talking about “sol idarity” as if we were all born stuck together with glue. another's faoea at ertremoly short rase* ondw such circumstances.’ “Soper also mode a study of the smells In the subway, which he found to be very num erous and powerful. He says ‘odors of prac tically every character connected with human existence were noticeable. When people are .crowded so closely together that their breath and other body odors are offensive, there Is always danger that disease may be trans mitted from one to another.’ ” “What are the other principal diseases be sides pneumonia disseminated by overcrowd lit* of cars. Commissioner?” How We Are Forced Into Contact with Tuberculosis. "Tuberouloals Is one of them,” replied the commissioner. "We know that there ere at least 30,000 persons walking about New York suffering from tuberculosis and we know that a certain proportion of them must be riding In the subway. The Health Department register this year showed 30,222 suffering from the die- ease, of whom about 21,000 were up and about. In addition, there must be at least 10/100 suf ferers not registered. “Of course a great many persons carry the tuberculosis germ In whom the disease has not yet been recognized. Dr. Jones, of New York, by inoculating the nasal mucus from ordinary persona found tubercle bacilli in eleven cases out of thirty-one, but this seems too high a per centage. Dr. Straus found the bacilli in nine out of twenty-nine nurses and non-sufferers In a tuberculosis ward, showing how widely and quickly the germs are scattered. "Diphtheria Is another disease which we meat regard as liable to be spread by car crowding. Wp have found the diphtheria bacillus in 5 per cent of healthy school chil dren and In 10 per cent of those not attacked after an epidemic had occurred In thedr school. In families where a case has oo- curred the bacillus has been found In 14 per cent of those not affected. This shows how Inevitable it is that many persons must be walking about with this germ. "The influenza or grip germ Is even more widely distributed and Is the cause of very serious diseases. Dr. Lord, of Boston, found that 60 per cent of persons with an ordinary cough in a non-epidemic period had the in fluenza germ In their nasal passages. Dr. Holt, the children’s specialist, obtained the Influenza germ in sixteen out of forty-eight healthy per sons. Dr. Wollsteln found the Influenza germ In sixteen out of thirty-seven cases of pneu monia and eleven out of thirty-four cases of bronchitis. "Influenza Is dangerous In ttself and makes the sufferer more subject to the attacks of other diseases. In infancy and old age It Is likely to be fatal. "The meningitis germ is another that is very widely scattered among the general popula tion. Dr. Charles F. Bolduan, of this depart ment, found the meningitis germ In 10 per cent of 160 persons who had been In contact with sufferers, and in two out of flfty-flve medi cal students who had not been in contact with the disease. Beware of the Subway Sneeze.. ' "The whooping cough germ Is another that must be disseminated very commonly In the Subway. In case a sufferer happens to travel there, the peculiar cough Insures the germ being scattered very liberally upon those In the vicinity. But, as in other diseases, the germ is commonly carried by those not suffering from it. “The act of sneezing Is a powerful aouroe of infection In a crowded subway oar. The Ill-bred person who sneezes without covering his nose with his handkerchief may scatter a perfectly terrible charge of disease germs In the mouth, nose and eyes of those about him "We must bear In mind that people In the rugh hours are often in a condition that moke* them peculiarly susceptible to the Inroads off disease germs. This Is especially true In the evening hours, when tired - out by a day's work, perhaps in overheated offices, they rush Into the overcrowded Subway. The bad ventila tion, which must obtain under these condi tions, produces what is called ’crowd poison ing,’ and this is a great cause of increased susceptibility to disease germs. If people could take a walk in cool, fresh air at this time of day Instead of pouring Into an over crowded car, it would be the means of averting many a premature death, but unfortunately this seems Impracticable for a vast number." "Then you do not believe that this danger ous spreading of disease by overcrowding cars can be stopped altogether?” "Not for the present, as it appears to me,” answered the Commissioner. “The only way of ending it would be a scientific system of city planning by which the population would be distributed in a rational manner and not con gested in heaps. Then the rapid transit facil ities could be developed to fit them. For the present I should strongly advise those who can avoid using the Subway in the rush hou/s\to do so and thus lessen the evil. There will still be enormous numbers who cannot help using it, and they will overcrowd It Even when the new Subway Is built it will Immediately be overcrowded. “But we mean at least to stop that part of this wholesale poisoning of the people which Is quite unnecessary and attributable only to greed.” f-'v V 1 » 1 3 *1 l ft i Ml