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LIFE •Landscape •Health & sanitation •Front Street privies •Families as consumers »HOME |
Health and Sanitation
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•Disease and the working poor |
Disease and the Working Poor
Sanitation for tenants on Front Street, as for most Americans in the late nineteenth and early twentieth centuries, was poor and relied on traditional practices. Persistence of traditional hygiene/sanitation was influenced by socioeconomic status and upper-middle-class stereotypes that stymied sanitation reform and offered the working classes few options. Attitudes about public health changed over the course of the nineteenth century, but the association of disease with the less affluent lingered in the minds of the upper class. During the early part of that century, disease was perceived as an affliction of those who lacked virtue, piety, and morality. As urban America grew, this perception gave way to the notion that offensive odor, or “miasma,” was the culprit, brought about by close living and reckless sanitary habits. Miasmas were commonly viewed as transmitters of disease. “Out of sight, out of mind” (and smell) became a widely held belief and practice. Later on, though, the development of germ theory and health reforms after the Civil War brought about major sanitary improvements by the close of the nineteenth century. In 1899, Dr. G. S. Franklin wrote “Sanitary Care of Privies,” an article outlining a strategy to combat typhoid fever (also known as nightsoil fever) and other centric diseases caused by poor sanitation. He promoted sewer systems instead of privies (earth closets). If sewers proved too costly, privies should at least use of impervious containers such as pails, tubs, and [lined] earth closets. Earth closets should be properly lined to prevent leakage, and deodorants and disinfectants should be added to control odor and help prevent the spread of disease (Carnes-McNaughton and Harper 2000:103). Even though advances in understanding the cause and spread of disease were made during the late nineteenth and early twentieth centuries, earlier misconceptions combined with new information about disease to perpetuate attitudes about the health of the working poor, and this had a profound effect on sanitary developments on Front Street over two generations.The reality of life for most textile workers in the South in the late nineteenth and early twentieth centuries was poverty. This condition was eased for some by steady wages and income brought about by multiple family members at work, but for many households it often had a dramatic effect on health (Beardsley 1987). Poverty was the root of parasitic and nutritional deficiency diseases, “especially in industrial communities where the entire population were on the margin of subsistence” (Roe 1973:107). Acute poverty and disease in this region during the early twentieth century prompted landmark health studies (Beardsley 1987; Goldenberger 1964; Roe 1973). Several of these studies focused on a particularly devastating (and fatal) disease common among the poor known as pellagra.
Pellagra
Called the sickness of the four “D’s” – diarrhea, dermatitis, dementia, and death – the first sign of pellagra was a reddening of the skin on hands, arms, feet, and face. It was often confused with sunburn or poison oak, but pellagra’s symptoms became unmistakable when reddened skin crusted over and peeled away leaving tell-tale butterfly-like lesions on the face. Accompanying the skin condition was a serious digestive disturbances and a general feeling of malaise. In severe cases depression became dementia, and victims were frequently committed as insane (Beardsley 1987:54).
Pellagra was caused by an inability “to raise or purchase those items of diet which would maintain them in health” (Roe 1973:107). Key to preventing the disease was adequate niacin in the diet. During the early years of the twentieth century, few families could afford to consistently eat niacin-rich fresh meat, fruits, vegetables, milk, and eggs. Long hours at work and small yards prevented many mill families from supplementing their diet significantly through small kitchen gardens. Intensive use of the backyards at the Front Street sites for hygiene-related activities (privies, slop holes) precluded gardens as a significant food source. By necessity, households like these relied more heavily on traditional Southern fare of “meat, meal, and molasses” (Beardsley 1987:57). The long-term effects of poor diet were catastrophic. The slow, wasting effect on the body from the onset of pellagra created a slumbering, lethargic appearance and personality that undoubtedly worked its way into misconceptions about mill worker character. “Vitamin research,” notes historian Edward Beardsley (1987:58), “was then in its infancy, and the notion that healthy people could be made sick by a deficiency of something seemed fantastic to doctors who had cut their teeth on the germ theory and the concept of insect-vectored disease.” In fact, researchers first suspected that the disease might be due to poor hygiene related to privy use (Beardsley 1987:56; Roe 1973:90). The discovery that its origin was nutritionally based instead of parasitic may have actually slowed the pace of sanitary improvements for tenants.
Hookworm
Hookworm was a prolific parasitic disease among Southern poor, and was
spread by poor sanitation practices. It was first recognized in the white
tenant farmer population whose “primitive sanitary practices caused
continual reinfection.” An estimated 35 percent of those families
did not even have privies (Beardsley 1987:51). The textile mill work force
came mainly from that population, and perhaps at least one third of those
who came to work in the industry were infected. Historian Edward Beardsley
(1987:49) noted that,
Victims not only looked bad; they functioned poorly as well. There was of course a range of disability, depending mostly on the number of worms a person carried hooked onto the intestines. Fifty would make a light case, whose symptoms would be a little blood loss. But infestation could exceed five hundred, in which event the victim's very life was threatened from exhaustion and cardiac arrest. In moderate infestation, which described the great majority of cases, the red blood cell count fell off sharply, and the victim was anemic, undernourished, and listless; eventually there was physical and occasionally mental retardation. Pregnant women were at special risk as they could not retain the higher level of minerals and nutrients they needed. As a result, they had problems in labor, and a higher proportion of their infants were stillborn.”
The effects of this disease were especially cruel for children in the community, and it shaped the outside world’s perception of them. A prematurely aged face on the body of a child was so common that to many an observer, it was synonymous with the “typical cotton mill child” (Stiles 1910, quoted from Beardsley 1987:49). By 1916 improved treatments had alleviated some of the suffering, but hookworm was still a problem. Prevention could only be accomplished through use of sanitary privies or sewer systems, and these improvements were slowly. A Public Health Service (PHS) study in South Carolina in 1916 discovered that most mill villages “provided families the kind of foul privy that was an encouragement to hookworm and other infection,”...and South Carolina “had no law requiring villages to install sewer systems, and there were too few sanitary inspectors to encourage much in the way of voluntary change” (Beardsley 1987:51, 54).
Sanitation Reform and Class Prejudice
Sanitation for most millworker households at the turn of the century, and for decades to follow, involved a long-standing reliance on privies. These practices persisted even as municipal sewer systems literally began to develop around them (Pena and Denmon 2000). Archaeologist M. Jay Stottman (2000:57) suggests that privies “may have attained some symbolic meaning of sanitation to those who used them for so long...” and “...had become a cultural institution, from which stories, jokes, myths, and folklore were created.”
As for privies [in Schoolfield], at first they contained large buckets under the seats, but afterwards a so-called “honey wagon,” maneuvered by a stoic, black and mysterious driver, went through the back alleys about the task of removing the waste from the cement tanks under the seats to haul to the river. Anyone who lived there will remember forever Hambone, who sat majestically above the “honey wagon” with his nose stuck high in the air, for more reasons than one.... It was said that one day the driver dropped his coat into the contents of his wagon. He went to the rescue but his helper said “Leave it alone. It was old anyway, wudn’t it? “Yeah,” replied the driver, “but it had my lunch in the pocket” (Thompson 1984:26).
It was known that the refusal or inability to change could have dire health consequences. Middle-class politicians and business leaders understood that “filth diseases” were caused by poor waste disposal practices and contaminated drinking water, but they were also instilled with the notion that the working poor were harbingers of disease, lacking the moral and intellectual fortitude to take care of themselves (Cain 1879; Carnes-McNaughton and Harper 2000:102). This characterization often led to complacency on the part of community leaders and restricted the poor’s access to municipal sewerage. Studies have shown that status influenced the order in which particular sections of a city received services (Pena and Denmon 2000:84). Typically, the working poor, or laboring class who lived in tenements, were the last to benefit from municipal systems such as water and sewer. “A water company runs its pipes only to those streets which will pay; the poor cannot pay, and no stream flows to gladden their sight, to allay their thirst, or bath their bodies. Every drop that flows has its price, and as it falls is watched with as jealous an eye as if it were expected that it would congeal into a diamond” (Newman 1856:23, quoted from Pena and Denmon 2000:84).