Author: Alexandra Rusu
Although medicine was making significant progress, and the level of trust in doctors was on the rise, Bucharest, in the second half of the 19th century was constantly under threat of illness. Upon his coming to the country, Dr. Carol Davila, the most prominent reformer of the medical service of this period, finds the medical life and hygiene of the population in a deplorable state. The small number of hospitals and the lack of a specialized education system weighed heavily on the future of the inhabitants, whether they lived on the outskirts or in the center of the capital.
In the 1870’s, despite the increase in the birth rate and the settlement of many foreigners in the city, Bucharest faced a population decline caused by epidemics of diphtheria, cholera, and smallpox. Mortality reaches alarming rates, statistics augmented by the victims of the War of Independence. In addition, many Romanian soldiers contracted the typhoid fever.
From the statistics presented by V. Bianu in his book “Hygiene of the City of Bucharest” (1881), we learn that one year after the end of the war the situation in the capital was as follows: out of a total of 7120 deaths, 5045 were children and celibates (70.77%), 1043 married (14.40%), 780 widowed (11.41%) and 252 with unknown marital status (3.42%). Among the unmarried and married, men died in greater number than women. The ratio reversed in the case of widows. Considering the age, the highest mortality was recorded in children between 1-5 years, then in those between 0-3 months and between 6 months-1 year. Of the 5,962 children born in 1879 in Bucharest, 1,654 (27.7%) died before turning 1, and 3,488 (58.4%) died before turning 5, reaching the 10-year mark only 13.9%. The situation improved slightly towards the end of the century. In 1896, only 3115 children died, aged up to 15 years. The parents who did not know the basic rules of hygiene and nutrition adapted to the age, were responsible for this situation. Moreover, poverty forced families to live crammed into squalid dwellings without adequate ventilation and light. To all this, we add the precariousness of sanitary measures.
In her work “Let the world not hear. The Romanian family in the Old Kingdom”, Liliana Andreea Vasile believes that the most frequent relentless diseases of Romanians in the Old Kingdom were tuberculosis, pneumonia and bronchitis, congenital and senile debility, gastro-enteritis, heart diseases, nephritis, congestion and cranial hemorrhages, cancers and, not least, contagious diseases, still quite common: diphtheria, scarlet fever, typhoid, or cholera.
In Bucharest, the emergence of many diseases was caused by the hygienic condition of the houses, which often proved a “guilty insensitivity on the part of the owners”, by the non-existence or poor management of public sanitation, the frequent contamination of water, soil, and air. The unbuilt privy in each yard frequently infected the well just a few meters away. After the introduction of sewerage and running water the situation does not improve significantly because: “All the filth flows into Dâmbovița, from which the inhabitants of the lower part drink water […]. Vegetables are watered with the infected water of this river. The farmers are asked to wash the vegetables, but even if they wash them, they still use the water from Dâmbovița, so that everything turns in a vicious and dangerous circle.”
Typhoid fever, cholera, exanthematic typhus and dysentery were among the top diseases caused by the lack of urban hygiene and the contamination of soil and water with organic waste, especially in crowded suburbs. Between 1868 and 1880, typhoid fever was responsible for an average of 330 deaths annually. Cholera was on an upward trajectory, in 1873 affecting 1,240 Bucharest residents, of whom 746 died and 494 recovered. To curb the evolution of epidemics, at the beginning of the 20th century, the town Hygiene Council mobilized its staff to inspect public premises (pubs, inns, public baths, workshops, etc.), public markets and even 250 private homes, having evacuation and, in extreme cases, demolition of buildings.
Because they did not benefit from a complete sewage network, paved streets, public toilets, and household waste continued to accumulate in yards and on the streets, certain areas of the city (Vitan, Grozăvești, Grant, Măgurele, Cărămidari, Afumati) remained sources of infection.
Contagious or “sticky” eruptive fevers such as smallpox, scarlet fever, or rubella that occurred annualy, especially in warm seasons, were no longer a serious problem compared to the early 19th century. In statistics, the fluctuation of annual deaths was caused by the insufficiency of vaccines. To prevent and combat them, Dr. Davila proposed: “1. Finding the sick. 2. Their isolation. 3. Disinfections. 4. Inoculation with preventive and therapeutic serums. 5. Antiseptic treatment.”
Unlike some Western countries where the mortality caused by tuberculosis had started to decrease since the middle of the century, in Romania it was still “the most aggressive of all diseases affecting Romanians”. From 1867 to 1900, the annual mortality figures in Bucharest varied between 625 and 915, related to a population that had grown from 155,000 (1867) to 250,000 (1900) inhabitants. In 1876, Dr. Felix called tuberculosis “an enemy”, permanently in the middle of the population, “which corrupts the health of future generations, and which makes Bucharest one of the unhealthiest European cities.”
In the “General report on public hygiene and the sanitary condition of the capital” (1898), Doctor Nicolae Georgescu gives advice against tuberculosis: “The patient must be isolated, that is, live alone in a room: if the patient cannot be isolated, then at least he should sleep alone in a bed, having his own clothes and bedding”. He was to spit “into a spittoon with antiseptic fluid on the bottom, and never into spittoons with sand, which do not prevent infection, and when he leaves the house he will spit into a small pocket spittoon, and never on the ground, especially on the sidewalks.”
Among the venereal diseases, syphilis was the most well-known, with 9880 cases registered (in 1895) across the country, with 94 deaths. The statistics do not reflect the situation because many patients preferred to hide the disease and did not go to the doctor for treatment, although the health law ensured free consultation. From a medico-social point of view, what aggravated the situation was the fact that, despite the prescription of treatment, those affected by the disease abandoned it or did not follow it regularly. Reaching advanced stages of the disease, they were refused admission. The state intervened, adopting measures to prevent the spread of the disease, such as the brothel reform or the strict control of clandestine prostitution.
Text: Alexandra Rusu
Image: Bucharest- Hospital for wounded soldiers (detail), artwork part of the Bucharest Municipality Museum heritage.
https://mmb.atcsol.ro/index.php?start=15&id=17&cod=7083500&ordonare=0&filtru=r%C4%83nit
Bibliography:
1. V. Bianu, Igiena orașului București, București, Tipografia Academiei Române, 1881.
2. Ghe. Brătescu, Istoria sănătății publice în România, București, Institutul de Igienă și Sănătate Publică, 1981.
3. Iacob Felix, Tratat de hygienă publică, Partea I, București, Tipografia Ion Weiss, 1870.
N. Manolescu, Apărătorul sănătăței, București, Editura Instit. De Arte Grafice Carol Göbl, 1904.
4. Ioana Pârvulescu, În intimitatea secolului 19, București, Humanitas, 2017.
5. Liliana Andreea Vasile, Să nu audă lumea. Familia românească în Vechiul Regat, București, Editura Tritonic, 2010.
