The Portland daily press. [volume] (Portland, Me.) 1862-1921, 1879-11-17
Sanitary Condition of Bath.

FROM lne annu3l duurtsS VI OHdrlcS ~.
Packard, NJ. D., of Bath, delivered before the
Maine Medical Association, we extract the
following regarding the sanitary condition Of
Bath:
In the city of Bath the ground is hilly and
rocky, the soil mostly heavy clay, in many
places hardly covering the rock, which crops
out frequently. The drainage is very imper-
feet, the great expense of blasting the rock
probably deterring the city authorities from
undertaking any complete system OF sewerage
or draina ge. The consequence is that the soil
is saturated with moisture during great part
of the year. The dampness arising from such
a condition of the soil Laennec has said "to be
one of the most certain developing causes OF
phthisis.'' Rheumatism is exceedingly COM
mon, and severe and protracted IN duration.
How far can the medical practitioner, by his
counsel and teachings, restrain the generation
of this disease, which occasions such an alarm
ing amount of mortality? What are some OF
the more obvious and avoidable causes OF tu-
berculiar consumption, which well regulated
prophylaxis would eliminate from the problem
of preventability?
At least four of the factors of causaton may
be classed as avoidable conditions. These are:
1st, Soil moisture and damp habitations. I'd,
impurty of air and unwholeSomeness OF the
conditions of indoor life. 3d. Defective sun
lighting of dwellings. 4th, Needless exposure
of the non-consumptive to the consump-
tive in badly ventilated apartments:
avoidance OF I06 Contiguous clcucut III
phthis and is of the circumstances which make
its contagious property operative.
. Comprehensive inquiries have demonstrated
that thorough drainage OF place Is always
followed by decrease in the number of cases
of phthisis, of typhoid fever and rheumatism.
1t has been shown that the result OF proper
system of drainage improvements, thoroughly
carried into effect, has reduced the mortality
by phthisis fifteen per cent, and that this re-
duction continues; and the same reduction is
true in other causes of mortality, it being
proved that they are diminished from one-haf
to one-tenth per cent.
Now it may not be possible for the physician
to cause a system of drainage improvements to
be accomplished by his patients or the citizens
of his town; but he can and should acquaint
the public with the facts as to the possible re-
duction of cases of consumption by the adop-
tion of these sanitary measures, and, with all
the force he is capable of, impress upon the au-
thorities the absolute necessity for these safe
guards to the public health. He will be met
by the cry of ''hard times;" the great expense
of these Improvements; the people will not sub
nit to further taxation, &c., &c., but the COM
munity can be made to perceive the value and
importance of these preventive expedients, and
will soon insist that municipal and town au-
thorities shall undertake this needful work.
But there are some economical aspects OF the
question which may assist him IN bringing the
authorities and the public, who are so mindful
of their pockets but regardless of their health,
TO a consideration of the subject, and which
would perhaps be an additional consideration
for our Legislators to establish and maintain
State Board of Health, which has been so con-
tumeliously put aside by them, despite the
earnest petitions and efforts OF our best citizens
and wiSeSt physicians.
In the 7S3 deaths from consumption. noted
above as occurring in Bath, the number OF
deaths among males was 327, among females
456. There were 56 children, from one to fif-
teen years of age, 419 persons from 10 to 49, and
30S between 40 years and 81. The ratio OF the
children to the adults was seven per cent;
deducting this gives us 3O4 males and 424 fe-
males, from 10 to 81 years OF age, deceased.
Let us estimate the cost of this amount Of
sickness to the community in which it occurred,
assuming that it fell upon those who were pur-
suing gainful occupations. The duration OF
tubercular phthisis is variously estimated at
from six months to three or four years. Reck-
onng from the beginning of the disease, unGer
the best treatment facilities for change of cli-
mate, &C., &C., DR.. j. G. b. Williams, OF Lon
don says the duration is seven or eight years
In this country, among the working classes,
who pay but little attention to the early symp-
TOMS and where the disease is seldom recog-
nized until it is so far advanced that the pa
tient is unable to work, the average duration
is much shorter, often not more than SIX
months. But if we include the whole commu-
nity, farmers, mechanics, merchants and we'll
to-do people, after the disease is clearly rec
ognizable, and as commonly managed, includ-
ing the neglected cases, the average duration
would be from TWO anu Il udIl W lniCO huu -
half years. We will assume that its duration
is one wear: that is, that tubercular patient
is, on an average, incapacitated from labor Tor
one year. Each male. in any gainful occupa-
tion, would probably earn six dollars per week,
ald the cost of his maintenance medical atten-
dance, medicines and nursing would not be
less than five dollars per week, thus making
the total loss and cost to each male patent
S572 90 for the duration of his sickness, and
for the 30i males of S173,SSo.oO We may es-
Il 49, l,,ra y,1 ford
seven dollars per week, at S154, $500, and in
the case of the fifty-siq children, at two dollars
per week, So ,S2i.00. We have here total
sum of $685., ,0lS.00, or about S425.33 Tor each
death by consumption, occurring in Bath dur
ing a period of twenty years. or again. an
annual loss and cost of S2l 26 per capita.
Let us extend the calculation to the whole
State. Assuming the mortality from consump-
ton in the State OF Maine to De pfoportlonate
To that of Bath, we find the total annual NOR
tality from this disease to be 2IOO This would
give us an annual pecuniary cost and loss to
the State of Maine of S57 ,42O.00. This esti-
mate does not include other items of expense,
snch as burial charges, &c. The actual money
loss falls upon the savings of the sick person,
partly upon the relatives, and partly upon the
various charitable associations and benevolent
fraternites, and to considerable extent upon
the appropriation for the poor III the several
towns We have said above that the mortality
by phthisis had, in some places, been reduced
by certain sanitary measures fifteen per cent,
and this would lessen the annual loss and cost
to the State SS,613.13, and to the city OF Bath,
which loses annually thirty-nine persons by
consumption "a yearly loss and cost OF SS29,4l),
S12441. Consider, also, that zymotlc diseases
cause an annual amount of mortality greater
than that of the tubercular phthisis; for 1t IS
well settled by sanitary statistics that zymotlc
diseases and phthlsis togetheT cause ohe-naIi y.
the actual mortality of New England and that
thorough drainage and scientific sanitation
and improvements may limit the prevalence
of these diseases to q much greater extent
than is possible in tubercglar phthlsls, and we
anr1ent for the establishment and maintenance
of a complete system of State or preventive
medicine.
But we may carry our estimate still farther.
1t has been computed that the ratio of sickness
to deaths is as two to one; that is for every
person who dies, there are two persons sick all
the time in every community, so that II there
are H. 900 deaths annually in the State OF
Maine, there are %, 900 who are sick for the
entire year. Taking, however, the deaths that
occur from day to day, it is estimated that Tor
each death there are from twenty-five to thirty