Evening star. [volume] (Washington, D.C.) 1854-1972, 1897-11-23
Views Of Many Local Physicians on
the Subject.
INQUIRY OF TIE MEDICAL SOCIETY
High Death Rate in the ThinIy Set
tied Sections.
POLLUTION OF THE POTOMAC

The issue of the National Medical Review
for November contains a symposium upon
typhoid fever in the District of Columbia.
Inc editorial upon the subject says:
The investigation, undertaken some time
since by the Medical Society Of the District
OF Columbia, clearly showed that we have
In Washington very high rate of morbid
ity from typhoid fever. 1t likewise dem
onstrated that in the sections of the city
where there were the most wells and box
privies there also the disease was most
prevalent. Shortly following the closing of
some of these wells and the institution in
certain localities of better system of
sewerage there was noted a decided dimi-
mutton in me rbidity from this affection.
The relation between cause and effect in
this instance seems most apparent.
The Medical Society, showing its in
terest in public health, carried through
its investigation with signal zeal and dis
erection. and our people are now begin
ming 10 reap the advantage of it's work
But the subject should not be allowed to
rest. Much remains to be DONE and the
Review would urge the Importance of re-
newed effort, and would offer its most
hearty cooperation in any steps that may
be taken to study the causes and to d.
minish the frequency of typhoid fever in
the District of Columbia
In an article upon Frequency. causes
mortality ana prev ention' of typhoid fe-
Yer. Dr. G. NJ. koter says:
"Of fifty-four American cities with a nom
ulation of over $1,000, tabulated in 1890 by
HaZen, Washington sands No. Z on the
INST as regards the death rate from ty-
phoid fever. This is all the more lament
able because 1t has increased with ap-
proxirnate uniformity during the past fif-
teen years; that is to say, while the ty-
phold fever death rate in 1881 was only
80 per 1000 residents. it has gradually
W nJtIHr eli
tons until for the year ending June 30
1886. 1t reached SO per 10000 During that
year there were DDS deaths from this dis
ease besides II deaths from typho-ma-
ported rs typhoid.
Murchison places the death rate at II ~
per cent. which. strange enough appears
to be none too high for this city, as the
autumn of 1895 was 17.6 per cent AS
Stunning. then, that each death represents
only six cases. there would have been in
that year 40 cases of typhoid fever,
morbidity of 49.S per 10000 residents
Where Typhoid is Prevalent.
This would. indeed, be discouraging if
investigation had not revealed the sig
nificant fact that the disease is more prev
aient In the suburbs and in sections where
people, in the absence of sewers and n
general water supply, are compelled to re-
sort to box prvies and wells. Thus for
example. while the typhoid fever death rate
IN the suburbs and northeast in 1898 was
y ~ and $40 per 10000. the region west of
18th street to Rock creek and north of
the Potomac to Florida avenue, with its
$1,000 residents. furnished only III per
1000, or a slight fraction over that of
Lynn, Mass. which city has a rate of
1.G and stands at the head of American
cities as regards exemption from this
disease. This difference is probably due.
not only to better sanitary environments.
IN fhf, fna
the better part of our city are especially
careful in the selection of their drinking
water.
While my official inquiry in the fall of
1873 showed that ia per cent of the 800
cases investigated contracted the disease
at various summer resorts, and that a few
cases were spread through infected milk
and other channels. The undue prevalence
OF the disease IN tie suburbs and certain
sections was clearly due to an impure
water supply and defective sewer system.
particularly the former.
Tine absence of sewers cor1pels recourse
In about 1900 houses to box privies and
makeshifts, by which the soil and ground
v alter are liable to pollution with infected
dejecta.
"At ell events. of 436 cases of typhoid
fever contracted in the city in the summer
and fall of 1895, 2Sl were la rgely consumers
,of well water and 1872 We're largely con-
sumers of Potomac water; and In twenty
SIX Of seventy samples examined by Drs
were actually found. 1t Is also note
worthy fact that the houses provided with
box privies and makeshifts furnished the
highest percentage of typhoid fever cases.
Tine role these boxes play in the pollJ-
ton Of the sell, water and air is best Judged
by the fact that during the fiscal year end
ing June 30, 1895. the sanitary inspector re-
ported 1872 as full TAG as leaky' 52O1 as
filthy and $50 as dilapidated
'"These makeshifts, even if there were no
wells, would still be a source of danger
in so far as they favor the Transmission of
germs by means of flies, injecting the food
Close the Wells In the City.
with this evidence, the profession could
scarcely fail to recommend the Immediate
closing of every well, wherever a better
water supply could be obtained, the early
completion and extension of all necessary
sewers and the abandonment of all box
prlvies within the city limits"
DR. kober then refers to the efforts of
the health office in closing wells and sur
face pumps and says:
There has been a gratifying improve
nent in the typhoid fever rate, for, during
the year ended June 80, 1897. there were
only li1 deaths, or 53 per 10000, which is
the lowest death rate from this disease
while l consider the prompt abandon
nent of every well and box privy extreme
ly desirable. because it eliminates two i'm
Iortant factors in the dissemination of the
disease, l lear the danger VIII not be re-
moved until we secure a pure general water
supply, because cities both at home and
abroad. in which there has been the most
marked decrease in the typhoid fever rate
are those in which n pure drinking water
has been substituted for pre-existing con-
taminated one.
Pollution of the Potomac.
There are now over % 900 people living
in towns along the Potomac river which
constitutes our general supply, and since
this stream receives directly or indirectly
the drainage not only of these towns, but
also of every hamlet and farm house wash
ed by its tributaries and as typhoid fever
prevails among the inhabitants and sew
age bacteria have been repeatedly demon
strated in the tap water of our houses the
possibilities of infection with the typhoid
bacillus are alas. too numerous.
Let us advocate, therefore, sand f1ltra-
ton of the Potomac water, extension and
completion of the sewer system and in the
meantime filter and boil our drinking water.
Pasteur:Ze our milk and thoroughly disin-
feet the excreta of typhoid fever patients"
Contributions are also made to the SYM
postum by Drs. S. c. Busey, Andrew Stew
art, d. w. Prentiss, w. w. Johnston, H
c. Iarrow and John Van Rensselaer,, on
the treatment of typhoid fever.