"It is commonly believed that much sickness is directly caused by the emanation of gases from sewers, drains, cesspools and other receptacles for sewage and similar foul or decomposing substances. This belief even goes so far popularly and sometimes professionally as to serve as the all-sufficient explanation for the occurrence of certain specific diseases, such as typhoid fever, dysentery, diphtheria and scarlet fever. "Closely examined, the belief in the efficiency of sewer gas as the cause not only of general, but also of specific, disease appears to rest upon the idea that in some way or other poisonous gases, after having been formed in sewers, cesspools and the like by active decomposition of the foul substances therein, escape into the air, and being inhaled. either by virtue of their chemical character or by means of microorganisms, for which they are a vehicle, produce insidious general poisoning or specific disease. It is very seldom, however, that the sewer-gas theory of disease is thus explicitly and clearly defined. More often it takes the form of the simple statement or belief that typhoid fever, dysentery, diphtheria or malaria are directly produced by broken drains; and it is this form chiefly of the theory or belief which requires to be corrected. "The facts with regard to sewer gas and the part which it plays in the causing of disease appear at present to be as follows: "In the first place, there is reason to believe that the dangers of sewer gas have been very much exaggerated. There is no doubt, of course, that sewage is a decomposing liquid, and that it may and often does contain the germs of specific diseases. But, on the other hand, the facts that workmen frequently spend much of their time in sewers with impunity, or work upon or about sewage in sewagepurification works or on sewage farms, seem to show that experience does not confirm the idea that the gases emanating from sewage are always or necessarily dangerous. Furthermore, careful chemical and bacteriological examinations of the air of sewers have shown not only that dangerous gases cannot ordinarily be detected in such air, but even that sewer air is singularly free from micro-organisms. "A little reflection will show that these results might have been expected, for decomposition of sewage in the sewers is seldom very advanced or extensive, while the air of sewers, being very quiet, ought to contain few bacteria. "If, now, we turn to stagnant sewage, such as might result from broken drains, or such as commonly exists in cesspools, we may reasonably expect to find more dangerous and more concentrated gases. We may even suppose that these are poisonous, and that, finding their way into human habitations, they are capable of producing sickness. There is no reason to doubt that some cases of sickness have, in fact, thus arisen, and to this extent the belief in sewer gas as the cause of disease is probably sound. In such cases, however, the sickness may be expected to take either the form of sudden, sharp attacks, suggestive of poisoning, or else a general lowering of the vital resistance, lassitude, weakness, etc. "While thus freely granting the possible efficiency of sewer gas as a general poison and depressant, we are very far from allowing the remaining and more popular form of the belief in sewer gas, namely, that it is capable of directly producing specific diseases, such as typhoid fever and diphtheria, which absolutely require for their genesis the introduction into the body of their own peculiar germs. The popular belief must presuppose that sewer gas is somehow a vehicle for these particular germs, which are lifted by it from the sewers or cesspools, and are conveyed with it into the alimentary or respiratory passages of the victim; and it is this part of the theory which cannot readily be allowed by the student of sanitary science. "Another popular belief which requires careful examination is that of the efficiency of broken drains as causes of disease. From what has just been said in regard to sewer gas, the reader will surmise that the author attaches but little importance to sewers as direct sources of infectious diseases. A broken drain may, and undoubtedly often does, yield more or less of objectionable and sometimes poisonous gases, but in the present state of our knowledge of the etiology of disease it is very difficult, if not impossible, to understand how the accumulation of sewage in a cellar, or leakages of sewage from broken drains, or the escape of gases from such drains, can possibly provoke infectious disease. "The belief in question has doubtless arisen, naturally enough, from a certain number of cases of coincidence between serious illness in the house and serious breaks in house drains. A well-known case of this kind occurred in Boston. The children of a family sickened and died of diphtheria; and inasmuch as on examination broken drains were discovered in the basement, the conclusion was immediately drawn that the drains were the cause of the disease. In many houses, however, broken drains occur, and even temporary accumulations of sewage matters, without any unfavorable consequences making their appearance. In the present state of sanitary science it is far more reasonable to suppose that the diphtheria was brought into the house by milk or other uncooked foods, or by a servant suffering a mild form of the disease, or in some other unsuspected way, than to attribute it to the occult influence of broken drains. Here, again, the gases arising from leaks and breaks may have a toxic effect, and thus lower vital resistance and increase susceptibility. To this extent, and probably to this extent only, broken drains are 'sources' of disease."-Principles of Sanitary Science and the Public Health, by William T. Sedgwick, Ph. D. In order to discover any defects that might exist in the plumbing system it was considered wise to give it a thorough test. To make the test official and satisfy the citizens, the chief plumbing inspector of Charlotte was employed to make this test, and he applied both the smoke and peppermint tests with his own apparatus and in the usual way. Only one break was discovered in the pipes and this was in the main sewer line, under the old engine bed near the front of the building. and directly under an unused room which was formerly the engine room of the building. There were two floor drains in the basement, which evidently had not been used for several months, as the water had evaporated from the traps. In the dry-storage room there is a 2-inch iron waste-pipe which had formerly been connected to a sink, but the sink was removed to another part of the building and the opening in the pipe was blocked with a piece of coal and lime. There is a wash basin in the negro women's toilet room, which was sealed in order to prevent its being used. Three of the vent pipes going to the top of the building were turned into fire flues of the chimneys at the roof line, two of them stopping at this point. Dr. King asked the plumbing inspector to recommend to me in writing the changes which he thought should be made in the plumbing, and his report is as follows: "MR. W. W. LOCKE. CHARLOTTE, N. C.. July 10, 1906. "DEAR SIR-I would recommend that the following changes be made at Elizabeth College: "All one-quarter bends, T's and sanitary T's on the ground line of soil pipe be taken out and Y's and one-eighth bends put in to take their places; also take up the urinals and floor drains in the urinal stalls in the basement and give each water-closet in the basement a separate 4-inch vent stack, each stack to be extended above the roof two feet and at least five feet from any chimney, and that all other fixtures in the basement should be revented either into the stack or be carried separately above the roof, and the line of wash trays should be separately trapped and revented. The water-closet not directly under the public toilet room to have a 4-inch vent stack and all other fixtures in this room to be revented into the 4-inch stack. The water-closet directly under the public toilet room to have the 2-inch ferrule vent carried up through the roof, and all other fixtures on this floor to be properly revented. The stacks from the public toilet rooms on the second and third floors which now go through the chimney should be taken out and carried separately through the roof, and the end closets on each floor should be taken up and continuous vents taken from the same up and through the roof. The slop sink and bath tubs on these two floors to be revented and the open 2-inch pipe in basement to be plugged with a clean-out plug; also the 4-inch vent pipe we cut off in the ground should be properly plugged with a clean-out plug and the balance of the stack that is in the chimney be taken out, as it might in some way become connected again. I think this is the easiest and cheapest way out of it to make a good sanitary job. Hoping this will meet with your approval, I am, "Yours truly, (Signed) "E. HYLAND, "City Plumbing Inspector. "P. S.-The pipe under the old engine bed, where we found a leak, should be taken up and repaired; also the two floor drains in the boiler room should have screw plugs. E. H." There is no doubt that the plumbing system would be more in accordance with the latest idea if the changes suggested by the chief plumbing inspector were made, but it is also true that the present system can be made tight and safe by the making of a few minor repairs and an entirely new plumbing system cannot be more than safe. I was surprised that more defects did not appear, as there is always danger in a building nine years old that rats under the floors or in the partitions will gnaw holes or that the building will settle and break the pipes. In order that the plumbing system may be made safe and that it may be easily tested (as it should be at least once a year at the Christmas vacation), I would suggest that the following changes be made: 1. Repair the break in the main sewer under the engine bed. 2. Remove the two floor drains and urinals in the basement and seal the pipes. 3. Cut out and remove the basin in the negro women's toilet room. 4. Effectually block the iron pipe in the dry-storage room. 5. Remove the vent pipes from the fire flues and extend them separately up through and two feet above the main roof. Dr. Anderson came prepared to take samples of water for bacteriological analysis, and as Boston is so many hours distant by railroad from Charlotte, he kindly consented to take additional samples of the filtered city water and of the water from the tap in the cooling room at McD. Watkins' dairy, for at least a partial chemical analysis. Dr. Anderson was not allowed to send me a copy of his report, but Dr. Richard H. Lewis, Secretary of the North Carolina State Board . of Health, under date of July 23d, kindly furnished me with that part of the report containing the results of the chemical and bacteriological examinations, which showed that the filtered city water is bad. This confirms the analysis made by Penniman and Browne, 213 Courtland Street, Baltimore, Md., on or about June 2 and 27, 1906. They reported the character of the water as "bad" and that the colon bacillus was present in 10 cubic centimeters of water in each instance. Mr. C. C. Beddoes, Consulting Engineer, in his admirable report of June 22, 1906, upon the watershed and sanitary conditions of the water of the Charlotte Water Works, which was kindly furnished me by the Water Supply Committee, made some excellent recommendations. Among other things he said: "Every large filter plant should have arrangements for the systematic bacteria examination of the water before and after filtration, especially where the water is subject to serious pollution. Such examinations need not be excessively expensive, and they will not only show the efficiency of the plant as a whole, but they may be made to show the relative efficiency of the separate filters, and will then be a substantial aid to the superintendent in always securing good effluents at a minimum cost. To allow a constant and complete control of the bacterial efficiency of filtration, the filtrate from each filter must be examined regularly, and any sudden increase in the number of bacteria should cause a suspicion of some unusual disturbance in the filter and should make the superintendent attentive to the possible causes of it. "Without the knowledge of the bacteria in the raw water and the percentage of purification, the plant is being run by guesswork. The amount of alum to use is guessed at. Everything is left to chance, which may or may not win out. By purifying the watershed and running the purification by approved methods, there should be no difficulty in turning out a very high grade of drinking water." I heartily agree with these recommendations and I am glad to say that the water committee, with his Honor the Mayor, are now searching for a competent bacteriologist to operate the filter plant. Thirteen samples of water were taken for bacteriological analysis from the places indicated below, and the results of the analyses were as follows: |