The sanitary drainage of houses and towns

Front matter

RoVALSocitry op health uv^^y

This book is returnable on or before the last date Marked below

ROYAL SANITARY INSTITUTE

Preface

This book has grown out of a series of articles originally published in the "Atlantic Monthly" magazine. The interest evinced in the subject by persons in every condition of life, and in all parts of the country, seemed to indicate that its more detailed treatment would be acceptable. As the investigations which the preparation of those articles made necessary have, together with professional studies, brought within my reach a wide range of material, I have presumed to submit what I have to say on the subject in this more permanent and more complete form.

The following chapters are not offered as of material value to such engineers and architects as have given attention to their subject, as these would naturally resort to the original authorities from which they have been so largely drawn. They are addressed more especially to the average citizen and householder, and are intended rather as an incentive to the securing of good work, than as a guide to the manner of its performance. For this reason they are largely devoted to the question of preventable disease ; to the manner in which this increases vi

PREFACE.

our death-rate and lessens our worth to ourselves and to the community ; and to those means which experience has shown to be best adapted for the removal of unhealthful conditions.

The instances are of course not rare in which the individual householder may have it in his power to secure, either by his own direction, or by his influence over the sanitary authorities of his town or city, an improvement of the conditions by which the health of his own household is now endangered. To this end I have endeavored to include so much of specific instruction as shall enable him to give a direction to the necessary local improvements.

Some of the points discussed are especially intended for the information of town authorities, and the usual sewer and health committees of local government boards.

If I shall have succeeded in inducing such persons to secure the needed reforms, and to insure their proper execution, this part of my work will have attained its best purpose.

Newport, E. I., March, 1876.

Contents

CHAPTER L The Sanitary Relations of Drainage .

CHAPTER n.

The Drainage of Houses .

Chapter I. The Sanitary Relations Of Drainage

" Mr. Wadley — described as a stout, robust gentleman — could not understand all the fuss made nowadays about the water question. Mr. Cooper cut the knot. He said that sin had brought disease into the world, and the Almighty permitted the outbreak of diarrhoea in their midst; neither doctors nor any one else could prevent it. Mr. Cooper is not far wrong. Sin has much to do with diarrhoea, especially municipal sin, which permits a population to drink sewage, and then coolly satisfies itself with referring the "udgment to the Almighty."

The art of Sanitary Drainage may almost be said to have been born — or reborn — but a quarter of a century ago, and it has contended with much difficulty in bringing itself to the notice of the public Indeed, it is only within the past ten years that it has made its way in any important degree outside of purely professional literature.

Dr. Henry Maccormac says, " We live or we die, live well or miserably, live our full term or perish prematurely, accordingly as we shall wisely or otherwise determine."

Happily, men, — and women too, — are fast coming to realize the fact that humanity is responsible for much of its own sickness and pi'emature death, and it is no longer necessary to offer an apology for presenting to public consideration a subject in which, more than in any other, — that is, the subject of its own healthfulness and the cleanliness of its own living, — the general public is vitally interested.

The evils arising from sanitary neglect are as old as civilization, perhaps as old as human life, and they exist about every isolated cabin of the newly settled country. As population multiplies, as cabins accumulate into hamlets, as hamlets grow into villages, villages into towns, and towns into cities, the effects of the evil become more intense, and in their appeal to our attention they are reinforced by the fact that while in isolated life fatal or debilitating illness may equally arise, in compact communities each case arising is a menace to others, so that a single centre of contagion may spread devastation on every side.

It is not enough that we build our houses on healthful sites, and where we have pure air and pure water ; we must also make provision for preventing these sites from becoming foul, as every unprotected house-site inevitably must, — by sheer force of the accumulated waste of its occupants.

Houses, even of the 4best class, which are free from sanitary objections are extremely rare. The best modern appliances of plumbing are made with

SANITARY RELATIONS OF DRAINAGE. H almost no regard for the tendency of sewer-gas to nnd its way into living-rooms, nor for other insidious but well known defects. So generally is this true, that it is hardly an exaggeration to say that unwholesomeness in our houses is practically universal. Hardly less universal is a curious sensitiveness on the part of the occupants of these houses to any suggestion of their short-comings.

Singularly enough, no one whose premises are subject to malarial influences seems, willing to be told the truth with regard to them. No man likes to confess that his own well and his own cess-pool occupy the same permeable stratum in his garden ; that the decaying vegetables in his cellar are the source of the ailments in his household ; or that an obvious odor from his adjacent pig-sty, or from his costly marble-topped wash-stand, has to do with the disease his physician is contending against.

That the imperfections of our own premises are a menace to our neighbors is a still more irritating suggestion, and such criticism seems to invade the domain of our private rights. Yet surely there can be no equitable or legal private right whose maintenance endanger the well-being of others, —as our wide-spread disregard of the defects in our own houses does endanger the well-being of our fellowtownsmen. It is not possible, in a closely built town or compact neighborhood, for one to retain in his own grounds (either on the surface or in a vault or cess-pool) any form of ordure or festering organic matter, without endangering the lives of his neighbors, through either the pollution of the common air or the poisoning of wells fed from strata underlying the whole ground and more or less tainted by household wastes. Even if he might be permitted to maintain a source of injury to his own family, his neighbors may well insist that he shall not endanger them.

It being important for all that each be made to live cleanly, and the requirements of all, so far as the removal of the wastes of life is concerned, being essentially of the same character, the question of drainage is one in which the whole public is interested, and which should be decided and carried out by public authority, — so that all may have the advantage of the economy of organized work and the security of work well done. This applies not only to the construction of common sewers and public drains, but equally to those lateral branches of the public works which extend into private grounds and houses, — and it applies to every detail of these. So long as these important duties are left to the negligence of house-holders and to the demand for excreta among those who use manure, so long will they remain haphazard, unsatisfactory, and dangerous.

Wherever there is a systematically organized and well conducted board of health, it has been well suggested that their duties should include some power of veto upon the right of building houses upon unwholesome sites. All scavenging and disinfecting must, in order to be effective, be thorough and systematic, — which conditions can only be secured by the most careful public direction and supervision.

The drainage question is essentially a question oi health and life. Dr. George Derby stated the whole case when he said : " The well are made sick and the sick are made worse for the simple lack of God's pure air and pure water." Air is infected and water is tainted, not only by defects in the public works, but quite as often and quite as dangerously by imperfections in household arrangements.

Neither Dr. Derby's statement nor the most perfect modern development of the art of cleansing towns by water-carriage has the merit of novelty. Hippocrates gave as the cardinal hygienic formula, " Pure air, pure water, and a pure soil," and after all these centuries we know nothing to add to it. Our modern sewerage works are thus far only taking us back to the cleanly condition of the most prosperous ancient cities ; only lifting us out of the slough of plague-causing filth that marked the darkest periods of the Middle Ages ; only continuing the wholesome revival that the Mohammedan Moors introduced among the unwashed Christians of Europe. It is a revival that has grown slowly, urged on by the harsh whip of disease and death. So late as the middle of the brilliant ninteenth century it had only begun to command the aid of the law, and as a subject of popular interest it can hardly yet be said to receive the attention of even the more intelligent members of society.

14 SANITARY DRAINAGE OE HOUSES AND TOWNS.

Yet when the subject is once' considered, every thoughtful person must appreciate the fact that in seeking the advantages of community of living we necessarily depend at every turn upon our fellowmen, and that in this communion we lay ourselves open to the consequences of the neglect of others, — while we equally threaten others with the consequences of our own neglect. The influence of thoughtful persons cannot long be withheld from a movement whose object it is to popularize the knowledge of good and evil in the conduct of the daily life of the household and of society, and to make the public at large insist that each shall so regulate his action as to secure the greatest safety for all.

Public sanitary improvement is not the affair of the philanthropist alone, nor is the interest of the individual satisfied when he has made his own immediate surroundings perfect. Everything that can affect the health of the poorest and most distant of our neighbors may affect us ; and, practically, the spread of disease in closely-built towns is more often than not, by the agency of public sewers, from the poorest classes upward, so that many a patient falling ill of contagious or infectious disease in the back slums of the city becomes the centre of a wide infection. The health of each is important to all, and all must join in securing it, — the public control, in the public interest, must extend to the sanitary condition of every household, — not among the poor alone, but at least equally among the rich. Indeed, from the greater complication of their plumbing work, the houses of the rich really require more careful supervision than do the simpler ones of the poorer class.

Not less important is the condition of the public sewers and drains.

An old-fashioned sewer has been well called a retort for the manufacture of sewer poisons which are " laid on " at every house by an ingenious system of pipes delivering an intermittent supply through every water-closet, bath-tub, and wash-basin, and producing its annual crop of zymotic disease.

The case has been very well stated by Dr. Sandwith. " Now, in doing away with the cess-pools all connected together, never properly cleansed, and last, and worst of all, communicating with the interior of dwelling-houses. If you have a case of typhoid fever a mile off, who knows but you may have the mysterious fungoid organisms conveyed into your own house through the water-closet. It is all very well to boast of traps and of similar mechanical arrangements, but remember there is such a thing as corrosion of metals, and the smallest defect, no larger than the interior of a straw, may introduce into your houses vast volumes of gas."

The great aim of all sewerage work is to secure to every member of the community his full supply of uncontaminated air, and, where wells are used, of pure drinking water.

Referring to the lower quarters of the city of Boston, Dr. Derby asks us to consider " what would be the effect upon the annual mortality in a community like Boston, if the wretched cellars and crystal palaces and rookeries and dens in which the extremely poor and improvident live could be depopulated, and their occupants transferred to well drained and lighted and ventilated buildings, of however cheap and simple construction ; if all the foul fluids could be made quickly to depart by force of gravity through ventilated sewers ; if all the foul solids could be removed without delay in carts provided with means for arresting putrefaction ; if the blind alleys and narrow streets were opened to the admission of the air and of sunlight; if the old vaults were removed, the old cisterns torn down or filled, and the general principle of cleanliness in its broadest sense applied to air, water, and food." The picture would have been complete, had he suggested the well-known fact that the danger to the community from the class of diseases known as "pythogenic" (born of putridity) is not confined to those who live amid these filthy surroundings, but that the very sewers with which the better houses are drained are too often subterranean channels for conveying poisonous gases from the places of their origin to quarters which, without this transmission, might have their own drains so arranged that they would remain free from contamination.

Self-preservation is the first law of our nature ; but it is a law which we ignorantly and constantly disregard in laying our life and health at the mercy of the foul conditions of life prevailing among our

SANITARY RELATIONS OF DRAINAGE.

neighbors, — and which we too often disregard in blindly trusting to the skillful but ill-advised work of our well-paid but untaught plumbers.

We roll up our eyes and stand aghast when contemplating the horrors of war ; yet the mortality of war is trifling as compared with the mortality by preventable disease. England, in twenty-two years of continuous war, lost 79,700 lives ; in one year of cholera she lost 144,860 lives.

We look icily on and see our population decimated by an infant mortality so great that its like among calves and colts would appall the farmer, and set the whole community energetically at work to discover a remedy.

It is estimated that for every person dying, twenty fall sick (Playfair estimates it at twenty-eight), and — to turn the argument in a direction best understood by many of our more influential neighbors — that every case of sickness is, on an average, equivalent to a loss of fifty dollars.

Dr. Stephen Smith says : " Man is born to health and longevity ; disease is abnormal, and death, except from old age, is accidental, and both are preventable by human agencies."

Disease is not a consequence of life ; it is due to an unnatural condition of living, — to neglect, abuse, or want.

Were any excuse needed for the constant reiteration of such truths as are known concerning the origin and spread of infectious diseases, it is to be found in the hope that by creating a public realization of the danger of sanitary neglect we may obviate the necessity that now seems to exist for the appearance of occasional severe epidemics, acting as scavengers and inducing the performance of sanitary duties whose continued neglect would lead to even more serious results.

Dr. Farmer speaks of pestilence as the angel " with which it would seem it has pleased the Almighty Creator and Preserver of mankind" to awaken the human race to the duty of self-preservation ; plagues " not committing havoc perpetually, but turning men to destruction and then suddenly ceasing, that they may consider. As the lost father speaks to the family, and the slight epidemic to the city, so the pestilence speaks to nations."

The death-rate in the healthiest broad districts in England may be fixed at about fifteen per thousand per annum ; but taking the whole kingdom into consideration, the death-rate is thirty-five per thousand, over one fourth of the deaths being due to preventable diseases. It is estimated that eighteen deaths take place every hour which might have been prevented by proper precaution. In addition to this, account must be taken of the lowering of the tone of health of those who survive, and of the existence of a vast number of weakly persons who are a tax on the community, and who transmit an inheritance of physical weakness to their offspring. Infants are most susceptible to unhealthful influences, and one half of the population of Great Britain dies before attaining the age of five years.

SANITARY RELATIONS OF DRAINAGE.

By another statement : " Looking at England as a whole, we see that of each one hundred persons who die, not quite ten have reached the standard old age of seventy-five years ; and that of each one hundred children born, hardly seventy-four complete five years of life."

An ordinary epidemic any modern community will bear almost with indifference. The few who know the close relation between the disease and its preventable cause will generally maintain their accustomed indifference until their own circle is attacked, and even then they are powerless to arcruse the authorities to the necessary action. It is only when an outbreak of more than ordinary malignity occurs that even the sanitary boards of most of our towns bestir themselves in the matter ; but if the prevalence and the malignity be sufficient, there follows a most active cleansing of streets, purification of drains, and investigation of the private habits of the lower classes of the people. Then only is such attention given to the most obvious duty not only of the sanitary authorities, but of every man in the community, as, had it been exercised in advance, would have prevented every unnecessary death and every case of preventable sickness that has gone to swell the aggregate needed to attract public attention.

Nothing so arouses the alarm of a people as an epidemic of cholera; yet it is a singular fact that, even during the most severe cholera epidemics, the deaths from this disease are less than from many others which attract no attention and excite no apprehension. During the very alarming epidemic of 1849-50, there were 31,506 deaths from cholera in the United States. During the same period, there were more than this number of deaths from other diseases of the intestinal canal, and more from fevers alone.

That a proper use of known sanitary appliances is competent to remove the causes of a large class of fatal diseases is hardly disputed, and it is clearly proven by experience here and abroad.

Mr. Baldwin Latham, in his excellent work on " Sanitary Engineering," gives the following table, showing the effect on health of sanitary works in different towns in England : —

Name of Place.

Banbury .

Cardiff . .

Croydon

Dover . .

Ely . . • Leicester Macclesfield

Merthyr .

Newport .

Rugby . .

Salisbury .

Warwick .

Population in 1861.

Average Mortality

Average Mortality

Reduction

Reduction

per 1,000 before

Saving of

of Typhoid in Rate of

since Com-

Life

Fever Rate

Phthisis

Construc-

pletion of

per Cent.1

per Cent.

per Cent.

tion of

AVorks.

Works.

23.4

33.2

22.0

23.7

18.0

22.0

20.9

23.9

20.5

20.4

25.2

29.8

23.7

33.2

20.2

31.8

21.0

19.1

18.0

27.5

21.9

22.7

1 It is to be remembered that even this great saving of life has been effected by works that are very far from perfect.

SANITARY RELATIONS OF DRAINAGE.

The average reduction of typhoid rate was nearly one half (47f percent.) in these twelve small towns. It is believed to be practicable, by the use of the most perfect known methods of drainage and ventilation, absolutely to prevent the occurrence of a single original case, and to confine all importations of the disease to the persons of those wlio bring them.

Two hundred years ago the death-rate of London was eighty per thousand ; under the influence of sanitary improvements it has now been reduced to twenty-one and one-half per thousand, in spite of the enormous growth of the town and the great crowding to which many of its people are still subjected.

When the improvement of sewerage was actively undertaken in London some twenty-five years ago, it was found that the death-rate was so much reduced, in some of the worst quarters of the town, that if the same reduction could be made universal the annual deaths would be twenty-five thousand less in London, and one hundred and seventy-seven thousand less in England and Wales ; or, by another view, that the average age at death would be forty-eight instead of twenty-nine, as it then was.

The early registration returns of England developed the fact that the prevalence of fatal diseases was in the case of some three times, of some ten or twenty times, and of others even forty or fifty times greater in certain districts than in others, and that these diseases raised the mortality of some districts from fifty to a hundred per cent, higher than that of other districts, the death-rate of the whole country being from thirty to forty per cent, above that of its healthiest parts.

The effect of sanitary improvement has been nowhere better shown than in the British navy, where in 1779 the death-rate was one in forty-two (this of able-bodied, picked men), and the sick were two in every five. In 1813, after the means and appliances of health had been furnished, the death-rate was one in one hundred and forty-three, and the sick two in twenty-one.

Less than a generation ago the idea prevailed that it was of doubtful propriety to ask why we are sick, and even to this day many believe that such an inquiry savors of irreligion. Happily this condition of otherwise intelligent minds is passing away.

While we know, thus far, comparatively little of the exact causes of disease, our knowledge at leabt points to certain perfectly well-established truths. One of these is that man cannot live in an atmosphere that is tainted by exhalations from putrefying organic matter, without danger of being made sick — sick unto death. It is true that not all of those who live in such an atmosphere either fall sick or die from its effects ; but it is also true that not all who go into battle are shot down. In both cases they expose themselves to dangers from which their escape is a matter of good fortune. Fewer would be shot if none went into battle, and fewer would die of disease if none were exposed to poisoned air.

SANITARY RELATIONS OF DRAINAGE.

Our adaptability is great, and we accustom ourselves to withstand the attacks of an infected atmosphere wonderfully well ; but for all that, we are constantly in the presence of the danger, and though insensibly resisting, are too often insensibly yielding to it. Some, with less power to resist, or exposed to a stronger poison, or finally weakened by long exposure, fall sick with typhoid fever or some similar disease, that springs directly from putrid infection. Of these, a portion die ; the community loses their services, and it sympathizes with their friends in mourning that, " in the wisdom of a kind but inscrutable Providence, it has been found necessary to remove them from our midst."

In this way we blandly impose upon Divine Providence the responsibility of our own short-comings. The victims of typhoid fever die, not by the act of God, but by the act of man ; they are poisoned to death by infections that are due to man's ignorance or neglect.

Pettenkofer states that, so far as the city of Munich is concerned, typhoid epidemics bear in their frequency or rarity a certain fixed relation to changes in the soil, which can only be surmised, but which correspond with the differences of elevation of the water-table, or line of saturation in the soil. The greatest mortality coincides with the lowest state of the water-table, and the least mortality with the approach of this to the surface of the ground.

Fifteen years' observation showed that the prevalence of typhoid was indicated by the water-level in the wells. This careful investigator believes that the cause of the disease exists not in the water, but in the soil ; that it is due to certain " organic processes " in the earth.

The English investigators say that when the water in the well is low, its area of drainage is extended, and it draws typhoid poison from a greater distance.

Neither of these theories is inconsistent with the hypothesis that the disease is due to organic matter reaching the soil from house-drains, cess-pools, etc., and finally either carried into the well to poison the drinking-water to a degree that becomes apparent when, during drought, it is reduced to a small quantity, and its impurities are concentrated, or else left in the soil after the withdrawal of the water, and there exposed in such quantities to the action of the permeating air that poisonous gases are generated by their decomposition.

Professor S. W. Johnson, of the Sheffield Scientific School, at Yale College, in a paper on the Earth Closet, says : " The use of open vaults or water-closets emptying in cess-pools tends to fill up the soil with faecal matter. A single vault poisons a circumscribed space around it. External to this limit the filth is destroyed by the action of the oxygen of the air, which is the great purifier. Within the limit named, the animal matters preponderate sither constantly or at some period of the year.

SANITARY RELATIONS OF DRAINAGE.

They may long remain simply disagreeable without being dangerous, and may again, of a sudden, in a way whose details have as yet escaped investigation, become the seed-bed or the nursery of the infection that breaks out in fevers and dysentery. The danger increases as the quantity of filth and the number of its receptacles increase. To cover them up does not necessarily remove the evil. The putrid matters soak into the soil, and move upward and downward in it with the motion of the soil-water. When we have copious rains, they are carried down perhaps to nearly the level of the water in our wells. In the heat and drought of August, these matters rise again. In the absence of rain, the rapid drying of the surface creates an upward capillary flow of the ground-water. The matters which in rainy times follow the surface-water to the depths, in drought follow the ground-water to the surface."

It is very clear that no system yet applied has been so generally efficient in lessening and weakening the attacks of typhoid as the English system of water supply and impervious drainage, which gives drinking-water free from contamination, and leaves the air untainted by the decomposition of organic matters in the immediate vicinity of dwellings.

Whether the London theory or the Munich theory be correct, the general result of all investigations shows that typhoid fever stands in a certain relation to the amount of neglected filth permitted to poison water and air.

The Massachusetts Board of Health published in

1871 a copious report on the causes of typhoid as occurring in that State. It concludes that the propagation of the fever is occasioned by a poison " as definite as that which causes vaccine disease ; " and divides the means of propagation under three heads : first, drinking-water made foul by the decomposition of any organic matter, whether animal or vegetable, and specially by the presence in such water of excrementitious matters discharged from the bodies of those suffering from typhoid fever ; second, propagation by air contaminated by any form of filth, and specially by privies, cess-pools, pig-sties, manure-heaps, rotten vegetables in cellars, and leaky or obstructed drains ; third, emanations from the earth, occurring specially in the autumnal months and in seasons of drought.

The agency of tainted water was enunciated by Canstatt, in Germany, in 1847, and many later medical writers have confirmed the theory.

So far as Massachusetts towns are concerned, the contamination of wells, though a prominent, was not found to be a preeminent cause of typhoid ; numerous instances show this to have been active, but other causes, such as foul drains, sewer-gas, etc., are more important. It appears that the attack is more frequently received through the lungs than through the intestines. While it may be necessary that a marked quantity of impurity should exist in drinking-water before it can do us harm, an extremely small proportion of impurity in air is greatly to be apprehended, for we drink but a comparatively

SANITARY RELATIONS OF DRAINAGE.

small amount of water, while we inhale, every twenty-four hours, from one to two thousand gallons of air. At the same time, the evidence of the communication of disease by tainted drinking water is strong and unmistakable, not only in Massachusetts, but elsewhere.

There has recently been an excitement in London concerning the condition of town pumps, especially of the celebrated Aldgate pump in the city, which has finally been ordered closed.